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140 Cards in this Set
- Front
- Back
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Is growth Hormone a steroid?
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No
it's a PEPTIDE |
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Somatostatin
a) receptor JAX-STAT b) receptor g-protein c) increases muscle growth d) increases fat breakdown |
receptor JAX-STAT
increases muscle growth increases fat breakdown |
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Which of the following is a growth hormone antagonist
a) somatorotropin b) somatostatin c) Oxytocin d) octreotide |
somatostatin
octreotide |
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What are growth hormones used for
a) growth deficiency b) obesity c) Hypoglycemia d) nutritional augmentation (HIV, short bowel syndrome) |
growth deficiency
obesity Hypoglycemia nutritional augmentation (HIV, short bowel syndrome) |
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What are growth hormone antagonist used for
a) hormone secreting tumors b) esophageal varicies c) dwarfism |
hormone secreting tumors
esophageal varicies |
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Growth hormone from the anterior/posterior pituitary
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ANTERIOR
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Oxytocin
a) produced in hypothalamus b) produced in posterior pituitary c) causes uterine contraction d) used to control post-partum bleeding |
produced in hypothalamus
causes uterine contraction used to control post-partum bleeding |
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Oxytocin receptor & 2nd messenger
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g-protein
phospholipase C |
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At high doses Oxytocin
a) HOTN b) decreased Na serum level r/t increased aquaporins c) uterine tetany |
HOTN
decreased Na serum level r/t increased aquaporins uterine tetany |
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Most side effects of hormone replacement (women) is related to
a) progesterone b) estrogen c) testosterone |
estrogen
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Side effects of estrogen hormone replacement
a) increased factor production b) HTN c) increased risk of MI & CVA d) glucose intolerance |
increased factor production
HTN increased risk of MI & CVA glucose intolerance |
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Vasopressin
a) peptide hormone b) released in response to low BP c) released in response to high osmolality d) released in response to low osmolality |
peptide hormone
released in response to low BP released in response to high osmolality |
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Match the following Vasopressin receptors with their function
V1 V2 V2 like Renal Increase factors VIII, Von Wille. vascular constriction |
V1 = vascular constriction
V2 = Renal (think "2" kidneys) V2 like = increase factors |
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The drug Desmopressin is an analog of Vasopressin, which receptors is it specific for
a) V1 b) V2 c) V2 like |
V2 V2 like
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T/F Vasopressin causes both systemic and coronary vasoconstriction
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True
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Your pt has the following symptoms
dec. metabolism, dec. HR, CNS slowing, an inc. TSH and dec. T4 & T3 levels...... Diagnosis & drug |
Hypothyroid
Levothroxyine |
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Levothyroxine
a) good oral availability b) long 1/2 life c) short 1/2 life d) must be stopped before surgery e) inc. metab. of drug with Rifampin & Phenytoin |
good oral availability
long 1/2 life inc. metab. of drug with Rifampin & Phenytoin |
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How does exogenous Iodine effect the thyroid
a) increased TSH levels b) decreased TSH levels c) shrinks/ dec. vascularity of thyroid d) helps the conversion of T4 to T3 |
decreased TSH levels
shrinks/ dec. vascularity of thyroid |
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Which of the following are adrenal medulla hormones
a) aldosterone b) cortisol c) ADH d) oxytocin |
aldosterone
cortisol |
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Mineralcorticoids
a) aldosterone b) cause sodium retention c) cause sodium diuresis d) help with inflammation |
aldosterone
cause sodium retention |
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If you wanted to choose a mineralcorticoid but wanted no anti-inflammatory effects which would you choose
a) fludrocortisone b) Deoxycorticosterone c) Dexamethasone d) Hydrocortisone |
Deoxycorticosterone
Fludrocortisone has a small cortisol effect but is #1 in POTENCY in the mineralcorticoids Dexamethasone & Hydrocortisone are Glucocorticoids |
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Your pt has adrenal insufficiency which drug would you choose to treat it
a) Hydrocortisone b) Prednisone c) Fludorcortisone d) Dexamethasone |
Hydrocortisone
Adrenal insuff. MUST be treated with both Mineral/Gluco corticoids Hydrocortisone has a 50/50 mix of both |
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Which of the following Glucocorticoids is the most potent
a) Dexamethasone b) Bethamethasone c) Prednisone d) Hydrocortisone |
Bethamethasone
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Which is more potent
Hydrocortisone or Cortisone? |
Hydrocortisone
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What would the equivalent doses of Hydrocortisone & Prednisone be if Hydrocortisone potency is 1 and Prednisone potency is 4
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Hydrocortisone 5mg
Prednisone 20mg |
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Which Glucocorticoid has NO Mineralcorticoid effect?
