Description : Vasoconstrictors should not be used in: A. Neurogenic shock B. Haemorrhagic shock C. Secondary shock D. Hypotension due to spinal anaesthesia
Last Answer : C. Secondary shock
Description : A 32-year-old man suffers a spinal cord injury with a resultant paraplegia in a motorcycle accident. He presents to the emergency room with hypotension. Which of the following statement(s) is/ ... injury will be uncommon d. There is no role for pharmacologic intervention to maintain blood pressure
Last Answer : Answer: c Neurogenic shock results from interruption of sympathetic vasomotor input and develops after spinal cord injury, spinal anesthesia, and severe head injury. Under normal conditions, baseline ... the cause is not neurogenic and search for occult blood loss or cardiogenic causes of shock
Description : All of the following are true about neurogenic shock except: A. There is a decrease in systemic vascular resistance and an increase in venous capacitance. B. Tachycardia or bradycardia may be ... Severe head injury, spinal cord injury, and high spinal anesthesia may all cause neurogenic shock.
Last Answer : Answer: C DISCUSSION: Neurogenic shock occurs when severe head injury, spinal cord injury, or pharmacologic sympathetic blockade leads to sympathetic denervation and loss of vasomotor tone. ... of treatment. The use of alpha-adrenergic agonist is infrequently necessary to treat neurogenic shock
Description : The following factor is not involved in the causation of hypotension due to spinal anaesthesia: A. Histamine release B. Reduced sympathetic vasoconstrictor tone C. Decreased venous return from the lower limbs D. Bradycardia
Last Answer : A. Histamine release
Description : The nurse anticipates that the immunosuppressed patient is at greatest risk for which type of shock? a) Septic Septic shock is associated with immunosuppression, extremes of age, ... disease of the heart. d) Anaphylactic Anaphylactic shock is associated with hypersensitivity reactions.
Last Answer : a) Septic Septic shock is associated with immunosuppression, extremes of age, malnourishment, chronic illness, and invasive procedures.
Description : While undergoing a surgical procedure a patient develops hypotension. Which of the following drugs can be injected intramuscularly to raise his BP (a) Noradrenaline (b) Isoprenaline (c) Mephentermine (d) Isoxsuprine
Last Answer : Ans: C
Description : A patient is admitted to the emergency room with orthostatic hypotension and evidence of marked GI bleeding. Which of the following most accurately describes the probable autonomic response to this ... constricted pupils, increased bowel sounds (e) Rapid heart rate, constricted pupils, warm skin
Last Answer : Ans: B
Description : Postural hypotension is a common adverse effect of which one of the following types of drugs ? (a) ACE inhibitors (b) Alpha-receptor blockers (c) Arteriolar dilators (d) ß1 – selective receptor blockers (e) Nonselective ß - blockers
Description : Which of the following drugs is the drug of choice in anaphylaxis associated with bronchospasm and hypotension ? (a) Cortisone (b) Epinephrine (c) Isoproterenol (d) Norepinephrine (e) Phenylephrine
Description : Which type of incontinence is associated with weakened perineal muscles that permit leakage of urine when intra-abdominal pressure is increased? a) Stress incontinence Stress incontinence ... intact urinary physiology who experience mobility impairment, environmental barriers, or cognitive problems.
Last Answer : a) Stress incontinence Stress incontinence may occur with coughing or sneezing.
