exam 3 Flashcards
A drug’s most direct and effective method of delivery to its site of action is:
Oral administration
Intramuscular injection
Intravenous administration
Aerosol ingestion
Intravenous administration
Which of the following is not true regarding the absorption of drugs?
Drug absorption rates may change with age
Morphine may slow the gastrointestinal motility of a drug
Liquid medications are often absorbed slower than capsule medications
Crohn’s disease may alter the absorption of some drugs
Liquid medications are often absorbed slower than capsule medications
Drugs are susceptible to hepatic metabolism, and this increases the concentration of the drug before it reaches the circulatory system.
True
False
False
Which of the following statements is true regarding drug elimination?
One drug half-life is the time needed for the drug concentration to increase by half
Five to seven drug doses are required to reach a steady state of drug concentration
Most medications are administered as a single dose versus a scheduled basis
Aminoglycoside antibiotics are reabsorbed by the renal tubules
Five to seven drug doses are required to reach a steady state of drug concentration
The relationship between a drug’s concentration at its target sites and its physiological responses is known as:
Pharmacokinetics
Pharmacogenomics
Pharmacotherapy
Pharmacodynamics
Pharmacodynamics
Which of the following is not true concerning therapeutic drug monitoring?
It ensures correct drug doses for the expected therapeutic range
It helps to identify non-compliance of the patient
It identifies drug-drug interactions if multiple drugs are taken simultaneously
It establishes a one-fit dosing model for all patients
It establishes a one-fit dosing model for all patients
A blood draw to determine a peak level of a drug should be drawn:
One hour after an orally administered dose
Immediately after drug administration
90 minutes after an orally administered dose
Immediately before drug administration
One hour after an orally administered dose
CYP450 is a gene that influences the effectiveness of a drug in an individual.
True
False
True
Which of the following is not true concerning aminoglycosides?
They are a class of drugs that is administered in the inpatient setting
Toxic levels can cause hearing impairment
They are used to treat gram positive and gram negative infections
Ototoxic effects of the drug are reversible
Ototoxic effects of the drug are reversible
Pharmacokinetics and drug concentration are influenced by which of the following factors?
Absorption, distribution, metabolism, excretion
Absorption, bioavailability, excretion, metabolism
Biotransformation, distribution, excretion, metabolism
Adaption, distribution, excretion, metabolism
Absorption, distribution, metabolism, excretion
Only bound fractions of drugs can interact with the site of action and result in a biological response.
True
False
False
Tolerance to drugs could be explained as:
Constant exposure of receptors to drugs that leads to a reduced response
Constant exposure of receptors to drugs that leads to an increased response
50% of the maximum effect of a drug on the body
Constant exposure of receptors to drugs that leads to a reduced response
This drug is used to treat arrhythmias and CHF.
Quinidine
Digoxin
Disopyramide
Dilantin
Digoxin
This drug may have the adverse effect of “redman syndrome”
Vancomycin
Tobramycin
Amikacin
Gentamicin
Vancomycin
This antiepileptic drug requires hepatic markers to be check frequently due to risk of hepatic dysfunction.
Carbamazepine
Phenobarbital
Phenytoin
Valproic acid
Valproic acid
Immunosuppressive drugs typically are collected as serum samples.
True
False
False
Common routes of exposure to toxins are through the gastrointestinal tract, lungs, and skin.
True
False
True
Which specimen type is preferred for analytes demonstrating variation in urinary elimination patterns?
Random specimen
24-hour collection
Midstream “clean catch” specimen
First morning specimen
24-hour collection
Which of the following is not true concerning analysis of toxic agents?
Screening tests have good specificity but lack sensitivity
Confirmatory tests report the concentration of the analyte
Screening tests are a rapid test intended to detect the presence of a substance
The reference method for most compounds is gas chromatography with a mass spectrometer (GC-MS)
Screening tests have good specificity but lack sensitivity
All of the following statements are true regarding blood alcohol measurements except:
During venipuncture, the skin must be disinfected with iodine or chlorohexidine gluconate
Plasma and serum are acceptable specimen types for analysis
When testing will be delayed, sodium chloride can be used as a preservative to maintain specimen integrity
Specimens should remain capped to avoid evaporation
When testing will be delayed, sodium chloride can be used as a preservative to maintain specimen integrity
The affinity of carbon monoxide for hemoglobin is 20-25 times greater than oxygen
True
False
False
Toxic levels of acetaminophen are associated with
Ototoxicity
Nephrotoxicity
Hepatotoxicity
Neurotoxicity
Hepatotoxicity
Which of the following statements is not true concerning testing for drugs of abuse?
A two-tired testing approach includes screening and confirmatory testing
Confirmatory testing must use methods with high specificity and low sensitivity
Screening tests detect classes of drugs
GC-MS is the reference method used for confirmation
Confirmatory testing must use methods with high specificity and low sensitivity
Which type of toxicology uses the results from animal experiments to predict what level of exposure will cause harm to humans?
