1.
Define Pharmacokinetics.
Correct Answer
C. Is the relationship between the dose of the drug given and its observed plasma concentration and/or tissue concentration
Explanation
Pharmacokinetics refers to the relationship between the dose of a drug administered and its observed concentration in the plasma and/or tissues. It involves understanding how the body processes the drug, including its absorption, distribution, metabolism, and elimination. By studying pharmacokinetics, researchers can determine the optimal dosage and dosing frequency for a drug to achieve the desired therapeutic effect.
2.
Define Pharmacodynamics.
Correct Answer
D. Describes the relationship between the drug concentration and the response.
Explanation
Pharmacodynamics refers to the relationship between the concentration of a drug in the body and the response it produces. It explains how the drug interacts with its target receptors or molecules in the body to produce a therapeutic effect or cause a physiological response. This includes studying the dose-response relationship, understanding the mechanism of action of the drug, and evaluating the time course of the drug's effects. By understanding pharmacodynamics, healthcare professionals can optimize drug dosing and predict the therapeutic outcomes for individual patients.
3.
PK and PD can vary between patients. Â Which of the following would be a reason for variation?
Correct Answer
D. All of the Above
Explanation
PK (pharmacokinetics) and PD (pharmacodynamics) can vary between patients due to several factors, including age, concomitant medications, and concurrent illness. Age can affect the way drugs are absorbed, distributed, metabolized, and eliminated in the body. Concomitant medications can interact with the drug of interest, altering its pharmacokinetics or pharmacodynamics. Concurrent illness can also impact drug metabolism and response. Therefore, all of these factors contribute to the variation in PK and PD between patients.
4.
What is assumed if the oral dose of a drug is the same as the IV dose of the same drug?
Correct Answer
C. There is little first dose metabolism
Explanation
If the oral dose of a drug is the same as the IV dose of the same drug, it can be assumed that there is little first dose metabolism. This means that the drug is not significantly metabolized or broken down by the liver or other organs before it reaches the systemic circulation. This assumption is made because when a drug is administered orally, it must first pass through the liver before entering the bloodstream, and this process can result in a significant amount of the drug being metabolized and rendered inactive. However, if the oral dose is the same as the IV dose, it suggests that the drug is not extensively metabolized during this "first pass" through the liver.
5.
The transfer of drug across a membrane is based on what?
Correct Answer
E. All of the above
Explanation
The transfer of drugs across a membrane is based on multiple factors, including molecular size, degree of ionization, lipid solubility, and protein binding. The size of the drug molecule can affect its ability to pass through the membrane. The degree of ionization determines whether the drug will be charged or uncharged, which can impact its ability to cross the membrane. Lipid solubility refers to how well the drug can dissolve in lipids, which can affect its ability to pass through the lipid bilayer of the membrane. Protein binding refers to the extent to which the drug binds to proteins in the blood, which can influence its distribution and transport across membranes. Therefore, all of these factors play a role in the transfer of drugs across a membrane.
6.
What is the pKa of a drug?
Correct Answer
B. Is the pH at which ionized vs nonionized form of the drug are the same.
Explanation
The pKa of a drug refers to the pH at which the ionized and nonionized forms of the drug are in equal proportions. This is important because the ionization state of a drug affects its solubility, absorption, distribution, and ability to bind to receptors. Understanding the pKa of a drug can help in determining its optimal formulation, dosing, and pharmacokinetic properties.
7.
Define pH.
Correct Answer
C. The negative log [H+].
Explanation
pH is a measure of the acidity or alkalinity of a solution. It is defined as the negative logarithm (base 10) of the concentration of hydrogen ions ([H+]) in the solution. The lower the pH value, the more acidic the solution is, while a higher pH value indicates alkalinity. The negative log [H+] is a mathematical representation of pH and is used to quantify the acidity or alkalinity of a solution. It is a fundamental concept in chemistry and is widely used in various scientific and industrial applications.
8.
Which anesthetic agent has analgesic effects?
Correct Answer
D. Nitrous oxide
Explanation
Nitrous oxide is the correct answer because it is known to have analgesic effects. It is commonly used as an anesthetic agent in dentistry and minor surgical procedures due to its ability to provide pain relief. Nitrous oxide works by inhibiting the transmission of pain signals in the central nervous system, making it an effective analgesic agent. Desflurane, sevoflurane, and isoflurane are all inhalation anesthetics but do not possess significant analgesic properties.
9.
What was the main problem with early anesthetic agents?
Correct Answer
C. Early agents were toxic
Explanation
Early anesthetic agents were toxic. This means that they posed a risk to patients' health and could potentially cause harm. This toxicity could manifest in various ways, such as damaging organs or causing adverse reactions. Therefore, the main problem with these early agents was their potential to be harmful to patients.
10.
When is a basic drug ionized.
Correct Answer
B. When the pH is less than the pKa
Explanation
When the pH is less than the pKa, a basic drug will become ionized. This is because the pKa represents the pH at which the drug is 50% ionized and 50% unionized. When the pH is lower than the pKa, the environment becomes more acidic, causing the drug to ionize and become positively charged. This ionization is important for the drug to be eliminated by the body, as ionized drugs are more water-soluble and can be excreted more easily.
11.
What helped decreased flammability of the anesthetic agents
Correct Answer
B. Combining carbon with fluorine
Explanation
Combining carbon with fluorine helps decrease the flammability of the anesthetic agents. Carbon-fluorine bonds are known to be very strong and stable, making the resulting compounds less likely to ignite or support combustion. By incorporating fluorine into the structure of the anesthetic agents, their overall flammability is reduced, enhancing safety during their use.
12.
Which drug has the tendency to potentiate cardiac arrythmias when halothane is used?
Correct Answer
C. EpinepHerine
Explanation
Epinepherine has the tendency to potentiate cardiac arrhythmias when halothane is used. This is because epinephrine is a sympathomimetic drug that stimulates the sympathetic nervous system, leading to increased heart rate and contractility. When combined with halothane, which is a volatile anesthetic, the risk of developing cardiac arrhythmias is increased.
13.
Which inhaled agent can cause renal failure?
Correct Answer
A. Methoxyflurane
Explanation
Methoxyflurane is the correct answer because it has been associated with nephrotoxicity, which can lead to renal failure. Nephrotoxicity refers to the ability of a substance to cause damage to the kidneys. Methoxyflurane can cause renal failure due to its metabolite, inorganic fluoride, which can accumulate in the kidneys and cause damage. The other inhaled agents listed (enflurane, isoflurane, desflurane) do not have the same level of nephrotoxicity as methoxyflurane.
14.
The less soluble the agent....
Correct Answer
C. The faster the drug goes to the brian
Explanation
The answer suggests that the faster the drug goes to the brain, the less soluble the agent is. This implies that a drug with low solubility will be absorbed quickly and reach the brain faster, resulting in a faster onset of sleep.
15.
Why do babies and infants require more anesthetic agent?
Correct Answer
C. They have higher metabolic rates
Explanation
Babies and infants require more anesthetic agent because they have higher metabolic rates. This means that their bodies process and eliminate the anesthetic at a faster rate than adults. Therefore, a higher dose is needed to ensure that they remain under anesthesia for the required duration of the procedure.
16.
Which patient will require the least anesthetic
Correct Answer
B. A heavily intoxicated high school student
Explanation
A heavily intoxicated high school student will require the least anesthetic because alcohol is a depressant that can already impair the central nervous system and decrease pain sensitivity. Therefore, less anesthetic will be needed to achieve the desired effect compared to the other options.
17.
Why is isoflurane not the best choice for inhalation induction in children
Correct Answer
B. Agent has pungent odor
Explanation
Isoflurane is not the best choice for inhalation induction in children because it has a pungent odor. This can be unpleasant and may cause discomfort or anxiety in children, especially during the induction process. It is important to use an agent with a more tolerable odor to ensure a smooth and comfortable induction experience for pediatric patients.
18.
Which agent is least likely to form carbon monxide when introduced to co2 absorbers?
Correct Answer
C. Sevoflurane
Explanation
Sevoflurane is least likely to form carbon monoxide when introduced to CO2 absorbers. This is because Sevoflurane is a halogenated volatile anesthetic that does not contain carbon in its chemical structure. Carbon monoxide is formed when carbon-containing compounds are metabolized or broken down, and since Sevoflurane does not contain carbon, it is unlikely to form carbon monoxide.
19.
What is the blood-gas solubility coefficient an indicator of?Â
Correct Answer
B. Speed of uptake and elimination
Explanation
The blood-gas solubility coefficient is an indicator of the speed at which an anesthetic is taken up by the body and eliminated from it. An anesthetic with a higher solubility coefficient will take longer to reach its desired effect and longer to be eliminated from the body compared to an anesthetic with a lower solubility coefficient. Therefore, the blood-gas solubility coefficient is a measure of how quickly an anesthetic can induce and recover from anesthesia.
