Market Research Quiz Template
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- 1.
A 13-year-old boy with type 1 diabetes is brought to the hospital complaining of dizziness.Laboratory findings include severe hyperglycemia, ketoacidosis, and a blood pH of 7.15. Which of the following agents should be administered to achieve rapid control of the severeketoacidosis in this diabetic boy?
- A.
Crystalline zinc insulin
- B.
Glyburide
- C.
Insulin glargine
- D.
NPH insulin
- E.
Tolbutamide
Correct Answer
A. Crystalline zinc insulinExplanation
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- 2.
13-year-old boy with type 1 diabetes is brought to the hospital complaining of dizziness.Laboratory findings include severe hyperglycemia, ketoacidosis, and a blood pH of 7.15. Which of the following is the most likely complication of insulin therapy in this patient?
- A.
Dilutional hyponatremia
- B.
Hypoglycemia
- C.
Increased bleeding tendency
- D.
Pancreatitis
- E.
Severe hypertension
Correct Answer
B. Hypoglycemia -
- 3.
24-year-old woman with type 1 diabetes wishes to try tight control of her diabetes toimprove her long-term prognosis. Which of the following regimens is most appropriate?
- A.
Morning injections of mixed insulin lispro and insulin aspart
- B.
Evening injections of mixed regular insulin and insulin glargine
- C.
Morning and evening injections of regular insulin, supplemented by small amounts ofNPH insulin at mealtimes
- D.
Morning injections of insulin glargine, supplemented by small amounts of insulinlispro at mealtimes
- E.
Morning injection of NPH insulin and evening injection of regular insulin
Correct Answer
D. Morning injections of insulin glargine, supplemented by small amounts of insulinlispro at mealtimes -
- 4.
Which one of the following drugs promotes the release of endogenous insulin?
- A.
Acarbose
- B.
Glipizide
- C.
Metformin
- D.
Miglitol
- E.
Pioglitazone
Correct Answer
B. Glipizide -
- 5.
Which of the following is an important effect of insulin?
- A.
Increased conversion of amino acids into glucose
- B.
Increased gluconeogenesis
- C.
Increased glucose transport into cells
- D.
Inhibition of lipoprotein lipase
- E.
Stimulation of glycogenolysis
Correct Answer
C. Increased glucose transport into cells -
- 6.
54-year-old obese patient with type 2 diabetes has a history of alcoholism. In this patient,metformin should either be avoided or used with extreme caution because the combina- tionof metformin and ethanol increases the risk of which of the following?
- A.
A disulfiram-like reaction
- B.
Excessive weight gain
- C.
Hypoglycemia
- D.
Lactic acidosis
- E.
Serious hepatotoxicity
Correct Answer
D. Lactic acidosis -
- 7.
Which of the following drugs is taken during the first part of a meal for the purpose ofdelaying the absorption of dietary carbohydrates?
- A.
Acarbose
- B.
Exenatide
- C.
Glipizide
- D.
Pioglitazone
- E.
Repaglinide
Correct Answer
A. Acarbose -
- 8.
The PPAR-γ receptor that is activated by thiazolidinediones increases tissue sensitivity toinsulin by which of the following mechanisms?
- A.
Activating adenylyl cyclase and increasing the intracellular concentration of cAMP
- B.
Inactivating a cellular inhibitor of the GLUT2 glucose transporter
- C.
Inhibiting acid glucosidase, a key enzyme in glycogen breakdown pathways
- D.
Regulating transcription of genes involved in glucose utilization
- E.
Stimulating the activity of a tyrosine kinase that phosphorylates the insulin receptor
Correct Answer
D. Regulating transcription of genes involved in glucose utilization -
- 9.
Which of the following drugs is most likely to cause hypoglycemia when used asmonotherapy in the treatment of type 2 diabetes?
- A.
Acarbose
- B.
Glyburide
- C.
Metformin
- D.
Miglitol
- E.
Rosiglitazone
Correct Answer
B. Glyburide -
- 10.
Which of the following patients is most likely to be treated with intravenous glucagon?
