Which of the following generalized statements about antidysrhythmic drugs is true?
A. They increase automaticity, speed conduction rates, and increase
refractoriness.
B. They cause impotence and poor pregnancy outcomes.
C. They cause dysrhythmia.
D. They cause hypertension and tachycardia.
The electrophysiological basis of automaticity is
A. rapid influx of calcium.
B. inhibition of the sodium-potassium pump.
C. slow leak of sodium into the cell.
D. rapid influx of potassium.
One strategy for treating angina is to reduce heart work. Which of the following drugs would be used to reduce heart work?
A. diltiazem (CARDIZEM)
B. digoxin (LANOXIN)
C. epinephrine (ADRENALINE)
D. dobutamine (DOBUTREX)
Most antidysrhythmic drugs act by:
A. antagonism of receptors on the SA and AV node
B. promoting metabolism of normal neurotransmitters
C. creating retrograde electrical flow
D. blocking ion channels in myocardial cells
An action potential characterized by a slow leak of ions into the cell, that has a phase 0, phase 3, and phase 4, is an __________.
A. fast action potential.
B. muscle action potential
C. slow action potential
D. repolarization potential
All of the following decrease heart work and oxygen demand EXCEPT
A. decreasing contractility.
B. decreasing heart rate.
C. increasing duration of diastole.
D. increasing preload.
When looking at an electrical tracing of the heart, the passage of electricity through the atria is displayed as:
A. The QRS
B. The AV node
C. The QT interval
D. The P wave
Which of the following should be given in the immediate time period after a heart attack?
A. beta blockers and aspirin
B. amiodarone and hydrocortisone
C. calcium channel blockers and acetaminophen
D. quinidine and lidocaine
An action potential characterized by a rapid influx of sodium through sodium channels in phase 0 and delayed repolarization secondary to calcium influx is an __________.
A. fast action potential
B. muscle action potential
C. slow action potential
D. repolarization potential
4.
If it took extra long for electricity to get from the atrium to the ventricle, what would you see on the EKG?
A. A prolonged PR interval.
B. A prolonged ST segment.
C. A wide QRS.
D. An inverted P wave.
5.
Drugs useful in treating angina include:
1. Calcium channel blockers because they relax arterial smooth muscle and may slow heart rate.
2. Sodium channel blockers because they slow conduction within the heart.
3. Potassium channel blockers because they increase the refractory period.
4. Magnesium channel blockers because they reduce preload and afterload.
Wednesday, October 29, 2008
Post 8 HTN/ Lipids
Before starting atorvastatin (LIPITOR), it is important to:
A. Document that the patient failed therapy with Niacin and one of the bile acid
sequestrants (Colestipol or Cholestyramine).
B. Be sure the patient is not pregnant.
C. Teach the patient how to do home blood sugar monitoring and be sure patient has
the equipment.
D. Document normal conductivity through heart with EKG.
Some antihypertensive drugs block both alpha and beta receptors. Why would this be a good thing for someone with hypertension?
A. it causes vasodilation
B. it decreases renin release
C. it increases cardiac output
D. 1, 2 only
E. 1,2,3
The mechanism of action of this drug is dilation of arterioles by a direct effect on vascular smooth muscle.
A. clonidine (CATAPRES)
B. captopril (CAPOTEN)
C. hydralazine (APRESOLINE)
D. atropine
Losartan (COZAAR) is an angiotensin II receptor antagonist which would be expected to have which side effect(s):
A. Hypokalemia (low potassium)
B. Pupil constriction
C. Dizziness
D. Dry mouth
Aldosterone alters blood pressure because it
A. causes potassium excretion.
B. dilates blood vessles.
C. causes sodium retention.
D. enhances renin release.
In acute head injury, the osmotic diuretic mannitol may be given to reduce brain swelling. What potential problem would you need to monitor for?
A. The mannitol prevents electrolytes from being excreted by the
kidney.
B. The blood pressure could drop quickly as fluid is pulled from cells into the
blood stream.
C. Urine output typically drops transiently during the first 4 hours.
D. Over time, if the mannitol diffuses into the brain, it would make the swelling
worse.
All of the following are adverse effects of furosemide (LASIX) EXCEPT
A. high blood potassium levels
B. low blood sodium and chloride levels
C. hypotension
D. hearing loss
Hyperlipidemia drug therapy for a person with existing coronary heart disease should begin when:
A. LDL cholesterol is greater than 100.
B. HDL cholesterol is elevated.
C. The patient has lost 10% of his/her body weight.
D. Blood pressure is under control.
R.J. is a 55 yo male with long standing hypertension who has been treated with Dyazide one capsule each day. On this clinic visit, a urine sample is positive for spilled protein. His BP is 136/82. You should:
A. Discontinue the Dyazide. After 1 week, start captopril 25 mg twice each
day.
B. No drug changes are required. He should have a low protein diet.
C. Increase the Dyazide dose to 2 capsule each day.
D. Add captopril 50 mg three times each day.
P.P. is a 52 yo diabetic AA female who just had a stroke. She has had long term HTN. Current meds are: lisinopril 20 mg each day, labetalol 400 mg twice a day, lasix 20 mg twice each day. Current labs include sodium 138 (normal 135-145) and potassium 3.5 (normal 3.5-5). Her BP is 210/118 and her pulse is 75. You should:
A. Increase the labetalol.
B. Add losartan.
C. Increase the lasix.
D. Increase the lisinopril.
A patient crushed his sustained-release verapamil tablet before ingesting it. Which action would you most likely take?
A. Administer short acting verapamil to keep the heart rate down.
B. Check heart rate and administer a beta-blocker such as atenolol (TENORMIN) to
keep the heart rate down.
C. Check the serum creatinine and start dialysis.
D. Check the BP and give fluids and other medication as necessary to keep the BP
up.
P.J. is a 56 year old male who is taking an angiotensin receptor blocker for hypertension. You should teach him to
A. discontinue his medications if he develops a headache.
B. take his medication first thing in the morning to counteract the
sedation.
C. purchase his new prescription 3-4 days before his old prescription runs
out.
D. increase his salt intake to counteract the salt wasting associated with this
drug.
A drug that antagonizes aldosterone would be useful in treating hypertension because it would
A. cause potassium excretion.
B. enhance renin release.
C. block vasoconstriction
D. increase renal excretion of sodium.
Which assessment finding best reflects effective management of hypertension?
A. blood pressure 155/95
B. blood pressure reduced 10%
C. blood pressure less than 130/90
D. increased urinary output with edema reduction
A patient without other cardiac risks has triglycerides 300 mg/dl, HDLs 40 mg/dl and LDLs 150 mg/dl. Which drug (if any) should be given?
A. fenofibrate
B. losartan
C. cholestyramine
D. atorvastatin
John Doe is taking spironolactone (ALDACTONE). You should teach him to
A. take this medication in the evening to avoid sedation.
B. take potassium supplements as this drug lowers potassium levels in the blood.
C. take over the counter medications to reduce hair loss.
D. restrict water intake as this medication causes water retention.
.B. is a 29 yo male with HTN. He takes Hydrochlorothiazide 50 mg and lisinopril 40 mg each day. Current BP is 164/98. You should:
1. Discontinue the ACE inhibitor and add an Angiotensin Receptor Blocker.
2. Increase the ACEi dose.
3. Add a calcium channel blocker.
4. Discontinue the diuretic and add a beta blocker.
Thanks Lily Sok for the additional questions!
Hypertension results from an increase in vascular resistance, and several factors contribute to this. Which of the following would be the MOST POWERFUL way to decrease blood pressure?
A. Decrease the viscosity of the blood
B. Increase the viscosity of the blood
C. Decrease the radius of the vessel
D. Increase the radius of the vessel
Which of the following drugs is most likely to raise serum LDL cholesterol?
A. atorvastatin
B. hydrochlorothiazide
C. Niacin (Vitamin B3)
D. Cholestyramine
S.Q. is a 45 yo diabetic with mild renal disease (creatinine 1.7, normal is 0.6-1.2). She is taking valsartan 320 mg each day, hydrochlorothiazide 50 mg each day, and metoprolol 50 mg twice each day. She has tolerated these drugs without significant side effects. Today her BP is 138/94. You should:
A. Add lisinopril.
B. Increase the metoprolol.
C. Continue the medications as listed.
D. Reduce the valsartan dose.
Which of the following drugs blocks both alpha and beta receptors?
A. carvedilol (COREG)
B. clonidine (CATAPRES) Student Response
C. hydralazine (APRESOLINE) Student Response
D. propranolol (INDEROL) Student Response
All of the following are adverse effects of hydrochlorothiazide (ESIDRIX) EXCEPT
A. dizziness and faintness.
B. hypoglycemia. Student Response
C. high calcium levels.
D. paresthesia.
Diuretics are useful in treating hypertension becasue they
A. decrease preload.
B. increase vessel diameter.
C. block renin release.
D. block angiotensin converting enzyme.
The mechanism of action of furosemide (LASIX) is
A. antagonizing aldoseterone.
B. inhibiting sodium and chloride reabsorption in the loop of Henle.
C. increasing the osmolality of urine, thus increasing urinary output.
D. supressing renin release.
A. Document that the patient failed therapy with Niacin and one of the bile acid
sequestrants (Colestipol or Cholestyramine).
B. Be sure the patient is not pregnant.
C. Teach the patient how to do home blood sugar monitoring and be sure patient has
the equipment.
D. Document normal conductivity through heart with EKG.
Some antihypertensive drugs block both alpha and beta receptors. Why would this be a good thing for someone with hypertension?
A. it causes vasodilation
B. it decreases renin release
C. it increases cardiac output
D. 1, 2 only
E. 1,2,3
The mechanism of action of this drug is dilation of arterioles by a direct effect on vascular smooth muscle.
A. clonidine (CATAPRES)
B. captopril (CAPOTEN)
C. hydralazine (APRESOLINE)
D. atropine
Losartan (COZAAR) is an angiotensin II receptor antagonist which would be expected to have which side effect(s):
A. Hypokalemia (low potassium)
B. Pupil constriction
C. Dizziness
D. Dry mouth
Aldosterone alters blood pressure because it
A. causes potassium excretion.
B. dilates blood vessles.
C. causes sodium retention.
D. enhances renin release.
In acute head injury, the osmotic diuretic mannitol may be given to reduce brain swelling. What potential problem would you need to monitor for?
A. The mannitol prevents electrolytes from being excreted by the
kidney.
B. The blood pressure could drop quickly as fluid is pulled from cells into the
blood stream.
C. Urine output typically drops transiently during the first 4 hours.
D. Over time, if the mannitol diffuses into the brain, it would make the swelling
worse.
All of the following are adverse effects of furosemide (LASIX) EXCEPT
A. high blood potassium levels
B. low blood sodium and chloride levels
C. hypotension
D. hearing loss
Hyperlipidemia drug therapy for a person with existing coronary heart disease should begin when:
A. LDL cholesterol is greater than 100.
B. HDL cholesterol is elevated.
C. The patient has lost 10% of his/her body weight.
D. Blood pressure is under control.
R.J. is a 55 yo male with long standing hypertension who has been treated with Dyazide one capsule each day. On this clinic visit, a urine sample is positive for spilled protein. His BP is 136/82. You should:
A. Discontinue the Dyazide. After 1 week, start captopril 25 mg twice each
day.
B. No drug changes are required. He should have a low protein diet.
C. Increase the Dyazide dose to 2 capsule each day.
D. Add captopril 50 mg three times each day.
P.P. is a 52 yo diabetic AA female who just had a stroke. She has had long term HTN. Current meds are: lisinopril 20 mg each day, labetalol 400 mg twice a day, lasix 20 mg twice each day. Current labs include sodium 138 (normal 135-145) and potassium 3.5 (normal 3.5-5). Her BP is 210/118 and her pulse is 75. You should:
A. Increase the labetalol.
B. Add losartan.
C. Increase the lasix.
D. Increase the lisinopril.
A patient crushed his sustained-release verapamil tablet before ingesting it. Which action would you most likely take?
A. Administer short acting verapamil to keep the heart rate down.
B. Check heart rate and administer a beta-blocker such as atenolol (TENORMIN) to
keep the heart rate down.
C. Check the serum creatinine and start dialysis.
D. Check the BP and give fluids and other medication as necessary to keep the BP
up.
P.J. is a 56 year old male who is taking an angiotensin receptor blocker for hypertension. You should teach him to
A. discontinue his medications if he develops a headache.
B. take his medication first thing in the morning to counteract the
sedation.
C. purchase his new prescription 3-4 days before his old prescription runs
out.
D. increase his salt intake to counteract the salt wasting associated with this
drug.
A drug that antagonizes aldosterone would be useful in treating hypertension because it would
A. cause potassium excretion.
B. enhance renin release.
C. block vasoconstriction
D. increase renal excretion of sodium.
Which assessment finding best reflects effective management of hypertension?
A. blood pressure 155/95
B. blood pressure reduced 10%
C. blood pressure less than 130/90
D. increased urinary output with edema reduction
A patient without other cardiac risks has triglycerides 300 mg/dl, HDLs 40 mg/dl and LDLs 150 mg/dl. Which drug (if any) should be given?
A. fenofibrate
B. losartan
C. cholestyramine
D. atorvastatin
John Doe is taking spironolactone (ALDACTONE). You should teach him to
A. take this medication in the evening to avoid sedation.
B. take potassium supplements as this drug lowers potassium levels in the blood.
C. take over the counter medications to reduce hair loss.
D. restrict water intake as this medication causes water retention.
.B. is a 29 yo male with HTN. He takes Hydrochlorothiazide 50 mg and lisinopril 40 mg each day. Current BP is 164/98. You should:
1. Discontinue the ACE inhibitor and add an Angiotensin Receptor Blocker.
2. Increase the ACEi dose.
3. Add a calcium channel blocker.
4. Discontinue the diuretic and add a beta blocker.
Thanks Lily Sok for the additional questions!
Hypertension results from an increase in vascular resistance, and several factors contribute to this. Which of the following would be the MOST POWERFUL way to decrease blood pressure?
A. Decrease the viscosity of the blood
B. Increase the viscosity of the blood
C. Decrease the radius of the vessel
D. Increase the radius of the vessel
Which of the following drugs is most likely to raise serum LDL cholesterol?
A. atorvastatin
B. hydrochlorothiazide
C. Niacin (Vitamin B3)
D. Cholestyramine
S.Q. is a 45 yo diabetic with mild renal disease (creatinine 1.7, normal is 0.6-1.2). She is taking valsartan 320 mg each day, hydrochlorothiazide 50 mg each day, and metoprolol 50 mg twice each day. She has tolerated these drugs without significant side effects. Today her BP is 138/94. You should:
A. Add lisinopril.
B. Increase the metoprolol.
C. Continue the medications as listed.
D. Reduce the valsartan dose.
Which of the following drugs blocks both alpha and beta receptors?
A. carvedilol (COREG)
B. clonidine (CATAPRES) Student Response
C. hydralazine (APRESOLINE) Student Response
D. propranolol (INDEROL) Student Response
All of the following are adverse effects of hydrochlorothiazide (ESIDRIX) EXCEPT
A. dizziness and faintness.
B. hypoglycemia. Student Response
C. high calcium levels.
D. paresthesia.
Diuretics are useful in treating hypertension becasue they
A. decrease preload.
B. increase vessel diameter.
C. block renin release.
D. block angiotensin converting enzyme.
The mechanism of action of furosemide (LASIX) is
A. antagonizing aldoseterone.
B. inhibiting sodium and chloride reabsorption in the loop of Henle.
C. increasing the osmolality of urine, thus increasing urinary output.
D. supressing renin release.
Wednesday, October 22, 2008
Pre 8 HTN/Lipids
The diuretic furosemide (LASIX), causes:
A. Hypernatremia (high Na+ level in blood)
B. Hyperkalemia (high K+ level in blood)
C. Hypokalemia (low K+ level in blood)
D. Edema and hypertension
Enalapril (VASOTEC) is an example of an antihypertensive medicne from which class?
