9 Flashcards
1
Q
page 2?
A
2
Q
price of a product was increased from 100 SA riyals to 105 SA Riyals. This resulted in a large decline on demand from 120 to 80. Which of the following types of demand does this product follow?
a. elastic
b. latent
c. inelastic
d. unaffected
A
a. elastic
3
Q
which of the following play a role in calcium homeostasis?
a. 1,25-dihydrocycholecalciferol and calcitonin
b. 1,25-digydrocycholecalciferol and insulin
c. parathyroid hormone and glucagon
d. insulin and lipase
A
a. 1,25-dihydrocycholecalciferol and calcitonin
4
Q
which of the following micro-organisms causes typhoid fever?
a. shigella
b. flavivirus
c. salmonella
d. Treponema pallidum
A
c. salmonella
5
Q
which of the following means that individuals have the capacity to understand basic health information to make appropriate health decision?
a. health literacy
b. cultural competency
c. communication skills
d. professional communication
A
a. health literacy
6
Q
which of the following is an inhibitory neurotransmitter?
a. aspartate
b. serotonin
c. glutamate
d. gamma aminobutyric acid (GABA)
A
d. gamma aminobutyric acid (GABA)
7
Q
which of the following pharmacoeconomic studies is the simplest because the outcomes are assumes to be equivalent and only the costs of intervention are compared?
a. cost-utility analysis
b. cost-benefit analysis
c. cost-minimization analysis
A
b. cost-benefit analysis
page 4
8
Q
the effects of four anti-hypertensive drug classes (A-D) on the Renin-angiotensin system are shown ( see table).
class
D
renin activity : increase
angiotensin 1: increase
angiotensin II: increase
angiotensin converting enzyme (ACE)
look at page 5
which class is represented by the drug-C?
a. diuretic
b. direct renin inhibitor
c. angiotensin II receptor blocker
d. angiotensin- converting enzyme inhibitors
A
c. angiotensin II receptor blocker
page 5
9
Q
which of the following is the main feature of celiac disease?
a. malabsorption of protein
b. increased protein degradation
c. decreased excretion of protein
d. decreased breakdown of protein
A
d. decreased breakdown of protein
10
Q
which of the following scenarios is considered a violation of the ethics?
a. submitting a research approval extension request to institutional review board after failing to finish the project within the approved period.
b. distributing questionnaire to patients waiting waiting in emergency collect information about their health status without consent page.
c. calling patients to collect information after telling them about the project and getting their agreements.
d. drawing blood samples after getting the approval from institutional review board
A
b. distributing questionnaire to patients waiting waiting in emergency collect information about their health status without consent page.
11
Q
which of the following communication techniques is the most appropriate at the message you want to deliver to a patient (or healthcare provider) is received correctly?
a. feedback
b. direct contact
c. high voice tone
d. non verbal communication
A
a. feedback
page 6
12
Q
which of the following drugs found under the Narcotic classification?
a. Fentanyl
b. Midazolam
c. Loprazolam
d. Pentobarbital
A
a. Fentanyl
13
Q
which of the following strategies are used with low literacy patients to encourage them to change their behavior?
a. keep information focused and organized
b. use a normal speaking tone and volume
c. use briefer educational sessions
d. use more visual aids
A
d. use more visual aids
page 7
14
Q
which of the following is the disadvantage of conducting randomized
controlled trial?
a. expensive
b. high possibility of bias
c. difficult to control confounders
d. cannot be used for hypothesis testing
A
a. expensive
not sure
page 7
15
Q
which of the following is the most appropriate source for information on compounding medications?
a.Micromedex
b. Orange book
c. a drug information websites
d. united states pharmacopeia (USP)
A
d. united states pharmacopeia (USP)
16
Q
which of the following measurements is use to assess patient adherence?
a. drug utilization reviews
b. medication event system
c. medication possession ration
d. medication therapy management
A
b. medication event system
not sure
page 8
17
Q
approximately 415 million people have been diagnosed with diabetes. Which of the following terms is referred to in the mentioned statement?
a. endemic
b. epidemic
c. incidence
d. prevalence
A
d. prevalence
page 8
18
Q
which of the following immunoglobulin (Ig) is frequently found to be elevated in asthmatic patients?
a. IgA
b. IgE
c. IgM
d. IgD
A
b. IgE
page 8
19
Q
who is responsible to promote the health in Saudi Arabia?
a. Saudi food and drug authority (SFDA)
b. Ministry of Education (MOE)
c. Ministry of health (MOH)
d. Health Colleges
A
c. Ministry of health (MOH)
page 8
20
Q
which of the following is the type of studies considers data from multiple studies of different designs to draw conclusions?
a. case series
b. double blind study
c. systematic review
d. consensus statement
A
c. systematic review
page 9
21
Q
A 25 year-old male is admitted due to hypersensitivity reaction to some drug ingestion four hours ago. Patient is given a drug which causes dilation of vessels in muscle, constriction of cutaneous vessels, and positive inotropic and chronotropic effects on the heart.
Which fo the following is the most likelyl drug given?
a. adrenaline
b. isoproterenol
c. acetylcholine
d. metaproterenol
A
a. adrenaline
page 9
22
Q
- From the following data of the highes in cm of 11 pediatric patients:
103,107,110,124,129,131,136,140,142,145,150
what does the value (131) represent?
a. mode
b. mean
c. median
d. confidence interval
A
c. median
page 9
23
Q
which of the following describes the transmission mode of coronavirus?
a. respiratory route
b. blood borne rout
c. contaminated food or drinks
d. direct contact with patient saliva
A
a. respiratory route
page 10
24
Q
- what the function al of small 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
A
b. modifies mRNA molecules
page 10
25
25. According to the FDA categories of drug safety during pregnancy
amoxicillin is under category B.
what does that mean?
a. no adequate animal or human studies have been conducted
b. controlled human studies show no fetal risks form amoxicillin
c. evidence of human fatal risk exists, but benefits may outweigh
d. animal studies show no risk to the fetus and no controlled human studies
d. animal studies show no risk to the fetus and no controlled human studies
page 10
26
which of the following is the function of the Pharmacy and therapeutic committee in a hospital?
a. responsible for poison management
b. monitor the adverse reaction reporting
c. monitor the medication error reporting
d. response for drug formulary management
d. response for drug formulary management
page 11
27
which of the following best describe pharmacy health literacy assessment?
a. measures how well the pharmacy is serving patients with limited health literacy skills
b. discover gaps in the written information provided to served patients
c. explore understanding of health care information by the illiterate
d. assess the level of literacy in the served patients
a. measures how well the pharmacy is serving patients with limited health literacy skills
page 11
28
which of the following medication error is difficult to prevent?
a. omission error
b. wrong time error
c. incorrect duration of treatment
d. allergic reactions to an unknown patient
d. allergic reactions to an unknown patient
29
which of the following best describes the structure of the healthcare systems in Saudi Arabia?
a. Primary care based
b. Private based care
c. 3-tier system
d. 2-tier system
c. 3-tier system
page 12
30
69 year old woman presented with com complains of severe dry cough for a has a week. She has been recently prescribed hydrochlorothiazide and captopril for hypertension, salbutamol and fexofenadine for allergic asthma.
Which drug is the most likely reason of the patient's complaint?
a. captopril
b. salbutamol
c. fexofenadine
d. hydrochlorothiazide
a. captopril
page 12
31
which one of the following medications can a gynecologist prescribe to a patient?
a. Tamoxifen
b. Fingolimod
c. Anastrozole
d. Misoprostol
d. Misoprostol
page 12
32
which of the following is the time after which morphine empty vials are to be discarded?
a. 3 months
b. 6 months
c. 9 months
d. 12 months
b. 6 months
not sure
page 13
33
which of the following is the validity of diazepam prescription (in days )
According to Ministry of Health rules and regulation?
a. 3
b. 7
c. 10
d. 14
b. 7
page 13
34
which of the following immunoglobulin activates complete system?
a. IgM
b. IgE
c. IgA
d. IgG
d. IgG
page 13
35
research investigators must submit all research protocols to the institutional review board and obtain approval before performing the research.
What is the main purpose of this board?
a. to help in collecting the data
b. to provide the needed fund for the research
c. to safeguard the rights of human research subjects
d. to calculate the most appropriate sample size for the research
c. to safeguard the rights of human research subjects
page 14
36
which of the following best describes the role of colipase in digestion of lipids?
a. It breaks down triglycerides into absorbable free fatty acids
b. it hydrolyzes cholesteryl esters into cholesterol and free fatty acids
c. it acts as co-enzyme for the action of lipase in the presence of bile acids
d. it plays an important role in the degradation and excretion of phospholipids
c. it acts as co-enzyme for the action of lipase in the presence of bile acids
page 14
37
which of the following pairs represents the purines nitrogenous bases?
a. adenine (A) and uracil (U)
b. cytosine (C) and uracil (U)
c. Adenine (A) and guanine (G)
d. Cytosine (C) and guanine (G)
c. Adenine (A) and guanine (G)
page 15
38
A 20 year old man encounters a serious road accident. He is brought to the hospital with 'deep wounds'. His vacation history is unknown.
Which of the following would be best to administer to his patient at his time?
a. Tetanus vaccine
b. Tetanus immune globulin
c. Tetanus vaccine and tetanus immune globulin
d. Tetanus vaccine and human papillomavirus vaccine
c. Tetanus vaccine and tetanus immune globulin
page 15
39
which of the following strategies are used with older adult patients to encourage them to change their behavior?
a. use teach-back more often throughout the session
b. introduce new concepts more slowly
c. use briefer educational sessions
d. use more visual aids
a. use teach-back more often throughout the session
page 15
40
which of the following is a functional of alcohol dehydrogenase enzyme?
a. accelerates the reduction of ethanol
b. accelerates 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
page 15
41
the authors report two solated gastro -intestinal tuberculosis in renal transplant recipients that illustrates the difficulty of making this diagnosis and a brief review of the literature on its clinical presentation, diagnosis and therapeutic approach. What is the type of study in the above- mentioned abstract?
a. case- series
b. case- cohort studies
c. case- control studies
d. cross- section studies
a. case- series
page 16
42
which of the following is the process of breaking down of glycogen?
a. glycolysis
b. glycogenesis
c. glycogenolysis
d. gluconeogenesis
c. glycogenolysis
page 16
43
A 37 year old mother breastfeeding her child has developed consistent high blood pressure. The physician consults the pharmacy to recommend an antihypertensive to control her blood pressure.
