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PHRM 825 Therapeutics > Exam 5 - Multiple Choice > Flashcards

Exam 5 - Multiple Choice Flashcards

1
Q
  1. Which of the following best describes how serum testosterone concentrations vary over time in men.
    A. Serum testosterone concentrations start high in men and decrease over time with aging
    B. Serum testosterone concentrations follow a bell-shaped curve, increasing and decreasing over time
    C. Serum testosterone concentrations do not vary over time in men
    D. Serum testosterone concentrations start low, increase heavily during puberty, and then decreases with aging
    E. None of the above
A

D. Serum testosterone concentrations start low, increase heavily during puberty, and then decreases with aging

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2
Q

All of the following happen in men during puberty EXCEPT….
A. Spermatolysis
B. Bone and muscle growth
C. Increased libido
D. Penis growth
E. Facial hair growth

A

a. Spermatolysis

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3
Q

What is the most common form of alopecia in men?

A. Alopecia areata
B. Androgenic alopecia
C. Traction alopecia
D. Alopecia universalis
E. Drug-induced alopecia

A

B. Androgenic alopecia

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4
Q

EB is a 46 year old male presenting to his primary care doctor with complaints of a receding hairline. After a discussion with his primary care provider and a physical exam, EB is diagnosed with androgenic alopecia. EB is ready to initiate medication therapy and has expressed a preference for an oral medication. Which of the following is the best medication to initiate at this time?

A. Minoxidil
B. Tamsulosin
C. Tadalafil
D. Testosterone
E. Finasteride

A

E. Finasteride

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5
Q

What is the mechanism of action of Minoxidil?

A. Inhibits type II 5-alpha reductase
B. Inhibits the conversion of testosterone to DHT
C. Enlarges miniaturized hair follicles
D. Enhances the effect of nitric oxide via the inhibition of phosphodiesterase 5

A

C. Enlarges miniaturized hair follicles

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6
Q

A TOTAL testosterone level of…..is positive for low testosterone
A. <100 ng/dL
B. <200 ng/dL
C. <300 ng/dL
D. <400 ng/dL
E. <500 ng/dL

A

c. <300 ng/dL

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7
Q

A free testosterone level of….can confirm low testosterone
A. <5 ng/dL
B. <10 ng/dL
C. < 50 ng/dL
D. < 100 ng/dL

A

a. <5 ng/dL

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8
Q

Of the many testosterone formulation products, which dosage form is the most similar to physiologic testosterone levels?
A. Gel
B. SQ pellet
C. IM injection
D. Patch
E. Buccal tablet

A

D. Patch

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9
Q

Which of the following are true contraindications to the use of testosterone? (Select all that apply)

A. Prostate cancer
B. Breast cancer
C. PSA > 2 ng/mL
D. Recent history of poorly controlled cardiovascular disease

A

A. Prostate cancer
B. Breast cancer
D. Recent history of poorly controlled cardiovascular disease

(C is wrong because you need PSA > 4 ng/mL)

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10
Q

When monitoring testosterone levels for patients diagnosed with hypogonadism, what is the goal range?
A. <100 ng/dL
B. 100 - 300 ng/dL
C. 300 - 600 ng/dL
D. 400 - 700 ng/dL
E. <500 ng/dL

A

D. 400 - 700 ng/dL

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11
Q

Which of the following drug classes is the biggest cause of drug-induced erectile dysfunction?
A. Antidepressants
B. Antihypertensive agents
C. Cancer chemotherapy agents
D. Estrogens/anti-androgens

A

A. Antidepressants

(SSRI’s)

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12
Q

Patients taking PDE-5 inhibitors CANNOT take which of the following types of medications
A. ACE-i/ARBs
B. Beta-blockers
C. Nitrates
D. Alpha-blockers

A

C. Nitrates

(PDE-5 inhibitors and nitrates both cause vasodilation, so taking both at the same time can lead to an increase drop in bp; D is wrong bc you can take an alpha-blocker, just have to start at a lower starting dose)

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13
Q

Which demographic has both the highest incidence and death rate of prostate cancer?

a. Caucasian people
b. Non-Hispanic African-Americans
c. Latinos

A

b. Non-Hispanic African-Americans

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14
Q

Which of the following is true regarding prostate specific antigen (PSA)? (Select all that apply)

A. If the PSA is greater than 10, the chance of having prostate cancer is over 50%
B. Men over the age of 70 should be screened annually for PSA
C. Men with PSA levels higher than 2.5 should not be tested annually for prostate cancer
D. Men of African American descent are at a lower risk of prostate cancer compared to other minorities

