PMCOL 343 Final Exam Questions With Correct Answers
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Course
PMCOL 343
Institution
PMCOL 343
PMCOL 343 Final Exam Questions With
Correct Answers
A-beta fibers - answer- respond to gentle mechanical stimuli
A-delta fibers - answer- respond to noxious mechanical stimuli
- fast conduction
C fibers - answer- respond to noxious heat or chemical stimuli
- slowly conducting
What is nocicep...
PMCOL 343 Final Exam Questions With
Correct Answers
A-beta fibers - answer✔- respond to gentle mechanical stimuli
A-delta fibers - answer✔- respond to noxious mechanical stimuli
- fast conduction
C fibers - answer✔- respond to noxious heat or chemical stimuli
- slowly conducting
What is nociception? - answer✔- neural encoding of noxious stimuli
What is pain? - answer✔- unpleasant sensory and emotional experience associated with actual
or potential tissue damage
Analgesic Definition - answer✔- blocks the sensation of pain without blocking other modalities
What is the difference between local and general anaesthetics? - answer✔- local anaesthetics
block nerve conduction and all sensation
- general anaesthetics cause unconsciousness, do not always produce analgesia
What is hyperalgesia? - answer✔- enhanced response to painful stimulus
What is allodynia? - answer✔- generation of a painful response by an innocuous stimuli
What is acute pain/first pain? - answer✔- nociceptive stimuli leads to acute pain via activation
of nociceptive pathways
- A-delta fibers
- good pain
- if causes inflammation then it is carried by C-fibers (chronic pain)
- treated with/prevented by local anaesthetics
- less than 3 months
What is deep pain? - answer✔- deep to body surface, poorly localized associated with major
trauma
- treated by major analgesics (opioids)
- good pain
What is neuropathic pain? - answer✔- pain induced by injury to the somatosensory system
- nerve injury or NS infections
- ex: phantom limb pain, shingles, diabetic neuropathy
- develops slowly and OUTLASTS healing of original injury
- not good pain??
What occurs if peripheral nerve injury pain is left untreated? - answer✔- leads to centralization
of pain
--> pain becomes chronic and hard to treat
What are the structural requirements of local anaesthetics? - answer✔- aromatic residue
- ester/amide linkage to alkylamino group
- weak bases
What are examples of local anaesthetics with ester linkages? How are they hydrolyzed? -
answer✔- cocaine
- procaine
--> hydrolyzed by plasma cholinesterase
--> half life in blood of less than one minute
What is the mechanism of action of local anaesthetics? - answer✔- block Na+ channels
(increased threshold for AP firing)
- must become neutral to enter membrane
- enters channel from inside
- use-dependent block (higher probability of blocking if more active)
How does pH influence local anaesthetic efficacy? - answer✔- low pH (high H) pushes the
reaction towards the cationic form which can't enter the membrane to block Na+ channels
How does pKa of a local anaesthetic influence its own efficacy? What are some examples? -
answer✔- smaller pKa has a faster rate of onset because more uncharged molecules are "ready
to go" and pass through membrane to block Na+ channels
- Mepivacaine has a faster rate of onset than Procaine because it has a smaller pKa
When administered local anaesthetics, vasoconstrictors like adrenaline are often added. What is
the purpose of this? - answer✔- limit systemic absorption (especially if applied to highly
vascularized area)
- increase local anaesthetic concentration at site of action
- counteract tendency for local anaesthetics to cause vasodilation
What are some factors that affect nerve fiber susceptibility for local anaesthetics? - answer✔1.
fibre diameter
- C- A-delta fibers most susceptible
- lowest safety factor for conduction
2. firing frequency (fire more = more susceptible)
3. spike width (broad spikes = more chances for entry)
How can systemic absorption of local anaesthetics lead to toxicity? - answer✔- hypotension
(direct effects on smc in b.vessel)
- cardiac depression (Na+ block in heart) esp with bupivacaine
What are the CNS effects of local anaesthetics? - answer✔- sleepiness, light-headedness,
auditory disturbances, restlessness
What are the characteristics of general anaesthesia? - answer✔- analgesia
- amnesia
- loss of consciousness
- inhibition of sensory and autonomic reflexes
- skeletal muscle relaxation
What are the characteristics of an ideal general anaesthetic agent? - answer✔- smooth and rapid
induction
- rapid recovery
- wide margin of safety
- limited adverse effects
What are some of the adverse effects of general anaesthetics? - answer✔- vomiting
- CV depression
- respiratory depression
- respiratory irritant effect of volatile (gas) anaesthetics
- toxicity
What types of anaesthetics are used for minor procedures? - answer✔- oral sedatives + regional
local anaesthesia
What types of anaesthetics are used for conscious sedation? - answer✔- benzodiazepines +
opioid analgesics
- can respond to verbal commands, patent airway
What are the preoperative medications? - answer✔- sedatives that have anxiolytic and amnesia
properties
- muscle relaxants (d-tubocurarine)
- atropine (to limit mucous secretions)
What is used to induce anaesthesia? - answer✔- via IV
- thiopental
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