[CLINCAL PHARMACY] PACOP PINK

Proverbs 16:3

D) Pharmaceutical care

It refers to the responsible provision of drug therapy to achieve definite outcomes that are intended to improve a patient's quality of life
A. Professional-patient's relationship
B. Therapeutic drug monitoring
C. Drug therapy assessment
D. Pharmaceutical care
E. Formal documentation

A) Cost-of-Illness Evaluation

It involves measuring direct and indirect costs attributable to a specific disease
A. Cost-of-Illness Evaluation
B. Cost-Effectiveness Analysis
C. Cost-Minimization Analysis
D. Cost-Utility Analysis
E. Cost-Benefit Analysis

E) Cost-Benefit Analysis

The method that allows for the identification, measurement, and comparison of the benefits and costs of a program or treatment alternative<br>A. Cost-of-Illness Evaluation<br>B. Cost-Effectiveness Analysis<br>C. Cost-Minimization Analysis<br>D. Cost-Utility Analysis<br>E. Cost-Benefit Analysis

C) Cost-Minimization Analysis

The method that involves the determination of the least costly alternative when comparing two or more treatment alternatives<br>A. Cost-of-Illness Evaluation<br>B. Cost-Effectiveness Analysis<br>C. Cost-Minimization Analysis<br>D. Cost-Utility Analysis<br>E. Cost-Benefit Analysis

D) Cost-Utility Analysis

The method that integrates the patient preferences and health-related quality of life
A. Cost-of-Illness Evaluation
B. Cost-Effectiveness Analysis
C. Cost-Minimization Analysis
D. Cost-Utility Analysis
E. Cost-Benefit Analysis

B) Cost-Effectiveness Analysis

A way of summarizing the health benefits and resources used by competing health care programs so that policy makers can choose among them
A. Cost-of-Illness Evaluation
B. Cost-Effectiveness Analysis
C. Cost-Minimization Analysis
D. Cost-Utility Analysis
E. Cost-Benefit Analysis

B) Quality of life

It refers to the value assigned to duration of life as modified by impairments, functional states, perceptions and social opportunities that are influenced by disease, injury, treatment or policy
A. Optimum health
B. Quality of life
C. Health outcomes
D. Responsiveness
E. Wellness of being

D) Blinded study

A study design in which neither the study subject nor the study staff is aware of which group or intervention the subjects has been assigned
A. Randomized control trial
B. Crossover study
C. Cohort study
D. Blinded study
E. Cross-sectional study

B) Case control study

A retrospective comparison of causal factors or exposures in a group of persons with disease and those of persons without the disease
A. Randomized control trial
B. Case control study
C. Cohort study
D. meta-analysis
E. open-label trial

D) Cohort study

A retrospective or prospective follow-up study of exposed and non-exposed defined groups in which a variable of interest is measured
A. Cross-sectional study
B. Case control study
C. Cross over study
D. Cohort study
E. open label trial

B) Cross over study

A trial comparing treatments in which participants, on completion of one treatment, are switched to the other
A. Cross-sectional study
B. Cross over study
C. meta-analysis
D. open label trial
E. cohort study

A) Cross-sectional study

A study that examines the presence or absence of a disease and other variable in a defined population and the potential risk factor at a particular point in time or time-interval
A. Cross-sectional study
B. Cohort study
C. case control study
D. cross over study
E. case series

D) those between 1 day and 1 month

Which of the following best describes the neonates?
A. those who are 1 month to 1 year of age
B. those who are 1 year to 12 years of age
C. those who are 12 to 16 years of age
D. those between 1 day and 1 month
E. those born before 32 weeks of gestational age

A) those who are 1 month to 1 year of age

Which of the following best describes the infant?<br>A. those who are 1 month to 1 year of age<br>B. those who are 1 year to 12 years of age<br>C. those who are 12 to 16 years of age<br>D. those between 1 day and 1 month<br>E. those born before 32 weeks of gestational age

D) I, II and IV only

• Characteristic gray color

• Abdominal distention

• Hypertension

Clinical manifestation of Gray Baby Syndrome include:
I. Characteristic gray color
II. Abdominal distention

