CC - ENHANCED Flashcards by Edricha Rose

Most common route of drug delivery:

A. Intravenous
B. Oral
C. Rectal
D. Transcutaneous

B. Oral

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Drug administration which offers the most direct route with effective delivery to their sites of action:

A. Intramuscular
B. Intravenous
C. Oral
D. Rectal
E. Subcutaneous

B. Intravenous

Rationale:

Intravenous (IV) administration into the circulatory system offers the most direct route with effective delivery to their sites of action.

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Drug delivery commonly used in INFANTS and in situations in which oral delivery is unavailable:

A. Intramuscular
B. Intravenous
C. Rectal
D. Subcutaneous

C. Rectal

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In pharmacokinetics, serum concentrations ______ when the rate of absorption exceeds distribution and elimination.

A. Decline
B. Spuriously decline
C. Rise
D. Spuriously rise

C. Rise

Rationale:

Serum concentrations rise when the rate of absorption exceeds distribution and elimination.

The concentration declines as the rate of elimination and distribution exceeds absorption.

The rate of elimination can only be determined after absorption and distribution are complete.

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In pharmacokinetics, the concentration of the drug _____ as the rate of elimination and distribution exceeds absorption.

A. Declines
B. Spuriously declines
C. Rises
D. Spuriously rises

A. Declines

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Single most important factor in therapeutic drug monitoring (TDM):

A. Amount of WBCs in the specimen
B. Presence of glucose in the specimen
C. Timing of specimen collection
D. Volume of specimen

C. Timing of specimen collection

Rationale:

In general, trough concentrations for most drugs are drawn right before the next dose; peak concentrations are drawn 1 hour after an orally administered dose.

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Specimen of choice for the determination of circulating concentrations of most drugs:

A. Expectorated sputum
B. Gastric fluid
C. Serum or plasma
D. Urine

C. Serum or plasma

Rationale:

Serum or plasma is the specimen of choice for the determination of circulating concentrations of most drugs.

Heparinized plasma is suitable for most drug analysis. The calcium-binding anticoagulants add a variety of anions and cations that may interfere with analysis or cause a drug to distribute differently between cells and plasma. As a result, ethylenediaminetetracetic acid (EDTA), citrated and oxalated plasma are not usually acceptable specimens.

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All of the following are cardioactive drugs, except:

A. Aminoglycoside
B. Digixon
C. Procainamide
D. Quinidine

A. Aminoglycoside

Rationale:

Aminoglycosides are a group of chemically related antibiotics used for the treatment of infections with gram-negative bacteria that are resistant to less toxic antibiotics.

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A BARBITURATE that effectively controls several types of seizures:

A. Carbamazepine
B. Phenobarbital
C. Phenytoin
D. Valproic acid

B. Phenobarbital

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An orally administered drug used to treat manic depression (bipolar disorder):

A. Digoxin
B. Lithium
C. Phenytoin
D. Theophylline

B. Lithium

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All of the following are immunosuppressive drugs, except:

A. Cyclosporine
B. Phenytoin
C. Sirolimus (rapamycin)
D. Tacrolimus

B. Phenytoin

Rationale:

AKA (Dilantin) commonly used treatment for seizures

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An anti-neoplastic drug that inhibits DNA synthesis in all cells:

A. Clozapine
B. Ethosuximide
C. Methotrexate
D. Procainamide

C. Methotrexate

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Defined as exogenous agents that may have an adverse effect on a living organism; this term is more often used to describe environmental chemicals or drug exposures:

A. Poisons
B. Toxins
C. Xenobiotics

C. Xenobiotics

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Agents that have an adverse effect on a biological system; this term is more often used when describing animal, plant, mineral, or gas:

A. Poisons
B. Toxins
C. Xenobiotics

A. Poisons

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Most sensitive organ to ethanol toxicity:

A. Brain
B. Heart
C. Kidney
D. Liver

D. Liver

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An AST/ALT ratio of greater than _____ is highly specific for ethanol-related liver disease

A. Greater than 0.5
B. Greater than 1.0
C. Greater than 1.5
D. Greater than 2.0

D. Greater than 2.0

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Also known as rubbing alcohol:

A. Butyl alcohol
B. Ethyl alcohol
C. Isopropyl alcohol
D. Methyl alcohol

C. Isopropyl alcohol

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Carbon monoxide expresses its toxic effects by causing a leftward shift in the oxygen–hemoglobin dissociation curve, resulting in:

A. Decrease amount of oxygen delivered to tissue
B. Increase amount of oxygen delivered to tissue
C. Variable amount of oxygen delivered to tissue
D. Normal amount of oxygen delivered to tissue

A. Decrease amount of oxygen delivered to tissue

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Only treatment for carbon monoxide poisoning:

A. Corticosteroids
B. Intravenous immunoglobulins
C. Platelet transfusion
D. 100% oxygen therapy

D. 100% oxygen therapy

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Overdose of acetaminophen is associated with a severe:

A. Nephrotoxicity
B. Hepatotoxicity
C. Ototoxicity
D. Neurotoxicity

B. Hepatotoxicity

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An illicit amphetamine derivative that is commonly referred to as “ecstasy”

A. Amphethamine
B. Cannabinoid
C. Metamphetamine
D. Methylenedioxymethylamphetamine

D. Methylenedioxymethylamphetamine

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Half-life of ecstasy:

A. 0.5 to 1 hour
B. 1 to 2 hours
C. 7 to 8 hours
D. 8 to 9 hours

D. 8 to 9 hours

Rationale:

● Half-life of ecstasy: 8 to 9 hours
● Half-life of THC: 1 day after a single use and 3 to 5 days in chronic, heavy consumers
● Half-life of cocaine: 0.5 to 1 hour
● Half-life of benzoylecgonine: 4 to 7 hours

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Half-life of cocaine:

A. 0.5 to 1 hour
B. 1 to 2 hours
C. 7 to 8 hours
D. 8 to 9 hours

A. 0.5 to 1 hour

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All of the following are naturally occurring opiates, except:

A. Codeine
B. Heroin
C. Morphine
D. Opium

B. Heroin

Rationale:

OPIATES:

The naturally occurring substances include opium, morphine, and codeine.

Heroin, hydromorphone (Dilaudid), and oxycodone (Percodan) are chemically modified forms of the naturally occurring opiates.

Meperidine (Demerol), methadone (Dolophine), propoxyphene (Darvon), pentazocine (Talwin), and fentanyl (Sublimaze) are the common synthetic opiates.

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25. Environmental pollutants: A. Elemental mercury B. Mercurous mercury C. Mercuric mercury D. Alkyl mercury

D. Alkyl mercury Rationale: In contrast to elemental and inorganic mercury, organic mercury com- pounds, containing alkyl, aryl, and alkoxyalkyl moieties, are environmental pollutants.

26. How do enzymes catalyze many physiologic processes? A. By increasing the activation energy B. By lowering the activation energy C. By eliminating the activation energy D. By adding energy to the reaction

B. By lowering the activation energy Rationale: Enzymes accelerate reactions by lowering the activation energy needed to overcome the transition state on the way to product formation.

27. Which of the following is the primary mechanism of compensation for metabolic acidosis? A. Hyperventilation B. Aldosterone release C. Release of epinephrine D. Bicarbonate excretion

A. Hyperventilation

28. Which of the following is the primary mechanism causing respiratory alkalosis? A. Renal failure B. Hyperventilation C. Too much bicarbonate D. Congestive heart failure

B. Hyperventilation

29. If a blood gas specimen is left exposed to the air for an extended period, which of the following changes will occur? A. p02 increases, pH and pC02 decrease B. p02 decreases, pH and pC02 increase C. p02 and pH increase, pC02 decreases D. p02 and pH decrease, pC02 increases

C. p02 and pH increase, pC02 decreases

30. Porphyrins are the building blocks of hemoglobin and are composed of: A. 4 pyrrole rings bound to an iron molecule B. 4 beta globin chains C. 4 alpha globin chains D. 2 pyrrole rings and 2 beta globin chains

A. 4 pyrrole rings bound to an iron molecule

31. TIBC measures: A. The total amount of iron in the blood B. The total amount of iron storage in the body C. The amount of oxygen that can be carried in the blood D. The total amount of iron that can be bound by transferrin

D. The total amount of iron that can be bound by transferrin

32. Which of the following disease states is characterized by a hyperviscosity syndrome, a monoclonal gammopathy, and Bence Jones proteins present in the patient's urine? A. Multiple sclerosis B. Glomerulonephritis C. Scarlet fever D. Multiple myeloma

D. Multiple myeloma

33. The folding of the protein molecule upon itself into a compact three-dimensional shape is known as which kind of structure? A. Primary B. Secondary C. Tertiary D. Quaternary

