Pharmacology Exam 3 Study Guide Quiz

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Pharmacology Exam 3 Study Guide Quiz

There are different ways that one can review the materials they have learnt in class and this can either be through study groups, checking past tests or looking for practice questions. The study guide quiz below is the third in a series of tests designed to adequately prepare you for the pharmacology exam. Why don’t you give it a shot and see just how high you will score?


Questions and Answers
  • 1. 
    _____________ is the most important fuel for the brain.
    • A. 

      Fructose

    • B. 

      Sucrose

    • C. 

      Galactose

    • D. 

      Glucose

  • 2. 
    Brain glucose uptake occurs at different rates during absorptive and post-absorptive periods and is not altered in type 2 diabetes.
    • A. 

      True

    • B. 

      False

  • 3. 
    What type of cells releases insulin?
    • A. 

      Pancreatic β cells

    • B. 

      Pancreatic α cells

    • C. 

      Follicular cells

    • D. 

      Pancreatic δ cells

  • 4. 
    Which of the following are specific-defined gene mutations of diabetes Mellitus?
    • A. 

      Type 1 diabetes

    • B. 

      Type 2 diabetes

    • C. 

      MODY

  • 5. 
    Hyperinsulinemia is a condition in which normal amounts of insulin are ineffective in lowering plasma glucose concentrations.
    • A. 

      True

    • B. 

      False

  • 6. 
    Insulin can bind to IGF receptors with high affinity.
    • A. 

      True

    • B. 

      False

  • 7. 
    Glucose is taken up by pancreatic β cells via _____________.
    • A. 

      GLUT1

    • B. 

      GLUT2

    • C. 

      GLUT3

    • D. 

      GLUT4

  • 8. 
    Glucose is ___________ by glucokinase.
    • A. 

      Dephosphorylated

    • B. 

      Phosphorylated

    • C. 

      Acetylated

    • D. 

      Hydrolyzed

  • 9. 
    What is the 1st phase in biphasic insulin secretion?
    • A. 

      Fusion

    • B. 

      Translocation

    • C. 

      Diffusion

    • D. 

      Transfusion

  • 10. 
    What is the 2nd phase in biphasic insulin secretion?
    • A. 

      Transport

    • B. 

      Translocation

    • C. 

      Transduce

    • D. 

      Transfuse

  • 11. 
    What type of cells releases glucagon?
    • A. 

      Pancreatic F cells

    • B. 

      Pancreatic β cells

    • C. 

      Pancreatic δ cells

    • D. 

      Pancreatic α cells

  • 12. 
    Insulin secretion is biphasic.
    • A. 

      True

    • B. 

      False

  • 13. 
    Glucagon increases gluconeogenesis and glycogenolysis.
    • A. 

      True

    • B. 

      False

  • 14. 
    Glucagon is an antagonist for G-protein coupled receptor (GPCR) that signals via stimulatory G-protein (Gs).
    • A. 

      True

    • B. 

      False

  • 15. 
    Which of the following are "metabolic effects"?
    • A. 

      Glucose uptake

    • B. 

      Increased Gluconeogenesis

    • C. 

      Glycogen synthesis

    • D. 

      Lipogenesis

  • 16. 
    _____________ signaling events involved in "metabolic" signaling by insulin.
    • A. 

      PI-1 Kinase

    • B. 

      PI-2 Kinase

    • C. 

      PI-3 Kinase

    • D. 

      PI-4 Kinase

  • 17. 
    Dysregulation of insulin signaling pathways is one of the hallmarks of Type I diabetes.
    • A. 

      True

    • B. 

      False

  • 18. 
    Hepatic glucose production is altered in Type 2 diabetes.
    • A. 

      True

    • B. 

      False

  • 19. 
    If the liver is insulin-resistant, it will continue to produce glucose leading to marked hyperglycemia.
    • A. 

      True

    • B. 

      False

  • 20. 
    Hypoglycemia is a potent inhibitor of hepatic glucose output (HGO).
    • A. 

      True

    • B. 

      False

  • 21. 
    _______________ occurs when the body cannot use glucose as a fuel source because the body has no insulin or not enough insulin, and fat is used instead.
    • A. 

      Diabetic ketoacidosis

    • B. 

      Nonketotic coma

    • C. 

      Diabetic retinopathy

    • D. 

      Hypertension

  • 22. 
    The following can greatly improve outcomes for diabetic patients:
    • A. 

      Early diagnosis

    • B. 

      Careful glucose monitoring

    • C. 

      Control

    • D. 

      Prevention

  • 23. 
    Glycosylated hemoglobin is a critical biomarker for glucose control.
    • A. 

      True

    • B. 

