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Pharmacology > Pharmacology 201-500 > Flashcards

Pharmacology 201-500 Flashcards

1
Q 
Which of the following chemotherapeutic drugs may be used for Lentigo Maligna?
A.    Actinomycin
B.    Bleomycin
C.    Doxorubicin
D.    Vinblastine
E.    Cisplatin
A

A

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2
Q 
Which of the following chemotherapeutic drugs may be used for Lung Cancer?
A.    Procarbazine
B.    Cytarabine
C.    Topotecan
D.    Cisplatin
E.    Cyclophosphamide
A

D

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3
Q 
Which of the following drugs is an effective prophylactic drug against migraine headache attacks?
A.    Ondansetron
B.    Sumatriptan
C.    Ergotamine
D.    Methylergonovine
E.    Propranolol
A

E

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4
Q 
A newly formulated drug with a half life of 6 hours is eliminated via 1st order kinetics, how many hours will the drug be 100% eliminated from the body of a normal person?
A.    6 hours
B.    12 hours
C.    18 hours
D.    24 hours
E.    36 hours
A

D
100% elimination will be reached in 4
half lives. (6 x 4=24)

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5
Q 
In calculating the loading dose of a drug, which of the following parameters are not necessary?
A.    Volume of distribution
B.    Desired Plasma Concentration
C.    Bioavailability
D.    Clearance
E.    None of the Above
A

D

LD = (Vd x DPC) / Bioavailability

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6
Q 
Which of the following is a reversible inhibitor of Xanthine Oxidase used in Chronic Gout?
A.    Allopurinol
B.    Colchicine
C.    Febuxostat
D.    Mycophenolate Mofetil
E.    Probenecid
A

C

Allopurinol is an IRREVERSIBLE Xanthine Oxidase inhibitor, Febuxostat is a REVERSIBLE Xanthine Oxidase inhibitor,

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7
Q 
A patient will be undergoing neurosurgery, the neurosurgeon would like to maintain the patient's consciousness while the procedure is on going. What would be the preferred anesthetic of choice?
A.    Ketamine
B.    Etomidate
C.    Midazolam
D.    Fentanyl
A

A

Ketamine is capable of Dissociative Anesthesia ( Analgesia, Amnesia and Catatonia with retained consciousness)

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8
Q 
A 14 year old child was diagnosed with Schizophrenia, which of the following is the only antipsychotic approved for pediatric patients?
A.    Clozapine
B.    Risperidone
C.    Quetiapine
D.    Olanzapine
E.    Thioridazine
A

B

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9
Q

The following statements are true of Aminoglycosides, EXCEPT:
A. Act by TimeDependent Killing Action
B. As the plasma level is increased above the MIC an increasing proportion of bacteria are killed and at a more rapid rate
C. Has a post-antibiotic eff

A

A

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10
Q 
Among the following Anti-arrhythmics, which of the following has a highest potential for Torsade de pointes?
A.    Lidocaine
B.    Propranolol
C.    Sotalol
D.    Procainamide
E.    Verapamil
A

C
K channel blockers like Sotalol can increase the QT interval thereby increasing the propensity to develop Torsade de Pointes

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11
Q

A patient with CHF was rushed to the ED where you are on-duty, ABG was done revealing Metabolic Acidosis. His wife told you that he had a history of severe allergic reaction to Sulfa drugs, but you need to give the patient a powerful diuretic, Unfortunate

A

D
Spironolactone and Acetazolamide can aggravate the ongoing acidosis of the patient, the only ones left are loop diuretics, but then Furosemide and Torsemide are both Sulfa containing hence cannot be given to the patient. Ethacrynic acid is most suitabl

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12
Q 
To improve the quality of life of patients with on-going treatment for Prostate Adenocarcinoma with Leuprolide, which of the following medications should be added?
A.    Anastrazole
B.    Examestane
C.    Flutamide
D.    Prednisone
E.    Morphine
A

C
Flutamide an Androgen Antagonist is given in adjunct to Leuprolide to lessen the side effects of Leuprolide like Gynecomastia, decreased libido, Apoplexy and hot flushes.(SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE)

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13
Q

A 9-year old Filipino child was brought to you in the clinics by her mother due to an observed blank-stare episodes noted by her mother which lasts from a few seconds to a few minutes. Which of the following medications is the most suitable for this patie

A

A
Valproate is the DOC for Absence Seizures, most especially in our setting here in the Philippines, Ethosuximide is NOT commercially available.

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14
Q 
Which of the following Beta Blockers has an Intrinsic Sympathomimetic Activity?
A.    Carvedilol
B.    Pindolol
C.    Nadolol
D.    Metoprolol
E.    Timolol
A

B

Pindolol has ISA, which makes it a B blocker with a partial Alpha agonist action.

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15
Q

Early morning hypoglycemia is a challenge among physicians in treating diabetic patients. When a diabetic patient monitors his Glucose at 3 AM revealing Hypoglycemia with a Hyperglycemic 7 AM CBG, This effect is termed as:
A. Somogyi
B. Waning
C.

A

A

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16
Q 
In a patient with Grave's Disease this drug is given to decrease peripheral conversion of T4 to T3:
A.    Propranolol
B.    I 131
C.    Methimazole
D.    PTU
E.    Lugol's Iodine
A

A

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17
Q 
In a Diabetic patient with impaired renal function which of the following drugs is contraindicated?
A.    Nateglinide
B.    Glipizide
C.    Metformin
D.    Pioglitazone
E.    Acarbose
A

B
Before prescribing 2nd generation Sulfonylureases liver and hepatic function must be checked first because they are contraindicated.

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18
Q 
Which of the following Cephalosporins is synergistic with Aminoglycosides?
A.    Cefazolin
B.    Cefaclor
C.    Cefixime
D.    Cefipime
E.    Loracarbef
A

C
3rd gen Cephalosporins have syndergistic effects with Aminoglycosides, 1st and 2nd gen cephalosporines can increase nephrotoxic effects of aminoflycosides.

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19
Q 
What class of antihypertensive drugs are also used in BPH?
A.    Alpha 1A Agonists
B.    Alpha 1B Agonists
C.    Alpha 1A Antagonists
D.    Alpha 1B Antagonists
E.    Alpha 2 Agonists
A

C
Alpha 1-A receptor is specifically seen in the Urinary tract most especially the Prostate.Alpha 1A antagonists/Quinazolines include Prazosin Terazosin, and Tamsulosin

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20
Q

Cocaine has which of the following mechanism of action?
A. Promotes Adrenergic Synthesis
B. Inhibits Adrenergic Storage
C. Promotes Adrenergice Release
D. Inhibits Adrenergic Metabolism/Degradation
E. Inhibits Adrenergic Reuptake

A

E

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21
Q

A condition where there is depletion of needed substrates as a result of continuous activation by a drug and hence decrease in responsiveness, such as in chronic nitroglycerin use, is known as:
A. Tachyphylaxis
B. Idiosyncratic response
C. Tolera

A

C
Idiosyncratic means unusual drug reponse, infrequently observed in most patients; tolerance on the other hand, refers to decrease in the intensity of response to drug as a consequence of continued administration

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22
Q 
Teratogenesis is one of the dreaded complications of improper use of drugs during pregnancy. Of note, lithium, a drug primarily used to treat bipolar disorders, can cause:
A.    Ebstein's anomaly
B.    Vaginal clear cell adenocarcinoma
C.    Phocomelia
D.
A

A

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23
Q

Pralidoxime is an antidote to organophosphate poisoning. Which of the following is not true about this drug?
A. It is a cholinesterase regenerator.
B. It requires to be given 6-8 hours before organophosphatecholinesterase binding occurs.
C. It binds wi

A

E

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24
Q

Methyldopa is a drug of choice in treating preeclampsia. Its ability to lower blood pressure is based on its action of:
A. Activating alpha-1 adrenergic receptors
B. Inhibiting alpha-1 adrenergic receptors
C. Activating alpha-2 adrenergic recepto

A

C
Activation of alpha-2 adrenergic receptors by methyldopa metabolites in the brainstem appears to inhibit sympathetic nervous system output and lower blood pressure. This is also the mechanism of action of clonidine. Activation of alpha-1 adrenergic rec

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25
Q 
Hydralazine lowers BP by causing arteriolar smooth muscle relaxation. This effect is achieved by its ability to alter metabolism of which ion?
A.    Sodium
B.    Potassium
C.    Magnesium
D.    Calcium
A

D

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26
Q 
Throbbing headaches in patients taking nitrates are mainly attributed to:
A.    Chemical toxicity
B.    Meningeal artery vasodilation
C.    Reflex tachycardia
D.    Abrupt lowering of BP
A

B

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27
Q 
Which diuretic is found to have long-term benefits and can reduce mortality in chronic heart failure?
A.    Thiazide
B.    Furosemide
C.    Spironolactone
D.    Ethacrynic acid
A

C

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28
Q

Aside from its lipidlowering action, statins are used in coronary artery disease because it can also:
A. Vasodilate stenotic segments of the coronary
B. Stabilize atherosclerotic plaques
C. Inhibits platelet aggregation
D. Decrease myocardial oxygen d

A

B

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29
Q 
Which of the following is considered as a reliever of asthma rather than a controller?
A.    Montelukast
B.    Cromolyn
C.    Omalizumab
D.    Terbutaline
A

D
Terbutaline is a beta-2 receptor agonist used as a fast-acting bronchodilator for asthma and is also used in preventing premature labor (tocolysis).

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30
Q 
Oral chelation treatment in hemochromatosis can be done by giving:
A.    Deferoxamine
B.    Deferasirox
C.    EDTA
D.    Penicillamine
A

B
Therapeutic phlebotomy is the main line of treatment of hemochromatosis, especially the primary type. Should chelation becomes warranted, it can be done via IV (deferoxamine) or oral (Deferasirox).

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31
Q

Aspirin toxicity results in increased respiratory drive that leads to hyperventilation and respiratory alkalosis. Which of these statements is not true about aspirin intoxication?
A. It is achieved when given at a dose of 150 mg/kg.
B. It can manifes

A

C
Aspirin is not an inhibitor of electrontransport chain (ETC), but an uncoupler. Uncouplers of oxidative phosphorylation in mitochondria inhibit the coupling between the electron transport and phosphorylation reactions and thus inhibit ATP synthesis wit

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32
Q

Tranexamic acid is used to prevent and treat acute bleeding episodes in patients who are at high risk, especially those who have hemophilia and intracranial aneurysms. The mechanism of action of this drug involves:
A. Inhibition of plasminogen activators

A

A
Plasminogen are converted to plasmin whose function is to lyse the formed fibrin. When it is inhibited, hemostasis is promoted.

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33
Q 
Treatment for inflammatory bowel disease:
A.    Sulfadiazine
B.    Sulfasalazine
C.    Sulfamethoxazole
D.    Sulfatide
A

B
Sulfasalazine is poorly absorbed in the GIT and therefore it is believed that it has its main action in lumen. It is used to treat IBDs by reducing the synthesis of inflammatory mediators known as eicosanoids and inflammatory cytokines. However, unlike

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34
Q 
Remarkable to these drugs is their ability to inhibit cytochrome P450 causing significant interactions with other drugs, except:
A.    Isoniazid
B.    Cimetidine
C.    Erythromycin
D.    Barbiturates
A

D

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35
Q 
Drugs like quinidine, procainamide and disopyramide are very useful in treatment of:
A.    Congestive heart failure
B.    Hypertension
C.    Thyrotoxicosis
D.    Status asthmaticus
E.    Arrhythmia
A

C

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36
Q

Antifolates sulfamethoxazole and trimethoprim are bactericidal by virtue of their synergistic actions. Nonetheless, resistence can develop via plasmidmediated:
A. Decrease in sensitivity of dihydropteroate synthase to sulfonamides
B. Increase in PABA sy

A

D

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37
Q

Isoniazid is the most important drug used in TB. It inhibits mycolic acid synthesis and is therefore bactericidal. Possible adverse effects include neuritis, insomnia and seizures. To prevent neurotoxicities, patient should be supplemented with:
A. Fol

A

B

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38
Q 
What is the drug of choice for the cyst carrier state of Entamoeba histolytica?
A.    Diloxanide furoate
B.    Metronidazole
C.    Tinidazole
D.    Paramomycin
A

A
Diloxanide furoate is a luminal amoebicide which is hydrolysed in the gut, thus releasing the free diloxanide which acts as an amoebicide. It is given alone in asymptomatic cyst passers. For patients with active amoebic infections, it can be administer

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39
Q 
A vinca alkaloid acting primarily in the M phase of cancer cell cycle that is useful in the treatment of acute leukemias, lymphomas and neuroblastoma:
A.    Paclitaxel
B.    Vincristine
C.    Doxorubicin
D.    Cytarabine
A

B

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40
Q 
This is a mucosal protective drug used as an adjunct treatment of PUD. It binds to injured tissues and forms a protective covering over ulcer beds, resulting in accelerated healing:
A.    Misoprostol
B.    Bismuth salicylate
C.    Calcium carbonate
D.
A

D

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41
Q 
Factor/s that influence/s passage of drugs through cell membranes: 
A. Presence of pores in the membrane 
B. Amount of protein binding
C. Lipid solubility 
D. pH 
E. All of the above
A

E
All are factors that influence passage of drugs through cell membranes. Lipid solubility is the most important limiting factor for permeation of drugs because cells are covered by lipid membranes.

