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Question block created by wizard 1.
The wife of a 24-year-old computer programmer considers him to be of a "nervous disposition." He is easily startled, worries about inconsequential matters, and sometimes complains of stomach cramps. At night he grinds his teeth in his sleep. There is no current history of drug abuse. Assuming that the symptoms experienced by this young man are not related to a medical condition, the most appropriate drug treatment would be the judicious use of  (1) Buspirone  (2) Midazolam  (3) Phenobarbital  (4) Triazolam  (5) Zolpidem
If choice 1 is selected set score to 1.

2.

A 24 year old woman attempts suicide by taking an overdose of diazepam. She is rushed to the emergency department, where the attending physician will most likely administer which of the following drugs  (1) Sodium bicarbonate  (2) Ammonium chloride  (3) Flumazenil  (4) Neostigmine  (5) Tubocurarine
If choice 3 is selected set score to 1.

3.

A 18 year old male is having difficulty sleeping because of the death of his grandfather. The doctor prescribes Alprazolam. Which of the following best describes the action of alprazolam.  (1) It is an agonist at GABA -A receptors  (2) It is a agonist at 5 HT 2 receptors  (3) It is an antagonist at 5HT1D receptors  (4) It is an agonist at Dopamine D2 receptors  (5) It is an antagonist at nicotinic receptors
If choice 1 is selected set score to 1. Anything else No score defined.

4.

A 63 year old man is admitted to the hospital for treatment of a psychotic episode, for which he is given haloperidol. He is also being treated for electrolyte abnormalities and is receiving salicylate therapy for osteoarthritis. While in the hospital he complains of dizziness and tinnitus, and over the past 12 hours, he begins experiencing agitation, tachycardia, nausea and vomiting. His signs and symptoms are most likely related to a drug interaction with one of his medication and which of the following  (1) Ammonium chloride  (2) Calcium carbonate  (3) Metoclopramide  (4) Sodium bicarbonate  (5) Cimetidine
If choice 1 is selected set score to 1.

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5.

A 3-year old boy develops severe toxicity symptoms after an accidental ingestion of paracetamol. Which is the best treatment for this poisoning?  (1) Neostigmine  (2) Sodium Bicarbonate  (3) N-Acetyl Cysteine  (4) Atropine  (5) Naloxone
If choice 3 is selected set score to 1.

6.

A 65 year old woman comes to the hospital with a complaint of black stools. Stool examination reveals occult blood positive and her hemoglobin is 8g/dl(normal 12-14). Medical history revealed that she has had rheumatoid arthritis for 15 years. On doctors recommendation she has been treated with aspirin with good control of her symptoms. A diagnosis of gastrointestinal bleeding due to NSAIDs drug is made. Which of the following drugs will control her rheumatoid arthritis symptoms with smallest risk of bleeding?  (1) Ibuprofen  (2) Diclofenac  (3) Indomethacin  (4) Celecoxib  (5) Piroxicam
If choice 4 is selected set score to 1.

7.

A patient is scheduled for surgery that requires spinal anesthesia. This patient has documented allergy to ester-type local anesthetics. Which of the following local anesthetics should NOT be used?  (1) Etidocaine  (2) Lidocaine  (3) Mepivacaine  (4) Ropivacaine  (5) Tetracaine
If choice 5 is selected set score to 1.

8.

A 35 year old woman in a family planning program camp underwent a laparoscopic tubectomy after an injection with bupivacaine. Which of the following best describes the property of bupivacaine?  (1) It stimulates sodium channels in their inactive state  (2) It can cause cardiac arrythmias  (3) Has a short duration of action  (4) Is metabolized by pseudocholinesterase  (5) Is a powerful vasoconstrictor
If choice 2 is selected set score to 1.

9.

A 45 yr old male patient with alcoholic cirrhosis is brought to ED with laceration wound of the scalp. Which of the following local anesthetics would be toxic for this patient?  (1) Lidocaine  (2) Benzocaine  (3) Procaine  (4) Tetracaine  (5) Chloroprocaine
If choice 1 is selected set score to 1.

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10. A 15 year old boy presents to emergency room after having an episode of seizure. He is presently
restless, irritable and complains of headache. His accompanying friend informs the doctor that he had ingested cocaine. Physical examination reveals a heart rate of 130/minute and BP of 160/98 mmHg. Which of the following mechanisms is responsible for cocaine induced hypertension?  (1) Blocking NE uptake  (2) Direct stimulation of alpha 1 receptors  (3) Direct stimulation of beta 1 receptors  (4) Inducing NE release  (5) Direct stimulation of beta 2 receptors
If choice 1 is selected set score to 1.

11. A 52-year-old middle school teacher has chronic peptic ulcer disease that has been treated for
several days with ranitidine and metoclopramide. On examination, the physician notes that the patient has involuntary irregular chewing movements and repetitive tongue protrusion. The most likely cause of these movements is  (1) Neuroleptic malignant syndrome  (2) Wilsons disease  (3) Huntingtons disease  (4) Cerebellar degeneration  (5) Tardive dyskinesia
If choice 5 is selected set score to 1.

12. Bradykinesia has now made drug treatment necessary in a 60-year-old male patient with Parkinson's
disease. You decide to initiate therapy with levodopa. As the physician, you could tell the patient (and close family members) all of the following things about levodopa EXCEPT  (1) Taking the drug in divided doses will decrease nausea and vomiting  (2) He should be careful when he stands up because he may get dizzy  (3) Uncontrollable muscle jerks may occur  (4) A net-like reddish to blue discoloration of the skin may occur  (5) The drug will probably improve his symptoms for a period of time but not indefinitely
If choice 4 is selected set score to 1.

13. A 72-year-old patient presents to hospital complaining of shaking in his right hand and trouble
starting movements. On physical examination, the patient has a resting tremor of the right hand that decreases with active movement. The man's face is expressionless, and his voice is very soft. Cogwheel rigidity is noted in both arms. He also has a slightly stooped posture, and a slow, shuffling gait. Which of the following treatments for this disease works by inhibiting the metabolism of dopamine?  (1) Benztropine  (2) Bromocriptine  (3) Levodopa  (4) Amantidine  (5) Selegiline
If choice 5 is selected set score to 1.

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14. Carbidopa is often used in patients with Parkinson disease because it
 (1) inhibits the metabolism  (2) inhibits the metabolism  (3) inhibits the metabolism  (4) inhibits the metabolism  (5) inhibits the metabolism of dopamine in the basal ganglia of dopamine in the blood and peripheral tissues of dopamine in the substantia nigra of levodopa in the brain of levodopa in peripheral tissues

If choice 5 is selected set score to 1.

15. A 30 year old man was evaluated for his psychiatric problems reported by his wife. Diagnosis of
Maniac Depressive Psychosis (bipolar disorder) was made. In addition to lithium, to take care of his manic component, a drug which can be used in epilepsy was prescribed to him. Which of the following statement is most appropriate in regard to use of antiepileptic drugs in his condition?  (1) Phenytoin is the best choice  (2) Carbamazepine is the only indicated drug  (3) Both phenytoin and carbamazepine are equally good  (4) Both valproate and carbamazepine are equally good  (5) Valproate is the only indicated drug
If choice 4 is selected set score to 1.

16. A patient suffers from partial seizures that have been well controlled by treatment with a
carbamazepine regimen. Which of the following new conditions is most likely to cause carbamazepine-induced diplopia and ataxia if the regular regimen is not altered?  (1) Coadministration of phenobarbital  (2) Gout treated with probenecid  (3) Hypertension treated with hydrochlorothiazide  (4) Initiation of smoking  (5) Peptic ulcer treated with cimetidine
If choice 5 is selected set score to 1.

17. A 25 year young female is suffering from grand mal epileptic seizures .She was treated
with phenytoin and carbamazepine each for 1 year. Since she failed to show any response physician is considering adding a newer antiepileptic to her present therapy. Which one of the following statement about the mechanism of action of newer antiepileptic drugs is true?  (1) Gabapentin acts by blocking glutamate mediated sodium channels  (2) Vigabatrin facilitates chloride channel opening  (3) Gabapentin and tiagabine increases GABA reuptake at synaptic junction  (4) Topiramate inhibits the GABA metabolism  (5) Lamotrigine facilitates more GABA transport into brain
If choice 2 is selected set score to 1.

18. Mr.Taylor is a 17-year-old patient who suffers from tonic-clonic seizures. This condition has been
well controlled with phenytoin. Which of the following signs or symptoms indicates phenytoin toxicity?  (1) Diplopia and abnormal gait  (2) Weight gain  (3) Polydipsia and polyuria  (4) Hepatotoxicity  (5) Rigidity and tremor
If choice 1 is selected set score to 1.

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19. Mr Brown has been prescribed a medication for a psychiatric condition and has been advised by his
physician to get weekly complete blood counts done. The psychotropic drug that has probably been prescribed is  (1) Amitryptyline  (2) Clozapine  (3) Haloperidol  (4) Lithium carbonate  (5) Thioridazine
If choice 2 is selected set score to 1.

20. A 30 year old woman with schizophrenia has been taking a neuroleptic drug since 2 years. Though
her psychotic symptoms are well controlled she complains of irregular menstruation, galactorrhoea, and loss of libido. Neuroleptic drugs act by blocking the postsynaptic Dopamine 2 receptors. Such a blockade in which of the following dopaminergic tracts underlies this impairment?  (1) Nigrostriatal tract  (2) Mesolimbic tract  (3) Medullary periventricular tract  (4) Incertohypothalamic tract  (5) Tuberoinfundibular tract
If choice 5 is selected set score to 1.

21. A 36-year-old male with a bipolar disorder is treated with lithium. Among the following adverse
effects, which is associated with lithium treatment?  (1) Browning of the vision  (2) Diabetes insipidus  (3) Agranulocytosis  (4) Neuroleptic malignant syndrome  (5) Tardive dyskinesia
If choice 2 is selected set score to 1.

22. A 22-year-old male was newly diagnosed with Schizophrenia and started on chlorpromazine, at a
follow-up visit one month after he has several complaints, listed below. Which of the following cannot be attributed to chlorpromazine?  (1) Drowsiness  (2) Sexual dysfunction  (3) Urinary hesitancy  (4) Vomiting  (5) Dry mouth
If choice 4 is selected set score to 1.

23. A 32-year-old man is with history of schizophrenia has been on treatment with fluphenazine since
10-years. However his psychotic symptoms are not well controlled with frequents episodes of akathesia and muscle dystonias. The physicians is considering treatment with aripiprazole. The most likely mechanism of its antipsychotic action is  (1) Antagonism at 5-HT 1 receptors  (2) Partial agonist at 5-HT1 receptors  (3) Partial agonist at D4 receptors  (4) Antagonist at D1 receptors  (5) Antagonist at Histamine1 receptors
If choice 2 is selected set score to 1.

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24. Which of the following antidepressants is most selective in blocking reuptake of serotonin as
compared with norepinephrine?  (1) Amitriptyline  (2) Citalopram  (3) Desipramine  (4) Imipramine  (5) Trazodone
If choice 2 is selected set score to 1.

25. A 14-year old teenager is brought to the deaddiction clinic by the parents. The boy has been an
addict to heroin since a year. The most suitable opiate which can be administered for the heroin detoxification treatment in this patient is  (1) Meperidine  (2) Methadone  (3) Naloxone  (4) Naltrexone  (5) Pentazocine
If choice 2 is selected set score to 1.

