1. A 62-year-old man with COPD presents to the emergency room in respiratory distress.

The
attending physician uses succinylcholine to produce skeletal muscle relaxation prior to tracheal
intubation. Soon after infusion of the succinylcholine, the patient develops a severe bradycardia.
Which of the following drugs would counteract the bradycardia without affecting muscle
relaxation?

1. Curare
2. Acetylcholine
3. Atropine
4. Dopamine
5. Epinephrine

2. After an accident at work resulting in severe hemorrhage, a machinist is rushed to the emergency
room. Which of the following sets of autonomic responses would be predicted in this patient?

1. Increased heart rate, increased bowel sounds, dilated pupil diameter

2. Decreased heart rate, decreased bowel sounds, constricted pupil diameter
3. Decreased heart rate, increased bowel sounds, constricted pupil diameter
4. Increased heart rate, decreased bowel sounds, constricted pupil diameter
5. Increased heart rate, decreased bowel sounds, dilated pupil diameter

3. A cardiovascular physiologist performs an experiment on an animal subject to study heart rate

and blood pressure changes with nerve stimulation. He selectively stimulates the afferent portions
of the glossopharyngeal and vagus nerves. Which of the following outcomes would most likely
occur after this manipulation?

1. Bradycardia with hypertension

2. Bradycardia with hypotension
3. Sinus arrhythmia with hypotension
4. Tachycardia with hypertension
5. Tachycardia with hypotension

4. A healthy 28-year-old woman stands up from a supine position. Which of the following
cardiovascular changes is most likely to occur?

1. Decreased myocardial contractility

2. Increased heart rate
3. Decreased total peripheral resistance
4. Dilation of large veins
5. Increased renal blood flow

5. An 18-year-old male, who became ill after eating mushrooms, is brought to the Emergency
Department, where he is treated for muscarinic poisoning. Which of the following signs is
consistent with muscarinic poisoning?

1. Bradycardia
2. Skeletal muscle contractures
3. Dilation of the pupils
4. Hypertension
5. Diuresis
6. A 16-year-old, highly allergic girl who is stung by a bee gives herself a shot of epinephrine
prescribed by her physician. Because epinephrine activates b-adrenergic receptors, it will relieve the
effects of the bee sting by decreasing which of the following?

1. The transport of calcium into skeletal muscle fibers

2. The strength of ventricular muscle contraction
3. The rate of depolarization in the SA node
4. The contraction of airway smooth muscle
5. The rate of glycogenolysis in the liver

7. During a pulmonary function test, a patient first generated Curve #1. Subsequent to
administration of a bronchodilator, she generated Curve #2

The increased flow in Curve #2 versus Curve #1 is a result of which of the following?

1. Stimulation of b2-adrenergic receptors in bronchial smooth muscle

2. Stimulation of a-adrenergic receptors in bronchial smooth muscle
3. Stimulation of parasympathetic nerves to airway smooth muscle
4. Stimulation of irritant airway receptors in airway epithelium
5. Mast cell degranulation in the airways

8. During a routine physical examination, a 35-year-old male is found to have a blood pressure of
170/105 mmHg. History reveals episodes of headache accompanied by palpitations, diaphoresis,
and anxiety. A diagnosis of pheochromocytoma (tumor of the adrenal medulla) is confirmed when
blood pressure falls in response to the administration of which of the following?

1. An ACE inhibitor
2. An a-adrenergic blocker
3. A b-adrenergic agonist
4. A loop diuretic
5. An AII antagonist

9. A woman with syndrome X is prescribed a low-calorie diet and 30-min of daily aerobic exercise.
Sympathetic stimulation during exercise has which of the following cardiac effects?
 1. An increase in the duration of systole
2. An increase in the activity of the SR calcium pump
3. An increase in the duration of diastole
4. A decrease in the affinity of troponin for calcium
5. A decrease in the concentration of Ca2+ during systole

10. A 69-year-old male presents with symptoms of thirst and dizziness, and physical evidence of
orthostatic hypotension and tachycardia, decreased skin turgor, dry mucous membranes, reduced
axillary sweating, and reduced jugular venous pressure. He was recently placed on an angiotensin-
converting enzyme inhibitor for his hypertension Urinalysis reveals a reduction in the fractional
excretion of sodium and the presence of acellular hyaline casts. The internist suspects acute renal
failure of prerenal origin, which has increased renin secretion by the kidney. A stimulus for
increasing renal renin secretion is an increase in which of the following?

