Description : When compared to unfractionated heparin, low molecular weight heparins have (a) Preferential binding affinity to factor Xa relative to Iia (thrombin) (b) Shorter half-lives (c) Dose – dependent renal clearance
Last Answer : Ans: A
Description : The following action(s) of heparin is/are essential for inhibition of factor Xa: A. Facilitation of antithrombin III mediated inhibition of factor XIIa B. Provision of scaffold for the clotting factor ... configurational change in antithrombin III to expose its interacting sites D. Both A' and B
Last Answer : C. Induction of a configurational change in antithrombin III to expose its interacting sites
Description : Low molecular weight heparins differ from unfractionated heparin in that: A. They selectively inhibit factor Xa B. They do not significantly prolong clotting time C. They are metabolized slowly and have longer duration of action D. All of the above are correct
Last Answer : D. All of the above are correct
Description : he primary mechanism by which heparin prevents coagulation of blood is: A. Direct inhibition of prothrombin to thrombin conversion B. Facilitation of antithrombin III mediated inhibition of factor Xa and ... of antithrombin III to inhibit factors IX and XI D. Inhibition of factors XIIa and XIIIa
Last Answer : B. Facilitation of antithrombin III mediated inhibition of factor Xa and thrombi
Description : Mini-dose heparin has been shown to be useful in the prophylaxis of postoperative venous thrombosis. Mechanism(s) by which low-dose heparin is/are thought to protect against venous ... aggregation and subsequent platelet release action d. A mild prolongation of activated partial thromboplastin time
Last Answer : Answer: a, b, c Low-dose heparin is thought to protect against venous thrombosis through three different mechanisms. First, antithrombin III activity with its inhibition of activated Factor X is ... release reaction. The standard doses of heparin administered (5000 units bid) does not affect aPTT
Description : Antithrombin III deficiency is a commonly observed hypercoaguable state. Which of the following statement(s) is/are true concerning this condition? a. A patient with this deficiency usually ... involves acutely the administration of fresh frozen plasma followed by long-term treatment with Coumadin
Last Answer : Answer: a, b, c, d Antithrombin III deficiency accounts for about 2% of venous thrombotic event. This deficiency has been described in patients with pulmonary embolism, mesenteric venous ... is established, fresh frozen plasma should be administered followed by long-term treatment with Coumadin
Description : There are a number of hypercoaguable states which can be associated with arterial or venous thrombosis and embolic phenomenon. These include: a. Heparin-associated thrombocytopenia b. Antithrombin III deficiency c. Von Willebrand disease d. Vitamin C deficiency
Last Answer : Answer: a, b A number of hypercoaguable states are present. These include heparin-associated thrombocytopenia in which a heparin-dependent platelet antibody causes aggregation of ... soft tissue increasing vascular permeability and fragility resulting in the potential for bleeding disorders
Description : As thrombin generation proceeds, the body has natural anticoagulant systems opposing further thrombus formation. Natural anticoagulants include: a. Tissue plasminogen activator (TPA) b. Antithrombin III c. Activated protein C d. Heparin cofactor II
Last Answer : Answer: b, c, d Just as thrombin generation is the key to coagulation, antithrombin III is the most central anticoagulant proteins. This glycoprotein binds to thrombin, preventing its removal of ... in the body. Therefore, TPA is part of the fibrinolytic system rather than a natural anticoagulant
Description : Low molecular weight heparins have the following advantages over unfractionated heparin except: A. Higher efficacy in arterial thrombosis B. Less frequent dosing C. Higher and more consistent subcutaneous bioavailability D. Laboratory monitoring of response not required
Last Answer : A. Higher efficacy in arterial thrombosis
Description : Neostigmine is beneficial in cobra envenomation because: A. It binds to and inactivates cobra toxin B. It reverses coma due to cobra toxin C. It counteracts the cardio-depressant action of cobra toxin D. It antagonizes the paralysing action of cobra toxin
Last Answer : D. It antagonizes the paralysing action of cobra toxin
Description : What drug is used to prevent embolism in the lung and during myocardial infarction? (a) Alteplase (b) Human growth hormone (c) Granulocyte–macrophage colony – stimulating factor (GM–CSF) (d) EPOGEN (EPO) (e) None of the above
