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Exam III practice quiz

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Diana Flores
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Pharm II Exam III practice quiz

Pharm II Exam III practice quiz

Question 1 of 144

1

Which of the following is NOT a cardinal sign of inflammation?

Select one of the following:

  • Rubor

  • Tumor

  • Functio Laesa

  • Crepitus

Explanation

Question 2 of 144

1

Inflammation ends with permanent destruction of tissue or with complete healing after removal of injurious stimulus

Select one of the following:

  • True
  • False

Explanation

Question 3 of 144

1

Chronic inflammation is beneficial

Select one of the following:

  • True
  • False

Explanation

Question 4 of 144

1

Cell damage results in the release of

Select one of the following:

  • Prostaglandins

  • Prostacyclines

  • Eiocosanoids

  • All of the above

Explanation

Question 5 of 144

1

A fundamental feature of inflammation is

Select one of the following:

  • Increase permeability of the microvasculature

  • Suppression of leukocytes

  • Relief of symptoms

  • Impaired quality of life

Explanation

Question 6 of 144

1

Which of the following is NOT a goal of treatment of inflammation?

Select one of the following:

  • Relief of symptoms

  • Maintenance of function

  • Slowing tissue damage

  • Short term control

Explanation

Question 7 of 144

1

Which of the following is NOT considered a drug treatment of arthritis?

Select one of the following:

  • NSAIDS

  • Corticosteroids

  • DMARDS

  • Naltrexone

Explanation

Question 8 of 144

1

Which of the following is true about NSAIDS?

Select one of the following:

  • Increases the inflammatory pain response

  • COX-2 inhibitors can decrease the chance of cardiovascular effects

  • COX-2 inhibitors are found to cause Upper GI complications as well as lower GI complications

  • COX-2 selective drugs inhibit PG synthesis through selective inhibition of COX-2 isoenzyme

Explanation

Question 9 of 144

1

Which of the following is best against release of arachidonic acid?

Select one of the following:

  • ASA

  • Indomethacin

  • Corticosteroids

  • Acetominophen

Explanation

Question 10 of 144

1

Which of the following is NOT a physiologic effect of COX-1?

Select one of the following:

  • Production of TXA2

  • Regulate renal blood flow

  • Maintain mucosal integrity

  • Induce inflammation and pain

Explanation

Question 11 of 144

1

Choose ALL of the following that can be seen in OA

Select one or more of the following:

  • Bone loss

  • Thickened synovial membrane

  • Eroded cartilage

  • Bone spurs

  • Synovial changes

  • Degenerated cartilage

Explanation

Question 12 of 144

1

Which best describes Osteoarthritis?

Select one of the following:

  • Causes systemic symptoms

  • Radiographic findings of narrowed joint space and lipping of marginal bone

  • The least common form of joint disease

  • Can be diagnosed with laboratory findings

Explanation

Question 13 of 144

1

Prevalence of OA increased due to aging population and obesity

Select one of the following:

  • True
  • False

Explanation

Question 14 of 144

1

Which of the following is NOT a radiographic finding of OA?

Select one of the following:

  • Heberden nodes

  • Bouchard nodes

  • Thinning subchondral bone

  • Hypertrophy of bone at articular margins

Explanation

Question 15 of 144

1

OA is overtreated

Select one of the following:

  • True
  • False

Explanation

Question 16 of 144

1

Which of the following would NOT be effective to treat nociceptive and inflammatory pain syndromes?

Select one of the following:

  • NSAIDS

  • COX-2 selective inhibitors

  • Acetominophen

  • SNRIs

Explanation

Question 17 of 144

1

Which of the following would NOT be effective in treating neuropathic and functional pain syndromes?

Select one of the following:

  • Gabapentin

  • Amytriptyline

  • Venlafaxine (SNRI)

  • Opioids

Explanation

Question 18 of 144

1

Nociceptive and inflammatory pain are both adaptive (protective)

Select one of the following:

  • True
  • False

Explanation

Question 19 of 144

1

OA pain mechanisms are unknown

Select one of the following:

  • True
  • False

Explanation

Question 20 of 144

1

Which of the following is NOT a method of pain management in OA?

