Certified Surgical Technologist Surgical Pharmacology and Anesthesia 4 — Questions and Answers
Question 1: Which intravenous induction agent is associated with pain on injection, dose-dependent respiratory depression, and is commonly used for procedural sedation?
- Ketamine
- Propofol (Correct answer)
- Etomidate
- Methohexital
Correct answer: Propofol
Propofol causes dose-dependent respiratory depression and pain at injection; its rapid onset, short duration, and antiemetic properties make it widely used for induction and sedation.
Question 2: Which anesthetic agent is known to produce a dissociative state, provide analgesia, and is contraindicated in patients with elevated intracranial pressure?
- Fentanyl
- Propofol
- Ketamine (Correct answer)
- Droperidol
Correct answer: Ketamine
Ketamine produces dissociative anesthesia with preserved airway reflexes and analgesia, but increases cerebral blood flow and intracranial pressure, making it relatively contraindicated in head injury.
Question 3: What is the significance of the 'cannot intubate, cannot oxygenate' (CICO) scenario in anesthesia?
- It indicates the need for deeper anesthesia
- It is a failed airway emergency requiring surgical airway (Correct answer)
- It necessitates reversal of neuromuscular blockade only
- It requires switching anesthetic agents
Correct answer: It is a failed airway emergency requiring surgical airway
CICO is a life-threatening failed airway scenario where all attempts at ventilation and intubation fail, requiring immediate surgical airway (cricothyrotomy).
Question 4: Which opioid is known to cause histamine release, resulting in hypotension, bronchospasm, and pruritus when given rapidly IV?
- Fentanyl
- Morphine (Correct answer)
- Sufentanil
- Remifentanil
Correct answer: Morphine
Morphine causes histamine release from mast cells, which can precipitate bronchospasm, hypotension, and pruritus, especially with rapid intravenous administration.
Question 5: A drug labeled 'Pitocin' is requested during an obstetric procedure. What is the mechanism of action of this drug?
- It relaxes the uterus to prevent hemorrhage
- It stimulates uterine contractions to control postpartum hemorrhage (Correct answer)
- It is a tocolytic used to stop premature labor
- It blocks prostaglandin synthesis
Correct answer: It stimulates uterine contractions to control postpartum hemorrhage
Pitocin (oxytocin) stimulates uterine smooth muscle contractions and is administered after delivery to reduce postpartum hemorrhage.
Question 6: Which pharmacological principle describes the relationship between drug dose and the magnitude of its effect?
- Pharmacokinetics
- Drug bioavailability
- Dose-response relationship (Correct answer)
- First-pass metabolism
Correct answer: Dose-response relationship
The dose-response relationship describes how increasing drug doses produce proportionally greater pharmacological effects up to a maximum.
Question 7: Sugammadex is used to reverse which class of neuromuscular blocking agents?
- Depolarizing agents like succinylcholine
- Aminosteroid non-depolarizing agents like rocuronium (Correct answer)
- Benzylisoquinoline agents like cisatracurium
- All neuromuscular blocking agents equally
Correct answer: Aminosteroid non-depolarizing agents like rocuronium
Sugammadex is a modified gamma-cyclodextrin that encapsulates and inactivates aminosteroid neuromuscular blockers like rocuronium and vecuronium.
Certified Surgical Technologist Surgical Pharmacology and Anesthesia 4
Which intravenous induction agent is associated with pain on injection, dose-dependent respiratory depression, and is commonly used for procedural sedation?