LE4 Flashcards

Question

Pre-Anesthetic Medication is given A. to make the anesthetic procedure pleasant and safe B. to decrease the duration of surgery C. to maintain blood pressure D. to control the patient's comorbidity

Answer 1

A. to make the anesthetic procedure pleasant and safe. Rationale: Pre-anesthetic medication is typically administered to reduce anxiety, prevent adverse responses to the induction of anesthesia, reduce the amount of induction agent needed, and to minimize potential adverse effects of anesthesia. The goal is to make the anesthetic procedure more pleasant for the patient and safer in terms of potential complications.

Answer 2

D. Potency. Rationale: The minimal alveolar concentration (MAC) of an inhalational anesthetic represents the concentration of the anesthetic in the alveoli of the lungs at which 50% of subjects do not respond to a standard painful stimulus. It is a measure of the potency of the anesthetic agent, with a lower MAC indicating a more potent agent.

Answer 3

The answer is: **D. Ketamine** **Rationale:** Ketamine is known to induce dissociative anesthesia, a unique state in which the patient feels detached from their environment and may experience hallucinations or dream-like states. While maintaining some level of consciousness, patients often feel disconnected from their pain. This is different from the profound sedation or traditional anesthesia induced by the other agents listed.

Answer 4

D. Carbon monoxide poisoning Rationale: The symptoms described are consistent with carbon monoxide (CO) poisoning. CO binds to hemoglobin with a much greater affinity than oxygen, forming carboxyhemoglobin, which reduces the oxygen-carrying capacity of the blood. This can lead to hypoxia, presenting with symptoms like headache, vomiting, seizures, and in severe cases, coma. The treatment for CO poisoning is to administer 100% oxygen to displace the CO from hemoglobin, allowing it to bind to oxygen instead.

Answer 5

B. Highly soluble in blood Rationale: Ether is actually poorly soluble in blood, which contributes to its fast induction and recovery. The other options are accurate descriptions of ether: it's an irritant, inflammable, explosive, a potent anesthetic, and a good muscle relaxant.

Answer 6

A. Trismus B. Dilated pupils C. Visual hallucinations D. Hyperreflexia Ecstasy, commonly known as MDMA, can have various effects when consumed in toxic amounts. Let's evaluate the options: A. Trismus - **Apply** (Trismus, or jaw clenching, is commonly associated with Ecstasy use.) B. Dilated pupils - **Apply** (Dilated pupils are a known effect of Ecstasy use.) C. Visual hallucinations - **Apply** (While Ecstasy is primarily an entactogen, it can sometimes produce hallucinations.) D. Hyperreflexia - **Apply** (Hyperreflexia can be a symptom of serotonin syndrome, which can be caused by excessive amounts of MDMA.) **Rationale:** Ecstasy (MDMA) is a synthetic drug that alters mood and perception. It is chemically similar to both stimulants and hallucinogens and can produce feelings of increased energy, pleasure, and distorted sensory perceptions. In toxic amounts, it can cause a range of effects including the ones listed above. Trismus or jaw clenching is notably common with its use. The drug can also cause dilated pupils, visual hallucinations, and hyperreflexia, especially in the context of serotonin syndrome.

Answer 7

D. Nitrous oxide Rationale: Nitrous oxide (often referred to as “laughing gas”) is a general anesthetic that provides good analgesic properties but has poor muscle relaxant action compared to other anesthetics on the list.

Answer 8

A. enable lower doses of inhalational agent to be used B. enhance or provide analgesia C. reduce visceral reflex responses Rationale: Using intravenous (IV) anesthetic agents in combination with inhalational agents has several advantages: A. By using IV agents alongside inhalational agents, it’s possible to reduce the dose of the inhalational agent required to achieve the desired depth of anesthesia. This can minimize side effects and complications related to the inhalational agents. B. Some IV anesthetic agents, like opioids, can provide or enhance analgesia during surgery, which is beneficial for patient comfort and post-operative pain management. C. Combining IV and inhalational agents can help suppress unwanted physiological reflexes, such as visceral reflex responses, which might occur during surgery.

