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1) Which is NOT a mechanism of action of an oral antidiabetic drug?

1. increased insulin sensitivity in target tissues
2. inhibit or delay the breakdown of carbohydrates in the intestine
3. direct action on the beta cell membrane-bound receptors
4. direct stimulation of insulin receptors in skeletal muscle

Reveal answer 2) 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

Reveal answer 3) 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

Reveal answer 4) 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

Reveal answer 5) Dwarfism is caused by

1. elevated thyroid hormone production
2. decreased adrenocorticotropic hormone (ACTH)
3. decreased growth hormone
4. high plasma glucose concentration

Reveal answer 6) 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)

Reveal answer 7) Which is not a function of hormones?

1. conduct electrical impulses
2. regulate growth
3. control metabolism
4. help in reproduction

Reveal answer 8) Which of the following is true of the hypothalamus?

1. it controls the master gland
2. it is composed of two main lobes
3. it is connected by a portal system to the posterior pituitary gland
4. it releases luteinizing hormone

Reveal answer 9) Choose the hormones whose target organs are the gonads of males and females.

1. TSH
2. ACTH
3. LH, FSH
4. GH

Reveal answer 10) 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

Reveal answer 11) 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

Reveal answer 12) 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

Reveal answer 13) 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 (too much...)
3. thyroid disease
4. rheumatoid arthritis

Reveal answer 14) A patient taking prednisone long term (chronically) might develop which of the following adverse effects?

1. dehydration
2. hypotension
3. bronchial asthma
4. weight loss

Reveal answer 15) 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

Reveal answer 16) 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

Reveal answer 17) 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

Reveal answer 18) 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

Reveal answer 19) In the menstrual cycle which of the following hormones is responsible for ovulation?

1. progesterone
2. FSH
3. hCG
4. LH

Reveal answer 20) 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

Reveal answer 21) 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

Reveal answer 22) 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

Reveal answer 23) Which of the following is true of monophasic oral contraceptives?

1. pill color varies over the cycle
2. estrogen to progestin ratio changes over the cycle
3. the first 10 pills of the cycle may be iron supplements
4. there is a fixed ratio of hormones for days 0 to 21

Reveal answer 24) Which hormone is synthesized in the hypothalamus and released from the posterior pituitary?

1. insulin
2. thyroxine
3. cortisol
4. oxytocin

Reveal answer 25) During parturition (childbirth), oxytocin

1. stimulates uterine muscle contraction
2. increases urine output
3. inhibits preterm labor
4. decreases urine output

Reveal answer 26) 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

Reveal answer 27) 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

Reveal answer 28) The uses of oxytocin include

1. control of postpartum bleeding
2. decreasing contractions
3. inducing therapeutic abortions
4. uterine tetany

Reveal answer 29) Histamine

1. is classified as a mast cell release inhibitor
2. is one of the substances released during an allergic response
3. is found in white blood cells known as neutrophils
4. does not cause skin reactions

Reveal answer 30) Mast cells:

1. are only found in the bloodstream
2. are coated with immunoglobulins that recognize antigens
3. have no other role than antiallergy in the body
4. degranulate when the H 1 -receptor is stimulated

Reveal answer 31) An acute allergic response

1. can be blocked only by histamine
2. cannot be prophylactically treated
3. is characterized by itching, sneezing, and edema
4. is only characterized by wheals and urticaria

Reveal answer 32) Antihistamines like chlorpheniramine

1. are the newest, third-generation drugs
2. are effective and can cause drowsiness
3. are not found in OTC products
4. do not have anticholinergic properties

Reveal answer 33) Fexofenadine and cetirizine

1. are more selective for peripheral H 1 -receptors
2. bind the H 1 -receptors in the brain to produce fewer side effects
3. are more sedating and drying than diphenhydramine
4. are mast cell stabilizers

Reveal answer 34) Which of the following is NOT a correct statement?

1. promethazine is the only antihistamine with a cautionary (black box) warning
2. antihistamines reduce itching and pain at the sensory nerve endings
3. histamine causes relaxation of bronchiolar smooth muscle
4. hypersensitivity can develop to antihistamines

Reveal answer 35) Mast cell stabilizers work by blocking

1. histamine after it is released
2. H 1 -receptors from binding histamine
3. the release of histamine and other active substances from mast cells
4. the effect of histamine after it binds

Reveal answer 36) Select the first-generation antihistaminic drug.