- A.
An 18-year-old woman who took an overdose of cocaine and now has a blood pressureof 190/110 mm Hg
- B.
A 27-year-old woman with severe diarrhea caused by a flare in her inflammatory boweldisease
- C.
A 57-year-old woman with type 2 diabetes who has not taken her glyburide for the last3 d
- D.
A 62-year-old man with severe bradycardia and hypoten- sion resulting fromingestion of an overdose of atenolol
- E.
A 74-year-old man with lactic acidosis as a complication of severe infection and shock
Correct Answer
D. A 62-year-old man with severe bradycardia and hypoten- sion resulting fromingestion of an overdose of atenolol -
- 11.
Which of the following drugs is routinely added to calcium supplements and milk for the purpose of preventing rickets in children and osteomalacia in adults?
- A.
Cholecalciferol
- B.
Calcitriol
- C.
Gallium nitrate
- D.
Sevelamer
- E.
Plicamycin
Correct Answer
A. Cholecalciferol -
- 12.
Which of the following drugs is most useful for the treatment of hypercalcemia in Paget’s disease?
- A.
Fluoride
- B.
Hydrochlorothiazide
- C.
Pamidronate
- D.
Raloxifene
- E.
Teriparatide
Correct Answer
C. Pamidronate -
- 13.
The active metabolites of vitamin D act through a nuclear receptor to produce which of the following effects?
- A.
Decrease the absorption of calcium from bone
- B.
Increase PTH formation
- C.
Increase renal production of erythropoietin
- D.
Increase the absorption of calcium from the gastrointes- tinal tract
- E.
Lower the serum phosphate concentration
Correct Answer
D. Increase the absorption of calcium from the gastrointes- tinal tract -
- 14.
Which of the following conditions is an indication for the use of raloxifene?
- A.
Chronic kidney failure
- B.
Hypoparathyroidism
- C.
Intestinal osteodystrophy
- D.
Postmenopausal osteoporosis
- E.
Rickets
Correct Answer
D. Postmenopausal osteoporosis -
- 15.
A 58-year-old postmenopausal woman was sent for dual-energy x-ray absorptiometry to evaluate the bone mineral density of her lumbar spine, femoral neck, and total hip. The test results revealed significantly low bone mineral density in all sites. Chronic use of which of the following medications is most likely to have contributed to this woman’s osteoporosis?
- A.
Lovastatin
- B.
Metformin
- C.
Prednisone
- D.
Propranolol
- E.
Thiazide diuretic
Correct Answer
C. Prednisone -
- 16.
A 58-year-old postmenopausal woman was sent for dual-energy x-ray absorptiometry to evaluate the bone mineral density of her lumbar spine, femoral neck, and total hip. The test results revealed significantly low bone mineral density in all sites. If this patient began oral therapy with alendronate, she would be advised to drink large quantities of water with the tablets and remain in an upright position for at least 30 min and until eating the first meal of the day. These instructions would be given to decrease the risk of which of the following?
- A.
Cholelithiasis
- B.
Diarrhea
- C.
Constipation
- D.
Erosive esophagitis
- E.
Pernicious anemia
Correct Answer
D. Erosive esophagitis -
- 17.
The patient’s condition was not sufficiently controlled with alendronate, so she began therapy with a nasal spray containing a protein that inhibits bone resorption. The drug contained in the nasal spray was which of the following?
- A.
Calcitonin
- B.
Calcitriol
- C.
Cinacalcet
- D.
Cortisol
- E.
Teriparatide
Correct Answer
A. Calcitonin -
- 18.
A 67-year-old man with chronic kidney disease was found to have an elevated serum PTH concentration and a low serum concentration of 25-hydroxyvitamin D. He was successfully treated with ergocalciferol. Unfortunately, his kidney disease progressed so that he required dialysis and his serum PTH concentration became markedly elevated. Which of the following drugs is most likely to lower this patient’s serum PTH concentration?
- A.
Calcitriol
- B.
Cholecalciferol
- C.
Furosemide
- D.
Gallium nitrate
- E.
