Dental Anesthesia MCQs 200 4dd. Dr.Tong Leang
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- 1.
Surface activity and low toxic potential?
- A.
Benzocaine
- B.
Cocaine
- C.
Bupivacaine
- D.
Procaine
- E.
Lidocaine
Correct Answer
A. BenzocaineExplanation
Benzocaine is the correct answer because it exhibits surface activity and has a low toxic potential. Surface activity refers to the ability of a substance to interact with the surface of a material or tissue. Benzocaine is commonly used as a topical anesthetic, meaning it is applied directly to the surface of the skin or mucous membranes to numb the area. It is known for its low toxicity, meaning it is relatively safe to use and has a low risk of causing harmful side effects.Rate this question:
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- 2.
Which of the following drugs can cause methemoglonemia?
- A.
Prilocaine
- B.
Cocaine
- C.
Lidocaine
- D.
Bupivacaine
- E.
Procaine
Correct Answer
A. PrilocaineExplanation
Prilocaine is a local anesthetic that can cause methemoglobinemia. Methemoglobinemia is a condition where the iron in hemoglobin is oxidized to the ferric state, resulting in reduced oxygen-carrying capacity of the blood. Prilocaine is metabolized in the body to o-toluidine, which causes the oxidation of hemoglobin. This can lead to symptoms such as cyanosis, shortness of breath, and fatigue. Treatment involves administration of methylene blue, which helps to convert methemoglobin back to its normal state.Rate this question:
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- 3.
Vasoconstrictor in Local anesthetic solution is?
- A.
Reduce toxic effects of LA solution
- B.
Decreases depth & duration of LA
- C.
Increase bleeding
- D.
Increase toxic effects of LA
- E.
Has no effect on efficacy LA solution
Correct Answer
A. Reduce toxic effects of LA solutionExplanation
The vasoconstrictor in a local anesthetic solution helps to reduce the toxic effects of the solution. Vasoconstriction narrows the blood vessels at the site of injection, which in turn reduces the absorption of the anesthetic into the bloodstream. This helps to minimize the systemic toxicity of the local anesthetic, making it safer for use.Rate this question:
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- 4.
When injecting Local solutionin maxilla on buccal side. The technique is ?
- A.
Supra periosteal
- B.
Sup periosteal
- C.
Sup mucosal
- D.
Intra osseous
- E.
Intra septal
Correct Answer
A. Supra periostealExplanation
The correct technique for injecting a local solution in the maxilla on the buccal side is the supra periosteal technique. This involves injecting the solution just above the periosteum, which is the membrane that covers the outer surface of the bone. This technique allows for effective anesthesia in the area and helps to minimize discomfort for the patient.Rate this question:
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- 5.
Disto buccal root of upper first molar is supplied by:?
- A.
Posterior superior alveolar nerve
- B.
Middle superior alveolar nerve
- C.
Infra orbital nerve
- D.
Mental nerve
- E.
Buccal nerve
Correct Answer
A. Posterior superior alveolar nerveExplanation
The disto buccal root of the upper first molar is supplied by the posterior superior alveolar nerve. This nerve is a branch of the maxillary nerve and provides sensory innervation to the maxillary molars, including the disto buccal root of the upper first molar. The middle superior alveolar nerve supplies the mesiobuccal root of the upper first molar, while the infraorbital nerve supplies the anterior teeth and the buccal nerve supplies the buccal mucosa. The mental nerve supplies the lower anterior teeth.Rate this question:
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- 6.
Technique of anesthesia in which local anesthetic solution is injected into the vein is ?
- A.
Intra venous regional anesthesia
- B.
Nerve block
- C.
Infiltration anesthesia
- D.
Epidural anesthesia
- E.
No such technique exists.
Correct Answer
A. Intra venous regional anesthesiaExplanation
Intra venous regional anesthesia is the technique of anesthesia in which a local anesthetic solution is injected into the vein. This allows for the anesthetic to be distributed throughout the body via the bloodstream, providing a regional anesthesia effect. This technique is commonly used for procedures that require a larger area of the body to be numbed or for longer durations of anesthesia.Rate this question:
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- 7.
You suspect that your patient has an enlarged submandibular salivary gland. You expect the enlarged gland?
- A.
To be palpable both intra- and extraorally
- B.
To be palpable intraorally
- C.
To be palpable extraorally.
- D.
Only to be detectable by radiographical examination.
Correct Answer
A. To be palpable both intra- and extraorallyExplanation
An enlarged submandibular salivary gland is expected to be palpable both intra- and extraorally. This means that the enlargement can be felt both inside the mouth and outside, on the surface of the neck. Palpation is a physical examination technique where the healthcare provider uses their hands to feel for abnormalities or changes in the body. In this case, the enlarged gland can be felt by touch, indicating its presence and size. This information can help in diagnosing and treating the patient's condition.Rate this question:
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- 8.
During an inferior alveolar nerve block the needle ideally passes?
- A.