Which of the following anti-hypertensive is most hazardous for the child?
a. atenolol
b. verapamil
c. metoprolol
d. propranolol
a. atenolol
page 17
44
which of th following is used as an electronic medication dispenser to improve medication adherence?
a. test messaging
b. cellphone calendar
c. e-pill multi-alarm time cap
d. Med-E-Lert Automatic pill Dispenser
d. Med-E-Lert Automatic pill Dispenser
page 17
45
which of the following is the major risk associated with the use of over-the-counter drugs?
a. increased cost without benefit
b. increased drug-drug interactions
c. increased potential for misuse and abuse
d. increased risk of adverse events
d. increased risk of adverse events
page 19
45
A pharmacy department needs to design a system to maximize the value of the drug therapy to the patients,
Which of the following systems should the pharmacy department operate?
a. patient safety program
b. pharmacy benefit management
c. pharmacy networking and bar-coding system
d. communication with the prescriber and the therapist
d. communication with the prescriber and the therapist
page 17
46
which of the following vaccines is contraindicated in a pregnant women?
a. Polio vaccine
b. Influenza (inactivated ) vaccine
c. Measles, mumps, rubella (MMR)
d. Tetanus, diphtheria, pertusis(Tdap)
c. Measles, mumps, rubella (MMR)
page 19
46
which of the following is required to consider an adverse drug event report a valid report?
a. drug dose
b. patients tall
c. event name
d. reporter's phone
answer?
page 18
46
A 65 year old man asks about vaccinations before he leaves for summer vacation next month. He brings his vaccination record for the past 4 years (see table).
Today's date:05/31/2024
date :08/2011 vaccination: herpes zoster
date: every year vaccination: influenza
date 10/2011 vaccination: Pneumococcal
Which vaccination should this patient receive?
a. influenza
b. hepatitis A
c. measles, mumps, rubella
d. Pneumococcal polysaccharide
d. Pneumococcal polysaccharide
page 18
47
Scenario: A study located a group of subjects with lymphoma and went to identity which subjects are smokers and which are not/
Which of the following study design is used to conduct the study in the scenario?
a. case series
b. cross sectional study
c. prospective cohort study
d. retrospective cohort study
b. cross sectional study
47
which of the following statements accurately explain the idea of " Diffusion of Innovation theory for health promotion?
a. Psychological process of creativity
b. the way how people develop new ideas
c. how new ideas are controlled by a culture
d. the method of disseminating innovative ideas a through a culture
d. the method of disseminating innovative ideas a through a culture
page 19
48
which of the following is the most appropriate advice to give to asthmatic patients as non-pharmacological management?
a. air purifiers will help ease the patients symptoms
b. OB weight-loss is unlikely to affect their symptoms now
c. patients should be trained on breathing exercise programs
d. OD. increase physical activity
c. patients should be trained on breathing exercise programs
page 20
49
which of the following situations allow for accepting verbal order?
a. in a code status
b. to start chemotherapy
c. when prescriber is on vacation
d. for a non-formulary drug request
a. in a code status
page 21
49
A 24 ear old male presented to the hospital with a skin infection the microbiology technician received a sample form this patient the sample in a special media was incubated over 24 hours and showed Staphylococcus aureus. The microbiologist used disk diffusion method to determine the susceptibility of different antibiotics ( see image)
what is the most sensitive antibiotic?
a. ampicillin (Amp)
b. vancomycin (Van)
c. Methicillin (Meth)
d. Penicillin (control)
c. Methicillin (Meth)
page 22
50
which of the following prescriptions may have a potential to cause medication error?
a. amlodipine 5.0 mg PO OD
b. Thyroxin 25 mcg PO daily
c. Acetaminophen 500 mg PO TID
d. Regular Insulin % units subcutaneously STAT
a. amlodipine 5.0 mg PO OD
page 20
51
which study ? Bun the following studies represent cost-effectiveness analyses study?
a. comparing cost for 2 therapeutically equivalent products
b. comparing costs and savings of pharmacist serves versus
c. comparing patients achieving control as the outcome for 2 anti-hyperglycemic drugs
d. comparison of costs of 2 chemotherapy regime with the cost c using best supportive care
c. comparing patients achieving control as the outcome for 2 anti-hyperglycemic drugs
page 23
52
There are four principles in biomedical ethics these ethics autonomy justice, beneficence and one more principles.
Which of the following as the fourth principles of biomedical ethics?
a. privacy
b. OB dilemmas
c. OC. non maleficence
d. conflict of interest
c. OC. non maleficence
page 23
53
which of the following terms describes living microbes with reduced virulence, and used for vaccination?
a. virulent
b. dormant
c. attenuated
d. encapsulated
c. attenuated
54
which of the following compounds is urea cycle a biochemical reaction that produces urea from?
a. sucrose
b. glucose
c. glycogen
d. ammonia
d. ammonia
page 24
55
which of the following terms measures the association between the exposure and the outcome?
a. P value
b. risk ratio
c. standard deviation
d. confidence interval
b. risk ratio
page 25
55
which of the following is the best approach for your patient when his/ her objective measures of adherence are inconsistent with subjective measures?
a. "I noticed there were some missing refills of your medication and I'm concerned that there might be a problem
b. " your refill rerecords provides that you did not refill your medication for the few months ago, do you want to be filled now?" EN
c. "Many of my patients have some difficulties remembering to take their medication, What kind of problems have you experienced"
d. "sound like you're not sure about how to take your medicine you show me how to take it"
d. "sound like you're not sure about how to take your medicine you show me how to take it"
page 24
56
which of the following is a characteristic cholesterol?
a. cholesterol has hydroxyl group at carbons
b. cholesterol is a very hydrophilic compound
c. cholesterol has four fused hydrocarbon rings
d. cholesterol has three double bonds in its structure
c. cholesterol has four fused hydrocarbon rings
page 25
57
which of the following bacteria is involved in the development of dental carries?
a. Streptococcus mutans
b. Listeria monocytogenes
c. Streptococcus pneumonia
d. Corynebacterium diphtheria
a. Streptococcus mutans
page 26
58
A 3 year old girl with symptoms of caught for the past 2 days.
The clinic with her mother. She has no fever and not other symptoms. Which of the following is the appropriate recommendation?
a. vicks
b. honey
c. diphenhydramine
d. dextromethorphan
b. honey
page 25
59
which of the following hormones stimulate mammy gland development and milk production?
a. Prolactin
b. Corticotropin
c. corticotropin
d. growth hormone
a. Prolactin
prolactin- secreted by anterior pituitary hormone.
inhibited by: dopamine
Drugs that are dopamine antagonist ( for example, metoclopramide and some antipsychotics) increase secretion of prolactin
Hyperprolactinemia=galactorrhea = hypogonadism ;treated with Bromocriptine and cabergoline
page 26
60
A patient visits pharmacy with fever and cough but has no prescription. Patient requests for acetaminophen, dextromethorphan syrup , glycerin suppository and amoxicillin 500mg capsules. Which of the following needs prescription for delivery?
a. amoxicillin capsules
b. glycerin suppository
c. acetaminophen table
d. dextromethorphan syrup
a. Amoxicillin capsule
Drug category: antibacteria: cell wall synthesis inhibitor: natural penicillin : amino penicillin / extended spectrum penicillin
Amoxicillin - better parenteral
side effect : pseudomembranous colitis
DOC: Metronidazole
Metronidazole drug category: antibacterial: miscellaneous
Metronidazole -MOA : form free radical -> interrupts ETC of protozoa / bacteria
**Metronidazole**
use(4):
-anaerobic
-intra abdominal abscess
- vaginitis
Pseudomembranous colitis
-Protozoan infection
**Metronidazole**
Side effects(3):
*metallic taste
*disulfiram reaction (tx antabuse )
*dark urine
* neuropathy, seizure
61
what is the main method transmission of Brucella species
a. Airborne
b. Blood transfusion
c. contact with infected person
d. ingestion of unpasteurized milk / milk products
d. ingestion of unpasteurized milk / milk products
Brucella species - zootonic disease
Brucella pallidum - Goat
Brucella abortus- cattle
Brucella suis- pig
Brucella canis- dog
page 27
62
A group of patients with diabetes were interviewed to determine they re currently eating fast food or not.
Which epidemiological study design is this?
a. Cohort
b. case control
c. cross sectional
d. randomized control trial
c. cross sectional/ PREVALENCE STUDIES
type: survey
Case control/ Retrospective
-type: observational
-sample based on : presence ( cases ) or absence ( controls) of disease
- advantage : in expensive
-D/A: recall bias
COHORT/ PROSPEXTIVE
- type: observational
-sample based on: presence or absence of risk factors (monitor for disease development)
-D/A: time-consuming , expensive
RANDOMIZED CONTROL CLINICAL TRIAL
-type: experimental
-sample based on: compares 2 or more tx or tx and placebo
-advantage: decreased bias and compounding. Blinded ort double blinded
-D/A: costly and time intensive ethical considerations
page 27
63
Which of the following distribution systems work better for medicine requiring a higher level of control?
a. bulk ward stock
b. direct procurement
c. automated dispensing
d. individual medication order
c. automated dispensing
page 27
64
A pregnant woman is traveling to a high risk malarial country which antimalarial prophylactic agent caries the most fetal risk in pregnant women?
a. Mefloquine
b. Doxycycline
c. Chloroquine
d. Atovaquone- Proguanil
b. Doxycycline
DOXYCYLINE drug category: antibacterial: Protein synthesis inhibitor :30s
Doxycyline
-MOA: block attachment of mRNA to the tRNA
Doxycycline side effect:
-bone dysplasia
- tooth enamel dysplasia
- photosensitivity
- hepatotoxic , nephrotoxic, ototoxic
page 27
65
Which of the following study design is the best to use to assess the awareness on the usage of vitamin D supplements among people Jeddah
a. cohort study
b. case control study
c. case control study
d. cross sectional study
d. cross sectional study
cross sectional/ PREVALENCE STUDIES
type: survey
Case control/ Retrospective
-type: observational
-sample based on : presence ( cases ) or absence ( controls) of disease
- advantage : in expensive
-D/A: recall bias
COHORT/ PROSPEXTIVE
- type: observational
-sample based on: presence or absence of risk factors (monitor for disease development)
-D/A: time-consuming , expensive
RANDOMIZED CONTROL CLINICAL TRIAL
-type: experimental
-sample based on: compares 2 or more tx or tx and placebo
-advantage: decreased bias and compounding. Blinded ort double blinded
-D/A: costly and time intensive ethical considerations
page28
65
which of the following is the presursor for 5- hydrotryptamine
a. proline
b. alanine
c. glutamine
d. tryptophan
d. tryptophan
66
which of the following system can be integrated with computerized physician order entry to guide physician during prescribing medication ?
a. smart plumbs
b. bar code systems
c. electronic distribution cabinets
d. clinical decision support system
c or d ?
page 28
66
which of the following documents created by the World medical. Which associated is the statement of ethical principles for medical research involving human subjects?
a. ethics code
b. belmont report
c. nuremberg zode
d. declaration of Helsinki
d. declaration of Helsinki
67
Which of the following method is successful in reducing medication error and enhance patient safety in hospitals?
a. performing continuous education sessions on safe dispensing
b. providing the pharmacy with the most updated drug references
c. implementation of computerized physician order entry (CPOE) system
d. encourages medical staff to participate in conferences and scientific meetings regular
c. implementation of computerized physician order entry (CPOE) system
page 29
67
which of the following committees is dedicated to developing and maintaining a list of approved medicine for the hospital medicines for the hospital use?
a. medication records
b. medication audit
c. quality assurance
d. pharmacy and therapeutics
d. pharmacy and therapeutics
page 30
68
page 31
the graph represents a quantal dose-response curve of a drug (see image)
what is the median lethal dose (LD50) of the drug?
a. 5
b. 10
c. 20
d. 50
c. 20
68
which one of the following question's types is used to identify a certain piece of information?
a. leading questions
b. open ended questions
c. close ended questions
d. process and outcome questions
b. open ended questions
68
a 23 year old drug addict man was brought to the Emergency room with severe agitation and excitement. He was administered intravenous diazepam, with no improvement in his condition. Which of the following is the most likely; ;drug the patient was addicted on?
a. opioids
b. cocaine
c. pregabalin
d.cannabinoids
d.cannabinoids
68
which of the following commitees is responsible for requests of removing a drug from the hospital formulary?
a. hospital patient safety
b. mortality and morbidity
c. hospital clinical research
d. pharmacy and therapeutic
d. pharmacy and therapeutic
69
an 8 year old child has difficulty in breathing, welling of lips and tongue, and fainted following eating a piece of cake containing nuts.
