MN553 Practice Quiz

MN553 Practice Quiz Question

Question 1 

Up to 21% of Asians are ultra-rapid 2D6 metabolizers, leading to:

• A need to monitor drugs metabolized by 2D6 for toxicity
• Increased dosages needed of drugs metabolized by 2D6, such as the selective serotonin reuptake inhibitors
• Decreased conversion of codeine to morphine by CYP 2D6
• The need for lowered dosages of drugs, such as beta blockers

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Question 2

Rifampin is a nonspecific CYP450 inducer that may:

• Lead to toxic levels of rifampin and must be monitored closely
• Cause toxic levels of drugs, such as oral contraceptives, when coadministered
• Induce the metabolism of drugs, such as oral contraceptives, leading to therapeutic failure
• Cause nonspecific changes in drug metabolism

Question 3

Inhibition of P-glycoprotein by a drug such as quinidine may lead to:

• Decreased therapeutic levels of quinidine
• Increased therapeutic levels of quinidine
• Decreased levels of a coadministered drug, such as digoxin, that requires P-glycoprotein for absorption and elimination
• Increased levels of a coadministered drug, such as digoxin, that requires P-glycoprotein for absorption and elimination

Question 4 

Warfarin resistance may be seen in patients with VCORC1 mutation, leading to:

• Toxic levels of warfarin building up
• Decreased response to warfarin
• Increased risk for significant drug interactions with warfarin
• Less risk of drug interactions with warfarin

Question 5

Pharmacogenetic testing is required by the U.S. Food and Drug Administration prior to prescribing:

• Erythromycin
• Digoxin
• Cetuximab
• Rifampin

Question 6

Carbamazepine has a Black Box Warning recommending testing for the HLA-B*1502 allele in patients with Asian ancestry prior to starting therapy due to:

• Decreased effectiveness of carbamazepine in treating seizures in Asian patients with the HLA-B*1502 allele
• Increased risk for drug interactions in Asian patients with the HLA-B*1502 allele
• Increased risk for Stevens-Johnson syndrome in Asian patients with HLA-B*1502 Allele
• Patients who have the HLA-B*1502 allele being more likely to have a resistance to carbamazepine

Question 7 

A genetic variation in how the metabolite of the cancer drug irinotecan SN-38 is inactivated by the body may lead to:

• Decreased effectiveness of irinotecan in the treatment of cancer
• Increased adverse drug reactions, such as neutropenia
• Delayed metabolism of the prodrug irinotecan into the active metabolite SN-38
• Increased concerns for irinotecan being carcinogenic

Question 8 

A good history of herb and supplement use is critical before prescribing because approximately ____ % of patients in the United States are using herbal products.

• 10
• 5
• 38
• 70

Question 9 

A potential harmful effect on patients who take some herbal medication is:

• Constipation
• Lead poisoning
• Diarrhea
• Life-threatening rash

Question 10 

A thorough understanding of herbs is critical to patient safety. An example is the use of cinnamon to treat type II diabetes. It is important the patient uses Ceylon cinnamon, as the commercially available cassia cinnamon contains:

• Coumadin, which may lead to bleeding problems
• Coumarin, which can cause liver and kidney damage
• Cinnamic aldehyde, which is toxic to the kidney
• Cinnamate eugenol, which is toxic to the liver

Question 11 

Traditional Chinese medicine utilizes yin (cooling) versus yang (warming) in assessing and treating disease. Menopause is considered a time of imbalance, therefore the Chinese herbalist would prescribe:

• Herbs which are yang in nature
• Herbs that are yin in nature
• Ginger
• Golden seal

Question 12 

According to traditional Chinese medicine, if a person who has a fever is given a herb that is yang in nature, such as golden seal, the patient’s illness will:

• Get worse
• Get better
• Not be adequately treated
• Need additional herbs to treat the yang

Question 13 

In Ayurvedic medicine, treatment is based on the patient’s dominant dosha, which is referred to as the person’s:

• Vata
• Pitta
• Kapha
• Prakriti

Question 14 

When melatonin is used to induce sleep, the recommendation is that the patient:

• Take 10 mg 30 minutes before bed nightly
• Take 1 to 5 mg 30 minutes before bed nightly
• Not take melatonin more than three nights a week
• Combine melatonin with zolpidem (Ambien) for the greatest impact on sleep

Question 15 

In the United States, over-the-counter drugs are regulated by:

• No one. There is no oversight for over-the-counter medications.
• The U.S. Food and Drug Administration Center for Drug Evaluation and Research
• The U.S. Drug Enforcement Administration
• MedWatch

Question 16 

As drugs near the end of their patent, pharmaceutical companies may apply for the drug to change to over-the-counter status in order to:

• Get a new patent for the over-the-counter form of the drug
• Lower the costs because most prescription benefit plans do not cover generics
• Market the drug to a whole new population, as they are able to market to patients instead of just providers
• Continue to make large profits from their blockbuster brand-name drug

Question 17 

The ailment that generates the greatest over-the-counter annual drug sales is:

• Constipation
• Cough and colds
• Heartburn
• Acute and chronic pain

Question 18 

• Common over-the-counter pain relievers such as acetaminophen or ibuprofen:
• Are always safer for the patient than prescription pain medication
• Are harmful if taken in higher than recommended amounts
• Have minimal interaction with prescription medications
• Should never be given to children unless recommended by their provider

Question 19 

When obtaining a drug history from Harold, he gives you a complete list of his prescription medications. He denies taking any other drugs, but you find that he occasionally takes aspirin for his arthritis flare ups. This is an example of:

• His appropriately only telling you about his regularly prescribed medications
• His hiding information regarding his inappropriate use of aspirin from you
• A common misconception that intermittently taken over-the counter medications are not an important part of his drug history
• A common misuse of over-the-counter aspirin

Question 20 

Michael asks you about why some drugs are over-the-counter and some are prescription. You explain that in order for a drug to be approved for over-the-counter use the drug must:

• Be safe and labeled for appropriate use
• Have a low potential for abuse or misuse
• Be taken for a condition the patient can reliably self-diagnose
• All of the above