Pharmacology Final

59 Questions

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Pharmacology Final

Questions and Answers
  • 1. 
    Which of the following is not an area where estrogens are produced in the body? (Males or Females)
    • A. 

      Testes

    • B. 

      Ovaries

    • C. 

      Adipose Tissue

    • D. 

      Uterus

  • 2. 
    Which of the following is not an aromatic compound? (Check all that apply)
    • A. 

      Estradiol

    • B. 

      Estrone

    • C. 

      Testosterone

    • D. 

      Estriol

    • E. 

      Progesterone

  • 3. 
    Estrogens bind _______ to a receptor that has ___________ subtype(s)
    • A. 

      Intracellularly ; Two

    • B. 

      Intracellularly ; One

    • C. 

      Extracellularly ; One

    • D. 

      Extracellularly ; Two

  • 4. 
    Which of the following is false concerning the mechanism of action of estrogens?
    • A. 

      Dimerization occurs after estrogens bind to the Estrogen Receptor

    • B. 

      Pharmacological effects are relatively slow

    • C. 

      Effects on the gene can only result in activation or an increase in gene activity

    • D. 

      The ER-ER dimer binds to what is called an Estrogen Response Element

  • 5. 
    Which estrogen is the major urinary metabolite?
    • A. 

      Estriol

    • B. 

      Estradiol

    • C. 

      Estrone

    • D. 

      All are equally likely

  • 6. 
    Which of the following are enzymes that control the metabolism of estrogens? (Check all that apply)
    • A. 

      COMT

    • B. 

      CYP 1A

    • C. 

      MAO

    • D. 

      UDP-Glucuronosyltransferase

  • 7. 
    Which substitutions on the structure above are required for activity? (Check all that apply)
    • A. 

      Ethinyl group on the 17-alpha carbon

    • B. 

      The aromatic ring

    • C. 

      3-carbon Hydroxyl group

    • D. 

      A hydroxyl group at 17-beta carbon

  • 8. 
    In order to decrease first pass metabolism, med chemists could add a(n) _________ group to the __________.
    • A. 

      Hydroxyl ; 3 carbon

    • B. 

      OH ; 6 carbon

    • C. 

      Ketone ; 16 carbon

    • D. 

      Ethinyl ; 17 carbon

  • 9. 
    A medicinal chemist would decrease the activity of an estrogen by doing which of the following? (Check all that apply) 
    • A. 

      Enlarging the D ring (5 membered ring)

    • B. 

      Addition of a vinyl group at the 17 Carbon

    • C. 

      Adding functional groups to carbon 1

    • D. 

      Changing the conformation of the 17 carbon from beta to alpha

  • 10. 
    Which of the following is a naturally occurring estrogen?
    • A. 

      Estrone Sulfate

    • B. 

      Mestronol

    • C. 

      Ethinyl Estradiol

    • D. 

      Estradiol Valerate

  • 11. 
    Which of the following estrogens is formulated for IM depot injection?
    • A. 

      Estradiol Valerate

    • B. 

      Ethinyl Estradiol

    • C. 

      Estradiol

    • D. 

      Estrone Sulfate

  • 12. 
    Which of the following is true concerning SERMs (Selective Estrogen Receptor Modulators)
    • A. 

      Tamoxifen is an estrogen receptor antagonist in all tissues

    • B. 

      The trans isomer of Tamoxifen has estrogenic activity

    • C. 

      Tamoxifen is not affected by CYPs

    • D. 

      Tamoxifen stimulates proliferation of the endometrium through partial agonism

  • 13. 
    Which of the following exerts anti-estrogenic effects at the level of the hypothalamus?
    • A. 

      Anastrazole

    • B. 

      Tamoxifen

    • C. 

      Raloxifene

    • D. 

      Clomiphene

  • 14. 
    Which of the following is false when contrasting estrogen and progesterone?
    • A. 

      Estrogen causes proliferation of the endometrium; Progesterone causes maturation

    • B. 

      Progesterone receptors interact with a coactivator or corepressor; Estrogen receptors do not

    • C. 

      Estrogens increase LDL; Progesterones decrease LDL

    • D. 

      Estrogens are aromatic ; Progesterones are not aromatic

  • 15. 
    In the structure above, which of the following is required for activity? (Check all that apply)
    • A. 

      4-en, 3-one in ring A (First ring on the left)

    • B. 

      Methyl group at carbon 10 (AKA carbon 19)

    • C. 

      Ketone group at carbon 17

    • D. 

      Methyl group at carbon 13 (AKA carbon 18)

  • 16. 
    5-alpha-reductase is responsible for producing which of the following molecules?
    • A. 

      Dehydroepiandrosterone (DHEA)

    • B. 

      Androstenedione

    • C. 

      Testosterone

    • D. 

      Dihydrotestosterone (DHT)

  • 17. 
    Which of the following is responsible for the increase in muscle mass of men during puberty?
    • A. 

      Testosterone

    • B. 

      Dihydrotestosterone

    • C. 

      Estradiol

    • D. 

      Dehyroepiandrosterone

  • 18. 
    Which of the following is responsible for the increase in bone density of men and facilitates epiphyseal bone closure.
    • A. 

