Big old exam

Question 1

Group of drugs that is universally applied in treatment of Congestive Heart Failure.

Answer 1

Cardiac Glycosides

Question 2

The pathological ventricular remodeling associated with congestive Heart Failure is thought to be most
effectively treated with:

Answer 2

Angiotensin II antagonists

Question 3

Coronary vasodilation mediated by Glyceryl trinitrate directly involves:

Answer 3

nitric-oxide-mediated synthesis of cyclic GMP

Question 4

drug that would be unlikely to improve oxygen supply to the area of the heart
receiving blood from a coronary artery that has been narrowed by atherosclerotic plaques.

Answer 4

Isofluorane

Question 5

You should always be prepared to handle a sudden rise in blood pressure as a result of epinephrine (in local
anesthetics) getting to the systemic circulation. However, the risk of such hypertensive emergency is particularly
high in patients treated with:

Answer 5

Non-selective beta-adrenergic antagonists

Question 6

The blood pressure-lowering effect of diuretics is potentiated by Angiotensin-Converting Enzyme (ACE) inhibitors
because ACE inhibitors prevent sodium reabsorption by indirectly inhibiting aldosterone release.

Answer 6

Both the statement and the reason are correct and related.

Question 7

Which of the following anti-hypertensive drugs should be withdrawn immediately upon learning that the patient is
pregnant?

Answer 7

Losartan

Question 8

The best drug choice for hypertensive emergencies (i.e. sudden, large-amplitude increases in arterial blood
pressure) would be:

Answer 8

Sodium nitroprusside

Question 9

When prescribing anti-hypertensive medication to a patient who suffers from asthma, you should definitely avoid

Answer 9

Propranolol

Question 10

In vasodilatory shock (i.e. a sudden relaxation of the vascular smooth muscle and the resulting drop in arterial
blood pressure), the most effective treatment would involve:

Answer 10

Vasopressin

Question 11

Please identify the diuretic that is most likely to exacerbate metabolic or respiratory acidosis and, due to this side
effect, is contraindicated in severe chronic obstructive pulmonary disease (COPD).

Answer 11

Acetazolamide

Question 12

Loop diuretics are highly efficacious and particularly useful for treatment of pulmonary edema because the
potassium-sparing feature of loop diuretics results in a decreased left ventricular filling pressure (i.e. preload).

Answer 12

The statement is correct, but the reason is not.

Question 13

The best initial therapy of uncomplicated hypertension involves

Answer 13

Hydrochlorothiazide

Question 14

Matching:

Spironolactone acts where

Answer 14

Aldosterone receptors in the Collecting Duct

Question 15

Which of the following drugs irreversibly inactivates cyclooxygenase 1:

Answer 15

Aspirin

Question 16

It is important to monitor renal function when dosing which drugs:

Answer 16

Dabigatran

Question 17

If bleeding occurs when a patient is taking dabigatran it can be quickly reversed with an intravenous injection of:

Answer 17

Idarucizumab

Question 18

Aspirin, heparin, clopidogrel and rivaroxaban all have actions that will limit thrombus formation. Which of the
following statements correctly describes these agents pharmacodynamic target and mechanism.

A: Clopidogrel irreversibly modified the platelet cell surface receptor for ADP.

B: Heparin prevents the generation of reduced vitamin K and the subsequent carboxylation of glutamic acid residues in clotting

factors.

C: Aspirin interacts reversibly with platelet cyclooxygenase 1 and prevents the production of thromboxane.

D: Rivaroxaban irreversibly binds to factor Xa and prevents the activation of prothrombin.

Answer 18

Clopidogrel irreversibly modified the platelet cell surface receptor for ADP.

Question 19

Which of the following drugs can be monitored with the INR but dosing does not require routine testing?

Answer 19

Rivaroxaban

Question 20

Which of the following drugs is selective for inhibition of factor Xa but requires anti-thrombin III for activity?

Answer 20

Fondaparinux

Question 21

Which drug is a direct thrombin inhibitor

Answer 21

Dabigatran

Question 22

An overdose of which of the following drugs can be treated with protamine?

Answer 22

Heparin

Question 23

new patient arrives at your clinic for an extraction. The patient was treated for deep vein thrombosis with
subcutaneous enoxaparin and started on oral warfarin therapy. She was instructed to return to her doctor in 3
days. Why was this patient treated with enoxaparin in addition to warfarin?

Answer 23

Warfarin’s pharmacological effect on the inhibition of clotting factor activation in not manifested for 3-4 clotting factor half lives.

Question 24

Propofol is known to cause:

Answer 24

Obtundation

Question 25

Which of the following is a known effect of Ketamine?