Which of hte following types of hypersensitivity reactions the child is exhibiting?
a. Immune complex
b. Delayed hypersensitivity
c. cytotoxic hypersensitivity
d. Immediate hypersensitivity
a. Immune complex
or
d. Immediate hypersensitivity?
page 32
70
which of the following is considered a direct method to measure adherence?
a. pill count
b. pharmacy record
c. patients questionnaires
d. body drug concentration
a. pill count?
page 33
71
In pharmacoeconomic studies, the costs (inputs) for all types of analyses are measured in dollars but the pharmacoeconomic method selected will depend on how the outcomes are measured.
Which of the following analysis described the method when patient preferences for alternative treatments are being considered as the outcome?
a. cost minimization
b. cost effectiveness
c. cost benefit
d. cost utility
d. cost utility
72
which of the following enzymes is responsible for forming a DNA copy from RNA?
a. reverse transcriptase
b. DNA polymerase
c. helicase
d. primase
a. reverse transcriptase
page 33
73
A 39 year old woman presents with complaints of episodes of epigastria burning and pain for the last 6 months. She has no significant medical history but reports an allergy to beta-lactam antibiotics. An office based Urea Breath Test is performed to diagnose Helicobacter pylori infection (see lab result).
test : Urea breath test
Result : Positive
Which of the following is the most appropriate treatment regimen?
a. Levofloxacin, amoxicillin and lansoprazole for 14 days
b. omeprazole, clarithromycin, and amoxicillin for 10 days
c. omeprazole, clarithromycin, and metronidazole for 14 days
d. Omeprazole, bismuth subsalicylate , tetracycline, and azithromycin for 14 days
c. omeprazole, clarithromycin, and metronidazole for 14 days
page 34
74
which of the following concepts that most of public health strategies are based on?
a. primary prevention
b. secondary prevention
c. clean water and food
d. ideal healthy community
a. primary prevention
page34
75
A researcher gathered all vitamin E studies from the past ten years. Vitamin E was used for variety of condition. The populations studied as well as the vitamin E formulations and doses were all different. The researcher compared the incidences of cardiovascular-related mortality in those taking vitamin E supplements versus those that did not.
Which of the following best describe this type of study?
a. meta analysis
b. cohort study
c. observational study
d. controlled clinical trial
a. meta analysis
page 36
CASE CONTROL/ RETROSPECTIVE
-Type: observational
-Sample:presence (cases) or absence (controls ) of a disease
-advantage: Inexpensive
-D/A: Recall bias
COHORT/ PROSPECTIVE
-Type: Observational
-Sample based on: Presence or absence of risk factors (monitor for disease development)
-advantage: less recall bias
-D/A: Time-consuming expensive
CROSS-SECTIONAL/ PREVALENCE STUDIES
-Type: Survey
-sample based on: disease prevalence and prevalence factors
RANDOMIZED CONTROLLED CLINICAL TRIAL
-type : experimental (gold st.)
-sample based on : Compares 2 or more tx or tx and placebo
-advantage: decrease bias and confounding Blinded or Double blinded
-D/A: costly and time- intensive, ethical considerations
76
which of he following vaccines is contraindicated in pregnant woman?
a. hepatitis B
b. BCG vaccine
c. Polio vaccine
d. Meningococcal vaccine
b. BCG vaccine
BCG vaccines has the maximum age (life long immunity)
- protect form light
note :
Bacille Calmette Guerin → Vaccine for TB (Tuberculosis)
77
Free medical sample drugs (formulary or non-formulary) are provided by pharmaceutical sales representatives to physicians or members of the health care team.
Which of the following is the most appropriate recommended policy for dealing with sample drugs?
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 doctor's offices
d. exclude them from in patient pharmacy, drug store or doctor's offices
78
Who is responsible to produce regulation for practicing health professions that include pharmacist?
a. Minister of Health (MOH)
b. Dean of college of pharmacy
c. executive director of Saudi Food and drug Authority
d. Board of Trustees of the Saudi Commission for Health specialties
a. Minister of Health (MOH)
1- Supervise health affairs
2- Set strategic plans for hospitals
3- Set laws concerning health care, clinical practice
4- Regulate drug distribution and usage
5- Determine the official role of each HCP
6- Check quality of clinical institutions (Inspection, fellow up
7- Responsible for psychological health
8- Responsible for drug information resources
9- Only source to issue data and analysis of diseases in KSA
10- Inspection of restaurants and food resources
Medication errors reported to MOH
MOH is responsible for vaccinations.
Look for Saudi MOH vaccination schedule (4) page 57
Pharmacy department make request to MOH medical supply
page 37
79
The following formula was prescribed by a dermatologist for a patient with dermatitis.
Hydrocortisone 1.5% w/w
Cream base to make 50g
The pharmacist has two strengths of hydrocortisone creams in his hand, 2.5% and 1%. Therefore, in order to compound this prescription the pharmacist is going to add these two creams strengths together in certain proportions to fulfill this formulation.
Which of the following is the weight ratio of the two strengths of hydrocortisone needed?
a. 1:2
b. 1:1
c. 0.5:1
d. 2:1
c. 0.5:1
page 38
80
which of the following viral infections best describes chronic infection?
a. infection in which host cell dies dues to interference with normal cellular function
b. infection in which there is uncontrolled growth or immortalization of the host cell
c. Infection in which virus persists within the host cell but new virion are not synthesized
d. infection in which virus persists within the host cell and continues to replicate the virions
d. infection in which virus persists within the host cell and continues to replicate the virions
page 38
81
a patient is admitted to the hospital for the treatment of atrial fibrillation. During the hospital stat, the patient receives IV diltiazem and was discharge on oral diltiazem plus his previous antihypertensive medication verapamil.
Which of the following medication error-reduction programs would most likely have helped to prevent this duplication of therapy?
a. Bar coding
b. High - Risk Drug Protocol
c. Medication Reconciliation
d. Computerized physician order entry
c. Medication Reconciliation
Diltiazem- Calcium channel blocker
Diltiazem DRUG CLASSIFICATION : Antihypertensive:Calcium channel blocker
Diltiazem- affects both cardiac and vascular smooth muscle cells, but it has a less pronounced negative inotropic effect on the heart compared to that of verapamil. Should be avoided with patient with heart failure. Diltiazem and verapamil use to treat atrial fibrillation.
❖ Medication reconciliation
* the process of comparing a patient's medication orders to all of the medications that the patient has been taking.
* This reconciliation is done to avoid medication errors such as omissions, duplications, dosing errors, or drug interactions.
* It should be done at every transition of care in which new medications are ordered or existing orders are rewritten
page 39
82
A 20 year olf man patient has had a road accident in which he suffers from minor injuries (no deep wound). His history of vaccination is unknown.
Which of the following is recommended regarding the administration of tetanus vaccine?
a. there is no need of tetanus vaccination
b. both Td and TIG should be administered
c. only tetanus vaccination (Td) should be administered
d. only tetanus immunoglobulin (TIG) should be administered
c. only tetanus vaccination (Td) should be administered
page 39
83
Which of the following in electrocardiograph (ECG) represents atrial depolarization?
a. P wave
b. PR interval
c. ST segment
d. QRS complex
a. P wave
page 40
83
A 28 year old pregnant female in labor is admitted to the hospital. She tested positive for Group B streptococcus colonization at her 36 week appointment. She has a penicillin allergy and her culture are resistant to both clindamycin and erythromycin.
What is the recommended treatment for this patient?
a. Cefazolin
b. Penicillin G
c. Ceftriaxone
d. Vancomycin
d. Vancomycin
Vancomycin DRUG CLASSIFICATION: Chemotherapeutic Drugs: Inhibitors or cell wall synthesis
treatment of methicillin-resistant Staphylococcus aureus (MRSA) generally includes one of the following: vancomycin, clindamycin, daptomycin, or linezolid.
Note: Gram negative organism are inherently resistant to vancomycin.
Vancomycin side effect: Red man syndrome.
- treatment: NSAIDS
- slow infusion to prevent Red man syndrome
VANCOMYCIN DRUG CLASSIFICATION: cell wall synthesis inhibitor : miscellaneous B lactams/ cell wall synthesis inhibitors: Glycopeptides
page 40
84
Which of the following hormones maintains the concentration of water in the body?
a. vasopressin
b. thyrotropin
c. adrenocorticotropic
d. Luteinizing hormone
a. vasopressin
84
which of the following best describes the " bio-psychological approach of health"?
a. broad view that arrtributes disease outcome to the variable interaction of biological factory psychological factors and social factors
b. health constitutes the freedom from disease, pain, or defect, making the normal human condition "healthy"
c. the scientific measure of health and regards disease as the human body having a breakdown due to a biological reason
d. the biological component seeks to understand how the cause of the illness stems form the functioning of the individuals body
a. broad view that arrtributes disease outcome to the variable interaction of biological factory psychological factors and social factors
page 41
85
67 year old man present with complains of tremors trouble walding and masked face parkinsons disease is suspected lecodopa is prescribed
along with a copound to lower requried dose of levodopa and to achieve and effective brain dopamine concentration.
Which of the following is that most likely compound?
a. Pergolide
b. Selegiline
c. Carbidopa
d. Entacapone
c. Carbidopa
page 42
86
the prescription of a patient shows xalatan drops 1 drop o.n.m. 1 bottle
which of the following is the most likely condition?
a. cataract
b. glaucoma
c. blepharitis
d. conjunctivitis
b. glaucoma
page 42
87
which of the following is the benefit from adding conjugate of polyethylene glycol (PEG) in some medications like Peg-interferon?
a. to extend the half life of medications
b. to extend the shelf-life of medications
c. to enhance the effect of the medications
d. to enhance the elimination of the medications
a. to extend the half life of medications
page 42
88
the pharmacist received a prescription to extemporaneously prepare moxifloxacin oral suspension from the 400 mg tablet in a concentration of 20 mg/mL with total volume of 60 mL.