Description : Your patient is to receive a selective ß2 stimulant drug ß2 selective stimulant are often effective in (a) Angina due to coronary insufficiency (b) Asthma (c) Chronic heart failure (d) Delayed or insufficiently strong labor (e) All of the above
Description : Several children at a summer camp were hospitalized with symptoms thought to be due to ingestion of food containing botulinum toxins. The effects of botulinum toxin are likely to include (a) Bronchospasm (b) Cycloplegia (c) Diarrhea (d) Skeletal muscle spasms (e) Hyperventilation
Description : Invasive hemodynamic monitoring using a Swan-Gantz catheter is essential in the optimal management of patients in shock or those suffering post-shock sequelae. Which of the following physiologic ... , increased SVR d. Neurogenic shock: Decreased PCWP, increased cardiac output, decreased SVR
Last Answer : Answer: a, c
Description : Which of the following statement(s) is/are true concerning the various types of shock? a. Traumatic shock is more commonly associated with subsequent organ injury and multiorgan failure ... responds quickly to resuscitation e. Neurogenic shock occurs with the absence of sympathetic activity
Last Answer : Answer: a, b, d, e Classification schemes of shock based on cause have been developed for the seemingly dissimilar processes leading to circulatory collapse and the shock state. ... and pressor agents. The response to exogenous corticosteroids is usually dramatic and potentially life-saving
Description : A 22-year-old man sustains a single stab wound to the left chest and presents to the emergency room with hypotension. Which of the following statement(s) is/are true concerning his ... diagnosis of pericardial tamponade d. The placement of bilateral chest tubes will likely resolve the problem
Last Answer : Answer: c Shock from cardiac compression occurs when external pressure on the heart impairs ventricular filling. Because ventricular filling is a function of venous return and myocardial compliance, ... sternotomy. Chest tube placement would not be appropriate as the sole treatment in this patient
Description : 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. ... test should be performed to help establish the diagnosis of acute adrenocortical insufficiency.
Last Answer : Answer: AD DISCUSSION: Shock due to acute adrenocortical insufficiency is relatively uncommon but must be considered when shock refractory to volume replacement and pressor therapy is present. ... and it is the corticosteroid of choice while the ACTH stimulation test is being performed
Description : Epidural anaesthesia differs from spinal anaesthesia in that: A. Epidural anaesthesia produces less cardiovascular complications B. Headache is more common after epidural anaesthesia C. Blood ... . Greater separation between sensory and motor blockade can be obtained with epidural anaesthes
Last Answer : D. Greater separation between sensory and motor blockade can be obtained with epidural anaesthesia
Description : Spinal anaesthesia is not suitable for: A. Vaginal delivery B. Lower segment caesarian section C. Prostatectomy D. Operations on mentally ill patients
Last Answer : D. Operations on mentally ill patient
Description : The duration of spinal anaesthesia depends on each of the following except: A. Which local anaesthetic is used B. Concentration of the local anaesthetic used C. Posture of the patient D. Whether adrenaline has been added to the local anaesthetic
Last Answer : C. Posture of the patient
Description : In spinal anaesthesia the segmental level of: A. Sympathetic block is lower than the sensory block B. Sympathetic block is higher than the sensory block C. Motor block is higher than the sensory block D. Sympathetic, motor and sensory block has the same level
Last Answer : B. Sympathetic block is higher than the sensory block
Description : The segmental level of spinal anaesthesia depends on: A. Volume of the local anaesthetic injected B. Specific gravity of the local anaesthetic solution C. Posture of the patient D. All of the above factors
Last Answer : D. All of the above factors
Description : n which of the following techniques the concentration of the local anaesthetic used is the lowest: A. Infiltration anaesthesia B. Nerve block anaesthesia C. Spinal anaesthesia D. Epidural anaesthesia
Last Answer : A. Infiltration anaesthesia
Description : Phenylephrine (a) Mimics the transmitter at post-synaptic receptors (b) Displaces transmitter from axonal terminal (c) Inhibits synthesis of transmitter (d) None of the above
Last Answer : Ans: A
Description : Propranolol does not block the following action of adrenaline (a) Bronchodilation (b) Lipolysis (c) Muscle tremor (d) Mydriasis
Last Answer : Ans: D
Description : Propanolol can be used to allay anxiety associated with (a) Chronic neurotic disorer (b) Schizopherenia (c) Short-term stressful situation (d) Endogenous depression
Description : The ß-adrenergic blocker which possesses both ß1 selectivity as well as intrinsic sympathomimetic activity is (a) Alprenolol (b) Atenolol (c) Acebutolol (d) Metoprolol