1. promethazine
2. cetirizine
3. loratadine
4. levocetirizine

Reveal answer 37) The bronchodilator drug that would provide the longest duration of action is

1. epinephrine (Adrenaline)
2. ipratropium (Atrovent)
3. salmeterol (Serevent)
4. theophylline (Elixophylline)

Reveal answer 38) The drug used in the treatment of asthma that blocks the leukotriene receptor is

1. fluticasone
2. cromolyn
3. albuterol
4. montelukast

Reveal answer 39) The only drug class that provides immediate relief of an acute asthmatic attack is

1. anticholinergics
2. beta adrenergics
3. methylxanthines
4. corticosteroids

Reveal answer 40) The mechanism of action of cromolyn sodium is to

1. produce bronchodilation
2. increase expectoration of mucus
3. inhibit release of mast cell mediators
4. liquefy bronchial secretions

Reveal answer 41) The pharmacologic actions of theophylline in the treatment of COPD include

1. bronchodilation
2. increased mucociliary activity
3. bronchodilation and increased mucociliary activity
4. none of them

Reveal answer 42) The drug used in asthma to block IgE antibodies is

1. cromolyn
2. omalizumab
3. ipratropium
4. guaifenesin

Reveal answer 43) The chemical mediators involved in asthma include

1. prostaglandins
2. ECF-A
3. leukotrienes
4. only prostaglandins and leukotrienes

Reveal answer 44) Parasympathetic activation of the respiratory tract causes which of the following?

1. bronchodilation
2. increased cyclic AMP
3. increased mucus secretion
4. stimulation of the beta-2 receptors

Reveal answer 45) Select the mechanisms of action for terbutaline (a beta-2 agonist).

1. inhibit release of mediators from mast cells
2. block beta-2 receptors
3. relax smooth muscle
4. only inhibit release of mediators from mast cells and relax smooth muscle

Reveal answer 46) Corticosteroids are used in the treatment of asthma in which of the following ways?

1. decrease activation of arachidonic acid
2. decrease the expression of pro-inflammatory mediators and pro-allergic antibodies
3. increase the production of pro-allergic antibodies
4. only decrease activation of arachidonic acid and decrease the production of allergic antibodies

Reveal answer 47) Which of the three phases of gastric acid secretion is stimulated by the distention of the stomach?

1. cephalic
2. colonic
3. gastric
4. intestinal

Reveal answer 48) What is the most common etiology of peptic ulcer disease?

1. alcohol
2. GERD (gastroesophageal reflux disease)
3. NSAIDs (nonsteroidal anti-inflammatory drugs)
4. Helicobacter pylori

Reveal answer 49) Which of the following drugs directly blocks the release of HCl from the parietal gland?

1. antacids
2. H2 -receptor antagonists
3. proton pump inhibitors
4. sucralfate

Reveal answer 50) The causes of peptic ulcers include

1. not enough mucosal lining in the stomach
2. suppressed acid production
3. regurgitation of bile acids into the esophagus
4. hypersecretion of mucus in the stomach

Reveal answer 51) The primary therapeutic goal in treatment of peptic ulcer is to

1. increase mucosal production
2. suppress acid production and relieve symptoms
3. prevent erosion of ileum
4. maintain levels of magnesium and calcium with antacids

Reveal answer 52) Select the mechanism of action for 5-HT 3 antagonists.

1. prevent labyrinthine stimulation of emesis
2. prevent serotonin from stimulating the CTZ
3. block stimulation of dopamine receptors
4. increase secretions from ECL cells

Reveal answer 53) A patient presents with severe diarrhea. Upon questioning, the patient mentions that he returned from Thailand a week ago. The patient is diagnosed with "traveler's diarrhea." The drug of choice for this patient would include

1. rifaximin (antibiotic)
2. bulk laxatives
3. lubiprostone (a ClC 2 chloride channel activator)
4. methylnaltrexone

Reveal answer 54) Which of the following treatments for simple diarrhea works by forming a complex with the irritant?

1. antibiotics
2. opioid derivatives
3. anticholinergics
4. adsorbents

Reveal answer 55) Which of the following drugs has been approved for treatment of patients with constipation caused by opioid analgesics?

1. emollients
2. lubiprostone
3. stimulants
4. methylnaltrexone

Reveal answer 56) Which of the following laxatives would be ordered before a colonoscopy?

1. docusate sodium (laxative to treat constipation in children)
2. polyethylene glycol
3. psyllium hydrophilic (dietary fiber to relieve symptoms of both constipation and mild diarrhea)
4. mineral oil

Reveal answer 57) Which of the following is NOT a primary cause of diarrhea?

