Midterm Flashcards
(20 cards)
With alcohol intake, a disulfiram-like reaction is expected among the following cephalosporins, EXCEPT: A. Cefamandole B. Cefoperazone C. Cefotetan D. Cefotaxime E. None of the above
D. Cefotaxime
Drugs containing a methylthiotetrazole group (e.g. cefamandole, cefoperazone, cefotetan) may cause hypoprothrombinemia and disulfiram-like reaction with ethanol.
A 17 year old male was operated for emergency appendectomy. Thirty minutes after induction of anesthesia, he developed high grade fever (40°C) and apnea. Which of the following may have been administered as an adjunct to anesthesia? A. Midazolam B. Succinylcholine C. Pralidoxime D. Carbachol E. Ketamine
B. Succinylcholine
Malignant hyperthermia may occur rarely with interaction of succinylcholine (and possibly tubocurarine) with inhaled anesthetics (halothane).
This antifungal is converted into a metabolite that inhibits fungal thymidylate synthase: A. Caspofungin B. Flucytosine C. Griseofulvin D. Terbinafine E. Cytarabine
B. Flucytosine
Flucytosine is accumulated in fungal cells by the action of permease and converted by cytosine deaminase to 5-FU, which inhibits thyimidylate synthase.
Which class of diuretic is MOST LIKELY to increase the risk for ototoxicity if given with aminoglycosides? A. Carbonic anhydrase inhibitors B. K-sparing diuretics C. Loop diuretics D. Thiazides E. Osmotic diuretic
C. Loop diuretics
Furosemide may cause synergistic ototoxicity with aminoglycosides
Which of the following drugs is CORRECTLY matched with the mechanism of action?
A. Allopurinol - reversible & selective inhibitor of xanthine oxidase
B. Colchicine - reduce proximal tubule reabsorption of uric acid
C. Meloxicam - selective COX2 inhibitor
D. Febuxostat - irreversible inhibition of xanthine oxidase activity
E. Probenecid - inhibits leukocyte migration and phagocytosis
C. Meloxicam - selective COX2 inhibitor
Colchicine: inhibits leukocyte migration and phagocytosis;
Allopurinol: irreversibly inhibits xanthine oxidase activity; Febuxostat: reversible & selective inhibitor of xanthine oxidase;
Probenecid: compete with uric acid for reabsorption in the proximal tubule
Which of the following is a short-acting benzodiazepine? A. Oxazepam B. Clonazepam C. Alprazolam D. Flurazepam E. Flunitrazepam
A. Oxazepam
SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE:
Oxazepam: short acting;
Alprazolam & Clonazepam: intermediate acting;
Flurzaepam & Flunitrazepam: long acting.
For a 21-year old chronic user of heroin, which agent may be appropriate for detoxification? A. Diazepam B. Methadone C. Naloxone D. Tramadol E. Codeine
B. Methadone
Methadone: used in therapy for opioid dependence; Naloxone: used for tx of opioid overdose;
Diazepam: used for treatment of alcohol withdrawal.
Ejection fraction is evaluated prior to the administration of this chemotherapeutic agent? A. Etoposide B. Trastuzumab C. Cisplatin D. Vincristine E. Cytarabine
B. Trastuzumab
Trastuzumab may also cause congestive heart failure.
A 45 year old male was brought to the ER after he was stabbed with a knife poisoned with curare. Which of the folllowing can be given as immediate antidote? A. Succinylcholine B. Pilocarpine C. Atropine D. Pralidoxime E. Edrophonium
E. Edrophonium
Curare poisoning results from competitive antagonism at skeletal muscle nicotinic acetylcholine receptors.
Edrophonium is a very short acting cholinomimetic drug which inhibits acetylcholinesterase increasing acetylcholine levels in the NMJ.
Atropine: antidote for mushroom poisoning;
Pralidoxime: antidote for organophosphate poisoning.
Which drug can be used to prevent renal calcium stone formation? A. Furosemide B. Hydrochlorthiazide C. Spirinolactone D. Amiloride E. Ethacrynic acid
B. Hydrochlorthiazide
Side-effects of thiazide diuretics: Hyper GLUC (hyperGlycemia, hyperLipidemia, hyperUricemia, hyperCalcemia).
A 52 year old male is recently treated for hypertension, he sought consult at your clinic complaining of cough which started a day after taking his antihypertensive medication. What is the MOST LIKELY antihypertensive drug is he taking? A. Lisinopril B. Losartan C. Amlodipine D. Clonidine E. Metoprolol
A. Lisinopril
SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE:
ACE I’s may cause cough;
ARB’s have the advantage of a lower incidence of cough.
