BigBrother CNS Pharmacology Qs

CNS

PHARMACOLOGY Questions For 3rd year

General anesthetics

Previous exams & Formatives:

1- One of the following anesthetic drug increase heart rate and blood pressure:

a) Enflurane b) Halothane c) ketamine d) Lidocaine

2- Malignant hyperthermia syndrome is manifested by the following signs except?

a) Hyperthermia b) Muscular relaxation c) Tachycardia d) Metabolic acidosis

3- One of the following drugs induce dissociative anesthesia: a) enflurane b) halothane c) ketamine d) lidocaine

4- One of the following drugs induce anesthesia rapidly but irritate tracheobronchial tree: a) enflurane b) desflurane c) isoflurane d) lidocaine

1-c 2-b 3-c 4-b

Extra questions:

1. One of the following drugs sensitizes myocardium to arrhythmogenic effects of epinephrine; a) Atropine b) Halothane c) Desflurance d) Lidocaine

2. Malignant hyperthermia syndrome is treated with; a) Adrenaline b) Atropine c) Dantrolene d) Ca

3. Which of the following anesthetics have rapid onset and recovery? a) Halothane b) Sevoflurane c) Ketamine d) Enflurane

4. Which of the following inhalational anesthetics has a Significant analgesic effect? a) Nitrous oxide b) Halothane c) Desflurane d) Isoflurane

5. Considering enflurane , halothane, and isoflurane cardiac output is well maintained with: a) enflurane b) halothane c) isoflurane

6. Which of the following is not an adverse effect of halothane? a) Hepatotoxicity b) Nephrotoxicity

c) Sensitization of the heart to the arrythmogenic effect of catecholamines d) Increased intracranial pressure

1-b 2-c 3-b 4-a 5-c 6-b

7. Which of the following inhalational anesthetics is most suitable for outpatient procedures?

a) Enflurane b) Isoflurane c) Desflurane d) Sevoflurane

8. Which of the following is a sign of deep anesthesia?

a. appearance of tears in eyes b. resistance to passive inflation c. fall in blood pressure d. patient make swallowing movements

9. Which of the following anesthetics causes malignant hyperthermia as its rare complications?

a. ketamine b. halothane c. thiopentone sodium d. Ether

10. A 33-year-old man undergoes sinus surgery under general anesthesia. Which of the Following anesthetic agents exits the body most quickly after administration? Select one: a) Isoflurane b) Nitrous oxide c) Halothane d) Enflurane e) Lidocaine

breathing pattern became regular. Under which stage of anesthesia does this fall? Select one: a) Stage II b) Stage III c) Stage V. d) Stage IV e) Stage I

7-c 8-c 9-b 10-b 11-b

12. A 43-year-old man is stabbed in the chest and is brought to the emergency department for evaluation. Because of hemodynamic instability, he is brought to the operating room for thoracotomy. An adequate anesthesia history could not be obtained from the patient No family member was present at the time of surgery. Upon induction of anesthesia with succinylcholine, the patient’s heart rate increased to 150 beats/ minute and experienced muscular rigidity. What is the most appropriate treatment for this patient?Select one: a) Succinylcholine intravenous drip at steady state b) Dantrolene c) Rapid warming with blanket d) Tubocurarine intravenous bolus e) Sodium bicarbonate administered intravenously

13. All of the following are inhalational general anesthetics EXCEPT Select one: a) Halothane b) Isoflurane c) Enflurane d) Propofol e) Nitrous oxide

15. Enflurane;

a) Widely used in pediatric cases b) may cause concern if patient has a seizure-disorder history c) skeletal muscle relaxation: inadequate for surgery d) Difficult adjustment of anesthesia depth due to significant effects on pulse and respiration

12-b 13-d 14-c 15-b

16. Four stages of general anesthesia:

a) medullary depression b) surgical anesthesia c) Excitement d) Analgesia e) all of the above

17. Apnea, non-reacted dilated pupils, circulatory failure, and hypertension are most likely associated with this stage of general anesthesia: a) analgesia b) delirium c) surgical anesthesia d) medullary depression

18. Central gaze, constricted pupils, regular aspirations, and the anesthetic depth is sufficient that noxious stimuli does not cause reflexes or excessive autonomic effects a) analgesia b) delirium c) surgical anesthesia d) medullary depression

19. Desflurane anesthesia:

a) associated with laryngospasm and coughing b) relatively high solubility c) typically provides adequate muscle relaxation d) malignanthyperthermia may be a problem,as with enflurane .

