Analeptical remedy of reflective type from the H-cholinomimetics group was given to the patient for restoration of breathing after poisoning with carbon monoxide. What medicine was prescribed to the patient? Pentamin A Lobeline hydrochloride B Adrenalin hydrochloride C !esaton D Atropine sulphate E 2 Patient with bronchial asthma was ta"ing tablets which caused insomnia# head headac ache he## incr increa ease sed d bloo blood d press ressur ure. e. What hat mede medeci cine ne can can caus causee such such complications? $uphyline A Adrenaline B $phedrine C %hromolin sodium D &'adrine E aged pati patien entt comp compla lain inss of head headac ache he## di'' di''in ines ess# s# (uic (uic" " tire tiredn dnes ess# s# 3 An aged worsening worsening of memory. memory. Anamnesis) craniocerebral craniocerebral in*ury in*ury. !edicine !edicine of what group should be prescribed? +omnific A ,euroleptics B ,ootropics C +edatives D Analgetics E 4 +pasm of smooth muscle of bronchi developed in the patient. sage of activators of what membrane cytoreceptors is fisiologically valid to decrease attac"? -cholinoreceptors A /-0drenoreceptors B 1-adrenoreceptors C /- and 1-0drenoreceptors D 2-cholinoreceptors E 5 Patient with complaints of dryness in the mouth# photophobia and vision violation violation was admitted admitted to the reception-room reception-room.. +"in is hyperemic# hyperemic# dry# dry# pupils are dilated# tachycardia. Poisoning with belladonna al"aloids was diagnosed on further examination. What medicine should be prescribed? 3ia'epam A Armine B Pilocarpine C Pro'erin D 3ipyroxim E 6 Patient in the unconscious state was admitted to the emergency room. +"in is cold# pupils are delayed# breathing is heavy# with cycles of the %heyne-+to"es 1
type# blood pressure is decreased# urinary bladder is overloaded. Poisoning with what substance is the most li"ely? -cholinergic antagonists A +edatives B ,arcotic analgesics C ,on-narcotic analgesics D ,one of the above E 4he pati patient ent has has ta"e ta"en n the the mixt mixtur uree pres prescri cribe bed d by neuro neuropa path thol olog ogis istt for for 7 4he neur neuras asth then enia ia for for 5 wee"s ee"s.. Pati Patien entt fel felt bett better er but but deve develloped oped cory cory'a 'a## con*un con*uncti ctivit vitis# is# rash# rash# inerti inertia# a# decreas decreasee of memory memory.. 6romi' 6romi'm m was diagno diagnosed sed.. What should be prescribed to decrease symptoms? 7lucose solution 8 9 A Asparcam B Polyglucin C ,atrium chloride D All of the above E 4he pati patien entt was was trea treate ted d medi medica call lly y for psyc psycho hosi siss for for 5 wee" wee"s. s. Pati Patien ent: t:ss 8 4he condition condition improved but rigidity rigidity## tremor# tremor# hypo"inesia hypo"inesia developed. Which of the drugs can cause such complications? +ydnocarb A 3iphenine B &mipramine C %hlordia'epoxide D Amina'ine E 9 4o anaestheti'e the manipulation connected with burn surface treatment# a patient was intravenously in*ected a medication for short-acting narcosis. ; minute later the patient being under anaesthesia had elevated blood pressure# tachycardia# increased tone of sceletal muscles< the reflexes were reserved. After awa"ening the patient had desorientation and visual hallucinations. What medication was in*ected to the patient? ,itrous oxide A =etamine B 4hiopental sodium C +ombrevin D 3iethylether E 10 After the usage of acetylsalicylic acid a patient developed epigastric pain because of exacerbation of his ulcer. What are the principles of this medication ulcerogenity? &mmunodepressive effect A %holagogic effect B Antiprostaglandinic effect C +timulation of pepsin secretion D +pasm of vessels E
type# blood pressure is decreased# urinary bladder is overloaded. Poisoning with what substance is the most li"ely? -cholinergic antagonists A +edatives B ,arcotic analgesics C ,on-narcotic analgesics D ,one of the above E 4he pati patient ent has has ta"e ta"en n the the mixt mixtur uree pres prescri cribe bed d by neuro neuropa path thol olog ogis istt for for 7 4he neur neuras asth then enia ia for for 5 wee"s ee"s.. Pati Patien entt fel felt bett better er but but deve develloped oped cory cory'a 'a## con*un con*uncti ctivit vitis# is# rash# rash# inerti inertia# a# decreas decreasee of memory memory.. 6romi' 6romi'm m was diagno diagnosed sed.. What should be prescribed to decrease symptoms? 7lucose solution 8 9 A Asparcam B Polyglucin C ,atrium chloride D All of the above E 4he pati patien entt was was trea treate ted d medi medica call lly y for psyc psycho hosi siss for for 5 wee" wee"s. s. Pati Patien ent: t:ss 8 4he condition condition improved but rigidity rigidity## tremor# tremor# hypo"inesia hypo"inesia developed. Which of the drugs can cause such complications? +ydnocarb A 3iphenine B &mipramine C %hlordia'epoxide D Amina'ine E 9 4o anaestheti'e the manipulation connected with burn surface treatment# a patient was intravenously in*ected a medication for short-acting narcosis. ; minute later the patient being under anaesthesia had elevated blood pressure# tachycardia# increased tone of sceletal muscles< the reflexes were reserved. After awa"ening the patient had desorientation and visual hallucinations. What medication was in*ected to the patient? ,itrous oxide A =etamine B 4hiopental sodium C +ombrevin D 3iethylether E 10 After the usage of acetylsalicylic acid a patient developed epigastric pain because of exacerbation of his ulcer. What are the principles of this medication ulcerogenity? &mmunodepressive effect A %holagogic effect B Antiprostaglandinic effect C +timulation of pepsin secretion D +pasm of vessels E
A pati patien entt suf suffers fers from from noct noctu urnal rnal paro paroxy xysm smss of bron bronch chia iall asth asthm ma accompanied by bradycardia# spastic intestinal pains and diarrhea. !edicine of what group can releave these symptoms? +ympatholytics A H-cholinergic receptors B !-cholinergic receptors C +aluretics D 1-adrenobloc"ers E 12 A patient with bronchial asthma is administered inhalation of >#8 9 isadrine solution. 6ronchospasm was releaved# but the patient began complaining of pain in the heart region and palpitation. palpitation. &t is connected with the the stimulation of) /; adrenoreceptors A 1; adrenoreceptors B 15 adrenoreceptors C Acetylcholine synthesis D !-cholinergic receptors E 13 A patient with fibrillation# who has had bronchial asthma in his anamnethis# shou should ld be admi admini nist stere ered d anti antiar arrhy rhyth thmi micc drug drug.. Whic Which h prepa prepara rati tion on from from the the suggested group is contraindicated for this patient? A*maline A ,ifedipine B Anapriline @Propranolol C ,ovocainamid D Berapamil E 14 A 58-year-old woman with red and itchy ec'ematoid dermatitis visits your office. +he had a dental procedure one day earlier with administration of a local anesthetic anesthetic.. 4here were no other findings# findings# although she indicated indicated that she had a hist histor ory y of alle allerg rgic ic reac reacti tion ons. s. Whic Which h of the the follo followi wing ng drug drugss is most most li"e li"ely ly involved? Procaine A 6upivacaine B Lidocaine C $tidocaine D %ocaine E 15 4o anaestheti'e the manipulation related to burn surface treatment# a patient was intravenously in*ected a medication for short-acting narcosis. ; minute later the patient being under anaesthesia had increased blood pressure# tachycardia# increased tone of sceletal muscles< reflexes remained. After awa"ening the patient had desorientation and visual hallucinations. What medication was the patient in*ected? +ombrevin A =etamine B 3iethylether C 11
4hiopental sodium ,itrous oxide E patien entt with with bronc bronchi hial al asth asthma ma had had been been ta"i ta"ing ng tabl tablet etss whic which h caus caused ed 16 A pati insomnia# headache# increased blood pressure. What medecine can cause such complications? %hromolin sodium A &'adrine B $uphyline C D Adrenaline E $phedrine 17 A patient patient has been been ta"ing ta"ing a mixture mixture prescri prescribed bed by neurop neuropath atholo ologis gistt for neurasthenia for two wee"s. 4he patient feels better but has developed cory'a# con* con*un unct ctiv ivit itis is## rash# rash# inert inertia ia## decr decrea ease se of memo memory ry.. +he +he is diag diagnos nosed ed with with bromi'm. What should be prescribed to decrease the symptoms? Polyglucin A B ,atrium chloride Asparcam C 7lucose solution 8 9 D All of the above E 18 A ;C-year-old girl with history of asthma complained of cough# dyspnea and whee'ing. Her symptoms became so severe that her parents brought her to the emer emerge genc ncy y room room.. Phys Physic ical al exami examina nati tion on reve reveal aled ed diap diapho hores resis is## dysp dyspnea nea## tachycardia and tachypnea. Her respiratory rate was D5Emin# pulse rate was ;;> beats per minute# and blood pressure was ;C>EF> mm Hg. %hoose from the follow following ing list list the most most approp appropria riate te drug drug to reverse reverse the broncho bronchocon constr strict iction ion rapidly) 6eclomethasone A &pratropium B !ethylprednidsolone C +albutamol D %romolyn E 19 A D5-year-old man who has been in*ured in a car accident is brought into the emergency room. His blood alcohol level on admission is 58> mgEdL. Hospital record recordss show show a prior prior hospit hospitali ali'at 'ation ion for alcohol alcohol relate related d sei'ure sei'ures. s. His wife wife confirms that he has been drin"ing heavily for C wee"s. What treatment should be provided to the patient if if he goes into withdrawal? Phenytoin A Pentobarbital B C ,one of the above Phenobarbital D 3ia'epam E D
A 8>-year-old male farm wor"er has been brought to the emergency room. He was foun found d conf confus used ed in the orcha rchard rd and and sinc sincee then hen has has rem remaine ained d unconscious. His heart rate is D8 and his blood pressure is G>ED> mm Hg. He is swea sweati ting ng and and sali saliva vati ting ng prof profus usel ely y. Whic Which h of the the foll follow owin ing g shou should ld be prescribed? Atropine sulfas A Proserine B Physostigmine C ,orepinephrine D Pentamine E 21 A patient with complaints of dryness in the mouth# photophobia and vision impairment was admitted to the reception-room. +"in is hyperemic# dry# pupils are dilated# tachycardia. Poisoning with belladonna al"aloids was diagnosed on further examination. What medicine should be prescribed Pilocarpine A 3ipiroxim B Pro'erin C 3ia'epam D Armine E 22 A 58-year-old woman with red and itchy ec'ematoid dermatitis visits your office. +he had a dental procedure one day earlier with administration of a local anesthetic anesthetic.. 4here were no other findings# findings# although she indicated indicated that she had a hist histor ory y of alle allerg rgic ic reac reacti tion ons. s. Whic Which h of the the follo followi wing ng drug drugss is most most li"e li"ely ly involved? $tidocaine A %ocaine B 6upivacaine C Lidocaine D Procaine E 23 A patient has got a spasm of smooth muscles of bronchi. Activators of what membrane cytoreceptors are phisiologically reasoned to stop an attac"? beta-adrenoreceptors A alpha- and beta 0drenoreceptors B 2-cholinoreceptors C !-# H-cholinoreceptors D -cholinoreceptors E &ntroducti ction on of a pharma pharmaceu ceutic tical al substa substance nce to an experi experimen mental tal animal animal 24 &ntrodu resu result lted ed in reduc reducti tion on of sali saliva vati tion on## pupi pupill mydr mydria iasi sis. s. ,ext ,ext intr intrav aveno enous us introduction of acetylcholine didn:t lead to any significant changes of heart rate. ,ame this substance) Proserin A Atropine B Propranolol C 20
Adrenaline +albutamol E 25 A patient with && stage hypertension has been ta"ing one of hypotensive medi medica cati tion onss for for the the purp purpos osee of trea treatm tmen ent. t. Afte Afterr a time time arte arteria riall press pressur uree decr decrea ease sed# d# but but the the pati patien entt star starte ted d comp compla lain inin ing g of flac flacci cidi dity ty## slee sleepi pines ness# s# indifference. A bit later he felt stomach pain. He was diagnosed with ulcer. What hypotensive medication has the patient been ta"ing? %aptopril A 3iba'ole B eserpine C Iurosemide D Berapamil E patient had to go through an operation. 3octors introduced him dithylinum 26 A patient @listenone @listenone and performed performed intubation. intubation. After the end of operation operation and cessation cessation of anesthesia the independent respiration wasn:t restored. Which en'yme deficit prolongs the action of muscle relaxant? Psendocholinesterase A =iBaadenosine =iBaadenosine triphosphatase B iBacetyltransferase C +uccinate dehydrogenase D %arbanhydrase E 27 A patient ill with bronchial asthma didn:t inform his doctor that he had attac"s of stenocardia. 3octor administered him a medication# which ta"ing resulted in less fre(uent attac"s of bronchial asthma# but stenocardia attac"s became more fre(uent. What medication was was administered? %romolyn sodium A +albutamol B Aminophylline C Phenotherol D &sadrin E 28 A patient with fracture of his lower *aw was admitted to the maxillofacial department. department. &t was decided to fix his bones surgically surgically under anaesthetic. anaesthetic. After After intr intrav aven enou ouss intr introdu oduct ctio ion n of musc muscle le rela relaxa xant nt there there arose arose shor shortt fibri fibrill llar ar contractions of the patient:s facial muscles. What muscle relaxant was applied? A 3ithylinum B Pipecuronium bromide C 3ia'epam !elictine D 4ubocurarin chloride E $xaminati ation on of a patien patientt reveal revealed ed extrem extremely ely myotic myotic pupils pupils## sleepi sleepiness ness## 29 $xamin infre(uent %hain+to"e:s respiration# urinary retention# slowingdown of heart rate# enhancement of spinal reflexes. What substance caused the poisoning? Atropine sulfas A D
Phosphactole %affeine C !orphine D 6arbital E 30 A patient who has been treated with dia'epam on account of neurosis complains of toothache. 3octor administered him an analgetic# but its dose was lower than average therapeutic dose. What phenomenon did the doctor ta"e into account while prescribing the patient an underdose? +ummation A Potentiation B %umulation C 4olerance D 3rug dependence E 31 Jn the 5-Crd day after stomach resection intestinal peristalsis wasn:t restore 3. What is to be administered for stimulation of gastrointestinal tract? Atropine sulfate A Proserin B Prasosin C %yclodole D Acetylcholine E 32 A stomatologist in*ected a patient with a certain drug in order to reduce salivation during tooth filling. What drug is it? A Atropine sulfate B Pilocarpine hydrochloride Proserin C !esaton D Adrenaline hydrochloride E 33 A patient with acute morphine poisoning was delivered to a hospital. What specific narcotic antagonist should be chosen in this case? nithiol A ,aloxone B !ethacin C 3igoxin D Paracetamol E 34 A patient who has been treated in a neural clinic and has been ta"ing a sedative for a long time got the following complication) cough# rhinitis# epiphor A. What drug caused these disturbances? Phena'epam A Balerian B +odium bromide C 3ia'epam D eserpine E B
An ophthalmologist used a ;9 mesaton solution for the diagnostic purpose @pupil dilation for eye-ground examination. What is the cause of mydriasis induced by the drug? Activation of ; adrenoreceptors A 6loc" of ; adrenoreceptors B Activation of !-cholinoreceptors C Activation of ;adrenoreceptors D Activation of 5adrenoreceptors E 36 &f a man has an attac" of bronchiospasm it is necessary to reduce the effect of vagus on smooth muscles of bronchi. What membrane cytoreceptors should be bloc"ed for this purpose? -adrenoreceptors A -adrenoreceptors B - and -adrenoreceptors C ,-cholinoreceptors D !-cholinoreceptors E 37 A patient came to the hospital complaining about (uic" fatigability and apparent muscle wea"ness. $xamination revealed an autoimmune disease that causes disorder of functional receptor condition in neuromuscular synapses. What transmitter will be bloc"ed? 3opamine A +erotonin B 7lycine C Acetylcholine D ,oradrenalin E 38 A patient with drug intoxication presented with the dryness of oral mucous membrane and mydriatic pupils. +uch action of this drug is associated with the following effect) A Adrenoreceptor bloc" B !uscarinic cholinoreceptor stumulation C Adrenoreceptor stimulation !uscarinic cholinoreceptor bloc" D ,icotinic cholinoreceptor stumulation E 39 A patient consulted a physician about muscle rigidity# constrained movements# permanent arm tremor. 4he patient was diagnosed with Par"inson:s diseas e. What preparation should be administered? Phenobarbital A Levodopa B 3ia'epam C Phenytoin D $thosuximide E 40 A patient with myocardial infarction was admitted to the cardiological department. Ior pain relief it was decided to potentiate fentanyl action with a 35
neurolepti c. Which of the following neuroleptics is the most suitable for neuroleptanalgesia? Haloperidol A 4rifta'ine B Amina'ine C +ulpiride D 3roperidol E 41 A patient with coronary artery disease was admitted to the cardiological department. Ior stenocardia prevention a drug from the group of -adrenoceptor bloc"ers was administered. What drug is it? !orphine hydrochloride A Jxytocin B !etoprolol C Iurosemide D Atropine sulfate E 42 A patient with a limb fracture must be administered a depolari'ing drug from the myorelaxant group for the purpose of a short-time surgery. What drug is it? Atropine sulfate A 3ithylinum B 4ubocurarine chloride C %ytitonum D Pentaminum E 43 A KC-year-old patient with collapse presentations was delivered to the emergency hospital. A physician has chosen noradrenalin against hypotension. What is its mechanism of action? Activation of ;-adrenoreceptors A Activation of serotonin receptors B Activation of dopamine receptors C 6loc" of !-cholinoreceptors D Activation of -adrenoreceptors E 44 A patient suffering from myasthenia has been administered proserin. After its administration the patient has got nausea# diarrhea# twitch of tongue and s"eletal muscles. What drug would help to eliminate the intoxication? A Atropine sulfate B Pyridostigmine bromide C &sadrine !esatonum D Physostigmine E 45 A D8-year-old patient suffers from neurosis characteri'ed by irritability# sleeplessness# motiveless anxiety. What drug would eliminate all the symptoms? Levodopa A Pyracetam B
Balerian extract 3ia'epam D %affeine sodium ben'oate E 46 Acetylcholine &+ ,J4 a specific neurotransmitter at) +ympathetic ganglia A +ympathetic postganglionic nerve endings B Parasympathetic ganglia C Parasympathetic postganglionic nerve endings D ,one of the above E 47 !uscarinic receptors are located in) Autonomic ganglia A +"eletal muscle neuromuscular *unctions B Autonomic effector cells C +ensory carotid sinus baroreceptor 'one D All of the above E 48 &ndicate the location of !5 cholinoreceptor type) Heart A 7lands B +mooth muscle C D $ndothelium E All of the above 49 4he symptoms of mushroom poisoning include all of the following $%$P4) +alivation# lacrimation# nausea# vomiting A 3ryness of mouth# hyperpyrexia# hallucination B Headache# abdominal colic C 6radycardia# hypotension and shoc" D ,one of the above E 50 Which of the following cholinomimetics activates both muscarinic and nicotinic receptors? Lobeline A Pilocarpine B ,icotine C %arbacholine D Adrenalin hydrochloride E 51 &ndicate a cholinomimetic agent# which is related to direct-acting drugs) Aceclidine A B %ytitone C %arbacholine D Proserine E 3ipiroxim 52 %haracteristics of carbacholine include all of the following $%$P4) &t decreases intraocular pressure A &t causes mydriasis B C
