Dr.

Emara 20
A.N.S.

A.N.S.
DIRECTIONS (Questions 1 through 121): Each of the numbered items or
incomplete statements in this section is followed by answers or by completions
of the statement. Select the ONE lettered answer of completion that is BEST in
each case.

1- Which of the following is the correct sequence in a typical reflex arc:

a) Receptor, afferent neuron, efferent neuron, integration center, effector.
b) Effector, efferent neuron, integration center, afferent neuron, receptor.
c) Receptor, afferent neuron, integration center, efferent neuron, effector.
d) Receptor, efferent neuron, integration center, afferent neuron, effector.

2- The following reflexes are all autonomic EXCEPT:

a) Salivary secretion.
b) Micturition.
c) Flexion of the arm following a painful stimulus.
d) Defecation.

3- Preganglionic autonomic fibres are of:

a) Type A (alpha).
b) Type A (delta).
c) Type B.
d) Type C.

4- The autonomic ganglia:

a) Are 5 types.
b) Are the site of relay of afferent neurons.
c) Function as distributing centers.
d) Are located inside the CNS.

5- Concerning the autonomic ganglia , all the following is true EXCEPT:

a) They acting as distributing centers.
b) They are 3 types.
c) Their chemical transmitter is acetylcholine.
d) Their receptors are specifically blocked by atropine.

6- The autonomic ganglia have all the following characters EXCEPT:

a) Are three types: lateral, collateral and terminal.
b) Are sites of relay of autonomic preg. and postgang. fibres.
c) Are all present adjacent to the spinal cord.
d) Are functioning as distributing centres.
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A.N.S.

7- The symp. preganglionic nerve fibres:

a) Leave the spinal cord in the grey rami communicantes.
b) Originate at the autonomic ganglia.
c) Are myelinated nerve fibres belonging to the B group of nerve fibres.
d) Show minimal divergence in the autonomic ganglia.

8- Which statement correctly describes the relationship between preganglionic and

postganglionic sympathetic axons?
a) The number of presynaptic axons is much greater than the number of
b) postsynaptic axons.
c) The number of postsynaptic axons is much greater than the number of presynaptic axons.
d) The number of presynaptic and postsynaptic axons is equal.

9- The sympathetic division of the A N S is characterized by:

a) Localized actions affecting few systems.
b) Thoracolumbar outflow from the spinal cord.
c) Short postganglionic fibres.
d) Adrenergic preganglionic fibres.

10- All the following structures are supplied by sympathetic system only EXCEPT:
a) Ventricles of the heart.
b) Constrictor pupillae muscle.
c) Adrenal medulla.
d) Skin.

11- Which of the following organs receive both sympathetic & parasympathetic:
a) Adrenal medulla.
b) Sweat glands.
c) Pilomotor muscles.
d) Lungs.

12- The preganglionic sympathetic that innervate the eye originate from:
a) Superior colliculi.
b) Thoracic segments of spinal cord.
c) Superior cervical ganglion.
d) Ciliary ganglion.

13- A lesion in the cervical symp. chain (Horner’s syndrome) causes :

a) Increased sweating.
b) Dropping of the upper eyelid (ptosis).
c) Vasoconstriction of the skin blood vessels (leading to pallor).
d) Mydriasis (dilatation of the pupil).
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A.N.S.

14- All of the following about Horner syndrome is true EXCEPT:

a) Manifested by dryness & redness of skin.
b) Group of signs including ptosis & miosis.
c) Is due to injury of L.H.Cs. present in thoracic 1-2 spinal segments.
d) Causes pallor of skin due to V.C.

15- Postganglionic sympathetic starting from cervical and upper four thoracic ganglia
causes:
a) Secretion of the adrenomedullary hormones.
b) Dilatation of the coronary vessels.
c) Contraction of the splenic capsule.
d) Narrowing of the respiratory passages.

