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129 Cards in this Set

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A succinate ester attached to the glucocorticoid base structure allows this preparation to be administered by which of the following routes?
a. Intravenous
b. Subcutaneous
c. Topically on the cornea
d. Intraarticular
e. All of the above
e.All of the above
Administration of pharmacological dosages of glucocorticoids influences the hypothalamic-pituitary-adrenal (HPA) axis by negative feedback and reduction of the production of:
a. cortisol
b. CRH
c. ACTH
d. TSH
e. All of the above.
e.All of the above.
"Alabama" is a 5 year-old MC Boxer who presents to your clinic with an acute onset of weakness, hematuria and a responsive anemia. On diagnostic workup, you conclude that he has autoimmune hemolytic anemia. The most rational glucocorticoid, glucocorticoid dosage, and route of administration would be:
a. A replacement dosage of hydrocortisone
b. A topical anti-inflammatory dosage of prednisone
c. An oral immunosuppressive dosage of prednisolone
d. An intramuscular depot of an antiinflammatory dosage of methylprednisolone acetate (Depo-Medrol (R) )
e. An intramuscular replacement depot of desoxycorticosterone (DOC) pivalate
c.An oral immunosuppressive dosage of prednisolone
All of the following clinicopathological abnormalities might accompany the use of glucocorticoids in the dog EXCEPT:
a. An increase in serum alkaline phosphatase activity
b. Lymphopenia
c. Neutrophilic leukocytosis
d. Hyperkalemia
e. Increased glucose in a dog with propensity toward diabetes mellitus
d.Hyperkalemia
General feedback: glucocorticoids have effects similar to aldosterone, so potassium loss or HYPOKALEMIA is the result.
Although a nonsteroidal antiinflammatory drug, flunixin carries the additional pharmacological ability to block hypotension and visceral forms of pain. Flunixin accomplishes this by blocking receptors for which peptide mediator?
a. Angiotensin II
b. Parathyroid hormone
c. Insulin
d. Interleukin-1
e. Bradykinin
e.Bradykinin
Although always controversial, the commonly quoted statement “No animal should die from a lack of ‘steroids’” in the context of treatment of shock certainly has no scientific basis if the animal:
a. arrives in your clinic 2 hours after the shock-inducing trauma.
b. arrives in your clinic 6 hours after the shock-inducing trauma.
c. is suffering from Addison’s disease.
d. is suffering from septic shock.
e. is suffering from hemorrhagic shock.
b.arrives in your clinic 6 hours after the shock-inducing trauma.
Although H2 antagonists are generally safe drugs, the oldest H2 antagonist cimetidine has the following potential side effect(s):
a) reduce the metabolism rate of other drugs
b) reduce the plasma biding of other drugs
c) exacerbate the severity of an allergic reaction
d) a and b
e) a and c
e) a and c
Aspirin and many other nonsteroidal antinflammatory drugs cause gastric ulceration. Which of the following statements best describes a mechanism believed to contribute to this side effect?
a. NSAIDs cause this effect only when given orally, and it is caused by a direct irritative effect on the gastric epithelium.
b. NSAIDs block H2 receptors involved in maintaining gastric acid production.
c. NSAIDs inhibit the production of prostaglandins involved with promoting mucus secretion.
d. NSAIDs block muscarinic receptors involved in maintaining gastric mucosal blood flow.
e. None of the above.
c. NSAIDs inhibit the production of prostaglandins involved with promoting mucus secretion.
Aspirin is a potent inhibitor of platelet aggregation at low dosages administered at infrequent intervals. Which two reasons explain this effect?
I. Platelet cyclooxygenase and thromboxane production is very sensitive to aspirin.
II. Vascular endothelial cell cyclooxygenase and prostacyclin (PGI2) production is very sensitive to aspirin.
III. Platelets cannot resynthesize cyclooxygenase
IV. Vascular endothelial cells cannot resynthesize cyclooxygenase.
a. I and II
b. I and III
c. II and III
d. III and IV
e. I and IV
b. I and III
Benzodiazepines are used for the treatment of seizures because:
a) they lead to an influx of sodium into the cell causing hyperpolarization
b) they lead to an influx of chloride into the cell causing hyperpolarization
c) they affect the cytochrome P450 system
d) they are not addictive
e) they cause anesthesia
b) they lead to an influx of chloride into the cell causing hyperpolarization
By mistake, a dog with arthritis was given its first dose of the the NSAID phenylbutazone instead of the intended NSAID, aspirin. Later that day, the dog developed peticchial hemorrhages consistent with a platelet deficiency or dysfunction. You decide to discontinue the NSAID. Was the drug dosing mistake fortunate or unfortunate, and why?
a. Fortunate because phenylbutazone has no effect on platelet function, whereas aspirin irreversibly inactivates COX1 and platelet thromboxane A2 production in platelets for a week or more reducing the tendency for platelet aggregation until new platelets are formed.
b. Unfortunate because phenylbutazone has irreversibly inactivated COX1 and platelet thromboxane A2 production in platelets for a week or more reducing the tendency for platelet aggregation until new platelets are formed. Aspirin would not have had this effect.
c. Fortunate because phenylbutazone has only a short reversible effect on platelet function, whereas aspirin irreversibly inactivates COX1 and platelet thromboxane A2 production in platelets for a week or more reducing the tendency for platelet aggregation.
d. Unfortunate because phenylbutazone has irreversibly inhibited COX1 in vascular endothelium and endothelial prostacyclin (PGI2) in vascular endothelium is important for platelet aggregation. Aspirin would not have had this effect.
e. None of the above is entirely correct.
c. Fortunate because phenylbutazone has only a short reversible effect on platelet function, whereas aspirin irreversibly inactivates COX1 and platelet thromboxane A2 production in platelets for a week or more reducing the tendency for platelet aggregation.
Carprofen (Rimadyl®), a nonsteroidal antiinflammatory drug now being advertised by Pfizer, is touted as being a relatively specific inhibitor of cyclooxygenase 2 (COX2) with fewer side effects. Why would there be fewer side effects compared to a COX 1-specific inhibitor like aspirin?
a. COX2 inhibitors are twice as potent as COX1 inhibitors so lower doses can be used.
b. COX1 is induced in inflammatory cells during an inflammatory stimulus
c. COX1 exists constitutively (at all times) in tissues like stomach and kidney and inhibition of prostaglandin production results in most serious signs of toxicity
d. COX2 is induced in inflammatory cells during an inflammatory stimulus
e. None of the above is the reason.
c. COX1 exists constitutively (at all times) in tissues like stomach and kidney and inhibition of prostaglandin production results in most serious signs of toxicity
Cushing's disease (hyperadrenocorticism) can be caused by hyperplastic or adenomatous pituitary cells. Which of the follwing statements is correct with respect to the mechanism of action of drugs that are currently on the market to treat this disease?:
a. L-Deprenyl stimulates monoaminoxidase B and decreases dopamine concentrations
b. L-Deprenyl increases dopamine concentrations and inhibits monoaminoxidase A
c. o,p'-DDD leads to necrosis of cells of the zona fasciculata and reticularis
d. Ketoconazole causes irreversible cortisol depletion
e. trilostane inhibits cholesterol synthesis
c. o,p'-DDD leads to necrosis of cells of the zona fasciculata and reticularis
Diazepam, a benzodiazepine, has which of the following effects?:
a. it decreases the membrane threshold for depolarization
b. it facilitates GABA binding to the GABA receptor
c. it increases REM sleep
d. it leads to tolerance
e. b, c, and d
e. b, c, and d
Dimethyl sulfoxide is given intravenously following surgical correction of gastric or intestinal torsion to minimize the effects of fill in the blank released upon reperfusion of ischemic tissue?
a. nitric oxide
b. free radicals
c. endotoxin
d. carbon dioxide
e. a and b
b. free radicals
Dr. Doitbetter has been treating a dog with a cortisol secreting adrenal tumor with a loading dose of o,p'-DDD for the last 10 days. The results from an ACTH stimulation test on day 10 are as follows:
Plasma cortisol concentration before exogenous ACTH administration: high
Plasma cortisol after exogenous ACTH administration: high
Endogenous plasma ACTH: low
These results tell you that the dog…
a. is poorly controlled
b. is well controlled
c. does not need any more o,p'-DDD. The dog is cured.
d. The dog needs a higher dose of o,p'-DDD
e. a and d
e. a and d
Dr. Doitbetter says that diarrhea is usually caused by hypomotility. Dr. Knowitall says that it is caused by hypermotility. Who is correct?
a) Dr. Doitbetter
b) Dr. Knowitall
c) Both of them
d) Neither of them
a) Dr. Doitbetter
Dr. Doitbetter started treating Oscar with propantheline, an antimuscarinic agent, for his urethral spasm. Oscar has been doing well but started vomiting violently yesterday. Dr. Doitbetter treats him with metoclopramide, a prokinetic agent. What would you expect:
a. decreased effect of propantheline
b. increased effect of propantheline
c. decreased effect of metoclopramide
d. increased effect of metoclopramide
e. a and c
e. a and c
Dry mouth is a side effect of Dramamine® (dimenhydrinate) , an H1 antagonist. It occurs because of the effect of this drug on:
a. Histaminic receptors
b. Muscarinic receptors
c. adenosine receptors
d. opioid receptors
e. dopamine receptors
b. Muscarinic receptors
Ebenezer is a 5 year-old MC Cocker Spaniel who presents to your clinic with an acute onset of weakness, bloody vomitus, epistaxis (bleeding through the nose), and peticchial hemorrhages of the skin, indicating spontaneous bleeding from small vessels . On diagnostic workup, you conclude that he has immune-mediated thrombocytopenia. The most rational glucocorticoid, glucocorticoid, dosage, and route of administration, would be:
a. An oral replacement dosage of hydrocortisone
b. A topical anti-inflammatory dosage of prednisone
c. An oral immunosuppressive dosage of prednisolone (assuming the dog does not vomit the drug)
d. An intramuscular depot of an antiinflammatory dosage of methylprednisolone acetate (Depo-Medrol (R) )
e. An intramuscular injection of an immunosuppressive dosage of dexamethasone phosphate
c. An oral immunosuppressive dosage of prednisolone (assuming the dog does not vomit the drug)
General feedback: is indicated in immune-mediated disease. The reason that c is the ideal answer, and not e is a common-sensical one. When an animal is bleeding, one should minimize the times you stick an animal with a needle. As long as the dog doesn’t vomit the dose, oral glucocorticoids tend to act rapidly.
Fluffer, an epileptic, is being treated with metaclopramide. He is in renal failure. Which is correct?:
a. neither of the conditions is a contraindication for using it
b. both of these conditions are contraindications
c. metoclopramide can cause neurologic problems
d. renal failure increases the excretion of metaclopramide
e. b and c
e. b and c
Flunixin and ketoprofen are nonsteroidal anti-inflammatory drugs with the capability to antagonize bradykinin receptors. Compared to an NSAID like aspirin, pharmacological effect of these 2 NSAIDs allows the following 2 additional clinical applications:
a. General anesthetic effects; antimuscarinic effects
b. Use with patients having gastric ulcers; reduce gastric acid secretion
c. Chronic use for arthritis without side effects in small animals; reduction of Angiotensin II in congestive heart failure
d. Management of some kinds of visceral pain; use in endotoxic shock to reverse hypotension
e. None of the above are entirely correct.
d. Management of some kinds of visceral pain; use in endotoxic shock to reverse hypotension
Flunixin is used to treat which of the following non-analgesic clinical conditions?
a. Renal failure
b. Autoimmune skin disease
c. Hypotension associated with endotoxemia
d. Congestive heart failure
e. Urinary bladder stones
c. Hypotension associated with endotoxemia
Glucocorticoids diminish the progressive spread of an inflammatory focus, in part, by:
a. Suppressing pituitary levels of ACTH
b. Reducing the release of lysosomal enzymes which digest surrounding cells
c. Increasing blood pressure
d. Stimulating chemotaxis of white blood cells
e. All of the above
b. Reducing the release of lysosomal enzymes which digest surrounding cells
Glucocorticoids have all but WHICH ONE of the following effects when administered in pharmacological quantities:
a. Suppress cell-mediated immunity
b. Reduce the production of prostaglandins and leukotrienes
c. Increase potassium retention
d. Increase the production of glucose from amino acids.
e. Decrease capillary permeability and increase the blood pressure response to alpha1 receptor agonists
c. Increase potassium retention
Glucocorticoids have been shown in many research publications to cure:
a) Autoimmune hemolytic anemia
b) Flea allergy dermatitis
c) Feline asthma
d) Addison’s disease
e) None of the above
e) None of the above
Glucocorticoids have greater antiinflammatory activity than nonsteroidal antiinflammatory drugs (NSAIDs) because:
a. they stimulate nuclear receptors resulting in inflammatory cell proliferation.
b. they directly inhibit COX1 and COX2 enzymes and NSAIDs only inhibit COX1
c. they induce the synthesis of lipocortin which inhibits the phopholipase A2 thereby reducing arachidonic acid release and its entry into the lipoxygenase and cyclooxygenase pathways.
d. they inhibit the cyclooxygenase enzyme more efficiently than do NSAIDs
e. All of the above.
c. they induce the synthesis of lipocortin which inhibits the phopholipase A2 thereby reducing arachidonic acid release and its entry into the lipoxygenase and cyclooxygenase pathways.
Glucocorticoids result in immunosuppressive effects mainly by:
a. inhibiting humoral immunity
b. inhibiting cellular immunity
c. stabilizing splenocyte cell membranes
d. moving neutrophils from the peripheral to the central vasculature
e. None of the above.
b. inhibiting cellular immunity
Heparin is used for the treatment of disseminated intravascular coagulation. What other effect does heparin have?