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42
Q 
In this clinical phase of drug development, the drug is studied in patients with the target disease to determine its efficacy:
A.    Phase 0
B.    Phase 1
C.    Phase 2
D.    Phase 3
E.    Phase 4
A

C
Phase 1 trial involves evaluation of doseresponse relationship and pharmacokinetics in normal volunteer patients with target disease. Phase 2 trial involves determination whether the agent has the desired efficacy at doses that are tolerated by sick pa

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43
Q

The most important pharmacologic action of digitalis in the treatment of heart failure is its ability to:
A. Increase heart rate
B. Reduce venous pressure
C. Reduce arterial pressure
D. Produce diuresis in edematous patients
E. Increase myocardia

A

E
The most important pharmacologic action of digitalis in the treatment of heart failure is its ability to increase myocardial contractile force by inhibiting Na/K ATPase and increaseing intracellular calcium.

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44
Q

Reserpine blocks this step of adrenergic transmission:
A. Synthesis of the neurotransmitter
B. Transport of neurotransmitter to vesicles
C. Release of the neurotransmitter
D. Reuptake into the presynaptic neuron
E. Diffusion in the synaptic cleft

A

B

Reserpine blocks vesicular transport in adrenergic transmission.

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45
Q

A 25 year-old farmer was brought to the emergency room after having allegedly drank a poison. PE revealed that he had constricted pupils, excessive salivation and sweating, wheezing and had several bouts of vomiting and diarrhea. He was given antidotes At

A

E
Pralidoxime is a cholinesterase regenerator, an antidote for organophosphate poisoning. Pralidoxime is an example of chemical antagonism. Chemical antagonism is when an antagonist directly interacts with the drug being antagonized to remove it or preve

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46
Q 
It is the major second messenger of beta receptor activation that participates in signal transduction:
A.   Inositol triphosphate
B.    cAMP
C.    cGMP
D.    Calcium
E.    Adenylyl cyclase
A

B

cAMP is the major second messenger of beta receptor activation that participates in signal transduction.

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47
Q

A neonate was given IV antibiotics for 3 days. However, the baby developed hypothermia associated with diarrhea and grayish color of the skin. What is the mechanism of action of the drug that was given to the baby?
A. Inhibits transpeptidation in bacteri

A

C
Chloramphenicol is the drug that was given to neonate causing gray baby syndrome. It inhibits transpeptidation at 50s subunit and it is bacteriostatic. Penicillin inhibits transpeptidation in bacterial cell walls. Aminoglycoside inhibits protein synthe

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48
Q 
It is a drug that is used almost solely as an alternative treatment for gonorrhea in patients whose gonococci are resistant to other drugs is:
A.    Docycycline
B.    Spectinomycin
C.    Ofloxacin
D.    Azithromycin
E.    Tetracycline
A

B
Spectinomycin is an aminoglycoside that inhibits protein synthesis by binding to 30s subunit. It is the drug of choice of drug-resistant gonorrhea and for gonorrhea in penicillin-allergic patients.

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49
Q 
Drugs like quinidine, procainamide and disopyramide are very useful in treatment of:
A.    Congestive heart failure
B.    Hypertension
C.    Thyrotoxicosis
D.    Status asthmaticus
E.    Arrhythmia
A

E

Drugs like quinidine, procainamide and disopyramide are very useful in treatment of arrhythmia.

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50
Q 
It is an anticonvulsant that is effective for neuropathic pain:
A.    Valproic acid
B.    Gabapentin
C.    Phenytoin
D.    Duloxetine
E.    Levetiracetam
A

B
Gabapentin is an anticonvulsant drug, a GABA derivative which blocks calcium channels, increases GABA release, very useful in neuropathic pain also in postherpetic neuralgia.

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51
Q

A 43 year-old male was diagnosed with Pulmonary Tuberculosis. He was given Anti-TB medications. However, he developed hyperuricemia. Which among these drugs inhibits the excretion of urate causing the above findings:
A. Ethionamide
B. Streptomycin
C

A

D

Pyrazinamide provoke avute gouty arthritis by inhibiting urate excretion.

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52
Q

A 28 year-old woman wanted to get pregnant. A substance that enhances probability of ovulation by blocking the inhibitory effect of estrogen and thus stimulating the release of gonadotrophin from the pituitary is:
A. Tamoxifen
B. Danazol
C. Clomi

A

C
Clomiphene citrate enhances probability of ovulation by blocking the inhibitory effect of estrogen and thus stimulating the release of gonadotrophin from the pituitary.

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53
Q

Upon taking Penicillin, a 20 year-old male suddenly experienced respiratory distress. A drug would be most helpful to treat the respiratory symptoms was given in this patient. In comparison to norepinephrine, epinephrine has more effects on:
A. alpha 1

A

D
Epinehrine is a sympathomimetic, nonselective and direct-acting. It is helpful in patients with anaphylactic shock. Respiratory distress is treated by Epinephrine’s action on beta 2 receptors resulting to bronchodilation.

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54
Q

Warfarin is prescribed to a 40 year-old male. The excessive anticoagulant effect results to bleeding in this patient can be reversed by:
A. Administration of vitamin K
B. Administration of fresh frozen plasma
C. Discontinuance of the drug
D. A

A

E

Bleeding with warfarin can be reversed by administration of Vitamin K, FFP and by discontinuance of the drug.

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55
Q 
An anticancer agent that is prescribed for melanoma:
A.    Carmustine
B.    Cytarabine
C.    Vincristine
D.    Vinblastine
E.    Cisplatin
A

A

Carmustine is an alkylating agent, cell cycle non-specific that is given for melanoma.

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56
Q 
An antihelminthic agent for strongyloidiasis:
A.    Nifurtimox
B.    Praziquantel
C.    Ivermectin
D.    Diethylcarbamazine
E.    Niclosamide
A

C
Ivermectin is the drug of choice for strongyloidiasis. It intensifies GABAmediated neurotransmission in nematodes and immobilizes parasites.

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57
Q

A 60 year-old female patient was diagnosed with breast cancer. She was given an alkylating agent, Cyclophosphamide. Later in the treatment, she developed hemorrhagic cystitis due to this toxic metabolite:
A. Amifostine
B. Acrolein
C. Mercaptopuri

A

B

Acrolein is the metabolite of Cyclophosphamide that causes hemorrhagic cystitis.

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58
Q 
Chlorpromazine may be used not only in treating schzophrenia but is also effective in:
A.    Reducing nausea and vomiting
B.    Allergies
C.    Hypertension
D.    Treating bipolar disorders
E.    Sleep disorders
A

A
Chlorpromazine may be used not only in
treating schzophrenia but is also effective
in reducing nausea and vomiting.

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59
Q 
The best treatment option for an obese patient with Type 2 Diabetes Mellitus is:
A.    Glibenclamide
B.    Metformin
C.    Repaglinide
D.    Acarbose
E.    Insulin
A

B

Metformin is a biguanide which is the first-line treatment for Type 2 DM, also a drug of choice for obese diabetics.

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60
Q 
A 10 year-old child with asthma was prescribed with a drug which inhibits binding of leukotriene D4 to its receptor on target tissues. The drug prescribed is:
A.    Zileuton
B.    Ipratropium
C.    Montelukast
D.    Omalizumab
E.    Theophylline
A

C
Montelukast blocks leukotriene receptor for leukotrienes C4, D4, E4 preventing airway inflammation and bronchoconstriction in asthmatic patients.

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61
Q 
The most dangerous hallucinogenic agent.
A.    LSD
B.    phencyclidine
C.    MDMA
D.    cocaine
E.    Marijuana
A

B

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62
Q

A 50 year old smoker, hypertensive patient complained of 2 month cough and dyspnea. He was on Carvedilol for his hypertension. What is the side effect of this drug that aggravates the condition.
A. bronchospasm
B. bronchoconstriction
C. tachycard

A

A

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63
Q 
Mr. X was maintaining an unrecalled drug for the past few months. He is now complaining of visual changes or "yellow halo vision". What is the drug that is known to cause such effect?
A.    amiodarone
B.    ethambutol
C.    digoxin
D.    furosemide
E.
A

C

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64
Q 
A 45 year old male complained of chest pain upon exertion but relieved by rest. The doctor prescribed him a beta blocker. What is the effect of beta blocker?
A.    Increase oxygen supply
B.    Decrease oxygen demand
C.    Increase oxygen demand
D.    decr
A

B
drugs used in angina pectoris are the following: those that increase the oxygen supply are: nitrates and calcium blockers; those that decrease the oxygen demand are: beta blockers and still calcium blockers

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65
Q 
Monday disease is caused by occupational exposure to:
A.    lead
B.    dust
C.    arsenic
D.    nitrates
E.    Gun powder
A

D

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66
Q 
What is the predominant form of a weakly acidic drug with pKa of 5 at physiologic pH?
A.    Unprotonated charged
B.    Protonated charged
C.    Unprotonated uncharged
D.    Protonated uncharged
E.    None of the choices
A

A
The physiologic pH is at 7.35-7.45 which is above the pKa of this drug 5. At pH above pKa, weakly acidic drug is predominantly unprotonated charged, if it is below pKa, the predominant form is protonated uncharged.

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67
Q 
It is the flow or transfer of a drug to the bloodstream.
A.    distribution
B.    bioequivalence
C.    absorption
D.    bioavailability
E.    Elimination
A

C
Absorption is the transfer of a drug to the bloodstream. Distribution is the entry of a drug to the target organ. Elimination is the termination of drug action. Bioavailability is the fraction of a drug that reaches the systemic circulation. Bioequival

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68
Q 
What type of muscarinic receptors is used by the heart?
A.    M1
B.    M2
C.    M3
D.    N1
E.    N2
A

B

M1 - nerve endings, M2-heart, M3 - smooth muscle, glands, endothelium

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69
Q 
Rivastigmine is used for:
A.    Motion sickness
B.    Myasthenia gravis
C.    Schizophrenia
D.    Parkinson's disease
E.    Alzheimer's disease
A

E

Rivastigmine is a cholinomimetic drug used for Alzheimer’s disease.

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70
Q 
The drug that is used for cardiogenic shock as a last resort
A.    epinephrine
B.    dopamine
C.    dobutamine
D.    norepinephrine
E.    Vasopressin
A

D

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71
Q 
A 58 year old male hypertensive was diagnosed with benign prostatic hyperplasia. What is the antihypertensive drug that is the most selective for prostatic smooth muscle?
A.    prazosin
B.    tamsulosin
C.    losartan
D.    metoprolol
E.    Terazosin
A

B
Alpha1 blockers are antihypertensive that is also used for BPH. Prazosin, tamsulosin, and terazosin are alpha1 blockers, but the most selective for prostatic smooth muscle is tamsulosin

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72
Q

A 75 year old male diabetic, hypertensive and a diagnosed case of CHF came in due to edema and dyspnea. If the patient had hypokalemia, a potassium sparing diuretic is indicated. This potassium sparing diuretic inhibits ENaC - epithelial sodium channel in

A

E
Spironolactone, triamterene, and amiloride are all potassium sparing diuretic. Triamterene and amiloride inhibit the ENaC of collecting duct, while spironolactone inhibits aldosterone receptor in collecting ducts.

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73
Q 
A 100kg male patient had elevated LDL and VLDL. What vitamin is also used as antihyperlipidemic drug?
A.    Vitamin A
B.    pyridoxine
C.    niacin
D.    resin
E.    Cholestyramine
A

C

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74
Q 
What is the drug of choice for paroxysmal supraventricular tachycardia?
A.    Esmolol 
B.    adenosine
C.    verapamil
D.    Sotalol 
E.    Any of the choices
A

B
Esmolol, sotalol, verapamil are all used for the treatment of supraventricular tachycardia. For paroxysmal supraventricular tachycardia, the drug of choice is adenosine.

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75
Q 
A 10 year old child, known asthmatic had episodes of nocturnal asthma attacks approximately 2- 3x/week. In order to prevent subsequent attack, what drug is used for prophylaxis against nocturnal attack?
A.    Salbutamol + 
Ipratropium
B.    Salbutamol
C.
A

E
Salbutamol is the druig of choice for acute asthma attack, while aminophylline is used for prophylaxis against nocturnal attacks.

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76
Q

A 4 year old child, febrile at 38deg. C was given Paracetamol at 15mkd. What is the mechanism of action of this drug?
A. COX-2 selective inhibitor
B. IL-1 and IL-6 inhibitors
C. COX-3 selective inhibitor
D. Irreversible COX-1 and COX-2 inhibi

A

C
Paracetamol or acetaminophen selectively inhibits COX-3. COX-2 selective inhibitors are coxib such as celecoxib. Irreversible COX-1 and 2 inhibitor is aspirin. TNF - ? inhibitors are infliximab, adalimumab and etanercept.

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77
Q 
One of the choices does not belong to the third generation cephalosporins.
A.    cefotaxime
B.    ceftazidime
C.    ceftriaxone
D.    cefoxitin
E.    Ceftizoxime
A

D

All of the choices except cefoxitin are all third generation cephalosporin. Cefoxitin is a second generation.

