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PODA II Final Adrenal Steroid

Total questions: 52

Worksheet time: 29mins

Name
Class
Date
1.

The drug illustrated below is hydrocortisone. The ring A conformation is

a)

Linear

b)

Planner

c)

Half-chair

d)

Flattened boat

e)

Butterfly

2.

OBA. The glucocorticoid agonist potency of the following steroids

a)

Betamethasone > Prednisolone < hydrocortisone

b)

Betamethasone > Prednisolone > hydrocortisone

c)

Betamethasone < Prednisolone < hydrocortisone

d)

Betamethasone > Prednisolone = hydrocortisone

e)

Betamethasone < Prednisolone > hydrocortisone

3.

The following structure is triamcinolone acetonide. What is the purpose of the F atom at C-9

a)

Fluorine (F) atom enhances hydrophilicity

b)

Fluorine (F) is an electron withdrawing group and increases the potency

c)

Fluorine (F) atom enhances water solubility

d)

Fluorine (F) is an electron donating group and decreases the potency

e)

Fluorine (F) is an electron withdrawing group and increases the toxicity

4.

The drug illustrated below is beclomethasone. The ring A conformation is

a)

Linear

b)

Planner

c)

Half-chair

d)

Flattened boat

e)

Butterfly

5.

OBA. AOTF statements about triamcinolone acetonide is true except

a)

C-9 Fluorine (F) is an electron withdrawing group and increases the potency

b)

Triamcinolone acetonide has 8 chiral centers

c)

Triamcinolone acetonide is a steroid analog

d)

Triamcinolone acetonide activates glucocorticoid receptor

e)

C-9 Fluorine (F) is an electron donating group and increases the water solubility

6.

SATA. WOTF is an adrenal steroid preparation that is administered orally for the treatment of ulcerative colitis?

a)

Corenema

b)

Medrol enema

c)

Symbicort

d)

Uceris

e)

Entocort

7.

AOTF products are used to reduce inflammation in the eye EXCEPT?

a)

Alrex

b)

FML

c)

Zetonnar

d)

Durezol

e)

Vexol

8.

WOTF is MOST LIKELY to be used to treat Duchenne muscular dystrophy?

a)

Entocort

b)

Symbicort

c)

Cyclocort

d)

Deflazacort

e)

Westcort

9.

OBA. WOTF statements about prednisolone sodium phosphate is correct?

a)

Prednisolone sodium phosphate is the lipophilic analog and metabolized by esterase

b)

Prednisolone sodium phosphate is the water-soluble analog and metabolized by phosphatases

c)

Prednisolone sodium phosphate is the water-soluble analog and metabolized by esterase

d)

Prednisolone inhibits glucocorticoid receptor

e)

Prednisolone sodium phosphate is not a prodrug

10.

WOTF is LEAST LIKELY to be an action/effect of adrenal steroids?

a)

Promotion of glycogenesis

b)

Promotion of gluconeogenesis

c)

Antagonism of insulin

d)

Decreased mobilization of fat

e)

Fat redistribution to the abdomen from the extremities

11.

Considering the effects of adrenal steroids on the renal system, WOTF is LEAST LIKELY to result from therapy with prednisone?

a)

Hyponatremia

b)

Hypokalemia

c)

Hypocalcemia

d)

Systemic alkalosis

12.

OBA. Aminoglutethimide is an inhibitor of steroid synthesis in the adrenal cortex, where it inhibits?

a)

CYP3A4

b)

CYP1A1

c)

CYP11A1

d)

Thyroid peroxidase

e)

5-deiodinase

13.

WOTF is NOT administered by oral inhalation to treat asthma?

a)

Azmacort

b)

Asmanex

c)

Flovent

d)

QVAR

e)

Omnaris

14.

WOTF is NOT an action of adrenal steroids that is conducive to their anti-inflammatory effect?

a)

Inhibition of phospholipase A 2

b)

Reduction of plasma levels of T-lymphocytes

c)

Decreasing the plasma level of B-lymphocytes

d)

Increasing the production of arachidonic acid

e)

Decreasing the production of prostaglandins

15.

WOTF is NOT matched with its correct ROA?

a)

Depo-Medrol (IM; intra-articular)

b)

Solu-Medrol (IM; IV)

c)

Medrol Dosepak (PO)

d)

Medrol Retention Enema (Anal)

e)

Methylprednisolone (Nasal inhalation)

16.