Answer 9

C. Concerning anesthetic gases -- there is a rapid equilibrium between blood and brain partial pressures Rationale: Anesthetic gases tend to have a rapid onset of action because they achieve equilibrium quickly between the blood and the brain. This property allows inhaled anesthetics to induce and reverse anesthesia efficiently. When the anesthetic is inhaled, it quickly passes from the lungs into the bloodstream and then from the blood to the brain, where it exerts its anesthetic effect. This rapid equilibrium is essential for the precise control of the depth of anesthesia during surgical procedures.

Answer 10

E. whole bowel irrigation Rationale: In cases where packets or bags of drugs (like cocaine) have been ingested, the primary concern is the rupture of a packet, which can lead to a rapid and potentially lethal absorption of the drug. Whole bowel irrigation (WBI) with polyethylene glycol electrolyte solution is recommended to enhance the passage of the packets through the gastrointestinal tract and prevent rupture. The other options listed, like gastric lavage, cathartics, activated charcoal, and ipecac, are not as effective in this specific scenario or might even be contraindicated.

Answer 11

B. typically used in combination with the inducing agent (e.g. thiopental (Pentothal) - TRUE C. the skeletal muscle relaxant, and hyperventilation - TRUE D. may be associated with diffusional hypoxia - TRUE Rationale: A. Nitrous oxide has a low blood/gas solubility coefficient, which means it's rapidly absorbed into the bloodstream and quickly eliminated from the body via the lungs. This property allows for quick onset and offset of its anesthetic effects. B. Nitrous oxide is typically used as part of a balanced anesthesia technique, combined with other agents such as inducing agents like thiopental. C. Nitrous oxide is often used in combination with skeletal muscle relaxants and can lead to increased ventilation (hyperventilation) due to its stimulatory effects on the sympathetic nervous system. D. Diffusional hypoxia can occur when nitrous oxide is discontinued, and it rapidly diffuses out of the bloodstream into the alveoli, diluting the oxygen content and leading to a reduced partial pressure of oxygen in the alveoli. This is why it's important to provide patients with 100% oxygen for a few minutes after discontinuing nitrous oxide to prevent this phenomenon.

Answer 12

A. anesthetic potency is determined based on alveolar gas concentration. Rationale: Anesthetic potency is typically quantified using the minimum alveolar concentration (MAC), which represents the concentration of an anesthetic agent in the alveoli of the lungs at which 50% of subjects do not respond to a standard painful stimulus. The MAC is a standard measure used for volatile anesthetics, and it provides an estimate of the concentration needed to achieve a clinical effect. While the brain is the target organ for anesthetics, it is currently not practical to measure brain anesthetic concentrations directly in routine clinical practice. Instead, the alveolar gas concentration serves as a surrogate marker because it closely reflects the partial pressure of the anesthetic in the brain.

Answer 13

B. Halothane Rationale: Malignant hyperthermia is a potentially life-threatening reaction that can be triggered by certain anesthetic agents. Halothane, a volatile inhalation anesthetic, is one of the agents known to be associated with a risk of inducing malignant hyperthermia in susceptible individuals.

Answer 14

B. Marijuana. Rationale: Marijuana (also known as cannabis) is derived from the hemp plant Cannabis sativa. It contains the psychoactive compound THC (tetrahydrocannabinol) among other cannabinoids. Opium is derived from the opium poppy, MDMA is a synthetic drug, and Crack is a form of cocaine.

Answer 15

A. Blood-gas solubility coefficient

Answer 16

A. Impairment in attention and memory B. Uncoordinated motor movements C. Slurred speech Rationale: Barbiturates and benzodiazepines are central nervous system depressants. When taken in excessive amounts, they can lead to sedative intoxication. Symptoms of this intoxication can include cognitive impairments such as difficulty with attention and memory. Additionally, physical symptoms can arise such as uncoordinated motor movements (ataxia) and slurred speech. These symptoms arise because these drugs depress the activity of the brain, slowing down both mental and physical processes.