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78
Q

A 32 year old G2P1 mother delivered a live term baby Boy with an upturned nose, mild midfacial hypoplasia, long upper lip, and lower distal digital hypoplasia. Upon review of maternal history, the mother was taking an anti-epileptic drug. The drug that is

A

A
The physical description of the neonate is consistent with fetal hydantoin syndrome which is the side effect of phenytoin

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79
Q 
A 50 year old obese patient was diagnosed to have DM type 2. There were no other comorbidities. What hypoglycemic drug should you prescribed with this patient?
A.    Insulin 
B.    Gliclazide 
C.    Metformin 
D.    Pioglitazone 
E.    Sitagliptin
A

C
Metformin is the first line treatment for type 2 DM and is the drug of choice for obese patients. It is contraindicated in patients with renal disease,

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80
Q 
Penicillin is the drug of choice for syphilis. It acts through:
A.    Inhibition of transpeptidase
B.    Inhibition of topoisomerase II
C.    Inhibition of glucan synthase
D.    Inhibition of D-alaD-ala terminus
E.    None of the choices
A

A
Penicillin inhibits transpeptidase enzyme needed for the bacterial cell wall synthesis. Vancomycin inhibits D-ala D ala synthase. Caspofungin inhibits glucan synthase. Flouroquinolone inhibits topoisomerase II and IV.

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81
Q 
Marc, an asthmatic, is on theophylline. He has a number of other medical conditions. Which of the following medications may be safely administered with theophylline?
A.    Penicillin
B.    Erythromycin
C.    Phenytoin
D.    Rifampicin
A

A
Theophylline has a narrow therapeutic window and drug interactions can lead to severe morbidity. Erythromycin decreases the clearance of theophylline and increases its serum levels. Phenytoin and rifampicin have the oppositve effect. Advice: Memorize t

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82
Q 
What is the maximum dose of Vincristine?
A.    100 micrograms
B.    200 micrograms
C.    1 milligram
D.    2 milligrams
A

D

SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE

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83
Q 
A pregnant patient complains of multiple external genital warts. Which of the following agents can be used in this patient?
A.    Podofilox solution
B.    Imiquimod cream
C.    Trichloroacetic acid
D.    Sinecatechins ointment
A

C
The most common treatments for genital warts in pregnancy are cryotherapy, laser removal, and trichloroacetic acid. The rest of the choices are under Pregnancy Category C.

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84
Q 
The drug of choice for leptospirosis is:
A.    Doxycycline
B.    Penicillin
C.    Ceftriaxone
D.    Erythromycin
A

B

SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE The rest of the choices are alternate drug choices for leptospirosis.

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85
Q 
A 23-year-old presents with abdominal pain, tenesmus, and mucoid diarrhea with frank blood. Which is the best empiric treatment?
A.    Ciprofloxacin
B.    Metronidazole
C.    Amoxicillin
D.    Cotrimoxazole
A

A
Ciprofloxacin is the recommended empiric treatment for patients with acute dysenteriae. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE

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86
Q 
The most powerful hallucinogen known to man is:
A.    LSD
B.    marijuana
C.    methamphetamine
D.    phencyclidine
A

A

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87
Q 
It is the only licensed chemotherapy drug for advanced melanoma:
A.    adriamycin
B.    bleomycin
C.    cisplatin
D.    Dacarbazine
A

D

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88
Q 
Plasma magnesium levels should be maintained at this therapeutic range to prevent eclamptic convulsions:
A.    2-4 meq/L
B.    4-7 meq/L
C.    8-10 meq/L
D.    10-12 meq/L
A

B

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89
Q 
This is the only ligandgated serotonin receptor:
A.    5HT1
B.    5HT2
C.    5HT3
D.    5HT4
A

C

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90
Q 
This autonomic drug should be given with caution in patients with depressive disorders:
A.    guanethidine
B.    metyrosine
C.    vesamicol
D.    Reserpine
A

D

Reserpine which crosses the blood brain barrier is notorious for causing depression and increasing suicidal tendencies.

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91
Q 
If a patient has COPD, which of the following beta-blockers would be more preferrable to use, theoretically?
A.    propranolol
B.    carvedilol
C.    labetalol
D.    Atenolol
A

D
Atenolol, metoprolol, esmolol, betaxolol, and acebutolol (A-BEAM) are more beta1-selective hence are advantageous in patients with comorbid pulmonary disease.

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92
Q

An 8-year-old being treated with a combination of chemotherapeutic agents had difficulty eating and drinking due to red, inflamed sores in her mouth and esophagus. Which of the following antineoplastic agents is the most likely etiology?
A. Methotrexat

A

A
Major toxicities of methotrexate include gastrointestinal mucositis, bone marrow suppression, skin erythema and hepatic dysfunction. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE

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93
Q 
A young boy with G6PD deficiency would note tea-colored urine after the intake of which drug/s:
A.    primaquine
B.    cotrimoxazole
C.    nitrofurantoin
D.    All of the above
A

D

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94
Q 
This drug activates peroxisome proliferator-activated receptors, a group of nuclear receptors, with greatest specificity to PPAR-? receptors:
A.    pioglitazone
B.    gemfibrozil
C.    sitagliptin
D.    Exenatide
A

A

Do not confuse with the mechanism of action of fibrates which is activation of the nuclear transcription factor PPAR-?.

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95
Q 
Constipation is one of the major side effects of this drug:
A.    Magnesium hydroxide
B.    Aluminum hydroxide
C.    Omeprazole
D.    Colchicine
A

B
Aluminum hydroxide causes constipation (ALang tae). Magnesium hydroxide causes diarrhea (MaGtatae). Colchicine also causes diarrhea if taken in excess.

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96
Q 
A patient presents with petit mal seizures. The drug of choice for this type of seizure is:
A.    phenytoin
B.    topiramate
C.    ethosuximide
D.    Lamotrigine
A

C
Petit mal seizures, also known as absence seizures, involves a brief, sudden lapse of consciousness. The DOC is ethosuximide.

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97
Q 
A psychotic patient on haloperidol presents with rigidity, hyperpyrexia and autonomic instability. This condition is known as:
A.    Serotonin syndrome
B.    Neuroleptic malignant syndrome
C.    Tardive dyskinesia
D.    Malignant hyperthermia
A

B
Tardive dyskinesia is also one of the toxicities of antipsychotics aside from NMS. It is a condition where the patient presents with stereotypic oral-facial movements.

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98
Q 
This diuretic can also be used in the treatment of glaucoma:
A.    acetazolamide
B.    hydrochlorothiazide
C.    mannitol
D.    Amiloride
A

A
Technically, mannitol can also be used but acetazolamide is a better answer. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE

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99
Q 
It is a monoclonal antiIgE antibody used in the treatment of asthma resistant to inhaled steroids and long-acting B2-agonists:
A.    trastuzumab
B.    rituximab
C.    infliximab
D.    Omalizumab
A

D
Trastuzumab aka herceptin is a monoclonal antibody that interferes with the HER2/neu receptor, rituximab is against the protein CD20 on B cells, and infliximab is against TNF-alpha.

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100
Q 
This drug inhibits platelet aggregation by irreversibly blocking ADP receptors:
A.    cilostazol
B.    tirofiban
C.    alteplase
D.    Ticagrelor
A

D
Cilostazol is a phosphodiesterase III inhibitor, tirofiban binds to GP IIb/IIIa receptor, and alteplase is a thrombolytic (not an anti-platelet) which converts plasminogen to plasmin.

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101
Q 
These drugs act by preventing the binding of the agonist molecule to the receptor but do not activate generation of a signal:
A.   Pharmacologic antagonists 
B.    Inverse agonists
C.    Competitive agonists
D.   Partial agonists
E.    Orphan drug
A

A
Katzung 10th ed, p. 11 - Pharmacologic anatgonists bind to the receptor preventing agonist binding thereby blocking the agonist’s biologic actions.

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102
Q 
This route of drug administration is the most convenient, however bioavailability may be less than 100% because of incomplete absorption and firstpass elimination.
A.    Intramuscular
B.    Subcutaneous
C.    Oral
D.    Transdermal
E.    All of the above
A

C

Katzung 10th ed, p. 41

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103
Q

Loca is a 23 year old G4P4 (4004) who has been on oral contraceptives for 8 months now. What is the expected drug-drug interaction If she was to start on an antituberculosis drug that acts by inhibitting RNA synthesis and which imparts orange color to uri

A

E
Rifampin revs up the cytochrome P450 enzyme system thereby enhancing the metabolism and hence the elimination of the oral contraceptive the patient is taking resulting to its significantly lower serum level. Katzung 10th ed, p.774.

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104
Q 
It is during this phase of drug development and testing that the effects of the drug as a function of dosage are established in a small number of healthy volunteers.
A.    Phase 1
B.    Phase 2
C.    Phase 3
D.    Phase 4
E.    Phase 5
A

A
Phase 1 trials determine the probable limits of the safe clinical dosage range in a small number of healthy volunteers. In Phase 2, the drug is studied in patients with the target disease to determine its efficacy. In phase 3, the drug is evaluated in

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105
Q 
Which of the following drugs lower blood pressure by preventing normal physiologic release of norepinephrine from postganglionic sympathetic neurons?
A.    Metyrosine
B.    Cocaine
C.    Reserpine
D.    Botulinum toxin
E.    Guanethidine
A

E
Metyrosine inhibits tyrosine hydroxylase which is responsible for the conversion of Tyrosine to Dopa, the rate-limiting step in catecholamine synthesis. Cocaine blocks re-uptake of NE from the synaptic cleft thereby prolonging its effect. Reserpine blo

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106
Q 
A tricyclic antidepresssant drug long used to reduce incontinence in institutionalized elderly patients and in children with bedwetting problems because of its strong anti-muscarinic actions:
A. Ipratropium    
B. Imipramine
C. Scopolamine   
D.  Oxybutin
A

B
Katzung 115: Ipratropium-is an antimuscarinic drug used as an inhalational drug for asthma. Scopolamine- is an antimuscarinic drug used to remedy seasickness. Oxybutinin- is an antimuscarinic selective for M3 receptors used to relieve bladder spasm aft

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107
Q

Which of the following statements regarding diuretics is not true?
A. Diuretics lower blood pressure primarily by depleting body sodium stores.
B. The most common adverse effect of thiazide diuretics is potassium depletion.
C. The intercalated cells in

A

D
The collecting tubule and not the distal tubule is the final site NaCl reabsorption. It is responsible for tight regulation of body fluid volume and for determining the final sodium concentration of the urine. Katzung 10th ed., 239.

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108
Q

Which of the following drug acts by selectively inhibitting stimulation of B1 adrenoceptor and may be advantageous in treating hypertensive patients who also suffer from asthma, diabetes, or peripheral vascular disease?
A. Nadolol
B. Metoprolol
C. Pro

A

B
Katzung 10th ed., 169. Metoprolol, Esmolol, Atenolol, Acebutolol, Betaxolol, Bisoprolol are selective B1-blockers. Propranolol and Nadolol are nonselective B-blockers. Labetalol and Carvedilol have combined alpha and bblocking activity.

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109
Q 
It is a very efficacious orally active arteriolar vasodilator that is also available in topical preparations used to stimulate hair growth for correction of baldness.
A.    Minoxidil
B.    Sodium Nitroprusside
C.    Hydralazine
D.    Diazoxide
E.    Fenol
A

A

Katzung 10th ed, 173.

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110
Q 
A Class I-B antiarrhythmic drug which has a high degree of effectiveness in arrhythmias associated with acute myocardial infarction.
A.    Quinidine
B.    Flecainide
C.    Propranolol
D.    Lidocaine
E.    Amiodarone
A

D
Katzung 10th ed., 225 Quinidine- Class IA, associated with cinchonism; Flecainide- Class IC, very effective in suppressing premature vebtricular contractions; Propranolol-Class 2, Amiodarone-broad spectrum of actions

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111
Q

A potent antiandrogen that is usually coadministered with leuprolide that has been used in the treatment of prostatic carcinoma that frequently causes gynecomastia and occassionally mild reversible hepatic toxicity:
A. Goserelin
B. Spironolactone
C.

A

E

Katzung 10th ed., 679. this is SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE

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112
Q

Disulfiram causes extreme discomfort in patients who drink alcoholic beverages by inhibitting which enzyme resulting to accumulation of acetaldehyde causing flushing, throbbing headache, nausea, vomiting, sweating, hypotension and confusion within few hou

A

B

Katzung 10th ed., 371. this was SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE

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113
Q

The following helminths are matched with their respective drug of choice except:
A. Fasciola hepatica - Bithionol
B. Echinococcus granulosus - Albendazole
C. Stongyloides stercoralis - Thiabendazole
D. Schistosoma mansoni - Praziquantel
E. Dracunculu

A

C
The drug of choice in strongylodiasis and onchocerciasis that acts by intensifying GABA-mediated transmission of signals in peripheral nerves resulting to paralysis of the worms is Ivermectin. Thiabendazole is an alternative drug only. Katzung 10th ed.

