Pmc 1 Exam 3

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  • 1/114 Questions

    Testosterone exhibits poor bioavailability due to extensive 1st pass metabolism.

    • True
    • False
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Androgens & Estrogens (Cox & Sumanasekera), Adrenocorticosteroids (Cox & Sumanasekera) and Antihistamines (Cox & McCune)


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  • 2. 

    How much cortisol is secreted by the body under stress compared to normal function?

    • Same under stress

    • More under stress

    • Less under stress

    Correct Answer
    A. More under stress
    Explanation
    (Adrenocorticosteroids 1 Dr. S)

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  • 3. 

    Isomers that exist in equilibrium and are readily interconverted by migration of a Hydrogen atom within the molecule are known as which of the following?

    • Stereoisomers

    • Rotamers

    • Tautomers

    • Stereomers

    Correct Answer
    A. Tautomers
    Explanation
    (Cox Antihistamines)

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  • 4. 

    The steroid molecule shown here is transformed by which of the following enzymes?

    • Gyrases

    • Esterases

    • Deaminases

    • Phosphatases

    Correct Answer
    A. Esterases
    Explanation
    This steroid has an ester at C17, so it is transformed by esterases into a COOH and alcohol (Cox androgens)

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  • 5. 

    Finasteride and Dutasteride act by which of the following mechanisms?

    • 5a Reductase inhibition

    • 5a Reductase induction

    • 11b Hydroxysteroid dehydrogenase inhibition

    • 11b Hydroxysteroid dehydrogenase induction

    Correct Answer
    A. 5a Reductase inhibition
    Explanation
    they are 5aR inhibitors (cox androgens)

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  • 6. 

    The drug-drug interaction between antibiotics and estrogens is due to the lack of Beta-glucuronidase that occurs after antibiotics kill intestinal bacteria. Estrogen levels decrease because estrogen can no longer undergo enterohepatic cycling.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    cox estrogens

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  • 7. 

    The purpose of the addition of the 17-alpha alkyne group to this estrogen molecule is to

    • Increase molecular size

    • Decrease oral bioavailability

    • Increase oral bioavailability

    • Make the molecule ionic

    Correct Answer
    A. Increase oral bioavailability
    Explanation
    this is Ethinyl Estradiol. the 17a-alkyne group increases oral bioavailability by preventing oxidation of C17 to a ketone (cox estrogens)

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  • 8. 

    Suicide inhibition is another name for which type of binding, exhibited by steroid binding to aromatase?

    • Irreversible

    • Reversible

    • Shannon Burton binding

    Correct Answer
    A. Irreversible
    Explanation
    Irreversible binding of steroids to aromatase is known as suicide inhibition (cox estrogens)

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  • 9. 

    Select two answers. Glucocorticoids mainly enhances which TWO of the following processes?

    • Gluconeogenesis

    • Glycogenolysis

    • Glycogen synthesis

    Correct Answer(s)
    A. Gluconeogenesis
    A. Glycogenolysis
    Explanation
    they also regulate glycogen synthesis, but mainly gluconeogensis and glycogenolysis (Adrenocorticosteroids 1 Dr. S)

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  • 10. 

    Esterases metabolize lipophilic esters found at C17 on steroid molecules. Where in the body can these enzymes be found?

    • Liver only

    • Lung and skin only

    • Fat tissues only

    • Throughout the body

    Correct Answer
    A. Throughout the body
    Explanation
    esterases are found in nearly all tissues (cox androgens)

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  • 11. 

    The antiandrogens Bicalutamide, Flutamide and Nilutamide act by blocking the effects of testosterone and DHT on androgen receptors in the treatment of advanced prostate cancer.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Cox androgens

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  • 12. 

    What type of reaction is shown here?

    • Reduction

    • Dehydroxylation

    • Oxidation

    • Dehydration

    Correct Answer
    A. Oxidation
    Explanation
    This is the oxidation of estradiol into estrione. Oxidation because it gains a bond to oxygen (cox estrogens)

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  • 13. 

