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  • Question 1 - When nitrous oxide is stored in cylinders at room temperature, it is a...

    Correct

    • When nitrous oxide is stored in cylinders at room temperature, it is a gas.
      Which of its property is responsible for this?

      Your Answer: Critical temperature

      Explanation:

      The temperature above which a gas cannot be liquefied no matter how much pressure is applied is its critical temperature. The critical temperature of nitrous oxide is 36.5°C

      The minimum pressure that causes liquefaction is the critical pressure of that gas.

      The Poynting effect refers to the phenomenon where mixing of liquid nitrous oxide at low pressure with oxygen at high pressure (in Entonox) leads to formation of gas of nitrous oxide.

      There is no relevance of molecular weight to this question. it does not change with phase of a substance.

    • This question is part of the following fields:

      • Pharmacology
      29.4
      Seconds
  • Question 2 - Which of the following statements is true regarding Entonox? ...

    Incorrect

    • Which of the following statements is true regarding Entonox?

      Your Answer: Consists of a 50:50 mixture by weight of oxygen and nitrous oxide

      Correct Answer: Exists only in gaseous form in a cylinder (under normal working conditions)

      Explanation:

      Entonox is a gas that consists of 50% oxygen and 50% Nitrous oxide. Nitrous oxide is sometimes used for anaesthetics but in this combination, it works as a short-acting painkiller.

      Under normal working conditions, it exists only in gaseous form in a cylinder. The gauge pressure of a full Entonox cylinder is 137 bar.

      Entonox cylinders should be stored horizontally at a temperature above 0 C. At temperatures below this the nitrous oxide component may separate.

      Pseudocritical temperature and pseudocritical pressure can be defined as the molal average critical temperature and pressure of mixture components. In other words, the pseudo-critical temperature is the temperature at which the two gases separate. The pseudo-critical temperature of Entonox is approximately -5.50 C

    • This question is part of the following fields:

      • Pharmacology
      202.4
      Seconds
  • Question 3 - Which of the following statement regarding Adrenaline (Epinephrine) is not true? ...

    Correct

    • Which of the following statement regarding Adrenaline (Epinephrine) is not true?

      Your Answer: Inhibits glycolysis in muscle

      Explanation:

      Adrenaline acts on ?1, ?2,?1, and ?2 receptors and also on dopamine receptors (D1, D2) and have sympathomimetic effects.

      Natural catecholamines are Adrenaline, Noradrenaline, and Dopamine

      Adrenaline is a sympathomimetic amine with both alpha and beta-adrenergic stimulating properties.
      Adrenaline is the drug of choice for anaphylactic shock
      Adrenaline is also used in patients with cardiac arrest. The preferred route is i.v. followed by the intra-osseous and endotracheal route.

      Adrenaline is released by the adrenal glands, acts on ? 1 and 2, ? 1 and 2 receptors, and is responsible for fight or flight response.

      It acts on ? 2 receptors in skeletal muscle vessels-causing vasodilation.

      It acts on ? adrenergic receptors to inhibit insulin secretion by the pancreas. It also stimulates glycogenolysis in the liver and muscle, stimulates glycolysis in muscle.

      It acts on ? adrenergic receptors to stimulate glucagon secretion in the pancreas
      It also stimulates Adrenocorticotrophic Hormone (ACTH) and stimulates lipolysis by adipose tissue

    • This question is part of the following fields:

      • Pharmacology
      35.1
      Seconds
  • Question 4 - Which of the following statements below would best describe the receptor response to...

    Incorrect

    • Which of the following statements below would best describe the receptor response to an opioid mu receptor agonist such as fentanyl?

      Your Answer: Maximal response occurs when only when all receptor sites are occupied

      Correct Answer: Intrinsic activity determines maximal response

      Explanation:

      Agonists activate the receptor as a direct result of binding to it with a characteristic affinity. Moreover, intrinsic activity of an agonist to its receptor determines the ability to create a maximal response.

