EXAM 2 - PHARMACOLOGY 1 NAGELHOUT UPDATED
ACTUAL QUESTIONS AND CORRECT ANSWERS
Question:
decrease blood pressure decrease renal blood flow decrease GFR decrease UO
Answer:
What are the renal effects of all anesthetics except nitrous oxide?
Question:
All except nitrous oxide
Answer:
What inhalation anesthetics trigger malignant hyperthermia and are contraindicated?
Question:
Nitrous Oxide
Answer:
This inhalation anesthetic blocks DNA and RNA synthesis.
Question:
oxidies the Cobalt atom on Vitamin B12 inhibits methionine synthetase
Answer:
How does Nitrous Oxide block DNA & RNA production?
Question:
(1) Nutritional disorders - elderly, vegans, and alcoholics (2) Malabsorption disorders - prolonged use of
proton pump inhibitors (H2 antagonists), pernicious anemia, atrophic gastritis, postgastrectomy, Crohn's
disease (3) Infection - bacterial overgrowth, tapeworm
Answer:
What patients are at risk with Nitrous oxide due to possible prior Cobalamin Deficiency?
Question:
(1) Known deficiency of enzyme or substrate in methionine synthase pathway (2) Potential toxicity from
expansion of gas filled space - emphysema, pneumothorax, middle ear, surgery, pneumocephalus, air
embolus (3) Raised intracranial pressure
Answer:
What are the absolute contraindications to Nitrous Oxide?
Question:
(1) Pulmonary HTN (2) Prolonged anesthesia (>6 hr) (3) First trimester of pregnancy (tetragenic) (4) High
risk of PONV
Answer:
What are the relative contraindications to Nitrous Oxide?
Question:
Risk of myocardial ischemia
, Answer:
What is a putative relative contraindication to Nitrous Oxide?
Question:
Nitrous oxide (teratogenic in animals)
Answer:
What anesthetic is contraindicated in pregnancy?
Question:
first trimester
Answer:
When is nitrous oxide most likely to cause teratogenic effects?
Question:
relax the uterus (increase risk of postoperative miscarriage)
Answer:
What is the effect of all anesthetics in pregnant women?
Question:
spinal (less bleeding - inhalation = uterine relaxation and more bleeding)
Answer:
Would it be better to use an inhalation anesthetic or spinal for a uterine surgery? Why?
Question:
(1) masks (2) high-pressure fittings (3) exhalation valves
Answer:
What are the three principle sources of waste anesthetic gasses?
Question:
<25 ppm
Answer:
Regulations in the USA require nitrous oxide levels to be _________________.
Question:
<2 ppm
Answer:
Regulations in the USA require halogenated gas levels to be _____________.
Question:
Nitrous oxide (50% NO = 15 mg IV morphine)
Answer:
Which of the inhalation anesthetics has analgesic effects?
Question:
(1) Analgesia (2) Rapid uptake and elimination (3) Little cardiac or respiratory depression (4) Nonpungent
(5) Reduces MAC of the more potent agents (6) Minimal biotransformation
ACTUAL QUESTIONS AND CORRECT ANSWERS
Question:
decrease blood pressure decrease renal blood flow decrease GFR decrease UO
Answer:
What are the renal effects of all anesthetics except nitrous oxide?
Question:
All except nitrous oxide
Answer:
What inhalation anesthetics trigger malignant hyperthermia and are contraindicated?
Question:
Nitrous Oxide
Answer:
This inhalation anesthetic blocks DNA and RNA synthesis.
Question:
oxidies the Cobalt atom on Vitamin B12 inhibits methionine synthetase
Answer:
How does Nitrous Oxide block DNA & RNA production?
Question:
(1) Nutritional disorders - elderly, vegans, and alcoholics (2) Malabsorption disorders - prolonged use of
proton pump inhibitors (H2 antagonists), pernicious anemia, atrophic gastritis, postgastrectomy, Crohn's
disease (3) Infection - bacterial overgrowth, tapeworm
Answer:
What patients are at risk with Nitrous oxide due to possible prior Cobalamin Deficiency?
Question:
(1) Known deficiency of enzyme or substrate in methionine synthase pathway (2) Potential toxicity from
expansion of gas filled space - emphysema, pneumothorax, middle ear, surgery, pneumocephalus, air
embolus (3) Raised intracranial pressure
Answer:
What are the absolute contraindications to Nitrous Oxide?
Question:
(1) Pulmonary HTN (2) Prolonged anesthesia (>6 hr) (3) First trimester of pregnancy (tetragenic) (4) High
risk of PONV
Answer:
What are the relative contraindications to Nitrous Oxide?
Question:
Risk of myocardial ischemia
, Answer:
What is a putative relative contraindication to Nitrous Oxide?
Question:
Nitrous oxide (teratogenic in animals)
Answer:
What anesthetic is contraindicated in pregnancy?
Question:
first trimester
Answer:
When is nitrous oxide most likely to cause teratogenic effects?
Question:
relax the uterus (increase risk of postoperative miscarriage)
Answer:
What is the effect of all anesthetics in pregnant women?
Question:
spinal (less bleeding - inhalation = uterine relaxation and more bleeding)
Answer:
Would it be better to use an inhalation anesthetic or spinal for a uterine surgery? Why?
Question:
(1) masks (2) high-pressure fittings (3) exhalation valves
Answer:
What are the three principle sources of waste anesthetic gasses?
Question:
<25 ppm
Answer:
Regulations in the USA require nitrous oxide levels to be _________________.
Question:
<2 ppm
Answer:
Regulations in the USA require halogenated gas levels to be _____________.
Question:
Nitrous oxide (50% NO = 15 mg IV morphine)
Answer:
Which of the inhalation anesthetics has analgesic effects?
Question:
(1) Analgesia (2) Rapid uptake and elimination (3) Little cardiac or respiratory depression (4) Nonpungent
(5) Reduces MAC of the more potent agents (6) Minimal biotransformation