Examples of ion channel blockers include: a. Tetrodotoxin b. Amiloride c. Xylocaine d. None of the above

Examples of ion channel blockers include: a. Tetrodotoxin b. Amiloride c. Xylocaine d. None of the above
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Answer: a, b, c  Channel blockade is an important mechanism of action for toxins and some therapeutic agents. The deadly toxin of the puffer fish, tetrodotoxin, acts by blocking the Na+ channels that are responsible for the conduction of nerve impulse. The diuretic, amiloride, acts by blocking the Na+ channels that inhabit the apical membrane of the epithelial cells of the distal nephron. Local anesthetics such xylocaine also act by blocking ion channels
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There are two properties of the cell necessary to maintain nonequilibrium cellular composition; the first is selectivity and the second is energy conversion. Which of the following statement(s) is/are true concerning energy converting transport? a. The site of energy conversion and transport in the plasma membrane involves the phospholipid component b. The Na+-K++-ATPase derives energy from hydrolysis of extracellular ATP c. In some systems, energy inherent in the transmembrane ion gradient can be used to drive transport of a second species d. Examples of species transported via secondary active transport include hydrogen ions, calcium, amino acids and glucose

Description : There are two properties of the cell necessary to maintain nonequilibrium cellular composition; the first is selectivity and the second is energy conversion. Which of the following statement(s ... transported via secondary active transport include hydrogen ions, calcium, amino acids and glucose

Last Answer : Answer: c, d The selectivity of the plasma membrane, although impressive, cannot account for the nonequilibrium composition of living cells. A cell can be maintained in a nonequilibrium state only by ... to drive the transport of a second species such as protons, calcium, amino acids, or glucose

Which of the following statement(s) is/are true concerning cellular ion channels? a. Ion channels are transmembrane proteins that form pores that can conduct ions across the plasma membrane b. Ion channels are formed by membrane-spanning peptides that are arranged so that polar moieties line a central core c. Ion channel proteins undergo conformational changes between open states and closed states d. Ion channels can be blocked

Description : Which of the following statement(s) is/are true concerning cellular ion channels? a. Ion channels are transmembrane proteins that form pores that can conduct ions across the plasma membrane b. ... undergo conformational changes between open states and closed states d. Ion channels can be blocked

Last Answer : Answer: a, b, c, d Ion channels are transmembrane proteins that form pores that can conduct ions across the plasma membrane. Ion channels are formed by membrane-spanning peptides that are arranged ... be blocked by ions or organic compounds that enter the channel, bind there, and occlude the pore

Interleukin-6 is recognized as the cytokine primarily responsible for the alteration in hepatic protein synthesis recognized as the acute phase response. Which of the following statement(s) is/are true concerning acute phase protein response to surgical stress? a. Glucocorticoid hormones inhibit this response b. Proteins such as albumin and transferrin which serve in serum transport are generally increased in this response c. Examples of acute phase proteins include fibrinogen and C-reactive protein d. In general, the physiologic role of acute phase proteins are to reduce the systemic effects of tissue damage

Description : Interleukin-6 is recognized as the cytokine primarily responsible for the alteration in hepatic protein synthesis recognized as the acute phase response. Which of the following statement(s) is/are true ... physiologic role of acute phase proteins are to reduce the systemic effects of tissue damage

Last Answer : Answer: c, d IL-6 is now recognized at the cytokine primarily responsible for the alteration in hepatic synthesis recognized as the acute phase response. Glucocorticoid hormones augment ... that generally inhibit the tissue destruction that is associated with the local initiation of inflammation

Which of the following statement(s) is/are true concerning carbon dioxide kinetics? a. The amount of carbon dioxide produced is equivalent to the amount of oxygen consumed b. Carbon dioxide levels in blood, present mostly as a bicarbonate ion, can quickly change c. Normally the amount of carbon dioxide excreted through the lung is exactly equal to the amount of carbon dioxide produced in peripheral tissues d. The amount of carbon dioxide excreted is a function of ventilation of perfused alveoli

Description : Which of the following statement(s) is/are true concerning carbon dioxide kinetics? a. The amount of carbon dioxide produced is equivalent to the amount of oxygen consumed b. Carbon dioxide levels ... tissues d. The amount of carbon dioxide excreted is a function of ventilation of perfused alveoli

Last Answer : Answer: a, c, d The total amount of carbon dioxide produced by systemic metabolism is roughly equivalent to the amount of oxygen consumed (100-120 cc/m2/min, 200 cc/min in a typical ... carbon dioxide excreted is a function of ventilation of perfused alveoli (i.e. the alveolar ventilation/min).

