Anxiolytic Drugs MCQ Assessment PDF

Anxiolytic Drugs MCQ Assessment 1- All the following are true regarding Glycopyrrolate except one : a) Anticholinergic drug b) Increase heart rate. c)..Causes sedation d) Not pass placenta e) No antiemetic effects 2- Fentanyl (all true except one): a) Potent analgesic 100 times...

Anxiolytic Drugs MCQ Assessment 1- All the following are true regarding Glycopyrrolate except one : a) Anticholinergic drug b) Increase heart rate. c)..Causes sedation d) Not pass placenta e) No antiemetic effects 2- Fentanyl (all true except one): a) Potent analgesic 100 times more than morphine b) Metabolized in the liver and excreted in the urine c) use in caution with COPD d) Cause less nausea and vomiting e).. Can be reversed by neostigmine 3.Metoclopramide (all true except one) : a) The most common used antiemetic drug b) Act centrally as dopaminergic antagonist on the vomiting center in the medulla c)..Act peripherally by decreasing the rate of gastric emptying d) increasing in the gut peristalsis e) May produce oculogyric (extrapyramidal) side effect 4.Atropine (all true except one) : a) has vagal inhibition b).. CNS depressant c) Antisialagogues (decrease salivation). d) The dose of atropine is 0.3 -0.4 mg iv e) Increases heart rate 5. Remifentanil (all true except one) : a) is a potent ultra-short-acting synthetic opioid given to patients during surgery for pain relief b) Remifentanil is a specific mu-type-opioid receptor agonist c) causes respiratory depression and analgesia. d).. is antagonized by flumazenil. e) The analgesic effects of remifentanil are rapid in onset and offset. 6.Pethidine(meperidine) versus morphine (all true except one) : a) 1/10th as potent as Morphine but Efficacy is similar b) less miosis, constipation and urinary retention c) Rapid but short duration of action (2-3 Hrs) d).. antitussive action e) Less histamine releases 7.Ondansetron (all true except one) : a) Ondansetron is a selective 5-HT3 serotonin-receptor antagonist b) used for its antiemetic properties. c) Ondansetron acts both centrally and peripherally to prevent and treat nausea and vomiting. d).. has effects peripherally by acting on the laryngeal nerve. e) The peripheral actions of ondansetron are thought to be the predominant mechanism for its antiemetic effects. 8.Midazolam (all true except one) : a) is a benzodiazepine b) It is water soluble at pH< 4 but becomes highly lipid soluble at physiologic ph. c) Water solubility minimizes pain at the injection site. d) Midazolam is more potent, has a faster onset and shorter duration of action than diazepam. e).. The elimination half-life is 20 hours as against approximately 1.5 t0 3.5 hours in case of diazepam 9.Anxiolytic drugs (all true except one) : a) They act predominantly on GABA receptors b) Minimum cardiac and respiratory depression c) Do not produce nausea and vomiting d).. Good analgesic effect  e) Cross the placenta and may cause neonatal depression 10- All the following drugs has analgesic effects except one : a) Clonidine b) Paracetamol c) Fentanyl d) Pethidine e).. Midazolam 11. Which of the following describes the action of anxiolytic drugs? a. Increase anxiety levels in patients b. Increase the patient's heart rate and breathing c.. Decrease anxiety levels in patients d. Induce nausea and vomiting in patients e.Has no effect on anxiety level 12. Anxiolytic drugs predominantly act on which receptors? a. Dopamine receptors b. Serotonin receptors c.. GABA receptors d. NMDA receptors e.Acetylcholine receptors 13. What effect do anxiolytic drugs have on cardiac and respiratory function? a.. Minimum cardiac and respiratory depression b. Have no effect on cardiac and respiratory function c. Sever cardiac and respiratory depression d. They increase cardiac and respiratory function e.Increase cardiac function and no effect on respiratory function 14. Anxiolytic drugs lack which of the following effects? a. Sedative effect b. Amnesic effect c.. Analgesic effect d. Anticonvulsant effect e.Anxiolytic effect 15. Which of the following is a common class of anxiolytic drugs? a. SSRIs b. Beta-blockers c.. Benzodiazepines d. Antipsychotics e. Antihypertensive 16. Which of the following benzodiazepines is often used for many years for oral premedication? a.. Diazepam b. Ketamine c.propofol d. Fentanyl e. All of the above 17. What are the main properties exhibited by benzodiazepines? a..Anxiolytic, sedative, and anticonvulsant properties b. Antidepressant, stimulant, and analgesic properties c. Antipsychotic, hypnotic, and antipyretic properties d. Antihistamine, diuretic, and anticoagulant properties e.Antihypertensive , analgesic properties 18. How do benzodiazepines differ from each other? a. They differ in their ability to cross the placenta b.. They differ in their pharmacokinetic properties c. They differ in their analgesic effects d. They differ in their cardiovascular side effects e. They differ in their anesthetic effect 19. What is the recommended standard dose of diazepam for its anxiolytic action by oral rote? a. 5 to 10 mg b..10 to 20 mg c. 20 to 30 mg d. 30 to 40 mg e.40-50 mg 20. Which of the following statements is true about diazepam? a. It has a short elimination half-life b.. It causes anterograde amnesia c. It is frequently used for intramuscular injection d. It is recommended for patients with repeated vomiting e. It is frequently used for analgesia 21. Why is midazolam considered suitable for producing conscious sedation in short endoscopic procedures? a. It has a slower onset and longer duration of action than diazepam b. It has negligible sedative effects c.. Water soluble. potent, faster onset and shorter duration of action than diazepam. d. It has agood analgesic effect e. It has agood anesthetic effect 22. What is the elimination half-life of midazolam? a.. 1.5 to 3.5 hours b. Approximately 20 hours c. 4 to 6 hours d. 6 to 8 hours e.8-10 hours 23. Midazolam has shown to provide superior pre-operative sedative effect compared to which benzodiazepine? a.. Diazepam b. Lorazepam c. Alprazolam d. Clonazepam e.None of the above 24. What advantage does midazolam have over diazepam in terms of metabolites? a. Midazolam metabolites have significant soporific effects b. Midazolam metabolites have no effect on sleep patterns c. Midazolam metabolites have a longer duration of action d.. Midazolam metabolites have negligible soporific effects e.All of the above 25. Which of the following agents is used to accelerate recovery from the sedative actions of intravenous benzodiazepines? a)Naloxone (b)Flumazenil c)Ketamine d)Fomepizole e) Atropine 26. How would you describe the hemodynamic stability of midazolam? a. Poor local tolerability b. Fair local tolerability c. Good hemodynamic stability d. Excellent local tolerability e.None of the above 27. Why midazolam is a suitable agent for producing conscious sedation in short endoscopic procedures, preoperative sedation and for induction of general anesthesia? a long elimination half-life b. Good analgesic effect c. Poor hemodynamic stability d.. More potent, faster onset and shorter duration of action than diazepam e.All of the above 28. What is the advantage of diazepam over midazolam? a. Diazepam has a faster onset of action than midazolam b. Diazepam has a shorter duration of action than midazolam c. Diazepam has a more potent sedative effect than midazolam d..Diazepam has a longer elimination half-life than midazolam e. Diazepam has same elimination half-life than midazolam 29. Which class of drugs are commonly used as anxiolytics and antiseizure medications? a. Antidepressants b. Beta-blockers c.. Benzodiazepines d. Opioids e.Antihypertensive 30. Regarding the use of anxiolytic drugs during pregnancy? a.. Cross the placenta and may cause neonatal depression b. They are safe to use during all stages of pregnancy c. Do not cross the placenta d. Do not produce neonatal depression e. None of the above 31.Reverses respiratory depression cause by benzodiazepine(Antidote) by: a..Flumazenil b. propofol c.Ketamine d.Diazepam e.Atropine 32. Diazepam may be used as: a..Relief of anxiety b. Relief of pain c.Reduction of saliva d.Reduce constipation e. Reduce nausea and vomiting 33. Midazolam may be used as: a) Relief of pain b)Sedation c)Reduction of saliva d)Reduction of constipation e) Reduce nausea and vomiting 34. Diazepam, Midazolam, and Atropine are: a.Postoperative analgesia b.Intraoperative analgesia c..Preanesthetic medications d.General anesthesia medications e.Local anesthetic medications 35. Antiemetics drugs : a.Reduce constipation b.Reduce abdominal distention c..Reduce nausea and vomiting d.Reduce pain e. Reduce anxiety 36. Analgesics like morphine : a.Reduce nausea and vomiting b..Reduce pain c.Reduce constipation d.Reduce urinary retention e.Reduce salivation 37. Fentanyl is : a..Analgesic drug b.Antihypertensive drug c.Muscle relaxant drug d.Antiemetic drug e.Inhalational drug Analgesic Drugs 38. Which of the following is NOT a classification of opioids? a. Natural Opium Alkaloids b. Semi-synthetic Opioids c. Synthetic Opioids d.. Non-steroidal anti-inflammatory drugs (NSAIDs) e.All of the above 39. Which analgesic drug can be given parenterally and helps control elevated blood pressure during endotracheal intubation? a. Paracetamol b. Codeine c..Fentanyl d. Ketamine