Exam 1 Nagelhout questions with verified correct answers

Exam 1 Nagelhout questions with |\ |\ |\ |\ |\




verified correct answers |\ |\




What are the renal effects of all anesthetics except nitrous oxide?
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- CORRECT ANSWERS ✔✔decrease blood pressure
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decrease renal blood flow |\ |\ |\




decrease GFR |\




decrease UO |\




What anesthetic is associated with hepatotoxicity in adults but
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not children? - CORRECT ANSWERS ✔✔Halothane
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What inhalation anesthetics trigger malignant hyperthermia and
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are contraindicated? - CORRECT ANSWERS ✔✔All except nitrous
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oxide


This inhalation anesthetic blocks DNA and RNA synthesis. -
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CORRECT ANSWERS ✔✔Nitrous Oxide |\ |\ |\




How does Nitrous Oxide block DNA & RNA production? - CORRECT
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ANSWERS ✔✔oxidies the Cobalt atom on Vitamin B12
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inhibits methionine synthetase
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What patients are at risk with Nitrous oxide due to possible prior
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Cobalamin Deficiency? - CORRECT ANSWERS ✔✔(1) Nutritional
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disorders - elderly, vegans, and alcoholics
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,(2) Malabsorption disorders - prolonged use of proton pump
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inhibitors (H2 antagonists), pernicious anemia, atrophic gastritis,
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postgastrectomy, Crohn's disease |\ |\




(3) Infection - bacterial overgrowth, tapeworm
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What are the absolute contraindications to Nitrous Oxide? -
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CORRECT ANSWERS ✔✔(1) Known deficiency of enzyme or
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substrate in methionine synthase pathway
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(2) Potential toxicity from expansion of gas filled space -
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emphysema, pneumothorax, middle ear, surgery, |\ |\ |\ |\ |\


pneumocephalus, air embolus |\ |\




(3) Raised intracranial pressure
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What are the relative contraindications to Nitrous Oxide? -
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CORRECT ANSWERS ✔✔(1) Pulmonary HTN
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(2) Prolonged anesthesia (>6 hr)
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(3) First trimester of pregnancy (tetragenic)
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(4) High risk of PONV
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What is a putative relative contraindication to Nitrous Oxide? -
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CORRECT ANSWERS ✔✔Risk of myocardial ischemia
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When does the risk of halothane hepatotoxity increase? -
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CORRECT ANSWERS ✔✔after puberty |\ |\ |\




Is there a better anesthetic technique to use when performing
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surgery in cancer patients? - CORRECT ANSWERS ✔✔(1) Local
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,anesthetics (reduced cancer recurrence and metastasis r/t anti-
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inflammatory and direct effects) |\ |\ |\




(2) Neuraxial anesthesia (immunosuppressive - reduced
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recurrence & metastasis) |\ |\




(3) NSAIDS (COX-2 and prostaglandin inhibition in cancer cells;
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prevents angiogenesis) |\




Is there any anesthetic technique you should avoid using when
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performing surgery in cancer patients? - CORRECT ANSWERS
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✔✔(1) Opioids (angiogenesis; decreased long-term survival;
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inhibit natural killer cells)
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(2) Volatile anesthetics (activates insulin-like growth factors)
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What anesthetic is contraindicated in pregnancy? - CORRECT
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ANSWERS ✔✔Nitrous oxide (teratogenic in animals)
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When is nitrous oxide most likely to cause teratogenic effects? -
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CORRECT ANSWERS ✔✔first trimester |\ |\ |\




What is the effect of all anesthetics in pregnant women? -
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CORRECT ANSWERS ✔✔relax the uterus (increase risk of
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postoperative miscarriage) |\




Would it be better to use an inhalation anesthetic or spinal for a
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uterine surgery? Why? - CORRECT ANSWERS ✔✔spinal (less
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bleeding - inhalation = uterine relaxation and more bleeding)
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, What are the three principle sources of waste anesthetic gasses?
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- CORRECT ANSWERS ✔✔(1) masks
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(2) high-pressure fittings
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(3) exhalation valves
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Regulations in the USA require nitrous oxide levels to be
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_________________. - CORRECT ANSWERS ✔✔<25 ppm |\ |\ |\ |\ |\




Regulations in the USA require halogenated gas levels to be
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_____________. - CORRECT ANSWERS ✔✔<2 ppm |\ |\ |\ |\ |\




T/F: All intravenous anesthetics consistently produce adverse
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neurodevelopmental consequences. - CORRECT ANSWERS |\ |\ |\ |\ |\


✔✔False (exception dexmedetomidine)|\ |\




Which of the inhalation anesthetics has analgesic effects? -
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CORRECT ANSWERS ✔✔Nitrous oxide (50% NO = 15 mg IV
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morphine)


What are the advantages of Nitrous Oxide? - CORRECT ANSWERS
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✔✔(1) Analgesia
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(2) Rapid uptake and elimination
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(3) Little cardiac or respiratory depression
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(4) Nonpungent
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(5) Reduces MAC of the more potent agents
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(6) Minimal biotransformation
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