Autonomic/CV Drugs Practice Questions

Q: A 69-year-old man is brought by his son to the emergency department with weakness in his right arm and leg. The man insists that he is fine and blames his son for "creating panic". Four hours ago the patient was having tea with his wife when he suddenly dropped his teacup. He has had difficulty moving his right arm since then and cannot walk because his right leg feels stuck. He has a history of hypertension and dyslipidemia, for which he currently takes lisinopril and atorvastatin, respectively. He is allergic to aspirin and peanuts. A computerized tomography (CT) scan shows evidence of an ischemic stroke. Which medication would most likely prevent such attacks in this patient in the future?

Clopidogrel. ***Clopidogrel*** - This patient has suffered an **ischemic stroke** and has a **contraindication to aspirin** due to allergy. **Clopidogrel**, an **alternative antiplatelet agent**, is the most appropriate long-term secondary prevention medication to reduce the risk of future thrombotic events. - As a **P2Y12 inhibitor**, clopidogrel prevents platelet aggregation, thereby reducing the likelihood of clot formation in patients at high risk for cardiovascular events. *Celecoxib* - **Celecoxib** is a **COX-2 selective NSAID** primarily used for pain and inflammation. It has no role in the prevention of ischemic stroke. - While NSAIDs can have antiplatelet effects through COX-1 inhibition, **COX-2 selective inhibitors like celecoxib generally have a prothrombotic effect** and are not indicated for stroke prevention. *Abciximab* - **Abciximab** is a **glycoprotein IIb/IIIa inhibitor** that potently prevents platelet aggregation. It is typically used in acute settings, such as during percutaneous coronary intervention (PCI), and not for long-term stroke prevention. - Its potent antiplatelet effect and **risk of bleeding** make it unsuitable for chronic outpatient management. *Urokinase* - **Urokinase** is a **thrombolytic agent** used to dissolve existing blood clots in acute conditions like pulmonary embolism or acute myocardial infarction. It is not indicated for the prevention of future ischemic strokes. - Thrombolytics carry a **significant risk of hemorrhage** and are solely for acute clot lysis, not chronic prevention. *Alteplase* - **Alteplase** is a **tissue plasminogen activator (tPA)**, a thrombolytic used in the **acute treatment of ischemic stroke** within a specific time window to dissolve clots and restore blood flow. - It is an **acute rescue therapy** and is not used for long-term secondary prevention of stroke due to its high bleeding risk and short duration of action.

Q: A 27-year-old female presents to general medical clinic for a routine checkup. She has a genetic disease marked by a mutation in a chloride transporter. She has a history of chronic bronchitis. She has a brother with a similar history of infections as well as infertility. Which of the following is most likely true regarding a potential vitamin deficiency complication secondary to this patient's chronic illness?

It may manifest itself as a prolonged PT. ***It may manifest itself as a prolonged PT*** - The patient's presentation with a **chloride transporter mutation**, chronic bronchitis, and a brother with similar infections and infertility is highly suggestive of **cystic fibrosis (CF)**. - CF leads to **pancreatic insufficiency** and **malabsorption of fat-soluble vitamins (A, D, E, K)**. A deficiency in **vitamin K** can result in impaired synthesis of **clotting factors**, leading to a **prolonged prothrombin time (PT)**. *It may result in connective tissue defects* - This symptom is characteristic of **vitamin C deficiency (scurvy)**, which manifests as impaired **collagen synthesis** and fragile connective tissues. - While CF patients can have various deficiencies, connective tissue defects are not a primary consequence of the fat-soluble vitamin deficiencies associated with CF. *It may result in corneal vascularization* - **Corneal vascularization** is typically associated with **riboflavin (vitamin B2) deficiency** or chronic ocular inflammation. - This is not a common complication of the fat-soluble vitamin malabsorption seen in cystic fibrosis. *It may result in the triad of confusion, ophthalmoplegia, and ataxia* - This triad describes **Wernicke-Korsakoff syndrome**, which is caused by a **thiamine (vitamin B1) deficiency**. - This deficiency is common in alcoholism or severe malnutrition but is not a direct complication of the fat-soluble vitamin malabsorption in cystic fibrosis. *It may be exacerbated by excessive ingestion of raw eggs* - Excessive ingestion of raw eggs can lead to **biotin (vitamin B7) deficiency** due to **avidin** binding to biotin, preventing its absorption. - While CF patients can have various nutritional issues, this specific interaction is unrelated to the fat-soluble vitamin deficiencies caused by their pancreatic insufficiency.

Question 1

A 69-year-old man is brought by his son to the emergency department with weakness in his right arm and leg. The man insists that he is fine and blames his son for "creating panic". Four hours ago the patient was having tea with his wife when he suddenly dropped his teacup. He has had difficulty moving his right arm since then and cannot walk because his right leg feels stuck. He has a history of hypertension and dyslipidemia, for which he currently takes lisinopril and atorvastatin, respectively. He is allergic to aspirin and peanuts. A computerized tomography (CT) scan shows evidence of an ischemic stroke. Which medication would most likely prevent such attacks in this patient in the future?

Accepted Answer

Clopidogrel

Answer

Celecoxib

Answer

Abciximab

Answer

Urokinase

Answer

Alteplase

Question 2

A 27-year-old female presents to general medical clinic for a routine checkup. She has a genetic disease marked by a mutation in a chloride transporter. She has a history of chronic bronchitis. She has a brother with a similar history of infections as well as infertility. Which of the following is most likely true regarding a potential vitamin deficiency complication secondary to this patient's chronic illness?

Accepted Answer

It may manifest itself as a prolonged PT

Answer

It may result in connective tissue defects

Answer

It may result in corneal vascularization

Answer

It may result in the triad of confusion, ophthalmoplegia, and ataxia

Answer

It may be exacerbated by excessive ingestion of raw eggs

Autonomic/CV Drugs — MCQs

Autonomic/CV Drugs — MCQs

On this page

Practice by Chapter

Want unlimited practice?