20. Hallucinations are seen after ________ anesthesia? a. Ketamine b. Thiopentone c. Tentanyl d. Nitrous oxide 21. All are seen in malignant hyperthermia syndrome except; a. hyperkalemia b. bradycardia c. metabolic acidosis d. hyperthermia

16-e 17-d 18-c 19-a 20-a 21- b 22-b 23-c

Local anesthetics 2

I- Previous exams & formatives

1- Which of the following local aesthetics is useful antiarrhythmic agent:

a. Cocaine. b. Lidocaine. c. Bupivacaine. d. Ropivacaine.

2- The route of local anesthetic administration, which is associated with instillation within subarachnoid space is: a. Topicalanesthesia, b. Infiltrative anesthesia. c. Regional anesthesia. d. Spinal anesthesia

3- The most potent local anaesthetic agent in this list is: a. Procaine b. Lidocaine c. Cocaine d. Bupivacain

4- Which of the following local anesthetics is more likely to cause allergic reactions: a. Lidocaine b. Bupivacaine c. Procaine d. Ropivacaine

Answers: 1. b 2.d 3.d 4.c

II- EXTRA

1- A physician is preparing to suture a wound in a 19-year-old man who sustains a laceration of his left leg while playing in a baseball game. The physician is injecting 1% lidocaine to anesthetize the wound. He aspirates back prior to injection. If he did not do this and the lidocaine got into the systemic circulation, which of the following effects would be possible? Select one:

a. Swallowing disorder b. CNS depression c. Muscle tetany d. Peripheral neurapraxia

2- The apparent stimulation of CNS by local anesthetic is due to:

a. Depression of inhibitory neurons b. Nonspecific action c. Direct excitatory action d. Stimulation of stimulatory neurons

3- A local anesthetic drug that can produce vasoconstriction is: a. Lidocaine b. Procaine c. Tetracaine d. Cocaine

4- The following are techniques for administration of local anesthesia except?

a. Inhalational anesthesia b. Nerve block anesthesia c. Surface anesthesia d. Spinal anesthesia

5- Which one of the following local anesthetics belongs to the ester group?

a. Procaine

b. Bupivacaine c. Lidocaine d. Mepivacaine

6- Local anesthetics produce:

a. Analgesia, amnesia, loss of consciousness

b. Blocking pain sensation without loss of consciousness c. Alleviation of anxiety and pain with an altered level of consciousness d. A stupor or somnolent state

Answers; 1.b 2.a 3.d 4.a 5.a 6.b

7- Indicate the local anesthetic agent, which has a shorter duration of action:

a. a.Lidocaine b. Procaine c. Bupivacaine d. Ropivacaine

8- Indicate the which has greater potency of the local anesthetic action:

a. Lidocaine

b. Bupivacaine c. Procaine d. Mepivacaine

9- Which of the following local anesthetics is preferable in patient with pseudocholinesterase deficiency?

a. Procaine b. Ropivacaine c. Tetracaine d. Benzocaine 10- The primary mechanism of action of local anesthetics is: a. Activation of ligand-gated potassium channels b. Blockade of voltage-gated sodium channels c. Stimulation of voltage-gated N-type calcium channels d. Blockade the GABA-gated chloride channels 11- Which of the following local anesthetics is a useful antiarrhythmic agent? a. Cocaine b. Lidocaine c. Bupivacaine d. Ropivacaine 12- Indicate the route of local anesthetic administration, which is associated with instillation within epidural or subarachnoid spaces: a. Topical anesthesia b. Infiltrative anesthesia c. Regional anesthesia d. Spinal anesthesia Answers 7.b 8.b 9.b 10.b 11.b 12.d 13- The choice of a local anesthetic for specific procedures is usually based on:

a. The duration of action

d. Mepivacaine

18- Which one of the following local anesthetics causes methemoglobinemia?

