Autonomic/CV Drugs — MCQs

A 3-year-old male is evaluated for frequent nose bleeds. Physical examination shows diffuse petechiae on the patient's distal extremities. Peripheral blood smear shows an absence of platelet clumping. An ELISA binding assay reveals that platelet surfaces are deficient in GpIIb/IIIa receptors. Which of the following drugs pharmacologically mimics this condition?

A 72-year-old man presents to his primary care physician with a 1 week history of persistent dry cough and worsening shortness of breath. He says that he has also been experiencing some abdominal pain and weakness. He has never experienced these symptoms before. His past medical history is significant for persistent ventricular tachycardia, and he started a new medication to control this arrhythmia about 1 month prior to presentation. Chest radiograph reveals patchy opacification bilaterally, and computed tomography (CT) scan shows diffuse ground glass changes. The drug that is most likely responsible for this patient's symptoms has which of the following mechanisms of action?

A 72-year-old man with coronary artery disease comes to the physician because of intermittent episodes of substernal chest pain and shortness of breath. The episodes occur only when walking up stairs and resolves after resting for a few minutes. He is a delivery man and is concerned because the chest pain has impacted his ability to work. His pulse is 98/min and blood pressure is 132/77 mm Hg. Physical examination is unremarkable. An ECG shows no abnormalities. A drug that blocks which of the following receptors is most likely to prevent future episodes of chest pain from occurring?

A 62-year-old woman is brought to the emergency department after briefly losing consciousness while walking her dog. She spontaneously regained consciousness 20 seconds later. She has a history of atrial fibrillation. Current medications include metoprolol. She reports that she forgot to take her medication the day before and took double the dose this morning instead. A decrease in which of the following most likely contributed to this patient's episode?

A 26-year-old woman comes to the physician for evaluation of nausea and fatigue. Her last menstrual period was 8 weeks ago. She has a history of bipolar disorder controlled by a drug known to sometimes cause hypothyroidism and nephrogenic diabetes insipidus. She does not smoke cigarettes or drink alcohol. A urine pregnancy test is positive. An ultrasound of the pelvis shows a viable intrauterine pregnancy. The fetus is most likely at increased risk for which of the following anomalies?

A 60-year-old African-American female presents to your office complaining of dysuria, paresthesias, and blurry vision. Her body mass index is 37.2 kg/m2. Which of the following drugs would most significantly increase the levels of C-peptide in the blood when administered to this patient?

A 54-year-old man comes to the physician for a health maintenance examination. He feels well. He is 173 cm (5 ft 8 in) tall and weighs 84 kg (185 lb); BMI is 28 kg/m2. His vital signs are within normal limits. Physical examination shows no abnormalities. Serum lipid studies show: Total cholesterol 280 mg/dL HDL-cholesterol 30 mg/dL LDL-cholesterol 195 mg/dL Triglycerides 275 mg/dL Treatment with atorvastatin and cholestyramine is initiated. Which of the following changes is most likely induced by both agents?

A 71-year-old woman comes to the physician because of palpitations and shortness of breath that started 3 days ago. She has hypertension and congestive heart failure. Her pulse is 124/min, and blood pressure is 130/85 mm Hg. Cardiac examination shows an irregularly irregular rhythm without any murmurs. An ECG shows a narrow-complex tachycardia without P waves. The patient is prescribed a prophylactic medication that can be reversed with idarucizumab. The expected beneficial effect of the prescribed drug is most likely due to which of the following effects?

A 32-year-old woman comes to the physician because of pain and stiffness in both of her hands for the past 3 weeks. The pain is most severe early in the day and does not respond to ibuprofen. She has no history of serious illness and takes no medications. Vital signs are within normal limits. Examination shows swelling and tenderness of the wrists and metacarpophalangeal joints bilaterally. Range of motion is decreased due to pain. There are subcutaneous, nontender, firm, mobile nodules on the extensor surface of the forearm. Which of the following is the most appropriate pharmacotherapy for this patient's current symptoms?

A 59-year-old man with a history of congestive heart failure presents to his cardiologist for a follow-up visit. His past medical history is notable for diabetes mellitus, hypertension, and obesity. He takes metformin, glyburide, aspirin, lisinopril, and metoprolol. He has a 40 pack-year smoking history and drinks alcohol socially. His temperature is 99.1°F (37.2°C), blood pressure is 150/65 mmHg, pulse is 75/min, and respirations are 20/min. Physical examination reveals bilateral rales at the lung bases and 1+ edema in the bilateral legs. The physician decides to start the patient on an additional diuretic but warns the patient about an increased risk of breast enlargement. Which of the following is the most immediate physiologic effect of the medication in question?