a) Dexamethasone b) Prednisone c) Methylprednisolone d) Cortisone |
Dexamethasone
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Would you expect to have problems with HTN, Na retention, & edema with Prednisone?
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NO because it is a Glucocorticoid with very minimal mineral effect
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Glucocorticoids are used to treat _______________________
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Auto-immune diseases such as Rheumatoid
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T/F Glucocorticoid
lipid soluble attaches to inactive receptor binds to another receptor = Dimer (becomes active) crosses nucleus & binds to Glucocorticoid Response Element (GRE) then either inhibits or stimulates gene transcription |
TRUE
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T/F Insulin Resistance can develop r/t Glucocorticoids
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TRUE
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Normal endogenous Cortisol production
a) 100 mg/day b) 20 mg/day c) 200 mg/day d) 1 mg/day |
20 mg/day
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Under stress how much Glucocorticoid would the body probably produce?
a) 150-200 mg/day b) 20 mg/day c) 500-600 mg/day d) 1000 mg/day |
150-200 mg/day
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Toxicities r/t cortisol
a) osteoporosis b) elev. glucose c) decreased K d) infection |
osteoporosis (Vit D not converted)
elev. glucose decreased K infection |
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Insulin
a) produced by alpha cells b) produced by beta cells c) can be increased with release of Somatostatin d) can be increased with secretion of glucagon |
produced by beta cells (in the islet of langerhans in the pancreas)
can be increased with release of Somatostatin |
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What is the basal rate of insulin that the body makes?
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1 unit/hr which keeps the body from breaking down muscle & fat and going into DKA
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Which of the following insulins would provide a basal rate of insulin for a Type I Diabetic
a) NPH b) Lente c) Glargine d) Ultra Lente |
Glargine
Ultra Lente These insulins can last for 24 hrs |
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Sulfonylureas
a) increase insulin release b) decrease insulin resistance c) need functioning beta cells d) decrease gi absorption of sugar |
increase insulin release
need functioning beta cells Drugs 3G's "ride, zide" & tolbutamide |
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Meglatinides
a) increase insulin release b) decrease insulin resistance c) need functioning beta cells d) decrease gi absorption of sugar |
increase insulin release
need functioning beta cells "nide" drugs |
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Biguanides
a) increase insulin release b) decrease insulin resistance c) need functioning beta cells d) decrease gi absorption of sugar |
decrease gi absorption of sugar
(improve insulin action) also cause glycolysis, dec. glucagon response Metformin (Phenorfin off market d/t lactic acidosis) |
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Thiazolid
a) increase insulin release b) decrease insulin resistance c) need functioning beta cells d) decrease gi absorption of sugar |
decrease insulin resistance
CV & LIVER TOXIC |
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ALPHA glucosidase Inhibitor
a) increase insulin release b) need functioning beta cells c) inhibit amylases d) decrease gut absorption of sugar |
decrease gut absorption of sugar
inhibit amylases |
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Dipeptidyl Peptidase IV Inhibitors
a) increase insulin release b) need functioning beta cells c) decrease glucagon response d) decrease gut absorption of sugar |
increase insulin release
decrease glucagon response |
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Side effects of Oral Hypoglycemics
a) weight gain b) hypoglycemia c) CV toxicity d) Liver toxicity |
weight gain
hypoglycemia CV toxicity Liver toxicity |
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Acetylzolamide
a) carbonic anhydrase inhibitor b) works at prox. tubule c) works in ascending loop d) can cause acidosis |
carbonic anhydrase inhibitor
works at prox. tubule can cause acidosis |
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Acetylzolamide causes excretion of
a) Na/H2O b) Ca c) K d) HCO3 |
a) Na/H2O
b) Ca c) K d) HCO3 |
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What is Acetylzolamide used for
a) diuretic b) glaucoma c) for seizures |
glaucoma
for seizures |
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Na/K/Cl symporter is found
