[CLINICAL PHARMACY] MANOR SET 2

Proverbs 16:3

D) Prevention usually is achieved by timely immunization

1. All of following statements concerning upper respiratory infections are true, EXCEPT:<br>A. Most of these infections are caused by viruses<br>B. Symptoms may involve the sinuses throat, larynx and alrways<br>C. Treatment is primarily symptomatic <br>D. Prevention usually is achieved by timely immunization

C) Nonsteroidal anti-inflammatory drugs

📌NSAIDs are the standard first-line pharmacologic management for pain and inflammation in moderate osteoarthritis.

2. Which of the following would be the most appropriate form of management of a patient with moderate osteoarthritis of the knee?
   A. Antimalarial Drug
   B. Colchicine
   C. Nonsteroidal anti-inflammatory drugs
   D. Oral Corticosteroids
   E. Joint replacement surgery

B) administration of therapeutic doses of salicylates

📌Rationale: Salicylates (like aspirin) can paradoxically alter uric acid excretion depending on dose, potentially worsening acute gout by causing urate retention at low-to-moderate doses.

3. All of the following are appropriate therapeutic regimens for a patient with acute gout, except:
   A. maintenance of stable allopurinol dosage
   B. administration of therapeutic doses of salicylates
   C. injection of corticosteroid into inflamed joints
   D. immobilization of inflamed joints
   E. Application of ice over inflamed joints

C) Adverse medication effect

📌Rationale: Sudden hallucinations and confusion in a previously healthy elderly woman suggest medication-induced delirium.

4. A previously healthy, 68-year old woman develops auditory hallucinations. She cannot provide many details but believes her mother is speaking to her, She has difficulty cooperating during the interview and physical examination which is unremarkable. The most likely diagnosis is:
   A. Complex partial seizures
   B. Alzheimer's disease
   C. Adverse medication effect
   D. Hyperthyroidism
   E. Peduncular Hallucinosis

E) Hyperparathyroidism

📌Factors that play a role in development of duodenal ulcer disease:

• Spicy food ingestion

• Tobacco smoking

• Genetic factors

• H.pylori

idk ano sagot pero sabi ni claude SPICY FOOD INGESTION TALAGA hahahahh

5. All of the factors listed below may play a role in the development of duodenal ulcer disease, except:
   A. Spicy food ingestion
   B. Tobacco smoking
   C. Genetic factors
   D. Helicobacter pylori infection
   E. Hyperparathyroidism

C) Reddened nasal mucosa

📌Rationale: Allergic rhinitis typically shows pale, boggy nasal mucosa, not reddened, which is more typical of infectious rhinitis.

6. Uncomplicated seasonal allergic rhinitis is associated with all of the following clinical features, EXCEPT:
   A. Pruritus of the nose, palate and eyes
   B. Thin, watery nasal discharge
   C. Reddened nasal mucosa
   D. Paroxysmal sneezing
   E. Excess lacrimation

E) Megaloblastic findings on marrow examination

📌Rationale: Megaloblastic changes indicate B12/folate deficiency, not iron deficiency anemia (which shows microcytic, hypochromic features instead).

7. The diagnosis of iron deficiency anemia can be made with all of the following findings, except;
   A. Absent marrow iron biopsy stain
   B. Low serum ferritin levels
   C. Hypochromia and microcytosis in specific clinical settings
   D. Response to iron therapy within 1 month
   E. Megaloblastic findings on marrow examination

E) Somatostatin analog

📌Rationale:

Therapies used for metastatic prostate cancer:

• Corticosteroids

• Orchiectomy

• Leuprolide

• Estrogen

8. All of the following therapies are used for metastatic prostate cancer, except:
   A. Estrogen
   B. Leuprolide
   C. Orchiectomy
   D. Corticosteroids
   E. Somatostatin analog

b. Menopausal status

9. Prognostic factors in breast carcinoma include all of the following, except:
   a. Estrogen receptor status
   b. Menopausal status
   c. Size of primary tumor
   d. Percentage of cells in s phase
   e. Presence of lymph node metastasis in axillae

A) in oxidation - reduction system

10. Iron, a necessary dietary constituent, functions primarily:
    A. in oxidation - reduction system
    B. to maintain water and electrolyte balance
    C. In growth and repair of tissues
    D. To stimulate bone formation

C) Ca++

11. Which of the following metallic ions is especially required in the blood clotting process?
    A. Ba++
    B. Na+
    C. Ca++
    D. Mg++
    E. K+

E) encephalitis

📌Rationale: Encephalitis is often caused by mosquito-borne viruses (e.g., Japanese encephalitis) or other non-respiratory routes, not primarily person-to-person droplet transmission.

