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Clinical Pharmacy > Midterms Case 3-5 > Flashcards

Midterms Case 3-5 Flashcards

1
Q

typically extend deeper into the muscularis mucosa.

gastritis
erosions
peptic ulcer

A

peptic ulcer disease (PUD)

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2
Q

The most important factors that influence ulcer recurrence are:

A

H. pylori infection & NSAID use.

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3
Q

Which of the following medications is the first-line treatment for peptic ulcer disease?

a. Antibiotics (clarithromycin, amoxicillin, metronidazole)
b. Proton pump inhibitors (omeprazole, lansoprazole, esomeprazole)
c. H2 blockers (ranitidine, famotidine, cimetidine)
d. Antacids (magnesium hydroxide, aluminum hydroxide, calcium carbonate)

A

Answer: b.

Proton pump inhibitors are the first-line treatment for peptic ulcer disease, as they help reduce stomach acid production and promote healing of the ulcer. Antibiotics may also be prescribed if the underlying cause of the ulcer is determined to be an infection with H. pylori. H2 blockers and antacids may be used to manage symptoms, but are not typically used as first-line treatments for PUD.

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4
Q

What is the gold standard diagnostic test for diagnosing peptic ulcer disease caused by Helicobacter pylori infection?

stool antigen testing
Urea breath test (UBT)
serologic antibody tests
Histology (endoscopy with biopsy)

A

Histology (endoscopy with biopsy)

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5
Q

This type of PUD is associated w/ weight gain

Duodenal ulcers
Gastric ulcers

A

Duodenal ulcers

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6
Q

This type of PUD is associated w/ weight loss

Duodenal ulcers
Gastric ulcers

A

Gastric ulcers

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7
Q

A condition in which the stomach produces too much acid?

A

Zollinger-Ellison disease (ZES)

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8
Q

Among this PPI-based combination who is less effective?

amoxicillin + metronidazole
clarithromycin + amoxicillin
clarithromycin + metronidazole

A

amoxicillin + metronidazole

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9
Q

Omeprazole and esomeprazole selectively inhibit hepatic cytochrome P450 (CYP450) isoenzyme 2C19 and decrease the elimination of phenytoin, and diazepam

T/F

A

T

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10
Q

a synthetic prostaglandin E1 analog, moderately inhibits acid secretion and enhances mucosal defense?

A

Misoprostol

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11
Q

They are the mainstay of today’s treatment strategies for PUD?

A

H. pylori eradication & antisecretory drugs

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12
Q

a condition in which there is an overproduction of the thyroid gland?

A

Thyrotoxicosis

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13
Q

Which among these reduce the synthesis of thyroid hormones and are similar in efficacy and adverse effects, but their dosing ranges differ by 10-fold.

Radioactive Iodine and Lugol’s iodine
PTU and MMI
Propranolol and Prednisone

A

PTU and MMI

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14
Q

What is the most common cause of primary hypothyroidism?

A. Autoimmune thyroiditis
B. Pituitary gland dysfunction
C. Iodine deficiency
D. Medication side effects

A

A. Autoimmune thyroiditis is the most common cause of primary hypothyroidism.

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15
Q

Which thyroid hormone is most commonly used to treat hypothyroidism?
A. Triiodothyronine (T3)
B. Thyroxine (T4)
C. Thyroid-stimulating hormone (TSH)
D. Calcitonin

A

B. Thyroxine (T4) is the most commonly used thyroid hormone replacement therapy for hypothyroidism.

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16
Q

Which of the following is a symptom of hypothyroidism?

A. Weight loss
B. Heat intolerance
C. Palpitations
D. Fatigue

A

D. Fatigue is a common symptom of hypothyroidism.

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17
Q

What is the recommended treatment for hypothyroidism during pregnancy?

A. Increase the dosage of levothyroxine
B. Decrease the dosage of levothyroxine
C. Monitor thyroid hormone levels and adjust medication as necessary
D. No treatment is necessary, as hypothyroidism does not affect pregnancy

A

A. Increasing the dosage of levothyroxine is the recommended treatment for hypothyroidism during pregnancy.

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18
Q

Which of the following tests is used to diagnose hypothyroidism?

A. Complete blood count (CBC)
B. Electrocardiogram (ECG)
C. Thyroid function tests (TFTs)
D. Urine analysis

A

C. Thyroid function tests (TFTs), including TSH and T4 tests, are used to diagnose hypothyroidism.

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19
Q

What is the most common age group affected by hypothyroidism?

A. Children and teenagers
B. Young adults
C. Middle-aged adults
D. Elderly adults

A

C. Middle-aged adults are the most commonly affected age group for hypothyroidism.

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20
Q

Which of the following is a potential complication of untreated hypothyroidism?

