NBR 2 - Clinical Skills/Critical Care Flashcards
1
Q
For questions 1 to 6, match the anesthetic agent with the description. Each response may be used once, more than once, or not at all. A. enflurane B. etomidate C. halothane . D. isoflurane E. ketamine F. thiopental 1. increases cerebral blood flow (CBF) and cerebral metabolic rate of oxygen consumption (CRM02)
A
Jawab : E
2
Q
For questions 1 to 6, match the anesthetic agent with the description. Each response may be used once, more than once, or not at all. A. enflurane B. etomidate C. halothane . D. isoflurane E. ketamine F. thiopental 2. Of the volatile anesthetics, it increases CBF the least.
A
Jawab : D
3
Q
For questions 1 to 6, match the anesthetic agent with the description. Each response may be used once, more than once, or not at all. A. enflurane B. etomidate C. halothane . D. isoflurane E. ketamine F. thiopental 3. induces seizure discharges
A
Jawab : A
4
Q
For questions 1 to 6, match the anesthetic agent with the description. Each response may be used once, more than once, or not at all. A. enflurane B. etomidate C. halothane . D. isoflurane E. ketamine F. thiopental 4. dissociative anesthetic
A
Jawab : E
5
Q
For questions 1 to 6, match the anesthetic agent with the description. Each response may be used once, more than once, or not at all. A. enflurane B. etomidate C. halothane . D. isoflurane E. ketamine F. thiopental 5. decreases CBF and CRM02 and produces cardiovascular depression
A
Jawab : F
6
Q
For questions 1 to 6, match the anesthetic agent with the description. Each response may be used once, more than once, or not at all. A. enflurane B. etomidate C. halothane . D. isoflurane E. ketamine F. thiopental 6. decreases CBF and CRM02 and suppresses adrenocortical response to stress
A
Jawab : B
7
Q
7. Which antiemetic medication lowers seizure threshold A. Phenergan B. droperidol C. Tigan D. Zofran E. Reglan
A
Jawab : A
8
Q
8. The most appropriate drug to administer to a stable patient with a narrow complex upraventricular tachycardia (no serious signs or symptoms) after vagal stimulation is A. adenosine B. figoxin C. procainamide D. quinidine E. verapamil
A
Jawab : A
Adenosineatan initial doseof6mg over 1 to 3 seconds, followed by a repeat of 12 mg in 1 to 2 minutes prn, is the initial drug of choice. If lidocaine is ineffective,procainamide at a dose of20to30mglmin for a maximum of 17mglkg is given.
9
Q
- Each is true of fat embolism except
A. Cerebral manifestations frequently occur in the absence of pulmonary manifestations.
B. Increased serum lipase occurs in up to half of all patients.
C. Petechia over the shoulders and chest is a classic finding.
D. Symptoms typically occur 12 to 48 hours after trauma.
E. Tachycardia and tachypnea are characteristic.
A
Jawab : A
Sch p. 459.Neurologic involvement does not develop in the absence of pulmonary abnormalities unless there is the rare event of a paradoxical embolus through a patent foramen ovale.
10
Q
10. Gamma irradiation of blood helps prevent A. graft-versus-host disease B. hemolytic transfusion reactions C. hepatitis B transmission D. nonhemolytic transfusion reactions E. transfusion siderosis
A
Jawab : A
Har p. 737.Transfusion-associated graft-versus-host disease may result if viable lymphocytes in blood are not irradiated
11
Q
- Citrate toxicity from massive transfusions results from the
A. binding of free ionized Ca2+
B. decrease of 2,3-diphosphoglyceric acid (DPG) levels
C. inactivation of factors 5 and 8
D. interaction with platelets, rendering them dysfunctional
E. precipitation of autoimmune hemolytic anemia
A
Jawab : A
12
Q
For questions 12 to 14, match the description with the disease.
A. Cushing’s disease
B. ectopic adrenocorticotropic hormone (ACTH) production
C. both
D. neither
12. Cortisol is suppressed with low-dose dexamethasone.
A
Jawab : D
13
Q
For questions 12 to 14, match the description with the disease.
A. Cushing’s disease
B. ectopic adrenocorticotropic hormone (ACTH) production
C. both
D. neither
13. Cortisol is suppressed with high-dose dexamethasone.
A
Jawab : A
14
Q
For questions 12 to 14, match the description with the disease.
A. Cushing’s disease
B. ectopic adrenocorticotropic hormone (ACTH) production
C. both
D. neither
- increase in urinary 17-hydroxycorticosteroids after a metyrapone test.
A
Jawab : A
15
Q
- Which of the following scenarios reflects hypochromic, microcytic anemia?
A. decreased mean corpuscular volume (Mev) and decreased total iron binding capacity (TIBC)
B. decreased MCV and increased TIBC
C. decreased Mev and normal TIBC
D. increased MCV and decreased TIBC
E. increased Mev and increased TIBC
A
Jawab : B
16
Q
16. Prolongation of bleeding time usually occurs in I. von Willebrand's disease II. use of nonsteroidal anti-inflammatory agents III. uremia IV. factor VII deficiency A. I, II, III B. I, III C. II, IV D. IV E. all of the above
A
Jawab : A
Har pp. 358-359.Although patients with von Willebrand’s disease usually have an abnormal bleeding time, it may occasionally be normal due to cycli- cal variations in the von Willebrand factor. Factor VII deficiency causes pro- longation of the prothrombin time (PT) and partial thromboplastin time (PlT).Uremia and the use of nonsteroidal anti-inflammatory agents result in platelet dysfunction (the latter by decreasing cyclooxygenaseactivity).
17
Q
17. Drugs that antagonize the anticoagulant effect of warfarin (Coumadin) include I. cholestyramine II. phenobarbital III. rifampin IV. cimetidine A. I, II, III B. I, Ill C. II, IV D. IV E. all of the above
A
Jawab : A
Har pp. 427-428.Trimethoprim sulfamethoxazole (Bactrim) increases the effect of Coumadin by decreasing clearance. Barbiturates and rifampim accel- erate Coumadin clearance by inducing hepatic metabolizing enzymes, and cimetidine inhibits its oxidative metabolism.
18
Q
18. Contraindications to the use of thiazide diuretics include I. diabetes mellitus II. hyperuricemia III. primary aldosteronism IV. lupus erythematosus A. I, II, III B. I, III C. II, IV D. IV E. all of the above
A
Jawab : A
Har p. 1326.Metabolic side effects of thiazide diuretics include hypokalemia from renal potassium loss, hyperuricemia from uric acid retention, carbohy- drate intolerance, and hyperlipidemia.
19
Q
19. Plasma levels of phenytoin (Dilantin) are increased by all of the following except A. carbamazepine B. cimetidine C. Coumadin D. isoniazide E. sulfonamides
A
Jawab : A
Har pp. 427,2364-2365.Carbamazepine (Tegretol)decreases plasma levels of phenytoin (Dilantin).
