Pharm 33 Flashcards

What is the primary function of ferrous sulfate in the body?

A) Supports heme synthesis

B) Stimulates platelet production

C) Increases neutrophil survival

D) Inhibits iron absorption

Iron is required to produce which heme-containing proteins?

A) Albumin and transferrin

B) Collagen and elastin

C) Hemoglobin and myoglobin

D) Insulin and glucagon

Which route is commonly used to administer ferrous sulfate?

A) Intrathecal

B) Oral

C) Intramuscular

D) Inhalational

Which gastrointestinal complication can result from acute iron overdose?

A) Chronic gastritis

B) Intestinal obstruction

C) Necrotizing gastroenteritis

D) Pancreatic insufficiency

Chronic iron overload can result in which condition?

A) Aplastic anemia

B) Pernicious anemia

C) Hemochromatosis D

) Megaloblastic anemia

What is the mechanism of action of deferoxamine?

A) Chelates excess iron

B) Increases iron absorption

C) Stimulates heme synthesis

D) Activates erythropoietin receptors

Deferoxamine is used to treat which conditions?

A) Iron deficiency and neutropenia

B) Vitamin B12 and folate deficiencies

C) Acute and chronic iron overload

D) Anemia and thrombocytopenia

Rapid intravenous administration of deferoxamine may cause which complication?

A) Hypertension

B) Thrombocytosis

C) Hypercalcemia

D) Hypotension

Which complications are associated with long-term deferoxamine therapy?

A) Neurotoxicity and increased infection susceptibility

B) Hyperglycemia and thrombocytosis

C) Hypertension and polycythemia

D) Neutrophilia and hypercalcemia

Which iron chelator is administered orally for iron overload?

A) Deferoxamine

B) Deferasirox

C) Epoetin alfa

D) Filgrastim

Which vitamin is available as cyanocobalamin and hydroxocobalamin?

A) Vitamin B9

B) Vitamin B12

C) Vitamin B6

D) Vitamin B1

Vitamin B12 participates in reactions that regenerate which folate compound?

A) Tetrahydrofolate

B) Dihydrofolate

C) Folic acid

D) Methotrexate

Vitamin B12 is required to convert homocysteine into which amino acid?

A) Cysteine

B) Methionine

C) Glycine

D) Serine

Vitamin B12 is required for metabolism of which compound?

A) Acetyl-CoA

B) Succinyl-CoA

C) Malonyl-CoA

D) L-methylmalonyl-CoA

Which form of vitamin B12 is also used as an antidote for cyanide poisoning?

A) Cyanocobalamin

B) Methylcobalamin

C) Adenosylcobalamin

D) Hydroxocobalamin

Which route of vitamin B12 administration is required according to the notes for pernicious anemia?

A) Oral

B) Sublingual

C) Topical

D) Parenteral

What is another name for folic acid?

A) Cyanocobalamin

B) Pyridoxine

C) Pteroylglutamic acid

D) Riboflavin

Folic acid serves as a precursor for compounds that transfer which chemical groups?

A) Phosphate groups

B) Sulfate groups

C) One-carbon groups

D) Acetyl groups

Folate is required for synthesis of which DNA components?

A) Cholesterol and fatty acids

B) Hemoglobin and myoglobin

C) Collagen and elastin

D) Purines and thymidylate

Folic acid supplementation during pregnancy helps prevent which congenital abnormalities?

A) Congenital heart block

B) Cleft palate exclusively

C) Renal agenesis

D) Neural tube defects

Why can excessive folic acid supplementation be problematic in unrecognized vitamin B12 deficiency?

A) Causes acute renal failure

B) Prevents iron absorption

C) Masks anemia without correcting neurological injury

D) Directly destroys spinal neurons

What is the mechanism of action of epoetin alfa?

A) Inhibits iron absorption

B) Activates thrombopoietin receptors

C) Inhibits tyrosine kinase activity

D) Activates erythropoietin receptors

Epoetin alfa primarily stimulates which bone marrow cells?

