Practice for exam! Pharm.pptx

A 35-year-old woman comes to the physician because of fever, night sweats, and fatigue. Biopsy specimen of an enlarged lymph node reveals Hodgkin lymphoma. The patient is treated with doxorubicin, bleomycin, vinblastine, and dacarbazine. This chemotherapeutic regimen increases the patient’s risk...

A 35-year-old woman comes to the physician because of fever, night sweats, and fatigue. Biopsy specimen of an enlarged lymph node reveals Hodgkin lymphoma. The patient is treated with doxorubicin, bleomycin, vinblastine, and dacarbazine. This chemotherapeutic regimen increases the patient’s risk for developing dilated cardiomyopathy which can be prevented with A. Amifostine B. Dexrazoxane C. Leucovorin D. Mesna A 35-year-old woman is undergoing an elective laparoscopic cholecystectomy. After being sedated, she is given a muscle relaxant intravenously. Just after administration of this drug, the patient’s arms and legs twitch briefly. Which of the following drugs was most likely administered? A. Dantrolene B. Fentanyl C. Succinylcholine D. Vecuronium A 64-year-old woman with peptic ulcer disease comes to the clinic with a 1-year history of worsening bilateral hip pain that is worse in the evening and improves with rest. Ibuprofen is prescribed. One month later, the patient’s serum creatinine has increased from 0.9 mg/dL to 1.5 mg/dL. Which of the following best explains this patient’s increased serum creatinine concentration? A. Constriction of the afferent arteriole B. Constriction of the efferent arteriole C. Dilation of the afferent arteriole D. Dilation of the efferent arteriole A 34-year-old man comes to the emergency department with a dry cough, low-grade fevers, and difficulty breathing that has become progressively worse with exertion for the past 2 to 3 weeks. He reports feeling increasingly fatigued and has had an unintentional weight loss of 4.5 kg (10 lb) in the same period. The patient has had unprotected intercourse with multiple sexual partners. Temperature is 38.1°C (100.6°F), pulse is 96/min, respiratory rate is 22/min, blood pressure is 102/72 mm Hg, and oxygen saturation is 86% on room air. Physical examination shows oral thrush, bilateral rales at the lung bases, and right axillary and left inguinal lymphadenopathy. He is treated with a drug combination that inhibits successive enzymatic steps key to bacterial DNA formation. Which of the following is the most likely mechanism of action for the drug used to treat this patient’s pulmonary symptoms A. Inhibition of folate synthesis B. Inhibition of peptidoglycan cross-linking C. Inhibition of protein synthesis by blocking attachment of the aminoacyl-transfer RNA D. Inhibition of topoisomerase II and IV A 56-year-old man is evaluated in the hospital for fever, a dramatic increase in leukocyte count, and profuse watery diarrhea. He was admitted 5 days ago after being stabbed in the right shoulder. He is currently being treated with antibiotics for an infected wound that showed signs of crepitus. On physical examination, his wound appears to be healing well, but his abdomen is tender to palpation. He is given medication to treat his watery diarrhea. Which of the following medication will you choose to treat his watery diarrhea caused by the administered antibiotics? A. Intravenous amikacin B. Oral albendazole C. Oral vancomycin D. Intravenous vancomycin A 24-year-old graduate female student presents to the clinic complaining of a severe toothache in her left upper palate. She reports feeling slightly feverish and has noticed increased swelling where her wisdom tooth is erupting. Plain films show that there is no wisdom tooth impaction, but that the soft tissue swelling is consistent with a dental abscess. You prescribe her an antibiotic, a protein translocation inhibitor that will be effective against mouth flora (anaerobes and gram-positive organisms) to treat her infection? A. Chloramphenicol B. Levofloxacin Amoxicillin C. Clindamycin D. Tobramycin A 68-year-old man comes to the office because of a 4-month history of low back pain. The patient is diagnosed with advanced prostate adenocarcinoma with bone metastases. Treatment with cisplatin, etoposide, and leuprolide begins. Which of the following describes the mechanism of action of etoposide? A. Binding to a protein, thus preventing breakdown of the mitotic spindle B. Blockage of vascular endothelial growth factor receptors C. Inhibition of an enzyme, leading to DNA strand breakage D. Noncovalent