16- Stimulation of the greater splanchnic nerve produces :

a) Increased motility of the plain muscles of the stomach.
b) Excessive secretion of the gastric juice by the stomach.
c) Decreased blood levels of both glucose & free fatty acids.
d) Secretion of epinephrine & norepinephrine by the adrenal medulla.

17- Stimulation of the greater splanchnic nerve produces :

a) Increased motility of the stomach.
b) Inhibition of micturition.
c) Increased blood level of both glucose & catecholamines.
d) V.C. of the blood vessels in the erectile tissue.

18- Stimulation of greater Splanchnic nerve produces:

a) Increased blood glucose level.
b) Decreased blood volume.
c) Secretion of epinephrine 20% & norepinephrine 80% from adrenal medulla.
d) Increased gastrointestinal motility.

19- Stimulation of greater splanchnic nerve produces all the following EXCEPT:
a) Secretion of catecholamines from the suprarenal medulla.
b) Increased gastric and pancreatic secretions.
c) Increased blood glucose level.
d) Decreased gastrointestinal motility.

20- Stimulation of lesser splanchnic nerve causes:

a) Micturition.
b) Defecation.
c) Ejaculation.
d) Erection.
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A.N.S.

21- Choose the correct statement:

a) Postganglionics starting from the superior cervical ganglion causes constriction of the
pupils.
b) Sympathetic nervous system supplies every organ in the body
c) Sympathetic supply to the lungs causes bronchoconstriction.
d) Stimulation of greater splanchnic nerve results in adrenomedullary secretion.

22- Increased activity of the sympathetic N.S causes:

a) Penile erection.
b) Pupillary constriction.
c) Accommodation for near vision.
d) Bronchiolar dilatation.

23- Choose the correct statement:

a) Postganglionics starting from the superior cervical ganglion causes constriction of the
pupils.
b) Sympathetic nervous system supplies every organ in the body
c) Sympathetic supply to the lungs causes bronchodilatation.
d) Stimulation of lesser splanchnic nerve results in adrenomedullary secretion.

24- Stimulation of the sympathetic N.S. causes :

a) Contraction of the ciliary muscle for near vision.
b) Generalized actions affecting many systems.
c) Bronchoconstriction.
d) Decreased glycogenolysis & lipolysis.

25- Activation of sympathetic N.S. causes:

a) Pupillary constriction.
b) Sweat secretion.
c) Bradycardia.
d) Cutaneous vasodilatation.

26- Activation of sympathetic N.S. produces the following EXCEPT:

a) Bronchodilatation.
b) Tachycardia.
c) Mydriasis (dilatation of pupil).
d) Contraction of detrusor muscle of urinary bladder wall.

27- Generalized sympathetic stimulation causes:

a) Inhibition of sweating.
b) Increased gastric motility.
c) Decreased blood sugar levels.
d) Increased arterial blood pressure.
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A.N.S.

28- During the fight reaction, the following effect takes place:
a) Dilatation of the pupil.
b) Increased motility of the gastrointestinal tract.
c) Decreased blood flow to the skeletal muscle.
d) Decreased heart rate.

29- The alarm response is accompanied by all of the following, EXCEPT:

a) High level of circulating adrenaline.
b) Hypotension.
c) Pupillo-dilatation (mydriasis).
d) Rise of blood glucose level.

30- The sympathetic response in fight reaction causes an increase in all the following,
EXCEPT:
a) Blood glucose concentration.
b) The size of the pupil.
c) The resistance of airways.
d) The arterial blood pressure.

31- The sympathetic supply can’t be responsible for:

a) Constriction of the pupil.
b) Erection of hair.
c) Bronchdilatation.
d) Dilatation of skeletal muscle blood vessels.

32- Concerning adrenal medulla, all the following is true EXCEPT:

a) It acts only in emergency conditions.
b) It secretes epinephrine 80% and norepinephrine 20%.
c) It is a modified sympathetic ganglion.
d) It receives preganglionic nerve supply from the anterior born cells of the lower 6 thoracic
segments of the spinal cord.

