7- there is structure Flashcards by Lovely jane Luchavez

Mortality of children was 8 in 2012 and 6.4 in 2017, This mean?
A- More hospital open
B- Improve health
C- Nothing, more information need

C- Nothing, more information need

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What database do insurance companies use?

A- C.L.U.E.” database
Comprehensive Loss Underwriting Exchange

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39- Sources of data in insurance companies?
A- CLAIMS
b- Health data
C- Information collection

A- CLAIMS

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49- Which of the following error detection strategies result in limiting detection?
A- bar-coding
B- trigger tools
C- voluntary reporting
D- mandatory reporting

D- mandatory reporting

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55- Mid goal to long term future goal?
A- Mission
B- Vision
C- Plan

B- Vision

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77- Preventive and curative institution?
A. primary
B. secondary
C. tertiary
D. specialty

A. primary

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177- Mission and vision can be present in which strategy?
A. Planning
B. Organization
C. Strategic

C. Strategic

strategic planning is to align a company’s mission with its vision

Strategies are a series of ways of using the mission to achieve the vision

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183- Long term plan use all aspects in organization
A- strategy
B- operation
C- organization

A- strategy

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184- Pharmacist wrote email to another pharmacist to ask add medication to theformulary in the hospital
this is consider as ?
A. Interinstitutional
B. Intra institutional
C. Written communication
D. Non Verbal communication

C. Written communication

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206-Head of pharmacy decide to make group to arrange formulary drugs in hospital?
A. organizing
B. planning
C. Leading

B. planning

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252- who’s responsible for accreditation of health care system?
A- SFDA
B- WHO
C- MOH
D- CBAHI

D- CBAHI

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360- You received a prescription on a plain paper what to do ?
A. Tell the manager
B. Talk to the prescriber and don’t dispense

A. Tell the manager

Don’t dispense the medicine and refer the patient to prescriber

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409- pharmacist manager screamed on one of the pharmacist who dispensed wrongmedication in front of
all the staff what is the good response ?
A. he should punish him in separate area
B. ask for a meeting with the staff
C. cut from his salary
D. Try to find the cause of the error and set solutions

D. Try to find the cause of the error and set solutions

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14) Which ofthe following isthe function ofthe pharmacy and therapeutic committee in ahospital?
A. Responsible for poison management
B. Monitor the adverse reaction reporting
C. Monitor the medication error reporting
D. Responsible for drug formulary management

D. Responsible for drug formulary management

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70- Which of the following distribution systems works better for medicine requiring a higherlevel of control?
A. Bulk ward stock
B. Direct procurement
C. Automated dispensing
D. Individual medication order

C. Automated dispensing Or unit dose system (UDS)

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77- Which of the following committees is dedicated to developing and maintaining a list ofapproved
medicine for the hospital medicines for the hospital use ?
A. Medical records
B. Medication audit
C. Quality assurance
D. Pharmacy and therapeutics

D. Pharmacy and therapeutics

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66- Which of the following is the definition of management?
A) The art of maximizing profitability
B) The art of maximizing productivity
C)The art of maximizing possibilities
D)The art of maximizing predictability

B) The art of maximizing productivity

The primary goal of management is to create an environment
that lets employees work efficiently and productively

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72- A 65-year-old man presents to the pharmacy for a refill his medications. On review of his refill history,
the pharmacist noticed that he does not refill his medications regularly. Upon askinghim, the patient started that
he has multiple medications that require complex administration.
Which of the following non adherence factors affecting above patient?
A. Patient related factors
B. Provider related factors
C. Health care system factors
D. Medication and condition factor

D. Medication and condition factor

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24- which of the following need to be considered first by a pharmacist in order to rationalize drug therapy
decisions?
A. Care plan
B. Follow-up evaluations
C. Pharmacotherapy workup

C. Pharmacotherapy workup

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75- Itisthe broad range of health care services provided by in order to optimize therapeuticoutcomes for
individual patients
Which of the following is the term used to describe the above- mentioned definition?
A. Pharmaceutical care
B. Medication counseling
C. Medication reconciliation
D. Medication therapy management

D. Medication therapy management

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91- Free medical sample drugs (formulary or non-formulary) are provided by pharmaceuticalsales
representatives to physicians or members of the health care team.
Which of the following is the most appropriate recommended policy for dealing with sampledrugs?
A. Dispense them directly to the patient
B. Keep them with the rest of original items
C. Keep in outpatient clinics or nursing units
D. Exclude them from in-patient pharmacy, drug store or doctors’ offices

D. Exclude them from in-patient pharmacy, drug store or doctors’ offices

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The hierarchy is showing Hospital X organizational chart. A pharmacist assigned as a clinicalpharmacist in
neuroscience ward (see image)
Which of the following managerial position will the coworker re submitting a complaint?
A) Pharmacy Director
B) Medical affair Director
C) Neuroscience ward director
D) Clinical pharmacy department Head

D) Clinical pharmacy department Head

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157- Most on prescription?
A- Patient name - mrn- date
B- Phystion name - number - signature
C- Patient name - age - sex - diagnosis
D- all above

