HEMATOPOIETIC & LYMPHATIC SYSTEM

- PHARMACOLOGY -

PULSE

1. WHICH OF THE FOLLOWING POTENTIATES THE EFFECT OF ORAL ANTICOAGULANTS

☐ Carbamezapine

☐ Co-trimixazole

2. HOW CAN WE MINIMIZE RESISTANT IN ANTICANCER DRUG

☐ Drug combination

☐ Short term therapy

☐ High dose

☐ Turn down thermostat.

☐ All are correct

3. ALL ARE MATCHED CORRECTLY REGARDING A SIDE EFFECT OR A MECHANISM OF

ACTION, EXCEPT :

☐ Bleomycin>> Mitotic spindle

☐ Vincristina>>thrombophilites

4. TREATMENT OF CHRONIC IRON TOXICITY IS DONE BY:

☐ Acid base and fluid

☐ Oral phosphate or carbonate

☐ Venesection

5. PREGRANT WOMEN IN THE 8TH MONTH OF PREGRANCY WITH IDA, IS TREATED BY:

☐ High dose of oral iron

☐ IV iron ( dextran )

6. WARFARIN:

☐ It is a mucopolysaccharide

☐ It is competitively inhibits Epoxide Reductase

7. WHICH F FOLLOWING NOT CORRECT REGARDING THE COMPARE BETWEEN LMHW

AND HEPARIN:

☐ LMWH is a result from the depolymerization of heparin

☒ LMWH is a dose independent ( FOK )

☒ LWHW has shorter half life

8. PATIENT WITH RENAL FAILURE IS TREATED WITH HEPARIN, SUDDENLY DEVELOPED

THROMBOCYTOPENIA, THE TREATMENT AFTER WE STOP THE DRUG IS :

☐ Lepiradin

☐ Warfarin

☐ Argatroban

9. WHICH OF THE FOLLOWING DRUGS HAS NO IMMUNOSUPPRESSOR EFFECT :

☐ Interferon (( not sure ))

10. TAMOXIFEN IS USED IN THE TREATMENT OF :

☐ Breast cancer in males

☐ Breast cancer in females

EHSAN

11. WHICH OF THE FOLLOWING DRUGS IS USED IN PATIENTS WITH CHRONIC RENAL

FAILURE?

☐ Epoetin

12. CICLOSPORINE IS:

☐ Used in organ transplantation for immune suppression

13. WHICH OF THE FOLLOWING DRUGS USAGE IS LIMITED BY ITS ADVERSE EFFECT OF

CARDIOTOXICITY?

☐ Doxorubicin

14. WHICH OF THE FOLLOWING DESCRIBES HOW DOXORUBICIN WORKS?

☐ Free radical generator that inhibits NA synthesis

15. WHICH OF THE FOLLOWING ISN’T ONE OF THE PRINCIPLES USED IN CANCER

CHEMOTHERAPY?

16. A PATIENT THAT HAS RECENTLY RECOVERED FROM A STROKE HAS BEEN PLACED ON

TICLOPIDINE THERAPY. WHICH OF THE FOLLOWING BEST DESCRIBES THE

MECHANISM OF ACTION OF TICLOPIDINE?

☐ Inhibits the production of ADP resulting in inhibition of platelet aggregation

17. WHICH OF THE FOLLOWING STATEMENTS IS INCORRECT

☐ LMWH follows zero order kinetics while heparin follows first order kinetics

18. WHICH OF THE FOLLOWING POTENTIATES THE EFFECT OF ORAL ANTICOAGULANTS?

☐ Rifampin

☐ Carbamezapine

☐ Co-trimixazole

19. WHICH OF THE FOLLOWING POTENTIATES THE EFFECT OF ORAL ANTICOAGULANTS?

☐ Cimetidine

20. ALTEPLASE IS:

☐ Clot selective in its action

☐ Not antigenic like streptokinase

☐ Is recombinant t-PA

☐ All of the following are correct

☐ The usage of drugs that have the same mechanism of action or affect at same stage of cell cycle.