33- The parasympathetic nerves:

a) Are important in emergency conditions e.g. fight & flight reactions.
b) Tend to have longer postgang. fibres than pregang. fibres .
c) Are catabolic in their actions .
d) Generally exert opposite effects to those of the symp. nerves.

34- Contraction of ciliary muscle during accommodation of the eye for near vision is
controlled by:
a) Optic nerve.
b) Occulomotor.
c) Sympathetic fibers that reach the eye.
d) Trochlear nerve.
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35- Salivary secretion increases on stimulation of:

a) Trigeminal nerve.
b) Glossopharyngeal nerve.
c) Vagus nerve.
d) Hypoglossal nerve.

36- The functions of parasymp. innervation to the salivary glands is:

a) V.C. & secretion.
b) V.D. & secretion.
c) V.D. & inhibition of secretion.
d) Secretion of scanty viscous saliva.

37- Facial nerve:

a) Stimulation increases the power of the lens of the eye.
b) Supplies the lacrymal gland.
c) Supplies the parotid salivary gland.
d) Contains sympathetic postganglionic fibres.

38- All of the following organs receive their parasympathetic innervation via the vagus
nerves EXCEPT:
a) Gall bladder.
b) Atria of the heart.
c) Proximal half of large intestine.
d) Distal half of large intestin

39- Vagus nerve supplies all the following structures EXCEPT:

a) Gall bladder.
b) Stomach.
c) Rectum.
d) Pancreas.

40- Vagal stimulation causes:

a) Tachycardia.
b) Dilatation of the bronchi and bronchioles.
c) Inhibition of plain muscles in stomach and small intestine.
d) Increase in gastric and pancreatic secretion.

41- Stimulation of pelvic nerve (sacral autonomic) causes:

a) Contraction of the internal urethral sphincter.
b) Contraction of the internal anal sphincter.
c) Contraction of bronchial muscle.
d) Dilatation of the blood vessels of the external genitalia.
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A.N.S.

42- Stimulation of the pelvic nerve (sacral autonomic) causes :

a) Contraction of the bronchial muscle.
b) Contraction of the internal urethral & anal sphincters.
c) V.D. of the blood vessels in the external genitalia.
d) Stoppage of prostatic secretion.

43- Stimulation of the pelvic nerve (sacral autonomic) produces:

a) Relaxation of the wall of rectum .
b) V.C. of the blood vessels in the external genitalia .
c) Contraction of the urinary bladder wall .
d) Ejaculation of semen.

44- Concerning the pelvic nerve, all the following is true EXCEPT:
a) It is the nerve of erection (=nervus erigentes).
b) It is motor to the urinary bladder & distal half of the large intestine.
c) It is inhibitory to both the internal anal & urethral sphincters.
d) It is motor to the wall of gall bladder.

45- All of the following about pelvic nerve is true EXCEPT:

a) It is the nerve of defecation.
b) It is the nerve of ejaculation.
c) It is the nerve of micturition.
d) It relays in terminal ganglia.

46- Concerning the cranial parasympathetic outflow:

a) Preganglionic outflow in the oculomotor nerve arises from the ciliary ganglion.
b) Preganglionic outflow in the glossopharyngeal nerve arises from superior salivary
nucleus.
c) They relax the sphincter of Oddi.
d) They cause bronchodilatation.

47- Which one of the following statements concerning the parasympathetic nervous
system is correct?
a) The parasympathetic system uses norepinephrine as a neurotransmitter.
b) The parasympathetic system controls the secretion of the adrenal medulla.
c) The parasympathetic division is involved in accommodation of near vision, movement
of food, and urination.
d) The postganglionic fibers of the parasympatheticdivision are long compared to those of
the sympathetic nervous system.
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48- Which of the following may be produced by parasymp. stimulation?:

a) Acceleration of the heart.
b) Contraction of the urinary bladder wall.
c) V.D. of skeletal muscle blood vessels.
d) Dilatation of the pupil.

