Question # 1 (Multiple Answer) Factors influencing the speed and extent of neuromuscular-blockade reversal by anticholinesterases

A) intensity of neuromuscular-blockade when reversal is initiated
B) which nondepolarizing neuromuscular-blocking drug is being reversed
C) hypothermia
D) hypokalemia
E) respiratory acidosis

Question # 2 (Multiple Choice) Preferred anticholinergic drug when the objective (in preoperative medication) is sedation:

A) atropine
B) glycopyrrolate (Robinul)
C) scopolamine
D) ipratropium (Atrovent)
E) neostigmine (Prostigmin)

Question # 3 (Multiple Choice) Preoperative medication: atropine --

A) sedation
B) antisialagogue
C) both
D) neither

Question # 4 (Multiple Answer) Atropine should be effective in blocking which of the following cardiac responses?

A) positive inotropism in response to significant increases in circulating epinephrine
B) reflex slowing of the heart due to peritoneal stimulation occurring during surgery
C) reflex slowing of the heart due to pressure on the eyeballs
D) A-V blockade associatet with acute myocardial infarction
E) all of the above

Question # 5 (True/False) Intrathecal neostigmine injection -- produces postoperative analgesia without respiratory depression seen with neuraxial opioids:

A) true
B) false

Question # 6 (Multiple Choice) Anticholinesterase better for reversing atracurium blockade:

A) neostigmine (Prostigmin)
B) edrophonium (Tensilon)
C) equally effective

Question # 7 (True/False) Atropine has limited effects on circulation because most vascular beds lack significant cholinergic innervation

A) true
B) false

Question # 8 (Multiple Choice) Probably better for reversing vecuronium (Norcuron) blockade:

A) edrophonium (Tensilon)
B) neostigmine (Prostigmin)
C) about equal

Question # 9 (Multiple Answer) Effect of ganglionic blockade at these anatomical sites:

A) veins: dilatation, blood pooling, decreased venous return, decreased cardiac output
B) arterioles: vasoconstriction, decreased peripheral blood flow, hypertension
C) heart: bradycardia
D) gastrointestinal tract: reduced tone and motility; constipation; decreased secretions

Question # 10 (Multiple Choice) More effective in reversing deep neuromuscular-blockade produced by continuous vecuronium infusion:

A) neostigmine (Prostigmin)
B) edrophonium (Tensilon)

Question # 11 (Multiple Choice) Least effect on pupil size of all anticholinergic drugs used in preoperative medication:

A) glycopyrrolate (Robinul)
B) atropine
C) scopolamine

Question # 12 (Multiple Answer) Concerning use of antimuscarinic agents a long with anticholinesterases in reversal of neuromuscular-blockade:

A) antimuscarinic agents are beneficial because they minimize muscarinic receptor-mediated effects of anticholinesterase agents
B) antimuscarinic drug should have a slower onset then the anticholinesterase drugs
C) higher does atropine has been recommended if opioid-based maintenance anesthesia has been used

Question # 13 (Multiple Answer) Predominant autonomic tone:

A) arterioles -- sympathetic: adrenergic
B) heart -- sympathetic: adrenergic
C) gastrointestinal tract -- parasympathetic: cholinergic
D) veins -- sympathetic: adrenergic

Question # 14 (Multiple Answer) Factors which may prevent or inhibit anticholinesterase-mediated reversal of neuromuscular blockade:

A) hyperthermia
B) hyperkalemia
C) respiratory acidosis
D) certain antibiotics
E) all of the above

Question # 15 (Multiple Choice) Effect of antimuscarinic agents on bronchiolar smooth muscle:

A) tends to promote bronchorelaxation
B) tends to promote bronchial constriction

Question # 16 (Multiple Choice) Highest CNS activity

A) atropine
B) glycopyrrolate (Robinul)
C) scopolamine

Question # 17 (Multiple Choice) Drug not appropriate for antagonist-assisted neuromuscular-blockade reversal, because the dosage requirement is excessive:

A) edrophonium (Tensilon)
B) physostigmine (Antilirium)
C) neostigmine (Prostigmin)
D) pyridostigmine (Mestinon)
E) vecuronium (Norcuron)

Question # 18 (Multiple Answer) Effects of ganglionic blockade on these anatomical sites:

A) veins: dilation, decreased venous return, decreased cardiac output
B) arterioles: vasoconstriction, decreaset peripheral blood flow, hypertension
C) heart: bradycardia

Question # 19 (Multiple Choice) Drug category of choice in management of intraoperative bradycardia -- especially if bradycardia results from increased vagal tone:

A) anticholinesterase
B) nicotinic receptor agonist
C) muscarinic receptor agonist
D) nicotinic receptor antagonist
E) muscarinic receptor antagonist

Question # 20 (Multiple Answer) Comparing ipratropium (Atrovent) and atropine in management of asthma:

A) ipratropium (Atrovent) does not inhibit mucociliary clearance --atropine does
B) ipratropium (Atrovent) has no significant CNS effects
C) ipratropium (Atrovent) is limited or no systemic effects
D) ipratropium (Atrovent) generally it is advantageous compared atropine in management of asthma

Question # 21 (Multiple Choice) Anesthetic that probably increases central venous tone:

A) enflurane (Ethrane)
B) halothane (Fluothane)
C) both
D) neither