Pharmacology Test #2B

Front 1

Which of the following statements regarding class III anti-arrhythmia drugs such as Amiodarone is Correct?
a) May display toxicity to thyroid and lungs
b) Can behave as a partial Beta-adrenergic antagonist (beta-blocker)
c) Attenuate the action potential (phase 0 depolarization)
d) Block Na+ channels to increase repolarization currents

Back 1

Block Na+ channels to increase repolarization currents

Front 2

Which of the following drugs is a Ca++ channel blocker used to treat arrhythmias?
a) Lidocaine
b) Flecainide
c) Pindolol
d) Diltiazem
e) Midazolam

Back 2

Diltiazem

Front 3

Which effect would be observed if binding of Angiotensin II to the AT1 receptor were inhibited?
a) Decreased vasoconstriction
b) Increased blood pressure
c) Increased Na+/H2O retention
d) Increased afterload

Back 3

Decreased vasoconstriction

Front 4

All of the following statements regarding isoproterenol are correct Except that it
a) Binds with poor affinity to beta-adrenergic receptors
b) Produces peripheral vasodilation
c) Is a good bronchodilator
d) Increases cardiac output

Back 4

Binds with poor affinity to beta adrenergic receptors

Front 5

The Ca++ blocker nifedipine reduces myocardial ischemia/angina by which of the following mechanisms?
a) Reducing activation of alpha1 adrenergic receptors
b) Decreasing blood pressure and dilating coronary arteries
c) Dilating coronary arteries and increasing myocardial wall tension
d) Enhancing growth of collateral vessels

Back 5

Decreasing blood pressure and dilating coronary arteries

Front 6

Spironolactone is effective in the treatment of hypertension because it?
a) Behaves as a beta adrenergic antagonist (beta blocker)
b) Blocks Ca++ channels
c) Blocks aldosterone effects on the kidney
d) Blocks acetylcholine binding

Back 6

Blocks aldosterone effects on the kidney

Front 7

Losartan or libesartan administration reduces blood pressure by which of the following reasons or mechanisms?
a) They are highly selective angiotensin II receptor antagonists
b) They are both potent angiotensin-converting enzyme (ACE) inhibitors
c) They are both Ca++ channel blockers
d) They both increase the production of aldosterone

Back 7

They are highly selective angiotensin II receptor antagonists

Front 8

Niacin at high doses can be used as an antihyperlipidemic agent because it?
a) Inhibits HMG-CoA reductase
b) Acts to inhibit transcription of proteins involved in fatty acid metabolism
c) Inhibits lipolysis in adipose tissue
d) Removes bile acids from the GI tract
e) Directly inhibits cholesterol uptake by the liver

Back 8

Inhibits lypolysis in adipose tissue

Front 9

Statins like Mevacor and lipitor are antihyperlipidemic agents because they
a) Inhibit HMG-CoA reductase
b) Act to inhibit transcription of proteins involved in fatty acid metabolism
c) Inhibit lipolysis in adipose tissue
d) Remove bile acids from the GI tract
e) Directly inhibit cholesterol uptake by the liver

Back 9

Inhibit HMG-CoA reductase

Front 10

Which of the following drugs, used as an anti-anginal agent, must be administered sublingually?
a) Captopril
b) Furosemide
c) Isosorbide dinitrate
d) Nitroglycerin
e) Atropine

Back 10

Nitroglycerin

Front 11

Which of the following drugs used in the treatment of cardiovascular disease would be contraindicated for someone undergoing major oral surgery?
a) Nitroglycerin
b) Captopril
c) Aspirin
d) Furosemide
e) Propranolol

Back 11

Aspirin

Front 12

Which of the following drugs is used to prevent deep vein thrombosis?
a) Atropine
b) Aspirin
c) Heparin
d) Vitamin K
e) Streptokinase

Back 12

Heparin

Front 13

Angiotensin converting enzyme inhibitors are used clinically for all of the following indications Except?
a) Treatment of cardiac systolic dysfunction
b) Therapy of normal renin associated hypertension
c) Management of hypokalemia
d) Treatment of acute coronary thrombosis and pulmonary edema
e) Prevention of cardiac remodeling in hypertensive states

Back 13

Management of hypokalemia

Front 14

Nearly 2/3 of filtered sodium is reabsorbed in which segment of the nephron?
a) The proximal renal tubules
b) The thin descending limb of the loop of Henle
c) The thick ascending limb of the loop of Henle
d) The distal convoluted tubules
e) The collecting ducts