26. A 31-year-old female has been treated with fluoxetine for two months with no improvement in her
depression. You decide to switch antidepressant therapy to phenelzine and instruct her to wait one week after stopping fluoxetine to start taking the new pills. She begins therapy immediately with phenelzine without discontinuing fluoxetine. Two days later, she is brought to the hospital with unstable vital signs, muscle rigidity, myoclonus, and hyperthermia. What caused these findings?  (1) Increased serotonin in synapses  (2) Increased norepinephrine in synapses  (3) Increased acetylcholine in synapses  (4) Increased dopamine in synapses  (5) Cheese reaction
If choice 1 is selected set score to 1.

27. A 47 year old lady suffering from severe rheumatoid arthritis who is on treatment with methotrexate
since 2 years is prescribed infliximab in addition to her previous medications since her rheumatoid symptoms were not adequately controlled. Which of the following best describes the mechanism of infliximab?  (1) Inhibition of dihydrofolate reductase  (2) Cytotoxic destruction of lymphocytes  (3) Inhibition of cyclooxygenase  (4) Inhibition of tumor necrosis factor  (5) Decreased leukocyte chemotaxis
If choice 4 is selected set score to 1.

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28. A 45 year old lady on hydrochlorothiazide since 5 years comes to the hospital with painful swelling
and redness of the great toe. Blood examination reveals elevated uric acid levels. The treating physician decides to initiate treatment with allopurinol. Which of the following is the possible mechanism of this drug?  (1) Uricosuric action  (2) Uric acid synthesis inhibition  (3) Inhibition of prostaglandins  (4) Inhibition of cyclooxygenase  (5) Inhibition of interleukins
If choice 2 is selected set score to 1.

29. A 48 year old man presented with signs and symptoms of rheumatoid arthritis. A decision was made
to initiate treatment with methotrexate. Which of the following best describes the mechanism of action of this drug?  (1) Reversible inhibition of cycloxygenase II  (2) Cytotoxic action on lymphocytes  (3) Inhibition of xanthine oxidase enzyme  (4) Antagonism of tumor necrosis factor  (5) Inhibition of dihydroorotate dehydrogenase
If choice 2 is selected set score to 1.

30. Which of the following combination drugs can produce neuroleptic analgesia and anesthesia?
 (1) Fenatanyl plus propofol  (2) Fentanyl plus haloperidol  (3) Fentanyl plus droperidol  (4) Droperidol plus ketamine  (5) Lidocaine plus epinephrine
If choice 3 is selected set score to 1.

31. A 55-year-old female given a general anesthetic for a surgical procedure develops hyperthermia,
hypertension, hyperkalemia, tachycardia, muscle rigidity, and metabolic acidosis. Which of the following general anesthetics did she receive?  (1) Ketamine  (2) Midazolam  (3) Thiopental  (4) Propofol  (5) Halothane
If choice 5 is selected set score to 1.

32. The most rapid onset of action of inhaled general anesthetics correlates with the smallest value for
the  (1) Blood : gas partition coefficient  (2) Minimum alveolar concentration  (3) Inspired gas partial pressure  (4) Ventillation rate  (5) Rate of distribution from the blood
If choice 1 is selected set score to 1.

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33. A 55 year old female patient suffering from fibroid uterus is posted for hysterectomy to be done
under general anaesthesia. Which of the following agents is used to induce general anesthesia?  (1) Diazepam  (2) Ketamine  (3) Droperidol  (4) Propofol  (5) Fentanyl
If choice 4 is selected set score to 1.

34. A 45 year old male visits the hospital complaining of persistent dry cough. Which of the following
opioids is preferred in this patient?  (1) Dextrometharphan  (2) Morphine  (3) Codeine  (4) Pentazocine  (5) Diphenoxylate
If choice 1 is selected set score to 1.

35. A 50 year old patient suffering from multiple myeloma with severe low back pain is admitted to the
hospital. The oncologist decided to administer an opioid analgesic transdermally for treating the severe back pain. Which of the following drugs is most appropriate for this patient?  (1) Fentanyl  (2) Hydroxocodone  (3) Methadone  (4) Mepiridine  (5) Naloxone
If choice 1 is selected set score to 1.

36. A 23 year old unemployed young man has been an opioid addict for the past three years. Which of
the following is not associated with the development of a high degree of tolerance following opiate administration?  (1) Euphoria  (2) Analgesia  (3) Nausea and vomiting  (4) Respiratory depression  (5) Constipation
If choice 5 is selected set score to 1.

37. A patient suffering from the pain of terminal cancer requires administration of a powerful analgesic. If
meperidine is used, the drug is not likely to cause  (1) Constipation  (2) Dependence  (3) Pupillary constriction  (4) Respiratory depression  (5) Development of tolerance
If choice 3 is selected set score to 1.

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38. Which one of the following actions of opioid analgesics is mediated via activation of kappa
receptors?  (1) Cerebral vascular dilation  (2) Respiratory depression  (3) Euphoria  (4) Sedation  (5) Psychologic dependence
If choice 4 is selected set score to 1.

39. A 50 year old man having high cholesterol is initiated treatment with simvastatin. While adding
another drug the physician is cautious of occurrence of rhabdomyolysis. Which one of the following drugs should be ideally avoided along with statins?  (1) Ezetimibe  (2) Gemfibrosil  (3) Cholestipol  (4) Probucol  (5) Cholestyramine
If choice 2 is selected set score to 1.

40. A patient is administered a skeletal muscle relaxant prior to abdominal surgery. The patient begins to
have hypotension, bronchospasm, excessive bronchial and salivary secretions. Which of the following muscle relaxant did the patient likely receive?  (1) Cisatracurium  (2) Pancuronium  (3) Tubocurarine  (4) Dantrolene  (5) Vecuronium
If choice 3 is selected set score to 1.

41. A 35 year old man is posted for a thoracic surgery. Following induction of anesthesia with
thiopentone and maintained by halothane and atropine, succinyl choline was also given to provide adequate muscle relaxation. During the procedure, the patient exhibited apnoea for nearly two hours requiring him to be maintained on respiratory support. Assuming an iatrogenic basis for the apnea, which of the above is the most likely cause for the above reaction?  (1) Excessive release of calcium from sarcoplasmic reticulum by halothane  (2) Rapid action of thiopentone due the phenomenon of redistribution  (3) Abnormal pseudocholinesterase enzyme which metabolises succinyl choline slowly  (4) Excessive release of calcium from sarcoplasmic reticulum by succinyl choline  (5) Genetically determined release of acetyl choline from nerve endings at skeletal muscle by atro pine
If choice 3 is selected set score to 1.

42. A 45 year old man presents to the physician with acute onset of muscle spasm in his lower back.
Which of the following muscle relaxant is most appropriate in this patient?  (1) Dantrolene  (2) Tizanidine  (3) Succinyl choline  (4) Mivacurium  (5) Ibuprofen
If choice 2 is selected set score to 1.

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43. Which of the following statements correctly associates a psychotherapeutic agent with a
demonstrated effect on neurotransmitter mechanisms?  (1) Diazepam-facilitation of GABA-stimulated chloride channel opening  (2) Amitryptyline-selective inhibition of presynaptic serotonin uptake  (3) Pentobarbital-inhibition of NMDA receptors  (4) Tranylcypromine-inhibition of O-methylation of catecholamines  (5) Trifluoperazine-competitive antagonism of GABA-A receptors
If choice 1 is selected set score to 1.

44. An electrophysiologist is performing intracellular recordings on neuronal cells in culture. He is trying
to identify a drug that would increase the firing rates in cultured cells. Assuming the cells in question express all the following receptor types, an agonist at which of the following receptors would most likely produce an increase in firing rate?  (1) Alpha 2 adrenergic  (2) Beta-1 adrenergic  (3) Glycine  (4) N-methyl D-aspartate  (5) Gamma amino butyric acid
If choice 4 is selected set score to 1.

45. A 54-year-old woman comes to the emergency room with complaints of pain associated with an
acute mild/moderate migraine attack. Which of the following drugs would you prescribe for the pain?  (1) Aspirin  (2) Propranolol  (3) Metoclopramide  (4) Sumatriptan  (5) Cyproheptadine
If choice 4 is selected set score to 1.

46. A 43 year old man diagnosed to have carcinoma of pancreas is receiving chemotherapy. The
oncologist plans to use ondansetron to reduce the nausea and vomiting associated with the chemotherapeutic agents. What is the mechanism of action of ondansetron?  (1) 5-HT4 agonist  (2) D2 receptor agonist  (3) D2 receptor antagonist  (4) H1 receptor antagonist  (5) 5-HT3 receptor antagonist
If choice 5 is selected set score to 1.

47. A 15 year old girl had consumed 10 tablets of a drug, which her mother was using for a skin allergy
(an antihistamine-promethazine). After about an hour she developed the following symptoms all of which can be attributed to the drug EXCEPT:  (1) Sedation  (2) Dry mouth  (3) Dizziness  (4) Fatigue  (5) Vomiting
If choice 5 is selected set score to 1.

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48. Your patient has been diagnosed with a rare metastatic carcinoid tumor. This neoplasm is releasing
serotonin, bradykinin, and several unknown peptides. The effects of serotonin in this patient are MOST likely to include which one of the following?  (1) <SPAN class=qmhtmlcontent1><SPAN style="FONT-SIZE: 10pt; mso-fareast-fontfamily: 'Times New Roman'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidilanguage: AR-SA"><FONT face=Arial>Hypersecretion of gastric acid  (2) <SPAN class=qmhtmlcontent1><SPAN style="FONT-SIZE: 10pt; mso-fareast-fontfamily: 'Times New Roman'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidilanguage: AR-SA"><FONT face=Arial>Hypotension  (3) Bronchospasm  (4) <SPAN class=qmhtmlcontent1><SPAN style="FONT-SIZE: 10pt; mso-fareast-fontfamily: 'Times New Roman'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidilanguage: AR-SA"><FONT face=Arial>Urinary retention  (5) <SPAN class=qmhtmlcontent1><SPAN style="FONT-SIZE: 10pt; mso-fareast-fontfamily: 'Times New Roman'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidilanguage: AR-SA"><FONT face=Arial>Constipation
If choice 3 is selected set score to 1.

49. A 34 year old pharmacist develops rashes on her face associated with severe itching after
consuming prawns in a restaurant. Suspecting it to be an allergic reaction to the sea food she self medicates by taking an antiallergic drug. She also consumes cimetidine as she develops gastritis. The next day she presents to the emergency room with episodes of dizziness and syncope. EKG reveals unduly prolonged QT interval. Which of the following antiallergic medication can cause such an abnormality?  (1) Astemizole  (2) Diphenhydramine  (3) Prednisone  (4) Chlorpheniramine  (5) Loratidine
If choice 1 is selected set score to 1.

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50. Which of the below dose response curves would be obtained from the combination of the agonist
represented in curve B and an irreversible

antagonist?  (1) Curve A  (2) Curve C  (3) Curve D  (4) Curve E  (5) Curve F
If choice 2 is selected set score to 1.

51. A patient is given a constant infusion of two drugs, A and B, whose pharmacokinetic profiles follow
first-order kinetics and are completely independent of each other. Both A and B reach ready-state plasma levels, and it is later decided that they should be withdrawn simultaneously. Given that the half-life of drug A is 4 hours and the half-life of drug B is 8 hours, which of the following statements is correct?  (1) After 8 hours, 50% of drug A remains and 50% of drug B remains  (2) After 24 hours, less than 5% of drug A remains and more than 10% of drug B remains  (3) After 8 hours, 25% of drug A remains and 75% of drug B remains  (4) After 24 hours, more than 5% of drug A remains and more than 10% of drug B remains  (5) After 16 hours, more than 5% of drug A remains and less than 10% of drug B remains
If choice 2 is selected set score to 1.