Which of the following statement(s) is/are true concerning carrier proteins? a. Carrier proteins are distinguished by three types of mechanisms: carrier-type, channel-type, and conduction-type b. Conformational changes in the membrane protein occur between the conducting and the nonconducting states c. A channel-type carrier protein has two states—closed and open d. Carrier-type transport proteins are equally accessible from either side of the membrane

Description : Which of the following statement(s) is/are true concerning carrier proteins? a. Carrier proteins are distinguished by three types of mechanisms: carrier-type, channel-type, and conduction-type b. ... and open d. Carrier-type transport proteins are equally accessible from either side of the membrane

Last Answer : Answer: b, c Most transport proteins appear to function as carriers, rather than channels. Important distinctions can be made between types of carrier proteins on the basis of transport kinetics. ... a carrier mechanism, the binding site is available only one side of the membrane at any instant

Phases of multiorgan failure will include: a. Generalized increased capillary permeability b. A hypermetabolic state c. Organ malfunction d. All of the above

Description : Phases of multiorgan failure will include: a. Generalized increased capillary permeability b. A hypermetabolic state c. Organ malfunction d. All of the above

Last Answer : Answer: d Clinically the multiple-organ failure patient progresses through well-defined phases. These phases include: Phase 1-a generalized increased capillary permeability resulting in edema, weight gain, ... tissue damage in the lung or brain, the death of the entire organ is likely

Useful steps to optimize systemic oxygen delivery include: a. Maintaining mean arterial blood pressure between 50 and 90 mm Hg b. Optimizing PEEP levels by monitoring mixed venous saturation c. Turning the patient prone d. Sedation or paralysis

Description : Useful steps to optimize systemic oxygen delivery include: a. Maintaining mean arterial blood pressure between 50 and 90 mm Hg b. Optimizing PEEP levels by monitoring mixed venous saturation c. Turning the patient prone d. Sedation or paralysis

Last Answer : Answer: a, b, c, d Optimizing systemic oxygen delivery in relationship to oxygen requirement is the primary goal of management. Improving oxygenation of the blood itself by ... sedation, and establishing muscular paralysis decrease oxygen consumption, and decrease the need for oxygen delivery

Which of the following statement(s) is/are true concerning hypoadrenal shock? a. In the United States, idiopathic adrenal atrophy (Addison’s disease) is the most common cause b. Laboratory abnormalities include hyponatremia, hypochloremia, and hyperkalemia c. Fever may be seen with hypoadrenal shock d. ACTH stimulation test is the diagnostic test of choice to confirm hypoadrenal shock

Description : Which of the following statement(s) is/are true concerning hypoadrenal shock? a. In the United States, idiopathic adrenal atrophy (Addison's disease) is the most common cause b. Laboratory ... hypoadrenal shock d. ACTH stimulation test is the diagnostic test of choice to confirm hypoadrenal shock

Last Answer : Answer: b, c, d Shock of a dramatic nature, poorly responsive to resuscitation, may develop as a consequence of adrenal insufficiency. In this country, adrenal insufficiency most ... of an ACTH stimulation test. A significant major cortisol response should be elicited by ACTH administration

Which of the following statement(s) is/are true concerning the pulmonary response to shock? a. The acute pulmonary vascular response to shock differs markedly from that of systemic vasculature b. The pulmonary edema of ARDS occurs in the face of elevated left heart pressures c. The initial physiologic changes of ARDS involve the capillary endothelial cells and the type I pneumocyte d. Mechanisms proposed in the pathogenesis of ARDS include injury from mediators of inflammation elsewhere and from activated cellular elements e. A decrease in lung compliance may result from the loss of type I pneumocytes

Description : Which of the following statement(s) is/are true concerning the pulmonary response to shock? a. The acute pulmonary vascular response to shock differs markedly from that of systemic vasculature b. The ... elements e. A decrease in lung compliance may result from the loss of type I pneumocytes

Last Answer : Answer: c, d, e Contributing pathophysiologic processes to the pulmonary manifestations of shock include the pulmonary component of the cardiovascular response, disruption of the normal ... injury from mediators of inflammation elaborated elsewhere, and from activated cellular blood elements

The following statement(s) is/are true concerning gram-negative bacterial sepsis. a. Mortality due to this condition has almost been eliminated due to therapeutic intervention with antibiotics, aggressive hemodynamic monitoring and fluid resuscitation b. Recent series have noted a decrease in the incidence of this condition c. Predisposing factors include old age, malnutrition, and immunosuppression d. Pseudomonas bacteremia is the most common cause of gram-negative sepsis e. Polymicrobial sepsis is generally considered a more serious problem than sepsis due to a single organism

