Anesthesia Gas

Question 1

Whos ready for more FLASHCARDSSSSSS!!!

Answer 1

Question 2

Inhaled anesthetics do not generally provide __________ but do produce immobility and amnesia.

A) Sedation
B) Analgesia
C) Euphoria
D) Muscle relaxation

Answer 2

B) Analgesia

…with the exception of nitrous oxide, inhaled anesthetics do not provide any significant analgesia.

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Question 3

Which of the following is an exception among inhaled anesthetics in terms of increasing skeletal muscle tone?

A) Isoflurane
B) Desflurane
C) Nitrous oxide
D) Sevoflurane

Answer 3

C) Nitrous oxide

-Inhaled anesthetics either do not affect, or in some cases lower skeletal muscle tone EXCEPT Nitrous oxide

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Question 4

Inhaled anesthetics produce immobility primarily through actions on:

A) The cerebral cortex
B) The spinal cord
C) Peripheral nerves
D) The brainstem

Answer 4

B) The spinal cord

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Question 5

Inhaled anesthetics are thought to produce anesthesia by enhancing __________ channels and attenuating __________ channels.

A) Inhibitory, excitatory
B) Excitatory, inhibitory
C) Potassium, calcium
D) Sodium, chloride

Answer 5

A) Inhibitory, excitatory

..whether or not this occurs through direct binding or membrane alterations is not known

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Question 6

What does the Minimum Alveolar Concentration (MAC) of an inhaled anesthetic represent?

A) The dose required to produce analgesia in 50% of patients during surgical incision
B) The alveolar concentration at which 50% of patients do not show a motor response to a surgical incision
C) The concentration that results in sedation for 50% of patients during surgery
D) The concentration that prevents any response in 100% of patients

Answer 6

B) The alveolar concentration at which 50% of patients do not show a motor response to a surgical incision

..MAC of an inhaled anesthetic is the alveolar (or end- expiratory)concentration at which 50% of patients will not show a motor response to a standardized surgical incision

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Question 7

Approximately what percentage of patients will not show a motor response to a surgical incision at 1.3 MAC of an anesthetic?

A) 50%
B) 80%
C) 95%
D) 99%

Answer 7

D) 99%

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Question 8

What does a MAC of 1.2 indicate in terms of patient response to a surgical incision?

A) 50% of patients will respond
B) 95% of patients will respond
C) 95% of patients will not respond
D) 99% of patients will not respond

Answer 8

C) 95% of patients will not respond

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Question 9

Which inhaled anesthetic is described as an airway irritant, requiring a special heated vaporizer, and is particularly expensive?

A) Sevoflurane
B) Isoflurane
C) Desflurane
D) Nitrous oxide

Answer 9

C) Desflurane

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Question 10

Why is Desflurane often considered suitable for obese patients?

A) It has a high lipid solubility.
B) It is metabolized primarily by the liver.
C) It has a low solubility
D) It is the cheapest inhaled anesthetic.

Answer 10

C) It has a low solubility
..absorbs quick, and goes away quick

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Question 11

What is a notable disadvantage of Desflurane as an anesthetic agent?

A) It has a long onset and offset.
B) Increased heart rate.
C) It has high blood solubility
D) It causes significant nephrotoxicity in humans.

Answer 11

B) Increased heart rate.
Corn: which leads to hypotension
## Footnote

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Question 12

Sevoflurane is commonly used in pediatric induction because it is:
Select 2

A) Very cheap
B) Longer emergence time
C) An airway irritant that requires a special vaporizer
D) Non-irritating to the airway
E) Not commonly used in humans
F) Quick emergence

Answer 12

D) Non-irritating to the airway
F) Quick emergence

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Question 13

What is a potential concern associated with the use of Sevoflurane based on animal studies?

A) Nephrotoxicity in rats
B) Neurotoxicity in humans
C) Cardiovascular instability
D) Hepatotoxicity in rats

Answer 13

A) Nephrotoxicity in rats

…not proved in humans

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Question 14

Which of the following are potential concerns or considerations when using Sevoflurane?
Select 2

A) It may cause emergence delirium in pediatric patients.
B) Needs a special heated vaporizer
C) It is very irritating to the airway.
D) It may linger longer in obese patients.
E) The most expensive

Answer 14

A) It may cause emergence delirium in pediatric patients
D) It may linger longer in obese patients.