Anterior and lateral to medial pterygoid
- B.
Posterior and medial to medial pterygoid.
- C.
Through medial pterygoid
- D.
Inferior to medial pterygoid.
Correct Answer
A. Anterior and lateral to medial pterygoidExplanation
During an inferior alveolar nerve block, the needle ideally passes anterior and lateral to the medial pterygoid muscle. This positioning allows for accurate administration of the anesthetic solution to the inferior alveolar nerve, which is located in close proximity to the medial pterygoid muscle. By passing the needle anterior and lateral to the muscle, the risk of damaging the nerve or other surrounding structures is minimized, ensuring a successful and safe nerve block procedure.Rate this question:
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- 9.
You notice that your patient's submandibular lymph nodes are enlarged. You would look for potential infection sites in the?
- A.
Hard palate, upper lip, upper central incisor and lower first molar
- B.
Hard palate.
- C.
Hard palate and upper lip.
- D.
Hard palate, upper lip and upper central incisor.
Correct Answer
A. Hard palate, upper lip, upper central incisor and lower first molarExplanation
The correct answer is hard palate, upper lip, upper central incisor and lower first molar. Enlarged submandibular lymph nodes can indicate an infection in the head and neck region. The lymph nodes drain lymphatic fluid from these areas, so an infection in the hard palate, upper lip, upper central incisor, or lower first molar could cause the lymph nodes to become enlarged. By examining these potential infection sites, the healthcare professional can determine the source of the infection and provide appropriate treatment.Rate this question:
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- 10.
You notice a lesion on the labial alveolar mucosa of the lower right lateral incisor tooth of one of your patients and decide to take a biopsy to send for oral pathology report Which nerve would require local anesthesia in order to carry out a pain-free biopsy?
- A.
The incisive nerve
- B.
The buccal nerve
- C.
The lingual nerve
Correct Answer
A. The incisive nerveExplanation
The incisive nerve would require local anesthesia in order to carry out a pain-free biopsy. The incisive nerve is responsible for providing sensory innervation to the labial alveolar mucosa of the lower anterior teeth, including the lateral incisor tooth. By administering local anesthesia to the incisive nerve, the patient will not feel any pain during the biopsy procedure.Rate this question:
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- 11.
The regional lymphatic drainage of the left side of the tip of the tongue is to the?
- A.
Left and right submental lymph nodes
- B.
Left submental lymph node.
- C.
Left submandibular lymph node.
- D.
Left and right submandibular lymph nodes.
Correct Answer
A. Left and right submental lympH nodesExplanation
The regional lymphatic drainage of the left side of the tip of the tongue is to the left and right submental lymph nodes. These lymph nodes are located beneath the chin, near the midline. They receive lymphatic drainage from the tongue, floor of the mouth, and lower lip. The submental lymph nodes are part of the submandibular lymph node group, which also includes the submandibular lymph nodes. However, in this case, the drainage is specifically to the submental lymph nodes on both the left and right sides.Rate this question:
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- 12.
A successful inferior alveolar nerve block will produce anesthesia of the?
- A.
Lower lip, mandibular teeth and labial gingivae of the anterior mandibular teeth
- B.
Lower lip.
- C.
Lower lip and mandibular teeth.
- D.
Lower lip, mandibular teeth and labial gingivae of the anterior and buccal gingivae of the posterior mandibular teeth.
Correct Answer
A. Lower lip, mandibular teeth and labial gingivae of the anterior mandibular teethExplanation
A successful inferior alveolar nerve block will produce anesthesia of the lower lip, mandibular teeth, and labial gingivae of the anterior mandibular teeth. This is because the inferior alveolar nerve supplies sensory innervation to these areas.Rate this question:
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- 13.
The mucosa of the hard palate is?
- A.
Keratinised and has submucosa and minor salivary glands posterolaterally
- B.
Non-keratinised and has submucosa and minor salivary glands posteromedially
- C.
Keratinised and lacks submucosa and minor salivary glands.
- D.
Non-keratinised and lacks submucosa and minor salivary glands.
Correct Answer
A. Keratinised and has submucosa and minor salivary glands posterolaterallyExplanation
The correct answer is "keratinised and has submucosa and minor salivary glands posterolaterally." The hard palate is the bony structure that forms the roof of the mouth. The mucosa of the hard palate is keratinized, which means it has a tough outer layer of keratin, similar to the skin. It also has a submucosa, which is a layer of connective tissue beneath the mucosa. Additionally, there are minor salivary glands located posterolaterally on the hard palate, which contribute to saliva production.Rate this question:
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- 14.
A successful infraorbital nerve block will produce anaesthesia of the?
- A.
Maxillary anterior teeth, their labial gingivae and the upper lip
- B.
Maxillary anterior teeth.
- C.
Maxillary anterior teeth and their labial gingivae.
- D.
