Block 9 Rx Cholinergics MCQ's

8 Questions | Total Attempts: 150

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Block 9 Rx Cholinergics MCQ

Questions and Answers
  • 1. 
    An 82-year-old male complains of retention of urine for the last 24 hours. Examination reveals a distended bladder that is palpable in suprapubic region. Bladder catheterization yielded 1500 ml of urine. He is diagnosed with atonic bladder due to a pelvic infection. He is placed on antibiotics and an oral choline ester. Which of the following drugs was most likely prescribed?
    • A. 

      Carbachol

    • B. 

      Bethanechol

    • C. 

      Neostigrnine

    • D. 

      Pralidoxime

    • E. 

      Pilocarpine

  • 2. 
    A 54-year-old woman recovering from abdominal surgery receives bethanechol pharmacotherapy. Which of the following side effects symptoms could be expected to be observed in this individual?
    • A. 

      Mydriasis, bronchospasm and flushed face

    • B. 

      Constipation, increased sweating and salivation

    • C. 

      Miosis, diarrhea and bradycardia

    • D. 

      Dry mouth, abdominal cramps and tachycardia

  • 3. 
    A 10 year old boy diagnosed to have strabismus, for surgical correction, was anesthetized with halothane prior to surgical correction, Succinylcholine was administered to facilitate endotracheal intubation. Twenty minutes later masseter muscle tone remained increased so that his teeth compressed the endotracheal tube. Even other skeletal muscle tone was found to be increased. His body temperature was 39 C (102.2 F), pulse was 125/minute and respiration rate was 20 breaths per minute. Administering a drug acting by which of the following mechanisms is the most approphate next step to decrease muscle tone?
    • A. 

      Inhibiting calcium release from sarcoplasmic reticulum

    • B. 

      Stimulating GABA type B receptors

    • C. 

      Facilitating GABA mediated chloride channel opening

    • D. 

      Facilitating calcium excretion in urine

  • 4. 
    Mr. X is a 53-year-old male who presents to you with memory loss and blackouts. His wife states that over the last year, Mr. X has become more and more forgetful. He used to take care of the family finances and run his own business out of his home until his memory loss forced him to turn the finances over to his wife and quit his business. Mrs. X also states that he forgets appointments and phone calls, sometimes just after he hangs up the phone. He identifies an increasing number of objects as "that thing" because he cannot recall the correct name. Which of the following drugs is most useful in treating his condition?
    • A. 

      Irreversible cholinesterase inhibitors

    • B. 

      Reversible cholinesterase inhibitors

    • C. 

      Reversible cholinesterase reactivators

    • D. 

      Cerebro-selective reversible cholinesterase inhibitors

  • 5. 
    A 30-year-old man takes a can of beer out of his refrigerator at the end of the day and rapidly swallows a mouthful of its contents before he realizes that it is not beer. Within a few minutes he develops severe abdominal cramps, blurred vision, twitching, and loss of consciousness. His wife notifies emergency medical personnel that she paced some roach spray in the beer can for storage and left it in the refrigerator to deal with roaches that were nesting there. She claims she forgot to advise her husband. Emergency personnel check the insecticide brand and determine that it is an organophosphate. To counteract the cholinesterase-inhibiting activity of the organophosphate poison, the patient should receive:
    • A. 

      Methacholine plus pralidoxime

    • B. 

      A muscarinic antagonist

    • C. 

      Physostigmine plus pralidoxime plus atropine

    • D. 

      An acetyl cholinesterase reactivator plus direct muscarinic agonist

  • 6. 
    Substituted organophosphate compounds were originally developed as insecticides (malathion and parathion) and then as very potent "nerve gases" (e.g, sarin). As a class of substances organophosphates inhibit the activity of acetylcholine esterase. What would be the expected effect if an organophosphate compound were applied topically to the eye?
    • A. 

      Droopy eyelid

    • B. 

      Miosis

    • C. 

      Mydriasis

    • D. 

      Unsusual sensitivity to light

  • 7. 
    A 42-year-old farmer visits the hospital for generalized weakness, diarrhea, and drooping eyelids for 1 day. He says he developed the symptoms after spraying his field with an insecticide. Which of following drugs will reverse the autonomic effects the patient is suffering from without acting on any enzyme?
    • A. 

      Bethanechol

    • B. 

      Atropine

    • C. 

      Pralidoxime

    • D. 

      Edrophonium

    • E. 

      Physostigmine

  • 8. 
    A 35-year-old farmer was brought to the emergency room complaining of severe abdominal cramps, vomiting and excess salivation. His skin was flushed, warm, and moist to the touch. He stated that he was working in his field with an organophosphate pesticide. Which of the following molecular actions most likely mediated the flushed skin in this patient?
    • A. 

      Increase in intracellular Ca ++

    • B. 

      Increased cGMP synthesis

    • C. 

      Opening of Na+ channels

    • D. 

      Increased cAMP synthesis

    • E. 

      Increased IP3/DAG synthesis

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