Risedronate
Correct Answer
A. Calcitriol -
- 19.
A 67-year-old man with chronic kidney disease was found to have an elevated serum PTH concentration and a low serum concentration of 25-hydroxyvitamin D. He was successfully treated with ergocalciferol. Unfortunately, his kidney disease progressed so that he required dialysis and his serum PTH concentration became markedly elevated. Although the drug therapy was effective at lowering serum PTH concentrations, the patient experienced several episodes of hypercalcemia. He was switched to a vitamin D analog that suppresses PTH with less risk of hypercalcemia. Which drug was the patient switched to?
- A.
Calcitriol
- B.
Cholecalciferol
- C.
Furosemide
- D.
Paricalcitol
- E.
Risedronate
Correct Answer
D. Paricalcitol -
- 20.
In the treatment of patients like this with secondary hyper- parathyroidism due to chronic kidney disease, cinacalcet is an alternative to vitamin D-based drugs. Cinacalcet lowers PTH by which of the following mechanisms?
- A.
Activating a steroid receptor that inhibits expression of the PTH gene
- B.
Activating the calcium-sensing receptor in parathyroid cells
- C.
Activating transporters in the GI tract that are involved in calcium absorption
- D.
Inducing the liver enzyme that converts vitamin D3 to 25-hydroxyvitamin D3
- E.
Option 5
Correct Answer
B. Activating the calcium-sensing receptor in parathyroid cells -
- 21.
Which of the following is a pharmacologic effect of exogenous glucocorticoids?
- A.
Increased muscle mass
- B.
Hypoglycemia
- C.
Inhibition of leukotriene synthesis
- D.
Improved wound healing
- E.
Increased excretion of salt and water
Correct Answer
C. Inhibition of leukotriene synthesis -
- 22.
A 34-year-old woman with ulcerative colitis has required long-term treatment withpharmacologic doses of a glucocorticoid agonist. Which of the following is a toxic effectassociated with long-term glucocorticoid treatment?
- A.
A “lupus-like” syndrome
- B.
Adrenal gland neoplasm
- C.
Hepatotoxicity
- D.
Osteoporosis
- E.
Precocious puberty in children
Correct Answer
D. Osteoporosis -
- 23.
A 46-year-old male patient has Cushing’s syndrome that is due to the presence of anadrenal tumor. Which of the following drugs would be expected to reduce the signs andsymptoms of this man’s disease?
- A.
Betamethasone
- B.
Cortisol
- C.
Fludrocortisone
- D.
Ketoconazole
- E.
Triamcinolone
Correct Answer
D. Ketoconazole -
- 24.
A newborn girl exhibited ambiguous genitalia, hyponatremia, hyperkalemia, andhypotension as a result of genetic deficiency of 21-hydroxylase activity. Treatmentconsisted of fluid and salt replacement and hydrocortisone administration. In this type ofadrenal hyperplasia in which there is excess production of cortisol precursors, which of thefollowing describes the primary therapeutic effect of glucocorticoid administration?
- A.
Increased adrenal estrogen synthesis
- B.
Inhibition of adrenal aldosterone synthesis
- C.
Prevention of hypoglycemia
- D.
Recovery of normal immune function
- E.
Suppression of ACTH secretion
Correct Answer
E. Suppression of ACTH secretion -
- 25.
Which of the following best describes a glucocorticoid response element?
- A.
A protein regulator that controls the interaction between an activated steroid receptor and DNA
- B.
A short DNA sequence that binds tightly to RNA polymerase
- C.
A small protein that binds to an unoccupied steroid receptor protein
- D.
A specific nucleotide sequence that is recognized by a steroid hormone receptor-hormone complex
- E.
The portion of the steroid receptor that binds to DNA
Correct Answer
D. A specific nucleotide sequence that is recognized by a steroid hormone receptor-hormone complex -
- 26.
Glucocorticoids have proved useful in the treatment of which of the following medicalconditions?
- A.
Chemotherapy-induced vomiting
- B.
Essential hypertension
- C.
Hyperprolactinemia
- D.
