Pharmacology Chapter 30

How do males differ from females in the context of the amount of iron in their bodies? A. After age 20, healthy males require less iron intake than do females. B. The depletion of iron reserves in adult males occurs more readily than in adult females. C. Adult males are more likely than adult females to develop a dietary deficiency of iron. D. Adult males are more likely than adult females to suffer from pica, a condition that leads to iron deficiency.

A. After age 20, healthy males require less iron intake than do females.

_____ is caused by the defective functioning of the blood-forming organs (bone marrow). A. Aplastic anemia B. Normocytic anemia C. Pernicious anemia D. Sickle cell anemia

A. Aplastic anemia

Which of the following statements is not true about erythropoietin? A. Erythropoietin is an enzyme produced in the liver that is necessary for carrying out the metabolic processes of the body's cells. B. Erythropoietin stimulates the production of red blood cells in the bone marrow. C. Erythropoietin production is impaired in patients with chronic renal failure. D. Erythropoietin, in general, should not be added to any other drug solution

A. Erythropoietin is an enzyme produced in the liver that is necessary for carrying out the metabolic processes of the body's cells.

Which of the following procedures is a treatment method for acute iron toxicity? A. Flushing the stomach with 5 to 10 grams of deferoxamine mesylate B. Taking 200 mg of vitamin C orally within 10 minutes of the toxic dose C. Eating a meal to help bind the iron and prevent it from being absorbed into the bloodstream D. None of the above

A. Flushing the stomach with 5 to 10 grams of deferoxamine mesylate

Which of the following is true of the various types of anemia? A. In deficiency anemia, where there is a lack of iron or lack of copper, the RBCs are microcytic hypochromic. B. In deficiency anemia, where there is a lack of iron or lack of copper, the RBCs are normocytic normochromic. C. In deficiency anemia, where there is a lack of iron or lack of copper, the RBCs are sickle-shaped microcytic. D. None of these are correct.

A. In deficiency anemia, where there is a lack of iron or lack of copper, the RBCs are microcytic hypochromic.

Which of the following is true of intrinsic factor? A. Intrinsic factor is a glycoprotein that is necessary for the intestinal absorption of vitamin B12. B. Intrinsic factor is an enzyme that is necessary for the metabolism of vitamin B12. C. The lack of intrinsic factor leads to a microcytic hypochromic type of anemia. D. None of these are correct.

A. Intrinsic factor is a glycoprotein that is necessary for the intestinal absorption of vitamin B12.

Which of the following vitamin deficiencies leads to the development of pernicious anemia? A. Vitamin B12 deficiency B. Vitamin C deficiency C. Vitamin B6 deficiency D. Vitamin B1 deficiency

A. Vitamin B12 deficiency

A patient should not take cimetidine within 2 hours of taking cobalamin to treat his or her anemia because: A. cimetidine decreases gastric acid so that cobalamin cannot combine with available gastric intrinsic factor, impairing but not totally inhibiting the absorption of cobalamin. B. cimetidine stops the production of gastric acid so that cobalamin cannot combine with available gastric intrinsic factor, totally inhibiting the absorption of cobalamin. C. cimetidine suppresses the bone marrow and interferes with red blood cell maturation so that cobalamin cannot function in these cells. D. None of these are correct.

A. cimetidine decreases gastric acid so that cobalamin cannot combine with available gastric intrinsic factor, impairing but not totally inhibiting the absorption of cobalamin.

Why are patients advised not to chew or crush enteric-coated or delayed-release iron supplements? A. Because it will lead to the development of a smooth, sore, beefy red tongue B. Because it will lead to gastrointestinal (GI) irritation C. Because it will lead to iron poisoning D. All of the above

B. Because it will lead to gastrointestinal (GI) irritation

Alba, an aspiring model, starts following a severe diet to lose weight. In a few months, she begins to experience extreme fatigue and an uncomfortable tingling sensation in her legs. Worried about her health, she visits Dr. Holmes for a checkup. Upon examination, Dr. Holmes notes that Alba's skin is abnormally pale, and she has difficulty breathing. He prescribes some mineral supplements and advises Alba to follow a healthy diet that is rich in meat, fish, and soy products. Based on the information provided in this scenario, from which of the following conditions is Alba most likely suffering? A. Mild anemia B. Chronic iron deficiency C. Bone marrow failure D. Pica

B. Chronic iron deficiency

Which of the following statements is true of the deficiency of cyanocobalamin (vitamin B12)? A. Adults can easily develop a cobalamin deficiency due to decreased dietary intake. B. Deficiency of this vitamin usually occurs when intrinsic factor synthesis is interrupted or damaged. C. The anemia resulting from cobalamin deficiency is a microcytic hypochromic anemia. D. None of these are correct

B. Deficiency of this vitamin usually occurs when intrinsic factor synthesis is interrupted or damaged.

_____ is a protein normally produced by the kidneys that participates in red blood cell homeostasis. A. Intrinsic factor B. Erythropoietin C. Transcobalamin II D. Transferrin

B. Erythropoietin

In the context of treating iron deficiency, which of the following is true of ferumoxytol (Feraheme)? A. Feraheme is a novel iron product that is supplied as capsules for oral administration. B. Feraheme is specifically formulated for iron deficiency anemia in patients with chronic kidney disease. C. Feraheme should be administered as a diluted intravenous injection. D. Feraheme should only be used in patients for whom gastrointestinal (GI) absorption is impaired.