&t exerts both nicotinic and muscarinic effects &t is resistant to acethylcholiesterase D All of the above E 53 Acetylcholine &+ ,J4 used in clinical practice because) &t is very toxic A 4he doses re(uired are very high B &t is very rapidly hydroly'ed C &t is very costly D ,one of the above E 54 Which of the following direct-acting cholinomimetics has the shortest duration of action? Acetylcholine A Proserinum B 7alanthamini hydrobromidum C D Pridostigmini bromidum E %ytitonum 55 A !-cholinimimetic agent is) A %arbacholinum Pilocarpini hydrochloridum B %ytitonum C Alloximum D Atropini sulfas E 56 %haracteristics of pilocarpine include all of the following $%$P4) &t is a tertiary amine al"aloid A &t causes miosis and a decrease in intraocular pressure B %auses a decrease in secretory and motor activity of gut C &t is useful in the treatment of glaucoma D All of the above E 57 Which of the following cholinomimetics is a plant derivative with lower potency than nicotine but with a similar spectrum of action? Lobelini hydrochloridum A Pilocarpini hydrochloridum B %arbocholinum C Aceclidinum D Proserinum E 58 Which of the following cholinomimetics is indirect-acting? Lobeline hydrochloridum A B Proserinum C Pilocarpini hydrochloridum D %arbocholinum E Atropini sulfas 59 4he mechanism of action of indirect-acting cholinomimetic agents is) 6inding to and activation of muscarinic or nicotinic receptors A &nhibition of the hydrolysis of endogenous acetylcholine B C
+timulation of the action of acetylcholinesterase eleasing acetylcholine from storage sites D All of the above E 60 &ndicate a reversible cholinesterase inhibitor) Proserinum A %arbacholinum B Pilocarpini hydrochloridum C Phosphacolum D %ytitonum E 61 Which of the following cholinesterase inhibitors is irreversible? %arbacholinum A Pilocarpini hydrochloridum B Proserinum C Phosphacolum D %ytitonum E 62 &ndicate !-cholinomimetic) %arbocholinum A Pilocarpini hydrochloridum B Proserinum C D 7alanthamini hydrobromidum E Pyridostigmini bromidum 63 Proserinum increases all of the following effects $%$P4) A Lacrimation 6ronchodilation B !uscle twitching C +alivation D 6radycardia E 64 Mholinesterase inhibitors do not produce) 6radycardia# no change or modest fall in blood pressure A &ncreased strength of muscle contraction# especially in muscles B wea"ened by myasthenia gravis !iosis and reduction of intraocular pressure C 3ramatic hypertension and tachycardia D All of the above E 65 Which of the following cholinomimetics is commonly used in the treatment of glaucoma? Pilocarpini hydrochloridum A B Lobelini hydrochloridum C %arbocholinum D Atropini sulfas E 7alanthamini hydrobromidum 66 Which of the following cholinomimetic is most widely used for paralytic ileus and atony of the urinary bladder? Pilocarpini hydrochloridum A C
Lobelini hydrochloridum Proserinum C Atropini sulfas D Phosphacolum E 67 . %hronic long-term therapy of myasthenia is usually accomplished with) Pilocarpini hydrochloridum A Lobelini hydrochloridum B Proserinum C Atropini sulfas D Phosphacolum E 68 Which of the following cholinomimetics is a drug of choice for reversing the effects of nondepolari'ing neuromuscular relaxants? Pilocarpini hydrochloridum A Lobelini hydrochloridum B C Proserinum D Atropini sulfas E Phosphacolum 69 &ndicate the reversible cholinesterase inhibitor# which penetrates the blood brain barrier) Pilocarpini hydrochloridum A Proserinum B %arbocholinum C Atropini sulfas D 7alanthamini hydrobromidum E 70 Which of the following cholinomimetics is used in the treatment of atropine intoxication? Pilocarpini hydrochloridum A Aceclidinum B %arbocholinum C Proserinum D Phosphacolum E 71 4he symptoms of excessive stimulation of muscarinic receptors include all of the following $%$P4) Abdominal cramps# diarrhea A &ncreased salivation# excessive bronchial secretion B !iosis C 6radycardia D Wea"ness of all s"eletal muscles E 72 4he excessive stimulation of muscarinic receptors by pilocarpine and choline esters is bloc"ed competitively by) Pilocarpini hydrochloridum A Aceclidinum B %arbocholinum C Proserinum D B
Atropini sulfas 73 4he toxic effects of a large dose of nicotine include all of the following $%$P4) Hypotension and bradycardia A %onvulsions# coma B espiratory arrest C +"eletal muscle depolari'ation bloc"ade and respiratory paralysis D Hypertension and cardiac arrhythmias E 74 4he dominant initial sights of acute cholinesterase inhibitors intoxication include all of the following $%$P4) A +alivation B +weating !ydriasis C 6ronchial constriction D Bomiting and diarrhea E 75 Which of the following drugs is used for acute toxic effects of !cholinomimetics? Atropini sulfas A Proserinum B 7alanthamini hydrobromidum C %arbocholinum D Proserinum E 76 4he group of nicotinic receptor-bloc"ing drugs consists of) 7anglion-bloc"ers A Atropine-similar drugs B ,euromuscular *unction bloc"ers C Anticholinesterases D 7anglion-bloc"ers and ,euromuscular *unction bloc"ers E 77 Which of the following drugs is both a muscarinic and nicotinic bloc"er? Atropini sulfas A %yclodolum B C 7alanthamini hydrobromidum D Phosphacolum E Pirilenum 78 &ndicate a muscarinic receptor-bloc"ing drug) +copolamini hydrobromidum A Proserinum B 7alanthamini hydrobromidum C Phosphacolum D Pirilenum E 79 Which of the following agents is a ganglion-bloc"ing drug? +copolamini hydrobromidum A Proserinum B 7alanthamini hydrobromidum C E
Phosphacolum Pirilenum E 80 &ndicate the s"eletal muscle relaxant# which is a depolari'ing agent) 3ithyllinum A Pipecuronii bromidum B !ellictinum C 4ubocurarini chloridum D Ami'ylum E 81 Which of the following drugs is a nondepolari'ing muscle relaxant? 3ithyllinum A Pirilenum B Aceclidinum C 4ubocurarini chloridum D Ami'ylum E 82 &ndicate the drug# which is rapidly and fully distributed into %,+ and has a greater effect than most other antimuscarinic agents? A Atropini sulfas B +copolamini hydrobromidum Proserinum C Phosphacolum D %arbocholinum E 83 4he effect of the drug on parasympathetic function declines rapidly in all organs $%$P4) $ye A Heart B +mooth muscle organs C 7lands D All of the above E 84 4he mechanism of Atropini sulfas action is) %ompetitive ganglion bloc"ade A %ompetitive muscarinic bloc"ade B %ompetitive neuromuscular bloc"ade C ,oncompetitive neuromuscular bloc"ade D All of the above E 85 Atropini sulfas is highly selective for) !; receptor subtype A !5 receptor subtype B C !C receptor subtype D All of the above E ,one of the above 86 Which of the following antimuscarinic drugs is often effective in preventing or reversing vestibular disturbances# especially motion sic"ness? Atropini sulfas A +copolamini hydrobromidum B D
Proserinum Phosphacolum D %arbocholinum E 87 Atropini sulfas causes) !iosis# a reduction in intraocular pressure and cyclospasm A !ydriasis# a rise in intraocular pressure and cycloplegia B !iosis# a rise in intraocular pressure and cycloplegia C !ydriasis# a rise in intraocular pressure and cyclospasm D ,one of the above E 88 Patients complain on dry or NsandyO eyes when receiving large doses of) Atropini sulfas A Proserinum B Phosphacolum C %arbocholinum D 7alanthamini hydrobromidum E 89 Atropini sulfas causes) 6radycardia# hypotension and bronchoconstriction A 4achycardia# little effect on blood pressure and bronchodilation B 3ecrease in contractile strength# conduction velocity through the AB C node 4achycardia# hypertensive crisis and bronchodilation D ,one of the above E 90 Atropine is fre(uently used prior to administration of inhalant anesthetics to reduce) !uscle tone A +ecretions B ,ausea and vomiting C All of the above D ,one of the above E 91 Atropine is now rarely used for the treatment of peptic ulcer because of) +low gastric empting and prolongation of the exposure of the ulcer A bed to acid B Low efficiency and necessity of large doses C Adverse effects D All of the above ,one of the above E 92 Which of the following antimuscarinic drugs is a selective ! ; bloc"er? Atropini sulfas A +copolamini hydrobromidum B Piren'epinum C 6en'ohexonium D Hygronium E 93 Atropini sulfas causes) +pasmolitic activity A C
&ntestinal hypermotility +timulation of contraction in the gut C +timulation of secretory activity D ,one of the above E 94 Which of the following drugs is useful in the treatment of uterine spasms? Proserinum A Phosphacolum B %arbocholinum C Atropini sulfas D 7alanthamini hydrobromidum E 95 4he pharmacologic actions of +copolamini hydrobromidum most closely resemble those of) Proserinum A Atropini sulfas B C Phosphacolum D %arbocholinum E Pilocarpini hydrochloridum 96 %ompared with Atropini sulfas# +copolamini hydrobromidum has all of the following properties $%$P4) !ore mar"ed central effect A Less potent in decreasing bronchial# salivary and sweat gland B secretion !ore potent in producing mydriasis and cycloplegia C Lower effects on the heart# bronchial muscle and intestines D ,one of the above E 97 Which of the following drugs is useful in the treatment of Par"insons disease? A Ami'ylum B Proserinum C Atropini sulfas Phosphacolum D 6en'ohexonium E 98 Which of the following agents is used as an inhalation drug in asthma? Atropini sulfas A &pratropium bromide B Lobelini hydrochloridum C Ami'ylum D 7alanthamini hydrobromidum E 99 &ndicate an antimuscarinic drug# which is effective in the treatment of mushroom poising) Atropini sulfas A Proserinum B Pilocarpini hydrochloridum C %arbocholinum D B
Aceclidinum Antimuscarinics are used in the treatment of the following disorders 100 $%$P4) !otion sic"ness A 7laucoma B Hyperhidrosis C Asthma D &ntestinal# renal and hepatic colic E 4he Atropini sulfas poisoning includes all of the following symptoms 101 $%$P4) A !ydriasis# cycloplegia B Hyperthermia# hot and flushed s"in 3ry mouth C Agitation and delirium D 6radicardia# orthostatic hypotension E %ontraindications to the use of antimuscarinic drugs are all of the 102 following $%$P4) 7laucoma A !yasthenia B 6ronchial asthma C Paralytic ileus and atony of the urinary bladder D All of the above E 4he applications of the ganglion bloc"ers have disappeared because of 103 all of the following reasons $%$P4) Jrthostatic hypotension A Lac" of selectivity B C Homeostatic reflexes bloc" D espiratory depression E ,one of the above 104 Which of the following agents is a short-acting ganglion bloc"er? Hygronium A Pirilenum B 6en'ohexonium C Pentaminum D !ellictinum E 7anglion bloc"ing drugs are used for the following emergencies 105 $%$P4) Hypertensive crises A %ontrolled hypotension B %ardiovascular collapse C Pulmonary edema D Peripheral vascular spasms E Agents that produce neuromuscular bloc"ade act by inhibiting) 106 &nteraction of acetylcholine with cholinergic receptors A E
elease of acetylcholine from pre*unctional membrane Pac"aging of acetylcholine into synaptic vesicles C eupta"e of acetylcholine into the nerve ending D All of the above E +"eletal muscle relaxation and paralysis can occur from interruption 107 of functions at several sites# including all of the following $%$P4) ,icotinic acethylcholine receptors A !uscarinic acethylcholine receptors B 4he motor end plate C %ontractile apparatus D ,one of the above E ,ondepolarisation neuromuscular bloc"ing agents) 108 6loc" acetylcholine reupta"e A Prevent access of the transmitter to its receptor and depolari'ation B C 6loc" transmission by an excess of a depolari'ing agonist D All of the above E ,one of the above 109 &ndicate the long-acting neuromuscular bloc"ing agent) 4ubocurarini chloridum A !ellictinum B 3ithylinum C %yclodolum D Ami'ylum E Which of the following neuromuscular bloc"ing drugs is an 110 intermediate-duration muscle relaxant? 4ubocurarini chloridum A !ellictinum B 3ithylinum C Pipecuronium bromidum D Ami'ylum E 3epolari'ing agents include all of the following properties $%$P4) 111 &nteract with nicotinic receptor to compete with acetylcholine without A receptor activation B eact with the nicotinic receptor to open the channel and cause depolarisation of the end plate %ause desensiti'ation# noncompetive bloc" manifested by flaccid C paralysis %holinesterase inhibitors do not have the ability to reverse the D bloc"ade All of the above E &ndicate muscles# which are more resistant to bloc" and recover more 112 rapidly) Hand A Leg B B
,ec" 3iaphragm D All of the above E Which neuromuscular bloc"ing agent has the potential to cause the 113 greatest release of histamine? 4ubocurarini chloridum A %yclodolum B Ami'ylum C All of the above D ,one of the above E $ffects seen only with depolari'ing bloc"ade include all of the 114 following $%$P4) Hypercaliemia A A decrease in intraocular pressure B $mesis C !uscle pain D All of the above E Which cholinergic bloc"ing agent is contraindicated in patients with 115 glaucoma? Proserinum A Atropini sulfas B Aceclidinum C Pilocarpini hydrochloridum D %arbocholinum E &ndicate the following neuromuscular bloc"er# which would be 116 contraindicated in patients with renal failure) A Pipecuronium bromidum B Aceclidinum C Pilocarpini hydrochloridum D Atropini sulfas Aceclidinum E %ompared to ranitidine# cimetidine) 117 is more effective in healing duodenal ulcers A is less selective for H5 receptors B produces a lower rate of recurrence of ulcers after cessation of C treatment is a more potent inhibitor of the hepatic P-D8> system D has little tendency to produce antiandrogenic effects E &n the treatment of gastric and duodenal ulcers) 118 effective initial therapy may utili'e antacids# sucralfate# or famotidine A recurrence of ulcers happens in less than ;>9 of patients upon B cessation of therapy with H5 antagonists C
omepra'ole should be reserved for maintenance therapy after G wee"s of treatment with ranitidine cimetidine is the drug of choice in older patients with impaired renal D function the use of ranitidine should not exceed G wee"s in order to avoid E coloni'ation of the stomach by bacteria 119 All of the following statements about misoprostol are true $%$P4) inhibits acid secretion by parietal cells A when given to patients ta"ing ,+A&3s# tends to replace endogenous B P7$5 causes a significant incidence of abdominal pain and diarrhea C is more effective than famotidine in healing gastric ulcers D can induce contraction of the uterus E Which of the following statements about omepra'ole is the L$A+4 120 valid? is indicated for the therapy of Qollinger-$llison syndrome A has a duration of action that far outlasts its lifetime in plasma B formation of active drug re(uires low pH C causes a greater inhibition of gastric acid secretion than does D ranitidine heals ulcers more slowly than cimetidine does E %isapride) 121 inhibits the actions of dopamine in the 7.&. tract A can cause hyperprolactinemia B promotes gastric emptying by stimulating 8H4 D receptors in the C mesenteric plexus and other intramural ganglia can be used to treat esophageal reflux in part because it reduces gastric D acidity as effectively as does cimetidine produces little or no increase in motility of the colon E Antacids that are used in the treatment of duodenal ulcers) 122 are less efficacious than ranitidine in promoting healing of ulcers A are usually mixtures of Al@JHC and !g@JH5 which neutrali'e HR B C are effective in part because they suppress gastric acid secretion D are more apt to cause constipation as the dosage is raised E have important bactericidal effects on Helicobacter pylori 123 !ethylcellulose# diphenoxylate# bismuth subcitrate# bisacodyl# !g+JD) Jrganic stool softener< promotes colonic motility A Poorly absorbed< used for rapid effect before bowel surgery B Poorly absorbed opioid< slows transit of intestinal contents C Promotes healing of peptic ulcers D Promotes secretion of H5J into the colon< chronic use can produce E Scathartic colonS C
6ismuth subcitrate# bisacodyl# !g+JD# methylcellulose# diphenoxylate) Jrganic stool softener< promotes colonic motility A Poorly absorbed< used for rapid effect before bowel surgery B Poorly absorbed opioid< slows transit of intestinal contents C Promotes healing of peptic ulcers D Promotes secretion of H5J into the colon< chronic use can produce E Scathartic colonS 125 %hoose the substance that inhibits histamine induced gastric acid secretion) P7&5 A Pyrilamine B 3iphenhydramine C !ecli'ine D Astemi'ole E &nfections with Helicobacter pylori) 126 can be suppressed by ranitidine but not by antacids A can be eradicated with omepra'ole and tetracycline B can be exacerbated by treatment with misoprostol because the drug C stimulates bowel function cause the great ma*ority of duodenal ulcers D can be suppressed by sucralfate E Which of the following diuretic agents would be the L$A+4 apt to 127 cause hypo"alemic al"alosis? Hydrochlorothia'ide A triamterene B furosemide C chlorthalidone D bumetanide E 6oth sucrafate and bismuth subcitrate) 128 eradicate Helicobacter pylori infections in the stomach A form a protective barrier on ulcer craters B have significant acid neutrali'ing capacity C have significant H5bloc"ing actions D can produce AlCR toxicity in renally impaired patients E 4he mechanism by which thia'ides induce hypo"alemic al"alosis 129 includes all of the following steps except) increased delivery of ,a to the late distalEcortical collecting duct A increased intraluminal secretion of = by the principal cells B inhibition of the ,a%l cotransporter in the early distal tubule C decreased concentration of %a in the lumen of the cortical collecting D duct reduced proximal reabsorption of H%JC E 124
4oxicities associated with the loop diuretics include all of the following $%$P4) Hypo"alemia A severe hyponatremia B hyperglycemia C hypomagnesaemia D hyperuricemia E %arbonic anhydrase inhibitors are not used to) 131 treat glaucoma A reduce the li"elihood of renal stones B treat metabolic al"alosis C promote the excretion of uric acid D al"alini'e the urine E Iurosemide) 132 A reaches its site of action primarily by tubular secretion B produces al"alosis primarily by reducing secretion of HR in the distal tubule inhibits ,aR reabsorption in the proximal tubule C reduces excretion of %a5R and !g5R D reduces renin secretion E +ide effect associated with spironolactone but not with thia'ide 133 diuretics) hypo"alemia A increased renin release B gynecomastia C hyperuricemia D hyperglycemia E !annitol) 134 is useful in the treatment of patients with congestive heart failure A reaches its site of action largely by tubular secretion B competes for tubular reabsorption of glucose C D can protect against accumulation of nephrotoxic substances E has no effect on the excretion of ,aR 135 All of the following increase urinary excretion of %l - $%$P4) A aceta'olamide furosemide B mannitol C ethacrynic acid D amiloride E Which of the following statements is true for 6J4H furosemide and 136 hydrochlorothia'ide? promotes excretion of uric acid A acutely decreases H%JC- excretion and can produce al"alosis with B chronic administration 130
promotes excretion of %a5R reduces the osmotic gradient in the renal medulla D reaches its site of action mostly by glomerular filtration E Which one of the following processes occurs in the loop of Henle? 137 4hia'ide diuretics inhibit ,aR reabsorption via $,a% @the A electrogenic ,aR channel in the late distal tubule and cortical collecting duct 4ubular @luminal fluid becomes isotonic to plasma by the end of the B 4AL. C ,HDR is secreted in the net sense into the lumen. D 4he lumen is electrically positive with respect to the interstitial fluid. !g5R is reabsorbed via an A4P powered pump in the tight *unction E All of the following statements about metoclopramide are true 138 $%$P4) can produce hyperprolactinemia A often produces constipation B increases tone of the lower esophageal sphincter C attenuates nausea produced by cancer chemotherapeutic agents D actions on gastric motility are reduced by atropine E A 5C-year-old graduate student goes on a cruise to the 6ahamas. +he 139 considers ta"ing a drug for sea-sic"ness as she is prone to developing motion sic"ness. Which compound and time of administration would be most effective? 4ransdermal scopolamine ta"en during the voyage A Iexofenadine ta"en D hours prior to sailing B 4ransdermal scopolamine ta"en D hours prior to sailing C %etiri'ine ta"en ; hour prior to sailing D !etoclopramide ta"en during the voyage E Which of the following antiemetic drugs possesses clinically 140 significant dopaminergic antagonist activity# but is not used as an antipsychotic agent? Jndansetron A Prometha'ine B C %hlorproma'ine D !etoclopramide E 3imenhydrinate 141 Analeptical remedy of reflective type from the H-cholinomimetics group was given to the patient for restoration of breathing after poisoning with carbon monoxide. What medicine was prescribed to the patient? Pentamin A Lobeline hydrochloride B Adrenaline hydrochloride C !esaton D Atropine sulphate E C