Description : The following statement(s) is/are true concerning gram-negative bacterial sepsis. a. Mortality due to this condition has almost been eliminated due to therapeutic intervention with antibiotics, aggressive ... sepsis is generally considered a more serious problem than sepsis due to a single organism

Last Answer : Answer: c, e Gram-negative bacterial sepsis is a serious disease process that produces substantial morbidity and mortality in both normal and immunocompromised patients (10% to 20% and ... and most investigators agree that polymicrobial sepsis is more lethal than infection with a single organism

The treatment of the following patient should include: a. Initial empiric therapy directed against both aerobes and anaerobes b. The addition of anti-fungal therapy in an elderly patient c. A minimum of two weeks of antibiotic therapy is indicated d. The addition of appropriate antibiotic therapy has made surgical therapy unnecessary in such cases e. Either a single agent or combination therapy is appropriate if the agents selected possess activity against both aerobic and anaerobic bacteria

Description : The treatment of the following patient should include: a. Initial empiric therapy directed against both aerobes and anaerobes b. The addition of anti-fungal therapy in an elderly patient ... therapy is appropriate if the agents selected possess activity against both aerobic and anaerobic bacteria

Last Answer : Answer: a, e The primary treatment for a perforated viscus is surgical, however antimicrobial therapy is an extremely important adjunct. Empiric antibiotic therapy for secondary ... whereas longer periods are indicated for immunosuppressed patients and with patients with extensive contamination

New treatment modalities designed to modulate host defense mechanisms that have been demonstrated conclusively to be of benefit include: a. Gut decontamination b. Anti-LPS antibody c. Anti-TNF antibody d. Thymopentin e. None of the above

Description : New treatment modalities designed to modulate host defense mechanisms that have been demonstrated conclusively to be of benefit include: a. Gut decontamination b. Anti-LPS antibody c. Anti-TNF antibody d. Thymopentin e. None of the above

Last Answer : Answer: e Selective gut decontamination involves the use of orally administered antibiotics that achieve a high intraluminal level directed against gram-negative aerobes and yeast, leaving ... but conclusive evidence that concurrent reduction of infection-related mortality occurs is not available

The following statement(s) is/are true concerning viral infections. a. The most common post-transplantation viral infections are caused by herpes viruses and include CMV and herpes simplex virus b. Viral infections occur at equal frequency anytime during the post-transplantation period c. CMV infection in the post-transplant patient is most likely a pulmonary process d. Herpes simplex virus (HSV) infection primarily presents with a mononucleosis-type syndrome with fever, lethargy, and cough

Description : The following statement(s) is/are true concerning viral infections. a. The most common post-transplantation viral infections are caused by herpes viruses and include CMV and herpes simplex virus ... HSV) infection primarily presents with a mononucleosis-type syndrome with fever, lethargy, and cough

Last Answer : Answer: a, c, Solid organ transplant patients are prone to develop viral infection by virtue of exogenous immunosuppression. The most common post-transplantation viral infections are those ... transplant patient or as painful herpes zoster in patients who have previously developed chicken pox

Wounds are classified according to the likelihood of bacterial contamination. Which of the following statement(s) is/are true concerning wound classifications? a. A clean-contaminated wound would be that associated with an elective colon resection with adequate mechanical and antibiotic bowel preparation b. A contaminated wound would include a resection of obstructed bowel with gross spillage of intestinal contents c. In a clean wound, no viscus is entered d. Antibiotic prophylaxis should be administered for all clean-contaminated and contaminated wounds and selectively in patients involving a clean wound

Description : Wounds are classified according to the likelihood of bacterial contamination. Which of the following statement(s) is/are true concerning wound classifications? a. A clean-contaminated wound would ... all clean-contaminated and contaminated wounds and selectively in patients involving a clean wound

Last Answer : Answer: a, b, c, d Wounds are classified under three classes according to the likelihood of bacterial contamination: 1) clean (no viscus is entered; e.g., herniorrhaphy); 2) clean- ... tenet involves cases in which a prosthetic material may be used (artificial joint, heart valve, tissue patch)

The use of prophylactic antibiotics has become commonplace. Which of the following statement(s) is/are true concerning the prophylactic use of antibiotics? a. The appropriate use of prophylactic antibiotics must include the initiation of the agent prior to the surgical procedure b. Continuing the antibiotic into the postoperative period has led to improved results in antibiotic prophylaxis c. The prophylactic administration of broad-spectrum agents (third-generation cephalosporins) has been shown to be particularly advantageous d. The topical use of antimicrobial agents is of no advantage in the prophylactic setting

Description : The use of prophylactic antibiotics has become commonplace. Which of the following statement(s) is/are true concerning the prophylactic use of antibiotics? a. The appropriate use of prophylactic ... d. The topical use of antimicrobial agents is of no advantage in the prophylactic setting

