Block 10 Skeletal Mus Myopath And DNA Tech MCQ's
Questions and Answers
- 1.
A 45 year old male has been recently diagnosed with amyotrophic lateral sclerosis. On a follow up visit he complains of constant spasms. So his physician prescribes a spasmolytic drug which facilitates GABA actions in the spinal cord. Which of the following drugs would fit the criteria?
- A.
Dantrolene
- B.
Botulinum toxin
- C.
Riluzole
- D.
Succinylcholine
- E.
Diazepam
Correct Answer
E. DiazepamExplanation
Diazepam is a drug that belongs to the class of benzodiazepines and acts as a spasmolytic by enhancing the actions of GABA in the spinal cord. GABA is an inhibitory neurotransmitter that helps to reduce the activity of neurons in the central nervous system, including the spinal cord. By enhancing GABA's actions, diazepam can help to reduce the frequency and intensity of spasms experienced by the patient with amyotrophic lateral sclerosis.Rate this question:
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- 2.
A 54 year old man with a recent condition of cervical dystonia, a movement disorder causing his neck to involuntarily turn to the left and upwards, has been treated with a drug which has effectively reduced the painful muscle spasms with the progress of drug treatment. Which of the following drugs could the patient have received?
- A.
Mivacurium
- B.
Tubocurarine
- C.
Botulinum toxin
- D.
Succinylcholine
- E.
Dantrolene
Correct Answer
C. Botulinum toxinExplanation
Botulinum toxin is the most appropriate drug for treating cervical dystonia. It is commonly used to reduce muscle spasms and involuntary movements in this condition. Mivacurium and tubocurarine are neuromuscular blocking agents used during anesthesia, but they do not specifically target dystonia. Succinylcholine is also a neuromuscular blocking agent, but it is not typically used for long-term treatment of movement disorders. Dantrolene is a muscle relaxant used to treat spasticity, but it is not as effective as botulinum toxin for cervical dystonia. Therefore, botulinum toxin is the most likely drug that the patient received.Rate this question:
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- 3.
A 22 year old woman presents with the symptom of cerebral palsy and complains of severe pain that is associated with spasms in the lower leg muscles. Which of the following drugs will reduce the skeletal muscle spasticity by producing an action inside the muscle cell?
- A.
Botulinum toxin
- B.
Tubocurarine
- C.
Diazepam
- D.
Baclofen
- E.
Dantrolene
Correct Answer
E. DantroleneExplanation
Dantrolene is a muscle relaxant that acts directly on the skeletal muscle by inhibiting the release of calcium ions from the sarcoplasmic reticulum. This reduces muscle contraction and helps to alleviate muscle spasticity. Botulinum toxin, Tubocurarine, Diazepam, and Baclofen all have different mechanisms of action and do not directly act on the muscle cell to reduce spasticity.Rate this question:
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- 4.
A 34-year-old woman while recuperating from a cesarean delivery 2 days earlier, becomes rigid, appears confused at times, and has a body temperature of 102°F. She developed serious tachycardia and hypercapnea. Her clinical notes indicated that halothane was the choice of anesthesia used for the del ivery, supplemented with a skeletal muscle relaxant, succinylchol ine. Which of the following drugs should immediately be given IV to this patient?
- A.
Dantrolene
- B.
Atropine
- C.
Neostigmine
- D.
Baclofen
- E.
Prazosine
Correct Answer
A. DantroleneExplanation
The symptoms described in the scenario, including rigidity, confusion, high body temperature, tachycardia, and hypercapnea, suggest the possibility of malignant hyperthermia (MH). MH is a potentially life-threatening condition that can occur as a reaction to certain anesthetic drugs, such as halothane, and muscle relaxants, such as succinylcholine. Dantrolene is the specific antidote for MH and should be immediately given intravenously to treat the condition. Atropine, neostigmine, baclofen, and prazosin are not indicated for the treatment of MH.Rate this question:
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- 5.
A 19 year old man who has a history of asthmatic attacks arrives to the ER complaining of intense pain in the right lower side of his abdomen. Patient complains of pain starting centrally before localizing to the right iliac fossa, and after gentle palpation the doctor finds the patient is sensitive to gentle pressure on the left iliac fossa therefore the diagnosis is typical appendicitis requiring major surgery. A drug is administered preoperatively and the anesthesia is supplemented with a skeletal muscle relaxant. Which of the following drugs would be contraindicated for this patient?