Select one of the following:

  • Intraarticular injections

  • Topical agents

  • Patient education

  • DMARDS

Explanation

Question 21 of 144

1

Which of the following is TRUE regarding acetominophen?

Select one of the following:

  • It has potenet anti-inflammatory activity

  • It acts as a prodrug, activating CB1 receptors in the CNS

  • The recommended daily max dose for alcoholics is 4g

  • It decreases risk of bleeding

Explanation

Question 22 of 144

1

95% of Acetaminophen is conjugated into NAPQ1, a toxic metabolite

Select one of the following:

  • True
  • False

Explanation

Question 23 of 144

1

Why does chronic ingestion of ethanol increase risk of hepatotoxicity?

Select one of the following:

  • Because ethanol induces the CYP2E1 enzymes

  • Because ethanol decreases the amount of glutathione, therefore there isn't enough to convert NAPQ1 into an inactive mtabolite

  • Because ethanol inhibits the CYP2E1enzyme

  • Because it inhibits conjugation of acetominophen

Explanation

Question 24 of 144

1

Why is acetylcysteine used as an antidote for acetaminophen toxicity?

Select one of the following:

  • It acts as a precursor for glutathione

  • It is an expectorant, thus it expectorates acetominophen from the body

  • It inhibits the CYP2E1 enzymes

  • It induces the CYP2E1 enzyme

Explanation

Question 25 of 144

1

How do NSAIDs block the COX protein?

Select one of the following:

  • They block the hydrophobic channel of the COX protein where arachidonic acid binds

  • They block the production of arachidonic acid

  • They bind to Phospholipid A2

  • They bind to the COX protein, which causes inactivation of the enzyme

Explanation

Question 26 of 144

1

Which of the following is NOT possible from the use of NSAIDs?

Select one of the following:

  • Dyspepsia

  • Gastropathology

  • Decrease renal blood flow resulting in renal ischemia

  • Thrombosis

Explanation

Question 27 of 144

1

Which of the following is true regarding -oxicam like drugs

Select one of the following:

  • It is a selective COX inhibitor

  • They inhibit collagenase and proteoglycanase

  • It has a short half-life and therefore requires multiple doses daily

  • Low percentage of patients report adverse effects

Explanation

Question 28 of 144

1

Which of the following is a possible side effect of -oxicam like drugs when taken for a long period of time?

Select one of the following:

  • Tinnitus

  • Thrombosis

  • CNS effects

  • Blurred vision

Explanation

Question 29 of 144

1

Fenamate derivatves are used for severe dysmenorrhea

Select one of the following:

  • True
  • False

Explanation

Question 30 of 144

1

Which of the following is NOT true regarding Indomethicin?

Select one of the following:

  • Used for spondylitis

  • It is an acetic acid derivative

  • Promotes closure of PDA

  • Used when ibuprofen is ineffective or not tolerated

Explanation

Question 31 of 144

1

Which of the following best describes the mechanism of Indomethacin?

Select one of the following:

  • Promotes the incorporation of arachidonic acid into triglycerides, thus reducing its availability for COX

  • Inhibits collagenase and proteoglycanase

  • Block the COX-2 enzyme ONLY

  • It is a folic acid analogue

Explanation

Question 32 of 144

1

Which of the following is true regarding ASA?

Select one of the following:

  • Decreases the duration of pregnancy

  • Used in treat fetal PDA

  • Reversibly binds to platelets so prolongs bleeding for one day

  • Can cause bronchoconstriction in ASA-sensitive asthmatics

Explanation

Question 33 of 144

1

Reye's syndrome develops in children who suffer a bacterial infection

Select one of the following:

  • True
  • False

Explanation

Question 34 of 144

1

Mr. Smith is a 70 year old male with history of inflammatory GI and gastric ulcers. You would like to prescribe NSAIDs to treat his OA. Which of the following drugs could you also co-prescribe to avoid worsening his other pre-existing conditions?

