Quiz
Neuromuscular Blockade
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Questions in this quiz (16)
1Use of succinylcholine to facilitate endotracheal intubation would be acceptable (“safe”) in which one of the following situations:
- A80 y.o. female patient 2 days after 40% body surface area burn
- B18 y. o. male one week after spinal cord transection injury
- C12 y.o. with Duchene’s muscular dystrophy
- D22 y. o. with evolving respiratory failure secondary to Guillian-Barre’
- E27 y. o. female with myasthenia gravis
2A patient taking which of the following drugs would most commonly be associated with resistance to (nondepolarizing) NMB drugs:
- AQuinidine
- BPhenytoin
- CCyclophosphamide
- DAminoglycosides
- EMagnesium
3The MOST important parameter that determines the speed of onset for NMB drugs is:
- APotency
- BLipophilicity
- CIonization
- DPlasma clearance
- EE. Receptor affinity
4A characteristic common to current aminosteroid-based NMB drugs such as vecuronium or rocuronium is:
- ASignificant histamine release after a bolus injection
- BVagolysis producing tachycardia
- CHofmann elimination
- DDeacetylation in the liver
- EProduction of laudanosine as the primary metabolite
5Clinical data support that when the TOFR exceeds [blank_start]__[blank_end],
anesthesia providers have trouble assessing the presence
of fade- A0.4
- B0.2
- C0.7
- D0.9
6TOF count of 3 would equate to a twitch suppression of [blank_start]__[blank_end]%
- A55
- B75
- C85
- D90
7Once the TOF ratio exceeds [blank_start]0.60[blank_end], fade to DBS generally cannot be detected subjectively
- A0.60
- B0.40
- C0.70
- D0.85
8What is true about Tetanic stimulation (TET)?
- ADuring partial depolarizing block, fade is not observed in response to tetanic stimulation
- BTetanic stimulation is not painful
- CMuscular fatigue usually develop at a stimulation frequency of 50 Hz
- DFade is thought to be an effect of a depolarizing agent on the presynaptic nerve membrane
9Which statement about posttetanic count is NOT correct?
- AThe number of posttetanic count twitches is inversely related to time until the first regular TOF twitch returns
- BPosttetanic count used when TOF or DBS is absent to estimate recovery time
- CPosttetanic count uses tetany followed by TOF at frequency of 1 Hz
- DThe main use of posttetanic count is when profound neuromuscular block is not required
10Correct statements about objective monitoring techniques include:
- AMechanomyography (MMG) measures isotonic contraction of peripheral muscles in response to nerve stimulation
- BAcceleromyography (AMG) calculates the force of contraction of a muscle using a miniature piezoelectric transducer
- CElectromyography (EMG) measures the electrical activity (compound muscle action potential) of a stimulated muscle
- DKinemyography (KMG) detects the acceleration of the thumb contraction in response to electrical stimulation of a nerve
11All of the following are examples of Benzylisoquinolinium compounds consist of two quaternary ammonium groups joined by methyl groups EXCEPT:
- AD-tubocurarine
- BAtracurium
- CMivacurium
- DPancuronium
- ECisatracurium
12Train-of-four (TOF) has all of the following characteristics, EXCEPT:
- ATOF consists of four ST stimuli at a frequency of 4 Hz
- BTOF does not require a “baseline” or “control” muscle response
- CTOF “fade” is defined as a weaker fourth twitch than the first twitch
- DTOF is delivered every 15-20 sec to prevent potentiation of subsequent responses
- ETOF ratios >0.40 cannot be reliably detected subjectively (visually or tactilely)
13Double burst stimulation (DBS) characteristics include all of the following, EXCEPT:
- AThe two mini-tetanic bursts are separated by 0.5 sec
- BDBS is delivered no more frequently than every 20 sec to prevent subsequent response potentiation
- CIn DBS, similar to TOF pattern, no control (“baseline”) muscle response is needed
- DDBS ratios >0.60 cannot be reliably detected by subjective (tactile, visual) means
- EIn awakening patients, DBS is more painful than TOF, but less so than tetanic stimulation
14Potential side-effects associated with the use of succinylcholine include all of the below, EXCEPT:
- AMyalgia
- BTachycardia
- CAnaphylaxis
- DHyperkalemia
15Since sugammadex has no direct cholinergic properties, anesthesiologist do not require the ready availability of an anticholinergic like glycopyrrolate at the time of reversal.
- ATrue
- BFalse
16When administering sugammadex through a peripheral IV, it is important to note that the drug has a physical incompatibility with all of the following drugs except:
- AVerapamil
- BDexamethasone
- CRanitidine
- DOdansetron
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- Diplomat of ABA Medicine (Fundamental Topics in Anesthesiology) Quiz on Neuromuscular Blockade, created by Mike Ru on 28/04/2018.
- Author
- Mike Ru
- Language
- English
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