49- Which of these is not a neurotransmitter in the autonomic nervous system?

a) Acetylcholine.
b) Norepinephrine.
c) Epinephrine.
d) Muscarine.

50- About acetylcholine, all the following is true EXCEPT:

a) It is synthesized & released by some symp. postgang. nerve fibres.
b) It is the chemical transmitter released by the pregang. nerve fibres.
c) It is broken down enzymatically by the cholinestrase enzyme.
d) It makes reading difficult because of relaxation of the ciliary muscle.

51- About acetylcholine, all the following is true EXCEPT:

a) Its synthesis is catalyzed by the choline acetyltransferase enzyme.
b) Its muscarinic action can be blocked by atropine.
c) Its nicotinic actions can be blocked by large doses of nicotine.
d) It is not secreted by any symp. postgang. nerve fibres.

52- Acetylcholine is secreted at all the following sites EXCEPT:

a) Postgang. sympathetic nerve terminals at skeletal muscle.
b) Postgang. parasymp. nerve terminals.
c) Pregang. symp. & parasymp. nerve terminals.
d) Postgang. symp. noradrenergic nerve terminals.

53- Cholinergic fibres include all the following EXCEPT:

a) Sympathetic & parasympathetic preganglionic nerve fibres.
b) Somatic motor nerve fibres.
c) Sympathetic nerve fibres to adrenal medulla.
d) Postganglionic nerve fibres to dilator pupilla muscle.

54- About acetyl choline, all the following are true EXCEPT:
a) Is synthesized in the adrenal medulla.
b) Released by all postganglionic parasympathetic nerves.
c) Inactivated by cholinesterase enzyme.
d) Released by the sympathetic cholinergic postganglionic nerve fibres.
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55- Muscarine-like action of acetyl choline is present in all the following EXCEPT:
a) Sympathetic postgang. supplying the skeletal muscle blood vessels.
b) Parasympathetic postaganglionic nerve endings to the heart.
c) Sympathetic postganglionic supplying the eccrine sweat glands.
d) Somatic neuromuscular junction.

56- Acetylcholine action at the autonomic ganglia is:

a) Muscarinic like action.
b) Nicotine like action.
c) Blocked by atropine.
d) Blocked by muscarine.

57- All preganglionic axons of the autonomic nervous system release ________.
a) Dopamine.
b) Noradrenaline.
c) The same transmitter as the only one released by the sympathetic postganglionic
axons.
d) The same transmitter as the one released by parasympathetic postganglionic axons.

58- Nicotinic receptors:

a) Accept nicotine released by nerve endings near the receptor.
b) Are not sensitive to accetylcholine.
c) Are blocked by atropine.
d) Are found in sympathetic ganglia.

59- The receptors found at synapses between preganglionic and postanglionic neurons of
the sympathetic system are:
a) Muscarinic.
b) Nicotinic.
c) Beta adrenergic.
d) Alpha adrenergic.

60- Which autonomic receptor mediates secretion of epinephrine by the adrenal medulla?
a) Adrenergic α receptor.
b) Adrenergic β receptor.
c) Cholinergic muscarinic receptor.
d) Cholinergic nicotinic receptor.

61- Regarding the nicotinic cholinergic receptors, all of the following is true, EXCEPT:
a) They are present at the motor end plate.
b) They are blocked by atropine.
c) They are found in the suprarenal medulla.
d) Are members of ligand-gated ion channels.
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62- Which of the following responses is mediated by parasympathetic muscarinic

receptors?
a) Dilation of bronchiolar smooth muscle.
b) Erection.
c) Ejaculation.
d) Constriction of gastrointestinal (GI) sphincters.

63- The eccrine sweat glands are innervated by:

a) Adrenergic postganglionic sympathetic fibers.
b) Cholinergic postganglionic parasympathetic fibers.
c) Cholinergic postganglionic sympathetic fibers.
d) Adrenergic preganglionic sympathetic fibers.

