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 or circulatolry collapse (c) Decreased cardiac output, as from congestive heart failure (d) Hemolysis, myoglobinuria (e) Hyperkalemia

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 or circulatolry collapse (c) Decreased cardiac output, as from congestive heart failure (d) Hemolysis, myoglobinuria (e) Hyperkalemia
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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

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

Last Answer : Ans: D

Essential amino acids have been advocated as standard therapy for renal failure. Which of the following statements are true? A. Increased survival from acute renal failure has been reported with both essential and nonessential amino acid therapy of patients in renal failure. B. Essential amino acids retard the rise of blood urea nitrogen (BUN) secondary to decreased urea appearance. C. Essential amino acids and hypertonic dextrose are a convenient form of therapy for hyperkalemia. D. Essential amino acids decrease BUN and creatinine to the same degree as solutions containing excessive nonessential amino acids.

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The term ischemic heart disease (IHD) is used to designate all of the following conditions except (a) Angina pectoris (b) Sudden cardiac death (c) Congestive heart failur (CHF) (d) Arrhythmias

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If a fibrinolytic drug is used for treatment of acute myocardial infarction, the adverse drug effect that is most likely to occur is (a) Acute renal failure (b) Development of antiplatelet antibodies (c) Encephalitis secondary to liver dysfunction (d) Hemorrhagic stroke (e) Neutropenia

Description : If a fibrinolytic drug is used for treatment of acute myocardial infarction, the adverse drug effect that is most likely to occur is (a) Acute renal failure (b) Development of antiplatelet antibodies (c) Encephalitis secondary to liver dysfunction (d) Hemorrhagic stroke (e) Neutropenia

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Lidocaine is the preferred antiarrhythmic for emergency control of cardiac arrhythmias following acute myocardial infarction because (a) It has a rapidly developing and titratable antiarrhythmic action (b) It casues little myocardial depression and hypotension (c) It has broad spectrum antiarrhythmic efficacy in atrial as well as ventricular arrhythmias (d) Both (a) and (b)

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Last Answer : Ans: D

Which of the following statement(s) is/are true concerning the outcome in patients with acute renal failure? a. Mortality for ischemic acute tubular necrosis without other organ failure is approximately 6% b. Multiple organ failure complicated with acute renal failure is associated with mortality ranging from 50% to 90% c. Recovery of renal function after six weeks is unlikely d. There is no difference in survival between oliguric and nonoliguric renal failure

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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

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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

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True statements concerning hypoadrenal shock include which of the following? A. Adrenocortical insufficiency may manifest itself as severe shock refractory to volume and pressor therapy. B. The presence of hyperglycemia and hypotension may suggest the diagnosis of shock due to adrenocortical insufficiency. C. Hydrocortisone does not interfere with the serum cortisol assay and should be given to hemodynamically unstable patients suspected of having hypoadrenal shock. D. The rapid adrenocorticotropic hormone (ACTH) stimulation test should be performed to help establish the diagnosis of acute adrenocortical insufficiency.

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A 55-year-old patient currently receiving other drugs for another condition is to be started on diuretic therapy for mild heart failure. Thiazides are known to reduce the excretion of (a) Diazepam (b) Fluoxetine (c) Imipramine (d) Lithium (e) Potassium

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Last Answer : Ans: D

Therapeutic dose of digoxin in a normal individual has the following effects, except (a) Increase in the speed of myocardial contractility (b) No significant change in cardiac output (c) Relaxation of peripheral vascular bed (d) Increase in the force of myocardial contractility

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Last Answer : Ans: C

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Last Answer : Ans: B

The following is true of mannitol except: A. It inhibits solute reabsorption in the thick ascending limb of loop of Henle B. It is contraindicated in patients with increased intracranial tension C. It is contraindicated in acute left ventricular failure D. It is not used to treat cardiac or hepatic or renal edema

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Situations that predispose a digitalistreated patient to toxicity include (a) Hypercalcemia (b) Hyperkalemia (c) Hypermagnesemia

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Last Answer : Ans: A

Digoxin given for cardiac failure is extremely valuable in patients of (a) Thyrotoxicosis (b) Beriberi (c) Cor pulmonale (d) Atrial fibrillation

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A patient of acute myocardial infarction being treated in intensive care unit developed left ventricular failure with raised central venous pressure. It was decided to use glyceryl trinitrate. Which route/method of administration would be most suitable. (a) Sublingual (b) Oral (c) Intravenous bolus injection (d) Slow intravenous infusion

Description : A patient of acute myocardial infarction being treated in intensive care unit developed left ventricular failure with raised central venous pressure. It was decided to use glyceryl trinitrate. Which route/ ... (a) Sublingual (b) Oral (c) Intravenous bolus injection (d) Slow intravenous infusion

Last Answer : Ans: D

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

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Last Answer : Ans: B

Choose the drug which is used as a short-term inotropic in severe congestive heart failure and has selective adrenergic β1 agonistic activity but no dopaminergic agonistic activity: A. Dopamine B. Dobutamine C. Amrinone D. Salmeterol

