Monday, December 15, 2008

Post 14 cancer/resp

Good Luck everyone on the final, If you have anymore questions to add feel free to send them to me. Thanks to everyone for doing that throughout the semester we really appreciate that. Good Luck again and I'll see some of you on Thursday at 12:45 in Mendo 2007.



Which drug combination is INAPPROPRIATE for treating asthma?

A. Combivent, albuterol, and ipratropium
B. Beclomethasone and salmeterol
C. Cromolyn sodium, theophylline
D. fluticasone, levalbuterol



Which of the following drugs is the best choice for treating acute bronchospasm?

A. albuterol sulfate (PROVENTIL)
B. cromolyn sodium (INTAL)
C. ipratroprium bromide (ATROVENT)
D. zafirlukast (ACCOLATE)



Which of the following drugs is the best drug for treating nighttime asthma symptoms?

A. ipratropium bromide (ATROVENT)
B. alpha-1 antritrypsin
C. theophylline
D. salmeterol (SERVENT)



The adverse effect characteristic of doxorubicin (ADRIAMYCIN) is

A. bladder irritation and bleeding.
B. cardiotoxicity.
C. hepatic fibrosis.
D. neurotoxicity.



Combinations of anti-cancer drugs are often given in order to

A. decrease adverse effects.
B. increase efficacy.
C. reduce cost of therapy.
D. 1 and 2



Which approach would be useful in treating cancer?

A. Giving a drug that caused clotting in new tumor blood vessels.
B. Lowering the dose of methotrexate (MTX) so that hair loss did not occur.
C. Administering telomerase to a woman with lung cancer.
D. Administering Leucovorin instead of doxorubicin (ADRIAMYCIN).



Common adverse reactions to chemotherapy include all of the following EXCEPT:

A. Low platelet count and bleeding
B. Sodium retention and hypertension
C. Low white blood cell count and infection
D. Nausea and vomiting



Inhaled corticosteroids are used in the treatment of asthma because they

A. dilate the airways.
B. control infections.
C. decrease inflammation.
D. have a strong placebo effect.



Ipratropium bromide (ATROVENT) is a drug used to treat asthma. Which of the following drugs is most similar to Ipratropium bromide (ATROVENT) in terms of its mechanism of action?

A. atropine
B. albuterol (PROVENTIL)
C. theophylline.
D. neostigmine (PROSTIGMIN)



Mitotic inhibitors such as vincristine (ONCOVIN) are used in cancer treatment because they:

A. Substitute for a structure necessary for building a strand of DNA.
B. Cause cross-linking between strands of DNA, thus preventing cell division.
C. Block transcription of new DNA or RNA.
D. Block cell division in metaphase.



The adverse effect characteristic of methotrexate (MTX) is

A. hypersensitivity.
B. cardiotoxicity.
C. hepatic fibrosis.
D. neurotoxicity.



Your patient needs to receive "colony stimulating factors". This is most likely because:

A. The bacteria suspected of causing the patient's infection is very difficult to grow, and thus has not been identified.
B. The patient needs to make more white blood cells.
C. It can carry chemotherapy drug molecules directly to the tumor cells.
D. It stimulates excretion of toxic metabolites of chemotherapy.



COMMON adverse reactions to chemotherapy include all of the following EXCEPT:

A. neurotoxicity.
B. Low platelet count and bleeding
C. Hair loss.
D. Nausea and vomiting



This anticholinergic agent is used to treat asthma and it works by blocking muscarinic receptors. This drug is

A. ipratropium bromide (ATROVENT).
B. cromolyn sodium (INTAL).
C. theophylline.
D. zileuton (ZYFLO).



What is the mechanism of action of the cancer drug methotrexate (MTX)?

A. Topoisomerase inhibition
B. Folate antagonism
C. Stimulate white blood cell production
D. Alpha adrenergic inhibition


More questions added 12/17, thanks again Lily!!


Here are the addtional questions that were not on the blog.
Which of the following drugs is the best drug for long term maintanence of asthma symptoms?