C. Tertiary

34. The level of which protein, measured at particular points during a woman's pregnancy, can indicate whether certain birth defects (neural tube or trisomy 21) are present in the fetus? A. Alpha2-macroglobulin B. Transferrin C. Alpha-fetoprotein D. Albumin

C. Alpha-fetoprotein

35. Which of the following tumor markers is elevated in pancreatic cancer? A. CA 19-9 B. CA 15-3 C. CA 27.29 D. CA 125

A. CA 19-9

36. The largest lipoprotein molecule is: A. LDL B. VLDL C. Chylomicron D. HDL

C. Chylomicron

37. What is the smallest lipoprotein molecule? A. Chylomicron B. LDL C. VLDL D. HDL

D. HDL

38. Which of the following conditions is the result of alpha1 -antitrypsin level lower than 1 1 mmol/L? A. Emphysema B. Asthma C. Pulmonary edema D. Sarcoidosis

A. Emphysema

39. High levels of indirect bilirubin, high levels of total bilirubin, and normal levels of direct bilirubin are associated with which of the following conditions? A. Gallstones B. Red blood cell hemolysis C. Hepatitis D. Wilson disease

B. Red blood cell hemolysis

40. The most specific and sensitive blood test for detection of acute pancreatitis is: A. Serum amylase B. Serum lipase C. Immunoreactive trypsinogen D. Fasting blood glucose

B. Serum lipase

41. The hormones that are secreted by the adrenal cortex are derived from which of the following precursors? A. Enterochromaffin cells B. Cholesterol C. Catecholamines D. Nucleoproteins

B. Cholesterol

42. Which of the following is not a site of action for calcium regulation associated with parathyroid hormone? A. Bones B. Kidneys C. Adrenal D. Small intestines

C. Adrenal

43. When the female body produces too many androgens and terminal hair (especially on the face) that grows in a male pattern, the condition is referred to as: A. Menopause B. Amenorrhea C. Hirsutism D. Orchitis

C. Hirsutism

26. The anti-acetylcholine receptor test is used to help diagnose which of the following diseases? A. Ankylosing spondylitis B. Myasthenia gravis C. Rhabdomyolysis D. Osteogenesis imperfecta

B. Myasthenia gravis

45. Many individuals diagnosed with diabetes mellitus suffer from which of the following nervous system diseases? A. Guillain-Barre syndrome B. Dementia C. Multiple sclerosis D. Peripheral neuropathy

D. Peripheral neuropath

46. In Tangier disease, lipid is deposited in the eye due to: A. Abnormally high HDL B. Very low or absent HDL C. Abnormally low LDL D. Abnormally high LDL

B. Very low or absent HDL

47. Cardiovascular drugs that are monitored by therapeutic drug monitoring include all the following EXCEPT: A. Tacrolimus B. Digoxin C. Procainamide D. Verapamil

A. Tacrolimus Rationale: Tacrolimus (proprietary name: Prograf) is used to prevent rejection of heart, allogenic liver and kidney transplants.

48. Antiepileptic drugs that are monitored by therapeutic drug monitoring include all the following EXCEPT: A. Phenytoin B. Theophyliine C. Carbamezepine D. Ethosuximide

B. Theophyliine

49. Immunosuppressant drugs that are monitored by therapeutic drug monitoring include all the following EXCEPT: A. Diazepam B. Cyclosporine C. Tacrolimus D. Sirolimus

A. Diazepam Rationale: Diazepam (proprietary name: Valium) is in a class of drugs called benzodiazepines, which are sedative-hypnotics.

50. In a person with normal glucose metabolism, the blood glucose level usually increases rapidly after carbohydrates are ingested but returns to a normal level after: A. 30 minutes B. 45 minutes C. 60 minutes D. 120 minutes

D. 120 minutes

51. Which of the following organs uses glucose from digested carbohydrates and stores it as glycogen for later use as a source of immediate energy by the muscles? A. Kidneys B. Liver C. Pancreas D. Thyroid

B. Liver

52. Which of the following statements is true about type 1 diabetes mellitus? A. It is associated with an insufficient amount of insulin secreted by the pancreas B. It is associated with insufficient activity of insulin secreted by the pancreas C. It is more frequent type of diabetes than the non-insulin-dependent type (type 2) D. Good control of this disease will eliminate complications in the future

A. It is associated with an insufficient amount of insulin secreted by the pancreas

53. Gestational diabetes can occur during pregnancy in some women. Which of the following can occur for a significant number of these women? A. Can develop type 1 diabetes at a later date B. Can develop type 2 diabetes at a later date C. Continue to manifest signs of diabetes after delivery D. No effect

