Pharmacology 2010 Medboard
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PHARMACOLOGY Physician’s Licensure Examination May 25, 2010; 1:00pm 5:00pm 1. If you want to achieve a concentration of 5 ug/ml, how much drug must be given via intravenous bolus? The volume of distribution is 50 liters: A. 10mg C. 250 mg B. 10ug D. 250 ug 2. The process by which the amount of orallyadministered drug is reduced before it reaches the systemic circulation A. Firstorder kinetics D. Excretion B. Firstpass effect E. Metabolism C. Pharmacokinetics 3. If a drug is repeatedly administered at dosing intervals equal to its elimination halflife, the number of doses required for the plasma concentration of the drug to reach the steady state is: A. 2 to 3 D. 8 to 9 B. 4 to 5 E. 10 or more C. 6 to 7 4. Two drugs act on the same tissue or organ via activation of different receptors in effects that are qualitatively the opposite of one another. This represents which of the following types of antagonism? A. Physiologic C. Irreversible antagonist B. Competitive D. Chemical antagonist 5. The dose or concentration required to bring about 50% of a drug’s maximal effect A. Potency D. Kd B. ED50 E. Therapeutic index C. Efficacy 6. The maximum effect of the drug may be produced even if not all receptors are bound in the presence of which of the following: A. Full agonist B. Partial agonist C. Spare receptors D. Inert binding site E. Effector 7. The pharmacokinetic value that most reliably reflects the amount of drug reaching the target tissue after oral administration is the A. B. C. D. E.
Peak blood concentration Time to peak blood concentration Product of the volume of distribution and the firstorder rate constant Volume of distribution Area under the blood concentrationtime curve
8. Which of the following terms is best described as a rapid reduction in the effect of a given dose of a drug after only one or two doses A. Supersensitivity D. Anaphylaxis B. Tachyphylaxis E. Synergism C. Tolerance
9. Aspirin is a weak organic acid with a pKa of 3.5. What percentage of a given dose will be in the lipid soluble form at a stomach pH of 2.5? A. About 1% C. About 50% B. About 10% D. About 90%
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PHARMACOLOGY Physician’s Licensure Examination May 25, 2010; 1:00pm 5:00pm E. About 99%
10. Given a drug with a volume of distribution of 80 L and clearance of 1.386 L/h, the halflife is approximately A. B. C. D. E.
0.02 h 40 h 58 h 80 h 111 h
11. Which of the following is NOT a Phase II reaction of drug metabolism A. Deamination B. Acetylation C. Glucuronidation D. Methylation E. Sulfate conjugation 12. The kinetics characteristic of elimination of ethanol and high doses of phenytoin and aspirin is known as A. Distribution B. Excretion C. Firstpass effect D. Firstorder elimination E. Zeroorder elimination 13. If the plasma concentration of a drug declines with “first order kinetics,” this means that: A. The halflife is the same regardless of plasma concentration B. The drug is largely metabolized in the liver after oral administration and has low bioavailability C. The rate of elimination is proportionate to the rate of administration at all times D. The drug is not distributed outside the vascular system 14. The drug interaction of alcohol and disulfiram would be an example of which of the following? A. Induction of metabolizing enzymes B. Displacement from serum albumin C. Inhibition of metabolizing enzyme D. Inhibition of uptake into adrenergic neuron 15. Which of the following is therapeutic action of beta adrenergic receptor blockers in the treatment of angina pectoris? A. Dilatation of coronary arteries B. Decrease in the amount of catecholamines C. Decrease in requirement of the myocardium for oxygen D. Increase in the sensitivity to catecholamines 16. Which of the following drugs should be used with extra caution in the treatment of hypertension in a diabetic patient? A. Hydralazine B. Guanethidine C. Propranolol D. Methyldopa 17. Which of the following is reduced by the action of sulfonylurea hypoglycemic agents? A. glycogen secretion
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PHARMACOLOGY Physician’s Licensure Examination May 25, 2010; 1:00pm 5:00pm B. insulin secretion C. tissue sensitivity to insulin D. tissue sensitivity to glycogen
