Medical Pharmacology
Mock Exam
Course Introduction
Medical Pharmacology is a comprehensive course that explores the principles of how drugs interact with biological systems to affect function and treat diseases. The course covers the mechanisms of action, therapeutic uses, side effects, and contraindications of major drug classes. It delves into pharmacokinetics (how the body absorbs, distributes, metabolizes, and excretes drugs) and pharmacodynamics (how drugs affect the body), with a focus on the clinical application of pharmacological principles. Emphasis is placed on the safe and effective use of medications in disease prevention and management, drug interactions, and emerging trends in drug development and personalized medicine.
Recommended Textbook
Pharmacology An Introduction 6th Edition by Henry Hitner
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Chapter 1: Pharmacology: An Introduction
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Q1) Taking two aspirin tablets instead of one will always result in:
A) Two times the analgesic effect
B) An enhanced analgesic effect
C) No change in analgesic effect
D) Toxicity
Answer: B
Q2) What type of curve should be used for representing data when a proper dosing frequency is being determined?
A) Time-response curve
B) Scatter plot
C) Graded dose-response curve
D) Quantal dose-response curve
Answer: A
Q3) Which of the following would not be considered an adverse effect from taking an oral antibiotic?
A) Extravasation
B) Diarrhea
C) Nausea
D) Vomiting
Answer: A
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Chapter 2: Pharmacokinetics and Factors of Individual
Variation
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Q1) Select the most appropriate reason why a patient with cirrhosis of the liver does not get the therapeutic response expected from the medications that she is taking.
A) The patient's ability to absorb drug is impaired.
B) The patient's ability to distribute drug throughout the body is impaired.
C) The patient's ability to metabolize drug is impaired.
D) The patient's ability to excrete unused drug from the body is impaired.
Answer: C
Q2) You have been asked to explain to a patient the possibility that he will experience drug interactions while taking his newly prescribed medications.Select the appropriate statement you will use when explaining "synergism" to the patient.
A) Drugs may increase each other's effect equal to the sum of their individual effects.
B) Drugs may increase each other's effect greater than the sum of their individual effects.
C) Drugs may cancel each other's effect or lead to a response that is less than the sum of their individual effects.
D) None of these are correct.
Answer: B
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Chapter 3: Geriatric Pharmacology
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Q1) An elderly patient who drinks lots of water and takes a water-soluble drug can expect:
A) A toxic effect
B) A subtherapeutic effect
C) A therapeutic effect
D) Competitive antagonism
Answer: C
Q2) An elderly man has been given an adult-strength dose of the topical steroid hydrocortisone for the past four weeks.He has developed thin skin and stria along his back,suggesting toxicity.The cause of the toxicity would be:
A) Decreased absorption through interactions reducing the half-life
B) Increased distribution to adipose tissues, prolonging the half-life
C) Increased metabolism in liver, increasing the half-life
D) Increased excretion from the kidneys, increasing the half-life
Answer: B
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5
Chapter 4: Math Review and Dosage Calculations
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Q1) Select the correct volume of the drug required to administer a dosage of 5 mg/kg for a patient who weighs 88 pounds and is 12 years old.The drug is available as a 1-g,which will be mixed in enough water to make 100 ml of final solution (W/V).
A) 12 ml
B) 20 ml
C) 37 ml
D) 42 ml
Q2) Select the correct number of drops per minute to be administered for a 500-ml Lactated Ringers IV given over 2 hours using an administration set labeled 15 drops per ml.
A) 32.5 drops/minute
B) 62.5 drops/minute
C) 40 drops/minute
D) 75 drops/minute
Q3) In summarizing the factors that affect IV solutions,you conclude that:
A) IV drug solutions must be free of organisms.
B) IV drug solutions must be compatible with all of the ingredients.
C) IV drug solutions must be adjusted to a targeted pH range.
D) All of these are correct.
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Page 6
Chapter 5: Introduction to the Autonomic Nervous System
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Q1) The neurotransmitter common to both preganglionic fibers in the sympathetic and parasympathetic nervous system is:
A) Norepinephrine
B) Acetylcholine
C) Epinephrine
D) Serotonin
Q2) Activation of the parasympathetic division will not directly reduce:
A) GI motility
B) Blood pressure
C) Urinary motility
D) Skeletal muscle contraction
Q3) The function of the autonomic nervous system is to regulate the rate of:
A)Cardiac muscle contractions
B)Skeletal muscle contractions
C)Spinal reflexes
D)Sensory conduction
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Chapter 6: Drugs Affecting the Sympathetic Nervous System
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Q1) What is the primary reason that alpha-blockers are used to treat Raynaud's disease?
A) Vasoconstriction increases blood flow to the skin and extremities.
B) Vasodilation lowers blood pressure.