e.Atropine 40. What is the main difference between pethidine and morphine? a. Pethidine is more potent than morphine. b. Pethidine has a longer duration of action than morphine. c.. Pethidine has a rapid onset and short duration of action compared to morphine. d. Pethidine causes less sedation and respiratory depression than morphine. e. More histamine releases than morphine 41. Which opioid is preferred for its rapid onset and short duration of action in anesthesia? a.. Remifentanil b. Diacetylmorphine c. Diphenoxylate d. Loperamide e. Pholcodeine 42. What is the primary use of remifentanil during surgery? a.. Pain relief and adjunct to anesthesia b. Treatment of hypotension c. Treatment of constipation d. Prevention of nausea and vomiting e.Reduce intraoperative hypoglycemia 43. Which opioid is metabolized in the liver and excreted in the urine? a. Paracetamol b.. Fentanyl c. Ketamine d. propofol e.sevoflurane 44. What is the potential side effect of fentanyl use in patients with chronic obstructive pulmonary disease (COPD)? a. Nausea and vomiting b..Respiratory depression c. Hypertension d. Urinary retention e.Hyperglycemia 45. Which opioid has the highest abuse potential? a. Paracetamol b. Codeine c.. Pethidine d. Fentanyl e. Remifentanil 46. Which opioid can be reversed using naloxone? a. Ketamine b. Paracetamol c.. Fentanyl d. Pentothal e.Propofol 47. Which analgesic drug is commonly used in day surgery, unless there are contra- indications? a..NSAIDs b. Atropine c. Glycopyrrolate d. Ketamine e.All of the above 48. What is the effect of opioids on the cardiorespiratory system? a. Increased heart rate and bronchospasm b.. Decreased heart rate and bronchospasm c. Increased heart rate and sedation d. Decreased heart rate and bronchodilatation e.No effect on cardiorespiratory system 49. Which opioid is known for its tachycardic effect (Vagolytic effect )? a. Fentanyl b. Paracetamol c. Morphine d.. Pethidine e. Remifentanil 50. pethidine lack which type of action ? a.. Antitussive action b. Analgesic action c. Vagolytic action d. Histamine releases e. All of the above 51. Meperidine is ? a.. Analgesic drug b. Antiemetic drug c. Anesthetic drug d. Anxiolytic drug e.All of the above 52. How long does the action of pethidine last after parenteral administration? a. 1-2 hours b.. 2-3 hours c. 3-4 hours d. 4-5 hours e.5-6 hours 53. Which opioid is safer in patients with asthma? a.. Meperidine b. Fentanyl c. Remifentanil d. Codeine e.Morphine 54. What is the main effect of remifentanil on the sympathetic nervous system? a. Increased sympathetic tone b.. Decreased sympathetic tone c. Increased parasympathetic tone d. Decreased parasympathetic tone e.No effect on sympathetic tone 55. How are the effects and side effects of opioids like remifentanil? a..They are dose-dependent and similar to other opioids. b. They are independent of the dosage and unique to remifentanil. c. They are primarily gastrointestinal in nature. d. They are primarily neurological in nature. e.They have no side effects 56. What is the most common side effect of opioid use? a. Hyperthermia b. Hypertension c.. Nausea and vomiting d. Constipation e.Hyperglycemia 57. Which medication can antagonize the opioid activity of remifentanil? a.. Naloxone b. Paracetamol c. Codeine d. Clonidine e. Neostigmine 58.Reverses respiratory depression cause by opioids(Antidote) by: a.. Naloxone b. propofol c. Ketamine d. Diazepam e. Paracetamol 59. Example of intravenous opioids -- used in anesthesia: a.. remifentanil b.Atropine c.Lidocaine d.Ketamine e.Propofol 60. Example of intravenous benzodiazepines used in anesthesia : a.. diazepam (Valium) b.flumazenil c.Propofol d.Lidocaine e.Ketamine 61. Premedications are : a..Administration of drugs before induction of anesthesia b. Induction of anesthesia c. Preoperative evaluation d.Recovery of anesthesia e.Postoperative analgesia 62. Goals of preoperative medications all are true excep one : a.Relief of anxiety b. Sedation c.Amnesia d..Increase of anesthetic requirements e.Reduce risk of nausea and vomiting 63. Adminstration of premedications all are false except one : a. 4 days before operation b..1-2 hr or night before operation c. 5 days before operation d.10 days before operation e.7 days before operation 64._______ is the most important advantages of pethidine over morphine a.Greater potency B.Longer duration of action c..Safer in asthmatics d.Less respiratory depression e.More histamine releases 65.Which anticholinergic drug has the least effect on vagal inhibition? a.Atropine b..Hyoscine c.Glycopyrrolate d. Pholcodeine e.None of the above 66.All true about ondansetron except one: a.Ondansetron is a selective 5-HT3 sertonin-receptor antagonist b.Used for its antiemetic properties c.Ondansetron acts both centrally and peripherally to prevent nausea and vomiting d..Has effect peripherally by acting on laryngeal nerve e.Has no analgesic effects 67.What is the common mechanism of action for antiemetic drug ? a.Blocking serotonin rceptors b.Antagonizing dopamine effects c.Increasing gastric PH d.Stimulating peristalsis in the gut e..All of the above 68.In which procedures midazolam is particularly useful for sedation? a..Endoscopic procedure b.Bone fractures c.Blood tests d.Vision tests e. None of the above 69.What is the specific sign of laryngospasm? a.Expiratory wheeze and an increased inflation pressures b..Inspiratory stridor and increased inspiratory efforts c.Desaturation and central cyanosis d.Bradycardia and abdominal movements e.None of the above Anti-autonomic Drugs 70. Which of the following drugs is an anticholinergic used in premedication? a. Atropine b. Hyoscine c. Glycopyrrolate d.. A+B+C e.None of the above 71. Which anticholinergic drug has vagal inhibition, CNS stimulation, and is used as an antidote for bradycardia? a.. Atropine b. Ketamine c. Glycopyrrolate d. Propofol e. Ondansetron 72. Which anticholinergic drug should be avoided in elderly patients due to its sedative and amnesic effects? a. Metoclopramide b.. Hyoscine c. Glycopyrrolate d.B+C e. None of the above 73. Which anticholinergic drug does not cross the blood-brain barrier and has a longer duration of action? a. Atropine b. Hyoscine c.. Glycopyrrolate d.A+B e. None of the above 74. Which of the following is not a side effect of anticholinergic drugs? a. Dry mouth b. Mydriasis c.. Bronchoconstriction d. Bronchodilatation e.Tachycardia 75. Which anticholinergic drug may cause central anticholinergic syndrome, which includes restlessness, agitation, somnolence and convulsion? a.. Atropine b. propofol c. Glycopyrrolate d. Ondansetron e. None of the above 76. What are antiemetic drugs used for? a. To decrease gastric emptying b.. To decrease incidence of nausea and vomiting c. To induce sedation during anesthesia d. To treat bradycardia e. To provide analgesia during anesthesia 77. Which drug is commonly used as an antiemetic and acts centrally as a dopaminergic antagonist? a. Ondansetron b.. Metoclopramide c. Atropine d. Glycopyrrolate e. Hyoscine 78. How does ondansetron prevent and treat nausea and vomiting? a.. By acting on 5-HT3 serotonin receptors (antagonist) b. By decreasing gastric emptying c. By increasing vagal stimulation d. By stimulating the vomiting center in the medulla e.All of the above 79. Besides central effects, how does ondansetron work to prevent and treat nausea and vomiting? a.. By acting peripherally on the vagus nerve terminals b. By decreasing gastric emptying c. By stimulation dopamine release d. By blocking histamine receptors e. By acting peripherally on the Radial nerve 80. Which drug is not recommended to patients at no risk of pulmonary aspiration as premedication? a.. Antacid drugs b. Ketamine c. propofol d. Scholine e.All of the above 81. How do histamine H2 receptor antagonists (H2-blockers) act as antacid drugs? a. By increasing gastric acid secretion b..By increase the ph. of the gastric content c. Have no effect on gastric acid secretion d. By increasing gastric volume e. All of the above 82. Which drug is a proton pump inhibitor commonly used as an antacid? a. Cimetidine b. Ranitidine c.. Omeprazole d. Sodium citrate e.All of the above 83. Which drug is given before anesthesia to decrease the pH of gastric content? a. Cimetidine b. Ranitidine c. Omeprazole d. Sodium citrate e..None of the above 84. Which drugs are used to increase the PH of the gastric juice and decrease volume and so decrease the side effect of the pulmonary aspiration if happen ? a.. Antacid drugs b. Antiemetic drugs c. Anticholinergic drugs d. Analgesic drugs e. Anxiolytic drugs 85. What is the dosing range of atropine for premedication? a. 0.1-0.2 mg b. 0.2-0.3 mg c.. 0.3-0.4 mg d. 0.4-0.5 mg e.0.5- 0.6 mg 86. Which drug is an antiemetic drug Used in emergency anesthesia? a. Ondansetron b.. Metoclopramide c. Atropine d. Glycopyrrolate e. Omeprazole 87. What is the duration of action of Metoclopramid (plasil) ? a. 4 hours b. 8 hours c.. 12 hours d. 24 hours e.5 hours 88. How do antacid drugs reduce the side effects of pulmonary aspiration? a. By increasing the pH of gastric juice b. By decreasing the volume of gastric juice c. By increasing the volume of gastric juice d..A+B e. None of the above 89. Which drug acts as a dopaminergic antagonist on the vomiting center in the medulla? a. Omeprazole