Last Answer : Answer: a Intravenous administration of an antibiotic is clearly indicated for patients undergoing clean contaminated operations. These antibiotics should be administered prior to surgery ... of antimicrobial agents is equivalent to the administration of intravenous antimicrobial agent antibiotics

The following statement(s) is/are true concerning newer detection methods of systemic infection. a. Enzyme-linked immunosorbent assay (ELISA) is a rapid immunologic assay used for both antigen and antibody detection b. Southern, northern, and western immunoblot techniques are used to detect DNA, RNA, or proteins, respectively c. Polymerase chain reaction (PCR) is a sensitive assay used to detect small amounts of microbial DNA, thus detecting infection at its early stages d. Infectious agents currently detected using advanced molecular techniques include cytomegalovirus (CMV) and human immunodeficiency virus (HIV)

Description : The following statement(s) is/are true concerning newer detection methods of systemic infection. a. Enzyme-linked immunosorbent assay (ELISA) is a rapid immunologic assay used for ... detected using advanced molecular techniques include cytomegalovirus (CMV) and human immunodeficiency virus (HIV)

Last Answer : Answer: a, b, c, d Although the classic detection of infection based on clinical signs of infection and bacterial culture remain the most common clinical tools, increasing ... including CMV and HIV. Furthermore, preliminary investigations into possible detection of fungal pathogens are underway

Eicosanoids mediate inflammation in a variety of ways. Of the following statements, which are true with regard to this? a. Eicosanoids are stored in cytoplasmic granules for release after receptor mediated signaling b. Eicosanoids include prostaglandins, thromboxanes, leukotrienes and lipoxins c. Eicosanoids generally have a plasma half-life measured in hours d. Physiologic responses to eicosanoids include vasodilatation, vasoconstriction, increased vascular permeability and both chemotaxis and chemoattractant inhibition

Description : Eicosanoids mediate inflammation in a variety of ways. Of the following statements, which are true with regard to this? a. Eicosanoids are stored in cytoplasmic granules ... include vasodilatation, vasoconstriction, increased vascular permeability and both chemotaxis and chemoattractant inhibition

Last Answer : Answer: b, d The eicosanoids are derived from arachidonic acid (eicosatetraenoic acid) and consist of prostaglandins, thromboxanes, leukotrienes and lipoxins. The eicosanoids are not ... nervous system d. Mononuclear phagocytes release a variety of proinflammatory cytokines and growth factors

Which of the following statements regarding the complement system are true? a. Complement activation yields products which are directly cytotoxic as well as products which act indirectly via activated leukocytes b. Complement products referred to as anaphylatoxins include C1, C3a, C4a, and C5a c. The principal role of C5a is in bacterial opsonization d. The alternative and classical pathways converge proximal to generating the membrane attack complex (C5b-9)

Description : Which of the following statements regarding the complement system are true? a. Complement activation yields products which are directly cytotoxic as well as products which act indirectly via activated ... and classical pathways converge proximal to generating the membrane attack complex (C5b-9)

Last Answer : Answer: a, d The complement system is composed of two different but linked sequences, the classic and alternative pathways. The pathways involve serum proteins that act to amplify the inflammatory-immune ... the C5 level proximal to generating the membrane attack complex (C5b-9) (Figure 6-3)

Cytokines with clearly defined actions in acute inflammation and early tissue injury include which of the following? a. Cysteine-X-Cysteine (C-X-C) chemokines b. Tumor Necrosis Factor (TNFa) c. Transforming Growth Factor-b (TGF-b) d. Interleukin-6 (IL-6) e. Platelet Derived Growth Factor (PDGF)

Description : Cytokines with clearly defined actions in acute inflammation and early tissue injury include which of the following? a. Cysteine-X-Cysteine (C-X-C) chemokines b. Tumor Necrosis Factor (TNFa) c. Transforming Growth Factor-b (TGF-b) d. Interleukin-6 (IL-6) e. Platelet Derived Growth Factor (PDGF)

Last Answer : Answer: a, b, c, d, e Polypeptide mediators, such as TNFa and IL-1, are considered early response cytokines and are actively involved in the initiation of the ... of tissue repair. Thus, coagulation and platelet activation provide the initial foundation for subsequent cellular recruitment

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

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

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

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

Von Willebrand’s disease is a common, congenital bleeding disorder. Which of the following statement(s) is/are true concerning Von Willebrand’s disease? a. As in hemophilia, it is much more common in men b. A history of spontaneous bleeding is common c. Screening laboratory tests will include a prolonged aPTT with a normal prothrombin time d. Pre-treatment for elective surgery require administration of cryoprecipitate to achieve levels of 23–50% of normal

