Pharmacology III

Description

Praxis Tests: Pharmacology Quiz on Pharmacology III , created by ACAPUN INSTITUTE on 08/11/2021.
ACAPUN INSTITUTE
Quiz by ACAPUN INSTITUTE, updated more than 1 year ago
ACAPUN INSTITUTE
Created by ACAPUN INSTITUTE about 3 years ago
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Resource summary

Question 1

Question
Which of the following is a local anesthetic subject to inactivation by plasma esterases?
Answer
  • a. Procaine
  • b. Lidocaine
  • c. Prilocaine
  • d. Mepivacaine
  • e. Bupivacaine

Question 2

Question
Procaine differs from lidocaine in that
Answer
  • a. Procaine is a p-aminobenzoic acid ester and lidocaine is not
  • b. Lidocaine is a meta-aminobenzoic acid ester and procaine is not
  • c. The duration of action of procaine is longer than that of an equal total dose of lidocaine
  • d. Procaine hydrochloride is metabolized into diethylaminoethanol and benzoic acid.

Question 3

Question
Which of the following local anesthetics would be expected to produce a sensitization reaction in a patient allergic to lidocaine? a. Mepivacaine b. Tetracaine c. Procaine d. Prilocaine e. Dibucaine?
Answer
  • a) (a), (b) and (c)
  • b) (a), (d) and (e)
  • c) (b) and (c) only
  • d) (b), (c) and (d)
  • e) (b), (d) and (e)

Question 4

Question
The hydrolysis of procaine occurs mainly in the
Answer
  • a. Liver
  • b. Lungs
  • c. Plasma
  • d. Muscles
  • e. Kidneys

Question 5

Question
Which of the following is local anesthetic subject to inactivation by plasma esterases?
Answer
  • a. Lidocaine
  • b. Prilocaine
  • c. Tetracaine
  • d. Mepivacaine
  • e. Bupivacaine

Question 6

Question
The activity of procaine is terminated by
Answer
  • a. Elimination by the kidney
  • b. Storage in adipose tissue
  • c. Metabolism in the liver only
  • d. Metabolism in the liver and by pseudocholinesterase in the plasma

Question 7

Question
All of the following factors are significant determinants of the duration of conduction block with amide-type local anesthetics EXCEPT the
Answer
  • a. pH of tissues in the area of injection
  • b. Degree of vasodilatation caused by the local anesthetic
  • c. Blood plasma cholinesterase levels
  • d. Blood flow through the area of conduction block
  • e. Concentration of the injected anesthetic solution

Question 8

Question
Which of the following is contraindicated for a patient who had an allergic reaction to procaine six months ago?
Answer
  • a. Nerve block with lidocaine
  • b. Topical application of lidocaine
  • c. Topical application of tetracaine
  • d. Infiltration with an antihistamine

Question 9

Question
Bupivacaine (Marcaine) has all of the following properties relative to lidocaine (Xylocaine) EXCEPT
Answer
  • a. Is more toxic
  • b. Is an ester-type local anesthetic
  • c. Has a slower onset of action
  • d. Has a longer duration of action

Question 10

Question
Amide-type local anesthetics are metabolized in the
Answer
  • a. Serum
  • b. Liver
  • c. Spleen
  • d. Kidney
  • e. Axoplasm

Question 11

Question
The duration of action of lidocaine would be increased in the presence of which of the following medications?
Answer
  • a. Prazosin
  • b. Propranolol
  • c. Hydrochlorothiazide
  • d. Lisinopril
  • e. Digoxin

Question 12

Question
Severe liver disease least affects the biotransformation of which of the following?
Answer
  • a. Lidocaine
  • b. Procaine
  • c. Prilocaine
  • d. Mepivacaine

Question 13

Question
A patient has been given a large volume of a certain local anesthetic solution and subsequently develops cyanosis with methemoglobinemia. Which of the following drugs most likely was administered?
Answer
  • a. Procaine
  • b. Prilocaine
  • c. Dibucaine
  • d. Lidocaine
  • e. Mepivacaine