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114
Q 
What is the drug of choice for the eradication of dormant liver forms of Plasmodium vivax and Plasmodium ovale?
A.    Quinidine
B.    Primaquine
C.    Mefloqione
D.    Chloroquine
E.    Lumefantrine
A

B
Primaquine is the only available agent active against the dormant hypnozoite stages of p. vivax and p. ovale. (radical cure) Katzung 10th ed., 852

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115
Q 
This halogen in a 1:20,000 solution is bactericidal in 1 minute and kills spores in 15 minutes. It is the most active antiseptic for intact skin:
A.    Phenol
B.    Hypochlorus acid
C.    Sodium hypochlorite
D.    Iodine
E.    Hexachlorophene
A

D
Katzung 10th ed., 822. Phenolic disinfectants are the oldest of the surgical antiseptics. They are used for hard surface decontamination in hospitals and labs. They are no longer used as a disinfectant because of its corrosive effect on tissues, its to

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116
Q

This antiviral agent against Influenza A acts by blocking the M2 proton ion channel of the virus particle and by inhibitting uncoating of the viral RNA within infected host cells, thus preventing its replication.
A. Amantadine
B. Ribavirin
C. Ose

A

A

katzung 10th ed., 815.

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117
Q 
This drug is a derivative of rifamycin which is indicated in place of rifampin for treatment of tuberculosis in HIVinfected patients who are receiving concurrent protease inhibitors:
A.    Rifapentine
B.    Rifabutin
C.    Ritonavir
D.    Rifadin
E.    Ri
A

B
Katzung 10th ed., 777. Rifabutin is a less potent inducer of the cytochrome P450 enzyme (compared to Rifampin) resulting to slower elimination and longer halflife of protease inhibitors used in treating HIV patients is cases of HIV with concurrent tube

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118
Q

A 35 year old woman came to your clinic because of dysuria. She has been experiencing burning on urination with increased frequency and urgency to urinate for 5 days now. Urinalysis revealed WBC of 20-30/hpf, bacteria=moderate, nitrite=positive. You may p

A

D
Quinolones act by blocking bacterial DNA synthesis by inhibitting bacterial topoisomerase II and IV. Moxifloxacin is the only non-renally cleared fluoroqionolone and thus achieves low urinary level making it ineffective for cases of UTI. Katzung 10th e

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119
Q

The following are true of sulfonamides except:
A. Sulfonamides are structural analogs of paminobenzoic acid and act by inhibitting dihydropteroate synthase and folate production.
B. Sulfonamides are very effective against rickettsiae.
C. Combination of

A

B
It is interesting that rickettsiae are not inhibitted by sulfonamides but are actually stimulated in their growth. Katzung 10th ed., 763.

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120
Q

A 45 year old soldier has been maintaining on fluoxetine for his major depressive disorder. Which of the following drugs can precipitate a potentially fatal syndrome of hypertension, hyperreflexia, tremor, clonus, hyperhtermia, diarrhea, mydriasis and agi

A

E
This is a case of serotonin syndrome which is a condition precipitated when MAO inhibitors are given with serotonin agaonists, especially antidepressants of the SSRI class. Amytriptyline and Imipramine are TCAs. Fluoxetine, Sertraline and Citalopram ar

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121
Q

A 37 year old man comes to the physician because of a 1 week history of pain with swallowing. He received the diagnosis of AIDS 4 years ago, but has not been able to tolerate highly active antiretroviral therapy. He currently takes TMPSMX. Vital signs are

A

C

122
Q

A 72 year old man is brought to the physician by his daughter because of a 7 month history of difficulty with memory. He frequently loses his keys and misses appointments and regular family dinners. He lives alone, but recently family members had to drive

A

B

123
Q

A 47 year old woman comes to the physician for a routine health maintenance examination. She has a 2 year history of venous insufficiency and noted daily swelling of her ankles that worsens in the evening. She takes no medications. Her pulse is 80 bpm, an

A

D

124
Q

A 55-year-old man has had crushing substernal chest pain on exertion over the past 6 weeks. He had a myocardial infarction 2 months ago. He takes nitroglycerin as needed and one aspirin daily. He has smoked two packs of cigarettes daily for 30 years. Exam

A

B

125
Q

A 72-year-old man comes for a routine follow-up examination. He has chronic obstructive pulmonary disease treated with ?- adrenergic agonists and ipratropium by metered-dose inhaler and mild arterial insufficiency of the lower extremities treated with asp

A

C
COPD and Peripheral arterial disease&raquo_space;
contraindications for Beta-Blockers

126
Q

A 17-year-old boy is brought to the emergency department by his parents because of bizarre behavior for 6 hours. Last night he was out with friends, and since returning, he has been confused and has “trashed” his room. His blood pressure is 165/95 mm Hg.

A

D

127
Q

A 72-year-old man comes to the physician because of a 2-month history of urination twice nightly and occasional urinary frequency and urgency. He has a 15-year history of type 2 diabetes mellitus now moderately well controlled with glyburide. His father w

A

D

128
Q

A 47-year-old man is admitted to the hospital after threatening to harm a radio announcer he believed was broadcasting his thoughts. Over the past 20 years, he has had multiple psychiatric hospitalizations for threatening people who he believed were plott

A

C

129
Q

A 47-year-old man is admitted to the hospital after threatening to harm a radio announcer he believed was broadcasting his thoughts. Over the past 20 years, he has had multiple psychiatric hospitalizations for threatening people who he believed were plott

A

C

130
Q

A 32-year-old woman comes to the physician because of a 3-month history of increasing pain and stiffness in her wrists, hands, and ankles. During this period, she also has had progressive fatigue and morning stiffness lasting 2 hours. She has a 1- year hi

A

C

131
Q

An otherwise healthy 19-year-old woman comes to the physician because of a 3-year history of intermittent facial blemishes. She drinks wine occasionally on weekends. She takes no medications. Examination shows multiple 1- to 2-mm red and white papules and

A

A
Oral isotretinoin is never the first option
for acne, only used when topical
treatments have failed

132
Q

A 57-year-old man has been hospitalized for 2 days for treatment of unstable angina pectoris. He is currently receiving intravenous heparin and undergoing evaluation for coronary artery bypass grafting. His blood pressure is 160/90 mm Hg, pulse is 88/min,

A

D
Heparin-induced thrombocytopenia&raquo_space;> the Heparin-Platelet4 complex are attacked by IgG in the human bodies that essentially activate the platelet and thus form clots. These clots are the reason free platelets are low.

133
Q

A 42-year-old woman, gravida 2, para 2, comes to the physician because of a 3-month history of swelling of her legs and mild abdominal pain and bloating. Abdominal examination shows no abnormalities. Rectovaginal examination shows fullness in the right ad

A

A

134
Q

A 67-year-old man is hospitalized for treatment of renal insufficiency. Three days after admission, his pulse is 40/min. An ECG shows tall, tented T waves. Serum studies show a sodium level of 134 mEq/L, potassium level of 6.9 mEq/L, and glucose level of

A

C

insulin and glucose&raquo_space; fastest way to lower down serum K

135
Q

A 37 year old man comes to the physician for a follow-up examination. He was diagnosed with HIV infection 3 weeks ago. He is asymptomatic and takes no edications. His temperature is 37.2 C, pulse is 100 bpm, and blood presure is 100/60 mmHg. Examination s

A

C

Start HAART with CD4 below 350 and Pneumocystis prophylaxis with CD4 below 200

136
Q

A 55-year-old woman was recently diagnosed with an adrenal mass due to symptoms of sweating, elevated blood pressure, and severe headaches. Which of the following nonselective, irreversible alpha blocker is the drug of choice as a preoperative agent used

A

B

Phenoxybenzamine&raquo_space; nonselective, IRREVERSIBLE alpha blocker..Phentolamine» reversible alpha blocker.

137
Q 
A 72-year-old man was diagnosed to have glaucoma. Which of the following drugs induces ciliary muscle contraction thereby opening the trabecular meshwork and increasing the outflow?
A) Timolol
B) Mannitol
C) Epinephrine
D) Pilocarpine
A

D

Pilocarpine&raquo_space; ciliary muscle contraction&raquo_space; opening trabecular meshwork and increasing the outflow

138
Q

A 58-year-old woman with newly diagnosed type 2 diabetes mellitus presents to the emergency department complaining of vomiting, severe headache, dizziness, blurry vision, and dyspnea. She says that she had been at a party when the symptoms began. Her skin

A

A

tolbutamide&raquo_space; disulfuram reaction

139
Q

A 25-year-old woman with AIDS comes to the physician because of a 10-day history of fever, shortness of breath, night sweats, fatigue, and a non-productive cough. She had been treated with antiretroviral agents for 2 years but stopped taking her medicatio

A

D

140
Q

A 27-year-old nulligravid woman comes to the physician for preconceptional counseling. She has a mechanical mitral heart valve and chronic rheumatoid arthritis. Her cardiac status is New York Heart Association Class II. She feels well. Current daily medic

A

C

141
Q 
What is the half-life of alcohol?
A. 2 hours    
B. 4 hours    
C. 8 hours   
D. 12 hours    
E. None of the above
A

E
Ethanol, over most of its plasma concentration range, exhibits zero-order elimination. Thus, there is no constant half life of elimination as in drugs exhibiting first order elimination. (Katzung Board Review 9e, p.6)

142
Q

A 48/M farmer with a history of alcohol abuse, is rushed to the emergency room after the patient has deliberately ingested 300 mL of an unknown pesticide while drunk. On examination, you note that the patient has pinpoint pupils and frothy secretions at t

A

E
A chemical antagonist interacts directly with the drug being antagonized to remove it or prevent it from binding to its target. Pralidoxime which combines avidly with the phosphorus in organosphosphate cholinesterase inhibitors is an example. (KBR9e, p

143
Q

A 48-year old Caucasian male is referred to you for chronic cough, night sweats and weight loss. Sputum AFB was positive on three occasions; findings of chest X ray done was also consistent with pulmonary tuberculosis. Before you start drug therapy, you r

A

A

50% of white and African american persons are slow acetylators of INH, hydralazine and procainamide. KBR9e, p33

144
Q

A recently-diagnosed hypertensive was started on a BP lowering agent. Due to financial constraints, the patient abruptly stopped taking the prescribed medications after stocks were consumed. A day later, the patient was brought to the clinic for light-hea

A

D

145
Q

A 24/G3P2(2002) who came in with a BP of 200/140 was given Hydralazine. What is the mechanism of action of hydralazine?
A. Reduction of Ca influx via L-type channels
B. Antagonism of alphaadrenergic receptors in blood vessels
C. Release of NO
D. Hyper

A 
C 
A describes the MOA of verapamil; 
D describes minoxidil; 
E describes fenoldopam. 
All are direct vasodilators.
146
Q

Which of the following diuretics is incorrectly paired with its associated toxicity?
A. Thiazide - renal stone
B. Acetazolamide -hepatic encephalopathy
C. Bumetanide -hypokalemic metabolic alkalosis
D. Eplerenone -hyperkalemic metabolic acidosi

A

A
Thiazides increase reabsorption of Ca and prevent Ca stone formation. Hepatic encephalopathy can ensue with acetazolamide because it causes alkalinization of urine due to decreased bicarbonate reabsorption. This prevents ammonia from turning to ammoniu

147
Q

Leukotrienes are among the most potent bronchoconstrictors implicated in the pathogenesis of bronchial asthma. Which of the following is a leukotriene receptor inhibitor that has found clinical application in asthma prophylaxis?
A. Zileuton
B. Zafirluk

A

B

Zileuton is a lipooxygenase inhibitor.

148
Q

8 A 28/M car mechanic was brought to the emergency room after ingesting automobile antifreeze. ABG reveals high anion gap metabolic acidosis; while urinalysis reveals calcium oxalate crystals. You suspect ethylene glycol poisoning. Which of the following

A

E
Ethylene glycol and methanol poisoning may be treated with fomepizole, an alcohol dehydrogenase inhibitor, which prvents conversion of methanol/ehtylene glycol to toxic metabolites.

149
Q 
A patient with neuropathic pain was prescribed gabapentin. What is the primary mechanism of action of gabapentin? 
A. Direct activation of GABA reeptors 
B. Inhibition of T type Ca2+ channels 
C. Blockade of voltagegated Na channels 
D. Inhibition of GABA
A

B

Although gabapentin is a structural analog of GABA, it does NOT activate GABA receptors directly.

150
Q

A 6/F is brought to the clinic due to frequent episodes of sudden activity arrest with staring and minimal eyelid flutter occurring for 10 - 20 seconds, 5 - 10 times per day. During such episodes, patient is unresponsive to voice or tactile stimulation. S

A

B

Ethosuzimide and valproic acid are the preferred drugs for absence seizures because they cause minimal sedation

151
Q 
Administration of most inhaled anesthetics cause a decrease in the following except:
A. Arterial blood pressure     
B. Brain metabolic rate   
C. Myocardial function    
D. Tidal volume    
E. None of the above
A

E

152
Q 
A 53/M, admitted at the Medical ICU, after having a myocardial infarction, develops ventricular tachycardia. Which of the following anti-arrhythmics is most appropriate?
A. Quinidine
B. Mexiletine    
C. Adenosine    
D. Lidocaine   
E. Flecainide
A

D

Lidocaine and other Class IB drugs act primarily in ischemic tissues and are best for arrhythmias following MI.