1. increased intestinal motility
2. inflammation
3. osmotic imbalance
4. drug therapy

Reveal answer 58) Choose the mechanism of action of adsorbents antidiarrheal drugs.

1. kill bacteria
2. decrease serotonin release
3. form a complex with irritating substance
4. absorbed into blood circulation to work on the system

Reveal answer 59) Which of the following drugs are used to stimulate defecation?

1. 5-HT 3 antagonists
2. adsorbents
3. antimotility drugs
4. cathartics

Reveal answer 60) Select the mechanisms by which swelling agents increase defecation.

1. soak up water and distend the rectum
2. irritate the mucosal lining of the intestine
3. inhibit stool formation in the large intestine
4. coat the fecal matter

Reveal answer 61) Which of the following oral antidiabetic agents increases the incretin's duration of action?

1. sitagliptin
2. acarbose
3. nateglinide
4. tolbutamide

Reveal answer 62) Which of the following oral agents is categorized as a secretagogue?

1. metformin
2. glipizide
3. sitagliptin
4. miglitol

Reveal answer 63) Which of the following hormones would be elevated during a fast?

1. insulin
2. glucagon
3. humulin
4. GnRH

Reveal answer 64) Which is NOT a mechanism of action of an oral antidiabetic drug?

1. increased insulin sensitivity in target tissues
2. inhibit or delay the breakdown of carbohydrates in the intestine
3. direct action on the beta cell membrane-bound receptors
4. direct stimulation of insulin receptors in skeletal muscle

Reveal answer 65) Which of the following is correct about type 2 DM?

1. insulin is secreted by the beta cells and insulin resistance is present
2. insulin cannot be used in type 2 DM
3. patients are only prone to persistent infections in type 1 DM
4. oral antidiabetic drugs cannot be combined to achieve glycemic control

Reveal answer 66) Which of the following is correct about polyuria in types 1 and 2 DM?

1. excess glucose spills into the urine and osmotically attracts water into the renal tubule
2. antidiuretic hormone is no longer secreted in DM
3. GLUT2 receptors move glucose from the blood into the renal tubule
4. sulfonylurea drugs interact with their receptors in the kidney to increase urine flow

Reveal answer 67) Which of the following when used together have complementary actions that increase insulin secretion?

1. insulin secretion?
2. regular human insulin and insulin glargine
3. DPP-4 inhibitor, sitagliptin and metformin
4. amylin and glucagon

Reveal answer 68) Beta cells secrete the following substances:

1. insulin and amylin
2. glucagon
3. incretins
4. acetate

Reveal answer 69) Which of the following is correct?

1. lipodystropy is exacerbated by alpha glucosidase inhibitors miglitol and acarbose
2. insulin is the preferred treatment in type 2 DM because there are no drug interactions
3. oral antidiabetic drugs include pramlintide
4. hypoglycemia is the most common adverse effect of many antidiabetic drugs

Reveal answer 70) Chronically elevated blood lipid levels may cause

1. pancreatitis when cholesterol is 80 to 100 mg/dL
2. plaque when HMG-CoA reductase is 80 to 100 mg/dL
3. plaque when LDL cholesterol exceeds 160 mg/dL
4. arthritis and edema

Reveal answer 71) 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 inhibit lipoprotein lipase to lower triglycerides
4. lovastatin (Mevacor) inhibits an enzyme in the cholesterol synthetic pathway

Reveal answer 72) 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)

Reveal answer 73) 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

Reveal answer 74) Which of these medications is NOT used to treat hyperlipidemia?

1. statins
2. thiazides
3. nicotinic acid
4. fibric acid derivatives

Reveal answer 75) 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

Reveal answer 76) 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

Reveal answer 77) 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)

Reveal answer 78) 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

Reveal answer 79) 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

Reveal answer 80) 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

Reveal answer 81) 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

Reveal answer 82) 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

Reveal answer 83) 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

Reveal answer 84) 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

Reveal answer 85) Which of the following actions is related to thiazide diuretics?

1. hyperuricemia (excess of uric acid in the blood)
2. hyperkalemia
3. hypernatremia
4. hypercalcemia

Reveal answer 86) Which of these is NOT true with regard to loop diuretics?

