CSFA Surgical Pharmacology and Anesthesia 5

Question 1

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

Accepted Answer

CO2 insufflation absorption combined with inadequate ventilation

Answer

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

Question 2

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

Accepted Answer

Procaine

Answer

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

Question 3

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

Accepted Answer

Phenylephrine or ephedrine IV bolus

Answer

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

Question 4

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

Accepted Answer

Hyponatremia, fluid overload, and CNS toxicity

Answer

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

Question 5

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

Accepted Answer

Inhibiting cyclooxygenase (COX) enzymes to reduce prostaglandin synthesis

Answer

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

CSFA - Certified Surgical First Assistant Practice Test

CSFA - Certified Surgical First Assistant Practice Test

CSFA Surgical Pharmacology and Anesthesia 5