Ther 201 Exam 2 Flashcards
1
Q
Specific/nonspecific properties of CNS neurotransmitters
A.
B. Increased concentration, becomes non-specific
C. Does not affect different areas equally
D. AOTA
A
Ans: D
2
Q
Developmental Pharmacology – NM Dando 1) If a child is malnourished A. Penicillin excretion increases B. Vd of tetracycline increases C. Salicylate plasma binding decreases D. Chloramphenicol excretion decreases
A
Ans: C/D
Trans: Malnutrition affects highly protein bound drugs excretion of penicillin and chloramphenicol decreases, Vd of tetracycline is decreases, plasma binding of salicylates decreased
3
Q
2) Drug that causes patent ductus arteriosus to remain open, as life-saving measure in neonates with transposition of great vessel A. Indomethacin B. Ibuprofen C. Prostaglandin E1 D. Aspirin
A
Ans: C
Alprostadil (PGE1 analogue) is used to keep the PDA open. NSAIDS such as indomethacin inhibit PG sysnthesis, closing the ductus arteriosus
4
Q
3) Lipophilic drugs have low Vd in prematures because of
A. Immaturity of the kidney
B. Low amount of enzymes in liver
C. Low water content of the body
D. Small amount of fat tissues in the body
A
Ans: D
5
Q
4) The following phase II metabolizing enzymes have low activity at birth EXCEPT A. Glucuronidation B. Sulfatation C. Acetylation D. Methylation
A
Ans: B
At birth, sulfation is increased, glucoronidation and acetylation is decreased
6
Q
5) Skin testing in neonates to detect allergy to penicillin will not be informative because
A. Erractic absorption of parenteral penicillin
B. Thinner stratum corneum especially in preterm
C. Absence of histamine in the skin until 3rd week of life
D. Small volume of drug compared to weight and surface area ratio
A
Ans: C
7
Q
6) At 4th to 10th week AOG, fetus is more prone to concern about drug-induced fetal A. Cardiac arrest B. Hemorrhage C. Malformations D. Jaundice
A
Ans: C
8
Q
7) Tetracycline is NOT recommended for children below 8 years old because it can cause A. Enamel dysplasia B. Fetal hydantoin syndrome C. Bone marrow suppression D. Cerebral palsy
A
Ans: A
Fetal hydantoin syndrome- phenytoin
9
Q
8) Pharmacogenetics is the study of genetically controlled variations in drug response. Which condition listed below is considered to be pharmacogenetic? A. Malignant hyperthermia B. Oligondontia C. Waardenburg syndrome D. Treacher Collins syndrome
A
Ans: A
Malignant hyperthermia after use of succinylcholine
10
Q
9) The following conditions have X-linked type of inheritance EXCEPT A. G6PD deficiency B. Pyridoxine sensitive anemia C. Vasopressin resistance D. Aminoglycoside-induced deafness
A
Ans: D
A,B,C are X-linked
11
Q
10) The probe drug used in pharmacogenetic study of CYP2D6 A. Isoniazid B. Debrisoquine C. Azathioprine D. Succinylcholine
A
Ans: B
12
Q
11) Increased risk of cancer is associated with the following polymorphism A. NAT2 B. TPMT C. G6PD D. CYP2D6
A
Ans: A
Increased risk of cancer is associated with the ff polymorphism: CYP 2A1, 1A2, 2E1, Glutatione transferases, epoxide hydrolase, NAT2
13
Q
12) Severe hemolytic anemia after administration of antimalarial agent primaquine is seen in individuals deficient with this enzyme A. Homogentisate 1,2-dioxygenase B. Glucose-6-phosphate dehydrogenase C. Dihydropyrimidine dehydrogenase D. Glutathione transferase
A
Ans: B
G6PD deficient patients may develop hemolytic anemia after intake of antimalarial drugs like primaquine
14
Q
13) Which of the following is the most common type of polymorphism in the human genome? A. Various tandem repeats B. Insertion polymorphism C. Deletion polymorphism D. Single nucleotide polymorphism
A
Ans: D
15
Q
14) To maintain concentrations similar to CYP 2D6 extensive metabolizers, the dose of nortriptylline given to poor metabolizers should be A. Increased B. Decreased C. The same D. Any of the above
A
Ans: A
Extensive metabolizers will have lower drug concentration compared to poor metabolizers.