1. can cause hyperuricemia
2. can cause hyperglycemia
3. can be used to reduce ascites due to malignancy
4. can cause metabolic acidosis

Reveal answer 87) 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 (DCT)
4. the capsule area of glomerular filtration

Reveal answer 88) Loop diuretics increase the excretion of all of the following EXCEPT

1. water
2. potassium
3. glucose
4. acid

Reveal answer 89) 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 involves hydrogen and potassium ions
3. uremia is an accumulation of nitrogen waste products
4. tubular reabsorption of water is diuresis

Reveal answer 90) 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

Reveal answer 91) 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 sodium ions into circulation

Reveal answer 92) Select the areas of the kidneys where water is mostly reabsorbed.

1. glomerulus
2. proximal convoluted tubule and collecting ducts
3. distal convoluted tubule
4. uremic channel

Reveal answer 93) 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

Reveal answer 94) The desired antihypertensive effects of adrenergic beta-blocking drugs include

1. decrease in release of renin
2. decrease in cardiac output
3. only decrease in heart rate and decrease in cardiac output
4. all of these

Reveal answer 95) 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

Reveal answer 96) 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 (ACE) inhibitors
4. angiotensin receptor blockers

Reveal answer 97) 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

Reveal answer 98) The release of renin causes which of the following?

1. vasodilation
2. water excretion
3. decreased blood pressure
4. activation of angiotensin I

Reveal answer 99) Thiazide diuretics help treat hypertension by

1. decreasing peripheral resistance
2. increasing cardiac output
3. increasing excretion of sodium
4. decreasing peripheral resistance and increasing excretion of sodium

Reveal answer 100) Clonidine works to reduce blood pressure by which of the following actions?

1. decreasing sympathetic nerve activity
2. stimulating inhibitory alpha-2 receptors
3. decreasing release of renin
4. decreasing sympathetic nerve activity and decreasing release of renin

Reveal answer 101) 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

Reveal answer 102) 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

Reveal answer 103) According to Vaughn-Williams, procainamide is classified as Class

1. IA
2. IB
3. IC
4. II

Reveal answer 104) The antiarrhythmic drug with the shortest duration of action that is administered IV in the emergency treatment of supraventricular tachycardia is

1. lidocaine
2. adenosine
3. propranolol
4. amiodarone

Reveal answer 105) The pharmacologic effects of verapamil may include

1. decreased heart rate
2. decreased force of myocardial contraction
3. slowed AV conduction
4. vasodilation

Reveal answer 106) Select the ion that enters the cardiac cell during phase 2 of the cardiac cycle.

1. Cl
2. Ca
3. Na
4. K

Reveal answer 107) 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

Reveal answer 108) Which of the following are types of supraventricular arrhythmias?

1. premature atrial contractions
2. premature ventricular contractions
3. paroxysmal atrial tachycardia
4. premature atrial contractions and paroxysmal atrial tachycardia

Reveal answer 109) 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

Reveal answer 110) The therapeutic actions of angiotensin-converting enzyme (ACE) inhibitors include

1. arterial dilation
2. elimination of sodium
3. venous dilation
4. increased bradykinin (a peptide cause blood vessel to dilate)

Reveal answer 111) 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

Reveal answer 112) The actions of digoxin (Lanoxin) include

1. decreased heart rate (yes)
2. inhibition of Na/K ATPase
3. increased calcium inside heart muscle
4. increase formation of actinomyosin

Reveal answer 113) 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

Reveal answer 114) 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)

Reveal answer 115) The causes of heart failure include

1. untreated hypertension
2. weakening of contractile force
3. myocardial infarction
4. valvular defects

Reveal answer 116) Which medication reduces edema by blocking the reabsorption of sodium in the distal tubules?

1. eplerenone
2. torsemide
3. triamterene
4. chlorothiazide

Reveal answer 117) Vasodilators decrease afterload by affecting

1. veins
2. arteries
3. the SA node
4. myocardial contraction

Reveal answer 118) The main effects of beta blockers include

1. slowing the heart rate
2. increasing the release of renin
3. increasing ADH
4. increasing aldosterone

Reveal answer 119) Diuretics like organic acids and thiazides are therapeutically useful because they

1. can be used in the treatment of refractory heart failure
2. antagonize antidiuretic hormone at the receptors in the collecting duct
3. block carbonic anhydrase in the loop of Henle, causing hypochloremic alkalosis
4. waste potassium at doses that cause diuresis

Reveal answer 120) Which of the following actions is related to thiazide diuretics?

1. hyperuricemia (excess of uric acid in the blood)
2. hyperkalemia
3. hypernatremia
4. hypercalcemia

Reveal answer 121) Which of these is NOT true with regard to loop diuretics?