intercalation into DNA strands, leading to decreased mRNA synthesis A 33-year-old woman is diagnosed with HIV and started on antiretroviral medications, including enfuvirtide. Which of the following best describes the most likely mechanism of action of enfuvirtide? A. Blocking incorporation of the viral genome into the host cell genome B. Preventing entry of viral particles into the target host cell C. Preventing synthesis of DNA from viral RNA D. Blocking translation of the viral messenger RNAs A 48-year-old man presents to his primary care physician’s office for an annual check-up. He reports that, over the past few months, he has noticed that he has been thirstier and has been urinating more frequently. His family history is significant for type 2 diabetes in both of his parents. A fasting glucose level is 142 mg/dL. All other laboratory studies are normal. You tell the patient that he has type 2 diabetes and you decide to begin him on a medication that will lower his blood sugar by inhibiting glucose production by the liver. Which of the following medication will you choose? A. Metformin B. Glimepiride C. Rosiglitazone D. Miglitol E. Acarbose A 20-year-old woman at 6 weeks of gestation comes to the clinic for pregnancy termination. She is prescribed mifepristone and a second drug, which, if given several days after mifepristone, increases the likelihood of pregnancy termination to almost 100%. Which of the following is the most likely prescribed drug? A. Misoprostol B. Aspirin C. Nifedipine D. Danazole A 26-year-old man is brought to the emergency department after being found unresponsive in his apartment. He has no known medical conditions and does not take any medications. On examination, his temperature is 37.1°C (98.7°F), pulse is 55/min, respirations are 6/min, and blood pressure is 110/89 mm Hg. The patient’s pupils are 2 mm in size and are nonreactive to light. Skin examination reveals evidence of injectable drug use on the patient’s forearms. The patient’s respiratory depression is most likely caused by which of the following mechanisms? A. Activation of κ opioid receptors B. Activation of μ opioid receptors C. Blockade of norepinephrine reuptake D. Inhibition of muscarinic receptor A 70-year-old patient with multiple cancer metastasis is prescribed extended-release morphine for pain management. To prevent constipation Sena glycoside and lactulose were tried but without any positive effect.. Which of the following medications should be prescribed for bowel regimen? A. Naloxone B. Naltrexone C. Methylnaltrexone D. Buprenorphine A 38-year-old man is being treated for HIV-induced acquired immunodeficiency syndrome (AIDS). When abacavir therapy is begun, he develops a severe skin rash. Having which of the following allele might explain this skin rash? A. CYP2D6*3 B. CYP3A5*3 C. HLA-B*57:01 D. HLA- B27 A 23-year-old woman is diagnosed with systemic lupus erythematosus and lupus nephritis and is started on prednisone and mycophenolate. Which of the following drug-related adverse effects is this patient most likely to experience? A. Hypertension B. Hypotension C. Hypoglycemia D. Hair loss A 70-year-old patient with multiple cancer metastasis is prescribed extended-release morphine for pain management. To prevent constipation Sena glycoside and lactulose were tried but without any positive effect.. Which of the following medications should be prescribed for bowel regimen? A. Naloxone B. Naltrexone C. Methylnaltrexone D. Buprenorphine A 68-year-old male is diagnosed with atrial fibrillation. Which of the following medications should be used to prevent stroke? A. Aspirin B. Clopidogrel C. Rivaroxaban D. Vitamin K  A research study is investigating new agents for preventing recurrent supraventricular arrhythmias. After administering the new agent to healthy volunteers, serum studies show the appearance of antinuclear and antihistone antibodies. Which of the following drugs is most likely to induce the same antibody response? A. Amiodarone B. Procainamide C. Lidocaine D. Amitriptyline A 5-year-old boy is brought to the pediatrician by his mother because the child frequently ceases his activities and “stares blankly into space” while smacking his lips. He resumes his normal activities shortly thereafter. These episodes happen both at school and at home. The pediatrician starts him on ethosuximide to treat his symptoms. Which of the following is the most likely mechanism of action of the patient’s medication? A. Activates chloride channel opening