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Therapeutics > ANS Review Questions > Flashcards

ANS Review Questions Flashcards

1
Q

Increase in blood pressure is compensated by:

a. Increase in baroreceptor receptor firing rate
b. Decrease in sympathetic activity
c. Increase in parasympathetic activity
d. Decrease in chronotropy and inotropy
e. All of the above

A

e. All of the above

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2
Q 
The sympathetic nervous system is derived from the:

a. Cranial division
b. Sacral division
c. Thoracolumbar division
d. a and b
e. b and c
A

c. Thoracolumbar division

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3
Q

The sweat gland is peculiar because it is:

a. Innervated by the parasympathetic nervous system but the transmitter is norepinephrine
b. Innervated by the sympathetic nervous system but the transmitter is acetylcholine
c. Innervated by the parasympathetic nervous system but the transmitter is nitric oxide
d. Innervated by the somatic motor nervous system but the transmitter is norepinephrine
e. Not innervated by the ANS

A

b. Innervated by the sympathetic nervous system but the transmitter is acetylcholine

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4
Q 
ACh analogs:
amide group (long/short) duration of action
A

long-not as easily hydrolyzed by ChE

ester is natural, short-acting option

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5
Q

ACh analogs:

methyl group on chain (high/low) receptor selectivity

A

high-causes muscarinic selectivity

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6
Q

Innervation of adrenal medulla

a. Acetylcholine
b. Norepinephrine
c. Dopamine
d. Epinephrine

A

a. Acetylcholine

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7
Q

sympathetic ganglion

a. Acetylcholine
b. Norepinephrine
c. Dopamine
d. Epinephrine

A

a. Acetylcholine

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8
Q

adrenal medulla to effector

a. Acetylcholine
b. Norepinephrine
c. Dopamine
d. Epinephrine

A

d. Epinephrine

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9
Q

sympathetic to effector

a. Acetylcholine
b. Norepinephrine
c. Dopamine
d. Epinephrine

A

b. Norepinephrine

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10
Q

parasympathetic to effector

a. Acetylcholine
b. Norepinephrine
c. Dopamine
d. Epinephrine

A

a. Acetylcholine

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11
Q

parasympathetic ganglion

a. Acetylcholine
b. Norepinephrine
c. Dopamine
d. Epinephrine

A

a. Acetylcholine

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12
Q

Cycloplegic effect of Tropicamide

c. sympathetic effector
d. parasympathetic effector

A

d. parasympathetic effector

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13
Q

Mydriatic effect of Atropine

c. sympathetic effector
d. parasympathetic effector

A

d. parasympathetic effector

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14
Q

Mydriatic effect of Norepinephrine

c. sympathetic effector
d. parasympathetic effector

A

c. sympathetic effector

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15
Q

Miosis produced by Echothiophate

c. sympathetic effector
d. parasympathetic effector

A

d. parasympathetic effector

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16
Q

Relaxation of Trigone and Sphincter and
contraction of Detrusor muscle
c. sympathetic effector
d. parasympathetic effector

A

d. parasympathetic effector

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17
Q

Atropine Fever

c. sympathetic effector
d. parasympathetic effector

A

c. sympathetic effector

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18
Q

Bradycardic effects of bethanechol

c. sympathetic effector
d. parasympathetic effector

A

d. parasympathetic effector

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19
Q

Tachycardic effect of atropine

c. sympathetic effector
d. parasympathetic effector

A

d. parasympathetic effector

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20
Q

Therapeutic effects of Sildenafil

c. sympathetic effector
d. parasympathetic effector

A

d. parasympathetic effector

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21
Q

Smooth muscle relaxation and antisecretory effect of Tiotropium in treatment of asthma

c. sympathetic effector
d. parasympathetic effector

A

d. parasympathetic effector

22
Q

Inotropic effect of Norepinephrine

c. sympathetic effector
d. parasympathetic effector

A

c. sympathetic effector

23
Q

a & b effects of Epinephrine

c. sympathetic effector
d. parasympathetic effector

A

c. sympathetic effector

AND adrenal effector

24
Q

Sildenafil is effective in treatment of erectile dysfunction because it:

a. Causes production of NO
b. Prevents the metabolism of NO
c. Prevents the metabolism of ACH
d. Causes relaxation of penile arteriole muscle
e. None of the above

A

e. None of the above

25
Q

Select the irreversible organophosphate inhibitor employed in ophthalmology.

a. Sarin
b. Echothiophate
c. Tropicamide
d. Ipratropium

A

b. Echothiophate

26
Q

Select the agent employed for treatment of motion sickness.