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52. A patient who weighs 50 kg is given 20 mg/kg dose of a new drug. The plasma concentrations
determined over time are illustrated in the graph below. The volume of distribution (Vd) of the drug is approximately

 (1) 0.2 L  (2) 1 L  (3) 2 L  (4) 10 L  (5) 20 L
If choice 4 is selected set score to 1.

53. When a steady-state concentration of drug is present in the systemic circulation and equilibration
between the systemic circulation and tissue compartments has been achieved, which of these fluid compartments has the largest total fluid-blood concentration ratio for the weak acid sulfadiazine (pKa=6.5)?  (1) Alkalinized urine at pH 8.0  (2) Acidified urine at pH 5.0  (3) Breast milk at pH 6.4  (4) Jejunum-ileum contents at pH 7.6  (5) Stomach contents at pH 2.0
If choice 1 is selected set score to 1.

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54. A new drug X (belonging to Angiotensin converting enzyme inhibitor category) is being tested on
1000 patients with essential hypertension in three different hospitals in United States. The safety and efficacy of the drug is evaluated by comparing the test drug X with enalapril as a standard drug. The data of whole study is pooled, a report is prepared by the sponsoring drug company and a New Drug Application (NDA) is made to the FDA to get approval for marketing the drug. Which of the following phases of the clinical trial matches with the description given?  (1) Phase I  (2) Phase II  (3) Phase III  (4) Phase IV  (5) Phase V
If choice 3 is selected set score to 1.

55. The area under curve (AUC) of oral and intravenous preparation of a drug A are plotted on the blood
concentration time graph to compare which of the following pharmacokinetic parameters

 (1) Bioavailability  (2) Biotransformation  (3) Plasma protein binding  (4) Volume of distribution  (5) Therapeutic margin
If choice 1 is selected set score to 1.

56. A ligand binds to the receptor which leads to the activation of a protein tyrosine kinase which
phosphorylates intracellular protein substrates. Therefore the ligand is most probably  (1) Insulin  (2) Adrenaline  (3) GABA  (4) Thyroid hormone  (5) Acetyl choline
If choice 1 is selected set score to 1.

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57. A drug with a therapeutic index of 10 would have an:
 (1) LD50 of 100 mg/kg and an ED50 of 1 mg/kg  (2) ED50 of 100 mg/kg and an LD50 of 10 mg/kg  (3) LD50 of 100 mg/kg and a ED50 of 100 mg/kg  (4) LD50 of 100 mg/kg and an ED50 of 10 mg/kg  (5) LD50 of 10 mg/kg and a ED50 of 10 mg/kg
If choice 4 is selected set score to 1.

58. A 45 year old diabetic patient complains of severe bloating after meals, which is sometimes followed
by vomiting. A diagnosis of diabetic gastro-paresis is made. Which of the following agents is most useful in treating this patients GI problem?  (1) Diphenhydramine  (2) Metoclopramide  (3) Omeprazole  (4) Ondansetron  (5) Scopolamine
If choice 2 is selected set score to 1.

59. A 43 year old man diagnosed to have lung cancer receives chemotherapy. The oncologist plans to
use ondansetron to reduce the nausea and vomiting associated with the chemotherapeutic agent. What is the mechanism of action of ondansetron?  (1) Muscarinic receptor agonist  (2) Corticosteroid agonist  (3) Dopamine antagonist  (4) Histamine antagonist  (5) Serotonin antagonist
If choice 5 is selected set score to 1.

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60.

The figure illustrates a current concept of the control of gastric acid secretion. Which of the following drugs acts at the site labeled H2?  (1) Aluminum hydroxide  (2) Misoprostol  (3) Omeprazole  (4) Ranitidine  (5) Sucralfate
If choice 4 is selected set score to 1.

61. A 25 year man diagnosed to have carcinoid syndrome. Which of the following agents is most
suitable to treat the secretory diarrhea in this patient?  (1) Sulfasalazine  (2) Bismuth subsalicylate  (3) Loperamide  (4) Octreotide  (5) Diphenoxylate
If choice 4 is selected set score to 1.

62. Which of the following agents is a stimulant laxative
 (1) Bisacodyl  (2) Psyllium  (3) Magnesium hydroxide  (4) Lactulose  (5) Docusate

If choice 1 is selected set score to 1.

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63. A 36 year old man is diagnosed to have chronic acid peptic disease. Antral biopsy reveals presence
of helicobacter pylori. Which of the following combination of drugs is most effective in the treatment of this patient  (1) Antacid plus bismuth plus ranitidine  (2) Bismuth plus tetracycline plus metoclopramide  (3) Metronidazole plus clarithromycin plus omeprazole  (4) Bismuth plus omeprazole plus ranitidine  (5) Misoprostol plus amoxicillin plus sucralfate
If choice 3 is selected set score to 1.

64. Which of the following items correctly associates the mechanism of action with the corresponding
agent used in hyperlipidemia?  (1) Cholestyramine-increased activity of lipoprotein lipase  (2) Clofibrate-decreased activity of lipoprotein lipase  (3) Probucol- inhibits VLDL synthesis  (4) Nicotinic acid- increases excretion of bile acids  (5) Simvastatin- inhibition of HMG-CoA reductase
If choice 5 is selected set score to 1.

65. A 73-year-old woman comes to the hospital complaining of difficulty sleeping, fatigue, and shortness
of breath. Examination reveals, swollen ankles, pulmonary rales, and dyspnea on reclining. Chronic treatment of this patient with an angiotensin-converting enzymes (ACE) inhibitor such as captopril may be beneficial because ACE inhibitors  (1) decrease both ventricular preload and afterload  (2) increase coronary perfusion  (3) increase efficiency of oxygen extraction by skeletal and cardiac muscle  (4) produce a positive inotropic effect and negative chronotropic effect  (5) promote left ventricular remodeling and hypertrophy
If choice 1 is selected set score to 1.

66. A 43-year-old man who is being treated with hydrochlorothiazide for control of mild edema complains
to the physician of malaise, fatigue, muscular weakness, and muscle cramps. The patients complaints most likely reflect a serious adverse effect of diuretic therapy, which is  (1) Hyperglycemia  (2) Hyperuricemia  (3) Hypocalcemia  (4) Hyperkalemia  (5) Hypokalemia
If choice 5 is selected set score to 1.

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67. A 29-year-old man who had a serious motor vehicle accident is brought to the ER. The bleeding has
been slowed by the paramedics, but the man has lost a substantial amount of blood. His blood pressure on arrival at the hospital is 72/30mm Hg. Right heart catheterization is performed. The physician begins volume replenishment with units of packed red blood cells and plasma. Which of the following pharmacologic agents would be most useful in supporting this patients cardiovascular system?  (1) Albuterol  (2) Propranolol  (3) Furosemide  (4) Dobutamine  (5) Tubocurarine
If choice 4 is selected set score to 1.

68. A previously healthy 60-year-old man collapsed while playing with his grandchildren. Although he
quickly regained consciousness and become fully alert, his family called an ambulance. The emergency medical team found no abnormalities on the electrocardiogram or on physical examination. However, the patient was admitted to the coronary care unit. At evening, the patient was noted to have a heart rate of 160 beats/min with a wide QRS complex on ECG monitor followed by hypotension and loss of consciousness. After electrical cardioversion, the most appropriate therapy would be intravenous administration of  (1) Propranolol  (2) Digitalis  (3) Lidocaine  (4) Diltiazem  (5) Esmolol
If choice 3 is selected set score to 1.

69. A 47-year-old man is on treatment for hypertension. He has responded well to the
antihypertensive medication with minimal adverse effects. However, the patient now complains of joint pains, fever and a facial rash. The probable antihypertensive agent which caused these effects is  (1) Captopril  (2) Clonidine  (3) Hydralazine  (4) Hydrochlorothiazide  (5) Methyldopa
If choice 3 is selected set score to 1.

70. A 61-year-old lady is admitted to the hospital as she complains of intermittent bouts of chest pain on
exertion associated with numbness and tingling in the fingers of her left hand since 2 months. The EKG is normal. She is treated with propranolol, which relieves her symptoms. What cardiovascular effect did the drug have?  (1) It decreased production of catecholamine  (2) It dilated the coronary vasculature  (3) It decreased the requirement for myocardial oxygen  (4) It increased peripheral vascular resistance  (5) It increased sensitivity to catecholamine
If choice 3 is selected set score to 1.

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71. A 35 year old man is found to have a blood pressure of 150/120 mmHg on routine physical
examination. Ultrasound studies reveals massively enlarged kidneys with many cysts of varying sizes. Which of the following drug classes would act by directly interrupting the probable mechanism by which hypertension was produced?  (1) ACE inhibitors  (2) Centrally acting sympatholytics  (3) Nitrates  (4) Calcium channel blockers  (5) Thiazide diuretics
If choice 1 is selected set score to 1.

72. A 67 year old man with supraventricular tachycardia is given a medication that blocks the potassium
channels, prolongs repolarisation widens QRS and prolongs QT interval. Which of the following medications is most likely being prescribed?  (1) Quinidine  (2) Amiodarone  (3) Propranolol  (4) Verapamil  (5) Lidocaine
If choice 2 is selected set score to 1.

73. A 57 year old male with a 10 year history of hypertension visits his physician for a routine physical
examination. Lab test results indicate that the patient has a plasma renin activity 3 to 4 times higher than normal. The patient is given a prescription for losartan. Following administration of losartan which of the following would be expected to increase in this patient?  (1) Total peripheral resistance  (2) Atrial natriuretic peptide  (3) Arterial pressure  (4) Aldosterone  (5) Ability of the kidney to excrete sodium
If choice 5 is selected set score to 1.

74. A 45-year-old man who is on treatment with antihypertensive drug with well controlled blood
pressure since 3 years presents to his physician with severe giddiness and palpitations. On examination his BP is 160/100mmHg. He informs the physician that he has not taken his antihypertensive medication for 2 days as he was travelling. Which of the following antihypertensive drug was the patient probably been taking for the past 3 years?  (1) Enalapril  (2) Hydrochlorothiazide  (3) Clonidine  (4) Losartan  (5) Hydrallazine
If choice 3 is selected set score to 1.

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75. A 72 -year old man visits the hospital for routine annual medical check up. His blood pressure is
170/100 mmHg. The physician prescribes amlodipine. This agent exerts its action by blocking which of the following?  (1) Angiotensin converting enzyme  (2) Sodium channels  (3) Potassium channels  (4) Calcium channels  (5) Angiotensin receptors
If choice 4 is selected set score to 1.

76. A 44 year old asthmatic patient is diagnosed to have essential hypertension. The doctor decided to
start antihypertensive treatment with betablockers. Which of the following betablockers should be avoided in this patient?  (1) Atenolol  (2) Pindolol  (3) Propranolol  (4) Esmolol  (5) Metoprolol
If choice 3 is selected set score to 1.

77. A 25 year old lady in her 5th month of pregnancy is admitted to the ER as she developed painful
contraction of uterus since a day. Which of the following drugs is best suited to relieve her premature uterine contractions?  (1) Ergometrine  (2) Salbutamol  (3) Propranolol  (4) Prazosin  (5) Isoprenaline
If choice 2 is selected set score to 1.

78. Ms. Brown has myasthenia gravis for several years. She is brought to the hospital with complains
of rapid onset of weakness of her hands, diplopia, and difficulty swallowing. She may be suffering from a change in response to her myasthenia therapy, ie, a cholinergic or a myasthenic crisis. The best drug for distinguishing between myasthenic crisis (insufficient therapy) and cholinergic crisis (excessive therapy) is  (1) Atropine  (2) Echothiophate  (3) Edrophonium  (4) Physostigmine  (5) Pralidoxime
If choice 3 is selected set score to 1.