      False

  • 24. 
    Insulin resistance/Metabolic syndrome is constellation of symptoms most often associated with obesity.
    • A. 

      True

    • B. 

      False

  • 25. 
    One of the glycemic goals is to maintain fasting blood glucose between ____________.
    • A. 

      70-130 mg/dL

    • B. 

      10-60 mg/dL

    • C. 

      150-220 mg/dL

    • D. 

      240-300 mg/dL

  • 26. 
    The following are stimulatory factors in the regulation of insulin secretion, except:
    • A. 

      Dietary amino acids (ALA, GLY, ARG)

    • B. 

      Acetylcholine (vagus nerve)

    • C. 

      Glucose-dependent insulinotropic peptide (GIP)

    • D. 

      Fatty Acids

    • E. 

      Dopamine

  • 27. 
    Type 1 diabetics have essentially no functional β cells therefore they cannot maintain basal insulin secretion, nor respond to variations in circulating fuels.
    • A. 

      True

    • B. 

      False

  • 28. 
    Oral glucose has less stimulus for insulin secretion than IV due to stimulatory effects of GI hormones.
    • A. 

      True

    • B. 

      False

  • 29. 
    Human insulin is produced by recombinant RNA technology.
    • A. 

      True

    • B. 

      False

  • 30. 
    As insulin is a polypeptide, it can be taken orally.
    • A. 

      True

    • B. 

      False

  • 31. 
    The following can alter insulin absorption and duration of action:
    • A. 

      Injection site

    • B. 

      Blood flow

    • C. 

      Temperature

    • D. 

      Physical activity

  • 32. 
    ________________ is the most common adverse event due to insulin Rx.
    • A. 

      Hyperglycemia

    • B. 

      Hypoglycemia

    • C. 

      Lipodystrophy

    • D. 

      Weight gain

  • 33. 
    The following are oral Rx for Type 2 diabetes mellitus, except:
    • A. 

      Insulin secretagogues

    • B. 

      Insulin desensitizers

    • C. 

      α-Glucosidase inhibitors

    • D. 

      Dipeptidyl Peptidase 4 (DPPIV) inhibitors

    • E. 

      None of the above

  • 34. 
    Insulin secretagogues promote insulin secretion from β cells.
    • A. 

      True

    • B. 

      False

  • 35. 
    Which of the following are sulfonylureas?
    • A. 

      Glibenclamide

    • B. 

      Nateglinide

    • C. 

      Metformin

    • D. 

      Glipizide

  • 36. 
    Which of the following are Meglitinides?
    • A. 

      Rosiglitazone/Avandia

    • B. 

      Nateglinide

    • C. 

      Replaglinide

    • D. 

      Metformin

  • 37. 
    ___________ are oral insulin sensitizer, and 1st line therapy for Type 2 Diabetes Mellitus.
    • A. 

      Actos

    • B. 

      Avandia

    • C. 

      Glipizide

    • D. 

      Metformin

  • 38. 
    Which of the following are Biguanides?
    • A. 

      Metformin

    • B. 

      Glipizide

    • C. 

      Actos

    • D. 

      Avandia

  • 39. 
    Which of the following are Thiazolidinediones?
    • A. 

      Rosiglitazone (Avandia)

    • B. 

      Pioglitazones (Actos)

    • C. 

      Nateglinide

    • D. 

      Miglitol

  • 40. 
    Which of the following are α-Glucosidase inhibitors?
    • A. 

      Actos

    • B. 

      Avandia

    • C. 

      Miglitol

    • D. 

      Acarbose

  • 41. 
    Which of the following are phases of the menstrual cycle?
    • A. 

      End-cycle / ovulation

    • B. 

      Follicular development and endometrial development

    • C. 

      Mid-cycle / ovulation

    • D. 

      Luteal Phase

  • 42. 
    In the follicular phase, a "pulse generator" in the basal hypothalamus produces a large burst of neuronal activity.
    • A. 

      True

    • B. 

      False

  • 43. 
    In the follicular phase, GnRH binds its receptors in the pituitary and causes lutienizing hormone (LH) and follicle stimulating hormone (FSH) to be released from the pituitary.
    • A. 

      True

    • B. 

      False

  • 44. 
    In the follicular phase, __________ and __________ feedback to the pituitary and hypothalamus to inhibit LH and FSH release.
    • A. 

      Estrogen (E2); inhibin

    • B. 

      Progesterone; estradiol

    • C. 

      Estrogen (E2); progesterone

    • D. 

      Inhibin; progesterone

  • 45. 
    The _________________ produces estrogen (E2) and inhibin.
    • A. 

      Corpus luteum

    • B. 

      Pituitary

    • C. 

      Hypothalamus

    • D. 

