cns exam 3 practice questions

n-methyl-d-aspartate (NMDA) receptors are permeable to which of the following ions? select all that apply.
a. sodium
b. chloride
c. calcium
d. potassium

a, c, d

exit of potassium ions from a neuron results in
a. depolarization
b. hyperpolarization
c. refractoriness
d. repolarization

d

opening of ligand-gated GABAa receptors allows the entry of which ions?
a. sodium
b. potassium
c. calcium
d. chloride

d

a neuron is most likely to fire when it is...
a. hyperpolarized
b. depolarized
c. in the refractory phase
d. repolarized

b

entry of chloride ions into a neuron will make its potential
a. negative
b. positive
c. no change

a

which neurotransmitter is involved in allowing entry of chloride ions into a neuron?
a. dopamine
b. serotonin
c. GABA
d. glutamate

c

which of the following can be used to decrease chemical neurotransmission? select all that apply
a. blockade of postsynaptic receptors
b. blockade of neurotransmitter reuptake transporter
c. blockade of calcium entry into the presynaptic membrane
d. blockade of the synaptic vesicle from merging with the presynaptic membrane

a, c, d

which type of calcium ion channel is responsible for the release of the neurotransmitter from the presynaptic nerve terminal?
a. t-type
b. n-type
c. l-type

b

of the following sites on the GABAa receptor, which one can actually cause convulsions?
a. GABA site
b. BZD site
c. picrotoxin
d. steroid site
e. barbiturate site

c

epileptogenesis is associated with conversion of normal circuits into chronically hyperexcitable ones.
a. true
b. false

a

loss of GABAnergic neurons can lead to epileptogenesis
a. true
b. false

a

epilepsy is defined as recurrent and predictable occurrence of muscle spasms
a. true
b. false

b

a focal seizure originates in a network in one hemisphere and rapidly engages both hemispheres
a. true
b. false

b

if a seizure involves only ringing in the ears and occurs for a brief period, what type of seizure is it?
a. focal
b. generalized
c. complex
d. status epilepticus

a

the clonic phase of the tonic-clonic seizure involves
a. sustained contraction of muscles
b. rhythmic contraction and relaxation of muscles
c. constant ringing in the ears
d. inability to maintain posture

b

epileptogenesis is associated with increased glutamate transmission
a. true
b. false

a

epilepsy should be treated because...
a. each seizure results in damage to the brain
b. seizures are embarrassing
c. seizures make finding a job difficult
d. seizures can result in super intelligent people

which neurons are most susceptible to repeated seizures?
a. glutamate
b. dopaminergic
c. GABAnergic
c. serotoninergic
d. noradrenergic

c

the anti-epileptic drug rufinamide (banzel) acts via
a. competitive inhibition of the AMPA receptors
b. activation of chloride channels
c. blockade of glutamate release
d. activation of potassium channels
e. inactivation/blockade of voltage-gated sodium channels

e

the mechanism of action of the antiepileptic drug topiramate is explained by which of the following? select all that apply.
a. blockade of ionotropic glutamate receptors
b. blockade of voltage gated Na+ channels
c. enhancement of GABAa currents
d. activation of a hyperpolarizing K+ current
e. inactivation of T-type calcium channels

a, b, c, d

which of the following drugs act via blocking glutamate neurotransmission? select all that apply
a. felbamate
b. ezogabine
c. topiramate
d. perampanel

a, c, d

which of the following statements regarding adverse events associated with AEDs is true?
a. idiosyncratic events can be fully explained based on MOA
b. acute adverse effects are dose-dependent
c. chronic effects are not usually seen with antiepileptic medications
d. drug interactions are extremely rare with antiepileptic medications

b

which of the following drugs increase GABA transmission by targeting the presynaptic GABA terminal? select all that apply
a. tiagabine
b. midazolam
c. gabapentin
d. stiripentol

a, c

barbiturates act by increasing the...
a. duration of opening of the GABAa receptor
b. frequency of opening of the GABAa receptor
c. duration of opening of the NMDA receptor
d. frequency of opening of the AMPA receptor

a

seizures can occur because of which of the following? select all that apply
a. hypoglycemia
b. hypoxia
c. gregorian chants
d. meningitis

a, b, d

which of the following drugs can lead to seizures? select all that apply
a. BZD withdrawal
b. cocaine intoxication
c. alcohol withdrawal
d. phenytoin sodium
e. ephedra supplement

a, b, c, e

SD, a 66 year old man, has been started on phenytoin Na for treatment of seizures he has been experiencing after he experienced a head injury last week. after starting, he has been feeling drowsy, confused, and unable to balance himself. upon examination of his eyes, nystagmus has been observed. in addition to phenytoin Na, SD also takes aspirin and omeprazole. these symptoms are most likely due to...
a. poor seizure control
b. aura associated with impending seizure
c. adverse effects of phenytoin
d. subdural hematoma

