ENADE: Medicina Veterinária · Brazil · INEP
Original practice questions written to the published syllabus · not past papersDrugs acting on the central nervous system: sedatives, tranquillisers, alpha-2 agonists, general and local anaesthetics, opioids, anticonvulsants and muscle relaxants.
In the exams: ICAR AICE-JRF core group 07; ICAR AIEEA-PG 13 (Pharmacology & Toxicology); BCSE anaesthesia 20-23 items
How our questions for ENADE spread across the units of Veterinary Neuropharmacology. Difficulty: 21 easy, 34 medium, 8 hard.
| Principles of CNS pharmacology | 9 | |
| Inhalant general anaesthetics | 8 | |
| Local anaesthetics | 8 | |
| Injectable general anaesthetics | 7 | |
| Opioid analgesics | 7 | |
| Anticonvulsants | 7 | |
| Sedatives and tranquillisers | 6 | |
| Alpha-2 adrenergic agonists | 6 | |
| Muscle relaxants | 5 |
Choose an answer, then open the working. Each explanation says why the right answer is right and why the others are not.
Which receptor blockade is chiefly responsible for the hypotension caused by acepromazine?
B. Alpha-1 adrenergic
Acepromazine calms by D2 blockade but causes vasodilation and hypotension by alpha-1 blockade. D2 blockade explains the tranquillising and antiemetic effects, not the fall in pressure.
Further reading: Riviere & Papich, Veterinary Pharmacology and Therapeutics, 10th ed.; Lumb and Jones' Veterinary Anesthesia and Analgesia, 6th ed.
Oral diazepam given daily to cats has been associated with which serious idiosyncratic adverse effect?
A. Acute hepatic necrosis
Idiosyncratic fulminant hepatic necrosis has been reported in cats given oral diazepam. Heinz bodies are linked to repeated propofol or paracetamol; eosinophilic airway disease to bromide in cats.
Further reading: Riviere & Papich, Veterinary Pharmacology and Therapeutics, 10th ed.; Lumb and Jones' Veterinary Anesthesia and Analgesia, 6th ed.
Which feature is characteristic of ketamine anaesthesia?
D. Eyes open and central with palpebral reflex present, increased muscle tone
Dissociative anaesthesia leaves eyes open and central with reflexes, increases muscle tone and stimulates the sympathetic system. Airway reflexes are partly kept, although they cannot be relied on to protect the airway.
Further reading: Riviere & Papich, Veterinary Pharmacology and Therapeutics, 10th ed.; Lumb and Jones' Veterinary Anesthesia and Analgesia, 6th ed.
A 20 kg premedicated dog is to be induced with propofol at 4 mg/kg as written in the anaesthetic protocol. The emulsion is 10 mg/mL. What is the maximum volume drawn up?
C. 8 mL
Dose = 20 × 4 = 80 mg; 80 ÷ 10 mg/mL = 8 mL, given to effect. 80 mL confuses mg with mL; 0.8 mL is a decimal slip; 2 mL would result from dividing body weight by the concentration (20 ÷ 10).
Further reading: Riviere & Papich, Veterinary Pharmacology and Therapeutics, 10th ed.; Lumb and Jones' Veterinary Anesthesia and Analgesia, 6th ed.
A dog is maintained on isoflurane, whose MAC in this species is taken as 1.3%. The anaesthetist wants 1.3 MAC. What end-tidal isoflurane concentration is targeted?
C. 1.69%
1.3 MAC × 1.3% = 1.69%. 1.30% is only 1 MAC; 2.60% is 2 MAC, deep enough to cause marked cardiovascular depression; 1.00% is below MAC.
Further reading: Riviere & Papich, Veterinary Pharmacology and Therapeutics, 10th ed.; Lumb and Jones' Veterinary Anesthesia and Analgesia, 6th ed.
Which local anaesthetic should never be used for intravenous regional anaesthesia or given intravenously because of cardiotoxicity?
C. Bupivacaine
Bupivacaine dissociates slowly from cardiac sodium channels, causing refractory arrhythmias and arrest. Lidocaine without adrenaline is the drug for IV regional blocks.
Further reading: Riviere & Papich, Veterinary Pharmacology and Therapeutics, 10th ed.; Lumb and Jones' Veterinary Anesthesia and Analgesia, 6th ed.
A dog stable on potassium bromide starts having seizures again after the owner changes to a high-salt diet. Why?
D. Chloride competes with bromide for renal reabsorption, so bromide excretion increases
Bromide and chloride share renal tubular handling; more chloride means more bromide is excreted and serum concentration falls. Bromide is not hepatically metabolised.
Further reading: Riviere & Papich, Veterinary Pharmacology and Therapeutics, 10th ed.; Lumb and Jones' Veterinary Anesthesia and Analgesia, 6th ed.
Imepitoin, authorised in some countries for canine idiopathic epilepsy, acts as a:
B. Low-affinity partial agonist at the benzodiazepine site of GABA-A
Imepitoin is a partial agonist at the benzodiazepine site; it is not intended for cluster seizures or status epilepticus. NMDA channel block describes ketamine, sodium channel block phenytoin, and SV2A binding levetiracetam.
Further reading: Riviere & Papich, Veterinary Pharmacology and Therapeutics, 10th ed.; Lumb and Jones' Veterinary Anesthesia and Analgesia, 6th ed.
A cow with seizures, blindness and head pressing is suspected of lead poisoning. Beyond a sedative or anticonvulsant to stop the seizures, which treatment addresses the cause?
A. Calcium disodium edetate (with thiamine)
Ruminant seizures are usually reactive; lead poisoning is treated with a chelator such as calcium disodium edetate, often with thiamine, while seizures are controlled acutely.
Further reading: Riviere & Papich, Veterinary Pharmacology and Therapeutics, 10th ed.; Lumb and Jones' Veterinary Anesthesia and Analgesia, 6th ed.
In which group of patients do benzodiazepines alone usually give reliable sedation?
B. Small ruminants and debilitated or geriatric animals
Benzodiazepines sedate sheep, goats and sick or old animals well; in healthy young dogs, cats and horses they often cause excitement or ataxia.
Further reading: Riviere & Papich, Veterinary Pharmacology and Therapeutics, 10th ed.; Lumb and Jones' Veterinary Anesthesia and Analgesia, 6th ed.
Ten here, 63 in the app. The Laisha app has every practice question we have written to ENADE in this subject, marked as you go, with timed papers, a jump-to-unanswered list and a certificate when you pass at 70 per cent.
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