Deck 8: The Modulat Ion of Behaviour, Cognition and Motor Activity

Question 1

The therapeutic action of spasmolytic agents for epilepsy management is:

A) to increase muscle tone.
B) to inhibit muscular spasms.
C) to initiate the efflux of sodium from within cells.
D) none of the above.

Answer 1

to inhibit muscular spasms.

Question 2

Which part of the human brain is not considered part of the brainstem?

A) Medulla oblongata.
B) Midbrain.
C) Pons.
D) Cerebrum.

Answer 2

Cerebrum.

Question 3

The transmitter that is particularly associated with cognition, memory formation and skeletal muscle activation is:

A) dopamine.
B) noradrenaline.
C) acetylcholine.
D) serotonin.

Answer 3

acetylcholine.

Question 4

Which of the following drug mechanisms of action is desirable in the management of seizures?

A) The stabilisation of the nerve membrane.
B) Inhibiting the action of glutamate.
C) The enhancement of GABA activity.
D) All of the above.

Question 5

With which neurotransmitter system are NMDA receptors primarily associated?

A) Acetylcholine.
B) Glutamate.
C) Dopamine.
D) Serotonin.

Question 6

Which description best matches the role of the thalamus?

A) A sorting area for sensory and motor impulses that relays the information to the most appropriate brain region.
B) An area involved in appetite, body temperature, thirst and hormone release.
C) The area involved in the primary perception and interpretation of sensation as well as the initiation of skeletal muscle movement.
D) This region is involved in equilibrium, postural control and coordinated movement.

Question 7

The potential role of antiseizure drugs in the management of bipolar disorder is to:

A) elevate the synaptic levels of noradrenaline and serotonin.
B) antagonise the effects of GABA.
C) substitute for sodium ion in neuronal processes.
D) stabilise the erratic firing in pathways associated with mood.

Question 8

Barbiturates remain in use for seizure management because:

A) They have few serious adverse effects.
B) Their antiseizure activity is greater than their sedating activity.
C) Physical dependence does not occur.
D) They are safe for use in patients with chronic kidney disease.

Question 9

Psychoses include the following conditions except:

A) Depression.
B) Schizophrenia.
C) Severe agitation.
D) Some forms of dementia.

Question 10

Cholestatic jaundice can occur with which phenothiazine antipsychotic agent, therefore requiring cessation of the agent?

A) Fluphenazine.
B) Pericyazine.
C) Chlorpromazine.
D) Pipothiazine.

Question 11

The proposed action of tetracyclic antidepressant drugs is:

A) block transmitter reuptake.
B) block the amine reuptake pump on the presynaptic terminal.
C) inhibit monoamine oxidase.
D) selectively block postsynaptic 5-HT₂ receptors.

Question 12

Which of the following antipsychotic drug groups is associated with photosensitivity, therefore requiring protection from the sun?

A) The butyrophenones.
B) The phenothiazines.
C) The dibenzodiazepines.
D) The thioxanthenes.

Question 13

The potentially fatal 'serotonin syndrome' is associated with SSRI therapy for depression. Which of the following signs or symptoms are not linked to serotonin syndrome?

A) Weight gain.
B) Hyperthermia.
C) Sweating.
D) Euphoria or drowsiness.

Question 14

One of the pharmacological issues associated with the widespread distribution of receptors for a particular transmitter throughout the brain is that:

A) the number of unwanted drug effects is low.
B) there is a need to develop more specific agents.
C) the drugs will not work on peripheral body receptors.
D) the receptors are all of the same subtype.

Question 15

A seizure characterised by an unresponsive, blank state and stereotypic behaviours (such as eyelid fluttering) is:

A) an absence seizure.
B) a psychomotor seizure.
C) a Jacksonian seizure.
D) tonic-clonic seizure.

Question 16

Which of the following statements regarding status epilepticus is true?

A) This is the medical term given to a person with epilepsy.
B) In this form of epilepsy the person is affected by a number of different seizure types.
C) In status epilepticus there is no spontaneous recovery from a seizure.
D) This condition is commonly associated with client compliance with medication.

Question 17

In terms of the proposed sites of action of antidepressant drugs, which of the following would be expected to produce a therapeutic benefit?

A) The induction of monoamine oxidase activity.
B) An increase in the synaptic levels of neurotransmitters serotonin and/or noradrenaline.
C) A centrally acting β₂ agonist.
D) Depletion of amine transmitter levels in the presynaptic nerve terminal.

Question 18

Spasmolytic muscle relaxants enhance the inhibitory transmitter GABA. How does this action produce a therapeutic effect in seizure management?

A) It reduces hyperexcitability of the motor pathways in the brain and spinal cord.
B) By inducing sedation in the patient.
C) By altering calcium levels that reduce skeletal muscle contraction.
D) Stimulation of GABAergic pathways in the spinal cord.

