Questions and Answers
1.A patient has endured several dosage adjustments of his tricyclic anti-
depressant, so the provider recommends genetic testing. Which
statement correctly describes the rationale for genetic testing?
a. The CYP2D6 gene influences metabolism of tricyclic antidepressants
and certain other drugs.
b. The HER2 gene is a tumor marker that impacts metabolism of
tricyclic antidepressants.
c. The BRCA2 gene influences metabolism of certain drugs and increases
the risk for breast cancer.
d.The x linked OPN1MW gene for male color blindness also slows
metabolism of certain
Answer a. The CYP2D6 gene influences metabolism of tricyclic
antidepressants and certain other drugs.
HER2 is a gene often implicated with cancer, as is BRCA2. OPN1MW is
the gene that codes for color blindness in men. Metabolism of 25% of
all prescribed drugs, including tricyclic antidepressants, beta
adrenergic receptor blockers, and
neuroleptics, is influenced by variants in a certain gene, requiring geneti
testing to reduce trial-and-error in estimating appropriate drug-dosage
levels.
2.According to the Centers for Disease Control and Prevention, the 10
most costly chronic conditions include cardiovascular diseases, obesity,
asthma, diabetes, smoking and alcohol related conditions, cancer,
Alzheimer's dis- ease, arthritis and stroke. Which are the top 4 in ranking
from most costly to least costly?
,a. Cardiovascular diseases, obesity, diabetes, cancer
b. Cardiovascular diseases, diabetes, obesity, cancer
c. Cardiovascular diseases, Smoking-related conditions, Alcohol-related
con- ditions, diabetes
d. Cardiovascular diseases, Stroke, Obesity, Diabetes
Answer c. Cardiovascular dis- eases, Smoking-related conditions,
Alcohol-related conditions, diabetes
3.A mother brought her child to the doctor for genetic testing. The health
care provider was trying to explain the genetic results of the child. During
his explanation he tells the mother that the child has 2 X chromosomes and
a Y chromosome in each cell. He begins to explain some physical
appearances the mother might notice on her son. He explains that she might
notice that he has sparse body hair, long limbs and small testes. The health
care practitioner is explaining which syndrome to the mother.
a. Klinefelter syndrome
b. Turners' syndrome
c. Down syndrome
d. Kawasaki's disease
Answer a. Klinefelter syndrome
Klinefelter syndrome is an individual with at least 2 X chromosomes
and a Y chromosome in each cell. Because of the Y chromosome these
individuals have
a male appearance, but they are usually sterile and about half develop
female-like breasts.
4.A patient reports a maternal family history of Lynch syndrome. Which
laboratory finding might indicate a need for further testing for the presence
of Lynch syndrome in this patient?
a. Elevated thyroid-stimulating hormone
b. Low cortisol level
, c. Positive heme-occult test
d. Sputum positive for Pseudomonas Aeruginosa
Answer a. Positive heme-occult test
Positive heme-occult because Lynch syndrome is a hereditary form of
colorectal cancer and colorectal bleeding can be a sign of cancer
5.An individual's acquired immunity is dependent on the function of
which cells? (Select all that apply.)
a. B lymphocytes
b. Opsonins
c. T lymphocytes
d. Macrophages
Answer a. B lymphocytes
c. T lymphocytes
d. Macrophages
T lymphocytes, B lymphocytes, macrophages, and dendritic cells are
involved in acquired immunity.
6.A 17-year-old female comes to the clinic for a physical exam. As part of
the visit, the APRN considers her risk factors for type 2 diabetes mellitus
(T2DM). Risk factors for T2DM would likely include all of the following
except
a. Native American ancestry
b. Family history of type 1 diabetes mellitus (T1DM)
c. Obesity
d. Personal history of polycystic ovary syndrome (PCOS)
Answer b. Family history of type 1 diabetes mellitus (T1DM)