biology 4480 exam2

8/4/2019 Biology 4480 Exam2

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BIOLOGY 4480EXAM 2- FALL 2006

1. Your neighbor Mel Gibson was taken to the hospital suffering from the following symptoms: skeletalmuscle fasciculation (twitching), excessive sweating, diarrhea and drooling. Exposure to which of thefollowing would explain all these symptoms?

1. an indirect-acting cholinergic agonist2. a non-depolarizing neuromuscular blocking agent

3. a ganglionic antagonist4. a muscarinic agonist

2. The muscarinic agonist bethanechol (URECHOLINE) increases _____________ which is useful in thetreatment of ________________, but can cause ______________________.

1. heart rate; bradycardia;tachycardia2. GI tone and motility,post-operative constipation; diarrhea3. the force of skeletal muscle contraction; myasthenia gravis; skeletal muscle paralysis4. blood pressure; hypotension; hypertension

3. Which of the following is a side effect associated with the use of a muscarinic antagonist like atropine?

1. hypotension2. diarrhea3. tachycardia4. skeletal muscle paralysis

4. Muscarinic agonists can __________ and their use in _______________ should be avoided if possible.

1. reduce gastric acid production; those with peptic ulcers2. cause constipation;post-operative diarrhea3. increase blood pressure; hypertensive individuals4. cause bronchiole constriction; asthmatics

5. At therapeutic doses, the non-depolarizing neuromuscular agent pancuronium (PAVULON)

1. paralyzes gastrointestinal smooth muscle2. causes skeletal muscle paralysis by blocking nicotinic receptors at the NMJ3. inhibits the activity of acetylcholinesterase (AChE)4. All of the above.

For question 6-9, select the BEST answer from the choices listed below. Each is used once.

1. ganglionic antagonist2. depolarizing neuromuscular blocking agent

3. indirect-acting cholinergic agonist4. non-depolarizing neuromuscular blocking agent

The muscle paralysis caused by a(n)_______6______ can be reversed with a(n) ________7________.

8. Decreased blood pressure and heart rate followed by constipation and urine retention are responsesassociated with the use of a(n)_________________

9. Acetylcholinesterase found at the neuromuscular junction reverses the effects of a(n) ___________.

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10. Indirect-acting cholinergic agents like neostigmine (PROSTIGMIN) are used to treat the skeletal muscleweakness associated with myasthenia gravis but can also cause muscle paralysis. Which of thefollowing statements BEST explains how this occurs?

1. These highly charged drugs prevent the activation of ganglionic nicotinic receptors.2. ACh is not broken down at the NMJ, causing continual activation of nicotinic receptors and an

inability to repolarize the muscle.3. The extension of AChs half-life at the NMJ leads to muscarinic receptor downregulation.4. ACh induces the activity of acetylcholinesterase at the NMJ causing the more rapid turnover of

ACh.

11. Muscarinic receptor antagonists produce which of the following effects at the NMJ?

1. They cause an initial muscle contraction followed by flaccid muscle paralysis.2. They block ACh access to receptors and cause flaccid paralysis.3. They downregulate receptors which weakens skeletal muscle contraction.4. They have little or no effect at the NMJ.

12. Which of the following drugs would be the BEST choice for producing the short-lived muscle paralysisrequired to set a dislocated shoulder?

1. a ganglionic antagonist2. an indirect-acting cholinergic agonists3. a depolarizing neuromuscular blocking agent4. a non-depolarizing neuromuscular blocking agent

13. At therapeutic doses, which of the following drugs will affect heart rate?

1. a muscarinic antagonist

2. a non-selective antagonist3. norepinephrine (NE)4. All of these drugs will affect heart rate.

14. In the pancreas, 1 receptor activation by epinephrine (EPI) inhibits insulin secretion while 2receptor activation by isoproterenol (ISO) stimulates insulin secretion. Based on your knowledge ocatecholamines, which of the following statements BEST explains these results?