A

A. If the PSA is greater than 10, the chance of having prostate cancer is over 50%

(B is wrong bc patients over 70 have less testosterone anyways so less chance of having prostate cancer; C is wrong bc they SHOULD be tested annually)

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15
Q

BD, a 75-year-old male, has just been diagnosed with moderate BPH. Which of the following treatments would be appropriate recommendations for him? (select all that apply)

a. Tamsulosin 0.4 mg po qhs
b. Balloon dilation
c. Tadalafil 5 mg po qd
d. Transurethral microwave thermotherapy (TUMT)
e. Dutasteride 0.5 mg po qd
f. Botox injection

A

a. Tamsulosin 0.4 mg po qhs
c. Tadalafil 5 mg po qd
e. Dutasteride 0.5 mg po qd

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16
Q

Which of the following best describes the role estrogen plays in contraceptives?

a. Allows for increased binding of free androgens
b. Suppresses LH production
c. Decrease sex-hormone binding globulin
d. Allow for the dominant follicle to form

A

a. Allows for increased binding of free androgens

(B is wrong bc it suppresses FSH production; C should be INCREASES; D is wrong bc it prevents formation)

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17
Q

Which of the following would be the best contraception option for a 24 year old female who is concerned about the side effects of estrogen and progesterone?

a. Slynd (drospirenone)
b. Paragard (copper IUD)
c. Nexplanon implant
d. Depo-Provera (medroxyprogesterone acetate)

A

b. Paragard (copper IUD)

18
Q

A patient calls your pharmacy requesting assistance after forgetting to take their birth control. After speaking with the patient, you determine that they are currently on a combined estrogen/progesterone pill and the last time they took their medication was three days ago. What are the best steps the patient can take moving forward?

a. Take one pill as soon as possible, take the next pill at the usual time, use a backup contraception method for 2 days
b. Take one pill as soon as possible, take the next pill at the usual time, use a backup contraception method for 5 days
c. Take one pill as soon as possible, take the next pill at the usual time
d. Take one pill as soon as possible, take the next pill at the usual time, use a backup contraception method for 7 days

A

d. Take one pill as soon as possible, take the next pill at the usual time, use a backup contraception method for 7 days

19
Q

A patient calls your pharmacy requesting assistance after forgetting to take their birth control. After speaking with the patient, you determine that they are currently on a combined estrogen/progesterone pill and the last time they took their medication was three days ago. What are the best steps the patient can take moving forward?

a. Take one pill as soon as possible, take the next pill at the usual time, use a backup contraception method for 2 days
b. Take one pill as soon as possible, take the next pill at the usual time, use a backup contraception method for 5 days
c. Take one pill as soon as possible, take the next pill at the usual time
d. Take one pill as soon as possible, take the next pill at the usual time, use a backup contraception method for 7 days

A

d. Take one pill as soon as possible, take the next pill at the usual time, use a backup contraception method for 7 days

(A is for the mini-pill, which is progestin only; return to fertility for COC is immediate)

20
Q

Which of the following contraceptives would put a patient at the greatest risk for a vulvovaginal infection/candidiasis?
a. Annovera
b. Nuvaring
c. Xulane
d. Twirla
e. Nexplanon

A

a. Annovera

(Annovera is a reusable vaginal ring; nuvaring is for one time use)

21
Q

true or false: Hormonal testosterone will protect a transgender male patient from pregnancy.

A

false

22
Q

EJ is a 17-year-old who presents to their family practitioner for follow-up after presenting with severe menstrual pain 6 months prior. At that time, she was prescribed Ibuprofen 800 mg TID. Today, EJ reports increase in pain during part of the month. Which of the following options is the best approach now?

a. Danazol
b. Leuprolide
c. Elagolix
d. Medroxyprogesterone

A

d. Medroxyprogesterone

(NSAIDs are first line for endometriosis; recognize dosing for NSAIDs)

23
Q

KR is a 33-year-old who is 3 months pregnant. Unfortunately, she has developed new uterine fibroids. What is an appropriate treatment plan to manage pain during pregnancy?

a. Tranexamic acid
b. Acetaminophen
c. Long term NSAIDS
d. Treatment in first trimester is not recommended

A

b. Acetaminophen

(C is wrong because of CI for long term NSAIDs, but we can use short term after 32 weeks)

24
Q

CO is a 30-year-old patient diagnosed with PMDD after charting symptoms for two cycles and attempting nonpharmacologic interventions for her symptoms without much relief. This patient is married and does not wish to use any form of birth control. Which of
the following agents would be most appropriate for managing CO’s PMDD?

a. Duloxetine
b. Alprazolam
c. Sertraline
d. St. John’s Wort

A

c. Sertraline

(SSRI; b. is wrong bc we usually don’t start therapy with a benzodiazapine)

25
Q

What are the possible side effects of Sertraline?

a. vomiting
b. increased libido
c. increased suicidal thinking
d. dizziness

A

c. increased suicidal thinking

26
Q

HM is a 35-year-old woman suffering from menstrual irregularity (8 to 10 times/year). ROS shows hair growth on chin/chest and severe acne on face/back. Ultrasound reveals ovarian cysts. What treatment would you recommend to her? She is married and interested in having children.