A) Mature lymphocytes

B) Erythroid progenitors

C) Mature platelets

D) Plasma cells

What effect does epoetin alfa have on erythroid progenitor cells?

A) Inhibits maturation

B) Promotes apoptosis

C) Reduces differentiation

D) Stimulates proliferation and differentiation

Epoetin alfa stimulates the release of which cells from bone marrow?

A) Myeloblasts

B) Reticulocytes

C) Megakaryocytes

D) Lymphoblasts

Which condition commonly requires epoetin alfa therapy due to reduced erythropoietin production?

A) Chronic liver disease

B) Chronic renal failure

C) Acute pancreatitis

D) Hyperthyroidism

Besides chronic renal failure, epoetin alfa may be used for anemia associated with which conditions?

A) HIV, cancer, and prematurity

B) Asthma, hypertension, and diabetes

C) Migraine, epilepsy, and arthritis

D) Hyperthyroidism, gout, and obesity

Why may epoetin alfa be administered before certain elective surgeries?

A) Prevent postoperative infections

B) Reduce platelet destruction

C) Reduce the need for transfusion

D) Prevent surgical thrombosis

Which adverse effects are associated with epoetin alfa?

A) Hypertension and thrombosis

B) Hypotension and bleeding

C) Neutropenia and neuropathy

D) Hypocalcemia and diarrhea

Which rare hematologic complication can result from epoetin alfa therapy?

A) Hemolytic anemia

B) Pure red cell aplasia

C) Essential thrombocythemia

D) Chronic myeloid leukemia

Which medication is a recombinant granulocyte colony-stimulating factor?

A) Oprelvekin

B) Romiplostim

C) Epoetin alfa

D) Filgrastim

Filgrastim primarily stimulates production of which blood cells?

A) Erythrocytes

B) Neutrophils

C) Platelets

D) B lymphocytes

Filgrastim stimulates neutrophil production by promoting which processes?

A) Proliferation and differentiation

B) Apoptosis and destruction

C) Sequestration and degradation

D) Aggregation and clotting

What effect does filgrastim have on mature neutrophils?

A) Increases phagocytosis and survival

B) Inhibits phagocytic activity

C) Accelerates neutrophil apoptosis

D) Prevents neutrophil activation

Filgrastim can be used to prevent neutropenia following which treatment?

A) Vitamin supplementation

B) Iron chelation

C) Antihypertensive therapy

D) Cytotoxic chemotherapy

Which additional disorders may be treated with filgrastim?

A) Polycythemia and thrombocytosis

B) Sickle cell trait and hemophilia

C) Pernicious anemia and hemochromatosis

D) Congenital and cyclic neutropenia

Why is filgrastim administered before certain stem cell transplants? A) Stimulates platelet destruction B) Prevents iron absorption C) Mobilizes hematopoietic stem cells D) Inhibits erythrocyte formation

Which adverse effects are associated with filgrastim?

A) Hypertension and pulmonary edema

B) Bone pain and splenic rupture

C) Myelosuppression and neuropathy

D) Severe iron overload

Oprelvekin is a recombinant form of which cytokine?

A) IL-11

B) IL-2

C) IL-5

D) IL-6

Which blood cell progenitors are stimulated by oprelvekin?

A) Erythroid progenitors

B) Lymphoid progenitors

C) Monocyte progenitors

D) Megakaryocyte progenitors

Oprelvekin increases circulating levels of which blood cells?

A) Erythrocytes and basophils

B) Platelets and neutrophils

C) Lymphocytes and eosinophils

D) Monocytes and erythrocytes

Oprelvekin is used to prevent which complication of chemotherapy for nonmyeloid cancers?

A) Hemolytic anemia

B) Iron overload

C) Thrombocytopenia

D) Vitamin B12 deficiency

Which cardiovascular complications are associated with oprelvekin?

A) Severe bradycardia and hypotension

B) Pulmonary fluid accumulation and atrial arrhythmias

C) Coronary artery dissection

D) Permanent ventricular fibrillation

Which medications are included among megakaryocyte growth factor therapies?