Maxillary anterior teeth, their labial gingivae, the upper lip and anterior hard palate
Correct Answer
A. Maxillary anterior teeth, their labial gingivae and the upper lipExplanation
A successful infraorbital nerve block will produce anesthesia of the maxillary anterior teeth, their labial gingivae, and the upper lip. This is because the infraorbital nerve supplies sensory innervation to these areas.Rate this question:
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- 15.
In a patient with a normal healthy mouth, you would expect the mucosa covering the alveolar process supporting the mandibular teeth to be?
- A.
Ed below the mucogingival junction and light pink above it
- B.
Light pink in colour on both sides of the mucogingigival junction.
- C.
Light pink below the mucogingival junction and red above it.
- D.
Red on both sides of the mucogingival junction
Correct Answer
A. Ed below the mucogingival junction and light pink above itExplanation
In a patient with a normal healthy mouth, the mucosa covering the alveolar process supporting the mandibular teeth would be expected to be light pink in color below the mucogingival junction and light pink above it. This is because the mucogingival junction is the area where the attached gingiva meets the alveolar mucosa, and the color of the mucosa can vary in different areas. The light pink color indicates a healthy and normal mucosal appearance.Rate this question:
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- 16.
Advantage(s) of 5% lidocaine (Xylocaine
- A.
No local irritation, even absorption and no systemic toxicity
- B.
Prilocaine (Citanest) cream (eutectic mixture) is?
- C.
No local irritation
- D.
Even absorption
- E.
No systemic toxicity
Correct Answer
A. No local irritation, even absorption and no systemic toxicityExplanation
The advantage of using 5% lidocaine (Xylocaine) cream is that it does not cause any local irritation, it is absorbed evenly, and it does not pose any risk of systemic toxicity. This means that the cream can be applied to the skin without causing any discomfort or irritation at the application site. Additionally, the lidocaine is absorbed evenly into the skin, ensuring consistent and effective pain relief. Furthermore, there is no risk of the lidocaine entering the bloodstream and causing any toxic effects on the body.Rate this question:
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- 17.
Local anesthetic used in greater than 50% of rhinolaryngologic cases:?
- A.
Cocaine
- B.
Prilocaine (Citanest)
- C.
Mepivacaine (Carbocaine)
- D.
Bupivacaine (Marcaine)
- E.
Tetracaine (pontocaine)
Correct Answer
A. CocaineExplanation
Cocaine is the correct answer because it is a local anesthetic that is commonly used in rhinolaryngologic cases. It has vasoconstrictive properties which help to reduce bleeding during procedures in the nose and throat. Additionally, cocaine has a rapid onset of action and provides effective anesthesia for a relatively short duration, making it suitable for these types of procedures. However, it is important to note that due to its potential for abuse and addictive properties, the use of cocaine as a local anesthetic is highly regulated and restricted.Rate this question:
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- 18.
Mechanism(s) of local anesthetic action in epidural anesthesia:?
- A.
Direct local anesthetic action on nerve roots and spinal cord following local anesthetic diffusion across the dura and diffusion of local anesthetic into paravertebral regions through the intervertebral foramina
- B.
Direct local anesthetic action on nerve roots and spinal cord following local anesthetic diffusion across the dura
- C.
Diffusion of local anesthetic into paravertebral regions through the intervertebral foramina
- D.
Neither
Correct Answer
A. Direct local anesthetic action on nerve roots and spinal cord following local anesthetic diffusion across the dura and diffusion of local anesthetic into paravertebral regions through the intervertebral foraminaExplanation
The correct answer is that the mechanism of local anesthetic action in epidural anesthesia involves both direct local anesthetic action on nerve roots and spinal cord following local anesthetic diffusion across the dura, as well as diffusion of the local anesthetic into paravertebral regions through the intervertebral foramina. This means that the local anesthetic directly affects the nerves and spinal cord, and also spreads to the surrounding areas through the intervertebral foramina, providing a wider area of anesthesia.Rate this question:
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- 19.
Rationale for adding epinephrine to a local anesthetic solution:?
- A.
Reduced local anesthetic systemic absorption and increased anesthetic concentration near nerve fibers
- B.
Reduced local anesthetic systemic absorption
- C.
Increased anesthetic concentration near nerve fibers
- D.
Reduced duration of conduction blockade
- E.
All of the above
Correct Answer
A. Reduced local anesthetic systemic absorption and increased anesthetic concentration near nerve fibersExplanation
The rationale for adding epinephrine to a local anesthetic solution is to achieve reduced local anesthetic systemic absorption and increased anesthetic concentration near nerve fibers. Epinephrine acts as a vasoconstrictor, causing constriction of blood vessels at the site of administration. This reduces the systemic absorption of the local anesthetic, preventing it from spreading throughout the body. At the same time, the vasoconstriction also helps in keeping the anesthetic solution concentrated near the nerve fibers, enhancing its effectiveness in blocking nerve conduction. Therefore, adding epinephrine to a local anesthetic solution provides both benefits of reduced systemic absorption and increased concentration near the target area.Rate this question:
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- 20.
