Test 1

Question 1

Evolution of anesthesia

Answer 1

Inhalation -> local and regional -> IV

Question 2

Ether was produced in _

Ether was first demonstrated in _ by _

Answer 2

1540

1846 by Morton

Question 3

Chloroform was first used in _ by _

Answer 3

1847 by Coyote

Question 4

Nitrous was first used for dental extractions in _ by _

Answer 4

1844 by Horace Wells

Question 5

Problem with ether and cyclopropane?

Answer 5

High combustion

Question 6

In the _ (decade), fluoridated hydrocarbon use was started. 4 first were:

Answer 6

1950s
Halothane
Methoxyflurane
Enflurane
Isoflurane

Question 7

Two new inhalational agents that are the most popular

Answer 7

Desflurane

Sevoflurane (most popular)

Question 8

Cocaine was used as an eye anesthetic in _ by _

Answer 8

1884 by Koller

Question 9

Lidocaine was invented in _ by _

Answer 9

1947 by Lofgren

Question 10

First and most common IV induction drug was first used by _ in the year _

Answer 10

Lundy and waters in 1934

Question 11

Most popular IV induction drug: _, first used in _

Answer 11

Propofol

1986

Question 12

Succinylcholine was first introduced in _

Answer 12

1949

Question 13

Things you have to monitor in moderate/deep/GA

Answer 13

Consciousness
Pulse oximetry
End-tidal CO2
BP, HR, ECG
Temp

Question 14

Most important airway management object

Answer 14

Yankauer suction

Question 15

4 things that can go wrong with airway management

Answer 15

Apnea
Obstruction
Laryngospasm
Bronchspasm

Question 16

Laryngospasm

Answer 16

Closure of vocal cords preventing breathing caused by irritation of cords

Question 17

Child emergencies most often involve _

Answer 17

Respiratory compromise

Question 18

Ventilation vs oxygenation

Answer 18

Ventilation: mvmnt of air in and out of lungs
Oxygenation: transport of oxygen to metabolically active tissues (brain)

Question 19

Chloral hydrate:
Class
Effects

Answer 19

Hypnotic

Disinhibition, anger, sedative

Question 20

Meperidine:
Class
Effects

Answer 20

Narcotic

Euphoria, analgesia

Question 21

Midazolam
Class
Effects
Onset

Answer 21

Benzodiazepine
Mood change, relaxation
Fast onset, short duration

Question 22

IV needle should be placed at what angle

Answer 22

20-30˚

Question 23

How do benzodiazepines work

Answer 23

GABA agonists

Question 24

Half life of Valium

Answer 24

Patient’s age

Question 25

What is used for a benzo reversal

Answer 25

Flumazenil

Question 26

Weird side effect of meperidine

Answer 26

Tachycardia

Question 27

Problem with meperidine

Answer 27

Active metabolite is a neurotoxin

Question 28

What is promethazine

Answer 28

Sedative, anti-histamine, anti-emetic. Side effects motor restlessness and muscle contractions

Question 29

MAPK signaling is responsible (among others) for what two things

Answer 29

Mood regulation | Tolerance

Question 30

Opioid receptors have what kind of interactions

Answer 30

Protein-protein

Question 31

Major risk of fentanyl

Answer 31

Respiratory depression

Question 32

What is tramadol

Answer 32

Mu receptor agonist precursor

Question 33

4 benzodiazepines in dentistry

Answer 33

Diazepam Midazolam Lorazepam Tirazolam

Question 34

_ has almost completely replaced diazepam (Valium) in clinical anesthesia use

Answer 34

Midazolam

Question 35

Ketamine: Class Route Problems

Answer 35

Dissociative anesthetic IV or IM Can cause agitation or hallucinations, raises intracranial pressure

Question 36

Ambien, sonata and lunesta are what type of drug

Answer 36

Non benzo GABA agonists

Question 37

Naloxone Concerns

Answer 37

Duration is shorter than most opioids | Use in dependent patient may cause acute opioid withdrawal symptoms

Question 38

T/F resedation is possible after administering flumazenil with long acting bzds

Answer 38

TRUE

Question 39

Dangerous vs hazardous

Answer 39

Dangerous has a restrictive statement | Hazardous is carcinogenic, teratogenic or toxic

Question 40

Ohio law says a patient can have no more than _ days supply of opioid and _ for minors

Answer 40

7, 5

Question 41

No more than _ MED per day on average

Answer 41

30

Question 42

Moderate pain control

Answer 42

Ibuprofen before Marciano Toradol, decadron, ketamine

Question 43

Normal blood glucose

Answer 43

80-100 mg/dL

Question 44

If seizure lasts longer than 2 mins, do 4 things

Answer 44

100% O2 Midazolam 5mg IM Prepare for BLS Activate EMS

Question 45

Stable vs unstable chest pain

Answer 45

Stable: alleviated by nitroglycerin, not at rest, no increase, no new symptoms’ Unstable: nitroglycerin doesn’t help, occurs at rest, increases in pain, new symptoms

Question 46

When is nitroglycerin contraindicated

Answer 46

When taking ED drug

Question 47

Allergies are caused by _ activating _ and _ causing release of _ and _ causing _, _ and _

Answer 47

IgE activating Basophils and mast cells causing release of histamine and leukotrienes causing vasodilation, capillary permeability, bronchconstriction

Question 48

``` Stages of anesthesia I II III (1,2,3,4) IV ```

Answer 48

I - normal II - excitement III - surgical anesthesia, constricted pupils, normal HR and RR IV - death, fixed dilation

Question 49

Isoflurane

Answer 49

Pungeant, safe

Question 50

Sevoflurane

Answer 50

Most used, sweet

Question 51

Desflurane

Answer 51

Irritating to airway, used once asleep

Question 52

Higher blood/gas coefficient, the _ the onset of action

Answer 52

Slower

Question 53

The lower the blood/gas coefficient, the _ the onset

Answer 53

Faster

Question 54

What is MAC

Answer 54

Minimum alveolar concentration. Concentration required to prevent movement in 50% of people to surgical stimulus

Question 55

Order of Mac values

Answer 55

HIS DNo | Least -> most

Question 56

Dose of epi in epi-pen

Answer 56

0.15-0.3mg

Question 57

Most worrying thing in anaphylaxis

Answer 57

Hypotension