79. A 24 year old farm worker is rushed to the emergency department after an accidental exposure to
parathion. He is in respiratory distress and is bradycardia. Which of the following drugs is given to increase the activity of his acetyl cholinesterase enzyme?  (1) Atropine  (2) Reserpine  (3) Physostigmine  (4) Pralidoxime  (5) Neostigmine
If choice 4 is selected set score to 1.

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80. A 34-year old woman comes to the hospital with complain of blurred vision. On examination there is
dilatation of the pupils. Which of the following pharmacological agents is most likely responsible for her symptoms?  (1) Pilocarpine  (2) Neostigmine  (3) Phenylephrine  (4) Timolol  (5) Physostigmine
If choice 3 is selected set score to 1.

81. A 4 yr old child presents to the emergency room after consuming some berries from a bush in his
back yard. The patients mother indicates that the child had been complaining of dry throat, excessive thirst and blurred vision. On examination the patient has fever, marked mydriasis and reddish skin color. Your initial diagnosis is that the active ingredient causing these symptoms is similar to  (1) Malathion  (2) Physostigmine  (3) Pilocarpine  (4) Nicotine  (5) Atropine
If choice 5 is selected set score to 1.

82. Pharmacotherapy for a patient diagnosed to have glaucoma is aimed to open trabecular meshwork
by contracting the ciliary muscle. A useful agent for this purpose is  (1) Atropine  (2) Timolol  (3) Pilocarpine  (4) Acetazolamide  (5) Latanoprost
If choice 3 is selected set score to 1.

83. The reversible cholinesterase inhibitor which is indicated in the treatment of Alzheimer’s disease is
 (1) Tacrine  (2) Edrophonium  (3) Neostigmine  (4) Pyridostigmine  (5) Ambenonium
If choice 1 is selected set score to 1.

84. Intravenous administration of drug x to an anaesthetized animal produces an increase in blood
pressure. After administration of drug Y, readministration of drug x will produce a decrease in blood pressure. Which of the following pairs of drugs could produce this sequence of events? Drug X Drug Y  (1) Acetyl Choline Propranolol  (2) Epinephrine Phentolamine  (3) Isoproterenol Atropine  (4) Norepinephrine Phenylephrine  (5) Phenylephrine Hexamethonium
If choice 2 is selected set score to 1.

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85. A 76-year-old male complains of difficulty in urination and increased frequency. Rectal examination
reveals an enlarged, smooth surfaced prostate. Which of the following drugs is suitable for use in this patient?  (1) Phenoxybenzamine  (2) Propranolol  (3) Pindolol  (4) Prazosin  (5) Pilocarpine
If choice 4 is selected set score to 1.

86. A patient is taken the emergency department with pinpoint pupils, a respiratory rate of 8/minute, and
a heart rate of 56 bpm. He is largely unresponsive to external stimuli. Which of the following pharmacologic interventions is most appropriate to be used in this patient?  (1) Intravenous administration of neostigmine  (2) Intravenous administration of naloxone  (3) Intravenous administration of sodium bicarbonate  (4) Intramuscular administration of atropine  (5) Intravenous administration of flumazenil
If choice 2 is selected set score to 1.

87. Halothane and methoxyflurane have blood: gas partition coefficients of 2.4 and 13 respectively.
Which of the following statements regarding these volatile anesthetics is correct?  (1) Both result is faster induction than does nitrous oxide (blood: gas partition coefficient of 0.47)  (2) The minimal alveolar concentration of halothane is less than that of methoxyflurane  (3) Both agents are useful because they do not have any cardiodepressant effects  (4) Recovery from methoxyflurane is faster than that from halothane  (5) An increase in ventilator rate make the onset of anesthesia more rapid for either agents
If choice 5 is selected set score to 1.

88. A 55-year-old female given a general anesthetic for a surgical procedure develops hyperthermia,
hypertension, hyperkalemia, tachycardia, muscle rigidity, and metabolic acidosis. Which of the following general anesthetics did she receive?  (1) Ketamine  (2) Midazolam  (3) Thiopental  (4) Propofol  (5) Halothane
If choice 5 is selected set score to 1.

89. A 19-year-old female whose roommate is being treated for depression decides that she is also
depressed and secretly takes her roommates pills as directed on the bottle for several days. One night, she makes herself a snack of chicken with cheese, accompanied by a glass of red wine. She soon develops headache, nausea, and palpitations. She is brought to the emergency unit, where her blood pressure is found to be 200/110 mmHg. Which antidepressant did she take?  (1) Sertraline  (2) Phenelzine  (3) Nortriptyline  (4) Trazodone  (5) Fluoxetine
If choice 2 is selected set score to 1.

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90. A 30 year old patient with history of long term insomnia attends a physician. He prescribes him a
sedative hypnotic which has the least hepatic enzyme inducing property. After few months of continuous therapy patient fails to show response to the dose prescribed. Then dose was increased slightly. What could be the mechanism of action of the drug prescribed in this patient?  (1) It facilitates the sodium channel opening  (2) It prolongs the duration of chloride channel opening facilitated by GABA  (3) It increases the frequency of chloride channel opening facilitated by GABA  (4) It prolongs the duration of chloride channel opening facilitated by NMDA  (5) Facilitate the GABA action by preventing its metabolism
If choice 3 is selected set score to 1.

91. A 45 year old lady visits the hospital complaining of recurrent attacks of severe migraine headache
2-3 times a week associated with nausea and vomiting. Which of the following drugs is helpful in preventing the recurrences of migrane attacks?  (1) Ibuprofen  (2) Ergotamine  (3) Metoclopromide  (4) Sumatriptan  (5) Propranolol
If choice 5 is selected set score to 1.

92. Carbamazepine is considered to be a primary drug for treatment of all types of epilepsy except
absence seizures. Its indications and proposed mechanism of action are most closely related to:  (1) Phenytoin  (2) Gabapentin  (3) Ethosuximide  (4) Clonazepam  (5) Diazepam
If choice 1 is selected set score to 1.

93. Haloperidol was prescribed to a schizophrenic patient. Akathesia, Parkinson-like syndrome,
galactorrhea, and amenorrhea the side effects of this neuroleptic agent are caused by  (1) Blockade of muscarinic receptors  (2) Blockade of alpha adrenergic receptors  (3) Blockade of dopamine receptors  (4) Stimulation of muscarinic receptors  (5) Stimulation of nicotinic receptors
If choice 3 is selected set score to 1.

94. Ketamine is characterized by which of the following pharmacologic properties?
 (1) Association with disagreeable dreams during and after recovery  (2) Depression of blood pressure and heart rate in a dose-dependent fashion  (3) High minimum alveolar concentration (MAC) value  (4) Moderately high risk of bronchospasm  (5) Excellent skeletal muscle relaxation
If choice 1 is selected set score to 1.

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95. A 45 year old male visits the hospital complaining of diarrhea and abdominal cramps. Which of the
following opioids is preferred in this patient?  (1) Heroin  (2) Morphine  (3) Codeine  (4) Pentazocine  (5) Diphenoxylate
If choice 5 is selected set score to 1.

96. Which of the following is an antiviral drug used in treatment of Parkinsons disease?
 (1) Amantadine  (2) Pergolide  (3) Entcapone  (4) Selegiline  (5) Carbidopa
If choice 1 is selected set score to 1.

97. A 23 year old man suffering from a maniac depressive illness is on treatment with lithium since 2
years. Consequently he develops polyuria and polydipsia. Which of the following drugs is most appropriate for use in his condition?  (1) Amiloride  (2) Desmopressin  (3) Frusemide  (4) Insulin  (5) Mannitol
If choice 1 is selected set score to 1.

98. An asthmatic patient who is on salbutamol inhalation comes to hospital complaining of tremors and
tachycardia. The treating pulmonologist decides to switch to another bronchodilator which acts by inhibiting the phosphodiesterase enzyme. Which of the following drugs would the pulmonologist choose?  (1) Ipratropium  (2) Theophylline  (3) Albuterol  (4) Beclomethasone  (5) Prednisolone
If choice 2 is selected set score to 1.

99. Inflammation is a complex tissue reaction that includes the release of cytokines, leukotrienes,
prostaglandins, and peptides. Prostaglandins involved in inflammatory processes are produced from arachidonic acid by  (1) Cyclooxygenase 1  (2) Cyclooxygenase 2  (3) Phosphodiesterase  (4) Lipoxygenase  (5) Phospholipase A2
If choice 2 is selected set score to 1.

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100.

A patient complains of severe itching of the eyes and watery nasal discharge during spring season. He is responsible for operating dangerous farm machinery and does not want any drug that will make him sleepy. Which of the following agents would be most suitable?  (1) Chlorpheniramine  (2) Cimetidine  (3) Diphenhydramine  (4) Hydroxyzine  (5) Loratadine
If choice 5 is selected set score to 1.

101.

Which of the following ergot derivative is correctly matched with its therapeutic use  (1) Bromocriptine: Migraine prophylaxis  (2) Ergotamine: Post partum haemorrhage  (3) Ergonovine: Acute migraine attack  (4) Pergolide: Hyperprolactinemia  (5) Methysergide: Parkinsons disease
If choice 4 is selected set score to 1.

102.

A 43 year old lady who has been taking aspirin for osteoarthritis develops severe bronhoconstriction. She is prescribed zileuton. Which of the following is the most suitable mechanism by which zileuton relieves her bronchospasm?  (1) By inhibiting the production of cyclooxygenase  (2) By blocking the leukotriene production  (3) By inhibiting the release of histamine from the mast cells  (4) By blocking the histamine 1 receptors  (5) By blocking the leukotriene receptors
If choice 2 is selected set score to 1.

103.

Following myocardial infarction a 54 year man is prescribed enteric coated 100 mg of aspirin daily. This drug inhibits platelet aggregation by inhibiting the production of which of the following  (1) Prostaglandins  (2) Leukotrienes  (3) Thromboxane  (4) Phospholipase  (5) Clotting factors II, VII, IX
If choice 3 is selected set score to 1.

104.

A 44 year old buisenessman presents to a physician because of markedly inflamed and painful right toe. On physical examination there is swelling and erythema of right great toe and small nodules in patients external ear. Aspiration of the fluid from metatarsophalyngeal joint reveals urate crystals. Which of the following agents would provide the most immediate relief of symptoms in this patient?  (1) Aspirin  (2) Colchicine  (3) Probenecid  (4) Allopurinol  (5) Sulfinpyrazone
If choice 2 is selected set score to 1.

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105.

A 23 year old patient who has severe skeletal muscle spasm due to cerebral palsy is treated with dantrolene. What is the site of action of dantrolene?  (1) Alpha 2 adrenoreceptors in the spinal cord  (2) GABA receptors in the brain  (3) Glycine receptors in the spinal cord  (4) Neuromuscular junction  (5) Sarcoplasmic reticulum calcium channels
If choice 5 is selected set score to 1.

106.

A 35 year old woman in a family planning program camp underwent a laparoscopic tubectomy after an injection with bupivacaine. Which of the following best describes the mechanism of action of bupivacaine?  (1) Stimulates sodium channels in their inactive state  (2) Blocks chloride channels on outer side  (3) Stimulates the glutamate receptors  (4) Blocks voltage dependent sodium channels  (5) Blocks T-type Calcium channels
If choice 4 is selected set score to 1.

107.

Which of the following non depolarizing neuromuscular blockers undergo hoffmanns elimination  (1) Mivacurium  (2) Atracurium  (3) Vecuronium  (4) Doxacurium  (5) Pancuronium
If choice 2 is selected set score to 1.

108.