153
Q 
Flumazenil may be effective in patients who overdosed on the following sedativehypnotics except:
A. Alprazolam     
B. Zolpidem    
C. Thiopental  
D. Midazolam    
E. Lorazepam
A

C
Most S-H drugs facilitate the actions of GABA, a major inhibitory transmitter. Benzodiazepines potentiate GABA by increasing frequency of Cl ion channel opening; its action is blocked by flumazenil, a BZ receptor antagonist. Flumazenil, on the other ha

154
Q 
Which of the following IV anesthetics is the only one that causes CV stimulation? Its use in neurosurgical operations is limited due to its propensity to increase ICP.
A. Midazolam    
B. Propofol    
C. Fentanyl    
D. Ketamine    
E. Thiopental
A

D

155
Q

5 Sisa, 28/F, recentlydiagnosed schizophrenic was admited to the Psychiatry ward and started on Risperidone. Three days later, the patient developed fever (39.9C) and rigidity. Patient was notably confused. Vital signs were as follows: BP 170/120, HR 118,

A

D
Neuroleptic malignant syndrome is characterized by FEVER, RIGIDITY, and AUTONOMIC INSTABILITY. NMS is linked to intake with several atypical antipsychotics.

156
Q 
Formation of methyltransferases that alter drug binding sites on the 50S ribosomal subunit is the primary mechanism of resistance to which antibiotic:
A. Streptomycin    
B. Tetracycline   
C. Amikacin    
D. Azithromycin    
E. Levofloxacin
A

D

Question could be rephrased into: which acts on the 50s subunit? Macrolides such as azithromycin do.

157
Q

A 41/M, presenting with high fever and chills, is admitted at the hospital. He reports having had serious allergic reactions to amoxicillin one year ago. Blood GS/CS reveals growth of Gram negative bacteremia. Which of the following antibiotics is MOST ap

A

D

Aztreonam is active only against Gram-(- ) organisms and has NO cross-reactivity with penicillins.

158
Q

Ceftriaxone is commonly given as an empiric antibiotic in the treatment of bacterial meningitis. However, it must be noted that this antibiotic will NOT cover the following etiologic agent in meningitis:
A. Neisseria meningitidis
B. Streptococcus pneu

A

C
Organisms NOT covered by cephalosporins are L.A.M.E.: Listeria monocytogenes, Atypicals (chlamydia, mycoplasma), MRSA, and Enterococci.

159
Q 
A 10/F, diagnosed case of HSV encephalitis, was given IV acyclovir. Acyclovir is an efffective antiviral because it inhibits:
A. DNA polymerase   
B. RNA polymerase    
C. Aspartate protease 
D. Neuraminidase     
E. Hemagluttinin
A

A

Acyclovir, foscarnet and ganciclovir are DNA polymerase inhibitors.

160
Q

A 55/M comes in due to sudden headache described as the “worst headache of his life.” He is a diagnosed hypertensive, with poor compliance to medications. PE reveals nuchal tenderness (positive Kernig’s sign), and a left cranial nerve palsy. Brain CT reve

A

A

Nimodipine given for 21 days should be started on admission for vasospasm prophylaxis.

161
Q

The drug of choice for clostridium tetani infection because of the drug’s excellent antimicrobial activity and the absence of the GABA-antagonistic activity

a. Penicillin G
b. Metrobidazole
c. Vancomycin
d. Chloramphenicol

A

B
The use of penicillin (10–12 million units IV, given daily for 10 days) has been recommended, but metronidazole (500 mg every 6 h or 1 g every 12 h) is preferred by some experts on the basis of this drug’s excellent antimicrobial activity and the absenc

162
Q

a second generation Cephalosporin with intrinsic activity against anaerobes:

a. cefoxitin
b. cefipime
c. cefaclor
d. ceftriaxone 0

A

A

Cefoxitin has anaerobe coverage apart from its activity against gram positive and some gram neg infections

163
Q

this oral iron compound has the highest elemental iron content:

a. ferrous sulfate
b. ferrous gluconate
c. ferrous fumarate
d. iron dextran

A 
C 
Ferrous sulfate (FEOSOL, others) is the hydrated salt, FeSO4×7H2O, which contains 20% iron. Dried ferrous sulfate (32% elemental iron) is also available. Ferrous fumarate (FEOSTAT, others) contains 33% iron and is moderately soluble in water, stable, a
164
Q

which anong the following drugs should be avoided in patients with porphyria?

a. phenytoin
b. secobarbital
c. midazolam
d. sodium valproate

A

B

Phenobarbitals should be avoided in patients diagbosed with porphyria

165
Q

Xenobiotic metabolizing enzymes have historically been grouped into the phase 1 reactions and the phase 2 reactions. Which is NOT TRUE regarding the former?

a. enzymes carry out oxidation, reduction, or hydrolytic reactions
b. enzymes lead to the introd

A

D

Phase 1 reaction does little to the water solubility of a drug metabolized

166
Q

NOT True of Phase 2 enzymes in Xenobiotic metabolism:

a. they facilitate the elimination of drugs
b. inactivation of electrophilic and potentially toxic metabolites produced by oxidation.
c. phase 2 reactions produce a metabolite with improved water solu

A

D

Because of conjugation of these substances, they have a higher molecular weight

167
Q

majority of phase2 reactions involving Glucoronic acid conjugation are found in what cell compartment?

a. ER
b. cytosol
c. Mitochondrial matrix
d. Golgi bodies

A

A

conjugating enzymes, notably the UGTs, are all located in the endoplasmic reticulum of the cell

168
Q

Notable to these drugs are its capability of inducing CP450 enzyme system in the liver except:

a. Phenytoin
b. Cimetidine
c. Carbamazepine
d. Griseofulvin

A

B

All except Cimetidine induce CYP450 enzyme complex

169
Q

Flushing is a unique side effect of Nicotinamide used in hyperlipidemia. The drug that may be used to counter this effect is:

a. Acetaminophen
b. Aspirin
c. Chlorphenamine
d. Arginine

A

B
The cutaneous effects include flushing and pruritus of the face and upper trunk, skin rashes, and acanthosis nigricans. Flushing and associated pruritus are prostaglandin-mediated. Taking an aspirin each day alleviates the flushing in many patients.

170
Q

Local anesthetics block nerve conduction through inhibition of what electrolyte?

a. Potassium
b. Sodium
c. Calcium
d. All of the above

A

B
Local anesthetics block conduction by decreasing or preventing the large transient increase in the permeability of excitable membranes to Na+ that normally is produced by a slight depolarization of the membrane

171
Q

a dreadful side effect, although not common, of this atypical antipsychotic is agranulocytosis.

a. Quetiapine
b. Clozapine
c. Risperidone
d. Aripiprazole

A

B

Clozapine is notorious for its side effect of agranulocytosis, although uncommon

172
Q

True of Acetaminophen:

a. It covalently binds to COX inhibiting prostaglandin synthesis
b. very weak antiinflammatory agent at the typical daily dose of 1000 mg
c. incidence of Gastrointestinal adverse effects comparable to Ibuprofen
d. its inhibition

A

B
Observational studies suggest that acetaminophen, which is a , very weak antiinflammatory agent at the typical daily dose of 1000 mg is associated with a reduced incidence of gastrointestinal adverse effects compared to tNSAIDs

173
Q

A condition characterized by the acute onset of encephalopathy, liver dysfunction, and fatty infiltration of the liver and other viscera known as Reye’s syndrome is associated with what drug?

a. Aminosalicylate
b. Long chain fatty acids
c. Indomethacin

A

A
Due to the association with Reye’s syndrome, aspirin and other salicylates are contraindicated in children and young adults less than 20 years old with fever associated with viral illness. Reye’s syndrome is characterized by the acute onset of encephal

174
Q

incidence of Reye syndrome among patients less than 20 who took Aspirin concurrent with influenza A/B infection:

a. 0.1%
b. 1%
c. 5%
d. 10%

A

A
Less than 0.1% of children who took aspirin developed Reye syndrome, but more than 80% of patients diagnosed with Reye syndrome had taken aspirin in the past 3 weeks

175
Q

. A good drug combination along with thiazides by virtue of its effect on potassium retention:

a. losartan
b. amlodipine
c. verapamil
d. Metoprolol

A

A
Urinary K+ loss can be a problem with thiazides. Angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor antagonists will attenuate diuretic-induced loss of potassium to some degree, and this is a consideration if a second drug is requi

176
Q

highly lipophilic derivative of obiquinone that has activity against plasmodium species and Pneumocystis pneumonia among patients intolerant to Co-trimoxazole:

a. Atorvaquone
b. Quinine
c. Proguanil
d. Artemisinin

A

A
Atorvaquone is promising synthetic derivative with potent activity against Plasmodium species and the opportunistic pathogens Pneumocystis carinii and Toxoplasma gondii. After limited clinical trials, the FDA approved this compound in 1992 for treatmen

177
Q

The least nephrotoxic among the aminoglycosides is:

a. Tobramycin
b. Kanamycin
c. Amikacin
d. Streptomycin

A

D
The nephrotoxic potential varies among individual aminoglycosides. The relative toxicity correlates with the concentration of drug found in the renal cortex in experimental animals. Neomycin, which concentrates to the greatest degree, is highly nephrot

178
Q

A fusion inhibitor used in the treatment of HIV infection

a. Efavirenz
b. Lamivudine
c. Enfuvirtide
d. Atazanavir

A

C

179
Q

In dermatologic pharmacology, approximately how many grams of topical preparation is needed to cover the body surface?

a. 10g
b. 20g
c. 30g
d. 40g

A

C
An amount of topical medication sufficient to cover affected body surfaces in repeated applications must be dispensed to the patient. A general rule is that approximately 30 g is required to cover the body surface.

180
Q

A topical preparation that are concentric spherical shells of phospholipids in an aqueous medium that may enhance percutaneous absorption

a. Liposome
b. Microgrel
c. Transfersome
d. Micelle

A

A
Newer vehicles include liposomes and microgel formulations. Liposomes are concentric spherical shells of phospholipids in an aqueous medium that may enhance percutaneous absorption. Variations in size, charge, and lipid content can influence liposome f

181
Q 
Theophylline has a pKa of 8.7, what is the predominant form at pH 11.3?
A.    Ionized and protonated
B.    Non-ionized and protonated
C.    Charged and unprotonated
D.    Uncharged and unprotonated
E.    None of the above
A

D

Above pKa, the unprotonated and uncharged form of a weak base predominates.

182
Q 
Some drugs like magnesium sulfate needs a loading dose in order to reach steady state at a reduced amount of time. The following are used to compute for loading dose EXCEPT?
A.    Clearance
B.    Volume of Distribution
C.    Minimum effective dose
D.    B
A

A
Loadign dose = (Vd) (desired plasma concentration)/(bioavailabitlity) the minimum effective dose is usually the desired plasma concentration. Clearance is used to calculate the maintenance dose

183
Q

A 5 year old known case of seizure disorder maintained on phenytoin was rushed to the ER due to an asthma attack. IV theophylline was given to control the asthma using usual dose computations. What are the consequences of the drug-drug interactions?
A. T

A

C
Phenytoin is an inducer, which will lower theophylline levels. Asthma may not be adequately treated with this monotherapy.

184
Q 
Which of the following substances will increase the available adrenergic neurotransmitter in the synaptic cleft by inibiting reuptake?
A.    Botulinum
B.    MAOIs
C.    Cocaine
D.    Guanethidine
E.    Reserpine
A

C
Cocaine and TCA prevents reuptake of norepinephrine. Review the inhibitors for each step in the process of neurotransmitter release for both the sympathetic and parasympathetic system.

185
Q

Which of the following drugs for glaucoma increased aqueous humor outflow through the non-conventional pathway without decreaing the secretion of aqueous humor by the ciliary body?
A. ?-blockers
B. Prostaglandin analogues
C. ?-adrenergic agonist

A

B
Beta blockers, CAIs and osmotic agents (mannitol) decreases aqueous humor production. Alpha adrenergic agonist increases outflow and also decreases the secretion of the ciliary body. Prostaglandins increased outflow but has no effect on production.

186
Q

Which of the following beta-blockers demonstrates the relative selectivity in the manner described?
A. Betaxolol: relatively selective for ?2- receptors
B. Timolol: relatively selective for ?1- receptors
C. Levobunolol: relatively selective for ?2-rece

A

D
Because of its relatively β1 selectivity, betaxolol has fewer side effects. Timolol and levobunolol are non-selective β- blockers

187
Q 
What hypertensive drug commonly used for the outpatient treatment of preeclampsia is prominent for its sideeffect of hemolytic anemia with a positive Coomb's test?
A.    ?1 adrenergic agonist
B.    ?2 adrenergic antagonist
C.    ?1 adrenergic agonist
D.
A

C

Methyldopa is a selective alpha 2 agonist.

188
Q 
Which of the following antiarrhythmics primarily exerts its action on phase 4 of the cardiac action potential, prolonging PR interval?
A.    Procainamide
B.    Lidocaine
C.    Propanolol
D.    Amiodarone
E.    Verapamil
A

C

Class 2 anti arrhythmics or B blockers exert its effort on phase 4 and prolongs the PR interval

189
Q 
9 Which of the following loop diuretics is not prone to induce an allergic response?
A.    Furosemide
B.    Bumetanide
C.    Brinzolamide
D.    Torsemide
E.    Ethacrynic acid
A

E

Ethacrynic acid does not contain a sulfa group.

