Gen. Pharmacology Tests PDF
Gen. Pharmacology Tests PDF
Gen. Pharmacology Tests PDF
General pharmacology
Pharmacokinetics
1. Which of the following statements is correct?
1. Drugs showing a large VD can be efficiently removed by dialysis of the plasma.
2. Stressful emotions can lead to a slowing of drug absorption.
3. If the VD for a drug is small, most of the drug is in the extraplasmic space.
4. Weak bases are absorbed efficiently across the epithelial cells of the stomach.
3. Which of the following is true for a drug whose elimination from plasma shows first-order kinetics?
1. The amount eliminated per unit of time is constant.
2. The half-life of the drug is proportional to the drug concentration in plasma.
3. A plot of drug concentration versus time is a straight line.
4. The rate of elimination is proportional to the plasma concentration.
5. A patient is treated with drug “A”, which has a high affinity to albumin and is administered in
amounts that do not exceed the binding capacity of albumin. The second drug “B” is added to the
treatment regimen. The “B” drug also has high affinity for albumin, but is administered in amounts, that
are 100 times more than the binding capacity of albumin. Which of the following occurs after
administration of the drug “B”?
1. A decrease in the tissue concentration of drug “A”.
2. An increase in the tissue concentrations of drug “A”.
3. A decrease in the volume of distribution of drug “A”.
4. A decrease in the half-life of drug ‘B”.
8. A drug given as a 100 mg single dose, results I a peak plasma concentration of 20 mcg/ml. The apparent
volume of distribution is (assume a rapid distribution and negligible elimination prior to measuring the
peak plasma level):
1. 10L
2. 5L
3. 2L
4. 1L.
9. A drug with a half-life of 12 hours is administered by continuous iv infusion. How long will it take the
drug to reach ninety percent of its final steady-state level?
1. 90 hours
2. 40 hours
3. 30 hours
4. 24 hours.
18. The following drugs can increase the rate of synthesis of CYP-450 enzymes, except:
1. Rifampicin (antituberculosis drug)
2. Phenytoin (antiepileptic drug)
3. Phenobarbital (hypnotic drug)
4. Cimetidine (antiulcer drug)
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30. Choose the correct answer:
Some very large or very polar drugs (vitamin B12, iron) are complexed with proteins and actively
transported into cells by:
1. Passive diffusion
2. Endocytosis
3. Facilitated diffusion
4. P-glycoprotein
34. Which of the following equations is correct related to the loading dose?
1. Loading dose = VD x TC (target concentration).
2. Loading dose = VD x Kel (elimination rate).
3. Loading dose = Cl x TC
4. Loading dose = TC x Accumulation factor.
36. The first-pass metabolism of a drug can be avoided by the following routes of administration, except:
1. Sublingual
2. Oral
3. Rectal
4. Intravenous.
42. Which of the following statement is true for a drug whose elimination from plasma shows first order
kinetics?
1. The amount eliminated per unit of time is constant.
2. The rate of elimination is proportional to the plasma concentration.
3. The half-life of the drug is proportional to the drug concentration in plasma.
4. Elimination involves a rate-limiting enzymic reaction operating at its maximal velocity (Vm).
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45. Choose the wrong answer:
1. Some drugs are destroyed by the acid or enzymes in the gut and must be given parenterally.
2. Drug that is bound to plasma proteins is combined to the vascular system and is not able to exert its
pharmacological actions.
3. The absorption of unionized molecules is favored because they are far more lipid-soluble than those
that are ionized.
4. Active transportation processes are mainly used to transfer lipid-soluble drugs against their
concentration gradients.
46. Drugs cross the lipid membranes mainly by:
1. Endocytosis
2. Passive diffusion
3. Facilitated diffusion
4. Filtration
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52. Choose the wrong answer:
1. For many drugs, disappearance from plasma follows an exponential time course characterized by the
plasma half-life.
2. Plasma half-life, in simple case, is directly proportional to the volume of distribution and inversely
proportional to the overall rate of clearance.
3. With repeated dosage or sustained delivery of a drug the plasma concentration approaches a steady value
within 2 plasma half-lives.
4. A two-compartment model is often needed. In this case the kinetics are biexponent. The two
components roughly represent the process of transfer between plasma and tissues (λ-phase) and
elimination from the plasma (β-phase).
Pharmacodynamics
56. Which of the following statements is correct?
1. Cellular responses to receptors that are ion channels are usually fast.
2. A drug usually binds to only one receptor.
3. Cellular responses are rapid if the mode of action involves modification of DNA transcription.
4. G-proteins do not amplify the effect of receptor stimulation.
64. Which of the following statements most accurately describes a system having spare receptors?
1. Agonist affinity for spare receptors is less than their affinity for non-spare receptors.
2. Spare receptors are active even in the absence of agonist.
3. A single drug-receptor integration results in many cellular response elements being activated.
4. Spare receptors are sequestered in the cytosol.
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74. Transmembrane tyrosine kinase receptors interact with:
1. Insulin
2. Norepinephrine
3. Corticosteroids
4. Acetylcholine
75. Which of the following agents activates a membrane G-protein that modulates an enzyme or channel?
1. Corticosteroid, thyroid hormone and estrogen
2. Norepinephrine
3. Insulin
4. Cytokines.
78. Activation of cytoplasmic protein kinase (STAT) results from the action of:
1. Norepinephrine
2. Acetylcholine
3. Cytokines
4. Corticosteroids.
79. Insulin:
1. Activates a membrane G-protein that modulates an enzyme or channel.
2. Activates transmembrane tyrosine kinase, which phosphorylates cytoplasmic proteins.
3. Opens ion channels to permit ion diffusion.
4. Activates steroid receptors resulting in modulation of gene expression in the nucleus.
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2. Drugs that within a chemical family may all bind to the same receptor but not all produce the same
maximum effect are called partial antagonists.
