Anesthesiology - Baby Miller and |\ |\ |\ |\ |\
Morgan/Mikhail exam questions with |\ |\ |\ |\
answers
L.A. amides are metabolized how? - CORRECT ANSWERS ✔✔liver
|\ |\ |\ |\ |\ |\ |\ |\
L.A. esters are metabolized how? - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\
✔✔plasma esterases - hydrolysis
|\ |\ |\
Butacaine
Benzocaine
Cocaine
Chloroprocaine
procaine
Tetracaine
P*i*peroca*i*ne - only ester to have two "I"s
|\ |\ |\ |\ |\ |\ |\
larger diameter nerve fibers = faster or slower conductance? -
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔faster
|\ |\
myelination of nerve fibers = faster or slower conductance? -
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔faster
|\ |\
,type C nerve fibers are? - CORRECT ANSWERS ✔✔small and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
unmyelinated. the "second pain" |\ |\ |\
Adelta fibers are? - CORRECT ANSWERS ✔✔small and myelinated.
|\ |\ |\ |\ |\ |\ |\ |\
the "First pain"
|\ |\ |\
Aalpha fibers are? - CORRECT ANSWERS ✔✔the fastest and deal
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
with proprioception |\
B fibers are? - CORRECT ANSWERS ✔✔myelinated and are what
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
preganlionic autonomics are. |\ |\
what is the significance of a "use-dependent" or "frequency-
|\ |\ |\ |\ |\ |\ |\ |\
depenedent" type of block? - CORRECT ANSWERS ✔✔block |\ |\ |\ |\ |\ |\ |\ |\
intensifies with more frequent rates of nerve firing |\ |\ |\ |\ |\ |\ |\
for more un-ionized (non-charged/lipophilic) locals, they'll have
|\ |\ |\ |\ |\ |\ |\
higher or lower pKA? - CORRECT ANSWERS ✔✔lower pKA = un-
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ionized
raising pH will make local work faster or slower? - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔faster. this is why bicarb is added. |\ |\ |\ |\ |\ |\ |\
,how many nodes-of-ranvier do you have to block to prevent
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
skippage and block conductance? - CORRECT ANSWERS ✔✔3
|\ |\ |\ |\ |\ |\ |\ |\
nodes-of-ranvier must be blocked in succession |\ |\ |\ |\ |\
are proximal structures or distal structures blocked first? -
|\ |\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔proximal. because they're more|\ |\ |\ |\ |\ |\
superficial compared to deeper axons are distal structures
|\ |\ |\ |\ |\ |\ |\
do amides or esters last longer? - CORRECT ANSWERS ✔✔amides
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
last longer|\
do amides or esters have lower pKA (more un-ionized)? -
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔amides have lower pKA |\ |\ |\ |\ |\
do amides or esters have higher max dose needed? - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔esters need greater max dose. think of it like because
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
they're metabolized so quickly by plasma esterases, you need to give
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
more to reach the same peak.
|\ |\ |\ |\ |\ |\
lidocaine is metabolzied how? and what is this significance? -
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔liver. and very hepatic blood flow
|\ |\ |\ |\ |\ |\ |\ |\
dependent. significant TNS (Transient Neuro S/e) occur if you have
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
CHF, liver disease, or under general anesthesia
|\ |\ |\ |\ |\ |\
, which blocks should epi be avoided in? - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔end-artery. like digit blocks. |\ |\ |\
s/e of CNS toxicity of local anesthetics? - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔peri-oral numbness |\
slurred speech |\
facial tingling|\
vertigo
tinnitis
restlessness
seizures (the local inhibited the inhibitory pathway)
|\ |\ |\ |\ |\ |\
if seizure occurs in Local Anesthetic (LA), what makes it worse? -
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔the subsequent hypoxemia and metabolic
|\ |\ |\ |\ |\ |\
acidosis during seizures enhance the CNS toxicity of LA.
