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

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Resumo de Recurso

Questão 1

Questão
What are the three ways in which a signal is terminated at a synapse?
Responda
  • Reuptake
  • Enzymatic breakdown
  • Negative feedback via autoreceptors on the presynaptic membrane
  • Positive feedback via autoreceptors on the presynaptic membrane
  • Depolarisation
  • Hyperpolarisation

Questão 2

Questão
What are some examples of anxiolytics?
Responda
  • Benzodiazepines
  • Barbiturates
  • Alcohol
  • Monoamine oxidase inhibitors
  • SSRI's

Questão 3

Questão
What are some examples of anti-depressants?
Responda
  • Monoamine oxidase inhibitors
  • Tricyclic
  • Selective serotonin reuptake inhibitors
  • Barbiturates
  • Benzodiazepines

Questão 4

Questão
What are some examples of anti-psychotics?
Responda
  • Typical neuroleptics
  • Atypical neuroleptics
  • Selective serotonin reuptake inhibitors
  • Benzodiazepines
  • Alcohol

Questão 5

Questão
How do anxiolytics work?
Responda
  • 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.

Questão 6

Questão
Novel anxiolytics that block peripheral receptors instead of central ones relieve sedative symptoms.
Responda
  • True
  • False

Questão 7

Questão
Depression is thought to be caused by monoaminergic synaptic hyperactivity.
Responda
  • True
  • False

Questão 8

Questão
What do MAOI's do?
Responda
  • Inhibit the reuptake of serotonin and noradrenaline into the pre-synaptic knob.
  • Inhibit the monoamine oxidase enzyme that breaks down serotonin and noradrenaline neurotransmitters.

Questão 9

Questão
What do TCA and SSRI's do?
Responda
  • They inhibit the re-uptake of serotonin and noradrenaline from the synaptic cleft.
  • They inhibit monoamine oxidase which breaks serotonin and noradrenaline down.

Questão 10

Questão
TCA's are much more selective than SSRI's at blocking serotonin rather than noradrenaline at monoaminergic synapses.
Responda
  • True
  • False

Questão 11

Questão
Typical neuroleptics are more selective at blocking dopamine receptors.
Responda
  • True
  • False

Questão 12

Questão
Psychosis is thought to be caused by dopaminergic hyperactivity.
Responda
  • True
  • False

Questão 13

Questão
Why can anti-psychotics sometimes cause parkinsonian?
Responda
  • 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.

Questão 14

Questão
As well as parkinsonian, what other motor symptoms can anti-psychotics produce? (CLOZAPINE DOES NOT PRODUCE THIS)
Responda
  • Tardive dyskinesia
  • Duchene muscular dystrophy
  • Ataxia

Questão 15

Questão
Which three areas of the brain are affected by anti-psychotics?
Responda
  • Mesolimbal
  • Mesocortical
  • Nigrostriatal
  • Lateral hypothalamic area
  • Primary gustatory cortex

Questão 16

Questão
What do mechanical nociceptors respond to? What is an example?
Responda
  • A-delta fibres
  • C fibres
  • Sharp cuts or Blunt force
  • Damaging heat

Questão 17

Questão
What do polymodal nociceptors respond to? What is an example?
Responda
  • A-delta fibres
  • C fibres
  • Many modalities
  • Only a few modalities

Questão 18

Questão
Myelination tends to reflect upon what property of a primary sensory neurone?
Responda
  • That is transmits a fast, sharp pain.
  • That it transmits a slow, dull pain.

Questão 19

Questão
Frequency coding states what?
Responda
  • 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.

Questão 20

Questão
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)
Responda
  • True
  • False

Questão 21

Questão
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?
Responda
  • 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.

Questão 22

Questão
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.
Responda
  • True
  • False

Questão 23

Questão
The GATEKEEPER sends out excitatory signals to aid pain signals passing up to the brain.
Responda
  • True
  • False

Questão 24

Questão
Where is pain perceived?
Responda
  • Subcortically (before the cortex)
  • At the cortex

Questão 25

Questão
Where is pain localised?
Responda
  • The cortex
  • Subcortically (before the cortex)

Questão 26

Questão
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.
Responda
  • True
  • False

Questão 27

Questão
Descending pathways that release endogenous opioids act where?
Responda
  • The GATEKEEPER to enhance inhibition of pain signals ascending to the brain.
  • The GATEKEEPER to enhance pain signals ascending to the brain.