B. Blocks T-type calcium channels C. Blocks voltage-gated sodium channels D. Blocks N-type calcium channels A 58-year-old woman is hospitalized for treatment of intractable nausea, vomiting, and abdominal pain. She has a long-standing history of type 2 diabetes, diabetic retinopathy, and chronic kidney disease. A gastric emptying study shows delayed passage of food into the duodenum, and she is discharged home with a medication to manage her symptoms. On follow-up 1 week later, she reports reduction of her nausea and vomiting but now complains of bilateral hand tremor, difficulty controlling movements, and stiffness in her legs. Which of the following drugs was she most likely prescribed? A. Scopolamine B. Erythromycin C. Metoclopramide D. Ondansetron A 35-year-old woman comes to the emergency department after multiple episodes of vomiting. She has a history of type 2 diabetes mellitus and hypertension, for which she takes medication. She states that her symptoms began after she went out for drinks with friends. Pulse is 110/min. On physical examination, the patient’s face is flushed. Which of the following medications is most likely causing this patient’s symptoms? A. Amlodipine B. Metformin C. Chlorpropamide D. Lisinopril A 34-year-old man who was prescribed citalopram for depression has decided he wants to stop taking the drug. When questioned, he said that it was affecting his sexual performance. You ascertain that he is also trying to overcome his dependency on tobacco products. If you decide to reinstitute drug therapy in this patient, the best choice would be: A. Amitriptyline B. Bupropion C. Fluoxetine D. Imipramine E. Venlafaxine A 26-year-old man is receiving antimicrobial treatment for methicillin-resistant Staphylococcus aureus endocarditis. Shortly after the antibiotic is given as a bolus intravenously, he becomes severely flushed around the face and neck. Which of the following strategies would best avoid this adverse drug effect while effectively treating his disease? A. Desensitization therapy B. Oral administration rather than intravenous C. Pretreatment with cortisone D. Slower infusion of the drug A 46-year-old AIDS patient presents to the clinic complaining of progressive decreased visual acuity and loss of peripheral vision. He reports that his symptoms started initially in his left eye, but that the symptoms quickly spread to the right eye as well. Your ophthalmologic examination, combined with serum studies that demonstrate the presence of CMV, suggests that CMV retinitis is a likely diagnosis. You begin administration of an intravenous medication that acts to inhibit viral DNA polymerase after activation by a viral kinase. Which of the following medication will be chosen? A. Acyclovir B. Ganciclovir C. Darunavir D. Emtricitabine A 32-year-old woman with hypertension wishes to become pregnant. Her physician informs her that she will have to switch to another antihypertensive drug. Which of the following drugs is absolutely contraindicated in pregnancy? A. Atenolol B. Losartan C. Methyldopa D. Nifedipine E. Propranolol A 34-year-old man with ulcerative colitis is treated with high dose of corticosteroids. Which of the following adverse effects is most likely to arise from long term use of this medications? A. Adrenal hyperplasia B. Hepatotoxicity C. Osteoporosis D. Hypotension A 36-year-old HIV-positive man presents to the AIDS clinic complaining of having vivid nightmares and delusional thoughts during the day. His current CD4 count is within acceptable range and his viral load is nearly undetectable. He has no other complaints other than the delusions and vivid nightmares, but he is concerned that he may be becoming schizophrenic. Upon reviewing his chart, you see that he was recently switched to a protease-sparing drug regimen and you begin to believe that the medication substituted for the protease inhibitor is the cause of the patient’s current symptoms as opposed to a primary psychiatric disorder. Which of the following medication was used as a protease-sparing drug? A. Emtricitabine B. Lamivudine C. Efavirenz D. Zidovudine E. Nevirapine A 69-year-old woman was brought to a local hospital emergency department by her son, who reported that his mother was found lethargic, disoriented, and combative a few hours earlier. Additional history revealed that she had ingested a large number of aspirin tablets in a suicide attempt. An appropriate therapy was instituted, which included the administration of sodium bicarbonate