12. The agent of which the following diseases is not transmitted from person to by droplets or droplet spray?
    A. Pneumonia
    B. Diphtheria
    C. Meningitis
    D. Whooping cough
    E. encephalitis

D) Pernicious anemia

13. A reduction in acid secretions by the stomach. An increased tendency toward gastric carcinoma, atrophic glossitis and myelin degeneration of peripheral nerves are characteristic findings with:
    A. Thalassemia
    B. Agranulocytosis
    C. Sickle cell anemia
    D. Pernicious anemia
    E. Polycythemia Vera

C) Diabetes mellitus

14. An endocrine disease characterized by increased susceptibility to infection, increased fatigability, recessive inheritance and polyuria is:
    A. Acromegaly
    B. Grave's disease
    C. Diabetes mellitus
    D. Cushing's disease
    E. Hashimoto's disease

E) Prevented by acute immunization

15. Rubeola, Pertussis, poliomyelitis, and mumps have in common the fact that all are :
    A. Air-Borne diseases
    B. Vector-Borne Diseases
    C. Characterized by a toxemia
    D. Primarily diseases of infants
    E. Prevented by acute immunization

C) Neutrophil

16. What type of leukocyte appears first and is present in greatest numbers in an inflammatory focus soon after tissue injury has occurred:
    A. Plasma cell
    B. Eosinophil
    C. Neutrophil
    D. Lymphocyte
    E. Monocyte

B) Fungi-diseases

17. Amphotericin B, Griseofulvin, and Nystatin are often useful in the treatment of:
    A. Streptococcal Infections
    B. Fungi-diseases
    C. Viral diseases
    D. Tuberculosis
    E. Cancer

B) Melanoma

📌Rationale: Melanoma is a malignant tumor with high metastatic potential

• Adenoma — benign glandular tumor

• Chondroma — benign cartilage tumor

• Papilloma — benign epithelial tumor

18. Metastasis is likely in which of the following neoplasms?
    A. Adenoma
    B. Melanoma
    C. Chondroma
    D. Papilloma

B) Coronary heart disease

19. The leading-cardiac cause of death is:
    A. Mitral stenosis
    B. Coronary heart disease
    C. Myocarditis
    D. Hypertensive cardiovascular disease
    E. Congenital animalies

E) With hypersensitivity to TB bacillus and its products

20. A positive tuberculin test means that the patient:
    A. has active tuberculosis
    B. Has subclinical infection
    C. Is susceptible to tuberculosis
    D. With immunity to tuberculosis from a past infection
    E. With hypersensitivity to TB bacillus and its products

A) Hypothyroidism

21. Cretinism is the result of a metabolic disturbance related to:
    A. Hypothyroidism
    B. Hyperthyroidism
    C. Hypoparathhyroidism
    D. Hyperfunction of anterior pituitary
    E. Hyperfunction of anterior pituitary

C) Develops as a sequela to group A streptococcal infections.

📌Rationale: Rheumatic fever is an autoimmune sequela following group A streptococcal pharyngitis

22. Rheumatic fever is a disease which:
    A. Can result from a transient bacteremia by viridans Streptococci
    B. Is preceded by a group A streptococcal infection of the heart
    C. Develops as a sequela to group A streptococcal infections.
    D. Affects the glomeruli of the kidney

E) Histoplasmosis

📌Rationale: Histoplasmosis causes pulmonary calcifications and granulomas similar to TB, often found in areas with bird/bat droppings.

23. A fungal disease which may be confused with tuberculosis because it produces pulmonary calcifications:
    A. amebiasis
    B. Candidias
    C. Blastomycosis
    D. Actinomycosis
    E. Histoplasmosis

D. B12

📌Rationale: Vitamin B12 deficiency (pernicious anemia) causes megaloblastic/macrocytic anemia, glossitis, achlorhydria, gastric mucosal atrophy, and subacute combined degeneration (affecting dorsal/lateral spinal columns).