A. ACE inhibitor
B. Angiotensin II Receptor Antagonist
C. Vasodilator
D. Beta Blocker
Which is the best approach to treating hard to control hypertension?
A. start with one drug at the normal dose and increase the dose until it
works.
B. use the maximum dose of one drug and add a second drug at its maximum
dose.
C. use the maximum dose and add a small amount of an antagonist.
D. start with a low dose of one drug and increase the dose slowly. It it is not
effective change drugs or add a second drug at a low dose.
What lab work should be done to monitor a patient's response to atorvastatin (LIPITOR)?
A. Blood sugar and Hemoglobin A1C
B. Potassium level
C. Total Cholesterol, HDL cholesterol, LDL cholesterol
D. Drug blood levels
A patient has a BP of 138/84. What condition would indicate a need to treat this patient with hypertensive medication?
1. Diabetes
2. High HDL cholesterol level
3. Age over 60 years.
4. Female gender.
Most patients with a blood pressure breater than 160/100 should be treated with:
1. A thiazide diuretic and one drug from another class.
2. Two beta blockers.
3. Lifestyle modification only.
4. A calcium channel blocker and an angiotensin receptor blocker.
All of the following drugs classes are used to treat hypertension EXCEPT
A. alpha-2 agonists
B. beta-2 agonists
C. vasodilators
D. calcium channel blockers
Enalapril (VASOTEC) treats hypertension by
A. Stimulating alpha1 receptors on blood vessels.
B. supressing renal excretion of sodium.
C. depressing contractility of the heart.
D. inhibiting angiotensin converting enzyme.
Additional Questions courtesy of Carissa Galvan, and Lily Sok, Thanks!!!
Teaching for a person taking an ACE inhibitor should include
A. report feelings of faintness to the health care provider.
B. if there is difficulty breathing or hoarsness, go to bed immediately.
C. monitor blood pressure at least once a year.
D. If you had angioedema from prior ACE inhibitor use, take a tylenol prior to taking your ACE inhibitor.
The serious, potentially life-threatening adverse of atorvastatin (LIPITOR), particularly if it is combined with a fibrate is
A. hyperglycemia
B. gastrointestinal bleeding.
C. chest pain.
D. skeletal muscle damage (rhabdomyolysis).
The Angiotensin Converting Enzyme (ACE) Inhibitor, ekanioril (VASOTEC) is associated with which adverse reaction(s) in as many as 1/3 of those who take it?
A. Hypokalemia (low K+ in blood)
B. Paradoxical hypertension
C. Liver failure
D. Cough and rash
A patient has a BP of 138/84. What condition would indicate a need to treat this patient with hypertensive medication?
1. Diabetes
2. High HDL cholesterol level
3. Age over 60 years.
4. Female gender.
A. Hypernatremia (high Na+ level in blood)
B. Hyperkalemia (high K+ level in blood)
C. Hypokalemia (low K+ level in blood)
D. Edema and hypertension
Enalapril (VASOTEC) is an example of an antihypertensive medicne from which class?
A. ACE inhibitor
B. Angiotensin II Receptor Antagonist
C. Vasodilator
D. Beta Blocker
Which is the best approach to treating hard to control hypertension?
A. start with one drug at the normal dose and increase the dose until it
works.
B. use the maximum dose of one drug and add a second drug at its maximum
dose.
C. use the maximum dose and add a small amount of an antagonist.
D. start with a low dose of one drug and increase the dose slowly. It it is not
effective change drugs or add a second drug at a low dose.
What lab work should be done to monitor a patient's response to atorvastatin (LIPITOR)?
A. Blood sugar and Hemoglobin A1C
B. Potassium level
C. Total Cholesterol, HDL cholesterol, LDL cholesterol
D. Drug blood levels
A patient has a BP of 138/84. What condition would indicate a need to treat this patient with hypertensive medication?
1. Diabetes
2. High HDL cholesterol level
3. Age over 60 years.
4. Female gender.
Most patients with a blood pressure breater than 160/100 should be treated with:
1. A thiazide diuretic and one drug from another class.
2. Two beta blockers.
3. Lifestyle modification only.
4. A calcium channel blocker and an angiotensin receptor blocker.
All of the following drugs classes are used to treat hypertension EXCEPT
A. alpha-2 agonists
B. beta-2 agonists
C. vasodilators
D. calcium channel blockers
Enalapril (VASOTEC) treats hypertension by
A. Stimulating alpha1 receptors on blood vessels.
B. supressing renal excretion of sodium.
C. depressing contractility of the heart.
D. inhibiting angiotensin converting enzyme.
Additional Questions courtesy of Carissa Galvan, and Lily Sok, Thanks!!!
Teaching for a person taking an ACE inhibitor should include
A. report feelings of faintness to the health care provider.
B. if there is difficulty breathing or hoarsness, go to bed immediately.
C. monitor blood pressure at least once a year.
D. If you had angioedema from prior ACE inhibitor use, take a tylenol prior to taking your ACE inhibitor.
The serious, potentially life-threatening adverse of atorvastatin (LIPITOR), particularly if it is combined with a fibrate is
A. hyperglycemia
B. gastrointestinal bleeding.
C. chest pain.
D. skeletal muscle damage (rhabdomyolysis).
The Angiotensin Converting Enzyme (ACE) Inhibitor, ekanioril (VASOTEC) is associated with which adverse reaction(s) in as many as 1/3 of those who take it?
A. Hypokalemia (low K+ in blood)
B. Paradoxical hypertension
C. Liver failure
D. Cough and rash
A patient has a BP of 138/84. What condition would indicate a need to treat this patient with hypertensive medication?
1. Diabetes
2. High HDL cholesterol level
3. Age over 60 years.
4. Female gender.
Pre 7 ANS2/CHF
Quiz 7 courtesy of Lily Sok, Jenny Lou, and Carissa Galvan. Thanks you very much ladies, we really appreciate it!!!
Beta-adrenergic blocking agents are used in the management of
A. asthma.
B. cirrhosis.
C. heart failure.
D. pneumonia.
Sympathomimetic drugs are likely to cause which of the following adverse effects?
A. bradycardia
B. tachycardia
C. hypertension
D. hyperglycemia
E. 1, 3, 4 only
F. 2, 3, 4 only
The adverse effects of beta blockers include
A. increased heart rate.
B. hypertension
C. bronchoconstriction.
D. urinary urgency.
A parasympathomimetic drug such as physostigmine (ANTILERIUM) is used to
1. decrease saliva production.
2. decrease motion sickness.
3. treat urinary retention.
4. counteract adverse effects of polocarpine.
Scopolamine may be used to treat motion sickness. Side effects of dry mouth, blurred vision and constipation result from
A. Inhibition of nicotinic receptors.
B. Stimulation of alpha receptors.
C. Inhibition of muscarinic receptors
D. Inhibition of dopamine recpetors
Drugs such as an alpha-1 agonist,that mimic the sympathetic nervous system would cause
A. pupil dilation.
B. decreased heart rate.
C. consriction of airways.
D. diarrhea.
The effects of sympathomimetic drugs include
A. decreased heart rate.
B. decreased blood sugar.
C. bronchoconstriction.
D. urinary retention.
Drug Y is an adrengeric receptor blocker. This means it
1. blocks acetylcholine receptors.
2. blocks nicotinic receptors.
3. simulates dopamine receptors.
4. blocks norepinephrine receptors.
More question courtesy of Corina Kendrick, Thanks!!!
Phenylephrine (NEOSYNEPHRINE)is an alpha-1 agonist. A predictable adverse effect of this drug is
A. hypertension.
B. Myasthenia Gravis.
C. sedation.
D. heart failure.
Which drug is administered parenterally in emergency situations, such as treating acute, liefe-threatening allergic reactions?
A. dobutamine (DOBUTREX)
B. dopamine (INTROPIN)
C. epinephrine (ADRENALIN)
D. norepinephrine (LEVOPHED
Phenylephrine (NEOSYNEPHRINE)is an alpha-1 agonist. This drug would be used to treat
A. hypertension.
B. Myasthenia Gravis.
C. nasal congestion.
D. heart failure.
Beta-adrenergic blocking agents are used in the management of
A. asthma.
B. cirrhosis.
C. heart failure.
D. pneumonia.
Sympathomimetic drugs are likely to cause which of the following adverse effects?
A. bradycardia
B. tachycardia
C. hypertension
D. hyperglycemia
E. 1, 3, 4 only
F. 2, 3, 4 only
The adverse effects of beta blockers include
A. increased heart rate.
B. hypertension
C. bronchoconstriction.
D. urinary urgency.
A parasympathomimetic drug such as physostigmine (ANTILERIUM) is used to
1. decrease saliva production.
2. decrease motion sickness.
3. treat urinary retention.
4. counteract adverse effects of polocarpine.
Scopolamine may be used to treat motion sickness. Side effects of dry mouth, blurred vision and constipation result from
A. Inhibition of nicotinic receptors.
B. Stimulation of alpha receptors.
C. Inhibition of muscarinic receptors
D. Inhibition of dopamine recpetors
Drugs such as an alpha-1 agonist,that mimic the sympathetic nervous system would cause
A. pupil dilation.
B. decreased heart rate.
C. consriction of airways.
D. diarrhea.
The effects of sympathomimetic drugs include
A. decreased heart rate.
B. decreased blood sugar.
C. bronchoconstriction.
D. urinary retention.
Drug Y is an adrengeric receptor blocker. This means it
1. blocks acetylcholine receptors.
2. blocks nicotinic receptors.
3. simulates dopamine receptors.
4. blocks norepinephrine receptors.
More question courtesy of Corina Kendrick, Thanks!!!
Phenylephrine (NEOSYNEPHRINE)is an alpha-1 agonist. A predictable adverse effect of this drug is
A. hypertension.
B. Myasthenia Gravis.
C. sedation.
D. heart failure.
Which drug is administered parenterally in emergency situations, such as treating acute, liefe-threatening allergic reactions?
A. dobutamine (DOBUTREX)
B. dopamine (INTROPIN)
C. epinephrine (ADRENALIN)
D. norepinephrine (LEVOPHED
Phenylephrine (NEOSYNEPHRINE)is an alpha-1 agonist. This drug would be used to treat
A. hypertension.
B. Myasthenia Gravis.
C. nasal congestion.
D. heart failure.
Saturday, October 18, 2008
Post 7 ANS2/CHF
The mechanism of action of atropine is
A. activation of post-synaptic muscarinic receptors.
B. blockade of pre-synaptic alpha receptors.
C. antagonism of acetylcholine binding sites.
D. releasing norepinephrine from nerve endings.
Your patient has high blood pressure and you are considering giving him Beta-adrenergic blocking agents. Which of the following questions should you ask prior to ordering a beta blocker like propranolol (INDERAL)?
A. Do you have asthma?
B. Do you have food intolerances?
C. Do you have a family history of alcholism?
D. Are you allergic to penicillin?
Which of the following drugs would be effective in treating hypertension?
A. albuterol (PROVENTIL)
B. DOBUTamine (DOBUTREX)
C. phenylephrine (NEOSYNEPHRINE)
D. prazosin (MINIPRESS)
You are making a home visit for physical therapy on a patient with a history of hypertension. When you ask if there have been any changes since your last visit, the patient tells you that yesterday the doctor increased the prazosin (MINIPRESS) dose. This alerts you to check for:
A. Anaphylactic allergic reaction.
B. wheezing
C. Hypotension and dizziness when the patient stands up.
D. Muscle spasms and tremors
The patient is in mild to moderate heart failure but is stable and is seen in the outpatient clinic. The heart rate is slightly elevated at 90. BP is normal at 110/70. The patient receives carvedilol (COREG) to:
A. Suppress the action of acetylcholine at muscarinic receptors thereby decreasing heart rate.
B. Activate alpha-2 receptors thereby decreasing SNS outflow from the central nervous system
C. Reduce afterload so the heart doesn't have to work so hard.
D. Stimulate alpha-1 receptors and keep the blood pressure up.
Your patient came in with the following symptoms: fever, flushed dry skin, confusion, blurred vision, and constipation. If you suspect atropine overdose, what should you give this patient?
A. atropine
B. physostigmin (ANTILERIUM)
C. bethanichol
D. pilocarpine
Pseudoephedrine is an alpha agonist added to many over the counter medications to treat:
A. diabetes
B. nasal congestion
C. insomnia
D. diarrhea
If a person has heart failure, the cardiac output is lower than is needed for adequate tissue blood flow. How would you improve cardiac output in a person who has lung congestion, jugular vein distention, tachycardia, and ankle edema?
A. decrease afterload.
B. increase increase preload.
C. increase heart work.
Drugs that improve morbidity and mortality in heart failure include:
A. Digoxin
B. Phenytoin (Dilantin)
C. Calcium channel blockers such as diltiazem (CARDIZEM)
D. The beta blocker carvedilol
A patient taking spironolactone (ALDACTONE) should be taught about adverse effects such as
A. alkalosis (high pH).
B. high potassium levels in the blood.
C. nausea.
D. constipation.
The mechanism of action of a direct acting beta agonist is
A. activation of post-synaptic receptors.
B. blockade of pre-synaptic receptors.
C. antagonism of acetylcholine binding sites.
D. releasing norepinephrine from nerve endings.
Beta-adrenergic blocking agents are used in the management of
A. asthma.
B. cirrhosis.
C. heart failure.
D. pneumonia.
A pregnant asthmatic patient leaves home for the birth clinic with the contractions are 10 minutes apart. She takes a dose of albuterol (PROVENTIL) before leaving home. What effect would you anticipate the albuterol would have?
A. Labor will be slowed as B-2 agonists relax the uterus and dilate the airways.
B. The fetus may undergo oxygen loss due to vasoconstriction associated with SNS activation.
C. The blood sugar may drop suddenly.
D. All of the above.
Propranolol (INDERAL) adverse effects include all of the following EXCEPT
A. bronchoconstriction.
B. hypertension.
C. impotence.
D. fatigue.
Drugs that improve morbidity and mortality in heart failure include:
A. Digoxin
B. Potassium supplements
C. Calcium channel blockers
D. ACE inhibitors
Patients who have NYHA class III heart failure should be taking
1. beta 2 adrenergics such as albuterol
2. non-selective beta blockers such as carvedilol.
3. peripheral alpha blockers such as prazocin
4. angiotensin converting enzymes such as angiotensin
Thanks Carissa for these additional questions!!
The mechanism of action of amphetamines is
A. interaction with post-synaptic receptors.
B. blockade of pre-ganglionic nicotinic receptors.
C. antagonism of acetylcholine binding sites.
D. releasing norepinephrine from nerve endings.
Which of the following drug classes produces the desired pharmacological effects by interacting with presynaptic receptors to reduce SNS outflow from the CNS?
A. alpha 1 agonists
B. alpha 2 agonists
C. beta 1 agonists
D. beta 2 agonists
Thanks Lily for the additional questions.
Drugs that improve morbidity and mortality in heart failure include:
A. Digoxin
B. Potassium supplements
C. ACE inhibitors Student Response
D. Calcium channel blockers
Atropine has which pharmacological property?