b.. Metoclopramide c. Atropine d. Glycopyrrolate e. Ranitidine 90.An elderly man given atropine becomes excited, restlessness, agitation, somnolence and confused, appropriate treatment is: a. Morphine b..Physostigmine c. Intubation and ventilation d. Flumazenil e.Naloxone 91.All true about midazolam except: a. Antero-grade amnesia b..Retrograde amnesia c. good hemodynamic stability. d faster onset and shorter duration of action e.Anxiolytic drug 92. Antiemetic agent is : a. Lidocaine b. Diazepam c.. Ondansetron d.Fentanyl e.Atopine 93. Anesthesia for patient with full stomach ,which of these factors decrease the risk of aspiration ? a.N.G. tube b. Metoclopramide c. Rapid sequence induction d.Endotracheal intubation e.. All of the above 94. Premedication that can be given : a.Anxiolysis b.Antiemetic c.Antacid d.Analgesic e..All of the above 95. Any drug administrated before anesthesia is termed as: a.Operation b.Vaccination c.Induction d..Pre-medication e.Recovery 96. All of the following are purposes of pre-anesthetic medication, except a.To reduce dose of anesthetic agent b..To postpone operation c.To reduce anxiety d.To reduce aspiration e.To provide analgesia 97. Atropine when used as a pre-anesthetic medication causes all of the following symptoms,except: a.Prevents bradycardia b..Bronchoconstriction c.Dryness of mouth d.Skin flush e.Mydriasis Antisialagogue effect can be achieved by the use of all of the following 98. drugs in pre-medication, except: a. Hyoscine b. Atropine c.Glycopyrrolate d. A+B+C e.. Neostigmine 99.In selecting appropriate drug for pre-operative medication for a male patient all of the following factors are important, except: a.Patient's psychological condition b.Outdoor patient c..Married d.Patient weight. e.Medical condition 100.Which of the following is anticholinergic drugs primarily used as preanaesthetic medication and during surgery? a.. Atropine b. Ketamine c. Isopropamide d. Dicyclomine e.propofol 101. Children are more susceptible than adults to the following action of atropine: A. Tachycardia producing B. Cycloplegic C. Gastric antisecretory D.. Central excitant and hyperthermic E.None of the above 102. Glycopyrrolate is the preferred antimuscarinic drug for use before and during surgery because: a. It is potent and fast acting b. It has no central action(does not cross the blood brain barrier) c. It has antisecretory and vagolytic actions d.No mydriasis e..All of the above 103. Atropine may be used to: a.Relieve anxiety b.Sedation c..Reduce saliva d.Reduce constipation e.Analgesia 104. The following anticholinergic drugs produce mydriasis (dilation of eye pupil) except? a.Atropine b. Hyoscine c..Glycopyrrolate d.Ipratropium bromide e.A+B 105. Central anticholinergic syndrome, which includes restlessness, agitation, somnolence and convulsion can be reversed by ? a.Atropine b.. physostigmine c.Nalaxone d.flumazenil e.Ketamine Laryngospasm and Bronchospasm 106. What is laryngospasm? a. A form of bronchospasm b. An allergic reaction c.. An airway obstruction d. A respiratory infection e An airway tumor 107. Which of the following subgroups is at greater risk of laryngospasm? a. Children with airway infections b. Adults undergoing anal surgery. c. Children with asthma d. undergoing oesophagoscope or hypospadias repair e..All of the above 108. When does laryngospasm occur most frequently? a. During anal surgery b. Difficult intubation, c. Nasal, oral or pharyngeal surgical site d. Obesity with obstructive sleep apnea e.All of the above 109. How is laryngospasm recognized (signs )? a. Increased inspiratory efforts /tracheal tug b. Inspiratory stridor /airway obstruction c. Paradoxical chest /abdominal movements d. Desaturation, bradycardia, central cyanosis. e..All of the above 110. What is one potential complication of laryngospasm? a.. Pulmonary aspiration b. Urinary retention c. Gastric ulcer d. Renal failure e.Duodenal ulcer 111. Which of the following is NOT a risk factor for laryngospasm? a. Difficulty in intubation b. Obesity with obstructive sleep apnea c. Nasal surgical site d. Oral or pharyngeal surgical site e. Normal body weight 112. What are the signs of laryngospasm? a. Inspiratory stridor/airway obstruction b Increased inspiratory efforts/tracheal tug. c Desaturation, bradycardia, central cyanosis d. Paradoxical chest /abdominal movements e.. All of the above 113. Which complication of laryngospasm may require intubation, ventilation, and management in an intensive care setting? a.. Post-obstructive pulmonary edema b. Coughing c. Sneezing d.Vomiting e.None of the above 114. What can precipitate laryngospasm? a Airway manipulation b. Blood/secretions in the pharynx c. Regurgitation/vomiting d. Surgical stimulus e..All of the above 115. Which statement about laryngospasm is FALSE? a. It is a form of airway obstruction. b. It is easily recognized and handled. c. It can cause serious morbidity and mortality. d.. It only occurs in children. e. Risk is greater in certain subgroups such as children with asthma or airway infections 116. Which subgroup is at higher risk of laryngospasm? a. Children with anemia b. Adults with kidney disease c.. Children with asthma or airway infections d. Adults with liver disease e.Healthy adult 117. A potential complication of laryngospasm is? a. Kidney failure b. Liver cirrhosis c.. Pulmonary aspiration and post obstructive pulmonary oedema. d. Gastrointestinal bleeding e.Gastric ulcer 118. Which factor may precipitate atypical laryngospasm? a. Eating spicy food b. Good analgesia c.. Surgical stimulus d. Lack of sleep e.None of the above 119. Which of the following is a signs of laryngospasm? a. Expiratory stridor b. Increased heart rate c. Increased blood pressure d.. Inspiratory stridor e.Decreased inspiratory efforts 120. All of the following are a risk factor for laryngospasm except one? a. Obesity with obstructive sleep apnea b. Difficulty in intubation c. Nasal surgical site d..Normal body weight e. Oral or pharyngeal surgical site 121. What is the potential consequence of laryngospasm? a.. Pulmonary aspiration and Post-obstructive pulmonary edema b. Urinary retention c. Gastrointestinal bleeding d. Renal failure e. Urinary tract infection 122. What may precipitate laryngospasm? a.. Smoking b. Drinking cold water c. Eating a Protein meal d. Taking deep breaths e.All of the above 123. Which statement is true about laryngospasm? a. It occurs exclusively in adults. b. It is easily prevented with medication. c.. It has the potential to cause serious complications especially if managed poorly. d. It is not a separate entity from other airway obstructions. e. Rarely occurring and difficult to recognized and handled 124. What is a risk factor for laryngospasm? a.. Having a history of sinusitis b. Being physically active c. Being underweight d. Having a history of headache e. Having a history of urinary tract infection 125. What is the sign of laryngospasm? a. Decreased blood pressure b. Increased heart rate c..Inspiratory stridor d. Expiratory stridor e.Increased oxygen saturation Precipitating Causes and Management of Laryngospasm 126. Which of the following is a precipitating causes of laryngospasm? a. Airway manipulation b. Blood/secretions in the pharynx c. Regurgitation/vomiting d. Surgical stimulus e..All of the above 127. Which action should be taken to manage laryngospasm? a. Request immediate assistance and Cease stimulation/surgery b. 100% Oxygen c. Try gentle chin lift/jaw thrust d. Deepen anesthesia with an IV agent e..All of the above 128. What percentage of laryngospasm cases present as regurgitation? a. About 77% b. About 14% c.. About 5% d. About 4% e.. About 90% 129.What percentage of laryngospasm cases present as airway obstruction? a. About 77% b.. About 14% c About 5% d. About 4% e.. About 90% 130.What percentage of laryngospasm cases present as desaturation?. a. About 77% b About 14% c About 5% d. About 4% e. About 90% 131What percentage of laryngospasm cases were clinically obvious? a. About 77% b About 14% cAbout 5% d. About 4% e. About 90% 132. Which muscle is the only tensor of the vocal cords? a.. Cricothyroid muscle b. Abdominal muscle c. Deltoid muscle d.Biceps muscle e.Trapezius muscle 133. What should be done when applying jaw thrust to relieve laryngospasm? a.. Exert gentle pressure on the angle of the mandible b. Exert firm pressure on the angle of the mandible c. Exert pressure on the soft tissues of the jaw d. Exert pressure on the maxilla bone e. None of the above 134. How much of the induction dose should be tried to relieve laryngospasm? a. 10% of the induction dose b.. 20% of the induction dose c. 30% of the induction dose d. 40% of the induction dose e.80% of the induction dose 135. Which medication can be used to relieve severe laryngospasm without intubation? a.. Suxamethonium (0.5mg/kg IV) b. pentothal 3-6 mg iv c. pavelone 4 mg iv d.Atracurium 0.4-0.5 mg iv e.None of the above 136. What is the recommended dosage of atropine to prevent bradycardia during laryngospasm? a. 0.05mg/kg iv b. 0.1mg/kg iv c.. 0.01mg/kg iv d. 0.5mg/kg iv e. 0.8 mg/kg iv 137. How should the pharynx/airway be visualized and cleared during laryngospasm? a.. Use a laryngoscope and suction device b. Use a flexible bronchoscope and forceps c. Use a nasal endoscope and saline solution d. Use a laryngeal mirror and