      Graafian follicle

  • 46. 
    The gonads (ovaries) secretes the following, except: 
    • A. 

      Estradiol (E2)

    • B. 

      Progesterone (P4)

    • C. 

      GnRH

  • 47. 
    At most times during the menstrual cycle, estrogen and/or progesterone provide positive feedback to GnRH and LH release.
    • A. 

      True

    • B. 

      False

  • 48. 
    Just prior to the preovulatory GnRH/LH/FSH surges, estradiol (E2) and progesterone (P4) are stimulatory to GnRH release.
    • A. 

      True

    • B. 

      False

  • 49. 
    Deactivated cAMP triggers protein kinase activity and the subsequent phosphorylation of proteins necessary for steroidogenesis.
    • A. 

      True

    • B. 

      False

  • 50. 
    In the early proliferative phase of the menstrual cycle, the uterine is relatively thin compared to the late proliferative phase where the endometrium thickens.
    • A. 

      True

    • B. 

      False

  • 51. 
    Which of the following are natural estrogens?
    • A. 

      Estradiol

    • B. 

      Estrone

    • C. 

      Estriol

    • D. 

      Esthinylestradiol

  • 52. 
    Estrogen directly regulate osteoclasts.
    • A. 

      True

    • B. 

      False

  • 53. 
    Which of the following are anti-estrogens?
    • A. 

      Tamoxifen

    • B. 

      Clomiphene

    • C. 

      Fulvestrant

    • D. 

      Formestane

  • 54. 
    Which of the following are SERMS?
    • A. 

      Tamoxifen

    • B. 

      Raloxifene

    • C. 

      Toremifene

    • D. 

      Clomiphene

  • 55. 
    The following are examples of progestins, except:
    • A. 

      Ethinyl estradiol 3-methyl ether

    • B. 

      Progesterone

    • C. 

      17a-acetoxyprogesterone (pregnane)

    • D. 

      19-nortestosterone (estrane)

    • E. 

      Norgestrel (gonane)

  • 56. 
    Thyroid hormones are the only known iodine-containing compounds with biological activity. 
    • A. 

      True

    • B. 

      False

  • 57. 
    Thyroid gland is essential for life and disorders of the thyroid are common.
    • A. 

      True

    • B. 

      False

  • 58. 
    The thyroid produces 3 fundamentally different hormones: (Choose from the following)
    • A. 

      Thyroxine (T4)

    • B. 

      Triiodothyronine (T3)

    • C. 

      Calcitonin

    • D. 

      Glucocorticoids

  • 59. 
    __________ synthesize T4 and T3.
    • A. 

      Microvilli

    • B. 

      Follicular cells

    • C. 

      Hepatic cells

    • D. 

      Adrenal glands

  • 60. 
    Which of the following are steps in thyroid hormone biosynthesis?
    • A. 

      Uptake of iodide

    • B. 

      Oxidation and Iodination

    • C. 

      Formation of T4 and T3 from iodotyrosines

    • D. 

      Resorption

    • E. 

      Reabsorption

    • F. 

      Proteolysis of colloid

    • G. 

      Secretion of thyroid hormones

    • H. 

      Conversion of T4 → T3 in peripheral tissues

  • 61. 
    Only free T4 and T3 are biologically active.
    • A. 

      True

    • B. 

      False

  • 62. 
    The major site of conversion of T4 to T3 outside the thyroid is the ___________.
    • A. 

      Kidney

    • B. 

      Pancreas

    • C. 

      GI tract

    • D. 

      Liver

  • 63. 
    _____________ is the main carrier of T4 and and T3.
    • A. 

      Albumin

    • B. 

      Thyroxine-binding globulin (TBG)

    • C. 

      GLUT2

    • D. 

      Hemoglobin

  • 64. 
    T4, but not T3, can also bind transthyretin and albumin.
    • A. 

      True

    • B. 

      False

  • 65. 
    At high plasma thyroid levels, thyrotropin-releasing hormones (TRH) and thyrotropin-stimulating hormones (TSH) synthesis and secretion are inhibited.
    • A. 

      True

    • B. 

      False

  • 66. 
    Thyrotropin-stimulating hormones (TSH) is stimulated by T3 and T4 and inhibited by thyrotropin-releasing hormones (TRH).
    • A. 

      True

    • B. 

      False

  • 67. 
    Thyroid hormones decreases O2 consumption (multi-organ effect).
    • A. 

      True

    • B. 

      False

  • 68. 
    ____________ is the most common cause of thyroid dysfunction.
    • A. 

      Hyperthyroidism

    • B. 

      Hypothyroidism

    • C. 

      Hypoglycemia

    • D. 

      Hyperglycemia

  • 69. 
    Congenital hypothyroidism due to iodine deficiency remains the major preventable cause of mental retardation worldwide.
    • A. 

