Drugs influencing metabolism Endocrine Drugs

1. Patient with diabetes mellitus experienced loss of consciousness and convulsions after an injection on insulin. What might be the result of biochemical blood analysis for concentration of sugar?

*A. 1.5 mmol/L

B. 10.0 mmol/L

C. 8.0 mmol/L

D. 3.3 mmol/L

E. 5.5 mmol/L

2. Patient with diabetes didn’t get insulin injection in time that caused hyperglycemic coma (glucose in blood 50 mmol/L). What mechanism is prevalent in the development of the coma?

*A. Hyperosmia

B. Acidosis

C. Hypoxia

D. Hyponatriemia

E. Hypokaliemia

3. A 56-year-old patient complaining of thirst and frequent urination was diagnosed with diabetes mellitus. Butamidum was prescribed. How does this drug act?

*A. It stimulates -cells of Langergans’ islets

B. It helps to absorb the glucose by the cells of the organism tissues

C. It inhibits -cells of Langergans’ islets

D. It inhibits the absorption of glucose in the intestines

E. It relieves transport of glucose through the cells’ membranes

4. Testosterone and it’s analogs increase the mass of skeletal muscles that allows to use them for treatment of dystrophy. Due to interaction of the hormone with what cell substance is this action caused?

*A. Nuclear receptors

B. Proteins-activators transcription

C. Ribosomes

D. Membrane receptors

E. Chromatin

5. A patient had been taking glucocorticoids for a long time. When the drug was withdrawn he developed the symptoms of disease aggravation, decreased blood pressure, and weakness. What is the reason of this condition?

*A. Appearance of adrenal insufficiency

B. Hyperproduction of ACTH

C. Sensibilization

D. Habituation

E. Cumulation

6. A patient with infectious mononucleosis had been taking glucocorticoiuds for two weeks. He was brought into remission, but he fell ill with acute attack of chronic tonsilitis. What action of glucocorticoids caused this complication?

*A. Immunosuppressive

B. Antiinflammatory

C. Antishock

D. Antiallergic

E. Antitoxic

7. Patient was on glucocorticoids for a long time, discontinuation of usage caused exacerbation of the illness, decreased BP, weakness. How can you explain it?

*A. Insufficiency of adrenal glands

B. Hyperproduction of ACTH

C. Adaptation to the drug

D. Sensitization

E. Cumulation

8. Testosterone and it’s analogs increase the mass of skeletal muscles that allows to use them for treatment of dystrophy. Due to interaction of the hormone with cell substance is this action caused?

*A. Nuclear receptors

B. Proteins-activators transcription

C. Ribosomes

D. Chromatin

E. Membrane receptors

9. Usage of oral contraceptives with sex hormones inhibits secretion of the hypophysiae hormones. Secretion of which of the indicated hormones is inhibited while using oral contraceptives with sex hormones?

*A. Follicle-stimulating

B. Thyrotropic

C. Somatotropic

D. Oxytocin

E. Vasopressin

10. Because of a long-term application of a drug such complications as osteoporosis, erosive ulcers of the mucous coat of stomach, edemas, increase of arterial pressure, insomnia have developed. Laboratory tests detected hypernatremia, hypokalemia, and hyperglycemia. What drug has been applied?

*A. Prednisolonum

B. Hypothiazidum

C. Digoxinum

D. Indometacinum

E. Reserpinum

11. Having a serious infection a patient needs an anabolic drug for the improvement of appetite. Which one?

*A. Retabolilum

B. Thiamini chloridum

C. Tinctura Absinthii

D. Heparinum

E. Acidi folicum

12. A medicine was prescribed for the treatment of arthritis. It has the following pharmacological characteristics: it increases the production of lipomoduline, reduces phospholipase A₂ activity, reduces the synthesis of arachidonic acid metabolism products (cyclic endoperoxides, prostaglandins). What drug is this?

*A. Prednisolonum

B. Adrenalini hydrochloridum

C. Isadrinum

D. Butadionum

E. Glibenclamidum

13. The patient in soporous condition is delivered to endocrinologic unit. The increasing sweating and small of acetone from a mouth are observed. The level of glucose in blood is 22,43 mmol/L. the diagnosis is heperglycemic coma. What hypoglycemic drug should be administered to patient?

*A. Insulin with short duration of action

B. Insulin with intermediate duration of action

C. Insulin with long duration of action

D. Drug from group of biguanides

E. Drug from group of sulfonilurea derivatives

14. The treatment of first type of diabetes mellitus foresees the imitation of basiс and of carbohydrate-induced secretion of insulin. What drug does imitate the carbohydrate-induced secretion of insulin?

*A. Suinsulin

B. Zinc-insulin

C. Glibenclamide

D. Metphormine

E. Glybutide

15. The patient with asthmatic status is delivered to urgent unit. The patient is suffering from bronchial asthma during 12 years. Earlier attacks were reduced by salbutamol but now this drug is ineffective. What drug should be administered to patient first of all?

*A. Prednisolon

B. Acyclovir

C. Oxytocin

D. Famotidine

E. Bisacodyl

16. The deficacy of birth activity has developed at the woman during delivery. What drug should be administered to woman for restoration of contractive activity of myometrium?

*A. Oxytocin

B. Dimedrolum

C. Unithiolum

D. Aminazine

E. Dithylinum

17. The woman with acute glomerulonephritis is delivered to nephrology unit. What drug should be prescribed to her?

*A. Prednisolon

B. Prazosin

C. Spirituous solution of iodine

D. Phenazepam

E. Bisacodyl

18. To prevent the transplant rejection after organ transplantation it is required to administer hormonotherapy for the purpose of immunosupression. What hormones are used for this purpose?

*A. Glucocorticoids

B. Mineralocorticoids

C. Sexual hormones

D. Thyroid hormones

E. Catecholamines

19. Continuous use of a certain drug may cause osteoporosis, erosions of stomach mucosa, hypokaliemia, retention of sodium and water in the organism, decreased concentration of corticotropin in blood. What drug is it?

*A. Prednisolone

B. Hypothiazide

C. Reserpine

D. Digoxin

E. Indometacin

20. An elderly female patient suffers from the type 2 diabetes mellitus accompanied by obesity, atherosclerosis, coronary artery disease. Basal hyperinsulinemia is also present. What treatment would be the most appropriate?

*A. Glibenclamide

B. Retabolil

C. Lovastatin

D. Insulin

E. Amlodipine

21. Woman with bronchial asthma was used prednisolone in tablets during two months. Owing to significant improving of condition, she suddenly stops drug intake. Which complication is possible in this case?

*A. Withdrawal syndrome

B. Cushing's syndrome

C. Obesity

D. Hypotension

E. Stomach bleeding

22. Patient with rheumatoid arthritis is using prednisolone during long time. Why he should to avoid the contacts with infectious patients?

*A. Owing to development of secondary immunodeficiency

B. Owing to blockage of interferon synthesis

C. Owing to ability of thrombosis

D. Owing to development of lymphopenia

E. Owing to possibility of arthritis aggravation

23. In experiment, hydrocortisone (intramuscularly, in dose 1g/1kg) was administered to rats. The development of stomach ulcers was observed after 10 injections. What is mechanism of ulceration?

*A. Ischemia of the stomach mucosa

B. Decrease of gastrin secretion

C. Hypersecretion of mucus

D. Embolism of vessels

E. Hyperacidity

24. Sugar in the urine was not found in examination of patient with diabetes mellitus. What is tactics of physician for this patient?

*A. Don’t prescribe antidiabetic therapy and use of carbohydrate diet

B. Prescribe insulin

C. Prescribe insulin and glibenclamide

D. Prescribe glibenclamide

E. Without any remedial measures

25. Patient suffers from insulin-dependent diabetes mellitus. Endocrinologist prescribes to him insulin and recommends to avoid of stress because increase of adrenaline level in stress is accompanied by elevation of glucose level from glycogen in skeletal muscles. Which link of the regulation of glycogenolysis by adrenaline is affected by insulin?