Description : Which of the following is true of sildenafil (a) It enhances sexul enjoyment in normal men (b) It delays ejaculation (c) It is indicated only for treatment of erectile dysfunction in men (d) It blocks cavernosal a2 adrenoceptors
Description : Prazosin is an effective antihypertensive while nonselective a adrenergic blockers are not because (a) It is the only orally active a blocker (b) It improves plasma lipid profile (c) It does not concurrently enhance noradrenaline release (d) It improves urine flow in males with prostatic hypertrophy
Description : The drug which produces vasoconstriction despite being an a adrenergic blocker is (a) Phenoxybenzamine (b) Ergotamine (c) Dihydroergotoxine (d) Tolazoline
Description : Guanethidine inhibits (a) Synthesis of transmitter (b) Metabolism of transmitter (c) Release of transmitter (d) Displacement of transmitter from axonal terminal
Description : Continuous exposure of ctecholaminesensitive cells and tissues to adrenergic agonists causes a progressive diminition in their capacity to respond, this phenomenon is called as (a) Refractoriness (b) Desensitization (c) Tachyphylaxis (d) All of the above
Description : Ephedrine is similar to adrenaline in the following feature (a) Potency (b) Inability to penetrate blood-brain barrier (c) Duration of action (d) Producing both a and ß adrenergic effects
Description : Dobutamine differs from dopamine in that (a) It does not activate peripheral dopaminergic receptors (b) It does not activate adrenergic ß receptors (c) It causes pronounced tachycardia (d) It has good blood-brain barrier penetrability
Description : Noradrenaline is administered by (a) Subcutaneous injection (b) Intramuscular injection (c) Slow intravenous infusion (d) All of the above routes
Description : Adrenaline raises blood glucose level by the following actions except (a) Inducing hepatic glycogenolysis (b) Inhibiting insulin secretion from pancreatic ß cells (c) Augmenting glucagons secretion from pancreatic a cells (d) Inhibiting peripheral glucose utilization
Description : a2–adrenergic receptors are associated with following except (a) Increase in phospholipase C activity (b) Increase in potassium channel conductance (c) Decrease in calcium channel conductance (d) Increase in adenylyl cyclase activity
Description : Low doses of adrenaline dilate the following vascular bed (a) Cutaneous (b) Mucosal (c) Renal (d) Skeletal muscle
Description : A sympathomimetic amine that acts almost exclusively by releasing noradrenaline from the nerve endings is (a) Ephedrine (b) Dopamine (c) Isoprenaline (d) Tyramine
Description : Choose the correct statement from the following about a1 – adrenergic receptor agonists (a) Norepinephrine > isoproterenol > epinephrine (b) Norepinephrine < epinephrine > isoproterenol (c) Epinephrine = norepinephrine >> isoproterenol (d) Epinephrine > isoproterenol > norepinephrine
Description : Tyramine induces release of noradrenaline from adrenergic nerve endings (a) By depolarizing the axonal membrane (b) By mobilizing Ca2+ (c) By a nonexocytotic process (d) Only in the presence of MAO inhibitors
Description : The most efficacious inhibitor of catecholamine synthesis in the body is (a) a - methyl – p - tyrosine (b) a - methyldopa (c) a - methyl - norepinephrine (d) Pyrogallol
Description : Select the correct statement from the following about a1 – adrenergic receptor agonists (a) Isoproterenol > epinephrine = norepinephrine (b) Epinephrine > isoproterenol > norepinephrine (c) Isoproterenol = epinephrine = norepinephrine (d) Epinephrine = norepinephrine > isoproterenol
Description : Atropine is contraindicated in (a) Cyclic AMP (b) Inositol trisphosphate (c) Diacyl glycerols (d) G protein
Description : The most effective antidote for belladonna poisoning is (a) Neostigmine (b) Physostigmine (c) Pilocarpine (d) Methacholine
Description : The most suitable mydratic for a patient of corneal ulcer is (a) Atropine sulfate (b) Homatropine (c) Cyclopentolate (d) Tropicamide
Description : Which of the following mydriatics has the fastest and briefest action ? (a) Atropine (b) Homatropine (c) Tropicamide (d) Cyclopentolate
Description : Glycopyrrolate is the preferred antimuscannic drug for use before and during surgery because (a) It is potent and fast acting (b) It has no central action (c) It has antisecretory and vagolytic actions (d) All of the above
Description : Which of the following anticholinergic drugs is primarily used in preanaesthetic medication and during surgery (a) Glycopyrrolate (b) Pipenzolate methyl bromide (c) Isopropamide (d) Dicyclomine
Description : Hyoscine differs from atropine in that it (a) Exerts depressant effects on the CNS at relatively low doses (b) Exerts more potent effects on the heart than on the eye (c) Is longer acting (d) Has weaker antimotion sickness activity
Description : a1 – receptors are coupled with _______ G protein. (a) Gs (b) Gi (c) Gq (d) Go