Pharmmcq1 Inhaled Anaesthetics

Front 1

Which compounds are broken down in Soda Lime?
A. N2O
B. Halothane
C. Sevoflurane
D. Desflurane
E. All of the Above

Back 1

E. All of the above

Front 2

Regarding N2O at 70%:
A. Synthesised from ? and N2 at 270 C
B. Decreases muscle blood flow by 30%
C. Decreases cerebral autoregulation by 24%
D.

Back 2

C. Decreases cerebral autoregulation

Front 3

Nitrous Oxide:
A. Decreases CBF
B. Is an effective oxidant
C. Is made by heating nitrogen and oxygen in an iron retort
D. Decreases pulmonary artery pressure in neonates

Back 3

B. An effective oxidant.

Front 4

The following drugs are (potent) triggers for MH except for:
A. Decamethonium
B. Suxamethonium
C. Isoflurane
D. Halothane
E. Calcium
F. Sevoflurane
G. Tubocurarine
H. Nitrous Oxide

Back 4

E. Calcium
G. Tubocurarine
H Nitrous Oxide

Front 5

IPPV with isoflurane at 1 MAC results in:
A. depressed cardiovascular reflexes more than halothane
B. Causes decreased conduction velocity
C. Maintains Cerebral autoregulation
D. Equal respiratory depression to enflurane
E. Reduction in cardiac output by 25%
F. Increased vasodilation

Back 5

C. Yes (“autoregulation of CBF in response to changes in systemic blood pressure is retained during administration of 1 MAC isolflurane, but not halothane.” Stoelting p.49)
F. Increased vasodilation

Front 6

The effect of increased cardiac output in Pa versus time for volatile agents:
A. No effect
B. Decreased slope
C. Decreased then increased slope
D. Increased then decreased slope

Back 6

B Decreased slope

Front 7

N2O:
A. Supports combustion
B. Is flammable
C. Causes muscle rigidity
D. In tissues is slower to reabsorb than oxygen
E. Has a partition coefficient of 0.76
F. All of the Above
G. Is formed by heating oxygen and nitrogen
H. Induces methionine synthesis
I. Oxidises the cobalt in Vitamin B12

Back 7

A. supports combustion
I. Oxidises the cobalt

Front 8

N2O:
A. MW of 42
B. Crit Temp 32 C
C. Formed using iron as a catalyst
D. Does not support combustion
E. ? SVP of 24 kPA
F. Produced using Ammonium Sulphate in an iron retort
G. Boiling point 32 C

Back 8

C. Historically using iron as a catalyst

Front 9

Desflurane:
A. Takes 5 minutes to reach equilibrium
B. Is fastest to approach equilibrium of any inhaled anaesthetic agent
C. Is a fluorinated diethyl ether

Back 9

All wrong

Front 10

Regarding Sevoflurane:
A. SVP < Enflurane
B. The SVP > Isoflurane
C. C/V Side effects similar to Isoflurane
D. MW < Isoflurane
E. Boiling Point > Enflurane

Back 10

A. Sevo SVP 170, Enflurane SVP 172
E.Sevo BP 58.5 Enflurane 56.5

Front 11

Sevoflurane:
A. Is a methylethyl ether
B. Is odourless
C. Is stable in soda lime at 37 degrees
D. BP > Enflurane
E. MW < Desflurane

Back 11

D. BP 58.5 cf Enflurane 56.5

Front 12

Sevoflurane:
A. MW > Enflurane
B. MAC < Enflurane
C. Contains Cl & F
D. SVP > Enflurane

Back 12

A. Sevo 200 cf Enflurane 184

Front 13

Uptake of N2O when breathing 70%:
A. More than 1 litre is absorbed in the first minute
B. Equilibrium is achieved in 3 minutes
C. Absorb 10 litres at time of 90% equilibration in first 3 mins
D. At steady state uptake is 200 ml/minute
E. Produces surgical anaesthesia

Back 13

A.0.43 x 5 x 0.7 = 1.7 litres in first minute

Front 14

N2O causes the second gas effect because:
A. It is insoluble
B. Reaches equilibrium faster than the more soluble second gas
C. Larger Volume
D. Its high concentration

Back 14

D. High concentration

Front 15

Desflurane:
A. Non irritant to the airways
B. Less potent than sevo
C. MW > Isoflurane
D. Cholirinated methy ethyl ether

Back 15

B. less potent than sevo

Front 16

Effects of volatile agents include:
A. Halothane increases hepatic artery and portal blood flow
B. Isoflurane causes hypotension by reducing cardiac output

