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PPT exam 1 -Fa22

Total questions: 250

Worksheet time: 4hrs 10mins

Name
Class
Date
1.

neurological condition which affects the nervous system

a)

convulsion

b)

seizures

c)

epilepsy

d)

muscle spasms

2.

TRUE/FALSE: epilepsy is also known as a seizure disorder.

a)

true

b)

false

3.

TRUE/FALSE: 1 in 26 people in the US will develop epilepsy at some point in their life

a)

true

b)

false

4.

TRUE/FALSE: epilepsy is usually diagnosed after a person had at least 3 seizures due to a medical condition

a)

true

b)

false

5.

TRUE/FALSE: epilepsy results from an imbalance between excitatory and inhibitory systems

a)

true

b)

false

6.

what are some causes of epilepsy?

a)

head trauma

b)

stroke

c)

cancer

d)

fever

e)

idiopathic

7.

which is NOT a class of seizures?

a)

partial

b)

generalized

c)

status epilepticus

d)

tonic-clonic

e)

all of these are classes

8.

which is the more dominant partial seizure

a)

simple partial

b)

complex partial

9.

which generalized seizure is most common in children?

a)

grand mal seizures

b)

atonic seizures

c)

tonic seizures

d)

absence seizures

10.

which partial seizure does not lose consciousness or awareness

a)

simple partial

b)

complex partial

11.

TRUE/FALSE: atonic and tonic seizures are the complete opposite of each other

a)

true

b)

false

12.

which are generalized seizures?

a)

generalized tonic-clonic seizures

b)

clonic/myoclonic siezures

c)

absence seizures

d)

tonic/atonic seizures

13.

which generalized seizures is seen in infants with sudden, brief massive myoclonic jerk in arms and legs

a)

tonic seizures

b)

infantile

c)

atonic seizures

d)

absence seizure

14.

defined as seizure activity lasting more than 30 minutes and constituting a neurological emergency

a)

partial seizures

b)

tonic-clonic

c)

generalized seizures

d)

status epilepticus

15.

TRUE/FALSE: there is no treatment for seizures

a)

true

b)

false

16.

seizure characterized by sustained contraction of muscles throughout the body followed by periods of muscle contraction alternating with periods of relaxation

a)

generalized seizure

b)

tonic-clonic

c)

partial seizure

d)

status epilepticus

17.

TRUE/FALSE: generalized seizures are always involved in loss of consciousness

a)

true

b)

false

18.

TRUE/FALSE: seizure symptoms don't typically vary person to person, unlike other disease states.

a)

true

b)

false

19.

TRUE/FALSE: no single drug is effective for all types of seizures under ANY circumstances

a)

true

b)

false

20.

significant side effects of antiepileptic drugs

a)

sedation, ataxia

b)

various idiosyncratic

c)

potential for teratogenesis

d)

dispositional drug interactions

e)

double vision

21.

three mechanisms of antiepileptic drugs

a)

depress spontaneous and evoked neuronal activity

b)

inhibition of the sodium or calcium influx responsible for neuronal depolarization

c)

inhibition of excitatory glutamate neurotransmission

d)

Augmentation of inhibitory GABA neurotransmission

22.

TRUE/FALSE: effective pharmacotherapy of antiepileptic drugs are rarely hindered by limitations in efficacy

a)

true

b)

false

23.

which antiepileptic drugs block voltage-gated Na+ channels in the CNS and reduce the ability of neurons to fire at high frequencies

a)

phenytoin

b)

carbamazepine + lamotrigine

c)

valproic acid

d)

topiramate

e)

all of these drugs

24.

which antiepileptic drugs block T-type Ca++ channels in the CNS and reduces the ability of neurons to fire at high frequencies

a)

ethosuximide

b)

valproic acid

c)

lamotrigine

d)

phenytoin

25.

TRUE/FALSE: antiepileptic drugs enhance GABAergic activity in the CNS

a)

true

b)

false

26.

which antiepileptic drugs increase receptor response to neurotransmitter

a)

phenobarbital

b)

primidone

c)

diazepam

d)

clonazepam

e)

all these drugs

27.

which drug inhibits GABA reuptake in forebrain by selective blockade of GAT-1; increasing synaptic availability of GABA

a)

gabapentin

b)

vigabatrin

c)

tiagabine

d)

valproic acid

28.

which antiepileptic drug decreases excitatory transmission by voltage-gated calcium channels

a)

tiagabine

b)

gabapentin

c)

vigabatrin

d)

diazepam

29.

TRUE/FALSE: antiepileptic drugs tend to have a lot of side effects

a)

true

b)

false

30.