to increase the elimination of salicylate. Which of the following best explains the mechanism of this increased elimination? A. Decreased tubular active transport of salicylate B. Decreased renal biotransformation of salicylate C. Urinary ion trapping of salicylate D. Increased glomerular filtration of salicylate A 28-year-old woman at 30 weeks of gestation with a 3-year history of HIV infection comes for consultation regarding the risk of HIV transmission to her child during delivery. She has been compliant with combined antiretroviral therapy since her diagnosis. HIV RNA viral load is 4 copies/mL. She is informed that zidovudine will be prescribed to her newborn after delivery. Which of the following best describes how zidovudine will inhibit HIV replication in the newborn? A. Competitively inhibits inosine-5'-monophosphate dehydrogenase B. Inhibits HIV reverse transcriptase C. Inhibits viral DNA polymerase D. Upregulates the activity of cytochrome P450 enzymes A 41-year-old woman comes to the clinic because of a 2-day history of lip smacking and abnormal tongue and jaw movements. Three months ago, she began treatment for schizophrenia. This patient’s presenting symptoms are most likely caused by which of the following medications A. Chlorpromazine B. Buspirone C. Sertraline D. Venlafaxine An 86-year-old man is brought to your geriatrics clinic by his daughter. He was diagnosed with Alzheimer disease 1 year ago and has been treated with donepezil since. His daughter reports that her father’s dementia has continued to worsen. He often forgets who she is and has been found wandering the streets twice in the last 2 weeks. You tell the daughter that her father will likely need full-time care at this point. In the meantime, you also prescribe another medication that acts as an N-methyl-D-aspartate (NMDA) receptor antagonist in the hopes of providing some symptomatic improvement in his dementia. A. Riluzole B. Sumatriptan C. Memantine D. Tetrabenazine E. Entacapone A 36-year-old woman with a history of bipolar disorder presents to the emergency room complaining of headache, palpitations, and dehydration. She complains of intense and uncontrollable thirst as well as excessive urination. On physical examination, she appears lethargic with dry skin, dry mucous membranes, and a fine hand tremor. Vital signs are significant for tachycardia and a blood pressure of 90/50 mm Hg. Laboratory studies show a high-serum sodium level, high-serum osmolality, and low-urine osmolality. Upon reviewing her medication list, you begin to suspect that the medication being used to treat her bipolar disorder may be causing her symptoms by acting as an anti-diuretic hormone antagonist. A. Lithium B. Haloperidol C. Lurasidone D. Triazolam E. Selegiline A 26-year-old gravida 2, para 1 woman at 36 weeks of gestation comes to the office for routine follow-up. She feels well. Two weeks ago, she felt symptoms of a urinary tract infection (UTI) and took sulfamethoxazole-trimethoprim, which she had from a prior UTI. The symptoms resolved in 2 days. The fetal examination and patient examination are normal. Her serum studies show total bilirubin of 5.1 mg/dL and direct bilirubin of 1.1 mg/dL. The fetus is most at risk for developing which of following? A. Basal ganglia damage B. Cartilage damage C. Inhibition of bone growth D. Ototoxicity E. Renal dysplasia A 9-year-old girl presents to your pediatric clinic for her routine check-up. Her mother tells you that the child has been generally healthy; however, she does seem to become excessively winded when she plays soccer or any other sports. The patient agrees with her mother, telling you that she never feels like she can play as long as the other children because it becomes hard to breathe. The child denies having any trouble breathing when she is not exercising. Her lung examination is unremarkable. You tell the child and her mother that she may have exercise-induced asthma. You give the child an inhaled medication that will produce bronchodilation via the stimulation of β2 - receptors and you instruct her to use the inhaler prior to soccer practice. A. Albuterol B. Terbutaline C. Isoproterenol D. Midodrine E. Phenylephrine A patient with parkinsonism is being treated with levodopa. He suffers from irregular, involuntary muscle jerks that affect the proximal muscles of the limbs. Which of the following statements about these symptoms is most accurate? A. Coadministration of muscarinic blockers prevents the occurrence of