Which of the following is the number of tablets of moxifloxacin 400mg needed to prepare the above prescription?
a. 2
b. 3
c. 4
d. 6
b. 3
89
which of the following substances is used to disinfect floves during compounding sterile products?
a. liquid soap
b. 70% isopropyl alcohol
c. sodium hypochloride 5%
d. sulfuric acid and nitric acid (3:1)
b. 70% isopropyl alcohol
page 43
90
repeated with 91-15 which of the following drugs has both an anti-inflammatory and analgesic activity?
a. codeine
b. pethidine
c. ibuprofen
d. paracetamol
c. ibuprofen
91
which of the following is an alkylating anticancer agent?
a. cyclophosphamide
b. fluorouracil
c. doxorubicin
d. etoposide
a. cyclophosphamide
page 44
92
which of the following medications may alter the renal function?
a. Isoniaxid
b. gentamicin
c. acetaminophen
d. cyclophosphamide
b. gentamicin
page 44
93
which of the following is an alkylating anticancer agent?
a. clyclophosphamide
b. fluorouracil
c. doxorubicin
d. etoposide
a. clyclophosphamide
94
repeated with 3-66
what is the latin abbreviation for " after meals"?
a. a.c
b. a.a.
c. p.c.
d. i,c
c. p.c.
95
repeated 130-74 which of the following medication sis a class I A antiarrhythmic agent?
a. quinidine
b. flecainide
c. verapamil
d. amiodarone
a. quinidine
page 45
96
which of the following molecules contains double bond?
a. CH3
b. CNH
c. C2H2
d. C2H4
d. C2H4
page 45
97
which of the following is a potential side effect of using chlorpromazine in an elderly person?
a. dyskinesia
b. constipation
c. urinary retention
d. tardive dyskinesia
d. tardive dyskinesia
page 45
98
Quinidine is an important antimalarial drug with very complicated structure and is very sensitive stereochemistry.
Which pharmacological activity the drug will possess if the stereochemistry at the arrow has changed from R to S?
a. anticancer
b. antimalarial
c. anticoagulant
d. antiarrhythmic
d. antiarrhythmic
page 46
99
Drug X has an infusion rate of 0.95 mg/kg/hr.
Which of the following is the amount of drug X (in mg) needed for a 12 hr infusion if patient weight is 70kg?
a. 66.5mg
b. 84mg
c. 665 mg
d. 798 mg
d. 798 mg
100
a 6 year old child weighing 28 kg came to the clinic with viral infection. The physician prescribed acyclovir at a dose of 20 mg/ kg four times a day. Acyclovir is available as 200 mg/5mL oral suspension.
How many milliliters would be administered per day?
a. 10
b. 14
c. 44
d. 56
d. 56
page 47
101
a patient is to receive one mg of hydromorphine hydrochloride injection for pain. Hydromorphine hydrochloride is available as 500 mg in a 50mL vial.
How many millilliters would be injected?
a. 0.1
b. 0.5
c. 1.0
d. 2.0
a. 0.1
page 47
102
A solution contains 2.5 mg of a drug per millimeter. The drug is to be administered at a rate of 50mg/hr. (1mL=30 drops).
Which of the following is the most appropriate infusion rate?
a. 5drops / mi n
b. 10 drops / min
c. 20 drops/ min
d. 40 drops / min
b. 10 drops/ min
page 48
103
a 2.5% intravenous drug is infused at a rate of 1.5ml/min.
Which of the amount of the drug (in mg) that is infused in each hour?
a. 25
b. 225
c. 2000
d. 2250
d. 2250
page 48
104
Which of the following statements best describes drug dependence?
a. discontinuation of the drug will produce withdrawal symptoms
b. action of onw drug is dependent on the presence of another drug
c. discontinuation of the drug will not produce withdrawal symptoms
d. patients progressively require increasingly larger doses of drug to achieve the same effect
a. discontinuation of the drug will produce withdrawal symptoms
page 49
105
a technician is preparing 250 mL of 70% (w/v) dextrose solution.
Which of the following is the total amount of dextrose ( in grams ) in the final preparation?
a. 125g
b. 150g
c. 175 g
d. 200g
c. 175 g
page 49
106
how many milliliters of paracetamol syrup of 120mg/5mL strength would be prepared using 1.8kg of paracetamol?
a. 15,000mL
b. 30,000mL
c. 50,000mL
d. 75,000mL
d. 75,000mL
page 49
107
which of the following drug has a high abuse potential?
a. nifedipine
b. allopurinol
c. varenicline
d. methylphenidate
d. methylphenidate
page 50
108
what is the percentage w/V of 10mL vial that contains 50mEq of ammonium chloride per 10 mL if 1 mEq of ammonium chloride = 0.0535?
a. 0.535
b. 2.675
c. 5.350
d. 26.750
b. 2.675
page 50
109
One folic acid tablet contains 400 mcg of folic aid as an active ingredient.
How many tablets would be required for the preparation of 30 grams of folic acid ?
a. 5000 tablets
b. 7500 tablets
c. 50000 tablets
d. 75000 tablets
d. 75000 tablets
page 50
110
which one of the following condition is a contraindication for the use of enalapril?
a. pregnancy
b. hypertension
c. diabetes mellitus
d. congestive heart failure
a. pregnancy
111
which of the following drugs is considered as an enzyme inhibitor that may effect the metabolism of other drugs?
a. phenytoin
b. furosemide
c. cimetidine
d. theophylline
c. cimetidine
page 51
112
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 the acetaminophen and the carboxylic 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
113
which of the following is the content of a monophasic contraceptive?
a. constant dose of estrogen
b. variable dose of progesterone
c. constant dose estrogen and progesterone
d. variable doses of estrogen and progesterone
c. constant dose estrogen and progesterone
page 52
114
which of the following is the best classification for Bisoprolol?
a. beta 1 adrenergic receptor agonist
b. beta 1 adrenergic receptor blocker
c. alpha 1 adrenergic receptor blocker
d. non-selective beta adrenergic receptor blocker
b. beta 1 adrenergic receptor blocker
115
which of the following fetal adverse effects are seen with the use of finasteride during pregnancy?
a. growth restrictions
b. genital abnormality
c. neural tube defects
d. placental abruptions
b. genital abnormality
116
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
d. alpha-adrenergic blocker
page 53
117
which of the following drugs causes water retention?
a. codeine
b. tramadol
c. indomethacin
d. acetaminophen
c. indomethacin
DRUG CLASSIFICATION OF Indomethacin
ANALGESIC : NSAIDS
Indomethacin -management of Barrett's syndrome
Acetaminophen - treatment of toxicity: N-acetylcysteine (NAC)
-causes hepatotoxic, transaminitis, SJS-TEN
Codeine- less sedating and less addicting
-use antitussive, moderate pain
Codeine---demethylation---> codeine
page 53
118
A year old boy presents with complaint of itchiness around the anus night. Lab tests revealed Enteroblus vermicularis infection (pinworm infection)
.
which of the following is the most appropriate management?
a. fluconazole
b. praziquantel
c. pantoprazole
d. mebendazole
d. mebendazole
page 54
119
which of the followinf drug is used for premature ejaculation?
a. atenolol
b. dapoxetine
c. olanzapine
d. aripiprazole
b. dapoxetine
page 54
120
which of the following is the Vaudhan Williams classification for the antiarrhythmic drug procainamid?
a. class IV
b. class III
c. class II
d. class IA
d. class IA
page 54
121
which of the following drugs used in rheumatoid arthritis can be dosed once a week?
a. hydroxychloroquine
b. methotrexate
c. sulfasalazine
d. prednisone
b. methotrexate
methotrexate DRUG CLASSIFICATION:
ONCOLOGIC " ANTIMETABOLITES :FOLATE ANTAGONISTS
methotrexate DRUG CLASSIFICATION: DMARDS: NON-BIOLOGIC : FIRST LINER AGENTS
methotrexate cause hepatotoxicity. treatment: Leucovorin / folinic acid
methotrexate major S/E: GI upset, oral ulceration
SULFASALAZINE-A/E: SJS -TEN
HYDROXYCHLOROQUINE - A/E: opthalmologic toxicity, cardiotoxicity
PREDNISONE
- use: cancer management
- side effects: Cushing's syndrome
page 55
122
A 6 year old HIV infected boy measuring 0.9 m2 is to receive nevirapine 140mg/m2 two times daily. Nevirapine is available as 50mg/5mL suspension.
How many milliliters of nevirapines suspension would be administered per dose?
a. 6.3
b. 12.6
c. 14.0
d.16.5
b. 12.6
123
which medication can cause orthostatic hypotension?
a. prazosin
b. donepezil
c. rivastigmine
d. spironolactone
a. prazosin
page 55
124
A drug has a clearance value of 4.75L/hour and 65% is cleared by renal excretion.
Which of the following would be the non-renal clearance value?
a. 1.25l/hrs
b. 1.66 L/hrs
c. 1.90 L/hrs
d. 2.05 L/hrs
b. 1.66 L/hrs
page 56
125
which of the following is a pharmacological property of chloropromazine
a. antihistamine
b. antiemetic drug
c. cholinesterase inhibitor
d. selective serotonin reuptake inhibitor
a. antihistamine
page 56
126
Which of the following medications promotes ripening and clation of the cervix during labor?
a. atosiban
b. nitric oxide
c. misoprostol
d. magnesium sulfate
c. misoprostol
page 57
127
what is the meaning of off-label drug use?
a. use of drug without prescription
b. use of drug expiration date
c. use of drug outside the hospital
d. use of drug for unapproved indications
d. use of drug for unapproved indications
page 57
128
which of the following medication is used treat benign prostatic hyperplasia?
a. donepezil
b. etanercept
c. tamsulosin
d. carbidopa- levodopa
c. tamsulosin
page 57
129
what is the therapeutic use of salbutamol?
a. antibiotic
b. antiemetic
c. anticoagulant
d. bronchodilator
d. bronchodilator
page 58
130
which of the following terms defines the metabolic reaction of this drug?
(see image)
a. hydrolysis
b. o-dealkylation
c. a-hydroxylation
d. oxidative deamination
page 58
131
Which of the following medication has a dise effect metallic taste?
a. cefuroxime
b. azithromycin
c. ciprofloxacin
d. metronidazole
d. metronidazole
page 58
132
which of the following can the pharmacological property of hydralazine be directly responsible for?
a. relaxation of cardiac muscle
b. blockage of dopamine receptors
c. relaxation of vascular smooth muscle
d. contraction of vascular smooth muscle
c. relaxation of vascular smooth muscle
page 59
133
which of the following statements best represents the intravenous (IV) medication in the hospital facilities?
a. IV drugs transmits the highest risk of infection
b. IV drugs are associated with lowest risk of undesirable side effects
c. IV solutions must be hypotonic to ensure compatibility with blood osmolarity
a. IV drugs transmits the highest risk of infection
page 59
134
A patient is to receive 400 ml intravenous infusion of a 1% drug that will be over 10 hours
which of the following is the amount (milligrams) of the drug that will be delivered in 15 minutes?
a. 100mg
b. 150 mg
c. 200mg
d. 400 mg
a. 100 mg
page 60
135
a 14 year old man expressed withdrawal symptoms from using benzodiazepine drug which included irritability and aggression.