190
Q 
Which of the following is a major toxicity associalted with gemfibrozil therapy?
A.    Bloating and constipation
B.    Cholelithiasis
C.    Hyperuricemia
D.    Myopathy
E.    Severe cardiac arryhtmia
A

B

Gemfibrozil is associated with cholelithiasis. Myopathy is only expected in combination with statins.

191
Q 
Which of these anesthetics is known to cause acute porphyria? 
A. Nitrous oxide
B.    Halothane
C.    Ketamine
D.    Thiopental
E.    Propofol
A

D

Barbiturates such as thiopental can cause acute porphyria.

192
Q 
Which of the following is the drug of choice for partial seizures?
A.    Valproic acid
B.    Phenobarbital
C.    Lamotrigine
D.    Ethosuximide
E.    Topiramate
A

C

Carbamazepine, phenytoin and lamotrigine are drug of choices for partial seizures

193
Q 
Which drugs reduces the risk of suicide?
A.    Clozapine
B.    Clonidine
C.    Clonazepam
D.    Clofazimine
E.    Clofibrate
A

A

Clozapine is the anit-psychotic that reduces the risk of suicide

194
Q 
In the acute settings the following drugs are useful for the emergent management of thyroid storm EXCEPT?
A.    Propanolol
B.    KI
C.    Propylthiouracil
D.    Methimazole
E.    Hydrocortisone
A

D
Propylthiouracil, iodides and propanolol are the first line drugs for thyroid storm. Hydrocortisone may be added for realtive adrenal insufficiency in the acute attack. Methimazole may be used, but is not usually given in the acute therapy of thyroid s

195
Q 
Which of the following insulin preparations mimics the secretion pattern of insulin by the normal pancreas in the fasting state?
A.    Lispro
B.    Regular
C.    NPH
D.    Glulisine
E.    Detemir
A

E

The long acting insulin mimics the normal secretion of the pancreas in the non-fed state.

196
Q 
Which of the following antibiotics does NOT follow time-dependent killing action?
A.    Amoxicillin
B.    Aztreonam
C.    Metronidazole
D.    Bacitracin
E.    Vancomycin
A 
C 
The broad class of Beta lactams including the class of monobactams and aztreonams exhibit time-dependent killing action. Bacitracin and vancomycin that also act on the cell wall exhibit time dependent killing. Metronidazole, FQ and AG are concentration
197
Q 
Which of the following anti-malarial is contraindicated for pregnant women?
A.    Chloroquine
B.    Quinine
C.    Quinidine
D.    Primaquine
E.    Mefloquine
A

D
The fetus is G6PD deficient, so primaquine cannot be used. To achieve radical cure for pregnant women, primaquine is given after delivery of the baby.

198
Q 
Which of the following anti-neoplastic drug is highly lipophilic, use for the treatment of cancers that are not readily permeable through vascular channels?
A.    Bleomycin
B.    Busulfan 
C.    Carmustine
D.    Cyclophosphamide
E.    Carboplatin
A

C

Carmustine and Lomustine are highly lipophilic, used to treat brain cancer.

199
Q 
Which novel and innovative drug is used to treat rheumatoid arthritis through its action as an antibody against the protein CD20, found in the surface of B-cells?
A.    Abciximab
B.    Rituximab
C.    Omalizumab
D.    Infliximab
E.    Trastuzumab
A

B
Abciximab - Glycoprotein Iib/IIIa (antiplatelet)
Omalizumab - IgE (asthma) Infliximab - TNF (inflammatory bowel disease)
Trastuzumba - Her2neu (Breast cancer)

200
Q 
Which of the following substances can be adsorbed by activated charcoal, effectively decontaminating the gastrointestinal tract?
A.    Barbiturates
B.    HCl
C.    Lithium 
D.    Cyanide 
E.    Lye
A

A
Remember that activated charcoal is effective only to organic substances, so if it is inorganic like ions or acids/bases, it is not effective. Alcohol, though organic does not enhance its elimination with activated charcoal.

201
Q

Salmeterol has a slower onset of action as compared with formoterol in terms of producing bronchodilation. This is because of:
A. Increased lipophilicity of salmeterol
B. Faster degradation of salmeterol
C. More efficient absorption of formoterol
D. H

A

A
The quickier onset of action of formoterol can be explained by diffusion microkinetic model. This model suggests that formoterol and salmeterol are both retained in the lipid bilayer adjacent to the beta2-adrenergic receptor. Because of salmeterol’s lip

202
Q

If the plasma concentration of a drug declines with “first order kinetics,” this means that:
A. The halflife is constant regardless of plasma concentration
B. The drug is largely metabolized in the liver after oral administration and has low bioavailabi

A

A
First Order Kinetics : elimination of the Drug is directly proportional to its plasma concerntration. its dependent on its half life, which remains constant. First order implies that no matter how much concerntration of the Drug u give it will be elimi

203
Q 
A 35 year old female underwent treatment for endometriosis for 12 months. She then developed male-pattern hair growth, deepening of the voice and acne. The drug given is most likely
A. GnRH agonist   
B. Danazol
C. Combined oral contraceptive pills
D. Med
A

B
Danazol is a derivative of the synthetic steroid ethisterone, a modified testosterone, also known as 17-alphaethinyl testosterone. Danazol inhibits ovarian steroidogenesis resulting in decreased secretion of estradiol and may increase androgens. This d

204
Q 
In the case above, which of the following patient's manifestations may be IRREVERSIBLE? 
A. Acne 
B. Male-pattern hair growth 
C. Deepening of the voice 
D. All of the above 
E. B and C
A

C

All the other side effects of danazol is reversible, except for deepening of the voice.

205
Q 
Which of the following anti-hypertensives has been recalled from the market due to its side effect of producing rebound suicide?
A. Guanethidine
B. Phenoxybenzamine
C. Reserpine
D. Trimetaphan
A

C
Reserpine is an indole alkaloid antipsychotic and antihypertensive drug that has been used for the control of high blood pressure and for the relief of psychotic symptoms. Reserpine mediated depletion of monoamine neurotransmitters in the synapses is o

206
Q 
Organs involved in xenobiotic metabolism are as follows, EXCEPT:
A. Liver
B. Small intestines
C. Lung
D. Nasal mucosa
E. None of the above
A

E
Xenobiotic metabolizing enzymes are found in most tissues in the body with the highest levels located in the tissues of the gastrointestinal tract (liver, small and large intestines). Other organs that contain significant xenobioticmetabolizing enzymes

207
Q 
A pure opioid antagonist with a greater affinity for ? receptors and used for acute opioid overdose:
A. Morphine
B. Naloxone
C. Codeine
D. Dextrometorphan
E. Diphenoxylate
A

B
Naloxone is a pure opioid anatagonist and is used to counter the effects of opiate overdose, for example heroin or morphine overdose. The other drugs are opioid agonists.

208
Q

Given a hypothetical species of bacteria that is resistant to antibacterial agents that prevent translocation during translation, which of the following can be used effectively for this bacterial infection?
A. Chloramphenicol
B. Clindamycin
C. Erythromyci

A

A

Chloramphenicol inhibits peptidyl transferase. Clindamycin and erythromycin inhibits translocation.

209
Q 
The drug of choice for the treatment of bladder and bowel atony is:
A. Neostigmine
B. Metoclopramide
C. Pilocarpine
D. Bethanecol  
E. None of the above
A

D
Bethanechol is a muscarinic agonist that is administered orally to promote GI and bladder motility, usually used in post-op ileus and diabetic neurogenic bladder.

210
Q 
Beta-lactamase inhibitors are usually given with beta-lactam containing antibiotics, such as penicillins. This is done to produce a favorable drug interaction, specifically:
A. Synergism
B. Potentiation
C. Additive
D. Antagonism
E. None of the above
A

B
Synergism is giving two active drugs and the combined effect is greater than the sum of their effects (1+1=3). Potentiation is the addition of an inactive drug to an active drug, leading to increased effect of the active drug (1+0=3)

211
Q

A 67-year old male, on warfarin maintenance after undergoing valve replacement surgery, was brought to the ER due to unresolving epistaxis and easy bruising noted for the past week. In asking the history, the following substances are also being taken by t

A

A

Cimetidine inhibits metabolism of warfarin, thereby prolonging its effect.

212
Q

Clopidogrel exerts its antithrombotic effect through which of the following mechanisms:
A. Irreversible inhibition of ADP receptor
B. Inhibition of thromboxane synthesis
C. Reversible blockade of glycoprotein IIb/IIIa
D. Conversion of plasminogen to p

A

A
Clopidogrel works by irreversibly inhibiting a receptor called P2Y12, an adenosine diphosphate (ADP) chemoreceptor on platelet cell membranes.

213
Q 
Sympathomimetic drug that causes mydriasis without cycloplegia:
A. Atropine    
B. Tropicamide
C. Phenyephrine   
D. Pilocarpine
E. Timolol
A

C

Atropine and tropicamide cause mydriasis and cycloplegia. Timolol has no mydriatic effect.

214
Q

A 33-year old farmer, after 1 hour of spraying insecticides, started to note generalized body weakness, drowsiness, shortness of breath, numbness and severe epigastric pain. After 10 hours, he was brought to the ER due to loss of consciousness. He was soa

A

A
The patient had an insecticide poisoning. Insecticides usually contain organophosphates or carbamates. Before 6 hours, pralidoxime and atropine should be both administered. In this patient, 10 hours has already elapsed, hence pralidoxime can no longer

215
Q 
Lactulose is the most frequently administered laxative in post-MI patients. It is classified as:
A. Bulk-forming laxative
B. Osmotic laxative
C. Stool softener
D. Emollient
E. None of the above
A

B
Lactulose is an osmotic agent. Bulk forming agents include insoluble fibers (psyllium). Stool softeners include docusate Na. Emollients include mineral oil.

216
Q 
A hypertensive patient was found to have elevated triglycerides, normal LDL and decreased HDL levels. Which of the following is most efficacious for this patient?
A. Simvastatin
B. Ezetimibe
C. Colestipol
D. Fenofibrate
E. Orlistat
A

D
Fibrates are indicated for hypertriglyceridemia. Fibrates typically lower triglycerides by 20% to 50%. Level of the good cholesterol HDL is also increased. Fibrates may decrease LDL, though generally to a lesser degree than statins.

217
Q 
Which of the following cephalosporins is highly effective against pseudomonas?
A. Cefazolin
B. Cefuroxime
C. Ceftazidime
D. Cefaclor
E. Ceftriaxone
A

C

Ceftazidime, 3rd gen cephalosporin, is considered to be most efficacious agaianst pseudo monas among cephalosporins.

218
Q 
Which of the following antivirals is a reverse transcriptase inhibitor that is used in the treatment of Hepatitis B infection?
A. Amantadine
B. Ganciclovir
C. Lamivudine
D. Interferon alpha
E. Acyclovir
A

C

Lamivudine is used in hepatitis B as well as in HIV infection.

219
Q

Which of the following is NOT true about insulin action?
A. It stimulates glycogen synthesis in muscle fiber
B. It inhibits lipolysis in the adipocyte
C. It stimulates fatty acid synthesis in the hepatocytes
D. It binds to G receptor to increase intra

A 
D 
The insulin receptor is a transmembrane receptor that is activated by insulin, IGFI, IGF-II and belongs to the large class of tyrosine kinase receptors.
220
Q 
Disseminated intravascular coagulation (DIC) is a condition characterized by widespread stimulation of thrombosis. Which of the following is NOT consistent with the clinical findings in DIC?
A. Increased PTT
B. Increased PT
C. Decreased fibrinogen
D. Incr
A

E
DIC clinical findings: ↓ Fibrinogen, ↑ fibrin split products, ↓ platelets, ↑ PT, ↑ PTT, fragmented red blood cells on peripheral smear

221
Q

A 53 year old woman with newly diagnosed type 2 diabetes presents to mergency department complaining of vomiting, severe headache, dizziness, blurry vision, and DOB. She says that she had been at a cocktail party when the symptoms began. her skin is notab

A

E
This is a disulfiram like reaction after drinking alcohol at a cocktail party. TOLBUTAMIDE is associated with this kind of reaction

222
Q

A 65 year old man comes to the physician because he awakens to urintae several times per night and has developed problems starting and stopping his stream of urine. A biopsy of the prostate shows enlargement and dilation of the prostate glands but no dysp

A

A

BPH. Finasteride is a 5 alpha reductase inhibitor that inhibits conversion of testosterone to DHT.

223
Q

A 45 year old man who has received long treatment for schizophrenia has recently been noted to display involuntary movements that include lateral deviations of the jaw and “fly catching” motions in his tongue. Which of the following agents is the most lik

A

B
this is TARDIVE DYSKINESIA, which is a complication of long term antipsychotic therapy with the older agents like, FLUPHENAZINE.

224
Q 
Which of the following drugs can be used to reduce intraocular pressure in the treatment of glaucoma?
A.    Pilocarpine
B.   Acetazolamide
C.    Neostigmine
D.    Timolol
E.    All of the above
A

E

225
Q

Dantrolene is the drug of choice to treat malignant hyperthermia caused by succinylcholine because?
A. It blocks Ca release from sarcoplasmic reticulum
B. It induces contraction of skeletal muscle
C. It increases the rate of succinylcholine metabolism

A

A

226
Q

In the kidney, which one of the following is inhibited by thiazide diuretics?
A. Sodium chloride reabsorption in the early part of the distal convuluted tubule
B. Water removal from intracellular space by osmosis
C. Reabsorption of Calcium
D. Aldoster

A

A

Thiazide diuretics inhibit sodium chloride reabsorption in DCT.

