Transcript Pharmacology II - 2-24

PHARMACOLOGY EXAM 4 – PART 2
BY ALAINA DARBY
• Which of the following is true of upper motor neurons?
a. Pyramidal neurons constitute the indirect cortico-bulbo-spinal tracts
b. Extrapyramidal neurons constitute the direct corticospinal tract
c. Pyramidal neurons control posture and fine coordinated motion
d. Extrapyramidal neurons control balance and coordination
• Which of the following is true?
a. Pyramidal neurons are located in the lateral portion of the posterior horn of
the spinal cord
b. Extrapyramidal neurons are located in the lateral portion of the posterior
horn of the spinal cord
c. Pyramidal neurons are located in the lateral portion of the anterior horn of
the spinal cord
d. Extrapyramidal neurons are located in the lateral portion of the anterior
horn of the spinal cord
• Injury to which of the following would produce weakness and increased
stretch reflexes?
a. Basal ganglia
b. Cerebellum
c. Spinal cord
d. Non-primary motor cortical areas
• Which of the following does not receive input directly from the brain stem?
a. Cerebellum
b. Spinal cord
c. Thalamus
d. Cerebral cortex
• Which of the following does not provide input directly to the thalamus?
a. Internal globus pallidus
b. Cerebral cortex
c. Brain stem
d. Cerebellum
• Which of the following is true of spasticity?
a. It is characterized by velocity dependent decreases in tonic stretch reflexes
b. It includes exaggerated tendon jerks resulting from hypoexcitability of the
stretch reflex
c. Resistance to stretch increases with increasing speed and varies with joint
angle
d. It is a component of the lower motor neuron syndrome
• Which of the following is a positive symptom of spasticity?
a. Babinski reflex
b. Paresis
c. Fatigability
d. Fine control
• Mary is trying to stretch out her arm but can’t because her bicep remains
tight. Which form of spasticity would this be considered?
a. Spastic dystonia
b. Spastic co-contraction
c. Extra-segmental co-contraction
d. Muscle shortening
• Bill has developed a spastic foot deformity. Which of the following types of
spasticity likely contributed to his deformation?
a. Spastic dystonia
b. Spastic co-contraction
c. Extra-segmental co-contraction
d. Muscle shortening
• Which of the following is caused by immobilization and muscle overactivity?
a. Spastic dystonia
b. Spastic co-contraction
c. Extra-segmental co-contraction
d. Muscle shortening
• Which of the following is not one of the most disabling features in spastic
patients?
a. Muscle shortening
b. Motor weakness
c. Muscle atonia
d. Spastic co-contration
• Which of the following tracts is not involved in spasticity?
a. Laterorospinal
b. Rubrospinal
c. Reticulospinal
d. Vestibulospinal
• Which of the following is not an established alteration within the reflex arc?
a. Increased ratio torque
b. Increased excitability of the alpha motor neuron
c. Decreased extensibility
d. Decreased pre-synaptic inhibition
• Which of the following is not a result of spasticity?
a. Cardiovascular problems
b. Respiratory infections
c. Liver toxicity
d. Osteoporosis
• Margret has painful spasticity resulting from a stroke and also has a history
of anxiety. Which of the following would be most likely to help her?
a. Tizanidine
b. Baclofen
c. Riluzole
d. Dantrolene
• Sara has stopped taking the medicine for her spasms but is now
experiencing seizures and hallucinations. Which medication was she most
likely taking?
a. Gabapentin
b. Baclofen
c. Cyproheptadine
d. Cannabinoids
• Which of the following may be taken with any of the other answer options
without potentiating sedation?
a. Tizanidine
b. Diazepam
c. Gabapentin
d. Baclofen
• Which of the following is an alpha-2 noradrenergic agonist?
a. Tizanidine
b. Baclofen
c. Gabapentin
d. Riluzole
• Amber is taking amlodipine for her high blood pressure and has spasticity
resulting from multiple sclerosis. Which of the following would be best for her
to take?
a. Baclofen
b. Tizanidine
c. Diazepam
d. Cyproheptadine
• Which of the following acts only postsynaptically?
a. Tizanidien
b. Diazepam
c. Baclofen
d. Riluzole
• Greg sustained a spinal cord injury playing football but has since recovered.
However, he now has spasms as a result. Which of the following would be
most appropriate for him to take?
a. Baclofen
b. Gabapentin
c. Riluzole
d. Orphenadrine
• Which of the following is used to treat spasms resulting from stroke,
multiple sclerosis, spinal cord injury, and cerebral palsy?
a. Gabapentin
b. Dantrolene
c. Baclofen
d. Diazepam
• Dan is starting physical therapy. Which of the following agents could be
useful in these sessions?
a. Dantrolene
b. Cyproheptadine
c. Orphenadrine
d. Botulinium toxin
• Which of the following is used to treat ALS by inhibiting glutamate
transmission?
a. Riluzole
b. Orphenadrine
c. Gabapentin
d. Dantrolene
• Which of the following is used off label for spasms but exhibits few side
effects?
a. Cyproheptadine
b. Orphenadrine
c. Botulinum toxin
d. Cannabinoids
• Which of the following types of headache are associated with
circumferential pain?
a. Migraine
b. Tension
c. Sinus
d. Cluster
• Which of the following types of headache is not treated with NSAIDs?
a. Migraine
b. Tension
c. Sinus
d. Cluster
• Which of the following is not true of migraines?
a. They occur more often in females
b. 50-70% of sufferers have a family history
c. Incidence is greater in higher income groups
d. They are most prevalent in the 35-45 year old age group
• Which of the following is true of migraines?
