Pathophysiology and Pharmacology
Midterm Exam
Course Introduction
Pathophysiology and Pharmacology explores the underlying mechanisms of disease processes and the pharmacological principles used to treat them. This course covers alterations in normal physiological functions due to disease, examining cellular changes, organ dysfunction, and systemic manifestations. Students will learn about drug classifications, mechanisms of action, therapeutic uses, side effects, and interactions, integrating this knowledge with case studies on various illnesses. Emphasis is placed on the rationale for drug therapy choices, safe medication administration, and the impact of drugs on disease progression and patient outcomes, preparing students for effective clinical decision-making.
Recommended Textbook
Pharmacology An Introduction 7th Edition by Henry Hitner PhD
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46 Chapters
1602 Verified Questions
1602 Flashcards
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Chapter 1: Introduction to Pharmacology
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Sample Questions
Q1) Which of the following would not be considered a dose-dependent adverse effect of a drug?
A) Nausea
B) Liver damage
C) Kidney damage
D) Idiosyncrasy
Answer: D
Q2) Identify an accurate statement about the dose-response relationship.
A) A drug response is inversely proportional to the dose.
B) The magnitude of a drug response decreases with an increase in its dose.
C) Drugs that continue to show an increase in drug response with an increase in dosage have a ceiling effect.
D) Above a certain dosage no further increase in effect is observed.
Answer: D
Q3) Examples of common adverse effects include all of the following except:
A) persistent diarrhea.
B) vomiting.
C) confusion.
D) anaphylaxis.
Answer: D
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Chapter 2: Pharmacokinetics and Factors of Individual
Variation
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Sample Questions
Q1) A patient presents with symptoms of malaria and the physician prescribes a basic drug to treat the patient.The patient skips a dose of the drug and tries to compensate the next time by consuming more than the recommended dosage.This leads to drug overdose.How should this drug toxicity be treated?
A) The patient's urine must be alkalinized.
B) The patient's urine must be acidified.
C) An alternative drug must be prescribed to treat malaria.
D) An alternative drug, preferably an acidic drug, must be prescribed to treat malaria.
Answer: B
Q2) Which of the following routes of drug administration has the fastest onset of action?
A) Inhalation
B) Transdermal
C) Intramuscular
D) Sublingual
Answer: A
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4
Chapter 3: Geriatric Pharmacology
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Sample Questions
Q1) How would John,an elderly patient who smokes and consumes alcohol,tolerate an adult-strength dose of actively oxidized medication in comparison to Rick,an elderly patient who neither smokes nor drinks?
A) John would not be able to metabolize the drug, whereas Rick would be able to metabolize it.
B) Rick would be able to metabolize the drug in the same amount of time as John would be able to metabolize it.
C) John would be able to metabolize the drug at a faster rate than Rick would be able to metabolize it.
D) Rick's body would absorb a lesser amount of the drug than John's body would absorb.
Answer: C
Q2) Which of the following factors can affect drug metabolism by reducing the efficiency with which organs function?
A) Genetics
B) Nutritional deficiency
C) Disease
D) All of these
Answer: D
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Chapter 4: Math Review and Dosage Calculations
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Sample Questions
Q1) Carry out the necessary calculations in order to administer the required number of tablets to a patient with an order for 60 mg of a drug that is available in 30-mg tablets.How many tablets should you administer?
A) 2 tablets
B) 1.5 tablets
C) 1 tablet
D) 0.5 tablet
Q2) A drug order contains 500 mg of a drug to be administered every day.The drug is available as 200-mg tablets.How many tablets should be administered per day?
A) 1 tablet
B) 2 tablets
C) 2.5 tablets
D) 3.5 tablets
Q3) While summarizing the factors that affect IV solutions,it can be concluded that:
A) IV drug solutions must be free of contamination.
B) IV drug solutions must constitute drugs and solutions that are chemically compatible. C) IV drug solutions must be adjusted to a targeted pH range.
D) all of these are correct.
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6
Chapter 5: Autonomic Nervous System
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Sample Questions
Q1) The function of the autonomic nervous system is to regulate the rate of:
A) cardiac muscle contractions.
B) skeletal muscle contractions.
C) striated muscle contractions.
D) sensory conduction.
Q2) The special property that allows cardiac and smooth muscles to initiate their own contractions is known as:
A) autorhythmicity.
B) biorhythmicity.
C) tachycardia.
D) bradycardia.
Q3) Which of the following statements is true of the effects of sympathetic stimulation on the body?
A) It decreases the rate at which the heart contracts and relaxes.
B) It increases the rate of atrioventricular conduction.
C) It stimulates the urinary bladder to contract.
D) It causes the pupils of the eyes to constrict.
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Chapter 6: Drugs Affecting the Sympathetic Nervous System
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Sample Questions
Q1) The physical effects of anaphylaxis caused by insect stings,drugs,or other allergens in sensitized individuals include:
A) difficulty in breathing.
B) decreased blood pressure.
C) symptoms of shock.
D) All of these are correct.
Q2) Identify the correct use of an EpiPen Auto-Injector.