16
Q
15) Which of the following would you expect in NAT2 fast/rapid acetylators compared to slow acetylators?
A. Lower concentration of isoniazid at any dose
B. Higher incidence of hydralazine-induced lupus erythematosus
C. Faster appearance of antinuclear antibodies with procainamide
D. Decreased risk of colon cancer with heterocyclic amines from cooked amines
A
Ans: A
Fast acetylators: lower concentration of isoniazid, lower incidence of hydralazine induced lupus, increased risk of colon cancer from acetylation of heterocyclic amines in cooked meats
17
Q
16) Administration of 6-mercaptopurine (6MP) in children with low intracellular activity of thiopurinemethyltransferase (TPMT) for acute lymphoblastic leukemia will result in A. Profound myelosuppression B. Cancer cell lysis C. Therapeutic failure D. Methemoglobinemia
A
Ans: A
TPMT metabolizes 6MP, hence low TPMT increased the toxicity of 6MP
18
Q
17) The “atypical alcohol dehydrogenase” variant beta-2 subunit is responsible for a
A. Lower ethanol Vmax of the atypical enzyme
B. Lower plasma level of acetaldehyde metabolite
C. Higher Km for the homozygous B2B2
D. Higher intracellular activity of the alcohol dehydrogenase enzyme
A
Ans: C
Mutation to an atypical B2 subunit is responsible for a higher ethanol Vmax of the atypical enzyme, higher Km for the homozygous B2B2
19
Q
18) Dibucaine number is indicative of possible abnormality in A. Tyrosine hydroxylase B. Catechol-O-methyltransferase C. Pseudocholinesterase D. Monoamine oxidase
A
Ans: C
20
Q
19) The accumulation of trimethylamine that can cause “Fish odor Syndrome” is due to what genetically determined
A. Hydrolysis
B. N-oxidation
A
Ans: B
Fish odor syndrome is due the excessive excretion of trimethylaminuria, due to defect in N-oxidation of trimethylamine
21
Q
What is true of the nature of the toxic actions of chemicals?
A. Toxic action is always an exaggeration of the therapeutic action
B. The MOA in acute reactions is the same as those in chronic reactions
C. A chemical may exert its effects thru several mechanisms
D. AOTA
A
Ans: C
A- type b reactions are not due to exaggeration
22
Q
The following is true about adverse drug reactions EXCEPT
A. ADRs are the fourth leading cause of death in US statistics
B. ADRs are the single largest source of malpractice suits in the US
C. Most ADRs are related to the wrong dosage
D. 3% to 11% of hospital admission can be attributed to adverse drug effects
A
Ans: C
23
Q
21) A noxious or unwanted response at any dosage of a drug and where causality has been established A. Toxidrome B. Therapeutic index C. Adverse drug reaction D. Adverse drug event
A
Ans: C
Adverse drug event: no causality established
24
Q
22) What is not an adverse drug reaction?
A. Bradycardia from methyldopa
B. Hypotension from generic nifedipine
C. No increase on the protime from generic warfarin
D. Agranulocytosis from propylthiuracil
A
Ans: C
C may be due to inappropriate dosing or counterfeit, not an ADR
25
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23) ADRs are hard to identify especially among sick patients with co-morbidites because of
A. Confounding by indication
B. Drug-drug interaction
C. Drug-disease interaction
D. AOTA
```
Ans: D
26
24) Dose-related type A pharmacokinetic variation causing adverse drug reaction can be due to one of the following
A. Change in formulation
B. Prolonged apnea on succinylcholine
C. Expired drugs
D. Presence of pyrogens in parenteral meds
Ans: B
pseudocholinesterase deficiency can lead to prolonged apnea in patients on succinylcholine. A,C, D are due to Pharmaceutical variation
27
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25) The reaction of GI hemorrhage from use of aspirin is considered as
A. Rebound phenomenon
B. Side effect
C. Extension effect
D. Tachyphylaxis
```
Ans: C
| due to the inhibition of synthesis of prostaglandins, which is protective to mucosa
28
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26) This drug should be avoided in patients with hepatic disease, because it may cause bleeding
A. Barbiturates
B. Indomethacin
C. Diuretics
D. Short-acting benzodiazepines
```
Ans: B
hepatic diseases causes decrease in drug metabolism, accumulation of anticoagulants and NSAIDS (Indomethacin) may leads to bleeding
29
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27) Hypokalemia potentiates the effect of the following drug
A. Quinidine