18. Which of the following is a tricyclic antidepressant that has a high anticholinergic activity, is sedating and is biotransformed to a longacting active product? A. Clozapine B. Amitriptyline C. Nortriptyline D. Trazodone 19. Which of the following has the lowest incidence of extrapyramidal reactions, but has the highest incidence of agranulocytosis among antipsychotic agents? A. Fluphenazine B. Pimozide C. Clozapine D. Molindone 20. Which of the following drugs inhibits cyclooxygenase irreversibly A. Aspirin B. Ibuprofen C. Prednisone D. Indomethacin E. Zileuton 21. Corticosteroids are usually indicated in the following conditions EXCEPT: A. Herpes simplex of the eye B. Status asthmaticus C. Severe allergic rhinitis D. Nephrotic syndrome E. Adrenal insufficiency 22. Which of the following characterizes local anesthetics A. They generally block myelinated before unmyelinated fibers B. They are generally administered along with epinephrine to prolong its action C. The primary action is on calcium permeability D. Do not readily cross the bloodbrain barrier 23. Which of the following is commonly used to treat both absence and generalized tonicclonic seizures? A. Phenytoin B. Valproate C. Carbamazepine D. Clonazepam E. Phenobarbital 24. Which of the following is the mechanism of action of effective antipsychotic agents A. Decreases acetylcholine in the CNS B. Blocks dopamine receptor sites in the CNS C. Makes acetylcholine more available in the CNS D. Facilitates the use of norepinephrine in the CNS E. Makes dopamine more available in the CNS
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PHARMACOLOGY Physician’s Licensure Examination May 25, 2010; 1:00pm 5:00pm 25. Which of the following drugs can cause StevensJohnson syndrome, megaloblastic anemia, ataxia, and gingival hyperplasia? A. Phenobarbital B. Disulfiram C. Phenytoin D. Valproic acid E. Carbamazepine
26. A pure opioid antagonist with a greater affinity for μ receptors and used for acute opioid overdose A. Morphine B. Naloxone C. Codeine D. Dextromethorpan E. Diphenoxylate 27. A patient with overdose toxicity of MDMA or “ecstasy” is UNLIKELY to manifest which of the following symptoms A. Agitation B. Hyperthermia C. Hyperreflexia D. Bradycardia E. Seizures 28. A patient who underwent percutaneous coronary angioplasty with placement of a stent in a coronary vessel was started on clopidogrel. This drug exerts its antithrombotic effect through which of the following mechanisms A. Irreversible inhibition of ADP receptor B. Inhibition of thromboxane synthesis C. Reversible blockade of glycoprotein IIb/IIIa D. Conversion of plasminogen to plasmin E. Posttranslational modification of vitamin Kdependent clotting factors 29. The effect of heparin in a patient who suddenly presented with gastrointestinal hemorrhage may be promptly reversed with which of the following: A. Vitamin K B. Ascorbic acid C. EDTA D. Protamine E. Folic Acid 30. Which of the following is most useful for patients with red cell deficiency caused by renal disease or depression of the bone marrow A. Erythropoietin B. Hemosiderin C. Transferrin D. Folic acid E. Vitamin B 12
31. A bactericidal glycoprotein with a narrow spectrum of activity and is used for serious infections caused by methicillin resistant staphylococci (MRSA), penicillinresistant pneumococci, and Clostridium difficile A. Aztreonam B. Clavulanic acid
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PHARMACOLOGY Physician’s Licensure Examination May 25, 2010; 1:00pm 5:00pm C. Imipinem D. Cefepime E. Vancomycin 32. Which of the following cephalosporins is highly effective against pseudomonas A. Cefazolin B. Cefuroxime C. Ceftazidime D. Cefaclor E. Ceftriaxone
33. Which of the following antibiotics inhibit microbial protein synthesis by binding to the 30S ribosomal subunit A. Clindamycin B. Erythromycin C. Chloramphenicol D. Tetracycline E. Linezolid 34. Aminoglycoside toxicity includes the following EXCEPT: A. Auditory or vestibular damage B. Acute tubular necrosis C. Respiratory paralysis in high doses D. Contact dermatitis E. Encephalopathy 35. The following are drugs used in the treatment of Tuberculosis, EXCEPT: A. Ethambutol B. Rifampicin C. Streptomycine D. Dapsone E. Ciprofloxacin 36. Urinary tract infection due to Chlamydia trachomatis will NOT respond to which of the following drug? A. Tetracycline B. Erythromycin C. Nitrofurantoin D. Ciprofloxacin 37. Which of the following drugs is a reverse transcriptase inhibitor that is useful in the treatment of Hepatitis B infection A. Amantadine B. Ganciclovir C. Lamivudine D. Interferonalpha E. Acyclovir
38. The use of chloroquine in Plasmodium vivax infection is primarily targeted on the elimination of which of the following forms of the parasite A. Secondary tissue schizonts B. Exoerythrocytic schizonts C. Erythrocytic stage D. Asexual forms
