Q- A patient is prepared for major surgery. Administration of which one of the following skeletal muscle relaxants may cause hypotension, bronchospasm, and increased bronchial and salivary secretions?
A- Atracurium
B- Dantrolene
C- Tubocurarine
D- Vecuronium
C- Tubocurarine- It is a non-depolarizing neuromuscular blocker. It can cause a release of histamine, leading to vasodilation and hypotension. Histamine release can also cause bronchial smooth muscle contraction and increased glandular secretions. These side effects make tubocurarine less desirable to use before surgeries.
Q- A female infant is diagnosed with Turner syndrome. Which one of the following long-term hormone replacement therapies should be started when she reaches puberty?
A- Estrogen only
B- Estrogen and progestin
C- Progestin only
D- Prolactin and progestin
B- Estrogen and progestin- Turner syndrome (45,X) is associated with gonadal dysgenesis, leading to estrogen deficiency and lack of spontaneous puberty. Hormone replacement therapy (HRT) is used to induce secondary sexual characteristics, promote normal growth and bone health, initiate and regulate menstrual cycles, and prevent osteoporosis. Estrogen is started around age 11–12 to begin pubertal development. Progestin is added after 1–2 years of estrogen therapy or once breakthrough bleeding occurs, to prevent endometrial hyperplasia due to unopposed estrogen.
Q- A drug addict presents to the clinic to ask for pain medication. Which of the following medications has the highest potential for drug abuse?
A- Codeine
B- Loperamide
C- Meperidine
D- Propoxyphene
C- Meperidine- Among the listed options, Meperidine is a potent opioid analgesic with high potential for abuse and addiction. It acts on the μ-opioid receptor and can produce euphoria, leading to misuse, particularly in individuals with a history of substance abuse. Codeine is a mild to moderate opioid; it has abuse potential but less than meperidine. Loperamide is an opioid receptor agonist used for diarrhea. It has low CNS penetration and thus minimal abuse potential under normal dosing, although very high doses can lead to misuse. Propoxyphene has been withdrawn from the U.S. market due to safety concerns. It had abuse potential, but less than meperidine.