Answer 17

E. Hydroxycobalamin Answer: E. Hydroxycobalamin Rationale: Toxic alcohol poisoning refers to poisoning from substances such as methanol, ethylene glycol, and isopropanol. The treatment options for these poisonings include: A. Fomepizole - an alcohol dehydrogenase inhibitor, used as an antidote primarily for ethylene glycol and methanol poisoning. B. Folic acid - given as an antidote for methanol poisoning to enhance the metabolism of formic acid, the toxic metabolite of methanol. C. Thiamine - given as an adjunct to treat or prevent Wernicke's encephalopathy in those with ethylene glycol poisoning. D. Pyridoxine - used as an antidote for isoniazid overdose, not specifically for toxic alcohol poisoning, but it's more relevant to this context than hydroxycobalamin. E. Hydroxycobalamin - used as an antidote for cyanide poisoning, not toxic alcohol poisoning.

Answer 18

Answer: A. False Rationale: The blood:gas partition coefficient is a measure of how soluble an anesthetic gas is in the blood relative to the alveolar air (lungs). A higher blood:gas partition coefficient indicates that the gas is more soluble in the blood compared to the lungs. Thus, a higher value means the gas has a greater affinity for the blood.

Answer 19

Answer: A. Releasing dopamine in the mesolimbic system of the brain Rationale: Nicotine primarily exerts its effects by binding to nicotinic acetylcholine receptors (nAChRs). When these receptors are activated, they increase the release of various neurotransmitters. One of the most notable effects of nicotine is the release of dopamine in the mesolimbic system (often referred to as the brain's reward pathway). This dopamine release contributes to the pleasurable and reinforcing properties of nicotine, which can lead to addiction.

Answer 20

C. surgical anesthesia Rationale: The description provided aligns with the stage of surgical anesthesia. During this stage, the patient exhibits central gaze, constricted pupils, and regular respiration. The depth of anesthesia is sufficient so that noxious stimuli, like surgical incisions, do not cause unwanted reflex responses or produce excessive autonomic effects. At this stage, surgeries can be performed without causing pain or distress to the patient.

Answer 21

Answer: A. CNS symptoms, such as ataxia and peripheral neuropathy Rationale: Thiamin (Vitamin B1) deficiency is commonly seen in chronic alcohol abusers. The central nervous system (CNS) is particularly affected by thiamin deficiency, leading to conditions like Wernicke's encephalopathy, which presents with symptoms such as ataxia (unsteady gait), ophthalmoplegia (eye muscle paralysis), and confusion. If not treated, it can progress to Korsakoff's psychosis, which is characterized by memory loss and confabulation. Additionally, thiamin deficiency can result in peripheral neuropathy.

Answer 22

B. True Rationale: The blood:gas partition coefficient is a measure of an anesthetic's solubility in the blood relative to its solubility in alveolar gas (lungs). An anesthetic with a lower blood:gas partition coefficient has less solubility in the blood, which means that it equilibrates faster between the lungs and the blood. As a result, its onset of action (induction) and offset (recovery) are quicker. Nitrous oxide has a low blood:gas partition coefficient, making it a rapidly acting inhalational anesthetic agent.

Answer 23

Answer: A. Inhibition of acetylcholinesterase through phosphorylation of the esteratic site Rationale: Organophosphates exert their toxic effects primarily through the inhibition of acetylcholinesterase. This enzyme is responsible for breaking down the neurotransmitter acetylcholine in the synapses. When acetylcholinesterase is inhibited by organophosphates, acetylcholine accumulates, leading to prolonged stimulation of cholinergic receptors. This results in the characteristic symptoms of organophosphate poisoning, which include excessive salivation, lacrimation, urination, defecation, gastrointestinal cramps, and emesis (often referred to by the acronym SLUDGE). It can also affect the respiratory and cardiovascular systems, potentially leading to respiratory failure and death.

Answer 24

C. Nitric oxide toxicity Rationale: Nitric oxide (NO) is used as a pulmonary vasodilator, especially in cases of persistent pulmonary hypertension in newborns. However, prolonged exposure or high concentrations can lead to nitric oxide toxicity. This can result in methemoglobinemia, where the iron in hemoglobin is oxidized, reducing its oxygen-carrying capacity. One of the side effects of NO inhalation is also airway inflammation and bronchospasm. In cases of nitric oxide toxicity, treatment includes discontinuing NO, administering humidified O2 to help with mucosal dryness, and using bronchodilators to reverse bronchospasm.

