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24 Cards in this Set
- Front
- Back
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1. 70 year old Irish immigrant who had been complaining for several years of chronic fatigue and arthritis was observed to have increased skin pigmentation and was recently diagnosed by her physician to have both diabetes and cirrhosis of the liver. After a series of blood tests she was found to have a relatively common genetic disease that should respond to which of the following treatments?
A. enzyme therapy B. decreased alcohol intake and attendance at AA meetings C. dietary restrictions and/or insulin D. serial phlebotomy or regular blood donations E. copper chelation therapy |
D
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A measure of a drug’s selectivity is its:
A. Potency. B. Maximum efficacy. C. Therapeutic Index. D. Binding affinity for its target site. E. ED50. |
C
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3. A drug, which binds to a receptor, reduces the potency of the endogenous receptor agonist, has no effect on the maximum efficacy of the agonist, and has no efficacy of its own, is referred to as:
A. A noncompetitive antagonist. B. A synergist C. A competitive antagonist. D. A partial agonist. E. A positive modulator. |
C
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4. The lower the KB of an atropine-like drug:
A. the greater its potency as a muscarinic antagonist. B. the lesser its potency as a muscarinic antagonist. C. the greater its selectivity as a muscarinic antagonist. D. the greater its efficacy as an adrenergic antagonist. E. the less likely it will distribute into the brain. |
A
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A 23 year old medical student with right lower quadrant pain and neutrophilic leukocytosis underwent emergent surgery. The excision of an abdominal organ showed findings noted in figure 1. Which one of the following complications is most likely to occur in this student:
(Picture of a ruptured appendix) A. Peritonitis B. Pancolitis C. Duodenitis D. Hepatitis E. Diverticulitis |
A
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6. Which of the following classes of drugs causes a decrease in total peripheral resistance by interacting with receptors present on vascular smooth muscle:
A. Beta 1 receptor agonists. B. Beta 1 receptor antagonists. C. Alpha 1 adrenergic receptor agonists. D. Alpha 1 adrenergic receptor antagonists. E. Alpha 2 receptor antagonists. |
D
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7. Which of the following classes of drugs causes dry mouth, tachycardia, and urinary retention:
A. Muscarinic antagonists. B. Muscarinic agonists. C. Adrenergic agonists. D. Adrenergic antagonists. E. Nicotinic receptor agonists. |
A
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8. Evidence from clinical trials of efficacy for a specific indication is required in the U.S. prior to marketing of:
A. Herbal medicines. B. Dietary supplements. C. Placebo medications. D. New chemical entities. E. Generic formulations. |
D
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9. Among the following organs/tissues, which is the most radiosensitive:
A. Vaginal squamous epithelium B. Skeletal muscle C. Cardiac muscle D. Aortic endothelium E. Hematopoietic tissue |
E
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10. A problem for the physician seeking evidence on the efficacy of herbal remedies is:
A. Trials that include use of a placebo group with randomization of subject assignment and double-blind procedures. B. Lack of standardization of the ingredients in herbal products. C. No organizations in the U.S. whose mission is to evaluate the validity of scientific evidence from published studies on herbal medicines. D. No support from NIH for research on complementary and alternative medicines. E. Absence of journals with the objective of publishing studies on herbal medicines. |
B
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11. The expenditures for drugs in the U.S.:
A. Primarily represent costs of generics, which represent 95% of spending on drugs. B. Are primarily paid ‘out-of-pocket’, directly by the patient. C. Have increased over the last ten years at about the rate of inflation. D. Have increased over the last ten years at about the same rate as hospital costs. E. Are affected by marketing practices of the pharmaceutical industy, which spends more on promotional activities directed to the physician than the patient. |
E
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12. A careless homeowner was jolted by an electrical shock while working on the wiring in his kitchen. Which one of the following statements regarding electrical injury is correct:
A. The greater the resistance of tissues to electrical current, the less heat is generated. B. Severity of electrical injury does not depend on the path of the current through the body. C. Electrical current may cause sudden death by disruption of neural regulatory impulses producing cardiac arrest. D. Dry skin has relatively low resistance to electrical current, in contrast to wet skin. E. Electrical current causes death by dissemiated intravascular coagulation |
C
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1. Which one of the following general statements regarding the Gram stain is true?