Prednisone should be avoided, or administered with caution, in a patient who has WOTF?

a)

Glaucoma

b)

Osteoporosis

c)

Peptic ulcer disorder

d)

Diabetes mellitus

e)

Edema

17.

OBA. AOTF statements about Clobetasol propionate is true except?

a)

Ring A adopts half-chair confirmation

b)

Clobetasol propionate has 8 chiral centers

c)

Clobetasol propionate has 8 chiral centers

d)

Clobetasol propionate activates glucocorticoid receptor

e)

Ring A adopts flattened boat conformation

18.

A pharmacist should question a prescription that calls for the oral inhalation of WOTF products?

a)

Trelegy ellipta

b)

Advair

c)

Dymista

d)

Breo ellipta

e)

Veramyst

19.

OBA. WOTF is LEAST LIKELY to be used for the treatment of Cushing's disease?

a)

Aminoglutethimide

b)

Signifor

c)

Spironolactone

d)

Cytadren

e)

Lysodren

20.

OBA. WOTF is LEAST LIKELY to be classified as a low potency adrenal steroid preparation?

a)

Locoid

b)

Hytone

c)

Cloderm

d)

Cortaid

e)

Aclovate

21.

OBA. WOTF statements is UNTRUE? Adrenal steroids can

a)

Promote gluconeogenesis

b)

Inhibit phosphoenolpyruvate carboxykinase

c)

Induces glucose-6-phophatase

d)

Promote glycogenesis

e)

Antagonize insulin

22.

SATA. WOTF products that are employed in the management of COPD contains a combination of fluticasone and vilanterol?

a)

Breo ellipta

b)

Incruse ellipta

c)

Arnuity ellipta

d)

Anoro ellipta

e)

Relvar ellipta

23.

OBA. Treglegy is FDA-approved for treating WOTF?

a)

Seasonal rhinitis

b)

Perennial rhinitis

c)

COPD

d)

Asthma

e)

Pneumonitis

24.

OBA. WOTF produces its pharmacological effect by inhibiting the conversion of deoxycortisol to cortisol?

a)

Spironolactone

b)

Metyrapone

c)

Arimidex

d)

Aminoglutethimide

e)

Florinef

25.

OBA. WOTF is NOT an effect of adrenal steroids on fat metabolism?

a)

Increased fat metabolism

b)

Increased lipolysis of triglycerides in adipose tissues

c)

Redistribution of fat to the face and the back of the neck

d)

Permissive effect on catecholamine-induced free fatty acid release

e)

Redistribution of fat from the abdomen to the extremities.

26.

OBA. WOTF is INCONSISTENT with the actions/effects of mineralocorticoids on electrolytes at the renal level?

a)

Reabsorption of potassium ions

b)

Excretion of calcium ions

c)

Excretion of hydrogen ions

d)

Reabsorption of sodium ions

e)

Positive sodium balance

27.

OBA. Glucocorticoid-induced coagulability is MOST OFTEN ascribed to WOTF?

a)

Positive sodium balance

b)

Elevation of plasminogen activator level

c)

Redistribution of fat to the abdomen

d)

Elevation of plasminogen activator inhibitor level

e)

Negative sodium balance

28.

OBA. WOTF is LEAST LIKELY to result from therapy with adrenal steroids?

a)

Hypocalcemia

b)

Hyperkalemia

c)

Increased extracellular fluid volume

d)

Increased blood pressure

e)

Alkalosis

29.

OBA. WOTF is the MOST OFTEN employed adrenal steroid preparation ins the management of cerebral edema?

a)

Prednisone

b)

Cortone

c)

Dexamethasone

d)

Ciclesonide

e)

Kenalog Orabase

30.

OBA. The anti-inflammatory activity of Deltasone is attributable to all of the following actions EXCEPT

a)

Inhibition of phospholipase A2

b)

Inhibition of interleukin-2

c)

Prevention of margination

d)

Reduction of diapedesis

e)

Stimulation of migration inhibitory factor

31.

SATA. Prednisone is used to treat WOTF?

a)

Breast cancer

b)

Lymphoma

c)

Rheumatoid arthritis

d)

Asthma

e)

Sacoidosis

32.

SATA. A COPD patient who is seriously allergic to formoterol specifically should not be treated with WOTF?

a)

Duaklir

b)

Bevespi

c)

Ultibro

d)

Apiolto

e)

Dymista

33.

OBA. A pharmacist should question a prescription that calls for the oral inhalation of WOTF?

a)

Rhinocort

b)

Azmacort

c)

QVAR

d)

Aerobid

e)

Dulera

34.

