FINAL: Exam 2

Question 1

Propofol crosses the _____ into _______; lower __ and __ min APGAR scores

Answer 1

BBB, placenta
1 and 5 min

Question 2

After induction dose, propofol causes respiratory depression referred to as:
A. transient
B. terminal
C. lengthy
D. permanent

Answer 2

A. transient

Question 3

Propofol is a mild _______ and _______

Answer 3

antiemetic
antipruretic

Question 4

Etomidate’s effect on CMRO2 (Cerebral metabolic rate of oxygen)

Answer 4

Decreases

Question 5

Etomidate elimination by: rapid _________

Metabolism: Ester ________ in liver and plasma __________

Answer 5

redistribution

hydrolysis
esterases

Question 6

Do prevent myoclonus with Etomidate, can pretreat with: (4)

Answer 6

Dex
Midazolam
Rocuronium
Lidocaine

Question 7

Etomidate can cause pain on injection ( _______)

Answer 7

thrombophlebitis

Question 8

The mechanism of etomidate-induced myoclonus appears to be disinhibition of subcortical structures that normally suppress extrapyramidal motor activity

True or false?

Answer 8

True

Question 9

Ketamine is an NMDA receptor ___________

NMDA = __________

Answer 9

antagonist

N-methyl-D-aspartate amino acid

Question 10

Ketamine produces a catatonic state where patient feels separated from environment. __________ anesthesia was coined to describe this state

Answer 10

dissociative

Question 11

Ketamine enhances _______-induced analgesia and prevents _________

Answer 11

opioid
hyperalgesia

Question 12

Ketamine us useful in high risk, pediatrics, and _________ patients

Answer 12

asthmatic

Question 13

Midazolam causes ___________ amnesia

Onset: ___ to __ mins
Duration: ___-___ mins

Answer 13

anterograde

2-5
20-30

Question 14

Benzodiazepines work allosterically to enhance endogenous GABA binding rather than directly, physiologic ______ ______ is noted

These drugs are relatively safe, and have ____ toxicity

Answer 14

ceiling effect

low

Question 15

Benzodiazepine less dependent on liver; can be used in liver disease, hepatic issues with no effect

Answer 15

Lorazepam

Question 16

Remimazolam (benzodiazepine) rapidly metabolized by ____- _______ _______ ________

Answer 16

Non-specific plasma esterases

Question 17

Dexmedetomidine is an alpha2-receptor agonist, more selective for alpha2 vs alpha 1 in a ____:___ ratio

Answer 17

1600:1

Question 18

Which drugs are barbiturates?

Answer 18

Thiopental
Methohexital
Sodium pentothal
Pentobarbital
Secobarbital
Phenobarbital
Thiamylal

Question 19

Anticholinergics that cross the BBB

A. Atropine
B. Scopalamine
C. Glycopyrollate

Answer 19

Atropine
Scopalamine

Question 20

In inhalational agents and N2O:

______- evoked potentials = most sensitive

______ -______ evoked potentials = least sensitive

Answer 20

Visual-evoked
Brain-stem evoked

Question 21

Nonbarbiturate IV anesthetics include: (5)

Answer 21

Propofol
Etomidate
Ketamine
Benzos
Dex

Question 22

MAC

Isoflurane: ____
Sevoflurane: ____
Desflurane: ____
Nitrous oxide: ____

Answer 22

1.15 %
2%
5.8%
105%

Question 23

Which inhalation agents have blood/gas coefficients <1 ?

Answer 23

Sevoflurane (0.6)
Desflurane (0.42)
Nitrous oxide (0.47)

Question 24

Blood/Gas Coefficients

Isoflurane: ____
Sevoflurane: ____
Desflurane: ____
Nitrous oxide: ____

Answer 24

1.4
0.6
0.42
0.47

Question 25

Oil/Gas Coefficients Isoflurane: ____ Sevoflurane: ____ Desflurane: ____ Nitrous oxide: ____

Answer 25

99 50 18.7 1.4

Question 26

An increased blood/gas solubility means = ____ solubility in blood = _______ anesthetic onset

Answer 26

increased slower ex: Isoflurane = 1.4 is more soluble than Desflurane = 0.42, and has a slower onset

Question 27

An increased oil/gas solubility = ___ lipid solubility = ____ potency (____ MAC)

Answer 27

increased increased Lower ex: Isoflurane = 99 is more lipid soluble, more potent, and has a lower MAC than Desflurane = 18.7

Question 28

Recognize structure that represents Desflurane

Answer 28

C3H2F6O

Question 29

Recognize structure that represents Sevoflurane

Answer 29

C4H3F7O

Question 30

Clonidine (alpha2 agonist) _______ (Reduces/Increases) MAC

Answer 30

Reduces

Question 31

Hypernatremia ______ (Reduces/Increases) MAC

Answer 31

Increases

Question 32

Chronic alcohol abuse _____ (Reduces/Increases) MAC

Answer 32

Increases

Question 33

Which inhalational agents increase HR?

Answer 33

Desflurane Isoflurane Nitrous oxide

Question 34

Isoflurane, sevoflurane, desflurane _______ (increase/decrease) CMRO2 cerebral metabolic rate of oxygen

Answer 34

decrease

Question 35

______ = minimum alveolar concentration required to produce anesthesia in 50% of the population upon surgical stimulation; usually 2-3 x dose clinically

Answer 35

MAC

Question 36

Oil/gas solubility coefficient is an indicator of _________

Answer 36

potency

Question 37

Sevoflurane metabolized ___ - ___ %

Answer 37

5-8%

Question 38

Treatment for emergence delirium

Answer 38

Dexmedetomadine

Question 39

Requirement of volatile anesthetics are highest at ___ months, then gradually decrease with age

Answer 39

6

Question 40

Factors affecting extent of effect of inhalational anesthetics: Co-administration ______, _______, ______, _______ drugs

Answer 40

opioids, benzos, propofol, vasoactive drugs

Question 41

Coronary steal can be avoided by maintaining __________

Answer 41

normotension

Question 42

Triggers for malignant hyperthermia: - _____, _____, and _____ -NOT _____

Answer 42

Sevoflurane Isoflurane Desflurane NOT N2O