NAGELHOUT PHARMACOLOGY EXAM
ASSESSMENT TEST PAPER QUESTIONS AND
ANSWERS GRADED A+ FULL REVIEW GUIDE
Question 1
Anesthetics have many effects. Amnesia occurs because of their effect in what part of
the CNS?
Correct Answer
Amygdala
Hippocampus
Question 2
What is the equation to calculate cerebral perfusion pressure?
Correct Answer
CPP = MAP - ICP
CPP = Cerebral Perfusion Pressure (same as periphery under normal circumstances
MAP = Mean Arterial Pressure
ICP = Intracranial Pressure
Question 3
What are the advantages of Desflurane?
Correct Answer
(1) Rapid uptake and elimination
(2) Stable molecules
(3) Minimal biotransformation
(4) No significant systemic toxicity
(5) Possible neuro- and cardiac protection
Page 1 of 163
,Question 4
What is the anticoagulant of choice during pregnancy?
Correct Answer
LMWH (does not cross placenta)
Question 5
Which of the inhalation anesthetics has analgesic effects?
Correct Answer
Nitrous oxide (50% NO = 15 mg IV morphine)
Question 6
the weakest bond in an ether anesthetic
Correct Answer
C-O
Question 7
Drugs with a large volume of distribution are likely ___________ soluble.
Correct Answer
lipid
Question 8
Why are concerns regarding protein binding and potential clinical effects unfounded?
Correct Answer
The body is an open system capable of increasing the rate of elimination.
Question 9
Drugs with protein binding ______ are conceptualized to have an unexpected
intensification of their effect if they are displaced from plasma proteins.
Correct Answer
> 90%
Page 2 of 163
,Question 10
What is the effect of Etomidate on
1) CBF
2) CMRO2
3) ICP
4) CPP
Correct Answer
1) CBF ↓↓
2) CMRO2 ↓↓
3) ICP ↓
4) CPP 0
Question 11
Amnesia occurs at what MAC fraction?
Correct Answer
0
Question 12
How would you treat a patient who has tachycardia on induction with Desflurane?
Correct Answer
Increase MAC slowly over ~ 2 minutes
Fentanyl
Question 13
Are all gas anesthetics bronchodialaters?
Correct Answer
all except nitrous oxide
Page 3 of 163
, Question 14
What are the relative contraindications to Nitrous Oxide?
Correct Answer
(1) Pulmonary HTN
(2) Prolonged anesthesia (>6 hr)
(3) First trimester of pregnancy (tetragenic)
(4) High risk of PONV
Question 15
the 1st non-explosive anesthetic
Correct Answer
halothane
Question 16
This figure depicts an initial steep drop followed by a more gradual decline. What
causes each?
Correct Answer
1) alpha (distribution) half-life: redistribution into tissues
2) beta (metabolism) half-life: drug metabolism
Question 17
You are giving a volatile anesthetic but want to avoid the associated increase in
cerebral pressure. What can you do?
Correct Answer
Hypocapnia (offsets/prevents increased cerebral blood flow; goal pCO2 is 30-35)
Question 18
What type of drugs does albumin bind?
Correct Answer
basic, neutral, or acid drugs (favors acidic)
Page 4 of 163
ASSESSMENT TEST PAPER QUESTIONS AND
ANSWERS GRADED A+ FULL REVIEW GUIDE
Question 1
Anesthetics have many effects. Amnesia occurs because of their effect in what part of
the CNS?
Correct Answer
Amygdala
Hippocampus
Question 2
What is the equation to calculate cerebral perfusion pressure?
Correct Answer
CPP = MAP - ICP
CPP = Cerebral Perfusion Pressure (same as periphery under normal circumstances
MAP = Mean Arterial Pressure
ICP = Intracranial Pressure
Question 3
What are the advantages of Desflurane?
Correct Answer
(1) Rapid uptake and elimination
(2) Stable molecules
(3) Minimal biotransformation
(4) No significant systemic toxicity
(5) Possible neuro- and cardiac protection
Page 1 of 163
,Question 4
What is the anticoagulant of choice during pregnancy?
Correct Answer
LMWH (does not cross placenta)
Question 5
Which of the inhalation anesthetics has analgesic effects?
Correct Answer
Nitrous oxide (50% NO = 15 mg IV morphine)
Question 6
the weakest bond in an ether anesthetic
Correct Answer
C-O
Question 7
Drugs with a large volume of distribution are likely ___________ soluble.
Correct Answer
lipid
Question 8
Why are concerns regarding protein binding and potential clinical effects unfounded?
Correct Answer
The body is an open system capable of increasing the rate of elimination.
Question 9
Drugs with protein binding ______ are conceptualized to have an unexpected
intensification of their effect if they are displaced from plasma proteins.
Correct Answer
> 90%
Page 2 of 163
,Question 10
What is the effect of Etomidate on
1) CBF
2) CMRO2
3) ICP
4) CPP
Correct Answer
1) CBF ↓↓
2) CMRO2 ↓↓
3) ICP ↓
4) CPP 0
Question 11
Amnesia occurs at what MAC fraction?
Correct Answer
0
Question 12
How would you treat a patient who has tachycardia on induction with Desflurane?
Correct Answer
Increase MAC slowly over ~ 2 minutes
Fentanyl
Question 13
Are all gas anesthetics bronchodialaters?
Correct Answer
all except nitrous oxide
Page 3 of 163
, Question 14
What are the relative contraindications to Nitrous Oxide?
Correct Answer
(1) Pulmonary HTN
(2) Prolonged anesthesia (>6 hr)
(3) First trimester of pregnancy (tetragenic)
(4) High risk of PONV
Question 15
the 1st non-explosive anesthetic
Correct Answer
halothane
Question 16
This figure depicts an initial steep drop followed by a more gradual decline. What
causes each?
Correct Answer
1) alpha (distribution) half-life: redistribution into tissues
2) beta (metabolism) half-life: drug metabolism
Question 17
You are giving a volatile anesthetic but want to avoid the associated increase in
cerebral pressure. What can you do?
Correct Answer
Hypocapnia (offsets/prevents increased cerebral blood flow; goal pCO2 is 30-35)
Question 18
What type of drugs does albumin bind?
Correct Answer
basic, neutral, or acid drugs (favors acidic)
Page 4 of 163