Postsynaptic targets include which two receptors

a)

NMDA

b)

AMPA

c)

ACET

d)

ACPD

31.

Do you block presynaptic targets or post synaptic targets?

a)

pre synaptic

b)

post synaptic

c)

you can block both

d)

you shouldn't block either

32.

Which is correctly paired?

a)

GABAB receptors - gabapentin

b)

GABAA receptors - benzodiazepines

c)

GABA-transaminase - vigabatrin

d)

GABA transporters - tiagabine

33.

Presynaptic targets diminishing glutamate release include

a)

voltage-gated Na+ channels

b)

voltage-gated Ca+ channels

c)

voltage-gated K+ channels

d)

NMDA receptors

34.

TRUE/FALSE: phenytoin is highly bound to plasma proteins

a)

true

b)

false

35.

blocks voltage-gated Na+ channels in the CNS to reduce ability of neurons firing at high frequencies

a)

Phenytoin

b)

valproic acid

c)

carbamazepine

d)

gabapentin

36.

TRUE/FALSE: phenytoin is generally more sedating than barbiturates

a)

true

b)

false

37.

TRUE/FALSE: phenytoin has numerous drug interactions

a)

true

b)

false

38.

TRUE/FALSE: phenytoin has a new formulation available for parenteral administration. If true, what is the drug called?

a)

True, forphenytoin

b)

false

39.

therapeutic use for phenytoin

a)

status epilepticus

b)

tonic-clonic seizures

c)

partial seizures

d)

narcolepsy

40.

what are the two most common side effects of phenytoin?

a)

diplopia

b)

ataxia

c)

hepatotoxicity

d)

teratogen

41.

TRUE/FALSE: sedation rarely occurs at high doses of phenytoin

a)

true

b)

false

42.

TRUE/FALSE: phenytoin may have teratogenic effects

a)

true

b)

false

43.

long-term use of phenytoin can cause

a)

mild peripheral neuropathy

b)

abnormal Vit D metabolism

c)

hyperplasia

d)

liver damage

44.

blocks T-type Ca++ channels in the CNS to reduce ability of neurons firing at high frequencies

a)

phenytoin

b)

valproic acid

c)

gabapentin

d)

carbamazepine

45.

TRUE/FALSE: valproic acid can also be used in bipolar disorder and migraines

a)

true

b)

false

46.

what side effect associated with valproic acid is more common in children

a)

Hirsutism

b)

hepatotoxicity

c)

sedation

d)

teratogenic effects

47.

what is the therapeutic use for valproic acid

a)

tonic-clonic seizures

b)

partial seizures

c)

absence seizures

d)

status elipticus

48.

what are some adverse effects of valproic acid

a)

possible teratogen

b)

hepatotoxicity

c)

Nausea and vomiting

d)

tremor

49.

TRUE/FALSE: valproic acid can inhibit the metabolism of other drugs and has the potential drug interactions

a)

true

b)

false

50.

TRUE/FALSE: valproic acid has an adverse effect of spina bifida

a)

true

b)

false

51.

blocks voltage-gated Na+ channels in the CNS to reduce the ability of neurons to fire at high frequencies and decrease glutamate release

a)

valproic acid

b)

gabapentin

c)

phenytoin

d)

carbamazepine

52.

TRUE/FALSE: carbamazepine is relatively safe and non-toxic

a)

true

b)

false

53.

TRUE/FALSE: Carbamazepine is not typically sedating

a)

true

b)

false

54.

TRUE/FALSE: Gabapentin doesn't have many drug interactions

a)

true

b)

false

55.

Which drug is commonly used as an add-on with carbamazepine or phenytoin?

a)

phenobarbital

b)

clonazepam

c)

valproic acid

d)

gabapentin

56.

which drug is effective in treating neuropathic pain?

a)

Epidiolex

b)

Clonazepam

c)

ethosuximide

d)

gabapentin

57.

Therapeutic use for gabapentin

a)

tonic-clonic seizures

b)

partial seizures

c)

'drop attacks' epilepsy

d)

bipolar disorder

58.

TRUE/FALSE: gabapentin is effective in refractory partial seizures when used in combo with other drugs

a)

true

b)

false

59.

TRUE/FALSE: gabapentin has numerous drug interactions

a)

true

b)

false

60.

TRUE/FALSE: gabapentin does not affect blood levels of other anticonvulsant medications

a)

true

b)

false

61.

adverse effects of gabapentin

a)

ataxia

b)

liver damage

c)

dizziness

d)

nausea

62.

TRUE/FALSE: gabapentin is not well absorbed after oral administration

a)

true

b)

false

63.