      True

    • B. 

      False

  • 70. 
    What is the therapy of choice for hypothyroidism?
    • A. 

      Levothyroxine sodium

    • B. 

      Liothyronine sodium

    • C. 

      Methimazole

    • D. 

      Carbimazole

  • 71. 
    Grave's disease is most common form of hyperthyroidism.
    • A. 

      True

    • B. 

      False

  • 72. 
    Which of the following are common auto-antibodies causing Grave's disease?
    • A. 

      Thyroid Stimulating Immunoglobulins

    • B. 

      Thyroid Growth Stimulating Immunoglobulins

    • C. 

      TSH-Binding Inhibitor Immunoglobulins

    • D. 

      All of the above

  • 73. 
    Which of the following are classes of anti-thyroid Rx?
    • A. 

      Anti-thyroid drugs

    • B. 

      Ionic inhibitors

    • C. 

      High concentrations of iodide

    • D. 

      Radioactive iodine

    • E. 

      Adjuvent Rx

  • 74. 
    Which of the following are thioureylenes?
    • A. 

      Propylthiouracil

    • B. 

      Methimazole

    • C. 

      Carbimazole

    • D. 

      Levothyroxine sodium

  • 75. 
    Anti-thyroid drugs block the incorporation of iodine into tyrosyl residues of thyroglobulin.
    • A. 

      True

    • B. 

      False

  • 76. 
    Which of the following are ionic inhibitors in the treatment of hyperthyroidism?
    • A. 

      Perchlorate

    • B. 

      Carbimazole

    • C. 

      Thiocyanate

    • D. 

      Propranolol

  • 77. 
    Ionic inhibitors interfere with the concentrations of iodide by the thyroid gland.
    • A. 

      True

    • B. 

      False

  • 78. 
    Calcium enters the body from dietary sources (not generated in the body) and is absorbed exclusively from the intestine.
    • A. 

      True

    • B. 

      False

  • 79. 
    Reabsorption of calcium in the kidneys are highly regulated by Vitamin D.
    • A. 

      True

    • B. 

      False

  • 80. 
    Alterations in bone turnover are seen first in the peripheral bone.
    • A. 

      True

    • B. 

      False

  • 81. 
    Bone remodeling is carried out by "bone remodeling units", ______________ and _____________.
    • A. 

      Osteoblasts; osteoclasts

    • B. 

      Vitamin D; vitamin E

    • C. 

      Parathyroid hormones; GnRH

    • D. 

      Epinephrine; norepinephrine

  • 82. 
    Indicate Step 1:
    • A. 

      Insulin receptor binds insulin and undergoes autophosphorylation on its carboxyl-terminal Tyr residues.

    • B. 

      Insulin receptor phosphorylates IRS-1 on its Tyr residues.

    • C. 

      SH2 domain of Grb2 binds to P-Tyr of IRS-1. Sos binds to Grb2, then to Ras, causing GDP release and GTP binding to Ras.

    • D. 

      Activated Ras binds and activates Raf-1.

    • E. 

      Raf-1 phosphorylates MEK on two Ser residues, activating it. MEK phosphorylates ERK on a Thr and a Tyr residue activating it.

    • F. 

      ERK moves into the nucleus and phophorylates nuclear transcription factors such as Elk1, activating them.

    • G. 

      Phosphorylated Elk1 joins SRF to stimulate the transcription and translation of a set of genes needed for cell division.

  • 83. 
    Indicate Step 2:
    • A. 

      Activated Ras binds and activates Raf-1.

    • B. 

      Raf-1 phosphorylates MEK on two Ser residues, activating it. MEK phosphorylates ERK on a Thr and a Tyr residue activating it.

    • C. 

      Insulin receptor phosphorylates IRS-1 on its Tyr residues.

    • D. 

      SH2 domain of Grb2 binds to P-Tyr of IRS-1. Sos binds to Grb2, then to Ras, causing GDP release and GTP binding to Ras.

    • E. 

      Insulin receptor binds insulin and undergoes autophosphorylation on its carboxyl-terminal Tyr residues.

    • F. 

      Phosphorylated Elk1 joins SRF to stimulate the transcription and translation of a set of genes needed for cell division.

    • G. 

      ERK moves into the nucleus and phophorylates nuclear transcription factors such as Elk1, activating them.

  • 84. 
    Indicate Step 3:
    • A. 

      ERK moves into the nucleus and phophorylates nuclear transcription factors such as Elk1, activating them.

    • B. 

      Phosphorylated Elk1 joins SRF to stimulate the transcription and translation of a set of genes needed for cell division.

    • C. 

      Insulin receptor binds insulin and undergoes autophosphorylation on its carboxyl-terminal Tyr residues.

