1.
Asthma is defined as a syndrome in which there is(are)
Correct Answer(s)
A. Recurrent reversible obstruction of the airways
B. Intermittent attacks of dyspnoea, wheezing , and cough
C. Disorders in breathing in
D. Disorders in breathing out
Explanation
Asthma is a syndrome characterized by recurrent reversible obstruction of the airways, which leads to intermittent attacks of dyspnea, wheezing, and cough. It involves difficulties in both breathing in and breathing out. This means that during an asthma attack, the airways become narrowed, making it difficult for air to flow in and out of the lungs. These symptoms can be triggered by various stimuli, such as allergens or exercise.
2.
The characteristic features of asthma is (are):
Correct Answer(s)
B. Bronchial hyper-responsiveness and inflammatory changes in the airways
C. The immediate and the late pHase
Explanation
Asthma is characterized by bronchial hyper-responsiveness and inflammatory changes in the airways. These changes can lead to symptoms such as wheezing, coughing, and shortness of breath. The immediate and late phase refer to the two stages of an asthma attack, with the immediate phase occurring shortly after exposure to triggers and the late phase happening several hours later. Asthma can occur in both adults and children, and it is not solely caused by the interaction of allergens with mast-cell-fixed IgE.
3.
The term bronchial hyper-responsiveness refers to abnormal sensitivity to:
Correct Answer(s)
A. Allergens (in sensitized individuals)
B. Exercise (the stimulus may be cold air)
C. Respiratory infections
D. AtmospHeric pollutants such as sulpHur dioxide, cigarette smoke
E. Genetic dispositions
Explanation
Bronchial hyper-responsiveness refers to an abnormal sensitivity in the bronchial tubes. This sensitivity can be triggered by various factors including allergens, exercise (especially in cold air), respiratory infections, atmospheric pollutants such as sulphur dioxide and cigarette smoke, and genetic dispositions. In individuals who are sensitized, exposure to allergens can cause an exaggerated response in the bronchial tubes, leading to symptoms such as coughing, wheezing, and difficulty breathing. Exercise, especially in cold air, can also trigger bronchial hyper-responsiveness in some individuals. Respiratory infections, atmospheric pollutants, and genetic dispositions can further contribute to the abnormal sensitivity of the bronchial tubes.
4.
The immediate (early) phase:
Correct Answer(s)
A. Occurs abruptly
B. The cells involved in this pHase are predominantly mast cells
C. Can be reversed by bronchodilators (glucocorticoids, cromoglycate)
Explanation
In the immediate (early) phase of a reaction, it occurs abruptly and the cells involved are predominantly mast cells. This phase can be reversed by bronchodilators such as glucocorticoids and cromoglycate, which help to relax and open up the airways. Additionally, anti-inflammatory agents can also reverse this phase by reducing inflammation in the airways. Sedatives and hypnotics, however, are not effective in reversing this phase.
5.
Bronchodilators are:
Correct Answer(s)
C. Beta 2 agonists
D. Antimuscarinic drugs
E. Methylxanthines
Explanation
Bronchodilators are medications used to relax and widen the airways in the lungs, making it easier to breathe. Beta 2 agonists are a type of bronchodilator that work by stimulating the beta 2 receptors in the smooth muscles of the airways, causing them to relax. Antimuscarinic drugs are another type of bronchodilator that work by blocking the action of acetylcholine, a neurotransmitter that causes constriction of the airways. Methylxanthines are a third type of bronchodilator that work by relaxing the smooth muscles of the airways and reducing inflammation. Therefore, the correct answer is beta 2 agonists, antimuscarinic drugs, and methylxanthines.
6.
Short acting beta 2 mimetics (for an acute attack management) :
Correct Answer(s)
A. Are administered via inhalation if possible
C. i.v.
D. S.c.
E. Parenterally
Explanation
Short acting beta 2 mimetics are commonly used for managing acute attacks, such as asthma attacks. These medications work by relaxing the muscles in the airways, making it easier to breathe. Inhalation is the preferred route of administration for these medications as it allows them to directly target the lungs and provide quick relief. However, in certain situations where inhalation may not be possible or ineffective, short acting beta 2 mimetics can also be administered intravenously, subcutaneously, or through other parenteral routes to ensure the medication reaches the lungs and provides the necessary relief.
7.
Inhalation method(s) is (are):
Correct Answer(s)
B. Metered dose inhaler-aerosol
C. Aerosol administered via a nebulizer
D. As a dry power (Turbohaler or Diskhaler)
Explanation
The correct answer is Metered dose inhaler-aerosol, Aerosol administered via a nebulizer, and As a dry powder (Turbohaler or Diskhaler). These are all methods of delivering medication directly to the lungs for the treatment of respiratory conditions. A metered dose inhaler is a handheld device that delivers a specific dose of medication in aerosol form. A nebulizer is a machine that converts liquid medication into a fine mist that can be inhaled. Turbohaler and Diskhaler are dry powder inhalers that deliver medication in a powdered form when the patient inhales. These methods allow for efficient and targeted delivery of medication to the lungs.
