MCQ Quiz: Autonomic Nervous System

The autonomic nervous system (ANS) regulates involuntary physiological functions such as heart rate, digestion, and respiratory rate. It is divided into the sympathetic and parasympathetic nervous systems, each with distinct neurotransmitters and receptor targets. This quiz is crafted according to Pharm.D. standards, especially from courses like PHA5439 and PHA5515, to assess your knowledge of ANS structure, function, and pharmacological modulation.

1. Which of the following divisions is part of the autonomic nervous system?

  • A. Somatic
  • B. Central
  • C. Sympathetic
  • D. Sensory
    Correct answer: C. Sympathetic

2. The primary neurotransmitter of the parasympathetic nervous system is:

  • A. Norepinephrine
  • B. Dopamine
  • C. Acetylcholine
  • D. Serotonin
    Correct answer: C. Acetylcholine

3. Which receptors are activated by norepinephrine in the sympathetic nervous system?

  • A. Muscarinic
  • B. Nicotinic
  • C. Alpha and beta adrenergic receptors
  • D. Histamine
    Correct answer: C. Alpha and beta adrenergic receptors

4. The “fight or flight” response is mediated by the:

  • A. Parasympathetic nervous system
  • B. Somatic nervous system
  • C. Sympathetic nervous system
  • D. Enteric nervous system
    Correct answer: C. Sympathetic nervous system

5. Muscarinic receptors are classified as:

  • A. Ionotropic receptors
  • B. Enzyme-linked receptors
  • C. G protein-coupled receptors
  • D. Nuclear receptors
    Correct answer: C. G protein-coupled receptors

6. What is the neurotransmitter at sympathetic ganglia?

  • A. Dopamine
  • B. Acetylcholine
  • C. Norepinephrine
  • D. Epinephrine
    Correct answer: B. Acetylcholine

7. Which receptor subtype is primarily responsible for heart rate increase?

  • A. Alpha-1
  • B. Alpha-2
  • C. Beta-1
  • D. Beta-2
    Correct answer: C. Beta-1

8. Which receptor causes bronchodilation when activated?

  • A. Alpha-1
  • B. Beta-1
  • C. Muscarinic M3
  • D. Beta-2
    Correct answer: D. Beta-2

9. Stimulation of muscarinic receptors in the GI tract leads to:

  • A. Decreased motility
  • B. Increased motility and secretion
  • C. Vasoconstriction
  • D. Smooth muscle relaxation
    Correct answer: B. Increased motility and secretion

10. Alpha-1 adrenergic receptor activation leads to:

  • A. Vasodilation
  • B. Bronchodilation
  • C. Vasoconstriction
  • D. Increased heart rate
    Correct answer: C. Vasoconstriction

11. Which enzyme breaks down acetylcholine in the synaptic cleft?

  • A. Monoamine oxidase
  • B. Catechol-O-methyltransferase
  • C. Acetylcholinesterase
  • D. Tyrosine hydroxylase
    Correct answer: C. Acetylcholinesterase

12. Which structure is involved in controlling autonomic functions like heart rate?

  • A. Cerebellum
  • B. Medulla oblongata
  • C. Frontal lobe
  • D. Thalamus
    Correct answer: B. Medulla oblongata

13. What is the main neurotransmitter of postganglionic sympathetic neurons (except sweat glands)?

  • A. Serotonin
  • B. Dopamine
  • C. Norepinephrine
  • D. Acetylcholine
    Correct answer: C. Norepinephrine

14. Nicotinic receptors are found at:

  • A. All parasympathetic effector sites
  • B. Sympathetic postganglionic terminals
  • C. Autonomic ganglia and neuromuscular junctions
  • D. Brain stem only
    Correct answer: C. Autonomic ganglia and neuromuscular junctions

15. What is the effect of beta-1 adrenergic receptor activation on the heart?

  • A. Bradycardia
  • B. Negative inotropic effect
  • C. Tachycardia and increased contractility
  • D. Vasodilation
    Correct answer: C. Tachycardia and increased contractility