A. Hyperthyroidism
B. Osteoporosis
C. Hypertension
D. Hyperglycemia

A

B. Osteoporosis is a potential complication of untreated hypothyroidism.

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21
Q

Which of the following conditions is commonly associated with autoimmune thyroiditis?

A. Type 1 diabetes
B. Rheumatoid arthritis
C. Systemic lupus erythematosus
D. All of the above

A

D. Autoimmune thyroiditis is commonly associated with type 1 diabetes, rheumatoid arthritis, and systemic lupus erythematosus.

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22
Q

Which of the following medications can interfere with thyroid hormone production and lead to hypothyroidism?

A. Amiodarone
B. Furosemide
C. Metoprolol
D. Aspirin

A

A. Amiodarone is a medication that can interfere with thyroid hormone production and lead to hypothyroidism.

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23
Q

What is the target range for TSH levels in patients receiving levothyroxine treatment for hypothyroidism?

A. 0.1-1.0 mIU/L
B. 0.3-3.0 mIU/L
C. 1.0-2.0 mIU/L
D. 2.0-4.0 mIU/L

A

B. The target range for TSH levels in patients receiving levothyroxine treatment for hypothyroidism is typically 0.3-3.0 mIU/L.

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24
Q

What is the most common cause of hyperthyroidism?

A. Graves’ disease
B. Toxic multinodular goiter
C. Thyroiditis
D. Pituitary gland dysfunction

A

Answer: A. Graves’ disease is the most common cause of hyperthyroidism, accounting for about 80% of cases.

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25
Q

What is the primary thyroid hormone responsible for the symptoms of hyperthyroidism?

A. Triiodothyronine (T3)
B. Thyroxine (T4)
C. Thyroid-stimulating hormone (TSH)
D. Calcitonin

A

Answer: A. Triiodothyronine (T3) is the primary thyroid hormone responsible for the symptoms of hyperthyroidism.

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26
Q

Which of the following is a symptom of hyperthyroidism?

A. Weight gain
B. Fatigue
C. Cold intolerance
D. Heat intolerance

A

Answer: D. Heat intolerance is a common symptom of hyperthyroidism.

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27
Q

What is the treatment of choice for hyperthyroidism caused by Graves’ disease?

A. Radioactive iodine therapy
B. Antithyroid medication
C. Thyroidectomy
D. Beta-blockers

A

Answer: A. Radioactive iodine therapy is the treatment of choice for hyperthyroidism caused by Graves’ disease.

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28
Q

Which of the following laboratory tests is used to diagnose hyperthyroidism?

A. Thyroid-stimulating hormone (TSH)
B. Triiodothyronine (T3)
C. Thyroxine (T4)
D. All of the above

A

Answer: D. All of the above laboratory tests can be used to diagnose hyperthyroidism.

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29
Q

What is the target range for TSH levels in patients with hyperthyroidism?

A. Less than 0.1 mIU/L
B. 0.1-0.4 mIU/L
C. 0.4-4.0 mIU/L
D. Greater than 4.0 mIU/L

A

Answer: A. In patients with hyperthyroidism, TSH levels are typically suppressed and kept below 0.1 mIU/L.

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30
Q

Which of the following is a potential complication of untreated hyperthyroidism?

A. Hypothyroidism
B. Osteoporosis
C. Hypertension
D. Hypoglycemia

A

Answer: B. Osteoporosis is a potential complication of untreated hyperthyroidism.

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31
Q

What is the role of beta-blockers in the treatment of hyperthyroidism?

A. To reduce thyroid hormone production
B. To treat the underlying cause of hyperthyroidism
C. To relieve symptoms such as palpitations and tremors
D. To prevent complications such as osteoporosis

A

Answer: C. Beta-blockers are used in the treatment of hyperthyroidism to relieve symptoms such as palpitations and tremors.

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32
Q

What is the most common age group affected by hyperthyroidism?

A. Children and teenagers
B. Young adults
C. Middle-aged adults
D. Elderly adults

A

Answer: B. Hyperthyroidism is most commonly diagnosed in young adults.

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33
Q

Which of the following conditions is commonly associated with hyperthyroidism?

A. Type 1 diabetes
B. Rheumatoid arthritis
C. Systemic lupus erythematosus
D. None of the above

A

Answer: D. None of the above conditions are commonly associated with hyperthyroidism.

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34
Q

first line treatment for hyperthyroidism?

A. Radioactive iodine therapy
B. Antithyroid medication
C. Thyroidectomy
D. Beta-blockers

A

Answer: B. Antithyroid medication, such as methimazole or propylthiouracil, is typically the first line treatment for hyperthyroidism, unless there is an urgent need to lower thyroid hormone levels, in which case beta-blockers may be used as a temporary measure.

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35
Q

what is the golden standard for diagnosing hyperthyroidism?

