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The ACT originally an abbreviation of American College Testing) college readiness assessment is a standardized test for high school achievement and college admissions in the United States produced by ACT, a nonprofit of the same name. It was first administered in November 1959 by Everett Franklin Lindquist as a competitor to the College Board's Scholastic Aptitude Test, now the SAT. The ACT originally consisted of four tests: English, Mathematics, Social Studies, and Natural Sciences. In 1989, the Social Studies test was changed into a Reading section (which included a Social Studies subsection) and the Natural Sciences test was renamed the Science Reasoning test, with more emphasis on problem solving skills In February 2005, an optional Writing test was added to the ACT, mirroring changes to the SAT that took place later in March of the same year. The ACT is now offered as a computer-based test. The test will continue to be offered in the paper format for schools that are not ready to transition to computer testing

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Question No 1:

A 14 yr old white female with asthma has been well controlled for the last 6 months on her current therapy of mometasone 200 mcg inhaler (1 inhalation per day, low dose), salmeterol inhaler (1 puff twice a day) and albuterol inhaler as needed (not used in > 6 months). Which of the following recommendations would be most appropriate?

A. Discontinue albuterol as she is not currently using the inhaler. Continue mometasone and salmeterol.B. Discontinue salmeterol. Continue scheduled mometasone and as needed albuterol.C. Discontinue mometasone. Continue scheduled salmeterol and as needed albuterol.D. Discontinue mometasone and salmeterol. Continue as needed albuterol.

Answer: B




Question No 2:

What two factors can influence the pharmacological effect of phenytoin (Dilantin) and the interpretation of measured drug levels by the lab?

A. Sodium and albumin levelsB. Potassium and bicarbonate levelsC. Albumin and creatinine kinase (CK) levelsD. Blood urea nitrogen and albumin levels

Answer: D




Question No 3:

A 55 year old patient with Stage 2A HER2 positive breast cancer receiving every three week adjuvant trastuzumab therapy. At her appointment, she complains of fatigue and the inability to do her normal daily activities. Her lab results show that she is anemic with a hemoglobin of 9.9 g/dL (hematocrit 29%). Which of the following treatments would be best for this patient?

A. Start epoetin alfa 40,000 units SQ weeklyB. Begin darbepoetin alfa 500 mcg SQ every three weeksC. Initiate iron sucrose 200 mg IV followed by darbepoetin 500 mcg SQ every 3 weeksD. No erythropoiesis stimulating agent (ESA) is indicated

Answer: D




Question No 4:

All proteins consist of a string of amino acids linked together by peptide bonds. Because of its unique

sequence of amino acids, every protein is distinct. Each protein folds into a specific conformation wh

en manufactured by cells. All proteins must attain three-dimensional structures to properly function i

n the cell. While the peptide bonds between the amino acids are relatively rigid, all the other chemic

al bonds within a protein are flexible and can contort within certain limits.

The ability of a protein to fold depends on the flexibility of these chemical bonds. A small protein of a

bout 100 amino acids could undergo an astronomical number of trials and errors before assuming its

final structure. This sampling of many conformations before attaining the right one would take far to

o long and so scientists hypothesize that there must be pathways which guide individual proteins to t

he right conformations, thereby eliminating total randomness in sampling. Three pathway models of

protein folding have been proposed.

Diffusion-collision model




This model suggests that an amino acid within a protein can diffuse within its environment until it collide

s with its specific partner amino acid, to which it adheres. When all the amino acids, are involved in favo

rable interactions, the protein ceases to diffuse and the proper conformation is attained.

Nucleation model

This model postulates that the acquisition of the proper fold within several amino acids would trigger t

he folding process. These amino acids act as nucleation centers and cause a domino effect in promoting

protein folding. The protein can be imagined to sequentially acquire its proper conformation beginning

from the nucleation centers.

Hydrophobic-collapse model

Out of the 20 different amino acids, some are hydrophobic. A hydrophobic amino acid is one that does no

t like to be associated with water but does like to be associated with others like itself. In the hydrophobic-

collapse model, hydrophobic amino acids in the protein collapse into the center of the protein leaving the

hydrophilic (water-loving) amino acids to surround them and interact with water.

The nucleation model suggests that some amino acids are more important than others whereas the diff

usion-collision model supposes that all amino acids are equally important. Which of the following state

ments is NOT true?

A. A mutation in an important amino acid in the nucleation model will have no effect acco

rding to the diffusion-collision model.

B. A mutation in an amino acid, which is important in the nucleation model, will result in a wr

ong conformation.

C. A mutation in an amino acid might affect proper protein conformation according to the

D. diffusion collision model.

E. A mutation in a certain amino acid might have an effect according to both the nucle

ation model and the diffusion-collision model.

Answer: A

Question No 5:


You set up an experiment to investigate the different rates at which soil and water heat and cool

. You use the followingequipment:

Thermometers (measuring in °C

) Container of soil

Container of water

Radiation La

mp Timer

You obtain the temperature of the soil and water over a period of time and collect the foll

owing data:



Based on the results of the experiment, what is true about the heating and cooling rates of soil

and water?

A. Water heats faster, but cools slower.

B. Water heats and cools faster.

C. Soil heats faster, but cools slower.

D. Soil heats and cools faster.

Answer: D

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