Pharmacology 10
Renal pharmacology
Question # 1 (Multiple Answer) Blockade of the Na/K/2Cl co-transporter -- basis for diuretic effect:
A) torsemide (Demadex) B) ethacrynic acid (Edecrin) C) bumetanide (Bumex) D) triamterene (Dyrenium) E) mannitol
Question # 2 (Multiple Answer) Secreted by the renal organic base secretory system:
A) creatinine B) procainamide (Procan SR, Pronestyl-SR) C) choline
Question # 3 (Multiple Choice) Substances which could retard water reabsorption:
A) mannitol B) high glucose levels C) both D) neither
Question # 4 (Multiple Answer) Distal convoluted tubule -- properties
A) impermeable to water B) about 10% of filtered sodium load reabsorbed here. C) calcium actively reabsorbed
Question # 5 (Multiple Choice) Localization of the renal organic base secretory system:
A) loop of Henle B) early in middle segments of proximal tubule C) collecting duct D) distal convoluted tubule
Question # 6 (Multiple Choice) Carbonic anhydrase inhibitor
A) furosemide (Lasix) B) bumetanide (Bumex) C) acetazolamide (Diamox) D) chlorothiazide (Diuril) E) spironolactone (Aldactone)
Question # 7 (Multiple Choice) About 35% of the filtered load of sodium chloride is reabsorbed here:
A) thin limb -- --loop of Henle B) collecting duct C) distal convoluted tubule D) thick ascending limb -- loop of Henle E) cortical collecting tubule
Question # 8 (Multiple Answer) Collecting tubule: properties --
A) 2%-5% sodium chloride reabsorption B) final site for sodium chloride reabsorption C) a site of action for mineralocorticoids D) major site of potassium secretion E) increased sodium delivery to the collecting tubule promotes potassium loss
Question # 9 (Multiple Choice) Location of the organic acid secretory system
A) distal tubule B) collecting duct C) middle third: proximal tubule D) loop of Henle E) macula densa
Question # 10 (Multiple Answer) Compound(s) secreted by the organic acid secretory system:
A) uric acid B) some antibiotics C) p-aminohippuric acid
Question # 11 (Multiple Choice) Mechanism of action: spironolactone (Aldactone)
A) through osmotic effects B) through enzyme inhibition C) through interaction with hormonal receptors
Question # 12 (Multiple Choice) Diuretics acting on specific membrane transport proteins:
A) loop diuretics B) thiazides C) amiloride (Midamor) D) triamterene (Dyrenium) E) all of the above
Question # 13 (True/False) The driving force for watery absorption by the thin limb of the loop of Henle is the hypertonic medullary fluid
A) true B) false
Question # 14 (Multiple Answer) Diuretic mechanism(s):
A) through osmotic effects (preventing water reabsorption) B) enzyme inhibition C) interaction with hormonal receptors
Question # 15 (Multiple Choice) Renal Site where most filtered sodium bicarbonate is reabsorbed:
A) collecting duct B) distal tubule C) collecting tubule D) loop of Henle E) proximal tubule
Question # 16 (Multiple Answer) Loop diuretics -- effects on ionic excretion:
A) increased sodium excretion B) decreased magnesium loss C) increased calcium loss D) decreased potassium loss
Question # 17 (Multiple Choice) Mechanism of action: acetazolamide (Diamox)
A) through osmotic effects B) through enzyme inhibition C) interacting with hormonal receptors
Question # 18 (Multiple Choice) Pharmacological blockade of sodium and chloride cotransport at the distal convoluted tubule:
A) bumetanide (Bumex) B) furosemide (Lasix) C) chlorothiazide (Diuril) D) triamterene (Dyrenium)
Question # 19 (Multiple Choice) Renal site where most water is reabsorbed:
A) medullary collecting tubule B) collecting duct C) early portions of the proximal tubule D) loop of Henle E) distal tubule
Answers
Question # 1 (Multiple Answer) Blockade of the Na/K/2Cl co-transporter -- basis for diuretic effect:
(A) torsemide (Demadex)
(B) ethacrynic acid (Edecrin)
(C) bumetanide (Bumex)
Question # 2 (Multiple Answer) Secreted by the renal organic base secretory system:
(A) creatinine
(B) procainamide (Procan SR, Pronestyl-SR)
(C) choline
Question # 3 (Multiple Choice) Substances which could retard water reabsorption:
Answer: (C) both
Question # 4 (Multiple Answer) Distal convoluted tubule -- properties
(A) impermeable to water
(B) about 10% of filtered sodium load reabsorbed here.
