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81 Cards in this Set

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Question
Correct Answer
My Incorrect Answer
A drug like that illustrated above is administered orally to a patient. Which of the following statements is correct? (R-CH2-NH2 --> <-- R-CH2-NH3+, Pka = 9.4)
over 50% of the drug will accumulate in the stomach
about 50% of the drug will be ionized in the plasma (false)
Some drugs can be classified as "partial agonists." A partial agonist differs from a "full agonist" in that:
partial agonists act as antagonists in addition to acting as agonists for the same receptor type.
the partial agonist is usually less potent than the full agonist (false)
Which of the following drugs is the most potent in causing sodium retention?
hydrocortisone
betamethasone (false)
Which of the following drugs causes the most prolonged hypoglycemic state?
chlorpropamide
pioglitazone (false)
With which drug is the following case scenario most associated? A diabetic newly started on this drug is admitted to the hospital three weeks later in severe congestive heart failure:
rosiglitazone
glipizide (false)
With which drug is the following case scenario most associated? A patient complains of 15-pound weight gain.
glipizide
rosiglitazone (false)
Digoxin can cause all of the following adverse effects EXCEPT: A. arrhythmias B. sinus bradycardia C. vomiting D. visual problems E. rapid response atrial fibrillation
rapid response atrial fibrillation is NOT an adverse effect of digoxin.
sinus bradycardia IS an adverse effect of digoxin (true, but incorrect answer)
Which of the following antimicrobial drugs is effective against infections caused by Bacteroides fragilis?
cefotetan
n/a
Which of the following drugs is the most effective for treating infections caused by Toxoplasma gondii?
pyrimethamine and sulfadiazine
pentamidine (false)
Which of the following aminoglycosides is often effective against organisms resistant to gentamicin?
amikacin
tobramycin (false)
A 50-year-old male with a 30-pack-year history of smoking and alcohol abuse presnts with a softball-sized mass protruding up from his lower mandible and a fever of 101 Fahrenheit (38.3 Celsius). Purulent-looking material is draining from the surface of the mass. Suspecting a squamous cell head and neck cancer, you admit the patient for IV antibiotics and nutrition. You start the patient on clindamycin for the superinfection and he defervesces. Three days later, he suddenly spikes to 102 degrees Fahrenheit (38.8 Celsius) and develops fulminant, severe diarrhea and abdominal pain. There is no rebound on exam and the patient has hyperactive bowel sounds. What antibiotic is most appropriate to treat this process?
metronidazole IV or PO
vancomycin IV (false)
Which of the following drugs does NOT cause a peripheral neuropathy? A. Didanosine (ddI) B. Zalcitabine (ddC) C. Vincristine D. Vinblastine E. Isoniazid
vinblastine does NOT cause peripheral neuropathy
didanosine DOES cause peripheral neuropathy (ddI)
Which of the following drugs is NOT nephrotoxic? A. Gentamicin B. Vancomycin C. Amphotericin B D. Clarithromycin E. Cisplatin
clarithromycin is NOT nephrotoxic
amphotericin B IS nephrotoxic
Which of the following is useful to eradicate hepatic stages of malaria infection?
primaquine
chloroquine
Which drug acts MOST rapidly to inhibit T4 release from the thyroid?
sodium iodide
propylthiouracil
Which of the above drugs is useful to treat constipation?
magnesium hydroxide
kaolin
Which of the above drugs produces unconsciousness, analgesia, and amnesia at doses that do NOT cause cardiovascular depression?
ketamine
halothane
Which of the above drugs produces neuroleptanalgesia when administered together with antipsychotic agents?
fentanyl
n/a
Which of the above drugs, when used in combination with lovastatin, often causes skeletal muscle pain?
gemfibrozil
n/a
Which of the above drugs increases 7-hydroxylase-mediated breakdown of cholesterol?
cholestyramine
clofibrate
Which of the above drugs should NOT be taken while the patient is eating cheeses and drinking wine?
phenelzine
L-dopa
Which of the above drugs works as an anti-emetic by blocking dopamine receptors?
metoclopramide
ondansetron
Which of the above drugs works as an anti-emetic by blocking 5-HT3 receptors?
ondansetron
sumatriptan
Which of the above drugs most effectively DECREASES airway inflammation in chronic, recurrent asthmatics?
triamcinolone
albuterol
Which of the above drugs is the most effective bronchodilator for asthmatics?
albuterol
triamcinolone
Which of the above drugs is a 1st-line anti-hypertensive agent?
hydrochlorothiazide
n/a
1st-line drug for essential hypertension?
beta-blockers or thiazide diuretics
alpha-blockers
1st-line drug for diabetic hypertensive patient?