What is the therapeutic use of epidiolex?

a)

'drop attacks'

b)

insomnia

c)

partial seizures

d)

complete seizures

64.

What is the main adverse effect of epidiolex?

a)

double vision

b)

kidney disease

c)

liver disease

d)

ataxia

65.

Characteristics of 'drop attacks'

a)

none of these

b)

epilepsy events that turn to paralysis

c)

2 rare forms of epilepsy

d)

in children 2+ years old

66.

what dosage form is available for epidiolex?

a)

oral solution

b)

parental injection

c)

capsule

d)

all options

67.

what are first-line drugs for generalized seizures?

a)

valproic acid

b)

gabapentin

c)

carbamazepine

d)

phenytoin

68.

which is the drug of choice for myoclonic atonic seizures?

a)

phenobarbital

b)

valproic acid

c)

ethosuximide

d)

lamotrigine

69.

firsts choice in treating children with generalized absence seizures

a)

gabapentin

b)

phenobarbital

c)

valproic acid

d)

ethosuximide

70.

Which drugs are the first-line in treating partial seizures

a)

cabamazepine

b)

phenytoin

c)

valproic acid

d)

phenobarbital

71.

what are second-line drugs for treatment of partial seizures

a)

phenobarbital

b)

phenytoin

c)

primidone

d)

gabapentin

72.

TRUE/FALSE: gabapentin or lamotrigine can be used in combination with other antiepileptic drugs in the treatment of generalized and partial seizures.

a)

true

b)

false

73.

which drugs are used to treat status epilepticus

a)

diazepam

b)

valproic acid

c)

lorazepam

d)

carbamazepine

74.

TRUE/FALSE: In a highly resistant case of status epilepticus, you can treat it with general anesthetics

a)

true

b)

false

75.

what newer antiepileptic drug blocks NMDA receptor potentiate and has a GABAa receptor response like barbiturates

a)

felbamate

b)

gabapentin

c)

levetiracetam

d)

topiramate

76.

which newer antiepileptic drug binds selectively to the synaptic vesicular protein and regulates the release of Glu/GABA

a)

felbamate

b)

levetiracetam

c)

tiagabine

d)

topiramate

77.

TRUE/FALSE: withdrawal from anti-seizure medications should be gradually tapered to avoid increased seizure frequency and severity.

a)

true

b)

false

78.

What do all general anesthetics need to have?

a)

rapid onset

b)

rapid recovery

c)

slow onset

d)

slow recovery

79.

which is NOT a stage of anesthesia

a)

stage of analgesia

b)

stage of excitement/disinhibition

c)

stage of surgical anestshesia

d)

stage of medullary depression

e)

stage of amnesia

80.

what are the two types of anesthetics?

a)

volatile

b)

gaseous

c)

intravenous

d)

hazardous

81.

TRUE/FALSE: general anesthetics have major effects on respiration, cardiovascular, renal and hepatic systems. therefore need to be monitored very carefully.

a)

true

b)

false

82.

TRUE/FALSE: general anesthetics display no emetic effects - which also means there is no excitation or emergence phenomenon

a)

true

b)

false

83.

stage when the patient often appears to be delirious, respiration is irregular followed by regular breathing

a)

stage of analgesia

b)

stage of excitement

c)

stage of surgical anesthesia

d)

stage of medullary depression

84.

stage from regular respiration to complete cessation of spontaneous respiration

a)

stage of analgesia

b)

stage of excitement

c)

stage of surgical anesthesia

d)

stage of medullary depression

85.

stage when patient experiences analgesia without amnesia

a)

stage of analgesia

b)

stage of excitement

c)

stage of surgical anesthesia

d)

stage of medullary depression

86.

stage of severe depression of the CNS and depression of vasomotor center varying from respiratory arrest to death

a)

stage of analgesia

b)

stage of excitement

c)

stage of surgical anesthesia

d)

stage of medullary depression

87.

TRUE/FALSE: gaseous anesthetics can be used as a carrier for volatile anesthetics

a)

true

b)

false

88.

example of gaseous anesthetic

a)

isoflurane

b)

nitrous oxide

c)

propofol

d)

midazolam

89.

Select the volatile anesthetics

a)

isoflurane

b)

sevoflurane

c)

enflurane

d)

halothane

e)

all options

90.

agents vary in

a)

rate of induction

b)

degree of muscle relaxation produced

c)

potency

d)

effects on hepatic systems

91.

most widely used volatile anesthetic

a)

sevoflurane

b)

desflurane

c)

isoflurane

d)

halothane

92.