Patient with bronchial asthma was ta"ing tablets which caused insomnia# headache# increased blood pressure. What medecine can cause such complications? $uphyline A Adrenaline B $phedrine C %hromolin sodium D &'adrine E 143 An aged patient complains of headache# di''iness# (uic" tiredness# worsening of memory. Anamnesis) craniocerebral in*ury. !edicine of what group should be prescribed? +omnific A ,euroleptics B ,ootropics C +edatives D Analgetics E +pasm of smooth muscle of bronchi developed in the patient. sage of 144 activators of what membrane cytoreceptors is fisiologically valid to decrease attac"? -cholinoreceptors A alpha-0drenoreceptors B beta-adrenoreceptors C alpha and beta-0drenoreceptors D 2-cholinoreceptors E Patient with complaints of dryness in the mouth# photophobia and 145 vision violation was admitted to the reception-room. +"in is hyperemic# dry# pupils are dilated# tachycardia. Poisoning with belladonna al"aloids was diagnosed on further examination. What medicine should be prescribed? A 3ia'epam B Armine C Pilocarpine Pro'erin D 3ipyroxim E Patient in the unconscious state was admitted to the emergency room. 146 +"in is cold# pupils are delayed# breathing is heavy# with cycles of the %heyne+to"es type# blood pressure is decreased# urinary bladder is overloaded. Poisoning with what substance is the most li"ely? -cholinergic antagonists A +edatives B C ,arcotic analgesics D ,on-narcotic analgesics E ,one of the above 142
4he patient has ta"en the mixture prescribed by neuropathologist for neurasthenia for 5 wee"s. Patient felt better but developed cory'a# con*unctivitis# rash# inertia# decrease of memory. 6romi'm was diagnosed. What should be prescribed to decrease symptoms? A 7lucose solution 8 9 B Asparcam C Polyglucin ,atrium chloride D All of the above E 4he patient was treated medically for psychosis for 5 wee"s. Patient:s 148 condition improved but rigidity# tremor# hypo"inesia developed. Which of the drugs can cause such complications? +ydnocarb A 3iphenine B &mipramine C %hlordia'epoxide D Amina'ine E 4o anaestheti'e the manipulation connected with burn surface 149 treatment# a patient was intravenously in*ected a medication for short-acting narcosis. ; minute later the patient being under anaesthesia had elevated blood pressure# tachycardia# increased tone of sceletal muscles< the reflexes were reserved. After awa"ening the patient had desorientation and visual hallucinations. What medication was in*ected to the patient? A ,itrous oxide B =etamine 4hiopental sodium C +ombrevin D 3iethylether E After the usage of acetylsalicylic acid a patient developed epigastric 150 pain because of exacerbation of his ulcer. What are the principles of this medication ulcerogenity? &mmunodepressive effect A %holagogic effect B Antiprostaglandinic effect C +timulation of pepsin secretion D +pasm of vessels E A patient suffers from nocturnal paroxysms of bronchial asthma 151 accompanied by bradycardia# spastic intestinal pains and diarrhea. !edicine of what group can releave these symptoms? +ympatholytics A H-cholinergic receptors B !-cholinergic receptors C +aluretics D 147
1-adrenobloc"ers A patient with bronchial asthma is administered inhalation of >#8 9 152 isadrine solution. 6ronchospasm was releaved# but the patient began complaining of pain in the heart region and palpitation. &t is connected with the stimulation of) A alpha; adrenoreceptors B beta; adrenoreceptors beta5 adrenoreceptors C Acetylcholine synthesis D !-cholinergic receptors E A patient with fibrillation# who has had bronchial asthma in his 153 anamnethis# should be administered antiarrhythmic drug. Which preparation from the suggested group is contraindicated for this patient? A*maline A ,ifedipine B Anapriline @Propranolol C ,ovocainamid D Berapamil E A 58-year-old woman with red and itchy ec'ematoid dermatitis visits 154 your office. +he had a dental procedure one day earlier with administration of a local anesthetic. 4here were no other findings# although she indicated that she had a history of allergic reactions. Which of the following drugs is most li"ely involved? Procaine A 6upivacaine B Lidocaine C $tidocaine D E %ocaine 155 4o anaestheti'e the manipulation related to burn surface treatment# a patient was intravenously in*ected a medication for short-acting narcosis. ; minute later the patient being under anaesthesia had increased blood pressure# tachycardia# increased tone of sceletal muscles< reflexes remained. After awa"ening the patient had desorientation and visual hallucinations. What medication was the patient in*ected? +ombrevin A =etamine B 3iethylether C 4hiopental sodium D ,itrous oxide E A patient with bronchial asthma had been ta"ing tablets which caused 156 insomnia# headache# increased blood pressure. What medecine can cause such complications? E
%hromolin sodium &'adrine B $uphyline C Adrenaline D $phedrine E A patient has been ta"ing a mixture prescribed by neuropathologist for 157 neurasthenia for two wee"s. 4he patient feels better but has developed cory'a# con*unctivitis# rash# inertia# decrease of memory. +he is diagnosed with bromi'm. What should be prescribed to decrease the symptoms? Polyglucin A ,atrium chloride B Asparcam C 7lucose solution 8 9 D All of the above E A ;C-year-old girl with history of asthma complained of cough# 158 dyspnea and whee'ing. Her symptoms became so severe that her parents brought her to the emergency room. Physical examination revealed diaphoresis# dyspnea# tachycardia and tachypnea. Her respiratory rate was D5Emin# pulse rate was ;;> beats per minute# and blood pressure was ;C>EF> mm Hg. %hoose from the following list the most appropriate drug to reverse the bronchoconstriction rapidly) 6eclomethasone A &pratropium B !ethylprednidsolone C +albutamol D %romolyn E A D5-year-old man who has been in*ured in a car accident is brought 159 into the emergency room. His blood alcohol level on admission is 58> mgEdL. Hospital records show a prior hospitali'ation for alcohol related sei'ures. His wife confirms that he has been drin"ing heavily for C wee"s. What treatment should be provided to the patient if he goes into withdrawal? Phenytoin A Pentobarbital B ,one of the above C Phenobarbital D 3ia'epam E A 8>-year-old male farm wor"er has been brought to the emergency 160 room. He was found confused in the orchard and since then has remained unconscious. His heart rate is D8 and his blood pressure is G>ED> mm Hg. He is sweating and salivating profusely. Which of the following should be prescribed? Atropine sulfas A A
Proserine Physostigmine C ,orepinephrine D Pentamine E A patient with complaints of dryness in the mouth# photophobia and 161 vision impairment was admitted to the reception-room. +"in is hyperemic# dry# pupils are dilated# tachycardia. Poisoning with belladonna al"aloids was diagnosed on further examination. What medicine should be prescribed Pilocarpine A 3ipiroxim B Pro'erin C 3ia'epam D Armine E A 58-year-old woman with red and itchy ec'ematoid dermatitis visits 162 your office. +he had a dental procedure one day earlier with administration of a local anesthetic. 4here were no other findings# although she indicated that she had a history of allergic reactions. Which of the following drugs is most li"ely involved? $tidocaine A %ocaine B 6upivacaine C Lidocaine D Procaine E A patient has got a spasm of smooth muscles of bronchi. Activators of 163 what membrane cytoreceptors are phisiologically reasoned to stop an attac"? beta-adrenoreceptors A alpha- and beta 0drenoreceptors B 2-cholinoreceptors C !-# H-cholinoreceptors D -cholinoreceptors E &ntroduction of a pharmaceutical substance to an experimental animal 164 resulted in reduction of salivation# pupil mydriasis. ,ext intravenous introduction of acetylcholine didn:t lead to any significant changes of heart rate. ,ame this substance) Proserin A Atropine B Propranolol C Adrenaline D +albutamol E A patient with && stage hypertension has been ta"ing one of 165 hypotensive medications for the purpose of treatment. After a time arterial pressure decreased# but the patient started complaining of flaccidity# sleepiness# B
indifference. A bit later he felt stomach pain. He was diagnosed with ulcer. What hypotensive medication has the patient been ta"ing? %aptopril A 3iba'ole B eserpine C Iurosemide D Berapamil E A patient had to go through an operation. 3octors introduced him 166 dithylinum @listenone and performed intubation. After the end of operation and cessation of anesthesia the independent respiration wasn:t restored. Which en'yme deficit prolongs the action of muscle relaxant? Psendocholinesterase A =iBaadenosine triphosphatase B iBacetyltransferase C +uccinate dehydrogenase D %arbanhydrase E A patient ill with bronchial asthma didn:t inform his doctor that he had 167 attac"s of stenocardia. 3octor administered him a medication# which ta"ing resulted in less fre(uent attac"s of bronchial asthma# but stenocardia attac"s became more fre(uent. What medication was administered? %romolyn sodium A +albutamol B Aminophylline C Phenotherol D &sadrin E A patient with fracture of his lower *aw was admitted to the 168 maxillofacial department. &t was decided to fix his bones surgically under anaesthetic. After intravenous introduction of muscle relaxant there arose short fibrillar contractions of the patient:s facial muscles. What muscle relaxant was applied? 3ithylinum A Pipecuronium bromide B 3ia'epam C !elictine D 4ubocurarin chloride E $xamination of a patient revealed extremely myotic pupils# sleepiness# 169 infre(uent %hain+to"e:s respiration# urinary retention# slowingdown of heart rate# enhancement of spinal reflexes. What substance caused the poisoning? Atropine sulfas A Phosphactole B %affeine C !orphine D 6arbital E
A patient who has been treated with dia'epam on account of neurosis complains of toothache. 3octor administered him an analgetic# but its dose was lower than average therapeutic dose. What phenomenon did the doctor ta"e into account while prescribing the patient an underdose? A +ummation B Potentiation C %umulation 4olerance D 3rug dependence E Jn the 5-Crd day after stomach resection intestinal peristalsis wasn:t 171 restore 3. What is to be administered for stimulation of gastrointestinal tract? Atropine sulfate A Proserin B Prasosin C %yclodole D Acetylcholine E A stomatologist in*ected a patient with a certain drug in order to 172 reduce salivation during tooth filling. What drug is it? Atropine sulfate A Pilocarpine hydrochloride B C Proserine D !esaton E Adrenaline hydrochloride 173 A patient with acute morphine poisoning was delivered to a hospital. What specific narcotic antagonist should be chosen in this case? nithiol A ,aloxone B !ethacin C 3igoxin D Paracetamol E A patient who has been treated in a neural clinic and has been ta"ing a 174 sedative for a long time got the following complication) cough# rhinitis# epiphor A. What drug caused these disturbances? A Phena'epam B Balerian C +odium bromide 3ia'epam D eserpine E An ophthalmologist used a ;9 mesaton solution for the diagnostic 175 purpose @pupil dilation for eye-ground examination. What is the cause of mydriasis induced by the drug? Activation of alpha; adrenoreceptors A 6loc" of alpha; adrenoreceptors B 170
Activation of !-cholinoreceptors Activation of beta;adrenoreceptors D Activation of alpha5adrenoreceptors E &f a man has an attac" of bronchiospasm it is necessary to reduce the 176 effect of vagus on smooth muscles of bronchi. What membrane cytoreceptors should be bloc"ed for this purpose? alpha-adrenoreceptors A beta-adrenoreceptors B C alpha- and beta-adrenoreceptors D ,-cholinoreceptors E !-cholinoreceptors 177 A patient came to the hospital complaining about (uic" fatigability and apparent muscle wea"ness. $xamination revealed an autoimmune disease that causes disorder of functional receptor condition in neuromuscular synapses. What transmitter will be bloc"ed? 3opamine A +erotonin B 7lycine C Acetylcholine D ,oradrenalin E 178 A patient with drug intoxication presented with the dryness of oral mucous membrane and mydriatic pupils. +uch action of this drug is associated with the following effect) Adrenoreceptor bloc" A !uscarinic cholinoreceptor stumulation B Adrenoreceptor stimulation C !uscarinic cholinoreceptor bloc" D ,icotinic cholinoreceptor stumulation E A patient consulted a physician about muscle rigidity# constrained 179 movements# permanent arm tremor. 4he patient was diagnosed with Par"inson:s diseas e. What preparation should be administered? Phenobarbital A Levodopa B 3ia'epam C Phenytoin D $thosuximide E A patient with myocardial infarction was admitted to the cardiological 180 department. Ior pain relief it was decided to potentiate fentanyl action with a neurolepti c. Which of the following neuroleptics is the most suitable for neuroleptanalgesia? A Haloperidol B 4rifta'ine C Amina'ine C
+ulpiride 3roperidol E A patient with coronary artery disease was admitted to the 181 cardiological department. Ior stenocardia prevention a drug from the group of adrenoceptor bloc"ers was administered. What drug is it? !orphine hydrochloride A Jxytocin B !etoprolol C D Iurosemide E Atropine sulfate 182 A patient with a limb fracture must be administered a depolari'ing drug from the myorelaxant group for the purpose of a short-time surgery. What drug is it? Atropine sulfate A 3ithylinum B 4ubocurarine chloride C %ytitonum D Pentaminum E A KC-year-old patient with collapse presentations was delivered to the 183 emergency hospital. A physician has chosen noradrenalin against hypotension. What is its mechanism of action? Activation of ;-adrenoreceptors A Activation of serotonin receptors B Activation of dopamine receptors C 6loc" of !-cholinoreceptors D Activation of -adrenoreceptors E A patient suffering from myasthenia has been administered proserin. 184 After its administration the patient has got nausea# diarrhea# twitch of tongue and s"eletal muscles. What drug would help to eliminate the intoxication? Atropine sulfate A Pyridostigmine bromide B &sadrine C D !esatonum E Physostigmine 185 A D8-year-old patient suffers from neurosis characteri'ed by irritability# sleeplessness# motiveless anxiety. What drug would eliminate all the symptoms? Levodopa A Pyracetam B Balerian extract C 3ia'epam D %affeine sodium ben'oate E Acetylcholine &+ ,J4 a specific neurotransmitter at) 186 D
+ympathetic ganglia +ympathetic postganglionic nerve endings B Parasympathetic ganglia C D Parasympathetic postganglionic nerve endings ,one of the above E !uscarinic receptors are located in) 187 Autonomic ganglia A +"eletal muscle neuromuscular *unctions B Autonomic effector cells C +ensory carotid sinus baroreceptor 'one D All of the above E &ndicate the location of !5 cholinoreceptor type) 188 A Heart 7lands B +mooth muscle C $ndothelium D All of the above E 4he symptoms of mushroom poisoning include all of the following 189 $%$P4) +alivation# lacrimation# nausea# vomiting A 3ryness of mouth# hyperpyrexia# hallucination B C Headache# abdominal colic 6radycardia# hypotension and shoc" D ,one of the above E Which of the following cholinomimetics activates both muscarinic 190 and nicotinic receptors? Lobeline A Pilocarpine B ,icotine C %arbacholine D Adrenalin hydrochloride E &ndica &ndicate te a cholin cholinomi omimet metic ic agent# agent# which which is relate related d to direct direct-ac -actin ting g 191 drugs) Aceclidine A B %ytitone %arbacholine C Proserine D 3ipiroxim E %haracteristics of carbacholine include all of the following $%$P4) $%$P4) 192 A
&t decreases intraocular pressure &t causes mydriasis B &t exerts both nicotinic and muscarinic effects C D &t is resistant to acethylcholiesterase All of the above E Acetylcholine &+ ,J4 used in clinical practice because) 193 &t is very toxic A 4he doses re(uired are very high B &t is very rapidly hydroly'ed C &t is very costly D ,one of the above E Local anesthetics produce) 194 A Analgesia# amnesia# 6loc"ing pain sensation without loss of consciousness B Alleviation of anxiety and pain with an altered level of consciousness C A stupor or somnolent state D Loss of consciousness E A good local anesthetic agent should cause) 195 Local irritation and tissue damage A +ystemic toxicity B Iast onset and long duration of action C D Basodilatation Heart failure E Which one of the following groups is responsible for the duration of 196 the local anesthetic action? A &ntermediate chain Lipophylic group B &oni'able group C Amino group D All of the above E &ndicate the local anesthetic agent# which has a shorter duration of 197 action) Lidocaine A Procaine B C 6upivacaine opivacaine D ltracaine E Which one of the following groups is responsible for the potency and 198 the toxicity of local anesthetics? A
A B C D E 199
&oni'able group &ntermediate chain Lipophylic group Amino-group All of the above &ndicate the drug# which has greater potency of the local anesthetic
action) A B C D E 200 A B C D E 201
Lidocaine 6upivacaine Procaine !epivacaine Anesthesine &oni'able group is responsible for) 4he potency 4he duration of action 4he ability to diffuse to the site of action 4oxicity All of the above Which one of the following local anesthetics is an ester of ben'oic
acid? A B C D E 202
Lidocaine Procaine opivacaine ltracaine %ocaine &ndicate the local anesthetic# which is an ester of paraaminoben'oic
acid) A B C D E 203 A B C D E 204
!epivacaine %ocaine Procaine Lidocaine ltracaine Which of the following local anesthetics is an acetanilide derivative? 4etracaine Lidocaine %ocaine Procaine Anesthesine &ndicate the local anesthetic# which is a toluidine derivative)
Lidocaine 6upivacaine B Prilocaine C D Procaine cocaine E Which of the following local anesthetics is a thiophene derivative? 205 Procaine A ltracaine B Lidocaine C !epivacaine D 6upivacaine E Local anesthetics are) 206 A Wea" bases Wea" acids B +alts# which formed by wea" acid and strong base C +alts# which formed by strong acid and wea" base D ,one of the above E Ior therapeutic application local anesthetics are usually made 207 available as salts for the reasons of) Less toxicity and higher potency A Higher stability B C 7reater lipid solubility Less local tissue damage and more potency D !ore stability and greater water solubility E Which of the following statements is not correct for local anesthetics? 208 A &n a tissue they exist either as an uncharged base or as a cation A charged cationic form penetrates biologic membranes more readily B than an uncharged form Local anesthetics are much less effective in inflamed tissues C Low ph in inflamed tissues decreases the dissociation of nonioni'ed D molecules Local anesthetics are wea" bases E Which one of the following statements about the metabolism of local 209 anesthetics is incorrect? A !etabolism of local anesthetics occurs at the site of administration !etabolism occurs in the plasma or liver but not at the site of B administration $ster group of anesthetics li"e procaine# are metaboli'ed systemically C by pseudocholinesterase A