Descriptive
Mechanistic
Regulatory
Environmental
Descriptive
Which is not a common route of exposure to toxic substances.
Ingestion
Intravenous
Inhalation
Transdermal absorption
Intravenous
What phrase best describes what ED50 stands for?
A drug is predicted to have a therapeutic benefit for 50% of the population.
A drug is predicted to have a lethal effect for 50% of the population.
A drug is predicted to have a negative effect on 50% of the population,
A drug is predicted to have a therapeutic benefit for 50% of the population.
Chronic exposure to a toxin always has the same effect as acute exposures.
True
False
False
Which is not a common specimen type for analysis of toxic agents?
Urine
Blood
Oral fluid
All are common types
All are common types
Match the alcohol with the common source
Isopropanol Homemade liquors
Methanol Tequila
Ethylene glycol Antifreeze
Ethanol Rubbing alcohol
Isopropanol Rubbing alcohol
Methanol Homemade liquors
Ethylene glycol Antifreeze
Ethanol Tequila
An alternative test that may be performed in order to estimate ethanol in serum is the osmolality.
True
False
True
This toxic substance can be found in its organic form in clams and oysters.
Cadmium
Cyanide
Lead
Arsenic
Arsenic
This environmental pollutant has been linked to Itai-itai disease.
Cadmium
Lead
Mercury
Arsenic
Cadmium
Match the drug with its descriptor phrase
Amphetamines Substances capable of analgesia, sedation,
and anesthesia
Barbiturates High demand as sedative and anti-anxiety
Benzodiazepines Stimulant with high abuse potential
Opioids “Downer” originally used as sleep inducer
Amphetamines Stimulant with high abuse potential
Barbiturates “Downer” originally used as sleep inducer
Benzodiazepines High demand as sedative and anti-anxiety
Opioids Substances capable of analgesia, sedation,
and anesthesia
Which of the following enzymes is increased in patients with cancer involving bone?
Amylase
Alkaline phosphatase
Neuron-specific enolase
Gamma glutamyl transferase
Alkaline phosphatase
Which tumor marker is associated with neuroblastoma?
CA-15-3
Carcinoembryonic antigen (CEA)
CA 125
Homovanillic acid (HVA)
Homovanillic acid (HVA)
Which of the following tumor markers is classified as an oncofetal antigen?
Carcinoembryonic antigen (CEA)
CA 19-9
BRCA-1
hCG
Carcinoembryonic antigen (CEA)
The utilization of tumor markers is most important for:
Screening of asymptomatic patients
Screening for molecular markers
Monitoring the effectiveness of treatment
Confirming the presence of cancer
Monitoring the effectiveness of treatment
Tumor marker methodology include all of the following except:
Immunoassays
Gas chromatography
Immunohistochemistry
Enzyme analysis
Gas chromatography
Abnormally low tumor marker concentrations are associated with antigen deficiency and can cause false negative results
True
False
False
To accurately monitor tumor marker levels of the patient, it is important to use the same methodology each time of testing.
True
False
True
If tumor cells are found in both the original tumor and also in the regional lymph nodes, this would be classified as stage:
1
2
3
4
3
This type of tumor marker is valuable in diagnosing neuroblastomas, pituitary and adrenal adenomas.
Serum protein tumor markers
Endocrine tumor markers
Oncofetal antigens
Carbohydrate antigen tumor markers
Endocrine tumor markers
These type of tumor markers help to choose between endocrine and cytotoxic therapies.
Endocrine tumor markers
Oncofetal antigens
Cancer antigen tumor markers
Receptor tumor markers
Receptor tumor markers
All tumor markers can be used to screen asymptomatic populations.
True
False
False
Which is not a reason that serial results can be difficult to interpret:
Assay design
Variation in reference ranges
Differences in antibody specificity
A and B
All of the above
All of the above
Which is not something that is a consideration when considering using immunoassay method for tumor markers.
Hook effect
Requires more specialized skill and experience
Assay linearity
HAMAs
Requires more specialized skill and experience
Match the tumor with the description.
Neuroblastoma Serotonin secreting tumors from
small intestine
Pheochromocytoma Common malignant tumor in kids
Carcinoid Rare tumor associated with
hypertension
Neuroblastoma Common malignant tumor in kids
Pheochromocytoma Rare tumor associated with
hypertension
Carcinoid Serotonin secreting tumors from small
intestine
Which is not an example of an enzyme tumor marker.
ALP
AST
PSA
LDH
AST
Which tumor marker is used primarily with hepatocelluar carcinoma and testicular cancer.
Alpha fetoprotein (AFP)
CA-125
Carcinoembryonic Antigen (CEA)
Human chorionic gonadotropin (hCG)
Alpha fetoprotein (AFP)
Elevations in this tumor marker in CSF may indicate Creutzfeldt-Jakob disease.
Carbohydrate antigen 19-9 (CA-19-9)
Immunoglobulin free light chains (FLC)
Human epididymis protein 4 (HE4)
Neuron-specific enolase (NSE)
Neuron-specific enolase (NSE)
