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601 Midterm Exam A+Questions and Answers
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- USMLE Step 1 Pharm
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- USMLE Step 1 Pharm
601 Midterm Exam A+Questions and Answers
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601 Midterm Exam A+Questions andAnswers
____ 1. The major impact of the physiological changes that occur with aging is:
A. Reduced physiological reserve
B. Reduced homeostatic mechanisms
C. Impaired immunological response
D. All of the above - ANS-D All of the above
____ 2. The strongest evidence regarding normal physiological aging is available
through:
A. Randomized controlled clinical trials
B. Cross-sectional studies
C. Longitudinal studies
D. Case control studies - ANS-C. Longitudinal studies
____ 3. All of the following statements are true about laboratory values in older adults
except:
A. Reference ranges are preferable
B. Abnormal findings are often due to physiological aging
C. Normal ranges may not be applicable for older adults
D. Reference values are not necessarily acceptable values - ANS-B. Abnormal findings
are often due to physiological aging
____ 4. Biochemical individuality is best described as:
A. Each individual's variation is often much greater than that of a larger group
B. The unique biochemical profile of a selected population
C. The truly "normal" individual—falling within average range
D. Each individual's variation is often much smaller than that of a larger group -
ANS-D. Each individual's variation is often much smaller than that of a larger group
____ 5. Polypharmacy is best described as taking:
A. More than nine medications per day
B. More than five medications per day
C. Even a single medication if there is not a clear indication for its use D. When a drug
is given to treat the side effect of another drug - ANS-C. Even a single medication if
,there is not a clear indication for its use
____ 6. Pharmacokinetic changes with aging is reflective of:
A. What the drug does to the body
B. What the body does to the drug
C. The effect at the site of action and the time and intensity of the drug D. The side
effects commonly associated with the drug - ANS-B. What the body does to the drug
____ 7. All the following statements are false about drug absorption except:
A. Antacids increase the bioavailability of digitalis
B. Gastric acidity decreases with age
C. Anticholinergics increase colonic motility
D. Underlying chronic disease has little impact on drug absorption - ANS-D. Underlying
chronic disease has little impact on drug absorption
____ 8. All of the following statements are true about drug distribution in the elderly
except:
A. Drugs distributed in water have lower concentration
B. Drugs distributed in fat have less intense, more prolonged effect C. Drugs
highly protein bound have greater potential to cause an adverse drug reaction
- ANS-A. Drugs distributed in water have lower concentration
____ 9. Men have faster and more efficient biotransformation of drugs and this is
thought to be due to:
A. Less obesity rates than women
B. Prostate enlargement
C. Testosterone
D. Less estrogen than women - ANS-C. Testosterone
____ 10. The cytochrome p system involves enzymes that are generally:
A. Inhibited by drugs
B. Induced by drugs
C. Inhibited or induced by drugs
D. Associated with decreased liver perfusion - ANS-C. Inhibited or induced by drugs
____ 11. A statement not shown to be true about pharmacodynamics changes with
aging is:
A. Decreased sensitivity to oral anticoagulants
B. Enhanced sensitivity to central nervous system drugs
C. Drug responsiveness can be influenced by patient activity level
,D. There is a decreased sensitivity to beta blockers - ANS-A. Decreased sensitivity to
oral anticoagulants
____ 12. Atypical presentation of disease in the elderly is reflected by all the following
except:
A. Infection without fever
B. Depression without dysphoric mood
C. Myocardial infarction with chest pain and diaphoresis
D. Cardiac manifestations of thyroid disease - ANS-C. Myocardial infarction with chest
pain and diaphoresis
____ 13. Functional abilities are best assessed by:
A. Self-report of function
B. Observed assessment of function
C. A comprehensive head-to-toe examination
D. Family report of function - ANS-B. Observed assessment of function
____ 1. The leading cause of death in elderly travelers worldwide is:
A. Cardiovascular disease
B. Infections
C. Accidents
D. Malaria - ANS-C. Accidents
____ 2. Which of the following should be avoided in countries where food and water
precautions are to be
observed?
A. Hot coffee
B. Bottled water
C. Salad buffet
D. Unpeeled bananas - ANS-C. Salad buffet
____ 3. What insect precautions are not necessary to prevent insect-borne diseases in
the tropics?
A. Using 100% DEET on skin to prevent bites
B. Treating clothes with permetherin
C. Covering up exposed skin to lessen biting surface
D. Taking malaria pills as directed for areas at risk for malaria - ANS-A. Using 100%
DEET on skin to prevent bites
, ____ 4. An example of secondary prevention you could recommend/order for older
adults would be to:
A. Check for fecal occult blood
B. Wear seat belts in the car
C. Provide foot care for a diabetic patient
D. Administer a tetanus shot - ANS-A. Check for fecal occult blood
____ 5. Ali is a 72-year-old man who recently came to the U.S. from Nigeria. He reports
having BCG
(bacille Calmette-Guerin) vaccination as a child. Which of the following is correct
regarding a
tuberculin skin test?
A. It should not be done at all.
B. It should be read as smaller than it really is.
C. Vaccination history is irrelevant; read as usual.
D. It should be read as larger than it really is. - ANS-C. Vaccination history is irrelevant;
read as usual.
____ 6. A 72-year-old woman and her husband are on a cross-country driving vacation.
After a long day of
driving, they stop for dinner. Midway through the meal, the woman becomes very short
of breath,
with chest pain and a feeling of panic. Which of the following problems is most likely?
A. Pulmonary edema
B. Heart failure
C. Pulmonary embolism
D. Pneumonia - ANS-C. Pulmonary embolism
____ 7. Ivan W. is a 65-year-old man who is new to your practice. He has a history of
COPD, CAD,
hypertension, and type 2 diabetes mellitus. He has had no immunizations since his
discharge from
the military at age 25. Childhood diseases included chickenpox, measles, mumps, and
"German
measles." He presents for a disease management visit. Which of the following
immunizations would
you recommend for Ivan?
A. MMR, influenza, pneumococcal, Zostavax
B. Influenza, pneumococcal, PPD, Hepatitis B
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