General Overview of the Renal System

1.

What is the primary function of the kidney?

2.
1. a) Metabolism of drugs
2. b) Excretion of metabolic waste and toxins
3. c) Synthesis of proteins
4. d) Breakdown of carbohydrates
Answer: b)
Explanation: The kidney excretes waste products and toxins while maintaining
electrolyte and fluid balance.
3.

Which part of the nephron is responsible for filtration?

4.

1. a) Proximal convoluted tubule

2. b) Distal convoluted tubule
3. c) Glomerulus
4. d) Collecting duct
Answer: c)
Explanation: The glomerulus filters blood, allowing water and small solutes to pass
into the renal tubule.

5.

The loop of Henle primarily functions to:

6.

1. a) Reabsorb glucose
2. b) Concentrate urine
3. c) Produce hormones
4. d) Filter blood plasma
Answer: b)
Explanation: The loop of Henle creates a concentration gradient in the kidney
medulla to concentrate urine.

Mechanism of Diuretics
 1.

Diuretics primarily work by:

2.

1. a) Increasing glomerular filtration

2. b) Blocking sodium and chloride reabsorption
3. c) Stimulating ADH secretion
4. d) Reducing blood flow to the kidney
Answer: b)
Explanation: Diuretics block sodium and chloride reabsorption, increasing osmotic
pressure and urine output.

3.

Which class of diuretics acts early in the nephron?

4.

1. a) Loop diuretics
2. b) Thiazides
3. c) Carbonic anhydrase inhibitors
4. d) Potassium-sparing diuretics
Answer: c)
Explanation: Carbonic anhydrase inhibitors act in the proximal tubule, the earliest
segment of the nephron.

5.

Which of the following produces the most diuresis?

6.

1. a) Thiazides
2. b) Loop diuretics
3. c) Potassium-sparing diuretics
4. d) Carbonic anhydrase inhibitors
Answer: b)
Explanation: Loop diuretics block sodium and chloride reabsorption in the thick
ascending limb, leading to the most diuresis.

Classification of Diuretics

1.

Carbonic anhydrase inhibitors include:

 2.

1. a) Spironolactone
2. b) Furosemide
3. c) Acetazolamide
4. d) Mannitol
Answer: c)
Explanation: Acetazolamide inhibits carbonic anhydrase in the proximal tubule,
increasing bicarbonate excretion.

3.

Which is a high-ceiling diuretic?

4.

1. a) Hydrochlorothiazide
2. b) Furosemide
3. c) Spironolactone
4. d) Amiloride
Answer: b)
Explanation: High-ceiling diuretics like furosemide produce a high degree of
diuresis.

5.

Potassium-sparing diuretics include:

6.

1. a) Amiloride and spironolactone

2. b) Furosemide and torsemide
3. c) Acetazolamide and mannitol
4. d) Hydrochlorothiazide and metolazone
Answer: a)
Explanation: Amiloride and spironolactone conserve potassium while promoting
sodium excretion.

Therapeutic Uses

1.

Thiazide diuretics are commonly used to treat:

2.

1. a) Pulmonary edema
2. b) Hypertension
 3. c) Hyperkalemia
4. d) Acute renal failure
Answer: b)
Explanation: Thiazides are first-line drugs for hypertension due to their mild diuretic
and vasodilatory effects.

3.

Which diuretic is used in cerebral edema?

4.

1. a) Furosemide
2. b) Mannitol
3. c) Spironolactone
4. d) Hydrochlorothiazide
Answer: b)
Explanation: Mannitol, an osmotic diuretic, reduces intracranial pressure by
drawing fluid from tissues.

5.

Loop diuretics are primarily indicated for:

6.

1. a) Hypertension
2. b) Pulmonary edema
3. c) Hypercalcemia
4. d) All of the above
Answer: d)
Explanation: Loop diuretics are used for edema, hypertension, and hypercalcemia
due to their potent effects.

Adverse Effects

1.

A common adverse effect of loop diuretics is:

2.

1. a) Hyperkalemia
2. b) Hypokalemia
3. c) Hypertension
4. d) Hypoglycemia
Answer: b)
Explanation: Loop diuretics promote potassium excretion, causing hypokalemia.
 3.

Thiazides may lead to:

4.