Description : In patients with chronic granulomatous disease which of the following agents increases the synthesis of tumor necrosis factor, leading to activation of phagocytosis? (a) Aldesleukin (b) Cyclosporine (c) Filgrastim (d) Infliximab (e) Interferon gamma
Last Answer : Ans: E
Description : Milrinone is an example of (a) Phosphodiesterase I inhibitor (b) Phosphodiesterase II inhibitor (c) Phosphodiesterase III inhibitor (d) Phosphodiesterase IV inhibitor
Last Answer : Ans: C
Description : Which of the following drugs is a class III antiarrhythmic agent that is effective in the acute management of atrial fibrillation or atrial flutter of recent onset ? (a) Bretylium (b) Lbutilide (c) Metoprolol (d) Disopyramide
Last Answer : Ans: B
Description : Aldosterone release is stimulated by (a) Angiotensin I (b) Angiotensin (c) Angiotensin III (d) Both (b) and (c)
Last Answer : Ans: D
Description : Tests of coagulation are used to monitor anticoagulation treatment and detect intrinsic abnormalities in coagulation. Which of the following statement(s) is/are true concerning ... is used to monitor heparin levels intraoperatively during cardiovascular and peripheral vascular operations
Last Answer : Answer: a, c, d Coagulation tests include prothrombin time (PT), which measures the intrinsic and extrinsic pathways of fibrinogen production and is the most common method for ... more while for peripheral vascular applications, values of 250 seconds or greater are considered appropriate
Description : In gas-liquid contact operation, the number of ideal stages, N = (xa - xb )/(xb - x *b ). This is true when the stripping factor 'S' is (A) S > 1 (B) S < 1 (C) S = 1 (D) S = ∞
Last Answer : (A) S > 1
Description : The following are true about blood coagulation: a. heparin inhibits blood coagulation through its interference with vitamin K metabolism in the liver b. addition of vitamin K to freshly drawn ... delays clotting c. thrombin converts fibrinogen to fibrin d. platelets are essential for blood clot
Last Answer : thrombin converts fibrinogen to fibrin
Description : Tolerance to nitroglycerin may be overcome by (a) Initially using the largest safe dose of the drug (b) Using other nitrites (c) Temporarily discontinuing the drug for one or two weeks (d) Use of higher doses (e) None of the above
Description : The chief use of levoarterenol is to treat (a) Shock (b) Diabetes (c) Hypertension (d) Cardiac arrhythmias (e) Iron deficiencies
Description : Which of the following is used to lower blood lipid levels? (a) Trimethadione (b) Clofibrate (c) Flucytosine (d) Coumarin (e) Propranolol
Description : In case of acute pain of angina pectoris the most effective treatment would be to administer (a) Mannitol hexanitrate (b) Erythrityl tetranitrate (c) Sodium nitrate (d) Pentaerythritol tetranitrate (e) Nitroglycerin
Description : The action of digitalis is enhanced by (a) Sodium (b) Calcium (c) Magnesium (d) Potassium (e) Chloride
Description : Overuse of digitalis may result in (a) Habituation (b) Tolerance (c) Addiction (d) Physical dependence (e) Cummulative poisoning
Description : The action of quinidine differs from that of digitalis in (a) Decreasing irritability of cardiac muscle (b) Preventing passage of impulses to the ventricle (c) Increasing irritability of heart muscle (d) Reducing conductivity (e) None of the above
Description : Acute renal failure (ARF) may be caused by all of the following except (a) Acute tubular necrosis (ATN) due to drug therapy (e.g., aminoglycosides, contrast media) (b) Severe hypotension ... (c) Decreased cardiac output, as from congestive heart failure (d) Hemolysis, myoglobinuria (e) Hyperkalemia
Description : For treating the patient with congestive heart failure (CHF), which of the following dosages of dopamine is selected for its positive inotropic effects? (a) 2.0 mg/kg/min (b) 5–10 mg/kg/min (c) 10–20 mg/kg/min (d) 40 mg/kg/min (e) 40 mg/kg/min
Description : Because of proven beneficial effects on “cardiac remodeling”, these agents are now indicated as first line therapy in CHF patients. Which of the following is representative of this group of drugs? (a) Hydrochlorothiazide (b) Enalapril (c) Furosemide (d) Carvedilol (e) Bumetanide
Description : When digoxin is used in a patient with congestive heart failure (CHF), it works by exerting a positive effect on (a) Stroke volume (b) Total peripheral resistance (c) Heart rate (d) Blood pressure (e) Venous return
Description : Which of the following combinations of drugs, when used together, reduce both preload and afterload? (a) Nitroglycerin and isosorbide dinitrate (b) Hydralazine and isosorbide dinitrate (c) Captopril and methyldopa (d) Prazosin and angiotension II (e) Hydralazine and methyldopa
