Autonomic/CV Drugs — MCQs

A 56-year-old man comes to the physician for evaluation of gradually worsening fatigue, increased urinary frequency, and blurry vision for 5 months. He has not seen a doctor in several years. Physical examination shows decreased vibratory sense and proprioception in the lower extremities. His hemoglobin A1c is 10.4%. Treatment for his condition with an appropriate medication is begun. In response to this drug, pancreatic islet cells begin producing increasing amounts of secretory granules. The patient was most likely treated with which of the following drugs?

An investigator is studying the principles of cell-to-cell signaling of the autonomic nervous system. It is found that the adrenal medulla has receptors that, when activated, result in the immediate opening of Na+, Ca2+, and K+ channels, which subsequently leads to the secretion of epinephrine and norepinephrine. These receptors are structurally most similar to which of the following receptors?

A 36-year-old woman is brought to the emergency department after a high-speed motor vehicle collision. Her temperature is 36.5°C (97.7°F), pulse is 120/min, respirations are 24/min, and blood pressure is 100/65 mm Hg. Examination shows second and third-degree burns covering 30% of the surface area of her body. Intravenous fluids are administered. 30 minutes later, the patient develops respiratory distress and requires intubation. Administration of succinylcholine during the procedure is most likely to increase this patient's risk of developing which of the following laboratory abnormalities?

A 36-year-old man comes to the physician for a routine health maintenance examination. He has a 20-year history of seizure disorder characterized by sudden-onset, periodic, jerking movements of both arms and lip smacking. He has a history of intravenous cocaine use. His temperature is 37.1°C (98.8°F), pulse is 80/min, respirations are 13/min, and blood pressure is 130/75 mm Hg. Examination shows gingival tissue covering the upper third of the teeth. There is bleeding of the gums when touched with a fine instrument. The remainder of the examination shows no abnormalities. Which of the following is the most likely cause of this patient's symptoms?

A 39-year-old man presents to the primary care physician complaining of 6 months of increasing dyspnea and non-productive cough. He has a past medical history of asthma, hypertension, obesity, and hypercholesterolemia. On examination, you notice that he takes shallow breaths and the respiratory rate is 22/min. On auscultation, you notice bibasilar rales, wheezes, and a grade 2/6 holosystolic murmur. The vital signs include: temperature 36.7°C (98.0°F), blood pressure 126/74 mm Hg, and heart rate 74/min. He then undergoes an outpatient high-resolution chest computed tomography (CT) scan which reveals bibasilar honeycombing, a calcified granuloma, and a mildly enlarged mediastinal lymph node. Which of the following medications can cause or contribute to this man’s lung disease?

A 50-year-old man presents to an ophthalmologist with progressive decrease in his visual acuity over the last 6 months. He also mentions that he has become excessively sensitive to light over the same duration. Past medical history is significant for schizophrenia diagnosed in early adulthood which has been managed with an antipsychotic medication for the past 20 years. The ophthalmologist performs a slit lamp examination and notes discrete brown deposits on the corneal epithelium in both eyes. Which of the following antipsychotic drugs has this patient most likely been taking?

A 68-year-old male with congestive heart failure recently had his medication regimen adjusted to better control his hypertension. Three weeks later, laboratory analysis shows his serum calcium and magnesium levels have both decreased. The diuretic used in this patient acts predominantly on which nephron segment:

A 47-year-old man with alcoholic cirrhosis is brought to the emergency department by ambulance 20 minutes after being involved in a high-speed motor vehicle collision. His pulse is 120/min, respirations are 28/min and labored, and blood pressure is 70/40 mm Hg. Physical examination shows ecchymoses over the trunk and abdomen. In preparation for an exploratory laparotomy, atracurium is administered as an anesthetic. Which of the following characteristics is the most likely reason that this drug was chosen over other drugs in the same class?

A 52-year-old woman with hypertension and type 2 diabetes mellitus comes to the physician because of a 1-day history of severe pain and swelling of her left great toe. She has had similar episodes sporadically over the past 3 years. She drinks 6 beers daily. She does not smoke or use illicit drugs. She is allergic to hydrochlorothiazide and glipizide. Her current medications are amlodipine and metformin. Examination shows erythema, warmth, and tenderness of the left first metatarsophalangeal joint and a nodule over the right elbow. The most appropriate next step in treatment is the administration of a drug that has which of the following mechanisms of action?

A 20-year-old premedical student travels abroad for a global health service semester and presents to the local clinic with palpitations. She initially dismissed these symptoms as a side effect of working too hard; however, she has been noticing that these episodes have increased in frequency. Otherwise, she has had headaches and episodes of sweating, but she says that many members of her family have migraines. In the clinic, her temperature is 99°F (37°C), blood pressure is 170/120 mmHg, pulse is 105/min, respirations are 20/min. Other laboratory testing is not available. The doctor provides an older medication that he says does not bind to the relevant receptor but instead blocks an upstream process. The drug provided most likely has which of the following mechanisms of action?