TRUE/FALSE: anesthetic drugs may increase inhibitory synaptic activity or diminish excitatory activity

a)

true

b)

false

93.

what are the putative targets of anesthetic action

a)

GABA

b)

glutamate

c)

several voltage and receptor-gated channels

d)

other neuronal synpases in the CNS

94.

TRUE/FALSE: volatile anesthetics only come in liquid form

a)

true

b)

false

95.

what are the advantages of inhaled anesthetics

a)

no affects on the heart

b)

very controllable

c)

readily reversible

d)

has zero toxicity

96.

what are some disadvantages of inhaled anesthetics

a)

induction is not smooth or fast

b)

hard to control

c)

too many drug interactions

d)

all of these

97.

Net Result(s) of anesthetic mechanism of action

a)

hyperpolarization

b)

neuronal excitation

c)

neuronal inhibition

d)

hypopolarization

98.

which describes the anesthetic mechanism of action?

a)

depress spontaneous and evoked neuronal activity

b)

GABAb receptor activation increases

c)

voltage gated K channel activation increases

d)

GABAa receptor Cl- activation increases

99.

liver toxicity is an adverse effect of what anesthetic

a)

sevoflurane

b)

halothane

c)

isoflurane

d)

nitrous oxide

100.

TRUE/FALSE: malignant hyperthermia is not an allergy, but an inherited disorder

a)

true

b)

false

101.

what occurs in genetically susceptible individuals with inhalable anesthetics combined with a neuromuscular blocking agent

(a)  

102.

TRUE/FALSE: MH interferes with the regulation of potassium in the muscle

a)

true

b)

false

103.

which drug is unstable in soda-lime

a)

desflurane

b)

sevoflurane

c)

enflurane

d)

halothane

104.

which anesthetics have medium rate of onset and recovery

a)

enflurane

b)

halothane

c)

isoflurane

d)

desflurane

e)

sevoflurane

105.

which anesthetic has low volatility, is a poor reduction agent but has rapid recovery

a)

desflurane

b)

isoflurane

c)

nitrous oxide

d)

sevoflurane

106.

which anesthetics have rapid onset and recovery

a)

nitrous oxide

b)

desflurane

c)

sevoflurane

d)

isoflurane

107.

TRUE/FALSE: nitrous oxide is an incomplete anesthetic

a)

true

b)

false

108.

which IV anesthetics provide cardiovascular stability

a)

etomidate

b)

midazolam

c)

propofol

d)

fentanyl

109.

Naloxone reversal is available for which IV anesthetic?

a)

midazolam

b)

fentanyl

c)

propofol

d)

methohexital

110.

flumazenil reversal is available for which IV anesthetic?

a)

propofol

b)

methohexital

c)

etomidate

d)

midazolam

111.

Which IV/fixed anesthetics facilitate GABAa-mediated inhibition at GABAa receptors

a)

barbiturates

b)

methohexital

c)

propofol

d)

midazolam

112.

TRUE/FALSE: barbiturates have rapid recovery following infusion

a)

true

b)

false

113.

TRUE/FALSE: barbiturates are used as standard induction agents

a)

true

b)

false

114.

TRUE/FALSE: barbiturates have easy and smooth induction

a)

true

b)

false

115.

which IV/fixed anesthetic is an ultra short-acting IV barbiturate anesthetic

a)

all barbiturates

b)

propofol

c)

midazolam

d)

methohexital

116.

therapeutic use for methohexital

a)

all the above

b)

induce anesthesia

c)

cardiovascular procedures

d)

in people with porphyrias

117.

TRUE/FALSE: methohexital has additive CNS depression with many drugs

a)

true

b)

false

118.

what is the most frequently administered drug for induction of anesthesia and has largely replaced barbiturates?

a)

ketamine

b)

fentanyl

c)

propofol

d)

midazolam

119.

What is the mechanism of action of propofol

a)

facilitates GABA-mediated inhibition at GABAa receptors

b)

facilitates GABA-mediated excitation at GABAa receptors

c)

facilitates GABA-mediated inhibition at GABAb receptors

d)

facilitates GABA-mediated excitation at GABAb receptors

120.

TRUE/FALSE: propofol has a slow onset but rapid recovery

a)

true

b)

false

121.

what are some therapeutic uses for propofol?

a)

induce anesthesia

b)

maintain anesthesia

c)

antimetic action

d)

all these options

122.

What are some adverse effects of propofol?

a)

cardiovascular depression

b)

significant decrease in BP during induction

c)

liver toxicity

d)

numerous drug interactions

123.

is midazolam a benzodiazepine

a)

yes

b)

no

124.

what are some characteristics of midazolam

a)

slow onset and recovery

b)

has longer duration than barbiturates

c)

good maintenance for anesthesia with other agents

d)

all these are characteristics

125.