B. Digitalis
C. Amlodipine
D. Lignocaine
```
Ans: B
30
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28) Peripheral neuropathy with the use of isoniazid is more commonly seen among
A. Slow acetylators
B. Rapid acetylators
C. Intermediate acetylators
D. Rapid hydroxylators
```
Ans: A
| in slow acetylators, isoniazid accumulates, increasing its ADR
31
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29) Type B or immunologic drug reactions are usually seen in
A. Vaccines
B. Patients with atopy
C. Polypeptides such as insulin
D. AOTA
```
Ans: D
Type B drug reactions are elicited by high MW proteins (vaccine), polypeptides(insulin), and dextrans, it occurs in inherently atopic patients wand those with deficiency in the major histocompatibility cells
32
30) Steven-Johnson syndrome and toxic epidermal necrolysis is associated with
A. IgE mediated reaction
B. Type 3 or immune complex type of reaction
C. Transmembrane protein associated with TNF
D. NOTA
Ans: C
SJS and TEN are associated with Fas/Fas-Ligand induced reaction. Fas ligand is a type 2 transmembrane protein that belongs to the TNF family. binding causes apoptosis
33
```
31) In Gell-Coombs classification, hemolytic anemia due to penicillin is classified under
A. Type 2 or cytotoxic type of reaction
B. Type 1 or IgE mediated
C. Specific T-cell activation
D. Type 4 or cell-mediated reaction
```
Ans: A
Type 1: anaphylaxis from beta-lactam
type 3/ immune complex: serum sickness from anti-thymocyte globulin
type 4: contact dermatitis from topical antihistamine
specific T-cell activation: morbilliform rask from sulfonamices
Fas/Fas-ligand induced: SJS, TEN
34
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32) The type of immunologically mediated adverse drug reaction are not mutually exclusive. Some drugs can exhibit ADRs from different mediators such as IgE or drug antibody complexes. An example of this is
A. Carbamezepine
B. Itraconazole
C. Indomethacin
D. Terbutaline
```
Ans: C
example in trans is penicillin
NSAIDS may cause both type 1 and 3 reactions
35
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33) A dermatologic manifestation of a reaction to oral contraceptive use
A. Urticaria
B. Liver peliosis
C. Melasma
D. Morbilliform rash
```
Ans: C
36
34) True of toxic action of hazardous substances
A. Toxic action of acute exposure is same with that of chronic exposure
B. Toxic action is not always the exaggeration of its therapeutic effects
C. Toxicity is mainly brought about by parent compound
D. Intensity of toxic action depends on the amount of chemical/drug
Ans: B
Toxic action of acute exposure is NOT the same with that of chronic exposure
Toxicity may be brought about by parent compound, or a metabolite
Intensity of toxic action depends on the amount of chemical/drug- if an extension effect, but not true for type b reactions
37
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35) Potential stages in the development of toxicity include the following EXCEPT
A. Delivery
B. Interaction with target molecule
C. Cellular dysfunction/injury
D. Dysrepair
```
Ans: B
Potential stages in the development of toxicity after clinical exposure: Delivery, interaction with target molecule, cellular dysfunction/injury, disrepair (toxicology trans)
38
36) The following statement/s is/are true of metabolism factors that affect toxicity of hazardous substances
A. Hazardous substances can pass through specialized barriers such as the blood brain barrier
B. The organ in which a chemical is most highly concentrated is not always the organ where most tissue damage occurs
C. A chemical may be converted to a toxic metabolite which is more toxic than the parent compound
D. Some chemicals/drugs undergo enterohepatic cicrulation
Ans: C
Factors affecting kinetic processes
A is ability of metabolites to pass through cell membranes
B is distribution of toxicant within the body
D is rate and site of excretion
39
37) Kinetic process/es that the body adapts to protect itself from effects of hazardous chemicals is/are
A. Conversion to toxic metabolites
B. Excretion of lipophilic compounds
C. Distribution to highly perfused tissues
D. First pass effect
Ans: D
includes presystemic elimination (first pass effect), distribution away from target site, detoxification, and excretion (hydrophilic)
40
38) The statement that is TRUE with regards duration of exposure is