1. EPI is an 1 agonist and a 2 antagonist.

2. EPI is an 1 antagonist and a 2 agonist

3. There are more 1 than 2 receptors in the pancreas.

4. EPI is converted to NE which has no effect at 2 receptors.

15. An i.v. injection of NE can produce which of the following responses?

1. bronchiole dilation2. hypertension3. CNS excitation4. bradycardia

16. Since a 1 antagonist ______________ it can be used to treat ________________.

1. reduces heart rate; tachycardia2. dilates both arteries and veins; hypertension3. increases the force of cardiac muscle contraction; heart failure4. relaxes bronchiole smooth muscle; asthma

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17. At therapeutic doses, which of the following drugs would affect respiratory function?

1. a 1antagonist2. a 2 agonist3. norepinephrine

4. a 1 agonist

18. Indirect-acting adrenergic agonists produce their effects by ________________.

1. inhibiting the activity of the inactivating enzymes monoamine oxidase and catechol-O-metheyltransferase

2. inhibiting the re-uptake of NE

3. antagonizing the activation of presynaptic 2 receptors4. All of the above.

For questions 19-22, select the BEST answer from the choices listed below. Each is used once.

1. The 1 agonist phenylephrine (NEO-SYNEPHRINE)

2. The 2 agonist albuterol (VENTOLIN)3. The 1 antagonist prazosin (MINPRESS)

4. The non-selective antagonist propranolol

19. ____________ is used to treat arrhythmias but should be used cautiously in asthmatics.

20. ____________ is the best choice for a bronchiole dilator in patients with a history of cardiac arrhythmia

21. ____________ reduces blood pressure by relaxing vascular smooth muscle.

22. ____________ can relieve nasal congestion but can also elevate blood pressure.

23. Which of the following is(are) characteristics of all catecholamines?

1. They are subject to extensive first pass metabolism in the liver.2. They have cause intense CNS excitation following i.v. injection.3. They are effective after oral administration.4. All of the above.

24. Inhibitory neurotransmitters like gamma amino butyric acid (GABA) ___________ post-synaptic nervesby ____________ channels.

1. hyperpolarize; opening chloride (Cl-)2. depolarize; closing sodium (Na+)3. inhibit; blocking K+4. activate; opening Ca2+

25. Excitatory post-synaptic potentials (EPSPs) ________________.

1. occur in response to Cl- channel blockade2. are the result of Na+ channel opening and depolarization of post-synaptic nerves3. lead to hyperpolization of post-synaptic nerves4. are caused by Ca2+ channel blockade and the hyperpolarization of post-synaptic nerves

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26. Which of the following statements is TRUE?

1. The loss of 70-80% of the cholinergic nerves in the motor cortex is the underlying cause of PD.2. The loss of dopaminergic neurons is found only in patients with PD.3. Most treatments for PD involve elevating DA activity.4. All of these statements are TRUE.

27. _________________ directly activate DA receptors without prior conversion to DA.

1. MAO-B inhibitors like selegiline (ELDEPRYL)2. DA receptor agonists like bromocriptine (PARLODEL)3. amino acid decarboxylase inhibitos like carbidopa4. catechol-O-methyltransferase (COMT) inhibitors like tolcapone (TASMAR)

28. Underlying inflammatory problems may contribute to the pathology of neurodegenerative disorders likeParkinsons Disease (PD). Which of the following statements BEST supports that hypothesis?

1. Hydroxyl free radicals are generated in the normal course of DA metabolism.2. Inhibition of mitochondrial electron transport compromises ATP production.3. Excitotoxic injury may result from the activation of neurotransmitter receptors which gate Ca2+

rather than Na+ channels.4. PD is less prevalent in people taking NSAIDs for chronic arthritis pain.

29. The dyskinesia (involuntary movements of the limbs, hands and head) observed with long-term highdose drug therapy with L-dopa/carbidopa may be the result of _________ and seem to be relieved by

___________.

1. conversion of L-Dopa into a dopamine (DA) receptor antagonist; lowering the dose of L-Dopa2. upregulation of DA receptors; increasing the dose of L-Dopa administered3. the anti-muscarinic effects of L-Dopa; administering a muscarinic receptor agonist4. fluctuating levels of DA; maintaining constant blood levels of DA with sustained release preparations

30. The amino acid decarboyxlase inhibitor carbidopa and the catecho-O-methyltransferase inhibitotalcapone are used together to ___________ but do not affect dopamine conversion in the brainbecause______________.