swab e.None of the above 138. What action should be taken if mask CPAP/IPPV is unsuccessful in relieving laryngospasm? a. Give suxamethonium unless contraindicated b. Give atropine unless contraindicated c. Again, try mask CPAP/IPPV d. Intubate and ventilate the patient e..All of the above 139. What could be the cause of a delay in relieving severe laryngospasm? a.. Post-obstructive pulmonary edema b. Gastric perforation c. Gastric ulcer d. Renal failure e.Liver failure 140. Which intervention should be attempted if laryngospasm is suspected? a. Cricothyrotomy b. Tracheostomy c. Nasopharyngeal intubation d..Orotracheal intubation e.None of the above 141. What is the primary purpose of providing 100% oxygen in laryngospasm management? a. To reduce the risk of aspiration b. To relieve laryngeal edema c.. To promote oxygenation of the patient d. To relax the vocal cords e.To treat hypertension 142. When should mask CPAP/IPPV be tried during laryngospasm management? a. As the first intervention b. Only if laryngospasm is severe c.. Only if deepening anesthesia fails d. As a last resort before intubation e.None of the above 143. What is the recommended dosage of suxamethonium for relieving laryngospasm? a.. 0.5mg/kg IV b. 1.0–1.5mg/kg IV c. 4.0mg/kg IM d. 10mg/kg IV e.8 mg /kg IV 144. How should the laryngospasm be managed if mask CPAP/IPPV is unsuccessful? a.. Intubate and ventilate the patient b. Increase the depth of anesthesia c. Administer an anticholinergic medication d. Apply continuous positive airway pressure e. Apply LMA 145. In what situations should atropine be contraindicated during laryngospasm management? a. Bradycardia b..Tachycardia c. Hypertension d. Hypotension e.All of the above Bronchospasm 146. Which of the following are a signs of bronchospasm during anesthesia? a.. Anexpiratory wheeze, prolonged expiration ,increased inflation pressures during intermittent positive pressure ventilation (IPPV) b. Decreased inflation pressures c. Increased oxygen saturation d. Normal capnogram e.All of the above 147. How is bronchospasm usually manifested during anesthesia? a. Inspiratory wheeze b. Decreased expiration c.. Increased inflation pressures d. Normal oxygen saturation e.Hypertension 148. What can the presence of expiratory wheeze indicate during anesthesia? a..Bronchospasm b. Normal airway function c. Expiratory phase obstruction d. Severe hypotension e.Laryngospasm 149. Which of the following can cause bronchospasm during the induction of anesthesia? a. Excessive airway irritation and allergic reaction b.. Aspiration of gastric contents c. Misplacement of endotracheal tube d. Pulmonary oedema (following failed intubation) e.. All of the above 150. Which of the following can cause bronchospasm during the maintenance of anesthesia? a. Anaphylaxis b. Severe allergy c. Ventilator problem d. Endotracheal tube problem e..All of the above 151. What are potential causes of bronchospasm during the emergence or recovery phase of anesthesia? a. Pulmonary edema only b. Allergic reaction only c. Accidental extubation only d. Aspiration only e.. Multiple causes 152. In cases of severe bronchospasm, why may the chest be silent on auscultation? a.. Reduced gas flow in the patient's airways b. Presence of wheezing c. Excessive secretion production d. Normal airway function e.None of the above 153. How can increased inflation pressures help diagnose bronchospasm? a. They indicate reduced airway resistance b. They indicate normal lung compliance c. They indicate normal ventilation d..They suggest the presence of bronchospasm e. They suggest the presence of laryngospasm 154. Which of the following can be a sign of bronchospasm during anesthesia? a. Hypoventilation b. Low oxygen saturation c. change in capnogram d. hypotension e..All of the above 155. What is a potential cause of bronchospasm during maintenance of anesthesia with endotracheal intubation? a. Hyperglycemia b. Hypertension c. Aspiration of gastric contents d..Endotracheal tube or ventilator problem e.None of the above 156.What is a potential cause of bronchospasm during maintenance of anesthesia with laryngeal mask or mask anesthesia? a.Hyperglycemia b. Hypertension c..Aspiration of gastric contents d. Endotracheal tube or ventilator problem e.None of the above 157. How can bronchospasm be diagnosed in cases where the chest is silent on auscultation? a. By auscultation b.. By correct assessment of increased inflation pressures c. Wheeze audible either with or without auscultation d. By correct assessment of decreased inflation pressures. e.All of the above 158. Which of the following can cause bronchospasm during the emergence or recovery phase of anesthesia? a. Aspiration only b. Accidental extubation only c. Allergic reaction only d. Pulmonary edema only e.. Multiple causes 159. What is a potential cause of bronchospasm during induction of anesthesia? a. Hypertension b. Excessive airway humidity c..Pulmonary edema (following failed intubation) d. Misplacement of laryngeal mask anesthesia e.All of the above 160.What is a potential cause of bronchospasm during induction of anesthesia? a. Hypertension b. Excessive airway humidity c.. Unknown, possibly allergy d. Misplacement of laryngeal mask anesthesia e.All of the above 161. What can a change in the capnogram indicate during bronchospasm? a. Increased oxygen saturation b. Normal airway function c. Increased blood pressure d..Bronchospasm or allergy e.Increased blood sugar 162. Which of the following is a cause of bronchospasm during the maintenance of anesthesia? a. ventilator problem b. Allergic reaction c. Aspiration of gastric contents d. Endotracheal tube problem e.All of the above 163. How can bronchospasm be diagnosed in cases where the chest is silent on auscultation? a. By monitoring blood pressure changes b. By checking capillary refill time c.. By assessing inflation pressures d. By performing bronchoscopy e.None of the above 164. What is a potential cause of bronchospasm during the emergence or recovery phase of anesthesia? a. Aspiration b. Anaphylaxis/allergy c. Accidental extubating d. No defined cause e.All of the above 165. What can low oxygen saturation indicate during bronchospasm? a. Normal airway function b. Excessive secretion production c.. Impaired gas exchange d. Reduced airway resistance e.None of the above 166. In cases of severe bronchospasm, what can the presence of increased inflation pressures indicate? a. Reduced airway resistance b. Excessive gas leakage c.. Increased airway resistance d. Normal lung compliance e.All of the above 167. Once the signs of bronchospasm appear during anesthesia , think of: a. Anaphylaxis. Allergy to drugs, IV fluid and latex. b. Airway manipulation, irritation, secretions and soiling. c Inadequate anesthetic depth d. Failure of anesthetic delivery system e..All of the above 168. Emergency management of bronchospasm: a. 100% oxygen b. Stop stimulation and surgery c. Deepen anesthesia d. If intubated exclude esophageal or endobronchial position e..All of the above 169. During bronchospasm If you cannot ventilate via endotracheal tube, consider: a. Misplaced, kinked, blocked tube or circuit b. Consider possible obstruction distal to the tube: Try to push a small tube past it or push the obstruction down one bronchus and ventilate the other lung. c. pneumothorax, aspiration, anaphylaxis and pulmonary edema. d. Magnesium sulfate 3 (1.2-2 g i.e.) can be helpful in difficult cases; it is cheap, available, and can also suppress tachyarrhythmias e..All of the above 170. Further management of bronchospasm: a. Bronchodilators b. Chest x-ray c.Admission to the ICU. d. Recommended dosage of drugs: Salbutamol 0.5% 1ml (5mg) solution ,Adrenaline 0.001 mg/kg bolus (0.01 ml/kg of 1:10 000 solution). e.All of the above Hypoxia and Malignant Hyperthermia 171. What is the main reason anesthesia providers make every effort to avoid hypoxemia during surgery? a.. To prevent irreversible damage to the brain , myocardium and other end organs. b. To reduce the degree of intraoperative bleeding c. To reduce the anesthetic drugs requirements d. To increase the risk of anesthesia-related mortality. e. To increase the anesthetic drugs requirements 172. Which technology has become an essential component in the operating room to detect, treat, and reduce the degree of intraoperative hypoxemia? a..Pulse oximetry. b. DC shock. c. ECG devices. d. Brain monitoring devices. e.Capnogram 173. Before the widespread use of pulse oximetry in the 1980s, what was the leading cause of anesthesia-related mortality? a..Hypoxemia. b. Malignant hyperthermia. c. Hypertension. d. Anesthesia provider errors. e.Hyperglycemia 174. What impact did the establishment of anesthesia monitoring standards in the 1990s have on anesthesia-related mortality? a.. decreased anesthesia-related mortality by nearly 20-fold. b. It increased anesthesia-related mortality by nearly 20-fold. c. It eliminated anesthesia-related mortality completely. d. It had no impact on anesthesia-related mortality. e.All of the above 175. Which of the following organs is at greater risk of irreversible damage due to hypoxemia during anesthesia? a..Brain. b. Liver. c. Kidneys. d. Stomach. e.Spleen 176. What is the relationship between hypoxemia and patients' risks during anesthesia and surgical care? a.. Hypoxemia is one of the patients' most serious risks. b. Hypoxemia does not pose any risks to patients during anesthesia. c. Patients are not at risk of hypoxemia during surgical care. d. The risks of hypoxemia vary depending on the type of surgery e.None of the above. 