C- Patient name - age - sex - diagnosis

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36-which of the following medication has a side effect metallic taste ?
A) cefuroxime
B) azithromycin
C) ciprofloxacin
D) metronidazole

D) metronidazole

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118- What is the type of anemia Lack of intrinsic factor?A- Megaloblastic anemia B- Pernicious anemia C- Hemolytic anemia D- Aplastic anemia

B- Pernicious anemia-> Vitamin B12 deficiency

42- which ofthe following anesthetics drug has a higher risk of causing hepatic toxicity? A) propofol B) ketamine C) isoflurane D) nitrous oxide

C) isoflurane ________________________________________________________ A) propofol- risk of hypotension B) ketamine- risk of hypertension C) isoflurane- risk of hepatotoxicity D) nitrous oxide- risk of cardiotoxicity and anemia

16- Which of the following is the advantage of using intravenous anesthetic drug? A. Produce fast onset of anesthesia B. Helps in maintaining anesthesia C. Increases the minimum alveolar concentration (MAC) of the anesthetic drugs D. Produce less cardiovascular and respiratory suppression

A. Produce fast onset of anesthesia

84- Which of the following is the mode of action of Phentolamine? A. beta-adrenergic blocker B. beta-adrenergic agonist C. alpha-adrenergic agonist D. alpha-adrenergic blocker (non selective alpha blocker)

D. alpha-adrenergic blocker (non selective alpha blocker)

22- Which of the following is a consequence ofstimulation of ꭤ1-Adrenoceptors? A. A flushing Adrenergic Receptors B. increased heart rate C. elevated blood pressure

C. elevated blood pressure

24- which drug is used to treat an anaphylactic reaction? A. Atropine B. Adrenaline C. Isoprinosine D. Phentolamine

B. Adrenaline

30- Which of the following is a property of amphetamine? A. It does not cross the blood brain barrier B. It stimulates the release of stored acetylcholine C. It stimulates the release of stored norepinephrine D. It stimulates the release of five hydroxytryptophan (5-HT)

C. It stimulates the release of stored norepinephrine

50-A 25-year-old driver was held for reckless driving and confronting a policeman. He istooconfident, talkatiye.restless and continuously walking around the hall. Which of the following is the drug that the driver is abusing? A. Diazepam B. Theophylline C. Amphetamine D. Lysergic acid diethylamide (LSD)

C. Amphetamine - CNS stimulants and increase ego

72- What isthe pharmacological classification of Ipratropium bromide? A. Beta agonist B. Alpha agonist C. Cholinergic agonist D. Antimuscarinic agent

D. Antimuscarinic agent

14- Which of the following is a consequence ofstimulation of ꭤ1 - adrenoceptors? A. flushing B. increased heart rate C. constricted bronchioles D. elevated blood pressure

D. elevated blood pressure

77- Which of the following describesthe mechanism of action of rivastigmine? A. cholinesterase inhibitor B. alpha-a receptor inhibitor C. serotonin reuptake inhibitor D. angiotensin converting enzyme inhibitor

A. cholinesterase inhibitor

106- Drug to reverse action of Atropine? A. Physostigmine B. Benztropine C. Disulfiram D. Propranolol

A. Physostigmine

301-Catechol amine with COMT ? A- rapid metabolism B- slow metabolism

A- rapid metabolism

55- A 21-year-old patient went through respiratory depression after receiving anesthetic agent. Which of the following agents will counteract post-anesthetic respiratory depression? A. morphine B. picrotoxin C. diazepam D. thiopental

B. picrotoxin

76- Which of the following drugs would decrease the amount of minimum alveolarconcentration (MAC) for an anesthetic drug? A. diazepam B. buspirone C. ephedrine D. loratadine

A. diazepam

83- Which of the following anesthetics drugs has a higher risk of causing anemia? A. propofol B. ketamine C. isoflurane D. nitrous oxide

D. nitrous oxide Nitrous oxide inactivates methionine synthase via oxidation of the cobalt in vitamin B12 and may lead to megaloblastic anemia.

71- Which depolarizing neuromuscular blocker isless potent than tubocurarine? A. succinylcholine (Anectine) B. rocuronium (Zemuron) C. pipecuronium (Arduan) D. doxacurium (Nuromax)

A. succinylcholine (Anectine)

100- Which of the following is heparin antidote? A. Protamine Sulphate B. Octreotide C. N-Acetylcysteine D. Naloxone Hydrochloride

A. Protamine Sulphate

32- What isthe antidote for heparin toxicity? A. Protamine sulfate B. Sodium salicylate C. Naloxone D. Glucagon

A. Protamine sulfate

9- Which of the following situation is most likely to be controlled by administering parenteral calcium as an antidote? A. Hypokalemia B. Verapamil overdose C. Heroine intoxication D. Cocaine intoxication

B. Verapamil overdose

11-A 55-year-old man presents with an excessive bronchial and oconasal secretions. History revealed, is exposed to an organophosphate insecticide. Which of the following is the best management? A. Atropine IV B. Diphenhydramine orally C. Pralidoxime intramuscularly D. Physostigmine intramuscularly

A. Atropine IV

40- In case a patient develops toxicity from midazolam. Which of the following medications can be given as an antidote? A. Atropine B. Flumazenil C. Amifostine D. Acetylcysteine