    • D. 

      Raf-1 phosphorylates MEK on two Ser residues, activating it. MEK phosphorylates ERK on a Thr and a Tyr residue activating it.

    • E. 

      Insulin receptor phosphorylates IRS-1 on its Tyr residues.

    • F. 

      Activated Ras binds and activates Raf-1.

    • G. 

      SH2 domain of Grb2 binds to P-Tyr of IRS-1. Sos binds to Grb2, then to Ras, causing GDP release and GTP binding to Ras.

  • 85. 
    Indicate Step 4:
    • A. 

      SH2 domain of Grb2 binds to P-Tyr of IRS-1. Sos binds to Grb2, then to Ras, causing GDP release and GTP binding to Ras.

    • B. 

      Insulin receptor phosphorylates IRS-1 on its Tyr residues.

    • C. 

      Activated Ras binds and activates Raf-1.

    • D. 

      Insulin receptor binds insulin and undergoes autophosphorylation on its carboxyl-terminal Tyr residues.

    • E. 

      Raf-1 phosphorylates MEK on two Ser residues, activating it. MEK phosphorylates ERK on a Thr and a Tyr residue activating it.

    • F. 

      ERK moves into the nucleus and phophorylates nuclear transcription factors such as Elk1, activating them.

    • G. 

      Phosphorylated Elk1 joins SRF to stimulate the transcription and translation of a set of genes needed for cell division.

  • 86. 
    Indicate Step 5:
    • A. 

      Insulin receptor phosphorylates IRS-1 on its Tyr residues.

    • B. 

      Phosphorylated Elk1 joins SRF to stimulate the transcription and translation of a set of genes needed for cell division.

    • C. 

      ERK moves into the nucleus and phophorylates nuclear transcription factors such as Elk1, activating them.

    • D. 

      Raf-1 phosphorylates MEK on two Ser residues, activating it. MEK phosphorylates ERK on a Thr and a Tyr residue activating it.

    • E. 

      Insulin receptor binds insulin and undergoes autophosphorylation on its carboxyl-terminal Tyr residues.

    • F. 

      SH2 domain of Grb2 binds to P-Tyr of IRS-1. Sos binds to Grb2, then to Ras, causing GDP release and GTP binding to Ras.

    • G. 

      Activated Ras binds and activates Raf-1.

  • 87. 
    Indicate Step 6:
    • A. 

      Insulin receptor binds insulin and undergoes autophosphorylation on its carboxyl-terminal Tyr residues.

    • B. 

      ERK moves into the nucleus and phophorylates nuclear transcription factors such as Elk1, activating them.

    • C. 

      Phosphorylated Elk1 joins SRF to stimulate the transcription and translation of a set of genes needed for cell division.

    • D. 

      Insulin receptor phosphorylates IRS-1 on its Tyr residues.

    • E. 

      SH2 domain of Grb2 binds to P-Tyr of IRS-1. Sos binds to Grb2, then to Ras, causing GDP release and GTP binding to Ras.

    • F. 

      Activated Ras binds and activates Raf-1.

    • G. 

      Raf-1 phosphorylates MEK on two Ser residues, activating it. MEK phosphorylates ERK on a Thr and a Tyr residue activating it.

  • 88. 
    Indicate Step 7:
    • A. 

      ERK moves into the nucleus and phophorylates nuclear transcription factors such as Elk1, activating them.

    • B. 

      Insulin receptor phosphorylates IRS-1 on its Tyr residues.

    • C. 

      Raf-1 phosphorylates MEK on two Ser residues, activating it. MEK phosphorylates ERK on a Thr and a Tyr residue activating it.

    • D. 

      Activated Ras binds and activates Raf-1.

    • E. 

      Phosphorylated Elk1 joins SRF to stimulate the transcription and translation of a set of genes needed for cell division.

    • F. 

      SH2 domain of Grb2 binds to P-Tyr of IRS-1. Sos binds to Grb2, then to Ras, causing GDP release and GTP binding to Ras.

    • G. 

      Insulin receptor binds insulin and undergoes autophosphorylation on its carboxyl-terminal Tyr residues.

  • 89. 
    ______________ suppressed in conditions favoring increase bone resorption.
    • A. 

      OPG

    • B. 

      RANK

    • C. 

      RANKL

    • D. 

      OMG

  • 90. 
    Calcium and phosphate ion levels in the body are hormonally regulated.
    • A. 

      True

    • B. 

      False

  • 91. 
    The most important regulatory hormone(s) of calcium and phosphate regulation: (Choose from the following)
    • A. 

      Glucocorticoids

    • B. 

      Parathyroid hormone (PTH)

    • C. 

