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Pharmacology 350
Section 001
Exam II, 5 April 2007
- Use only a number 2 pencil to mark the machine scored answer sheet.
- Remember to enter your name and ID# on the answer sheet and accurately encode machine read spaces with this information. Sign your name in the box provided.
- There are 65 questions. Make sure that you have all the pages of the exam. Answer all questions: there are no deductions for incorrect answers. Each correct answer is worth one point. Total points available from this exam: 65.
- When you are finished, turn in your answer sheet, delete your name from the attendance sheet and leave the room quietly. You may keep the question paper.
- Concerns regarding individual questions should be e-mailed to Dr Cobbett by 3.00pm Friday 6 April 2007. Make it clear to which exam you are referring.
This is exam A.
For each of the following multiple choice questions, choose the single most appropriate answer.
B1. A drug which has anti-inflammatory effects and is effective in treatment of asthma because it is an antagonist at leukotriene receptors
A. Prednisone B. Montelukast C. Aspirin D. Zileuton E. A and C above.
D2. 5-Fluorouracil (ADRUCIL):
A. Induces rapid replication of cells B. Reduces cytosine incorporation into DNA C. Directly inhibits protein synthesis D. Inhibits synthesis of thymidine necessary for DNA production E. A and C.
C3. In congestive heart failure, the prime objective of drug therapy is:
A. To address the imbalance of oxygen use by the heart (muscle) and of oxygen supply to the heart (muscle) B. To reduce blood volume C. To improve the ability of the heart to supply sufficient blood (and oxygen) to all organs and tissues of the body D. To increase work done by (and oxygen use of) the heart muscle E. To reduce sympathetic input to the heart.
E4. Cortisone:
A. Acts as an immune system suppressant B. Reduces lipolytic activity in adipose tissue C. Enhances the ability of epinephrine to induce hyperglycemia D. Maintains bone mass E. A and C, above.
E5. Ezetimibe (ZETIA):
A. Reduces plasma low density lipoprotein (LDL) concentration by inhibition of uptake of cholesterol from the gastrointestinal tract B. Reduces blood pressure by inducing vasodilation C. Reduces formation of atherosclerotic plaques by reducing plasma LDL concentration D. Reduces plasma low density lipoprotein (LDL) concentration by inhibition of HMG Reductase E. A and C, above.
For each of the following multiple choice questions, choose the single most appropriate answer.
E11. Thiazide diuretics:
A. Are potassium wasting diuretics B. Act in a manner dependent on plasma pH C. Are used in the management of hypertension D. Are aldosterone receptor antagonists E. A and C, above.
B12. Which of the following cancer chemotherapeutic drugs acts by inhibiting tyrosine kinase.
A. Vincristine B. Erlotinib C. Vinblastine D. Methotrexate E. A and C, above.
A13. An antihypertensive which is an α 2 adrenreceptor agonist:
A. Clonidine B. Diltiazem C. Captopril D. Reserpine E. Minoxidil.
A14. Carbonic anhydrase inhibitors may be used to:
A. Increase the rate of excretion of acidic drugs such as aspirin B. Decrease urine pH to reduce the rate of excretion of acidic drugs such as aspirin C. Increase urine production tenfold over normal D. Increase blood pressure by reducing urine output. E. A and C, above.
D15. Which of the following is a cancer chemotherapeutic drug and is an antibody?.
A. Cyclophosphamide B. Cisplatin C. Carmustine D. Rituximib E. A and C, above.
For each of the following multiple choice questions, choose the single most appropriate answer.
E16. Levonorgestrel:
A. Inhibits ovulation through actions in the pituitary B. Mimics estradiol C. Is an agonist at progesterone receptors D. Has different side effects when used as a contraceptive pill than when used as a contraceptive patch E. A and C above.
D17. Cisplatin (PLATINOL) is used in cancer chemotherapy. Cisplatin:
A. Prevents separation of chromosomes during mitosis B. Is an estrogen receptor antagonist C. Causes neuropathy as a major side effect D. Inhibits DNA synthesis E. A and C, above.
E18. Carvedilol is effective as an antihypertensive because it:
A. Binds β 1 adrenoreceptors in the heart and thus blocks the sympathetic tone to the heart B. Reduces stores of norepinephrine and therefore reduces sympathetic tone to the heart and blood vessels C. Binds α 1 adrenoreceptors in the vasculature producing vasodilation D. Activates muscarinic cholinergic receptors in the heart and thus reduces cardiac output E. A and C, above.
E19. As an antiinflammatory agent, prednisone:
A. Reduces activity of phospholipase A 2 B. Increases permeability of capillary blood vessels at the site of inflammation C. Reduces the production of prostaglandins and leukotrienes D. Increases production of prostaglandin at sites of inflammation E A and C above.