a. Prilocaine

b. Procaine c. Lidocaine d. Ropivacaine

19- Procaine has all of the following properties EXCEPT:

a. It has ester linkage b. Its metabolic product can inhibit the action of sulfonamides c. It readily penetrates the skin and mucosa d. It is relatively short-acting

20- Correct statements concerning lidocaine include all of the following EXCEPT:

a. It is a universal anesthetic b. It has esteratic linkage c. It widely used as an antiarrhythmic agenta. Swallowing disorder d. It is metabolized in liver

21- Which of the following local anesthetics is more likely to cause allergic reactions?

a. Lidocaine b. Bupivacaine c. Procaine d. Ropivacaine

22- Tetracaine has all of the following properties EXCEPT:

a. Slow onset

Answer

17.b ` 18.a 19.c 20.b 21.c 22.b

3 Hypnotics & Anxiolytics

Previous exams & Formative:

1- Which of the following Z - compounds can be used safely for treatment of sleep - onset Insomnia:

a. Ramelteon b. Buspirone c. Diazepam d. Zolpidem

2- Diazepam can be used in treatment of the following disorders except:

a. Status epilepticus b. Absence seizures c. Anxiety disorders d. Sleep disorders

3- ALL of the following are of benzodiazepine receptors agonists EXCEPT:

a. Zolpidem b. Buspirone c. Zaleplon d. Benzodiazepines

4- One of the following is among the therapeutic uses of benzodiazepine:

a. Clonazepam is useful in absence seizures and diazepam used in status epilepticus b. Alprazolam has been used in the treatment of panic disorders c. Midazolam, diazepam and lorazepam are the most frequently used benzodiazepine in the perioperative period

9- Which of the following hypnotic agents is a positive allosteric modulator of GABAA receptor function?

a. Zaleplon b. Flurazepam c. Zolpidem d. All of the above

10- Flumazenil blocks the actions of:

a. Phenobarbital b. Morphine c. Zolpidem d. Ethanol 11- Barbiturates are being replaced by hypnotic benzodiazepines because of:

a. Low therapeutic index b. Suppression in REM sleep c. High potential of physical dependence and abuse d. All of the above

12- Which of the following benzodiazepines is used mainly for hypnosis?

a. Clonazepam b. Lorazepam c. Flurazepam d. Midazolam

13- Which of the following statements is correct for zolpidem?

a. Causes minor effects on sleep patterns

b. The risk of development of tolerance and dependence is less than with the use of hypnotic benzodiazepines

c. Has minimal muscle relaxing and anticonvulsant effects d. All of the above

14- All of the hypnotic drugs induce:

a. Increase the duration of REM sleep

b. Decrease the duration of REM sleep

c. Do not alter the duration of REM sleep

d. Increase the duration of slow wave sleep (stages 3 &4 of NREM sleep)

15- Indicate the mechanism of Benzodiazepines action (at hypnotic doses):

a. Increasing the duration of the GABA - gated Cl channel openings

b. Directly activating the chloride channels

c. Increasing in the frequency of CI channel opening events

d. All of the above

Ans: 9-d 10-c 11-d 12-c 13-d 14-b 15-c

e. Extrapyramidal dysfunction

5- Which of the following antipsychotic drugs is typical:

a. Risperidone b. Clozapine c. Quetiapine d. Olanzapine e. Haloperidol

6- Indicate the atypical antipsychotic drug:

a. Chlorpromazine b. Clozapine c. Haloperidol d. Thiothixene e. Thioridazine

7- Parkinson′s syndrome, tardive dyskinesia, antimuscarinic actions, orthostatic hypotension, galactorrhea are possible adverse effects of: a. Chlorpromazine b. Olanzapine c. Risperidone d. Quetiapine e. Clozapine

8- This drug is a serotonin receptor (5HT2) blocker and exhibits a low incidence of extrapyramidal side effects; it is reported to improve both positive and negative symptoms of schizophrenia:

a. Fluphenazine b. Haloperidol c. Thioridazine d. Risperidone e. Chlorpromazine

Answer: 1-b 2-c 3-d 4- a

5- Chlorpromazine is prescribed for schizophrenia and could be also used in case of: a. Epilepsy. b. Hypotension. c. Vomiting d. Urinary retention from prostatic hypertrophy. e. Infertility

