PHARMACOLOGY
51. In the autonomic regulation of blood pressure
(a) Cardiac output is maintained constant at the expense of other hemodynamic variables
(b) Elevation of blood pressure results in elevated aldosterone secretion
(c) Baroreceptor nerve fibers docrease firing rate when arterial pressure increases
(d) Stroke volume and mean arterial blood pressure are the primary direct determinants of cardiac output
52. The autonomic nervous system is also known as
(a) Visceral
(b) Vegetative
(c) Involuntary nervous system
(d) All of the above
53. Full activation of the sympathetic nervous system, as in maximal exercise, can produce all of the following responses except
(a) Bronchial relaxation
(b) Decreases intestinal motility
(c) Increased renal blood flow
(d) Mydriasis
54. 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
55. The neurotransmitter agent that is normally released in the sinoatrial node of the heart in response to a blood pressure increase is
(a) Acetylcholine
(b) Dopamine
(c) Epinephrine
(d) Glutamate
56. A direct-acting cholinomimetic that is lipid-soluble and often used in the treatment of glaucoma is
(a) Acetylcholine
(b) Bethanechol
(c) Physostigmine
(d) Pilocarpine
57. Which of the following agents is a prodrug that is much less toxic in mammals than in insects?
(a) Acetylcholine
(b) Bethanechol
(c) Physostigmine
(d) Pilocarpine
(e) Neostigmine
58. Atropine overdose may cause which one of the following
(a) Gastrointestinal smooth muscle crampine
(b) Increased cardiac rate
(c) Increased gastric secretion
(d) Pupillary constriction
59. The synaptic pre-ganglionic neurons have their cell bodies in the lateral horn of the grey matter of the
(a) Thoracic segment only
(b) Lumbar segment only
(c) Both (a) and (b)
(d) None of the above
60. Which one of the following can be blocked by atropine?
(a) Decreased blood pressure caused by hexamethonium
(b) Increased blood pressure caused by nicotine
(c) Tachycardia caused by exercise
(d) Tachycardia caused by infusion of acetylcholine
61. Which of the following best describes the mechanism of action of scopolamine?
(a) Irreversible antagonist at nicotinic receptors
(b) Irreversible antagonist at muscarinic receptors
(c) Physiologic antagonist at muscarinic receptors
(d) Reversible antagonist at muscarinic receptors
62. Accepted therapeutic indications for the use of antimuscarinic drugs include all of the following except
(a) Hypertension
(b) Motion sickness
(c) Parkinson’s disease
(d) Postoperative bladder spasm
63. In male sex organs _______ system is responsible for erection.
(a) Sympathetic
(b) Parasympathetic
(c) Norepinephrine
(d) None of the above
64. A 7-years-old boy has a significant bed-wetting problem. A long-acting indirect sympathomimetic agent sometimes used by the oral route for this and other indications is
(a) Dobutamine
(b) Ephedrine
(c) Epinephrine
(d) Isoproterenol
65. When pupillary dilation-but not cycloplegia is desired, a good choice is
(a) Homatropine
(b) Isoproterenol
(c) Phenylephrine
(d) Pilocarpine
66. ‘Fight or flight’ state can be described as
(a) Sympathetic active; para-sympathetic quiescent
(b) Sympathetic active; para-sympathetic active
(c) Sympathetic quiescent; para-sympathetic active
(d) All of the above
67. Your patient is to receive a selective βββ2 stimulant drug βββ2 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
68. 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
69. Which of the following effects of epinephrine would be blocked by phentolamine but not by metoprolol?
(a) Cardiac stimulation
(b) Increase of camp in fat
(c) Relaxation of bronchial smooth muscle
(d) Relaxation of the uterus
70. Propranolol is useful in all of the following except
(a) Angina
(b) Familial tremor
(c) Hypertension
(d) Partial atrioverntricular heart block
71. ‘Rest and digest’ state can be described as
(a) Sympathetic active; para-sympathetic quiescent
(b) Sympathetic active; para-sympathetic active
(c) Sympathetic quiescent; para-sympathetic active
(d) All the above
72. A friend has very severe hypertension and asks about a drug her doctor wishes to prescribe. Her physician has explained that this drug is associated with tachycardia and fluid retention (which may be marked) and increased hair growth. Which of the following is most likely to produce the effects that your friend has described?