a. it leads to platelet aggregation
b. it inhibits lipoprotein lipase
c. it increases cortisol
d. it decreases K with longterm administration
e. none of the above
e. none of the above
Hepatic fibrosis is one of the side effects of which of the following?

a. primidone
b. phenobarbital
c. bromide
d. valproic acid
e. diazepam
a. primidone
Hypoglycemia in many insulin-treated diabetic is associated with which of the follwoing:
a. cortisol secretion
b. glucagon secretion
c. catecholamine secretion
d. Somogyi rebound
e. All of the above
e. All of the above
Hypotension is a side effect of Dramamine® (dimenhydrinate) , an H1 antagonist. It occurs because of the effect of this drug on:
a. Histaminic receptors
b. Muscarinic receptors
c. adenosine receptors
d. alpha1 adrenergic receptors
e. dopamine receptors
d. alpha1 adrenergic receptors
In general , nonsteroidal anti-inflammatory drugs like aspirin are most effective at managing which types of pain?
a. Surgical
b. Somatic
c. Visceral
d. Dramatic
e. a and b
b. Somatic
In the boxer puppy, the prior administration of the glucocorticoid dexamethasone may have caused two adverse effects: 1) increased joint capsule fragility, and 2) encouragement of an infected joint (septic arthritis). These adverse effects of glucocorticoids were due to, respectively, to:

a. 1) inhibition of collagen synthesis; 2) inhibition of cell-mediated immunity
b. 1) stimulation of collagen synthesis; 2) inhibition of cell-mediated immunity
c. 1) increased protease production; 2) attraction of neutrophils to the joint
d. 1) increased trypsin production; 2) toxic effect to lymphocytes
e. None of the above are entirely true.
a. 1) inhibition of collagen synthesis; 2) inhibition of cell-mediated immunity
Inhibition of cyclooxygenase results in:
a. a decrease in the synthesis of norepinephrine
b. a reduction in the formation of angiotensin II
c. decreased synthesis of PGE2
d. decreased synthesis of leukotrienes
e. reduced metabolism of histamine
c. decreased synthesis of PGE2
It has long been observed that administration of pharmacological amounts of adrenocorticotropic hormone (ACTH) following the chronic administration of pharmacological amounts of glucocorticoids, DOES NOT speed recovery of the hypothalamic-pituitary-adrenal (HPA) axis. Which of the following statements BEST reflect(s) the mechanism(s) underlying this observation?
a. ACTH only stimulates recovery of pituitary gland function
b. ACTH only stimulates recovery of the hypothalamus
c. ACTH only stimulates recovery of the adrenal gland's production of cortisol
d. ACTH is only a weak antagonist against glucocorticoid
e. None of the above
c. ACTH only stimulates recovery of the adrenal gland's production of cortisol
It has been determined that there are multiple forms of the 5’-deiodinase (5’-D) enzyme which are regulated in divergent ways when comparing one tissue with another. Which of the following best represents the impact that this physiological information has on determining the MOST PHYSIOLOGICAL manner to replace thyroid hormone in an animal with hypothyroidism?
a) 5’D is not a factor since most hypothyroidism is associated with lack of thyroid gland production of hormone; therefore, the most active hormone, triiodothyronine (T3) should be administered in most cases
b) Because 5’-D may go up or down depending on the tissue requirements and the enzyme form present, it is best to administer thyroxine (T4) to allow this final step of metabolic regulation, the production of T3 locally in a given tissue
c) 5’-D is actually associated only with the breakdown of inactive thyroid hormone analogue reverse T3. Therefore, it only has relevance to the eventual recovery and recycling of iodine used to synthesize thyroid hormones
d) In hypothyroidism, the brain’s form of 5’-D (Type II) tends to decline because the brain is not constantly dependent upon oxygen production stimulated by T3. Therefore, T3 should be administered to the animal to reverse this deficiency.
e) None of the above
b) Because 5’-D may go up or down depending on the tissue requirements and the enzyme form present, it is best to administer thyroxine (T4) to allow this final step of metabolic regulation, the production of T3 locally in a given tissue
Ketoconazole is an alternative drug for the treatment of hyperadrenocoritcism and:
a) it only works well in adrenal tumors
b) it inhibits steroid synthesis
c) it enhances the breakdown of cortisol
d) it needs to be given daily
e) b and d
e) b and d
L-deprenyl is a new treatment for hyperadrenocorticisim. Which of the following statements is true:
a) it inhibits a monoamine oxidase B and is indicated for pituitary-dependent hyperadrenocorticisim as well as adrenal tumors
b) the response to L-deprenyl is seen within the first week
c) L-deprenyl is safe and therefore is the drug of choice in complicated Cushing’s cases
d) a common side effect of L-deprenyl is a change in hair color
e) L-deprenyl leads to a normalization of dopamine levels in the hypothalamus.
e) L-deprenyl leads to a normalization of dopamine levels in the hypothalamus.
Metoclopramide, a prokinetic agent, has all of the following except:
a) it relaxes the pyloric sphincter
b) it closes the esophageal sphincter
c) it antagonizes dopamine receptors
d) it relaxes the small intestine
e) it affects the chemoreceptor trigger zone (CRZ)
d) it relaxes the small intestine
Molly has epilepsy. She is vomiting and is being treated with metaclopramide. She is in also renal failure. Which is correct?:
a. the dose should be decerased because metaclopramide is metabolized more slowly in renal failure
b. metaclopramide is metabolized by the liver not kidney
c. metoclopramide can cause neurologic problems
d. renal failure increases the excretion of metaclopramide
e. a and c
e. a and c
Molly, the dog, needs a blood transfusion but her platelets are extremely low. You administer:
a) blood collected in heparin and taken 36 hours ago
b) blood collected in heparin and taken 1 week ago
c) blood collected in citrate-phosphate-dextrose and taken 36 hours ago
d) blood collected in citrate-phosphate-dextrose and taken 1 week ago
e) blood collected in citrate-phosphate-dextrose and taken 2 hours ago
e) blood collected in citrate-phosphate-dextrose and taken 2 hours ago
Mrs. Smith calls you. She is a nurse and measures her dog’s blood glucose every morning before she gives insulin. For the last week or so, the morning glucose has always been high. You tell her that:
a) this is a sign of insufficient insulin and she needs to increase the dose
b) this is a sign of too much insulin and she needs to decrease the dose
c) neither
d) either
d) either
Narcotic analgesics are useful in the treatment of diarrhea because they:
a. increase electrolyte secretion
b. increase propulsion
c. decrease the anal sphincter tone
d. "coat" the GI mucosa
e. increase segmentation
e. increase segmentation
Nonsteroidal antinflammatory drugs are notorious for causing gastric ulceration. The molecular site for this toxic effect is __(1)__ and a drug class for managing this condition is __(2)__.
a. (1) Na/K ATPase enzyme; (2) H2 receptor antagonists.
b. (1) Cyclooxygenase 2 enzyme; (2) H1 receptor antagonists.
c. (1) Cyclooxygenase 1 enzyme; (2) H2 receptor antagonists
d. (1) Phospholipase A2 enzyme; (2) glucocorticoids
e. None of the above are entirely true.
c. (1) Cyclooxygenase 1 enzyme; (2) H2 receptor antagonists
Pharmacological dosages of glucocorticoids may cause all but which one of the following side effects?
a. Excessive collagen deposition during wound healing
b. Polyuria and polydipsia
c. Muscle wasting
d. Bilateral symmetrical alopecia
e. Insulin resistance and potentially diabetes mellitus
a. Excessive collagen deposition during wound healing
Phenobarbital has which of the following effects:
a. it increases liver enzymes
b. it causes polyuria/polydipsia
c. it causes hypotension
d. it leads to tolerance
e. all of the above
e. all of the above
Polly just had her thyroid glands removed. Unfortunately, all of her parathyroid tissue was removed as well. You treat her with calcium and a vitamin D preparation. Which of the following statements is true?
a) 25-hydroxyvitamin D is the drug of choice in these cases
b) Dihydrotachysterol should be used because it only needs to be hydroxylated at the 1-position
c) Vitamin D3 should be used because it is cheaper
d) 1,25-dihydroxyvitamin D should be used because it only needs to be hydroxylated at the 3-position
e) Dihydroxytachysterol should be used because it only needs to be hydroxylated at the 25-position
e) Dihydroxytachysterol should be used because it only needs to be hydroxylated at the 25-position
Prior administration of the glucocorticoid dexamethasone may have which of the two adverse effects on the joint of a young animal which might predispose to slow healing of an injury and increased risk of infection?
a. 1) inhibition of collagen synthesis; 2) inhibition of cell-mediated immunity
b. 1) stimulation of collagen synthesis; 2) inhibition of cell-mediated immunity
c. 1) increased protease production; 2) attraction of neutrophils to the joint
d. 1) increased trypsin production; 2) toxic effect to lymphocytes
e. None of the above are entirely true.
a. 1) inhibition of collagen synthesis; 2) inhibition of cell-mediated immunity
Research has identified receptors for glucocorticoids in which of the following pairs of cellular organelles?
a. Nucleus; mitochondrion
b. Golgi apparatus; mitochondrion
c. Plasma membrane; endoplasmic reticulum
d. Nucleus; plasma membrane
e. Plasma membrane; mitochondrion
d. Nucleus; plasma membrane
Salicylic acid, heparin, warfarin, and tissue plasminogen activator (TPA) are used for the treatment of thromboembolism. Which of the following is true?:
a. they all dissolve existing clots rapidly
b. warfarin inhibits the oxidation of Vit K
c. heparin does not work in lipemic blood
d. they only work when administered with calcium
e. only TPA dissolves existing clots
e. only TPA dissolves existing clots
Salicylic acid, heparin, and warfarin are used for the treatment of thromboembolism. Which of the following is true?:
a. they dissolve existing clots rapidly
b. they prevent the formation of other clots but don't dissolve existing clots
c. they only work when administered with vitamin K
d. they only work when administered with calcium
e. all of the above
b. they prevent the formation of other clots but don't dissolve existing clots
The antithyroid drug methimazole decreases thyroid hormone concentrations in cats with hyperthyroidism by:
a. Inhibiting the uptake of iodide by the thyroid gland.
b. Blocking the release of thyroid hormone
c. Preventing the peripheral tissue conversion of T4 to T3
d. Inhibiting the thyroidal enzyme thyroid peroxidase (TPO)
e. Direct cytotoxicity to the thyroid gland.
d. Inhibiting the thyroidal enzyme thyroid peroxidase (TPO)