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PHARMACOLOGY Physician’s Licensure Examination May 25, 2010; 1:00pm 5:00pm E. Liver stages 39. Which of the following is the drug of choice for Schistosoma haematobium A. Praziquantel B. Mebendazole C. Metronidazole D. Diethlcarbamazine E. Albendazole 40. Drug of choice for the relief of acute exacerbations of asthma A. Terbutaline B. Ipatropium bromide C. Cromolyn sodium D. Montelukast E. Prednisone 41. Which of the following drugs is used to decrease uric acid production in gout A. Allopurinol B. Aspirin C. Colchicine D. Probenecid E. Hydroxychloroquine 42. Treatment for thyrotoxicosis does not include which of the following drugs A. Radioactive iodine B. Thyroglobulin C. Propylthiouracil D. Potassium iodide E. Methimazole 43. Action of Sulfonylurea hypoglycemic agents does NOT include A. Stimulate release of endogenous insulin B. Reduce glucagon release C. Increase functional insulin receptors in peripheral tissues D. Increase target tissue sensitivity to insulin E. Closing of potassium channels in the pancreatic B cell membrane 44. Which of the following is most likely to cause hypoglycemia when used as a monotherapy for Type II diabetes A. Acarbose B. Glimepiride C. Metformin D. Rosiglitazone E. Miglitol 45. The hypoglycemic agent of choice in pregnant women A. Biguanides B. Sulfonylurea C. Insulin D. Rosiglitazone E. Acarbose 46. Which of the following is NOT an effect of muscarinic blocking drugs A. Miosis B. Constipation C. Reduced salivation and gastric secretion
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PHARMACOLOGY Physician’s Licensure Examination May 25, 2010; 1:00pm 5:00pm D. Urinary retention E. Bronchodilation 47. Which of the following is NOT a directacting cholinergic agonist A. Bethanechol B. Carbachol C. Pilocarpine D. Neostigmine E. Nicotine 48. Cause of death from exposure to a high concentration of organophosphate insecticide will most likely be A. Cardiac arrhythmia B. Respiratory failure C. Hypertension D. Renal failure E. Gastrointestinal hemorrhage 49. A patient with “warm” septic shock presents with hypotension and generalized vasodilation. High dose Dopamine intravenous infusion was started. Which adrenoceptor does dopamine act to constrict the vessels? A. Beta1 B. Alpha1 C. Alpha2 D. D1 E. D2 50. A patient rushed to the emergency room for anaphylactic shock was given intramuscular epinephrine. Which of the following are expected effects of the drug A. Bronchodilation B. Vasodilation C. Decreased cardiac contractility D. Pupillary constriction E. Uterine contraction 51. Which of the following is the drug of choice for a hypertensive patient with benign prostatic hypertrophy and urinary obstruction: A. Metoprolol B. Clonidine C. Prazosin D. Ephedrine E. Methlydopa 52. A patient diagnosed to have pheochromocytoma, a tumor of the adrenal medulla causing excessive release of epinephrine and norepinephrine, was started on a nonselective alpha antagonist, an example of which is A. Yohimbine B. Methyldopa C. Terazosin D. Phenoxybenzamine E. Clonidine 53. The following is NOT a clinical use of betaadrenoceptor antagonists: A. Portal hypertension B. Glaucoma C. Hypothyroidism
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PHARMACOLOGY Physician’s Licensure Examination May 25, 2010; 1:00pm 5:00pm D. Chronic heart failure E. Angina 54. Postsynaptic activation of Alpha1 receptors will lead to the following cellular effects A. Decreased intracellular calcium B. Increased cAMP C. Increased IP3 and DAG D. Inhibition of phospholipase activity E. Inhibition of Phosphodiesterase III 55. Which of the following drugs will decrease heart rate in a normal heart but has little or no effect in a denervated heart A. Phenylephrine B. Isoproterenol C. Dobutamine D. Epinephrine E. Prazosin
56. Which among the following is the most potent diuretic A. Furosemide B. Hydrochlorothiazide C. Spironolactone D. Acetazolamide E. Eplerenone 57. Which of the following is a direct centrallyacting sympatholytic agent? A. Methyldopa B. Guanethedine C. Reserpine D. Propranolol E. Prazosin 58. A major air pollutant which can cause headache, tachycardia, and syncope A. Carbon monoxide B. Nicotine C. Nitrogen dioxide D. Ozone E. Sulfur dioxide 59. A patient manifesting with wristdrop, anorexia, anemia, tremor, weight loss and gastrointestinal symptoms is most likely suffering from which of the following A. Acute mercury poisoning B. Chronic mercury poisoning C. Iron poisoning D. Chronic lead poisoning E. Chronic arsenic poisoning 60. A child with diagnosed to have acute lead poisoning with signs and symptoms of encephalopathy should be given A. Acetylcysteine B. Deferoxamine C. EDTA