1. prevent the peripheral conversion of DA to L-dopa; they are subject to first pass metabolism inthe liver

2. prevent the peripheral conversion of L-dopa to DA; they do not cross the blood-brain barrier3. stimulate the peripheral metabolism of L-dopa to DA; their half-lives are too short to affect DA

metabolism in the brain4. stimulate the peripheral metabolism of DA to DOPAC; they cannot be administered orally


1. Neuropathic pain is the consequence of nerve damage and responds well to treatment withNSAIDs or opioids.

2. The subjective aspects of pain require interpretation by higher cortical centers of the brain andare effectively inhibited by the administration of NSAIDs.

3. Nociceptive pain is caused by activating nociceptive receptors and the transmission of thisactivation along nerve pathways.

4. In most circumstances, pain serves no useful protective function.

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32. Aspirin suppresses platelet aggregation by ________________.

1. inhibiting the production of thromboxane2. stimulating vasodilation and local edema3. suppressing the activity of COX1 but not COX24. reducing prostaglandin production

33. Aspirin _____________________________.

1. inhibits COX1 but not COX22. reduces fever through peripheral vasodilation3. overdoses are not lethal even when large doses are consumed4. stimulates prostaglandin synthesis in the stomach

34. The newest NSAIDs (celecoxib {CELEBREX] and the recently withdrawn roficoxib [VIOXX]) ________.

1. do not reduce fever or relieve pain2. have limited effects on prostaglandin synthesis is the stomach3. target the constitutively active form of COX

4. All of the above.

35. Acetaminophen (TYLENOL) ___________________.

1. effectively inhibits the production of inflammatory mediators2. should not be used to reduce fever in children suffering from a viral infection like a cold or the flu3. can cause liver damage and should not be taken by someone has consumed alcohol4. suppresses the activity of both COX1 and COX2

36. Which of the following is a CNS effect associated with the use of the opioid analgesic morphine?

1. vasodilation2. urine retention3. emesis4. constipation

37. ________________________ limits the dose of morphine that can be delivered to relieve pain.

1. Emesis (nausea and vomiting)2. Cough supression3. Reduced GI tone and motility

4. Respiratory depression

38. Post-synaptic opioid receptors increase K+ entrance which ______________________.

1. hyperpolarizes the post-synaptic cell and prevents nerve transmission2. prevents Ca2+ entrance and the release of neurotransmitter from the presynaptic cells3. enhances Na+ entry into post-synaptic cells causing excitatory post-synaptic potentials (EPSPs)4. phosphorylates and opens Na+ channels and produces an inhibitory post-synaptic potential

(IPSP)

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39. Repeated administration of the opioid analgesic methadone (DOLOPHIN) extends its half-life fromabout 2 hours to 24-48 hours. Why would this be useful in detoxifying heroin addicts?

1. Methadones duration of action will be substantially shortened and its analgesic propertiesdiminished.

2. The dose of methadone could slowly be reduced making withdrawal symptoms be moretolerable.

3. Methadone would be converted from a receptor agonist into receptor antagonist whichwould block withdrawal symptoms.

4. Methadone would no longer cause respiratory depression making it safe to administer higheand higher doses.


1. Because of their distinct mechanisms of action, the combination preparation of the opioidoxycodone and the NSAID aspirin (PERCODAN) can provide the same degree of analgesia asa larger dose of oxycodone alone.

2. The dose of morphine administered to a patient tolerant to its analgesic effects could be lethalfor a patient receiving the same dose for the first time.

3. Abstinence syndrome is a collection of physical symptoms that occur in response to opioid

withdrawal.4. All of these statement are TRUE.

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biology 4480 exam2

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