6- Antipsychotic drugs produce the following EXCEPT: a. Neuroleptanalgesia (Droperidol & fentanyl) b. Galactorrhea. c. Tardive dyskinesia d. Hypertension e. neuroleptic malignant syndrome

7- Atypical antipsychotic agents (such clozapine) differ from typical ones as : a. In reduced risks of extrapyramidal system dysfunction and tardive dyskinesia b. In having low affinity for Dl and D2 dopamine receptors c. In having high affinity for D4 dopamine receptors d. All of the above

8- Which of the following antipsychotic drugs has high affinity for D4 and 5-HT2 receptors:

9 - The strong antiemetic effect of the phenothiazine derivatives is due to dopamine receptor blockade:

a. In the chemoreceptor trigger zone of the medulla b. Of the receptors in the stomach c. The medullar vomiting center d. All of the above

10- Phenothiazine derivatives are able to:

a. Alter temperature-regulating mechanisms producing hypothermia b. Decrease levels of prolactin c. Increase corticotrophin release and secretion of pituitary growth hormone d. Decrease appetite and weigh

11- Most phenothiazine derivatives have:

a. Antihistaminic activity b. Anticholinergic activity c. Antidopaminergic activity d. All of the above

12- Indicate the antipsychotic drug, which is a thioxanthene derivative:

a. Haloperidol b. Clozapine c. Chlorpromazine d. Thiothixene

13- Indicate the antipsychotic drug having significant peripheral alpha adrenergic blocking activity:

a. Haloperidol b. Chlorpromazine c. Clozapine

d. Risperidone

answer: 9-c 10-a 11-d 12-d 13-b

14- Orthostatic hypotension can occur as a result of:

a. The central action of phenothiazines

b. Inhibition of norepinephrine uptake mechanisms

c. Alpha adrenoreceptor blockade

d. All of the above

15- Adverse peripheral effects, such as loss of accommodation, dry mouth, tachycardia, urinary retention, constipation are related to:

a. Alpha adrenoreceptor blockade

b. Muscarinic cholinoreceptor blockade

c. Supersensitivity of the dopamine receptor

d. Dopamine receptor blockade

16- The mechanism of haloperidol antipsychotic action is:

a. Blocking D2 receptors

b. Inhibition of norepinephrine uptake mechanisms

c. Central alpha-adrenergic blocking

d. All of the above

Answer: 14-c 15-b 16-d

a. Anti - depressant action

b. Anti - anxiety action

c. Potent atropine - like action d. Appetite stimulation e. Antihypertensive action

5- Paroxetine is:

a. Dopamine agonist b. Antihypertensive drug c. Has atropine - like action d. Selective serotonin reuptake inhibitor e. Antispasmodic drug

Ans: 1-a 2-c 3-d 4-a 5-d

6- Both the older (tricyclic) antidepressants and the newer ones (e.g., fluoxetine) relieve signs and symptoms of depression mainly by doing which one of the following things?

a. Blocking adrenergic and serotonin receptors in the extrapyramidal system b. Blocking muscarinic receptors in the brain c. Blocking reuptake of one or more neurotransmitters in the brain d. Selectively stimulating serotonin receptors e. stimulating the synthesis of GABA (gamma - aminobutyric acid)

7- Lithium carbonate is useful in the treatment of:

a. Petit mal seizures b. Bipolar disorder c. Neurosis d. Trigeminal neuralgia

8- The drug of choice for manic - depressive psychosis is:

a. Imipramine b. Chlordiazepoxide

c. Isocarboxazid d. Lithium carbonate

9- The principal mechanism of action of antidepressant agents is:

a. Stabilization of dopamine and beta - adrenergic receptors b. Inhibition of the storage of serotonin and epinephrine in the vesicles of presynaptic nerve endings c. Blocking epinephrine or serotonin reuptake pumps d. Stimulation of alta2 - norepinephrine receptors

