NBDE quiz
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1. Question
Infection causes tissue to be more resistant to the anesthetic effect of local anesthetics because:
CorrectThe correct answer is D. The acidic environment of infected tissue has a tendency to shift
the balance regarding a local anesthetic’s equilibrium toward more of the ionized form of the
local anesthetic. In turn, there is a decrease in the non-ionized form of local anesthetic and less penetration of local anesthetic through the cell membrane of the neuron. Non-ionized molecules readily diffuse across cell membranes. Infected tissue is acidic; thereby, readily ionizing local anesthetic to an ionized form, which is not effective at traversing a neuron’s cell membrane. There is a decrease in the no ionized form of the local anesthetic. A shift toward more ionized local anesthetic molecules prevents the local anesthetic from exerting their effect on the sodium channels.IncorrectThe correct answer is D. The acidic environment of infected tissue has a tendency to shift
the balance regarding a local anesthetic’s equilibrium toward more of the ionized form of the
local anesthetic. In turn, there is a decrease in the non-ionized form of local anesthetic and less penetration of local anesthetic through the cell membrane of the neuron. Non-ionized molecules readily diffuse across cell membranes. Infected tissue is acidic; thereby, readily ionizing local anesthetic to an ionized form, which is not effective at traversing a neuron’s cell membrane. There is a decrease in the no ionized form of the local anesthetic. A shift toward more ionized local anesthetic molecules prevents the local anesthetic from exerting their effect on the sodium channels.