a) proximal tubule b) ascending loop c) distal tubule d) collecting duct |
ascending loop
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Na/Cl symporter is found
a) proximal tubule b) ascending loop c) distal tubule d) collecting duct |
distal tubule
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ENaC channel is found
a) proximal tubule b) ascending loop c) distal tubule d) collecting duct |
collecting duct
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Which of the following drugs is used for hypercalcemia
a) spironolactone b) HCTZ c) lasix d) Acetylzolamide |
lasix
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Which of the following drugs is a Ca sparing drug
a) Acetylzolamide b) spironolactone c) HCTZ d) Lasix |
HCTZ
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T/F The more Na the kidney dumps further down the nephron the more K is lost with it
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True
When combining loop diuretics & thiazides there is a huge K loss |
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Which area of the nephron does Mannitol work in
a) glomerulus b) proximal tubule c) ascending loop d) collecting duct |
glomerulus
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Which drug is K sparing
a) Lasix b) HCTZ c) Spironolactone d) Ethacryinc Acid |
Spironolactone
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Which of the following are Mast Cell stabilizers
a) Ipratroprium b) Cromolyn c) Salmeterol d) Formoterol |
Cromolyn
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What does Mast Cell stabilization do?
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decreases Histamine release
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Are Mast Cell stabilizers for acute or chronic treatment?
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Chronic
used to treat Excercise induced & allergc asthma |
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Mechanism of bronchodilation
a) preferential dilation of proximal bronchioles b) preferential dilation of distal bronchioles |
preferential dilation of distal bronchioles
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Theophylline
a) increases cAMP thru phosphodiesterase inhibition b) "digoxin" for muscle c) decreases histamine release d) inhibits Na reabsorption in distal tubule |
a) increases cAMP thru phosphodiesterase inhibition
b) "digoxin" for muscle c) decreases histamine release d) inhibits Na reabsorption in distal tubule |
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Which drug would be the best choice for treating a COPD pt
a) Albuterol b) Tiotroprium c) Salmeterol d) formoterol |
Tiotroprium it is an anti-muscarinic with specific blocking on m1 & m3 receptors
M1 = secretions decreased M3 = bronchodilation effect |
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Beta 2 agonist short acting
a) Albuterol b) Isuprel c) Salmeterol d) Epi |
Isuprel
Epi |
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Beta 2 agonist intermediate acting
a) Albuterol b) Isuprel c) Salmeterol d) Metaproteronal |
Albuterol
Metaproteronal |
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Beta 2 agonist long acting
a) Albuterol b) Formoterol c) Salmeterol d) Metaproteronal |
Salmeterol
Formoterol |
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Adverse Effects of Beta 2 agonists
a) inc. HR b) inc. K c) dec. Mg d) dec. phos e) dec. Ca |
a) inc. HR
b) inc. K c) dec. Mg d) dec. phos e) dec. Ca |
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Leukotriene inhibition
a) prevents bronchoconstriction b) decreases inflammation c) decreases rescue inhaler use d) usually a single dose/day |
a) prevents bronchoconstriction
b) decreases inflammation c) decreases rescue inhaler use d) usually a single dose/day |
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Which of the following is/ are Leukotriene Inhibitors
a) Singulair b) Zyflo c) Accolate d) Omalizumab |
Singulair
Accolate |
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T/F Leukotriene Inhibitors (blockers) make for better long term control of lung inflammation
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True
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Ketamine
a) inc. SNS tone b) inc. Circulating catechols c) good for intubation of asthmatic pt |
inc. SNS tone
inc. Circulating catechols good for intubation of asthmatic pt |
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Lipoxygenase Inhibition
a) blocks formation of leukotrienes b) block action of leukotrienes |
blocks formation of leukotrienes
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Leukotriene Inhibitors
a) blocks formation of leukotrienes b) block action of leukotrienes |
block action of leukotrienes
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Heliox how does it work?
