Sedatives, Paralytics, and Analgesics

Question 1

Regarding Richmond agitation–sedation scale, an alert and calm patient will be given a score of what?
● A. 0
● B. 1
● C. 3
● D. 5
● E. 7

Answer 1

A. 0

Question 2

Propofol is a sedative hypnotic and a neuroprotectant. What is the maximum dose (μg/kg/min) for sedation?
● A. 1
● B. 5
● C. 10
● D. 25
● E. 50

Answer 2

E. 50

Question 3

Succinylcholine is an ultra-short muscle relaxant. Its onset is within 1 minute and duration of action is 5 to 10 minutes and spontaneous recovery occurs after long?
● A. 5 minutes
● B. 10 minutes
● C. 20 minutes
● D. 45 minutes
● E. 1 hour

Answer 3

C. 20 minutes

Question 4

Regarding analgesic properties of Aspirin, what is the maximum daily dose?
● A. 25 mg
● B. 50 mg
● C. 100 mg
● D. 1 g
● E. 4 g

Answer 4

E. 4 g

Question 5

For reduction of gastrointestinal side effects of NSAIDs, which of the following is most important?
● A. Taking before meals
● B. Taking with meals
● C. Taking after meals
● D. Antacids
● E. Misoprostol

Answer 5

E. Misoprostol

Question 6

A patient is admitted in neurosurgical ICU after sustaining head injury in a road traffic accident. The patient has to be mechanically ventilated but he/she is aggressive, trying to pull and remove tubes and catheters. The on-call doctor has to give sedation to this patient. After 20 minutes of giving sedation the
patient is not responding to voice but shows movement or eye opening on physical stimulation. According to Richmond agitation-sedation scale (RASS), what are the agitation and sedation
scores, respectively, in this patient?
● A. + 4,−4
● B. + 3,−3
● C. + 4,−3
● D. + 3,−4
● E. + 2,−3

Answer 6

D. + 3,−4

Question 7

Thiopental (Pentothal) is a short-acting barbiturate which is used for sedating patients. Following are the side effects of thiopental except?
● A. Dose-related respiratory depression
● B. Myocardial depression
● C. Damage to basal ganglia in brain
● D. Hypotension in hypovolemic patients
● E. Intra-arterial injection can cause necrosis

Answer 7

C. Damage to basal ganglia in brain

Question 8

Propofol is a sedative hypnotic. It is used for sedation during general anesthesia and acts as neuroprotectant in aneurysm surgery at high doses. If a patient develops hyperkalemia, hepatomegaly, myocardial failure, renal failure, or death after propofol infusion then what is this condition called?
● A. Anaphylaxis reaction due to propofol infusion
● B. Multiorgan failure
● C. Propofol infusion reaction
● D. Propofol infusion syndrome
● E. All of the above

Answer 8

D. Propofol infusion syndrome

Question 9

Following are the characteristics of nonsteroidal anti-inflammatory drugs (NSAIDs) except?
● A. No dependence develops with NSAIDs
● B. NSAIDs do not demonstrate a ceiling effect
● C. Risk of GI upset is common
● D. Most reversibly inhibit platelet function and prolong bleeding time
● E. All of them cause sodium and water retention and carry the risk of NSAID-induced nephrotoxicity

Answer 9

B. NSAIDs do not demonstrate a ceiling effect

Question 10

A patient presented in neurosurgical emergency with severe headache. He is given pain killer after which he develops respiratory depression. Which analgesic overdosage can cause this side effect?
● A. Ketorolac tromethamine (Toradol)
● B. Indomethacin
● C. Tramadol (Ultram)
● D. Naproxen sodium
● E. All of the above

Answer 10

C. Tramadol (Ultram)

Question 11

For percutaneous rhizotomy in which the patient needs to be sedated and awakened repeatedly, which of the following sedative drugs is most suitable?
● A. Methohexital (Brevital)
● B. Thiopental (Pentothal)
● C. Remifentanil (Ultiva)
● D. Propofol
● E. Precede (Dexmedetomidine)

Answer 11

A. Methohexital (Brevital)

Question 12

Precedex (Dexmetomidine), an alpha-2 adrenoceptor agonist, has both sedative and analgesic properties and dramatically reduces the risk of respiratory depression as well. It has to
be with caution in the following patients except?
● A. In advanced heart block
● B. In basal bradycardia
● C. Using with other drug that lowers heart rate
● D. Hypovolemic patients
● E. Hypertensive patients

Answer 12

E. Hypertensive patients

Question 13

During intubation of a head injury patient in the emergency department, which of the following muscle relaxants can be used?
● A. Rocuronium (Zemuron)
● B. Cisatracurium (Nimbex)
● C. Succinylcholine (Anectin)
● D. Vecuronium (Norcuron)
● E. All of the above

Answer 13

E. All of the above

Question 14

Reversal of competitive muscle blockade is achieved by using neostigmine. What is its maximum dosage?
● A. 2.5 mg
● B. 5 mg
● C. 7.5 mg
● D. 10 mg
● E. 15 mg

Answer 14

B. 5 mg

Question 15

For visceral or deafferentation pain, which of the following analgesics is used?
● A. Tricyclic antidepressants
● B. Tryptophan
● C. Carbamazepine
● D. Tegretol
● E. All of the above

Answer 15

E. All of the above