Description : Vasoconstrictors should not be used in (a) Neurogenic shock (b) Haemorrhagic shock (c) Secondary shock (d) Hypotension due to spinal anaesthesia
Last Answer : Ans: C
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 : Which of the following drugs has been used both as orally active nasal decongestant as well as appetite suppressant, and has been implicated in precipitating haemorrhagic stroke: A. Dexfenfluramine B. Phenylpropanolamine C. Isoxsuprine D. Oxymetazoline
Last Answer : B. Phenylpropanolamine
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 : Adrenaline injected with a local anaesthetic: A. Reduces local toxicity of the local anaesthetic B. Reduces systemic toxicity of the local anaesthetic C. Shortens duration of local anaesthesia D. Makes the injection less painful
Last Answer : B. Reduces systemic toxicity of the local anaesthetic
Description : The nonselective α adrenergic blockers produce the following actions except: A. Postural hypotension B. Bradycardia C. Miosis D. Inhibition of ejaculation
Last Answer : B. Bradycardia
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 : 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 : 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 : 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 : Which of the following physical findings are associated with the various classes of hemorrhagic shock? a. Mild shock (< 20% blood volume): Pallor, cool extremities, diminished capillary refill and ... ): Systemic hypotension, changes in mental status, tachycardia, oliguria d. All of the above
Last Answer : Answer: a, c PHYSICAL FINDINGS IN HEMORRHAGIC SHOCK* Moderate Mild (40% Blood Volume) Blood Volume) Blood Volume) Pallor Pallor Pallor Cool extremities Cool extremities Cool extremities ... hypotension Mental status changes * Alcohol or drug intoxication may alter physical findings
Description : Shock can best be defined as: A. Hypotension. B. Hypoperfusion of tissues. C. Hypoxemia. D. All of the above.
Last Answer : Answer: B DISCUSSION: Shock, no matter what the cause, is a syndrome associated with tissue hypoperfusion. Tissue hypoperfusion leads to tissue hypoxia, which may or may not be due to hypoxemia ... of shock and, therefore, is not a good clinical indicator of the presence of tissue hypoperfusion
Description : Which of the following vasoactive drugs used in treating shock results in reduced preload and afterload, reducing oxygen demand of the heart? a) Nitroprusside (Nipride) A disadvantage ... increases cardiac output. d) Methoxamine (Vasoxyl) Methoxamine increases blood pressure by vasoconstriction.
Last Answer : a) Nitroprusside (Nipride) A disadvantage of nitroprusside is that it causes hypotension.
Description : Select the β-adrenergic blocker that has additional α1 blocking, vasodilator and antioxidant properties: A. Carvedilol B. Celiprolol C. Acebutolol D. Metoprolol
Last Answer : C. Acebutolol
Last Answer : A. Carvedilol
Description : In a patient of myocardial infarction, β adrenergic blockers are used with the following aim/aims: A. To reduce the incidence of reinfarction B. To prevent cardiac arrhythmias C. To limit size of the infarct D. All of the above
Last Answer : D. All of the above
Description : Select the β adrenergic blocker that is primarily eliminated unchanged by renal excretion: A. Propranolol B. Metoprolol C. Esmolol D. Atenolol
Last Answer : D. Atenolol
Description : The following is not a feature of cardioselective beta blockers, when compared to propranolol: A. They are ineffective in suppressing muscle tremor B. They are safer in diabetics C. They are less likely to cause bradycardia D. They are less likely to worsen Raynaud’s disease
Last Answer : C. They are less likely to cause bradycardia
Description : Esmolol has the following features except: A. Rapidly developing, shortlasting β adrenergic blockade B. Cardioselectivity of action C. Intrinsic sympathomimetic activity D. Suitability for intraoperative use
Last Answer : C. Intrinsic sympathomimetic activity
Description : Select the ultrashort acting cardioselective β adrenergic blocker: A. Bisoprolol B. Timolol C. Sotalol D. Esmolol
Last Answer : D. Esmolol
