0 of 21 questions completed
Questions:
1. Mechanism of action questions regarding analgesic, antipyretic and effects on bleeding:
Analgesic effects: aspirin inhibits the synthesis of prostaglandins
Antipyretic effects: aspirin inhibits PG synthesis in the hypothalamic temperature regulation center
Bleeding time: inhibit synthesis of thromboxane A2 preventing platelet synthesis
2. A 2nd type of question has to do with pharmacological or toxic effects of aspirin: you get to pick which of the list is or is not associated with aspirin. Therapeutic effects of aspirin include pain relief, antipyretic effects, antirheumatic and anti-inflammatory effects. Adverse or toxic effects include all of the following: occult bleeding from the GI tract, tinnitus, nausea and vomiting, acid-base disturbance or metabolic acidosis, decreased tubular reabsorption of uric acid, salicylism, delirium, hyperventilation, etc.
3. A third type of question focuses on the difference between 1) aspirin and acetaminophen, 2) aspirin and other anti-inflammatories like prednisone, and 3) between aspirin and ibuprofen:
1) Acetaminophen lacks anti-inflammatory activity, is hepatotoxic, and does not cause GI upset
2) Anti-inflammatories like prednisone, hydrocortisone, triamcinolone etc. are steroids and do not act primarily by PG inhibition
3) Ibuprofen causes much less GI irritation
4) Diflunisal (Dolobid) has a longer half-life than aspirin, acetaminophen and ibuprofen
4. Newer versions of the boards have questions about COX-2 inhibitors like vioxx. (Which of the following is a COX-2 inhibitor?)
5. These old questions focus a lot on aspirin. Nowadays, acetaminophen and ibuprofen are used much more commonly than aspirin, because of the many side effects of aspirin that turn up in these kinds of questions. So since aspirin is the comparator prototype drug, reviewing these questions are still useful. But expect newer questions asking you to know:
a. Acetaminophen causes liver toxicity, especially when combined with alcohol or taken in excess of 4 gr/day.
b. Acetaminophen is the drug of choice for the feverish child (they usually ask the reverse, which is which drug should be avoided in the feverish child (aspirin- increased risk of Reye’s syndrome)
You have already completed the quiz before. Hence you can not start it again.
Exam is loading ...
You must sign in or sign up to start the exam.
You have to finish following exam, to start this exam:
0 of 21 questions answered correctly
Your time:
Time has elapsed
You answered 0 of 0 (0) questions correct
Average score |
|
Your score |
|
Based on your performance on this Optometry Board Part 1 Practice Test, you’re not yet ready for the NBEO® Part 1.
Keep your head up! Also, don’t focus on your estimated score, they mean essentially nothing at the start. Rarely does anyone start these exams and score well immediately, if that was the case then they wouldn’t even need to practice! These are ‘practice’ tests, meaning you’re practicing to improve your skills. If you continue to work hard and study, read and understand the solutions, practice with “OptometryBoards.com” daily and give it your best effort, we promise your score will improve. Review and learn for now, and the scores will come.
-The “OptometryBoards.com” Team
Congratulations! Based on your performance on this Optometry Board Part 1 Practice Test, you’re predicted to pass your NBEO® Part 1! Keep hammering away at our Optometry Board questions so that you can keep up the great work!
-The “OptometryBoards.com” Team
The therapeutic effect of the salicylates is explained on the basis of the ability of the drug to
The mechanism of the antipyretic action of salicylates probably results from
The antipyretic action of salicylates is explained in part by
The locus of action of aspirin’s central antipyretic effect is the
(b) memorization question- remember antipyresis means antifever. Temperature regulation center is in the hypothalamus
(b) memorization question- remember antipyresis means antifever. Temperature regulation center is in the hypothalamus
A patient who has been taking large quantities of aspirin might show increased postoperative bleeding because aspirin inhibits
(a) The first fact you must remember is that aspirin prevents platelet aggregation- this limits your choices to (a) and (b). They hope to confuse you by using prostacylin, but of course you know that this is wrong immediately, the right word is prostaglandin, as in (c), but you have already eliminated that choice because it doesn’t mention prevention of platelet aggregation. Thus, even if you didn’t remember that thromboxane A2 induces platelet aggregation, and aspirin blocks this action, you could get the answer by elimination. (d) is how heparin works, while (e) is how coumarin works
(a) The first fact you must remember is that aspirin prevents platelet aggregation- this limits your choices to (a) and (b). They hope to confuse you by using prostacylin, but of course you know that this is wrong immediately, the right word is prostaglandin, as in (c), but you have already eliminated that choice because it doesn’t mention prevention of platelet aggregation. Thus, even if you didn’t remember that thromboxane A2 induces platelet aggregation, and aspirin blocks this action, you could get the answer by elimination. (d) is how heparin works, while (e) is how coumarin works
Anti-inflammatory agents, such as aspirin, interfere with hemostasis by
Which of the following anti-inflammatory agents does NOT act primarily by inhibiting activity of prostaglandin synthetase?
