Board Questions in Pharmacology

BOARD QUESTIONS IN PHARMACOLOGY

Questions Answer Reference MPL

1. Extrapyramidal adverse effect is commonly seen with the use of this antipsychotic agent:

A. Haloperidol C. ChlorpromazineB. Thioridazine D. Fluoxetine

A Goodman and Gilman 10th ed p.488

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2. An anti-malarial agent which also exerts an amebicidal effect

A. Chloroquine C. PrimaquineB. Chloroguanide D. Mefloquine


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3. An anti-arrhythmic drug that predominantly block the slow calcium channels

A. Verapamil C. LidocaineB. Amiodarone D. Metoprolol


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4. Repeated exposure to which of the following anesthetic agents is most associated with liver damage

A. Isoflurane C. Nitrous oxideB. Halothane D. Enflurane

B Goodman and Gilman 10th ed p.351-352

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5. The pharmacokinetic parameter which determines the speed of drug input that must balance the speed of drug elimination to achieve a steady state concentrationA. clearance C. dosing rateB. bioavailability D. volume of distribution

C Basic and Clinical Pharmacology 9th Ed. Katzung p.34-41

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6. If a drug has a high distribution volume, it indicates that:A. it is highly bound to plasma proteinsB. drug is highly retained in the vascular compartmentC. the plasma drug concentration will increaseD. there is extensive tissue uptake

D Basic and Clinical Pharmacology 9th Ed. Katzung p.35 & 47

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7. In what condition are the drugs phenoxybenzamine and phentolamine useful?

A. pheochromocytoma C. essential hypertensionB. migraine attacks D. benign prostatic hyperplasia

A Basic and Clinical Pharmacology 9th Ed. Katzung p.144-146

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8. A college friend consulted you regarding the suitability of the therapy his doctor prescribed for severe hypertension. He complained of postural and exercise hypotension (“dizziness”), diarrhea and problems with ejaculation. Which of the following is most likely to produce the effects that your friend has described?

A. Propanolol C. HydralazineB. Guanethidine D. Captopril

B Basic and Clinical Pharmacology 9th Ed. Katzung p.166

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9. Norpepinephrine acts as a neurotransmitter at:A. all preganglionic neuronsB. parasympathetic postganglionic neuronsC. sympathetic postganglionic neuronsD. neuromuscular junction

C Basic and Clinical Pharmacology 9th Ed. Katzung p.145

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10. In the treatment of organophosphate poisoning, the mechanism of action of pralidoxime is:

A. competitive inhibition with acetylcholineB. non-competitive antagonism with acetylcholineC. regeneration of acetylcholineD. regeneration of acetylcholinesterase

D Basic and Clinical Pharmacology 9th Ed. Katzung p.103

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11. A patient was given digitalis for heart failure, complained of nausea, vomiting, and diarrhea. PE revealed irregular cardiac rhythm. Which of the following is the most appropriate thing to do?

A. increase the dose of digitalisB. add a beta-blockerC. discontinue digitalisD. administer potassium


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12. A 52 year old man consulted at the clinic due to hypertension (BP 190/90). Except for mild wheezing, his PE findings were unremarkable. The drug given can depress AV conduction, hence the use of beta-blocker is contraindicated. The drug that was given is:

A. Methyldopa C. Verapamil B. Enalapril D. Hydrochlorothiazide

C Basic and Clinical Pharmacology 9th Ed. Katzung p.235-236

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13. A patient noted to have elevated cholesterol, LDL, and VLDL. Which among the following drugs act by blocking HMG-CoA reductase to inhibit cholesterol synthesis?

A. Probucol C. LovastatinB. Clofibrate D. Nicotinic acid

C Goodman and Gilman 8th ed p.881-884

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14. A 20 year old female was treated for endometriosis for 6 months. She claims to have been given a drug with androgenic effects such as hirsutism, deepening of the voice, and acne. Which of the following drugs could have been given?

A. GnRH agonistB. Combined oral contraceptive pillsC. DanazolD. Medroxyprogesterone acetate

C Pharmaco-logy 4th ed page 447

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15. A patient underwent hip replacement and was given morphine for pain relief. At present her RR was noted to be at 8 cycles/min with prolonged episodes of apnea. What will you give this patient to reverse the present condition?

A. atropine sulfate C. NaloxoneB. Flumazenil D. Protamine sulfate

C Pharmaco-logy 4th ed RangPage 598

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16. A 7-year old was admitted because of pneumonia. On routine stool exam E. histolytica cyst 5-8/hpf was noted. What will you give?