20
Q
- The most common electrocardiogram (EKG) finding in patients with pulmonary emboli is
A. a peaked T wave
B. an Sl-Q,-T 3 pattern
C. rightward shift of the QRS axis
D. sinus tachycardia (ST) and T wave changes
E. tachycardia
A
Jawab : D
Sch p. 1017.Nonspecific sinus tachycardia (ST) and T wave changes occur in 66%of patients
21
Q
- Which of the following disorders leads to hypernatremia?
A. Addison’s disease
B. hyperaldosteronism
C. hypothyroidism
D. renal failure
E. syndrome of inappropriate antidiuretic hormone (SIADH)
A
Jawab : B
22
Q
- The most common acid-base disturbance in mild to moderately injured patients without severe renal, circulatory, or pulmonary decompensation is
A. respiratory acidosis and metabolic alkalosis
B. respiratory alkalosis and metabolic acidosis
C. respiratory or metabolic acidosis
D. respiratory or metabolic alkalosis
A
Jawab : D
23
Q
- The reabsorption of Na+ ions in the thin ascending Henle’s loop
A. is by active transport
B. is by a Na+ -K+ exchange pump
C. passively follows the active transport of Cl- ions
D. passively follows the active transport of water molecules
A
Jawab : C
24
Q
For questions 24 to 27, match the antiplatelet agent with the description. Each response may be used once, more than once, or not at all.
A. abciximab (Reopro)
B. aspirin
C. clopidogrel (Plavix)
D. eptifibatide (Integrilin)
E. ticlopidine (Ticlid)
24. Of the two prod rugs that block the Gi-coupled platelet adenosine diphosphate (ADP) receptor. it has a slightly more favorable toxicity profile.
A
Jawab : C
see G&G pp. 1534-1536.Aspirin inactivates cyclooxy- genase,theenzymethat producestheprecursorofthromboxaneA2.Ticlodipine and clopidogrel are thienopyridines that block the Gi-coupled platelet adenosine diphosphate (ADP) receptor. They are thought to be prodrugs requiring conversion to the active metabolite. Thrombocytopenia and leukopenia occur less commonly with clopidogrel. Reopro and Integrilin are the inhibitors of glycoprotein Ilb/llIa receptor, but the former is the Fab frag- ment of a humanized monoclonal antibody against the receptor, and the latter is a cyclic peptide inhibitor of the arginine-glycine-aspartate (RGD) binding site on the receptor.
25
For questions 24 to 27, match the antiplatelet agent with the description. Each response may be used once, more than once, or not at all.
A. abciximab (Reopro)
B. aspirin
C. clopidogrel (Plavix)
D. eptifibatide (Integrilin)
E. ticlopidine (Ticlid)
25. is the Fab fragment of a monoclonal antibody directed against the lIb/IlIa receptor
Jawab : A
see G&G pp. 1534-1536.Aspirin inactivates cyclooxy- genase,theenzymethat producestheprecursorofthromboxaneA2.Ticlodipine and clopidogrel are thienopyridines that block the Gi-coupled platelet adenosine diphosphate (ADP) receptor. They are thought to be prodrugs requiring conversion to the active metabolite. Thrombocytopenia and leukopenia occur less commonly with clopidogrel. Reopro and Integrilin are the inhibitors of glycoprotein Ilb/llIa receptor, but the former is the Fab frag- ment of a humanized monoclonal antibody against the receptor, and the latter is a cyclic peptide inhibitor of the arginine-glycine-aspartate (RGD) binding site on the receptor.
26
For questions 24 to 27, match the antiplatelet agent with the description. Each response may be used once, more than once, or not at all.
A. abciximab (Reopro)
B. aspirin
C. clopidogrel (Plavix)
D. eptifibatide (Integrilin)
E. ticlopidine (Ticlid)
26. is a cyclic peptide inhibitor of the arginine-glycine-aspartate (RGD) binding site on the glycoprotein lIb/IlIa
Jawab : D
see G&G pp. 1534-1536.Aspirin inactivates cyclooxy- genase,theenzymethat producestheprecursorofthromboxaneA2.Ticlodipine and clopidogrel are thienopyridines that block the Gi-coupled platelet adenosine diphosphate (ADP) receptor. They are thought to be prodrugs requiring conversion to the active metabolite. Thrombocytopenia and leukopenia occur less commonly with clopidogrel. Reopro and Integrilin are the inhibitors of glycoprotein Ilb/llIa receptor, but the former is the Fab frag- ment of a humanized monoclonal antibody against the receptor, and the latter is a cyclic peptide inhibitor of the arginine-glycine-aspartate (RGD) binding site on the receptor.
27
```
For questions 24 to 27, match the antiplatelet agent with the description. Each response may be used once, more than once, or not at all.
A. abciximab (Reopro)
B. aspirin
C. clopidogrel (Plavix)
D. eptifibatide (Integrilin)
E. ticlopidine (Ticlid)
```
27. blocks production of thromboxane A2
Jawab : B
see G&G pp. 1534-1536.Aspirin inactivates cyclooxy- genase,theenzymethat producestheprecursorofthromboxaneA2.Ticlodipine and clopidogrel are thienopyridines that block the Gi-coupled platelet adenosine diphosphate (ADP) receptor. They are thought to be prodrugs requiring conversion to the active metabolite. Thrombocytopenia and leukopenia occur less commonly with clopidogrel. Reopro and Integrilin are the inhibitors of glycoprotein Ilb/llIa receptor, but the former is the Fab frag- ment of a humanized monoclonal antibody against the receptor, and the latter is a cyclic peptide inhibitor of the arginine-glycine-aspartate (RGD) binding site on the receptor.
28
28. Which laboratory findings in disseminated intravascular coagulation (DIC) correlates most closely with bleeding?
A. decreased fibrinogen
B. increased fibrin degradation products
C. increased prothrombin time (PT)
D. increased partial thromboplastin time (PTI)
E. increased thrombin time (IT)
Jawab : A
29
29. The definition of oxygen saturation is the
A. amount 0" oxygen dissolved in plasma
B. fractional concentration of inspired oxygen
C. partial pressure of oxygen in the blood
D. percentage of hemoglobin that is bound to oxygen
E. ratio of unbound to bound hemoglobin
Jawab : D
30
```
30. Metabolic responses to trauma include each of the following except
A. hypoglycemia
B. increased rate of lipolysis
C. increased Na+ reabsorption
D. increased water reabsorption
E. metabolic' alkalosis
```
Jawab : A
| Sch pp. 26-33.Hyperglycemia, not hypoglycemia, is one of the metabolic responses to trauma.
