Pharm Exam 3 And 4
.
Questions and Answers
- 1.
An elderly patient with a history of HD and who is having difficulty breathing is brought to the ER. Exam reveals that she has pulmonary edema. Which of the following would be indicated?
- A.
Spironolactone
- B.
Furosemide
- C.
Acetazolamide
- D.
Chlorthalidone
Correct Answer
B. FurosemideExplanation
Furosemide would be indicated in this case because it is a loop diuretic that helps to remove excess fluid from the body. Pulmonary edema is a condition where fluid accumulates in the lungs, causing difficulty in breathing. Furosemide works by increasing the production of urine, which helps to reduce fluid overload in the body, including the lungs. This can help to alleviate the symptoms of pulmonary edema and improve the patient's breathing.Rate this question:
-
- 2.
A group of college students is planning a mountain climbing trip to Andes. Which of the following drugs would be appropriate to take for mountain sickness?
- A.
A thiazise diuretic
- B.
An anticholinergic
- C.
A carbonic anhydrase inhibitor
- D.
A loop diuretic
- E.
A beta blocker
Correct Answer
C. A carbonic anhydrase inhibitorExplanation
A carbonic anhydrase inhibitor would be appropriate to take for mountain sickness. Mountain sickness, also known as acute mountain sickness (AMS), is caused by the decreased oxygen levels at high altitudes. Carbonic anhydrase inhibitors help to alleviate AMS symptoms by increasing the amount of bicarbonate in the blood, which in turn helps to increase the oxygen-carrying capacity of red blood cells. This can help to prevent or reduce the symptoms of AMS, such as headache, dizziness, and nausea.Rate this question:
-
- 3.
An alcoholic male has developed hepatic cirrhosis. To control the ascites and edema he is prescribed which of the following?
- A.
Hydrochlorothiazide
- B.
Acetazolamide
- C.
Spironolactone
- D.
Furosemide
- E.
Chlorthalidone
Correct Answer
C. SpironolactoneExplanation
Spironolactone is prescribed to control ascites and edema in a patient with hepatic cirrhosis. This medication is a potassium-sparing diuretic that works by blocking the effects of aldosterone, a hormone that can cause fluid retention. By blocking aldosterone, spironolactone helps to reduce fluid buildup in the body and control the symptoms of ascites and edema. Hydrochlorothiazide, acetazolamide, furosemide, and chlorthalidone are diuretics that may be used to treat other conditions but are not typically prescribed for ascites and edema in patients with hepatic cirrhosis.Rate this question:
-
- 4.
A 55 yo man with kidney stones has been placed on a diuretic to decrease calcium excretion. However, after a few weeks, he develops an attack of gout. Which diuretic was he taking?
- A.
Furosemide
- B.
HCTZ
- C.
Spironolactone
- D.
Triamterene
- E.
Urea
Correct Answer
B. HCTZExplanation
HCTZ can increase calcium reabsorption thus decreasing calcium excreted.Rate this question:
-
- 5.
A 75 yo woman with hypertension is being treated with a thiazide. Her BP responds and reads 120/76. After several months on the medication, she complains of being tired and weak. An analysis of the blood indicates low values for which of the following?
- A.
Calcium
- B.
Uric acid
- C.
Potassium
- D.
Sodium
- E.
Glucose
Correct Answer
C. PotassiumExplanation
Hypokalemia is a common AE of thiazide diuretics.Rate this question:
-
- 6.
Which of the following drugs is contraindicated in a patient with hyperkalemia?
- A.
Acetazolamide
- B.
Chlorothiazide
- C.
Ethacrynic acid
- D.
Chlorthalidone
- E.
Spironolactone
Correct Answer
E. SpironolactoneExplanation
Spironolactone is contraindicated in a patient with hyperkalemia because it is a potassium-sparing diuretic. This means that it helps the body retain potassium and can further increase potassium levels in the blood, which is already elevated in hyperkalemia. Therefore, prescribing spironolactone to a patient with hyperkalemia can worsen the condition and lead to potential complications.Rate this question:
-
- 7.
Which would be the initial treatment choice to manage the hypertension in an AA women with a past medical history of gout and severe hypokalemia?
- A.
HCTZ
- B.
Spironolactone
- C.
Valsartan
- D.
Atenolol
- E.
Enalapril
Correct Answer
B. SpironolactoneExplanation
Spironolactone would be the initial treatment choice to manage hypertension in an AA woman with a past medical history of gout and severe hypokalemia. Spironolactone is a potassium-sparing diuretic that not only helps to lower blood pressure but also helps to prevent hypokalemia. This is especially important in this case since the patient already has a history of severe hypokalemia. Additionally, spironolactone is a good choice for patients with gout as it does not increase uric acid levels like other diuretics such as HCTZ.Rate this question:
-
- 8.