III. Hypertension

IV. Progressive shock
A. I only
B. I and IV only
C. I, II and III only
D. I, II and IV only
E. I and III only

B) I, II and III only

• Polyneuritis

• Mental retardation

• Limb deformities

Which of the following is associated with the use of thalidomide?
I. Polyneuritis
II. Mental retardation

III. Limb deformities
A. I only
B. I, II and III only
C. II and III only
D. III only
E. I and III only

D) I, II and IV only

• Polypharmacy

• Inappropriate prescribing

• Multiple adherence

Factors that increase the risk of drug-related problems in the elderly include:
I. Polypharmacy
II. Inappropriate prescribing

III. Medication adherence

IV. Multiple diseases
A. I and II only
B. I, II and III only
C. II and IV only
D. I, II and IV only
E. I, II, III and IV

B) I, III and IV only

• Impaired hearing

• Multiple diseases and medication

• Reliance on a caregiver for the history

Potential difficulties that may occur while taking medication histories from the elderly include:
I. Impaired hearing
II. Mental acuity

III. Multiple diseases and medication

IV. Reliance on a caregiver for the history
A. I, II and III only
B. I, III and IV only
C. II, III and IV only
D. I, II and IV only
E. I, II, III and IV

B) Pharmacovigilance

Refers to the continual monitoring for unwanted effects and other safety-related aspects of marketed drugs
A. Pharmacoepidemiology
B. Pharmacovigilance
C. Pharmacoinformatics
D. Pharmacogenetics
E. Pharmacogenomics

A) Pharmacoepidemiology

Study of the use of and effect of drugs in a large number of people
A. Pharmacoepidemiology
B. Pharmacovigilance
C. Pharmacoinformatics
D. Pharmacogenetics
E. Pharmacogenomics

D) Adverse drug reaction

Any noxious, unintended, and undesired effect of a drug that occurs at doses used in humans for prophylaxis, diagnosis or therapy
A. Adverse drug event
B. Allergy
C. Hypersensitivity
D. Adverse drug reaction

D) I and III only

• Provides supplemental information to the physical examination and usually the first diagnostic test in a cardiac workup

• Gives information about position and size of the heart and chambers and surrounding anatomy

Which of the following is/are true regarding chest x-ray?
I. Provides supplemental information to the physical examination and usually the first diagnostic test in a cardiac workup
II. Provides details of internal cardiac structures
III. Gives information about position and size of the heart and chambers and surrounding anatomy
A. I only
B. I, II and III
C. I and II only
D. I and III only
E. II and III only

E) IV only

The manifestation of chromium deficiency include:
I. Alopecia
II. Depigmentation of hair and skin

III. Red blood cell fragility

IV. Glucose intolerance
A. I and II only
B. II and IV only
C. I, II, III and VI
D. III only
E. IV only

E) I, II and III only

• Poor wound healing

• Poor growth

• Poor resistance to infection

The manifestation of zinc deficiency include:
I. Poor wound healing
II. Poor growth

III. Poor resistance to infection
A. I only
B. II and III only
C. I and IV only
D. III only
E. I, II and III only

C) I, II and IV only

• Nature of amino acid solution

• pH

• Electrolyte content

Incompatibilities with fat emulsions cause majority of formulation problems in TPN. Which of the following affects lipid stability in TPN preparations?
I. Nature of amino acid solution
II. pH

III. The amount of dissolved oxygen in the solution

IV. Electrolyte content
A. I, II and III only
B. II, III and IV only
C. I, II and IV only
D. I and II only
E. I and IV only

D) II, III and IV only

• Presence of trace minerals

• Amount of dissolved oxygen in the solution

• pH

Ascorbic acid is the most rapidly oxidized vitamin. The rate of oxidation depends on:
I. Electrolyte content
II. Presence of trace minerals

III. Amount of dissolved oxygen in the solution

IV. pH
A. IV only
B. I and III only
C. I, II and III only
D. II, III and IV only
E. II and IV only

C) Thiamine

Which of the following is the most rapidly reduced vitamin?
A. Riboflavin
B. Niacin
C. Thiamine
D. Cevitamic Acid
E. Ascorbic Acid

