2nd ASSESSMENT

Question 1

Effects of Methylxanthines:
• Calming effect
• Convulsions
• Tremor
• Increase gastric acidity
• Bradycardia

Answer 1

Calming effect
• Tremor
• Increase gastric acidity

Question 2

A 36-year-old male seeks medical advice on what medication to take for his allergic rhinitis. His concern with treatment is that he often feels drowsy, thus affecting his work during daytime. Which of the following antihistamines would you avoid because of greater sedative effects?

Answer 2

Diphenhydramine

Question 3

Which is not a proposed mechanism of action of theophylline?
• Increases intracellular concentration of cAMP
• Inhibits several members of the phosphodiesterase (PDE) enzyme family
• Inhibits cell surface receptors for adenosine
• Stimulates adenylyl cyclase

Answer 3

Stimulates adenylyl cyclase

Question 4

Several adults at a weekend drinking session were hospitalized with symptoms thought to be due to ingestion of canned food containing botulinum toxin. Which one of the following signs or symptoms is consistent with the diagnosis of botulinum poisoning?

Answer 4

cycloplegia

Question 5

Parathion is an insecticide ingredient that activates the parasympathetic nervous system (cholinomimetic).
Intentional ingestion of a significant enough volume is likely to produce which of the following effects?
• Bronchodilation
• decreased pupillary constrictor tone (mydriasis)
• Increased intestinal motility
• increased heart rate (tachycardia)

Answer 5

Increased intestinal motility

Question 6

When using dry powder inhalers, patients should exhale before they actuate the inhaler, and then begin to inhale slowly as they press the canister and continue inhaling slowly and deeply throughout actuation.

Answer 6

False

Question 7

The baroreceptor reflex is an example of what kind of integration of the autonomic nervous system?

Answer 7

systemic integration

Question 8

Neostigmine is an acetylcholinesterase inhibitor. Which of the following symptoms would result from an overdose of neostigmine?

Answer 8

Increased pupillary constrictor tone (miosis)

Question 9

Atropine is commonly used as an adjunct drug in anesthesia. It blocks muscarinic receptors in effector organs. Which would be an expected effect from administration of this drug?

Answer 9

mydriasis

Question 10

Its preganglionic motor fibers originate in cranial nerve nuclei III, VII, IX, and X and in sacral segments (usually S2–S4) of the spinal cord.

Answer 10

Parasympathetic fibers of the autonomic nervous system

Question 11

Stimulation of lipolysis is mediated by which ANS receptors?

Answer 11

Beta 3 receptors

Question 12

Which is a non-adrenergic non cholinergic substance (NANC) that causes blood vessel dilatation?
• adenosine triphosphate (ATP)
• peptides
• nitric oxide
• substance P

Answer 12

nitric oxide

Question 13

Mechanism of action of tetrodotoxin poisoning from the puffer fish.

Answer 13

Block action potential propagation

Question 14

Activation of M2 receptors in the heart will lead to opening of potassium channels and inhibition of adenylyl cyclase. Which statement is correct?
• decreased parasympathetic effect on the heart
• Increased contractility of heart muscles
• Increased ectopic discharge
• Deceleration of heart rate

Answer 14

Deceleration of heart rate

Question 15

Mechanism of cocaine and tricyclic antidepressants on the autonomic nervous system.

Answer 15

Inhibit transmitter uptake at adrenergic nerve terminals

Question 16

Compared to asthma, COPD is associated with neutrophilic rather than eosinophilic inflammation, and is poorly responsive even to high-dose ICS therapy.

Answer 16

TRUE

Question 17

A four-year-old female child has swallowed 60 ml of a colds and cough medicine that contains phenylephrine, a potent, selective -adrenoceptor agonist drug. Which is a sign of -1 receptor activation?

Answer 17

Pupillary dilation (mydriasis)

Question 18

Which one of the following is the primary neurotransmitter agent normally released in the sinoatrial node of the heart in response to a blood pressure decrease?

Answer 18

Norepinephrine

Question 19

Mr. Reyes is a 60-year-old man who is taking hydralazine for treatment of his hypertension. He has not been taking his other medications for chronic hypertension. Which of the following effects will be observed?
• Decreased mean arterial pressure and decreased cardiac contractility
• Tachycardia and decreased cardiac output
• No change in mean arterial pressure and decreased cardiac contractility
• Tachycardia and increased cardiac contractility

Answer 19

Tachycardia and increased cardiac contractility

Question 20

Propanolol is a non-selective blocker of beta 1 and beta 2 receptors. Which side effect should be monitored when administered to an asthmatic patient with thyroid storm?

Answer 20

bronchoconstriction

Question 21

Primary transmitter at ANS ganglia, at the somatic neuromuscular junction, and at parasympathetic postganglionic nerve endings.

Answer 21

Acetylcholine

Question 22

You prescribed intranasal phenylephrine to a patient with allergic rhinitis complaining of watery rhinorrhea and nasal congestion. How long would you recommend that the patient use this drug and why?

Answer 22

For only 3 days to avoid the risk of rebound nasal congestion

Question 23

You wake up at 3 am in your dark room and turn on your study lamp. Your eyes adjust to the sudden brightness. Which receptors are involved with this reaction?

Answer 23

M2 muscarinic receptors

Question 24

The most important anti-inflammatory drugs in the treatment of chronic asthma are:

Answer 24

Corticosteroids

Question 25

Which of the following sites does NOT contain nicotinic receptors?
• sympathetic ganglia
• parasympathetic ganglia
• bronchial smooth muscle
• skeletal muscle end plates

Answer 25

bronchial smooth muscle

Question 26

A 7-year-old girl recently diagnosed with intermittent asthma started treatment with inhaled albuterol "as needed". Which of the following adverse effects was most likely to occur during the therapy?
• Nervousness or restlessness
• Sleepiness
• Atrioventricular block
• Postural hypotension

Answer 26

Nervousness or restlessness

Question 27

These 3 groups of drugs are used to treat acute bronchospasm in asthma:

Answer 27

Beta2 agonists, muscarinic antagonists, and theophylline

Question 28

A 9-year old girl who is a known asthmatic was brought to the emergency room early in the morning due to nonproductive cough and worsening dyspnea. Her mother states her current asthma attack is poorly relieved
by her usual inhaler. Upon physical examination, her respiratory rate is 36 breaths/min, O2 saturation 88%, and there is expiratory wheezing on auscultation. Which intervention/s is/are most appropriate for this patient?

Answer 28

Give oxygen, frequent aerosolized albuterol, and prednisone