31
```
31. A normal PT. a prolonged PTI. and a bleeding disorder would result from a deficiency off actor
A. II
B. V
C. VIII
D. X
E. XII
```
Jawab : C
Har p. 359. Deficiency of factors 11. V, or X causes prolonged IT and PTT. A deficiency of factor XI1 causes a prolonged PITbut no clinical bleeding.
32
```
For questions 32 to 37. match the coagulation factor with the description. Each response may be used once. more than once. or not at all.
A. factor II
B. factor VII
C. factor VIII
D. factor IX
E. factor X
32. shortest half-life
```
Jawab : B
33
```
For questions 32 to 37. match the coagulation factor with the description. Each response may be used once. more than once. or not at all.
A. factor II
B. factor VII
C. factor VIII
D. factor IX
E. factor X
33. reflects the extrinsic pathway
```
Jawab : B
34
For questions 32 to 37. match the coagulation factor with the description. Each response may be used once. more than once. or not at all.
A. factor II
B. factor VII
C. factor VIII
D. factor IX
E. factor X
34. deficient or abnormal in hemophilia A (classic)
Jawab : C
35
For questions 32 to 37. match the coagulation factor with the description. Each response may be used once. more than once. or not at all.
A. factor II
B. factor VII
C. factor VIII
D. factor IX
E. factor X
35. deficient in hemophilia B (Christmas disease)
Jawab : D
36
For questions 32 to 37. match the coagulation factor with the description. Each response may be used once. more than once. or not at all.
A. factor II
B. factor VII
C. factor VIII
D. factor IX
E. factor X
36. All except this factor are vitamin K-dependent factors.
Jawab : C
37
For questions 32 to 37. match the coagulation factor with the description. Each response may be used once. more than once. or not at all.
A. factor II
B. factor VII
C. factor VIII
D. factor IX
E. factor X
37. Deficiency of factor II or this factor results in prolonged PT and PTI.
Jawab : E
38
For questions 38 to 45. match the combination of laboratory values with the hematologic diagnosis. Each response may be used once. more than once. or not at all.
A. abnormal PT. PTI. and bleeding time
B. abnormal PT. normal PTI and bleeding time
C. normal PT. PTI. and bleeding time
D. normal PT. abnormal PTI and bleeding time
E. hypercoagulable state
F. normal PT. abnormal PTI. normal bleeding time
38. antithrombin III deficiency
Jawab : E
39
For questions 38 to 45. match the combination of laboratory values with the hematologic diagnosis. Each response may be used once. more than once. or not at all.
A. abnormal PT. PTI. and bleeding time
B. abnormal PT. normal PTI and bleeding time
C. normal PT. PTI. and bleeding time
D. normal PT. abnormal PTI and bleeding time
E. hypercoagulable state
F. normal PT. abnormal PTI. normal bleeding time
39. DlC
Jawab : A
40
For questions 38 to 45. match the combination of laboratory values with the hematologic diagnosis. Each response may be used once. more than once. or not at all.
A. abnormal PT. PTI. and bleeding time
B. abnormal PT. normal PTI and bleeding time
C. normal PT. PTI. and bleeding time
D. normal PT. abnormal PTI and bleeding time
E. hypercoagulable state
F. normal PT. abnormal PTI. normal bleeding time
40. von Willebrand's disease
Jawab : D
41
For questions 38 to 45. match the combination of laboratory values with the hematologic diagnosis. Each response may be used once. more than once. or not at all.
A. abnormal PT. PTI. and bleeding time
B. abnormal PT. normal PTI and bleeding time
C. normal PT. PTI. and bleeding time
D. normal PT. abnormal PTI and bleeding time
E. hypercoagulable state
F. normal PT. abnormal PTI. normal bleeding time
41. dysfibrinogenemia
Jawab : A
42
For questions 38 to 45. match the combination of laboratory values with the hematologic diagnosis. Each response may be used once. more than once. or not at all.
A. abnormal PT. PTI. and bleeding time
B. abnormal PT. normal PTI and bleeding time
C. normal PT. PTI. and bleeding time
D. normal PT. abnormal PTI and bleeding time
E. hypercoagulable state
F. normal PT. abnormal PTI. normal bleeding time
42. malnutrition
Jawab : B
43
For questions 38 to 45. match the combination of laboratory values with the hematologic diagnosis. Each response may be used once. more than once. or not at all.
A. abnormal PT. PTI. and bleeding time
B. abnormal PT. normal PTI and bleeding time
C. normal PT. PTI. and bleeding time
D. normal PT. abnormal PTI and bleeding time
E. hypercoagulable state
F. normal PT. abnormal PTI. normal bleeding time
43. factor VII deficiency
Jawab : B
44
For questions 38 to 45. match the combination of laboratory values with the hematologic diagnosis. Each response may be used once. more than once. or not at all.
A. abnormal PT. PTI. and bleeding time
B. abnormal PT. normal PTI and bleeding time
C. normal PT. PTI. and bleeding time
D. normal PT. abnormal PTI and bleeding time
E. hypercoagulable state
F. normal PT. abnormal PTI. normal bleeding time
44. factor XIII deficiency
Jawab : C
45
For questions 38 to 45. match the combination of laboratory values with the hematologic diagnosis. Each response may be used once. more than once. or not at all.
A. abnormal PT. PTI. and bleeding time
B. abnormal PT. normal PTI and bleeding time
C. normal PT. PTI. and bleeding time
D. normal PT. abnormal PTI and bleeding time
E. hypercoagulable state
F. normal PT. abnormal PTI. normal bleeding time
45. factor VIII deficiency
Jawab : F
46
For questions 46 to 52, match the acid-base disturbance with the description or diagnosis. Each response may be used once, more than once, or not at all.
A. increased anion-gap metabolic acidosis
B. normal anion-gap metabolic acidosis
C. metabolic alkalosis
D. respiratory acidosis
E. respiratory alkalosis
46. often occurs with hypokalemia
Jawab : C
see Har pp. 285-291.Respiratory alkalosis is the earliest abnormality and may be the only acid-base disorder in some patients with salicylate overdose. Production of a mixture of endogenous acids, from a metabolic block, may later lead to metabolic acidosis.
47
For questions 46 to 52, match the acid-base disturbance with the description or diagnosis. Each response may be used once, more than once, or not at all.
A. increased anion-gap metabolic acidosis
B. normal anion-gap metabolic acidosis
C. metabolic alkalosis
D. respiratory acidosis
E. respiratory alkalosis
47. Addison's disease
Jawab : B
see Har pp. 285-291.Respiratory alkalosis is the earliest abnormality and may be the only acid-base disorder in some patients with salicylate overdose. Production of a mixture of endogenous acids, from a metabolic block, may later lead to metabolic acidosis.
48
For questions 46 to 52, match the acid-base disturbance with the description or diagnosis. Each response may be used once, more than once, or not at all.
