Quick Quiz 3

Question 1

Which of the following risk factors does NOT contraindicate the use of estrogens as hormone replacement therapy for women?

a. deep venous thrombosis
b. diabetes mellitus, type 2
c. pulmonary thromboembolism
d. prior resection of estrogen receptor positive breast cancer

Answer 1

b. diabretes mellitus, type 2

Breast cancer (estrogen receptor positive), DVT, and pulmonary embolism contraindicate the use of estrogens as HRT, DM does not.

Question 2

Glucocorticoids taken for periods longer than __________________ will require a tapered dose reduction over time when stopping them.

a. two weeks
b. six weeks
c. one month
d. one week

Answer 2

a. two weeks

Corticosteroids taken longer than two weeks should be tapered

Question 3

The CYP450 enzyme family most responsible for metabolizing SSRIs is

a. 2C19.
b. 1A2.
c. 2C9.
d. 2D6.

Answer 3

d. 2D6

Question 4

Which class of oral hypoglyemic agents is associated with development of cancer of the bladder?

a. sulfonylureas (second generation)
b. thiazolidinediones
c. alpha-glucosidase inhibitors
d. biguanides

Answer 4

c. thiazolidinediones
rosiglitazone (Avandia)
pioglitazone (Actos)
Only the thiazolidinediones are associated with bladder cancer to date

Question 5

Ben is 77 years old, and is to be started on metformin (Glucophage). His fasting blood gluocse is averaging 150 mg/dL. You will recommend that he

a. take the maximum dose of metformin twice daily to assure his HbA1C level falls to within normal levels as soon as possible to prevent neuropathy and diabetic foot problems.
b. take the medication late a night, before retiring to sleep.
c. take the medication with the largest meal of the day.
d. begin by taking a smaller dose of metformin, and escalating the dose slowly to prevent hypoglycemia.

Answer 5

d. begin by taking a smaller dose of metformin, and escalating the dose slowly to prevent hypoglycemia

At Ben’s age, taking a small dose will help prevent hypoglycemia. This is a standard suggested by the Beer’s criteria.

Question 6

Which of the following hormones does not alter gene expression by having its receptor act directly in the nucleus?

a. levothyroxine
b. calcitonin
c. vitamin D
d. estrogen

Answer 6

b. calcitonin

Vitamin D, estrogens (and all sex steroids and corticosteroids), and thyroid hormones all use receptors that bind to, or are within, the nucleus, altering gene expression. Calcitonin does not.

Question 7

A patient is being treated for Alzheimer’s dementia. You understand that the neurotransmitter “needed” by this patient belongs to which class?

a. cholinergic
b. serotonergic
c. adrenergic
d. dopaminergic

Answer 7

a. cholinergic

Deficiency of acetylcholine in the cerebral cortex underlies the pathophysiology of Alzheimer’s disease.

Question 8

The primary function of vitamin D in treating or preventing osteoporosis is to

a. increase the absorption of calcium and phosphorus.
b. stimulate the translation of 24-hydroxylase in the liver.
c. stimulate the release of parathormone.
d. decrease the efflux of calcium into the bowel lumen using the P-glycoprotein pump.

Answer 8

a. increase the absorption of calcium and phosphorus

Vitamin D stimulates the absorption of calcium and phosphorus