ANS

Prof. Dr. Shah Murad

shahmurad65@gmail.com
At GTTH, in medical OPD, Just as a trial, final
year MBBS students injected a drug to 3rd
year MBBS student USMAN. Drug injected
was in a clinical dose. Route of
administration was S/C. After 30 minutes
there was dilation of pupil and a rise in
systolic blood pressure of USMAN. The
drug could be
a) Morphine
b) Adrenaline
c) Atropine
d) Acting by blocking ganglia
e) Stimulating beta receptors throughout the
body
• At SURGIMED Hospital, a Physician
was discussing autonomic
pharmacology with house officers. He
asked “when given to man a drug
causes bradycardia, increased GI
motility and pupilary constriction.
Which one of the following drug
produces these combined effects:
a) morphine
b) Histamine
c) anti-histamine
d) nor-epinephrine
e) neostigmine
• In emergency ward of Meo hospital
medical officers were treating a
comatose patient. They were
differentiating effects of adrenaline
and nor-adrenaline. One said which
was true, “subcutaneous injection of
noradrenaline in man” cuases:
a) Decrease in systolic BP
b) Decrease in diastolic BP
c) Tachycardia
d) Lowers peripheral resistance
e) Predominantly alpha-actions
• Beta-action of adrenaline include:
a) Decreased glycogenolysis in skeletal
muscles
b) Constriction of arterioles in skin
c) Decrease in force of cardiac
contraction
d) Increase in rate of cardiac
contraction
e) Constriction of bronchioles
3rd year MBBS students were discussing
about ephedrine. There are 5 statements
about the drug. Which one is correct:
a) It is contraindicated by oral route
b) Is especially indicated in patients already
taking monoamine oxidase inhibitors
c) Causes depression of the CNS
d) Stimulates predominantly alpha-receptors
e) It is a mixed acting amine, ie; acts directly
on receptors and by causing release of
transmitter from sympathetic nerves
A 35 years old patient Muhammad Nawaz was
admitted in emergency at GTTH at 11 am.
He had have breathlessness. A Junior
doctor was on duty, who nebulized him with
SALBUTAMOL. This drug:
a) Is selective beta1 agonist
b) Has its actions competitively antagonised
by chlorpheneramine
c) Produces constriction of blood vessels in
skeletol muscles
d) Is used in asthma
e) Produces accommodation for near vision
A young medical graduate of LM&DC was observing
treatment of his 22 years brother-in-law at Jinnah
Hospital, Lahore. When injected a drug to that young
man, drug has no effect on resting pulse rate, does not
produce a dry mouth, and depresses tachycardia, that
normally follows the Valsave manoeuvre. What do you
think that the drug:
a) Would be expected to block the tachycardia induced by
inhalation of amyl nitrate
b) Could be atropine
c) Could be bethanecol
d) Could be ipratropium
e) Is surely H2 receptor antagonist
The transmitter substance at:
a) Parasympathetic postganglionic nerve
endings is usually nor-epinephrine
b) Parasympathetic ganglia is epinephrine
c) Sympathetic ganglia is nicotine
d) Parasympathetic preganglionic nerve
endings is muscarine
e) Parasympathetic postganglionic nerve
endings is adrenaline
A 12 years old child was admitted in
casualty of sheikh zaid hospital ,
Lahore. History revealed that he has
taken 2 bottles of a drug which was
used by his mother for nasal
decongestion. It is basically alpha
adrenoceptor agonist drug. What will
you observe in this patient:
a) tachycardia
b) mydriasis
c) bronchodilation
d) vasodilation
e) none of the above
23 years nurse at GTTH was observing management of patient
in shock. Doctor used drug ‘adrenaline’ in that patient. Nurse
was considering about the drug. Regarding ADRENALINE:

a) It is a catalytic agent
b) It is useful drug to relieve constipation
c) It is indicated in glaucoma
d) It is commonly used by oral route
e) It is commonly used in hypertensive patients
 Practolol has been withdrawn
from general clinical use because
it:
a) Is a non-selective beta-blocker
b) Is dangerous to give it to asthmatics
c) Cause hyperurecemia
d) Induces thyrotoxicosis
e) Causes ocular damage
Salivary secretion is under autononmic control. Sympathetic activity
produces a small amount of thick mucus secretion rich in enzyme
content, whilst parasympathetic activity produces a copious watery
secretion. Ganglion blockade blocks all secretion,and an unpleasant
dry mouth results.Which drug of the following has ganglion blocking
activity:

• A)adrenaline
• B)nor-adrenaline
• C)hexamethonium
• D)haloperidol
• E)carbachol
LM&DC graduate of 2005 Dr. Amin is GP at
Shadman town , Lahore. He prescribed tablet
alpha methyl dopa, in patient who was
suffering from………………..