A. increased anion-gap metabolic acidosis
B. normal anion-gap metabolic acidosis
C. metabolic alkalosis
D. respiratory acidosis
E. respiratory alkalosis
48. salicylate overdose (early stage)
Jawab : D
see Har pp. 285-291.Respiratory alkalosis is the earliest abnormality and may be the only acid-base disorder in some patients with salicylate overdose. Production of a mixture of endogenous acids, from a metabolic block, may later lead to metabolic acidosis.
49
For questions 46 to 52, match the acid-base disturbance with the description or diagnosis. Each response may be used once, more than once, or not at all.
A. increased anion-gap metabolic acidosis
B. normal anion-gap metabolic acidosis
C. metabolic alkalosis
D. respiratory acidosis
E. respiratory alkalosis
49. myasthenia gravis
Jawab : D
see Har pp. 285-291.Respiratory alkalosis is the earliest abnormality and may be the only acid-base disorder in some patients with salicylate overdose. Production of a mixture of endogenous acids, from a metabolic block, may later lead to metabolic acidosis.
50
For questions 46 to 52, match the acid-base disturbance with the description or diagnosis. Each response may be used once, more than once, or not at all.
A. increased anion-gap metabolic acidosis
B. normal anion-gap metabolic acidosis
C. metabolic alkalosis
D. respiratory acidosis
E. respiratory alkalosis
50. ethylene glycol overdose
Jawab : A
see Har pp. 285-291.Respiratory alkalosis is the earliest abnormality and may be the only acid-base disorder in some patients with salicylate overdose. Production of a mixture of endogenous acids, from a metabolic block, may later lead to metabolic acidosis.
51
For questions 46 to 52, match the acid-base disturbance with the description or diagnosis. Each response may be used once, more than once, or not at all.
A. increased anion-gap metabolic acidosis
B. normal anion-gap metabolic acidosis
C. metabolic alkalosis
D. respiratory acidosis
E. respiratory alkalosis
51. Cushing's disease
Jawab : C
see Har pp. 285-291.Respiratory alkalosis is the earliest abnormality and may be the only acid-base disorder in some patients with salicylate overdose. Production of a mixture of endogenous acids, from a metabolic block, may later lead to metabolic acidosis.
52
For questions 46 to 52, match the acid-base disturbance with the description or diagnosis. Each response may be used once, more than once, or not at all.
A. increased anion-gap metabolic acidosis
B. normal anion-gap metabolic acidosis
C. metabolic alkalosis
D. respiratory acidosis
E. respiratory alkalosis
52. primary aldosteronism
Jawab : C
see Har pp. 285-291.Respiratory alkalosis is the earliest abnormality and may be the only acid-base disorder in some patients with salicylate overdose. Production of a mixture of endogenous acids, from a metabolic block, may later lead to metabolic acidosis.
53
```
53. The formula for mean arterial pressure is (OBP = diastolic blood pressure; SBP = systolic blood pressure)
A. (OBP + SBP)/2
B. OBP + (SBl- OBP)/2
C. OBP/2 + SBP/3
D. OBP + (SBP - OBP)/3
E. OBP/2 + (SBP - OBP)/3
```
Jawab : D
see Har pp. 2184-2185,2187. MEN type I (Werner's syndrome) is characterized by parathyroid, pancreatic, and pituitary tumors, most commonly.MEN type IIA (Sipple's syndrome)is characterized by medullary thyroid carcinoma, pheochromocytoma, mucosal and gastrointestinal neuromas, and marfanoid features. Rarely, pheochromocytomas may be seen in MEN type I.
54
For questions 54 to 60, match the description with the syndrome.
A. multiple endocrine neoplasia (MEN) type I (Werner's syndrome)
B. MEN type llA (Sipple's syndrome)
C. both
D. neither
54. parathyroid hyperplasia or adenoma
Jawab : C
see Har pp. 2184-2185,2187. MEN type I (Werner's syndrome) is characterized by parathyroid, pancreatic, and pituitary tumors, most commonly.MEN type IIA (Sipple's syndrome)is characterized by medullary thyroid carcinoma, pheochromocytoma, mucosal and gastrointestinal neuromas, and marfanoid features. Rarely, pheochromocytomas may be seen in MEN type I.
55
For questions 54 to 60, match the description with the syndrome.
A. multiple endocrine neoplasia (MEN) type I (Werner's syndrome)
B. MEN type llA (Sipple's syndrome)
C. both
D. neither
55. pancreatic islet cell hyperplasia, adenoma, or carcinoma
Jawab : A
see Har pp. 2184-2185,2187. MEN type I (Werner's syndrome) is characterized by parathyroid, pancreatic, and pituitary tumors, most commonly.MEN type IIA (Sipple's syndrome)is characterized by medullary thyroid carcinoma, pheochromocytoma, mucosal and gastrointestinal neuromas, and marfanoid features. Rarely, pheochromocytomas may be seen in MEN type I.
56
For questions 54 to 60, match the description with the syndrome.
A. multiple endocrine neoplasia (MEN) type I (Werner's syndrome)
B. MEN type llA (Sipple's syndrome)
C. both
D. neither
56. pituitary hyperplasia or adenoma
Jawab : A
see Har pp. 2184-2185,2187. MEN type I (Werner's syndrome) is characterized by parathyroid, pancreatic, and pituitary tumors, most commonly.MEN type IIA (Sipple's syndrome)is characterized by medullary thyroid carcinoma, pheochromocytoma, mucosal and gastrointestinal neuromas, and marfanoid features. Rarely, pheochromocytomas may be seen in MEN type I.
57
For questions 54 to 60, match the description with the syndrome.
A. multiple endocrine neoplasia (MEN) type I (Werner's syndrome)
B. MEN type llA (Sipple's syndrome)
C. both
D. neither
57. Pheochromocytomas are common.
Jawab : B
see Har pp. 2184-2185,2187. MEN type I (Werner's syndrome) is characterized by parathyroid, pancreatic, and pituitary tumors, most commonly.MEN type IIA (Sipple's syndrome)is characterized by medullary thyroid carcinoma, pheochromocytoma, mucosal and gastrointestinal neuromas, and marfanoid features. Rarely, pheochromocytomas may be seen in MEN type I.
58
For questions 54 to 60, match the description with the syndrome.
A. multiple endocrine neoplasia (MEN) type I (Werner's syndrome)
B. MEN type llA (Sipple's syndrome)
C. both
D. neither
58. Medullary thyroid carcinomas are common.
Jawab : B
see Har pp. 2184-2185,2187. MEN type I (Werner's syndrome) is characterized by parathyroid, pancreatic, and pituitary tumors, most commonly.MEN type IIA (Sipple's syndrome)is characterized by medullary thyroid carcinoma, pheochromocytoma, mucosal and gastrointestinal neuromas, and marfanoid features. Rarely, pheochromocytomas may be seen in MEN type I.