(C) calcium actively reabsorbed
Question # 5 (Multiple Choice) Localization of the renal organic base secretory system:
Answer: (B) early in middle segments of proximal tubule
Question # 6 (Multiple Choice) Carbonic anhydrase inhibitor
Answer: (C) acetazolamide (Diamox)
Question # 7 (Multiple Choice) About 35% of the filtered load of sodium chloride is reabsorbed here:
Answer: (D) thick ascending limb -- loop of Henle
Question # 8 (Multiple Answer) Collecting tubule: properties --
(A) 2%-5% sodium chloride reabsorption
(B) final site for sodium chloride reabsorption
(C) a site of action for mineralocorticoids
(D) major site of potassium secretion
(E) increased sodium delivery to the collecting tubule promotes potassium loss
Question # 9 (Multiple Choice) Location of the organic acid secretory system
Answer: (C) middle third: proximal tubule
Question # 10 (Multiple Answer) Compound(s) secreted by the organic acid secretory system:
(A) uric acid
(B) some antibiotics
(C) p-aminohippuric acid
Question # 11 (Multiple Choice) Mechanism of action: spironolactone (Aldactone)
Answer: (C) through interaction with hormonal receptors
Question # 12 (Multiple Choice) Diuretics acting on specific membrane transport proteins:
Answer: (E) all of the above
Question # 13 (True/False) The driving force for watery absorption by the thin limb of the loop of Henle is the hypertonic medullary fluid
Answer: True
Question # 14 (Multiple Answer) Diuretic mechanism(s):
(A) through osmotic effects (preventing water reabsorption)
(B) enzyme inhibition
(C) interaction with hormonal receptors
Question # 15 (Multiple Choice) Renal Site where most filtered sodium bicarbonate is reabsorbed:
Answer: (E) proximal tubule
Question # 16 (Multiple Answer) Loop diuretics -- effects on ionic excretion:
(A) increased sodium excretion
(C) increased calcium loss
Question # 17 (Multiple Choice) Mechanism of action: acetazolamide (Diamox)
Answer: (B) through enzyme inhibition
Question # 18 (Multiple Choice) Pharmacological blockade of sodium and chloride cotransport at the distal convoluted tubule:
Answer: (C) chlorothiazide (Diuril)
Question # 19 (Multiple Choice) Renal site where most water is reabsorbed:
Answer: (C) early portions of the proximal tubule
Parkinson's disease
Question # 1 (Multiple Choice) Reason that dopamine itself is not used to treat in Parkinson's disease:
A) too expensive B) the problem is cholinergic in nature C) dopamine does not cross the blood-brain barrier D) levodopa has a higher affinity for the D2 receptor
Question # 2 (Multiple Choice) Dominantly inherited disease: associated with progressive chorea and dementia; related to neurotransmitter imbalance
A) Wilson's disease B) tardive dyskinesia C) Tourette's syndrome D) Huntington's disease E) Shy-Drager syndrome
Question # 3 (Multiple Choice) Antiviral drug found to have anti-Parkinson's properties:
A) procyclidine B) pergolide C) amantadine D) levodopa E) reserpine
Question # 4 (True/False) Benefits of dopaminergicanti--Parkinson's drugs probably due to stimulation of D2 dopamine receptors
A) true B) false
Question # 5 (Multiple Choice) Irregular, unpredictable, involuntary muscle contractions:
A) athetosis B) dystonia C) tics D) chorea E) akinesia
Question # 6 (Multiple Choice) Dopamine agonist ergot derivative -- stimulates D1 & D2 receptors
A) levodopa B) amantadine C) pergolide D) selegiline E) trihexyphenidyl
Question # 7 (Multiple Choice) Characterized by chronic, multiple tics:
A) Parkinson's disease B) Wilson's disease C) Shy-Drager syndrome D) Tourette's syndrome E) all of the above
Question # 8 (Multiple Choice) Percentage of levodopa that enters the brain unaltered
A) 1-3% B) 5-10% C) 15-30% D) > 50%
Question # 9 (Multiple Answer) Effective in managing essential tremor
A) propranolol B) metoprolol C) primidone D) diazepam E) chlordiazepoxide
Question # 10 (Multiple Choice) First-line anti-Parkinson drug; also used to treat hyperprolactinemia at lower doses
A) amantadine B) levodopa C) bromocriptine D) selegiline E) benztropine mesylate
Question # 11 (Multiple Choice) Carbidopa is useful in the management of Parkinson's disease because it is an:
A) effective D2 agonist B) effective D2 antagonist C) effective peripheral decarboxylase inhibitor D) effective central decarboxylase inhibitor E) :effective competitor at the GABA receptor
Answers
Question # 1 (Multiple Choice) Reason that dopamine itself is not used to treat in Parkinson's disease:
Answer: (C) dopamine does not cross the blood-brain barrier
Question # 2 (Multiple Choice) Dominantly inherited disease: associated with progressive chorea and dementia; related to neurotransmitter imbalance
Answer: (D) Huntington's disease
Question # 3 (Multiple Choice) Antiviral drug found to have anti-Parkinson's properties:
Answer: (C) amantadine
Anti-Parkinson mechanism of action unclear; knack by affecting dopamine reuptake, synthesis, or release
Question # 4 (True/False) Benefits of dopaminergicanti--Parkinson's drugs probably due to stimulation of D2 dopamine receptors
Answer: True
Question # 5 (Multiple Choice) Irregular, unpredictable, involuntary muscle contractions:
Answer: (D) chorea
chorea: may be hereditary, secondary to non--neurological disease; drug-induced
Question # 6 (Multiple Choice) Dopamine agonist ergot derivative -- stimulates D1 & D2 receptors
Answer: (C) pergolide
pergolide & bromocriptine are ergot alkaloid derivatives useful in treating Parkinson's disease
Question # 7 (Multiple Choice) Characterized by chronic, multiple tics:
Answer: (D) Tourette's syndrome
Question # 8 (Multiple Choice) Percentage of levodopa that enters the brain unaltered
Answer: (A) 1-3%
most levodopa is metabolized extracerebrally
Question # 9 (Multiple Answer) Effective in managing essential tremor
(A) propranolol
(B) metoprolol
(C) primidone
probably a beta-adrenergic receptor dysfunction; anti-Parkinson agents, diazepam, chlordiazepoxide, mephenesin not useful
Question # 10 (Multiple Choice) First-line anti-Parkinson drug; also used to treat hyperprolactinemia at lower doses
Answer: (C) bromocriptine
ergot derivative; dopamine agonist, probably at D2 receptors
Question # 11 (Multiple Choice) Carbidopa is useful in the management of Parkinson's disease because it is an:
Answer: (C) effective peripheral decarboxylase inhibitor
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