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decreases viscosity of air to improve flow
DOES NOT CHANGE CALIBRATION OF AIRWAY!! |
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How does Mg help with bronchodilation?
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it is a direct smooth muscle relaxant, by inhibiting intracellular Ca
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Adverse effects of Mg?
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HOTN, hyporeflexia, cardiac depression
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How do Volatile anesthetic agents help with bronchodilation?
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Decrease intracellular Ca & cause vasodilation
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T/F depression of airway reflexes decrease neural humoral release
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True
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When treating pt with COPD what drug types would decrease exacerbations?
a) glucocorticoids b) anti-muscarinics c) long acting beta 2 agonists d) all of the above e) b & c only |
anti-muscarinics
long acting beta 2 agonists inhaled steroids do NOT alter inflammation & progression of dz |
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Histamines
a) stored in Mast cells b) majority of storage in lungs & gi tract c) released by certain drugs (ie: morphine, sux) d) 3 types of histamine receptors |
stored in Mast cells
majority of storage in lungs & gi tract released by certain drugs (morphine, sux) 3 types of histamine receptors |
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Match the Histamine receptors with their function
H1 H2 H3 bronchoconstriction bronchodilation/inc heart rate/GI inhibits synthesis & release of histamine |
H1 bronchoconstriction
H2 bronchodilation/inc. heart rate/GI H3 inhibit synthesis & release of histamine |
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Which histamine receptors are important for vasodilation & capillary leak (permeability)?
a) H1 b) H2 c) H3 |
H1
H2 |
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Cardiovascular effects of Histamine
include |
decreased SVR,
increased HR, all H2 effect increased contractility coronary constriction H1 effect |
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Which histamine receptor has it's effect in the GI system by increasing acid production?
a) H1 b) H2 c) H3 |
H2 (think H2 blockers like zantac, pepcid)
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H1 second messenger
a) phospholipase c b) adenylcyclase |
phospholipase c (incr. gAMP) constriction
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H2 second messenger
a) phospholipase c b) adenylcyclase |
adenylcyclase (inc. cAMP)
dilation |
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Crossover effects of H1 antagonists
a) dry mouth, urinary retention b) HOTN, dizziness,reflex tachycardia c) increased appetite |
dry mouth, urinary retention (cholinergic effects)
HOTN, dizziness,reflex tachycardia (alpha adrenergic effects) increased appetite (seretonin effects) |
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Which H1 antagonists have more CNS effects?
a) first generation b) second generation |
first generation (Benadryl, hydroxyzine, meclizine, phenergan)
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Why don't second generation H1 antagonists have CNS effects?
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they are polar and don't cross the BBB
(allegra, claritin, zyrtec) |
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H2 antagonists
a) decrease gastric acid production b) increase esophageal tone c) have their effect on parietal cells |
decrease gastric acid production
increase esophageal tone have their effect on parietal cells |
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Proton pump inhibitors
a) decrease gastric volume b) decrease pH c) increase pH |
decrease gastric volume
increase pH (Lansoprazole, Pantoprazole, Omeprazole) |
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How does sucralfate work?
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forms a viscous suspension that protects gastric mucosa
DOES NOT CHANGE pH |
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Metoclopromide
a) dopamine antagonist b) cholinergic agonist c) decreases gastric volume d) increases lower esophageal tone e) relaxes pylorus |
dopamine antagonist
cholinergic agonist decreases gastric volume increases lower esophageal tone relaxes pylorus |
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How does Metoclopromide work as an anti-nausea drug?