    Cortisol is mainly metabolized by which of the following organs?

    • Lung

    • Skin

    • Kidney

    • Liver

    Correct Answer
    A. Liver
    Explanation
    mainly in the liver, some in the kidney (Adrenocorticosteroids 1 Dr. S)

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  • 14. 

    Which of the following is NOT a symptom of Addison's Disease?

    • Hypertension

    • Hypoglycemia

    • Weakness

    • Fatigue

    Correct Answer
    A. Hypertension
    Explanation
    Addison's causes HYPOtension (Adrenocorticosteroids 2 Dr. S)

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  • 15. 

    Promethazine has antiemetic effects and can be used in combination to reduce congestion.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    (McCune antihistamines)

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  • 16. 

    The 2nd generation piperadine antihistamine Terfenadine was removed from the market due to which of the following adverse effects?

    • Shannon Burton syndrome

    • Ventricular tachycardia

    • Pancreatitis

    • SJS

    Correct Answer
    A. Ventricular tachycardia
    Explanation
    (McCune antihistamines)

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  • 17. 

    Another name for leukotrienes is slow reacting substance of anaphylaxis. Leukotrienes have the same effects as histamine, but are more potent.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    (McCune antihistamines)

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  • 18. 

    Codeine and morphine displace mast cell granules.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    this was bolded for some reason (McCune Antihistamines)

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  • 19. 

    Steroids bind receptors ____

    • Inside the cell membrane

    • Extracellularly

    • Intracellularly

    Correct Answer
    A. Intracellularly
    Explanation
    Steroids bind receptors intracellularly because they are lipid-soluble molecules that can easily pass through the cell membrane. Once inside the cell, steroids bind to specific intracellular receptors located in the cytoplasm or nucleus. This binding activates the receptor and initiates a series of cellular responses, including changes in gene expression. Unlike other signaling molecules that bind receptors on the cell membrane, steroids directly affect gene transcription and protein synthesis within the cell.

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  • 20. 

    The enzyme which catalyzes the Phase 2 reaction of estradiol shown here is which of the following?

    • UDP-glucuronosyltransferase

    • Methyltransferase

    • Thioesterase

    • Sulfotransferase

    Correct Answer
    A. Sulfotransferase
    Explanation
    Sulfotransferase conjugates a sulfate group in Phase 2 to make the molecule more polar so it can be removed from circulation by the kidneys (cox estrogens)

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  • 21. 

    The reaction shown here occurs in Phase ___ and is catalyzed by the enzyme ______.

    • 2; dehydrogenase

    • 1; UGT

    • 2; UGT

    • 1; dehydrogenase

    Correct Answer
    A. 2; UGT
    Explanation
    this reaction is the glucuronide conjugation of estradiol by UGT in phase 2 (cox estrogens)

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  • 22. 

    Selective Estrogen Receptor Modulators, or SERMs, act as agonists for estrogen in bone tissue (not marrow) and antagonists in breast tissue.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    SERMs are agonists in some tissues and antagonists in others (cox estrogens)

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  • 23. 

    Dutasteride blocks the conversion of Testosterone to which of the following?

    • DHT

    • Androstenedione

    • Estriol

    • Aldosterone

    Correct Answer
    A. DHT
    Explanation
    Dr. S

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  • 24. 

    Spironolactone reverses the effects of aldosteronism and acts as a diuretic at the renal collecting tubules.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    (Adrenocorticosteroids 2 Dr. S)

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  • 25. 

    The interconversion shown here is an example of which of the following?

    • Keto-Enol Tautomerization

    • Keto-Enol Epimerization

    • Imine-Enamine Tautomerization

    • Imine-Enamine Epimerization

    Correct Answer
    A. Keto-Enol Tautomerization
    Explanation
    (Cox Antihistamines)

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  • 26. 

    Fexofenadine is a non-cardiotoxic metabolite of Terfenadine. Fexofenadine has increased selectivity for H1 receptors compared to first generation antihistamines.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    (McCune antihistamines)

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  • 27. 