B. Flumazenil

(3) Which ofthe following isthe precursor for 5_hydroxytryptamine? A) proline B) alanine C) glutamine D) tryptophan

D) tryptophan

30- Which of the following enzymes regulate supercoiling of DNA? A) Helicases B) Primases C) Topoisomerases D) Reverse transcriptase

C) Topoisomerases

83- Where dose the electron transport chain reaction pathway take? A) Cell cytoplasm B) Golgi apparatus C) Outer mitochondrial membrane D) Inner mitochondrial membrane

D) Inner mitochondrial membrane

99. Which of the following vitamin deficiency can cause scurvy? A. vitamin A B. vitamin B6 C. vitamin C D. Vitamin D

C. vitamin C

The diagram shows the role of a vitamin as coenzyme for cystathionine synthase and cystathionase enzymes which catalyze the transsulfuration of methionine to cysteine (see image). Which of the following is the vitamin indicated by the star* in the figure? A. B2 B. B3 C. B5 D. B6

d. B6 page 8 number 51

2- pH difference between extracellular and intracellular fluid is A. Nil B. 0.2 C. 0.4 D. 0.8

C. 0.4

3- Role of ATP ? A. Energy carrier B. Oxygen carrier C. Amino acid carrier

A. Energy carrier

5- which is cytokine A. Leukotriene B. Adrenaline C. Gonadotropin

A. Leukotriene- inflammatory mediator

7- Which process does Insulin work on or increase ? A. Glycogenolysis B. Glyconeogenesis C. Glucogensis D. Ketogenesis E-Glycogenesis

E-Glycogenesis

13-The synthesis of glycogen from glucose called?

A- Glycogenesis

42- How much molecule ATP molecules are produced for every glucose. A- 12 B- 24 C- 38

C- 38

61- Which Amino acid we give for anorexia? A. Alanine B. arginine C. Valine

C. Valine

62- starch is digested in saliva by ? A. Amylase B. lipase

A. Amylase

64- POLYSACCHARIDE? A- B- Glucose b- glycogen c- glucagon

b- glycogen

73- Which of the following is the precursor for 5- hydrotryptamine (serotonin)? A. Proline B. Alanine C. Glutamine D. Tryptophan

D. Tryptophan

79- How much ATP molecules are produced for every glucose molecule? A. 12 B. 24 C. 38

C. 38

101- Which process does Insulin work on increase? A- Glycogenolysis B- Glyconeogenesis C- Glucogensis C- Ketogenesis D- Glycogenesis

D- Glycogenesis

131- Krebs cycle for production of ?

ATP look at page 9 number 64

134- DNA ligase enzyme for ligation of ? A. mRNA with TRNA B. 2mRNA molecules C. 2tRNA molecules D. 2DNA strands

D. 2DNA strands look at page 9 number 65

138- use Glucosamine for uses ?? A- Osteoporosis B- Osteomyelitis C- Osteoarthritis

C- Osteoarthritis

155- Where dose the electron transport chain reaction A. pathway take B. Cell cytoplasm C. Golgi apparatus D. Outer mitochondrial membrane E. Inner mitochondrial membrane

E. Inner mitochondrial membrane

163- How many amino acid in the human body ? A. 20 B. 30 C. 40

A. 20

181- Which parameter used when we give statin and there is rhabdomyolysis ? A- Creatine kinase B- Crcl

A- Creatine kinase

210- Purpose of mitochondria ?A- Synthesis of DNA B- Synthesis of RNA C- Produce ATP

C- Produce ATP

270- Which is complex protein ? A. Pr B. Sec C. Tri D. Quaternary in structure

D. Quaternary in structure

356- acetyl-CoA to form malonyl- coA which vitamine is used ? A. biotin (B7) B. riboflavin C. pyridoxine D. nicotinamide

A. biotin (B7)

357- coenzyme for cystathionine synthase and cystathionase enzymes which catalyze the transfiguration of methionine to cysteine ? A- B2 B- B3 C- B5 D- B6

D- B6

358- Acetyl coA and citric acid cycle which vitamin is used ? A. B6 B. B12 C. B2 D. B9

C. B2

365-Which the carrier in Krebs Cycle? A. Carrier in cycle B. oxaloacetate C. Citric acid

B. oxaloacetate

403- Number of ATP in glycolysis ? A- 1 B- 22 C- 24 D- 2

D- 2

12) What the function ofsmall nuclear (snRNAs) in protein synthesis? A. Act as catalyst B. Modifies mRNA molecules C. Genetic blueprint for the protein D. Translates genetic code to amino acid

B. Modifies mRNA molecules

25) Which ofthe following pairsrepresentsthe purines nitrogenous bases? A. Adenine (A) and Uracil (U) B. Cytosine (C) and Uracil (U) C. C)Adenine (A) and guanine (G) D. D)Cytosine (C) and guanine (G)

C. C)Adenine (A) and guanine (G)

30) Which ofthe following isthe process of breaking down of glycogen ? A. Glycolysis B. Glycogenesis C. Glycogenolysis D. Gluconeogenesis

C. Glycogenolysis

40) Which ofthe following inhibits gluconeogenesis? A. Insulin B. Glucagon C. Epinephrine D. Glucocorticoid

A. Insulin

73- Which of the following is a non-essential amino acid? A) Lysine B) Valine C) Cysteine D) Isoleucine

C) Cysteine N.B:-The 9 essential amino acids are: histidine, isoleucine, leucine, lysine, methionine,phenylalanine, threonine, tryptophan, and valine.