*A. Activation of adenylyl cyclase

B. Synthesis of cAMP

C. Stimulation of phosphodiesterase

D. Inhibition of protein phosphatase

E. Activation of protein kinase

26. A patient is in unconsciousness with the smell of acetone from the mouth. The doctor has diagnosed of diabetic coma. Which drug should be administered to patient for interruption of coma?

*A. Insulin

B. Chlorpropamide

C. Butformin

D. Glipizide

E. Acarbose

27. The patient on the third day after thyroidectomy having seizures. Which drug should be prescribed to him?

*A. Calcium chloride

B. Potassium chloride

C. Neuroleptics

D. Potassium bromide

E. Phenobarbital

28. An excessive granulations have developed in patient with chronic inflammatory processes of the skin. Specify the hormonal drug which should be used in treatment of this patient.

*A. Glucocorticoids

B. Insulin

C. Thyroxine

D. Somatotropin

E. Mineralocorticoids

29. Hormonal therapy is compulsory for suppression of autoimmune reactions after organ transplantation. Which hormones are used for this aim?

*A. Glucocorticoids

B. Mineralocorticoids

C. Adrenaline

D. Somatotropin

E. Sex hormones

30. Glucocorticoids are widely used in modern clinical practice. Specify effect which is achieved only with administration of high doses of glucocorticoids.

*A. Inhibition of adrenocorticotropin secretion

B. Suppression of inflammation

C. Support of normal vessels tone

D. Increase of water excretion

E. Increase of sodium excretion

31. A significant increase of diuresis is developed in 50-old-eyars woman after infective disease of brain. The glucose blood level is 4.1 mmol/L. Doctor diagnosed the lack of endocrine function. What hormone deficiency is most likely?

*A. Vasopressin

B. Insulin

C. Aldosterone

D. Glucagon

E. Cortisone

32. Massive glucocorticoids therapy in patient with rheumatism results in hyperuricemia. Indicate metabolic process owing to change in which hyperuricemia is released.

*A. Intensive degradation of purine nucleotides

B. Activation of gluconeogenesis

C. Intensive catabolism of proteins

D. Intensive catabolism of pyrimidine nucleotides

E. Intensive lipolysis

33. A patient is admitted to the hospital with the diagnosis of lobar pneumonia. Doctor prescribes to him injections of benzylpenicillin. An injection of antibiotic results to development of anaphylactic shock in patient. Choose the hormonal rug which should be administered for rescue emergency care:

*A. Prednisolone hemisuccinate

B. Adrenaline

C. Euphillinum

D. Calcium chloride

E. Dimedrolum

34. A doctor recommended the iodine-containing drugs to liquidators, the victims of the Chernobyl nuclear power plant. What is aim of this recommendation?

*A. Replacement of radioactive iodine by non-radioactive iodine

B. Compensation of iodine deficiency in organism

C. Compensation of iodine deficiency in thyroid gland

D. Preventive saturation of thyroid gland with non-radioactive iodine

E. Increase of iodine's storage in organism

35. Long-term use of drug A. can causes osteoporosis, erosions of the gastric mucosa, hypokalemia, sodium and water retention in the body, reducing the content of corticotropin in the blood. Identify the product.

*A. Prednisolone

B. Reserpine

C. Hydrochlorthiazide

D. Digoxin

E. Indomethacin

36. The woman has been a habitual miscarriage. Identify drug which should be prescribed to woman for saving of pregnancy.

*A. Progesterone

B. Methandrostenolone

C. Testosterone

D. Estrone

E. Hydrocortisone

37. Explain why corticotropin is administered in the morning?

*A. According to natural rhythm of hormone’s synthesis

B. For compensation of decrease of glucose level after sleep

C. For maintenance of necessary hormone’s concentration during day

D. Drug doesn’t cause ulceration of stomach in morning

E. Drug doesn’t influence upon sleep structure

38. 63-year-old woman suffers from diabetes mellitus. Endocrinologist prescribes to her butamide. What is mechanism of butamide’s action?