21. WHICH OF THE FOLLOWING DRUGS MUST NOT BE USED FOR THE TREATMENT OF

ROCKY MOUNTAIN SPOTTED FEVER?(QUESTION WAS REPEATED TWICE IN EXAM)

☐ Streptomycin

☐ Doxycycline

☐ Sulfonamides

☐ Chloramphenicol

☐ Erythromycin

HOPE

22. PERNICIOUS ANEMIA IS BEST INITIALLY TREATED BY INITIALLY BY:

☐ Parenteral hydroxocobalamin

23. WHICH OF THE FOLLOWING DRUGS IS USED IN THE TREATMENT OF PATIENTS WITH

PERSISTENT NEUTROPENIA DUE TO HIV INFECTION:

☐ Molgramostim

24. PATIENTS WHO IS STABILIZED ON WARFARIN FOR FEW MONTHS SUDDENLY HAS

SEVERE NASAL BLEEDING, INR = 7, THIS PATIENT WAS ADVISED TO STOP WARFARIN

AND TREATED IMMEDIATELY WITH:

☐ Phytomenadione

25. HEPARIN DOSE ADJUSTMENT IS BY:

☐ Measurement of aPTT.

26. 65 YEARS OLD MALE, WITH PREVIOUS HISTORY OF STROKE IS TREATED BY ASPIRIN AS

A PROPHYLAXIS AND PREVENTION IF FURTHER STROKES, WHICH OF THE FOLLOWING

IS CONSIDERED THE EFFECTIVE MECHANISM OF ACTION OF ASPIRIN:

☐ Irreversible inhibition of platelets TXA2

27. ALL OF THE FOLLOWING DRUGS ARE CORRECTLY MATCHED WITH THEIR ANTIDOTES

EXCEPT:

☐ Methotrexate --- folic acid

28. WHICH OF THE FOLLOWING IS THE EFFECTIVE MECHANISM OF ACTION OF

VENCRISTINE:

☐ Inhibition of function of microtubules.

29. CARDIOTOXICITY LIMITS THE CLINICAL USEFULNESS OF THE FOLLOWING DRUG:

☐ Doxorubicin

30. THE ADVERSE REACTION OF CYTOTOXIC DRUGS THERAPY WHICH MIGHT BE SEVERE

AND REGARDED AS THE MAIN CAUSE OF TREATMENT REJECTION:

☐ Nausea and vomiting

31. WHICH OF THE FOLLOWING DRUGS HAS NO IMMUNOSUPPRESSOR EFFRCT:

☐ Abciximab

32. WHICH OF THE FOLLOWING TREATMENT IS THE MOST ACCURATE:

☐ Anemia prevention program among young children

SAMA AND

BEFORE

33. WHICH OF THE FOLLOWING IS MISMATCHED WITH ITS SPECIFIC SIDE EFFECT:

☐ Methotrexate --- nephrotoxicity

☐ Vinblastin --- skin hyperpigmentation

☐ Doxorubicin --- cardiotoxocity

☐ Bleomycin --- pulmonary toxicity

34. ALL OF THE FOLLOWING ARE CORRECT CONCERNING CHEMOTHERAPY EXCEPT:

☐ Small intermittent doses are better than high doses

35. WHICH OF THE FOLLOWING IS A SIDE EFFECT OF RADIOTHERAPY:

☐ Pneumonitis

36. CICLOSPORIN IS:

☐ Immunosuppressant agent used to prevent rejection of transplanted tissue.

☐ Used in Hodgkin lymphoma

☐ Used in breast cancer

37. ASYMMETRIC SUBSTITUTION OF THE ACETATE AND PROPIONATE IS SEEN IN:

☐ Porphyrin 3

☐ Porphyrin 1

☐ Porphyrin 2

38. HEPARIN IS:

☐ Given with monitoring of APTT

☐ Share the same structure with vitamin K

39. WHICH OF THE FOLLOWING IS USED IN CANCER TREATMENT :

☐ Chemotherapy

☐ Radiotherapy

☐ Surgery

☐ Antibodies

☐ All of the above

40. IRON SUPPLEMENT IS INDICATED IN ALL OF THESE DISORDERS EXCEPT:

☐ Talassemia

☐ IDA

☐ Hook worm infection

41. THE ANTICOAGULANT ACTIVITY OF WARFARIN CAN POTENTIATED BY ALL OF THE

FOLLOWING EXCEPT:

☐ Rifampin

☐ Aspirin

☐ Acute alcohol intoxication

☐ Phenylbutazone

☐ Cimetidine

42. MYELOSUPPRESSION (OR APLASTIC ANEMIA) IS A PARTICULARLY SERIOUS TOXICITY

WITH ALL OF THE FOLLOWING EXCEPT:

☐ Vinblastine

☐ Cyclophosphamide

☐ Cytarabine

☐ Mechlorethamine

☐ Asparaginase

43. A PATIENT WITH CHRONIC RENAL FAILURE PRESENTED TO YOU WITH FATIGUE. HER

HB WAS 7.2 WITH A NORMOCYTIC NORMOCHROMIC BLOOD FILM. THE DRUG THAT

WILL MOST LIKELY IMPROVE HER CONDITION IS:

☐ Ferrous sulphate

☐ Iron dextran

☐ Hydroxycobolamine

☐ Erythropoietin

☐ Folate supplements

44. SELECT THE CORRECT PAIRING OF AN ANTICANCER DRUG AND ITS CLASS:

☐ Vincristine → antimetabolites

☐ Methotrexate → folate analogues

☐ Cisplatin → plant alkaloids

☐ Bleomycin→ alkylating agent

☐ All of the above

45. ALL THE FOLLOWING STATEMENTS ABOUT CYCLOPHOSPHAMIDE ARE CORRECT,

EXCEPT:

☐ It is active orally

☐ It can be complicated with nausea and vomiting

☐ It is a cell cycle-non specific agent

☐ It belongs to the anti-metabolite class of antineoplastic agents

☐ It is converted to cytotoxic metabolite by the liver

46. IN THE MANAGEMENT OF THROMBOEMBOLISM:

☐ Alteplase directly converts fibrin bound plasminogen to plasmin

☐ Vitamin K is used for rapid reversal of plasmin-induced bleeding

☐ Streptokinase is a directly acting fibrinolytic agent

☐ Dipyridamol inhibits the synthesis of clotting factors in the liver

☐ Aspirin can be used in large doses

47. ALL OF THE FOLLOWING STATEMENTS ABOUT ANTICOAGULANT ARE TRUE, EXCEPT:

☐ Low molecular weight heparin (Enoxaprin) is not active orally.

☐ Parenteral administration of warfarin provides immediate anticoagulant

☐ Heparin effect is associated with antithrombin III

☐ Warfarin can be transported to the fetus

☐ Heparin overdose can be reversed by protamine sulfate administration

48. ACTIVATION OF PLASMINOGEN TO PLASMIN CAN BE INDUCED BY ALL OF THE

FOLLOWING AGENTS, EXCEPT:

☐ Streptokinase

☐ t-PA

☐ Anistreplase

☐ Antithrombin III

☐ Urokinase

49. WHICH OF THE FOLLOWING STATEMENT ABOUT HEPARIN IS FALSE?

☐ It is safe in early pregnancy

☐ It is monitored therapeutically by prothrombin time

☐ It is effective in vitro

☐ It mediated its effects by enhancing antithrombin III effects

☐ Its prolonged use might be complicated with thrombocytopenia

50. WHICH OF THE FOLLOWING IS FALSE ABOUT IRON POISONING?

☐ Acute poisoning can be complicated with GI bleeding and diarrhea

☐ Chronic iron overload leads to hemosiderosis

☐ Acute intoxication with iron can be complicated with metabolic alkalosis

☐ Frequent blood transfusion can be complicated with chronic iron toxicity

☐ Desferrioxamine is indicated in the management of acute iron poisoning

51. TARGETING THE GAMETOCYTES OF FALCIPARUM MALARIAE AND PREVENTING THE

TRANSMISSION OF THE DISEASE IS ACHIEVED BY TREATMENT WITH:

☐ Chlorquine

☐ Sulfonamides

☐ Primaquine

☐ Pyrimethanamine

☐ Melarsoprol B

52. WHAT IS THE DRUG OF CHOICE FOR THE TREATMENT OF MENINGO ENCEPHALITIS

CAUSED BY TRYPANOSOMA BRUCEI?

☐ Tetracycline

☐ Allopurinol

☐ Melarsoprol B

☐ Suramin

☐ Pentamidine

53. INDICATIONS OF PARENTERAL IRON PREPARATIONS ARE?

☐ . Iron can not be absorbed from GIT.

☐ A sure and definite response is needed.

☐ Non compliance.

