Pharmacology

MCU-FDTMF COLLOGE OF MEDICINE DEPARTMENT OF PHARMACOLOGY Board Questions 1. A patient came in because of severe headache. Before giving a drug, the physician must know what the drug will do to the body. This is known as: A. Pharmacodynamic C. Drug development B. Pharmacokinetic D. Adverse drug reaction MPL= 1 GG 10th Ed pp. 31 2. Distribution of drugs to tissue: A. Is independent on blood flow to the organ B. Is independent of the solubility of the drug to the tissue C. Depend on the unbound drug concentration gradient between blood and the tissue D. Is increased for drugs that are strongly bound to plasma proteins MPL = 0.5 GG 10th Ed pp.20 3. Giving a second drug in order to enhance the action of a primary drug is a kind of drug interaction known as: A. potentiation C. additive B. synergism D. antagonism MPL= 1 GG 10th Ed pp 72 4. Two drugs have said to have this property when they reached the same plasma concentration at the same rate after oral administration: A. Potency C. Bioavailability B. Efficacy D. Bioequivalence MPL= 0.5 GG 10th Ed pp 8 5. When the rate of elimination is proportionate to the concentration it is: A. Zero order kinetic C. Maechelis Menten kinetics B. First order kinetics D. none of the above MPL= 0.33 Katzung 8th Ed pp 35 6. Entero-hepatic recycling of drugs is: A. Volume of distribution B. Half-life

C. First pass effect D. First order kinetics MPL= 0.5 Katzung 8th Ed pp 52

7. Which of the following reactions is most effective for Phase II elimination of hydrophobic drugs? A. glucoronidation C. oxidation B. hydrolysis D. reduction MPL= 0.33 GG 8th Ed pp12

8. Drug oxidation frequently involve all of the following EXCEPT:

A. Cytochrome p450 enzymes B. NADH or NADPH cofactors

C. Esterases D. Molecular oxygen MPL= 0.25 GG 10th Ed pp12

9. Jovita after recurrent seizure became comatose. Blood gas analysis showed severe metabolic acidosis. The antidote for Jovita is: A. Endophonium C. Pyridoxine B. Atropine sulfate D. Thiamine MPL= 0.5 GG 8th Ed. Pp76 10. A 14 year old was rushed to the E.R. because of poisoning. P.E. showed increased sweating and salivation with constricted pupils. The most likely substance ingested is: A. Salicylates C.Opioids B. Anticholinesterase drugs D.Antidepressants MP= 0.5 GG 8th Ed. pp184 11. Which of the following will produce the most rapid induction of anesthesia? A. Halothane C. Methoxyflurane B. Nitrous oxide D. Isoflurane MPL= 0.25 GG 8th Ed.pp 12. Of the following drugs, this tranquilizer has muscle relaxant and anticonvulsant properties: A. Diazepam C. Ethanol B. Sodium Luminal D. Meprobamate MPL= 1 GG 10th Ed pp 409 13. An anticonvulsant which is metabolized to Phenobarbital, hence, their clinical effects are very similar: A. Carbamazepine C. Diazepam B. Primidone D. Oxazepam MPL= 0.5 GG 10th Ed pp 532 14. The first synthetic local anesthetics widely used for infiltration anesthesia: A. Procaine C. Etidocaine B. Bupivacaine D. Benzocaine MPL= 0.25 GG 10th Ed pp 376

15. Repeated exposure to which of the following anesthetic agents is most associated with liver damage:

A. Isoflurane B. Halothane

C. Nitrous oxide D. Enflurane MPL= 0.33 GG 10th Ed pp 351-352

16. Which of the following inhalation anesthetics is most likely to produce diffusional hypoxia? A. Cyclopropane C. Nitrous oxide B. Halothane D. Methoxyflurane MPL= 0.25 GG 10th Ed pp 355 17. Secobarbital and ethanol when given together show: A. Additive sedative action B. Reduced sedative action C. Competitive antagonism D. Chemical antagonism MPL= 0.25 GG 10th Ed pp 418 18. Nitrous oxide has a: A. potent action on the medullary center B. significant effect on renal function C. reliable surgical anesthesia only under hyperbaric condition D. potent relaxation effect MPL= 0.25 GG 10th Ed pp 355-356 19. Of the Phenothiazines, which is the most popularly used as an antipsychotic drug? A. Chlorpromazine C. Chlordiazepoxide B. Meprobamate D. Diphenhydramine MPL= 1 Katzung 8th Ed pp 478 20. Extrapyramidal adverse effect is commonly seen with the use of this antipsychotic agent: A. Haloperidol C. Chlorpromazine B. Thioridazine D. Fluoxetine MPL= 1 GG 10th Ed pp 488 21. An agent that is used in the treatment of organo-phosphate poisoning: A. Atropine C. Physostigmine B. Neostigmine D. Naloxone MPL= 1 GG 10th Ed pp 185

