MOD4 (BRS) PCOL EXAM QUESTIONS AND
100% CORRECT ANSWERS
A - ANSWER 1.1. Somatostatin interacts with
(a) Gi-protein-coupled receptor
(B) Gq-protein-coupled receptor
(C) Ligand-activated ion channel
(D) Receptor-activated tyrosine kinase
(e) Intracellular nuclear receptor
C - ANSWER 1.2. Cortisol is able to target intranuclear receptors secondary to its ability
to
(a) Recruit intracellular kinases
(B) Undergo autophosphorylation
(C) Diffuse through lipid membranes
(D) Interact with G-protein
(e) Interact with AC
C - ANSWER 1.3. Which of the following parameters is used
to indicate the ability of a drug to produce
the desired therapeutic effect relative to a
toxic effect?
(a) Potency
(B) Intrinsic activity
(C) TI
(D) Efficacy
,(e) Bioavailability
B - ANSWER 1.4. A 64 yr-old female patient with history
of multiple abdominal surgeries secondary to
Crohn's disease presents to the emergency
department with obstipation and feculent emesis.
A diagnosis of small bowel obstruction is
rendered and she is brought to the operating
room for lysis of adhesions and resection of
stenosed region of small bowel.
The patient is noted post-operatively to have
high blood pressure, and oral metoprolol
is given; however, there is no elevation
of hypertension. This is most probably
due to
(a) The first-pass effect
(B) Reduced passage of the drug through
intestine
(C) Reduced GI blood flow
(D) Inactivation of drug by stomach acid
(e) Enhanced protein binding of the drug
C - ANSWER 1.5. What is an important characteristic of con-
gestive heart failure (CHF) with respect to
drug action?
(a) Reduced blood flow to the intestine
(B) Increased protein binding of several drugs
(C) Volume of distribution increased
,(D) Drug elimination enhanced
(e) Altered drug kinetics
A - ANSWER 1.6. What is the term to be used for defining the rate of elimination through
metabolism catalysed by alcohol dehydrogenase when this enzyme is saturated?
(a) Zero-order kinetics
(B) First-order elimination
(C) Clearance
(D) Biotransformation
(e) Redistribution
D - ANSWER 1.7. A 69-year-old female patient has been admitted in the intensive care
unit for the treatment of presumed staphylococcal sepsis. In order to avoid the
problems that may occur with possible
resistance, she is empirically given IV vancomycin while waiting for the culture results
to
come back. Vancomycin is a renally excreted
drug. The routine laboratory workup in this patient reveals a creatinine value of 3.2
consistent with
acute renal failure. What specific considerations will have to be made with regard to
adjustments of the prescribed medication?
(a) She will have to be switched to an oral (per
nasogastric tube) vancomycin preparation
(B) The patient will need to be water
restricted to reduce the volume of
distribution
(C) No adjustments to the current regimen will
be made due to the fact that the condition of
the patient is life-threatening and the drug
, must be given regardless
(D) The dose of vancomycin will need
to be reduced due to increased
accumulation
(e) Adjustments to the dose will need to
be made due to the patient currently
being ventilated
B - ANSWER 1.8. Glucuronidation reactions
(a) Are considered phase I reactions
(B) Require an active center as the site of
conjugation
(C) Use the enzymatic activity of alcohol dehydrogenase
(D) Present in mitochondria are inducible
by drugs
(e) Use NADPH for the enzymatic reaction
A - ANSWER 1.9. A 38 year old female presents to her
psychiatrist and requests to be switched to another type of
antidepressant as she feels that her current
medication is not providing her with much benefit.
She became so depressed that recently, over the
past few months she started drinking heavily.
The doctor would like to try imipramine; however, because this medication is known to
have an extensive first-pass effect, he orders a hepatic function panel prior to
prescribing the medication in light of the patient's history of recent alcohol use. Which
of the following best explains why the doctor ordered a hepatic function panel?