Zone of differential motor blockade may average up to four segments below the sensory level?
- A.
Epidural
- B.
Spinal
- C.
Epidural and Spinal
Correct Answer
A. EpiduralExplanation
The zone of differential motor blockade refers to the area where motor function is affected by anesthesia. In the case of epidural anesthesia, the motor blockade can extend up to four segments below the sensory level. This means that the muscles controlled by the affected nerves may experience decreased or loss of motor function. In contrast, spinal anesthesia typically only affects the sensory level without significant motor blockade. Therefore, the correct answer is epidural.Rate this question:
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- 21.
Duration of sensory anesthesia is likely to be extended for abdominal regional anesthesia?
- A.
False
- B.
True
- C.
.
- D.
.
Correct Answer
A. FalseExplanation
The given statement is "Duration of sensory anesthesia is likely to be extended for abdominal regional anesthesia." The correct answer is False. This means that the duration of sensory anesthesia is not likely to be extended for abdominal regional anesthesia. This suggests that the effect of the anesthesia on the sensory nerves in the abdominal region is not expected to last longer than usual.Rate this question:
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- 22.
Primary side effect/toxicities associated with local anesthetic use:?
- A.
Allergic reactions and systemic toxicity
- B.
Allergic reactions
- C.
Systemic toxicity
- D.
Neither
Correct Answer
A. Allergic reactions and systemic toxicityExplanation
The primary side effects/toxicities associated with local anesthetic use are allergic reactions and systemic toxicity. Allergic reactions can occur in response to the local anesthetic, leading to symptoms such as rash, itching, and difficulty breathing. Systemic toxicity can also occur, where the local anesthetic enters the bloodstream and affects the central nervous system, leading to symptoms such as dizziness, confusion, seizures, and even cardiac arrest.Rate this question:
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- 23.
Factors enhancing bupivacaine (Marcaine) toxicity?
- A.
Pregnancy, presence of calcium channel blockers, arterial hypoxemia, acidosis and hypercarbia
- B.
Pregnancy
- C.
Presence of calcium channel blockers
- D.
Arterial hypoxemia
- E.
Acidosis and hypercarbia
Correct Answer
A. Pregnancy, presence of calcium channel blockers, arterial hypoxemia, acidosis and hypercarbiaExplanation
Bupivacaine (Marcaine) is a local anesthetic that is commonly used for pain relief during childbirth or surgery. However, it can be toxic if excessive amounts are absorbed into the bloodstream. Pregnancy can enhance the toxicity of bupivacaine due to physiological changes that occur during pregnancy, such as increased blood volume and decreased protein binding of the drug. Calcium channel blockers, which are medications used to treat hypertension and certain heart conditions, can also enhance bupivacaine toxicity by inhibiting the metabolism and elimination of the drug. Arterial hypoxemia, which is low oxygen levels in the blood, can decrease the body's ability to metabolize and eliminate bupivacaine, leading to increased toxicity. Acidosis, a condition characterized by increased acidity in the blood, and hypercarbia, elevated levels of carbon dioxide in the blood, can also enhance bupivacaine toxicity by impairing its metabolism and elimination.Rate this question:
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- 24.
Agents added to local anesthetics that prolonged local anesthetic duration of action?
- A.
Epinephrine, phenylephrine (Neo-Synephrine) and dextran
- B.
Epinephrine
- C.
Phenylephrine (Neo-Synephrine)
- D.
Dextran
Correct Answer
A. EpinepHrine, pHenylepHrine (Neo-SynepHrine) and dextranExplanation
Epinephrine, phenylephrine (Neo-Synephrine), and dextran are all agents that can be added to local anesthetics to prolong their duration of action. Epinephrine is a vasoconstrictor that reduces blood flow to the site of administration, thereby slowing down the absorption and metabolism of the local anesthetic. Phenylephrine also acts as a vasoconstrictor and can enhance the effects of the local anesthetic. Dextran is a substance that increases the viscosity of the local anesthetic solution, allowing for a slower release and prolonged effect. Therefore, the addition of these agents can help to extend the duration of action of local anesthetics.Rate this question:
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- 25.
Typically a zone of differential sympathetic nervous system blockade?
- A.
Spinal
- B.
Epidural
- C.
Epidural and spinal
Correct Answer
A. SpinalExplanation
A zone of differential sympathetic nervous system blockade typically occurs with a spinal anesthesia. This type of anesthesia involves injecting medication directly into the cerebrospinal fluid in the spinal canal, which blocks the transmission of nerve signals. As a result, the sympathetic nervous system, which controls involuntary bodily functions such as heart rate and blood pressure, is selectively blocked in the area below the level of the injection. This allows for targeted pain relief and anesthesia in the specific region where the medication is administered.Rate this question:
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- 26.
Preferred local anesthetics for local infiltration:?
- A.
Lidocaine (Xylocaine), ropivacaine (Naropin) and bupivacaine (Marcaine)
- B.
Lidocaine (Xylocaine)
- C.