A. isoproterenol (MEDIHALER-ISO) by inhalation
B. Isoetharine (BRONKOMETER) by inhalation
C. salmeterol (SEREVENT) by inhalation
D. High dose oral prednisone



Match the statement to the appropriate drug.

Blocks leukotriene receptors zafirlukast (ACCOLATE)
Inhibits lipoxygenase zileuton (ZYFLO)
Inhibits inflammation Both of these drugs



Which approach would be useful in treating cancer?

A. Administering estrogen to a woman with estrogen receptor positive breast cancer.
B. Administering an anti-angiogenesis drug such as Thalidomine to a man with a cancerous tumor too large for surgical removal.
C. Administering telomerase to a woman with liver cancer.
D. Lowering the dose of methotrexate (MTX) to reduce nausea.



This drug is used to treat asthma and it works by stabilizing mast cells. This drug is

A. cromolyn sodium (INTAL).
B. ipratropium bromide (ATROVENT).
C. theophylline.
D. zileuton (ZYFLO).



According to the National Asthma Education Program, Cromolyn sodium (INTAL) should be used

A. as the first choice of therapy in children.
B. in combination with ipratropium bromide (ATROVENT).
C. only when inhaled coriticosteroids are not acceptable to the patient/family.
D. when the patient is allergic to aspirin.

Wednesday, December 10, 2008

Pre 14 resp/cancer

A relatively new treatment for asthma is the use of leukotriene antagonists/inhibitors. Examples from this drug class include:

A. Aspirin and other nonsteroidal anti-inflammatory drugs
B. COX2 inhibitors
C. Zafirlukast (ACCOLATE) and zileuton (ZYFLO)
D. Cromolyn sodium (INTAL) and albuterol (PROVENTIL)



Which of the following diseases is chracterized by persistent cough resulting in sputum production for more than 3 months for more than 2 years? Note: you may find the answer fastest in your lecture notes.

A. asthma
B. chronic bronchitis
C. emphysema



Which of the following drugs causes bronchodilation and is classified as a bronchodilator?

A. albuterol sodium (PROVENTIL)
B. cromolyn sodium (INTAL)
C. zafirlukast (ACCOLATE)
D. zileuton (ZYFLO)



Which of the following drugs is the best drug for long term maintanence of asthma symptoms?

A. zafirlukast (ACCOLATE)
B. metoprolol subcutaneoulsy
C. inhaled corticosteroids
D. methotrexate



Patients who receive traditional chemotherapy should be taught to

A. eat salty, crunchy foods such as potato chips to make up for salt loss.
B. continue having un-protected sex only if it is with one partner.
C. eat fresh, unpeeled fruit only if the neutrophil (WBC) count is acceptble.
D. avoid brushing or flossing teeth for 48 hours before chemotherapy.



Which of the following is a beta2 adrenergic agent used to treat asthma?

A. cromolyn sodium (INTAL).
B. ipratropium bromide (ATROVENT).
C. albuterol (PROVENTIL).
D. zileuton (ZYFLO).



Which of the following diseases is chracterized by abnormal enlargement of gas exchange airways with destruction of alveolar walls? Note: you may find the answer fastest in your lecture notes.

A. asthma
B. chronic bronchitis
C. emphysema


Added 12/15, thanks Lily!!!!


Which of the following diseases is chracterized by hyper-reactive airways, reversible airflow obstruction, and increased mucus production? Note: you may find the answer fastest in your lecture notes.

A. asthma
B. chronic bronchitis
C. emphysema



Cancer is known to be a result of changes in DNA that predispose a person to cancer. One DNA change that is involved with more than 40 different kinds of cancer is

1. deletion or mutation of tumor suppressor genes.
2. addition of tumor suppressor genes in unusual locations.
3. deletion of oncogenes.
4. absence of benign tumors.



Cancer cells are known to show abnormal features such as

1. increased cell stickiness.
2. lack of resoponse to growth control signals.
3. decreased rate of growth.
4. aggressive immune responsiveness.