Question 19

The psychological disorder characterised by persistent thoughts and repetitive, ritualistic behaviours is called:

A) endogenous depression.
B) panic disorder.
C) mania.
D) obsessive-compulsive disorder.

Question 20

An adverse effect profile of antimuscarinic and antiadrenergic activity and potentially lethal cardiac dysrhythmias is characteristic of which antidepressant drug group?

A) Non-selective MAO inhibitors.
B) Tricyclic antidepressants.
C) Selective serotonin reuptake inhibitors.
D) Tetracyclic antidepressants.

Question 21

Alzheimer's disease is characterised by the lack of which neurotransmitter in the higher centres of the brain?

A) Noradrenaline.
B) Acetylcholine.
C) Dopamine.
D) Serotonin.

Question 22

Modafinil is useful in the treatment of:

A) ADD.
B) ADHD.
C) narcolepsy.
D) amphetamine addiction.

Question 23

Which of the following antiseizure drugs requires visual fields to be tested before commencing therapy and at regular intervals during therapy?

A) Valproic acid.
B) Phenytoin.
C) Vigabatrin.
D) Lamotrigine.

Question 24

More than how many weeks of continuous treatment with benzodiazepines results in dependence and tolerance?

A) One week.
B) Two to four weeks.
C) Four to six weeks.
D) Six to eight weeks.

Question 25

Which of the following is an atypical antipsychotic?

A) Trifluoperazine.
B) Prochlorperazine.
C) Haloperidol.
D) Clozapine.

Question 26

Benzodiazepines can induce:

A) amnesia.
B) rage.
C) depression.
D) all of the above.

Question 27

Which of the following measures does not help to avoid the serotonin syndrome associated with the use of selective serotonin reuptake inhibitors (SSRIs)?

A) Co-administration of two SSRI preparations.
B) Having a 'washout' period when switching drugs.
C) Administering a therapeutic dose of a single SSRI agent.
D) Tapering high doses of the SSRI agent.

Question 28

Apart from its use in psychoses, chlorpromazine is also used in the treatment of:

A) intractable hiccoughs.
B) hypotension.
C) stopping lactation.
D) diarrhoea.

Question 29

What is the rationale for giving levodopa and carbidopa as combination therapy for Parkinson's disease?

A) Levodopa increases the therapeutic effect of carbidopa.
B) Carbidopa inhibits the breakdown of levodopa increasing distribution to the central nervous system.
C) Both preparations are required to increase the availability of dopamine in the peripheries.
D) Levodopa increases the half-life of carbidopa.

Question 30

Which of the following antiseizure drugs may cause gingivitis and gingival hyperplasia, therefore necessitating the need for meticulous dental care?

A) Phenytoin.
B) Carbamazepine.
C) Ethosuximide.
D) Vigabatrin.

Question 31

Parkinson's disease is a defect in the function of which transmitter system in the basal ganglia?

A) Noradrenaline.
B) Acetylcholine.
C) Dopamine.
D) Serotonin.

Question 32

Blood counts should be performed regularly in clients using:

A) pimozide.
B) chlorpromazine.
C) clozapine.
D) risperidone.

Question 33

To ensure a uniform concentration of levodopa, the dose should be taken:

A) with milk.
B) before exercise.
C) immediately before breakfast and one hour after the evening meal.
D) at the same time each day and in a consistent manner in relation to food.

Question 34

An example of a psychosis is:

A) schizophrenia.
B) depression.
C) anxiety.
D) panic disorder.

Question 35

Which of the following practices is not associated with rational prescribing of antidepressants?

A) The use of a combination of antidepressant agents is the best way of treating depression.
B) When changing antidepressant agents, the client should have a 'washout' period.
C) If one antidepressant does not work at therapeutic doses, the client should be changed to another antidepressant.
D) Significant antidepressant benefit is not apparent immediately starting treatment. The prescriber should wait three to four weeks before assessing the benefit.

Question 36

Mr Penson was being treated with drugs for Parkinson's disease and noted an increase in his libido. What drug may have caused this?

A) The dopamine precursor, levodopa.
B) The antimuscarinic, benzhexol.
C) Amantadine.
D) The MAO-B inhibitor, selegiline.

Question 37

How does donepezil work to improve the symptoms associated with Alzheimer's disease?

A) It induces sedation which reduces agitation in sufferers and allows recovery time for the brain, which in turn improves memory.
B) It stimulates the release of the neurotransmitter acetylcholine into synapses.
C) It blocks the release of the neurotransmitter dopamine to improve the balance between dopamine and acetylcholine.
D) It blocks the enzyme that degrades acetylcholine, which increases the availability and prolongs the action of the neurotransmitter.

Question 38

'Drug holidays' from dexamphetamine may be important to avoid:

A) addiction.
B) growth retardation.
C) insomnia.
D) cognitive impairment.