Which of the following is a highly selective inhibitor of cyclooxygenase II?  (1) Aspirin  (2) Acetaminophen  (3) Ibuprofen  (4) Celecoxib  (5) Piroxicam
If choice 4 is selected set score to 1.

109.

The enzyme responsible for metabolism of succinyl choline is  (1) Monoaminooxidase  (2) Catechol-o- methyl transferase  (3) Xanthine oxidase  (4) Cytochrome oxidase  (5) Cholinesterase
If choice 5 is selected set score to 1.

110.

The amount of the drug required to produce a response is termed as  (1) Efficacy  (2) Affinity  (3) Antagonist  (4) Intrinsic activity  (5) Potency
If choice 5 is selected set score to 1.

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111.

Quantal dose-response curves are  (1) Used for determining the therapeutic index of a drug  (2) Used to determine the statistical variation of the maximal response to the drug  (3) Obtainable from the study of intact subjects but not from isolated tissue preparations  (4) More precisely quantitated than ordinary graded dose-response curves  (5) Used for determining the maximal efficacy of a drug
If choice 1 is selected set score to 1.

112.

The antagonism seen between Adrenaline and Histamine is  (1) Chemical antagonism  (2) Competitive antagonism  (3) Physiological antagonism  (4) Physical antagonism  (5) Irreversible antagonism
If choice 3 is selected set score to 1.

113.

A patient has to be treated for severe pain with an analgesic. Drugs X and Y have the same mechanism of analgesic action. Drug X in a dose of 10mg produces the same magnitude of analgesia as 100mg of drug Y. this suggests that  (1) Drug Y is more efficacious than drug X  (2) Drug X is a safer drug than drug Y  (3) Drug X will have a shorter duration of action than drug Y  (4) Drug Y is 10 times less potent than drug X  (5) Toxicity of drug Y is less than that of drug X
If choice 4 is selected set score to 1.

114.

A new drug for the treatment of schizophrenia is being tested. It has an ED50 of 250 mg, and an LD50 of 1500mg. Thus its therapeutic index is _________, a value that seems _________ for clinical use.  (1) 0.167; unacceptable  (2) 0.167; acceptable  (3) 6; unacceptable  (4) 60; acceptable  (5) 60; unacceptable
If choice 3 is selected set score to 1.

115.

A person who repeatedly used drug "X" loses interest in it because the drug no longer seems to produce the effect that it once did. She decides to try a new drug, "Y". She shows a much smaller response to Y than another person who had never used X before. This might be because of:  (1) Cross-tolerance  (2) Reverse tolerance  (3) Inverse tolerance  (4) Antagonism  (5) hypersensitivity
If choice 1 is selected set score to 1.

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116.

Which of the following most accurately describes the transmembrane signaling process involved in Insulin action?  (1) Activation of a G protein, which activates or inhibits adenylyl cyclase  (2) Diffusion across the membrane and binding to an intracellular receptor  (3) Action on a membrane-spanning tyrosine kinase  (4) Opening of transmembrane ion channels  (5) Diffusion of STAT molecules across the membrane
If choice 3 is selected set score to 1.

117.

The delicate balance between the desired effect and unwanted toxicity of a drug is referred to as its  (1) Potency  (2) Therapeutic index  (3) Intrinsic activity  (4) Bioavailability  (5) Efficacy
If choice 2 is selected set score to 1.

118.

Steroids are capable of targeting intranuclear receptors secondary to its ability to  (1) Undergo autophosphorylation  (2) Dimerize upon ligand binding  (3) Induce conformational change in its receptor  (4) Diffuse through lipid membrane  (5) Interact with adenylyl cyclase
If choice 4 is selected set score to 1.

119.

A drug is administered in the form of an inactive pro-drug. The pro-drug increases the expression of a cytochrome P450 that converts the pro-drug to its active form. With chronic, long term administration of the pro-drug, which of the following will be observed?  (1) The potency will increase  (2) The potency will decrease  (3) The efficacy will increase  (4) The efficacy will decrease  (5) The potency as well as the efficacy decreases
If choice 1 is selected set score to 1.

120.

Which of the following factors will determine the number of drug-receptor complexes formed?  (1) Efficacy of the drug  (2) Receptor affinity for the drug  (3) Therapeutic index of the drug  (4) Half life of the drug  (5) Rate of renal excretion
If choice 2 is selected set score to 1.

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121.

Which of the following is an action of a noncompetitive antagonist?  (1) Alters the mechanism of action of an agonist  (2) Alters the potency of an agonist  (3) Shifts the dose response curve of an agonist to the right  (4) Decreases the maximum response to an agonist  (5) Binds to the same site on the receptor as the agonist
If choice 4 is selected set score to 1.

122.

Requirement of higher dose of a drug to produce a given response is  (1) Tachyphylaxis  (2) Cumulation  (3) Tolerance  (4) Resistance  (5) Intolerance
If choice 3 is selected set score to 1.

123.

The pharmacokinetic properties of a new drug are being studied in normal volunteers during phase I clinical trials. The volume of distribution and clearance determined in the first subject are 80 L and 4L/hr, respectively. The half life of the drug in this subject is approximately  (1) 0.03 hours  (2) 14 hours  (3) 78 hours  (4) 139 hours  (5) 222 hours
If choice 2 is selected set score to 1.

124.

Drugs with large apparent volumes of distribution (Vd) usually have:  (1) a high degree of plasma protein binding  (2) high tissue affinity relative to plasma  (3) a large first-pass effect if given orally  (4) high renal and hepatic clearances  (5) a short plasma elimination half-life
If choice 2 is selected set score to 1.

125.

A new antifungal agent is being tested in phase I clinical trials. Examination of the pharmacokinetic properties of the drug reveals that the half life of the drug is 6 hours. If a continuous intravenous infusion was started on a research subject how long would it take to reach 75% of the steady state?  (1) 3 hours  (2) 6 hours  (3) 12 hours  (4) 18 hours  (5) 24 hours
If choice 3 is selected set score to 1.

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126.

A bolus of drug K is given intravenously. The drug is noted to follow first order kinetics. Which of the following describes the elimination of drug K?  (1) the rate of elimination of drug K is constant  (2) the rate of elimination of drug K is proportional to the patients renal function  (3) the rate of elimination of drug K is proportional to its concentration in plasma  (4) the rate of elimination of drug K is dependent on a nonlinear relationship to the plasma concen tration
If choice 3 is selected set score to 1.

127.

A 35 kg child with heart disease recquires immediate treatment with antiarrythmic drug procainamide. The following are the pharmacokinetic values for procainamide in a 70-kg person: Vd 130L, clearance 36L/hr, oral bioavailability 83%, and therapeutic concentration 5 mg/L. what intravenous loading dose should be administered?  (1) 180 mg  (2) 225 mg  (3) 270 mg  (4) 325 mg  (5) 783 mg
If choice 4 is selected set score to 1.

128.

Which of the following is used to calculate the degree of ionization  (1) Graded dose-response curve  (2) Quantal dose-response curve  (3) Henderson Hasselbalchs equation  (4) Ficks equation  (5) Michaelis-Menten Equation
If choice 3 is selected set score to 1.

129.

The bioavailability of a preparation of a drug is a measure of:  (1) The relative toxicity of the preparation to laboratory animals  (2) The stability of the preparation  (3) The proportion of active drug appearing in the plasma  (4) The acceptability of the preparation to the patient  (5) The availability of the drug from natural sources
If choice 3 is selected set score to 1.

130.

A 3-year-old child is brought to the emergency department having just ingested a large overdose of aspirin (acetyl salicylic acid), an antiflammatory drug. On examination the child had hyperthermia, dehydrated and developed metabolic acidosis. In this case of salicylate overdose  (1) Urinary excretion would be accelerated by administration of an acidifying agent NH4Cl  (2) Urinary excretion would be accelerated by giving NaHCO3  (3) More of the drug would be ionized at stomach pH than at blood pH  (4) Absorption of the drug would be faster from the small intestine than the stomach  (5) Hemodialysis is the only effective treatment
If choice 2 is selected set score to 1.

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131.

A patient with a history of episodic attacks of coughing, wheezing, and shortness of breath is being evaluated in the asthma clinic. Several drug treatments with different routes of administration are under consideration. Which of the following statements about routes of administration is MOST correct?  (1) Blood levels often rise more slowly after intramuscular injection than after oral dosing  (2) The "firstpass" effect is the result of metabolism of a drug after administration and before it enters the systemi c circulation  (3) Administration of antiasthmatic drugs by inhaled aerosol is usually associated with more adver se effects than is administration of these drugs by mouth  (4) Bioavailability of most drugs is greater with rectal (suppository) administration than with sublin gual administration  (5) Administration of a drug by transdermal patch is often faster but is associated with more firstpass metabolism than oral administration
If choice 2 is selected set score to 1.

132.

The following are microsomal enzyme inducers except  (1) Benzopyrene  (2) Griseofulvin  (3) Phenytoin  (4) Ketoconazole  (5) Phenobarbitone
If choice 4 is selected set score to 1.

133.

Of the following, which is a phase II biotransformation reaction?  (1) Sulfoxide formation  (2) Nitro reduction  (3) Ester hydrolysis  (4) Acetylation  (5) Deamination
If choice 4 is selected set score to 1.

134.

A factor that is likely to increase the duration of action of a drug that is partially metabolized by CYP3A4 in the liver is  (1) Chronic administration of phenobarbital prior to and during therapy with the drug in question  (2) Chronic therapy with cimetidine prior to and during therapy with the drug in question  (3) Displacement from tissue binding sites by another drug  (4) Increased cardiac output  (5) Chronic administration of rifampin
If choice 2 is selected set score to 1.

135.

An Example of antimicrobial drug antagonism established at the clinical level include  (1) Amphotericin B and flucytosine in cryptococcal meningitis  (2) Carbenicillin and gentamicin in pseudomonal infections  (3) Penicillin and tetracycline in bacterial meningitis  (4) Penicillin and vancomycin in enterococcal infections  (5) Trimethoprim and sulfamethoxazole in coliform infections
If choice 3 is selected set score to 1.

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136.

Antibiotic which exhibits concentration dependent bactericidal activity is  (1) Gentamicin  (2) Vancomycin  (3) Amoxicillin  (4) Carbapenems  (5) Penicillin G
If choice 1 is selected set score to 1.

137.

A patient is given a constant infusion of two drugs, A and B, whose pharmacokinetic profiles follow first-order kinetics and are completely independent of each other. Both A and B reach readystate plasma levels, and it is later decided that they should be withdrawn simultaneously. Given that the half-life of drug A is 4 hours and the half-life of drug B is 8 hours, which of the following statements is correct?  (1) After 8 hours, 50% of drug A remains and 50% of drug B remains  (2) After 24 hours, less than 5% of drug A remains and more than 10% of drug B remains  (3) After 8 hours, 25% of drug A remains and 75% of drug B remains  (4) After 24 hours, more than 5% of drug A remains and more than 10% of drug B remains  (5) After 16 hours, more than 5% of drug A remains and less than 10% of drug B remains
If choice 2 is selected set score to 1.

138.

Combination of which of the following antibacterial drug with aminoglycosides results in a synergistic response?  (1) Macrolides  (2) Sulfonamides  (3) Clavulanic acid  (4) Doxycycline  (5) Penicillin G
If choice 5 is selected set score to 1.

139.

Which form of the drug would readily be absorbed across the biological membrane?  (1) Ionised  (2) Unionised  (3) Protein bound  (4) Lipid insoluble  (5) Drug with high molecular size
If choice 2 is selected set score to 1.

140.

