NMS Semester 2 Set 2 Quiz - Anti-depressants, anti-psychotics, anxiolytics and control of pain.

Question 1 of 51

1

What are the three ways in which a signal is terminated at a synapse?

Select one or more of the following:

Reuptake
Enzymatic breakdown
Negative feedback via autoreceptors on the presynaptic membrane
Positive feedback via autoreceptors on the presynaptic membrane
Depolarisation
Hyperpolarisation

Explanation

Question 2 of 51

1

What are some examples of anxiolytics?

Select one or more of the following:

Benzodiazepines
Barbiturates
Alcohol
Monoamine oxidase inhibitors
SSRI's

Explanation

Question 3 of 51

1

What are some examples of anti-depressants?

Select one or more of the following:

Monoamine oxidase inhibitors
Tricyclic
Selective serotonin reuptake inhibitors
Barbiturates
Benzodiazepines

Explanation

Question 4 of 51

1

What are some examples of anti-psychotics?

Select one or more of the following:

Typical neuroleptics
Atypical neuroleptics
Selective serotonin reuptake inhibitors
Benzodiazepines
Alcohol

Explanation

Question 5 of 51

1

How do anxiolytics work?

Select one of the following:

They bind to a different site to GABA and increase the affinity of the receptor for GABA, causing increased inhibition and the user to feel drowsy.
They inhibit the neurotransmission at a synaptic junction which creates fewer excitatory signals in the post-synaptic membrane.

Explanation

Question 6 of 51

1

Novel anxiolytics that block peripheral receptors instead of central ones relieve sedative symptoms.

Select one of the following:

True
False

Explanation

Question 7 of 51

1

Depression is thought to be caused by monoaminergic synaptic hyperactivity.

Select one of the following:

True
False

Explanation

Question 8 of 51

1

What do MAOI's do?

Select one of the following:

Inhibit the reuptake of serotonin and noradrenaline into the pre-synaptic knob.
Inhibit the monoamine oxidase enzyme that breaks down serotonin and noradrenaline neurotransmitters.

Explanation

Question 9 of 51

1

What do TCA and SSRI's do?

Select one of the following:

They inhibit the re-uptake of serotonin and noradrenaline from the synaptic cleft.
They inhibit monoamine oxidase which breaks serotonin and noradrenaline down.

Explanation

Question 10 of 51

1

TCA's are much more selective than SSRI's at blocking serotonin rather than noradrenaline at monoaminergic synapses.

Select one of the following:

True
False

Explanation

Question 11 of 51

1

Typical neuroleptics are more selective at blocking dopamine receptors.

Select one of the following:

True
False

Explanation

Question 12 of 51

1

Psychosis is thought to be caused by dopaminergic hyperactivity.

Select one of the following:

True
False

Explanation

Question 13 of 51

1

Why can anti-psychotics sometimes cause parkinsonian?

Select one of the following:

Anti-psychotics reduce the activity at dopaminergic synapses. This can be so extreme that motor function is impaired and parkinson like symptoms are experienced.
Anti-psychotics increase the activity at dopaminergic synapses. This can be so extreme that motor function is impaired and parkinson like symptoms are experienced.
Anti-psychotics reduce the activity at monoaminergic synapses. This can be so extreme that motor function is impaired and parkinson like symptoms are experienced.
Anti-psychotics increase the activity at monoaminergic synapses. This can be so extreme that motor function is impaired and parkinson like symptoms are experienced.

Explanation

Question 14 of 51

1

As well as parkinsonian, what other motor symptoms can anti-psychotics produce? (CLOZAPINE DOES NOT PRODUCE THIS)

Select one of the following:

Tardive dyskinesia
Duchene muscular dystrophy
Ataxia

Explanation

Question 15 of 51

1

Which three areas of the brain are affected by anti-psychotics?

Select one or more of the following:

Mesolimbal
Mesocortical
Nigrostriatal
Lateral hypothalamic area
Primary gustatory cortex

Explanation

Question 16 of 51

1

What do mechanical nociceptors respond to? What is an example?

Select one or more of the following:

A-delta fibres
C fibres
Sharp cuts or Blunt force
Damaging heat

Explanation

Question 17 of 51

1

What do polymodal nociceptors respond to? What is an example?