Ropivacaine (Naropin)
- D.
Bupivacaine (Marcaine)
Correct Answer
A. Lidocaine (Xylocaine), ropivacaine (Naropin) and bupivacaine (Marcaine)Explanation
Lidocaine (Xylocaine), ropivacaine (Naropin), and bupivacaine (Marcaine) are all preferred local anesthetics for local infiltration. These medications are commonly used to numb a specific area of the body during minor surgical procedures or dental work. They work by blocking nerve signals in the area, preventing the sensation of pain. Lidocaine is a commonly used local anesthetic due to its fast onset and relatively short duration of action. Ropivacaine and bupivacaine are longer-acting local anesthetics that provide prolonged pain relief. The combination of these three medications offers a range of options for healthcare providers to choose from based on the specific needs of the patient and procedure.Rate this question:
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- 27.
Neurotoxicity associate with local anesthesia: sensory anesthesia, bowell & bladder sphincter dysfunction, paraplegia -- may because by nonhomogeneous local anesthetic distribution?
- A.
Cauda equina syndrome
- B.
Anterior spinal artery syndrome
- C.
Transient radicular irritation
Correct Answer
A. Cauda equina syndromeExplanation
Cauda equina syndrome is a condition that occurs when the nerves at the base of the spinal cord, known as the cauda equina, become compressed. This compression can lead to symptoms such as sensory anesthesia, dysfunction of the bowell and bladder sphincters, and even paraplegia. In the context of neurotoxicity associated with local anesthesia, it is possible that the nonhomogeneous distribution of the anesthetic could result in compression of the cauda equina nerves, leading to the development of cauda equina syndrome.Rate this question:
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- 28.
Neurotoxicity -- moderate/severe lower back, buttocks, posterior side pain?
- A.
Transient radicular irritation
- B.
Cauda equina syndrome
- C.
Anterior spinal artery syndrome
Correct Answer
A. Transient radicular irritationExplanation
Transient radicular irritation is a condition characterized by moderate to severe pain in the lower back, buttocks, and posterior side. It is caused by irritation of the nerve roots in the spinal cord, often due to trauma or inflammation. This condition is usually temporary and resolves on its own. Cauda equina syndrome, on the other hand, is a more serious condition that involves compression of the nerve roots in the lower spinal cord, resulting in severe lower back pain, weakness, and bladder or bowel dysfunction. Anterior spinal artery syndrome is a rare condition caused by a blockage in the artery supplying blood to the spinal cord, leading to severe pain and paralysis.Rate this question:
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- 29.
Factors that influence lidocaine (Xylocaine) metabolism:?
- A.
Pregnancy-induced hypertension, hepatic disease, reduced liver blood flow and volatile anesthetics
- B.
Pregnancy-induced hypertension
- C.
Hepatic disease
- D.
Reduced liver blood flow
- E.
Volatile anesthetics
Correct Answer
A. Pregnancy-induced hypertension, hepatic disease, reduced liver blood flow and volatile anestheticsExplanation
Lidocaine (Xylocaine) is a medication used for local anesthesia. Its metabolism can be influenced by various factors. Pregnancy-induced hypertension, hepatic disease, reduced liver blood flow, and volatile anesthetics are all factors that can affect the metabolism of lidocaine. Pregnancy-induced hypertension can alter the body's ability to metabolize lidocaine, while hepatic disease can impair liver function and affect lidocaine metabolism. Reduced liver blood flow can also impact the metabolism of lidocaine. Additionally, the presence of volatile anesthetics can interact with lidocaine and affect its metabolism.Rate this question:
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- 30.
Most common cause of toxic plasma local anesthetic concentrations?
- A.
Accidental direct intravascular injection during block
- B.
Incorrect dosage during peripheral or block
- C.
Increase vasoconstrictors solution in the anesthetic
- D.
Without solution of vasoconstrictors for anesthetic
Correct Answer
A. Accidental direct intravascular injection during blockExplanation
Accidental direct intravascular injection during a block is the most common cause of toxic plasma local anesthetic concentrations. This occurs when the local anesthetic is inadvertently injected into a blood vessel, leading to rapid absorption into the systemic circulation and potentially toxic levels of the drug in the plasma. This can result in systemic toxicity and adverse effects on the central nervous system, cardiovascular system, and other organ systems. It is important for healthcare professionals to take precautions and use proper techniques to minimize the risk of intravascular injection during local anesthetic administration.Rate this question:
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- 31.
Common eutectic mixture of local anesthetics (EMLA)?
- A.
Lidocaine (Xylocaine) and prilocaine (Citanest)
- B.
Tetracaine (pontocaine) and epinephrine
- C.
Lidocaine (Xylocaine) and tetracaine (pontocaine)
- D.
Prilocaine (Citanest) and bupivacaine (Marcaine)
- E.
