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Finals Flashcards

1
Q 
Which of the following correctly represents the mecha- nism of action of tofacitinib in the treatment of RA?
A. TNF-α inhibitor.
B. Inhibitor of Janus kinases.
C. IL-6 receptor blocker.
D. Dihydrofolate reductase inhibitor.
A

B. Inhibitor of Janus kinases.

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2
Q 
All of the following are preferred antihistamines for the management of allergic rhinitis except:
A. Chlorpheniramine. 
B. Fexofenadine.
C. Loratadine.
D. Cetirizine.
E. Intranasal azelastine.
A

A. Chlorpheniramine.

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3
Q

Inhibits mycolic acid synthesis

A

Isoniazid

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4
Q

Which of the following statements about fentanyl is correct?
A. Fentanyl is 100 times more potent than morphine.
B. Its withdrawal symptoms can be relieved by
naloxone.
C. The active metabolites of fentanyl can cause
seizures.
D. It is most effective by oral administration.

A

A. Fentanyl is 100 times more potent than morphine.

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5
Q 
Which of the following drugs has been known to cause discoloration of the tongue?
A. Amoxicillin.
B. Omeprazole.
C. Bismuth compounds. 
D. Lubiprostone.
A

C. Bismuth compounds.

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6
Q 
Which of the following opioids is the best choice for treating pain associated with diabetic peripheral neuropathy?
A. Morphine.
B. Tapentadol.
C. Codeine.
D. Buprenorphine.
A

B. Tapentadol.

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7
Q 
A patient has a severe ear infection that is associated with significant vertigo. Which of the following might be helpful?
A. Azelastine.
B. Brompheniramine. 
C. Meclizine.
D. Olopatadine.
A

C. Meclizine

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8
Q 
A 68-year-old patient with cardiac failure is diagnosed with ovarian cancer. She begins using cisplatin but becomes nauseous and suffers from severe vomiting. Which of the following medications would be most effective to counteract the emesis in this patient without exacerbating her cardiac problem?
A. Droperidol.
B. Dolasetron.
C. Prochlorperazine. 
D. Dronabinol.
E. Palonosetron.
A

E. Palonosetron.

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9
Q 
Your neighbor said she used an H1 antihistamine that was available over-the-counter (OTC), and it caused her marked drowsiness and dry mouth and she slept quite longer than usual. Which is the most possible drug that she used?
A. Loratadine.
B. Levocetirizine.
C. Diphenhydramine. 
D. Fexofenadine.
E. Desloratadine.
A

C. Diphenhydramine.

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10
Q 
A 9-year-old girl has severe asthma, which required three hospitalizations in the last year. She is now receiving therapy that has greatly reduced the frequency of these severe attacks. Which of the following therapies is most likely responsible for this benefit?
A. Inhaled albuterol.
B. Inhaled ipratropium. 
C. Inhaled fluticasone. 
D. Oral theophylline. 
E. Oral zafirlukast.
A

C. Inhaled fluticasone.

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11
Q

Optic neuritis

A

Ethambutol

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12
Q

Inhibit RNA Polymerase

A

Rifampacin

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13
Q 
A 64-year-old male presents with signs and symptoms of an acute gouty flare. His doctor wishes to treat him accordingly to improve his symptoms. Which of the following strategies would be the LEAST likely to acutely improve his gout symptoms and pain?
A. Naproxen. 
B. Colchicine. 
C. Probenecid. 
D. Prednisone.
A

C. Probenecid.

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14
Q

Flu like symptom

A

Rifampacin

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15
Q 
Which of the following medications inhibits the action of 5-lipoxygenase and consequently the action of leukotriene B4 and the cysteinyl leukotrienes?
A. Cromolyn.
B. Zafirlukast. 
C. Zileuton.
D. Montelukast. 
E. Theophylline.
A