3. Drugs that produce less than the full effect observed for that receptor system even when given in doses
that fully saturate the receptors are called partial agonists.
4. Partial agonists act like irreversible pharmacologic antagonists when combined with full agonist.
86. Which of the following statements most accurately describes a system, having spare receptors?
1. Agonist ability for spare receptors is less than their affinity for nonspare receptors.
2. Spare receptors are active even in the absence of agonist.
3. Spare receptors are more sensitive to partial agonists.
4. A single-drug receptor interaction results in many cellular response elements being activated.
91. Choose the wrong answer regarding pharmacodynamics. Phramacodynamics processes include drugs:
1. Pharmacologic effect
2. interaction with receptors
3. Side effects
4. Metabolism.
99. Which of the receptors are associated with tyrosine kinase molecules (JAK) and activation of transcription
(STAT) molecules?
1. Cytokine receptors
2. Kinase-linked receptors for insulin
3. Agonist (ligand)-gated channels
4. G-protein coupled receptors.
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106. Ion channel receptors are located in:
1. Cell membrane and cytoplasm
2. Nucleus
3. Cell membrane
4. Cytoplasm
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1. Gene-active hormones can be expected to alter the pathologic state within minutes (e.g.
glucocorticoids).
2. The effects of gene-active hormones can persist for hours or days after the agonist concentration has
been reduced to zero.
3. The beneficial (or toxic) effects of the gene-active hormone usually decrease rapidly when the
hormone administration is stopped.
4. Voltage-gated ion channels bind neurotransmitters directly and they do not control by membrane
potential.
124. Which term is used when the total number of cell-surface receptors is reduced and the cells
responsiveness to ligand is correspondingly diminished?
1. Desensitization
2. Up-regulation
3. Down-regulation
4. Tachyphylaxis
125. Receptor “up-regulation” more frequently may be developed after long-term exposure to:
1. Competitive antagonist
2. Full agonist
3. Partial agonist
4. Inverse agonist
126. A 70-year old man has been taking beta-blockers for many years for his angina pectoris. He develops
intermitten claudication (the complication characteristic for beta-blockers) and his doctor stops the beta-
blocker. Suddenly his angina worsens within days and he is taken to hospital with myocardial infarction.
In this case it is likely that beta receptors undergo:
1. Down-regulation
2. Desensization
3. Upregulation
4. Hypersensitivity
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2. Drugs with narrow therapeutic windows are less toxic and can be used without measuring of their
plasma concentration.
3. Competitive antagonists form bonds with receptor molecules that are irreversible.
4. Non-competitive antagonists form bonds with the receptor, usually at the “natural” agonist-binding
site.
129. A 40-year-old man has been abusing diamorphine (heroin) for many years, which is opioid receptor
agonist. Gradually, the dose needed to achieve the desired effect (euphori1. has increased. He is found
dead in his flat (heroin is respiratory depressant).
What is the reason for gradually increasing dose of heroin regarding to opioid receptors?
1. Upregulation
2. Downregulation
3. Tachyphylaxis
4. Hypersensitivity
130. Which routes of drug administration can produce the most rapid effect?
1. Rectal
2. Oral
3. Transdermal
4. Sublingual
131. cAMP accumulation is associated with the activation of the following proteins:
1. Gq
2. Gi
3. Gs
4. Gt1, Gt2.
132. ITP3 and DAG concentration are increased by the stimulation of the:
1. Gq protein
2. Adenylyl cyclase
3. Gi protein
4. Gt1, Gt2 proteins.
133. ITP3 and DAG concentration are linked with the activation of:
1. Adenylyl cyclase
2. Phospholipase “C”
3. Gi protein
4. Gs protein
136. Which of the following proteins activation can decrease cGMP concentration?
1. Gi
2. Gq
3. Gt1, Gt2
4. Gs
137. The specific toxicity of drugs include all of the following, except of the:
1. General toxicity
2. Reproductive toxicity
3. Immunotoxicity
4. Teratogenic toxicity
138. Which one of the clinical trial phase determines the useful dose range, pharmacokinetics and minimal
toxic effect?
1. Phase I
2. Phase II
3. Phase III
4. Phase IV
139. Determine the efficacy of the drug on the target disease under conditions of typical use is associated with:
1. Phase I
2. Phase II
3. Phase III
4. Phase IV
140. Surveillance of toxicities reported during the normal use is linked to:
1. Phase I
2. Phase II
3. Phase III
4. Phase IV
141. Determine the efficacy of the drug on the target disease under highly controlled conditions is associated
with:
1. Phase I
2. Phase II
3. Phase III
4. Phase IV
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143. Which of the following drugs can produce the contrasting physiologic results?