E) I, II and III

• Administration of albumin

• Congestive heart failure

• Cirrhosis

Which of the following are associated with delusional hyponatremia?
I. Administration of albumin
II. Congestive heart failure

III. Cirrhosis
A. II only
B. I and III only
C. I and II only
D. I only
E. I, II and III

B) I and III only

• End product of protein metabolism

• Filtered completely at golmerulus

Which of the following is/are true regarding blood urea nitrogen (BUN)?
I. End product of protein metabolism
II. Produces by liver and kidney
III. Filtered completely at glomerulus
A. I and II only
B. I and III only
C. II and III only
D. I, II and III
E. I only

D) I and II only

• Not absorbed and secreted by the kidney

• Filtered freely at the glomerulus

Which of the following accurately describes creatinine?
I. Not absorbed and secreted by the kidney
II. Filtered freely at the glomerulus
III. Metabolized by the kidney
A. I only
B. II only
C. III only
D. I and II only
E. II and III only

D) II and III only

Which of the following is/are true regarding aspartate aminotransferase (AST)?<br>I. Also called serum glutamic pyruvic transaminase<br>II. Abundant in heart and liver tissue<br>III. Used to evaluate myocardial injury and case prognosis of liver disease resulting from hepatocellular injury<br>A. I only<br>B. I and II only<br>C. I and III only<br>D. II and III only<br>E. III only

A) I, II and III

Which of the following is/are true regarding the comparison of ALT and AST enzyme?<br>I. ALT elevations persist longer than those of AST.<br>II. ALT is more liver specific.<br>III. The liver contains 3.5 times more AST than ALT.<br>A. I, II and III<br>B. I and II only<br>C. II and III only<br>D. I and III only<br>E. II only

D) I and III only

Which of the following may result to a decrease in hematocrit?<br>I. Hemolysis III. Sickle cell anemia<br>II. Polycythemia vera<br>A. I only<br>B. II only<br>C. I and II only<br>D. I and III only<br>E. I, II and III

C) an SBP less than 120, and a DBP less than 80

According to the Seventh report of Joint National Committee (JNC 7), which of the following best describes a normal blood pressure?<br>A. an SBP less than 130, and a DBP less than 85<br>B. an SBP between 120 and 139, or a DBP between 80 and 89<br>C. an SBP less than 120, and a DBP less than 80<br>D. an SBP between 140 and 159, or a DBP between 90 and 99<br>E. an SBP equal to or greater than 160, or a DBP equal to or greater than 100

D) an SBP between 140 and 159, or a DBP between 90 and 99

According to JNC 7, which of the following best describes Stage I hypertension?<br>A. an SBP less than 130, and a DBP less than 85<br>B. an SBP between 120 and 139, or a DBP between 80 and 89<br>C. an SBP less than 120, and a DBP less than 80<br>D. an SBP between 140 and 159, or a DBP between 90 and 99<br>E. an SBP equal to or greater than 160, or a DBP equal to or greater than 100

C) I and III only

Which of the following are the objectives of evaluating patients with documented hypertension?<br>I. to assess lifestyle and identify other cardiovascular risk factors or concomitant disorders that may affect prognosis and guide treatment<br>II. to reveal identifiable causes of high blood pressure and allow patient self-medication<br>III. to assess the presence or absence of target organ damage and cardiovascular diseases<br>A. I only<br>B. II only<br>C. I and III only<br>D. I, II and III<br>E. I and II only

D) I, III and IV only

Routine laboratory tests for hypertension recommended before initiating therapy include:<br>I. Electrocardiogram III. Blood glucose and hematocrit<br>II. Urinary albumin excretion IV. lipid profile<br>A. I and IV only<br>B. I and II only<br>C. I, II and III only<br>D. I, III and IV only<br>E. I, II and IV only

E) I, II, III and IV

Lifestyle modification for hypertension include:<br>I. Diet rich in potassium and calcium<br>II. Physical activity<br>III. Moderation of alcohol consumption<br>IV. Weight reduction of overweight and obese patients<br>A. II, III and IV only<br>B. I, III and IV only<br>C. I, II and IV only<br>D. I, II and III only<br>E. I, II, III and IV

