MCQs: Anti-inflammatory Drugs

Question # 1 (Multiple Answer) Manifestations of rheumatoid arthritis:

A) inflammatory synovitis

B) cartilage destruction

C) bone erosion

D) changes in joint integrity

E) progressive, relentless polyarthritis with functional impairment

Question # 2 (Multiple Choice) The major role in chronic management of arthritis:

A) glucocorticoids

B) nonsteroidal antiinflammatory drugs

Question # 3 (Multiple Choice) Mechanism of action: aspirin-platelet effects:

A) promotes platelet aggregation

B) activates thromboxane synthesis

C) both

D) neither

Question # 4 (Multiple Answer) Factors accounting for rheumatoid arthritis incidence:

A) genetics

B) climate

C) urbanization

Question # 5 (Multiple Choice) Mediator most likely to promote pain:

A) histamine

B) serotonin

C) bradykinin

D) prostaglandins

E) leukotrienes

Question # 6 (True/False) Aspirin: bleeding time

A) increases bleeding time

B) decreases bleeding time

Question # 7 (True/False) Genetic risk factors fully account for the incidence of rheumatoid arthritis.

A) true

B) false

Question # 8 (Multiple Choice) At low doses required to inhibition of thymidylate synthase, an enhanced adenosine release

A) chloroquine

B) gold

C) methotrexate

D) cyclophosphamide to

E) ketorolac

Question # 9 (Multiple Choice) Mediator promoting greatest increase in vascular permeability, associated with acute inflammation:

A) serotonin

B) prostaglandins

C) bradykinin

D) leukotrienes

Question # 10 (Multiple Choice) Isozyme primarily responsible for prostaglandin production by cells involve an inflammation:

A) COX-I

B) COX-II

Question # 11 (Multiple Answer) Aspirin and antipyresis:

A) elevation of body temperature is typically a useful defense mechanism

B) aspirin — best available drug for reducing fever (in the absence of contraindications to its use recurrent

C) aspirin — more effective in lowering elevated temperature than normal body temperature

D) aspirin-induced temperature reduction is caused by vasodilation

E) fever associated with infection: caused by actions of prostaglandins and interleukin 1 at the periphery

Question # 12 (Multiple Answer) Phases of inflammation:

A) acute inflammation

B) the immune response

C) chronic inflammation

Question # 13 (Multiple Answer) Advantages of other NSAIDs compared with aspirin:

A) generally less expensive

B) less gastric irritation

C) potentially better compliance (e.g. naproxen, sulindac)

D) easier to establish therapeutic range using blood levels

E) absence of acute renal failure/nephrotic syndrome

Question # 14 (Multiple Answer) Aspirin:

A) inhibits prostaglandin synthase

B) inhibits cyclooxygenase

C) decreases prostaglandin formation

D) decreases thromboxane A2 formation

E) decreases leukotrienes

Question # 15 (Multiple Answer) Mediators of chronic inflammation in rheumatoid arthritis:

A) IL-1

B) IL-2

C) IL-3

D) TNF alpha

E) interferons

Question # 16 (Multiple Choice) Effective in managing acute gouty arthritisand ankylosing spondylitis; also accelerates closure of patent ductus arteriosus in premature infants:

A) gold

B) ketorolac

C) phenylbutazone

D) methotrexate

E) indomethacin

Question # 17 (Multiple Choice) Approximate prevalence of rheumatoid arthritis:

A) 1%

B) 5%

C) 7%

D) 10%

E) 15%

Question # 18 (Multiple Choice) In rheumatoid arthritis: primary effect of this mediator is on prostaglandin production:

A) PDGF (platelet-derived growth factor)

B) GM-CSF

C) TNF alpha

Question # 19 (Multiple Choice) Analgesic effects of aspirin:

A) peripheral action (inflammation)

B) subcortical site of action

C) both

D) neither

Question # 20 (True/False) rheumatoid arthritis: genetic predisposition

A) yes

B) no

Question # 21 (Multiple Answer) Correct drug-drug interactions:

A) aspirin — acetazolamide: enhanced salicylate intoxication

B) aspirin — spironolactone: reduced spironolactone activity

C) aspirin — probenecid: increased uricosuric activity

D) aspirin — phenytoin: increased free phenytoin serum levels

E) aspirin-alcohol: increased gastrointestinal bleeding

Question # 22 (Multiple Choice) NSAID primarily promoted as an analgesic, not as an anti-inflammatory agent:

A) piroxicam

B) ibuprofen

C) naproxen

D) ketorolac

E) sulindac

Question # 23 (Multiple Choice) Drug associated with the hepatic/renal toxic metabolite: N-acetyl-p-benzoquinone

A) diclofenac

B) meclofenamate

C) indomethacin

D) acetaminophen

E) aspirin

Correct Answers

Question # 1 (Multiple Answer) Manifestations of rheumatoid arthritis:

(A) inflammatory synovitis

(B) cartilage destruction

(C) bone erosion

(D) changes in joint integrity

(E) progressive, relentless polyarthritis with functional impairment

Question # 2 (Multiple Choice) The major role in chronic management of arthritis:

Answer: (B) nonsteroidal antiinflammatory drugs

Question # 3 (Multiple Choice) Mechanism of action: aspirin-platelet effects:

Answer: (D) neither

Question # 4 (Multiple Answer) Factors accounting for rheumatoid arthritis incidence:

(A) genetics

(B) climate

(C) urbanization

Question # 5 (Multiple Choice) Mediator most likely to promote pain:

Answer: (C) bradykinin

Question # 6 (True/False) Aspirin: bleeding time

Answer: True

Question # 7 (True/False) Genetic risk factors fully account for the incidence of rheumatoid arthritis.

Answer: False

Question # 8 (Multiple Choice) At low doses required to inhibition of thymidylate synthase, an enhanced adenosine release

Answer: (C) methotrexate

Question # 9 (Multiple Choice) Mediator promoting greatest increase in vascular permeability, associated with acute inflammation:

Answer: (D) leukotrienes

Question # 10 (Multiple Choice) Isozyme primarily responsible for prostaglandin production by cells involve an inflammation:

Answer: (B) COX-II

Question # 11 (Multiple Answer) Aspirin and antipyresis:

(B) aspirin — best available drug for reducing fever (in the absence of contraindications to its use recurrent

(C) aspirin — more effective in lowering elevated temperature than normal body temperature

(D) aspirin-induced temperature reduction is caused by vasodilation

Question # 12 (Multiple Answer) Phases of inflammation:

(A) acute inflammation

(B) the immune response

(C) chronic inflammation

Question # 13 (Multiple Answer) Advantages of other NSAIDs compared with aspirin:

(B) less gastric irritation

(C) potentially better compliance (e.g. naproxen, sulindac)

Question # 14 (Multiple Answer) Aspirin:

(A) inhibits prostaglandin synthase

(B) inhibits cyclooxygenase

(C) decreases prostaglandin formation

(D) decreases thromboxane A2 formation

Question # 15 (Multiple Answer) Mediators of chronic inflammation in rheumatoid arthritis:

(A) IL-1

(B) IL-2

(C) IL-3

(D) TNF alpha

(E) interferons

Question # 16 (Multiple Choice) Effective in managing acute gouty arthritisand ankylosing spondylitis; also accelerates closure of patent ductus arteriosus in premature infants:

Answer: (E) indomethacin

Question # 17 (Multiple Choice) Approximate prevalence of rheumatoid arthritis:

Answer: (A) 1%

Question # 18 (Multiple Choice) In rheumatoid arthritis: primary effect of this mediator is on prostaglandin production:

Answer: (C) TNF alpha

Question # 19 (Multiple Choice) Analgesic effects of aspirin:

Answer: (C) both

Question # 20 (True/False) rheumatoid arthritis: genetic predisposition

Answer: True

Question # 21 (Multiple Answer) Correct drug-drug interactions:

(A) aspirin — acetazolamide: enhanced salicylate intoxication

(B) aspirin — spironolactone: reduced spironolactone activity

(D) aspirin — phenytoin: increased free phenytoin serum levels

Question # 22 (Multiple Choice) NSAID primarily promoted as an analgesic, not as an anti-inflammatory agent:

Answer: (D) ketorolac

Question # 23 (Multiple Choice) Drug associated with the hepatic/renal toxic metabolite: N-acetyl-p-benzoquinone

Answer: (D) acetaminophen