A) EpiPen must be carried at all times and should be administered immediately following the onset of an anaphylactic allergic reaction.
B) EpiPen must be carried at all times and should be administered upon suspecting the onset of an anaphylactic allergic reaction.
C) EpiPen must be carried at all times and should be administered after 15 minutes of the onset of an anaphylactic allergic reaction.
D) EpiPen must be carried at all times and should be administered within 60 minutes of the onset of an anaphylactic allergic reaction.
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8
Chapter 7: Drugs Affecting the Parasympathetic Nervous System
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Sample Questions
Q1) Pyridostigmine is useful in treating patients with myasthenia gravis because:
A) it increases the secretion of acetylcholine from cholinergic nerve endings.
B) it binds to nicotinic-muscle receptors and produces the same effects as those of acetylcholine.
C) it causes the irreversible inhibition of acetylcholinesterase, thereby increasing the levels of acetylcholine at the parasympathetic postganglionic nerve endings.
D) it causes the reversible inhibition of acetylcholinesterase, thereby increasing the levels of acetylcholine at the skeletal neuromuscular junction.
Q2) Which class of drugs is preferred for increasing urinary flow in patients with benign prostatic hyperplasia?
A) Beta-blockers
B) Alpha-blockers
C) Muscarinic blockers
D) Nicotinic blockers
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Chapter 8: Drugs Affecting the Autonomic Ganglia
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Sample Questions
Q1) Identify a consequence of sympathetic stimulation by the use of nicotine products.
A) Heart rate will increase.
B) Blood pressure will decrease.
C) GI activity will decrease.
D) All of these are correct.
Q2) When selecting bupropion for treatment of smoking cessation,it is important to differentiate between bupropion and the nicotine replacement products.Which of the following statements is true of bupropion?
A) It is an antidepressant drug.
B) It has an adverse effect profile that includes insomnia, dry mouth, and gastrointestinal (GI) disturbances.
C) It is available as 25-, 50-, 75-, and 150-mg tablets.
D) All of the above statements are correct.
Q3) Nicotine stimulates sympathetic nerves predominantly in the _____.
A) endocrine system
B) cardiovascular system
C) gastrointestinal system
D) renal system
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Chapter 9: Skeletal Muscle Relaxants
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Sample Questions
Q1) Ella has been taking large doses of a particular neuromuscular blocker over a very long period of time.Consequently,she has developed signs of respiratory paralysis and has severe trouble breathing.After Dr.Kurt examines her,he concludes that Ella's deteriorating health is the result of the growing concentration of the neuromuscular blocker drug in her system.He prescribes the drug neostigmine to relieve her symptoms.How will the drug neostigmine help counteract the effects of the neuromuscular blocker drug?
A) It will inhibit the enzyme acetylcholinesterase so that acetylcholine (ACH) accumulates within the synaptic junctions.
B) It will attach itself to the synaptic vesicles containing ACH and prevent ACH from being released into the synaptic cleft.
C) It will damage the nicotinic-muscle receptors, thereby altering the ability of these receptors to become stimulated.
D) It will enhance the activity of the enzyme acetylcholinesterase so that the concentration of ACH in the synaptic cleft decreases.
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Chapter 10: Local Anesthetics
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Sample Questions
Q1) What is the effect of local anesthetics on the heart?
A) Local anesthetics depress the function of the cardiac conduction system.
B) Local anesthetics produce tachycardia.
C) Local anesthetics cause hypertension.
D) Local anesthetics increase the function of the myocardium.
Q2) A practitioner has to perform a surgical procedure that requires the administration of a local anesthetic to the patient.The surgical procedure is to be performed on the right leg of the patient.The practitioner is unlikely to prescribe cocaine as the anesthetic because:
A) cocaine is classified as a Schedule II stimulant drug.
B) cocaine is obtained from a plant in South and Central America.
C) cocaine is a naturally occurring drug.
D) cocaine is a synthetically produced drug.
Q3) Which of the following could indicate central nervous system (CNS)toxicity?
A) Dizziness, blurred vision, and slurred speech
B) Nausea, vomiting, and diarrhea
C) Hyperactivity, hostility, and confusion
D) None of the above
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Chapter 11: Introduction to the Central Nervous System
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Sample Questions
Q1) Identify a difference between the cerebral cortex and the basal ganglia.
A) The cerebral cortex is composed of the bodies of neurons, whereas the basal ganglia are composed of the myelinated axons of neurons.
B) The basal ganglia are located within the outermost layer of the cerebrum, whereas the cerebral cortex is located within the innermost layer of the cerebrum.
C) The basal ganglia are composed of gray matter, whereas the cerebral cortex is composed of white matter.
D) The cerebral cortex perceives all sensory sensations and initiates all voluntary muscle movements, whereas the basal ganglia help coordinate and regulate muscular activity.
Q2) The axons of efferent neurons transmit nerve impulses carrying information associated with all of the following except:
A) pain.
B) voluntary movement.
C) involuntary movement.
D) glandular activation.
