CPPS 304 COMPREHENSIVE EXAM 2026 QUESTIONS AND
SOLUTIONS RATED A+
✔✔Does honey actually work in wound healing? - ✔✔Cochrane review 2013 - 25 trials
burns - reduced healing time by 4.5 days compared to basic dressings
more severe burns - delayed healing by 13.5 days (!) compared to more complicated
dressings
✔✔Does honey actually reduce cough? - ✔✔Cochrane review 2012 - 2 trials
honey reduced frequency of cough compared to "no treatment"
no difference seen compared to dextromethorphan (conventional medicine)
✔✔Side effects of honey - ✔✔may contain clostridium botulinum spores - only a
problem in infants
topical use can cause irritation to wounds
✔✔Ginkgo mechanism and uses - ✔✔appears to have anti-platelet properties (thins the
blood)
- improve cerebral blood flow to increase increase memory??
may have antioxidant properties
- may help with Alzheimer's disease?
✔✔Does ginkgo work to treat dementia? - ✔✔Cochrane review 2009 - 9 trials (of
sufficient duration: 6 months)
inconsistent and unreliable results (3 trials found no change, only 1 did)
no safety issues identified
✔✔Does ginkgo work for memory - ✔✔no systematic reviews - inconclusive
✔✔Ginkgo safety issues - ✔✔generally well tolerated
- gastric upset
- headaches
- hypersensitivity skin reactions
drug interactions - rare with ASA, potentially due to anti-platelet effects
✔✔What is saw palmetto used for? - ✔✔inhibits prostate growth
✔✔Benign prostatic hypertrophy - ✔✔prostate grows throughout lifetime
presses on urinary sphincter and obstructs flow of urine
results in frequent urination and and kidney damage
✔✔Saw palmetto mechanism - ✔✔DHT responsible for prostate growth
SP inhibits 5 a-reductase, the enzyme that produces DNT
✔✔What drug does saw palmetto have the same mechanism as? - ✔✔finasteride
,✔✔Does saw palmetto actually work? - ✔✔Cochrane review 2023 - 27 studies
4-60 weeks durations - 4 weeks is too short to see results; not accurate?
saw that SP was not more effective than the placebo
doesn't work
✔✔Safety issues with saw palmetto - ✔✔has less sexual side effects than finasteride
- impotence
- diminished libido
✔✔Ingredient of interest in chocolate - ✔✔cocoa
✔✔What are the claimed uses of cocoa? - ✔✔cardiovascular disease
- hypertension
- hypercholesterolemia
✔✔Proposed mechanism of action of chocolate (4) - ✔✔stimulent (caffeine)
vasodilator
antioxidant
increased HDL (good cholesterol)
✔✔Does chocolate actually treat cardiovascular disease? - ✔✔2024 systematic review -
31 trials
- no trials over 18 weeks
- participants consumed cocoa extract or dark choc
cocoa lowered cholesterol (both LDL and total) by a modest (small) amount
2017 Cochrane review - 35 trials
modest (small) decreases in both systolic and diastolic BP
✔✔cocoa science - ✔✔
✔✔Adverse effects of cocoa (4) - ✔✔excess stimulation
GI upset
trigger migraines?
cavities/sugar?
✔✔Green tea mechanisms of action (2) - ✔✔caffeine - stimulent
polyphenols - antioxidants, anti-angiogenic effects
✔✔What is green tea used for? - ✔✔cancer prevention (anti-angiogenic effects)
✔✔Does cancer actually prevent cancer? - ✔✔Cochrane review 2016 - 51 studies
(mostly observational)
may reduce
may reduce risk of prostate cancer (slow growing)
, conflicting/no evidence for other cancers
✔✔Safety of green tea? - ✔✔moderate intake (3-5 cups) appears safe
generally well tolerated
side effects related to caffeine - stimulation
✔✔What is St. Johns wort used for? - ✔✔treating depression
✔✔St. Johns wort mechanism of action - ✔✔inhibits serotonin, NE, and possibly
dopamine re-uptake
acts like classes antidepressant
✔✔Does St. Johns wort work? - ✔✔Cochrane review 2009
showed superior efficacy compared to placebo
showed similar efficacy compared to other conventional antidepressants
- heterogeneity among trials
✔✔Side effects of St. Johns wort? - ✔✔GI problems
insomnia
restlessness
less than conventional antidepressants
✔✔Drug interactions involved with St. Johns wort - ✔✔pharmacodynamic
serotonergic - avoid with other antidepressants
pharmacokinetic - induces cytochrome P450 and P-glycoprotein transporters
- decreases metabolism of other drugs
✔✔What is Kava used for? - ✔✔"party drug" - similar effects to alcohol (euphoria) but
with retained mental clarity
- also believed to not develop dependence
used for anxiety and insomnia
✔✔What is kava's mechanism - ✔✔similar to alcohol
thought to work through GABA
may have effects on the re-uptake of NT such as NE
unknown
✔✔Does kava work to treat anxiety? - ✔✔Cochrane review (2010) - 12 trials
statistically significant improvement compared to placebo
small improvement, small sample
✔✔Does Kava work to treat insomnia? - ✔✔systematic review (2012) studied results of
different herbals to treat insomnia
non worked, including kava
SOLUTIONS RATED A+
✔✔Does honey actually work in wound healing? - ✔✔Cochrane review 2013 - 25 trials
burns - reduced healing time by 4.5 days compared to basic dressings
more severe burns - delayed healing by 13.5 days (!) compared to more complicated
dressings
✔✔Does honey actually reduce cough? - ✔✔Cochrane review 2012 - 2 trials
honey reduced frequency of cough compared to "no treatment"
no difference seen compared to dextromethorphan (conventional medicine)
✔✔Side effects of honey - ✔✔may contain clostridium botulinum spores - only a
problem in infants
topical use can cause irritation to wounds
✔✔Ginkgo mechanism and uses - ✔✔appears to have anti-platelet properties (thins the
blood)
- improve cerebral blood flow to increase increase memory??
