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Cholinergic Practice Exam I

Cholinergic Practice Exam I

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Question # 1 (Multiple Answer) Anticholinesterases used to treat myasthenia gravis:

    A) neostigmine (Prostigmin)
    B) pyridostigmine (Mestinon)
    C) ambenonium

Question # 2 (Multiple Choice) Nicotinic receptor:

    A) ionic channel coupling
    B) G protein coupling

Question # 3 (Multiple Choice) Glaucoma category responding to anticholinesterase treatment

    A) primary (narrow angle -- acute, congestive)
    B) secondary (aphakic --no lens; following cataract surgery)
    C) congenital

Question # 4 (Multiple Answer) Major contraindications to the use of muscarinic agonists

    A) postoperative abdominal distention
    B) asthma
    C) treatment of diminished salvation, secondary to radiation
    D) peptic ulcer
    E) hyperthyroidism

Question # 5 (Multiple Choice) Cardiac muscarinic Type M2 receptor effects:

    A) decreased phase 4 depolarization
    B) decreased atrial contractility
    C) decreased conduction velocity through the AV node
    D) decreased ventricular contractility
    E) all the above

Question # 6 (Multiple Answer) Anticholinesterase agents used in antagonist-assisted neuromuscular-blockade reversal:

    A) edrophonium (Tensilon)
    B) neostigmine (Prostigmin)
    C) physostigmine (Antilirium)
    D) pyridostigmine (Mestinon)

Question # 7 (Multiple Answer) Drug:correct clinical application

    A) bethanechol (Urecholine)l: treatment of paralytic ileus
    B) bethanechol (Urecholine): treatment of postpartum urinary retention
    C) methacholine (Provocholine): testing for bronchial hyperreactivity
    D) bethanechol (Urecholine): treatment of esophageal reflux

Question # 8 (Multiple Choice) Major of route of elimination for anticholinesterase drugs:

    A) pulmonary
    B) hepatic
    C) renal

Question # 9 (Multiple Choice) Determines recovery rate following neuromuscular blockade:

    A) A, spontaneous recovery rate from the blocking drug
    B) B. activity the pharmacologic antagonist
    C) A plus B
    D) A minus B

Question # 10 (Multiple Choice) Probable cause of myasthenia gravis:

    A) defect in acetylcholine synthesis
    B) decreased receptor turnover
    C) binding of anti-nicotinic receptor antibodies to the nicotinic receptor

Question # 11 (Multiple Choice) Probably most important ion for transmission to the AV node --

    A) sodium
    B) potassium
    C) chloride
    D) calcium
    E) magnesium

Question # 12 (Multiple Choice) In clinical anesthesia (anesthetized patients): longer duration of action --

    A) edrophonium (Tensilon)
    B) neostigmine (Prostigmin)
    C) both about the same

Question # 13 (Multiple Choice) Rationale of combining atropine and anticholinesterases in reversal of nondepolarizing neuromuscular-blockade

    A) the antimuscarinic increases the rate of recovery
    B) the antimuscarinic reduces muscarinic-receptor-mediated side effects
    C) both
    D) neither

Question # 14 (Multiple Choice) Renal clearance of anticholinesterase drugs:

    A) glomerular filtration
    B) active secretion into renal tubule lumen

Question # 15 (Multiple Choice) Dominant autonomic tone in the ventricle:

    A) adrenergic
    B) cholinergic

Question # 16 (Multiple Choice) Quaternary ammonium compound; anticholinesterase -- permanently positively charged:

    A) neostigmine (Prostigmin)
    B) physostigmine (Antilirium)

Question # 17 (Multiple Answer) Cardiovascular effects of cholinomimetics:

    A) negative chronotropic
    B) vasoconstriction
    C) decreased AV nodal conduction velocity
    D) negative inotropism

Question # 18 (Multiple Choice) Reactivation of acetylcholinesterase following inhibition by organophosphates:

    A) atropine
    B) pilocarpine (Pilocar)
    C) 2-PAM-- pralidoxime (Protopam)
    D) scopolamine
    E) mecamylamine (Inversine)

Question # 19 (Multiple Choice) Longest duration of acetylcholinesterase inhibition:

    A) DFP
    B) neostigmine (Prostigmin)
    C) physostigmine (Antilirium)
    D) edrophonium (Tensilon)
    E) tacrine (Cognex)

Question # 20 (Multiple Answer) Muscarinic receptor activation: effects on cardiac currents

    A) increase potassium conductance in atrial muscle, S.A., AV nodal tissue
    B) decreased inward calcium current
    C) increase in phase 4 depolarization (increased diastolic depolarization)

Question # 21 (Multiple Answer) Increased nitric oxide production:

    A) bradykinin
    B) substance P
    C) acetylcholine

Question # 22 (Multiple Choice) Effects of muscarinic agonists on the gastrointestinal tract

