Airway disease is a bread-and-butter issue for a physician of the 21st century.  So a good grasp on the mechanism, and side effectsm of common drugs are vital. Good luck! 

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Introduction to the Pharmacology of Airway Disease

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Question 1
In atopic asthma, mast cell activation occurs in the
A
Immediate phase
B
Late phase
C
Chronic phase
D
Subacute phase
Question 2
Administration of beclomethasone (inhaled) would be most prudent in
A
Immediate phase
B
Late phase
C
Both immediate and late phase
D
Neither phases above
Question 3
On auscultation, the patient appears to have lung field wheeze.  Which type of immune cell will be unregulated uniquely in the phase at which this sign presents?
A
Monocyte
B
B lymphocyte
C
Eosinophil
D
Antigen presenting cell
Question 4
Which of the following drugs have a cellular target as a particular granulocyte?
A
Terbutaline
B
Zafirlukast
C
Methyxanthine
D
Hydrocortisone
Question 5
Matrix metallopeptidases are released by white cells in response to nicotinic upregulation of which class of inflammatory mediating cell?
A
Neutrophils
B
Mast cells
C
Eosinophils
D
Basophils
Question 6
Which of the following is not a mechanism of a bronchodilator medication?
A
Downregulation of adenylate cyclase
B
Inhibition of various leukocyte inflammatory events
C
Calcium sequestration into the sacroplasmic reticulum
D
Reduction of phospholipase C utilisation
Question 6 Explanation: 
The correct answer is listed above, this is the mechanism of glucocorticoids which are anti-inflammatory but not directly bronchodilators.
Question 7
A 10 year old patient, on long-term medication for her asthma, presents complaining of xerostomia.  Which medication is the patient most likely taking?
A
Tiotropium
B
Salmeterol
C
Zafirlukast
D
Theophylline
Question 7 Explanation: 
Muscarinic blockade causes dry mouth.
Question 8
What is the shared cellular target of ipratropium bromide and terbutaline?
A
Bronchial epithelium
B
Cardiomyocytes
C
Bronchial smooth muscle cells
D
Bronchial eosinophils
Question 9
What is the similar mechanism of theophylline and salmeterol?
A
Both up regulate adenylate cyclase
B
Both can act selectively on adrenoreceptors
C
Both recruit monocytes
D
Both maintain high intracellular cAMP levels
Question 10
Which of the following statements are false in regards to aminophylline?
A
its administration is contraindicated in a patient with history of absence seizure
B
A patient with history of fast AF would be cautioned against use
C
It can be administered as PO only
D
It is a compettiive, non-selective phosphodiesterase inhibitor
Question 11
A leukotriene is best defined as?
A
Peptide derived
B
Activates the same intracellular enzyme as adrenaline
C
Has complementary receptors on a granulocyte
D
Is a potent additive adjunct to other therapies for management of bronchospasm
Question 12
A patient requires an oral glucocorticoid to manage inflammatory-induced remodelling process of asthma. Which of the following are best indicated in this instance?
A
Fluticasone
B
Beclomethasone
C
Prednisolone
D
Hydrocortisone
Question 13
A patient is on a new regimen for the management of their asthma condition.  They present to their GP with new onset headaches and abdominal pain. Which of the below medications best explain the side effects described?
A
Salbutamol
B
Tiotropium
C
Aminophylline
D
Montelukast
Question 13 Explanation: 
Leukotrienes, commonly used as prophylaxis for asthma, are known to have side-effects of abdominal pain and headache.
Question 14
Which of the following is not a cellular target of fluticasone?
A
A common phagocyte
B
An involuntary muscle cell of the bronchus
C
A cell which can sensitise B cells to release IgE
D
A cell that is upregulated in parasitic infection
Question 15
Which of the following is a recognised side effect of long-term prednisolone use?
A
Gaunt-appearing facial features
Hint:
Gaunt: lean and haggard
B
Rapid weight loss
C
Falls risk second to osteoporosis
D
Decreased BM reading
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