كل جابترات العلاجيات وزاري خامس

AD
Appropriate laboratory tests of AD include all the following, except:

A. Serum B12, folate, thyroid panel, blood cell counts, and serum electrolytes.
B. Liver function tests.
C. ECG.
D. Computed tomography (CT).
E. Magnetic resonance imaging (MRI).
Signature findings in AD include the following features, except:

A. Intracellular neurofibrillary tangles (NFTs).
B. Elevated body temperature.
C. Extracellular amyloid plaques in the cortex and medial temporal lobe.
D. Degeneration of neurons and synapses.
E. Cortical atrophy.
Proposed mechanisms of Alzheimer disease (AD) involve:

A. β-amyloid protein aggregation, leading to formation of plaques.
B. Hyperphosphorylation of tau protein, leading to NFTs.
C. Synaptic failure and depletion of neurotrophin and neurotransmitters.
D. Mitochondrial dysfunction, and oxidative stress.
E. All the above.
All the following statements regarding AD are correct, except:

A. Loss of cholinergic activity is most prominent.
B. Loss of serotonergic neurons.
C. Excitatory neurotransmitters, such as GABA, may be neurotoxic.
D. Monoamine oxidase type B activity is increased.
E. Glutamate pathways of the cortex and limbic structures are abnormal.
Which point is most correct concerning clinical presentations of AD?

A. Cognitive decline is gradual.
B. Cognitive symptoms includes memory loss, aphasia, apraxia, agnosia.
C. Non-cognitive symptoms include depression, psychotic symptoms, aggression,
motor hyperactivity.
D. All the above.
E. None of the above.
Primary prevention of AD include all the following, except:

AD
A. Smoking cessation.
B. Increasing physical activity.
C. Reducing physical activity.
D. Reducing midlife obesity, hypertension, and diabetes.
E. Adherence to the Mediterranean Diet.
Which point is not correct regarding the pharmacologic therapy of cognitive symptoms of AD:
A. Cholinesterase inhibitors are indicated for the treatment of AD.
B. NMDA-receptor antagonists are indicated for the treatment of AD.
C. Donepezil, rivastigmine, and galantamine are indicated in mild-to-moderate AD.
D. Combination therapy with cholinesterase inhibitors and memantine, is generally
prescribed for people with moderate-to-severe AD.
E. Estrogen, NSAIDS, prednisone, statins, ginkgo biloba and vitamin E are commended
to prevent and treat dementia.
All the following facts concerning the pharmacologic therapy of noncognitive symptoms are
correct, except:
A. Valproic acid use is highly recommended due to low adverse effects.
B. No drug is FDA approved for the treatment of AD behavioral and psychological
symptoms of AD.
C. Selective serotonin reuptake inhibitors (SSRIs) like sertraline and citalopram are
usually given to depressed patients with AD.
D. Tricyclic antidepressants are usually avoided.
E. Aripiprazole, risperidone, olanzapine, and quetiapine are effective atypical
antipsychotics for disruptive behaviors and neuropsychiatric symptoms of AD.
Answers:
Appropriate laboratory tests of AD include all the following, except:
A. Serum B12, folate, thyroid panel, blood cell counts, and serum electrolytes.
B. Liver function tests.
AD
C. ECG.
D. Computed tomography (CT).
E. Magnetic resonance imaging (MRI).
Signature findings in AD include the following features, except:

A. Intracellular neurofibrillary tangles (NFTs).
B. Elevated body temperature.
C. Extracellular amyloid plaques in the cortex and medial temporal lobe.
D. Degeneration of neurons and synapses.
E. Cortical atrophy.
Proposed mechanisms of Alzheimer disease (AD) involve:

A. β-amyloid protein aggregation, leading to formation of plaques.
B. Hyperphosphorylation of tau protein, leading to NFTs.
C. Synaptic failure and depletion of neurotrophin and neurotransmitters.
D. Mitochondrial dysfunction, and oxidative stress.
E. All the above.
All the following statements regarding AD are correct, except:

A. Loss of cholinergic activity is most prominent.
B. Loss of serotonergic neurons.
C. Excitatory neurotransmitters, such as GABA, may be neurotoxic.
D. Monoamine oxidase type B activity is increased.
E. Glutamate pathways of the cortex and limbic structures are abnormal.
Which point is most correct concerning clinical presentations of AD?

A. Cognitive decline is gradual.
B. Cognitive symptoms includes memory loss, aphasia, apraxia, agnosia.
C. Non-cognitive symptoms include depression, psychotic symptoms, aggression,
motor hyperactivity.
D. All the above.
Primary prevention of AD includes all the following, except:

A. Smoking cessation.
B. Increasing physical activity.
C. Reducing physical activity.
D. Reducing midlife obesity, hypertension, and diabetes.
AD
E. Adherence to the Mediterranean Diet.
Which point is not correct regarding the pharmacologic therapy of cognitive symptoms of
AD:
A. Cholinesterase inhibitors are indicated for the treatment of AD.
B. NMDA-receptor antagonists are indicated for the treatment of AD.
C. Donepezil, rivastigmine, and galantamine are indicated in mild-to-moderate AD.
D. Combination therapy with cholinesterase inhibitors and memantine, is generally
prescribed for people with moderate-to-severe AD.
E. Estrogen, NSAIDS, prednisone, statins, ginkgo biloba and vitamin E are
commended to prevent and treat dementia.
All the following facts concerning the pharmacologic therapy of noncognitive symptoms are
correct, except:
A. Valproic acid use is highly recommended due to low adverse effects.
B. No drug is FDA approved for the treatment of AD behavioral and psychological
symptoms of AD.
C. Selective serotonin reuptake inhibitors (SSRIs) like sertraline and citalopram are
usually given to depressed patients with AD.
D. Tricyclic antidepressants are usually avoided.
E. Aripiprazole, risperidone, olanzapine, and quetiapine are effective atypical
antipsychotics for disruptive behaviors and neuropsychiatric symptoms of AD.
Adrenal gland disorders
1. Cushing syndrome: select the most appropriate answer:

A. Supraphysiologic glucocorticoid concentrations.
B. May be due to exogenous glucocorticoid administration.
C. Endogenous overproduction (adrenocorticotropic hormone [ACTH] dependent).
D. Abnormal adrenocortical tissues (ACTH independent).
E. All the above.
2. ACTH-dependent Cushing syndrome: which one is not correct?

A. 80% of all Cushing syndrome cases.
B. 20% of cases is usually caused by adrenal adenomas and carcinomas.
C. Overproduction of ACTH by the pituitary gland such as pituitary adenomas.
D. Ectopic ACTH syndrome refers to excessive ACTH production resulting from an
endocrine or nonendocrine tumor, usually of the pancreas, thyroid, or lung.
3. The most common findings in Cushing syndrome are all the following, except:
A. Central obesity, facial rounding, peripheral obesity and fat accumulation.
B. Myopathy or muscular weakness.
C. Gonadal dysfunction, amenorrhea and hirsutism in women.
D. Hypertension, and glucose intolerance.
E. Improve immunity and low incidence of infections.
4. Which selection is most correct regarding diagnosis of Cushing syndrome:

A. Hypercortisolism.
B. Plasma ACTH,
C. Adrenal vein catheterization, and metyrapone stimulation test.
D. Adrenal nodules and masses are identified using high-resolution CT scanning or MRI.
E. Corticotropin-releasing hormone (CRH) stimulation test.
F. All the above.
5. Concerning the nonpharmacologic therapy: The treatment of choice for both ACTH-
dependent and ACTH-independent Cushing syndrome is:
1
A. Surgical resection of tumors.

B. Radiotherapy.
C. Laparoscopic adrenalectomy.
D. Steroidogenesis Inhibitors.
E. All the above.
6. All the following statements regarding metyrapone are correct, except:

A. Inhibits 11 β-hydroxylase.
B. Inhibiting cortisol synthesis.
C. Adrenal steroidogenesis shunts toward androgen production, resulting in androgenic
side effects such as acne and hirsutism.
D. Inhibition of aldosterone synthesis.
E. Has antifungal action.
7. In regard to Ketoconazole, which statement is not correct?

A. Inhibits 11 β-hydroxylase and 17 α-hydroxylase.
B. Decreasing serum cortisol levels.
C. It is a cytotoxic drug.
D. It has antiandrogenic activity.
E. Ketoconazole may be used with metyrapone to achieve synergistic reduction in cortisol
levels; and antiandrogenic actions reverse the androgenic effect of metyrapone.
8. Mitotane has all the following properties, except:

A. Cytotoxic drug.
B. It is not a steroidogenesis inhibitor.
C. Reducing synthesis of cortisol and corticosterone.
D. Mitotane can cause significant neurologic (Lethargy, and GI side effects, in addition,
it may cause reversible hypercholesterolemia.
E. Mitotane degenerates cells of the adrenal gland (Acute effects include atrophy of the
adrenal cortex; while long term effects involve glomerulosa).
2
9. Pituitary secretion of ACTH is normally mediated by neurotransmitters such as:

A. Serotonin.
B. γ-aminobutyric acid (GABA).
C. Acetylcholine.
D. Catecholamines.
E. All the above.
10. Cyproheptadine has all the following features, except:

A. Nonselective serotonin receptor antagonist.
B. Has anticholinergic effects.
C. It is a somatostatin analogue like Pasireotide.
D. Decreases ACTH secretion.
E. Side effects such as sedation and weight gain significantly limit its use.
11. All the statements below are true concerning Pasireotide, except:
A. It is a somatostatin analogue that binds and activates somatostatin receptors.
B. Inhibiting ACTH secretion, leading to decreased cortisol secretion.
C. Used for Cushing disease when pituitary surgery is not an option.
D. Side effects include cholelithiasis, increased hepatic transaminases, hyperglycemia,
sinus bradycardia, and QT prolongation.
E. It is a nonselective serotonin receptor antagonist.
12. Regarding Mifepristone, which point is not true?

A. A progesterone- and glucocorticoid-receptor agonist, and increases endogenous
cortisol and ACTH levels.
B. It reverses the manifestations of hypercortisolism (hyperglycemia, hypertension, and
weight gain).
C. It is FDA approved for treatment of endogenous Cushing syndrome in patients who
have type 2 diabetes or glucose intolerance.
D. Common adverse effects include peripheral edema, endometrial hyperplasia, and
hypokalemia.
3
13. In Cushing syndrome, evaluation of therapeutic outcomes of pharmacologic treatment

includes:
A. 24-hour urine free cortisol (UFC).
B. Serum cortisol is essential.
C. Monitor steroid secretion with all drug therapy (except mifepristone).
D. All the above.
14. Hyperaldosteronism involves all of the following characteristics, except:

A. Primary hyperaldosteronism is caused by bilateral adrenal hyperplasia and
aldosterone-producing adenoma (Conn syndrome).
B. Secondary hyperaldosteronism results from excessive stimulation by an extra-adrenal
factor, usually the renin–angiotensin system.
C. Excessive potassium intake, oral contraceptives, pregnancy, and menses, heart failure,
cirrhosis, renal artery stenosis, and Bartter syndrome can lead to elevated aldosterone
concentrations.
D. Resistant hypertension, and elevated plasma renin activity are highly suggestive of
primary hyperaldosteronism.
E. Hyperaldosteronism causes hyperkalemia.
15. Nonpharmacologic therapy of aldosterone-producing adenomas includes which option of

the following?
A. Laparoscopic resection of the tumor.
B. Spironolactone.
C. Eplerenone.
D. Amiloride.
16. Adrenal insufficiency involves all the following properties, except?
4
A. Addison disease usually involves destruction of all regions of the adrenal cortex
causing primary adrenal insufficiency.
B. Exogenous corticosteroid use, leading to suppression of the hypothalamic–pituitary–
adrenal axis causing secondary adrenal insufficiency.
C. Mirtazapine and progestins induce primary adrenal insufficiency.
D. Medications that inhibit cortisol synthesis (eg, ketoconazole) can cause primary
adrenal insufficiency.
E. Medications accelerate cortisol metabolism (eg, phenytoin, rifampin, phenobarbital)
can cause primary adrenal insufficiency.
17. Patients with adrenal insufficiency (primary) commonly complain of all the following,
except:
A. Weakness.
B. Weight loss.
C. Memory impairment.
D. Depression, and hypotension.
E. Decreased skin pigmentation.
18. Diagnosis of adrenal insufficiency includes all the options below, except:
A. Short cosyntropin stimulation test
B. Plasma ACTH level, which is usually decreased in primary insufficiency versus high
levels in secondary insufficiency.
C. Insulin hypoglycemia test.
D. Metyrapone test,
E. CRH stimulation test can be used in the diagnosis.
19. Which statement is not correct regarding corticosteroids?

A. The agents of choice are hydrocortisone and cortisone acetate (have short duration).
B. In primary adrenal insufficiency, use fludrocortisone acetate (high mineralocorticoid
effect), with hydrocortisone before severe physical stress, such as exercise.
C. In secondary adrenal insufficiency, use hydrocortisone or prednisone.
5
D. Mineralocorticoids are necessary in secondary adrenal insufficiency.

E. The end point of therapy for adrenal insufficiency is usually assessed by reducing
excess pigmentation, while development of features of Cushing syndrome indicates
excessive replacement therapy.
Answers:
Cushing syndrome: select the most appropriate answer:
A. Supraphysiologic glucocorticoid concentrations.

B. May be due to exogenous glucocorticoid administration.
C. Endogenous overproduction (adrenocorticotropic hormone [ACTH] dependent).
D. Abnormal adrenocortical tissues (ACTH independent).
E. All the above.
ACTH-dependent Cushing syndrome: which one is not correct?
A. 80% of all Cushing syndrome cases.

B. 20% of cases is usually caused by adrenal adenomas and carcinomas.
C. Overproduction of ACTH by the pituitary gland such as pituitary adenomas.
D. Ectopic ACTH syndrome refers to excessive ACTH production resulting from an
endocrine or nonendocrine tumor, usually of the pancreas, thyroid, or lung.
6
The most common findings in Cushing syndrome are all the following, except:
A. Central obesity, facial rounding, peripheral obesity and fat accumulation.

B. Myopathy or muscular weakness.
C. Gonadal dysfunction, amenorrhea and hirsutism in women.
D. Hypertension, and glucose intolerance.
E. Improve immunity and low incidence of infections.
Which selection is most correct regarding diagnosis of Cushing syndrome:
A. Hypercortisolism.
B. Plasma ACTH,
C. Adrenal vein catheterization, and metyrapone stimulation test.
D. Adrenal nodules and masses are identified using high-resolution CT scanning or
MRI.
E. Corticotropin-releasing hormone (CRH) stimulation test.
F. All the above.
Concerning the nonpharmacologic therapy: The treatment of choice for both ACTH-dependent
and ACTH-independent Cushing syndrome is:
A. Surgical resection of tumors.

B. Radiotherapy.
C. Laparoscopic adrenalectomy.
D. Steroidogenesis Inhibitors.
E. All the above.
6. All the following statements regarding metyrapone are correct, except:

A. Inhibits 11 β-hydroxylase.
B. Inhibiting cortisol synthesis.
7
C. Adrenal steroidogenesis shunts toward androgen production, resulting in androgenic

side effects such as acne and hirsutism.
D. Inhibition of aldosterone synthesis.
E. Has antifungal action.
In regard to Ketoconazole, which statement is not correct?

A. Inhibits 11 β-hydroxylase and 17 α-hydroxylase.
B. Decreasing serum cortisol levels.
C. It is a cytotoxic drug.
D. It has antiandrogenic activity.
E. Ketoconazole may be used with metyrapone to achieve synergistic reduction in
cortisol levels; and antiandrogenic actions reverse the androgenic effect of
metyrapone.
Mitotane has all the following properties, except:
A. Cytotoxic drug.
B. It is not a steroidogenesis inhibitor.
C. Reducing synthesis of cortisol and corticosterone.
D. Mitotane can cause significant neurologic (Lethargy, and GI side effects, in
addition, it may cause reversible hypercholesterolemia.
E. Mitotane degenerates cells of the adrenal gland (Acute effects include atrophy of
the adrenal cortex; while long term effects involve glomerulosa).
Pituitary secretion of ACTH is normally mediated by neurotransmitters such as:
A. Serotonin.
B. γ-aminobutyric acid (GABA).
C. Acetylcholine.
D. Catecholamines.
E. All the above.
8
Cyproheptadine has all the following features, except:
A. Nonselective serotonin receptor antagonist.

