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Chem > Tumor Markers, TDM, Toxicology > Flashcards

Tumor Markers, TDM, Toxicology Flashcards

1
Q

A drug’s most direct and effective method of delivery to its site of action is

a. oral administration
b. intramuscular injection
c. Intravenous administration
d. aerosol ingestion

A

c. intravenous administration

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2
Q

Which of the following is not true regarding the absorption of drugs?

a. drug absorption rates may change with age
b. morphine may slow the gastrointestinal motility of a drug
c. liquid medications are often absorbed slower than capsule medications
d. Crohn’s disease may alter the absorption

A

c. liquid medications are often absorbed slower than capsule medications

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3
Q

TRUE or FALSE. Drugs are susceptible to hepatic metabolism and this increases the concentration of the drug before it reaches the circulatory system

A

FALSE

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4
Q

Which of the following statements is true regarding drug elimination?

a. one drug half-life is the time needed for the drug concentration to increase by half
b. five to seven drug doses are required to reach a steady state of a drug concentration
c. most medications are administered as a single dose versus a scheduled basis
d. aminoglycoside antibiotics are reabsorbed by the renal tubules

A

b. five to seven drug doses are required to reach a steady state of a drug concentration

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5
Q

The relationship between a drug’s concentration at its target sites and its physiological responses is known as:

a. pharmacokinetics
b. pharmacogenomics
c. pharmacotherapy
d. pharmacodynamics

A

d. pharmacodynamics

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6
Q

Which of the following is not true concerning therapeutic drug monitoring?

a. it ensures correct drug doses for the expected therapeutic range
b. it helps to identify non-compliance of the patient
c. it identifies drug-drug interactions if multiple drugs are taken simultaneously
d. it establishes a one- fit dosing model for all patients

A

d. it establishes a one- fit dosing model for all patients

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7
Q

A blood draw to determine a peak level of a drug should be drawn

a. one hour after an orally administered dose
b. immediately after drug administration
c. 90 minutes after an orally administered dose
d. immediately before drug administration

A

a. one hour after an orally administered dose

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8
Q

TRUE or FALSE. CYP450 is a gene that influences the effectiveness of a drug in an individual

A

TRUE

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9
Q

Which of the following is not true concerning aminoglycosides?

a. they are a class of drugs that is administered in the impatient setting
b. toxic levels can cause hearing impairment
c. they are used to treat gram positive and gram negative infections
d. ototoxic effects of the drugs are reversible

A

d. ototoxic effects of the drugs are reversible

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10
Q

Pharmacokinetics and drug concentration are influenced by which of the following factors?

a. absorption, distribution, metabolism, excretion
b. absorption, bioavailability, excretion, metabolism
c. biotransformation, distribution, excretion, metabolism
d. adaption, distribution, excretion, metabolism

A

a. absorption, distribution, metabolism, excretion

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11
Q

TRUE or FALSE. Only bound fractions of drugs can interact with the site of action and result in a biological response

A

FALSE

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12
Q

Tolerance to drugs could be explained as:

a. constant exposure of receptors to drugs that leads to a reduced response
b. constant exposure of receptors to drugs that leads to an increased response
c. 50% of the maximum effect of a drug on the body

A

a. constant exposure of receptors to drugs that leads to a reduced response

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13
Q

This drug is used to treat arrhythmias and CHF.

a. quinidine
b. digoxin
c. disopyramide
d. dilantin

A

b. digoxin

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14
Q

This drug may have the adverse effect of “reman syndrome”

a. vancomycin
b. tobramycin
c. amikacin
d. gentamicin

A

a. vancomycin

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15
Q

This antiepileptic drug requires hepatic markers to be checked frequently due to risk of hepatic dysfunction

a. carbamazepine
b. phenobarbital
c. phenytoin
d. valproic acid

A

d. valproic acid

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16
Q

TRUE or FALSE. Immunosuppressive drugs typically are collected as serum samples

A

FALSE

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17
Q

TRUE or FALSE. Common routes of exposure to toxins are through the gastrointestinal tract, lungs, and skin

A

TRUE

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18
Q

Which specimen type if preferred for analyses demonstrating variation in urinary elimination patterns?

a. random specimen
b. midstream “clean catch” specimen
c. first morning specimen
d. 24-hour collection

A

d. 24-hour collection

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19
Q

Which of the following is not true concerning analysis of toxic agents?

a. screening tests have good specificity but lack sensitivity
b. confirmatory tests report the concentration of the analyte
c. screening tests are a rapid test intended to detect the presence of a substance
d. the reference method for most compounds is gas chromatography with a mass spectrometer (GC-MS)

A

a. screening tests have good specificity but lack sensitivity

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20
Q

All of the following statements are true regarding blood alcohol measurements except:

a. during venipuncture the skin must be disinfected with iodine or chlorohexidine gluconate
b. plasma and serum are acceptable specimen types for analysis
c. when testing will be delayed, sodium chloride can be used as a preservative to maintain specimen integrity
d. specimens should remain capped to avoid evaporation