Post 13 GI

The patient is comatose following ingestion of an unknown poison. Staff in the Emergency Room will:

A. Induce vomiting with ondansetron (ZOFRAN)
B. Administer a universal poisoning antidote
C. Insert a stomach tube and give activated charcoal
D. Suppress symptoms with tricyclic antidepressants



Client teaching for someone taking over-the-counter antacids might include which statement?

A. Antacids interfere with absorption of many medicines, so take them at different times.
B. Although antacids are the mainstay of therapy for peptic ulcers, they must be taken frequently to be effective.
C. If gastrointestinal bleeding does not stop within 2 weeks, consult your practitioner.
D. If constipation results from magnesium antacids, try switching to aluminum antacids.



The obesity drug sibutramine (MERIDIA) works by:

A. Decreasing appetite by inhibiting reuptake of serotonin and norepinephrine
B. Blocking fat absorbtion from the gut
C. Blocking adrenergic receptors in the brain
D. Stimulating a craving for low-fat foods



When administering psyllium and bran (METAMUCIL) to treat constipation, it is important to:

A. Allow the solution to sit for 30 minutes before the patient drinks it
B. Minimize the amount of oral water taken (no more than 1/2 glass with the medication and no more than 2 glasses total for the day)
C. Assess for hypersensitivity to psyllium and GI obstruction, both of which are contraindications
D. Verify that the patient has a bowel movement within 30 minutes of administration.



Which of the following combination products would be most likely to treat heartburn (acid indigestion) associated with excessive gas, without side effects of either constipation or diarrhea?

A. GAVISCON (aluminum hydroxide and magnesium carbonate)
B. MYLANTA (aluminum hydroxide, magnesium hydroxide and simethicone)
C. METAMUCIL (psyllium)
D. PHOSPHAJEL CAPS (aluminum phosphate)



A patient has one medium sized tube into the stomach and one small tube into the small intestine. To give sucralfate to this patient:

A. Dissolve the tablet and put down the stomach tube.
B. None of the above. A patient with tubes into the stomach and intestine should not be receiving sucralfate.
C. Dissolve the tablet and put down the intestinal tube.
D. Give the tablet rectally.



The most effective drugs for treating gastric ulcers are:

A. Histamine stimulants
B. Aluminum Antacids
C. Anticholinergics
D. Antibiotics



Vitamin K has been ordered for your patient, most likely because of a problem with:

A. wound healing
B. bleeding
C. numbness and tingling in the extremeties
D. chronic infections



Lansoprazole is a Category B proton pump inhibitor, available in several forms. What precautions should you advise about/monitor for in patients taking this drug?

A. Get out of bed slowly.
B. Do not take if pregnant.
C. Do not crush delayed release beads inside the capsule.
D. Do not open capsule before swallowing.



Which of the following doctor's orders for nausea treatment should be questioned?

A. The patient has postoperative nausea without vomiting (yet). Orders are for prochlorperazine intravenously and ondansetron intravenously if that does not work.
B. The patient is vomiting postoperatively in the recovery room: Orders are to place topical scopolamine patch, and if ineffective give prochlorperazine intravenously.
C. The patient is a diabetic with nerve damage that slows down transit of food in the stomach (gastroparesis): Orders are to give metoclopramide intravenously.
D. The patient will receive chemotherapy in 30 minutes: Oders are to give dexamethasone and granisetron orally now.



If antacids have been unsuccessful in treating gastroesophageal reflux disease (GERD), which drug would be tried next?

A. A stimulant such as bisacodyl (DUCOLAX)
B. A prostaglandin such as misoprostol (CYTOTEC)
C. A proton pump inhibitor such as lansoprazole (PREVACID)
D. An opiate such as diphenoxylate and atropine (LOMOTIL)



Before starting an herbal weight loss product containing ephedra, it is most important to check the patient's:

A. Body mass index
B. Weight
C. Ability to swallow large pills
D. Blood pressure



A client selects cimetidine over-the-counter to treat symptoms of gastro-esophageal reflux disease. Which assessment is most important to make?