Digoxin has a profound effect on myocyte intracellular concentrations of sodium, potassium and calcium. These effects are caused by digoxin inhibiting:
- A.
Ca-ATPase of the sarcoplasmic reticulum
- B.
Sodium ATpase of the myocyte membrane
- C.
Cardiac phosphodiesterase
- D.
Cardiac beta receptors
- E.
Juxtoglomerular renin release
Correct Answer
B. Sodium ATpase of the myocyte membraneExplanation
Digoxin inhibits the sodium ATPase of the myocyte membrane. This inhibition leads to an increase in intracellular sodium levels, which subsequently affects the function of other ion transporters, including the sodium-calcium exchanger. The higher intracellular sodium concentration reduces the activity of the exchanger, resulting in an increase in intracellular calcium levels. This increase in calcium enhances myocardial contractility, making digoxin an effective treatment for heart failure.Rate this question:
-
- 9.
Compensatory increases in heart rate and renin release that occur in heart failure may be alleviated by which of the following drugs?
- A.
Milrinone
- B.
Digoxin
- C.
Dobutamine
- D.
Enalapril
- E.
Metoprolol
Correct Answer
E. MetoprololExplanation
Metoprolol is the correct answer because it is a beta-blocker, which helps to reduce heart rate and blood pressure. In heart failure, compensatory increases in heart rate can occur, and metoprolol can help to alleviate this by blocking the effects of adrenaline on the heart. Additionally, metoprolol can also reduce the release of renin, which is an enzyme involved in regulating blood pressure. Therefore, metoprolol can help to improve symptoms and outcomes in heart failure patients.Rate this question:
-
- 10.
A 58 yo man is admitted to the hospital with acute heart failure and pulmonary edema. Which one of the following drugs would be most useful in treating the pulmonary edema?
- A.
Digoxin
- B.
Dobutamine
- C.
Furosemide
- D.
Minoxidil
- E.
Spironolactone
Correct Answer
C. FurosemideExplanation
Furosemide would be the most useful drug in treating the pulmonary edema in this patient. Furosemide is a loop diuretic that works by inhibiting the reabsorption of sodium and chloride in the loop of Henle in the kidneys. This leads to increased urine production and decreased fluid volume, which can help alleviate the pulmonary edema by reducing the fluid overload in the lungs.Rate this question:
-
- 11.
A 46 yo man is admitted to the ED. He has taken more than 90 digoxin tablets about 3 hours prior. His pulse is 5o to 60 and EKG shows third degree block. Serum potassium is normal. Which one of the following treatments is the most important therapy to intiate in this patient?
- A.
Digoxin immune Fab
- B.
Potassium salts
- C.
Lidocaine
- D.
Verapamil
- E.
Amiodarone
Correct Answer
A. Digoxin immune FabExplanation
In this scenario, the patient has taken an overdose of digoxin, which has resulted in third-degree heart block. The most important therapy to initiate in this patient is digoxin immune Fab. Digoxin immune Fab is an antidote that binds to digoxin, reducing its concentration in the body and reversing its toxic effects. This treatment is crucial in preventing further deterioration of the patient's heart block and potentially life-threatening arrhythmias. Potassium salts may be used to correct any electrolyte imbalances, but they would not directly counteract the effects of the digoxin overdose. Lidocaine, verapamil, and amiodarone are antiarrhythmic medications that may be used in other situations but are not the first-line treatment for digoxin toxicity.Rate this question:
-
- 12.
A 65 yo man had a MI. Which of the following would be appropriate trophy antiarrhtymic therapy?
- A.
Lidocaine
- B.
Metoprolol
- C.
Procainamide
- D.
Quinidine
- E.
Verapamil
Correct Answer
B. MetoprololExplanation
Metoprolol would be an appropriate choice for antiarrhythmic therapy in a 65-year-old man who had a myocardial infarction (MI). Metoprolol is a beta-blocker that helps reduce the workload on the heart and decrease the risk of arrhythmias. It is commonly used in post-MI patients to prevent recurrent ischemic events and arrhythmias. Lidocaine, procainamide, quinidine, and verapamil are also antiarrhythmic medications, but they may not be the best choice in this specific scenario. Lidocaine is typically used for ventricular arrhythmias, while procainamide, quinidine, and verapamil may have negative effects on cardiac function or conduction.Rate this question:
-
- 13.
Suppression of arrhytmias resulting from a reentry focus is most likely to occur if the drug:
- A.
Has vagomimetic effects on the AV node
- B.
Is a beta blocker
- C.
Converts a unidirectional block to a bidirectional block
- D.
Slows conduction through the atria
- E.