Select one of the following:

  • Cytotec

  • ASA

  • Sulindac

  • Naproxen

Explanation

Question 35 of 144

1

What advantage does Sulindac have over any other NSAID?

Select one of the following:

  • It causes less renal toxicity

  • It is a synthetic prostaglandin E1 analogue

  • It has no significant effect on bleeding time because it is a Cox-2 inhibitor

  • It decreases gastric irritation

Explanation

Question 36 of 144

1

Long-term NSAID analgesic medication is perfectly acceptable in patients with history of CV disease

Select one of the following:

  • True
  • False

Explanation

Question 37 of 144

1

Which of the following drugs is MOST appropriate for a nursing mother?

Select one of the following:

  • ASA

  • Ibuprofen

  • Celecoxib

  • Ketorolac

Explanation

Question 38 of 144

1

Why does ASA interact with antihypertensives?

Select one of the following:

  • Because antihypertensives depend on renal PG to work

  • Because it can cause prolonged bleeding

  • Because ASA prevents excretion of antihypertensives

  • Because antihypertensives increase plasma levels of ASA

Explanation

Question 39 of 144

1

Why should you not use SSRIs in combination with NSAIDs?

Select one of the following:

  • Because they can increase the risk of upper GI bleed

  • Because they cause more CNS effects

  • Because together can cause increase in hypersensitivity reactions

  • Because together they can worsen bronchoconstrition

Explanation

Question 40 of 144

1

The use of anticoagulants and ________ has caused reported fatal hemorrhages

Select one of the following:

  • ASA

  • NSAIDS

  • Acetominophen

  • Both A and B

Explanation

Question 41 of 144

1

Choose ALL of the following drugs whose renal clearance is reduced due to use of ASAs and NSAIDS

Select one or more of the following:

  • Digoxin

  • Methotrexate

  • Anticoagulants

  • Ethanol

Explanation

Question 42 of 144

1

High ASA dose can inhibit the metabolism of which drug?

Select one of the following:

  • Valproic acid

  • Methotrexate

  • Digoxin

  • Cyclosporine

Explanation

Question 43 of 144

1

Which of the following drugs should be avoided in patients with sulfa allergy (according to Foong, not Chand)?

Select one of the following:

  • Celecoxib

  • Sulfasalazine

  • Sulfinpyrazone

  • Cyclosporine

Explanation

Question 44 of 144

1

Celecoxib is metabolized by CYP 2D6

Select one of the following:

  • True
  • False

Explanation

Question 45 of 144

1

Which of the following drugs does NOT interact with COX-2 inhibitors?

Select one of the following:

  • ACE inhibitors

  • Fluconazole

  • Rifampin

  • Valproic acid

Explanation

Question 46 of 144

1

Which of the following is NOT an adverse effect of COX-2 inhibitors?

Select one of the following:

  • Bleeding time

  • Gastric disorder

  • Bronchoconstriction

  • Cardiovascular toxicity

Explanation

Question 47 of 144

1

Celecoxib and Ibuprofen are overall similar, except for cost, GI effects, and bleeding time effects

Select one of the following:

  • True
  • False

Explanation

Question 48 of 144

1

High carb diet can decrease absorption of acetominophen

Select one of the following:

  • True
  • False

Explanation

Question 49 of 144

1

SSRIs are more effective than TCAs as adjuvant analgesics

Select one of the following:

  • True
  • False

Explanation

Question 50 of 144

1

How can you delay absorption of ASA?

Select one of the following:

  • Increase pH

  • Food

  • Decrease pH

  • A and B

Explanation

Question 51 of 144

1

Under normal conditions, which of the following prevents platelet aggregation?

Select one of the following:

  • PG12

  • PGE2

  • TXA2

  • Both A and B

Explanation

Question 52 of 144

1

Phospholipase A2 is activated by which of the following?

Select one of the following:

  • Cytokines

  • Growth factors

  • LPS

  • All of the above

Explanation

Question 53 of 144

1

Which of the following medications can lower the seizure threshold?

