Pathopharm 2 Final Exam Flashcards
T/F ?
A basic drug with a pka of 8.4 that is placed into physiologic pH (7.4) will have 10 more ionized than unionized molecules?
True
(7.4 = 8.4 + log [UP/P]) → 10-1 = log [UP/P] → 0.1/1 → 1/10 UP/P or 1:10 unionized:ionized
D-Penicillamine (Cuprimine) is used to treat what?
Wilson’s disease
Copper chelator
T/F
Long term use of continuous propofol infusion is associated with lactic acidosis?
True
T/F
Nitroprusside dose requirements are decreased with volatile anesthetics?
True
Which drug is least risk with asthmatic patient?
a. Nadolol
b. Labetalol
c. Propranolol
d. Metaproterenol
Metaproterenol
is a bronchodilator used in the treatment of asthma.
The rest are B-blockers
T/F
Glycopyrrolate is classified as an anticholinergic?
True
Volatile induction rate would be increased by all except ?
a. Decreased blood:gas PC
b. Increased lipid solubility (increased oil:water)
c. Increased RR/MV
d. Decreased partial pressure of volatile anesthetic
d. Decreased partial pressure of volatile anesthetic
Which of the following is not an ionophoric type channel ?
a. Muscarinic M2
b. Nicotinic ACh neuromuscular
c. 5-HT3
d. GABAa
Muscarinic M2
its a G-protein coupled receptor
T/F ?
Thromboxane production is not markedly inhibited by celebrex ?
True
T/F ?
Unlike Huntington’s, Parkinson’s disease is due to underactivity in the nigrostriatal adrenergic pathway.
True
At a constant volume, which law relates pressure and temperature?
Gay Lussac’s law
T/F ?
Phase 1 of cardiac conduction is a rapid influx of Na+?
False
it is phase 0
T/F ?
Perioperative pt, enteral feeding proven less likely to lead to infectious complications than parenteral feeding?
False
What is Theophylline MOA?
Phosphodiesterase inhibitor
T/F ?
Local anesthetics work on voltage-gated Sodium channels?
True
Which agent’s MOA is not primarily Sodium channel blocker: ?
a. Gabapentin
b. Topamax
c. Mexiletine
d. Lidocaine
e. Lamictal
Gabapentin (structural analog of GABA)
T/F?
An advantage of Neostigmine over Pyridostigmine is that it is a quaternary amine and does not cross BBB well ?
True
T/F ?
The consumption of dark leafy green vegetables is contraindicated in individuals on Coumadin anticoagulation therapy ?
True
Phenelzine (Nardil) is an ?
MAOI (depression treatment)
Which of the following is not considered a first class antihypertensive agent?
a. Clonidine
b. Hydralazine
c. Labetalol
d. Lisinopril
a. Clonidine
T/F?
If a patient takes Baclofen and stops it suddenly prior to surgery, they are at risk for cardiac instability?
True
Compound A production is associated with which of the following concerns?
a. Cardiotoxicity
b. Nephrotoxicity w/ sevo
b. Nephrotoxicity w/ sevo
Which of the following contains an ester group?
a. Prilocaine
b. Lidocaine
c. Benzocaine
d. None of these
c. Benzocaine
A complication that can occur from Ginkgo Biloba includes ?
Increased bleeding times (prolonged pT)
T/F?
Local anesthetics work at voltage-gated chloride channels?
False
sodium channels
T/F?
Legend drugs are drugs that do not require a prescription but may require a signature by the patient?
False
T/F ?
FFP is 25% of the extracted volume of a unit of whole blood?
False
Should be 55%
You are about to care for a patient who has received multiple doses of Doxorubicin in the last few weeks. What is your biggest concern?
a. Pulmonary function (bleomycin)
b. Cardiotoxicity
b. Cardiotoxicity
T/F?
For a patient undergoing a colostomy procedure, surgical prophylaxis with CeftriaxONE is appropriate as long as the patient does not have a preexisting allergy to the compound.
True
T/F?
Simvastatin (Zocor) inhibits the synthesis of cholesterol?
False
T/F?