Has atropine like effects on the AV node
Correct Answer
C. Converts a unidirectional block to a bidirectional blockExplanation
When a reentry focus is present, the arrhythmias occur due to the reentry circuit. By converting a unidirectional block (where the electrical signal can only pass through in one direction) to a bidirectional block (where the electrical signal can pass through in both directions), the drug can disrupt the reentry circuit and suppress the arrhythmias. This allows the normal electrical conduction to resume and prevents the reentry circuit from perpetuating the arrhythmias.Rate this question:
-
- 14.
A 57 yo man is being treated for an atrial arrhythmia. He complains of HA, dizziness, and tinnitus. Which one of the following antiarrhtymics is the most likely cause?
- A.
Amiodarone
- B.
Procainamide
- C.
Propranolol
- D.
Quinidine
- E.
Verapamil
Correct Answer
D. QuinidineExplanation
Quinidine is the most likely cause of the symptoms described in the question. Quinidine is an antiarrhythmic medication that can cause side effects such as headache (HA), dizziness, and tinnitus. These symptoms are consistent with the patient's complaint. Amiodarone, procainamide, propranolol, and verapamil are also antiarrhythmic medications, but they are not known to commonly cause these specific symptoms.Rate this question:
-
- 15.
A 58 yo is being treated for chronic suppression of vent arrhytmia. After 2 months of therapy she complains about feeling tired all the time. Exam reveals resting HR of 10 bpm lower than previous rate. Her skin is cool and clammy. Lab test results indicate low thyroxin and elevated TSh. Which of the following is the likely cause of these symptoms?
- A.
Amiodarone
- B.
Procainamide
- C.
Propranolol
- D.
Quinidine
- E.
Verapamil
Correct Answer
A. AmiodaroneExplanation
The likely cause of the symptoms described (feeling tired, lower heart rate, cool and clammy skin, low thyroxin, and elevated TSH) is amiodarone. Amiodarone is a medication commonly used to treat arrhythmias, but it can also cause hypothyroidism as a side effect. Hypothyroidism can lead to fatigue, bradycardia (lower heart rate), and cool and clammy skin. The lab test results of low thyroxin and elevated TSH further support the diagnosis of amiodarone-induced hypothyroidism.Rate this question:
-
- 16.
A 56 yo patient complains of chest pain following any sustained exercise. He is diagnosed with atherosclerotic angina. He is prescribed sublingual nitro for treatment of acute chest pain. Which of the following adverse effects is likely to be experienced by this patient?
- A.
Hypertension
- B.
throbbing HA
- C.
Bradycardia
- D.
Sexual dysfunction
- E.
Anemia
Correct Answer
B. throbbing HAExplanation
The correct answer is throbbing HA (headache). Nitroglycerin, which is a medication used to treat angina, can cause headaches as a common side effect. This occurs because nitroglycerin causes blood vessels to dilate, including those in the head, leading to increased blood flow and resulting in a throbbing headache. It is important for patients to be aware of this potential side effect and discuss it with their healthcare provider if it becomes bothersome.Rate this question:
-
- 17.
The patient in #16 is also prescribed propranolol to prevent episodes of angina. The beta blockers has the added benefit of preventing the following side effects of nitro?
- A.
Dizziness
- B.
Methemoglobinemia
- C.
Throbbing HA
- D.
Reflex tachycardia
- E.
Edema
Correct Answer
D. Reflex tachycardiaExplanation
Propranolol is a beta blocker medication that can help prevent episodes of angina by blocking the effects of adrenaline on the heart. One of the side effects of nitro, a medication used to treat angina, is reflex tachycardia, which is a rapid increase in heart rate. By prescribing propranolol along with nitro, the doctor is aiming to prevent this side effect of nitro, as beta blockers like propranolol can counteract the increased heart rate caused by nitro. Therefore, reflex tachycardia is the side effect that propranolol can help prevent.Rate this question:
-
- 18.
A 68 yo man has been successfully treated for exercise induced angina for several years. He recently has been complaining about being awakened at night with chest pain. Which of the following drugs would be useful in preventing this patients nocturnal angina?
- A.
Amyl nitrate
- B.
Nitro sublingual
- C.
Nitro transdermal
- D.
Esmolol
Correct Answer
C. Nitro transdermalExplanation
Nitro transdermal is the correct answer because it is a long-acting nitrate that can provide continuous protection against angina, including during the night. It is applied topically and absorbed through the skin, allowing for a slow and sustained release of nitric oxide, which helps to relax and dilate the blood vessels, improving blood flow to the heart and reducing the frequency and severity of angina episodes. This makes nitro transdermal an effective choice for preventing nocturnal angina in this patient.Rate this question:
-
- 19.
A 45 yo man has recently been diagnosed with hypertension and started on mono therapy designed to reduce peripheral resistance and prevent sodium and water retention. he has developed a persistent cough. Which of the following SEs is most likely responsible for this side effect?
- A.
Losartan
- B.
Nifediepine
- C.
Prazosin
- D.
Propranolol
- E.