A. Thyroid-stimulating hormone (TSH) level
B. Triiodothyronine (T3) level
C. Thyroxine (T4) level
D. Radioactive iodine uptake (RAIU) test

A

Answer: A. The golden standard diagnosis for hyperthyroidism is a low serum thyroid-stimulating hormone (TSH) level in combination with elevated serum triiodothyronine (T3) and/or thyroxine (T4) levels.

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36
Q

Which of the following is a feature of Graves disease?

A. Hypothyroidism
B. Weight gain
C. Exophthalmos
D. Cold intolerance

A

Answer: C. Exophthalmos, or bulging eyes, is a characteristic feature of Graves disease, which is an autoimmune disorder that results in hyperthyroidism. Other features of Graves disease may include goiter, weight loss, heat intolerance, tremors, and palpitations. Hypothyroidism is not a feature of Graves disease, as it is a condition characterized by low levels of thyroid hormone, whereas Graves disease results in excess thyroid hormone production. Weight gain and cold intolerance are also not typical features of Graves disease, as hyperthyroidism generally leads to weight loss and heat intolerance.

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37
Q

Best treatment for toxic nodules and toxic multinodular goiter. It cures hyperthyroidism and it is the most cost effective.

A

Radioactive iodine (131I)

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38
Q

the most serious adverse effect of thiourea drug therapy and is characterized by fever, malaise, gingivitis, oropharyngeal infection, and a granulocyte count less than 250/mm

A

Agranulocytosis

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39
Q

It is the most common cause of spontaneous hypothyroidism in the adult?

A

Autoimmune thyroiditis (Hashimoto’s disease)

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40
Q

considered to be the drug of choice to treat hypothyroidism?

A

levothyroxine (L-thyroxine; T4)

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41
Q

Why LT4 is considered as the treatment of choice?

A

Chemically stable,
Relatively inexpensive
Free of antigenicity
Has uniform potency

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42
Q

medications that can cause hypothyroidism or interfere with thyroid function:

A

Lithium, Amiodarone, Interferon alpha, Tyrosine kinase inhibitors (sunitinib, sorafenib), Immune checkpoint inhibitors, and Anti-seizure medications (phenytoin, carbamazepine)

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43
Q

It is recommended to take ferrous sulfate and calcium carbonate together?

T/F

A

F.
Taking ferrous sulfate and calcium carbonate together can interfere with the absorption of both supplements, as they both compete for absorption in the gastrointestinal tract. Calcium can bind with ferrous sulfate, forming an insoluble complex that is poorly absorbed by the body.

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44
Q

a rare consequence of decompensated hypothyroidism. Clinical features include hypothermia, advanced stages of hypothyroid symptoms, and altered sensorium ranging from delirium to coma.

A

Myxedema coma

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45
Q

Which of the following is the most commonly prescribed medication for hypothyroidism?

A) Levothyroxine
B) Liothyronine
C) Propylthiouracil
D) Methimazole

A

Answer: A) Levothyroxine

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46
Q

Which of the following medications can interfere with the absorption of levothyroxine?

A) Calcium carbonate
B) Metformin
C) Propranolol
D) Hydrochlorothiazide

A

Answer: A) Calcium carbonate

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47
Q

Which of the following is a potential adverse effect of levothyroxine therapy?

A) Hypertension
B) Weight gain
C) Fatigue
D) Bradycardia

A

Answer: D) Bradycardia

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48
Q

Which of the following medications should be used with caution in patients with hypothyroidism due to the risk of inducing hyperthyroidism?

A) Lithium
B) Amiodarone
C) Propranolol
D) Levothyroxine

A

Answer: B) Amiodarone

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49
Q

In patients with severe hypothyroidism, which of the following should be monitored closely when initiating levothyroxine therapy?

A) Blood pressure
B) Serum electrolytes
C) Serum cholesterol levels
D) Heart rate

A

Answer: D) Heart rate

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50
Q

What is the most common cause of primary hypothyroidism?

A) Autoimmune thyroiditis
B) Pituitary dysfunction
C) Iodine deficiency
D) Medications

A

Answer: A) Autoimmune thyroiditis

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51
Q

Which of the following laboratory tests is most commonly used to diagnose hypothyroidism?

A) Thyroid-stimulating hormone (TSH)
B) Free thyroxine (FT4)
C) Total triiodothyronine (TT3)
D) Thyroid peroxidase antibody (TPOAb)

A

Answer: A) Thyroid-stimulating hormone (TSH)

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52
Q

Which of the following is a characteristic finding on physical examination in patients with severe hypothyroidism?

A) Tachycardia
B) Hyperreflexia
C) Goiter
D) Dry skin

A

Answer: C) Goiter

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53
Q

Which of the following imaging studies may be useful in the diagnosis of hypothyroidism?