A. dilation of pupil
B. excessive sweating
C. decreased heart rate
D. increased GI motility
A. activation of post-synaptic muscarinic receptors.
B. blockade of pre-synaptic alpha receptors.
C. antagonism of acetylcholine binding sites.
D. releasing norepinephrine from nerve endings.
Your patient has high blood pressure and you are considering giving him Beta-adrenergic blocking agents. Which of the following questions should you ask prior to ordering a beta blocker like propranolol (INDERAL)?
A. Do you have asthma?
B. Do you have food intolerances?
C. Do you have a family history of alcholism?
D. Are you allergic to penicillin?
Which of the following drugs would be effective in treating hypertension?
A. albuterol (PROVENTIL)
B. DOBUTamine (DOBUTREX)
C. phenylephrine (NEOSYNEPHRINE)
D. prazosin (MINIPRESS)
You are making a home visit for physical therapy on a patient with a history of hypertension. When you ask if there have been any changes since your last visit, the patient tells you that yesterday the doctor increased the prazosin (MINIPRESS) dose. This alerts you to check for:
A. Anaphylactic allergic reaction.
B. wheezing
C. Hypotension and dizziness when the patient stands up.
D. Muscle spasms and tremors
The patient is in mild to moderate heart failure but is stable and is seen in the outpatient clinic. The heart rate is slightly elevated at 90. BP is normal at 110/70. The patient receives carvedilol (COREG) to:
A. Suppress the action of acetylcholine at muscarinic receptors thereby decreasing heart rate.
B. Activate alpha-2 receptors thereby decreasing SNS outflow from the central nervous system
C. Reduce afterload so the heart doesn't have to work so hard.
D. Stimulate alpha-1 receptors and keep the blood pressure up.
Your patient came in with the following symptoms: fever, flushed dry skin, confusion, blurred vision, and constipation. If you suspect atropine overdose, what should you give this patient?
A. atropine
B. physostigmin (ANTILERIUM)
C. bethanichol
D. pilocarpine
Pseudoephedrine is an alpha agonist added to many over the counter medications to treat:
A. diabetes
B. nasal congestion
C. insomnia
D. diarrhea
If a person has heart failure, the cardiac output is lower than is needed for adequate tissue blood flow. How would you improve cardiac output in a person who has lung congestion, jugular vein distention, tachycardia, and ankle edema?
A. decrease afterload.
B. increase increase preload.
C. increase heart work.
Drugs that improve morbidity and mortality in heart failure include:
A. Digoxin
B. Phenytoin (Dilantin)
C. Calcium channel blockers such as diltiazem (CARDIZEM)
D. The beta blocker carvedilol
A patient taking spironolactone (ALDACTONE) should be taught about adverse effects such as
A. alkalosis (high pH).
B. high potassium levels in the blood.
C. nausea.
D. constipation.
The mechanism of action of a direct acting beta agonist is
A. activation of post-synaptic receptors.
B. blockade of pre-synaptic receptors.
C. antagonism of acetylcholine binding sites.
D. releasing norepinephrine from nerve endings.
Beta-adrenergic blocking agents are used in the management of
A. asthma.
B. cirrhosis.
C. heart failure.
D. pneumonia.
A pregnant asthmatic patient leaves home for the birth clinic with the contractions are 10 minutes apart. She takes a dose of albuterol (PROVENTIL) before leaving home. What effect would you anticipate the albuterol would have?
A. Labor will be slowed as B-2 agonists relax the uterus and dilate the airways.
B. The fetus may undergo oxygen loss due to vasoconstriction associated with SNS activation.
C. The blood sugar may drop suddenly.
D. All of the above.
Propranolol (INDERAL) adverse effects include all of the following EXCEPT
A. bronchoconstriction.
B. hypertension.
C. impotence.
D. fatigue.
Drugs that improve morbidity and mortality in heart failure include:
A. Digoxin
B. Potassium supplements
C. Calcium channel blockers
D. ACE inhibitors
Patients who have NYHA class III heart failure should be taking
1. beta 2 adrenergics such as albuterol
2. non-selective beta blockers such as carvedilol.
3. peripheral alpha blockers such as prazocin
4. angiotensin converting enzymes such as angiotensin
Thanks Carissa for these additional questions!!
The mechanism of action of amphetamines is
A. interaction with post-synaptic receptors.
B. blockade of pre-ganglionic nicotinic receptors.
C. antagonism of acetylcholine binding sites.
D. releasing norepinephrine from nerve endings.
Which of the following drug classes produces the desired pharmacological effects by interacting with presynaptic receptors to reduce SNS outflow from the CNS?
A. alpha 1 agonists
B. alpha 2 agonists
C. beta 1 agonists
D. beta 2 agonists
Thanks Lily for the additional questions.
Drugs that improve morbidity and mortality in heart failure include:
A. Digoxin
B. Potassium supplements
C. ACE inhibitors Student Response
D. Calcium channel blockers
Atropine has which pharmacological property?
A. dilation of pupil
B. excessive sweating
C. decreased heart rate
D. increased GI motility
Monday, October 13, 2008
Post 6 ANS 1
The antidote for atropine poisoning is
A. bethanechol (URECHOLINE)
B. phenytoin (DILANTIN)
C. physostigmine (ANTILIRIUM)
D. propranolol (INDERAL)
The antidote for overdose with a parasympathomimetic drug is:
A. atropine.
B. physostigmine (ANTILIRIUM).
C. edrophonium chloride (TENSILON)
D. propranolol (INDERAL)
Mr. Jones is a 75 year old man who was admitted to the hospital because he fainted at home. His heart rate was only 40 and his BP was low. He is given atropine. What side effects do you need to observe for?
A. Urinary retention
B. Diarrhea
C. Diaphoresis (sweating)
D. Heart block or other very slow heart rate
Extravasation of an alpha1 agonist (such as epinephrine) into the tissue surrounding a vein (or infused accidentally into an artery) can cause such severe vasoconstriction as to cut off blood supply and cause death of the tissue. What drug could be given to block this vasocontriction?
A. Phentolamine
B. Clonidine
C. Atenolol
D. Ephedra
Your patient came in with the following symptoms: fever, flushed dry skin, confusion, blurred vision, and constipation. If you suspect atropine overdose, what should you give this patient?
A. atropine
B. physostigmin (ANTILERIUM)
C. bethanichol
D. pilocarpine
Which of the following is a predictable adverse effect of clonidine (CATAPRES), an alpha-2 agonist?
A. insomnia
B. hypotension and dizziness.
C. diarrhea
D. bronchospasm
Atropine has which pharmacological property?
A. constriction of pupil
B. excessive sweating
C. increased blood sugar
D. constipation and decreased GI motility
Knowing herself to be prone to motion sickness, before her trip to the mountains, Dizzy Lizzy places a transdermal scopolamine patch behind her ear. The transdermal application will allow blockage of the muscarinic receptors in the pathway from the inner ear to the vomiting center of the brain. Although fairly selective for these receptors, there is some action at other muscarinic sites resulting in side effects of:
A. dry skin and mouth
B. diarrhea and uterine cramping
C. CNS stimulation: insomnia and seizures
D. bradycardia and urinary frequency
For many years, patients with psychosis were treated with phenothiazines like chlorproMAZINE (Thorazine). Troubling side effects included anticholinergic problems such as:
A. Constipation
B. Insomnia
C. Urinary frequency
D. Hypertension
A patient developed urinary retention after surgery. She was prescribed bethanechol (UROCHOLINE). Why is it important that nothing be obstructing the urethra?
A. The drug works by stimulating receptor sites on the urethra. Obstruction
prevents this stimulation.
B. Obstruction increases the risk of incontinence from this drug.
C. Skeletal muscles must first be in the relaxed state to allow this drug to
work.
D. Bladder contraction against an obstruction could cause backflow of urine
into the kidneys.
K. Samuels was admitted to the emergency department with the following symptoms: excessive saliva production, copious tear production, frequent urination, diarrhea, anxiety, and hypotension. K. Samuels' symptoms are characteristic of __________ drug overdose.
A. parasympathomimetic/cholinergic
B. sympathomimetic/adrengergic
C. parasympatholytic
D. sympatholytic
Mr. Jones is a 75 year old man who was admitted to the hospital because he fainted at home. His heart rate was only 40 and his BP was low. What drug should be given?
A. The alpha-2 agonist clonidine.
B. The parasympathomimetic drug neostigmine.
C. The anticholinergic drug atopine.
D. The beta-2 agonist albuterol
Phenylephrine (NEOSYNEPHRINE)is an alpha-1 agonist. A predictable adverse effect of this drug is
A. hypertension.
B. Myasthenia Gravis.
C. sedation.
D. heart failure.
Which of the following drug classes produces the desired pharmacological effects by interacting with presynaptic receptors to reduce SNS outflow from the CNS?
A. alpha 1 agonists
B. alpha 2 agonists
C. beta 1 agonists
D. beta 2 agonists
Atropine has which pharmacological effect?
A. dilation of pupil
B. excessive sweating
C. decreased heart rate
D. increased GI motility
For many years, patients with psychosis were treated with phenothiazines like chlorproMAZINE (Thorazine). Troubling side effects included anticholinergic problems such as:
A. Hypertension
B. Diarrhea
C. Urinary retention
D. Cough
A patient developed urinary retention after surgery. She was prescribed bethanechol (UROCHOLINE). Adverse effects of this drug include:
A. abdominal cramps, hypotension, excess salivation
B. Pupil dilation, tachycardia, constipation
C. Dry as a bone, red as a beet, blind as a bat, hot as a furnance, mad as a
hatter
D. Hypertension, tachycardia, increased urine output,
hyperglycemia
A patient receives atropine preoperatively. Why?
A. To prevent them from having to urinate during the surgery.
B. To decrease respiratory secretions and keep heart rate up.
C. To temporarily paralyze muscles so the patient holds still.
D. To prevent infection.
F. Ames presented with the following symptoms: dry skin, facial flushing, visual problems, elevated temperature, confusion, tachycardia, urinary retention, and constipation. Which of the following drugs should be administered?
A. phentolamine (REGITINE)
B. physostigmine (ANTILERIUM)
C. atropine
D. propranolol (INDEROL)
6.
Which of the following is a predictable adverse effect of clonidine (CATAPRES), an alpha-2 agonist?
A. drowsiness
B. hypertension
C. diarrhea
D. bronchospasm
Edrophonium (Tensilon) is a short-acting AchE inhibitor used to diagnose myasthenia gravis. In a patient with MG, this drug should:
A. Relax muscle spasm.
B. Raise the blood pressure.
C. Improve muscle strength.
D. Increase heart rate.
A. bethanechol (URECHOLINE)
B. phenytoin (DILANTIN)
C. physostigmine (ANTILIRIUM)
D. propranolol (INDERAL)
The antidote for overdose with a parasympathomimetic drug is:
A. atropine.
B. physostigmine (ANTILIRIUM).
C. edrophonium chloride (TENSILON)
D. propranolol (INDERAL)
Mr. Jones is a 75 year old man who was admitted to the hospital because he fainted at home. His heart rate was only 40 and his BP was low. He is given atropine. What side effects do you need to observe for?
A. Urinary retention
B. Diarrhea
C. Diaphoresis (sweating)
D. Heart block or other very slow heart rate
Extravasation of an alpha1 agonist (such as epinephrine) into the tissue surrounding a vein (or infused accidentally into an artery) can cause such severe vasoconstriction as to cut off blood supply and cause death of the tissue. What drug could be given to block this vasocontriction?
A. Phentolamine
B. Clonidine
C. Atenolol
D. Ephedra
Your patient came in with the following symptoms: fever, flushed dry skin, confusion, blurred vision, and constipation. If you suspect atropine overdose, what should you give this patient?
A. atropine
B. physostigmin (ANTILERIUM)
C. bethanichol
D. pilocarpine
Which of the following is a predictable adverse effect of clonidine (CATAPRES), an alpha-2 agonist?
A. insomnia
B. hypotension and dizziness.
C. diarrhea
D. bronchospasm
Atropine has which pharmacological property?
A. constriction of pupil
B. excessive sweating
C. increased blood sugar
D. constipation and decreased GI motility
Knowing herself to be prone to motion sickness, before her trip to the mountains, Dizzy Lizzy places a transdermal scopolamine patch behind her ear. The transdermal application will allow blockage of the muscarinic receptors in the pathway from the inner ear to the vomiting center of the brain. Although fairly selective for these receptors, there is some action at other muscarinic sites resulting in side effects of:
A. dry skin and mouth
B. diarrhea and uterine cramping
C. CNS stimulation: insomnia and seizures
D. bradycardia and urinary frequency
For many years, patients with psychosis were treated with phenothiazines like chlorproMAZINE (Thorazine). Troubling side effects included anticholinergic problems such as:
A. Constipation
B. Insomnia
C. Urinary frequency
D. Hypertension
A patient developed urinary retention after surgery. She was prescribed bethanechol (UROCHOLINE). Why is it important that nothing be obstructing the urethra?
A. The drug works by stimulating receptor sites on the urethra. Obstruction
prevents this stimulation.
B. Obstruction increases the risk of incontinence from this drug.
C. Skeletal muscles must first be in the relaxed state to allow this drug to
work.
D. Bladder contraction against an obstruction could cause backflow of urine
into the kidneys.
K. Samuels was admitted to the emergency department with the following symptoms: excessive saliva production, copious tear production, frequent urination, diarrhea, anxiety, and hypotension. K. Samuels' symptoms are characteristic of __________ drug overdose.
A. parasympathomimetic/cholinergic
B. sympathomimetic/adrengergic
C. parasympatholytic
D. sympatholytic
Mr. Jones is a 75 year old man who was admitted to the hospital because he fainted at home. His heart rate was only 40 and his BP was low. What drug should be given?
A. The alpha-2 agonist clonidine.
B. The parasympathomimetic drug neostigmine.
C. The anticholinergic drug atopine.
D. The beta-2 agonist albuterol
Phenylephrine (NEOSYNEPHRINE)is an alpha-1 agonist. A predictable adverse effect of this drug is
A. hypertension.
B. Myasthenia Gravis.
C. sedation.
D. heart failure.
Which of the following drug classes produces the desired pharmacological effects by interacting with presynaptic receptors to reduce SNS outflow from the CNS?
A. alpha 1 agonists
B. alpha 2 agonists
C. beta 1 agonists
D. beta 2 agonists
Atropine has which pharmacological effect?
A. dilation of pupil
B. excessive sweating
C. decreased heart rate
D. increased GI motility
For many years, patients with psychosis were treated with phenothiazines like chlorproMAZINE (Thorazine). Troubling side effects included anticholinergic problems such as:
A. Hypertension
B. Diarrhea
C. Urinary retention
D. Cough
A patient developed urinary retention after surgery. She was prescribed bethanechol (UROCHOLINE). Adverse effects of this drug include:
A. abdominal cramps, hypotension, excess salivation
B. Pupil dilation, tachycardia, constipation
C. Dry as a bone, red as a beet, blind as a bat, hot as a furnance, mad as a
hatter
D. Hypertension, tachycardia, increased urine output,
hyperglycemia
A patient receives atropine preoperatively. Why?
A. To prevent them from having to urinate during the surgery.
B. To decrease respiratory secretions and keep heart rate up.
C. To temporarily paralyze muscles so the patient holds still.
D. To prevent infection.
F. Ames presented with the following symptoms: dry skin, facial flushing, visual problems, elevated temperature, confusion, tachycardia, urinary retention, and constipation. Which of the following drugs should be administered?
