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