Which of the following types of benzodiazepine is more likely associated with these symptoms ?
a. long acting benzodiazepines
b. ultra short acting benzodiazepines
c. benzodiazepines with active metabolism
d. benzodiazepines with high plasma protein binding
c. benzodiazepines with active metabolism
page 60
136
Which of the following drugs passes into mothers milk due to high liquid solubility?
a. diazepam
b. methyldopa
c. promethazine
d. dihydroergotamine
a. diazepam
page 60
137
which of the following anesthetic drug has a higher risk causing hepatic toxicity ?
a. propofol
b. ketamine
c. isoflurane
d. nitrous oxide
c. isoflurane
page 61
138
Drugs may accumulate the tissues as result of their physiochemical characteristics or special affinity of the tissue for the drug.
Which of the following parts of the body dose tetracycline acumalate?
a. liver
b. bone
c. muscle
d. adipose tissue
b. bone
page 61
139
49 year old woman is regularly drinking an herbal made from dry senna fruit she developed severe hepatotoxicity.
Which of the following is the active glycoside of the senna that is associated with hepatotoxic effect?
a. flavonoid
b. saponine
c. triterpene
d. anthraquinone
d. anthraquinone
page 62
140
51 penicilin G potassium is available in 50 mL vial containing 20 gram. Each milligram of penicillin G potassium is equal to 1500 units.
How many units of penicillin G potassium are there in each vial ?
a. 15,000,000
b. 20,000,000
c. 25,000,000
d. 30,000,000
d. 30,000,000
page 63
141
a 31 year old hypertensive man was treated for addiction to amphetamine. He was also discharge on a n antihypertensive drug. Later, he presented with severe depression.
Which of the following medications was most likely prescribed?
a. losartan
b. captopril
c. methyldopa
d. hydrochlorothiazide
c. methyldopa
page 63
142
Which of teh following is most likely the reason for using amlodipine in the treatemnt of hypertension?
a. selective beta 1 blocker
b. selective alpha 1 blocker
c. calcium channel blocker
d. selective serotonin reuptake inhibitor
c. calcium channel blocker
page 63
143
which of the following is the effect of smoking on serum olanzapine levels
a. has no effect
b. increase serum olanzapine levels
c. decrease in serum olanzapine levels
d. decrease in olanzapine levels initially then increase in it
c. decrease in serum olanzapine levels
page 64
144
which of the following lab results support a diagnosis of primary hyperthyroidism?
a. low TSH and a low free T4
b. low TSH and elevate free T4
c. elevated TSH and low free T4
d. elevated TSH and elevated T4
b. low TSH and elevate free T4
page 64
145
a 7 year old girl is brought to the clinic with complain of itchy scalp.
a. examination show lice infestation/
What is the best management?
a. permetrin
b. magic mouth wash
c. ketoconazole shampoo
d. dimethicone lotion
d. dimethicone lotion
page 64
146
a 4 week infant is diagnosed with patetn ductus arteriosis. The doctor want to avoid performing surgery.
Which of the following will be administered to avoid a surgical closure?
a. allopurinol
b. indomethacin
c. pseudoephedrine
d. bromopheniramine
b. indomethacin
page 65
147
which of the following vaccines is recommended for people at the age of >65 year?
a. hepatitis B vaccine
b. pneumococcal vaccine
c. meningococcal vaccine
d. DTaP vaccine ( diphtheria, tetanus, pertussis)
b. pneumococcal vaccine
page 65
148
which of the following is an example of parenteral direct thrombin inhibitor?
a. enoxaparin
b. argatroban
c. fondaparinux
d. unfractionated heparin
b. argatroban
page 65
149
a 90 year old man with diabetes mellitus, hypertension and congestive heart failure presented to his cardiology clinic complaining of nausea, anorexia and visual changes. Current home medications include; metformin, aspirin, lisinopril , atorvastatin and digoxin ( see lab result)
test : serum creatinine 44-115 umol/ L
result
blood urea nitrogen 2.8-8.9mmol/l
result:15
sodium 134-146mmol/L
result: 140
potassium 3.5-5.1mmol/L
result:4
chloride 97-108 mmol/L
result :100
bicarbonate 21-28 mmol/L
result 23
calcium 2.15-2.62 mmol/L
result :2.5
digoxin (Men) 0.8-2ng/L
result:3
which fot he following most likel;y explaines the patient symptoms?
a. digoxin-lisinopril iteraction
b. adverse drug reaction of atrovastatin
c. congestive heart failure exacerbation
d. high serum digoxin level due to renal impalment
d. high serum digoxin level due to renal impairment
page 67
150
a 90 year old man with diabetes mellitus, hypertension and congestive heart failure presented to his cardiology clinic complaining of nausea, anorexia and visual changes. Current home medications include; metformin, aspirin, lisinopril , atorvastatin and digoxin ( see lab result)
test : serum creatinine 44-115 umol/ L
result
blood urea nitrogen 2.8-8.9mmol/l
result:15
sodium 134-146mmol/L
result: 140
potassium 3.5-5.1mmol/L
result:4
chloride 97-108 mmol/L
result :100
bicarbonate 21-28 mmol/L
result 23
calcium 2.15-2.62 mmol/L
result :2.5
digoxin (Men) 0.8-2ng/L
result:3
which of the following is the timeline where symptoms start to occur in type 1 diabaetes mellitus?
a.as early when destruction of the islets of langerhans of the pancrease is starting
b. when 50% of the islets of langerhans of the pancrease are destroyed
c. when 70 % of the islets of langerhans of the pancrease are destroyed
d. when destruction of the islets of langerhans of the pancrease is complete
c. when 70 % of the islets of langerhans of the pancrease are destroyed
page 67
151
Which of the following of the antihypertensive therapies is preferred to be used during the acute phase of ischemic stroke if elevated blood pressure should be treated?
a. lisinorpril
b. nicardipine
c. hydrochlorothiazide
d. metoprolol succinate
b. nicardipine
page 68
152
which of the following condition use " the plate method" as lifestyle modification?
a. asthma
b. dyslipidemia
c .hypertension
d. diabetes mellitus
d. diabetes mellitus
note:
Type 1 DM (TIDM) - "insulin dependent DM"
Type 2 DM - non insulin dependent DM
-insulin resistant
- inadequate insulin secretion form beta cells
page 68
153
which of the following is the most appropriate time to draw a plasma blood sample for digoxin monitoring?
a. 2 hours post dose
b. 4 hours post dose
c. 5 hours post dose
d. 6 hours post dose
d. 6 hours post dose
page 68
154
what is the indication of sevelamer in a patient with chronic kidney disease?
a. hypercalcemia
b. aluminium toxicity
c. hypermagnesemia
d. hyperphosphatemia
d. hyperphosphatemia
page 69
155
Which of the following parenteral anticoagulants require routine monitoring of coagulation lab parameters?
a. UFH intravenously
b. UFH subcutaneously
c. enoxaparin subcutaneously
d. fondaparinux subcutaneously
a. UFH intravenously
page 69
156
Which of the following can be used safely in a patient with sulfa allergy?
a. gliclazide
b. furosemide
c. sulfamethoxazole
d. sodium thiosulfate
b. furosemide
Drug classification: CARDIOVASCULAR DRUGS: DIURETICS: Loop diuretic / high ceiling diuretics
Furosemide
MOA: inhibit Na+/K+/Cl- contrsnsporter in thick ascending limb of Henle
use : -management in anion poisoning
-manangement in pulmonary edema
page 69
157
A 33 year old woman with history of migraine and hypothyroidism, she is a nurse with one son and she is currently 15 weeks pregnant. She is concerned about vaccination and seeks your advice.
a. hepatitis B
b. inactivated influenza
c. MMR (measles , mumps, and rubella)
c. MMR (measles , mumps, and rubella)
note: vaccine contraindicated in pregnancy.
It contain trace of egg protein.
Saudi MOH vaccination schedule :
MMR - 12,18,school entry (4-6 years) months
page 70
158
A 55 year old woman presents with symptoms of helicobacter pylori infection s. She was previously treated with the classical amoxicillin, clarithromycin, omeprazole regimen. The physician is unable to obtain susceptibility testing for the Helicobacter pylori but the pattern of local antimicrobial resistance to penicilllin's is well known.
what would be the optimal treatment for her?
a. amoxicillin (1g) , clarithomycin ( 500mg) and metronidazole (500 mg) pluc omeprazole (20 mg) BID for 14 days
b. amoxicillin (1g) , clarithomycin ( 500mg) and metronidazole (500 mg) pluc omeprazole (40 mg) BID for 14 days
c. bismuth subsalicylate (2) and tetracycline (500mg) QID plus metronidazole (500mg) and omeprazole (40mg) BID for 14 days
c. bismuth subsalicylate (2) and tetracycline (500mg) QID plus metronidazole (500mg) and omeprazole (40mg) BID for 14 days
page 71
159
which of the following is the most appropriate regimen to prevent constipation in a patient starting on morphine for pain?
a. docusate and senna
b. bisacodyl and lactulose
c. polyethylene glycol and metamucil
d. methylnatrexone and magnesium sulfate
a. docusate and senna
docusate - use : stool surfactant agent
Stool Surfactant Agents (Softenerss/Emollients)
Action : permits water and lipid to penetrate stool softening materials
Senna- stimulant laxative
Stimulant laxatives
Action : stimulates GIT movement
Use : Colonic cleansing before colonoscopy
CONSTIPATION
treatment:
A. laxatives
a. bulk forming laxative
b. stool surfactant agents
c. osmotic laxative
s
d. stimulant laxative
B. chloride channel activator
C. opioid receptor antagonists
D. serotonin (5HT4) receptor agonist
page 71
160
which of the following conditions use the plate method as a lifestyle modification?
a. hypertension
b. thyroid disorder
c. diabetes mellitus
d. mycordial infraction
c. diabetes mellitus
page 71
161
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
page 72
162
which of the ethical principles do vioalte as a pharmacist when time and give consultations to only relative?
a. justice
b. autonomy
c. beneficence
d. non maleficence
a. justice
page 72
163
which of the following is the precursor for 5 hydroxytryptamine?
a. proline
b. alanine
c. glutamine
d. tryptophan
d. tryptophan
tyrptophan : Trp, W
https://www.technologynetworks.com/applied-sciences/articles/essential-amino-acids-chart-abbreviations-and-structure-324357
page 72
164
which of the following is the interpretation of the result of statistical test denoted P?
a. null hypothesis H0 is rejected if P>0.05
b. the null hypothesis H0 is accepted if P<0.05
c. the null hypothesis H0 is rejected if p<0.05
d. the null hypothesis H0 is accepted if p>0.05
c. the null hypothesis H0 is rejected if p<0.05
page 73
165
A 68 year old man was diagnosed with rheumatoid arthritis 1 month
ago. He has high disease activity as per the patient activity scale a eposions on radiograph. A trial of non pharmacologic therapy is ineffective.