Description : Von Willebrand's disease is a common, congenital bleeding disorder. Which of the following statement(s) is/are true concerning Von Willebrand's disease? a. As in hemophilia, it is ... -treatment for elective surgery require administration of cryoprecipitate to achieve levels of 23-50% of normal

Last Answer : Answer: c, d Von Willebrand's factor is an adhesive protein that mediates platelet adhesion to collagen. In addition, it protects and prevents the rapid removal of factor VIII ... platelet aggregation responses to ristocetin. The most reliable source of Von Willebrand's factor is cryoprecipitate

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 thrombosis include: a. Enhancement of antithrombin III activity b. A decrease in thrombin availability c. Inhibition of platelet aggregation and subsequent platelet release action d. A mild prolongation of activated partial thromboplastin time

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

Products of platelet degranulation include: a. Tumor necrosis factor b. Interleukin-1 c. Transforming growth factor b d. Platelet-derived growth factor

Description : Products of platelet degranulation include: a. Tumor necrosis factor b. Interleukin-1 c. Transforming growth factor b d. Platelet-derived growth factor

Last Answer : Answer: c, d The initial response to injury and disruption of a blood vessel is bleeding. The hemostatic response to this is clot formation to stop hemorrhage. Platelet plug ... . Tumor necrosis factor and interleukin-1 also stimulate fibroblast proliferation, however are produced by macrophages

Appropriate guidelines for the use of TPN in cancer patients include: a. Long-term TPN in patients with rapid progressive tumor growth unresponsive to other therapy b. Mildly malnourished patients undergoing surgery for a curable cancer c. Preoperatively administered TPN prior to surgery or other therapy in patients with severe malnutrition d. Patients in whom treatment toxicity precludes the use of enteral nutrition

Description : Appropriate guidelines for the use of TPN in cancer patients include: a. Long-term TPN in patients with rapid progressive tumor growth unresponsive to other therapy b. Mildly malnourished ... with severe malnutrition d. Patients in whom treatment toxicity precludes the use of enteral nutrition

Last Answer : Answer: c, d As a general rule, the most important factor to consider when making decisions about the use of TPN in patients with cancer is the response of the tumor to antineoplastic ... . Long-term TPN is not indicated with rapidly progressive tumor growth which is unresponsive to such therapy

Cytokines which play an important role in the metabolic response to injury include: a. Tumor necrosis factor—a (TNF) b. Interleukin-1 (IL-1) c. Interleukin-6 (IL-6) d. Interferon-g

Description : Cytokines which play an important role in the metabolic response to injury include: a. Tumor necrosis factor—a (TNF) b. Interleukin-1 (IL-1) c. Interleukin-6 (IL-6) d. Interferon-g

Last Answer : Answer: a, b, c, d TNF or cachetin is considered the primary mediator of the systemic effects of endotoxin, producing anorexia, fever, tachypnea, and tachycardia at low doses and hypotension, ... infected sells. IFN-g has the ability to upregulate the number of TNF receptors on various cell types

Intracellular organelles involved with protein synthesis include: a. Mitochondria b. Endoplasmic reticulum c. Golgi complex d. Lysosomes

Description : Intracellular organelles involved with protein synthesis include: a. Mitochondria b. Endoplasmic reticulum c. Golgi complex d. Lysosomes

Last Answer : Answer: b, c Mitochondria are the major source of energy production in eukaryotic cells. The endoplasmic reticulum is the network of interconnected membranes forming closed vesicles, ... containing acid hydrolytic enzymes that degrade polymers such as proteins, carbohydrates, and nucleic acids

Proteins that are destined to be secreted from the cells must pass through a series of organelles. These organelles include: a. Endoplasmic reticulum b. Golgi apparatus c. Mitochondria d. Lysosomes

Description : Proteins that are destined to be secreted from the cells must pass through a series of organelles. These organelles include: a. Endoplasmic reticulum b. Golgi apparatus c. Mitochondria d. Lysosomes

Last Answer : Answer: a, b, d Proteins targeted for the secretory pathway most commonly begin with translocation from the cytoplasm across the lipid bilayer into the lumen of the endoplasmic reticulum. It ... apparatus where they are further processed and sorted and end up in a secretory vesicle or lysosome

Factors that decrease collagen synthesis include all of the following except: A. Protein depletion. B. Infection. C. Anemia. D. Advanced age. E. Hypoxia.

Description : Factors that decrease collagen synthesis include all of the following except: A. Protein depletion. B. Infection. C. Anemia. D. Advanced age. E. Hypoxia.