1. Full agonist
2. Inverse agonist
3. Competitive antagonist
4. Irreversible antagonist.
159. Which of the following drugs is used in opthalmology for pupillary dilation?
1. Isoproterenol
2. Salbutamol
3. Phenylephrine
4. Terbutaline
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160. A 70-year-old man presents to the emergency department with acute heart failure. You decide that this
patient needs immediate drug therapy to improve his cardiac function. Which of the following drugs
would be most beneficial?
1. Phenylephrine
2. Isoproterenol
3. Dobutamine
4. Albuterol
162. Remedies for nasal stuffiness often contain which of the following drugs?
1. Norepinephrine
2. Epinephrine
3. Terbutaline
4. Phenylephrine
163. Which of the following agents have the most affinity to α1-adrenoceptors?
1. Norepinephrine
2. Terbutaline
3. Albuterol
4. Dobutamine
164. Which of the following adrenoceptors agonists can stimulate α 1, α 2, B1, B2 and B3 adrenoceptors?
1. Norepinephrine
2. Epinephrine
3. Phenylephrine
4. Albuterol
167. Which agent is synthesized and released by adrenergic neurons, most postganglionic sympathetic neurons
and the adrenal medulla?
1. Dopamine
2. Noreprnephrine
3. Serotonine
4. Epinephrine
173. The main places of B2-adrenoreceptors location are the following, except:
1. Respiratory, uterine, and vascular smooth muscle
2. Skeletal muscle
3. Human liver
4. Fat cells
179. Norepinephrine:
1. Slowly inactivated by COMT and MAO enzymes
2. Usually given by intravenous infusion
3. Is effective bronchodilator
4. is more effective than dobutamine in hemodynamic shock.
184. Side effects and toxicity of epinephrine comprise the following, except:
1. Palpitations, arrhythmias, hypertension
2. Anxiety
3. Tremor
4. Hypoglycemia
186. The following reactions are produced be dopamine, with the exception of:
1. Stimulates the medullary chemoreceptor trigger zone and causes nausea and vomiting .
2. Inhibits prolactin release from the anterior pituitary.
3. Positive inotropic and chronotropic (B1) effects – moderate to high doses.
4. Low dose causes vasoconstriction and high dose- vasodilation.
190. Side effects and toxicity of dopamine include the following, except:
1. With high doses – decrease renal perfusion.
2. Tachycardia.
3. Arrhythmias.
4. Hypotension.
194. Which drug causes the increase in blood pressure due to vasoconstriction and also leads to vagally-
mediated bradycardia?
1. Clonidine
2. Phenylephrine
3. Isoproterenol
4. Terbutaline
199. The following side effects such as orthostatic hypotension, dry mouth and sexual dysfunction, are
characteristic for:
1. Terbutalin
2. Albuterol
3. Clonidine
4. Phenylephrine
201. The following agents have relatively selective action for B2-adrenoceptors, except:
1. Terbutalin
2. Albuterol
3. Salbutanol
4. Dobutamine
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202. Which agent selectively stimulates B1-adrenoceptors:
1. Dobutamine
2. Phenylephrine
3. Salbutamol
4. Terbutaline
204. Which drug is most rarely used for treatment of bronchial asthma?
1. Terbutalin
2. Isoproterenol
3. Albuterol
4. Metaproterenol
207. Which drug is indicated for use in congestive heart failure in the post-myocardial infarction period?
1. Isoproterenol
2. Dobutamine
3. Albuterol
4. Terbutaline
209. Which of the drugs are frequently used to delay delivery in premature labor?
1. Terbutaline
2. Albuterol
3. Isoproterenol
4. Metaproterenol
213. Which agent is present in red wines, beer, cheese, chocolate and many other foods?
1. Ephedrine
2. Norepinephrine
3. Tyramine
4. Metaraminol
215. Which agent acts primarily through the release of catecholamines, but has some direct effects on
adrenergic receptors at higher doses?
1. Amphetamine
2. Tyramine
3. Ephedrine
4. Metaraminol
216. Which agents peripheral effects are mediated by norepinephine (causes release of the stored NE), whereas
the central effects are predominantly mediated by dopamine?
1. Tyramine
2. Ephedrine
3. Amphetamine
4. Norepinephrine
217. Which of the drug is used for the treatment of attention deficit disorder, narcolepry and for appetite
suppression?
1. Ephedrine
2. Amphetamine
3. Tyramine
4. Metaraminol
218. Which of agents, ingested by a person taking an MAO inhibitor, can cause the massive release of
catecholamines, which may induce hypertensive crisis and severe arrhythmias?
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1. Amphetamine
2. Tyramine
3. Ephedrine
4. Metaraminol
220. Choose the agent which is resistant to metabolism by MAO and COMT with long duration of action:
1. Ephedrine
2. Tyramine
3. Norepinephrine
4. Epinephrine
221. Which agent is used for prevention of enuresis (increases bladder sphincter tone) and less extensively for
bronchospasm?