Question 14

Question
Use of prilocaine carries the risk of which of the following adverse effects?
Answer
  • a. Porphyria
  • b. Renal toxicity
  • c. Gastric bleeding
  • d. Methemoglobinemia

Question 15

Question
The most probable cause for a serious toxic reaction to a local anesthetic is
Answer
  • a. Psychogenic
  • b. Deterioration of the anesthetic agent
  • c. Hypersensitivity to the vasoconstrictor
  • d. Hypersensitivity to the local anesthetic
  • e. Excessive blood level of the local anesthetic

Question 16

Question
High plasma levels of local anesthetics may cause
Answer
  • a. Inhibition of peristalsis
  • b. stimulation of baroreceptors resulting in severe hypotension
  • c. Inhibition of the vagus nerve to the heart
  • d. Depression of inhibitory neurons in the CNS

Question 17

Question
Unfortunately, you injected your lidocaine intra-arterially. The first sign of lidocaine toxicity that might be seen in the patient would be
Answer
  • a. Elevated pulse rate
  • b. Sweating
  • c. CNS excitation
  • d. Cardiovascular collapse
  • e. CNS depression

Question 18

Question
The first sign that your patient may be experiencing toxicity from too much epinephrine would be
Answer
  • a. Cardiovascular collapse
  • b. Convulsions
  • c. Elevated pulse rate
  • d. Slurred speech

Question 19

Question
Which disease condition would make the patient most sensitive to the epinephrine in the local anesthetic?
Answer
  • a. Grave’s disease
  • b. Diabetes
  • c. HIV
  • d. Alcoholism
  • e. Schizophrenia

Question 20

Question
Cardiovascular collapse elicited by a high circulating dose of a local anesthetic may be caused by
Answer
  • a. Syncope
  • b. Vagal stimulation
  • c. Histamine release
  • d. Myocardial depression
  • e. Medullary stimulation

Question 21

Question
The most serious consequence of systemic local anesthetic toxicity is
Answer
  • a. Vertigo
  • b. Hypertension
  • c. Hyperventilation
  • d. Post depressive central nervous system convulsions
  • e. Postconvulsive central nervous system depression

Question 22

Question
Hypotensive shock may result from excessive blood levels of each of the following local anesthetics EXCEPT
Answer
  • a. Cocaine
  • b. Procaine
  • c. Lidocaine
  • d. Tetracaine
  • e. Mepivacaine

Question 23

Question
Which of the following anesthetic drugs produces powerful stimulation of the cerebral cortex?
Answer
  • a. Cocaine
  • b. Procaine
  • c. Lidocaine
  • d. Tetracaine
  • e. Mepivacaine

Question 24

Question
Local anesthetics block nerve conduction by
Answer
  • a. Depolarizing the nerve membrane to neutrality
  • b. Increasing membrane permeability to K+
  • c. Increasing membrane permeability to Na+
  • d. Preventing an increase in membrane permeability to K+
  • e. Preventing an increase in membrane permeability to Na+

Question 25

Question
Which of the following is true regarding the mechanism of action of local anesthetics?
Answer
  • a. Usually maintain the nerve membrane in a state of hyperpolarization
  • b. Prevent the generation of a nerve action potential
  • c. Maintain the nerve membrane in a state of depolarization
  • d. Prevent increased permeability of the nerve membrane to potassium ions
  • e. Interfere with intracellular nerve metabolism

Question 26

Question
Local anesthetic agents prevent the generation of nerve impulses by
Answer
  • a. Decreasing threshold for stimulation
  • b. Decreasing resting membrane potential
  • c. Decreasing inward movement of sodium ion
  • d. Increasing inward movement of potassium ion

Question 27

Question
Local anesthetics interfere with the transport of which of the following ions during drug-receptor interaction
Answer
  • a. Sodium
  • b. Calcium
  • c. Chloride
  • d. Potassium
  • e. Magnesium