dyskinesias during treatment with levodopa B. Drugs that activate dopamine receptors can exacerbate dyskinesias in a patient taking levodopa C. Dyskinesias are less likely to occur if levodopa is administered with carbidopa D. Symptoms are likely to be alleviated by continued treatment with levodopa E. The symptoms are usually reduced if the dose of levodopa is increased A 60-year-old man comes to the clinic for evaluation of sudden-onset severe pain in his fingers and toes. He has a history of alcohol use disorder. Once his acute episode has been appropriately managed, he is prescribed a drug that reduces uric acid reabsorption in renal proximal tubule cells. Which of the following medications was most likely prescribed? A. Allopurinol B. Colchicine C. Methotrexate D. Probenecid Certain drugs can cause severe hypotension when combined with nitrates. Which of the following interacts with nitroglycerin by inhibiting the metabolism of cGMP A. Atenolol B. Hydralazine C. Isosorbide mononitrate D. Nifedipine E. Sildenafil A 65-year-old woman with a history of congestive heart failure (HF) comes to the clinic with worsening symptoms suggesting an HF exacerbation. She is treated with diuretics as well as a medication that increases cardiac contractility and decreases peripheral vascular resistance. Which of the following medications was likely administered A. Atropine B. Carvedilol C. Dobutamine D. Phenylephrine A 45-year-old man comes to the office for a routine examination. Due to his lipid profile, therapy with a lipid-lowering medication is initiated. The patient is advised that this medication may be associated with muscle pain and liver toxicity. The drug that was most likely prescribed affects cholesterol metabolism by which of the following mechanisms? A. Inhibits HMG-CoA reductase B. Directly increases apparent dissociation constant for LDL receptors C. Decreases the maximum velocity of hepatic LDL cholesterol receptors D. blocks absorption of cholesterol A 27-year-old woman is diagnosed with depression and is treated with amitriptyline and cognitive behavioral therapy. Amitriptyline has mechanism of action most similar to A. Clozapine B. Duloxetine C. Selegiline D. Sertraline A 56-year-old migrant farm worker is brought to the emergency department after working 10 days straight in the fields. He is extremely weak and complains of difficulty breathing. Physical examination reveals a heart rate of 35 beats/min, a blood pressure of 82/50 mm Hg, wheezing throughout both lung fields, and significant weakness on his motor exam in all limbs. You also note that the patient is drooling. After questioning his employer who brought him in, you find that the patient has been working with insecticides in the field. You become concerned that the patient is suffering from organophosphate poisoning and you immediately administer atropine and another drug to counteract the parasympathetic effects of organophosphate poisoning. Which of the following is the other drug? A. Rivastigmine B. Pralidoxime C. Echothiophate D. Pyridostigmine E. Malathion An 82-year-old man comes to the emergency department because of fatigue, confusion, chest palpitations, and increased sweating for 45 minutes. He has a history of heart failure, hypertension, and type 2 diabetes mellitus, and his medications include lisinopril, chlorthalidone, spironolactone, metformin, and chlorpropamide. Pulse is 150/min. On examination, his conjunctiva is pale. He is given orange juice, and his symptoms improve. Which of the following is the most likely mechanism of the drug that is causing his symptoms? A. Aldosterone receptor antagonist B. Binds to ATP-sensitive potassium channels in pancreatic β-cells C. Improves insulin sensitivity D. Inhibits angiotensin-converting enzyme A 38-year-old man with advanced AIDS presents to the emergency department with a 6-day history of fever, hemoptysis, pleuritic chest pain, and difficulty breathing. On physical examination, he is in respiratory distress and a lung examination reveals bilateral rales. A CT scan of the chest demonstrates a multifocal pneumonia with a cavitary lesion containing a fungus ball. You immediately begin the patient on an anti-fungal agent, which acts by altering the permeability of the fungal cell membrane, to treat his severe lung infection. Which of the following medication will you choose? A. Clotrimazole B. Amphotericin B C. Nystatin D. Flucytosine E. Ketoconazole A 24-year-old male presents to the emergency department complaining