- A.
Tubocurarine
- B.
Glycopyrrolate
- C.
Clonidine
- D.
Vecuronium
- E.
Cisatracurium
Correct Answer
A. TubocurarineExplanation
Tubocurarine would be contraindicated for this patient because it is a skeletal muscle relaxant that can cause histamine release, leading to bronchoconstriction. Given the patient's history of asthmatic attacks, using tubocurarine could potentially worsen his asthma symptoms and lead to a life-threatening situation. Therefore, it is not safe to administer tubocurarine to this patient.Rate this question:
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- 6.
A 34 year old woman while recuperating from a cesarean delivery 2 days earlier becomes rigid, appears confused at times and has a body temperature of 1020F, and also develops tachycardia, and hypercapnia. Halothane had been the choice of anesthesia used for her delivery, supplemented with skeletal muscle relaxant succinylcholine. Which of the following drugs should be immediately given IV to this patient?
- A.
Atropine
- B.
Tizanidine
- C.
Dantrolene
- D.
Baclofen
- E.
Prazosin
Correct Answer
C. DantroleneExplanation
The symptoms described in the question (rigidity, confusion, high body temperature, tachycardia, and hypercapnia) are consistent with malignant hyperthermia (MH), a rare but potentially life-threatening reaction to certain anesthetic drugs. Dantrolene is the specific antidote for MH and should be immediately given intravenously to counteract the symptoms and prevent further complications. Atropine is a medication used to treat bradycardia, Tizanidine is a muscle relaxant, Baclofen is also a muscle relaxant, and Prazosin is an alpha-blocker used to treat high blood pressure. None of these drugs are appropriate for treating the symptoms described in the question.Rate this question:
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- 7.
A 24 year-old man presents with hypoxia, respiratory distress, pulmonary edema and stiff legs. He is diagnosed with Acute Respiratory Distress. He is given a neuromuscular blocking agent to facilitate lung protection while on the mechanical ventilator. Which non -depolarizing drug is likely infused for 48 hours while the patient is on a ventilator?
- A.
Succinylcholine
- B.
Dantrolene
- C.
Baclofen
- D.
Cisatracurium
- E.
Mivacurium
Correct Answer
D. CisatracuriumExplanation
Cisatracurium is the likely non-depolarizing drug that would be infused for 48 hours while the patient is on a ventilator. This drug is commonly used in the intensive care unit to provide muscle relaxation and facilitate mechanical ventilation in patients with acute respiratory distress syndrome (ARDS). It works by blocking the action of acetylcholine at the neuromuscular junction, leading to muscle paralysis. This helps to prevent the patient from fighting against the ventilator and allows for better lung protection and oxygenation.Rate this question:
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- 8.
A 55-year-old man is going to have internal surgery and a muscle relaxant is given. What kind of drug keeps the channel open, desensitizes the channel and blocks the ability to initiate an action potential?
- A.
Nondepolarizing drug
- B.
Central spasmolytic drug
- C.
Depolarizing drug
- D.
Peripheral spasmolytic drug
Correct Answer
C. Depolarizing drugExplanation
A depolarizing drug keeps the channel open, desensitizes the channel, and blocks the ability to initiate an action potential. This type of drug causes a sustained depolarization of the muscle membrane, leading to muscle relaxation. It works by mimicking the action of acetylcholine, the neurotransmitter responsible for initiating muscle contraction. By continuously activating the muscle receptors, the depolarizing drug prevents the normal repolarization and prevents the muscle from contracting.Rate this question:
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- 9.
A 66 year old woman visits the neurologist. She is brought by her daughter because she has recently noticed her mother has developed the following symptoms which include: difficulty swallowing, difficulty opening the mouth, spasms of the jaw, pain in the jaw also and has difficulty speaking. She also has uncontrollable squinting of the eyes when she talks. The neurologist who specializes in movement disorders immediately recognizes the condition and makes the diagnosis of Meige's syndrome and schedules a treatment regimen that includes injection of a peripheral spasmolytic drug. Which of the following is the most appropriate pharmacotherapy at this time?