A. What other medications is the client taking? There are many drug-drug interactions with cimetidine.
B. What time and how is the drug being taken? It is best taken with food at bedtime.
C. What dose is being used? The recommended OTC dose should be doubled for active symptoms.
D. How long have the symptoms been going on? Cimetidine is only effective in the first 2 weeks of symptoms.


A patient should take pancrelipase:

A. On first awakening in the morning.
B. At bedtime.
C. With meals.
D. 3 hours after meals.




Added 12/15 Thanks Lily!!!!!


Which of the following is tried first in the treatment of gastroesophageal reflux disease?

A. A stimulant such as bisacodyl (DUCOLAX)
B. A prostaglandin such as misoprostol (CYTOTEC)
C. An opiate such as diphenoxylate and atropine (LOMOTIL)
D. An antacid such as MAALOX



The most important vitamins for an alcoholic to take are:

A. D and C
B. The B vitamins
C. Vitamin A and E
D. The fat soluble vitamins



MD orders should be questioned if the drug ordered would be dangerous for the patient to receive, if the patient needs a drug which is not ordered and when multiple drugs are ordered for the same condition when combination therapy is not called for. Which drug order should be questioned?

A. No prescription for a stool softner in a patient on morphine for cancer.
B. Lansoprozole in a hospitalized patient without a prior history of ulcer disease.
C. Metronidazole in a patient who just had open bowel surgery.
D. Metoclopramide in a diabetic patient with nausea from slow peristalsis.



Activated charcoal may be given in the emergency room to:

A. Prevent absorption of phosphate from the gut
B. Assist in the diagnosis of appendicitis
C. Bind and prevent absorption of ingested drugs and toxins
D. Treat nausea associated with intestinal blockage



Which of the following doctor's orders for nausea treatment should be questioned?

A. The patient will receive chemotherapy in 30 minutes: Oders are to give dexamethasone and granisetron orally now.
B. The patient is a diabetic with nerve damage that slows down transit of food in the stomach (gastroparesis): Orders are to give metoclopramide intravenously.
C. The patient has postoperative nausea without vomiting (yet). Orders are for prochlorperazine intravenously and ondansetron intravenously if that does not work.
D. The patient is vomiting postoperatively in the recovery room: Orders are to place topical scopolamine patch, and if ineffective give prochlorperazine intravenously.

Thursday, December 4, 2008

Pre 13 GI

Saline laxatives, such as milk of magnesia, work by:

A. Osmotically drawing water into the small intestine
B. Killing constipation causing gut bacteria
C. Lubricating and coating the surface of the feces
D. Increasing peristalsis via nerve stimulation in colon



Drug classes that are useful in treating gastric ulcers include:

A. H2 agonists
B. H1 blockers
C. Proton pump inhibitors
D. Bulk laxatives



Drug classes that are useful in treating gastric ulcers include:

A. Serotonin reuptake inhibitors
B. H1 blockers
C. Antibiotics
D. H2 agonists



Ranitidine may be preferred over cimetidine because:

A. Cimetidine is not available over the counter
B. Ranitidine has fewer drug interactions
C. Ranitidine penetrates into the brain better
D. Cimetidine is taken once daily



Sibutramine is approved for therapy lasting no longer than:

A. 2 weeks
B. 6 weeks
C. 3 months
D. 1 year



Many times you can develop almost a complete list of patient problems and potential problems just by looking at the list of medications the patient takes. Your patient can have either ondansetron or metoclopramide as needed. What problem would these have been prescribed for?

A. Weight loss
B. Nausea or vomiting
C. Gastroesophageal reflux disease
D. Constipation



Many times you can develop almost a complete list of patient problems and potential problems just by looking at the list of medications the patient takes. Your patient is taking docusate and biscodyl. What problem would these have been prescribed for?

A. Constipation
B. Gastroesophageal reflux disease
C. Weight loss
D. Irritable bowel syndrome



Pancrease should be taken:

A. With meals.
B. 60 minutes before each meal.
C. With grapefruit juice.
D. On an empty stomach.



Thanks Jose Rodriguez for the extra questions, we appreciate it!!!