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Principles of NS Pharmacology 102925

Total questions: 101

Worksheet time: 51mins

Name
Class
Date
1.

The main functional cells of the nervous system are:

a)

Erythrocytes

b)

Neurons

c)

Chondrocytes

d)

Osteoclasts

2.

Which glial cell forms myelin in the CNS?

a)

Schwann cell

b)

Oligodendrocyte

c)

Astrocyte

d)

Microglia

3.

Primary immune cells of the CNS are:

a)

Astrocytes

b)

Microglia

c)

Ependymal cells

d)

Satellite cells

4.

The BBB restricts passage mainly via:

a)

Fenestrated capillaries

b)

Tight junctions of endothelial cells

c)

Lymphatic drainage

d)

Loose basement membrane

5.

A typical resting neuronal membrane potential is about:

a)

+30 mV

b)

0 mV

c)

–70 mV

d)

–10 mV

6.

Depolarization of a neuron is primarily due to:

a)

Cl– influx

b)

Na+ influx

c)

K+ efflux

d)

Ca2+ efflux

7.

Repolarization during an action potential is mainly caused by:

a)

Na+ influx

b)

K+ efflux

c)

Ca2+ influx

d)

Cl– efflux

8.

Absolute refractory period occurs because:

a)

K+ channels are closed

b)

Na+ channels are inactivated

c)

Ca2+ channels are open

d)

Cl– channels are blocked

9.

Saltatory conduction occurs in:

a)

Unmyelinated axons

b)

Dendrites only

c)

Myelinated axons at nodes of Ranvier

d)

Cell bodies

10.

The PNS myelinating cell is the:

a)

Oligodendrocyte

b)

Schwann cell

c)

Astrocyte

d)

Microglia

11.

Which ion triggers neurotransmitter vesicle fusion?

a)

Na+

b)

K+

c)

Ca2+

d)

Cl–

12.

Electrical synapses primarily use:

a)

Chemical transmitters

b)

Gap junctions

c)

Second messengers

d)

Receptors

13.

The BBB permits easiest entry of:

a)

Large polar molecules

b)

Charged peptides

c)

Lipophilic small molecules

d)

Plasma proteins

14.

Gray matter is rich in:

a)

Myelinated axons

b)

Neuronal cell bodies and synapses

c)

Collagen

d)

CSF

15.

A demyelinating disease of the CNS that impairs conduction is:

a)

Guillain–Barré syndrome

b)

Multiple sclerosis

c)

Myasthenia gravis

d)

Lambert–Eaton syndrome

16.

The principal excitatory neurotransmitter in the CNS is:

a)

GABA

b)

Glycine

c)

Glutamate

d)

Acetylcholine

17.

The main inhibitory transmitter in the brain is:

a)

Dopamine

b)

GABA

c)

Glutamate

d)

Serotonin

18.

Dopamine is synthesized from:

a)

Tryptophan

b)

Tyrosine

c)

Choline

d)

Histidine

19.

Serotonin (5-HT) is synthesized from:

a)

Tyrosine

b)

Tryptophan

c)

Glutamine

d)

Phenylalanine

20.

Termination of catecholamine action mainly involves:

a)

Diffusion only

b)

Reuptake by transporters

c)

Hydrolysis by AChE

d)

Binding to albumin

21.

MAO and COMT are enzymes that:

a)

Synthesize serotonin

b)

Degrade catecholamines

c)

Synthesize acetylcholine

d)

Degrade GABA

22.

22. VMAT loads monoamines into:

a)

A) Synaptic cleft

b)

B) Vesicles

c)

C) Mitochondria

d)

D) Nucleus

23.

Glycine is an important inhibitory transmitter mainly in the:

a)

Cortex

b)

Spinal cord and brainstem

c)

Hippocampus

d)

Cerebellar cortex only

24.

Acetylcholine is degraded by:

a)

MAO

b)

COMT

c)

Acetylcholinesterase

d)

Tyrosine hydroxylase

25.

Which transmitter is a gas and diffuses freely across membranes?

a)

NO

b)

NE

c)

ACh

d)

GABA

26.