B. Has anticholinergic effects.
C. It is a somatostatin analogue like Pasireotide.
D. Decreases ACTH secretion.
E. Side effects such as sedation and weight gain significantly limit its use.
All the statements below are true concerning Pasireotide, except:
A. It is a somatostatin analogue that binds and activates somatostatin receptors.

B. Inhibiting ACTH secretion, leading to decreased cortisol secretion.
C. Used for Cushing disease when pituitary surgery is not an option.
D. Side effects include cholelithiasis, increased hepatic transaminases,
hyperglycemia, sinus bradycardia, and QT prolongation.
E. It is a nonselective serotonin receptor antagonist.
Regarding Mifepristone, which point is not true?
A. A progesterone- and glucocorticoid-receptor agonist, and increases endogenous

cortisol and ACTH levels.
B. It reverses the manifestations of hypercortisolism (hyperglycemia, hypertension,
and weight gain).
C. It is FDA approved for treatment of endogenous Cushing syndrome in patients
who have type 2 diabetes or glucose intolerance.
D. Common adverse effects include peripheral edema, endometrial hyperplasia, and
hypokalemia.
In Cushing syndrome, evaluation of therapeutic outcomes of pharmacologic treatment includes:
A. 24-hour urine free cortisol (UFC).

B. Serum cortisol is essential.
9
C. Monitor steroid secretion with all drug therapy (except mifepristone).

D. All the above.
Hyperaldosteronism involves all of the following characteristics, except:
A. Primary hyperaldosteronism is caused by bilateral adrenal hyperplasia and

aldosterone-producing adenoma (Conn syndrome).
B. Secondary hyperaldosteronism results from excessive stimulation by an extra-
adrenal factor, usually the renin–angiotensin system.
C. Excessive potassium intake, oral contraceptives, pregnancy, and menses, heart
failure, cirrhosis, renal artery stenosis, and Bartter syndrome can lead to elevated
aldosterone concentrations.
D. Resistant hypertension, and elevated plasma renin activity are highly suggestive
of primary hyperaldosteronism.
E. Hyperaldosteronism causes hyperkalemia.
Nonpharmacologic therapy of aldosterone-producing adenomas includes which option of the

following?
A. Laparoscopic resection of the tumor.

B. Spironolactone.
C. Eplerenone.
D. Amiloride.
Adrenal insufficiency involves all the following properties, except?
A. Addison disease usually involves destruction of all regions of the adrenal cortex
causing primary adrenal insufficiency.
B. Exogenous corticosteroid use, leading to suppression of the hypothalamic–
pituitary–adrenal axis causing secondary adrenal insufficiency.
10
C. Mirtazapine and progestins induce primary adrenal insufficiency.

D. Medications that inhibit cortisol synthesis (eg, ketoconazole) can cause primary
adrenal insufficiency.
E. Medications accelerate cortisol metabolism (eg, phenytoin, rifampin,
phenobarbital) can cause primary adrenal insufficiency.
Patients with adrenal insufficiency (primary) commonly complain of all the following,
except:
A. Weakness.
B. Weight loss.
C. Memory impairment.
D. Depression, and hypotension.
E. Decreased skin pigmentation.
Diagnosis of adrenal insufficiency includes all the options below, except:
A. Short cosyntropin stimulation test

B. Plasma ACTH level, which is usually decreased in primary insufficiency versus
high levels in secondary insufficiency.
C. Insulin hypoglycemia test.
D. Metyrapone test,
E. CRH stimulation test can be used in the diagnosis.
Which statement is not correct regarding corticosteroids?
A. The agents of choice are hydrocortisone and cortisone acetate (have short
duration).
B. In primary adrenal insufficiency, use fludrocortisone acetate (high
mineralocorticoid effect), with hydrocortisone before severe physical stress, such
as exercise.
C. In secondary adrenal insufficiency, use hydrocortisone or prednisone.
11
D. Mineralocorticoids are necessary in secondary adrenal insufficiency.

E. The end point of therapy for adrenal insufficiency is usually assessed by reducing
excess pigmentation, while development of features of Cushing syndrome
indicates excessive replacement therapy.
12
Contraception questions
All the following facts regarding contraception are correct, except:

A. Contraception is the prevention of pregnancy.
B. Contraception is inhibiting sperm from reaching a mature ovum.
C. Contraception is preventing a fertilized ovum from implanting in the endometrium.
D. Both A and B.
E. All the above.
Which statement is not true concerning menstruation cycle?

A. The median menstrual cycle length is 28 days.
B. In the follicular phase, FSH levels decrease and cause recruitment of a small group of
follicles for continued growth.
C. Ovulation occurs 24–36 hours after the estradiol peak.
D. Ovulation occurs 10–16 hours after the LH peak.
E. The LH surge is the most clinically useful predictor of approaching ovulation.
Goals of using contraception may involve all the following, except:

A. Treatment of hypertensive women.
B. Prevention of pregnancy following sexual intercourse.
C. Replacement therapy.
D. Prevent sexually transmitted infections.
E. Menstrual cycle regulation.
All the options below are considered nonpharmacological contraception (nonhormonal contraception),
except?
A. Diaphragms.
B. Cervical cap.
C. Male condoms.
D. Female condoms.
E. Nonoxynol-9.
Spermicides are surfactants that destroy sperm cell wall and block entry into the ovum, which option is a
spermicide?
A. Combined Hormonal Contraceptive.
B. Vaginal contraceptive sponge (Today).
C. Female condom (Reality).
D. Cervical cap.
E. Progestins.
All the following contraceptives contain hormones or drugs, except:

A. Transdermal contraceptives.
B. Vaginal rings.
C. Condoms.
D. Long-acting injectable and implantable contraceptives.
E. Combined hormonal contraceptive.
Long-acting injectable and implantable contraceptives are recommended for women who particularly
benefit from progestin-only methods, including all the following conditions, except:
A. Breastfeeding women.
B. Intolerant of estrogens.
C. Concomitant medical conditions in which estrogen is not recommended.
D. Breast cancer of progesterone receptor positive
E. Adherence issues as failure rates are lower than with CHC.
All the following facts regarding Estrogens are correct, except:

A. Suppress FSH release (which may contribute to blocking the LH surge).
B. Stabilize the endometrial lining.
C. Provide cycle control.
D. Ethinyl estradiol (EE) is the most common used synthetic estrogen.
E. Some oral contraceptives contain estrogens alone.
Progestins have all the following activities, except:

A. Thicken cervical mucus.
B. Progestin-only tend to be more effective than combined contraceptives.
C. Delay sperm transport.
D. Block the LH surge and thus inhibit ovulation.
E. Induce endometrial atrophy.
Noncontraceptive benefits of oral contraceptives include all the following, except:

A. Decreased menstrual cramps, pain and blood loss.
B. Improved menstrual regularity.
C. Decreased iron deficiency anemia.
D. Reduced risk of ovarian and endometrial cancer.
E. Increase risk of pelvic inflammatory disease, endometriosis, and uterine fibroids.
Depot medroxyprogesterone acetate (DMPA) has al the facts below, except:

A. Can be given immediately postpartum in women who are not breastfeeding.
B. Contains combination of Ethinyl estradiol and norelgestromin.
C. Is contraindicated in women with a current diagnosis of breast cancer.
D. Most frequent adverse effect of DMPA is menstrual irregularity.

E. Is associated with reduced bone mineral density (BMD).
All the following statements regarding contraception are correct, except:

A. Use of CHCs containing less than 50 mcg estrogen may be considered in healthy nonsmoking
women older than 35 years.
B. CHCs are recommended for women older than 35 years with migraine, uncontrolled
hypertension, smoking, or diabetes with vascular disease.
C. Studies have not demonstrated an increased risk of cardiovascular disease with low-dose CHCs
in healthy, nonobese women.
D. Smoking 15 or more cigarettes per day by women over 35 years is a contraindication to the use
of CHCs.
E. Progestin-only methods should be considered in this group.
Which type of contraceptives are not recommended for obese women?

A. Combined contraceptives.
B. IUDs.
C. Implants.
D. DMPA.
E. Progestin-only contraceptives.
For women who have migraines with aura, which type of contraception of the following is not
recommended?
A. IUDs.
B. Condom.
C. Combined contraceptives.
D. DMPA.
Which of the following agents may increase efficacy of oral contraceptives?

A. Rifampin.
B. Phenobarbital and phenytoin.
C. Carbamazepine.
D. Strong CYP3A inhibitors.
E. St. John’s Wort.
All the following options can be used to prevent unintended pregnancy after unprotected or inadequately
protected sexual intercourse, except:
A. Progestin-only like preparations containing one (1.5) mg tablet of levonorgestrel.
B. Progesterone receptor modulator like Ulipristal.
C. Copper IUD.
D. Higher doses of combined OCs.
E. Condoms.
Medications used to terminate early pregnancy (≤70 days) include all the following, except:
A. Ulipristal.
B. Mifepristone.
C. Misoprostol.
D. Methotrexate.
E. Progesterone receptors blockers and prostaglandin 1 analogs.
Evaluation of therapeutic outcomes of contraceptives involves all the following options, except:
A. Monitor blood pressure annually in all CHC users.
B. Monitor glucose levels closely in women with a history of glucose intolerance or diabetes
mellitus.
C. Annual cytologic screening.
D. Evaluate women using DMPA every year for weight gain, menstrual cycle disturbances, and
fractures.
E. Screen for HIV and sexual transmitted disease (STIs).
Answers:
All the following facts regarding contraception are correct, except:

A. Contraception is the prevention of pregnancy.
B. Contraception is inhibiting sperm from reaching a mature ovum.
C. Contraception is preventing a fertilized ovum from implanting in the endometrium.
D. Both A and B.
E. All the above.
Which statement is not true concerning menstruation cycle?

A. The median menstrual cycle length is 28 days.
B. In the follicular phase, FSH levels decrease and cause recruitment of a small group of follicles
for continued growth.
C. Ovulation occurs 24–36 hours after the estradiol peak.
D. Ovulation occurs 10–16 hours after the LH peak.
E. The LH surge is the most clinically useful predictor of approaching ovulation.
Goals of using contraception may involve all the following, except:

A. Treatment of hypertensive women.
B. Prevention of pregnancy following sexual intercourse.
C. Replacement therapy.
D. Prevent sexually transmitted infections.
E. Menstrual cycle regulation.
All the options below are considered nonpharmacological contraception (nonhormonal contraception), except?
A. Diaphragms.
B. Cervical cap.
C. Male condoms.
D. Female condoms.
E. Nonoxynol-9.
Spermicides are surfactants that destroy sperm cell wall and block entry into the ovum, which option is a
spermicide?
A. Combined Hormonal Contraceptive.
B. Vaginal contraceptive sponge (Today).
C. Female condom (Reality).
D. Cervical cap.
E. Progestins.
All the following contraceptives contain hormones or drugs, except:

A. Transdermal contraceptives.
B. Vaginal rings.
C. Condoms.
D. Long-acting injectable and implantable contraceptives.
E. Combined hormonal contraceptive.
Long-acting injectable and implantable contraceptives are recommended for women who particularly benefit
from progestin-only methods, including all the following conditions, except:
A. Breastfeeding women.
B. Intolerant of estrogens.
C. Concomitant medical conditions in which estrogen is not recommended.
D. Breast cancer of progesterone receptor positive

E. Adherence issues as failure rates are lower than with CHC.
All the following facts regarding Estrogens are correct, except:

A. Suppress FSH release (which may contribute to blocking the LH surge).
B. Stabilize the endometrial lining.
C. Provide cycle control.
D. Ethinyl estradiol (EE) is the most common used synthetic estrogen.
E. Some oral contraceptives contain estrogens alone.
Progestins have all the following activities, except:

A. Thicken cervical mucus.
B. Progestin-only tend to be more effective than combined contraceptives.
C. Delay sperm transport.
D. Block the LH surge and thus inhibit ovulation.
E. Induce endometrial atrophy.
Noncontraceptive benefits of oral contraceptives include all the following, except:

A. Decreased menstrual cramps, pain and blood loss.
B. Improved menstrual regularity.
C. Decreased iron deficiency anemia.
D. Reduced risk of ovarian and endometrial cancer.
E. Increase risk of pelvic inflammatory disease, endometriosis, and uterine fibroids.
Depot medroxyprogesterone acetate (DMPA) has al the facts below, except:

A. Can be given immediately postpartum in women who are not breastfeeding.
B. Contains combination of Ethinyl estradiol and norelgestromin.
C. Is contraindicated in women with a current diagnosis of breast cancer.
D. Most frequent adverse effect of DMPA is menstrual irregularity.
E. Is associated with reduced bone mineral density (BMD).
All the following statements regarding contraception are correct, except:

A. Use of CHCs containing less than 50 mcg estrogen may be considered in healthy nonsmoking
women older than 35 years.
B. CHCs are recommended for women older than 35 years with migraine, uncontrolled hypertension,
smoking, or diabetes with vascular disease.
C. Studies have not demonstrated an increased risk of cardiovascular disease with low-dose CHCs in
healthy, nonobese women.
D. Smoking 15 or more cigarettes per day by women over 35 years is a contraindication to the use of
CHCs.
E. Progestin-only methods should be considered in this group.
Which type of contraceptives are not recommended for obese women?

A. Combined contraceptives.
B. IUDs.
C. Implants.
D. DMPA.
For women who have migraines with aura, which type of contraception of the following is not recommended?
A. IUDs.
B. Condom.
C. Combined contraceptives.
D. DMPA.
Which of the following agents may increase efficacy of oral contraceptives?

A. Rifampin.
B. Phenobarbital and phenytoin.
C. Carbamazepine.
D. Strong CYP3A inhibitors.
E. St. John’s Wort.
All the following options can be used to prevent unintended pregnancy after unprotected or
inadequately protected sexual intercourse, except:
A. Progestin-only like preparations containing one (1.5) mg tablet of levonorgestrel.
B. Progesterone receptor modulator like Ulipristal.
C. Copper IUD.
D. Higher doses of combined OCs.
E. Condoms.
Medications used to terminate early pregnancy (≤70 days) include all the following, except:
A. Ulipristal.
B. Mifepristone.
C. Misoprostol.
D. Methotrexate.
E. Progesterone receptors blockers and prostaglandin 1 analogs.
Evaluation of therapeutic outcomes of contraceptives involves all the following options, except:
A. Monitor blood pressure annually in all CHC users.
B. Monitor glucose levels closely in women with a history of glucose intolerance or diabetes mellitus.
C. Annual cytologic screening.
D. Evaluate women using DMPA every year for weight gain, menstrual cycle disturbances, and
fractures.
E. Screen for HIV and sexual transmitted disease (STIs).
Depression questions (MDD)
1. The pathophysiological factors of depression could involve all the following parameters,
except:
A. Monoamine hypothesis and/or postsynaptic changes in receptor sensitivity.
B. Emotional theory.
C. Dysregulation hypothesis (Failure of homeostatic neurotransmitter regulation).
D. Inflammatory hypothesis (Chronic stress and inflammation).
E. Neuroactive steroids.
2. In the pathophysiology of depression, monoamine hypothesis involves decreased brain levels

of all the following, except:
A. Norepinephrine.
B. Epinephrine.
C. Serotonin.
D. Brain-derived neurotrophic factor (BDNF).
E. Dopamine.
3. In the pathophysiology of depression, inflammatory hypothesis includes all the following

facts, except:
A. Chronic stress.
B. Chronic inflammation.
C. Alter glutamatergic transmission.
D. Alter GABA transmission
E. Increased expression of brain-derived neurotrophic factor (BDNF).
4. The clinical presentations of depression may include the following symptoms, except:
A. Emotional symptoms: Diminished ability to experience pleasure, loss of interest
in usual activities, and sadness.
B. Physical symptoms: Weight gain or loss, headache, sleep disturbance, loss of
sexual interest, and palpitations.
C. Manic or hypomanic symptoms.
D. Cognitive symptoms: Decreased ability to concentrate, poor memory, and
confusion.
E. Psychomotor disturbances: Psychomotor retardation or psychomotor agitation.
5. Which diagnostic parameter of the following is not related to major depressive disorder
(MDD)?
A. Clinical symptoms as well as physical and mental examinations.

