Exam 2 Stoetling's Book Propofol questions

Question 1

What are some side effects of propofol due to the lipid emulsion formulation?
a. Allergic reactions
b. Risk of infection
c. Pain on injection
d. Hypertriglyceridemia
e. All of the above

Answer 1

Answer: e. All of the above

Question 2

What are the allergenic components of propofol?
a. Soybean oil and glycerin
b. Yolk lecithin and sodium edetate
c. The phenyl nucleus and diisopropyl side chain
d. Neuromuscular blocking drugs
e. None of the above

Answer 2

Answer: c. The phenyl nucleus and diisopropyl side chain

Question 3

What is lactic acidosis and how is it related to propofol?

a. It is a type of allergic reaction to propofol.
b. It is a side effect of the lipid emulsion formulation of propofol.
c. It is a metabolic condition that can occur in patients receiving high doses of propofol for prolonged periods of time.
d. It is a type of seizure that can occur after propofol administration.
e. None of the above.

Answer 3

Answer: c. It is a metabolic condition that can occur in patients receiving high doses of propofol for prolonged periods of time.

Question 4

What is the differential diagnosis for propofol-induced lactic acidosis?

a. Hyperchloremic metabolic acidosis associated with large volume infusions of 0.9% saline
b. Metabolic acidosis associated with excessive generation of organic acids
c. Both a and b
d. Neither a nor b

Answer 4

Answer: c. Both a and b

Question 5

Does propofol have proconvulsant activity?

a. Yes
b. No

Answer 5

Answer: b. No

Question 6

What is the treatment of propofol-induced bradycardia that may require treatment with?

A. Anticholinergic drugs
B. Direct β agonist such as isoproterenol
C. Atropine
D. None of the above

Answer 6

Answer: B. Direct β agonist such as isoproterenol

Question 7

Does propofol increase the incidence of the oculocardiac reflex in pediatric strabismus surgery, despite prior administration of anticholinergics?

A. Yes
B. No
C. Unclear
D. None of the above

Answer 7

Answer: A. Yes

Question 8

Does propofol prolong the QTc interval on the electrocardiogram?

A. Yes
B. No
C. Unclear
D. None of the above

Answer 8

Answer: B. No

Question 9

What is the recommended precaution before rapid IV administration of propofol in hypovolemic patients, elderly patients, and patients with compromised left ventricular function?

A. Adequate hydration
B. Administer anticholinergic drugs
C. Administer direct β agonist such as isoproterenol
D. None of the above

Answer 9

Answer: A. Adequate hydration

Question 10

What is the impact of propofol on desflurane-mediated sympathetic nervous system activation?

A. Unclear
B. Attenuates the transient cardiovascular response
C. Augments the increase in epinephrine concentration
D. None of the above

Answer 10

Answer: A. Unclear

Question 11

Does propofol interfere with the adequacy of electrocorticographic recordings during awake craniotomy performed for the management of refractory epilepsy?

A. Yes
B. No
C. Unclear
D. None of the above

Answer 11

Answer: B. No

Question 12

Does administration of propofol increase intracranial pressure (ICP)?

A. Yes
B. No
C. Unclear
D. None of the above

Answer 12

Answer: B. No

Question 13

What is the effect of propofol on cerebral metabolic rate for oxygen (CMRO2)?

A. Increases
B. Decreases
C. No effect
D. Unclear

Answer 13

Answer: B. Decreases

Question 14

What preservative in propofol can cause bronchoconstriction in asthmatic patients?

A. Soybean oil
B. Glycerin
C. Yolk lecithin
D. Metabisulfite

Answer 14

Answer: D

Question 15

How does propofol attenuate bronchoconstriction?

A. By decreasing vagal nerve stimulation
B. By increasing airway responsiveness
C. By inhibiting gastric emptying
D. By modulating subcortical pathways

Answer 15

Answer: A

Question 16

What is the mechanism of the anticonvulsant activity of propofol?

