Cns MCQ
Cns MCQ
Cns MCQ
10. Which one of the following chemicals 16. Suramin is an antagonists of ________
does not satisfy the criteria for a receptors
neurotransmitter role in the CNS? (a) Purine (b) Somatostanin
(a) Acetylcholine (b) Dopamine (c) Neuropeptide Y (d) Neurotensin
(c) Glycine (d) Nitric Oxide
17. Which one of the following statements
(e) Substance P
best describes the mechanism of action
11. Neurotransmitters may of benzodiazepines?
(a) Increase chloride conductance to cause (a) Benzodiazepines activate GABAB receptors
inhibition in the spinal cord
(b) Increase potassium conductance to cause (b) Their inhibition of GABA transminase leads
excitation to increased levels of GABA
(c) Increse sodium conductance to cause (c) Benzodiazepines block glutamate receptors
inhibition in hierarchical neuronal pathways in the
(d) Increase calcium conductance to cause brain
inhibition (d) They increase the frequency of opening of
(e) Exert all of the above actions chloride ion channels that are coupled to
GABAA receptors
12. Which of the following chemicals is most (e) They are direct-acting GABA receptor
likely to function as a neurotransmitter agonists in the CNS
in hierarchical systems?
18. Which one of the following statements
(a) Dopamine (b) Glutamate
about the use of triazolam in this elderly
(c) Metenkephalin (d) Norepinephrine patient is accurate?
(e) Serotonin
(a) Ambulatory dysfunction does not occur in
13. Activation of metabotropic receptors elderly patients taking one-half of the
located presynaptically causes inhibition conventional adult dose
by decreasing the inward flux of (b) Hypertension is a common adverse effects
(a) Calcium (b) Chloride of benzodiazepines in patients over 70 years
of age
(c) Potassium (d) Sodium
(c) Over-the-counter cold medications may
(e) None of the above
antagonize the hypnotic effects of the drug
14. This compound decrease the functional
activities of several CNS neurotransmit- (d) She may experience amnesia, especially if
ters, including dopamine, norepineph- she also drinks alcoholic beverages
rine, and serotonin. At high doses it may (e) Triazolam is distinctive in that it does not
cause parkinsonism-like extrapyramidal cause rebound insomnia on abrupt
system dysfunction. discontinuance
(a) Amphetamine (b) Baclofen
19. The most likely explanation for the
(c) Diazepam (d) Ketamine increased sensitivity of elderly patients
(e) Reserpine to a single dose of triazolam and other
15. This amine neurotransmitter is found in sedative-hypnotic drugs is
high concentration in cell bodies in the (a) Changes in brain function that accompany
pons and brain stem; at some sites, the aging process
release of transmitter is autoregulated via (b) Decreased renal function
presynaptic inhibition. (c) Increased cerebral blood flow
(a) Acetylcholine (b) Dopamine (d) Decreased hepatic metabolism of lipid-
(c) Glutamate (d) Norepinephrine soluble drugs
(e) Substance P (e) Changes in plasma protein binding
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM 31
(d) Induces liver drug-metabolizing enzymes 36. Withdrawal of antiseizure drugs can
(e) Inhibits renal clearance of acetaminophen cause increased seizure frequency and
severity. Withdrawal is least likely to be
31. The activity of this enzyme is specifically
a problem with
decreased in the Wernicke-Korsakoff
syndrome (a) Clonazepam (b) Diazepam
46. Use of this agent is associated with a high (a) Serious cardiovascular reactions are more likely
incidence of disorientation, sensory and to occur with tetracaine than with bupivacaine
perceptual illusions, and vivid dreams (b) Cyanosis may occur following injection of
during recovery from anesthesia large doses of lidocaine, especially in
patients with pulmonary disease
(a) Diazepam (b) Fentanyl
(c) Intravenous injection of local anaesthetics may
(c) Ketamine (d) Midazolam
stimulate ectopic cardiac pacemaker activity
(e) Thiopental
(d) In overdosage, hyper ventilation (with
47. Postoperative vomiting is uncommon oxygen) is helpful to correct acidosis and
with this intravenous agent; patients are lower extracellular potassium
able to ambulate sooner than those who (e) Most local anaesthetics cause vasoconstriction
34 MCQs IN PHARMACOLOGY
(b) Fluctuates in its effectiveness with increasing (c) The primar y therapeutic benefit of
frequency as treatment continues antimuscarinic drugs in parkinsonism is their
(c) Prevents extrapyramidal adverse effects of ability to reliever bradykinesia
antipsychotic drugs (d) Dopamine receptor against should not be
(d) Protects against cancer in patients with used in Parkinson’s disease prior to a trial of
melanoma levodopa
(e) Has toxic effects that include pulmonary (e) The concomitant use of selegiline may
infiltrates increase the peripheral adverse effects of
levodopa
66. The major reason why carbidopa is of
value in parkinsonism is that the 70. A previously healthy 50-year-old woman
