Nokea
Indicate the “specific” modality of treatment for severe methanol poisoning:
- A. Dialysis to enhance removal of methanol
- B. Alkalinization to counteract metabolic acidosis
- C. Suppression of metabolism by alcohol dehydrogenase to toxic products
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D because severe methanol poisoning requires a multi-modal approach. Dialysis enhances methanol removal. Alkalinization helps counteract metabolic acidosis. Suppressing metabolism by alcohol dehydrogenase prevents the formation of toxic products. Therefore, all options (A, B, and C) are necessary for effective treatment of severe methanol poisoning. Other choices are incorrect as they do not address the multiple facets of methanol toxicity.
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Which of the following therapeutic changes would be most appropriate for the patient diagnosed with variant angina?
- A. Substitute nifedipine for the propranolol
- B. Add nitroglycerin to the therapeutic regimen
- C. Substitute captopril for the propranolol
- D. Substitute nifedipine for the hydrochlorothiazide
Correct Answer: B
Rationale: The correct answer is B: Add nitroglycerin to the therapeutic regimen. Nitroglycerin is a standard treatment for variant angina as it helps dilate blood vessels, increasing blood flow to the heart. This can help relieve chest pain associated with the condition.
Choice A is incorrect as nifedipine and propranolol are both used to treat angina, but nifedipine is not specifically indicated for variant angina.
Choice C is incorrect as captopril is an ACE inhibitor used for hypertension and heart failure, not specifically for variant angina.
Choice D is incorrect as nifedipine and hydrochlorothiazide are both used for hypertension but not specifically for variant angina.
Indicate the route of local anesthetic administration, which is associated with instillation within epidural or subarachnoid spaces:
- A. Topical anesthesia
- B. Infiltrative anesthesia
- C. Regional anesthesia
- D. Spinal anesthesia
Correct Answer: D
Rationale: The correct answer is D: Spinal anesthesia. Spinal anesthesia involves injecting local anesthetics directly into the subarachnoid space, which is within the spinal canal. This allows for the anesthetic to block sensation in the lower part of the body. Topical anesthesia (A) is applied to the surface of the skin, infiltrative anesthesia (B) involves injecting local anesthetics into tissues surrounding the surgical site, and regional anesthesia (C) includes nerve blocks to numb specific areas. Spinal anesthesia is distinct as it targets the spinal nerves directly within the epidural or subarachnoid spaces.
Cimetidine has no effect on hepatic drug metabolism. It’s
- A. TRUE
- B. FALSE
- C. All
- D. None of the above
Correct Answer: B
Rationale: The correct answer is B: FALSE. Cimetidine is a known inhibitor of hepatic drug metabolism, specifically through inhibition of CYP enzymes. This leads to increased levels of certain drugs in the body. Choice A is incorrect because cimetidine does have an effect on hepatic drug metabolism. Choice C is also incorrect as it implies that all statements are true, which is not the case. Choice D is incorrect as well, as the statement is indeed false.
Which of the following inhaled anesthetics causes centrally mediated sympathetic activation leading to a rise in blood pressure and heart rate?
- A. Desflurane
- B. Sevoflurane
- C. Nitrous oxide
- D. Isofurane
Correct Answer: A
Rationale: Desflurane is the correct answer because it causes sympathetic activation by stimulating the central nervous system, leading to increased blood pressure and heart rate. Desflurane has a high potency in activating sympathetic responses compared to the other options. Sevoflurane and isoflurane have minimal impact on sympathetic activation. Nitrous oxide primarily acts as a weak anesthetic and does not cause significant sympathetic stimulation.
Indicate the antiseizure drug – a benzodiazepine receptor agonist:
- A. Phenobarbital
- B. Phenytoin
- C. Carbamazepine
- D. Lorazepam
Correct Answer: D
Rationale: The correct answer is D: Lorazepam. Lorazepam is a benzodiazepine receptor agonist, which enhances the inhibitory effect of GABA in the brain, reducing neuronal excitability and preventing seizures. Phenobarbital (A) acts by enhancing GABAergic transmission but is not a benzodiazepine. Phenytoin (B) works by blocking sodium channels. Carbamazepine (C) also blocks sodium channels but is not a benzodiazepine receptor agonist. Therefore, D is the correct answer as it directly acts on the benzodiazepine receptor to control seizures.