C. Zileuton.

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16
Q 
All of the following drugs are generally well tolerated for the treatment of constipation except:
A. Castor oil.
B. Methylcellulose.
C. Polyethylene glycol. 
D. Docusate.
A

A. Castor oil.

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17
Q

A 12-year-old girl with a childhood history of asthma complained of cough, dyspnea, and wheezing after visiting a riding stable. Her symptoms became so severe that her parents brought her to the emergency room. Which of the following is the most appropriate drug to rapidly reverse her bronchoconstriction?
A. Inhaled fluticasone.
B. Inhaled beclomethasone.
C. Inhaled albuterol.
D. Intravenous propranolol. E. Oral theophylline.

A

C. Inhaled albuterol.

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18
Q 
A 56-year-old patient who has suffered with severe chronic pain with radiculopathy secondary to spinal stenosis for years presents to the clinic for pain management. Over the years, this patient has failed to receive relief from the neuropathic pain from the radiculopathy with traditional agents such as tricyclics or anticonvulsants. Based on the mechanism of action, which opioid might be beneficial in this patient to treat both nociceptive and neuropathic pain?
A. Meperidine.
B. Oxymorphone. 
C. Morphine.
D. Methadone.
A

D. Methadone.

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19
Q 
Which of the following is an H1 receptor antagonist that also has serotonin receptor antagonism on the appetite center with the ability to stimulate appetite?
A. Hydroxyzine.
B. Loratadine.
C. Diphenhydramine. 
D. Cetirizine.
E. Cyproheptadine.
A

E. Cyproheptadine.

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20
Q

Which one of the following statements concerning
H antihistamines is correct?
A. Second-generation H1 antihistamines are relatively free of adverse effects.
B. Because of the established long-term safety of the first generation H1 antihistamines, they are the first choice for allergic rhinitis.
C. The motor coordination involved in driving an
automobile is not affected by the use of first-
generation H1 antihistamines.
D. H1 antihistamines can be used in the treatment of
acute anaphylaxis.
E. Both first- and second-generation
H1 antihistamines readily penetrate the blood– brain barrier

A

A. Second-generation H1 antihistamines are relatively free of adverse effects.

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21
Q

Which of the following is correct regarding clofazimine in the treatment of leprosy?
A. Clofazimine should not be used in patients with a deficiency in glucose-6-phosphate dehydrogenase (G6PD).
B. Peripheral neuropathy is one of the most common adverse effects seen with the drug.
C. Clofazimine may cause skin discoloration over time.
D. The risk of erythema nodosum leprosum is
increased in patients given clofazimine.

A

C. Clofazimine may cause skin discoloration over time.

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22
Q 
A 35-year-old male, formerly a heroin abuser, has been on methadone maintenance for the last 13 months. Two weeks ago, he had a positive tuberculosis skin test (PPD test), and a chest radiograph showed evidence of right upper lobe infection. He was started on standard four-drug antimycobacterial therapy. He has come to the emergency department complaining of “withdrawal symptoms.” Which of the following antimycobacterial drugs is likely to have caused this patient’s acute withdrawal reaction?
A. Ethambutol. 
B. Isoniazid.
C. Pyrazinamide. 
D. Rifampin.
E. Streptomycin.
A

D. Rifampin.

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23
Q

A patient is going on a deep sea fishing trip and is worried about motion sickness. Which of the following would be the most appropriate?
A. Dimenhydrinate 1 hour prior to departure.
B. Desloratadine 1 hour prior to departure.
C. Doxylamine 1 hour prior to departure.
D. Meclizine at onset of symptoms.

A

A. Dimenhydrinate 1 hour prior to departure.

24
Q

Peripheral neuropathy

A

Isoniazid

25
Q

A 24-year-old male has returned to the clinic fo
his 1-month check-up after starting treatment for tuberculosis. He is receiving isoniazid, rifampin, pyrazinamide, and ethambutol. He states he feels fine, but now is having difficulty reading his morning newspaper and feels he may need to get glasses. Which of the following drugs may be causing his decline in vision?
A. Isoniazid.
B. Rifampin.
C. Pyrazinamide.
D. Ethambutol.