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thru the dopaminergic antagonism on the CTZ (chemoreceptor trigger zone)
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Daily caloric need
a) 2.5-3.5 kcal/kg/day b) 25 - 35 kcal/kg/day c) 0.5-1 kcal/kg/day |
25 - 35 kcal/kg/day
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Of the following which one increases caloric need the most
a) Major Trauma b) Major Surgery c) Major Burn d) Sepsis |
Major Burn
(next would be sepsis, surgery, trauma, fever) |
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Daily protein requirement
a) 0.5 - 1gm/kg/day b) 5 -10 gm/kg/day c) 2.5 - 3.5 gm/kg/day |
0.5 - 1gm/kg/day
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Of the following which stressor increases protein need the most
a) Sepsis b) Burns c) Infection d) post-op |
Burns
(next would be sepsis, infection, post-op) |
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Daily Lipid requirement
a) 2gm/day b) 20 gm/day c) 200 gm/day |
20 gm/day
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T/F The body produces linoleic acid
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False!! it is an essential lipid that the body needs but must be consumed to get it
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Which is a better source of calories
a) lipids b) carbs |
Lipids 9 cal/gm
vs Carbs 4 cal/gm |
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Which cycloxygenase is active all the time
a) Cox 1 b) Cox 2 |
Cox 1
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Which cycloxygenase is turned on genetically
a) Cox 1 b) Cox 2 |
Cox 2
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Cox 1 effects
a) inflammation b) GI c) platelet d) renal |
GI
platelet renal |
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Which Cox is associated with heart disease & stroke
a) Cox 1 b) Cox 2 |
Cox 2
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Non-specific Cox inhibitor drugs
a) Celecoxib b) ASA c) Indomethacin d) Propionic Acid Derivatives e) Tylenol |
ASA
Indomethacin Propionic Acid Derivatives Tylenol |
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Side effects of Cox inhibitors include
a) gi upset b) ulcers c) renal toxicity d) hepatic toxicity e) cardiovascular risks |
gi upset
ulcers renal toxicity hepatic toxicity cardiovascular risks (MI, CVA) |
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Side effects of Cox inhibitors include
a) gi upset b) ulcers c) renal toxicity d) hepatic toxicity e) cardiovascular risks |
gi upset
ulcers renal toxicity hepatic toxicity cardiovascular risks (MI, CVA) |
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Which of the following Cox inhibitors binds irreversibly
a) ASA b) Indomethacin c) Propionic acid derivatives |
ASA requires new plt formation to reverse the effects (takes about 10-14 days)
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Which of the following Cox inhibitors binds irreversibly
a) ASA b) Indomethacin c) Propionic acid derivatives |
ASA requires new plt formation to reverse the effects (takes about 10-14 days)
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Which of the following non-specific Cox inhibitors has more CNS effect than peripheral effect on Cox
a) indomethacin b) Motrin c) Acetaminophen |
Acetaminophen (minimal anti inflammatory effect, but good analgesic & antipyretic effect)
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Which of the following non-specific Cox inhibitors has more CNS effect than peripheral effect on Cox
a) indomethacin b) Motrin c) Acetaminophen |
Acetaminophen
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How do propionic acid drugs (toradol, aleve) cause renal toxicity?
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Blocks the "protector" prostanoids (which normally cause dilation & inc. GFR) SO END UP WITH VASOCONSTRICTION
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How do propionic acid drugs (toradol, aleve) cause renal toxicity?
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Blocks the "protector" prostanoids (which normally cause dilation & inc. GFR) SO END UP WITH VASOCONSTRICTION
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Stabilzes membranes, builds cells, forms bile acid, precursor to hormones describes
a) triglycerides b) cholesterol |
cholesterol
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Stabilzes membranes, builds cells, forms bile acid, precursor to hormones describes
a) triglycerides b) cholesterol |
cholesterol
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Energy/Fuel, protection, message/ signals describes
a) triglycerides b) cholesterol |
triglycerides
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Which type of cholesterol drugs have the most effect on raising HDL
a) Statins b) Niacin c) Fibrates |
Niacin (most effect)
Fibrates |
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Which of the following carries the exogenous lipids
a) VLDL b) Chylomicrons c) LDL d) HDL |
Chylomicrons
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Which of the following transports endogenous lipids
a) VLDL b) Chylomicrons c) LDL d) HDL |
VLDL
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Endogenous lipids are formed in the ___________________
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Liver
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HDL or LDL which has anti-inflammatory effect?