177. What is the current rate of hypoxemia occurrence in the operating room despite efforts to avoid it? a..High rate. b. Low rate. c. Moderate rate. d. The rate varies depending on the patient's age. e. The rate varies depending on the patient's color 178. Which of the following became widely used in the 1980s to monitor oxygen saturation during surgery? a..Pulse oximetry. b. Electrocardiography. c. Blood pressure monitoring. d. Capnography. e.DC shock 179. What is the main purpose of pulse oximetry during anesthesia? a. To monitor heart rhythm. b. To monitor blood pressure. c.. To measure oxygen saturation. d. To detect malignant hyperthermia. e. To measure ETCO2 180. What impact did the widespread use of pulse oximetry have on anesthesia-related mortality? a..It significantly reduced anesthesia-related mortality. b. It had no impact on anesthesia-related mortality. c. It increased anesthesia-related mortality. d. The impact varied among different patient populations. e.All of the above 181. What technology has become an integral part of operating room technology? a..Pulse oximetry. b. Electroencephalography. c. Magnetic resonance imaging. d. Ultrasound. e.X-ray 182. What is the risk of irreversible damage to the myocardium due to hypoxemia during anesthesia? a.. High risk. b. Low risk. c. Moderate risk. d. Depends on the patient's color e.Have no risk. 183. Which of the following components of operating room technology is used to reduce the degree of intraoperative hypoxemia? a.. Pulse oximetry. b. Capnography. c. Electrocardiography. d. Magnetic resonance imaging. e.X-ray 184. What is the leading cause of anesthesia-related mortality in the past? a..Hypoxemia. b. Malignant hyperthermia. c. Hypertension. d. Hyperglycemia e.None of the above. 185. What progress has been made in anesthesia-related mortality since the establishment of anesthesia monitoring standards? a..Anesthesia-related mortality has decreased nearly 20-fold. b. Anesthesia-related mortality has remained the same. c. Anesthesia-related mortality has increased nearly 20-fold. d. Depends on the patient weight e. Anesthesia-related mortality has increased nearly 50-fold 186. What organ is at risk of irreversible damage due to hypoxemia during anesthesia? a..Myocardium. b. Lungs. c. Spleen. d. Pancreas. e.Stomach 187. How has the use of pulse oximetry impacted the occurrence of hypoxemia during surgery? a..It has helped in detecting and treating hypoxemia. b. It has completely eliminated the occurrence of hypoxemia. c. It has had no impact on the occurrence of hypoxemia. d. It has increased the rate of hypoxemia occurrence. e.All of the above 188. What has the widespread use of pulse oximetry in the 1980s helped to prevent during surgery? a..Hypoxemia. b. Malignant hyperthermia. c. Hypertension. d. Hypothyroidism e.Hyperthyroidism 189. Which of the following is NOT a risk associated with hypoxemia during anesthesia? a. Irreversible damage to the brain. b. Irreversible damage to the myocardium. c.. Irreversible damage to the bones. d. Irreversible damage to other end organs. e.All of the above 190. How does pulse oximetry help in reducing the degree of intraoperative hypoxemia? a. By continuously monitoring oxygen saturation. b. By regulating the delivery of anesthesia gases. c. By controlling the patient's heart rate. d. By controlling the patient's blood pressure e. By controlling the patient's blood sugar 191. An obstructed airway prevents oxygen from reaching the lungs. This is an example of a cause of hypoxia related to which factor? a.. Airway b. Breathing c. Circulation d. Drugs e.None of the above 192. The tracheal tube can be misplaced e.g. in the esophagus, leading to hypoxia. This is an example of a cause of hypoxia related to which factor? a.. Airway b. Breathing c. Circulation d. Drugs e.None of the above 193. Aspirated vomit can block the airway, causing hypoxia. This is an example of a cause of hypoxia related to which factor? a.. Airway b. Breathing c. Circulation d. Drugs e.None of the above 194. Inadequate breathing prevents enough oxygen from reaching the alveoli. This is an example of a cause of hypoxia related to which factor? a. Airway b.. Breathing c. Circulation d. Drugs e.None of the above 195. Severe bronchospasm may not allow enough oxygen to reach the lungs nor carbon dioxide to be removed from the lungs. This is an example of a cause of hypoxia related to which factor? a. Airway b.. Breathing c. Circulation d. Drugs e.None of the above 196. A pneumothorax may cause the affected lung to collapse, resulting in hypoxia. This is an example of a cause of hypoxia related to which factor? a. Airway b. Breathing c. Circulation d. Drugs e.None of the above 197. High spinal anesthesia may cause inadequate breathing, leading to hypoxia. This is an example of a cause of hypoxia related to which factor? a. Airway b.. Breathing c. circulation d. Drugs e.None of the above 198. Circulatory failure prevents oxygen from being transported to the tissues. This is an example of a cause of hypoxia related to which factor? a. Airway b. Breathing c.. Circulation d. Drugs e.None of the above 199. Common causes of circulatory failure include hypovolemia, abnormal heart rhythm, or cardiac failure. This is an example of a cause of hypoxia related to which factor? a. Airway b. Breathing c.. Circulation d. Drugs e.None of the above 200. Deep anesthesia may depress breathing and circulation, leading to hypoxia. This is an example of a cause of hypoxia related to which factor? a. Airway b. Breathing c. Circulation d.. Drugs e.None of the above 201. Many anesthetic drugs cause a drop in blood pressure, contributing to hypoxia. This is an example of a cause of hypoxia related to which factor? a. Airway b. Breathing c. Circulation d.. Drugs e.None of the above 202. Muscle relaxants paralyze the muscles of respiration, resulting in hypoxia. This is an example of a cause of hypoxia related to which factor? a. Airway b. Breathing c. Circulation d.. Drugs e.None of the above 203. Anaphylaxis can cause bronchospasm and low cardiac output, leading to hypoxia. This is an example of a cause of hypoxia related to which factor? a. Airway b. Breathing c. Circulation d.. Drugs e.None of the abov 204. Problems with the anesthetic equipment include disconnection or obstruction of the breathing circuit, leading to hypoxia. This is an example of a cause of hypoxia related to which factor? a. Airway b. Breathing c. Circulation d..Equipment e.None of the abov 205. Problems with the oxygen supply include an empty cylinder, contributing to hypoxia. This is an example of a cause of hypoxia related to which factor? a. Airway b. Breathing c. Circulation d..Equipment e.None of the abov 206. Problems with the monitoring equipment include battery failure in the oximeter or a faulty probe, leading to hypoxia. This is an example of a cause of hypoxia related to which factor? a. Airway b. Breathing c. Circulation d..Equipment e.None of the abov 207. What are the signs of mild laryngospasm? a.. High pitched inspiratory noise b. Silent, no gas passes between the vocal cords c. High pitched expiratory noise d. Low pitched expiratory noise e. None of the above 208. What is the most common cause of hypoxia in theatre? a.. Airway obstruction b. Inadvertent esophageal intubation c. Displaced tracheal tube d. Obstruction by secretions e.None of the above 209. How can unrecognized inadvertent esophageal intubation affect a patient's saturation level? a. Increases saturation level b.. Decreases saturation level c. No effect on saturation level d. Not mentioned in the passage e.All of the above 210. What should be done if there is doubt about the endotracheal tube? a.. Remove it b. Keep it in place c. Observe the patient d.Increased CO2 concentration e. None of the above 211. What should be checked regarding the patient's breathing? a. Chest movements and tidal volume b. Bilateral air entry and breath sounds c. Lung consolidation/collapse and pulmonary edema d. pneumothorax e.. All of the above 212. Which condition may prevent oxygen from getting into the alveoli? a. Bronchospasm b. Lung trauma c. Pneumothorax d. lung consolidation e. All of the above 213. Which drugs may depress breathing during anesthesia? a. Opioids b. Poorly reversed neuromuscular blocking agents d. A high spinal anesthetic may paralyze the muscles of respiration c. Deep volatile anesthesia e.. All of the above 214. What can cause an infant's stomach distension from facemask ventilation? a.. Splinting of the diaphragm b. Lung consolidation/collapse c. Pulmonary edema d. Pneumothorax e.. None of the above 215. What should be checked regarding the patient's circulation during hypoxia? a. Pulse b. Blood pressure c. Peripheral perfusion and capillary refill time d. Is the patient in septic or cardiac shock? e..All of the above 216. What might indicate inadequate circulation on a pulse oximeter? a. Loss of pulsatile waveform b. Reduction of pulsatile waveform c. Difficulty getting a pulse signal d.A+B+C e. None of the above 217. What should be