Pharmboardsreview2009 (Answers Higlighted)[1]

7/30/2019 Pharmboardsreview2009 (Answers Higlighted)[1]

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UPCM 2009 BOARDS ORIENTATION AND REVIEW COURSE

PHARMACOLOGY

1. The process by which the amount of orally-administered drug is reduced before it reaches the

systemic circulation

A. First-order kineticsB. First-pass effectC. Pharmacokinetics

D. ExcretionE. Metabolism

2. A drug repeatedly administered at dosing intervals equal to its elimination half-life will

reach steady state after how many dosesA. 2 to 3

B. 4 to 5

C. 6 to 7

D. 8 to 9E. 10 or more

3. A drug that counters the effects of another by binding the drug and preventing its action

A. Physiologic antagonist

B. Partial antagonistC. Competitive antagonist

D. Irreversible antagonist

E. Chemical antagonist

4. The dose or concentration required to bring about 50% of a drugs maximal effect

A. PotencyB. ED50C. EfficacyD. KdE. Therapeutic index

5. The concentration of drug that results in binding to 50% of the receptors

A. PotencyB. ED50C. Efficacy

D. Kd

E. Therapeutic index

6. The maximum effect of the drug may be produced even if not all receptors are bound in the

presence of which of the following:

A. Full agonistB. Partial agonist

C. Spare receptors

D. Inert binding site


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E. Effector

7. The pharmacokinetic value that most reliably reflects the amount of drug reaching the targettissue after oral administration is the

A. Peak blood concentration

B. Time to peak blood concentrationC. Product of the volume of distribution and the first-order rate constant

D. Volume of distribution

E. Area under the blood concentration-time curve

8. Which of the following terms is best described as a rapid reduction in the effect of a given

dose of a drug after only one or two doses

A. Supersensitivity

B. Tachyphylaxis

C. Tolerance

D. Anaphylaxis

E. Synergism

9. FALSE of plasma protein bindingA. Acidic drugs generally bind to plasma albumin and basic drugs to alpha-1

glycoprotein

B. It reduces the availability of a drug for diffusion or transport to drugs target organC. Inhibition of clearance of the unbound drug is the relevant mechanism explaining

drug interaction of highly-protein bound drugs

D. A highly-protein drug has a relatively higher volume of distribution

E. Many drugs bind with albumin through both hydrophobic and electrostatic forces

10. Aspirin is a weak organic acid with a pKa of 3.5. What percentage of a given dose will be in

the lipid soluble form at a stomach pH of 2.5?A. About 1%

B. About 10%

C. About 50%

D. About 90%

E. About 99%

11. Which of the following is TRUE in Promethazine overdose given that its a weak base with a

pKa of 9.1

A. Urinary excretion would be accelerated by administration of an acidifying agent

B. Urinary excretion would be accelerated by giving an alkalinizing agentC. More of the blood will be ionized at blood than at stomach pH

D. Absorption will be faster from the stomach than the small intestine

E. Peritoneal dialysis is the only effective therapy

12. Given a drug with a volume of distribution of 80 L and clearance of 1.386 L/h, the half-life is

approximately

A. 0.02 h


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B. 40 h

C. 58 h

D. 80 hE. 111 h

13. Which of the following is NOT a Phase II reaction of drug metabolismA. DeaminationB. Acetylation

C. GlucuronidationD. Methylation

E. Sulfate conjugation

14. The plasma concentration of a drug rendered inactive by Cytochrome P450 enzymes willincrease when given concomitantly with which of the following drugs

A. Phenobarbital

B. Phenytoin

C. RifampicinD. Carbamazepine

E. Fluconazole

15. An important modulator of intestinal drug transport and usually functions to expel drugs

from the intestinal mucosa to the lumenA. UDP-glucuronic acid

B. P-glycoprotein

C. Microsomal mixed function oxidase system

D. NADPH-cytochrome P450 reductaseE. Glutathione

16. Phase of drug development and testing process involving evaluation of drug in a moderatenumber of patients (100-300) with the target disease

