MOOC 臨床藥學(xué)英語-南京醫(yī)科大學(xué) 中國大學(xué)慕課答案

MOOC臨床藥學(xué)英語-南京醫(yī)科大學(xué)中國大學(xué)慕課答案單元作業(yè)1單元測試11、問題：Whatwouldyourecommendtothispatientatthistime?選項(xiàng)：A、Fulvestrant（氟維司群）aloneB、Fulvestrant+PI3K/AKT/mTORinhibitorinaclinicaltrialC、pan-ErbBreceptorinhibitorinaclinicaltrialD、Chemotherapy正確答案:【Fulvestrant+PI3K/AKT/mTORinhibitorinaclinicaltrial】2、問題：WhydoweneedtolearnClinicalPharmacyEnglish?選項(xiàng)：A、IncreaseinternationalmedicalandpharmacyknowledgeB、Improveglobalhealthawarenessandcross-culturalcommunicationabilityC、Broadenstudents’internationalvisionandcultivatestudents’globalcompetenceD、Layfoundationforfollow-upscientificresearch正確答案:【Increaseinternationalmedicalandpharmacyknowledge#Improveglobalhealthawarenessandcross-culturalcommunicationability#Broadenstudents’internationalvisionandcultivatestudents’globalcompetence#Layfoundationforfollow-upscientificresearch】單元作業(yè)2單元測試21、問題：2.Whichoneisfaster,thenormalrateofimpulseinitiationortheSAnode?選項(xiàng)：A、impulseinitiationB、theSAnodeC、AVnodeD、same正確答案:【theSAnode】2、問題：HeartTheheartactsasapumpandmaintainscirculationofthebloodbyalternateconcentrationandrelaxationofcardiacmuscle(themyocardium).Itgenerallycontractsatarateof70to75beats/minuteinahealthy70-kgpersonatrest.Thenormalheartrhythm,knownassinusrhythm,originatesinspecializedcardiaccells,calledpacemakercells,inthesino-atrial(SA)orsinusnodeandhasbeendefinedasasinusnoderateof60to100beats/minute.EachheartbeatorcontractionisinitiatedbygenerationofanactionpotentialintheSAnode;theelectricalimpulsespreadsoverbothatria,causingthemtocontract,andontotheatrioventricular(AV)node.FromtheAVnodeitspreadsthroughthebundleofHisanddownthePurkinjefiberstotheventricles,causingthemtocontract.Itisthemovementofionsacrossthecardiaccellmembranethatgeneratestheactionpotential.Theelectricalchangesinvolvedcanberecordedonanelectrocardiogram(ECG).Othercardiaccellsthatarelocatedoutsidethesinusnodearealsocapableofinitiatingimpulses.Thesecells,termedectopicpacemakers,canbefoundintheatriovertricularjunctionandintheHis-Purkinjesystem.Thenormalrateofimpulseinitiationbytheseectopicpacemakersislessthanthatofthesinusnodeandthereforetheydonotnormallyinitiatetheheartbeat.However,theymaybecomedominantincertaincircumstancessuchas:iftheintrinsicrateoftheectopicpacemakerrisesabovethatofthesinusnode;ifthesinusnoderatefallsbelowthatoftheectopicpacemaker;orwhenanormalsinusnodeimpulseispreventedfrombeingconductedthroughtheheart(heartblock)leavingtheectopicpacemakertofireatitsownintrinsicrate.Acardiacarrhythmiacanbedefinedinsimpletermsasanyabnormallyofrate,regularity,orsiteoforiginofthecardiacimpulseorasadisturbanceinconductionthatcausesanabnormalsequenceofactivation.Symptomsdependonthearrhythmiabutmayincludefatigue,dyspnoea,dizziness,andsyncope;suddendeathmayoccur.Palpitationisatermusedtodescribeanunacceptableawarenessofthebeatingheartbythepatient.Thismayoccurnormallyincircumstancessuchasemotion,exercise,orstressormayoccurinassociationwitharrhythmias.Clinically,arrhythmiasmaybeclassifiedbypresumedsiteoforigin,namelyassupraventriculararrhythmias(includingatrialarrhythmiasandatrioventricularjunctionalarrhythmias)orasventriculararrhythmias.Classificationcanalsobebasedonrateaseitherbradyarrhythmias(slow)ortachyarrhythmias(fast).Bradyarrhythmiasarecausedbysinusnodedysfunction,whicheitherdepressesimpulsegenerationordisturbstheconductionofimpulsesfromthesinusnodetotheatria.Atrioventricularblockindicatesdisturbanceofconductionoftheatrialimpulsetotheventricles.Infirst-degreeblocktheimpulseisdelayed.Itisusuallyasymptomaticbutmayprogresstosecond-orthird-degreeblock.Insecond-degreeblocktheimpulseisblockedintermittentlyandinthird-degreeblockthereisacompleteblock.Atrioventriculardissociationindicatesaconditioninwhichventricularactivityisfasterthan,andindependentof,theatrialactivity.Bradyarrhythmiasmaybetreatedwitheitheratropineorisoprenaline,althoughcardiacpacingisthetreatmentofchoice.Fortachyarrhythmiasaclassificationordiagnosisbasedontheprecisemechanismofthearrhythmiawouldalsobedesirablebutthisisnotalwaysclear.Inmanyoftheclinicallyrelevantarrhythmias,however,themechanismisoneofre-entry.Re-entryoccurswhentheinitialimpulsedoesnotdieoutbutcontinuestopropagateandreactivatetheheart.Questions1.OnlytheSAnodecaninitiatetheheartbeat,trueorfalse,why?選項(xiàng)：A、正確B、錯(cuò)誤正確答案:【錯(cuò)誤】3、問題：BradyarrhythmiasarecausedbyAVnodedysfunction,trueorfalse?選項(xiàng)：A、正確B、錯(cuò)誤正確答案:【錯(cuò)誤】4、問題：Kate’sdoctortoldherthatshemighthasafirst-degreeatrioventricularblockandsuggestedhertotakefurtherexamination.However,Marydoesnotfeelanyuncomfortable.Shouldshetakethedoctor’sadvice?選項(xiàng)：A、正確B、錯(cuò)誤正確答案:【正確】單元作業(yè)3單元測試31、問題：HypertensionHypertension,particularlyessentialorprimaryhypertension,iswidespreadandalthoughusuallyasymptomatic,isamajorriskfactorforstrokeandtosomeextentischemicheartdisease.Controlofhypertensionisthereforeamajoraspectofcardiovascularriskreduction.Nationalandinternationalguidelinesonmanagementhavebeenpublished.Definitions:Thetermbloodpressuregenerallymeansarterialbloodpressure,thepressureofthebloodonarterywalls.ItisusuallymeasuredindirectlyinthebrachialarteryjustabovetheelbowusinganappropriatelycalibratedsphygmomanometerandisexpressedinmmHg.Twomeasurementsaremade:systolicormaximumbloodpressure(achievedduringventricularcontractionoftheheart)anddiastolicorminimumbloodpressure(achievedduringventriculardilatation).Hypertensionmeansahigherthan“normal”bloodpressure;ithasbeendefinedasthelevelofbloodpressureabovewhichinterventionhasbeenshowntoreducetheassociatedcardiovascularrisk.Manyfactorsinfluencebloodpressure,resultinginabell-shapeddistributioncurveinthegeneralpopulation,andinconsequenceitisdifficulttodefineanabsolutenorm.Normaladultbloodpressurehasbeenarbitrarilydefinedasasystolicpressurebelow130mmHgtogetherwithadiastolicpressurebelow85mmHg(i.e.below130/85mmHg),butmorerecentstudieshavesuggestedthatoptimalbloodpressure,intermsofcardiovascularrisk,maybelowerthanthis.USguidelinesnowdefinenormalbloodpressureasbelow120/80mmHg,whileEuropeanandBritishguidelinesclassifythisasoptimal.Bloodpressureof130~139/85~89mmHgareregardedashighnormalorareincludedintheclassificationofprehypertension.Althoughhypertensionwasformerlydefinedintermsofdiastolicbloodpressurealone,itisnowrecognizedthatsystolicpressureisalsoimportantindeterminingrisk,andcurrentguidelinesgiveequalemphasistoboth.Bloodpressureabove140mmHgsystolic,and/or90mmHgdiastolicisgenerallyconsideredtorepresenthypertension.Althoughclassificationsofmild,moderate,andseverehypertensionhavebeenwidelyused,thesetermsmaybemisleadingsinceabsolutecardiovascularriskismoreimportantindeterminingtheneedfortreatmentanddependsonotherfactorsinadditiontobloodpressure.Mostguidelinesthereforeuseagradingsystemtoclassifyhypertension,asfollows:grade1:140~159/90~99mmHg;grade2:160~179/100~109mmHg;grade3:≥180/≥110mmHg.IntheUSguidelines,stage1hypertensioncorrespondstograde1,whereasstage2includesbothgrades2and3.Whensystolicanddiastolicpressuresfallintodifferentcategoriesthehighervaluesisusedforclassificationpurposes.Classificationandsubsequenttreatmentdecisionsshouldbebasedonbloodpressuremeasurementstakenonseveraloccasionsoveraperiodthatvariesaccordingtotheseverityofhypertension.Ambulatorybloodpressuremonitoringmaybeusedinsomecases.However,readingstendtobelowerwithambulatorymonitoringthanwithconventionalmeasurementandnormalandabnormalvaluesarenotyetclearlyestablished,althoughrecommendationshavebeenmade.Inmalignantoracceleratedhypertensionrapidlyprogressingseverehypertensionisassociatedwithretinopathyandoftenrenalimpairment.Isolatedsystolichypertensionoccursmainlyintheelderlyandhasbeendefinedassystolicpressureof140mmHgormoreanddiastolicpressureunder90mmHg.1.What’stheshapeofbloodpressuredistribution?選項(xiàng)：A、Bell-shapedB、arrow-shapedC、heart-shapedD、linear正確答案:【Bell-shaped】2、問題：Ifthesystolicpressureis144andthediastolicpressureis105,whichgradedoeshypertensioncorrespondto?選項(xiàng)：A、Grade1B、Grade2C、Grade3D、Heisnormal正確答案:【Grade2】3、問題：Whichoneusuallyhasalargerreading,ambulatorymonitoringorconventionalmeasurement?選項(xiàng)：A、AmbulatorymonitoringB、ConventionalmeasurementC、SameD、Can'tcompare正確答案:【Conventionalmeasurement】4、問題：Allyhasabloodpressureof145/85Hg.Whatisthegivennameforthishypertension?選項(xiàng)：A、IsolatedsystolichypertensionB、IsolateddiastolichypertensionC、Grade1D、Grade2正確答案:【Isolatedsystolichypertension】5、問題：Chrishasacardiovascularrelateddisease.Thisyear,hisbloodpressuremeasuredinannualexaminationwas130/85Hg.Hethoughtthattheresultwasveryoptimal.Whatdoyouthinkaboutit,ifyouarehisphysician?選項(xiàng)：A、正確B、錯(cuò)誤正確答案:【錯(cuò)誤】單元作業(yè)4單元測試41、問題：PaclitaxelTradeNamesAbraxane-Injection,lyophilizedpowderforsuspension(albuminbound)100mgPaclitaxel-Injection,solution,concentrate6mg/mLApo-PaclitaxelInjectable(Canada)PharmacologyPaclitaxelisanovelantimicrotubuleagentthatpromotestheassemblyofmicrotubulesfromtubulindimersandstabilizesmicrotubulesbypreventingdepolymerization.Thisstabilityinhibitsthenormaldynamicreorganizationofthemicrotubulenetworkthatisessentialforvitalinterphaseandmitoticcellularfunctions.Inaddition,paclitaxelinducesabnormalarraysorbundlesofmicrotubulesthroughoutthecellcycleandmultipleastersofmicrotubulesduringmitosis,furtherdisruptingcellfunction.PharmacokineticsAbsorptionAbraxaneCmaxis18,741ng/mL.PaclitaxelinjectionsolutionFollowing3-and24-hinfusions,Cmaxis195to3,650ng/mLandAUCis6,300to15,007ng?h/mL.Distribution89%to98%proteinbound.Extensiveextravasculardistributionand/ortissuebinding.AbraxaneVdis632L/m2.PaclitaxelinjectionsolutionVdis227to688L/m2atsteadystatewith24-hinfusion.MetabolismPaclitaxelismetabolizedprimarilyto6-alpha-hydroxypaclitaxelbyisoenzymesCYP2C8andto2minormetabolites,3′-p-hydroxypaclitaxeland6-alpha,3′-p-dihyroxypaclitaxelbyCYP3A4.EliminationAbraxaneExcretedintheurine(4%)andinthefeces(20%).Terminalhalf-lifeisapproximately27handtotalbodyClis15L/h/m2.PaclitaxelinjectionsolutionExcretedintheurine(14%)andinthefeces(71%).Following3-and24-hinfusions,thehalf-lifeis13.1to52.7handtotalbodyClis12.2to23.8L/h/m2.SpecialPopulationsRenalFunctionImpairmentTheeffectofrenaldysfunctiononthedispositionofpaclitaxelhasnotbeeninvestigated.HepaticFunctionImpairmentPlasmapaclitaxelexposureisincreased.IndicationsandUsageAbraxaneForthetreatmentofbreastcancerafterfailureofcombinationchemotherapyformetastaticdiseaseorrelapsewithin6moofadjuvantchemotherapy.PaclitaxelinjectionsolutionAsfirst-lineandsubsequenttherapyforthetreatmentofadvancedcarcinomaoftheovary;adjuvanttreatmentofnode-positivebreastcanceradministeredsequentiallytostandarddoxorubicin-containingcombinationchemotherapy;treatmentofbreastcancerafterfailureofcombinationchemotherapyformetastaticdiseaseorrelapsewithin6moofadjuvantchemotherapy;incombinationwithcisplatin,forthefirst-linetreatmentofnon–smallcelllungcancer(NSCLC)inpatientswhoarenotcandidatesforpotentiallycurativesurgeryand/orradiationtherapy;forthesecond-linetreatmentofAIDS-relatedKaposisarcoma.UnlabeledUsesPaclitaxelinjectionsolutionhasbeenusedforsquamouscellheadandneckcancer,smallcelllungcancer,bladdercancer,esophagealcancer,testicularcancer,endometrialcancer,prostatecancer,gastriccancer,germcelltumors,andrefractoryleukemiaandrecurrentWilmstumorinchildren.AbraxanehasbeenusedforNSCLC,metastaticmelanoma,andsquamouscellcancerofthetongue,headandneck,oranalcanal.ContraindicationsHypersensitivityreactionstopaclitaxelorotherdrugsformulatedinCremophorEL(polyoxyethylatedcastoroil)(paclitaxelinjectionsolutiononly);patientswithsolidtumorswhohavebaselineneutrophilcountoffewerthan1,500cells/mm3orinpatientswithAIDS-relatedKaposisarcomawithbaselineneutrophilcountsoflessthan1,000cells/mm3.DosageandAdministrationAbraxaneAdultsBreastcancerIV260mg/m2over30minevery3wk.Forpatientsexperiencingsevereneutropenia(neutrophilcountlessthan500cells/mm3for1wkorlonger)orseveresensoryneuropathy,reducedoseto220mg/m2forsubsequentcourses.Forrecurrenceofsevereneutropeniaorseveresensoryneuropathy,reducedoseto180mg/m2.Forgrade3sensoryneuropathy,holdtreatmentuntilresolutiontograde1or2,andreducethedoseforallsubsequentcoursesoftreatment.PaclitaxelinjectionsolutionAdultsReducedoseby20%forallsubsequentcoursesinpatientswithsevereneuropathyorsevereneutropenia(neutrophilcountlessthan500cells/mm3forlongerthan7days).Questions1)What’sthetradenameforPaclitaxelinCanada?選項(xiàng)：A、Apo-PaclitaxelInjec