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Chapter 6 Quiz

1) Nitrous oxide is contraindicated in ALL BUT ONE of the following settings. Indicate the exception:

  • a) Total hip arthroplasty in the lateral position
  • b) Laparotomy for bowel obstruction
  • c) Multiple trauma with pneumothorax
  • d) Patient with history of severe post operative nausea and vomiting

2) Which class of drugs is most commonly responsible for intraoperative anaphylactic (or anaphylactoid) reactions?

  • a) Opioid analgesic agents
  • b) Induction agents
  • c) Muscle relaxants
  • d) Volatile anesthetic agents

3) Other than analgesia, what is the most important clinical effect of the opioid analgesics?

  • a) Cardiac depression
  • b) Sedation
  • c) Nausea and vomiting
  • d) Respiratory depression

4) Which ONE of the following describes an advantage of sevoflurane over desflurane?

  • a) Lower lipid solubility therefore quicker onset and offset of effect
  • b) Less pungent therefore more practical for mask induction
  • c) Can be used with lower flows therefore more economical
  • d) Mild sympathomimetic effect minimizes hypotension

5) Which ONE of the following best describes the reason for the rapid OFFSET of effect of the induction agents? 

  • a) Ester hydrolysis
  • b) Liver metabolism
  • c) Redistribution
  • d) Renal excretion

6) ALL BUT ONE of the following conditions predisposes the patient to prolonged effect of non-depolarizing muscle relaxants. Indicate the exception:

  • a) Hyperkalemia
  • b) Hypothermia
  • c) Gentamycin administration
  • d) Myasthenia gravis

7) ALL BUT ONE of the following are contraindications to succinylcholine. Indicate the exception:

  • a) Cervical spinal cord injury (1 week ago)
  • b) Monoamine oxidase administration
  • c) Malignant hyperthermia susceptibility
  • d) Burn injury (24 hours ago)

8) Which of the following is the correct MAXIMUM safe dose of bupivacaine (plain):

  • a) 1 mg/kg
  • b) 2 mg/kg
  • c) 5 mg/kg
  • d) 7 mg/kg

9) ALL BUT ONE of the following describes a feature of phenylephrine. INDICATE THE EXCEPTION:

  • a) Phenylephrine causes (reflex) bradycardia.
  • b) Phenylephrine can be safely used in patients with cocaine intoxication.
  • c) Phenylephrine acts directly at the alpha adrenergic receptor.
  • d) Phenylephrine improves cardiac performance in cardiogenic shock.

10) ALL BUT ONE of the following are effects of the synthetic opioids (fentanyl, sufentanil and remifentanil). Indicate the exception:

  • a) Muscle rigidity
  • b) Biliary spasm
  • c) Myocardial depression
  • d) Bradycardia

11) Which ONE of the following most closely describes the MAC of three commonly-used volatile anesthetic agents?

  • a) Desflurane 6%; Sevoflurane 1%; Isoflurane 2%
  • b) Desflurane 2%; Sevoflurane 6%; Isoflurane 1%
  • c) Desflurane 1%; Sevoflurane 2%; Isoflurane 6%
  • d) Desflurane 6%; Sevoflurane 2%; Isoflurane 1%
  • e) Desflurane 2%; Sevoflurane 1%; Isoflurane 6%
  • f) Desflurane 1%; Sevoflurane 6%; Isoflurane 2%

12) Which of the following opioids are most commonly administered into the intrathecal (spinal) space?

  • a) Morphine and sufentanil
  • b) Fentanyl and sufentanil
  • c) Morphine and fentanyl
  • d) Fentanyl and remifentanil

13) Which ONE of the following receptors is NOT targeted in the treatment or prevention of post-operative nausea and vomiting?

  • a) GABA
  • b) Histamine
  • c) Serotonin
  • d) Dopamine

14) Which ONE of the following sets correctly describes the cholinergic effects of neostigmine?

  • a) Bradycardia and bronchospasm
  • b) Mydriasis and confusion
  • c) Urinary retention and constipation
  • d) Dry mouth and dry eyes

15) Which of the following correctly describes an important principle in the use of ketorolac as an adjunct for post-operative pain?

  • a) IV therapy should be minimized to less than 5 days.
  • b) Ketorolac must not be given to patients with renal insuffciency.
  • c) Potentiation of opioid effect is a risk.
  • d) Gastrointestinal bleeding is not a concern with the Cox 1 inhibitors such as ketorolac.

16) What is the main advantage of the use of glycopyrrolate compared to atropine to counteract the cholinergic effects of anticholinesterase administration?

  • a) Faster onset of action
  • b) Does not cross the blood brain barrier
  • c) More effective anticholinergic activity
  • d) Safe in patients with narrow angle glaucoma

Answers: 1a, 2c, 3d, 4b, 5c, 6a, 7b, 8b, 9d, 10c, 11d, 12c, 13a, 14a, 15b, 16b