Which is NOT a reason for using anticholinergics preanesthetic?

1.   ?    Block vagal reflexes
2.   ?    Decrease secretions
3.   ?    Block pain associated tachycardia

Infants and children (compared to adults) have a predominance of what portion of the nervous system?

1.   ?    sSympathetics
2.   ?    Parasympathetics

Neonatal cardiac output is primarily dependent upon what?

1.   ?    Heart rate
2.   ?    Peripheral resistance
3.   ?    Preload
4.   ?    Afterload

Preanesthetic sedation is NOT be indicated in all but which patients?

1.   ?    Infants less than 1 year of age
2.   ?    Patients with airway or ventilatory problems
3.   ?    CNS disorders, for instance mentally retarded
4.   ?    ENT procedures
5.   ?    Congenital heart disease

True or false: atropine (0.02 mg per kg) will block or reverse the bradycardia and decreased cardiac output that results from succinylcholine and halothane?

1.   ?    True
2.   ?    False

Should atropine be used in patients with cystic fibrosis?

1.   ?    Atropine should not be given for cystic fibrosis. Drying of their secretions isn't good for them

Atropine is OK for which patient?

1.   ?    Febrile patient
2.   ?    Cystic Fibrosis patient
3.   ?    Child less than 1 year of age

Which is NOT a side effect of scopolamine?

1.   ?    Excitement
2.   ?    Increased temperature
3.   ?    Nausea and vomiting
4.   ?    Delirium
5.   ?    Hallucinations

Glycopyrrolate produces more tachycardia than does atropine?

1.   ?    True
2.   ?    False

Thiopental works like methohexital but has a longer or shorter recovery time?

1.   ?    Shorter recovery
2.   ?    Longer recovery
3.   ?    Equivalent recovery

Sufentanil does what to lung compliance?

1.   ?    Decrease
2.   ?    Increase
3.   ?    No effect on complaince

Does Midazolam (Versed) produce amnesia?

1.   ?    True
2.   ?    False

Which statement is NOT true regarding Thiopental intravenous induction in children?

1.   ?    Preoxygenation helps avoid hypoxia
2.   ?    Metabolized by Hoffman degredation
3.   ?    Effects occur within 60 seconds
4.   ?    lasts for approximately 8-20 minutes
5.   ?    It has minimal cardiovascular effects

>What 2 drugs are used for induction in high-risk cardiovascular patients?

1.   ?    Ketamine and thiopental sodium
2.   ?    Nitrous oxide and thiopental sodium
3.   ?    Ketamine and succinylcholine

Which is NOT part of the management of laryngospasm during induction?

1.   ?    100 percent oxygen
2.   ?    Tight mouth seal with the mask
3.   ?    Positive expiratory pressure
4.   ?    Neostigmine
5.   ?    Succinylcholine and intubation

Which is NOT part of the management of a full stomach in an emergent procedure?

1.   ?    Oral gastric or nasogastric suction
2.   ?    Cimetidine or Zantac
3.   ?    Sellick maneuver (cricoid pressure)
4.   ?    Rapid sequence induction
5.   ?    Use of long acting nondepolarizing neuromusc. blockers

Nitrous oxide has a (high or low) solubility and (does or does not) increase pulmonary artery pressures?

1.   ?    High solubility and lowers pulmonary artery pressures.
2.   ?    High solubility and does not change pulmonary artery pressures.
3.   ?    Low solubility and does not change pulmonary artery pressures.
4.   ?    Low solubility and lowers pulmonary artery pressures.

Halothane is a bronchodilator or bronchoconstrictor?

1.   ?    Bronchoconstrictor
2.   ?    Bronchodilator
3.   ?    It has no effect on the airways

Halothane can safely be used in patients with cystic fibrosis: T or F?

1.   ?    True
2.   ?    False

Which is true of vecuronium and atracurium?

1.   ?    They are depolarizing blockers
2.   ?    They are intermediate-acting (35 minutes)
3.   ?    They cannot be reversed with pyridostigmine

Which is true of Succinylcholine?

1.   ?    A few minutes duration (short acting)
2.   ?    Nondepolarizing blocker
3.   ?    reversed with pyridostigmine

Which is NOT an intermediate-acting nondepolarizing agents?

1.   ?    Atracurium
2.   ?    Vecuronium
3.   ?    Pancuronium
4.   ?    Metocuronium

Which is NOT a long-acting nondepolarizing agents?

1.   ?    Atracurium
2.   ?    Metocurine
3.   ?    D-turbocurarine

T or F: Nondepolarizing agents can be reversed with atropine, glycopyrrolate, pyridostigmine, edrophonium.

1.   ?    True
2.   ?    False

What is the best criterion for adequacy of reversal of the neuromuscular blockade?

1.   ?    Return of orbicularis reflex
2.   ?    Absence of tetanic fade @ F2.
3.   ?    Spontaneous respiration

T or F: Neostigmine reverses depolarizing muscle blockers?

1.   ?    True
2.   ?    False

All are advantages of regional anesthesia EXCEPT?

1.   ?    decreased risk of post operative respiratory depression
2.   ?    decreased vascular spasm
3.   ?    prolonged postop pain relief without narcotics
4.   ?    lower anesthetic mortality

Which is NOT true of succinylcholine?

1.   ?    Contraindicated in Duchenne's muscular dystrophy: they may suffer cardiac arrest.
2.   ?    Contraindicated in trauma and burns
3.   ?    Contraindicated in liver disease patients
4.   ?    Trigger for malignant hyperthermia
5.   ?    Causes tachycardia

Succinylcholine may cause all of the following except?

