Gi drugs review questions
61 year old woman suffering from the hepatitis B virus underwent a follow-up examination. She was found to have more that 105HBV DNA copies/ml and alanine transaminase of 210 U/L (normal 8-20 U/L). Therapy with entecavirwas started. Inhibition of which of the following viral enzymes most likely mediated the therapeutic effects of the drug in this patient's disease? A.DNA polymeraseB.Phosphotransferase C.RNA polymerase D.Thymidine kinase E.Neuraminidase
A
A 51-year old man with peptic ulcer disease has been on drug therapy for 3 months and has noticed changes in his bowel habits, increasing headaches, dizziness, skin rashes, loss of libido, and gynecomastia. Which of the following drugs is most likely responsible for these side effects? a)Cimetidine b)Famotidine c)Metronidazole d)Omeprazole e)Sulcralfate
A
An otherwise healthy 33-year old man sees his physician for a routine physical examination. The patient has no complaints and is planning to vacation in Mexico next month. However, he is afraid of developing traveler's diarrhea. Which of the following drugs could he take to prevent travelers' diarrhea? a)Bismuth subsalicylate b)Diphenoxylatec)Glucocorticoids d)Loperamide
A
A 58-year old man suffering from hepatic cirrhosis was admitted to the hospital because of drowsiness and disorientation in time and place. Further exams led to the diagnosis of portal systemic encephalopathy. Which of the following drugs would be appropriate treatment in this patient? A.Omeprazole B.Lactulose C.LoperamideD.SucralfateE.Aprepitant
B
A 62-year old man with long standing, poorly controlled diabetes is admitted for yet another episode of ketoacidosis. Now that he is out of the intensive care unit, he complains of regurgitation of food following even small meals. You suspect the development of diabetic gastropathy. Which of the following drugs might help his condition? A)Bismuth B)Metoclopramide C)Misoprostol D)Scopolamine E)Sucralfate
B
A 45-year old man suffering from the hepatitis C virus (HCV) began a therapy involving the drugs sofosbuvirand simeprevir. Which of the following steps in the HCV life cycle is specifically affected by sofosbuvir? A.Viral Attachment B.Viral Entry C.Nucleic acid synthesis D.Proteolytic cleavage E.Virus assembly
C
A 47-year old man with a duodenal ulcer was treated with a combination of drugs intended to heal mucosal damage and to eradicate Heliobacterpylori. Which of the following antibacterial drugs is commonly used to eradicate Heliobacterpylori? A.CefazolinB.CiprofloxacinC.ClarithromycinD.Clindamycin E.Vancomycin
C
A 56-year old man suffering from viral hepatitis B had started a treatment with interferon alfa-2a. However, nine months after the start of the treatment he was still positive for the hepatitis B early antigen (HBeAg). His gastroenterologist decided to stop interferon and start another drug. Which of the following drugs would be appropriate for the patient at this time? A.BoceprevirB.LopinavirC.LamivudineD.PancrelipaseE.Sofosbuvir
C
A 68-year old man suffering from a small cell carcinoma of the lung was hospitalized for his first cycle of chemotherapy. Which of the following three drug regimens would be the best to prevent nausea and vomiting in this patient? A.Ranitidine, diazepam, dexamethasone B.Scopolamine, dexamethasone, ondansetronC.Ondansetron, aprepitant, dexamethasone D.Diphenhydramine, prochlorperazine, dronabino
C
A 68-year old man went on a cruise to celebrate his 45thwedding anniversary. Concerned about a history of motion sickness, the patient saw his primary care physician about a medication to take. He is now seen by the onboard physician with complaints of blurred vision, confusion, constipation and urinary retention. Which of the following did the primary care physician likely prescribe? A)DronabinolB)Haloperidol C)Metoclopramide D)Ondansetron E)Scopolamine
E
Which of the following is a small molecule that polymerizes in stomach acid and coats the ulcer bed, resulting in accelerated healing and reduction of symptoms? A.Cimetidine B.Dexamethasone C.Omeprazole D.PancrelipaseE.Sucralfate
E
A 58-year-old man suffering from small gallstones refuses to have gallbladder surgery. His physician decides to prescribe a medication that will dissolve his gallstones. Which of the following drugs was most likely given to this patient? A.AprepitantB.Lactulose C.Pancrelipase D.SofosbuvirE.Ursodiol
E
A 74-year old man was admitted to the hospital because of persistent epigastric pain and tarry stools. The patient had been suffering from hypertension and was being treated with two medications to lower his blood pressure. Past history was significant for a serious hypersensitivity to omeprazole taken 1 year ago for heartburn. Pertinent lab results on admission were as follows: red blood cell count 3.5 x 106/mm3(normal 4.5 -5.5 x 106/mm3), hemoglobin 9 g/dl (normal 14-16 g/dl), creatinine 4.5 mg/dl (normal 0.9 -1.3 mg/dl). Endoscopy disclosed a large gastric ulcer. Therapy with famotidine was started. Which of the following best describes the mechanism by which famotidine produces a therapeutic effect in this patient? A.It coats the gastric ulcer crater B.It activates EP3 receptors in the gastric epithelial cells C.It blocks H2 receptors in gastric parietal cells D.It neutralizes hydrochloric acid in the stomach lumen E.It inhibits the H+/K+ ATPase in gastric parietal cells
C