A) Thiazide diuretics

Which of the following diuretics should be used as initial therapy for most patients with hypertension, either alone or in combination?<br>A. Thiazide diuretics<br>B. Loop diuretics<br>C. Potassium-sparing diuretics<br>D. Osmotic diuretics<br>E. a and b

B) I and II only

Which of the following statements is/are true regarding the potential unfavorable effects of antihypertensive drug choices?<br>I. Thiazide diuretics should be used cautiously in patients with gout<br>II. Beta-blockers should generally be avoided in individuals with asthma<br>III. Aldosterone antagonist and potassium-sparing diuretics can cause hypokalemia<br>A. I, II and III<br>B. I and II only<br>C. I and III only<br>D. II and III only<br>E. I only

E) I, II, III and IV

Factors that increase the chances of patients' non-adherence to anti-hypertensive therapy include:<br>I. Misunderstanding of condition or treatment<br>II. Lack of patient involvement in the care plan<br>III. Unexpected adverse effects of medications<br>IV. Complexity of care<br>A. I and II only<br>B. III and IV only<br>C. I, II and III only<br>D. I, II and IV only<br>E. I, II, III and IV

E) I, II and III

Which of the following is/are true regarding cholesterol?<br>I. It is naturally occurring alcohol.<br>II. It is the precursor molecule for the synthesis of bile acids and steroid hormones.<br>III. It is used by the body to form cell membranes.<br>A. II only<br>B. II and III only<br>C. I and II only<br>D. III only<br>E. I, II and III

E) I and III only

General principles of the diet therapy intended to lower cholesterol levels include:<br>I. Choose foods high in complex carbohydrates like starch and fiber.<br>II. Replace monounsaturated fats with saturated fats and fish oils.<br>III. Eat less high-fat, high-cholesterol foods.<br>A. I only<br>B. III only<br>C. I, II and III<br>D. II and III only<br>E. I and III only

E) I and III only

Which of the following is/are true regarding bile acid resins as part of the management of hypercholesterolemia?<br>I. Resins are not absorbed from the gastrointestinal tract and thus lack systemic toxicity.<br>II. They reduce total and LDL cholesterol in a dose-independent manner.<br>III. They have a strong safety record established from years of use.<br>A. I only<br>B. III only<br>C. I, II and III<br>D. II and III only<br>E. I and III only

E) I, II, III and IV

Which of the following is/are the side effects of bile acid resins?<br>I. Constipation III. Nausea<br>II. Bloating and epigastric fullness IV. Flatulence<br>A. I and II only<br>B. II and IV only<br>C. I and IV only<br>D. II, III and IV only<br>E. I, II, III and IV

A) I and II only

Which of the following is/are true regarding niacin in the management of hypercholesterolemia?<br>I. It inhibits the mobilization of free fatty acids from peripheral adipose tissue to the liver.<br>II. It reduces the synthesis and secretion of VLDL particles by the liver.<br>III. One of its side effects is vasoconstriction which leads to flushing itching and headache.<br>A. I and II only<br>B. III only<br>C. I, II and III<br>D. II and III only<br>E. I and III only

B) HMG-CoA reductase inhibitors

Which of the following drugs has the most potent cholesterol lowering potential?<br>A. Bile acid resins<br>B. HMG-CoA reductase inhibitors<br>C. Beta-blockers<br>D. ACE inhibitor<br>E. Calcium Channel Blockers

D) Lovastatin and Simvastatin

During drug interactions with statins that result in higher blood levels of the statin or activate metabolite can increase the risk of myositis. Which of the following statins are most vulnerable to this interaction?<br>A. Atorvastatin and Pravastatin<br>B. Fluvastatin and Simvastatin<br>C. Cerivastatin and Lovastatin<br>D. Lovastatin and Simvastatin<br>E. Atorvastatin and Fluvastatin

A) Embolus

A small part of clot that breaks off and travels to another part of the vascular system<br>A. Embolus<br>B. Thrombosis<br>C. Infarction<br>D. Ischemia<br>E. Stroke

