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Test bank Kaplan
Chemistry 14,49,50,51,55,56 Test Bank Kaplan
| Question | Answer |
|---|---|
| 1. It is of particular importance to monitor drug levels in patients for drugs that have a _____ index. A therapeutic index of 2.0 is associated with a high likelihood of the patient experiencing _____. | a. low, significant toxicity from the drug |
| 2. Blood Samples should be collected for therapeutic drug monitoring: | d. at varied times and based on the characteristic of the particular drug, rout of administration, and intent of the drug. |
| 3. Where will an acidic drug with pK of 3.5 have the greatest chance for absorption by passive diffusion? | A. The stomach |
| 4. Which of the following are considered goals of metabolism? | 1. to make the drug more water soluble 2. to make the drug less active |
| 5. The primary driving force for drugs to move from the point of absorption to the site of action is ____, and the primary driving force for drugs to leave the site of action following a single dose is_____. | D. Passive transport, passive transport |
| 6. Some active drugs are known to be enzymatically metabolized active metabolites but are no considered prodrugs. Which of the following explains the difference between these drugs and prodrugs? | D. The active form of the prodrug is unstable, not readily soluble, or poorly absorbed. |
| 7. In general consideration of drug blood level and the time a drug spends in the body before elimination under normal physiological conditions, which of the statements below is true following a single dose of drug? | B. The more rapidly the peak concentration is attained, the longer the period of time the drug will spend in the body. |
| 8. Considering the administration of a single does of a hypothetical drug by different routes, which of the following gives the correct order of attaining peak concentration of the drug in the blood stream | C. Intravenous, intramuscular, oral |
| Different drug manufacturers influence the lvl time curve after a single dose and release from diff formulations. Describe the correlations between the diff formulations. | D. The area under the blood level- time curve for each formulation will be the same |
| 10. The 2 main organs associated w/ the elimination of drugs are the kidney and the liver. What would be the effect on the blood lvl-time curve following the administration of a single dose of a medication in the presence of liver disease or renal failure | C. The peak concentration will increase, and the duration of time the drug spends in the body will increase |
| 11. Given that a drug has a half-life of 10 hours and is administered at a dosing internal of slightly less than the half-life, approximately how long will it take to reach the steady-state interval? | C. 40 hours |
| 12. A situation where the amount of drug excreted between two doses is equal to the previous dose administered is known as. | A. A steady- state |
| 13. Kinetic processes related to the fate of a drug in the body, where the rate of change of drug concentration is dependent upon the drug concentration, is known as: | B. first order kinetics |
| 14. Kinetic processes related to the fate of a drug in the body, where the rate of change of drug concentration is independent of the concentration of a particular drug, is known as: | A. zero order kinetics |
| 15. Kinetic processes related to the fate of a drug in the body, where the drug concentration exceeds the capacity of the system is known as | C. Michaelis-Menten kinetics |
| 16. Which of the following statements are true regarding drug half-life? | B. Half life is equal to the time required to change the drug blood level by 50% |
| 17.A pt is experiencing toxic side effects after dose that subsides approx an hour later. The bld sample collected for initial eval is___.If lvl is found to have higher concentrations the desired, a lab test to evaluate___would be advised. | B. Peak blood sample, kidney function |
| 1.Which amino acid residue of thyroglobulin is responsible for binding iodine in the formation of thyroid hormones? | A. Tyrosine |
| 2.Which of the following steps in thyroid hormone synthesis, storage, and release are stimulated by TSH? | 1.uptake of amino acids for use in synthesis of thyroglobulin 2.uptake of iodine for use in formation of thyroid hormones 3.hydrolysis of thyroglobulin complex to free thyroid hormones |
| 3.Which of the following thyroid hormones is considered to be most active physiologically? | C.T3 |