ACE inhibitors
thiazide diuretics (false)
1st-line drug for post-myocardial infarction patient?
beta-blockers + ACE inhibitors + HMG-CoA reductase inhibitors
beta-blockers only (false)
1st-line drug for hypertensive patient with BPH?
alpha-blockers
ACE inhibitors
1st-line drug for hypertensive patient with osteoporosis?
thiazide diuretic
spirinolactone (false)
1st-line drug for heart failure?
beta-blockers + ACE inhibitors + spirinolactone
beta-blockers only (false)
Which of the above drugs promotes DNA interstrand cross-linking, and causes bone marrow suppression and alopecia but no renal or bladder toxicity?
melphalan
n/a
Which of the above drugs is designed to treat nosocomial gram-negative rod infections, especially Pseudomonas?
ceftazidime
n/a
Which of the above drugs is only active against aerobic gram-negative rods?
aztreonam
n/a
Which of the above drugs has essentially NO oral bioavailability?
vancomycin
levofloxacin
Which of the above drugs achieves essentially identical serum levels whether dosed IV or orally?
levofloxacin
vancomycin
Which of the above drugs has no gram-positive activity by itself, but synergizes with cell-wall inhibitors to provide extra killing of gram-positive organisms?
gentamicin
erythromycin
Which of the above drugs can cause marked GI intolerance?
erythromycin
gentamicin
Which of the above drugs can cause idiosyncratic aplastic anemia?
chloramphenicol
n/a
Which of the above drugs can cause drug-induced lupus?
isoniazid
pyrazinamide
Which of the above drugs can cause optic neuritis?
ethambutol
isoniazid
Which of the above drugs causes nephrolithiasis?
indinavir
n/a
Which of the above drugs is active against both hepatitis B and HIV?
lamivudine (3TC)
n/a
Which of the above drugs antagonizes AZT therapy?
stavudine (d4T)
nevirapine
Which of the above drugs causes severe heptatitis?
nevirapine
stavudine (d4T)
The efficacy of which of the above drugs is markedly INCREASED in the presence of hydroxyurea?
didanosine (ddI)
n/a
binds 50S ribosome, blocks peptidyltransferase reaction:
chloramphenicol
linezolid
neuromuscular blocker:
praziquantal
n/a
binds 50S ribosome, prevents union of 50S and 30S subunits
linezolid
clindamycin
inhibits beta-1-3 glucan synthesis, blocking cell wall formation
caspofungin
n/a
blocks DNA gyrase (topoisomerase)
ofloxacin
n/a
binds to 30S ribosome, causes misreading of mRNA code
amikacin
tetracycline
inhibits synthesis of ergosterol
fluconazole
n/a
binds to 30S ribosome, blocks aminoacyl-tRNA acceptor site
tetracycline
amikacin
binds 50S ribosome, blocks amino acid translocation
clarithromycin
chloramphenicol
inhibits oxidative phosphorylation
niclosamide
n/a
binds 50S ribosome, blocks formation of peptide bond
clindamycin
clarithromycin
Which of the above therapies is an enzyme inhibitor?
STI-571
n/a
Which of the above therapies induces diferentiation of malignant cells?
all-trans retinoic acid (ATRA)
STI-571
Which of the above therapies are used to treat hematologic malignant cells (choose as many as apply)?
all-trans retinoic acid (ATRA) + rituximab + gemtuzumab + interferon-alpha + STI-571 (BUT NOT TRASTUZUMAB OR G-CSF)
all-trans retinoic acid (ATRA) + interferon-alpha only
Which of the above compounds would you use to treat junctional tachycardia in a patient in CHF on several heart failure medicines?
Digibind
n/a
Which of the above drugs is the standard first-line pressor for most hypotensive patients and can also promote diuresis at low doses?
dopamine
vasopressin
Which of the above pressors is particularly useful in patients with low systemic vascular resistance (e.g., sepsis), but can promote severe tachycardia?
norepinephrine
dobutamine
Which of the above pressors is particularly useful in patients who are already tachycardic?
phenylephrine
n/a
Which of the above pressors is 1st line for cardiogenic shock, but may lower blood pressure and therefore is often combined with a second agent?
dobutamine
dopamine
Which of the above pressors is now considered a 1st-line option for pulseless ventricular fibrillation or tachycardia during cardiac resuscitation, but is not on the ACLS guidelines for any other type of code?
vasopressin
norepinephrine
Which is greater? A) Efficacy of BETHANECHOL as a topical preparation for glaucoma B) Efficacy of PILOCARPINE as a topical preparation for glaucoma
PILOCARPINE (better CNS/ocular penetration b/c it's non-ionized and non-polar)
n/a
Which is greater? A) Magnitude of bronchoconstriction in asthmatic caused by PROPRANOLOL. B) Magnitude of bronchoconstriction in asthmatic caused by METOPROLOL.