General feedback: thyroid peroxidase is the primary enzymatic target of virtually all antithyroid drugs. Some of the drugs also have other effects (inhibition of 5’-deiodinase like PTU, or blockade of nuclear action of thyroid hormone like ipodate).
The histological section (s) of the adrenal gland which is (are) atrophied following the chronic (> 2 weeks) administration of pharmacological quantities of glucocorticoids is (are):
a. Zona glomerulosa
b. Zona fasciculata
c. Zona reticularis
d. a and b
e. b and c
e. b and c
The main clinical effects of aspirin include all of the following except:
a. Antithrombosis
b. Immunosuppression
c. Antipyresis
d. Antiinflammation
e. Analgesia
b. Immunosuppression
The major disadvantage of using synthetic triiodothryonine (L-T3) compared to thyroxine (T4) for replacement therapy for canine hypothyroidism is that:
a) dogs metabolize T3 too rapidly and it is difficult to maintain adequate serum concentrations
b) since T4 is more potent than T3, giving T3 may not meet the hormonal demands of all organs
c) T3 administration may not meet the demands of some organs that typically maintain high levels of active hormone by extracting T4 and deiodinating it to T3
d) T3 is poorly absorbed from the gastrointestinal tract and undergoes significant hepatic first-pass metabolism
e) T3 is totally unbound by serum thyroid hormone binding proteins so it is more likely to cause hyperthyroidism
c) T3 administration may not meet the demands of some organs that typically maintain high levels of active hormone by extracting T4 and deiodinating it to T3

General feedback: is preferred because each organ has varying amounts of Type I or Type II 5’-deiodinases. Type I deiodinases, such as in the liver and kidney, which also supply T3 to other organs via the circulation, tend to fail when there is illness or protein-calorie malnutrition to hypothyroidism. Type II deiodinases in the brain and pituitary remain more stable in order to deliver adequate amounts of T3 to these organs which must continue functioning despite illness or caloric intake. T4 is preferred so as not to subvert this physiologica/pathophysiological regulatory step.
The most common molecular target of the thiourelene drugs methimazole (MMI) and propylthiouracil (PTU) is:
a) the thyroid hormone nuclear receptor in thyroid-responsive tissues
b) the thryocyte plasma membrane Na+/I- exchanger
c) the serum binding protein thyroxine binding globulin
d) the thyroid peroxidase enzyme which adds inorganic iodine to the tyrosine residues on thyroglobulin in the thyroid follicle
e) the Type II 5’-deiodinase enzyme
d) the thyroid peroxidase enzyme which adds inorganic iodine to the tyrosine residues on thyroglobulin in the thyroid follicle
The most common side effect for the antithyroid drug methimazole is:
a. Diarrhea
b. Direct nephrotoxicity
c. Hyperactivity
d. Vomiting and anorexia
e. Autoimmune problems
d. Vomiting and anorexia
The most potent nonsteroidal analgesics like flunixin and ketoprofen are capable of reducing either the production of or blocking the effects of which two inflammatory mediators?:
a. prostaglandins, angiotensin II
b. IL-2 and serotonin
c. prostaglandins, bradykinin
d. phospholipase A2, serotonin
e. nitric oxide, epinephrine
c. prostaglandins, bradykinin
The primary mechanism by which glucocorticoids inhibit the production of arachadonic acid metabolites associated with inflammation is by:
a) binding to the lipoxygenase enzyme directly and inhibiting its activity
b) directly inhibiting COX2, the primary cyclooxygenase associated with inflammatory cells
c) interaction with a nuclear receptor which then directs protein production of lipocortin, a protein which inhibits phospholipase A2, and through another nuclear receptor-mediated process, inhibits induction of cyclooxygenase enzyme during inflammation
d) Interaction with a plasma membrane receptor on the pituitary which results in inhibition of adrenocorticotropic hormone (ACTH) which normally would be stimualate phospholipase A2 directly
e) None of the above
c) interaction with a nuclear receptor which then directs protein production of lipocortin, a protein which inhibits phospholipase A2, and through another nuclear receptor-mediated process, inhibits induction of cyclooxygenase enzyme during inflammation
The primary mechanism by which glucocorticoids inhibit the production of arachidonic acid metabolites associated with inflammation is by:
a. binding to the lipoxygenase enzyme directly and inhibiting its activity
b. directly inhibiting COX2, the primary cyclooxygenase associated with inflammatory cells
c. interaction with a plasma membrane receptor which then directs protein production of lipocortin, a protein which inhibits phospholipase A2.
d. Interaction with a nuclear receptor in the pituitary which results in inhibition of adrenocorticotropic hormone (ACTH), a hormone which normally would stimulate phospholipase A2 directly.
e. None of the above are correct.
e. None of the above are correct.

