Practice Midterm

Question 1

Which of the following MOA of drugs is most likely to cause weight gain?

Answer 1

Inhibition of K channels

Question 2

Pt with Type 2 DM and a family history of medullary thyroid cancer seeks for treatment for her Diabetes. Her past medical history is significant for heart failure which is currently controlled with metoprolol and hydrochlorothiazide. Her A1C is 9%. Which of the following drugs would you recommend?

(A) Exenatide
(B) Metformin
(C) Rosiglitazone
(D) Sitagliptin

Question 3

An increase in which of the following parameters would be a concerning risk factor for lactic acidosis in a patient taking metformin?

(A) Blood pressure
(B) Heart rate
(C)Plasma glucose
(D)Serum creatinine

Question 4

A 65-year old man with history of ethanol abuse, chronic pancreatitis, and chronic renal insufficiency comes to clinic for Type 2 Diabetes control. He has good appetite, and no reported hypoglycemic episodes. He is refusing any insulin therapy. Which of the following oral hypoglycemic therapy is the BEST OPTION in his case?

Answer 4

(A) Metformin
(B) Pioglitazone
(C) Sitagliptin
(D) Glargine
(E) Repaglinide

Question 5

A 45-year old woman presents with recently diagnosed Type 2 Diabetes. Her A1C is 9%. You decide to use dual hypoglycemic therapy. While waiting to obtain more clinical information on her, which combination of hypoglycemic classes below would have THE LEAST synergistic effect?

Answer 5

(A) Metformin and sitagliptin
(B) Pioglitazone and exenatide
(C)Glipizides and repaglinide (D)Metformin and pioglitazone

Question 6

***Which of the following MOA of drugs most likely will cause weight gain?

(A) Inhibition of SGLT-2
(B) Inhibition of K+ channels (C)Inhibition DPP-4
(D)Agonist at GLP-1 receptors

Question 7

A drug that targets a nuclear receptor and increases tissue sensitivity to insulin has which of the following adverse effects?
(A) Lactic acidosis
(B) Metallic taste
(C) Osteoporosis
(D)Renal toxicity
(E) Weight loss

Question 8

A patient takes high doses of a dexamethasone. As the chemical structure of this medication is different from cortisol, it can NOT be detected by plasma cortisol assays. Which of the following effects would you expect on the patients endogenous plasma ACTH and cortisol levels?

(A) Decrease in ACTH, decrease in cortisol
(B) Decrease in ACTH, increase in cortisol
(C)Increase in ACTH, decrease in cortisol
(D)Increase in ACTH, increase in cortisol

Question 9

Which of the following corticosteroids most likely causes a problem in a patient with heart failure?
(A) Dexamethasone
(B) Methylprednisolone
(C) Prednisolone
(D) Fludrocortisone
(E) Triamcinolone

Question 10

A patient that has been taking dexamethasone for three months abruptly stops taking the corticosteroid. She is admitted to the emergency room. Which of the following symptoms is she most likely experiencing?

(A) Hypoglycemia
(B) Hypertension
(C) Hypokalemia
(D) Hypernatremia

Question 11

A patient has Addison disease is receiving fludrocortisone. Which of the following abnormalities would be corrected with the administration of fludrocortisone?

(A) Hyperkalemia
(B) Hypernatremia
(C) Hypertension
(D) Hypoglycemia

Question 12

Which of the following is a danger of increasing a patient’s liothyronine dose too rapidly?

(A) Constipation
(B) Lethargy
(C) Tachycardia
(D) Weight gain

Question 13

Which of the following drugs inhibits an enzyme in the in the membrane of thyroid follicular cells?

(A) Methimazole
(B) Desiccated thyroid
(C) Levothyroxine
(D) Letrozole

Question 14

Which of the following patients should probably receive methimazole, not propylthiouracil?

(A) Patient who is 2 months pregnant
(B) Patient who has hypertension and no other comorbidities (C)Patient who is experiencing thyrotoxicosis

Question 15

A woman taking an oral contraceptive presents with acne. Which of the following most likely contributes to this adverse effect?