Neuropeptide transmitters are typically:

a)

Synthesized at terminals

b)

Stored in small clear vesicles

c)

Degraded by peptidases after release

d)

Recycled by high-affinity transporters

27.

Co-transmission implies:

a)

A) A neuron releases only one transmitter

b)

B) Same vesicle always carries two transmitters

c)

C) Neuron can release classical transmitter plus a peptide

d)

D) Only peptides are released

28.

SSRIs primarily increase synaptic levels of:

a)

NE

b)

DA

c)

5-HT

d)

ACh

29.

Levodopa increases brain dopamine because it:

a)

Inhibits MAO-B

b)

Directly activates D2 receptors

c)

Crosses BBB and is converted by AADC

d)

Blocks DAT

30.

Donepezil’s therapeutic effect is via inhibition of:

a)

COMT

b)

AChE

c)

MAO-A

d)

GABA-T

31.

Ionotropic receptors are:

a)

Enzymes

b)

Ligand-gated ion channels

c)

GPCRs

d)

Nuclear receptors

32.

Metabotropic receptors signal via:

a)

Direct ion flux

b)

GPCR second messengers

c)

Voltage sensors

d)

Pumps

33.

NMDA receptor requires glutamate and:

a)

GABA

b)

Glycine/D-serine co-agonist

c)

ACh

d)

NE

34.

At resting potentials, NMDA channels are blocked by:

a)

Na+

b)

Ca2+

c)

Mg2+

d)

Cl–

35.

AMPA receptors primarily conduct:

a)

Cl–

b)

Na+ (and some Ca2+)

c)

K+ only

d)

HCO3–

36.

Nicotinic receptors are:

a)

GPCRs

b)

Tyrosine kinases

c)

Ligand-gated cation channels

d)

Voltage-gated channels

37.

Muscarinic receptors are:

a)

Ionotropic

b)

GPCRs

c)

Nuclear receptors

d)

Transporters

38.

D1-like dopamine receptors couple to:

a)

Gi → ↓cAMP

b)

Gq → ↑IP3

c)

Gs → ↑cAMP

d)

Go → ↓Ca2+

39.

5-HT1A typically couples to:

a)

Gs

b)

Gi

c)

Gq

d)

G12/13

40.

β1-adrenoceptors primarily signal via:

a)

Gs → ↑cAMP

b)

Gi → ↓cAMP

c)

Gq → ↑IP3/DAG

d)

Ion channel opening directly

41.

Receptor desensitization after prolonged agonist exposure often involves:

a)

Channel opening

b)

β-arrestin and internalization

c)

Increased gene transcription

d)

Enhanced G protein coupling

42.

Allosteric modulators bind:

a)

Orthosteric site

b)

Active ion pore

c)

Distinct site altering response

d)

DNA

43.

Benzodiazepines act at which receptor class?

a)

NMDA receptor orthosteric site

b)

GABA_A allosteric site

c)

GABA_B GPCR

d)

AMPA receptor

44.

Ketamine is an antagonist at:

a)

AMPA

b)

NMDA

c)

GABA_A

d)

5-HT3

45.

Clozapine mainly targets:

a)

D2 only

b)

5-HT2A and D2 (multireceptor)

c)

NMDA

d)

α4β2 nAChR

46.

Vesicle docking is mediated by:

a)

SNARE proteins

b)

Na+/K+ pump

c)

Tubulin

d)

Dynein

47.

Ca2+ sensor for vesicle fusion is primarily:

a)

Synaptophysin

b)

Synaptotagmin

c)

Dynamin

d)

Clathrin

48.

Endocytosis of vesicles after release requires:

a)

Clathrin and dynamin

b)

SNAREs

c)

NMDA receptors

d)

Na+ channels

49.

A reuptake inhibitor increases transmitter by:

a)

Enhancing degradation

b)

Blocking transporter

c)

Blocking synthesis

d)

Activating autoreceptors

50.

Autoreceptors typically:

a)

Enhance release

b)

Inhibit further release

c)

Degrade transmitter

d)

Open voltage-gated Na+ channels

51.

EPSPs are usually mediated by:

a)

Cl− influx

b)

Na+/Ca2+ influx

c)

K+ efflux only

d)

Pump activity

52.