A

D. Ethambutol.

26
Q

Inhibit arbinosyl transferase

A

Ethambutol

27
Q 
A 32-year-old male with a history of opioid addiction presents with symptoms of an upper respiratory system infection for the past 5 days. It is determined to be viral in nature, and no treatment of the underlying infection is appropriate. Which of the following is appropriate symptomatic treatment for this patient’s cough?
A. Guaifenesin/dextromethorphan. 
B. Guaifenesin/codeine.
C. Cromolyn.
D. Benzonatate.
E. Montelukast.
A

D. Benzonatate.

28
Q 
A 64-year-old male presents with mild to moderate musculoskeletal back pain after playing golf. He states he has tried acetaminophen and that it did not help. His past medical history includes diabetes, hypertension, hyperlipidemia, gastric ulcer (resolved), and coronary artery disease. Which of the following is the most appropriate NSAID regimen to treat this patient’s pain?
A. Celecoxib.
B. Indomethacin and omeprazole. 
C. Naproxen and omeprazole.
D. Naproxen.
A

C. Naproxen and omeprazole.

29
Q 
Which of the following medications for gastrointestinal problems is contraindicated in pregnancy?
A. Calcium carbonate. 
B. Famotidine.
C. Lansoprazole.
D. Misoprostol.
A

D. Misoprostol.

30
Q 
KM is a 64-year-old male who has been hospitalized following a car accident in which he sustained a broken leg and broken arm. He has been converted to oral morphine in anticipation of his discharge. What other medication should he receive with his morphine upon discharge?
A. Diphenhydramine.
B. Methylphenidate.
C. Docusate sodium with senna. 
D. Docusate sodium.
A

C. Docusate sodium with senna.

31
Q 
Which of the following histamine receptor antagonists is known to enter the central nervous system readily and is known to be sedative?
A. Hydroxyzine. 
B. Cetirizine.
C. Desloratadine.
D. Loratadine.
E. Fexofenadine.
A

A. Hydroxyzine.

32
Q 
A young woman is brought into the emergency room. She is unconscious, and she has pupillary constriction and depressed respiration. Based on reports, an opioid overdose is almost certain. Which of the listed phenanthrene opioids will exhibit a full and immediate response to treatment with naloxone?
A. Meperidine.
B. Morphine.
C. Buprenorphine. 
D. Fentanyl.
A

B. Morphine.

33
Q

A 58-year-old female ceramics worker with a COPD exacerbation has recently been discharged from the hospital. This is the third hospitalization in the past year for this condition, although the patient reports only mild symptoms in between exacerbations. The patient is currently still on the same drug regimen prior to her admission of salmeterol inhalation twice daily and tiotropium inhalation once daily. Her current FEV1 is below 60%. Which of the following would be an appropriate change in her medication regimen?
A. Chronic systemic corticosteroids.
B. Discontinue the tiotropium.
C. Discontinue the salmeterol.
D. Change the salmeterol to a combination product that includes both a LABA and an inhaled corticosteroid (for example, salmeterol/fluticasone DPI).
E. Theophylline.

A

D. Change the salmeterol to a combination product that
includes both a LABA and an inhaled corticosteroid
(for example, salmeterol/fluticasone DPI).

34
Q 
A 27-year-old woman who is 34 weeks pregnant is on bed rest and visits her obstetrician. During the visit, she informs her physician that she has been experiencing mild constipation. Which of the following medications will most likely be recommended to her?
A. Castor oil. 
B. Docusate. 
C. Mineral oil. 
D. Loperamide.
A

B. Docusate

35
Q

Which of the following describes appropriate inhaler technique for a dry powder inhaler?
A. Inhale slowly and deeply just before and throughout actuation of the inhaler.
B. Use a large-volume chamber (spacer) to decrease deposition of drug in the mouth caused by improper inhaler technique.
C. Inhale quickly and deeply to optimize drug delivery to the lungs.
D. Rinse mouth in a “swish-and-spit” method with water prior to inhaler use to decrease the chance of adverse events.