Clopidogrel (Plavix) causes decreased platelet aggregation by lipoxygenase inhibition?
False
The metabolism of diethyl ether to ethanol and acetaldehyde is an example of what kind of reaction?
A. O-dealkylation
B. S-demethylation
C. N-oxidation
D. N-hydroxylation
O-dealkylation
Considering men and women, which of the following is true?
Women have lower pain tolerance (pain tolerance is increased during pregnancy)
High plasma protein binding is an example of ?
Displacement
The conversion of norepinephrine to epinephrine occurs via ?
Phenylethanolamine N-methyltransferase (PNMT)
The abbreviation “GTT” is latin for ?
Drops
Roflumilast (Daliresp) MOA:
Phosphodiesterase inhibition
Which of the following is metabolized to free fluoride the most?
A. Desflurane
B. Sevoflurane
C. Halothane
D. Isoflurane
B. Sevoflurane
7
Candesartan (Atacand) works on which of the following receptors?
A. Angiotensin-II
B. Beta-1
C. Alpha
D. Beta-2
Angiotensin-II
Gemfibrozil mechanism of action?
Fibrate, stimulation of lipoprotein lipases to break down triglycerides
Which class of chemotherapy drugs causes irreversible cardiomyopathy?
a. Anthracyclines
b. Purine analogues
c. Pyrimidine analogues
d. Topoisomerase inhibitors
a. Anthracyclines
T/F ?
Bleomycin causes SIADH?
False
Which chemotherapeutic drug causes electrolyte abnormalities?
A. Cisplatin
B. Doxurobicin
C. Bleomycin
D. 5-Fluorouracil
Cisplatin
Paclitaxel affects all systems except: ?
a. Hepatic
b. Cardiac
c. Pulmonary
d. Central nervous system
a. Hepatic
Patient comes in with oxygen of 85% on Flutamide, how do you treat ?
a. Methylene blue
b. Supplemental oxygen
c. Stat chest xray
d. Albuterol
a. Methylene blue
Which class of drug causes disruption of normal growth factor receptor interactions and leads to cell proliferation ?
a. Signal transduction modifiers
b. Tubulin-binding drugs
c. Antimetabolites
d. Alkylating agents
a. Signal transduction modifiers
Which medication causes gynecomastia and hot flashes ?
a. Anti-androgens
b. Monoclonal antibodies
c. Taxanes
9. Which drug readily crosses the placenta
a. Anti-androgens
Which drug readily crosses the placenta?
a. Nitroglycerin
b. Heparin
c. Succinylcholine
d. Phenylephrine
a. Nitroglycerin
(HIGNS) accronym for not cross
Which factors make a medication NOT readily cross the placenta? (Select 2)
a. Hydrophilic
b. Ionized drug form
c. Uncharged
d. Increased free drug concentration
a. Hydrophilic
b. Ionized drug form
Maternal uterine blood flow is what percent of cardiac output at term?
a. 10-12%
b. 15-20%
c. 45-50%
a. 10-12%
T/F ?
In utero, fetal metabolism is significantly affected by first pass metabolism ?
True
Which vitamin if given in excess can increase ICP and mimic a pseudocerebri tumor?
a. Vitamin A
b. Vitamin D
c. Vitamin E
d. Vitamin C
a. Vitamin A
What is a concern of valerian root ?
a. Increased anesthetic duration
b. Increased bleeding
c. Increased absorption of sodium and water
d. Decreased blood glucose
a. Increased anesthetic duration
Which medications prolong bleeding select 2?
a. Ginseng
b. Feverfew
c. Valerian root
d. St johns wort
Ginseng
Feverfew
Which vitamins are water soluble (Select 2)
a. Vitamin C
b. Vitamin B
c. Vitamin D
d. Vitamin K
a. Vitamin C
b. Vitamin B
T/F - Chronic GI issues and alcoholism are implicated with pellagra?
True
T/F - Volatile anesthetics and opioids according to recent research should be avoided in patients to avoid postoperative immunosuppression and potential for cancer metastasis?