B. Medication review.
C. Lab blood tests like, complete blood count with differential, thyroid function tests,
and electrolytes determination.
D. Cosyntropin stimulation test.
E. Standardized rating scale.
6. Medications associated with depressive symptoms include the agents below, except:
A. Many antihypertensives.
B. Sertraline.
C. Oral contraceptives.
D. Isotretinoin.
E. Interferon-β1a.
7. Goals of treatment of depression include:

A. Resolution of current symptoms (remission).
B. Prevention of further episodes of depression (relapse or recurrence).
C. Prevention of suicide.
D. All the above.
8. Nonpharmacologic treatment of major depressive disorders:

A. Psychotherapy (eg, cognitive therapy, behavioral therapy, or interpersonal
psychotherapy).
B. Electroconvulsive therapy (ECT).
C. Repetitive transcranial magnetic stimulation.
D. Physical activity.
E. Selective serotonin reuptake inhibitors.
9. All the following statements regarding pharmacological treatment of depression are correct,
except:
A. Pharmacological treatment may improve varying types of depression in 80% -
90% of patients.
B. Antidepressants are equal in efficacy when administered in comparable doses.
C. An individual’s pharmacogenomics may help in choosing therapy.
D. At least a 6-week trial of an antidepressant at maximum dosage is considered an
adequate trial of that medication.
E. The acute phase of treatment lasts 6–12 weeks, and the continuation phase (4–9
months after remission).
Answers:
1. The pathophysiological factors of depression could involve all the following parameters,
except:
A. Monoamine hypothesis and/or postsynaptic changes in receptor sensitivity.
B. Emotional theory.
C. Dysregulation hypothesis (Failure of homeostatic neurotransmitter regulation).
D. Inflammatory hypothesis (Chronic stress and inflammation).
E. Neuroactive steroids.
2. In the pathophysiology of depression, monoamine hypothesis involves decreased brain levels

of all the following, except:
A. Norepinephrine.
B. Epinephrine.
C. Serotonin.
D. Brain-derived neurotrophic factor (BDNF).
E. Dopamine.
3. In the pathophysiology of depression, inflammatory hypothesis includes all the following

facts, except:
A. Chronic stress.
B. Chronic inflammation.
C. Alter glutamatergic transmission.
D. Alter GABA transmission
E. Increased expression of brain-derived neurotrophic factor (BDNF).
4. The clinical presentations of depression may include the following symptoms, except:
A. Emotional symptoms: Diminished ability to experience pleasure, loss of interest
in usual activities, and sadness.
B. Physical symptoms: Weight gain or loss, headache, sleep disturbance, loss of
sexual interest, and palpitations.
C. Manic or hypomanic symptoms.
D. Cognitive symptoms: Decreased ability to concentrate, poor memory, and
confusion.
E. Psychomotor disturbances: Psychomotor retardation or psychomotor agitation.
5. Which diagnostic parameter of the following is not related to major depressive disorder
(MDD)?
A. Clinical symptoms as well as physical and mental examinations.
B. Medication review.
C. Lab blood tests like, complete blood count with differential, thyroid function tests,
and electrolytes determination.
D. Cosyntropin stimulation test.
E. Standardized rating scale.
6. Medications associated with depressive symptoms include the agents below, except:
A. Many antihypertensives.
B. Sertraline.
C. Oral contraceptives.
D. Isotretinoin.
E. Interferon-β1a.
7. Goals of treatment of depression include:

A. Resolution of current symptoms (remission).
B. Prevention of further episodes of depression (relapse or recurrence).
C. Prevention of suicide.
D. All the above.
8. Nonpharmacologic treatment of major depressive disorders:

A. Psychotherapy (eg, cognitive therapy, behavioral therapy, or interpersonal
psychotherapy).
B. Electroconvulsive therapy (ECT).

C. Repetitive transcranial magnetic stimulation.
D. Physical activity.
E. Selective serotonin reuptake inhibitors.
9. All the following statements regarding pharmacological treatment of depression are correct,
except:
A. Pharmacological treatment may improve varying types of depression in 80% -
90% of patients.
B. Antidepressants are equal in efficacy when administered in comparable doses.
C. An individual’s pharmacogenomics may help in choosing therapy.
D. At least a 6-week trial of an antidepressant at maximum dosage is considered an
adequate trial of that medication.
E. The acute phase of treatment lasts 6–12 weeks, and the continuation phase (4–9
months after remission).
GAD
Pathophysiological changes during generalized anxiety disorder (GAD) include all the following,
except:
A. Noradrenergic model.
B. γ-Aminobutyric acid (GABA) receptor model.
C. High cortisol level.
D. 5-HT model.
E. Glutamate signaling abnormalities model.
Noradrenergic model of anxiety includes all the following facts, except:
A. The autonomic nervous system of anxious patients is hypersensitive and overreacts to

various stimuli.
B. The locus ceruleus (LC) activates norepinephrine release and stimulates the
sympathetic and parasympathetic nervous systems.
C. Antidepressants inhibit LC firing, increase noradrenergic activity, and block the
effects of anxiogenic drugs.
D. Chronic noradrenergic overactivity downregulates α2-adrenoreceptors in patients
with GAD.
E. Benzodiazepines inhibits LC firing, decrease noradrenergic activity, and block the
γ-Aminobutyric acid (GABA) receptor model of anxiety includes all the following facts, except:
A. GABA is the major inhibitory neurotransmitter in the central nervous system (CNS).
B. Benzodiazepines enhance the inhibitory effects of GABA.
C. GABA regulates or inhibits serotonin (5-hydroxytryptamine; 5-HT), norepinephrine,
and dopamine activity.
D. Abnormal functioning of several neurotransmitter systems, including norepinephrine,
GABA, glutamate, dopamine, and 5-HT, may affect manifestations of anxiety
disorders.
E. Benzodiazepines enhance the excitatory effects of GABA.
Abnormal functioning of several neurotransmitter systems may affect manifestations of anxiety

disorders, including all the following neurotransmitter are involved, except:
A. Norepinephrine.
B. Acetyl choline.
GAD
C. GABA.
D. Glutamate.
E. Dopamine and 5-HT.
All the following statements regarding 5-HT model of anxiety are true, except:
A. Abnormalities in serotonergic functioning may play a role in anxiety.

B. Primate studies show that reducing 5-HT increases aggression.
C. GAD symptoms may reflect excessive 5-HT transmission or overactivity of the
stimulatory 5-HT pathways.
D. The selective serotonin reuptake inhibitors (SSRIs) increase 5-HT levels at the
synapse.
E. SSRIs are effective in blocking manifestations anxiety but not panic.
All the statements below regarding clinical presentation and diagnosis of generalized
anxiety disorder (GAD) are correct, except:
A. Psychological and cognitive symptoms of GAD include excessive anxiety, worries,

and trouble concentrating.
B. Physical symptoms include restlessness, fatigue, sleep disturbance, and irritability.
C. The diagnosis of GAD requires excessive anxiety and worry most days for at least 6
months with at least three physical symptoms present.
D. Women are twice as likely as men to have GAD.
E. The disease is an acute disorder.
Goals of treatment of generalized anxiety disorder (GAD) do not include:
A. Reduce severity, duration, and frequency of symptoms.

B. Cure from the disease.
C. Improve functioning.
D. The long-term goal is minimal or no anxiety symptoms.
E. Improved quality of life.
GAD
Pharmacological therapy of generalized anxiety disorder (GAD) include all the medications
below, except:
A. Antidepressants.
B. Benzodiazepines.
C. Corticosteroids.
D. Buspirone.
E. Hydroxyzine, pregabalin, and quetiapine.
Which antidepressant of the following should be avoided in pregnant women due to its
cardiovascular malformation risk?
A. Fluoxetine.
B. Sertraline.
C. Citalopram.
D. Paroxetine.
E. Fluvoxamine.
Which drug of the following is considered a second-line agent for anxiety?
A. Imipramine.
B. Venlafaxine extended release.
C. Duloxetine.
D. Paroxetine.
E. Escitalopram.
The most common side effect of benzodiazepines is:
A. Disorientation.
B. Psychomotor impairment.
C. Confusion.
D. Anterograde amnesia.
E. CNS depression.
Which point is not correct regarding diazepam and clorazepate?
A. Have high lipophilicity and are rapidly absorbed.

GAD
B. less lipophilic, have a slower onset, but a longer duration of action.

C. Rapidly distributed into the CNS.
D. have rapid antianxiety effects, but a shorter duration of effect after a single dose.
E. Rapidly distributed to the periphery.
Which point is not correct regarding pharmacological therapy of anxiety?
A. Nefazodone, ritonavir, or ketoconazole are CYP3A4 inhibitors.

B. Nefazodone, ritonavir, or ketoconazole can increase the blood levels of alprazolam
and diazepam.
C. Carbamazepine induce cytochrome CYP3A4.
D. St. John’s wort reduce benzodiazepine levels.
E. Both antidepressants and benzodiazepines are safely used for pregnant women with
anxiety.
Answers:
Pathophysiological changes during generalized anxiety disorder (GAD) include all the following,
except:
A. Noradrenergic model.
B. γ-Aminobutyric acid (GABA) receptor model.
C. High cortisol level.
D. 5-HT model.
E. Glutamate signaling abnormalities model.
Noradrenergic model of anxiety includes all the following facts, except:
A. The autonomic nervous system of anxious patients is hypersensitive and overreacts to

various stimuli.
GAD
B. The locus ceruleus (LC) activates norepinephrine release and stimulates the
sympathetic and parasympathetic nervous systems.
C. Antidepressants inhibit LC firing, increase noradrenergic activity, and block the
D. Chronic noradrenergic overactivity downregulates α2-adrenoreceptors in patients
with GAD.
E. Benzodiazepines inhibits LC firing, decrease noradrenergic activity, and block the
γ-Aminobutyric acid (GABA) receptor model of anxiety includes all the following facts, except:
A. GABA is the major inhibitory neurotransmitter in the central nervous system (CNS).
B. Benzodiazepines enhance the inhibitory effects of GABA.
C. GABA regulates or inhibits serotonin (5-hydroxytryptamine; 5-HT), norepinephrine,
and dopamine activity.
D. Abnormal functioning of several neurotransmitter systems, including norepinephrine,
GABA, glutamate, dopamine, and 5-HT, may affect manifestations of anxiety
disorders.
E. Benzodiazepines enhance the excitatory effects of GABA.
Abnormal functioning of several neurotransmitter systems may affect manifestations of anxiety

disorders, including all the following neurotransmitter are involved, except:
A. Norepinephrine.
B. Acetyl choline.
C. GABA.
D. Glutamate.
E. Dopamine and 5-HT.
All the following statements regarding 5-HT model of anxiety are true, except:
A. Abnormalities in serotonergic functioning may play a role in anxiety.
B. Primate studies show that reducing 5-HT increases aggression.
C. GAD symptoms may reflect excessive 5-HT transmission or overactivity of the
stimulatory 5-HT pathways.
D. The selective serotonin reuptake inhibitors (SSRIs) increase 5-HT levels at the
synapse.
E. SSRIs are effective in blocking manifestations anxiety but not panic.
GAD
All the statements below regarding clinical presentation and diagnosis of generalized
anxiety disorder (GAD) are correct, except:
A. Psychological and cognitive symptoms of GAD include excessive anxiety, worries,

and trouble concentrating.
B. Physical symptoms include restlessness, fatigue, sleep disturbance, and irritability.
C. The diagnosis of GAD requires excessive anxiety and worry most days for at least 6
months with at least three physical symptoms present.
D. Women are twice as likely as men to have GAD.
E. The disease is an acute disorder.
Goals of treatment of generalized anxiety disorder (GAD) do not include:

A. Reduce severity, duration, and frequency of symptoms.
B. Cure from the disease.
C. Improve functioning.
D. The long-term goal is minimal or no anxiety symptoms.
E. Improved quality of life.
Pharmacological therapy of generalized anxiety disorder (GAD) include all the medications
below, except:
A. Antidepressants.
B. Benzodiazepines.
C. Corticosteroids.
D. Buspirone.
E. Hydroxyzine, pregabalin, and quetiapine.
Which antidepressant of the following should be avoided in pregnant women due to its
cardiovascular malformation risk?
A. Fluoxetine.
B. Sertraline.
C. Citalopram.
D. Paroxetine.
E. Fluvoxamine.
Which drug of the following is considered a second-line agent for anxiety?

A. Imipramine.
GAD
B. Venlafaxine extended release.

C. Duloxetine.
D. Paroxetine.
E. Escitalopram.
The most common side effect of benzodiazepines is:

A. Disorientation.
B. Psychomotor impairment.
C. Confusion.
D. Anterograde amnesia.
E. CNS depression.
Which point is not correct regarding diazepam and clorazepate?

A. Have high lipophilicity and are rapidly absorbed.
B. less lipophilic, have a slower onset, but a longer duration of action.
C. Rapidly distributed into the CNS.
D. have rapid antianxiety effects, but a shorter duration of effect after a single dose.
E. Rapidly distributed to the periphery.
Which point is not correct regarding pharmacological therapy of anxiety?
A. Nefazodone, ritonavir, or ketoconazole are CYP3A4 inhibitors.

B. Nefazodone, ritonavir, or ketoconazole can increase the blood levels of alprazolam
and diazepam.
C. Carbamazepine induce cytochrome CYP3A4.
D. St. John’s wort reduce benzodiazepine levels.
E. Both antidepressants and benzodiazepines are safely used for pregnant women with
anxiety.
Hormonal Therapy questions
Symptoms of perimenopause and menopause does not include:

A. Vasomotor symptoms (hot flushes and night sweats).
B. Sleep disturbances, depression, anxiety, poor concentration.
C. Vaginal dryness and urogenital atrophy.
D. Dyspareunia sexual dysfunction.
E. Increase estrogen production
The diagnosis of menopause should include all the following, except:

A. Comprehensive medical history.
B. Physical examination.
C. Complete blood count.
D. Serum FSH level, a serum FSH concentrations exceed 10 IU/L means ovarian
function has ceased.
E. Altered thyroid function and pregnancy must be excluded.
Nonpharmacologic therapies to alleviate mild vasomotor and/or vaginal symptoms of menopause

involve all the following, except:
A. Lowering the room temperature.
B. Decreasing intake of caffeine, spicy foods, and hot beverages.
C. Estrogen replacement therapy.
D. Smoking cessation.
E. Exercise.
Pharmacologic therapies of symptoms of menopause include the options below, except:

A. Androgens.
B. Estrogens, including conjugated equine estrogens, estradiol, ethinyl estradiol, and
Non-Oral estrogens, including intravaginal estrogen cream, tablet, or ring.
C. Non-Hormonal treatments like clonidine and exercise.
D. Compounded Bioidentical Hormone Therapy (CBHT).
E. Progestogen or tissue selective estrogen complex (estrogen/bazedoxifene).
Non-Hormonal treatments of symptoms of menopause include the options below, except:

A. Paroxetine and fluoxetine.
B. Citalopram and escitalopram.
C. Serotonin-norepinephrine reuptake inhibitors (eg, venlafaxine and
desvenlafaxine).
D. Gabapentin and clonidine.

E. Vaginal creams, tablets, and rings.
Estrogens used in hormonal replacement therapy include all the following, except:
A. Conjugated equine estrogens.
B. Dehydroepiandrosterone.
C. Estradiol and ethinyl estradiol.
D. Non-Oral estrogens including transdermal, intranasal, and vaginal products.
E. Estradiol pellets.
Combination estrogen–progestogen regimens are all the following agents, except:

A. Continuous-cyclic estrogen-progestogen (sequential).
B. Continuous-combined estrogen-progestogen.
C. Conjugated equine estrogens.
D. Continuous long-cycle estrogen-progestogen (cyclic withdrawal).
E. Intermittent-combined estrogen-progestogen (continuous pulsed).
All the statements below are correct regarding Selective Estrogen Receptor Modulators
(SERMs), except:
A. Tamoxifen is an antagonist in breast tissue and an agonist on the bone and
endometrium.
B. Raloxifene is approved for prevention and treatment of postmenopausal
osteoporosis and reduction in risk of invasive breast cancer.
C. Bazedoxifene (Third-generation SERM), FDA-approved for moderate-to-severe
vasomotor symptoms and prevention of osteoporosis.
D. Ospemifene is approved for moderate-to-severe dyspareunia from menopausal
vulvar and vaginal atrophy.
E. All agents of SERMs have the same pharmacodynamic properties.
Tibolone has all the following activities, except:

A. Estrogenic activity.
B. Progestogenic activity.
C. Androgenic activity.
D. Selective Estrogen Receptor Modulator.
E. Improves mood, libido, menopausal symptoms, and vaginal atrophy.
Which of the following has an estrogen-like biologic activity and relatively weak estrogen
receptor-binding properties?
A. Phytoestrogens.
B. black cohosh.
C. Dong quai.
D. Red clover leaf.
E. Tibolone.
Answers:
Symptoms of perimenopause and menopause does not include:

A. Vasomotor symptoms (hot flushes and night sweats).
B. Sleep disturbances, depression, anxiety, poor concentration.
C. Vaginal dryness and urogenital atrophy.
D. Dyspareunia sexual dysfunction.
E. Increase estrogen production.
The diagnosis of menopause should include all the following, except:

A. Comprehensive medical history.
B. Physical examination.
C. Complete blood count.
D. Serum FSH level, a serum FSH concentrations exceed 10 IU/L means ovarian
function has ceased.
E. Altered thyroid function and pregnancy must be excluded.
Nonpharmacologic therapies to alleviate mild vasomotor and/or vaginal symptoms of menopause

involve all the following, except:
A. Lowering the room temperature.
B. Decreasing intake of caffeine, spicy foods, and hot beverages.
C. Estrogen replacement therapy.