Parkinson’s disease
- E.
Type II diabetes
Correct Answer
A. Chemotherapy-induced vomiting -
- 27.
A 56-year-old woman with systemic lupus erythematosus had been maintained on amoderate daily dose of prednisone for 9 mo. Her disease has finally gone into remission andshe now wishes to gradually taper and then discontinue the prednisone. Gradual tapering ofa glucocorticoid is required for recovery of which of the following?
- A.
Depressed release of insulin from pancreatic B cells
- B.
Hematopoiesis in the bone marrow
- C.
Normal osteoblast function
- D.
The control by vasopressin of water excretion
- E.
Option 5
Correct Answer
B. Hematopoiesis in the bone marrow -
- 28.
A 54-year-old man with advanced tuberculosis has developed signs of severe acute adrenalinsufficiency. Which of the following signs or symptoms is this patient most likely toexhibit?
- A.
A moon face
- B.
Dehydration
- C.
Hyperglycemia
- D.
Hypertension
- E.
Hyperthermia
Correct Answer
B. Dehydration -
- 29.
A 54-year-old man with advanced tuberculosis has developed signs of severe acute adrenalinsufficiency. The patient should be treated immediately. Which of the followingcombinations is most rational?
- A.
Aldosterone and fludrocortisone
- B.
Cortisol and fludrocortisone
- C.
Dexamethasone and metyrapone
- D.
Fludrocortisone and metyrapone
- E.
Triamcinolone and dexamethasone
Correct Answer
B. Cortisol and fludrocortisone -
- 30.
Which of the following is a drug that, in high doses, blocks the glucocorticoid receptor?
- A.
Aminoglutethimide
- B.
Beclomethasone
- C.
Ketoconazole
- D.
Mifepristone
- E.
Spironolactone
Correct Answer
D. Mifepristone -
- 31.
A 56-year-old man has hypertension and an enlarged prostate, which biopsy shows to be benign prostatic hyperplasia. He complains of urinary retention. Which of the following drugs would be the most appropriate initial therapy?
- A.
Albuterol
- B.
Atenolol
- C.
Metoprolol
- D.
Prazosin
- E.
Timolol
Correct Answer
D. Prazosin -
- 32.
A 36-year-old woman presents with symptoms of major depression that are unrelated to a general medical condition, bereavement, or substance abuse. She is not currently taking any prescription or over-the-counter medications. Drug treatment is to be initiated with paroxetine. In your information to the patient, you would tell her that
- A.
It is preferable that she does not take the drug in the evening
- B.
Muscle cramps and twitches can sometimes occur
- C.
She should tell you if she anticipates using other prescription drugs
- D.
The antidepressant effects of paroxetine may take 2 weeks or more to become effective
- E.
All of the above
Correct Answer
E. All of the above -
- 33.
Concerning the proposed mechanisms of action of antidepressant drugs, which statement is accurate?
- A.
Bupropion inhibits 5-HT reuptake into nerve endings in the CNS
- B.
Chronic treatment with tricyclic antidepressants leads to upregulation of adrenoceptors in the CNS
- C.
Decreased levels of NE and 5-HT in cerebrospinal fluid are characteristic of depressed patients before drug therapy
- D.
Nefazodone blocks 5-HT receptors in the CNS
- E.
Selegiline selectively decreases the metabolism of serotonin
Correct Answer
D. Nefazodone blocks 5-HT receptors in the CNS -
- 34.
A 34-year-old male patient who was prescribed citalopram for depression has decided he wants to stop taking the drug. When questioned, he said that it was affecting his sexual performance. You ascertain that he is also trying to overcome his dependency on tobacco products. If you decide to reinstitute drug therapy in this patient, the best choice would be
- A.
Bupropion
- B.
Fluoxetine
- C.
Imipramine
- D.
Paroxetine
- E.
Venlafaxine
Correct Answer
A. Bupropion -
- 35.
Regarding the clinical use of antidepressant drugs, which statement is accurate?
- A.
Chronic use of antidepressants increases the activity of hepatic drug metabolizing enzymes
- B.