20.
What does the Oil-gas coefficient represent?
Correct Answer
B. The higer the coefficient the more potent the gas
Explanation
The oil-gas coefficient represents the potency of the gas. A higher coefficient indicates that the gas is more potent.
21.
Define general anesthesia.
Correct Answer
A. An altered pHysiologic state characterized by loss of consciousness analgesia of the entire body, amnesia, and to some degree muscle relaxation
Explanation
General anesthesia is defined as an altered physiologic state where the patient experiences loss of consciousness, analgesia of the entire body, amnesia, and some degree of muscle relaxation. This state is induced to perform surgical procedures and ensure the patient's comfort and safety. It involves the administration of medications that render the patient unconscious and pain-free, while also causing temporary memory loss and muscle relaxation. General anesthesia allows the medical team to perform invasive procedures without the patient feeling any pain or having any recollection of the surgery.
22.
What does MAC stand for.
Correct Answer
C. Minimum alveolar concentration
23.
P-450 sevoflurabe
Correct Answer
B. B
24.
Factors that influence the magnitude of
carbon monoxide production from volatile anesthetics include:
Correct Answer
E. All of the above
Explanation
The correct answer is "All of the above" because all of the factors mentioned in the options can influence the magnitude of carbon monoxide production from volatile anesthetics. Dryness of the carbon dioxide absorbent can lead to the formation of carbon monoxide, while hydration can prevent this formation. High temperatures of the carbon dioxide absorbent, which can occur during low fresh gas flows and/or increased metabolic production of carbon dioxide, can also increase carbon monoxide production. Prolonged high fresh gas flows that cause dryness can further contribute to carbon monoxide production. The type of carbon dioxide absorbent used can also affect the magnitude of carbon monoxide production.
25.
What is Monday morning phenomena.
Correct Answer
B. When CO2 absorbers have been exhausted over the weekend from lack of use and are no longer effective
Explanation
The correct answer is when CO2 absorbers have been exhausted over the weekend from lack of use and are no longer effective. This phenomenon refers to a situation where the CO2 absorbers in an anesthesia machine have not been replaced or replenished over the weekend, leading to their ineffectiveness in removing CO2 from the patient's breathing circuit. This can result in an increased risk of complications during surgery if not addressed promptly.
26.
Which inhaled agent causes the largest increase in heart rate
Correct Answer
B. Isoflurane
Explanation
Isoflurane is the correct answer because it is known to cause the largest increase in heart rate among the given inhaled agents. It is a volatile anesthetic that acts as a potent vasodilator, leading to a decrease in systemic vascular resistance and an increase in heart rate. This effect is mediated through the activation of sympathetic nervous system, resulting in an increased release of catecholamines and subsequent stimulation of beta-adrenergic receptors in the heart.
27.
Which inhalation agent has the least amount of effects on BP?
Correct Answer
D. Sevoflurane
Explanation
Sevoflurane is the inhalation agent that has the least amount of effects on blood pressure (BP). Sevoflurane is known for its minimal effects on cardiovascular stability, making it a suitable choice for patients with cardiovascular conditions or those who are at risk of developing changes in blood pressure during anesthesia. N2O, isoflurane, and desflurane, on the other hand, can cause more significant changes in blood pressure compared to sevoflurane.
28.
Which agent's use has the highest incident of coronary steal?
Correct Answer
A. Isoflurane
Explanation
Isoflurane has the highest incident of coronary steal compared to the other agents listed. Coronary steal refers to the phenomenon where blood flow is diverted away from healthy coronary arteries towards ischemic or blocked arteries. Isoflurane is known to cause vasodilation, which can lead to increased blood flow to ischemic areas and a decrease in blood flow to healthy areas, resulting in coronary steal. N2O, desflurane, and sevoflurane do not have the same vasodilatory effects as isoflurane, making them less likely to cause coronary steal.
29.
Which inhaled agent would be best for a patient with an ischemic CVA
Correct Answer
C. Isoflurane
Explanation
Isoflurane would be the best inhaled agent for a patient with an ischemic CVA. Ischemic CVA refers to a stroke caused by a blockage in the blood vessels supplying the brain. Isoflurane is known to have neuroprotective properties, meaning it can help protect the brain from further damage during a stroke. It also has minimal effects on cerebral blood flow and metabolism, making it a suitable choice for patients with compromised blood flow to the brain. Sevoflurane and desflurane can increase cerebral blood flow, which may worsen the condition in a patient with ischemic CVA. N2O is not commonly used for anesthesia in stroke patients due to concerns about increasing intracranial pressure.