1.   ?    Bradycardia
2.   ?    Increased intraocular pressures
3.   ?    Pulmonary edema in newborns
4.   ?    Chest wall rigidity
5.   ?    Increases the intragastric pressures

Fentanyl is how many times more potent than morphine?

1.   ?    50 to 100
2.   ?    10 to 20
3.   ?    5 to 10

Sufentanil is how many times more potent than fentanyl?

1.   ?    50 to 100
2.   ?    10 to 20
3.   ?    5 to 10

Alfentanil is long or short-acting? It is also (less or more) potent than fentanyl?

1.   ?    ultra-short acting, less portent
2.   ?    intermediate acting, less portent
3.   ?    ultra-short acting, more portent
4.   ?    intermediate acting, more portent

What drug is a muscle relaxant that will do the following: release histamine, cause bronchospasm, have no effect on cardiac output, requires a lower dose when used with halothane, has an unpredictable effect on neonates, its effects are potentiated by aminoglycosides?

1.   ?    d- turbocurarine. It is a long-acting, nondepolarizing neuromuscular blocker.

Which statment is NOT true regarding Vecuronium?

1.   ?    Nondepolarizing
2.   ?    Intermediate duration
3.   ?    Circulatory side effects
4.   ?    Safe in malignant hyperthermia
5.   ?    10 times more potent than pancuronium

Which statment is NOT true regarding Pancuronium?

1.   ?    Nondepolarizing
2.   ?    Intermediate duration
3.   ?    Dose decreased with Halothane
4.   ?    Causes bradycardia
5.   ?    10 times more potent than curare

Which statement is NOT true regarding Atracurium?

1.   ?    Nondepolarizing
2.   ?    Intermediate duration
3.   ?    Metabolized by Hoffman degredation
4.   ?    Longer recovery time in hypothermic newborns
5.   ?    10 times more potent than curare

Which local anesthetics is NOT an amide?

1.   ?    Lidocaine
2.   ?    Bupivacaine
3.   ?    Carbocaine
4.   ?    Novicaine
5.   ?    Etidocaine

Hypoxia increases the uptake of which local anesthetic?

1.   ?    Lidocaine
2.   ?    Etodicaine
3.   ?    Bupivicaine
4.   ?    Tetracaine

True or false: Infants are at higher risk for toxicity with Marcaine than are adults?

1.   ?    True
2.   ?    False

True or false: Marcaine has greater sensory than motor block?

1.   ?    True
2.   ?    False

What happens to the muscles in malignant hyperthermia?

1.   ?    Rhabdomyolysis
2.   ?    Spadmodic contraction
3.   ?    Active sarcolemmal transport increases

T or F: Currently, the mortality of malignant hyperthermia ow mortality approaches 0 if the treatment is initiated quickly?

1.   ?    True
2.   ?    False

Spinal anesthesia in newborns must be below what level?

1.   ?    Below T4
2.   ?    Below S1
3.   ?    Below L2

What agent used for spinal anesthesia lasts the longest?

1.   ?    Lidocaine
2.   ?    Tetracaine
3.   ?    Bupivicaine

What is the incidence of inability to walk for up to 6 hours after caudals?

1.   ?    5 percent
2.   ?    30 percent
3.   ?    50 percent

T or F: Normally, Ca++ uptake leads to muscle relaxation, but muscle calcium is high in malignant hyperthermia.?

1.   ?    True
2.   ?    False

Where does the newborn chord end; what about the conus medullaris? What about the dural sac?

1.   ?    The chord ends at T12 to L3
2.   ?    The chord ends at T10 to T12
3.   ?    At the S1 body

Where does the newborn conus medullaris end?

1.   ?    At the S3 body
2.   ?    At the S1 body
3.   ?    At the L3 body

What is the incidence of an attack of malignant hyperthermia per episode of anesthesia in adults and children?

1.   ?    children 1 in 50,000; adults 1 in 20,000
2.   ?    children 1 in 100,000; adults 1 in 50,000
3.   ?    children 1 in 14,000; adults 1 in 40,000
4.   ?    children 1 in 4,000; adults 1 in 10,000

Wich of the following is NOT a malignant hyperthermia risk?

1.   ?    Family history of myopathy
2.   ?    Positive muscle biopsy
3.   ?    Positive PCR for gene

What triggers malignant hyperthermia?

1.   ?    Succinylcholine, halothane, and all potent inhalational anesthetic agents. Two well-recognized triggers are halothane and succinylcholine. Muscle spasm of the masseter may be the 1st sign of malignant hyperthermia, or may just be due to an effect of succinylcholine.

What is NOT an early sign of malignant hyperthermia?

1.   ?    Tachycardia and arrhythmias
2.   ?    Masseter spasm
3.   ?    Tachypnea and hypertension
4.   ?    Cyanosis

Which is NOT a late sign of malignant hyperthermia?

1.   ?    Masseter spasm
2.   ?    Hyperpyrexia and mottling
3.   ?    Generalized muscle rigidity
4.   ?    Cyanosis

Which is NOT part of the treatment of malignant hyperthermia?

1.   ?    Turn off the triggering agents
2.   ?    100 percent FIO2
3.   ?    Dantrolene at a dose of 2.5-10 milligrams per kilogram. (
4.   ?    Keep giving dantrolene until the acidosis clears.
5.   ?    Cool the patient: cold saline, ice packs
6.   ?    ECMO

Which is NOT part of the treatment of malignant hyperthermia?

1.   ?    CVP, pulmonary artery line, Foley, arterial line.
2.   ?    Treat arrhythmia with procainamide
3.   ?    HCO3 for metabolic acidosis.
4.   ?    Increased potassium is treated with insulin, 10 units in D50; intravenous calcium may be needed (Yes, even with malignant hyperthermia).
5.   ?    Volume boluses
6.   ?    High dose mannitol