Nokea
Jacob has hypertension, for which a calcium channel blocker has been prescribed. This drug helps control blood pressure because it:
- A. Decreases the amount of calcium inside the cell
- B. Reduces stroke volume
- C. Increases the activity of the Na+/K+/ATPase pump indirectly
- D. Decreases heart rate
Correct Answer: A
Rationale: Calcium channel blockers reduce intracellular calcium, relaxing vascular smooth muscle.
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Which of the following drug increase the sensitivity of fatty tissue and muscles towards insulin:
- A. Dapagliphlozin
- B. Miglitol
- C. Nateglinide
- D. Rosiglitasone
Correct Answer: D
Rationale: Rosiglitazone, a thiazolidinedione, enhances insulin sensitivity in fat and muscle via PPAR-gamma activation.
The adverse events of biguanides are:
- A. Alkalosis
- B. Hypoxemia/acidosis
- C. Weight loss
- D. Anemia
Correct Answer: B
Rationale: Biguanides like metformin can cause lactic acidosis, a serious adverse effect related to impaired mitochondrial function.
A patient with Cushing's syndrome is being treated by X-irradiation of the pituitary. It may take several months of treatment for adequate symptomatic and metabolic improvement. Until that time, which of the following might be administered adjunctively to suppress glucocorticoid synthesis?
- A. Cimetidine
- B. Cortisol (massive doses)
- C. Fludrocortisone
- D. Ketoconazole
Correct Answer: D
Rationale: Ketoconazole inhibits adrenal steroidogenesis, reducing glucocorticoid levels in Cushing's syndrome.
Under the influence of thyroxin, cholesterol level in the blood:
- A. Increase
- B. Decrease
- C. Does not change
Correct Answer: B
Rationale: Thyroxine lowers cholesterol by increasing its metabolism and excretion.
Patients need to be instructed regarding the drug interactions with St John's wort, including:
- A. MAO inhibitors
- B. Serotonin reuptake inhibitors
- C. Over-the-counter cough and cold medications
- D. All of the above
Correct Answer: D
Rationale: St John's wort interacts with MAOIs, SSRIs (risk of serotonin syndrome), and OTC drugs via CYP450 induction.