Pharm II - Quiz 3 - Quiz & Trivia

1. Which of the following is an appropriate renal dose of dopamine?

2 mcg/kg/min

8 mcg/kg/min

15 mcg/kg/min

All of above

2. Which of the following is an alpha 2 agonist?

Phenylephrine

Norepinephrine

Clonodine

Dopamine

3. COMIC RELIEF: Best Prank Call Ever

Ha ha!! Now that is how you handle a telemarketer.

Poor telemarketer, he sounds like he is gonna piss his pants.

Evil.... but i like it!

All the Above

4. How do class III antidysrhythmic drugs work?

By antagonizing adrenergic receptors

Through blockade of Na channels.

By blocking the slow inward calcium driven current

By prolonging repolarization

5. You are caring for Mrs. Undavi who is the ER right now. She takes a wide range of cardiac medications, and is currently complaining of pain in her face (alone jaw, nose and forehead). She has also been been vomiting all day and has not eaten a thing all day due the nausea. What do you thing may be wrong with her?

Digitalis Toxicity

Lidocaine Toxicity

Amiodarone Toxicity

Phenytoin Toxicity

6. Which of the following is would not increase risk for cardiac disarrythmias?

ST elevation on ECG

Low serum K

ABG showing hypoxia

Diabetes

7. Phenylephrine primarily acts upon which receptor?

Beta 2

Alpha 1

Beta 1

Alpha 2

8. Which of the following is a pre-synaptic receptor?

Alpha 1

Alpha 2

Beta 1

Beta 2

9. Epinephrine should be used cautiously in patients with what condition?

Dysrhythmias

Renal Failure

COPD

Hypertensive ischemic heart disease

10. Which of the following is not an effect of precedex?

Maintaining respiratory stability

Sedation

Reduces brain Noradrenergic Activity

Increase pt BP

11. Which of the following is not a cardiac effect of alpa 1 receptor activation?

Decrease SVR

Vasoconstriction

Increase LV afterload

Increase arterial BP

12. What is the mechanism of action of Diltiazem?

Beta 2 agonist

Blocks calcium channels of AV node

Directly relaxes arterial smooth muscle

Imitates cGMP in smooth vasculature

13. After the breakdown of epinephrine by MAO and COMT, what product is excreted in the urine?

Vanillymandelic Acid

3,7-dicarboxyvandelic acid

Nelson-Mandelic Acid

4,6-Pheocomtic acid

14. How do class I antidysrhythmic drugs work?

By antagonizing adrenergic receptors

Through blockade of Na channels.

By blocking the slow inward calcium driven current

By prolonging repolarization

15. Which of the following would be the best choice to prevent vasospasms associated with subarachnoid hemorrhage?

Nifedipine

Diltiazem

Isoproteronol

Nimodipine

16. Which of the following is not one of the 3 mechanisms for termination of norepinephrine?

Re-uptake

Diffusion from receptor sites

Irreversible protein binding

Enzyme degredation

17. Beta 2 agonism may result in which of the following electrolyte imbalances?

Hypokalemia

Hypochloremia

Hyponatremia

None of above

18. What is an appropriate IV starting dose of lidocaine to control frequent PVC’s?

4.5 mg/kg

10 mg/kg

2 mg/kg

5 mg/kg

19. Where is calcium stored in the cell?

Synaptic Vessicles

Mitochondria

Golgi Bodies

Sarcoplasmic Reticulum

20. What is the preferred medication to raise the BP of an OB patient?

Epinephrine

Amphetamine

Dopamine

Ephedrine

21. Which of the following would be the best choice to increase cardiac contractility in a pt with CHF and CAD?

Phenylephrine

Dopamine

Dobutamine

Norepinephrine

22. What occurs during Phase 2 of action potential?

Repolarization to resting potential results from outward K current

Rapid phase of repolarization caused by inactivation of Na influx and activation of a transient outward K current

Voltage dependent Na channel opens and rapid sodium influx depolarizes cell

Plateau phase, characterized by low membrane conductance and the activation of slow inward Ca current

Outward K current is deactivated and an inward Na current reduces transmembrane potential

23. Which of the following is release from the adrenal gland in times of stress and acts on alpha and beta receptors?

Dopamine

Norepinephrine

Epinephrine

Acetylcholine

24. When a neurotransmitter binds to a postsynaptic receptor it is likely to likely cause which of the following?

Opening of an ion channel

Activation of a second messenger such as cAMP or inositol phosphate

Depolarization

All of above.

