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NMS Semester 2 Set 3 Quiz - General anaesthetics

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Question 1

Question
What does lipid theory say?
Answer
  • 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.
  • 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.
  • 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.
  • 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.

Question 2

Question
What can reverse lipid theory?
Answer
  • High pressure - reduces lipid volume back to normal
  • Low pressure - reduces lipid volume back to normal

Question 3

Question
What is protein theory?
Answer
  • 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.
  • 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.

Question 4

Question
Optical isomers of GA have the same lipid solubility and the same potency.
Answer
  • True
  • False

Question 5

Question
What are the inhibitory responses caused by general anaesthetics?
Answer
  • Opening of K+ channels (efflux)
  • Increase GABA activity
  • Inhibit excitatory channels such as nAchR
  • Increase glutaminergic activity
  • Opening of K+ channels (influx)

Question 6

Question
What is meant by the cut-off phenomenon?
Answer
  • 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.
  • After a certain high dose of GA, the patients condition rapidly deteriorates.
  • The general anaesthetic stops working after a certain period of time.

Question 7

Question
GA have a large therapeutic window.
Answer
  • True
  • False

Question 8

Question
The minimum alveolar concentration effectively describes what?
Answer
  • The more lipid soluble a GA is, the lower the concentration required in inspired air.
  • The more lipid soluble a GA is, the higher the concentration required in inspired air.
  • The less lipid soluble a GA is, the lower the concentration required in inspired air.
  • The less lipid soluble a GA is, the higher the concentration required in inspired air.

Question 9

Question
What increases transfer of GA to the alveoli?
Answer
  • Increased concentration of GA
  • Increased rate and depth of breathing
  • Decreased concentration of GA
  • Decreased rate and depth of breathing

Question 10

Question
A higher blood:gas partition coefficient means that the GA is highly soluble in blood.
Answer
  • True
  • False

Question 11

Question
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.
Answer
  • True
  • False

Question 12

Question
Why would pulmonary blood flow increase help with absorption of GA when GA concentration in the body is initially low?
Answer
  • It maintains a high, favourable concentration gradient for the absorption of GA from the lungs into the blood, therefore increasing speed of induction.
  • It helps to increase blood flow to the brain to increase the concentration of general anaesthetic in the desired place.

Question 13

Question
What tissue has a high tissue:blood partition coefficient?
Answer
  • Adipose tissue
  • Muscle tissue
  • Brain tissue

Question 14

Question
Overall, what is evidence for lipid theory?
Answer
  • Volume expansion of the lipid bilayer
  • Cut-off phenomenon
  • Stereoselectivity

Question 15

Question
Overall, what is evidence for protein theory?
Answer
  • Volume expansion of the lipid bilayer
  • Cut-off phenomenon
  • Stereoselectivity

Question 16

Question
GA is usually metabolised by the body and excreted in the urine.
Answer
  • True
  • False

Question 17

Question
Both blood:gas and tissue:blood partition coefficients are inversely proportional to the speed of induction of GA.
Answer
  • True
  • False

Question 18

Question
What is an advantage of using halothane?
Answer
  • Potent and fast acting
  • Pleasant odour
  • Less liver damage

Question 19

Question
What is a disadvantage of sevoflurane?
Answer
  • Liver toxicity
  • Bad smell
  • Possible seizures

Question 20

Question
Intravenous GA is usually used for induction.
Answer
  • True
  • False

Question 21

Question
Intravenously administered thiopental and propofol act at which receptors?
Answer
  • GABA-a receptors
  • GABA-b receptors
  • NMDA

Question 22

Question
Intravenously administered ketamine act at what receptors?
Answer
  • NMDA
  • GABA-a
  • GABA-b

Question 23

Question
Adjuncts are used to enhance the potency of a GA.
Answer
  • True
  • False

Question 24

Question
Give some examples of adjuncts used for GA administration.
Answer
  • Anxiolytics
  • Anti-depressants
  • Anti-psychotics
  • Anti-emetics
  • Muscle relaxants
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