Which of the following is the best drug therapy?
a. hydroxylchloroquine
b. mercaptopurine
c. adalimumab
d. abatacept
hydroxylchloroquine
page 73
166
which of the following is used to determine the significance of the result?
a. p value
b. odds ratio
c. hazard risk
a. p value
page 73
167
what is the estimated amount of plasma in a 70 kg male ?
a. 3.5 liter
b. 1.1 liter
c. 35 liter
d. 11 liter
a. 3.5 liter
168
a 24 year old male presented to the hospital with a skin infection. The microbiology technician received a sample from this patient . The sample special media was incubated over 24 hour and showed staph. aureus . the microbiologist used disk diffusion method to determine susceptibility of different antibiotics ( see image )
what is the most sensitive antibiotic ?
a. ampicilin ( amp)
b. vancomycin (van)
c. methicillin (meth)
d. penicillin (control )
c. methicillin (meth)
page 74
169
which of the following white blood cell types is the target of immunodeficiency virus during acquired immune deficiency syndrome (AIDS) ?
a. CD1 lymphocytes
b. CD2 lymphocytes
c. CD3 lymphocytes
d. CD4 lymphocytes
d. CD4 lymphocytes
page 74
170
A 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 wants to 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 start chemotherapy with very low doses and less frequent
b. to go with the option of surgery immediately because it is
c. to discuss the risk and benefit with the patient and take he 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 he decision
page 75
171
which of the following studies represent a cost effectiveness study?
a. comparing costs for 2 therapeutically equivalent products
b. comparing costs and savings of pharmacokinetics service diabetes clinic
c. comparing patient achieving control as the outcome for 2 antihyperglycemic drugs
d. comparison of costs of 2 chemotherapy regimens with the using best supportive care
c. comparing patient achieving control as the outcome for 2 antihyperglycemic drugs
page 75
172
the treatment of tuberculosis (anti TB ) involves multiple medication have to be taken for a long period of time.
Which of the following is the best way to ensure patient adhe anti TB ?
a. apply direct observed therapy , short course strategy (DOT
b. add multivitamins to increase absorption of anti TB
c. interview the patient to assess their knowledge about anti TB
d. review current medications profile to avoid drug-drug inten with anti TB
a. apply direct observed therapy , short course strategy (DOT
page 74
173
what kind of association between the variables id you want to association between age and depression pre/post drug (A) use ?
a. 2 continuous variables
b. a continuous variables and binary variable
c. a continuous variables and ordinal variable
d. a continuous variable and categorical variable
c. a continuous variables and ordinal variable
page 76
174
which one of the following questioning techniques uses hints and aid patients in answering questions?
a. changing questions
b. empathic responding
c. prompting while asking
d. redirection the questions
c. prompting while asking
page 76
175
which of the following describe glucose uptake and usage by as compared to other tissues of the body?
a. brain cell can uptake and use glucose only in the presence
b. brain cells can uptake and use glucose without being stimul insulin
c. brain cells can uptake and use glucose when glucose is abol 100mg/dL in the blood
b. brain cells can uptake and use glucose without being stimul insulin
page 76
176
A physician prescribes, for a 6 year old child 10 mg, omeprazole daily for seven days as a syrup formulation. Omeprazole capsules strength are available in the pharmacy.
Which of the following is the number of capsules required to ma to suffice the total doses in the prescription if the final concent syrup should be 2 mg/ mL?
a. 2
b. 3
c. 5
d. 7
d. 7
page 77
177
which of the following represents the immunity acquired by inocu living organism with attenuated virulence?
a. local immunity
b. passive immunity
c. natural active immunity
d. artificial active immunity
a. local immunity
c. natural active immunity
?
page 77
178
A 62 old man who just had a needle biopsy of pancreas adenocarcinoma. A pharmacist saw his brother in the hall and him not to tell the patient because the knowledge would be very on his health . A family conference to discuss the prognosis is scheduled for later that afternoon .
What is the way for the healthcare practitioner tp o handle the situa
a. the healthcare practitioner should ask the patient how he handle the information in front of the rest of the family , and for some family discussion time for this matter.
b. the healthcare practitioner shoul.d honor the request of the member who is protecting his beloved brother form the ba
c. the healthcare practitioner should tell the patietns brother wtihholding information is nor permitted under any circum
d. the patient should withhold informing the patient about the pancreatic cancer because of the grave diagnosi
b. the healthcare practitioner shoul.d honor the request of the member who is protecting his beloved brother form the ba
page 78
179
A pharmacist is working in a busy community pharmacy where has several patients at the counter. A patient brought to you a pre of Sildenavil for erectile dysfunction.
Which of the following is the best way of communication with you to provide counseling?
a. ask other patients to leave the pharmacy in order to commu with the patient
b. to protect patient privacy , no need to communication with just provide the drug to him
c. ask the patient to move to a private area in the pharmacy hear you clearly and ask questions
d. write down the instructions in a paper and provide it him talking to him in front of other patients
c. ask the patient to move to a private area in the pharmacy hear you clearly and ask questions
page 79
180
A 38 year old man is using citalopram 20 mg po daily for dep which he has been taking for 1 year. A week ago, he had a sen infection and was prescribed linezolid 600 mg PO q12h for a total of 14 days . The patient began to get confused and easily agitated like he was breathing rapidly and started to sweat and developed . He was noticeably shaking.
Which of the folllowing is name of this drud-drug interact happened to this patient ?
a. heaptotoxicity
b. seizure activity
c. serotonin syndrome
d. stevens johnsons syndrome
c. serotonin syndrome
page 79
181
which of the following in electrocardiographn (ECG) represe absolute refractory period ?
a. p wave
b. pr interval
c. st segment
d. QRS complex
d. QRS complex
page 79
182
look at phar 80 graph .
the graphs represents qusntal dose response curves fot he effect and lethality by a drug ( see image )
a. 0.9
b.1.1
c.4
d.10
c.4
page 80
183
what is the main absorptive function of the colon?
a, iron
b. triglycerides
c. water and glucose
d. sodium, chloride and water
c. water and glucose
page 80
184
which governement agency gives approval to generic media center the drug market in Saudi Arabia after completing all requirements ?
a. ministry of health (MOH)
b. ministry of commerce (MOC)
c. saudi food and drug authority (SFDA)
d. saudi commission for health specialists (SCFHS)
c. saudi food and drug authority (SFDA)
Duties and obligation of SDFA :
1-Drug registration and pricing
2- Receives complains about drug products
3- Inspection of pharmaceutical firms
4- Setting laws for importing pharmaceutical and cosmetics
5- Setting laws concerning medical equipment.
6- Determine list of companies for dealing with outside KSA
7- Approving drug formulary.
8- Responsible for medication regulation.
Adverse drug reactions reports uploaded to SFDA
Drug shortage is reported to SFDA
Misleading advertisement is reported to SFDA
Loss of narcotic log book is reported to SFDA
Chief pharmacist signs the form that is sent to SFDA
page 81
185
which of the following medications can cause pneumonia as a side effect?
a.lisinopril
b. metformin
c. simvastatin
d. omeprazole
D. OMEPRAZOLE
a. llisinopril-CARDIOVASCULAR: ANGIOTENSIN MODIFIERS
b. metformin -ENDOCRINE SYSTEM : BIGUANIDES
c. simvastatin-DRUGS FIR DYSKIPIDEMIA :HMG COA REDUCTASE INHIBITOR
d. omeprazole
MOA:
a. llisinopril - 1st line management in HTN. management in HF. management of albuminuria.
b. metformin -treatment of all T2DM . recommended therapy for prediabetes
c. simvastatin-( at bed time). first line agent in hypercholesterolemia, management of CAD
d. omeprazole- is a proton-pump inhibitor used to manage and treat several conditions, including uncomplicated heartburn, peptic ulcer disease, gastrointestinal reflux disease, Zollinger-Ellison syndrome, multiple endocrine adenomas, systemic mastocytosis, erosive esophagitis, gastric ulcers, and helicobacter pylori
S/E:
a. lisinopril -isiosyncratic cough, angioedema . hypotension, interstitial nephritis, hyperkalemia.
b. metformin-diarrhea. more serious: lactic acidosis
c. simvastatin- hepatotoxic (so need liver function test, myalgia, myositis, rhabdomyolysis
d. omeprazole-headache
186
a 1l6 month baby with bronchopulmonary dysplsia is dmitted pediatric intensive care unit with respiratory distress requiring in ( see lab results).
hear rate 86/min
respiratory rate 30/min
temperature 38.6 Celsius
test : swab
result: positive for respiratory syncytial virus
what is the best management ?
a. cefuroxime
b. palivizumab
c. corticosteroids
d. intravenous fluids and supportive care
d. intravenous fluids and supportive care
a. cefuroxime- ANTIBACTERIAL: CEPHALOSPORIN 2ND GEN
b. palivizumab - protein antibody
c. corticosteroids -DRUGS FOR RESPIRATORY DISORDER: ANTIINFLAMMAORY DRUGS : GLUCOCORTICOIDS
d. intravenous fluids and supportive care
MOA:
a. cefuroxime- surgical prophylaxis, GI distress, bone infections, G(+) cocci ( staphylococcus , streptococcus , E. coli, Klebsiella)
b. palivizumab-to prevent serous sequelae caused by respiratory syncytial virus infection in pediactric patients
c. corticosteroids - inhibition of phospholipase A2(PLA2). inhibition of the release of interleukins by macrophage
d. intravenous fluids and supportive care
S/E:
a. cefuroxime-(+) aminoglycoside = nephrotoxicity
b. palivizumab-M2M
c. corticosteroids
d. intravenous fluids and supportive care
187
Which of the following pharmcoeconomic studies is the simple conducted ?
a. cost utility analysis
b. cost benefit analysis
c. cost minimization analysis
d. cost effectiveness analysis
d. cost effectiveness analysis
a. cost utility analysis
b. cost benefit analysis
c. cost minimization analysis
d. cost effectiveness analysis
188
which of the following perspectives incorporates all the costs and regardless of whi incurs or obtains them
a. patient
b. hospital
c. societal
d. ministry of health
c. societal
page 82
189
Which of the following enzymes regulate supercoiling of DNA ?