Tetracaine (pontocaine) and bupivacaine (Marcaine)
Correct Answer
A. Lidocaine (Xylocaine) and prilocaine (Citanest)Explanation
The common eutectic mixture of local anesthetics (EMLA) is lidocaine (Xylocaine) and prilocaine (Citanest). This combination is often used as a topical anesthetic to numb the skin before certain medical procedures. Lidocaine is a fast-acting local anesthetic that works by blocking nerve signals in the area where it is applied, while prilocaine helps to enhance the numbing effect. Together, they provide effective pain relief for minor procedures such as needle insertions, skin grafts, and the removal of warts or moles.Rate this question:
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- 32.
Most frequent local anesthetic clinical use:?
- A.
Regional anesthetia
- B.
Treatment of grand mal seizure
- C.
Analgesia
- D.
Management of cardiac arrhythmias
- E.
Management of increased intracranial pressure
Correct Answer
A. Regional anesthetiaExplanation
The correct answer is regional anesthesia. Regional anesthesia refers to the administration of local anesthetic agents to block nerve transmission in a specific region of the body, resulting in loss of sensation and motor function. It is commonly used in surgical procedures to provide pain relief and allow for a pain-free operation. This technique is preferred over general anesthesia in certain cases as it has fewer systemic side effects and allows for faster recovery.Rate this question:
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- 33.
Lidocaine (Xylocaine) effect on ventilation response to hypoxia?
- A.
Depressed response
- B.
Enhanced response
- C.
No effect
- D.
Enhanced response and no effect
Correct Answer
A. Depressed responseExplanation
Lidocaine, also known as Xylocaine, depresses the response of ventilation to hypoxia. This means that when exposed to low oxygen levels, the body's natural reaction to increase ventilation and oxygen intake is reduced or suppressed when lidocaine is present.Rate this question:
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- 34.
Clinical use(s) of EMLA applications:?
- A.
Lumbar puncture
- B.
Arterial cannulation
- C.
Venipuncture
- D.
Myringotomy
Correct Answer
A. Lumbar punctureExplanation
EMLA applications are used in clinical settings for various procedures such as lumbar puncture, arterial cannulation, venipuncture, and myringotomy. In this case, the correct answer is lumbar puncture, indicating that EMLA can be applied during this procedure. EMLA is a topical anesthetic cream that contains lidocaine and prilocaine, which helps numb the skin and reduce pain during medical interventions. It is commonly used for procedures that involve needle insertion, such as lumbar puncture, where a needle is inserted into the spinal canal to collect cerebrospinal fluid for diagnostic purposes.Rate this question:
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- 35.
Allergic reactions to local anesthetics:?
- A.
High-risk with ester-type agents which are metabolized to p-aminobenzoic acid-related compounds and intradermal testing for possible allergy to local anesthetics should use preservative-free drug
- B.
Common > 10% of adverse reactions due to allergic mechanisms
- C.
High-risk with ester-type agents which are metabolized to p-aminobenzoic acid-related compounds
- D.
Cross-sensitivity between esters and amide-type local anesthetics are common
- E.
Intradermal testing for possible allergy to local anesthetics should use preservative-free drug
Correct Answer
A. High-risk with ester-type agents which are metabolized to p-aminobenzoic acid-related compounds and intradermal testing for possible allergy to local anesthetics should use preservative-free drugExplanation
Allergic reactions to local anesthetics are more likely to occur with ester-type agents, as they are metabolized to p-aminobenzoic acid-related compounds. Intradermal testing for possible allergy to local anesthetics should use preservative-free drugs to minimize the risk of allergic reactions. Cross-sensitivity between esters and amide-type local anesthetics is also common, further increasing the risk of allergic reactions. Therefore, the statement "high-risk with ester-type agents which are metabolized to p-aminobenzoic acid-related compounds and intradermal testing for possible allergy to local anesthetics should use preservative-free drug" accurately summarizes the information provided.Rate this question:
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- 36.
Factors which increase local anesthetic CNS toxicities:?
- A.
Rate of injection, patient receiving mexiletine (Mexitil) when lidocaine (Xylocaine) is used and high PaCO2 (reduced local anesthetic seizure threshold)
- B.
Hypokalemia
- C.
Rate of injection
- D.
Patient receiving mexiletine (Mexitil) when lidocaine (Xylocaine) is used
- E.
High PaCO2 (reduced local anesthetic seizure threshold)
Correct Answer
A. Rate of injection, patient receiving mexiletine (Mexitil) when lidocaine (Xylocaine) is used and high PaCO2 (reduced local anesthetic seizure threshold)Explanation
The factors that increase local anesthetic CNS toxicities are the rate of injection, patient receiving mexiletine (Mexitil) when lidocaine (Xylocaine) is used, and high PaCO2 (reduced local anesthetic seizure threshold).Rate this question:
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- 37.
Least likely to exhibit cross-sensitivity with amide or ester local anesthetics.?
- A.
Dyclonine (Dyclone)
- B.
Lidocaine (Xylocaine)
- C.
Tetracaine (pontocaine)
- D.