A) Epoetin, filgrastim, deferoxamine

B) Cyanocobalamin, folate, ferrous sulfate

C) Fostamatinib, deferasirox, hydroxocobalamin

D) Romiplostim, eltrombopag, avatrombopag

What type of medication is fostamatinib?

A) Iron chelator

B) Oral tyrosine kinase inhibitor

C) Erythropoietin receptor agonist

D) Recombinant interleukin

Fostamatinib decreases signaling through which receptors?

A) Erythropoietin and insulin receptors

B) G-CSF and IL-11 receptors

C) Fc and B-cell receptors

D) Adrenergic and histamine receptors

What is the main effect of fostamatinib on platelet survival?

A) Increases antibody-mediated platelet destruction

B) Inhibits platelet production

C) Increases platelet aggregation

D) Decreases antibody-mediated platelet destruction

Which two endogenous factors regulate platelet production?

A) Erythropoietin and IL-6

B) Thrombopoietin and IL-11

C) G-CSF and IL-5

D) GM-CSF and IL-2

Which drugs act as thrombopoietin receptor agonists?

A) Epoetin and darbepoetin

B) Filgrastim and sargramostim

C) Deferoxamine and deferasirox

D) Romiplostim and eltrombopag

Romiplostim and eltrombopag are indicated for which hematological condition?

A) Chronic neutropenia

B) Aplastic anemia

C) Chronic immune thrombocytopenia

D) Acute myeloid leukemia

Which major organ toxicity is associated with eltrombopag?

A) Nephrotoxicity

B) Cardiotoxicity

C) Hepatotoxicity

D) Pulmonary toxicity

According to the notes, romiplostim can be associated with progression to which malignancy?

A) Chronic lymphocytic leukemia

B) Acute myeloid leukemia

C) Follicular lymphoma

D) Multiple myeloma

Sargramostim is a recombinant form of which growth factor?

A) G-CSF

B) Erythropoietin

C) Thrombopoietin

D) GM-CSF

Which intracellular signaling pathway is activated by filgrastim?

A) JAK/STAT pathway

B) Wnt signaling pathway

C) Hedgehog signaling pathway

D) TGF-beta signaling pathway

G-CSF and GM-CSF may be used as supportive therapy in patients with which leukemia?

A) Chronic lymphocytic leukemia

B) Acute myeloid leukemia

C) Hairy cell leukemia

D) Chronic myeloid leukemia

Which drug may be added when G-CSF alone inadequately mobilizes hematopoietic stem cells?

A) Oprelvekin

B) Plerixafor

C) Epoetin alfa

D) Fostamatinib

What is the mechanism of action of plerixafor?

A) Inhibits CXCR4

B) Activates G-CSF receptors

C) Inhibits JAK2

D) Activates erythropoietin receptors

Which fluid accumulation complications can occur with G-CSF therapy?

A) Ascites and hydrocele

B) Cerebral and retinal edema

C) Pulmonary and renal cysts

D) Pleural and pericardial effusions

Which complication explains fluid leakage during G-CSF therapy?

A) Nephrotic syndrome

B) Portal hypertension

C) Venous thrombosis

D) Capillary leak syndrome

Which two medications are recombinant erythropoietin-stimulating agents?

A) Epoetin and darbepoetin

B) Filgrastim and sargramostim

C) Romiplostim and eltrombopag

D) Deferoxamine and deferiprone

Which signaling pathway is activated by erythropoietin receptors?

A) Hedgehog pathway

B) Wnt pathway

C) JAK/STAT pathway

D) NF-kappaB pathway

Which nutrients should be supplemented during erythropoietin therapy according to the notes?

A) Iron and folate

B) Calcium and magnesium

C) Zinc and copper

D) Sodium and potassium

Which enzyme reduces folic acid to dihydrofolic acid?

A) Thymidylate synthase

B) Methionine synthase

C) Ribonucleotide reductase

D) Dihydrofolate reductase

Where is dietary folic acid primarily absorbed?

