WorksheetsCNS FORMATIVE ASSESSMENT
Total questions: 50
Worksheet time: 50mins
Which of the following antipsychotics cause cardiac arrhythmias?
a. Chlorpromazine
b. Clozapine
c. Thioridazine
d. Haloperidol
Lithium toxicity occurs due to all of the following EXCEPT
Thiazides
Dehydration
NSAIDs
Pregnancy
Which of the following drugs is absolutely contraindicated in a patient with porphyria
Zolpidem
Chloral hydrate
Phenobarbitone
Diazepam
The skeletal muscle relaxant with the longest duration of action is
Suxamethonium
Pancuronium
Rocuronium
Mivacurium
Regarding non-depolarising muscle relaxants
Produce non-surmountable blockade
Rocuronium is the most potent
Jaw and eye muscles are paralysed before the limb and trunk muscles
None of the above
Regarding local anaesthetics
Lignocaine is metabolised in the liver faster than any of the other amide LA
Allergies to amide Las are more common than with the ester Las
Prilocaine is the most cardiotoxic LA
The T 1/2 of lignocaine may be increased 3-4 fold in a patient with severe liver disease
Regarding GABA: all the following are true EXCEPT
Receptor blockers have anticonvulsant activity
Metabolism is inhibited by sodium valproate
GABA A is a ionotropic receptor
Is found in high concentrations in the basal ganglia
Codeine
Depresses the cough reflex
Frequently causes diarrhoea
Is more potent than fentanyl
none of the above
Nitrous oxide
Can be used with O2 as a carrier gas for halothane
Has poor analgesic properties
Sensitises the heart to the action of catecholamines
Is an effective agent for inducing anaesthesia
Thiopentone
Is not lipid soluble
Can be used IM or IV to induce anaesthesia
Has good analgesic properties d. Can cause convulsive movement
Anaesthetic action is terminated by redistribution from CNS to other highly vascularised tissues
The main side effect of benztropine is
Miosis
Confusion
Hemorrhage
Diarrhoea
Which of the following side effects for given drugs is wrong
Phenytoin – gum hypertrophy
Ethosuximide – hirsuitism
Phenobarbital – enzyme induction
Carbamazepine – ataxia
Valproate – idiosyncratic hepatic toxicity
Regarding inhaled anaesthetics
MAC is directly proportional to lipid solubility
Nitrous oxide has a relatively low MAC
Halogenated agents have a lower brain:blood partition coefficient
Nitrous oxide causes a decrease in tidal volume and an increase in respiratory rate
Regarding adverse effects of propofol
Post op vomiting is common
Hypertension is a complication
Metabolic acidosis
Tremor is a common side effect
Opioid receptors
Fentanyl works predominantly at the kappa receptors
Both Mu and delta receptors contribute to respiratory depression
Methadone is used for heroin withdrawal because its actions are predominantly at the delta receptors
Physical dependence and tolerance is caused by the rapid disintegration of receptors
Lithium
Has rapid onset of action
Is partially renally excreted
Is contraindicated in sick sinus syndrome
Has no contraindications to be given in conjunction with NSAIDS
A patient complains of post op muscle pain. This is most likely to be due to
Suxamethonium
Propofol
Isoflurane
Atracurium
Regarding drugs used in Parkinson’s disease
Bromocriptine is the first line drug to treat Parkinson’s disease in psychotic patients
80-90% of a single dose of Levodopa enters the brain unaltered
Amantadine has anti Parkinsonian effects and is administered at a dose of 100mg bd
Anti muscarinic drugs are of benefit in elimination of bradykinesia in Parkinson’s
Benzodiazepines
Increase the duration of GABA gated chloride channel openings
Bind to GABA B receptors
Have extensive cardiodepressant effects in doses used to cause hypnosis
Decrease the duration of stage 2 NREM sleep
Regarding the antiepileptic drugs
Lorazepam has documented efficacy against absence seizures
Phenytoin is able to stimulate its own metabolism by enzyme induction
Vigabatrin works by inhibiting GABA transaminase
Valproate has a large Vd
Which of the following local anaesthetic agents is an ester
Bupivacaine
Ropivacaine
Prilocaine
Procaine
The opiate associated with seizures when given in high doses to patients with renal failure is
Morphine
Pethidine
Methadone
Fentanyl
Which of the following is a direct serotonin agonist
Fluoxetine
Amitriptylline
Moclobemide
Sumatriptan
Phenytoin
Is 20-30% bound to albumin
Is the drug treatment of choice in absence seizures
Preferentially binds to activated state sodium channels
Steady state mean plasma concentrations varies disproportionately with the dose