      Responses to low doses of a drug usually increase in direct proportion to dose. As doses increase, however, the response increment diminishes; finally, doses may be reached at which no further increase in response can be achieved. The relationship formed between the dose and response when plotted graphically is hyperbolic. This also shows that even at low receptor occupancy, a maximal response may be produced.

      Antagonists bind to receptors in the same affinity as agonists, but they have no intrinsic efficacy. They do not activate generation of signal. Instead, they interfere with the ability of the agonist to activate the receptor.

      Partial agonists are similar to full agonists in that they have similar affinity to the target receptor, but they produce a lower response than full agonists.

    • This question is part of the following fields:

      • Pharmacology
      45.8
      Seconds
  • Question 5 - Because this benzodiazepine has a half-life of 2-4 hours, it is preferred for...

    Correct

    • Because this benzodiazepine has a half-life of 2-4 hours, it is preferred for clinical use.

      This benzodiazepine has which of the following properties that no other benzodiazepine has?

      Your Answer: It is water soluble at a pH of 3.5 and lipid soluble at a pH of 7.4

      Explanation:

      Midazolam is the benzodiazepine in question. It’s the only benzodiazepine that undergoes tautomeric transformation (dynamic isomerism). The molecule is ionised and water soluble at pH 3.5, but when injected into the body at pH 7.4, it becomes unionised and lipid soluble, allowing it to easily pass through the blood brain barrier.

      The half-life of midazolam is only 2-4 hours.

      It is a GABAA receptor agonist because it is a benzodiazepine. GABAA receptors are found in abundance throughout the central nervous system, particularly in the cerebral cortex, hippocampus, thalamus, basal ganglia, and limbic system. GABAA receptors are ligand-gated ion channels, with the inhibitory neurotransmitter gamma-aminobutyric acid as the endogenous agonist. It is a pentameric protein (2, 2 and one subunit) that spans the cell membrane, and when the agonist interacts with the alpha subunit, a conformational change occurs, allowing chloride ions to enter the cell, resulting in neuronal hyperpolarization.

      For status epilepticus, midazolam is not the drug of choice. Lorazepam is the benzodiazepine of choice for status epilepticus.

    • This question is part of the following fields:

      • Pharmacology
      290.9
      Seconds
  • Question 6 - Which of the following is the most appropriate first-line pharmacologic treatment for status...

    Correct

    • Which of the following is the most appropriate first-line pharmacologic treatment for status epilepticus?

      Your Answer: Lorazepam

      Explanation:

      Lorazepam is an intermediate-acting benzodiazepine that binds to the GABA-A receptor subunit to increase the frequency of chloride channel opening and cause membrane hyperpolarization.

      Lorazepam has emerged as the preferred benzodiazepine for acute management of status epilepticus. Lorazepam differs from diazepam in two important respects. It is less lipid-soluble than diazepam, with a distribution half-life of two to three hours versus 15 minutes for diazepam. Therefore, it should have a longer duration of clinical effect. Lorazepam also binds the GABAergic receptor more tightly than diazepam, resulting in a longer duration of action. The anticonvulsant effects of lorazepam last six to 12 hours, and the typical dose ranges from 4 to 8 mg. This agent also has a broad spectrum of efficacy, terminating seizures in 75-80% of cases. Its adverse effects are identical to those of diazepam. Thus, lorazepam also is an effective choice for acute seizure management, with the added possibility of a longer duration of action than diazepam.

      Phenobarbitone is a long-acting barbiturate that binds to GABA-A receptor site and increase the duration of chloride channel opening. It also blocks glutamic acid neurotransmission, and, at high doses, can block sodium channels. It is considered as the drug of choice for seizures in infants.

      Phenytoin is an anti-seizure drug that blocks voltage-gated sodium channels. It is preferred in prolonged therapy of status epilepticus because it is less sedating.

      In cases wherein airway protection is required, thiopentone and propofol are the preferred drugs.

    • This question is part of the following fields:

      • Pharmacology
      5.5
      Seconds
  • Question 7 - Which of the following correctly explains the mechanism of sevoflurane preconditioning? ...