of severe pelvic pain. He reports that he has been suffering from insomnia recently, so he took one of his brother’s prescription pills to help him sleep earlier in the evening. Unfortunately, he states that he has been experiencing a painful, unremitting erection for the past 5 hours. As you rapidly initiate treatment for his symptoms, you explain that his condition is likely a side effect of the medication he took for sleep, which can also be used as an atypical antidepressant. Which of the following medication is discussed in this clinical scenario? A. Venlafaxine B. Imipramine C. Mirtazapine D. Trazodone E. Fluoxetine  A 25-year-old woman comes to the office 4 days after unprotected intercourse. The patient is concerned about getting pregnant and would like to prevent this because of economic and cultural concerns. She has no underlying medical problems and takes no medications. Body mass index is 37 kg/m2. Which of the following describes the mechanism of action of the most effective form of emergency contraception(copper IUD) for this patient? A. Acts as a progestin to delay ovulation B. Causes endometrial inflammation C. Inhibits progestin-progesterone receptor binding D. Negative feedback on the hypothalamus A 33-year-old woman is diagnosed with HIV and started on antiretroviral medications, including Maraviroc. Which of the following best describes the most likely mechanism of action of Maraviroc? A. Blocking incorporation of the viral genome into the host cell genome B. Preventing entry of viral particles into the target host cell C. Preventing synthesis of DNA from viral RNA D. Blocking translation of the viral messenger RNAs A 68-year-old man comes to the office because of a 4-month history of low back pain. The patient is diagnosed with advanced prostate adenocarcinoma with bone metastases. Treatment with cisplatin, etoposide, and leuprolide begins. Which of the following describes the mechanism of action of cisplatin? A. Cross-link DNA B. Binding to a protein, thus preventing breakdown of the mitotic spindle C. Blockage of vascular endothelial growth factor receptors D. Inhibition of an enzyme, leading to DNA strand breakage A 71-year-old woman presents to your clinic complaining of pain in her right knee. Upon further questioning, she tells you that she has noticed that the pain is usually worse during the evening after a full day of activity. Physical examination reveals a swollen, tender right knee with a minimal joint effusion. You also notice bony nodules on her distal and proximal interphalangeal joints. You tell the patient that you suspect that she has osteoarthritis and you recommend an over-the- counter medication that will help relieve her symptoms by reversibly inhibiting cyclooxygenase 1 and 2. Which of the following medications is described in this scenario? A. Montelukast B. Ibuprofen C. Celecoxib D. Acetaminophen A 34-year-old woman comes to her primary care physician for her annual physical examination. She has smoked one pack of cigarettes daily for the past 14 years and wishes to quit. She attempted to quit once before but was unable to resist the urge to smoke. After hearing her options, the patient agrees to start pharmacologic treatment. The drug most likely to assist the patient in smoking cessation has which of the following mechanisms of action? A. Dopamine receptor agonism B. Monoamine oxidase inhibition C. Nicotinic partial agonism D. Serotonin reuptake inhibition A 37-year-old man comes to the emergency department because of difficulty breathing and a productive cough for the past 4 days. He is diagnosed with Pneumocystis jirovecii pneumonia and is found to be HIV positive with a reduced CD4+ cell count. He is placed on several medications to manage his condition. Three weeks later, his serum creatinine concentration has increased from 1.1 mg/dL to 2.8 mg/dL. Which of the following medications is the most likely cause of his increased serum creatinine? A. Abacavir B. Didanosine C. Enfuvirtide D. Tenofovir A 22-year-old woman with Graves disease was started an antithyroid medication. 