Question 1

Which of the following are classified as sleep disorders?
1)Insomnia
2)Narcolepsy
3)Restless legs syndrome
4)Asthma
5)Parasomnias

A)2 and 5 only
B)1 and 2 only
C)1,2,and 3 only
D)1,2,3,and 5 only

1,2,3,and 5 only

Accepted Answer

Until the mid-1960s,the field of sleep medicine focused primarily on describing and treating insomnia,parasomnias (e.g. ,sleepwalking,night terrors),and hypersomnias such as narcolepsy.Patients experiencing these symptoms typically sought consultations from neurologists,psychiatrists,psychologists,or their family physician.Until more recently,treatments were generally based on empiric pharmaceutical intervention along with behavioral modification protocols or psychotherapy or both.In the future,respiratory therapists may find themselves in a position in which they are involved with the attending physician in determining appropriate pharmacotherapy for sleep-related disorders such as narcolepsy or periodic limb movement disorder.

Question 2

A chronic and progressive neurologic disorder characterized by unpleasant sensations in the legs and a compelling urge to move the legs while the patient is awake is referred to as&#10;A)RLS.&#10;B)insomnia.&#10;C)narcolepsy.&#10;D)parasomnias.

Accepted Answer

Restless legs syndrome (RLS)is a chronic,progressive neurologic disorder characterized by unpleasant sensations in the legs and a compelling urge to move the legs while the patient is awake.These symptoms occur most frequently during the evening or at night and during periods of rest.Insomnia is characterized by difficulty in falling asleep (i.e. ,a sleep latency of >30 minutes),insufficient sleep (i.e. ,total sleep time <5.5 to 6 hours),multiple nocturnal awakenings,early morning awakening with inability to resume sleep,or nonrestorative sleep.Narcolepsy is characterized by a tetrad of clinical symptoms.Two features of the tetrad-persistent excessive daytime sleepiness and cataplexy-were documented in the original descriptions of the disorder and remain the only two clinical features essential for diagnosis.Two additional features-hypnagogic hallucinations (the onset of dreams while still awake)and sleep paralysis (a temporary loss of muscle tone or an inability to perform voluntary movements either at sleep onset or on awakening)-were added later.Another common symptom of narcolepsy is fragmented sleep with multiple arousals and awakenings at night.Parasomnias are undesirable motor,sensory,or behavioral phenomena that occur primarily during sleep.

Question 3

Pharmacologic treatment of insomnia includes&#10;1)estazolam.&#10;2)eszopiclone.&#10;3)zolpidem.&#10;4)ramelteon.&#10;A)2 and 3 only&#10;B)1 and 3 only&#10;C)1,2,and 3 only&#10;D)1,2,3,and 4

Accepted Answer

All options listed, estazolam, eszopiclone, zolpidem, and ramelteon, are pharmacologic treatments used for insomnia.

Question 4

What are the two phases of REM sleep?&#10;A)Tonic and periodic&#10;B)Phasic and cyclic&#10;C)Tonic and phasic&#10;D)Tonic and cyclic

Accepted Answer

The term for REM sleep is derived from the periodic bursts of rapid eye movements during sleep.REM sleep has both tonic (persistent)and phasic (episodic)components.

Question 5

The prototypic chronobiotic is&#10;A)valium.&#10;B)melatonin.&#10;C)phenobarbital.&#10;D)klonopin.

Accepted Answer

Drugs that directly influence circadian mechanisms are often referred to as chronobiotics.The prototype for this type of drug is melatonin (N-acetyl-5-methoxytryptamine),a pineal hormone that has been identified as an important endogenous regulatory factor,with levels that vary with circadian time.Valium and Klonopin are benzodiazepines.Phenobarbital is a barbiturate.

Question 6

Reduced extracellular levels of which neurotransmitter can contribute to the symptoms of restless legs syndrome (RLS)?&#10;A)Dopamine&#10;B)Histamine&#10;C)Norepinephrine&#10;D)Glutamate

Accepted Answer

Research has focused on determining if reductions in extracellular dopamine levels within the central nervous system or deficiencies in postsynaptic responsivity to dopamine might contribute to the symptoms of RLS.Reduced levels of extracellular dopamine are central to several hypotheses regarding neurochemical substrates contributing to RLS.Elucidation of any actual dopaminergic dysfunction has remained enigmatic,however.

