Ivms-USMLE Step 1 Review Course- Summative Assessment-pharmacology

75 Questions | Total Attempts: 56

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Ivms-USMLE Step 1 Review Course- Summative Assessment-pharmacology - Quiz

Directions: Each of the numbered items or incomplete statements in this section is followed by answers or by completions of the statement. Select the ONE lettered answer or completion that is BEST in each case.


Questions and Answers
  • 1. 
    A 17-year-old male was placed on carbamazepine therapy by his neurologist to control newly developed seizures of unknown etiology. The patient was also recently given a macrolide antibiotic by his family physician for a presumed “walking pneumonia.” Halfway through his antibiotic course, the patient again developed seizures. What could account for this new seizure activity?
    • A. 

      Inhibition of the cytochrome P-450 monooxygenase system

    • B. 

      Induction of the cytochrome P-450 monooxygenase system

    • C. 

      Impairment of renal excretion of the antiseizure medication

    • D. 

      Induction of glucuronyl transferase activity in the liver

    • E. 

      Reduction in the amount of nicotinamide adenine dinucleotide phosphate (NADPH)

  • 2. 
    A 21-year-old male sustains multiple blunt traumas after being beaten with a baseball bat by a gang. Aside from his fractures, a serum creatine kinase measurement is dramatically elevated and the trauma team is worried as the myoglobinuria caused by the trauma can cause kidney failure. They immediately begin to administer bicarbonate to alkalinize the urine. How does this serve to decrease myoglobin levels?
    • A. 

      Increasing glomerular filtration

    • B. 

      Promoting renal tubular secretion

    • C. 

      Inhibiting renal tubular reabsorption

    • D. 

      Increasing hepatic first-pass metabolism

    • E. 

      Inducing the P-450 system

  • 3. 
    Which of the following correctly describes the formula for a loading dose?
    • A. 

      Loading dose = (Desired plasma concentration of drug) × (clearance)

    • B. 

      Loading dose = (Clearance) × (Plasma drug concentration)

    • C. 

      Loading dose = (0.693) × (Volume of distribution)/(Clearance)

    • D. 

      Loading dose = (Amount of drug administered)/(Initial plasma concentration)

    • E. 

      Loading dose = (Desired plasma concentration of the drug) × (Volume of distribution)

  • 4. 
    A 32-year-old HIV-positive male follows up with an infectious disease (ID) specialist in the clinic. The results of his recent blood work suggest that the virus has become resistant to multiple nucleoside reverse transcriptase inhibitors. The ID specialist decides to include in the treatment a nonnucleoside inhibitor (nevirapine), which works by binding to a site near the active site on the reverse transcriptase. Nevirapine is an example of what?
    • A. 

      Full agonist

    • B. 

      Reversible competitive antagonist

    • C. 

      Partial agonist

    • D. 

      Noncompetitive antagonist

    • E. 

      Irreversible competitive antagonist

  • 5. 
    Which of the following drugs is a selective α-adrenergic receptor agonist that is available over-the-counter?
    • A. 

      Epinephrine

    • B. 

      Phenylephrine

    • C. 

      Isoproterenol

    • D. 

      Norepinephrine

    • E. 

      Phentolamine

  • 6. 
    Pilocarpine is what type of pharmacologic agent?
    • A. 

      Indirect muscarinic agonist

    • B. 

      α2-Adrenergic agonist

    • C. 

      Carbonic anhydrase inhibitor

    • D. 

      β-Adrenergic antagonist

    • E. 

      Direct-acting muscarinic agonist

  • 7. 
     Which of the following is a short-acting acetylcholinesterase inhibitor?
    • A. 

      Pyridostigmine

    • B. 

      Bethanechol

    • C. 

      Edrophonium

    • D. 

      Scopolamine

    • E. 

      Methantheline

  • 8. 
    Dantrolene
    • A. 

      Inhibits calcium release from the sarcoplasmic reticulum

    • B. 

      Functions as a GABAB receptor agonist

    • C. 

      Facilitates GABA activity in the CNS

    • D. 

      Reactivates acetylcholinesterase

    • E. 

      Competitively inhibits the effects of acetylcholine

  • 9. 
    A 63-year-old male, with a history of multiple myocardial infarctions is admitted for shortness of breath. A diagnosis of congestive heart failure is made on clinical grounds, and a cardiologist orders a positive inotropic agent for his heart failure. He is also concerned about maintaining perfusion to the kidneys, so an agent that increases renal blood flow is also desirable. Which of the following agents produces both of these desired effects?
    • A. 

      Epinephrine

    • B. 

      Dopamine

    • C. 

      Isoproterenol

    • D. 

      Terbutaline

  • 10. 
    Clonidine works by
    • A. 

      Activating β1-adrenergic receptors

    • B. 

      Activating α1-adrenergic receptors

    • C. 

      Activating β2-adrenergic receptors

    • D. 

      Activating α2-adrenergic receptors

    • E. 

      Blocking β-adrenergic receptors

  • 11. 
    A 23-year-old female presents with hypertension, anxiety, and palpitations. Her thyroid-stimulating hormone levels are normal, but she has increased levels of urinary catecholamines. She is referred to a endocrine surgeon after a CT scan shows a unilateral pheochromocytoma. The surgeon should start therapy with which of the following agents prior to removing the lesion?
    • A. 

      Dopamine

    • B. 

      Phentolamine

    • C. 

      . Pancuronium

    • D. 