*A. Activation of beta-cells of pancreatic islet

B. Increase of glucose degradation

C. Drug directly provides the transport of glucose into the cells

D. Drug increases the degradation of proteins

E. Drug stimulates the hypothalamus

39. A doctor prescribed to 60-year-old woman after mastectomy synthetic drug which reduced simulative influence of estrogens upon tumor growth. Identify this drug.

*A. Tamoxifen

B. Fosfestrol

C. Rubomycinum

D. Diethystilbestrol

E. Cisplatin

40. A doctor prescribed butadionum to patient with diabetes mellitus who treated with butamide. After butadionum intake, the hypoglycemia is developed in this patient. What is cause of this complication?

*A. Butadionum replaces butamide from the binding with plasma proteins

B. Increase of biotransformation of butamide

C. Increase of butamide excretion

D. Competition of drugs for connection with receptors

E. Pharmaceutical incompatibility of drugs

41. 60-year-old patient with diabetes mellitus receives insulin-semilente for correction of hyperglycemia. 10 days ago he began treatment of hypertensive disease. In hour after reception of hypotensive drug patient felt weakness, dizziness, the decrease of blood pressure, and in few minutes later the patient lost consciousness. Identify pathological state which is developed.

*A. Hypoglycemic coma

B. Acute disturbance of cerebral circulation

C. Cardiogenic schlock

D. Hyperglycemic coma

E. All answers are incorrect

42. Hyperglycemic coma develops in patient with diabetes mellitus. Glucose concentration in the blood is 18.44 mmol/L. Which drug should be administered to patient?

*A. Insulin with short action

B. Biguanide derivative

C. Insulin with intermediate duration of action

D. Insulin with long action

E. Sulfonylurea derivative

43. Merzcolilum (methimazole) is prescribed to patient with thyrotoxicosis. What is mechanism of drug action?

*A. Mercazolilum decreases the synthesis of thyroxine in thyroid gland

B. Mercazolilun suppresses the activity of thyrotropin

C. Mercazolilum blocks the incorporation of iodine in hormones molecules

D. Mercazolilum destroys the tissue of thyroid gland

E. Mercazolilum blocks the release of hormones by thyroid gland

44. Iodine-containing drug is prescribed to patient with initial stage of hyperthyroidism. Which effect is the basis of antithyroid action of this drug?

*A. Inhibition of thyrotropin-releasing hormone secretion by hypothalamus

B. Inhibition of thyrotropin secretion by pituitary

C. Inhibition of enzymes synthesizing thyroid hormones

D. Blockage of iodine incorporation in the structure of hormones

E. Destruction of tissue of thyroid gland

45. Hypoglycemic drug A. was prescribed to patient with diabetes mellitus. In several weeks of treatment, the glucose level in blood is decreased. But lactic acidosis develops in patient. Identify the group of hypoglycemic drugs for which this complication is most typical.

*A. Biguanides

B. Insulins with short action

C. Combined insulins

D. Insulins of long duration of action

E. Sulfonylurea derivatives

46. Patient with infectious mononucleosis took glucocorticoids during 2 weeks. Owing this treatment, the remission of infectious mononucleosis is developed in patient. But aggravation of chronic tonsillitis also arises in him. What is cause of this complication?

*A. Immunosuppressive effect of glucocorticoids

B. Anti-shock effect of glucocorticoids

C. Antiinflammatory effect of glucocorticoids

D. Antiallergic effect of glucocorticoids

E. antioxidant effect of glucocorticoids

47. The increased glucose blood concentration is revealed in patient with neurodermatitis which is using dexamethazone during long time. Identify the metabolic effect of glucocorticoids which is resulting in this complication.