Select one or more of the following:

A-delta fibres
C fibres
Many modalities
Only a few modalities

Explanation

Question 18 of 51

1

Myelination tends to reflect upon what property of a primary sensory neurone?

Select one of the following:

That is transmits a fast, sharp pain.
That it transmits a slow, dull pain.

Explanation

Question 19 of 51

1

Frequency coding states what?

Select one of the following:

The greater the pain stimulus is, the higher the frequency of action potentials fired from the periphery to the CNS.
The lower the pain stimulus is, the higher the frequency of action potentials fired from the periphery to the CNS.

Explanation

Question 20 of 51

1

The laminar order in which primary sensory neurones synapse in the spinal cord means that each "sheet" in the spinal cord receives input from a particular part of the body (somatotopic)

Select one of the following:

True
False

Explanation

Question 21 of 51

1

When a painful stimulus is detected and an action potential is propagated to the spinal cord, how is the pain then transmitted up to the brain?

Select one of the following:

Excitatory neurotransmitters are released from the a-delta/c fibre and this causes pain signals to be carried to the brain.
Excitatory neurotransmitter are released from the a-delta/c fibre which stimulate an inhibitory interneurone to inhibit the GATEKEEPER. This inhibits the inhibitory GATEKEEPER and weakens the inhibition that the GATEKEEPER provides to the ascending pain signal. This allows pain signals to carry up to the brain.

Explanation

Question 22 of 51

1

Rubbing your knee activates a-beta mechanoreceptor fibres which cause excitatory neurotransmitter release to the GATEKEEPER which then releases more inhibitory signals to block pain signals going to the brain.

Select one of the following:

True
False

Explanation

Question 23 of 51

1

The GATEKEEPER sends out excitatory signals to aid pain signals passing up to the brain.

Select one of the following:

True
False

Explanation

Question 24 of 51

1

Where is pain perceived?

Select one of the following:

Subcortically (before the cortex)
At the cortex

Explanation

Question 25 of 51

1

Where is pain localised?

Select one of the following:

The cortex
Subcortically (before the cortex)

Explanation

Question 26 of 51

1

The emotional (psychogenic) element of pain means that it is not just a single part of the brain that takes part in pain signal processing, but many different regions that co-ordinate together.

Select one of the following:

True
False

Explanation

Question 27 of 51

1

Descending pathways that release endogenous opioids act where?

Select one of the following:

The GATEKEEPER to enhance inhibition of pain signals ascending to the brain.
The GATEKEEPER to enhance pain signals ascending to the brain.

Explanation

Question 28 of 51

1

Primary hyperalgesia occurs where?

Select one of the following:

CNS
Peripheral nervous system

Explanation

Question 29 of 51

1

Secondary hyperalgesia occurs where?

Select one of the following:

CNS
Peripheral nervous system

Explanation

Question 30 of 51

1

Primary hyperalgesia occurs due to what process?

Select one of the following:

Noxious stimulus occurs after initial injury -> AXON REFLEX -> SP and CGRP release -> vasodilatation + immune cell activation -> Bradykinin, PG etc "inflammatory soup"
Noxious stimulus occurs after initial injury -> AXON REFLEX -> Bradykinin and CGRP release -> vasodilatation + immune cell activation -> SP, PG etc "inflammatory soup"
Noxious stimulus occurs after initial injury -> AXON REFLEX -> SP and Bradykinin release -> vasodilatation + immune cell activation -> CGRP, PG etc "inflammatory soup"

Explanation

Question 31 of 51

1

Which receptor does substance P act?

Select one of the following:

NK-1
AMPA
NMDA

Explanation

Question 32 of 51

1

Which receptor does Glutamate act at?

Select one of the following:

NK-1
AMPA
NMDA

Explanation

Question 33 of 51

1

Glutamate is usually released during normal, acute pain, rather than Substance P.

Select one of the following:

True
False

Explanation

Question 34 of 51

1

Why does binding of Substance P and Glutamate cause secondary hyperalgesia?