59
For questions 54 to 60, match the description with the syndrome.
A. multiple endocrine neoplasia (MEN) type I (Werner's syndrome)
B. MEN type llA (Sipple's syndrome)
C. both
D. neither
59. mucosal and gastrointestinal tumors
Jawab : D
see Har pp. 2184-2185,2187. MEN type I (Werner's syndrome) is characterized by parathyroid, pancreatic, and pituitary tumors, most commonly.MEN type IIA (Sipple's syndrome)is characterized by medullary thyroid carcinoma, pheochromocytoma, mucosal and gastrointestinal neuromas, and marfanoid features. Rarely, pheochromocytomas may be seen in MEN type I.
60
For questions 54 to 60, match the description with the syndrome.
A. multiple endocrine neoplasia (MEN) type I (Werner's syndrome)
B. MEN type llA (Sipple's syndrome)
C. both
D. neither
60. marfanoid features
Jawab : D
see Har pp. 2184-2185,2187. MEN type I (Werner's syndrome) is characterized by parathyroid, pancreatic, and pituitary tumors, most commonly.MEN type IIA (Sipple's syndrome)is characterized by medullary thyroid carcinoma, pheochromocytoma, mucosal and gastrointestinal neuromas, and marfanoid features. Rarely, pheochromocytomas may be seen in MEN type I.
61
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61. Characteristics of hyperaldosteronism include each of the following except
A. edema
B. hypokalemia
C. increased diastolic blood pressure
D. metabolic alkalosis
E. polyuria
```
Jawab : A
| Har pp. 2095-2096.In the absence of associated disorders, edema is charac- teristically absent.
62
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62. Adequacy of pulmonary ventilation is assessed by
A. FiO2
B. oxygen saturation
C. Pa CO2
D. partial pressure of O2 in blood
E. tidal volume
```
Jawab : C
63
```
For questions 63 to 68, match the abnormality in the EKG with the diagnosis. Each response may be used once, more than once, or not at all.
A. atrial fibrillation
B. J-point elevation
C. peaked T wave
D. prolonged QT interval
E. U wave
63. hypocalcemia
```
Jawab : D
64
```
For questions 63 to 68, match the abnormality in the EKG with the diagnosis. Each response may be used once, more than once, or not at all.
A. atrial fibrillation
B. J-point elevation
C. peaked T wave
D. prolonged QT interval
E. U wave
```
64. hypokalemia
Jawab : E
65
```
For questions 63 to 68, match the abnormality in the EKG with the diagnosis. Each response may be used once, more than once, or not at all.
A. atrial fibrillation
B. J-point elevation
C. peaked T wave
D. prolonged QT interval
E. U wave
```
65. hyperkalemia
Jawab : C
66
```
For questions 63 to 68, match the abnormality in the EKG with the diagnosis. Each response may be used once, more than once, or not at all.
A. atrial fibrillation
B. J-point elevation
C. peaked T wave
D. prolonged QT interval
E. U wave
```
66. hypothermia
Jawab : B
67
```
For questions 63 to 68, match the abnormality in the EKG with the diagnosis. Each response may be used once, more than once, or not at all.
A. atrial fibrillation
B. J-point elevation
C. peaked T wave
D. prolonged QT interval
E. U wave
```
67. hyperthyroidism
Jawab : A
68
```
For questions 63 to 68, match the abnormality in the EKG with the diagnosis. Each response may be used once, more than once, or not at all.
A. atrial fibrillation
B. J-point elevation
C. peaked T wave
D. prolonged QT interval
E. U wave
```
68. quinidine toxicity
Jawab : D
69
69. Which of the following is false of malignant hyperthermia?
A. Calcium is released from the muscle cell's sarcoplasmic reticulum.
B. end-tidal pC02 increases
C. It is precipitated by the use of inhalational anesthetics.
D. Treatment is with dantrolene.
E. Use of succinylcholine can help prevent it.
Jawab : E
| Har pp. 92,94.Barash pp. 521-529.Succinylcholinecan precipitate malignant hyperthermia.
70
```
70. Of the following, the best choice for Clostridium diffidle enterocolitis is
A. clindamycin orally
B. metronidazole (Flagyl) orally
C. penicillin G orally
D. penicillin VK intravenously
E. vancomycin intravenously
```
Jawab : B
| Har pp. 926-927.Oral vancomycin is also effective in the treatment of this infection
71
```
For questions 71 to 73, match the description with the process.
A. cardiac tamponade
B. tension pneumothorax
C. both
D. neither
71. pulsus paradoxus
```
Jawab : A
72
```
For questions 71 to 73, match the description with the process.
A. cardiac tamponade
B. tension pneumothorax
C. both
D. neither
```
72. increased venous pressure
Jawab : C
73
```
For questions 71 to 73, match the description with the process.
A. cardiac tamponade
B. tension pneumothorax
C. both
D. neither
```
73. increased pulse pressure
Jawab : D
74
```
74. Meningitis occurring within 72 hours after a basilar skull fracture is most commonly secondary to
A. Haemophilus influenzae
B. Neisseria meningitidis
C. Staphylococcus aureus
D. Staphylococcus epidermidis
E. Streptococcus pneumoniae
```
Jawab : E
75
```
75. Postoperative shunt infections are most commonly caused by
A. coagulase-negative staphylococci
B. H. influenzae
C. Pseudo"+onas species
D. S. aureus
E. S. Pneumoniae
```
Jawab : A
76
```
76. The most likely cause of a fever occurring in the first 24 hours after surgery is
A. atelectasis
B. deep vein thrombosis
C. pneumonia
D. urinary tract infection
E. wound infection
```
Jawab : A
77
```
For questions 77 to 81, match the description with the drug.
A. dobutamine
B. dopamine
C. both
D. neither
77. a positive inotropic agent
```
Jawab : C
78
```
For questions 77 to 81, match the description with the drug.
A. dobutamine
B. dopamine
C. both
D. neither
```
78. has very little effect on a-adrenergic receptors
Jawab : A
79
```
For questions 77 to 81, match the description with the drug.
A. dobutamine
B. dopamine
C. both
D. neither
```
79. is the second-line drug for symptomatic bradycardia
Jawab : B
80
```
For questions 77 to 81, match the description with the drug.
A. dobutamine
B. dopamine
C. both
D. neither
```
80. has no effect on beta 2 receptors
Jawab : D
81
```
For questions 77 to 81, match the description with the drug.
A. dobutamine
B. dopamine
C. both
D. neither
```
81. has a dose-related effect
Jawab : B
82
```
82. Of the following, the most common cause of neonatal meningitis is
A. H. influenzae
B. Listeria species
C. N. meningitidis
D. staphylococci
E. streptococci
```
Jawab : E
| Har p. 2462.Gram-negative bacilli and group B streptococci are the most common causes of neonatal meningitis.