Amides such as lidocaine# are metaboli'ed in the liver by microsomal mixed function oxidases &n a tissue they exist either as an uncharged base or as a cation E 210 &ndicate the anesthetic agent of choice in patient with a liver disease) Lidocaine A 6upivacaine B Procaine C $tidocaine D !epivacaine E Which of the following local anesthetics is preferable in patient with 211 pseudocholinesterase deficiency? Procaine A B opivacaine 4etracaine C 6en'ocaine D %ocaine E 4he primary mechanism of action of local anesthetics is) 212 Activation of ligand-gated potassium channels A 6loc"ade of voltage-gated sodium channels B +timulation of voltage-gated ,-type calcium channels C 6loc"ade the 7A6A-gated chloride channels D E +timulation of voltage-gated sodium channels Which of the following local anesthetics is more water-soluble? 213 4etracaine A $tidocaine B C Procaine 6upivacaine D ltracaine E &ndicate the local anesthetic# which is more lipid-soluble) 214 6upivacaine A Lidocaine B !epivacaine C Procaine D ltracaine E 215 4he more lipophylic drugs) Are more potent A Have longer duration of action B 6ind more extensively to proteins C 6etter penetration D D
E 216 A B C D E 217
All of the above &ndicate the function# which the last to be bloc"ed) Pain 4emperature !uscle spindles !otor function 4ouch Which of the following local anesthetics is an useful antiarrhythmic
agent? %ocaine Lidocaine B 6upivacaine C D opivacaine Procaine E &ndicate the route of local anesthetic administration# which is 218 associated with instillation within epidural or subarachnoidal spa ces) 4opical anesthesia A &nfiltrative anesthesia B egional anesthesia C conductive anesthesia D +pinal anesthesia E 219 4he choice of a local anesthetic for specific procedures is usually based on) 4he duration of action A Water solubility B C %apability of rapid penetration through the s"in or mucosa with limited tendency to diffuse away from the site of application Absents of the allergic reaction D All of the above E Which of the following local anesthetics is a short-acting drug? 220 Procaine A 4etracaine B 6upivacaine C %ocaine D E opivacaine &ndicate the local anesthetic# which is a long-acting agent) 221 Lidocaine A 6upivacaine B Procaine C A
!epivacaine ltracaine E 4he anesthetic effect of the agents of short and intermediate duration 222 of action can not be prolonged by adding) $pinephrine A ,orepinephrine B 3opamine C Phenylephrine D $phedrine E A vasoconstrictor does not) 223 etard the removal of drug from the in*ection site A Hence the chance of toxicity B C 3ecrease the blood level educe a local anesthetic upta"e by the nerve D &ncrease the duration of local anesthesia E Basoconstrictors ar e less effective in prolonging anesthetic properties 224 of) Procaine A 6upivacaine B Lidocaine C !epivacaine D E ltracaine Which of the following local anesthetics is only used for surface or 225 topical anesthesia? %ocaine A B 4etracaine Procaine C 6upivacaine D Lidocaine E &ndicate the local anesthetic# which is mainly used for regional nerve 226 bloc" anesthesia) 3ibucaine A 6upivacaine B 4etracaine C D %ocaine Anesthesine E Which of the following local anesthetics is used for infiltrative and 227 regional anesthesia? Procaine A D
Lidocaine ltracaine C !epivacaine D E All of the above &ndicate the local anesthetic# which is used for spinal anesthesia) 228 4etracaine A %ocaine B 3ibucaine C 6upivacaine D Anesthesine E Which of the following local anesthetics is called a universal 229 anesthetic? A Procaine opivacaine B Lidocaine C 6upivacaine D Anesthesine E 4he most serious toxic reaction to local anesthetics is) 230 +ei'ures A %ardiovascular collapse B %ardiac arrest C D espiratory failure All of the above E %orrect statements concerning cocaine include all of the following 231 $%$P4) A %ocaine is often used for nose and throat procedures Limited use because of abuse potential B !yocardial depression and peripheral vasodilatation C %auses sympathetically mediated tachycardia and vasoconstriction D %an case addiction E Which of the following local anesthetics is more cardiotoxic? 232 Procaine A 6upivacaine B Lidocaine C D ltracaine !epivacaine E !ost local anesthetics can cause) 233 3epression of abnormal cardiac pacema"er activity A 3epression of the strength of cardiac contraction B B
%ardiovascular collapse 3epression of the cardiac excitability and conduction D All of the above E 234 Which one of the following local anesthetics causes methemoglobinemia? Prilocaine A Procaine B Lidocaine C ltracaine D opivacaine E Procaine has all of the following properties $%$P4) 235 &t has ester lin"age A B &ts metabolic product can inhibit the action of sulfonamides &t readily penetrates the s"in and mucosa C &t is relatively short-acting D &t in derivative of the p-aminoben'oic acid E %orrect statements concerning lidocaine include all of the following 236 $%$P4) &t is a universal anesthetic A &t has ester lin"age B &t widely used as an antiarrhythmic agent C D &t is metaboli'ed in liver &t has amide group E Which of the following local anesthetics is more li"ely to cause 237 allergic reactions? A Lidocaine 6upivacaine B Procaine C opivacaine D ltracaine E 4etracaine has all of the following properties $%$P4) 238 +low onset A Low potency B Long duration C D High toxicity &t has ester lin"age E %orrect statements concerning bupivacaine include all of the 239 following $%$P4) &t has low cardiotoxicity A C
B C D E 240 A B C D E 241 A B C D E 242 A B C D E 243 A B C D E 244 A B C D E 245 A B C
&t has amide lin"age &t is a long-acting drug An intravenous in*ection can lead to sei'ures &t is cardiotoxic +ympathetic stimulation is mediated by) elease of norepinephrine from nerve terminals Activation of adrenoreceptors on postsynaptic sites elease of epinephrine from the adrenal medulla 3opamine All of the above %haracteristics of epinephrine include all of the following $%$P4) $%$P4) &t is synthesi'ed into the adrenal medulla &t is synthesi'ed into the nerve ending &t is transported in the blood to target tissues &t directly interacts with and activates adrenoreceptors &t stimulates glycogenolysis Which of the following sympathomimetics acts indirectly? $pinephrine ,orepinephrine 3opamine $phedrine !ethoxamine %atecholamine includes following $%$P4) $%$P4) $phedrine $pinephrine &soprenaline ,orepinephrine 3opamine $pinephrine decreases intracellular camp levels by acting on) / ; receptor / 5 receptor beta ; receptor beta 5 receptor 3-receptors Which of the following statements is not correct? Alfa receptors increase arterial resistance 6eta 5 receptor promote smooth muscle relaxation 4he s"in and splanchic vessels have predominantly alfa receptors
Bessels in a s"eletal muscle may constrict or dilate depending on whether alfa or beta 5 receptors are activated +"el +"elet etal al musc muscle le vess vessels els have have pred predom omin inan antl tly y alfa alfa rece recept ptors ors and and E constrict in the presence of epinephrine and norepinephrine 3irect effects on the heart are determined largely by) 246 Alfa ; receptor A Alfa 5 receptor B 6eta ; receptor C 6eta 5 receptor D dofamino-receptors E Which of the following effects is related to direct beta ; 247 -adrenoreceptor stimulation? A 6ronchodilation Basodilatation B 4achycardia C 6radycardia D 3ecreasing of the heart conductance E 3istribution of alfa adrenoreceptor subtypes is associated with all of 248 the following tissues except those of) Heart A 6lood vessels B C Prostate Pupillary dilator muscle D 6ronchial glands E 6eta adrenoreceptor subtypes are contained in all of the following 249 tissues $%$P4) 6ronchial muscles A Heart B Pupillary dilator muscle C Iat cells D 6ronchial glands E &n which of the following tissues both alfa and beta ; adrenergic 250 stimulation produces the same effect? 6lood vessels A B &ntestine terus C 6ronchial muscles D Heart E D
4he effects of sympathomimetics on blood pressure are associated with their effects on) 4he heart A B 4he peripheral resistance 4he venous return C 4he blood vessels D All of the above E A rela relati tive vely ly pure pure alfa alfa agoni agonist st cause causess all all of the the foll follow owin ing g effec effects ts 252 $%$P4) &ncrease peripheral arterial resistance A &ncrease venous return B Has no effect on blood vessels C D eflex bradycardia !uscle contraction E A nonselective beta receptor agonist causes all of the following effects 253 $%$P4) &ncrease cardiac output A &ncrease peripheral arterial resistance B 3ecrease peripheral arterial resistance C 3ecrease the mean pressure D 3ecrease need of miocardium in oxygen E 254 Which of the following statement is not correct? Tlfa agonists cause miosis A Tlfa agonists cause mydriasis B 6eta antagonists decrease the production of a(ueous humor C D Tlfa agonists increase the outflow of a(ueous humor from the eye Alfa antagonists case expansion of peripheral blood vessels E A bronchial smooth muscle contains) 255 Tlfa ; receptor A Tlfa 5 receptor B 6eta ; receptor C 3ofamino-receptor D 6eta 5 receptor E All of the following agents are beta receptor agonists $%$P4) 256 A $pinephrine &soproterenol B !ethoxamine C 3obutamine D ,orepinephrine E 251
Which of the following drugs causes bronchodilation without significant cardiac stimulation? &soprenaline A B Jrciprenaline sulfate 4erbutaline C ylometa'oline D !ethoxamine E Tlfa-receptor stimulation includes all of the following effects 258 $%$P4) elaxation of gastrointestinal smooth muscle A %ontraction of bladder base B %ontraction of uterus and prostate C D +timulation of insulin secretion +timulation of platelet aggregation E 6eta ; receptor stimulation includes all of the following effects 259 $%$P4) &ncrease in contractility A 6ronchodilation B 4achycardia C &ncreasing strength and heart rate D &ncrease in conduction velocity in the atrioventricular node E 260 6eta 5 receptor stimulation includes all of the following effects $%$P4) +timulation of renin secretion A Iall of potassium concentration in plasma B C elaxation of uterus elaxation of bladder D 4achycardia E Hyperglycemia induced by epinephrine is due to) 261 7luconeogenesis @beta 5 A &nhibition of insulin secretion @alfa B +timulation of glycogenolysis @beta 5 C All of the above D ,one of above E 262 Which of the following effects is associated with beta C -receptor stimulation? Lipolysis A 3ecrease in platelet aggregation B 6ronchodilation C 257
D E 263 A B C D E 264
4achycardia 6radicardia Which of the following statements is not correct? $pinephrine acts on both alfa- and beta-receptors ,orepinephrine has a predominantly beta action !ethoxamine has a predominantly alfa action ,orepinephrine acts on both alfa- and beta-receptors &soprenaline has a predominantly beta action &ndicate the drug# which is a direct-acting both alfa- and beta-receptor
agonist) ,orepinephrine !ethoxamine B C &soproterenol $phedrine D !etoprolol E Which of the following agents is an alfa-;# alfa-5# beta-;# beta-5 265 receptor agonist? !ethoxamine A Albuterol B $pinephrine C !etoprolol D E ,orepinephrine &ndicate the direct-acting sympathomimetic# which is an alfa-;# alfa-5# 266 beta-; receptor agonist) &soproterenol A B $phedrine 3obutamine C !etoprolol D ,orepinephrine E Which of the following agents is an alfa-; -selective agonist? 267 ,orepinephrine A !ethoxamine B itodrine C $phedrine D E &soproterenol &ndicate the alfa 5 -selective agonist) 268 ylometa'oline A $pinephrine B ,orepinephrine C A
D E 269 A B C D E 270 A B C D E 271
3obutamine !ethoxamine Which of the following agents is a nonselective beta receptor agonist? ,orepinephrine $pinephrine $phedrine &soproterenol 3obutamine &ndicate the beta ; -selective agonist) &soproterenol 3obutamine !etaproterenol $pinephrine ,orepinephrine Which of the following sympathomimetics is a beta 5 -selective
agonist? A B C D E 272 A B C D E 273 A B C D E 274 A B C D E
4erbutaline ylometa'oline $phedrine &soproterenol 3obutamine &ndicate the indirect-acting sympathomimetic agent) $pinephrine ,orepinephrine Phenylephrine $phedrine &soproterenol $pinephrine produces all of the following effects except) Positive inotropic action on the heart @beta ; receptor &ncrease peripheral resistance @alfa receptor Predominance of alfa effects at low concentration Positive chronotropic action on the heart @beta ; receptor +"eletal muscle blood vessel dilatation @beta 5 receptor $pinephrine produces all of the following effects except) 3ecrease in oxygen consumption &ncrease in oxygen consumption 6ronchodilation Hyperglycemia !ydriasis
275
$pinephrine is used in the treatment of all of the following disorders
except) 6ronchospasm B Anaphylactic shoc" %ardiac arrhythmias C Jpen-angle glaucoma D Hypoglycemic coma E %ompared with epinephrine# norepinephrine produces all of the 276 following effects except) +imilar effects on beta ; receptors in the heart and similar potency at A an alfa receptor 3ecrease the mean pressure below normal before returning to the B control value +ignificant tissue necrosis if in*ected subcutaneously C &ncrease systolic blood pressure D &ncrease diastolic blood pressure E ,orepinephrine produces) 277 Basoconstriction A Basodilatation B 6ronchodilation C 3ecreased potassium concentration in the plasma D E &ncreased blood pressure Which of the following direct-acting drugs is a relatively pure alfa 278 agonist# an effective mydriatic and decongestant and can be used to raise blood pressure? A $pinephrine ,orepinephrine B Phenylephrine C $phedrine D eserpine E %haracteristics of methoxamine include all of the following except) 279 &t is a direct-acting alfa ; -receptor agonist A &t increases heart rate# contractility and cardiac output B &t causes reflex bradycardia C D &t increases total peripheral resistance &nduced vasoconstriction E Which of the following agents is an alfa 5 -selective agonist with 280 ability to promote constriction of the nasal mucosa? ylometa'oline A A
Phenylephrine !ethoxamine C $pinephrine D E ,orepinephrine &ndicate the sympathomimetic# which may cause hypotension# 281 presumably because of a clonidine-li"e effect) !ethoxamine A Phenylephrine B ylometa'oline C &soproterenol D $pinephrine E &soproterenol is) 282 A 6oth an alfa- and beta-receptor agonist 6eta ; -selective agonist B Alfa receptor agonist C 6eta 5 -selective agonist D ,onselective beta receptor agonist E &soproterenol produces all of the following effects except) 283 &ncrease in cardiac output A Iall in the diastolic pressure B Iall in the mean arterial pressure C D 6ronchoconstriction 4achycardia E %haracteristics of dobutamine include all of the following except) 284 &t is a relatively beta ; -selective synthetic catecholamine A B &t is used to treat bronchospasm &t increases atrioventricular conduction C &n over dosage can provo"e arrhytmia D &t causes minimal changes in heart rate and systolic pressure E %haracteristics of salmeterol include all of the following except) 285 &t is a potent selective beta 5 agonist A &t causes uterine relaxation B &t stimulates heart rate# contractility and cardiac output C &t is used in the therapy of asthma D E A and 6 %haracteristics of ephedrine include all of the following except) 286 &t acts primarily through the release of stored cathecholamines A &t is a mild %,+ stimulant B &t causes tachyphylaxis with repeated administration C B
&t decreases arterial pressure A and % E $phedrine causes) 287 A !iosis +edatation effect on %,+ B 6ronchodilation C Hypotension D 6radycardia E %ompared with epinephrine# ephedrine produces all of the following 288 features except) &t is a direct-acting sympathomimetic A &t has oral activity B C &t is resistant to !AJ and has much longer duration of action &ts effects are similar# but it is less potent D 6 and 3 E Which of the following sympathomimetics is preferable for the 289 treatment of chronic orthostatic hypotension? $pinephrine A ,orepinephrine B $phedrine C +albutamol D E 3obytamine &ndicate the sympathomimetic drug# which is used in a hypotensive 290 emergency) ylometa'oline A B $phedrine 4erbutaline C 3obutamine D Phenylephrine E Which of the following sympathomimetics is preferable for the 291 emergency therapy of cardiogenic shoc"? $pinephrine A 3obutamine B &soproterenol C D !ethoxamine +albutamol E &ndicate the sympathomimetic agent# which is combined with a local 292 anesthetic to prolong the duration of infiltration nerve bloc") $pinephrine A D
ylometa'oline +albutamol C &soproterenol D E 3obutamine Which of the following sympathomimetics is related to short-acting 293 topical decongestant agents? ylometa'oline A 4erbutaline B Phenylephrine C ,orepinephrine D +albutamol E &ndicate the long-acting topical decongestant agents) 294 A $pinephrine ,orepinephrine B Phenylephrine C ylometa'oline D +albutamol E Which of the following topical decongestant agents is an alfa 5 295 -selective agonist? Phenylephrine A ylometa'oline B C $phedrine $pinephrine D ,orepinephrine E &ndicate the sympathomimetic# which may be useful in the emergency 296 management of cardiac arrest) !ethoxamine A Phenylephrine B $pinephrine C ylometa'oline D +albutamol E Which of the following sympathomimetics is used in the therapy of 297 bronchial asthma? Ienoterol A B ,orepinephrine $pinephrine C !ethoxamine D 3obutamine E B
298
&ndicate the agent of choice in the emergency therapy of anaphylactic
shoc") A B C D E 299
!ethoxamine 4erbutaline +albutamol c,orepinephrine $pinephrine Which of the following sympathomimetics is an effective mydriatic
agent? A B C D E 300
+albutamol Phenylephrine 3obutamine ,orepinephrine Ienoterol 4he adverse effects of sympathomimetics include all of the following
except) 3rug-induced par"insonism %erebral hemorrhage B Pulmonary edema C !yocardial infarction D Bentricular arrhythmias E 301 Which of the following drugs is a nonselective alfa receptor antagonist? Pra'osin A Phentolamine B C !etoprolol eserpine D +albutamol E &ndicate the alfa ; -selective antagonist) 302 Phentolamine A 3ihydroergotamine B Pra'osin C Labetalol D Atenolol E 303 Which of the following drugs is an nonselective beta receptor antagonist? !etoprolol A Atenolol B Propranolol C A
Acebutolol +albutamol E &ndicate the beta ; -selective antagonist) 304 A Propranolol !etoprolol B %arvedilol C +otalol D Propranolol E Which of the following agents is a beta 5 selective antagonist? 305 Acebutolol A Pindolol B Labetolol C D $rgotamin 6utoxamine E Which of the following is not a side effect of the cholinoreceptor 306 bloc"er @Atropine? &ncreased pulse A rinary retention B %onstipation C !ydriasis D Photophobia E Which of the following is not a side effect of the %aptopril? 307 ash A B Angioedema C %ough D %ongestion E Head pain Which of the following is not a side effect of the %lonidine? 308 Hypertension A Asthma B 3ry oral cavity C Lethargic behavior D ,ausea E Which of the following is not an effect of the drug @&soflurane? 309 $levated lipid levels A ,ausea B &ncreased blood flow to the brain. C 3ecreased respiratory function D Head pain E Which of the following is not an effect of the drug @!ida'olam? 310 Amnesia A 3ecreased respiratory function B Anesthetic C D
3i''iness Head pain E Which of the following is not an effect of the drug @%lo'apine? 311 Agranulocytosis A Antipsychotic B sed for +chi'ophrenia C &ncreased appetite D %onstipation E Which of the following is not treated with @$pinephrine? 312 enal disease A Asthma B Hypotension C 7laucoma D +hoc" E Which of the following is not treated with @$phedrine? 313 %JP3 A Hypotension B %ongestion C &ncontinence D E 6ronchospasm 314 Which of the following is not treated with 6arbiturates? A +ei'ures B Hypotension &nsomnia C Anxiety D $pilepsy E Which of the following are not treated with opioid analgesics li"e 315 @dextromethorphan and methadone? Pulmonary $dema A %ough suppression B +edation C Pain D +ei'ures E Pupil dilatation occurs with) 316 neostigmine A propranolol B atenolol C codeine D ganglion bloc"er E Pupil dilatation occurs with) 317 neostigmine A cocaine B C atenolol D metoprolol E ganglion bloc"er D