Enalapril
Correct Answer
E. EnalaprilExplanation
Enalapril is an angiotensin-converting enzyme (ACE) inhibitor commonly used to treat hypertension. One of the common side effects of ACE inhibitors is a persistent cough, which occurs due to the accumulation of bradykinin in the lungs. This cough is non-productive and can be bothersome to patients. Therefore, enalapril is the most likely responsible for the persistent cough in the given scenario.Rate this question:
-
- 20.
Which one of the following drugs may cause a precipitous fall in BP and fainting on initial administration?
- A.
Atenolol
- B.
HCTZ
- C.
Metoprolol
- D.
Prazosin
Correct Answer
D. PrazosinExplanation
Prazosin is an alpha-1 adrenergic blocker that works by relaxing blood vessels and reducing blood pressure. When prazosin is initially administered, it can cause a sudden and significant drop in blood pressure, leading to fainting. This is because prazosin blocks the alpha-1 receptors in the smooth muscles of blood vessels, causing them to dilate and resulting in a sudden decrease in peripheral vascular resistance. This sudden drop in blood pressure can cause fainting or syncope, especially in individuals who are more susceptible to hypotension.Rate this question:
-
- 21.
Which one of the following antihypertensive drugs can precipitate a hypertensive crisis following abrupt cessation of therapy?
- A.
Clonidine
- B.
Diltiazem
- C.
Enalapril
- D.
Losartan
Correct Answer
A. ClonidineExplanation
Clonidine is an antihypertensive drug that works by reducing blood pressure. However, if clonidine is abruptly stopped, it can cause a sudden increase in blood pressure, leading to a hypertensive crisis. This is because clonidine acts on certain receptors in the brain that regulate blood pressure, and abrupt cessation can cause these receptors to become overactive. Therefore, clonidine is the correct answer as it can precipitate a hypertensive crisis if therapy is abruptly discontinued.Rate this question:
-
- 22.
A 48 yo hypertensive patient has been successfully treated with a thiazide diuretic for the last 5 years. Over the last 3 months, his diastolic pressure has steadily increased and he has started on an additional antihypertensive med. He has severael instances of being unable to achieve an erection and is no longer able to complete three sets of tennis. Which of the following is the likely cause?
- A.
Captopril
- B.
Losartan
- C.
Minoxidil
- D.
Metoprolol
Correct Answer
D. MetoprololExplanation
Metoprolol is the likely cause for the patient's inability to achieve an erection and decreased exercise capacity. Metoprolol is a beta-blocker commonly used to treat hypertension. One of its side effects is sexual dysfunction, including difficulty achieving and maintaining an erection. Additionally, beta-blockers can cause fatigue and decreased exercise tolerance, which could explain the patient's inability to complete three sets of tennis.Rate this question:
-
- 23.
A 22 yo has a thrombosis in popliteal vein. She is in second trimester of pregnancy and is discharged on Day 8 - which would be used if she lives 100 miles from hospital?
- A.
Warfarin
- B.
Aspirin
- C.
Alteplase
- D.
LMWH
Correct Answer
D. LMWHExplanation
LMWH, or Low Molecular Weight Heparin, would be the appropriate choice in this case. Warfarin is contraindicated in pregnancy as it can cause birth defects. Aspirin is not as effective as LMWH for treating thrombosis. Alteplase is a thrombolytic agent and is not typically used for treating venous thrombosis. LMWH is the preferred anticoagulant in pregnancy as it has a lower risk of bleeding complications compared to unfractionated heparin.Rate this question:
-
- 24.
A 60 yo man has a DVT and was started with a bolus of heparin. One hour later he was bleeding profusely from IV site. The heparin was suspended and bleeding continued. Protamine sulfate was administered IV and the bleeding resolved - The protamine
- A.
Degrades the heparin
- B.
Inactivates the antithrombin
- C.
Activates the coagulation cascade
- D.
Ionically combines with heparin
Correct Answer
D. Ionically combines with heparinExplanation
Protamine sulfate ionically combines with heparin. Protamine is a positively charged molecule that binds to the negatively charged heparin, forming a stable complex. This complex helps to neutralize the anticoagulant effects of heparin and prevent further bleeding.Rate this question:
-
- 25.
A 54 yo with prosthetic valve has black and tarry stools - PE unremarkable except for subconunctival hemorrhages and bleeding gums. Stools tested positive for heme. Patient has been on oral warfarin since valve replacement one year ago. PT elevated. Which of the following therapies should be given?
- A.
Intravenous vitamin K
- B.
Transfusion of FFP
- C.
IV protamine sulfate
- D.