83
83. Each of the following is true of nitroprusside except
A. Cyanide is produced when the ferrous ion in the nitroprusside molecule reacts with sulfhydryl-containing compounds in the red blood cells.
B. The cyanide is reduced to thiocyanate in the liver.
C. The half-life of thiocyanate is 3 to 4 days.
D. Thiocyanate is excreted in the gastrointestinal (GI) tract.
E. With prolonged administration, accumulation of thiocyanate may cause an acute toxic psychosis.
Jawab : D
G&Gpp. 889-890.924.Cyanide is reduced to thiocyanate in the liver. and the thiocyanate is then excreted in the urine.
84
84. Isoproterenol
A. acts almost exclusively on ~ receptors
B. decreases SBP
C. increases DBP
D. increases peripheral vascular resistance (PVR)
E. relaxes smooth muscle
Jawab : E
G&Gp.228.Isoproterenolactsalmostexclusivelyonbeta receptors.Itincreases (or leaves unchanged) systolic blood pressure and decreases diastolic blood pressure, and mean arterial pressure typically falls. It also decreases peripheral vascular resistance and relaxes smooth muscle.
85
85. Splenectomy for hereditary spherocytosis
A. corrects the anemia
B. corrects the defects in red blood cells
C. has no effect on red blood cell survival
D. is never followed by relapse
E. should be performed before age 3
Jawab : A
Har pp. 682-683.Splenectomy for hereditary spherocytosis leads to normal or near normal red blood cell (RBC) survival. It does not correct the RBC deficit and should be performed after age4,when the risk of severe infections is low. Rare relapses have been reported.
86
```
For questions 86 to 92, match the time period after creation of a wound with the event occurring during wound healing. Each response may be used once, more than once, or not at all.
A. 12 hours
B. 5 days
C. 17 days
D. 42 days
E. 2 years
86. Epithelial migration occurs.
```
Jawab : A
87
For questions 86 to 92, match the time period after creation of a wound with the event occurring during wound healing. Each response may be used once, more than once, or not at all.
A. 12 hours
B. 5 days
C. 17 days
D. 42 days
E. 2 years
87. Increase in tensile strength occurs at least up to this point.
Jawab : E
88
```
For questions 86 to 92, match the time period after creation of a wound with the event occurring during wound healing. Each response may be used once, more than once, or not at all.
A. 12 hours
B. 5 days
C. 17 days
D. 42 days
E. 2 years
88. Wound contraction begins.
```
Jawab : B
89
For questions 86 to 92, match the time period after creation of a wound with the event occurring during wound healing. Each response may be used once, more than once, or not at all.
A. 12 hours
B. 5 days
C. 17 days
D. 42 days
E. 2 years
89. Maximum amount of total collagen occurs at this time.
Jawab : D
90
```
For questions 86 to 92, match the time period after creation of a wound with the event occurring during wound healing. Each response may be used once, more than once, or not at all.
A. 12 hours
B. 5 days
C. 17 days
D. 42 days
E. 2 years
```
90. Visible collagen synthesis begins.
Jawab : B
91
For questions 86 to 92, match the time period after creation of a wound with the event occurring during wound healing. Each response may be used once, more than once, or not at all.
A. 12 hours
B. 5 days
C. 17 days
D. 42 days
E. 2 years
91. Significant gain in tensile strength begins at this time.
Jawab : B
92
```
For questions 86 to 92, match the time period after creation of a wound with the event occurring during wound healing. Each response may be used once, more than once, or not at all.
A. 12 hours
B. 5 days
C. 17 days
D. 42 days
E. 2 years
```
92. The rapid increase in collagen content slows considerably at this point.
Jawab : D
93
93. Each of the following is consistent with the Zollinger-Ellison syndrome except a(n)
A. decrease in serum gastrin with secretin injection
B. duodenal ulcer
C. duodenal wall gastrinoma
D. pancreatic gastrinoma
E. increased serum gastrin level
Jawab : A
| Har p. 1661.Intravenous secretin increases serum gastrin in patients with a gastrinoma.
94
For questions 94 to 99, match the description with the disease.
A. type I (distal) renal tubular acidosis (RTA)
B. type II (proximal) RTA
C. both
D. neither
94. nonanion gap acidosis
Jawab : C
see Har pp. 1602-1604. Hyperkalemia is found in renal tubular acidosis (RTA) type4. Nephro calcinosis is rare inRTA type2, and the urine pH is les than 5.5 in this type.
95
For questions 94 to 99, match the description with the disease.
A. type I (distal) renal tubular acidosis (RTA)
B. type II (proximal) RTA
C. both
D. neither
95. hyperkalemic
Jawab : D
see Har pp. 1602-1604. Hyperkalemia is found in renal tubular acidosis (RTA) type4. Nephro calcinosis is rare inRTA type2, and the urine pH is les than 5.5 in this type.
96
For questions 94 to 99, match the description with the disease.
A. type I (distal) renal tubular acidosis (RTA)
B. type II (proximal) RTA
C. both
D. neither
96. Nephrocalcinosis commonly occurs.
Jawab : A
see Har pp. 1602-1604. Hyperkalemia is found in renal tubular acidosis (RTA) type4. Nephro calcinosis is rare inRTA type2, and the urine pH is les than 5.5 in this type.
97
For questions 94 to 99, match the description with the disease.
A. type I (distal) renal tubular acidosis (RTA)
B. type II (proximal) RTA
C. both
D. neither
97. urine pH > 5.5
Jawab : A
see Har pp. 1602-1604. Hyperkalemia is found in renal tubular acidosis (RTA) type4. Nephro calcinosis is rare inRTA type2, and the urine pH is les than 5.5 in this type.
98
For questions 94 to 99, match the description with the disease.
A. type I (distal) renal tubular acidosis (RTA)
B. type II (proximal) RTA
C. both
D. neither
98. defect in reabsorption of bicarbonate
Jawab : B
see Har pp. 1602-1604. Hyperkalemia is found in renal tubular acidosis (RTA) type4. Nephro calcinosis is rare inRTA type2, and the urine pH is les than 5.5 in this type.
99
For questions 94 to 99, match the description with the disease.
A. type I (distal) renal tubular acidosis (RTA)
B. type II (proximal) RTA
C. both
D. neither
99. hypokalemia
Jawab : C
see Har pp. 1602-1604. Hyperkalemia is found in renal tubular acidosis (RTA) type4. Nephro calcinosis is rare inRTA type2, and the urine pH is les than 5.5 in this type.