1. a) Hyperuricemia
2. b) Hypoglycemia
3. c) Hypercalcemia
4. d) Both a and c
Answer: d)
Explanation: Thiazides decrease calcium excretion and increase uric acid retention.

5.

Hyperkalemia is a potential side effect of:

6.

1. a) Furosemide
2. b) Hydrochlorothiazide
3. c) Spironolactone
4. d) Acetazolamide
Answer: c)
Explanation: Potassium-sparing diuretics like spironolactone reduce potassium
excretion, risking hyperkalemia.

Mechanisms of Action

1.

Loop diuretics block which transporter?

2.

1. a) Sodium-chloride symporter
2. b) Sodium-potassium-chloride cotransporter
3. c) Sodium-hydrogen exchanger
4. d) Sodium-calcium pump
Answer: b)
Explanation: Loop diuretics inhibit the Na+/K+/2Cl− cotransporter in the thick
ascending limb.

3.

Thiazides work by inhibiting:

4.
 1. a) Sodium-chloride symporter
2. b) Sodium-potassium ATPase
3. c) Carbonic anhydrase
4. d) Aquaporins
Answer: a)
Explanation: Thiazides inhibit sodium and chloride reabsorption in the distal
convoluted tubule.

Comparison of Diuretics

1.

Which diuretic is effective in low GFR?

2.

1. a) Thiazides
2. b) Loop diuretics
3. c) Potassium-sparing diuretics
4. d) Carbonic anhydrase inhibitors
Answer: b)
Explanation: Loop diuretics remain effective in low renal function, unlike thiazides.

3.

Thiazides differ from loop diuretics because they:

4.

1. a) Cause less diuresis

2. b) Retain calcium
3. c) Are less effective in low GFR
4. d) All of the above
Answer: d)
Explanation: Thiazides have a milder effect and are dependent on normal GFR for
efficacy.

Specific Drugs

1.

Which drug inhibits aldosterone?

2.

1. a) Furosemide
 2. b) Spironolactone
3. c) Hydrochlorothiazide
4. d) Mannitol
Answer: b)
Explanation: Spironolactone is an aldosterone antagonist, reducing sodium
reabsorption.

3.

Mannitol’s diuretic action is due to:

4.

1. a) ADH inhibition
2. b) Osmotic force
3. c) Aldosterone blockade
4. d) Sodium channel inhibition
Answer: b)
Explanation: Mannitol creates osmotic pressure within the nephron, preventing
water reabsorption.

Drug Interactions

1.

Loop diuretics combined with digoxin may lead to:

2.

1. a) Hyperkalemia
2. b) Hypokalemia-induced digoxin toxicity
3. c) Hypercalcemia
4. d) Hypoglycemia
Answer: b)
Explanation: Loop diuretics can cause hypokalemia, increasing digoxin toxicity risk.

3.

Thiazides can interact with:

4.

1. a) ACE inhibitors
2. b) NSAIDs
3. c) Digoxin
4. d) All of the above
Answer: d)
 Explanation: Thiazides interact with multiple drugs, affecting electrolyte balance
and renal function.

General Concepts

1.

What is the primary action of diuretics?

2.
1. a) Increase urine output
2. b) Decrease blood pressure
3. c) Improve kidney function
4. d) Reduce plasma protein levels
Answer: a)
Explanation: Diuretics increase urine production by inhibiting reabsorption of
sodium and water in the nephron.
3.

Which part of the nephron is the site of action for loop diuretics?

4.

1. a) Proximal convoluted tubule

2. b) Loop of Henle
3. c) Distal convoluted tubule
4. d) Collecting duct
Answer: b)
Explanation: Loop diuretics act on the thick ascending limb of the Loop of Henle,
inhibiting the Na+/K+/2Cl- transporter.

5.

What is the basic structural and functional unit of the kidney?

6.

1. a) Nephron
2. b) Glomerulus
3. c) Loop of Henle
4. d) Distal tubule
Answer: a)
Explanation: The nephron is the functional unit responsible for filtration,
reabsorption, and secretion.

Types of Diuretics
 1.

Which of the following is a carbonic anhydrase inhibitor?

2.