*A. Activation of gluconeogenesis

B. Increase of glucose absorption in intestine

C. Inhibition of glycogen synthesis

D. Increase of insulin degradation

E. Activation of glycogen synthesis

48. Patient uses prednisolone in tablets for treatment with bronchial asthma. Doctor recommends to him to replace prednisolone by dexamethazone. In how many times should be less dose of dexamethazone in comparison with prednisolone?

*A. In 7 times

B. In 20 times

C. In 2 times

D. In 50 times

E. In 4 times

49. In 43-year-old patient the glucose is determined in urine the first time. Which drug should be prescribed to him?

*A. Butamide

B. Vasopressin

C. Oxytocin

D. Allopurinol

E. Saccharose

50. 38-year-old woman went to the Cancer Center with tumor of the breast. After mastectomy doctor prescribes to woman antitumoral hormonal drug. Identify this drug.

*A. Testosterone

B. Myelosanum

C. Sarcolysinum

D. Progesterone

E. Fosfeestrol

51. Doctor administers prednisolone for increase of blood pressure in patient with acute vessels insufficiency. Why glucocorticoids increase blood presse?

*A. Glucocorticoids increase sensitivity of adrenergic receptors to catecholamines

B. Glucocorticoids cause retention of water in organism

C. Glucocorticoids directly stimulate alpha-adrenergic receptors of vessels

D. Glucocorticoids decrease the sensitivity of cholinoreceptors to acetylcholine

E. Glucocorticoids cause redistribution of blood in organism

52. Doctor prescribes finasteride (Proscar) to patient with benign hyperplasy of the prostate. What is mechanism of antiandrogenic action of this drug?

*A. Inhibition of enzyme 5alpha-reductase which promote the transformation of testosterone into the dihydrotestosterone

B. Inhibition of androgens synthesis

C. Inhibition of androgens secretion

D. Inhibition of gonadotropin synthesis

E. Blockage of androgenic receptors

53. 65-year-old woman has applied to orthopedic department with complaints of pain in left leg. Medical examination has found the symptoms of osteoporosis and aseptic necrosis of femoral head. Which drug should be prescribed to treatment of this woman?

*A. Calcitonin

B. Methionine

C. Ergocalciferol

D. Calcium gluconate

E. Cyanocobalamine

54. 60-year-old patient is suffering from diabetes mellitus and receiving insulin-semilente for correction of hyperglycemia. 10 days ago he began treatment of hypertensive disease with certain drug. In a hour after drug’s intake, the hypoglycemic coma is developed in patient. Which of the following drug can cause this complication?

*A. Anaprilinum

B. Prazosin

C. Verapamil

D. Captopril

E. Nifedipine

55. 60-year-old patient is suffering from diabetes mellitus and receiving insulin-semilente for correction of hyperglycemia. 10 days ago he began treatment of hypertensive disease with anaprilinum. In a hour after drug’s intake, the hypoglycemic coma is developed in patient. What is mechanism of development of this complication?

*A. Inhibition of glycogenolysis

B. Decrease of glucagon release

C. Increase of half-life of insulin-semilente

D. Decrease of glucose absorption

E. Increase of bioavailability of insulin-semilente

56. 60-year-old patient is suffering from diabetes mellitus and receiving insulin-semilente for correction of hyperglycemia. 10 days ago he began treatment of hypertensive disease with anaprilinum. In a hour after drug’s intake, the patient felt weakness, dizziness, drop of blood pressure. The patient lost consciousness in several minutes. Which pathological condition is developed in patient?

*A. Hypoglycemic coma

B. Hyperglycemic coma

C. Cardiogenic shock

D. Acute disturbance of cerebral blood flow

E. Acute vessels insufficiency

57. 60-year-old patient is suffering from diabetes mellitus and receiving insulin-semilente for correction of hyperglycemia. 10 days ago he began treatment of hypertensive disease with anaprilinum. In a hour after drug’s intake, the patient felt weakness, dizziness, drop of blood pressure. The patient lost consciousness in several minutes. Which drug should be administered to patient for primary care?