a. helicase
b. primases
c. topoisomerases
d. reverse transcriptase
c. topoisomerase
https://www.youtube.com/watch?v=Qqe4thU-os8
page 82
190
which of the following is a characteristic for facultative anaerobic
a. only grow anaerobically
b. only grow in the presence of oxygen
c. an aerobe but can grow in the absence of oxygen
d. require simultaneous presence of aerobic and anaerobic environment
c. an aerobe but can grow in the absence of oxygen
PHYSICAL REQUIREMENTS
1. Temperature
Psychrophiles - cold loving (0°C)
Psychrotrophs - grow in refrigerator (20-30°C)
Mesophiles - moderate (25-40°C)
Thermophiles - heat loving (50-60°C)
Hyperthermophiles - extreme thermophiles (80°C)
*Minimum growth temperature, Maximum growth temperature, Optimum growth temperature
2. pH (Optimum: 6.5-7.5)
Acidophiles, Alkaliphiles, Neutrophile
3. Osmotic Pressure/Salt Concentration
Extreme halophiles - require high concentration for growth
Obligate halophiles - grows at extremely high concentration (nearly 30%)
Facultative halophiles - require high salt but can grow at concentrations up to 2%
191
which of the following population is studied in phase 1 clinical trial
a. healthy participants
b. patient with single disease
c. patients with multiple disease
d. patients in real world practice
a. healthy participants
page 83
192
which of the following is the name of the body responsible for the approval of research in health institutions?
a. date review board
b. research review board
c. institutional review board
d. date nd safety monitoring board
c. institutional review board
page 83
193
click image to enlarge (page 84)
the hierarchy is chowing hospital X organizational chart. a pha assigned as a clinical pharmacist 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
page 84
194
which of the following reflect the significance of sample evidence?
a. the p value
b. the F ratio
c. value of alpha
d. the importance of the sample
a. the p value
page 84
195
which of the following parts of the body does urea synthesis take
a. liver
b. heart
c. blood
d. kidney
a. liver
196
which of the following marketing mix contains market covern assortments?
a. price
b. place
c. product
d. promotion
b. price
page 85
197
what is the type of costs for traveling from Jeddah to Riyadh to healthcare form pharmcoeconomic perspective?
a. indirect
b. intangible
c. direct medical
d. direct non medical
d. direct non medical
page 85
198
A patient medication was changed from carbamazepine to phen . THe technician pulled the 100 mg tablet of phenobarbital off instead of the 30 mg tablets. The pharmacist did not notice the when the prescription was checked. The patient received a higher phenobarbital and was hospitalized for few days for observation.
Which of the following is the best statements concerning this situation
a. this is considered as adverse drug reaction
b. the physician should have improved the pharmacist about prescription's chnge
c. the patient should be aware of what he was prescribed and teh difference
d. this is a preventable medication error if the pharmacy im safety measures
d. this is a preventable medication error if the pharmacy im safety measures
page 85
199
which of the following is the first antibody to be produced in resp new infecion ?
a. IgM
b. IgG
c. IgA
d. IgE
a. IgM
IgG - most common, smallest (crosses placenta)
IgM- first responder , second most common
IgA - secretory Ab( mucosal surfaces)
IgE - attach to mast cells and basophils -> release of histamine
IgD- growth and differentiation
200
an 81 year old man presents with urinary hesitancy and difficult for the past 1 month. He has a history to urge incontinence and his physician suspects that he may have benign prostatic. He is currently taking oxybutynin and lisinopril.
Which of the following intervention is the most appropriate?
a. discontinue oxybutynin
b. discontinue lisinopril
c. start alfuzosin
d. start prazosin
a. discontinue oxybutynin
page 86
201
a 35 year old individual is receiving 20mg of propranolol hydro four times daily as prophylaxis to migraine attacks. The drug 25% bioavailability due to extensive first pass effect.
What amount of the drug reaches the systemic circulation after dosing?
a. 2.5mg
b. 5.0 mg
c. 7.5 mg
d. 10 mg
b. 5.0 mg
page 86
202
if a study is to follow a group of smokers and a group of nonsmoker time ,and see which one eventually develop lymphoma and which.
what do you call this study design?
a. retrospective cohort study
b. prospective cohort study
c. cross sectional study
d. case series
b. prospective cohort study
page 87
203
a 74 year old man with chest infection is dmitted to a teaching. The patient requires chest n x ray . the chief resident bronchoscopy to be conducted. One of her reasons for this decision allow an inexperienced intern to practice this technical procedure.
which of the following describes his action?
a. individual patients are not obligated to participate in the society's future physicians, but if the patients agree, it is
b. good as this is a teaching hospital and the students have these skills to funstion effectively as physicians
c. procedures involving any risk should be performed only for diagnostic or therapeutic purpose but not teaching
d. the senior physician should remain present when inexpen students make his procedure
d. the senior physician should remain present when inexpen students make his procedure
page 87
204
what kind of outcomes can be determined by cost minimization
a. monetary units (e.g. dollars
b. quality adjusted life years (QALYs)
c. natural units e.g. life years saved )
d. comparing the cost of two identical products (e.g. generic brand)
a. monetary units (e.g. dollars )
page 87
205
which of the following statements provides the best describtic incremental cost- effectiveness ratio?
a. cost per extra benefit of a new strategy, independent
b. the extra cost to obtain an extra benefit when switching alternative to another
c. the cost per quality life uear gaines
d. a summary measuremtn of efficiency
b. the extra cost to obtain an extra benefit when switching alternative to another
page 87
206
which of the following government bodies is responsible for disease prevention during Hajj?
a. ministry of health
b. saudi health counsil
c. saudi fod and drug authority
d. saudi commission for health specialists
a. ministry of health
page 88
207
what is the description of viruses taht live as parasites on bacteria
a. fungi
b. lichens
c. commensels
d. bacteriophage
d. bacteriophage
page 88
208
which one of the following dsign could be deemed an study ?
a. cohort
b. clinical trials
c. case control
d. cross sectional
b. clinical trials
page 88
209
which of the following situation demonstrates a direct association pharmacoepidemiological study?
a. the study reveals that it is not a false ssociation
b. the regression between two variables is a result of another
c. the association betwen two variables is a result of another
d. hte association between the two atributes is not trough attributes
c. the association betwen two variables is a result of another
page 88
210
a patient came to the pharmacy returning phenytoin 30 mg suspension bottles. He explaines that when he opened the second after consuming the first one, he noticed the solution has different. the pharmacist dispensed another bottle to the patient and the event in the patinet profile.
which one of the following reports the pharmacist show products ?
a. opportunity reports form
b. quality defects reporting form
c. adverse drug event reporting form
d. medication returnd by patient form
c. the association betwen two variables is a result of another
page 89
211
during prescription verification , a pharamcist identified a drug interaction in a 23 year olf woman diagnosed with urinary tract and prescribed an antibiotic. Pharmacist contacted the change to a drug that will not harm the patient. she has a G6PD deficiency
which of the follo;wing antibiotics is the best option for the patietn?
a. cephalexin
b. ciprofloxacin
c. nitrofurantoin
d. trimethoprim -sulfamethoxazole
c. nitrofurantoin
page 89
212
a 7 year old girl presents with moderate dehydration due to vomiting (see lab result).
test :
sodium
resut: 134
normal value:
134-146mmol/L
test postassium
result:2.9
normal value: 3.5-5.1mmol/L
test chloride
result: 98
normal vlaues : 97-108 mmol/L
test bicarbonate
result: 30
normal value: 21-28 mmol/L
what is the most suitable replacement fluid?
a. 0.9% sodium chloride
b. 5% dextrose /0.225% sodium chloride with potassium
c. 0.9sodium chloride with potassium chloride
d. 5% dextrose /0.225% sodium chloride with potassium
c. 0.9sodium chloride with potassium chloride
page 89
213
which of the following communication skillscan help patient complete their train of thought?
a. close ended questions
b. facial expression
c. use of reminders
d. body posture
c. use of reminders
page 89
214
go to page 90
in 2017, a research paper published in NEJM* found the canagliflozin,a n antidiabetic drug belongs to SGLT2 cardiovascular, renal , hospitalization, and death events were the figure (see image).
which one of the following statement is correct bearing in mind of canagliflozin?
a. exacerbates albuminuria
b. causes cardiovascular death
c. increases the chance of fatal strokes
d. has protein effect agaisnt cardiovascular deaths
d. has protein effect agaisnt cardiovascular deaths
page 90
215
A 25 year old man with leukemia admitted to hematology oncology center.
Who is allowed to read the patient file without additional permission
a. patients 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
page
216
which of the following is the interpretation of P value of 0.05?
a. there is 0.05% probability that hte result are due to random chance
b. there is 5% probability that the results are due to random
c. there is 50% probability that the results are due to random
d. there is 95% probability that the results are due to random
b. there is 5% probability that the results are due to random
page 91
217
public health is the science of protecting the health of a community .
which population from the following list is their target?
a. people at risk of being sick
b. injured and sick people
c. mothers and children
d. entire community
d. entire community
page 91
218
a pharmacist is hired as in charged of controlled medication pharmacist made inventory record for controlled medications pharmacy before the old pharmacist left.
Which of the following is most likely to receive the original record?
a. pharmacy
b. hospital administration
c. medical record department
d. saudi food and drug authority
a. pharmacy
page 91
219
An elderly man presented to the emergency room with dizziness, consciousness and respiratory depression. He was recently medication for inability to sleep/
Which of the following medications is the most likely drug involved toxicity?
a. aspirin
b. naproxen
c. diazepam
d. acetaminophen
c. diazepam
page 91
220
watch the data at page 92.
a researcher reported the data (see image ).
what is the name of this chart?
a. pie chart
b. histogram
c. forest plot
d. funnel plot
b. histogram
page 92
221
a 55 year old man brought a prescription for oxycontin on april year. the script from doctor is dated December 17th of last year prescription allow five refills.
What quantity of fill (s) is / are to likely to be received by the patient?
a. 1 today + 1 refill
b. 0 today + 0 refill
c. 1 today + 2 refill
d. 1 today + 0 refill
a. 1 today + 1 refill
page 92
222
which of the following is an intercentional study?
a. cohort
b. ecological
c. case control
d. randomized clinical trial
d. randomized clinical trial
page 92
223
which of the following local organization's primary mission is to the safety and quality of healthcare institution?
a. Saudi central broad for accreditation of healthcare institution (CBAHI)
b. Saudi commission for health specialties (SCFHS)
c. Saudi Food and Drug Authority (SFDA)
d. Saudi pharmaceutical Society (SPS)
a. Saudi central broad for accreditation of healthcare institution (CBAHI)
page 92
224
which of the following is most likely to inhibit lactation?
a. prolactin
b. progestrone
c. growth hormone
d. chorionic somatomammotropin
b. progestrone
page 93
225
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
page 93
226
A 28 year old man was recently diagnosed with Crohn's was treated with high dose intravenous corticosteroids. She conversion to oral drugs and was started on Infliximab, a tumoun factor alpha ( TNf- alpha) inhibitor.
