Local Anesthetics
What is the primary determinant of local anesthetic potency?
A. pKa
B. Molecular weight
C. Lipid solubility
D. Concentration
E. Protein binding
Which of the following conditions is MOST likely to increase the cardiac toxicity of bupivacaine?
(A) Bradycardia
(B) Hypokalemia
(C) Hyperthermia
(D) Acidosis
What are the nerves at the level of a supraclavicular nerve block?
A. Brachial plexus
B. Trunks
C. Cords
D. Roots
What is a side effect when the common peroneal is damaged?
A. Foot drop
B. Foot pain
C. Complex regional pain syndrome
D. Loss of plantar flexion
Between these the two muscles is where local is deposited for TAP Block
A. internal oblique and transversus abdominis muscles
B. external oblique and transversus abdominis muscles
C. internal oblique and external oblique
D. quadratus lumborum and transversus abdominis muscles
Apart from Benzocaine, this local anesthetic is known to cause allergic reactions due to its metabolism to para-amino benzoic acid (PABA)
A. Procaine
B. Prilocaine
C. Articaine
D. Iocaine
An axillary block is performed on a healthy 19-year-old athlete. Thirty mL of 0.75% bupivacaine is injected incrementally. Fifteen minutes after the bupivacaine injection, the patient has a seizure and experiences a ventricular fibrillation arrest. Which of the measures below is NOT indicated.
A. Begin chest compressions at 100 per minute
B. Ventilate with 100% oxygen
C. Bolus propofol to bind local anesthetic
D. Infuse 20% lipid emulsion
E. Repeat emulsion infusion if fibrillation continues
What nerve travels within the belly of the coracobrachialis muscle?
A. Axillary
B. Radial
C. Musculocutaneous
D. Median
What is located superficially between the lateral malleolus and the achilles tendon?
A. Posterior tibial nerve
B. Superficial peroneal nerve
C. Deep peroneal nerve
D. Sural Nerve
What epidural dose of bupivacaine will give similar sensory analgesia as 10 mL of 2% lidocaine?
A. 5 mL of 0.25% bupivacaine
B. 10 mL of 0.25% bupivacaine
C. 5 mL of 0.5% bupivacaine
D. 10 mL of 0.5% bupivacaine
E. 5 mL of 0.75% bupivacaine
True statements concerning the physiochemical properties of local anesthetic agents include all EXCEPT
A. The degree of protein binding correlates positively with the duration of action
B. Lipid solubility correlates with potency
C. The ionized form diffuses through the epineurium
D. The pKa partially determines the speed of onset
The correct arrangement of local anesthetics in order of their ability to produce cardiotoxicity from most to least is
A. Bupivacaine, lidocaine, ropivacaine
B. Bupivacaine, ropivacaine, lidocaine
C. Lidocaine, bupivacaine, ropivacaine
D. Ropivacaine, bupivacaine, lidocaine
E. Lidocaine, ropivacaine, bupivacaine
What lies along the anterior scalene muscle?
A. C4 nerve root
B. C5 nerve root
C. Superficial cervical plexus
D. Phrenic nerve
What nerve is more medial during a popliteal nerve block?
A. Tibial nerve
B. Common peroneal nerve
C. Sciatic nerve
D. Saphenous nerve
Which of the following characteristics is an advantage of a quadratus lumborum (QL) block compared to a transversus abdominis plane (TAP) block?
A. Density of motor block
B. Local anesthetic dose
C. Sensory blockade distribution
D. Presence of visceral analgesia
Which of the following local anesthetic adjuvants is MOST effective in prolonging the analgesia provided by brachial plexus blockade?
A. Neostigmine
B. Ketamine
C. Midazolam
D. Dexmedetomidine
In addition to acting as a lipid sink, which of the following is a proposed mechanism by which lipid emulsion reverses local anesthetic systemic toxicity (LAST)?
A. Increasing free concentration of local anesthetic
B. Providing an energy source to intoxicated tissue
C. Indirectly stimulating the cardiovascular system
D. Increasing cellular metabolic rate
What nerve is blocked if a patient has a hoarse voice after an interscalene block?
A. Recurrent laryngeal nerve
B. Phrenic nerve
C. Superior laryngeal nerve
D. Vagus nerve
What muscle makes up the medial border of adductor canal?
A. Adductor longus
B. Sartorius muscle
C. Vastus medialis
D. Vastus intermedius
A sensory level of T2 is achieved after administration of spinal anesthesia. Which of the following lung volumes is LEAST likely to be affected?
(A) Expiratory reserve volume
(B) Inspiratory reserve volume
(C) Inspiratory capacity
(D) Tidal volume
(E) Vital capacity
Apart from Benzocaine, this local anesthetic can cause methemoglobinemia
A. Procaine
B. Prilocaine
C. Pontocaine
D. Cocaine
A 45-year-old woman undergoes popliteal nerve blockade with 30 mL of 0.5% bupivacaine and develops tinnitus followed by disorientation, which resolves after infusion of a lipid emulsion bolus. How long should cardiovascular monitoring be continued after the resolution of symptoms?
A. 30 minutes
B. 2-3 hours
C. 4-6 hours
D. 10-12 hours
Which upper extremity block has the highest rate of chylothorax?
A. PECs block
B. Supraclavicular block
C. Infraclavicular block
D. Suprascapular nerve block
When doing a femoral block with nerve stimulator, what is the key twitch to assure the optimum needle placement?
A. Intraneural
B. Patellar
C. Flexion
D. Sartorius
The three borders of the Triangle of Petit include the follow EXCEPT?
A. latissimus dorsi muscle
B. external oblique muscle
C. costal margin
D. iliac crest inferiorly