A. Acute exposure refers to repeated daily exposure to the toxicant for 14 days
B. Subacute exposure refers to repeated daily exposure to the toxicant for 30 days
C. Acute exposure refers to single exposure to the toxicant for less than 24 hours
D. Subchronic exposure refers to repeated daily exposure to the toxicant for throughout the animal’s lifetime
Ans: C
Acute exposure effects appear within 14 days
Subacute exposure refers to repeated daily exposure to the toxicant for LESS THAN 21 DAYS
Subchronic exposure refers to repeated daily exposure to the toxicant for 90 DAYS
41
39) Best describes ion trapping mechanism
A. In alkaline urine pH, a weakly acidic drug will be ionized, trapped in kidney tubules, and excreted
B. In alkaline urine pH, a weakly acidic drug will be nonionized and reabsorbed in the kidney tubules
C. In acidic urine pH, a weakly acidic drug will be ionized, trapped in kidney tubules, and excreted
D. In acidic urine pH, a weakly alkaline drug will be nonionized, and reabsorbed in the kidney tubules
Ans: A
acidic drug in acidic pH= NON-ionized
acidic drug in alkaline pH=ionized, which is not reabsorbed in the nephron, hence excreted.
42
40) Toxicant-neurotransmitter interaction is an example of this mechanism of toxic action
A. Dysregulation of gene expression
B. Dysregulation of on-going cellular activity
C. Oxidative stress
D. Dysrepair
Ans: B
| alteration in the binding of neurotransmitters, inhibiting it’s activity (basically the toxin acts as an antagonist)
43
41) Impairment of ATP synthesis is an example of this mechanism of toxic action
A. Dysregulation of on-going cellular activity
B. Disruption of toxicant delivery
C. Impaired internal maintenance
D. Impaired external maintenance
Ans: B
Impaired ATP synthesis affects the activity of the cell itself. An example of impaired external maintenance is the inhibition of synthesis of coagulation factors in the liver-impairing the function of the cell, but not the cell itself
44
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42) Repair mechanism/s that the body undertake/s after cellular injury is/are
A. Necrosis
B. Apoptosis
C. Fibrosis
D. AOTA
```
Ans: B
Repair mechanisms:
• molecular repair (of proteins, lipids, DNA)
• cellular repair
• tissue repair
o apoptosis, proliferation, side reactions to tissue injury
45
43) Spectra of toxic effects of hazardous substances include/s the following
A. Chemical idiosyncracy refers to genetically determined abnormal reactivity to a hazardous substance
B. Chemical allergy refers to immunologically mediated adverse reaction to a chemical or to a structurally similar one
C. Chronic effects
D. AOTA
Ans: D
Spectrum includes allergic reaction, idiosyncratic reactions, immediate and delayed toxicity, reversible and irreversible effects, local and systemic toxicity
46
44) The following statement is true of pharmacokinetic drug interactions
A. These type of interactions involve actions of drugs in their site of actions
B. Pharmacokinetic interactions involve IV incompatibilities
C. Pharmacokinetic interactions involve agonist-antagonist interactions
D. Pharmacokinetic interactions involve actions of drugs on their elimination process
Ans: D
| PK interaction involves absorption, distribution, metabolism or excretion
47
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45) Pharmaceutical drug interactions involve the following
A. Drug-container interaction
B. Excipient-drug interaction
C. Additives to IV fluids
D. AOTA
```
Ans: D
48
46) Physiologic pharmacodynamic drug interaction involves
A. Interactions of drugs with similar effects but different sites of action
B. Agonist-antagonist interactions
C. IV incompatibilities
D. Inhibition of metabolizing enzyme action
Ans: A
B is pharmacologic pharmacodynamic interaction
C is pharmaceutical interaction
D is Pharmacokinetic interaction
49
47) Which is true of drug interactions?
A. Can be assumed that drug interactions observed in some patients will occur in all patients, or that interactions observed in vitro or in animals will occur in man
B. Interactions demonstrated with certain drugs can be extrapolated to closely related drugs
C. Most important interactions involve drugs of low therapeutic margin
D. There are no beneficial drug interactions
Ans: C
50
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48) In which of the following conditions/structures is the blood brain barrier compromised?