227
Q 
Which of the following agents will increase myocardial contractility with the LEAST effect on total peripheral resistance?
A.    Epinephrine
B.    Phenylephrine
C.     Terbutaline
D.     Dobutamine
E.     Carbachol
A

D

Dobutamine increases myocardial contractility, but it has little effect on TPR. Beta 1 selective.

228
Q 
Which of the following antihypertive agents commonly used in hypertension in pregnancy is contraindicated to patients having myocardial ischemia?
A.    Methyldopa
B.    Methergine
C.     Clonidine
D.     Hydralazine
E.     Magnesium sulfate
A

D

Hydralazine is CI in ptients with myocardial ischemia.

229
Q 
Which of the following beta blocker drugs has/have intrinsic sympathomimetic activity?
A.    Timolol
B.    Acebutolol
C.     Pindolol
D.     Betaxolol
E.   B and C
A

E

Pindolol and Acebutolol have intrinsic sympathomimetic activity.

230
Q 
Which of the following nonselective , irreversible alpha blocker is the drug of choice as a preoperative agent used in Pheochromocytoma?
A.    Phentolamine
B.    Phenoxybenzamine
C.     Prazosin
D.    Yohimbine
E.     Clonidine
A

B
DOC for pheochromocytoma is Phenoxybenzamine, it is a nonselective, IRREVERSIBLE alpha blocker.. Phentolamine is a reversible alpha blocker.

231
Q 
Succor Mendiola was diagnosed to have glaucoma. Which of the following drugs induces ciliary muscle contraction thereby opening the trabecular meshwork and increasing the outflow?
A.    Timolol
B.     Mannitol
C.      Epinephrine
D.     Latanoprost
E.
A

E

Pilocarpine induces ciliary muscle contraction thereby opening the trabecular meshwork and increasing the outflow

232
Q 
Which of the following vasodilators has the common side effect of headache, hypotension and CYANIDE toxicity?
A.    Fenoldopam
B.    Nitroprusside
C.     Nifedipine
D.     Dopamine
E.    Minoxidil
A

B

Nitroprusside is a parenteral vasodilator known to cause CYANIDE toxicity

233
Q 
Which of the following drug/s is/are notorius in causing gingival hyperplasia?
A.    Nifedipine
B.    Cyclosporine
C.     Phenytoin
D.    Verapamil
E.   All of the above
A

E

234
Q

Which of the following statements concerning barbiturates is true?
A. Barbiturates can increase bleeding time when administered to patients taking anticoagulants
B. Barbiturates are contraindicated in patients with acute intermittent porphyria
C. Patie

A

B

235
Q 
Which of the following has the lowest incidence of extrapyramidal symptoms but is known to cause agranulocytosis?
A.    Clozapine
B.   Fluphanazine
C.    Chlorpromazine
D.    Pimozide
E.    Haloperidol
A

A

Clozapine is a new drug with least extrapyramidal effect but is known to cause agranulocytosis.

236
Q

Which of the following statements about the mechanism of action of ipratropium?
A. It acts cebtrally to decrease vagal Ach release
B. It inhibits pulmonary Ach receptors
C. It decreases mast cell release of histamine
D. It blocks the action of histami

A

B

237
Q 
Which of the following anti TB drugs is known to cause hyperuricemia and is noted to be the most hepatotoxic?
A.    Rifampicin
B.   Ethambutol
C.    Pyrazinamide
D.    Streptomycin
E.    Isoniazid
A

C

238
Q

A 5 year old boy with Trisomy 21 was diagnosed to have acute lymphoblastic leukemia. What is the most important drug in the therapeutic regimen of this disease entity?
A. Rituximab

A

D

Asparaginase, depletes serum asparagine. It is the main and the most impt drug in the management od ALL.

239
Q 
Which of the following ergot alkaloids is known to cause retroperitoneal fibrosis?
A.    Methylsergide
B.    Dihydroergotamine
C.    Methylergonovine
D.    Sumatriptan
E.    None of the above
A

A

240
Q 
Which of the following medication-rescue therapy pair is INCORRECT?
A.    Methotrexate : Leucovorin
B.    Cyclophosphamide : MESNA
C.     Doxorubicin : Dexrazoxane
D.     Cisplatin : Amifostine
E.     None of the above
A

E

241
Q 
Allen Dimo, is a 38 y/o G8P8(6208), known hypertensive and diabetic, turned out to be pregnant for 5 weeks already. What antihypertensive medication should you AVOID to give to the patient?
A.    Propranolol
B.    Captopril
C.    Hydralazine
D.    Methyld
A

B
Captopril is an ACE inhibitor and its use during gestation may result in IUGR, acute fetal renal failure, PDA, and even fetal death.

242
Q 
Assuming that the patient above is NOT pregnant. What is the best medication for her?
A.    Propranolol
B.    Captopril
C.    Hydralazine
D.    Methyldopa
E.    None of the above
A

B
ACE inhibitors block the formation of Angiotensin II which is a potent vasoconstrictor of the afferent and efferent Renal blood vessels. When administered to the patient, it prevents diabetic nephropathy by increasing blood flow to the kidneys.

243
Q 
Excessive use of Nitroprusside may result in Methemoglobinemia. The antidote for this condition is?
A.    Methylene blue
B.    Silver Nitrate
C.    100% oxygen
D.    Dialysis
E.    Blood transfusion
A

A

Methylene blue

244
Q 
This is the anti-Asthma drug which is only of worth if given as prophylaxis.
A.    Salbutamol
B.    Budesonide
C.    Salmeterol
D.    Cromolyn
E.    Hydrocortisone
A

D

245
Q 
One of the following drugs causes an increase in metabolism of other drugs when administered simultaneously.
A.    Valproic Acid
B.    Rifampicin
C.    Venlafaxine
D.    Ritonavir
E.    Ketoconazole
A

B

Rifampicin is an inducer. All other choices are inhibitors.

246
Q

Before intubation, prior to surgery, a 66 year-old male Asthmatic was injected with Succinylcholine. He was noted to remain apneic and paralyzed for an extended period of time. The patient most likely
A. Received an excessive dose of the drug
B. has bee

A

E
Succinylcholine is being metabolized by the enzyme pseudocholinesterase, hence deficiency or lack of this enzyme will lead to extended drug effect of Succinyhlcholine.

247
Q 
What is the drug of choice for trigeminal neuralgia?
A.    Lamotrigine
B.    Gabapentin
C.    Pregabalin
D.    Carbamazepine
E.    B or C
A

D

248
Q 
Which among the lipidlowering medicatins causes flushing?
A.    Statins
B.    Niacin
C.    Cholestyramine
D.    A and B
E.    B and C
A

B

249
Q 
Which anti-parasitic drug exerts its actions on the microtubules of helminths?
A.    Mebendazole
B.    Stibogluconate
C.    Ivermectin
D.    Diloxanide Furoate
E.    Metronidazole
A

A

250
Q 
Zidovudine is a very remarkable drug for HIV. Howeve,r precaution for its use should be observed because of this side effect.
A.    pancreatitis
B.    diarrhea
C.    myelosuppression
D.    Pulmonary fibrosis
E.    Optic neuritisq
A

C

251
Q

A 50 year old female consulted due to palpitations. This was accompanied by frequent bowel movements and heat intolerance. You gave her Radioactive iodine and you know that its most common side effect is?
A. Papillary Thyroid CA
B. Medullary Thyroid

A

D
RAI may induce production of cancer cells but ALL patients administered with RAI will suffer from permanent hypothyroidism and will require exogenous thyroxine as supplement

252
Q 
Which among the following diuretics can also be used for mountain sickness?
A.    Acetazolamide
B.    Furosemide
C.    Thiazide
D.    Mannitol
E.     None
A

A

Carbonic anhydrase inhibitors

253
Q 
Cimetidine is used as anti-PUD drug and it acts as a/an?
A.    mucuprotectant
B.    H1 blocker
C.    pH neutralizer
D.    A and B
E.    None
A

E

Cimetidine is a H2 blocker

254
Q 
Which among the following is/are opioid agonist?
A.    Hyoscine
B.    Metoclopramide
C.    Loperamide
D.    Attapulgite
E.    AlMg(OH)
A

C

Loperamide is an opioid that acts on Kappa receptors to increase gastric emptying time.

255
Q

After the oath-taking, you decided to establish a clinic on your province. A 63 year-old farmer was brought to you, soaked in sweat and salivating. When you asked his son about the history, you were told that he was found in that condition at the middle o

A

C
The antidote for organophosphate poisoning is Pralidoxime. BUT the golden period of 6 hours had already passed. And the best medication to give in this case is ATROPINE.

256
Q 
On your clinic, an 18 month old infant was brought for consult due to "blank stares" with a duration of 5-10 seconds. The best medication to be given for this case is
A.    Phenobarbital
B.    Valproic acid
C.    Ethosuximide
D.    Levepiracetam
E.    Car
A

C

This is absence seizure and DOC is Ethosuximide

257
Q 
You encountered a 2 year old patient suffering from an acute asthmatic attack. You immediately nebulized him with Salbutamol. Knowing its mode of action, you would expect that the patient may have
A.    Seizures
B.    Dry mouth
C.    Tachycardia
D.    Som
A

C
Salbutamol is a short-acting beta agonist and may stimulate beta 1 receptors of the heart, leading to transient tachycardia.

258
Q 
Furosemide is a loop diuretic that is known for its ototoxicity. Which among the following drugs should you AVOID administering it simultaneously?
A.    Penicillin
B.    Ceftriaxone
C.    Clindamycin
D.    Kanamycin
E.    Erythromycin
A

D

Kanamycin is an aminoglycoside is very ototoxic

259
Q 
Which among the following drugs is commonly used in controlling the manic phase of a bipolar patient?
A.    Lithium
B.    Selegiline
C.    Reserpine
D.    Haloperidol
E.    Biperiden
A

A

260
Q 
Being an IM resident, you are assigned to watch over a patient who is undergoing chemotherapy. Which drug is best to be given to prevent post-chemo vomiting?
A.    Metoclopramide
B.    Hyoscine N-Butyl-bromide
C.    Ondansteron
D.    Methylergonovine
E.
A

C

Ondansetron is a 5TH-3 anatagonist and is the drug of choice for post-chemo vomiting

261
Q

This is time of drug solubility and absorption and clearance?
A. Ionized drugs are better absorbed in the GIT
B. Polar drugs have decreased clearance
C. Non-ionized drugs are better absorbed in the GIT
D. Non-polar drugs have increased clearan

A

C

polar, ionized - less soluble in lipids, excreted; non - polar, unionized - more soluble, absorbed

262
Q 
Route of administration with instantaneous absorption, bypasses first pass effect with I00% bioavailabilty?
A.    IV
B.    SL
C.    Oral
D.    Rectal
E.    None of the above
A

A
Compared with other routes of administration, the intravenous route is the fastest way to deliver fluids and medications throughout the body.

263
Q 
Drugs which undergo zero order kinetics, except?
A.    Warfarin
B.    Heparin
C.    Hydralazine
D.    Aspirin
E.    None of the above
A

C

WHATPET - Warfarin, Heparin, ASA, Tolbutamide, Phenytoin, Ethanol, Theophylline

264
Q 
In this phase of clinical trials, the drig is evaluated in a moderate number of target patients to test dose efficacy of the drug?
A.    I 
B.    II
C.    III
D.    IV
E.    None of the above
A

B
I - normal volunteers, pharmacokinteics and dose sensitive acute effects
II - moderate number of PATIENTS, dose efficacy
III - large # of patients, toxicities
IV - post - marketing, idiosyncratic reactions

265
Q 
Which of the following drugs is a direct acting cholinoninetic used for treatment of glaucoma, sjoqren and sicca syndrome?
A.    Betanechol
B.    Pilocarpine
C.    Physostigmine
D.    Neostigmine
E.    None of the above
A

B

Bethanecol for bowel and bladder atony

266
Q 
Muscarinic antagonists used for the treatment of parkinsonism, except?
A.    Trinexyphenidyl
B.    Triamterene
C.    Benztropine
D.    Biperiden
E.    None of the above
A

B

Triamterene - potassium sparing diuretic

267
Q 
Drug of choice for uncomplicated essential hypertension?
A.    Furosemide
B.    Metoprolol
C.    HCTZ
D.    Captopril
E.    None of the above
A

C

Thiazide diuretics are first line of treatment for uncomplicated hypertension.

268
Q 
B - Blocker with intrinsic sympathomimetic activity?
A.    Acebutolol
B.    Atenolol
C.    esmolol
D.    metroprolol
E.    None of the above
A

A

Acebutolol and Pindolo has ISA.

269
Q 
What is the MOSTSLECTIVE alpha 1 selective antagonist used in the treatment of BPH?
A.    Prazosin
B.    tamsulosin
C.    Terazosin
D.    Doxazosin
E.    all of the above
A

B
However, all of the mentioned drugs are alpha-1 selective antagonists used in the treatment of BPH (Prazosin, Tamsulosin, Terazosin, Doxazosin).

