The document provides a syllabus and questions for an exam on the autonomic nervous system. It covers topics like receptors, neurotransmitters, drugs that act on the parasympathetic and sympathetic nervous systems, and their effects. The questions test knowledge of agonists and antagonists of nicotinic and muscarinic receptors, drugs used to treat conditions like glaucoma and myasthenia gravis, mechanisms of action of neuromuscular blocking agents and ganglionic drugs.

1. GPAT-MCQS-SERIES
PART-2
AUTONOMIC NERVOUS SYSTEM
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SYLLABUS: Neurohumoral transmission (Autonomic and somatic). Parasympathomimetics,
Parasympatholytics, Sympathomimetics, Sympatholytics, Ganglionic stimulants and blockers.
Neuromuscular blocking agents and skeletal muscle relaxants (peripheral). Local anesthetic
agents. Drugs used in Myasthenia Gravis.
1. Cholinergic M2 - and M3- receptors produce following effects:
[P] Decreased heart rate
[Q] Dilatation effect on salivary gland
[R] Increased heart rate
[S] Effect on erectile tissue
(a) P and Q (b) Q and R (c) Q and S (d) P and S
2. Following statements are true:
[P] Substance P is located at sympathetic ganglia
[Q] Neuropeptide Y is located at postganglionic sympathetic neurons
[R] Nitric oxide located at enteric neurons
[S] Gonadotrophin-releasing hormone is not located at sympathetic ganglia
(a) P and Q (b) P and R (c) Q and R (d) R and S
3. Following statements are true:
[P] GABA transmitter is responsible for peristaltic reflex
[Q] Neuropeptide Y facilitates constrictor action of adrenaline and inhibits adrenaline release

2. [R] Substance P is co-transmitter with acetylcholine
[S] Dopamine transmitter is responsible for vasoconstrictor
(a) P and Q (b) Q and R (c) P and R (d) R and S
4. Following are the agonist of nicotinic receptor (α3)2:
[P] Carbachol [Q] Trimetaphan
[R] Hexamethonium [S] Acetylcholine
(a) P and S (b) Q and R (c) P and R (d) R and S
5. Following are the agonist of muscarinic receptor M2:
[P] Dicycloverine [Q] Ipratropium
[R] Carbachol [S] Talsaclidine
(a) Q and S (b) Q and R (c) P and Q (d) R and S
6. Following are the antagonist of nicotinic receptor (α1)2:
[P] Cytosine [Q] Epibatidine
[R] Atracurium [S] Vecuronium
(a) Q and S (b) Q and R (c) P and Q (d) R and S
7. Following are the antagonist of muscarinic receptor:
[P] Oxotremorine [Q] Oxybutynin
[R] Tolterodine [S] Carbachol
(a) Q and S (b) Q and R (c) P and Q (d) R and S
8. M2 receptor is responsible for following effects:
[P] Cardiac inhibition [Q] Neural inhibition
[R] Gastric secretion [S] Vasodilatation

3. (a) P and Q (b) P and R (c) Q and S (d) Q and R
9. Following drugs lower the interocular pressure
[P] Pilocarpine [Q] Lananoprost
[R] Atropine [S] Tiotropium
(a) P and Q (b) P and R (c) Q and S (d) Q and R
10. In urinary incontinence following drug is widely used:
(a) Pirenzepine (b) Cyclopentolate
(c) Darifenacin (d) Hyoscine
11. The main side effect of tubocurarine is
[P] Bradycardia [Q] Bronchoconstriction
[R] Hypotension [S] Cardiac arrhythmia
(a) R and S (b) P and R (c) Q and S (d) Q and R
12. Following statements are true:
[P] Hemicholinium inhibits the acetylcholine synthesis
[Q] Parathion is a short duration anticholineterase
[R] Botulinum toxin inhibits acetylcholine release
[S] Physostigmine is used in treatment of myasthenia gravis
(a) Q and R (b) P and R (c) R and S (d) P and Q
13. In the treatment of myasthenia gravis, the best agent for distinguishing between myashenic
crisis and cholinergic crisis, given intravenously, is
(a) Pyridostigmine (b) Edrophonium (c) Physostigmine (d) Neostigmine
14. Which of the following drug may cause cycloplegia when used topically in the eye?