Answer 25

Bronchodilation

Question 26

The reversal agent for benzodiazepines is:

Answer 26

Flumanezil

Question 27

The ideal benzodiazepine to administer to an anxious patient undergoing a short dental procedure is:

Answer 27

Triazolam (Halcion)

Question 28

Benzodiazepines exert their pharmacologic effect at the ____________ receptor.

Answer 28

GABA

Question 29

significant adverse effect of Halothane is:

Answer 29

Increased risk of cardiac arrhythmia

Question 30

The ideal agent to use for inhalation induction of general anesthesia due to lack of pungency and its minimal cardiovascular impact is:

Answer 30

Sevoflurane

Question 31

Which statement best describes the relevance of MAC (Minimal Alveolar Concentration)?

Answer 31

A high MAC correlates with low potency of an anesthetic gas.

Question 32

The statement which correctly describes the relevance of the blood:gas coefficient is:

A: A low blood: gas coefficient correlates with low solubility and therefore, slow onset.

B: A low blood:gas coefficient correlates with low solubility and therefore, fast onset.

C: A high blood:gas coefficient correlates with high solubility, and therefore, slow onset.

D: A high blood:gas coefficient correlates with high solubility, and therefore, fast onset.

Answer 32

A low blood:gas coefficient correlates with low solubility and therefore, fast onset.

Question 33

Which of the following is an antiepileptic drug that is also used to treat anxiety

A: Gabapentin
B: Diazepam
C: Phenytoin
D: Buspirone
E: Valproic acid

Answer 33

Diazepam

Question 34

Which of the following is an antiepileptic drug that acts by binding to the presynaptic Na+ channel

Answer 34

Phenytoin

Question 35

Carbidopa is often prescribed together with Levodopa. Which of the following is NOT true:

B: Carbidopa reduces peripheral adverse effects of Levodopa
C: Levodopa crosses the Blood Brain Barrier, Carbidopa does not.
D: Levodopa is a dopamine receptor agonist
E: Ropirinole is an alternative antiparkinson therapy.

Answer 35

Levodopa is a dopamine receptor agonist

Question 36

Among the drugs a patient indicates they are taking are haloperidol and an anticholinergic. Which one of the
following statements is true

A: The anticholinergic is to treat dry mouth, caused by Haloperidol
B: The anticholinergic is to reduce the Extrapyramidal dysfunction caused by Haloperidol
C: Haloperidol is effective against positive and negative symptoms of schizophrenia
D: The patient is confused, Haloperidol and anticholinergics are contraindicated, since anticholinergics would enhance
Haloperidol’s adverse effects
E: Haloperidol is a tricyclic

Answer 36

The anticholinergic is to reduce the Extrapyramidal dysfunction caused by Haloperidol

Question 37

Which of the following is not a symptom of Schizophrenia or its treatment

A: Dyskinesia (involuntary movements)
B: Hallucinations
C: Disorganized speech
D: Social isolation
E: Absence seizures (brief, sudden lapses of consciousness)

Answer 37

Absence seizures (brief, sudden lapses of consciousness)

Question 38

Which of the following is the first line treatment for bipolar disorder

Answer 38

Lithium

Question 39

Which of the following is NOT an anti-cholinergic side effect

A: Dry mouth and caries
B: Dry skin
C: Constipation
D: Small pupils
E: Urinary retention

Answer 39

Small pupils

Question 40

Which of the following statements is true:

A: Fluoxetine and Sertraline are Tricyclics
B: Buprion and Duloxetine are SSRI
C: Paroxetine inhibits CYP450 hepatic enzymes
D: Lithium is the first line treatment for major depression
E: Monamine oxidase inhibitors are the first line treatment for major depression

Answer 40

Paroxetine inhibits CYP450 hepatic enzymes

Question 41

Which of the following antidepressants has anticholinergic effects:

Answer 41

Imipramine

Question 42

Which of the following does not contain a drug binding site?

A: Presynaptic Ca2+ channels
B: Synaptic vesicle release machinery
C: Plasma membrane
D: Presynaptic neurotransmitter receptors
E: Postsynaptic neurotransmitter receptors

Answer 42

Plasma membrane

Question 43

Which of one of the following statements is TRUE:
A: An action potential hyperpolarizes the synaptic terminal
B: The change in transmembrane potential induced by the action potential activates calcium channels
C: Calcium exits the synaptic terminal through calcium channels
D: Calcium entry stimulates the release of neurotransmitter from the cytoplasm
E: SSRI inhibit vesicular transporters

Answer 43

The change in transmembrane potential induced by the action potential activates calcium channels