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13
Chapter 12: Sedative-Hypnotic Drugs and Alcohol
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Sample Questions
Q1) An elderly patient requests that the physician prescribe her chloral hydrate in place of zaleplon or zolpidem.You research the drug and find that chloral hydrate is an old drug related to alcohol that is still being used today,primarily in the elderly.The usual dosage range is 500-1000 mg.The patient states that she has difficulty in swallowing tablets because they stick to her tongue.Select the dosage form of chloral hydrate that is commercially available and could be prescribed for this patient.
A) Rectal suppositories
B) Syrup
C) Capsules
D) All of the above
Q2) Identify the possible cause of nausea, vomiting, and headache that an alcoholic patient is experiencing while taking disulfiram.
A) Acetaldehyde is accumulating in the blood, causing these symptoms to occur.
B) The patient may be drinking alcoholic beverages while taking disulfiram.
C) The patient may be using OTC products that contain alcohol while taking disulfiram.
D) All of the above are correct.
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14
Chapter 13: Antipsychotic and Antianxiety Drugs
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Sample Questions
Q1) How does anxiety affect the human body?
A) It enhances the activity of the parasympathetic nervous system.
B) It deactivates the reticular activating system.
C) It triggers the hyperarousal of the cerebral cortex.
D) It decreases the activity of the limbic system.
Q2) Identify a difference between butyrophenones and phenothiazines.
A) Butyrophenones produce a higher incidence of peripheral effects than phenothiazines.
B) Butyrophenones block 5HT<sub>2A</sub> receptors more than they block D<sub>2</sub> receptors, whereas phenothiazines block D<sub>2</sub> receptors more than they block 5HT<sub>2A</sub> receptors.
C) Butyrophenones are less potent than phenothiazines on a milligram basis.
D) Butyrophenones produce a higher incidence of extrapyramidal symptoms than phenothiazines.
Q3) The adverse effects of phenothiazine antipsychotics arise due to the:
A) stimulation of cholinergic and histamine receptors.
B) blocking of cholinergic and histamine receptors.
C) stimulation of D<sub>2</sub> and histamine receptors.
D) blocking of gamma-aminobutyric acid receptors.
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Page 15
Chapter 14: Antidepressants,psychomotor Stimulants,and
Lithium
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Sample Questions
Q1) Identify the type of depression in which there is a period of shock followed by a period of readjustment and resolve that life must go on.
A) Exogenous depression
B) Mania
C) Major depressive disorder
D) None of the above
Q2) Kevin,a 12-year-old boy,grew up with his pet dog,Sparky,who was almost the same age as Kevin.Age-related health complications caused Sparky?s death,following which Kevin was distraught.He was depressed for more than a week and refused to go to school.The type of depression affecting Kevin is termed _____.
A) exogenous depression
B) major depressive disorder
C) mania
D) bipolar mood disorder
Q3) The adverse effects of SNRIs include:
A) increased sedation, insomnia, and nephritis.
B) cardiac arrhythmias, seizures, and CNS depression.
C) GI disturbances, CNS excitation, and increased blood pressure.
D) renal insufficiency, mania, and convulsions.
Page 16
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Chapter 15: Psychotomimetic Drugs of Abuse
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Q1) David takes a dose of lysergic acid diethylamide (LSD).An hour after administration,David begins to experience the hallucinogenic effects of the drug.His perception of the sounds he hears and the objects he sees becomes distorted.He also begins to feel as though his arms have detached themselves from his body.Which of the following neurological phenomena is David most likely experiencing?
A) Allochiria
B) Parosmia
C) Flashback
D) Synesthesia
Q2) Phencyclidine produces its psychotomimetic effects by blocking the _____ receptor.
A) 5HT<sub>2A</sub>
B) N-methyl-D-aspartate
C) D<sub>2</sub>
D) CB<sub>1</sub>
Q3) Cocaine produces less intense effects when administered _____.
A) intravenously
B) orally
C) parenterally
D) intranasally
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Chapter 16: Antiepileptic Drugs
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Sample Questions
Q1) What is the primary mechanism of action of carbamazepine,phenytoin,and valproic acid?
A) Inhibiting the release of gamma-aminobutyric acid
B) Increasing the influx of Ca++ ions
C) Increasing T-type calcium currents
D) Delaying the inactivation of the Na+ channels
Q2) When required to arrest status epilepticus,the administration of diazepam or lorazepam is ideally followed by the administration of _____.
A) phenobarbital or carbamazepine
B) phenytoin or fosphenytoin
C) valproic acid or vigabatrin
D) lacosamide or ethosuximide
Q3) Which of the following drugs is rarely prescribed because of the high incidence of adverse effects?
A) Valproic acid
B) Lamotrigine
C) Diazepam
D) Trimethadione
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18
Chapter 17: Antiparkinson Drugs
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Sample Questions
Q1) _____ is an inhibitory neurotransmitter released by neurons from the substantia nigra.
A) Acetylcholine
B) Dopamine
C) Serotonin
D) Gamma-aminobutyric acid
Q2) The symptoms of Parkinson's disease include all of the following except:
A) hypertension.
B) increased sweating.
C) drooling.
D) urinary disturbances.