Procaine metaboli'ed primarily in the liver A seldom combined with a vasoconstrictor because it inhibits ,$ upta"e B interacts with ,aR channels predominantly in its cationic form C used more fre(uently to produce epidural anesthesia than is tetracaine D reaches its site of action more rapidly in infected tissues compared to E normal tissue !epivacaine most closely resembles which of the following drugs? 319 Lidocaine A Anesthesine B 4etracaine C %hloroprocaine D opivacaine E Local anesthetic agents such as procaine) 320 A bloc" nerve conduction in part by causing depolari'ation via inhibition of = R channels bloc" conduction in motor fibers more rapidly than in pain fibers B cause convulsions when excessive amounts reach the brain C cause local vasoconstriction# which prolongs their duration of action D inhibit resting ,aR channels more readily than those activated by E depolari'ation Which of the following drugs and doses would be expected to have 321 the (uic"est onset of sensory bloc"ade during a brachial plexus nerve bloc"? 5> ml of 59 5-chloroprocaine A 5> ml of 59 lidocaine. B 5> ml of >.89 ropivacaine C D 5> ml of >.89 bupivacaine E 5> ml of >.89 tetracaine 322 6upivacaine) A %ontains amide lin"age< administered intravenously for treatment of cardiac arrhythmias %ontains ester lin"age< hydrochloride salt can be used topically to B anestheti'e mucous membranes %ontains ester lin"age< shortest duration of all local anaesthetics used C clinically %ontains amide lin"age< duration of action is longer than that of D lidocaine Jnly employed topically on the s"in and mucous membranes E Lidocaine) 323 %ontains amide lin"age< administered intravenously for treatment of A cardiac arrhythmias %ontains ester lin"age< hydrochloride salt can be used topically to B anestheti'e mucous membranes 318
%ontains ester lin"age< shortest duration of all local anaesthetics used clinically %ontains amide lin"age< duration of action is longer than that of D bupivacaine Jnly employed topically on the s"in and mucous membranes E Procaine) 324 %ontains amide lin"age< administered intravenously for treatment of A cardiac arrhythmias %ontains ester lin"age< hydrochloride salt can be used topically to B anestheti'e mucous membranes %ontains ester lin"age< shortest duration of all local anaesthetics used C clinically %ontains amide lin"age< duration of action is longer than that of D bupivacaine Jnly employed topically on the s"in and mucous membranes E 325 4etracaine) A %ontains amide lin"age< administered intravenously for treatment of cardiac arrhythmias %ontains ester lin"age< hydrochloride salt can be used topically to B anestheti'e mucous membranes %ontains ester lin"age< shortest duration of all local anaesthetics used C clinically %ontains amide lin"age< duration of action is longer than that of D bupivacaine E Jnly employed topically on the s"in and mucous membranes Which of the following is IAL+$ regarding procaine? 326 metaboli'ed in plasma A use is confined with infiltration anesthesia and diagnostic nerve bloc" B short duration local anesthetic C high potency D none of the above are false @all true E Which of the following is 4$ regarding bupivacaine? 327 more potent than procaine A an ester B metaboli'ed in plasma C short duration of action D contraindicated for use in epidural anesthesia E Which of the following statements is IAL+$ regarding the effects of 328 local anesthetics on sensory modalities and motor function? small fiber axons bloc"ed more (uic"ly than large fiber axons A when a patient is wa"ing up from anesthesia# their foot would regain B sensation before their "nee C faster firing axons are bloc"ed first C
proprioceptive fibers are bloc"ed more easily than pain fibers analgesia precedes the loss of non-nociceptive sensations and motor E function. ecovery occurs in the opposite order. Which of the following local anesthetics is useful for elderly patients 329 or those with cardiovascular disease? 6upivacaine A Lidocaine B mepivicaine C D procaine E tetracaine 330 Which of the following is IAL+$ regarding the structural features of local anesthetics is @LA? 4he hydrophobic aromatic moiety permits diffusion through the A membrane to the site of action# which is the intracellular side of the sodium channel pore LA are wea" bases B LA have an ester or an amide lin"age. 4hose with esters are C hydroly'ed in the plasma whereas amides are degraded in the liver D 4he charged form of an LA @6HR has the L$A+4 of the channel bloc"ing activity 4he uncharged form of an LA @6 is lipid soluble and thus can diffuse E through lipid bilayers Which of the following is 4$ regarding side effects of local 331 anesthetics is @LA? amides are more li"ely to cause hypersensitivity reactions than esters A low doses of LA can cause convulsions B LA are often mixed with epinephrine when wor"ing on areas supplied C by a terminal artery such as the digits or the penis A concern when doing spinal anesthesia are indirect effects on the D cardiovascular system due to sympathetic bloc"ade High systemic concentrations of LA cannot cause conduction failure# E ventricular arrhythmias or fibrillation of the myocardium 6upivacaine) 332 An amide. Jften used in continuous epidural anesthesia A An ester. ;> times more potent than procaine. Longer duration of B action C An amide. 5-C times more potent than procaine. Jne of the most widely used LA An ester. Iirst synthetic LA D ,one of the above E Lidocaine) 333 An amide. Jften used in continuous epidural anesthesia A D
B
An ester. ;> times more potent than procaine. Longer duration of
action An amide. 5-C times more potent than procaine. Jne of the most widely used LA An ester. Iirst synthetic LA D ,one of the above E Procaine) 334 An amide. Jften used in continuous epidural anesthesia A B An ester. ;> times more potent than procaine. Longer duration of action An amide. 5-C times more potent than procaine. Jne of the most C widely used LA An ester. Iirst synthetic LA D ,one of the above E 4etracaine) 335 An amide. Jften used in continuous epidural anesthesia A An ester. ;> times more potent than procaine. Longer duration of B action An amide. 5-C times more potent than procaine. Jne of the most C widely used LA An ester. Iirst synthetic LA D ,one of the above E 4he rate of upta"e of an anesthetic gas from the lung) 336 is proportional to the solubility of the gas in blood. A increases as the partial pressure of the gas in tissues approaches that in B the alveolus is decreased when pulmonary ventilation is increased C increases as the ratio of the partial pressures in the inspired and D expired gas approaches unity increases if !A% has been lowered by prior administration of E preanesthetic medication %ompared to desflurane at e(ual values of !A%# isoflurane) 337 is more irritating to the airway A will be administered at a greater concentration B will induce anesthesia more slowly C is more li"ely to induce hypertension D is more li"ely to induce tachycardia E All of the following statements about nitrous oxide are true $%$P4) 338 surgical anesthesia at normal atmospheric pressure re(uires the A concomittant use of other agents produces analgesia at subanesthetic partial pressures B accumulates in fat# which slows emergence from prolonged surgical C anesthesia C
its solubility in blood is low compared to other inhalational anesthetics produces little or no decrease in cardiac output or arterial pressure E Which of the following statements is !J+4 valid? 339 4he tension of isoflurane in blood is identical to its concentration if it A is the only anesthetic gas administered Low protein binding in blood explains the low solubility of B sevoflurane !A% is essentially an indicator of partial pressure C D Administered at e(ual !A% values at e(uilibrium# concentrations of isoflurane and sevoflurane at their anesthetic site of action are similar. Anesthetics act at the site of action in low micromolar concentrations E Where is a spinal anesthetic applied? 340 &nside the membrane sheath surrounding the dorsal root ganglion A &n the subdural space B &n the subarachnoid space C &n the grey matter of the spinal cord D &n the white matter of the spinal cord E Which of the following is not a symptom of shoc"? 341 %old clammy s"in A Hypotension B Hypertension C 4achycardia D 6ronchospasm E What is an adverse reaction of an adrenergic drug depending on? 342 +pecific drug A 3rug dose B &ndividual patient response C 4he way of usage D All of above E Which drug has the greatest effect on the vascular system? 343 6eta;-adrenergic bloc"ing drug A B Alfa- adrenergic bloc"ing drug C Antiadrenergic drugs D Alfa-# beta-adrenergic bloc"ing agents E 6eta5-adrenergic bloc"ing drug Which drug has the greatest effect on the adrenergic nerves in the 344 heart? 6eta;-adrenergic bloc"ing drug A Alfa- adrenergic bloc"ing drug B Antiadrenergic drugs C Alfa-# beta-adrenergic bloc"ing agents D 6eta5-adrenergic bloc"ing drug E Which drug has the wider range of effects? 345 Alfa-# beta-adrenergic bloc"ing agents A D
Alfa;- adrenergic bloc"ing drug 6eta- adrenergic bloc"ing drug C Antiadrenergic drugs D Alfa5- adrenergic bloc"ing drug E What is the primary usage of beta-bloc"ers agents? 346 Hypotension A Hypertension B 7laucoma C %hest pain D !yasthenia gravis E What is not considered for ma*or use of cholinergic drugs? 347 7laucoma A Hypertension B !yasthenia gravis C rinary retention D Hypotension E What adverse reaction would be commonly noted with the usage of 348 cholinergic bloc"ers? 6lurred vision A 3ry mouth B 7& upset C $xpanding of the pupil D All of above E What drug is contraindicated for a patient ta"ing adrenergic drugs for 349 high blood pressure? 6ronchodilator A ,asal decongestant B Aspirin C Anesthetic D Analgin E What is the neurotransmitter that inactivates acetylcholine? 350 Acetyl cholinesterase A Lactase B Alanine aminotranspherase C Aspartate aminotranspherase D Adenylatecyclase E Purpose of adrenergic drugs 351 A +hoc" B Hypotension C Asthma D Anesthesia &nsomnia E 6utyrophenone antipsychotic) 352 4hiorida'ine A B
B C D E 353 A B C D E 354 A B C D E 355 A B C D E 356 A B C D E 357 A B C D E 358 A B C D
%hlorproma'ine 4hiothixene Haloperidol Iluphena'ine An example of an SatypicalS antipsychotic agent) 4hiorida'ine 4hiothixene isperidone %hlorproma'ine ,one of the above +ite@s of chlorproma'ine @4hora'ine receptor bloc"ade) Alpha adrenergic receptor !uscarinic cholinergic receptor H; histaminic receptor +erotonin - 8-H45 receptor All of the above Antipsychotic drug with least extrapyramidal toxicity) Iluphena'ine Haloperidol %lo'apine 4hiothixene %hlorproma'ine Antipsychotic drug)least hypotensive effect) %hlorproma'ine 4hiothixene %lo'apine Jlan'apine All about e(ual in hypotensive action Antipsychotic endocrine effect@s) Ialse -positive pregnancy tests &ncreased libido in women 3ecreased libido in men Amenorrhea -galactorrhea All the above Least li"ely to cause an increase in prolactin) %hlorproma'ine Haloperidol Perphena'ine Jlan'apine
4hiothixene %ardiovascular effects of Shigh-doseS @low-potency phenothia'ines) 359 Hypertension A B &ncreased peripheral resistance &ncreased stro"e volume C +hortening of the U-4 interval D ,one of the above E 6loc"ade of this receptor system most li"ely associated with A"athisia 360 side effect of antipsychotic treatment) !uscarinic cholinergic A Alpha adrenergic B 3opamine C D serotonin 7A6A E 4oxic-confusion states due to antipsychotic medication associated 361 with effects on this receptor system Alpha -adrenergic A 3opamine B !uscarinic cholinergic C +erotonergic D ,one -of the above E 362 ,eurological adverse effect associated with antipsychotic drug use) occurs late in therapy Par"inson:s syndrome A A"athisia B C Acute dystonic reactions 4ardive dys"inesia D All of the above E easonable pharmacological step@s to treat tardive dys"inesia) 363 &ncrease antipsychotic drug dose A Add a tricyclic antidepressants to the drug regimen B Add ben'tropine @%ogentin C +tart high-dose dia'epam @C>-D> milligrams per day D ,o pharmacological intervention is helpful after tardive dys"inesia is E induced by antipsychotic treatment 6efore the infiltration anesthesia was carried out# the test for 364 novocaine sensitivity was made to the patient. &t was positive. Which of the following drugs can be used for anesthesia in this case? Lidocaine A E
+treptomycin %ocaine C Anaesthesinum D 3iVaine E &n the psychiatric hospital# during the long-term treatment# symptoms 365 of the Par"inson:s disease appeared in the patients condition. What drug was administered to the patient? Amina'ine e A B !e'apam C +odium bromide D Lithium %arbonate E ,ialamide 4he unconscious patient was delivered to the admission department 366 of the hospital. 4he patients s"in was cold# pupils of the eyes were narrowed# breathing was difficult# blood pressure was decreased# the urinary bladder was full. 4he diagnosis was morphine poisoning. What preparation should be used as antagonist? A ,aloxone B 6emegride %ytiton C nithiol D +odium thiosulfate E 4he patient# who complained of dry mouth# photophobia# sight 367 disturbance# dry s"in# tachycardia etc.# was delivered to the admission department. 4he administered diagnosis was belladonna al"aloids poisoning. Which drugs should be used? ,eostigmine A B 3ia'epam C Pilocarpine D Armin E 3ipiroxim 4he patient was diagnosed with acute myocardial infarction# which is 368 accompanied by the persistent pain behind the breastbone. 4he inefficiency of previously administered drugs allowed the doctor to ma"e neuroleptc B
procedure. What neuroleptic drugs are used for this type of anesthesia?
3roperidol !etapera'yn B Haloperidol C eserpine D Amina'ine e E 4he condition of patient with hypotension was gradually worsening. 369 4he patient complained of di''iness# wea"ness# and he too" some nonprescription ephedrine drugs tablets. However# some improvement was A
observed only after the first use of the pill. What phenomenon is caused by this action? 4achyphylaxis A +ensiti'ation B &diosyncrasy C Habituation D %umulation E 3uring the next attac" of asthma# the patient inhaled medication# 370 "nown as bronchodilator or as the drug used in obstetric practice to prevent miscarriages# with the help of the inhaler. What medical preparation was used for the patient? Ienoterol A +albutamol B Adrenalini hydrochloridum C $phedrinum D 4heophylline E 4he man in age of CK with traumatic brain in*ury complained of 371 wea"ened breathing# threadli"e pulse# absent reflexes. What is the most appropriate route of of piracetam administration in this case? &ntravenously A +ubcutaneously. B Jrally. C ectally. D &nhalation E 4he woman in age of C8 complained of the pain associated with 372 delayed first childbirth period. What is the best drug to decrease the pain? Promedol A Analgin B !orphine hydrochloridum. C %odeine phosphas. D Paracetamol E 4he patient complained of di''iness# thirst# swallowing difficulties# 373 poor sight was as"ed to the doctor. He had his rapid breathing# dilated pupils# general arousal# lo(uacity and the blood pressure was ;;> EF> mm Hg and the pulse was ;;> per minute. 4he following symptoms may indicate at the drug overdose? Atropine sulfas A !orphine hydrochloridum B $phedrinum C %hlorproma'ine D %affeine E At the molecular level# best defined lithium effect) 374 $ffect on transmitters A
$ffect on inositol phosphates $ffect on neurotransmitter receptors C $ffect on transmitters< $ffect on inositol phosphates D E $ffect on transmitters< $ffect on inositol phosphates< $ffect on neurotransmitter receptors Lithium carbonate is the preferred treatment for) 375 4ypical rendogenous depression A +chi'ophrenia B Anxiety C 6ipolar disorder D $nuresis E Lithium) polydipsiaEpolyuria due to) 376 A $xcessive renal blood flow %ollecting tubule in ade(uately responsive to A3H B 3ecreased 7I C eaction of concurrent amiloride administration D ,one of the aboveX E +ympathetic nervous system anatomy and properties) 377 7angionic neurotransmitter) acetylcholine A 7enerali'ed response upond sympathetic stimulation B 4horaco -lumbar origin for preganglionic cell bodies C D All of the above 7angionic neurotransmitter) acetylcholine< 7enerali'ed response E upond sympathetic stimulation %omparing autonomic and somatic nerves) 378 A +omatic nerves# li"e autonomic nerves contain ganglia. !ost of the fibers in the vagus nerve ar sensory B 3enervated smooth muscle show spontaneous activity C !oto r nerves are typically unmyelinated. D +omatic nerves E !a*or anatomical site for integration of autonomic information) 379 %erebellum A +ensory cortex B Hypothalamus C D +pinal cord--dorsal horn %erebellum < +ensory cortex E 3ivision of the autonomic nervous system associated with diffuse 380 autonomic responses. +ympathetic A B
Parasympathetic 6oth C ,either D E +ympathetic < Parasympathetic Activation of the sympathetic nervous system will caus which change 381 in the s"eletal muscle versus cutaneous vascular beds. Basoconstriction # vasoconstriction A Basodilatation # vasodilatation B Basodilatation # vasoconstriction C Basoconstriction # vasodilation D All of the above E Adrenergic receptor type@s mediating pupillary dilation 382 A 6eta -5 Alpha -; B !uscarinic C +erotonergic D All of the above E %holinergic receptor type that mediates vasodilation following low383 dose i.v. acetylcholine administration) ,icotinic A !uscarinic B C ,itric oxide receptor +ubstance P receptor D All of the above E S4rueS acetylcholinesterase is found in) 384 A 7lia Liver B $rythrocytes C Plasma D 7lia < Liver E %ataly'es rate-limiting step in catecholamine biosynthesis) 385 3JPA decarboxylase A Phenylethanolamine ,-methyl transferase B 4yrosine hydroxylase C D 3opamine -beta-hydroxylase 3JPA decarboxylase< Phenylethanolamine ,-methyl transferase E &nhibited by drugs such as phenel'ine or tranylcypromine< 386 %J!4 @catechol-J-methyl transferase A !AJ @monoamine oxidase B B
%holine acetyltransferase eupta"e -& inhibitor D All of the above E 387 %oncentation increased by epinephrine) 6lood free fatty acids A 6lood glucose B +"eletal muscle glycogen C 6lood free fatty acids< 6lood glucose D All of the above E 3ue to receptor specificity# catecholamine L$A+4 li"ely to produce 388 bronchiolar smooth muscle relaxation) $pinephrine A B 4erbutaline Phenylephrine C Phentolamine D $pinephrine< 4erbutaline E Alpha adrenergic receptor bloc"er 389 Phentolamine A Phenoxyben'amine B 4erbutaline C Phentolamine< Phenoxyben'amine D E All of the above Alpha-adenergic receptor agonist) 390 4erbutaline A Atropine sulfas B C !ethoxamine &soproterenol D 4erbutaline< Atropine sulfas E Parasympathetic direct cardiac effects) 391 3ecrease heart rate< increase contractility A &ncrease heart rate< decrease contractility B 3ecrease heart rate< decrease contractility C &ncrease AB nodal conduction velocity D 3ecrease heart rate< increase contractility< &ncrease heart rate< E decrease contractility %holine ester substrate for acetylcholinesterase) 392 %arbachol A !ethacholine @Provocholine B 6oth C C
,either All of the above E Al"aloid agonist acting at muscarinic# cholinergic receptors) 393 A 3IP Pilocarpine B Physostigmine bromid C &pratropium D All of the above E $ffective in treating both organophosphate and muscarine 394 intoxication) ,icotine A $chothiophate B C Atropine sulfas Pilocarpine D ,icotine< $chothiophate E %holinergic activity on stomach acid secretion 395 &ncreased A 3ecreased B ,o changed C Jne of the others is right D &ncreased< 3ecreased E 396 !ost li"ely to reduce blood pressure by directly decreasing heart rate) Phentolamine A Propranolol B ,itroprusside sodium C D Phenylephrine All of the above E Irom the point of view of +tarling:s law which antihypertensive would 397 be most li"ely to reduce contractility. !ethoxamine A ,itroprusside sodium B Propranolol C !etoprolol D All of the above E 398 ,egative inotropism &soproterenol A $pinephrine B 3iltia'em C ,orepinephrine D D