compound begins to suffer from slowed mentation
(a) Crosses the blood-brain barrier and develops writhing movement of her
tongue and hands. In addition, she has
(b) Inhibits monoamine oxidase type A
delusions of being persecuted. The
(c) Inhibits aromatic L-amino acid decarboxylase woman has no past history of psychiatric
(d) Is converted to the false neurotransmitter or neurologic disorders. The most
carbidopamine appropriate drug for treatment is
(e) Inhibits monoamine oxidase type B (a) Amantadine (b) Bromocriptine
67. Which one of the following statements (c) Haloperidol (d) Levodopa
about bromocriptine is accurate? (e) Trihexyphenidyl
(a) It should not be administered to patients
71. Great caution must be exercised in the
taking antimuscarinic drugs
use of this drug (or drugs from the same
(b) Effectiveness in Parkinson’s disease requires class) in parkinsonian patients who have
its metabolic conversion to an active prostatic hypertrophy or obstructive
metabolite gastrointestinal disease
(c) The drug is contraindicated in patients with
(a) Benztropine (b) Carbidopa
a history of psychosis
(c) Levodopa (d) Ropinirole
(d) The drug should not be administered to
patients already taking levodopa (e) Selegiline
(e) Mental disturbances occur more commonly 72. Which of the following statements about
with levodopa than with bromocriptine pramipexole is accurate?
68. A 72-year-old patient with parkinsonism (a) Activates dopamine D2 receptors
presents with swollen feet. They are red, (b) Commonly a first-line therapy for Parkinson’s
tender, and very painful. You could clear disease
up these symptoms within a few days if (c) May cause postural hypotension
you told the patient to stop taking
(d) Not an ergot derivative
(a) Amantadine (b) Benztropine
(e) All of the above
(c) Bromocriptine (d) Levodopa
73. Tolcapone may be of value in patient
(e) Selegiline
being treated with levodopa–carbidopa
69. Concerning the drugs used in because it
parkinsonism, which of the following (a) Activates catechol – O – methyltransferease
statements is accurate?
(b) Decreases formation of 3 – O – methyldopa
(a) Levodopa causes mydriasis and can
(c) Inhibits monoamine oxidase type B
precipitate an attack of acute glaucoma
(d) Inhibits dopamine reuptake
(b) Useful therapeutic effects of amantadine
continue for several years (e) Releases dopamine from nerve endings
36 MCQs IN PHARMACOLOGY
74. Concerning hypotheses for the patho- (c) Give oral diphenydramine
physiologic basis of schizophrenia, which (d) Switch the patient to fluphenazine
one of the following statements is accu- (e) Inject benztropine
rate?
(a) Positron emission tomography has shown 78. Which one of the following statements
decreased dopamine receptors in the brains about the action of phenothiazines is
of both untreated and drug-treated accurate?
schizophrenics (a) They activate muscarinic receptors
(b) Drugs that block dopamine receptors are (b) They are antiemetic
useful for alleviating psychotic symptoms in (c) They decrease serum prolactin levels
parkinsoniam patients
(d) They elevate the seizure threshold
(c) The clinical potency of many antipsychotic
(e) They raise blood pressure
drugs correlates well with their beta
adrenoceptor-blocking actions 79. Within days of starting haloperidol treat-
(d) Drug-induced psychosis can occur without ment for a psychatric disorder, a young
activation of brain dopamine receptors male patient developed severe general-
(e) All effective antipsychotic drugs have high ized muscle rigidity and a high fever. In
affinity for dopamine D2 receptors the emergency room he was incoherent,
with increased heart rate, hypotension,
75. Choose the correct statement from the
and diaphoresis, Laboratory studies in-
following? dicated acidosis, leukocytosis, and in-
(a) Muscimol is GABAB selective creased creatine kinase. The most likely
(b) Bicuculline is GABAA agonist reason for these symptoms is that the pa-
(c) Picrotoxin blocks chloride channels tient was suffering from
associated with GABAA receptors (a) Agranulocytosis
(d) Baclofen is GABAA agonist (b) A severe bacterial infection
76. A 30-year-old male patient is on drug (c) Neuroleptic malignant syndrome
therapy for a psychiatric problem. He (d) Spastic retrocollis
complains that he feels “flat” and that (e) Tardive dyskinesia
he gets confused at times. He has been
gaining weight and has lost his sex drive. 80. Following is the main inhibitor y
As he moves his had, you notice a slight transmitter in the brain
tremor. He tells you that since he has been (a) Dopamine (b) Norepinephrine
on medication he is always thirsty and (c) Glycine (d) GABA
frequently has to urinate. The drug he is
most likely to be taking is 81. Concerning the proposed mechanisms of
(a) Clonazepam (b) Clozapine action of antidepressant drugs, which one
of the following statements is accurate?