A Drugs with extensive first-pass metabolism reach high systemic concentrations in the
presence of hepatic dysfunction
B The hepatic function panel may indicate a specific sensitivity to the drug
100% CORRECT ANSWERS
A - ANSWER 1.1. Somatostatin interacts with
(a) Gi-protein-coupled receptor
(B) Gq-protein-coupled receptor
(C) Ligand-activated ion channel
(D) Receptor-activated tyrosine kinase
(e) Intracellular nuclear receptor
C - ANSWER 1.2. Cortisol is able to target intranuclear receptors secondary to its ability
to
(a) Recruit intracellular kinases
(B) Undergo autophosphorylation
(C) Diffuse through lipid membranes
(D) Interact with G-protein
(e) Interact with AC
C - ANSWER 1.3. Which of the following parameters is used
to indicate the ability of a drug to produce
the desired therapeutic effect relative to a
toxic effect?
(a) Potency
(B) Intrinsic activity
(C) TI
(D) Efficacy
,(e) Bioavailability
B - ANSWER 1.4. A 64 yr-old female patient with history
of multiple abdominal surgeries secondary to
Crohn's disease presents to the emergency
department with obstipation and feculent emesis.
A diagnosis of small bowel obstruction is
rendered and she is brought to the operating
room for lysis of adhesions and resection of
stenosed region of small bowel.
The patient is noted post-operatively to have
high blood pressure, and oral metoprolol
is given; however, there is no elevation
of hypertension. This is most probably
due to
(a) The first-pass effect
(B) Reduced passage of the drug through
intestine
(C) Reduced GI blood flow
(D) Inactivation of drug by stomach acid
(e) Enhanced protein binding of the drug
C - ANSWER 1.5. What is an important characteristic of con-
gestive heart failure (CHF) with respect to
drug action?
(a) Reduced blood flow to the intestine
(B) Increased protein binding of several drugs
(C) Volume of distribution increased
,(D) Drug elimination enhanced
(e) Altered drug kinetics
A - ANSWER 1.6. What is the term to be used for defining the rate of elimination through
metabolism catalysed by alcohol dehydrogenase when this enzyme is saturated?
(a) Zero-order kinetics
(B) First-order elimination
(C) Clearance
(D) Biotransformation
(e) Redistribution
D - ANSWER 1.7. A 69-year-old female patient has been admitted in the intensive care
unit for the treatment of presumed staphylococcal sepsis. In order to avoid the
problems that may occur with possible
resistance, she is empirically given IV vancomycin while waiting for the culture results
to
come back. Vancomycin is a renally excreted
drug. The routine laboratory workup in this patient reveals a creatinine value of 3.2
consistent with
acute renal failure. What specific considerations will have to be made with regard to
adjustments of the prescribed medication?
(a) She will have to be switched to an oral (per
nasogastric tube) vancomycin preparation
(B) The patient will need to be water
restricted to reduce the volume of
distribution
(C) No adjustments to the current regimen will
be made due to the fact that the condition of
the patient is life-threatening and the drug
, must be given regardless
(D) The dose of vancomycin will need
to be reduced due to increased
accumulation
(e) Adjustments to the dose will need to
be made due to the patient currently
being ventilated
B - ANSWER 1.8. Glucuronidation reactions
(a) Are considered phase I reactions
(B) Require an active center as the site of
conjugation
(C) Use the enzymatic activity of alcohol dehydrogenase
(D) Present in mitochondria are inducible
by drugs
(e) Use NADPH for the enzymatic reaction
A - ANSWER 1.9. A 38 year old female presents to her
psychiatrist and requests to be switched to another type of
antidepressant as she feels that her current
medication is not providing her with much benefit.
She became so depressed that recently, over the
past few months she started drinking heavily.
The doctor would like to try imipramine; however, because this medication is known to
have an extensive first-pass effect, he orders a hepatic function panel prior to
prescribing the medication in light of the patient's history of recent alcohol use. Which
of the following best explains why the doctor ordered a hepatic function panel?
A Drugs with extensive first-pass metabolism reach high systemic concentrations in the
presence of hepatic dysfunction
B The hepatic function panel may indicate a specific sensitivity to the drug