All of the above &ncreases pulmonary congestion in congestive heart failure @%HI 399 3opamine A B !etoprolol @Lopressor ,itroprusside sodium @,ipride C 3igoxin @Lanoxin# Lanoxicaps D All of the above E !a*or neurotransmitter released at end organ effectors of the 400 thoracolumbar division of the autonomic nervous system) 3opamine A $pinephrine B ,orepinephrine C D Acetylcholine 3opamine< $pinephrine E ,eurotransmitter of preganglionic fibers) 401 ,orepinephrine A +ubstance P B $pinephrine C Acetylcholine D ,orepinephrine< +ubstance P E SIight or flightS activation of the A,+) 402 A Pupillary constriction 6lood flow shifted from cutaneous beds to s"eletal muscle B 6lood glucose falls C 6ronchiolar constriction D E All of the above !ethoxamine @Basoxyl-induced bradycardia would be prevented by) 403 Phentolamine @egitine A !ecamylamine @&nversine B Atropine sulfas C All of the above D Phentolamine @egitine< !ecamylamine @&nversine E 3opamine beta hydroxylase cataly'es) 404 4yrosine to 3JPA A B 3JPA to dopamine 3opamine to norepinephrine C ,orepinephrine to epinephrine D 4yrosine to 3JPA< 3JPA to dopamine E E
405
Primary mechaism for termination of norepinephrine and epinephrine
action) A B C
!etabolic transformation cataly'ed by !AJ !etabolic transformation cataly'ed by %J!4 3iffusion away from the synaptic cleft and upta"e at extraneuronal
sites eupta"e into nerve terminals !etabolic transformation cataly'ed by !AJ< !etabolic E transformation cataly'ed by %J!4 !ost potent at beta adrenergic receptors 406 $pinephrine A &soproterenol B C ,orepinephrine 3opamine D All of the above E alpha-5 receptor agonist< peripheral sympathomimetic 407 Yohimbin A 3obutamine B %lonidine C Phenylephrine D All of the above E 408 Primary antihypertensive effect due to nitric oxide mediation of smooth muscle relaxation. Atropine sulfas A ,itroprusside sodium B C !ecamylamine %aptopril D All of the above E &nhibits neurotransmitter en'ymic degradation) 409 4ubocurarine A Phenoxyben'amine B Physostigmine C 6retylium D 4ubocurarine< Phenoxyben'amine E 410 %ardiac effects not li"e to be directly affected by the presence of an anticholinesterase) Acetylcholine A !ethacholine B Bagal stimulation C D
%arbamylcholine Acetylcholine< !ethacholine E &ndicate Pilocarpine action) 411 A 3ry mouth Pupillary dilation B &ncreased gastrointestinal tone C 6ronchiolar relaxation D All of the above E Preganglionic fibers terminating on adrenal medullary chromaffin 412 cells release) ,orepinephrine A $pinephrine B C Acetylcholine 3opamine D +ubstance P E Primary receptor type at autonomic ganglia) 413 Adrenergic ) beta ; A Adrenergic ) beta 5 B %holinergic ) muscarinic C %holinergic ) nicotinic D 3opaminergic ) 3. ; E 414 Besicular protein important in doc"ing with the presynaptic membrane) ,eurexin A +yntaxin B C +axitonin +ynaptobrevin D All of the above E ate-limiting step in acetylcholine synthesis) 415 %holine acetyltransferase activity A Besicular protein synthesis B %holine upta"e C Acetylcholinesterase activity D Availability of acetate E 416 &nflux of this ion promotes fusion between axoplasmic membrane and nearby vesicles. +odium A Potassium B %alcium C D
%hloride All of the above E %lostridium toxins) 417 A &nhibit acetylcholinesterase Prevent reupta"e of choline B &nhibit vesicular acetylcholine release C Prevent calcium influx D All of the above E 3enervation supersensitivity in s"eletal muscle is mainly due to) 418 &ncrease in receptor affinity A ,o increase in the receptor number B Proliferation of receptors C D &ncrease in 7-protein coupling efficiency &ncrease in acetylcholine release E %holinergic receptor type that mediates the decrease in heart rate by 419 activating potassium channels) !;-- muscarinic A !5-muscarinic B !C-muscarinic C ,icotinic D All of the above E 420 $ssential cofactor for the en'yme dopamine beta-hydroxylase) Pyridoxyl phosphate A Ascorbate B 4etrahydrobiopterin C D 7lycine All of the above E Phosphorylation of this en'yme is most li"ely to have an effect on 421 catecholamine biosynthesis) Phenylethanolamine ,-methyltransferase A 3opamine beta-hydroxylase B 4yrosine hydroxylase C 3opa decarboxylase D All of the above E 422 3rugs activating this receptor are used in treating asthma) 6eta ; adrenergic A !uscarinic cholinergic B 6eta 5 adrenergic C ,icotinic cholinergic D D
E 423 A B C D E 424 A B C D E 425 A B C D E 426 A B C D E 427 A B C D E 428 A B C D E 429 A
All of the above $pinephrine effects on the heart &ncreased rate 3ecreased contractility %oronary vasodilation &ncreased rate< %oronary vasodilation All of the above eceptor activation mainly responsible for positive inotropism) Alpha ; 6eta ; 3opamine 3; !uscarinic cholinergic All of the above Activates alpha receptors &soproterenol Propranolol Phenylephrine 4erbutaline All of the above 6loc"s cardiac isoproterenol effects 4erbutaline $smolol Atropine sullfas !ecamylamin All of the above Alpha agonist) vasoconstriction and elevates blood pressure) !etoprolol !ethoxamine 4erbutaline &pratropium All of the above ,erve terminal reupta"e inhibitor !ethoxamine %ocaine eserpine 4imolol All of the above Alpha adrenoceptor %JBAL$,4 bloc"er) Propranolol
Phenoxyben'amine Phentolamine C Pilocarpine D E All of the above Jrthostatic @postural hypotension 430 6eta receptor activation A Alpha receptor activation B Alpha receptor bloc"er C 3opamine receptor bloc"ade D All of the above E ,orepinephrine pressor response bloc"ed by) 431 !ecamylamine A B Pra'osin Atropine sulfas C Propranolol D All of the above E 6ronchodilation action belong to 432 &pratropium A 4imolol B Albuterol C &pratropium < Albuterol D E All of the above Positive chronotropic effects of epinephrine) 433 &ncreased +A nodal potassium current A 6eta ; receptor activation B C !ediated by 7 protein 6eta ; receptor activation< !ediated by 7 protein D All of the above E !aximal Z-adrenergic receptor desensiti'ation depends on) 434 eceptor occupancy by agonists A An arrestin protein B eceptor phosphorylation C eceptor occupancy by agonists< An arrestin protein< eceptor D phosphorylation E All of the above !ost li"ely to increase myocardial afterload 435 Angiotensin converting en'yme inhibitor @decreases angiotensin && A concentration Propranolol B B
Phenylephrine Low -dose epinephrine D All of the above E 436 Pressor effects of epinephrine are bloc"ed by this drug @Sepinephrine reversalS Propranolol A Phentolamine B Phenylephrine C !etoprolol D All of the above E 3ecreases blood pressure 437 Propranolol A B !ecamylamine Phentolamine C All of the above D Paracetamol E +pecific alpha5 receptor agonist 438 Phenoxyben'amine A Propranolol B 7uanfacine C !ethoxamine D E All of the above %entrally-acting antihypertensive drug 439 ,itroprusside sodium A %lonidine B C !ethoxamine %aptopril D All of the above E &soproterenol @&suprel) cardiopulmonary effects) 440 &ncreases peripheral resistance< Positive inotropism A &ncreases peripheral resistance B Positive inotropism C Positive chronotropism D ,one of the above E 441 3rug causes pupillar dilation with no effect on accommodation) Pilocarpine A Phenoxyben'amine B Phentolamine C Atropine sulfas D C
,eostigmine Prevents blood pressure reduction seen with isoproterenol @&suprel) 442 Propranolol A B Phenylephrine Atropine sulfas C Phentolamine D $smolol E 6eta-5 selective agonist) 443 !etaproterenol A Phenylephrine B $pinephrine C Labetalol D E Phentolamine Physiological effects associated with isoproterenol @&suprel) 444 &ncreased 7& motility A &ncreased peripheral resistance B 6ronchoconstriction C 3ecreased heart rate D &ncreased level of blood glucose E &ndicate action of salbutamolum) 445 6ronchodilation A B 6y &.B. in*ection only 3ecreases myocardial contractility C Alpha adrenoceptor antagonist D +ignificant heart rate increase E 446 4he magnitude of the cardiovascular response to norepinephrine is increased by cocaine because) %ocaine decreases cholinergic receptor number A %ocaine inhibits norepinephrine reupta"e B %ocaine decreases ,.$. metabolism by !AJ C %ocaine increases ,.$. receptor number D %ocaine increases conversion of norepinephrine to phenylephrine E &ncreases both magnitude of the blood pressure increase due to 447 phenylephrine and the heart rate decrease due to methacholine) A 4imolol !ecamylamine B ,itroprusside sodium C Atropine sulfas D %lonidine E E
&mmediate biosynthetic precursor of epinephrine) L-3JPA A &soproterenol B C 3oapmine !etaraminol D ,orepinephrine E 4herapeutic use of metaprolol) 449 enal vasodilator A Positive inotrope in %HI B Antihypertensive C Antiarrhythmic drug D 6ronchial asthma E 450 Probably the neurotransmitter in sensory afferents Acetylcholine A 6rady"inin B +ubstance P C 7lycine D ,orepinephrine E Preganglionic fibers terminating on adrenal medullary chromaffin 451 cells release) ,orepinephrine A B $pinephrine Acetylcholine C 3opamine D +ubstance P E 452 Primary receptor type at autonomic ganglia) Adrenergic ) beta ; A Adrenergic ) beta 5 B %holinergic ) muscarinic C %holinergic ) nicotinic D 3opaminergic ) 3; E Besicular protein important in doc"ing with the presynaptic 453 membrane) ,eurexin A B +yntaxin +axitonin C +ynaptobrevin D All of the above E ate-limiting step in acetylcholine synthesis) 454 448
%holine acetyltransferase activity Besicular protein synthesis B %holine upta"e C D Acetylcholinesterase activity Availability of acetate E &nflux of this ion promotes fusion between axoplasmic membrane and 455 nearby vesicles. +odium A Potassium B %alcium C %hloride D All of the above E 456 %lostridium toxins) &nhibit acetylcholinesterase A Prevent reupta"e of choline B &nhibit vesicular acetylcholine release C Prevent calcium influx D All of the above E $ssential cofactor for the en'yme dopamine beta-hydroxylase) 457 Pyridoxyl phosphate A Ascorbate B C 4etrahydrobiopterin 7lycine D All of the above E Phosphorylation of this en'yme is most li"ely to have an effect on 458 catecholamine biosynthesis) Phenylethanolamine ,-methyltransferase A 3opamine beta-hydroxylase B 4yrosine hydroxylase C 3opa decarboxylase D All of the above E $ffects of $pinephrine) 459 Limited effect on alpha receptors A &ncreases heart rate# contributing to increase blood pressure B C $pinephrine often reduces peripheral vascular resistance# especially at high concentration $pinephrine tends to exhibit negative inotropic effects D All of the above E Basoconstrictive effects of epinephrine) 460 A
Alpha -; adrenergic receptor-mediated affecting precapillary resistance vessels of the s"in# "idney# and mucosa Beins B C 6oth ,either D All of the above E enal effects relatively low epinephrine dose. 461 Limited effect A 6eta ; adrenergic receptor activation decreases renin release B +ignificant reduction in renal blood flow C +ignificant increase in renal blood flow< mechanism similar to that D exhibited by low-dose dopamine E All of the above %ardiac effects associated with epinephrine) 462 Positive chronotropic A Positive inotropic B &ncreased cardiac output C &ncreased oxygen consumption D All of the above E +ignificant respiratory tract effects of epinephrine) 463 6eta -5 receptor mediated bronchoconstriction A B Alpha -; receptor-mediated bronchodilation 6eta -; receptor-mediated bronchodilation C 6eta -5 receptor-mediated bronchodilation D All of the above E 464 $xamples of epinephrine metabolic effects &nsulin secretion reduced by beta5 adrenergic receptor activation A 7lucagon secretion) diminished by beta adrenergic receptor activation B Iree fatty acids) increased C !inimal calorigenic effect D 7lycolysis inhibition E 4oxicitiesEadverse reactions associated with sympathomimetics 465 Angina A Hypertension < cerebral hemorrhage B C %ardiac arrhythmias Anxiety reactions D All the above E 3rugs antagoni'e epinephrine pressor effects) 466 Phentolamine A A
4erbutaline 3opamine C 3obutamine D E Atropine sulfas Bentricular effects associated with epinephrine administration) 467 &ncreased automaticity A &ncreased ectopic pacema"er activity B &ncreased conduction philosophy C &ncreased contractility D All the above E Primary neurotransmitter released by postganglionic neurons of the 468 autonomic sympathetic system) A $pinephrine 3opamine B 3obutamine C ,orepinephrine D Phenylephrine E 3ecreased heart rate following norepinephrine infusion is most li"ely 469 due to) 3irect norepinephrine activation of muscarinic receptors at the +A A node B Heart rate cannot decrease following norepinephrine infusion because norepinephrine activates beta-; adrenergic receptors Activation of the baroreceptor system causing a reflex-mediated C decrease in heart rate D Peripheral vasodilation ,one of the above E Bascular effects of norepinephrine) 470 +ignificantly decreases glomerularl filtration rates A $ffective in treating variant @Prin'metal:s angina B ,orepinephrine pressor effects bloc"ed by pra'osin @!inipress C &ncreased blood flow to liver# "idney# and s"eletal muscle D All of the above E &mmediate synthetic precursor of norepinephrine) 471 A $pinephrine 4yrosine B 4yrosine hydroxylase C 3opamine D 3opa E B
472
%,+ neurotransmitter associated with the basal ganglia and motor
control) A B C D E 473
3opamine Acetylcholine 6oth ,either All of the above Low doses# this precursor of norepinephrine causes renovascular
dilation) $pinephrine 3opa B 3opamine C D 3obutamine ,itroprusside sodium E Pharmacological action@s of dopamine @&ntropin) 474 Positive inotropism A Promotes myocardial norepinephrine release B &ncreases glomerular filtration rates @low-dose C Basoconstriction by alpha-; receptor activation @high-dose D All the above E +ignificant therapeutic use for dopamine) 475 A !anagement of sleep cycles 4reatment of aynaud:s phenomenon B 4reatment of cardiogenicEhypovolemic shoc" C !anagement of tachyarrhythmias D E All of the above 4his drug has limited action at alpha-adrenergic receptors 476 Phenylephrine A !ethoxamine B ,orepinephrine C &soproterenol D Pra'osin E $ffect of &B isoproterenol @&suprel infusions on blood pressure) 477 +ignificant vasopressor effect A B +ignificant hypotensive effect +light decrease in mean pressure with a significant decrease in C diastolic pressure +ignificant increase in systolic pressure with minimal effect on D diastolic pressure A
All of the above Adverse effects associated with isoproterenol @&suprel administration) 478 Palpitations A B 4achycardia Arrhythmias C Palpitations< Arrhythmias D Palpitations< Arrhythmias< 4achycardia E +imultaneous increases in myocardial contractility# glomerular 479 filtration rate# sodium excretion# urine output# and renal blood flow are associated most li"ely with) $pinephrine A &soproterenol B C Phenylephrine 3opamine D ,orepinephrine E &B dopamine @&ntropin properties) 480 Promotes renal tubule or solid reabsorption A educes sodium excretion B %auses reduced ventilatory response to arterial hypoxemia C 3ecreases myocardial contractility D &ncreases atrial filling pressures E 481 4herapeutic uses for isoproterenol @&suprel) !anagement of heart bloc" A !anagement of severe bradycardia B !anagement 4orsades de pointes @a ventricular arrhythmia C D All of the above ,one of the above< no therapeutic uses for isoproterenol @&suprel E Properties of dobutamine @3obutrex) 482 Positive inotropic agent< causes significant increase in heart rate A Promotes catecholamine release B !ainly acts through dopamine receptors C Positive inotropic effect is mediated through beta-adrenergic receptor D activation Appropriate for long-term management of myocardial pump-failure E following surgery $xamples of beta-5 selective adrenergic agonists 483 !etaproterenol A 4erbutaline B Albuterol C E
!etaproterenol< 4erbutaline !etaproterenol< 4erbutaline< Albuterol E Adverse effects associated with beta5 adrenergic receptor agonists) 484 A $xcessive cardiovascular stimulation +"eletal muscle tremor B Jver usage of these drugs may predisposed to morbidity immortality C in asthmatics $xcessive cardiovascular stimulation< Jver usage of these drugs may D predisposed to morbidity immortality in asthmatics $xcessive cardiovascular stimulation< +"eletal muscle tremor< Jver E usage of these drugs may predisposed to morbidity immortality in asthmatics 485 Alpha-;-selective adrenergic agonists) properties of Phenylephrine is an example of the indirect-acting vasoconstrictor A !etaraminol acts by direct and indirect mechanisms B !ethoxamine is an indirect acting vasoconstrictor C Alpha ;-receptor activation decreases calcium influx D All of the above E %linical use@s of alpha-;-receptor agonists) 486 !anagement hypotensive states A 4ermination of paroxysmal atrial tachycardia B C ,asal decongestant !anagement hypotensive states< 4ermination of paroxysmal atrial D tachycardia !anagement hypotensive states< 4ermination of paroxysmal atrial E tachycardia< ,asal decongestant Primary use for alpha-5-selective adrenergic agonists) 487 4o manage hypotensive states A 4o increase myocardial contractility B 4o reduce blood pressure C 4o manage hypotensive states< 4o increase myocardial contractility D 4o manage hypotensive states< 4o increase myocardial contractility< E 4o reduce blood pressure Adverse effects associated with clonidine) 488 A 3ry mouth +edation B +exual dysfunction C All of the above D 3ry mouth< +edation E D
489 A B C D E 490
%linical uses for sympathomimetic drugs) Hypovolemic shoc" caused by dehydration or blood loss %ardiogenic shoc" @pump failure %ardiac output obstruction Loss of peripheral vascular tone All of the above Primary ob*ective sympathomimetic drug use for management of
shoc") &ncrease myocardial contractility 3ecreased peripheral resistance B Promote better renal perfusion C $nsure ade(uate %,+ perfusion D E &mprove coronary perfusion !ost li"ely to reduce myocardial performance in a damaged heart by 491 increasing afterload) &soproterenol A Phenylephrine B Low -dose dopamine C Low -dose epinephrine D All of the above E eceptor system most li"ely responsible for improved myocardial 492 contractility when dopamine is administered at low concentrations) !uscarinic cholinergic receptors A Alpha adrenergic receptors B 6eta adrenergic receptors C D 3opamine receptors @3; Leu"otriene receptors E easonable intervention@s to reverse cardiogenic shoc" caused by 493 acute myocardial infarction +upplemental oxygen A &B nitroglycerin B &ntra -aortic balloon pump C evasculari'ation D All of the above E 494 Phosphodiesterase inhibitor@s which have positive inotropic actions< might be used in management of cardiogenic shoc" Phentolamine A ,itroglycerin B Amrinone C A
%lonidine %affeine E !echanism by a which methoxamine might terminate paroxysmal 495 supraventricular tachycardia) 3irect action at the AB node A &ncreases +A nodal rates overdrives the ectopic focus B 6loc"s beta-;-receptors C %auses increased vagal tone through reflex activation secondary to D increase blood pressure 3irectly inhibit sodium channel conductance E %linical applications of beta-adrenergic antagonists) 496 !anagement of coronary vascular disease A B 4reatment of arrhythmias 4reatment of hypertension C All the above D !anagement of coronary vascular disease< 4reatment of arrhythmias E A non-selective beta-adrenergic receptor bloc"er) 497 !etoprolol A Atenolol B 4imolol C $smolol D E !etoprolol< Atenolol 6eta-adrenergic receptor bloc"ers) effects on the heart 498 &ncrease heart rate A &ncreased AB nodal refractory period B C &ncreased contractility &ncreased myocardial oxygen demand D &ncreased phase D depolari'ation E !ost li"ely to cause dangerous bronchiolar constriction in asthmatic 499 patients or patients with %JP3 !etoprolol A Propranolol B $smolol C Atenolol D E !etoprolol< Propranolol !echanism@s for propranolol-decreased amide local anesthetic 500 clearance) 3ecreased hepatic blood flow A &nhibition of hepatic metabolism of local anesthetic B D