10- The therapeutic response to antidepressant drugs is usually over a period of:

a. 2-3 days b. 2-3 weeks c. 24 hours d. 2-3 months

Ans: 6-c 7-b 8-d 9-c 10-b

11- The most dangerous pharmacodynamic interaction is between MAO inhibitors and: a. Selective serotonin reuptake inhibitors b. Tricyclics c. Sympathomimetics d. All of the above

12- Which of the following agents is related to tricyclic antidepressants?

a. Nefazodone b. Amitriptyline c. Fluoxetine d. Isocarboxazid

13- Monoamine Oxidase A:

d. Benzodiazepines

2- One of the following is among the therapeutic uses of benzodiazepine:

a. Clonazepam is useful in absence seizures and diazepam used in status epilepticus

b. Alprazolam has been used in the treatment of panic disorders

c. Midazolam, diazepam and lorazepam are the most frequently used benzodiazepine in the perioperative period

d. All of the above

3- Which of the following drugs would be the most appropriate choice for treating generalized tonic-clonic seizure, due to its ability to block Na channels in a frequency-dependent manner?

a. Carbamazepine

b. Diazepam

c. Ethosuximide d. Phenobarbital

4-Year-old girl has been having 5-10 second staring spells several times a day while in class. During these spells, the girl exhibits small amplitude hand motions, and yet becomes fully alert immediately afterwards What would be a drug of first choice for treating this patient's seizure disorder?

a. Carbamazepine

b. Diazepam

c. Ethosuximide d. Phenytoin

1- b 2- d 3- a 4- c

5- Indicate an antiseizure drug, which has an impotent effect on the T-type calcium channels in thalamic neurons?

a. Carbamazepine

b. Lamotrigine c. Ethosuximide d. Phenytoin

6- Which of the following antiseizure drugs produces a voltagedependent inactivation of sodium channels?

a. Lamotrigine b. Carbamazepine c. Phenytoin d. All of the above

7- The drug for partial and generalized tonic-clonic seizures is:

a. Carbamazepine b. Valproate c. Phenytoin d. All of the above

8- Phenytoin is used in the treatment of:

a. Petit mal epilepsy b. Grand mal epilepsy c. Myoclonic seizures d. All of the above

5- c 6- d 7- d 8- b

9- Dose-related adverse effect caused by phenytoin is:

a. Physical and psychological dependence b. Exacerbated grand mal epilepsy c. Gingival hyperplasia

d. Extrapyramidal symptoms

10- Granulocytopenia, gastrointestinal irritation, gingival hyperplasia, and facial hirsutism are possible adverse effects of:

a. Phenobarbital b. Carbamazepine c. Valproate d. Phenytoin 11- The drug of choice for partial seizures is:

a. Carbamazepine b. Ethosuximide c. Diazepam d. Lamotrigine 12- The mechanism of action of carbamazepine appears to be similar to that of:

a. Benzodiazepines b. Valproate c. Phenytoin d. Ethosuximide 13- Lamotrigine can be used in the treatment of:

a. Partial seizures b. Absence c. Myoclonic seizures d. All of the above 9- c 10-d 11- a 12- c 13- d

18- Adverse effect caused by phenobarbital is:

a. Physical and psychological dependence b. Exacerbated petit mal epilepsy c. Sedation d. All of the above 19- Which of the following antiseizure drugs is a prodrug, metabolized to phenobarbital?

a. Phenytoin b. Primidone c. Felbamate d. Vigabatrin

20- The drug of choice in the treatment of petit mal (absence seizures) is:

a. Phenytoin b. Ethosuximide c. Phenobarbital d. Carbamazepine

21- The dose-related adverse effect of ethosuximide is: a. Gastrointestinal reactions, such as anorexia, pain, nausea and vomiting b. Exacerbated grand mal epilepsy c. Transient lethargy or fatigue d. All of the above

17- c 18- d 19- b 20- b 21- d 22- Valproate is very effective against:

a. Absence seizures b. Myoclonic seizures c. Generalized tonic-clonic seizures

d. All of the above

23- Although the benzodiazepines continue to be the agents of choice for insomnia, they have:

a. The possibility of psychological and physiological dependence b. Synergistic depression of CNS with other drugs (especially alcohol) c. Residual drowsiness and daytime sedation d. All of the above