24. The presence of glossitis, pallor, macrocytic anemia, hyperplasia of the bone marrow, achlorhydria, atrophy of the gastric mucosa, and focal degenerative lesions of the dorsal and lateral columns of the spinal cord in a person older than middle-age suggests the individual has had a deficiency of vitamin:
    A.A
    B.B1
    C.B6
    D. B12
    E. C

B. Purines

25. Gout is an example of a disturbance in the metabolism of:
    A. Calcium
    B. Purines
    C. Cholesterol
    D. Carbohydrates

E. The cost of medication

26. Arguments against indiscriminate use of antibiotics as chemotherapeutic agents include the following, except:
    A. Toxic effects of the antibiotics
    B. Allergic reactions induced in patients
    C. Development of drug resistance by an infectious agent
    D. Secondary effects experienced due to creation of an imbalance in the normal body flora
    E. The cost of medication

A. Nystatin

📌Rationale: Nystatin is an antifungal specifically effective against Candida infections.

27. Which of the following antibiotics is effective in treating candidiasis?
    A. Nystatin
    B. Bacitracin
    C. Tetracycline
    D. Greiseofulvin
    E. Penicillin

D. Detection of hepatitis B antigen in serum is indicative of the carrier state

28. Which of the following statements is correct regarding a patient from hepatitis type B Infection?
    A. The virus will be excreted in the feces
    B. The patient is a good candidate for blood donation
    C. Patient will have protective Immunity to all viral hepatitis
    D. Detection of hepatitis B antigen in serum is indicative of the carrier state

B. six months in utero and eight years

Tetracycline antibiotics may stain children's teeth between the ages of:

A. one month in utero and three years

B. six months in utero and eight years

C. birth and ten years

D. one and years

E. Amount of bile pigments excreted by the liver

📌Rationale: RBC destruction releases hemoglobin, which is broken down into bilirubin (a bile pigment) and excreted — making bile pigment excretion the best indicator of RBC turnover/destruction rate.

30. The amount of red blood cell destruction per day is best measured by the:
    A. Hematocrit
    B. Amount of iron excreted
    C. Change in the red blood cell count
    D. Amount of hemoglobin/100 mL blood
    E. Amount of bile pigments excreted by the liver

B. Cortisone

31. A history of medication with which of the following drugs requires special BEconsideration prior to general anesthesia?<br>A. Estrogen<br>B. Cortisone<br>C. Meperidine<br>D. Phenacetin<br>E. Diphenhydramine

C. Heart rate

32. The following are "Vital Signs" except:<br>A. Temperature<br>B. Blood pressure<br>C. Heart rate<br>D. Respiratory rate<br>E. Pulse

D. Eosinophilia

📌A differential WBC count specifically identifies the proportion of eosinophils, detecting eosinophilia (elevated eosinophil levels),

33. Differential white blood cell counts in the laboratory are useful in the diagnosis of:
    A. Anemia
    B. Spherocytosis
    C. Vitamin deficiency
    D. Eosinophilia
    E. Thrombocytopenic purpura

A. Oxygen

📌Rationale: Supportive respiratory care (oxygen, ventilation) is the most effective management for barbiturate-induced respiratory depression

34. The most effective agent for the treatment of respiratory depression due to overdose of barbiturates is:
    A. Oxygen
    B. Caffeine
    C. Coramine
    D. Metrazol

E. Any of the above

• Psychosis

• Peptic ulcer

• Tuberculosis

• Diabetes mellitus

35. Administration of corticosteroids is contraindicated when there is a history of:
    A. Psychosis
    B. Peptic ulcer
    C. Tuberculosis
    D. Diabetes mellitus
    E. Any of the above

D. Phenobarbital

36. Which of the following barbiturates, in therapeutic doses, is the longest acting?<br>A. Amytal<br>B. Nembutal<br>C. Secobarbital<br>D. Phenobarbital<br>E. Pentothal

C. Difficult to treat because of drug-resistance strains

37. Staphylococcal infections are:<br>A. Controlled in hospitals<br>B. Readily responsive to penicillin<br>C. Difficult to treat because of drug-resistance strains<br>D. Not disseminated by carriers

C. Hospital

38. Completed patient hospital records or charts are the legal property of the:<br>A. Patient<br>B. Doctor-in charge<br>C. Hospital<br>D. Patient representative (Lawyer)<br>E. Insurance Carrier

B. Large tongue

39. Which of the following may be a feature of acromegaly<br>A. Crowded teeth<br>B. Large tongue<br>C. Hypoglycemia<br>D. Micrognathia<br>E. Echma

E. Hyperthyroidism

📌Rationale: These are classic hyperthyroidism symptoms: increased metabolic rate causing wide-eyed appearance (exophthalmos), nervousness, tachycardia, increased systolic pressure, fine hair/skin, and weight loss.