A. Diloxanide furoate C. both A& BB. metronidazole D. no treatment necessary

A Pharmaco-logy 4th ed RangPage 736

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17. A patient with septic shock was noted to have absent urine output for the past 12 hours. Which of the following drugs would be most helpful to this patient?

A. Furosemide C. DopamineB. Norpeinephrine D. Epinephrine


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18. A 40 year old male was seen at the ER because of anaphylaxis immediately given epinephrine. Apparently, the patient has taken prazosin for his hypertension. Which of the following may be observed in this patient?

A. He may develop hypertensive crisis.B. There will be no effect on his blood pressureC. He may develop hypotension.D. he may develop severe difficulty of breathing due to

bronchoconstriction


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19. Two drugs A and B have the same mechanism of action. Drug A at a dose of 5 mg produce the same magnitude of effect as drug B at a dose of 500 mg. This means that

A. drug B is less efficacious than drug AB. drug A is 100x more potent than drug BC. toxicity of drug A is less than that of drug BD. drug A is more effective than drug B

B Pharmaco-logy 4th ed RangPage 29

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20. A diabetic patient developed hyperlipedemia (elevated LDL, and triglycerides, normal HDL). Which of the following is least appropriate for the patient?

A. Colestipol C. LovastatinB. Gemfibrozil D. Niacin

D Pharmaco-logy 4th ed RangPage 308

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21. A patient with tachyarrhythmia and hypertension would be given an antihypertensive. What agent would be the best choice for this patient?

A. Felodipine C. NifedipineB. Isradipine D. Verapamil


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22. Which of the following conditions will NOT benefit from the use of vasodilators?

A. hypertension C. anginaB. migraine D. peripheral vascular disease


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23. A patient at the delivery room is having uterine atony after giving birth toan 8-lb baby boy. Her BP at present is 150/90 mmHg. What agent should you give her:

A. methyergonovine maleateB. oxytocinC. carboprostD. ergometrine


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24. The 2nd generation cephalosporin which crosses the blood brain barrier:

A. Cefoxime C. CefoxitinB. Cefuroxime D. Cefoperazone


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25. A G2 P1 term, will be given prophylactic antibiotic prior to CS. Which of the following should be recommended?

A. Cephalexin C. CefazolinB. Cefoxitin D. Ceftriaxone


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26. After prolonged treatment with penicillin, the patient developed pseudomembranous colitis. What antibiotic will you give for this case?

A. Aztreonam C. ImipenemB. Ceftriazone D. Vancomycin


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27. This agent inhibits topoisomerase II (DNA gyrase)A. Clindamycin C. SpectinomycinB. Ciprofloxacin D. Tetracycline


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28. A neonate was given IV antibiotics for 3 days. However, the baby developed hypothermia, diarrhea and grayish color of the skin. The baby was probably given:

A. Amikacin C. ChloramphenicolB. Erythromycin D. Gentamycin


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29. The purpose of giving compound drug therapy in the treatment of tuberculosis:

A. to rapidly eradicate the strains of tubercle bacilliB. to shorten the infectious phaseC. to decrease the emergence of resistant organismsD. to prevent complications of tuberculosis


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30. Which of the following is NOT a first line agent in the treatment of tuberculosis?

A. Ethambutol C. RifampicinB. Pyrazinamide D. Streptomycin


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32.A patient taking warfarin was also being treated for fungal infection. After 7 days,the patient developed epistaxis. Which of the following antifungal agents was given? A.Nystatin C.Flucytosine B.Ketoconazole D.Amphotericin B


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33.If the physician makes a prescription order that utilizes a drug supplied by the pharmaceutical company, what class of prescription order was made? A.Extemporaneous C.Precompounded B.Compounded D.Erroneous

C Generics Acts of the Philippines

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34. Which among these antithrombotic drugs inhibit the synthesis of thromboxane by irreversible acetylation of the enzyme cyclooxygenase?A. Abciximab C. IntegrilinB. Aspirin D. Ticlopidine

B Pharmaco-logy Goodman and Gilman 10th ed. Pp 1534

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35. A 60 year old was seen at the OPD due to epistaxis which occurred thrice for the past week and easy bruising. He is taking warfarin for AF. Perinent Lab exam: INR-4.5The INR result is brought about by which of the following? A.increased thrombin activity B.decreased platelet activity C.diminished levels of vitamin K D.decreased levels of factors II, VII,IX and X