      Testosterone

    • B. 

      Dihydrotestosterone

    • C. 

      Estradiol

    • D. 

      Dehyroepiandrosterone

  • 19. 
    Which of the following is most significantly responsible for stimulation of the prostate gland?
    • A. 

      Testosterone

    • B. 

      Dihydrotestosterone

    • C. 

      Estradiol

    • D. 

      Dehyroepiandrosterone

  • 20. 
    DHEA is produced in what part of the adrenal gland?
    • A. 

      Adrenal medulla

    • B. 

      Zona glomerulosa

    • C. 

      Zona reticularis

    • D. 

      Zona fasiculata

  • 21. 
    All steroid hormones start with which molecule at the beginning of the pathway?
    • A. 

      Progesterone

    • B. 

      Pregnenolone

    • C. 

      Cortisol

    • D. 

      Thyroid Hormone

  • 22. 
    The image above is a representation of which of the following molecules?
    • A. 

      DHEA

    • B. 

      Aldosterone

    • C. 

      Prednisolone

    • D. 

      Cortisone

  • 23. 
    The image above is a representation of which of the following molecules?
    • A. 

      DHEA

    • B. 

      Aldosterone

    • C. 

      Prednisolone

    • D. 

      Cortisone

  • 24. 
    The image above is a representation of which of the following molecules?
    • A. 

      DHEA

    • B. 

      Aldosterone

    • C. 

      Prednisolone

    • D. 

      Fludrocortisone

  • 25. 
    The image above is a representation of which of the following molecules?
    • A. 

      DHEA

    • B. 

      Aldosterone

    • C. 

      Prednisolone

    • D. 

      Fludrocortisone

  • 26. 
    The image above is a representation of which of the following molecules?
    • A. 

      Dexamethasone

    • B. 

      Cortisone

    • C. 

      Prednisolone

    • D. 

      Fludrocortisone

  • 27. 
    The image above is a representation of which of the following molecules?
    • A. 

      Dexamethasone

    • B. 

      Cortisone

    • C. 

      Prednisolone

    • D. 

      Fludrocortisone

  • 28. 
    The production of which of the following steroid hormones would least likely be affected by the presence of a strong CYP17 inhibitor?
    • A. 

      Aldosterone

    • B. 

      Cortisol

    • C. 

      DHEA

    • D. 

      Estradiol

  • 29. 
    The production of which of the following steroid hormones would be affected by strong inhibition of CYP21? (Check all that apply)
    • A. 

      Progesterone

    • B. 

      Aldosterone

    • C. 

      Cortisol

    • D. 

      DHEA

  • 30. 
    Which of the following is the longest acting corticosteroid?
    • A. 

      Prednisone

    • B. 

      Methylprednisolone

    • C. 

      Betamethasone

    • D. 

      Triamcinolone

  • 31. 
    For a patient receiving 20mg of Hydrocortisone, what is the equivalent dose of prednisone?
    • A. 

      4mg

    • B. 

      5mg

    • C. 

      20mg

    • D. 

      1mg

  • 32. 
    Which of the following agents is used to treat Cushing's syndrome and has significant anti-progestin activity?
    • A. 

      Meglitinide

    • B. 

      Mitotane

    • C. 

      Mifepristone

    • D. 

      Metyrapone

  • 33. 
    For a patient who is pregnant and has Cushing's disease, which of the following would be your only option for treatment?
    • A. 

      Mifepristone

    • B. 

      Metyrapone

    • C. 

      Mitotane

    • D. 

      Abiraterone

  • 34. 
    Mitotane is an adrenocorticolytic, meaning it destroys the adrenal cortex. Which of the following steroids would it decrease the production of?
    • A. 

      Glucocorticoids

    • B. 

      Mineralocorticoids

    • C. 

      Androgens

    • D. 

      1 of the above

    • E. 

      2 of the above

    • F. 

      All of the above

  • 35. 
    Which of the following is true concerning insulin's glucose regulation?
    • A. 

      Insulin is only released from the beta cells after meals

    • B. 

      Production of ATP from the metabolism of glucose results in potassium channel opening and exocytosis of insulin

    • C. 

      Incretins are responsible for inhibiting insulin release

    • D. 

      Chronic elevated glucose levels suppress insulin release

  • 36. 
    Which of the following insulin products would be most likely useful for continuous infusion?
    • A. 

      Insulin Detemir

    • B. 

      NPH Insulin

    • C. 

      Insulin Glargine

    • D. 

      Insulin Aspart

  • 37. 
    Which of the following insulin products are complexed with zinc to stabilize and alter the release of the molecule?
    • A. 

      Insulin Lispro

    • B. 

      Normal Insulin

    • C. 

      Insulin NPH

    • D. 

      Insulin Detemir

  • 38. 
    Which of the following insulin secretagogues would be recommended for someone with a sulfa allergy?
    • A. 

      Tolbutamide

    • B. 

      Glipizide

    • C. 

      Chlorpropamide

    • D. 

      Nateglinide

  • 39. 
    Which of the following agents used to treat Type II diabetes can interfere with B12 absorption?
    • A. 

