Anesthesiology and Pharmacology Multiple Choice Worksheet

A patient will undergo a tooth extraction procedure. The doctor uses lidocaine as a local anesthetic. The main mechanism of action of this drug is...

• Inhibiting GABA receptors at the synapse

• Blocking sodium channels (Na+) from the intracellular side of the axon

• Activating nicotinic acetylcholine receptors on nerve fibers

• Inhibiting the release of acetylcholine neurotransmitter at the nerve terminal

• Lowering the action potential threshold by increasing Na+ influx

A 32-year-old female patient undergoes epidural block with bupivacaine. After a few minutes, the patient experiences bradycardia and hypotension. The most likely mechanism of this side effect is...

• Stimulation of the sympathetic center in the medulla

• Systemic vasoconstriction by local anesthetics

• Decreased conduction and myocardial contractility

• Activation of beta receptors in the heart

• Increased acetylcholine levels at cardiac synapses

Compared to procaine, lidocaine has a faster onset of action because...

• Higher water solubility

• pKa closer to physiological pH

• Not metabolized in the liver

• Has a direct vasoconstrictive effect

• Not bound to plasma proteins

A patient is given topical local anesthetic cocaine. Shortly after, the patient develops hypertension. This effect is caused by...

• Increased norepinephrine release

• Peripheral vasodilation due to Na+ block

• Reuptake blockade of norepinephrine at the synapse

• Decreased activity of the parasympathetic system

• Activation of central dopamine receptors

A patient undergoing caesarean section receives spinal anesthesia with lidocaine. Postoperatively, the patient complains of back pain radiating to the lower limbs without permanent neurological deficit. The most likely diagnosis is...

Which of the following is a complication that can occur after spinal anesthesia?

• Transient neurological symptoms (TNS)

• Spinal cord infarction

• Epidural abscess

• Post-dural puncture headache

Local anesthetic drugs of the amide group tend to have a longer duration of action than esters because...

• Synthesized in the kidneys

• Rapid hydrolysis by plasma cholinesterase

• Slow metabolism in the liver

• Do not undergo systemic distribution

• Inhibit presynaptic calcium channels

A patient with severe depressive symptoms is given fluoxetine (SSRI). The main mechanism of action of this drug is...

• Increases serotonin degradation in the synaptic cleft

• Inhibits serotonin reuptake in presynaptic neurons

• Activates 5-HT1A postsynaptic receptors

• Decreases serotonin release from presynaptic neurons

• Inhibits tryptophan synthesis into serotonin

Disorders of the nigrostriatal dopaminergic system are associated with the following disease...

• Schizophrenia

• Parkinson's

• Depression

• Alzheimer's

• Epilepsy

Administration of antipsychotic drugs can cause side effects such as tremor and rigidity because...

• Activation of D2 dopamine receptors in the striatum

• Inhibition of D2 dopamine receptors in the nigrostriatal pathway

• Activation of GABA postsynaptic receptors

• Blockade of 5-HT2A serotonin receptors

• Decreased acetylcholine levels in the cortex