Q3) The use of which medication for Parkinson's disease is associated with livedo reticularis?
A) Biperiden
B) Bromocriptine
C) Benztropine
D) Amantadine
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Chapter 18: General Anesthetics
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Q1) Select the primary reason why the use of ketamine would be contraindicated in patients with a history of hypertension.
A) Ketamine stimulates the sympathetic nervous system, leading to elevated blood pressure and heart rate during the anesthesia.
B) Ketamine competitively inhibits the activity at the benzodiazepine recognition site on the GABA receptor, leading to elevated blood pressure and heart rate.
C) Ketamine activates the alpha<sub>2</sub> adrenergic receptors in the CNS and inhibits sympathetic activity, resulting in increased blood pressure and heart rate.
D) None of these are correct.
Q2) Francisca,an anesthesiologist,is assisting with a surgical procedure.The drug she chooses should induce anesthesia quickly and allow the patient to recover quickly.Francisca decides to use methohexital.Which of the following statements,if true,supports Francisca's choice?
A) The patient is undergoing neurosurgery.
B) The patient is susceptible to postoperative nausea and vomiting.
C) The patient is susceptible to laryngospasms.
D) The patient is undergoing a cardiac procedure.
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Page 20
Chapter 19: Opioid Narcoticanalgesics
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Sample Questions
Q1) In the context of opioids,identify an advantage of parenteral administration over oral administration.
A) Lower bioavailability of injected medications
B) Increased metabolism from hepatic drug microsomal metabolizing system
C) Poor absorption in the acidic environment of the stomach
D) Poor absorption in the alkaline environment of the intestines
Q2) Enkephalins are endogenous peptides that are produced throughout the central nervous system (CNS)and peripheral nerve endings and have a preference for _____.
A) kappa receptors
B) delta receptors
C) mu<sub>1</sub> receptors
D) mu<sub>2</sub> receptors
Q3) A drug that suppresses coughing is known as an _____.
A) analgesic
B) antitussive
C) antidiuretic
D) anesthetic
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21
Chapter 20: Nonnarcotic Analgesics
Anti-Inflammatory,and Antigout Drugs
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Q1) Identify a true statement about petechia.
A) Petechia is a condition in which there is a large, immature form of the red blood cell, which does not function as efficiently as the mature form.
B) Petechia is a small area of the skin or mucous membranes that is discolored because of localized hemorrhages.
C) Petechia is a condition in which the total number of white blood cells circulating in the blood is less than normal.
D) None of the above are correct.
Q2) Which of the following is true of salicylates?
A) Salicylates directly irritate the stomach mucosal lining.
B) Salicylates inhibit prostaglandin synthesis.
C) Salicylates stimulate the medullary center known as the chemoreceptor trigger zone.
D) All of the above are correct.
Q3) Identify the physiological signs that indicate the presence of inflammation.
A) Swelling and redness
B) Pain and warmth
C) Loss of function
D) All of the above
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Chapter 21: Cardiac Glycosides and the Treatment of
Congestive Heart Failure
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Sample Questions
Q1) The P wave of an electrocardiogram (ECG)represents the:
A) depolarization of the atria.
B) repolarization of the atria.
C) depolarization of the ventricles.
D) repolarization of the ventricles.
Q2) An increase in heart rate primarily begins with stimulation of which part of the conduction system?
A) Purkinje fibers
B) Atrioventricular bundle
C) Atrioventricular (AV) node
D) Sinoatrial (SA) node
Q3) Which of the following statements is true of the blood flow through the heart?
A) The pulmonary veins carry oxygenated blood from the lungs to the left atrium.
B) The left ventricle pumps deoxygenated blood to the lungs through the pulmonary arteries, where it gets oxygenated.
C) The right ventricle of the heart pumps blood out of the heart into the aorta, where it gets distributed to the rest of the body.
D) Blood passes from the right atrium into the right ventricle through the bicuspid valve.
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Chapter 22: Antiarrhythmic Drugs
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Q1) While treating chronic heart failure,which of the following signs should one look out for after the administration of a vasodilator such as hydralazine?
A) Postural hypotension
B) Reflex tachycardia
C) Nausea and headache
D) All of the above
Q2) Identify a true statement about digoxin.
A) Digoxin is bound significantly to plasma proteins.
B) Food does not delay the absorption of digoxin.
C) Digoxin is excreted mostly unmetabolized by the urinary tract.
D) Food interferes with the extent of absorption of digoxin.
Q3) A patient who is under digoxin therapy to treat chronic heart failure presents with symptoms such as nausea,vomiting,headache,and visual disturbances.Which of the following treatment options should be pursued?
A) The dose of digoxin should be increased.
B) The patient should be administered a calcium blocker instead of digoxin.
C) The patient should be taken off digoxin immediately.
D) The dose of digoxin should be reduced.
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Chapter 23: Antianginal Drugs
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Q1) Ectopic foci are often caused due to:
A) an increase in the activity of the sinoatrial (SA) node.
B) an increase in the activity of the atrioventricular (AV) node.
C) a delay or blockage in the conduction of electrical impulses.
