Local Anesthetics (Msq Drill 178)
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- 1.
All local anesthetics are __________ connected to an aromatic ring.
- A.
Weak acids
- B.
Strong acids
- C.
Weak bases
- D.
Stog bases
Correct Answer
C. Weak bases -
- 2.
What are the two structural classes of local anesthetics?
- A.
Esters
- B.
Amines
- C.
Amides
- D.
Carboxylic acids
- E.
Purines
Correct Answer(s)
A. Esters
C. Amides -
- 3.
Local anesthetics that have one "i" in their name are esters or amides?
- A.
Esters
- B.
Amides
Correct Answer
A. Esters -
- 4.
Which local anesthetics are hepatically metabolized and should therefore be used cautiously in paitients with hepatic impairment?
- A.
Esters
- B.
Amides
Correct Answer
B. Amides -
- 5.
Which local anesthetics are structurally and immunologically related to p-aminobenzoic acid (PABA?)
- A.
Esters
- B.
Amides
Correct Answer
A. EstersExplanation
PABA is an intermediate in the bacterial synthesis of
folate. Sulfonamide drugs are structurally similar to PABA, and their antibacterial activity is due to their ability to interfere with the conversion of PABA to folate by the enzyme dihydropteroate synthetase. Thus, bacterial growth is limited through folate deficiency without effect on human cells.Rate this question:
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- 6.
Esters are preferable for patients with hepatic dysfunction. What enzyme degrades esters?
- A.
Acetylcholinestarase
- B.
Mono amine oxidase
- C.
Plasma cholinesterase
- D.
Synaptic cholinesterase
Correct Answer
C. Plasma cholinesterase -
- 7.
If you add epinephrine to a local anesthetic, does this increase or decrease absorption?
- A.
Increases absorption of local anesthetic
- B.
Decreases absoption of local anesthetic
Correct Answer
B. Decreases absoption of local anesthetic -
- 8.
You should use epinephrine in distal, perfusion limited sites such as the tip on of the nose, toes and fingers. True or false?
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
You should NEVER use epinephrine in perfusion limited areas.Rate this question:
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- 9.
Which organs will quickly feel the effects of a local anesthetic?
- A.
Organs with high perfusion
- B.
Organs with low perfusion
Correct Answer
A. Organs with high perfusion -
- 10.
In order for anesthetics to work they have to block the action potential. How do they do this?
- A.
By blocking pottassium channels
- B.
By blocking sodium channels
- C.
By blocking release of acetylcholine from the presynaptic neuron
- D.
By blocking chloride channels
Correct Answer
B. By blocking sodium channels -
- 11.
Which molecules would have a faster onset?
- A.
Lipophilic molecules
- B.
Hydrophilic molecules
Correct Answer
A. LipopHilic molecules -
- 12.
Smaller lipophilic molecules have a faster onet. Do they also have a long duration?
- A.
Yes
- B.
No
Correct Answer
A. Yes -
- 13.
What types of anesthetics should be used for long precedures?
- A.
Longer acting anesthetics
- B.
Shorter acting anesthetics
Correct Answer
A. Longer acting anesthetics -
- 14.
Which anesthetics should be used for a long procedure?
- A.
Water soluble
- B.
Lipophilic
Correct Answer
B. LipopHilicExplanation
Water soluble anesthetics have a shorter duration.Rate this question:
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- 15.
Lidocaine, mepivaciane and procaines (novocain) are lipophilic or water soluble?
- A.
Lipophilic
- B.
Water soluble
Correct Answer
B. Water soluble -
- 16.
Would you use procaine for a long or a short procedure?
- A.
Long procedure
- B.
Short procedure
Correct Answer
B. Short procedureExplanation
Because it is hydrophilic and therefore has a shorter duration of action.Rate this question:
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- 17.
A patient who has received an local anesthetic complains of a metallic taste in their mouth and a feeling of numbness around their mouth (cirumoral numbing). Are these symptoms reflective of a high or a low concentration of the local anesthetic?
- A.
High dose
- B.
Low dose
Correct Answer
B. Low dose -
- 18.
Do you need a high concentration of a local anesthetic in order to induce sedation in a patient?
- A.
Yes
- B.
No
Correct Answer
B. No -
- 19.
Death is most definitiely resultant of a high concentration of a local anesthetic, what about nystagmus, do you need a high or a low concentration?
- A.
Nystagmus occurs at high concentrations
- B.