100
```
100. The percentage of total body weight represented by total extracellular fluid volume is approximately
A. 5%
B. 15%
C. 20%
D. 40%
E. 60%
```
Jawab : C
101
101. Each of the following occurs in venous air embolism except a(n)
A. decrease in cardiac output
B. increase in end-tidal peo2
C. increase in pulmonary artery pressure
D. increase in pulmonary vascular resistance
E. ventilation-perfusion mismatch
Jawab : B
| Barash p. 766. End-tidal pCOz decreases with venous air embolism.
102
102. The most sensitive noninvasive monitor of venous air embolism is
A. auscultation of the chest with a stethoscope
B. end-tidal pC02
C. end-tidal pN2
D. precordial Doppler
E. pulmonary artery catheterization
Jawab : D
Barash p. 766. The most sensitive is transesophageal echocardiography, the most sensitive noninvasive monitor is the precordial Doppler.
103
```
103. Which EKG change in the anterior leads is the most characteristic finding in subendocardial ischemia?
A. hyperacute T wave
B. Qwave
C. ST depression
D. ST elevation
E. T wave inversion
```
Jawab : C
| Har p. 1267. Transmural ischemia may lead to ST elevation in the electrocar- diogram (EKG).
104
104. Which set of laboratory values is most consistent with hypothyroidism of hypothalamic or pituitary origin?
A. Decreased thyroid-stimulating hormone (TSH) and decreased free thyroxine (T4)
B. decreased TSH and increased free T4
C. decreased TSH and normal free T 4
D. increased TSH and decreased free T4
E. increased TSH and increased free T4
Jawab : A
Har p. 2068. Occasionally, in patients with hypothyroidism of pituitary or hypothalamic origin, serum thyroid-stimulating hormone (TSH) concentra- tions may be slightly increased rather than decreased if the form of TSH secreted is immunoactive but not bioactive.
105
```
105. Of the following treatment options for hyperkalemia, which one does not alter serum potassium?
A. calcium
B. cation-exchange resins
C. hemodialysis
D. insulin
E. sodium bicarbonate
```
Jawab : A
| Har p. 282. Calcium gluconate infusion is useful for cardiotoxicity,but it does not reduce serum potassium.
106
For questions 106 to 111, match the acid-base disturbance with the arterial blood gas result. Each response may be used once, more than once, or not at all.
A. respiratory acidosis
B. respiratory acidosis and metabolic acidosis
C. metabolic acidosis
D. metabolic acidosis and compensatory respiratory alkalosis
E. respiratory alkalosis
F. respiratory alkalosis and compensatory metabolic acidosis
G. uninterpretable
106. pH = 7.5, pC02 = 30, HC03 = 19
Jawab : E
107
For questions 106 to 111, match the acid-base disturbance with the arterial blood gas result. Each response may be used once, more than once, or not at all.
A. respiratory acidosis
B. respiratory acidosis and metabolic acidosis
C. metabolic acidosis
D. metabolic acidosis and compensatory respiratory alkalosis
E. respiratory alkalosis
F. respiratory alkalosis and compensatory metabolic acidosis
G. uninterpretable
107. pH = 7.3, pC02 = 52, HC03 = 29
Jawab : A
108
For questions 106 to 111, match the acid-base disturbance with the arterial blood gas result. Each response may be used once, more than once, or not at all.
A. respiratory acidosis
B. respiratory acidosis and metabolic acidosis
C. metabolic acidosis
D. metabolic acidosis and compensatory respiratory alkalosis
E. respiratory alkalosis
F. respiratory alkalosis and compensatory metabolic acidosis
G. uninterpretable
108. 7.35, pC02 = 17, HC03 = 9
Jawab : D
109
For questions 106 to 111, match the acid-base disturbance with the arterial blood gas result. Each response may be used once, more than once, or not at all.
A. respiratory acidosis
B. respiratory acidosis and metabolic acidosis
C. metabolic acidosis
D. metabolic acidosis and compensatory respiratory alkalosis
E. respiratory alkalosis
F. respiratory alkalosis and compensatory metabolic acidosis
G. uninterpretable
109. 7.55, pC02 = 32, HC03 = 12
Jawab : F
110
For questions 106 to 111, match the acid-base disturbance with the arterial blood gas result. Each response may be used once, more than once, or not at all.
A. respiratory acidosis
B. respiratory acidosis and metabolic acidosis
C. metabolic acidosis
D. metabolic acidosis and compensatory respiratory alkalosis
E. respiratory alkalosis
F. respiratory alkalosis and compensatory metabolic acidosis
G. uninterpretable
110. 7.22, pC02 = 55, HC03 = 22
Jawab : B
111
For questions 106 to 111, match the acid-base disturbance with the arterial blood gas result. Each response may be used once, more than once, or not at all.
A. respiratory acidosis
B. respiratory acidosis and metabolic acidosis
C. metabolic acidosis
D. metabolic acidosis and compensatory respiratory alkalosis
E. respiratory alkalosis
F. respiratory alkalosis and compensatory metabolic acidosis
G. uninterpretable
111. 7.25, pC02 = 28, HC03 = 12
Jawab : C
112
```
112. If Q1 and Q2 are pulmonary shunt and total blood flow, respectively, and Ceo Co, and Cy are the oxygen contents of end-capillary, arterial. and mixed venous blood, respectively, then the shunt fraction Q1/Q2 =
A. C,/(C,-Cy)
B. (Co - Cy)/Cy
c. (Cy - Ca)/Ce
D. (C, - Ca)/(C, - Cy )
E. (Ca + Cy)/(Ca + C, + Cy)
```
Jawab : D
113
```
113. Atropine toxicity produces each of the following except
A. blurred vision
B. decreased intestinal peristalsis .. ,
C. drymouth
D. increased pulse
E. increased sweating
```
Jawab : E
| G&Gpp. 162-167. Decreased sweating is a manifestation of atropine toxicity.
114
114. Each of the following is true of hyperosmolar coma except
A. Free fatty acid concentration is lower than in ketoacidosis
B. Glucose concentration is higher than in ketoacidosis
C. It is more common in insulin-dependent diabetes mellitus (IDDM) thanin non-insulin dependent diabetes mellitus (NIDOM)
D. Mortality is more than 50%
E. Volume depletion is usually severe
Jawab : C
Har pp. 2116-2119. Hyperosmolar, nonketotic diabetic coma is usually a complication of non-insulin-dependent diabetes mellitus (NIDDM).