Is midazolam safe for cardiac procedures?

a)

yes

b)

no

126.

TRUE/FALSE: Ketamine is a non-controlled susbstance

a)

true

b)

false

127.

which IV/fixed anesthetics blocks excitation by blocking glutamate receptor (NMDA)

a)

Ketamine

b)

fentanyl

c)

midazolam

d)

propofol

128.

ketamine causes:

a)

cardiac stimulation

b)

cardiac stability

129.

what population is ketamine limited to?

a)

elderly

b)

children

c)

male

d)

female

130.

Ketamine

a)

rapid onset and slow recovery

b)

moderately rapid onset and recovery

c)

slow onset and recovery

d)

rapid onset but slow recovery

131.

what are some additional characteristics of ketamine

a)

analgesic

b)

amnesia

c)

poor muscle relaxation

d)

increased cerebral blood flow

132.

TRUE/FALSE: emergence reactions impair recovery time of ketamine

a)

true

b)

false

133.

what are some adverse effects of ketamine

a)

increased intracranial pressure

b)

hallucination/ disorientation

c)

excitation during recovery

d)

'emergence phenomenon'

e)

all of these are adverse effects

134.

which opioid receptor does fentanyl and alfentanil interact with?

a)

mu

b)

kappa

c)

delta

d)

gamma

135.

what are some adverse effects of fentanyl or alfentanil?

a)

cardiovascular depression

b)

respiratory depression

c)

hallucinations

d)

all of these

136.

TRUE/FALSE: fentanyl and alfentanil can achieve anesthesia with sufficient dosing

a)

true

b)

false

137.

Fentanyl or alfentanil:

a)

rapid onset and recovery

b)

moderately rapid onset and recovery

c)

slow onset and recovery

d)

rapid onset but slow recovery

138.

TRUE/FALSE: ketamine is often used during bypass surgery

a)

true

b)

false

139.

what population are fentanyl and alfentanil useful in?

a)

patients with compromised CV function

b)

patients with compromised pulmonary function

c)

elderly

d)

children

140.

TRUE/FALSE: fentanyl produces marked analgesic

a)

true

b)

false

141.

what are some adverse effects of etomidate

a)

pain on injection site

b)

myoclonus

c)

nausea and vomiting

d)

cardiovascular depression

142.

which IV/fixed anesthetic stimulates GABA receptors

a)

ketamine

b)

fentanyl

c)

etomidate

d)

all options

143.

TRUE/FALSE: etomidate has minimal cardiovascular or respiratory depressant effects

a)

true

b)

false

144.

which anesthetic has rapid onset and moderately fast recovery

a)

Precedex

b)

etomidate

c)

ketamine

d)

midazolam

145.

uses for etomidate

a)

sedative

b)

induction of anesthesia

c)

balance/ maintain anesthesia

d)

patients at risk for hypotension

146.

which sedative/anesthetic is popular in outpatient

a)

dexmedetomidine

b)

ketamine

c)

etomidate

d)

all of these

147.

TRUE/FALSE: dexmedetomidine is similar to clonidine

a)

true

b)

false

148.

what are the effects of dexmedetomidine

a)

decrease NE reuptake

b)

increase NE reuptake

c)

increase 5HT reuptake

d)

decrease 5HT reuptake

149.

dexmedetomidine acts as a

a)

NMDA receptor agonist

b)

alpha 2 agonist

c)

alpha 1 agonist

d)

AMDA receptor

150.

what types of drugs can be used as preanesthetic medications?

a)

anxiolytics and hypnotics

b)

analgesics

c)

antimetics

d)

neuromuscular blocking agents

e)

beta blockers

151.

select the purpose(s) of pre-anesthetic medications

a)

increase rate of induction

b)

decrease anxiety

c)

decrease pre-post op pain

d)

decrease adverse effects of general anesthetics

e)

reduce amount of required general anesthetics

152.

what are the two groups of local anesthetics?

a)

esters

b)

amides

c)

alpha

d)

beta

153.

Which ester penetrates the membranes, is a vasoconstrictor, is medium acting, and has low potency?

a)

cocaine

b)

benzocaine

c)

procaine

d)

tetracaine

154.

which ester is used for surface use only and has low potency?

a)

benzocaine

b)

cocaine

c)

procaine

d)

tetracaine

155.

Which ester is used for infiltration and spinal block only, is short-acting and has low potency?

a)

procaine

b)

tetracaine

c)

chlorprocaine

d)

cocaine

156.