D. Smoking cessation.
E. Exercise.
Pharmacologic therapies of symptoms of menopause include the options below, except:

A. Androgens.
B. Estrogens, including conjugated equine estrogens, estradiol, ethinyl estradiol, and
Non-Oral estrogens, including intravaginal estrogen cream, tablet, or ring.
C. Non-Hormonal treatments like clonidine and exercise.
D. Compounded Bioidentical Hormone Therapy (CBHT).
E. Progestogen or tissue selective estrogen complex (estrogen/bazedoxifene).
Non-Hormonal treatments of symptoms of menopause include the options below, except:

A. Paroxetine and fluoxetine.
B. Citalopram and escitalopram.
C. Serotonin-norepinephrine reuptake inhibitors (eg, venlafaxine and
desvenlafaxine).
D. Gabapentin and clonidine.
E. Vaginal creams, tablets, and rings.
Estrogens used in hormonal replacement therapy include all the following, except:
A. Conjugated equine estrogens.
B. Dehydroepiandrosterone.
C. Estradiol and ethinyl estradiol.
D. Non-Oral estrogens including transdermal, intranasal, and vaginal products.
E. Estradiol pellets.
Combination estrogen–progestogen regimens are all the following agents, except:

A. Continuous-cyclic estrogen-progestogen (sequential).
B. Continuous-combined estrogen-progestogen.
C. Conjugated equine estrogens.
D. Continuous long-cycle estrogen-progestogen (cyclic withdrawal).
E. Intermittent-combined estrogen-progestogen (continuous pulsed).
All the statements below are correct regarding Selective Estrogen Receptor Modulators
(SERMs), except:
A. Tamoxifen is an antagonist in breast tissue and an agonist on the bone and

endometrium.
B. Raloxifene is approved for prevention and treatment of postmenopausal
osteoporosis and reduction in risk of invasive breast cancer.
C. Bazedoxifene (Third-generation SERM), FDA-approved for moderate-to-severe
vasomotor symptoms and prevention of osteoporosis.
D. Ospemifene is approved for moderate-to-severe dyspareunia from menopausal
vulvar and vaginal atrophy.
E. All agents of SERMs have the same pharmacodynamic properties.
Tibolone has all the following activities, except:

A. Estrogenic activity.
B. Progestogenic activity.
C. Androgenic activity.
D. Selective Estrogen Receptor Modulator.
E. Improves mood, libido, menopausal symptoms, and vaginal atrophy.
Which of the following has an estrogen-like biologic activity and relatively weak estrogen
receptor-binding properties?
A. Phytoestrogens.
B. black cohosh.
C. Dong quai.
D. Red clover leaf.
E. Tibolone.
Schizophrenia Questions
1. Schizophrenia is characterized by:

A. Positive symptoms (eg, delusions, disorganized speech, hallucinations, behavior
disturbance).
B. Negative symptoms (eg, alogia, avolition, flat affect, anhedonia, and social isolation
C. Cognitive dysfunction (eg, impaired attention, working memory, and executive function).
D. All the above symptoms (positive, negative, and cognitive).
2. All the following can be involved in the pathophysiology of schizophrenia, except;

A. Obstetric complication.
B. Dopamine receptor defects like, including hyper- or hypoactivity of dopaminergic
processes in specific brain regions.
C. Smocking.
D. Genetic predisposition.
E. Neurodegenerative theories.
3. Which statement is not correct regarding pathophysiology of schizophrenia?

A. Positive symptoms may be closely associated with dopamine receptor hyperactivity in the
mesocaudate.
B. Decreased gray matter has not been reported in schizophrenia.
C. Negative and cognitive symptoms may be most closely related to dopamine receptor
hypofunction in the prefrontal cortex.
D. Alterations in glutamatergic neurotransmission resulting in increased neuronal pruning
have also been implicated in schizophrenia pathogenesis.
E. Studies have also shown increased susceptibility to immune/autoimmune disorders in
schizophrenia.
4. Symptoms of the acute episode of schizophrenia may include all the following, except:
A. Being out of touch with reality.
B. Hallucinations.
C. Delusions.
D. Illogical conversation.
E. After the acute psychotic episode has resolved, typically there are no residual features.
5. Diagnosis of schizophrenia include all the following, except:

A. Continuous symptoms that persist for at least 6 months with at least 1 month of active
phase symptoms.
B. At least 2 weeks of active phase symptoms.
C. At least two of the following symptoms present like, delusions, hallucinations,
disorganized speech.
D. Negative symptoms.
E. Criterion B: Significantly impaired functioning.
6. Before treatment of schizophrenia, some measures should be considered including::

A. Mental status examination and psychiatric diagnostic interview.
B. Physical and neurologic examination.
C. Complete family and social history.
D. Laboratory workup (tests).
E. All the above.
7. Laboratory workup (tests) recommended before treatment of schizophrenia include all the
following, except:
A. Complete blood count and electrolytes.
B. Hepatic function and renal function tests.
C. Electrocardiogram (ECG) is not performed.
D. Fasting serum glucose.
E. Serum lipids, and thyroid function.
8. Goals of treatment of schizophrenia involve all the following, except:

A. Alleviate target symptoms.
B. Complete cure.
C. Avoid side effects.
D. Improve psychosocial functioning and productivity.
E. Achieve compliance, integrate the patient back into the community, and prevent relapse.
9. All the following pharmacological options can be used to treat schizophrenia, except:
A. First-generation antipsychotics (FGAs, also known as traditional).
B. Second generation antipsychotics (SGAs, also known as atypical).
C. Mood stabilizers (eg, lithium).
D. D2 dopamine receptors agonists.
E. Valproic acid, and carbamazepine.
10. Dystonia could occur as a result of using the first-generation antipsychotics (FGA) in the
treatment of schizophrenia, lines of treatment of dystonia include all the medications below,
except:
A. Anticholinergics.
B. Benzodiazepines.
C. Analgesics.
D. Diphenhydramine.
E. First-generation antipsychotics with high anticholinergic activity (eg, haloperidol and
fluphenazine).
11. Akathisia occurs in 20%–40% of patients treated with high-potency first-generation

antipsychotics (FGA), all options below can be used to treat akathisia, except:
A. Reduction in antipsychotic dose is the best intervention.
B. Propranolol.
C. Antagonists of 5-HT2 receptors (like, cyproheptadine and trazodone).
D. Acetylcholine.
E. Mirtazapine.
12. Treatment of pseudoparkinsonism includes:

A. Benztropine.
B. Diphenhydramine.
C. Amantadine.
D. All the above.
13. All the following medications are used in the treatment of tardive dyskinesia, except:
A. Clonazepam.
B. Antocholinergics.
C. Ginkgo biloba.
D. Deutetrabenazine.
E. Valbenazine.
14. All the following symptoms may be caused by the use of antipsychotic medications,
(particularly, first generation agents), which of these symptoms appears in the later courses?
A. Dystonia.
B. Akathesia.
C. Pseudoparkinsonism
D. Tardive dyskinesia.
15. Tardive dyskinesia (TD) is characterized by all the following, except:

A. Abnormal voluntary movements.
B. Classic presentation is buccolingual-masticatory or orofacial movements that may
interfere with chewing, speech, respiration, or swallowing.
C. Facial movements include frequent blinking.
D. Delay onset (occur in late stages).
E. Movements may worsen with stress.
16. Neuroleptic malignant syndrome (NMS) occurs in 0.5%–1% of schizophrenic patients taking
first-generation antipsychotics (FGAs), treatment options do not include:
A. Discontinue antipsychotics and provide supportive care.
B. Bromocriptine.
C. Amantadine.
D. Dantrolene.
E. Chemotherapeutic agents
17. To evaluate the therapeutic outcomes of therapeutic options used in the treatment of
schizophrenia, which selection is most correct?
A. The four-item Positive Symptom Rating Scale.
B. Brief Negative Symptom Assessment.
C. Patient-rated self-assessments.
D. Monitoring parameters like reduction in day time sleep.
E. Engage the patient in treatment and patient education.
Answers:
1. Schizophrenia is characterized by:

A. Positive symptoms (eg, delusions, disorganized speech, hallucinations, behavior
disturbance).
B. Negative symptoms (eg, alogia, avolition, flat affect, anhedonia, and social isolation
C. Cognitive dysfunction (eg, impaired attention, working memory, and executive
function).
D. All the above symptoms (positive, negative, and cognitive).
2. All the following can be involved in the pathophysiology of schizophrenia, except;

A. Obstetric complication.
B. Dopamine receptor defects like, including hyper- or hypoactivity of dopaminergic
processes in specific brain regions.
C. Smocking.
D. Genetic predisposition.
E. Neurodegenerative theories.
3. Which statement is not correct regarding pathophysiology of schizophrenia?

A. Positive symptoms may be closely associated with dopamine receptor hyperactivity in
the mesocaudate.
B. Decreased gray matter has not been reported in schizophrenia.
C. Negative and cognitive symptoms may be most closely related to dopamine receptor
hypofunction in the prefrontal cortex.
D. Alterations in glutamatergic neurotransmission resulting in increased neuronal
pruning have also been implicated in schizophrenia pathogenesis.
E. Studies have also shown increased susceptibility to immune/autoimmune disorders in
schizophrenia.
4. Symptoms of the acute episode of schizophrenia may include all the following, except:
A. Being out of touch with reality.
B. Hallucinations.
C. Delusions.
D. Illogical conversation.
E. After the acute psychotic episode has resolved, typically there are no residual features.
5. Diagnosis of schizophrenia include all the following, except:

A. Continuous symptoms that persist for at least 6 months with at least 1 month of active
phase symptoms.
B. At least 2 weeks of active phase symptoms.
C. At least two of the following symptoms present like, delusions, hallucinations,
disorganized speech.
D. Negative symptoms.
E. Criterion B: Significantly impaired functioning.
6. Before treatment of schizophrenia, some measures should be considered including::

A. Mental status examination and psychiatric diagnostic interview.
B. Physical and neurologic examination.
C. Complete family and social history.
D. Laboratory workup (tests).
E. All the above.
7. Laboratory workup (tests) recommended before treatment of schizophrenia include all the
following, except:
A. Complete blood count and electrolytes.
B. Hepatic function and renal function tests.
C. Electrocardiogram (ECG) is not performed.
D. Fasting serum glucose.
E. Serum lipids, and thyroid function.
8. Goals of treatment of schizophrenia involve all the following, except:

A. Alleviate target symptoms.
B. Complete cure.
C. Avoid side effects.
D. Improve psychosocial functioning and productivity.
E. Achieve compliance, integrate the patient back into the community, and prevent
relapse.
9. All the following pharmacological options can be used to treat schizophrenia, except:
A. First-generation antipsychotics (FGAs, also known as traditional).
B. Second generation antipsychotics (SGAs, also known as atypical).
C. Mood stabilizers (eg, lithium).

D. D2 dopamine receptors agonists.
E. Valproic acid, and carbamazepine.
10. Dystonia could occur as a result of using the first-generation antipsychotics (FGA) in the
treatment of schizophrenia, lines of treatment of dystonia include all the medications below,
except:
A. Anticholinergics.
B. Benzodiazepines.
C. Analgesics.
D. Diphenhydramine.
E. First-generation antipsychotics with high anticholinergic activity (eg, haloperidol and
fluphenazine).
11. Akathisia occurs in 20%–40% of patients treated with high-potency first-generation

antipsychotics (FGA), all options below can be used to treat akathisia, except:
A. Reduction in antipsychotic dose is the best intervention.
B. Propranolol.
C. Antagonists of 5-HT2 receptors (like, cyproheptadine and trazodone).
D. Acetylcholine.
E. Mirtazapine.
12. Treatment of pseudoparkinsonism includes:

A. Benztropine.
B. Diphenhydramine.
C. Amantadine.
D. All the above.
13. All the following medications are used in the treatment of tardive dyskinesia, except:
A. Clonazepam.
B. Antocholinergics.
C. Ginkgo biloba.
D. Deutetrabenazine.
E. Valbenazine.
14. All the following symptoms may be caused by the use of antipsychotic medications,
(particularly, first generation agents), which of these symptoms appears in the later courses?
A. Dystonia.
B. Akathesia.
C. Pseudoparkinsonism
D. Tardive dyskinesia.
15. Tardive dyskinesia (TD) is characterized by all the following, except:

A. Abnormal voluntary movements.
B. Classic presentation is buccolingual-masticatory or orofacial movements that may
interfere with chewing, speech, respiration, or swallowing.
C. Facial movements include frequent blinking.
D. Delay onset (occur in late stages).
E. Movements may worsen with stress.
16. Neuroleptic malignant syndrome (NMS) occurs in 0.5%–1% of schizophrenic patients taking
first-generation antipsychotics (FGAs), treatment options do not include:
A. Discontinue antipsychotics and provide supportive care.
B. Bromocriptine.
C. Amantadine.
D. Dantrolene.
E. Chemotherapeutic agents
17. To evaluate the therapeutic outcomes of therapeutic options used in the treatment of
schizophrenia, which selection is most correct?
A. The four-item Positive Symptom Rating Scale.
B. Brief Negative Symptom Assessment.
C. Patient-rated self-assessments.
D. Monitoring parameters like reduction in day time sleep.
E. Engage the patient in treatment and patient education.
Sleep Disorders Problems
1. Which drug is not used for the treatment of cataplexy?

A. Modafinil.
B. Amphetamine.
C. Imipramine.
D. Selegiline.
E. Sodium oxybate.
2. Which drug of the following is herbal product?

A. Ramelteon.
B. Valerian.
C. Suvorexant.
D. Flurazepam.
E. Trazodone.
3. All the following drugs can be utilized to treat insomnia and have anticholinergic effects,
except:
A. Diphenhydramine.
B. Doxylamine.
C. Pyrilamine.
D. Quazepam
E. Amitriptyline
4. An agent often used for insomnia induced by selective serotonin reuptake inhibitors or
bupropion and in patients prone to substance abuse. Side effects include serotonin syndrome.
A. Suvorexant
B. Ramelteon
C. Doxepin
D. Zolpidem
E. Trazodone
5. Which selection is not correct regarding benzodiazepines:

A. Side effects include drowsiness, decreased concentration, cognitive deficits, and
anterograde amnesia.
B. Tolerance to daytime CNS effects.
C. Long elimination half-life benzodiazepines like flurazepam and quazepam are
preferred in older individuals.
D. Rebound insomnia.
E. Benzodiazepines have sedative, anxiolytic, muscle relaxant, and anticonvulsant
properties.
Answers:
1. Which drug is not used for the treatment of cataplexy?
F. Modafinil.
G. Amphetamine.
H. Imipramine.
I. Selegiline.
J. Sodium oxybate.
2. Which drug of the following is herbal product?

F. Ramelteon.
G. Valerian.
H. Suvorexant.
I. Flurazepam.
J. Trazodone.
3. All the following drugs can be utilized to treat insomnia and have anticholinergic effects,
except:
F. Diphenhydramine.
G. Doxylamine.
H. Pyrilamine.
I. Quazepam
J. Amitriptyline
4. An agent often used for insomnia induced by selective serotonin reuptake inhibitors or
bupropion and in patients prone to substance abuse. Side effects include serotonin syndrome.
F. Suvorexant
G. Ramelteon
H. Doxepin
I. Zolpidem
J. Trazodone
5. Which selection is not correct regarding benzodiazepines:

F. Side effects include drowsiness, decreased concentration, cognitive deficits, and
anterograde amnesia.
G. Tolerance to daytime CNS effects.
H. Long elimination half-life benzodiazepines like flurazepam and quazepam are
preferred in older individuals.
I. Rebound insomnia.
J. Benzodiazepines have sedative, anxiolytic, muscle relaxant, and anticonvulsant
properties.
Thyroid gland disorders
1. Which point is not correct regarding amiodarone?