A) I and II only

Which of the following are the primary factors that influence the formation of pathologic clots?<br>I. Abnormalities of blood flow that cause venous stasis<br>II. Abnormalities of blood vessel walls<br>III. Hypocoagulability resulting from alterations in the availability or the integrity of blood clotting components<br>A. I and II only<br>B. III only<br>C. I, II and III<br>D. II and III only<br>E. I and III only

D) I, II and III

Which of the following is/are true regarding heparin?<br>I. A rapid-acting anticoagulant that is effective only when administered parenterally<br>II. Obtained from bovine lung or porcine intestinal mucosa<br>III. Acts by binding to the naturally circulating anticoagulant antithrombin III<br>A. I only<br>B. II and III only<br>C. I and III only<br>D. I, II and III<br>E. III only

E) III only

Which of the following is/are true regarding warfarin?<br>I. Acts as a Vitamin K agonist<br>II. A rapid-acting anticoagulant that is effective only when administered parenterally<br>III. Rapidly and completely absorbed in the upper gastrointestinal tract<br>A. I only<br>B. II and III only<br>C. I and III only<br>D. I, II and III only<br>E. III only

C) I and III only

Which of the following is/are true regarding Prothrombin Time (PT)?<br>I. Prolonged by deficiencies of clotting factor II, V, VII and X<br>II. Reflects alterations in the intrinsic and common pathways of the clotting cascade<br>III. The internationally recognized standard for monitoring warfarin therapy when exposed as INR<br>A. I only<br>B. II and III only<br>C. I and III only<br>D. I, II and III only<br>E. III only

B) II and III only

Which of the following statements is/are true regarding Activated Partial Thromboplastin Time (aPTT)?<br>I. Reflects alterations in the extrinsic and common pathways of the clotting cascade<br>II. Used to monitor heparin therapy<br>III. Performed by adding a surface-activating agent, a partial thromboplastin reagent, and calcium to the plasma sample<br>A. I only<br>B. II and III only<br>C. I and III only<br>D. I, II and III only<br>E. III only

B) Angina pectoris

A clinical syndrome characterized by discomfort in the chest, jaw, shoulder, back or arm<br>A. Atrial fibrillation<br>B. Angina pectoris<br>C. Myocardial infarction<br>D. Deep vein thrombosis<br>E. Ischemic heart disease

D) I, II and III

Which of the following statements describe/s accurately events in the process of atherosclerosis?<br>I. Extracellular lipids accumulate and undergo oxidation<br>II. As lesions progress, smooth muscle cells migrate, proliferate, and secrete large amounts of extracellular matrix<br>III. The end results is the presence of an elevated plaque, which occludes the vessel lumen.<br>A. I only<br>B. II and III only<br>C. I and III only<br>D. I, II and III<br>E. III only

D) Stable or classic angina

A type of angina which can be induced y exertion, emotional stress, or a heavy meal, and can be relieved by rest, nitroglycerin or both<br>A. Prinzmetal's angina<br>B. Angina decubitus<br>C. Unstable angina<br>D. Stable or classic angina<br>E. Preinfarction angina

A) Prinzmetal's angina

A type of angina precipitated by coronary artery spasm that reduces blood flow, and usually occurs at rest rather than with exertion or emotional stress<br>A. Prinzmetal's angina<br>B. Angina decubitus<br>C. Unstable angina<br>D. Stable or classic angina<br>E. Preinfarction angina

D) I, II and III

Which of the following is/are true regarding the mechanism of action of nitrates?<br>I. Causes venous dilation, which reduces left ventricular volume and myocardial wall tension, decreasing oxygen requirements<br>II. Reduces arteriolar resistance, helping to reduce afterload, which decreases myocardial oxygen demand<br>III. Facilitates collateral circulation by reducing pressure in cardiac tissues<br>A. I only<br>B. II and III only<br>C. I and III only<br>D. I, II and III<br>E. III only