154- which of the following inhibits gluconeogenesis A- insulin B- glucagon C- epinephrine D- glucocorticoids

A- insulin

197- which the Carbohydrates produce more energy A. glucose B. maltose C. sucrose

ــــــــــــ ــــــــــــ ـ All Produce Same amount of Energy per gram

48) Which of the following compounds is urea cycle a biochemical reaction that produce ureafrom? A. Sucrose B. Glucose C. Glycogen D. Ammonia (NH3)

D. Ammonia (NH3)

86-Click image to enlarge A water-soluble vitamin catalyzes the carboxylation of acetyl-COA to form malonyl-CoA, whichis required for the synthesis of fatty acids (see image) Which of the following vitamins plays this role? A. biotin (b7) B. riboflavin C. pyridoxine D. nicotinamide

A. biotin (b7)

46- Which of the following is a potential serious side effect that is common among all anticoagulant agents? A. Hypokalemia. B. Major Bleeding C. Liver Dysfunction D. Renal Dysfunction

B. Major Bleeding

28) Which ofthe following is a function of alcohol dehydrogenase enzyme? A. Accelerates the reduction of ethanol B. Accelerate the addition of hydrogen to ethanol C. Accelerates the addition of phosphate to ethanol D. Accelerates the removal of hydrogen from ethanol

D. Accelerates the removal of hydrogen from ethanol

86- Which of the following enzymes is responsible for forming DNA copy from RNA? A. Reverse transcriptase B. DNA polymerase C. Helicase D. Primase

A. Reverse transcriptase

6) Which of the following is an example of a parenteral direct thrombin inhibitor? A) enoxaparin B) argatroban C) fondaparinux D) unfractionated heparin

B) argatroban

11- which of the following anti platelets is contraindicated patients with transient ischemicattack (TIA) or stroke? A. Prasugrel B. Ticagrelor C. Clopidogrel

A. Prasugrel

26- which of the following antiplatelet agents the highest risk of causing dyspnea ? A. Prasugrel B. Ticagrelor C. Clopidogrel D. Dipyridamole

B. Ticagrelor

(34) Which of the following isthe recommended anti-coagulation strategy for atrial fibrillation patient with a CHA2DS2-VACS score of 5? A. aspirin B. dabigatran C. clopidogrel D. no anticoagulation

B. dabigatran

Which of the following could lead to decrease in international normalization ratio (INR) in a patient of warfarin therapy? A. decrease the consumption of dietary vitamin K B. carbamazepine therapy C. cotrimoxazole therapy D. metronidazole therapy

B. carbamazepine therapy

64- Which of the following is the preferred anticoagulant therapy during hemodialysis procedure? A. Enoxaparin B. Dabigatran C. Rivaroxaban D. Unfractionated heparin (UFH)

D. Unfractionated heparin (UFH)

71- A 51-year-old man diagnosed with pulmonary embolism. The patient planned for warfarinand started combination with warfarin until INR is therapeutic (see lab result). weight :80kg height :160cm test : creatinine result:85 normal value:44-115 umol/L creatinin clearance reasult:103 normal value:70-103 umol/L Which of the following enoxaparin dose regimen should the patient receive? A. Enoxaparin 30 mg SC every 24h B. Enoxaparin 40 mg SC every 24h C. Enoxaparin 80 mg SC every 12h D. Enoxaparin 160 mg SC every 12h

C. Enoxaparin 80 mg SC every 12h

2- Which of the following medications is an anticoagulant agent? A. Aspirin B. Warfarin C. Clopidogrel D. D. Streptokinase

B. Warfarin

Which of the following isthe mechanism of action of apixaban? A. an indirect inhibitor of thrombin B. an indirect inhibitor of factor Xa C. a direct inhibitor of thrombin D. a direct inhibitor of factor Xa

D. a direct inhibitor of factor Xa

73- Which of the following best represents the activity of dipyridamole? A. It has fibrinolytic activity B. It has antifibrinolytic activity C. It is a platelet aggregation inhibitor D. It is a phosphodiesterase enzyme inducer

C. It is a platelet aggregation inhibitor

45- Which of the following can decrease the effect of warfarin? A. Antibiotics B. Paracetamol C. Multivitamins (contain vit k) D. Calcium supplement

C. Multivitamins (contain vit k)

25- What is the route of administration of Enoxaparin? A. Intrathecal bolus B. Transdermal injection C. Subcutaneous injection D. Intramuscular injection

C. Subcutaneous injection

97- Which of the following drugs can be used to lyse fibrin clots? A. heparin B. warfarin C. enoxaparin D. streptokinase

D. streptokinase

18- Which of the following can decrease the effect of warfarin? A. antibiotics B. paracetamol C. multivitamins D. calcium supplement