IPSPs often involve:

a)

Na+ influx

b)

Ca2+ influx

c)

Cl− influx or K+ efflux

d)

HCO3− influx exclusively

53.

Desensitization reduces response to:

a)

Antagonists

b)

Agonists after sustained exposure

c)

Placebo

d)

Inverse agonists only

54.

Potency is best reflected by:

a)

E_max

b)

EC50/ED50

c)

Hill slope

d)

Therapeutic index only

55.

Efficacy is:

a)

Maximal effect (E_max) a drug can produce

b)

Concentration to produce 50% effect

c)

Binding affinity alone

d)

Slope of dose–response

56.

Competitive antagonism shifts the dose–response curve:

a)

Left, ↓E_max

b)

Right, same E_max

c)

Down, ↓E_max

d)

Left, same E_max

57.

Irreversible antagonists typically:

a)

Reduce E_max

b)

Shift right only

c)

Increase potency

d)

Have no effect

58.

Cocaine increases synaptic monoamines by blocking:

a)

MAO

b)

Vesicular transport

c)

Reuptake transporters (DAT/NET/SERT)

d)

COMT

59.

Botulinum toxin impairs release by cleaving:

a)

Voltage-gated Ca2+ channels

b)

SNARE proteins

c)

GABA_A subunits

d)

DAT

60.

Reserpine depletes monoamines by inhibiting:

a)

VMAT

b)

MAO

c)

COMT

d)

Tyrosine hydroxylase

61.

Benzodiazepines enhance:

a)

GABA_B currents

b)

GABA_A receptor Cl− channel opening frequency

c)

NMDA currents

d)

AMPA currents

62.

Barbiturates mainly:

a)

Block DAT

b)

Prolong GABA_A channel open time

c)

Antagonize NMDA

d)

Activate 5-HT3

63.

Methylxanthines (e.g., caffeine) primarily:

a)

Inhibit AChE

b)

Antagonize adenosine receptors

c)

Block Na+ channels

d)

Enhance GABA

64.

Amphetamines increase synaptic monoamines by:

a)

Blocking MAO only

b)

Reversing transporters and releasing vesicular stores

c)

Inhibiting AChE

d)

Blocking NMDA

65.

General anesthetics typically:

a)

Increase CNS excitability

b)

Enhance inhibitory or reduce excitatory transmission

c)

Block all GPCRs

d)

Only block Na+ channels

66.

Sedative vs hypnotic distinction is primarily by:

a)

Mechanism

b)

Dose producing calming vs sleep

c)

Route of administration

d)

Half-life

67.

Physical dependence risk increases with:

a)

Short half-life and rapid CNS entry

b)

Long half-life

c)

Poor oral absorption

d)

Peripheral action

68.

Overdose with benzodiazepines is most dangerous when combined with:

a)

Antihistamines

b)

Opioids/alcohol

c)

SSRIs

d)

Antacids

69.

Tolerance to barbiturates includes:

a)

Enzyme induction and receptor adaptation

b)

Only receptor upregulation

c)

Only enzyme inhibition

d)

No tolerance

70.

Which is a wake-promoting agent targeting DAT/NET modestly?

a)

Modafinil

b)

Diazepam

c)

Propofol

d)

Phenobarbital

71.

Flumazenil is a/an:

a)

Benzodiazepine agonist

b)

Benzodiazepine antagonist

c)

Barbiturate antagonist

d)

Opioid antagonist

72.

Propofol’s major CNS action is:

a)

NMDA antagonism

b)

GABA_A potentiation

c)

Na+ channel block

d)

5-HT1A agonism

73.

Methylphenidate primarily:

a)

Inhibits MAO-B

b)

Blocks DAT/NET reuptake

c)

Blocks SERT only

d)

Activates α2 autoreceptors

74.

Z-drugs (zolpidem) preferentially act at:

a)

GABA_B

b)

GABA_A α1 subunit sites

c)

NMDA

d)

H1 receptors

75.

The stimulant with greatest risk of psychosis at high doses:

a)

Caffeine

b)

Modafinil

c)

Amphetamines

d)

Melatonin

76.