A. phentolamine (REGITINE)
B. physostigmine (ANTILERIUM)
C. atropine
D. propranolol (INDEROL)
6.
Which of the following is a predictable adverse effect of clonidine (CATAPRES), an alpha-2 agonist?
A. drowsiness
B. hypertension
C. diarrhea
D. bronchospasm
Edrophonium (Tensilon) is a short-acting AchE inhibitor used to diagnose myasthenia gravis. In a patient with MG, this drug should:
A. Relax muscle spasm.
B. Raise the blood pressure.
C. Improve muscle strength.
D. Increase heart rate.
Monday, October 6, 2008
Pre 6 ANS 1
Which of the following components of the nervous system has a short preganglionic fiber, and long post-ganglionic fiber?
A. ANS
B. Parasympathetic Nervous System
C. Sympathetic Nervous System
D. Somatic Nervous System
The neurotransmitter at adrenergic nerve endings is
A. acetylcholine.
B. norepinephrine.
The neurotransmitter at SNS ganglia is
A. acteylcholine.
B. dopamine.
C. norepinephrine.
D. substance P.
The recptor types occupied by norepinephrine include
A. alpha.
B. beta.
C. muscarinic.
D. nicotinic.
E. 1 and 2
Your patient is scheduled for a dilated eye exam. She is given atropine-like eye drops to dilate the pupils. You should teach her to
1. avoid driving and hazardous activities until she regains ability to focus.
2. take her heart rate every hour for two days.
3. suck on ice chips to ensure hydration.
4. take a laxative for the next two days to prevent constipation.
Which of the following components of the nervous system is specifically responsible for "fight or flight" responses?
A. ANS
B. Parasympathetic Nervous System
C. Sympathetic Nervous System
D. Somatic Nervous System
The neurotransmitter at cholinergic nerve endings is
A. acetylcholine.
B. norepinephrine.
The neurotransmitter at PNS ganglia is
A. acteylcholine.
B. dopamine.
C. norepinephrine.
D. substance P.
The recptor types occupied by acetylcholine include
A. alpha.
B. beta.
C. muscarinic.
D. nicotinic.
E. 3 and 4
Thanks Lily for the extra questions, we appreciate it!!!
Which of the following components of the nervous system is specifically responsible for vegitative, resting functions?
A. ANS
B. Parasympathetic Nervous System
C. Sympathetic Nervous System
D. Somatic Nervous System
5.
Norepinephrine is inactivated by MAO and COMT. What do you expect would happen if you blocked these two enzymes?
A. less SNS activity
B. more SNS activity
C. nothing would happen as there are other ways to break down norepinephrine.
The recptor types occupied by norepinephrine include
A. alpha.
B. beta.
C. muscarinic.
D. nicotinic.
E. 1 and 2
A. ANS
B. Parasympathetic Nervous System
C. Sympathetic Nervous System
D. Somatic Nervous System
The neurotransmitter at adrenergic nerve endings is
A. acetylcholine.
B. norepinephrine.
The neurotransmitter at SNS ganglia is
A. acteylcholine.
B. dopamine.
C. norepinephrine.
D. substance P.
The recptor types occupied by norepinephrine include
A. alpha.
B. beta.
C. muscarinic.
D. nicotinic.
E. 1 and 2
Your patient is scheduled for a dilated eye exam. She is given atropine-like eye drops to dilate the pupils. You should teach her to
1. avoid driving and hazardous activities until she regains ability to focus.
2. take her heart rate every hour for two days.
3. suck on ice chips to ensure hydration.
4. take a laxative for the next two days to prevent constipation.
Which of the following components of the nervous system is specifically responsible for "fight or flight" responses?
A. ANS
B. Parasympathetic Nervous System
C. Sympathetic Nervous System
D. Somatic Nervous System
The neurotransmitter at cholinergic nerve endings is
A. acetylcholine.
B. norepinephrine.
The neurotransmitter at PNS ganglia is
A. acteylcholine.
B. dopamine.
C. norepinephrine.
D. substance P.
The recptor types occupied by acetylcholine include
A. alpha.
B. beta.
C. muscarinic.
D. nicotinic.
E. 3 and 4
Thanks Lily for the extra questions, we appreciate it!!!
Which of the following components of the nervous system is specifically responsible for vegitative, resting functions?
A. ANS
B. Parasympathetic Nervous System
C. Sympathetic Nervous System
D. Somatic Nervous System
5.
Norepinephrine is inactivated by MAO and COMT. What do you expect would happen if you blocked these two enzymes?
A. less SNS activity
B. more SNS activity
C. nothing would happen as there are other ways to break down norepinephrine.
The recptor types occupied by norepinephrine include
A. alpha.
B. beta.
C. muscarinic.
D. nicotinic.
E. 1 and 2
Post 5 Vac/Coag
Common side effects from vaccines include
A. slight fever and pain at the injection site.
B. seizures.
C. generalized pain.
D. vomiting.
A patient complained of weakness on one side of the body and had trouble speaking. They are seen 30 minutes later in the ER. Brain scan confirms a non-hemorragic stoke. What drug would be the most likely choice in the Emergency Room to restore blood flow to the brain?
A. Tissue Plasminogen Activator (TPA)
B. Coumadin (WARFARIN)
C. Heparin
D. Atorvastatin (LIPITOR)
One day after knee surgery, a patient is started on both heparin and coumadin. The rationale for doing this is:
A. Heparin works right away and provides anticoagulation until the coumadin starts working a few days later.
B. Coumadin works right away and provides anticoagulation until the heparin starts working a few days later.
C. Coumadin will reduce the risk of bleeding from the heparin.
D. Heparin will reduce the risk of bleeding from the coumadin.
A patient taking clopidogrel (Plavix) should have which lab test done to monitor for adverse effects?
A. INR
B. aPTT
C. Hematocrit
D. Platelet
Your 80 year old patient tells you he takes the herb ginko to "improve his aging memory". You are alert to the potential for drug interaction with which of his other medications?
A. digoxin
B. furosemide (LASIX)
C. potassium
D. warfarin (COUMADIN)
Which of the following is an example of passive immunization?
A. An elderly patient receives an influenza vaccination every year which causes the person to produce antibodies against influenza virus.
B. A child receives the inactivated polio vaccine instead of the live attenuated form.
C. An unborn baby receives antibodies from the mom across the placenta.
D. The World Health Organization uses oral polio vaccine rather than one that is injected with a needle.
Which of the following is an example of active immunization?
A. An elderly patient receives an influenza vaccination every year which causes the person to produce antibodies against influenza virus.
B. An infant receives respiratory syncytial virus intravenous immune globulin (RespiGam) every month during winter and spring.
C. An unborn baby receives antibodies from the mom across the placenta.
D. A person receives rabies immune globulin after being bitten by an infected animal.
A healthy, low-risk child who has received all scheduled immunization comes in for a 5 year old, preschool check up. What immunizations will be given?
A. Boosters for DTaP, IPV, varicella and MMR
B. New immunization series for MMR and Varicella
C. New immunization series for H. Influenza, polio, and pneumococcal
D. Boosters for Hepatitis B and tetanus
A healthy 47 year old who lives with his healthy wife and works in a library, should receive which vaccination?
A. pneumococcal pneumonia if not received within the last 5 years
B. zoster if antibody titer to chickenpox is low
C. influenza if not received within the within the last 10 years
D. tetanus toxoid if not received within the last 10 years
One of your friends tells you that giving a child multiple vaccinations for different diseases at the same time increases the risk of harmful side effects and can overload the immune system. Your response to this friend should be:
A. You are correct, but only for infants. Very young children (<1 year) cannot make antibodies against more than one antigen at a time.
B. You are correct, but only for older children. Children 6-12 years of age understand the concept of getting a shot to prevent an infection. Psychologically, they do better with one shot for one disease for one visit.
C. You are correct but only for adolescents. It is not until puberty that vaccine boosters work better when separated from other vaccines by at least one month..
D. There have been many studies showing vaccine efficacy when given in combination. Parents save time and money with fewer office visits, which might improve compliance. Kids prefer fewer trips to the clinic and fewer shots too.
Lab tests are done to monitor anticoagulant dosing. For which patient would you hold the heparin?
A. The aPTT is 100 (normal is 25-40 seconds)
B. The INR is 1.8 (normal is 1)
C. The aPTT is 20 (normal is 25-40 seconds).
D. The INR is 0.8 (normal is 1)
A 56 yo female (whose last pertussis vaccination was as a child), has a 3 yo child with whooping cough. She asks about spread of infection to herself and her 4 yo son who has received the following vaccinations: 1 MMR, 4 Hib, 3 hepB, 3 IPV and 4 DTaP. You should respond:
1. Your son should be ok, but watch for onset of persistant cough in yourself.
2. You and your son should both get boosters.
3. You and your 4 yo should be protected, but do wash your hands well after caring for your younger child.
4. You should be ok, but your 4 yo should receive pneumococcal conjugated vaccine.
At the 2 month checkup, an infant should receive (along with other vaccines not listed):
A. Measles
B. Rotavirus
C. dTP
D. Hepatitis A
Thanks Lily for the additional questions!!!
A 60 year old male has risk factors for a myocardial infarction (heart attack) because he smokes, has high blood pressure and has several family members who had heart attacks. What drug should be given to prevent a heart attack?
A. Tissue Plasminogen Activator (TPA)
B. Coumadin (WARFARIN)
C. Heparin
D. Aspirin
7.
Your 65 year old patient has chronic atrial fibrillation of the heart and is at risk for throwing a blood clot to the brain. What drug would be the best choice to prevent blood clot development in this patient?
A. Tissue Plasminogen Activator (TPA)
B. Coumadin (WARFARIN)
C. Heparin
D. Atorvastatin (LIPITOR)
8.
Lab tests are done to monitor anticoagulant dosing. For which patient would you hold the coumadin?
A. The aPTT is 30 (normal is 25-40 seconds).
B. The aPTT is 60 (normal is 25-40 seconds)
C. The INR is 0.8 (normal is 1)
D. The INR is 5 (normal is 1)
An elderly person residing in a skilled nursing facility needs:
A. Tetanus and diptheria toxoids every 10 years.
B. Human Papilloma virus once at age 70.
C. Varicella if the titer of antibodies is high
D. Meningococcocal once at age 80
A. slight fever and pain at the injection site.
B. seizures.
C. generalized pain.
D. vomiting.
A patient complained of weakness on one side of the body and had trouble speaking. They are seen 30 minutes later in the ER. Brain scan confirms a non-hemorragic stoke. What drug would be the most likely choice in the Emergency Room to restore blood flow to the brain?
A. Tissue Plasminogen Activator (TPA)
B. Coumadin (WARFARIN)
C. Heparin
D. Atorvastatin (LIPITOR)
One day after knee surgery, a patient is started on both heparin and coumadin. The rationale for doing this is:
A. Heparin works right away and provides anticoagulation until the coumadin starts working a few days later.
B. Coumadin works right away and provides anticoagulation until the heparin starts working a few days later.
C. Coumadin will reduce the risk of bleeding from the heparin.
D. Heparin will reduce the risk of bleeding from the coumadin.
A patient taking clopidogrel (Plavix) should have which lab test done to monitor for adverse effects?
A. INR
B. aPTT
C. Hematocrit
D. Platelet
Your 80 year old patient tells you he takes the herb ginko to "improve his aging memory". You are alert to the potential for drug interaction with which of his other medications?
A. digoxin
B. furosemide (LASIX)
C. potassium
D. warfarin (COUMADIN)
Which of the following is an example of passive immunization?
A. An elderly patient receives an influenza vaccination every year which causes the person to produce antibodies against influenza virus.
B. A child receives the inactivated polio vaccine instead of the live attenuated form.
C. An unborn baby receives antibodies from the mom across the placenta.
D. The World Health Organization uses oral polio vaccine rather than one that is injected with a needle.
Which of the following is an example of active immunization?
A. An elderly patient receives an influenza vaccination every year which causes the person to produce antibodies against influenza virus.
B. An infant receives respiratory syncytial virus intravenous immune globulin (RespiGam) every month during winter and spring.
C. An unborn baby receives antibodies from the mom across the placenta.
D. A person receives rabies immune globulin after being bitten by an infected animal.
A healthy, low-risk child who has received all scheduled immunization comes in for a 5 year old, preschool check up. What immunizations will be given?
A. Boosters for DTaP, IPV, varicella and MMR
B. New immunization series for MMR and Varicella
C. New immunization series for H. Influenza, polio, and pneumococcal
D. Boosters for Hepatitis B and tetanus
A healthy 47 year old who lives with his healthy wife and works in a library, should receive which vaccination?
A. pneumococcal pneumonia if not received within the last 5 years
B. zoster if antibody titer to chickenpox is low
C. influenza if not received within the within the last 10 years
D. tetanus toxoid if not received within the last 10 years
One of your friends tells you that giving a child multiple vaccinations for different diseases at the same time increases the risk of harmful side effects and can overload the immune system. Your response to this friend should be:
A. You are correct, but only for infants. Very young children (<1 year) cannot make antibodies against more than one antigen at a time.
B. You are correct, but only for older children. Children 6-12 years of age understand the concept of getting a shot to prevent an infection. Psychologically, they do better with one shot for one disease for one visit.
C. You are correct but only for adolescents. It is not until puberty that vaccine boosters work better when separated from other vaccines by at least one month..
D. There have been many studies showing vaccine efficacy when given in combination. Parents save time and money with fewer office visits, which might improve compliance. Kids prefer fewer trips to the clinic and fewer shots too.
Lab tests are done to monitor anticoagulant dosing. For which patient would you hold the heparin?
A. The aPTT is 100 (normal is 25-40 seconds)
B. The INR is 1.8 (normal is 1)
C. The aPTT is 20 (normal is 25-40 seconds).
D. The INR is 0.8 (normal is 1)
A 56 yo female (whose last pertussis vaccination was as a child), has a 3 yo child with whooping cough. She asks about spread of infection to herself and her 4 yo son who has received the following vaccinations: 1 MMR, 4 Hib, 3 hepB, 3 IPV and 4 DTaP. You should respond:
1. Your son should be ok, but watch for onset of persistant cough in yourself.
2. You and your son should both get boosters.
3. You and your 4 yo should be protected, but do wash your hands well after caring for your younger child.
4. You should be ok, but your 4 yo should receive pneumococcal conjugated vaccine.
At the 2 month checkup, an infant should receive (along with other vaccines not listed):
A. Measles
B. Rotavirus
C. dTP
D. Hepatitis A
Thanks Lily for the additional questions!!!
A 60 year old male has risk factors for a myocardial infarction (heart attack) because he smokes, has high blood pressure and has several family members who had heart attacks. What drug should be given to prevent a heart attack?
A. Tissue Plasminogen Activator (TPA)
B. Coumadin (WARFARIN)
C. Heparin
D. Aspirin
7.
Your 65 year old patient has chronic atrial fibrillation of the heart and is at risk for throwing a blood clot to the brain. What drug would be the best choice to prevent blood clot development in this patient?
A. Tissue Plasminogen Activator (TPA)
B. Coumadin (WARFARIN)
C. Heparin
D. Atorvastatin (LIPITOR)
8.
Lab tests are done to monitor anticoagulant dosing. For which patient would you hold the coumadin?