Back 16

Neither

Front 17

Volatile agents:
A. Halothane causes less cerebral vasodilation than enflurane
B. Isoflurane causes less cerebral vasodilation than halothane

Back 17

B. See Figure 2.6 Stoelting

Front 18

Problems with MAC:
A. Large interspecies variability
B. Affected by temp and other factors
C. Affected by obesity

Back 18

B. temp and things

Front 19

MAC:
A. Decreased in the elderly
B. Unchanged through pregnancy
C. Increased in hypothermia
D. Altered with hyperkalaemia

Back 19

A. Decreases with age (after 6 months of age)

Front 20

All the factors decrease MAC except:
A. Pregnancy
B. Hyperthermia
C. Hypothermia
D. Hypoxia

Back 20

A. Hyperthermia

Front 21

MAC:
A. Highest between 2-5 yrs
B. Increase with pregnancy
C. MAC BAR means 95% dont move
D. 0.2% Halothane in 70% N2O

Back 21

D

Front 22

MAC:
A. MAC of Halothane in 70% N2O is 0.29
B. Concentration at which 95% of patients don't move in response to a surgical stimulus
C. MAC-BAR?
D. Decreased by increased CO2

Back 22

A (?N2O drops MAC of volatile by 40%, e.g. for Halothane = 0.6 x 0.75 = 0.45 and not 0.29)
D: high CO2 acts as narcotic (95mmHg<PaCO2<15mmHg, also PAO2 <38mmHg, and BP <40mmHg)

(ref: anaesthesia review, 2nd ed, pg 127 table)

Front 23

SVR is lease changed with:
A. Isoflurane
B. Sevoflurane
C. Desflurane
D. Enflurane
E. Halothane

Back 23

E. Halothane

Front 24

MAC awake during emergence when patients respond to commands:
A. 0.1
B. 0.2
C. 0.3
D. 0.5
E. 0.7

Back 24

C. 0.3

Front 25

Isoflurane & Enflurane:
A. Structural Isomers
B. Enantiomers
C. Diastereoisomers
D. Optical isomers
E. Configurational isomers

Back 25

A. Structural Isomers

Front 26

Sevoflurane:
A. Broken down to Compound A in the body and toxic to rats
B. BG coefficient of 2.3
C. Irritant causing coughing at induction
D. BP of 24 C
E. CL & F atoms
F. None of the above

Back 26

F. None

Front 27

Isoflurane, MAC ETawake is:
A. 0.1%
B. 0.3%
C. 0.5%
D. 1%

Back 27

C. 0.5%

Front 28

Isoflurane
A. Halogenated methyl ethyl ether
B. Higher BP than sevoflurane
C. No Odour
D. Enantiomer of Enflurane

Back 28

A. halogenated methyl ethyl ether

Front 29

N2O is not relatively contraindicated with:
A. Pneumothorax
B. Ear Surgery
C. PONV
D. Renal Failure

Back 29

D. Renal failure

Front 30

Which of the following does not affect the speed of induction with a volatile agent?
A. FRC
B. pCO2
C. Cardiac Output
D. Body Mass
E. MAC
F. Obesity

Back 30

B. ?CO2
E. MAC

Front 31

Regarding the time constant for volatile anaesthetic uptake in the lungs:
A. Affected by lung concentration
B. Affected by obesity
C. Not affected by FRC
D. Affected by restrictive lung disease

Back 31

A. Agent Conc

Front 32

22g of N2O at STP occupies a volume of:
A. 3.6 L
B. 11.2 L
C. 22.4 L
D. 44.1 L

Back 32

C. 22.4 L

Front 33

Wash in of volatile anaesthetics in neonates is reduced in neonates because:
A. Reduced FRC
B. Increased CI
C. Decreased plasma protein levels
D. Different BG coefficient

Back 33

B. Increased CI

Front 34

Compound A:
A. Increased production with Baralyme compared to Sodalime
B. More likely in children
C. Sevoflurane metabolites cause hepatotoxicity
D. Sevoflurane is metabolised to Compound A in the liver

Back 34

A.Baralyme more

Front 35

Which of the following is not associated with epileptiform activity:
A. Propofol
B. Enflurane

Back 35

A. Propofol

Front 36

Which of the following does not increase risk of carboxyhaemaglobin poisoning:
A. Dry Absorbent
B. Baralyme
C. Low Flows
D. Desflurane
E. Halothane

Back 36

E. Halothane