1. Atrial natriuretic peptide secretion

2. Mean blood pressure
3. Glomerular filtration rate
4. Circulating angiotensin II
5. Sympathetic nerve activity

11. A patient’s 24-hour urine output is lower-than-normal. Which of the following situations would
reduce urinary flow?

1. Increased renal arterial pressure

2. Diabetes insipidus
3. Diabetes mellitus
4. Sympathetic stimulation
5. Infusion of mannitol

12. A 17-year-old girl is brought to the emergency department 15 minutes after being stung by a
bee. She has mild lightheadedness but no difficulty swallowing. Her temperature is 37.1°C
(98.8°F), pulse is 100/min, respirations are 30/min, and blood pressure is 115/70 mm Hg. Physical
examination shows no urticaria. Bilateral wheezing is heard on auscultation of the chest. Which of
the following types of drugs is the most appropriate for this patient?

1. β2-Adrenergic agonist
2. α1-Adrenergic agonist
3. α2-Adrenergic agonist
4. α1-Adrenergic antagonist
5. β2-Adrenergic antagonist

13. The excitation of the parasympathetic autonomic nervous system can cause the following
reactions:

1. Narrowing of the pupil, slowing down the heartbeat rate, lowering of blood pressure, an
increase of motility of the small intestine, relaxation of the bladder sphincter
2. Narrowing of the pupil, slowing down the heartbeat rate, narrowing of the coronary
arteries, a decrease of motility of the small intestine
3. Dilation of pupils, an increase of heartbeat rate, an increase of blood pressure, narrowing
of the coronary arteries, slowing of motility of the small intestine
 4. Dilation of pupils, an increase of heartbeat rate, an increase of motility of the small
intestine, relaxation of the bladder sphincter
5. Dilation of pupils, an increase of heartbeat rate, an increase of blood pressure,
hyperglycemia, slowing of motility of the small intestine

14. Which of these physiological changes would not be considered part of the sympathetic fight-or-
flight response?

1. Increased stomach motility

2. Increased heart rate
3. Increased sweating
4. Dilated pupils
5. -

15. Which type of fiber could be considered the longest?

1. Preganglionic sympathetic
2. Preganglionic parasympathetic
3. Postganglionic parasympathetic
4. Postganglionic sympathetic
5. -

16. Which signaling molecule is most likely responsible for an increase in digestive activity?

1. Epinephrine
2. Acetylcholine
3. Norepinephrine
4. Adrenaline
5. -

17. Which of these cranial nerves contains preganglionic parasympathetic fibers?

1. Optic, CN II
2. Trigeminal, CN V
3. Facial, CN VII
4. Hypoglossal, CN XII
5. -

18. Which of the following is not a target of a sympathetic preganglionic fiber?

1. Collateral ganglion
2. Intermural ganglion
3. Adrenal gland
4. Chain ganglion
5. -

19. A 22-year-old woman presents at the student medical center with tachycardia and palpitations.
She reports that she has been taking a diet supplement containing ephedrine that she purchased from
an Internet site. Activation of the sympathetic nervous system by ephedrine causes smooth muscle
contraction in which of the following?
 1. Arterioles
2. Bronchioles
3. Ciliary bodies
4. Intestines
5. Pupils

20. A 59-year-old woman with bilateral glaucoma is treated with drops of the parasympathetic
agent pilocarpine. Cholinergic stimulation of the pupil causes which of the following?

1. Pupillary constriction (miosis)

2. Absence of the pupillary response to light
3. Inequality of pupil size
4. Pupillary dilation (mydriasis)
5. Tonic pupil (slow redilation after exposure to light)