A. The aPTT is 30 (normal is 25-40 seconds).
B. The aPTT is 60 (normal is 25-40 seconds)
C. The INR is 0.8 (normal is 1)
D. The INR is 5 (normal is 1)
An elderly person residing in a skilled nursing facility needs:
A. Tetanus and diptheria toxoids every 10 years.
B. Human Papilloma virus once at age 70.
C. Varicella if the titer of antibodies is high
D. Meningococcocal once at age 80
Tuesday, September 30, 2008
Pre 5 Vacc/Coag
Courtesy of Sean Knight (Thanks!!) since I haven't done mine yet.
The antidote for heparin (LIQUAEMIN) is
A. aminocaproic acid (AMICAR).
B. acetylsalacylic acid (ASPIRIN).
C. protamine sulfate.
D. vitamin K.
Warfarin (COUMADIN)is an anaticoagulant that reaches therapeutic levels in:
A. minutes.
B. hours.
C. days.
D. weeks.
The effectiveness of a vaccine can be measured by:
A. Measuring the level of the vaccination in the blood.
B. Giving a small test booster dose of the vaccination.
C. Measuring the amount of antibody in the blood
D. Giving a large test booster dose of the vaccination
An infant who has received all scheduled immunization comes in for a 1 year check up. What new immunizations will be given?
A. Diptheria, Tetanus, Pertussis
B. Hepatitis A and B
C. Measles, Mumps, Rubella, Varicella
D. H. Influenza, polio, and pneumococcal
The main side effect of all anticoagulants is:
A. bleeding.
B. white blood cell clotting.
C. excessive red blood cell production.
D. activation of the clotting cascade.
Additional Questions from my quiz
A patient has a thrombus in a vein and requires immediate anticoagulation. This best drug to use for this is:
A. Warfarin (COUMADIN).
B. Protamine sulfate.
C. Vitamin K.
D. Heparin (LIQUAEMIN).
The antidote for warfarin sodium (COUMADIN)is
A. aminocaproic acid (AMICAR).
B. acetylsalacylic acid (ASPIRIN).
C. protamine sulfate.
D. vitamin K.
A patient has a thrombus in a vein and requires immediate anticoagulation. This best drug to use for this is:
A. Warfarin (COUMADIN).
B. Protamine sulfate.
C. Vitamin K.
D. Heparin (LIQUAEMIN).
At 3 months old, which vaccinations should have been given?
A. measles, mumps, rubella, haemophilus influenza
B. diphtheria, tetanus, pertussis, haemophilus influenza, Hepatitis B, polio
C. varicellar, haemolphilus influenza, measles, mumps
D. hepatitis A and B, diptheria, varicella
A predictable side effect of either heparin (LIQUAEMIN) or warfarin (COUMADIN)is:
A. bronchospasm.
B. hypertension.
C. bleeding.
D. fatigue.
The antidote for heparin (LIQUAEMIN) is
A. aminocaproic acid (AMICAR).
B. acetylsalacylic acid (ASPIRIN).
C. protamine sulfate.
D. vitamin K.
Warfarin (COUMADIN)is an anaticoagulant that reaches therapeutic levels in:
A. minutes.
B. hours.
C. days.
D. weeks.
The effectiveness of a vaccine can be measured by:
A. Measuring the level of the vaccination in the blood.
B. Giving a small test booster dose of the vaccination.
C. Measuring the amount of antibody in the blood
D. Giving a large test booster dose of the vaccination
An infant who has received all scheduled immunization comes in for a 1 year check up. What new immunizations will be given?
A. Diptheria, Tetanus, Pertussis
B. Hepatitis A and B
C. Measles, Mumps, Rubella, Varicella
D. H. Influenza, polio, and pneumococcal
The main side effect of all anticoagulants is:
A. bleeding.
B. white blood cell clotting.
C. excessive red blood cell production.
D. activation of the clotting cascade.
Additional Questions from my quiz
A patient has a thrombus in a vein and requires immediate anticoagulation. This best drug to use for this is:
A. Warfarin (COUMADIN).
B. Protamine sulfate.
C. Vitamin K.
D. Heparin (LIQUAEMIN).
The antidote for warfarin sodium (COUMADIN)is
A. aminocaproic acid (AMICAR).
B. acetylsalacylic acid (ASPIRIN).
C. protamine sulfate.
D. vitamin K.
A patient has a thrombus in a vein and requires immediate anticoagulation. This best drug to use for this is:
A. Warfarin (COUMADIN).
B. Protamine sulfate.
C. Vitamin K.
D. Heparin (LIQUAEMIN).
At 3 months old, which vaccinations should have been given?
A. measles, mumps, rubella, haemophilus influenza
B. diphtheria, tetanus, pertussis, haemophilus influenza, Hepatitis B, polio
C. varicellar, haemolphilus influenza, measles, mumps
D. hepatitis A and B, diptheria, varicella
A predictable side effect of either heparin (LIQUAEMIN) or warfarin (COUMADIN)is:
A. bronchospasm.
B. hypertension.
C. bleeding.
D. fatigue.
Sunday, September 28, 2008
Post 4 Infect
Serious adverse reactions to the aminoglycoside antibiotics such as gentamicin are:
A. ringing in the ears and metallic taste in the mouth
B. kidney failure and loss of hearing
C. localized pain over the upper cheeks and eyes
D. liver failure
Infections caused by beta-lactamase producing bacteria may be treated with:
A. Use of a broad spectrum antibiotic such as amoxicillin.
B. An antibiotic with minimal oral absorbtion such as neomycin.
C. An antibiotic with a beta-lactam ring, such as penicillin.
D. An antibiotic prepared with an enzyme inhibitor such as clavulonate.
Drugs effective against tuberculosis include:
A. amphotericin B, fluconazole, nystatin
B. lamivudine, indinavir, zidovudine
C. vancomycin, amikacin, cefotaxime
D. rifabutin, ethambutol, isoniazid
Sue is a 19 year old sexually active female being seen in a family planning clinic for birth control. Her routine annual screening for chlamydia was positive despite being asymptomatic. She has no drug allergies. Should she be treated? With what drug(s), dose and for how long?
A. Yes, she should be treated with Zidovudine (x 7days) and Indinavir (x 7days) by mouth.
B. Yes, she should be treated with Mycostatin vaginal cream for 7 days.
C. Yes, she should be treated with Azithromycin (x 1 dose)
D. No, she does not need to be treated.
Robert is a 42-year-old prison guard whose annual TB skin test converted this year, with a 20-mm induration. He does not feel sick. Several of the inmates are receiving treatment for TB. What treatment if any should he receive?
A. 2 weeks of metronidazole
B. A single dose of streptomycin
C. 6-9 months of isoniazid
D. No treatment is needed.
With therapeutic doses of ticarcillin, brain (CSF) concentrations of 15 mcg/ml are acheivable. You get a report from the laboratory that there is a bacteria in the patient's CSF that has an ticarcillin "MIC" of 128 mcg/ml. This means:
A. You could treat the infection with ticarcillin.
B. You could treat the infection with ticarcillin, but it would have to be high dose.
C. The bacteria is resistant to ticarcillin.
D. The patient is allergic to ticarcillin.
Match the drug to its main mechanism of action.
Penicillin
Sulfonamides
Aminoglycosides
Flouroquinolones
a. inhibit protein synthesis
b. inhibit cell wall synthesis
c. inhibit nucleic acid syntheisis
d. antimetabolite, competition for folate
The main use of metronidazole is in the treatment of:
A. Superficial skin infections.
B. Intestinal amebias and anaerobic infections
C. Viral infections of the throat.
D. Malaria.
A patient insured by Aetna has an infection and is being considered for therapy with Zyvox (Linezolid). You know that:
A. Aetna will not permit their customers to have Zyvox.
B. Prior approval is required to have insurance pay for the Zyvox (Linezolid).
C. Aetna prefers this inexpensive, effective drug treatment for vancomycin and methicillin susceptible infections.
D. Aetna will only pay for this drug if the patient has been insured by Aetna for over 3 years.
While making a home visit to a patient, you want to verify that the patient understands his medications. The patient tells you he took his cefuroxime once a day for the first 3 days, then twice a day for 3 days and now he is up to three times a day. Which would be your best response?
A. And were you able to tolerate the side effects alright building up to a therapeutic dose like that?
B. May I see the directions on the bottle? That's a very unusual way to take an antibiotic.
C. You must have had a previous allergy to that medicine. Are you having any rashes or difficulty breathing now?
D. Will you increase the dose again or stay at 3 tablets each day?
Ototoxicity (ear) and nephrotoxicity (kidney) are serious side effects of which of the following drug classes?
A. aminoglycosides
B. rifampins
C. penicillins
D. sulfonamides
Which of the following drug(s) is/are used in the treatment of tuberculosis?
A. azithromycin and ciprofloxacin
B. rifampin and isoniazid
C. phenazopyridine
D. echinacea
Michael is a 10-month-old seen in a primary care office with a 4-day history of runny nose. Yesterday he was rubbing his ear and was described by his mother as being "cranky". He looks sick and has a high fever 39.5). Tympanic membranes in his ears are red and swollen. He has not been treated for ear infections in the past and has no known allergies. Should he be treated? What medicine might be appropriate?
A. Yes, he should be hospitalized and treated with intravenous vancomycin for 14 days.
B. No, he does not require treatment. He probably has a viral irritation of the ear which will resolve on its own without treatment. Over-prescribing antibiotics lead to resistance.
C. Yes, he should be treated as an outpatient with ampicillin for 10 days.
D. Yes, he should be treated as an outpatient with oral vancomycin for 7 days.
You go to employee health after being stuck deep into your muscle with a needle containing blood from a patient with end-stage AIDS. Which of the following should happen?
A. You will be placed on broad spectrum antibiotics such as imipenem and taken to the operating room to have the wound thoroughly cleaned out.
B. It will be recommended that you take zidovudine, lamivudine and perhaps indinavir, starting within hours of the needlestick.
C. You will be offered zidovudine as single drug therapy.
D. Nystatin (MYCOSTATIN) will be applied topically to the wound after it has been thoroughly cleaned.
Match the drug to its mechanism of action or target organism.
Rifampin
Trimethoprim
Cephalosporins
a. interferes with folic acid metabolism
b. inhibit nucleic acid synthesis
c. inhibits cell wall synthesis
The main use of tetracyclines is in the treatment of:
A. Skin, lung and urinary tract infections.
B. Infections in pregnant women and infants.
C. Viral infections of the throat.
D. Malaria.
A patient insured by Medical has a fungal infection and is being considered for therapy with Sporanox (Itraconazole). You know that:
A. Patients on Medical cannot get Sporanox.
B. Prior approval is required to have Medical pay for the Sporanox.
C. Medical prefers this inexpensive, effective drug treatment for all fungal infections.
D. Sporanox is not effective against fungal infections.
Azithromycin can be useful for treating:
A. Some community-acquired pneumonias and sexually transmitted infections
B. Inflammatory pain in the joints not responsive to NSAIDS
C. Seizures in patients allergic to macrolides
D. Drug resistant strains of HIV
Additional Questions
You are splashed on your intact skin with normal looking, yellow urine from an HIV positive patient. Center for Disease Control Guidelines would advise you to:
A. Take a 4 week course of zidovudine, lamivudine, and indinavir.
B. Take a single dose of fluconazole (DIFLUCAN), and have an HIV test done.
C. Take a 6 month course of metronidazole (FLAGYL).
D. No prophylaxis will be offered.
Martha is a 70-year-old female who is brought from home to the emergency department by her daughter with a three-day history of "flu" and a one-day history of coughing purulent sputum. She has no co-morbidities except mild congestive heart failure. Her vital signs are: temp 38.1, pulse 100, respirations 26, BP130/80, 92% oxygen saturation on room air. Chemistries labs are normal. The WBC is 16,000 with left shift indicating new infection. Her chest X-ray shows an abnormal consolidation but no effusion. She is allergic to penicillin, which caused a rash.Should she receive drug treatment for an infection?
A. Yes, she should receive a single dose of oral vancomycin and followed up as an outpatient.
B. No treatment is needed. This pneumonia is probably caused by a virus, so she just needs some tike to get better.
C. Yes, she should be treated in the hospital with intravenous ampicillin for 2 weeks.
D. Yes, a fluroquinolone such as levofloxacin would be effective outpatient treatment.
A. ringing in the ears and metallic taste in the mouth
B. kidney failure and loss of hearing
C. localized pain over the upper cheeks and eyes
D. liver failure
Infections caused by beta-lactamase producing bacteria may be treated with:
A. Use of a broad spectrum antibiotic such as amoxicillin.
B. An antibiotic with minimal oral absorbtion such as neomycin.
C. An antibiotic with a beta-lactam ring, such as penicillin.
D. An antibiotic prepared with an enzyme inhibitor such as clavulonate.
Drugs effective against tuberculosis include:
A. amphotericin B, fluconazole, nystatin
B. lamivudine, indinavir, zidovudine
C. vancomycin, amikacin, cefotaxime
D. rifabutin, ethambutol, isoniazid
Sue is a 19 year old sexually active female being seen in a family planning clinic for birth control. Her routine annual screening for chlamydia was positive despite being asymptomatic. She has no drug allergies. Should she be treated? With what drug(s), dose and for how long?
A. Yes, she should be treated with Zidovudine (x 7days) and Indinavir (x 7days) by mouth.
B. Yes, she should be treated with Mycostatin vaginal cream for 7 days.
C. Yes, she should be treated with Azithromycin (x 1 dose)
D. No, she does not need to be treated.
Robert is a 42-year-old prison guard whose annual TB skin test converted this year, with a 20-mm induration. He does not feel sick. Several of the inmates are receiving treatment for TB. What treatment if any should he receive?
A. 2 weeks of metronidazole
B. A single dose of streptomycin
C. 6-9 months of isoniazid
D. No treatment is needed.
With therapeutic doses of ticarcillin, brain (CSF) concentrations of 15 mcg/ml are acheivable. You get a report from the laboratory that there is a bacteria in the patient's CSF that has an ticarcillin "MIC" of 128 mcg/ml. This means:
A. You could treat the infection with ticarcillin.
B. You could treat the infection with ticarcillin, but it would have to be high dose.
C. The bacteria is resistant to ticarcillin.
D. The patient is allergic to ticarcillin.
Match the drug to its main mechanism of action.
Penicillin
Sulfonamides
Aminoglycosides
Flouroquinolones
a. inhibit protein synthesis
b. inhibit cell wall synthesis
c. inhibit nucleic acid syntheisis
d. antimetabolite, competition for folate
The main use of metronidazole is in the treatment of:
A. Superficial skin infections.
B. Intestinal amebias and anaerobic infections
C. Viral infections of the throat.
D. Malaria.
A patient insured by Aetna has an infection and is being considered for therapy with Zyvox (Linezolid). You know that:
A. Aetna will not permit their customers to have Zyvox.
B. Prior approval is required to have insurance pay for the Zyvox (Linezolid).
C. Aetna prefers this inexpensive, effective drug treatment for vancomycin and methicillin susceptible infections.
D. Aetna will only pay for this drug if the patient has been insured by Aetna for over 3 years.
While making a home visit to a patient, you want to verify that the patient understands his medications. The patient tells you he took his cefuroxime once a day for the first 3 days, then twice a day for 3 days and now he is up to three times a day. Which would be your best response?
A. And were you able to tolerate the side effects alright building up to a therapeutic dose like that?
B. May I see the directions on the bottle? That's a very unusual way to take an antibiotic.
C. You must have had a previous allergy to that medicine. Are you having any rashes or difficulty breathing now?
D. Will you increase the dose again or stay at 3 tablets each day?
Ototoxicity (ear) and nephrotoxicity (kidney) are serious side effects of which of the following drug classes?