      1,25-dihydroxyvitamin D (calcitriol)

    • D. 

      Triiodothyronine (T3)

  • 92. 
    The four parathyroid glands are located on the interior surface of the thyroid gland.
    • A. 

      True

    • B. 

      False

  • 93. 
    Proparathyroid hormone (PPTH) is converted to parathyroid hormone (PTH) in the endoplasmic reticulum (ER).
    • A. 

      True

    • B. 

      False

  • 94. 
    Ca2+ in the plasma is the main factor in regulating PTH release.
    • A. 

      True

    • B. 

      False

  • 95. 
    Calcium-sensitive receptor (CaSR) activation by Ca2+ results in increased PTH secretion.
    • A. 

      True

    • B. 

      False

  • 96. 
    Mobilization of Ca2+ from bone (resorption) causes skeleton instability.
    • A. 

      True

    • B. 

      False

  • 97. 
    ____________ increases bone resorption and increases Ca2+ delivery to the extracellular fluid.
    • A. 

      PTH

    • B. 

      Calcitonin

    • C. 

      Thyronine

    • D. 

      Corticotropin

  • 98. 
    Parathyroid hormones (PTH) reduces the formation of:
    • A. 

      Type I collagen

    • B. 

      Alkaline phosphatase

    • C. 

      Osteoclacin

    • D. 

      Type II collagen

  • 99. 
    Calcitriol is the active form of Vitamin D.
    • A. 

      True

    • B. 

      False

  • 100. 
    Vitamin D plays an active role in Ca2+ homeostasis.
    • A. 

      True

    • B. 

      False

  • 101. 
    Levels of the enzyme 1α-hydroxylase are tightly regulated in order to keep Ca2+ levels in homeostasis
    • A. 

      True

    • B. 

      False

  • 102. 
    Decreased dietary Vitamin D, Ca2+, or phosphate will decrease 1α-hydroxylase.
    • A. 

      True

    • B. 

      False

  • 103. 
    Calcitriol aids in the absorption and retention of Ca2+ and phosphate in the liver.
    • A. 

      True

    • B. 

      False

  • 104. 
    Calcitriol controls 1α-hydroxylase synthesis and PTH secretion via negative feedback loops
    • A. 

      True

    • B. 

      False

  • 105. 
    24-hydroxylase activity is inhibited by calcitrol and stimulated by factors that stimulate 1α-hydroxylase.
    • A. 

      True

    • B. 

      False

  • 106. 
    Vitamin D increases the transcellular movement of Ca2+ in the intestine via three steps:
    • A. 

      Decreased Ca2+ diffusion through the cell

    • B. 

      Increased Ca2+ movement across the mucosal membrane

    • C. 

      Increased Ca2+ diffusion through the cell

    • D. 

      Increased energy-dependent extrusion of Ca2+ across the serosal membrane

  • 107. 
    Which of the following are disorders of mineral homeostasis?
    • A. 

      Hypercalcemia

    • B. 

      Hypocalcemia

    • C. 

      Disturbed phosphate metabolism

    • D. 

      Vitamin D

    • E. 

      Vitamin D deficiency

  • 108. 
    Bisphosphonates are the first line Rx for prevention and treatment of postmenopausal osteoporosis.
    • A. 

      True

    • B. 

      False

  • 109. 
    The first biologic bone loss Rx is Prolia.
    • A. 

      True

    • B. 

      False

  • 110. 
    The main effect of adrenocorticotropin hormone (ACTH) is on glucocorticoid secretion.
    • A. 

      True

    • B. 

      False

  • 111. 
    The zonae fasciculata/reticularis secretes aldosterone.
    • A. 

      True

    • B. 

      False

  • 112. 
    The following are main classes of adrenocortical hormones, except:
    • A. 

      Corticosteroids

    • B. 

      Androgens

    • C. 

      Glucagon

  • 113. 
    __________________ are involved in the maintenance of electrolyte balance.
    • A. 

      Glucocorticoids

    • B. 

      Mineralocorticoids

    • C. 

      Androgens

    • D. 

      Inuslin

    • E. 

      1α-hydroxylase

  • 114. 
    Which of the following competitively antagonizes mineralcorticoid receptors?
    • A. 

      Metyrapone

    • B. 

      Ketoconazole

    • C. 

      Spironolactone

  • 115. 
    Calcitonin is more effective than bisphosphonates in inhibition of bone resorption.
    • A. 

      True

    • B. 

      False

  • 116. 
    ____________ is the first-line alternative in patients who are intolerant to bisphosphonates.
    • A. 

      Calcitonin

    • B. 

      SERMs

    • C. 

      Calcimimetics

  • 117. 
    _____________ is metabolized by CYP2D6 and inhibitor of CYP2D6.
    • A. 