| 4.Thyroid hormones exert influence in most areas of the body. How do thyroid hormones influence the heart? | a.They affect cardiac gene expression b.They influence the sensitivity of the heart to the sympathic nervous system c.They cause peripheral hemodynamic alterations that influence cardiac function |
| 5.Thyroid hormones are metabolized predominantly by deiodination. Which of the following statements are true of deiodinase DI? | 1.It is present in increased concentrations in liver and kidney 2.It is the main source of T3 in hyperthyroid patients 3.It converts T4 to equimolar amounts of T3 and rT3 |
| 6.Which of the following characteristics are true of Graves’ disease? | 1.It is the most common cause of hyperthyroidism 2.It is an autoimmune disorder 3.Patients often have high serum concentration of antibodies against thyroglobulin and thyroid peroxidase. |
| 7.In primary hyperthyroidism, fT4 will be _____, and TSH will be _____ | A.increased, decreased |
| 8.In patients with developing subclinical hyperthyroidism, TSH levels will likely be _____, and fT4 will likely be _____. | C.decreased, normal |
| 9.After treatment with med. or radioactive iodine is initiated for hyper thyroidism, disease activity is berst initially monitored with _____, because _____ will take several weeks or more to return to reference interval. | C.fT3 and fT4, TSH |
| 10.What tests are used as part of newborn screening programs to identify congenital hypothyroidism? | B.T3 and/or T4 |
| 11.During pregnancy, serum TBG concentration _____, total thyroid hormone levels are _____, and free thyroid hormone levels are _____. | A.Increases, increased, unaffected |
| 12.Which thyroid hormone normally peaks at 24-36 hours post-delivery in newborn and gradually falls over the first four weeks of life? | a.Total T4 b.fT4 c.T3 |
| 13.the following lab data are suggestive of which clinical situation? TSH decreased T4 decreased T3 decreased rT3 increased | Euthyroid Sick Syndrome |
| 14.Given the following, which disease state is most likely? TSH decreased fT4 increased fT3 increased T3RU increased | Grave’s Disease |
| 15.Given the following characteristics, which disease is most likely? TSH increased fT4 increased fT3 increased T3RU decreased TSI negative TPO-ab unlikely to be positive Thyroid scan uptake increased | Secondary hyperthyroidism |
| 16. When free thyroxine cannot be measured directly, the free thyroxine index (FT4I) may be calculated by using which measured laboratory data? | T4 & T3 resin uptake |
| 17. The T3 resin uptake test is used to measure | C. Thyroxine binding globulin (TBG) |
| 18. There is a concern that the reference interval for TNH is is set too high to detect subtle thyroid disease. It is suggested that the upper reference value be reduced to what level to address this concern? | C. 3.0 mU/L |
| 1. The ovary is composed of what cell types? | 1. coelomis epithelial cells 3. mesenchymal cells 4. primordial germ cells |
| 2. The central medulla region of the ovary consists of which of the following? | 1. stroma |
| 3. Gonadotropin-releasing hormone (GnRh) regulates which of the following? | a. synthesis and storage of gonadotropins b. movement of gonadotropins from a reservoir pool ready for secretion c. immediate release of FSH and LH |
| 4. Which of the following are true of progestagens? | they promote the development of the female secondary sex characteristics,They are the primary secretory product of the corpus luteum, They are required for the induction of secretory activity in an estrogen-primed uterus. |
| 5. Which androgens are capable of interacting with the androgen receptor? | 1. testosterone 2. dihydrotestosterone |
| 6. What hormone controls conversion of androgens to estrogens? | B. FSH |
| 7. Sex hormone-binding globulin (SHBG) is a β-globulin synthesized by the liver and exhibits _____________ binding of testosterone and estradiol in the blood stream. | high-affinity and low-capacity |
| 8. In the postmenopausal state, there is a 10 to 15 fold increase in circulating _________. A 4 to 5 fold increase in circulating ____________, and a more than 90% decrease in circulating ___________. | FSH, LH, Estradiol |
| 9. Classical symptoms of menopause such as, hot flashes, vaginal dryness, and urinary frequency are thought to result from _______________________. | decreased estradiol level |
| 10. The clinical problem of menorrhea may be defined by which of the following criteria? | No period @14 w/absence of growth, No period @16, regardless of the presence of normal growth, & menstrating women, w/absence of periods for some time is equivalent to a total of at least 3 of the previous cycle intervals or 6 months of amenorrhea. |