A. aminoglycosides
B. rifampins
C. penicillins
D. sulfonamides
Which of the following drug(s) is/are used in the treatment of tuberculosis?
A. azithromycin and ciprofloxacin
B. rifampin and isoniazid
C. phenazopyridine
D. echinacea
Michael is a 10-month-old seen in a primary care office with a 4-day history of runny nose. Yesterday he was rubbing his ear and was described by his mother as being "cranky". He looks sick and has a high fever 39.5). Tympanic membranes in his ears are red and swollen. He has not been treated for ear infections in the past and has no known allergies. Should he be treated? What medicine might be appropriate?
A. Yes, he should be hospitalized and treated with intravenous vancomycin for 14 days.
B. No, he does not require treatment. He probably has a viral irritation of the ear which will resolve on its own without treatment. Over-prescribing antibiotics lead to resistance.
C. Yes, he should be treated as an outpatient with ampicillin for 10 days.
D. Yes, he should be treated as an outpatient with oral vancomycin for 7 days.
You go to employee health after being stuck deep into your muscle with a needle containing blood from a patient with end-stage AIDS. Which of the following should happen?
A. You will be placed on broad spectrum antibiotics such as imipenem and taken to the operating room to have the wound thoroughly cleaned out.
B. It will be recommended that you take zidovudine, lamivudine and perhaps indinavir, starting within hours of the needlestick.
C. You will be offered zidovudine as single drug therapy.
D. Nystatin (MYCOSTATIN) will be applied topically to the wound after it has been thoroughly cleaned.
Match the drug to its mechanism of action or target organism.
Rifampin
Trimethoprim
Cephalosporins
a. interferes with folic acid metabolism
b. inhibit nucleic acid synthesis
c. inhibits cell wall synthesis
The main use of tetracyclines is in the treatment of:
A. Skin, lung and urinary tract infections.
B. Infections in pregnant women and infants.
C. Viral infections of the throat.
D. Malaria.
A patient insured by Medical has a fungal infection and is being considered for therapy with Sporanox (Itraconazole). You know that:
A. Patients on Medical cannot get Sporanox.
B. Prior approval is required to have Medical pay for the Sporanox.
C. Medical prefers this inexpensive, effective drug treatment for all fungal infections.
D. Sporanox is not effective against fungal infections.
Azithromycin can be useful for treating:
A. Some community-acquired pneumonias and sexually transmitted infections
B. Inflammatory pain in the joints not responsive to NSAIDS
C. Seizures in patients allergic to macrolides
D. Drug resistant strains of HIV
Additional Questions
You are splashed on your intact skin with normal looking, yellow urine from an HIV positive patient. Center for Disease Control Guidelines would advise you to:
A. Take a 4 week course of zidovudine, lamivudine, and indinavir.
B. Take a single dose of fluconazole (DIFLUCAN), and have an HIV test done.
C. Take a 6 month course of metronidazole (FLAGYL).
D. No prophylaxis will be offered.
Martha is a 70-year-old female who is brought from home to the emergency department by her daughter with a three-day history of "flu" and a one-day history of coughing purulent sputum. She has no co-morbidities except mild congestive heart failure. Her vital signs are: temp 38.1, pulse 100, respirations 26, BP130/80, 92% oxygen saturation on room air. Chemistries labs are normal. The WBC is 16,000 with left shift indicating new infection. Her chest X-ray shows an abnormal consolidation but no effusion. She is allergic to penicillin, which caused a rash.Should she receive drug treatment for an infection?
A. Yes, she should receive a single dose of oral vancomycin and followed up as an outpatient.
B. No treatment is needed. This pneumonia is probably caused by a virus, so she just needs some tike to get better.
C. Yes, she should be treated in the hospital with intravenous ampicillin for 2 weeks.
D. Yes, a fluroquinolone such as levofloxacin would be effective outpatient treatment.
Friday, September 26, 2008
Pre 4 Infect
Examples of antibiotics in the cephalosporin class include:
A. azithromycin, clarithromycin, erythromycin
B. amoxicillin, nafcillin, pipercillin
C. cefazolin, cephalexin, ceftriaxone
D. amikacin, gentamicin, tobramycin
Match the drug to its mechanism of action or target organism.
Rifampin a A inhibit nucleic acid synthesis
Trimethoprim c C interferes with folic acid metabolism
Cephalosporins b B inhibits cell wall synthesis
A patient who has been on antibiotics for several weeks now has an infection with fungus and a bacteria resistant to the antibiotic which was previously taken. This patient is said to have:
A. Viralemia.
B. A super-infection.
C. Multimicrobial Supplantation Syndrome
D. Prophylactic propagation
Patients who will be taking drugs to treat infection are instructed to take every dose as prescribed. The main reason for doing this is to:
A. Decrease the possibility of acquiring an allergy to the drug.
B. Manage the infection without developing resistance to the drug.
C. Prevent the patient from saving left over drug to use in a future infection when it may not be the appropriate choice.
D. Limit costs associated with drug therapy.
What teaching is important for patients receiving a tetracyline antibiotic?
A. Take with food or milk.
B. Narrow spectrum, superinfection unlikely.
C. Avoid exposure to sun.
D. Safe to use in pregnancy.
General Feedback: Tetracylines are broad spectrum so superinfection risk is relatively high. They bind divalent cations, such as iron or calcium so should not be taken with milk or absorption could be decreased by up to 50%! If used during pregnancy or under 9yo, it binds to calcium in bones and discolors teeth permananetly. it does make skin more sensitive to burning.
Examples of antibiotics in the penicillin class include:
A. cefazolin, cephalexin, ceftriaxone
B. azithromycin, clarithromycin, erythromycin
C. amoxicillin, nafcillin, pipercillin
D. amikacin, gentamicin, tobramycin
Resistance to antibiotics can be minimized by:
A. early treatment of all viral infections.
B. limiting use of prophylactic antibiotics.
C. teaching patients to stop taking the antibiotic when the symptoms of infection resolve.
D. using broad spectrum antibiotics whenever possible
Match the drug to its main mechanism of action.
Penicillin a. inhibit nucleic acid syntheisis
Sulfonamides b. inhibit cell wall synthesis
Aminoglycosides c. antimetabolite, competition for folate
Flouroquinolones d. inhibit protein synthesis
A "superinfection" refers to:
A. An infection with a resistant organism.
B. The presence of several different organisms in an infected site.
C. Overgrowth of undesired microbes when normal flora has been destroyed by antibiotic therapy.
D. Infection with a fungus.
A. azithromycin, clarithromycin, erythromycin
B. amoxicillin, nafcillin, pipercillin
C. cefazolin, cephalexin, ceftriaxone
D. amikacin, gentamicin, tobramycin
Match the drug to its mechanism of action or target organism.
Rifampin a A inhibit nucleic acid synthesis
Trimethoprim c C interferes with folic acid metabolism
Cephalosporins b B inhibits cell wall synthesis
A patient who has been on antibiotics for several weeks now has an infection with fungus and a bacteria resistant to the antibiotic which was previously taken. This patient is said to have:
A. Viralemia.
B. A super-infection.
C. Multimicrobial Supplantation Syndrome
D. Prophylactic propagation
Patients who will be taking drugs to treat infection are instructed to take every dose as prescribed. The main reason for doing this is to:
A. Decrease the possibility of acquiring an allergy to the drug.
B. Manage the infection without developing resistance to the drug.
C. Prevent the patient from saving left over drug to use in a future infection when it may not be the appropriate choice.
D. Limit costs associated with drug therapy.
What teaching is important for patients receiving a tetracyline antibiotic?
A. Take with food or milk.
B. Narrow spectrum, superinfection unlikely.
C. Avoid exposure to sun.
D. Safe to use in pregnancy.
General Feedback: Tetracylines are broad spectrum so superinfection risk is relatively high. They bind divalent cations, such as iron or calcium so should not be taken with milk or absorption could be decreased by up to 50%! If used during pregnancy or under 9yo, it binds to calcium in bones and discolors teeth permananetly. it does make skin more sensitive to burning.
Examples of antibiotics in the penicillin class include:
A. cefazolin, cephalexin, ceftriaxone
B. azithromycin, clarithromycin, erythromycin
C. amoxicillin, nafcillin, pipercillin
D. amikacin, gentamicin, tobramycin
Resistance to antibiotics can be minimized by:
A. early treatment of all viral infections.
B. limiting use of prophylactic antibiotics.
C. teaching patients to stop taking the antibiotic when the symptoms of infection resolve.
D. using broad spectrum antibiotics whenever possible
Match the drug to its main mechanism of action.
Penicillin a. inhibit nucleic acid syntheisis
Sulfonamides b. inhibit cell wall synthesis
Aminoglycosides c. antimetabolite, competition for folate
Flouroquinolones d. inhibit protein synthesis
A "superinfection" refers to:
A. An infection with a resistant organism.
B. The presence of several different organisms in an infected site.
C. Overgrowth of undesired microbes when normal flora has been destroyed by antibiotic therapy.
D. Infection with a fungus.
Post 3 Inflam
When comparing antihistamines such as the classic diphenhydramine (BENADRYL) to the more recently marketed fexofenadine (ALLEGRA), you would say that fexofenadine is:
A. Less expensive
B. Available by more routes of administration (oral, intravenous, topical)
C. More likely to cause sedation
D. Less likely to cause dry mouth
Atheletes have been known to abuse steroids for body building purposes. The mechanism behind this is:
A. Glucocorticoids cause protein synthesis in exercising muscles.
B. Glucocorticoids inhibit insulin from carrying glucose into muscle cells.
C. Glucocorticoids stimulate the uptake of proteins from the GI tract.
D. Glucocorticoids are not the type of steroids abused by athletes.
When ASPIRIN is used to reduce fever in an adult, the usual dose is:
A. 80-325 mg each day
B. 80 mg as needed
C. 650 mg as neeeded
D. 4 grams as neeeded
In rheumatoid arthritis, valdecoxib (BEXTRA) may be preferred over a traditional NSAID such as naproxen (ALEVE), because:
A. COX-2 inhibitors are associated with a high rate of GI bleeding
B. Once-a-day dosing is possible.
C. It is less expensive.
D. It works in both women and men.
A transplant patient receiving immunosupression with drugs such as corticosteroids with tacrolimus, mycophenolate or cyclosporine is at greatest risk for which adverse effect?
A. Sedation
B. Infection
C. Blood clots
D. Hypotension
General Feedback: Suppressing the immune system decreases the chance of rejecting the transplanted organ but also suppresses the ability to fight off infection.
Loratadine (CLARITIN) is an antihistamine useful in treating:
A. arthritis
B. ulcers
C. runny nose associated with allergies
D. headache associated with migraines
In the treatment of allergic rhinitis, nasal sprays of fluticasone are preferred over oral pills of prednisone because:
A. the cost is significantly lower
B. absorption is better
C. risk of addiction is lower
D. there are fewer side effects
General Feedback: Steroids have significant side effects and should be given locally, not systemically when possible.
Naproxen (ALEVE) works by:
A. Stimulating the release of leukotrines from white blood cells.
B. Blocking the enzyme lipo-oxygenase.
C. Inhibiting prostaglandin synthesis.
D. All of the above
If a patient had a tumor that was secreting adrenocorticotropin (ACTH), what would happen if dexamethasone was given for several days?
A. The tumor would increase secretion of ACTH.
B. Blood levels of the body's natural glucocorticoid, (cortisol) would remain high.
C. Blood levels of the body's natural glucocorticoid, (cortisol) would drop.
D. The tumor would decrease secretion of ACTH.
General Feedback: When the body's only supply of ACTH is from the pituitary, giving a glucocorticosteroid like dexamethasone, creates a negative feedback loop so the pituitary puts out less ACTH and thus less cortisol is released from the adrenal gland. ACTH secreting tumors are not responsive to this negative feedback loop and keep secreting ACTH, thus keeping cortisol levels up.
When glucocorticoid drugs have been given systemically in high dose for several weeks or more:
A. The patient will probably have liver failure which will not resolve on discontinuation of the drug.
B. The patient will probably have liver failure which will resolve on discontinuation of the drug.
C. The patient will have a life-time dependency on the drugs.
D. The dose should be tapered off slowly when the patient no longer needs the steroid.
Newer generation antihistamines, such as fexofenadine (ALLEGRA), are less likely to enter __________ tissue than the older drugs such as the classic diphenhydramine (BENADRYL).
A. liver
B. renal
C. brain
D. fat
When systemic steroids are given for replacement (as in Addison's disease), doses are generally _____________ than when they are given for inflammation (such as in an acute asthma attack).
A. larger and given for a longer period of time
B. larger and given for a shorter period of time
C. smaller and given for a longer period of time
D. smaller and given for a shorter period of time
Mr. Kim has had a kidney transplant and has been taking cyclosporin. His serum creatinine is going up. What is the best explanation of this?
A. He is having an allergic reaction to the drug.
B. He is having a very common adverse reaction to the drug.
C. He is rejecting his transplanted kidney.
D. Adverse drug reaction and transplant rejection must both be considered.
A patient is to recieve ketorolac (TORADOL) for 3 days after surgery. This drug will act to:
A. Stimulate the release of leukotrines from white blood cells.
B. Block the enzyme lipo-oxygenase.
C. Inhibit prostaglandin synthesis.
D. All of the above
Glucocorticoid preparations are available by which routes?
A. Oral and intraveneous only
B. Topical and oral only
C. direct injection into a joint or lesion and inhaled only
D. all of the above routes are available
Additional Questions courtesy of Vanessa Kelly and Lily Sok, Thanks!!! (added 12/2)
Indications for H1 blockers include all of the following EXCEPT:
A. Asthma
B. Nasal allergies
C. Itching
D. Motion sickness
Let's assume a patient's only supply of adrenocorticotropin (ACTH) is from the pituitary. In other words, they do not have and ACTH-secreting tumor. What would happen if dexamethasone was given for several days?
A. Blood levels of the body's natural glucocorticoid, (cortisol) would remain high.
B. The pituitary would be stimulated to secrete more ACTH.
C. The adrenal gland would be stimulated to secrete ACTH.
D. Blood levels of the body's natural glucocorticoid, (cortisol) would drop.
A patient with frequent bruising and fat deposits on the cheeks and shoulders, is being evaluated for Cushing's Syndrome. Dexamethasone is given for several days. What would be tested next?
1. Urine and or cortisol levels.
2. Fasting blood sugar.
3. Hemoglobin A1C
4. Platelets and cholesterol.
A. Less expensive
B. Available by more routes of administration (oral, intravenous, topical)
C. More likely to cause sedation
D. Less likely to cause dry mouth
Atheletes have been known to abuse steroids for body building purposes. The mechanism behind this is:
A. Glucocorticoids cause protein synthesis in exercising muscles.
B. Glucocorticoids inhibit insulin from carrying glucose into muscle cells.
C. Glucocorticoids stimulate the uptake of proteins from the GI tract.
D. Glucocorticoids are not the type of steroids abused by athletes.
When ASPIRIN is used to reduce fever in an adult, the usual dose is:
A. 80-325 mg each day
B. 80 mg as needed
C. 650 mg as neeeded
D. 4 grams as neeeded
In rheumatoid arthritis, valdecoxib (BEXTRA) may be preferred over a traditional NSAID such as naproxen (ALEVE), because:
A. COX-2 inhibitors are associated with a high rate of GI bleeding
B. Once-a-day dosing is possible.
C. It is less expensive.
D. It works in both women and men.
A transplant patient receiving immunosupression with drugs such as corticosteroids with tacrolimus, mycophenolate or cyclosporine is at greatest risk for which adverse effect?
