CH 27 Questions

Question 1

Characteristics of phase I depolarizing neuromuscular blockade due to succinylcholine include
(A) Easy reversibility with nicotinic receptor antagonists
(B) Marked muscarinic blockade
(C) Muscle fasciculations only in the later stages of block
(D) Reversibility by acetylcholinesterase (AChE) inhibitors
(E) Sustained tension during a period of tetanic stimulation

Answer 1

(E) Sustained tension during a period of tetanic stimulation

Question 2

A patient underwent a surgical procedure
of 2 h. Anesthesia was provided by isoflurane, supplemented by intravenous midazolam and a nondepolarizing muscle relaxant. At the end of the procedure, a low dose of atropine was administered followed by pyridostigmine. The main reason for administering atropine was to
(A) Block cardiac muscarinic receptors
(B) Enhance the action of pyridostigmine
(C) Prevent spasm of gastrointestinal smooth muscle
(D) Provide postoperative analgesia
(E) Reverse the effects of the muscle relaxant

Answer 2

(A) Block cardiac muscarinic receptors

Question 3

A patient underwent a surgical procedure
of 2 h. Anesthesia was provided by isoflurane, supplemented by intravenous midazolam and a nondepolarizing muscle relaxant. At the end of the procedure, a low dose of atropine was administered followed by pyridostigmine.
A muscarinic receptor antagonist would probably not be needed for reversal of the skeletal muscle relaxant actions of a nondepolarizing drug if the agent used was
(A) Cisatracurium
(B) Mivacurium
(C) Pancuronium
(D) Tubocurarine
(E) Vecuronium

Answer 3

(C) Pancuronium

Question 4

Which of the following drugs is the most effective in the emergency management of malignant hyperthermia?
(A) Atropine
(B) Dantrolene
(C) Haloperidol
(D) Succinylcholine
(E) Vecuronium

Answer 4

(B) Dantrolene

Question 5

The clinical use of succinylcholine, especially in patients with diabetes, is associated with
(A) Antagonism by pyridostigmine during the early phase of blockade
(B) Aspiration of gastric contents
(C) Decreased intragastric pressure
(D) Histamine release in a genetically determined population
(E) Metabolism at the neuromuscular junction by acetylcholinesterase

Answer 5

(B) Aspiration of gastric contents

Question 6

Which drug (related to clonidine) is most often associated with hypotension?
(A) Baclofen
(B) Pancuronium
(C) Succinylcholine
(D) Tizanidine
(E) Vecuronium

Answer 6

(D) Tizanidine

Question 7

Regarding the spasmolytic drugs, which of the following statements is not accurate?
(A) Baclofen acts on GABA receptors in the spinal cord to increase chloride ion conductance
(B) Cyclobenzaprine decreases both oropharyngeal secretions and gut motility
(C) Dantrolene has no significant effect on the release of calcium from cardiac muscle
(D) Diazepam causes sedation at doses commonly used to reduce muscle spasms
(E) Intrathecal use of baclofen is effective in some refractory cases of muscle spasticity

Answer 7

(A) Baclofen acts on GABA receptors in the spinal cord to increase chloride ion conductance

Question 8

Which drug is most likely to cause hyperkalemia leading to cardiac arrest in patients with spinal cord injuries?
(A) Baclofen
(B) Dantrolene
(C) Pancuronium
(D) Succinylcholine
(E) Vecuronium

Answer 8

(D) Succinylcholine

Question 9

Which drug has spasmolytic activity and could also be used in the management of seizures caused by overdose of a local anesthetic?
(A) Baclofen
(B) Cyclobenzaprine
(C) Diazepam
(D) Gabapentin
(E) Tizanidine

Answer 9

(C) Diazepam

Question 10

Myalgias are a common postoperative complaint of patients who receive large doses of succinylcholine, possibly the result
of muscle fasciculations caused by depolarization. Which drug administered in the operating room can be used to prevent
postoperative pain caused by succinylcholine?
(A) Atracurium
(B) Baclofen
(C) Dantrolene
(D) Diazepam
(E) Lidocaine

Answer 10

(A) Atracurium