| 11. All patients with elevated __________ in association with amenorrhea and/or galactorrhea require radiological imaging of the pituitary. | Prolactin |
| 12. Which of the following are associated with Polycystic Ovary Syndrome? | 1. menstrual irregularity 2. elevated serum androgen levels 3. deepened voice |
| 13. Which of the following statements are true regarding cell types involved in the formation of the testes? | primordial germ cells which remain quiescent until puberty, when they divide by mitosis to form spermatogonia. |
| 14. In the negative-feedback regulation of androgens, which of the following functions to inhibit production of FSH? | inhibin |
| 1.Which of the following are characteristic of ketosteroids? | 3. Contain 19 carbon atoms 4. Contain a ketone group at the carbon 17 position |
| 2. The predominant androgens secreted by the adrenal cortex are: | 1. DHEA-S, DHEA, and androstenedione |
| 3. Adrenal androgens can be converted by peripheral tissues to which primary sex hormones? | a. Testosterone b. Dihydrotestosterone c. Estradiol |
| 4. In normal individuals, four main factors control the secretion of aldosterone for the zona glomerulusa. Under normal circumstances, which factor predominates? | C. The renin-angiotensin system |
| 5. Which of the following conditions results from excess cortisol production? | A. Cushings SYNDROME |
| 6. Primary autonomous hpyersecretion of aldosterone by the zona glomerulosa is mainly caused by: | A. Conn’s syndrome B. Idiopathic hyperaldosteronism due to bilateral adrenal hyperplasia |
| 7. Which of the following lab observations would be seen in Addisonian crisis? | 2. Hyponatremia 3. Hemoconcentration 4. Increased urea levels |
| 8. Symptoms of secondary adrenal insufficiency include which of the following lab observations? | 1. Hypothyroidism 2. Concomitant hypogonadism 4. Hypoglycemia |
| 9. A patient with itemittent hypertension has an elevated urinary vanillylamdelic acid (VMA). This result suggests: | D. pheochromocytoma |
| 10. Which of the following patients should undergo screening for Cushing’s Syndrome? | A. Osteoporosis patients B. A woman with polycystic ovary syndrome C. patient with poorly controlled diabetes |
| 11. Which of the following patients could have a false-postitive lat night salivary cortisol? | A. 1,2,3 1. A patient with hypertension 2. Advanced age 3. psychiatric problems |
| 12. A morning cortisol level of ____ is normal and usually excludes Cushing’s syndrome, but a level of ____ indicates hypercortisolism. | C. < 50nmol/L , > 280 nmol/L |
| 13. When is cortisol usually at its lowest concentration? | B. Midnight |
| 14. Which of the following is as indication for screening hypertension patients for primary aldosteronism? | 2. Hypertension refractory to treatment with 3+ drugs 3. Adrenal incidentaloma 4. onset of hypertension at a young age |
| 15. In a patient with suspected primary aldosteronism, screening can be accomplished by measuring a morning ambulatory paired random aldosterone and a renin activity. A + test result is defined as a combination of _____ aldosterine to plasma renin activi | A. Increased, Increased |
| 16. Which of the following is considered a definitive lab finding for congenital adrenal hyperplasia? | C.Increased 17-hydroxyprogesterone in serum |
| 17. Which of the following is considered the most sensitive test for the diagnosis and exclusion of pheochromocytoma? | A.plasma free metanephrines |
| 18. Which of the following is the most common pattern of urine free catecholamine finding in patients with pheochromocytoma? | B. Increased levels of norepinephrine, with smaller increases or normal levels of epinephrine and dopamine |
| 1.What type of toxicology focuses on the pathological processes that are caused by the exposure of a patient to a toxin and includes subsequent medical evaluation and treatment of the patient? | A.clinical |
| 2.What is the primary means by which most drugs and toxins cross membranes? | C. passive diffusion |
| 3.Which type of toxin induces genetic changes that become inheritable? | a.mutagens b.teratogens |
| 4.Which of the following is true of neurotoxicity? | Effect of 1 chem may lead to ^ in neurotransmitters,& another inhibits production/release,a chem can alter flow of NA,K,CA across ion channels in membranes,& w/chronic exposure,it may be difficult to determine if symp are related to toxicity/disease state |
| 5.Which toxins enter the body through what route? | 1.skin 2.lungs 3.gastrointestinal tract |
| 6.In which of the following situations would an individual not experience a high from cocaine use? | 1.Applying to skin 2.Drinking |
| 7.Which of the following is considered part of pharmacokinetic parameters? | 1.Half-life 2.Volume of distribution 3.Clearance rates |