Select one of the following:

  • Tramadol

  • Morphine

  • Codeine

  • Vicodin

Explanation

Question 54 of 144

1

Which of the following is NOT a substrate of CYP2D6?

Select one of the following:

  • Codeine

  • Tramadol

  • Oxycodone

  • Celecoxib

Explanation

Question 55 of 144

1

Which of the following is NOT a clinical use of Naltrexone?

Select one of the following:

  • Opioid overdose

  • Treatment of alcohol dependence

  • Prevent opioid addiction

  • Analgesia during the induction and maintenance of general anesthesia

Explanation

Question 56 of 144

1

Which of the following is NOT true regarding tramadol?

Select one of the following:

  • Its active metabolite has a greater affinity for mu receptors than codeine

  • Inhibits reuptake of NE and 5HT

  • Suppresses cough reflex

  • Has a quick onset of action

Explanation

Question 57 of 144

1

Which of the following is NOT true regarding opioids with mixed mechanisms?

Select one of the following:

  • Large doses can cause anxiety and dysphoria

  • They may antagonize action of opioids

  • Respiratory depression has a ceiling effect

  • Has full agonist effect at mu receptors, thus increasing addiction liability

Explanation

Question 58 of 144

1

Which of the following is NOT an indication for use of opioids with mixed mechanisms?

Select one of the following:

  • Obstetric analgesia during labor and delivery

  • Pre and post operative analgesia

  • Orally for mild pain

  • These are all indications

Explanation

Question 59 of 144

1

OA primarily attacks the joints but also skn, lungs, vessels and muscles

Select one of the following:

  • True
  • False

Explanation

Question 60 of 144

1

Rheumatoid arthritis, along with bacterial endocarditis and SLE, is found to have elevated levels of autoantibodies against

Select one of the following:

  • Rheumatoid factor

  • IgG

  • IgA

  • None of the above

Explanation

Question 61 of 144

1

Rheumatoid can occur at any age

Select one of the following:

  • True
  • False

Explanation

Question 62 of 144

1

Which of the following is NOT a goal of treating RA

Select one of the following:

  • Active patient and family participation

  • Preservation of function

  • Prevent deformity

  • These are all objectives

Explanation

Question 63 of 144

1

Successful treatment of RA is seen with when ________ are started immediately

Select one of the following:

  • Biological DMARDs

  • Non-biological DMARDs

  • Acetominophen

  • NSAIDs

Explanation

Question 64 of 144

1

What is the role of glucocorticoids in RA

Select one of the following:

  • Slow bone erosion and prevent new bone erosion

  • Reverse bone erosion

  • Prevent secondary fungal infection

  • Increase blood sugar

Explanation

Question 65 of 144

1

Newer biologic DMARDs are known to

Select one of the following:

  • Mask serious infections (bacterial or fungal)

  • Cause leukopenia

  • Cause thrombocytopenia

  • All of the above

Explanation

Question 66 of 144

1

Which of the following DMARDs is a folic acid analogue that may also increase adenosine levels?

Select one of the following:

  • Methotrexate

  • Leflunomide

  • Hydroxychloroquine

  • Penicillamine

Explanation

Question 67 of 144

1

Which of the following drugs requires monthly monitoring of CBC, liver, and renal function

Select one of the following:

  • Methotrexate

  • Leflunomide

  • Gold

  • Minocycline

Explanation

Question 68 of 144

1

Use of methotrexate increases risk of hepatotoxicity with fibrosis and cirrhosis

Select one of the following:

  • True
  • False

Explanation

Question 69 of 144

1

Which of the following DMARDs blocks synthesis of UMP, thus reducing B and T cell populations?

Select one of the following:

  • Methotrexate

  • Leflunomide

  • Minocycline

  • Hydroxychloroquine

Explanation

Question 70 of 144

1

Leflunomide is currently used for

Select one of the following:

  • RA

  • SLE

  • Myasthenia gravis

  • All of the above

Explanation

Question 71 of 144

1

Cholestyramine can be given to clear hydroxychloroquine from the system quickly

Select one of the following:

  • True
  • False

Explanation

Question 72 of 144

1

How does Hydroxychloroquine work against RA?

