Questions

Question 1

The development of antimuscarinic side effects is dose-dependent. A low dose of atropine would most likely cause the peripheral side effect of

1-Cardiac vagal blockade
2-Inhibition of secretion of salivary glands
3-Excitement
4-Inhibition of gastric secretion
5-Hypomotility of gastrointestinal tract smooth muscle

Answer 1

Inhibition of secretion of salivary glands

Question 2

Which of the following is an over-the-counter agent used to treat diarrhea?

1-Loperamide (Imodium)
2-Sucralfate (Carafate)
3-Misoprostol (Cytotec)
4-Metoclopramide (Reglan)
5-Aluminum glycinate

Answer 2

1 Loperamide (Imodium)

Question 3

What antacid is also a mild cathartic (causes expulsion of GI tract contents)?

1-Magnesium hydroxide (in Milk of Magnesia)
2-Sodium bicarbonate (Tums)
3-Famotidine (Pepcid)
4-Aluminum hydroxide (in Amphojel)
5-Sucralfate (Carafate)

Answer 3

1 Magnesium hydroxide (in Milk of Magnesia)

Question 4

The drug cimetidine (Tagamet®) is an analog of the compound

Answer 4

Histamine

Question 5

The neurotransmitter histamine is derived from which of the following amino acids?

Answer 5

Histadine

Question 6

Which cell type secretes histamine in response to inflammation?

Answer 6

Mast Cells

Question 7

A 74-year-old male presents to your general practice, complaining that he catches every “bug” that comes along. You thumb through his medical file and find a 4-year history of recurrent infections and chronic illness. Your patient insists that he complies with all instructions on the medications given for his various ailments. You decide to take a small risk and prescribe cimetidine as an immunostimulant. Which of the following describes the immuno-stimulatory effect of cimetidine?

1-Cimetidine blocks H2 receptors on B cells, diminishing the humoral response, thus increasing cellular immunity

2-Cimetidine blocks H2 receptors on B cells, decreasing their cAMP levels, increasing their activity

3-Cimetidine blocks H2 receptors on T cells, decreasing their cAMP levels, increasing their activity

4-Cimetidine stimulates H1 receptors on T cells, increasing their cAMP levels, increasing their activity

5-Cimetidine stimulates H1 receptors on B cells, increasing their cAMP levels, increasing their activity

Answer 7

Cimetidine blocks H2 receptors on T cells, decreasing their cAMP levels, increasing their activity

Question 8

Which of the following is a drug that irreversibly inhibits the H+/K+ ATPase in the parietal cells?

A- Cimetidine

B- Diphenoxylate

C- Esomeprazole

D- Metoclopramide

E- Sulfasalazine

Answer 8

Esomeprazole

Question 9

A patient who is taking verapamil for hypertension and angina has become constipated. Which of the following drugs is an osmotic laxative that could be used to treat the patient’s constipation?

A- Aluminum hydroxide

B- Diphenoxylate

C- Magnesium hydroxide

D- Metoclopramide

E- Ranitidine

Answer 9

Magnesium hydroxide

Question 10

A 34-year-old woman has irritable bowel syndrome with diarrhea that is not responsive to conventional therapies. Despite the small risk of severe constipation and ischemic colitis, the patient decides to begin therapy with alosetron. Alosetron has which of the following receptor actions?

A- 5-HT3 receptor antagonist

B- 5-HT4 receptor agonist

C- D2 receptor antagonist

D- NK1 receptor antagonist

E- Muscarinic receptor antagonist

Answer 10

5-HT3 receptor antagonist

Question 11

On your way to an examination, you experience the vulnerable feeling that an attack of diarrhea is imminent. If you stopped at a drugstore, which one of the following antidiarrheal drugs could you buy without a prescription even though it is related chemically to the strong opioid analgesic meperidine?

A- Aluminum hydroxide

B- Diphenoxylate

C- Loperamide

D- Magnesium hydroxide

E- Metoclopramide

Answer 11

Loperamide

Question 12

Which drug stimulates chloride secretion into the gut lumen and is used for irritable bowel syndrome?

Cimetidine

Dexamethasone

Methotrexate

Linaclotide

Answer 12

Linaclotide

Question 13

A 55-year-old woman with type 1 diabetes of 40 years’ duration complains of severe bloating and abdominal distress, especially after meals. Evaluation is consistent with diabetic gastroparesis. Which of the following is a prokinetic drug that could be used in this situation?

Alosetron

Cimetidine

Loperamide

Metoclopramide

Sucralfate

Answer 13

Metocloparamide

Question 14

A patient is receiving highly emetogenic chemotherapy for metastatic carcinoma. To prevent chemotherapy-induced nausea and vomiting, she is likely to be treated with which of the following?

Levodopa

Methotrexate

Misoprostol

Ondansetron

Sucralfate

Answer 14

Ondansetron

Question 15

A 45-year-old man with a duodenal ulcer was treated with a combination of drugs intended to heal the mucosal damage and to eradicate Helicobacter pylori. Which of the following antibacterial drugs is used commonly to eradicate intestinal H pylori?

Cefazolin

Ciprofloxacin

Clarithromycin

Clindamycin

Vancomycin

Answer 15

Clindamycin

Question 16

Case
A 25-year-old man presents for evaluation of intermittent chest pain. He reports a burning sensation in his chest 1-2 days per week after eating. The symptoms are worse with large meals, eating late at night, and excessive alcohol consumption. He denies difficulty swallowing, weight loss, night sweats, chest pain, use of tobacco, or coughing up blood. His vital signs and physical examination are unremarkable.

Question
What is the most appropriate treatment for this patient’s current symptoms?

Answer 16

H2 Receptor Antagonists

This patient has mild GERD with twice weekly symptoms for which an H2 Receptor antagonist is the first line

Question 17

Case
A 66-year-old male patient with a history of obesity and hyperlipidemia presents with an 8-month history of progressing “burning in his chest.” This sensation is noted in the midline of the chest, and it is provoked when bending over, when wearing tight clothing, after eating a large meal, and when lying supine. He denies chest pressure, cough, shortness of breath, palpitations, dizziness, lightheadedness, and diaphoresis. Physical examination is unremarkable. An upper endoscopy is performed and inflammation in the esophagus is noted.

Question
What is the most appropriate pharmacotherapeutic intervention for this patient?

1Omeprazole
2Nystatin
3Cisapride
4Metoclopramide
5Sucralfate

Answer 17

Omeprazole

Question 18

Case
A 60-year-old male patient with hypertension presents with constipation. He states that he often only has two bowel movements weekly. This has been an ongoing problem for months, but the situation has worsened since being released from the hospital after treatment for a myocardial infarction a few weeks ago.

Question
What is the most appropriate treatment?

1Glycerin suppository
2Oral bisacodyl
3Oral lactulose
4Oral psyllium
5Oral senna

Answer 18

Oral Psyllium