A. Phase I

B. Phase II

C. Phase III

D. Phase IV

E. Phase V

17. Which of the following factors commonly decrease half-life

A. Aging

B. ObesityC. Cytochrome P450 inhibition

D. Hepatic failure

E. Cardiac failure

18. The kinetics characteristic of elimination of ethanol and high doses of phenytoin and aspirin

is known as

A. Distribution


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B. Excretion

C. First-pass effect

D. First-order elimination

E. Zero-order elimination

19. Which of the following drug combinations is known to lead to a pharmacokinetic druginteraction

A. Furosemide and hydrochlorthiazide

B. Cimetidine and warfarin

C. Metoprolol and Dobutamine

D. Digoxin and Propranolol

E. ACE inhibitor and spironolactone

20. Which of the following drugs has the highest probability of toxicity or loss of efficacy with

changes in plasma concentration

A. Amoxicillin

B. FurosemideC. Atenolol

D. Digoxin

E. Enalapril

21. Which of the following CNS receptors is an Ionotropic receptor

A. Nicotinic

B. Muscarinic

C. Dopamine receptor

D. Beta-adrenergic receptorE. Alpha-adrenergic receptor

22. Which of the following drugs inhibits cyclooxygenase irreversibly

A. Aspirin

B. Ibuprofen

C. PrednisoneD. Indomethacin

E. Zileuton

23. Prostaglandins involved in inflammatory processes are produced from arachidonic acid byA. Phospholipase A2

B. Lipoxygenase

C. Glutathione-S-transferaseD. Cyclooxygenase-1

E. Cyclooxygenase- 2

24. Corticosteroids are usually indicated in the following conditions EXCEPT:

A. Herpes simplex of the eye

B. Status asthmaticus

C. Severe allergic rhinitis


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D. Nephrotic syndrome

E. Adrenal insufficiency

25. Which of the following drugs is most often associated with hypotension caused by histamine

release?

A. DiazepamB. Pancuronium

C. Vecuronium

D. Tubocurarine

E. Succinylcholine

26. Which of the following characterizes local anesthetics

A. They generally block myelinated before unmyelinated fibers

B. They are generally administered along with epinephrine to prolong its action

C. The primary action is on calcium permeability

D. Do not readily cross the blood-brain barrier

27. Which of the following is commonly used to treat both absence and generalized tonic-clonic

seizuresA. Phenytoin

B. Valproate

C. CarbamazepineD. Clonazepam

E. Phenobarbital

28. Which of the following is the mechanism of action of effective anti-psychotic agentsA. Decreases acetylcholine in the CNS

B. Blocks dopamine receptor sites in the CNS

C. Makes acetylcholine more available in the CNSD. Facilitates the use of norepinephrine in the CNS

E. Makes dopamine more available in the CNS

29. Which of the following drugs can cause Stevens-Johnson syndrome, ataxia, and gingival

hyperplasia

A. Phenobarbital

B. Disulfiram

C. Phenytoin

D. Valproic acid

E. Carbamazepine

30. A pure opioid antagonist with a greater affinity for receptors and used for acute opioid

overdoseA. Morphine

B. Naloxone

C. CodeineD. Dextromethorpan


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E. Diphenoxylate

31. A patient with overdose toxicity of MDMA or ecstasy is UNLIKELY to manifest which ofthe following symptoms

A. Agitation

B. HyperthermiaC. Hyperreflexia

D. Bradycardia

E. Seizures

32. A patient who underwent percutaneous coronary angioplasty with placement of a stent in a

coronary vessel was started on clopidogrel. This drug exerts its antithrombotic effect throughwhich 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 plasminE. Posttranslational modification of vitamin K-dependent clotting factors

33. The effect of heparin in a patient who suddenly presented with gastrointestinal hemorrhage

may be promptly reversed with which of the following:

A. Vitamin KB. Ascorbic acid

C. EDTA

D. Protamine

E. Folic Acid

34. Which of the following is most useful for patients with red cell deficiency caused by renaldisease or depression of the bone marrow

