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Corticosteroids and Glucocorticoid Receptors

Total questions: 108

Worksheet time: 2hrs 30mins

Name
Class
Date
1.

Asthma COPD

__________ introduced an anti-inflammatory effect when treating asthma

a)

Corticosteroids

b)

Long acting B2 agonists

c)

Short acting B2 agonists

d)

Methylxanthines

2.

Glucocorticoid receptors tend to down regulate what?

a)

Growth and production

b)

Cardiovascular tone

c)

Immune and inflammation

d)

Metabolism

3.

Corticosteroids can bind to smooth muscle in the airway stimulating __________ receptors which relaxes airways

a)

Beta-2 receptors

b)

Cytokine

c)

Beta-1 receptors

d)

mRNA

4.

High potency corticosteroids

a)

Fluticasone and Mometasone

b)

Budesonide and Beclomethasone

c)

Triamcinolone

5.

Low potency corticosteroids

a)

Fluticasone and Mometasone

b)

Budesonide and Beclomethasone

c)

Triamcinolone

6.

Asthma and bronchodilation

Sympathetic control MOA

(a)  

7.

Asthma and bronchodilation

Parasympathetic control MOA

(a)  

8.

Why is Norepinephrine not used in a drug to treat asthma?

a)

Norepinephrine does not specifically target the lungs, therefore it does not work effectively

b)
Norepinephrine is effective for bronchodilation and reduces blood pressure.
c)
Norepinephrine is not used to treat asthma because it does not provide bronchodilation and can increase blood pressure.
d)
Norepinephrine helps in reducing airway inflammation and is widely used.
9.

How can actions at non-target Beta-2 receptors be minimized?

a)

Deliver drugs by inhalation

b)
Increase non-selective Beta agonist use.
c)
Administer higher doses of Beta-2 antagonists.
d)
Combine with non-target receptor blockers.
10.

Norepinephrine (NE) or epinephrine (E)
is NOT a good drug candidate for asthma
because?

Modifying NE to:

a)

Enhance beta-2 receptor selectivity

b)

Reduce metabolic inactivation

c)

Alter beta-2 receptor binding kinetics

d)

Increase metabolic inactivation

11.

SABAs are “alternate reliever option” for all
Steps of asthma maintenance in Track (a)  

12.

Which enantiomer (R or S) displays high affinity of beta-2 receptors?

(a)  

13.

(a)   is the “optically pure” and pharmacologically active R-enantiomer of the albuterol racemate

14.

Albuterol is typically dosed in (a)   per puff

15.

LABAs have long duration (__ to__) –
Receptor affinity

(a)  

16.

Beta-receptors have higher affinity for ________ than _______

(a)  

17.

(a)   can increase the expression of
beta-2 receptors to overcome/reduce tolerance

18.

Many patients with obstructive lung diseases also have hypertension, coronary artery disease, or congestive heart failure that necessitate the use of ß blockers:

When treating the conditions above what is a safer cardioselective agent?

(a)  

19.

Albuterol brand name

(a)  

20.

ProAir generic

(a)  

21.

Albuterol Class

(a)  

22.

Albuterol is known as a _______

a)

Reliever

b)

Controller

23.

Budesonide Brand

(a)  

24.

Pulmicort generic

(a)  

25.

Budesonide class

(a)  

26.

Bupropion brand

(a)  

27.

Wellbutrin generic

(a)  

28.

Bupropion class

(a)  

29.

Donepezil brand

(a)  

30.

Aricept generic

(a)  

31.

Donepezil class

(a)  

32.

Escitalopram brand

(a)  

33.

Lexapro generic

(a)  

34.

Escitalopram class

(a)  

35.

Fluticasone brand

(a)  

36.

Flonase generic

(a)  

37.

Fluticasone class

(a)  

38.

What are the three hallmarks to Alzheimer's disease?

a)

Extracellular amyloid
plaques

b)

hypophosphorylated tau

c)

Intracellular
neurofibrillary tangles

d)

Neuron loss

39.