may have antioxidant properties
- may help with Alzheimer's disease?
✔✔Does ginkgo work to treat dementia? - ✔✔Cochrane review 2009 - 9 trials (of
sufficient duration: 6 months)
inconsistent and unreliable results (3 trials found no change, only 1 did)
no safety issues identified
✔✔Does ginkgo work for memory - ✔✔no systematic reviews - inconclusive
✔✔Ginkgo safety issues - ✔✔generally well tolerated
- gastric upset
- headaches
- hypersensitivity skin reactions
drug interactions - rare with ASA, potentially due to anti-platelet effects
✔✔What is saw palmetto used for? - ✔✔inhibits prostate growth
✔✔Benign prostatic hypertrophy - ✔✔prostate grows throughout lifetime
presses on urinary sphincter and obstructs flow of urine
results in frequent urination and and kidney damage
✔✔Saw palmetto mechanism - ✔✔DHT responsible for prostate growth
SP inhibits 5 a-reductase, the enzyme that produces DNT
✔✔What drug does saw palmetto have the same mechanism as? - ✔✔finasteride
,✔✔Does saw palmetto actually work? - ✔✔Cochrane review 2023 - 27 studies
4-60 weeks durations - 4 weeks is too short to see results; not accurate?
saw that SP was not more effective than the placebo
doesn't work
✔✔Safety issues with saw palmetto - ✔✔has less sexual side effects than finasteride
- impotence
- diminished libido
✔✔Ingredient of interest in chocolate - ✔✔cocoa
✔✔What are the claimed uses of cocoa? - ✔✔cardiovascular disease
- hypertension
- hypercholesterolemia
✔✔Proposed mechanism of action of chocolate (4) - ✔✔stimulent (caffeine)
vasodilator
antioxidant
increased HDL (good cholesterol)
✔✔Does chocolate actually treat cardiovascular disease? - ✔✔2024 systematic review -
31 trials
- no trials over 18 weeks
- participants consumed cocoa extract or dark choc
cocoa lowered cholesterol (both LDL and total) by a modest (small) amount
2017 Cochrane review - 35 trials
modest (small) decreases in both systolic and diastolic BP
✔✔cocoa science - ✔✔
✔✔Adverse effects of cocoa (4) - ✔✔excess stimulation
GI upset
trigger migraines?
cavities/sugar?
✔✔Green tea mechanisms of action (2) - ✔✔caffeine - stimulent
polyphenols - antioxidants, anti-angiogenic effects
✔✔What is green tea used for? - ✔✔cancer prevention (anti-angiogenic effects)
✔✔Does cancer actually prevent cancer? - ✔✔Cochrane review 2016 - 51 studies
(mostly observational)
may reduce
may reduce risk of prostate cancer (slow growing)
, conflicting/no evidence for other cancers
✔✔Safety of green tea? - ✔✔moderate intake (3-5 cups) appears safe
generally well tolerated
side effects related to caffeine - stimulation
✔✔What is St. Johns wort used for? - ✔✔treating depression
✔✔St. Johns wort mechanism of action - ✔✔inhibits serotonin, NE, and possibly
dopamine re-uptake
acts like classes antidepressant
✔✔Does St. Johns wort work? - ✔✔Cochrane review 2009
showed superior efficacy compared to placebo
showed similar efficacy compared to other conventional antidepressants
- heterogeneity among trials
✔✔Side effects of St. Johns wort? - ✔✔GI problems
insomnia
restlessness
less than conventional antidepressants
✔✔Drug interactions involved with St. Johns wort - ✔✔pharmacodynamic
serotonergic - avoid with other antidepressants
pharmacokinetic - induces cytochrome P450 and P-glycoprotein transporters
- decreases metabolism of other drugs
✔✔What is Kava used for? - ✔✔"party drug" - similar effects to alcohol (euphoria) but
with retained mental clarity
- also believed to not develop dependence
used for anxiety and insomnia
✔✔What is kava's mechanism - ✔✔similar to alcohol
thought to work through GABA
may have effects on the re-uptake of NT such as NE
unknown
✔✔Does kava work to treat anxiety? - ✔✔Cochrane review (2010) - 12 trials
statistically significant improvement compared to placebo
small improvement, small sample
✔✔Does Kava work to treat insomnia? - ✔✔systematic review (2012) studied results of
different herbals to treat insomnia
non worked, including kava