Question 28

Question
If the pH of an area is lower than normal body pH, the membrane theory of local anesthetic action predicts that the local anesthetic activity would be
Answer
  • a. Greater, owing to an increase in the free-base form of the drug
  • b. Greater, owing to an increase in the cationic form of the drug
  • c. Less, owing to an increase in the free-base form of the drug
  • d. Less, owing to a decrease in the free-base form of the drug
  • e. None of the above

Question 29

Question
A local anesthetic injected into an inflamed area will NOT give maximum effects because
Answer
  • a. The pH of inflamed tissue inhibits the release of the free base
  • b. The drug will not be absorbed as rapidly because of the decreased blood supply
  • c. The chemical mediators of inflammation will present a chemical antagonism to the anesthetic
  • d. Prostaglandins stabilize the nerve membrane and diminish the effectiveness of the local anesthetic

Question 30

Question
The penetration of a local anesthetic into nervous tissue is a function of the
Answer
  • a. Length of the central alkyl chain
  • b. Lipid solubility of the ionized form
  • c. Lipid solubility of the unionized form
  • d. Ester linkage between the aromatic nucleus and the alkyl chain
  • e. Amide linkage between the aromatic nucleus and the alkyl chain

Question 31

Question
At a pH of 7.8, lidocaine (pKa = 7.8) will exist in
Answer
  • a. the ionized form
  • b. the nonionized form
  • c. an equal mixture of ionized and nonionized forms
  • d. a mixture 10 times more ionized than nonionized forms

Question 32

Question
The more rapid onset of action of local anesthetics in small nerves is due to
Answer
  • a. The slightly lower pH of small nerves
  • b. The greater surface-volume ratio of small nerves
  • c. The increased rate of penetration resulting from depolarization
  • d. Smaller nerves usually having a higher threshold

Question 33

Question
Which of the following statements are true regarding onset, degree and duration of action of local anesthetics? a. The greater the drug concentration, the faster the onset and the greater the degree of effect b. Local anesthetics block only myelinated nerve fibers at the nodes of Ranvier c. The larger the diameter of the nerve fiber, the faster the onset of effect d. The faster the penetrance of the drug, the faster the onset of effect
Answer
  • a) (a), (b), and (c)
  • b) (a), (b) and (d)
  • c) (a) and (c) only
  • d) (b), (c) and (d)

Question 34

Question
A dentist administers 1.8 ml of a 2% solution of lidocaine. How many mg of lidocaine did the patient receive?
Answer
  • a. 3.6
  • b. 9
  • c. 18
  • d. 36
  • e. 180

Question 35

Question
Three ml of a local anesthetic solution consisting of 2% lidocaine with 1:100,000 epinephrine contains how many milligrams of each?
Answer
  • a. 6 mg. lidocaine, 0.3 mg. epinephrine
  • b. 6 mg. lidocaine, 0.03 mg. epinephrine
  • c. 60 mg. lidocaine 0.3 mg. epinephrine
  • d. 60 mg. lidocaine 0.03 mg epinephrine
  • e. 600 mg lidocaine, 0.3 mg. epinephrine

Question 36

Question
The maximum allowable adult dose of mepivacaine is 300 mg. How many milliliters of 2% mepivacaine should be injected to attain the maximal dosage in an adult patient?
Answer
  • a. 5
  • b. 10
  • c. 15
  • d. 20
  • e. 25

Question 37

Question
A recently introduced local anesthetic agent is claimed by the manufacturer to be several times as potent as procaine. The product is available in 0.05% buffered aqueous solution in 1.8 ml. cartridge. The maximum amount recommended for dental anesthesia over a 4-hour period is 30 mg. The amount is contained in approximately how many cartridges?
Answer
  • a. 1-9
  • b. 10-18
  • c. 19-27
  • d. 28-36
  • e. Greater than 36

Question 38

Question
According to AHA guidelines, the maximum # of carpules of local anesthetic containing 1:200,000 epinephrine that can be used in the patient with cardiovascular disease is
Answer
  • a. 1
  • b. 2
  • c. 3
  • d. 4
  • e. 11
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