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PHARMACOLOGY Physician’s Licensure Examination May 25, 2010; 1:00pm 5:00pm D. Penicillamine E. Succimer 61. A patient who suddenly deteriorated due to respiratory depression after being given diazepam may benefit from this antidote A. Flumazenil B. Acetylcysteine C. Atropine D. Oxygen E. Pralidoxime 62. Which of the following will confer passive immunity A. Diphtheria toxoid B. Measles vaccine C. Tetanus antitoxin D. Oral polio vaccine E. Purified protein derivative 63. Drug that blocks estrogen receptors in the pituitary gland increasing FSH and LH output A. Clomiphene B. Diethylstilbesterol C. Danazol D. Tamoxifen E. Raloxifene 64. Estrogen used in most combined hormonal contraceptives A. Clomiphene B. Ethinyl estradiol C. Estrone D. DES E. Norgestrel 65. Which of the phases of the cell cycle is most resistant to most chemotherapeutic agents and requires increased drug dose to obtain response A. S phase B. G0 phase C. G1 phase D. G2 phase 66. By which of the following mechanisms do vinca alkaloids work in cancer chemotherapy A. Inhibition of function of microtubules B. Damage and prevention of repair of DNA C. Inhibition of purine synthesis D. Inhibition of DNA gyrase E. Inhibition of protein synthesis 67. Doxorubicin, a drug used in the treatment of Hodgkin’s disease belongs to which group of antineoplastic drugs A. Alkylating agents B. Antimetabolites C. Plant alkaloids D. Antibiotics E. Hormones
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PHARMACOLOGY Physician’s Licensure Examination May 25, 2010; 1:00pm 5:00pm 68. A patient in heart failure was given a diuretic which inhibits Na reabsorption and potassium secretion by acting as a competitive antagonist of a receptor located at the blood side of the tubule. The drug is most likely A. Spironolactone B. Hydrochlorothiazide C. Amiloride D. Furosemide E. Mannitol 69. Hydrochlorothiazide was prescribed when lifestyle modification failed to lower the blood pressure of a patient with Stage I hypertension. Adverse effects of this drug include which of the following: A. Hypokalemic metabolic acidosis B. Hyperuricemia C. Hypoglycemia D. Hypocalcemia E. Decrease in serum cholesterol and LDL 70. A patient diagnosed to have essential hypertension was receiving enalapril, furosemide, metoprolol and clonidine. Good control of hypertension made the doctor decide to discontinue one drug. Gradual withdrawal of which drug will prevent rebound hypertension: A. Enalapril B. Furosemide C. Metoprolol D. Clonidine E. Losartan
71. An antihypertensive agent which acts through nitric oxide, dilates arterioles but not veins, and causes a lupuserythematosuslike syndrome A. Minoxidil B. Nitroprusside C. Fenoldapam D. Hydralazine E. Verapamil 72. A 20year old male was admitted in moderate cardiorespiratory distress due to heart failure secondary to Rheumatic Heart Disease. Drugs which were found useful in heart failure include the following EXCEPT: A. Diuretics B. Beta adrenoceptor agonists C. Calcium channel blockers D. ACE inhibitors E. Digoxin 73. A 37year old male presenting with pancreatitis, eruptive xanthoma and centripetal obesity had a triglyceride level of 900 mg/dL. The rest of the lipid profile was normal. This patient will most likely benefit from which of the following drugs A. Lovastatin B. Ezetimibe C. Niacin D. Cholestyramine
74. Most potent H2 blocker with negligible binding with CYP450 enzyme
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PHARMACOLOGY Physician’s Licensure Examination May 25, 2010; 1:00pm 5:00pm A. Cimetidine B. Famotidine C. Ranitidine D. Nizatidine 75. A laxative usually given as suppository and promotes peristaltic action and defecation in 1530 minutes A. Methylcellulose B. Bisacodyl C. Magnesium sulfate D. Lactulose
76. H. pylori associated peptic ulcer can be treated with the following regimen: A. PPI, Amoxicillin, Metronidazole for 1014 days B. Bismuth, PPI, Amoxicillin, Clarithromycin for 46 weeks C. PPI for 1014 days; Clarithromycin and Amoxicillin for 46 weeks D. PPI for 46 weeks; Clarithromycin and Amoxicillin for 1014 days 77. Which of the following is NOT a drug mechanism used in the treatment of parkinsonism? A. Amantadine stimulates release of dopamine from storage sites B. Bromocriptine stimulates dopamine receptors C. Levodopa enhances the synthesis of dopamine D. Selegeline is an inhibitor of monoamine oxidase 78. Aluminum and calcium salts inhibit the intestinal absorption of which of the following agents? A. Isoniazid B. Phenomymethyl penicillin C. Erythromycin D. Tetracycline
