Neuromuscular Blockade

Questão 1 de 16

1

Use of succinylcholine to facilitate endotracheal intubation would be acceptable (“safe”) in which one of the following situations:

Selecione uma das seguintes:

80 y.o. female patient 2 days after 40% body surface area burn
18 y. o. male one week after spinal cord transection injury
12 y.o. with Duchene’s muscular dystrophy
22 y. o. with evolving respiratory failure secondary to Guillian-Barre’
27 y. o. female with myasthenia gravis

Explicação

Questão 2 de 16

1

A patient taking which of the following drugs would most commonly be associated with resistance to (nondepolarizing) NMB drugs:

Selecione uma das seguintes:

Quinidine
Phenytoin
Cyclophosphamide
Aminoglycosides
Magnesium

Explicação

Questão 3 de 16

1

The MOST important parameter that determines the speed of onset for NMB drugs is:

Selecione uma das seguintes:

Potency
Lipophilicity
Ionization
Plasma clearance
E. Receptor affinity

Explicação

Questão 4 de 16

1

A characteristic common to current aminosteroid-based NMB drugs such as vecuronium or rocuronium is:

Selecione uma das seguintes:

Significant histamine release after a bolus injection
Vagolysis producing tachycardia
Hofmann elimination
Deacetylation in the liver
Production of laudanosine as the primary metabolite

Explicação

Questão 5 de 16

1

Selecione da lista do Menu para completar o texto.

Clinical data support that when the TOFR exceeds ( 0.4, 0.2, 0.7, 0.9 ),
anesthesia providers have trouble assessing the presence
of fade

Explicação

Questão 6 de 16

1

Selecione da lista do Menu para completar o texto.

TOF count of 3 would equate to a twitch suppression of ( 55, 75, 85, 90 )%

Explicação

Questão 7 de 16

1

Selecione da lista do Menu para completar o texto.

Once the TOF ratio exceeds ( 0.60, 0.40, 0.70, 0.85 ), fade to DBS generally cannot be detected subjectively

Explicação

Questão 8 de 16

1

What is true about Tetanic stimulation (TET)?

Selecione uma das seguintes:

During partial depolarizing block, fade is not observed in response to tetanic stimulation
Tetanic stimulation is not painful
Muscular fatigue usually develop at a stimulation frequency of 50 Hz
Fade is thought to be an effect of a depolarizing agent on the presynaptic nerve membrane

Explicação

Questão 9 de 16

1

Which statement about posttetanic count is NOT correct?

Selecione uma das seguintes:

The number of posttetanic count twitches is inversely related to time until the first regular TOF twitch returns
Posttetanic count used when TOF or DBS is absent to estimate recovery time
Posttetanic count uses tetany followed by TOF at frequency of 1 Hz
The main use of posttetanic count is when profound neuromuscular block is not required

Explicação

Questão 10 de 16

1

Correct statements about objective monitoring techniques include:

Selecione uma das seguintes:

Mechanomyography (MMG) measures isotonic contraction of peripheral muscles in response to nerve stimulation
Acceleromyography (AMG) calculates the force of contraction of a muscle using a miniature piezoelectric transducer
Electromyography (EMG) measures the electrical activity (compound muscle action potential) of a stimulated muscle
Kinemyography (KMG) detects the acceleration of the thumb contraction in response to electrical stimulation of a nerve

Explicação

Questão 11 de 16

1

All of the following are examples of Benzylisoquinolinium compounds consist of two quaternary ammonium groups joined by methyl groups EXCEPT:

Selecione uma das seguintes:

D-tubocurarine
Atracurium
Mivacurium
Pancuronium
Cisatracurium

Explicação

Questão 12 de 16

1

Train-of-four (TOF) has all of the following characteristics, EXCEPT:

Selecione uma das seguintes:

TOF consists of four ST stimuli at a frequency of 4 Hz
TOF does not require a “baseline” or “control” muscle response
TOF “fade” is defined as a weaker fourth twitch than the first twitch
TOF is delivered every 15-20 sec to prevent potentiation of subsequent responses
TOF ratios >0.40 cannot be reliably detected subjectively (visually or tactilely)

Explicação

Questão 13 de 16

1

Double burst stimulation (DBS) characteristics include all of the following, EXCEPT:

Selecione uma das seguintes:

The two mini-tetanic bursts are separated by 0.5 sec
DBS is delivered no more frequently than every 20 sec to prevent subsequent response potentiation
In DBS, similar to TOF pattern, no control (“baseline”) muscle response is needed
DBS ratios >0.60 cannot be reliably detected by subjective (tactile, visual) means
In awakening patients, DBS is more painful than TOF, but less so than tetanic stimulation

Explicação

Questão 14 de 16

1

Potential side-effects associated with the use of succinylcholine include all of the below, EXCEPT:

Selecione uma das seguintes:

Myalgia
Tachycardia
Anaphylaxis
Hyperkalemia

Explicação

Questão 15 de 16

1

Since sugammadex has no direct cholinergic properties, anesthesiologist do not require the ready availability of an anticholinergic like glycopyrrolate at the time of reversal.

