Chapter·SurgeryAnesthesia and Perioperative medicine

Local anesthesia and nerve blocksDownloads

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1

A 17-year-old male presents with altered mental status. He was recently admitted to the hospital due to a tibial fracture suffered while playing soccer. His nurse states that he is difficult to arouse. His temperature is 98.6 deg F (37 deg C), blood pressure is 130/80 mm Hg, pulse is 60/min, and respirations are 6/min. Exam is notable for pinpoint pupils and significant lethargy. Which of the following describes the mechanism of action of the drug likely causing this patient's altered mental status?

ANeuronal hyperpolarization due to sodium influx

BNeuronal depolarization due to sodium efflux

CNeuronal depolarization due to potassium influx

DNeuronal hyperpolarization due to potassium efflux

ENeuronal hyperpolarization due to chloride influx

2

A 75 year-old gentleman presents to his general practitioner. He is currently being treated for hypertension and is on a multi-drug regimen. His current blood pressure is 180/100. The physician would like to begin treatment with minoxidil or hydralazine. Which of the following side effects is associated with administration of these drugs?

APersistent cough

BCyanosis in extremities

CFetal renal toxicity

DSystemic volume loss

EReflex tachycardia

3

A 47-year-old man with alcoholic cirrhosis is brought to the emergency department by ambulance 20 minutes after being involved in a high-speed motor vehicle collision. His pulse is 120/min, respirations are 28/min and labored, and blood pressure is 70/40 mm Hg. Physical examination shows ecchymoses over the trunk and abdomen. In preparation for an exploratory laparotomy, atracurium is administered as an anesthetic. Which of the following characteristics is the most likely reason that this drug was chosen over other drugs in the same class?

AQuickest onset of action

BHighest potency

CProlonged depolarization

DOrgan-independent elimination

ELow risk of bleeding

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