1. a) Spironolactone
2. b) Acetazolamide
3. c) Furosemide
4. d) Mannitol
Answer: b)
Explanation: Acetazolamide inhibits carbonic anhydrase, reducing bicarbonate
reabsorption and increasing urine output.

3.

Which diuretic is classified as a high-ceiling diuretic?

4.

1. a) Hydrochlorothiazide
2. b) Furosemide
3. c) Spironolactone
4. d) Mannitol
Answer: b)
Explanation: Furosemide is a loop diuretic, producing a significant diuresis
compared to other classes.

5.

Thiazide diuretics act on which part of the nephron?

6.

1. a) Glomerulus
2. b) Loop of Henle
3. c) Proximal convoluted tubule
4. d) Distal convoluted tubule
Answer: d)
Explanation: Thiazides inhibit the Na+/Cl- symporter in the early distal convoluted
tubule.

7.

What is the primary action of potassium-sparing diuretics?

8.

1. a) Inhibit carbonic anhydrase

2. b) Inhibit the Na+/K+/2Cl- transporter
 3. c) Block aldosterone or Na+ channels
4. d) Increase bicarbonate secretion
Answer: c)
Explanation: Potassium-sparing diuretics either block aldosterone receptors (e.g.,
spironolactone) or inhibit Na+ channels (e.g., amiloride).

9.

Which diuretic creates an osmotic gradient within the nephron?

10.

1. a) Acetazolamide
2. b) Mannitol
3. c) Hydrochlorothiazide
4. d) Spironolactone
Answer: b)
Explanation: Mannitol, an osmotic diuretic, inhibits passive water reabsorption by
increasing osmotic pressure in the nephron.

Therapeutic Uses

1.

Which diuretic is commonly used in acute pulmonary edema?

2.

1. a) Hydrochlorothiazide
2. b) Furosemide
3. c) Spironolactone
4. d) Mannitol
Answer: b)
Explanation: Furosemide rapidly reduces fluid overload in pulmonary edema by
enhancing sodium and water excretion.

3.

Acetazolamide is used to treat:

4.

1. a) Hypertension
2. b) Open-angle glaucoma
3. c) Pulmonary edema
4. d) Heart failure
Answer: b)
 Explanation: Acetazolamide reduces aqueous humor production, lowering
intraocular pressure in glaucoma.

5.

Mannitol is indicated for:

6.

1. a) Hypertension
2. b) Reducing intracranial pressure
3. c) Chronic heart failure
4. d) Pulmonary hypertension
Answer: b)
Explanation: Mannitol is used in cerebral edema to reduce intracranial pressure by
promoting osmotic diuresis.

7.

Which diuretic is preferred for treating mild to moderate hypertension?

8.

1. a) Mannitol
2. b) Furosemide
3. c) Hydrochlorothiazide
4. d) Spironolactone
Answer: c)
Explanation: Thiazides like hydrochlorothiazide are first-line agents for mild
hypertension due to their modest diuretic effect and vasodilation.

9.

Spironolactone is primarily used in:

10.

1. a) Congestive heart failure

2. b) Cerebral edema
3. c) Glaucoma
4. d) Hypokalemia
Answer: a)
Explanation: Spironolactone helps manage fluid retention in heart failure by
blocking aldosterone.

Adverse Effects

1.
Which diuretic is most likely to cause hypokalemia?

2.

1. a) Spironolactone
2. b) Amiloride
3. c) Furosemide
4. d) Triamterene
Answer: c)
Explanation: Loop diuretics like furosemide cause significant potassium loss due to
their mechanism of action.

3.

An adverse effect of thiazide diuretics is:

4.

1. a) Hypercalcemia
2. b) Hyperkalemia
3. c) Hypoglycemia
4. d) Hypermagnesemia
Answer: a)
Explanation: Thiazides reduce calcium excretion, potentially causing hypercalcemia.

5.

Spironolactone may cause:

6.

1. a) Hypokalemia
2. b) Gynecomastia
3. c) Ototoxicity
4. d) Hypernatremia
Answer: b)
Explanation: Spironolactone can cause gynecomastia due to its anti-androgenic
effects.

7.

A potential side effect of loop diuretics is:

8.