A new born infant is diagnosed with a disorder caused by elevated unconjugated bilirubin levels. Which of the following antimicrobials administered to the infants mother during her last trimester of her pregnancy might account for this presentation?  (1) Sulfonamides  (2) Chloramphenicol  (3) Gentamycin  (4) Ceftriaxone  (5) Vancomycin
If choice 1 is selected set score to 1.

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141.

A 50-year-old man is brought into the emergency room because of fever and confusion. The patient has a dental disease and on auscultation has a mid diastolic murmur. There is no past history of allergy to penicillins. Echocardiogram revealed vegetations on the calcified aortic valve. Which of the following drugs or combinations would you administer pending the results of bacterial cultures?  (1) Azithromycin  (2) Ampicillin plus gentamicin  (3) Tetracycline plus gentamicin  (4) Sulfamethoxazole plus trimethoprim  (5) Aztreonam
If choice 2 is selected set score to 1.

142.

A 22 year old woman presented with complaints of vaginal discharge, dysuria abdominal pain and fever. She was diagnosed to have gonococcal infection and was treated with a betalactum antibiotic which was most likely  (1) Azetreonam  (2) Ceftriaxone  (3) Cefazolin  (4) Cefuroxime  (5) Carbenicillin
If choice 2 is selected set score to 1.

143.

A 67 year old woman with a hospital acquired infections that is drug resistant is given a combination of drug X with cilastatin. Which of the following is drug X ?  (1) Azetreonam  (2) Imipenem  (3) Amoxicillin  (4) Vancomycin  (5) Cefuroxime
If choice 2 is selected set score to 1.

144.

A 30 year old man with history of fever and vomiting since a week was admitted to hospital. Lab report confirmed the diagnosis of typhoid fever based on a positive widal test. Patient was prescribed a ciprofloxacin 500mg twice day for 14 days. This drug acts by inhibiting which of the following bacterial enzyme.  (1) 5-alpha reductase  (2) DNA gyrase  (3) Dihydrofolate reductase  (4) Dihydropteroate synthase  (5) Beta lactamase
If choice 2 is selected set score to 1.

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145.

An 86-year-old male complains of cough and blood in his sputum for the past two days. On admission, his temperature is 103?F. Physical examination reveals rales in his right lung, and x-ray examination shows increased density in the right middle lobe. A sputum smear shows many Grampositive cocci, confirmed by sputum culture as penicillinase-producing Staphylococcus aureus. Which of the following agents should be given?  (1) Ampicillin  (2) Oxacillin  (3) Carbenicillin  (4) Ticarcillin  (5) Mezlocillin
If choice 2 is selected set score to 1.

146.

A 35-year-old male is diagnosed with primary syphilis. Which of the following agents is the best choice for treating this patient?  (1) Ceftriaxone  (2) Sulfonamide  (3) Penicillin G  (4) Clarithromycin  (5) Clindamycin
If choice 3 is selected set score to 1.

147.

A patient diagnosed to have cystic fibrosis has a history of frequent respiratory infections. A recent sputum analysis indicates the presence of Staphylococcus aureus, Haemophilus influenzae, and Pseudomonas aeruginosa. Although the value of antibiotic therapy in cystic fibrosis remains unclear, a conventional approach to such therapy based on sputum culture might include  (1) Gentamicin and Ceftazidime  (2) Clarithromycin  (3) Metronidazole  (4) Vancomycin  (5) Quinupristin and Dalfopristin
If choice 1 is selected set score to 1.

148.

Which of the following antibiotics is correctly paired with its associated toxicity?  (1) Sulfonamides gray baby syndrome  (2) Tetracycline aplastic anaemia  (3) Chloramphenicol ototoxicity  (4) Clindamycin enterocolitis  (5) Streptomycin redman syndrome
If choice 4 is selected set score to 1.

149.

Which of the following proteins bind to penicillin?  (1) DNA gyrase  (2) 30S Ribosomes  (3) Peptidoglycan  (4) Dihydropteroate synthetase  (5) Transpeptidase
If choice 5 is selected set score to 1.

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150.

A 75-year-old woman is hospitalized for pneumonia and treated with an intravenous . On day three, she develops severe diarrhea. Stool is positive for Clostridium difficile toxin. What is the best treatment?  (1) Clindamycin  (2) Cefaclor  (3) Metronidazole  (4) Erythromycin  (5) Doxycycline
If choice 3 is selected set score to 1.

151.

A 30-year-old female develops a UTI that is caused by anaerobic bacteria bacteroid fragilis. Of the following, which is the best agent to use in this patient?  (1) Tetracycline  (2) Clindamycin  (3) Ampicillin  (4) Erythromycin  (5) Sulfamethoxazole-trimethoprim
If choice 2 is selected set score to 1.

152.

Which of the following tetracyclines is most suitable for administration to patients with renal sufficiency?  (1) Oxytetracycline  (2) Demeclocycline  (3) Chlortetracycline  (4) Doxycycline
If choice 4 is selected set score to 1.

153.

Clarithromycin and erythromycin have very similar spectrums of antimicrobial activity. The major advantage of clarithromycin is that it  (1) Eradicates mycoplasmal infections in a single dose  (2) Is active against strains of streptococci that are resistant to erythromycin  (3) Is more active against Mycobacterium avium complex  (4) Does not inhibit liver drug-metabolizing enzymes  (5) Acts on methicillin-resistant strains of staphylococci
If choice 3 is selected set score to 1.

154.

The mechanism of antibacterial action of tetracyclines involves  (1) Binding to a component of the 50S ribosomal subunit  (2) Inhibition of translocase activity  (3) Blockade of binding of aminoacyl-tRNA to bacterial ribosomes  (4) Selective inhibition of ribosomal peptidyl transferases  (5) Inhibition of DNA-dependent RNA polymerase
If choice 3 is selected set score to 1.

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155.

An undesirable effect of a drug that occurs at therapeutic doses and can be predicted from its pharmacological actions is called  (1) Side effect  (2) Toxic effect  (3) Idiosyncrasy  (4) Allergic reactions  (5) Intolerance
If choice 1 is selected set score to 1.

156.

Which of the following is the only life saving measure in case of anaphylactic shock?  (1) Intravenous hydrocortisone hemisuccinate  (2) Intravenous chlorpheniramine maleate  (3) Intramuscular adrenaline hydrochloride  (4) Intravenous dextrose  (5) Intravenous saline
If choice 3 is selected set score to 1.

157.

The type of drug reaction that was caused by penicillin is  (1) An autoimmune syndrome  (2) A cell mediated reaction  (3) A type II drug allergy  (4) Mediated by IgE  (5) Serum sickness
If choice 4 is selected set score to 1.

158.

Which of the following binds covalently to the site specified?  (1) Atenolol - beta receptor  (2) Carvedilol - cardiac beta receptors  (3) Labetalol - alpha and beta receptors  (4) Phenoxybenzamine - alpha receptor  (5) Pindolol - beta receptor
If choice 4 is selected set score to 1.

159.

A new drug is to be tested in 1000 patients in different centers all over the country. This drug is compared with the standard drug available to treat the disease. Both these treatments are given to the patients randomly. Neither the patient nor the principal investigator knows about the treatment. Which phase of the clinical trial the new drug is undergoing  (1) Phase I  (2) Phase II  (3) Phase III  (4) Phase IV  (5) Phase V
If choice 3 is selected set score to 1.

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160.

Phocomelia is caused by ___________, a human teratogenic drug  (1) Tetracyclines  (2) Phenytoin  (3) Corticosteroids  (4) Thalidomide  (5) Lithium
If choice 4 is selected set score to 1.

161.

Ecothiophate, which is used mainly for its ophthalmic actions, inhibits  (1) Tyrosine hydroxylase  (2) Acetylcholine esterase  (3) Catechol-o-methyl transferase  (4) Mono amine oxidase  (5) DOPA decarboxylase
If choice 2 is selected set score to 1.

162.

Tachyphylaxis is very common with use of the following drug  (1) Dobutamine  (2) Adrenaline  (3) Isoprenaline  (4) Phenylephrine  (5) Tyramine
If choice 5 is selected set score to 1.

163.

Which of the following organs is innervated only by parasympathetic nerves?  (1) Iris muscle  (2) Ciliary muscle  (3) Intestinal smooth muscle  (4) Sweat glands  (5) Heart
If choice 2 is selected set score to 1.

164.

The choline ester resistant to both pseudo and true choline esterase is  (1) Methacholine  (2) Bethanechol  (3) Benzoylcholine  (4) Butyrylcholine  (5) Acetylcholine
If choice 2 is selected set score to 1.

165.

Cholinergic muscarinic stimulation produces the following effects except  (1) Sweating  (2) Bradycardia  (3) Urination  (4) Rise in blood pressure  (5) Miosis
If choice 4 is selected set score to 1.

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166.

Which is the reversible choline esterase inhibitor that is indicated for the treatment of Alzheimers disease?  (1) Edrophonium  (2) Ambenonium  (3) Neostigmine  (4) Pyridostigmine  (5) Tacrine
If choice 5 is selected set score to 1.

167.

Ritodrine hydrochloride is used in the treatment of  (1) Bronchial asthma  (2) Parkinsonism  (3) Depression  (4) Hypertension  (5) Premature labor
If choice 5 is selected set score to 1.

168.

Which of the following drugs reduces intra ocular pressure by decreasing the formation of the aqueous humor?  (1) Ecothiophate  (2) Timolol  (3) Pilocarpine  (4) Isofluorophate  (5) Physostigmine
If choice 2 is selected set score to 1.

169.

Which is a muscarinic receptor blocking agent that is administered by inhalational to cause bronchodilatation in patients with chronic obstructive pulmonary disorder?  (1) Albuterol  (2) Diphenhydramine  (3) Pancuronium  (4) Ipratropium  (5) Pilocarpine
If choice 4 is selected set score to 1.

170.

The neuromuscular blocker that does not need reversal of action by Neostigmine at the end of the operation is  (1) d-Tubocurarine  (2) Doxacurium  (3) Pipecuronium  (4) Mivacurium  (5) Pancuronium
If choice 4 is selected set score to 1.

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171.

Which of the following is a centrally acting skeletal muscle relaxant?  (1) Chlorzoxazone  (2) Rapacuronium  (3) Quinine  (4) Decamethonium  (5) Suxamethonium
If choice 1 is selected set score to 1.

172.

Dantrolene sodium reduces skeletal muscle tone by  (1) Reducing ACh release from motor nerve ending  (2) Suppressing spinal polysynaptic reflexes  (3) Inhibiting the generation of muscle action potential  (4) Reducing calcium release from the sarcoplasmic reticulum in the muscle fibre  (5) Stimulating central alpha2 adrenergic receptor
If choice 4 is selected set score to 1.

173.

Which of the following applies to both phentolamine and prazosin?  (1) Are competitive antagonists at alpha1 receptor  (2) Profoundly inhibit gastric acid secretion  (3) Cause a high incidence of bronchoconstriction in asthmatics  (4) Are used chronically for the treatment of primary hypotension  (5) Cause bradycardia
If choice 1 is selected set score to 1.

174.

Which of the following is a uroselective alpha1A blocker?  (1) Prazosin  (2) Terazosin  (3) Doxazosin  (4) Yohimbine  (5) Tamsulosin
If choice 5 is selected set score to 1.

175.

Physostigmine is the antidote for atropine poisoning. Another acetylcholine esterase inhibitor Neostigmine is not suitable. This is because Neostigmine cannot overcome the adverse effects of atropine in or on which of the following?  (1) Exocrine glands  (2) Heart  (3) Central nervous system  (4) Smooth muscle  (5) Skeletal muscle
If choice 3 is selected set score to 1.

176.

