Sociedade Brasileira de Dermatolodia Surgical & Cosmetic Dermatology


ISSN-e 1984-8773

Questoes e Gabaritos

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Topical Anesthetics


1. All of the following are conditions that allow a better
penetration of topical anesthetics in the skin except for:
a. Higher hydro solubility of the medicine
b. Degreasing with acetone
c. Agent’s pKa close to the skin’s pH
d. Previous use of ablative laser
e. Occlusion
2. The following alternative is correct regarding topical
a. Amides group substances are more easily metabolized in the plasma by the enzyme pseudocholinesterase than those in the esters group
b. The amides are more stable in solution than the esters
c. The metabolite generated by the degradation of amides anesthetics is para-aminobenzoic acid (PABA), meaning that this anesthetics group has a greater sensitization potential
d. Esters-type anesthetics are metabolized in the liver
e. The amides have greater sensitization potential
3. All of the factors below are linked to higher risks of
systemic adverse effects except for:
a. Renal or hepatic insufficiency
b. Occlusion
c. Application on palms and soles
d. Application to mucous membranes
e. Application on inflamed skin
4. Methemoglobinemia is a side effect mainly caused by
which anesthetic substance?
a. Tetracaine
b. Xylocaine
c. Lidocaine
d. Prilocaine
e. Cocaine
5. Signs and symptoms of the first phase of intoxication
by lidocaine are:
a. Cyanosis and dyspnea
b. Pruritus, erythema and edema
c. Buzzing, metallic taste, perioral paresthesia
d. Angioedema
e. Seizures and cardiorespiratory failure
6. Anesthetic substances belonging in the amides
functional group are:
a. Lidocaine and tetracaine
b. Prilocaine and lidocaine
c. Prilocaine and tetracaine
d. Benzocaine and tetracaine
e. Tetracaine and cocaine
7. All of the below alternatives regarding adverse
reactions of topical anesthetics are correct except for:
a. Allergic contact dermatitis is more commonly caused by lidocaine than prilocaine
b. Edema, erythema and pruritus at the application site are the most common side effects of tetracaine
c. Unintentional contact with topical anesthetics in cream may lead to a lesion in the conjunctival mucus caused by the formulation’s alkaline pH
d. Serious allergic reactions to topical anesthetics are very rare
e. Even in infants, methemoglobinemia is a rare event
8. The treatment of methemoglobinemia caused by the
use of topical anesthetics is made using:
a. Activated coal
b. Oxygen and dialysis
c. Sodium bicarbonate
d. Oxygen and Prussian blue
e. Oxygen and methylene blue
9. The following are risk factors for methemoglobinemia
caused by topical anesthetics, except for:
a. A deficiency of glucose-6-phosphate dehydrogenase enzyme
b. Concomitant use of paracetamol
c. Prematurity
d. Concomitant use ofdapsone
e. Concomitant use ofmetoclopramide
10. Regarding topical anesthetics, it is correct to assert
a. The use of topical anesthetics is not associated with a risk of death
b. Topical anesthetics can never be applied to children less than 2 years old due to the high risk of methemoglobinemia
c. The absorption of anesthetics in dispensed preparations is not always equal to that of commercial products, even when in similar concentrations
d. The association of topical anesthetics with injectable anesthetics does not pose an additional risk
e. In adults, the application of EMLA in areas greater than 200 cm2 can cause systemic side effects

Gabarito do número anterior

1. C 2. E 3. D 4. A 5. C 6. C 7. D 8. B 9. A 10. B

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