A. Clomiphene
B. Metformin
C. Spironolactone
D. Combined oral contraceptive

A

A. Clomiphene

(C is teratogenic)

27
Q

BB is a 32-year-old patient who initially presented with complaints of irregular menses and excess hair growth around the jawline. She was diagnosed with PCOS and was started on an oral contraceptive and lifestyle modification. Today at her 6-month follow-up appointment, her BMI is 35 kg/m2 with a waist circumference of 40 in. (102
cm). A 2-hour oral glucose tolerance test suggests impaired glucose tolerance. Which of the following is the most appropriate option for BB now?

A. Continue her oral contraceptive
B. Discontinue her oral contraceptive and initiate a LNG-IUS
C. Discontinue her oral contraceptive and initiate letrozole
D. Add metformin

A

D. Add metformin

28
Q

Which is true regarding indication and timing of infertility evaluation?
A. Women <25 years should initiate evaluation after 12 months
B. Women between 35-40 years should evaluate after 6 months of frequent
protected intercourse
C. Women >40 years should evaluate after less than 6 months of frequent
unprotected intercourse
D. Both B and C

A

C. Women >40 years should evaluate after less than 6 months of frequent
unprotected intercourse

(B is wrong because it says PROTECTED intercourse)

29
Q

Which of these can be used as an expectant management?
A. Timed intercourse
B. Urine ovulation predictor kits
C. Basal body temperature (BBT) monitoring
D. All of the above

A

D. All of the above

30
Q

Which of the following are possible treatments for anovulation? Select all that apply.

A. Spironolactone
B. Letrozole
C. IVF
D. High dose gonadotropin therapy

A

B. Letrozole
C. IVF

31
Q

Which of these vaccines should a pregnant woman avoid?
a. Influenza
b. Tdap
c. HPV
d. HepB

A

c. HPV

(avoid live vaccines)

32
Q

AJ is 35 YOF who is currently pregnant in her 2nd trimester. She is recently diagnosed with HTN. Which of these should be avoided?
a. Lisinopril
b. Amlodipine
c. HCTZ
d. Hydralazine

A

a. Lisinopril

(don’t use ACE inhibitors in pregnant women)

33
Q

AJ returns to the pharmacy complaining of morning sickness. She states she shas tried to avoid foods that make it worse. She has even tried Vitamin B6 but has not helped. She asks what medication she could take to help with her nausea.

a. Pepto Bismol
b. Dramamine
c. Pyridoxine with Doxylamine
d. She should wait as nausea will resolve for itself

A

c. Pyridoxine with Doxylamine

(Pyridoxine is B6, 2nd line is to add Doxylamine i.e. Unisom)

34
Q

Which stages of pregnancy does oxytocin play a role in? (select all that apply)

a. Stage 1
b. Stage 2
c. Stage 3

A

a. Stage 1
b. Stage 2

35
Q

Which of the following is a contraindication for labor induction? Select all that apply.
a. Oxytocin can be used regardless of any complications
b. Umbilical cord prolapse
c. Placenta previa
d. None of the above

A

b. Umbilical cord prolapse
c. Placenta previa

(Umbilical cord prolapse is when the umbilical cord comes out before the baby; Placenta previa is when placenta completely or partially covers the opening of the uterus)

36
Q

What are side effects of oxytocin?
a. Hypernatremia
b. Hypertension
c. Hyperbilirubinemia
d. All the above

A

c. Hyperbilirubinemia

37
Q

At what stage can oxytocin be used for medical termination?
a. 1st trimester
b. 2nd trimester
c. Can’t be used
d. 3rd trimester

A

b. 2nd trimester

38
Q

preeclampsia prevention treatment

A

aspirin 60-80 mg starting in late first trimester

39
Q

severe preeclampsia management (4 drugs)

A

hydralazine
labetalol
nitroprusside
nifedipine

40
Q

seizure management in pregnancy

A

magnesium sulfate 4-6 g IV bolus

41
Q

HELLP syndrome what does it stand for?

A

hemolysis
elevated liver enzymes
low platelet count

42
Q

1st line treatment of group B strep in pregnancy

A

antibiotic

PHRM 825 Therapeutics (25 decks)

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