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Autonomic Nervous System

Total questions: 30

Worksheet time: 15mins

Name
Class
Date
1.

A 51-year-old woman goes to her physician for a follow-up examination. She had a history of borderline Asthma for 5 years. Repeated blood pressure measurement over multiple visits average 148/102mmhg and diagnosed as hypertensive. Her physician prescribes a Beta-Adrenoreceptor blocking agent. Which of the following agents is not recommended for use in this patient

a)

Acebutolol

b)

Atenolol

c)

Bisoprolol

d)

Propranolol

2.

A 44 years old woman comes to her physician complaining of intermittent fatigue and difficulty swallowing. On physical examination she exhibits drooping eyelids and slurred speech. Administration of which of the following agents is most appropriate to confirm a diagnosis?

a)

Physostigmine

b)

Neostigmine

c)

Edrophonium

d)

Trimethaphan

3.

A male patient is admitted to the emergency department with dispnea and breathlessness. he is anxious and wheeze are audible. he has respiratory rate of 44 breaths per minute. After admission ,he is immediately given oxygen by face mask and hydrocortisone IV and nebulized by salbutamol. After 20 minutes,he is still wheezing. the doctor on duty should plan next to administer:

a)

Repeat Salbutamol to treat wheeze

b)

Antibiotics to treat infections

c)

Hydrocortisone to treat Inflammation

d)

Alprazolam to treat anxiety

4.

74 year old man who underwent major surgery, complaints of pain in epigastrium the day after the surgery. This condition rapidly deteriorated, and he was transferred to the ICU because of septic shock which of the following therapeutic regimens should be best to increase his blood pressure

a)

Rabeprazole

b)

Adrenaline

c)

Noradrenaline

d)

Dopamine

5.

A patient came to the casualty with asthma after treatment for glaucoma .The probable drug may be

a)

Timolol

b)

Betaxolol

c)

Lantanoprost

d)

Anticholinesterase

6.

60 year old patient shows decrease heart rate, decrease in force of contraction and reduced both systolic and diastolic blood pressure, after administration of propanol aur resulting in bradycardia so which drug can be used as an alternative to propranolol?

a)

Timolol

b)

Pindolol

c)

Labetalol

d)

Both a and b

7.

A Suspected case of poisoning has been brought to the casualty with weakness ,fainting, involuntary passage of urine and stool ,profuse sweating, salvation, watering from nose and eyes. His pulse is 120 per minute, lower volume, BP 90/60 mm Hg, respiration shallow, pupil constricted muscles flabby with occasional fasciculations.which is most likely type of poisoning:

a)

Belladonna

b)

Barbiturate

c)

Anticholinesterase

d)

Dicophane

8.

A 70 year old male presented with complaints of weak stream of urine ,sense of incomplete bladder voiding, urinary frequency and nocturia. After physical examination and ultrasound, he was diagnosed to have developed Benign hypertrophy of prostate(BHP)and was prescribed -tab Terazosin 5mg one tablet daily at bed time.He took the medicine as advised and went off to sleep .At might when he got up to pass urine ,he felt fainted .On being laid flat on bed ,he regained consciousness within 2 min.

Which is the likely explanation for fainting attack ?

a)

Faliure of peripheral vasodilation due to receptor blockade

b)

Bronchodilation

c)

Faliure of reflex vasoconstriction due to receptor blockade

d)

Negative chronotropic. And ionotropic effect

9.

A 24 year old male comes to the ER complaining sudden and marked rise in BP with headache ,palpitation, excess sweating blood and urine samples indicated increase in catecholamines VMA ->8mg/24 urine sample. the diagnosis is phreochromocytoma further established by CT and MRI scan

what should be the drug treatment for followed?

a)

β blockers used to control tachycardia and arrhythmias

b)

Non selective α in with beta blocker

c)

Selective alpha 2 blocker yohimbine

d)

None of above

10.

What could be done to avoid mild episodic asthma in the patient?

a)

Avoiding beta blocker ocular hypertensive drug

b)

Salbutamol (nebulized aerosol + Ipratropium bromide

c)

Use beta 2 selective antagonist( betaxolol) and prostaglandin analogues (lantanoprost)

d)

All of the above

11.

