Manor Preboards - Module 4

An antiviral drug that was found out to have antiparkinsonism properties by chance

a.Isocarboxazid

b.Entacapone

c.Amantadine

d.Rasagiline

C

An advantage of Salmeterol over Isoproterenol in the treatment of bronchial asthma is that Salmeterol:

a.is more selective for β2 adrenergic receptors

b.has more β-agonist activity than Isoproterenol

c.has a more rapid onset of action

d.has an action against cardiogenic shock

A

Advantages of Acetaminophen over Aspirin include the following except

a.Greater anti-inflammatory action

b.Less gastric irritation

c.No appreciable effect on uric acid excretion

d.No alteration of bleeding time

A

Repaglinide is believed to work by

a.decreasing hepatic gluconeogenesis

b.stimulating the release of insulin from the pancreas

c.increasing hepatic gluconeogenesis

d.reducing glucagon secretion from the pancreas

B

Pamidronate sodium is indicated for the treatment of

a.

Crohn's disease

b.

Ménière's disease

c.

Paget's disease

d.

Hansen's disease

C

True about active transport of the drug across a membrane exceptI. Carrier-mediatedII. Uphill transport so it does not require energyIII. Carrier may be selective and may be saturated at high drug concentrationIV. Drugs with similar structures may compete for the same carrier

a.I, III, IV

b.II only

c.I, II, III, IV

d.II, IV

B

True about vesicular transport

I. It is the only transport mechanism that does not require a drug to be in an aqueous solution to be absorbed

II. Pinocytosis is the engulfment of larger particles or macromolecules, generally by mcrophages

III. Phagocytosis is the engulfment of small solute or fluid volumes

IV. Endocytosis and exocytosis are the movement of macromolecules out and into the cell, respectively.

a.I only

b.I, II, III

c.II, III, IV

d.I, IV

A

True about drug distribution except

a.Tetracycline may accumulate in the bone because complexes are formed with Calcium

b.Lipid-soluble may accumulate in adipose tissue because of partitioning of the drug

c.Diseases like meningitis makes the BBB more permeable to the penetration of drugs into the brain

d.Drugs distribute slightly more rapid into the adipose tissues and slightly slower into the liver

D

After peroral administration, drugs generally are absorbed best from the

a.Stomach

b.Jejunum

c.Ileum

d.Duodenum

D

The termination of heparin activity by Protamine sulfate is the result of

a.a chelating action

b.inhibition of gastrointestinal absorption of Heparin

c.prothrombin-lik activity of Protamine

d.an acid-base interaction

D

Angiotensin receptor antagonists or blockers (ARBs) are less likely to cause angioedema and cough than the Angiotensin-converting enzyme inhibitors (ACEI) because

a.

ARB's do not contain a sulfhydryl functional group

b.

ACEI's are more specific for inhibiting the production of Angiotensin II

c.

ARB's are pseudo-irreversible antagonists

d.

ARB's do not inhibit the breakdown of bradykinin

D

Which of the following statements regarding thyroid hormones are not correct?

I. Levothyroxine and Liothyronine are naturally-occurring thyroid hormones

II. T3 is converted into T4 in the peripheral circulation

III. The concentration of T3 needed to exhibit effect is less than that of T4

IV. T3 is more potent than T4

a.II, III

b.III, IV

c.I, IV

d.I, II

D

Ethyl alcohol (EtOH) is administered to patients who have ingested either ethylene glycol or methanol because EtOH

a.Helps sedate patients

b.Increase the metabolism of ethylene glycol and methanol

c.Blocks the formation of the toxic metabolites of ethylene glycol and methanol

d.Increases the renal clearance of ethylene glycol and methanol

C

Phenytoin is effective for the treatment of all of the following types of seizures except

a.Generalized tonic-clonic

b.Simple partial

c.Complex partial

d.Absence

D

Which of the following compounds is correctly matched with one of its therapeutic uses?