a. Benadryl
b. Scopolamine
c. Atropine
d. Tropicamide
e. a and b

A

e. a and b

27
Q

Sildenafil is effective in treatment of erectile dysfunction because it:

a. Enhances release of NO
b. Prevents metabolism of NO
c. Prevents metabolism of cGMP
d. Prevents metabolism of cAMP
e. All of the above

A

c. Prevents metabolism of cGMP

28
Q

An antidote recommended for treatment of organophosphate poisoning is:

a. 2-PAM
b. Atropine
c. Physostigmine
d. Pyridostigmine
e. a plus b

A

e. a plus b

29
Q

In the list below the drug of choice for decreasing secretions and relaxing bronchial smooth muscle of an asthmatic patient is:

a. Atropine-methyl bromide b. Ipratropium
c. Isoproterenol
d. Phentolamine e. Inhaled Scopolamine

A

b. Ipratropium

30
Q

This drug is used to suppress premature labor:

a. Isoproterenol (Isuprel)
b. Ritodrine (Yutopar)
c. Clonidine (Catapres)
d. Methoxamine (Vasoxyl)
e. Epinephrine

A

b. Ritodrine (Yutopar)

31
Q

If the potency of Drug X, an alpha receptor antagonist, is significantly greater at the alpha-1 receptor than at the alpha-2 receptor, then:
a. Drug X can be used to treat hypertension with low risk of increased norepinephrine release
b. Drug X cannot be used to treat hypertension because it would cause beta-2 mediated sympathetic hyperstimulation
c. Drug X would have a high liability for producing postural hypotension as a result of alpha-1 receptor blockade
d. Both statements A and C are correct for Drug X

A

a. Drug X can be used to treat hypertension with low risk of increased norepinephrine release

32
Q

Administration of phenylephrine produces a decrease in heart rate. Which one of the following statements best explains this observation?
a. Phenylephrine decreases the peripheral resistance
b. Phenylephrine acts on the nerve ending to decrease the release of NE
c. Phenylephrine directly decreases the heart rate
d. Phenylephrine causes a reflex decrease in sympathetic outflow and an increased vagal reflex that decreases the heart rate
e. Phenylephrine blocks alpha-1 receptors

A

d. Phenylephrine causes a reflex decrease in sympathetic outflow and an increased vagal reflex that decreases the heart rate

33
Q

In many cases, the same effect can be produced by two different autonomic drugs. For example, an increase in heart rate could be produced by either of the following two drugs:
a. Alpha-1 blocking agent and beta-1 blocking agent
b. Alpha-1 agonist and beta-2 agonist
c. Beta-1 agonist and muscarinic blocker
d. Beta-1 blocker and muscarinic agonist
e. Alpha-1 agonist and muscarinic agonist

A

c. Beta-1 agonist and muscarinic blocker

34
Q

The sharper rise in mean blood pressure caused by epinephrine administered after propranolol can be most appropriately attributed to which of the following explanations?

a. Epinephrine stimulates alpha-1 receptors and propranolol blocks beta-1 receptors
b. Epinephrine stimulates alpha-2 receptors and propranolol blocks all beta receptors
c. Epinephrine stimulates alpha-1 receptors and propranolol blocks beta-2 receptors
d. Epinephrine activates all beta receptors and propranolol blocks all beta receptors
e. None of the above explanations correctly accounts for the response

A

e. None of the above explanations correctly accounts for the response

35
Q 
timulation of the following receptor would be most useful in a patient with nasal congestion:	
a. Alpha-1
b. Alpha-2
c. Beta-1
d. Beta-2
e. Muscarinic
A

a. Alpha-1

36
Q

Beta-1 receptor agonists produce the following effect on second messengers:
a. Activation of cyclic AMP
b. Inhibition of cyclic AMP
c. Increased production of diacylglycerol
d. Decreased production of inositol triphosphate
e. Decrease in intracellular calcium ions

A

a. Activation of cyclic AMP

37
Q 
Which of the following adrenoceptor antagonists will reduce responses mediated by both alpha and beta receptors?
a. Propranolol                 
b. Prazosin (Minipres)        
c. Nadalol (Corgard)                 
d. Labetalol (Trandate)
e. Metoprolol (Lopressor)
A

d. Labetalol (Trandate)