General feedback: would have been completely correct if it had mentioned the main site of action of glucocorticoids which results in all new protein synthesis stimulated by glucocorticoids….i.e. the NUCLEAR receptor. All steroids influence protein synthesis through stimulation of mRNA, etc. The plasma membrane receptors for glucocorticoids DO exist and may result in some of the rapid benefit of glucocorticoids, particularly in hypovolemic shock, but these receptors do not result, by definition, in new protein synthesis.
The treatment of arthritis in a dog with chronic hip dysplasia would constitute which class(es) of glucocorticoid usage?
a. Antiinflammatory
b. Replacement
c. Palliative
d. a and c
e. b and c
d. a and c
The use of oral prednisolone given in a dog with a dermatitis resulting from a flea infestation would be an example of which class of therapeutic usage of glucocorticoids?
a. Physiological replacement
b. Shock therapy
c. Antiinflammatory/antiallergy
d. Immunosuppressive
e. Palliative
c.Antiinflammatory/antiallergy
What clinical signs might signal a dog weaned too rapidly from glucocorticoids?
a. Lethargy
b. Vomiting
c. Diarrhea
d. Collapse
e. All of the above
e. All of the above
Which of the following antithyroid drugs will inhibit peripheral tissue 5'-deiodination of T4 to T3 as well as thyroidal production of thyroid hormones?
a. Methimazole (MMI)
b. Radiocontrast agents (such as iopanoic acid)
c. Propylthiouracil (PTU)
d. a and b
e. b and c
e. b and c
Which of the following are true regarding currently available nonsteroidal anti-inflammatory drugs which are targeted for the Cyclooxygenase 2 (COX2) enzyme?
a. Most of the beneficial effects of NSAIDs are associated with COX2 inhibition
b. COX 2 inhibits prostanoid production mainly in tissues only where inflammation exists.
c. The selectivity of some of these drugs for COX2 in the animal has been questioned because of sideeffects similar to COX1 inhibitory drugs.
d. a and b
e. a, b, and c
e. a, b, and c
Which of the following best describes why alternate day therapy with short or intermediate duration glucocorticoids can be an effective way to administer glucocorticoids chronically while minimizing side effects?
a. The steroid is released at a “constant rate” similar to the pattern of physiological glucocorticoid release.
b. One administers half as much glucocorticoid over a 48 hour period resulting in half of the side effects.
c. The body is benefited by a lower frequency of administration of glucocorticoid...every 3rd or 4th day therapy is also often therapeutically effective.
d. The duration of therapeutic effect lasts for approximately 48 hours whereas the duration of the suppression of the hypothalamic-pituitary adrenal axis lasts approximately only 24 hours.
e. All of the above
d. The duration of therapeutic effect lasts for approximately 48 hours whereas the duration of the suppression of the hypothalamic-pituitary adrenal axis lasts approximately only 24 hours.