64- Which of the following is used in treatment of myasthenia gravis:

a) Prostigmine.
b) Eserine.
c) Atropine.
d) Curare.

65- Motility of the intestine is increased by:

a) Adrenaline.
b) Parasympathetic stimulation.
c) Sympathetic blockers.
d) Adrenal medulla secretions.

66- Administration of physostigmine, a drug that inhibit acetyl choline esterase would be
expected to produce all the following, EXCEPT:
a) An increase of gastric secretion.
b) An increase of adrenaline secretion from adrenal medulla.
c) Inhibition of micturition.
d) Slowing of the heart.

67- Administration of physostigmine would be expected to produce all the following

EXCEPT:
a) Increase the secretion of gastric juice.
b) Increase the rate of epinephrine secretion from adrenal medulla.
c) Cause hypotension & bradycardia.
d) Produce lacrymation & bronchodilatation.

68- Administration of prostigmine, a drug that inhibits acetylcholine esterase, would be

expected to:
a) Increase the secretion of gastric juice.
b) Cause retention of urine.
c) Produce dilatation of pupil.
d) Inhibit salivary secretion.
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69- About Prostigmine (Neostigmine), all are true EXCEPT:

a) Acts specifically at motor end plate.
b) Is used in treatment of myasthenia gravis.
c) Inhibits cholinesterase enzyme.
d) Is an irreversible anticholinesterase.

70- The antidote of eserine is:

a) Amphetamine.
b) Noradrenaline.
c) Ergotoxine.
d) Atropine.

71- Atropine injection causes, all the following EXCEPT:

a) Pupillodilatation.
b) Increased heart rate.
c) Relaxation of skeletal muscles.
d) Diminished salivary secretion.

72- Atropine injection causes, all the following EXCEPT:

a) An increase in the heart rate.
b) Pupillo-dilatation.
c) Difficult micturition.
d) Constriction of the bronchi.

73- Atropine blocks the action of A.Ch. at the following sites EXCEPT:
a) Heart.
b) Adrenal medulla.
c) Sweat glands.
d) Constrictor pupillae muscle.

74- Atropine blocks the action of A.Ch. on receptors located in the following areas,
EXCEPT:
a) The gastric glands secreting HCl.
b) Sinoatrial node.
c) Motor end plate.
d) Iris.

75- Atropine causes dry mouth by inhibiting which of the following receptots?
a) α receptor.
b) β receptor.
c) Muscarinic receptor.
d) Nicotinic receptor.
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76- Atropine is given before surgical operations to:

a) Decrease heart rate.
b) Prevent bronchial secretion.
c) Relax skeletal muscle.
d) Induce bronchconstriction.

77- Atropine:
a) Increases the tone & motility of GIT.
b) Decreases gastric acid secretion.
c) Stimulates sweat secretion.
d) Stimulates bronchial secretion.

78- Atropine causes:

a) Contraction of ciliary muscle.
b) Dryness of mouth & skin.
c) Bradycardia during rest.
d) Bronchodilatation & increases bronchial secretion.

79- Administration of atropine, a drug that blocks muscarinic receptors, would be expected
to produce:
a) Slowing of the heart rate.
b) An increase contractility of ventricular muscle.
c) Decrease of gastric secretion.
d) Constriction of the pupil.

80- Which autonomic receptor is blocked by hexamethonium at the ganglia, but not at the
motor end plate?
a) Adrenergic β1 receptors.
b) Adrenergic β2 receptors.
c) Cholinergic muscarinic receptors.
d) Cholinergic nicotinic receptors.

81- Curare:
a) Blocks the neuromuscular transmission.
b) Competes with acetyl choline at autonomic ganglia..
c) Prevents the release of acetyl choline at motor end plate.
d) Causes relaxation of smooth muscles.

82- Acetyl choline:

a) Release is blocked by curare at motor end plate.
b) Synthesis is catalyzed by cholinesterase enzyme.
c) Action at motor end plate is blocked by atropine.
d) Is the only neurotransmitter secreted by parasympathetic neurones.
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83- Which of the following is not synthesized in postganglionic sympathetic neurons:

a) Acetylcholine.
b) Norepinephrine.
c) Epinephrine.
d) Dopamine.

