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Surgical Pharmacology and Anesthesia Flashcards

7 cards from real CSFA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Surgical Pharmacology and Anesthesia flashcards as text

  1. During a laparoscopic procedure, the patient's end-tidal CO2 rises to 60 mmHg. The MOST likely cause related to anesthesia/pharmacology is:

    Answer: CO2 insufflation absorption combined with inadequate ventilation

    Peritoneal CO2 insufflation is absorbed systemically; if minute ventilation is not increased, end-tidal CO2 rises significantly during laparoscopy.

  2. Which local anesthetic is an ESTER type and is metabolized by plasma pseudocholinesterase?

    Answer: Procaine

    Procaine is an ester-type local anesthetic hydrolyzed by plasma pseudocholinesterase, producing PABA metabolites that can cause allergic reactions.

  3. A patient develops hypotension immediately after induction with propofol. The BEST initial pharmacological intervention is:

    Answer: Phenylephrine or ephedrine IV bolus

    Phenylephrine (pure vasopressor) or ephedrine (vasopressor + mild inotrope) are first-line agents for propofol-induced hypotension due to vasodilation.

  4. The surgeon irrigates the bladder during a TURP procedure with glycine solution. The CSFA should monitor for TURP syndrome, which includes:

    Answer: Hyponatremia, fluid overload, and CNS toxicity

    Absorption of hypotonic glycine irrigant causes dilutional hyponatremia, fluid overload, and CNS effects from glycine toxicity.

  5. Which analgesic mechanism do NSAIDs use that makes them useful as opioid-sparing agents in multimodal analgesia?

    Answer: Inhibiting cyclooxygenase (COX) enzymes to reduce prostaglandin synthesis

    NSAIDs inhibit COX-1 and/or COX-2 enzymes, reducing prostaglandin synthesis and thereby decreasing inflammation and peripheral pain sensitization.

  6. Spinal anesthesia is administered for a lower extremity procedure. The CSFA should be prepared for which MOST common immediate complication?

    Answer: Hypotension due to sympathetic blockade

    Spinal anesthesia blocks sympathetic fibers, causing vasodilation and venous pooling that results in a rapid drop in blood pressure.

  7. Which medication is used intraoperatively to treat acute intraoperative anaphylaxis as the DRUG OF CHOICE?

    Answer: Epinephrine

    Epinephrine is the drug of choice for anaphylaxis; it reverses bronchospasm, vasodilation, and urticaria through alpha and beta adrenergic stimulation.