Certified Surgical Technologist Surgical Pharmacology and Anesthesia 3 — Questions and Answers
Question 1: Which inhaled anesthetic agent is known to trigger malignant hyperthermia in susceptible patients?
- Nitrous oxide
- Sevoflurane (Correct answer)
- Xenon
- Halothane
Correct answer: Sevoflurane
Sevoflurane, like all volatile halogenated agents, can trigger malignant hyperthermia in genetically susceptible individuals through abnormal RYR1 receptor activation.
Question 2: A surgeon requests epinephrine to be added to a local anesthetic. What is the primary purpose of this combination?
- Increase anesthetic potency
- Prolong duration and reduce systemic absorption (Correct answer)
- Provide additional analgesia
- Prevent allergic reaction
Correct answer: Prolong duration and reduce systemic absorption
Epinephrine causes local vasoconstriction, which slows systemic absorption of the local anesthetic, prolonging its duration and reducing toxicity.
Question 3: Which muscle relaxant is classified as a depolarizing neuromuscular blocking agent?
- Vecuronium
- Rocuronium
- Succinylcholine (Correct answer)
- Cisatracurium
Correct answer: Succinylcholine
Succinylcholine is the only clinically used depolarizing neuromuscular blocker, acting by mimicking acetylcholine and causing persistent depolarization.
Question 4: What is the term for the minimum alveolar concentration (MAC) of an inhaled anesthetic?
- The concentration that blocks all sensory input
- The alveolar concentration preventing movement in 50% of patients to skin incision (Correct answer)
- The concentration causing loss of consciousness
- The maximum safe inhaled dose
Correct answer: The alveolar concentration preventing movement in 50% of patients to skin incision
MAC is defined as the minimum alveolar concentration of an anesthetic at which 50% of patients do not move in response to a standard surgical stimulus (skin incision).
Question 5: Which benzodiazepine is commonly used for preoperative anxiolysis and intraoperative sedation in monitored anesthesia care?
- Diazepam
- Lorazepam
- Midazolam (Correct answer)
- Temazepam
Correct answer: Midazolam
Midazolam is preferred for perioperative use due to its rapid onset, short duration, water solubility, and amnestic properties.
Question 6: When a patient is on anticoagulation therapy with warfarin, which lab value must be monitored preoperatively?
- Platelet count
- Partial thromboplastin time (PTT)
- International normalized ratio (INR) (Correct answer)
- Bleeding time
Correct answer: International normalized ratio (INR)
INR measures the extrinsic coagulation pathway affected by warfarin; a therapeutic INR for most indications is 2.0–3.0, and surgery typically requires it below 1.5.
Question 7: The scrub technologist notes a medication labeled 'Marcaine' on the sterile field. What is the generic name?
- Lidocaine
- Mepivacaine
- Ropivacaine
- Bupivacaine (Correct answer)
Correct answer: Bupivacaine
Marcaine is the brand name for bupivacaine, a long-acting amide local anesthetic used for regional anesthesia and postoperative pain control.
Certified Surgical Technologist Surgical Pharmacology and Anesthesia 3
Which inhaled anesthetic agent is known to trigger malignant hyperthermia in susceptible patients?