Which of the following tests should be performed prior to Infliximab?
a. HIV screening
b. Influenza screening
c. hepatitis C screening
d. tuberculosis screening
d. tuberculosis screening
page 93
226
A pharmacist working in impatient pharmacy received a request pharmacy therapeutic (P and T) committee to evaluate a included in the hospital formulary. The request wants to have the value in a monetary value (dollar value).
Which of the following pharmacoeconomics tools will the pharmacy to answer the request?
a. cost utility analysis
b. cost benefit analysis
c. cost minimization analysis
d. cost effectiveness analysis
b. cost benefit analysis
page 93
227
An ambulatory care phamacist received a prescription fo r(liraglutide) (REMS) , from Bariatric / Endocrine consultant as per medication under (REMS) should be provided to the patient with documents.
Which of the following is the meaning of (REMS) beside the name?
a. this medication has teratogenicity effect
b. this medication is under (restriction and elevation medication strategy)
c. this medication is under (Risk Evaluation and Mitigation
d. This medication is under ( Restriction Evaluation Medication is SFDA)
Risk Evaluation and Mitigation Strategies
page 94
228
to which of the following the major histocompatibility complex unique?
a. each cell
b. each organ
c. each species
d. each individual
a or D?
page 94
229
a hospital; conducted a pharmacovigilance (PV) activity to detected events after certain treatment, by asking patients directly and patient records.
which of the following is the type of PV activity conducted
a. active PV
b. passive PV
c. mandatory PV
d. spontaneous PV
a. active PV
page 94
230
which of the following means that individuals have the understand basic health information to make appropriate health
a. health literacy
b. cultural competency
c. communication skills
d. professional communication
a. health literacy
page 94
231
which of the following is a non essential amino acid?
a. lysine
b. valine
c. cysteine
d. isoleucine
c. cysteine
page 94
232
which of the following is a beta lactamase enzyme?
a. plasmid
b. pyrogens
c. DNA gyrase
d. carbapenemase
d. carbapenemase
page 95
233
which of the following age groups is inactivated polio recommended for infants less than 6 months old only?
a. immediately after birth
b. children up to 6 years old
c. children more than 10 years old
d. recommended for all age groups
b. children up to 6 years old
page 95
234
which one of the following measures can be classified as a central tendency?
a. confidence interval
b. standard deviation
c. sampling error
d. validity
b. standard deviation
page 95
235
which of the following Clostridia spp. is linked to the develop pseudomembranous colitis ?
a. C. tetani
b. C. difficile
c. C. botulinum
d. C. perfringens
b. C. difficile
page 95
236
researchers compare a group of people who have diabetres with of people who have no diabetes, and looks back in time to see characteristics of the two group differ.
Which of the following is the described study design ?
a. prospective cohort
b. case control
c. experimental
d. randomized clinical
b. case control
page 95
237
which of the following is the appropriate definished pharmacoepidemiology?
a. study of chronic diseases
b. the study of infectious disease in large populations
c. the study of the use of and effects of drugs in large number people
d. the study of the distribution and determinants of diseases populations?
c. the study of the use of and effects of drugs in large number people
page 96
238
a study that investigate if drinking coffee lead to coronary hear found that there is a correlation between two variables. However drinkers are more often smokers than the average and correlation between drinking smoking and incidence of heart disease.
Which of the following type of bias affect this study results?
a. measurement errors
b. Hawthorne effect
c. Information bias
d. confounding
d. confounding
page 96
239
which of the following hormones is responsible for milkf product mammary glands?
a. oxytocin
b. prolactin
c. Luteinizing hormone
d. follicle stimulating hormone
b. prolactin
page 96
240
where does 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
page 96
241
In pharamacoeconomics and outcomes research, QALYs are used utilities. QLY is the quality adjusters life year.
Whihch of the following is an interpretation of individual
a. death
b. coma
c. illness
d. perfect health
d. perfect health
page 96
242
which of the following is a common enzyme polymorphism that could potentially alter clopidogrel efficacy
a. Cyp 2c7
b. Cyp 2c9
c. Cyp2c10
d. Cyp2c19
d. Cyp2c19
page 97
243
which id the best treatemtn for staphylococcus aureus positive mastitis
a. Cephalexin
b. clindamycin
c. ciprofloxacin
d. nitrofurantoin
a. Cephalexin
page 97
244
which of the following infection be preventable using vaccine
a. HIV
b. varicella
c. brucellosis
d. hepatitis C
b. varicella
page 97
245
a 23 year old man has recen tly been started on phenytoin for the treatmetn of epilepsy. He is taking no other medication he has noted recently swelling and bleeding of the gum and wants to know if this might be drug related.
a. drug interaction facts
b. the Harriet lane handbook
c. Meylers side effects of drugs
d. natural medicine comprehensive database
c. Meylers side effects of drugs
page 98
246
a 73 year old man is diagnosed with osteoarthritis of the knee.
Which of the following is the best initial therapy?
a. Ibuprofen
b. Gaba pentin
c. acetaminophen
d. GLucosamine sulfate
c. acetaminophen
page 98
247
an 18 year old boy with a history of illicit drug use is suspected to have an overdose of benzodiazepines and is experiencing ataxia, drowsiness and nystagmus.
Which of the following would be the best antidote
a. activated charcoal 50 grams
b. flumazenil 300 mcg intravenously
c. naloxone 400 mcg intramuscularly
d. haloperinol 10 mg intramuscularly
b. flumazenil 300 mcg intravenously
page 98
248
which of the following lifestyle measures help in reducing chronic construction?
a. increasing physical activity
b. taking iron supplementation
c. drinking 4-5 cups od coffee daily
d. consuming more protein especially red meat
a. increasing physical activity
page 99
249
A 33 year old is woman with history of migraine and hypothyroidism. She is a nurse with one son and she is currently 15 weeks pregnant. She is considered about vaccinations and seeks your advice.
Which of the following vacciners is contraindicated?
a. hepatitis B
b. inactivated influenza
c. MME (measles , mumps and rubella)
d. tetanus ,diphtheria, and pertussis (Tdap )
c. MME (measles , mumps and rubella)
page 99
250
Whihc of the following group of drugs can prevent the progression of micro albuminuria to macro- albuminuria in patients with diabetes mel--.
a, angiotensin converting enzyme inhibitors
b. B blockers
c. diuretics
d. digitalis
a. angiotensin converting enzyme inhibitor
page 99
251
A nurse has an inquiry about the appropriate time to withdraw a through gentamicin level for a patient.
what is the best answer for her inquiry?
a. 1 hour after gentamicin administration
b. 30 minutes after gentamicin administration
c. 1 hour before the scheduled gentamicin dose
d. 30 minutes before the scheduled gentamicin dose
d. 30 minutes before the scheduled gentamicin dose
page 100
252
which of the following anti platelets is contraindicated patients with price transient ischemic attack (TIA) or stroke?
a. prasugrel
b. ticagrelor
c. clopidogrel
d. dipyridamole
a. prasugrel
page 100
253
in 80 year old female patient is admitted ho the hospital for pyeloneph _
with sepsis. Her past medical history includes myocardial infarction heart failure, hypertension and osteoporosis. She is initiated on trimethorpim / sulfanilamide(TMP/ SMX). Her other medication include lisinopril, digoxin , furosemide, carvedilol and calcium carbonate. Her labs are shown in the table (see lab result).
test
normal values
Blood urea nitrogen
2.8 to 8.9 mmol/l
result : 8.92
creatinine
44-115 umol/L
result: 81.41
whihc of the following is the best assessment fo rthis patients renal function
a. Her SCr is in the mornal range and no dosage adjustments are necessary
b. her SCr is in normal range bu her BUN is elevated, so dosage may need to adjusted
c. because of the pyelonephritis, she will have renal dysfunction, and dosages may need to be adjusted
d. because of her age, she will ahve some degree of renal disfunction and dosage may need to be adjusted
a. Her SCr is in the mornal range and no dosage adjustments are necessary
or
b. her SCr is in normal range bu her BUN is elevated, so dosage may need to adjusted
?
page 101
254
a 36 year old woman is her first trimester of pregnancy who is recently diagnosed with hypertension.
blood pressure 150/90 mmHg
heart rate 76 / min
respiratory 18/min
which of the following is the best and safest therapy?
a. aliskiren
b. captopril
c. valsartan
d. labetalol
d. labetalol
page 102
255
a 6 year old boy is diagnosed with pin worm infection.
Which of the following drugs should be used for treatment
a. mefloquine
b. doxycycline
c. albendazole
d. pyrimenthamine
c. albendazole
page 102
256
What is the recommended prophylactic therapy for pregnant women colonized with group B streptococcus in labor with penicillin allergies at high risk for anaphylaxis?
a. cefazoline
b. linezolid
c. penicillin G
d. clindamycin
d. clindamycin
page 102
257
which of the following section of a research paper describes the aims and objectives?
a. method
b. discussion
c. introduction
d. date analysis
c. introduction
page 103
258
a 65 year old man was diagnosed with type 2 diabetes five year age, meaintained on metformin. Which of the following need to be monitored?
a. vitamin C level
b. vitamin D level
c. vitamin B1 level
d. vitamin B12 level
d. vitamin B12 level
page 103
259
which of the following insulins has the longest duration of action?
a. aspart
b. detemir
c. glargine
d. degludec
d. degludec
page 103
260
which of the following reduces the risk of transmission of sexual disease?
a. spermicide
b. oral contraceptive
c. intrauterine device
d. male latex condom
d. male latex condom
page 104
261
whihc of the following instructions hould be provided to a patient receiving fentanyl transdermal patches
a. apply on area with fresh wound
b. avoid increase in body core temperature
c. store patches in the refrigerator to decrease stinging sensation
d. apply heating pads on the transdermal patch to improve absorption
b. avoid increase in body core temperature
page 105
262
a 33 year old woman who presents with complains of fatigue weigh gain. She is planning to become pregnant. She reported that she starts talking multivitgamin and suppleemnts her current medication is levothyroxine 100 mcg daily ( see lab result).
test
normal values
thyroid stimulating hormone
0.4-5.0u/mL
result: 6
Thyroxine ( T4 free serum)
8.5-15.2 pmol/L
result : 9
Which of the following is the dosage recommendations in (mcg) to take it daily for thyroid medication when dhe became pregnant?
a. levothyroxin-50
b. levothyroxine -75
c. levothyroxine -100
d. levothyroxine -125
d. levothyroxine -125
263
which of the following might develop in association with high serum amikacin?
a. bleeding
b. ototoxicity
c. liver failure
d. visual changes
b. ototoxicity
page 106
264
A 10 year old boy is brought with complaints for fever sore throat and non productive cough for 1 day.
Which of the following is best regimen for no productive cough?
a. codeine 10 mg 4 times daily
b. guafenesin 50 mg 4 times daily
c. dextromethorphan 15 mg twice daily
d. dextromethorphan 30 mg twice daily
d. dextromethorphan 30 mg twice daily
page 106
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