C. multivitamins

41- Which of the following medications produces antiplatelet effect by inhibiting Adenosine Diphosphate (ADP) receptors? A. aspirin B. abciximab C. clopidogrel D. streptokinase

C. clopidogrel

63- Which of the following isrecommended regarding air bubble in the syringe for a patientstarting on enoxaparin subcutaneous Injection? A. inject the dose with the air bubble B. Inject the air bubble if the volume is small C. remove the air bubble to avoid wastage of the dose D. remove air bubble and adjust volume before injection

A. inject the dose with the air bubble

74- Which of the following is a potentialseriousside effect that is common among all anticoagulant agents? A. hypokalemia B. major bleeding C. liver dysfunction D. renal dysfunction

B. major bleeding

75- Which of the following statements describes unfractionated heparin? A. enolic acid derivative B. propionic acid derivative C. acetyl ester of salicylic acid D. mucopolysaccharide polymers

D. mucopolysaccharide polymers

71- Which of the following isrecommended regarding air bubble in the syringe for a patient starting on enoxaparin subcutaneous injection? A. Inject the dose with the air bubble B. inject the air bubble if the volume is small C. remove air bubble to avoid wastage of the dose D. remove air bubble and adjust volume before injection

A. Inject the dose with the air bubble

22- Risk factor cause DVT? A. Age B. food rich of VK C. surgery

C. surgery

59- The recommended DVT prophylaxis dose for postpartum in women with heigh risk ofDVT is? A. 3 weeks B. 6 weeks C. 3 months D. 6 months

B. 6 weeks most accurate 6 weeks to 12 weeks depend on risk factor

92- Which of the following is parenteral direct thrombin inhibitor? A. Argatroban B. Dabigatran C. Heparin D. Warfarin

A. Argatroban

96- Which of the following antiplatelet working by inhibition of adenosine diphosphate receptor? A. Aspirin B. Abciximab C. Clopidogrel D. Streptokinase

C. Clopidogrel

136- how ibuprofen inhibit antiplatelet effect of aspirin ?

A- Ibuprofen bind to cox1 and hinder it's acetylation by aspirin

113- Which direct anticoagulant needs premedication 5-10 dayswith anticoagulant ?

Note: endoxaban > Apixaban >Dabigatran

146- Neonate with coagulopathy which vit K route will you use ? A. Suppository B. Iv C. Sc D. Im Child is IM Coagulopathy.. IV

B. Iv

141- Ptient on Warfarin and has mechanical valve and INR 3.5, what should you do ? A- No management B- decrease warfarin dose

A- No management

239- antiplatelet C.I. in patients with transient ischemic attack ?A- dipyradimole B- clopidogrel C- prasugrel D- ticagrelor

C- prasugrel

253- INR monitoring after initiation as outpatient ?A- next day B- 2-5 days C- 1 month D- 3 months

B- 2-5 days

318- treatments of pulmonary embolism? A- Enoxaparin 40 mg sc once daily B- Rivaroxaban C- Enoxaparin 1 mg/ kg twice dailyOr 2 mg/ kg once daily

C- Enoxaparin 1 mg/ kg twice dailyOr 2 mg/ kg once daily

334- patient is taking warfarin 4.5 mg PO daily came to the clinic with INR of 5.1 withoutany signs of active bleeding, what is the appropriate management for her ? A. Hold warfarin and give vit K IV B. Hold warfarin and resume with lower dose C. Hold warfarin and give platelet

B. Hold warfarin and resume with lower dose

345- in pregnancy what the trimester can be use warfarin ? A. first B. second C. third trimester D. avoided use in pregnancy

D. avoided use in pregnancy

397- Pt use Warfarin 10mg and INR low why ? A. Low dose B. Diet C. Low bioavailability of warfarin

B. Diet

425- which the fallowing uses in prophylaxis strock A. anticoagulant B. thrombolytic drug C. antiplatelet

C. antiplatelet

427- Which the fallowing drugs inducing thrombocytopenia A- UFH heparin B- LMWH C- warfarin D- Aspirin

A- UFH heparin

428- Which the fallowing drugs treatment thrombocytopenia A- UFH B- LMWH C- warfarin D- Argatroban

D- Argatroban

120- Medication for osteoporosis in women given weekly ? A- Zoledronic acid B- ibandronate C- raloxifene D- Alendronate

D- Alendronate 70mg PO once weekly

110- Medication for osteoporosis in menopausal women given monthly? A. Zoledronic acid B. ibandronate C. raloxifene

B. ibandronate

119- Medication for osteoporosis in women given once per a year ? A- Zoledronic acid B- ibandronateC- raloxifene

A- Zoledronic acid 5mg IV once yearly

202- gold standard test for Osteoporosis ?