C) Vasodilation increases blood flow to the skin and extremities.
D) None of these are correct.
Q2) Identify the type of muscles that are affected by norepinephrine.
A) Smooth and skeletal muscle
B) Skeletal and cardiac muscle
C) Smooth and cardiac muscle
D) None of these are correct.
Q3) Differentiate between the drug effects of the nonselective and selective beta-1 blockers,and select the major pharmacokinetic differences that exist between the two that can alter the therapeutic response.
A) Duration of action and extent of drug metabolism
B) Onset of action and extent of drug metabolism
C) Duration of action and extent of drug excretion
D) Onset of action and extent of drug absorption
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Page 8
Chapter 7: Drugs Affecting the Parasympathetic Nervous System
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Q1) What is a desirable property that would need to be enhanced in developing a new direct-acting cholinergic drug?
A) Longer duration of action
B) Shorter duration of action
C) Quicker absorption
D) Quicker elimination
Q2) The injection of botulinin toxin will affect which type of cholinergic receptor?
A) Ganglionic
B) Muscarinic
C) Nicotinic-m
D) Nicotinic-n
Q3) Botulinin toxin can be used to reduce wrinkles and lines on the face by inducing what type of paralysis?
A) Intermittent
B) Irreversible
C) Flaccid
D) Rigid
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Page 9
Chapter 8: Drugs Affecting the Autonomic Ganglia
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Q1) A patient who recently started on a smoking cessation treatment plan is complaining of throat irritation.Using what you have learned about the smoking cessation products,you determine that this adverse effect is due to his use of:
A) Nicorette
B) Nicotrol Inhaler
C) Chantix
D) Nicorette gum
Q2) Identify the neurotransmitter found at the autonomic ganglia that stimulates the nicotinic-neural (Nn) receptors.
A) Serotonin
B) Epinephrine
C) Acetylcholine
D) Dopamine
Q3) When integrating a smoking cessation treatment with the Nicotrol inhaler,it should be used with caution because:
A) Use of the inhaler may cause nervousness.
B) Use of the inhaler may cause heartburn.
C) Use of the inhaler may cause minor breathing difficulties.
D) None of these are correct.
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Page 10
Chapter 9: Skeletal Muscle Relaxants
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Q1) Some patients may have a genetic predisposition to developing malignant hyperthermia when taking an inhalation anesthetic with which type of skeletal muscle relaxant?
A) Pancuronium
B) Succinylcholine
C) Dantrolene
D) Baclofen
Q2) Which medication can potentiate the effects of succinylcholine due to shifting the levels of potassium in the body?
A) Narcotics
B) NSAIDs
C) Antiemetics
D) Diuretics
Q3) A medication that results in spinal hyperpolarization would belong to which class of skeletal muscle relaxants?
A) Nondepolarizing
B) Depolarizing
C) Centrally acting
D) Direct acting
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Page 11
Chapter 10: Local Anesthetics
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Q1) EMLA is a topical anesthetic containing 2.5% of each of two ingredients.You use the Physicians' Desk Reference and determine that the two ingredients are:
A) Lidocaine and epinephrine
B) Procaine and lidocaine
C) Lidocaine and prilocaine
D) None of these are correct.
Q2) Explain how local anesthetics affect cardiac function.
A) Local anesthetics depress the function of the cardiac conduction system.
B) Local anesthetics produce tachycardia.
C) Local anesthetics cause hypertension.
D) All of these are correct.
Q3) Select the statement that best explains potency.
A) Potency is the ability to increase velocity of nerve conduction.
B) Potency is the ability to produce a nerve block at a relatively low dose.
C) Potency is the ability to produce a heightened conduction of nerve impulses.
D) None of these are correct.
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Chapter 11: Introduction to the Central Nervous System
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Q1) Gray matter is attributed to _____ located in the _____ of the brain.
A) Cell bodies, cerebral cortex
B) Axons, cerebral cortex
C) Dendrites, basal nuclei
D) Axons, basal nuclei
Q2) A person choking on a piece of steak is displaying activation of which brain structure?
A) Thalamus
B) Hypothalamus
C) Pons
D) Medulla oblongata
Q3) Someone who is unable to sense pain or temperature stimulation may have a problem in this region of the brain
A) Hypothalamus
B) Pons
C) Medulla oblongata
D) Thalamus
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13
Chapter 12: Sedative-Hypnotic Drugs and Alcohol
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Q1) Using duration of action as a guide,select the group of hypnotic drugs that are listed in order from lowest to greatest duration of action.
A) Zaleplon, estazolam, flurazepam
B) Zolpidem, flurazepam, temazepam
C) Temazepam, zolpidem, flurazepam
D) Zolpidem, temazepam, zaleplon
Q2) Flurazepam (Dalmane) is classified as a long-acting benzodiazepine.The antianxiety effects of flurazepam are usually evident the day after taking the flurazepam dose.Select the precaution that you will emphasize to the patient when you give him the prescription the doctor has written.