a. The headache phase consists vasoconstriction
b. The prodromal phase consists of vasoconstriction
c. The aura phase consist of vasodilation
d. The postdrome phase consists of vasodilation
• Which of the following is correct concerning the order of events in a migraine?
a. Trigger, migraine originates deep within the brain, decreased electrical impulses, surge of
b.
c.
d.
excitation, blood vessel dilation, inflammation and edema and release of nociceptive
neuropeptides, irritation of trigeminal nerve
Trigger, migraine originates deep within the brain, surge of excitation, decreased electrical
impulses, irritation of trigeminal nerve, blood vessel dilation, inflammation and edema and
release of nociceptive neuropeptides
Trigger, migraine originates deep within the brain, surge of excitation, decreased electrical
impulses, blood vessel dilation, inflammation and edema, release of nociceptive
neuropeptides, irritation of trigeminal nerve
Trigger, surge of excitation, migraine originates deep within the brain, decreased electrical
impulses, inflammation and edema and release of nociceptive neuropeptides, blood vessel
dilation, irritation of trigeminal nerve
• What did Leao theorize to be the cause of migraines?
a. Initial excitation in regions deep within the brain
b. Depression of electrical activity throughout the brain
c. Initial blood vessel constriction
d. Compensatory blood vessel dilation
• What is thought to induce the aura that many migraine sufferers
experience?
a. Initial excitation in regions deep within the brain
b. Depression of electrical activity throughout the brain
c. Initial blood vessel constriction
d. Compensatory blood vessel dilation
• Which of the following is not used in the treatment of mild migraine?
a. Mild analgesics
b. Antiemetics
c. Combination analgesics
d. 5-HT agonists
• Which of the following would not be a prophylactic treatment for moderate
to severe migraine?
a. Tricyclic antidepressants
b. 5-HT agonists
c. MAO inhibitors
d. Ca channel blockers
• Which of the following is not an action of combination analgesics?
a. Inhibition of cyclooxygenase
b. Alpha and beta adrenergic antagonism
c. Muscarinic antagonism
d. CNS depression
• Which of the following is an antiemetic that works by inhibiting the
chemoreceptor trigger zone?
a. Diphenhydramine
b. Metoclopramine
c. Promethazine
d. Prochlorperazine
• How does the prokinetic antiemetic metoclopramide work?
a. Antagonize receptors in chemoreceptor trigger zone
b. Stimulate gastric smooth muscle motility to empty the stomach
c. Inhibit CNS vomit center stimulation
d. Inhibit the limbic system of the forebrain
• Which of the following sets of receptors can inhibit the release of nociceptic
neuropeptides when activated?
a. 5-HT1A and 5-HT1B
b. 5-HT2A and 5-HT2B
c. 5-HT1B and 5-HT1D
d. 5-HT2B and 5-HT2D
• Which of the following is a side effect of sumatriptan?
a. Nausea
b. Chest pressure
c. Vomiting
d. Photophobia
• Why might one consider an ergot alkaloid over a triptan?
a. Angina pectoris
b. Headache lasting longer than 48 hours
c. Poorly controlled hypertension
d. History of myocardial infarction
• How should sumatriptan be taken for maximal effectiveness?
a. During the aura phase
b. During the headache phase
c. Prophylactically
d. During the prodrome phase
• What is not a difference among the triptans?
a. Dosage form
b. Duration of action
c. Mechanism of action
d. Blood brain barrier penetration
• Which of the following triptans has the longest duration of action?
a. Rizatriptan
b. Frovatriptan
c. Zolmitriptan
d. Naratriptan
• Which of the following triptans would not be given to someone taking an
MAOI?
a. Almotriptan
b. Rizatriptan
c. Sumatriptan
d. Naratriptan
• To which of the following is methysergide maleate a related compound?
a. Dopamine
b. Lysergic acid
c. Serotonin
d. Muscarine
• How is methysergide maleate most effectively taken?
a. During the aura phase
b. During the headache phase
c. Prophylactically
d. During the prodrome phase
• Which of the following is not an effect of methysergide maleate?
a. Pleuropulmonary and retroperitoneal fibrosis
b. Cardiovascular disorders
c. Psychomimetic activity
d. Vasoconstriction and pressor effects
• Specifically, why has ergotamine fallen out of use and its use recently been
replaced almost exclusively with triptans?
a. It is most effective given rectally with little oral usefulness
b. It is only effective as a single dose early in the attack
c. Multiple doses of triptans are now allowed for long attacks
d. It may induce rebound headache with frequent use
• What is not a reason that dihydroergotamine has fallen out of use?
a. Nausea side effect
b. Contraindicated in coronary artery disease
c. Effectiveness
d. Nonspecific receptor blocking
• Which of the following preventative treatments is preferred for patients with
down mood or insomnia?
a. Amitriptyline
b. Doxepin
c. Methysergide
d. Cyproheptadine
• Which of the following preventative treatments is preferred in children?
a. Amitriptyline
b. Doxepin
c. Methysergide
d. Cyproheptadine
• Which two beta blockers are FDA-approved for migraine prophylaxis?
a. Atenolol and metoprolol
b. Propranolol and timolol
c. Nadolol and propranolol
d. Atenolol and timolol
• Which of the following is an anti-epileptic drug that stimulates the action of
GABA synthetic enzymes and inhibits the action of GABA degradative enzymes
and is also prescribed prophylactically for migraine?
a. Methysergide
b. Cyproheptadine
c. Doxepin
d. Divalproex