A. Amiodarone may induce thyrotoxicosis (2%–3% of patients).
B. Amiodarone may induce overt hypothyroidism or subclinical hypothyroidism.
C. Amiodarone has low iodine content.
D. Amiodarone increased thyroid hormone synthesis commonly exacerbates thyroid
dysfunction in patients with preexisting thyroid disease.
E. Amiodarone also causes a destructive thyroiditis with leakage of thyroglobulin and
thyroid hormones.
2. Select the correct answer, the symptoms of thyrotoxicosis include:
A. Nervousness and anxiety.
B. Palpitations.
C. Emotional lability.
D. Heat intolerance.
E. All the above.
3. Thyrotoxicosis factitia is:
A. Hyperthyroidism due to ingestion of exogenous thyroid hormone.
B. It may occur when thyroid hormone is used for inappropriate indications.
C. It may occur due to accidental ingestion.
D. All the above.
4. Goals of treatment of hyperthyroidism include eliminating excess thyroid hormone
and minimizing symptoms and consequences. However, providing individualized therapy
depends on all the following, except:
A. The type and severity of disease.
B. Patient age and gender.
C. Patient skin color.
D. Existence of nonthyroidal conditions.
E. Response to previous therapy.
5. All the following statements regarding pharmacological treatment of hyperthyroidism are
correct, except:
1
A. Methimazole and propylthiouracil block thyroid hormone synthesis by inhibiting the

peroxidase enzyme system.
B. Corticosteroids are used as first line therapy for hyperthyroidism.
C. Iodide acutely blocks thyroid hormone release, biosynthesis, and decreases size and
vascularity of the gland.
D. β-Blockers are used to ameliorate symptoms such as palpitations, anxiety, tremor, and
heat intolerance.
E. Sodium iodide-131 is an oral liquid that concentrates in the thyroid gland, disrupts
hormone synthesis, and develop evidence of cellular necrosis.
6. Treatment of thyroid storm includes all options below, except:
A. Suppression of thyroid hormone formation and secretion.
B. Antiadrenergic therapy.
C. Administration of corticosteroids.
D. Treatment of associated complications or coexisting factors.
E. Administration of adrenergic stimulant drugs.
7. The vast majority of patients have primary hypothyroidism due to thyroid gland failure
caused by:
A. Chronic autoimmune thyroiditis (Hashimoto disease).
B. Iatrogenic hypothyroidism.
C. Secondary hypothyroidism.
D. Thyroid cancer.
E. Excessive thionamide doses.
8. Symptoms of hypothyroidism include all the following, except:
A. Dry skin and cold intolerance.
B. Tachycardia.
C. Depression and fatigue.
D. Menorrhagia and infertility are common in women.
E. In children, thyroid hormone deficiency may manifest as growth or intellectual
retardation.
9. All the statements below regarding Myxedema coma are correct, except:
A. It is a rare consequence of decompensated hypothyroidism.
2
B. It is manifested by hypothermia, advanced stages of hypothyroid symptoms, and

altered sensorium ranging from delirium to coma.
C. Mortality rates of 60%–70%.
D. No need for immediate and aggressive therapy.
10. All the following statements concerning diagnosis of hypothyroidism are true, except:
A. Elevated TSH level is the first evidence of primary hypothyroidism.
B. Subclinical hypothyroidism involves normal T4 with slightly elevated TSH levels.
C. In secondary hypothyroidism, serum TSH concentrations are generally low.
D. Low T4 and TSH levels indicate primary hypothyroidism.
11. Goals of treatment of hypothyroidism involve
A. Restore thyroid hormone concentrations in tissues.
B. Permanently cure the disease.
C. Provide symptomatic relief.
D. Prevent neurologic deficits in newborns and children.
E. Reverse the biochemical abnormalities of hypothyroidism.
12. All the following medicinal agents can be used in the management of hypothyroidism,
except:
A. Thyroxine.
B. Desiccated thyroid.
C. Liothyronine (synthetic T3).
D. Liotrix.
E. Radioactive iodine.
3
Answers:
Which point is not correct regarding amiodarone?
A. Amiodarone may induce thyrotoxicosis (2%–3% of patients).

B. Amiodarone may induce overt hypothyroidism or subclinical hypothyroidism.
C. Amiodarone has low iodine content.
D. Amiodarone increased thyroid hormone synthesis commonly exacerbates thyroid
dysfunction in patients with preexisting thyroid disease.
E. Amiodarone also causes a destructive thyroiditis with leakage of thyroglobulin and
thyroid hormones.
Select the correct answer, the symptoms of thyrotoxicosis include:
A. Nervousness and anxiety.

B. Palpitations.
C. Emotional lability.
D. Heat intolerance.
E. All the above.
Thyrotoxicosis factitia is:
A. Hyperthyroidism due to ingestion of exogenous thyroid hormone.

B. It may occur when thyroid hormone is used for inappropriate indications.
C. It may occur due to accidental ingestion.
D. All the above.
Goals of treatment of hyperthyroidism include eliminating excess thyroid hormone and

minimizing symptoms and consequences. However, providing individualized therapy
depends on all the following, except:
A. The type and severity of disease.

B. Patient age and gender.
4
C. Patient skin color.

D. Existence of nonthyroidal conditions.
E. Response to previous therapy.
All the following statements regarding pharmacological treatment of hyperthyroidism are

correct, except:
A. Methimazole and propylthiouracil block thyroid hormone synthesis by inhibiting

the peroxidase enzyme system.
B. Corticosteroids are used as first line therapy for hyperthyroidism.
C. Iodide acutely blocks thyroid hormone release, biosynthesis, and decreases size
and vascularity of the gland.
D. β-Blockers are used to ameliorate symptoms such as palpitations, anxiety, tremor,
and heat intolerance.
E. Sodium iodide-131 is an oral liquid that concentrates in the thyroid gland, disrupts
hormone synthesis, and develop evidence of cellular necrosis.
Treatment of thyroid storm includes all options below, except:
A. Suppression of thyroid hormone formation and secretion.

B. Antiadrenergic therapy.
C. Administration of corticosteroids.
D. Treatment of associated complications or coexisting factors.
E. Administration of adrenergic stimulant drugs.
The vast majority of patients have primary hypothyroidism due to thyroid gland failure
caused by:
A. Chronic autoimmune thyroiditis (Hashimoto disease).

B. Iatrogenic hypothyroidism.
C. Secondary hypothyroidism.
D. Thyroid cancer.
E. Excessive thionamide doses.
Symptoms of hypothyroidism include all the following, except:
5
A. Dry skin and cold intolerance.

B. Tachycardia.
C. Depression and fatigue.
D. Menorrhagia and infertility are common in women.
E. In children, thyroid hormone deficiency may manifest as growth or intellectual
retardation.
All the statements below regarding Myxedema coma are correct, except:
A. It is a rare consequence of decompensated hypothyroidism.

B. It is manifested by hypothermia, advanced stages of hypothyroid symptoms, and
altered sensorium ranging from delirium to coma.
C. Mortality rates of 60%–70%.
D. No need for immediate and aggressive therapy.
All the following statements concerning diagnosis of hypothyroidism are true, except:
A. Elevated TSH level is the first evidence of primary hypothyroidism.

B. Subclinical hypothyroidism involves normal T4 with slightly elevated TSH levels.
C. In secondary hypothyroidism, serum TSH concentrations are generally low.
D. Low T4 and TSH levels indicate primary hypothyroidism.
Goals of treatment of hypothyroidism involve
A. Restore thyroid hormone concentrations in tissues.

B. Permanently cure the disease.
C. Provide symptomatic relief.
D. Prevent neurologic deficits in newborns and children.
E. Reverse the biochemical abnormalities of hypothyroidism.
All the following medicinal agents can be used in the management of hypothyroidism,
except:
A. Thyroxine.
B. Desiccated thyroid.
C. Liothyronine (synthetic T3).
6
D. Liotrix.
E. Radioactive iodine.
7
Cancer questions
Cancer is a group of diseases (more than 100 diseases) characterized by all the following, except:
A. Uncontrolled cellular growth.
B. Tissue infiltration (invasion).
C. Spread of abnormal cells (metastasis).
D. Can't carry out normal physiological functions.
E. Can be classified into stages based on the type of chemotherapeutic treatment.
All the statements below concerning cancer are correct, except:

A. Most cancers are not curable in advanced stages.
B. Both lifestyle modifications and chemoprevention agents may significantly reduce the
risk of developing cancer.
C. Medications, such as tamoxifen, raloxifene and exemestane reduce breast cancer in
high-risk women.
D. Smoking cessation is associated with a gradual increase in the risk of cancer.
E. Some vaccines have been approved to prevent cancer such as those that prevent
infection with human papillomavirus (HPV), and hepatitis B viral infections.
All the following measures can help in preventing the risk of skin cancer, except:
A. Minimizing sun exposure.
B. Using sun screens with a sun protection factor (SPF≥15) on exposed areas.
C. Wearing protective clothing and sunglasses.
D. Administration of prophylactic chemotherapy.
E. Avoiding tanning beds and sun lamps.
Which selection of the following is the process by which normal cells are transformed into
cancer cells?
A. Carcinogenesis.
B. Carcinogen exposure.
C. Metastasis.
D. Invasion.
E. Proliferation.
Evidence indicates that there are four stages in the cancer development process, including all the
stages below, except:
A. Initiation.
B. Promotion.
Cancer questions
C. Transformation.
D. Transcription.
E. Progression.
A reversible stage occurs when the environment is altered by carcinogens or other factors to
favor the growth of mutated cell over the normal cell, this stage is called:
A. Initiation.
B. Promotion.
C. Transformation.
D. Transcription.
E. Progression.
Metastases indicates which stage of cancer?

A. Initiation.
B. Promotion.
C. Transformation.
D. Transcription.
E. Progression.
Which genes have protective effects against oncogenes, and they inhibit inappropriate cellular
growth and proliferation?
A. Protooncogens.
B. Tumor suppressor genes.
C. DNA repair genes.
D. Mitochondrial genes.
E. All the above.
Carcinogenic substances include which selection of the following:

A. Chemicals, such as aniline and benzene.
B. Environmental factors, such as excessive sun exposure.
C. Viruses, including HPV, Epstein-Barr virus, and hepatitis B virus.
D. Anticancer agents such as the alkylating agents (eg, melphalan), anthracyclines (eg,
doxorubicin), and epipodophyllotoxins (eg, etoposide).
E. All the above.
Promoters of carcinogenesis may include all the following, except:

Cancer questions
A. The patient’s age and gender.

B. Family history.
C. Diet.
D. Chronic irritation or inflammation.
E. Invasion.
All the following facts regarding metastasis are correct, except:

A. A growth of the same cancer cell found at some distance from the primary tumor site.
B. The presence of metastasis at diagnosis usually is associated with a poorer prognosis.
C. Usually, once distant metastases have occurred, the cancer is considered incurable.
D. Cancers spread usually by two pathways: Blood and cerebrospinal fluid.
E. The usual metastatic sites for solid tumors are the brain, bone, lung, and liver.
All the following statements regarding tumor origin are correct, except:
A. Tumors may arise from the 4 basic tissue types: epithelial, connective, lymphoid, or
nerve tissue.
B. Adenocarcinomas arise from glandular tissue (eg. Lung, breast and colon).
C. Malignancies of the bone marrow or lymphoid tissue, such as leukemias or
lymphomas, are named differently.
D. The suffix -oma is added to the name of the cell type if the tumor cells are benign (eg.
Lipoma).
E. Precancerous cells have cellular changes that are normal and but not yet malignant
and may be described as hyperplastic or dysplastic.
Benign tumor has all the following properties, except:

A. Encapsulated.
B. Localized.
C. Indolent.
D. Metastasize.
E. Rarely recur once removed.
Chemotherapy that is given before surgical resection of the tumor to decrease the tumor burden
to be removed and make the surgery easier to perform is called:
A. Adjuvant therapy.
B. Neoadjuvant therapy.
C. Palliative therapy.
D. Localized therapy.
Cancer questions
E. All the above.
Systemic therapies that administered after surgery to destroy microscopic malignant cells is
called:
A. Adjuvant therapy.
B. Neoadjuvant therapy.
C. Palliative therapy.
D. Localized therapy.
E. All the above.
All the following facts regarding dosing of chemotherapy are true, except:
A. Chemotherapeutic agents typically have a very narrow therapeutic index.
B. The doses of chemotherapy must be given at a frequency that allows the patient to
recover from the toxicity of the chemotherapy.
C. Each cycle of chemotherapy may have the same dosages.
D. The dose density of chemotherapy refers to increasing doses of chemotherapeutic
agent.
E. Factors that affect chemotherapy selection and dosing are age, concurrent disease
states, and performance status.
Combination therapy of chemotherapeutic agents should meet all the following principles,
except:
A. Agents with different pharmacologic actions.
B. Agents with different organ toxicities.
C. Agents that are active against the tumor and ideally synergistic when used together.
D. Agents that do not result in significant drug interactions.
E. Agents combined together must be given at constant doses during all cycles.
A prodrug that is metabolized by dihydropyrimidine dehydrogenase (DPD), inhibits thymidylate

synthase (TS) enzyme, and has good activity against several solid tumors like, breast and colon
cancer:
A. 5-FU.
B. Mercaptopurine.
C. Methotrexate.
D. Hydroxy urea.
E. Vincristine.
Cancer questions
Which chemotherapeutic agent is metabolized by xanthine oxidase (an enzyme that is inhibited
by allopurinol), that represents a major drug–drug interaction?
A. 5-FU.
B. Mercaptopurine.
C. Methotrexate.
D. Hydroxy urea.
E. Vincristine.
Which chemotherapeutic agent inhibits dihydrofolate reductase of both malignant and

nonmalignant cells, and the most common side effects are myelosuppression, nausea and
vomiting, and mucositis?
A. 5-FU.
B. Mercaptopurine.
C. Methotrexate.
D. Hydroxy urea.
E. Vincristine.
All the following drugs may inhibit or compete with tubular secretion of methotrexate, except:
A. Probenecid.
B. Salicylates.
C. Penicillin G.
D. Ketoprofen.
E. Ceftriaxone.
Vinca alkaloids have all the following properties, except:

A. Vincristine, vinblastine, and vinorelbine are used in several malignancies, primarily
hematologic.
B. Incidence and severity of toxicities are similar among the agents.
C. The dose-limiting toxicity of vincristine is neurotoxicity.
D. The dose-limiting toxicity associated with Vinorelbine and vinblastine is
myelosuppression.
E. All of the vinca alkaloids are vesicants and can cause tissue damage.
Chemotherapeutic agents similar to the vinca alkaloids, exhibit cytotoxicity during the M phase
of the cell cycle by binding to tubulin (inhibit microtubule disassembly).
Cancer questions
A. Nitrosoureas.
B. Taxanes.
C. Folate Antagonists.
D. Purine Analogues.
E. Anthracene.
Which one of taxanes has the ability to induce hypersensitivity reactions, which requiring
administration of dexamethasone, diphenhydramine, and an H2 blocker?
A. Monoclonal antibodies.
B. Docetaxel.
C. Cremophor EL (paclitaxel diluents).
D. Nanoparticle Albumin-Bound Paclitaxel.
E. Cabazitaxel.
Fluid-retention syndrome is associated with the use of docetaxel and is characterized by all the
following, except:
A. Prevented by pretreatment with dexamethasone.
B. Characterized by edema and weight gain.
C. Unresponsive to diuretic therapy.
D. Associated with cumulative doses greater than 800 mg/m2.
E. Patients usually have asymptomatic bradycardia.
Anthracyclines do not include:

A. Daunorubicin.
B. Doxorubicin.
C. Idarubicin.
D. Vincristine.
E. Epirubicin.
Chemotherapeutic agents known as antitumor antibiotics or topoisomerase inhibitors when

considering their mechanism of action:
A. Anthracyclines.
B. Nitrosoureas.
C. Taxanes.
D. Folate Antagonists.
E. Tyrosine Kinase Inhibitors (TKI).
Cancer questions
Which anticancer of the following results in red-orange urine after administration, which is an
important counseling point for patients?
A. 5-FU.
B. Methotrexate.
C. Daunorubicin.
D. Hydroxy urea.
E. Vincristine.
Oxygen-free-radical formation is a cause of cardiac damage and extravasation injury (vesicant

drugs), which is common with:
A. Vincristine.
B. 5-FU.
C. Methotrexate.
D. Doxorubicin.
E. Cyclophosphamide.
Which drug has less cardiotoxicity than others?