(a) Captopril
(b) Guanethidine
(c) Minoxidil
(d) Prazosin
(e) Propranolol
73. Which one of the following is characteristic of captopril and enalapril?
(a) Competitively blocks angiotensim II at its receptor
(b) Decreases angiotensin II concentration in the blood
(c) Decreases rennin concentration in the blood
(d) Increases sodium and decreases potassium in the blood
74. 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) β1 – selective receptor blockers
75. A visitor from another city comes to your office complaining of incessant cough. He has diabetes and hypertension and has recently started taking a different antihypertensive medication. The most likely cause of his cough is
(a) Enalapril
(b) Losartan
(c) Minoxidil
(d) Propranolol
(e) Verapamil
76. Reserprine, an alkaloid derived from the root of Rauwolfia serpentina
(a) Can be used to control hyperglycemia
(b) Can cause severe depression of mood
(c) Has no cardiac effects
(d) A spare receptor agonist
77. Nitroglycerin, either directly or through reflexes, results in which one of the following effects
(a) Decreased heart rate
(b) Decreased venous capacitance
(c) Increased afterload
(d) Increased cardiac force
78. The antianginal effect of propranolol may be attributed to which one of the following
(a) Block of exercise – induced tachycardia
(b) Decreased end – diastolic ventricular volume
(c) Dilation of consticted coronary vessels
(d) Increased cardiac force
79. The major common determinant of myocardial oxygen consumption is
(a) Blood volume
(b) Cardiac output
(c) Diastolic blood pressure
(e) Myocardial fiber tension
80. Choose the incorrect statement from the following
(a) Sympathetic system increases rate of SA node
(b) Sympathetic system causes constriction of coronary arteries
(c) Sympathetic system causes increased motility of GIT smooth muscles
(d) Sympathetic system causes constriction of sphincter in GIT
81. Denervation super-sensitivity includes
(a) Proliferation of receptors
(b) Loss of mechanism for transmitter removal
(c) Increased post-junctional responsiveness
(d) All of the above
82. Which of the following is approved for the treatment of hemorrhagic stroke?
(a) Amyl nitrite
(b) Hydralazine
(c) Isosorbide moninitrate
(d) Nimodipine
83. Which of the following drugs used for the treatment of angina by inhalation has a very rapid onset and a brief duration of effect?
(a) Amyl nitrite
(b) Hydralazine
(c) Isosorbide mononitrate
(d) Nifedipine
84. Which of the following is a vasodilator drug used for hypertension that lacks a direct effect on autonomic receptors but may provoke anginal attacks?
(a) Amyl nitrite
(b) Hydralazine
(c) Isosorbide mononitrate
(d) Nifedipine
85. The biochemical mechanism of action of digitalis is associated with
(a) A decrease in calcium uptake by the sarcoplasmic reticulum
(b) An increase in ATP synthesis
(c) A modification of the actin molecule
(d) An increase in systolic intracellular calcium levels
86. A patient has been taking digoxin for several years for chronic heart failure is about to receive atropine for another condition. A common effect of digoxin (at therapeutic blood levels) that can be almost entirely blocked by atropine is
(a) Decreased appetite
(b) Increased atrial contractility
(c) Increased PR interval on the ECG
(d) Headaches
87. In a patient given a cardiac glycoside, important effects of the drug on the heart include which of the following?
(a) Decreased atrioventricular conduction velocity
(b) Decreased ejection time
(c) Increased ectopic automaticity
(d) All of the above
88. Which of the following situations constitutes an added risk of digoxin toxicity?
(a) Starting administration of captopril
(b) Starting administration of quinidine
(c) Hyperkalemia
(d) Hypermagnesemia
89. At rest, the interior of the typical mammalian neuronal axon potential is approximately ________ mV
(a) 0                                                                                             (b) –70
(c) –100                                                                                             (d) –20
90. Following enzyme is involved in the synthesis of actylcholine?
(a) Choline acetyl transferase
(b) Acetyl cholinesterase
(c) Both (a) and (b)
(d) None of the above
91. Which of the following has been shown to prolong life in patient with chronic congestive failure but has a negative inotropic effect on cardiac contractility?
(a) Carvedilol
(b) Digitoxin
(c) Digoxin
(d) Dobutamine
92. Which of the following is the drug of choice in treating suicidal overdose of digitoxin?
(a) Digoxin antibodies
(b) Lidocaine
(c) Magnesium
(d) Potassium
93. When used as an antiarrhythmic drug, Lidocaine typically
(a) Increases action potential duration
(b) Increases contractility
(c) Increses PR interval
(d) Reduces abnormal automaticity
94. A 16-year-old-girl is found to have paroxysmal attacks of rapid heart rate. The antiarrhythmic of choice in most cases of acute AV nodal tachycardia is
(a) Adenosine
(b) Amiodarone
(c) Flecainide
(d) Propranolol
95. Recognized adverse effects of quinidine include which one of the following?
(a) Cinchonism
(b) Constipation
(c) Lupus erythematosus
(d) Increase in digoxin clearance
96. Following is an antagonist of ganglion type nicotinic receptors
(a) Tubercurarine
(b) α-bungarotoxin
(c) Trimethaphan
(d) All of the above
97. Which of the following is an orally active drug that blocks sodium channels and decreases action potential duration?
(a) Adenosine
(b) Amiodarone
(c) Disopyramide
(d) Mexiletine
98. Which of the following has the longest half-life of all antiarrhythmic drugs?
(a) Adenosine
(b) Amiodarone
(c) Disopyramide
(d) Esmolol
99. Which of the following diuretics would be most useful in a patient with cerebral edema?
(a) Acetazolamide
(b) Amiloride
(c) Ethacrynic acid
(d) Mannitol
100. Which of the following therapies would be most useful in the management of severe hypercalcemia?
(a) Amiloride plus saline infusion
(b) Furosemide plus saline infusion
(c) Hydrochlorothiazide plus saline infusion
(d) Mannitol plus saline infusion