Description : Which of the following groups of symptoms is most often associated with a patient who has right-sided heart failure? (a) Nocturia, rales, paroxysmal nocturnal dyspnea (b) Paroxysmal ... distention (e) Paroxysmal nocturnal dyspnea, jugular venous distention, abdominal distention, shortness of breath
Description : Which of the following agents has a direct effect on the AV mode, delaying calciumchannel depolarization? (a) Lidocaine (b) Diltiazem (c) Bretylium (d) Quinidine (e) Lbutilide
Description : Which of the following drugs is a class IV antiarrhythmic that is primarily indicated for the treatment of supraventricular tachyarrhythmias? (a) Lbutilide (b) Mexiletine (c) Diltiazem (d) Quinidine (e) Propranolol
Description : A patient receiving a class I antiarrhythmic agent on a chronic basis complains of fatigue, low-grade fever, and joint pain suggestive of systemic lupus erythematosus (SLE). The patient is most likely receiving (a) Lidocaine (b) Procainamide (c) Quinidine (d) Flecainide (e) Propranolol
Description : Strong anticholinergic effects limit the antiarrhythmic use of (a) Quinidine (b) Procainamide (c) Tocainide (d) Flecainide (e) Disopyramide
Description : Maximal medical therapy for treating angina pectoris is represented by which of the following choices? (a) Diltiazem, verapamil, nitroglycerin (b) Atenolol, isoproterenol, diltiazem (c) Verapamil, nifedipine, propranolol (d) Isosorbide, atenolol, diltiazem (e) Nitroglycerin, isosorbide, atenolol
Description : Which of the following agents used in prinzmetal’s angina has spasmolytic actions, which increase coronary blood supply? (a) Nitroglycerin (b) Nifedipine (c) Timolol (d) Isosorbide mononitrate (e) Propranolol
Description : Myocardial oxygen demand is increased by all of the following factors except (a) Exercise (b) Smoking (c) Cold temperatures (d) Isoproterenol (e) Propranolol
Description : Exertion–induced angina, which is relieved by rest, nitroglycerin, or both, is referred to as (a) Prinzmetal’s angina (b) Unstable angina (c) Classic angina (d) Variant angina (e) Preinfarction angina
Description : Which of the following cyclotron produced radiopharmaceuticals is used for assessing regional myocardial perfusion as part of an exercise stress test? (a) Thallous chloride 201TI USP (b) Sodium iodide 123I (c) Gallium citrate 67Ga USP (d) Indium 111In pentetate (e) Cobalt 57Co cyanocobalamin
Description : Which of the following cardiovascular agents is classified chemically as a glycoside? (a) Nifedipine (b) Digoxin (c) Flecainide (d) Cholestyramine (e) Warfarin
Description : Regarding verapamil, which one of the following statements is false? (a) Angina pectoris is an important indication for the use of verapamil (b) Contraindicated in the asthmatic patient (c) ... phase of the action potential in AV nodal cells (e) Used in management of supraventricular tachycardias
Description : A 54-year-old woman with severe hypercholesterolemia is to be treated with a combination of niacin and atorvastatin. With this drug combination, it is important that the patient be monitored closely for signs of (a) Agranulocytosis (b) Gallstones (c) Lactic acidosis (d) Myopathy (e) Thyrotoxicosis
Description : Which of the following is the drug of choice for management of cardiac arrhythmias that occur in digitalis toxicity? (a) Amiodarone (b) Lidocaine (c) Propranolol (d) Sotalol (e) Prazosin
Description : Which one of the following drugs predictably prolongs the PR interval and increases cardiac contractility? (a) Digoxin (b) Lidocaine (c) Propranolol (d) Quinidine (e) Verapamil
Description : The mechanism of action of cyclosporine involves (a) Activation of calcineurin (b) Binding to cyclophilin to cause inhibition of a cytoplasmic phosphatase (c) Blockade of interleukin – 2- receptors (d) Inhibition of phospholipase A2 (e) Suppression of bone marrow progenitors
Description : Drugs used in asthma that often cause tachycardia and tremor include (a) Beclomethasone (b) Cromolyn sodium (c) Ipratropium (d) Metaproterenol (e) All of the above
Description : Methylxanthine drugs such as aminophylline cause which one of the following? (a) Vasoconstriction in many vascular beds (b) Decrease in the amount of cAMP in mast cells (c) Bronchodilation (d) Activation of the enzyme phosphodiesterase (e) Sedation
Description : In a patient receiving digoxin for congestive heart failure, condition that may facilitate the appearance of toxicity include (a) Hyperkalemia (b) Hypernatremia (c) Hypocalcemia (d) Hypomagnesemia (e) All of the above