Apex-ANS Exam Questions and Verified
Answers
Question 1
Stimulation of the alpha 2 receptor reduces (select two):
a. sympathetic tone
b. platelet aggregation
c. serum glucose
d. shivering
Correct Answer
A&D
a. sympathetic tone
d. shivering
Question 2
How does the oculocardiac reflex present?
Correct Answer
bradycardia
hypotension
junctional rhythm
AV block
asystole
Question 3
How is acetylcholine released into the synpatic cleft?
Correct Answer
ACh is packaged into vesicles after production. Ca++ influx into the nerve releases
the packages of ACh into the synaptic cleft
Page 1 of 33
,Question 4
Why is esmolol wearing off by the time labetolol can even get started?
Correct Answer
esmolol is metabolized by esterases, giving it a half-life of approximately 9 minutes
Question 5
What should you prepare for once the pheochromocytoma is out?
Correct Answer
hypotension and hypoglycemia
Question 6
Where are the V2 receptors located?
Correct Answer
collecting tubules of the kidneys
Question 7
What is the primary neurotransmitter in the PNS?
Correct Answer
acetylcholine
Question 8
Can a heart transplant patient still have a Bainbridge reflex?
Correct Answer
Yes. Volume stretching the SA node can cause tachycardia
Page 2 of 33
,Question 9
Which agents reduces coronary artery prefusion pressure the most?
a. dobutamine
b. phenylephrine
c. isoproterenol
d. dopamine
Correct Answer
c. isoproterenol
Question 10
What is the most important thing to remember with drug administration for the
patient with a pheochromocytoma?
Correct Answer
BLOCK alpha before beta for the love of all that is holy
Question 11
What is the gold standard for diagnosing a pheochromocytoma?
Correct Answer
VMA in urine
Question 12
What is the origin of the SNS division of the ANS?
Correct Answer
known as the thoracolumbar division
T1-L3
Question 13
Cholinergic PNS postganglionic fibers release _______________.
Correct Answer
ACh
Page 3 of 33
, Question 14
What happens if you block beta before alpha with a pheochromocytoma?
Correct Answer
inhibition of skeletal muscle vasodilation, increased SVR, decreased inotropy can
precipitate CHF
Question 15
What does SNS stimulation cause increased insulin output?
Correct Answer
Cells have to have insulin to utilize glucose
Question 16
What is the PRIMARY mechanism for termination of action of norepinephrine in the
synaptic cleft
a. catechol-O-methyltransferase
b. reuptake
c. diffusion
d. monoamine oxidase
Correct Answer
b. reuptake
Question 17
Which alpha receptors is predominantly stimulated in the SNS in the veins?
Correct Answer
alpha 2
Question 18
After an effector activates the second messenger, what is the next step?
Correct Answer
2nd messenger starts an enzymatic cascade to lead to a cellular response
Page 4 of 33
Answers
Question 1
Stimulation of the alpha 2 receptor reduces (select two):
a. sympathetic tone
b. platelet aggregation
c. serum glucose
d. shivering
Correct Answer
A&D
a. sympathetic tone
d. shivering
Question 2
How does the oculocardiac reflex present?
Correct Answer
bradycardia
hypotension
junctional rhythm
AV block
asystole
Question 3
How is acetylcholine released into the synpatic cleft?
Correct Answer
ACh is packaged into vesicles after production. Ca++ influx into the nerve releases
the packages of ACh into the synaptic cleft
Page 1 of 33
,Question 4
Why is esmolol wearing off by the time labetolol can even get started?
Correct Answer
esmolol is metabolized by esterases, giving it a half-life of approximately 9 minutes
Question 5
What should you prepare for once the pheochromocytoma is out?
Correct Answer
hypotension and hypoglycemia
Question 6
Where are the V2 receptors located?
Correct Answer
collecting tubules of the kidneys
Question 7
What is the primary neurotransmitter in the PNS?
Correct Answer
acetylcholine
Question 8
Can a heart transplant patient still have a Bainbridge reflex?
Correct Answer
Yes. Volume stretching the SA node can cause tachycardia
Page 2 of 33
,Question 9
Which agents reduces coronary artery prefusion pressure the most?
a. dobutamine
b. phenylephrine
c. isoproterenol
d. dopamine
Correct Answer
c. isoproterenol
Question 10
What is the most important thing to remember with drug administration for the
patient with a pheochromocytoma?
Correct Answer
BLOCK alpha before beta for the love of all that is holy
Question 11
What is the gold standard for diagnosing a pheochromocytoma?
Correct Answer
VMA in urine
Question 12
What is the origin of the SNS division of the ANS?
Correct Answer
known as the thoracolumbar division
T1-L3
Question 13
Cholinergic PNS postganglionic fibers release _______________.
Correct Answer
ACh
Page 3 of 33
, Question 14
What happens if you block beta before alpha with a pheochromocytoma?
Correct Answer
inhibition of skeletal muscle vasodilation, increased SVR, decreased inotropy can
precipitate CHF
Question 15
What does SNS stimulation cause increased insulin output?
Correct Answer
Cells have to have insulin to utilize glucose
Question 16
What is the PRIMARY mechanism for termination of action of norepinephrine in the
synaptic cleft
a. catechol-O-methyltransferase
b. reuptake
c. diffusion
d. monoamine oxidase
Correct Answer
b. reuptake
Question 17
Which alpha receptors is predominantly stimulated in the SNS in the veins?
Correct Answer
alpha 2
Question 18
After an effector activates the second messenger, what is the next step?
Correct Answer
2nd messenger starts an enzymatic cascade to lead to a cellular response
Page 4 of 33