In the treatment of major depressive disorders, sertraline is usually more effective than fluoxetine
- C.
Tricyclics are highly effective in depressions with attendant anxiety, phobic features, and hypochondriasis
- D.
Weight gain often occurs during the first few months in patients taking SSRIs
- E.
When selecting an appropriate drug for treatment of depression, the history of patient response to specific drugs is a valuable guide
Correct Answer
E. When selecting an appropriate drug for treatment of depression, the history of patient response to specific drugs is a valuable guide -
- 36.
A patient under treatment for a major depressive disorder is brought to the emergency department after ingesting 30 times the normal daily therapeutic dose of amitriptyline. In severe tricyclic antidepressant overdose, it would be of minimal value to
- A.
Administer bicarbonate and potassium chloride (to correct acidosis and hypokalemia)
- B.
Administer lidocaine (to control cardiac arrhythmias)
- C.
Initiate hemodialysis (to hasten drug elimination)
- D.
Maintain heart rhythm by electrical pacing
- E.
Use intravenous diazepam to control seizures
Correct Answer
C. Initiate hemodialysis (to hasten drug elimination) -
- 37.
This drug, an antagonist at 5-HT2 receptors, is widely used for the management of insomnia.
- A.
Citalopram
- B.
Doxepin
- C.
Trazodone
- D.
Triazolam
- E.
Zolpidem
Correct Answer
C. Trazodone -
- 38.
A recently bereaved 73-year-old female patient was treated with a benzodiazepine for several weeks after the death of her husband, but she did not like the daytime sedation it caused even at low dosage. Living independently, she has no major medical problems but appears rather infirm for her age and has poor eyesight. Because her depressive symptoms are not abating, you decide on a trial of an antidepressant medication. Which of the following drugs would be the most appropriate choice for this patient?
- A.
Amitriptyline
- B.
Mirtazapine
- C.
Phenelzine
- D.
Sertraline
- E.
Trazodone
Correct Answer
D. Sertraline -
- 39.
SSRIs are much less effective than tricyclic antidepressants in the management of
- A.
Bulimia
- B.
Chronic pain of neuropathic origin
- C.
Generalized anxiety disorder
- D.
Obsessive-compulsive disorder
- E.
Premenstrual dysphoric disorder
Correct Answer
B. Chronic pain of neuropathic origin -
- 40.
Which of the following drugs is most likely to be of value in obsessive-compulsive disorders?
- A.
Amitriptyline
- B.
Clomipramine
- C.
Doxepin
- D.
Nefazodone
- E.
Venlafaxine
Correct Answer
B. Clomipramine -
- 41.
A 9-year-old child is having learning difficulties at school. He has brief lapses of awareness with eyelid fluttering that occur every 5–10 min. Electroencephalogram (EEG) studies reveal brief 3-Hz spike and wave discharges appearing synchronously in all leads. Which drug would be effective in this child without the disadvantages of excessive sedation or tolerance development?
- A.
Clonazepam
- B.
Ethosuximide
- C.
Gabapentin
- D.
Felbamate
- E.
Phenobarbital
Correct Answer
B. Ethosuximide -
- 42.
Which statement concerning the proposed mechanisms of action of anticonvulsant drugs is inaccurate?
- A.
Diazepam facilitates GABA-mediated inhibitory actions
- B.
Ethosuximide selectively blocks potassium ion (K+) channels in thalamic neurons
- C.
Phenobarbital has multiple actions, including enhancement of the effects of GABA antagonism of glutamate receptors, and blockade of sodium ion (Na+) channels
- D.
Phenytoin prolongs the inactivated state of the Na+ channel
- E.
Zonisamide blocks voltage-gated Na+ channels
Correct Answer
B. Ethosuximide selectively blocks potassium ion (K+) channels in thalamic neurons -
- 43.
Which drug used in management of seizure disorders is most likely to elevate the plasma concentration of other drugs administered concomitantly?
- A.
Carbamazepine
- B.
Clonazepam
- C.
Gabapentin
- D.