      Calcimimetics

    • B. 

      Calcitonin

    • C. 

      Bisphosphonates

  • 118. 
    Vitamin D deficiency causes over-secretion of PTH and bone loss.
    • A. 

      True

    • B. 

      False

  • 119. 
    Which of the following are inhibitors of adrenocortical secretion?
    • A. 

      Mitotane

    • B. 

      Metyrapone

    • C. 

      Aminoglutethimide

    • D. 

      Ketoconazole

    • E. 

      Trilostane

  • 120. 
    Individual cells in the pituitary generally make more than one hormone.
    • A. 

      True

    • B. 

      False

  • 121. 
    Insulin-stimulated glucose transport is impaired in adipose tissue and skeletal muscle of obese insulin resistant and diabetic patients.
    • A. 

      True

    • B. 

      False

  • 122. 
    Somatostatin inhibits growth hormone secretion by its actions at the levels of the hypothalamus and the pituitary.
    • A. 

      True

    • B. 

      False

  • 123. 
    Measuring concentrations of AGE is an important clinical biomarker for glucose control.
    • A. 

      True

    • B. 

      False

  • 124. 
    Prolactin:
    • A. 

      Receptors are GPCRs that ultimately activate JAK signaling pathways

    • B. 

      Secretion is stimulated by the dopamine D2 receptor agonist bromocriptine

    • C. 

      Secretion is inhibited by antipsychotic agents that antagonize dopamine D2 receptors

    • D. 

      Release is stimulated by stress

    • E. 

      None of the above

  • 125. 
    Estrogen receptors alpha and beta: 
    • A. 

      Form homodimers before binding estrogen receptor response elements

    • B. 

      Form heterodimers before binding estrogen receptor response elements

    • C. 

      When bound to DNA, recruit co-activators

    • D. 

      When bound to DNA, recruit co-repressors

    • E. 

      All of the above

  • 126. 
    GnRH:
    • A. 

      Secretion is inhibited by estrogen

    • B. 

      Secretion is stimulated by estrogen

    • C. 

      Secretion amplitude (not frequency) is regulated at the level of the pituitary

    • D. 

      A and B

    • E. 

      A and C

  • 127. 
    Insulin regulates hepatic glucose production by:
    • A. 

      Signaling via PI3K in the hypothalamus

    • B. 

      Activation of phosphodiesterases in the liver, leading to the breakdown of cAMP

    • C. 

      Activation of hepatic PP-1 leading to de-phosphorylation of glycogen phosphorylase a

    • D. 

      B and C

    • E. 

      All of the above

  • 128. 
    Metformin:
    • A. 

      Is first-line therapy for T2DM

    • B. 

      Enhances glucose absorption from the GI tract and glucose uptake into tissues

    • C. 

      Reduces hepatic glucose output by reducing rates of gluconeogenesis

    • D. 

      Activates AMPK

    • E. 

      A and B

    • F. 

      A, C and D

    • G. 

      All of the above

  • 129. 
    Thryotropin Releasing Hormone: (Choose from the following)
    • A. 

      Made in several areas of the hypothalamus and secreted at the median eminence

    • B. 

      Synthesized and secreted throughout the brain as a neurotransmitter

    • C. 

      Secreted in a pulsatile manner from the anterior hypothalamus

    • D. 

      A bipeptide

  • 130. 
    Antimicrobials: (Choose from the following)
    • A. 

      Agents that inhibit synthesis of bacterial cell walls

    • B. 

      Bacteriostatic agents that disrupt function of 30S or 50S ribosomal subunits to inhibit protein synthesis

    • C. 

      Bactericidal agents that bind to the 30S ribosomal subunit and alter protein synthesis

    • D. 

      Agents that affect bacterial nucleic acid metabolism (e.g. rifamycins), which inhibit RNA polymerase or topoisomerases

    • E. 

      The anti-metabolites which stimulate essential enzymes of folate metabolism

  • 131. 
    Which antimicrobial to use? Keys to selection of best Rx:
    • A. 

      Identification of infecting organism

    • B. 

      Site of Infection

    • C. 

      Safety of the Rx

    • D. 

      Determining organism's susceptibility to a particular drug

    • E. 

      Patient-specific factors

    • F. 

      Cost

  • 132. 
    Some critically ill patients require immediate antibiotic treatment prior to bacterial ID and susceptibility testing.
    • A. 

      True

    • B. 

      False

  • 133. 
    ______________ arrest the growth and replication of bacteria at clinical serum concentrations, and ______________ kill bacteria at clinical serum concentrations. Used in seriously ill patients.
    • A. 

      Bacteriostatic; Bactericidal

    • B. 

