WorksheetsAV 21 final
Total questions: 30
Worksheet time: 16mins
Which receptor activation in airway smooth muscle most directly causes bronchoconstriction and increased mucus secretion?
Beta-2 adrenergic receptors in airways
Alpha-1 adrenergic receptors in airways
Nicotinic receptors on airway glands
M3 muscarinic receptors in airways
Which drug class is intended for immediate relief during an acute asthma episode?
Leukotriene pathway antagonists
Short-acting β2-agonist bronchodilators
Glucocorticoids for long-term reduction
Anti-IgE monoclonal antibody therapy
A patient has frequent nocturnal awakenings due to asthma. Which therapy category should be prioritized to reduce attack frequency?
Control therapy with anti-inflammatory agents
Rescue xanthine preparations before bedtime
Antimuscarinic inhalers used only during attacks
Quick relief bronchodilators for episodic attacks
Which class of bronchodilators primarily activates β2 adrenoceptors to produce rapid relief of bronchoconstriction?
β2 adrenoceptor agonists
Antimuscarinic agents
Xanthine derivatives
Leukotriene modifiers
A patient inhales a β2 agonist. Which sequence best explains how bronchodilation occurs?
β2 activation → ↓ cAMP → smooth muscle contraction
Mast cell degranulation → ↑ cAMP → airway dilation
β2 activation → adenyl cyclase stimulation → ↑ cAMP
Muscarinic blockade → ↓ cAMP → airway relaxation
Which statement best describes epinephrine as a bronchodilator?
Potent bronchodilator with prolonged action
Weak bronchodilator with slow onset
Selective β2 bronchodilator with minimal side effects
Potent bronchodilator with rapid onset
Which clinical scenario makes non-selective β-agonists unsuitable in asthma management?
Normal glucose tolerance status
Mild intermittent asthma symptoms
Stable sinus rhythm without tachycardia
Hypertension or heart failure risk
Which route is primarily used to administer selective beta-2 agonists for asthma management?
Subcutaneous depot injection
Inhalation via inhaler or nebulizer
Intravenous continuous infusion
Oral tablets daily dosing
A patient presents with an acute asthma attack needing rapid relief. Which drug class and examples are most appropriate?
Anticholinergics: ipratropium, tiotropium
Short-acting beta-2 agonists: salbutamol, terbutaline
Inhaled corticosteroids: budesonide, fluticasone
Long-acting beta-2 agonists: salmeterol, formoterol
Explain why long-acting beta-2 agonists are combined with inhaled corticosteroids for chronic control rather than used alone for acute relief.
They have slow onset and long duration, not for acute relief
They cause bronchospasm without steroids
They reduce steroid absorption in the lungs
They only work overnight but not daytime
Which statement best differentiates short-acting from long-acting selective beta-2 agonists?
Long-acting have onset 1–2 min and 1–2 hr duration
Short-acting have onset 15–30 min and 4–6 hr duration
Long-acting are first-line for acute exacerbations
Short-acting are given only orally, never inhaled
Class IV antiarrhythmics primarily act at the AV and SA nodes to slow conduction and prolong the effective refractory period. Which pair represents these Class IV calcium channel blockers?
Amiodarone and ibutilide
Adenosine and lidocaine
Verapamil and diltiazem
Sotalol and quinidine
What is a primary function of an implantable cardiac defibrillator (ICD)?
Maintain sinus rhythm after cardioversion
Prevent bradycardia during myocardial infarction
Deliver continuous pacing to treat heart block
Automatically detect and treat ventricular fibrillation
In atrial fibrillation, which beta blocker is commonly used in the treatment map?
Esmolol ultrashort agent
Propranolol nonselective agent
Metoprolol selective agent
Acebutolol partial agonist
Which alternative agent is shown for AV nodal reentry besides beta blockers and verapamil?
Lidocaine anesthetic option
Digoxin cardiac glycoside option
Amiodarone iodine-rich option
Epinephrine adrenergic option
A 60-year-old man with myocardial infarction shows ventricular tachycardia on ECG. Immediate treatment should be
Amiodarone
Lidocaine
Quinidine
Verapamile
Which therapeutic strategy directly addresses myocardial oxygen demand in angina management?
Stimulating platelet aggregation pathways
Increasing hematocrit and blood viscosity
Reducing heart rate and contractility
Enhancing coronary collateral growth
All of the following drug classes can reduce myocardial oxygen demand in angina Except:
CCB
Antiplatelet drugs
Nitrates
Beta blockers
Which nitrate is primarily formulated for longer duration prophylaxis rather than acute relief?
Glyceryl trinitrate
Isosorbide mononitrate
Short-acting isosorbide dinitrate
Sublingual nitroglycerin
Which two overarching strategies guide drug treatment of angina pectoris?
Increase oxygen delivery to myocardium
Increase myocardial glycogen stores
Reduce myocardial oxygen demand
Lower plasma glucose concentration
Co-administration of sildenafil with nitroglycerin is contraindicated primarily because it increases the risk of:
Dangerous hypotension and syncope
Rebound hypertension and angina
Methemoglobinemia and cyanosis
Severe hypokalemia and arrhythmia
Which effects decrease myocardial oxygen demand with beta blockers? Select all that apply.
Lowered cardiac output
Enhanced β2-mediated bronchodilation
Decreased contractility
Reduced heart rate
Increased systolic blood pressure
Excessive sodium and water retention leading to increased blood volume refers to which mechanism?
Volume Overload
Increased Peripheral Resistance
Impaired Vasodilation
Which effects are reduced as a result of ACE inhibition?
Heart rate and myocardial contractility
Renin release and natriuresis
Vasoconstriction and aldosterone secretion
Platelet aggregation and thrombin generation
Which statement best reflects this mechanism of ARNIs?
They solely inhibit neprilysin, causing sodium retention and vasoconstriction
They act as beta-blockers to reduce heart rate without affecting RAAS or natriuretic peptides.
They combine RAAS inhibition with enhanced natriuretic peptide effects, producing vasodilation and reduced fibrosis.
They increase aldosterone activity to promote fluid retention.
Which hypertension phenotypes are shown to decrease with ARNI therapy? Except:
Uncontrolled (resistant) hypertension
Systolic hypertension
Orthostatic hypotension
Nocturnal hypertension
What are some characteristics of direct thrombin inhibitors
decreased conversion of fibrinogen to fibrin
increased endothelial cell/platelet activation
decreased endothelial cell/platelet activation
decreased activation of factor XIII
increased conversion of fibrinogen to fibrin
What are some ways we can reverse bleeding ADRs due to Warfarin? select all possible ways
vit K
Aspirin
Plasma transfusion
Rifampin
All of the following drugs are anticoagulants, Except:
Heparins
Clopidogrel
Warfarin
Direct thrombin inhibitors
Direct factor Xa inhibitors
All of the following are treatment strategies to prevent or reverse thrombus formation, Except:
Anticoagulants
Inhibit platelet activity
Vitamin K supplements
Dissolve clot