Answer 25

B. Partial Agonist Rationale: A partial agonist binds to and activates a receptor, but only produces a partial response compared to a full agonist.

Answer 26

D. Nucleus Accumbens Rationale: The nucleus accumbens is a key component of the brain's reward circuitry and plays a central role in the reinforcement and reward system.

Answer 27

D. Nucleus Accumbens Rationale: The nucleus accumbens, often referred to as the "pleasure center" of the brain, is associated with feelings of reward and pleasure.

Answer 28

A. Clozapine Rationale: Clozapine is often considered the gold standard for treatment-resistant schizophrenia due to its superior efficacy.

Answer 29

**D. Asenapine** **Rationale:** Asenapine is an atypical antipsychotic with a unique receptor profile. In addition to its norepinephrine reuptake inhibition, it has actions on multiple serotonin receptors (5HT7, 5HT2C, 5HT1A) and antagonism at the alpha-2 receptor. This diverse pharmacological profile not only contributes to its antipsychotic effects but also to its potential antidepressant effects. This makes it different from the other choices, which have varying receptor profiles but not the combination described in the question.

Answer 30

B. Risperidone Rationale: Risperidone is approved for the treatment of schizophrenia in adolescents and for the short-term treatment of manic or mixed episodes of bipolar I disorder in children and adolescents.

Answer 31

C. Amisulpride Rationale: Amisulpride is an atypical antipsychotic that was developed in Europe and is known for its effectiveness in treating the negative symptoms of schizophrenia.

Answer 32

C. insomnia Rationale: Among patients with major depressive disorder who do not achieve full remission, insomnia is one of the most commonly reported residual symptoms.

Answer 33

A. SSRI, NRI, 5HT2C antagonist Rationale: Fluoxetine is primarily an SSRI. It does not have significant NRI or 5HT2C antagonist properties.

Answer 34

D. Sertraline Rationale: Sertraline has dopamine reuptake inhibition properties, especially at higher doses, in addition to its primary action as an SSRI.

Answer 35

B. Paroxetine Rationale: Paroxetine has mild anticholinergic effects and can also inhibit norepinephrine reuptake at higher doses.

Answer 36

B. Paroxetine Rationale: Paroxetine is known to be a potent inhibitor of the CYP2D6 enzyme.

Answer 37

The answer is: **C. Fluvoxamine** **Rationale:** Fluvoxamine, an SSRI, has been shown to have significant binding affinity for the Sigma-1 receptor. The Sigma-1 receptor has been implicated in several neuropsychiatric conditions, and drugs that interact with it may have potential in treating conditions like psychotic or delusional depression. While all the options are SSRIs, fluvoxamine is particularly noted for its Sigma-1 binding property.

Answer 38

B. Paroxetine Rationale: Paroxetine has antihistaminic properties, which can lead to sedation, making it potentially useful for elderly patients with insomnia.

Answer 39

D. Venlafaxine Rationale: Venlafaxine acts primarily as a serotonin reuptake inhibitor at lower doses and also inhibits norepinephrine reuptake at higher doses.

Answer 40

The answer is: **D. Venlafaxine** **Rationale:** Venlafaxine, a Serotonin-Norepinephrine Reuptake Inhibitor (SNRI), has been shown to be effective in reducing vasomotor symptoms, such as hot flashes, in perimenopausal women. While other SNRIs might also provide some relief, venlafaxine has been specifically studied and used for this indication.

Answer 41

B. Duloxetine Rationale: Duloxetine has been shown to have benefits in addressing cognitive symptoms in geriatric patients with depression.

Answer 42

Answer: B. Radafaxine Rationale: Bupropion is metabolized in the liver, and one of its primary active metabolites is hydroxybupropion, also known as radafaxine. This metabolite contributes to the therapeutic effects of bupropion and has a similar pharmacological profile. NAPQI is a toxic metabolite of acetaminophen, ODV is the active metabolite of venlafaxine, and imipramine is a tricyclic antidepressant itself and not a metabolite of bupropion.