8.
Using metered dose inhaler -aerosol the dose of........ /puff is administered:
Correct Answer
C. 100ug
Explanation
The correct answer is 100ug because a metered dose inhaler delivers a specific amount of medication with each puff. In this case, the dose administered is 100ug, which stands for 100 micrograms.
9.
The increase in FEV-1 after inhalation of 200 ug of salbutamol:
Correct Answer(s)
B. Begins within 15 min
C. Peaks at 1 hour
Explanation
The increase in FEV-1 after inhalation of 200 ug of salbutamol begins within 15 minutes because it takes some time for the medication to be absorbed and reach the airways. It then peaks at 1 hour, indicating the maximum effect of the medication on improving lung function. The fact that it begins within 15 minutes suggests a relatively fast onset of action, while the peak at 1 hour indicates the duration of the medication's effect. The statement "persists for 10-12 hours" is not mentioned in the given options, so it cannot be considered as part of the explanation.
10.
Pharmacological effects of beta 2 agonists are:
Correct Answer(s)
B. Relaxation of bronchial smooth muscle
C. Relaxation of uterine smooth muscle
E. Increase in ectopic foci in the myocardium and automaticity in pacemaker tissue
Explanation
Beta 2 agonists have various pharmacological effects. They cause relaxation of bronchial smooth muscle, which helps in relieving symptoms of asthma and other respiratory conditions. They also cause relaxation of uterine smooth muscle, making them useful in the management of preterm labor. Additionally, beta 2 agonists can increase the occurrence of ectopic foci in the myocardium and enhance automaticity in pacemaker tissue, which can have implications for cardiac arrhythmias. However, beta 2 agonists do not have any direct effect on skeletal muscle or on heart rate, force of myocardial contraction, and speed of impulse conduction.
11.
Adverse effects of beta 2 agonists are:
Correct Answer(s)
A. Muscle tremor, headache and insomnia
B. Tachycardia, flushing, palpitations and cardiac arrhythmias
C. The risk of precipitating or exacerbating angina in patients with ischemic heart disease
Explanation
Beta 2 agonists are medications commonly used to treat conditions such as asthma and chronic obstructive pulmonary disease (COPD). These medications work by relaxing the muscles in the airways, making it easier to breathe. However, they can also have adverse effects. Muscle tremor, headache, and insomnia are common side effects of beta 2 agonists. Tachycardia (rapid heart rate), flushing, palpitations, and cardiac arrhythmias (abnormal heart rhythms) can also occur. In patients with ischemic heart disease, beta 2 agonists can increase the risk of precipitating or worsening angina, a condition characterized by chest pain due to reduced blood flow to the heart.
12.
Muscarinic receptor antagonists (used for the treatment of asthma) involve:
Correct Answer(s)
B. Ipratropium
C. Berodual
D. Atrovent
Explanation
Ipratropium, Berodual, and Atrovent are all muscarinic receptor antagonists used for the treatment of asthma. Muscarinic receptors are found in the smooth muscles of the airways, and their activation leads to bronchoconstriction. By blocking these receptors, muscarinic receptor antagonists help to relax the smooth muscles and widen the airways, making it easier for the patient to breathe. Fenoterol is not a muscarinic receptor antagonist but rather a beta-2 adrenergic agonist, which works by stimulating beta-2 receptors in the airways to cause bronchodilation. Atropine, on the other hand, is a non-selective muscarinic receptor antagonist used for other purposes, such as treating bradycardia and reducing secretions during surgery.
13.
Ipratropium:
Correct Answer(s)
C. Could precipitate acute glaucoma
D. Is used for patients with heart disease
Explanation
Ipratropium could precipitate acute glaucoma because it is an anticholinergic medication that can increase intraocular pressure. It is used for patients with heart disease because it helps to relax and open up the airways, making it easier to breathe. However, it cannot be used for patients with thyrotoxicosis because it can worsen symptoms such as rapid heart rate and high blood pressure.
14.
Methylxanthines used for the treatment of asthma are:
Correct Answer(s)
A. TheopHyllin
C. AminopHyllin
Explanation
Methylxanthines are a class of drugs used for the treatment of asthma. Theophylline and aminophylline are two specific methylxanthines that are commonly used for this purpose. They work by relaxing the muscles in the airways, allowing for easier breathing. Other options listed, such as oxyphyllin, pentoxiphyllin, and caffeine, are not typically used for the treatment of asthma. Therefore, the correct answer is theophylline and aminophylline.
15.