General feedback: therapeutic effect is longer than suppression of the HPAA and for some conditions, this allows “relief” of the suppression of the HPAA and recovery of that endogenous rhythm while still managing signs of the disease.
Which of the following could be used for treatment of thrombocytopenia?:
a. blood collected in heparin one week prior
b. blood collected in acid citrate dextrose (ACD) 1 week prior
c. blood collected in ACD 2 day prior
d. blood collected in heparin 1 hour prior
e. blood collected in citrate phosphate dextrose (CPD) 3 days prior
d. blood collected in heparin 1 hour prior
Which of the following forms of the cyclooxygenase enzyme is(are) induced in inflammatory cells attracted to sites of tissue injury?
a. COX1
b. COX2
c. COX3
d. a and b
e. b and c
b. COX2
Which of the following is correct?:
a. A 0.45% NaCl solution given intravenously increases water flux out of cells
b. A 0.45% NaCl solution given intravenously increases water flux into cells
c. A 2.5% glucose in water solution is isotonic
d. adding urea to a solution increases its osmolarity
e. a and d
b. A 0.45% NaCl solution given intravenously increases water flux into cells
Which of the following is correct?
a) insulin leads to K+ uptake into cells
b) plasma K+ is decreased in acidosis
c) administration of intravenous lactated Ringer’s maintains serum K+ in an animal that is not eating
d) intravenous Na+ administration increases osmotic pressure
e) a and d
e) a and d
Which of the following might influence vitamin K concentrations?:
a. bile acids
b. antibiotics
c. gut flora
d. liver function
e. all of the above
e. all of the above
Which of the following nonsteroidal analgesics are generally touted as "COX 2-selective" or "COX 1- sparing"?
a. Carprofen
b. Aspirin
c. Etodolac
d. a and b
e. a and c
e. a and c
Which of the following NSAIDs is INCORRECTLY matched with a clinically observed toxicity?
a. Phenylbutazone: renal papillary necrosis in foals
b. Carprofen: acute hepatic failure in dogs
c. Acetaminophen: methemoglobinemia in the cat
d. Aspirin: reversible inhibition of platelet aggregation
e. Ibuprofen: gastrointestinal ulceration in dogs.
d. Aspirin: reversible inhibition of platelet aggregation
Which of the following statements is correct?
a) a 5% dextrose in water solution will dilute plasma electrolytes
b) a 5% dextrose solution will provide adequate calories to an animal that is not eating
c) a 5% dextrose solution should be given subcutaneously
d) a 5% dextrose in water solution can be given at higher than maintenance rates
e) a 5% dextrose in water solution can be used to increase oncotic pressure
a) a 5% dextrose in water solution will dilute plasma electrolytes
Which of the following statements is true?
a) K+ is safe when given orally
b) Plasma increases oncotic pressure
c) Plasma Na is the major determinant of osmolarity
d) Preservatives in fluids are toxic to cats
e) All of the above
e) All of the above
Which of the following statements best explains why administration of multiple doses of exogenous adrenocorticotropic hormone (ACTH) to stimulate the adrenal glands is NOT going to be successful at completely normalizing the animal's adrenal physiological mechanisms following chronic (>2 weeks) administration of an immunosuppressive dosage of glucocorticoid?
a. The action of ACTH is to stimulate hypothalamic corticotropic releasing hormone (CRH) release, not normalize its physiological rhythms.
b. There is shortloop feedback of ACTH to the pituitary so the pituitary corticotroph cell function will not be normalized.
c. The term ACTH is a misnomer and it has no influence on the adrenal glandular function because it is derived from an endogenous opiate precursor, pro-opiomelanocortin (POMC).
d. Glucocorticoid administration does not suppress pituitary ACTH concentrations so replacing it has no effect.
e. All of the above.
b. There is shortloop feedback of ACTH to the pituitary so the pituitary corticotroph cell function will not be normalized.
Which of the following statements concerning the pharmacological properties of nonsteroidal anti-inflammatory drugs (NSAID’s) is INCORRECT?
a. They are weak acids that are highly protein bound.
b. They block the production of prostaglandins by inhibiting the enzyme cyclooxygenase.
c. Most undergo hepatic biotransformation and renal elimination.
d. They are prothrombotic
e. They are antipyretic.
d. They are prothrombotic
Which of the following statements is correct?
a) all dogs respond well to NPH insulin
b) all cats respond well to NPH insulin
c) obesity is a biomarker for insulin
d) regular insulin can be given IV
e) c and d
e) c and d
Which of these statements regarding insulin therapy is correct?:
a. Glargine insulin has a longer half-life than NPH insulin in all dogs
b. NPH has a longer half-life than ultralente insulin in all cats
c. NPH is the only insulin that can be administered IV
d. U100 insulin contains 100 units per dl
e. none of the above
e. none of the above
Which of these statements regarding insulin therapy is correct?
a) ultralente has a longer half life than NPH insulin in all dogs
b) NPH has a longer half life than ultralente insulin an all cats
c) NPH is the only insulin that can be administered IV
d) Ultralente is the only insulin that can be administered IV
e) NPH insulin is a suspension and needs to be gently mixed before administration
e) NPH insulin is a suspension and needs to be gently mixed before administration
Why do glucocorticoids cause the side-effect of polyuria and polydipsia?
a. They increase glucose levels resulting in an osmotic diuresis in all cases.
b. They inhibit antidiuretic hormone production by the posterior pituitary.
c. They inhibit antidiuretic hormone action in the nephron.
d. a and b
e. b and c
e. b and c
Why should alternate day therapy not be used as primary (initial) therapy?
a. The owners will forget to pill the animal on the day “on” therapy.
b. For most conditions, a “loading” period is necessary to result in full induction of the protein synthesis.
c. Glucocorticoids are metabolized more rapidly at the beginning of treatment.
d. The hypothalamic-pitutiary adrenal axis is not yet suppressed.
e. All of the above.
b. For most conditions, a “loading” period is necessary to result in full induction of the protein synthesis.
Why were drug companies interested in developing cyclooxygenase 2 (COX2)- selective nonsteroidal anti-inflammatory drugs?
a. COX 2 inhibition produces prostanoids which counter COX 1 side effects like gastric ulceration and renal insufficiency
b. Most of the beneficial effects of NSAIDs are associated with COX2 inhibition
c. COX 2 inhibits prostanoid production mainly in tissues only where inflammation exists.
d. a and b
e. b and c
e. b and c
You have treated a Cushingoid dog with o.p’-DDD. One day the owner calls you and tells you that the dog is not doing well. What will you tell him?
a) he should observe the dog for a while and bring it in in a few days if it is not better
b) he should bring the dog in immediately
c) he should give the dog karo syrup as it may be hypoglycemic
d) he should give glucocorticoids immediately
e) don’t worry – o,p’-DDD is very safe
d) he should give glucocorticoids immediately
You started treating a dog with Addison's disease with desoxycorticosterone pivalate. Successful therapy would be indicated by:
a. increase in plasma H+
b. decrease in plasma K+
c. increase in plasma K+
d. decrease in plasma Na+
e. c and d
b. decrease in plasma K+
Carprofen (Rimadyl®), a nonsteroidal antiinflammatory drug now being advertised by Pfizer, is touted as being a relatively specific inhibitor of cyclooxygenase 2 (COX2) with fewer side effects. Why would there be fewer side effects compared to a COX 1-specific inhibitor like aspirin?
a. COX2 inhibitors are twice as potent as COX1 inhibitors so lower doses can be used.
b. COX1 is induced in inflammatory cells during an inflammatory stimulus
c.COX1 exists constitutively (at all times) in tissues like stomach and kidney and inhibition of prostaglandin production results in most serious signs of toxicity
d. COX2 is induced in inflammatory cells during an inflammatory stimulus
e. None of the above is the reason.
c.COX1 exists constitutively (at all times) in tissues like stomach and kidney and inhibition of prostaglandin production results in most serious signs of toxicity
Sucralfate is often used for the treatment of gastric ulcers. What is one of its mechanisms of action?
a. it inhibits the H/K exchanger
b. it inhibits prostaglandin synthesis
c. It inhibits H2 receptors
d. It stimulates bicarbonate secretion
e. It enhances the absorption of ketoconazole
d. It stimulates bicarbonate secretion
All but the following are seen after administration of barbiturates
a. drowsiness
b. polyuria/polydipsia
c. hypotension
d. decreased pain perception
e. tolerance
d. decreased pain perception
Smoke, the cat, is being treated with diazepam. He just recently also was started on cimetidine. Dr. Knowitall tells the owner that Smoke may now be more sleepy but Dr. Doitbetter says that the opposite is true. Who is right?
a. Dr. Knowitall
b. Dr. Doitbetter
a. Dr. Knowitall
Why should alternate day therapy not be used as primary (initial) therapy?
a. The owners will forget to pill the animal on the day “on” therapy.
b. For most conditions, a “loading” period is necessary to result in full induction of the protein synthesis.
c. Glucocorticoids are metabolized more rapidly at the beginning of treatment.
d. The hypothalamic-pitutiary adrenal axis is not yet suppressed.
e. All of the above.
b. For most conditions, a “loading” period is necessary to result in full induction of the protein synthesis.
Which of the following best describes why alternate day therapy with short or intermediate duration glucocorticoids can be an effective way to administer glucocorticoids chronically while minimizing side effects?
a. The steroid is released at a “constant rate” similar to the pattern of physiological glucocorticoid release.
b. One administers half as much glucocorticoid over a 48 hour period resulting in half of the side effects.
c. The body is benefited by a lower frequency of administration of glucocorticoid...every 3rd or 4th day therapy is also often therapeutically effective.
d. The duration of therapeutic effect lasts for approximately 48 hours whereas the duration of the suppression of the hypothalamic-pituitary adrenal axis lasts approximately only 24 hours.
e. All of the above
d. The duration of therapeutic effect lasts for approximately 48 hours whereas the duration of the suppression of the hypothalamic-pituitary adrenal axis lasts approximately only 24 hours.

General feedback: therapeutic effect is longer than suppression of the HPAA and for some conditions, this allows “relief” of the suppression of the HPAA and recovery of that endogenous rhythm while still managing signs of the disease.
Which of the following side effects may be seen in the cat?
a. Phenothiazine-sedation
b. Metoclopramide-neurologic
c. Antihistamines-dry mouth
d. diphenoxylate (narcotic)-hyperactivity
e. All of the above
e. All of the above
Nonsteroidal antinflammatory drugs are notorious for causing gastric ulceration. The molecular site for this toxic effect is __(1)__ and a drug class for managing this condition is __(2)__.
a. (1) Na/K ATPase enzyme; (2) H2 receptor antagonists.
b. (1) Cyclooxygenase 2 enzyme; (2) H1 receptor antagonists.
c. (1) Cyclooxygenase 1 enzyme; (2) H2 receptor antagonists
d. (1) Phospholipase A2 enzyme; (2) glucocorticoids
e. None of the above are entirely true.
c. (1) Cyclooxygenase 1 enzyme; (2) H2 receptor antagonists
Which of the following could be used for treatment of thrombocytopenia?:
a. blood collected in heparin one week prior
b. blood collected in acid citrate dextrose (ACD) 1 week prior
c. blood collected in ACD 2 day prior
d. blood collected in heparin 1 hour prior
e. blood collected in citrate phosphate dextrose (CPD) 3 days
d. blood collected in heparin 1 hour prior
Which of the following is (are) true regarding currently available nonsteroidal anti-inflammatory drugs which are targeted for the Cyclooxygenase 2 (COX2) enzyme?
a. Most of the beneficial effects of NSAIDs are associated with COX2 inhibition
b. The synthesis of COX 2 is induced in activated inflammatory cells.
c. In theory, a perfectly COX2-selective NSAID would have minimal impact on the gastrointestinal tract.
d. a and b
e. a, b, and c
e. a, b, and c