Select one of the following:

  • Inhibits chemotaxis of eosinophils and neutrophils

  • It is a pyrimidine synthesis inhibitor

  • It inhibits macrophages responsible for inflammation

  • It inhibits matrix metalloproteinase

Explanation

Question 73 of 144

1

Which drug causes the least toxicity?

Select one of the following:

  • Hydroxychloroquine

  • Methotrexate

  • Leflunomide

  • TNF inhibitors

Explanation

Question 74 of 144

1

Which of the following is NOT an adverse effect of hydroxychloroquine?

Select one of the following:

  • Pigmentary retinitis

  • Irreversible myopathies

  • Photophobia

  • Visual loss

Explanation

Question 75 of 144

1

Which of the following is a mechanism of Minocycline

Select one of the following:

  • Matrixmetalloproteinase inhibitor

  • Inhibits inflammatory cell migration and transformation of lymphocytes

  • Both A and B

  • None of the above

Explanation

Question 76 of 144

1

Which of the following is NOT true regarding Chrysotherapy?

Select one of the following:

  • It is erratically absorbed orally

  • It acts by inhibition of macrophages responsible for inflammation

  • It is excreted through the kidneys

  • The intravenous route is preferred

Explanation

Question 77 of 144

1

Which of the following is true regarding the use of cyclophosphamide in the use of RA?

Select one of the following:

  • Increases bone erosion

  • It is used to reverse the progression of RA

  • It s used in patients where other anti-inflammatory drugs have been successful

  • Causes hematuria

Explanation

Question 78 of 144

1

Each of the following is a mechanism of penicillamine except

Select one of the following:

  • Reduces numbers of T-lymphocytes

  • Decreases IL-1 and rheumatoid factor

  • Prevents collagen from cross-linking

  • Inhibits inflammatory cell migration

Explanation

Question 79 of 144

1

Monitoring the CBC and liver enzymes is necessary when taking which drug?

Select one of the following:

  • Leflunomide

  • Gold

  • Penicillamine

  • None of the above

Explanation

Question 80 of 144

1

Which of the following is NOT a common side effect of penicillamine?

Select one of the following:

  • Bone marrow suppression

  • Dysgeusia

  • Anorexia

  • Dizziness

Explanation

Question 81 of 144

1

Which of the following is NOT a disadvantage when using biological DMARDs?

Select one of the following:

  • They are very expensive

  • They increase risk of bcterial infections

  • Demyelination can occur

  • These are all disadvantages of biological DMARDs

Explanation

Question 82 of 144

1

Biological DMARDs are not recommended until at least one non-biological DMARD has been administered without sufficient success

Select one of the following:

  • True
  • False

Explanation

Question 83 of 144

1

Which of the following is FALSE regarding TNF inhibitors such as Entanercept?

Select one of the following:

  • They inhibit cytokines, thus preventing PG production and up-regulation of COX-2

  • They decrease joint destruction

  • They are also used for Crohn's disease

  • They prevent latent infections such as fungal or tuberculoid

Explanation

Question 84 of 144

1

Which of the following is true regarding rituximab?

Select one of the following:

  • Not used with methotrexate

  • Rash occurs in 30% of patients

  • No cardiovascular effects

  • It is a T-cell activation inhibitor

Explanation

Question 85 of 144

1

Rituximab depletes B lymphocytes by apoptosis

Select one of the following:

  • True
  • False

Explanation

Question 86 of 144

1

Which of the following best describes the mechanism of abatacept?

Select one of the following:

  • Prevents T-cell activation by complexing with 'co-stimulatory' molecules

  • Inhibits cytokines such as TNF alpha/IL-1 thus preventing PG production

  • Targets CD20 and depletes T lymphocytes

  • All of the above

Explanation

Question 87 of 144

1

Abatacept cannot be used as monotherapy but can be used combination with other DMARDS

Select one of the following:

  • True
  • False

Explanation

Question 88 of 144

1

Which of the following is best described as "unique" and caused by deposition of urate crystals in joints

Select one of the following:

  • Gout

  • Rheumatoid

  • Osteoartritis

  • Kidney stones

Explanation

Question 89 of 144

1

Which of the following is NOT one of the four stages of gout?