24- Hypnotic benzodiazepines can cause:

a. A dose-dependent increase in both REM and slow wave sleep b. Do not change sleep patterns c. A dose-dependent decrease in both REM and slow wave sleep d. A dose-dependent increase in REM sleep and decrease in slow wave sleep 25- Which one of the following hypnotic benzodiazepines is more likely to cause rebound insomnia?

a. Triazolam b. Flurazepam c. Temazepam d. All of the above 22- d 23- d 24- c 25- a

Antiparkinsonism

Previous Exams and Formative:

1- At high doses the following drug may cause parkinsonism-like dysfunction:

a. Amphetamine

b. Propranolol c. Diazepam d. Ketamine e. Reserpine Answer: e

2- The following drug causes swollen tender bluish discolored feet in patient with Parkinsonism:

a. Amantadine b. Benztropine c. Bromocriptine d. Levodopa e. Selegiline Answer: a

3- Which of the following drugs is used in the treatment of Parkinsonian disorders Select one:

a. Haloperidol b. Ipratropium c. Selegiline d. Phenytoin e. Fluoxetine Answer: c

4- The redness, tenderness, and painful swollen feet is the side effect of the following drug:

a. Amantadine. b. Benztropine c. Bromocriptine. d. Levodopa Answer: a

5- The most effective single drug in parkinsonism is:

a. Bromocriptine. b. Selegiline c. Levodopa d. Biperiden Answer: c

6- 63-year-old man with Parkinson’s disease presents to his primary care physician for followup. Over the past 6 months, his tremor has worsened and his gait has become more unstable. He noticed his symptoms have been progressively worsening and he wants a medication that could make them better. The physician adds MAO B inhibitor. What is the most likely medication added to his regimen? Select one:

a. Selegiline. b. Amantadine. c. Tolcapone. d. Carbidopa. e. Benztropine. Answer is: a

7- 58-year-old man with Parkinson’s disease presents to the clinic for follow- up. Recently, he has experienced an increase in his resting tremor and rigidity. He was wondering if there is a medication that

could help these symptoms. What anticholinergic is the most appropriate treatment? Select one:

a. Scopolamine.

b. Bromocriptine.

c. Ipratropium. d. Benztropine. e. Tropicamide. Answer: d

Extra Questions:

1- 83-year-old woman with Parkinson’s disease is currently being treated with carbidopa/levodopa, but her Parkinson’s symptoms are worsening. She has normal liver function and no history of liver disease. Selegiline is added to her regimen. How does Selegline help in Parkinson’s? Select one:

a. Increased norepinephrine synthesis.

b. Inhibition of MAO.

c. Stimulation of norepinephrine.

d. Stimulation of acetylcholine release.

e. Inhibition of COMT. Answer: b

2- 60-year-old woman known to have schizophrenia. She is taking typical antipsychotic for her condition. Now she is complaining of rigidity and tremors and diagnosed as Parkinson’s disease. What is the best drug for her condition? Select one:

a. Selegiline.

b. Bromocriptine.

c. Levodopa. d. Tropicamide.

e. Benztropine. Answer: e

3- All of the following are neurological characteristics of Parkinsonism except:

a. Tremors

b. Postural disturbances

c. Hyperkinesia

d. Rigidity

Answer: c

4- Carbidopa is useful in treatment of Parkinsonism because:

a. It is a precursor for Levodopa

b. It prevents peripheral biotransformation of L-dopa.

c. It prevents the breakdown of dopamine d. It has an anti-apoptic effect

Answer: b.