D) a decrease in the number of cholinergic neurons innervating the heart.
Q2) Dr.Cooper notices some irregularities in Alex's heartbeat.After a thorough examination,he diagnoses Alex with ventricular arrhythmia.Dr.Cooper advises Alex to start taking a Class 1A antiarrhythmic drug in an extended-release tablet form once every 12 hours.On being asked about the drug's mechanism of action by an assistant,Dr.Cooper states that the drug slows conduction in the heart and prolongs the cardiac refractory period.Based on the information provided in this scenario,which of the following drugs has Dr.Cooper most likely prescribed?
A) Sotalol
B) Amiodarone
C) Esmolol
D) Procainamide
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Chapter 24: Diuretics
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Q1) Which of the following is an important therapeutic effect achieved by nitrates in the treatment of angina?
A) Decrease in cardiac work
B) Increase in preload
C) Increase in afterload
D) Decrease in clot formation
Q2) Betty,an angina patient,is asthmatic.Betty's doctor prescribes a combination of a nitrate and a beta-blocker to treat her angina.Which of the following combination of drugs is contraindicated?
A) Verapamil and isosorbide dinitrate
B) Nadolol and isosorbide dinitrate
C) Atenolol and isosorbide dinitrate
D) Metoprolol and isosorbide dinitrate
Q3) Identify a nonpharmacologic treatment that a patient should consider to prevent the progression of angina attacks.
A) Exercise and a low-fat diet
B) Smoking cessation
C) Weight control
D) All of the above
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Page 26
Chapter 25: Antihypertensive Drugs
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Q1) In which of the following parts of the nephron is weak acids and weak bases secreted?
A) The proximal convoluted tubule
B) The distal convoluted tubule
C) The nephron loop
D) The collecting ducts
Q2) _____ are preferred therapy when a patient is suffering from hypertension,mild heart failure,or nephrolithiasis.
A) Loop diuretics
B) Thiazides
C) Osmotic diuretics
D) Carbonic anhydrous inhibitors
Q3) Dr.Lawson is scheduled to perform cardiovascular surgery on a patient.He decides to use mannitol to reduce a swelling on the patient's arm.Which of the following statements,if true,would support Dr.Lawson's choice?
A) The patient's renal system is not functioning appropriately.
B) The patient's acid-base balance has been altered, and it is more alkaline.
C) The patient's electrolyte levels are appropriate.
D) The patient is prone to nausea and headaches.
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Page 27
Chapter 26: Anticoagulants and Coagulants
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Q1) Select the preferred treatment for hypertension for patients with renal disease.
A) Beta-blockers and diuretics
B) ACEIs and ARBs
C) Calcium channel blockers and diuretics
D) Thiazide and loop diuretics
Q2) Mark suffers from mild hypertension.Which of the following is best suited to treat his condition?
A) Diuretics
B) Diazoxide
C) Sodium Nitroprusside
D) Vasodilators
Q3) In the context of the mechanism of antihypertensive action,which of the following is the treatment option to be used when the desired effect is to block the beta-1 receptors in the heart to decrease cardiac output and blood pressure?
A) Clonidine (Catapres), guanabenz (Wytensin), and guanfacine (Tenex)
B) Doxazosin (Cardura), prazosin (Minipress), and terazosin (Hytrin)
C) Atenolol (Tenormin), metoprolol (Lopressor), and nadolol (Corgard)
D) None of these
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Chapter 27: Nutrition and Therapy
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Q1) Which of the following are the first cells or cell components to reach a site of injury to initiate coagulation?
A) Thrombocytes
B) Erythrocytes
C) Monocytes
D) Leucocytes
Q2) Which of the following terms refers to the balance between clot formation and clot breakdown that occurs throughout the day?
A) Hematuria
B) Albuminuria
C) Hemostasis
D) Metastasis
Q3) Why should a patient currently experiencing thromboembolisms be given warfarin?
A) To increase the production of several Vitamin K dependent clotting factors
B) To dissolve the preformed clot
C) To prevent secondary thromboembolic complications
D) To bind calcium ions so that the coagulation scheme is interrupted
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Chapter 28: Hypolipidemic Drugs
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Q1) What is the minimum amount of milk,cheese,and dairy products that a senior adult should consume in a day?
A) 6-8 servings
B) 1 serving
C) 2 servings
D) 3-5 servings
Q2) Use your knowledge of vitamins and nutritional therapy to determine the instructions that you must give a patient regarding therapy with nutritional supplements.
A) Nutritional supplements should be taken with meals to avoid gastrointestinal (GI) distress.
B) Extended-release formulations of vitamins should not be chewed or crushed.
C) If pregnancy is suspected, the supplements should not exceed the recommended maximum daily amounts.
D) All of these statements are correct.
Q3) Which of the following statements is true of vitamin A?
A) Provitamin A is converted to retinol in the stomach.
B) A deficiency of vitamin A can lead to night blindness.
C) Vitamin A usage leads to increased sebum production.
D) None of these are correct.
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Page 30
Chapter 29: Antianemic
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Q1) Which of the following is true of the immediate-release preparation of niacin?