A

c. when testing will be delayed, sodium chloride can be used as a preservative to maintain specimen integrity

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21
Q

TRUE or FALSE. The affinity of carbon monoxide for hemoglobin is 20-25 times greater than oxygen

A

FALSE

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22
Q

Toxic levels of acetaminophen are associated with

a. ototoxicity
b. nephrotoxicity
c. hepatotoxicity
d. neurotoxicity

A

c. hepatotoxicity

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23
Q

Which of the following statements is not true concerning testing for drugs of abuse?

a. A two-tired testing approach includes screening and confirmatory testing
b. Confirmatory testing must use methods with high specificity and low sensitivity
c. Screening tests detect classes of drugs
d. GC-MS is the reference method used for confirmation

A

b. Confirmatory testing must use methods with high specificity and low sensitivity

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24
Q

Which type of toxicology uses the results from animal experiments to predict what level of exposure will cause harm to humans?

a. descriptive
b. mechanistic
c. regulatory
d. environmental

A

a. descriptive

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25
Q

Which is not a common route of exposure to toxic substances

a. ingestion
b. intravenous
c. inhalation
d. transdermal absorption

A

b. intravenous

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26
Q

What phrase best describes what ED50 stands for?

a. a drug is predicted to have a therapeutic benefit for 50% of the population
b. a drug is predicted to have a lethal effect for 50% of the population
c. a drug is predicted to have a negative effect on 50% of the population

A

a. a drug is predicted to have a therapeutic benefit for 50% of the population

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27
Q

TRUE or FALSE. Chronic exposure to a toxin always has the same effect as acute exposures

A

FALSE

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28
Q

Which is not a common specimen type for analysis of toxic agents?

a. urine
b. blood
c. oral fluid
d. all are common types

A

d. all are common types

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29
Q

Match the alcohol with the common source: ISOPROPANOL

a. rubbing alchohol
b. antifreeze
c. homemade liquors
d. tequila

A

a. rubbing alchohol

30
Q

Match the alcohol with the common source: METHANOL

a. rubbing alchohol
b. antifreeze
c. homemade liquors
d. tequila

A

c. homemade liquors

31
Q

Match the alcohol with the common source: ETHYLENE GLYCOL

a. rubbing alchohol
b. antifreeze
c. homemade liquors
d. tequila

A

b. antifreeze

32
Q

Match the alcohol with the common source: ETHANOL

a. rubbing alchohol
b. antifreeze
c. homemade liquors
d. tequila

A

d. tequila

33
Q

TRUE or FALSE. An alternative test that may be performed in order to estimate ethanol in serum is the osmolality

A

TRUE

34
Q

This toxic substance can be found in its organic form in clams and oysters

a. cadmium
b. cyanide
c. lead
d. arsenic

A

d. arsenic

35
Q

This environmental pollutant has been linked to Itai-Itai disease

a. cadmium
b. lead
c. mercury
d. arsenic

A

a. cadmium

36
Q

Match the drug with its descriptor phase: AMPHETAMINES

a. “downer” originally used as sleep inducer
b. high demand as sedative and anti-anxiety
c. stimulant with high abuse potential
d. substances capable of analgesia, sedation, and anesthesia

A

c. stimulant with high abuse potential

37
Q

Match the drug with its descriptor phase: BARBITURATES

a. “downer” originally used as sleep inducer
b. high demand as sedative and anti-anxiety
c. stimulant with high abuse potential
d. substances capable of analgesia, sedation, and anesthesia

A

a. “downer” originally used as sleep inducer

38
Q

Match the drug with its descriptor phase: BENZODIAZEPINES

a. “downer” originally used as sleep inducer
b. high demand as sedative and anti-anxiety
c. stimulant with high abuse potential
d. substances capable of analgesia, sedation, and anesthesia

A

b. high demand as sedative and anti-anxiety

39
Q

Match the drug with its descriptor phase: OPIOIDS

a. “downer” originally used as sleep inducer
b. high demand as sedative and anti-anxiety
c. stimulant with high abuse potential
d. substances capable of analgesia, sedation, and anesthesia

A

d. substances capable of analgesia, sedation, and anesthesia

40
Q

Which of the following enzymes is increased in patients with cancer involving bone?

a. amylase
b. alkaline phosphatase
c. neuron-specific enolase
d. gamma glutamyl transferase

A

b. alkaline phosphatase

41
Q

Which tumor marker is associated with neuroblastoma?

a. CA 15-3
b. carcinoembryonic antigen (CEA)
c. CA-125
d. Homovanillic acid (HVA)

A

d. Homovanillic acid (HVA)

42
Q

Which of the following tumor markers is classified as an oncofetal antigen?

a. carcinoembryonic antigen (CEA)
b. CA 19-9
c. BRA-1
d. hCG

A

a. carcinoembryonic antigen (CEA)

43
Q

The utilization of tumor markers is most important for:

a. screening of asymptomatic patients
b. screening for molecular markers
c. monitoring the effectiveness of treatment
d. confirming the presence of cancer

A

c. monitoring the effectiveness of treatment

44
Q

Tumor marker methodology include all of the following except:

a. immunoassays
b. gas chromatography
c. immunohistochemistry
d. enzyme analysis

A

b. gas chromatography

45
Q

TRUE or FALSE. Abnormally low tumor marker concentrations are associated with antigen deficiency and can cause false negative results

A

False

46
Q

TRUE or FALSE. To accurately monitor tumor marker levels of the patient, it is important to use the same methodology each time of testing.