A

C. Inhale quickly and deeply to optimize drug delivery to the lungs

36
Q

Which of the following statements regarding methadone is correct?
A. Methadone is an excellent choice for analgesia in most patients since there are limited drug–drug interactions.
B. The equianalgesic potency of methadone is similar to that of morphine.
C. The duration of analgesia for methadone is much shorter than the elimination half-life.
D. The active metabolites of methadone accumulate in patients with renal dysfunction.

A

C. The duration of analgesia for methadone is much shorter than the elimination half-life.

37
Q

A 42-year-old male HIV patient was recently diagnosed with active tuberculosis. Currently, he is on a stable HIV regimen consisting of two protease inhibitors and two nucleoside reverse transcriptase inhibitors (NRTIs). What is the most appropriate regimen to use for treatment of his tuberculosis?
A. Rifampin + isoniazid + pyrazinamide + ethambutol.
B. Rifabutin + isoniazid + pyrazinamide + ethambutol.
C. Rifapentine + isoniazid + pyrazinamide +
ethambutol.
D. Rifampin + moxifloxacin + pyrazinamide +
ethambutol.
E. Amikacin + moxifloxacin + cycloserine +
streptomycin.

A

B. Rifabutin + isoniazid + pyrazinamide + ethambutol.

38
Q

A 45-year-old woman complains of persistent heartburn and an unpleasant, acid-like taste in her mouth. The clinician suspects that she has gastroesophageal reflux disease and advises her to raise the head of her bed 6 to 8 inches, not to eat for several hours before retiring, and to eat smaller meals. Two weeks later, she returns and says the symptoms have subsided slightly but still are a concern. The clinician will likely prescribe which one of the following drugs?
A. An antacid such as aluminum hydroxide.
B. Dicyclomine.
C. An antianxiety agent such as alprazolam.
D. Esomeprazole.

A

D. Esomeprazole.

39
Q 
A 64-year-old male is preparing for a total knee replacement. He is taking many medications that are metabolized by the CYP450 enzyme system and is worried about drug interactions with the pain medication that will be used following his surgery. Which of the following opioids would have the lowest chance of interacting with his medications that are metabolized by the CYP450 enzyme system?
A. Methadone.
B. Oxymorphone. 
C. Oxycodone.
D. Hydrocodone.
A

B. Oxymorphone.

40
Q

Which of the following statements about histamine receptor antagonists is MOST ACCURATE?
A. Most antihistamines have no antimuscarinic effects.
B. α-Adrenergic effects of antihistamines may cause
hypertension.
C. First-generation antihistamines have no sedative
side effects.
D. Because of their cholinergic properties,
antihistamines may not be effective in the relief of
vertigo associated with motion sickness.
E. Headache may be associated with some second-generation antihistamines.

A

E. Headache may be associated with some second-generation antihistamines.

41
Q 
A 43-year-old heavy machine operator complains of seasonal allergies. Which one of the following medi- cations would be most appropriate for management of his allergy symptoms?
A. Cyclizine.
B. Doxylamine. 
C. Hydroxyzine. 
D. Fexofenadine.
A

D. Fexofenadine.

42
Q 
AN is a 57-year-old male who has been treated with oxycodone for chronic nonmalignant pain for over 2 years. He is now reporting increased pain in the afternoon while at work. Which of the following opioids is a short-acting opioid and is the best choice for this patient’s breakthrough pain?
A. Methadone. 
B. Pentazocine. 
C. Hydrocodone. 
D. Nalbuphine.
A

