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Nervous System

True/False: Somatosensation and the perception of pain

Pain information is transmitted to the brain in the dorsal column. False, pain information is transmitted to the brain in the spinothalamic tracts.
Primary hyperalgesia occurs in undamaged tissue surrounding the originally damaged area. False, primary hyperalgesia occurs within the damaged area. Secondary hyperalgesia occurs in the surrounding undamaged tissues.
The co-transmitter substance P causes a very long-lasting excitatory post-synaptic potential, thereby helping to sustain the effect of noxious stimuli. True, the co-transmitter substance P causes a very long-lasting excitatory post-synaptic potential, thereby helping to sustain the effect of noxious stimuli.
The central nervous system is able to accurately distinguish between superficial pain from cutaneous structures and pain from the viscera. False, nociceptor fibres from viscera and cutaneous structures converge on the same pathway hence there is an inability to distinguish between deep and superficial pain.
Inflammation affecting the diaphragm is felt in the tip of the shoulder. True, phrenic nerve roots C3 and C5 are involved.
Morphine is a u-receptor agonist. True, endogenous enkephalins are also active at u-receptors (as well as delta-receptors).
Naloxone is a u-receptor antagonist. True, hence its use in the management of opiate overdose.
Opioid analgesics act by reducing the production of inflammatory mediators. False, non-steroidal anti-inflammatory drugs (NSAID's) reduce the production of inflammatory mediators.
Opioids cause pupillary dilation. False, opioids cause miosis (pupillary constriction) by stimulation of the parasympathetic component of cranial nerve III.
Co-codamol is a combination of codeine and paracetamol. True, this is a common first-line prescription analgesic.
Naloxone is a long-acting u-receptor antagonist. False, naloxone is short acting.
Naloxone acts more rapidly than naltrexone. True, naloxone is rapid acting with a short duration of action whereas naltrexone is slower acting but has a longer duration of action.
Opioid overdose causes hyperventilation. False, opioid overdose causes respiratory depression.
With repeated administration of opioids and consequent tolerance, pin-point pupils (characteristic of overdose) become less obvious. False, there is no tolerance to pupillary constriction with repeated opioid administration.
Opioid overdose causes increased PaO2. False, opioid overdose causes respiratory depression with increased PaCO2 and decreased PaO2.
Morphine is effective when given orally. False, when given orally, a high rate of first pass metabolism results in poor bioavailability.
Morphine has a half-life of of approximately 12 hours. False, morphine has a half-life of approximately 3 hours.
Codeine exhibits high oral bioavailability. True, hence its use in oral analgesics such as co-codamol.
Pethidine does not cause miosis. True, pethidine does not cause miosis.
Methadone has a half life exceeding 24 hours. True, hence its usefulness as a maintenance drug in those addicted to opiates.
Cyclo-oxygenase metabolises arachidonic acid to leukotrienes. False, cyclo-oxygenase metabolises arachidonic acid to prostaglandins.
NSAIDs upregulate cyclo-oxygenase. False, NSAIDs inhibit cyclo-oxygenase.
Gastric ulceration is an important side effect of NSAID use. True, potentially fatal bleeding may occur.
Reye's syndrome is associated with aspirin use in children. True, Reye's syndrome causes liver damage and encephalopathy.
Tranexamic acid is an NSAID. False, tranexamic acid is an anti-fibrinolytic and is not to be confused with mefenamic acid - which is an NSAID.
Local anaesthetics block the ability of axons to conduct action potentials. True, local anaesthetics block the ability of axons to conduct action potentials.
Local anaesthetics block K+ channels in the axonal membrane. False, local anaesthetics block Na+ channels in the axonal membrane.
Local anaesthetics are weak acids. False, local anaesthetics are weak bases.
Local anaesthetics can pass straight through the lipid membrane of the axon when in the hydrophilic state. False, in the hydrophilic state they may only enter through the open Na+ channel.
At low concentrations, local anaesthetics only affect small-diameter myelinated and non-myelinated fibres. True, hence administration of local anaesthetic agents can be used to produce a differential nerve block affecting only A-delta and C fibres.
The sensory homunculus is organised so that a given area of the body has a proportionate area of cortex responsible for its processing, regardless of the density of sensory receptors in that area. False, areas used for exploration which have the greatest receptor density have a disproportionately large area of corresponding sensory cortex.
The sensory cortex is located in the frontal lobe. False, sensory cortex is located in the parietal lobe.
C type sensory afferent fibres are unmyelinated. True, these fibres transmit information from nociceptors and thermoreceptors.
Fibres signalling thermal information travel in the dorsal column of the spinal cord. False, fibres signalling thermal information travel in the spinothalamic tract of the spinal cord.
Slowly adapting receptors are particularly adept at signalling the rate of change and duration of a stimulus. False, slowly adapting fibres typically signal magnitude or location whereas rapidly adapting fibres signal rate of change and duration.
Created by: sallyelphick



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