A) Thyroid ultrasound
B) Magnetic resonance imaging (MRI)
C) Computed tomography (CT) scan
D) X-ray

A

Answer: A) Thyroid ultrasound

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54
Q

In patients with suspected hypothyroidism, which of the following should be evaluated to determine the cause of the disorder?

A) Serum electrolytes
B) Adrenal function
C) Antinuclear antibody (ANA) test
D) Thyroid peroxidase antibody (TPOAb) test

A

Answer: D) Thyroid peroxidase antibody (TPOAb) test

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55
Q

a pathologic condition characterized by excessive production of GH?

A

Acromegaly

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56
Q

even more rare than acromegaly, is the excess secretion of GH prior to epiphyseal closure in children.

A

Gigantism

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57
Q

commonly used as an important diagnostic tool of acromegaly?

A

Oral Glucose Tolerance Test (OGTT)

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58
Q

Which of the following is the first-line treatment for acromegaly?

a) Somatostatin analogs (e.g.Ocreotide (Sandostatin))
b) Dopamine agonists (bromocriptine, pergolide, cabergoline, lisuride, quinagolide)
c) GH receptor antagonists (e.g. Pegvisomant (Somavert))
d) GH secretagogues

Answer: a) Somatostatin analogs

A

Answer: a) Somatostatin analogs

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59
Q

Which of the following medications can be used as second-line treatment for acromegaly?

a) Bromocriptine
b) Pegvisomant
c) Lanreotide
d) Octreotide

A

Answer: b) Pegvisomant (GH receptor antagonist)

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60
Q

How do somatostatin analogs work in the treatment of acromegaly?

a) They inhibit GH secretion from the pituitary gland
b) They stimulate GH secretion from the pituitary gland
c) They block the GH receptor
d) They promote GH degradation

A

Answer: a) They inhibit GH secretion from the pituitary gland

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61
Q

Which of the following is a potential adverse effect of GH receptor antagonists?

a) Hypertension
b) Hypoglycemia
c) Nausea and vomiting
d) Injection site reactions

A

Answer: b) Hypoglycemia

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62
Q

Which of the following medications is a GH secretagogue?

a) Somatostatin analogs
b) Dopamine agonists
c) GH receptor antagonists
d) GHRH analogs

A

Answer: d) GHRH analogs

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63
Q

Which of the following is the most common cause of acromegaly?

a) Pituitary adenoma
b) Ectopic growth hormone-releasing hormone (GHRH) secretion
c) Adrenal gland tumor
d) Thyroid gland tumor

A

Answer: a) Pituitary adenoma

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64
Q

What is the gold standard diagnostic test for acromegaly?

a) Insulin-like growth factor-1 (IGF-1) level
b) Growth hormone (GH) suppression test
c) Magnetic resonance imaging (MRI) of the pituitary gland
d) Physical examination

A

Answer: c) Magnetic resonance imaging (MRI) of the pituitary gland

65
Q

Which of the following is a sign of acromegaly?

a) Hyperpigmentation
b) Hypoglycemia
c) Enlarged hands and feet
d) Tachycardia

A

Answer: c) Enlarged hands and feet

66
Q

What is the normal range for IGF-1 level in adults?

a) 50-100 ng/mL
b) 100-250 ng/mL
c) 250-500 ng/mL
d) 500-1000 ng/mL

A

Answer: b) 100-250 ng/mL

67
Q

How is acromegaly treated?

a) Surgery
b) Medications
c) Radiation therapy
d) All of the above

A

Answer: d) All of the above

68
Q

currently considered as the mainstay therapy for treatment of GHD short stature

A

Recombinant GH

69
Q

a state of persistent prolactin elevation (2o mcg/L).

A

Hyperprolactinemia

70
Q

Medications most frequently associated with hyperprolactinemia?

A

SSRIs (fluoxetine, paroxetine, sertraline, fluvoxamine)
D2 receptor antagonist (metoclopramide, domperidone)

71
Q

a dopamine-receptor agonist that is 10 -1,000x more potent than bromocriptine per mg

Bromocriptine
Cabergoline
Pergolide
Quinagolide

A

Pergolide

72
Q

long-acting dopamine agonist w/ high selectivity for dopamine D2-receptors.

Bromocriptine
Cabergoline
Pergolide
Quinagolide

A

Cabergoline

73
Q

The first D2-receptor agonist to b used in the treatment of hyperprolactinemia.

Bromocriptine
Cabergoline
Pergolide
Quinagolide

A

Bromocriptine

74
Q

D2-receptor agonist frequently used in Europe and is dosed once daily.