Last Answer : Answer: C DISCUSSION: Collagen synthesis, an integral part of wound healing, is affected by many local and systemic factors. Protein depletion impairs fibroplasia. Hypoproteinemia leads to diminution of ... more than any other factor, wound infection is associated with the risk of wound failure

Advantages of epidural analgesia include: A. Earlier mobilization after surgery. B. Earlier return of bowel function. C. Shorter hospitalizations. D. Decreased stress response to surgery. E. All of the above.

Description : Advantages of epidural analgesia include: A. Earlier mobilization after surgery. B. Earlier return of bowel function. C. Shorter hospitalizations. D. Decreased stress response to surgery. E. All of the above.

Last Answer : Answer: E DISCUSSION: Epidural analgesia include excellent pain relief, decreased sedation with more rapid recovery to presurgical levels of consciousness, earlier mobilization after surgery ... , shorter hospitalizations, and decreased morbidity have all been associated with epidural analgesia

Advantages of patient-controlled analgesia (PCA) include: A. Immediate medication delivery. B. Less contact with nursing staff. C. Rapid onset of analgesia. D. Patient control over pain medication. E. All of the above.

Description : Advantages of patient-controlled analgesia (PCA) include: A. Immediate medication delivery. B. Less contact with nursing staff. C. Rapid onset of analgesia. D. Patient control over pain medication. E. All of the above.

Last Answer : Answer: ACD DISCUSSION: Advantages of PCA are immediate medication delivery, rapid onset of analgesia, and patient control over pain medication. Disadvantages of PCA are less contact with ... ' fears that they could inadvertently administer an overdose or possibly become addicted to the opioid

Discharge criteria following ambulatory surgery include: A. Ability to eat solid food. B. Stable vital signs. C. Ability to ambulate. D. Ability to have protective airway reflexes.

Description : Discharge criteria following ambulatory surgery include: A. Ability to eat solid food. B. Stable vital signs. C. Ability to ambulate. D. Ability to have protective airway reflexes.

Last Answer : Answer: BCD DISCUSSION: Discharge criteria following ambulatory surgery include the patient's being fully awake and oriented, the ability to have protective airway reflexes, stable vital signs, adequate ... with them to transport them-and ideally to stay with them on the first postoperative night

Determinants of cerebral blood flow include: A. Preoperative neurologic dysfunction. B. Arterial CO 2 tension. C. Arterial O 2 tension. D. Systemic arterial pressure. E. All of the above.

Description : Determinants of cerebral blood flow include: A. Preoperative neurologic dysfunction. B. Arterial CO 2 tension. C. Arterial O 2 tension. D. Systemic arterial pressure. E. All of the above.

Last Answer : Answer: BCD DISCUSSION: Determinants of cerebral blood flow include arterial CO 2 and O 2 tensions, systemic arterial pressure, and temperature. Other factors that may affect cerebral ... and intracranial pressure are head position, jugular venous obstruction, and positive end-expiratory pressure

It has been suggested that enterocyte-specific fuels be utilized for all patients receiving parenteral nutrition. Theoretically, the benefits of such fuels include: A. Glutamine increases gut mucosal protein content and wall thickness. B. Butyrate increases jejunal mucosal protein content and wall thickness. C. The short-chain fatty acids—butyrate, propionate, and acetate—are useful in supporting ileal mucosal protein content and thickness. D. The use of glutamine-enriched solutions for parenteral nutrition for patients with chemotherapy toxicity or radiation enteritis is without hazards.

Description : It has been suggested that enterocyte-specific fuels be utilized for all patients receiving parenteral nutrition. Theoretically, the benefits of such fuels include: A. Glutamine increases ... parenteral nutrition for patients with chemotherapy toxicity or radiation enteritis is without hazards.

Last Answer : Answer: NONE IS ENTIRELY TRUE DISCUSSION: The use of enterocyte-specific fuels is part of a new and potentially exciting phase of nutritional pharmacology in parenteral nutrition; ... the maintenance of colonocyte-specific nutrition and, in the case of butyrate, ileal enterocyte nutrition

The evaluation of a patient scheduled for elective surgery should always include the following as tests of hemostasis and coagulation: A. History and physical examination. B. Complete blood count (CBC), including platelet count. C. Prothrombin time (PT) and activated partial thromboplastin time (APTT). D. Studies of platelet aggregation with adenosine diphosphate (ADP) and epinephrine.

Description : The evaluation of a patient scheduled for elective surgery should always include the following as tests of hemostasis and coagulation: A. History and physical examination. B. Complete blood count ( ... (APTT). D. Studies of platelet aggregation with adenosine diphosphate (ADP) and epinephrine.

