Assignment

Question 1

Which of the following statements best describes the role of neurotransmitters?

a. They only bridge the communication pathway from the Peripheral Nervous System to terminal sensory ganglia
b. They mostly bridge the communication pathway only in the Central Nervous System
c. They mostly bridge the communication pathway, across the synaptic cleft, from a preganglionic neuron to a postganglionic neuron
d. They mostly bridge the communication pathway, across the synaptic cleft, from a postganglionic neuron to preganglionic neurons

Answer 1

c. They mostly bridge the communication pathway, across the synaptic cleft, from a preganglionic neuron to a postganglionic neuron

Question 2

Which of the following statements is FALSE regarding the distinguishing roles of the Sympathetic and Parasympathetic Nervous system divisions?

a. The somatic system is largely concerned with movement, respiration and posture
b. The Enteric Nervous System is receives input from both the Sympathetic and Parasympathetic divisions
c. The somatic system is largely concerned with unconscious functions
d. The Cardiac system is innervated by the sympathetic division

Answer 2

c. The somatic system is largely concerned with unconscious functions

Question 3

Which of the following statements regarding the Anatomy of the Autonomic Nervous System is FALSE?

a. Afferent nerves transmit feedback impulses to the CNS
b. Efferent nerves transmit feedback impulses to the CNS
c. Afferent feedback modulates CNS input to efferent nerves
d. Efferent nerves consists of both preganglionic and postganglionic nerves

Answer 3

b. Efferent nerves transmit feedback impulses to the CNS

Question 4

Which of the following statements is FALSE regarding Acetylcholine’s action?

a. It activates Sympathetic Norepinephrine release
b. It is released and interacts with Adrenergic receptors
c. It is released into the synaptic cleft between somatic fibers and skeletal muscle
d. It attaches to Parasympathetic Nicotinic receptors

Answer 4

b. It is released and interacts with Adrenergic receptors

Question 5

The release if Acetylcholine into the synaptic cleft is dependent on which of the following substances?

a. Oxygen
b. Nitric oxide
c. Calcium
d. Sodium

Answer 5

c. Calcium

Question 6

Sympathetic postganglionic adrenergic nerve fibers are responsible for which of the following reactions?

a. Dilates pupils and bronchioles and increases blood flow to skeletal muscle
b. Increases blood flow to skin and viscera
c. Decreases energy stores and glycolysis
d. Constricts pupils and bronchioles and decreases blood flow to skeletal muscle

Answer 6

a. Dilates pupils and bronchioles and increases blood flow to skeletal muscle

Question 7

Please complete this sentence and choose the best statement: The Parasympathetic Nervous System “…”

a. “…Inhibits aldosterone secretion to increase urine outflow and decrease intravascular volume”
b. “…Stimulates aldosterone secretion to decrease urine outflow and increase intravascular volume”
c. “…increases inotropic cardiac activity and vascular resistance”
d. “…increases venous tone and heart rate”

Answer 7

b. “…Stimulates aldosterone secretion to decrease urine outflow and increase intravascular volume”

Question 8

Which of the following substances is responsible for terminating Acetylcholine’s action?

a. Transferase
b. Acetylcholinesterase
c. Calcium
d. Nitric Oxide

Answer 8

b. Acetylcholinesterase

Question 9

Which of the following is FALSE regarding the termination processes of Norepinephrine’s action?

a. Metabolized by Monoamine oxidase
b. Reuptake, by the Norepinephrine Transporter, is blocked
c. Reuptake into terminal by Norepinephrine Transporter
d. Diffused away from receptor and metabolized

Answer 9

b. Reuptake, by the Norepinephrine Transporter, is blocked

Question 10

A cholinoceptor’s role in ANS processes refers to which of the following?

a. Binding of muscarinic and nicotinic receptors
b. Binding of β1 and β2-adrenoceptors
c. Binding of adrenergic and dopamine receptors
d. Binding of α1 and α2-adrenoceptors