c

a patient has a genetic polymorphism which allows for prolonged opening of his neuronal sodium channels. which of the following drugs will be most effective in this patient?
a. lamotrigine
b. ezogabine
c. gabapentin
d. perampanel

a

a patient has a genetic polymorphism which allows for prolonged opening of his neuronal sodium channels. what effect will this have on his neuronal activity?
a. neurons will be hyperpolarized
b. no effect on neuronal excitability
c. neurons will have prolonged depolarization phase
d. neurons will show faster repolarization

c

which of the following mechanisms of action explains the effects of cannabidiol (epidiolex) in epilepsy?
a. blockade of NMDA receptors
b. blockade of AMPA receptors
c. blockade of voltage-gated potassium channels
d. blockade of voltage-gated sodium channels
e. activation of GABAa receptors

d, e

in all voltage gated ion channels, which of the following transmembrane segments usually serves as the voltage sensor?
a. S4
b. S5
c. S1
d. S6

a

which of the following statements is true about the t-type calcium channels? select all that apply
a. they are involved in absence seizures
b. ethosuximide blocks this type of channel
c. composed of alpha, beta, delta, and gamma subunits
d. they are high voltage activated
e. S4 serves as the voltage sensor

a, b, e

which of the following statements is/are true about voltage-gated potassium ion channels?
a. they are simple ion channels and contain only one subunit
b. S4 harbors the voltage sensor
c. the pore for the voltage-gated ion channels exists between S2 and S3
d. ezogabine blocks voltage-gated potassium ion channels
e. voltage-gated potassium ion channels are involved in absence seizures

a, b, c

frank is experiencing psychosis related to his diagnosis of Alzheimer's. which of the following medication/class could he be recommended if he was a risk to his own personal safety?
a. benzodiazepines
b. antipsychotics
c. AChEis
d. SSRIs

b

what are the potential safety concerns related to use of antipsychotics in patients experiencing dementia-related psychosis?
a. increased risk of coagulation deficiencies
b. increased risk of mortality
c. increased risk of respiratory depression
d. blurred vision

b

EM is taking rivastigmine for AD. he was initially prescribed rivastigmine 1.5 mg BID. two weeks ago, his dose was increased to 3 mg BID. since the dose increased, he has been experiencing nausea/diarrhea. as the pharmacist, what is your best recommendation?
a. discontinue the medication
b. convert to the patch
c. recommend and antiemetic and loperamide

b

which of the following AChEi's has the greatest clinical efficacy for the treatment of alzheimer's?
a. rivastigmine
b. donepezil
c. galantamine
d. memantine
e. all equally efficacious

e

what is the role of the MMSE in the care of alzheimer's patients?
a. measures disorder thinking patterns
b. identifies presence of depression
c. assesses cognitive impairment
d. diagnostic of AD

c

which of the following symptoms might be observed in mild AD? select all that apply
a. difficulty managing finances
b. agitation and paranoia
c. loss of long-term memories
d. withdrawal from hobbies and activities

a, d

which of the following medications has the highest incidence of GI side effects such as n/v, abdominal pain, anorexia, etc?
a. galantamine IR
b. rivastigmine TD
c. donepezil ODT
d. rivastigmine tab
e. donepezil tab
f. galantamine ER

d

AChEis should be titrated to the highest tolerated dose and used for a trial of at least _____ months in AD
a. 6
b. 24
c. 12
d. 2

a

which of the following BPSDs are not typically responsive to medication treatment? select all that apply
a. agnosia
b. incontinence
c. aggression
d. wandering

c, d

what is the recommended PCP follow up timeframe for AD?
a. 9 months
b. 12 months
c. prn
d. 3 months

d

which of the following medications causes cognitive impairment and/or delirium? select all that apply
a. lisinopril
b. levothyroxine
c. prednisone
d. omeprazole

a, c

what AD medication is commonly prescribed to be taken at night but may have the side effect of insomnia?
a. memantine
b. donepezil
c. ropinirole
d. vitamin e

b

the compound primarily deactivated by direct phase 2 conjugation of the parent drug is...
a. phenytoin
b. primidone
c. lamotrigine
d. zonisamide

c

the antiepileptic with a latent functional group that is activated by its target of drug action is...
a. lacosamide
b. vigabatrin
c. rufinamide
d. oxycarbazepine

b

the following structure is classified as a... a. GABA modulator b. barbiturate c. Na+ flux modulator d. K+ flux modulator

b

the drug that targets a synaptic neurotransporter is...
a. diazepam
b. mag sulfate
c. pregabalin
d. tiagabin

d

the drug that produces its pharmacological effects by modulation of Na+ flux is...
a. pregabalin
b. an endogenous NT
c. tiagabine
d. lacosamide

d