A. CNS infection
B. Premature infants
C. Area postrema
D. AOTA
```
Ans: D
| BBB is also less prominent at the hypothalamus, median eminence, pineal gland, subfornical organ, subcommissural organ
51
49) Characteristic of a voltage-gated Na channel
A. Found on 1st part of dendrites
B. Modulates rate of neuron discharge
C. Mediates signal from cell body to nerve terminal
D. Slow acting
Ans: C
| Nicotinic receptors at neuromuscular junctions
52
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50) Which of the following receptors activated by glutamate is partially voltage gated?
A. APMA
B. KA
C. NMDA
D. NOTA
```
Ans: C
NMDA receptor is patially voltage gated, Mg2+ ion blocks the channel, a change in voltage causes the release of the Mg ion, allowing glutamate to bind to the receptor
53
51) Norepinephrine enhances excitatory inputs by which of the following mechanisms?
A. Hyperpolarize neurons by increasing potassium conductance
B. Disinhibition of inhibitory local circuits
C. Blocking potassium conductance
D. B and C
Ans: D
54
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52) Which of the following is selective for GABAB¬ receptors?
A. Diazepam
B. Baclofen
C. Phenobarbital
D. Muscimol
```
Ans: B
55
53) Which of the following statements describes the property of synaptic mimicry in the identification of central neurotransmitters?
A. The transmitter must be shown to be present in the presynaptic terminals of the synapse and in the neurons from which those presynaptic terminals arise
B. When applied experimentally to the target cells, the effects of the putative transmitter should be identical to the effects of stimulating the presynaptic pathway
C. The transmitter must be released from the presynaptic nerve concomitantly with presynaptic nerve activity
D. NOTA
Ans: B
56
54) Which of the following is a characteristic of local circuit neurons in hierarchical systems?
A. Interconnect pathways over large distances
B. Majority are inhibitory, releasing GABA or glycine
C. Large cell bodies
D. Involve ionotropic receptors
Ans: B
57
55) Which of the following is TRUE regarding diffuse systems in the cellular organization of the brain?
A. Systems involved in sensory perception and motor control
B. Clearly delimited in their anatomic distribution
C. Conduct slowly at 0.5 m/s
D. Information is processed by successive integration circuits
Ans: C
58
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57) Which of the following organs/structures would have predominantly sympathetic tone at the effector sites? (di ko sure bat may highlight sa gdrive to)
A. Heart
B. Arterioles
C. Urinary bladder
D. Ciliary muscle
```
Ans: B
59
Matching type:
58) Reserpine
59) Pyridostigmine
60) Botulinum toxin
61) Vesamicol
62) Atropine
63) Beta-bungarotoxin
64) Malathion
65) Magnesium
66) Edrophonium
```
A. Synthesis
B. Storage
C. Release
D. Receptor
E. Degradation
```
58. B
59. E
60. C
61. B
62. D
63. C
64. E
65. C
66. E
60
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65) A patient is rushed to the ER after ingesting an unknown substance. On examination, the patient was restless, had miotic pupils, excessive salivation and lacrimation, and wheezes were noted on auscultation of the lungs. Given the following drugs, which of the following would most likely be the drug ingested?
A. Trimetaphan
B. Vesamicol
C. Scopolamine
D. Parathion
```
Ans: D
61
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66) Which of the following has the greatest susceptibility to cholinesterase?
A. Methacholine
B. Acetylcholine
C. Carbachol
D. Bethanecol
```
Ans: B
62
67) Pyridostigmine may cause all of the following EXCEPT
A. Bronchoconstriction
B. Constipation
C. Reversible inhibition of acetylcholinesterase
D. Nicotine effects at the neuromuscular end plate
E. Spasm of accommodation
Ans: B
63
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68) Which of the following is used mainly in the diagnosis of myasthenia gravis?
A. Physostigmine
B. Ecothiopate
C. Edrophonium
D. Parathion
```
Ans: C
64
```
69) Which of the following is used in the treatment of glaucoma?
A. Pyridostigmine
B. Pilocarpine
C. Parathion
D. Neostigmine
```
Ans: B
65
70) Which of the following is the rate-limiting step in the synthesis of acetylcholine?