Bromocriptine
Cabergoline
Pergolide
Quinagolide

A

Quinagolide

75
Q

Which of the following drugs is used to treat hyperprolactinemia?

a) Bromocriptine
b) Digoxin
c) Warfarin
d) Metformin

A

Answer: a) Bromocriptine

76
Q

Which of the following is a common adverse effect of bromocriptine?

a) Hypertension
b) Hypotension
c) Diarrhea
d) Nausea and vomiting

A

Answer: d) Nausea and vomiting

77
Q

Which of the following is a long-acting dopamine agonist used to treat hyperprolactinemia?

a) Cabergoline
b) Levodopa
c) Carbidopa
d) Pramipexole

A

Answer: a) Cabergoline

78
Q

Which of the following is a pituitary hormone that is inhibited by dopamine?

a) Growth hormone
b) Prolactin
c) Adrenocorticotropic hormone
d) Thyroid-stimulating hormone

A

Answer: b) Prolactin

79
Q

Which of the following is a potential complication of untreated hyperprolactinemia in females?

a) Osteoporosis
b) Polycystic ovary syndrome
c) Hypothyroidism
d) Cushing’s syndrome

A

Answer: a) Osteoporosis

80
Q

complete or partial loss of anterior and posterior pituitary function resulting in a complex disorder characterized by multiple pituitary hormone deficiencies.

A

Panyhypopituitarism

81
Q

Which of the following is a risk factor for hyperprolactinemia?

a) Obesity
b) Smoking
c) Alcohol consumption
d) Physical inactivity

A

Answer: a) Obesity

82
Q

Hyperprolactinemia is caused by:

a) Increased dopamine levels
b) Increased prolactin levels
c) Decreased dopamine levels
d) Decreased prolactin levels

A

Answer: c) Decreased dopamine levels

83
Q

Which of the following is a nonpharmacological treatment option for hyperprolactinemia?

a) Surgery
b) Radiation therapy
c) Weight loss
d) Chemotherapy

A

Answer: c) Weight loss

84
Q

The diagnosis of hyperprolactinemia is typically made by measuring:

a) Blood glucose levels
b) Thyroid hormone levels
c) Prolactin levels
d) Cortisol levels

A

Answer: c) Prolactin levels

85
Q

Which of the following is a sign or symptom of hyperprolactinemia in females?

a) Erectile dysfunction
b) Infertility
c) Gynecomastia
d) Testicular atrophy

A

Answer: b) Infertility

86
Q

Which of the following is a known risk factor for type 2 diabetes mellitus?

a) Being underweight
b) Smoking
c) Low-fat diet
d) Physical activity

A

Answer: b) Smoking

87
Q

Which of the following is an essential component of the pathophysiology of type 1 diabetes mellitus?

a) Insulin resistance
b) Autoimmune destruction of pancreatic beta cells
c) Beta-cell hyperplasia
d) Overproduction of insulin

A

Answer: b) Autoimmune destruction of pancreatic beta cells

88
Q

Which of the following nonpharmacological treatments is recommended for individuals with diabetes mellitus?

a) Smoking cessation
b) Limiting carbohydrate intake
c) Regular physical activity
d) All of the above

A

Answer: d) All of the above

89
Q

Which of the following is a sign or symptom of diabetes mellitus?

a) Blurred vision
b) Chest pain
c) Shortness of breath
d) Joint pain

A

Answer: a) Blurred vision

90
Q

Which of the following tests is used to diagnose diabetes mellitus?

a) Fasting plasma glucose test
b) Hemoglobin A1C test
c) Oral glucose tolerance test
d) All of the above

A

Answer: d) All of the above

91
Q

Which of the following is a known risk factor for gestational diabetes mellitus?

a) Being underweight
b) Young maternal age
c) Previous pregnancy with a normal birthweight infant
d) Low-fat diet

A

Answer: b) Young maternal age

92
Q

Which of the following medications is commonly used to manage type 2 diabetes mellitus?

a) Metformin
b) Insulin
c) Aspirin
d) Antibiotics

A

Answer: a) Metformin

93
Q

Which of the following is a potential complication of uncontrolled diabetes mellitus?

a) Hypertension
b) Osteoporosis
c) Diarrhea
d) Diabetic retinopathy

A

Answer: d) Diabetic retinopathy

94
Q

Which of the following lifestyle changes can help prevent the development of type 2 diabetes mellitus?

a) Quitting smoking
b) Following a low-carbohydrate diet
c) Engaging in regular physical activity
d) All of the above

A

Answer: d) All of the above

95
Q

Which of the following symptoms is indicative of hypoglycemia in individuals with diabetes mellitus?

a) Nausea
b) Fatigue
c) Blurred vision
d) Sweating

A

Answer: d) Sweating

96
Q

Which of the following is a commonly used medication to manage type 1 diabetes mellitus?

a) Metformin
b) Insulin
c) Glipizide
d) Pioglitazone

A

Answer: b) Insulin

97
Q

Which of the following medications works by increasing insulin secretion from pancreatic beta cells?

