MCQ's: CVS 2 Flashcards
The following are recognised complications of amiodarone:
T/F
A. Peripheral neuropathy B. Prolngation of the Q-T interval C. Hyperthyroidism D. Reversible restrictive lung defect E. Optic atrophy
Peripheral neuropathy, prolongation of QT, and reversible restrictive lung disease (pulmonary fibrosis)
In eyes it causes corneal deposits.
Hypothyroidism, and hyperthyroidism.
The following Beta-blockers are metabolised predominantly by the liver:
Select true or false for each of the following statements.
A. Labetolol B. Propranolol C. Atenolol D. Metoprolol E. Sotalol
Atenolol and Sotalol are water soluble and excreted from the kidneys. Sotalol, Atenolol minimally unchanged.
All others are metabolised by the liver.
Labetolol:
Select true or false.
A. Acts on alpha and beta receptors with higher affinity for alpha-receptors
B. May cause retrograde ejaculation by its beta-blocking action
C. Has significant intrinsic sympathomimetic activity (ISA)
D. Causes significant postural hypotension
E. Is contraindicated in pregnancy
A. False. It has more affinity for beta receptors: beta:alpha 3:1 following oral ingestion and 7:1 after IV administration.
B. False. This can occur secondary to its alpha action.
C. True. It does have significant ISA.
D. True.
E. False. It is one of the drugs used in pre-eclampsia.
The following are natural precursors of adrenaline: T/F
A. Aspartate B. Glycine C. Glutamine D. Dihydroxyphenylalanine E. Dobutamine
Dihydrophenylalanine
Dopamine as well
Dopexamine hydrochloride:
A. Has significant alpha-adrenoceptor activity at higher doses
B. Acts mainly at beta-1 receptors to produce an increased cardiac output
C. Acts mainly at alpha-1 receptors to produce an increased cardiac output
D. Requires use of a loading dose
E. Improves renal blood flow at the expense of splanchnic blood flow
A. False. Dopexamine is an analogue of dopamine.
B. False. It acts mainly at beta-2 and DA-1/DA-2 receptors. It has no alpha activity. It also inhibits uptake-1.
C. False.
D. False. - short half life
E. False. It is a weak positive inotrope but powerful splanchnic vasodilator reducing afterload.
Hyoscine:
A. Is a less potent anti-sialagogue than atropine
B. Does not cross the blood-brain barrier
C. Is largely excreted unchanged in the urine
D. Is an effective anti-emetic which can be delivered transdermally
E. May produce excitement and restlessness
A. False. It is a more potent anti-sialagogue than atropine.
B. False. It has central and peripheral effects, which include sedative, anti-emetic and anti-sialogogue actions.
C. False. Only 1% is excreted unchanged.
D. True.
E. True. Through paradoxical central stimulation.
Isoprenaline:
A. Has alpha and beta adrenergic activity
B. Increases peripheral vascular resistance
C. Is a naturally occurring catecholamine
D. May decrease mean arterial pressure
E. It’s effects are mediated via adenylate cyclase
A. False. It acts on beta-1 and beta-2 receptors only.
B. False. It causes a fall in peripheral vascular resistance via it’s beta-2 effets.
C. False. Isoprenaline is a synthetic catecholamine.
D. True.
E. True.
Hydralazine:
A. Dilates arterioles and veins equally
B. It’s first pass metabolism is dependent on the acetylator status of the patient.
C. Increases cerebral blood flow
D. May cause a lupus-like syndrome
E. Is contraindicated in pre-eclampsia
A. False. Hydralazine is predominantly an arteriolar dilator.
B. True.
C. True.
D. True. After chronic usage. Peripheral neuropathies and blood dyscrasias have also been reported.
E. False.
Nitric oxide (NO):
A. Is synthesised exclusively by vascular endothelium
B. Is synthesised from L-asparagine
C. Is produced by the lung
D. Binds to haemoglobin with an affinity equal to that of carbon monoxide (CO)
E. Ultimately is metabolised to nitrate which is excreted by the kidneys
A. False. Nitric oxide is also produced by macrophages and thrombocytes.
B. False. It is synthesised from L-arginine.
C. True.
D. False. The haemoglobin molecule has an affinity 1500 times higher to NO than to CO. Nitrosyl haemoglobin is produced, which in the presence of oxygen, is oxidised to methaemoglobin.
E. True.
The following drugs exhibit tachyphylaxis:
A. Glyceryl trinitrate
B. Ephedrine
C. Suxemethonium
D. Trimetaphan
E. Hydralazine
GTN, EPHEDRINE, TRIMETAPHAN