Immediate withdrawal of warfarin treatment
Correct Answer
B. Transfusion of FFPExplanation
The patient's presentation of black and tarry stools, subconjunctival hemorrhages, and bleeding gums suggests gastrointestinal bleeding, which can be a complication of anticoagulant therapy with warfarin. The positive test for heme in the stools further supports this suspicion. The elevated PT indicates that the patient's blood is not clotting properly. Transfusion of fresh frozen plasma (FFP) is the appropriate therapy in this situation as it contains clotting factors that can help restore normal clotting function and control the bleeding. Intravenous vitamin K is not the correct choice as it takes longer to take effect compared to FFP. IV protamine sulfate is used to reverse the anticoagulant effects of heparin, not warfarin. Immediate withdrawal of warfarin treatment may worsen the bleeding and is not recommended.Rate this question:
-
- 26.
Which one of the following is the most common side effect of antihyperlipidemic drug therapy?
- A.
Elevated BP
- B.
GI disturbance
- C.
Neurologic problems
- D.
Heart palpitations
- E.
Migraine headache
Correct Answer
B. GI disturbanceExplanation
The most common side effect of antihyperlipidemic drug therapy is gastrointestinal (GI) disturbance. This can include symptoms such as nausea, vomiting, diarrhea, and abdominal pain. Antihyperlipidemic drugs work by reducing cholesterol levels in the blood, and these medications can irritate the lining of the stomach and intestines, leading to GI disturbances. It is important for patients to discuss any GI symptoms with their healthcare provider, as they may need to adjust the medication or try a different one to minimize these side effects.Rate this question:
-
- 27.
Which one of the following is characterized by elevated plasma levels of chylomicrons and has no drug therapy available to lower the plasma lipoprotein levels?
- A.
Type 1
- B.
Type II
- C.
Type III
- D.
Type IV
Correct Answer
A. Type 1Explanation
Type 1 hyperlipoproteinemia is characterized by elevated plasma levels of chylomicrons, which are large lipoprotein particles that transport dietary fats. This condition is caused by a deficiency in lipoprotein lipase, an enzyme responsible for breaking down chylomicrons. Without this enzyme, chylomicrons cannot be properly metabolized, leading to their accumulation in the blood. Unfortunately, there is currently no drug therapy available to lower the plasma lipoprotein levels in type 1 hyperlipoproteinemia.Rate this question:
-
- 28.
Which one of the following decreases de novo cholesterol synthesis by inhibiting the enzyme 3 hydroxy...coenzyme A reductase?
- A.
Fenofibrate
- B.
Niacin
- C.
Cholestyramine
- D.
Lovastatin
Correct Answer
D. LovastatinExplanation
Lovastatin decreases de novo cholesterol synthesis by inhibiting the enzyme 3 hydroxy...coenzyme A reductase. It is a type of medication known as a statin, which works by blocking the action of this enzyme, thereby reducing the production of cholesterol in the body. By inhibiting this enzyme, lovastatin helps to lower levels of LDL (bad) cholesterol and triglycerides, while increasing levels of HDL (good) cholesterol. This can help to reduce the risk of cardiovascular diseases such as heart attack and stroke.Rate this question:
-
- 29.
Which one of the following drugs causes a decrease in liver triacylglycerol synthesis by limiting available free fatty acids needed as building blocks for this pathway?
- A.
Niacin
- B.
Fenofibrate
- C.
Cholestyramine
- D.
Gemfibrozil
Correct Answer
A. NiacinExplanation
Niacin causes a decrease in liver triacylglycerol synthesis by limiting available free fatty acids needed as building blocks for this pathway. Niacin, also known as vitamin B3, inhibits lipolysis in adipose tissue, leading to a decrease in the release of free fatty acids into the bloodstream. With fewer free fatty acids available, the liver has limited substrates to synthesize triacylglycerols, resulting in a decrease in their synthesis.Rate this question:
-
- 30.
Which one of the following drugs binds bile acids in the intestine, thus preventing their return to the liver via the enterohepatic circulation?
- A.
Niacin
- B.
Fenofibrate
- C.
Cholestyramine
- D.
Fluvastatin
Correct Answer
C. CholestyramineExplanation
Cholestyramine is a drug that binds to bile acids in the intestine, preventing their reabsorption and return to the liver through the enterohepatic circulation. By binding to bile acids, cholestyramine reduces their concentration in the liver, which in turn stimulates the liver to produce more bile acids from cholesterol. This leads to a decrease in cholesterol levels in the blood, making cholestyramine an effective treatment for high cholesterol. Niacin, fenofibrate, and fluvastatin are not known to bind bile acids in the intestine.Rate this question:
-
- 31.
A 50 yo women has just been diagnosed with type 2 DM and given metformin - which is correct?
- A.
Metformin shoudln;t be used in type 2
- B.
Metformin decreases hepatic glucose production
- C.
Metformin undergoes significant P450 metabolism
- D.