checked regarding the administration of anesthesia drugs during hypoxia? a. Correct administration of halothane b. Adequate reversal of muscle relaxants c. Proper administration of opioids and sedatives d.A+B+C e. None of the above 218. How does excessive halothane affect the heart? a. Increases cardiac function b.. Causes cardiac depression c. No effect on the heart d. A+C e.All of the above 219. How might opioids and sedatives affect breathing? a. Increase breathing b.. Decrease breathing c. No effect on breathing d. A+C e.All of the above 220. What should be done in case of anaphylaxis? a. Continue administering the causative agent b. Administer 50% oxygen c. Give intravenous glucose starting with a bolus of 10ml/kg d.. Stop administering the causative agent e.All of the above 221. What should be administered in case of anaphylaxis? a. Administer 100% oxygen. b. Adrenaline c. Steroids d. Bronchodilators e. All of the above 222. What should be checked regarding the equipment during anesthesia if hypoxia happened ? a. Oxygen delivery system b. Breathing circuit or tracheal tube c. Oxygen cylinder d. Central hospital oxygen supply e..All of the above Malignant Hyperthermia 223. Which of the following is NOT a trigger for malignant hyperthermia (MH)? a. Halothane b. Sevoflurane c. Desflurane d.. Propofol e. Succinylcholine 224. What is the primary diagnostic feature of malignant hyperthermia (MH) ? a. Unexplained elevation of end-tidal carbon dioxide (ETCO2) concentration b. Muscle rigidity c. Tachycardia d. Arrhythmias e..All of the above 225. What is the order of onset of signs in malignant hyperthermia (MH) diagnosis? a. Muscle rigidity, hyperthermia, acidosis, hyperkalemia b. Hyperthermia, acidosis, muscle rigidity, hyperkalemia c. Acidosis, muscle rigidity, hyperthermia, hyperkalemia d. Hyperkalemia, acidosis, hyperthermia, muscle rigidity e. unexplained elevation of end-tidal carbon dioxide (ETCO2) concentration, muscle rigidity, tachycardia, acidosis, hyperthermia, and hyperkalemia 226. Which of the following may trigger malignant hyperthermia (MH ) in humans? a. Succinylcholine b. Vigorous exercise c. Heat d.Inhalational anesthetics e. All of the above 227. What is the main cause of rhabdomyolysis in malignant hyperthermia (MH) ? a. Acidosis b. Hypothermia c. Hyperkalemia d.. Muscle rigidity e.Alkalosis 228. How can malignant hyperthermia (MH) susceptibility be diagnosed without anesthesia exposure? a. Genetic testing b. Cardiac stress test c. Blood test for muscle enzyme levels d.. It is impossible to diagnose susceptibility without anesthesia exposure e.None of the above 229. What is the key diagnostic features of malignant hyperthermia( MH) ? a. Elevated expired carbon dioxide b. Hyperthermia c. Decreased blood pH d. Elevated blood potassium levels e..All of the above 230. Which of the following anesthetic agents can trigger malignant hyperthermia ( MH) ? a. Nitrous oxide b.. Isoflurane c. Midazolam d. Opioids e.Propofol 231. Malignant hyperthermia (MH) triggered by all the following except ? a. Sevoflurane b. Halothane c. Desflurane d..Non depolarizing Muscle relaxants e.Isoflurane 232. Which of the following is NOT a symptom of Malignant hyperthermia ( MH) ? a.. Hypothermia b. Muscle rigidity c. Hyperthermia d. Acidosis e.Hyperkalemia 233. What is the most effective treatment for Malignant hyperthermia ( MH) ? a. Antipyretic medication b. Intravenous fluid administration c..Administration of dantrolene sodium d. Oxygen therapy e.None of the above 234. How is Malignant hyperthermia (MH) susceptibility determined? a. Genetic testing b. Family history c. Physical examination d.. Anesthetic exposure e.None of the above 235. Which of the following is a phenotypic change associated with malignant hyperthermia ( MH) susceptibility ? a. Elevated body temperature at rest b. Increased muscle mass c. Abnormal heart rhythm with out anesthesia exposure d.Hyperkalemia with out anesthesia exposure e..None of the above 236. What is the primary cause of hyperkalemia in malignant hyperthermia( MH) ? a. Acidosis b.Alkalosis c.. Increased potassium release from damaged muscles d. Adrenal gland dysfunction e.Renal failure 237. Which of the following is a characteristic of malignant hyperthermia (MH) ? a. Normal end-tidal carbon dioxide levels b.. Hypotension c. Bradycardia d. Alkalosis e.Hypokalemia 238. What triggers malignant hyperthermia (MH) in susceptible individuals? a. Light physical activity b. Psychological stress c.. Exposure to specific anesthetics d. High-altitude environments e. Exposure to cold weather 239. What is the recommended treatment for an malignant hyperthermia (MH ) crisis ? a. Initiating hemodialysis b. Administering calcium channel blockers c.. Administering dantrolene sodium and cooling measures d. Performing immediate surgery to remove the trigger e.Increasing inhalational anesthetic concentration 240. Which of the following is a potential complication of malignant hyperthermia ( MH) ? a. Hypoglycemia b.. Renal failure c. Hypernatremia d. Gallstones e.Brain tumor 241. What is the primary mechanism of action of dantrolene sodium in the treatment of malignant hyperthermia (MH) ? a.. Inhibits calcium release from the sarcoplasmic reticulum b. Increases muscle oxygenation c. Neutralizes metabolic acidosis d. Enhances muscle relaxation e.All of the above Intravenous Fluid 242. What are the three main indications for intravenous fluid administration? a.. Resuscitation, Replacement, and Maintenance b. Rehydration, Rehabilitation, and Monitoring c. Retention, Refinement, and Movement d. Regulation, Recovery, and Mobilization e.All of the above 243. Which of the following is not one of the four Ds when prescribing fluids? a. Drug b. Dosing c. Duration of therapy d. De-escalation e..Diagnosis 244. When considering the "drug" aspect of fluid administration, what should be taken into account? a. The color of the fluid b.. The route of administration c. The temperature of the fluid d. The taste of the fluid e. The weight of the fluid 245. In terms of fluid therapy, what does "duration of therapy" refer to? a. The time it takes for the fluid to be absorbed by the body b. The time between fluid doses c..The total time the patient requires fluid administration d. The time it takes for the fluid to be prepared for administration e. None of the above 246. How should the dosing of intravenous fluids be determined? a.. Based on the patient's weight b. Based on the patient's height c. Based on the patient's age d. Based on the patient's favorite color e. Based on the patient's wishes 247. When should de-escalation of fluid therapy be considered? a. When the patient's condition worsens b.. When the patient no longer requires fluid administration c. When the patient requests a different fluid d. When the fluid bag is almost empty e. When the fluid bag is half amount 248. What is the primary purpose of intravenous fluid resuscitation? a. To replace lost fluids b. To maintain fluid balance c. To restore circulation d. To maintain electrolyte balance e.. All of the above 249. Which of the following is not a benefit of maximizing intravenous fluid administration? a. Improved patient outcomes b. Faster recovery time c. Reduced risk of complications d.. Enhanced taste of the fluid e.All of the above 250. What is the recommended approach to intravenous fluid administration? a. Start with a high dose and gradually decrease b.. Start with a low dose and gradually increase c. Administer a fixed amount throughout therapy d. Administer fluids based on the patient's mood e. Administer fluids based on the patient's favorite color 251. How should intravenous fluid therapy be tailored to the patient's needs? a. Based on their favorite flavor b.. Based on their hydration status c. Based on their mood d. Based on their hair color e.All of the above 252. Which of the following is not an appropriate consideration when prescribing fluids? a. Patient's medical history b. Patient's response to previous therapies c.. Patient's hair color d. Patient's current medication e.All of the above 253. What is the recommended approach to de-escalating fluid therapy? a. Abruptly stop fluid administration b.. Gradually decrease fluid rate c. Switch to oral fluid intake d. Increase fluid dosage e.All of the above 254. What can happen if intravenous fluid administration is prolonged unnecessarily? a.. Increased risk of complications b. Faster recovery time c. Increased drug effectiveness d. Improved fluid taste e. None of the above 255. How can clinicians ensure the proper dosing of intravenous fluids? a.. Using a standardized dosing protocol b. Guessing the appropriate dose c. Administering the same dose to all patients d. Using the patient's horoscope sign as a guide e.All of the above 256. When should intravenous fluid therapy be started? a. Only after the patient's condition stabilizes b.. At the earliest indication of fluid need c. Only when the patient requests it d. A day after the patient's admission e. None of the above 257. What is the primary goal of intravenous fluid replacement therapy? a.. To maintain fluid balance b. To resuscitate the patient c. To improve drug effectiveness d. To prevent fluid loss e.None of the above 258. Which of the following is not a potential harm of intravenous fluid administration? a. Fluid