A- (DEXA) dual-energy x-ray absorptiometry

285- Patient with Osteoporosis which need for Diagnosis? A- X-ray B- MRI C- CT

A- X-ray

(39) Which of the following osteoporosis drugs can cause esophageal ulcers? A. denosumab B. teriparatide C. alendronate D. zelodronic acid

C. alendronate

73- Which of the following medications for osteoporosis will significantly reduce the risk of hip fracture? A. Phosphate B. Risedronate C. Raloxifene D. Calcitonin

B. Risedronate

14-A 65-year patient suffered from Osteomalacia with finger numbness, tingling and burning of extremities. The doctor prescribed vitamin D and an IV calcium supplement. Which of the followingcalcium salts did the physician most likely prescribed ? A. Calcium citrate (21%calcium) B. Calcium lactate(13%calcium) C. Calcium gluconate (9%calcium) D. Calcium phosphate (39% calcium)

C. Calcium gluconate (9%calcium) calcium gluconate is a calcium salt used to directly replete serum calcium levels N.B:-Ca phosphate no more effective — and may in fact be less effective — than calcium citrateor calcium carbonate.

56- A 25-year-old man with leukemia admitted to hematology oncology center. Who is allowedto read the patient file without additional permission? A) Patient's cousin who is working as out-patient nurse in the hospital B) Medical resident in pediatric who wants to explore the risk leukemia C) Clinical nutritionist who is assigned to calculate the requires for the patient D) Pharmacy resident who is planning to do a research cell transplant

C) Clinical nutritionist who is assigned to calculate the requires for the patient

57 -Which of the following anti-neoplastic medications is known to cause bone marrowsuppression? A. bleomycin B. vincristine C. doxorubicin D. l-asparaginase

C. doxorubicin

(11) 42-year-old woman, a mother of 2 boys is diagnosed with cancer, treatment options includes either hysterectomy or chemotherapy The patient refused the surgery because she still wantsto daughter, and do not want to receive any chemotherapy in protect her hair and beauty.What will be the most appropriate suggestion for her? A-To starts chemotherapy with very low doses and less frequency B- To go with the option of surgery immediately because it is C-To discuss the risk and benefit with the patient and take the decision D-To force the patient to receive chemotherapy and wear syn hair extensions

C-To discuss the risk and benefit with the patient and take the decision

59- Which of the following is an alkylating anticancer agent? A. cyclophosphamide B. fluorouracil C. doxorubicin D. etoposide

A. cyclophosphamide

42-year-old woman, a mother of 2 boys is diagnosed with cancer, treatment options includes either hysterectomy or chemotherapy The patient refused the surgery because she still wantsto daughter, and do not want to receive any chemotherapy in protect her hair and beauty.What will be the most appropriate suggestion for her? A-To starts chemotherapy with very low doses and less frequency B- To go with the option of surgery immediately because it is C-To discuss the risk and benefit with the patient and take the decision D-To force the patient to receive chemotherapy and wear syn hair extensions

C-To discuss the risk and benefit with the patient and take the decision

Which of the following anti-cancer alkaloids act by stabilizing the microtubule polymer and protecting it from disassembly? A. Paclitaxel B. Colchicine C. Vinblastine D. Camptothesin

A. Paclitaxel

26. Which of the following is a recommendation to reduce the inadvertent intrathecal administration of vincristine? A. dispense the syringe without needle B. dispense vincristine in 60-ml syringe C. dispense vincristine in mini bag instead of syringe D. dispense the vial for the nurse to prepare at the bedside

C. dispense vincristine in mini bag instead of syringe

8- What is the most common adverse reaction of doxorubicin? A. Bone marrow depression B. Hepatic toxicity C. Cardiac toxicity D. Skin necrosis

C. Cardiac toxicity BELOMYCIN _ pulmonary fibrosis MITOMYCIN _nephrotoxicity

35- What is the therapeutic indication fo r nilotinib ? D A. Ulcerative colitis B. Familial hyperlipidemia C. Highly active and relapsing remitting multiple sclerosis D. Philadelphia chromosome positive chronic myelogenous leukemia

D. Philadelphia chromosome positive chronic myelogenous leukemia

29- 40 years old women with breast cancer, topoisomerase is elevated, which drug shouldbe used A- Cyclophosphamide B- Melphalan C- Irinotican D- Methotrexate

C- Irinotican

129- Immune system works an important role in cancer treatment by ? A. Macrophage B. cytotoxic C. complex

B. cytotoxic

173- prevention breast cancer ? A. Vit A 100 B. Vit D 200 C. None of them D. Vit A + vit d

B. Vit D 200

196- Prevention breast cancer ? A. Vit A 100 B. Vit D 200 C. None of them D. Vit A + vit d

B. Vit D 200 N.B : Deficiency of Vitamin D is combined with tumor progression , Metastasis

265- Immune system works an important role in cancer treatment by ? A. Macrophage B. cytotoxic C. complex

B. cytotoxic

267-Cysteine in chemotherapy agent benefit ? A- Increase Target B- Increase effects C- increase solubility D- More information need

B- Increase effects can abrogate the effects of the majority of oxidative or alkylating drugs used in cancer therapy

90- Click image to enlarge Acetaminophen is an antipyretic and an analgesic drug. It binds to a cytosolic protein (see image). Which of the following types of bonds is formed between the protonated amine of theacetaminophen and the cytosolic acid of the aspartate residue of the protein? A. ionic bond B. covalent bond C. hydrogen bond D. VAN_der walls interaction