1. can cause hyperuricemia
2. can cause hyperglycemia
3. can be used to reduce ascites due to malignancy
4. can cause metabolic acidosis

Reveal answer 122) The primary site of action of thiazide diuretics in the nephron is

1. the proximal tubule
2. the loop of Henle
3. the distal tubule
4. the capsule area of glomerular filtration

Reveal answer 123) Which drugs are NOT routinely used in the clinical management of hypertension?

1. thiazide diuretics
2. chlorthalidone
3. isosorbide mononitrate
4. triamterene

Reveal answer 124) Loop diuretics increase the excretion of all of the following EXCEPT

1. sodium
2. uric acid
3. water
4. potassium

Reveal answer 125) 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 involves hydrogen and potassium ions
3. uremia is an accumulation of nitrogen waste products
4. tubular reabsorption of water is diuresis

Reveal answer 126) 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

Reveal answer 127) 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 sodium ions into circulation

Reveal answer 128) Select the areas of the kidneys where water is reabsorbed.

1. glomerulus
2. proximal convoluted tubule and collecting ducts
3. distal convoluted tubule
4. uremic channel

Reveal answer 129) 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

Reveal answer 130) 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

Reveal answer 131) 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

Reveal answer 132) 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

Reveal answer 133) 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

Reveal answer 134) The antihypertensive drug that decreases sympathetic activity by an action on the vasomotor center in the medulla oblongata is

1. hydralazine
2. clonidine
3. diltiazem
4. losartan

Reveal answer 135) The release of renin causes which of the following?

1. activation of RNA mechanism
2. vasodilation
3. water excretion
4. decreased blood pressure

Reveal answer 136) Thiazide diuretics help treat hypertension by

1. increasing peripheral resistance
2. increasing cardiac output
3. increasing excretion of sodium
4. only decreasing blood volume and increasing excretion of sodium

Reveal answer 137) Clonidine works to reduce blood pressure by which of the following actions?

1. decreasing sympathetic nerve activity
2. stimulating inhibitory alpha-2 receptors
3. decreasing release of renin
4. decreasing sympathetic nerve activity and decreasing release of renin

Reveal answer 138) 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

Reveal answer 139) 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

Reveal answer 140) The immunosuppressive drug that inhibits the production of interleukin-2 is

1. azathioprine
2. cyclosporine
3. cyclophosphamide
4. infliximab

Reveal answer 141) The immunosuppressive drug that forms a toxic metabolite and that can cause hemorrhagic cystis is

1. cyclosporine
2. muromonab-CD3
3. cyclophosphamide
4. mycophenolate

Reveal answer 142) 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

Reveal answer 143) Which of the following are roles of macrophages?

1. release interleukins
2. produce antibodies
3. provide long-term immunity
4. recognize foreign antigens

Reveal answer 144) Select the cells involved in the immune response.

1. killer T-cells
2. B-cells
3. memory cells
4. killer T-cells and memory cells

Reveal answer 145) 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

Reveal answer 146) Select the drug that is non cytotoxic.

1. lefazathioprine
2. cyclophosphamide
3. cyclosporine
4. mycophenolate mofetil

Reveal answer 147) Which of the following are uses for interferons?

1. multiple sclerosis
2. hairy cell leukemia
3. lymphoma
4. multiple sclerosis and lymphoma

Reveal answer 148) 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.

Reveal answer 149) 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.

Reveal answer 150) 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. etanercept.
2. OKT3.
3. rituximab.
4. efalizumab.

Reveal answer 151) Which of the following is NOT correct about antifungal drugs or fungal infection?

1. systemic infection may occur in patients who are receiving drugs to suppress their immune system
2. warts are an example of a dermatophytic fungal infection
3. the majority of antifungal drugs interfere with fungal cell-wall integrity
4. amphotericin B is associated with serious renal toxicity

Reveal answer 152) The bactericidal antibiotic that interferes with bacterial cell-wall synthesis and that may cause "red man syndrome" if injected too rapidly is

1. piperacillin
2. vancomycin
3. gentamicin
4. clindamycin

Reveal answer 153) The antibiotic whose adverse effects include heartburn, photosensitivity, and possible depression of bone growth in young children is

1. erythromycin
2. tetracycline
3. gentamicin
4. clindamycin

Reveal answer 154) The main pharmacokinetic feature of aminoglycosides is that they are

1. lipid soluble
2. well absorbed orally
3. poorly absorbed from the GI tract and excreted mostly unchanged in the urine if injected
4. devoid of serious adverse effects

Reveal answer 155) Griseofulvin is useful in dermatophytic infections because it

1. binds to keratin
2. is fungicidal
3. forms ergosterol in hair and nails
4. incorporates itself into fungal RNA

Reveal answer 156) Which antifungal drug is matched with its correct mechanism of action?