115
```
For questions 115 to 119, match the autonomic drug with the description. Each response may be used once, more than once, or not at all
A. clonidine
B. isoproterenol
C. phenoxybenzamine
D. phentolamine
E. prazosin
115. beta agonist
```
Jawab : B
116
```
For questions 115 to 119, match the autonomic drug with the description. Each response may be used once, more than once, or not at all
A. clonidine
B. isoproterenol
C. phenoxybenzamine
D. phentolamine
E. prazosin
```
116. pure alfa1 antagonist
Jawab : E
117
```
For questions 115 to 119, match the autonomic drug with the description. Each response may be used once, more than once, or not at all
A. clonidine
B. isoproterenol
C. phenoxybenzamine
D. phentolamine
E. prazosin
```
117. noncompetitive alfa antagonist
Jawab : C
118
```
For questions 115 to 119, match the autonomic drug with the description. Each response may be used once, more than once, or not at all
A. clonidine
B. isoproterenol
C. phenoxybenzamine
D. phentolamine
E. prazosin
```
118. competitive, nonselective alfa antagonist
Jawab : D
119
```
For questions 115 to 119, match the autonomic drug with the description. Each response may be used once, more than once, or not at all
A. clonidine
B. isoproterenol
C. phenoxybenzamine
D. phentolamine
E. prazosin
```
119. central alfa 2 agonist
Jawab : B
120
```
120. The most appropriate cholinergic agent to be used in urinary retention is
A. acetylcholine
B. bethanechol
C. carbachol
D. choline
E. methacholine
```
Jawab : A
G&Gpp. 159-160. Bethanechol and carbachol selectively stimulate the urinary and gastrointestinal (GI)tract. Carbacholis less desirable for urinary retention, however, because it has greater nicotinicaction at autonomic ganglia.
121
121. Which of the following is false of polycythemia vera?
A. Budd-Chiari syndrome is common.
B. Hyperuricemia can complicate the disorder.
C. It is the most common of the myeloproliferative disorders.
D. Massive splenomegaly is usually the presenting sign.
E. The use of alkylating agents should be avoided.
Jawab : D
Has pp. 701-703. Although massive splenomegaly can be the presenting sign, the disorder is usually first recognized by a high hematocrit.
122
```
122. The serum osmolarity of a patient with a sodium level of 130 meq/L. K of 4.0 meq/L, glucose of 126 mg/dL, and blood urea nitrogen (BUN) of 28 mg/dL, is
A. 276
B. 285
C. 296
D. 304
E. 310
```
Jawab : B
HndbkNS p. 14. Serum osmolarity can be calculated from the formula Serum osmolarity = 2(Na+K)+Glucosell8+BUNl2.8
= 2(130+4)+126118+2812.8
= 2(134)+7 +10=
123
```
123. Each of the following is a result of the use of positive end-expiratory pressure (PEEP) in the ventilated patient except
A. decreased cerebral perfusion pressure
B. decreased physiologic dead space
C. decreased work of breathing
D. improved lung compliance
E. predisposition to barotraumas
```
Jawab : B
CC Med pp. 78-83. Positive end-expiratory pressure (PEEP) increases physio- logic dead space by raising intra-alveolar pressure and lung perfusion, thereby impairing C02elimination.
124
```
124. The oxyhemoglobin dissociation curve is shifted to the right (decreased oxygen affinity) by
I. acidosis
II. decreased 2,3-diphosphoglyceric acid (2,3-0PG)
III. fever
IV. banked blood
A. I, II, III
B. I, III
C. II, IV
D. IV
E. all of the above
```
Jawab : B
Clin PR p. 171. The curve is shifted to the right by acidosis, fever, increased 2.3-diphosphoglyceric acid (DPG),and hypoxemia, and to the left by alkalo- sis, hypothermia, banked blood, and decreased 2,3-DPG
125
```
125. Gastrointestinal carcinoids are most frequently found in the
A. appendix
B. colon
C. ileum
D. rectum
E. stomach
```
Jawab : A
Sch p. 1244. Forty-six percent of carcinoids of the GI tract are located in the appendix. The ileum (28%)and the rectum (17%)are less frequently involved.
126
```
126. Alkalinization of the urine promotes excretion of
I. salicylates
II. tricyclic antidepressants
Ill. phenobarbital
IV. amphetamines
A. I, II, III
B. I, III
C. II,IV
D. IV
E. all of the above
```
Jawab : A
CC Med p. 232. The excretion of weak acids is facilitated by alkalinization of the urine and serum. Amphetamines are weak bases.
127
For questions 127 and 128, match the description wih the substance.
A. cryoprecipitate
B. fresh frozen plasma
C. both
D. neither
127. reliably effective in von Willebrand's disease
Jawab : A
128
```
For questions 127 and 128, match the description wih the substance.
A. cryoprecipitate
B. fresh frozen plasma
C. both
D. neither
```
128. used in the treatment of hemophilia B
Jawab : B
129
```
129. The free water deficit in a dehydrated 70 kg man with a Na+ of 160 is
A. 2L
B. 4L
C. 6L
D. 7L
E. 8 L
```
Jawab : C
Free water deficit can be calculated from the formula
Free water deficit (L) = [(Na- 140)/140]x body weight (kg) x 0.6 = [(I60- 140)/140]x 70 x 0.6
= 2012 x 0.6=6 L
130
```
For questions 130 to 134, match the autonomic drug with the description. Each response may be used once, more than once, or not at all.
A. amrinone
B. dopamine
C. epinephrine
D. neosynephrine
E. norepinephrine
130. pure alfa Agonist
```
Jawab : D
131
For questions 130 to 134, match the autonomic drug with the description. Each response may be used once, more than once, or not at all.
A. amrinone
B. dopamine
C. epinephrine
D. neosynephrine
E. norepinephrine
131. does not interact with alfa or beta receptors
Jawab : A
132
```
For questions 130 to 134, match the autonomic drug with the description. Each response may be used once, more than once, or not at all.
A. amrinone
B. dopamine
C. epinephrine
D. neosynephrine
E. norepinephrine
```
132. Effects vary significantly with dose administered.
Jawab : B
133
```
For questions 130 to 134, match the autonomic drug with the description. Each response may be used once, more than once, or not at all.
A. amrinone
B. dopamine
C. epinephrine
D. neosynephrine
E. norepinephrine
```
133. primarily an a. agonist with mild beta 2 activity
Jawab : E
134
For questions 130 to 134, match the autonomic drug with the description. Each response may be used once, more than once, or not at all.
A. amrinone
B. dopamine
C. epinephrine
D. neosynephrine
E. norepinephrine
134. balanced alfa and beta agonist properties
Jawab : C
135
```
135. Thallium intoxication causes each of the following except
A. cardiac dysfunction
B. GI disturbance
C. hirsutism
D. lower extremity joint pain
E. peripheral neuropathy
```
Jawab : C
| Nelson pp. 191-192. Thallium poisoning causes alopecia, not hirsutism.
136
```
136. Which of the following symptoms is least characteristic of acute intermittent porphyria?
A. abdominal pain
B. hypotension
C. polyneuropathy
D. psychosis
E. tachycardia
```
Jawab : B
| V&A pp. 1389-1390. Hypertension. not hypotension. typically occurs during an attack.
