PCAM 2

1.

1 point

Starch blockers

are regulated by FDA and must be proven to be effective.

are a reliable option for losing weight when used with fat blockers.

are as effective as low-calorie diets for losing weight.

None of the above

2.

1 point

Which of the following is correctly matched:

Calcium <> increases weight loss when consumed as a supplement, but not from foods.

Garcinia <> increases weight loss, but only when products are standardized to 50% hydroxycitric acid.

Conjugated linoleic acid <> increases lean body mass, but there are concerns about insulin resistance.

Cha de bugre <> increases weight loss, but there are concerns about long-term safety.

3.

1 point

Based on the system described above, an interaction that is "Probable" and of "Moderate" severity is given an overall rating of:

Minor

Major

Moderate

Insignificant

4.

1 point

Which of the following is most likely to help reduce hot flashes?

Panax ginseng

Black cohosh

Evening primrose oil

Wild yam

5.

1 point

Which of the following products should be recommended for reducing pain related to osteoarthritis of the knee?

Dona

CosaminDS

Chondroitin sulfate

Glucosamine hydrochloride plus chondroitin sulfate

6.

1 point

Which of the following is TRUE about using glucosamine for osteoarthritis?

It appears to reduce pain.

All of the above

It might slow disease progression.

It does not work as quickly as conventional analgesics.

7.

1 point

Which of the following is TRUE about calcium and weight loss?

High-fat dairy products are more effective than low-fat dairy.

Calcium supplements are more effective than calcium containing dairy products.

People with low calcium intake are more likely to gain weight.

Calcium citrate is more effective than calcium carbonate.

8.

1 point

Which of the following is TRUE?

The long-term safety of the Atkins diet is well established.

Foods low in "net carbs" are also always low in calories.

Compared with low-fat diets, Atkins provides more weight loss after one year.

The South Beach diet divides carbohydrates into "good" and "bad" based on their glycemic index.

9.

1 point

Which of the following is TRUE about ginger, stinging nettle, cat's claw, and devil's claw?

It's too soon to recommend any of them for most people with osteoarthritis.

All of the above

They are all thought to have anti-inflammatory effects.

Preliminary evidence suggests that they might have some benefit for osteoarthritis pain.

10.

1 point

Now that FDA has banned ephedra, what other ephedrine-like products should you caution patients about?

5-HTP

Hoodia

Bitter orange

All of the above

11.

1 point

Based on evidence to date, which of the following products would be most appropriate to recommend for a patient with osteoarthritis?

SAMe

Chondroitin sulfate

Glucosamine sulfate

Glucosamine hydrochloride plus chondroitin sulfate

12.

1 point

Which best describes the effect of using soy for hot flashes?

Soy increases the effects of warfarin.

It's modestly effective for menopausal hot flashes.

Soy is about as effective as estradiol, but soy works more quickly.

Soy isoflavones are more effective than Premarin.

13.

1 point

Which of the following best explains how cranberry juice might prevent urinary tract infections?

Lowering vaginal pH

Bactericidal effect

Stimulating immune function

Preventing bacterial adhesion

14.

1 point

Which of the following is a potential hot flash trigger?

Insomnia

Spicy food

Cold environment

High carbohydrates

15.

1 point

Which of the following is TRUE about obesity?

Daily calorie intake has remained about the same over the last several decades.

Obesity raises the risk of diabetes by 10-20 times.

Most adults are NOT overweight.

Though still a problem, childhood obesity is decreasing.

16.

1 point

There's a lot of interest in using antioxidants for osteoarthritis. Which of the following is TRUE?

Taking SOD supplements orally decreases joint pain.

Increasing dietary consumption of antioxidants such as vitamin C, vitamin E, and beta-carotene might slow the progression of osteoarthritis.

Taking a combination of vitamin C, vitamin E, and beta-carotene supplements decreases the risk of developing osteoarthritis.

None of the above

17.

1 point

A diabetes patient is interested in trying the supplement Glucosol by Now Health group. He currently takes aspirin, glyburide (Diabeta), simvastatin (Zocor), and benazepril (Lotensin). Which of the following combinations might result in a significant interaction?