Weight gain is a common AE
Correct Answer
B. Metformin decreases hepatic glucose productionExplanation
Metformin is a commonly prescribed medication for type 2 diabetes mellitus (DM). It works by decreasing hepatic glucose production, which helps to lower blood sugar levels. This is why it is the correct answer in this case. Metformin is actually recommended as the first-line therapy for type 2 DM due to its effectiveness and safety profile. It does not lead to weight gain, unlike some other diabetes medications. Additionally, metformin is not extensively metabolized by the P450 enzyme system.Rate this question:
-
- 32.
Which of the following is true of insulin glargine?
- A.
Peakless
- B.
Prolonged action
Correct Answer
A. PeaklessExplanation
Insulin glargine is a type of long-acting insulin that is known for its peakless action. Unlike other types of insulin, insulin glargine does not have a pronounced peak in its activity. Instead, it provides a steady and prolonged release of insulin, resulting in a more stable blood sugar level throughout the day. This makes it an effective option for managing diabetes, as it helps to mimic the natural release of insulin by the body.Rate this question:
-
- 33.
Which of the following classes of glucose lowering agents has the ability to reduce insulin resistance?
- A.
Alpha glucosidase inhibitors
- B.
DPP IV inhibitors
- C.
Meglitinides
- D.
Sulfonyureas
- E.
Thiazolidnediones
Correct Answer
E. ThiazolidnedionesExplanation
Thiazolidinediones have the ability to reduce insulin resistance. These agents work by activating peroxisome proliferator-activated receptor-gamma (PPAR-gamma) in the adipose tissue, skeletal muscle, and liver. This activation leads to increased insulin sensitivity, allowing for better glucose uptake and utilization in these tissues. By reducing insulin resistance, thiazolidinediones help to improve glycemic control in individuals with type 2 diabetes.Rate this question:
-
- 34.
A 64 yo women has a history of type 2 and has HF. Which of the following would be a poor choice?
- A.
Exenatide
- B.
Glyburide
- C.
Nateglinide
- D.
Rosliglitazone
Correct Answer
D. RosliglitazoneExplanation
Rosiglitazone would be a poor choice for the 64-year-old woman with a history of type 2 diabetes and heart failure (HF). Rosiglitazone belongs to the thiazolidinedione class of antidiabetic medications, which have been associated with an increased risk of cardiovascular events and heart failure. Therefore, prescribing rosiglitazone to a patient with HF would not be recommended due to the potential harm it may cause to the cardiovascular system.Rate this question:
-
- 35.
IN which of the following would aspirin be contraindicated?
- A.
Myalgia
- B.
Fever
- C.
Peptic ulcer
- D.
RA
Correct Answer
C. Peptic ulcerExplanation
Aspirin would be contraindicated in individuals with peptic ulcer. This is because aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that can irritate the stomach lining and increase the risk of bleeding or ulceration in individuals with peptic ulcers. Therefore, it is recommended to avoid aspirin in such cases and consider alternative pain relievers that are safer for individuals with peptic ulcers.Rate this question:
-
- 36.
Which one of the following is true for COx 2?
- A.
COX 2 have greater analgesic effects that tranditional NSAIDS
- B.
COX 2 decrease platelet function
- C.
COX 2 do not affect the kidney
- D.
COX 2 show antiinflammatory effects similar to traditional NSAIDS
Correct Answer
D. COX 2 show antiinflammatory effects similar to traditional NSAIDSExplanation
COX 2 show antiinflammatory effects similar to traditional NSAIDs. This means that COX 2 inhibitors, like traditional NSAIDs, can help reduce inflammation in the body. This is an important property for medications used to treat conditions such as arthritis, where inflammation is a major component of the disease. COX 2 inhibitors specifically target the COX 2 enzyme, which is responsible for producing inflammatory molecules called prostaglandins. By inhibiting COX 2, these medications can help reduce inflammation and alleviate symptoms associated with inflammatory conditions.Rate this question:
-
- 37.
An 8 yo has a fever and muscles aches from viral infection?
- A.
Acetaminophen
- B.
Aspirin
- C.
Celecoxib
- D.
Codeine
Correct Answer
A. AcetaminophenExplanation
Acetaminophen is the correct answer because it is a commonly used over-the-counter medication for reducing fever and relieving mild to moderate pain. It is safe and effective for children, including an 8-year-old, when used as directed. Aspirin is not recommended for children due to the risk of Reye's syndrome. Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) that is typically used for arthritis and not for treating viral infections. Codeine is an opioid medication that is generally not recommended for children due to safety concerns.Rate this question:
-
- 38.
A 70 yo man has a history of ulcer disease. He has swelling and pain of joints in hands now. Which one of the following would be good to give to reduce risk of activating ulcer disease?
- A.
Allopurinol
- B.
Clchicine
- C.
Misoprostol
- D.