OBA. The pKa of ketoconazole is listed as 6.5. At what pH does the drug exist in a ratio of 100:1 ionized to unionized?

a)

4.5

b)

5.5

c)

6.5

d)

7.5

e)

8.5

35.

AOTF statements about triamcinolone acetonide is true except

a)

Fluocinonide acetonide has 9 chiral centers

b)

Ring A adopts flattened boat conformation

c)

Steroid analogue

d)

Inhibits glucocorticoid receptor

e)

Acetonide substitution enhances lipophilicity and penetration

36.

Mr. Juani has glaucoma. WOTF should not be administered to Mr. Juani?

a)

Deltasone

b)

Trelegy

37.

SATA. A pharmacist should question a prescription that calls for the I.V. administration of WOTF?

a)

Medrol Dosepak

b)

Depo-Medrol

c)

Medrol retention enema

38.

SATA. A pharmacist should question a prescription that calls for the nasal inhalation of WOTF?

a)

Trelegy ellipta

b)

Advair

c)

Breo ellipta

39.

SATA. A pharmacist should question a prescription that calls for the nasal administration of the WOTF?

a)

Qvar

b)

Flovent

c)

Asmanex

d)

Breo ellipta

e)

Azmacort

40.

SATA. Deflazacort is beneficial in the management of WOTF?

a)

COPD

b)

Asthma

c)

Urticaria

d)

Crohn's disease

e)

Allergy

41.

WOTF is a monoclonal antibody that is employed in the management of systemic lupus erythematosus?

a)

Cinqair

b)

Topicort

c)

Benlysta

d)

Arnuity ellipta

e)

Emflaza

42.

WOTF is BEST classified as an intermediate-acting glucocorticoid?

a)

Celestone

b)

Florinef

c)

DOCA

d)

Decadron

e)

Qvar

43.

A medical team wants to use an orally administered product containing mometasone and formoterol to treat Mr. Ziam's asthma. WOTF should the pharmacist recommend?

a)

Dulera

b)

Relvar ellipta

c)

Advair

d)

Anoro ellipta

e)

Symbicort

44.

WOTF is characterized by a hyperfunction of only the zona glomerulosa of the adrenal cortex?

a)

Cushing's disease

b)

Zollinger-Ellison syndrome

c)

Addison's disease

d)

Conn's syndrome

e)

Sarcoidosis

45.

The ophthalmologist wants to use loteprednol 0.2 % ophthalmic solution to manage an inflammatory condition in Mr. Cue's eyes. WOTF should the pharmacist recommend?

a)

Alrex

b)

Flarex

c)

Vexol

d)

Lotemax

e)

Durezol

46.

AOTF action so fprednisone contribute to its anti-inflammatory effect EXCEPT

a)

Inhibition of migration inhibitory factor

b)

Stimulation of interleukin-2

c)

Inhibition of phospholipase A2

d)

Inhibition of histamine release from mast cells

e)

Stimulation of adherence of neutrophils to capillary endothelial cells

47.

Long-term use of prednisone should be avoided in patients with AOTF pre-existing conditions EXCEPT

a)

Diabetes mellitus

b)

Glaucoma

c)

Psychosis

d)

Peptic ulcer disease

e)

Inflammation

48.

WOTF is a fully synthetic analog of adrenocorticotropic hormone that is employed in the management of secondary hypercortisolism?

a)

Cortef

b)

Cortone

c)

Prenisolone

d)

Cordran

e)

Cortrosyn

49.

WOTF is LEAST LIKELY to result from the pharmacological actions of adrenal cortex hormones?

a)

Increased renal excretion of calcium and hydrogen ions

b)

Elevation of plasminogen-activator inhibitor-1 levels

c)

Fat redistribution

d)

Increased reabsorption of sodium and potassium from the distal tubule of the nephron

e)

Antagonism of insulin

50.

Triamcinolone can be administered via AOTF routes EXCEPT

a)

Intramuscular

b)

Oral inhalation

c)

Intra-arterial

d)

Nasal inhalation

e)

Intralesional

51.

OBA. Metyrapone is an inhibitor of steroid synthesis in the adrenal cortex, which it inhibits *

a)

CYP3A4

b)

5--deiodinase

c)

11 beta-hydroxylase

d)

CYP11A1

e)

CYP1A1

52.

OBA. Prednisone and prednisolone were found to be _____ more potent than cortisone and hydrocortisone.

a)

20-fold

b)

10-fold

c)

8 or 9-fold

d)

3 or 4-fold

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