General feedback: Although in practice, many of the so-called COX2 inhibitors have side effects which indicate that they also influence COX1, a pure COX2 inhibitor, should, in theory, have minimal effect on the g.i. tract.
Which of the following statements regarding phenothiazines is correct?
a. Phenothiazines should be used for motion sickness in the cat
b. Phenothiazines only affect the emetic center
c. phenothiazines stimulate cholinergic receptors as well
d. Phenothiazines are safe to use in any animal
e. Phenothiazines only affect dopamine receptors in the medulla
a. Phenothiazines should be used for motion sickness in the cat
Which of the following is correct?:
a. A 0.45% NaCl solution given intravenously increases water flux out of cells
b. A 0.45% NaCl solution given intravenously increases water flux into cells
c. A 2.5% glucose in water solution is isotonic
d. adding urea to a solution increases its osmolarity
e. a and d
b. A 0.45% NaCl solution given intravenously increases water flux into cells

General feedback: glucocorticoids have effects similar to aldosterone, so potassium loss or HYPOKALEMIA is the result.
General feedback: glucocorticoids have effects similar to aldosterone, so potassium loss or HYPOKALEMIA is the result.

Proton pump inhibitors are a new class of antacids. Which of the following is (are) true?:
a. They inhibit the Na/K ATPase proton pump
b. They activate the K/H ATPase proton pump
c. Their inhibitory action depends on the pH in the stomach
d. They are always active regardless of pH
e. b and c
e. b and c
The use of oral prednisolone given in a dog with a dermatitis resulting from a flea infestation would be an example of which class of therapeutic usage of glucocorticoids?
a. Physiological replacement
b. Shock therapy
c. Antiinflammatory/antiallergy
d. Immunosuppressive
e. Palliative
c. Antiinflammatory/antiallergy
Why were drug companies interested in developing cyclooxygenase 2 (COX2)- selective nonsteroidal anti-inflammatory drugs?
a. COX 2 inhibition produces prostanoids which counter COX 1 side effects like gastric ulceration and renal insufficiency
b. Most of the beneficial effects of NSAIDs are associated with COX2 inhibition
c. COX 2 inhibits prostanoid production mainly in tissues only where inflammation exists.
d. a and b
e. b and c
e. b and c
You started treating a dog with Addison's disease with desoxycorticosterone pivalate. Successful therapy would be indicated by:
a. increase in plasma H+
b. decrease in plasma K+
c. increase in plasma K+
d. decrease in plasma Na+
e. c and d
b. decrease in plasma K+
Research has identified receptors for glucocorticoids in which of the following pairs of cellular organelles?
a. Nucleus; mitochondrion
b. Golgi apparatus; mitochondrion
c. Plasma membrane; endoplasmic reticulum
d. Nucleus; plasma membrane
e. Plasma membrane; mitochondrion
Nucleus; plasma membrane
Which of the following statements concerning the pharmacological properties of nonsteroidal anti-inflammatory drugs (NSAID’s) is INCORRECT?
a. They are weak acids that are highly protein bound.
b. They block the production of prostaglandins by inhibiting the enzyme cyclooxygenase.
c. Most undergo hepatic biotransformation and renal elimination.
d. They are prothrombotic
e. They are antipyretic.
d. They are prothrombotic
Bismuth subsalicylate is a valuable coating agent in the gastrointestinal tract. Which of the following statements is correct?
a. It is used for colonic disease because the salicylate moiety is released in the colon
b. It should be used with caution in the cat
c. It may worsen preexisting ulcerations
d. Bismuth alone has no effect
e. b and c
e. b and c
The primary mechanism by which glucocorticoids inhibit the production of arachidonic acid metabolites associated with inflammation is by:
a. binding to the lipoxygenase enzyme directly and inhibiting its activity
b. directly inhibiting COX2, the primary cyclooxygenase associated with inflammatory cells
c. interaction with a nuclear receptor which then directs protein production of lipocortin, a protein which inhibits phospholipase A2, and through another nuclear receptor-mediated process, inhibits induction of cyclooxygenase enzyme during inflammation
d. Interaction with a plasma membrane receptor on the pituitary which results in inhibition of adrenocorticotropic hormone (ACTH) which normally would stimulated phospholipase A2 directly.
e. None of the above are correct.
c. interaction with a nuclear receptor which then directs protein production of lipocortin, a protein which inhibits phospholipase A2, and through another nuclear receptor-mediated process, inhibits induction of cyclooxygenase enzyme during inflammation
Apomorphine is a particulary effective emetic in dogs. This pharmacologic effect is a consequence of the ability of apomorphine to:
a. antagonize dopamine receptors in the chemoreceptor trigger zone
b. activate dopamine receptors in the chemoreceptor trigger zone.
c. antagonize opioid receptors in the chemoreceptor trigger zone
d. activate opioid receptors in the chemoreceptor trigger zone
e. mimic the actions of morphine in the cerebral cortex
b. activate dopamine receptors in the chemoreceptor trigger zone.
Which one of the following statements is CORRECT?
a. GABA leads to Cl influx into cells leading to depolarization
b. o,p'-DDD is a very safe drug
c. Normal saline is a 9% saline solution
d. Platelets have a short half-life
e. Heparin preserves blood components because it contains dextrose
d. Platelets have a short half-life
Pharmacological dosages of glucocorticoids may cause all but which one of the following side effects?
a. Excessive collagen deposition during wound healing
b. Polyuria and polydipsia
c. Muscle wasting
d. Bilateral symmetrical alopecia
e. Insulin resistance and potentially diabetes mellitus
a. Excessive collagen deposition during wound healing

General feedback: is indicated in immune-mediated disease. The reason that c is the ideal answer, and not e is a common-sensical one. When an animal is bleeding, one should minimize the times you stick an animal with a needle. As long as the dog doesn’t vomit the dose, oral glucocorticoids tend to act rapidly
Prior administration of the glucocorticoid dexamethasone may have which of the two adverse effects on the joint of a young animal which might predispose to slow healing of an injury and increased risk of infection?
a. 1) inhibition of collagen synthesis; 2) inhibition of cell-mediated immunity
b. 1) stimulation of collagen synthesis; 2) inhibition of cell-mediated immunity
c. 1) increased protease production; 2) attraction of neutrophils to the joint
d. 1) increased trypsin production; 2) toxic effect to lymphocytes
e. None of the above are entirely true.
1) inhibition of collagen synthesis; 2) inhibition of cell-mediated immunity
You have an argument with Dr. Knowitall. He says that diazepam increases the binding of GABA to its receptor and leads to an increase in Cl influx while you say that GABA increases the binding of diazepam to its receptor and leads to an increase in Cl influx. Who is correct?
a. Dr. Knowitall
b. You
c. Both of you
c. Both of you
The primary mechanism by which glucocorticoids inhibit the production of arachidonic acid metabolites associated with inflammation is by:
a. binding to the lipoxygenase enzyme directly and inhibiting its activity
b. directly inhibiting COX2, the primary cyclooxygenase associated with inflammatory cells
c. interaction with a plasma membrane receptor which then directs protein production of lipocortin, a protein which inhibits phospholipase A2.
d. Interaction with a nuclear receptor in the pituitary which results in inhibition of adrenocorticotropic hormone (ACTH), a hormone which normally would stimulate phospholipase A2 directly.
e. None of the above are correct.
e. None of the above are correct.

