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Anesthesiology Team Challenge > Team challenge > Flashcards

Team challenge Flashcards

(98 cards)

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1
Q

What drug is thiopental

A

Barbiturate

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2
Q
A
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3
Q

Local anesthetics work at the internal or external membrane of the sodium channel?

A

Internal

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4
Q

Thiopental is a strong base or strong acid

A

Strong acid (barbituric acid)

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5
Q

Which intravenous anesthetic also has a protective effect against post-operative nausea and vomiting?

A

Propofol (anti-emetic properties)

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6
Q

Unconsciousness produced by inhaled anesthetics is reversible or non-reversible?

A

Reversible

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7
Q

Ketamine is most like what drug?

A

PCP

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8
Q

What is the treatment for local anesthetic toxicity?

A

Intralipid

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9
Q

Ture or false, local anesthetics do NOT block sympathetic nerves?

A

False, act on all nerves

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10
Q

What is the effect of inhaled anesthetics on EEG

A

Flatten EEG

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11
Q

What disease is associated with inhaled anesthetics that results in increased temperature and results in death?

A

Malignant hyperthermia

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12
Q

Which inhaled anesthetics is least soluble in blood: isoflurane, desflurane, sevoflurane?

A

Desflurane: rapid onset and offset

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13
Q

Which intravenous anesthetic results in more deaths at pearl harbor than the actual attack? When induced in soldiers that were hypovolemic, soldiers will die in sleep

A

Thiopental

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14
Q

Emergence from inhaled anesthetics depends on which, elimination or metabolism?

A

Elimination. Inhaled anesthetics DON’t undergo metabolism!!

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15
Q

Which local anesthetic has more rapid onset: bupivacaine (pKA 8.1), lidocaine (pKA 7.9)

A

Lidocaine: closer to body pKa assodicated with faster onset

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16
Q

Which induction agent is contraindicated in egg allergy?

A

Propofol

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17
Q

Which IV anesthetic has minimal effects on the cardiovascular system?

A

Etomidate - profound hemodynamic stability

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18
Q

Which of the following drugs is the mechanism of action clear? IV, inhaled, or local anesthetics?

A

Local anesthetics

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19
Q

Rapid induction of anesthesia is done with an inhaled or IV anesthetic?

A

IV anesthetic

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20
Q

Maintenance of anesthesia occurs with an inhaled or IV anesthetic?

A

Inhaled anesthetic

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21
Q

What hair color increases MAC?

A

Red hair (also resistant to inhaled anesthetic)

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22
Q

What is the effect of inhaled anesthetic on minute ventilation?

A

Goes down - increased respiration can’t compensate for decrease in tidal volume

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23
Q

For inhaled anesthetics, speed of onset is determined by which property?

A

Blood solubility

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24
Q

What gas is typically administered for analgesia?