A) Avoid hazardous activities.
B) Do not take other antianxiety agents at the same time.
C) Do not drink alcohol while taking flurazepam.
D) All of these are correct.
Q3) Identify the clinical indication for the use of benzodiazepines.
A) Mental relaxation and sleep disorders
B) Reduction of anxiety and sleep disorders
C) Mental relaxation and reduction in desire for physical activity
D) Reduction of anxiety and desire for physical activity
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Page 14
Chapter 13: Antipsychotic and Antianxiety Drugs
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Q1) Long-acting benzodiazepines are inactivated by _____.
A) Hyaluronic acid which forms an inactive metabolite
B) Glucuronic acid which forms an inactive metabolite
C) Ascorbic acid which forms an inactive metabolite
D) Linoleic acid which forms an inactive metabolite
Q2) Situations that bring about stress and anxiety in a person will directly result in increased activity of which part of the brain?
A) Limbic system
B) Substantia nigra
C) Hippocampus
D) Thalamus
Q3) Benzodiazepines rely on ligand-gated _____ channels to achieve their effect of membrane _____.
A) Sodium, depolarization
B) Sodium, hyperpolarization
C) Chloride, depolarization
D) Chloride, hyperpolarization
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15
Chapter 14: Antidepressants, psychomotor Stimulants, and Lithium
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Q1) Using the Physicians' Desk Reference,you determine that due to their alpha-blocking,anticholinergic and antihistaminic effects,the TCAs are contraindicated in patients suffering from:
A) Glaucoma and benign prostatic hypertrophy
B) Glaucoma and hypertension
C) Benign prostatic hypertrophy and hypertension
D) Glaucoma and epilepsy
Q2) Using the Physicians' Desk Reference,you determine that the common adverse effects of use of the psychomotor stimulant drugs are:
A) Dry mouth, tachycardia, hypertension, and insomnia
B) Excess saliva production, bradycardia, hypotension, and sedation
C) Dry mouth, bradycardia, hypotension, and sedation
D) Excess saliva production, tachycardia, hypertension, and insomnia
Q3) Identify the common characteristics associated with mania.
A) Patient shows signs of hyperactivity.
B) Patient is very talkative.
C) Patient exhibits unrealistic thoughts.
D) All of these are correct.
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Chapter 15: Psychotomimetic Drugs of Abuse
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Q1) Cross-tolerance has been found to exist within which group of commonly abused drugs?
A) Marijuana
B) Phencyclidine
C) Psychomotor stimulants
D) LSD
Q2) Heavy marijuana use can cause _____ which could be an indication of _____.
A) Excessive elation, mania
B) Depressed behavior, permanent brain damage
C) Auditory hallucinations, damage to auditory cranial nerve
D) Psychosis, a latent psychiatric disorder
Q3) Tricyclic antidepressant drugs have been used in treating cocaine dependency because they:
A) Lessen euphoric effect and minimize tolerance
B) Lessen euphoric effect and reduce cravings
C) Minimize tolerance and reduce cravings
D) Establish a cross tolerance and reduce cravings
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Chapter 16: Antiepileptic Drugs
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Sample Questions
Q1) Identify the type of seizure that does not involve any type of motor convulsion.
A) Atonic seizure
B) Myoclonic seizure
C) Absence seizure
D) Partial seizure
Q2) Using adverse effects,determine the information you will need to educate a patient who takes carbamazepine (Tegretol).
A) Bone marrow depression that can lead to aplastic anemia
B) Impaired liver function that can lead to jaundice
C) Convulsions and difficulty breathing
D) All of these are correct.
Q3) Explain why diazepam (Valium),although effective in the treatment of status epilepticus,may require additional administration of the drug to control the seizures.
A) Diazepam has a quick onset of action.
B) Diazepam has a short duration of action.
C) Diazepam has a long half-life.
D) None of these are correct.
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18
Chapter 17: Antiparkinson Drugs
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Q1) Levodopa use is delayed in the beginning stages of Parkinson's disease.
A) To avoid drug-food interactions that may occur
B) To avoid having to use multiple medications
C) To avoid tolerance to levodopa over time
D) To avoid the development of movement disorders that develop over time
Q2) The main feature in Parkinson's disease is the accelerated loss of
A) Cholinergic neurons
B) Dopamine neurons
C) Serotonin neurons
D) Norepinephrine neurons
Q3) The addition of carbidopa to levodopa is beneficial because it _____ the amount of dopamine being produced in the periphery and decreases the _____ seen with higher levels of levodopa.