84- Epinephrine is :
a) Synthesized in the adrenal medulla by methylation of norepinephrine.
b) The chemical transmitter of most symp. postgang. nerve fibres.
c) More powerful as a pressor agent than norepinephrine.
d) Hydrolyzed by the cholinestrase enzyme.

85- Epinephrine is secreted by

a) Sympathetic preganglionic fibers.
b) Sympathetic postganglionic fibers.
c) Parasympathetic postganglionic fibers.
d) The adrenal medulla.

86- Noradrenaline:
a) Increases intestinal motility.
b) Is the neurotransmitter in the alpha-adrenergic receptors.
c) Is released by both pre- & postganglionic sympathetic nerve endings.
d) Is a potent vasodilator.

87- Concerning Epinephrine, all the following are true EXCEPT:

a) Is synthesized in adrenal medulla by methylation of norepinephrine.
b) Is the chemical transmitter of adrenergic postgang. sympath.fibres.
c) Is less potent than norepinephrine as a pressor agent.
d) Helps in treatment of bronchial asthma.

88- Concerning norepinephrine, all are true EXCEPT:

a) Contributes to 20% of the suprarenal medulla secretion.
b) Secreted under stressful conditions.
c) Removed from tissues by active reuptake into symp. nerve endings.
d) It is the chemical transmitter at most sympathetic postganglionic.

89- Removal of norepinephrine at postgang. symp. fibers occurs by:

a) Reuptake back into the terminal symp. nerve endings.
b) Transformation into epinephrine.
c) The action of transaminase enzyme.
d) A demethylation action.
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90- Epinephrine produces all the following effects EXCEPT:

a) Cutaneous V.C.
b) Brobchoconstriction.
c) Coronary V.D.
d) Glycogenolysis.

91- Stimulation of a adrenoceptors produces all the following EXCEPT:

a) Contraction of dilator pupillae muscle.
b) Dilatation of skeletal muscle blood vessels.
c) Constriction of cutaneous blood vessels.
d) Ejaculation of semen.

92- The a-adrenoceptors mediate all the following effects EXCEPT:

a) Vasoconstriction.
b) Pupil dilatation.
c) Spleen contraction.
d) Increased cardiac activity.

93- The a-adrenergic receptors:

a) Are not stimulated by epinephrine.
b) When stimulated, they reduce the gastrointestinal (GI) motility.
c) Are blocked by propranolol.
d) When stimulated, they accelerate the heart.

94- Giving alpha blocking drugs;

a) Increases secretion of sweat glands.
b) Increases heart rate.
c) Impairs ejaculation.
d) Promotes bronchodilation.

95- Which adrenergic receptor produces its stimulatory effect through increasing
intracellular Ca++:
a) α1 receptors.
b) α2 receptors.
c) β1 receptors.
d) β 2 receptors.

96- Which autonomic receptor mediates an increase in the heart rate?

a) Adrenergic β1 receptors.
b) Adrenergic β2 receptors.
c) Cholinergic muscarinic receptors.
d) Cholinergic nicotinic receptors.
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97- The following structures respond to b adrenoceptors stimulation EXCEPT:

a) Sinoatrial node (SAN).
b) Skeletal muscle blood vessels.
c) Dilator pupillae muscle.
d) Bronchial smooth muscles.

98- All the following drugs would be expected to increase sympathetic discharge or mimic
the effects of increased sympathetic discharge EXCEPT:
a) Norepinephrine.
b) Neostigmine.
c) Amphetamine.
d) Tyramine.

99- Administration of b blockers produce all the following EXCEPT:

a) May cause bronchoconstriction.
b) Produces bradycardia & lowers the arterial blood pressure.
c) Decreases the secretion of renin from the kidney.
d) Leads to bronchodilatation.

