Biochemistry PDF

1. Which of the following is considered the simplest structure of phospholipids? a. phosphatidylinositol b. Phosphatidylserine c. phosphatidic acid d. phosphatidylcholine e. phosphatidylethanolamine 2. Phospholipids are predominant lipids in which of the following a. intracellular matrix b. Cytosol c. cell membrane d. nucleus e. extracellular matrix 3. Which of the following phospholipids doesn’t contain glycerol backbone? a. phosphatidylinositol b. Phosphatidylserine c. platelet activating factor d. sphingomyelin e. phosphatidylethanolamine 4. Which of the following phospholipids does its degradation affect calcium release and protein phosphorylation in the cell? a. phosphatidylserine b. phosphatidic acid c. sphingomyelin d. Phosphatidylinositol 4,5-bisphosphate e. phosphatidylethanolamine 5. The degradation products of phosphatidylinositol 4,5-bisphosphate are? Select all that apply a. arachidonic acid b. inositol 1,4,5-triphosphate (IP3) c. stearic acid d. Diacylglycerol (DAG) e. phospholipids C 6. Which of the following phospholipids serves as a reservoir of arachidonic acid in membranes and, this, provides the substrate for prostaglandin synthesis a. Phosphatidylserine b. phosphatidic acid c. sphingomyelin d. phosphatidylinositol e. phosphatidylethanolamine 7. Which of the following products contain omega-3 fatty acid? Select all that apply a. Tylenol b. vascepa c. advil d. lovaza e. celebrex 8. Which of the following biological structures is composed of repeating disaccharide units? a. alkaline phosphatase b. glucosamine c. glycosaminoglycan d. glucuronic acid e. acetylcholine esterase 9. Which of the following biological structure have the special ability to bind large amounts of water producing gel like matrix which along with collagen, elastin, and fibronectin, make up the extra cellular matrix (ECM)? Select all that apply. a. Glucosamine b. chondroitin sulfates c. heparin d. hyaluronic acid e. glycosaminoglycan 10.Which of the following lipases act on phospholipids to release arachidonic acid, the precursor of the prostaglandins? a. phospholipase D b. phospholipase A1 c. phospholipase A2 d. phospholipase B e. phospholipase C 11.which of the following lipases plays a role in producing second messengers a. phospholipase D b. phospholipase A1 c. phospholipase A2 d. phospholipase B e. Phospholipase C 12.Which of the following is the most potent steroid? a. hydrocortisone b. methylprednisolone c. triamcinolone d. dexamethasone e. betamethasone 13.Which of the following is considered eicosanoids? Select all that apply a. arachidonic acids b. linoleic acids c. prostaglandins d. thromboxanes e. leukotrienes 14.Prostaglandins are biochemically synthesized by which of the following pathways? Select all that apply a. desaturation and elongation of arachidonic acid b. desaturation and elongation of linoleic acid c. oxidation cyclization by PGH synthase d. oxidative cyclization peroxidase e. oxidative cyclization by cyclooxygenase 15.Which of the following enzymes is made constitutively in most tissues and is required for maintenance of healthy gastric tissue, renal homeostasis, and platelet aggregation? a. PGH synthase b. COX 1 c. peroxidase d. COX 2 e. Lipoxygenase 16.Arachidonic acid can be converted in the body by which of the following? Select all that apply a. Linoleic acids b. prostaglandins c. Thromboxane d. leukotrienes e. Heparin 17.SC is a 4 year old patient with moderate persistent asthma. He has been poorly controlled on an albuterol inhaler and a low dose inhaled corticosteroid. The physician wants to add a leukotriene modifier to SC’s regimen. Which agent can be recommended? a. Zileuton b. theophylline c. indacaterol d. reslizumab e. montelukast 18. MS is a four-year-old girl with asthma. She will receive montelukast. Select the correct dose for a four-year-old child. a. A 4 mg chewable tablet taken once daily in the evening b. A 5 mg chewable tablet taken once daily in the evening c. A 5 mg chewable tablet taken BID d. A 10 mg chewable tablet taken once daily in the evening e. A 10 mg chewable tablet taken BID 19.SF is an 18-month-old boy who has been prescribed montelukast granules. Counsel the parents on how to administer the granules to their son: a. Mix with 4 oz of applesauce and administer within 24 hours. b. The granule packet can be opened up to 8 hours prior to use. c. Mix with one tablespoon of warm water. d. Mix with a spoonful of cool, mashed carrots and administer within minutes. e. Mix with a tablespoon of breast milk or formula; the mixture can be stored for up to 2 hours. 