6oth ,either D All the above E 501 4he ma*or exception to the rule that additive myocardial depression between anesthetics and beta-adrenergic antagonists is not excessive) !etoprolol A Propranolol B $smolol C 4imolol D ,adolol E 6radycardia hypotension# refractory to atropine# may occur during 502 anesthesia in pediatric and adult patients receiving this beta adrenergic receptor antagonist) ,adolol A Propranolol B $smolol C 4imolol D All the above E 7reatest additive cardiovascular effects with inhaled anesthetics in the 503 presence of beta-adrenergic receptor bloc"ade) $nflurane A B Halothane &soflurane C All the above D $nflurane< Halothane E 504 Preferred beta-bloc"ing agent to prevent systolic blood pressure increases associated with direct laryngoscopy in tracheal intubation) &B propranolol A &B labetalol B B esmolol C &B timolol D &B nadolol E 6eta-bloc"er having special benefits for patients undergoing 505 noncardiac surgery but having significant underlying coronary artery disease-given &B perioperatively and orally during remainder of hospital stay. $smolol A Atenolol B Propranolol C ,adolol D C
E 506 A B C D E 507 A B C D E 508 A B C D E 509 A B C D E 510 A B C D E 511 A B C D E 512 A
$smolol< Atenolol +ympathetic ,ervous +ystem 7anglionic neurotransmitter) acetylcholine 7enerali'ed response upon sympathetic activation 4horaco -lumbar origin for preganglionic cell bodies A# 6 and % All the above %holine ester most susceptible to hydrolysis by acetylcholinesterase) %arbachol Acetylcholine !ethacholine Pilocarpine All the above esistant to hydrolysis by acetylcholinesterase %arbachol !ethacholine 6oth ,either All the above 4he highest nicotinic receptor activity among choline esters has) Acetylcholine Atropine !ethacholine %arbacholine All the above &ndicate the direct effects associated with parasympathetic activation) &ncrease heart rate 3ecreased 7& motility 3ecrease cardiac contractility rinary retention All the above 6ronchoconstriction in an asthmatic) !etoprolol Atropine sulfas Albuterol &pratropium !etoprolol< Atropine sulfas Antimuscarinic drug with highest %,+ activity Atropine sulfas
B C D E 513 A B C D E 514
+copolamine Homatropine !uscarine Atropine sulfas< +copolamine !uscarinic agent) enhances transmission through the A-B node) &soproterenol Atropine Propranolol !ethacholine &soproterenol< Atropine Least li"ely to be used as a mydriatic because of long-duration of
action) Homatropine Atropine sulfas B %yclopentolate C 6en'tropine D Homatropine< Atropine sulfas E %linically-used to treat sinus bradycardia secondary to acute 515 myocardial infarction) Homatropine A Atropine sulfas B C 6en'tropine 4ropicamide D Homatropine< Atropine sulfas E +ymptoms following 3IP exposure @diisopropylfluorophosphate# an 516 organophosphate poison) %onstipation A +alivation B 3ecreased gastric acid secretion C ,one of the above D All the above E Location@s of cholinergic synaptic sites) 517 ,euromuscular *unction A Autonomic effector sites innervated by post-ganglionic sympathetic B fibers +ome %,+ synapses C ,euromuscular *unction< +ome %,+ synapses D Autonomic effector sites innervated by post-ganglionic sympathetic E fibers< +ome %,+ synapses A
Iactors that limit %,+ effects of systemic acetylcholine) administration) Poor %,+ penetration A B &nactivation by plasma butrylcholinesterase 6oth C ,either D All the above E Locali'ation of muscarinic cholinergic receptors) 519 Postganglionic parasympathetic effector sites A Autonomic ganglia cells B Adrenal medulla C Postganglionic parasympathetic effector sites< Adrenal medulla D E Postganglionic parasympathetic effector sites< Autonomic ganglia cells< Adrenal medulla Highly sensitive to the action of acetylcholinesterase) 520 %arbachol A 6ethanechol B Acetylcholine C %arbachol< Acetylcholine D %arbachol< Acetylcholine< 6ethanechol E !uscarinic receptor subtype primarily associated with the heart) 521 A !; !5 B !C C !D D E !;< !C !ost li"ely to be effective in bloc"ing all ganglionic 522 neurotransmission) 4ubocurarine A !ecamylamine B Atropine sulfas C All of the above D 4ubocurarine< Atropine sulfas E %ardiac muscarinic 4ype !5-receptor mediated action@s) 523 A &ncreased phase D depolari'ation rate &ncreased AB nodal conduction velocity B 3ecreased atrial and ventricular contractility C All the above D 518
&ncreased phase D depolari'ation rate< 3ecreased atrial and ventricular contractility Ligand-gated ion channels) 524 A ,icotinic !uscarinic B 6oth C ,either D ,one of the above E &ndirect-acting cholinomimetic) 525 Atropine sulfas A $drophonium B %arbachol C D Acetylcholine $phedrine E %holinergic-receptor-mediated vasodilation -- changes in intracellular 526 concentration of this ion is principally responsible) +odium A Potassium B %hloride C %alcium D !agnesium E 527 %holinergic-mediated vasodilation involves liberation of this substance# a gas# from endothelial cells) Prostaglandins A Leu"otrienes B C ,itric oxide %alcium D Prostaglandins< ,itric oxide E !echanism@s of vasodilation mediated by the cholinergic system) 528 %holinergic activation promotes nitric oxide release from endothelial A cells Acetylcholine inhibits norepinephrine release from postganglionic B sympathetic fibers 6oth C D ,either All the above E Parasympathetic system) negative chronotropic effect -529 !ediated by !5 muscarinic receptors A E
Associated with increased diastolic depolari'ation @increased phase D depolari'ation 6oth C D ,either All the above E !a*or mechanism responsible for decreased AB nodal conduction 530 following increased vagal tone) 3ecreased calcium currents in the AB node A +econdary affected to reduced norepinephrine release B 3ecreased sodium currents in the AB node C &ncreased potassium conductance in the AB nodal fibers D All of the above E 531 Associated with excessive vagal tone) Partial heart bloc" A 4otal heart bloc" B Jther bradyarrhythmias C All the above D Partial heart bloc"< Jther bradyarrhythmias E %oncerning negative inotropism associated with increased vagal tone) 532 !ore prominent in atrial compared to ventricular muscle A 3ue to a decrease in inward calcium currents B C 6oth ,either D ,one of the above E !echanisms by which muscarinic stimulation reduces ventricular 533 contractility) educes ventricular responds to norepinephrine A educes norepinephrine release from adrenergic terminals B 6oth C ,either D educes ventricular responds to norepinephrine< 6oth E $ffects of muscarinic receptor activation and cardiac ionic currents) 534 3ecreases potassium currents in atrial muscle and in +A nodal !Ab A nodal tissue B &ncreases in slow# inward calcium currents 3ecreased in diastolic depolari'ation @decrease in phase D C depolari'ation B
3ecreases potassium currents in atrial muscle and in +A nodal !Ab nodal tissue< 3ecreased in diastolic depolari'ation @decrease in phase D depolari'ation E &ncreases in slow# inward calcium currents< 3ecreased in diastolic depolari'ation @decrease in phase D depolari'ation $ffect@s of muscarinic agonists on the gastrointestinal and urinary 535 tracts) &ncreased intestinal peristalsis A &ncreased tone B &ncreased contraction amplitude C &ncrease ureteral peristalsis D All the above E 536 +ubstances that increase nitric oxide production) +ubstance P A 6rady"inin B Acetylcholine C +ubstance P< 6rady"inin D +ubstance P< 6rady"inin< Acetylcholine E %linical uses of bethanecol) 537 !anagement of postoperative abdominal distention A !anagement of esophageal reflux B C Postoperative urinary bladder stimulant 4reatment of reduced salivation secondary to radiation therapy D All the above E Jpthalmological uses of cholinomimetics) 538 A Acetylcholine may be used as a miotic 4reatment of glaucoma B sed along with mydriatic agent in brea"ing iris-lens adhesions C Acetylcholine may be used as a miotic< 4reatment of glaucoma D Acetylcholine may be used as a miotic< 4reatment of glaucoma< sed E along with mydriatic agent in brea"ing iris-lens adhesions !a*or contraindications -- muscarinic agonists 539 Asthma A Hyperthyroidism B C Peptic ulcer %oronary vascular disease D All the above E %holinergic-receptor-mediated vasodilation -- changes in intracellular 540 concentration of this ion is principally responsible) D
+odium Potassium B %hloride C D %alcium !agnesium E %holinergic-mediated vasodilation involves liberation of this 541 substance# a gas# from endothelial cells) Prostaglandins A Leu"otrienes B ,itric oxide C %alcium D Prostaglandins< ,itric oxide E 542 !echanism@s of vasodilation mediated by the cholinergic system) %holinergic activation promotes nitric oxide release from endothelial A cells Acetylcholine inhibits norepinephrine release from postganglionic B sympathetic fibers 6oth C ,either D All the above E Parasympathetic system) negative chronotropic effect -543 A !ediated by !5 muscarinic receptors Associated with increased diastolic depolari'ation @increased phase D B depolari'ation 6oth C D ,either All the above E !a*or mechanism responsible for decreased AB nodal conduction 544 following increased vagal tone) 3ecreased calcium currents in the AB node A +econdary affected to reduced norepinephrine release B 3ecreased sodium currents in the AB node C &ncreased potassium conductance in the AB nodal fibers D All of the above E 545 Associated with excessive vagal tone) Partial heart bloc" A 4otal heart bloc" B Jther bradyarrhythmias C All the above D A
Partial heart bloc"< Jther bradyarrhythmias %oncerning negative inotropism associated with increased vagal tone) 546 !ore prominent in atrial compared to ventricular muscle A B 3ue to a decrease in inward calcium currents 6oth C ,either D All the above E !echanisms by which muscarinic stimulation reduces ventricular 547 contractility) educes ventricular responds to norepinephrine A educes norepinephrine release from adrenergic terminals B 6oth C D ,either All the above E $ffects of muscarinic receptor activation and cardiac ionic currents) 548 3ecreases potassium currents in atrial muscle and in +A nodal !Ab A nodal tissue &ncreases in slow# inward calcium currents B 3ecreased in diastolic depolari'ation @decrease in phase D C depolari'ation 3ecreases potassium currents in atrial muscle and in +A nodal !Ab D nodal tissue< 3ecreased in diastolic depolari'ation @decrease in phase D depolari'ation &ncreases in slow# inward calcium currents< 3ecreased in diastolic E depolari'ation @decrease in phase D depolari'ation 549 $ffect@s of muscarinic agonists on the gastrointestinal and urinary tracts) &ncreased intestinal peristalsis A &ncreased tone B &ncreased contraction amplitude C &ncrease ureteral peristalsis D All the above E +ubstances that increase nitric oxide production) 550 +ubstance P A B 6rady"inin Acetylcholine C +ubstance P< 6rady"inin D +ubstance P< 6rady"inin< Acetylcholine E %linical uses of bethanecol) 551 E
!anagement of postoperative abdominal distention !anagement of esophageal reflux B Postoperative urinary bladder stimulant C D 4reatment of reduced salivation secondary to radiation therapy All the above E Jpthalmological uses of cholinomimetics) 552 Acetylcholine may be used as a miotic A 4reatmen t of glaucoma B sed along with mydriatic agent in brea"ing iris-lens adhesions C All the above D Acetylcholine may be used as a miotic< 4reatmen t of glaucoma< sed E along with mydriatic agent in brea"ing iris-lens adhesions 553 !a*or contraindications -- muscarinic agonists Asthma A Hyperthyroidism B Peptic ulcer C %oronary vascular disease D All the above E %lasses of anticholinesterase drugs) 554 eversible # short-acting A &ntermediate # carbamylating B C long-acting # phosphorylate agents All the above D eversible # short-acting< &ntermediate # carbamylating< long-acting # E phosphorylate agents 555 anticholinesterase agent< (uaternary ammonium compound< intermediate-duration# carbamylating agent) physostigmine A ,eostigmine B $drophonium C 4acrine D Atropine sulfas E enal clearance -- acetylcholinesterase inhibitors-556 Actively secreted into renal tubule lumen A B enal clearance) 8>9 for neostigmine enal clearance) F89 for edrophonium and pyridostigmine C All of the above D Actively secreted into renal tubule lumen< enal clearance) 8>9 for E neostigmine A
&n organophosphate poisoning# this agent may be capable of reactivating inhibited acetylcholinesterase) Atropine sulfas A B Pilocarpine !ecamylamine C 5-PA! D All of the above E %onse(uences of acetylcholinesterase inhibitor application to the 558 con*unctiva elaxation of the pupillary sphincter muscle A elaxation of the ciliary muscle B 6oth C D ,either elaxation of the pupillary sphincter muscle< elaxation of the E ciliary muscle 4ypes of glaucoma) 559 Primary A +econdary B %ongenital C All the above D Primary< +econdary E 560 Anticholinesterases) used in treating glaucoma-$chothiophate A 3emecarium B Atropine sulfas C D $chothiophate [ 3emecarium All the above E Probable cause of myasthenia gravis) 561 $xcessive synthesis of cholinergic receptors A &nade(uate synthesis of acetylcholine B Iailure of acetylcholine reupta"e system C 6inding of anti--muscarinic receptor antibodies to the muscarinic D cholinergic receptor 6inding of anti-nicotinic receptor antibodies to the nicotinic E cholinergic receptor ationale for prescribing anticholinesterase drugs to patients with 562 myasthenia gravis) &ncrease acetylcholine turnover A &ncrease receptor number B 557
&ncrease amount of acetylcholine available of neuromuscular *unctions educe choline reupta"e D E All of the above Associated disorders in myasthenic patients -563 4hymic abnormalities A Hyperthyroidism B Jther autoimmune disorders C Bentilatory dysfunction D All the above E 7eneral clinical uses) anticholinesterases 564 Antagonist -assisted reversal of neuromuscular bloc"ade produced by A nondepolari'ing neuromuscular-bloc"ing drugs !yasthenia gravis management B 7laucoma treatment C 4reatment of paralytic ileus and urinary bladder atony D All of the above E 3rugs used for antagonist-assisted neuromuscular-bloc"ade reversal 565 Acetylcholine A Physostigmine B 3IP C D $drophonium All of the above E 3etermination of the recovery rates from neuromuscular-bloc"ade 566 when antagonist-assisted reversal is used) A +pontaneous recovery rate from the bloc"ing drug Activity of the pharmacologic antagonist @anticholinesterase drug B 6oth @sum of A plus 6 C 3ifferenc @A- 6 D All of the above E When our anticholinesterase agents usually administered to enhance 567 neuromuscular bloc"ade reversal? 6efore the neuromuscular-bloc"ing drug is given A While the neuromuscular-bloc"ing drug is being infused B C 3uring the spontaneous neuromuscular-bloc"ade recovery# following cessation of neuromuscular-bloc"ing administration 6efore the neuromuscular-bloc"ing drug is given< While the D neuromuscular-bloc"ing drug is being infused All of the above E C
Pharmacologic antagonism @anticholinesterase drugs would li"ely be more effective for which type of neuromuscular bloc"ing drug? +hort -or intermediate-acting neuromuscular-bloc"ing drugs A B Long -acting nondepolari'ing neuromuscular-bloc"ade $(ually effective C All of the above D +hort -or intermediate-acting neuromuscular-bloc"ing drugs< Long E -acting nondepolari'ing neuromuscular-bloc"ade ationale for using muscarinic antagonists in pharmacologic 569 @anticholinesterase-mediated reversal of neuromuscular-bloc"ade) &ncreases acetylcholine concentration that neuromuscular *unctions A &nhibits acetylcholinesterase B C !inimi'es muscarinic receptor-mediated effects of anticholinesterase drugs &ncreases acetylcholine concentration that neuromuscular *unctions< D &nhibits acetylcholinesterase All of the above E which antimuscarinic agent might be used in combination with an 570 anticholinesterase when desiring reversal of neuromuscular-bloc"ade and opioid-based maintenance anesthesia has been used) $drophonium A B High -dose atropine @;>-;8 ugE"g ,eostigmine C All of the above D $drophonium< High -dose atropine @;>-;8 ugE"g E 571 !ore effective in reversing deep neuromuscular-bloc"ade produced by continuous atracurium @4racrium# vecuronium @,orcuron# or pancuronium @Pavulon infusions $drophonium A ,eostigmine B 6oth are e(ually effective C $drophonium< ,eostigmine D All of the above E Iactor@s that may prevent or inhibit anticholinesterase-mediated 572 antagonism of neuromuscular-bloc"ade) Hyperthermia A espiratory al"alosis B Hyper"alemia C %ertain antibiotics D 568
All of the above eversal of phase && bloc" @following prolonged repeated 573 succinylcholine @Anectine in patients with normal plasma cholinesterase) A $drophonium ,eostigmine B 6oth C ,either D All of the above E %urrent primary therapeutic rationale for using anticholinergic 574 preoperative medication) +edation A Antisialagogue effects B C 6oth ,either D All of the above E &n using anticholinergic drugs as preoperative medication in a patient 575 with glaucoma) drug least li"ely to have an effect on pupil si'e +copolamine bromid A Atropine sulfas B 7lycopyrrolate C All of the above D E +copolamine bromid< Atropine sulfas Preferred anticholinergic drug when sedation is the principal 576 ob*ective# preoperatively) Atropine sulfas A B 7lycopyrrolate +copolamine bromid C Atropine sulfas< 7lycopyrrolate D All of the above E Atropine) most li"ely to increase heart rate in this patient population) 577 Young adult A &nfants B $lderly C All of the above D E Young adult< &nfants Anticholinergic drug most li"ely to be used clinically to promote 578 bronchodilation) &B atropine A Aerosoli'ed atropine B E
Aerosoli'ed ipratropium bromide +copolamine bromid D All of the above E 579 !ore effective in producing bronchodilation in patients with chronic bronchitis or emphysema) Bentolin#Proventil @beta-adrenergic agonist A &pratropium @Atrovent @antimuscarinic agent B $(ually effective C Bentolin#Proventil @beta-adrenergic agonist< &pratropium @Atrovent D @antimuscarinic agent All of the above E Atropine is effective in bloc"ing reflex cardiac slowing secondary to) 580 A %arotid sinus stimulation Pressure on the eyeballs B Peritoneal stimulation which may occur or during surgery C %arotid sinus stimulation< Pressure on the eyeballs D %arotid sinus stimulation< Pressure on the eyeballs< Peritoneal E stimulation which may occur or during surgery 6en'odia'epine pharmacology is most closely lin"ed to which 581 neurotransmitter system? ,oradrenergic A B 7A6A system %holinergic C 7lycine system D All of the above E 582 4herapeutic disadvantage@s of ben'odia'epines) Amestic effects A High cost B Psychologic dependencies C All of the above D Amestic effects< High cost E Pharmacological basis for prescribing ben'odia'epines for anxiety) 583 Low ris" of drug interactions based on hepatic en'yme induction A High therapeutic index B C Availability of fluma'enil @oma'icon to manage overdosage All of the above D Low ris" of drug interactions based on hepatic en'yme induction< E High therapeutic index &on channel that contains the 7A6A receptor) 584 C
+odium %alcium B %hloride C D Potassium +odium< %alcium E !ost useful in reversing symptoms of ben'odia'epine overdosage) 585 Amphetamine A 6uspirone B Iluma'enil C ,altrexone D Amphetamine< 6uspirone E A comatose patient is brought to the emergency department with 586 severe respiratory depression caused by dia'epam overdosage. easonable intervention at this point include) Administer naloxone to bloc" the drug:s effect at the receptor A Provide supportive therapy until the drug effect wears off. B Administer fluma'enil C Provide supportive therapy until the drug effect wears off < D Administer fluma'enil All of the above E Pupillary constriction) 587 A 3ia'epam 6uspirone B 4ria'olam C Iluma'enil D E 3ia'epam< 6uspiron +hort-acting ben'odia'epine 588 3ia'epam A Ilura'epam B 4ria'olam C 6uspirone D All of the above E !ay be especially effective in treating anxiety associated with 589 nicotine withdrawal) A !eprobamate %lonidine B 6oth C ,either D All of the above E A