True
Most anesthetic drugs cross the placenta via ?
a. Diffusion
b. Active transport
c. Pinocytosis
d. Osmosis
a. Diffusion
T/F: Dilantin (Phenytoin) affects folic acid absorption ?
True
Which term is used to describe a cell showing a loss of cellular differentiation?
a. Dysplasia
b. Hyperplasia
c. Metaplasia
d. Anaplasia
d. Anaplasia
A person has been diagnosed with primary dysmenorrhea and wants to know why ibuprofen is a good choice for pain control. What response by the health care professional is best?
a. “It inhibits the release of leukotrienes in your system.”
b. “It reduces the production of prostaglandins in your body.”
c. “It enhances the effects of bradykinin release.”
d. “It contributes to a higher C reactive protein in your blood.”
b. “It reduces the production of prostaglandins in your body.”
Changes in coagulation factors and fibrinolytic at term include ?
a. Decreased Factor 2
b. Increased Factor 7
c. Long prothrombin time
d. Decreased plasminogen
b. Increased Factor 7
T/F
A drug which is a weak acid has a pKa of 4.7. This drug would be more lipid soluble at a pH of 3.0 than a pH of 6.4.
True
T/F
Sodium-Potassium ATPase transfers 3 potassium ions out of the cell while transporting 2 Na ions into of the cell.
False
3 Na out
2 K in
T/F
All Opioid receptors function via a G-protein complex ?
True
T/F
MAC values can be used to predict the induction time of the volatile anesthetics?
False
high B:G partition coefficient= fast
Which opioid receptor is believed to be primarily responsible for the sedative effects of the opioids?
a. Kappa
b. Delta
c. mu
a. Kappa
T/F
Plasma protein binding of the LAs is predominantly to alpha-1 acid glycoproteins?
True
T/F
Ketamine (Ketalar) should be used cautiously in pts with known bleeding disorders b/c it can inhibit platelet aggregation?
True
T/F
Prinzmetal’s angina is commonly treated with the Ca channel blockers?
True
T/F
Long term use of Procainamide Hydrochloride has a high risk of inducing a lupus syndrome?
True
Anti arrhythmic classes?
I
II
III
IV
I- Na channel blockers (C.A.B) Flecanid/Quinidine/Lido
II- Beta blockers (metoprolol/esmolol/propanolol)
III- Potassium channel blockers (Amio/Sotalol)
IV- Calcium channel blockers (verapamil/Diltazem)
T/F
Each yr in the US, the national flu vaccine produced is developed to provide immunity to 3 major flu varieties?
True
Which factor is not decreased at term?
a. Antithrombin III
b. Factor V
c. Factor XI
d. Factor XIII
b. Factor V
Placental crossing of drugs dependent on: (select 2)?
a. Membrane surface area
b. Membrane thickness
c. Oxygen affinity of maternal hemoglobin only
d. Oxygen affinity of fetal hemoglobin only
a. Membrane surface area
b. Membrane thickness
Which cancer originates from connective tissue?
a. Osteogenic sarcoma
b. Basal cell carcinoma
c. Multiple myeloma
d. Adenocarcinoma
a. Osteogenic sarcoma
Autocrine stimulation is the ability of cancer cells to do what?
a. Stimulate angiogenesis to create their own blood supply
b. Encourage secretions that turn off normal growth inhibitors
c. Secrete growth factors that stimulate their own growth
d. Divert nutrients away from normal tissue for their own use
c. Secrete growth factors that stimulate their own growth
Which form of cancer is linked to congenital malformation syndromes?
a. Osteosarcoma
b. Wilms tumor
c. Retinoblastoma
d. Neuroblastoma
b. Wilms tumor
A factor leading to increased uptake of volatile agents in pregnant patients ?
a. Decreased FRC
b. Increased CO
c. Decreased MV
d. Increased SVR
a. Decreased FRC
What causes the physiologic anemia of pregnancy?
a. Increased plasma volume compared to erythrocyte mass
b. Increased erythrocyte mass compared to plasma volume
c. Increased blood volume
d. Decreased blood volume
a. Increased plasma volume compared to erythrocyte mass