A) Decreases, side effects
B) Increases, side effects
C) Maintains, toxic effects
D) Increases, toxic effects
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19
Chapter 18: General Anesthetics
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Q1) Identify the part of the brain that influences mood,motivation,and the ability to perceive pain.
A) Hypothalamus
B) Thalamus
C) Medulla oblongata
D) Cerebral cortex
Q2) Using the physiological effects of the injected benzodiazepine and barbiturate anesthetic agents on the respiratory system,select the true statement.
A) Benzodiazepines and barbiturates produce a dose-dependent respiratory depression.
B) Benzodiazepines and barbiturates decrease respiratory rate and tidal volume.
C) Patients with underlying chronic obstructive pulmonary disease are more susceptible to respiratory depression from the use of benzodiazepine and barbiturate anesthetic agents, even at doses that would be considered therapeutic in healthy individuals.
D) All of these are correct.
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Chapter 19: Opioid Analgesics
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Q1) Two naturally occurring opiates derived from the poppy plant are:
A) Morphine and heroin
B) Morphine and codeine
C) Codeine and heroin
D) Codeine and marijuana
Q2) Opioid overdose results in respiratory depression because:
A) The suppressed medulla cannot respond to CO<sub>2</sub> stimulation.
B) The suppressed medulla cannot respond to O<sub>2</sub> stimulation.
C) Increased levels of CO<sub>2</sub> bound to hemoglobin slow breathing.
D) Increased levels of O<sub>2</sub> bound to hemoglobin slow breathing.
Q3) Oral formulations of opioid drugs should never be _____ in order to avoid _____.
A) Chewed, an enhanced degradation in the stomach leading to side effects
B) Chewed, an enhanced effect leading to side effects
C) Taken with food, decreased absorption
D) Taken with food, food-drug interactions
Q4) The opioids used to suppress coughing include all of the following except:
A) Loperamide
B) Codeine
C) Hydrocodone
D) Dextromethorphan
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Chapter 20: Nonopioid Analgesic, nonsteroidal
Antiinflammatory, and Antigout DR
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Q1) Use the adverse-effects profile of acetaminophen to determine the recommended treatment options for acetaminophen poisoning.
A) The treatment for acetaminophen poisoning includes gastric aspiration and lavage.
B) Maintenance of fluid balance by conventional means is necessary in the treatment of acetaminophen poisoning.
C) Use of activated charcoal will absorb the acetaminophen if administered within hours of the overdose.
D) All of these are correct.
Q2) Match the term megaloblastic anemia with the correct definition.
A) Megaloblastic anemia is a condition in which there is a large, immature form of the red blood cell, which does not function as efficiently as the mature form.
B) Megaloblastic anemia is a condition in which the total number of white blood cells circulating in the blood is less than normal.
C) None of these are correct.
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22
Chapter 21: Review of Cardiac Physiology and Pathology
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Q1) A disease in which the aging process leads to fibrosis and narrowing of the arteries is:
A) Atherosclerosis
B) Arteriosclerosis
C) Ischemia
D) Angina pectoris
Q2) Excitation and contraction of the heart occurs with:
A) Contraction of the right side of the heart followed by contraction of the left side
B) Contraction of the left side of the heart followed by contraction of the right side
C) Contraction of both ventricles followed by contraction of both atria
D) Contraction of both atria followed by contraction of both ventricles
Q3) A decrease in myocardial function will immediately result in:
A) Thromboembolisms
B) Myocardial infarction
C) Ischemia
D) Arteriosclerosis
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23
Chapter 22: Treatment of Heart Failure
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Q1) Translate the presence of excessive ST segments and T wave depressions on an ECG.
A) The presence of excessive ST segments and T wave depressions on an ECG indicate an excess of aldosterone in the body.
B) The presence of excessive ST segments and T wave depressions on an ECG indicate an excess of antidiuretic hormone in the body.
C) The presence of excessive ST segments and T wave depressions on an ECG indicate digoxin toxicity.
D) None of these are correct
Q2) Implementing a treatment plan with digoxin for a patient who already takes quinidine for arrhthymias requires:
A) An increase in the dosage of the digoxin due to antagonism with the quinidine
B) A decrease in the dosage of the digoxin due to the potentiation of the digoxin levels in the plasma
C) An increase in the dosage of the quinidine due to antagonism with the digoxin
D) None of these are correct.
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24
Chapter 23: Antiarrhythmic Drugs
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Q1) Calcium channel blockers affect the SA node by
A) Slowing depolarization and decreasing the heart rate
B) Slowing repolarization and decreasing the heart rate
C) Increasing depolarization and decreasing the heart rate
D) Increasing repolarization and decreasing the heart rate
Q2) Antiarrhythmic drugs primarily affect the activity of the following ion channels except
A) Cl
B) Na
C) K
D) Ca
Q3) A type of arrhythmia that originates in the SA node and causes a sustained heart rate over 100 beats per minute.