      Bactericidal; Bacteriostatic

    • C. 

      Macrophage; Dendrites

  • 134. 
    Which of the following are patient-specific variables to determine the appropriate antimicrobial?
    • A. 

      Immune function

    • B. 

      Renal function

    • C. 

      Liver function

    • D. 

      Blood flow/perfusion

    • E. 

      Age

    • F. 

      Pregnancy

    • G. 

      Lactation

  • 135. 
    ________________ is a failure to produce sufficient thyroid hormone.
    • A. 

      Primary hypothyroidism

    • B. 

      Secondary hypothyroidism

    • C. 

      Tertiary hypothyroidism

  • 136. 
    Secondary hypothyroidism is a failure of the hypothalamus stimulation, and tertiary hypothyroidism is a failure of the pituitary stimulation of the thyroid.
    • A. 

      True

    • B. 

      False

  • 137. 
    Tetracyclines: 
    • A. 

      Blocks protein synthesis by binding to 30s

    • B. 

      Blocking tRNA binding to A site

    • C. 

      Blocking tRNA binding to P site

    • D. 

      A and B

    • E. 

      A and C

    • F. 

      All of the above

  • 138. 
    _________________ is used only in patients with life-threatening infections where no other alternatives exist.
    • A. 

      Chloramphenicol

    • B. 

      Tetracycline

    • C. 

      Macrolides

    • D. 

      Clindamycin

  • 139. 
    Which of the following are protein synthesis inhibitors that targets bacteria?
    • A. 

      Tetracyclines

    • B. 

      Chloramphenicol

    • C. 

      Macrolides

    • D. 

      Clindamycin

    • E. 

      Linezolid

  • 140. 
    Macrolides:
    • A. 

      Bind reversibly to 50S ribosomal subunits

    • B. 

      Inhibit the translocation step

    • C. 

      Cause conformational change that terminates protein synthesis by interfering with transpeptidation

    • D. 

      All of the above

  • 141. 
    Chloramphenicol: (Choose from the following)
    • A. 

      Penetrates bacterial cells via facilitated diffusion

    • B. 

      Binds reversibly to 50S ribosomal subunit at the P site

    • C. 

      Inhibits transpeptidation reaction

    • D. 

      Promote mitochondrial synthesis in mammalian cells

  • 142. 
    Vancomycin:
    • A. 

      Inhibits synthesis of bacterial cell wall via binding to the D-Ala-D-Ala of pentapeptide

    • B. 

      Prevents the trans-glycosylation step in peptidoglycan polymerization

    • C. 

      Bactericidal for dividing microorganisms

    • D. 

      Effective against gram positive organisms

    • E. 

      Important in treating multiple drug-resistant organisms such as MRSA and enterococci

  • 143. 
    The hypothalamus makes and secrete hormones indirectly into the general circulation.
    • A. 

      True

    • B. 

      False

  • 144. 
    The hypothalamus makes and secretes releasing factors into the portal blood.
    • A. 

      True

    • B. 

      False

  • 145. 
    The anterior pituitary consists of neuronal tissues, and the posterior pituitary consists of non-neuronal tissues.
    • A. 

      True

    • B. 

      False

  • 146. 
    Dopamine inhibits prolactin secretions, and thyrotophin releasing hormone stimulates prolactin secretions.
    • A. 

      True

    • B. 

      False

  • 147. 
    Pituitary hormones are typically homodimeric glycoproteins and have an alpha and beta subunit. 
    • A. 

      True

    • B. 

      False

  • 148. 
    Which of the following pertaining to Growth Hormone are true?
    • A. 

      Highest quantities secreted at night

    • B. 

      Ghrelin stimulates GHRH

    • C. 

      Inhibited by somatostatin (SST)

    • D. 

      Indirectly stimulates the release of insulin-like growth factors

  • 149. 
    Growth Hormone Receptor:
    • A. 

      Causes autophosphorylation of JAK2

    • B. 

      Recruitment of IRS-1

    • C. 

      Phosphorylation of cAMP

    • D. 

      A and B

    • E. 

      B and C

    • F. 

      All of the above

  • 150. 
    Control of prolactin release is mainly stimulatory. 
    • A. 

      True

    • B. 

      False

  • 151. 
    There are no therapeutic uses of prolactin.
    • A. 

      True

    • B. 

      False

  • 152. 
    Dopamine D2 antagonists inhibit prolactin release.
    • A. 

      True

    • B. 

      False

  • 153. 
    Which of the following are true pertaining to oxytocin?
    • A. 

      A nonpeptide hormone and neurotransmitter

    • B. 

      Released from the anterior pituitary

    • C. 

      Released in response to suckling, cervix changes, stress

    • D. 

      Stimulates prostaglandin synthesis