B. Can develop type 2 diabetes at a later date

54. Which of the following electrolytes is the chief cation in the plasma, is found in the highest concentration in the extravascular fluid, and has the main function of maintaining osmotic pressure? A. Potassium B. Sodium C. Calcium D. Magnesium

B. Sodium

55. Analysis of a serum specimen gives a potassium result of 6.0 mmol/L. Before the result is reported to the physician, what additional step should be taken? A. The serum should be observed for hemolysis; hemolysis of the red cells will shift potassium from the cells into the serum, resulting in a falsely elevated potassium value B. The serum should be observed for evidence of jaundice; jaundiced serum will result in a falsely elevated potassium value C. The test should be run again on the same specimen D. Nothing needs to be done; simply report the result

A. The serum should be observed for hemolysis; hemolysis of the red cells will shift potassium from the cells into the serum, resulting in a falsely elevated potassium value

56. Calculation of the anion gap is useful for quality control for: A. Calcium B. Test in the electrolyte profile (sodium, potassium, chloride and bicarbonate) C. Phosphorus D. Magnesium

B. Test in the electrolyte profile (sodium, potassium, chloride and bicarbonate)

57. Ninety percent of the carbon dioxide present in the blood is in the form of: A. Bicarbonate ions B. Carbonate C. Dissolved carbon dioxide D. Carbonic acid

A. Bicarbonate ions

58. The main waste product of protein metabolism is: A. Creatinine B. Creatine C. Uric acid D. Urea

D. Urea

59. Expected creatinine clearance for a patient with chronic renal disease would be: A. Very low; renal glomerular filtration is functioning normally B. Normal; renal glomerular filtration is functioning normally C. Very high; renal glomerular filtration is not functioning normally D. Very low; renal glomerular filtration is not functioning normally

D. Very low; renal glomerular filtration is not functioning normally Rationale: Late stages of renal failure show increased serum potassium and phosphorus and decreased serum calcium and urinary potassium. Creatinine clearance decreases, often to less than 50 mL/min compared with reference ranges.

60. A urea nitrogen result for a serum sample is reported as 10 mg/dL. Calculate the concentration of urea for this sample: A. 28 mg/dL B. 21 mg/dL C. 92 mg/dL D. 43 mg/dL

B. 21 mg/dL

61. Testing blood from a patient with acute glomerulonephritis would most likely result in which of the following laboratory findings? A. Decreased creatinine B. Decreased urea C. Increased glucose D. Increased creatinine

D. Increased creatinine

62. Uric acid is the final breakdown product of which type of metabolism? A. Urea B. Glucose C. Purine D. Bilirubin

C. Purine

63. Blood is collected from a patient who has been fasting since midnight; the collection time is 7 am. Which of the following tests would not give a valid test result? A. Cholesterol B. Triglycerides C. Total bilirubin D. Potassium

B. Triglycerides Rationale: Serum or plasma specimens collected from patients in blood collection tubes who have fasted for at least 12 hours are required for triglyceride testing.

64. Which of the following laboratory values is considered a positive risk factor for the occurrence of coronary heart disease? A. HDL cholesterol > 60 mg/dL B. HDL cholesterol < 35 mg/dL C. LDL cholesterol < 130 mg/dL D. Total cholesterol < 200 mg/dL

B. HDL cholesterol < 35 mg/dL

65. As part of a lipid-screening profile, the following results were obtained for a blood specimen drawn from a 30-year-old woman immediately after she had eaten breakfast: triglycerides 200 mg/dL; cholesterol 180 mg/dL. Which of the following would be a reasonable explanation for these results? A. The results fall within the reference values for the two tests; they are not affected by the recent meal. B. The cholesterol is normal, but the triglyceride test is elevated; retest using a 12-hour fasting specimen, because the triglyceride test is affected by the recent meal C. The results are elevated for the two tests; retest for both using a 12-hour fasting specimen, because both the cholesterol and the triglyceride test are affected by the recent meal. D. The results for both tests are below the normal reference values despite the recent meal.