4. (a) Bethanechol (b) Physostigmine (c) Atropine (d) Pilocarpine
15. Epinephrine is added to local anaesthetics
(a) To cause haemeostasis
(b) To prolong the action of local anaesthetics
(c) To stimulate wound healing
(d) All of the above
16. Neostigmine may cause all of the followings except
(a) Block accommodation reflex
(b) Reversible inhibition of acetyl cholinesterase
(c) Constipation
(d) Bronchoconstriction
17. Following statements are true for β2 receptor
[P] It produces glycogenolysis effect
[Q] It produces lipolysis effect
[R] It relaxes uterus
[S] It produces constriction effect on bronchi
(a) Q and S (b) Q and R (c) P and R (d) P and Q
18. Following statements are true for ritodrine
[P] It is β2 agonist
[Q] It produces arrhythmia as side effect
[R] It is β1 agonist
[S] It is used for nasal decongestion
(a) P and Q (b) Q and R (c) P and R (d) Q and S

5. 19. Following statement is true for labetalol
[P] It is α and β antagonist
[Q] It produces tachycardia as side effect
[R] It is non-selective β antagonist
[S] It is used in hypertension in pregnancy
(a) Q and R (b) P and Q (c) P and S (d) R and S
20. Atropine over dosage may causes all of the following except
(a) Miosis
(b) Increased heart rate
(c) Relaxation of GIT smooth muscle
(d) Mental aberration
21. Orally effective sympathomimetics agent is
[P] Epinephrine [Q] Isoproterenol
[R] Ephedrine [S] Amphetamine
(a) P and Q (b) Q and R (c) Q and S (d) R and S
22. Pilocarpineis classified as
(a) Cholinesterase inhibitor
(b) Sympathomimetic
(c) Cholinomimetic
(d) Cholinolytics
23. Propranolol is contraindicated in patients with
(a) Angina pectoris

6. (b) Supraventricular arrhythmias
(c) Glaucoma
(d) Hypertension
24. Mechanism of action of organic phosphate parathion is
(a) Phosphorylation of the cationic site of cholinesterases
(b) Phosphorylation of the esteratic site of cholinesterases
(c) Acetylation of the esteratic site of cholinesterases
(d) Acetylation of the cationic site of cholinesterases
25. Muscarinic receptor M3 are mainly located at
[P] Exocrine gland [Q] Cerebral cortex
[R] Heart [S] CNS
(a) P and S (b) Q and R (c) P and R (d) R and S
26. Neostigmine effectively antagonizes skeletal muscle relaxation produced by
(a) Tubocurarine (b) Gallamine (c) Pancuronium (d) All of the above
27. All of the following statements related to neostigmine are correct except
(a) Neostigmine is a quaternary ammonium compound
(b) Neostigmine is medium duration of action
(c) Neostigmine has direct effect on neuromuscular junctions
(d) All of the above
28. Muscarinic receptor M4 are mainly located at
(a) Exocrine gland (b) Cerebral cortex (c) Heart (d) CNS

7. 29. Antidote of atropine is
(a) Neostigmine (b) Pralidoxime (c) Physostigmine (d) None of above
30. Atropine blocks the muscarinic actions of acetylcholine by
(a) Inhibiting synthesis of ACH
(b) Inhibiting release from storage sites
(c) Competing at receptor sites
(d) All of the above
31. Sweating is inhibited by
(a) Atropine (b) Phenothiazines (c) Scopolamines (d) All of the above
32. Beta agonist used in bronchial asthma exert action by
(a) Blocking B1 receptor
(b) Blocking B2 receptor
(c) Stimulating B1 receptor
(d) Stimulating B2 receptor
33. Which of the following agent irreversibly bound with acetyl cholinesterase
(a) Dispropyl flurophosphate
(b) Ecothiopate
(c) Both a and b
(d) None of the above
34. Alcuronium is a semisynthetic derivative with similar properties of
(a) Gallamine (b) Pancuronium (c) Succinylcholine (d) D-tubocurarine