Select one of the following:

  • Tophi

  • Asymptomatic hyperuricemic

  • Intercritical

  • These are all stages of gout

Explanation

Question 90 of 144

1

Which of the following would not be used for gout

Select one of the following:

  • NSAIDs

  • Colchine

  • Allopurinol

  • Rituximab

Explanation

Question 91 of 144

1

Colchicine can be used in low doses as prophylaxis for acute attacks of gout

Select one of the following:

  • True
  • False

Explanation

Question 92 of 144

1

Colchicine can be taken continuously at high doses

Select one of the following:

  • True
  • False

Explanation

Question 93 of 144

1

Colchicine limits the inflammatory response by which of the following mechanisms?

Select one of the following:

  • Decreasing motility of neutrophils

  • Deactivating URAT 1 transporter

  • Inhibit cytokines such as TNF alpha/IL-1 thus preventing PG production and up-regulation of COX-2

  • All of the above

Explanation

Question 94 of 144

1

Which drug shares the same mechanism as Allopurinol?

Select one of the following:

  • Febuxostate

  • Cochicine

  • Methotrexate

  • Probenecid

Explanation

Question 95 of 144

1

Why can't allopurinol be used for monotherapy?

Select one of the following:

  • Because it does not have any anti-inflammatory effects

  • Because it has no uric acid prevention mechanism

  • Because allopurinol only works in the presence of colchicine

  • Because it only works in the presence of NSAIDs

Explanation

Question 96 of 144

1

Which of the following is NOT an adverse effect of Allopurinol?

Select one of the following:

  • Steven Johnson rash

  • Hepatic necrosis

  • Vomiting

  • Renal stones

Explanation

Question 97 of 144

1

Which of the following is NOT true regarding Probenecid

Select one of the following:

  • It deactivates the URAT 1 transporter, thus preveting reabsorption of urate

  • Can cause renal stones

  • Used for treatment of chronic hyperuricemia

  • Makes uric acid levels fall which causes more crystal deposition in the synovium

Explanation

Question 98 of 144

1

Febuxostat requires dose adjustment during renal insufficiency

Select one of the following:

  • True
  • False

Explanation

Question 99 of 144

1

Which of the following gout medications could also be useful in a patient with hypertension

Select one of the following:

  • Losartan

  • Sulfinpyrazone

  • Glucocorticoids

  • Febuxostate

Explanation

Question 100 of 144

1

Which of the following has a similar mechanism to Probenecid but should be used with caution in patients taking anticoagulants?

Select one of the following:

  • Losartan

  • Sulfinpyrazone

  • Glucocorticoids

  • None of the above

Explanation

Question 101 of 144

1

Which of the following is NOT true regarding SLE?

Select one of the following:

  • Can be cause by environmental factors

  • Increased IgA production

  • Failure to remove immune complexes from circulation can lead to vasculitis and disease

  • There is impaired T cell regulation

Explanation

Question 102 of 144

1

There is a prevalence of SLE in women. One possible reason for this is because

Select one of the following:

  • Calcium is a B-cell stimulator

  • IL-10 is a B-cell stimulator

  • Estrogen is a B-cell stimulator

  • Prolactin is a B-cell stimulator

Explanation

Question 103 of 144

1

Increased levels of erythrocyte sedimentation rate is specific to SLE

Select one of the following:

  • True
  • False

Explanation

Question 104 of 144

1

For treatment of SLE, we should NOT use drugs with

Select one of the following:

  • the least side effects

  • the lowerst dose to control disease

  • long term damage prevention

  • steroids in mild disease

Explanation

Question 105 of 144

1

Corticosteroids can cause muscle wasting

Select one of the following:

  • True
  • False

Explanation

Question 106 of 144

1

What is a concern with abruptly withdrawing corticosteroids?