20.A patient is starting on Singulair. Which of the following is a warning associated with the use of Singulair? a. Hepatotoxicity b. Peripheral neuropathy c. Floppy iris syndrome d. Bone marrow suppression e. Neuropsychiatric events 21.CF, a patient with a diagnosis of rheumatoid arthritis, has been taking prednisone 20 mg PO daily for 6 months. Which of the following are side effects that can occur from her prednisone therapy? (Select ALL that apply.) a. Impaired wound healing b. Weight gain c. Osteoporosis d. Hyperglycemia e. A buffalo hump 22.What is the indication for Lovaza? a. To lower LDL cholesterol in patients with an LDL cholesterol ≥ 200 mg/dL. b. To lower triglycerides in patients with TGs ≥ 500 mg/dL as an adjunct to diet. c. To increase HDL in patients with familial-induced low HDL levels. d. To reduce the risk of statin-induced muscle damage. e. To lower LDL in patients with heterozygous familial hypercholesterolemia. 23.Vascepa should be dispensed with caution to a patient with this allergy? a. fish or shellfish b. eggs c. sulfa d. soy or peanuts e. fenofibrate medications 24.Aspirin exerts its antiplatelet effects via inhibition of: a. Cyclooxygenase-1 and b. Cyclooxygenase-2 c. Prostaglandin d. Angiotensin II e. Chloride channels 25.A patient has been using aspirin for pain relief. He takes aspirin multiple times daily. He also suffers from an upset stomach and has been using bismuth subsalicylate (Pepto Bismol). How might drug toxicity from these agents present? a. Skin rash b. Decreased night vision c. Ringing in the ears in the absence of noise d. Arthralgias e. Heartburn and dyspepsia 26.Which of the following agents has the highest degree of selectivity for cyclooxygenase-2? a. A. Cerebyx b. Mobic c. Celebrex d. Indomethacin e. Nabumetone 27.A mother presents to the pharmacy with her twelve-year-old child, who has a sore throat and fever. The mother states that the child used naproxen in the past, but it did not help. She gave the child aspirin 325 mg once or twice a day and found it helpful. Choose the correct statement about this scenario. a. The occasional use of aspirin for mild illness in children is acceptable. b. The aspirin dose should not exceed 10 mg/kg/day. c. She should be counseled to increase the dosing to Q4-6H as needed. d. She should be instructed to stop all aspirin use in the child immediately. e. It is best to use only enteric-coated aspirin formulations in anyone less than 16 years of age 28.A patient with nasal polyps and asthma has told the pharmacist that if she uses aspirin, she can't breathe. Which of the following will be unlikely to trigger a similar reaction in this patient? a. Acetaminophen b. Naproxen c. Ibuprofen d. Nabumetone e. Magnesium salicylate 29.Select the correct over-the-counter dosing for ibuprofen for an adult. a. 200 mg tablets, Q12 hours, take 1-2 as needed b. 400 mg tablets, Q4-6 hours, take 1-2 as needed c. 100 mg tablets, Q4-6 hours, take 1-2 as needed d. 100 mg tablets, Q6-8 hours, take 1-2 as needed e. 200 mg tablets, Q4-6 hours, take 1-2 as needed 30.Choose the correct statement concerning Arthrotec. a. This drug contains an NSAID and the prostaglandin analog misoprostol b. This drug is safe in pregnancy. c. Arthrotec is the preferred NSAID in renal disease. d. Arthrotec is the preferred NSAID in a patient with irritable bowel syndrome. e. This drug is only available in an injectable form 31.A patient has chronic back pain and requires both analgesic and anti-inflammatory effects. Previously, the patient had a GI bleed from chronic use of ibuprofen that he was purchasing over-the-counter. The physician will begin celecoxib therapy. The patient has the following medication history: hypertension, elevated triglycerides, myocardial infarction (twice), heart failure and alcohol use disorder. Choose the correct statement regarding celecoxib use in this patient. a. Celecoxib use must be limited to less than 5 days in this patient b. Celecoxib is not an appropriate choice for this patient. c. A more appropriate option is Kadian. d. A more appropriate option is Nucynta ER. e. A more appropriate option is the Lidoderm patch 32.A patient with rheumatoid arthritis uses daily ibuprofen therapy and requires occasional therapy with prednisone for acute flares. She is reporting abdominal pain with burning. Upon examination, she is found to have GI ulceration, which the physician feels is due to her use of these medications. She is not a candidate for celecoxib. Which medication would provide the strongest protection from NSAID-induced GIulceration and