(c) triamcinolone is a corticosteroid. Corticosteroids inhibit phospholipase A2, the enzymatic step that precedes prostaglandin synthetase. Diflunisal is a salicylate analgesic, like aspirin.
(c) triamcinolone is a corticosteroid. Corticosteroids inhibit phospholipase A2, the enzymatic step that precedes prostaglandin synthetase. Diflunisal is a salicylate analgesic, like aspirin.
A nonsteroidal, anti-inflammatory agent that appears to produce fewer gastrointestinal disturbances than high does of aspirin is
a) you might be tempted to answer acetaminophen, because it doesn’t cause GI upset, but remember it is also not anti- inflammatory. The answer is ibuprofen. Tricky – you had to sort through two distinguishing characteristics. Good question!
a) you might be tempted to answer acetaminophen, because it doesn’t cause GI upset, but remember it is also not anti- inflammatory. The answer is ibuprofen. Tricky – you had to sort through two distinguishing characteristics. Good question!
Prolonged use of which of the following drugs does NOT cause a predisposition to gastric irritation and bleeding?
(a) This is a straight drug identification question. Answers 2-5 are all non-steroidal antiinflammatory drugs which cause gastric irritation and bleeding due to their effects on prostaglandin synthesis in the mucosal wall of the gut. # , phenytoin, is an anti-convulsant-its major side effect that often appears as a question on boards is the production of gingival hyperplasia.
(a) This is a straight drug identification question. Answers 2-5 are all non-steroidal antiinflammatory drugs which cause gastric irritation and bleeding due to their effects on prostaglandin synthesis in the mucosal wall of the gut. # , phenytoin, is an anti-convulsant-its major side effect that often appears as a question on boards is the production of gingival hyperplasia.
Each of the following agents has been associated with gastric irritation EXCEPT
(e) note the difference in this question and the two last questions. Ibuprofen was previously the answer to “shows reduced GI irritation”, but it does cause some, which you have to remember to answer #12 and this question. So aspirin and ibuprofen are out. Indomethacin is a very strong NSAID that causes lots of GI irritation, so much that use is limited in humans, so it is out. What about alcohol vs. acetaminophen. Well, you should really know that acetaminophen is usually the answer to these types of analgesics questions, but if you didn’t know that, perhaps you may know that alcohol also causes GI irritation, so it is out.
(e) note the difference in this question and the two last questions. Ibuprofen was previously the answer to “shows reduced GI irritation”, but it does cause some, which you have to remember to answer #12 and this question. So aspirin and ibuprofen are out. Indomethacin is a very strong NSAID that causes lots of GI irritation, so much that use is limited in humans, so it is out. What about alcohol vs. acetaminophen. Well, you should really know that acetaminophen is usually the answer to these types of analgesics questions, but if you didn’t know that, perhaps you may know that alcohol also causes GI irritation, so it is out.
Which of the following is NOT produced by excessive doses of acetylsalicylic acid?
(c) it only lowers your temperature if you have a fever,, taking aspirin does not have any effect on body temperature in the non-feverish patient, but high doses can cause all the other effects listed.
(c) it only lowers your temperature if you have a fever,, taking aspirin does not have any effect on body temperature in the non-feverish patient, but high doses can cause all the other effects listed.