Select one of the following:

  • Possible adrenal insufficiency

  • Infection

  • Retinitis

  • Immunosuppresion

Explanation

Question 107 of 144

1

Which of the following is NOT true regarding the use of hydroxychloroquine?

Select one of the following:

  • Exact mechanism is unknown

  • May lead to regression of skin lesions

  • May improve psoriasis

  • Ophthalmologic examinations should be performed prior to administration and periodically after

Explanation

Question 108 of 144

1

What leads to the formation of PGE2 and PGI2?

Select one of the following:

  • B1

  • B2

  • Protons

  • ATP

Explanation

Question 109 of 144

1

Which of the following does NOT use a voltage-gated calcium channel?

Select one of the following:

  • Ziconitide

  • Omega-conotoxin

  • Gabapentin

  • Glutamate

Explanation

Question 110 of 144

1

Which of the following is NOT a common mediator in peripheral sensitization?

Select one of the following:

  • Glutamate

  • Bradykinins

  • Protons

  • NGF

Explanation

Question 111 of 144

1

For peripheral sensitization, which of the following is NOT used to target analgesia?

Select one of the following:

  • ASA

  • COX-2 inhibitors

  • Indomethicin

  • Acetominophen

Explanation

Question 112 of 144

1

Which of the following does NOT contribute to central sensitization?

Select one of the following:

  • Nitric oxide synthase

  • Glutamate

  • Substance P

  • Bradykinins

Explanation

Question 113 of 144

1

L-NAME can be used to inhibit NOS which prevents further retrograde stimulation of glutamate release

Select one of the following:

  • True
  • False

Explanation

Question 114 of 144

1

Which ion is usually associated with NMDA in its inactive state ?

Select one of the following:

  • Magnesium

  • Sodium

  • Calcium

  • Potassium

Explanation

Question 115 of 144

1

Which of the following inhibits the dissociation of Mg from the NMDA receptor, thus preventing activation?

Select one of the following:

  • Ketamine

  • DM

  • GABA

  • Both A and B

  • Both A and C

Explanation

Question 116 of 144

1

Which of the following is NOT a mechanism of opioids?

Select one of the following:

  • They activate descending PAG neurons

  • They directly activate opioid receptors

  • They activate descending NMR and LC neurons

  • They activate presynaptic potassium channels which decreases conductance

Explanation

Question 117 of 144

1

Which of the following opioid receptors does NOT mediate the main pharmacological effects of opiates?

Select one of the following:

  • Mu

  • Kappa

  • Delta

  • Epsilon

Explanation

Question 118 of 144

1

Which opioid receptor subunit is responsible for most of the analgesic effects along with some unwanted effects?

Select one of the following:

  • Mu

  • Kappa

  • Delta

  • Sigma

Explanation

Question 119 of 144

1

Opioid receptor activation is G-coupled

Select one of the following:

  • True
  • False

Explanation

Question 120 of 144

1

Select ALL of the strong opiods

Select one or more of the following:

  • Morphine

  • Meperidine

  • Methadone

  • Fentanyl

  • Codeine

  • Oxycodone

  • Pentazocine

  • Hydrocodone

Explanation

Question 121 of 144

1

Select ALL of the pure opioid agonists

Select one or more of the following:

  • Morphine

  • Hydromorphone

  • Codeine

  • Oxycodone

  • Meperidine

  • Fentanyl

  • Pentazocine

  • Naloxone

  • Naltrexone

  • Buprenorphine

Explanation

Question 122 of 144

1

Opiod pure agonists have a higher affinity for_________ receptors.

Select one of the following:

  • Mu

  • Kappa

  • Delta

  • B and C

Explanation

Question 123 of 144

1

Pentazocine is an antagonist at the ___________ receptor, but a partial agonist at the _____________ receptor.

Select one of the following:

  • Mu; Kappa and delta

  • Kappa; Mu and delta

  • Delta; kappa and mu

  • Mu; Kappa and sigma

Explanation

Question 124 of 144

1

Most mixed mechanism opioids cause

Select one of the following:

  • Dysphoria

  • Euphoria

  • Respiratory depression

  • Physical dependence

Explanation

Question 125 of 144

1

Which peripherally acting opioid antagonist can be used to reduce post-op ileus and opioid-induced constipation?