Which of the following response is seen after administering a drug that is a selective agonist at the presynaptic alpha2 receptor?  (1) Activation of NA exocytosis  (2) Activation of the amine pump, stimulation of NA reuptake  (3) Dependent on what the postsynaptic effector cell is  (4) Stimulation of intraneuronal MAO  (5) Inhibition of NA release
If choice 5 is selected set score to 1.

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177.

Select the drug which can impair carbohydrate tolerance in prediabetics and prolongs insulin hypoglycaemia  (1) Salbutamol  (2) Propranolol  (3) Prazosin  (4) Amphetamine  (5) Dopamine
If choice 2 is selected set score to 1.

178.

Applied to the skin in a transdermal patch (transdermal therapeutic delivery system), this drug is used to prevent or reduce the occurrence of nausea and vomiting that are associated with motion sickness  (1) Domperidone  (2) Chlorpromazine  (3) Ondansetron  (4) Dimenhydrinate  (5) Hyoscine
If choice 5 is selected set score to 1.

179.

A 45 year-old female patient was being operated for hysterectomy. During the surgery there was sudden rise in blood pressure. The anesthetist administered a drug by intravenous bolus to control this rise in blood pressure. What is the most appropriate drug to be administered in this situation?  (1) Acebutolol  (2) Atenolol  (3) Betaxolol  (4) Esmolol  (5) Metoprolol
If choice 4 is selected set score to 1.

180.

A 55-year-old woman with congestive heart failure is to be treated with a diuretic drug. Drugs X and Y have the same mechanism of diuretic action. Drug X in a dose of 5 mg produces the same magnitude of diuresis as 500 mg of drug Y. This suggests that  (1) Drug Y is less efficacious than drug X  (2) Drug X is about 100 times more potent than drug Y  (3) Toxicity of drug X is less than that of drug Y  (4) Drug X will have a shorter duration of action than drug Y  (5) Drug X is 100 times more efficient than drug Y
If choice 2 is selected set score to 1.

181.

The pharmacokinetic value that most reliably reflects the amount of drug reaching the target tissue after oral administration is the  (1) Peak blood concentration  (2) Steady state concentration  (3) Elimination rate constant  (4) Volume of distribution  (5) Bioavailability
If choice 5 is selected set score to 1.

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182.

Despite careful adherence to basic pharmacokinetic principles, your patient on digoxin therapy has developed digitalis toxicity. The plasma digoxin level is 4 ng/mL. Renal function is normal, and the plasma t1/2 for digoxin in this patient is 1.6 days. How long should you withhold digoxin in order to reach a safer yet probably therapeutic level of 1 ng/mL?  (1) 1.6 days  (2) 2.4 days  (3) 3.2 days  (4) 4.8 days  (5) 6.4 days
If choice 3 is selected set score to 1.

183.

Which of the following is used to calculate the degree of ionization of a drug  (1) Graded dose-response curve  (2) Quantal dose-response curve  (3) Henderson Hasselbalchs equation  (4) Ficks equation  (5) Michaelis-Menten Equation
If choice 3 is selected set score to 1.

184.

In which of the following phases of the clinical trial is adverse drug reaction monitoring and post marketing surveillance of a drug is performed?  (1) Phase I  (2) Phase II  (3) Phase III  (4) Phase IV  (5) Phase V
If choice 4 is selected set score to 1.

185.

Of the following, which is a phase II biotransformation reaction?  (1) Sulfate conjugation  (2) Sulfoxide formation  (3) Nitro reduction  (4) Ester hydrolysis  (5) Deamination
If choice 1 is selected set score to 1.

186.

Which of the following belongs to an intracellular family of receptors?  (1) Hydrocortisone receptor  (2) GABA-A receptor  (3) Adrenergic receptor  (4) Insulin receptor  (5) Nicotinic receptor
If choice 1 is selected set score to 1.

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187.

In the absence of other drugs, pindolol causes an increase in heart rate by activating beta adrenoceptors. In the presence of highly effective beta stimulants, however, pindolol causes a dosedependent, reversible decrease in heart rate. Therefore, pindolol is probably  (1) An irreversible antagonist  (2) A physiologic antagonist  (3) A chemical antagonist  (4) A partial agonist  (5) A noncompetitive antagonist
If choice 4 is selected set score to 1.

188.

39 year old woman complains of severe epigastric discomfort. Past medication history reveals that she has been taking Ibuprofen, which she got over the counter and took it quite frequently for her pain in the knee joints. After a thorough investigation you diagnose the condition as drug induced peptic ulcer. Inclusion of which of the following drugs is most appropriate in the management of this condition?  (1) Misoprostol  (2) Alprostadil  (3) Promethazine  (4) Prostacyclin  (5) Indomethacin
If choice 1 is selected set score to 1.

189.

A 43 year old man diagnosed to gastroesophageal reflux disease. The gastroenterologist plans to use metoclopramide. Which of the following is best describes the beneficial effect of metoclopramide in the above patient?  (1) Dopamine agonism  (2) Decrease the propulsive contraction in the bowel  (3) Increase lower esophageal tone  (4) Histamine antagonism  (5) Serotonin antagonism
If choice 3 is selected set score to 1.

190.

Bismuth salts are effective in peptic ulcer disease because they have bactericidal properties against  (1) Escherichia coli  (2) Bacteroides fragilis  (3) Clostridium difficile  (4) Helicobacter pylori  (5) Staphylococcus aureus
If choice 4 is selected set score to 1.

191.

A 25 year man is diagnosed to have inflammatory bowel disease. Which of the following drugs is most suitable in the treatment of this patient?  (1) Sulfasalazine  (2) Bismuth subsalicylate  (3) Loperamide  (4) Octreotide  (5) Diphenoxylate
If choice 1 is selected set score to 1.

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192.

Which of the following agents is a osmotic laxative  (1) Bisacodyl  (2) Psyllium  (3) Magnesium hydroxide  (4) Lactulose  (5) Docusate
If choice 3 is selected set score to 1.

193.

Applied to the skin in a transdermal patch, which of the following drugs is used to prevent or reduce the occurrence of nausea and vomiting that are associated with motion sickness  (1) Domperidone  (2) Chlorpromazine  (3) Ondansetron  (4) Dimenhydrinate  (5) Hyoscine
If choice 5 is selected set score to 1.

194.

Which of the following drugs acts by inhibiting HMG Co-A reductase enzyme?  (1) Cholestyramine  (2) Clofibrate  (3) Probucol  (4) Nicotinic acid  (5) Simvastatin
If choice 5 is selected set score to 1.

195.

A 70-year-old female is treated with sublingual nitroglycerin for her occasional bouts of angina. Which of the following is involved in the action of nitroglycerine?  (1) Alpha2 adrenergic activity  (2) Phosphodiesterase activity  (3) Phosphorylation of light chains of myosin  (4) Norepinephrine release  (5) Increasing cGMP
If choice 5 is selected set score to 1.

196.

An 82-year-old woman develops left ventricular failure following myocardial infarction and needs a diuretic for treatment of pulmonary edema. Which of the following diuretics would be most appropriate in this patient?  (1) Furosemide  (2) Hydrochlorothiazide  (3) Mannitol  (4) Acetazolamide  (5) Desmopressin
If choice 1 is selected set score to 1.

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197.

A 67 year old man diagnosed to have atrial fibrillation is on treatment with digoxin. Which of the following would precipitate digoxin toxicity?  (1) Hypokalemia  (2) Hyperkalemia  (3) Hypocalcemia  (4) Hyperuricemia  (5) Hypermagnesemia
If choice 1 is selected set score to 1.

198.

A 54 year old man with premedical history of myocardial infarction and recent diagnosis of left ventricular failure complains of shortness of breath and dyspnea on mild physical exertion. He has a ejection fraction of 25%. The cardiologist decides to start treatment with oral digoxin therapy along with the other medications he has been taking. Digoxin is helpful in such cases of heart failure as it:  (1) Increases the cAMP levels in the myocytes  (2) Inhibits Na+K+ ATPase to cause an increase in intracellular K+ ions  (3) Inhibits Na+K+ ATPase to cause an increase in intracellular Ca2+ ions  (4) Stimulates Na+K+ ATPase to cause an increase in intracellular K+ ions  (5) Stimulates Na+K+ ATPase to cause an increase in intracellular Ca2+ ions
If choice 3 is selected set score to 1.

199.

Amrinone, a bipyridine class of drug used to treat congestive heart failure acts by  (1) Stimulating the beta receptors in the cardiac cells  (2) Blocking the sodium potassium ATPase enzyme  (3) Inhibiting the enzyme phosphodiesterase  (4) Blocking alpha receptors in the vasculature  (5) Inhibiting the enzyme phospholipase A2
If choice 3 is selected set score to 1.

200.

A 45 year old female is brought to the Emergency Room following head injury with a BP of 260/110 mmHg. An IV infusion of a vasodilator drug is begun which has an onset of action within seconds in an attempt to lower her BP. The patient is most likely receiving  (1) Propranolol  (2) Enalapril  (3) Sodium nitroprusside  (4) Clonidine  (5) Reserpine
If choice 3 is selected set score to 1.

201.

A 54 year old man is admitted to hospital with chest pain. Based on serial enzyme estimations and his electrocardiogram, he is diagnosed to have myocardial infarction. He is hospitalized for three days and recovers, but left ventricular dysfunction remains. He is prescribed several medications and discharged. A week later he complains to his doctor about a dry non-productive persistent cough. Which of the following medications is most likely responsible for the appearance of these symptoms?  (1) Aspirin  (2) Captopril  (3) Metoprolol  (4) Warfarin  (5) Procainamide
If choice 2 is selected set score to 1.

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202.

A 45 year old man with a premedical history of ischemic heart disease is brought to the emergency department with sudden onset of severe palpitations and dizziness. His EKG shows signs of paroxysmal supraventricular tachycardia. What is the drug of choice in the management of this condition?  (1) Amiodarone  (2) Adenosine  (3) Flecainide  (4) Sotalol  (5) Lidocaine
If choice 2 is selected set score to 1.

203.

A 33 year old man diagnosed to have essential hypertension. He is started on a medication to lower his blood pressure, and after 6 weeks, he notes fatigue, rash over his face, joint aches and effusions. A serum antinuclear antibody (ANA) test is positive. Which of the following is the most likely antihypertensive agent which was prescribed to this patient?  (1) Hydrallazine  (2) Propranolol  (3) Nifedipine  (4) Methyldopa  (5) Enalapril
If choice 1 is selected set score to 1.

204.

A 45-year-old man who is on treatment with antihypertensive drug with well controlled blood pressure since 3 years presents to his physician with severe giddiness, and palpitations. On examination his BP is 160/100mmHg. He informs the physician that he has not taken his antihypertensive medication for the past one week. Which of the following antihypertensive drug was the patient probably been taking for the past 3 years?  (1) Enalapril  (2) Hydrochlorothiazide  (3) Propranolol  (4) Losartan  (5) Hydrallazine
If choice 3 is selected set score to 1.

205.

A 72 -year old man visits the hospital for routine annual medical check up. His blood pressure is 170/100 mmHg. The physician prescribes Losartan. This agent exerts its action by blocking which of the following?  (1) Angiotensin converting enzyme  (2) Sodium channels  (3) Potassium channels  (4) Calcium channels  (5) Angiotensin receptors
If choice 5 is selected set score to 1.

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206.

The antihypertensive drug which acts by depleting norepinephrine stores in the adrenergic nerve terminal is  (1) Trimethaphan  (2) Reserpine  (3) Clonidine  (4) Guanethidine  (5) Phenoxybenzamine
If choice 2 is selected set score to 1.

