Previous Page

Medical Pharmacology:  Local Anesthetics Practice Test

This is a self-grading exam. Answers are entered by clicking the button corresponding to your selection. The examination is scored by clicking 'Grade Test' at the bottom of the form. Correct answers are found using hyperlinks at the bottom of the page.



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