40. A patient is wide-eyed, very nervous with an increased systolic pressure, increased pulse rate, fine skin and hair, and loss of body weight. He is probably suffering from:
    A. Diabetes
    B. Hyperituitarism
    C. Hyperparathyroidism
    D. Hypothyroidism
    E. Hyperthyroidism

D. Establishing and maintaining a patient airway

41. When rendering first aid care to a severely injured person, priority should be given to:<br>A. Arresting hemorrhage<br>B. Recognition and treatment of shock<br>C. Recognition of associated head injuries<br>D. Establishing and maintaining a patient airway

C. Leukopenia

📌Rationale: A WBC count below the normal range (typically <4,000-5,000/mm³) is classified as leukopenia — this patient's 3,000/mm³ falls below normal.

42. A patient having a white blood count of 3,000 cells per cubic millimeter would be said to have:
    A. Leukemia
    B. Leukolysis
    C. Leukopenia
    D. Leukocytosis

B. Mg and Ca

43. What elements interfere with the activity of tetracycline?<br>A. Mg and Na<br>B. Mg and Ca<br>C. Na and K<br>D. Ca and B1

B. Virus

44. Serum hepatitis is caused by a/an:<br>A. Allergic reaction to serum<br>B. Virus<br>C. Fungus<br>D. Bacillus<br>E. Reaction to a local anesthetic

E. Vesicle

📌Rationale: Herpes virus infections classically produce small, fluid-filled vesicles on the skin or mucous membranes.

45. The characteristic lesion of herpes virus infections on the skin or mucous membrane is :
    A. Necrosis
    B. Tumefaction
    C. Abscess
    D. Hyperkeratosis
    E. Vesicle

B. Sucrose

46. Which of the following has been determined to be the most cariogenic carbohydrate?
    A. Starch
    B. Sucrose
    C. Glucose
    D. Glycogen
    E. Dextranaase

B. Glossitis

47. Pernicious anemia is usually associated with:
    A. Iron deficiency
    B. Glossitis
    C. Blue sclera
    D. Microcytic anemia
    E. Gastric hyperacidity

B. Rubeola

📌Rationale: These oral lesions are Koplik's spots — small white dots with a red halo on the buccal mucosa — classic for measles (rubeola), typically appearing before the measles skin rash.

48. A seven-year-old girl has a temperature of 102° F, Her mother states the child has had an upper respiratory infection for several days. Examination reveals a few small white dots surrounded by a reddish, halo on the buccal mucosa. The oral lesions most probably are Indicative of:
    A. Varcella
    B. Rubeola
    C. Herpes Zoster
    D. Hand-foot-and-mouth disease
    E. Herpangina

D. Propranolol

49. Administration of which of the following drugs would be contraindicated in patients with allergic bronchial asthma:<br>A. Atropine<br>B. Methacholine<br>C. d-Tubocurarine<br>D. Propranolol<br>E. Phentolamine

E. Chloramphenicol

50. Which of the following antibiotics is most likely to of the bone marrow?
    A. Streptomycin
    B. Tetracycline
    C. Amphotericin B
    D. Penicillin G
    E. Chloramphenicol

C. Chlorpheniramine

51. Which of the following drugs would be useful in treating the dermatologic manifestations of an allergic response?<br>A. Diazepam<br>B. Phenoxybenzamine<br>C. Chlorpheniramine<br>D. Atropine<br>E. Hexylresorcinol

E. Antineoplastic agents

52. Which of the following drug classes has been definitely established to be teratogenic in humans?<br>A. Salicylates<br>B. Antianginals<br>C. Local anesthetics<br>D. Barbiturates<br>E. Antineoplastic agents

C. Respiratory Depression

53. Which of the following adverse effects is most commonly associated with administration of an intravenous barbiturate?<br>A. Hypotension<br>B. Hepatic Neocrosis<br>C. Respiratory Depression<br>D. Renal failure<br>E. Nausea and vomiting

E. Volatile anesthetics

📌Rationale: Volatile (inhalation) anesthetics undergo minimal metabolism, being largely eliminated unchanged via exhalation from the lungs.