E) I, III and IV only

Nitrate tolerance is one major problem with the long-term use of nitroglycerin and long-acting nitrates. Which of the following drugs have shown to be capable of reversing this phenomenon?<br>I. Acetylcysteine III. ACE inhibitors<br>II. Beta-blockers IV. Diuretics<br>A. I and II only<br>B. II and III only<br>C. I, II and III only<br>D. II, III and IV only<br>E. I, III and IV only

B) Calcium-channel blocker

Considered drug of choice in treatment of angina at rest<br>A. Nitroglycerin<br>B. Calcium-channel blocker<br>C. ACE inhibitor<br>D. Beta-blockers<br>E. Clopidogre

A) Procainamide

Used for the same arrhythmias for which quinidine is given, but poses added concern when used intravenously because of increased cardiovascular effects such as hypotension, syncope and myocardial depression<br>A. Procainamide<br>B. Disopyramide<br>C. Tocainide<br>D. Mexiletine<br>E. Flecainide

C) Phenytoin

Most commonly used to treat digitalis-induced ventricular and supraventricular arrhythmias<br>A. Profapenone<br>B. Flecainide<br>C. Phenytoin<br>D. Quinidine<br>E. Propranolol

A) Class IA

Class I anti-arrhythmics work by blocking the rapid inward sodium current and thereby slow down the rate of rise of the cardiac tissue's action potential. Which subclassification moderately reduces the depolarization rate and prolongs repolarization?<br>A. Class IA<br>B. Class IB<br>C. Class IC<br>D. Class ID<br>E. Class IA and Class IB

D) I, III and IV only

Which of the following is/are not associated with cinchonism caused by quinidine?<br>I. Hearing loss III. Tinnitus<br>II. Photophobia IV. Blurred vision<br>A. I and II only<br>B. III and IV only<br>C. I, II and III only<br>D. I, III and IV only<br>E. II, III and IV only

C) Amiodarone

Among the type III anti-arrhythmics listed below, which has been reported as causing Torsade's de Pointes type of ventricular tachycardia?<br>A. Sotalol<br>B. Flecainide<br>C. Amiodarone<br>D. Quinidine<br>E. Lidocaine

D) Procainamide

A class I anti-arrhythmic drug that can cause fatigue, arthralgia, myalgia and low-grade fever, suggestive of systemic lupus erythematosus-like syndrome<br>A. Flecainide<br>B. Disopyramide<br>C. Mexiletine<br>D. Procainamide<br>E. Quinidine

A) Verapamil

A class IV anti-arrhythmic that is primarily indicated for the treatment of supraventricular tachyarrthymias<br>A. Verapamil<br>B. Disopyramide<br>C. Propranolol<br>D. Sotalol<br>E. Ibutilide

A) Class I

The New York Heart Association functional limitation class that indicates that the degree of effort necessary to elicit Heart Failure symptoms is equal to those that would limit normal individuals<br>A. Class I<br>B. Class II<br>C. Class III<br>D. Class IV<br>E. Class V

C) Class III

The New York Heart Association functional limitation class that indicates that the degree of effort necessary to elicit Heart Failure symptoms occurs with less-than ordinary exertion<br>A. Class I<br>B. Class II<br>C. Class III<br>D. Class IV<br>E. Class V

D) Class IV

The New York Heart Association functional limitation class that indicates that the degree of effort necessary to elicit Heart Failure symptoms occurs while at rest<br>A. Class I<br>B. Class II<br>C. Class III<br>D. Class IV<br>E. Class V

D) Preload

Refers to the force exerted on the ventricular muscle at the end of diastole that determines the degree od muscle fiber stretch<br>A. Frank-Starling mechanism<br>B. Afterload<br>C. Cardiac Output<br>D. Preload<br>E. Decompensation

B) Afterload

Determined by the amount of force needed to overcome pressure in the aorta<br>A. Frank-Starling mechanism<br>B. Afterload<br>C. Cardiac Output<br>D. Preload<br>E. Decompensation

E) II and III only

Which of the following is/are true regarding precautions with the use of digoxin?<br>I. Increased potassium levels favor digoxin binding to cardiac cells and increase its effect.<br>II. Increased calcium levels increase the force of myocardial contraction.<br>III. Magnesium levels are inversely related to digoxin activity.<br>A. I only<br>B. II only<br>C. I and II only<br>D. I and III only<br>E. II and III only