1. Tyramine
2. Norepinephrine
3. Amphetamine
4. Ephedrine
222. Choose the agent which may cause tachyphylaxis with repetitive dosing?
1. Ephedrine
2. Norepinephrine
3. Epinephrine
4. Metaraminol
223. Choose a drug with the following side effects as: insomnia, dysphoria, psychotic reactions and impotence:
1. Ephedrine
2. Amphetamine
3. Tyramine
4. Norepinephrine
Adrenergic antagonists
231. The α1-adrenoceptors selective blockers are used for the treatment of the following situations, except for:
1. Arterial hypertension
2. Prostatic hyperplasia
3. Raynaud’s phenomenon
4. Hypertensive crises associated with pheochromocytoma.
232. First dose reaction –marked postural hypotension 30 to 90 minutes following the initial dose, is produced
by the following agent, except for:
1. Terazosin
2. Doxazosin
3. Prazosin
4. Phentolamine
234. Choose the wrong answer regarding the side effects of phenoxybenzamine:
1. Nasal congestion
2. Orthostatic hypotension
3. Tachycardia
4. Stimulation of ejaculation
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235. Which of the following agents produces more significant tachycardia?
1. Prazosin
2. Tamsulosin
3. Phentolamine
4. Terazosin
Beta-blocking agents
240. Choose the wrong answer concerning the use of beta-blocking agents:
1. Supraventricular or ventricular arrhythmias.
2. Essential tremor.
3. Very severe congestive heart failure (with profound reduction of cardiac inotropic function).
4. Hyperthyroidism
242. The less duration of action has a following beta-adrenoceptors bclocking agent:
1. Timolol
2. Propranolol
3. Esmolol
4. Metoprolol
243. Side effects of beta-adrenoceptors blocking agents include several conditions, except for:
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1. Bradycardia
2. Bronchospasm
3. Hypertension and angina pectoris in case of abrupt withdrawal
4. Increased sexual activity
244. Which of the following beta-adrenoceptors blocking agent has the most duration of action?
1. Metoprolol
2. Esmolol
3. Nadolol
4. Pindolol
246. Choose the beta-adrenoceptors blocking agent with intrinsic sympathetic activity:
1. Atenolol
2. Esmolol
3. Pindolol
4. Metoprolol
247. Mixed α1 and B adrenergic receptors blocking agent-Labetolol is used for the treatment of:
1. Hypertensive emergencies
2. Arrhythmias
3. Diabetes
4. Angina pectoris
249. Which drug prevents the re-uptake of neurotransmitters in adrenergic neurons into the vesicles leading
to neurotransmitter depletion?
1. Guanethidin
2. Pindolol
3. Reserpine
4. Esmolol
250. Which drug inhibits peripheral adrenergic neurons by inhibiting Norepinephrine release?
1. Reserpine
2. Labetalol
3. Guanethidin
4. Bisoprolol
252. Choose the main side effects of adrenergic neurons blocking agent Guanethidin:
1. Bradycardia
2. Severe orthostatic hypotension and sexual dysfunction
3. Psychiatric depression
4. Hypoglycemia.
Cholinergic Agonists
253. Choose the cholinergic agonist with mixed action on muscarinic and nicotinic receptors:
1. Bethanehol
2. Carbochol
3. Metacholine
4. Pilocarpine
254. Relatively selective muscarinic cholinergic agonists are the following agents, except:
1. Acetylcholine
2. Pilocarpine
3. Methacholine
4. Bethanechol
255. Choose the wrong answer regarding the indications of muscarinic agonists:
1. Glaucaoma
2. Atonic bladder
3. Atonic bowel
4. Arterial hypertension
257. Which cholinergic agonist agent is mostly used for the treatment of glaucoma:
1. Pilocarpine
2. Bethanechol
3. Methacholine
4. Carbochol
259. The muscarinic over-activity side effects include the following symptoms, except for:
1. Nausea vomiting, abdominal pain
2. Diaphoresis, salivation
3. Urinary urgency
4. Tachycardia
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260. Contraindications for using the muscarinic agonist drugs include:
1. Bronchial asthma
2. Atonic bladder
3. Atonic bowel
4. Glaucoma
263. Carbamylating inhibition of cholinesterase caused the following agents, except for:
1. Physostigmine
2. Neostigmine
3. Pyridostigmine
4. Echothiophate
266. A quarternary nitrogen anticholinesterase agents are the following drugs, except for:
1. Neostigmine
2. Demecarium
3. Physostigmine
4. Edrophonium
267. Which anticholinesterase drugs can be used for the treatment of glaucoma?
1. Edrophanium
2. Physostigmine
3. Neostigmine
4. Pyridostigmine
270. Choose the correct answer regarding the indication of anticholinesterase agent neostigmine:
1. Glaucoma
2. Myasthemia gravis
3. Diagnostic testing with suspected myasthenia gravis (tension test)
4. Tachycardia
271. Choose the anticholinesterase agent used for diagnostic testing of myasthemia gravis:
1. Physostigmine
2. Edrophonium
3. Echothiophate
4. Pyridostigmine
276. Which anticholinesterase agent can be used for the treatment of atonic bowel?
1. Physostigmine
2. Edrophonium
3. Echothiophate
4. Neostigmine
280. Which anticholinesterase drug is used as antidote for tubocurarine (skeletal muscle relaxant)?
1. Echothiophate
2. Edrophonium
3. Neostigmine
4. Physostigmine
281. The M1 muscarinic cholinoceptors binding sites for competitive antagonists are located in the following
organs:
1. Skeletal muscles
2. Vascular smooth muscles and various glands
3. Cerebral cortex
4. Cardiac muscle
282. The M2 muscarinic cholinoceptors binding sites for competitive antagonists are identified in:
1. Cardiac muscle
2. Vascular smooth muscle
3. Skeletal muscle
4. Carotid-sino-aortic zone
283. M3 muscarinic cholinoceptors as binding sites for competitive antagonists are localized in:
1. Cardiac muscle
2. Skeletal muscles
3. Vascular smooth muscles and various glands
4. Adrenal medulla
284. Which antagonist of M-muscarinic cholinoceptors readily crosses the blood-brain barrier?
1. Scopolamine
2. Propantheline
3. Glycopyrrolate
4. Ipratropium
285. Choose the M-muscarinic cholinoceptors antagonist drug with tertiary amine structure:
1. Benztropin
2. Ipratropium
3. Glycopyrrolate
4. Propantheline
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286. The following M-muscarinic cholinoceptors antagonists belong to quaternary amines:
1. Tropicamide
2. Scopolamine
3. Atropine
4. Ipratropium
290. Which antimuscarinic drug is effective for the treatment of bronchial asthma?
1. Tropicamide
2. Pirenzepine
3. Ipratropum
4. Scopolamine
291. Which antimuscarinic drug in needed doses usually has minimal stimulant effect, especially on the
parasympathetic medullary centers, which is followed by longer-lasting sedative effect on the brain?
1. Ipratropium
2. Tropicamide
3. Atoropine
4. Pirenzepine
292. Which antimuscarinic drug is used for urinary disorders (overactive bladder)?
1. Scopolamine
2. Pirenzepine
3. Oxybutynine
4. Tropicamide
293. Antimuscarinic drugs – darifenacin, solifenacin and tolterodine are especially effective for the application
in:
1. Ophthalmology.
2. Gastroenterology.
3. Cardiology.
4. Urology.
294. The most sensitive organs for the atropine action are:
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1. Salivary glands
2. Heart
3. Eye
4. Gastrointestinal tract
301. The statements “dry as a bone, blind as bat, red as a beet, mad as hatter” characterize overdosage of
antimuscarinic drug:
1. Tropicamide
2. pirenzepine
3. Glycopyrrolate
4. Atropine
Anti-nicotinic agents (ganglionic blocking agents)
302. Ganglionic blocking agents mostly block the actions of acetylcholine by blocking the nicotinic receptors
in:
1. Only parasympathetic ganglia
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2. Only sympathetic ganglia
3. Both ganglia
4. Skeletal muscles
304. Ganglionic blocking agents effects due to inhibition mostly parasympathetic tone include:
1. Tachycardia
2. Diarrhea
3. Micturition
4. Salivation
305. Ganglionic blocking agents effects due to inhibition mostly sympathetic tone include:
1. Hypotension
2. Hidrosis (sweat glands)
3. Dry mouth
4. Constipation
306. Ganglionic blocking agent trimetaphan is used for the several states, except for:
1. Hypertensive crises with acute dissecting aortic aneurysm
2. Autonomic hyperreflexion following the spinal cord injury.
3. Controlled hypotension
4. Constipation.
307. Side effects of ganglionic blocking agents (mecamylamine) due to parasympathetic blockade include:
1. Constipation, paralytic ileus
2. Hypertension
3. Impotence
4. Syncope.
308. Side effects of ganglionic blocking agents due to sympathetic blockade include:
1. Orthostatic hypotension
2. Constipation
3. Blurred vision
4. Urinary retention.
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3. Sensitivity to them of muscle groups is characterized by ascending order – diaphragm, abdomen,
intercostals, jaw and eyelids.
4. Antibiotics (aminoglycosides) may decrease potency of skeletal muscle relaxants.
311. Choose the depolarizing blockers that bind to skeletal muscles nicotinic receptors and cause
depolarization (agonists).
1. Tubocurarine
2. Pancuronium
3. Vecuronium
4. Succinylcholine.
312. The following skeletal muscle relaxants are non-depolarizing blockers, except for:
1. Atracurium
2. Vecuronium
3. Succinylcholine
4. Pancuronium
316. Choose the wrong answer related to the skeletal muscle relaxants:
1. Phase I (depolarising) block prolonged binding to receptor produces persistent depolarization, thus
making membrane unresponsive to new impulses.
2. Phase II (Desensitation block) membrane becomes repolarized but is unresponsive to new impulses;
3. Succinylcholine has the most prolonged action.
4. Tubocurarine action is diminished by anticholinesterase agents.
317. Which of the skeletal muscle relaxants may induce histamine release, bronchospasm and hypotension
(due to blockade of nicotinic receptors in autonomic gangli1.?
