Final Genomics (only quiz 5 material added)

Question 1

CYP4F2 — if reduced function it does what to what drug?

Answer 1

reduces warfarin sensitivity

Question 2

what gene is related to clopidogrel

Answer 2

CYP2C19

Question 3

what gene is related to warfarin

Answer 3

CYP2C9 and VKORC1 and CYP4F2

Question 4

what gene is related to statins

Answer 4

SLOCB1

Question 5

what genotype is ultrarapid metabolizer for CYP2C19

Answer 5

*17

Question 6

what genotype is poor metabolizer for CYP2C19

Answer 6

*2 and *3 (multiple 2 and 3 genes)

Question 7

T or F: Clopidogrel has required genetic testing

Answer 7

nah, just recommended — still not routinely performed before PCIs

Question 8

what is warfarins MOA

Answer 8

Inhibits Vitamin K epoxide reductase 1

VKORC1

Question 9

PK Of warfarin:

the ______ isomer is the active one

Answer 9

s isomer

Question 10

Warfarin is eliminated by _______

Answer 10

CYP2C9

Question 11

CYP2C9 *2 or *3 reduces warfarin clearance the most

Answer 11

*3 (reduces clearance 75-90%)

Question 12

VKORC Haplotypes:
1639___>___
and
1173___>____

Answer 12

G>A

C>T

Question 13

Largest doses of warfarin are needed when VKORC1 has
1639____
and
1173____

Answer 13

GG

CC

Question 14

CYP4F2: results in less ______ for ______

Answer 14

vit. k; clotting factors

Question 15

what types of patients would benefit from genetic testing — in regards to warfarin

Answer 15

high risk patients for bleeding
and
pts who can’t get INR checked all the time (way to get better guess on right dose

Question 16

MOA of HMGCoA reductase inhibitors:
upregulate ________
decrease ________

Answer 16

LDL receptors

decrease LDL concentrations

Question 17

SLOC1B1: transport drug into ______

Answer 17

liver

Question 18

what SLOC1B1: mutations would increase statin myopathy risk

Answer 18

*5 and *15

Question 19

CPIC reccomendations for Simvastatin 80 mg:
Avoid ____ mg dose of simvastatin (consistent with labeling)
Exception may be in a patient with a _______ genotype AND a history of tolerating the dose

Answer 19

80;

521TT

Question 20

we know what is SNP is..what is SNV

Answer 20

Aberration seen in only one individual (not well characterized)
Occur at low frequency so not common

Question 21

most cancer mutations are somatic or germline?

Answer 21

somatic!! (acquired throughout life… not inherited)

Question 22

what are the two cancer genes

Answer 22

tumor supressor

and oncogene

Question 23

For Simvastatin/CPIC Guidelines:

Max of ____ mg in patients with 521 CT and CC genotypes (i.e. *5 or *15 carriers)

Answer 23

20

Question 24

For Simvastatin/CPIC Guidelines:

Max of 20 mg in patients with 521 CT and CC genotypes (i.e. *___ or *____ carriers)

Answer 24

*5; *15

Question 25

For Simvastatin/CPIC Guidelines: | Max of 20 mg in patients with 521 ___ and ____ genotypes (i.e. *5 or *15 carriers)

Answer 25

CT;CC

Question 26

For Simvastatin/CPIC Guidelines: Routinely monitor ____ if… 521 CT and CC genotypes are present (i.e. *5 or *15 carriers) AND 20 or 40 mg simvastatin is being used

Answer 26

CK

Question 27

For Simvastatin/CPIC Guidelines: Routinely monitor CK if… 521 CT and CC genotypes are present (i.e. *5 or *15 carriers) AND ____ or___ mg simvastatin is being used

Answer 27

20 or 40

Question 28

For Simvastatin/CPIC Guidelines: Routinely monitor CK if… 521 ____ and ____ genotypes are present (i.e. *5 or *15 carriers) AND 20 or 40 mg simvastatin is being used

Answer 28

CT;CC | T = safe/no myopathy problems, any C is increase myopathy risk

Question 29

All of the following statements are true regarding CYP4F2: ``` Metabolizes vitamin K to ______ metabolite Reduced function results in ______ warfarin sensitivity Its genotype contributes less to warfarin _______ than VKORC1 Reduced function (does/does not) alter warfarin pharmacokinetics ```

Answer 29

hydroxyl decreased dose variability does not