1. echinocandins inhibit polysaccharide (glucan) synthesis in the cell wall
2. flucytosine binds to the cell membrane
3. ticonazole is an antimetabolite for fungal RNA
4. amphotericin B binds to a cytochrome P450-dependent enzyme

Reveal answer 157) Which drug is effective against systemic viral infections?

1. griseofulvin
2. butenafine
3. gentian violet
4. clotrimazole

Reveal answer 158) The mechanisms of action for antiviral medications include

1. changing cell-wall synthesis
2. binding to ergosterol
3. inhibiting cell mitosis
4. inhibiting neuraminidase

Reveal answer 159) Which of the following is NOT true of the treatment for viral infections?

1. they are difficult to treat due to host cell invasion
2. immunity can be gained through the attenuated live virus
3. treatment can be given via an intranasal spray
4. the vaccines are contraindicated in people allergic to eggs

Reveal answer 160) The antimetabolite that blocks DNA synthesis by interfering with folic acid is

1. mercaptopurine
2. fluorouracil
3. methotrexate
4. cytarabine

Reveal answer 161) The drug that binds to mitotic tubules to cause metaphase arrest is

1. doxorubicin
2. asparaginase
3. etoposide
4. vincristine

Reveal answer 162) Enzyme inhibition of aromatase is the mechanism of action of

1. tamoxifen
2. anastrozole
3. leuprolide
4. goserelin

Reveal answer 163) The monoclonal antibody that inhibits vascular endothelial growth factor (VEGF) and new blood vessel formation is

1. imatinib
2. trastuzumab
3. bevacizumab
4. gefitinib

Reveal answer 164) Which of the following is true of chemotherapy?

1. one of the early goals of chemotherapy is remission
2. antineoplastic drugs only attack cancerous cells
3. drug resistance is increased with combination therapy
4. it is the primary form of treatment for solid tumors

Reveal answer 165) The mechanisms of actions for the antimetabolites include

1. preventing DNA replication
2. blocking DNA synthesis
3. forming abnormal nucleotides
4. preventing DNA replication and forming abnormal nucleotides

Reveal answer 166) Select the correct statements for alkylating drugs.

1. bind irreversibly with nucleic acids
2. decrease cells' ability to synthesize proteins
3. are cell-cycle nonspecific
4. bind irreversibly with nucleic acids and are cell-cycle nonspecific

Reveal answer 167) Select the correct statements about the plant extract treatments for cancer.

1. they can bind to microtubules
2. they induce enzymes
3. they increase DNA strand breakage
4. they can bind to microtubules, and they increase DNA strand breakage

Reveal answer 168) Which of the following insulins would provide a patient diagnosed with type 1 diabetes mellitus a constant release of insulin over a 24-hour period?

1. Insulin aspart
2. Insulin glargine
3. Insulin lispro
4. Regular insulin

Reveal answer 169) What is the cause of type 1 diabetes?

1. Autoantibody destruction of beta cells
2. Malformed beta cells
3. Failure of target tissue to respond to insulin
4. Hyperinsulinemia

Reveal answer 170) Which of the following is NOT a risk factor for atherosclerosis?

1. Male over the age of 45
2. Smoker
3. Hypothyroidism
4. Elevated HDL levels

Reveal answer 171) Which of the following is correct: 75 to 80 percent of total cholesterol in the body

1. is synthesized in the liver
2. enters the body as dietary cholesterol
3. is transported as chylomicrons in the blood
4. is transported as HDL

Reveal answer 172) All of the following are correct about "bad" cholesterol EXCEPT

1. it is a high-density lipoprotein
2. high levels of LDL contribute to atherosclerosis
3. it is a lipoprotein
4. it contains more fat and less protein than "good cholesterol"

Reveal answer 173) All of the following are correct about cholesterol or these hypolipidemic drugs EXCEPT

1. cholesterol is lowered by a diet rich in saturated fats
2. cholesterol is elevated in people with primary hypercholesterolemia
3. nicotinic acid is used to treat hyper cholesterolemia
4. fenofibrate primarily affects VLDL and triglycerides

Reveal answer 174) All of the following make cholesterol so important for the body EXCEPT

1. essential for building cell membranes
2. needed to help form myelin sheath
3. helps in digestion of dietary fats
4. inhibits formation of nerve covering

Reveal answer

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