What are the three most common types of dementia

a)

Vascular

b)

Lewy-body

c)

Alzheimer's

d)

Parkinson's

40.

The common age for AD presentation is >85

a)

True

b)

False

41.

What is the median survival time after AD diagnosis

a)

4-8 years

b)

5-9 years

c)

10-12 years

d)

2-6 years

42.

What genotype of APOE indicates the highest risk for developing AD

a)

APOE*4

b)

APOE*3

c)

APOE*1

d)

APOE*2

43.

What is the most aggressive chromosome in early onset AD

a)

14

b)

13

c)

9

d)

8

44.

What other genetic condition is associated with early onset AD

a)
Klinefelter syndrome
b)
Fragile X syndrome
c)
Turner syndrome
d)
Down syndrome
45.

What are the risk factors for developing AD

a)

Age

b)

CVD

c)

Head trauma

d)

Physical activity

e)

Years of education

46.

What role does inflammation play in the development of AD

a)
Inflammation enhances synaptic plasticity and memory retention in Alzheimer's disease.
b)
Inflammation contributes to neuronal damage and the accumulation of amyloid plaques and tau tangles in Alzheimer's disease.
c)
Inflammation has no significant impact on the progression of Alzheimer's disease.
d)
Inflammation primarily aids in the removal of damaged neurons in Alzheimer's disease.
47.

_______ is negatively associated with Alzheimer's disease

a)

NSAIDs

b)

Rheumatoid arthritis

c)
Sedentary lifestyle
48.

Alzheimer's disease - Cholinergic hypothesis

a)
The cholinergic hypothesis posits that Alzheimer's disease is linked to a deficiency in acetylcholine.
b)
The cholinergic hypothesis indicates Alzheimer's is linked to a lack of norepinephrine.
c)
The cholinergic hypothesis claims Alzheimer's is due to high serotonin levels.
d)
The cholinergic hypothesis suggests Alzheimer's is caused by excess dopamine.
49.

What is the treatment goal for the cholinergic hypothesis

a)

To reduce cholinergic activity and improve cognitive symptoms.

b)

To enhance ACh function by decreasing ACh breakdown

c)
To eliminate cholinergic function and enhance memory loss.
d)
To stabilize cholinergic levels without affecting cognition.
50.

What medication is primarily used to combat symptoms of Alzheimer's disease when talking about acetylcholine

a)
Donepezil
b)
Rivastigmine
c)
Memantine
d)
Galantamine
51.

Explain the Glutamatergic hypothesis in Alzheimer's disease

a)
The Glutamatergic hypothesis suggests that low glutamate levels cause Alzheimer's disease.
b)
The Glutamatergic hypothesis claims that glutamate has no role in Alzheimer's disease progression.
c)
The Glutamatergic hypothesis indicates that glutamate enhances neuroprotection in Alzheimer's disease.
d)
The Glutamatergic hypothesis posits that excessive glutamate signaling leads to neurotoxicity in Alzheimer's disease.
52.

How does donepezil work

a)
Donepezil enhances dopamine production in the brain.
b)
Donepezil blocks serotonin receptors to reduce anxiety.
c)
Donepezil works by inhibiting the enzyme acetylcholinesterase, thereby increasing acetylcholine levels in the brain.
d)
Donepezil increases blood flow to the brain for better function.
53.

Cognitive symptoms such as sudden decline or step-like usually related to an event is closely related to which type of dementia?

(a)  

54.

What is the amount of air one can force from the lungs in one second is

(a)  

55.

The amount of air that can be forcibly exhaled from your lungs after taking the deepest breath possible

(a)  

56.

What is the equation for pulmonary function?

a)
Tidal volume is the primary measure of lung capacity.
b)
Vital capacity is the main equation for lung function.
c)
FEV1/FVC ratio is a key equation for assessing pulmonary function.
d)
Peak expiratory flow rate is used for assessing lung health.
57.

Reversibility is significant if

(a)  

58.

What treatment chart is primarily used for starting treatment or adjustment of treatment?

(a)  

59.