Which ester is used for spinal and epidural injections and is long-acting?

a)

cocaine

b)

benzocaine

c)

tetracaine

d)

chloroprocaine

157.

which ester is used as epidural, infiltration, and nerve block anesthesia, is short-acting and has low potency?

a)

chloroprocaine

b)

procaine

c)

benzocaine

d)

tetracaine

158.

what are amides used for in terms of local anesthetics?

a)

infiltration

b)

peripheral nerve block

c)

epidural block

d)

all of these

159.

which amide is most widely used?

a)

benzocaine

b)

lidocaine

c)

bupivicaine

d)

ropivacaine

160.

which amides are long-acting and have high potentcy

a)

bupivacaine

b)

benzocaine

c)

ropivacaine

d)

lidocaine

161.

Lidocaine, Bupivicaine, and Ropivacaine are

a)

esters

b)

amides

162.

what are some characteristics of lidocaine?

a)

high potencty

b)

long acting

c)

medium acting

d)

intermediate potency

163.

which amide is similar to lidocaine in terms of therapeutic use?

a)

procaine

b)

benzocaine

c)

ropivacaine

d)

bupivicaine

164.

therapeutic uses for local anesthetics

a)

infiltration

b)

field block

c)

spinal nerve block

d)

epidural

e)

topical application

165.

injection of local anesthetic into the tissue to be anesthetized

a)

field block

b)

infiltration

c)

spinal nerve block

d)

epidural

166.

Injection of a local anesthetic in an area bordering on the field to be anesthetized

a)

spinal nerve block

b)

field block

c)

epidural

d)

infiltration

167.

Injection into subarachnoid space

a)

infiltration

b)

spinal nerve block

c)

field block

d)

epidural

168.

TRUE/FALSE: pain is blocked first (in local anesthetics)

a)

true

b)

false

169.

when Na channels are blocked, action potentials cannot propagate along the neuronal fiber... what happens to the sensory input?

a)

no affect on sensory input

b)

accumulation of sensory input

c)

sensory input is lost

170.

what is the Mechanism of Action of local anesthetics?

a)

blocks voltage-gated Na channels

b)

blocks voltage-gated Ca channels

c)

blocks ligand-gated Na channels

d)

blocks voltage-gated Cl channels

171.

which neurons are affect first?

a)

large diameter neurons

b)

small diameter neurons

c)

protons

d)

electrons

172.

what are CNS adverse effects of local anesthetics?

a)

CNS stimulation

b)

excitation

c)

convulsion

d)

hallucinations

173.

what are some adverse effects of CVS for local anesthetics?

a)

depression of myocardial conduction and peripheral vascular tone

b)

hypotension

c)

arrhythmias

d)

irregular heartbeat

174.

TRUE/FALSE: esters can cause allergic reactions to local anesthetics in response to metabolites

a)

true

b)

false

175.

where are local anesthetics metabolized?

a)

liver

b)

kidney

c)

blood

176.

TRUE/FALSE: sensitivity to local anesthetics is decreased during pregnancy

a)

true

b)

false

177.

how are local anesthetics excreted

a)

urinary

b)

excreted unchanged

178.

how could you increase the duration of action of local anesthetics?

a)

add a vasoconstrictor

b)

add a vasodilator

c)

use combination products

d)

none of these

179.

which local anesthetics are short-acting?

a)

procaine

b)

tetracaine

c)

lidocaine

d)

benzocaine

180.

select the medium-acting local anesthetics

a)

procaine

b)

lidocaine

c)

mepivacaine

d)

cocaine

e)

benzocaine

181.

select the long-acting local anesthetics

a)

bupivacaine

b)

ropivacaine

c)

tetracaine

d)

mepivacaine

182.

Which spasmolytic drug has the longest duration (12-24 hours)

a)

dantrolene

b)

tizanidine

c)

diazepam

d)

cyclobenzaprine

e)

baclofen

183.

which spasmolytic drug is also a direct-acting muscle relaxant

a)

cyclobenzaprine

b)

baclofen

c)

diazepam

d)

tizanidine

e)

dantrolene

184.