22. The major action involve in the antiseizure activity of Phenytoin is: A. Block of sodium ion channel B. Block of calcium ion channel C. Facilitation of GABA action on chloride ion D. Inhibition of GABA transaminase MPL= 0.5 GG 10th Ed pp 529 23. A 3 years old was brought to the ER because of recurrent attacks of blank stares lasting for few minutes. This child is best manage with this anti-seizure agent: A. Phenobarbital C. Lamotrigine B. Ethosuximide D. Vigabantrine MPL= 0.25 GG 10th Ed pp 535 24. Prolonged treatment with this anti-seizure agent is associated with gingival hyperplasia : A. Ethosuximide C. Valproate B. Phenobarbital D. Phenytoin MPL= 1 GG 10th Ed 530 25. This is an inhibitory neurotransmitter: A. Acetylcholine B. Glutamic acid

C. Glycine D. GABA MPL= 1 GG 10th Ed pp 304

26. The best treatment for Parkinson’s disease is: A. Levodopa C. Amantadine B. Selegiline D. Pergolide MPL= 1 GG 10th Ed pp 555 27. This drug competitively inhibits the binding of aldosterone to mineralocorticoid receptors: A. amiloride C. spirinolactone B. triamterene D. hydrochlorothiazide MPL= 1 GG 10th Ed pp 779 28. This drug potentiates the ototoxic effect of loop diuretics: A. coumadin C. digitalis B. lithium D. streptomycin MPL= 1 GG 10th Ed pp 773 29. A diuretic agent that inhibit NaCl symport: A. spirinolactone C. triamterene B. ethacrynic acid D. hydrochlorothiazide MPL= 0.5 GG 10th Ed pp 775

30. A symphatomimetic agent that also acts as beta adrenergic agonist: A. dopamine C. isoproterenol B. dobutamine D. norepinephrine MPL= 0.5 GG 10th Ed pp 228 31. This drug acts by inhibiting renal systemic and tissue generation of angiotensin II: A. losartan C. amrinone B. captopril D. hydralazine MPL= 1 GG 10th Ed. Pp910 32. Dopamine is used in the treatment of advanced left heart failure because it: A. causes vasoconstriction B. produces positive inotropic effect C. reduces left ventricular afterload D. decreases cardiac output MPL= 1 GG 10th Ed pp 925 33. The following are effects of cardiac glycosides except: A. inhibits NaKATPase B. decreased calcium entry to myocardium C. reduced reuptake of norepinephrine from nerve terminals D. direct inotropic effects on cardiac muscle MPL= 0.33 GG 10th Ed pp 916 34. Of the vasodilators listed below, the drug of choice for the treatment of acute anginal attack is: A. Nitroglycerin C. Nifedipine B. Hydralazine D. Propranolol MPL= 1 GG 10th Ed pp 911 35. This angiotensin converting enzyme inhibitor (ACEI) is a prodrug and must be hydrolyzed by the esterases in the liver: A. captoril C. lisinopril B. enalapril D. trondolapril MPL= 0.25 GG 10th Ed pp 822 36. A contraindication to the use of beta blockers A. Bronchial asthma C. Thyrotoxicosis B. Hypertension D. Congestive heart failure MPL=1 GG 10th Ed pp 884

