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Pharmacology Exam 2

Number of questions: 81

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1) The immune cell that when activated stimulates the activity of killer T-cells and B-cells is
  1. macrophage
  2. B-cell
  3. helper T-cell
  4. killer T-cell
 2) The immunosuppressive drug that inhibits the production of interleukin-2 is
  1. azathioprine
  2. cyclosporine
  3. cyclophosphamide
  4. infliximab
 3) The immunosuppressive drug that forms a toxic metabolite and that can cause hemorrhagic cystis is
  1. muromonab-CD3
  2. cyclophosphamide
  3. mycophenolate
  4. azathioprine
 4) The monoclonal antibody that inhibits tumor necrosis factor-alpha in the treatment of Crohn's disease is
  1. sargramostim
  2. infliximab
  3. interleukin-2
  4. daclizumab
 5) Which of the following are roles of macrophages?
  1. release interleukins
  2. produce antibodies
  3. provide long-term immunity
  4. recognize foreign antigens
 6) Select the cells involved in the immune response
  1. B-cells
  2. memory cells
  3. killer T-cells and memory cells
  4. all of these
 7) Corticosteroids work by doing which of the following?
  1. reduce the number of T- and B-cells
  2. increase the number of lymphocytes in the blood
  3. inhibit synthesis of inflammatory mediators
  4. reduce the number of T- and B-cells and inhibit synthesis of inflammatory mediators
 8) Select the drug that is non cytotoxic
  1. lefazathioprine
  2. cyclophosphamide
  3. cyclosporine
  4. mycophenolate mofetil
 9) Which of the following are uses for interferons?
  1. hairy cell leukemia
  2. lymphoma
  3. multiple sclerosis and lymphoma
  4. all of these
 10) A 52-year-old male heart transplant recipient is on an immunosuppressant regimen with cyclosporine, prednisolone, and azathioprine. Cyclosporine binds to cyclophilin. The resulting complex
  1. inhibits dihydroorotate dehydrogenase, leading to inhibition of pyrimidine synthesis
  2. inhibits inosine monophosphate dehydrogenase, the rate limiting enzyme in the formation of guanosine
  3. inhibits the phosphatase activity of calcineurin, a cell-signaling protein that mediates T-cell activation
  4. inhibits mTOR, a regulator of protein translation
 11) The mechanism by which tacrolimus inhibits interleukin-2 (IL-2) production in activated T cells most closely resembles the pharmacodynamic action of
  1. cyclosporine
  2. sirolimus
  3. mycophenolate mofetil
  4. leflunomide
 12) A 15-year-old female has severe inflammatory bowel disease. She has been treated with mesalamine. Recently, frequent flares of her disease have increased the need for oral prednisone and antibiotics. Her gastroenterologist considers treatment with an anti-tumor necrosis factor alpha (anti-TNF- ) antibody. This drug is most likely to be:
  1. OKT3
  2. rituximab
  3. efalizumab
  4. infliximab
 13) Select the ion movement that is associated with depolarization of ventricular muscle
  1. Na ions move out of the cell
  2. K ions move out of the cell
  3. Na ions move into the cell
  4. Ca ions move into the cell
 14) According to Vaughn-Williams, procainamide is classified as Class
  1. IA
  2. IB
  3. IC
  4. II
 15) The pharmacologic effects of verapamil may include
  1. decreased heart rate
  2. decreased force of myocardial contraction
  3. slowed AV conduction
  4. vasodilation
 16) Select the ion that enters the cardiac cell during phase 2 of the cardiac cycle
  1. Cl
  2. Ca
  3. Na
  4. K
 17) A class IB antiarrhythmic drug, like lidocaine, does which of the following?