I. Raloxifene: Advanced breast cancer

II.Propylthiouracil : Hypothyroidism

III. Finasteride: BPH

IV. Metformin: PCOS

a.III only

b.I, III

c.III, IV

d.I, II, III, IV

C

Draw water into the urine, without interfering with ion secretion or absorption in the kidney

a.Loop diuretics

b.Thiazide diuretics

c.Osmotic diuretics

d.Potassium-sparing diuretics

C

Which of the following is correct?

a.Reduced binding to protein by the drug molecule will decrease the therapeutic effect of the drug

b.Saturation of binding produces linear pharmacokinetics

c.Bound drugs can diffuse into the tissues

d.Only the unbound drug may be available for metabolism

D

Alkalinizing the urine with sodium bicarbonate is useful in the treatment of poisoning with

I. ASA

II.Salicylates

III. Barbiturates

IV. Morphine

a.I, II

b.I, II, III

c.I, II, IV

d.I, III, IV

B

Cromolyn sodium acts by

a.Metabolizing histamine

b.Destroying histamine

c.Releasing histamine

d.Preventing the release of histamine

D

Stimulation of β-adrenoreceptor, a G-protein-linked receptor involves generation of secondary messenger/s known as

a.IP3

b.DAG

c.cAMP

d.A and B

C

A given adrenergic agent induces lipolysis, increases the release of renin, and increases myocardial contractility. These effects are attributed to

a.α1 receptors

b.α2 receptors

c.β1 receptors

d.β3 receptors

A

Astemizole and Terfenadine have been withdrawn from the market because of their intrinsic cardiotoxicity. The risk of cardiotoxicity is increased with concomitant intake of Grapefruit juice or Erythromycin. The explanation for this interaction is

a.Displacement from the protein binding of Astemizole or Terfenadine by Grapefruit juice or Erythromycin

b.Decreased urinary excretion of Astemizole and Terfenadine since Grapefruit juice and Erythromycin competes with them in using transporters

c.Inhibition of the CYP3A4 enzyme by Grapefruit juice or Erythromycin

d.Increased absorption of Astemizole and Terfenadine due to the effects of Grapefruit juice and Erythromycin on the GI tract

C

Guanfacine and Guanabenz are primarily agonists at what receptors

a.M1

b.NN

c.Presynaptic α1

d.Postsynaptic α2

C

What is the principal mechanism of action of Cardiac glycosides?

a.Stimulate the release of Calcium from the sarcoplastic reticulum leading to an increase in intracellular Calcium

b.Inhibit the cell membrane outward calcium transporter preventing Calcium extrusion

c.Inhibit Na-K-ATPase leading to increase in intracellular Sodium and preventing Calcium extrusion

d.Inhibit Na-Ca exchanger in the sarcoplasmic reticulum leading to increase in intracellular Calcium

C

What is the mechanism of action of AmA. iodarone?

a.Prolong the action potential by blocking Sodium channels

b.Shorten the action potential by blocking Sodium channels

c.Prolong the action potential by blocking Potassium channels

d.Shorten the action potential by blocking Potassium channels

C

What is the most important associated with Pyrazolone derivatives like Phenylbutazone which necessitated the withdrawal of a number of these drugs from the market?

a.Severe hepatoxicity

b.Nephrotoxicity

c.Hematologic toxicity

d.Gastric ulceration

C

Methylphenidate and dextroamphetamine are centrally-acting sympathomimetics which may found use in which of the following conditions?

a.Manic-depression

b.Alcohol withdrawal

c.Attention deficit hyperactivity disorder

d.Generalized anxiety disorder

C

Which of the following agents is most useful for the management of nephrolithiasis due to idiopathic hypercalciuria?

a.Ethacrynic acid

b.Dorzolamide

c.Hydrochlorothiazide

d.Triamterene

C

Which antibacterial drug increases the risk of developing serotonin syndrome?

a.Vancomycin

b.Linezolid

c.Chloramphenicol

d.A and B

B

Which antibacterial drug class does not work by inhibiting protein synthesis?