Which spasmolytic drug has an adverse effect of strong antimuscarinic effects?

a)

cyclobenzaprine

b)

baclofen

c)

diazepam

d)

tizanidine

e)

dantrolene

185.

how is baclofen given?

a)

orally

b)

intathecally

c)

IV

d)

rectally

186.

how is Dantrolene given?

a)

orally

b)

intrathecally

c)

IV

d)

rectally

187.

which spasmolytics have an adverse effect of sedation?

a)

baclofen

b)

diazepam

c)

tizanidine

d)

dantrolene

e)

cyclobenzaprine

188.

which spasmolytics can cause weakness

a)

baclofen

b)

tizanidine

c)

cyclobenzaprine

d)

diazepam

e)

dantrolene

189.

which spasmolytics are used for cerebral palsy

a)

baclofen

b)

cyclobenzaprine

c)

diazepam

d)

tizanidine

e)

dantrolene

190.

which spasmolytics are used for MS?

a)

baclofen

b)

cyclobenzaprine

c)

diazepam

d)

tizanidine

e)

dantrolene

191.

which spasmolytics can cause a stroke?

a)

baclofen

b)

cyclobenzaprine

c)

diazepam

d)

tizanidine

e)

dantrolene

192.

which spasmolytics are used for spinal cord injury

a)

baclofen

b)

cyclobenzaprine

c)

diazepam

d)

tizanidine

e)

dantrolene

193.

Cyclobenzaprine metabolism:

a)

hepatic

b)

renal

c)

3-6 hours

d)

4-6 hours

194.

diazepam metabolism:

a)

hepatic

b)

renal

c)

12-24h

d)

3-6 h

195.

Tizanidine metabolism

a)

hepatic

b)

renal

c)

3-6 h

d)

4-6 h

196.

dantrolene metabolism

a)

hepatic

b)

renal

c)

4-6 h

d)

3-6 h

197.

baclofen:

a)

GABAb agonist

b)

GABAa agonist

c)

alpha 2 agonist

d)

RyR1 Ca antagonist

198.

Diazepam

a)

GABAb

b)

GABAa

c)

alpha 2 agonist

d)

RyR1 Ca antagonist

199.

tizanidine

a)

GABAb agonist

b)

GABAa agonist

c)

alpha 2 agonist

d)

RyR1 Ca antagonist

200.

dantrolene

a)

GABAb agonist

b)

GABAa agonist

c)

alpha2 agonist

d)

RyR1 Ca antagonist

201.

what symptoms are considered to be the hallmark motor features of idiopathic PD?

a)

tremor

b)

rigidity

c)

bradykinesia

d)

postural instability

202.

TRUE/FALSE: prevalence of parkinson's disease increases with age

a)

true

b)

false

203.

TRUE/FALSE: there is a higher incidence reported in females

a)

true

b)

false

204.

TRUE/FALSE: cognitive decline occurs in many patients as the disease advances

a)

true

b)

false

205.

TRUE/FALSE: the etiology of Parkinson's Disease is unknown

a)

true

b)

false

206.

what contributes to developing Parkinson's Disease?

a)

aging

b)

genetic

c)

environmental factors

d)

all of these

207.

Neuronal vulnerability in PD extends beyond the nigrostriatal pathway and includes specific neurons where?

a)

autonomic ganglia

b)

basal ganglia

c)

spinal cord

d)

neocortex

208.

what are the 4 dopaminergic pathways/systems?

a)

nigrostriatal

b)

mesolimbic

c)

mesocortical

d)

tuberoinfundibular

209.

which dopaminergic pathways controls voluntary movement?

a)

nigrostriatal

b)

mesolimbic

c)

mesocortical

d)

tuberoinfundibular

210.

which dopaminergic pathway that controls reward and addictive behavior

a)

nigrostriatal

b)

mesolimbic

c)

mesocortical

d)

tuberoinfundibular

211.

which dopaminergic pathway controls motivational, cognitive, and emotional behavior

a)

nigrostriatal

b)

mesolimbic

c)

mesocortical

d)

tuberoinfundibular

212.

which dopaminergic pathway controls prolactin secretion

a)

nigrostriatal

b)

mesolimbic

c)

mesocortical

d)

tuberoinfundibular

213.

TRUE/FALSE: In Parkinson's Disease, there is a decrease in cholinergic function in the corpus striatum

a)

true

b)

false

214.

TRUE/FALSE: there is selective loss of dopamine neurons in the corpus striatum

a)

true

b)

false

215.

TRUE/FALSE: balance between D1 and D2 is important for the greatest efficacy

a)

true

b)

false

216.

what is the interaction that occurs between D1 and D2?

a)

permissive

b)

synergistic interaction

c)

direct

d)

none of these options

217.

what is the first therapeutic strategy to treat Parkinson's Disease

a)

replace dopamine by L-DOPA

b)

increase dopamine function

c)

reduce cholinergic symptoms

d)

potentiate dopamine function

218.

what is the second therapeutic strategy to treat Parkinson's Disease

a)

replace dopamine by L-DOPA

b)

increase dopamine function

c)

reduce cholinergic symptoms

d)

potentiate dopamine function

219.

what are other therapeutic strategies to treat Parkinson's Disease

a)

replace dopamine by L-DOPA

b)

increase dopamine function

c)

reduce some cholinergic sumptoms

d)

potentiate dopamine function

220.

what drugs would we use to reduce cholinergic symptoms?

a)

COMT inhibitors

b)

antiviral

c)

MAO inhibitors

d)

antimuscarinic drugs

221.

how do we potentiate dopamine function?

a)

influence synthesis

b)

release and reuptake of dopamine

c)

antiviral drug

d)

all of these

222.

TRUE/FALSE: dopamine can cross the BBB

a)

true

b)

false

223.

what is the precursor for dopamine?

(a)  

224.

what are some behavioral pharmacological effects of L-DOPA

a)

sense of well-being

b)

anxiety relief

c)

improved mental function

d)

works as antidepressant

225.

what is an adverse effect of the neuroendocrine system when trying to replace dopamine?

a)

postural hypotension

b)

nausea

c)

migraines

d)

deceased prolactin secretion

226.

what is the cardiovascular side effects of replacing dopamine?

a)

decreased prolactin secretion

b)

postural hypotention

c)

nausea

d)

vomiting

227.

what are very common GIT adverse effects of replacing dopamine?

a)

dyskenesias

b)

nausea and vomiting

c)

migraines

d)

upset stomach

228.

L-DOPA is always administered with (a)  

229.

mechanism of action of carbidopa

a)

blocks aromatic L-aromatic acid decarboxylase in the periphery

b)

increases L-DOPA in the brain

c)

decreases L-DOPA in the brain

d)

decreases the dosing therefore the GIT side effects

230.

Patients who are treated with L-DOPA on a long-term basis develop _______ as a result of excessive dopamine concentrations in the striatum

a)

cardiovascular depression

b)

malignant hypotension

c)

dyskinesias

d)

all of these symptoms

231.

which classes of drugs help to increase dopamine function?

a)

dopamine agonist

b)

MAO Inhibitors

c)

COMT inhibitors

d)

all of these

232.

what are the specific drugs discussed that are dopamine agonists

a)

pramipexole

b)

ropinerole

c)

propranolol

d)

bromocriptine

233.

therapeutic use of dopamine agonists

a)

act as D3 agonist

b)

act as D2 agonist

c)

increase efficacy of L-DOPA

d)

all of these

234.

TRUE/FALSE: dopamine agonists can only be used as mono-therapy

a)

true

b)

false

235.

What are some adverse effects of dopamine agonists?

a)

nausea and vomiting

b)

postural hypotension

c)

hallucinations

d)

dyskinesias

e)

confusion

236.

TRUE/FALSE: activity at the D2 receptor may confer greater efficacy and may mediate neuroprotective effects

a)

true

b)

false

237.

What are the drugs discussed under MAO inhibitors

a)

selegiline

b)

rasagiline

c)

pramipexole

d)

bromocriptine

238.

Which MAO does selegiline inhibit?

a)

MAO-A

b)

MAO-B

239.

TRUE/FALSE: MAO-Inhibitors increase the efficacy of L-DOPA and to decrease L-DOPA dose

a)

true

b)

false

240.

Which class used to increase dopamine function may cause serotonin syndrome with meperidine and possibly with SSRIs and TCAs?

a)

COMT inhibitors

b)

MAO inhibtiors

c)

dopamine agonists

d)

other agents

241.

TRUE/FALSE: MAO inhibitors block the metabolism of dopamine

a)

true

b)

false

242.

Adverse effects of COMT inhibitors:

a)

increased L-DOPA toxicity

b)

nausea

c)

dyskinesias

d)

confusion

243.

What drugs are part of other strategies to treat Parkinson’s disease?

a)

anticholinergics

b)

antiviral

c)

antidepressants

d)

sedatives

244.

Which anticholinergics did we cover in class for treating Parkinson’s Disease?

a)

trihexyphenidyl

b)

benztropine

c)

amantadine

d)

haloperidol

245.

What are some adverse effects of trihexyphenidyl and benztropine?

a)

constipation

b)

urinary hesitance

c)

retention

d)

mental confusion

e)

hallucinations

246.

Which class has the mechanism of action of striatal interneurons by antagonizing cholinergic (muscarinic) receptors?

a)

anticholinergics

b)

antiviral

247.

What is the antiviral drug we talked about?

(a)  

248.

TRUE/FALSE: amantadine have the opposite adverse effects of dopamine agonists.

a)

true

b)

false

249.

Which class may increase dopamine function and/or have antimuscarinic effects?

a)

antiviral

b)

anticholinergic

250.

Which drug often produces drug-induced Parkinsonism?

a)

amantadine

b)

haloperidol

c)

benztropine

d)

pramipexole

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