Back 14

The proximal renal tubules

Front 15

Which portion of the nephron utilizes the greatest amounts of ATP?
a) The proximal renal tubules
b) The thin descending limb of the loop of Henle
c) The thick ascending limb of the loop of Henle
d) The distal convoluted tubules
e) The collecting ducts

Back 15

The thick ascending limb of the loop of Henle

Front 16

Which one of the following combinations of diuretic drugs is least effective?
a) Bumetanide and hydrochlorothiazide
b) Furosemide and triamterene
c) Hydrochlorothiazide and amiloride
d) Spironolactone and triamterene
e) Spironolactone and furosemide

Back 16

Spironolactone and Triamterene

Front 17

Furosemide can produce all of the following effects Except
a) Hypokalemia
b) Acute renal failure
c) Toxicity similar to that of sulfonamides
d) Enhanced renal excretion
e) Metabolic alkalosis

Back 17

Enhanced renin secretion

Front 18

All of the following diuretics act at the lumenal side of renal tubules Except
a) Hydrochlorothiazide
b) Triamterene
c) Ethacrynic acid
d) Bumetanide
e) Spironolactone

Back 18

Spironolactone

Front 19

All of the following ions are important in generating currents during each cardiac cycle Except?
a) Ca++
b) K+
c) Mg++
d) Na+

Back 19

Mg++

Front 20

Which of the following receptors is important for sensing short term changes in blood pressure?
a) Beta1 adrenergic receptors
b) Baroreceptors
c) Chemoreceptors
d) Dopamine receptors
e) Nicotinic cholinergic receptors

Back 20

Baroreceptors

Front 21

Which tissue is responsible for the pacemaker potentials that control contraction of the heart?
a) Atrioventricular node
b) Bundle of His
c) Purkinje fibers
d) Sinoatrial node
e) Ventricular myocardium

Back 21

Sinoatrial node

Front 22

All of the following pairs of agents and actions or agents and receptors occur physiologically in normal individuals Except
a) Acetylcholine - muscarinic receptors
b) Angiotensin II - vasoconstriction
c) Epinephrine - dopamine receptors
d) Epinephrine - vasodilation
e) Norepinephrine - alpha adrenergic receptors

Back 22

Epinephrine - dopamine receptors

Front 23

All of the following drugs are antiinflammatory Except?
a) Ibuprofen
b) Naproxen
c) Acetaminophen
d) Aspirin
e) Prednisone

Back 23

Acetaminophen

Front 24

A patient who has been taking large quantities of aspirin might show increased postoperative bleeding because aspirin inhibits
a) Synthesis of thromboxane and prevents platlet aggregation
b) Synthesis of prostacyclin and prevents platelet disaggregation
c) Synthesis of prostaglandins and prevents production of blood platelets
d) Thrombin and prevents formation of the fibrin network
e) Intestinal absorption of vitamin K and prevents synthesis of blood clotting factors

Back 24

Synthesis of thromboxane and prevents platelet aggregation

Front 25

Which of the following pharmacologic actions is NOT produced by prostaglandins?
a) Pyrexia
b) Uterine contraction
c) Increased gastric acid secretion
d) Increased capillary permeability
e) Increased sensitivity to pain upon intradermal injection

Back 25

Increased gastric acid secretion

Front 26

Which of the following conditions or effects does NOT result from prolonged treatment with corticosteroids?
a) Gastric ulcer
b) Osteoporosis
c) Hyperglycemia
d) Skeletal muscle atrophy
e) Redistribution of body fat

Back 26

Gastric ulcer

Front 27

All of the following agents useful for treatment of rheumatoid arthritis can be used simultaneously with anakinra Except?
a) Aspirin
b) Celecoxib (celebrex)
c) Infliximab
d) Methotrexate
e) Prednisone

Back 27

Infliximab

Front 28

The most prominent acute toxic effect associated with acetaminophen use is?
a) hemorrhage
b) renal necrosis
c) hepatic necrosis
d) gastric ulceration
e) respiratory alkalosis

Back 28

Hepatic necrosis

Front 29

Which of the following drugs is an effective antitussive?
a) Ibuprofen
b) Dextromethorphan
c) Guaifenesin
d) Aspirin
e) Acetaminophen

Back 29

Dextromethorphan

Front 30

Receptors which mediate the primary effects of opioids are?
a) Presynaptic transporters of amines
b) Membrane proteins activated by endogenous peptides
c) Enzymes which convert arachidonic acid to prostaglandins
d) NMDA and glutamate receptors
e) Present in the brain but not the spinal cord