All of the following are pharmacologic and toxicologic properties of aspirin EXCEPT
Therapeutic effects of aspirin include
a. Analgesia
b. Tranquilization
c. Pyretic action
d. Anti-inflammatory action
e. Antirheumatic action
All of the following are pharmacologic or toxicologic properties of acetylsalicylic acid EXCEPT
All of the following are possible effects of aspirin EXCEPT
Of the following, aspirin does NOT cause
(d) Answer is (d)- (a) & (b) are the major side effects of aspirin (resulting from the inhibition of prostaglandin synthesis) for the majority of people, and one reason for the popularity of aspirin alternatives such as acetaminophen and ibuprofen, which produce these effects to a lesser extent. # 3 & 5 may also be seen following larger doses of aspirin. (d) is not seen with aspirin, but is a major therapeutic use of narcotic opiates such as codeine. I guess they are hoping that you will get the effects of codeine and aspirin mixed up, since the two are often compared and contrasted as moderate pain relievers.
(d) Answer is (d)- (a) & (b) are the major side effects of aspirin (resulting from the inhibition of prostaglandin synthesis) for the majority of people, and one reason for the popularity of aspirin alternatives such as acetaminophen and ibuprofen, which produce these effects to a lesser extent. # 3 & 5 may also be seen following larger doses of aspirin. (d) is not seen with aspirin, but is a major therapeutic use of narcotic opiates such as codeine. I guess they are hoping that you will get the effects of codeine and aspirin mixed up, since the two are often compared and contrasted as moderate pain relievers.
Which of the following is NOT true regarding acetaminophen?
(d) reworded version of the preceding question, just asking what you know about acetaminophen. Nowadays, I think they would also put something about liver damage in the question, as below.
(d) reworded version of the preceding question, just asking what you know about acetaminophen. Nowadays, I think they would also put something about liver damage in the question, as below.
The most prominent acute toxic effect associated with acetaminophen use is
(c) Remember, acetaminophen (tylenol) is an aspirin alternative. Alternatives 1, 4, 5 are side effects of aspirin-type drugs. The popularity of acetaminophen as an aspirin alternative is because the incident of such effects with his drug is very low.However, because acetaminophen can undergo biotransformation to a toxic intermediate, hepatic and renal necrosis have been reported, especially after very high doses. (c), hepatic necrosis is the most prominent, specially when combined with alcohol consumption, since the alcohol induces the liver enzymes which make the hepatotoxic metabolites of acetaminophen
(c) Remember, acetaminophen (tylenol) is an aspirin alternative. Alternatives 1, 4, 5 are side effects of aspirin-type drugs. The popularity of acetaminophen as an aspirin alternative is because the incident of such effects with his drug is very low.However, because acetaminophen can undergo biotransformation to a toxic intermediate, hepatic and renal necrosis have been reported, especially after very high doses. (c), hepatic necrosis is the most prominent, specially when combined with alcohol consumption, since the alcohol induces the liver enzymes which make the hepatotoxic metabolites of acetaminophen
Which of the following anti-inflammatory agents does NOT act primarily by inhibiting the activity of cyclooxygenase?
Answer is (c)- (a), 2, 4, and 5 are NSAIDS that reduce inflammation by reducing prostaglandin synthesis by blocking the activity of cyclooxygenase. Prednisone is a corticosteroid. Corticosteroids are potent nonspecific inhibitors of the inflammatory process, acting at a variety of point throughout the inflammatory process. Although they do reduce prostaglandin production as well, they do this by a mechanism other then blocking cyclooxygenase, probably by inhibiting the release of the fatty acid substrate for prostaglandin synthesis.
Answer is (c)- (a), 2, 4, and 5 are NSAIDS that reduce inflammation by reducing prostaglandin synthesis by blocking the activity of cyclooxygenase. Prednisone is a corticosteroid. Corticosteroids are potent nonspecific inhibitors of the inflammatory process, acting at a variety of point throughout the inflammatory process. Although they do reduce prostaglandin production as well, they do this by a mechanism other then blocking cyclooxygenase, probably by inhibiting the release of the fatty acid substrate for prostaglandin synthesis.
Which of the following is the most appropriate drug to use to lower fever in a child under 12?
(c) acetaminophen is the best choice. Aspirin is contraindicated due to the potential for causing Reye’s syndrome. Ibuprofen is approved, but usually not the #1 choice. The others would be inappropriate as well.
(c) acetaminophen is the best choice. Aspirin is contraindicated due to the potential for causing Reye’s syndrome. Ibuprofen is approved, but usually not the #1 choice. The others would be inappropriate as well.
Which analgesic from the following list has the longest half-life?
(c) Diflunisal can be taken twice a day, the others three-four times a day is required.
(c) Diflunisal can be taken twice a day, the others three-four times a day is required.