General feedback:c would have been completely correct if it had mentioned the main site of action of glucocorticoids which results in all new protein synthesis stimulated by glucocorticoids….i.e. the NUCLEAR receptor. All steroids influence protein synthesis through stimulation of mRNA, etc. The plasma membrane receptors for glucocorticoids DO exist and may result in some of the rapid benefit of glucocorticoids, particularly in hypovolemic shock, but these receptors do not result, by definition, in new protein synthesis.
Molly is an epileptic and is treated with phenobarbital. She develops a gastric ulcer and the vet treats her with cimetidine, an agent that inhibits the microsomal enzyme system. What would you expect to see?
a. Molly becomes more active
b. Molly becomes more sleepy
b. Molly becomes more sleepy
Warfarin inhibits the clotting of blood by:
a. decreasing the recycling of vitamin K between the oxidized and reduced forms
b. changing the gut flora
c. chelating calcium in blood
d. activating antithrombin 3
e. None of the above
a. decreasing the recycling of vitamin K between the oxidized and reduced forms
Why do glucocorticoids cause the side-effect of polyuria and polydipsia?
a. They increase glucose levels resulting in an osmotic diuresis in all cases.
b. They inhibit antidiuretic hormone production by the posterior pituitary.
c. They inhibit antidiuretic hormone action in the nephron.
d. a and b
e. b and c
e. b and c
Dr. Knowitall says that metoclopramide increases the effect of acetylcholine in the GI
tract, whereas Dr. Doitbetter says that it decreases it. Who is right?
a. Dr. Knowitall
b. Dr. Doitbetter
c. none of the above
a. Dr. Knowitall
The major difference between cimetidine and ranitidine is:
a. cimetidine but not ranitidine inhibits H2 receptors
b. cimetidine but not ranitidine increases the metabolism of phenobarbital
c. cimetidine has a shorter halflife than ranitidine
d. cimetidine but not ranitidine can be used for gastric ulcers
e. ranitidine but not cimetidine affects H1 receptors
cimetidine has a shorter halflife than ranitidine
Metoclopramide, a prokinetic agent, has all of the following effects except:
a. It relaxes the pyloric sphincter
b. It antagonizes dopamine receptors
c. it decreases vagal activity
d. It affects the chemoreceptor trigger zone (CRTZ)
e. None of the above. All 4 effects above are seen with metoclopramide.
c. it decreases vagal activity
Dr. Knowitall has just recently attended continuing education seminars. He tells Dr. Doitbetter that misoprostol, a prostaglandin E derivative, is a new drug that can be used for the treatment of gastric ulcers. It works by:
a. increasing gastric mucous production
b. increasing bicarbonate secretion
c. increasing blood flow
d. inhibiting pepsin
e. all of the above
e. all of the above
Your aunt Matilde was worried about her cat's fever and before calling you, administered a human dose of children's Tylenol(r) (acetaminophen, an NSAID) because she always found it helpful when your cousins had a fever. She calls you 10 minutes later. Your response to her would most appropriately be:
a. Tell her that acetaminophen is very toxic in cats due to their slow drug metabolism and that they can quickly develop a blood disorder and liver failure. She should bring the cat immediately to the nearest veterinarian.
b. Tell her that she made a good choice of an NSAID because it has high antipyretic properties.
c. Tell her to first call Dr. Finco in retirement because he wrote the first paper on the subject.
d. Tell her that acetaminophen is mildly toxic in cats because the drug doesn't bind to the same enzyme as other NSAIDs and can quickly build up, causing diarrhea. Tell her to make an appointment to see her veterinarian within the next week.
e. a and c
a. Tell her that acetaminophen is very toxic in cats due to their slow drug metabolism and that they can quickly develop a blood disorder and liver failure. She should bring the cat immediately to the nearest veterinarian.
Nelly has had epileptic seizures almost all of her life which were controlled by phenobarbital. Now she is 16 years old and her vet just diagnosed congestive heart failure which he treats with digoxin. Which of the following statements is true?
a. there is no interaction between phenobarbital and digoxin
b. phenobarbital increases the metabolism of digoxin
c. phenobarbital decreases the metabolism of digoxin
d. the half life of digoxin will probably be reduced
e. b and d
e. b and d
Which of the following NSAIDs is INCORRECTLY matched with a clinically observed toxicity?
a. Phenylbutazone: renal papillary necrosis in foals
b. Carprofen: acute hepatic failure in dogs
c. Acetaminophen: methemoglobinemia in the cat
d. Aspirin: reversible inhibition of platelet aggregation
e. Ibuprofen: gastrointestinal ulceration in dogs.
d. Aspirin: reversible inhibition of platelet aggregation

General feedback: s effect is IRREVERSIBLE due to covalent binding to the cyclooxygenase 1 enzyme.
Bello is on diazepam for aggression. He develops gastric ulcers and is being treated with the H2 antagonist, cimetidine. Keeping the diazepam dose the same,would you expect Bello now to be:
a. calmer
b. more excited
a. calmer
Cimetidine is given to a dog that is also being treated with benzodiazepines. The effect you expect will be that the dog will be less sedate and need a higher dose of benzodiazepines.
a. True
b. False
b. False
Dr. Knowitall and Dr. Doitbetter argue. Dr. Knowitall say that heparin in addition to its anticoagulant activity leads to activation of lipoprotein lipase. Dr. Doitbetter says that heparin only inhibits antithrombin III. Who is correct?
a. Dr. Knowitall
b. Dr. Doitbetter
c. none of the above
a. Dr. Knowitall
Molly, a German Shephard, is being treated with metoclopramide for vomiting. Which of the following statements regarding metoclopramide is correct:
a. stimulates dopamine and inhibits cholinergic receptors
b. inhibits dopaminergic and inhibits cholinergic receptors
c. works well in cats with neurologic problems
d. inhibits dopaminergic and stimulates cholinergic receptors
e. has a long half-life
d. inhibits dopaminergic and stimulates cholinergic
Which of the following side effects would you NOT expect to see:
a. phenothiazine-sedation
b. ketoconazole-anorexia
c. hypertonic IV fluids-cell swelling
d. bromide-ataxia
e. op'DDD-vomiting
c. hypertonic IV fluids-cell swelling
Anticholinergics are sometimes used for the treatment of vomiting and diarrhea. Which of the following is true:
a. they are a good choice if the gut is hypermotile
b. they are a good choice if the gut is hypomotile
c. they increase fluid secretion in the gut
d. they increase tenesmus
e. none of the above
a. they are a good choice if the gut is hypermotile
Which of the following antimcrobials is also used at low dosages intravenously to bind endotoxin?
a. Flunixin
b. Cuprimyxin
c. Polymixin
d. Amoxicillin
e. Richard Nixon
c. Polymixin