- A.
Neostigmine
- B.
Succinylcholine
- C.
Riluzole
- D.
Gabapentin
- E.
Botulinum toxin
Correct Answer
E. Botulinum toxinExplanation
The most appropriate pharmacotherapy for the patient with Meige's syndrome is botulinum toxin. Meige's syndrome is a movement disorder characterized by involuntary muscle contractions, specifically affecting the muscles of the jaw and face. Botulinum toxin injections can help relax the overactive muscles and provide relief from symptoms such as difficulty swallowing, difficulty speaking, and spasms of the jaw. Neostigmine, Succinylcholine, Riluzole, and Gabapentin are not typically used in the treatment of Meige's syndrome.Rate this question:
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- 10.
A 52-year-old man comes to his physician today, complaining of excruciating pain in his left toe. On examination of the patient's foot, the doctor notes a swollen, red, first metatarsophalangeal joint which is warm to the touch, and also 0.5cm mobile nodules near the olecranon bilaterally. PMH reports that over a two year period he had twice presented with similar complaints about a painful joint; his doctor had treated the acute pain with ibuprofen. Today, the acute pain is treated with a three-day regimen of Drug A, which binds to tubulin, inhibiting neutrophil activation. Two weeks after the acute attack had resolved , the doctor prescribes another drug, Drug B, a long term prophylactic, to manage this patient's chronic cond ition. Which of the following pairs of drugs fits the characteristics of drugs "A" and "B"?
- A.
Ibuprofen and cortisone
- B.
Probenecid and indomethacin
- C.
Indomethacin and cortisone
- D.
Allopurinol and colchicines
- E.
Colchicine and allopurinol
Correct Answer
E. Colchicine and allopurinolExplanation
The patient's symptoms and medical history are consistent with gout, a type of arthritis caused by the buildup of uric acid crystals in the joints. Colchicine is commonly used to treat acute gout attacks by reducing inflammation and pain. Allopurinol, on the other hand, is a long-term prophylactic drug used to lower the levels of uric acid in the body and prevent future gout attacks. Therefore, colchicine and allopurinol fit the characteristics of drugs A and B in this case.Rate this question:
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- 11.
In which of the following conditions will electromyography likely show no denervation?
- A.
Poliomyelitis
- B.
Amyotrophic Lateral Sclerosis
- C.
Carpal Tunnel Syndrome
- D.
Primary Lateral Sclerosis
- E.
Sl radiculopathy
Correct Answer
D. Primary Lateral SclerosisExplanation
Primary Lateral Sclerosis (PLS) is a rare neurological disorder that primarily affects the upper motor neurons. Unlike other conditions mentioned in the options, PLS does not involve denervation of the muscles. Electromyography (EMG) is a diagnostic test that evaluates the electrical activity of muscles and nerves. In conditions like Poliomyelitis, Amyotrophic Lateral Sclerosis (ALS), Carpal Tunnel Syndrome, and Sl radiculopathy, there is damage or degeneration of the motor neurons, leading to denervation of the muscles. However, in PLS, the upper motor neurons are primarily affected, and there is no denervation, which is why EMG is unlikely to show denervation in PLS.Rate this question:
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- 12.
In an experiment Dr. Kirlin intends to silence VEGF genes associated with abnormal proliferation of blood vessels in mice with induced age-related macular degeneration (AMD). The synthetic siRNAs that he injected intravitreally into the mouse eye for this purpose are most likely:
- A.
75 nbp long double stranded RNA fragments
- B.
22 nbp long double stranded RNA fragments
- C.
120 nbp long cDNA strands
- D.
9 nbp long mRNA sequences
- E.
1000 nbp long DNA sequences
Correct Answer
B. 22 nbp long double stranded RNA fragmentsExplanation
The synthetic siRNAs injected into the mouse eye are most likely 22 nbp long double stranded RNA fragments. This is because siRNAs are small RNA molecules that are typically around 20-25 nucleotides in length. They are designed to specifically target and silence specific genes, such as the VEGF genes associated with abnormal blood vessel proliferation in this case. The double stranded structure of the siRNAs allows them to bind to the target mRNA and trigger its degradation, effectively silencing the gene expression.Rate this question:
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