*A. Glucose

B. Insulin

C. Noradrenaline

D. Sodium hydrocarbonate

E. Bemegride

58. Woman who during time is treated from chronic polyarthritis complains of increase of blood pressure, redistribution of fat, menstrual disturbances. Choose drug which is used by woman.

*A. Prednisolone

B. Indomethacin

C. Butadionum

D. Synaphlanum

E. Beclomethasone

59. Patient with recurrent allergic dermatitis needs in the appointment of the glucocorticoid. Choose drug which has local influence upon the skin without systemic side effects.

*A. Synaphlanum

B. Prednisolone

C. Hydrocortisone

D. Dexamethazone

E. Triamcinolone

60. Hypoglycemic coma is developed in patient owing to overdose of insulin. Which drug should be administered to its elimination?

*A. Glucose

B. Insulin-lente

C. Prednisolone

D. Glucagon

E. Tolbutamide

61. 60-year-old woman during long time uses dexamethazone for treatment of arthritis. What is mechanism of antiinflammatory effect of this drug?

*A. Blockage of phospholipase A₂

B. Blockage of cyclooxygenase-1

C. Blockage of cyclooxygenase-2

D. Blockage of folate synthetase

E. Blockage of folate reductase

62. 9-year-old child with multiple caries receives calcitonin. Which therapeutic effect of drug is used in this case?

*A. Activation of osteoblasts

B. Inhibition of glycolysis

C. Decrease of glucose concentration on oral cavity

D. Increase of fluor concentration in oral cavity

E. Increase of pH of saliva

63. Patient with diabetes mellitus receives injections of thiamine for correction of metabolic acidosis. What is mechanism of therapeutic action of vitamin B1 in this case?

*A. Activation of dehydrogenases of the Krebs cycle

B. Activation of adenylyl cyclase

C. Blockage of phosphodiesterase

D. Increase of acetylcholine synthesis

E. Increase of adrenaline synthesis

64. Owing to sudden cessation of glucocorticoid intake, the following complications develop in patient: aggravation of rheumatoid arthritis, decrease of blood pressure, and weakness. What is case of these complications?

*A. Insufficiency of adrenal cortex

B. Development of tolerance

C. Sensibilization

D. Hypersecretion of adrenocorticotropin

E. Cumulation

65. 25-year-old pregnant woman is admitted to the department of pathology of pregnancy with threatened abortion. Which drug should be prescribed to woman?

*A. Progesteron

B. Folliculin

C. Retabolilum

D. Estradiol

E. Synoestrolum

66. A patient after subtotal resection of thyroid gland receives drug of substitute therapy. Whot is name of this drug?

*A. Thyroxine

B. Potassium iodide

C. Mercazolilum

D. Antistrumin

E. Potassium perchlorate

67. 65-year-old patient with non-insulin-dependent diabetes mellitus receives glibenclamide perorally. What is mechanism of action of glibenclamide?

*A. Drug stimulates the release of insulin by beta-cells of pancreas

B. Drug inhibits the gluconeogenesis in liver

C. Drug increase the utilization of glucose by peripheral tissues

D. Drug suppresses the absorption of glucose in intestine

E. Drug inhibits the degradation of polysaccharides

68. Pituitrin was administered to woman with weak labors. Indicate hormones which are contained in this drug?

*A. Oxytocin and vasopressin

B. Oxytocin and estradiol

C. Oxytocin and progesterone

D. Vasopressin and estradiol

E. Vasopressin and progesterone

69. 47-year-old patient with thyrotoxicosis receives drug which inhibits the synthesis of thyroid hormones in thyroid gland. Choose this drug.

*A. Mercazolilum

B. Diiodothyrosine

C. Potassium iodide

D. Thyroidin

E. Radioactive iodine

70. A 45-year-old patient complains of constant thirst, marked polyuria. The glucose level in plasma 5 mmol/L. Glucose is not in urine. Which drug should be prescribed to treatment of this patient?

*A. Adiurecrinum

B. Insulin

C. Desoxycorticosterone

D. Hydrocortisone

E. Prednisolone