1. Vecuronium
2. Pancuronium
3. Atracurium
4. Tubocurarine
318. Which of the skeletal muscle relaxants has vagolytic effect (by blocking cardiac M2-muscarinic receptors
leading to tachycardi1.?
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1. Tubocurarine
2. Atracurium
3. Pancuronium
4. Vecuronium
319. Which of the following skeletal muscle relaxants is a drug of choice for patients having renal or hepatic
failure?
1. Succinylcholine
2. Atracurium
3. Pancuronium
4. Vecuronium
320. Which of the skeletal muscle relaxants are metabolized by ester hydrolysis and Hoffman reaction
(independently of renal and hepatic function)?
1. Atracurium
2. Rocuronium
3. Pancuronium
4. Vecuronium
321. The effect of non-depolarizing skeletal muscle relaxants may be reverse by:
1. Atropin
2. Anticholinesterase agents
3. Cholinesterase reactivators
4. Epinephrine
323. Choose the wrong answer related to skeletal muscle relaxant syccinylcholine:
1. Anticholinesterases enhance phase I blockade and antagonize phase II.
2. It is broken down by plasma cholinesterase (pseudocholinesterase).
3. Rapid onset and short duration of action (5-10 minutes).
4. Its action is not associated with genetic polymorphism.
325. Malignant hyperthermia in genetically susceptible patients occurs more frequently when the following
skeletal muscle relaxants are given along with halothane (general anesthetic):
1. Tubocurarine
2. Pancuronium
3. Atracurium
4. Succinylcholine
326. Which of muscle relaxants after administration in burn or stroke patients may result in potentially fatal
hyperkalemia (due to vigorous muscle contraction/depolarization):
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1. Pancuronium
2. Atracurium
3. Succinylcholine
4. Vecuronium
327. Which of muscle relaxants is contraindicated for patients having open eye injuries, as tonic extra-ocular
muscle contractions raise the intraocular pressure?
1. Vecuronium
2. Rocuronium
3. Succinylcholine
4. Atracurium
328. Cardiac arrhythmias can occur (due to muscarinic activity) by the action of the following skeletal muscle
relaxants:
1. Tubocurarine
2. Pancuronium
3. Rocuronium
4. Succinylcholine
331. Which of the skeletal muscle relaxants originally called diacetylcholine is simply two molecules of
acetylcholine linked through the acetate methyl groups:
1. Tubocurarine
2. Atracurium
3. Vecuronium
4. Succinylcholine
332. Which of the following skeletal muscle relaxants predominantly undergo to hepatic metabolism?
1. Tubocurarine
2. Vecuronium
3. Doxacurium
4. Succinylcholine
333. Which of the following skeletal muscle relaxants predominantly are excreted by the kidney?
1. Tubocurarine
2. Vecuronium
3. Atracurium
4. Vecuronium
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Histamine, serotonin and the ergot alkaloids
334. . Histamine (H1) receptors are located in:
a) Smooth muscle, endothelium and brain;
b) Gastric musoca, cardiac muscle, mast cells;
c) Myenteric plexus;
d) CD4 T cells.
339. A 53 year-old ship’s captain complains of seasonal allergies. Which one of the following would
be indicated?
a) Promethazine;
b) Dimenhydrinate;
c) Fexofenadine;
d) Hydroxyzine
344. Which one of the following antihistamines are produced α-adrenoceptor blocking effects?
a) Loratadine;
b) Cetirizine;
c) Promethazine;
d) Cyclizine
345. Which one of the following antihistamines are produced anticholinergic activity?
a) Diphenhydramine;
b) Fexofenadine;
c) Loratadine;
d) Cetirizine
347. First generation (older) antihistamines are used in the treatment of following condition,
except:
a) Allergy;
b) Sleep aid;
c) Motion sickness;
d) Arterial hypertension
349. Strong blocking effects at serotonin receptors have been demonstrated for the following
antihistamines:
a) Loratadine;
b) Cetirizine;
c) Fexofenadine;
d) Cyproheptadine
351. Which antihistamine drugs have negligible CNS and ANS effects?
a) Diphenhydramine;
b) Promethazine;
c) Dimenhydrinate;
d) Cetirizine
358. Serotonin 5-HT1D/1B receptor agonist are used in the treatment of:
a) Migraine;
b) Serotonin syndrome;
c) Smooth muscle manifestation of carcinoid tumor;
d) Cold-induced urticaria
362. The 5-HT3 serotonin receptor antagonists are used in the prevention of:
a) Migraine attacks;
b) Nausea and vomiting associated with cancer chemotherapy;
c) Serotonin syndrome;
d) Malignant hyperthermia
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363. Which irreversible α-adrenoceptor blocking agent has a long-lasting blocking action at 5-HT2
receptors?