Question 7

The onset and duration of sleep is orchestrated through
1)hypothalamic-pituitary-adrenal (HPA)axis.
2)multiple brain structures.
3)neurotransmitter substrates.
4)mast cells.

A)2 and 3 only
B)1 and 3 only
C)1 and 4 only
D)1,2,and 4 only

Accepted Answer

The onset and duration of sleep is orchestrated through
1)hypothalamic-pituitary-adrenal (HPA)axis.
2)multiple brain structures.
3)neurotransmitter substrates.
4)mast cells.

A)2 and 3 only
B)1 and 3 only
C)1 and 4 only
D)1,2,and 4 only

Question 8

Treatment for NREM and REM sleep parasomnias frequently includes&#10;A)phenobarbital.&#10;B)avoidance of potential triggers.&#10;C)longer acting benzodiazepines.&#10;D)both B and C.

Accepted Answer

Treatment for NREM and REM sleep parasomnias frequently includes avoidance of potential triggers and in the case of somnambulism and REM behavior disorder also necessitates a safe,well-monitored sleeping environment.The most common pharmaceutical treatment for REM and NREM sleep parasomnias is usually one of the longer acting benzodiazepines.

Question 9

The sleep disorder characterized by difficulty falling asleep,insufficient sleep,or nonrestorative sleep is&#10;A)restless legs syndrome (RLS).&#10;B)insomnia.&#10;C)narcolepsy.&#10;D)parasomnias.

Accepted Answer

Insomnia is characterized by difficulty in falling asleep (i.e. ,a sleep latency of >30 minutes),insufficient sleep (i.e. ,total sleep time <5.5 to 6 hours),multiple nocturnal awakenings,early morning awakening with inability to resume sleep,or nonrestorative sleep.RLS is a chronic,progressive neurologic disorder characterized by unpleasant sensations in the legs and a compelling urge to move the legs while the patient is awake.These symptoms occur most frequently during the evening or at night as well as during periods of rest.Narcolepsy is characterized by a tetrad of clinical symptoms.Two features of the tetrad-persistent excessive daytime sleepiness and cataplexy-were documented in the original descriptions of the disorder and remain the only two clinical features essential for diagnosis.Two additional features-hypnagogic hallucinations (the onset of dreams while still awake)and sleep paralysis (a temporary loss of muscle tone or an inability to perform voluntary movements either at sleep onset or on awakening)-were recognized later.Another common symptom of narcolepsy is fragmented sleep with multiple arousals and awakenings at night.Parasomnias are undesirable motor,sensory,or behavioral phenomena that occur primarily during sleep.

Question 10

Most ascending activating system (AAS)projections that mediate electroencephalographic (EEG)arousal and wakefulness synapse in which brain region?&#10;A)Laterodorsal pontine tegmentum&#10;B)Thalamus&#10;C)Pedunculopontine tegmentum&#10;D)Hippocampus

Accepted Answer

Most AAS projections that mediate EEG arousal and wakefulness synapse in the thalamus,which is an essential center for the organization of EEG arousal and for maintaining activation at a cortical level.Thalamic mechanisms at a cellular level influence the differences between wakefulness and NREM sleep.

Question 11

The sleep disorder characterized by undesirable motor,sensory,or behavioral phenomena is referred to as&#10;A)insomnia.&#10;B)narcolepsy.&#10;C)parasomnias.&#10;D)restless legs syndrome (RLS).

Accepted Answer

The answer of The sleep disorder characterized by undesirable motor,sensory,or...

Question 12

The sleep disorder characterized by persistent excessive daytime sleepiness,cataplexy,hypnagogic hallucinations,and sleep paralysis is&#10;A)restless legs syndrome (RLS).&#10;B)insomnia.&#10;C)narcolepsy.&#10;D)parasomnias.

Accepted Answer

The answer of The sleep disorder characterized by persistent excessive...

Question 13

Pharmacologic treatment for narcolepsy includes&#10;A)valium.&#10;B)xyrem.&#10;C)phenobarbital.&#10;D)zolpidem.

Accepted Answer

The answer of Pharmacologic treatment for narcolepsy includes&#10;A)valium.&#10;B)xyrem.&#10;C)phenobarbital.&#10;D)zolpidem....