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HDL
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LDL
a) bad cholesterol b) good cholesterol c) transported to tissue d) transported to liver |
bad cholesterol
transported to tissue |
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HDL
a) bad cholesterol b) good cholesterol c) transported to tissue d) transported to liver |
good cholesterol
transported to liver |
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Adverse effects of Statin Drugs
a) liver injury b) myopathy c) rhabdomylysis d) can increase coumadin levels |
liver injury
myopathy rhabdomylysis can increase coumadin levels |
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Statins
a) inhibit HMG CoAReductase b) inhibit livers ability to make LDL c) cause an increase in LDL receptors d) inhibit formation of mevalonic acid |
inhibit HMG CoAReductase
(inhibits mevalonic acid formation) inhibit livers ability to make LDL cause an increase in LDL receptors (removes more cholesterol from body) inhibit formation of mevalonic acid (a precursor to cholesterol) |
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Statin drugs
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all end with "statin"
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Which of the following carries the exogenous lipids
a) VLDL b) Chylomicrons c) LDL d) HDL |
Chylomicrons
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Which of the following transports endogenous lipids
a) VLDL b) Chylomicrons c) LDL d) HDL |
VLDL
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Endogenous lipids are formed in the ___________________
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Liver
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HDL or LDL which has anti-inflammatory effect?
|
HDL
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Adverse effects of Statin Drugs
a) liver injury b) myopathy c) rhabdomylysis d) can increase coumadin levels |
liver injury
myopathy rhabdomylysis can increase coumadin levels |
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Statins
a) inhibit HMG CoAReductase b) inhibit livers ability to make LDL c) cause an increase in LDL receptors d) inhibit formation of mevalonic acid |
inhibit HMG CoAReductase
(inhibits mevalonic acid formation) inhibit livers ability to make LDL cause an increase in LDL receptors (removes more cholesterol from body) inhibit formation of mevalonic acid (a precursor to cholesterol) |
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Pleiotropic effects of statins include
a) inhibit inflammation b) decrease thrombosis c) decrease platelet activity d) restore endothelial function |
inhibit inflammation
decrease thrombosis decrease platelet activity restore endothelial function |
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Statin drugs
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all end with "statin"
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Niacin
a) strongly inhibits lypolysis in adipose tissue b) inhibits intestinal absorption of cholesterol c) bind to bile acid causing cholesterol to be diverted to make more bile acid |
strongly inhibits lypolysis in adipose tissue
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Cholestryamine, Colestipol are bile acid binding drugs how do they work
a) strongly inhibits lypolysis in adipose tissue b) inhibits intestinal absorption of cholesterol c) bind to bile acid causing cholesterol to be diverted to make more bile acid |
bind to bile acid causing cholesterol to be diverted to make more bile acid (which decreases LDL level)
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Ezetimibe is a cholesterol absorption inhibitor how does it work
a) strongly inhibits lypolysis in adipose tissue b) inhibits intestinal absorption of cholesterol c) bind to bile acid causing cholesterol to be diverted to make more bile acid |
inhibits intestinal absorption of cholesterol
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Fenofibrate & Gemfibrozil are fibrates how do they work
a) activate a gene that increases HDL & causes breakdown of triglycerides b) inhibits intestinal absorption of cholesterol c) bind to bile acid causing cholesterol to be diverted to make more bile acid |
activate a gene that increases HDL & causes breakdown of triglycerides
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Which drug has the biggest effect on decreasing LDL
a) Fenofibrate b) Niacin c) Ezetimibe d) Cholestryamine e) Pravastatin |
Pravastatin
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Which drug has the biggest effect on decreasing Triglycerides
a) Fenofibrate b) Niacin c) Ezetimibe d) Cholestryamine e) Pravastatin |
Fenofibrate
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Which drug has the biggest effect on increasing HDL
a) Fenofibrate b) Niacin c) Ezetimibe d) Cholestryamine e) Pravastatin |
Niacin
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Which drug has the LEAST effect on decreasing Triglycerides?
a) Fenofibrate b) Niacin c) Ezetimibe d) Cholestryamine e) Pravastatin |
Cholestryamine
(bile acid binding drug) |