The following antitussive is present in opium but has no analgesic or addicting properties
Noscapine
Codeine
Pholcodeine
Ethylmorphine
Which of the following are correctly paired
Imipramine: Inhibits 5HT and NA reuptake at presynaptic nerve endings
Citalopram: Inhibits 5HT selectively and has significant histamine effects
Selegiline: Blocks 5HT2 receptors
Venlafaxine: Inhibits NA and 5HT reuptake with potent alpha-blocking effects
Venlafaxine: Inhibits NA and 5HT reuptake with potent alpha-blocking effects
Sedation
Seizures
Hepatotoxicity
Tremor
Which of the following antidepressants is not highly protein bound
Amitriptyline
Fluoxetine
Selegiline
Venlafaxine
SSRI’s are not
Used in the treatment of obsessive-compulsive disorder and eating disorders
Well absorbed orally
Converted to active metabolites in the case of paroxetine
Inhibitors of CYP450 - 2D6
Tricyclic antidepressants are
5HT and NA reuptake inhibitors at post-synaptic nerve endings
Antinicotinics
Histamine receptor agonists
Alpha 1 blockers
Regarding lithium
It is responsible for inducing type II diabetes
It requires no treatment in overdose
Dosing does not need to be reduced in renal impairment
It is excreted almost entirely in the urine
Haloperidol
Is more sedative than chlorpromazine
May lower the convulsive threshold
Is a potent dopamine agonist
Has a low incidence of extra-pyramidal reactions
Regarding chlorpromazine which is NOT true
It is more than 80% protein bound – 95-98%
Is has a plasma half life of approximately 6 hours
It is excreted in urine and faeces
It induces hepatic microsomal enzymes
The drug used as an antipsychotic most likely to cause extrapyramidal effects is
Chlorpromazine
Risperidone
Haloperidol
Clozapine
Ethanol is used therapeutically in methanol poisoning because:
It increases the NADH/NAD ratio in the liver, thus reducing liver injury
It induces alcohol dehydrogenase and increases the clearance of methanol
It has greater binding affinity to alcohol dehydrogenase than methanol and hence prevents the metabolism of methanol by that enzyme
It inhibits the NMDA subtype of glutamate receptors in brain cells
Chronic alcohol consumption, all EXCEPT
Inhibits liver metabolism of other drugs
Has significant effect on the lethal dose of alcohol
Causes tolerance via an increase in its own metabolism
Causes malnutrition
Methanol intoxication
Is partly due to inhibition of aldehyde dehydrogenase
Is due to formation of oxalic acid
Is treated with activated charcoal
Can be treated with 4 methylpyrazole
Buspirone relieves anxiety without sedation by
Direct GABA stimulation
Indirect GABA stimulation
noradrenaline receptor stimulation
5HT1 partial agonist action
The most potent sedative is
Diazepam
Midazolam
Temazepam
Chloral hydrate
A young man of 24 years is suffering from Generalized Anxiety Disorder; which drug may be preferred for his problem
Zolpidem
Buspirone
Midazolam
Phenobarbital
With prolonged use in seizure states, which of the following drugs can cause coarsening of facial features, hirsutism, gingival hyperplasia and osteomalacia
Valproic acid
Carbamazepine
Ethosuximide
Phenytoin
Morphine should be used with extreme caution in all of the following conditions EXCEPT
Biliary tract surgery
Pulmonary edema
Last stage of labor
Adrenal insufficiency
Epinephrine added to a solution of lidocaine for local anesthesia will:
Cause cyanosis locally
Increase the risk of convulsions
Increase the duration of local anesthesia
Increase the absorption of lidocaine
Tolerance develops to all of the following effects of opioids except
Euphoria
Miosis
Analgesia
Nausea
Which of the following action is ascribed to delta type of opioid receptors?
Supraspinal analgesia
Respiratory depression
Euphoria
Reduced intestinal motility
‘Dissociative anaesthesia’ is produced by:
Ketamine
Fentanyl
Propofol
None of the above
Patients treated with the following drug should be cautioned not to consume alcoholic beverages
Mebendazole
Metronidazole
Methimazole
Metamizol
A patient of endogenous depression was put on imipramine therapy. After what interval the therapeutic effect is likely to manifest
Three days
One week
Three weeks
Three months
Morphine analgesia differs from that produced by aspirin in the following respect(s):
It has a higher ceiling
It covers both perception as well as psychic processing of the pain
Visceral and ischaemic pain is relieved better than somatic inflammatory pain
All of the above are correct
The following are pure opioid antagonists except:
Nalmfene
Nalbuphine
Naloxone
Naltrexone
