Pharmacology Ii

Front 1

All of the following are clinical symptoms & physical manifestations of congestive heart failure except:
a. edema such as ankle swelling
b. distended neck veins
c. increased urinary output
d. hepatomegaly
e. atrial tachycardia

Back 1

C

Front 2

Diuretics such as furosemide are used to treat congestive heart failure because they:
a. increase pulmonary congestion
b. decrease plasma volume
c. create a negative nitrogen balance
d. increase oxygen demand
e. cause increased urinary calcium retention

Back 2

B

Front 3

Which effect would best describe the mechanism of action of digoxin, a digitalis glycoside used in treatment of congestive heart failure?
a. decreases systolic force of contraction
b. activates Na+-K+ exchange in cardiac muscle
c. decreases the influx of Ca2+ into cardiomyocytes
d. increases cardiac output
e. decreases systolic blood pressure

Back 3

D

Front 4

Angiotensin converting enzyme (ACE) inhibitors such as captopril are effective in the treatment of congestive heart failure because they are:
a. afterload reducing agents
b. preload reducing agents
c. direct vasoconstrictors
d. direct vasodilators
e. effective in increasing sodium and water retention

Back 4

A

Front 5

Which of the following is a beta-adrenergic antagonist (beta blocker) used in the treatment of CHF?
a. hydrochlorthiazide
b. propranolol
c. verapamil
d. enalapril
e. digoxin

Back 5

B

Front 6

Which of the following statements regarding class III anti-arrhythmia drugs such as amiodarone is correct?
a. may display toxicity to thyroid and lungs
b. can behave as a partial beta blocker
c. attenuate the action potential (phase 0 depolarization)
d. block sodium channels to increase repolarization currents

Back 6

D

Front 7

Which effect would be observed if binding of angiotensin II to the AT1 receptor were inhibited?
a. decreased vasoconstriction
b. increased blood pressure
c. increased sodium and water retention
d. increased afterload

Back 7

A

Front 8

All of the following statements regarding isoproterenol are correct except isoproterenol:
a. binds with high affinity to alpha-adrenergic receptors
b. produces peripheral vasodilation
c. is a good bronchodilator
d. increased cardiac output
e. is a good antiarrhythmic

Back 8

A

Front 9

The calcium channel antagonist nifedipine reduces myocardial ischemia/angina by which of the following mechanisms?
a. reducing activation of a1-adrenergic receptors
b. decreasing b.p. and dilating coronary arteries
c. dilating coronary arteries and increasing myocardial wall tension
d. enhancing growth of collateral coronary arteries
e. dissolving atherosclerotic plaques

Back 9

B

Front 10

Spironolactone is effective in the treatment of hypertension because it blocks:
a. b-adrenergic receptors
b. calcium channels
c. aldosterone effects on the kidney
d. cortisol effects on the kidney
e. a-adrenergic receptors

Back 10

C

Front 11

Losartan or Irbesartan administration reduces blood pressure by blocking/inhibiting

A. angiotensin II receptors.
B. angiotensin-converting enzyme.
C. Ca2+-channels in the vasculature.
D. a-adrenergic receptors in the vasculature.
E. b-adrenergic receptors in the heart.

Back 11

A

Front 12

Which of the following physiological effects is associated with the proper administration of verapamil?

A. Reduced triglyceride levels
B. Shortening of cardiac action potential
C. Suppression of phase 4 depolarization
D. Reduction in phase 0 depolarization
E. Reduces ventricular fibrillation

Back 12

B

Front 13

Statins such as MevacorTM and LipitorTM are antihyperlipidemic agents because they

A. inhibit HMG-CoA reductase.
B. inhibit transcription of proteins involved in fatty acid metabolism.
C. inhibit lipolysis in adipose tissue.
D. remove bile acids from the gastrointestinal tract.
E. inhibit cholesterol uptake by the liver.

Back 13

A

Front 14

CholestipolTM is used as an antihyperlipidemic agent because it

A. inhibits HMG-CoA reductase.
B. inhibits transcription of proteins involved in fatty acid metabolism.
C. inhibits lipolysis in adipose tissue.
D. inhibits cholesterol uptake by the intestine.
E. inhibits cholesterol uptake by the liver.

Back 14

C

Front 15

Which of the following drugs would likely be used to treat sinus tachycardia?

A. Dopamine
B. Dobutamine
C. Propranolol
D. Captopril
E. Verapamil

Back 15

C

Front 16

All of the following cations are important in generating currents during each cardiac cycle EXCEPT

A. Ca2+.
B. K+.
C. Cl.
D. Na+.

Back 16

C

Front 17

Which of the following receptors is important for sensing short term changes in blood pressure?

A. b1-Adrenergic receptors
B. Baroreceptors
C. Chemoreceptors
D. Angiotensin II receptors
E. Muscarinic cholinergic receptors

Back 17

B

Front 18

Which tissue is responsible for the pacemaker potentials that control contraction of the heart?

A. Atrioventricular node
B. Bundle of His
C. Purkinje fibers
D. Sinoatrial node
E. Ventricular myocardium

Back 18

D

Front 19

Which of the following sequences correctly describes the order of the conduction pathway for the cardiac action potential?

A. AV node – SA node – internodal pathways – Purkinje fibers – ventricular myocardium
B. AV node – SA node – Purkinje fibers – internodal pathways – ventricular myocardium
C. SA node – AV node – Internodal pathways – Purkinje fibers – ventricular myocardium
D. SA node – internodal pathways – AV node – Purkinje fibers – ventricular myocardium
E. Ventricular myocardium – SA node – internodal pathways – AV node – Purkinje fibers

Back 19

C

Front 20

All of the following are common precipitants of arrhythmias EXCEPT

A. hypoxia.
B. excessive sympathetic discharge.
C. excessive parasympathetic discharge.
D. genetic defects in potassium channels.
E. genetic defects in sodium channels.