C. hydrogen bond

63- Which of the following molecules contains double bond? A. CH3 B. CNH C. C2H2 D. C2H4

D. C2H4

80) Click image to enlarge Acetaminophen is an anti pyretic and an analgesic drug. It binds to a cytosolic protein (see image). Which of the following types of bonds is formed between the protonated amine of theacetaminophen and the carboxylic acid of the aspartate residue of the protein? A) lonic bond B) covalent bond C) hydrogen bond D) van-der wallsinteraction

C) hydrogen bond

65) Quinine is an important antimalarial drug with very complicated structure and is very sensitive stereochemistry (see image). Which pharmacological activity the drug will possess stereochemistry at the arrow has changedfrom R to S? A. anticancer B. antimalarial C. anticoagulant D. antiarrhythmic

D. antiarrhythmic

(14) Which ofthe following can be used safely in a patient with sulfa allergy? A) gliclazide B) furosemide C) sulfamethoxazole D) sodium thiosulfate

B) furosemide

13) The structure of norepinephrine-serotonin reuptake inhibitor (NSRI) (see image) Which of the following structure modifications can transform this drug into a selective norepinephrine re- uptake inhibitor (SNRI) analogue? A. quaternization of the side chain amino group B. transformation of the side chain amino group into a primary amine C. replacement of the side chain N.N-dimethylamino group with a hydroxyl group D. demethylation of the side chain tertiary amino group to yield a secondary amino group

D. demethylation of the side chain tertiary amino group to yield a secondary amino group

Thalidomide is a potent immunomodulatory drug used to treat leprosy Thalidomide exist intwo conformation structures with different pharmacological and toxicological activatesteratogenicity is believed to becaused on conformational structure (see image ). Which of the following is the most appropriate term used tocall the two conformations of the thalidomide? A. Isomers B. Epimers C. Enatntimomers D. diasteriomers

C. Enatntimomers see image

28) A structure of the glibenclamide (glyburide)(see image) Which of the following pharmacophore does Glibenclamide (glyburide) contain? A. Benzenesulfate urea B. Benzenesulfinyl urea C. Benzenesulfhydryl urea D. Benzenesulphonyl urea

D. Benzenesulphonyl urea

29- Aspirin is well-known antiplatelet aggregating agent (see image) What is the role of the acetyle group in its antiplatelet activity? A. it represents a good leaving group to form the active salicylic acid B. it provides hydrogen binding with tyrosine moiety on COX binding C. it provides covalent binding with serine moiety found on COX binding site D. it provides hydrophobic binding with a tryptophan moiety on COX binding site

C. it provides covalent binding with serine moiety found on COX binding site

38) Examine the drug in the figure (see image). What is the effect of replacement of the methoxyl group (boxed) with a hydroxyl group? A. Decrease in analgesic activity B. Decrease in addition activity C. Reduction in the antitussive activity D. Lower affinity to morphine receptors

C. Reduction in the antitussive activity N.B:-structure in pic is codeine (anti tussive) convert into morphine(analgesic)

40- The structure of erythromycin (see image) Which of the following is the reason why erythromycin is sensitive to acidic pH? A. The presence of lactone group in the ring B. The presence of two basic sugars at position 3 and 5 C. The presence of 6 months methyl groups at alternate positions of the macrolide ring D. Ketal fomation between hydroxyl group (6 and 12) and ketone at position 9

D. Ketal fomation between hydroxyl group (6 and 12) and ketone at position 9

35- Which of the following polymorphic enzyme isresponsible for the conversion of codeine to morphine? A. CYP2D6 B. CYP2C9 C. CCR5 corecptor D. N-Acetyltransferase

A. CYP2D6

38- Structures of four antidepressant drugs (see image) Which of the following antidepressant structure undergoes a photo- oxidation reaction uponexposure to the light? A. 1 B. 2 C. 3 D. 4

A. 1

39- The chemical structure of four non-steroidal anti-inflammatory agents (NSAIDs) (see image). Which of the following NSAIDs has minimal possible gastric side effects? A. (ibuprofen) B. (celecoxib) selective cox-2 C. (indomethacin) D. (diclofenac)

A. (ibuprofen)

10- Which of the following is the most common cause of drug instability? A. oxidation B. racemization C. epimerization D. decarboxylation

A. oxidation

30- Which of the following molecules contains double bond? A. CH3 B. CNH C. C2H2 D. C2H4

D. C2H4

50- Structure of ciprofloxacin (SEE IMAGE ) Which of the following is the benefit of the piperazine group at position? A. Increases drug resistance to β-lactamase A. improves the oral bioavailability of the drug B. Increases lipophilicity and hence penetration of the bacterial cell wall C. Improves the spectrum of antibacterial activity (especially Gram- negative)

C. Improves the spectrum of antibacterial activity (especially Gram- negative)

51- Which one of the following isthe effect to alkaline buffersthat have in commercial formulations of aspirin? A. they have one effect on the rate of absorption. B. they increase the rate of its absorption by alkalinizing the pH of the stomach C. they reduce the rate of absorption of aspirin by converting it to the less readily absorbed lonic form D. they Increase the rate of absorption by increasing the PH immediately around the disintegrating aspirin particles and accelerating their dissolution