54. Which of the following classes of drugs undergoes the least change in the body?
    A. Alcohols
    B. Salicylates
    C. Local anesthetics
    D. Barbiturates
    E. Volatile anesthetics

E. Penicillin V

📌Rationale: Erythromycin is the classic alternative to penicillin for endocarditis/rheumatic heart disease prophylaxis in penicillin-allergic patients.

55. The proper antibiotic to be employed prophylactically in a patient with rheumatic heart disease not receiving prophylactic penicillin is :
    A. Erythromycin
    B. Lincomycin
    C. Cephalosporin
    D. Penicillin G
    E. Penicillin V

D. Cardiovascular and respiratory system

56. Most Life-threatening adverse drug reactions affect the:<br>A. Central nervous system<br>B. Liver and Kidney system<br>C. Bronchial smooth muscle<br>D. Cardiovascular and respiratory system<br>E. Gastrointestinal tract

C. Chloramphenicol

57. Aplastic anemia is a serious toxic effect, which particularly occurs after a course of treatment with which of the following antibiotics?<br>A. Penicillin<br>B. Lincomycin<br>C. Chloramphenicol<br>D. Tetracycline<br>E. Chlortetracycline

D. Idiosyncrasy

58. Which of the following types of drug responses is least predictable in occurrence?<br>A. Side effect<br>B. Tachyphylaxis<br>C. Overdosage toxicity<br>D. Idiosyncrasy<br>E. Therapeutic action

E. Reduction of migraine episode

📌Epinephrine is not used for migraine treatment (triptans, NSAIDs, or other specific migraine agents are used instead).

59. Which one of the following is not considered in epinephrine use?
    A. Control of hemorrhage
    B. Decongestant
    C. Use in combination with local anesthetics
    D. use in allergic disorders
    E. Reduction of migraine episode

D. Heart and Bronchi

60. The organs most prominently affected by B-blockers are:<br>A. Cardiovascular and CNS<br>B. Stomach and kidney<br>C. Stomach and kidney<br>D. Heart and Bronchi<br>E. Liver and skin

D. Insulin

📌Rationale: Propranolol (non-selective beta-blocker) can mask hypoglycemia symptoms (like tachycardia, tremor) and impair glucose recovery,

61. The responses of Which one of the following drugs should be monitored when it is used simultaneously with propranolol?
    A. Digoxin
    B. Quinidine
    C. Chlorothiazide
    D. Insulin

D. The most recently marketed drug

62. In the selection of a B-blocker, which of the following is not dominating factor?<br>A. The patient's disease state<br>B. The cost of medication<br>C. The desirable pharmacokinetic effect of the drug<br>D. The most recently marketed drug<br>E. The desirable pharmacologic effect

B. Nitroprusside

63. In hypertensive crisis in a patient with a history of CHF, which one of the following agents should be the drug of first choice?<br>A. Diazoxide<br>B. Nitroprusside<br>C. Hydralazine<br>D. Trimethaphen

D. Mannitol

📌Rationale: Mannitol is an osmotic diuretic that can be used to induce forced diuresis in certain poisonings (e.g., salicylates, barbiturates, lithium) to enhance renal excretion.

64. A diuretic specifically useful to induce diuresis in cases of poisoning is:
    A. Hydrochlorothiazide
    B. Triamterene
    C. Chlorthalidone
    D. Mannitol

C. Ethacrynic acid

65. A diuretic which could be used in patients with hypersensitivity to sulfonamide is:<br>A. Hydrochlorothiazide<br>B. Furosemide<br>C. Ethacrynic acid<br>D. Spironolactone

B. Cardiac glycosides

66. Which of the following groups of drugs does not aggravate congestive heart failure?<br>A. Estrogen<br>B. Cardiac glycosides<br>C. Beta-blocking agents<br>D. Corticosteroids

C. Digitoxin

📌Rationale: Digitoxin is extensively metabolized by hepatic microsomal enzymes, so phenobarbital (an enzyme inducer) significantly increases its metabolism, reducing its therapeutic effect.