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Last Answer : B. Dobutamine

Choose the drug which is used as a short-term inotropic in severe congestive heart failure and has selective adrenergic β 1 agonistic activity but no dopaminergic agonistic activity: A. Dopamine B. Dobutamine C. Amrinone D. Salmeterol

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Last Answer : B. Dobutamine

When the post-cardiac surgery patient demonstrates restlessness, nausea, weakness, and peaked T waves, the nurse reviews the patient’s serum electrolytes anticipating which abnormality? a) Hyperkalemia Hyperkalemia is indicated by mental confusion, restlessness, nausea, weakness, and dysrhythmias (tall, peaked T waves). b) Hypercalcemia Hypercalcemia would likely be demonstrated by asystole. c) Hypomagnesemia Hypomagenesemia would likely be demonstrated by hypotension, lethargy, and vasodilation. d) Hyponatremia Hyponatremia would likely be indicated by weakness, fatigue, and confusion without change in T wave formation

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The following apply to use of spironolactone in CHF except: A. It is indicated only in NYHA class III/IV cases as additional drug to conventional therapy B. It affords prognostic benefit in severe heart failure over and above that afforded by ACE inhibitors C. It helps overcome refractoriness to diuretics D. It affords rapid symptomatic relief

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Last Answer : D. It affords rapid symptomatic relief

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 : 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

Last Answer : Ans: D

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 : 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

Last Answer : Ans: A

All the following statements about renal tubular acidosis are correct except (A) Renal tubules may be unable to reabsorb bicarbonate (B) Renal tubules may be unable to secrete hydrogen ions (C) Plasma chloride is elevated (D) Anion gap is decreased

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Last Answer : Answer : D

The following drug is used to reduce the frequency of angina pectoris as well as to terminate an acute attack (a) Digoxin (b) Furosemide (c) Enalapril (d) Amrinone

Description : The following drug is used to reduce the frequency of angina pectoris as well as to terminate an acute attack (a) Digoxin (b) Furosemide (c) Enalapril (d) Amrinone

Last Answer : Ans: A

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

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

The following is true of β-adrenergic blocker therapy in CHF: A. They are added to conventional therapy after cardiac compensation is restored B. They are indicated only in severe (NYHA class IV) heart failure C. They are to be used only at low doses D. All of the above

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Last Answer : A. They are added to conventional therapy after cardiac compensation is restored

Which of the following statements about septic shock are true? A. A circulating myocardial depressant factor may account for the cardiac dysfunction sometimes seen with shock due to sepsis or SIRS. B. A cardiac index (CI) of 6 liters per minute per square meter of body surface, a pulmonary capillary wedge pressure of 15 mm. Hg, and a systemic vascular resistance index (SVRI) of 800 dynes-sec/(cm 5-m 2) is a hemodynamic profile consistent with septic shock. C. An increase in SvO 2 in septic patients may be explained by the finding of anatomic arteriovenous shunts. D. Results of human trials employing antimediator therapy, such as antiendotoxin antibodies, IL-1 receptor antagonist, and tumor necrosis factor (TNF) antibodies, have confirmed animal studies that demonstrate a significant im

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Last Answer : Answer: AB DISCUSSION: Shock due to sepsis or SIRS frequently manifests as a hyperdynamic cardiovascular response, consisting of an elevated CI and a decreased SVR or SVRI. Occasionally, ... been encouraging thus far in human clinical trials, despite the promising results from many animal studies

Which of the following is associated with Hyperuricaemia? 1) is usually due to an excess purine consumption 2) occurs in association with acute lymphoblastic leukaemia 3) in primary gout is inherited in an autosomal dominant manner 4) can be reduced with low dose aspirin therapy 5) can be treated with uricosuric drugs even in renal failure

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Which one of the following statements about “one daily” dosing with aminoglycosides is false ? (a) It is convenient for outpatient therapy (b) Adjustment of dosage is less important in renal insufficiency (c) Less nursing time is required (d) It is often less toxic than conventional (multiple)dosing regimens (e) Under-dosing is less of a problem

Description : Which one of the following statements about one daily dosing with aminoglycosides is false ? (a) It is convenient for outpatient therapy (b) Adjustment of dosage is less important in renal ... often less toxic than conventional (multiple)dosing regimens (e) Under-dosing is less of a problem

Last Answer : Ans: B

Increased serum levels of which of the following may be associated with a decreased risk of atherosclerosis? (a) Very low-density lipoproteins (VLDL) (b) Low-density lipoproteins (LDL) (c) Intermediate – density lipoproteins (IDL) (d) High-density lipoproteins (HDL) (e) Cholesterol

Description : Increased serum levels of which of the following may be associated with a decreased risk of atherosclerosis? (a) Very low-density lipoproteins (VLDL) (b) Low-density lipoproteins (LDL) (c) Intermediate – density lipoproteins (IDL) (d) High-density lipoproteins (HDL) (e) Cholesterol