D) 5-10ug/kg/min

Which of the following dosages of dopamine is selected for its positive inotropic effects in treating the patient with Heart Failure?<br>A. 40mg/kg/min<br>B. 40ug/kg/min<br>C. 10-20ug/kg/min<br>D. 5-10ug/kg/min<br>E. 2ug/kg/min

B) Furosemide

A loop diuretic that is useful as a rapid-acting intravenous agent in reversing acute pulmonary edema<br>A. Ethacrynic acid<br>B. Furosemide<br>C. Spironolactone<br>D. Bumetanide<br>E. Mannitol

D) II, III and IV only

Diuretics which have become preferred due to their ability to increase sodium excretion by 20-25% of the filtered load and to maintain their efficacy until renal function is severely impaired<br>I. Spironolactone III. Furosemide<br>II. Ethacrynic acid IV. Bumetanide<br>A. I and II only<br>B. II and III only<br>C. I, II and III only<br>D. II, III and IV only<br>E. I, III and IV only

E) I, II and III only

Which of the following may be used in the acute management of digitalis toxicity?<br>I. Potassium III. Fab fragment antibody<br>II. Cholestyramine resin<br>A. I only<br>B. II only<br>C. I and II only<br>D. I and III only<br>E. I, II and III only

C) Requires pyridoxine supplementation

Which of the following best describes Isoniazid?<br>A. May be nephrotoxic and ototoxic<br>B. Has limited use due to its hepatotoxic potential<br>C. Requires pyridoxine supplementation<br>D. May discolor the tears and urine orange red<br>E. A pyrazine analogue of nicotinamide

D) II and IV only

Which of the following may be treated with streptomycin?<br>I. Bacterial endocarditis III. Urinary tract infection<br>II. Tularemia IV. Tuberculosis<br>A. I, II and III only<br>B. II, III and IV only<br>C. I and II only<br>D. II and IV only<br>E. III and IV only

A) Streptomycin=kanamycin>amikacin=gentamicin

Which of the following best illustrates the relative ototoxicity of aminoglycosides?<br>A. Streptomycin=kanamycin>amikacin=gentamicin<br>B. Kanamycin>streptomycin=tobramycin>amikacin<br>C. Streptomycin=gentamicin>kanamycin=amikacin<br>D. Kanamycin>streptomycin>kanamycin>amikacin<br>E. Streptomycin>kanamycin>amikacin>gentamicin

B) Gentamicin and streptomycin

Which of the following aminoglycosides can cause primarily vestibular damage?<br>A. Neomycin and amikacin<br>B. Gentamicin and streptomycin<br>C. Kanamycin and streptomycin<br>D. Amikacin and neomycin<br>E. Streptomycin and amikacin

C) Amikacin and kanamycin

Which of the following aminoglycosides can cause mainly auditory damage?<br>A. Gentamicin and streptomycin<br>B. Streptomycin and neomycin<br>C. Amikacin and kanamycin<br>D. Kanamycin and streptomycin<br>E. Amikacin and gentamicin

A) Streptomycin

Which is the least nephrotoxic aminoglycoside?<br>A. Streptomycin<br>B. Tobramycin<br>C. Neomycin<br>D. Amikacin<br>E. Netilmicin

C) Neomycin

Which is the most nephrotoxic aminoglycoside?<br>A. Streptomycin<br>B. Tobramycin<br>C. Neomycin<br>D. Amikacin<br>E. Netilmicin

E) Imipenem

Which carbapenem needs to be combined with cilastatin sodium to inhibit the action of renal dipeptidases to this drug?<br>A. Aztreonam<br>B. Meropenem<br>C. Carbamazepine<br>D. Ertapenem<br>E. Imipenem

C) II and III only

Which of the following is/are the routes of administration of Penicillin G Sodium and potassium?<br>I. Intradermal III. Intramuscular<br>II. Intravenous IV. Oral<br>A. II, III and IV only<br>B. I, III and IV only<br>C. II and III only<br>D. IV only<br>E. II and IV only