A. Sedation
B. Infection
C. Blood clots
D. Hypotension
General Feedback: Suppressing the immune system decreases the chance of rejecting the transplanted organ but also suppresses the ability to fight off infection.
Loratadine (CLARITIN) is an antihistamine useful in treating:
A. arthritis
B. ulcers
C. runny nose associated with allergies
D. headache associated with migraines
In the treatment of allergic rhinitis, nasal sprays of fluticasone are preferred over oral pills of prednisone because:
A. the cost is significantly lower
B. absorption is better
C. risk of addiction is lower
D. there are fewer side effects
General Feedback: Steroids have significant side effects and should be given locally, not systemically when possible.
Naproxen (ALEVE) works by:
A. Stimulating the release of leukotrines from white blood cells.
B. Blocking the enzyme lipo-oxygenase.
C. Inhibiting prostaglandin synthesis.
D. All of the above
If a patient had a tumor that was secreting adrenocorticotropin (ACTH), what would happen if dexamethasone was given for several days?
A. The tumor would increase secretion of ACTH.
B. Blood levels of the body's natural glucocorticoid, (cortisol) would remain high.
C. Blood levels of the body's natural glucocorticoid, (cortisol) would drop.
D. The tumor would decrease secretion of ACTH.
General Feedback: When the body's only supply of ACTH is from the pituitary, giving a glucocorticosteroid like dexamethasone, creates a negative feedback loop so the pituitary puts out less ACTH and thus less cortisol is released from the adrenal gland. ACTH secreting tumors are not responsive to this negative feedback loop and keep secreting ACTH, thus keeping cortisol levels up.
When glucocorticoid drugs have been given systemically in high dose for several weeks or more:
A. The patient will probably have liver failure which will not resolve on discontinuation of the drug.
B. The patient will probably have liver failure which will resolve on discontinuation of the drug.
C. The patient will have a life-time dependency on the drugs.
D. The dose should be tapered off slowly when the patient no longer needs the steroid.
Newer generation antihistamines, such as fexofenadine (ALLEGRA), are less likely to enter __________ tissue than the older drugs such as the classic diphenhydramine (BENADRYL).
A. liver
B. renal
C. brain
D. fat
When systemic steroids are given for replacement (as in Addison's disease), doses are generally _____________ than when they are given for inflammation (such as in an acute asthma attack).
A. larger and given for a longer period of time
B. larger and given for a shorter period of time
C. smaller and given for a longer period of time
D. smaller and given for a shorter period of time
Mr. Kim has had a kidney transplant and has been taking cyclosporin. His serum creatinine is going up. What is the best explanation of this?
A. He is having an allergic reaction to the drug.
B. He is having a very common adverse reaction to the drug.
C. He is rejecting his transplanted kidney.
D. Adverse drug reaction and transplant rejection must both be considered.
A patient is to recieve ketorolac (TORADOL) for 3 days after surgery. This drug will act to:
A. Stimulate the release of leukotrines from white blood cells.
B. Block the enzyme lipo-oxygenase.
C. Inhibit prostaglandin synthesis.
D. All of the above
Glucocorticoid preparations are available by which routes?
A. Oral and intraveneous only
B. Topical and oral only
C. direct injection into a joint or lesion and inhaled only
D. all of the above routes are available
Additional Questions courtesy of Vanessa Kelly and Lily Sok, Thanks!!! (added 12/2)
Indications for H1 blockers include all of the following EXCEPT:
A. Asthma
B. Nasal allergies
C. Itching
D. Motion sickness
Let's assume a patient's only supply of adrenocorticotropin (ACTH) is from the pituitary. In other words, they do not have and ACTH-secreting tumor. What would happen if dexamethasone was given for several days?
A. Blood levels of the body's natural glucocorticoid, (cortisol) would remain high.
B. The pituitary would be stimulated to secrete more ACTH.
C. The adrenal gland would be stimulated to secrete ACTH.
D. Blood levels of the body's natural glucocorticoid, (cortisol) would drop.
A patient with frequent bruising and fat deposits on the cheeks and shoulders, is being evaluated for Cushing's Syndrome. Dexamethasone is given for several days. What would be tested next?
1. Urine and or cortisol levels.
2. Fasting blood sugar.
3. Hemoglobin A1C
4. Platelets and cholesterol.
Pre 3 Inflam
Actions of glucocorticoids include:
A. supresses inflammation
B. fight off infection
C. inhibit glucose production
D. stimulate adrenal secretions
In addition to decreasing inflammation, NSAIDS are used to:
A. Reduce pain
B. Proote blood clotting
C. Prevent allergies
D. Raise body temperature
Azathioprine (Imuran) is used for:
A. Boosting the immune response to vaccines.
B. Preventing rejection of transplanted organs.
C. Reducing inflammation associated with migraine headaches.
D. Preventing viral infections in patients who are immune suppressed.
A transplant patient receiving immunosupression with drugs such as corticosteroids with tacrolimus, mycophenolate or cyclosporine is at greatest risk for which adverse effect?
A. Sedation
B. Infection
C. Blood clots
D. Hypotension
General Feedback: Suppressing the immune system decreases the chance of rejecting the transplanted organ but also suppresses the ability to fight off infection.
Drugs that interact with H1 receptors may be useful in:
1. Infection
2. Auto-immune disease
3. Hay fever
4. Gastric ulcer prevention
The mechanism of action of NSAIDS is to:
A. Bind reversibly to thromboxane, preventing release of acetylcholine from mast cells.
B. Inhibit the enzyme cyclooxygenase, preventing synthesis of prostaglandin and thromboxane.
C. Block glucocorticoid channels, stimulating the release of interleukin from white blood cells.
D. Stimulate release of iron stores from lymph cells, causing migration of white blood cells to inflammed tissue.
Azathioprine (Imuran) is used for:
A. Preventing viral infections in patients who are immune suppressed.
B. Preventing inflammation associated with sports injuries.
C. Supressing inflammation in rheumatoid arthritis..
D. Stimulating inflammation to treat migraine headaches.
A relatively common adverse reaction to diphenhydramine (Benadryl) is:
A. Sedation
B. Infection
C. Gastric bleeding
D. Rash
General Feedback: Sedation and anticholinergic effects (constipation, dry mouth, blurred vision) are relatively common with diphenhydramine. Rash is less common.
Additional Questions courtesy of Vanessa Kelly and Lily Sok, Thanks!!! (added 12/2)
Adverse effects of glucocorticoids include:
A. Decreased blood sugar
B. Loss of fat tissue in the face and upper back
C. Mood and behavior changes
D. Decreased feeling in the fingers and toes.
Drugs that interact with H1 receptors attach to which tissue?
1. Blood vessels and airways
2. Stomach
3. White blood cells
4. Nerve cells
Azathioprine (Imuran) is used for:
A. Stimulating inflammation to treat migraine headaches.
B. Supressing inflammation in rheumatoid arthritis.
C. Preventing inflammation associated with sports injuries.
D. Preventing viral infections in patients who are immune suppressed.
A. supresses inflammation
B. fight off infection
C. inhibit glucose production
D. stimulate adrenal secretions
In addition to decreasing inflammation, NSAIDS are used to:
A. Reduce pain
B. Proote blood clotting
C. Prevent allergies
D. Raise body temperature
Azathioprine (Imuran) is used for:
A. Boosting the immune response to vaccines.
B. Preventing rejection of transplanted organs.
C. Reducing inflammation associated with migraine headaches.
D. Preventing viral infections in patients who are immune suppressed.
A transplant patient receiving immunosupression with drugs such as corticosteroids with tacrolimus, mycophenolate or cyclosporine is at greatest risk for which adverse effect?
A. Sedation
B. Infection
C. Blood clots
D. Hypotension
General Feedback: Suppressing the immune system decreases the chance of rejecting the transplanted organ but also suppresses the ability to fight off infection.
Drugs that interact with H1 receptors may be useful in:
1. Infection
2. Auto-immune disease
3. Hay fever
4. Gastric ulcer prevention
The mechanism of action of NSAIDS is to:
A. Bind reversibly to thromboxane, preventing release of acetylcholine from mast cells.
B. Inhibit the enzyme cyclooxygenase, preventing synthesis of prostaglandin and thromboxane.
C. Block glucocorticoid channels, stimulating the release of interleukin from white blood cells.
D. Stimulate release of iron stores from lymph cells, causing migration of white blood cells to inflammed tissue.
Azathioprine (Imuran) is used for:
A. Preventing viral infections in patients who are immune suppressed.
B. Preventing inflammation associated with sports injuries.
C. Supressing inflammation in rheumatoid arthritis..
D. Stimulating inflammation to treat migraine headaches.
A relatively common adverse reaction to diphenhydramine (Benadryl) is:
A. Sedation
B. Infection
C. Gastric bleeding
D. Rash
General Feedback: Sedation and anticholinergic effects (constipation, dry mouth, blurred vision) are relatively common with diphenhydramine. Rash is less common.
Additional Questions courtesy of Vanessa Kelly and Lily Sok, Thanks!!! (added 12/2)
Adverse effects of glucocorticoids include:
A. Decreased blood sugar
B. Loss of fat tissue in the face and upper back
C. Mood and behavior changes
D. Decreased feeling in the fingers and toes.
Drugs that interact with H1 receptors attach to which tissue?
1. Blood vessels and airways
2. Stomach
3. White blood cells
4. Nerve cells
Azathioprine (Imuran) is used for:
A. Stimulating inflammation to treat migraine headaches.
B. Supressing inflammation in rheumatoid arthritis.
C. Preventing inflammation associated with sports injuries.
D. Preventing viral infections in patients who are immune suppressed.
Post 2 Gen 2
The incidence and severity of adverse reactions caused by a drug determines which property of that drug?
A. efficacy
B. potency
C. purity
D. safety/toxicity
A drug company is conducting a "Phase III" study on a new drug. Which activity will be occuring?
A. The drug will be tested on a third species of animal.
B. The drug will be tested on a second species of animal.
C. The drug will be tested on patients who might benefit from it.
D. The drug will be tested on a small group of human volunteers.
Which of the following affects drug absorption from the site of administration?
A. binding to plasma proteins.
B. liver function
C. solubility.
D. receptor specificity
Drug K can be administered by mouth or parenterally (by injection in vein or tissue). However, the drug dose needed to produce therapeutic blood levels is three times higher when the drug is administered by mouth. Which of the following provides the best explanation for this phenomenon?
A. first-pass liver metabolism of oral dose
B. hepatic enzyme induction resulting from oral route
C. differences in drug solubility between the oral and parenteral routes
D. differences in plasma protein binding between the oral and parenteral routes
Not all drugs in use today have been rated for safety in pregnancy. Of those that have been rated, which classification represents the greatest risk?
A. Schedule II
B. Schedule III
C. Category A
D. Category X
Drug X is an acidic drug that is largely un-ionized in acidic environments. Alkalinizing the urine would __________urinary elimination of this drug.
A. increase
B. decrease
C. have no effect on
Recently the FDA has reccommended the use of Tall man lettering, such as DOPamine rather than dopamine. The purpose of this is to
1. differentiate between trade name and generic name.
2. reduce drug name confusion that could cause errors.
3. designate that this is an OTC medication.
A drug that occupies a receptor but does not activate the receptor is an:
A. adjuvant.
B. affinitant.
C. agonist.
D. antagonist.
Select the true statement about drug allergies:
A. The bigger the first dose of the drug, the more likely you will see an allergic reaction.
B. Symptoms range from mild rash and swelling to airway constriction and shock.
C. It is the same as an idiosyncratic reaction.
D. All of the above.
The 100,000 lives campaign suggested that nationwide implementation of 6 interventions could save 100,000 lives each year. Which is one of these interventions?
A. Patients should be advised to not bring a list of their home medicine when they are admitted to a hospital.
B. When a patient is on a mechanical ventilator, medicine to prevent peptic ulcers should be avoided.
C. We should give a beta-blocker drug early on and at discharge for patients with heart attacks.
D. Aspirin and other platelet inhibitors should never be given in chest pain until you are sure the patient did not have a heart attack.
General Feedback: The 100,000 lives campaign called for research based interventions (among other things) to deploy rapid response teams, give aspirin right away for heart attack, clean skin with chlorhexidine before starting central intravenous lines, keep glucose normal after surgery, reconciliate medications, and prevent pneumonia for patients on ventilators.
A teratogen is a drug that is likely to
1. cause birth defects
2. have a high abuse potential.
3. require a prescription.
4. be illegal.
A drug company is conducting a "Phase I Clinical Trial" study on a new drug. Which activity will be occuring?
A. The drug will be chemically tested in test tubes.
B. The drug will be tested in non-human animals.
C. The drug will be tested in a small number of healthy volunteers.
D. The drug will be tested in a small number of patients who might benefit from the drug.
For the breastfed infant, factors which enhance drug excretion into breast milk include:
A. Drug has a high molecular weight
B. Drug is not fat soluble
C. Drug is in the ionized form
D. Maternal drug level is high
Drugs may not be sold in the United States until they have been approved by:
A. The Food and Drug Administration
B. The National Institute of Drugs
C. The American Association of Pharmacists
D. The Center for Drug Control
What activity takes place during "medication reconciliation"?
A. Before approving a drug name, comparisons are made with other drug names to be sure nothing is similar.
B. Double checks are made on labeling of the drug before it is released to patients or those who will administer them.
C. Before administering the drug, double checks are made that it is the right drug, dose, time, route, and patient.
D. A list of the patient home medications is compared to what has been ordered in the hospital.
Additional questions courtesy of Vanessa Kelly, Thanks!!(added on 10/3)
One reason why most drugs have side effects is because
A. drugs bind to more than one receptor.
B. drugs cannot bind to the desired receptor.
C. drugs are pure.
D. the drug is not given in high enough doses.
Which property of drugs is determined by the degree that a drug can be absorbed and transported by the body to its active site?
A. bioavailability
B. efficacy
C. purity
D. safety/toxicity
S. Henry has been taking digoxin for many years. Knowing that digoxin is highly plasma protein bound, what do you predict will occur if you give him a second drug that also binds plasma proteins?
A. the potential for digoxin toxicity will increase
B. the potential for digoxin toxicity will decrease
C. the potential for toxicity of the second drug will decrease
D. nothing should happen
Binding to plasma proteins can affect
A. drug distribution.
B. drug metabolism.
C. drug elimination.
D. distribution, metabolism and elimination
In pregnancy:
A. Most drugs reach the fetus, some cause adverse effects.
B. Few drugs are able to cross the placenta, but the ones that do are almost always very toxic to the baby.
Which of the following would best apply to the term, drug interactions (as opposed to contraindications, precautions, and adverse reactions)?
A. Every drug has some side effects that many patients may experience when taking the drug.
B. One drug may counteract or enhance the effect of another drug the patient is taking.
C. Specific drugs should not be used under certain conditions, such as when a patient is pregnant.
D. The risk of complications is increased if the drug is given to a patient with an organ impairment, such as a kidney.
Which of the following is recommended by the FDA to reduce medication errors?