30.
What is the meyer-overton theory?
Correct Answer
A. Explains the increasing oil-gas partition pressure coefficient that is correlated with anesthetic potency
Explanation
The meyer-overton theory explains the increasing oil-gas partition pressure coefficient that is correlated with anesthetic potency. This means that the more soluble an anesthetic is in oil, the more potent it is. The theory suggests that the anesthetic potency is directly related to the lipid solubility of the anesthetic, as it affects the ability of the anesthetic to dissolve and penetrate the lipid-rich cell membranes in the body.
31.
Which of the following agents does not have any muscle relaxing properties?
Correct Answer
C. N2O
Explanation
N2O, also known as nitrous oxide or laughing gas, does not have any muscle relaxing properties. While the other agents listed (isoflurane, sevoflurane, desflurane, and halothane) are all inhalation anesthetics that have muscle relaxing properties, N2O does not produce significant muscle relaxation. Instead, it primarily provides analgesia and sedation during medical procedures.
32.
What is MAC?
Correct Answer
D. Minimum alveolar concentration
33.
Describe how MAC changes with age
Correct Answer
C. It decrease 6% for every decade of life
Explanation
As a person ages, their MAC (mean alveolar concentration) decreases by 6% for every decade of life. This means that the amount of an inhaled anesthetic required to achieve the desired level of anesthesia decreases as a person gets older. This may be due to changes in metabolism, organ function, or sensitivity to the anesthetic drugs.
34.
At what age is a patients highest MAC levels?
Correct Answer
C. 6 months
Explanation
The question asks about the age at which a patient's highest MAC levels occur. MAC levels refer to the minimum alveolar concentration of anesthetic required to prevent movement in response to a surgical stimulus in 50% of patients. The correct answer is 6 months because MAC levels are highest in infants between 3 and 6 months of age, after which they gradually decrease.
35.
What is the only inorganic agent used
Correct Answer
A. N2O
Explanation
N2O is the only inorganic agent used among the given options. Nitrous oxide, also known as laughing gas, is a colorless and odorless gas commonly used as an anesthetic. It is considered inorganic because it does not contain carbon. Sevoflurane, isoflurane, and desflurane are all organic compounds that are used as inhalation anesthetics.
36.
What are the cardiac effects of N20?
Correct Answer
D. Can cause myocardial ischemia in hypovolemic patients and in patients with CAD.
Explanation
N20, also known as nitrous oxide, can cause myocardial ischemia in hypovolemic patients and in patients with CAD. This means that it can lead to a reduced blood flow to the heart muscle, which can result in damage or dysfunction of the heart. This effect is particularly significant in patients who already have low blood volume or pre-existing coronary artery disease. It is important to be aware of this potential cardiac effect when administering N20 to these patients.
37.
Which of the following is NOT a respiratory effect of N2O?
Correct Answer
B. Reddish skin discoloration
Explanation
Reddish skin discoloration is not a respiratory effect of N2O. N2O is a respiratory depressant and can cause tachypnea (increased respiratory rate), depression of response to CO2, and an increase in the apneic threshold (the level of CO2 in the blood at which breathing resumes after a period of apnea). However, it does not cause reddish skin discoloration.
38.
 Who is the best looking guy in FIU's CRNA program scheduled to graduate in December of 2011?
Correct Answer(s)
A. Chris
B. All of the above
39.
All of these factors affect pharmacokinetics of a drug except?
Correct Answer
E. Skin pigmentation
Explanation
Skin pigmentation does not affect the pharmacokinetics of a drug. Pharmacokinetics refers to how the body processes a drug, including its absorption, distribution, metabolism, and excretion. Extremes of age, hydration, renal or hepatic disease, and skeletal muscle mass can all affect these processes. However, skin pigmentation does not have a direct impact on drug metabolism or elimination.
40.
The Pka of the drug delineates what % of a drug is in an ionized form?
Correct Answer
C. 50%
Explanation
The pKa of a drug refers to the pH at which 50% of the drug is in its ionized form and 50% is in its non-ionized form. Therefore, the correct answer is 50%. This means that at a pH equal to the drug's pKa, half of the drug molecules will be ionized and half will be non-ionized.
41.
Does a weak acid inserted into an alkaline medium manifest its desired effects faster?