100- Administration of a drug that blocks β-adrenergic receptors would be expected to

produce all the following changes, EXCEPT:
a) Dilatation of the bronchioles.
b) Decrease of the heart rate.
c) Decrease of myocardial contractility.
d) An increased of the arterial blood pressure.

101- A drug which blocks b adrenoceptors is likely to cause:

a) Dilatation of bronchi.
b) Decrease heart rate.
c) Ciliary muscle relaxation for far vision.
d) Reduces blood sugar level due to stimulation of insulin secretion.

102- Concerning adrenoceptors, all the following are true EXCEPT:

a) Stimulation of b1 adrenoceptors increases the force & rate of cardiac contraction.
b) Activation of b1 & b2 adrenoceptors results in activation of adenyl cyclase.
c) Stimulation of alpha adrenoceptors causes bronchodilatation.
d) Stimulation of b1 receptors causes renin secretion & lipolysis.

103- All of the following statements are true EXCEPT:

a) Nicotinic receptors can be blocked by large dose of nicotine.
b) Muscarinic receptors are blocked by atropine.
c) Alpha adrenergic receptors are blocked by phentolamine.
d) Beta adrenergic receptors are blocked by ergotamine.
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104- As regards autonomic receptors, all are true EXCEPT:

a) Sweat glands innervated by sympathetic nerves have receptors that can be blocked by
atropine.
b) Propranolol blocks the action of noradrenaline on alpha receptors.
c) Nicotinic receptors are blocked following a large dose of nicotine.
d) Alpha adrenoceptors are blocked by phentolamine or ergotamine.

105- Administration of noradrenaline to a person whose symp. system has been surgically
removed reacts by developing:
a) Hypoglycaemia.
b) Hypotension.
c) Pupil constriction.
d) More marked sympathetic response than before sympathectomy.

106- Beta 3 receptors are only found in:

a) The adrenal medulla.
b) Adipose tissue.
c) The lungs and bronchi.
d) The kidneys.

107- Adrenaline used to treat asthma binds to ___________ and causes bronchiole
dilation:
a) α1 receptors.
b) α2 receptors.
c) β1 receptors.
d) β 2 receptors.

108- In the autonomic nervous system:

a) Efferent fibres are myelinated A type fibres.
b) Muscarinic cholinergic receptors are blocked by atropine.
c) Sympathetic stimulation slows the heart rate.
d) β1 receptors are present in the heart only.

109- A 59-year-old woman with bilateral glaucoma is treated with drops of the
parasympathomimetic agent pilocarpine. Cholinergic stimulation of the pupil causes
which of the following?
a) Pupillary dilation (mydriasis).
b) Pupillary constriction (miosis).
c) Inequality of pupil size.
d) Absence of the pupillary response to light.
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110- An 18-year-old male, who became ill after eating mushrooms, is brought to the
Emergency Department, where he is treated for muscarinic poisoning. Which of the
following signs is consistent with muscarinic poisoning?
a) Skeletal muscle contractures.
b) Bradycardia.
c) Dilation of the pupils.
d) Hypertension.

111- 3. A 16-year-old, highly allergic girl who is stung by a bee gives herself a shot of
epinephrine prescribed by her physician. Because epinephrine activates β-adrenergic
receptors, it will relieve the effects of the bee sting by decreasing which of the
following?
a) The contraction of airway smooth muscle.
b) The strength of ventricular muscle contraction.
c) The transport of calcium into skeletal muscle fibers.
d) The rate of glycogenolysis in the liver.

112- 4. A patient who is being treated with a medication complains of the adverse effect of
difficulty adjusting his eyes to bright lights. How is the medication modifying
autonomic function?
a) Enhancing cholinergic activity.
b) Enhancing adrenergic activity.
c) Inhibiting cholinergic activity.
d) Inhibiting adrenergic activity.

