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Local Anesthetics Exam I

Local Anesthetics Exam I

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Question # 1 (Multiple Choice) Duration of action -- subarachnoid injection of ester-type local anesthetics

    A) extremely short
    B) extremely long

Question # 2 (Multiple Choice) Consequences of vasodilatory local anesthetic property:

    A) reduced systemic absorption
    B) shorter duration of action
    C) both
    D) neither

Question # 3 (Multiple Choice) Highest local anesthetic blood levels associated with this type of regional anesthesia:

    A) epidural
    B) brachial plexus
    C) sciatic
    D) intercostal
    E) caudal

Question # 4 (Multiple Choice) Consequences of fetal acidosis (sometimes associated with prolonged labor) on local anesthetic accumulation in the fetus

    A) reduced
    B) enhanced

Question # 5 (Multiple Choice) Plasma concentration of local anesthetics determined by:

    A) rate of tissue distribution
    B) rate of drug clearance
    C) both
    D) neither

Question # 6 (Multiple Choice) Ester-type local anesthetic-most rapid hydrolysis

    A) tetracaine (pontocaine)
    B) procaine (Novocain)
    C) chloroprocaine (Nesacaine)

Question # 7 (Multiple Choice) Enhancement of spinal anesthesia by the presence of epinephrine in local anesthetics: Reason(s) --

    A) increased substance P release
    B) increased dorsal horn neuronal activity
    C) decreased local neuronal uptake
    D) none of the above

Question # 8 (Multiple Choice) Ester type local anesthetics are more likely available for significant placental transfer

    A) true
    B) false

Question # 9 (Multiple Answer) Propranolol (Inderal) -- local anesthetic effect(s):

    A) inhibits bupivacaine (Marcaine) extraction
    B) increases lidocaine (Xylocaine) plasma clearance
    C) decreases bupivacaine (Marcaine) plasma clearance

Question # 10 (Multiple Choice) Duration of action

    A) Ester-type local anesthetics -- longer duration of action compared to amides
    B) Amide-type local anesthetics -- longer duration of action compared to esters

Question # 11 (Multiple Answer) Factor(s) that may reduce plasma cholinesterase activity:

    A) hepatic disease
    B) elevated BUN
    C) parturient patient

Question # 12 (Multiple Choice) Systemic toxicity: ester-type local anesthetics

    A) inversely proportional to hydrolytic rate
    B) directly proportional the hydrolytic rate

Question # 13 (Multiple Answer) Chemical properties -- local anesthetics

    A) weak bases
    B) may exist as a cation
    C) may exist in uncharged form
    D) most local anesthetics have pKa's ranging from 6.0-7.0

Question # 14 (Multiple Answer) Local anesthetics: chemical properties

    A) many local anesthetics are chiral
    B) S enantiomers are often less toxic than racemates
    C) ropivacaine (Naropin) is an example of a pure R enantiomer
    D) all of the above

Question # 15 (Multiple Choice) Higher vascularity -- promotes increased, rapid local anesthetic absorption

    A) tendon
    B) tracheal mucosal

Question # 16 (Multiple Choice) Consequence of clonidine (Catapres) addition to local anesthetic solutions --

    A) increase local anesthetic effect
    B) reduce local anesthetic effect

Question # 17 (Multiple Choice) Clearance mechanisms for local anesthetics:

    A) amides-mainly renal
    B) esters-rapid clearance; hydrolysis
    C) both
    D) neither

Question # 18 (Multiple Choice) Local infection (acidotic conditions) --effect on anesthetic effectiveness

    A) increased effectiveness
    B) reduced effectiveness

Question # 19 (Multiple Answer) Factors that influence local anesthetic absorption and distribution:

    A) dosage
    B) presence of epinephrine in the local anesthetic solution
    C) injection site
    D) chemical properties of the drug

Question # 20 (Multiple Answer) Factors influencing local anesthetic distribution and plasma concentrations:

    A) liver function
    B) cardiovascular status
    C) extent of protein binding
    D) patient age

Question # 21 (Multiple Choice) Ester-type local anesthetic:

    A) lidocaine (Xylocaine)
    B) tetracaine (pontocaine)
    C) ropivacaine (Naropin)
    D) dibucaine (Nupercainal, generic)
    E) bupivacaine (Marcaine)

Question # 22 (Multiple Choice) Pulmonary extraction from the venous circulation limits the amount of local anesthetic that will reach the systemic circulation