A. Use of bar codes on patient name bands.
B. Placing medications at the patient's bedside for self-administration.
C. Asking patient care technicians to administer drugs.
D. Using only trade name drugs in hospital pharmacies.
When a drug is heavily plasma protein bound, the fraction of the drug that exerts the pharmacological effect is the
A. free drug
B. protein bound drug
C. both the free and protein bound drug
D. metabolized drug fragments
Pharmacists are licensed to perform all of the following activities EXCEPT:
A. Prescribe which drug the patient needs.
B. Label and dispense the drug.
C. Teach the patient about the drug.
D. Analyze potential interactions with other drugs the patient is taking.
A. efficacy
B. potency
C. purity
D. safety/toxicity
A drug company is conducting a "Phase III" study on a new drug. Which activity will be occuring?
A. The drug will be tested on a third species of animal.
B. The drug will be tested on a second species of animal.
C. The drug will be tested on patients who might benefit from it.
D. The drug will be tested on a small group of human volunteers.
Which of the following affects drug absorption from the site of administration?
A. binding to plasma proteins.
B. liver function
C. solubility.
D. receptor specificity
Drug K can be administered by mouth or parenterally (by injection in vein or tissue). However, the drug dose needed to produce therapeutic blood levels is three times higher when the drug is administered by mouth. Which of the following provides the best explanation for this phenomenon?
A. first-pass liver metabolism of oral dose
B. hepatic enzyme induction resulting from oral route
C. differences in drug solubility between the oral and parenteral routes
D. differences in plasma protein binding between the oral and parenteral routes
Not all drugs in use today have been rated for safety in pregnancy. Of those that have been rated, which classification represents the greatest risk?
A. Schedule II
B. Schedule III
C. Category A
D. Category X
Drug X is an acidic drug that is largely un-ionized in acidic environments. Alkalinizing the urine would __________urinary elimination of this drug.
A. increase
B. decrease
C. have no effect on
Recently the FDA has reccommended the use of Tall man lettering, such as DOPamine rather than dopamine. The purpose of this is to
1. differentiate between trade name and generic name.
2. reduce drug name confusion that could cause errors.
3. designate that this is an OTC medication.
A drug that occupies a receptor but does not activate the receptor is an:
A. adjuvant.
B. affinitant.
C. agonist.
D. antagonist.
Select the true statement about drug allergies:
A. The bigger the first dose of the drug, the more likely you will see an allergic reaction.
B. Symptoms range from mild rash and swelling to airway constriction and shock.
C. It is the same as an idiosyncratic reaction.
D. All of the above.
The 100,000 lives campaign suggested that nationwide implementation of 6 interventions could save 100,000 lives each year. Which is one of these interventions?
A. Patients should be advised to not bring a list of their home medicine when they are admitted to a hospital.
B. When a patient is on a mechanical ventilator, medicine to prevent peptic ulcers should be avoided.
C. We should give a beta-blocker drug early on and at discharge for patients with heart attacks.
D. Aspirin and other platelet inhibitors should never be given in chest pain until you are sure the patient did not have a heart attack.
General Feedback: The 100,000 lives campaign called for research based interventions (among other things) to deploy rapid response teams, give aspirin right away for heart attack, clean skin with chlorhexidine before starting central intravenous lines, keep glucose normal after surgery, reconciliate medications, and prevent pneumonia for patients on ventilators.
A teratogen is a drug that is likely to
1. cause birth defects
2. have a high abuse potential.
3. require a prescription.
4. be illegal.
A drug company is conducting a "Phase I Clinical Trial" study on a new drug. Which activity will be occuring?
A. The drug will be chemically tested in test tubes.
B. The drug will be tested in non-human animals.
C. The drug will be tested in a small number of healthy volunteers.
D. The drug will be tested in a small number of patients who might benefit from the drug.
For the breastfed infant, factors which enhance drug excretion into breast milk include:
A. Drug has a high molecular weight
B. Drug is not fat soluble
C. Drug is in the ionized form
D. Maternal drug level is high
Drugs may not be sold in the United States until they have been approved by:
A. The Food and Drug Administration
B. The National Institute of Drugs
C. The American Association of Pharmacists
D. The Center for Drug Control
What activity takes place during "medication reconciliation"?
A. Before approving a drug name, comparisons are made with other drug names to be sure nothing is similar.
B. Double checks are made on labeling of the drug before it is released to patients or those who will administer them.
C. Before administering the drug, double checks are made that it is the right drug, dose, time, route, and patient.
D. A list of the patient home medications is compared to what has been ordered in the hospital.
Additional questions courtesy of Vanessa Kelly, Thanks!!(added on 10/3)
One reason why most drugs have side effects is because
A. drugs bind to more than one receptor.
B. drugs cannot bind to the desired receptor.
C. drugs are pure.
D. the drug is not given in high enough doses.
Which property of drugs is determined by the degree that a drug can be absorbed and transported by the body to its active site?
A. bioavailability
B. efficacy
C. purity
D. safety/toxicity
S. Henry has been taking digoxin for many years. Knowing that digoxin is highly plasma protein bound, what do you predict will occur if you give him a second drug that also binds plasma proteins?
A. the potential for digoxin toxicity will increase
B. the potential for digoxin toxicity will decrease
C. the potential for toxicity of the second drug will decrease
D. nothing should happen
Binding to plasma proteins can affect
A. drug distribution.
B. drug metabolism.
C. drug elimination.
D. distribution, metabolism and elimination
In pregnancy:
A. Most drugs reach the fetus, some cause adverse effects.
B. Few drugs are able to cross the placenta, but the ones that do are almost always very toxic to the baby.
Which of the following would best apply to the term, drug interactions (as opposed to contraindications, precautions, and adverse reactions)?
A. Every drug has some side effects that many patients may experience when taking the drug.
B. One drug may counteract or enhance the effect of another drug the patient is taking.
C. Specific drugs should not be used under certain conditions, such as when a patient is pregnant.
D. The risk of complications is increased if the drug is given to a patient with an organ impairment, such as a kidney.
Which of the following is recommended by the FDA to reduce medication errors?
A. Use of bar codes on patient name bands.
B. Placing medications at the patient's bedside for self-administration.
C. Asking patient care technicians to administer drugs.
D. Using only trade name drugs in hospital pharmacies.
When a drug is heavily plasma protein bound, the fraction of the drug that exerts the pharmacological effect is the
A. free drug
B. protein bound drug
C. both the free and protein bound drug
D. metabolized drug fragments
Pharmacists are licensed to perform all of the following activities EXCEPT:
A. Prescribe which drug the patient needs.
B. Label and dispense the drug.
C. Teach the patient about the drug.
D. Analyze potential interactions with other drugs the patient is taking.
Pre 2 Gen 2
According to the Drug Enforcement Agency, which drug class has the highest potential for abuse?
1. Schedule I
2. Schedule II
3. Schedule III
4. Schedule IV
After a drug is administered, it must get to the site where it exerts its action. This phase of pharmacokinetics is called
1. absorption
2. distribution
3. metabolism
4. excretion
After a drug is administered, it goes to the site of action. Soon after this, the blood level of the drug begins to decline. This decline in blood levels best represents
1. absorption
2. distribution
3. metabolism
4. allergy
If a rapid onset of action is important, which route of administration would you choose?
1. transcutaneous
2. inhaled
3. intravenous
4. oral
Which pregnancy category indicates that controlled studies in humans have not shown risk to the mother or fetus?
A. Category A
B. Category C
C. Category D
D. Category X
In the US, controlled substances are
A. drugs whose use, distribution, and prescribing is determed by the Controlled Substances Act of 1970 and it ammendaments.
B. not intended for human use.
C. usually sold over the counter in low doses.
D. restricted because of risk in pregnancy.
When two or more drugs are given together and the result is smaller than you would have seen if the drugs had been given alone, you have a drug interaction known as:
A. potentiation
B. synergy
C. summation
D. antagonism
Which of the following is an adverse effect of subcutaneous administration of drugs?
1. little of the drug is absorbed by this route.
2. drug metabolism is slower.
3. drug distribution is usually a problem.
4. pain, swelling or infection could occur.
Additional Question courtesy of Vanessa Kelly, THanks!!! (added 10/3)
In the US, controlled substances are
A. not intended for human use.
B. usually sold over the counter in low doses.
C. restricted because of risk in pregnancy.
D. drugs whose use, distribution, and prescribing is determed by the Controlled Substances Act of 1970 and it ammendaments.
An important disadvantage of administering a drug intravenously is that
1. the potential for infection is higher than for oral administration.
2. drug metabolism is slower.
3. drug abosrption is less complete.
4. drug absorption is erratic.
Most drug metabolism occurs in the:
A. liver
B. kidney
C. intestines
D. gall bladder
An important disadvantage of administering a drug intravenously is that
1. the potential for infection is higher than for oral administration.
2. drug metabolism is slower.
3. drug abosrption is less complete.
4. drug absorption is erratic.
Which pregnancy category indicates that either risks found in animal studies were not validated in human studies, or there were no risks found in animal studies?
A. Category A
B. Category B
C. Category C
D. Category X
Drugs may not be sold in the United States until they have been approved by:
A. The Food and Drug Administration
B. The National Institute of Drugs
C. The American Association of Pharmacists
D. The Center for Drug Control
An important advantage of administering a drug intravenously is that
1. you can control the duration of action.
2. there are fewer adverse effects.
3. the onset of action is faster than other routes.
4. first pass metabolism is enhanced.
Which pregnancy category indicates that there is evidence of human fetal risk but that use of the drug might still be acceptable if the woman is very ill and there are not safer, effective drug choices.
1. Category A
2. Category C
3. Category D
4. Category X
1. Schedule I
2. Schedule II
3. Schedule III
4. Schedule IV
After a drug is administered, it must get to the site where it exerts its action. This phase of pharmacokinetics is called
1. absorption
2. distribution
3. metabolism
4. excretion
After a drug is administered, it goes to the site of action. Soon after this, the blood level of the drug begins to decline. This decline in blood levels best represents
1. absorption
2. distribution
3. metabolism
4. allergy
If a rapid onset of action is important, which route of administration would you choose?
1. transcutaneous
2. inhaled
3. intravenous
4. oral
Which pregnancy category indicates that controlled studies in humans have not shown risk to the mother or fetus?
A. Category A
B. Category C
C. Category D
D. Category X
In the US, controlled substances are
A. drugs whose use, distribution, and prescribing is determed by the Controlled Substances Act of 1970 and it ammendaments.
B. not intended for human use.
C. usually sold over the counter in low doses.
D. restricted because of risk in pregnancy.
When two or more drugs are given together and the result is smaller than you would have seen if the drugs had been given alone, you have a drug interaction known as:
A. potentiation
B. synergy
C. summation
D. antagonism
Which of the following is an adverse effect of subcutaneous administration of drugs?
1. little of the drug is absorbed by this route.
2. drug metabolism is slower.
3. drug distribution is usually a problem.
4. pain, swelling or infection could occur.
Additional Question courtesy of Vanessa Kelly, THanks!!! (added 10/3)
In the US, controlled substances are
A. not intended for human use.
B. usually sold over the counter in low doses.
C. restricted because of risk in pregnancy.
D. drugs whose use, distribution, and prescribing is determed by the Controlled Substances Act of 1970 and it ammendaments.
An important disadvantage of administering a drug intravenously is that
1. the potential for infection is higher than for oral administration.
2. drug metabolism is slower.
3. drug abosrption is less complete.
4. drug absorption is erratic.
Most drug metabolism occurs in the:
A. liver
B. kidney
C. intestines
D. gall bladder
An important disadvantage of administering a drug intravenously is that
1. the potential for infection is higher than for oral administration.
2. drug metabolism is slower.
3. drug abosrption is less complete.
4. drug absorption is erratic.
Which pregnancy category indicates that either risks found in animal studies were not validated in human studies, or there were no risks found in animal studies?
A. Category A
B. Category B
C. Category C
D. Category X
Drugs may not be sold in the United States until they have been approved by:
A. The Food and Drug Administration
B. The National Institute of Drugs
C. The American Association of Pharmacists
D. The Center for Drug Control
An important advantage of administering a drug intravenously is that
1. you can control the duration of action.
2. there are fewer adverse effects.
3. the onset of action is faster than other routes.
4. first pass metabolism is enhanced.
Which pregnancy category indicates that there is evidence of human fetal risk but that use of the drug might still be acceptable if the woman is very ill and there are not safer, effective drug choices.
1. Category A
2. Category C
3. Category D
4. Category X
Post 1 Gen 1
| The time between when a drug response is observable and when there is no longer an observable drug effect is called the | ||||||||||||
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| General Feedback: | This accounts for the selectivity we see in drugs, acting on some cells and not on others. The binding may activate or inhibit an enzyme, alter cell permeability, or alter the production of a cellular protein. | |||||||||||
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| Recombinant technology is allowing us to: | ||||||||||||
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| General Feedback: | Hepatitis vaccine is a good example. The DNA that codes for the portion of the hepatitis virus to which we make an immune reponse is inserted in a yeast cell. When the yeast makes protein from it's DNA it makes many copies of the hepatitis protein, which we can inject as a vaccine. | |||||||||||
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| Nicotine induces P-450 enzymes in the liver. An AIDS patient taking a protease inhibitor drug which is metabolized by these enzymes would experience which of the following if they smoked? | |||||||||||
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| You have a patient with Parkinson's disease, and you want to get more dopamine into the brain. Dopamine is a polar molecule. How can you accomplish this best? | |||||||||||
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| General Feedback: | Charged (polar or water soluble) molecules cannot cross the blood brain barrier. The Parkinson's patient takes levadopa (a lipid soluble precurser to dopamine). After it diffuses across the blood brain barrier, it coverts to dopamine. (You could get into trouble by converting all that dopamine out in the periphery as the blood pressure would sky rocket. Add a peripheral conversion inhibitor (carbidopa) to prevent this. Sinemet is the typical drug taken. It is a combination of levadopa and carbidopa. | ||||||||||
| The time between when a drug is administered and when there are observable effects is called the | |||||||||||
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A drug that occupies and "turns on" a receptor is an:
| | Student Response |
| A. | adjuvant. |
| B. | affinitant. |
| C. | antagonist. |
| D. | agonist. |
| Drug A can produce the same effects as Drug B at a lower dose of drug A. Drug A is: | ||||||||||
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| Once a drug's peak effect has been reached, further doses of the drug will increase efficacy. | |||||||||||||
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| Which of the following recent advances is most likely to influence future drug development and use? | |||||||||||||
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| General Feedback: | We have been able to isolate compounds out of plants for hundreds of years. Consider getting morphine from opium and digitalis form foxglove. The first antibiotics were discovered in the early 20th century and most/all microbes known to man have already been sceeened for potential new antibiotics. Chronopharmacolgy is a relatively new field but we do not have the ability to alter biological rhythms in a systematic way that could be exploited for drug therapy. In 2000 with the completion of the human genome project our knowledge of genetics is enabling us to customize drug therapy. This is anticipated to really change the way drugs are developed and used. | ||||||||||||
| You have a patient with meningitis, an inflammation of the brain covering. How can you get antibiotics to cross the blood brain barrier? | |||||||||||
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| General Feedback: | Inflammation opens the tight juction between endothelial cells in the brain allowing the antibiotics to enter. | ||||||||||
Thanks Lily for the extra questions!!
"Potency" refers to:
A. The severity of side effects.
B. The dose required to achieve therapeutic effect.
C. How quickly the drug will work.
D. Whether the drug will work.
6.
Which of the following would be the most appropriate way to measure efficacy of a drug?
A. Analyzing chemically the ingredients of the drug for impurities.
B. Asking clients if their symptoms were relieved after taking the drug.
C. Observing clients for harmful side effects while being treated with the drug.
D. Testing blood samples for concentration of the drug after the drug has been given.
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