overload b. Electrolyte imbalance c.. Increased risk of dehydration d. Tissue damage at the injection site e.None of the above 259. When should intravenous fluid therapy be de-escalated? a.. When the patient's condition stabilizes b. When the patient experiences fluid overload c. When the patient receives all prescribed doses d. When the patient reaches a certain age e. When the patient reaches a certain weight 260. How can the risks and benefits of intravenous fluid administration be balanced? a. By using the same fluid for all patients b. By considering the patient's weight only c.. By individualizing the fluid therapy approach d. By providing fluid therapy without monitoring e.All of the above 261. Which of the following is not a factor to consider when de-escalating fluid therapy? a. Improvement in the patient's condition b. Stability of vital signs c..Patient's preference for a different fluid d. Evaluation of fluid effectiveness e.None of the above 262.what is the intravascular half- life of a crystalloid solution ? a.1-2 hr b..20-30 min c. 3-6 hr d.1 day e.72 hrs 263.what is the preferred solution for diluting packed red blood cells prior to transfusion ? A.Hypertonic saline b. 0.45 % sodium chloride c..0.9 % sodium chloride d.3 % saline e.Lactate ringer 264.which of the following solutions has no effect on cell volume ? a..Isotonic b.Hypotonic c.colloid solution d.Hypertonic e.None of the above 265.what do colloid solutions contain ? a.Vitamins b..Hydroxyethyl starch or proteins c.Blood cells d.Water e.None of the above 266.What is the main disadvantage of rapidly administering large amounts of crystalloids? a.Decreased blood pressure b.Increased bleeding c.Organ failure d..Frequently associated with tissue edema e.None of the above 267.what is one of the disadvantages of glucose infusions ? a.Decreased CO2 production b.Improved neural function c..Increased risk of infection d.Reduced mortality in septic shock e.None of the above 268.Which drug is used as an opiod antagonist to counter the effects of remifentanil? a..Naloxone b.Hyoscine c.Glycopyrrolate d.Atropine e. Ondansetron 269.Which drug is commonly used as an antiemetic? a.Atropine b..Ondansetron c.Glycopyrrolate d.Hyoscine e.Midazolam 270.What is the main function of ondansetron? a.Induce vomiting b.Relieve pain c.Stimulate gastric emptying d..prevent and treat nausea and vomiting e.Induce sleep Osmolarity and Tonicity 271. What does the term osmolarity of a solution refer to? a. Color of a solution. b.Route of administration of solution. c.. The number of osmoles per liter of solution. d. Dose of solution. e.Duration of therapy 272. Which term is often used interchangeably with osmolarity? a. Hypertonicity b.. Tonicity c. Intravascular d. Extravascular e.Hyperosmolarity 273. What is the effect of an isotonic solution on cell volume? a. It increases cell volume. b. It decreases cell volume. c.. It has no effect on cell volume. d. It cannot be determined. e.All of the above 274. How do hypotonic solutions affect cell volume? a..They increase cell volume. b. They decrease cell volume. c. They have no effect on cell volume. d. They cannot be determined. e.None of the above 275. What is the effect of hypertonic solutions on cell volume? a. They increase cell volume. b..They decrease cell volume. c. They have no effect on cell volume. d. They cannot be determined. e.None of the above 276. How would you define tonicity? a. The ability of a solution to diffuse through barriers separating body fluid compartments. b. The effect a solution has on cell volume. c. The number of osmoles per liter of solution. d.. The effective osmolality of a fluid. e.None of the above 277. How are I.V. fluids classified based on their ability to diffuse through barriers? a. Based on their effect on cell volume. b. Based on their tonicity. c. Based on their intravascular and extravascular fluid compartments. d.. Based on their ability to pass readily through the membrane. e. Based on the color of fluid 278. Which type of fluid can diffuse easily through barriers separating body fluid compartments? a.. Crystalloids b. Colloids c. Whole blood d. Colloids and Crystalloids e.All of the above 279. Which type of fluid cannot diffuse through barriers separating body fluid compartments? a. Crystalloids b..Colloids c. Hypotonic solutions d. Isotonic solutions e.None of the above 280. What does the word "colloids" mean? a. The effect a solution has on cell volume. b. The ability of a solution to diffuse through barriers. c. The number of osmoles per liter of solution. d.. The Greek word for glue. e.Tonicity 281. What is the primary difference between osmolarity and tonicity? a. Osmolarity refers to cell volume, while tonicity refers to the number of osmoles per liter. b.. Osmolarity refers to the number of osmoles per liter, while tonicity refers to the effective osmolality of a fluid. c. Osmolarity refers to the ability of a solution to diffuse through barriers, while tonicity refers to the effect on cell volume. d. Osmolarity and tonicity are interchangeable terms and have the same definition. e.All of the above 282. Which term describes the effective osmolality of a fluid? a. Osmolarity b..Tonicity c. Intravascular d. Extravascular e.All of the above 283. How are IV fluids classified based on their ability to diffuse through barriers? a. Based on their effect on cell volume. b. Based on their tonicity. c. Based on their intravascular and extravascular fluid compartments. d..Based on their ability to pass readily through the membrane. e.None of the above 284. Which type of fluid can pass readily through the membrane? a.. Crystalloids b. Colloids c. Dextran d. Colloids and Crystalloids e. Gelatin 285. Which type of fluids do not diffuse through barriers separating body fluid compartments? a. Crystalloids b. Colloids c. 0.9 % Nacl d. Isotonic solutions e. Lactated ringer 286. What is the primary definition of tonicity? a. The ability of a solution to diffuse through barriers separating body fluid compartments. b.. The effect a solution has on cell volume. c. The number of osmoles per liter of solution. d. The effective osmolality of a fluid. e. None of the above Crystalloids and Colloids 287. Regarding crystalloid solutions, which of the following statements is correct? a. They are just as effective as colloids in restoring intravascular volume. b. They replace an intravascular volume deficit with three to four times the volume needed when using colloid. c. Severe intravascular fluid deficits can be more rapidly corrected using colloid solutions. d. The rapid administration of large amounts of crystalloids (>4-5L) is more frequently associated with tissue edema. e..All of the above 288. How are colloid solutions different from crystalloid solutions? a. Colloid solutions contain smaller solutes compared to crystalloid solutions. b. Colloid solutions have shorter intravascular half-lives than crystalloid solutions. c. Colloid solutions are composed of proteins or hydroxyethyl starches suspended in a crystalloid solution. d. Colloid solutions are only used for mild intravascular fluid deficits. e.None of the above 289. Which of the following is true about the intravascular half-life of crystalloid solutions and colloid solutions? a. Crystalloid solutions have a longer intravascular half-life compared to colloid solutions. b. Crystalloid solutions and colloid solutions have similar intravascular half-lives. c.. Colloid solutions have a longer intravascular half-life compared to crystalloid solutions. d.Neither Crystalloid nor Colloid have intravascular half-lives e. Non of the above 290. When administering crystalloids in sufficient amounts, what is their effect on intravascular volume? a. They are just as effective as colloids in restoring intravascular volume. b. They replace an intravascular volume deficit with three to four times the volume needed when using colloid. c. Severe intravascular fluid deficits can be more rapidly corrected using colloid solutions. d. The rapid administration of large amounts of crystalloids (>4-5L) is more frequently associated with tissue edema. e..All of the above 291. Which type of solution would be preferred for correcting severe intravascular fluid deficits quickly? a. Crystalloid solutions b.. Colloid solutions c. GW 5% d.GW 10% e. None of the above 292. What is the potential drawback of rapidly administering large amounts of crystalloids? a. It can lead to an intravascular volume deficit. b.. It can cause tissue edema, which may impair oxygen transport and tissue healing. c. It can result in a shorter intravascular half-life of the crystalloid solution. d. It can increase the effectiveness of colloid solutions. e. It can cause no effect 293. Which type of solution has a longer intravascular half-life, on average? a. Crystalloid solutions b. Colloid solutions c. Both crystalloid and colloid solutions have similar intravascular half-lives. d. The intravascular half-life varies depending on the specific solutes used. e.None of the above 294. How do crystalloid solutions categorize based on tonicity? a.. Hypertonic, isotonic, and hypotonic b. Hypertonic, isotonic, and colloid c. Isotonic, colloid, and hypotonic d. Hypotonic, colloid, and hypertonic e.All of the above 295. Which of the following accurately describes colloid solutions? a. They are composed of small solutes such as electrolytes and glucose. b..They contain large molecular weight particles suspended in a crystalloid solution. c. Colloid solutions have shorter intravascular half-lives than crystalloid solutions. d. Colloid solutions replace intravascular volume deficit with three to four times the volume needed when using crystalloid. e.Colloid solution has no effecfs 296. What is the primary composition of crystalloid solutions? a.. Small solutes such as electrolytes and glucose. b. Large molecular weight particles suspended in a crystalloid solution. c. Colloid particles such as proteins or hydroxyethyl starches. d.All crystalloid solutions are hypertonic e. None of the above. 