C) I, II and III only

Anaphylaxis is a life-threatening reaction that most commonly occurs with parenteral administration of penicillin. The following are its sign and symptoms:<br>I. Nausea III. Abdominal pain<br>II. Bronchoconstriction IV. Severe Hypertension<br>A. I only<br>B. I and II only<br>C. I, II and III only<br>D. IV only<br>E. II and IV only

D) Erythromycin and chloramphenicol

With which antibiotics does antibiotic antagonism occur when given within 1 hour of penicillin administration?<br>A. Tetracycline<br>B. Aminglycoside<br>C. Carbapenems<br>D. Erythromycin and chloramphenicol<br>E. Carbenicillin and isoniazid

B) Piperacillin

An extended spectrum penicillin that is 10 times as active as carbenicillin against Pseudomonas organisms?<br>A. Carbenicillin<br>B. Piperacillin<br>C. Ticarcillin<br>D. Mezlocillin<br>E. Tazobactam

D) I, II and III

Which of the following are manifestations of complex partial seizure?<br>I. Glassy stare<br>II. Visual, Auditory, or olfactory hallucinations<br>III. Automatism<br>A. I only<br>B. I and II only<br>C. I and III only<br>D. I, II and III<br>E. III only

B) Petit mal seizures

Seizures that present as alteration of consciousness lasting 10-30 seconds<br>A. Simple partial seizures<br>B. Petit mal seizures<br>C. Myoclonic seizures<br>D. Tonic-clonic seizures<br>E. Complex partial seizures

D) Muscle jerking and flaccidity of muscle

In a grand mal seizure, which of the following may mark the clonic phase?<br>A. Contraction of the diaphragm<br>B. Arching of the back<br>C. Nausea<br>D. Muscle jerking and flaccidity of muscle<br>E. soreness

D) I, II and III only

Which of the following is/are true regarding the tonic phase of a grand mal seizure?<br>I. The individual becomes rigid and falls.<br>II. Respirations are interrupted.<br>III. The tonic phase lasts for about a minute<br>IV. The individual may experience confusion and disorientation.<br>A. I only<br>B. II only<br>C. I, II, III and IV<br>D. I, II and III only<br>E. I, II and IV only

E) IV only

Which of the following may compromise the postical phase of generalized tonic-clonic seizure?<br>I. Heavy salivation III. Tachycardia<br>II. Incontinence IV. Drowsiness<br>A. I, II, III and IV only<br>B. I, II and III only<br>C. I and II only<br>D. I, II and IV only<br>E. IV only

C) III only

Which of the following is/are true regarding the major phases of seizure activity?<br>I. The ictal phase may precede the seizure by hour or days depending on the changes in the behavior or mood of the patient.<br>II. The prodromal phase may include a subjective sensation, lethargy and confusion.<br>III. The ictal phase is the seizure itself, and its onset is heralded by a scream or cry.<br>A. I only<br>B. II only<br>C. III only<br>D. I and II only<br>E. IV only

B) EEG

Measures the electrical activity of brain, and helps to identify functional cerebral changes underlying structural abnormalities<br>A. CBC<br>B. EEG<br>C. MRI<br>D. PET<br>E. CSF

A) I only

Which of the following is/are true regarding neurological imaging studies for seizures?<br>I. The MRI can detect brain lesions related to epilepsy.<br>II. The PET measures the electrical activity of the brain.<br>III. EEG offer functional views of the brain to detect hypometabolism or relative hypoperfusion<br>A. I only<br>B. I and II only<br>C. I and III only<br>D. I, II and III only<br>E. II only

B) Carbamazepine

Which of the following anti-convulsants is contraindicated in patients with a history of Tricyclic antidepressants hypersensitivity?<br>A. Ethosuximide<br>B. Carbamazepine<br>C. Phenobarbital<br>D. Phenytoin<br>E. Gabapentin

C) I, II and III only

What are the most common adverse effects of anticonvulsive drugs?<br>I. Alteration in cognition and mentation<br>II. Headaches and dizziness<br>III. Gastrointestinal symptoms<br>A. II only<br>B. II and III only<br>C. I, II and III only<br>D. III only<br>E. I and II only