a) Metformin
b) Insulin
c) Glipizide
d) Pioglitazone

A

Answer: c) Glipizide

98
Q

Which of the following medications works by inhibiting the breakdown of incretin hormones?

a) Metformin
b) Insulin
c) Sitagliptin
d) Pioglitazone

A

Answer: c) Sitagliptin

99
Q

Which of the following medications works by improving insulin sensitivity and reducing hepatic glucose production?

a) Metformin
b) Insulin
c) Glipizide
d) Pioglitazone

A

Answer: a) Metformin

100
Q

Which of the following medication classes is associated with an increased risk of hypoglycemia in individuals with diabetes mellitus?

a) ACE inhibitors
b) Beta-blockers
c) Calcium channel blockers
d) Sulfonylureas

A

Answer: d) Sulfonylureas

101
Q

Which of the following is a diagnostic criterion for diabetes mellitus according to the American Diabetes Association?

a) Fasting plasma glucose level ≥ 120 mg/dL
b) Random plasma glucose level ≥ 200 mg/dL
c) HbA1c level ≥ 6.5%
d) All of the above

A

Answer: d) All of the above

102
Q

Which of the following tests is used to screen for gestational diabetes mellitus?

a) Fasting plasma glucose test
b) HbA1c test
c) Oral glucose tolerance test
d) Random plasma glucose test

A

Answer: c) Oral glucose tolerance test

103
Q

Which of the following factors can affect the accuracy of HbA1c measurements?

a) Iron deficiency anemia
b) Chronic kidney disease
c) High altitude
d) All of the above

A

Answer: d) All of the above

104
Q

Which of the following tests is recommended for screening for type 2 diabetes mellitus in asymptomatic individuals?

a) Fasting plasma glucose test
b) HbA1c test
c) Oral glucose tolerance test
d) Random plasma glucose test

A

Answer: b) HbA1c test

105
Q

Which of the following tests is used to monitor blood glucose levels in individuals with diabetes mellitus?

a) Fasting plasma glucose test
b) HbA1c test
c) Oral glucose tolerance test
d) Random plasma glucose test

A

Answer: b) HbA1c test

106
Q

Diabetes Association medication algorithm?

a) Metformin
b) Sulfonylureas
c) DPP-4 inhibitors
d) GLP-1 receptor agonists

A

Answer: a) Metformin

107
Q

Which of the following medications should be added to metformin if the HbA1c target is not achieved?

a) Sulfonylureas
b) DPP-4 inhibitors
c) GLP-1 receptor agonists
d) All of the above

A

Answer: d) All of the above

108
Q

Which of the following medications should be avoided in patients with heart failure according to the American Diabetes Association medication algorithm?

a) Metformin
b) Sulfonylureas
c) DPP-4 inhibitors
d) SGLT-2 inhibitors

A

Answer: b) Sulfonylureas
SGLT-2 inhibitors may be preferred in these patients due to their cardiovascular benefits.

109
Q

Which of the following medications can cause weight loss in patients with diabetes mellitus?

a) Sulfonylureas
b) DPP-4 inhibitors
c) GLP-1 receptor agonists
d) None of the above

A

Answer: c) GLP-1 receptor agonists

110
Q

Which of the following medications can cause weight loss in patients with diabetes mellitus?

a) Sulfonylureas
b) DPP-4 inhibitors
c) GLP-1 receptor agonists
d) None of the above

A

Answer: c) GLP-1 receptor agonists

111
Q

Which of the following medications is contraindicated in patients with a history of pancreatitis or pancreatic cancer?

a) Metformin
b) Sulfonylureas
c) DPP-4 inhibitors
d) SGLT-2 inhibitors

A

Answer: d) SGLT-2 inhibitors

112
Q

a group of metabolic disorders of fat, carbohydrate, and protein metabolism that results from defects in insulin secretion, sensitivity, or both.

A

Diabetes mellitus

113
Q

3 criteria for diagnosis of diabetes:

A
  1. fasting plasma glucose ≥126 mg/dL,
  2. 2-hour value from a 75-g oral glucose tolerance test ≥200 mg/dL, or
  3. a casual plasma glucose level of ≥200 mg/dL
114
Q

acute complication in Type 1 DM?

A

Diabetic ketoacidosis

115
Q

acute complication in Type 2 DM?

A

Hyperosmolar hyperglycemic state

116
Q

Which of the following medications is commonly used to treat ACTH insufficiency?

A. Aspirin
B. Levothyroxine
C. Insulin
D. Hydrocortisone

A

Answer: D. Hydrocortisone

117
Q

Which of the following statements is true regarding hydrocortisone treatment for ACTH insufficiency?

A. Hydrocortisone is only available as an oral medication.
B. The dosage of hydrocortisone should be gradually increased over time.
C. Hydrocortisone can cause hyperglycemia and hypertension.
D. Hydrocortisone treatment is not effective in treating ACTH insufficiency.