Selecione uma das opções:

VERDADEIRO
FALSO

Explicação

Questão 16 de 16

1

When administering sugammadex through a peripheral IV, it is important to note that the drug has a physical incompatibility with all of the following drugs except:

Selecione uma das seguintes:

Verapamil
Dexamethasone
Ranitidine
Odansetron

	Criado por Mike Ru mais de 6 anos atrás

Diplomat of ABA Medicine (Fundamental Topics in Anesthesiology) Quiz sobre Neuromuscular Blockade, criado por Mike Ru em 28-04-2018.

Neuromuscular Blockade

Questão 1 de 16

Use of succinylcholine to facilitate endotracheal intubation would be acceptable (“safe”) in which one of the following situations:

Selecione uma das seguintes:

Explicação

Questão 2 de 16

A patient taking which of the following drugs would most commonly be associated with resistance to (nondepolarizing) NMB drugs:

Selecione uma das seguintes:

Explicação

Questão 3 de 16

The MOST important parameter that determines the speed of onset for NMB drugs is:

Selecione uma das seguintes:

Explicação

Questão 4 de 16

A characteristic common to current aminosteroid-based NMB drugs such as vecuronium or rocuronium is:

Selecione uma das seguintes:

Explicação

Questão 5 de 16

Selecione da lista do Menu para completar o texto.

Clinical data support that when the TOFR exceeds 0.4 0.2 0.7 0.9( 0.4, 0.2, 0.7, 0.9 ), anesthesia providers have trouble assessing the presence of fade

Explicação

Questão 6 de 16

Selecione da lista do Menu para completar o texto.

TOF count of 3 would equate to a twitch suppression of 55 75 85 90( 55, 75, 85, 90 )%

Explicação

Questão 7 de 16

Selecione da lista do Menu para completar o texto.

Once the TOF ratio exceeds 0.60 0.40 0.70 0.85( 0.60, 0.40, 0.70, 0.85 ), fade to DBS generally cannot be detected subjectively

Explicação

Questão 8 de 16

What is true about Tetanic stimulation (TET)?

Selecione uma das seguintes:

Explicação

Questão 9 de 16

Which statement about posttetanic count is NOT correct?

Selecione uma das seguintes:

Explicação

Questão 10 de 16

Correct statements about objective monitoring techniques include:

Selecione uma das seguintes:

Explicação

Questão 11 de 16

All of the following are examples of Benzylisoquinolinium compounds consist of two quaternary ammonium groups joined by methyl groups EXCEPT:

Selecione uma das seguintes:

Explicação

Questão 12 de 16

Train-of-four (TOF) has all of the following characteristics, EXCEPT:

Selecione uma das seguintes:

Explicação

Questão 13 de 16

Double burst stimulation (DBS) characteristics include all of the following, EXCEPT:

Selecione uma das seguintes:

Explicação

Questão 14 de 16

Potential side-effects associated with the use of succinylcholine include all of the below, EXCEPT:

Selecione uma das seguintes:

Explicação

Questão 15 de 16

Since sugammadex has no direct cholinergic properties, anesthesiologist do not require the ready availability of an anticholinergic like glycopyrrolate at the time of reversal.

Selecione uma das opções:

Explicação

Questão 16 de 16

When administering sugammadex through a peripheral IV, it is important to note that the drug has a physical incompatibility with all of the following drugs except:

Selecione uma das seguintes:

Explicação

Clinical data support that when the TOFR exceeds ( 0.4, 0.2, 0.7, 0.9 ),
anesthesia providers have trouble assessing the presence
of fade

TOF count of 3 would equate to a twitch suppression of ( 55, 75, 85, 90 )%

Once the TOF ratio exceeds ( 0.60, 0.40, 0.70, 0.85 ), fade to DBS generally cannot be detected subjectively