Don't do Drugs!
One of your patients presents with chest pain. You do an EKG, and blood work that shows no evidence of a myocardial infarction. Because of her age and risk factors, you want to investigate the cardiac status further. The patient uses a walker and is unable to participate in a treadmill-based stress test. What can you give her to test the health of her heart?
A Isopreterenol
B Pindolol
C Dobutamine
D Propanolol
E Clonidine
C. Dobutamine
At 12 hrs after administration of a bolus dose, the plasma concentration of a drug is 4 mg/L. If the Vd=10 L and the elimination half-life=6 hrs, what was the dose administered?
A 160 mg
B 180 mg
C 320 mg
D 40 mg
E 80 mg
A. 160 mg
Which of the following conditions is the most optimal for the lac operon to be fully functional?
A. glucose, CRP
B. allolactose, cAMP
C. allolactose, glucose
D. cAMP, glucose
E. cAMP, CRP
B. allolactose, cAMP
A 2-year-old is diagnosed with I-cell disease as she has inclusion bodies in her lysosomes. What is leading to her disease?
A. Deficiency of mannose 6-phosphate receptor in Golgi
B. Deficiency of mannose 6-phosphate marker on lysosomal enzymes
C. Deficiency of one particular lysosomal enzyme
D. Loss of lysosomal enzymes into blood and urine
E. Defective N-glycosylation of lysosomal enzymes
B. Deficiency of mannose 6-phosphate marker on lysosomal enzymes
A 50 year old man presents to the physician for joint swelling, particularly in his big toes. His doctor tells him that he has hyperuricemia and prescribes him a drug that lowers uric acid levels by binding to an allosteric site on the receptor. What mechanism of inhibition is portrayed by this drug?
Non-competitive irreversible inhibition.
A 24-year-old woman presented to the physician for evaluation of episodic evaluations of hypertension, sweating, and tachycardia. The patient was diagnosed with pheochromocytoma and was scheduled for surgery and was started on medication immediately prior to surgery. What is the mode of action of this drug?
A Irreversibly binds alpha 1 and 2
B Irreversibly inhibits b1
C Reversibly inhibits alpha 1
D Reversibly inhibits b2
E Reversibly inhibits M2
A Irreversibly binds alpha 1 and 2
A team of pharmacologists is determining the pharmacokinetic properties of a new analgesic drug. The drug is a weak organic acid with a pKa of 3.5. Assuming a pH of 6.5 in the duodenum, which percentage of a given dose of the drug will most likely be in the liposoluble form in the duodenum?
A. About 0.1 %
B. About 1%
C. About 10%
D. About 50%
E. About 90%
F. About 99%
A. About 0.1%
In your free time, you decide to culture bacteria with the purpose of studying prokaryotic gene regulation. Why? Who knows. In your studies, you encounter the lac operon, a very important variety of genes that aid the bacteria in breaking down lactose. If there is glucose present, but there is also lactose present, which state will the lac operon be in?
A. No repressor bound, activator bound
B. No repressor bound, no activator bound
C. Repressor bound, no activator bound
D. Repressor bound, activator bound
B. No repressor bound, no activator bound
A research group investigates the structure and function of glycosaminoglycans (GAGs) in the extracellular matrix. Of the following statements, this is true regarding hyaluronic acid.
A. It is found in mast cells
B. It is involved with embryogenesis
C. It is linked to protein by O-glycosylation
D. It is the most sulfated GAG
E. It contains a sulfated galactose
B. It is involved with embryogenesis
A 2-year-old boy was brought to the pediatrician by his mother because she noticed unusual orange colored crystals in his diapers. Physical examination shows truncal hypotonia and spastic muscle movements. The physician suspects an X-linked recessive disorder. Which of the following enzymes is deficient in the patient?
Hypoxanthine Guanine Phosphoribosyl Transferase.
A 19-year-old female presented to the emergency department for evaluation of a high fever of 103.4 F. Examination showed that the patient had severe dry mouth, appeared flushed, and was confused about her location? Which of the following would the patient be treated with?
A. Atropine
B. Physiostigmine
C. Neostigmine
D. Pyridostigmine
E. Bethancol
B. Physiostigmine
A 74-year old retired mechanic is admitted with a myocardial infarction and a severe acute cardiac arrhythmia. You decide to give lidocaine to correct the arrhythmia. A continuous intravenous infusion of lidocaine, 1.92mg/min is started at 8 AM. The average pharmacokinetic parameters of lidocaine are Vd= 77 L; clearance= 640 mL/min; half-life=1.4 hrs. What is the expected steady state plasma concentration?
A 4.0 mg/L
B 3.0 mg/L
C 0.003 mg/L
D 0.05 mg/L
E 3.46 mg/L
B. 3.0 mg/L
What is the most common mechanism of silencing gene expression when the siRISC binds to target mRNA?
A. Inhibition of translation
B. Cleavage of the target mRNA
C. Interfering with ribosome assembly
D. Gene silencing at the transcription level
E. The silencing of chromatin
B. Cleavage of the target mRNA
A 34-year-old presents to his physician for evaluation of bleeding gums and inadequate wound healing. The patient reports that he has been sea traveling for a while and has a diet deficient of grapefruits and lemons. What two enzymes are most likely deficient in this patient?