A. Doxorubicin.
B. Daunorubicin.
C. Idarubicin.
D. Epirubicin.
E. Liposomal doxorubicin.
All of the following are alkylating agents act through DNA cross linking, except:
A. Cyclophosphamide.
B. Ifosfamide.
C. Cisplatin.
D. Carmustine.
E. Lomustine.
Cyclophosphamide and ifosfamide have all the following properties, except:

A. Both prodrugs, requiring activation by mixed hepatic oxidase enzymes.
B. During the activation process, additional byproducts (acrolein and chloroacetaldehyde)
are formed.
C. Acrolein has responsible for the hemorrhagic cystitis.
D. Prophylaxis is necessary with aggressive hydration, administration of 2-
mercaptoethane sulfonate sodium (mesna).
E. They are nitrosoureas.
Platinum compounds (cisplatin, carboplatin, and oxaliplatin) have all the facts below, except:
A. They act by cross linking DNA.
Cancer questions
B. Cisplatin is used for the treatment of head, neck, anal cancer, including many types of
lymphoma and carcinoma of unknown primary.
C. Cisplatin is less likely to induce emesis (emetogenic) than carboplatin and oxaliplatin.
D. Significant nephrotoxicity and electrolyte abnormalities can occur if inadequate
hydration occurs.
E. Ototoxicity may limit cisplatin therapy.
Second-generation proteasome inhibitor:

A. Tisagenlecleucel.
B. Carfilzomib.
C. Bortezomib.
D. Bleomycin.
E. Almetuzumab.
First gene therapy approved in cancer. It is an autologous T cell immunotherapy comprised of T

cells that are genetically modified using a vector to encode an anti-CD19 chimeric antigen
receptor (CAR):
A. Bleomycin.
B. Carfilzomib.
C. Tisagenlecleucel.
D. Bortezomib.
E. Almetuzumab.
Monoclonal antibodies have all the characteristic features below, except:

A. Antibodies bind to the antigen, which may trigger the immune system to result in cell
death through complement-mediated cellular toxicity.
B. Antigen–antibody cell complex may be internalized to the cancer cell, which results
in cell death.
C. Hot antibodies are radioimmunotherapy.
D. Cold antibodies have no radioactivity.
E. All monoclonal antibodies end in the suffix -mib.
Anti CD-52, used in the treatment of chronic lymphocytic leukemia (CLL):

A. Bleomycin.
B. Almetuzumab.
C. Carfilzomib.
D. Tisagenlecleucel.
E. Bortezomib.
Almetuzumab requires prophylaxis or premedication with all these therapeutic options, except:
Cancer questions
A. Pneumocystis jirovecii pneumonia (PJP) prophylaxis.

B. Antifungal prophylaxis.
C. Antiviral prophylaxis.
D. 2-mercaptoethane sulfonate sodium (mesna).
E. Antihistamines and acetaminophen.
Hormonal or endocrine therapies against cancer have all the following criteria, except:
A. Used for cancers whose growth is affected by gonadal hormonal control.
B. Hormonal treatments may act through blocking endogenous hormones.
C. Hormonal treatments may act through decreasing the production of endogenous
hormones.
D. Hormonal treatments may act as agonists for endogenous hormones.
E. They are mainly used to treat breast and prostate cancer.
Cancer questions
Answer:
Cancer is a group of diseases (more than 100 diseases) characterized by all the following, except:
F. Uncontrolled cellular growth.
G. Tissue infiltration (invasion).
H. Spread of abnormal cells (metastasis).
I. Can't carry out normal physiological functions.
J. Can be classified into stages based on the type of chemotherapeutic treatment.
All the statements below concerning cancer are correct, except:

F. Most cancers are not curable in advanced stages.
G. Both lifestyle modifications and chemoprevention agents may significantly reduce the
risk of developing cancer.
H. Medications, such as tamoxifen, raloxifene and exemestane reduce breast cancer in
high-risk women.
I. Smoking cessation is associated with a gradual increase in the risk of cancer.
J. Some vaccines have been approved to prevent cancer such as those that prevent
infection with human papillomavirus (HPV), and hepatitis B viral infections.
All the following measures can help in preventing the risk of skin cancer, except:
F. Minimizing sun exposure.
G. Using sun screens with a sun protection factor (SPF≥15) on exposed areas.
H. Wearing protective clothing and sunglasses.
I. Administration of prophylactic chemotherapy.
J. Avoiding tanning beds and sun lamps.
Which selection of the following is the process by which normal cells are transformed into
cancer cells?
F. Carcinogenesis.
G. Carcinogen exposure.
H. Metastasis.
I. Invasion.
J. Proliferation.
Evidence indicates that there are four stages in the cancer development process, including all the
stages below, except:
Cancer questions
F. Initiation.
G. Promotion.
H. Transformation.
I. Transcription.
J. Progression.
A reversible stage occurs when the environment is altered by carcinogens or other factors to
favor the growth of mutated cell over the normal cell, this stage is called:
F. Initiation.
G. Promotion.
H. Transformation.
I. Transcription.
J. Progression.
Metastases indicates which stage of cancer?

F. Initiation.
G. Promotion.
H. Transformation.
I. Transcription.
J. Progression.
Which genes have protective effects against oncogenes, and they inhibit inappropriate cellular
growth and proliferation?
F. Protooncogens.
G. Tumor suppressor genes.
H. DNA repair genes.
I. Mitochondrial genes.
J. All the above.
Carcinogenic substances include which selection of the following:

F. Chemicals, such as aniline and benzene.
G. Environmental factors, such as excessive sun exposure.
H. Viruses, including HPV, Epstein-Barr virus, and hepatitis B virus.
I. Anticancer agents such as the alkylating agents (eg, melphalan), anthracyclines (eg,
doxorubicin), and epipodophyllotoxins (eg, etoposide).
J. All the above.
Cancer questions
Promoters of carcinogenesis may include all the following, except:

F. The patient’s age and gender.
G. Family history.
H. Diet.
I. Chronic irritation or inflammation.
J. Invasion.
All the following facts regarding metastasis are correct, except:

F. A growth of the same cancer cell found at some distance from the primary tumor site.
G. The presence of metastasis at diagnosis usually is associated with a poorer prognosis.
H. Usually, once distant metastases have occurred, the cancer is considered incurable.
I. Cancers spread usually by two pathways: Blood and cerebrospinal fluid.
J. The usual metastatic sites for solid tumors are the brain, bone, lung, and liver.
All the following statements regarding tumor origin are correct, except:
F. Tumors may arise from the 4 basic tissue types: epithelial, connective, lymphoid, or
nerve tissue.
G. Adenocarcinomas arise from glandular tissue (eg. Lung, breast and colon).
H. Malignancies of the bone marrow or lymphoid tissue, such as leukemias or
lymphomas, are named differently.
I. The suffix -oma is added to the name of the cell type if the tumor cells are benign (eg.
Lipoma).
J. Precancerous cells have cellular changes that are normal and but not yet malignant
and may be described as hyperplastic or dysplastic.
Benign tumor has all the following properties, except:

F. Encapsulated.
G. Localized.
H. Indolent.
I. Metastasize.
J. Rarely recur once removed.
Chemotherapy that is given before surgical resection of the tumor to decrease the tumor burden
to be removed and make the surgery easier to perform is called:
F. Adjuvant therapy.
Cancer questions
G. Neoadjuvant therapy.
H. Palliative therapy.
I. Localized therapy.
J. All the above.
Systemic therapies that administered after surgery to destroy microscopic malignant cells is
called:
F. Adjuvant therapy.
G. Neoadjuvant therapy.
H. Palliative therapy.
I. Localized therapy.
J. All the above.
All the following facts regarding dosing of chemotherapy are true, except:
F. Chemotherapeutic agents typically have a very narrow therapeutic index.
G. The doses of chemotherapy must be given at a frequency that allows the patient to
recover from the toxicity of the chemotherapy.
H. Each cycle of chemotherapy may have the same dosages.
I. The dose density of chemotherapy refers to increasing doses of chemotherapeutic
agent.
J. Factors that affect chemotherapy selection and dosing are age, concurrent disease
states, and performance status.
Combination therapy of chemotherapeutic agents should meet all the following principles,
except:
F. Agents with different pharmacologic actions.
G. Agents with different organ toxicities.
H. Agents that are active against the tumor and ideally synergistic when used together.
I. Agents that do not result in significant drug interactions.
J. Agents combined together must be given at constant doses during all cycles.
A prodrug that is metabolized by dihydropyrimidine dehydrogenase (DPD), inhibits thymidylate

synthase (TS) enzyme, and has good activity against several solid tumors like, breast and colon
cancer:
F. 5-FU.
G. Mercaptopurine.
H. Methotrexate.
Cancer questions
I. Hydroxy urea.
J. Vincristine.
Which chemotherapeutic agent is metabolized by xanthine oxidase (an enzyme that is inhibited
by allopurinol), that represents a major drug–drug interaction?
F. 5-FU.
G. Mercaptopurine.
H. Methotrexate.
I. Hydroxy urea.
J. Vincristine.
Which chemotherapeutic agent inhibits dihydrofolate reductase of both malignant and

nonmalignant cells, and the most common side effects are myelosuppression, nausea and
vomiting, and mucositis?
F. 5-FU.
G. Mercaptopurine.
H. Methotrexate.
I. Hydroxy urea.
J. Vincristine.
All the following drugs may inhibit or compete with tubular secretion of methotrexate, except:
F. Probenecid.
G. Salicylates.
H. Penicillin G.
I. Ketoprofen.
J. Ceftriaxone.
Vinca alkaloids have all the following properties, except:

F. Vincristine, vinblastine, and vinorelbine are used in several malignancies, primarily
hematologic.
G. Incidence and severity of toxicities are similar among the agents.
H. The dose-limiting toxicity of vincristine is neurotoxicity.
I. The dose-limiting toxicity associated with Vinorelbine and vinblastine is
myelosuppression.
J. All of the vinca alkaloids are vesicants and can cause tissue damage.
Cancer questions
Chemotherapeutic agents similar to the vinca alkaloids, exhibit cytotoxicity during the M phase
of the cell cycle by binding to tubulin (inhibit microtubule disassembly).
F. Nitrosoureas.
G. Taxanes.
H. Folate Antagonists.
I. Purine Analogues.
J. Anthracene.
Which one of taxanes has the ability to induce hypersensitivity reactions, which requiring
administration of dexamethasone, diphenhydramine, and an H2 blocker?
F. Monoclonal antibodies.
G. Docetaxel.
H. Cremophor EL (paclitaxel diluents).
I. Nanoparticle Albumin-Bound Paclitaxel.
J. Cabazitaxel.
Fluid-retention syndrome is associated with the use of docetaxel and is characterized by all the
following, except:
F. Prevented by pretreatment with dexamethasone.
G. Characterized by edema and weight gain.
H. Unresponsive to diuretic therapy.
I. Associated with cumulative doses greater than 800 mg/m2.
J. Patients usually have asymptomatic bradycardia.
Anthracyclines do not include:

F. Daunorubicin.
G. Doxorubicin.
H. Idarubicin.
I. Vincristine.
J. Epirubicin.
Chemotherapeutic agents known as antitumor antibiotics or topoisomerase inhibitors when

considering their mechanism of action:
F. Anthracyclines.
G. Nitrosoureas.
H. Taxanes.
Cancer questions
I. Folate Antagonists.
J. Tyrosine Kinase Inhibitors (TKI).
Which anticancer of the following results in red-orange urine after administration, which is an
important counseling point for patients?
F. 5-FU.
G. Methotrexate.
H. Daunorubicin.
I. Hydroxy urea.
J. Vincristine.
Oxygen-free-radical formation is a cause of cardiac damage and extravasation injury (vesicant

drugs), which is common with:
F. Vincristine.
G. 5-FU.
H. Methotrexate.
I. Doxorubicin.
J. Cyclophosphamide.
Which drug has less cardiotoxicity than others?

F. Doxorubicin.
G. Daunorubicin.
H. Idarubicin.
I. Epirubicin.
J. Liposomal doxorubicin.
All of the following are alkylating agents act through DNA cross linking, except:
F. Cyclophosphamide.
G. Ifosfamide.
H. Cisplatin.
I. Carmustine.
J. Lomustine.
Cyclophosphamide and ifosfamide have all the following properties, except:

F. Both prodrugs, requiring activation by mixed hepatic oxidase enzymes.
G. During the activation process, additional byproducts (acrolein and chloroacetaldehyde)
are formed.
H. Acrolein has responsible for the hemorrhagic cystitis.
I. Prophylaxis is necessary with aggressive hydration, administration of 2-
mercaptoethane sulfonate sodium (mesna).
J. They are nitrosoureas.
Cancer questions
Platinum compounds (cisplatin, carboplatin, and oxaliplatin) have all the facts below, except:
F. They act by cross linking DNA.
G. Cisplatin is used for the treatment of head, neck, anal cancer, including many types of
lymphoma and carcinoma of unknown primary.
H. Cisplatin is less likely to induce emesis (emetogenic) than carboplatin and oxaliplatin.
I. Significant nephrotoxicity and electrolyte abnormalities can occur if inadequate
hydration occurs.
J. Ototoxicity may limit cisplatin therapy.
Second-generation proteasome inhibitor:

F. Tisagenlecleucel.
G. Carfilzomib.
H. Bortezomib.
I. Bleomycin.
J. Almetuzumab.
First gene therapy approved in cancer. It is an autologous T cell immunotherapy comprised of T

cells that are genetically modified using a vector to encode an anti-CD19 chimeric antigen
receptor (CAR):
F. Bleomycin.
G. Carfilzomib.
H. Tisagenlecleucel.
I. Bortezomib.
J. Almetuzumab.
Monoclonal antibodies have all the characteristic features below, except:

F. Antibodies bind to the antigen, which may trigger the immune system to result in cell
death through complement-mediated cellular toxicity.
G. Antigen–antibody cell complex may be internalized to the cancer cell, which results
in cell death.
H. Hot antibodies are radioimmunotherapy.
I. Cold antibodies have no radioactivity.
J. All monoclonal antibodies end in the suffix -mib.
Anti CD-52, used in the treatment of chronic lymphocytic leukemia (CLL):

F. Bleomycin.
G. Almetuzumab.
H. Carfilzomib.
I. Tisagenlecleucel.
J. Bortezomib.
Cancer questions
Almetuzumab requires prophylaxis or premedication with all these therapeutic options, except:
F. Pneumocystis jirovecii pneumonia (PJP) prophylaxis.
G. Antifungal prophylaxis.
H. Antiviral prophylaxis.
I. 2-mercaptoethane sulfonate sodium (mesna).
J. Antihistamines and acetaminophen.
Hormonal or endocrine therapies against cancer have all the following criteria, except:
F. Used for cancers whose growth is affected by gonadal hormonal control.
G. Hormonal treatments may act through blocking endogenous hormones.
H. Hormonal treatments may act through decreasing the production of endogenous
hormones.
I. Hormonal treatments may act as agonists for endogenous hormones.
J. They are mainly used to treat breast and prostate cancer.
Menstrual related disorders questions
Which condition of the following is the most commonly reported menstrual complaint?
A. Dysmenorrhea.
B. Amenorrhea.
C. Anovulatory uterine bleeding.
D. Abnormal uterine bleeding.
E. Pregnancy.
Which condition is associated with pelvic pain, and generally described as painful cramping,
occurring during or just prior to menstruation?
A. Amenorrhea.
B. Anovulatory uterine bleeding.
C. Abnormal uterine bleeding.
D. Dysmenorrhea.
E. Pregnancy.
Risk factors for dysmenorrhea include all the following, except:

A. Irregular or heavy menses and menarche prior to age 12.
B. Age less than 30 and body mass index (BMI) less than 20 kg/m2.
C. History of sterilization.
D. Sexual abuse and smoking.
E. Peripheral vascular disease.
Causes of secondary dysmenorrhea may include the conditions below, except:

A. Endometriosis.
B. Chemical imbalance in the body.
C. Pelvic inflammatory disease (PID).
D. Uterine or cervical polyps.
E. Uterine fibroids.
Primary dysmenorrhea (Pathophysiology) may be caused by the following, except:

A. Elevated arachidonic acid levels in the menstrual fluid.
B. Increased concentrations of prostaglandins and leukotrienes in the uterus.
C. Inhibition of uterus pain fibers.
D. Reduction in uterine blood flow.
E. Uterine hypoxia.
1
First-line therapy for dysmenorrhea is:

A. Nonsteroidal anti-inflammatory drugs (NSAIDs).
B. Combination Hormonal Contraceptives.
C. Progestin-Only Hormonal Contraceptives.
D. Ethinyl estradiol.
E. IUD therapy.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are first-line therapy for dysmenorrhea, they
work by all the following mechanisms, except:
A. Inhibiting prostaglandin production.
B. Exert analgesic properties.
C. Decrease uterine contractions.
D. Increasing leukotriene level.
E. Reduce menstrual blood flow.
For patients with contraindication to NSAID therapy, or with dysmenorrhea unresponsive to

initial NSAID treatment, which option is recommended?
A. Higher doses of nonsteroidal anti-inflammatory drugs (NSAIDs).
B. Combination Hormonal Contraceptives (CHCs).
E. IUD therapy.
Combination Hormonal Contraceptives (CHCs) improve mild to severe dysmenorrhea by all the
actions below, except:
A. Decreasing endometrial lining.
B. Inhibiting ovulation.
C. Negative feedback on the hypothalamus and pituitary.
D. Decreasing the formation of prostaglandins.
E. Decreasing the formation of leukotrienes.
All the following statements regarding the use of progestin-only hormonal contraceptives for
dysmenorrhea are correct, except:
A. They diminish dysmenorrhea by reducing or eliminating menses over time.
B. They eliminate prostaglandin release.
2
C. Three agents are available: depot medroxyprogesterone acetate, etonogestrel implant,

and levonorgestrel-releasing IUD.
D. Dysmenorrhea reduced from 60% to 29% after 3 years of levonorgestrel-releasing
IUD therapy.
E. The available agents are short-acting reversible contraceptive agents.
Adolescents with symptoms unresponsive to NSAID therapy for three menstrual periods should
be offered:
A. High dose nonsteroidal anti-inflammatory drugs (NSAIDs).
C. Non-pharmacological therapy.
E. IUD therapy.
The absence of menses is called:

A. Dysmenorrhea.
B. Amenorrhea.
E. Pregnancy.
All the following facts regarding primary amenorrhea are true, except:
A. Failure to reach menarche.
B. No pubertal development by age 13.
C. Menarche has not occurred within 5 years after initial breast development.
D. Menarche has not occurred when patient is 15 years or older.
E. Irregular or heavy menses and menarche prior to age 12.
Primary amenorrhea is often caused by one of the following, except:

A. Chromosomal irregularities.
B. Polycystic ovary syndrome.
C. Primary ovarian insufficiency.
D. Anatomic abnormalities.
E. Unrecognized pregnancy.
Causes of secondary amenorrhea do not include:

3
A. Polycystic ovary syndrome (PCOS).

B. Hypothalamic suppression.
C. Chromosomal irregularities.
D. Hyperprolactinemia.
E. Undernutrition or anorexia and excessive exercise.
Which condition could be a potential side effect from using low-dose or extended oral CHCs,
depot medroxyprogesterone acetate, or levonorgestrel-releasing IUD?
A. Dysmenorrhea.
B. Amenorrhea.
E. Pregnancy.
The pharmacological therapy of amenorrhea includes all the options below, except:
A. Estrogens/progestins replacement therapy.
B. Dopamine agonists, like bromocriptine.
C. Progestins.
D. Insulin sensitizing agents, like metformin.
E. Warfarin.
In amenorrheic women with hyperprolactinemia (with or without a pituitary tumor), which

treatment is preferred?
C. Aspirin.
D. Progestins.
E. Insulin sensitizing agents, like metformin.
All the statements below regarding progestins use for amenorrhea are correct, except:
A. Progestins induce withdrawal bleeding in women with secondary amenorrhea.
B. Efficacy varies depending on the formulation used.
C. Withdrawal bleeding occurs with intramuscularly injected progesterone and oral
medroxyprogesterone acetate.
D. The usual dose of medroxyprogesterone acetate is 10 mg orally once daily for 7 to 10
days.
E. They reduce menstrual blood flow.
4
Irregular menstrual bleeding from the endometrium which is ranging from light spotting to heavy
blood flow is known as:
A. Dysmenorrhea.
B. Amenorrhea.
E. Abortion.
Which point is not correct concerning anovulatory uterine bleeding?

A. Noncyclic menstrual bleeding.
B. Ovulatory dysfunction.
C. Anovulation or oligo-ovulation.
D. It is secondary to the effects of unopposed estrogen.
E. It includes bleeding due to uterine anatomic lesion.
Which condition is the most common cause of noncyclic uterine bleeding that occurring in 5% to
10% of women, and is responsible for 55% to 91% of ovulatory dysfunction cases?
Anovulatory uterine bleeding typically may present with the following clinical manifestations,
except:
A. Irregular menstrual bleeding.
B. Hirsutism.
C. Uterine hypoxia.
D. Obesity.
E. Infertility.
Anovulation results from dysfunction at any level of the hypothalamic-pituitary-ovarian (HPO)

axis which can be due to physiologic life stages including all the following, except:
A. Adolescence.
B. Perimenopause.
5
C. Pregnancy.
D. Lactation.
E. Pathologic causes.
The most common causes of nonphysiologic (pathologic) ovulatory dysfunction are all of the
following, except:
A. Perimenopause.
B. Polycystic ovary syndrome (PCOS).
C. Hypothalamic amenorrhea.
E. Premature ovarian failure.
For women with polycystic ovary syndrome (PCOS), weight loss may be beneficial. In
overweight or obese women, a 5% weight reduction is associated with all the following, except:
A. Resumption of menses.
B. Improved pregnancy rates.
C. Decreased hirsutism.
D. Degreased glucose levels.
E. Increased androgen level.
Anovulatory bleeding can be treated with the following therapeutic options, except:
A. Combined hormonal contraceptives.
B. Medroxyprogesterone acetate.
C. NSAIDs.
D. Estrogen modulators.
E. Insulin sensitizing agents.
……………………. is the recommended treatment for managing acute bleeding episodes

because it promotes endometrial growth and stabilization:
A. Estrogens or combined hormonal contraceptive (CHC) therapy.
C. Progestins.
E. Warfarin.
6
Long-term therapy with combined hormonal contraceptives (CHCs) may have all the following
effects, except:
A. Reduces the risk of endometrial cancer.
B. CHCs suppress ovarian hormones.
C. CHCs suppress adrenal androgen production.
D. Increase sex hormone–binding globulin (SHBG).
E. Increasing circulating androgen.
If pregnancy is an immediate goal, which estrogen modulator may be used to induce ovulation?
A. Clomiphene.
C. NSAIDs.
D. Estrogen.
In patients with PCOS, metformin performs all these actions, except:

A. Reduces circulating androgen concentrations.
B. Increases ovulation rates.
C. Improves glucose tolerance.
D. decreases sex hormone–binding globulin (SHBG) that occurs via increased insulin
sensitivity.
E. Metformin may decrease cardiovascular risk and promote weight loss.
Answers:
7
Which condition of the following is the most commonly reported menstrual complaint?
A. Dysmenorrhea.
B. Amenorrhea.
E. Pregnancy.
Which condition is associated with pelvic pain, and generally described as painful cramping,
occurring during or just prior to menstruation?
A. Amenorrhea.
B. Anovulatory uterine bleeding.
C. Abnormal uterine bleeding.
D. Dysmenorrhea.
E. Pregnancy.
Risk factors for dysmenorrhea include all the following, except:

A. Irregular or heavy menses and menarche prior to age 12.
B. Age less than 30 and body mass index (BMI) less than 20 kg/m2.
C. History of sterilization.
D. Sexual abuse and smoking.
E. Peripheral vascular disease.
Causes of secondary dysmenorrhea may include the conditions below, except:

A. Endometriosis.
B. Chemical imbalance in the body.
C. Pelvic inflammatory disease (PID).
D. Uterine or cervical polyps.
E. Uterine fibroids.
Primary dysmenorrhea (Pathophysiology) may be caused by the following, except:

A. Elevated arachidonic acid levels in the menstrual fluid.
B. Increased concentrations of prostaglandins and leukotrienes in the uterus.
C. Inhibition of uterus pain fibers.
D. Reduction in uterine blood flow.
E. Uterine hypoxia.
First-line therapy for dysmenorrhea is:
8
A. Nonsteroidal anti-inflammatory drugs (NSAIDs).

E. IUD therapy.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are first-line therapy for dysmenorrhea, they
work by all the following mechanisms, except:
A. Inhibiting prostaglandin production.
B. Exert analgesic properties.
C. Decrease uterine contractions.
D. Increasing leukotriene level.
E. Reduce menstrual blood flow.
For patients with contraindication to NSAID therapy, or with dysmenorrhea unresponsive to

initial NSAID treatment, which option is recommended?
A. Higher doses of nonsteroidal anti-inflammatory drugs (NSAIDs).
B. Combination Hormonal Contraceptives (CHCs).
E. IUD therapy.
Combination Hormonal Contraceptives (CHCs) improve mild to severe dysmenorrhea by all the
actions below, except:
A. Decreasing endometrial lining.
B. Inhibiting ovulation.
C. Negative feedback on the hypothalamus and pituitary.
D. Decreasing the formation of prostaglandins.
E. Decreasing the formation of leukotrienes.
All the following statements regarding the use of progestin-only hormonal contraceptives for
dysmenorrhea are correct, except:
A. They diminish dysmenorrhea by reducing or eliminating menses over time.
B. They eliminate prostaglandin release.
C. Three agents are available: depot medroxyprogesterone acetate, etonogestrel implant,
and levonorgestrel-releasing IUD.
D. Dysmenorrhea reduced from 60% to 29% after 3 years of levonorgestrel-releasing
IUD therapy.
E. The available agents are short-acting reversible contraceptive agents.
9
Adolescents with symptoms unresponsive to NSAID therapy for three menstrual periods should
be offered:
A. High dose nonsteroidal anti-inflammatory drugs (NSAIDs).
C. Non-pharmacological therapy.
E. IUD therapy.
The absence of menses is called:

A. Dysmenorrhea.
B. Amenorrhea.
E. Pregnancy.
All the following facts regarding primary amenorrhea are true, except:
A. Failure to reach menarche.
B. No pubertal development by age 13.
C. Menarche has not occurred within 5 years after initial breast development.
D. Menarche has not occurred when patient is 15 years or older.
E. Irregular or heavy menses and menarche prior to age 12.
Primary amenorrhea is often caused by one of the following, except:

Causes of secondary amenorrhea do not include:

A. Polycystic ovary syndrome (PCOS).
B. Hypothalamic suppression.
C. Chromosomal irregularities.
E. Undernutrition or anorexia and excessive exercise.
10
Which condition could be a potential side effect from using low-dose or extended oral CHCs,
depot medroxyprogesterone acetate, or levonorgestrel-releasing IUD?
A. Dysmenorrhea.
B. Amenorrhea.
E. Pregnancy.
The pharmacological therapy of amenorrhea includes all the options below, except:
C. Progestins.
E. Warfarin.
In amenorrheic women with hyperprolactinemia (with or without a pituitary tumor), which

treatment is preferred?
C. Aspirin.
D. Progestins.
E. Insulin sensitizing agents, like metformin.
All the statements below regarding progestins use for amenorrhea are correct, except:
A. Progestins induce withdrawal bleeding in women with secondary amenorrhea.
B. Efficacy varies depending on the formulation used.
C. Withdrawal bleeding occurs with intramuscularly injected progesterone and oral
medroxyprogesterone acetate.
D. The usual dose of medroxyprogesterone acetate is 10 mg orally once daily for 7 to 10
days.
E. They reduce menstrual blood flow.
Irregular menstrual bleeding from the endometrium which is ranging from light spotting to heavy
blood flow is known as:
A. Dysmenorrhea.
B. Amenorrhea.
11
E. Abortion.
Which point is not correct concerning anovulatory uterine bleeding?

A. Noncyclic menstrual bleeding.
B. Ovulatory dysfunction.
C. Anovulation or oligo-ovulation.
D. It is secondary to the effects of unopposed estrogen.
E. It includes bleeding due to uterine anatomic lesion.
Which condition is the most common cause of noncyclic uterine bleeding that occurring in 5% to
10% of women, and is responsible for 55% to 91% of ovulatory dysfunction cases?
Anovulatory uterine bleeding typically may present with the following clinical manifestations,
except:
A. Irregular menstrual bleeding.
B. Hirsutism.
C. Uterine hypoxia.
D. Obesity.
E. Infertility.
Anovulation results from dysfunction at any level of the hypothalamic-pituitary-ovarian (HPO)

axis which can be due to physiologic life stages including all the following, except:
A. Adolescence.
B. Perimenopause.
C. Pregnancy.
D. Lactation.
E. Pathologic causes.
The most common causes of nonphysiologic (pathologic) ovulatory dysfunction are all of the
following, except:
A. Perimenopause.
B. Polycystic ovary syndrome (PCOS).
C. Hypothalamic amenorrhea.
12
E. Premature ovarian failure.
For women with polycystic ovary syndrome (PCOS), weight loss may be beneficial. In
overweight or obese women, a 5% weight reduction is associated with all the following, except:
A. Resumption of menses.
B. Improved pregnancy rates.
C. Decreased hirsutism.
D. Degreased glucose levels.
E. Increased androgen level.
Anovulatory bleeding can be treated with the following therapeutic options, except:
A. Combined hormonal contraceptives.
C. NSAIDs.
D. Estrogen modulators.
……………………. is the recommended treatment for managing acute bleeding episodes

because it promotes endometrial growth and stabilization:
A. Estrogens or combined hormonal contraceptive (CHC) therapy.
C. Progestins.
E. Warfarin.
Long-term therapy with combined hormonal contraceptives (CHCs) may have all the following
effects, except:
A. Reduces the risk of endometrial cancer.
B. CHCs suppress ovarian hormones.
C. CHCs suppress adrenal androgen production.
D. Increase sex hormone–binding globulin (SHBG).
E. Increasing circulating androgen.
If pregnancy is an immediate goal, which estrogen modulator may be used to induce ovulation?
A. Clomiphene.
13
C. NSAIDs.
D. Estrogen.
In patients with PCOS, metformin performs all these actions, except:

A. Reduces circulating androgen concentrations.
B. Increases ovulation rates.
C. Improves glucose tolerance.
D. decreases sex hormone–binding globulin (SHBG) that occurs via increased insulin
sensitivity.
E. Metformin may decrease cardiovascular risk and promote weight loss.
14
Breast cancer questions
The most strongly risk factors associated with occurrence of breast cancer are:
A. Gender and age.
B. Endocrine factors (eg, early menarche, nulliparity, late age at first birth, and hormone
replacement therapy).
C. Genetic factors (eg, personal and family history, mutations of tumor suppresser genes
[BRCA1 and BRCA2]).
D. Environmental factors.
E. Lifestyle factors (eg, radiation exposure, weight, height, and alcohol use).
The most common metastatic sites of breast cancer are all the following sites, except:
A. Lymph nodes.
B. Skin and bone.
C. Liver and lungs.
D. Brain.
E. Colon.
The pharmacologic risk reduction of breast cancer includes all the following agents, except:
A. Tamoxifen.
B. Raloxifene.
C. Estrogen.
D. Exemestane.
E. Anastrozole.
Risk reduction strategies of breast cancer include the therapeutic options below, except:
A. Mastectomy.
B. Estrogen hormonal therapy.
C. Oophorectomy.
D. Pharmacologic agents.
E. Nonpharmacologic therapy.
Which agent of the following increases the incidence of endometrial cancer?