    A) reduced intestinal peristalsis
    B) reduced smooth muscle tone
    C) reduced contraction amplitude
    D) all of the above
    E) none of the above

Question # 23 (Multiple Answer) Example of short-acting reversible, anticholinesterases:

    A) physostigmine (Antilirium)
    B) neostigmine (Prostigmin)
    C) edrophonium (Tensilon)
    D) DFP
    E) tacrine (Cognex)

Correct Answers

1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23






































Question # 1 (Multiple Answer) Anticholinesterases used to treat myasthenia gravis:

(A) neostigmine (Prostigmin)

(B) pyridostigmine (Mestinon)

(C) ambenonium

BACK







































Question # 2 (Multiple Choice) Nicotinic receptor:

Answer: (A) ionic channel coupling

BACK







































Question # 3 (Multiple Choice) Glaucoma category responding to anticholinesterase treatment

Answer: (A) primary (narrow angle -- acute, congestive)

BACK







































Question # 4 (Multiple Answer) Major contraindications to the use of muscarinic agonists

(B) asthma

(D) peptic ulcer

(E) hyperthyroidism

BACK







































Question # 5 (Multiple Choice) Cardiac muscarinic Type M2 receptor effects:

Answer: (E) all the above

BACK







































Question # 6 (Multiple Answer) Anticholinesterase agents used in antagonist-assisted neuromuscular-blockade reversal:

(A) edrophonium (Tensilon)

(B) neostigmine (Prostigmin)

(D) pyridostigmine (Mestinon)

physostigmine: would require too large a dosage BACK







































Question # 7 (Multiple Answer) Drug:correct clinical application

(A) bethanechol (Urecholine)l: treatment of paralytic ileus

(B) bethanechol (Urecholine): treatment of postpartum urinary retention

(C) methacholine (Provocholine): testing for bronchial hyperreactivity

(D) bethanechol (Urecholine): treatment of esophageal reflux

other drugs are better than bethanecol for esophageal reflux, e.g. cisapride (serotonin agonists),metoclopramide (dopamine antagonist) BACK







































Question # 8 (Multiple Choice) Major of route of elimination for anticholinesterase drugs:

Answer: (C) renal

BACK







































Question # 9 (Multiple Choice) Determines recovery rate following neuromuscular blockade:

Answer: (C) A plus B

BACK







































Question # 10 (Multiple Choice) Probable cause of myasthenia gravis:

Answer: (C) binding of anti-nicotinic receptor antibodies to the nicotinic receptor

BACK







































Question # 11 (Multiple Choice) Probably most important ion for transmission to the AV node --

Answer: (D) calcium

BACK







































Question # 12 (Multiple Choice) In clinical anesthesia (anesthetized patients): longer duration of action --

Answer: (C) both about the same

BACK







































Question # 13 (Multiple Choice) Rationale of combining atropine and anticholinesterases in reversal of nondepolarizing neuromuscular-blockade

Answer: (C) both

BACK







































Question # 14 (Multiple Choice) Renal clearance of anticholinesterase drugs:

Answer: (B) active secretion into renal tubule lumen

BACK







































Question # 15 (Multiple Choice) Dominant autonomic tone in the ventricle:

Answer: (A) adrenergic

BACK







































Question # 16 (Multiple Choice) Quaternary ammonium compound; anticholinesterase -- permanently positively charged:

Answer: (A) neostigmine (Prostigmin)

quaternary ammonium compounds are poorly absorbed due to their permanent charge BACK







































Question # 17 (Multiple Answer) Cardiovascular effects of cholinomimetics:

(A) negative chronotropic

(C) decreased AV nodal conduction velocity

(D) negative inotropism

BACK







































Question # 18 (Multiple Choice) Reactivation of acetylcholinesterase following inhibition by organophosphates:

Answer: (C) 2-PAM-- pralidoxime (Protopam)

BACK







































Question # 19 (Multiple Choice) Longest duration of acetylcholinesterase inhibition:

Answer: (A) DFP

BACK







































Question # 20 (Multiple Answer) Muscarinic receptor activation: effects on cardiac currents

(A) increase potassium conductance in atrial muscle, S.A., AV nodal tissue

(B) decreased inward calcium current

BACK







































Question # 21 (Multiple Answer) Increased nitric oxide production:

(A) bradykinin

(B) substance P

(C) acetylcholine

BACK







































Question # 22 (Multiple Choice) Effects of muscarinic agonists on the gastrointestinal tract

Answer: (E) none of the above

increased intestinal peristalsis, tone, contraction amplitude BACK







































Question # 23 (Multiple Answer) Example of short-acting reversible, anticholinesterases:

(C) edrophonium (Tensilon)

(E) tacrine (Cognex)

non-covalent; other agents form covalent bonds --some very stable BACK