82 Questions
Which of the following statements about ketamine is true?
Ketamine does not produce significant depression of ventilation.
Which of the following is a potential adverse effect of ketamine?
Both tissue damage and allergic reactions
What is the incidence of emergence delirium with ketamine?
20 to 30%
Which of the following is NOT a risk factor for emergence delirium with ketamine?
Age older than 15 years
How do barbiturates differ from benzodiazepines in terms of their clinical applications?
Barbiturates are used for induction of anesthesia.
What is the relative potency of thiopental compared to thiamylal?
Thiopental is 61% more potent than thiamylal.
Which of the following is a benefit of propofol compared to barbiturates for inducing anesthesia?
Both less nausea and faster recovery
Which of the following statements about ketamine is true?
Ketamine is a derivative of phencyclidine.
What is the characteristic feature of dissociative anesthesia produced by ketamine?
Dissociation between the thalamocortical and limbic systems
Which isomer of ketamine is used for treatment resistant depression?
S (-) ketamine
What is the most frequently used form of ketamine in the US?
Racemic mixture
What is a limitation of ketamine as a sole agent?
High risk for abuse potential
Which isomer of ketamine has a lower incidence of emergence reactions?
S (-) ketamine
What is the mechanism of action of ketamine?
Inhibition of re-uptake of catecholamines
Which receptors does ketamine bind to?
N-methyl-D-aspartate receptors
What is the mechanism of action of ketamine-induced analgesia and dissociative anesthesia?
Unknown
What is the rapid onset of action, duration of action, and lipid solubility of ketamine?
Rapid onset, relatively short duration, and high lipid solubility
What is the main metabolite of ketamine and how potent is it compared to ketamine?
Norketamine, 1/5 - 1/3 as potent as ketamine
What is a clinical use of ketamine?
Analgesia
What are the central nervous system side effects of ketamine?
Increases cerebral blood flow and cerebral metabolic rate of oxygen consumption
What is a potential neuroprotective effect of ketamine?
Antagonistic effect on NMDA receptors
Which of the following is a side effect of Thiopental?
Increased heart rate
What is the main function of Dexmetomidine?
Decrease plasma catecholamine concentration
What is the elimination half-life of Dexmetomidine?
3 hours
What is the clinical use of Dexmetomidine?
All of the above
What is the main difference between Dexmetomidine and Clonidine?
Dexmetomidine is more selective for alpha-2 receptors
What is the dose-dependent change in SSEP's and BAEP's caused by Thiopental?
Change in somatosensory and brainstem auditory evoked potentials
What is the main side effect of intra-arterial injection of Thiopental?
Gangrene and permanent damage
What is the main function of Atipamezole?
Reverse the sedative and cardiovascular effects of Dexmetomidine
What is the effect of Dexmetomidine on ventilation?
Mild depression of ventilation
Which of the following statements about ketamine is true?
Ketamine does not precipitate generalized convulsions in patients with seizure disorders.
Which of the following is a side effect of ketamine?
Allergic reactions.
Which of the following is a risk factor for emergence delirium with ketamine?
Dose greater than 2 mg/kg.
Which of the following is a drug interaction with ketamine?
Ketamine administered in the presence of inhaled anesthetics may result in hypotension.
Which of the following is a characteristic feature of dissociative anesthesia produced by ketamine?
Visual, auditory, proprioceptive and confusional illusions which may progress to delirium.
Which of the following is a clinical use of thiopental?
Induction of anesthesia.
Which of the following is a pharmacokinetic characteristic of barbiturates?
Hangover type CNS effects that may persist after administration.
Which of the following is a potential clinical use of ketamine?
All of the above
What is the main metabolite of ketamine and how potent is it compared to ketamine?
Norketamine, 1/5 - 1/3 as potent as ketamine
What is the rapid onset of action, duration of action, and lipid solubility of ketamine?
Rapid onset, short duration, high lipid solubility
What is the mechanism of action of ketamine-induced analgesia and dissociative anesthesia?