A. Erythropoietin

B. Hemosiderin

C. TransferrinD. Folic acid

E. Vitamin B 12

35. Which of the following is FALSE about Vitamin B 12

A. It can be synthesized by multicellular organisms

B. It is stored in the liver in large amounts which can last up to 5 years

C. Used in the treatment of anemia caused by gastric resectionD. Deficiency of Vitamin B12 can cause neurologic defects

E. It is essential in the conversion of methylmalonyl CoA to succinyl-CoA

36. A bactericidal glycoprotein with a narrow spectrum of activity and is used for serious

infections caused by methicillin resistant staphylococci (MRSA), penicillin-resistant

pneumococci, and Clostridium difficile

A. Aztreonam


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B. Clavulanic acid

C. Imipinem

D. Cefepime

E. Vancomycin

37. Which of the following cephalosporins is highly effective against pseudomonasA. Cefazolin

B. Cefuroxime

C. Ceftazidime

D. Cefaclor

E. Ceftriaxone

38. Which of the following antibiotics inhibit microbial protein synthesis by binding to the 30Sribosomal subunit

A. Clindamycin

B. Erythromycin

C. ChloramphenicolD. TetracyclineE. Linezolid

39. A selective inhibitor of bacterial dihydrofolate reductase

A. Sulfonamide

B. Trimethoprim

C. Ciprofloxacin

D. Nalidixic acid

E. Linezolid

40. Aminoglycoside toxicity includes the following EXCEPT:

A. Auditory or vestibular damageB. Acute tubular necrosis

C. Respiratory paralysis in high doses

D. Contact dermatitis

E. Encephalopathy

41. The following are drugs used in the treatment of Tuberculosis, EXCEPT:

A. EthambutolB. Rifampicin

C. Streptomycine

D. Dapsone

E. Ciprofloxacin

42. Urinary tract infection due to Chlamydia trachomatis will NOT reapond to which of thefollowing drug?

A. Tetracycline

B. Erythromycin

C. Nitrofurantoin


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D. Ciprofloxacin

43. Which of the following statements about fluconazole is most accurate:

A. It is highly effective in the treatment of aspergillosis

B. Its oral bioavailability is less than that of ketoconazoleC. It does not penetrate the blood brain barrier

D. It inhibits demethylation of lanosterol

E. It is a potent inducer of Cytochrome P450 enzymes

44. Which of the following drugs is a reverse transcriptase inhibitor that is useful in the treatment

of Hepatitis B infection

A. AmantadineB. Ganciclovir

C. Lamivudine

D. Interferon-alpha

E. Acyclovir

45. The use of chloroquine in Plasmodium vivax infection is primarily targeted on the

elimination of which of the following forms of the parasite

A. Secondary tissue schizonts

B. Exoerythrocytic schizonts

C. Erythrocytic stage

D. Asexual forms

E. Liver stages

46. Which of the following is the drug of choice for Schistosoma haematobium

A. PraziquantelB. MebendazoleC. Metronidazole

D. Diethlcarbamazine

E. Albendazole

47. Drug of choice for the relief of acute exacerbations of asthma

A. Terbutaline

B. Ipatropium bromide

C. Cromolyn sodium

D. Montelukast

E. Prednisone

48. Which of the following drugs is used to decrease uric acid production in gout

A. Allopurinol

B. Aspirin

C. Colchicine

D. ProbenecidE. Hydroxychloroquine


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49. Treatment for thyrotoxicosis does not include which of the following drugs