5- Which statement about Bromocriptine

is accurate?

a. It is contraindicated with psychotic patients.

b. Should not be administered with high protein meals. c. It has an adverse effect of ankle edema

d. It is the drug of choice in drug-induced Parkinsonism

Answer: a

6- Which one of the following drugs is used in treatment of extrapyramidal side effects caused by neuroleptic drugs?

a. L-dopa

b. Trihexyphenidyl

c. Selegiline

d. Amantadine

Answer: b

7- Which one of the following drugs is contraindicated in prostatic hypertrophy and GIT block?

a. L-dopa

b. Carbidopa c. Bromocriptine d. Benztropine Answer is: d

8- Antipsychotic drug-induced Parkinsonism is treated by: a. Anticholinergics b. Levodopa c. Selegiline d. Amantadine Answer: a

9- Parkinson's disease is associated with a significant depletion of which neurotransmitter?

a. Serotonin. b. Dopamine. c. Acetylcholine. d. Norepinephrine. Answer: b

10- Which is the primary treatment for Parkinson's disease?

a. Nadolol. b. Reserpine. c. Levodopa. d. Clonazepam. Answer: c

11- Which drug inhibits the decarboxylation of levodopa in the periphery so more levodopa can reach the CNS?

a. Selegiline. b. Carbidopa. c. Tolcapone. d. Entacapone

Answer: b

12- A patient suffers from Parkinsonism if his …… levels are high and his …… levels are low.

a. Dopamine; Ach b. Ach; Dopamine Answer: b

13- Which of the following antimuscarinic drugs is used in treatment of Parkinsonism?

a. Bromocriptine b. Atropine c. Amantadine d. None of the above Answer: d

14- Which of the following is an adjuvant drug (cannot be used alone) in treatment of Parkinsonism?

a. Amantadine b. L-dopa c. Bromocriptine d. None of the above Answer: a

15- Dopamine is not used in treatment of Parkinsonism because

a. It has massive side effects b. It cannot cross the BBB c. It is quickly metabolized d. None of the above Answer: b

16- Sinemet is the combination of L-dopa and

a. Benztropine b. Amantadine c. Carbidopa Central Nervous System - Pharmacology Quiz 15 of 22 Alex School of Medicine – ASM d. None of the above Answer: c

17- Why is carbidopa used in treatment of Parkinsonism?

a. To decrease the dose of L-dopa administered b. To minimize the side effects of L. dopa c. It inhibits Dopa decarboxylase outside the CNS d. All of the above Answer: d 18- The on off phenomenon is a side effect of a. L-dopa b. Bromocriptine c. Benztropine d. Selegiline Answer: a 19- Which of the following is not a side effect of L-dopa

a. Nausea b. Cardiac arrhythmia c. Excessive salivation d. Postural hypotension Answer: c

20- Which of the following manifestations of Parkinsonism can be improved by benztropine?

a. Shuffling gait

b. Tremors

c. Expressionless face

d. None of the above Answer: b

21- Which of the following is an antagonist of L-dopa?

a. Vitamin B6

b. MAO B inhibitor

c. MAO A inhibitor d. Carbidopa

Answer: a

22- Which neurons are involved in parkinsonism?

a. Cholinergic neurons

b. GABAergic neurons

c. dopaminergic neurons

d. All of the above Answer: d

23- The pathophysiologic basis for antiparkinsonism therapy is:

a. A selective loss of dopaminergic neurons

b. The loss of some cholinergic neurons

c. The loss of the GABAergic cells

d. The loss of glutamatergic neurons

Answer: a 24- Which of the following neurotransmitters is involved in Parkinson′s disease?

a. Acetylcholine

b. Glutamate c. Dopamine d. All of the above Answer: d

c. Increase the incidence of nausea, vomiting and cardiac arrhythmia.

d. Reduce its side effects

Answer: c 30- Regarding levodopa: All the following statements are correct Except:

a. Its absorption is affected by food.

b. It is transport to the brain through passive diffusion.

c. It is decarboxylated to dopamine in the peripheral tissues.

d. Only 1-3 % of the oral dose reaches the brain.

Answer: b

31- The beneficial effect to tolcapone in the treatment of parkinsonism is attributed to :

a. Reduction of the peripheral decarboxylation of levodopa.

b. Agonistic effect at D2 receptors.

c. Reduction of the plasma level of 3 O methyl dopa.

d. Inhibition of MAOB which metabolize dopamine selectively. Answer: c

32- Bromocriptine is contraindicated to be given in all of the following disorders Except:

a. Psychiatric illness.

b. Parkinsonism.

c. Peptic ulcer.

d. Peripheral vascular diseases.

Answer: b