Local Anaesthetics MCQs

1. Regarding local anaesthetics, which is incorrect:

a. Blood levels will be 30% lower with added vasoconstrictors leading to enhanced
neuronal uptake
b. A lower pH means that more of the anaesthetic will be in the uncharged form
and thus less effective
c. Systemic absorption is greater when injecting highly vascular sites like the
tracheal mucosa
d. Ester-based local anaesthetics will be rapidly broken down in the plasma

2. The following are all examples of amide local anaesthetics except:

a. Lignocaine
b. Bupivacaine
c. Tetracaine
d. Ropivicaine

3. The following are all examples of ester local anaesthetics except:

a. Priolocaine
b. Procaine
c. Cocaine
d. Benzocaine

4. Regarding local anaesthetics, which is correct:

a. Unmyleinated A fibres are the most sensitive to block
b. Primary action is blockade of ligand-gated sodium channels
c. Hepatic disease will cause increased toxicity from the ester local anaesthetics
d. Repeated injections of local anaesthetic can result in tachyphylaxis

5. Regarding the effects of local anaesthetics which is incorrect:

a. At least 2 nodes of Ranvier need to be blocked to prevent AP propagation in a
myelinated nerve
b. Unmyelinated nerves tend to be blocked before myelinated nerves of the same
diameter
c. Sensory fibres are preferentially blocked because they have a higher rate of
firing and a longer AP
d. Block of a large nerve will result in sensory analgesia that starts proximally and
spreads distally
6. Toxicity due to local anaesthetics includes all of the following except:
a. Direct neural toxicity
b. Direct and indirect cardiotoxicity
c. Seizures
d. Methaglobulin accumulation

Neuropharmacology – Antidepressant MCQ’s

1. Which of the following are correctly paired?
a. Imipramine: Inhibits 5HT and NA reuptake at presynaptic nerve endings
b. Citalopram: Inhibits 5HT selectively and has significant histamine effects
c. Selegiline: Blocks 5HT2 receptors
d. Venlafaxine: Inhibits NA and 5HT reuptake with potent alpha-blocking effects

2. Neurologic side effects of TCA’s include all but which of the following:
a. Sedation
b. Seizures
c. Hepatotoxicity
d. Tremor

3. Which of the following antidepressants is not highly protein bound?

a. Amitriptyline
b. Fluoxetine
c. Selegiline
d. Venlafaxine

4. SSRI’s are not:

a. Used in the treatment of obsessive-compulsive disorder and eating disorders
b. Well absorbed orally
c. Converted to active metabolites in the case of paroxetine
d. Inhibitors of CYP450 - 2D6

5. TCA’s are:
a. 5HT and NA reuptake inhibitors at post-synaptic nerve endings
b. Antinicotinics
c. Histamine receptor agonists
d. Alpha 1 blockers
 Muscle relaxants MCQs:

1. Regarding non-depolarising relaxants, which of the following is incorrect:

a. Vd is only slightly larger than blood volume
b. Drugs excreted by the kidney have t ½ less than 60 minutes
c. Drugs excreted by the liver have short half lives
d. Rocuronium is more dependent on biliary excretion for elimination

2. The duration of action of rocuronium is closest to:

a. 20-35 minutes
b. 10-15 minutes
c. 60 minutes
d. Less than 10 minutes

3. Regarding succinylcholine, which of the following is correct:

a. It reacts at the muscarinic receptor
b. It prevents opening of the sodium channel preventing depolarisation of the
motor end plate
c. Phase I block is augmented by cholinesterase inhibitors
d. It is metabolised predominantly in the liver

4. Adverse effects of succinylcholine include all of the following, except:

a. Hyperkalemia
b. Muscle pains
c. Malignant hyperthermia
d. Decreased intragastric pressure

5. Which of the following muscle relaxants has the longest duration of action:
a. Rocuronium
b. Vecuronium
c. Succinylcholine
d. Pancuronium
  MCQs EPILEPSY
1. Regarding the pharmacokinetics of Phenytoin, which is incorrect:
a) It undergoes dose-dependent elimination
b) Absorption is variable
c) It is 10% bound to plasma proteins
d) It has a half-life of 12 to 36 hours
e) It can bind to thyroid binding globulin

2. Clinical uses of Valproate include the following, except:

a) Absence seizures
b) Generalised seizures
c) Bipolar disorder
d) Migraine prophylaxis
e) Trigeminal neuralgia

3. Regarding Carbamazepine, which of the following is true:

a) It is a hepatic enzyme inhibitor
b) It can be given as a rapid IV bolus in status epilepticus
c) It has a very fast systemic clearance
d) It can be used in the treatment of bipolar disorder
e) It is never used in the treatment of seizures

4. Which is NOT a side effect of Phenytoin:

a) Nystagmus
b) Ataxia
c) Dry cough
d) Gingival hyperplasia
e) Agranulocytosis

5. Regarding Valproate, which is correct:

a) It is a hepatic enzyme inducer
b) It is 90% bound to plasma proteins
c) Side effects are not dose related
d) It has a large volume of distribution
e) It is not very effective in the treatment of absence seizures