a) Ondansetron;
b) Phenoxybenzamine;
c) Sumatriptan;
d) Ritanserin
365. Dihydroergotamine:
a) Causes vasodilation;
b) Exerts its actions by binding to specific ergotamine receptors;
c) Is useful in treating acute migraine headaches;
d) Is useful for maintaining uterine muscle tone during pregnancy
366. The powerful hallucinogenic effects are produced by following ergot alkalois:
a) Ergonovine;
b) Lysergic acid diethylamide (LSD);
c) Bromocriptine;
d) Cabergoline
367. The following ergot alkaloids exert the high affinity for dopamine receptors:
a) Bromocriptine;
b) Ergonovine;
c) Ergotamine;
d) Dihydroergotamine
368. Which ergot derivates are highly specific for migraine pain?
a) Cabergoline;
b) Ergotamine;
c) Pergolide;
d) Bromocriptine
380. Vasodilator prostaglandins – PGI2 and PGE2 promote vasodilation via the:
a) IP and EP4 receptors;
b) EP3 receptors;
c) FP receptors;
d) TP receptors
390. Which drugs are used for prevention of NSAID – induced ulcers:
a) Latanoprost;
b) Misoprostol;
c) Carboprost;
d) Alprostadil
391. Which drug is used to induced second-trimester abortions and to control postpartum
hemorrhage that is not responding to conventional methods of management:
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a)Carboprost;
b) Alprostadil;
c) Iloprost;
d) Epoprostenol
393. Which prostanoid receptors stimulation activate adenylyl cyclase via Gs protein?
a) EP3;
b) TP;
c) FP;
d) IP
394. “Contractile” prostanoid receptors which activation leading to the formation of inositol
triphosphate (IP3), with subsequent mobilization of Ca2+ stores and increase of free intracellular Ca2+:
a) IP, EP2;
b) EP2, EP4;
c) TP, FP, EP1;
d) DP1, IP
Anti-inflammatory drugs
404. An 8 year-old girl has a fever and muscle aches from a presumptive viral infection. Which one
of the following drugs would be most appropriate to treat her symptoms?
a) Paracetamol;
b) Aspirin;
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c) Celecoxib;
d) Indomethacin
405. A 70 year-old man has a history of ulcer disease. He has recently experienced swelling and
pain in the joints of his hads. His physician wants to begin therapy with an NSAID-s. Which one of
the following drugs might also be prescribed along with the NSAID to reduce the risk of activaing this
patient’s ulcer disease?
a) Allopurinol;
b) Colchicine;
c) Misoprostol;
d) Probenecid
406. Which one of the following drugs have the greatest half-life (T1/2)?
a) Diclofenac;
b) Ibuprofen;
c) Indometacin;
d) Piroxicam
410. Which of drugs have a lower risk of gastrointestinal bleeding but is associated with an
increased risk of cardiovascular events (myocardial infarction and stroke)?
a) Non-COX-selective NSAIDs;
b) The selective COX-2 inhibitors;
c) Paracetamol;
d) Leukotrienes antagonists
411. Which drug at low doses is a very effective antiplatelet agent and widely used to reduce the
risk of myocardial infarction and stroke:
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a) Allopurinol;
b) Aspirin;
c) Paracetamol;
d) Celecoxib
412. Which drug in children with viral infections has been associated with an increased risk of
Reye’s syndrome?
a) Iburpofen;
b) Flurbiprofen;
c) Aspirin;
d) Celecoxib
413. Diversion of arachidonic acid metabolism to the leukotriene pathway may rarely present with
the clinical picture of:
a) An allergic response to aspirin, including anaphylaxia;
b) Toxicities of NSAIDs include gastrointestinal upset;
c) Reye’s syndrome;
d) Peptic ulcers with or without bleeding
417. Arachidonic acid is metabolized by two main pathways: cyclooxygenase and lipoxygenase.
Which of the following is a main end-product of the lipoxygenase pathway?
a) Prostaglandins;
b) Prostacyclin (PGI2);
c) Leukotrienes;
d) Thromboxanes
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418. In an overdose situation, the elimination of aspirin follows zero-order kinetics. This means
that:
a) No drug appears in the urine;
b) The metabolism rate of aspirine is zero;
c) Elimination rate is directly proportional to plasma concentration;
d) Plasma concentrations decrease linearly with time
419. A child takes what comes close to being a lethal dose of paracetamol. Which of the following is
the most likely pathology involved in this drug overdose?
a) Acute nephropathy;
b) A-V conduction disturbances, heart block;
c) Liver failure;
d) Status asthmaticus
420. A patient has been taking doses of aspirin that are too high for several weeks. Low-grade
aspirin toxicity (salicylism) develops. Which of the following signs of symptoms would be most
indicative of the salicylism and the high salicylate levels:
a) Constipation;
b) Cough;
c) Hypertension;
d) Tinnitus
421. Which of the following property combinations is peculiar to the majority of NSAIDs?
a) Antihistaminic, antipyretic, Analgesic;
b) Immunodepressive, anti-inflammatory, analgesic;
c) Antipyretic, Analgesic, Anti-inflammatory;
d) Anti-inflammatory, immunodepressive, antihistaminic
425. Disease modifying antirheumatic drugs include the following agents, except:
a) Abatacept;
b) Azathioprine;
c) Cyclophosphamide;
d) Probenecid
428. TNF-α (tumor necrosis factor) blocking agents are used in the treatment of following diseases,
except:
a) Crohn’s disease;
b) Ankylosing spondylitis;
c) Gout;
d) Psoriatic arthritis
430. Which drug inhibits xanthine oxidase activity and is used in patients with recurrent attacks of
gout?
