Module 4 Modulars (2023)

A

Which of the following groups of drugs inhibit platelet aggregation by interfering with GPIIB / Illa binding to fibrinogen ?

A. Abciximab , Eptifibatide , Tirofiban

B. Clopidogrel , Ticlopidine , Prasugrel

C. Aspirin , Salsalate , Sodium Salicylate

D. Cilostazol , Dipyradamole

B

A 65 - year - old woman received an antithrombotic prophylaxis of Enoxaparin , a low molecular weight heparin ( LMWH ) . What is the mechanism of action of the drug used ?

A. Impairs post - translational modification of Vitamin K - dependent clotting factors ( Factors II , VII , IX , X )

B. Activates antithrombin III

C. Inhibits Factors Xa in the final common pathway

D. Inhibits Vitamin K epoxide reductase

D

Which of the following drugs accelerates the conversion of plasminogen to plasmin ?

A. Aminocaproic acid

B. Heparin

C. Argatroban

D. Reteplase

D

A patient complains of severe nosebleed after being treated with warfarin . To prevent severe hemorrhage , the warfarin should be discontinued , and the patient should be treated immediately with which of the following ?

A. Aminocaproic acid

B. Desmopressin

C. Factor VIII

D. Vitamin K1

D

Injecting botulinum toxin causes flaccid paralysis of the facial muscles via which mechanism on acetylcholine ?

A. Inhibiting its degradation

B. Blockade of vesicular storage

C. Acting on the rate - limiting step

D. Preventing its release

A

A patient with suspected mushroom poisoning presents with blurring of vision , small pupils , diarrhea , abdominal cramps , excessive sweating and salivation , and a heart rate of 50. What treatment will you give ?

A. Atropine

B. Diazepam

C. Loperamide

D. Salbutamol

C

Dobutamine is used for cardiogenic shock because of its effect on which receptor ?

A. Alpha - 1

B. Alpha - 2

C. Beta - 1

D. Beta - 2

B

The first dose phenomenon that manifests as orthostatic hypotension may occur when a patient takes which medication ?

A. Propranolol

B. Terazosin

C. Nitroglycerin

D. Diltiazem

A

A hypertensive patient was prescribed with metoprolol to be taken once a day . What is the principal contraindication when giving this drug ?

A. Pre - existing AV block

B. Arrhythmia

C. Anginal

D. Migraine

D

A medication that can be utilized for both asthma and premature labor is likely to be acting on which receptor ?

A. Muscarinic - 2

B. Muscarinic - 3

C. Beta - 1

D. Beta - 2

B

Ethacrynic acid being given for pulmonary edema acts by inhibiting which transporter ?

A. Na / Cl transporter

B. Na / K / 2Cl transporter

C. Na - Glucose co - transporter

D. Aquaporin - 2 channels .

C

Verapamil may be useful in patients with angina or hypertension , but a usual undesirable effect is that it may cause :

A. Cyande toxicity

B. Hirsutism

C. Gingival hyperplasia

D. Lupus

C

Which of the following drugs do we avoid giving to pregnant hypertensive patients due to risk of renal agenesis and neonatal morbidity ?

A. Nifedipine

B. Propranolol

C. Losartan

D. Nitroglycerin

C

We must be cautious in combining Atorvastatin with Gemfibrozil because of an increased risk for which of the following ?

A. Cholelithiasis

B. Hypercholesterolemia

C. Rhabdomyolysis

D. Hepatotoxicity

A

Which of the following BP lowering agents has been discontinued due to its psychiatric effects such as predisposition for severe depression and suicidal ideations ?

A. Reserpine

B. Metolazone

C. Fenoldopam

D. Diazoxide

D

A 20 - year - old student was prescribed with a beta - blocker that blocks B1 > B2 . The most likely drug prescribed is :

A. Propranolol

B. Carvedilol

C. Nadolol

D. Metoprolol

C

A 15 - year - old teen developed bronchoconstriction , mucous membrane congestion , angioedema , and severe hypotension following intake of a drug which he is allergic to . This is a case of anaphylaxis . The first line drug is :

A. Dobutamine

B. Prednisone

C. Epinephrine

D. Terbutaline

B

An 18 - year - old was given atropine 0.5mg tablet two times a day for the reversal of hyperhidrosis . However , she took 20 tablets in single dose because of several problems . Which of the following do you expect to see ?