Mepivacaine (Carbocaine)
- E.
Bupivacaine (Marcaine)
Correct Answer
A. Dyclonine (Dyclone)Explanation
Dyclonine is least likely to exhibit cross-sensitivity with amide or ester local anesthetics. This means that it is less likely to cause an allergic reaction or sensitivity in individuals who have previously had a reaction to other local anesthetics. Cross-sensitivity occurs when a person has an allergic reaction to one substance and then develops a similar reaction to another substance that is structurally similar. In this case, dyclonine is less structurally similar to amide or ester local anesthetics compared to the other options, making it less likely to cause cross-sensitivity.Rate this question:
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- 38.
Factor(s) that reduce lidocaine (Xylocaine) seizure threshold.?
- A.
Hypoxemia, Hyperkalemia and Acidosis
- B.
Hypoxemia
- C.
Hyperkalemia
- D.
Acidosis
Correct Answer
A. Hypoxemia, Hyperkalemia and AcidosisExplanation
Hypoxemia, hyperkalemia, and acidosis are all factors that can reduce the seizure threshold of lidocaine (Xylocaine). Hypoxemia refers to low levels of oxygen in the blood, which can impair brain function and increase the risk of seizures. Hyperkalemia is an elevated level of potassium in the blood, which can disrupt the electrical activity of the brain and make it more prone to seizures. Acidosis is a condition characterized by excessive acidity in the blood, which can also interfere with normal brain function and lower the seizure threshold. Therefore, the presence of any of these factors can increase the likelihood of experiencing seizures when using lidocaine.Rate this question:
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- 39.
Local anesthetic which produces localized vasoconstriction and anesthesia?
- A.
cocaine
- B.
Tetracaine (pontocaine)
- C.
Lidocaine (Xylocaine)
- D.
Prilocaine (Citanest)
- E.
Chloroprocaine (Nesacaine)
Correct Answer
A. cocaineExplanation
Cocaine is a local anesthetic that produces localized vasoconstriction and anesthesia. It works by blocking the transmission of nerve signals, which leads to numbness and loss of sensation in the area where it is applied. Additionally, cocaine also causes vasoconstriction, which helps to reduce bleeding and prolong the effects of anesthesia.Rate this question:
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- 40.
Agents not recommended for Bier block:
- A.
chloroprocaine (Nesacaine), mepivacaine (Carbocaine), and bupivacaine (Marcaine)
- B.
Chloroprocaine (Nesacaine
- C.
Mepivacaine (Carbocaine)
- D.
Bupivacaine (Marcaine)
Correct Answer
A. chloroprocaine (Nesacaine), mepivacaine (Carbocaine), and bupivacaine (Marcaine) -
- 41.
Manifestation of systemic toxicity
- A.
CNS toxicity, cardiovascular toxicity and neurological symptoms
- B.
CNS toxicity
- C.
Cardiovascular toxicity
- D.
Neurological symptoms
Correct Answer
A. CNS toxicity, cardiovascular toxicity and neurological symptomsExplanation
This answer suggests that the manifestation of systemic toxicity can include CNS toxicity, cardiovascular toxicity, and neurological symptoms. This means that when a substance or condition causes toxicity in the body, it can affect the central nervous system, the cardiovascular system, and result in various neurological symptoms.Rate this question:
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- 42.
Most commonly used local anesthetic for rhinolaryngologic cases
- A.
Cocaine
- B.
Ropivacaine (Naropin)
- C.
Bupivacaine (Marcaine)
- D.
Mepivacaine (Carbocaine)
- E.
Tetracaine (pontocaine)
Correct Answer
A. CocaineExplanation
Cocaine is the most commonly used local anesthetic for rhinolaryngologic cases. This is because it has potent vasoconstrictive properties, which helps in reducing bleeding during the procedure. It also provides effective anesthesia and has a rapid onset of action.Rate this question:
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- 43.
Commonly use local anesthetics for topical/surface application:
- A.
Lidocaine (Xylocaine), tetracaine (pontocaine) and cocaine
- B.
Chloroprocaine (Nesacaine)
- C.
Lidocaine (Xylocaine)
- D.
Tetracaine (pontocaine)
- E.
Cocaine
Correct Answer
A. Lidocaine (Xylocaine), tetracaine (pontocaine) and cocaineExplanation
Lidocaine (Xylocaine), tetracaine (Pontocaine), and cocaine are commonly used local anesthetics for topical/surface application. These medications are applied directly to the skin or mucous membranes to numb the area and provide pain relief. Lidocaine and tetracaine are widely used for various procedures, such as minor surgeries, dental work, and dermatological procedures. However, cocaine, although historically used as a local anesthetic, is now primarily a controlled substance due to its potential for abuse and addiction.Rate this question:
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- 44.
Clinical presentations suggestive of local anesthetic allergies:
- A.
All are correct
- B.
Rash
- C.
Laryngeal edema
- D.
Bronchospasm
- E.