a.Aminoglycosides

b.Streptogramins

c.Oxazolidinones

d.Fuoroquinolones

D

Which of the following aminoglycosides are the most nephrotoxic?

a.Amikacin, Kanamycin, Neomycin

b.Streptomycin, Gentamicin

c.Gentamicin, Tobramycin, Neomycin

d.Spectinomycin, Mupirocin

C

All these drugs work as microtubule inhibitors except for

a.Colchicine

b.Griseofulvin

c.Mebendazole

d.Allopurinol

D

Which of the following drugs is not an SSRI?

a.Fluvoxamine

b.Sertraline

c.Fluoxetine

d.Venlafaxine

D

Which of the following antidote - drug pairs is incorrect?

a.

Leucovorin - Methotrexate

b.

Phytomenadione - Warfarin

c.

Physostigmine - Benzodiazepines

d.

Prussian blue - Thallium

C

Which of these are nucleotide-analog reverse transcriptase inhibitors?

I. Abacavir

II.Emtricitabine

III. Stavudine

IV. Tenofovir

V. Nevirapine

VI. Lamivudine

a.I, II, III, VI

b.IV only

c.II, III, V, VI

d.I, II, III, IV, VI

B

Which ADP receptor inhibitor binds reversibly to their receptor?

a.Clopidogrel

b.Ticlopidine

c.Ticagrelor

d.Prasugrel

C

Metronidazole is effective against these types of organisms except

a.Aerobic

b.Anaerobic

c.Protozoan

d.

None of the above - Metronidazole is effective against all of the organisms stated above

A

These drug - adverse effect pairs are incorrect except

a.

Verapamil - Diarrhea

b.

Atypical antipsychotics - Weight gain

c.

Celecoxib - GI toxicity

d.

Biphosphonates - Hyperphosphatemia

B

Which of the following drugs works by inhibiting HIV integrase, thereby preventing DNA transfer from the viral genome?

a.Cidofovir

b.Maraviroc

c.Atazanavir

d.Raltegravir

D

This drug works as a competitive reversible inhibitor of DPP-4, reducing enzymatic inactivation of the incretin hormone, GLP-1.

a.Metformin

b.Pioglitazone

c.Nateglinide

d.Sitagliptin

D

Anakinra - a drug used in the treatment of rheumatoid arthritis - works by which means?

a.T-cell co-stimulation modulator

b.Interleukin-1 receptor antagonist

c.Anti-CD20 B-cell depleter

d.Antibody against TNF-α

B

Which of the following drugs works by inhibiting the enzyme dihydroorotate dehydrogenase?

a.Chloroquine

b.Mesalazine

c.Leflunomide

d.Etanercept

C

Which drug has keratolytic action - an effect which unblocks the pilosebaceous follicles and reduces sebum production by up to 90 percent?

a.Isotretinoin

b.Clindamycin

c.Benzoyl peroxide

d.Azelaic acid

A

Which drug works by antagonizing RYR1 receptors of the sarcoplasmic reticulum leading to decreased release of Calcium, wherein a buildup of the ion in skeletal muscle is present in patients experiencing a fast rise in body temperature and severe muscle contractions when a muscle relaxant is administered?

a.Ethosuximide

b.Nimodipine

c.Biphosphonates

d.Dantrolene

D

Long term use of proton-pump inhibitors is linked to

a.hypomagnesemia

b.hyponatremia

c.hypokalemia

d.hypocalcemia

A

Orexigenic drugs, which include corticosteroids, most antipsychotics, TCA's and anabolic steroids, has the ability to

a.Stimulate appetite

b.Improve metabolism and built

c.Enhance taste

d.Disturb hearing function

A

Tranexamic acid is a synthetic analog of the amino acid

a.Lysine

b.Cysteine

c.Threonine

d.Glutamic acid

A

This drug can cause Aluminum toxicity in patients with renal failure

a.Sucralfate

b.Bismuth subgallate

c.Lactulose

d.Docusate sodium

A

Also known as drug release; delivery of the active ingredient from a dosage form into solution

a.Liberation

b.Absorption

c.Biotransformation

d.A and B

A

True about absorption of drugs according to their design and purpose except

I. Drugs intended for systemic activity should ideally be completely and consistently absorbed from the site of application

