Internal-Medicine
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
260 13: Clinical Pharmacology<br />
6. A 48-year-old man presents with fever, cough,<br />
and purulent sputum production. His chest<br />
x-ray (CXR) reveals a right middle lobe infiltrate<br />
and he is started on intravenous (IV)<br />
antibiotics after sputum and blood cultures are<br />
obtained. The following day his sputum cultures<br />
grow Streptococcus pneumoniae, which is<br />
sensitive to penicillin. He is better now so you<br />
step him down to oral treatment with amoxicillin<br />
rather than penicillin. Which of the following<br />
is the most likely reason why oral<br />
amoxicillin is preferred over penicillin?<br />
(A) penicillin is not effective orally<br />
(B) amoxicillin is not inactivated by<br />
penicillinase<br />
(C) amoxicillin is acid stable<br />
(D) amoxicillin is not effective against<br />
coliform organisms and therefore has a<br />
narrower spectrum<br />
(E) amoxicillin is not allergenic<br />
7. A 69-year-old man develops renal failure.<br />
Which of the following drugs requires a major<br />
adjustment in dosage?<br />
(A)<br />
(B)<br />
(C)<br />
(D)<br />
(E)<br />
levofloxacin<br />
ceftriaxone<br />
amphotericin B<br />
clindamycin<br />
ampicillin<br />
8. Which of the following are mechanisms of<br />
action for thiocyanate and perchlorate?<br />
(A)<br />
(B)<br />
(C)<br />
(D)<br />
(E)<br />
inhibit thyroglobulin release<br />
increase basal metabolic rate (BMR)<br />
inhibit iodide transport<br />
inhibit thyroid organic binding<br />
increase thyroxin synthesis<br />
9. A 63-year-old woman with hypertension is<br />
started on a beta-blocker. Which of the following<br />
conditions require caution in prescribing<br />
this medication?<br />
(A)<br />
(B)<br />
(C)<br />
migraine headaches<br />
hypertrophic subaortic stenosis<br />
Marfan syndrome<br />
(D)<br />
(E)<br />
atrioventricular (AV) node dysfunction<br />
intermittent claudication<br />
10. A 69-year-old woman, with poor dietary habits<br />
and alcoholism, is found to have a macrocytic<br />
anemia with hypersegmented neutrophils.<br />
Which of the following is the most appropriate<br />
diagnostic test?<br />
(A)<br />
(B)<br />
(C)<br />
(D)<br />
(E)<br />
red blood cell vitamin levels<br />
plasma vitamin levels<br />
bone marrow<br />
Schilling test<br />
therapeutic trial<br />
11. A 69-year-old man is given a multivitamin containing<br />
B 12<br />
. Which of the following is most<br />
characteristic of vitamin B 12<br />
absorption?<br />
(A)<br />
(B)<br />
(C)<br />
(D)<br />
(E)<br />
totally dependent on the intrinsic factor<br />
best in the duodenum<br />
improved in folic acid deficiency<br />
best in the distal ileum<br />
prevented by antiparietal cell antibodies<br />
12. A 19-year-old man takes an overdose of lysergic<br />
acid diethylamide (LSD). Which of the following<br />
clinical findings are mostly to be seen in<br />
this individual?<br />
(A)<br />
(B)<br />
(C)<br />
(D)<br />
(E)<br />
pupillary dilatation<br />
pupillary constriction<br />
bradycardia<br />
blindness<br />
deafness<br />
13. A 15-year-old boy is prescribed tetracycline for<br />
facial acne. Which of the following is the most<br />
common side effect of tetracycline?<br />
(A)<br />
(B)<br />
(C)<br />
(D)<br />
(E)<br />
neutropenia<br />
allergic reactions<br />
hepatitis<br />
gastrointestinal (GI) symptoms<br />
polyuria<br />
14. A 79-year-old man on quinidine for paroxysmal<br />
atrial fibrillation develops thrombocytopenia.
Change language