The following statement forms the basis for high dose once-daily aminoglycoside dosing protocols of aminoglycosides:
A. As the plasma level is increased above MIC, aminoglycosides kill an increasing proportion of bacteria
B. The efficacy of aminoglycosides is directly related to time above MIC and becomes independent of concentration once the MIC has been reached
C. The toxicity of aminoglycosides is independent to the critical plasma concentration and on the time that such a level is exceeded
D. The time above the threshold for toxicity is shorter when multiple smaller doses are given.
E. None of the above
A. As the plasma level is increased above MIC, aminoglycosides kill an increasing proportion of bacteria
SIMLAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE: Aminoglycosides have greater efficacy when administered as a single large dose than when given as multiple smaller dose. It exhibits a concentration dependent killing action such that as the plasma level is increased above the MIC, aminoglycosides kill an increasing proportion of bacteria and do so at a more rapid rate.
A selective B1-antagonist with additonal vasodilating action: A. Nadolol B. Esmolol C. Acebutolol D. Nebivolol E. Pindolol
D. Nebivolol
Nebivolol has vasodilating action in addition to dose-dependent B1-selective antagonism.
Pindolol & acebutolol: has intrinsic sympathomimetic activity;
Nadolol: longest acting B blocker;
Esmolol is a short-acting B blocker.
Combination of HMG-CoA reductase inhibitors with this drug increases the risk of myopathy: A. Exenatide B. Colesevelam C. Colestipol D. Ezetimibe E. Clofibrate
E. Clofibrate
Fibrate + resin - increased risk of cholelithiasis;
Statin + resin - impaired statin absorption;
Statin + fibrate & statin + niacin - increased risk of myopathy and rhabdomyolysis.
To reduce the primary toxicity of this drug, patients are advised to take it with large quantities of water and avoid situations that permit esophageal reflux: A. Alendronate B. Tamoxifene C. Teriparitide D. Calcitonin E. Cinacalcet
A. Alendronate
SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE: The primary toxicity of oral bisphosphonates is gastric and esophageal irritation.
Cilastin is given in combination to this drug to inhibit the formation of potentially nephrotoxic metabolite: A. Ertapenem B. Imipinem C. Meropenem D. Doripenem E. Aztreonam
B. Imipinem
Cilastin inhibits renal metabolism of imipinem which is converted to a nephrotoxic metabolite by dehydropeptidase I.
Which of the following drugs has a serotonin receptor-blocking effect? A. Sumatriptan B. Phenoxybenzamine C. SSRI D. TCA E. Tegaserod
B. Phenoxybenzamine
SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE: Phenoxybenzamine also has serotonin receptor-blocking effects, which justify its occasional use in carcinoid tumor.
An antidiabetic drug which acts by inhibiting renal glucose reabsorption: A. Acarbose B. Sitagliptin C. SGLT2 inhibitors D. GLP-1 agonists E. Pramlintide
C. SGLT2 inhibitors
SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE: SGLT2 accounts for 90% of renal glucose reabsorption. The SGLT2 inhibitors canagloflozin and dapagliflozin are approved for use to lower glucose levels in patients with type 2 DM.
Which is an antiplatelet drug given to prevent restenosis after coronary angioplasty? A. Tranexamic acid B. Trastuzumab C. Infliximab D. Alteplase E. Abciximab
E. Abciximab
SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE: Abciximab is a monoclonal antibody that reversibly inhibits the binding of fibrin and other ligands to the platelet glycoprotein IIb/IIIa receptor.
A 58 year old male maintained on chronic warfarin anticoagulant for atrial fibrillation consulted at the ER because of multiple petechiae, gum bleeding, and hemetochezia. He was recently started on cimetidine which was given at a medical mission at his barangay. What is the MOST LIKELY reason for his symptoms?
A. Reduced effect of warfarin because of induction of metabolism by cimetidine
B. Increased risk of toxicity to warfarin due to inhibition of metabolism by cimetidine
C. Increased risk of toxicity to warfarin because of induction of metabolism by cimetidine
D. Reduced effect of warfarin due to inhibition of metabolism by cimetidine
E. Increased oral reabsorption of warfarin because of H2-block by cimetidine
B. Increased risk of toxicity to warfarin due to inhibition of metabolism by cimetidine
CYP450 inhibitors: INHibitors Stop Cyber Kids from Eating GRApefruit Q
(INH, Sulfonamides, Cimetidine, Ketoconazole, Erythromycin, Grapefruit juice, Ritonavir, Amiodarone, Quinidine).