Answer 10

a. Binding of muscarinic and nicotinic receptors

Question 11

Which of the following receptor is most predominant in Brain tissue?

a. Nicotinic
b. Beta
c. Alpha
d. Dopamine

Answer 11

d. Dopamine

Question 12

Hepatic Gluconeogenesis is modulated by which of the following ANS receptors?

a. M3
b. β 3, α3
c. β 2, α
d. D5

Answer 12

c. β 2, α

Question 13

The sympathetic and parasympathetic divisions of the ANS may work in tandem for which of the following purposes?

a. To prevent homeostatic imbalance
b. To block postsynaptic regulation
c. To inhibit presynaptic regulation
d. To increase effector organ function’s window of tolerance

Answer 13

a. To prevent homeostatic imbalance

Question 14

Which of the following examples best describes autoreceptor regulation?

a. Noradrenergic α2 receptor block by enzymatic processes
b. Noradrenergic α2 receptor binding by catalytic enzymes
c. Noradrenergic α2 receptor stimulation that results in activation-induced reduction in noradrenergic release
d. Noradrenergic α2 receptor inhibition that results in activation-induced reduction in noradrenergic release

Answer 14

d. Noradrenergic α2 receptor inhibition that results in activation-induced reduction in noradrenergic release

Question 15

Please complete this sentence: A clinical consequence of the chronic use of a drug (drug X) that blocks adrenergic receptors to a particular neurotransmitter is…?

a. An exaggerated response to the neurotransmitter when drug X is discontinued
b. A decreased response to the neurotransmitter when drug X is discontinued
c. An exaggerated response to presynaptic Bretylium and guanethidine
d. An inhibitory response to post synaptic potentials

Answer 15

a. An exaggerated response to the neurotransmitter when drug X is discontinued

Question 16

Neurotransmitters can be affected by specific drugs in which of the following ways?

a. Alteration of direction of action potential
b. Alteration of the synaptic cleft
c. Alteration of neurotransmitter receptors
d. Alteration of axonal-dendritic arborization

Answer 16

c. Alteration of neurotransmitter receptors

Question 17

Which of the following response would be expected from a cholinesterase inhibitor?

a. Permanent destruction of acetylcholine receptors
b. Increased acetylcholine
c. No change in acetylcholine
d. Decreased acetylcholine

Answer 17

b. Increased acetylcholine

Question 18

Which of the following statements is TRUE regarding the role of Muscarinic Receptors and autonomic effector tissue response?

a. M2 and M4 have no role in autonomic effector response
b. M2 and M4 lead to cellular excitation
c. M1, M3 and M5 lead to cellular excitation
d. M1, M3 and M5 inhibits cellular excitation

Answer 18

c. M1, M3 and M5 lead to cellular excitation

Question 19

Which of the following receptors and target tissues respond to Nicotinic Alkaloid?

a. Heart and smooth muscle
b. Neuromuscular end plate and skeletal muscle
c. Glands and endothelium
d. Skin and fatty tissue

Answer 19

b. Neuromuscular end plate and skeletal muscle

Question 20

The action of the norepinephrine transporter can be blocked by which of the following drugs?

a. Guanethidine
b. Cocaine
c. Reserpine
d. Botulinum toxin

Answer 20

b. Cocaine

Question 21

The main effect, caused by Cholinomimetics, on the Genitourinary (GU) system, in a patient with urinary retention, is best explained by which of the following mechanisms?

a. Contracts the trigone and sphincter muscles and relaxes the detrusor muscle
b. Relaxes the trigone, sphincter and detrusor muscles
c. Contracts the trigone, sphincter and detrusor muscles
d. Relaxes the trigone and sphincter muscles and contracts the detrusor muscle

Answer 21

d. Relaxes the trigone and sphincter muscles and contracts the detrusor muscle

Question 22

A 42 year-old farmer presents to your office with muscle weakness, spasms and paresis, difficulty with walking, speaking and swallowing, miosis, excessive salivation, lacrimation, bronchial secretions with shortness of breath (SOB), uncontrollable diarrhea and voiding, hypotensive with bradycardia. Which of the following is the most likely cause of your patient’s symptoms?