A. Increased salivation

B. Cycloplegia

C. Bradycardia

D. Hypothermia

B

Release inhibitor that reduces degranulation of mast cells from immunologic triggering by antigen IgE interaction .

A. Epinephrine

B. Cromolyn Na

C. Loratadine

D. Montelukast

A

A 17 - year - old on flight to USA has history of motion skicness the most appropriate drug to give 30 minutes before departure to prevent this symptom is :

A. Scopolamine

B. Hydroxyzine

C. Chlorpheniramine

D. Cetirizine

B

This drug , when given to a patient with pesticide poisoning , will NOT BE EFFECTIVE in reversing its central effects :

A. Atropine

B. Pralidoxime

C. Edrophonium

D. Physostigmine

C

KC , a 65 y / o , hypertensive female presents with bipedal edema and low eGFR . The most effective drug for producing diuresis is :

A. Amlodipine

B. Losartan

C. Furosemide

D. Hydrochlorothiazide

B

A 60 y / o hypertensive male who had myocardial infarction a few years ago is now showing signs of congestive heart failure . Spironolactone was added regimen . Which of the following adverse effect / s may be anticipated from this drug ?

A. Hyperuricemia

B. Gynecomastia

C. Lupus - like syndrome

D. Ototoxicity

C

This diuretic binds to mineralocorticoid receptors and blocks aldosterone .

A. Amiloride

B. Ethacrynic acid

C. Eplerenone

D. Traimterene

C

A 35 y / o male who has been taking an unrecalled diuretic developed alkalosis and ototoxicity . The most likely drug is :

A. Acetazolamide

B. Chlorothiazide

C. Furosemide

D. Spironolactone

C

A pregnant mother recently had a BP of 150/190 . What anti - hypertensive agent may be most likely prescribed to her ?

A. Irbesartan

B. Resperine

C. Methyldopa

D. Captopril

C

This anti - hypertensive agent inhibits vesicular catecholamine transport and storage

A. Methyldopa

B. Guanabenz

C. Reserpine

D. Clonidine

C

Irbesartan was substituted for Lisinopril after the patient developed a bothersome dry cough . What is the culprit for the cough of the patient ?

A. Overproduction of renin

B. Sulfhydryl group

C. Bradykinin

D. Chymase

B

Nifedipine acts to :

A. Decrease the sensitivity of the ryanodine receptors

B. Prevent the activation of the L - type calcium channels on the T - tubules

C. Increase intracellular calcium by inhibiting the Na - K ATPase pump

D. Blocks the active site of actin

B

Which stage of anesthesia is present if the patient is hyperactive and has irregular vital signs .

A. Stage 1 - Analgesia

B. Stage 2 Excitation and Delirium

C. Stage 3 - Surgical Anesthesia

D. Stage 4 - Respiratory Depression

D

The following are inhaled general anesthetics , EXCEPT :

A. Nitrous oxide

B. Halothane

C. Methoxyflurane

D. Midazolam

C

TRUE regarding ESTER vs AMIDE anesthetics :

A. Amides are usually short - acting compared to ester - based anesthetics

B. Esters are degraded by hepatic esterases

C. Mepivacaine and Bupivacaine are examples of amide anesthetic agents

D. Propivacaine has the shortest half - life among all local anesthetics .

C

A 28 - year - old pregnant woman in her 1st trimester comes to you with exophthalmos , heat intolerance , palpitations , and unintentional weight loss which are signs of Grave's Disease ( Under hyperthyroidism ) . What is the preferred treatment ?

A. Propranolol

B. Methimazole

C. Propylthiouracil

D. Lugol's solution

C

Finasteride may be used in managing benign prostatic hyperplasia because of its ability to inhibit :

A. Aromatase

B. GnRH receptors

C. 5 - alpha - reductase

D. Androgen receptors

D

An example of a long - acting insulin .

A. Lispro

B. Aspart

C. Humulin R

D. Degludec

B

The first line treatment for a diabetic patient with a BMI of 29 ( obese ) is a :

A. GLP - 1 agonist

B. Biguanide

C. DPP - 4 inhibitor

D. SGLT - 2 inhibitor

D

This drug is used for hyperthyroidism acts via the mechanism of Wolff - Chalkoff effect :

A. Propranolol

B. Methimazole

C. Propylthiouracil

D. Lugol's solution

D

Which of the following is a common direct or reflex effect of nitroglycerin ?