A) It reduces total cholesterol.
B) It increases HDL.
C) It reduces LDL preferentially.
D) It increase triglycerides preferentially.
Q2) Cholesterol is considered to be a critical substrate for the body because of its importance in building all of the following except _____.
A) androgens
B) glucocorticoids
C) amino acids
D) aldosterone
Q3) Plaque refers to a substance that accumulates in the innermost layer of the arteries and consists of _____.
A) cholesterol and calcium
B) potassium and sodium
C) fatty acids and protein
D) fatty acids and water
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Chapter 30: Antiallergic and Antihistaminic Drugs
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Q1) Allison,a teacher at a school for underprivileged children,notices that one of her students,8-year-old Sarah,has an abnormal eating disorder.She often observes Sarah eating clay and chalk.When this habit continues in spite of intervention,Allison takes Sarah to Dr.Ford's clinic for a medical checkup.In addition to pale skin and rapid breathing,Dr.Ford notes that Sarah has abnormally low levels of iron in her blood stream.Based on the information provided in this scenario,Sarah shows the characteristic symptoms of _____.
A) scurvy
B) pica
C) hypokalemia
D) hemochromatosis
Q2) _____ has the longest half-life of all erythropoietin stimulating agents (ESAs).
A) Aranesp
B) Epogen
C) MIRCERA
D) Procrit
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Chapter 31: Bronchodilator Drugs and the Treatment of Asthma
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Q1) Which of the following first-generation antihistaminic drugs inhibits the actions of histamine and serotonin?
A) Dimenhydrinate
B) Cyproheptadine
C) Meclizine
D) Clemastine
Q2) Why should oral cromolyn dosage forms avoid being taken with fruit juice or milk?
A) Fruit juices and milk combine with the drug and form an insoluble complex that is difficult to excrete.
B) The acidic conditions will induce metabolism and increase bioavailability of the drug.
C) The dissolution and absorption of the drug will be compromised.
D) Fruit juice and milk potentiate the action of the drug.
Q3) Which of the following is true of fexofenadine?
A) Fexofenadine should not be taken with an antacid.
B) Fexofenadine decreases the blood level of nasally administered azelastine.
C) Fexofenadine absorption is delayed when taken closely with high fatty meals.
D) Fexofenadine does not undergo drug interactions with other drugs.
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Page 33
Chapter 32: Respiratory Pharmacology, treatment of
Asthma and Copd
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Q1) Caffeine,theophylline,and theobromine are compounds found in nature and these compounds are classified as methylxanthines.Identify the type of compound being exemplified in this question.
A) Mineral compounds
B) Plant compounds
C) Synthetic compounds
D) None of these
Q2) Select the correct statement related to the bronchodilators salmeterol and formoterol.
A) Salmeterol and formoterol are administered as oral tablets, have an immediate onset of action, and have a duration of action of 12 hours.
B) Salmeterol and formoterol are administered by nebulization, have an immediate onset of action, and have a duration of action of 4 to 6 hours.
C) Salmeterol and formoterol are administered by inhalation, have an onset of action of 10 to 20 minutes, and have a duration of action of 12 hours.
D) None of these are correct.
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Chapter 33: Agents That Affect Intestinal Motility
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Q1) Why should cimetidine never be mixed with a barbiturate when compounding an IV admixture?
A) The drugs will exhibit pharmacological antagonism to each other.
B) Cimetidine will precipitate out of solution.
C) The drugs will exhibit pharmacological synergism with each other.
D) The barbiturate will precipitate out of solution.
Q2) Gastric juices are released during the gastric phase when the _____.
A) chyme or partially digested foods enter the intestine.
B) adrenergic receptors on parietal cells are stimulated.
C) brain receives sensory input.
D) stomach distends.
Q3) Antibiotic treatment for peptic ulcers caused by H.pylori requires the use of _____.
A) two antibiotics
B) one antibiotic and one antifungal
C) three antibiotics
D) one antibiotic and one antiprotozoal
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Chapter 34: Introduction to the Endocrine System
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Q1) Select the statement that best describes the involvement of the sympathetic and parasympathetic nervous system in the movement of feces.
A) Stimulation of the adrenergic fibers that innervate the intestines increases intestinal motility, whereas stimulation of the cholinergic fibers decreases motility.
B) Stimulation of the cholinergic fibers that innervate the intestines increases intestinal motility, whereas stimulation of the adrenergic fibers decreases motility.
C) Stimulation of either the cholinergic fibers or the adrenergic fibers that innervate the intestines increases intestinal motility.
D) Stimulation of either the cholinergic fibers or the adrenergic fibers that innervate the intestines decreases intestinal motility.
Q2) Which of the following is the most frequent side effect produced by antidiarrheal drugs?
A) Vomiting
B) Constipation
C) Renal failure
D) Hypertension
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Chapter 35: Introduction to the Endocrine System Adrenal
Steroids
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Q1) _____ is secreted through positive feedback.