    Which of the following is NOT an adverse effect of Ipratropium, an anticholinergic that can treat COPD and rhinorrhea due to its drying effects?

    • Urinary frequency

    • Nose bleed

    • Headache

    • Nasal dryness

    Correct Answer
    A. Urinary frequency
    Explanation
    (McCune antihistamines)

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  • 28. 

    Zileuton inhibits which of the following enzymes?

    • 5-lipoxygenase

    • 11b-hydroxysteroid dehydrogenase

    • CYP3A4

    • Phosphorylase

    Correct Answer
    A. 5-lipoxygenase
    Explanation
    5-lipoxygenase converts arachadonic acid to LT's and Zileuton blocks it to reduce LT's (McCune antihistamines)

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  • 29. 

    5-alpha Reductase inhibitors, such as Dutasteride, are irreversible modifiers.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    5aRI's are irreversible (cox androgens)

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  • 30. 

    Which feature of the molecule shown here is very rarely found in drug molecules today?

    • Tri-fluoro group

    • Nitro group

    • Amide group

    • Cyano group

    Correct Answer
    A. Nitro group
    Explanation
    Cox androgens

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  • 31. 

    The structure shown here is produced by metabolism of Estrogen by Estrogen 2-hydroxylase enzyme. This molecule is further metabolized by which of the following enzymes?

    • UGT

    • Estrogen 4-hydroxylase

    • COMT

    • Aromatase

    Correct Answer
    A. COMT
    Explanation
    recognize that this product is now a catechol, which can be metabolized by COMT (catechol O-methyltransferase) (cox estrogens)

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  • 32. 

    The follicular phase of menstruation involves the conversion of pregnenolone to DHEA. The luteal phase involves the conversion of pregnenolone to which of the following?

    • Cortisol

    • Aldosterone

    • Progesterone

    • Estradiol

    Correct Answer
    A. Progesterone
    Explanation
    Luteal: pregnenolone to progesterone via 3B-dehydrogenase (S estrogens/androgens)

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  • 33. 

    The most potent endogenous glucocorticoid is _____ while the most potent endogenous mineralocorticoid is _____.

    • Estrogen; Fludrocortisone

    • Methylprednisolone; Aldosterone

    • Cortisol; Aldosterone

    • Cortisol; Fludrocortisone

    Correct Answer
    A. Cortisol; Aldosterone
    Explanation
    cox adrenocorticoids 1

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  • 34. 

    The anticholinergic effects of antihistamines and other drugs are determined by the presence of two rings connected by a single intermediate link, an amino group and a short carbon chain between the rings and amino. Which of the following drugs does NOT have anticholinergic properties?

    • Option 1

    • Option 2

    • Option 3

    • Option 4

    Correct Answer
    A. Option 2
    Explanation
    all examples are shown in the slides (Cox Antihistamines)

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  • 35. 

    A substituent attached to the 10 Carbon on the steroid nucleus shown here would have what numbering?

    • 18

    • 19

    • 20

    • 21

    Correct Answer
    A. 19
    Explanation
    19 is attached to 10, 18 is attached to 13 (Cox Androgens)

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  • 36. 

    Steroids are transported in the blood via transport proteins. Which of the following is NOT a transport protein for steroids?

    • Albumin

    • Corticosteroid Binding Globulin

    • Sex Hormone Binding Globulin

    • Immunoglobulns

    Correct Answer
    A. Immunoglobulns
    Explanation
    cox adrenocorticoids 1

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  • 37. 

    Which of the following enzymes catalyzes the reaction shown here?

    • 11-alpha Hydrogenase

    • 11-beta Hydroxysteroid Dehydrogenase

    • 17-alpha Hydroxylase

    • 17-beta Esterase

    Correct Answer
    A. 11-beta Hydroxysteroid Dehydrogenase
    Explanation
    cox adrenocorticoids 1

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  • 38. 

    Which of the following are Phase 2 reactions undergone by Estrogens?