Glucosol <> glyburide (Diabeta)

Glucosol <> aspirin

Glucosol <> simvastatin (Zocor)

Glucosol <> benazapril (Lotensin)

18.

1 point

There is some concern that echinacea might interact with some prescription drugs. Which of the following drugs, in theory, might interact with echinacea?

Aspirin

Ampicillin

Ezetimibe (Zetia)

Cyclosporine

19.

1 point

Which of the following best explains how probiotics might prevent urinary tract infections?

Preventing bacterial adhesion

Lowering vaginal pH

All of the above

Stimulating immune function

20.

1 point

SAMe seems to be effective for osteoarthritis. Which of the following is TRUE about SAMe?

It might interact with antidepressants.

It's expensive.

Many SAMe brands have poor product quality.

All of the above

21.

1 point

Topically applied Mexican wild yam cream

is converted by the body to progesterone.

raises serum levels of DHEA.

provides immediate relief from hot flashes.

is not effective for hot flashes.

22.

1 point

Which of the following increases the risk of urinary tract infections?

Taking showers

Sexual inactivity

Recent bacterial infection

Using an oral contraceptive

23.

1 point

Which of the following has the best evidence for relief of osteoarthritis pain?

Stinging nettle

Capsaicin cream

Phellodendron amurense

Ginger extract

24.

1 point

A patient wants to use garlic to prevent recurring urinary tract infections. Which of the follow should you tell her?

It should be applied intravaginally for the best results.

It's most effective if combined with uva ursi and goldenseal.

There's no proof that it is effective.

Garlic extract is more effect than fresh garlic.

25.

1 point

Which of the following is matched appropriately?

Noni juice should not be combined with CYP3A4 substrates.

Bitter orange should be administered at least 4 hours before or after an ACE inhibitor.

Kava should not be combined with QT-prolonging drugs.

Calcium should be taken at least 4 hours before or after levothyroxine.

26.

1 point

What lifestyle changes can menopausal women make to decrease symptoms?

Start a yoga or exercise program

Cut diet sodas

Cut dietary protein

Sleep 8-10 hours per day

27.

1 point

Which of the following is correctly matched?

Pomegranate INCREASES levels of CYP3A4 substrates

Grapefruit juice DECREASES levels of CYP3A4 substrates

All of the above

St. John's wort INCREASES levels of CYP3A4 substrates

28.

1 point

Overall, the evidence supporting natural medicines for preventing urinary tract infections is weak. Which of the following has the best evidence for PREVENTING urinary tract infections?

Asparagus

Cranberry

Echinacea

Bifidobacteria

29.

1 point

Which of the following is the most potent and most common phytoestrogen?

Coumestans

Flaxseed

Lignans

Isoflavones

30.

1 point

What can you tell women who ask you about DHEA for treating menopausal symptoms?

DHEA can sometimes cause unwanted side effects such as increased facial hair.

DHEA might not be safe for some patients.

All of the above

DHEA might increase the risk of breast cancer.

31.

1 point

Which of the following supplements is appropriate to recommend for weight loss?

Hoodia

None of the above

Calcium

Bitter orange

32.

1 point

Drug therapy for obesity should be considered when a patient has a BMI of:

27 or greater and no co-morbidities.

30 or greater and no co-morbidities.

All of the above

25 or greater plus diabetes.

33.

1 point

Which of the following is TRUE about the pharmacological effects of phytoestrogens?

They are chemically related to estrogen.

They have SERM-like effects.

They can increase the effects of tamoxifen.

They are more potent than estrogen.

34.

1 point

Which of the following natural products works most similar to an antibiotic?

Parsley

Lactobacillus

Echinacea

Uva ursi

35.

1 point

An organ transplant patient is depressed. He is considering trying St. John's wort. Which of the following is the best advice for this patient?

St. John's wort is a better choice than a conventional SSRI.

Do not take St. John's wort.

St. John's wort interacts with cyclosporine, but not tacrolimus.