1. a) Hyponatremia
2. b) Hyperglycemia
3. c) Ototoxicity
 4. d) All of the above
Answer: d)
Explanation: Loop diuretics can cause hyponatremia, hyperglycemia, and ototoxicity
among other effects.

9.

What adverse effect is commonly seen with carbonic anhydrase

inhibitors?

10.

1. a) Hyperkalemia
2. b) Metabolic acidosis
3. c) Hypercalcemia
4. d) Hypoglycemia
Answer: b)
Explanation: By inhibiting bicarbonate reabsorption, these drugs can lead to
metabolic acidosis.

Mechanisms of Action

1.

Which diuretic inhibits the Na+/K+/2Cl- symporter?

2.

1. a) Furosemide
2. b) Acetazolamide
3. c) Spironolactone
4. d) Hydrochlorothiazide
Answer: a)
Explanation: Loop diuretics like furosemide block this transporter in the thick
ascending loop of Henle.

3.

The site of action for thiazide diuretics is:

4.

1. a) Collecting duct
2. b) Loop of Henle
3. c) Distal convoluted tubule
4. d) Proximal tubule
Answer: c)
 Explanation: Thiazides act on the distal tubule to inhibit sodium and chloride
reabsorption.

5.

Potassium-sparing diuretics act by:

6.

1. a) Blocking aldosterone receptors or sodium channels

2. b) Inhibiting carbonic anhydrase
3. c) Blocking the Na+/K+/2Cl- transporter
4. d) Reducing water permeability in the nephron
Answer: a)
Explanation: Potassium-sparing diuretics either block aldosterone (e.g.,
spironolactone) or inhibit sodium channels (e.g., amiloride).

7.

Which diuretic class inhibits bicarbonate reabsorption?

8.

1. a) Loop diuretics
2. b) Carbonic anhydrase inhibitors
3. c) Thiazides
4. d) Osmotic diuretics
Answer: b)
Explanation: Carbonic anhydrase inhibitors like acetazolamide reduce bicarbonate
reabsorption in the proximal tub

General Concepts

1.

What neurotransmitter is primarily associated with the adrenergic

system?

2.
1. a) Acetylcholine
2. b) Dopamine
3. c) Norepinephrine
4. d) Serotonin
Answer: c)
Explanation: Norepinephrine is the main neurotransmitter released by
postganglionic sympathetic neurons in the adrenergic system.
3.
 Which adrenergic receptor subtype primarily causes vasoconstriction?

4.

1. a) Beta-1
2. b) Beta-2
3. c) Alpha-1
4. d) Alpha-2
Answer: c)
Explanation: Alpha-1 receptors are located on vascular smooth muscle and mediate
vasoconstriction when activated.

5.

Beta-2 adrenergic receptors are primarily involved in:

6.

1. a) Cardiac stimulation
2. b) Bronchodilation and smooth muscle relaxation
3. c) Vasoconstriction
4. d) Decreasing insulin secretion
Answer: b)
Explanation: Beta-2 receptors mediate bronchodilation and relax smooth muscles in
various tissues, including the uterus.

Adrenergic Agonists

1.

Which of the following is a direct-acting adrenergic agonist?

2.

1. a) Amphetamine
2. b) Cocaine
3. c) Norepinephrine
4. d) Tyramine
Answer: c)
Explanation: Norepinephrine acts directly on adrenergic receptors, unlike indirect
agents like amphetamine or tyramine.

3.

Epinephrine acts on which adrenergic receptors?

4.
 1. a) Alpha-1 only
2. b) Beta-2 only
3. c) Alpha-1, Alpha-2, Beta-1, and Beta-2
4. d) Alpha-2 and Beta-1 only
Answer: c)
Explanation: Epinephrine is a non-selective adrenergic agonist, acting on all alpha
and beta receptors.

5.

A short-acting beta-2 agonist used for asthma is:

6.

1. a) Salmeterol
2. b) Albuterol
3. c) Epinephrine
4. d) Dobutamine
Answer: b)
Explanation: Albuterol is a short-acting beta-2 adrenergic agonist commonly used
for quick relief of asthma symptoms.

7.

Clonidine is classified as:

8.

1. a) Beta-1 agonist
2. b) Alpha-2 agonist
3. c) Beta-2 agonist
4. d) Alpha-1 agonist
Answer: b)
Explanation: Clonidine is an alpha-2 agonist that reduces sympathetic outflow,
leading to decreased blood pressure.