a) Indometacin;
b) Aspirin;
c) Allopurinol;
d) Probenecid
433. Which drug binds to tubulin in leucocytes and prevents its polymerization into microtubules?
a) Naproxen;
b) Colchicine;
c) Sylfipyrazone;
d) Indometacin
434. What is a common side effect of colchicine used to treat acute gout, especially when given
orally:
a) Reye’s syndrome;
b) Gi side effects;
c) Anemia;
d) GU side effects
446. Which of these groups of drugs is used for management of acute asthma?
a) Leukotriene receptor antagonists;
b) 5-LO inhibitors;
c) Cromolyn;
d) Corticosteroids
447. The standard treatment regimen for asthma is best described by which of the following:
a) Theophylline;
b) Inhaled Beta-2 adrenoceptors agonists only;
c) A combination of inhaled bronchodilators and inhaled corticosteroids;
d) Inhaled corticosteroids only
450. A 23 year old women with asthma has what is described as “aspirin hypersensitivity” and
experiences severe bronchospasm in response to even small doses of the drug. Which of the following
is the most likely mechanism by which the aspirin provokes her pulmonary problems?
a) Blocks synthesis of endogenous prostaglandins that have bronchodilator activity;
b) Induces hypersensitivity of muscarinic receptors on airway smooth muscles;
c) Induces hypersensitivity of H1-histamine receptors on airway smooth muscles;
d) Prevents or reduces epinephrine binding to B2-adrenergic receptors (airways and elsewhere).
451. A-26 year old patient with asthma is being treated with zafirlucast. Which of the following in
the main mechanism by which this drug works:
a) Blocks the proinflammatory effects of certain arachidonic acid metabolites;
b) Enhances release of epinephrine from the adrenal (suprarenal) medulla;
c) Increases airway β-adrenergic receptor responsiveness to endogenous norepinephrine;
d) Inhibits cAMP breakdown via phosphodiesterase inhibition
453. Which drug group used to treat asthma causes oral candidiasis?
a) Leukotriene receptor antagonists;
b) Anti IgE antibodies;
c) Corticosteroids;
d) Beta-adrenoceptor agonists
Hormons
455. Thyroid deficiency (hypothyroidism or myxedema) is treated by simple replacement therapy
by using:
a) Liothyronine (T3);
b) Propylthiouracil;
c) Methimazole;
d) Radioactive iodine (131I).
458. The toxicity symptoms of prophylthiouracil and methimazole include the following, ecxept:
a) Rash;
b) Hypoprothrombinemia;
c) Hyperprothrombinemia;
d) Agranulocytosis.
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459. Which drugs are used to destroy most or all of the gland in thyrotoxicosis:
a) I;
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b) Methimazole;
c) Propylthiouracil;
d) Levothyroxine
460. Iodides:
a) Stimulate the incorporation of iodine into the thyroglobulin molecule;
b) Inhibit the release of thyroxine from the gland;
c) Increase vascularity of hyperplastic gland;
d) Are contraindicated before thyroidectomy
462. Choose right answers (Mechanism of action of radiocontrast media Ipodate and beta-blockers
during thyroid storm):
a) Ipodate increases the release of thyroxine from the thyroid gland;
b) Ipodate blocks the conversion of thyroxine to triiodothyronine;
c) Beta-blockers (eg, propranolol) are contraindicated in the management of thyroid storm;
d) Beta-blockers stimulate the conversion of thyroxine into thiiodothyronine.
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c) Decrease mRNA of COX-2, decreased platelet activating factor (PAF), and reduce synthesis of
interleukin 2 (IL-2);
d) Cellular consequences include increased leukocyte migration, increased phagocytosis and
lymphocyte proliferation and activation.
478. A progestin receptor antagonist, which also blocks glucocorticoid receptors and has been used
in Cushing’s syndrome:
a) Metyrapone;
b) Ketoconazole;
c) Spironolactone;
d) Mifepristone
479. Drug which inhibits the steroid 11-hydroxylation and is used diagnostically in tests of adrenal
function:
a) Ketoconazole;
b) Mifepristone;
c) Metyrapone;
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d) Spironolactone
484. Rapid-onset, short-acting forms of insulin used to control postprandial hyperglycemia include:
a) Regular zinc insulin;
b) Insulin glargine ;
c) NPH (Neutral protamine Hagedorn);
d) Insulin lente.
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487. Choose right answers:
a) Hypoglycemia from insulin overdosage may require parenteral beta-adrenoceptor blockers by
intramuscular injection;
b) Patients with nephropathy are less susceptible to hypoglycemia;
c) Animal origin Insulin may cause systemic allergy which may result in severe rashes and possible
anaphylaxis;
d) Diabetic ketoacidosis necessitated intravenous treatment with insulin Glargin.
492. Which sulfonylureas drugs can be displaced from plasma proteins by many drugs with
enhancement of hypoglycemeic actions:
a) Glyburide.
b) Glimepiride;
c) Tolbutamide;
d) Glipiside
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