Theophylline and/or aminophylline in the form of sustained release preparation:
Correct Answer(s)
B. Is administered orally once or twice a day
D. Is not dependent on food
E. Has a reduced incidence of gastrointestinal adverse effects
Explanation
The correct answer is "is administered orally once or twice a day, is not dependent on food, has a reduced incidence of gastrointestinal adverse effects." Theophylline and aminophylline in the form of sustained release preparation are designed to be taken orally once or twice a day. They do not need to be taken with food and have a lower risk of causing gastrointestinal side effects compared to other formulations.
16.
Aminophylline is:
Correct Answer(s)
A. Used i.v.( injections)
B. Used orally
C. Used orally in the form of sustained release preparations
E. Used i.v. (infusions)
Explanation
Aminophylline can be administered through different routes depending on the desired effect and the patient's condition. It can be used intravenously (i.v.) in the form of injections or infusions, which allows for rapid absorption and onset of action. Aminophylline can also be taken orally, either in immediate-release form or as sustained-release preparations, which provide a longer duration of action. Additionally, aminophylline can be administered by inhalation for the treatment of respiratory conditions.
17.
Adverse effects of theophylline:
Correct Answer(s)
A. Are generally related to its plasma concentration
B. Include tachycardia, cardiac arrhythmias
D. Include nauzea and vomiting
E. TheopHylline can induce anxiety and seizures
Explanation
The adverse effects of theophylline are generally related to its plasma concentration, meaning that higher levels of theophylline in the blood can lead to more severe side effects. These side effects include tachycardia (rapid heart rate) and cardiac arrhythmias (abnormal heart rhythms). Additionally, nausea and vomiting can occur as a result of theophylline use. It is also possible for theophylline to induce anxiety and seizures in some individuals.
18.
Theophylline produces bronchodilating effects by means of:
Correct Answer(s)
A. Inhibition of mediator release from mast cells
B. Antagonism of adenosine at A 2 receptors
C. Anti-inflammatory activity on T lympHocytes
D. Central stimulation of respiration
Explanation
Theophylline produces bronchodilating effects by inhibiting the release of mediators from mast cells, antagonizing adenosine at A2 receptors, exerting anti-inflammatory activity on T lymphocytes, and centrally stimulating respiration. These mechanisms work together to relax and open up the airways, improving breathing in individuals with respiratory conditions such as asthma or chronic obstructive pulmonary disease (COPD).
19.
The therapeutic range of theophylline in plasma is:
Correct Answer(s)
A. 5-15 ug/ml in children
B. 8-15 ug/ml in adults
Explanation
The therapeutic range of theophylline in plasma varies depending on the age group. For children, the recommended range is 5-15 ug/ml, while for adults, it is slightly higher at 8-15 ug/ml. This indicates the optimal concentration of theophylline in the blood to achieve the desired therapeutic effect without causing toxicity.
20.
Pharmacokinetics of theophylline. Theophylline is:
Correct Answer(s)
D. Not used in patients with congestive heart failure
E. Not used in patients with congestive heart failure
Explanation
Theophylline is not used in patients with congestive heart failure because it can worsen the condition by increasing heart rate and causing fluid retention.
21.
The half-life of theophylline is:
Correct Answer(s)
B. Increased by cimetidine
C. Increased by oral contraceptives
E. Decreased by carbamazepin
Explanation
Cimetidine and oral contraceptives are known to inhibit the metabolism of theophylline, leading to increased levels of the drug in the body. This results in a longer half-life for theophylline. On the other hand, carbamazepine is known to induce the metabolism of theophylline, leading to decreased levels of the drug in the body and a shorter half-life. Therefore, theophylline's half-life is increased by cimetidine and oral contraceptives, and decreased by carbamazepine.
22.
Glucocorticoids are:
Correct Answer(s)
B. Not bronchodilators, are not effective in the treatment of the early response to the eliciting agent
C. Administered by inhalation they are extremely powerful anti-inflammatory drugs.
D. Considered as first-line drugs in asthma propHylaxis, for all but the mildest cases
E. For severe asthma an oral glucocorticoid is indicated
Explanation
Glucocorticoids are not bronchodilators and are not effective in treating the early response to the eliciting agent. However, when administered by inhalation, they are extremely powerful anti-inflammatory drugs. They are considered first-line drugs in asthma prophylaxis for all but the mildest cases. For severe asthma, an oral glucocorticoid is indicated.
23.
Glucocorticoids given by inhalation:
Correct Answer(s)
A. Can cause oropHaryngeal candidiasis
C. Are administered 2-4times daily
D. Involve budesonide, beclomethasone
Explanation
Glucocorticoids given by inhalation can cause oropharyngeal candidiasis, a fungal infection in the mouth and throat. This is because inhalation of glucocorticoids can suppress the immune system in the oropharyngeal area, allowing for the overgrowth of candida fungus. These medications are also typically administered 2-4 times daily to maintain their therapeutic effect. Budesonide and beclomethasone are examples of glucocorticoids commonly used for inhalation therapy. Hydrocortisone, prednisolone, and methylprednisolone are not typically administered via inhalation.