38
Q 
Administration of a beta-1 selective antagonist will affect all of the following functions EXCEPT:
a. Rate of cardiac contraction
b. Cardiac output
c. Force of cardiac contraction
d. Cardiac work
e. Peripheral vascular resistance
A

e. Peripheral vascular resistance

39
Q 
Which one of the following drugs, when administered intravenously, can directly decrease blood flow to the skin, increase blood flow to skeletal muscle, and increase the force and rate of cardiac contraction?
a.	Epinephrine
b.	Isoproterenol
c.	Norepinephrine
d.	Phenylephrine
e.	Terbutaline
A

a. Epinephrine

40
Q

A student goes to the clinical center and exhibits a sinus tachycardia at a rate of 165 beats per minute. He tells you he has been taking a lot of drug X, which you recognize as a drug that is an indirect-acting adrenergic agonist (acts by increasing the release of NE). If a beta-adrenergic receptor antagonist is administered to this student, which of the following clinical effects could result?
a. Hyperglycemia
b. Bronchodilation if the patient has a history of asthma
c. Tachycardia
d. Increase in blood pressure
e. Hypothermia

A

d. Increase in blood pressure

41
Q 
Which of the following drugs, injected IV by itself, would produce a cardiovascular response similar to the profile obtained with injecting the combination of prazosin and epinephrine?
a. Phenylephrine
b. Isoproterenol
c. Terbutaline
d. Timolol	
e. Clonidine
A

b. Isoproterenol

42
Q

Clonidine has been used as an antihypertensive agent. What is its mechanism of action in reducing blood pressure?
a. Is a direct alpha-2 adrenergic receptor agonist that enhances vasodilation even though there is a slightly increased release of NE from nerve endings
b. Is a direct alpha-2 adrenergic receptor antagonist that decreases NE release and sympathetic tone
c. Is a direct alpha-2 adrenergic receptor agonist that decreases NE release and sympathetic tone
d. Is a direct alpha -1 adrenergic receptor antagonist that decreases vasoconstriction
e. Is a direct alpha-1 adrenergic receptor antagonist that decreases cardiac output

A

c. Is a direct alpha-2 adrenergic receptor agonist that decreases NE release and sympathetic tone

43
Q

Regular use of drugs like terbutaline and metaproterenol can result in
a. Bronchoconstriction and shortness of breath with exercise
b. Severe migraine headaches
c. A decreased effectiveness due to receptor downregulation/desensitization
d. Drowsiness and difficulty in concentrating
e. Bradycardia and cardiac arrhythmias

A

c. A decreased effectiveness due to receptor

44
Q 
Which of the following beta adrenergic blocking agents has the shortest duration of action?
 a. Metoprolol (Lopressor)
 b. Pindolol (Visken)
 c. Labetalol (Normodyne)
 d. Carvedilol (Coreg)
 e. Esmolol (Brevibloc)
A

e. Esmolol (Brevibloc)

45
Q 
A diabetic patient suddenly developed hypoglycemia.  The patient had been taking a drug that decreased the ability of the patient to feel some warning signs such as tachycardia and palpitations, and that decreased the ability of the body to compensate metabolically.  The drug was most likely
a. Metoprolol (Lopressor)
b. Metaproterenol (Alupent)
c. Prazosin (Minipress)
d. Nadolol (Corgard)
e. Dobutamine (Dobutrex)
A

a. Metoprolol (Lopressor)

46
Q 
Which of the following agents would not be effective in treating a patient having an acute asthmatic attack?
a. Isoproterenol (Isuprel)
b. Epinephrine
c. Salmeterol (Serevent) 
d. Bitolterol (Tornalate)
e. Metaproterenol (Alupent)
A

c. Salmeterol (Serevent)

47
Q

Alpha-2 receptor agonists produce the following effect on second messengers:
a. Activation of cyclic AMP
b. Inhibition of cyclic AMP
c. Increased production of diacylglycerol
d. Decreased production of inositol triphosphate
e. Decrease in intracellular calcium ions

A

b. Inhibition of cyclic AMP

48
Q

Which of the following is the least likely clinical use for beta-adrenoceptor antagonist?

a. Cardiac arrhythmias
b. Ischemic heart disease
c. Benign prostatic hypertrophy
d. Hypertension
e. Open-angle glaucoma

A

c. Benign prostatic hypertrophy

49
Q

Which of the following statements is the most accurate?

a. Alpha-adrenoceptor sympathomimetic agonists are used to reduce mucous membrane congestion
b. Alpha-adrenoceptor sympathomimetic agonists are used to treat bronchospasm
c. Beta-adrenoceptor sympathomimetic agonists are used to reduce surgical bleeding
d. Beta-2 adrenoceptor agonists are used to prolong local anesthesia
e. Selective beta-1 adrenergic antagonists are effective in treating patients with migraine or essential tremor

A

a. Alpha-adrenoceptor sympathomimetic agonists are used to reduce mucous membrane congestion

50
Q

The following is a property of carvedilol?

a. It is non-selective
b. It is a calcium channel blocker
c. It is an alpha-1 receptor blocker
d. All of the above
e. None of the above

A

d. All of the above

Therapeutics (9 decks)

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