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36. A 67 year old with atrial fibrillation is currently taking warfarin and digoxin. In the event this patient develops massive bleeding, which of the following would be appropriate for him? A.give vitamin K B.change to LMWH C.give protamine sulfate D.transfuse platelets


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37.A 26 year old medical student was brought to the ER for an apparent suicide poisoning due to a broken heart. The maid could not recall the medication but claimed the bottle contained medicine for headache. On PE, the physician noted cyanosis of the oral mucosal, tongue and nail beds. Which of the following is the drug most likely ingested? A.Aspirin C.Flurbiprofen B.Acetaminophen D.Meloxicam


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38.A 52 year old woman was suffering from severe joint pains and was diagnosed to have Rheumatoid Arthritis. Apparently, she also appears to be suffering from acid peptic disease. Among the following, which is the safest to give her? A.Aspirin C.Celecoxib B.Ibuprofen D.Phenylbutazone


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39.A 21 year old male, took a bottle of insecticide from their garden approximately 30-40 cc in amount. He later developed dizziness, visual blurring, generalized body weakness, numbness, severe epigastric pain and shortness of breath. He was found lying on the floor with stiffening of the trunk and extremities and soaked with sweat. He was rushed to the ER, pertinent findings included drooling of saliva with 3 episodes of non projectile vomiting. Which of the following should be given? A.Pilocarpine C.Atropine D.Physostigmine D.Carbachol


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40.This inhibits de novo synthesis of cholesterol by inhibiting HMG CoA reductase- A.Atorvastatin C.Gemfribozil B.Colestipol D.Niacin


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41.An asthmatic patient came to the ER because of generalized wheezing in the lungs. Urgent management was done. However, after a while, hypertension was noted. Which of the following medications was probably given? A.salbutamol C.terbutaline B.isoproterenol D.salmeterol


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42.A flight attendant has been having allergic rhinitis. She comes to your clinic asking for medication prescription two hours prior to her flight. What will be appropriate for her? A.diphenhydramine C.loratadine B.chlorpheniramine D.promethazine


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43.This acts by inhibiting the immediate phase of asthma as it prevents mediator release from mast cells- A.cromolyn sodium C.montelukast B.beclomethasone D.zileuton


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44.A patient with severe persistent asthma was treated for six months now with prednisone. Which of the following would be the expected side effect. A.cushingoid facie C.hyperkalemia B.hypoglycemia D.leonine facie


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45.FM, 40 year old male was seen at the clinic for check-up. He has bradykinesia, muscle rigidity, pill rolling movement, resting tremors and shuffling gait. The single most effective agent in the treatment of this disorder is:

A. Levodopa C. CarbamazepineB. Baclofen D. Tacrine


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46. Which of the following is a selective inhibitor of MAO-B?A. Selegeline C. TolcaponeB. Amantadine D. Bromocriptine


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47. Which of the following statement is NOT true regarding Levodopa?

A. It is almost always used in combination with decarboxylase inhibitors.

B. It has a short half-life about 1 – 3 hrs.C. If administered with meals, its absorption is

delayed.D. It has very little side effect and can be withdrawn

abruptly.


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48. What effect does the use of oral contraceptive (OC) have on a patient with hypothyroidism?

A. Low dose OC are unlikely to affect her thyroid function tests.

B. Estrogen may falsely increase TSH due to alteration in TSH secretion.

C. Estrogen may falsely decrease FT4 index due to alterations in TBG

D. Estrogen may falsely elevate total T4 levels due to alterations in TBG


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49. If a hypothyroid patient pregnant, how might her levothyroxine replacement be affected?

A. She might require an increase in dose.B. She may need a decrease in dose.C. She may need to stop the medication.D. She may have to change levothyroxine to

liothyronine.

A Basic and clinical Pharmacology 9th Edition Katzung p 631

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50. A 62 year old with atrial fibrillation was seen at the ER with light headedness and palpitations associated with exercise usually relieved by rest. At present his heart rate is at 140/min. Which of the following is least likely effective in controlling his heart rate?

A. Digoxin C. VerapamilB. Diltiazem D. Atenolol


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51. Patients receiving insulin therapy generally require which of the following interventions with progression to end-stage renal disease?