Questão 28

Questão
Primary hyperalgesia occurs where?
Responda
  • CNS
  • Peripheral nervous system

Questão 29

Questão
Secondary hyperalgesia occurs where?
Responda
  • CNS
  • Peripheral nervous system

Questão 30

Questão
Primary hyperalgesia occurs due to what process?
Image:
0c70ece1-e08b-4bf0-9ade-263e595cb100 (image/png)
Responda
  • 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"

Questão 31

Questão
Which receptor does substance P act?
Image:
4cc9e8c2-a00f-47e5-acec-00546039b1f6 (image/png)
Responda
  • NK-1
  • AMPA
  • NMDA

Questão 32

Questão
Which receptor does Glutamate act at?
Image:
9ab6d8e3-d5e6-4ae9-b36f-78248e230ff1 (image/png)
Responda
  • NK-1
  • AMPA
  • NMDA

Questão 33

Questão
Glutamate is usually released during normal, acute pain, rather than Substance P.
Responda
  • True
  • False

Questão 34

Questão
Why does binding of Substance P and Glutamate cause secondary hyperalgesia?
Image:
96d0a27b-3978-4052-9013-89498f51dfaa (image/png)
Responda
  • 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.

Questão 35

Questão
Neuropathic pain is the overall sensation of pain; the physiological factor and the psychogenic factor.
Responda
  • True
  • False

Questão 36

Questão
Name two types of endogenous opioids
Responda
  • Enkephalins
  • Beta-endorphins
  • Naloxone
  • Pethidine

Questão 37

Questão
Name two types of therapeutic agent opioids
Responda
  • Heroin
  • Codeine
  • Methadone
  • Fentanyl
  • Beta-endorphins

Questão 38

Questão
Name four types of synthetic agent opioids
Responda
  • Pethidine
  • Fentanyl
  • Methadone
  • Buprenorphine (partial agonist)
  • Fluoxetine
  • Enkephalins

Questão 39

Questão
Opioids are usually administered parenterally as the GIT does not absorb opioids well.
Responda
  • True
  • False

Questão 40

Questão
What are the three sites of action for opioids?
Responda
  • 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

Questão 41

Questão
What does label 2 show?
Image:
c7c0e4a6-3f7e-41b7-b301-36f78a51f7a2 (image/png)
Responda
  • Activation of the G-protein
  • Less opening of Ca2+ channels - less neurotransmitter release
  • More opening of K+ channels - leading to hyperpolarisation

Questão 42

Questão
What does label 3 show?
Image:
b9492ea3-1779-42c3-8445-07d765bcec16 (image/png)
Responda
  • Activation of G-protein
  • Less opening of Ca2+ channels - less neurotransmitter release
  • More opening of K+ channels - leading to hyperpolarisation

Questão 43

Questão
What does label 4 show?
Image:
c50b4e93-52b7-4dfa-a32c-932870198858 (image/png)
Responda
  • Activation of the G-protein
  • Less opening of Ca2+ channels - less neurotransmitter release
  • More opening of K+ channels - leading to hyperpolarisation

Questão 44

Questão
Opioids inhibit adenylyl cyclase which leads to increased cAMP levels.
Responda
  • True
  • False

Questão 45

Questão
What effects occur due to opioid action?
Responda
  • Analgesia
  • Constriction of smooth muscle at all sites
  • Nausea
  • Relaxation of smooth muscle at all sites
  • Euphoria at all sites

Questão 46

Questão
What are two problems with prolonged opioid use?
Responda
  • Tolerance - due to increased adenylyl cyclase expression
  • Dependence - withdrawal symptoms

Questão 47

Questão
NSAIDS are cyclo-oxygenase inhibitors.
Responda
  • True
  • False

Questão 48

Questão
Aspirin is a competitive inhibitor of COX.
Responda
  • True
  • False

Questão 49

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

Questão 50

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

Questão 51

Questão
Prostaglandins help to produce the mucus lining of the stomach, therefore NSAIDs can cause increased risk of peptic ulcers.
Responda
  • True
  • False

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