Correct Answer
B. False
Explanation
A weak acid inserted into an alkaline medium does not manifest its desired effects faster. In fact, the opposite is true. In an alkaline medium, the weak acid will undergo neutralization reactions with the alkali present, resulting in the formation of a salt and water. This neutralization process slows down the desired effects of the weak acid. Therefore, the statement is false.
42.
A weak acid inserted into an acidic environment will be absorbed how?
Correct Answer
A. Faster
Explanation
When a weak acid is inserted into an acidic environment, it will be absorbed faster. This is because the weak acid has a lower concentration of hydrogen ions compared to the acidic environment. As a result, the weak acid will undergo ionization and release more hydrogen ions, allowing it to be rapidly absorbed by the surrounding solution.
43.
A weak acid inserted into an alkaline medium will manifest its desired effect how?
Correct Answer
A. Faster
Explanation
When a weak acid is inserted into an alkaline medium, it will manifest its desired effect faster. This is because the alkaline medium provides a higher concentration of hydroxide ions (OH-) which can react with the weak acid to form water and a salt. The increased concentration of hydroxide ions increases the rate of the reaction, resulting in a faster manifestation of the desired effect.
44.
A weak base injected into an alkaline medium will most likely exhibit which trait?(Choose all that apply)
Correct Answer(s)
A. More in an unionized form
D. More lipid soluble
Explanation
When a weak base is injected into an alkaline medium, it is more likely to exhibit the traits of being more in an unionized form and more lipid soluble. In an alkaline medium, the pH is high, which favors the unionized form of the weak base. This is because weak bases tend to ionize less in alkaline conditions. Additionally, being lipid soluble means that the weak base has a higher affinity for lipids or fats, which allows it to easily cross lipid membranes and distribute throughout the body.
45.
An ionized medication will be metabolized by the liver.
Correct Answer
B. False
Explanation
The statement is false because an ionized medication is typically not metabolized by the liver. Ionized medications are usually water-soluble and are excreted by the kidneys instead of being metabolized by the liver. The liver primarily metabolizes lipid-soluble medications through various enzymatic processes. Therefore, an ionized medication would not undergo significant metabolism in the liver.
46.
What happens to a drug when the Pka and the pH are the same?
Correct Answer
C. 50% inoized & 50% unionized
Explanation
When the pKa and the pH are the same, it means that the drug is in its half-ionized and half-unionized form. This is because the pKa represents the pH at which 50% of the drug is ionized and 50% is unionized. Therefore, when the pKa and the pH are equal, the drug will be 50% ionized and 50% unionized.
47.
When the pH and the Pka are equal how does a small change in pH effect the ionization
Correct Answer
D. Large changes is degree of ionization
Explanation
When the pH and the pKa are equal, it means that the concentration of the ionized and unionized forms of a compound are equal. In this case, a small change in pH will have a significant effect on the degree of ionization. This is because even a slight change in pH can disrupt the balance between the ionized and unionized forms, leading to a large change in the degree of ionization. Therefore, when pH and pKa are equal, small changes in pH can result in large changes in the degree of ionization.
48.
Propofol, a weak acid, has a Pka of 11, how will propofol behave in a body with a pH of 7.4
Correct Answer
B. Less Ionized
Explanation
Propofol, being a weak acid, will ionize in an aqueous solution. The pKa of propofol indicates the pH at which it is 50% ionized and 50% non-ionized. Since the body's pH is 7.4, which is lower than the pKa of propofol (11), propofol will be less ionized in the body. This means that a larger portion of propofol will exist in its non-ionized form, allowing it to easily cross cell membranes and exert its effects.
49.
Isoflurane is a methyl esther what is halothane.
Correct Answer
C. Alkane derivative
Explanation
Isoflurane is a halogenated hydrocarbon that belongs to the class of volatile inhalation anesthetics. It is commonly used in medical practice as a general anesthetic. The statement "Isoflurane is a methyl ester what is halothane" is incorrect. Isoflurane is not a methyl ester, but rather an alkane derivative. It does not contain any ester functional group. Therefore, the correct answer is "Alkane derivative".
50.
What is the MAC of sevoflurane?
Correct Answer
A. 1.7
Explanation
The MAC (minimum alveolar concentration) of a volatile anesthetic like sevoflurane is the concentration at which 50% of patients do not respond to a surgical stimulus. In other words, it is a measure of the potency of the anesthetic. A MAC of 1.7 indicates that sevoflurane is less potent compared to other anesthetics, as a higher concentration is required to achieve the desired effect.