bleeding? a. Famotidine b. Calcium acetate c. Rabeprazole d. Sucralfate e. Metoclopramide 33.A pharmacist receives a prescription for Yosprala. This combination drug contains the following two individual agents: a. Naproxen and sumatriptan b. Ibuprofen and sumatriptan c. Naproxen and esomeprazole d. Aspirin and omeprazole e. Esomeprazole and sumatriptan 34.Select the correct mechanism of action for naproxen. a. Antagonist at the mu-opioid receptor in the CNS. b. Inhibits cyclooxygenase, which reduces prostaglandin formation and decreases pain and inflammation. c. Serotonin/norepinephrine reuptake inhibitor. d. Agonist at the mu-opioid receptor in the CNS. e. Decreases substance P and reduces pain transmission from the nerve ending (localized effect). 35.Which NSAID should be chosen if an agent with high COX-2 selectivity is requested, but Celebrex is too expensive? a. Indocin b. Feldene c. Mobic d. Toradol e. Aspirin 36.Choose the correct statement concerning ketorolac. a. The maximum combined duration of treatment (parenteral, PO and nasal formulations) is 5 days. b. Begin with oral or nasal therapy and switch to IV as soon as possible. c. The maximum recommended duration of treatment is 10 days. d. Ketorolac is for pre-operative use only. e. Ketorolac can be used in patients with severe renal impairment. 37.59-year-old male has a past medical history of stable angina, heart failure with reduced ejection fraction, type 2 diabetes mellitus, and peripheral neuropathy. He was recently discharged from the hospital and provided with the following discharge medication list: What is the mechanism of action of the antiplatelet medication on this patient's discharge list? a. Binds to adenosine diphosphate P2Y12 receptors b. Binds to fibrin and converts plasminogen to plasmin c. Binds to protease-activated receptor-1 d. Inhibits cyclooxygenase-1 enzyme e. Inhibits glycoprotein lIb/Illa receptors 38.What is the primary reason for using aspirin in a patient with chest pain? a. Inhibit platelet aggregation b. Provide moderate degree of analgesia c. Increase mortality in patients with STEMI d. Prevent flushing e. Break down the clot 39.Which of the following NSAIDs would be considered the safest in patients who have had an MI? a. Celecoxib b. Naproxen c. Diclofenac d. Meloxicam e. Etodolac 40.Which label on the figure best represents the site where aspirin exerts its mechanism of action? Cyclogenase a. A b. B c. C d. D 41.Which of the following describes the mechanism of action of epoprostenol? a. It is a prostacyclin analogue. b. It is an endothelin receptor antagonist. c. It is a phosphodiesterase-5 inhibitor. d. It is a soluble guanylate cyclase stimulator. e. It is an intravenous calcium channel blocker. 42.A 30-year-old female (75 kg) receives epoprostenol 3.8 mL/hr. She uses two epoprostenol 1.5 mg vials and dilutes them to a total volume of 100 mL. What is her dose in ng/kg/min? a. 12.7 ng/kg/min b. 25.3 ng/kg/min c. 30.9 ng/kg/min d. 55.9 ng/kg/min e. 0.03 ng/kg/min 43.Which of the following is a counseling point for Flolan? a. Cooling packs are required for stability. b. Take one tablet BID. c. Elevated blood pressure can occur. d. Flolan offers a cure for PAH. e. Start with 3 inhalations four times per day. 44.Which of the following is true regarding infusions of epoprostenol? a. The infusion pump heats epoprostenol for administration. b. Parenteral administration can cause vision and hearing loss. c. The drug must be protected from light during administration. d. The infusion can be given intravenously or subcutaneously. e. The infusion rate (in mL/hr) is the same for every patient. 45.The primary goal of therapy when treating a patient with glaucoma is to: a. Decrease aqueous humor outflow b. Decrease intraocular pressure c. Increase production of aqueous humor d. Decrease the risk of infection e. Decrease histamine release 46.Which of the following is used to increase eyelash growth? a. Timoptic b. Restasis c. Latisse d. Cosopt e. Zaditor 47.Prostaglandin analogs decrease intraocular pressure by: a. Increasing the outflow of aqueous humor b. Decreasing production of aqueous humor c. Decreasing the outflow of aqueous humor d. Decreasing the outflow and increasing the production of aqueous humor e. Increasing the outflow and decreasing the production of aqueous humor 48.A patient presents the following prescription to a pharmacy. Based on the instructions given in the prescription, where should the drops be placed? a. Right eye b. Left eye c. Right ear d. Left ear e. Both eyes

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