Last Answer : Answer: A DISCUSSION: The evaluation of most patients scheduled for elective surgery who do not have a history of significant bleeding disorders is somewhat controversial. An adequate history and ... suspected of having qualitative defects of platelet function (e.g., von Willebrand's disease)

Which of the following statements are true of a patient with hyperglycemia and hyponatremia? A. The sodium concentration must be corrected by 5 mEq. per 100 mg. per 100 ml. elevation in blood glucose. B. With normal renal function, this patient is likely to be volume overloaded. C. Proper fluid therapy would be unlikely to include potassium administration. D. Insulin administration will increase the potassium content of cells. E. Early in treatment adequate urine output is a reliable measure of adequate volume resuscitation.

Description : Which of the following statements are true of a patient with hyperglycemia and hyponatremia? A. The sodium concentration must be corrected by 5 mEq. per 100 mg. per 100 ml. elevation in blood ... . E. Early in treatment adequate urine output is a reliable measure of adequate volume resuscitation.

Last Answer : Answer: D DISCUSSION: Each 100-mg. per 100 ml. elevation in blood glucose causes a fall in serum sodium concentration of approximately 2 mEq. per liter. Excess serum glucose ... correction of the patient's associated acidosis produce movement of potassium ions into the intracellular compartment

Which of the following statements are true of oxidants? A. In addition to their pathophysiologic roles in inflammation, injury, and infection, oxidants also have physiologic roles. B. Oxidants may be generated from activated neutrophils and during reperfusion following a period of ischemia. C. The deleterious effects of oxidants include lipid peroxidation and cell membrane damage, oxidative damage to DNA, and inhibition of adenosine triphosphate (ATP) synthesis. D. The mechanism of ischemia-reperfusion injury involved the catalytic production of superoxide anion (O 2•) by the enzyme xanthine oxidase.

Description : Which of the following statements are true of oxidants? A. In addition to their pathophysiologic roles in inflammation, injury, and infection, oxidants also have physiologic roles. B. Oxidants may ... involved the catalytic production of superoxide anion (O 2 ) by the enzyme xanthine oxidase.

Last Answer : Answer: ABCD DISCUSSION: Oxidants are reactive oxygen metabolites that have both physiologic and pathophysiologic roles. As potent oxidizing agents, oxidants are involved in cytochrome P ... leukocyte infiltration and activation, causing further tissue damage by the release of cytotoxic proteases

An 18-year-old man shot once in the left chest has a blood pressure of 80/50 mm. Hg, a heart rate of 130 beats per minute, and distended neck veins. Immediate treatment might include: A. Administration of one liter of Ringer's lactate solution. B. Subxiphoid pericardiotomy. C. Needle decompression of the left chest in the second intercostal space. D. Emergency thoracotomy to cross-clamp the aorta.

Description : An 18-year-old man shot once in the left chest has a blood pressure of 80/50 mm. Hg, a heart rate of 130 beats per minute, and distended neck veins. Immediate treatment might include: A. ... of the left chest in the second intercostal space. D. Emergency thoracotomy to cross-clamp the aorta.

Last Answer : Answer: AC DISCUSSION: The finding of distended neck veins in conjunction with hypotension should suggest tension pneumothorax or pericardial tamponade. Absent ipsilateral breath sounds and a trachea ... injuries. There is no role for aortic cross-clamping in this scenario of cardiogenic shock

True statements regarding eicosanoids include which of the following? A. Prostaglandins and thromboxanes are synthesized via the cyclo-oxygenase pathway. B. The vasoconstricting, platelet-aggregating, and bronchoconstricting effects of thromboxane A 2 are balanced by the actions of prostacyclin, which produces the opposite effects. C. Leukotriene synthesis is inhibited by the action of nonsteroidal anti-inflammatory drugs (NSAIDs). D. The principal prostaglandins have a short circulation half-life and exert most of their effects locally.

Description : True statements regarding eicosanoids include which of the following? A. Prostaglandins and thromboxanes are synthesized via the cyclo-oxygenase pathway. B. The vasoconstricting, platelet-aggregating, ... prostaglandins have a short circulation half-life and exert most of their effects locally.

Last Answer : Answer: ABD DISCUSSION: The eicosanoids are a group of compounds arising from the metabolism of arachidonic acid. The prostaglandins and thromboxanes are synthesized via the cyclo-oxygenase ... effects and may be involved in the physiologic responses associated with anaphylactic and septic shock

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.

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

The characteristic changes that follow a major operation or moderate to severe injury do not include the following: A. Hypermetabolism. B. Fever. C. Tachypnea. D. Hyperphagia. E. Negative nitrogen balance.