If a 12+ patient has daily symptoms or waking at night once a week or more and low lung function or recent exacerbation what is the PREFERRED track and what is included in that track

a)

Track 1 - Medium dose ICS-formoterol maintenance and reliever (MART)

b)

Track 1 - Low dose ICS-formoterol maintenance and reliever (MART)

c)

Track 1 - As needed only low dose ICS-formoterol

d)

Track 2 - Medium dose ICS-LABA + SABA

60.

If a 12+ patient has symptoms most days ot waking at night once a week or more or low lung function what is PREFERRED track and what track is it

a)

Track 1 - Medium dose ICS-formoterol maintenance and reliever (MART)

b)

Track 1 - Low dose ICS-formoterol maintenance and reliever (MART)

c)

Track 2 - Medium dose ICS-LABA + as needed SABA

d)

Track 2 - As needed ICS + SABA

61.

If a 12+ patient presents with symptoms less than 3-5 days a week, with normal lung function what is the PREFERRED track and what is included in that track

a)

Track 1 - Medium dose ICS-formoterol maintenance and reliever (MART)

b)

Track 1 - Low dose ICS-formoterol maintenance and reliever (MART)

c)

Track 1 - As needed only low dose ICS-formoterol

d)

Track 2 - As needed ICS + SABA

62.

If a 12+ patient has daily symptoms or waking at night once a week or more and low lung function or recent exacerbation what is the non-preferred (still acceptable) track and what is included in that track

a)

Track 1 - Medium dose ICS-formoterol maintenance and reliever (MART)

b)

Track 1 - Low dose ICS-formoterol maintenance and reliever (MART)

c)

Track 2 - Low dose ICS-LABA + as needed SABA

d)

Track 2 - Medium dose ICS-LABA + as needed SABA

63.

If a 12+ patient has symptoms most days ot waking at night once a week or more or low lung function what is non-preferred (still acceptable) track and what track is it

a)

Track 1 - Medium dose ICS-formoterol maintenance and reliever (MART)

b)

Track 1 - Low dose ICS-formoterol maintenance and reliever (MART)

c)

Track 2 - Medium dose ICS-LABA + as needed SABA

d)

Track 2 - Low dose ICS-LABA + as needed SABA

64.

If a 12+ patient presents with symptoms less than 3-5 days a week, with normal lung function what is the non-preferred (still acceptable) track and what is included in that track

a)

Track 1 - Low dose ICS-formoterol maintenance and reliever (MART)

b)

Track 2 - Medium dose ICS-LABA + as needed SABA

c)

Track 2 - Low dose ICS + as needed SABA

d)

Track 2 - As needed ICS + SABA

65.

How often should asthma be reviewed (GINA)

a)

1-3 months after treatment started, then every 3-12 months

b)

3-6 months after treatment started, then every 8-12 months

c)

2-6 weeks after treatment started, then every 1-6 months

d)

Within 1 week after exacerbation

66.

What are the four questions to review in the past four weeks when looking at asthma control? (GINA)

a)

Daytime symptoms more than twice a week

b)

Any night time waking due to asthma

c)

SABA reliever needed more than twice a week

d)

Any activity limitation due to asthma

e)

SABA reliever needed more than one a week

67.

No symptoms of the four questions when talking about the past four weeks for symptom control is..

a)

Well-controlled

b)

Partly controlled

c)

Uncontrolled

68.

1-2 of the four questions when talking about the past four weeks for symptom control is..

a)

Well-controlled

b)

Partly controlled

c)

Uncontrolled

69.

3-4 of the four questions when talking about the past four weeks for symptom control is..

a)

Well-controlled

b)

Partly controlled

c)

Uncontrolled

70.

How long until you should consider stepping treatment down for asthma with control of symptoms

(a)  

71.

Which chromosome is associated with Down Syndrome?

(a)  

72.

(a)   is an important NT involved in memory

73.

Mild and moderate AD lasts for ~-- years

(a)  

74.

When talking about AD. What severity of the diseases spreads from the medial temporal lobe to the lateral temporal and parietal lobes?