a) hyperlipidemia
b) Diabetes mellitus
c) hypertension
d) gout
e) Peptic ulcer
 Which of the statement
is correct:
a) Adrenaline is a rational choice in the treatment of sinus
bradycardia
b) Noradrenaline is useful in all types of cardiac arrhythmias
c) Guanethidine prevents release of noradrenaline from
sympathetic neurons
d) Pempidine is a useful antihistamine
e) Salbutamol produces more tachycardia than isoprenaline
Sympathetic ganglia can
be
a) Blocked by alpha methyl dopa
b) Stimulated by acetylcholine
c) Stimulated by nicotine
d) Blocked by pempidine
e) Stimulated by bradykinin
• 25 years old male patient was admitted in General
Hospital Lahore at 4 pm, due to hypersensitivity
reaction to some drug ingestion 4 hours before. At
emergency he was treated by a drug which causes
dilattion of vessels in muscle, constriction of
cutaneous vessels, and positive inotropic and
chronotropic effects on the heart. The drug given may
be:
A) isoproterenol
B) acetylcholine
C) adrenaline
D) metaproterenol
E) noradrenaline
A 9 years old baby was brought at medicine
OPD of the hospital. Mother told physician
that child has bed-wetting problem. Which
drug may be prescribed for this problem:

a) phenylephrine
b) adrenaline
c) ephedrine
d) antihistamine
e) tricyclic antidepressant
In Opthalmology OPD doctors are used to
administered following drug for routine
examination of EYE. That drug should be
mydriatic but not cycloplegic. Which one of
the following drugs has that property:
a) tropicamide
b) pilocarpine
c) phenylephrine
d) homatropine
e) isoproterenol
SEXUAL DYSFUNCTION IS
COMMON SIDE EFFECT of:
a) Lorazepam
b) Antihistamines
c) Beta blockers
d) Ephedrine
e) Sildenafil
 Write short note on:

1) Indications of beta blockers

2) SEs of non-selective beta blockers
3) Dobutamine
4) Contra-indications of epinephrine
5) Clinical uses of Phenoxybenzamine
14 years old Ms. Fahmida was brought at casualty of
GTTH, complain with epistaxis. It was due to fragile
vessels of the nose. Doctor on duty kept adrenaline
swab at her nose. Which of the following effects of
adrenaline would be blocked by phentolamine but not
by metoprolol:

a) Contraction of radial smooth muscle in the iris

b) Cardiac stimulation
c) Increase of cAMP in fat
d) Relaxation of bronchial smooth muscle
e) Relaxation of uterus
Phenoxybenzamine is not used in:

a) Pheochromocytoma
b) Raynaud’s phenomenon
c) Essential hypertension
d) Carcinoid
e) Mastocytosis
28 years male patient, already diagnosed case of
pheochromocytoma was admitted in Surgical ward of
Meo Hospital. At day-0, surgeon started IV injection
of Phentolamine Mesylate for this patient.
Phentolamine was used in this patient, because:

a) It has antipsychotic effects

b) It increases BP by increasing peripheral
resistance
c) It decreases BP by blocking α-receptors, both
α1 and α2
d) It has anxiolytic effect
e) It decreases adrenaline presynaptically
28 years Haqnawaz was hypertensive since last 5
years. He came to GP at Mustafabad, Dharampura for
his treatment. GP prescribed tablet Minipress
(prazosin) 5 mg OD for him, for three days.
Regarding PRAZOSIN:

a) It is highly α-1 selective blocker agent

b) It dilates arterioles more than veins
c) It causes postural hypotension
d) Dizziness and fainting occurs as “1st DOSE EFFECT”
e) All are true about prazosin
An accident occured at north canal road, near DYAL
HOUSE. Driver of that car was severely injured and
shifted to GTTH. There was remarkable blood & fluid
loss in the patient. PATIENT IS INFRONT OF YOU.
What will you do?

a) Start fresh blood and dextrose saline, immediately

b) You will start adrenaline s/c immediately
c) You will observe all vital functions then you will decide
what to do?
d) Immediately inject corticosteroids (SOLUCORTEF)
e) Do not think, just administer atropine IV
47 years old patient has benign hypertrophy of
prostate. He visited surgical OPD of AADIL
HOSPITAL, bediyan road, Lahore. Before surgical
treatment of the case, Doctor may prescribe some
drugs for this patient. Which drugs should be
prescribed:

a) α-1 adrenergic blocker like prazosin

b) Propranolol
c) Atenolol
d) Combined propranolol + atenolol
e) None of the above
35 years old patient was operated for inguinal hernia.
Surgeon decided to operate him under GA. After
recovery from anesthesia, on routine investigations
at ICU, tachycardia and extrasystoles were observed
by doctor. For this patient at this stage, which drugs
are helpful:

a) Bethanichol may improve extrasystoles

b) Ipratropium may be helpful to control tachycardia
c) Beta blockers suppress extrasystoles and tachycardia
d) Esmolol is special beta blocker used in this case
e) No any drug available to control tachycardia &
extrasystoles