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Anesthesiology Team Challenge > Team challenge > Flashcards

Team challenge Flashcards

1
Q

What drug is thiopental

A

Barbiturate

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2
Q
A
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3
Q

Local anesthetics work at the internal or external membrane of the sodium channel?

A

Internal

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4
Q

Thiopental is a strong base or strong acid

A

Strong acid (barbituric acid)

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5
Q

Which intravenous anesthetic also has a protective effect against post-operative nausea and vomiting?

A

Propofol (anti-emetic properties)

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6
Q

Unconsciousness produced by inhaled anesthetics is reversible or non-reversible?

A

Reversible

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7
Q

Ketamine is most like what drug?

A

PCP

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8
Q

What is the treatment for local anesthetic toxicity?

A

Intralipid

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9
Q

Ture or false, local anesthetics do NOT block sympathetic nerves?

A

False, act on all nerves

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10
Q

What is the effect of inhaled anesthetics on EEG

A

Flatten EEG

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11
Q

What disease is associated with inhaled anesthetics that results in increased temperature and results in death?

A

Malignant hyperthermia

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12
Q

Which inhaled anesthetics is least soluble in blood: isoflurane, desflurane, sevoflurane?

A

Desflurane: rapid onset and offset

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13
Q

Which intravenous anesthetic results in more deaths at pearl harbor than the actual attack? When induced in soldiers that were hypovolemic, soldiers will die in sleep

A

Thiopental

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14
Q

Emergence from inhaled anesthetics depends on which, elimination or metabolism?

A

Elimination. Inhaled anesthetics DON’t undergo metabolism!!

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15
Q

Which local anesthetic has more rapid onset: bupivacaine (pKA 8.1), lidocaine (pKA 7.9)

A

Lidocaine: closer to body pKa assodicated with faster onset

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16
Q

Which induction agent is contraindicated in egg allergy?

A

Propofol

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17
Q

Which IV anesthetic has minimal effects on the cardiovascular system?

A

Etomidate - profound hemodynamic stability

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18
Q

Which of the following drugs is the mechanism of action clear? IV, inhaled, or local anesthetics?

A

Local anesthetics

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19
Q

Rapid induction of anesthesia is done with an inhaled or IV anesthetic?

A

IV anesthetic

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20
Q

Maintenance of anesthesia occurs with an inhaled or IV anesthetic?

A

Inhaled anesthetic

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21
Q

What hair color increases MAC?

A

Red hair (also resistant to inhaled anesthetic)

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22
Q

What is the effect of inhaled anesthetic on minute ventilation?

A

Goes down - increased respiration can’t compensate for decrease in tidal volume

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23
Q

For inhaled anesthetics, speed of onset is determined by which property?

A

Blood solubility

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24
Q

What gas is typically administered for analgesia?

A

Nitrous oxide

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25
Q

What is the effect of inhaled anesthetics on uterine tone?

A

Decreases uterine tone (increase bleeding)

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26
Q

What does the injection if IV opioids due to MAC?

A

Decrease MAC - don’t need as much inhaled anesthetics

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27
Q

What do the inhaled anesthetics due to ventilatory response to low blood oxygen?

A

Decreases - areflexia (also to bronchomotor tone)

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28
Q

What do the inhaled anesthetics due to bronchiolar tone?

A

Bronchodilates

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29
Q

What do the inhaled agents do to cerebral blood flow?

A

Increase cerebral blood flow - don’t use for patients with ICP

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30
Q

The inhaled agents are supplied from the manufacturer in what form?

A

Liquid and then converted to a vapor

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31
Q

What class of drugs are the inhaled anesthetics?

A

All ethers (C-O-C configuration)

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32
Q

For the termination of a drug effect, which is more important: redistribution or elimination?

A

Redistribution

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33
Q

What drug is contraindicated with acute intermittent porphyria?

A

Thiopental (IV anesthetic)

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34
Q

What does propofol due to cerebral blood flow?

A

Decrease cerebral blood flow

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35
Q

What is the amount of IV anesthetic to prevent awareness?

A

Don’t know! inhaled anesthetics have MAC

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36
Q

Which IV anesthetic can also be given IM?

A

Ketamine

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37
Q

In addition to potassium chloride and panchorinium, which anesthetic is used for lethal injection?

A

Thiopental

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38
Q

Thiopental causes hypotension by myocardial depression and …?

A

vasodilation

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39
Q

The term for the longer you infuse a drug, the longer it takes to eliminate

A

Context-sensitive half life

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40
Q

The term for how drugs get to the effect site

A

Pharmacokinetics

41
Q

The term for the drug effect due to receptor binding

A

Pharmacodynamics

42
Q

What is the most common cause of abuse (death) in anesthesiologist <35?

A

Substsance abuse

43
Q

Give an example in which EMLA would be used?

A

Lumbar puncture in pediatric patients: lidocaine and prilocaine

44
Q

What local anesthetic is also used as an anti-arrhythmic?

A

Lidocaine

45
Q

Which of the following OTC drug contains a local anesthetic?

A

Bactine - anti-septic and lidocaine

46
Q

What medication is added to a local anesthetic to prolong duration of blockage?

A

Epinephrine

47
Q

When a certain area receives local anesthetic and does not respond to local stimuli, this is called?