(a)  

75.

When talking about AD. What severity of the diseases spreads to the frontal lobe?

(a)  

76.

When talking about AD. What severity of the disease spreads to the occipital lobe?

(a)  

77.

What cognitive test is most commonly used to test for memory complaints?

(a)  

78.

When assessing a MMSE, What score indicated mild dementia?

(a)  

79.

When assessing a MMSE, what score indicates moderate dementia

(a)  

80.

Which cognitive test do you add 1 point for lower education?

(a)  

81.

When assessing a MoCA, what score indicated mild cognitive impairment?

(a)  

82.

When assessing a SLUMS, what score indicated mild neurocognitive disorder with a patient who finished high school; what about for a patient that did not finish high school?

(a)  

83.

Treatment Goal

Mild to moderate dementia calls for what drug class to be used to treat

(a)  

84.

Treatment Goal

Moderate to severe dementia calls for what drug class to be used to treat

(a)  

85.

How do ACHE inhibitors increase ACh levels?

a)
ACHE inhibitors increase ACh levels by preventing its breakdown.
b)
ACHE inhibitors increase ACh levels by blocking its receptors.
c)
ACHE inhibitors increase ACh levels by promoting its release.
d)
ACHE inhibitors increase ACh levels by enhancing its synthesis.
86.

What dementia medication is instructed to take in the AM to avoid nightmares from insomnia?

(a)  

87.

What are some ADRs of ACHE inhibitors?

a)

Bradycardia

b)

Dizziness

c)

N/V/D

d)

GI bleeding

e)

Tachycardia

88.

What class of drug blocks pathological activation of NMDA receptors without impairing normal transmission?

(a)  

89.

What are some ADRs of NMDA receptor antagonist

a)

Confusion

b)

Hallucinations

c)

Constipation

d)

Dizziness

90.

What is a really important non-pharm intervention for AD management?

(a)  

91.

A 79-year-old patient was diagnosed with AD 2 months ago with an MMSE score of 23 at diagnosis. At that time, donepezil was started at 5 mg nightly at bedtime. Would it be considered appropriate to add memantine to the medication regimen now?

a)

Yes

b)

No

92.

Genetic susceptibility to early-onset AD is primarily linked to which of the following?

a)

Presenilin gene mutation

b)

Amyloid precursor protein mutations

c)

APOE4

d)

APOE2

93.

What are some ADRs for SABAs and LABAs

a)

Tremors

b)

Palpitations

c)

Hyperglycemia

d)

Hypoglycemia

94.

What drug is a SAMA

(a)  

95.

What drugs are LAMAs

a)

Ipratropium

b)

Tiotropium

c)

Aclidinium

96.

What are some ADRs of SAMAs and LAMAs

a)

Blurred vision

b)

Dry mouth

c)

Urinary retention

d)

Bradycardia

97.

Medications like (a)   can trigger or worsen asthma symptoms

98.

CYP metabolism of the LTRAs results in drug

(a)  

99.

Bronchial tone is maintained through parasympathetic innervation of the airways via the (a)   nerve (M3 receptor)

100.

Patient with a predicted FEV1 of > (a)   % indicated mild COPD

101.

Patient with a predicted FEV1 of between _% and _% indicates moderate COPD

(a)  

102.

Patient with a predicted FEV1 of between _% and _% indicates severe COPD

(a)  

103.

Patient with a predicted FEV1 of _% indicates very severe COPD

(a)  

104.

Exacerbation history

>2 exacerbations or >1 leading to hospitalization indicates what step

(a)  

105.

Exacerbation history

0-1 exacerbations (no hospitalization) with a cat score of <10 indicates what step

(a)  

106.

Exacerbation history

0-1 exacerbations (no hospitalization) with a cat score of >10 indicates what step

(a)  

107.

(a)   is indicated to reduce the risk of COPD exacerbations in patients with severe COPD

108.

Blockade of M2 receptors allows further release of presynaptic
acetylcholine, and may antagonize the bronchodilatory effect of
blocking M3, a possible basis of

(a)  

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