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1. Use of the unpaired, Student’s t-test for making multiple comparisons requires correction of the significance limit by which one of the following techniques?
*A. Bonferroni correction
B. Tukey’s A test
C. Tukey’s B test
D. Mantel-Hanenszel test
E. Fisher-Behren’s test
2. Often scientists will inappropriately determine a linear regression between two dependent variables, e.g., effect versus concentration, without adding appropriate weighting functions for both the x and y axis values. Which linear regression parameters are affected by weighting?
B. y-axis intercept
C. x-axis intercept
D. The correlation coefficient
E. None of the above
* F. All of the above
3. Chronobiologic changes in the physiology of disease states would theoretically support the use of a circadian-based dosage regimen for which of the following medications?
4. A urine specimen screened positive for benzodiazepines using an immunoassay. On GC/MS confirmation temazepam and oxazepam were found but there was no evidence for nordiazepam. Which of the following drugs was the patient taking?
5. Which of the following method is used to facilitate the measurement of free (unbound) drug concentrations in animal or human plasma?
A. C18 column eluation and centrifugation
C. Gradient centrifugation
*D. Equilibrium membrane dialysis
F. Addition of alpha-1 acid glycoprotein and trichloacetic acid precipitation
6. Which one of the following cytochrome P450 isoforms is responsible for the bioactivation of aflatoxin B in humans?
7. A 43 year old woman has a lifelong allergy to sulfonamides. She is prescribed hydrochlorothiazide for hypertension. Two weeks later, she presents to her doctor with a persistent fever, a petechial rash, aching joints and abnormal hepatic transaminases. This reaction is best described as:
A. an IgE-mediated response
B. a cytotoxic reaction
*C. a serum sickness-like reaction
D. a delayed, cell-mediated response
E. an idiosyncratic response
8. The requirement for bioactivation has been implicated in the pathogenesis of serious adverse drug reactions for which of the following compounds?
D. None of the above
*E. All of the above
9. A receptor binding assay in a brain homogenate, on computer analysis, has a slope factor which is 2.5. This finding is consistent with which of the following ?
A. Two receptor subtypes
B. Non-equilibrium conditions
D. Receptor saturation
E. Incorrect temperature at which the assay was performed
10. The flushing and tachycardia that occurs in many Orientals after ethanol ingestion is likely to be due to genetic polymorphism resulting in deficiency of which of the following enzymes?
A. Alcohol dehydrogenase
B. Xanthine oxidase
*C. Aldehyde dehydrogenase
D. Aldehyde oxidase
E. Lactate dehydrogenase
11. In a plot of plasma concentrations (x axis) versus effect (y axis) for a drug that distributes to the effect site, a counterclockwise hysteresis loop could indicate which of the following?
A. Residual effects of a prior dose
*B. Equilibrium delay
C. Clearance delay
D. Absorption delay
E. Reduced receptor affinity
12. CremaphorTM is a natural product derived from the castor bean which is used as a vehicle for the parenteral formulation of paclitaxel. Which one of the following answers best describes the reason for including this particular vehicle in paclitaxel for intravenous injection? (New 97)
A. To prevent chemical degradation of paclitaxel
B. To facilitate the bioactivation of paclitaxel
*C. To insure the complete dissolution (or miscibility) of paclitaxel
D. To prevent photodegradation of paclitaxel
E. To increase the half-life of paclitaxel
13. Despite the apparent absence of CYP1A2 in fetal liver, studies have demonstrated the demethylation of caffeine to paraxanthine and theophylline in fetal liver microsomes. Which one of the following cytochrome P450 isoforms is most likely responsible for this particular biotransformation event in the fetus?
14. A randomized clinical trial is designed to compare two treatments with respect to their effect on blood pressure is stratified by gender. There is no significant difference on blood pressure overall in men, but a nominally significant difference between treatments is observed in women. Which of the following statements is true?
*A. Because the study was prospectively stratified, no correction of the nominal p-value is needed.
B. If the planned analysis of the study was to examine men and women separately, but not men and women pooled, a reasonable approximate corrected value of a nominal p-value of 0.05 is 0.1.
C. If the planned analysis of the study was to examine men and women separately, but not men and women pooled, a reasonable approximate corrected value for a nominal p-value of 0.05 is 0.05 times the cube root of 2 or about 0.071.
D. The overall efficacy in men and women pooled must be determined
E. The efficacy is independent of sex of the patient
15. Pralidoxime (2-PAM) represents the antidote of choice for poisoning produced by which one of the following substances?
C. Agent orange
16. It is generally known that chronic alcoholics are at increased risk for the development of hepatotoxicity from the ingestion of acetaminophen. Which of the following factors best describe the reason(s) for this particular susceptibility?
A. Reduced glucuronyltransferase activity
B. Induced CYP2E1
C. Induced CYP3A4
D. Reduced glutathione pool
E. Induced gamma glutamyl transferase
*F. B and D
17. The "designer" drug 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)
A. Directly causes hepatic necrosis
B. Directly causes renal failure
*C. Causes Parkinson's disease after metabolism in the central nervous system
D. Causes Parkinson's disease after hepatic metabolism
E. Causes early onset dementia and after hepatic metabolism
18. An 18 year old male presents with acute alcohol intoxication. His blood ethanol concentration is 800 mg/dL (8000 mg/L) for a typical adult, blood alcohol declines at a rate of 15 mg/dL/hr. Ethanol elimination in this patient could be increased by administration of which of the following treatments?
B. St Johns Wort
*E. None of the above
19. Acidosis (either respiratory and/or metabolic) is a common problem with acute intoxication with a variety of alcohols. Which one of the following alcohols produces the LEAST severe extent of acidosis following an acute overdose?
C. Ethylene Glycol
D. Polyethylene Glycol (mol. wt. < 500)
20. The mother of a 7 year old with ADHD brings the child to your office requesting that you discontinue the methylphenidate he has been receiving and start atomoxetine. You agree with this therapeutic plan. In order to safely and effectively treat this child, you should?
A. Be certain that he does not use ibuprofen concurrently with atomoxetine
*B. Check his CYP2D6 genotype before starting the medication
C. Check his CYP2C19 genotype before starting the medication
D. Instruct mother not to give the drug in the morning, but to give it in the evening before bed
E. Avoid caffeine and chocolate when using this medication