Nsaids - Part 2 (Msq Drill 176)
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- 1.
Aspirin is a platelet inhibitor. True or false?
- A.
True
- B.
False
Correct Answer
A. True -
- 2.
How does Aspirin prevent clotting?
- A.
It reversibly acetylates COX
- B.
It irreversibly aceylates COX
Correct Answer
B. It irreversibly aceylates COX -
- 3.
Do platelets have a nuclei?
- A.
Yes
- B.
No
Correct Answer
B. No -
- 4.
Do platelets make new COX after Aspirin has IRREVERSIBLY reversed their COX?
- A.
Yes, it is a continuous process
- B.
No, they cannot make new COX because they have no nuclei.
Correct Answer
B. No, they cannot make new COX because they have no nuclei. -
- 5.
Therefore Aspirin inhibits platelet function for the life of the platelet. True or false?
- A.
True
- B.
False
Correct Answer
A. True -
- 6.
If you give a low dose of Aspirin (which will be hereto referred to as ASA) is this more selective for COX 1 or COX 2?
- A.
Low dose ASA selective for COX 1
- B.
Low dose ASA selective for COX 2
Correct Answer
A. Low dose ASA selective for COX 1 -
- 7.
Macrophage chemotaxis is mediated by COX enzymes. If you give a patient low dose ASA, does this also block the mediatory effect of COX 2 on macrophages?
- A.
Yes
- B.
No
Correct Answer
B. No -
- 8.
Giving low dose ASA may contribute to ASA resistance. True or false?
- A.
True
- B.
False
Correct Answer
A. True -
- 9.
What is the hallmark of salicylism?
- A.
Blindness
- B.
Weight gain
- C.
Bleeding
- D.
Tinnutis
Correct Answer
D. Tinnutis -
- 10.
What is salisylism?
- A.
Toxic overdose of ibuprofen
- B.
Toxic effects of overdosage with acetylsalicylic acid only
- C.
Toxic effects of overdosage with salicylic salts
Correct Answer
C. Toxic effects of overdosage with salicylic salts -
- 11.
ASA: salicylic acid or acetylsalicylic acid?
- A.
Salicylic acid
- B.
Acetylsalicylic acid
Correct Answer
B. Acetylsalicylic acidExplanation
same compound but it is acetylated in ASA.Rate this question:
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- 12.
Tinnutis is the hallmark of salicylism. What other symptoms can be present? check all that apply.
- A.
Hyperpyrexia
- B.
Sweating
- C.
Hyperventilation
- D.
Metabolic acidosis with respiratory alkalosis
- E.
Metabolic alkalosis with respiratory acidosis
Correct Answer(s)
A. Hyperpyrexia
B. Sweating
C. Hyperventilation
D. Metabolic acidosis with respiratory alkalosisExplanation
hyperpyexia - abnormally high fever.
"Alive until dead."Rate this question:
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- 13.
Can ASA contribute to Salicylism?
- A.
Yes
- B.
No
Correct Answer
A. Yes -
- 14.
A child taking ASA is at risk for:
- A.
Steven Johnson's syndrome
- B.
Reye's syndrome
- C.
Chronic fatigue syndrome
- D.
Fibromyalgia
Correct Answer
B. Reye's syndrome -
- 15.
Acetaminophen has a HUGE anti-inflammatory effect. True or false?
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
It has minimal anti-inflammatory effect.Rate this question:
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- 16.
Would you give a patient presenting with acute gout acetaminophen?
- A.
Yes, it will reduce the pain
- B.
No, it is not useful for acute gout
Correct Answer
B. No, it is not useful for acute gout -
- 17.
Does tylenol have minimal or severe GI effects?
- A.
Minimal GI effects
- B.
Severe GI effects
Correct Answer
A. Minimal GI effects -
- 18.
What should you watch for with tylenol?
- A.
Hepatotoxicity
- B.
Nephrotoxocity
Correct Answer
A. Hepatotoxicity -
- 19.
What is the specific antidote for acetaminophen?
- A.
Atropine
- B.
Vitamin K
- C.
Benadryl
- D.
Acetylcysteine
Correct Answer
D. AcetylcysteineExplanation
AKA mucomystRate this question:
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- 20.
What is the acetominophen toxic intermediate that is capable of necrotizing hepatocytes?
- A.