(c) Haloperidol (d) Lithium
(e) Trifluoperazine (a) Bupropion is an effective inhibitor of NE and
5-HT transporters
77. A young male patient diagnosed as (b) Chronic treatment with an antidepressant often
schizophrenic develops severe muscle leads to the up-regulation of adrenoceptors
cramps with torticollis a short time after
(c) Elevation in amine metabolites in cere-
drug therapy is intiated with haloperidol.
brospinal fluid is characteristic of most
The best course of action would be to
depressed patients prior to drug therapy
(a) Add clozapine to the drug regimen
(d) MAO inhibitors used as antidepressants
(b) Discontinue haloperidol and observe the selectively decrease the metabolism of
patient norepinephrine
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM 37
(e) The acute effect of most tricyclics is to block 87. Established clinical uses of this drug
the neuronal reuptake of both norepinephrine include enuresis and chronic pain
and serotonin in the CNS (a) Bupropion (b) Fluvoxamine
82. Which one of the following effects is (c) Imipramine (d) Phenelzine
unlikely to occur during treatment with (e) Selegiline
amitriptyline?
88. Which one of the following drugs is most
(a) Alpha adrenoceptor blockade likely to increase plasma levels of
(b) Elevation of the seizure threshold alprazolam, the ophyline, and warfarin
(c) Mydriasis (a) Desipramine (b) Fluvoxamine
(d) Sedation (c) Imipramine (d) Nefazodone
(e) Urinary retention (e) Venlafaxine
83. A 54-year-old male patient was using 89. Which one of the following actions of
fluoxetine for depression but decided to opioid analgesics is mediated via
stop taking the drug. When questioned, activation of kappa receptors?
he said that it affected his sexual (a) Cerebral Vascular dilation
performance and that “he wasn’t getting
(b) Decreased uterine tone
any younger.” You notice that he is a used
of tobacco products. If you decide to (c) Euphoria
reinstitute drug therapy in this patient, (d) Sedation
the best choice would be (e) Psychologic dependence
(a) Amoxapine (b) Bupropion 90. ______ antagonists are known to
(c) Imipramine (d) Sertraline attenuate some of the actions of alcohol.
(e) Venlafaxine (a) GABAA (b) GABAB
84. Regarding maprotiline, which one of the (c) NMDA (d) Glycine
following statements is accurate? 91. Which one of the following statements
(a) Blocks serotonin reuptake selectively about propoxyphene is accurate?
(b) Cause hypertension (a) Analgesia equivalent to oxycodone
(c) Raises the seizure threshold (b) Antagonist at mu receptors
(d) Sedation occurs commonly (c) Causes dose-limiting diarrhea
(e) Has a tricyclic structure (d) Highly effective cough suppressant
85. Which one of the following drugs is most (e) Seizures have occurred in overdose
likely to be of value in obsessive 92. A young male patient is brought to the
compulsive disorders (OCD)? emergency room of a hospital suffering
(a) Amitriptyline (b) Bupropion from an overdose of cocaine following
(c) Clomipramine (d) Desipramine intravenous administration. His symp-
toms are unlikely to include
(e) Mirtazapine
(a) Agitation (b) Bradycardia
86. Compared with other antidepressant
(c) Hyperthermia (d) Myocardial infarct
drugs, mirtazapine has the distinctive
(e) Seizures
ability to act as an antagonist of
(a) Alpha2 adrenoceptors 93. Which one of the following statements
(b) Beta adrenoceptors about hallucinogens is accurate?
(c) D2 receptors (a) Mescaline and related hallucinogens are
(d) NE transporters thought to exert their CNS actions through
dopaminergic systems in the brain
(e) 5-HT transporters
38 MCQs IN PHARMACOLOGY