A. Tamoxifen.
B. Raloxifene.
C. Trastuzumab.
D. Exemestane.
E. Anastrozole.
1
The initial signs of breast cancer in most women are:

A. Nipple changes.
B. Bone pain.
C. Painless, palpable lump (Solitary, unilateral, solid, irregular, and nonmobile).
D. Skin edema, redness, warmth, and induration.
E. Abdominal pain or enlargement, jaundice, and mental status changes.
What diagnostic method is indicated when there is mammographic abnormality that suggests
breast malignancy or for a palpable mass on physical examination?
A. Careful history.
B. Physical examination of the breast.
C. Three-dimensional mammography.
D. Breast imaging techniques, as ultrasound and magnetic resonance imaging (MRI).
E. Breast biopsy.
Goals of treatment of breast cancer include all the following facts, except:
A. Adjuvant therapy for early and locally advanced breast cancer (curative intent).
B. Neoadjuvant therapy is given to eradicate micrometastatic disease, determine prognosis,
and potentially conserve breast tissue for a better cosmetic result.
C. Curative therapy is the desired therapeutic outcome in the treatment of metastatic breast
cancer (MBC).
D. Treatment can cause substantial toxicity, which differs depending on the individual agent,
administration method, and combination regimen.
E. Treatment is rapidly evolving.
First line of therapy of early breast cancer (stage I and II) includes:
A. Surgery or breast-conserving therapy (BCT).
B. Adjuvant chemotherapy.
C. Adjuvant biological therapy.
D. Targeted therapy.
E. Adjuvant endocrine therapy.
Surgery or breast-conserving therapy (BCT) includes all of the following, except:

A. Removal of part of the breast.
B. Lymphatic mapping or surgical evaluation of axillary lymph nodes.
C. Sentinel lymph node biopsy.
2
D. Radiation therapy (RT).

E. Total mastectomy.
Adjuvant chemotherapy of breast cancer does not include:

A. Anthracyclines like, doxorubicin and epirubicin.
B. LHRH agonists like, goserelin.
C. Taxanes like, docetaxel and paclitaxel.
D. Alkylating agents like, cyclophosphamide.
E. Antimetabolites like, methotrexate, and fluorouracil.
In adjuvant chemotherapy, dose intensity refers to all the below facts, except:
A. It is the amount of drug administered per unit of time.
B. It can be increased by increasing dose.
C. It can be increased by decreasing time between doses.
D. To elevate dose intensity, it is recommended to increase the dose of chemotherapy.
E. To elevate dose intensity, it is recommended to decrease the time between treatment
cycles.
A drug given in combination with or sequentially after adjuvant chemotherapy, and is

indicated in patients with early stage, HER2-positive breast cancer:
A. Trastuzumab.
B. Tamoxifen.
C. Goserelin.
D. Exemestane.
E. Anastrozole.
All the following agents are hormonal therapies used in the treatment of primary or early-stage
breast cancer, except:
A. Estrogen modulators like, tamoxifen and toremifene.
B. Oophorectomy and ovarian irradiation.
C. Aromatase inhibitors like, letrozole, exemestane and anastrozole.
D. Pertuzumab.
E. Luteinizing hormone–releasing hormone (LHRH) agonists.
3
All the statements below concerning locally advanced breast cancer (stage III) are correct,
except:
A. Neoadjuvant or primary chemotherapy is the initial treatment of choice.
B. Primary chemotherapy with an anthracycline- and taxane-containing regimen is
recommended.
C. The use of trastuzumab and pertuzumab with chemotherapy is appropriate for patients
with HER2-positive tumors.
D. Surgery followed by chemotherapy and adjuvant RT should be administered to minimize
local recurrence.
E. Palliation is the primary goal of therapy for most patients with stage III disease.
Treatment of metastatic breast cancer (MBC) may include all the following, except:
A. Cytotoxic chemotherapy.
B. Endocrine therapy.
C. Surgery or breast-conserving therapy (BCT).
E. Biologic therapy.
First-line therapy for HER2-overexpressing metastatic breast cancer (MBC) is:

A. Pertuzumab-trastuzumab-taxane combination.
B. Cytotoxic chemotherapy.
C. Endocrine therapy.
D. Surgery or breast-conserving therapy (BCT).
E. Orchiectomy.
All HER2-targeted therapies are mainly:

A. Nephrotoxic.
B. Ototoxic.
C. Neurotoxic.
D. Cardiotoxic.
E. Hepatotoxic.
Metastatic breast cancer (stage IV) has all the following facts, except:
A. Treatment of MBC with cytotoxic, endocrine, or targeted therapy often results in
regression of disease and improvement in quality of life.
4
B. The choice of therapy for MBC is based on the extent of disease involvement and the
presence or absence of certain tumor or patient characteristics.
C. The most important predictive factors are the presence of HER2, ER, and PR receptors in
the primary or metastatic tumor tissue.
D. Consider adding bone-modifying agents (eg, pamidronate, zoledronic acid, or
denosumab) to treat breast cancer patients with metastases to the bone.
E. Cure is the primary goal of therapy for most patients with stage IV disease.
All the following agents are anti-HER2, except:

A. Neratinib.
B. Lapatinib.
C. Exemestane.
D. Pertuzumab.
E. Adotrastuzumab emtansine.
Which agent is not a targeted therapy?

A. Everolimus.
B. Anastrozole.
C. Bemaciclib.
D. Palbociclib.
E. Ribociclib.
Which therapy is the treatment of choice for patients who have hormone receptor positive
metastases?
Aromatase inhibitors are first-line therapy in postmenopausal women which are all of the
following, except:
A. Anastrozole.
B. Letrozole.
C. Exemestane.
D. Testolactone.
E. Tamoxifen.
5
Endocrine therapy of breast cancer may include all these agents, except:
A. Aromatase Inhibitors such as anastrozole, letrozole, and exemestane.
B. Estrogen modulators such as tamoxifen.
C. Surgical or chemical ovarian ablation.
D. Medical castration with an LHRH analogue such as goserelin, leuprolide, and triptorelin.
E. mTOR inhibitors such as everolimus.
Tumor response is measured by changes in all the following, except:

A. Laboratory tests.
B. Drug serum level.
C. Diagnostic imaging.
D. Physical signs.
E. Symptoms.
6
Answers:
The most strongly risk factors associated with occurrence of breast cancer are:
A. Gender and age.
B. Endocrine factors (eg, early menarche, nulliparity, late age at first birth, and hormone
replacement therapy).
C. Genetic factors (eg, personal and family history, mutations of tumor suppresser genes
[BRCA1 and BRCA2]).
D. Environmental factors.
E. Lifestyle factors (eg, radiation exposure, weight, height, and alcohol use).
The most common metastatic sites of breast cancer are all the following sites, except:
A. Lymph nodes.
B. Skin and bone.
C. Liver and lungs.
D. Brain.
E. Colon.
The pharmacologic risk reduction of breast cancer includes all the following agents, except:
A. Tamoxifen.
B. Raloxifene.
C. Estrogen.
D. Exemestane.
E. Anastrozole.
Risk reduction strategies of breast cancer include the therapeutic options below, except:
A. Mastectomy.
B. Estrogen hormonal therapy.
C. Oophorectomy.
D. Pharmacologic agents.
E. Nonpharmacologic therapy.
Which agent of the following increases the incidence of endometrial cancer?

A. Tamoxifen.
B. Raloxifene.
7
C. Trastuzumab.
D. Exemestane.
E. Anastrozole.
The initial signs of breast cancer in most women are:
A. Nipple changes.
B. Bone pain.
C. Painless, palpable lump (Solitary, unilateral, solid, irregular, and nonmobile).
D. Skin edema, redness, warmth, and induration.
E. Abdominal pain or enlargement, jaundice, and mental status changes.
What diagnostic method is indicated when there is mammographic abnormality that suggests
breast malignancy or for a palpable mass on physical examination?
A. Careful history.
B. Physical examination of the breast.
C. Three-dimensional mammography.
D. Breast imaging techniques, as ultrasound and magnetic resonance imaging (MRI).
E. Breast biopsy.
Goals of treatment of breast cancer include all the following facts, except:
A. Adjuvant therapy for early and locally advanced breast cancer (curative intent).
B. Neoadjuvant therapy is given to eradicate micrometastatic disease, determine prognosis,
and potentially conserve breast tissue for a better cosmetic result.
C. Curative therapy is the desired therapeutic outcome in the treatment of metastatic breast
cancer (MBC).
D. Treatment can cause substantial toxicity, which differs depending on the individual agent,
administration method, and combination regimen.
E. Treatment is rapidly evolving.
First line of therapy of early breast cancer (stage I and II) includes:
A. Surgery or breast-conserving therapy (BCT).
B. Adjuvant chemotherapy.
C. Adjuvant biological therapy.
E. Adjuvant endocrine therapy.
Surgery or breast-conserving therapy (BCT) includes all of the following, except:
8
A. Removal of part of the breast.

B. Lymphatic mapping or surgical evaluation of axillary lymph nodes.
C. Sentinel lymph node biopsy.
D. Radiation therapy (RT).
E. Total mastectomy.
Adjuvant chemotherapy of breast cancer does not include:

A. Anthracyclines like, doxorubicin and epirubicin.
B. LHRH agonists like, goserelin.
C. Taxanes like, docetaxel and paclitaxel.
D. Alkylating agents like, cyclophosphamide.
E. Antimetabolites like, methotrexate, and fluorouracil.
In adjuvant chemotherapy, dose intensity refers to all the below facts, except:
A. It is the amount of drug administered per unit of time.
B. It can be increased by increasing dose.
C. It can be increased by decreasing time between doses.
D. To elevate dose intensity, it is recommended to increase the dose of chemotherapy.
E. To elevate dose intensity, it is recommended to decrease the time between treatment
cycles.
A drug given in combination with or sequentially after adjuvant chemotherapy, and is

indicated in patients with early stage, HER2-positive breast cancer:
A. Trastuzumab.
B. Tamoxifen.
C. Goserelin.
D. Exemestane.
E. Anastrozole.
All the following agents are hormonal therapies used in the treatment of primary or early-stage
breast cancer, except:
A. Estrogen modulators like, tamoxifen and toremifene.
B. Oophorectomy and ovarian irradiation.
C. Aromatase inhibitors like, letrozole, exemestane and anastrozole.
D. Pertuzumab.
E. Luteinizing hormone–releasing hormone (LHRH) agonists.
9
All the statements below concerning locally advanced breast cancer (stage III) are correct,
except:
A. Neoadjuvant or primary chemotherapy is the initial treatment of choice.
B. Primary chemotherapy with an anthracycline- and taxane-containing regimen is
recommended.
C. The use of trastuzumab and pertuzumab with chemotherapy is appropriate for patients
with HER2-positive tumors.
D. Surgery followed by chemotherapy and adjuvant RT should be administered to minimize
local recurrence.
E. Palliation is the primary goal of therapy for most patients with stage III disease.
Treatment of metastatic breast cancer (MBC) may include all the following, except:
First-line therapy for HER2-overexpressing metastatic breast cancer (MBC) is:

A. Pertuzumab-trastuzumab-taxane combination.
B. Cytotoxic chemotherapy.
C. Endocrine therapy.
D. Surgery or breast-conserving therapy (BCT).
E. Orchiectomy.
All HER2-targeted therapies are mainly:

A. Nephrotoxic.
B. Ototoxic.
C. Neurotoxic.
D. Cardiotoxic.
E. Hepatotoxic.
Metastatic breast cancer (stage IV) has all the following facts, except:
A. Treatment of MBC with cytotoxic, endocrine, or targeted therapy often results in
regression of disease and improvement in quality of life.
10
B. The choice of therapy for MBC is based on the extent of disease involvement and the
presence or absence of certain tumor or patient characteristics.
C. The most important predictive factors are the presence of HER2, ER, and PR receptors in
the primary or metastatic tumor tissue.
D. Consider adding bone-modifying agents (eg, pamidronate, zoledronic acid, or
denosumab) to treat breast cancer patients with metastases to the bone.
E. Cure is the primary goal of therapy for most patients with stage IV disease.
All the following agents are anti-HER2, except:

A. Neratinib.
B. Lapatinib.
C. Exemestane.
D. Pertuzumab.
E. Adotrastuzumab emtansine.
Which agent is not a targeted therapy?

A. Everolimus.
B. Anastrozole.
C. Bemaciclib.
D. Palbociclib.
E. Ribociclib.
Which therapy is the treatment of choice for patients who have hormone receptor positive
metastases?
Aromatase inhibitors are first-line therapy in postmenopausal women which are all of the
following, except:
A. Anastrozole.
B. Letrozole.
C. Exemestane.
D. Testolactone.
E. Tamoxifen.
11
Endocrine therapy of breast cancer may include all these agents, except:
A. Aromatase Inhibitors such as anastrozole, letrozole, and exemestane.
B. Estrogen modulators such as tamoxifen.
C. Surgical or chemical ovarian ablation.
D. Medical castration with an LHRH analogue such as goserelin, leuprolide, and triptorelin.
E. mTOR inhibitors such as everolimus.
Tumor response is measured by changes in all the following, except:

A. Laboratory tests.
B. Drug serum level.
C. Diagnostic imaging.
D. Physical signs.
E. Symptoms.
12

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AD

Appropriate laboratory tests of AD include all the following, except:

Signature findings in AD include the following features, except:

Proposed mechanisms of Alzheimer disease (AD) involve:

All the following statements regarding AD are correct, except:

Which point is most correct concerning clinical presentations of AD?

Primary prevention of AD include all the following, except:

Signature findings in AD include the following features, except:

Proposed mechanisms of Alzheimer disease (AD) involve:

All the following statements regarding AD are correct, except:

Which point is most correct concerning clinical presentations of AD?

Primary prevention of AD includes all the following, except:

E. Adherence to the Mediterranean Diet.

1. Cushing syndrome: select the most appropriate answer:

2. ACTH-dependent Cushing syndrome: which one is not correct?

4. Which selection is most correct regarding diagnosis of Cushing syndrome:

A. Surgical resection of tumors.

6. All the following statements regarding metyrapone are correct, except:

7. In regard to Ketoconazole, which statement is not correct?

8. Mitotane has all the following properties, except:

9. Pituitary secretion of ACTH is normally mediated by neurotransmitters such as:

10. Cyproheptadine has all the following features, except:

12. Regarding Mifepristone, which point is not true?

13. In Cushing syndrome, evaluation of therapeutic outcomes of pharmacologic treatment

14. Hyperaldosteronism involves all of the following characteristics, except:

15. Nonpharmacologic therapy of aldosterone-producing adenomas includes which option of

16. Adrenal insufficiency involves all the following properties, except?

19. Which statement is not correct regarding corticosteroids?

D. Mineralocorticoids are necessary in secondary adrenal insufficiency.

Cushing syndrome: select the most appropriate answer:

A. Supraphysiologic glucocorticoid concentrations.

ACTH-dependent Cushing syndrome: which one is not correct?

A. 80% of all Cushing syndrome cases.

A. Central obesity, facial rounding, peripheral obesity and fat accumulation.

Which selection is most correct regarding diagnosis of Cushing syndrome:

A. Surgical resection of tumors.

6. All the following statements regarding metyrapone are correct, except:

C. Adrenal steroidogenesis shunts toward androgen production, resulting in androgenic

In regard to Ketoconazole, which statement is not correct?

Mitotane has all the following properties, except:

Pituitary secretion of ACTH is normally mediated by neurotransmitters such as:

Cyproheptadine has all the following features, except:

A. Nonselective serotonin receptor antagonist.

All the statements below are true concerning Pasireotide, except:

A. It is a somatostatin analogue that binds and activates somatostatin receptors.

Regarding Mifepristone, which point is not true?

A. A progesterone- and glucocorticoid-receptor agonist, and increases endogenous

In Cushing syndrome, evaluation of therapeutic outcomes of pharmacologic treatment includes:

A. 24-hour urine free cortisol (UFC).

C. Monitor steroid secretion with all drug therapy (except mifepristone).

Hyperaldosteronism involves all of the following characteristics, except:

A. Primary hyperaldosteronism is caused by bilateral adrenal hyperplasia and

Nonpharmacologic therapy of aldosterone-producing adenomas includes which option of the

A. Laparoscopic resection of the tumor.

Adrenal insufficiency involves all the following properties, except?

C. Mirtazapine and progestins induce primary adrenal insufficiency.

Diagnosis of adrenal insufficiency includes all the options below, except:

A. Short cosyntropin stimulation test

Which statement is not correct regarding corticosteroids?

D. Mineralocorticoids are necessary in secondary adrenal insufficiency.

All the following facts regarding contraception are correct, except:

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Goals of using contraception may involve all the following, except:

All the following contraceptives contain hormones or drugs, except: