Block 7 Pharm Dr Thomas
From her workshop. If anyone took good notes/explanations on any of these questions, send them to me and I will include them in the questions.
- 1.Which of the following is the best explanation for why oral testosterone is not used for androgen replacement?
- A.
High “first pass effect”
- B.
Hepatoxicity
- C.
Increased DHT/T
- D.
Poor oral absorption
- E.
High abuse potential
- 2.(NBME-type) A 62-year-old man complains to his physician that he frequently feels the urge to urinate, but then he has trouble starting the flow and is sometimes troubled by dribbling when he has finished urinating. His prostate gland is found to be significantly enlarged, and following additional tests, benign prostatic hyperplasia is diagnosed. The physician prescribes a drug to help prevent further enlargement of the prostate and possibly to help reduce the size. Which of the following drugs was most likely prescribed to achieve these effects?
- A.
Fluoxetine
- B.
Flutamide
- C.
Medroxyprogesterone
- D.
Finasteride
- E.
Leuprolide
- F.
Testosterone enanthate
- 3.Which of the following clinical diagnoses would be an indication for using bromocriptine to address infertility in a 25-year-old woman?
- A.
Hypothyroidism
- B.
Hyopituitarism
- C.
Hypogonadism
- D.
Hyperprolactinemia
- E.
Oligomenorrhea
- F.
Addison’s Disease
- 4.Is bromocriptine acting as an agonist or an antagonist in the above situation?
- A.
Agonist
- B.
Antagonist
- 5.Which of the following is most likely to be an effective drug target for a man with prostate cancer?
- A.
Aromatase enzyme
- B.
5a-reductase enzyme
- C.
Adenylate cyclase enzyme
- D.
DHT receptors
- E.
GnRH receptors
- F.
LH receptors
- 6.What is the primary direct site of action of combined oral contraceptives?
- A.
Ovary
- B.
Uterus
- C.
Cerebellum
- D.
Hypothalamus
- E.
Posterior pituitary
- F.
Anterior pituitary
- G.
Fallopian tube
- 7.(NBME type) A 25-year-old woman is conferring with her gynecologist regarding treatment options for debilitating endometriosis. She wishes to have children in the future and hopes to get her endometriosis under control without further compromising her fertility. They decide to try depot injections of leuprolide for the next 6 months and then re-evaluate the condition. In addition, the physician prescribes a low dose combined oral contraceptive preparation. What is the most important therapeutic reason for adding the low-dose OC?
- A.
To prevent pregnancy during exposure to leuprolide
- B.
To prevent bone loss
- C.
To maintain normal menstrual periods
- D.
To maintain body weight
- E.
To prevent hypotension
- 8.Use the following stem for questions 8-11: Progestin-only contraception can be administered orally, intravaginally, subcutaneously or intramuscularly. Which of these routes is most likely to employ release from a silastic (or other polymer) substrate?
- A.
Oral
- B.
Intravaginal
- C.
Subcutaneous
- D.
Intramuscular
- 9.Use the following stem for questions 8-11: Progestin-only contraception can be administered orally, intravaginally, subcutaneously or intramuscularly. Which of these routes requires daily administration?
- A.
Oral
- B.
Intravaginal
- C.
Subcutaneous
- D.
Intramuscular
- 10.Use the following stem for questions 8-11: Progestin-only contraception can be administered orally, intravaginally, subcutaneously or intramuscularly. Which of these routes bypass the “first pass” effect?
- A.
Oral
- B.
Intravaginal
- C.
Subcutaneous
- D.
Intramuscular
- E.
All but the oral route
- 11.Use the following stem for questions 8-11: Progestin-only contraception can be administered orally, intravaginally, subcutaneously or intramuscularly. Which of these routes access the primary site of contraceptive action without significantly increasing circulating blood levels?
- A.
Oral
- B.
Intravaginal
- C.
Subcutaneous
- D.
Intramuscular
- 12.(NBME) A 13-year-old girl has no signs of puberty. She was previously diagnosed with a condition that includes hypogonadotropic hypogonadism. Which of the following best describes an appropriate first step for hormone replacement therapy for this girl?
- A.
An estradiol patch at night
- B.
Bromocriptine
- C.
Leuprolide
- D.
Low dose oral contraceptive
- E.
Medroxyprogesterone depot injections
- 13.A 20-year-old female college student complains of breakthrough bleeding 3 months after starting to use a low-dose combined oral contraceptive regimen. Her physician questions her carefully about her pill-taking habits, and is satisfied that the patient has been taking the pills on a regular basis. Which of the following might be the most reasonable next step for this patient to continue to sustain reliable contraception with minimal adverse events?
- A.
Switch to a progestin-only mini-pill
- B.
Switch to a depot progesterone method
- C.
Switch to a combined OC with a different E component
- D.
Switch to a combined OC with a higher dose E component
- E.
Switch to a combined OC with a higher dose P component
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