Nystagmus occurs at low concentrations
Correct Answer
A. Nystagmus occurs at high concentrations -
- 20.
Between audio-visual disturbances and convulsions, which one occurs at high concentations?
- A.
Audio-visual disturbances
- B.
Convulsions
Correct Answer
B. Convulsions -
- 21.
In general local anesthetics can cause central nervous system side effects. True or false?
- A.
True
- B.
False
Correct Answer
A. True -
- 22.
In terms of cardiovascular side effects, what channels are blocked when a high concentration of local anesthetics is administered?
- A.
Sodium channels
- B.
Calcium channels
- C.
Pottasium channels
- D.
Chloride channels
Correct Answer
B. Calcium channels -
- 23.
If you block calcium channels because of a high concentration of a local anesthetic you will have increased or decreased conduction?
- A.
Increased conduction
- B.
Decreased conduction
Correct Answer
B. Decreased conduction -
- 24.
Calcium channels are blocked by a high conentration of a local anesthetics resulting in decreased conduction. Would this lead to high or low blood pressure?
- A.
High blood pressure - hypertension
- B.
Low blood pressure - hypotension
Correct Answer
B. Low blood pressure - hypotension -
- 25.
At low concentration of local anesthetics sodium channels are blocked. True or false?
- A.
True
- B.
False
Correct Answer
A. True -
- 26.
If sodium channels are blocked because of a LOW concentration of a local anesthetic the cardiac tissue will experience increased or decreased automaticity?
- A.
Increased automaticity
- B.
Decreased automaticity
Correct Answer
A. Increased automaticity -
- 27.
In other words a low dose of a local anesthetic can block sodium channels, and lead to hyper or hypo excitalbility of cardiac muscle?
- A.
Hyper excitability
- B.
Hypo excitability
Correct Answer
A. Hyper excitability -
- 28.
A dose >10mg/kg of procaine is being prepared to be administered on patient. You walk in and state the following:
- A.
The patient will becone cyanotic because of the oxidation of hemoglobin
- B.
The patient will become cyanotic because of the oxidation of myoglobin
- C.
The patient will becone cyanotic because of the oxidation of iron Fe2+
- D.
The patient will become cynotic because of the reduction of Fe3+
Correct Answer
C. The patient will becone cyanotic because of the oxidation of iron Fe2+ -
- 29.
Local anesthetics can cause cyanosis due to the oxidation of Fe2+ to Fe3+. What is this process all known as?
- A.
Methylhemoglobinemia
- B.
Methomoglobinemia
- C.
Methylmyoglobiuria
Correct Answer
B. Methomoglobinemia -
- 30.
If oxidation of Fe2+ occurs as a result of a local anesthetics what will happen to the patient's respiratory status?
- A.
Shortness of breath
- B.
Hypoventiation
- C.
No change in respiratory status
Correct Answer
A. Shortness of breath -
- 31.
Oxdiation of FE2t to Fe3t with eventual cyanosis as a result of a local anesthetic will lead to cyanosis and shortness of breath. This can also be referred to:
- A.
Chocolate blood
- B.
Thick blood
- C.
Thin blood
- D.
Black blood
Correct Answer
A. Chocolate blood -
- 32.
If a patient has a PABA allergy, do you use an amide or an ester?
- A.
Amide
- B.
Ester
Correct Answer
A. Amide -
- 33.
Which of the following is a sodium channel blocker that also inhibits the reuptake of dopamine and norepi?
- A.
Heroin
- B.
Cannabis
- C.
Coccaine
- D.
Methamphetamine
Correct Answer
C. Coccaine -
- 34.
Is coccaine an amide or an ester?
- A.
Amide
- B.
Ester
Correct Answer
B. Ester -
- 35.
So if someone has taken coccaine and they are thus euphoric which of the following may you observe?
- A.
CNS depression
- B.
CNS stimulation
- C.
Bradycardia
- D.
Tachycardia
- E.
Hypertension
Correct Answer(s)
B. CNS stimulation
D. Tachycardia
E. HypertensionExplanation
The hypertension is from an increased level of dopamine and norepi because of the reduced reuptake.Rate this question:
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- 36.
In other words coccaine can act as a local anesthetic since it blocks sodium channels?
- A.
Yes
- B.
No
Correct Answer
A. Yes -
- 37.
Is there a possibility that a patient who has taken coccaine might develop arrythmias
- A.
Yes
- B.
No
Correct Answer
A. Yes -
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Feb 16, 2019Quiz Edited by
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