Pharmacology Jeopardy

Antimicrobials

100

The molecular basis for the resistance of pneumococci to penicillin G is A) alterations in porin structure B) b-lactamase production C) changes in chemical structure of penicillin binding proteins D) changes in the D-Ala-D-Ala building block of peptidoglycan precursor E) decreased intracellular accumulation of penicillin G

(C) changes in chemical structure of penicillin binding proteins

200

Which statement about Imipenem is accurate? A) Active against methicillin-resistant staphylococci B) Has narrow spectrum of antibacterial action C) Is highly susceptible to beta-lactamases produced by Enterobacter species D) In renal dysfunction, dosage reduction is necessary to avoid seizures E) Used in fixed combination with sulbactam

(D) In renal dysfunction, dosage reduction is necessary to avoid seizures

300

In the treatment of Tuberculosis, which of the following considerations is necessary when administering the drug that is a prodrug converted by catalase peroxidase that acts by blocking mycolic acid synthesis? A) co-administer B6 to prevent peripheral neurophathy B) monitor urinary output C) should not be given to AIDS pts because it blocks protease inhibitors D) perform routine hearing screenings due to potential ototoxicity E) perform routine liver function tests due to potential hepatotoxicity

A) co-administer B6 to prevent peripheral neuropathy. The drug is Isoniazid.

400

Which statement about flucytosine is accurate? A) It is bioactivated by fungal cytosine deaminase B) It does not cross the blood-brain barrier C) It is a CYP450 inhibitor D) It is useful in esophageal candidiasis E) It has a wide spectrum of antifungal activity

A) It is bioactivated by fungal cytosine deaminase

500

A 30 y/o male pt who is HIV-positive with a CD4 count of 250,000, presents with complaints of anorexia, N/V, and epigastric tenderness. He is diagnosed with acute pancreatitis. Which of the following combinations of medications correctly reflects (1) the offending drug responsible for the pancreatitis and (2) the appropriate alternative drug choice? A) 1- Didanosine, 2- Foscarnet B) 1- Zidovudine, 2- Didanosine C) 1- Acyclovir, 2- Ribavirin D) 1- Didanosine, 2- Lamivudine E) 1- Lamivudine, 2- Ribavirin

D) 1- Didanosine (causes dose-limiting acute pancreatitis), 2- Lamivudine (nucleoside reverse transcriptase inhibitor- same class as Didanosine)

Kinin and Histamine Modulators

100

The serine protease that mediates the conversion of High Molecular Weight Kininogen to Bradykinin

What is plasma kallikrein?

200

A 20 y/o WF is taking diphenhydramine for severe allergic rhinitis. Which of the following adverse effects is she most likely to report? A) Muscarinic increase in bladder tone B) Nervousness, anxiety C) Nausea D) Uterine cramps E) Sedation

E) Sedation

300

Which of the following will result from blockade of H2 receptors? A) Decreased cAMP in target cells B) Decreased channel opening in enteric nerves C) Decreased IP3 in gastric mucosa D) Increased IP3 in gastric mucosa E) Increased IP3 in smooth muscle

Decreased cAMP in target cells

400

The receptor target of drugs under development to modify the biosynthesis and actions of kinins in the therapeutic management of pain, asthma, allergic rhinitis.

What is B2?

500

A 35 y/o single mom with 5 children presents with allergic rhinitis. She recently took a 2nd job in security working the night shift. Which of the following anti-histamines would be the most appropriate choice for this patient? A) diphenhydramine B) chlorpheniramine C) ranitidine D) cimetidine E) loratidine

E) loratidine

Anti-Inflammatories

100

Which of the following drugs inhibits cyclooxygenase irreversibly? A) Aspirin B) Hydrocortisone C) Ibuprofen D) Indomethacin E) Zileuton

A) Aspirin

200

A 60-year old woman undergoes routine bilateral cataract surgery, after which she is found to have moderately elevated intraocular pressure. Which of the following can be used to reduce intraocular pressure? A) LTD4 or its analogs B) PGE2 or its analogs C) PGF2a or its analogs D) Slow-reacting substance of anaphylaxis (SRS-A) E) TXA2 or its analogs

C) PGF2a or its analogs

300

Which of the following reduces the activity of phospholipase A2? A) Aspirin B) Ibuprofen C) Misoprostol D) Prednisone E) Zafirlukast

D) Prednisone

400

Which of the following is an appropriate choice for reducing the leukotriene mediated symptoms of asthma? A) Zafirlukast B) Fluticasone C) Albuterol D) Cromolyn sodium E) Zileuton

A) Zafirlukast

500

Which of the following is a drawback to treatment of severe asthma by an IgE monoclonal antibody? A) It is not FDA approved B) It must be administered parenterally C) Emergency treatment of sx with inhaled beta agonists must be discontinued while on the medication D) It causes hirsutism in female pts E) It has significant effects on the taste of food

B) It must be administered parenterally

Autonomics

100

Nicotinic receptor sites do not include which of the following? A) bronchial smooth muscle B) adrenal medullary cells C) parasympathetic ganglia D) skeletal muscle end plates E) sympathetic ganglia

A) bronchial smooth muscle

200

Which one of the following receptors paired with its correct protein mediates the main effect of pilocarpine in the smooth muscle of the bronchi? A) M1- Gq B) M2- Gs C) M3- Gs D) M2- Gi E) M3- Gq

E) M3- Gq

300

The tx of choice for a child who presents to the ED with bronchospasm, tachycardia and hypotension.

What is epinephrine?

400

In considering the possible side effects of tx of asthma with B2 stimulants, you note that these drugs frequently cause A) direct stimulation of renin release B) hypoglycemia C) increased cGMP in mast cells D) skeletal muscle tremor E) vasodilation in the skin

D) skeletal muscle tremor

500

Which of the following effects of epinephrine would be blocked by phentolamine but not by metoprolol? A) cardiac stimulation B) increase of cAMP in fat C) mydriasis D) relaxation of bronchial smooth muscle E) relaxation of uterus

C) mydriasis

Inhalational Anesthetics

100

Which of the following is an approved application for NO administered as a gas? A) Asthma B) Dysmennorhea C) Patent Ductus Arteriosus D) Pulmonary HTN E) Rejection after renal transplantation

D) Pulmonary HTN

200

Which statement concerning MAC value is accurate? A) low MAC = low potency B) MAC decreases with age C) MAC gives information about the dose-response curve D) NO has an extremely low MAC E) Simultaneous use of opioid analgesia increases the MAC for inhaled anesthetics

B) MAC decreases with age

300

A 23 y/o man has a pheochromocytoma, BP of 190/120, and Hct of 50%. Pulmonary and renal function are normal. His catecholamines are elevated, and he has a well-defined abdominal tumor on MRI. He has been scheduled for surgery. Which of the following should not be included in the anesthesia protocol? A) Desflurane B) Fentanyl C) Halothane D) Midazolam E) Thiopental

C) Halothane

400

Which anesthetic has a low blood:gas partition coefficient but is not used for induction of anesthesia because of airway irritation? A) Desflurane B) Enflurane C) Halothane D) Isoflurane E) Sevoflurane

A) Desflurane

500

The inhalation anesthetic with the fastest onset of action is A) isoflurane B) halothane C) Nitric oxide D) Nitrogen dioxide E) Nitrous oxide

E) Nitrous oxide