Clinical Uses of Adrenergic Agonists

1.

Epinephrine is the drug of choice for:

2.

1. a) Hypertension
2. b) Bronchial asthma
3. c) Anaphylactic shock
 4. d) Cardiac arrhythmias
Answer: c)
Explanation: Epinephrine counteracts the severe bronchoconstriction, vasodilation,
and hypotension seen in anaphylactic shock.

3.

Dobutamine is mainly used for:

4.

1. a) Asthma treatment
2. b) Heart failure with reduced cardiac output
3. c) Reducing blood pressure
4. d) Treating nasal congestion
Answer: b)
Explanation: Dobutamine, a beta-1 agonist, increases cardiac output in acute heart
failure.

5.

Phenylephrine is commonly used as a:

6.

1. a) Cardiac stimulant
2. b) Nasal decongestant
3. c) Bronchodilator
4. d) Diuretic
Answer: b)
Explanation: Phenylephrine, an alpha-1 agonist, induces vasoconstriction, reducing
nasal congestion.

Adrenergic Antagonists

1.

Which of the following blocks both alpha and beta receptors?

2.

1. a) Propranolol
2. b) Labetalol
3. c) Prazosin
4. d) Atenolol
Answer: b)
Explanation: Labetalol has mixed activity, blocking alpha-1 and beta receptors,
making it effective in hypertensive emergencies.
 3.

Which drug is an alpha-1 selective blocker?

4.

1. a) Phentolamine
2. b) Propranolol
3. c) Prazosin
4. d) Atenolol
Answer: c)
Explanation: Prazosin selectively blocks alpha-1 receptors, leading to vasodilation.

5.

Beta-1 selective blockers include:

6.

1. a) Propranolol
2. b) Timolol
3. c) Metoprolol
4. d) Nadolol
Answer: c)
Explanation: Metoprolol selectively inhibits beta-1 receptors, sparing beta-2
receptors, and is often used for cardiac conditions.

7.

The therapeutic use of alpha-1 blockers includes:

8.

1. a) Glaucoma treatment
2. b) Treating benign prostatic hyperplasia (BPH)
3. c) Managing arrhythmias
4. d) Treating asthma
Answer: b)
Explanation: Alpha-1 blockers relax the smooth muscle in the bladder neck and
prostate, improving urine flow in BPH.

Adverse Effects

1.

A common side effect of non-selective beta blockers is:

2.
 1. a) Bronchospasm
2. b) Tachycardia
3. c) Vasoconstriction
4. d) Hypoglycemia
Answer: a)
Explanation: Non-selective beta blockers can block beta-2 receptors in the lungs,
leading to bronchoconstriction.

3.

First-dose hypotension is a notable side effect of:

4.

1. a) Beta blockers
2. b) Alpha-1 blockers
3. c) Alpha-2 agonists
4. d) Beta-2 agonists
Answer: b)
Explanation: Alpha-1 blockers like prazosin can cause significant hypotension upon
the first dose due to vasodilation.

5.

Propranolol is contraindicated in:

6.

1. a) Hypertension
2. b) Heart failure
3. c) Bronchial asthma
4. d) Hyperthyroidism
Answer: c)
Explanation: Propranolol, a non-selective beta blocker, can exacerbate
bronchoconstriction in asthma patients.

7.

Beta blockers may mask symptoms of:

8.

1. a) Hypertension
2. b) Hyperthyroidism
3. c) Hypoglycemia
4. d) Tachycardia
Answer: c)
Explanation: Beta blockers blunt sympathetic responses, masking hypoglycemia
symptoms like tachycardia and tremors.
Mechanisms of Action

1.

Alpha-2 receptor activation results in:

2.

1. a) Increased insulin release

2. b) Decreased norepinephrine release
3. c) Vasoconstriction
4. d) Bronchodilation
Answer: b)
Explanation: Alpha-2 receptors inhibit norepinephrine release via negative feedback
mechanisms.

3.

Beta-1 adrenergic receptors primarily affect:

4.

1. a) Smooth muscle relaxation

2. b) Cardiac output
3. c) Vasodilation
4. d) Insulin secretion
Answer: b)
Explanation: Beta-1 receptors are located in the heart, where they increase heart
rate and contractility.