A. Radioactive iodine

B. Thyroglobulin

C. Propylthiouracil

D. Potassium iodide

E. Methimazole

50. A patient with chronic overdose of exogenous T4 will have which of the following

manifestations:A. Dry, puffy skin

B. Large tongue and drooping eyelids

C. Weight loss

D. Lethargy, sleepiness

E. Bradycardia

51. Action of Sulfonylurea hypoglycemic agents does NOT include

A. Stimulate release of endogenous insulinB. Reduce glucagon release

C. Increase functional insulin receptors in peripheral tissues

D. Increase target tissue sensitivity to insulin

E. Closing of potassium channels in the pancreatic B cell membrane

52. Which of the following is most likely to cause hypoglycemia when used as a monotherapy

for Type II diabetes

A. Acarbose

B. Glimepiride

C. Metformin

D. RosiglitazoneE. Miglitol

53. The hypoglycemic agent of choice in pregnant women

A. BiguanidesB. Sulfonylurea

C. Insulin

D. RosiglitazoneE. Acarbose

54. Which of the following is NOT an effect of muscarinic blocking drugs

A. Miosis

B. Constipation

C. Reduced salivation and gastric secretion

D. Urinary retentionE. Bronchodilation

55. Which of the following is NOT a direct-acting cholinergic agonistA. Bethanechol


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B. Carbachol

C. Pilocarpine

D. Neostigmine

E. Nicotine

56. Cause of death from exposure to a high concentration of organophosphate insecticide willmost likely be

A. Cardiac arrhythmia

B. Respiratory failure

C. Hypertension

D. Renal failure

E. Gastrointestinal hemorrhage

57. A patient with warm septic shock presents with hypotension and generalized vasodilation.

High dose Dopamine intravenous infusion was started. Which adrenoceptor does dopamine

act to constrict the vessels?

A. Beta-1B. Alpha-1C. Alpha-2D. D1

E. D2

58. A patient rushed to the emergency room for anaphylactic shock was given intramuscular

epinephrine. Which of the following are expected effects of the drug

A. Bronchodilation

B. VasodilationC. Decreased cardiac contractility

D. Pupillary constriction

E. Uterine contraction

59. Which of the following is the drug of choice for a hypertensive patient with benign prostatic

hypertrophy and urinary obstruction:A. Metoprolol

B. Clonidine

C. Prazosin

D. EphedrineE. Methlydopa

60. A patient diagnosed to have pheochromocytoma, a tumor of the adrenal medulla causingexcessive release of epinephrine and norepinephrine, was started on a non-selective alpha-

antagonist, an example of which is

A. YohimbineB. Methyldopa

C. Terazosin

D. Phenoxybenzamine

E. Clonidine


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61. The following is NOT a clinical use of beta-adrenoceptor antagonists:

A. Portal hypertension

B. Glaucoma

C. Hypothyroidism

D. Chronic heart failure

E. Angina

62. Postsynaptic activation of Alpha-1 receptors will lead to the following cellular effects

A. Decreased intracellular calciumB. Increased cAMP

C. Increased IP3 and DAG

D. Inhibition of phospholipase activity

E. Inhibition of Phosphodiesterase III

63. In an experiment by Arinze and Kawai in 1983, glycogenolysis in hepatocytes isolated from

fed guinea pigs was stimulated by catecholamines with the following order of potency:

Isoproterenol>Epinephrine>>Norepinephrine. This order of potency is characteristic ofwhich adrenoceptor:

A. Alpha-1B. Alpha-2

C. Beta-1

D. Beta-2

E. Beta-3

64. Increased cardiac contractility, decreased peripheral vascular resistance, increased pacemaker

activity are actions ofA. Dopamine

B. NorepinephrineC. IsoproterenolD. High-dose epinephrine

E. Atenolol

65. Which of the following drugs will decrease heart rate in a normal heart but has little or no

effect in a denervated heart

A. Phenylephrine

B. Isoproterenol

C. Dobutamine

D. Epinephrine

E. Prazosin

66. Beta-receptor activation will produce which of the following metabolic effects

A. Increased fat storesB. Increased extracellular potassium

C. Increased glycogen stores

D. Increased renin secretion

E. Insulin release inhibition


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67. Which among the following is the most potent diuretic

