Midterms Pcol Flashcards

1
Q
An elderly patient with a history of heart disease is brought to the emergency room with difficulty breathing. Examination reveals that she has pulmonary edema. Which treatment is indicated?
A. Acetazolamide.
B. Chlorthalidone.
C. Furosemide.
D. Hydrochlorothiazide. 
E. Spironolactone.
A

C. Furosemide.

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2
Q

A group of college students is planning a mountain climbing trip to the Andes. Which would be appropriate for them to take to prevent mountain sickness?
A. A thiazide diuretic such as hydrochlorothiazide.
B. An anticholinergic such as atropine.
C. A carbonic anhydrase inhibitor such as
acetazolamide.
D. A loop diuretic such as furosemide.
E. A β-blocker such as metoprolol.

A

C. A carbonic anhydrase inhibitor such as

acetazolamide.

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3
Q
An alcoholic male has developed hepatic cirrhosis. To control the ascites and edema, which should be prescribed?
A. Acetazolamide.
B. Chlorthalidone.
C. Furosemide.
D. Hydrochlorothiazide. 
E. Spironolactone.
A

E. Spironolactone.

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4
Q
A 55-year-old male with kidney stones has been placed on a diuretic to decrease calcium excretion. However, after a few weeks, he develops an attack of gout. Which diuretic was he taking?
A. Furosemide.
B. Hydrochlorothiazide. 
C. Spironolactone.
D. Triamterene.
E. Urea.
A

B. Hydrochlorothiazide.

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5
Q
A 75-year-old woman with hypertension is being treated with a thiazide. Her blood pressure responds well and reads at 120/76 mm Hg. After several months on the medication, she complains of being tired and weak. An analysis of the blood indicates low values for which of the following?
A. Calcium. 
B. Glucose. 
C. Potassium. 
D. Sodium.
E. Uric acid.
A

C. Potassium.

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6
Q
What is the contraindicated in a patient with hyperkalemia?
A. Acetazolamide. 
B. Chlorthalidone. 
C. Chlorothiazide. 
D. Ethacrynic acid. 
E. Spironolactone.
A

E. Spironolactone.

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7
Q
Which of the following should be avoided in a patient with a history of severe anaphylactic reaction to sulfa medications?
A. Amiloride.
B. Hydrochlorothiazide. 
C. Mannitol.
D. Spironolactone.
E. Triamterene.
A

B. Hydrochlorothiazide.

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8
Q
A male patient is placed on a new medication and notes that his breasts have become enlarged and tender to the touch. Which medication is he most likely taking?
A. Chlorthalidone.
B. Furosemide.
C. Hydrochlorothiazide. 
D. Spironolactone.
E. Triamterene.
A

D. Spironolactone.

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9
Q
A patient presents to the emergency department with an extreme headache. After a thorough workup, the attending physician concludes that the pain is due to increased intracranial pressure. Which diuretic would work best to reduce this pressure?
A. Acetazolamide.
B. Indapamide.
C. Furosemide.
D. Hydrochlorothiazide. 
E. Mannitol.
A

E. Mannitol.

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10
Q
Which diuretic has been shown to improve blood pressure in resistant hypertension or those already treated with three blood pressure medications including a thiazide or thiazide-like diuretic?
A. Chlorthalidone. 
B. Indapamide.
C. Furosemide.
D. Mannitol.
E. Spironolactone.
A

E. Spironolactone.

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11
Q

Which of the following statements is correct regarding insulin glargine?
A. It is primarily used to control postprandial hyperglycemia.
B. It is a “peakless” insulin.
C. The prolonged duration of activity is due to slow
dissociation from albumin.
D. It should not be used in a regimen with insulin lispro
or glulisine.
E. It may be administered intravenously in emergency
cases.