Description : β-adrenergic blockers are indicated in the following conditions except: A. Hypertrophic cardiomyopathy B. Congestive heart failure C. Vasospastic angina pectoris D. Dissecting aortic aneurysm
Last Answer : C. Vasospastic angina pectoris
Description : The following disease is worsened by propranolol: A. Glaucoma B. Raynaud’s disease C. Benign prostatic hypertrophy D. Parkinsonism
Last Answer : B. Raynaud’s disease
Description : Select the drug which can impair carbohydrate tolerance in prediabetics but prolongs insulin hypoglycaemia: A. Salbutamol B. Propranolol C. Prazosin D. Nifedipine
Last Answer : B. Propranolol
Description : The β adrenergic blocker having β1 selectivity, intrinsic sympathomimetic activity and membrane stabilizing property is: A. Carvedilol B. Atenolol C. Acebutolol D. Metoprolol
Description : Select the drug which is administered orally for erectile dysfunction in men: A. Yohimbine B. Papaverine C. Alprostadil D. Sildenafil
Last Answer : D. Sildenafil
Description : What is true of sildenafil: A. It enhances sexual enjoyment in normal men B. It delays ejaculation C. It improves penile tumescence in men with erectile dysfunction D. It blocks cavernosal α2 adrenoceptors
Last Answer : C. It improves penile tumescence in men with erectile dysfunction
Description : Sildenafil is contraindicated in patients taking the following class of drugs: A. α-adrenergic blockers B. β-adrenergic blockers C. Organic nitrates D. Angiotensin converting enzyme inhibitors
Last Answer : C. Organic nitrates
Description : Which of the following is a selective α1A receptor blocker that affords symptomatic relief in benign prostatic hypertrophy without producing significant fall in blood pressure: A. Terazosin B. Doxazosin C. Trimazosin D. Tamsulosin
Last Answer : D. Tamsulosin
Description : The primary reason for preferring phentolamine as the α adrenergic blocker for performing diagnostic test for pheochromocytoma is: A. It produces rapid and short lasting α-adrenergic blockade B. It equally ... It is the most potent α blocker D. It has no additional β adrenergic blocking property
Last Answer : A. It produces rapid and short lasting α-adrenergic blockade
Description : The bladder trigone and prostatic muscles are relaxed by: A. Adrenergic α1 agonists B. Adrenergic α1 antagonists C. Adrenergic α2 agonists D. Adrenergic α2 antagonists
Last Answer : B. Adrenergic α1 antagonists
Description : The drug which produces vasoconstriction despite being an α adrenergic blocker is: A. Phenoxybenzamine B. Ergotamine C. Dihydroergotoxine D. Tolazoline
Last Answer : B. Ergotamine
Description : Choose the correct statement about sibutramine: A. It is an anorectic drug used to assist weight reduction B. It is an atypical antidepressant C. It is a 5-HT1D receptor antagonist D. Both A and C are correct
Last Answer : A. It is an anorectic drug used to assist weight reduction
Description : The following is true of fenfluramine except: A. It lacks CNS stimulant action B. Its use has been associated with cardiac abnormalities and pulmonary hypertension C. It causes weight loss independent of reduced food intake D. It enhances serotonergic transmission in the brain
Last Answer : C. It causes weight loss independent of reduced food intake
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 α and β adrenergic effects
Last Answer : D. Producing both α and β adrenergic effects
Description : 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
Last Answer : B. Dobutamine
Description : Dobutamine differs from dopamine in that: A. It does not activate peripheral dopaminergic receptors B. It does not activate adrenergic β receptors C. It causes pronounced tachycardia D. It has good blood-brain barrier penetrability
Last Answer : A. It does not activate peripheral dopaminergic receptors
Description : Dopaminergic D1 and D2 as well as adrenergic α and β1, but not β2 receptors are activated by: A. Dopamine B. Dobutamine C. Methoxamine D. Phenylephrine
Last Answer : A. Dopamine
Description : Noradrenaline is administered by: A. Subcutaneous injection B. Intramuscular injection C. Slow intravenous infusion D. All of the above routes
Last Answer : C. Slow intravenous infusion
Description : Low doses of adrenaline dilate the following vascular bed: A. Cutaneous B. Mucosal C. Renal D. Skeletal muscle
Last Answer : D. Skeletal muscle