Select one of the following:

Binding of Substance P and Glutamate activate the NK-1 and AMPA receptors respectively. This causes sufficient depolarisation in order to repel the magnesium dependent block out of the VG Ca2+ channel. Calcium entry causes 2ndry messenger activation and increased neurone responsiveness. This increases the rate of AP firing and explains why pain is more intense in secondary hyperalgesia.
Binding of Substance P and Glutamate activate the AMPA and NK-1 receptors respectively. This causes sufficient depolarisation in order to repel the magnesium dependent block out of the VG Ca2+ channel. Calcium entry causes 2ndry messenger activation and increased neurone responsiveness. This increases the rate of AP firing and explains why pain is more intense in secondary hyperalgesia.
Binding of Substance P and Glutamate activate the NK-1 and AMPA receptors respectively. This causes sufficient depolarisation in order to repel the calcium dependent block out of the VG Ca2+ channel. Calcium entry causes 2ndry messenger activation and increased neurone responsiveness. This increases the rate of AP firing and explains why pain is more intense in secondary hyperalgesia.

Explanation

Question 35 of 51

1

Neuropathic pain is the overall sensation of pain; the physiological factor and the psychogenic factor.

Select one of the following:

True
False

Explanation

Question 36 of 51

1

Name two types of endogenous opioids

Select one or more of the following:

Enkephalins
Beta-endorphins
Naloxone
Pethidine

Explanation

Question 37 of 51

1

Name two types of therapeutic agent opioids

Select one or more of the following:

Heroin
Codeine
Methadone
Fentanyl
Beta-endorphins

Explanation

Question 38 of 51

1

Name four types of synthetic agent opioids

Select one or more of the following:

Pethidine
Fentanyl
Methadone
Buprenorphine (partial agonist)
Fluoxetine
Enkephalins

Explanation

Question 39 of 51

1

Opioids are usually administered parenterally as the GIT does not absorb opioids well.

Select one of the following:

True
False

Explanation

Question 40 of 51

1

What are the three sites of action for opioids?

Select one or more of the following:

Inhibition of primary sensory neurones synapsing to second order neurones in the spinal cord
Excitation of the nucleus raphe magnus which causes inhibition of pain signals at the spinal cord level
Excitation of the nucleus reticularis which causes inhibition of pain signals at the spinal cord level
Decreased excitability of peripheral nociceptor neurones

Explanation

Question 41 of 51

1

What does label 2 show?

Select one of the following:

Activation of the G-protein
Less opening of Ca2+ channels - less neurotransmitter release
More opening of K+ channels - leading to hyperpolarisation

Explanation

Question 42 of 51

1

What does label 3 show?

Select one of the following:

Activation of G-protein
Less opening of Ca2+ channels - less neurotransmitter release
More opening of K+ channels - leading to hyperpolarisation

Explanation

Question 43 of 51

1

What does label 4 show?

Select one of the following:

Activation of the G-protein
Less opening of Ca2+ channels - less neurotransmitter release
More opening of K+ channels - leading to hyperpolarisation

Explanation

Question 44 of 51

1

Opioids inhibit adenylyl cyclase which leads to increased cAMP levels.

Select one of the following:

True
False

Explanation

Question 45 of 51

1

What effects occur due to opioid action?

Select one or more of the following:

Analgesia
Constriction of smooth muscle at all sites
Nausea
Relaxation of smooth muscle at all sites
Euphoria at all sites

Explanation

Question 46 of 51

1

What are two problems with prolonged opioid use?

Select one or more of the following:

Tolerance - due to increased adenylyl cyclase expression
Dependence - withdrawal symptoms

Explanation

Question 47 of 51

1

NSAIDS are cyclo-oxygenase inhibitors.

Select one of the following:

True
False

Explanation

Question 48 of 51

1

Aspirin is a competitive inhibitor of COX.

Select one of the following:

True
False

Explanation

Question 49 of 51

1

COX enzymes catalyse the reaction that turns arachidonic acid into prostaglandins. Inhibition of COX therefore reduces prostaglandin production and thus inflammation.

Select one of the following:

True
False

Explanation

Question 50 of 51

1

As a result of the action of NSAIDs, what effects are produced?

Select one or more of the following:

Anti-pyretic - decreases the temp set point in the hypothalamus
Anti-inflammatory - dec PG = dec vasodilation
Analgesia - dec PG = decrease sensitivity of nerves to inflammatory pain
Anti-inflammatory - dec PG = inc vasodilation
Anti-pyretic - decreases the temp set point in the basal ganglia

Explanation

Question 51 of 51

1

Prostaglandins help to produce the mucus lining of the stomach, therefore NSAIDs can cause increased risk of peptic ulcers.

Select one of the following:

True
False

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