37. An acute attack of re-entrant supraventricular tachycardia will respond to: A. Digitalis C. Magnesium sulfate B. Verapamil D. Quinidine MPL= 0.5 GG 10th Ed pp 965 38. A 60 years old female patient complained of nystagmus after taking this antiarrythmic drug. The drug could be: A. Disopyramide C. Procainamide B. Lidocaine D. Quinidine MPL= 1 GG 10th Ed pp 961 39. The mechanism of action of gembfibrozil is: A. Increase excretion of bile acid salts B. Increase expression of high affinity LDL- receptor C. Increase hydrolysis by lipoprotein lipase D. Inhibition of secretion of VLDL by the liver MPL= 0.33 GG 10th Ed 993 40. This antihyperlipidemic agents reduces circulating cholesterol levels by binding to cholesterol in the GIT? A. niacin C. clofibrate B. cholestyramine D. gemfibrozil MPL= 0.33 GG = 10th Ed 989 41. Which of the following drugs is used as an emergency agent for hypertensive crisis? A. Methyldopa C. Hydralazine B. Diltiazem D. Nitroprusside MPL= 1 GG 10th Ed pp 890 42. A Second generation Sulfonylurea that can inhibit peripheral deiodination of thyroid hormone A. Tolbutamide C. Glyburide B. Chlorpropamide D. Glimepiride MPL=0.5 GG 10th Ed pp1702 43. A member of the newer oral hypoglycemic agents classified as insulin sensitizers A. Rosiglitazone C. Glimepiride B. Voglibose D. Repaglinide MPL= 0.33 GG 10th Ed pp 1706 44. A thionamide that can block peripheral deiodination of thyroid hormone A. Propranolol C. Prophylthiouracil B. Carbimazole D. Methimazole MPL = 0.5 GG 10th Ed pp 1581

45. Which among these antithombotic drugs inhibit the synthesis of thomboxane by irreversible acetylation of the enzyme cyclooxygenase? A. Abciximab C. Integrilin B. Aspirin D. Ticlodipine MPL= 0.5 GG 10th Ed pp 1534 46. An isoxazole derivative of ethinyltestosterone that is used to suppress ovarian function: A. Danazol C. Raloxifene B. Clomiphene D. Mifepristone MPL= 0.33 Katzung 8th Ed pp 699 47. A gnRH analog which produces gonadal suppression: A. Flutamide C. Finasteride B. Leuprolide D. Spironolactone MPL= 0.25 Katzung 8th Ed pp 942 48. A principal regulator of bone mineral homeostasis which needs to be metabolized to gain biologic activity: A. Vitamin D C. Glucocorticoids B. Parathyroid hormone D. Adrenal androgens MPL=1 GG 10th Ed pp 1728 49. Which among the following is a long-acting glucocorticoids? A. Betamethasone C. Prednisone B. Cortisone D. Triamcinolone MPL= 1 GG 10th Ed pp 1657 50. Antineoplastic agent usually cause the following side effects EXCEPT: A. loss of hair C. nausea and vomiting B. liver damage D. bone marrow suppression MPL= 0.25 GG 10th ed pp 1388 51. Busulfan, a useful drug in chronic myelocytic leukemia is: A. An antimetabolite C. an alkylating agent B. An antibiotic D. a hormonal agent MPL= 0.5 GG 10-th Ed pp 1383 52. An immunopotentiating agent with an antihelminthic property: A. Herceptin C. Interferon B. Rituximab D. Levamisole MPL= 0.5 GG 10th Ed pp 1477

53. The most effective drug to use during acute attacks of gouty arthritis is: A. Allopurinol C. Colchicine B. Probenecid D. Phenylbutazone MPL= 1 GG 10th Ed pp 719 54. One approach in the treatment of bronchial asthma is the use of mediator release inhibitors which would include: A. Cromolyn sodium C. Terbutaline B. Theophylline D. Ketotifen MPL= 1 GG 10th Ed pp 742 55. Which anti-asthmatic would be your choice if you want one with a less cardiac activity? A. Epinephrine C. Terbutaline B. Ephedrine D. Isoproterenol MPL= 1 GG 10th ed pp 736 56. A long acting Beta-2 selective agonist used for asthma prophylaxis: A. Cromolyn C. Metaproterenol B. Ipatropium D. Salmeterol MPL= 1 GG 10th ed pp 737 57. The H2 antagonist with the highest bioavailability: A. Cimetidine C. Ranitidine B. Famotidine D. Nizatidine MPL= 0.25 GG 10th ed pp 1011 58. An irreversible proton pump inhibitor: A. Lanzoprazole B. Pantoprazole

C. Omeprazole D. Famotidine MPL= 0.75 GG 10th Ed 1007

59. This drug is used in the treatment of PUD as a mucosal protective agent A. Sucralfate C. magnesium OH B. metronidazole D. ocreotide MPL= 0.5 GG 10th Ed pp 1012 60. Ethambutol is administered concurrently with other antituberculous drugs in the treatment of TB inorder to: A. Reduce the pain of injection B. Facilitate penetration of the BBB C. Retard the development of organism resistance D. Delay excretion of other anti TB drugs by the kidney MPL= 0.25 GG 10th Ed pp 1280