Sulindac
Correct Answer
C. MisoprostolExplanation
Misoprostol would be a good option to give to reduce the risk of activating ulcer disease in this 70-year-old man with a history of ulcer disease. Misoprostol is a medication that helps protect the lining of the stomach and intestines by increasing the production of protective mucus and decreasing the production of stomach acid. This can help prevent the development of ulcers or reduce the risk of ulcers worsening. Therefore, misoprostol would be a suitable choice in this case to minimize the risk of exacerbating the patient's ulcer disease while treating the joint pain and swelling in his hands.Rate this question:
-
- 39.
A 43 yo ships captain has seasonal allergies. Which would be indicated?
- A.
Cyclizine
- B.
Doxepin
- C.
Doxylamine
- D.
Fexofenadine
Correct Answer
D. FexofenadineExplanation
Fexofenadine would be indicated for a 43-year-old ship captain with seasonal allergies. Fexofenadine is a non-drowsy antihistamine that helps relieve symptoms such as sneezing, itching, watery eyes, and runny nose caused by allergies. It is a commonly prescribed medication for seasonal allergies and is known to be effective in reducing allergy symptoms without causing drowsiness, which is important for a ship captain who needs to stay alert and focused while on duty.Rate this question:
-
- 40.
Which of the following statements concerning H1 antihistamines is correct?
- A.
Second gen are relatively free of adverse effects
- B.
H1 antihistamines can be used in the treatment of acute anaphylaxis
Correct Answer
A. Second gen are relatively free of adverse effectsExplanation
The correct answer is "second gen are relatively free of adverse effects". Second generation H1 antihistamines, such as loratadine and cetirizine, are known to have fewer adverse effects compared to first generation antihistamines. They have a reduced sedative effect and are less likely to cause drowsiness, dizziness, or impair cognitive function. This makes them a preferred choice for long-term use in the treatment of allergies. However, it is important to note that H1 antihistamines, including second generation ones, are not typically used in the treatment of acute anaphylaxis, as this requires more immediate and specific interventions such as epinephrine administration.Rate this question:
-
- 41.
Which one of the following would impair the ability to drive an automobile?
- A.
Diphenhydramine
- B.
Ergotamine
- C.
Fexofenadine
- D.
Ranitidine
Correct Answer
A. DiphenhydramineExplanation
Diphenhydramine is an antihistamine that can cause drowsiness and impair cognitive and motor skills, which are essential for safe driving. It is a common ingredient in many over-the-counter sleep aids and allergy medications. Impairment of these abilities can increase the risk of accidents while operating a vehicle. Ergotamine, fexofenadine, and ranitidine do not typically have sedative effects and are less likely to impair driving ability.Rate this question:
-
- 42.
Which of the following is associated with digoxin in patients wtih HF?
- A.
Improvement of symptoms in a patient with CHF
- B.
Increase myocardial contractility
- C.
All of these
- D.
Slowing down AV conduction
- E.
Inhibition of sympathetic activity
Correct Answer
C. All of theseExplanation
Digoxin is a medication commonly used in the treatment of heart failure (HF). It works by increasing myocardial contractility, which improves the pumping ability of the heart and helps alleviate symptoms of HF. Additionally, digoxin can slow down atrioventricular (AV) conduction, which can be beneficial in certain cases. Moreover, it can also inhibit sympathetic activity, further contributing to the improvement of symptoms in patients with congestive heart failure (CHF). Therefore, all of these options are associated with digoxin in patients with HF.Rate this question:
-
- 43.
A patient with CHF is currently treated with a full dose of lisinopril and a low dose of furosemide. The patient is stable and has no fluid retention. Which of the following meds may be added to reduce morbidity and mortality?
- A.
Valsartan
- B.
High dose metoprolol
- C.
Digoxin
- D.
Low dose carvedilol
Correct Answer
D. Low dose carvedilolExplanation
Low dose carvedilol may be added to reduce morbidity and mortality in a patient with CHF who is stable and has no fluid retention. Carvedilol is a beta-blocker that has been shown to improve outcomes in patients with heart failure. It helps to reduce the workload on the heart and improve cardiac function. The low dose is chosen to minimize the risk of side effects such as hypotension or bradycardia. Valsartan, high dose metoprolol, and digoxin are also used in the treatment of CHF, but in this scenario, low dose carvedilol would be the most appropriate choice.Rate this question:
-
- 44.
Which of the following statements is correct?
- A.
The major effect of hydralazine is to reduce preload
- B.
A comb of hydralazine and organic nitrates are effective in AA with CHF
- C.
Digoxin increases stokre volume and ejection fraction
- D.
Beta blockers are anti-remodeling drugs
Correct Answer
A. The major effect of hydralazine is to reduce preloadExplanation
Hydralazine is a direct-acting arterial vasodilator that primarily reduces afterload rather than preload. By dilating arterioles, it reduces systemic vascular resistance, leading to a decrease in left ventricular afterload. This results in improved ventricular emptying and reduced myocardial oxygen demand. While hydralazine can also have mild venous dilation effects, its main mechanism of action is reducing afterload rather than preload.Rate this question:
-
- 45.