A. Inhibition of chloride ion channels
B. Inhibition of gastric emptying
C. Modulation of subcortical pathways
D. Depression of spinal cord activity

Answer 16

Answer: A

Question 17

What is the mechanism of the antipruritic effect of propofol?

A. Inhibition of gastric emptying
B. Modulation of subcortical pathways
C. Depression of spinal cord activity
D. Inhibition of dopaminergic activity

Answer 17

Answer: C

Question 18

What is the plasma concentration needed for antiemetic effects of propofol?

A. 5 mg followed by 5 μg/kg/minute
B. 10 mg followed by 10 μg/kg/minute
C. 15 mg followed by 15 μg/kg/minute
D. 20 mg followed by 20 μg/kg/minute

Answer 18

Answer: B

Question 19

What is the advantage of propofol in the postoperative period?

A. Minimal residual sedative effects
B. Significant sedation
C. Delayed awakening
D. High incidence of postoperative nausea and vomiting

Answer 19

Answer: A

Question 20

Why is propofol considered superior to thiopental for induction of anesthesia?

A. It is less expensive
B. It has a longer half-life
C. It causes less nausea and vomiting
D. It has a quicker recovery time without residual CNS effects

Answer 20

Answer: D. It has a quicker recovery time without residual CNS effects

Question 21

Is propofol cleared from the neonatal circulation quickly?

A. Yes, propofol is rapidly cleared from the neonatal circulation
B. No, propofol is retained in the neonatal circulation for a prolonged period
C. It depends on the gestational age of the neonate
D. There is not enough information to determine the answer

Answer 21

Answer: A

Question 22

Does the clearance of propofol decrease in older patients?

A. Yes, older patients exhibit a decreased rate of plasma clearance of propofol
B. No, there is no change in plasma clearance of propofol in older patients
C. It depends on the type of surgery being performed
D. There is not enough information to determine the answer

Answer 22

Answer: A

Question 23

What is the effect of renal dysfunction on the clearance of propofol?

A. It increases the clearance of propofol
B. It decreases the clearance of propofol
C. It has no influence on the clearance of propofol
D. It impairs the elimination of propofol

Answer 23

Answer: C

Question 24

What is the significance of pulmonary uptake of propofol?

A. It influences the initial availability of propofol
B. It transforms propofol into 2,6-diisopropyl-1,4-quiniol
C. It releases propofol back into the circulation
D. It impairs elimination of propofol in patients with cirrhosis of the liver

Answer 24

Answer: A

Question 25

What is the major metabolic pathway for propofol?

A. Glucuronidation
B. Renal excretion
C. Pulmonary uptake
D. First-pass elimination

Answer 25

Answer: A

Question 26

How is propofol eliminated from the body?

A) Excreted unchanged in urine
B) Metabolized by cytochrome P450 to active metabolites
C) Rapidly metabolized by the liver to inactive metabolites
D) Both B and C

Answer 26

Answer: C) Rapidly metabolized by the liver to inactive metabolites

Question 27

What is the context-sensitive half-time of propofol?

A) Less than 40 minutes for infusions up to 8 hours
B) More than 40 minutes for infusions up to 8 hours
C) Less than 40 minutes for infusions lasting longer than 8 hours
D) More than 40 minutes for infusions lasting longer than 8 hours

Answer 27

Answer: A) Less than 40 minutes for infusions up to 8 hours

Question 28

How does propofol cause hyperpolarization of the postsynaptic cell membrane?

A) By inhibiting the release of GABA from the presynaptic neuron
B) By decreasing the rate of dissociation of GABA from the receptor
C) By directly activating GABAA receptors
D) By increasing the rate of dissociation of GABA from the receptor

Answer 28

Answer: B) By decreasing the rate of dissociation of GABA from the receptor

Question 29

Which receptors does propofol modulate?

A) NMDA receptors
B) Dopamine receptors
C) GABA receptors
D) Serotonin receptors

Answer 29

Answer: C) GABA receptors