QQ N7310 Flashcards
Preliminary data suggest that a large hippocampus is BLANK in the development of PTSD
a neuroprotective factor
The body’s reaction to an acutely stressful situation is activation of the BLANK (fast) and activation of BLANK (not as fast)
sympathetic nervous system/endocrine
Activity in the amygdala, hippocamps, and insula are implicated in which scenario?
Dreading personal interactions in which you will be the focus of attention
The PMHNP understands that any drug or other substance that is tightly controlled by the government because it may be abused or cause addiction is called a:
controlled substance
The PMHNP understands that alpha-2-delta ligands:
bind on the alpha-2-delta subunit of voltage sensitive calcium channels
The PMHNP understands that when prescribing benzodiazepines
tolerance can develop with prolonged use
All of the following are pharmacologic effects of oral benzodiazepines except
profound hypotension
Which of the following structures are not thought to be involved in obsessive-compulsive disorders?
Cerebellum, Globus pallidus, putamen, caudate nucleus
Cerebellum
Lorazepam is a first line agent for
generalized anxiety disorder
The PMHNP understands that the following statements about norepinephrine and stress response are true except:
- blocking norepinephrine reuptake paradoxically increases anxiety
- norepinephrine stimulates the release of corticotropin-releasing hormone
- cell bodies of involved NE neurons are in the locus coeruleus
- peripheral norepinephrine produces somatic symptoms of anxiety
blocking norepinephrine reuptake paradoxically increases anxiety
The PMHNP understands that the feeling that one is not in control resides in the
medial prefrontal cortex
Flumazenil
blocks benzodiazepine receptors at ligand-gated chloride channel complexes
Feelings of fear are regulated by overaction of reciprocal connections between the amygdala and which structures?
the anterior cingulate cortex and the orbitofrontal cortex
Activating GABA neurons
calms down the brain
Benzodiazepines modulate excessive (BLANK) by (BLANK) actions of inhibitory interneurons in the CSTC circuits
worry/increasing
The initial dose and usual range for escitalopram when treating generalized anxiety disorder are:
initial dose 10 mg once/day and usual range 20 mg/day
Which type of GABA receptor are targets of benzodiapzines?
GABA-A
The PMHNP understands that normal anxiety responses:
include avoidance, hypervigilance, and increased arousal
What DEA schedule are preparations containing not more than 200 miligrams of codeine per 100 mL or per 100 g?
Schedule V
What DEA schedule are opioid medications, stimulants, and cocaine?
Schedule II
What DEA schedule are benzodiazepines, Darvon
Schedule IV
What DEA schedule are marijuana, heroin, ecstasy?
Schedule I
What DEA schedule are combination products containing less than 15 mg of hydrocodone per dosage unit and products containing not more than 90 mg of codeine?
Schedule III
Once receiving initial licensure from the state, the PMHNP applies to the Drug Enforcement Administration for which business activity?
Dispensing or Instructing
Once receiving licensures from the state, the PMHNP initially registers with the DEA by submitting which form?
Form 224
Once receiving licensure from the state the PMHNP applies to the DEA to prescribe which schedules of substances?
schedule II thru V
The application fee for a new registration with the DEA for a licensed PMHNP is
731 dollars
The registration period with the DEA for a licensed PMHNP is
3 years
The PMHNP understand that stimulation of the periaqueductal gray inducing analgesia is evidence of:
top-down control of pain by descending pathways
In the gate theory of pain:
Ascending pain signals can be modified by descending fibers
The PMHNP understands that all the following characteristics apply to the affective-motivational domain of ascending pathways except?
- signals travel up the anterolateral spinal cord region
- proceeds to bilateral aspects of the brain
- synapses terminate on the visual cortex
- answers the question How much does it hurt?
-synapses terminate on the visual cortex
The classic triad of morphine toxicity includes:
pinpoint pupils, respiratory depression, CNS suppression
The prescribing NP understand that oxycodone OP formulation:
cannot be dissolved into an injectable solution
Free nerve endings that respond to a broad range of physical and chemical stimuli at intensities that can cause damage are called?
nociceptors
The mechanoreceptors are also called
A-beta fibers
Non-opioid analgesics for migraines include
serotonin 1B/1D receptor agonists
Early signs associated with the abrupt discontinuation of morphine are:
yawning, rhinorrhea, sweating
The PMHNP understands that the properties of naloxone as a pure opioid antagonist include all the following except:
- antagonist at kappa receptors
- antagonist at mu receptors
- maintains analgesic effects
- reversal of respiratory and CNS depression
maintains analgesic effects
The opioid receptors are found throughout the body, but are concentrated in all but which of the following areas that are well known for pain?
cerebral cortex
Post-synaptic opioid receptors have a BLANK affinity for a partial agonist than for the endogenous ligand or agonist and has a BLANK rate of dissociation than endogenous ligands and agonists.
higher/lower
The BLANK opioid receptor is thought to play a role in modulating chronic pain and is activated by BLANK
delta/enkephalins
The PMHNP understands that all are characteristics of tramadol except:
- blocks uptake of serotonin
- blocks uptake of norepinephrine
- is weak agonist at mu opioid receptors
- is fully antagonized by naloxone
is fully antagonized by naloxone
The PMHNP understands that all of the following characteristics apply to the sensory-discriminative domain of ascending pathways except:
- synapse in the medial thalamus
- answer the question, where does it hurt?
- signals travel up the spinothalamic tract
- proceed to the somatosensory cortex
synapse in the medial thalamus
The potency of an opioid medication is directly correlated to its binding affinity for
mu receptors
Regarding the spectrum of congenital insensitivity to pain, the PMHNP understands that
frank congenital insensitivity to pain is associated with missing peripheral A-delta and C fibers
Doses of morphine
case headaches if metabolites build up
The PMHNP understands that evidence that the chronic use of opioids might not be beneficial and might even make pain worse does not include:
- opioid induced hyperalgesia develops in some patients with long-term use
- tolerance to analgesic and euphoric effects quickly requires dose escalation
- persistent pain sensitivity induced by morphine may explain how acute pain can transition to chronic pain
- rapid development of tolerance for respiratory depression
rapid development of tolerance for respiratory depression
The PMHNP understands that patients with a family history of schizophrenia
show elevated pain thresholds and tolerance
Dull pain matches with what type of fiber?
C fibers
Fast pain signals matches with what type of fiber?
A-delta fibers
Myelinated fibers are?
C fibers
Pain signals synapse in the dorsal horn of the spinal cord are?
A delta fibers AND c fibers
Pain signals transverse the dorsal root ganglia?
A delta fibers AND c fibers
Sharp pain match what type of fiber?
C fibers