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Frage 1
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What does lipid theory say?
Antworten
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When the concentration of general anaesthetic exceeds 0.05mM, anaesthesia is induced as a result of a lipid volume increase of 0.4%. The lipid expansion interferes with nerve impulse conduction and thus anaesthesia is induced.
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When the concentration of general anaesthetic exceeds 0.5mM, anaesthesia is induced as a result of a lipid volume increase of 0.4%. The lipid expansion interferes with nerve impulse conduction and thus anaesthesia is induced.
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When the concentration of general anaesthetic exceeds 0.5mM, anaesthesia is induced as a result of a lipid volume increase of 4%. The lipid expansion interferes with nerve impulse conduction and thus anaesthesia is induced.
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When the concentration of general anaesthetic exceeds 0.1mM, anaesthesia is induced as a result of a lipid volume increase of 0.4%. The lipid expansion interferes with nerve impulse conduction and thus anaesthesia is induced.
Frage 2
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What can reverse lipid theory?
Antworten
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High pressure - reduces lipid volume back to normal
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Low pressure - reduces lipid volume back to normal
Frage 3
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What is protein theory?
Antworten
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A concentration of general anaesthetic that reaches 0.05mM leads to a lipid volume increase of 0.4% which induces anaesthesia. This is because the increase in lipid volume interferes with conduction of nerve impulses.
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Lipid solubility of general anaesthetics is required for the general anaesthetic to reach a hydrophobic pocket on a channel protein. Channel proteins targeted are usually ion channels like GABA, K+ or nAchR.
Frage 4
Frage
Optical isomers of GA have the same lipid solubility and the same potency.
Antworten
- True
- False
Frage 5
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What are the inhibitory responses caused by general anaesthetics?
Antworten
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Opening of K+ channels (efflux)
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Increase GABA activity
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Inhibit excitatory channels such as nAchR
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Increase glutaminergic activity
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Opening of K+ channels (influx)
Frage 6
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What is meant by the cut-off phenomenon?
Antworten
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The lipid solubility of a GA (and thus its potency) increases with the number of carbons in a GA but after a certain point (usually >11 carbons) the GA's potency abruptly declines.
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After a certain high dose of GA, the patients condition rapidly deteriorates.
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The general anaesthetic stops working after a certain period of time.
Frage 7
Frage
GA have a large therapeutic window.
Antworten
- True
- False
Frage 8
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The minimum alveolar concentration effectively describes what?
Antworten
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The more lipid soluble a GA is, the lower the concentration required in inspired air.
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The more lipid soluble a GA is, the higher the concentration required in inspired air.
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The less lipid soluble a GA is, the lower the concentration required in inspired air.
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The less lipid soluble a GA is, the higher the concentration required in inspired air.
Frage 9
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What increases transfer of GA to the alveoli?
Antworten
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Increased concentration of GA
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Increased rate and depth of breathing
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Decreased concentration of GA
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Decreased rate and depth of breathing
Frage 10
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A higher blood:gas partition coefficient means that the GA is highly soluble in blood.
Antworten
- True
- False
Frage 11
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A GA with a high blood:gas partition coefficient will travel to the brain much quicker than one with a lower blood:gas partition coefficient.
Antworten
- True
- False
Frage 12
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Why would pulmonary blood flow increase help with absorption of GA when GA concentration in the body is initially low?
Antworten
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It maintains a high, favourable concentration gradient for the absorption of GA from the lungs into the blood, therefore increasing speed of induction.
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It helps to increase blood flow to the brain to increase the concentration of general anaesthetic in the desired place.
Frage 13
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What tissue has a high tissue:blood partition coefficient?
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Adipose tissue
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Muscle tissue
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Brain tissue
Frage 14
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Overall, what is evidence for lipid theory?
Antworten
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Volume expansion of the lipid bilayer
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Cut-off phenomenon
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Stereoselectivity
Frage 15
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Overall, what is evidence for protein theory?
Antworten
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Volume expansion of the lipid bilayer
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Cut-off phenomenon
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Stereoselectivity
Frage 16
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GA is usually metabolised by the body and excreted in the urine.
Antworten
- True
- False
Frage 17
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Both blood:gas and tissue:blood partition coefficients are inversely proportional to the speed of induction of GA.
Antworten
- True
- False
Frage 18
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What is an advantage of using halothane?
Antworten
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Potent and fast acting
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Pleasant odour
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Less liver damage
Frage 19
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What is a disadvantage of sevoflurane?
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Liver toxicity
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Bad smell
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Possible seizures
Frage 20
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Intravenous GA is usually used for induction.
Antworten
- True
- False
Frage 21
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Intravenously administered thiopental and propofol act at which receptors?
Antworten
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GABA-a receptors
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GABA-b receptors
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NMDA
Frage 22
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Intravenously administered ketamine act at what receptors?
Antworten
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NMDA
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GABA-a
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GABA-b
Frage 23
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Adjuncts are used to enhance the potency of a GA.
Antworten
- True
- False
Frage 24
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Give some examples of adjuncts used for GA administration.
Antworten
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Anxiolytics
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Anti-depressants
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Anti-psychotics
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Anti-emetics
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Muscle relaxants
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