B. Feraheme is specifically formulated for iron deficiency anemia in patients with chronic kidney disease.

Which of the following statements is true of folic acid? A. Folic acid can be used to treat aplastic and normocytic anemias. B. Folic acid is heat labile. C. Folic acid and cyanocobalamin deficiencies produce opposite anemias. D. Folic acid can produce high degrees of toxicity when taken in large quantities.

B. Folic acid is heat labile.

Jenna suffers from anemia caused due to a dietary deficiency of iron. When Dr. Calvin studies Jenna's medical reports, he discovers that Jenna's gastrointestinal tract is impaired and that her body cannot absorb adequate amounts of iron from her intestine. Which of the following drugs can Dr. Calvin prescribe for Jenna's treatment keeping these considerations in mind? A. Chromagen B. INFeD C. Geritol tonic liquid D. Vitron-C

B. INFeD

Which of the following statements is true of cobalamin (vitamin B12)? A. Cobalamin is primarily found is green vegetables and fruits. B. Strict vegetarians are more likely to develop a deficiency of cobalamin. C. The anemia resulting from cobalamin deficiency is a microcytic hypochromic anemia. D. Cobalamin has recognized therapeutic value in the treatment of hepatitis, allergies, and sterility.

B. Strict vegetarians are more likely to develop a deficiency of cobalamin.

Which of the following statements is true of iron intake by the body? A. After age 20, healthy males require more iron intake than do females. B. The recommended dietary allowance (RDA) for iron should be between 10 and 18 mg. C. Strict vegetarians are less likely to develop a dietary deficiency of iron. D. The amount of iron in the body is maintained at a relatively constant level between 15 and 20 g.

B. The recommended dietary allowance (RDA) for iron should be between 10 and 18 mg.

Why should liquid iron preparations be taken through a straw or with juice or water? A. So that the iron does not erode the lining of the esophagus B. To prevent or decrease the staining of the teeth C. So that the iron does not come in contact with the tongue, causing glossitis D. All of these are correct.

B. To prevent or decrease the staining of the teeth

People suffering from pernicious anemia should: A. be given 1 mcg of cobalamin orally every day. B. be given an injection of about 100 mcg of cobalamin every month. C. be given 100 mcg of cobalamin intravenously on a daily basis. D. be given 500 mcg of cobalamin intravenously once a month.

B. be given an injection of about 100 mcg of cobalamin every month.

Pablo underwent a major surgery a few months ago where certain portions of his stomach were surgically removed. Following the surgery, Pablo developed a form of anemia and started experiencing weakness and a "pins and needles" sensation in certain parts of his body. His doctor advised him to take monthly injections of cobalamin for the rest of his life. Based on the information provided in this scenario, Pablo was most likely diagnosed with _____. A. aplastic anemia B. pernicious anemia C. normocytic anemia D. microcytic hypochromic anemia

B. pernicious anemia

Allison, a teacher at a school for underprivileged children, notices that one of her students, 8-year-old Sarah, has an abnormal eating disorder. She often observes Sarah eating clay and chalk. When this habit continues in spite of intervention, Allison takes Sarah to Dr. Ford's clinic for a medical checkup. In addition to pale skin and rapid breathing, Dr. Ford notes that Sarah has abnormally low levels of iron in her blood stream. Based on the information provided in this scenario, Sarah shows the characteristic symptoms of _____. A. scurvy B. pica C. hypokalemia D. hemochromatosis

B. pica

Identify the correct definition of the term "hypochromic" by breaking the word into its component parts. A. "Hypo-" refers to less than normal and "-chromic" means size. B. "Hypo-" refers to more than normal and "-chromic" means color. C. "Hypo-" refers to less than normal and "-chromic" means color. D. None of these are correct.