Anxiolytic effects 3ia'epam A %lonidine B C 6oth ,either D All of the above E 6en'odia'epine most appropriate in patients with impaired hepatic 591 function) Lora'epam because of first-pass effects and because it lac"s longA acting metabolites. Jxa'epam since it has no long-acting metabolites and is con*ugated to B an inactive glucuronide directly. C 6uspirone since it has limited abuse potential All of the above D Lora'epam because of first-pass effects and because it lac"s longE acting metabolites< Jxa'epam since it has no long-acting metabolites and is con*ugated to an inactive glucuronide directly Anxiolytic drug acting through serotonin receptors) 592 3ia'epam A 6uspirone B 4ria'olam C D Phenobarbital 3ia'epam< 6uspirone E A chronic alcohol and dia'epam abuser is hospitali'ed for 593 management of withdrawal symptoms. 6uspirone# an anxiolytic# is administered to alleviate withdrawal# but the symptoms continue and worsen. Why? 6uspirone dosage too low. A 6uspirone does not exhibit cross-tolerance with sedativeB hypnoticEben'odia'epines. !anagement of alcohol or ben'odia'epine withdrawal must be C managed with a stronger drug# such as haloperidol. 6uspirone is too rapidly inactivated @first-pass effect to be useful in D managing withdrawal. E 6uspirone dosage too low< 6uspirone does not exhibit cross-tolerance with sedative-hypnoticEben'odia'epines Antianxiety drug@s 594 Propranolol A 6uspirone B 590
Phenobarbital All of the above D Propranolol< 6uspirone E 595 Pharmacology effect of Qolpidem @Ambien) Antagoni'ed by fluma'enil A !uscle relaxation B !inimal hypnotic properties C Long duration of action D Antagoni'ed by fluma'enil< !uscle relaxation E %ontraindicated in patients with a history of acute intermittent 596 porphyria) 3ia'epam A B Phenobarbital %lona'epam C 6uspirone D 3ia'epam< Phenobarbital E &ndicate the i.v. anesthetic used for induction. 597 !ethohexital A 4hiopental B 6oth C ,either D E 3ia'epam !ay be especially effective in treating anxiety associated with 598 nicotine withdrawal) !eprobamate A B %lonidine 6oth C ,either D All of the above E 4herapeutic disadvantage@s of ben'odia'epines) 599 Amestic effects A High cost B Psychologic dependencies C All of the above D E ,either i.v. anesthetic used for induction. 600 !ethohexital A 4hiopental B 6oth C C
,either All of the above E A chronic alcohol and dia'epam abuser is hospitali'ed for 601 management of withdrawal symptoms. 6uspirone# an anxiolytic# is administered to alleviate withdrawal# but the symptoms continue and worsen. Why? 6uspirone dosage too low. A 6uspirone does not exhibit cross-tolerance with sedativeB hypnoticEben'odia'epines. !anagement of alcohol or ben'odia'epine withdrawal must be C managed with a stronger drug# such as haloperidol. 6uspirone is too rapidly inactivated @first-pass effect to be useful in D managing withdrawal. All of the above E Anxiolytic effects 602 3ia'epam A %lonidine B 6oth C ,either D All of the above E %ontraindicated in patients with a history of acute intermittent 603 porphyria) 3ia'epam A Phenobarbital B %lona'epam C D 6uspirone All of the above E Qolpidem) 604 Antagoni'ed by fluma'enil A !uscle relaxation B !inimal hypnotic properties C Long duration of action D All of the above E A comatose patient is brought to the emergency department with 605 severe respiratory depression caused by dia'epam overdosage. easonable intervention at this point include) Administer naloxone to bloc" the drug:s effect at the receptor A Provide supportive therapy until the drug effect wears off. B Administer fluma'enil C D
Provide supportive therapy until the drug effect wears off < Administer fluma'enil All of the above E 606 6en'odia'epine pharmacology is most closely lin"ed to which neurotransmitter system? ,oradrenergic A 7A6A system B %holinergic C 7lycine system D All of the above E Pharmacological basis for prescribing ben'odia'epines for anxiety) 607 Low ris" of drug interactions based on hepatic en'yme induction A B High therapeutic index Availability of fluma'enil to manage overdosage C All of the above D All of the above E Antianxiety drug@s 608 Propranolol A 6uspirone B Phenobarbital C All of the above D E All of the above !ost useful in reversing symptoms of ben'odia'epine overdosage) 609 Amphetamine A 6uspirone B C Iluma'enil ,altrexone D All of the above E Anxiolytic drug acting through serotonin receptors) 610 3ia'epam A 6uspirone B 4ria'olam C Phenobarbital D All of the above E 611 Pupillary constriction) 3ia'epam A 6uspirone B 4ria'olam C Iluma'enil D D
All of the above &on channel that contains the 7A6A receptor) 612 +odium A B %alcium %hloride C Potassium D All of the above E +hort-acting ben'odia'epine 613 3ia'epam A Ilura'epam B 4ria'olam C 6uspirone D E All of the above ,euroendocrine effects of morphine 614 3ecrease in corticotropin releasing factor A 3ecrease in gonadotropin-releasing factor B 3ecrease in cortisol levels C 3ecrease in corticotropin releasing factor< 3ecrease in gonadotropinD releasing factor< 3ecrease in cortisol levels All of the above E ,arcotic agonists) most serious adverse effect) 615 A %ardiac arrhythmias espiratory depression B %onvulsions C $ndogenous depression D E All of the above Physiological effects of meperidine) 616 !iosis A %ns depressive effects due to metabolite. B ,ausea C !iosis< ,ausea D All of the above E An opioid with both agonist and antagonist properties) 617 !orphine A B !eperidine Penta'ocine C Jxycodone D All of the above E Physiological effects of morphine) 618 E
%hronic diahrrea !ydriasis B espiratory depression C D %hronic diahrrea< espiratory depression All of the above E Jpioid direct action on neurons) 619 !ay close a voltage-gated calcium channel on presynaptic nerve A terminals# resulting in reduced transmitter release 3epolari'ation of postsynaptic neurons by opening a sodium channel B 6loc"ade of sodium channels# in a manner similar to the neurotoxin# C tetrodotoxin !ay close a voltage-gated calcium channel on presynaptic nerve D terminals# resulting in reduced transmitter release< 6loc"ade of sodium channels# in a manner similar to the neurotoxin# tetrodotoxin 3epolari'ation of postsynaptic neurons by opening a sodium E channel< 6loc"ade of sodium channels# in a manner similar to the neurotoxin# tetrodotoxin Jpioid effect least li"ely to exhibit tolerance following prolonged 620 opioid administration) Analgesia A 6radycardia B C espiratory depression !iosis D $uphoria E Bery short-acting< substrate for tissue esterases 621 A !orphine Levorphanol B emifentanil C Ientanyl D ,one of the above E %rosses the blood-brain barrier most easily) 622 !orphine A %odeine B 6oth C D ,either All of the above E Anatomical sites of opioid action) pain-modulating descending 623 pathways -ostral ventral medulla A A
B C D E 624
Locus ceruleus Peria(ueductal gray ostral ventral medulla< Peria(ueductal gray ostral ventral medulla< Peria(ueductal gray< Peria(ueductal gray Jpioid R oute of Administration most li"ely associated with truncal
rigidity) Jral penta'ocine Jral propoxyphene B &ntravenous# rapidly infused# alfentanil C &ntravenous naloxone D &ntravenous naltrexone E !ost reliable indicator of opioid-mediated respiratory depression) 625 A educed patient responsiveness Alveolar P%J5 increased B 3epressed patient response to a carbon dioxide challenge C &ncreased levels of al"aline phosphatase D &ncreased levels of creatinine E Principal al"aloid in opium @derived from opium poppy 626 !orphine A Ientanyl B %odeine C D ,aloxone !eperidine E 3escriptive of the drug that may have an agonist effect at one opioid 627 receptor site and an antagonist effect at another opioid receptor site. A Iull agonist Pure antagonist B !ixed agonist-antagonist C $ndorphin D 3ynorphins E %rosses the neonatal blood-brain barrier) 628 !orphine A !eperidine B Ientanyl C D Jxycodone All of the above E !ain tissue reservoir for opioids) 629 Iat A +"eletal muscle B A
+pleen Liver D Lungs E 630 Polar glucuronide metabolite of this opioid may have higher analgesic potency then the parent compound) emifentanil A !orphine B 6oth C ,either D All of the above E $ffective antitussive@s 631 %odeine A B !orphine 3extromethorphan C oxycodone D All the above E Jpioid antagonist with shortest duration of action) 632 ,aloxone A ,almefene B ,altrexone C Al l about e(ual duration of action D E 4hese agents are not opioid antagonists +igns and symptoms of acute opioid withdrawal @abstinence 633 syndrome Yawning A B Lacrimation Hyperventilation C 3iarrhea D All the above E Physiological effect ,J4 typically associated with opioids) 634 %onstipation A %onstriction of biliary smooth muscle B $nhanced renal function C Limited direct cardiovascular effects D E !ay prolong labor %ontraindicationsEcaution for opioid use) 635 Patients with Addison:s disease A Patients with impaired pulmonary function B Patients with head in*ury C C
D
Patients with impaired pulmonary function< Patients with head
in*ury Patients with Addison:s disease< Patients with impaired pulmonary function< Patients with head in*ury seful drug@s for opioid detoxification and maintenance of chronic 636 relapsing heroin addict) !ethadone A Levomethadyl acetate B Propoxyphene C !ethadone< Levomethadyl acetate D !ethadone< Levomethadyl acetate< Propoxyphene E !ixed agonist-antagonist) 637 A ,aloxone ,altrexone B Hydromorphone C ,albuphine D 3iphenoxylate E outes of opioid agonist administration) 638 4ransdermal A Patient -controlled analgesia @P%A B &ntranasal C D 4ransdermal< Patient -controlled analgesia @P%A 4ransdermal< Patient -controlled analgesia @P%A< &ntranasal E sed in treatment diarrhea) 639 3ifenoxin A B 3iphenoxylate Loperamide C 3iphenoxylate< Loperamide D 3ifenoxin< 3iphenoxylate< Loperamide E ,eurolept analgesia) 640 Propofol A 3roperidol R fentanyl citrate B =etamine C $nflurane R hydoxy'ine D E All of the above npredictable hepatitis occurrence has been one factor that reduce the 641 use of this inhalational anesthetic) &soflurane A $nflurane B E
C D E 642 A B
Halothane 3esflurane All of the above Properties of inhalational anesthetics) !ore soluble in blood leads to more rapid induction. Anesthetic tension in the blood rises more rapidly for highly soluble
drugs. 6rain concentration of nitrous oxide rises rapidly. ate of pulmonary blood flow significantly affects time to anesthetic D e(uilibrium. All of the above E Accepted measure of anesthetic potency. 643 A Lipid solubility +peed of induction. B Presence of a Ssecond gas effectS C !inimum alveolar concentration @!A% value D All of the above E Bery brief anesthetic effects of this barbiturate is explained by Srapid 644 redistributionS) ,itrous oxide A Halothane B C 4hiopental Ientanyl D All of the above E Iastest rate of rise of arterial gas tension @as9 of inspired tension) 645 A Halothane $ther B ,itrous oxide C &soflurane D All are e(ual E Iactors determining anesthetic partial pressure in arterial blood) 646 Anesthetic concentration in the inspired air A Pulmonary ventilation B 4ransfer of gas from blood to body tissues C D Anesthetic concentration in the inspired air< 4ransfer of gas from blood to body tissues Anesthetic concentration in the inspired air< Pulmonary ventilation< E 4ransfer of gas from blood to body tissues Anesthetic solubility in the blood) 647 C
4he more soluble in age and is in the blood the less must be dissolved to raise its partial pressure &nhalational agent solubility is a relatively unimportant factor in B determining the speed of induction recovery &nduction times may be prolonged with methoxyflurane because of C its high solubility All of the above D ,either E 3epth of anesthesia primarily depends on) 648 Patient age A ate of hepatic anesthetic metabolism B Anesthetic partial pressure in brain C D ate of transfer of gas from the blood to alveoli ate of redistribution of the anesthetic from the brain to other tissues E Iactors that determine how (uic"ly anesthetics pass from the inspired 649 gas to the blood) Anesthetic solubility in the blood A Partial pressures in arterial and mixed venous blood B Pulmonary blood flow C Anesthetic solubility in the blood< Pulmonary blood flow D Anesthetic solubility in the blood< Partial pressures in arterial and E mixed venous blood< Pulmonary blood flow Pulmonary blood flow [ gas transfer from alveoli to blood 650 Pulmonary blood flow is inversely related to cardiac output A With higher pulmonary flow# there is an initial relative decrease in B the rate of rise of anesthetic tension 6oth C ,either D All of the above E Iactors affecting transport of anesthetic from arterial blood to tissues) 651 ate of delivery of anesthetic to tissue A +olubility of the gas in tissues B 3ifference impartial pressures between arterial blood and tissue C ate of delivery of anesthetic to tissue< 3ifference impartial D pressures between arterial blood and tissue ate of delivery of anesthetic to tissue< +olubility of the gas in E tissues< 3ifference impartial pressures between arterial blood and tissue +evoflurane ) 652 Low blood solubility A A
esembles desflurane in pharmacological properties Bery commonly used C Low blood solubility< Bery commonly used D E Low blood solubility< esembles desflurane in pharmacological properties.8-; A 5-D B 8-;> C \ ;> D E All of the above ,itrous oxide) 657 $ffective muscle relaxation A +hould not be used in the patient has occluded middle ear B +ignificant depression of myocardial contractility C B
+ignificant respiratory depression $ffective muscle relaxation< +hould not be used in the patient has E occluded middle ear< +ignificant depression of myocardial contractility 658 Apnea# non-reacted dilated pupils# circulatory failure# and hypertension are most li"ely associated with this stage of general anesthesia) Amnesia Eanalgesia A 3elirium B +urgical anesthesia C !edullary depression D All of the above E &soflurane @Iorane anesthesia -659 apid # smooth ad*ustment of depth of anesthesia with limited effects A on pulse or respiration $asily controlled depth of anesthesia B +ignificant renal toxicity C apid # smooth ad*ustment of depth of anesthesia with limited effects D on pulse or respiration< $asily controlled depth of anesthesia apid # smooth ad*ustment of depth of anesthesia with limited effects E on pulse or respiration< $asily controlled depth of anesthesia< +ignificant renal toxicity $nflurane @$thrane-660 A Widely used in pediatric cases !ay cause concern if patient has a sei'ure-disorder history B +"eletal muscle relaxation)inade(uate for surgery C 3ifficult ad*ustment of anesthesia depth due to significant effects on D pulse and respiration All of the above E %entral ga'e# constricted pupils# regular aspirations# and the anesthetic 661 depth is sufficient that noxious stimuli does not cause reflexes or excessive autonomic effects Analgesia Eamnesia A 3elirium B +urgical anesthesia C !edullary depression D E All of the above 3esflurane used for which tipe of anesthesia) 662 Associated with laryngospasm and coughing A elatively high solubility B 4ypically provides ade(uate muscle relaxation C D
!alignant hyperthermia may be a problem# as with enflurane @$thrane All of the above E 663 ,itrous oxide anesthesia) elativity solubility of nitrous oxide prevents rapid absorption of A significant (uantities of gas !ay be associated with diffusional hypoxia B ,itrous oxide is typically used in combination with the inducing C agent @e.g. thiopental # the s"eletal muscle relaxant# and hyperventilation !ay be associated with diffusional hypoxia< ,itrous oxide is D typically used in combination with the inducing agent @e.g. thiopental # the s"eletal muscle relaxant# and hyperventilation E elativity solubility of nitrous oxide prevents rapid absorption of significant (uantities of gas< !ay be associated with diffusional hypoxia Associated with malignant hyperthermia 664 Halothane A &soflurane B 6oth C ,either D All of the above E ,itrous oxide disadvantages 665 A ,o s"eletal muscle relaxation Wea" anesthetic B Air poc"ets in closed spaces expand C Post -anesthesia hypoxia D E All of the above &soflurane ) 666 !inimal muscle relaxation A Promotes uterine muscle contraction< desirable if uterine contraction B is re(uired to limit blood loss +timulates airway reflexes -- increasing secretions# coughing# and C laryngospasm %onvulsive activity is associated with isoflurane# similar to D enflurane E All of the above Halothane -667 sually ade(uate analgesia A Li"ely to provide ade(uate muscle relaxation B %ommonly used in adults< less li"ely to be used in children C D
eversible reduction of 7I All of the above E 7uedel:s four stages of general anesthesia) 668 A !edullary depression +urgical anesthesia B 3elirium C Analgesia Eamnesia D All of the above E &B opioids -- anesthesia) 669 Hypotension not associated opioid use A Ior certain procedures# large-dose morphine can be used to obtain B anesthesia C 6oth ,either D All of the above E &nnovar -670 Haloperidol R nitrous oxide A %hlorproma'ine R mida'olam B 3roperidol R nitrous oxide C Ientanyl R meperidine D Ientanyl R droperidol E 671 ationale for use of intravenous anesthetic agents with inhalational agents) $nhance or provide analgesia A $nable lower doses of inhalational agent to be used B C educe visceral reflex responses $nable lower doses of inhalational agent to be used< $nable lower D doses of inhalational agent to be used $nhance or provide analgesia< $nable lower doses of inhalational E agent to be used< $nable lower doses of inhalational agent to be used Antagoni'es droperidol -mediated extrapyramidal side effects 672 L-3JPA A Phentolamine B 6en'tropine C D Propranolol ,one of the above E =etamine -673 educed muscle tone A +ignificant amnesia B D
!inimal analgesia educed muscle tone< !inimal analgesia D !inimal analgesia educed muscle tone< +ignificant amnesia E 674 %omponent@s of balanced anesthesia may include) !uscle relaxants A 4hiopental B !ida'olam C !uscle relaxants< !ida'olam D !uscle relaxants< 4hiopental< !ida'olam E 3roperidol R fentanyl ) 675 ,euroleptic analgesia A 3issociative anesthesia B C 6oth ,either D All of the above E apid recovery time associated with remifentanil use) %ause -676 Iast renal excretion of unchanged drug A apid hepatic# cytochrome PD8> metabolism B $sterase -mediated inactivation C Iast renal excretion of unchanged drug< $sterase -mediated D inactivation E Iast renal excretion of unchanged drug< $sterase -mediated inactivation< apid hepatic# cytochrome PD8> metabolism 6en'odia'epines) 3ia'epam pharmacology -677 Advantage ) combination with opioids do not result in significant A cardiovascular depression %entral nervous system depression can be reversed with naltrexone B $ffective analgesic C Associated with anterograde amnesia D All of the above E 6en'odia'epines in anesthesia) may be used alone for procedures not 678 re(uiring analgesic# including 3% cardioversion A +ome radiological procedures B C $ndoscopy %ardiac catheri'ation D All the above E !ore potent then fentanyl ) 679 Alfentanil A C
+ufentanil 6oth C ,either D E All of the above %haracteristics of thiopental administration) 680 %ough # laryngospasm# bronchospasm A +ignificant post-operative excitement or vomiting B Absolute contraindications in patients with acute intermittent C porphyria or variegate porphyria %ough # laryngospasm# bronchospasm< Absolute contraindications in D patients with acute intermittent porphyria or variegate porphyria %ough # laryngospasm# bronchospasm< +ignificant post-operative E excitement or vomiting< Absolute contraindications in patients with acute intermittent porphyria or variegate porphyria 3iffusional hypoxia 681 3ilutes alveolar oxygen< may cause postoperative hypoxia A Lessened by supplemental oxygen administration B 6oth C ,either D All of the above E everses respiratory depression cause by opioids) 682 A ,aloxone ,almefene B ,altrexone C ,aloxone< ,altrexone D E ,aloxone< ,altrexone< ,almefene %ompared to morphine -- fentanyl 683 Less amnestic A more li"ely to provo"e hypotensive responses B &ncreased duration of respiratory depression C ,one of the above D All of the above E $xamples of intravenous opioids -- used in anesthesia 684 emifentanil A B Penta'ocine Alfentanil C emifentanil< Alfentanil D emifentanil< Alfentanil< Penta'ocine E $xample@s of intravenous ben'odia'epines used in anesthesia -685 B