C. Hydrocodone.

43
Q 
A patient is receiving treatment with lorazepam prior to chemotherapy to help reduce her anticipatory nausea and vomiting. Which of the following should generally be avoided in this patient?
A. Docusate.
B. Ondansetron.
C. Polyethylene glycol. 
D. Ethanol.
A

D. Ethanol.

44
Q 
An elderly woman with a recent history of myocardial infarction is seeking a medication to help treat her occasional heartburn. She is currently taking several medications, including aspirin, clopidogrel, simvastatin, metoprolol, and lisinopril. Which of the following choices should be avoided in this patient?
A. Calcium citrate. 
B. Famotidine.
C. Omeprazole.
D. Ranitidine.
E. Calcium carbonate.
A

C. Omeprazole.

45
Q

NSAID Induced ulcer

A

Misoprostol

46
Q 
Due to its anti-inflammatory mechanism of action, which of the following medications requires regular administration for the treatment of asthma?
A. Tiotropium MDI. 
B. Salmeterol DPI. 
C. Mometasone DPI. 
D. Albuterol MDI.
A

C. Mometasone DPI.

47
Q 
Which of the following categories of allergic rhinitis medications is most likely to be associated with rhinitis medicamentosa (rebound nasal congestion) with prolonged use?
A. Intranasal corticosteroid. 
B. Intranasal decongestant. 
C. Leukotriene antagonist. 
D. Oral antihistamine.
A

B. Intranasal decongestant.

48
Q 
A 68-year-old male has COPD with moderate airway obstruction. Despite using salmeterol twice daily as prescribed, he reports continued symptoms of shortness of breath with mild exertion. Which one of the following agents would be an appropriate addition to his current therapy?
A. Systemic corticosteroids. 
B. Albuterol.
C. Tiotropium.
D. Roflumilast.
E. Theophylline
A

C. Tiotropium.

49
Q 
A couple celebrating their 40th wedding anniversary are given a trip to Peru to visit Machu Picchu. Due to past experiences while traveling, they ask their doctor to prescribe an agent for diarrhea. Which of the following would be effective?
A. Omeprazole. 
B. Loperamide. 
C. Famotidine. 
D. Lorazepam.
A

B. Loperamide

50
Q 
Which of the following opioids is the LEAST lipophilic?
A. Fentanyl.
B. Methadone. 
C. Meperidine. 
D. Morphine.
A

D. Morphine.

51
Q 
A 76-year-old female with renal insufficiency pres- ents to the clinic with severe pain secondary to a compression fracture in the lumbar spine. She reports that the pain has been uncontrolled with tramadol, and it is decided to start treatment with an opioid. Which of the following is the best opioid for this patient?
A. Meperidine.
B. Fentanyl transdermal patch. 
C. Hydrocodone.
D. Morphine.
A

C. Hydrocodone.

52
Q 
Which of the following drugs for headache is contra- indicated in patients with peripheral vascular disease?
A. Ergotamine.
B. Aspirin.
C. Acetaminophen. 
D. Naproxen
E. Ibuprofen.
A

A. Ergotamine.

53
Q 
Which of the following medications has the most potential to significantly impair the ability to drive an automobile?
A. Diphenhydramine. 
B. Levocetirizine.
C. Fexofenadine.
D. Ranitidine.
A

A. Diphenhydramine.

54
Q 
Extrapyramidal symptoms (EPS) have been associ- ated with which of the following drugs?
A. Metoclopramide. 
B. Alprazolam.
C. Aprepitant.
D. Loperamide.
A

A. Metoclopramide.

55
Q 
A passenger sitting next to you in a plane boasts that he was a famous biochemist. He said he carboxylated a sedating antihistamine, and it is now only partially sedating and is a very well-known drug in the market. Which drug is he talking about?
A. Hydroxyzine.
B. Cetirizine.
C. Diphenhydramine. 
D. Doxylamine.
E. Cyproheptadine.
A

B. Cetirizine.

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