A

B. It is a “peakless” insulin.

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12
Q
DW is a patient with type 2 diabetes who has a blood glucose of 400 mg/dL today at his office visit. The physician would like to give some insulin to bring the glucose down before he leaves the office. Which of the following would lower the glucose in the quickest manner in DW?
A. Insulin aspart. 
B. Insulin glargine. 
C. NPH insulin.
D. Regular insulin.
A

A. Insulin aspart.

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13
Q

Which of the following classes of oral diabetes drugs is paired most appropriately with its primary mechanism of action?
A. DPP-4 inhibitor—inhibits breakdown of complex carbohydrates.
B. Glinide—increases insulin sensitivity.
C. Sulfonylurea—increases insulin secretion.
D. Thiazolidinedione—decreases hepatic
gluconeogenesis.

A

C. Sulfonylurea—increases insulin secretion.

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14
Q

Which of the following statements is characteristic of metformin?
A. Metformin is inappropriate for initial management of type 2 diabetes.
B. Metformin decreases hepatic glucose production.
C. Metformin undergoes significant metabolism via the
cytochrome P450 system.
D. Metformin should not be combined with
sulfonylureas or insulin.
E. Weight gain is a common adverse effect.

A

B. Metformin decreases hepatic glucose production.

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15
Q
Which of the following is the most appropriate initial oral agent for management of type 2 diabetes in patients with no other comorbid conditions?
A. Glipizide.
B. Insulin.
C. Metformin. 
D. Pioglitazone.
A

C. Metformin.

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16
Q
A 64-year-old woman with a history of type 2 diabetes is diagnosed with heart failure. Which of the following medications would be a poor choice for controlling her diabetes?
A. Exenatide. 
B. Glyburide. 
C. Nateglinide. 
D. Pioglitazone. 
E. Sitagliptin.
A

D. Pioglitazone.

17
Q
KD is a 69-year-old male with type 2 diabetes and advanced chronic kidney disease. Which of the following diabetes medications is contraindicated in this patient?
A. Glipizide.
B. Insulin lispro. 
C. Metformin. 
D. Saxagliptin.
A

C. Metformin.

18
Q
Which of the following drugs for diabetes would be LEAST likely to cause weight gain?
A. Glimepiride.
B. Liraglutide.
C. Pioglitazone.
D. Repaglinide.
E. Insulin glulisine.
A

B. Liraglutide.

19
Q
A patient with type 2 diabetes is taking metformin. The fasting glucose levels are in range, but the postprandial glucose is uncontrolled. All of the following drugs would be appropriate to add to metformin to target postprandial glucose except:
A. Acarbose.
B. Exenatide.
C. Insulin aspart. 
D. Pramlintide.
A

D. Pramlintide.

20
Q
Which of the following diabetes medications is most appropriately paired with an adverse effect associated with its use?
A. Canagliflozin—lactic acidosis.
B. Metformin—urinary tract infections. 
C. Nateglinide—heart failure.
D. Liraglutide—pancreatitis.
A

D. Liraglutide—pancreatitis.

21
Q
Which of the following zones of the adrenal gland is correctly paired with the type of substance it secretes?
A. Adrenal medulla—corticotropin. 
B. Zona fasciculata—cortisol.
C. Zona glomerulosa—androgens. 
D. Zona reticularis—catecholamines.
A

B. Zona fasciculata—cortisol.

22
Q
Corticosteroids are useful in the treatment of all of the following disorders except:
A. Addison disease.
B. Allergic rhinitis.
C. Cushing syndrome.
D. Inflammatory bowel disease. 
E. Rheumatoid arthritis.
A

C. Cushing syndrome.

23
Q

All of the following adverse effects commonly occur with glucocorticoid therapy except:
A. Glaucoma.
B. Increased risk of infection.
C. Hypotension.
D. Emotional disturbances. E. Peripheral edema.

A

C. Hypotension.

24
Q

Osteoporosis is a major adverse effect caused by the glucocorticoids. It is due to their ability to:
A. Increase the excretion of calcium.
B. Inhibit absorption of calcium.
C. Stimulate the hypothalamic–pituitary–adrenal axis.
D. Decrease production of prostaglandins.
E. Decrease collagen synthesis.