    A) true
    B) false

Question # 23 (Multiple Answer) Amide-type local anesthetic

    A) cocaine
    B) tetracaine (pontocaine)
    C) prilocaine (Citanest)
    D) lidocaine (Xylocaine)
    E) bupivacaine (Marcaine)

Correct Answers

1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23






































Question # 1 (Multiple Choice) Duration of action -- subarachnoid injection of ester-type local anesthetics

Answer: (B) extremely long

CSF-no cholinesterase activity BACK







































Question # 2 (Multiple Choice) Consequences of vasodilatory local anesthetic property:

Answer: (B) shorter duration of action

BACK







































Question # 3 (Multiple Choice) Highest local anesthetic blood levels associated with this type of regional anesthesia:

Answer: (D) intercostal

BACK







































Question # 4 (Multiple Choice) Consequences of fetal acidosis (sometimes associated with prolonged labor) on local anesthetic accumulation in the fetus

Answer: (B) enhanced

ion trapping BACK







































Question # 5 (Multiple Choice) Plasma concentration of local anesthetics determined by:

Answer: (C) both

BACK







































Question # 6 (Multiple Choice) Ester-type local anesthetic-most rapid hydrolysis

Answer: (C) chloroprocaine (Nesacaine)

BACK







































Question # 7 (Multiple Choice) Enhancement of spinal anesthesia by the presence of epinephrine in local anesthetics: Reason(s) --

Answer: (D) none of the above

BACK







































Question # 8 (Multiple Choice) Ester type local anesthetics are more likely available for significant placental transfer

Answer: (B) false

BACK







































Question # 9 (Multiple Answer) Propranolol (Inderal) -- local anesthetic effect(s):

(A) inhibits bupivacaine (Marcaine) extraction

(C) decreases bupivacaine (Marcaine) plasma clearance

BACK







































Question # 10 (Multiple Choice) Duration of action

Answer: (B) Amide-type local anesthetics -- longer duration of action compared to esters

BACK







































Question # 11 (Multiple Answer) Factor(s) that may reduce plasma cholinesterase activity:

(A) hepatic disease

(B) elevated BUN

(C) parturient patient

BACK







































Question # 12 (Multiple Choice) Systemic toxicity: ester-type local anesthetics

Answer: (A) inversely proportional to hydrolytic rate

BACK







































Question # 13 (Multiple Answer) Chemical properties -- local anesthetics

(A) weak bases

(B) may exist as a cation

(C) may exist in uncharged form

(D) most local anesthetics have pKa's ranging from 6.0-7.0

BACK







































Question # 14 (Multiple Answer) Local anesthetics: chemical properties

(A) many local anesthetics are chiral

(B) S enantiomers are often less toxic than racemates

BACK







































Question # 15 (Multiple Choice) Higher vascularity -- promotes increased, rapid local anesthetic absorption

Answer: (B) tracheal mucosal

BACK







































Question # 16 (Multiple Choice) Consequence of clonidine (Catapres) addition to local anesthetic solutions --

Answer: (A) increase local anesthetic effect

BACK







































Question # 17 (Multiple Choice) Clearance mechanisms for local anesthetics:

Answer: (B) esters-rapid clearance; hydrolysis

amides-hepatic BACK







































Question # 18 (Multiple Choice) Local infection (acidotic conditions) --effect on anesthetic effectiveness

Answer: (B) reduced effectiveness

BACK







































Question # 19 (Multiple Answer) Factors that influence local anesthetic absorption and distribution:

(A) dosage

(B) presence of epinephrine in the local anesthetic solution

(C) injection site

(D) chemical properties of the drug

BACK







































Question # 20 (Multiple Answer) Factors influencing local anesthetic distribution and plasma concentrations:

(A) liver function

(B) cardiovascular status

(C) extent of protein binding

(D) patient age

BACK







































Question # 21 (Multiple Choice) Ester-type local anesthetic:

Answer: (B) tetracaine (pontocaine)

BACK







































Question # 22 (Multiple Choice) Pulmonary extraction from the venous circulation limits the amount of local anesthetic that will reach the systemic circulation

Answer: (A) true

BACK







































Question # 23 (Multiple Answer) Amide-type local anesthetic

(D) lidocaine (Xylocaine)

(E) bupivacaine (Marcaine)

BACK