CORRECT ANSWERS 2025
Local anesthetics are essential agents used in current surgical practice. Which of the following stateme
nts is true concerning the use of local anesthetic agents?
A. The addition of epinephrine to a local anesthetic agent increases the toxicity and decreases the dur
ation of local anesthesia.
B. Complications caused by excessive plasma concentration can result only from inadvertent intravascu
lar injection of the agent.
C. Bupivacaine has a slow onset but a long duration
D. Hypotension that occurs when a local anesthetic is administered in the form of a spinal epidural blo
ck is the result of myocardial depression - CORRECT ANSWER -
Bupivacaine has a slow onset but a long duration
Correct.
Local anesthetics constitute a class of drugs that produce temporary blockage of nerve conduction by
binding to neuronal sodium channels. Adverse consequences associated with the use of local anestheti
cs fall into three categories: acute central nervous system toxicity caused by excessive plasma concentr
ation, hemodynamic and respiratory consequences caused by excessive conduction block of the sympa
thetic or motor nerves, and allergic reactions. Whenever a local anesthetic is injected, there can be un
intentional intravascular injection or an overdose of the drug resulting from rapid uptake from the tiss
ues. Both of these effects can cause seizures. Complications can be minimized by means of aspiration
before injection to avoid intravascular injection and limiting the doses to the safe range. When local a
nesthetics are administered for a spinal or epidural block, progressive blockade of the sympathetic ner
vous system produces systemic vasodilation. If the block travels along the thoracolumbar region, symp
athetic blockade results in marked systemic vasodilation and bradycardia with resultant hypotension. L
ocal anesthetics are divided into two groups: esters and amides. The more commonly used agents, the
amides, include lidocaine and bupivacaine. Lidocaine has a fast onset of action but a short duration,
whereas bupivacaine has a slower onset but lasts 4 to 12 hours. Addition of epinephrine (100µg) decr
eases the toxicity and increases the duration of a local anesthetic.
During an airway examination when the patient opens his mouth, his uvula is partially seen. This findi
ng is called:
A. Mallampati II
, B. Mallampati OI
C. Mallampati OV
D. Mallampati OIV
E. Mallampati III
O -
O O CORRECT OANSWER O-
Mallampati OII OCorrect.
The Opreprocedure Oevaluation Oshould Oinclude O a Oreview Oof Ocurrent Omedications Oand Ocoexisting
Odisease Oan O d Oa Obrief Ophysical Oexamination, Oincluding Oevaluation Oof Othe Oairway. OIt Ois Oimportant
Oto Odetermine Ohow Odiff Oicult Oit Omay Obe Oto Oobtain Ocontrol Oof Othe Oairway Oif Oapnea Oshould Ooccur.
OAlthough Othere Ois Ono Oabsolute Osta Ondard Ofor Opredicting Odifficult Ointubation, Oa Osimple Ofour-
step Oexamination Ohelps Oto Odetermine Othe Olikelihood. OFirst, Othe Opatient Oshould Ohave Oa Onormal
Omouth Oope Oning. OSecond, Othe Opatient Oshould Ohave Onormal Oneck Oflexion Oand Oextension. OThird,
Othe Ophysician Oshould Ob O e Oable Oto Ofit Othree Ofinger-
widths Ounder Othe Opatient's Ochin Obetween Othe Othyroid Ocartilage Oand Othe Omentum. OFinally, Owhen
Othe Opatie Ont Oopens Ohis Oor Oher Omouth Oand Ois Oasked Oto Ostick Oout Othe Otongue, Othe Oairway Ocan Obe
Oclassified Odepending O on Owhether Othe Ouvula Ocan Obe Ocompletely Oseen O(Mallampati Oclass OI), Oonly
Opartly Oseen O(class OII), Onot Oseen Owith Oonly Othe Ohard Oand Osoft Opalate Ovisible O(class OIII), Oor Oonly Othe
Ohard Opalate Ovisible O(class OIV). OThis Oclass Oification Ois Oroughly O predictive Oof Oprogressive O difficulty Oin
Ointubation O resulting Ofrom Odifficulty O in Ovisualizin O g Othe Olarynx.
Muscle Orelaxants Oare Oa Oclass Oof Oanesthetic Oagents Oused Oto Oprevent Omovement Oand Ofacilitate
Osurgical Oexp Oosure. OWhich Oof Othe Ofollowing Ostatements Ois Otrue Oconcerning Othe Ouse Oof Omuscle
Orelaxants Oin Osurgical Opro Ocedures?
A. The Obest Oclinical Otest Ofor Ocomplete Oreversal Oof Oneuromuscular Oblockade Ois Othe Oability Oof Othe
Opatient Ot O o Oraise Ohis Oor Oher Ohead Ofor O5 Oseconds
B. Pancuronium Ocan Obe Oreversed Oby Oincreasing Oacetylcholine Oconcentration Owith Oan
Oanticholinesterase Oi Onhibitor O(neostigmine)
C. Prolonged Operiods Oof Omuscle Orelaxation Ofor Opatients Orequiring Oprolonged Oventilation Oshould Obe
Oused Oi O n Oconjunction Owith Oanalgesics Oand Oamnesic Oagents
D. Succinylcholine O produces Orapid O obvious O muscle O fasciculations