Test 2

Question 1

Amount of vapor to block autonomic response to surgical stimulation

Answer 1

MAC BAR

Question 2

Highest MAC

Answer 2

MAC BAR

Question 3

Suppression of “bucking” and/or laryngospasm in 50% of pt

Higher or lower than classical MAC

Answer 3

MAC tracheal stimulation

Higher than classical MAC

Question 4

Clinical anesthesia requires concentrations of what?

Answer 4

Exceed MAC by 10-30%

Question 5

Immobility under anesthesia mediated by what

Answer 5

Spinal Cord

Question 6

Isoflurane BGPC

Answer 6

1.46

Question 7

Volatile anesthetic OK with closed circuit techniques

Answer 7

Isoflurane

Question 8

Brain partial pressures reflect what

Answer 8

Concentrations in alveoli

Question 9

The longer the case with Isoflurane the ____

Answer 9

Longer/slower the recovery time

Question 10

Is Isoflurane an airway irritant?

Anesthesia implications

Answer 10

YES.

Cannot use for inhalation induction

Question 11

Obesity implications with Isoflurane

Answer 11

Larger fat compartment for Iso storage = slower emergence

Question 12

Provides chemical stability and makes Iso inflammable

Answer 12

Fluoridation

Question 13

Isoflurane and ICP

Answer 13

Will increase ICP in pt with closed head injury or intracranial HTN

Question 14

Isoflurane

• MAC
• BGPC
• OGPC
• Vapor pressure
• Metabolism rate

Answer 14

• MAC 1.17
• BGPC 1.46
• OGPC 91
• Vapor Pressure- 238
• Metabolism rate 0.2%

Question 15

Goal of volatile anesthetic administration

Answer 15

Reversible effect of CNS productions immobility to noxious stimuli and amnesia

Question 16

Amnesia mediated where?

Answer 16

Brain

Question 17

Iso binds to what receptors

Answer 17

GABA, Glutamate, and Glycine receptors

Question 18

How is isoflurane eliminated?

Answer 18

By lungs through exhalation

Question 19

Does Iso produce does dependent changes on EEG?

Answer 19

YES

Question 20

Iso and seizure activity

Answer 20

Isoflurane suppresses drug induced convulsions

Question 21

Does Iso produce skeletal muscle relaxation

Answer 21

Yes

Question 22

Brain sites of action for isoflurane

Answer 22

• brain stem
• cerebral cortex
• hippocampus

Question 23

The only inorganic anesthetic agent

Answer 23

Nitrous Oxide

Question 24

Nitrous

• MAC
• Metabolism rate
• BGPC
• OGPC

Answer 24

• MAC 104%
  Metabolism rate 0.004%
  BGPC 0.46
  OGPC 1.4

Question 25

When pressure begins to decrease in N20 cylinder how much left in cylinder?

Answer 25

About 40L

Question 26

Does N20 have analgesic effects?

Answer 26

Yes

10% N2) = 7.5 mg Morphine

Question 27

Alveolar concentration = what

Answer 27

Brain concentration

Question 28

The higher the inspired concentration of and inhaled anesthetic, the sooner alveolar concentrations will equal inspired concentrations

Answer 28

Concentration effect

Question 29

Use of a N20 in high concentrations decreases the time required for alveolar concentrations to equal inspired concentrations

Answer 29

Second Gas Effect

Question 30

Receptors activation responsible for anxiolysis with N20

Answer 30

GABA receptors

Question 31

Anesthetic effect of Nitrous caused by what

Answer 31

Inhibition of NMDA receptor mediated currents

Question 32

Nitrous produces analgesia via what mech.

Answer 32

Opioid like neurons in periaqueductal gray matter of the brain stem

Question 33

N20 causes no skeletal muscle relaxation but can cause what

Answer 33

Skeletal muscle rigidity

Question 34

Nitrous effect on

• CVP
• PVR
• R to L shunt
• CO

Answer 34

• CVP Increased
• PVR increased
• R to L shunt worsens
• CO modestly increased

Question 35

Nitrous effect on methionine synthase

Implication

Answer 35

Inactivates the enzyme which regulates B12 and folic acid

Question 36

Avoid nitrous in what 10 cases

Answer 36

• laparoscopic
• bowel cases
• potential for air emoji (cardiac, vascular)
• PONV
• B12/folate deficiencies
• Pneumothorax
• Free flaps
• Pulmonary HTN
• R to L shunt