A

Answer: B. The dosage of hydrocortisone should be gradually increased over time.

118
Q

Which of the following laboratory tests is used to diagnose ACTH insufficiency?

A. Thyroid function tests
B. Serum electrolytes
C. Cosyntropin stimulation test
D. Lipid panel

A

Answer: C. Cosyntropin stimulation test

119
Q

Which of the following is a risk factor for developing ACTH insufficiency?

A. Family history of type 2 diabetes
B. Long-term use of corticosteroids
C. Active smoking
D. Regular physical activity

A

Answer: B. Long-term use of corticosteroids

120
Q

What is the primary pathophysiological mechanism of ACTH insufficiency?

A. Impaired insulin secretion
B. Decreased production of cortisol and other adrenal hormones
C. Autoimmune destruction of pancreatic beta cells
D. Overproduction of growth hormone

A

Answer: B. Decreased production of cortisol and other adrenal hormones

121
Q

Which of the following is a common sign of ACTH insufficiency?

A. Hyperpigmentation of the skin
B. Hypertension
C. Weight gain
D. Tachycardia

A

Answer: A. Hyperpigmentation of the skin

122
Q

Which of the following is the first-line medication for the treatment of ACTH insufficiency?

A. Levothyroxine
B. Insulin
C. Metformin
D. Hydrocortisone

A

Answer: D. Hydrocortisone

123
Q

Which of the following is a non-pharmacological treatment option for managing ACTH insufficiency?

A. Regular exercise
B. Dietary modification
C. Transplantation of a healthy pituitary gland
D. Psychotherapy

A

Answer: B. Dietary modification

124
Q

the drug of choice in bilateral adrenal hyperplasia (BAH)-dependent hyperaldosteronism.

A

Spironolactone, a competitive inhibitor of aldosterone

125
Q

Which of the following drugs is the first-line treatment for acute gout attacks?

a. Allopurinol
b. Colchicine
c. Febuxostat
d. Probenecid

A

Answer: b. Colchicine

126
Q

Which of the following drugs is a xanthine oxidase inhibitor used to treat chronic gout?

a. Allopurinol
b. Colchicine
c. Febuxostat
d. Probenecid

A

Answer: a. Allopurinol

127
Q

Which of the following drugs is used to treat chronic gout by increasing the excretion of uric acid?

a. Allopurinol
b. Colchicine
c. Febuxostat
d. Probenecid

A

Answer: d. Probenecid

128
Q

Which of the following is the primary underlying cause of gout?

a. Decreased renal excretion of uric acid
b. Increased production of uric acid
c. Autoimmune dysfunction
d. Vascular damage

A

Answer: b. Increased production of uric acid

129
Q

What is the mechanism by which uric acid crystals cause inflammation in gout?

a. Activation of complement system
b. Stimulation of mast cells
c. Recruitment of neutrophils
d. Upregulation of cytokine production

A

Answer: c. Recruitment of neutrophils

130
Q

Which of the following medical conditions is commonly associated with the development of gout?

a. Hypothyroidism
b. Hyperthyroidism
c. Diabetes mellitus
d. Hypertension

A

Answer: d. Hypertension

131
Q

Which of the following is a known risk factor for the development of gout?

a. Vegetarian diet
b. Low alcohol consumption
c. Obesity
d. Regular exercise

A

Answer: c. Obesity

132
Q

Which of the following is a common symptom of acute gout?

a. Joint stiffness
b. Fever
c. Muscle weakness
d. Sudden onset of severe joint pain

A

Answer: d. Sudden onset of severe joint pain

133
Q

Which of the following is a potential complication of chronic gout?

a. Hypertension
b. Liver failure
c. Kidney stones
d. Pneumonia

A

Answer: c. Kidney stones

134
Q

Which of the following is the recommended serum urate level for patients with gout?

a. Less than 4 mg/dL
b. Less than 6 mg/dL
c. Less than 8 mg/dL
d. Less than 10 mg/dL

A

Answer: b. Less than 6 mg/dL

135
Q

Which of the following is gold standard for the diagnosis of gout?

a. X-ray of the affected joint
b. Ultrasound of the affected joint
c. Blood test for uric acid levels
d. Joint aspiration and analysis of synovial fluid

A

Answer: d. Joint aspiration and analysis of synovial fluid

136
Q

Which of the following medications is not recommended for the treatment of gout?

a. Allopurinol
b. Colchicine
c. Probenecid
d. Aspirin

A

Answer: d. Aspirin

137
Q

Which of the following medications is used for the long-term management of gout?

a. Colchicine
b. Indomethacin
c. Allopurinol
d. Prednisone

A

Answer: c. Allopurinol

138
Q

Which of the following medications can cause a serious hypersensitivity reaction in patients with gout?

a. Colchicine
b. Allopurinol
c. Probenecid
d. Prednisone

A

Answer: b. Allopurinol

139
Q

Which of the following medications can be used to treat both acute gout attacks and hyperuricemia in patients with gout?

a. Colchicine
b. Allopurinol
c. Probenecid
d. Febuxostat

A

Answer: d. Febuxostat

140
Q

Which of the following medications is contraindicated in patients with severe renal impairment?

a. Colchicine
b. Allopurinol
c. Probenecid
d. Prednisone

A

Answer: b. Allopurinol

141
Q

Which of the following is considered first-line therapy for osteoarthritis?