a. Exposure to norepinephrine insecticides
b. Exposure to wife’s Beta agonist medication
c. Exposure to farm animals’ secretions
d. Exposure to organophosphate insecticide

Answer 22

d. Exposure to organophosphate insecticide

Question 23

The treatment of choice for a patient who comes in with generalized weakness of limbs, respiratory and ocular muscles, ptosis and difficulty speaking would be which of the following?

a. Organophosphates
b. Echothiophate
c. Nicotine
d. Neostigmine

Answer 23

d. Neostigmine

Question 24

Atropine and scopolamine are examples of which of the following Rx classes?

a. Nicotinic neuromuscular blockers
b. Cholinomimetics
c. Sympathomimetics
d. Muscarinic parasympatholytics

Answer 24

d. Muscarinic parasympatholytics

Question 25

Organ systems most affected by Atropine and its derivatives include which of the following groups? a. Eye, Cardiovascular, Genitourinary b. Lymphatics c. Dermatologic, muscular d. Hair follicles, nail beds

Answer 25

a. Eye, Cardiovascular, Genitourinary

Question 26

Which of the following drugs might you consider in a patient with Parkinson’s Disease? a. Benztropine b. Succinylcholine c. Scopolamine d. Atropine

Answer 26

a. Benztropine

Question 27

The use of antimuscarinics must be avoided in which of the following patients? a. Asthmatic with excessive secretions b. Uncontrolled narrow angle glaucoma c. In the ophthalmic use to induce mydriasis d. Bradycardic

Answer 27

b. Uncontrolled narrow angle glaucoma

Question 28

A patient who presents with urinary incontinence might do well with which of the following medications? a. Echothiophate b. Oxybutynin c. Pilocarpine d. Ipratropium

Answer 28

b. Oxybutynin

Question 29

In a patient whom you are suspecting cholinesterase inhibitor poisoning, which of the following agents would be the best treatment choice? a. Dicyclomine b. Atropine c. Oxybutynin d. Ipratropium

Answer 29

b. Atropine

Question 30

A patient who presents with dry mouth, tachycardia, urinary retention and fecal incontinence and is on an unknown medication may be on which of the following drug classes? a. Direct acting nicotinic agonist b. Anticholinergics c. Cholinesterase inhibitor d. Cholinergics

Answer 30

b. Anticholinergics

Question 31

Which of the following statements is TRUE regarding dopamine’s action on receptors? a. D2 receptor is found in renal vascular smooth muscle that corresponds to vascular constriction b. D2 receptor is found in renal vascular smooth muscle that corresponds to vascular dilation c. D1 receptor is found in renal vascular smooth muscle that corresponds to vascular constriction d. D1 receptor is found in renal vascular smooth muscle that corresponds to vascular dilation

Answer 31

d. D1 receptor is found in renal vascular smooth muscle that corresponds to vascular dilation

Question 32

The function of Alpha 2 receptors is represented in which of the following statements? a. Stimulates cardiac inotropy and excitability b. Stimulates the release of norepinephrine and insulin c. Inhibits the release of norepinephrine and insulin d. Stimulates cardiac chronotropy and dromotropy

Answer 32

c. Inhibits the release of norepinephrine and insulin

Question 33

A 12 year-old girl presents to your office with a new onset of allergic induced asthma. Which of the following drug classes would be most efficacious in controlling her condition? a. Beta 2 agonist b. Dopamine 2 agonist c. Alpha 1 agonist d. Beta 1 antagonist

Answer 33

a. Beta 2 agonist

Question 34

Dopamine, has which of the following effects on adrenergic receptors? a. Adrenergic receptors do not respond to dopamine stimulation b. At moderate doses has no effect on Beta or Alpha receptors c. At moderate doses can effect Beta and higher doses effect Alpha receptors d. Dopamine only interacts with dopaminergic receptors