A. decrease total insulin doseB. increase total insulin doseC. increase frequency of insulin administrationD. no change in insulin regimen

A Basic and clinical Pharmacology 9th Edition Katzung p 694

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52. The inhibitor of GIT lipase is useful in the treatment of obesity and has minimal side effects:

A. sibutramine C. orlistatB. phentermine D. glucosan


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53. An experiment on GI drugs was done. The baseline gastric volume 2 cc and when tested with litmus paper, The paper remained pink. After administering drug A, the gastric volume was 2 cc and litmus paper turned blue. This means

A. drug A is effective in lowering gastric pHB. drug A is effective in increasing gastric pH but no

effect on volumeC. The drug is effective in lowering the gastric pH and

volumeD. The drug has no effect on the volume and pH of

gastric juice


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54.A patient taking this drug came into the clinic due to visual disturbances, constipation, difficulty in urination and dry mouth. This drug could be: A.Muscarinic antagonist B.histamine H2 antagonist C.dopamine D2 antagonist D.gastrin antagonist


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55.The onset and duration of action of NPH insulin are extended because: A.protamine decreases the rate at which insulin is absorbed B.protamine blocks insulin metabolism in the liver C.protamine is basic and combines with insulin by charge interactions D.protamine is slowly degraded proteolytically releasing the bound insulin


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56. An estrogen receptor antagonist which is useful for postmenopausal breast cancer

A. Megastrol C. FlutamideB. Tamoxifen D. Leuprolide


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57. The agent of choice in the treatment of gestational diabetes

A. Sulfonylurea C. InsulinB. Biguanide D. Acarbose


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58. A 40 year old bank executive sought consult due to a difficulty of going to sleep but no problem in maintaining sleep. He stopped drinking coffee, eating chocolates, and smoking a month ago. The most appropriate drug for him is:

A. Diphenhydramine C. PhenobarbitalB. Midazolam D. Clonazepam


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59. A kidney transplant patient is given a drug for immunosuppression to prevent rejection of the allografted organ. The drug is most likely

A. Cyclosprine C. CyclophosphamideB. Azathioprine D. Vincristine


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60. The preferred treatment for a patient who suffers a series without complete recovery is:

A. Diazepam C. SuccinylcholineB. Chlopromazine D. Ethosuximide


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61. A company manager is suffering from allergic rhinitis. He has a series of staff meeting so he needs a medication that will not make him drowsy. Which of the following would you give?

A. Chlorpheniramine C. TerfenadineB. Hydroxyzine D. Diphenhydramine


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62. A patient with severe liver disease eventually developed encephalopathy. Which agent is important in the therapy of this condition?

A. Lactulose C. LoperamideB. Lactate D. Lorazepam


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63. A substance that enhances the probability of ovulation by blocking the inhibitory effect of estrogen and thus stimulating the release of gonadotrophin from the pituitary is:

A. Clomiphene citrate C. TamoxifenB. Danazol D. Progesterone

A Basic and Clinical Pharmacology 9th Ed. Katzung p.681

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64. Which of the following combination (diuretic agent and MOA) is CORRECT?

A. Furosemide – inhibition of carbonic anhydraseB. Acetazolamide – osmotic effectC. Hydrochlorothiazide – inhibition of Na-Cl symportD. Indapamide – inhibition of Na-K-2Cl symport


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65. Which of the following combination of diuretic and site of action on the nephron is CORRECT?

A. Ethacrynic acid – thick ascending limb of loop of Henle

B. Furosemide – proximal tubuleC. Hydrochlorothiazide – late distal tubuleD. Spironolactone – distal convoluted tubule


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66. Which of the following is preferred for a pregnant woman with hyperthyroidism?

A. Carbimazole C. RAIB. Methimazole D. PTU


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67. Drugs A and B act on the same tissue or organ through independent receptors, but with opposite effects. This is known as:

A. Competitive antagonismB. Irreversible antagonismC. Physiologic antagonismD. Chemical antagonism

C Goodman and Gilman 8th ed p 53-54

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68. This pharmacokinetic value most reliably reflects the amount of drug reaching the target tissue after oral administration

A. Volume of distributionB. Area under the blood concentration-time curveC. Peak blood concentrationD. Time to peak blood concentration

B Goodman and gilman 8th editionPp2627

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69. A 3 year old patient passed out noodle-like worms and was given an appropriate anti-helminthic. The mechanism of the drug is most probably via

A. interference with cell wall synthesisB. inhibition of neuromuscular transmissionC. interference with cell wall divisionD. interference with protein synthesis

B Goodman and gilman 8th editionpp. 969-970

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70. A patient with nosocomial pneumonia is given ceftazidime and another antibiotic. The most probabale purpose for adding the second antiobiotic is to:

D Goodman and gilman 8th edition

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A. Increase renal excretionB. Decrease systemic toxicityC. Increase oral absorptionD. Prevent the emergence of resistant bacteria