(A) Drospirenone
(B) Ethinyl estradiol
(C) Norgestrel

Question 16

Which of the following is a contraindication for the use of ethinyl estradiol/ norethindrone acetate?

(A) Hyperthryoidism
(B) Hypotension
(C) Osteoporosis
(D) Thromboembolic disease

Question 17

A patient is refilling a prescription for an anti-thyroid drug that blocks two enzymes. For which of the following is the dose too low?

(A) A patient feeling hot all the time
(B) A patient with bradycardia
(C)A patient with continued hair loss
(D)A patient with hot flashes
(E) A patient with hyperglycemia

Question 18

Which of the following drugs is indicated for the treatment of osteoporosis and acts on a G-protein coupled receptor?

(A) Alendronate
(B) Calcitonin
(C) Calcitriol
(D) Raloxifene

Question 19

A patient with a history of osteoporosis presents with bone lesions in the jaw that do not heal. Which of the following is another adverse effect of the drug that causes the bone lesions?

(A) Atypical femur fractures
(B) Hypercalcemia
(C) Osteosarcoma
(D) Rhinitis

Question 20

***Which of the following immunosuppressive drugs target a phosphatase that is responsible for the activation of a transcription factor?

(A) Azathioprine
(B) Basiliximab
(C) Sirolimus
(D) Tacrolimus

Question 21

Which of the following drugs binds to CD28 on antigen presenting cells?

(A) Azathioprine
(B) Belatecept
(C) Cyclosporine
(D) Everolimus
(E) Thymoglobulin

Question 22

Which of the following drugs is a monoclonal antibody against a B-cell marker and is used to treat certain B-cell lymphomas?
(A) Belatacept
(B) Bevacizumab
(C) Cetuximab
(D) Rituximab

Question 23

Which of the following medications can be used as maintenance therapy post- transplantation and acts directly downstream of IL-2 signaling?

(A) Belatacept
(B) Basiliximab
(C) Sirolimus
(D) Tacrolimus

Question 24

An immunosuppressive drug that has nephrotoxicity as the major dose-limiting side effect has which of the following MOA?

(A) Inhibition if calcineurin
(B) Inhibition of costimulation (signal 2)
(C) Inhibition of de novo purine synthesis
(D)Inhibition of mTOR

Question 25

A patient is receiving erlotinib for his lung cancer. Unfortunately, he does not respond to the treatment, probably due to increased expression of a gene that pumps drugs out of the cells. Which of the following medications would have the same target as erlotinib but would be not affected by the gene that is responsible for the poor response?

(A) Bevacizumab
(B) Cetuximab
(C) Omalizumab
(D) Tocilizumab

Question 26

Which of the following medications is used for the treatment of asthma and mainly acts by decreasing the recruitment and activation of eosinophiles?

(A) Bevacizumab
(B) Cetuximab
(C) Mepolizumab
(D) Montelukast
(E) Omalizumab

Question 27

A patient suffers from recurrent venous thrombosis due to antithrombin III deficiency. Which of the following drugs could be used to treat the patient?

A. Dabigatran
B. Dalteparin
C. Fondaparinux
D. Heparin

Question 28

A drug causing “purple toe syndrome” as an adverse effect has which of the following other adverse effects?

A. Hepatotoxicity
B. Hypertension
C. Neuropathy
D. Teratogenicity
E. Thrombocytopenia

Question 29

Which of the following drugs do NOT work on the primary clot formation?

A. Abciximab
B. Aspirin
C. Dabigatran
D. Dipyridamole
E. Ticagrelor

Question 30

Match the following drugs with their correct MOA:

29. Rivaroxaban
30. Fondaparinux

A. Factor IIa inhibitor
B. Factor Xa inhibitor
C. Vitamin K epoxide inhibitor
D. Antithrombin activator

Answer 30

29.

30.