Which of the following drugs accumulates in parietal cell canaliculi and undergoes conversion to a derivative that irreversibly inhibits H+/K+ ATPase? A)Cimetidine B)DiphenoxylateC)Esomeprazole D)Metoclopramide E)Sulfasalazine
C
45-year old female patient is receiving highly emetogenic chemotherapy for a metastatic cancer. To prevent chemotherapy-induced nausea and vomiting, she is likely to be treated with which of the following drugs? A.Levodopa B.Methotrexate C.Misoprostol D.Ondansetron E.Sucralfate
D
A 24-year old man with a 7-year history of Crohn's disease was suffering from persistent diarrhea, abdominal pain, and signs of systemic inflammation that were poorly controlled by first line agents. The patient's physician proposed treatment with an immunoglobin-based agent that inhibits TNF. Which of the following drugs fits this description? A.AldesleukinB.Cyclosporine C.FilgrastimD.InfliximabE.Interferon-g
D
A 30-year old woman attempts suicide by ingesting 50 acetaminophen tablets. She is rushed to the ER. Which of the following treatments would the attending physician most likely order? A.Alkalinzationof urineB.Administration of a calcium chelatorC.DeferoxamineD.N-acetylcysteineE.Protamine sulfate
D
A 34-year old man presented to the clinic with jaundice and complaints of incapacitating fatigue and vague intermittent abdominal pain for the past month. The patient had a history of intravenous drug use and alcohol abuse. Hepatitis serological test were positive for hepatitis B surface antigen. Which of the following drugs would be appropriate for this patient? A.EnfuvirtideB.AtazanavirC.Amantadine D.Interferon alfa-2a E.Ganciclovi
D
A 45-year old man suffering from the hepatitis C virus (HCV) began a therapy involving the drugs sofosbuvirand simeprevir. Which of the following steps in the HCV life cycle is specifically affected by simeprevir? A.Viral Attachment B.Viral Entry C.Nucleic acid synthesis D.Proteolytic cleavage E.Virus assembly
D
A 53-year old woman suffers from abdominal pain and bloody diarrhea that has been diagnosed as ulcerative colitis. Which of the following is a first-line drug for treatment of ulcerative colitis that acts locally in the gastrointestinal tract to provide an anti-inflammatory effect? A.Aluminum hydroxide B.Metoclopramide C.Misoprostol D.MesalamineE.Ranitidine
D
A 56-year-old woman suffering from chronic constipation routinely self-administered milk of magnesia daily. Which of the following actions most likely mediated the laxative effect of the drug? A.Inhibition of cholecystokinin release B.Retention of water in the vessels by osmosis C.Lubrication of fecal material D.Stretching of the intestinal wallE.Formation of a bulky emollient gel
D
A 59-year old woman with ovarian cancer was hospitalized for her first cycle of chemotherapy. To prevent nausea and vomiting, she was given a combination therapy that included the drug dexamethasone. Which of the following receptor types is believed to mediate the anti-emetic effects of dexamethasone? A.Ion channel receptorsB.G protein coupled receptorsC.Cytokine receptors D.Transcription factor receptors E.Tyrosine kinase receptors
D
A 64-year old man with newly diagnosed lung cancer was schedule to receive his first round of chemotherapy. A prophylactic antiemetic treatment was planned that included the drug ondansetron. Which of the following brain regions represent a site of antiemetic action of ondansetron? A.Locus ceruleusB.Medial forebrain bundle C.Nucleus accumbensD.Nucleus tractussolitariusE.Putamen
D
A 65-year old man complains of chronic heartburn. It is painful for him to bend over, and he sleeps on a wedge-shaped pillow to try to reduce the burning sensation. Which of the following agents would be the most efficacious in reducing his symptoms? A)BisacodylB)Cimetidine C)Magnesium hydroxide D)Omeprazole E)Promethazine
D
A 68-year-old woman complained to her physician of persistent constipation. Her physician prescribed a laxative that acts in the colon by absorbing water into the fecal contents, thus promoting peristalsis about 1-2 days after administration. Which of the following drugs was most likely prescribed? A.Castor oilB.Docusate C.Magnesium sulfate D.MethylcelluloseE.Sodium phosphate
D
A 74-year old man was admitted to the hospital because of persistent epigastric pain and tarry stools. The patient had been suffering from hypertension and was being treated with two medications to lower his blood pressure. Past history was significant for a serious hypersensitivity to omeprazole taken 1 year ago for heartburn. Omeprazole belongs to which of the following drug classes? A.Antacid B.Anticholinergic C.Histamine H2 antagonist D.Proton pump inhibitor E.Prostaglandin analog
D
A 30-year old man went to his physician because of 1 month of worsening intermittent abdominal pain, bloating, diarrhea and rectal bleeding. Vital signs were normal, and physical examination disclosed only diffuse abdominal pain. Sigmoidoscopy showed erythematous mucosa in the rectum and sigmoid and descending colon. The mucosa had areas of fine granular appearance with some focal hemorrhage and ulcerations. Biopsies demonstrated abnormal crypt abscesses. A diagnosis was made and a therapy was prescribed. Which of the following drugs would be most appropriate for the patient at this time? A.Metronidazole B.Clarithromycin C.Loperamide D.Ondansetron E.Prednisolone
E. Prednisolone
What drugs would you give for travelors diarrhea
Fluoroquinolones: -Floxacins Azithromycin
What drugs would you give for C-Diff
Metrodizole, oral vancomycin