16. Which adrenergic receptor causes decreased norepinephrine release via negative feedback?

  • A. Alpha-1
  • B. Beta-1
  • C. Alpha-2
  • D. Beta-2
    Correct answer: C. Alpha-2

17. Activation of parasympathetic nerves to the eye causes:

  • A. Pupil dilation
  • B. Pupil constriction
  • C. Eyelid elevation
  • D. Lens flattening
    Correct answer: B. Pupil constriction

18. Which of the following drugs is a muscarinic receptor antagonist?

  • A. Bethanechol
  • B. Pilocarpine
  • C. Atropine
  • D. Neostigmine
    Correct answer: C. Atropine

19. Sympathetic stimulation of sweat glands releases:

  • A. Dopamine
  • B. Acetylcholine
  • C. Norepinephrine
  • D. Serotonin
    Correct answer: B. Acetylcholine

20. Which division of the ANS promotes digestion and urinary function?

  • A. Sympathetic
  • B. Parasympathetic
  • C. Enteric
  • D. Central
    Correct answer: B. Parasympathetic

21. Which enzyme is responsible for norepinephrine breakdown in neurons?

  • A. MAO (Monoamine oxidase)
  • B. COMT
  • C. Cholinesterase
  • D. Acetylcholinesterase
    Correct answer: A. MAO (Monoamine oxidase)

22. What drug class mimics the action of norepinephrine and epinephrine?

  • A. Cholinomimetics
  • B. Adrenergic agonists
  • C. Anticholinergics
  • D. Beta-blockers
    Correct answer: B. Adrenergic agonists

23. Which cranial nerve carries the majority of parasympathetic output?

  • A. CN III
  • B. CN V
  • C. CN VII
  • D. CN X (Vagus nerve)
    Correct answer: D. CN X (Vagus nerve)

24. Parasympathomimetics are also known as:

  • A. Adrenergic antagonists
  • B. Cholinergic agonists
  • C. Antimuscarinics
  • D. Beta agonists
    Correct answer: B. Cholinergic agonists

25. Beta-2 agonists are commonly used in:

  • A. Hypertension
  • B. Asthma and COPD
  • C. Glaucoma
  • D. Arrhythmias
    Correct answer: B. Asthma and COPD

26. Sympatholytics do what to the sympathetic nervous system?

  • A. Stimulate it
  • B. Block or suppress it
  • C. Replace neurotransmitters
  • D. Have no effect
    Correct answer: B. Block or suppress it

27. Parasympatholytics would cause which of the following effects?

  • A. Bradycardia
  • B. Salivation
  • C. Mydriasis (pupil dilation)
  • D. Diarrhea
    Correct answer: C. Mydriasis (pupil dilation)

28. The drug neostigmine enhances cholinergic transmission by:

  • A. Blocking nicotinic receptors
  • B. Inhibiting acetylcholinesterase
  • C. Stimulating beta receptors
  • D. Enhancing dopamine release
    Correct answer: B. Inhibiting acetylcholinesterase

29. Which of the following is a beta-blocker?

  • A. Albuterol
  • B. Atropine
  • C. Propranolol
  • D. Epinephrine
    Correct answer: C. Propranolol

30. Alpha-2 agonists like clonidine are used to:

  • A. Raise blood pressure
  • B. Increase heart rate
  • C. Lower blood pressure by reducing sympathetic outflow
  • D. Cause bronchodilation
    Correct answer: C. Lower blood pressure by reducing sympathetic outflow

31. Cholinergic crisis is caused by:

  • A. Excessive sympathetic stimulation
  • B. Acetylcholinesterase inhibition
  • C. Alpha receptor blockade
  • D. Beta agonist overdose
    Correct answer: B. Acetylcholinesterase inhibition

32. Alpha-1 blockers like prazosin are used to treat:

  • A. Asthma
  • B. Hypertension and BPH
  • C. Constipation
  • D. Depression
    Correct answer: B. Hypertension and BPH