61. The mainstay drug in the treatment of all types of leprosy is: A. Clofazimine C. Isoniazid B. Dapsone D. Rifampicin MPL= 1 GG 10th ed pp 1288 62. Vestibular and auditory dysfunction can follow the administration of: A. Tetracycline C. Clindamycin B. Amikacin D. Carbenicillin MPL= 0.75 GG 10th ed 1227-1228 63. A beta-lactamase inhibitor: A. Cefotaxime B. Amoxicillin

C. Sulbactam D. Ticarcillin MPL= 0.5 GG 10th Ed pp 1214

64. A drug of choice in Rickettsial infections: A. Chloramphenicol C. Sulfonamide B. Tetracycline D. Polymyxin B MPL= 1 GG 10th Ed 1240 65. An antimicrobial agent which inhibits bacterial cell wall synthesis: A. Neomycin C. Erythromycin B. Cephalexin D. Trimethoprim MPL= 1 GG 10th Ed pp 1190 66. Gray baby syndrome, a form of cardio-respiratory collapse, is an age specific toxicity of which antimicrobial in the newborn? A. Sulfonamides C. Chloramphenicol B. Nalidixic acid D. Nitrofurantoin MPL= 1 GG 10th ed pp 1249 67. Exerts a synergistic effect with Sulfonamide: A. Trimethoprim C. Atropine B. Prostaglandin D. Metronidazole MPL= 1 GG 10th Ed pp 1176 68. An anti-malarial agent which also exerts an amebicidal effect: A. Chloroquine C. Primaquine B. Chloroguanide D. Mefloquine MPL= 0.5 GG 10th Ed pp 1084

69. Antimicrobial agent with greatest CSF penetration: A. Chloramphenicol C. Tetracycline B. Penicillin D. Erythromycin MPL= 1 GG 10th Ed 1247 70. The most absorbable of all the oral erythromycin salt is: A. Lactobromate C. Estolate B. Succinate D. Stearate MPL= 0. 75 GG 10th Ed pp 1252 71. This drug, with less side effects, is effective against ascaris and hookworms A. Mebendazole C. Pyrantel pamoate B. Piperazine D. Niclosamide MPL= 0.5 GG 10th Ed pp 1025 72. An effective amebicidal agent and at the same time displays antibacterial activity against anaerobes: A. Metronidazole C. Paromomycin B. Quinacrine D. Chloroquine MPL= GG 10th Ed pp 1106 73. The drug of choice for monilial infections of skin and mucous membrane: A. Griseofulvin C. Amphotericin B B. Nystatin D. Selenium sulfide MPL= GG 10th Ed pp1307 74. Antiviral drug which is effective on the treatment of herpes simplex encephalitis is: A. Idoxuridine C. Acyclovir B. Vidarabine D. Amantadine MPL= 0,75 GG 10th Ed pp 1317 75. Primaquine should be used with caution in G6PD deficient individuals because of the possibility of production of: A. Aplastic anemia C. Granulocytopenia B. Hemolytic anemia D. Megaloblastic anemia MPL= 0.25 GG 10th Ed pp 1084 76. Imipenem is combined with this drug: A. Clindamycin B. Cilastatin

C. Cephalosporin D. Carbenicillin MPL=0.75 GG 10th Ed1214

77. Which of the chemical structure of Beta-lactams is the site of action of Penicillinase? A. Beta-lactam ring C. R-side chain B. Thiazolidine ring D. Dihydrothiazine ring MPL= 1 GG 1190 78. The Penicillin with the longest half life (24-28 days ) is: A. Phenoxymethylpenicillin C. Benzathine penicillin B. Procaine penicillin D. Benzyl penicillin MPL= 0.75 GG 1197 79. Antibiotic that is NOT recommended for use in children or during pregnancy because of its potential to cause arthropathy: A. Sulfonamides C. Aminoglycosides B. Macrolides D. Quinolones MPL= 1 GG 10th Ed pp1182 80. Most nephrotoxic of the aminoglycosides: A. Streptomycin C. Gentamicin B. Neomycin D. Amikacin MPL= 0.25 GG 10th Ed pp 1229 81. The ratio of sulfamethoxazole to Trimethoprim for it to be effective is: A. 40:1 C. 200:1 B. 20:1 D. 10:1 MPL=1 GG 10th Ed pp 1176 82. Doxycycline is an appropriate therapy in infection caused by: A. Rickettsiae C. Schistosomiasis B. Plasmodium vivax D. Histoplasma capsulatum MPL= 0.25 GG 10th Ed pp 1156 83. The drug recommended for most heavy metal intoxications is: A. CaNa2EDTA C. Dimercaprol B. Penicillamine D. Deferoxamine MPL= 0.5 GG 10th Ed pp 1867 84. A 24 year old man working in a company that manufacture “semiconductors”. Following accident at the plant he manifested with nausea and vomiting, headache, hypotension and chills. Laboratory showed hemoglobinuria and a plasma hemoglobin of 1,4g/dl. This individual is probably exposed to: A. Arsine C. Mercury vapor B. Inorganic arsenic D. Methylmercury MPL 0.5 GG 10th Ed pp1862