II. Drugs intended for local activity should be minimally absorbed from the site of administration to prevent systemic exposure and systemic side effects

III. Extended-release drug products should remain at or near the application site and then slowly release the drug for the desired period of time

a.I, II, III

b.I, II

c.III only

d.None of the above - All statements are correct

D

Incorrect about physicochemical factors altering biological performance of drugs

I. Amorphous state is more soluble and has a higher dissolution rate than the crystalline form

II. The most stable polymorph has the lowest rate of dissolution and may least likely to be biologically active

III. Disintegration and dissolution of tablets are decreased with decreasing viscosity

a.I only

b.II only

c.III only

d.None of the above - All statements are correct

D

True about drug protein binding

I. Irreversible protein binding involves a hydrogen bond or van der Waals force between the drug and the protein

II. Reversible protein binding attaches a drug to the protein by covalent chemical bonding

III. Many weak acidic anionic drugs bind to orosomucoid by electrostatic and hydrophobic bonds

IV. Alpha-1-acid glycoprotein (AAGP) binds primarily basic cationic drugs such as saquinavir, propranolol, and lidocaine

a.I, II, III, IV

b.I, II, IV

c.III, IV

d.IV only

D

The blood-brain barrier (BBB) is a lipid barrier which slows the diffusion and penetration of water-soluble and polar drugs into the brain and the spinal cord. What cellular transporters decrease drug absorption and cause drug outflow?

a.Efflux transporters

b.Influx transporters

c.P-glycoprotein transporters

d.Regulatory transporters

A

Which biotransformation process mature at 2 months after birth? The inability of neonates to carry out this process causes the accumulation of a toxic metabolite of APAP.

a.Reduction

b.Oxidation

c.Glucuronidation

d.Glutathione conjugation

C

Which is/are Gq protein-linked?

a.M1 receptor type

b.M2 receptor type

c.M3 receptor type

d.M1 and M3 receptor types

D

Which of the following local anesthetics is a PABA derivative?

a.Cocaine

b.Procaine

c.Bupivacaine

d.Lidocaine

B

This hypoglycemic agent is contraindicated in the elderly since prolonged hypoglycemic reactions are common due to its long half-life of 32 hours.

a.Tolbutamide

b.Chlorpropamide

c.Tolazamide

d.Glipizide

B

It refers to the reduction of microbial load on an inanimate surface to a level considered acceptable for public health purposes.

a.Decontamination

b.Sanitation

c.Sterilization

d.Pasteurization

B

True about laxatives except

a.Phenolphthalein, a diphenylamine derivative just like Bisacodyl, was removed from the market due to the possibility of cardiac toxicity

b.Stool softeners or stool surfactant agents include Docusate and Glycerin suppository

c.Osmotic laxatives are indigestible and hydrophilic colloids that absorb water, forming a bulky, emollient gel that distends the colon and promotes peristalsis

d.Chronic use of stimulant laxatives such as aloe, senna, and cascara can lead to a characteristic brown pigmentation of the colon known as "melanosis coli."

C

Which is a reversible non-selective blocker of α adrenereceptors and is used in pheochromocytoma?

a.Phenoxybenzamine

b.Phentolamine

c.Tamsulosin

d.Yohimbine

B

This glucose transporter is responsible for the regulation of insulin release and other aspects of glucose homeostasis. Tissues of liver, kidney, and beta cells of pancreas are the locations of this transporter.

a.GLUT 1

b.GLUT 2

c.GLUT 3

d.GLUT 4

B

Warfarin, an oral anticoagulant, inhibits the vitamin K epoxide reductase complex 1 (VKORC1) which in turn inhbits the γ-carboxylation of glutamate residues of what factors?