A. All Gram-negative bacteria are bacilli. B. All Gram-positive bacteria are cocci. C. All Gram-negative cocci are purple/blue. D. All Gram-positive bacteria are red/pink. E. All Gram-positive rods are purple/blue. |
E
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2. A 25-year-old female developed hepatitis A following a trip to Costa Rica. A liver biopsy showed numerous hepatocytes with the appearance shown in figure 1. The cellular changes illustrated are due to which of the following alterations in the virus infected cells
A. Induction of CD95 (FAS) expression on the hepatocyte membranes which interacts with Fas ligand on T cells B. Virus induced DNA damage leading to activation of the mitochondrial pathway of apoptosis by p53 C. Calcium infusion across the cell membrane leading to phospolipase activation and membrane destruction D. Direct viral injury to mitochondria causing ATP depletion and cell death E. Membrane damage from lipid peroxidation induced by excess production of free radicals |
A
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3. The apparent volume of distribution of a highly lipophilic drug is most likely to be:
A. About 5% of body weight. B. About 17% of body weight. C. About 60% of body weight. D. Greater than 60% of body weight. E. Greater than 60% of body weight, but cannot exceed 100% of body weight. |
D
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4. Greg is experiencing “flu-like” symptoms, including fever, malaise, and loss of appetite.
Which one of the following statements regarding his symptoms is most likely true? A. These symptoms are consistent with the prodrome stage of Gram-negative bacteria, but not Gram-positive bacteria. B. These symptoms are consistent with the specific illness stage of a chronic, but not an acute illness. C. These symptoms allow a definitive diagnosis of the flu to be made. D. These symptoms are characteristic of the prodrome stage of many infectious diseases. E. These symptoms generally appear after the specific illness period of bacterial infections. |
D
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5. Which of the following is the main role of fibroblasts in tissue repair?
A. Removal of dead (necrotic) tissue B. Secretion of cytokines C. Formation of new blood vessels D. Antigen presentation to immune cells E. Synthesis of extracellular matrix |
E
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6. Which of the following factors is most likely to explain the low oral bioavailability of a drug with a quaternary ammonium group, which is administered as an aqueous solution:
A. First pass effect. B. Low lipophilicity and, therefore, poor diffusion through the intestinal mucosa. C. Slow disintegration rate. D. Gastric acidity, which would increase ionization of the drug. E. Precipitation in the duodenal lumen due to poor aqueous solubility. |
B
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7. Plasmids are best characterized as:
A. replicons that carry genes required for bacterial replication. B. autonomously replicating minichromosomes. C. conjugative transposons that carry antibiotic resistance genes. D. replicons that can only be transferred among Gram-positive bacteria. E. bacterial viruses that carry antibiotic resistance genes. |
B
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8. A female patient who has complained for several years of gastroesophageal acid reflux (GERD) has a biopsy of the distal esophagus performed. Microscopic examination shows a columnar mucosa that contains absorptive and goblet (mucin) cells. This finding is best described as an example of:
A. Metaplasia B. Repair C. Degeneration D. Necrosis E. Apoptosis |
A
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9. In a 70-kg healthy 25-year old patient, the renal clearance of a lipophilic drug that has no ionizable groups, does not bind to plasma proteins, and is not a substrate for a carrier protein in the proximal tubule, is most likely to be:
A. About 640 ml/min. B. Between 120 and 640 ml/min. C. Approximately 120 ml/min, independent of renal pH. D. Between 0 and 120 ml/min, depending on renal pH. E. Less than 120 ml/min, independent of renal pH. |
E
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10. Mei Lin is a 2-year-old child with an ear infection. Her pediatrician knows that the most likely causative agent is a Gram-negative coccobacillus. Which one of the following statements regarding this organism is true?
A. It has lipoteichoic acid in its cell wall. B. The outermost layer of this organism is composed of peptidoglycan. C. It has lipopolysaccharide in its cell wall. D. It has mitochondria in its cytoplasm. E. It will produce spores under adverse environmental conditions. |
C
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11. Which of the following is the source of substrate for cyclooxygenase and lipoxygenase conversion of arachadonic acid to inflammatory mediators?
A. Mitochondria B. Nucleus C. Cell membrane D. Lysosomes E. Residual bodies |
C
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12. A dose of 64 mg of Drug X was injected intravenously in a 6.0-kg infant. Plasma concentrations (Cp) of the drug at various times after administration were as follows:
Time (hour) 2 4 6 8 10 Cp (µg/ml) 32 22 16 11 8 These data indicate that in this subject the elimination half-life of Drug X: A. Is not the same for all doses of this drug. B. Is about 2 hours. C. Is about 4 hours. D. Is about 6 hours. E. Cannot be computed from these data, because the elimination is by zero-order kinetics. |
C
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