  1. mildly decrease in Phase 0 depolarization
  2. prolongation of ventricular repolarization
  3. decrease in AV conduction
  4. increase in PR interval
 18) Select the actions of beta-blockers
  1. decrease heart rate
  2. increase AV conduction
  3. decrease automaticity of ventricular muscle
  4. decrease heart rate and decrease automaticity of ventricular muscle
 19) The therapeutic actions of angiotensin-converting enzyme (ACE) inhibitors include
  1. elimination of sodium
  2. venous dilation
  3. increased bradykinin (a peptide cause blood vessel to dilate)
  4. all of these
 20) The mechanism of action of triamterene (Dyrenium) is to
  1. block aldosterone receptors
  2. increase sodium excretion at loop of Henle
  3. block sodium channels (ENaC) at nephron collecting ducts
  4. increase the release of aldosterone
 21) The actions of digoxin (Lanoxin) include
  1. inhibition of Na/K ATPase
  2. increased calcium inside heart muscle
  3. increase formation of actinomyosin
  4. all of these
 22) The actions of carvedilol (Coreg) include
  1. blockade of beta receptors
  2. increased force of myocardial contraction
  3. blockade of alpha-1 receptors
  4. blockade of beta receptors and blockade of alpha-1 receptors
 23) The most effective drug to relieve edema and congestion in acute heart failure would be
  1. hydralazine (Apresoline)
  2. furosemide (Lasix)
  3. metoprolol (Lopressor)
  4. hydrochlorothiazide (HyroDIURIL)
 24) Which medication reduces edema by blocking the reabsorption of sodium in the distal tubules?
  1. eplerenone
  2. torsemide
  3. triamterene
  4. chlorothiazide
 25) Vasodilators decrease afterload by affecting
  1. veins
  2. arteries
  3. the SA node
  4. myocardial contraction
 26) The main effects of beta blockers include
  1. slowing the heart rate
  2. increasing the release of renin
  3. increasing ADH
  4. increasing aldosterone
 27) The primary site of action of thiazide diuretics in the nephron is
  1. the proximal tubule
  2. the loop of Henle
  3. the distal convoluted tubule
  4. the capsule area of glomerular filtration
 28) Loop diuretics increase the excretion of all of the following EXCEPT
  1. chloride
  2. water
  3. potassium
  4. glucose
 29) All of the following are true EXCEPT
  1. anuria is a state where no urine is formed
  2. the major tubular secretory function of the nephron includes hydrogen and potassium ions
  3. uremia is an accumulation of nitrogen waste products
  4. tubular reabsorption of water is diuresis
 30) All potassium-sparing diuretics
  1. produce a mild diuresis without acid/base disturbance
  2. inhibit aldosterone receptors
  3. produce hypokalemia
  4. produce similar adverse effects to thiazide diuretics
 31) Tubular reabsorption involves which of the following?
  1. movement of small molecules into the glomerulus
  2. nephron production of calcium carbonate
  3. transport of ions into the blood
  4. movement of potassium ions into circulation
 32) Select the areas of the kidneys where water is reabsorbed
  1. glomerulus
  2. proximal convoluted tubule and collecting ducts
  3. uremic channel
  4. zona glomerulosa
 33) Kidneys maintain acid balance in the body by which of the following actions?
  1. tubular secretion of hydrogen ions
  2. increasing the pH of the urine
  3. neutralizing cell waste products
  4. decreasing the production of bicarbonate ions
 34) The desired antihypertensive effects of adrenergic beta-blocking drugs include
  1. decrease in heart rate
  2. decrease in release of renin
  3. decrease in cardiac output
  4. only decrease in heart rate and decrease in cardiac output
 35) The antihypertensive action of hydrochlorothiazide (thiazide class) includes
  1. reduction of blood volume
  2. blockade of alpha adrenergic receptors
  3. relaxation of vascular smooth muscle
  4. only reduction of blood volume and relaxation of vascular smooth muscle
 36) A decrease in the formation of angiotensin II and an increase in the concentration of bradykinin explains the vasodilator action of
  1. alpha-blockers
  2. beta-blockers
  3. angiotensin-converting enzyme inhibitors
  4. angiotensin receptor blockers
 37) The drug that is classified as an arterial vasodilator and that also has a direct effect to decrease heart rate and cardiac contractility is
  1. verapamil
  2. propranolol
  3. prazosin
  4. captopril
 38) The release of renin causes which of the following?
  1. vasodilation
  2. water excretion
  3. decreased blood pressure
  4. activation of angiotensin I
 39) Thiazide diuretics help treat hypertension by
  1. decreasing peripheral resistance
  2. increasing cardiac output
  3. increasing excretion of sodium
  4. only decreasing peripheral resistance and increasing excretion of sodium
 40) Clonidine works to reduce blood pressure by which of the following actions?