Question 39

Which benzodiazepine is sometimes useful in the treatment of endogenous depression?

A) Alprazolam.
B) Triazolam.
C) Diazepam.
D) Flunitrazepam.

Question 40

Which benzodiazepine agent would be considered suitable for a person who has problems with early morning awakening?

A) Triazolam.
B) Diazepam.
C) Temazepam.
D) Flunitrazepam.

Question 41

Which of the following antiseizure medications is associated with severe skin reactions?

A) Valproic acid.
B) Phenytoin.
C) Vigabatrin.
D) Lamotrigine.

Question 42

Echolalia and coprolalia are common features of:

A) Huntington's disease.
B) Schizophrenia.
C) Tourette's syndrome.
D) Parkinson's disease.

Question 43

Neuroleptic drug-induced Parkinsonian symptoms are often treated with:

A) an antimuscarinic agent.
B) a serotonin receptor agonist.
C) an antiemetic agent.
D) an increase in neuroleptic dose.

Question 44

In order to promote maximum benefit for the treatment of narcolepsy, modafinil should be taken as a daily dose:

A) in the morning, or as two divided doses in the morning and at noon.
B) in the mid afternoon.
C) with the evening meal.
D) at bedtime.

Question 45

Which one of the following drugs is not used in the management of multiple sclerosis to modify the immune response?

A) Baclofen.
B) Glatiramer.
C) Prednisone.
D) Interferon β.

Question 46

Behaviour associated with ADD in children includes:

A) forgetfulness.
B) daydreaming.
C) lack of interest.
D) all of the above.

Question 47

The transmitter associated with emesis is:

A) Dopamine.
B) Serotonin.
C) Noradrenaline.
D) Acetylcholine.

Question 48

When switching from one antipsychotic medication to clozapine:

A) the other antipsychotic medication is reduced over one day, and stopped for 24 hours before starting clozapine.
B) the other antipsychotic medication is reduced over two days, and stopped for 24 hours before starting clozapine.
C) the other antipsychotic medication is reduced over four days, and stopped for 24 hours before starting clozapine.
D) the other antipsychotic medication is reduced over seven days, and stopped for 24 hours before starting clozapine.

Question 49

All of the following antidepressants are suitable forms of therapy for a woman with postpartum depression who is breastfeeding, except for:

A) paroxetine.
B) fluoxetine.
C) sertraline.
D) fluvoxamine.

Question 50

Which of the following is not an appropriate clinical management activity in relation to tetrabenazine therapy for Huntington's disease?

A) The client should avoid drinking alcohol with tetrabenazine.
B) Therapy is stopped if dysphagia or choking occurs.
C) If depression occurs, the dose of tetrabenazine is reduced or treatment is stopped.
D) The dose of tetrabenazine is reduced gradually over two days to prevent rebound involuntary movements.

Question 51

Which one of the following statements about lithium carbonate is true?

A) It has a high therapeutic index.
B) The body treats it like it is sodium.
C) It enhances the synaptic levels of noradrenaline.
D) It is used in the management of panic disorders.

Question 52

Akathisia, dystonic reactions and tardive dyskinesia are extrapyramidal symptoms associated with:

A) Antipsychotic use.
B) Anxiolytics.
C) Hypnotics.
D) Tetracyclic antidepressants.

Question 53

A seizure that manifests as muscle spasms of body parts in sequence is most likely a:

A) Myoclonic seizure.
B) Absence seizure.
C) Psychomotor seizure.
D) Jacksonian seizure.

Question 54

Which of the following benzodiazepine agents would be suitable for a plane journey where the traveller is having trouble getting off to sleep?

A) Clobazam.
B) Diazepam.
C) Triazolam.
D) Nitrazepam.

Question 55

Which one of the following anxiolytic/sedative drugs can directly activate GABA receptors, even in the absence of GABA itself?

A) Benzodiazepines.
B) Buspirone.
C) Barbiturates.
D) Dexmedetomidine.

Question 56

As well as an anti-seizure agent, phenytoin is also used for treating:

A) dysrhythmia.
B) ADHD.
C) migraine.
D) Parkinson's disease.

Question 57

Excessive glutamine repeats in the protein coded by the HTT gene is associated with:

A) Motor neurone disease.
B) Multiple sclerosis.
C) Huntington's disease.
D) Alzheimer's disease.

Question 58

Which of the following describes extrapyramidal reactions associated with first-line antipsychotic therapy?

A) Lip smacking and rapid darting tongue movements.
B) Facial grimacing, wry neck and limb spasticity.
C) Tremor and rigidity.
D) All of the above.

Question 59

Which dopamine receptor is most frequently associated with psychotic illness?

A) D1.
B) D2.
C) D3.
D) D4.

Question 60

The major inhibitory neurotransmitter is:

A) Dopamine.
B) Glutamate.
C) Serotonin.
D) GABA