A) Oxytocin
B) Somatotropin
C) Prolactin
D) Calcitonin
Q2) Noah, a 42-year-old, consults Dr. Miller as he has enlarged bones in his hands and feet. Dr. Miller diagnoses him with acromegaly and prescribes lanreotide to him. Dr. Miller should consider switching Noah to octreopeptide if Noah has _____.
A) adrenal insufficiency
B) stents in his blood vessels
C) Cushing's disease
D) carcinoid tumors
Q3) Oxytocin and antidiuretic hormone are:
A) produced in the posterior pituitary gland and stored in the mammary glands.
B) produced in the hypothalamus and are stored in the posterior pituitary gland.
C) produced in the uterus and are stored in the mammary glands.
D) produced in the anterior pituitary gland and are stored in the uterus.
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Page 37
Chapter 36: Gonadal Hormones and the Oral Contraceptives
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Q1) Summarize the relationship between the hypothalamus,the anterior pituitary gland,and the adrenal gland.
A) The hypothalamus secretes ACTH (adrenocorticotropic hormone), which stimulates the release of CRH (corticotropin-releasing hormone) from the anterior pituitary gland that leads to the secretion of glucocorticoids by the adrenal gland.
B) The hypothalamus secretes CRH (corticotropin-releasing hormone), which stimulates the release of ACTH (adrenocorticotropic hormone) from the anterior pituitary gland that leads to the secretion of mineralocorticoids by the adrenal gland.
C) The hypothalamus secretes CRH (corticotropin-releasing hormone), which stimulates the release of ACTH (adrenocorticotropic hormone) from the anterior pituitary gland that leads to the secretion of glucocorticoids by the adrenal gland.
D) None of these are correct.
Q2) Which of the following factors contributes to stress?
A) Infection
B) Cold weather
C) Surgery
D) All of the above
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Page 38
Chapter 37: Drugs Affecting the Thyroid and Parathyroid Glands and Bone Degeneration
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Q1) Jeremy is diagnosed with erectile dysfunction,and his doctor prescribes tadalafil to treat his condition.How is tadalafil likely to help Jeremy?
A) Tadalafil will increase the blood flow to the penis by acting as a vasodilator.
B) Tadalafil will increase the blood pressure in the penis by acting as a vasoconstrictor.
C) Tadalafil will selectively block PDE5 in the penis so that cGMP accumulates and a full erection is maintained.
D) Tadalafil will alter psychomotor activity and increase nerve excitability so that an erection is established and maintained.
Q2) Which of the following hormones causes ovulation as a result of a surge in its level?
A) LH
B) FSH
C) GnRH
D) Progesterone
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Chapter 38: Pancreatic Hormones and Antidiabetic Drugs
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Q1) Which of the following instructions should a healthcare professional give a patient who is undergoing hormonal replacement therapy?
A) One need not inform the physician if he or she chooses to discontinue thyroid hormone replacement therapy.
B) If one is receiving radioactive iodide, he or she should not expectorate.
C) Drugs like cholestyramine should be taken only an hour after taking the thyroid hormones.
D) Thyroid hormones should preferably be taken at night.
Q2) Which of the following statements is true of thyroid hormone?
A) Thyroid hormone inhibits protein synthesis.
B) Thyroid hormone decreases the rate of carbohydrate breakdown.
C) Thyroid hormone decreases the insulin-dependent entry of glucose into cells.
D) Thyroid hormone decreases the level of serum cholesterol.
Q3) What are the physical ramifications of hypothyroidism in infants and children?
A) Mental and physical retardation
B) Exophthalmos
C) Toxic nodular goiter
D) None of the above
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Chapter 39: Posterior Pituitary Hormones and Drugs
Affecting Uterine
Muscle
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Q1) Diabetes mellitus is a syndrome that involves a problem with which hormone?
A) Insulin
B) Glucagon
C) Amylin
D) GIP
Q2) Which antidiabetic agents are considered hypoglycemics?
A) Insulins and alpha-glucosidase inhibitors
B) Biguanides and secretagogues
C) Insulin sensitizers and peptidase inhibitors
D) Insulins and secretagogues
Q3) Identify the statement that is true about diabetes.
A) Therapy of type 2 diabetics does not include insulin.
B) Type 2 diabetics secrete unlimited amounts of insulin from the pancreas.
C) Patients' diets are adjusted to limit the intake of carbohydrates in both forms of diabetes.
D) Maintenance therapy of diabetes is directed at regulating the blood glucose level through drug administration only.
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Page 41
Chapter 40: Antibacterial Agents
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Q1) Which of the following statements is correct about the proper dosage of desmopressin acetate (DDAVP)for the treatment of enuresis according to the Physicians' Desk Reference?
A) The dose of desmopressin (DDAVP) used to treat enuresis is 0.1 to 0.4 ml daily intranasally.
B) The dose of desmopressin (DDAVP) is 1 vaginal suppository (20 mg) up to 2 days.
C) The dose of desmopressin (DDAVP) used to treat enuresis is 0.2 to 0.6 mg PO daily at bedtime.
D) None of these are correct.
Q2) Identify an accurate statement about oxytocin.
A) The duration of uterine contraction is dependent on the oxytocin dose.