A. Active transport of choline into the cell
B. Entry of neurotransmitter
C. Acetylation of choline with acetylCoA
D. Hydrolysis of acetylcholine
Ans: A
66
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71) Which of the following is a centrally acting cholinesterase inhibitor used in the treatment of Alzheimer’s type of dementia?
A. Pyridostigmine
B. Rivastigmine
C. Edrophonium
D. Pilocarpine
```
Ans: B
67
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72) Which neuromuscular blocker has the shortest duration of action?
A. Succinylcholine
B. Pancuronium
C. Tubocurarine
D. Mivacurium
```
Ans: A
68
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73) Which of the following is an effect of an autonomic ganglion stimulant?
A. Postural hypotension
B. Gastrointestinal paralysis
C. Impaired micturition
D. Tachycardia
```
Ans: D
69
Choose from choices below:
A. Non-depolarizing blocker
B. Depolarizing blocker
74) This group of neuromuscular blockers generally has a duration of action of more than 20 minutes(also has highlight on Gdrive)
75) Malignant hyperthermia is a common complication
76) Tetanic stimulation readily reverses the neuromuscular block early in the action of neuromuscular blocker
A, B, A
70
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77) An adrenergic drug can potentially lead to any of the following EXCEPT
A. Mydriasis
B. Tachycardia
C. Bronchodilation
D. Gluconeogenesis
```
Ans: D
71
78) Which of the following is TRUE about structure-activity relationship of direct adrenergic agonists?
A. Decreased substitution in the benzene ring increases potency
B. Decreased substitution in the benzene ring decreases distribution of the molecule to the central nervous system
C. Increasing the size of alkyl substituents on the amino group tends to increase beta-receptor activity
D. Substitution in the alpha-carbon shortens drug action
Ans: C
72
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79) Increase in cAMP results from activation of which receptor
A. Alpha 1
B. Alpha 2
C. Beta 1
D. AOTA
```
Ans: C
73
80) The activation of presynaptic alpha-2 receptor will result to
A. Increased reuptake of norepinephrine from the synaptic cleft
B. Decreased release of norepinephrine from the synaptic cleft
C. Decreased storage of norepinephrine
D. Decreased catabolism of norepinephrine
Ans: B
74
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81) A drug which can cause renovasodilation, improve cardiac contractility, and increase peripheral vascular resistance depending on dose given
A. Propranolol
B. Dopamine
C. Isoproterenol
D. Phentolamine
```
Ans: B
75
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82) Adrenergic alpha-1 blockade in a patient given epinephrine results in a decrease in BP. This BP depressor effect can be attributed to which of the following?
A. B-1 agonist
B. B-2 agonist
C. B-1 antagonist
D. B-2 antagonist
```
Ans: B
76
83) An adolescent brought to the ER presenting with aggressive behavior, tremor, anxiety, paranoid state, hypertension, and tachycardia was diagnosed to have metamphetamine abuse. Which of the following is TRUE about the action of amphetamine?
A. It binds directly to beta-1 and alpha-1 receptors
B. It displaces norepinephrine from vesicles
C. It enhances MAO activity
D. It promotes exocytotic release of norepinephrine
Ans: B
77
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84) A patient diagnosed to have rheumatic heart disease was brought to the ER due to severe heart failure. Along with a diuretic, this selective beta-1 adrenergic agonist which can increase cardiac contractility and cardiac output can be started
A. Dobutamine
B. Norepinephrine
C. Phenylephrine
D. Terbutaline
```
Ans: A
78
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86) Clonidine is
A. A selective alpha-1 agonist
B. A selective alpha-2 agonist
C. A selective beta-1 agonist
D. A selective beta-2 agonist
```
Ans: B
79
```
both beta and alpha blocking effects, proven to decrease mortality and morbidity in the same subset of patients
A. Atenolol
B. Carvedilol
C. Metoprolol
D. Propranolol
```
Ans: B
80
88) Possible mechanisms of action of indirect adrenergic antagonists
A. Block adrenergic receptors
B. Inhibit the Ca2+-dependent release of norepinephrine
C. Block MAO
D. Inhibit reuptake of norepinephrine from synaptic cleft
Ans: B
81
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89) A patient with Ischemic Heart Disease was given a beta-blocker for his chronic heart disease. Adverse effects of beta-adrenoceptor blocker include
A. Bronchospasm
B. Orthostatic hypotension
C. Tachycardia
D. Psychotic behavior
```
Ans: A
82
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90) Atenolol was started to control hypertension of a 35 year old executive. Which of the following is true of the drug?