A. Furosemide

B. HydrochlorothiazideC. Spironolactone

D. Acetazolamide

E. Eplerenone

68. Which of the following is a direct centrally-acting sympatholytic agent

A. Methyldopa

B. Guanethedine

C. Reserpine

D. Propranolol

E. Prazosin

69. The expected frequency of occurrence of a particular toxic effect in response to a particular

agent is known as

A. BioaccumulationB. Biomagnification

C. Threshold limit value

D. Risk

E. Toxic threshold

70. Chemical compounds known to contribute to environmental pollution does NOT include

which of the following

A. Dioxins

B. Polychlorinated biphenyls

C. Malathion

D. DDT

71. A major air pollutant which can cause headache, tachycardia, and syncope

A. Carbon monoxide

B. NicotineC. Nitrogen dioxide

D. Ozone

E. Sulfur dioxide

72. A patient manifesting with wrist-drop, anorexia, anemia, tremor, weight loss and

gastrointestinal symptoms is most likely suffering from which of the following

A. Acute mercury poisoningB. Chronic mercury poisoning

C. Iron poisoning

D. Chronic lead poisoning

E. Chronic arsenic poisoning

73. A child with diagnosed to have acute lead poisoning with signs and symptoms of

encephalopathy should be given


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A. Acetylcysteine

B. Deferoxamine

C. EDTA

D. Penicillamine

E. Succimer

74. A patient who suddenly deteriorated due to respiratory depression after being given diazepam

may benefit from this antidote

A. Flumazenil

B. Acetylcysteine

C. Atropine

D. Oxygen

E. Pralidoxime

75. Which of the following will confer passive immunity

A. Diphtheria toxoid

B. Measles vaccineC. Tetanus antitoxinD. Oral polio vaccineE. Purified protein derivative

76. Drug that blocks estrogen receptors in the pituitary gland increasing FSH and LH output

A. Clomiphene

B. Diethylstilbesterol

C. Danazol

D. TamoxifenE. Raloxifene

77. Estrogen used in most combined hormonal contraceptivesA. Clomiphene

B. Ethinyl estradiol

C. EstroneD. DES

E. Norgestrel

78. Which of the phases of the cell cycle is most resistant to most chemotherapeutic agents andrequires increased drug dose to obtain response

A. S phaseB. G0 phase

C. G1phase

D. G2phase

79. By which of the following mechanisms do vinca alkaloids work in cancer chemotherapy

A. Inhibition of function of microtubules

B. Damage and prevention of repair of DNA

C. Inhibition of purine synthesis


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D. Inhibition of DNA gyrase

E. Inhibition of protein synthesis

80. Which of the following is an alkylating chemotherapeutic agent

A. Mercaptopurine

B. MethotrexateC. CyclophosphamideD. Fluorouracil

E. Cytarabine

81. Doxorubicin, a drug used in the treatment of Hodgkins disease belongs to which group of

antineoplastic drugs

A. Alkylating agentsB. Antimetabolites

C. Plant alkaloids

D. Antibiotics

E. Hormones

82. A monoclonal antibody targeted against TNF-alpha which is used in Crohns disease andrheumatoid arthritis

A. Infliximab

B. AbciximabC. Etanercept

D. Thalidomide

E. Cyclosporine

83. A patient in heart failure was given a diuretic which inhibits Na reabsorption and potassium

secretion by acting as a competitive antagonist of a receptor located at the blood side of the

tubule. The drug is most likely

A. Spironolactone

B. Hydrochlorothiazide

C. AmilorideD. Furosemide

E. Mannitol

84. Hydrochlorothiazide was prescribed when lifestyle modification failed to lower the bloodpressure of a patient with Stage I hypertension. Adverse effects of this drug include which of

the following:

A. Hypokalemic metabolic acidosis

B. Hyperuricemia

C. Hypoglycemia

D. HypocalcemiaE. Decrease in serum cholesterol and LDL


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85. A patient diagnosed to have essential hypertension was receiving enalapril, furosemide,

metoprolol and clonidine. Good control of hypertension made the doctor decide to

discontinue one drug. Gradual withdrawal of which drug will prevent rebound hypertension:A. Enalapril

