Pharmacology Test

Question 1

Ten months after starting procainamide therapy for cardiac arrhythmias, a 56-year-old man develops arthritis and other symptoms consistent with drug-induced systemic lupus erythematosus.
Results of a blood test are positive for antinuclear antibodies.
This finding is consistent with which of the following genetic polymorphisms in drug metabolism?

Accepted Answer

Slow acetylator phenotype

Answer

Debrisoquine 4-hydroxylase deficiency

Answer

Erythrocyte catechol-O-methyltransferase deficiency

Answer

Glucose 6-phosphate dehydrogenase deficiency

Answer

Phenytoin hydroxylase deficiency

Question 2

An 83-year-old man has a 2-month history of akinesia, rigidity, and tremor. He has been taking a drug for the past 7 years to control severe behavioral and psychiatric symptoms associated with dementia, Alzheimer type. This adverse effect is most likely mediated through which of the following?

Accepted Answer

Antidopaminergic effects

Answer

Anticholinergic effects

Answer

Downregulation of γ-aminobutyric acid (GABA)

Answer

Inhibition of norepinephrine reuptake

Answer

Inhibition of serotonin reuptak

Answer

Upregulation of GABA

Question 3

A 23-year-old man with HIV infection has Pneumocystis jirovecii pneumonia. Therapy is started with trimethoprimsulfamethoxazole, and his pneumonia resolves. The pharmacotherapy was effective because of inhibition of which of the following?

Accepted Answer

Dihydrofolate reductase

Answer

Cell wall synthesis

Answer

Incorporation of p-aminobenzoic acid

Answer

Incorporation of sterol into membranes

Answer

Topoisomerase II

Question 4

A 62-year-old man comes to the physician because of burning pain and tenderness of his right great toe 1 day after heavy ethanol consumption. Physical examination shows erythema, swelling, warmth, and tenderness of the right great toe. After a 2-week course of nonsteroidal anti-inflammatory drug treatment, his symptoms decrease in severity but do not completely resolve. The serum concentration of which of the following is most likely increased in this patient?

Accepted Answer

Uric acid

Answer

Calcium

Answer

Carotene

Answer

Creatinine

Answer

Iron

Answer

Orotic acid

Answer

Phosphate

Question 5

A 62-year-old man is being treated with cisplatin for small cell carcinoma of the lungs. The efficacy of cisplatin depends on interaction with which of the following?

Accepted Answer

DNA

Answer

DNA polymerase

Answer

Growth factor receptors

Answer

Reverse transcriptase

Answer

Ribosomes

Question 6

An 18-year-old woman comes to the physician because of nausea, vomiting, and abdominal pain 1 hour after ingesting a glass of wine with dinner. Three days ago, she began antibiotic treatment for vaginitis after a wet mount preparation of vaginal discharge showed a motile protozoan. This patient most likely has been taking which of the following drugs?

Accepted Answer

Metronidazole

Answer

Ceftriaxone

Answer

Chloroquine

Answer

Clindamycin

Question 7

A 20-year-old woman comes to the emergency department after ingesting at least 30 tablets of an unknown drug. Initial physical examination shows no abnormalities. Thirty-six hours later, serum AST activity is 1500 U/L, and serum ALT activity is 2000 U/L. The drug this patient ingested is most likely which of the following?

Accepted Answer

Acetaminophen

Answer

Aspirin

Answer

Chlorpheniramine

Answer

Ibuprofen

Answer

Prednisone

Question 8

A 42-year-old woman who is a chemist is brought to the emergency department because of a 1-hour history of severe abdominal cramps, nausea and vomiting, hypotension, bradycardia, sweating, and difficulty breathing due to bronchospasm and congestion. Exposure to which of the following is most likely?

Accepted Answer

Isoflurophate (DFP)

Answer

Acrylamide

Answer

Cyanogen bromide

Answer

Phentolamine

Answer

Propranolol

Question 9

A 35-year-old woman is diagnosed with gastroesophageal reflux disease. Omeprazole is administered. Which of the following is the most likely mechanism of action of this drug?

Accepted Answer

Inhibition of H + –K + ATPase activity

Answer

Blockade of gastrin receptors

Answer

Blockade of H1 receptors

Answer

Blockade of M3 receptors

Answer

Inhibition of synthesis of gastrin

Question 10

In a 40-year-old man with hypertension, which of the following agents has the greatest potential to activate presynaptic autoreceptors, inhibit norepinephrine release, and decrease sympathetic outflow?

Accepted Answer

α2-Adrenergic agonist

Answer

α1-Adrenergic agonist

Answer

β1/β2-Adrenergic antagonist

Answer

Angiotensin-converting enzyme inhibitor

Answer

Calcium antagonist