Back 30

Membrane proteins activated by endogenous peptides

Front 31

All of the following terms have a distinct medical meaning or definition Except?
a) Opioid
b) Opiate
c) Dependence
d) Addiction
e) Narcotic

Back 31

Narcotic

Front 32

All of the following bind to opioid receptors Except?
a) endorphins
b) enkephalins
c) naloxone
d) substance P
e) dynorphins

Back 32

Substance P

Front 33

All of the following effects are commonly produced by administration of an opioid Except?
a) respiratory depression
b) nausea
c) constipation
d) tolerance
e) smooth muscle relaxation

Back 33

Smooth muscle relaxation

Front 34

Which of the following agents sensitizes peripheral nerve endings to noxious and/or painful stimuli?
a) Bradykinin
b) Serotonin
c) Histamine (itching)
d) H+ (acid)
e) Prostaglandins

Back 34

Prostaglandins

Front 35

All of the following effects can be produced by administration of an opiod Except?
a) Suppression of the cough reflex (antitussive)
b) Elevation of mood
c) Constriction of pupils
d) Inhibition of vomiting (antiemetic)
e) Stimulation of release of histamine from mast cells

Back 35

Inhibition of vomiting (antiemetic)

Front 36

Which of the following agents is LEAST likely to produce either physical dependence or addiction?
a) Codeine
b) Morphine
c) Oxycodone
d) Hydrocodone
e) Tramadol

Back 36

Tramadol

Front 37

A 57 year old person receiving propranolol (beta blocker) for hypertension presents with an acute allergic asthma attack. Which of the following treatments is specifically contraindicated?
a) Ipratropium bromide (anti-cholinergic)
b) Loratadine (anti-histamine)
c) Budenoside (Pulmocort or Rhinocort)
d) Albuterol
e) None of the above

Back 37

Albuterol

Front 38

Which of the following classes of bronchodilators is MOST effective in chronic obstructive pulmonary disease (COPD)?
a) Anticholinergics
b) Beta-adrenergic agonists
c) Beta-adrenergic receptor antagonists
d) Corticosteroids
e) Methylxanthines

Back 38

Anticholinergics

Front 39

Bronchoconstriction in chronic obstructive pulmonary disease (COPD) due to epithelial damage occurs by what mechanism?
a) Loss of endogenous beta-agonist release leading to increased smooth muscle contraction
b) Activation of exposed sensory nerve fibers leading to acetylcholine release and cholinergic bronchoconstriction
c) Increased inflammatory mediator release leading to smooth muscle oxidative damage
d) Loss of epithelial derived acetylcholine release leading to increased bronchoconstriction
e) None of the above

Back 39

Activation of exposed sensory nerve fibers leading to acetylcholine release and cholinergic bronchoconstriction

Front 40

Anti-leukotrienes and antihistamines are both used as treatments for allergen-induced asthma. These compounds are best used
a) prophylactically to prevent allergen-mediated responses
b) in response to an acute asthmatic attack due to their fast action
c) in combination with anti-cholinergic agents
d) In combination with beta-adrenergic antagonists (beta-blockers)

Back 40

Prophylactically to prevent allergen-mediated responses

Front 41

Which statement accurately describes the mechanisms of action of corticosteroids?
a) Fast-acting anti-inflammatory due to increased calcium release stimulated in inflammatory cells, especially Mast cells
b) Bind selectively to epithelial cells leading to endogenous beta-agonist release
c) Slow-acting agents that influence protein expression by binding to nuclear receptors which then bind directly to specific DNA sequences
d) Fast-acting agents that increase chloride secretion across epithelial cells leading to improved airway clearance
e) Fast-acting agents that bind to membrane receptors and elevate Ca++

Back 41

Slow-acting agents that influence protein expression by binding to nuclear receptors which then bind directly to specific DNA sequences

Front 42

Which of the following drugs has an antihypertensive effect at low doses and an antidiuretic effect at high doses?
a) Bumetanide
b) Lisinopril
c) Spironolactone
d) Hydrochlorothiazide
e) Losartan

Back 42

Hydrochlorothiazide

Front 43

Leukotrienes are derived from arachidonic acid and are potent mediators of allergic asthmatic responses. Which of the following therapies would NOT ameliorate leukotriene effects?
a) Increased expression lipocortin-1 after corticosteroid treatment
b) Inhibition of cyclooxygenase activity by aspirin or ibuprofen leading to reduced prostaglandin synthesis
c) Inhibition of 5-lipoxygenase activity leading to reduced 5-HPETE formation
d) Receptor blockade using "lukast" drugs