A

Nitrous oxide

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25
What is the effect of inhaled anesthetics on uterine tone?
Decreases uterine tone (increase bleeding)
26
What does the injection if IV opioids due to MAC?
Decrease MAC - don't need as much inhaled anesthetics
27
What do the inhaled anesthetics due to ventilatory response to low blood oxygen?
Decreases - areflexia (also to bronchomotor tone)
28
What do the inhaled anesthetics due to bronchiolar tone?
Bronchodilates
29
What do the inhaled agents do to cerebral blood flow?
Increase cerebral blood flow - don't use for patients with ICP
30
The inhaled agents are supplied from the manufacturer in what form?
Liquid and then converted to a vapor
31
What class of drugs are the inhaled anesthetics?
All ethers (C-O-C configuration)
32
For the termination of a drug effect, which is more important: redistribution or elimination?
Redistribution
33
What drug is contraindicated with acute intermittent porphyria?
Thiopental (IV anesthetic)
34
What does propofol due to cerebral blood flow?
Decrease cerebral blood flow
35
What is the amount of IV anesthetic to prevent awareness?
Don't know! inhaled anesthetics have MAC
36
Which IV anesthetic can also be given IM?
Ketamine
37
In addition to potassium chloride and panchorinium, which anesthetic is used for lethal injection?
Thiopental
38
Thiopental causes hypotension by myocardial depression and ...?
vasodilation
39
The term for the longer you infuse a drug, the longer it takes to eliminate
Context-sensitive half life
40
The term for how drugs get to the effect site
Pharmacokinetics
41
The term for the drug effect due to receptor binding
Pharmacodynamics
42
What is the most common cause of abuse (death) in anesthesiologist <35?
Substsance abuse
43
Give an example in which EMLA would be used?
Lumbar puncture in pediatric patients: lidocaine and prilocaine
44
What local anesthetic is also used as an anti-arrhythmic?
Lidocaine
45
Which of the following OTC drug contains a local anesthetic?
Bactine - anti-septic and lidocaine
46
What medication is added to a local anesthetic to prolong duration of blockage?
Epinephrine
47
When a certain area receives local anesthetic and does not respond to local stimuli, this is called?
Regional anesthesia
48
What property of local anesthetic influences its duration?
Speed of onset and lipid solubility
49
What protein channel do local anesthetics work?
Sodium channel
50
What stereoisomer of bupivacaine is more cardiotoxic?
R-form
51
Which year was the first medical school established in the US?
Penn! 1765
52
What type of local anesthetic is cocaine?
Ester
53
Inhaled anesthetic has been linked to which disease in adults?
Alzheimer's
54
The population variants of inhaled anesthetics are large or small?
Small! also works in different species
55
Induction of anesthesia begins at the beginning or end of anesthesia?
Beginning
56
The concentration of inhaled anesthetics necessary to prevent awareness is higher or lower than the amount needed to prevent pain?
Less (MAC)
57
Which inhaled anesthetic has the highest MAC?
Desflurane (less lipid soluble, faster offset/onset)
58
Why is propofol used for sedation in the ICU?
Anti-nausea, quickly reversed
59
Which induction agent is also metabolized in the lung and small intestine?
Propofol
60
Which anesthetic was first used for surgery?
Cocaine
61
Which local anesthetic is more rapidly metabolized if injected by IV? Chloroprocaine or bupivacaine?
Chloroprocaine! Esters are much more rapidly metabolized
62
Which organ metabolizes amide local anesthetic?
Liver
63
Is there an antagonist to the inhaled anesthetics?
No, just blow it off
64
Which depends on a drug metabolism: distribution half-life or elimination half-life?
Elimination half-life
65
Propofol potentiates the effects of which neurotransmitters
GABA
66
Primary termination of clinically effective IV anesthetics is metabolism or redistribution?
Redistribution
67
Local anesthetics bind to which configuration of the sodium channel
Open & Inactive state
68
The aromatic ring on the local anesthetic is hydrophilic or lipophilic?
Lipophilic
69
Which local anesthetic has the larger potential for allergic reaction? Lidocaine or tetrocaine?
Tetrocaine - Ester --> PABA
70
Which IV anesthetic does not depress respiration?
Ketamine
71
Which will achieve a peak level first, inhaled or IV?
IV - that's what you use for induction
72
Inhaled anesthetics have been linked to the progression of which disease in kids?
Developmental delay or learning disability
73
In the resting state, the sodium channel is in which configuration?
Closed
74
What is the first sign of local anesthetic toxicity from lidocaine? Numbness of the tongue, seizure, ventricular tachycardia?
Numbness in the tongue, often metallic taste
75
Which local anesthetic causes vasoconstriction?
Cocaine: reason why they use it for topical anesthetics
76
Inhaled anesthetics with low blood solubility will have a slow or fast onset of action?
Fast onset: lower blood solubility, the faster onset. More soluble has slower onset.
77
Which IV anesthetic would be good to induce for a patient that is scheduled to go home?
Propofol
78
When the ENTIRE body does not respond to anesthesia, this is called:
General anesthesia
79
What is the breakdown product of local anesthetics?
PABA
80
Which IV anesthetic increases ICP?
Ketamine - stimulates blood flow (don't use for trauma patients)
81
What is the primary organ for metabolism of IV anesthetics?
Liver
82
Do the inhaled anesthetics provide analgesia?
Yes
83
What do local anesthetics bind to in the blood?
Albumin and alpha-1-glycoprotein
84
What is the effect of inhaled anesthetics on blood pressure?
Decreases
85
Which IV anesthetics increase ICP and cerebral blood flow
Ketamine
86
Local anesthetics are weak acids or bases?
Bases
87
The pka determines what of a local anesthetic?
Speed of onset
88
Name one of the two intermediate chains of local anesthetics:
Amides or esters
89
What is the term for concentration of vapor that prevents movements in response to 50% of the population?
MAC
90
Which term describes an unaware patient that does not respond to pain?
Anesthesia
91
Which of the following organs has the greatest uptake of anesthesia following accident IV injections: stomach, brain, muscle, skin?
Brain
92
Which IV anesthetic has analgesic properties?
Ketamine
93
What determines speed of onsets of the inhaled anesthetic?
Blood solubility
94
What is the effect of inhaled anesthetics on temperature?
Decreases temperature
95
What property of a loca anesthetic influences potency?
Lipid solubility
96
Which anesthetic causes adrenocortical suppression?
Etomidate
97
What enzyme hydrolyzes local anesthetics?
Pseudocholinesterase
98
Antihistamines have sedative and hypnotic effects, true or false?
True

Anesthesiology Team Challenge (2 decks)

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