|\ |\ |\ |\ |\ |\ |\ |\ |\
which drug is the biggest cardiotoxic LA? - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔Bupivicaine. which is why S entantiomer (levobupivicaine and |\ |\ |\ |\ |\ |\ |\ |\
ropivicaine were made) |\ |\
treatment for LA toxicities? - CORRECT ANSWERS ✔✔1. Benzo to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
terminate seizure |\
Morgan/Mikhail exam questions with |\ |\ |\ |\
answers
L.A. amides are metabolized how? - CORRECT ANSWERS ✔✔liver
|\ |\ |\ |\ |\ |\ |\ |\
L.A. esters are metabolized how? - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\
✔✔plasma esterases - hydrolysis
|\ |\ |\
Butacaine
Benzocaine
Cocaine
Chloroprocaine
procaine
Tetracaine
P*i*peroca*i*ne - only ester to have two "I"s
|\ |\ |\ |\ |\ |\ |\
larger diameter nerve fibers = faster or slower conductance? -
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔faster
|\ |\
myelination of nerve fibers = faster or slower conductance? -
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔faster
|\ |\
,type C nerve fibers are? - CORRECT ANSWERS ✔✔small and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
unmyelinated. the "second pain" |\ |\ |\
Adelta fibers are? - CORRECT ANSWERS ✔✔small and myelinated.
|\ |\ |\ |\ |\ |\ |\ |\
the "First pain"
|\ |\ |\
Aalpha fibers are? - CORRECT ANSWERS ✔✔the fastest and deal
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
with proprioception |\
B fibers are? - CORRECT ANSWERS ✔✔myelinated and are what
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
preganlionic autonomics are. |\ |\
what is the significance of a "use-dependent" or "frequency-
|\ |\ |\ |\ |\ |\ |\ |\
depenedent" type of block? - CORRECT ANSWERS ✔✔block |\ |\ |\ |\ |\ |\ |\ |\
intensifies with more frequent rates of nerve firing |\ |\ |\ |\ |\ |\ |\
for more un-ionized (non-charged/lipophilic) locals, they'll have
|\ |\ |\ |\ |\ |\ |\
higher or lower pKA? - CORRECT ANSWERS ✔✔lower pKA = un-
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ionized
raising pH will make local work faster or slower? - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔faster. this is why bicarb is added. |\ |\ |\ |\ |\ |\ |\
,how many nodes-of-ranvier do you have to block to prevent
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
skippage and block conductance? - CORRECT ANSWERS ✔✔3
|\ |\ |\ |\ |\ |\ |\ |\
nodes-of-ranvier must be blocked in succession |\ |\ |\ |\ |\
are proximal structures or distal structures blocked first? -
|\ |\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔proximal. because they're more|\ |\ |\ |\ |\ |\
superficial compared to deeper axons are distal structures
|\ |\ |\ |\ |\ |\ |\
do amides or esters last longer? - CORRECT ANSWERS ✔✔amides
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
last longer|\
do amides or esters have lower pKA (more un-ionized)? -
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔amides have lower pKA |\ |\ |\ |\ |\
do amides or esters have higher max dose needed? - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔esters need greater max dose. think of it like because
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
they're metabolized so quickly by plasma esterases, you need to give
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
more to reach the same peak.
|\ |\ |\ |\ |\ |\
lidocaine is metabolzied how? and what is this significance? -
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔liver. and very hepatic blood flow
|\ |\ |\ |\ |\ |\ |\ |\
dependent. significant TNS (Transient Neuro S/e) occur if you have
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
CHF, liver disease, or under general anesthesia
|\ |\ |\ |\ |\ |\
, which blocks should epi be avoided in? - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔end-artery. like digit blocks. |\ |\ |\
s/e of CNS toxicity of local anesthetics? - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔peri-oral numbness |\
slurred speech |\
facial tingling|\
vertigo
tinnitis
restlessness
seizures (the local inhibited the inhibitory pathway)
|\ |\ |\ |\ |\ |\
if seizure occurs in Local Anesthetic (LA), what makes it worse? -
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔the subsequent hypoxemia and metabolic
|\ |\ |\ |\ |\ |\
acidosis during seizures enhance the CNS toxicity of LA.
|\ |\ |\ |\ |\ |\ |\ |\ |\
which drug is the biggest cardiotoxic LA? - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔Bupivicaine. which is why S entantiomer (levobupivicaine and |\ |\ |\ |\ |\ |\ |\ |\
ropivicaine were made) |\ |\
treatment for LA toxicities? - CORRECT ANSWERS ✔✔1. Benzo to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
terminate seizure |\
