BCA Pharmacology of Anesthetic Agents 3

Question 1

Which local anesthetic has the longest duration of action due to its high protein binding?

Accepted Answer

Bupivacaine

Answer

Bupivacaine's approximately 95% protein binding prolongs its duration of action to 4-12 hours depending on block type.

Question 2

Propofol infusion syndrome is most associated with which metabolic derangement?

Accepted Answer

Severe metabolic acidosis with cardiac failure

Answer

Propofol infusion syndrome causes mitochondrial dysfunction leading to severe metabolic acidosis, rhabdomyolysis, and cardiac failure.

Question 3

Which volatile anesthetic is most associated with triggering malignant hyperthermia?

Accepted Answer

Desflurane

Answer

All halogenated volatile anesthetics including desflurane can trigger malignant hyperthermia via uncontrolled RYR1 calcium release.

Question 4

The Hofmann elimination pathway of cisatracurium degradation means its duration is:

Accepted Answer

Independent of organ function

Answer

Hofmann elimination is a spontaneous, temperature- and pH-dependent chemical degradation that does not rely on renal or hepatic function.

Question 5

Neostigmine reverses non-depolarizing neuromuscular blockade by:

Accepted Answer

Inhibiting acetylcholinesterase to increase ACh at the NMJ

Answer

Neostigmine inhibits acetylcholinesterase, increasing ACh concentration at the neuromuscular junction to compete with the blocking agent.

(BCA) Board of Certification in Anesthesiology Practice Test