A

TRUE

47
Q

If tumor cells are found in both the original tumor and also in the regional lymph nodes, this would be classified as stage

a. 1
b. 2
c. 3
d. 4

A

c. 3

48
Q

This type of tumor marker is valuable in diagnosing neuroblastomas, pituitary and adrenal adenomas

a. serum protein tumor markers
b. endocrine tumor markers
c. oncofetal antigens
d. carbohydrate antigen tumor markers

A

b. endocrine tumor markers

49
Q

These type of tumor markers help to choose between endocrine and cytotoxic therapies.

a. endocrine tumor markers
b. oncofetal antigens
c. cancer antigen tumor markers
d. receptor tumor markers

A

d. receptor tumor markers

50
Q

TRUE or FALSE. All tumor markers can be used to screen asymptomatic populations.

A

FALSE

51
Q

Which is not a reason that serial results can be difficult to interpret:

a. assay design
b. variation in reference ranges
c. differences in antibody specificity
d. A and B
e. all of the above

A

e. all of the above

52
Q

Which is not something that is a consideration when considering using immunoassay method for tumor markers.

a. hook effect
b. requires more specialized skill and experience
c. assay linearity
d. HAMAs

A

b. requires more specialized skill and experience

53
Q

Which is not an example of an enzyme tumor marker

a. ALP
b. AST
c. PSA
d. LDH

A

b. AST

54
Q

Which tumor marker is used primarily with hepatocelluar carcinoma and testicular cancer.

a. alpha fetoprotein (AFP)
b. CA-125
c. Carcinoembryonic antigen (CEA)
d. Human chorionic gonadotropin (hCG)

A

a. alpha fetoprotein (AFP)

55
Q

Elevations in this tumor marker in CSF may indicate Creutzfeldt-Jakob disease.

a. carbohydrate antigen 19-9 (CA-19-9)
b. Immunoglobulin free light chains (FLC)
c. Human epididymis protein 4 (HE4)
d. Neuron-specific enolase (NSE)

A

d. Neuron-specific enolase (NSE)

56
Q

Match the tumor with the description: NEUROBLASTOMA

a. rare tumor associated with hypertension
b. serotonin secreting tumors from small intestine
c. common malignant tumor in kids
d. Neuron-specific enolase (NSE)

A

d. Neuron-specific enolase (NSE)

57
Q

Match the tumor with the description: PHEOCHROMOCYTOMA

a. rare tumor associated with hypertension
b. serotonin secreting tumors from small intestine
c. common malignant tumor in kids
d. Neuron-specific enolase (NSE)

A

a. rare tumor associated with hypertension

58
Q

Match the tumor with the description: CARCINOID

a. rare tumor associated with hypertension
b. serotonin secreting tumors from small intestine
c. common malignant tumor in kids
d. Neuron-specific enolase (NSE)

A

b. serotonin secreting tumors from small intestine

59
Q

If you have a result for a total phenytoin of 11 ug/mL, what would an approximate value be for the free fraction?

A

1.1 ug/mL (10% free, 90% bound)

60
Q

This is the biochemical pathway responsible for a large portion of drug metabolism

A

Hepatic mixed-function oxidase system (MFO)

61
Q

Positive drug screens for this type of substance has wide cross-reactivity with common OTC medications.

A

Amphetamines/Methamphetamines

62
Q

If a person consumes alcohol at the same time as taking this drug, there is a higher risk of hepatic damage

A

Acetaminophen

63
Q

This toxin is found in solid, liquid, and in solution. It binds to heme iron and high lactic levels are common.

A

Cyanide

64
Q

This tumor marker is often elevated in patients with hepatocellular carcinoma and germ cell tumors.

A

alpha fetoprotein (AFP)

65
Q

Which tumor marker has both free and bound forms that can be measured to help assist in risk stratification?

A

Prostate Specific Antigen (PSA)

66
Q

This test is not actually cleared by the FDA as a tumor marker even though there is widespread use of it as one

A

Human Chorionic Gonadotropin (hCG)

67
Q

This tumor marker is primarily used for ovarian cancer and has improved specificity over CA-125

A

Human epididymis protein 4 (HE4)

68
Q

What is the generic term for aspirin?

A

Acetylsalicylic acid

69
Q

This potent inhibitor of many enzymes may cause basophilic stippling in RBCs.

A

Lead

70
Q

This tumor marker is a modified Lewis blood group antigen.

A

Carbohydrate antigen 19-9 (CA 19-9)

71
Q

What type of drugs are used to treat depression and mood disorders and are named for their chemical structure?

A

Tricyclic antidepressants (TCAs)

Chem (8 decks)

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