Tutorial 2

Several children at a summer camp were hospitalized with symptoms thought to be due to ingestion of food containing botulinum toxin. Which one of the following signs or symptoms is consistent with the diagnosis of botulinum poisoning?

• Bronchospasm

• Cycloplegia

• Diarrhea

• Skeletal muscle spasms

• Hyperventilation

Which of the following properties regarding nicotine is TRUE?

• It activates nicotinic receptors via second messengers.

• It has high potency at muscarinic receptors.

• It has low affinity to nicotinic receptors.

• It is less susceptible to cholinesterase.

• It is not readily absorbed from gastrointestinal tract.

Pilocarpine decrease the heart rate and cardiac contractility by:

• Activate the adenylate cyclase.

• Increase the intracellular calcium ion.

• Increase the phosphorylation of protein kinase A.

• Increase the formation of diacylglycerol.

• Inhibit the synthesis of cAMP.

A 30-year-old woman undergoes abdominal surgery and suffering of postoperative ileus. Mild cholinomimetic stimulation with bethanechol or neostigmine is often effective in relieving these complications of surgery. Neostigmine and bethanechol in moderate doses have significantly different effects on which one of the following?

• Gastric secretory cells

• Vascular endothelium

• Salivary glands

• Sweat glands

• Ureteral tone

Which of the following is NOT the therapeutic use of cholinesterase-inhibiting drugs?

• Treatment of myasthenia gravis

• Smoking cessation

• Treatment of postoperative ileus

• Treatment of glaucoma

• Reversal of neuromuscular blockade

A 3-year-old child is admitted to the emergency department after taking a drug from her parents’ medicine cabinet. The signs suggest that the drug is an indirect-acting cholinomimetic with little or no CNS effect and duration of action of about 1–2 h. Which of the following is the most likely cause of these effects?

 

• Acetylcholine

• Bethanechol

• Neostigmine

• Echothiophate

• Pilocarpine

 

Which one of the following drugs causes vasodilation that can be blocked by atropine?

• Benztropine

• Bethanechol

• Botulinum toxin

• Cyclopentolate 

• Edrophonium

Which of the following signs would distinguish between an overdose of a ganglion blocker versus a muscarinic blocker?

• Cycloplegia

• Dry skin in a warm environment

• Miosis

• Postural hypotension

• Tachycardia