Back 43

Inhibition of cyclooxygenase activity by aspirin or ibuprofen leading to reduced prostaglandin synthesis

Front 44

Which of the following is a concern with prolonged, repeated use of beta-receptor agonists for the treatment of acute asthmatic exacerbations?
a) Negative regulation of corticosteroid receptor function resulting in reduced steroid effectiveness
b) Secondary release of acetylcholine leading to cholinergic airway contraction
c) Increased mast cell recruitment leading to more severe allergic responses
d) Beta-receptor desensitization via beta-receptor kinase (betaARK) activation
e) None of the above

Back 44

Beta-receptor densensitization via beta-receptor kinase (betaARK) activation

Front 45

In the electrocardiogram, the QRS complex corresponds to approximately what part of the action potential?
a) Phase 0 to 1
b) Phase 1 to 2
c) Phase 2 to 3
d) Phase 3 to 4
e) Phase 4 to 0

Back 45

Phase 0 to 1

Front 46

While effective in the treatment of congestive heart failure, Beta adrenergic antagonists (beta blockers) can also used to treat arrhythmias because they
a) are excreted soley through the kidneys
b) have no effect on the A-V node
c) reduce ventricular response to atrial fibrillations
d) have no effect on mortality

Back 46

Reduce ventricular response to atrial fibrillations

Front 47

Cholestipol is used as an antihyperlipidemic agent because it
a) Inhibits HMG-CoA reductase
b) Acts to inhibit transcription of proteins involved in fatty acid metabolism
c) Inhibits lipolysis in adipose tissue
d) Removes bile acids from the GI tract
e) Directly inhibits cholesterol uptake by the liver

Back 47

Inhibits lipolysis in adipose tissue

Front 48

Which of the following drugs would likely be used to treat sinus tachycardia?
a) Atropine
b) Isoproterenol
c) Propranolol
d) Lidocaine
e) Verapramil

Back 48

Propranolol

Front 49

All of the following statements describe a known effect of corticosteroid treament Except?
a) Decreased recruitment of eosinophils
b) Increased expression of beta receptors on smooth muscle cells
c) Decreased cytokine expression from T-lymphocytes and macrophages
d) Reduced mucous secretion from glands
e) Increased mast cell recruitment and histamine release

Back 49

Increased mast cell recruitment and histamine release

Front 50

Which of the following sequences correctly describes the order of the conduction pathway for the cardiac action potential?
a) AV node - SA node - Internodal pathways - Purkinje fibers - Ventricular myocardium
b) AV node - SA node - Purkinje fibers - Internodal pathways - Ventricular myocardium
c) Internodal pathways - SA node - Purkinje fibers - AV node - Ventricular myocardium
d) Purkinje fibers - SA node - Internodal pathways - AV node - Ventricular myocardium
e) SA node - AV node - Internodal pathways - Purkinje fibers - Ventricular myocardium

Back 50

SA node - AV node - Internodal pathways - Purkinje fibers - Ventricular myocardium

Front 51

Diuretics such as furosemide are used to treat congestive heart failure because they?
a) Increase pulmonary congestion
b) Decrease plasma volume
c) Display and afterload effect
d) Increase oxygen demand

Back 51

Decrease plasma volume

Front 52

Which effect Best describes the mechanism of action of digoxin, a digitalis glycoside used in treatment of congestive heart failure?
a) Decrease systolic force of contraction
b) Activates Na+ K+ exchange in cardiac muscle
c) Decreases the influx of Ca++
d) Increases cardiac output

Back 52

Increases Cardiac Output
due to inhibition of Na+/K+ ATPase pump

Front 53

Angiotesin converting enzyme (ACE) inhibitors such as Captopril are effective in the treatment of congestive heart failure because they are
a) afterload reducing agents
b) preload reducing agents
c) direct vasoconstrictors
d) direct vasodilators
e) effective in increasing sodium and water retention

Back 53

Afterload reducing agents

Front 54

Which of the following is a beta-adrenergic antagonist (beta-blocker) used in the treatment of congestive heart failure?
a) Lidocaine
b) Propranolol
c) Verapamil
d) Enalapril
e) Digoxin

Back 54

Propranolol

Front 55

Which of the following reasons Best explains why lidocaine can be used to treat arrhythmias?
a) Ineffective against atrial flutters and atrial fibrillations
b) Blocks activated Na+ channels
c) Increases conduction velocity
d) Increases phase 4 depolarization
e) Blocks closed K+ channels

Back 55

Blocks activated Na+ channels