67. Which one of the digitalis preparations should be monitored when simultaneously used with phenobarbital?
    A. Digoxin
    B. Quabain
    C. Digitoxin
    D. d-Lanatoside

A. Stable angina

68. Which type of angina pectoris Is most likely to respond to drug therapy?<br>A. Stable angina<br>B. Unstable angina<br>C. Nocturnal angina<br>D. Prinzmetal

C. Myocardial ischemia

69. Which of the following factors is most directly attributed to angina attacks?<br>A. Stress<br>B. Heavy smoking<br>C. Myocardial ischemia<br>D. Obesity

A. Diazoxide

📌Rationale: Diazoxide causes reflex tachycardia and increased myocardial oxygen demand from its vasodilatory/hypotensive effect, posing a risk in angina patients.

70. Which of the following drugs is considered a "Risk factor" in a patient with history of angina pectoris?
    A. Diazoxide
    B. Nitroprusside
    C. Quinidine
    D. Hydrochlorothiazide

D. Calcium channel blockers

71. The newest group of drugs used in the treatment of angina pectoris<br>A. Chewable isosorbide dinitrate<br>B. Transdermal patches<br>C. Beta-blocking agents<br>D. Calcium channel blockers

C. Orange

72. U-100 Insulin is
    A. Red
    B. White
    C. Orange
    D. brown

D. Acute infections

73. Which one of the following may increase the insulin requirements?<br>A. Increased physical activity<br>B. Increased food intake<br>C. Pregnancy<br>D. Acute infections

D. Piroxicam

📌Rationale: Piroxicam has a long half-life, allowing once-daily (OD) dosing, unlike the others which typically require multiple daily doses.

74. Which one of the following agents can be used QID/OD?
    A. Ibuprofen
    B. Indomethacin
    C. Tolmetin
    D. Piroxicam

E. Bleeding

📌Bleeding is not a classic feature of rheumatoid arthritis itself, though it may occur as a drug side effect (e.g., from NSAIDs), not from the disease process.

75. Which one of the following is not associated with rheumatoid arthritis? J
    A. Fatigue
    B. Anorexia
    C. Morning stiffness
    D. Joint swelling and pain
    E. Bleeding

C. Aspirin

📌Rationale: Aspirin has historically been considered the classic first-line/most commonly recommended NSAID for rheumatoid arthritis due to its anti-inflammatory and analgesic properties at high doses.

76. The drug most commonly recommended by most clinicians in rheumatoid arthritis is:
    A. Motrin
    B. Indomethacin
    C. Aspirin
    D. Phenylbutazone
    E. Acetaminophen

C. Presence of monosodium urates in the synovial fluid

77. Diagnosis of gout can only be confirmed by:<br>A. Presence of severe pain and inflammation in the big toe<br>B. Presence of hyperuricemia<br>C. Presence of monosodium urates in the synovial fluid<br>D. Vesicle-formation in the joints

D. Sodium Cromolyn

📌Rationale: Cromolyn stabilizes mast cells, preventing mediator release, effectively inhibiting both early and late asthmatic responses.

78. Which of the following medications would inhibit both the early asthmatic response and the late asthmatic response?
    A. Corticosteroids
    B. Albuterol
    C. Theophylline
    D. Sodium Cromolyn

B. IgG

79. The only class of immunoglobulin that crosses the placenta:<br>A. IgA<br>B. IgG<br>C. IgM<br>D. IgE<br>E. IgD

E. Vitamin K

80. Warfarin anticoagulation is used for a variety of cardiac conditions. Each of the following medications increases the anticoagulant effect of warfarin, except:<br>A. Cimetidine<br>B. Quinidine<br>C. A-methyldopa<br>D. Phenylbutazone<br>E. Vitamin K

B. Hydralazine

📌Drugs associated with lupus like syndrome:

• Hydralazine

• Isoniazid

• Procainamide

• Sulfonamide

81. Which of the following is associated with lupus like syndrome?
    A. Captopril
    B. Hydralazine
    C. Propranolol
    D. Minoxidil

A. Vertebral Body Collapse

📌Rationale:

Complications of heparin anticoagulation

• Hemorrhage

• Skin Necrosis

• Thrombosis

• Thrombocytopenia

82. Complications of heparin anticoagulation include all the following, except:
    A. Vertebral Body Collapse
    B. Hemorrhage
    C. Skin Necrosis
    D. Thrombosis
    E. Thrombocytopenia

B. Gastric Carcinoma

📌AIDS-related malignancies include:

• CNS lymphoma

• Hodgkin’s disease

• Kaposi’s sarcoma

• Cervical cancer

83. AIDS-related malignancies include all the following, except:
    A. Cervical cancer
    B. Gastric Carcinoma
    C. CNS lymphoma
    D. Hodgkin's disease
    E. Kaposi's sarcoma

D. Griseofulvin

📌Rationale: Griseofulvin is the classic drug of choice for dermatophyte infections like ringworm (tinea).

• Nystatin — used for Candida infections, not dermatophytes

• Neomycin — an antibacterial, not antifungal

• Amphotericin B — used for systemic fungal infections, not typically for ringworm

84. Drug of choice for ringworm infection is:
    A. Nystatin
    B. Neomycin
    C. Amphotericin B
    D. Griseofulvin

A. Almost at once after administration

📌Rationale: Anaphylactic shock is an immediate (Type I, IgE-mediated) hypersensitivity reaction, occurring within minutes of exposure.

85. Anaphylactic shock to penicillin occurs:
    A. Almost at once after administration
    B. Between 6 to 12 Hours of adminsistration
    C. Between 4 to 6 hours of administration
    D. After 12 hours of administration

E. Chlorpromazine

📌Rationale: Chlorpromazine is an antiemetic for chemotherapy/vomiting but ineffective against motion sickness.

86. Which of the following agents is not effective against motion sickness?
    A. Dimenhydrinate
    B. Meclizine
    C. Diphenydramine
    D. Promethazine
    E. Chlorpromazine

B. Cystitis

📌Rationale: Cystitis — inflammation of the bladder

• Urethritis — inflammation of the urethra

• Prostatitis — inflammation of the prostate gland

• Pyelonephritis — inflammation of the kidney (renal pelvis and parenchyma)

• Urinitis — not a standard medical term

87. Inflammation of the bladder:
    A. Urethritis
    B. Cystitis
    C. Prostatitis
    D. Pyelonephritis
    E. E. Urinitis

A. Nosocomial infection

📌Rationale: Nosocomial infection — infection acquired in a healthcare setting, typically after at least 48 hours (2 days) of hospital admission

88. Infection acquired after at least 2 days in the hospital:
    A. Nosocomial infection
    B. Superficial infection
    C. Secondary infection
    D. Superinfection
    E. Hirsutism

A. 10 mg BID initially, increased slowly into the therapeutic range:

📌Rationale: Elderly patients (especially with cardiac disease) require very low starting doses of tricyclic antidepressants like imipramine due to increased sensitivity to cardiotoxic and anticholinergic effects, with slow titration.

89. A 91-year-old nursing home patient has Alzheimer's Disease and congestive heart failure that is being treated with Digoxin. The patient now Is to be administered imipramine for depression. What Is the best dose and regimen of imipramine for this patient?
    A. 10 mg BID initially, increased slowly into the therapeutic range:
    B. 25mg TID, Increased to 50 mg TID in 1 week
    C. 75 mg at bedtime
    D. 150 mg at bedtime

B. Escherichia coli and Bacteroides fragilis

90. The most common organisms isolated from intra-abdominal infections are:<br>A. Escherichia coli and staphylococcus aureus<br>B. Escherichia coli and Bacteroides fragilis<br>C. Pseudomonas aeruginosa and bacteroldes fragilis<br>D. Pseudomonas aeruginosa and staphylococcus aureus

A. Nystatin ointment

📌Rationale: Nystatin is an antifungal effective against Candida infections of mucous membranes (e.g., oral thrush).