      Glipizide

    • B. 

      Metformin

    • C. 

      Pioglitazone

    • D. 

      Acarbose

  • 40. 
    Which of the following agents to treat diabetes has a primary mechanism of altering gene transcription at a target tissue?
    • A. 

      Pioglitazone

    • B. 

      Metformin

    • C. 

      Repaglinide

    • D. 

      Acarbose

  • 41. 
    Which of the following agents to treat diabetes inhibits an enzyme?
    • A. 

      Rosiglitazone

    • B. 

      Alogliptin

    • C. 

      Exenatide

    • D. 

      Canagliflozin

  • 42. 
    Which of the following agents to treat diabetes in has a primary mechanism of inhibition of an enzyme?
    • A. 

      Pioglitazone

    • B. 

      Dulaglutide

    • C. 

      Acarbose

    • D. 

      Pramlintide

  • 43. 
    Which of these agents used to treat diabetes does not require renal dosage adjustment for patients with poor renal function? (Check all that apply)
    • A. 

      Nateglinide

    • B. 

      Liraglutide

    • C. 

      Dulaglitide

    • D. 

      Linagliptin

  • 44. 
    Of the first generation sulfonyureas, _________ has the longest half-life, while _________ has the shortest half-life?
    • A. 

      Tolbutamide; Tolazamide

    • B. 

      Tolazamide; Tolbutamide

    • C. 

      Glimepiride;Glipizide

    • D. 

      Chlorpropamide;Tolbutamide

  • 45. 
    Which class of drugs have been known to mask the symptoms of hypoglycemia and thus should be used with caution when taking antidiabetic medications?
    • A. 

      Calcium Channel Blockers

    • B. 

      Beta Blockers

    • C. 

      Statins

    • D. 

      Diuretics

  • 46. 
    Which insulin secretagogue is currently in disfavor due to its cardiac toxicity?
    • A. 

      Repaglinide

    • B. 

      Glimepiride

    • C. 

      Chlorpropamide

    • D. 

      Glyburide

  • 47. 
    Of all the insulin secretagogues, which of the following has the lowest incidence of hypoglycemia?
    • A. 

      Chlorpropamide

    • B. 

      Glyburide

    • C. 

      Glipizide

    • D. 

      Nateglinide

  • 48. 
    Which medication to treat diabetes has a black box warning risk of heart failure?
    • A. 

      Metformin

    • B. 

      Pioglitazone

    • C. 

      Acarbose

    • D. 

      Linagliptin

  • 49. 
    Which of the following medications to treat diabetes should possibly be avoided in patients with a history of thyroid cancer?
    • A. 

      Albiglutide

    • B. 

      Metformin

    • C. 

      Pioglitazone

    • D. 

      Sitagliptin

  • 50. 
    In estrogen deficiency, activity of which of the following is increased? (Check all that apply)
    • A. 

      OPG Production

    • B. 

      Bone resorption

    • C. 

      Binding of RANKL to RANK

    • D. 

      Number of osteoclasts

  • 51. 
    Which of the following is true?
    • A. 

      RANK is the natural ligand for RANKL

    • B. 

      OPG is produced by osteoclasts

    • C. 

      RANKL is the decoy ligand for RANK

    • D. 

      Osteoblasts produce OPG when estrogen is sufficient

  • 52. 
    Which of the following is the active form of Vitamin D?
    • A. 

      Cholecalciferol (D3)

    • B. 

      Ergocalciferol (D2)

    • C. 

      24,25-(OH)2D3 (Secalciferol)

    • D. 

      1,25-(OH)2D3 (Calcitriol)

  • 53. 
    When a vitamin D level is requested, which of the following molecules is measured due to its stability?
    • A. 

      Cholecalciferol (D3)

    • B. 

      25(OH)D3

    • C. 

      24,25-(OH)2D3 (Secalciferol)

    • D. 

      1,25-(OH)2D3 (Calcitriol)

  • 54. 
    Liver failure would least likely affect which of the following levels in the body?
    • A. 

      D3

    • B. 

      25(OH)D3

    • C. 

      1,25(OH2)D3

    • D. 

      24,25(OH2)D3

  • 55. 
    End stage renal disease would most likely affect which of the following levels in the body?
    • A. 

      D3

    • B. 

      25(OH)D3

    • C. 

      1,25(OH2)D3

    • D. 

      It would affect none of the above

  • 56. 
    The bone remodeling cycle takes approximately:
    • A. 

      3 months

    • B. 

      6 months

    • C. 

      9 months

    • D. 

      25 years

  • 57. 
    Which of the following is responsible for increasing serum concentration of phosphate?
    • A. 

      Parathyroid hormone

    • B. 

      FGF23

    • C. 

      Calcitriol

    • D. 

      Calcitonin

    • E. 

      Two of the above

  • 58. 
    Glucocorticoids have negative effects on the bone growth due to all of the following mechanisms EXCEPT:
    • A. 

      Inhibition of vitamin D - stimulated absorption of calcium in the intestines

    • B. 

      Stimulation of renal calcium excretion

    • C. 

      Inhibition of osteoblasts

    • D. 

      Inhibition of calcitonin