Which of the following used to treat patients with heart failure do NOT provided survival benefit?
- A.
Digoxin
- B.
ARBs
- C.
Beta blockers
- D.
ACE
- E.
Aldosterone receptor antagonists
Correct Answer
A. DigoxinExplanation
Digoxin is the only option among the given medications that does not provide a survival benefit for patients with heart failure. Digoxin is primarily used to control heart rate and improve symptoms, but it does not have a significant impact on reducing mortality or improving survival outcomes. On the other hand, medications like ARBs, beta blockers, ACE inhibitors, and aldosterone receptor antagonists have been shown to improve survival rates and are commonly prescribed for patients with heart failure.Rate this question:
-
- 46.
Compensatory increases in heart rate and renin release that occur in heart failure may be alleviated by which of the following drugs?
- A.
Metoprolol
- B.
Dobutamine
- C.
Enalapril
- D.
Milrinone
- E.
Digoxin
Correct Answer
A. MetoprololExplanation
Metoprolol is a beta-blocker that can alleviate compensatory increases in heart rate and renin release that occur in heart failure. It works by blocking the effects of adrenaline on the heart, reducing heart rate and blood pressure. This helps to improve the efficiency of the heart and reduce the workload on the heart, ultimately alleviating the symptoms of heart failure. Dobutamine, enalapril, milrinone, and digoxin are not specifically indicated for alleviating compensatory increases in heart rate and renin release in heart failure.Rate this question:
-
- 47.
A 68 yo man had an MI - what can be prophy?
- A.
Metoprolol
- B.
Quiniine
- C.
Verapamil
- D.
Lidocaine
- E.
Procainamide
Correct Answer
A. MetoprololExplanation
Metoprolol is a beta-blocker commonly used in the prophylaxis of myocardial infarction (MI). It helps reduce the workload on the heart and decreases the oxygen demand, thereby preventing further damage to the heart muscle. It is a preferred choice for post-MI patients as it has been shown to improve survival rates and reduce the risk of recurrent MI. Quinine, verapamil, lidocaine, and procainamide are not typically used for prophylaxis in this context.Rate this question:
-
- 48.
Which is INCORRECT?
- A.
When given with amiodarone warfarin must be increased
- B.
Floxacins prolong the QT interval
- C.
Azole antifungal agents have multiple drug interactions
- D.
All class III drugs prolong the QT interval
Correct Answer
A. When given with amiodarone warfarin must be increased -
- 49.
A patient receovering from respiartory viral infection presetns with dry cough. A codeine containing cough suppressant formulation is prescribed. Which of the following side effects are you expected to observe if patient is being treated with supra-ventricular arrhytias?
- A.
Greater dry mouth
- B.
Greater rebound hypertension
- C.
Greater peripheral edema
- D.
Greater constipation
Correct Answer
D. Greater constipationExplanation
If a patient recovering from a respiratory viral infection is being treated with a codeine-containing cough suppressant formulation, they may experience greater constipation as a side effect. Codeine is known to slow down the movement of the intestines, leading to constipation. This side effect is expected in this scenario, especially if the patient is already being treated for supra-ventricular arrhythmias.Rate this question:
-
- 50.
Which of the following is NOT an expected effect of diltiazem?
- A.
Decreased ventricular rate in a fib
- B.
BP lowering
- C.
Prolonged QT interval of ECG
- D.
Slow AV conduction and first degree of AV block
Correct Answer
C. Prolonged QT interval of ECGExplanation
Diltiazem is a calcium channel blocker commonly used to treat conditions such as high blood pressure and certain heart rhythm disorders. It works by relaxing and widening the blood vessels, which helps to lower blood pressure. It also slows down the heart rate and can affect the conduction of electrical impulses in the heart. However, prolonged QT interval on an ECG is not an expected effect of diltiazem. A prolonged QT interval can increase the risk of developing dangerous heart rhythm abnormalities, so it is not a desired effect of this medication.Rate this question:
-
Quiz Review Timeline +
Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.
-
Current Version
-
Mar 21, 2023Quiz Edited by
ProProfs Editorial Team -
Apr 27, 2013Quiz Created by
Perduekm
- Anesthetics Quizzes
- Cardiology Quizzes
- Chinese Medicine Quizzes
- Drug Quizzes
- Forensic Medicine Quizzes
- Gastroenterology Quizzes
- Geriatrics Quizzes
- Gynecology Quizzes
- Hematology Quizzes
- NASM Quizzes
- Neurology Quizzes
- Obstetrics Quizzes
- Oncology Quizzes
- Ophthalmology Quizzes
- Pediatrics Quizzes
Back to top