A) Paroxysmal supraventricular tachycardia
B) Ventricular tachycardia
C) Supraventricular tachycardia
D) Sinus tachycardia
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Chapter 24: Antianginal Drugs
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Q1) Compare the routes of administration of the nitrates and determine the most common route of administration during attacks of angina.
A) Topical
B) Intravenous
C) Sublingual
D) Oral
Q2) Describe the goal of the treatment of coronary artery disease.
A) Reducing the number and severity of anginal attacks
B) Limiting the progression of atherosclerosis
C) Preventing myocardial infarction
D) All of these are correct
Q3) Select the mechanism of action of the calcium channel blockers in the treatment of angina and CAD.
A) Prevention of influx of calcium ions into vascular smooth muscle
B) Reversal of the effects of sympathetic activation
C) Relaxation of vascular smooth muscle
D) All of these are correct.
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Chapter 25: Diuretics
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Q1) Carbonic anhydrase inhibitors can become refractory over time because:
A) The supply of CO<sub>2</sub> is rate-limiting.
B) An acid-base balance is needed for the medication to work properly.
C) The supply of H<sub>2</sub>O is rate-limiting.
D) Overproduction of bicarbonate ion will prevent the medication from working properly
Q2) Edema is a result of insufficient _____ clearance where fluid accumulates in the _____.
A) Sodium, extracellular space
B) Sodium, intracellular space
C) Chloride, extracellular space
D) Chloride, intracellular space
Q3) _____ is a diuretic that also has a beneficial effect for people with open-angle glaucoma,since _____ is associated with ocular fluid formation.
A) Mannitol, cyclooxygenase
B) Isosorbide, carbonic anhydrase
C) Furosemide, cyclooxygenase
D) Acetazolamide, carbonic anhydrase
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Chapter 26: Antihypertensive Drugs
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Q1) Differentiate between the angiotensin-converting enzyme inhibitors (ACEIs) and the angiotensin receptor blockers (ARBs),and select the drug agent of choice in the treatment of hypertension because it possesses the shortest plasma half-life within this group.
A) Quinapril (Accupril)
B) Captopril (Capoten)
C) Losarten (Cozaar)
D) Valsarten (Diovan)
Q2) Select the primary indication for the use of minoxidil (Loniten).
A) Minoxidil is indicated for patients who do not respond to therapy with calcium antagonists.
B) Minoxidil is indicated for patients who do not respond to triple therapy with other drug combinations.
C) Minoxidil is indicated for patients who do not respond to therapy with beta-blockers.
D) None of these are correct.
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Chapter 27: Anticoagulants and Coagulants
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Q1) Standard heparin is preferred for pregnant patients needing an anticoagulant because:
A) Molecular size will allow it to cross the placenta to help the offspring.
B) The offspring will receive the full anticoagulant effect.
C) Molecular size will not allow it to cross the placenta to affect the offspring.
D) The offspring will receive only a partial anticoagulant effect.
Q2) The primary reason heparin cannot be administered orally is that:
A) The mucopolysaccharide is too large to be absorbed in the intestines.
B) The mucopolysaccharide is destroyed by gastric acid in the stomach.
C) The peptide is too large to be absorbed in the intestines.
D) The peptide is destroyed by gastric acid in the stomach.
Q3) Patients on oral anticoagulant therapy should be monitored by which tests?
A) PTT or APTT
B) INR or APTT
C) Protime (PT) or APTT
D) Protime (PT) or INR
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Chapter 28: Nutrition and Therapy
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Q1) Select the statement that best explains the potential effect of the presence of hyperchloremia in the body.
A) The presence of high levels of chloride causes more chloride to be reabsorbed from the renal tubules, leaving less chloride in the extracellular fluid, causing the development of acidosis.
B) The presence of high levels of chloride causes more hydrogen to be retained in the blood to help balance the excess chloride, causing hyperchloremic alkalosis.
C) The presence of high levels of chloride causes more hydrogen to be retained in the blood to help balance the excess chloride, causing the development of hyperchloremic acidosis.
D) None of these are correct.
Q2) Describe the type of patient who would benefit from the administration of a TPN.
A) Cancer patient having difficulty with excessive weight loss
B) Diabetic patient having difficulty keeping his or her blood sugar level down
C) Pregnant patient who has been vomiting excessively and is dehydrated
D) None of these are correct.
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Chapter 29: Hypolipidemic Drugs
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Q1) For patients requiring an aggressive lipid-lowering strategy treatment protocol,a
A) Dual combination of lovastatin and niacin should be given
B) Dual combination of simvastatin and niacin should be given
C) Triple combination of simvastatin, lovastatin and colestipol should be given
D) Triple combination of niacin, colestipol, and lovastatin should be given
Q2) What is the rate limiting step in cholesterol biosynthesis that allows the statin drugs to be effective?