A

Regional anesthesia

48
Q

What property of local anesthetic influences its duration?

A

Speed of onset and lipid solubility

49
Q

What protein channel do local anesthetics work?

A

Sodium channel

50
Q

What stereoisomer of bupivacaine is more cardiotoxic?

A

R-form

51
Q

Which year was the first medical school established in the US?

A

Penn! 1765

52
Q

What type of local anesthetic is cocaine?

A

Ester

53
Q

Inhaled anesthetic has been linked to which disease in adults?

A

Alzheimer’s

54
Q

The population variants of inhaled anesthetics are large or small?

A

Small! also works in different species

55
Q

Induction of anesthesia begins at the beginning or end of anesthesia?

A

Beginning

56
Q

The concentration of inhaled anesthetics necessary to prevent awareness is higher or lower than the amount needed to prevent pain?

A

Less (MAC)

57
Q

Which inhaled anesthetic has the highest MAC?

A

Desflurane (less lipid soluble, faster offset/onset)

58
Q

Why is propofol used for sedation in the ICU?

A

Anti-nausea, quickly reversed

59
Q

Which induction agent is also metabolized in the lung and small intestine?

A

Propofol

60
Q

Which anesthetic was first used for surgery?

A

Cocaine

61
Q

Which local anesthetic is more rapidly metabolized if injected by IV? Chloroprocaine or bupivacaine?

A

Chloroprocaine! Esters are much more rapidly metabolized

62
Q

Which organ metabolizes amide local anesthetic?

A

Liver

63
Q

Is there an antagonist to the inhaled anesthetics?

A

No, just blow it off

64
Q

Which depends on a drug metabolism: distribution half-life or elimination half-life?

A

Elimination half-life

65
Q

Propofol potentiates the effects of which neurotransmitters

A

GABA

66
Q

Primary termination of clinically effective IV anesthetics is metabolism or redistribution?

A

Redistribution

67
Q

Local anesthetics bind to which configuration of the sodium channel

A

Open & Inactive state

68
Q

The aromatic ring on the local anesthetic is hydrophilic or lipophilic?

A

Lipophilic

69
Q

Which local anesthetic has the larger potential for allergic reaction? Lidocaine or tetrocaine?

A

Tetrocaine - Ester –> PABA

70
Q

Which IV anesthetic does not depress respiration?

A

Ketamine

71
Q

Which will achieve a peak level first, inhaled or IV?

A

IV - that’s what you use for induction

72
Q

Inhaled anesthetics have been linked to the progression of which disease in kids?

A

Developmental delay or learning disability

73
Q

In the resting state, the sodium channel is in which configuration?

A

Closed

74
Q

What is the first sign of local anesthetic toxicity from lidocaine? Numbness of the tongue, seizure, ventricular tachycardia?

A

Numbness in the tongue, often metallic taste

75
Q

Which local anesthetic causes vasoconstriction?

A

Cocaine: reason why they use it for topical anesthetics

76
Q

Inhaled anesthetics with low blood solubility will have a slow or fast onset of action?

A

Fast onset: lower blood solubility, the faster onset. More soluble has slower onset.

77
Q

Which IV anesthetic would be good to induce for a patient that is scheduled to go home?

A

Propofol

78
Q

When the ENTIRE body does not respond to anesthesia, this is called:

A

General anesthesia

79
Q

What is the breakdown product of local anesthetics?

A

PABA

80
Q

Which IV anesthetic increases ICP?

A

Ketamine - stimulates blood flow (don’t use for trauma patients)

81
Q

What is the primary organ for metabolism of IV anesthetics?

A

Liver

82
Q

Do the inhaled anesthetics provide analgesia?

A

Yes

83
Q

What do local anesthetics bind to in the blood?

A

Albumin and alpha-1-glycoprotein

84
Q

What is the effect of inhaled anesthetics on blood pressure?

A

Decreases

85
Q

Which IV anesthetics increase ICP and cerebral blood flow

A

Ketamine

86
Q

Local anesthetics are weak acids or bases?

A

Bases

87
Q

The pka determines what of a local anesthetic?

A

Speed of onset

88
Q

Name one of the two intermediate chains of local anesthetics:

A

Amides or esters

89
Q

What is the term for concentration of vapor that prevents movements in response to 50% of the population?

A

MAC

90
Q

Which term describes an unaware patient that does not respond to pain?

A

Anesthesia

91
Q

Which of the following organs has the greatest uptake of anesthesia following accident IV injections: stomach, brain, muscle, skin?

A

Brain

92
Q

Which IV anesthetic has analgesic properties?

A

Ketamine

93
Q

What determines speed of onsets of the inhaled anesthetic?

A

Blood solubility

94
Q

What is the effect of inhaled anesthetics on temperature?

A

Decreases temperature

95
Q

What property of a loca anesthetic influences potency?

A

Lipid solubility

96
Q

Which anesthetic causes adrenocortical suppression?

A

Etomidate

97
Q

What enzyme hydrolyzes local anesthetics?

A

Pseudocholinesterase

98
Q

Antihistamines have sedative and hypnotic effects, true or false?

A

True

Anesthesiology Team Challenge (2 decks)

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