25. What effect will ephedrine have on your MAC?

Increase MAC

Decrease MAC

No effect on MAC

26. What is the mechanism of action of dexmedetomidine hydrochloride?

Beta 2 adrenoreceptor agonist

Alpha 2 adrenoreceptor agonist

Potentiation of GABA

None of above

27. Which calcium channel blocker will cause the greatest amount of coronary vasodilation?

Nifedipine

Nicardipine

Nimodipine

Hydralyzine

28. Stimulation of Beta 1 receptors is likely to have all of the following effects except …

Increase Contractility

Increase HR

Increase CO

Decreased SVR

29. Which of the following is not a direct sympathomimetic?

Phenylephrine

Amphetamine

Isoproterenol

Dobutamine

30. What enzyme acts on Dopamine to turn it into Norepinephrine?

N-methyltransferase

Dopamine B-Hydroxylase

DOPA decarboxylase

Dopamine does not directly turn into norepi… you’re missing a step.

31. How do class II antidysrhythmic drugs work?

By antagonizing adrenergic receptors

Through blockade of Na channels.

By blocking the slow inward calcium driven current

By prolonging repolarization

32. How do class IV antidysrhythmic drugs work?

By antagonizing adrenergic receptors

Through blockade of Na channels.

By blocking the slow inward calcium driven current

By prolonging repolarization

33. Depolarization of cardiac cells mainly has to do with _____, while repolarization has to do mainly with _____.

Calcium, Magnesium

Potassium, Sodium

Magnesium, Calcium

Sodium, Potassium

34. What is the postsynaptic neurotransmitter of the parasympathetic nervous system?

Acetylcholine

Norepinephrine

Epinephrine

Tyrosine

35. Which of the following has both direct and indirect sympathomimetic activity?

Norepinephrine

Amphetamine

Ephedrine

Phenylephrine

36. What is the most potent activator of alpha adrenergic receptors?

Norepinephrine

Ephedrine

Phenylephrine

Epinephrine

37. Which of the following is not a factor associated with cardiac dysrhythmias?

Altered sympathetic nervous system activity

Venous Hypoxia

Myocardial Ischemia

Bradycardia

38. Where is norepinephrine synthesized?

Post-synaptic Neurons

Pineal Body

Posterior Lobe of Pituitary

Synaptic Vessicles

39. Which of the following Antidysrhythmic medication may cause seizures?

Phenytoin

Amiodarone

Procainamide

Lidocaine

40. You are having the worst day ever, you have just had to give Dantrolene to a pt (and you know what that means….). When looking over the pts medical history again you find their medication list includes verapimil. GGrrrreeeaaaaaaattt. Now what should you start checking? (Cause you know, your day wasn’t screwed enough already

Watch your Arterial BP very closely, these drugs together cause profound HTN and increase risk for stroke

Monitor pt for cyanide toxicity

Send serum K levels and watch for arrythmias

Monitor for hpoxemia and seizure activity

41. When Tyrosine is hydroxylated it becomes what?

Dopa

Phenylalanine

Norepinephrine

Epinephrine

42. Which of the following would be the best medication to increase the HR on a pt with an amiodarone induced heart block?