    • Sulfation

    • Glucuronidation

    • Hydroxylation

    • Esterification

    Correct Answer(s)
    A. Sulfation
    A. Glucuronidation
    Explanation
    cox estrogens

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  • 39. 

    Which of the following enzymes is responsible for enterohepatic cycling?

    • Beta-glucuronidase

    • Estrogen 2/4-hydroxylase

    • COMT

    • UGT

    Correct Answer
    A. Beta-glucuronidase
    Explanation
    b-glucuronidase hydrolyzes estradil glucuronide back into estradiol so it can be cycled again (cox estrogens)

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  • 40. 

    11-deoxycorticosterone is converted to Aldosterone in the Zona Glomerulosa via which of the following enzymes?

    • 11b-hydroxylase

    • 21b-hydroxylase

    • 3b-dehydrogenase

    • 3,20-lyase

    Correct Answer
    A. 11b-hydroxylase
    Explanation
    Dr. S

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  • 41. 

    The enzyme Aromatase produces 17b-estradiol from which of the following androgens?

    • DHEA

    • Testosterone

    • Androstenedione

    • Cortisol

    Correct Answer
    A. Testosterone
    Explanation
    Dr. S

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  • 42. 

    90% of Cortisol in the body can be found where?

    • Bound to albumin

    • Freely circulating

    • Bound to CBG

    • In the kidney

    Correct Answer
    A. Bound to CBG
    Explanation
    cortisol is 90% bound to CBG; the rest is free. cortisol bound to albumin is considered free because it is loosely bound (Adrenocorticosteroids 1 Dr. S)

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  • 43. 

    Deoxycorticosterone (DOC) is a precursor to aldosterone. Adrenal hyperplasia and carcinomas have what effect of DOC secretion?

    • Decrease

    • Increase

    • No effect

    • The Aaron Liu effect

    Correct Answer
    A. Increase
    Explanation
    (Adrenocorticosteroids 2 Dr. S)

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  • 44. 

    First generation molecules, like the diphenhydramine shown here, contain two aromatic groups linked through a short chain to a tertiary aliphatic amine. What classification of antihistamine is diphenhydramine?

    • Ethylenediamine

    • Ethanolamine

    • Piperadine

    • Alkylamine

    Correct Answer
    A. Ethanolamine
    Explanation
    (Cox Antihistamines)

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  • 45. 

    Why is the nitro group found in antiandrogens such as Nilutamide and Flutamide so unusual in modern drugs?

    • Highly nephrotoxic

    • Highly hepatotoxic

    • Highly neurotoxic

    • Highly cardiotoxic

    Correct Answer
    A. Highly hepatotoxic
    Explanation
    Nitro groups are rarely used because they are highly hepatotoxic upon conversion to free radicals (cox androgens)

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  • 46. 

    SERMs, such as Clomifene and Tamoxifen, act by which of the following mechanisms?

    • They prevent translocation of the receptor complex to the nucleus

    • They prevent estrogen from entering the cell membrane

    • They degrade the intracellular estrogen receptor in the cytosol before estrogen can bind

    • They kill cells to prevent estrogen action

    Correct Answer
    A. They prevent translocation of the receptor complex to the nucleus
    Explanation
    cox estrogens

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  • 47. 

    Progestins reduce the risk of cancer from estrogen therapy and decrease water retention by competing with aldosterone.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Dr. S

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  • 48. 

    A 17-Beta Ketol group, which may or may not be esterified, is a MUST for which type of activity?

    • Corticosteroid

    • Androgenic

    • Estrogenic

    • Physical

    Correct Answer
    A. Corticosteroid
    Explanation
    cox adrenocorticoids 1

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  • 49. 

    Synthesis of histamine from histidine is which type of reaction?

    • Hydrolysis

    • Deamination

    • Esterification

    • Decarboxylation

    Correct Answer
    A. Decarboxylation
    Explanation
    (Cox Antihistamines)

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  • Aug 28, 2016
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