WorksheetsAutonomic Nervous System
Total questions: 30
Worksheet time: 15mins
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
Acebutolol
Atenolol
Bisoprolol
Propranolol
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?
Physostigmine
Neostigmine
Edrophonium
Trimethaphan
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:
Repeat Salbutamol to treat wheeze
Antibiotics to treat infections
Hydrocortisone to treat Inflammation
Alprazolam to treat anxiety
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
Rabeprazole
Adrenaline
Noradrenaline
Dopamine
A patient came to the casualty with asthma after treatment for glaucoma .The probable drug may be
Timolol
Betaxolol
Lantanoprost
Anticholinesterase
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?
Timolol
Pindolol
Labetalol
Both a and b
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:
Belladonna
Barbiturate
Anticholinesterase
Dicophane
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 ?
Faliure of peripheral vasodilation due to receptor blockade
Bronchodilation
Faliure of reflex vasoconstriction due to receptor blockade
Negative chronotropic. And ionotropic effect
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?
β blockers used to control tachycardia and arrhythmias
Non selective α in with beta blocker
Selective alpha 2 blocker yohimbine
None of above
What could be done to avoid mild episodic asthma in the patient?
Avoiding beta blocker ocular hypertensive drug
Salbutamol (nebulized aerosol + Ipratropium bromide
Use beta 2 selective antagonist( betaxolol) and prostaglandin analogues (lantanoprost)
All of the above
Rank order of potencies for alpha adrenergic receptor are
Adrenaline ≥N/A > Isoprenaline
Isoprenaline >Adrenaline>N/A
Isoprenaline>N/A>Adrenaline
N/A> Isoprenaline>Adrenaline
Which of the following beta blockers also has additional Alpha blocking activity
Esmolol
Labetalol
Pindolol
Nadolol
Which of the following is the example of short acting reversible anticholinesterases?
Physostigmine
Neostigmine
Edrophonium
DFP
Among the following which is not a clinical effect of alpha -1
adrenoreceptors?
Mydriasis
Contraction of uterus
Relaxation of uterus
Both B and C
Characteristics of phentolamine include all of the following except
Reduction in peripheral resistance
Stimulation of responses to serotonin
Tachycardia
Stimulation of muscarinic H1 , H2 histamine receptor
Selective beta to stimulants like salbutamol , terbutaline causes
Bronchodilation
Vasodilation
Cardiac stimulation
Both A and B
Which of the following beta blocker has intrinsic sympathomimetic activity
Pindolol
Propranolol
Timolol
Bisoprolol
Which of the following drug is used to differentiate myasthenia gravis and cholinergic crisis?
Edrophonium
Pyridostigmine
Atracurium
Pancuronium
The chief location of beta 2 adrenergic blocking receptor is
Heart
GIT
Adipose tissue
Skeletal muscle
Adrenaline produces effect on heart by
Positive chronotropic
Positive inotropic
Positive chronotropic
Both A and B
Which of the following direct acting cholinomimetic is mainly muscarinic in action
Bethanecol
Carbacol
Acetylcholine
None of above
Adrenergic agonist typically causes which effect on smooth muscle
Tencing
Relaxation
Muscle spasm
Increased motility
Simulation of Alpha 1 receptor causes all of the following except
Vasoconstriction
Increase BP
Miosis
Increase peripheral resistance
The principal mechanism of action of adrenoreceptor antagonist
Reversible or irreversible interaction with adreno receptor
Depletion of storage of catecholamines
Blockade of amine reuptake pumps
Non selective MAO inhibitors
Which adrenergic agonist is known to cause severe xerostomia
Clonidine
Epinephrine
Ephedrine
Amphetamine
Beta blockers aside from their cardiovascular indication are also used in the treatment of which disease
Gout
Glaucoma
Asthma
Reynaud's phenomenon
Which of the following drug has both Alpha 1 selective and beta blocking effects
Labetalol
Betaxolol
Propranolol
Timolol
Ganglionic transmission is mediated by
Presynaptic Alpha receptor
Postsynaptic beta 1 receptor
Postsynaptic dopaminergic receptor
Postsynaptic nicotinic receptor
Which of the following drug can be used in cases of beta blocker overdose
Naloxone
Flumazenil
Glucagon
Dexferoxamine
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
Is used for the management of hypertension
Has some selectivity for beta to adrenoreceptors
Is less likely to precipitate bronchoconstriction
Is less likely to reduce cardiac output