B) The use of oxytocics lessens the chance of violent uterine contractions.
C) Natural preparations (animal source) of oxytocin are generally administered during pregnancy.
D) Oxytocin prevents the forceful expulsion of a fetus through an undilated birth canal.
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Chapter 41: End of Chapter Questions
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Q1) An antibiotic will have no effect on an infection if:
A) the antibiotic has a broad-spectrum.
B) the bacteria are not resistant to the antibiotic.
C) the bacteria do not fall within the drug's antibacterial spectrum.
D) beta-lactamase activity is not present.
Q2) Which of the following are two of the simplest methods used to determine antibiotic susceptibility?
A) Disk test and agar plating
B) Disk test and serial dilution
C) Serial dilution and agar plating
D) Disk test and autoclaving
Q3) Which one of the following reactions requires emergency medical attention?
A) Disulfiram reaction
B) Stevens-Johnson syndrome
C) Fanconi syndrome
D) Pruritis and photosensitivity
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Chapter 42: Antifungal and Antiviral Aidsdrugs
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Q1) What is the effect of the azole drugs on the action of warfarin?
A) The azole drugs completely inhibit the action of warfarin and should, therefore, not be taken together.
B) The azole drugs prolong the anticoagulant action of warfarin.
C) The azole drugs speed the anticoagulant action of warfarin.
D) None of these are correct.
Q2) Which of the following instructions should be given to a patient receiving treatment with delavirdine (Rescriptor)?
A) It must be taken with meals to maximize absorption and bioavailability.
B) It must be taken on an empty stomach or 2 hours after a meal.
C) It must be taken 1 hour before antacids.
D) None of these are correct.
Q3) Which of the following is the mechanism of action of amantadine (Symadine)?
A) It inhibits early viral replication by uncoating the virus.
B) It inhibits the release of viral DNA into host cells.
C) It inhibits viral neuraminidase.
D) None of these are correct.
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44
Chapter 43: Antiprotozoal and Anthelmintic Drugs
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Q1) A patient with malaria has overdosed on chloroquine.If no antidote is available,what can be done for the patient?
A) Administration of oxygen
B) Administration of plenty of fluids
C) Alkalinization of the urine
D) Acidification of the urine
Q2) Which of the following protozoal infections respond to drug therapy?
A) Malaria
B) Dysentery
C) Trichomoniasis
D) All of these
Q3) A therapeutic use of quinine,other than for treating malaria,is for treating:
A) blurred vision.
B) headache.
C) motion sickness.
D) nocturnal leg cramps.
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Chapter 44: Antiseptics and Disinfectants
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Q1) Select the correct statement about peroxides.
A) Hydrogen peroxide can be used as an oral debriding agent.
B) As peroxide oxidizes, it releases oxygen that causes it to effervesce (bubble).
C) Hydrogen peroxide rapidly stops capillary bleeding when it is used to clean abrasions with slow blood oozing.
D) All of these are correct
Q2) Select the true statement about the mechanism of action of antiseptics and disinfectants.
A) They destroy microorganisms by altering the nucleic acid.
B) They can decrease the surface tension of bacterial cell walls causing the cells to swell and lyse.
C) They can disrupt the protein function of the cell.
D) All of these are correct.
Q3) Chlorhexidine is used:
A) to treat second- and third-degree burns.
B) to fumigate operating rooms.
C) as an ophthalmic irrigant.
D) as a mouthwash for aphthous ulcers.
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46
Chapter 45: Antineoplastic Agents
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Q1) Which of the following approaches is commonly used to treat cancer?
A) Surgery
B) Radiation
C) Chemotherapy
D) All of these
Q2) Tumor growth inhibition by the Vinca alkaloids occurs through:
A) inhibition of DNA transcription.
B) inhibition of protein translation.
C) metaphase arrest.
D) anaphase arrest.
Q3) Mrs.Smith's treatment for cancer has showed promise.The first treatment session has yielded a 50 percent reduction in the number of tumor cells.Identify the statement that best explains why only one more treatment session will not be enough to eradicate all the cancer cells in Mrs.Smith.
A) Cancer treatment eradicates cells by percentage, not number.
B) Cancer treatment only prolongs a patient's life and cannot completely cure a patient.
C) Cancer cells grow at a faster rate than normal cells.
D) Cancer cells can only be eliminated over the course of several weeks.
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Chapter 46: Immunopharmacology
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Q1) _____ is an immunomodulating agent that is used to treat Kaposi's sarcoma.
A) Proleukin
B) Roferon-AC.
C) Infergen
D) Rebif
Q2) Select the true statement about infliximab (Remicade).
A) Infliximab is a cytotoxic drug that inhibits the activity of the T-cells and B-cells.
B) Infliximab is a monoclonal antibody that binds to and inhibits the activity of tumor necrosis factor (TNF-alpha).
C) Administration of infliximab is not associated with any adverse reactions.
D) None of these are correct.
Q3) _____ is administered using subcutaneous injections to treat chronic hepatitis
A) Neupogen
B) Betaseron
C) Alferon NC.
D) Infergen
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