1 month later the patient comes to the emergency department due to fever and sore throat. Physical examination shows an erythematous pharynx and a normal sized- thyroid. There is no tremor of the outstretched hands. Which of the following is the most likely cause of this patient's current condition? A. Acute adrenal insufficiency B. Drug induced granulocyte destruction C. Excessive thyroid suppression D. Viral destruction of neutrophils A 68-year-old male is diagnosed with atrial fibrillation. He also has severe mitral stenosis. Which of the following medications should be used to prevent stroke? A. Ticagrelor B. Prasugrel C. Warfarin D. Vitamin K A 70-year-old patient with multiple cancer metastasis is prescribed extended- release morphine for pain management. To prevent constipation Sena glycoside is also prescribed. Which of the following is the mechanism by which Sena glycoside works? A. Osmosis of the water into the lumen B. Stimulates peristaltic activity of the intestine C. It is an acetylcholine receptor agonist D. Activates adrenergic alpha receptors A 76-year-old woman is admitted to the hospital because of fever, shortness of breath, and productive cough. She is diagnosed with pneumonia and sepsis and treated with cefoxitin. Blood cultures reveal Klebsiella pneumoniae and a second antibiotic is added for broader coverage. Nine days later, the patient’s pneumonia is improved but urine output drops, and the serum creatinine rises to 2.4 mEq/L. Urine microscopy shows dark brown casts and renal tubular epithelial cells. Which of the following medications was most likely added to this patient’s regimen 9 days ago? A. Azithromycin B. Clindamicyn C. Gentamycin D. Piperacillin A 63-year-old man comes to the physician, requesting medication to manage erectile dysfunction. The most likely prescribed medication has which of the following initial mechanisms of action? A. Block L-type calcium channels B. Blocks sodium channel C. Increases the level of cGMP D. Decreases the level of nitric oxide A 19-year-old man taking a trek in Nepal takes a medication to assist adjusting to high altitudes. The medication is also used to treat glaucoma and inhibits an enzyme in renal proximal tubule cells. Which of the following is the most likely acid- base abnormality caused by this drug? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis A 48-year-old woman undergoes multidrug chemotherapy for non-Hodgkin lymphoma. After 2 months of therapy, she develops painless episodes of bloody urine. Her serum creatinine, complete blood count, international normalized ratio, and partial thromboplastin time are normal. Administration of which of the following drugs would most likely have prevented this new symptom? A. Amifostine B. Dexrazoxane C. Leucovorin D. Mesna A 39-year-old woman presents to the emergency room complaining of a “racing heart.” She tells you that she has experienced these sorts of palpitations several times over the past 6 months. Upon further questioning, you discover that she has lost 20 lb over the last 6 months, that she has two or three episodes of diarrhea a day, and that she has been having difficulty sleeping. Her physical examination is remarkable for the presence of exophthalmos and a mildly enlarged thyroid gland. You begin to suspect that this woman would benefit from a medication that inhibits thyroid hormone synthesis.. A. Propylthiouracil B. Alendronate C. Gemfibrozil D. Cholestyramine A 37-year-old man with diabetes mellitus and hypertension is found to have 100 mg albumin in a 24-hour urine collection. He is prescribed a medication that will improve his blood pressure and reduce his albuminuria. Which medication is likely to be prescribed? A 45-year-old man develops watery diarrhea after traveling and is prescribed a one-week course of an appropriate antibiotic drug for the infection. Three days later, his diarrhea is gone. That night while having dinner with friends, he experiences intense flushing, nausea, vomiting, and a racing pulse. The patient mentions that he didn’t smoke and didn’t consume any foods that he might be allergic to, but that he did drink alcohol. Which of the following antibiotics was most likely prescribed? A. Albendazole B. Azithromycin C. Levofloxacin D. Metronidazole A 42-year-old woman is found to have a pulmonary embolus secondary to deep venous thrombosis. She receives heparin and warfarin while in the hospital and is discharged on 5 days of subcutaneous enoxaparin and 6 months of oral warfarin. This patient is most likely receiving concurrent enoxaparin due to what effect of the warfarin? A 41-year-old woman comes to the clinic because of a 2-day history of lip smacking and abnormal tongue and jaw movements. Three months ago, she began treatment for schizophrenia. This patient’s presenting symptoms are most likely caused by which of the following medications? A. Amitriptyline B. Haloperidol C. Fluoxetine D. Tramadol