5.

Beta-2 receptor activation in the liver causes:

6.

1. a) Glycogenolysis
2. b) Insulin secretion
3. c) Decreased blood glucose
4. d) Lipogenesis
Answer: a)
Explanation: Beta-2 activation promotes glycogen breakdown into glucose in the
liver, increasing blood glucose levels.

Drug Specifics
 1.

Which drug is used in the treatment of pheochromocytoma?

2.

1. a) Phenoxybenzamine
2. b) Atenolol
3. c) Clonidine
4. d) Salmeterol
Answer: a)
Explanation: Phenoxybenzamine is a non-selective, irreversible alpha blocker used
to manage pheochromocytoma symptoms.

3.

Timolol is used to treat:

4.

1. a) Hypertension
2. b) Glaucoma
3. c) Heart failure
4. d) Asthma
Answer: b)
Explanation: Timolol reduces intraocular pressure by decreasing aqueous humor
production.

General Concepts

1.

Which neurotransmitter is primarily involved in the cholinergic nervous

system?

2.
1. a) Dopamine
2. b) Norepinephrine
3. c) Acetylcholine
4. d) Serotonin
Answer: c)
Explanation: Acetylcholine (ACh) is the main neurotransmitter of the cholinergic
system, acting on muscarinic and nicotinic receptors.
3.

Which receptor type is associated with the parasympathetic system?

4.
 1. a) Adrenergic
2. b) Muscarinic
3. c) Dopaminergic
4. d) Serotonergic
Answer: b)
Explanation: Muscarinic receptors mediate the effects of acetylcholine in the
parasympathetic nervous system.

5.

Nicotinic receptors are found at:

6.

1. a) Autonomic ganglia and neuromuscular junctions

2. b) Blood vessels
3. c) Adrenal medulla
4. d) Liver
Answer: a)
Explanation: Nicotinic receptors are located at the autonomic ganglia and the
neuromuscular junction, mediating rapid synaptic transmission.

Direct-Acting Cholinergic Agonists

1.

Which of the following is a naturally occurring alkaloid?

2.

1. a) Acetylcholine
2. b) Pilocarpine
3. c) Carbachol
4. d) Bethanechol
Answer: b)
Explanation: Pilocarpine is a naturally occurring cholinergic agonist that acts on
muscarinic receptors.

3.

What is the primary use of pilocarpine?

4.

1. a) Treating dry mouth

2. b) Reducing intraocular pressure in glaucoma
3. c) Treating asthma
 4. d) Treating hypertension
Answer: b)
Explanation: Pilocarpine is commonly used for glaucoma to reduce intraocular
pressure by increasing aqueous humor drainage.

5.

Bethanechol is primarily used to treat:

6.

1. a) Glaucoma
2. b) Urinary retention
3. c) Hypertension
4. d) Constipation
Answer: b)
Explanation: Bethanechol is a muscarinic agonist that stimulates bladder
contractions to treat urinary retention.

Indirect-Acting Cholinergic Agonists

1.

Which enzyme is inhibited by indirect cholinergic agonists?

2.

1. a) Monoamine oxidase
2. b) Acetylcholinesterase
3. c) Cyclooxygenase
4. d) Lipoxygenase
Answer: b)
Explanation: Indirect cholinergic agonists inhibit acetylcholinesterase, prolonging
the action of acetylcholine.

3.

Which of the following is a reversible acetylcholinesterase inhibitor?

4.

1. a) Sarin
2. b) Neostigmine
3. c) Echothiophate
4. d) Parathion
Answer: b)
Explanation: Neostigmine reversibly inhibits acetylcholinesterase and is used for
conditions like myasthenia gravis.
 5.

What is the main therapeutic use of edrophonium?

6.

1. a) Diagnosis of myasthenia gravis

2. b) Treatment of Alzheimer's disease
3. c) Reversal of organophosphate poisoning
4. d) Treating glaucoma
Answer: a)
Explanation: Edrophonium is a short-acting acetylcholinesterase inhibitor used in
the Tensilon test to diagnose myasthenia gravis.

7.

Which drug is used to treat antimuscarinic poisoning?

8.