B. Furosemide

C. MetoprololD. ClonidineE. Losartan

86. An anti-hypertensive agent which acts through nitric oxide, dilates arterioles but not veins,

and causes a lupus-erythematosus-like syndrome

A. Minoxidil

B. NitroprussideC. Fenoldapam

D. Hydralazine

E. Verapamil

87. A 20-year old male was admitted in moderate cardiorespiratory distress due to heart failure

secondary to Rheumatic Heart Disease. Drugs which were found useful in heart failureinclude the following EXCEPT:

A. Diuretics

B. Beta- adrenoceptor agonists

C. Calcium channel blockers

D. ACE inhibitors

E. Digoxin

88. This anti-heart failure drug increases cAMP and cGMP leading to both vasodilation and

enhanced myocardial contractilityA. DobutamineB. Digoxin

C. Nesiritide

D. Milrinone

E. Dopamine

89. Which calcium channel blocker/s is/are ideally used in patients with atrioventricularconduction abnormalities

A. Diltiazem

B. Verapamil

C. Nifedipine

D. Bepridil

E. All of the above

90. Both an intravenously and orally administered drug useful for both supraventricular and

ventricular tachyarrhythmias

A. AdenosineB. Verapamil


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C. Lidocaine

D. Esmolol

E. Amiodarone

91. A 37-year old male presenting with pancreatitis, eruptive xanthoma and centripetal obesity

had a triglyceride level of 900 mg/dL. The rest of the lipid profile was normal. This patientwill most likely benefit from which of the following drugs

A. Lovastatin

B. Ezetimibe

C. Niacin

D. Cholestyramine

92. A 35-year old male diagnosed to have familial combined hyperlipoproteinemia with elevatedlevels of both triglycerides and LDL was started on fenofibrate and a statin. To avoid drug

interactions, the best statin of choice is

A. Atorvastatin

B. SimvastatinC. Lovastatin

D. Pravastatin

93. When used as a monotherapy, a major toxicity of gemfibrozil is increased risk of

A. Bloating and constipation

B. Cholelithiasis

C. Myopathy

D. Cutaneous flushing

E. Hepatic toxicity

94. Most potent H2 blocker with negligible binding with CYP450 enzyme

A. Cimetidine

B. Famotidine

C. Ranitidine

D. Nizatidine

95. Which is FALSE of proton pump inhibitorsA. Reversibly inhibits K+/H+ATPase

B. Inactive at neutral pHC. Effectively inhibits meal-stimulated acid secretion

D. Inhibit 90-98% of 24-hour acid secretion

E. Inhibits Cytochrome P450 enzyme

96. A laxative usually given as suppository and promotes peristaltic action and defecation in

15-30 minutes

A. Methylcellulose

B. Bisacodyl

C. Magnesium sulfate

D. Lactulose


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97. Which of the following is NOT effective for cytotoxic drug emesis

A. Ondansetron

B. Metoclopromide

C. Cyclizine

D. Dronabinol

98. H. pylori associated peptic ulcer can be treated with the following regimen:

A. PPI, Amoxicillin, Metronidazole for 10-14 days

B. Bismuth, PPI, Amoxicillin, Clarithromycin for 4-6 weeksC. PPI for 10-14 days; Clarithromycin and Amoxicillin for 4-6 weeks

D. PPI for 4-6 weeks; Clarithromycin and Amoxicillin for 10-14 days

99. A 65-year old man being treated for both pneumonia and gastroesophageal reflux disease

was brought to the ER for syncope and pulselessness. The cardiac monitor showed Torsades

de pointes. The most likely combination of drug he is taking is:

A. Erythromycin/Cisapride

B. Ciprofloxacin/MetoclopromideC. Clarithromycin/Domperidone

D. Amoxicillin/Cisapride

100.A high incidence of adverse effects including pericarditis, pneumonitis, and interstitial

nephritis characterize this drug used to induce remission in ulcerative colitis:A. Prednisone

B. Sulfasalazine

C. Azathioprine

D. 6-mercaptopurineE. Olsalazine

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Pharmboardsreview2009 (Answers Higlighted)[1]