A) Terminal ileum

B) Proximal ileum

C) Proximal jejunum

D) Distal jejunum

Folate is an important cofactor for which enzyme involved in DNA synthesis?

A) Methionine sulfoxide reductase

B) Thymidylate synthase

C) Pyruvate dehydrogenase

D) Glucose-6-phosphate dehydrogenase

Which diagnostic test historically evaluates vitamin B12 absorption using radiolabeled B12?

A) Osmotic fragility test

B) Direct Coombs test

C) Ham test

D) Schilling test

Which adverse effects are commonly associated with oral iron therapy?

A) Nausea, cramps, constipation, diarrhea

B) Neuropathy, ataxia, seizures, tremors

C) Thrombosis, hypertension, splenic rupture

D) Rash, alopecia, hearing loss

Which combination includes oral iron preparations?

A) Iron dextran and iron sucrose

B) Ferrous sulfate, gluconate, and fumarate

C) Sodium ferric gluconate and sucrose

D) Deferoxamine, deferasirox, and deferiprone

Which combination includes parenteral iron preparations?

A) Ferrous sulfate and ferrous fumarate

B) Ferrous gluconate and ferrous sulfate

C) Deferoxamine and deferasirox

D) Iron dextran, ferric gluconate, iron sucrose

Which additional iron chelator can be used for chronic iron overload?

A) Deferiprone

B) Epoetin alfa

C) Sargramostim

D) Romiplostim

Which gastrointestinal symptoms can occur during acute iron poisoning?

A) Constipation and bloating

B) Dysphagia and reflux

C) Steatorrhea and jaundice

D) Abdominal pain and bloody diarrhea

Which severe systemic complications can occur following acute iron overdose?

A) Hypertension and seizures

B) Shock and dyspnea

C) Thrombocytosis and polycythemia

D) Hypercalcemia and tetany

Which organs are commonly damaged by chronic iron overload?

A) Heart, liver, and pancreas

B) Brain, spleen, and thyroid

C) Lungs, kidneys, and bladder

D) Stomach, colon, and skin

Increased erythropoiesis produces which pattern of transferrin and hepcidin levels?

A) Both increase

B) Both decrease

C) Increased transferrin, decreased hepcidin

D) Decreased transferrin, increased hepcidin

Where is vitamin B12 predominantly absorbed?

A) Proximal jejunum

B) Duodenum

C) Ascending colon

D) Distal ileum

Which form of iron is absorbed through the DMT1 transporter?

A) Ferrous iron (Fe2+)

B) Ferric iron (Fe3+)

C) Elemental iron (Fe0)

D) Ferryl iron (Fe4+)

Which enzyme oxidizes ferrous iron to ferric iron for transferrin binding?

A) Ferrireductase

B) Dihydrofolate reductase

C) Hephaestin

D) Ferroportin

Which form of iron binds transferrin for transport in the bloodstream?

A) Ferrous iron (Fe2+)

B) Elemental iron (Fe0)

C) Ferryl iron (Fe4+)

D) Ferric iron (Fe3+)

Filgrastim can be used for neutropenia associated with which marrow disorders?

A) Polycythemia and thrombocytosis

B) Myelodysplasia and aplastic anemia

C) Hemochromatosis and thalassemia

D) Spherocytosis and sickle cell disease

Why are G-CSF and GM-CSF used in preparation for stem cell transplantation?

A) Mobilize peripheral blood progenitor cells

B) Prevent erythrocyte destruction

C) Increase platelet aggregation

D) Suppress lymphocyte proliferation

Which constitutional adverse effects can occur with oprelvekin?

A) Hearing loss and tinnitus

B) Muscle rigidity and tremors

C) Fatigue and dizziness

D) Photosensitivity and tooth discoloration

Which hematologic adverse effect can occur during oprelvekin therapy?

A) Polycythemia

B) Neutrophilia

C) Thrombocytosis

D) Anemia