Organophosphate
- B.
NAPQ 1
- C.
3-methylindole
Correct Answer
B. NAPQ 1 -
- 21.
The following drugs are all COX 2 drugs. Which drug is COX 2 specific?
- A.
Celexocib ( celebrex)
- B.
Meloxicam (mobic)
- C.
Nabemutone (Relafen)
- D.
Edotolac (lodine)
Correct Answer
A. Celexocib ( celebrex) -
- 22.
Which of the following drugs are non selective COX acting drugs?
- A.
Ibuprofen
- B.
Naproxen
- C.
Ketorolax (toradol)
- D.
ASA
- E.
Meloxicam (mobic)
Correct Answer(s)
A. Ibuprofen
B. Naproxen
C. Ketorolax (toradol) -
- 23.
Ibuprofen, naproxen and ketorolax(toradol) are all non specific COX inhibitors. Of these three drugs which has has the MOST COX 1 selectivity and thus has the greatest rsik of GI erosion?
- A.
Ibuprofen
- B.
Naproxen
- C.
Ketorolac (toradol)
Correct Answer
C. Ketorolac (toradol) -
- 24.
Since ketorolac (toradol) has the greatest risk of GI erosion it should only be administered for ___ days.
- A.
1
- B.
2
- C.
3
- D.
4
- E.
5
Correct Answer
E. 5 -
- 25.
Which of the following increases the risk of GI erosion?
- A.
Duplicating and NSAID dose
- B.
Taking NSAIDS when you have a prior history of GI or cardiovascular disease
- C.
Taking an NSAID concurrently with an SSRI
- D.
Taking an NSAID for arthritis
- E.
Taking NSAIDS with steroids
Correct Answer(s)
A. Duplicating and NSAID dose
B. Taking NSAIDS when you have a prior history of GI or cardiovascular disease
C. Taking an NSAID concurrently with an SSRI
D. Taking an NSAID for arthritis
E. Taking NSAIDS with steroids -
- 26.
Are elderly patients at a higher risk of GI erosion from NSAIDS?
- A.
Yes
- B.
No
Correct Answer
A. Yes -
- 27.
It is better to take a low dose antiacid with an NSAID. True or false?
- A.
True, a low dose antiacid will decrease the risk of GI erosion
- B.
False, concurrent low dose antacid intake with an NSAID puts you at risk for GI erosion
Correct Answer
B. False, concurrent low dose antacid intake with an NSAID puts you at risk for GI erosion -
- 28.
What can you take to try and prevent GI erosion is you going to take an NSAID?
- A.
An ASA every morning.
- B.
Misoprostol (cytotec)
- C.
Omeprazole (prilosec)
- D.
Lasix (furosemide)
Correct Answer(s)
B. Misoprostol (cytotec)
C. Omeprazole (prilosec) -
- 29.
Taking misoprostol (cytotec) whilst taking an NSAID can prevent toxicity. What class does misoprostol belong to?
- A.
Proton pump inhibitor
- B.
Prostaglandin inhibitor
- C.
Diuretic
- D.
Anti hypertensive
Correct Answer
B. Prostaglandin inhibitor -
- 30.
Whereas misoprostol 9cytotec) is a prostaglandin analog, ____________ is a proton pump inhibitor.
- A.
Lasix (furosemide)
- B.
Protonix (pantoprazole)
- C.
Zantac (ranitidine)
Correct Answer
B. Protonix (pantoprazole)Explanation
drugs ending in prazole. Zantac is a histamine H2 receptor agonist not a PPI.Rate this question:
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- 31.
What is often the FIRST symptom of NSAID toxicity?
- A.
Mild GI bleed
- B.
Chronic GI bleed
- C.
Life threatening GI bleed
Correct Answer
C. Life threatening GI bleedExplanation
Most people are asymptomatic initiallyRate this question:
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- 32.
If you inhibit COX _____ you decrease renal perfusion via EFFERENT constriction.
- A.
1
- B.
2
Correct Answer
A. 1Explanation
This can lead to ARB and elevated BP as covered in part 1 of this quiz. This is worse when combined with ACEI-ARBs.Rate this question:
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- 33.
When renal perfusion is decreased, is ADH secretion upregulated or downregulated?
- A.
ADH secretion is upregulated
- B.