79. Which of the following mechanisms is associated with bacterial resistance to Blactam penicillins? A. bacterial production of lysozymes B. alteration of penicillinbinding proteins (PBPs) C. increased metabolism of the penicillin D. ability of the bacteria to produce an acid media 80. Which of the following drugs exhibit linear kinetics? A. phenytoin B. penicillin C. digoxin D. procainamide 81. The following drugs are metabolized in the liver, EXCEPT; A. Cefoperazone B. Chloramphenicol C. Clindamycin D. Amikacin 82. The following are time dependent antibiotics, EXCEPT: A. Ceftriaxone B. Meropenem C. Erythromycin
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PHARMACOLOGY Physician’s Licensure Examination May 25, 2010; 1:00pm 5:00pm D. Gentamicin 83. Which of the following antiepileptic drugs have active metabolites that are clinically significant? A. Phenytoin B. Phenobarbital C. Carbamazepine D. Ethosuximide 84. The rate of acetylation is important with respect to the duration of action of: A. atropine B. cocaine C. isoniazid D. acetaminophen 85. A weak organic acid (pK=3) would be least ionized in: A. the small intestine B. pulmonary alveoli C. the stomach D. arterial blood 86. The expected effect of toxic hepatitis on the rate of drug metabolism by the liver: A. Increased B. Decreased C. Unchanged D. Changed from a Type I to Type II process 87. A patient presents to the emergency room with acute bronchial asthma. The treating physician decides to administer a loading dose of Theophylline. Knowledge of which of the following parameters is needed for proper dosing? A. elimination halflife B. volume of distribution C. elimination clearance D. creatinine clearance
88. In the treatment of hypertensive emergency (crisis), the drug of choice is: A. thiazide diuretic B. sodium nitroprusside C. reserpine D. hydralazine 89. Drug with a low therapeutic index that induces delayed afterdepolarization in cardiac tissue: A. quinidine B. isoproterenol C. adenosine D. digoxin 90. An antiarrhythmic drug known to produce a potentially fatal form of pulmonary fibrosis A. Lidocaine B. Amiodarone C. Sotalol D. Procainamide
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PHARMACOLOGY Physician’s Licensure Examination May 25, 2010; 1:00pm 5:00pm 91. Which of the following anticancer drugs does not produce covalent modification of DNA or breakage of DNA strands? A. bleomycin B. cyclophosphamdie C. melphalan D. vinblastine 92. In cancer chemotherapy, alkylating agents are used in combination regimens with antimetabolites to treat patients with certain cancers because they: A. Do not cause hair root toxicity B. Are selectively toxic to cancer cells C. Do not damage the bone marrow cells D. Are not cell cycle specific 93. All of the following pharmacological actions of morphine are mu opioid receptor responses, EXCEPT: A. respiratory depression B. hallucinations C. bradycardia D. decreased GI motility 94. Which of the following provides information about the variation in sensitivity to a drug within the population studied? A. maximal efficacy B. therapeutic index C. gradeddose response curve D. quantaldose response curve 95. A patient is to undergo day surgery for a short procedure, and intravenous anesthesia will be used. A shortacting drug that appears to affect GABAergic neurotransmission and is often used for day surgery because patients are not hampered by postoperative nausea and malaise: A. fentanyl B. ketamine C. propofol D. thiopental
96. When treating a patient who has been exposed to a chemical agent with known toxicity, the primary determinant of whether or not a toxic effect will be seen is: A. the agent’s dose B. the patient’s age C. the route of exposure D. the duration of exposure 97. Three symptoms of atropine intoxication are: A. dry mouth, cutaneous vasodilatation B. dry mouth, spasm of accommodation, miosis C. fever, dry mouth, CNS excitation D. fever, bed wetting, dry mouth 98. Both acetylcholine and norepinephrine affect cardiac force of contraction. They do this by influencing: A. the M2 muscarinic receptor B. the B1 adrenergic receptor
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PHARMACOLOGY Physician’s Licensure Examination May 25, 2010; 1:00pm 5:00pm C. a K+ channel D. adenyl cyclase 99. Reserpine decreases arterial pressure by: A. interfering with the synthesis of norepinephrine B. interfering with the storage of norepinephrine C. interfering with the release of norepinephrine D. interfering with the metabolism of norepinephrine 100. The interaction between an acetylcholinesterase inhibitor and acetylcholine at the neuromuscular junction would be an example of: A. Addition B. Potentiation C. Competitive antagonism D. Noncompetitive antagonism
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