☐ All of the above

54. TT OF CHRONIC IRON TOXICITY IS DONE BY?

☐ Oral phosphate or carbonate to precipitate iron.

☐ Venesection in non anemic

☐ Acid base, fluid and electrolyte correction

55. CLINICAL USES OF FOLIC ACID ARE ALL OF THE MENTIONED BELOW EXCEPT?

☐ Chronic hemolytic anemia

☐ Prevention of spina bifida

☐ TT of pernicious anemia and improvement of the neurological picture

☐ Anticonvulsants

56. TO REDUCE SEVERITY AND DURATION OF NEUTROPENIA WE USE WHICH OF THE FOLLOWING?

☐ IL-11 “Oprelvekin”

☐ GM-CSF & G-CSF

☐ Erythropoietin

57. HEPARIN?

☐ Strongest acid in the body with a positive charge.

☐ Both in vivo and in vitro.

☐ Dose adjustment by PT

58. WHICH OF THE FOLLOWING IS FALSE REGARDING HEPARIN?

☐ Antidote “Protamine sulphate”

☐ Injectable “Parentral”

☐ A powerful anti-coagulant

☐ An effective anticoagulant even in the absence of Anti thrombin III

59. PATIENT WHO IS STABILIZED ON WARFARIN FOR FEW MONTHS SUDDENLY HAS

SEVERE NASAL BLEEDING, INR=7, THIS PATIENT WAS ADVISED TO STOP WARFARIN

AND SHOULD BE GIVEN?

☐ Phytomenadione

☐ Protamine

☐ MESNA

60. WHEN USED WITH THIS SPECIFIC DRUG, OACS DOSAGE SHOULD BE REDUCED (I DON'T

KNOW IF I WROTE THE QUESTION PROPERLY)?

☐ Phenytoin

☐ Cimetidine

☐ Rifampin

61. CLOPIDOGREL?

☐ Inhibitors of TXA2 production

☐ Inhibitors of ADP receptors

☐ Inhibitors of platelet aggregation

☐ Irreversibly acetylating COX-1

62. ALL ARE TRUE REGARDING CYTOTOXIC DRUGS EXCEPT?

☐ Recovery of normal cells from toxic effects of the drugs is faster and better than that of malignant cells

☐ Small continuous doses are better than full intermittent doses

☐ ADRs of the drugs should be diverse and not centered on the same organ system.

63. WHICH OF THE FOLLOWING IS MIS-MATCHED?

☐ Mercaptopurine--- Hepatotoxicity

☐ Vincristine --- skin hyper-pigmentation

☐ Methotrexate --- Nephrotoxicity

64. CICLOSPORINE?

☐ Used in organ transplantation

☐ Anti TNF – alpha agent

☐ Interferes with purine synthesis

65. WHAT IS THE FUNCTION OF ANTILYMPHOCYTE GLOBULINS (ALG) AND

ANTILYMPHOCYTE GLOBULINS (ATG)?

☐ Treating autoimmune disease

☐ Preventing rejection of transplanted organ

☐ Treating rheumatoid arthritis

☐ All

66. WHICH OF THE FOLLOWING IS NOT IMMUNOSUPPRESSANT DRUGS?

☐ Cyclosporine

☐ Prednisone

☐ Mycophenolatemofetil

☐ Bleomycin

67. CHOOSE THE WRONG COMBINATION

☐ Monoclonal antibodies - neutropenia

☐ Mycophenolatemofetil - given with cyclosporine to reduce nephrotoxicity

☐ Etanercept- rheumatoid arthritis

☐ Rho immunoglobulins- prevent Rh hemolytic disease of newborn

68. WHICH OF THE FOLLOWING IS NOT SPECIFIC SIDE EFFECTS OF CYCLOSPORINE AND

TACROLIMUS:

☐ Neurotoxicity

☐ Hyperglycemia

☐ Hypertension

☐ Cardiotoxicity

☐ Hyperlipidemia

69. CHOOSE A WRONG COMBINATION:

☐ Methrotrexate - specific side effects are pneumonia and nephrotoxicity

☐ Cytabarine - inhibit DNA synthesis at M phase

☐ Mercatopurine - hepatotoxicity

☐ Flurouracil- inhibit thymidylatesynthetase

70. WHICH OF THE FOLLOWING IS WRONG:

☐ Antidotes for acroline is MESNA

☐ Doxorubicin is associated with cardiotoxicity and congestive heart failure

☐ Vincristine inhibits mitosis at S phase

☐ Allergic patients are pretreated with steroid and antihistamine drug

☐ Estrogen is used to treat breast cancer In males

71. ALL THE FOLLOWING ARE SPECIFIC SIDE EFFECTS OF PACLITAXEL EXCEPT:

☐ Thrombophlebitis

☐ Fluid retention

☐ Neurotoxicity

☐ Hypersensitivity

72. HEPATOTOXICITY, NEPHROTOXICITY AND NEUROTOXICITY ARE ASSOCIATED WITH

WHICH DRUG?

☐ Asparaginase

☐ Cisplastin

☐ Busulfan

☐ Procarbazine

73. WHICH IS THE SPECIFIC SIDE EFFECTS OF PROCARBAZINE?

☐ Disulfiram like reaction

☐ MES inhibitor

☐ Nephrotoxicity

☐ A & B

☐ All

74. PANCREATITIS AND SEIZURES ARE SPECIFIC SIDE EFFECTS OF WHICH DRUG?

☐ Cisplastin

☐ Procarbazine

☐ Asparginase

☐ Doxorubicin

75. WHICH DRUG HAS ANTIVIRAL AND ANTINEOPLASTIC EFFECTS?

☐ Doxorubicin

☐ Mustine

☐ Vinblastine

☐ Interferons

76. CHOOSE A CORRECT COMBINATION:

☐ Abxicimab&tirofiban- Platelet aggregation inhibitor

☐ Aspirin - TXA2 inhibitors

☐ Ticlopidine&clopidogrel- ADP receptors inhibitor

☐ All

77. WHICH OF THE FOLLOWING IS WRONG:

☐ A baby aspirin is sufficient to produce antiplatelet effects

☐ Neutropenia is associated with long term use of ticlopidine

☐ Antiplatelet drug is the first choice of treating arterial fibrillation

☐ Intermittent claudication is treated with antiplatelets drugs

☐ Main side effects of antiplatelets drugs are bleeding

☐ Dipyridamole causes accumulation of C AMP and little vasodilator effect

78. WHICH OF THE FOLLOWING IS NOT FIBRINOLYTICS AGENTS?

☐ Alteplase

☐ Tranexamic acid

☐ Urokinase

☐ Anistreplase

79. IF THE BLEEDING IS SERIOUS PRIOR TO THE USE OF FIBRINOLYTIC AGENTS, WHICH IS

NOT THE TREATEMENT?

☐ Tranexamic acid

☐ Fresh plasma

☐ Clotting factors

☐ Protalminesulphate

80. CHOOSE THE WRONG COMBINATION

☐ Streptokinase- have antistreptococcal antibodies formed after 4 days administration

☐ Alteplase- clot selective

☐ Reteplase- short lived effect and given IV infusion

☐ Streptokinase - cause allergy and hypotension

81. WHICH IS NOT THE CLINICAL USES OF TRANEXAMIC ACID?

☐ Menorrhagia

☐ Epistaxis

☐ Dental extraction

☐ Prostatectomy

☐ Unstable angina

82. WHEN THERE IS RECENT THROMBOEMBOLISM FOLLOWING FIBRINOLYTIC

OVERDOSE, WHAT IS THE BEST CURE?

☐ Aprotinin

☐ Menadiol sodium phosphate

☐ Tranexamic acid

☐ Phytomenadione

83. TREATMENT OF IRON DEFICIENCY ANEMIA CONSIST OF:

☐ Correction of underlying cause

☐ Iron replacement therapy

☐ A&B

☐ None

84. WHICH OF THE FOLLOWING INTERFERE IRON ABSORPTION?

☐ Tetracycline

☐ Levodopa

☐ Captopril

☐ egg yolk

☐ All

85. FERROUS SUCCINATE ELIXIR AND FERROUS FUMARATE SYRUP ARE RARELY USED

BECAUSE IT CAUSE:

☐ Fertility

☐ Dark brown teeth

☐ Red urine color

☐ Inhibit iron absorption

86. WHICH IS FALSE ABOUT IRON ORAL PREPARATION?

☐ Ferrous sulphate, fumarate& succinate arepreferred

☐ One of the side effect is blacken feces

☐ It starts by giving small doses and increase gradually to avoid GIT upset

☐ None

87. WHICH OF THE FOLLOWING IS WRONG?

☐ Imferon ( Iron dextran ) can be given IM or IV

☐ Jectofer ( Iron sorbitol ) can be given IV only

☐ IM injection must be given deeply injected to prevent iron leakage and causing skin discoloration into

dark brown

☐ None

88. IRON TOXICITY MAY CAUSE THE FOLLOWING EXCEPT:

☐ Hypovolemic shock

☐ Impaired oxidative phosphorylation

☐ Electrolyte loss

☐ Cirrhosis

89. WHICH OF THE FOLLOWING IS FALSE REGARDING HEPARIN?

☐ Venesection in anemic patients

☐ Oral PO4 & CO3

☐ Iron chelation like desferrioxamine ( desferal )

☐ All

90. WHICH IS FALSE ABOUT B12 DEFICIENCY?

☐ Associated with megaloblastic anemia

☐ May lead to subacute combined degeneration of spinal cord

☐ Can be treated with cyano by IM injection if case of pernicious anemia

☐ Low doses of oral hydroxycobalamin can be used to treat cyanide poisoning

91. NEURONAL TUBE DEFECT KNOWN AS SPINA BIFIDA IS MOSTLY SUITABLE TREATED BY

USING:

☐ vitamin B12

☐ Folic acid

☐ Vitamin C

☐ Folinic acid

92. TRANSIENT INFLUENZA-LIKE SYMPTOMS, ENCEPHALOPATHY AND RISKS OF

THROMBOSIS ARE SOME SIDE EFFECTS FOLLOWING THE USE OF:

☐ Molgrasmostim (GM-CSF)

☐ Filgrastim

☐ Epoetin

☐ Oprelvekin (thrombopoietin)

93. WHICH HGF IS ASSOCIATED WITH DYSUREA AND ABNORMAL LIVER FUNCTION TEST

AS SOME SIDE EFFECTS?

☐ L-CSF

☐ r-erythropoietin

☐ GM-GSF

☐ G-CSF

94. WHICH DRUG CAN BE INJECTED BY INTRAPERITONEALLY?

☐ Molgrasmostim (GM-CSF)

☐ Filgrastim

☐ Epoetin (erythropoietin)

☐ Oprelvekin (thrombopoietin)

95. WHICH IS FALSE REGARDING PARENTERAL INJECTED ANTICOAGULANTS?

☐ Heparin can be given IV, SC not IM because may lead to hematoma.

☐ Heparin stimulates the action of antithrombin III

☐ Heparin increases postprandial lipemia

☐ Heparin’s effect can be predicted from dose so APTT is not needed

☐ Heparin is the strongest acid in the body with a negative charge

96. ALL THE FOLLOWING IS THE SIDE EFFECTS OF PARENTERAL ANTICOAGULANTS

EXCEPT:

☐ Hepatotoxicity

☐ Bleeding from any site

☐ Osteoporosis

☐ Hypoaldosteronism

97. WARFARIN:

☐ Similar to vitamin K in structure

☐ Inhibits epoxide reductase enzyme

☐ May cross placenta and cause teratogenicity

☐ Its antidotes are fresh blood &phytomenadione

☐ All

98. ANTICOAGULANTS ARE USED FOR THE FOLLOWING PREVENTION EXCEPT:

☐ Hyperkalemia

☐ Deep vein thrombosis-DVT

☐ Thrombosis & embolism in arterial fibrilation

☐ Unstable angina

99. ANTICOAGULANTS ARE CONTRAINDICATED IN WHICH PATIENT?

☐ Advanced cardiac disease

☐ Suspected intracranial hemorrhage

☐ Severe hypotension

☐ All

100. WHICH OF THE FOLLOWING IS USED FOR LYSIS OF THE BLOOD CLOT:

A. Heparin

B. Anti-thrombin III

C. Plasminogen

D. Plasmin

E. All of the above

101. WHICH OF THE FOLLOWING IMPROVES THE FUNCTION OF ANTITHROMBIN III

Answer: Heparin

102. WHICH OF THE FOLLOWING IS USED TO MONITOR THE ORAL ANTICOAGULANT

THERAPY?

Answer: PT (Prothrombin time)