Question 14

Melatonin is secreted&#10;A)exclusively during the subjective night.&#10;B)exclusively during the subjective day.&#10;C)during day and night.&#10;D)continuously.

Accepted Answer

The answer of Melatonin is secreted&#10;A)exclusively during the subjective night.&#10;B)exclusively...

Question 15

The suprachiasmatic nucleus (SCN)is localized to the&#10;A)anterior hypothalamus.&#10;B)posterior hypothalamus.&#10;C)laterodorsal pontine tegmentum.&#10;D)pedunculopontine tegmentum.

Accepted Answer

The answer of The suprachiasmatic nucleus (SCN)is localized to the&#10;A)anterior...

Question 16

Your patient is experiencing worsening of symptoms associated with restless legs syndrome (RLS).Which medications could be causing this?&#10;A)Albuterol&#10;B)Valium&#10;C)Ranitidine&#10;D)Zolpidem

Accepted Answer

The answer of Your patient is experiencing worsening of symptoms...

Question 17

Lunesta is the trade name for&#10;A)estazolam.&#10;B)temazepam.&#10;C)triazolam.&#10;D)eszopiclone.

Accepted Answer

The answer of Lunesta is the trade name for&#10;A)estazolam.&#10;B)temazepam.&#10;C)triazolam.&#10;D)eszopiclone....

Question 18

Drugs that directly influence circadian mechanisms are often referred to as&#10;A)chronobiology.&#10;B)chronopharmacology.&#10;C)chronotoxicity.&#10;D)chronobiotics.

Accepted Answer

The answer of Drugs that directly influence circadian mechanisms are...

Question 19

Under normal circumstances,circadian rhythms become synchronized to the&#10;A)person's work schedule.&#10;B)chronopharmacology.&#10;C)chronobiology.&#10;D)environmental light/dark cycle.

Accepted Answer

The answer of Under normal circumstances,circadian rhythms become synchronized to...

Question 20

Restoril is the trade name for&#10;A)estazolam.&#10;B)temazepam.&#10;C)triazolam.&#10;D)eszopiclone.

Accepted Answer

The answer of Restoril is the trade name for&#10;A)estazolam.&#10;B)temazepam.&#10;C)triazolam.&#10;D)eszopiclone....

Question 21

Halcion is the trade name for&#10;A)estazolam.&#10;B)temazepam.&#10;C)triazolam.&#10;D)eszopiclone.

Accepted Answer

The answer of Halcion is the trade name for&#10;A)estazolam.&#10;B)temazepam.&#10;C)triazolam.&#10;D)eszopiclone....

Question 22

Side effects of phenobarbital include&#10;1)potential risk for addiction.&#10;2)respiratory suppression when taken with alcohol.&#10;3)insomnia.&#10;A)1 and 3 only&#10;B)2 and 3 only&#10;C)1 and 2 only&#10;D)1,2,and 3

Accepted Answer

The answer of Side effects of phenobarbital include&#10;1)potential risk for...

Question 23

______________________ is the study of time-dependent variations in pharmacology.&#10;A)Chronopharmacology&#10;B)Chronobiology&#10;C)Circopharmacology&#10;D)Chromopharmacology

Accepted Answer

The answer of ______________________ is the study of time-dependent variations...

Question 24

The trade name for Zaleplon is&#10;A)Ambien&#10;B)ProSom&#10;C)Sonata&#10;D)Rozerem

Accepted Answer

The answer of The trade name for Zaleplon is&#10;A)Ambien&#10;B)ProSom&#10;C)Sonata&#10;D)Rozerem...

Question 25

The trade name for Ramelteon is&#10;A)Ambien&#10;B)ProSom&#10;C)Sonata&#10;D)Rozerem

Accepted Answer

The answer of The trade name for Ramelteon is&#10;A)Ambien&#10;B)ProSom&#10;C)Sonata&#10;D)Rozerem...

Question 26

The trade name for Zolpidem is&#10;A)Ambien.&#10;B)ProSom.&#10;C)Sonata.&#10;D)Rozerem.

Accepted Answer

The answer of The trade name for Zolpidem is&#10;A)Ambien.&#10;B)ProSom.&#10;C)Sonata.&#10;D)Rozerem....

Deck 23: Sleep and Sleep Pharmacology