113- Administration of a drug that blocks β-adrenergic receptors would be expected to

produce all the following changes, EXCEPT:
a) Decrease the force of cardiac contraction.
b) Decrease the heart rate.
c) Decrease resistance of air flow.
d) Decrease secretion of renin from the kidneys.

114- Which effects would destruction of the lumbar paravertebral ganglia by a gunshot
cause in the ipsilateral leg?
a) It would be cold and clammy.
b) It would be weak.
c) It would be warm and dry.
d) There would be no detectable change.
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115- Which of the following may precipitate an attack of glaucoma if instilled into the eye?
a) Physostigmine.
b) Atropine.
c) Pilocarpine.
d) Echothiophate.

116- Patient presents with salivation, lacrimation, urination and defecation as side effects
of a medication. Which one of the following receptors mediates the actions of this
drug?
a) Nicotinic receptors.
b) Muscarinic receptors.
c) α Receptors.
d) β Receptors.

117- A drug that might be used specifically to reduce heart rate in cardiac patients could
be:
a) Anticholinesterase.
b) Epinephrine.
c) Norepinephrine.
d) A beta-blocker.

118- Which of the following are correctly paired?

a) Sweat glands:α2-adrenergic receptors.
b) Autonomic ganglia:muscarinic cholinergic receptors.
c) Pilomotor smooth muscle:β2-adrenergic receptors.
d) Blood vessels of some skeletal muscles:muscarinic cholinergic receptors.

119- A 37-year-old woman with worsening muscle weakness was diagnosed with
myasthenia gravis. She was treated with the acetylcholinesterase inhibitor
neostigmine, and reported improved muscle strength within 1 day of starting
treatment. Which of the following is the most likely reason for improved muscle
performance in response to neostigmine treatment?
a) Increased action potential frequency in the motor nerves.
b) Increased acetylcholine synthesis in the motor nerve terminals.
c) Decreased acetylcholine breakdown at the neuromuscular junctions.
d) Decreased reuptake of choline by the presynaptic motor nerves.
 Dr.Emara 38
A.N.S.

120- A 22-year-old woman presents at the university hospital with tachycardia and
palpitations. She reports that she has been taking a diet supplement containing
ephedrine that she purchased from television channel. Activation of the sympathetic
nervous system by ephedrine causes smooth muscle contraction in which of the
following?
a) Arterioles.
b) Bronchioles.
c) Ciliary bodies.
d) Intestinal wall.

121- Congenital megacolon is a disease that results from a loss of autonomic innervation to
the descending colon. Loss of which fibers would cause a loss of gut motility in this
segment?
a) Vagus (cranial nerve X).
b) Preganglionic sympathetic fi bers T12–L1.
c) Postganglionic sympathetic fi bers T12–L1.
d) Sacral autonomic nerves.
 Dr.Emara 39
A.N.S.

Answer Key
1- C 41- D 81- A
2- C 42- C 82- D
3- C 43- C 83- C
4- C 44- D 84- A
5- D 45- B 85- D
6- C 46- C 86- B
7- C 47- C 87- B
8- C 48- B 88- C
9- B 49- D 89- A
10- B 50- D 90- B
11- D 51- D 91- B
12- B 52- D 92- D
13- B 53- D 93- B
14- D 54- A 94- C
15- B 55- D 95- A
16- D 56- B 96- A
17- C 57- D 97- C
18- A 58- D 98- B
19- B 59- B 99- D
20- C 60- D 100- D
21- D 61- B 101- B
22- D 62- B 102- C
23- C 63- C 103- D
24- B 64- A 104- B
25- B 65- B 105- D
26- D 66- C 106- B
27- D 67- D 107- D
28- A 68- A 108- B
29- B 69- D 109- B
30- C 70- D 110- B
31- A 71- C 111- A
32- D 72- D 112- C
33- D 73- B 113- C
34- B 74- C 114- C
35- B 75- C 115- B
36- B 76- B 116- B
37- B 77- B 117- D
38- D 78- B 118- D
39- C 79- C 119- C
40- D 80- D 120- A
121- D