Rank order of potencies for alpha adrenergic receptor are

a)

Adrenaline ≥N/A > Isoprenaline

b)

Isoprenaline >Adrenaline>N/A

c)

Isoprenaline>N/A>Adrenaline

d)

N/A> Isoprenaline>Adrenaline

12.

Which of the following beta blockers also has additional Alpha blocking activity

a)

Esmolol

b)

Labetalol

c)

Pindolol

d)

Nadolol

13.

Which of the following is the example of short acting reversible anticholinesterases?

a)

Physostigmine

b)

Neostigmine

c)

Edrophonium

d)

DFP

14.

Among the following which is not a clinical effect of alpha -1

adrenoreceptors?

a)

Mydriasis

b)

Contraction of uterus

c)

Relaxation of uterus

d)

Both B and C

15.

Characteristics of phentolamine include all of the following except

a)

Reduction in peripheral resistance

b)

Stimulation of responses to serotonin

c)

Tachycardia

d)

Stimulation of muscarinic H1 , H2 histamine receptor

16.

Selective beta to stimulants like salbutamol , terbutaline causes

a)

Bronchodilation

b)

Vasodilation

c)

Cardiac stimulation

d)

Both A and B

17.

Which of the following beta blocker has intrinsic sympathomimetic activity

a)

Pindolol

b)

Propranolol

c)

Timolol

d)

Bisoprolol

18.

Which of the following drug is used to differentiate myasthenia gravis and cholinergic crisis?

a)

Edrophonium

b)

Pyridostigmine

c)

Atracurium

d)

Pancuronium

19.

The chief location of beta 2 adrenergic blocking receptor is

a)

Heart

b)

GIT

c)

Adipose tissue

d)

Skeletal muscle

20.

Adrenaline produces effect on heart by

a)

Positive chronotropic

b)

Positive inotropic

c)

Positive chronotropic

d)

Both A and B

21.

Which of the following direct acting cholinomimetic is mainly muscarinic in action

a)

Bethanecol

b)

Carbacol

c)

Acetylcholine

d)

None of above

22.

Adrenergic agonist typically causes which effect on smooth muscle

a)

Tencing

b)

Relaxation

c)

Muscle spasm

d)

Increased motility

23.

Simulation of Alpha 1 receptor causes all of the following except

a)

Vasoconstriction

b)

Increase BP

c)

Miosis

d)

Increase peripheral resistance

24.

The principal mechanism of action of adrenoreceptor antagonist

a)

Reversible or irreversible interaction with adreno receptor

b)

Depletion of storage of catecholamines

c)

Blockade of amine reuptake pumps

d)

Non selective MAO inhibitors

25.

Which adrenergic agonist is known to cause severe xerostomia

a)

Clonidine

b)

Epinephrine

c)

Ephedrine

d)

Amphetamine

26.

Beta blockers aside from their cardiovascular indication are also used in the treatment of which disease

a)

Gout

b)

Glaucoma

c)

Asthma

d)

Reynaud's phenomenon

27.

Which of the following drug has both Alpha 1 selective and beta blocking effects

a)

Labetalol

b)

Betaxolol

c)

Propranolol

d)

Timolol

28.

Ganglionic transmission is mediated by

a)

Presynaptic Alpha receptor

b)

Postsynaptic beta 1 receptor

c)

Postsynaptic dopaminergic receptor

d)

Postsynaptic nicotinic receptor

29.

Which of the following drug can be used in cases of beta blocker overdose

a)

Naloxone

b)

Flumazenil

c)

Glucagon

d)

Dexferoxamine

30.

A 41 year old man comes to his physician for a follow-up examination.On his previous visit he was diagnosed with hypertension and pharmacotherapy was initiated with metoprolol. In which of the following ways does metoprolol differ from the actions of propranolol

a)

Is used for the management of hypertension

b)

Has some selectivity for beta to adrenoreceptors

c)

Is less likely to precipitate bronchoconstriction

d)

Is less likely to reduce cardiac output