Description : The characteristic changes that follow a major operation or moderate to severe injury do not include the following: A. Hypermetabolism. B. Fever. C. Tachypnea. D. Hyperphagia. E. Negative nitrogen balance.

Last Answer : Answer: D DISCUSSION: The characteristic metabolic response to injury includes hypermetabolism, fever, accelerated gluconeogenesis, and increased proteolysis (creating a negative nitrogen balance). ... time, food intake increases, but the patient generally experiences anorexia, not hyperphagia

Amiloride has the following effect on urinary cation excretion: A. Decreases both K+ and H+ ion excretion B. Decreases K+ excretion but increases H+ ion excretion C. Increases K+ but decreases Na+ excretion D. Decreases both Na+ and K+ excretion

Description : Amiloride has the following effect on urinary cation excretion: A. Decreases both K+ and H+ ion excretion B. Decreases K+ excretion but increases H+ ion excretion C. Increases K+ but decreases Na+ excretion D. Decreases both Na+ and K+ excretion

Last Answer : A. Decreases both K+ and H+ ion excretion

Which of the following drugs is a potassium channel opener ? (a) Pinacidil (b) Hydralazine (c) Glibenclamide (d) Amiloride

Description : Which of the following drugs is a potassium channel opener ? (a) Pinacidil (b) Hydralazine (c) Glibenclamide (d) Amiloride

Last Answer : Ans: A

Which of the following drugs is a potassium channel opener: A. Nicorandil B. Hydralazine C. Glibenclamide D. Amiloride

Description : Which of the following drugs is a potassium channel opener: A. Nicorandil B. Hydralazine C. Glibenclamide D. Amiloride

Last Answer : D. Amiloride

Tetrodotoxin blocks nerve impulse/junctional transmission by: A. Anticholinergic action B. Depleting acetylcholine C. Blocking Na+ channels D. Blocking Ca2+ channels

Description : Tetrodotoxin blocks nerve impulse/junctional transmission by: A. Anticholinergic action B. Depleting acetylcholine C. Blocking Na+ channels D. Blocking Ca2+ channels

Last Answer : C. Blocking Na+ channels

Tetrodotoxin blocks nerve impulse/junctional transmission by: A. Anticholinergic action B. Depleting acetylcholine C. Blocking Na+ channels D. Blocking Ca2+ channels

Description : Tetrodotoxin blocks nerve impulse/junctional transmission by: A. Anticholinergic action B. Depleting acetylcholine C. Blocking Na+ channels D. Blocking Ca2+ channels

Last Answer : C. Blocking Na+ channels

Despite having read up on it, I don't fully understand calcium channel blockers for high BP and have a few questions.

Description : Despite having read up on it, I don't fully understand calcium channel blockers for high BP and have a few questions.

Last Answer : http://www.medicinenet.com/script/main/mobileart.asp?articlekey=26009

Though nitrates and calcium channel blockers are both vasodilators, they are used concurrently in angina pectoris because (a) They antagonize each other’s side effects (b) Nitrates primarily reduce preload while calcium channel blockers primarily reduce after load (c) Nitrates increase coronary flow while calcium (d) Both (b) and (c)

Description : Though nitrates and calcium channel blockers are both vasodilators, they are used concurrently in angina pectoris because (a) They antagonize each other's side effects (b) Nitrates primarily reduce preload while calcium ... load (c) Nitrates increase coronary flow while calcium (d) Both (b) and (c)

Last Answer : Ans: B

Choose the correct statement about long acting calcium channel blocking drugs as antihypertensives: A. They are the most effective drugs in suppressing hypertensive left ventricular hypertrophy B. They are as effective as diuretics or β blockers in reducing cardiovascular/total mortality C. They compromise quality of life more than β blockers D. They have no beneficial effect in hypertensive/diabetic nephropath

Description : Choose the correct statement about long acting calcium channel blocking drugs as antihypertensives: A. They are the most effective drugs in suppressing hypertensive left ventricular hypertrophy B. They ... more than β blockers D. They have no beneficial effect in hypertensive/diabetic nephropath

Last Answer : B. They are as effective as diuretics or β blockers in reducing cardiovascular/total mortality

The antihypertensive action of calcium channel blockers is characterized by the following except: A. Delayed onset; blood pressure starts falling after 1–2 weeks therapy B. Lack of central side effects C. No compromise of male sexual function D. Safety in peripheral vascular diseases

Description : The antihypertensive action of calcium channel blockers is characterized by the following except: A. Delayed onset; blood pressure starts falling after 1–2 weeks therapy B. Lack of central side effects C. No compromise of male sexual function D. Safety in peripheral vascular diseases

Last Answer : A. Delayed onset; blood pressure starts falling after 1–2 weeks therapy