Isoproterenol

Phenylephrine

Ephedrine

Calcium Chloride

43. Which of the following drugs would be appropriate to treat hypotension in a patient who is taking MAOI’s?

Vifedipine

Epinephrine

Dopamine

Phenylephrine

44. What is the postsynaptic neurotransmitter of the sympathetic nervous system?

Acetylcholine

Norepinephrine

Epinephrine

Tyrosine

45. A 1: 10,000 mix of epinephrine contains how many micrograms of epinephrine per ml?

10

5

100

20

46. Why do direct acting non-catecholamine have a longer serum half life than catecholamine?

They are not metabolized by MAO or COMT

Higher degree of protein binding

Increase volume of distribution

All of above

47. Which of the following will have the greatest effect on AV node conduction?

Nifedipine

Verapimil

Nimodipine

Diltiazem

48. Which of the following drugs would be the best choice for Mrs. Taliss who is experiencing a ventricular dysrhythmia due to digitalis toxicity?

Phenytoin

Digoxin

Lidocaine

Amiodarone

49. Which of the following neuro-muscular blockers would not have a prolonged effect on a pt taking cardene?

Calcium channel blockers prolong both depolarizing and non-depolarizing agents

Succinylcholine

Rocuronium

Cisatracurium

50. Norepinephrine is synthesized from ______ which is hydroxylated to form Dopa.

Dopamine

Tyrosine

COMT

Phenylalanine

51. Activation of Alpha 2 receptors inhibits ______ activity.

Dopa-b hydroxylase

Tyrosine

Adenylate cyclase

COMT

52. Norepinephrine exerts its greatest action on which receptors?

Alpha

Beta 1

Beta 2

All are equal

53. What occurs during Phase 0 of action potential?

Repolarization to resting potential results from outward K current

Rapid phase of repolarization caused by inactivation of Na influx and activation of a transient outward K current

Voltage dependent Na channel opens and rapid sodium influx depolarizes cell

Plateau phase, characterized by low membrane conductance and the activation of slow inward Ca current

Outward K current is deactivated and an inward Na current reduces transmembrane potential

54. What is the mechanism of action of digitalis?

Blocks calcium channels

Decreases rate of phase 4 repolarization

Depresses conduction in AV node

Inhibits NA-K-ATPase ion transport system

55. Which medication would be the best choice to suppress SVT in a patient with Wolff-Parkinson White syndrome?

Lidocaine

Amiodarone

Phenytoin

Digitalis

56. What is half life of amiodarone?

29 days

2 months

17 hours

8 days

57. You are the SRNA for Mr. Kodaris who is have open heart surgery today. Which of the following medications would be useful to give pre-op to decrease the incidence of post-op A-fib?

Amiodarone

Lidocaine

Digitalis

Procainamide

58. Which of the following is not a direct acting catecholamine?

Epinephrine

Dobutamine

Phenylephrine

Isoproterenol

59. Which of the following would not be an effect of epinephrine?

Increased renal blood flow

Increase rate of phase IV depolarization

Bronchodilation

Increase cerebral perfusion pressure

60. What would be an appropriate dose of phenytoin to give to a patient in Torsades?

100 mg in D5NS every 5 minutes

5mg/kg over 2 minutes

18 mcg/kg

1.5 mg/kg in NS every 5 min

61. N-Methyltransferase acts on Norepinephrine in the adrenal medulla to turn it into…

Vanillymandelic acid

Dopa

Epinephrine

Ephedrine

62. What dose of Dopamine would you give to achieve alpha 1 agonism and an increase in PVR?

16 mcg/kg/min

24 mcg/kg/min

5 mcg/kg/min

63. How will Renal impairment effect metabolism of Precedex?

It won’t effect it… only hepatic impairment will.

You will need to decrease the dose

You will need to increase the dose

Pt will be more prone to bradycardia and hypotension

64. What occurs during Phase 3 of action potential?

Repolarization to resting potential results from outward K current

Rapid phase of repolarization caused by inactivation of Na influx and activation of a transient outward K current

Voltage dependent Na channel opens and rapid sodium influx depolarizes cell

Plateau phase, characterized by low membrane conductance and the activation of slow inward Ca current

Outward K current is deactivated and an inward Na current reduces transmembrane potential

65. What occurs during Phase 1 of action potential?

Repolarization to resting potential results from outward K current

Rapid phase of repolarization caused by inactivation of Na influx and activation of a transient outward K current