Parkinson’s disease involves loss of neurons in the:

a)

Locus coeruleus

b)

Substantia nigra pars compacta

c)

Raphe nuclei

d)

Amygdala

77.

Levodopa is combined with carbidopa to:

a)

Increase central conversion and reduce peripheral side effects

b)

Inhibit COMT centrally

c)

Block MAO-B

d)

Reduce tolerance

78.

Alzheimer’s hallmark pathology includes:

a)

Lewy bodies

b)

β-amyloid plaques and tau tangles

c)

Pick bodies

d)

Tuberous sclerosis

79.

Epileptic discharges reflect:

a)

Hypopolarization

b)

Abnormal synchronized neuronal firing

c)

Decreased excitability

d)

Purely glial dysfunction

80.

First-line therapy for absence seizures targets:

a)

Na+ channels

b)

T-type Ca2+ channels

c)

NMDA receptors

d)

GABA_B only

81.

Major depression is associated with:

a)

Excess monoamines

b)

Deficits/dysregulation in monoaminergic signaling

82.

Schizophrenia positive symptoms relate to:

a)

Reduced glutamate

b)

Excess mesolimbic dopamine activity

c)

Low serotonin

d)

Low NE

83.

Neuropathic pain responds best to:

a)

NSAIDs only

b)

Anticonvulsants/SNRIs/TCAs

c)

Acetaminophen only

d)

Placebo

84.

Levodopa long-term use commonly causes:

a)

Nephrotoxicity

b)

Dyskinesias and motor fluctuations

c)

Agranulocytosis

d)

Severe rash

85.

Valproate’s broad antiepileptic effect involves:

a)

Only Na+ channel block

b)

Na+ channel block + ↑GABA + T-type effects

c)

Only GABA-A agonism

d)

Only NMDA block

86.

SSRIs treat depression by:

a)

Inhibiting 5-HT reuptake

b)

Blocking MAO-A

c)

Blocking NMDA

d)

Activating D2 receptors

87.

Atypical antipsychotics reduce EPS risk largely due to:

a)

Pure D2 blockade

b)

5-HT2A antagonism with moderate D2 block

c)

NMDA agonism

d)

GABA_B agonism

88.

Triptans relieve migraine via:

a)

D2 agonism

b)

5-HT1B/1D agonism causing cranial vasoconstriction and ↓neuropeptide release

c)

H1 antagonism

d)

β2 agonism

89.

For acute status epilepticus first choice is:

a)

Ethosuximide

b)

Lorazepam/diazepam

c)

Lamotrigine

d)

Levetiracetam only

90.

Cholinesterase inhibitors in AD most improve:

a)

Motor symptoms

b)

Cognitive/behavioral symptoms modestly

c)

Disease progression halt

d)

Hallucinations only

91.

Sympathetic postganglionic transmitter to most organs is:

a)

ACh

b)

NE

c)

Dopamine

d)

Serotonin

92.

Parasympathetic postganglionic transmitter is:

a)

NE

b)

ACh

c)

DA

d)

5-HT

93.

Heart rate increase is mediated primarily by:

a)

M2 activation

b)

β1 activation

c)

α1 activation

d)

M3 activation

94.

Bronchoconstriction is mediated by:

a)

β2

b)

α1

c)

M3

d)

D1

95.

Mydriasis (radial muscle) is via:

a)

M3

b)

β2

c)

α1

d)

M2

96.

Bladder detrusor contraction uses:

a)

β3

b)

M3

c)

α1

d)

D2

97.

β2 stimulation in bronchi causes:

a)

Constriction

b)

Dilation

c)

Secretion

d)

Edema

98.

α2 autoreceptor activation generally:

a)

Increases NE release

b)

Decreases NE release

c)

No effect

d)

Increases ACh release

99.

Cholinesterase inhibitors will:

a)

Decrease secretions

b)

Increase parasympathetic tone

c)

Cause mydriasis

d)

Tachycardia always

100.

Atropine blocks:

a)

Nicotinic receptors

b)

Muscarinic receptors

c)

α receptors

d)

β receptors

101.

Phenylephrine primarily stimulates

a)

β1

b)

β2

c)

M3

d)

α1

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