Select one of the following:

  • Alvimopan

  • Morphine

  • Naltrexone

  • Pentazocine

Explanation

Question 126 of 144

1

Opioids have a ceiling effect

Select one of the following:

  • True
  • False

Explanation

Question 127 of 144

1

Which of the following does NOT have a 90% first pass effect?

Select one of the following:

  • Morphine

  • Codeine

  • Hydromorphone

  • Meperidine

Explanation

Question 128 of 144

1

Which of the following receptors does codeine activate?

Select one of the following:

  • Kappa

  • Delta

  • Mu

  • Both B and C

Explanation

Question 129 of 144

1

How is morphine excreted?

Select one of the following:

  • Renally

  • Through the bile

  • Both and A and B

  • None of the above

Explanation

Question 130 of 144

1

How is codeine excreted?

Select one of the following:

  • Renally

  • Through breast milk

  • Hepatic

  • Both A and B

  • Both A and C

Explanation

Question 131 of 144

1

Which of the following is true?

Select one of the following:

  • Codeine is a more effective analgesia than morphine

  • Codeine provides little euphoria

  • Physical dependence is common in users of low daily dose

  • No risk of opiate withdrawal symptoms with sudden stop

Explanation

Question 132 of 144

1

Codeine does not cause tolerance over prolonged use

Select one of the following:

  • True
  • False

Explanation

Question 133 of 144

1

Which of the following is an alternative to codeine when a weak opiod is required?

Select one of the following:

  • Meperidine

  • Fentanyl

  • Propoxyphene

  • Oxycodone

Explanation

Question 134 of 144

1

Which of the following is an alternative to codeine when a strong opiod is required?

Select one of the following:

  • Morphine

  • Meperidine

  • Propoxyphene

  • Fentanyl

Explanation

Question 135 of 144

1

Which of the following is equipotent to morphine but has greater oral efficacy?

Select one of the following:

  • Methadone

  • Meperidine

  • Codeine

  • Fentanyl

Explanation

Question 136 of 144

1

Which of the following is used to treat opioid addiction?

Select one of the following:

  • Methadone

  • Meperidine

  • Morphine

  • Codeine

Explanation

Question 137 of 144

1

Which of the following opioids can prolong QT interval

Select one of the following:

  • Methadone

  • Meperidine

  • Morphine

  • Fentanyl

Explanation

Question 138 of 144

1

Methadone has a long duration and therefore can be given has a single dose daily

Select one of the following:

  • True
  • False

Explanation

Question 139 of 144

1

It is better to give meperidine orally rather than IV because it decreases risk of anxiety and other CNS side effects

Select one of the following:

  • True
  • False

Explanation

Question 140 of 144

1

Which of the following is correct, starting with the least potent to the most potent

Select one of the following:

  • Fentanyl<morphine<codeine

  • Fentanyl<codeine<morphine

  • Morphine<codeine<fentanyl

  • Codeine<morphine<fentanyl

Explanation

Question 141 of 144

1

Which of the following is NOT true regarding fentanyl?

Select one of the following:

  • It may induce skeletal rigidity at high doses

  • Does NOT cause histamine release

  • Smaller safety margin than morphine

  • Minimal respiration depression

Explanation

Question 142 of 144

1

There is no ceiling effect of respiratory depression with use of opioids with mixed mechanisms

Select one of the following:

  • True
  • False

Explanation

Question 143 of 144

1

Which of the following is an advantage of fentanyl patches?

Select one of the following:

  • Good if concerned about drug abuse

  • Quick onset

  • Residual activity after patch is removed

  • It's cheap

Explanation

Question 144 of 144

1

Which of the following is true regarding opioids with mixed mechanisms

Select one of the following:

  • May antagonize action of opioid agonists

  • Increases addiction liability

  • Small doses can cause hallucinations

  • Large doses can cause euphoria

Explanation

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