  1. increasing sympathetic nerve activity
  2. stimulating inhibitory alpha-2 receptors
  3. decreasing release of renin
  4. decreasing sympathetic nerve activity and decreasing release of renin
 41) Verapamil would be useful to treat hypertension in individuals who also suffer from
  1. coronary artery disease
  2. CHF
  3. supraventricular arrhythmias
  4. coronary artery disease and supraventricular arrhythmias
 42) Which of the following mechanisms of action is correct?
  1. ezetimibe (Zetia) acts in the intestinal lumen to bind and trap cholesterol
  2. fibric acid derivatives act at the brush border of the intestine wall
  3. nicotinamide stimulates lipoprotein lipase to lower triglycerides
  4. lovastatin inhibits an enzyme in the cholesterol synthetic pathway
 43) The greatest reduction in circulating LDL is associated with which hypolipidemic drug?
  1. gemfibrozil (Lopid)
  2. nicotinic acid (Niacor)
  3. atorvastatin (Lipitor)
  4. colesevelam (Welchol)
 44) All of the following are correct EXCEPT
  1. LDL pulls cholesterol out of plaque and returns it to the liver
  2. VLDL transports triglycerides
  3. apolipoproteins B and E contain a cholesterol core to form LDL and HDL, respectively
  4. foam cells are cholesterol-rich macrophages
 45) Which of these medications is NOT used to treat hyperlipidemia?
  1. statins
  2. thiazides
  3. nicotinic acid
  4. fibric acid derivatives
 46) HMG-CoA reductase inhibitors (statins) work by doing which of the following?
  1. blocking the intestinal absorption of cholesterol
  2. inhibiting triglyceride lipase
  3. inhibiting the production of mevalonic acid
  4. decreasing hepatic VLDL-triglyceride synthesis
 47) The main therapeutic effects of the statins include
  1. reducing LDL and CRP levels
  2. reducing HDL levels
  3. reducing hepatic CYP3A4 levels
  4. reducing acetyl CoA levels
 48) The nitroglycerin dosage form providing the longest duration of action is
  1. sublingual nitroglycerin tablets
  2. nitroglycerin ointment
  3. transdermal nitroglycerin
  4. IV nitroglycerin (bolus injection)
 49) The therapeutic actions of propranolol to prevent anginal attacks include
  1. reduced force of myocardial contraction
  2. decreased oxygen consumption
  3. decreased cardiac work
  4. all of these
 50) The pharmacologic actions of verapamil include
  1. decreased AV conduction
  2. increased myocardial contraction
  3. decreased heart rate
  4. only decreased AV conduction and decreased heart rate
 51) In the treatment of variant angina, the drug that is an arterial dilator without direct effects on the heart is
  1. nitroglycerin
  2. metoprolol
  3. nifedipine
  4. verapamil
 52) The drug that is best described as a venodilator that decreases preload (venous return) in the treatment of angina is
  1. propranolol
  2. verapamil
  3. nifedipine
  4. isosorbide dinitrate
 53) The main mechanisms of action of nitrates include
  1. increasing the venous return to the heart
  2. reducing atherosclerosis in the arteries
  3. increasing cardiac work
  4. relaxation of systemic veins and arteries
 54) Propranolol works by doing which of the following?
  1. decreasing cardiac work
  2. decreasing force of contractions
  3. decreasing oxygen consumption
  4. all of these
 55) Variant angina is best treated with what types of medication?
  1. calcium channel blockers
  2. beta-blockers
  3. nitrates
  4. only calcium channel blockers and nitrates
 56) A hormone
  1. rapidly responds to a stimulus
  2. is a neurotransmitter
  3. binds to specific receptors to produce its effects
  4. produces nerve impulses
 57) Releasing hormones
  1. travel along axons to the posterior pituitary
  2. affect the secretion of hormones in the anterior pituitary
  3. are released by the target organ to regulate hypothalamus
  4. produce nerve impulses
 58) All hormones released by the anterior pituitary are regulated by
  1. the hypothalamus
  2. the posterior pituitary
  3. the fat-soluble releasing hormones
  4. TSH
 59) Dwarfism is caused by
  1. elevated thyroid hormone production
  2. decreased adrenocorticotropic hormone (ACTH)
  3. decreased growth hormone
  4. high plasma glucose concentration
 60) A patient newly diagnosed with hyperthyroidism has blood drawn for labs. The physician tells the patient that his TRH function is normal as is the TSH level. Using negative feedback, which location is most likely secreting excess hormone?