A. Decreased heart rate

B. Decreased venous capacitance

C. Increased afterload

D. Increased cardiac force

A

A 23 - year - old woman is using albuterol inhaler for frequent acute episodes of asthma and complains of symptoms that she ascribes to the albuterol . Which of the following is not a recognized action of albuterol ? ( Note : albuterol is also known Salbutamol ?

A. Diuretic effect

B. Positive inotropic effect

C. Skeletal muscle tremor

D. Smooth muscle relaxation

B

A 19 - year - old college student has well - controlled asthma , but on reporting to the college health clinic , complains of a sore throat . On examination , he has typical signs of thrush , a fungal infection with Candida albicans . The asthma controller medication most likely to be associated with Candida infection is :

A. Salbutamol by aerosol

B. Beclomethasone by aerosol

C. Ipratropium inhaler

D. Prednisone by mouth

D

Oral medications are population for the treatment of asthma in children because young children may have difficulty with proper use of aerosol inhaler . Which of the following is an orally active inhibitor of leukotriene receptors ?

A. Zileuton

B. Aminophylline

C. Ipratropium

D. Zafirlukast

A

Which fo the following drugs can be used by nebulizer for a prompt direct bronchodilator effects in severe , acute asthma attacks ?

A. Salbutamol

B. Ipratropium

C. Prednisone

D. Salmeterol

D

Which of the following drugs has been shown to reduce mortality in chronic heart failure ?

A. Atenolol

B. Digoxin

C. Furosemide

D. Spironolactone

D

Which of the following drugs in high doses can cause bradycardia ?

A. Amlodipine

B. Isosorbide dinitrate

C. Nitroglycerin

D. Verapamil

D

The following are examples of mucolytics / mucoregulators , EXCEPT ?

A. Carbocisteine

B. Erdosteine

C. Bromhexine

D. Butamirate citrate

A

This drug classification used for cough acts by reducing disulfide bridges that bind glycoproteins to other proteins such as albumin .

A. Mucolytic

B. Expectorant

C. Centrally - acting Antitussive

D. Peripherally - acting Antitussive

B

This condition can occur if topical decongestants are used for more than 5 days .

A. Stevens - Johnsons Syndrome

B. Rhinitis medicamentosa

C. Pharmacodynamics

D. Pharmacokinetics

D

The following are drugs with narrow therapeutic index , EXCEPT :

A. Warfarin

B. Theophylline

C. Dioxin

D. Paracetamol

D

Which of the following is TRUE regarding crystalline properties of drugs ?

A. Crystals are less rigid & less thermodynamically stable than amorphous form

B. Generally , they have a faster dissolution rate compared to amorphous forms

C. Hydrates are also called amorphous compounds

D. Erythromycin dihydrate has a faster dissolution than its monohydrate or anhydrous counterparts in phosphate buffer

D

Supposed that the drugs below were administered at the same dosages , which of the following has the highest fraction / concentration in the central compartment ?

A. Drug A - 40 % peripheral tissues , 60 % systemic circulation ( 20 % protein bound , 40 % unbound )

B. Drug B - 40 % peripheral tissues , 60 % systemic circulation ( 45 % protein bound , 15 % unbound

C. Drug C - 70 % peripheral tissues , 30 % systemic circulation ( 10 % protein bound , 20 % unbound )

D. Drug - D 20 % peripheral tissues , 80 % systemic circulation ( 30 % protein bound , 50 % unbound )

D

Which of the following drugs will be most active ?

A. Drug A - 40 % peripheral tissues , 60 % systemic circulation ( 20 % protein bound , 40 % unbound )

B. Drug B - 40 % peripheral tissues , 60 % systemic circulation ( 45 % protein bound , 15 % unbound )

C. Drug C - 70 % peripheral tissues , 30 % systemic circulation ( 10 % protein bound , 20 % unbound )

D. Drug D - 20 % peripheral tissues , 80 % systemic circulation ( 30 % protein bound , 50 % unbound )

B

What type of reaction order / elimination order is being portrayed by the image . provided : (linear graph)

A. First - Order Elimination

B. Zero - Order Elimination

C. Pseudo - Order Elimination

D. Second - Order Elimination

D

The time required for one - half of the drug concentration to disappear .

A. Half - life

B. t50

C. 1₁ / 2

D. All of the above

D

The following statements describe First - Order Kinetics , EXCEPT :

A. Fixed percentage or fraction of drug is removed per unit of time .

B. To compute for the half - life of a drug in first - order kinetics we use the formula , to = 0.693 / k1 .

C. The rate is dependent upon the concentration of the drug .

D. Fixed amount or concentration of drug is removed per unit of time .

B

Drugs with long elimination half - lives will have a clearance .