A

B. Inhibit absorption of calcium.

25
Q
A child with severe asthma is being treated with high doses of inhaled corticosteroids. Which of the following adverse effects is of particular concern?
A. Hypoglycemia.
B. Hirsutism.
C. Growth suppression. 
D. Cushing syndrome. 
E. Cataract formation.
A

C. Growth suppression.

26
Q

The diagnosis of congenital adrenal hyperplasia (CAH) is confirmed in a child. This condition can be effectively treated by:
A. Administering a glucocorticoid.
B. Administering an androgen antagonist.
C. Administering ketoconazole to decrease cortisol
synthesis.
D. Removing the adrenal gland surgically.
E. Administering adrenocorticotropic hormone.

A

A. Administering a glucocorticoid.

27
Q
A patient with Addison disease is being treated with hydrocortisone but is still having problems with dehydration and hyponatremia. Which of the following drugs would be best to add to the patient’s therapy?
A. Dexamethasone. 
B. Fludrocortisone. 
C. Prednisone.
D. Triamcinolone.
A

B. Fludrocortisone.

28
Q

All of the following are strategies to minimize the development of HPA axis suppression with corticosteroid therapy except:
A. Alternate-day administration of therapy.
B. Administration via topical or inhalation routes when
possible.
C. Using the lowest dose of corticosteroid that
adequately controls symptoms.
D. Administration of two-thirds of the daily dose in the
morning and one-third in the afternoon.

A

D. Administration of two-thirds of the daily dose in the

morning and one-third in the afternoon.

29
Q

Which of the following patients would most likely have suppression of the HPA axis and require a slow taper of corticosteroid therapy?
A. A patient taking 40 mg of prednisone daily for 7 days to treat an asthma exacerbation.
B. A patient taking 10 mg of prednisone daily for 3 months for rheumatoid arthritis.
C. A patient using mometasone nasal spray daily for 6 months for allergic rhinitis.
D. A patient receiving an intra-articular injection of methylprednisolone for osteoarthritis.

A

B. A patient taking 10 mg of prednisone daily for 3 months for rheumatoid arthritis.

30
Q
Which of the following corticosteroids is most appropriate to administer to a woman in preterm labor to accelerate fetal lung maturation?
A. Betamethasone. 
B. Fludrocortisone. 
C. Hydrocortisone. 
D. Prednisone.
A

A. Betamethasone.

31
Q

A 53-year-old woman has severe vasomotor symptoms (hot flushes) associated with menopause. She has no pertinent past medical or surgical history. Which of the following would be most appropriate for her symptoms?
A. Conjugated estrogens vaginal cream.
B. Estradiol transdermal patch.
C. Oral estradiol and medroxyprogesterone acetate. D. Injectable medroxyprogesterone acetate

A

C. Oral estradiol and medroxyprogesterone acetate.

32
Q
A 70-year-old woman is being treated with raloxifene for osteoporosis. Which of the following is a concern with this therapy?
A. Breast cancer.
B. Endometrial cancer. 
C. Venous thrombosis. 
D. Hypercholesterolemia.
A

C. Venous thrombosis.

33
Q

Which of the following is the most appropriate oral contraceptive for a patient with moderate acne?
A. Ethinyl estradiol/levonorgestrel.
B. Ethinyl estradiol/norethindrone acetate.
C. Ethinyl estradiol/norgestimate.
D. Ulipristal.

A

C. Ethinyl estradiol/norgestimate.

34
Q
A 26-year-old female is using injectable medroxy- progesterone acetate as a method of contraception. Which of the following adverse effects is a concern if she wishes to use this therapy long-term?
A. Hyperkalemia.
B. Male pattern baldness. 
C. Osteoporosis.
D. Weight loss.
A

C. Osteoporosis.

35
Q
All the following drugs maybe beneficial in the patients with arcomegaly except:
A. Lanreotide
B. Octreotide
C. Pegvisomant
D. Somatropin
A

D. Somatropin

36
Q
A 40 year old female is undergoing infertility treatments. Which of the ff. drugs might be included in her treatment regimen?
A. Cabergoline
B. Follitropin
C. Methimazole
D. Vasopressin
A

B. Follitropin

37
Q
Which of the ff. is the treatment of choice for hypothyroidism?
A. Iodine
B. Levothyroxine
C. Liothyronine
D. Liotrix
E. Propylthiouracil
A

B. Levothyroxine