ABA ABA Pharmacology & Drug Management 2

Question 1

Which local anesthetic has the highest risk of cardiovascular toxicity upon accidental intravascular injection?

Accepted Answer

Bupivacaine

Answer

Bupivacaine binds cardiac sodium channels with high affinity and slow dissociation, making resuscitation from its cardiovascular toxicity extremely difficult.

Question 2

A patient receiving a propofol infusion at 75 mcg/kg/min for 72 hours develops metabolic acidosis, rhabdomyolysis, and cardiac failure. This is MOST consistent with:

Accepted Answer

Propofol infusion syndrome

Answer

Propofol infusion syndrome occurs with prolonged high-dose infusions and presents with metabolic acidosis, rhabdomyolysis, renal failure, and cardiac dysfunction.

Question 3

Ketamine's analgesic and dissociative effects are primarily mediated through which receptor?

Accepted Answer

NMDA receptor antagonism

Answer

Ketamine is a non-competitive NMDA receptor antagonist, blocking glutamate-mediated excitation to produce dissociative anesthesia and analgesia.

Question 4

Which vasopressor has the MOST selective alpha-1 adrenergic activity with minimal beta effects, making it the preferred agent for spinal hypotension?

Accepted Answer

Phenylephrine

Answer

Phenylephrine is a pure alpha-1 agonist that increases SVR and corrects spinal hypotension without increasing heart rate, preferred in obstetric anesthesia.

Question 5

The Bier block (IV regional anesthesia) uses which local anesthetic as the standard agent in the United States?

Accepted Answer

Lidocaine 0.5%

Answer

Lidocaine 0.5% is the standard agent for Bier blocks in the US; bupivacaine is CONTRAINDICATED due to fatal cardiac toxicity risk if the tourniquet deflates early.

(ABA) ASA (American Society of Anesthesiologists) Board Certification Practice Test

(ABA) ASA (American Society of Anesthesiologists) Board Certification Practice Test

ABA ABA Pharmacology & Drug Management 2