8. 35. Which of the following a is directly acting sympathomimetic agent?
(a) Ephedrine (b) Amphetamine (c) Dopamine (d) All of the above
36. Antidote of organo phosphorous poisoning is
(a) Physostigmine (b) Pralidoxime (c) Neostigmine (d) Tubocurarine
37. Action of D-tubocurarine is
(a) Competitive blockade of musscarinic receptors
(b) Competitive blockade of nicotinic receptors
(c) Irreversible blockade of muscarinic receptor
(d) None of above
38. Gingival hyperplasia is an oral condition possible in using
(a) Phenobarbital (b) Phenytoin (c) Pentobarbital (d) Valproic acid
39. Which of the following agent is a cholinesterase re-activator?
(a) Pilocarpine (b) Pralidoxime (c) Neostigmine (d) Physostigmine
40. Which of the following drug inhibits the acetylcholine synthesis?
(a) Neomycin (b) Vasamicol (c) Botulinum toxin (d) Atropine
41. Tachyphylaxis is an unwanted effect of
(a) Methohexamine (b) Methylphenidate (c) Ephedrine (d) Methamphetamine
42. Activation of alpha-2 receptors in the pancreatic islets causes
(a) Suppression of insulin secretion
(b) Stimulation of insulin release

9. (c) Suppression of glucagon secretion
(d) None of above
43. Darifenacin is a
(a) M1 antagonist (b) M2 antagonist(c) M3 agonist (d) M3 antagonist
44. Which of the following drugs. do(es) not cross the blood–brain barrier?
(a) Physostigmine (b) Neostigmine (c) Atropine (d) All of the above
45. Drug of choice in the treatment of cardiogenic shock is/are
(a) Isoproterenol (b) Epinephrine (c) Dopamine (d) All of the above
46. Which of the following muscle relaxant has peripheral action?
(a) Diazepam (b) Mephenesin (c) D-Tubocurarine (d) Orphenadrine
47. Pilocarpine is best used in
(a) Congential glaucoma
(b) Open angle glaucoma
(c) Secondary glaucoma
(d) All of the above
48. Timolol reduces the intraocular pressure by which mechanism of action?
(a) Muscarinic agonist
(b) Anticholinestarase
(c) Carbonic anhydrase inhibitor
(d) Beta-adrenoceptor antagonist

10. 49. For glycogenolysis in liver one of the following adrenoreceptor is responsible:
(a) Alpha-1 receptor
(b) Alpha-2 receptor
(c) Beta-1 receptor
(d) Beta-2 receptor
50. Cardiac effects of epinephrine includes all except
(a) Act on B – receptor of myocardium
(b) Induced cardiac arrhythmias are blocked by propranolol
(c) Prolong refractory period of AV nodes
(d) Decrease the Amplitude of the T-waves of ECG
51. Serious unwanted effect of epinephrine is
(a) Respiratory difficulty (b) Palpitation (c) Cerebral heamorrhage (d) Tremor
52. Drug of choice in motion sickness is
(a) Atropine (b) Scopolamine (c) Carbamazepine (d) Metoclopromide
53. In belladonna poisoning convulsions can be controlled by
(a) Paraldehyde (b) Phenytoin (c) Diazepam (d) Carbamazepine
54. Atropine are is used prior the administration of a general Aanaesthetics agent due tobecause
it
(a) Inhibits salivation and secretions of respiratory tract
(b) Inhibits GIT motility
(c) Prevents miosis
(d) Causes skeletal muscle relaxation

11. 55. Major adverse effect of clonidine is
(a) Bradycardia (b) Tachycardia (c) Sexual dysfunction (d) Dry mouth
56. Ganglionic blocking agents may cause all of the following except
(a) Mydriasis
(b) Loss of accommodation
(c) Reduced sweating is reduce
(d) Inhibit erection and ejaculation
Answer Keys
1. (a) 2. (a) 3. (c) 4. (c) 5. (d) 6. (d) 7. (a) 8. (a) 9. (a) 10. (c) 11. (d) 12. (b) 13. (b) 14. (c) 15. (b)
16. (c) 17. (c) 18. (a) 19. (c) 20. (a) 21. (d) 22. (c) 23. (c) 24. (b) 25. (a) 26. (d) 27. (d) 28. (d) 29.
(c) 30. (d) 31. (d) 32. (d) 33. (c) 34. (d) 35. (c) 36. (b) 37. (b) 38. (b) 39. (b) 40. (b) 41. (c) 42. (a)
43. (d) 44. (b) 45. (c) 46. (c) 47. (b) 48. (d) 49. (a) 50. (c) 51. (c) 52. (b) 53. (c) 54. (a) 55. (d) 56.
(d)