  1. CNS
  2. anterior pituitary
  3. hypothalamus
  4. target organ (thyroid gland)
 61) Which is not a function of hormones?
  1. conduct electrical impulses
  2. regulate growth
  3. control metabolism
  4. help in reproduction
 62) Which of the following is true of the hypothalamus?
  1. it controls the master gland it is composed of two main lobes
  2. it is connected by a portal system to the posterior pituitary gland it releases luteinizing hormone
  3. it is the target organ for growth hormone
 63) Choose the hormones whose target organs are the gonads of males and females
  1. TSH
  2. ACTH
  3. LH, FSH
  4. GH
 64) Water-soluble hormones work by
  1. binding receptors on the cell membranes
  2. crossing the plasma membrane
  3. being second messengers
  4. stimulating gene transcription
 65) Which of the following is true of the negative feedback system?
  1. levels of circulating hormone always change suddenly and severely
  2. the target organ turns off pituitary secretion
  3. a baby suckling is an example of negative feedback
  4. hormones are NOT controlled by this process
 66) Which of the following is correct about mineralocorticoids?
  1. they are secreted by the adrenal medulla
  2. the target organ is the pancreas
  3. they cause excess excretion of sodium ions
  4. their principle action is to reduce inflammation
 67) A patient presents with dehydration. Following ACTH administration, plasma cortisol levels cannot be detected. The most likely diagnosis for this patient is
  1. Addison's disease (generate too little...)
  2. Cushing's disease
  3. thyroid disease
  4. rheumatoid arthritis
 68) A patient taking prednisone long term (chronically) might develop which of the following adverse effects?
  1. hypotension
  2. bronchial asthma
  3. weight loss
  4. moon face or buffalo hump
 69) Which of the following is not a function of secreted glucocorticoids?
  1. regulate the metabolism of carbohydrates
  2. make new protein
  3. retention of sodium
  4. transcription of nucleus DNA
 70) Which of the following is not true of mineralocorticoids like fludrocortisone?
  1. cause an increase in reabsorption of sodium
  2. cause K ion transport to urine
  3. regulate fluid balance
  4. decrease inflammation
 71) Which of these effects is not associated with long-term steroidal hormone therapy?
  1. obesity
  2. thinning of skin
  3. glaucoma
  4. increased muscle strength
 72) In both males and females the hypothalamus secretes this hormone to stimulate the release of LH and FSH
  1. testosterone
  2. estrogen
  3. GnRH
  4. DHEA
 73) In the menstrual cycle which of the following hormones is responsible for ovulation?
  1. FSH
  2. hCG
  3. LH
  4. oxymetholone
 74) A mechanism by which oral contraceptives prevent ovulation includes
  1. inhibiting the corpus luteum's production of progesterone
  2. facilitating implantation to occur
  3. increasing the levels of estrogen and progesterone
  4. stimulating the release of LH and FSH
 75) The mechanism of drug action by which erectile dysfunction is treated
  1. inhibition of phosphodiesterase 5
  2. inhibition of GnRH
  3. vasoconstriction of the blood vessels in the penis
  4. stimulation of the release of testosterone
 76) Which of the following are true about oral contraceptives?
  1. the hormone is delivered via a vaginal ring
  2. they can be monophasic, biphasic, or triphasic
  3. they can be administered as a spray
  4. the doses of estrogen are at the highest effective coverage dose
 77) Which hormone is synthesized in the hypothalamus and released from the posterior pituitary?
  1. insulin
  2. thyroxine
  3. cortisol
  4. oxytocin
 78) During parturition (childbirth), oxytocin
  1. stimulates uterine muscle contraction
  2. increases urine output
  3. inhibits preterm labor
  4. decreases urine output
 79) Choose the correct action of antidiuretic hormone on the body
  1. it increases urine output
  2. it regulates water balance
  3. the adrenal glands are its target organ
  4. its secretion is controlled by ADH-releasing factor
 80) Which of the following is true?
  1. oxytocin and ADH are both polypeptides
  2. ADH is the only hormone secreted from the posterior pituitary
  3. the release of ADH and oxytocin is caused by another hormone
  4. ADH and oxytocin are secreted by the anterior pituitary gland vasopressin is the trade name for oxytocin
 81) The uses of oxytocin include
  1. control of postpartum bleeding
  2. decreasing contractions
  3. inducing therapeutic abortions
  4. uterine tetany

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