D. they Increase the rate of absorption by increasing the PH immediately around the disintegrating aspirin particles and accelerating their dissolution

73-Examine the chemical structure of diclofenac (see image ب . ي ر ق ت(. Which of the following structures best represents a major active metabolite of diclofenac? A.1 B.2 C.3 D.4

D.4

78- Click image to enlarge The presented structure belongs to the proton pump inhibitor tenatoprazol (see image). Which of the following metabolic reactions can occur at the pointed arrow on the structure? A. sulfation B. oxidation C. demethylation D. glucoronidation

B. oxidation

Click image to enlarge Which of the following medications contains triazole moiety? (see image)

98- Click image to enlarge Histamine (pKa=9.4) is endogenous chemical release when allergic reaction happened. As a pharmacist you are responsible to understand the mechanism and the conformation of this chemical in the blood (see image). Which of the following is the least dominant tautomer of the histamine?at the physiological pH? A. a B. b C. c D. d

C. c

80- Click image to enlarge D-Galactose and D-Mannose are monosaccharide sugar. They have the same number of carbons and the same functional group, but they differ in their configurations. This reflects their pharmacoceutical uses (see image) Which of the following types of stereo-isomerization do these sugars represent? A. isomers B. epimers C. anomers D. diasteromers

B. epimers

8) - Ropivancain e is an important local anesthetic. The figure shows the chemical structures of D ropivacaine and 4 other local anesthetics (see image). Which of the following is the bioisoster for ropivacaine? A. Etidocaine B. Bupivacaine C. Mepivacaine D. Levobupivacaine

D. Levobupivacaine

63- epimor of glucose? A. Ribose B. galactose C. deoxyribose

B. galactose

60- Amphotericin undergo which reaction? A. Hydrolysis B. Alkylation C. Reduction D. Oxidation

A. Hydrolysis

66- two chemical configurations for the same drug, one is R and the other is S what it is called ?

Enantiomer

74- Morphine to heroine? A. Carboxylation B. Esterification

A. Carboxylation

124- Morphine to heroine?? A- Carboxylation B- esterification

B- esterification

135- type of bond between amino acids ? A. amide bond B. disulfide bond C. Ionic bond D. Van der vals bond

A. amide bond

145- Aspirin metabolism ? A- Methylation b- Hydroxylation c- Conjugation

b- Hydroxylation

169- Bond between Carboxyl and amine ? A. hydrogen bond B. b- ionic bond C. Vander wal D. Peptide bond

D. Peptide bond

295-Structures of zidovudine antivirals, marked 4 area on structure and asked about which part to remove that make the antiviral drug not effective ? A. N3 B. CH3 C. C=O D. OH

A. N3 Any Modification to Chemical Structure of AZT may affect its ability to mimic thymidine and inhibit reverse transcriptase effectively so inhibit its antiviral activity

246-Banzimidazole and pyridine connected together with ?

disulphide bond methylene -ch2-

364- Which element is not involve in heterocyclic compounds ? A. N B. H C. Se D. Fe

D. Fe

367- which the least dominant Tautomerism of the histamine atthe physiological ph ?

NH3

375- ephedrine phenylephrine additional of hydroxyl group what do to activity ? A. increase alpha 1 B. decrease alpha 1 C. increase alpha 2 D. decrease alpha 2

A. increase alpha 1

82- Which of the following is the active metabolite of primidone? A. phenytoin B. dopamine C. phenobarbital D. methsuximide

C. phenobarbital

85- Which of the following is the therapeutic indication for methylphenidate? A. eczema B. insomnia C. anorexia nervous D. attention deficit disorder in children

D. attention deficit disorder in children

96- A 6-year-old boy is brought with complaint of uncontrollable spasm-like movements and excessive eye blinking for four months. Chronic motor disorder was diagnosed.Which of the following is the best management? A. pregabalin B. Haloperidol C. Methadone D. Chlorzoxazone

D. Chlorzoxazone

Which of the following is an inhibitory neurotransmitter? A. Aspartate B. Sertonin C. Glutamate D. Gama aminobutyric acid (GABA)

D. Gama aminobutyric acid (GABA)

44) 67-year-old man presents with complaints of tremors trouble waiding and masked face Parkinson’s disease is suspected levodopa is prescribed along with a compound to lower requireddose of levodopa and to achieve an effective brain dopamine concentration which of the following is that most likely compound? A. pergolide B. selegiline C. carbidopa D. entacapone

C. carbidopa

64) Which ofthe following is a potentialside effect of using chlorpromazine in an elderly person? A. dyskinesia B. constipation C. urinary retention D. tardive dyskinesia

D. tardive dyskinesia

40) 14 years-old man expressed withdrawalsymptoms from using benzodiazepine drug which included Irritability and aggression which of the following types of benzodiazepines is more likely associated with these symptoms? A) long-acting benzodiazepines B) ultra-short acting benzodiazepines C) benzodiazepines WITH ACTIVE METABOLITES

B) ultra-short acting benzodiazepines Short-acting benzodiazepines have stronger withdrawal effects and can be more addictive than long-acting ones.