Answer 43

A. blocks alpha 2 receptor Rationale: Mirtazapine is known to block alpha-2 adrenergic receptors, which results in increased release of norepinephrine and serotonin. Additionally, Mirtazapine is also an antagonist at the serotonin 5-HT2 and 5-HT3 receptors and has strong antihistamine activity, leading to its sedative properties. However, it does not act as an H1 receptor agonist; rather, it is an H1 antagonist. The option "potent antagonist of 5HT2A" is also correct, but based on the provided choices, "blocks alpha 2 receptor" is the most characteristic action of Mirtazapine.

Answer 44

61. Acts like 2 different drugs at different doses: Answer: Trazodone Rationale: At lower doses, Trazodone acts primarily as a serotonin antagonist and has sedative effects, making it useful as a sleep aid. At higher doses, it inhibits serotonin reuptake and acts as an antidepressant. 62. SARI that causes liver toxicity (Heptotoxicity): Answer: Nefazodone Rationale: Nefazodone has been associated with rare but serious cases of liver toxicity, leading to its decreased usage. 63. multifunctional neurotransmitter antagonist: Answer: Trazodone Rationale: Trazodone antagonizes several receptors, including serotonin 5-HT2A/C and alpha-1 adrenergic receptors. 64. hypnotic: Answer: Trazodone Rationale: Due to its sedative properties at lower doses, Trazodone is often prescribed off-label as a sleep aid or hypnotic.

Answer 45

BOTH: (Breakdown Substrate) -Dopamine -Tyramine (Tissue Distribution) -Brain MOA-A (Breakdown Substrate) -5-HT -NE (Tissue Distribution) -Gut -Liver -Placenta -Skin MOA-B (Breakdown Substrate) -Phenylethylamine (Tissue Distribution) -Platelets -Lymphocyte

Answer 46

1. Treatment of Mania - A. Lithium 2. Prophylactic and acute mania - B. Valproate 3. for Bipolar depression - C. Lamotrigine 4. blocks voltage sensitive sodium and calcium channels - D. Carbamazepine Treatment of Mania: • Lithium is the first line of treatment for acute episodes of mania and hypomania. Prophylactic and acute mania: • Lithium is the first psychotropic agent used as a mood stabilizer and can prevent episodes of depression in patients with bipolar disorder. • Valproic Acid (Valproate) is also a first-line treatment for bipolar disorders and can be combined with lithium for refractory cases, rapid cycling, and mixed episodes. For Bipolar depression: • Lamotrigine appears effective in reducing the frequency of recurrent depressive cycles and is approved as a maintenance treatment for bipolar disorder. Blocks voltage-sensitive sodium and calcium channels: • Carbamazepine enhances GABA function, potentially in part through actions on sodium and/or potassium channels.

Answer 47

Amphetamine: B. Reversible inhibitor: Amphetamine is not primarily an MAOi, but it can reversibly inhibit monoamine oxidase, which can contribute to its stimulant effects by increasing the levels of neurotransmitters like dopamine. Phenelzine, Tranycypromine, Isocarboxazid: A. Irreversible enzyme inhibitor: These are classic MAOis that irreversibly inhibit the monoamine oxidase enzyme. This means that once the enzyme is inhibited, it cannot function again, and the body must produce new enzymes. This irreversible action is why dietary and drug restrictions are crucial when taking these medications, as they can lead to hypertensive crises when combined with tyramine-rich foods or certain medications.

Answer 48

D. Glutamate. Glutamate is the primary excitatory neurotransmitter in the CNS. When glutamate binds to its receptors, it often results in the opening of ion channels that allow positively charged ions (like sodium and calcium) to enter the neuron, leading to depolarization and an EPSP.

Answer 49

C. Carbamazepine. Carbamazepine primarily acts by stabilizing the inactivated state of voltage-gated sodium channels, inhibiting repetitive neuronal firing.

Answer 50

C. Converted to active metabolites by hepatic enzymes Rationale: While many sedative-hypnotic drugs are water-soluble, well absorbed in the gastrointestinal (GI) tract, and metabolized rapidly by liver enzymes, not all of them are converted to active metabolites by hepatic enzymes. Some sedative-hypnotics are metabolized to inactive compounds. The presence of active metabolites can prolong the effects of the drug, which isn't always the case with all sedative-hypnotic drugs.