      Pseudoephedrine

    • E. 

      Isoproterenol

  • 12. 
    A 45-year-old male with a history remarkable for both asthma and angina now has a kidney stone stuck in his right ureter. The urologist needs to perform cystoscopy, but the anesthesiologist is concerned about using a β-blocker during surgery to control the patient's blood pressure in light of his history of asthma. Ultimately, it is decide to use an ultra-short-acting β-blocker and closely monitor both his blood pressure and respiratory status. Which of the following is best to use in this situation?
    • A. 

      Atenolol

    • B. 

      Norepinephrine

    • C. 

      Albuterol

    • D. 

      Pseudoephedrine

    • E. 

      Esmolol

  • 13. 
    A neurosurgeon decides to start a patient on a diuretic that works by altering the diffusion of water relative to sodium (an osmotic diuretic) that is helpful in reducing cerebral edema. Which agent did the physician likely prescribe?
    • A. 

      Furosemide

    • B. 

      Hydrochlorothiazide

    • C. 

      Spironolactone

    • D. 

      . Acetazolamide

    • E. 

      Mannitol

  • 14. 
    . Which of the following would be useful in treating nocturnal enuresis?
    • A. 

      . Mannitol

    • B. 

      Indomethacin

    • C. 

      Furosemide

    • D. 

      Vasopressin

    • E. 

      Probenecid

  • 15. 
    Vasopressin
    • A. 

      Reduces ADH levels

    • B. 

      Increases permeability of the collecting duct

    • C. 

      Inserts aquaporins into the plasma membrane of collecting duct cells

    • D. 

      Increases diffusion of sodium

    • E. 

      Reduces production of prostaglandins

  • 16. 
    AcA 45-year-old male with a 60-pack/year history of smoking presents to his primary care provider with loss of appetite, nausea, vomiting, and muscle weakness. His chest CT reveals enlarged hilar lymph nodes and a suspicious mass in the left hilar region. A presumptive diagnosis of lung cancer is made. Laboratory results reveal low levels of sodium, which in this setting has likely contributed to the syndrome of inappropriate ADH secretion. Which medication might be helpful for this patient's symptoms?
    • A. 

      Clofibrate

    • B. 

      Demeclocycline

    • C. 

      Allopurinol

    • D. 

      Acetazolamide

    • E. 

      Furosemide

  • 17. 
    Which of the following drugs inhibits xanthine oxidase?
    • A. 

      Colchicine

    • B. 

      Indomethacin

    • C. 

      Probenecid

    • D. 

      Clofibrate

    • E. 

      Allopurinol

  • 18. 
    Which of the following is a common adverse effect of quinidine?
    • A. 

      Cinchonism

    • B. 

      Lupuslike syndrome

    • C. 

      Seizures

    • D. 

      Constipation

    • E. 

      Pulmonary fibrosis

  • 19. 
    What is the mechanism of action of β-blockers in heart disease?
    • A. 

      Prolongation of AV conduction

    • B. 

      Activation of the sympathetic system

    • C. 

      Promotion of automaticity

    • D. 

      Increase in heart rate

    • E. 

      Arteriolar vasodilation

  • 20. 
    Which of the following would be useful in the management of arrhythmia due to Wolf-Parkinson-White syndrome?
    • A. 

      Digoxin

    • B. 

      Lidocaine

    • C. 

      Amiodarone

    • D. 

      Adenosine

    • E. 

      Atropine

  • 21. 
    Which of the following inhibit HMG-CoA reductase?
    • A. 

      Nicotinic acid

    • B. 

      Rosuvastatin

    • C. 

      Ezetimibe

    • D. 

      Cholestyramine

    • E. 

      Gemfibrozil

  • 22. 
    Which of the following would be a good option to help a patient fall asleep with minimal “hangover”?
    • A. 

      Secobarbital

    • B. 

      Zolpidem

    • C. 

      Chlordiazepoxide

    • D. 

      Flumazenil

    • E. 

      Buspirone

  • 23. 
    Which of the following is a good choice to treat newly diagnosed generalized anxiety disorder (GAD) in a patient who is a truck driver?
    • A. 

      Alprazolam

    • B. 

      Triazolam

    • C. 

      Buspirone

    • D. 

      Trazodone

    • E. 

      Thiopental

  • 24. 
    A 57-year-old male with a strong family history of Parkinson's disease sees a neurologist for an evaluation. On examination, the neurologist notes a slight pill-rolling tremor and subtle gait abnormalities. He begins treatment with levodopa, along with the addition of carbidopa. How does carbidopa work in this setting?
    • A. 

      . Restores dopamine levels in the substantia nigra

    • B. 

      Inhibits monoamine oxidase (MAOI)

    • C. 

      Inhibits catechol-O-methyltransferase (COMT)

    • D. 

      Functions as a dopamine agonist

    • E. 

      Inhibits the metabolism of levodopa outside the CNS

  • 25. 
    The patient in the previous question returns to see his neurologist 3 years later. At this time the patient's symptoms have progressed, and he now has marked bradykinesia and a profound shuffling gait. In an attempt to prevent further deterioration, the neurologist prescribes a catechol-O-methyltransferase (COMT) inhibitor on top of the patient's levodopa and carbidopa. Which agent below is likely to have been added?
    • A. 

      Entacapone

    • B. 

      Selegiline

    • C. 

      Ropinirole

    • D. 

      Amantadine

    • E. 

      Benztropine

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