85. Serotonin antagonist not derived from a fungus that is useful for the treatment of migraine headache is: A.Sumapitran C. Bromocriptine B.Ergotamine D. Ketanserin MPL= 0.25 GG 10th Ed pp 278 86. Clarithromycin and erythromycin have very similar spectrum of antimicrobial activity. The major advantage of Clarithromycin is that: A. Eradicate mycoplasmal infection in a single dose B. Active against strains of streptococci that are resistant to erythromycin C. More active against Mycobacterium avium complex D. Acts on methicillin resistant staphylococci MPL= 0.25 GG 10th ave.pp 1250 87. The primary mechanism underlying the resistance of gram positive organism to macrolide antibiotics is: A. Methylation of binding site on the 50S ribosomal subunits B. Formation of esterases that hydrolyzed the lactone ring C. Formation of drug- inactivating acetyltransferase D. Decrease drug permeability of the cytoplasmic membrane MPL= 0.25 GG 10TH ED PP1250 88. Weeping lesion is best treated with: A, Wet dressing B. Gels

C. Ointment D. Aerosol MPL= 1 GG 10TH Ed pp1796

89. Host factors affecting the use of antimicrobial agents is/are: A. Age of patient C. Genetic factor B. Site of infection D. All of the above MPL= 1 GG 1144 90. The mechanism of action of miconazole is best described as: A. Binding to 80 S ribosomes B. Inhibition of sterol synthesis C. Blockade of tetrahydrofolate reductase D. DNA intercalation MPL= 0.75 GG 10th Ed pp1301 91. Leukoverin rescue is used to reverse toxicity of which of the following anticancer agents? A. Vinblastine C. Adriamycin B. Cyclophosphamide D. Methotrexate MPL= 1 GG 10th Ed pp 1512

92. Antiarrhythmic drug that predominantly block the slow calcium channels :

A. Verapamil B. Amiodarone

C. Lidocaine D. Metoprolol MPL=025 GG 10th Ed pp 948

93. Antiarrythmic drug that predominantly block potassium channels and prolongs repolarization: A. Class I C. Class II B. Class III D. Class IV MPL= 0.25 GG 10th Ed pp 949 94. Recommended drug therapy for angina in patients with hyperthyroidism: A. Dihydroperidine Calcium Channel blockers B. Beta-Adrinergic Receptor Blocker C. Non-Dihydroperidine Calcium Channel blockers D. Organic Nitrates MPL= 0.25 GG 10th Ed pp 860 95. Anti anginal drug which should be avoided in patients with Hypertrophic cardiomyopathy: A. Metoprolol C. Isosorbide-5-mono nitrate B. Diltiazem D. Verapamil MPL= 0.25 GG 10th Ed pp 851 96. The least antigenic source of Insulin is A. Beef B. Human

C. Pork D. Horse MPL= 1 GG 10th Ed pp 1692

97. Preparation of choice for replacement and suppression therapy of the thyroid hormone A. levothyroxine C. liothyronine B. triiodothyronine D. tyrosine MPL=0.75 GG 10th Ed pp 1577 98. Anemia with neurologic abnormalities occur most often in deficiencies of: A. vitamin B12 C. iron B. folic acid D. biotin MPL= 1 GG 10th Ed pp 1507

99. Which of the following has the highest elemental iron?

A. Ferrous gluconate B. Hydrated ferrous sulfate

C. Ferrous fumarate D. Desiccated ferrous sulfate MPL= 0.25 GG 10th Ed pp 1496

100. A direct acting cholinomimetic that is lipid soluble and often used in the treatment of glaucoma? A. Acetycholine C. Pilocarpine B. Bethanecol D. Physostigmine MPL= 1 GG 10th Ed pp161