Valproic acid
- E.
Vigabatrin
Correct Answer
D. Valproic acid -
- 44.
A young female patient suffers from absence seizures. Which of the following statements about her proposed drug management is NOT accurate?
- A.
Ethosuximide and valproic acid are preferred drugs
- B.
Gastrointestinal side effects are common with ethosuximide
- C.
She should be examined every 2 or 3 month for deep tendon reflex activity
- D.
The use of valproic acid in pregnancy may cause congenital malformations
- E.
Weight gain is common in patients on valproic acid
Correct Answer
C. She should be examined every 2 or 3 month for deep tendon reflex activity -
- 45.
The mechanism of antiseizure activity of carbamazepine is
- A.
Block of sodium ion channels
- B.
Block of calcium ion channels
- C.
Facilitation of GABA actions on chloride ion channels
- D.
Glutamate receptor antagonism
- E.
Inhibition of GABA transaminase
Correct Answer
A. Block of sodium ion channels -
- 46.
A 43-year-old very overweight man complains of not sleeping well and feeling tired during the day. He tells his physician that his wife is the cause of the problem because she wakes him up several times during the night because of his loud snores. This appears to be a breathing-related sleep disorder, so you should probably write a prescription for
- A.
Buspirone
- B.
Eszopiclone
- C.
Flurazepam
- D.
Secobarbital
- E.
None of the above
Correct Answer
E. None of the above -
- 47.
Which statement concerning the barbiturates is accurate?
- A.
Abstinence syndromes are more severe during withdrawal from phenobarbital than from secobarbital
- B.
Alkalinization of the urine accelerates the elimination of phenobarbital
- C.
Barbiturates may increase the half-lives of drugs metabolized by the liver
- D.
Compared with barbiturates, the benzodiazepines exhibit a steeper dose-response relationship
- E.
Respiratory depression caused by barbiturate over dosage can be reversed by flumazenil
Correct Answer
B. Alkalinization of the urine accelerates the elimination of phenobarbital -
- 48.
A 24-year-old stockbroker has developed a “nervous disposition’’. He is easily startled, worries about inconsequential matters, and sometimes complains of stomach cramps. At night he grinds his teeth in his sleep. There is no history of drug abuse. Diagnosed as suffering from generalized anxiety disorder, he is prescribed buspirone. His physician should inform the patient to anticipate
- A.
A need to continually increase drug dosage because of tolerance
- B.
A significant effect of the drug on memory
- C.
Additive CNS depression with alcoholic beverages
- D.
That the drug is likely to take a week or more to begin working
- E.
That if he stops taking the drug abruptly, he will experience withdrawal signs
Correct Answer
D. That the drug is likely to take a week or more to begin working -
- 49.
Which of the following best describes the mechanism of action of benzodiazepines?
- A.
Activate GABAB receptors in the spinal cord
- B.
Block glutamate receptors in hierarchical neuronal pathways in the brain
- C.
Increase frequency of opening of chloride ion channels coupled to GABAA receptors
- D.
Inhibit GABA transaminase to increase brain levels of GABA
- E.
Stimulate release of GABA from nerve endings in the brain
Correct Answer
C. Increase frequency of opening of chloride ion channels coupled to GABAA receptors -
- 50.
An 82-year-old woman, otherwise healthy for her age, has difficulty sleeping. Triazolam is prescribed for her at one half of the conventional adult dose. Which statement about the use of triazolam in this elderly patient is accurate?
- A.
Ambulatory dysfunction does not occur in elderly patients taking one half of the conventional adult dose
- B.
Hypertension is a common adverse effect of benzodiazepines in elderly patients
- C.
Over-the-counter cold medications may antagonize the hypnotic effects of the drug
- D.
The patient may experience amnesia, especially if she also consumes alcoholic beverages
- E.
Triazolam is distinctive in that it does not cause rebound insomnia on abruptdiscontinuance
Correct Answer
D. The patient may experience amnesia, especially if she also consumes alcoholic beverages -
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Mar 29, 2024Quiz Edited by
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