Last Answer : Ans: D

Enhanced automaticity in cardiac cells may occur because of (a) ß-adrenergic stimulation (b) Hypokalemia (c) Mechanical stretch of cardiac muscles (d) All of the above

Description : Enhanced automaticity in cardiac cells may occur because of (a) ß-adrenergic stimulation (b) Hypokalemia (c) Mechanical stretch of cardiac muscles (d) All of the above

Last Answer : Ans: D

Which of the following are not determinants of a postoperative cardiac complication? A. Myocardial infarct 4 months previously. B. Clinical evidence of congestive heart failure in a patient with 8.5 gm. per dl. hemoglobin. C. Premature atrial or ventricular contractions on electrocardiogram. D. A harsh aortic systolic murmur. E. Age over 70 years.

Description : Which of the following are not determinants of a postoperative cardiac complication? A. Myocardial infarct 4 months previously. B. Clinical evidence of congestive heart failure in a patient with 8.5 gm ... on electrocardiogram. D. A harsh aortic systolic murmur. E. Age over 70 years.

Last Answer : Answer: B DISCUSSION: Clinical evidence of congestive heart failure in a patient with 8.5 gm. per dl. hemoglobin concentration is a misleading sign. Evidence of congestive ... or ventricular contractions on the electrocardiogram are less strong determinants of a postoperative cardiac complication

he current therapeutic indication of acetazolamide is: A. Congestive heart failure B. Renal insufficiency C. Cirrhosis of liver D. Glaucoma

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Last Answer : D. Glaucoma

The basis for use of β-adrenergic blockers in congestive heart failure (CHF) is: A. They exert positive inotropic effect in CHF B. They counteract deleterious effect of sympathetic overactivity on the myocardium C. They exert antiischaemic effect on the heart D. They prevent cardiac arrhythmias

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Last Answer : B. They counteract deleterious effect of sympathetic overactivity on the myocardium

The basis for use of β -adrenergic blockers in congestive heart failure (CHF) is: A. They exert positive inotropic effect in CHF B. They counteract deleterious effect of sympathetic overactivity on the myocardium C. They exert antiischaemic effect on the heart D. They prevent cardiac arrhythmias

Description : The basis for use of β -adrenergic blockers in congestive heart failure (CHF) is: A. They exert positive inotropic effect in CHF B. They counteract deleterious effect of sympathetic overactivity on the myocardium C. They exert antiischaemic effect on the heart D. They prevent cardiac arrhythmias

Last Answer : B. They counteract deleterious effect of sympathetic overactivity on the myocardium

A patient on oral anticoagulant therapy is commenced on sulfamethoxazoletrimethoprim, double-strength twice daily. One may expect to see the international normalized ratio (a) Increase (b) Decrease (c) Remain unchanged

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Acute tubular necrosis?

Description : Acute tubular necrosis?

Last Answer : DefinitionAcute tubular necrosis is a kidney disorder involving damage to the tubule cells of the kidneys, resulting in acute kidney failure.Alternative NamesNecrosis - renal tubular; ATN; ... reactionInjury or trauma that damages the musclesRecent major surgerySeptic shock or other forms of shockS

Creatinine clearance is deceased in (A) Acute tubular necrosis (B) Acute glomerulonephritis (C) Hypertension (D) Myopathies

Description : Creatinine clearance is deceased in (A) Acute tubular necrosis (B) Acute glomerulonephritis (C) Hypertension (D) Myopathies

Last Answer : Answer : D

The chief use of levoarterenol is to treat (a) Shock (b) Diabetes (c) Hypertension (d) Cardiac arrhythmias (e) Iron deficiencies

Description : The chief use of levoarterenol is to treat (a) Shock (b) Diabetes (c) Hypertension (d) Cardiac arrhythmias (e) Iron deficiencies

Last Answer : Ans: A

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 : 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

Last Answer : Ans: A

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 : 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

Last Answer : Ans: E

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 : 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

Last Answer : Ans: C

A hypertensive patient has been using nifedipine for some time without untoward effects. If he experiences a rapidly developing enhancement of the antihypertensive effect of the drug, it is probably due to (a) Concomitant use of antacids (b) Fods containing tyramine (c) Grapefruit juice (d) Induction of drug metabolism (e) Over – the – counter decongestants

Description : A hypertensive patient has been using nifedipine for some time without untoward effects. If he experiences a rapidly developing enhancement of the antihypertensive effect of the drug, it is probably due to ... ) Grapefruit juice (d) Induction of drug metabolism (e) Over - the - counter decongestants

Last Answer : Ans: C

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

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

Cardiac glycosides are obtained from following plant source. (a) Rauwolfia serpentina (b) Strophanthus gratus (c) Ricinus commounts. (d) Atropa belladonna

Description : Cardiac glycosides are obtained from following plant source. (a) Rauwolfia serpentina (b) Strophanthus gratus (c) Ricinus commounts. (d) Atropa belladonna

Last Answer : Ans: B