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NMS Semester 2 Set 3 Quiz - General anaesthetics

NMS Semester 2 Set 3 Quiz - General anaesthetics

Question 1 of 24

1

What does lipid theory say?

Select one of the following:

  • When the concentration of general anaesthetic exceeds 0.05mM, anaesthesia is induced as a result of a lipid volume increase of 0.4%. The lipid expansion interferes with nerve impulse conduction and thus anaesthesia is induced.

  • When the concentration of general anaesthetic exceeds 0.5mM, anaesthesia is induced as a result of a lipid volume increase of 0.4%. The lipid expansion interferes with nerve impulse conduction and thus anaesthesia is induced.

  • When the concentration of general anaesthetic exceeds 0.5mM, anaesthesia is induced as a result of a lipid volume increase of 4%. The lipid expansion interferes with nerve impulse conduction and thus anaesthesia is induced.

  • When the concentration of general anaesthetic exceeds 0.1mM, anaesthesia is induced as a result of a lipid volume increase of 0.4%. The lipid expansion interferes with nerve impulse conduction and thus anaesthesia is induced.

Explanation

Question 2 of 24

1

What can reverse lipid theory?

Select one of the following:

  • High pressure - reduces lipid volume back to normal

  • Low pressure - reduces lipid volume back to normal

Explanation

Question 3 of 24

1

What is protein theory?

Select one of the following:

  • A concentration of general anaesthetic that reaches 0.05mM leads to a lipid volume increase of 0.4% which induces anaesthesia. This is because the increase in lipid volume interferes with conduction of nerve impulses.

  • Lipid solubility of general anaesthetics is required for the general anaesthetic to reach a hydrophobic pocket on a channel protein. Channel proteins targeted are usually ion channels like GABA, K+ or nAchR.

Explanation

Question 4 of 24

1

Optical isomers of GA have the same lipid solubility and the same potency.

Select one of the following:

  • True
  • False

Explanation

Question 5 of 24

1

What are the inhibitory responses caused by general anaesthetics?

Select one or more of the following:

  • Opening of K+ channels (efflux)

  • Increase GABA activity

  • Inhibit excitatory channels such as nAchR

  • Increase glutaminergic activity

  • Opening of K+ channels (influx)

Explanation

Question 6 of 24

1

What is meant by the cut-off phenomenon?

Select one of the following:

  • The lipid solubility of a GA (and thus its potency) increases with the number of carbons in a GA but after a certain point (usually >11 carbons) the GA's potency abruptly declines.

  • After a certain high dose of GA, the patients condition rapidly deteriorates.

  • The general anaesthetic stops working after a certain period of time.

Explanation

Question 7 of 24

1

GA have a large therapeutic window.

Select one of the following:

  • True
  • False

Explanation

Question 8 of 24

1

The minimum alveolar concentration effectively describes what?

Select one of the following:

  • The more lipid soluble a GA is, the lower the concentration required in inspired air.

  • The more lipid soluble a GA is, the higher the concentration required in inspired air.

  • The less lipid soluble a GA is, the lower the concentration required in inspired air.

  • The less lipid soluble a GA is, the higher the concentration required in inspired air.

Explanation

Question 9 of 24

1

What increases transfer of GA to the alveoli?

Select one or more of the following:

  • Increased concentration of GA

  • Increased rate and depth of breathing

  • Decreased concentration of GA

  • Decreased rate and depth of breathing

Explanation

Question 10 of 24

1

A higher blood:gas partition coefficient means that the GA is highly soluble in blood.

Select one of the following:

  • True
  • False

Explanation

Question 11 of 24

1

A GA with a high blood:gas partition coefficient will travel to the brain much quicker than one with a lower blood:gas partition coefficient.

Select one of the following:

  • True
  • False

Explanation

Question 12 of 24

1

Why would pulmonary blood flow increase help with absorption of GA when GA concentration in the body is initially low?

Select one of the following:

  • It maintains a high, favourable concentration gradient for the absorption of GA from the lungs into the blood, therefore increasing speed of induction.

  • It helps to increase blood flow to the brain to increase the concentration of general anaesthetic in the desired place.

Explanation

Question 13 of 24

1

What tissue has a high tissue:blood partition coefficient?

Select one of the following:

  • Adipose tissue

  • Muscle tissue

  • Brain tissue

Explanation

Question 14 of 24

1

Overall, what is evidence for lipid theory?

Select one of the following:

  • Volume expansion of the lipid bilayer

  • Cut-off phenomenon

  • Stereoselectivity

Explanation

Question 15 of 24

1

Overall, what is evidence for protein theory?

Select one or more of the following:

  • Volume expansion of the lipid bilayer

  • Cut-off phenomenon

  • Stereoselectivity

Explanation

Question 16 of 24

1

GA is usually metabolised by the body and excreted in the urine.

Select one of the following:

  • True
  • False

Explanation

Question 17 of 24

1

Both blood:gas and tissue:blood partition coefficients are inversely proportional to the speed of induction of GA.

Select one of the following:

  • True
  • False

Explanation

Question 18 of 24

1

What is an advantage of using halothane?

Select one of the following:

  • Potent and fast acting

  • Pleasant odour

  • Less liver damage

Explanation

Question 19 of 24

1

What is a disadvantage of sevoflurane?

Select one of the following:

  • Liver toxicity

  • Bad smell

  • Possible seizures

Explanation

Question 20 of 24

1

Intravenous GA is usually used for induction.

Select one of the following:

  • True
  • False

Explanation

Question 21 of 24

1

Intravenously administered thiopental and propofol act at which receptors?

Select one of the following:

  • GABA-a receptors

  • GABA-b receptors

  • NMDA

Explanation

Question 22 of 24

1

Intravenously administered ketamine act at what receptors?

Select one of the following:

  • NMDA

  • GABA-a

  • GABA-b

Explanation

Question 23 of 24

1

Adjuncts are used to enhance the potency of a GA.

Select one of the following:

  • True
  • False

Explanation

Question 24 of 24

1

Give some examples of adjuncts used for GA administration.

Select one or more of the following:

  • Anxiolytics

  • Anti-depressants

  • Anti-psychotics

  • Anti-emetics

  • Muscle relaxants

Explanation

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