Tamsulosin is the most selective alpha-1 selective antagonist. .

Tamsulosin is a selective α1 receptor

270
Q 
Mechanism of action of cyanide poisoning? 
A. Inhibits complex III of ETC 
B. Uncoupler 
C. Inhibits oxidative bursts 
D. Inhibits complex IV of ETC 
E. None of the above
A

D
Complex I - amytal, rotenone; Complex II - malonate; Complex III - antimycin A, Dimercaprol; Complex IV - CN, CO, Na azide; Complex V - Oligomycin Uncoupler - ASA, 2,4 - DNP

271
Q 
An anticoagulant which has a more selective effect on factor Xa?
A.    hepanin
B.    Lepirodin
C.    enoxaparin
D.    warfarin
E.    None of the above
A

C
It is an anticoagulant used to prevent and treat deep vein thrombosis or pulmonary embolism, and is given as a subcutaneous injection (by a health care provider or the patient).

272
Q 
Antihyperlipidemic agent which is contraindicated in patients prone to GB stone formation?
A.    Genifibrozil
B.    Niacin
C.    Ezetimibe
D.    Simvastatin
E.    None of the above
A

A

Fibrates and cholestipol increases risk of forming gallstones.

273
Q

Mechanism of action of chloroquine except:?
A. Suppression of BLymphocyte response to mitogens
B. Free-Radical Trapping
C. Lysosomal enzyme stabilization
D. Decreased leukocyte chemotaxis
E. None of the above

A

A

Chloroquine suppress T - lymphocyte response

274
Q

Mechanism of action of diazepam?
A. Increases duration of Cl- channel opening
B. Increases frequency of Cl- channel opening
C. Agonist at 5HT1a and D2 receptors
D. Blocks voltage gated Na+ channels
E. None of the above

A

B

Increases frequency of channel opening

275
Q 
Drug of choice for partial seizures?
A.    Diazepam
B.    Phenobarbital
C.    Valproic Acid 
D.    Carbamazepine
E.    None of the above
A 
D
Diazepam - s. epilepticus 
Phenobarbital - s. epilepticus 
Valproic Acid - absence, myoclonic 
Carbamazepine - partial seizures
276
Q 
Causes analgesia, amnesia and catatonia with retained conciousness?
A.    Midazolam
B.    Ketamine
C.    Thiopental
D.    Fentanyl
E.    None of the above
A

B

Dissociative anesthesia

277
Q 
Early morning hyperglycemia characterized by development of hypoglycemia around 3AM and pre-breakfast hyperglycemia:?
A.    Waning of insulin dose
B.    Dawn Phenomenon
C.    Somogyi Effect
D.    Combined Waning + Dawn
E.    None of the above
A

C
Waning of insulin dose - low dose insulin Dawn
Phenomenon - wrong type of insulin
Somogyi Effect - high dose of insulin

278
Q

Antibiotic which inhibits transpeptidation by binding to 50s subunit, used in the treatment of meningitis secondary to strep, H.inf, Neisseria neningitidis, causes aplastic anemia as its most common idiosyncratic effect?
A. Chloramphenicol
B. Erythr

A

A
Chloramphenicol is a bacteriostatic drug that stops bacterial growth by inhibiting protein synthesis. Chloramphenicol prevents protein chain elongation by inhibiting the peptidyl transferase activity of the bacterial ribosome.

279
Q

Mechanism of action of mebendazole?
A. Inhibits microtubule assembly
B. Inhibits glucose uptake in rematudes
C. Causes dipolarization induced paralysis
D. Increase permeability of membrane to Ca2+ causing muscle paralysis
E. None of the above

A

A
Mebendazole causes degenerative alterations in the tegument and intestinal cells of the worm by binding to the colchicine-sensitive site of tubulin, thus inhibiting its polymerization or assembly into microtubules. The loss of the cytoplasmic microtubu

280
Q 
Drug of choice for prostatic carcinoma?
A.    gemcitabine
B.    Paditaxel
C.    Cisplatin
D.    Leuprolide
E.    None of the above
A

D
Leuprolide acts as an agonist at pituitary GnRH receptors. By interrupting the normal pulsatile stimulation of, and thus desensitizing, the GnRH receptors, it indirectly down regulates the secretion of gonadotropins luteinizing hormone (LH) and follicl

281
Q

Doxylamine is an ethanolamine H1 antagonist drug previously utilized as a possible treatment of nausea and vomiting of pregnancy. Now, this drug is still available over-the-counter as sleep aid. What Bvitamin is a component of Doxylamine?
A. Vitamin B2
B.

A

C
Answer: C. Vitamin B6 (pp. 389 [.pdf file], Katzung Pharmacology, 9th edition) Notes: Several H1 antagonist drugs have been studied for possible use in treating “morning sickness.” The piperazine derivatives were withdrawn from such use when it was dem

282
Q

A few substances that are almost completely inert in the chemical sense nevertheless have significant pharmacologic effects. An example of these substances is Simethicone, which is included in many antacid preparations in order to act as
A. Antispasmodic

A

B
Answer: B. Antiflatulent (pp. 1520 [.pdf file], Katzung Pharmacology, 9th edition) Notes: Some antacid preparations include simethicone, an antiflatulent to relieve symptoms of bloating and pressure.
*SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE

283
Q 
Future clinicians may screen every patient for a variety of individual differences in drug response. Differences in the rate of acetylation of isoniazid among groups of individuals exemplifies
A. Pharmacodynamics
B. Posology
C. Pharmacogenetics
D. Biochem
A

C

Answer: C. Pharmacogenetics (pp. 3 and 82 [.pdf file] Katzung Pharmacology, 9th edition)

284
Q

A college friend consults you regarding the suitability of the medication given by his doctor for severe hypertension. He complains of postural and exercise hypotension (“dizziness”), some diarrhea, and problems with ejaculation during sexual activity. Gi

A

A
Answer: A. A drug which inhibits the release of norepinephrine from sympathetic nerve endings. The adverse effects described pertains to Guanethidine (pp. 237, 241, 244 and 251 [.pdf file], Katzung Pharmacology, 9th edition). Notes:
• A drug which dec

285
Q

The Board of Medicine decided to change the program of examination for the August 2013 Physician Licensure Examination (PLE) changing the first subject to Pharmacology. Because of this, a non-prepared Non-Topnotch examinee suddenly got an attack of diarrh

A

C

Answer: C. Loperamide (pp. 713 [.pdf file], Katzung Pharmacology, 9th edition) – must know, MPL 1.0

286
Q

Sources of drugs can either be natural or synthetic. These might be derived from plant sources, animal or marine products, minerals, microorganisms and others from laboratory sources. Many antibiotics were derived from Genus Streptomyces, Penicillium, Mic

A 
D 
Answer: D. Amphotericin B (pp. 1104 [.pdf file], Katzung Pharmacology, 9th edition.) 
Notes: incomplete list 
Streptomycin à Strept. griseus 
Neomycin à Strept. fradiae 
Paromomycin à Strept. rimosus 
Kanamycin (der. Amikacin) à Strept.kanamyceticus 
T
287
Q

Mrs. T. Anga, 25 yo, G1P1 was misdiagnosed to have preeclampsia because of the inaccuracy of her history and was given an anti-hypertensive to control her blood pressure. Fortunately, patient had no postpartum complications and BP was controlled. She cont

A

A
Answer: A. Methyldopa (pp. 235 [.pdf file], Katzung Pharmacology, 9th edition). Notes: The symptoms experienced by the patient are consistent with Autoimmune Hemolytic Anemia which is a rare adverse effect of methyldopa. Methyldopa is a drug which lowe

288
Q

Baby B. Ulate, suffers from infestation of the “unholy trinity” of roundworms, namely Ascaris lumbricoides, Trichuris trichiura and Ancylostoma duodenale. What is the mechanism of action of the drug suitable for the patient’s condition?
A. Increases perm

A

B
Answer: B. Selectively inhibits microtubule synthesis and glucose uptake in nematodes is the mechanism of action of Mebendazole, the drug of choice for Ascariasis (pp. 40 of part2, Pharmacology, Topnotch Handouts). Notes:
• Increases permeability to c

289
Q 
The following drugs are included in the ABVD regimen for Hodgkin’s Lymphoma, except:
A. Vinblastine
B. Doxorubicin
C. Dacarbazine
D. Oncovin
E. Bleomycin
A 
A 
Answer: A. Vinblastine (pp 41 [part 1], Pharmacology, Topnotch Handouts). Notes: 
A – Adriamycin (Doxorubicin) 
B – Bleomycin V – Vincristine (Oncovin) 
D – Dacarbazine
290
Q 
The following drugs accelerate substrate metabolism causing a decrease in the pharmacologic action of the co-administered drug, except;
A. Griseofulvin
B. Rifampicin
C. Ethanol
D. Cimetidine
A

D
Answer: D. Cimetidine (pp. 8 [part 1], Pharmacology, Topnotch Handouts; pp. 77 [.pdf file], Katzung Pharmacology, 9th edition). The question defines a CYP450 Inducer. The only CYP450 inhibitor among the choices is Cimetidine.

291
Q

Mr. A. Lipin, a farmer from a distant hacienda was brought to the ED and admitted due to unconsciousness, profuse salivation and shallow breathing. It took 7 hours of travel time from the hacienda to the nearest Provincial Hospital. BP 140/90 mmHg, PR 52

A

B
Answer: B. Atropine (pp. 141, 149 and 162, Katzung Pharmacology, 9th edition)
Notes: Atropine is the prototype antimuscarinic drug to be given initially in this patient suffering from organophosphate poisoning. It is best to give both Atropine and Pra

292
Q 
A patient in PACU is in no apparent distress. The V/S are stable except for HR of 128 bpm that is irregular with no p wave. Which of the following treatment option would not be appropriate as initial therapy?
A. Metoprolol
B. Diltiazem
C. Digoxin
D. Adeno
A

D
Answer: D Patient has atrial fibrillation w/ rapid ventricular response. B-blocker, Ca Channel blocker or Digoxin may be used. Supraventricular tachycardia, not a.fib responds to adenosine.

293
Q

3 This factor indicates the spread of local anesthetic in CSF?
A. Addition of narcotic to local anesthetic.
B. Density of local anesthetic
C. Patient’s body surface area
D. Dose administered

A

Answer: B
Density of local anesthetic in relation to density of CSF at normal body temp.is termed as baricity. Degree of spread is determnined primarily by density of anesthetic & patient’s position.

294
Q

A young, male patient presents with mental deterioration and tremors. He has brown pigmentation in a ring surrounding the periphery of his cornea and altered liver function tests. Which treatment modality should he receive?
A. Dimercaprol
B. Penicillamine

A

Answer: B

Wilson’s disease: excess copper deposition (cornea = Kayser-Fleischer ring)

295
Q 
In the treatment of CHF, this drug is characterized as having a selective beta-1 antagonistic activity and devoid of dopaminergic activity:
A. Fenoldopam
B. Dobutamine
C. Dopamine
D. Isoproterenol
A

Answer: B
Dobutamine is a relatively b-1 selective adrenoreceptor agonist that causes peripheral vasodilation in some vascular beds useful for many cases of acute heart failure.

296
Q 
A 7 year-old male child with nephritic syndrome on steroid therapy was exposed to a sister with measles. You would administer: 
A. Measles vaccine 
B. Human immunoglobulin 
C. Antisera 
D. Vitamin A
A

Answer: B
After susceptible person is exposed to measles, either measles vaccine given within 72 hrs or immune globulin given within 6 days can prevent or modify disease. However, px has nephritic syndrome & is immunocompromised so an active measles vacci

297
Q

At the E.R., you saw a 24-yr old woman complaining of severe, acute, generalized headache. PE revealed T 400C with (+) nuchal rigidity. Her CSF showed gram-neg diplococci & 200 leukocytes/mm3 (98% PMNs). Administration of which of these is the next import

A

Answer: C

Lab picture: N.meningitides. Tx = Pen G 4 million units IV q4h

298
Q 
An asthmatic patient whose symptoms occur less than once a week, lasts a few hours to a few days and has nighttime symptoms twice a month is best managed with an:
A. Inhaled long-acting 
B2 agonist at H.S.
B. Inlahed short-acting 
B2 agonist PRN
C. Inhale
A

Answer: B

Px’s asthma is classified as intermittent. *Review GINA guidelines

299
Q

The absorption of most orally administered drug, which occur in the small intestine, may be enhanced by
A. Taking agents that accelerate gastric emptying time
B. The presence of food
C. Stimulation of hepatic microsomal CYP3A4 enzymes
D. Increasing intest

A

Answer: A
Increasing gastric emptying time allow drugs to reach the small intestine sooner, hence increasing the rate of drug absorption.

300
Q

Adverse events associated with the use of quinolones include all of the following except:
A. Tendinitis and possible tendon rupture
B. Seizures
C. Arthropathy in children
D. Clostridium difficile colitis
E. Narrowing of QT interval

A

Answer: E
Quinolones inhibit topoisomerase II (DNA gyrase) & IV impairing DNA synthesis. Adverse effects include GI intolerance, antibiotic-asso.colitis, cutaneous rxns, hepatotoxicity, prolongation of QT interval and Achilles tendon rupture

Pharmacology (2 decks)

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