A) Production of mevalonic acid
B) Production of HMG-CoA
C) Production of acetyl-CoA
D) Production of pyruvic acid
Q3) What is the first line of defense when treating hyperlipidemia?
A) Diet control
B) HMG-CoA reductase inhibitor
C) Nicotinic acid
D) Bile acid sequestrant
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Chapter 30: Antianemics
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Q1) Describe a physiological situation that can lead to the development of anemia.
A) Anemia may be caused by deficiency in the amount of hemoglobin, occurring when the number of circulating red blood cells is decreased.
B) Anemia may be caused by an excessive loss of blood or an increased destruction of RBCs.
C) Anemia may be caused by a decreased production of RBCs, which reduces the amount of circulating hemoglobin.
D) All of these are correct.
Q2) Differentiate between the treatment options for folic acid,iron,and vitamin B<sub>12</sub> deficiency,and select the true statement related to these deficiencies.
A) Erythropoietin therapy cannot reverse the effects of folic acid, iron, or vitamin B<sub>12</sub> deficiency.
B) Cyanocobalamin therapy is approved for the treatment of iron deficiency.
C) Floic acid deficiency is associated with pernicious anemia and can be treated with cyanocobalamin.
D) All of these are correct
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Chapter 31: Antihistaminic Drugs and Mast Cell Release
Inhibitors
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Q1) Antihistaminics can be used in cold remedies because of the anticholinergic properties responsible for:
A) Inhibiting the degranulation process in mast cells
B) Promoting sedation
C) Slowing the breathing process
D) Drying nasal secretions
Q2) Why shouldn't oral cromolyn dosage forms be taken with fruit juice or milk?
A) The acidic conditions will induce metabolism and be less powerful.
B) Enhanced activity of drug occurs with juices and milk.
C) An insoluble complex is formed that is difficult to excrete.
D) Absorption of drug will be compromised.
Q3) Advantages of newer-generation antihistaminics over first-generation antihistaminics are:
A) Increased selectivity for central H<sub>1</sub>-receptors and less sedation
B) Decreased selectivity for peripheral H<sub>1</sub>-receptors and less sedation
C) Decreased selectivity for peripheral H<sub>1</sub>-receptors and more sedation
D) Increased selectivity for peripheral H<sub>1</sub>-receptors and less sedation
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Page 33
Chapter 32: Respiratory Pharmacology, treatment of
Asthma, and Copd
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Q1) Identify the factors that can trigger an asthmatic attack.
A) Allergens, air pollutants, humidity, infections, and exercise
B) Air pollutants, hot air, certain drugs, infections, and exercise
C) Allergens, air pollutants, cold air, infections, and exercise
Q2) Caffeine,theophylline,and theobromine are classified as methylxanthines and are found in nature.Methylxanthines can be described as:
A) Mineral compounds
B) Plant compounds
C) Synthetic compounds
D) None of these are correct.
Q3) Select the mechanism of action of the bronchodilator drug known as theophylline.
A) Theophylline antagonizes adenosine, a bronchoconstrictor.
B) Theophylline inhibits the enzyme phosphodiesterase (PDE), which slows the metabolism of cAMP.
C) Theophylline inhibits the enzyme phosphodiesterase (PDE), which slows the inactivation of cAMP.
D) All of these are correct.
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Page 34
Chapter 33: Therapy of Gastrointestinal Disorders: Peptic Ulcers,
gerd, and Vom
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Q1) Gastric juices mainly consist of
A) HCl and gastrin
B) HCl and pepsin
C) Sodium bicarbonate and gastrin
D) Sodium bicarbonate and pepsin
Q2) Which medications can actually promote the formation of ulcers by interfering with mucus production or secretion?
A) NSAIDs and diuretics
B) NSAIDs and steroids
C) Steroids and diuretics
D) Steroids and antibiotics
Q3) Acid secretion and gastrin-induced secretion is inhibited by blocking which receptors?
A) Cholinergic and H1 receptors
B) Adrenergic and H1 receptors
C) Cholinergic and H2 receptors
D) Adrenergic and H2 receptors
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Page 35
Chapter 34: Agents That Affect Intestinal Motility
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Q1) Use critical thinking to select the drug of choice for the treatment of constipation in a patient who is taking opioid-based analgesics for the relief of pain following extensive back surgery.
A) Lubiprostone
B) Lactulose
C) Methylnaltrexone bromide
D) Polycarbophil
Q2) Select the group of drug agents that contribute to increased intestinal motility,resulting in diarrhea.
A) NSAIDs, antacids, chemotherapy agents
B) Antiarrhythmic and blood pressure medications
C) Antibiotics and laxatives
D) All of these are correct.