…good for pediatric induction though and very commonly used

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Question 15

Which of the following are true statements about Isoflurane?
Select 2

A) It is relatively inexpensive
B) It has a low lipid solubility
C) It is ideal for cases where quick extubation is desired.
D) Not used very often
E) Used the most often

Answer 15

A) It is relatively inexpensive
D) Not used very often

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Question 16

Isoflurane is very lipid-soluble, leading to a __________ emergence, making it suitable for cases where extubation is not expected.

A) Quick
B) Longer
C) Abrupt
D) Slow but unpredictable

Answer 16

B) Longer

(Ex: Sick ICU patient going to stay on a ventilator)

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Question 17

Nitrous oxide is known to be an effective __________, allowing it to be used to reduce the required dose of primary anesthetic agents.

A) Muscle relaxant
B) Hypnotic
C) Amnestic
D) Analgesic

Answer 17

D) Analgesic

NOT a solo anesthesia gas. Used as an adjunct.

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Question 18

In which of the following situations might the use of nitrous oxide be contraindicated or not recommended?
Select 2

A) Neurosurgical procedures
B) Procedures involving open body cavities
C) The need for high doses of Nitrous
D) Pediatric dental procedures

Answer 18

A) Neurosurgical procedures
C) The need for high doses of Nitrous N/V at higher doses

Not recommended for procedures involving closed body cavities (e.g., bowel surgery)

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Question 19

What Factors increase Anesthetic Requirements. Select 5
1. Chronic ethanol (ETOH)
2. Acute ethanol (ETOH)
3. Infant (highest MAC at 6 months)
4. Elderly patients
5. Red hair
6. Hyperthermia
7. Hypothermia
8. Anemia (Hgb < 5 g/dL)
9. Hypercarbia
10. Pregnancy
11. Hyponatremia
12. Hypernatremia
13. Hypoxia

Answer 19

1. Chronic ETOH
2. Infant (highest MAC at 6 mo.)
3. Red hair
4. Hyperthermia
5. Hypernatremia

All the rest decrease Anesthetic Requirements

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Question 20

Anesthetic gases are preferred in clinical anesthesia due to which of the following reasons?
Select 2

A) Quick adjustment in patient sedation level
B) Limited to no metabolism
C) High metabolism
D) They have wide therapeutic window

Answer 20

A) Quick adjustment in patient sedation level
B) Limited to no metabolism

Titratable: Working on the very steep part of the dose response curve.

Very potent: They do have a narrow therapeutic window.

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Question 21

Which of the following benefits of anesthetic gases allow for precise dosing and patient monitoring?
Select 2

A) Speed of onset
B) Low potency
C) Ability to measure exhaled gases to assess brain levels
D) High metabolism requirements for adjustment

Answer 21

A) Speed of onset
C) Ability to measure exhaled gases to assess brain levels

Available Measure: Watching what the patient breaths in and out tells us what is in the patients brain.

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Question 22

Match the anesthetic agent with its correct MAC (Minimum Alveolar Concentration) percentage.

Desflurane
Isoflurane
Sevoflurane
Nitrous Oxide

Options:
A. 1.8%
B. 1.17%
C. 6.6%
D. 104%

Answer 22

Desflurane - 6.6% (C)

Isoflurane - 1.17% (B)

Sevoflurane - 1.8% (A)

Nitrous Oxide - 104% (D)

TXWes Reference

Question 23

Match the anesthetic agent with its correct vapor pressure (in mmHg at 20°C).

Desflurane
Sevoflurane
Isoflurane
Nitrous Oxide

Options:
A. 157 mmHg
B. 38,770 mmHg
C. 669 mmHg
D. 238 mmHg

Answer 23

Desflurane - 669 mmHg (C)

Sevoflurane - 157 mmHg (A)

Isoflurane - 238 mmHg (D)

Nitrous Oxide - 38,770 mmHg (B)

TXWes Reference

Question 24

Match the anesthetic agent with its correct blood:gas partition coefficient.

Desflurane
Sevoflurane
Isoflurane
Nitrous Oxide

Options:
A. 0.46
B. 0.69
C. 1.46
D. 0.42

Answer 24

Desflurane - 0.42 (D)

Sevoflurane - 0.69 (B)

Isoflurane - 1.46 (C)

Nitrous Oxide - 0.46 (A)

TXWes Reference