It's OK to take St. John's wort as long as cyclosporine levels are monitored.

36.

1 point

If a patient asked you to recommend a cranberry product for preventing recurrent urinary tract infection, which of the following would be appropriate to recommend?

Cranberry juice cocktail

Natural Cranberry with Vitamin C

Cran-Max supplement

Any of the above

37.

1 point

Which of the following steps can women take to decrease their risk of developing a urinary tract infection?

Wear cotton-crotch underwear.

Don't hold urine for long periods of time.

Drink plenty of fluids.

All of the above

38.

1 point

There has been some debate about whether cranberry juice might interact with warfarin. Which of the following represents the most current thinking on this issue? (HINT: Click link above to go to the cranberry monograph; then scroll down to the Interactions with Drugs section)

It is possible that the interaction might occur.

It probably doesn't interact with warfarin, but might interact with clopidogrel (Plavix).

The interaction is likely to occur.

None of the above

39.

1 point

Which of the following best explains how capsaicin works for pain?

Inhibits lipoxygenase

Inhibits substance P

Inhibits tumor necrosis factor (TNF)

Inhibits cyclooxygenase (COX)

40.

1 point

A 32-year old female asks you if she should take garlic for lowering cholesterol. Her current medications include an oral contraceptive, ibuprofen as needed for menstrual discomfort, and calcium. What advice is appropriate for this patient?

All of the above

She should separate administration of ibuprofen and garlic by at least 2 hours.

Calcium might decrease the effectiveness of garlic if taken concurrently.

She should use a backup form of birth control if she takes garlic.

41.

1 point

A patient with breast cancer asks you about taking phytoestrogens for treating menopausal symptoms. What should you tell her?

Phytoestrogens might interfere with tamoxifen.

Phytoestrogens can be safely used by breast cancer patients.

Phytoestrogens are more effective than estrogens.

Phytoestrogens are proven safer than estrogen.

42.

1 point

What should you tell a patient who wants to take black cohosh for hot flashes?

It does not work for hot flashes.

Liver function tests are needed.

It's more effective than soy for hot flashes.

It decreases the risk of breast cancer.

43.

1 point

Which of the following is TRUE about digestion inhibitors?

Orlistat (Xenical) inhibits the breakdown and absorption of dietary fats.

Some fibers can decrease the absorption of oral medications.

All of the above

Psyllium and other fibers bind dietary fats preventing absorption.

44.

1 point

Which of the following is good advice for launching a weight loss program?
1. Aim for a diet providing about 500-1000 kcal per day.
2. Walk for 30 minutes 3-5 times per week.
3. Reduce food portion sizes.
4. Eliminate carbohydrates from the diet.

2 and 3

1 and 3

3 and 4

1 and 2

45.

1 point

Orange juice might inhibit organic anion transporting polypeptide (OATP). This peptide is involved in drug transport in the gut, liver, and kidney. Drinking orange juice DECREASES absorption of fexofenadine (Allegra) by about 72%, possibly by inhibiting OATP. This interaction is an example what type of interaction?

Pharmacokinetic

Pharmaco-dynamic

46.

1 point

Which of the following is TRUE about cetylated fatty acids?

They're most effective for morning stiffness.

They work by building mucopolysaccharides.

They slow progression of osteoarthritis.

A specific product (Celadrin) improves joint pain in the knee.

47.

1 point

Which of the following is TRUE?
1. There is more evidence to support chondroitin than glucosamine.
2. Glucosamine SULFATE is preferred over glucosamine HCL.
3. An appropriate dose of glucosamine is 1500 mg daily.
4. Glucosamine should be avoided in patients with diabetes

1 and 2

2 and 3

3 and 4

1 and 4

48.

1 point

SAMe (S-adenosyl-methionine) is used for depression and other conditions. SAMe increases serotonin levels in the CNS. Combining SAMe with a conventional selective serotonin reuptake inhibitor (SSRI) such as paroxetine (Paxil) might result in serotonin syndrome. This interaction is an example of what type of interaction?

Pharmaco-dynamic

Pharmacokinetic