    Incorrect

    • Which of the following correctly explains the mechanism of sevoflurane preconditioning?

      Your Answer: Opening of Ca2+ channels

      Correct Answer: Opening of mitochondrial KATP channels

      Explanation:

      Sevoflurane is highly fluorinated methyl isopropyl ether widely used as an inhalational anaesthetic. It is suggested that sevoflurane preconditioning occurs via the opening of mitochondrial Potassium ATP dependent channel similar to that of Ischemic Preconditioning protection.

    • This question is part of the following fields:

      • Pharmacology
      211.6
      Seconds
  • Question 8 - Which of the following statement is correct regarding the difference between dabigatran and...

    Correct

    • Which of the following statement is correct regarding the difference between dabigatran and other anticoagulants?

      Your Answer: Competitive thrombin inhibitor blocking both free and bound thrombin

      Explanation:

      Dabigatran template is a prodrug and its active metabolite is a direct thrombin inhibitor. It is a synthetic, reversible, non-peptide thrombin inhibitor. This inhibition of thrombin results in a decrease of fibrin and reduces platelet aggregation.

      Drugs like warfarin act by inhibiting the activation of vitamin K-dependent clotting factors. These factors are synthesized by the liver and activated by gamma-carboxylation of glutamate residues with the help of vitamin K. Hydroquinone form of vitamin K is converted to epoxide form in this reaction and regeneration of hydroquinone form by enzyme vitamin K epoxide reductase (VKOR) is required for this activity. Oral anticoagulants prevent this regeneration by inhibiting VKOR, thus vitamin K-dependent factors are not activated. These factors include clotting factors II, VII, IX, and X as well as anti-clotting proteins, protein C and protein S.

    • This question is part of the following fields:

      • Pharmacology
      38.4
      Seconds
  • Question 9 - All of the following statements are false regarding insulin except: ...

    Incorrect

    • All of the following statements are false regarding insulin except:

      Your Answer: Is synthesised in the alpha cells of islets of Langerhans

      Correct Answer: Can be detected in the lymph

      Explanation:

      Insulin is secreted from the ? cells of the pancreas. It consists of 51 amino acids arranged in two chains. It interacts with cell surface receptors (not the nuclear receptors and thus mechanism of action is not similar to steroids).
      Since insulin can pass from plasma to interstitium and lymphatics, it can be measured in lymph but the concentrations here can be up to 30% less than that of plasma.

      It decreases blood glucose by stimulating the entry of glucose in muscle and fat (by increasing the synthesis of Glucose transporters)

    • This question is part of the following fields:

      • Pharmacology
      38.6
      Seconds
  • Question 10 - Which of the following statements most accurately describes a drug's efficacy or intrinsic...

    Incorrect

    • Which of the following statements most accurately describes a drug's efficacy or intrinsic activity?

      Your Answer: Is greater for drug X if X is effective in a dose of 100 mcg than for drug Y if Y is effective in a dose of 10 mg

      Correct Answer: Describes the ability of a drug to produce a therapeutic effect

      Explanation:

      An agonist is a molecule with intrinsic efficacy and affinity for a receptor. The ability of a drug-receptor interaction to produce a maximal response is referred to as intrinsic efficacy or activity. Efficacy also refers to a drug’s ability to have a therapeutic or beneficial effect. Although the potencies of morphine and fentanyl differ, they both have the same intrinsic efficacy.

      The amount of drug required to produce a given effect is referred to as potency. If drug X is effective in a dose of 100 mcg, its potency is greater than if drug Y is effective in a dose of 10 mg.

      The therapeutic index, also known as the margin of safety, is a ratio of the lethal or serious side effect dose of a drug divided by the therapeutic dose of the same drug.

      The term bioavailability refers to the ability of a substance to be absorbed. The area under a curve (AUC) of a graphic plot of plasma concentration and time is used to calculate oral bioavailability. It’s used to figure out how much of a drug to take and when to take it.

    • This question is part of the following fields:

      • Pharmacology
      170.5
      Seconds

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