Answer 34

c. At moderate doses can effect Beta and higher doses effect Alpha receptors

Question 35

Which of the following drug classes would have the potential to worsen your diabetic patient’s hyperglycemia? a. Dopamine 4 and beta 1 agonists b. Alpha 3 and 4 agonists c. Alpha 1 , 2 agonists, beta 2 d. Dopamine 1 and 2

Answer 35

c. Alpha 1 , 2 agonists, beta 2

Question 36

A hypotensive patient, who is being treated in the Intensive Coronary Unit (ICU), has been placed on a Dopamine IV infusion. Which of the following statements is correct regarding Dopamine infusion and the cardiovascular response? a. A low infusion rate increases vasoconstriction b. Dopamine has no effects on cardiovascular receptors c. A high infusion rate increases vasoconstriction d. Dopamine infusion rates have no effect on the cardiovascular system

Answer 36

c. A high infusion rate increases vasoconstriction

Question 37

A patient with dangerous hypotension that is progressing to imminent cardiac shock and arrest, might be best treated with which of the following medications? a. Clonidine b. Fenoldopam c. Isoproterenol d. Bromocriptine

Answer 37

c. Isoproterenol

Question 38

A patient with chronic orthostatic hypotension, due to impaired autonomic reflexes, may be best treated with which of the following medications? a. Fenoldopam b. Midodrine c. Clonidine d. Dobutamine

Answer 38

b. Midodrine

Question 39

Please complete this sentence: “The drug, Modafinil, is useful for the treatment of narcoplesy because…” a. “It has an alerting action, that affects the CNS and cardio-respiratory centers that inhibits deoxygenation throughout the day.” b. “It has the ability to deepen sleep and dreaming quality, this reducing the tendency to “day-dream.” c. “It has an alerting, sleep deferring action that improves attention to repetitive tasks.” d. “It has the ability to deepen sleep quality, thus, improving alertness.”

Answer 39

c. “It has an alerting, sleep deferring action that improves attention to repetitive tasks.”

Question 40

Which of the following statements best describes the cardiovascular effect of Alpha1 receptor Antagonists? a. Stimulates vasodilation, decreases peripheral resistance and blood pressure and can cause reflex tachycardia and postural (orthostatic) hypotension b. Stimulates vasodilation, increases peripheral resistance and blood pressure and can cause reflex tachycardia and postural (orthostatic) hypotension c. Stimulates vasodilation, increases peripheral resistance and blood pressure and can cause hypertensive crisis d. Stimulates vasoconstriction, decreases peripheral resistance and blood pressure

Answer 40

a. Stimulates vasodilation, decreases peripheral resistance and blood pressure and can cause reflex tachycardia and postural (orthostatic) hypotension

Question 41

Which of the following drugs is to be avoided in a patient with Chronic Obstructive Pulmonary Disease (COPD)? a. Acebutolol b. Atenolol c. Propranolol d. Metoprolol

Answer 41

c. Propranolol

Question 42

Beta antagonists exert an antihypertensive by which of the following mechanisms? a. Renin is not involved in intra-arterial pressure control b. Deceases renin secretion c. Has no effect on renin secretion d. Increase in renin secretion

Answer 42

b. Deceases renin secretion

Question 43

Please complete the sentence: “Beta blockers are used in the treatment of glaucoma because of their…” a. Ability to increase tear production b. Ability to decrease tear production c. Ability to decrease aqueous humor production d. Ability to increase aqueous humor production

Answer 43

c. Ability to decrease aqueous humor production

Question 44

Which of the following are correct regarding clinical use of Beta Antagonists (Blocker)? a. Most beta blockers are poorly metabolized excreted unchanged in the urine b. Beta blockers are self-metabolizing and need little clinical monitoring c. Tapering is not essential once discontinued since the half-life is long enough d. Tapering is essential to avoid rebound cardiac ischemia

Answer 44

d. Tapering is essential to avoid rebound cardiac ischemia