WorksheetsAutonomic Nervous System Post Quiz
Total questions: 30
Worksheet time: 10mins
Which neurotransmitter is released from preganglionic sympathetic fibers?
Acetylcholine
Norepinephrine
Epinephrine
Dopamine
The primary neurotransmitter of postganglionic sympathetic fibers is:
Acetylcholine
Norepinephrine
Dopamine
Serotonin
Which receptor subtype mediates increased heart rate and contractility?
α1
β1
β2
M2
Which muscarinic receptor subtype is located in the heart?
M1
M2
M3
M5
The adrenal medulla secretes primarily:
Acetylcholine
Dopamine
Epinephrine
Norepinephrine
The neurotransmitter removed by reuptake into nerve terminals is:
Acetylcholine
Norepinephrine
Dopamine
Serotonin
Nicotinic receptors at the neuromuscular junction are classified as:
Nn
Nm
M2
M3
Which enzyme degrades acetylcholine in the synaptic cleft?
Monoamine oxidase
Catechol-O-methyltransferase
Acetylcholinesterase
Dopamine hydroxylase
Which adrenergic receptor subtype causes vasodilation in skeletal muscle?
α1
β1
β2
M3
Parasympathetic preganglionic fibers originate from:
Thoracolumbar region
Craniosacral region
Lumbar spinal cord only
Cervical spinal cord
A patient develops severe bradycardia after spinal anesthesia. Which drug is least effective?
Atropine
Ephedrine
Glycopyrrolate
Epinephrine
Why does atropine occasionally cause paradoxical bradycardia at low doses?
It blocks presynaptic muscarinic receptors
It blocks postsynaptic β1 receptors
It enhances vagal outflow
It stimulates nicotinic ganglia
In a patient with pheochromocytoma, which drug is contraindicated?
Atropine
Scopolamine
Glycopyrrolate
Phenoxybenzamine
Which muscarinic antagonist does not cross the blood-brain barrier?
Atropine
Scopolamine
Glycopyrrolate
Diphenhydramine
A patient develops central anticholinergic syndrome after scopolamine. Which drug is treatment of choice?
Neostigmine
Physostigmine
Pyridostigmine
Atropine
Why is atropine contraindicated in narrow-angle glaucoma?
It decreases aqueous humor formation
It increases outflow via trabecular meshwork
It causes pupillary dilation, narrowing iridocorneal angle
It lowers intraocular pressure
Which muscarinic antagonist produces the greatest CNS sedation and amnesia?
Atropine
Scopolamine
Glycopyrrolate
Ipratropium
Which of the following explains atropine's ability to increase HR?
Direct β1 stimulation
Inhibition of vagal outflow
Blockade of presynaptic muscarinic inhibition of NE release
Both B and C
In which patient population should atropine be avoided due to risk of hyperthermia?
Elderly
Febrile patients
Trauma patients
Patients with renal failure
Why is glycopyrrolate favored during reversal of neuromuscular blockade?
It crosses the BBB
It avoids CNS side effects
It causes intense tachycardia
It increases seizure threshold
A trauma patient with hemorrhagic shock cannot tolerate volatile anesthetics. Which drug can provide amnesia without cardiovascular depression?
Atropine
Glycopyrrolate
Scopolamine
Neostigmine
A patient with atropine toxicity presents with delirium, mydriasis, and dry skin. What is the most specific antidote?
Flumazenil
Naloxone
Physostigmine
Neostigmine
Which receptor subtype is most responsible for bronchoconstriction?
M1
M2
M3
β2
Which sympathetic receptor subtype regulates lipolysis in adipose tissue?
α1
β1
β2
β3
During administration of neostigmine for reversal, atropine is co-administered to prevent:
Tachycardia
Bronchodilation
Muscarinic side effects (bradycardia, secretions)
Hypertension
Which muscarinic antagonist is most associated with postoperative delirium in elderly patients?
Atropine
Scopolamine
Glycopyrrolate
Tiotropium
What explains paradoxical bronchospasm after atropine administration in some patients?
β2 blockade
Vagal stimulation
Incomplete muscarinic blockade → unopposed M1 stimulation
Release of histamine
A patient with thyrotoxicosis develops tachycardia. Which antimuscarinic should be avoided?
Atropine
Scopolamine
Glycopyrrolate
Ipratropium
Sweat glands are unique in that they are:
Adrenergic, β2 mediated
Adrenergic, α1 mediated
Cholinergic but under sympathetic control
Cholinergic under parasympathetic control
Which best explains why physostigmine is effective in treating central anticholinergic syndrome, while neostigmine is not?
Longer duration of action
Tertiary amine → crosses BBB
Stronger cholinesterase inhibition
Greater muscarinic selectivity