A. Acetaminophen
B. Non-steroidal anti-inflammatory drugs (NSAIDs)
C. Glucosamine and chondroitin
D. Intra-articular corticosteroid injections

A

Answer: A. Acetaminophen

142
Q

Which of the following is a potential side effect of long-term NSAID use for osteoarthritis?

A. Hypotension
B. Gastrointestinal bleeding
C. Hyperkalemia
D. Hepatotoxicity

A

Answer: B. Gastrointestinal bleeding

143
Q

Which of the following medications is not recommended for the treatment of osteoarthritis?

A. Celecoxib
B. Naproxen
C. Diclofenac
D. Codeine

A

Answer: D. Codeine

144
Q

Which of the following drugs is the most effective for the long-term management of osteoarthritis?

A. Acetaminophen
B. Naproxen
C. Celecoxib
D. Glucosamine

A

Answer: C. Celecoxib

145
Q

Which of the following is a potential side effect of long-term use of COX-2 inhibitors for osteoarthritis?

A. Renal impairment
B. Gastrointestinal bleeding
C. Hyperkalemia
D. Hepatotoxicity

A

Answer: A. Renal impairment

146
Q

Which of the following drugs is not recommended for the treatment of osteoarthritis in older adults?

A. Acetaminophen
B. NSAIDs
C. Tramadol
D. Opioids

A

Answer: D. Opioids

147
Q

Which of the following is a common risk factor for the development of osteoarthritis?

A. Obesity
B. Hypertension
C. Hyperthyroidism
D. Asthma

A

Answer: A. Obesity

148
Q

Which of the following is a common sign of osteoarthritis?

A. Joint swelling
B. Joint redness
C. Joint warmth
D. Joint stiffness

A

Answer: D. Joint stiffness

149
Q

Which of the following is a common symptom of osteoarthritis?

A. Fatigue
B. Headache
C. Fever
D. Joint pain

A

Answer: D. Joint pain

150
Q

Which of the following is a key pathophysiological feature of osteoarthritis?

A. Synovial inflammation
B. Synovial hypertrophy
C. Articular cartilage destruction
D. Pannus formation

A

Answer: C. Articular cartilage destruction

151
Q

Which of the following nonpharmacological treatments is recommended for patients with osteoarthritis?

A. Weight loss
B. High-impact exercise
C. Prolonged bed rest
D. Inactivity

A

Answer: A. Weight loss

152
Q

Which of the following nonpharmacological treatments has been shown to be effective in reducing joint pain and improving function in patients with osteoarthritis?

A. Acupuncture
B. Chiropractic manipulation
C. Physical therapy
D. Herbal supplements

A

Answer: C. Physical therapy

153
Q

What is the gold standard for the diagnosis of osteoarthritis?

A. MRI
B. X-ray
C. CT scan
D. Ultrasound

A

Answer: B. X-ray

154
Q

Which of the following drugs should be avoided in patients with osteoarthritis who are taking warfarin?

a. Acetaminophen
b. Celecoxib
c. Codeine
d. Naproxen

A

Answer: b. Celecoxib

155
Q

Which of the following drugs should be avoided in patients with osteoarthritis who are taking lithium?

a. Acetaminophen
b. Celecoxib
c. Ibuprofen
d. Tramadol

A

Answer: c. Ibuprofen

156
Q

Which of the following medications is a first-line treatment for osteoarthritis pain?

a. Methotrexate
b. Celecoxib
c. Acetaminophen
d. Prednisone

A

Answer: c. Acetaminophen

157
Q

Which of the following medications is a disease-modifying agent for osteoarthritis?

a. Celecoxib
b. Glucosamine
c. Codeine
d. Naproxen

A

Answer: b. Glucosamine
Rationale: Glucosamine is a disease-modifying agent that can slow the progression of osteoarthritis by promoting cartilage regeneration. Celecoxib, codeine, and naproxen are all used to manage osteoarthritis symptoms but are not disease-modifying agents.

158
Q

Which of the following medications can cause hepatotoxicity in patients with osteoarthritis?

a. Methotrexate
b. Celecoxib
c. Acetaminophen
d. Prednisone

A

Answer: a. Methotrexate

Clinical Pharmacy (10 decks)

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