D20. Statin drugs such as atorvastatin (LIPITOR):
A. Reduce plasma low density lipoprotein (LDL) concentration by inhibition of uptake of cholesterol from the gastrointestinal tract B. Reduce blood pressure by inducing vasodilation C. Increase formation of atherosclerotic plaques by reducing plasma LDL concentration D. Reduce plasma low density lipoprotein (LDL) concentration by inhibition of hepatic HMG Reductase E. A and C, above.
For each of the following multiple choice questions, choose the single most appropriate answer.
E26. Cushingoid signs are:
A. Caused by excessive glucocorticoid concentration in the plasma B. Characterized by a lack of development of the secondary sex organs at puberty C. A sign of hormone imbalance the opposite to that of Addison’s disease D. Can be the result of the inability of certain cells in the anterior pituitary gland to secrete adrenocorticotrophic hormone (ACTH) E. A and C, above.
A27. 6-Mercaptopurine (MERCAPTOPURINE):
A. Is a substitute for guanine in synthesis of DNA used as a therapeutic agent in cancer treatment B. Is an antiinflammatory agent C. Is an alkylating agent used as a therapeutic agent in cancer treatment D. Activates bone marrow (i.e. is hemopoietic or hematopoietic) E. A and C.
D28. Progesterone:
A. Is secreted by cells of the anterior pituitary gland B. Is secreted in response to estrogen and progesterone from the ovary C. Is secreted in response to gonadotrophin releasing hormone from the hypothalamus D. Is blocked pharmacologically by mifepristone E. A and C, above.
B29. Individuals with Type I or Juvenile-onset diabetes:
A. Have chronically low plasma glucose concentration when untreated B. Can be treated with insulin administered by injection C. Is treated successfully with rosiglitazone (AVANDIA) D. Are hyperglycemic primarily because they are “insulin resistant” E. A and C, above.
A30. Levothyroxine, aka T4, (SYNTHROID):
A. Is converted to triiodothyronine in the blood B. Is used to treat individuals with Type I diabetes C. In chronic excess, produces heat intolerance D. Increases TSH secretion from the anterior pituitary gland E. A and C, above.
For the following questions, select the most appropriate answer
Select (A) if 1, 2 and 3 are correct Select (B) if 1 and 3 (but not 2 and 4) are correct Select (C) if 2 and 4 (but not 1 and 3) are correct Select (D) if only 4 is correct Select (E) if 1, 2, 3 and 4 are correct
A31. Acetaminophen:
- Has a metabolite which produces hepatic toxicity
- Toxicity is increased in individuals who drink sufficient ethanol to induce the liver enzyme which metabolizes acetaminophen
- Is a therapeutically useful, antipyretic agent
- Prolongs bleeding time in a manner and amount similar to aspirin.
B32. Triamterene (DYRENIUM):
- Is a potassium sparing diuretic
- Is an aldosterone receptor antagonist
- Blocks pores in the membrane of cells of the collecting ducts and consequently prevents water reabsorption from the lumen of the renal tubule into the cytoplasm of cells lining the tubule
- Is a cancer chemotherapeutic agent.
E33. Congestive heart failure is characterized by:
- Decreased slope of the relation between cardiac output and end diastolic pressure (i.e. preload) - compared to normal individuals
- Congestion in capillary beds
- Edema
- Dyspnea.
B34. Individuals with hyperthyroidism are:
- Treated with radioactive iodine
- Cold intolerant
- Treated with methimazole (TAPAZOLE)
- Treated with cortisol (CORTEF).
B35. Dexamethasone may be useful to treat:
- Rheumatoid arthritis
- Hypertension
- Adrenocortical insufficiency
- Osteoporosis.
For each of the following questions, select the most appropriate answer
Select (A) if 1, 2 and 3 are correct Select (B) if 1 and 3 (but not 2 and 4) are correct Select (C) if 2 and 4 (but not 1 and 3) are correct Select (D) if only 4 is correct Select (E) if 1, 2, 3 and 4 are correct
D41. Captopril (CAPTOTEN) is used as an antihypertensive agent because captopril:
- Reduces (central nervous system originating) drive of the sympathetic nervous system
- Is a pharmacological antagonist at receptors for angiotensin II
- Acts in the heart to reduce cardiac output
- Reduces synthesis of angiotensin II.
B42. Ethinyl estradiol:
- Is used in “daily pill” oral contraceptives
- Like any estrogen, induces bone loss and development of osteoporosis
- Is used in “emergency, day after” oral contraceptives
- Has the same mechanism as mifepristone (RU486).
D43. Insulin:
- Increases plasma glucose concentration
- Increases the concentration of plasma free fatty acids
- Is normally secreted by α cells of the pancreas
- Induces uptake of glucose into skeletal muscle fibers.