Answer 51

A. Flumazenil. Flumazenil is a benzodiazepine antagonist and is used to reverse the effects of benzodiazepine overdose.

Answer 52

B. Dopamine. The described symptoms are characteristic of Parkinson's disease, which is primarily caused by a deficiency of dopamine in the basal ganglia.

Answer 53

C. Glycine. Glycine is a primary inhibitory neurotransmitter in the spinal cord and brainstem.

Answer 54

The answer is: **A. Gabapentin** **Rationale:** Gabapentin is primarily excreted unchanged in the urine and is not metabolized by hepatic enzymes to a significant extent. In contrast, Valproic Acid, Phenytoin, and Carbamazepine are all metabolized by the liver.

Answer 55

D. Phenytoin. Phenytoin exhibits saturable (non-linear) metabolism, meaning that as the dose increases, the proportion metabolized decreases, leading to disproportionately higher blood levels.

Answer 56

Lamotrigine: B. Sodium channel blocker: Lamotrigine primarily acts by stabilizing the inactivated state of voltage-gated sodium channels, thereby inhibiting repetitive firing of action potentials. Phenobarbital: D. Enhances GABA activity: Phenobarbital is a barbiturate that enhances the inhibitory effects of GABA, the primary inhibitory neurotransmitter in the CNS. Pregabalin: A. Calcium channel blocker: Pregabalin binds to the alpha2-delta subunit of voltage-gated calcium channels, reducing the release of excitatory neurotransmitters. Carbamazepine: B. Sodium channel blocker: Carbamazepine acts by stabilizing the inactivated state of voltage-sensitive sodium channels, thereby inhibiting repetitive firing of action potentials. Levetiracetam: C. SV2A receptor antagonist: Levetiracetam's exact mechanism of action is not fully understood, but it is known to bind to the synaptic vesicle protein SV2A, which may contribute to its anti-seizure properties.

Answer 57

D. Valproic Acid. Valproic Acid (also known as valproate) is a commonly prescribed drug for absence seizures. Ethosuximide is also a drug of choice for absence seizures, but it's not one of the options provided.

Answer 58

C. Ethosuximide. Ethosuximide is an older, first-generation anti-seizure medication primarily used for absence seizures. The other options listed are newer or third-generation anti-seizure medications. 1st Generation (Traditional) AEDs: 1. Phenytoin (Dilantin): Used for partial and tonic-clonic seizures. 2. Carbamazepine (Tegretol): Used for partial and tonic-clonic seizures. 3. Valproic acid/Valproate (Depakote): Broad-spectrum, used for various seizure types including absence, tonic-clonic, and partial seizures. 4. Ethosuximide (Zarontin): Specifically for absence seizures. 2nd Generation AEDs: 1. Gabapentin (Neurontin): Used for partial seizures. 2. Lamotrigine (Lamictal): Broad-spectrum, used for various seizure types including partial, tonic-clonic, and absence. 3. Topiramate (Topamax): Broad-spectrum, used for various seizure types. 4. Levetiracetam (Keppra): Broad-spectrum, used for various seizure types. 3rd Generation AEDs: 1. Lacosamide (Vimpat): Used for partial-onset seizures. 2. Perampanel (Fycompa): Used for partial and tonic-clonic seizures. 3. Ezogabine/Retigabine (Potiga): Used for partial-onset seizures. 4. Rufinamide (Banzel): Used for Lennox-Gastaut syndrome.

Answer 59

Most teratogenic (i.e., neural tube defects): Answer: B. Valproic Acid. Valproic acid is known to be teratogenic and can increase the risk of neural tube defects when taken during pregnancy. Stevens-Johnson syndrome especially for those with HLA 1502 allele: Answer: E. Carbamazepine. Individuals with the HLA-B*1502 allele are at an increased risk for Stevens-Johnson syndrome and toxic epidermal necrolysis when treated with carbamazepine. Gingival hyperplasia: Answer: C. Phenytoin. Gingival hyperplasia (overgrowth of the gums) is a known side effect of phenytoin. Weight loss: Answer: D. Topiramate. Topiramate can cause weight loss as a side effect. Dyskinesia: Answer: A. Levodopa. Dyskinesias are a common side effect of levodopa, especially with long-term use in Parkinson's disease treatment.