Voltage dependent Na channel opens and rapid sodium influx depolarizes cell

Plateau phase, characterized by low membrane conductance and the activation of slow inward Ca current

Outward K current is deactivated and an inward Na current reduces transmembrane potential

66. Which of the following drugs should not be administered to pts taking Digitalis?

Nicardipene

Amiodarone

Calcium

All the above

67. What is the appropriate shock and allergic reaction dose of epinephrine?

1:1000 solution .1-.5 ml SQ/IM

0.5 -1mg IV

2-20 ug/min

Racemic inhalation 0.5 ml of 2.25% solution

68. What dose of dopamine would you give to achieve selective beta 1 agonism?

16 mcg/kg/min

24 mcg/kg/min

5 mcg/kg/min

69. What is the mechanism of action of Lidocaine as a Class 1 antidysrhythmic?

Blocks calcium channels

Decreases rate of phase 4 repolarization

Depresses conduction in AV node

Inhibits NA-K-ATPase ion transport system

70. You are the SRNA for Ms. Nyen, who is having a liver biopsy today. You see her home meds include amiodarone. Knowing about the effects of amiodarone, how will this affect your anesthesia management?

You should not use Isoflurane due to increased risk of sinus arrest

Pt is at an increased risk for aspiration and thus requires RSI

Should not use Sux as pt is likely to be hyperkalemic

Decrease FiO2 to decrease risk of pulmonary alveolitis

71. Which of the following will not increase the risk of Dig toxicity?

Impaired renal Function

Concurrent administration of Ca Channel blocker

Hypocalcemia

Hypomagnesemia

72. Which of the following is not true regarding Terbutaline?

May treat pulmonary edema

May relax the uterus in near term pregnant women

Increases secretion of rennin

Exerts its action primarily on Beta 2 receptors

73. What occurs during Phase 4 of action potential?

Repolarization to resting potential results from outward K current

Rapid phase of repolarization caused by inactivation of Na influx and activation of a transient outward K current

Voltage dependent Na channel opens and rapid sodium influx depolarizes cell

Plateau phase, characterized by low membrane conductance and the activation of slow inward Ca current

Outward K current is deactivated and an inward Na current reduces transmembrane potential

74. Free calcium reacts with _______ to increase the number of cross bridges and thus increase strength of contraction.

Troponin

Myosin

Actin

Phosphokinase

75. How do calcium channel blockers reduce myocardial O2 demand? (two answers)

Through decrease in preload

By decreasing HR

Through a decrease in Afterload

Through alpha 2 antogonist activity

Submit

76. At which subunit do calcium channel blockers exert their action?

Beta 1

Alpha 1

Alpha 2

Beta 2

77. Where does dopa-b hydroxylase act upon dopamine to turn it into norepinephrine?

Mitochondria

Synaptic cleft

Synaptic Vessicles

Storage Vessicles

78. What would be the best choice to suppress SVT caused by reentry phenomenon in the heart?

Procainamide

Phenytoin

Lidocaine

Digitalis

79. How would you treat bradycardia in a patient who has been given amiodarone?

Transcutaneous pacemaker

Atropine

Gylcopyrolate

Phenytoin

80. How will a pt who has a history of chronic amphetamine abuse affect your anesthetic requirements?

Increase MAC

Decrease MAC

No Effect

81. What is an appropriate IV dose of amiodarone?

1.5 mg/kg in NS every 5 min

2 mg/kg rapid IV push

5 mg/kg over 2-5 min

2-6 mg/min IV infusion

82. Which of the following is not an effect of norepinephrine?

Increase myocardial O2 demand

Increase CO

Bradycardia

Increase Afterload

83. Which of the following Class I antidysrhythmics will have little effect on phase 0 depolarization?

Class IB

Class IA

Class IC

All the above have profound effects upon Phase O depolarization.

84. What would be an appropriate IV infusion dose of procainamide to control v-tach?

2 mg/kg/min

2-6 mg/min

1-3.5 mcg/kg/min

5-15 mg/min