Unknown
What are the central nervous system side effects of ketamine?
Increased cerebral blood flow and metabolism
Which receptors does ketamine bind to?
N-methyl-D-aspartate receptors
What is the most correct statement about ketamine's induction of anesthesia?
Useful in burn patients for dressing changes
Which of the following is a potential side effect of thiopental?
Laryngeal and cough reflex depression
What is the main function of dexmedetomidine?
To produce sedation by decreasing sympathetic nervous system activity
What is a potential neuroprotective effect of ketamine?
Attenuation of postoperative delirium effects
What is a clinical use of ketamine?
To decrease perioperative requirements of opioids and inhaled anesthetics
What is the main side effect of intra-arterial injection of thiopental?
Gangrene and permanent damage
What is the effect of dexmedetomidine on ventilation?
Mild depression of ventilation
What is the mechanism of action of ketamine-induced analgesia and dissociative anesthesia?
Binding to alpha-2 receptors
What is the main difference between dexmedetomidine and clonidine?
Dexmedetomidine has a higher selectivity for alpha-2 receptors
Which of the following statements about ketamine is true?
It has a high incidence of emergence reactions
Which of the following is a characteristic feature of dissociative anesthesia produced by ketamine?
Patient is amnesic and analgesia is intense
Which of the following is true about ketamine's resemblance to phencyclidine?
Ketamine has two optical isomers
Which of the following statements about esketamine is true?
Esketamine is the R (-) isomer of ketamine
What is the main limitation of ketamine as a sole agent?
It has a high incidence of emergence delirium
Which of the following is a potential adverse effect of ketamine?
Respiratory depression
What is the main clinical use of dexmedetomidine?
Sedation in the intensive care unit
Which of the following is NOT a risk factor for emergence delirium with ketamine?
Young age
Propofol clearance from plasma exceeds hepatic blood flow.
True
Propofol is commonly used for induction of anesthesia in children.
True
Propofol has a short context-sensitive half-time and site equilibrium.
True
Propofol decreases cerebral blood flow.
True
Propofol is a sedative-hypnotic drug that induces rapid drug-induced unconsciousness.
True
Propofol is typically mixed with other drugs, such as lidocaine, to enhance its effects.
False
Propofol acts as a selective modulator of GABAA receptors and may potentiate glycine receptors.
True
True or false: Diazepam is commonly used as part of the anesthesia care plan.
False
True or false: Diazepam has a high degree of protein binding.
True
True or false: Diazepam has a longer elimination half-life compared to lorazepam.
True
Propofol increases the risk of oculocardiac reflex during pediatric strabismus surgery repair.
True
Propofol does not alter tests of coagulation or platelet function.
True
Thiopental can cause hepatocellular injury and lactic acidosis.
True
Propofol has potent antioxidant properties similar to Vitamin E.
True
Etomidate is primarily metabolized by hepatic microsomal enzymes and plasma esterases.
True
Etomidate is 99% protein bound to albumin.
False
Etomidate has a longer terminal elimination half-life compared to propofol.
False
Etomidate can cause adrenocortical suppression.
True
True or false: Benzodiazepines have a built-in ceiling effect that prevents them from exceeding the physiologic maximum of GABA inhibition.
True
True or false: Differences in onset and duration among benzodiazepines reflect differences in potency (receptor binding affinity), lipid solubility (ability to cross the BBB), and pharmacokinetics (uptake, distribution, metabolism, and elimination).
True
True or false: Benzodiazepines decrease adenosine degradation by inhibiting the nucleoside transporter.
True
True or false: Benzodiazepines exert synergistic sedative effects with alcohol, inhaled anesthetics, opioids, and α2 agonists.
True
Test your knowledge about the effects of ketamine on seizure disorders, SSEP's, auditory and visual evoked potentials, epinephrine dysrhythmogenicity, and myocardial depression. Find out if ketamine affects ventilation, airway bronchomotor tone, and more in this quiz.
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