| 8.Which of the following individuals would have the highest metabolism of a drug based strictly on age? | B.a 20-year old |
| 9.Hemodialysis or hemoperfusion may be effective in removing water-soluble toxins that have which of the following characteristics? | 1.Low volume of distribution 2.Low protein binding |
| 10.Which of the following chelating agents are used to bind and remove metals? | a.Ethylenediaminetetraacetate b.Deferoxamine c.British anti-Lewisite |
| 11.Which of the following drugs shows a relationship between the concentration of the toxin found in the circulation and toxicity? | a.Acetaminophen b.Salicylate c.Carbon monoxide |
| 12.When considering herbal drugs and toxins, licorice and licorice rott can cause which of the following symptoms? | 1.Hypertension 2.Hypokalemia |
| 13.Naloxone is an antidote for what type of poisoning? | A.opiates |
| 14.Which of the following is the correct antidote for iron or aluminum poisoning? | C.deferoxamine |
| 15.Ginseng can cause toxicity in which of the following sites? | A.heart |
| 16.Cocaine has what window of detection? | B. <72 hours |
| 17.Which of the following binds sulfhydryl groupls of enzymes and proteins, uncouples oxidative phosphorylation, and can be found in urine, hair, nail, and blood samples? | D. arsenic |
| 18.Cadmium can be found in what sample types? | 1.Urine 2.Hair |
| 1. What is the most commonly abused substance in the West? | D. Alcohol |
| 2. Which of the following are true of addiction? | 1. It is a chronic deteriorating process 3. Abstinence from the addictive agent allows the mind and body to recover |
| 3. Which of the following is an aspect of addiction? | 1. Craving 2. Withdrawal 3. Dependence 4. Denial |
| 4. Which of the following theories characterize addiction as an attachment disorder induced by a person’s attempt to self- repair developmental deficits in psychic structure and early environmental deprivation leading to ineffective attachment styles? | 1. Attachment theory 2. Self-psychology 3. Affect regulation theory |
| 5. The heaviest alcohol use occurs in what age group? | B 18-25 years |
| 6. Which of the following situation could produce withdrawal symptoms? | a. chronic regular use of narcotics for pain b. chronic regular use of sedatives for anxiety c. chronic regular use of sedatives for insomnia |
| 7. Which of the following would best help a physician determine that a patient is escalating a dose of prescribed medication? | C. quantitative drug screens over a period of time |
| 8. Which of the following tests has recently emerged as a new biochemical marker to measure excessive alcohol consumption? | B. Carbohydrate- deficient transferring |
| 9. By law, individuals employed by the feds or who are under the authority of the DOT will be screened for which drugs? | 1.cocaine 2. Marijuana 4. opioids |
| 10. Which of the following is considered a reason that a person will fail a drug screen even though he was given advanced warning? | a. a person who did not understand the physiological aspect of drug testing b. denial about his addiction c. no intention of using drugs at the time of the drug screen but loses control and uses the drug at an inopportune moment |
| 11. Which of the following statements is true of drug screens? | 1. Drug screens can be critical in the confrontation of active denial in patients 2. Drugs screens are performed most often on untimed specimens 4. Legal requirement of the treatment in methadone maintenance |
| 12.Chronic abuse of opiates is associated with which of the following conditions? | 1. Viral infections 3. hepatitis 4. Insomnia |
| 13. Pulmonary disorders, various types of cancer, heart attack, osteoporosis, and low birth weight in newborns are associated with chronic abuse of which of the following drugs? | C. tobacco |
| 14. Which of the following is a symptom of withdrawal from cocaine? | 1. Hypersomnia 2. Hyperphagia 3. Depressed mood |
| 15.Lacrimation. rhinorrhea, piloerection, sweating, diarrhea, yawning, and tachycardia are all withdrawal symptoms of which of the following drugs? | C. Opiates |
| 16. Which of the following statements are true of a craving for a drug? | 2. Cravings can be caused by environmental triggers 3. Craving can be caused by psychological states that evoke the urge |
| 17. _____ is defined as the CNS adjustment to the relatively sudden cessation of regular psychoactive substance use. | A. Withdrawal |
| 18. Which of the following is a type of change that occurs during withdrawal? | a. physical b. psychological c. behavior |
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