ADH secretion is downregulated
Correct Answer
A. ADH secretion is upregulated -
- 34.
Does ADH upregulation lead to fluid retention or fluid excretion
- A.
Fluid retention
- B.
Fluid excretion
Correct Answer
A. Fluid retention -
- 35.
Therefore giving a patient a COX 1 inhibitor, will decrease renal perfusion, increase ADH secretion and thus lead to which symptoms?
- A.
Edema
- B.
Polyuria
- C.
Hypertension
- D.
Hypotension
Correct Answer(s)
A. Edema
C. Hypertension -
- 36.
Inhibiting COX 1 leads to edema because of increased ADH. Inhibiting COX 2 also leads to edema. Is the mechanism exactly the same?
- A.
Yes, ADH is involved in both mechanisms
- B.
No, sodium retention causes edema in COX 2 inhibition
Correct Answer
B. No, sodium retention causes edema in COX 2 inhibition -
- 37.
In addition to edema, inhibiting COX 2 will also affect fluid and electrolyte balance. True or false?
- A.
True
- B.
False
Correct Answer
A. True -
- 38.
Analegesic nephropathy can also occur due to NSAID administration. True or false?
- A.
True
- B.
False
Correct Answer
A. True -
- 39.
Which patients are at risk for complications if they take NSAIDs?
- A.
A patient with hypertension
- B.
A patient who is 20 years old and has bursitis, and is dehydrated and diabetic
- C.
A patient with CHF
- D.
A patient with impaired kidney function
- E.
An old patient
Correct Answer(s)
A. A patient with hypertension
B. A patient who is 20 years old and has bursitis, and is dehydrated and diabetic
C. A patient with CHF
D. A patient with impaired kidney function
E. An old patientExplanation
HARDD - Htn, aged, renal impairement, dehydrated/diuresed. diabetic.)Rate this question:
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- 40.
Can you get headaches from taking NSAIDS?
- A.
Yes
- B.
No
Correct Answer
A. Yes -
- 41.
Which of the following is a CNS manifestation that you might observe in a patient with systemic lupus eythmatosus who is also taking NSAIDS?
- A.
Psychosis
- B.
Septic meningitis
- C.
Avascular necrosis
- D.
Aseptic meningitis
- E.
Subdural hematoma
Correct Answer
D. Aseptic meningitis -
- 42.
Celexocib (celebrex) should not be administered to a patient with ______ allergy.
- A.
Sulfonamide
- B.
Shell fish
- C.
Pottasium
- D.
Peanut
Correct Answer
A. Sulfonamide -
- 43.
Can ASA induce bronchospasm?
- A.
Yes
- B.
No
Correct Answer
A. Yes -
- 44.
Would you give an NSAID to a patient that has a history of ASA induced bronchospasm?
- A.
Yes
- B.
No
Correct Answer
B. No -
- 45.
COX 1 or COX 2?increased GI erosionDecreased renal perfusiondecreased platelet aggregation
- A.
COX 1
- B.
COX 2
Correct Answer
A. COX 1 -
- 46.
Do you see decreased renal perfusion with COX 1 or COX 2 or both?
- A.
COX 1 only
- B.
COX 2 only
- C.
Both COX 1 and COX 2
Correct Answer
C. Both COX 1 and COX 2 -
- 47.
What method is better for administering COX inhibitors?
- A.
High doses for the shortest amount of time
- B.
Low doses for the shortest amount of time
- C.
Low doses over a long time
Correct Answer
B. Low doses for the shortest amount of time -
- 48.
Which of the following should never take an NSAID?
- A.
Creatine clearance >60
- B.
Creatine clearance >30
- C.
Allergy to ASA
- D.
GI injury
- E.
At risk for thrombosis
Correct Answer
E. At risk for thrombosis -
- 49.
Which of the following are classes of drugs or drugs that NSAIDS seem to interfere with?
- A.
Lithium - cause decreased elimjination
- B.
Diuretics
- C.
Antihypertensives
- D.
All antipsychotics
Correct Answer(s)
A. Lithium - cause decreased elimjination
B. Diuretics
C. Antihypertensives -
- 50.
If a pateint has a GI risk which COX will you opt for. You will either give the COX inhibitor at the normal dose or with a PPI if you use a classic dose?
- A.
COX 1
- B.
COX 2
Correct Answer
B. COX 2 -
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