A. fast

C. intermediate

B. slow

D. instantaneous

C

The removal of the " intact " drug from the body is

A. Drug elimination

B. Biotransformation

C. Drug excretion

D. Absorption

D

The rate at which a drug reaches the systemic circulation can be determined by the slowest step of the sequence of a kinetic process which we call

A. Irreversible step

B. Reversible step

C. Steady - state concentration

D. Rate - limiting step

A

Which statement is TRUE regarding Fick's Law of Diffusion ?

A. Increasing the concentration absorption .

B. Increasing the thickness of the membrane will increase the rate of absorption . X C. Decreasing the lipid / water partition coefficient will increase the lipid solubility of the substance , thus increasing its rate of absorption .

D. Increasing the surface area for absorption will decrease the rate of diffusion . x

A

TRUE regarding passive diffusion vs carrier - mediated system :

A. In carrier - mediated transport , the initial rise in the curve is governed by first - order kinetics , while the saturation point or plateau phase of the slide is governed by zero - order kinetics .

B. Passive Diffusion has a curvilinear graph

C. Passive Diffusion is governed by zero - order kinetics .

D. In carrier - mediated transport , once the saturation point is reached , increasing the drug's concentration can increase the rate of drug absorption .

D

The movement of drugs across biologic membranes is influenced by :

A. Mechanism of transport

B. Binding affinity for tissue or plasma proteins

C. Degree of ionization as influenced by the pa of the drug and the pH of the medium

D. All of the above .

E. None of the above .

B

A patient who took excessive amounts of Aspirin had ABG findings revealing high - anion gap metabolic acidosis . One way to aid in the elimination of this drug from the body is by :

A. Acidification of urine with ammonium chloride

B. Alkalinization of urine with sodium bicarbonate

C. Administration of tranexamic acid

D. Administration of prostaglandin analog

A

Characteristics of a drug that allows it to undergo extensive distribution include the following , EXCEPT :

A. Charged

B. Non polar

C. Water - insoluble

D. Unionized

A

What is the possible reason why a patient taking Warfarin may have increased risk of hemorrhage when he / she is also taking grapefruit juice ?

A. The juice is a cytochrome p450 inhibitor .

B. The juice also has anticoagulant effects

C. Warfarin increases the amount of the juice .

D. The two severely damage the mucosal lining .

B

A drug administered via which route would be able to completely reach the systemic circulation ?

A. Intramuscular

B. Intravenous

C. Oral

D. Subcutaneous

D

The following are functions of gastric / stomach motility :

A. To allow the stomach to serve as a reservoir for the large volume of food that may be ingested at a single meal .

B. To fragment food into smaller particles via the process of antral milling , and mixing these food particles with gastric secretions to form chyme .

C. Emptying gastric context into the duodenum at a controlled rate .

D. All of the above .

D

The following factors will cause an increase in the gastric emptying , EXCEPT :

A. Increase in food temperature

B. Metoclopramide

C. Anxiety , stress , aggressiveness

D. GIT with high osmolality

A

The following drugs will have increased absorption with food , EXCEPT :

A. Penicillin G

B. Phenytoin

C. Dicoumarol

D. Griseofulvin

A

This is the best site for GIT absorption . It has a large surface area ( due to villi and microvilli ) and is highly perfused , thus drug absorption is highly effective in this segment .

A. Duodenum

B. Jejunum

C. lleum

D. Colon

D

How does bile affect GI drug absorption ?

A. Bile increases the absorption of polar drugs through the process of micelle formation .

B. Bile increases the absorption of fat soluble drug through the process of pinocytosis .

C. Bile increases the absorption of polar drugs through the process of pinocytosis .

D. Bile increases the absorption of non - polar drugs through the process of micelle formation .

C

These are any foreign substances not normally found in the human body .

A. Toxins

B. Poisons

C. Xenobiotics

D. Antibiotics

C

The ability of a substance to cause biological change , leading to adverse effects .

A. Risk

B. Hazard

C. Toxicity

D. Intoxication

A

This is the smallest dose that kills 50 % of the population and is usually measured in poisons administered at any route except inhalation .