1. a) Atropine
2. b) Physostigmine
3. c) Pilocarpine
4. d) Scopolamine
Answer: b)
Explanation: Physostigmine can cross the blood-brain barrier and is used to treat
central and peripheral effects of antimuscarinic toxicity.

Muscarinic Effects

1.

Which muscarinic receptor subtype is primarily involved in heart rate

reduction?

2.

1. a) M1
2. b) M2
3. c) M3
4. d) M4
Answer: b)
Explanation: M2 receptors are located in the heart and mediate bradycardia when
activated.

3.

A common side effect of cholinergic drugs is:

 4.

1. a) Tachycardia
2. b) Xerostomia
3. c) Diarrhea
4. d) Constipation
Answer: c)
Explanation: Cholinergic drugs stimulate the gastrointestinal system, often leading
to diarrhea.

5.

SLUDGE is an acronym for:

6.

1. a) Side effects of cholinergic drugs

2. b) Symptoms of cholinergic blockade
3. c) Stages of drug metabolism
4. d) Categories of neurotransmitters
Answer: a)
Explanation: SLUDGE stands for Salivation, Lacrimation, Urination, Defecation,
Gastrointestinal upset, and Emesis, indicating cholinergic overactivity.

Cholinergic Antagonists

1.

Which of the following is a muscarinic receptor antagonist?

2.

1. a) Atropine
2. b) Pilocarpine
3. c) Neostigmine
4. d) Carbachol
Answer: a)
Explanation: Atropine blocks muscarinic receptors, reducing parasympathetic
activity.

3.

Atropine is used in the treatment of:

4.

1. a) Myasthenia gravis
2. b) Bradycardia
 3. c) Glaucoma
4. d) Anticholinesterase poisoning
Answer: b)
Explanation: Atropine increases heart rate by inhibiting parasympathetic
stimulation, making it effective for bradycardia.

5.

Which of the following drugs is used to treat motion sickness?

6.

1. a) Physostigmine
2. b) Scopolamine
3. c) Bethanechol
4. d) Pilocarpine
Answer: b)
Explanation: Scopolamine, a muscarinic antagonist, prevents nausea and vomiting
associated with motion sickness.

Therapeutic Uses

1.

Neostigmine is primarily used for:

2.

1. a) Treating myasthenia gravis

2. b) Diagnosing Alzheimer's disease
3. c) Treating glaucoma
4. d) Treating bradycardia
Answer: a)
Explanation: Neostigmine is a reversible acetylcholinesterase inhibitor used to
improve muscle strength in myasthenia gravis.

3.

A cholinergic antagonist like ipratropium is used for:

4.

1. a) Hypertension
2. b) Asthma and COPD
3. c) Glaucoma
4. d) Urinary retention
Answer: b)
 Explanation: Ipratropium is an anticholinergic bronchodilator used to manage
obstructive airway diseases.

5.

Which cholinergic antagonist is used in ophthalmology to cause

mydriasis?

6.

1. a) Atropine
2. b) Bethanechol
3. c) Edrophonium
4. d) Neostigmine
Answer: a)
Explanation: Atropine dilates the pupil by blocking muscarinic receptors in the eye.

7.

Physostigmine is unique among acetylcholinesterase inhibitors because it:

8.

1. a) Cannot cross the blood-brain barrier

2. b) Crosses the blood-brain barrier
3. c) Is irreversible
4. d) Does not affect the central nervous system
Answer: b)
Explanation: Physostigmine can cross the blood-brain barrier, making it useful for
treating CNS effects of anticholinergic toxicity.

Adverse Effects

1.

A major adverse effect of organophosphate poisoning is:

2.

1. a) Bradycardia
2. b) Respiratory paralysis
3. c) Constipation
4. d) Hypertension
Answer: b)
Explanation: Organophosphate poisoning leads to excessive acetylcholine
accumulation, causing respiratory muscle paralysis.

3.
Which of the following is a symptom of anticholinergic toxicity?

4.

1. a) Diarrhea
2. b) Dry mouth
3. c) Excessive salivation
4. d) Bradycardia
Answer: b)
Explanation: Anticholinergic toxicity inhibits parasympathetic activity, leading to dry
mouth (xerostomia) and other symptoms.