297. How long is the intravascular half-life for most colloid solutions? a. 20-30 minutes b..3 to 6 hours c. Less than 20 minutes d. More than 6 hours e. More than 12 hours 298. Which type of solution is more frequently associated with tissue edema when rapidly administering large amounts? a.. Crystalloid solutions b. Colloid solutions c Neither crystalloid nor colloid solutions d. Crystalloid and colloid e. All of the above 299. How does severe tissue edema potentially impact the body? a.. It impairs oxygen transport, tissue healing, and return of bowel function. b. It enhances the effectiveness of colloid solutions. c. It leads to a longer intravascular half-life of crystalloid solutions. d. It reduces intravascular volume deficits. e. None of the above 300. True or False: Crystalloid solutions can be categorized as hypotonic, isotonic, or hypertonic based on tonicity. a.. True b. False 301. Which type of solution has a shorter intravascular half-life, on average? a.. Crystalloid solutions b. Colloid solutions c. Both crystalloid and colloid solutions have similar intravascular half-lives. d. The intravascular half-life varies depending on the specific solutes used. e.All of the above 302. True or False: Colloid solutions have intravascular half-lives between 3 and 6 hours. a.. True b. False 303. Which type of solution is more effective in restoring intravascular volume when given in sufficient amounts? a. Crystalloid solutions b. Colloid solutions c. Both crystalloid and colloid solutions d. Neither crystalloid nor colloid solutions e. None of the above 304. What is the potential impact of marked tissue edema caused by the rapid administration of large amounts of crystalloids? a. Enhanced oxygen transport and tissue healing b. Increased intravascular volume deficit c..Impairment of bowel function following major surgery d. Increased intravascular half-life of crystalloids e.All of the above 305. What is the result of infusing 1 L of 0.9% NACL to the plasma volume ? a. Adds 150 mL to the plasma volume b..Adds 275 mL to the plasma volume c. Adds 550 mL to the plasma volume d. Adds 825 mL to the plasma volume e. All of the above 306. Where does the fluid shift occur when infusing isotonic saline? a. From plasma to the ICF b. From the interstitial space to the ICF c.. From the ICF to extracellular space d. From the plasma to the interstitial space e. All of the above 307. Which of the following is NOT an indication for using normal saline infusion? a. Dehydration b. Hypovolemia c.. Hypertension d. Sepsis e. Hemorrhage 308. Which concentration of saline is employed in the therapy of severe symptomatic hyponatremia? a. 0.45% Sodium Chloride b. Gelatin c.. Hypertonic saline d. Isotonic saline e.0.9 % NacL 309. Which concentration of sodium chloride is considered hypotonic? a. 0.9% NACL b. 0.45% Sodium Chloride c. 3% Saline d. 7.5% Saline e.All of the above 310. What is the preferred solution for diluting packed red blood cells prior to transfusion? a. 0.45% Sodium Chloride b. 0.9% NACL c. Hypertonic saline d. GW 5% e.None of the above 311. When is normal saline used in the treatment of diabetic ketoacidosis (DKA)? a. When there is severe hypovolemia b.. When serum sodium is less than 140meq/L c. To treat metabolic alkalosis d. To replace extracellular fluid e.C+D 312. Lactated Ringer's solution is also known as: a.. Hartmann's solution b. Normal saline c. Glucose water d. Dextran e.Hypertonic saline 313. Lactated Ringer's solution has sodium, potassium, and chloride contents similar to: a. Intracellular fluid b.. Extracellular fluid c. Neither Intracellular fluid nor Extracellular fluid d. Intracellular fluid and Extracellular fluid e. All of the above 314. In which situation is Lactated Ringer's solution commonly used? a. Treatment of metabolic acidosis b. Promotion of cardiac contraction c. Replacement fluid in burn patients d. Diluent for blood transfusions e.All of the above 315. All of the following are true regarding Lactated Ringer's solution except ? a. Used as a replacement fluid in burn patients when BSA >20% (Parkland formula). b. Reduces the bioavailability of certain drugs c. Calcium binding to the citrated anticoagulant in blood products can inactivate the anticoagulant and promote the formation of clots in donor blood d. Lactated Ringer's solution is contraindicated as a diluent for blood transfusions. e.. Lactated Ringer's composed of water and glucose 316. Lactated Ringer's solution is contraindicated as a diluent for: a. Cardiac contraction b. Sodium lactate buffer c..Blood transfusions d. Intracellular fluid infusion e.None of the above 317. Which of the following drugs can be negatively affected by the calcium in lactated Ringer's solution? a. Amphoterecin b. Ampicillin c. Thiopentone d.. A + B+ C e.None of the above 318. What formula is used to determine the appropriate use of Lactated Ringer's solution in burn patients? a. Hemoglobin formula b. Frog heart formula c. Cardiac contraction formula d.. Parkland formula e.None of the above 319. What is the primary advantage of using Lactated Ringer's solution over other fluids? a.. Fewer adverse effects on acid-base balance b. Higher calcium content c. Lower sodium content d. Increased bioavailability of drugs e. None of the above 320. Lactated Ringer's solution was introduced by: a. Alexis Hartmann b. Sydney Ringer c. Frog hearts d. Parkland formula e. A + B 321. Which of the following is NOT a component of Lactated Ringer's solution? a. Sodium b. Potassium c. Chloride d. Glucose e. A + B + C 322. Which solution can potentially bind to the citrated anticoagulant in blood products? a. Gelatin b. Sodium chloride c. Potassium chloride d.. Lactated Ringer's solution e.GW 5% 323. What is the main purpose of using Lactated Ringer's solution in burn patients? a. To promote cardiac contraction b. To reduce hyperchloremic metabolic acidosis c. To increase the bioavailability of certain drugs d..To replace lost fluid from burns e. None of the above 324. Lactated Ringer's solution is contraindicated as a diluent for blood transfusions due to its interaction with: a. Sodium lactate buffer b. Potassium chloride c.. Citrated anticoagulant d. Sodium chloride diluent e.All of the above 325. What did Alexis Hartmann propose in the 1930s regarding Ringer's solution? a. Addition of calcium chloride b.. Addition of sodium lactate buffer c. Replacement of sodium chloride diluent d. Removal of potassium content e.None of the above 326. Which of the following is NOT a disadvantage of using Lactated Ringer's solution? a. Reduced bioavailability of certain drugs b. Inactivation of the anticoagulant in blood products c. Potential formation of clots in donor blood d.. Increased adverse effects on acid-base balance e. None of the above 327. Lactated Ringer's solution contains which of the following ions? a. Calcium and potassium only b. Sodium and chloride only c. Potassium and chloride only d. Sodium and calcium only e..Sodium, potassium and chloride 328. What is the primary purpose of adding sodium lactate buffer to Ringer's solution? a.. To reduce metabolic acidosis b. To increase cardiac contraction c. To provide additional potassium d. To reduce adverse effects on acid-base balance e. None of the above 329. Lactated Ringer's solution is commonly used as a replacement fluid in burn patients when the burn surface area (BSA) is: a. Less than 5% b. Between 5% and 10% c. Between 10% and 15% d.. Greater than 20% e.None of the above 330. Which Dextrose solution is used to prevent protein breakdown in NPO patients after consumption of endogenous glycogen (24-48 hours)? a.. D5% b. D10% c. D20% d. D50% e.D 25 % 331. Which Dextrose solution is used for replacement of pure water deficits and as a maintenance fluid for patients with hypernatremia? a.. D5% b. D10% c. D20% d. D50% e. D 25 % 332. Which Dextrose solution is used in hypoglycemia? a. D5% b.. D10% , D20%, D50% c. D20% only d. D50% only e.None of the above 333. Which Dextrose solution is used in TPN? a. D5% b. D10% c. D20% d. D5% and D10% e. D20% , D25% and D50% 334. What percentage of glucose remains in the intra vascular space after distribution? a.. 1.5 with: b) Anticipated invasive procedure or surgery. c) Massive hemorrhage (over one blood volume) d).. Emergent reversal of muscle relaxant drug. e) Treatment of isolated factor deficiencies. 443. BLOOD CELL transfusion guidelines (all true except one) : a.Hemodynamic instability: Ongoing bleeding with unresponsive (or incompletely responsive) to infusion of 2- 3 Liters crystalloid b) Hemodynamically Stable: ICU Patients: Hemoglobin