B. The cholesterol is normal, but the triglyceride test is elevated; retest using a 12-hour fasting specimen, because the triglyceride test is affected by the recent meal

66. An adult male patient with jaundice complains of fatigue. He has a decreased blood hemoglobin level(he is anemic) and an elevated serum bilirubin value, most of which represents unconjugated bilirubin. His liver enzyme tests are within the normal reference ranges. The most likely disease process for this patient is: A. A gallstone obstructing the common bile duct B. Hemolytic anemia in which his red blood cells are being destroyed C. Infectious (viral) hepatitis D. Cirrhosis of the liver

B. Hemolytic anemia in which his red blood cells are being destroyed

67. Integral part of the transmission of nerve impulses: A. Bicarbonate B. Chloride C. Potassium D. Sodium

C. Potassium Rationale: As the primary intracellular cation, potassium is an integral part of the transmission of nerve impulses. Movement of potassium across the nerve tissue membrane permits the neural signal to move down the nerve fiber. Potassium also seems to be involved in synaptic processes, where the impulse "jumps" from one nerve fiber to another.

68. Second most abundant anion in the extracellular fluid; major component of the blood buffering system, accounts for 90% of total blood carbon dioxide, and maintains charge neutrality in the cell: A. Bicarbonate B. Chloride C. Magnesium D. Potassium

A. Bicarbonate Rationale: Bicarbonate is the second most abundant anion in the extracellular fluid. It is a major component of the blood buffering system, accounts for 90% of total blood carbon dioxide, and maintains charge neutrality in the cell.

69. The formation of glucose from amino acids and lipids that occurs when carbohydrate intake decreases: A. Glycogenesis B. Glycogenolysis C. Glycolysis D. Gluconeogenesis

D. Gluconeogenesis Rationale: ● Gluconeogenesis is the formation of glucose from amino acids and lipids that occurs when carbohydrate intake decreases. ● Glycogenesis is the process of glycogen formation by enzyme action on glucose to eventually form glycogen. ● Glycogenolysis is the breakdown of glycogen, with the eventual formation of glucose-6-phosphate or free glucose that can be used for energy production. ● Glycolysis is the catabolism of glucose to pyruvate or lactate for adenosine triphosphate (ATP) production (Embden-Meyerhof pathway and Krebs’ cycle).

70. Which form of jaundice occurs within days of delivery and usually lasts 1–3 weeks, but is not due to normal neonatal hyperbilirubinemia or hemolytic disease of the newborn? A. Gilbert syndrome B. Lucey-Driscoll syndrome C. Rotor syndrome D. Dubin-Johnson syndrome

B. Lucey-Driscoll syndrome Rationale: Lucey–Driscoll syndrome is a rare form of jaundice caused by unconjugated bilirubin that presents within 2–4 days of birth and can last several weeks. It is caused by an inhibitor of UDP-glucuronyl transferase in maternal plasma that crosses the placenta. Jaundice is usually severe enough to require treatment.

71. In ketoacidosis, the anion gap would most likely be affected in what way? A. Unchanged from normal B. Increased C. Decreased D. Balanced

B. Increased Rationale: INCREASED ANION GAP 1. Uremia/renal failure, which leads to PO4- and SO42- retention 2. Ketoacidosis, as seen in cases of starvation or diabetes 3. Methanol, ethanol, ethylene glycol poisoning, or salicylate 4. Lactic acidosis 5. Hypernatremia 6. Instrument error DECREASED ANION GAP 1. Hypoalbuminemia (decrease in unmeasured anions) 2. Severe hypercalcemia (increase in unmeasured cations)

72. If the aspartate aminotransferase (AST) and the alanine aminotransferase (ALT) serum levels are increased 50-fold over the reference range, what would be the most consistent diagnosis? A. Extrahepatic cholestasis B. Cirrhosis C. Carcinoma of the liver D. Viral hepatitis

D. Viral hepatitis

73. Usually _____ are required after the onset of chest pain before CK-MB become elevated in a patient with myocardial infarction. A. 1 to 2 hours B. 2 to 4 hours C. 4 to 6 hours D. 6 to 8 hours

C. 4 to 6 hours

74. In primary hypothyroidism, one would expect the serum FT4 level to be _____ , the TSH level to be _____ and TBG level to be ______. A. Decreased, increased, increased B. Decreased, decreased, increased C. Increased, decreased, increased D. Decreased, increased, decreased

A. Decreased, increased, increased

75. Subclinical hypothyroidism: A. Normal T3 T4, increased TSH B. Normal T3 T4, decreased TSH C. Decreased T3 T4, increased TSH D. Decreased T3 T4, decreased TSH

A. Normal T3 T4, increased TSH Rationale: In subclinical hypothyroidism, the TSH is minimally increased while the free T4 stays within the normal range. Likewise, in subclinical hyperthyroidism, the TSH is suppressed while the free T4 is normal.

CC - ENHANCED Flashcards

(75 cards)