Internal-Medicine

264 13: Clinical Pharmacology
40. Which of the following is a symptom of withdrawal
from prolonged moderate dose benzodiazepine
usage?
(A)
(B)
(C)
(D)
(E)
delirium
somnolence
seizures
decreased hearing
anxiety and agitation
41. Which of the following features concerning
heroin withdrawal is correct?
(A) it is frequently life-threatening
(B) it starts about 24 hours after the last
dose
(C) pupillary constriction is present
(D) irritability and restlessness
(E) blood pressure is lowered
42. Which of the following opioid analgesics is
most likely to cause central nervous system
(CNS) disturbance?
(A)
(B)
(C)
(D)
(E)
heroin
morphine
meperidine
fentanyl
codeine
43. Which of the following is the most likely reason
why fentanyl does not disturb cardiovascular
stability as much as morphine?
(A)
(B)
(C)
(D)
(E)
is water soluble
is lipid soluble
does not stimulate histamine release
is long acting
is not as potent as morphine
DIRECTIONS (Questions 44 through 66): Each set
of matching questions in this section consists of a
list of lettered options followed by several numbered
items. For each numbered item, select the
appropriate lettered option(s). Each lettered option
may be selected once, more than once, or not at all.
EACH ITEM WILL STATE THE NUMBER OF
OPTIONS TO SELECT. CHOOSE EXACTLY THIS
NUMBER.
Questions 44 through 48
(A) neutralizes gastric acid
(B) works by binding to cysteine
(C) inhibits gastrin release
(D) irreversible H1-receptor blockade
(E) synthetic analogue of prostaglandin E1
(F) reversibly competes with histamine for
binding to the H2 receptor on parietal
cells
(G) prevents hydrolysis of mucosal proteins
by pepsin
(H) can enhance gastric secretion
(I) inhibition of the gastric H/K, adenosine
triphosphatase (ATPase) pump
For each patient with an acid-peptic disorder,
select the mechanism of action of the prescribed
medication.
44. A 27-year-old woman occasionally uses calcium
carbonate (Tums) for “heartburn” symptoms
after a large meal. (SELECT ONE)
45. A 56-year-old man has intermittent symptoms
of burning-type epigastric discomfort. The
symptoms are not related to exertion and a
recent cardiac evaluation is normal. He is felt to
have gastroesophageal reflux disease (GERD)
and is prescribed ranitidine for symptom relief.
(SELECT ONE)
46. A 76-year-old woman with urosepsis becomes
hypotensive and needs admission to the intensive
care unit (ICU) for inotropic medications,
mechanical ventilation, and monitoring. She is
prescribed sucralfate for the prophylaxis of gastric
stress ulcers. (SELECT ONE)
47. A 46-year-old man with rheumatoid arthritis
(RA) takes naproxen (nonsteroidal antiinflammatory
drug [NSAID]) for the treatment
of his joints inflammation and discomfort. He
is prescribed misoprostol for NSAID-induced
gastric ulcer prophylaxis. (SELECT ONE)
48. A 43-year-old man presents with presyncope
and a history of very dark black stools starting
2 days ago. He also reports having nonspecific