Q3) Describe the patient population in which chronic diarrhea develops more readily.
A) Children
B) Individuals in poor health or with poor nutrition
C) Elderly
D) All of these are correct
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36
Chapter 35: Introduction to the Endocrine System
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Q1) The production of the hormone erythropoietin in the formation of red blood cells is regulated by the
A) Hypothalamus
B) Kidney cells
C) Anterior pituitary
D) Posterior pituitary
Q2) Releasing and inhibiting hormones travel from the hypothalamus to the anterior pituitary through the
A) Portal artery
B) Fourth ventricle
C) Portal vein
D) Blood brain barrier
Q3) In addition to bone,muscle,and fat,what organ is particularly responsive to the effects of somatotropin?
A) Liver
B) Stomach
C) Lymph nodes
D) Spleen
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Chapter 36: Adrenal Steroids
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Sample Questions
Q1) Select the adverse effects of excessive administration of the mineralocorticoids.
A) Increased gluconeogenesis
B) Sodium and water retention and loss of potassium
C) Increased protein catabolism
D) None of these are correct.
Q2) Match the term gluconeogenesis with the correct statement.
A) The process of making "new" glucose in the liver, where amino acids or glycerol are
B) converted into glucose. As a result, plasma glucose concentration rises and can be used by injured tissue or the brain.
C) The process of breaking down proteins into amino acids. This occurs mainly in skeletal muscle. The amino acids that are released can then be used by the liver to make new glucose.
D) The process of breaking down glucose in the liver.
E) None of these are correct.
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Chapter 37: Gonadal Hormones, oral Contraceptives, and Erectile Dysfunction Dru
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Q1) Which of the following would not be a risk associated with taking HRT?
A) Heart attack
B) Osteoporosis
C) Stroke
D) Breast cancer
Q2) The risk of older women having offspring with Down syndrome is due to chromosomal changes occurring in the ova:
A) Arrested in prophase of the second meiotic division
B) Arrested in metaphase of the second meiotic division
C) Arrested in prophase of the first meiotic division
D) Arrested in metaphase of the first meiotic division
Q3) Ovulation occurs as a result of a surge from which hormone?
A) LH
B) FSH
C) GnRH
D) Progesterone
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Chapter 38: Drugs Affecting the Thyroid and Parathyroid Glands
and Bone Degener
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Q1) Use the contraindications and special considerations of the replacement thyroid hormones to explain to a diabetic patient the outcome of discontinuing thyroid treatment without notifying the physician.
A) Stopping thyroid therapy may bring about hyperglycemia unless the antidiabetic medication is adjusted upward after stopping thyroid treatment.
B) Stopping thyroid therapy may bring about hypoglycemia unless the antidiabetic medication is adjusted downward after stopping thyroid treatment.
C) Stopping thyroid therapy may bring about exophthalmos.
D) None of these are correct.
Q2) Identify the condition characterized by a significant reduction in bone mass.
A) Hypothyroidism
B) Agranulocytosis
C) Osteoporosis
D) Cretinism
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Chapter 39: Pancreatic Hormones and Antidiabetic Drugs
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Q1) The need for amputation for diabetics occurs because of:
A) An increase in levels of stored glucose in the extremities
B) A decrease in immune response with high levels of insulin
C) A decrease in immune response with high levels of glucagon
D) Inadequate circulation to the extremities
Q2) Cells that secrete GIP and GLP-1,which promote insulin secretion,are located in the:
A) Small intestines
B) Large intestines
C) Pancreas
D) Liver
Q3) Which one of the following receptors is not coupled to a G-protein?
A) GIP receptor
B) GLP-1 receptor
C) Glucagon receptor
D) Insulin receptor
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Chapter 40: Posterior Pituitary Hormones: Antidiuretic Hormone
and Oxytocin
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Sample Questions
Q1) Use the pharmacological action of the oxytocics and tocolytics to select the drug of choice for the treatment of postpartum bleeding.
A) Dinoprost
B) Methylergonovine
C) Carboprost
D) Protaglandins
Q2) Summarize the uses of desmopressin or DDAVP.
A) Desmopressin is used to prevent or relieve abdominal distention associated with surgical procedures.
B) Desmopressin is used for the treatment of diabetes insipidus.
C) Desmopressin is proven effective in the treatment of nocturnal enuresis when administered prior to bedtime
D) All of these are correct.
Q3) Use the adverse-effect profile of the oxytocics to explain the reason why these agents are contraindicated in patients with asthma.
A) The oxytocics cause vomiting and diarrhea.
B) The oxytocics cause headache and dizziness.
C) The oxytocics cause constriction of bronchial smooth muscle.
D) None of these are correct.