33. Which of the following is NOT controlled by the autonomic nervous system?

  • A. Digestion
  • B. Heart rate
  • C. Voluntary muscle movement
  • D. Respiratory rate
    Correct answer: C. Voluntary muscle movement

34. Beta-1 antagonists decrease:

  • A. Bronchodilation
  • B. Renin release
  • C. Heart rate and contractility
  • D. Insulin secretion
    Correct answer: C. Heart rate and contractility

35. The enteric nervous system is sometimes called:

  • A. Somatic division
  • B. Second brain
  • C. Spinal autonomic control
  • D. Motor efferent system
    Correct answer: B. Second brain

36. Which muscarinic receptor subtype is mainly found in the heart?

  • A. M1
  • B. M2
  • C. M3
  • D. M4
    Correct answer: B. M2

37. Which class of drugs is commonly used to treat overactive bladder?

  • A. Beta-blockers
  • B. Anticholinergics (e.g., oxybutynin)
  • C. ACE inhibitors
  • D. Calcium channel blockers
    Correct answer: B. Anticholinergics (e.g., oxybutynin)

38. The sympathetic nervous system originates from which spinal segments?

  • A. Cervical
  • B. Thoracolumbar
  • C. Sacral
  • D. Coccygeal
    Correct answer: B. Thoracolumbar

39. What is the action of albuterol?

  • A. Muscarinic antagonist
  • B. Alpha-1 agonist
  • C. Beta-2 agonist
  • D. Beta-1 blocker
    Correct answer: C. Beta-2 agonist

40. What neurotransmitter is used at the neuromuscular junction in the somatic nervous system?

  • A. Dopamine
  • B. Acetylcholine
  • C. Norepinephrine
  • D. Epinephrine
    Correct answer: B. Acetylcholine

41. Activation of the M3 receptor causes:

  • A. Smooth muscle contraction and glandular secretion
  • B. Heart rate increase
  • C. Vasodilation via NO
  • D. Both A and C
    Correct answer: D. Both A and C

42. Epinephrine stimulates which receptors?

  • A. Only beta receptors
  • B. Alpha and beta receptors
  • C. Only alpha receptors
  • D. Muscarinic receptors
    Correct answer: B. Alpha and beta receptors

43. An anticholinergic effect would include:

  • A. Diarrhea
  • B. Bradycardia
  • C. Dry mouth
  • D. Increased secretions
    Correct answer: C. Dry mouth

44. Parasympathetic nerves originate from which segments?

  • A. Thoracolumbar
  • B. Lumbosacral
  • C. Craniosacral
  • D. Cervical only
    Correct answer: C. Craniosacral

45. What class of drugs is phenylephrine?

  • A. Beta-blocker
  • B. Muscarinic agonist
  • C. Alpha-1 agonist
  • D. Beta-2 antagonist
    Correct answer: C. Alpha-1 agonist

46. Ganglia in the autonomic nervous system serve as:

  • A. Final effector organs
  • B. Integration centers for reflexes
  • C. Relay points for synapses
  • D. Motor cortex regulators
    Correct answer: C. Relay points for synapses

47. An example of a non-selective beta-blocker is:

  • A. Metoprolol
  • B. Atenolol
  • C. Propranolol
  • D. Esmolol
    Correct answer: C. Propranolol

48. Which receptor is involved in lipolysis stimulation?

  • A. Alpha-1
  • B. Beta-3
  • C. M2
  • D. Alpha-2
    Correct answer: B. Beta-3

49. Which of the following increases salivary secretion?

  • A. Sympathetic stimulation
  • B. Parasympathetic stimulation
  • C. Alpha-2 activation
  • D. Beta-1 blockade
    Correct answer: B. Parasympathetic stimulation

50. A beta-2 antagonist would most likely cause:

  • A. Bronchodilation
  • B. Bradycardia
  • C. Bronchoconstriction
  • D. Salivation
    Correct answer: C. Bronchoconstriction

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