Old Exam Questions Flashcards
Which of the following statements about the ans is most correct?
A- it is divided into the sympathetic, parasympathetic, and adrenergic systems
B- It is under voluntary control
C- Only the sympathetic nervous system is tonically active
D- The system is composed of a two neuron unit in which two myilenated axons connect at the autonomic ganglion
E- The vagus nerve is the primary source of the autonomic sensory input from the thoracic and abdominal organs
E
Which of the following is LEAST regulated by the autonomic nervous system: A- cardiac muscle B- gastrointestinal motility C- gland secretion D- neuromuscular junction E- vascular tone
D- neuromuscular junction
Which statement about the sympathetic nervous is most correct?
A- Ach is a precursor in the synthesis of epi
B- circulating cathecolimines cross the BBB
C- Circulating catecholimines have a shorter duration of action than those released from post-ganglionic neurons
D- It includes a chain of paired paravertebral ganglia
E- it originates from the brainstem or sacral segments of the spinal chord
D
Which of the following statements about autonomic physiology is most correct?
A- Adrenergic nerves release neurotransmitters that bind dopaminergic receptors in the heart and blood vessels
B- parasympathetic nerves innervate the heart and blood vessels
C- Sympathetic nerves release neurotransmitters that bind cholinergic receptors in the renal blood vessels
D- the distribution of neurons in the cholingeric system allows a system wide mass discharge
E- the post-ganglionic neuron from the adrenal medulla releases epi at its target organs
B
Which statement about the autonomic system is most correct?
A- Muscarinic receptors are also found at the NMJ
B- Neostigmine will cause activation of muscurinic but not nicotinic receptors
C- nicotinic receptors are blocked by atropine
D- Nicotinic receptors are located in cholinergic and adrenergic ganglia
E- the primary sympathetic neurotransmitters are Ach (80%) and norepi (20%)
D
Which statement about atropine is most correct?
A- it cant cross the BBB
B- it has a longer duration of action than glyco
C- it is known to cause myosis
D- it will cause diaherrea
E- its effects mimic those of epi
E
A patient is started on an epi infusion in the ICU. Which of the following statements is most correct?
A- Epi binds equally to alpha and beta receptors
B- its action on BP will be mediated primarily by beta receptors
C- its action on alpha-2 receptors cause release of norepi
D- The infusion will cause decrease in myocardial contracility
E- this infusion will exacerbate preexisting COPD and precipitate broncospasm
A
What statement about the metabolism of an epi infusion is most accurate?
A- it is cleaved by plasma esterases
B- it is excreted unchanged in the urine
C- it is taken up by the adrenal gland
D- it undergoes hepatic metabolism
E- it undergoes re-uptake into the nerve terminal
B,C or D
Maggie says D
this was Q14 on the final
Which statement about adrenergic receptors is MOST CORRECT?
a) they can b found both in the ganglia and at the end-organ
b) alpha receptors are only located on the presynaptic membrane
c) alpha receptors can be found in smooth muscle of skin, uterus, and intestine
d) Beta 2 receptors are primarily located in the heart and peripheral vasculature
e) the Ach receptor is an example of an alpha 1 receptor
C
Which statement is most correct about patients with a heart transplant?
a) bradycardia will respond to Tx w/ glyco
b) resting HR is slower than that of a non-transplant pt
c) phenylephrine may lead to significant bradycardia
d) tachycardia will respond to tx w/ beta blockers
e) these pts should be managed w/ IV volume restriction
D
Which statement is most correct about the mechanism of action of phenylephrine:
a) acts as a vasodilator
b) inhibits reuptake of epi
c) lowers HR, causing reflex hypertension
d) mimics the action of norepi
e) stimulates the release of catecholamines
d
Which of the following comparisons is most correct:
a) dobutamine increases SBP more than epi
b) NE causes arrhythmias more than epi
c) Isoproterenol bronchodilates more than dobutamine
d) NE increases CO more than isoproterenol
e) Vasopressin causes bowel ischemia more than NE
C
Which statement is MOST CORRECT about IV ephedrine?
a) It acts as an indirect vasodilator
b) It inhibits re-uptake
c) It is a catecholamine
d) It stimulates the release of endogenous adrenergic agonists
e) Its duration of effect is similar to that of IV epi
d
A woman gets a spinal for a scheduled c/s. She then gets hTN, nausea, chest is “numb” and her hands get weak bilaterally. Which statement is MOST CORRECT about the tx for this pt?
a) give ephedrine bc it has anti-emetic properties
b) ephedrine bc it will prevent bradycardia from the high spinal
c) ephedrine bc it will prevent fetal acidosis
d) phenylephrine bc it can be used as an infusion
e) phenylephrine bc it will prevent tachycardia during the surgery
A
A pt is post-lung transplant and is doing poorly in the ICU w/inc PA pressures, tachycardia, heart failure, and systemic HTN. Which drug will increase contractility w/o inc the BP or HR?
a) dobutamine
b) dopamine
c) epi
d) Milrinone
e) NE
D
Which statement about dopamine is MOST correct?
a) at high doses it will protect the heart from arrhythmias
b) at low doses it has been shown to dec risk of renal injury
c) it can bind to all adrenergic and cholinergic receptors
d) it inc BP at lower doses - vasodilator at high doses
e) it will inc contractility but also myocardial O2 demand
This was Q 22 on the final. the answer is not B
Maggie says E
A pt w/ a Dibucaine # of 7 is about to have anesthesia for electroconvulsive therapy (ECT). The induced seizure causes sig muscle activity as well as major inc in HR and BP. The entire procedure is only 1-2 min. Which statement is most correct?
a) Esmolol must be avoided in this pt
b) Etomidate cannot be used as an induction agent
c) Labetalol is a poor choice due to its duration of action
d) Remifentanil will have a prolonged duration of action in this pt
e) Sux should be used to prevent generalized seizure activity
c
What is the best definition of bioavailability?
a) the amount of drug metabolized by the liver
b) the amt of drug that enters systemic circulation
c) the lethal dose of a drug
d) the maximum effect a drug can achieve
e) the toxic dose of a drug
b
What is the BEST definition of pharmacokinetics?
a) properties of a drug that make it medically effective
b) the way in which drugs bind and interact w/ receptors
c) process of how drug is absorbed, distrib, metab & elim by body
d) the study of the origin, nature, properties, and action of drugs and their effects on living organisms
c
Which of the statements about biotransformation is correct?
a) it is the process by which drugs become more hydrophobic
b) drugs can be excreted in the urine w/o any biotransformation
c) for most drugs, it is limited by hepatic enzyme activity
d) Phase I reactions are known as conjugation reactions
e) Phase II reactions are typically catalyzed by the CYP enzyme
B
In the two-compartment model, what process is responsible for the Beta phase decline in serum concentration after an IV bolus?
a) Bioavailability
b) Elimination
c) First-pass effect
d) Protein binding
e) Redistribution
B
Which of the following best describes first order kinetics?
a) elimination is a fixed quantity of drug per unit of time
b) looks like a straight line on a concentration v time plot
c) most drugs exhibit first-order kinetics at very high plasma [ ]
d) quantity of drug eliminated per unit of time is dependent on [ ]
e) the % of existing drug that is metabolized changes over time
d
Which drug undergoes biotransformation via plasma esterase?
a) Etomidate
b) Ketamine
c) Methohexital
d) Propofol
e) Thiopental
A
Which statement is MOST CORRECT about Ketamine?
a) binds to the alpha-2-adrenergic receptor
b) causes adrenal suppression
c) effect mediated by NMDA
d) Inappropriate for pts with severe bronchospasm
e) no significant analgesic properties
C