A. Selective beta-1 receptor antagonist
B. Short-acting
C. Subject to hepatic metabolism
D. AOTA
```
Ans: A
83
91) The clinical effects of a beta-blocker include which of the following:
A. Increases production of aqueous humor and is used for glaucoma
B. Facilitates peripheral conversion of thryoxine to triiodothyronine and hypothyroidism
C. Decreases incidence of first episode of bleeding in portal hypertension
D. Causes increased CNS alertness and drive, and is used to alleviate “stage fright”
Ans: C
84
92) Glucocorticoids cause the following cellular changes that affect inflammation
A. Increased eosinophil count
B. Increased pathogen phagocytosis by macrophages
C. Decreased basophil count
Ans: C
85
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94) Among the following glucocorticoids, which has the highest potential for inducing hyperglycemia or elevation of blood sugar?
A. Prednisone
B. Hydrocortisone
C. Triamcinolone
D. Dexamethasone
```
Ans: D
86
95) The following is true of hydrocortisone
A. It is a long-acting agent
B. It is preferred steroid for anaphylaxis
C. It has very little anti-inflammatory activity
D. It is a fluorinated compound
Ans: B
87
96) The following practice decreases the likelihood of adverse effects with the use of glucocorticoids
A. Give a higher dose at night than in the morning
B. For contact dermatitis, steroids should be administered systematically for faster effect
C. Use at the highest doses for optimal effect
D. Give prednisone rather than dexamethasone whenever possible
Ans: D
88
97) The following are normal physiologic processes concerning steroid secretion which we attempt to mimic whenever exogenous steroids are given
A. The peak of ACTH secretion is early in the morning at around 8 am
B. The peak of cortisol secretion is at 8 pm
C. Mineralocorticoid secretion peaks at 8 am
D. Cortisol secretion is lowest at around midnight
Ans: D
89
98) The following is an expected metabolic effect of using glucocorticoids
A. Increased hepatic gluconeogenesis
B. Increased glycogen formation
C. Increased glycolysis by muscle
Ans: A
90
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99) The following is a histamine-2 receptor antagonist used to decrease gastric acidity
A. Chlorphenamine
B. Ranitidine
C. Cetirizine
D. Loratidine
```
Ans: B
91
100) The following is false with regard to KKK system
A. Bradykinin is associated with vasodilation
B. The KKK-system is not activated by tissue damage
C. HMW kininogen is an important factor in activating the intrinsic clotting pathway
D. Aprotonin is a kallikrein inhibitor important in reversing bleeding due to the effects of heparin
Ans: B
92
101) What is false about histamine?
A. Found in areas prone to injury like the nose, skin, mouth, feet
B. Stored in macrophages and neutrophils
C. Powerful secretagogue of GI secretions
D. Have a central role in immediate hypersensitivity and allergic response
Ans: B
93
102) Which of the following is not a known function of 5-hydroxytryphtophan?
A. Regulation of GI motility
B. Central chemical transmitter for tryptaminergic neurons in the brain
C. Dilatation of the bronchi
D. Precursor for melatonin
Ans: C
94
103) Which of the following is not a known physiological effect of angiotensin?
A. Decreases ADH secretion
B. Stimulates synthesis and secretion of aldosterone
C. Arteriolar vasoconstriction
D. Promotes cardiac muscle and vascular hypertrophy
Ans: A
95
104) The following is considered false information about aspirin?
A. Inhibits the generation of thromboxane A2
B. Decreases gastric mucosal production especially in higher doses
C. A known analgesic and anti-pyretic
D. Reversible inhibitor of platelet function for 72 hours duration
Ans: D – it is irreversible
96
105) The following is not an associated function of the leukotrienes
A. Promotes contraction of smooth muscles of the bronchial airways
B. Stimulates the production of proinflammatory cytokines
C. Promotes the secretion of mucous in the bronchial glands
D. Inhibits the transendothelial migration of neutrophils
Ans: D
97
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107) How viruses choose specific cell tissue organ etc. to attach to
A. Viral proteins
B. Capsid adherence
C. Host cell receptor
D. Envelope solubility
```
Ans: C