Urticarial and possibly hypotension
Correct Answer
A. All are correctExplanation
All of the listed clinical presentations, including rash, laryngeal edema, bronchospasm, urticaria, and possibly hypotension, are suggestive of local anesthetic allergies. These symptoms can indicate an allergic reaction to the local anesthetic, which can range from mild to severe. It is important to recognize and address these symptoms promptly to prevent any further complications or adverse reactions.Rate this question:
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- 45.
Local anesthetic most likely to cause cyanosis secondary to reduced oxygen transport:
- A.
Prilocaine (Citanest)
- B.
Lidocaine (Xylocaine)
- C.
Bupivacaine (Marcaine)
- D.
Dibucaine (Nupercainal, generic)
- E.
Procaine (Novocain)
Correct Answer
A. Prilocaine (Citanest)Explanation
Prilocaine is the most likely local anesthetic to cause cyanosis secondary to reduced oxygen transport. This is because prilocaine has a higher affinity for binding to hemoglobin compared to other local anesthetics. When prilocaine binds to hemoglobin, it reduces the ability of hemoglobin to carry oxygen, leading to a decrease in oxygen transport to tissues. This can result in cyanosis, a bluish discoloration of the skin and mucous membranes due to inadequate oxygenation. Lidocaine, bupivacaine, dibucaine, and procaine have lower affinity for hemoglobin and are less likely to cause cyanosis.Rate this question:
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- 46.
This amide-type local anesthetic is used to assess the possible presence of atypical cholinesterase
- A.
Dibucaine (Nupercainal, generic)
- B.
Ropivacaine (Naropin)
- C.
Bupivacaine (Marcaine)
- D.
Procaine (Novocain)
- E.
Chloroprocaine (Nesacaine)
Correct Answer
A. Dibucaine (Nupercainal, generic)Explanation
Dibucaine is an amide-type local anesthetic that is specifically used to assess the possible presence of atypical cholinesterase. Atypical cholinesterase is a genetic variant of the enzyme cholinesterase, which is responsible for breaking down certain medications, including local anesthetics. Dibucaine is used as a diagnostic tool to determine if an individual has this genetic variant, as it produces a different response in individuals with atypical cholinesterase compared to those with normal cholinesterase. Therefore, dibucaine is the correct answer in this case.Rate this question:
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- 47.
Toxicities associated with systemic epinephrine absorption following local anesthetic use with epinephrine included in the local anesthetic solution
- A.
Hypertension and Arrhythmias
- B.
Hypertension
- C.
Arrhythmias
- D.
Neither
Correct Answer
A. Hypertension and ArrhythmiasExplanation
Systemic absorption of epinephrine, which is included in the local anesthetic solution, can lead to toxicities such as hypertension and arrhythmias. Epinephrine is a vasoconstrictor that can cause an increase in blood pressure, leading to hypertension. Additionally, it can affect the electrical conduction system of the heart, resulting in arrhythmias. Therefore, both hypertension and arrhythmias are potential adverse effects associated with systemic epinephrine absorption following local anesthetic use.Rate this question:
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- 48.
Ropivacaine (Naropin):less cardiotoxic then bupivacaine (Marcaine)
- A.
True
- B.
False
- C.
.
- D.
.
Correct Answer
A. TrueExplanation
Ropivacaine (Naropin) is indeed less cardiotoxic than bupivacaine (Marcaine). Cardiotoxicity refers to the potential of a drug to cause harm to the heart. Ropivacaine, a local anesthetic, has been found to have a lower risk of causing adverse effects on the cardiovascular system compared to bupivacaine. This makes it a safer option for certain medical procedures where local anesthesia is required.Rate this question:
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- 49.
Factor(s) which determine extent of systemic local anesthetic absorption:
- A.
All are not correct
- B.
Initial dose
- C.
Injection site vascularity
- D.
Intrinsic drug properties
- E.
Whether or not epinephrine was used to provide local vasoconstriction
Correct Answer
A. All are not correctExplanation
The extent of systemic local anesthetic absorption is not determined by any of the factors mentioned in the options. The correct answer implies that factors other than the initial dose, injection site vascularity, intrinsic drug properties, or the use of epinephrine for local vasoconstriction play a role in determining the extent of systemic local anesthetic absorption. The question suggests that there are additional factors that need to be considered.Rate this question:
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- 50.
Lidocaine (Xylocaine) cardiotoxicity -- electrophysiological characteristics
- A.
All are not correct
- B.
ECG -PR interval prolongation
- C.
Increased conduction velocity
- D.
Reduced phase 4 depolarization
- E.
Reduced automaticity
Correct Answer
A. All are not correctExplanation
The given answer states that all of the given options are incorrect. This means that ECG - PR interval prolongation, increased conduction velocity, reduced phase 4 depolarization, and reduced automaticity are not electrophysiological characteristics of lidocaine (Xylocaine) cardiotoxicity. However, without further information or context, it is not possible to provide a more detailed explanation.Rate this question:
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