A. LD50

B. LC50

C. ED50

D. Therapeutic Index

C

TRUE regarding local effects of acids and bases :

A. Alkalis are corrosives which lead to coagulative type of necrosis ( solidification )

B. Acids are caustics which lead to liquefactive type of necrosis ( perforation )

C. Acid are corrosives which lead to coagulative type of necrosis ( solidification )

D. Alkalis are caustics which lead to coagulative type of necrosis ( solidification )

B

Sternutators are substances which stimulate ____________. Examples of which are strychnine and veratrine .

A. Excessive flow of tears from lacrimal glands

B. Excessive sneezing

C. Produce muscular weakness ; exhaustives

D. Produce mental weakness , depression , stupor , coma , and respiratory depression

C

Exposure to a toxic substance for 2 months will be classified under .

A. Acute

B. Sub - acute

C. Sub - chronic

D. Chronic

A

Which organ system is usually the first one involved during systemic toxicity ?

A. CNS

B. Circulatory System

C. Blood and hematopoietic system

D. Visceral organs ( liver , kidneys , lungs , skin )

A

This type of reaction / molecular binding is practically irreversible ( permanent ) . It is common with electrophilic toxicants and to a lesser degree with neutral free radicals .

A. Covalent Binding

B. Noncovalent Binding

C. Hydrogen Abstraction

D. Electron Transfer

C

A classic hepatotoxin , but kidney injury is often more severe in humans . It also plays a significant role in atmospheric ozone depletion .

A. Tetrachloroethylene

B. Methylene chloride

C. Carbon Tetrachloride

D. Chloroform

D

It is used primarily in the production of the refrigerant chlorodifluoromethane ( Freon 22 ) . Is it hepatotoxic and nephrotoxic . It can invoke CNS symptoms at subanesthetic concentrations ( similar to alcohol intoxication ) .

A. Tetrachloroethylene

B. Methylene chloride

C. Carbon Tetrachloride

D. Chloroform

A

It is derived primarily from petroleum and is used in the synthesis of other chemicals and is used as an antiknock agent in unleaded gasoline . Inhalation is the primary route of exposure . It can cause hematopoietic toxicity on chronic exposure manifesting initially as anemia , leukopenia , thrombocytopenia , or a combination of these

A. Benzene

B. Toluene

C. Xylene

D. Ethylbenzene

B

This poison identification test is used to detect the presence of acetone . A positive result yields an indigotin , blue ppt .

A. Beilstein Test

B. Benzoldt Gunning Test

C. Marquis Test

D. Nessler Test

C

Penicillamine acts as a chelator and is given to patients with toxicity to which metal ?

A. Mercury

B. Lead

C. Copper

D. Arsenic

D

In the management of a poisoned patient , a commonly used agent which acts via adsorption is

A. Normal saline solution

B. EDTA

C. Petroleum jelly

D. Activated charcoal

B

Which of the " sampung halamang gamot " approved by the DOH is said to be useful in patients with gout or rheumatic pains ?

A. Ampalaya

B. Ulasimang bato

C. Sambong

D. Yerba buena

Physostigmine

A 30 y / o male with dilated pupils , tachycardia , muscle twitching , and urinary retention .

IV Sodium Bicarbonate

Salicylate poisoning

Naloxone

Newborn baby developed respiratory depression due to IV meperidine ( an opioid ) given to her mother

Deferoxamine

A 53 y / o accidentally ingests 10 tablets of a certain medication and is currently experiencing vomiting abdominal pain , black - tarry stools , with frequent passage of bloody diarrhea

Loop Diuretic

Bumetanide

Potassium - Sparing Diuretic ( via Sodium Channel Inhibition )

Amiloride

Carbonic Anhydrase Inhibitor

Brinzolamide

Thiazide Diuretic

Metolazone

Loop Diuretic

Ethacrynic Acid

Potassium - Sparing Diuretic ( via Aldosterone Antagonism )

Eplerenone

Decreases hepatic glucose production and increases peripheral tissue response to insulin

Metformin

Inhibits alpha glucosidase located in the intestinal brush border

Acarbose

Prevents deactivation / degradation of GLP - 1

Vildagliptin

Blocks ATP - sensitive K * channels leading to depolarization , influx , and insulin release

Gliclazide

Inhibits reabsorption of glucose by inhibiting sodium - glucose - 2 transporters

Dapagliflozin

D

The study of a drugs absorption, distribution, metabolism, and extraction.

A. Biopharmaceutics

B. Bioavailability

C. Pharmacodynamics

D. Pharmacokinetics