C. "Hypo-" refers to less than normal and "-chromic" means color.

How can anemia resulting from altered RBC production or from increased RBC destruction be best treated? A. By replacing iron or cyanocobalamin in the diet B. By replacing iron or copper through supplements C. By giving a blood transfusion D. All of the above

C. By giving a blood transfusion

Which of the following statements is true of erythropoietin? A. Erythropoietin is a protein normally produced by the parietal cells of the stomach. B. Erythropoietin is not effective in the treatment of chronic renal failure and cancer. C. Erythropoietin can be used to treat zidovudine-related anemia in HIV patients. D. Preparations of erythropoietin should be vigorously shaken before use.

C. Erythropoietin can be used to treat zidovudine-related anemia in HIV patients.

Which of the following is not true about the use of folic acid? A. Administration of folic acid in a cobalamin deficiency can reverse the production of the megaloblastic cells. B. Folic acid has no effect on the synthesis of myelin. C. Folic acid can reverse the neurological changes associated with cobalamin deficiency. D. Folic acid is not effective in the treatment of aplastic and normocytic anemias.

C. Folic acid can reverse the neurological changes associated with cobalamin deficiency.

Which of the following statements is true of using folic acid for treating anemias? A. Folic acid cannot be used to reverse the production of the megaloblastic cells associated with cobalamin deficiency. B. Folic acid can be used to treat aplastic anemia. C. Folic acid should never be given for treatment of cobalamin (vitamin B12) deficiency anemia. D. Folic acid is effective in the treatment of normocytic anemias.

C. Folic acid should never be given for treatment of cobalamin (vitamin B12) deficiency anemia.

Which of the following is true of treating iron deficiency? A. Anemia caused by a nutritional lack of iron cannot be treated with oral iron supplements. B. Vitamin C should not be used in combination with iron supplements in the treatment of iron deficiency as it reduces the intestinal absorption of iron. C. Iron dextran (INFeD) can be used to treat iron deficiency in patients who have impaired gastrointestinal absorption. D. Long-term iron-deficient patients should be treated with 20 to 50 mg of iron per day for at least 6 months.

C. Iron dextran (INFeD) can be used to treat iron deficiency in patients who have impaired gastrointestinal absorption.

_____ has the longest half-life of all erythropoietin stimulating agents (ESAs). A. Aranesp B. Epogen C. MIRCERA D. Procrit

C. MIRCERA

_____ are characterized by unusually small red blood cells (RBCs). A. Macrocytic anemias B. Megaloblastic anemias C. Microcytic anemias D. Normochromic anemias

C. Microcytic anemias

David works as a health-care professional at Silver Oak Nursing Home. He is instructed to tend to Alisha Pavel, an undernutritioned patient who has been admitted at the nursing home for treatment. Which of the following instructions should David give Alisha when she is taking her oral hematinics? A. Do not take the supplements on an empty stomach. B. Chew or crush the supplements prior to swallowing. C. Take liquid iron preparations with juice or water. D. Always take antacids simultaneously with oral iron supplements.

C. Take liquid iron preparations with juice or water.

What is the main function of hemoglobin? A. The main function of hemoglobin is to stimulate the production of red blood cells in the bone marrow. B. The main function of hemoglobin is to stimulate the intestinal absorption of cyanocobalamin. C. The main function of hemoglobin is to transport oxygen to all tissues of the body. D. All of these statements are correct.

C. The main function of hemoglobin is to transport oxygen to all tissues of the body.

Which of the following special considerations should a health-care professional keep in mind while using erythropoietin? A. Preparations of erythropoietin cannot be frozen or vigorously shaken. B. Erythropoietin should not be added to any other drug solution. C. Benzyl alcohol 0.9 percent may be added to the erythropoietin to act as a bacteriostatic agent. D. All of these are correct.

D. All of these are correct.

Which of the following statements is true about the treatment of anemia with hematinics? A. Hematinics are available as over-the-counter products in tablet, capsule, and liquid forms. B. The addition of ascorbic acid (vitamin C) to hematinics enhances the intestinal absorption of iron. C. Long-term iron-deficient patients may require 100 to 200 mg of iron TID for at least 6 months. D. All of these are correct.

D. All of these are correct.

Which of the following is true of how is anemia caused? A. Anemia may be caused by a deficiency in the amount of hemoglobin that occurs when the number of circulating red blood cells decreases. B. Anemia may be caused by excessive blood loss or by an increase in the destruction of red blood cells (RBCs). C. Anemia may be caused by a decrease in the production of RBCs, which reduces the amount of circulating hemoglobin. D. All of these statements are correct.

D. All of these statements are correct.

Which of the following statements is true of anemia? A. All forms of anemia are inherited. B. Inherited anemias can be successfully treated or cured with drug replacement therapy. C. Anemia is typically caused by an abnormal increase in the number of circulating red blood cells. D. The characteristic symptoms of anemia include weakness, fatigue, irritability, and pallor.

D. The characteristic symptoms of anemia include weakness, fatigue, irritability, and pallor.