Magnitude of bronchoconstriction in asthmatic caused by PROPANOLOL (a beta blocker)
n/a
Which is greater? A. In vitro anticoagulant activity of HEPARIN. B. In vitro anticoagulant activity of COUMADIN
In vitro anticoagulant activity of HEPARIN
In vitro anticoagulant activity of COUMADIN
Which is greater? A) Half-life of AMIODARONE B) Half-life of DIGOXIN
Half-life of AMIODARONE
Half-life of DIGOXIN
Which is greater? A) Incidence of bone marrow suppression in patients taking VINCRISTINE. B) Incidence of bone marrow suppression in patients taking VINBLASTINE
VINBLASTINE
n/a
A 56-year-old male presents to the ER with worsening dyspnea on exertion, orthopnea, and a thirty-pound weight gain over two months. He has long-standing hypertension, and has been taking hydrochlorothiazide. His vital signs are stable. He has jugular venous distention to fifteen centimeters, an S3, crackles halfway up both lungs posteriorly, and 3+ pitting edema in both extremities. Which initial therapeutic regimen is most appropriate?
furosemide + captopril + digoxin
furosemide + lisinopril + carvedilol + digoxin
Assume you successfully treat the 56-year-old patient with ACUTE CHF, and you see him in your office a month later for a check-up. Which of the following regimens should he be taking when he sees you in your office?
furosemide + lisinopril + carvedilol + digoxin + spironolactone
n/a
A 47-year-old male with a twenty-year history of alcohol abuse presents to the hospital after being found down at home by a family member. The patient was lying in a pool of vomitus and was unresponsive. According to the paramedics, the vomitus was tinged with blood. During transport to the hospital, the patient suffered from a witnessed tonic-clonic seizure. His family members tell you he was not taking any medications, although he does have a history of bloody vomitus in the past. He has no prior history of seizures. On arrival to the ER, the patient is febrile to 102 F (38.8C), has an HR of 130, a blood pressure of 90/30, and a respiratory rate of 33. He is disheveled and non-responsive. He has scleral icterus, numerous spider angiomata, coarse rales at bilateral lung bases, a distended abdomen with a fluid wave, decreased bowel sounds, palmar erythema, and guaic-positive melenic stool. You place a nasogastric tube in the ER and lavage out clots of bright red blood and coffee-ground material. Laboratories are as follows: WBC count 23,000 with 95% neutrophils, hemoglobin of 8.5, platelets of 100,000, BUN of 96, creatinine of 1.6, AST of 130, ALT of 90. Head CT and lumbar puncture are normal. Ascitic fluid reveals 700 WBC with 90% neutrophils, gram stain positive for gram-positive cocci in pairs. Urinalysis reveals pyuria and gram stain reveals gram-negative rods in the urine. Chest x-ray shows bilateral opacifications in the superior segments of the lower lobes. Since you are a strong Resident, you break down this complex patient into his various problems and address each individually: GI bleed. In addition to blood transfusion, which of the following therapeutic regimens is most appropriately initiated in the ER?
octreotide + ranitidine
octreotide + DDAVP + ranitidine
A 66-year-old female with a history of hypertension, diabetes, and hypercholesterolemia presents to the ER with shortness of breath and a vague sensation of tingling in her chest. Being an astute clinican, you note her cardiac risk factors and realize that ischemia in females and diabetics is often atypical. Therefore, you order an EKG as part of your evaluation. The EKG reveals 4mm of ST elevation in leads V2 to V4. You immediately diagnose MI and initiate the ER protocol for MI management. The patient's vital signs are: T 99.5 F (37.5 C), HR 110, BP 170/90, RR 23. Which of the following are primary therapies for myocardial infarction accompanied by ST elevation?
urokinase + tPA plus heparin + streptokinase
tPA plus heparin
A patient becomes neutropenic during the third cycle of CHOP therapy, and presents to clinic complaining of severe abdominal pain, nausea, and vomiting. On exam, the pateient's vitals are as follows: T 101 F (38.3 C), HR 130, BP 80/40, RR 34. He has marked acute distress, with peritoneal signs on abdominal exam, and hypoactive bowel sounds. WBC count is 250 cells/uL with 10% neutrophils (i.e., the patient is neutropenic). Creatinine is normal. The patient is admitted to intensive care and surgery is called to evaluate him. You immediately begin antibiotic and pressor therapy. What antibiotic regimen is most appropriate?
ampicillin + gentamicin + metronidazole
clindamycin and azithromycin
For the patient with peritoneal signs, which pressor is your agent of first choice?
dopamine
epinephrine
A 54-year-old female with no past medical history presents to your primary care office for a routine annual exam. In the past, you have twice noted that the patient had borderline elevations in blood pressure, and you have advised the rather portly woman on diet and exercise as a therapy to prevent the need for antihypertensive medications. Alas, the patient did not modify her behavior and now you again note a blood pressure of 150/90. You decide to initiate anti-hypertensive therapy. Which therapy would you use in this patient?
hydrochlorothiazide or metoprolol
benazepril
For a patient with previous hypertension with comorbid illness: Two years later, you diagnose the patient with Type II diabetes mellitus, and on screening, you detect the presence of microalbuminuria. What medicine would you now use to control the patient's persistent hypertension?
benazepril
hydrochlorothiazide