Back 20

C

Front 21

All of the following agents have significant physiological roles in directly regulating one or more components of the cardiovascular system EXCEPT

A. acetylcholine.
B. atrial natriuretic peptide.
C. dopamine.
D. epinephrine.
E. norepinephrine.

Back 21

C

Front 22

Which of the following conditions or effects does NOT result from prolonged treatment with corticosteroids?

A. Gastric ulcer
B. Osteoporosis
C. Hyperglycemia
D. Skeletal muscle atrophy
E. Redistribution of body fat

Back 22

A

Front 23

A 57 year old person receiving propranolol (b-blocker) for hypertension presents with an acute allergic asthma attack. Which of the following treatments will not work?

A. Ipratropium bromide (Atrovent)
B. Loratadine (Claritin)
C. Dudenoside (Pulmicort)
D. Albuterol (Proventil)

Back 23

D

Front 24

Bronchoconstriction in chronic obstructive pulmonary disease (COPD) due to epithelial damage occurs by what mechanism?

A. Loss of endogenous b-agonist release leading to increased smooth muscle contraction
B. Activation of exposed sensory nerve fibers leading to acetyl choline release and cholinergic bronchoconstriction
C. Increased inflammatory mediator release leading to smooth muscle oxidative damage
D. Loss of epithelial derived acetyl choline release leading to increased bronchoconstriction

Back 24

B

Front 25

Which statement accurately describes the mechanisms of action of corticosteroids?

A. Fast-acting anti-inflammatory due to increased calcium release stimulated in inflammatory cells, especially mast cells.
B. Bind selectively to epithelial cells leading to endogenous b-agonist release
C. Slow-acting agents that influence protein expression by forming complexes with nuclear receptors and binding directly to specific DNA sequences
D. Fast-acting agents that increase chloride secretion across epithelial cells leading to improved airway clearance
E. Slow-acting agents that bind to membrane receptors and elevate Ca2+

Back 25

C

Front 26

All of the following statements describe a known effect of corticosteroid treatment EXCEPT

A. decreased recruitment of eosinophils.
B. increased expression of b-receptors on smooth muscle cells.
C. decreased cytokine expression from T-lymphocytes and macrophages.
D. reduced mucous secretion from glands.
E. increased mast cell recruitment and histamine release.

Back 26

E

Front 27

Anti-leukotrienes and antihistamines are both used as treatments for allergen-induced asthma. These compounds are best used

A. prophylactically to prevent allergen-mediated responses.
B. in response to an acute asthmatic attack due to their fast action.
C. in combination with anti-cholinergic agents.
D. in combination with NSAIDs.

Back 27

A

Front 28

Which of the following is a concern for prolonged, repeated use of b-receptor agonists for the treatment of acute asthmatic exacerbations?
A. negative regulation of corticosteroid receptor function resulting in reduced steroid effectiveness.
B. secondary release of acetyl choline leading to cholinergic airway contraction.
C. increased mast cell recruitment leading to more severe allergic responses.
D. desensitization of b-receptors due to b-adrenergic receptor kinase (bARK) activation.

Back 28

D

Front 29

Dobutamine is contraindicated for which of the following conditions?

A. Congestive heart failure
B. Hypotension
C. Angina
D. Arrhythmia

Back 29

B

Front 30

All of the following agents can bind to and inactivate Na+ channels EXCEPT

A. local anesthetics.
B. general anesthetics.
C. dihydropyridine class Ca2+ channel antagonists.
D. frog toxins.
E. b-adrenergic antagonists.

Back 30

E

Front 31

Pseudoephedrine and oxymetazoline are marketed as nasal decongestants. They are a-adrenergic agonists. Which of the following effects is likely from oral administration of pseudoephedrine but not after intranasal administration of oxymetazoline?

A. Bradycardia
B. Increased blood pressure
C. Decreased blood pressure
D. Tachycardia
E. Bronchoconstriction

Back 31

B

Front 32

Minoxidil is used to treat

A. excess hair growth.
B. congestive heart failure.
C. hypertension.
D. atrial fibrillation.
E. hypotension.

Back 32

C

Front 33

Niacin at high doses can be used as an antihyperlipidemic agent because it

A. inhibits HMG-CoA reductase.
B. inhibits lipolysis in adipose tissue.
C. removes bile acids from the gastrointestinal tract.
D. inhibits cholesterol uptake by the intestine.
E. inhibits cholesterol uptake by the liver.

Back 33

B

Front 34

All of the following pairs of agents and actions or agents and receptors occur and/or interact physiologically in normal individuals EXCEPT

A. acetylcholine – muscarinic receptors.
B. acetylcholine – nicotinic receptors.
C. epinephrine – dopamine receptors.
D. epinephrine – vasodilation.
E. norepinephrine – bronchodilation.

Back 34

C

Front 35

A patient who has been taking large quantities of aspirin might show increased postoperative bleeding because aspirin inhibits

A. synthesis of thromboxane and thus prevents platelet aggregation.
B. synthesis of prostacyclin and thus prevents platelet disaggregation.
C. synthesis of prostaglandin and thus prevents production of blood platelets.
D. thrombin and thus prevents formation of the fibrin network.
E. intestinal absorption of vitamin K and thus prevents synthesis of blood clotting factors.

Back 35

A

Front 36

All of the following bind to opioid receptors EXCEPT

A. endorphins.
B. enkephalins.
C. naloxone.
D. triptans.
E. dynorphins.

Back 36

D