Answer 60

Answer: B. Clozapine Rationale: Clozapine is an atypical antipsychotic that is particularly effective for treatment-resistant schizophrenia. It is often considered for patients who do not respond adequately to standard antipsychotic treatments. Clozapine has been shown to be effective in reducing both positive symptoms (like paranoid delusions) and negative symptoms of schizophrenia. However, its use is limited due to potential side effects, including agranulocytosis (a significant decrease in white blood cells), which requires regular blood monitoring.

Answer 61

B. Acute dystonia: Benztropine Rationale: The symptoms described are consistent with acute dystonia, which is an extrapyramidal side effect that can be seen after administration of antipsychotic medications like Fluphenazine. Acute dystonia involves sudden, often painful, muscle spasms commonly affecting the neck ("torticollis"), eyes ("oculogyric crisis"), and other parts of the body. Treatment for acute dystonia includes anticholinergic agents like benztropine (Cogentin) or antihistamines like diphenhydramine (Benadryl). Both of these medications can provide rapid relief from the symptoms. So, options B and C would both be appropriate treatments. However, since the question is asking for a singular answer, option B is the best choice.

Answer 62

Answer: D. Haloperidol Rationale: Among the options provided, Haloperidol is the antipsychotic with the least anticholinergic effects. Anticholinergic effects can exacerbate conditions like prostatic hypertrophy and chronic constipation. Clozapine, Thioridazine, and Chlorpromazine have more pronounced anticholinergic properties, making them less suitable for elderly patients with these specific conditions. Haloperidol, being a typical antipsychotic with fewer anticholinergic side effects, would be a more appropriate choice in this context.

Answer 63

Answer: B. 2 meq/L Rationale: The therapeutic range for lithium (used primarily for bipolar disorder) is typically between 0.6 to 1.2 meq/L, although some sources might mention up to 1.5 meq/L for acute mania. Levels above 1.5 meq/L are considered to be potentially toxic, with the risk of toxicity increasing as levels rise. Levels at or above 2 meq/L are commonly associated with increased signs and symptoms of lithium toxicity. However, clinical signs of toxicity can vary among individuals, and some might experience symptoms even at lower levels. It's essential to monitor lithium levels and adjust the dosage accordingly.

Answer 64

A. Convulsion, Coma, Cardiotoxicity

Answer 65

B. Fluoxetine Rationale: Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) that is commonly used as a first-line treatment for major depressive disorder. Additionally, it has FDA indications for obsessive-compulsive disorder (OCD), panic disorder, bulimia nervosa, and premenstrual dysphoric disorder (PMDD). It is also used off-label for anxiety, phobias, post-traumatic stress disorder (PTSD), and alcohol dependence.

Answer 66

C. Serotonin Syndrome

Answer 67

Answer: C. Bupropion Rationale: Priapism is a prolonged and often painful erection not related to sexual arousal. Among the options provided: A. Trazodone, an antidepressant, is known to be associated with priapism as a rare side effect. B. Sildenafil, a PDE5 inhibitor used for treating erectile dysfunction, can cause priapism in situations where the erection becomes prolonged. D. Imipramine, a tricyclic antidepressant, has priapism as a rare but documented side effect. C. Bupropion, an atypical antidepressant primarily used for depression and smoking cessation, is not commonly associated with priapism.

Answer 68

A. Ultra- short acting: Thiopental

Answer 69

Answer: C. Clozapine Rationale: Clozapine is an atypical antipsychotic that has a high affinity for the 5HT2 (serotonin) receptor. Atypical antipsychotics, in general, often have significant serotonergic activity, which differentiates them from the older typical antipsychotics like haloperidol. This serotonergic activity is thought to contribute to their efficacy, especially in treating negative symptoms of schizophrenia, and might also be associated with a lower risk of extrapyramidal side effects compared to typical antipsychotics.