A44. A diuretic is useful in the treatment of hypertension because:
- Diuresis reduces edema
- Diuresis reduces blood volume
- Diuresis decreases afterload on the heart
- Diuresis increases urine volume.
A45. Which are the following statements are correct?
- Aspirin should not be used in children with chickenpox or other viral infections
- Aspirin increases bleeding time
- Selective COX-2 inhibitors have a lower tendency to cause gastrointestinal ulcers than non selective COX inhibitors
- Aspirin and indomethacin relieve fever by increasing prostaglandin synthesis in the hypothalamus.
For each of the following multiple choice questions, choose the single most appropriate answer.
B46. Ethacrynic acid (EDECRIN):
- Is a high ceiling diuretic
- Decreases urine acidity
- Causes ototoxicity
- Is a cancer chemotherapeutic agent.
E47. Estrogens:
A. Can either inhibit or stimulate cell proliferation in estrogen-sensitive tumors B. Increase bleeding time by reducing formation of clotting factors C. Are used to minimize bone loss in postmenopausal women D. Inhibit uterine muscle contraction E. A and C, above
A48. Digoxin:
A. Increases contractility of the myocardium B. Decreases the slope of the relation between cardiac output and ventricular end diastolic pressure C. Activates Na/K ATPase of cell membranes in the heart D. Decreases the intracellular concentration of calcium in myocardial cells E. A and C, above.
E49. Lidocaine (XYLOCAINE):
A. Is used to treat ventricular arrhythmias B. Blocks K channels in the heart C. Reduces (abnormal damage-induced) automaticity in ventricular tissue D. Is used to treat angina E. A and C, above.
D50. Indomethacin (INDOCIN) is used to treat:
A. Cancer B. Infertility C. Addison’s disease D. Patent ductus arteriosus E. A and C.
For the following questions, select the most appropriate answer
Select (A) if 1, 2 and 3 are correct Select (B) if 1 and 3 (but not 2 and 4) are correct Select (C) if 2 and 4 (but not 1 and 3) are correct Select (D) if only 4 is correct Select (E) if 1, 2, 3 and 4 are correct
D56. A drug which has anti-inflammatory effects and is effective in treatment of asthma because it is an antagonist at leukotriene receptors
- Prednisone
- Zileuton
- Aspirin
- Montelukast.
D57. Clomiphene:
- Is used as an daily oral contraceptive pill
- Is an antagonist at progesterone receptors
- Is used to induce a “medicinal abortion”
- Is used to treat certain types of reproductive infertility in women.
D58. Tamoxifen:
- Is an alkylating agent used in cancer chemotherapy
- Is used to treat hyperthyroidism
- Is an agonist at some estrogen receptors but has no therapeutic benefit as a result of this action
- Is an antagonist at some estrogen receptors and is used in treatment of breast cancer.
D59. The common problem with the use of either prazosin (MINIPRESS) or hydralazine (APRESOLINE) as the only agent to treat hypertension is that:
- Renal artery dilation and diuresis is induced
- The renin-angiotensin system (RAS) is inhibited
- Norepinephrine stores in the sympathetic nervous system are depleted by these drugs
- Reflex tachycardia may be induced.
For the following questions, select the most appropriate answer
Select (A) if 1, 2 and 3 (but not 4) are correct Select (B) if 1 and 3 (but not 2 and 4) are correct Select (C) if 2 and 4 (but not 1 and 3) are correct Select (D) if only 4 is correct Select (E) if 1, 2, 3 and 4 are correct
C61. Amrinone (INOCOR):
- Increases the refractory period in ventricular muscle
- Causes elevation of cAMP concentration in ventricular muscle by inhibiting phosphodiesterase
- Is used to treat ventricular tachycardia/fibrillation
- Is used in the treatment of congestive heart failure.
C62. Metformin (GLUCOPHAGE):
- Activates insulin receptors
- Is an antihyperglycemic agent
- Is a hypoglycemic agent
- Decreases glucose absorption from the gastrointestinal tract.
D63. Reserpine:
- Inhibits DNA synthesis
- Alkylates DNA
- Inhibits production of norepinephrine in noradrenergic neurons
- Reduces storage of norepinephrine in noradrenergic neurons.
A64. Isosorbide dinitrate (ISORDIL):
- Increases coronary blood flow
- Acts as a source for nitric oxide
- Is used, by sublingual administration, in treatment of an ongoing anginal episode
- Is used as an antihypertensive drug because it induces diuresis by inhibiting renal carbonic anhydrase.
C65. Side effects of use of propranolol (INDERAL) in treatment of cardiovascular disorders:
- Are also produced by atenolol (TENORMIN)
- Include constriction of coronary arteries
- Include dilation of bronchioles
- Include constriction of bronchioles.