207.

A 25 year old lady in her 5th month of pregnancy is admitted to the ER as she developed painful contraction of uterus since a day. Which of the following drugs is best suited to traet this patient?  (1) Ergometrine  (2) Salbutamol  (3) Propranolol  (4) Prazosin  (5) Isoprenaline
If choice 2 is selected set score to 1.

208.

A 30 year old man suffering from schizophrenia, after treatment with neuroleptic agents develops Parkinsons like disease. Which of the following drug is used to treat Parkinsons symptoms in this patient?  (1) Levodopa  (2) Chlorpromazine  (3) Levodopa plus carbidopa  (4) Benzatropine  (5) Bromocriptine
If choice 4 is selected set score to 1.

209.

A 24 year old farm worker is rushed to the emergency department after an accidental exposure to parathion, he is in respiratory distress and is bradycardic. Which of the following drugs is given to reactivate the cholinesterase enzyme?  (1) Atropine  (2) Reserpine  (3) Physostigmine  (4) Pralidoxime  (5) Neostigmine
If choice 4 is selected set score to 1.

210.

A 34 year old woman comes to the hospital complaining of tunneled vision. On examination there is constriction of the pupils. Which of the pharmacological agents is most likely responsible for her symptoms?  (1) Pilocarpine  (2) Neostigmine  (3) Phenylephrine  (4) Timolol  (5) Tropicamide
If choice 1 is selected set score to 1.

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211.

A 4 yr old child presents to the emergency room after consuming some berries from a bush in his back yard. The patients mother indicates that the child had been complaining of dry throat, an abnormally high thirst for water and blurred vision. On examination the patient has fever, marked mydriasis and reddish skin color. Your initial diagnosis is that the active ingredient causing these symptoms is similar to  (1) Malathion  (2) Physostigmine  (3) Pilocarpine  (4) Nicotine  (5) Atropine
If choice 5 is selected set score to 1.

212.

Which of the following drugs is used to treat the maniac component of the bipolar disease  (1) Fluoxetine  (2) Diazepam  (3) Dantrolene  (4) Chlorpromazine  (5) Lithium
If choice 5 is selected set score to 1.

213.

The reversible cholinesterase inhibitor used for differentiating myasthenic and cholinergic crisis is  (1) Tacrine  (2) Edrophonium  (3) Neostigmine  (4) Pyridostigmine  (5) Ambenonium
If choice 2 is selected set score to 1.

214.

An example of an irreversible alpha receptor blocker is:  (1) Atenolol  (2) Prazosin  (3) Propranolol  (4) Albuterol  (5) Phenoxybenzamine
If choice 5 is selected set score to 1.

215.

A 76-year-old male complains of progressive difficulty starting his stream on urinating and having to get up at least once each night to urinate. Rectal examination reveals a generally enlarged, smooth surfaced prostate. Which of the following drugs is suitable for use in this patient?  (1) Phenoxybenzamine  (2) Propranolol  (3) Pindolol  (4) Prazosin  (5) Pilocarpine
If choice 4 is selected set score to 1.

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216.

A 23 year old unemployed young man has been an opioid addict for the past three years. Which of the following is not associated with the development of a high degree of tolerance following opiate administration?  (1) Euphoria  (2) Analgesia  (3) Nausea and vomiting  (4) Respiratory depression  (5) Constipation
If choice 5 is selected set score to 1.

217.

Which one of the following is a 5-lipoxegenase inhibitor used in the treatment of bronchial asthma?  (1) Beclomethasone  (2) Monteleukast  (3) Ketotifen  (4) Zileuton  (5) Aspirin
If choice 4 is selected set score to 1.

218.

A 55-year-old female given a general anesthetic for a surgical procedure develops hyperthermia, hypertension, hyperkalemia, tachycardia, muscle rigidity, and metabolic acidosis. Which of the following general anesthetics did she receive?  (1) Ketamine  (2) Midazolam  (3) Thiopental  (4) Propofol  (5) Halothane
If choice 5 is selected set score to 1.

219.

A 25-year-old male with difficulty in sleeping and poor appetite associatedwith weight loss is placed on amitriptyline. How is amitriptyline classified?  (1) As an MAO Inhibitor  (2) As a tricyclic nonselective amine reuptake inhibitor  (3) As a heterocyclic nonselective amine reuptake inhibitor  (4) As a selective serotonin reuptake inhibitor  (5) As an ?2-adrenergic receptor inhibitor
If choice 2 is selected set score to 1.

220.

A 18 year old male is having difficulty sleeping because of the death of his grandfather. He is given Alprazolam which  (1) binds to 5 HT1 receptors  (2) binds to GABA -A receptors  (3) is an antagonist at 5HT1D receptors  (4) is an agonist at Dopamine 2 receptors  (5) is an antagonist at nicotinic receptors
If choice 2 is selected set score to 1.

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221.

A 45 year old lady visits the hospital complaining of recurrent attacks of severe migraine headache 2-3 times a week associated with nausea and vomiting. Which of the following drugs is helpful in preventing the recurrences of migrane attacks?  (1) Ibuprofen  (2) Ergotamine  (3) Metoclopromide  (4) Sumatriptan  (5) Propranolol
If choice 5 is selected set score to 1.

222.

Ethosuccimide is considered to be a primary drug for treatment of absence seizures. Its proposed mechanism of action is  (1) Blockade of glutamate mediated sodium channels  (2) Facilitation of chloride channel opening  (3) Increased GABA reuptake at synaptic junction  (4) Inhibits the GABA metabolism  (5) Blockade of thalamic calcium channels
If choice 5 is selected set score to 1.

223.

Haloperidol was prescribed to a schizophrenic patient. Hypotension, a frequent side effect of this neuroleptic agent is caused by  (1) Blockade of muscarinic receptors  (2) Blockade of alpha adrenergic receptors  (3) Blockade of dopamine receptors  (4) Stimulation of muscarinic receptors  (5) Stimulation of nicotinic receptors
If choice 2 is selected set score to 1.

224.

A 34 year old male patient scheduled for hernia surgery is anaesthesised with halothane and nitrous oxide. The minimum alveolar concentrations of (MAC) of these anaesthetics are 0.75 and 100 respectively, which are measures of which of the following characteristic of an anaesthetic  (1) Solubility in blood  (2) Efficacy  (3) Potency  (4) Entry into CNS  (5) Arteriovenous concentration gradient
If choice 3 is selected set score to 1.

225.

A 3 year old boy develops severe toxicity symptoms after an accidental poisoning with paracetamol. Which is the best treatment for this poisoning?  (1) Charcoal  (2) Sodium Bicarbonate  (3) N-Acetyl Cysteine  (4) Atropine  (5) Naloxone
If choice 3 is selected set score to 1.

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226.

A 37 year old male with history of headache attends the physician. On examination his intraocularpressure was very high. Which of the following drug is most likely to be useful in his case?  (1) Propranolol  (2) Spironolactone  (3) Acetazolamide  (4) Sumatriptan  (5) Atropine
If choice 3 is selected set score to 1.

227.

A 23 year old man suffering from a maniac depressive illness is on treatment with lithium since 2 years. Consequently he develops polyuria and polydipsia. Which of the following drugs is most appropriate to be used in his condition?  (1) Amiloride  (2) Desmopressin  (3) Frusemide  (4) Insulin  (5) Mannitol
If choice 1 is selected set score to 1.

228.

A 57 year old chronic asthmatic presents with white patches on the inside of his cheeks that can be easily wiped off leaving a red bleeding sore surface. Which of the following inhalational antiasthmatic medications is responsible for the above patient condition?  (1) Salbutamol  (2) Ipratropim bromide  (3) Beclomethasone  (4) Sodium chromoglycate  (5) Monteleukast
If choice 3 is selected set score to 1.

229.

A 48 year old man presented with signs and symptoms of rheumatoid arthritis. A decision was made to initiate treatment with methotrexate. Which of the following best describes the mechanism of action of this drug?  (1) Reversible inhibition of cycloxygenase II  (2) Cytotoxic action there by suppressing the lymphocytes  (3) Inhibition of xanthine oxidase enzyme  (4) Antagonism of tumor necrosis factor  (5) Inhibition of dihydroorotate dehydrogenase
If choice 2 is selected set score to 1.

230.

Patency of the ductus arteriosus can be prolonged after birth by administration of  (1) Glucocorticoids  (2) Celecoxib  (3) Latanoprost  (4) Prostaglandin  (5) Aspirin
If choice 4 is selected set score to 1.

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231.

A 48 year old man presented to the hospital with increasing pain, redness and warmth in his great toe, fluid from the joint was aspirated and on examination revealed uric acid crystals. Of the following drugs which can be used in this patient acts by enhancing the excretion of uric acid.  (1) Probenecid  (2) Indomethacin  (3) Allopurinol  (4) Cochicine  (5) Penicillamine
If choice 1 is selected set score to 1.

232.

A 16-year-old female is brought to the emergency department because of increasing drowsiness and inattentiveness. Her family tells you that she takes medication for epilepsy and may have taken an extra dose that day. On examination, she has an ataxic gait, Phenytoin  (1) Carbamazepine  (2) Ethosuximide  (3) Valproic acid  (4) Trimethadione A 22- year old pregnant lady develops severe vaginal bleeding soon after the delivery of the fetus. Which of the following is the preferred drug to treat this patient?  (1) Dinoprostone  (2) Bromocriptine  (3) Misoprostol  (4) Mifepristone  (5) Ergonovine
If choice 5 is selected set score to 1.

233.

234.

An example of a long-acting Beta 2 adrenergic receptor agonist is:  (1) Salbutamol  (2) Salmeterol  (3) Ipratropium bromide  (4) Isoprenaline  (5) Adrenaline
If choice 2 is selected set score to 1.

235.

A 26-year-old woman is undergoing surgery and is anesthetized with an inhalant anesthetic. She is also given an IV dose of succinylcholine. Within minutes, she develops a heart rate of 124 and increasing core body temperature. What is the mechanism of action of the drug of choice for this patient's condition?  (1) It interferes with the release of Ca2+ from the sarcoplasmic reticulum  (2) It is a competitive antagonist of ACh at the motor end plate  (3) It is a GABA receptor agonist that enhances inhibition of nerve impulses  (4) It uncouples oxidative phosphorylation, thereby preventing heat formation  (5) Inhibition central spinal and supraspinal reflexes
If choice 1 is selected set score to 1.

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236.

A 35 year old woman in a family planning program camp underwent a laparoscopic tubectomy after an injection with bupivacaine. Which of the following best describes the mechanism of action of bupivacaine?  (1) Stimulates sodium channels in their inactive state  (2) Blocks chloride channels on outer side  (3) Stimulates the glutamate receptors  (4) Blocks voltage dependent sodium channels  (5) Blocks T-type Calcium channels
If choice 4 is selected set score to 1.

237.

Which of the following depolarizing neuromuscular blockers  (1) Mivacurium  (2) Succinyl choline  (3) Gabpentine  (4) Diazepam  (5) Tizanidine
If choice 2 is selected set score to 1.

238.

A 53 year old man has glaucoma and requires treatment to lower the intraocular pressure. Which of the following eicosanoids is most likely to be used?  (1) Alprostadil  (2) Dinoprostone  (3) Latanoprost  (4) Misoprostol  (5) Prostacyclin
If choice 3 is selected set score to 1.

239.

The enzyme responsible for metabolism of allopurinol is  (1) Monoaminooxidase  (2) Catechol-o- methyl transferase  (3) Xanthine oxidase  (4) Cytochrome oxidase  (5) Cholinesterase
If choice 3 is selected set score to 1.

If assessment score is 0% to 100% Completed

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