Page 42
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Chapter 41: Antibacterial Agents
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Q1) A person experiencing a delayed allergic reaction to a penicillin will likely be switched to a(n):
A) Aminoglycoside
B) Tetracycline
C) Cephalosporin
D) Sulfonamide
Q2) A person taking a diuretic and rifampin should be aware of:
A) Increased risk of renal bleeding
B) Voiding red-orange urine
C) Potential oliguria
D) Extreme diuresis
Q3) Aminoglycosides can produce a synergistic bactericidal action when combined with:
A) Cephalosporins
B) Tetracyclines
C) Sulfonamides
D) Macrolides
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Chapter 42: Antifungal and Antiviral Drugs
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Sample Questions
Q1) Identify the condition in which there is an abnormal decrease in the number of circulating platelets.
A) Neutropenia
B) Thrombocytopenia
C) Leukopenia
D) None of these are correct.
Q2) Describe the patient group most commonly diagnosed with esophageal candidiasis.
A) Esophageal candidiasis is most commonly diagnosed in patients with HIV.
B) Esophageal candidiasis is most commonly diagnosed in patients who are receiving treatment with antibiotics.
C) Esophageal candidiasis is most commonly diagnosed in patients using inhaled corticosteroids or those receiving chemotherapy.
D) All of these are correct.
Q3) Using the available treatment options,select the primary treatment for Tinea pedis.
A) Terbenafine (Lamisil)
B) Fluconazole (Diflucan)
C) Griseofulvin (Grifulvin V)
D) Ketoconazole (Nizoral)
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44
Chapter 43: Parasitic Infections: Antiprotozoal and Anthelmintic Drugs
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Q1) A patient with severe liver disease and dysentery arrives at the hospital.Can the patient receive metronidazole?
A) Yes, but treatment should be supplemented with vitamin B<sub>12</sub>.
B) Yes, but close monitoring will be required.
C) No. This has been shown to increase the patient's risk for developing cancer.
D) No. This can cause a disulfiram-like reaction in the patient.
Q2) An example of a sexually transmitted protozoan would be:
A) Malaria
B) Trichomoniasis
C) Dysentery
D) Toxoplasmosis
Q3) A desirable feature of metronidazole is its ability to:
A) Limit its effect to certain regions of the body
B) Distribute over a wide range systemically
C) Be well tolerated in patients with liver problems
D) Not cross the placenta
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Chapter 44: Antiseptics and Disinfectants
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Q1) Differentiate between heat and cold sterilization,and select the statement that best explains their differences.
A) Heat sterilization can be achieved by using high-pressure steam for hours in specialized tanks called autoclaves. Cold sterilization is the destruction of microorganisms at room temperature without the use of heat or ionizing radiation.
B) Heat sterilization can be achieved by using high-pressure steam for hours in specialized tanks called autoclaves. Cold sterilization is the destruction of microorganisms using temperatures below freezing.
C) Heat sterilization can be achieved by using high-wattage ovens to destroy the organisms. Cold sterilization is the destruction of microorganisms using temperatures below freezing.
D) None of these are correct.
Q2) Identify the definition of the term sterilization.
A) Process that inhibits the growth of disease-causing microorganisms.
B) Process that completely eradicates all microorganisms and spores.
C) Process that inhibits the growth of microorganisms.
D) None of these are correct.
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Chapter 45: Antineoplastic Agents
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Q1) Methotrexate is a chemotherapeutic medication that:
A) Causes metaphase arrest
B) Blocks DNA synthesis
C) Inhibits transcription
D) Inhibits protein translation
Q2) Which of the following would best represent the best drug product of current research on developing a new chemotherapeutic medication?
A) Antimetabolite
B) Alkylating drug
C) Polyclonal antibody
D) Monoclonal antibody
Q3) Mr.Smith is not showing a positive response after receiving his chemotherapy.What would be the next step in his treatment?
A) Increase the dose of the current chemotherapy medication.
B) Change to a different chemotherapy medication in the same family.
C) Initiate combination therapy.
D) Change to a completely different chemotherapy medication.
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Chapter 46: Immunopharmacology
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Q1) Select the true statement that outlines the actions of a natural killer cell.
A) The natural killer cell releases perforins, which polymerize and form a hole in the enemy cell membrane.
B) Granzymes from the natural killer cell enter the perforin hole and degrade the enemy cell enzymes.
C) The enemy cell dies by apoptosis. The macrophage engulfs and digests the dying cell.
D) All of these are correct.
Q2) Using the adverse-effects profile of infliximab (Remicade),educate a patient who is considering the use of the drug.
A) Administration of infliximab is associated with an infusion reaction that can include tremors and seizures.
B) Administration of infliximab is associated with an infusion reaction that can include hypotension, renal impairment, and chest pain.
C) Administration of infliximab is associated with an infusion reaction that can include fever, chills, hives, hypotension, and chest pain.
D) None of these are correct.
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