Prolyl hydroxylase and lysyl hydroxylase
A 65-year-old female comes to the Emergency department due to significant weight loss and abdominal pain. She has a 2-month history of diarrhea and blood in her stools. The physician diagnoses her with colorectal cancer and administers 5-fluorouracil as treatment. Which step is specifically inhibited by this drug?
A. Conversion of Xanthine to Uric Acid
B. Formation of thymidine monophosphate
C. Formation of purine deoxyribonucleotides
D. Reduction of dihydrofolate
E. Formation of GMP to IMP
B. Formation of thymidine monophosphate.
DAILY DOUBLE!!! Which of the following is a proper pairing between the difference between low and high does of epinephrine on the human body?
A. Low dose: bronchodilates B2; High dose: Vasodilate B1 receptors
B. Low dose: bronchoconstrict B2; High dose: Vasoconstrict a1 receptors
C. Low dose: vasoconstrictor a1; High dose: Vasodilate B1 receptors
D. Low dose: bronchodilates B2; High dose: Vasoconstrict a1 receptors
E. Low dose: bronchoconstrict B2; High dose: Vasodilate B1 receptors
D. Low dose: bronchodilates B2; High dose: Vasoconstrict a1 receptors
A severely obese 32-year-old female G2P1 comes to the hospital for delivery of a child. Placental indications for caesarian delivery are observed on pelvic ultrasound and she is transported to surgery. Induction of anesthesia is performed with an IV bolus of sodium thiopental. Sodium thiopental is highly non polar and minimally ionized at plasma pH; as such its Vd=3L. Despite having a half life of 8 hours, rapid plasma decay from steady state is observed and emergence is rapidly achieved. This decay is attributable to rapid transport from its site of action into well-perfused to poorly-perfused tissues. Which of the following can be said about the thiopental?
A It has entered the cells
B It is heavily bound to plasma proteins
C It is rapidly excreted by the kidney
D Its bioavailability is low
E It binds to the tissue constituents
B It is heavily bound to plasma proteins
A 5-year-old girl is brought to the physician by her mother because of a seizure. Her mother admits that she has begun to lose some of her speech and hand skills and demonstrates repetitive hand movements, irregular breathing, and motor control problems. What is the mutated gene causing this disorder?
A. Snrpn
B. Dnmt3b
C. UBE3A
D. HDAC1
E. MeCP2
E. MeCP2
A 56-year-old man comes to the physician because of a 1-month history of pain in his left knee. Physical examination shows swelling and tenderness in the joint. Imaging studies show reduced joint space and decreased volume of synovial fluid. What component of this fluid is most likely to function in binding water and lubricating the joint?
Hyaluronic acid
A 2-year-old boy is brought to the physician by his mother because of a 1-month history of weakness, a 3-week history of refusal to feed and a 1-week history of shortness of breath. Physical examination shows conjunctival pallor. A 4th heart sound is heard on cardiac auscultation. Laboratory studies show macrocytic, megaloblastic anemia. Urine testing shows normal ammonia levels with elevated levels of orotic acid. Which enzyme is deficient in this patient?
Orotate phosphoribosyl transferase.
A 40 year old man comes to your office on a gloomy sunday. He mentions he experienced nausea on his boat during a fishing trip. To avoid this, you prescribe him scopolamine. Before leaving, you warn him about which of the following side effects?
A. Hyporurination
B. Diarrhea
C. Hypersalivation
D. Xerostomia
E. Tachycardia
F. Cycloplegia
Xerostomia
A 73-year-old woman develops an infected abscess on the third day of her hospital stay. She is started on a constant intravenous infusion of an antibiotic at a dose of 100 mg/h. No loading dose is given. The antibiotic is eliminated by first-order kinetics and has a volume of distribution of 61 L, a clearance of 7 L/h, and half-life of 6 hours. How long will it take for the plasma levels of the antibiotic to reach 75% of steady state?
12 hours
A 37 y/o woman comes to the ER after having gone snowboarding at an altitude of about 15,378 feet. Upon inspection, her skin is blue and she is out of breath. Her O2 saturation is 87%. Which of the following is most likely occurring at the cellular level?
A. Dimerization of HIF-1 factors and activation of erythropoiesis.
B. Hydroxylation of HIF-1a and activation of erythropoiesis
C. Degradation of HIF-1a and inactivation of erythropoiesis
D. Dimerization of Myc/Max and inactivation of erythropoiesis
E. Homodimerization of Max and activation of erythropoiesis
A. Dimerization of HIF-1 factors and activation of erythropoiesis.
A scientist investigates the enzymatic activity of lysyl oxidase and compares the enzyme to lysyl hydroxylase. Which one of the following descriptions of lysyl oxidase is correct?
A. Lysyl oxidase is needed for both collagen and elastin synthesis
B. Lysyl oxidase needs zinc as cofactor
C. Lysyl oxidase is mainly found inside of fibroblasts
D. Lysyl oxidase is defective in osteogenesis imperfecta
E. Lysyl oxidase acts on pro-alpha chains of procollagen
A. Lysyl oxidase is needed for both collagen and elastin synthesis
DAILY DOUBLE!!! A woman brings her 9-month old son to the physician for recurrent infections and neurodevelopmental delay. Both parents have familial history of an autosomal recessive disorder but they do not know much about it. The doctor runs a CBC lab test, which indicates a low T-cell count but normal B-cell. Serum uric acid levels are also low. The physician is most likely to recommend this stem cell transplant for treatment therapy.
Erythrocyte transfusion hematopoietic.