• Undecylenic acid — used for skin fungal infections (athlete's foot), not typically mucous membranes

• Polymyxin ointment — an antibacterial, not antifungal

• Saturated magnesium sulfate — used as an osmotic/drawing agent, not antifungal

• 10% aluminum chloride solution — used as an antiperspirant/astringent, not antifungal

91. Which of the following substances is the most effective agent against fungus infections of the mucous membrane?
    A. Nystatin ointment
    B. undecylenic acid
    C. polymyxin ointment
    D. Saturated magnesium sulfate
    E. 10% aluminum chlroide solution

E. Penicillin

📌Rationale: Tetracycline is bacteriostatic and can antagonize penicillin's bactericidal action, which requires actively dividing/growing bacteria to be effective.

92. The action of which of the following drugs will most likely be impaired by concurrent administration of tetracycline?
    A. Chloramphenicol
    B. Sulfonamide
    C. Lincomycin
    D. Eryhtromycin
    E. Penicillin

E. Elevated white cell count

📌Rationale: Chemotherapy typically causes bone marrow suppression, leading to decreased (not elevated) white cell counts, increasing infection risk.

93. The following are often seen in patients receiving chemotherapy for cancer, except:
    A. oral ulcerations
    B. delayed wound healing
    C. increased susceptibility to infection
    D. Alopecia
    E. Elevated white cell count

C. Alcohol

📌Rationale: Alcohol abuse causes extensive physiological damage (liver, cardiovascular, neurological) combined with significant psychological dependence and withdrawal risks, making it the most damaging overall

94. Abuse of which of the following drugs produces the greatest physiological and psychological damage?
    A. LSD
    B. Cocaine
    C. Alcohol
    D. Marijuana
    E. Barbiturate

C. Methylphenidate

📌Rationale: Methylphenidate (Ritalin) is a mild CNS stimulant classically used to treat ADHD/hyperkinetic children.

95. Which of the following drugs is a mild CNS stimulant useful in treating hyperkinetic children?
    A. Caffeine
    B. Doxapram
    C. Methylphenidate
    D. Theophylline
    E. Nikethamide

E. Ampicillin

📌Rationale: Ampicillin has an extended spectrum including gram-negative coverage (extends to some E. coli, Salmonella, Shigella, H. influenzae, and Proteus mirabilis).

• Nafcillin — narrow-spectrum, primarily anti-staphylococcal (penicillinase-resistant)

• Methicillin — narrow-spectrum, penicillinase-resistant; no gram-negative activity

• Penicillin V — narrow-spectrum, mainly gram-positive

• Phenethicillin — narrow-spectrum, similar to Penicillin V

96. Which of the following penicillins has the best gram negative spectrum?
    A. Nafcillin
    B. Methicillin
    C. Penicillin V
    D. Phenethicillin
    E. Ampicillin

B. Free Fatty acids

📌Rationale: Elevated free fatty acids (from uncontrolled lipolysis in insulin deficiency) are the direct substrate for hepatic ketone body production, correlating with the degree of ketosis.

97. In a poorly treated diabetic individual. The degree of ketosis is closely correlated with the blood level of:
    A. Amino acids
    B. Free Fatty acids
    C. Lipoprotein triglycerides
    D. Lipoprotein phospholipids

E. Benzodiazepine compounds

📌Benzodiazepines are effective for sleep-maintenance insomnia (staying asleep), addressing this patient's difficulty maintaining sleep after initial onset.

98. A patient has no difficulty going to sleep at night, but awakens after a couple of hours and cannot get back to sleep. Which of the following drug groups would be most appropriate to treat this condition:
    A. Nitrous oxide
    B. Phenothiazine compounds
    C. Sympathomi metic agents
    D. tricyclic antidepressants
    E. Benzodiazepine compounds

C. Methadone

📌Rationale: Methadone is the classic drug widely used for opioid dependence treatment/maintenance therapy.

99. Which of the following drugs is currently widely used in treating opioid-dependent individuals?
    A. Codeine
    B. Alphapropdine
    C. Methadone
    D. Meperidine
    E. Pentazocine

B. Prednisolone

📌Rationale: Prednisolone is a glucocorticoid with potent mineralocorticoid activity; excess produces full Cushing syndrome features (hypertension, moon face, hirsutism, glycosuria, sodium retention).

100. Overdosage with certain steroids leads to manifestations of cushing syndrome: Hypertension, rounding of the face, hirsutism, glycosuria and sodium retention, Which of the following steroids produces most the of the above effects?
     A. Estradiol
     B. Prednisolone
     C. Diethylstibestrol
     D. Testosterone
     E. Progesterone