a.Factors II, VII, VIII, X

b.Factors III, VII, IX, X

c.Factors III, VII, VIII, X

d.Factors II, VII, IX, X

D

This drug is given as a ketone prodrug that resembles Naproxen in structure and is converted into acetic acid derivative in the body. It is the only non-acid NSAID in current use.

a.Nabumetone

b.Ketorolac

c.Ketoprofen

d.Etodolac

A

It is a relatively selective vasopressin V2 receptor agonist which may be used in pituitary diabetes insipidus and pediatric primary nocturnal enuresis.

a.Tolvaptan

b.Vasopressin

c.Conivaptan

d.Desmopressin

D

Which of the following 'drug-process affected' pairs is incorrect?

a.

Metyrosine - Transmitter synthesis

b.

Nicotine - Receptor activation

c.

Cocaine - Transmitter release

d.

Vesamicol - Transmitter storage

C

Which of the following agents is not an example of an extended-spectrum penicillin?

a.Amoxicillin

b.Piperacillin

c.Ticarcillin

d.Nafcillin

D

Cell cycle-specific (CCS) chemotherapeutic drugs exert their action on cells traversing the cell cycle. Which of the following is not a cell cycle-specific chemotherapeutic drug?

a.Capecitabine

b.Paclitaxel

c.Bleomycin

d.Cisplatin

D

Patient MOLN arrives at the hospital and complains of mild gastrointestinal upset. Later, it was found to be caused by APAP poisoning. What is the antidote of choice for APAP poisoning?

a.N-acetylcysteine

b.Phytomenadione

c.Flumazenil

d.Sodium bicarbonate

A

What is the most toxic β-blocker?

a.Metoprolol

b.Propranolol

c.Bisoprolol

d.Nadolol

B

Lesions characterized by expansive growth, frequently exhibiting slow rates of proliferation that do not invade surrounding tissues

a.Benign

b.Malignant

c.Metastases

d.Tumor

A

In 1960, a large increase in newborns with Amelia or various degrees of phocomelia was recorded in West Germany. Congenital heart disease, and ocular, intestinal, and renal anomalies were also involved. What was the causative agent?

a.Diethylstilbestrol

b.Thalidomide

c.Ethanol

d.Antiepileptic drugs

B

Metabolic food reactions differ from other categories of adverse reactions in that the food demonstrates toxic effects only when eaten in excess and when improperly prepared. Lima beans, cassava roots, bitter almonds, apricot, and peach pits cause cyanosis by

a.Releasing hydrogen cyanide on contact with stomach acid

b.Interfering with utilization of Iodine

c.Mimicking mineralocorticosteroids

d.Interfering with oxidation of fatty acids

A

Carbon monoxide (CO) exerts its toxic effects via its interaction with

a.DNA polymerase

b.Actin

c.Microtubules

d.Hemoglobin

D

NAPQI is a metabolite normally produced only in small amounts, and then almost immediately detoxified in the liver. However, under some conditions such as APAP poisoning in which NAPQI is not effectively detoxified, it causes severe damage to the liver. What does the acronym NAPQI stand for?

a.N-acetyl-ρ-quinone imine

b.N-acetoacetyl-ρ-quinone imine

c.N-acetyl-ρ-benzoquinone imine

d.N-acetoacetyl-ρ-benzoquinone imine

C

Wilson's disease is a rare genetic disorder characterized by the failure to export which of the following metals into bile?

a.Silver

b.Copper

c.Lead

d.Aluminum

B

Conjugation of xenobiotics with glutathione form glutathione conjugates. These conjugates formed in the liver can be effluxed into bile and blood, and is converted to mercapturic acid in the kidney and excreted in the body. In what phase of metabolism does it belong?

a.Phase I metabolism or Conjugation phase

b.Phase II metabolism or Functionalization phase

c.Phase I metabolism or Functionalization phase

d.Phase II metabolism or Conjugation phase

C

Which of the following is an endogenous opioid?

a.Methadone

b.Fentanyl

c.Enkephalin

d.Levorphanol

C