Pp1127

71. About 75% of patients in this condition may suffer from vertigo, inability to perceive termination of movement and difficulty in sitting or standing without visual clues

A. Patients allergic to penicillinB. Patients receiving streptomycin therapyC. Patients on isoniazid for tuberculosisD. Patients on amphotericin B

B Goodman and gilman 8th editionPp1104 - 1108

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72. A kidney transplant patient is given a drug for immunosuppression to prevent rejection of the allografted organ. The most appropriate drug is:

A. CyclosporineB. AzathioprineC. CyclophosphamideD. Vincristine

B Goodman and gilman 8th editionPp1270

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73. A hypertensive patient is treated by a doctor and experiences hemolytic anemia with a positive Coomb’s test. This is most likely caused by:

A. Clonidine C. MethyldopaB. Captopril D. Prazosin

C DiPalma 4th

ed p. 4720.50

74. In a hypertensive patient who is taking insulin to treat diabetes, which of the following drugs should be used with caution?A. Propanolol C. Hydralazine B. Methyldopa D. Prazosin


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75. A patient has been taking Imipramine for depression. He would most likely experience which of the following adverse effects?A. Seizures C. hepatotxicityB. anticholinergic effects D. nephrotoxicity

B Goodman and Gilman 8th ed p.405-414

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76. Chlorpromazine may be used not only in treating schizophrenia but is also effectiveA. in reducing nausea and vomitingB. as an antihistaminicC. as an antihypertensive agentD. for treating bipolar affective disorder

A DiPalma 4th

ed p.275-277

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77. A child suffers from lapses of consciousness or vacant stares lasting about 10 secs, often in clusters. The drug which may be most helpful for his disorder is:A. Phenytoin C. EthosuximideB. Carbamazepine D. Phenobarbital

C Goodman and Gilman 8th p. 449 – 453

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78. Upon taking Penicillin, a patient suddenly experiences respiratory distress and circulatory collapse. Which drug would be most helpful in this situation?A. Norepinephrine C. IsoproterenolB. Epinephrine D. Atropine

B Goodman and Gilman 8th ed p.198

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79. A gout patient developed nephropathy characterized by overproduction of uric acid and extreme hyperuricemia. What agent could have helped prevent this?A. Cyclophosphamide C. Sodium chlorideB. Allopurinol D. Antidiuretic hormone


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80. A patient with peptic ulcer and on therapy with cimetidine may experience decreased effects of many other drugs because cimetidine is an inhibitor ofA. the proton pump C. monoamine oxidaseB. tyrosine kinase D. cytochrome P-450

D Goodman and Gilman 8th ed p.901

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81. The index of safety of a drug decreases as the median toxic dose:A. decreases and the median effective dose increasesB. increases and the median effective dose decreasesC. the median effective dose decreasesD. the median effective dose increases


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82. What is the major second messenger of beta receptor activation that participates in signal transduction?A. inositol triphosphates C. calciumB. cAMP D. adenylyl cyclase

B Basic and Clinical Pharmacology 9th Ed. Katzung p.25-27

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83. Which of the following bronchodilators is a xanthine derivative?A. Terbutaline C. theophyllineB. ipratropium bromide D. salmeterol

C Basic and Clinical Pharmacology 9th Ed. Katzung p.324, 325, 328

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84. Myelosuppression is a common side effect associated with the use of the following anticancer drugs, EXCEPT:A. Vincristine C. MethotrexateB. Cyclophosphamide D. Chlorambucil


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85. The following anticancer drug, with its toxic effect, is correctly matched with the appropriate antidote:A. cyclophosphamide-induced hemorrhagic cystitis –

ondansetronB. methotrexate-induced myelosuppression – MESNAC. cisplatin-induced nausea and vomiting – leucovorinD. doxorubicin-induced arrhythmia - dexrazoxane


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86. Which of the following anticancer drugs act as a mitotic inhibitor?A. Methotrexate C. BleomycinB. Vinblastine D. Carmustine


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87. Radical cure for malaria is achieved by giving:A. Chloroquine C. MefloquineB. Quinine D. Primaquine


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88. A 3 year old was brought to the ER because of recurrent attacks of blank stares lasting for a few minutes. The anti-seizure agent that you will give the child is:A. Phenobarbital C. LamotrigineB. Ethosuximide D. Vigabantrine


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89. The mainstay drug in the treatment of all types of leprosy is:A. Clofazime C. IsoniazidB. Dapsone D. Rifampicin


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90. A patient on anti-TB drug developed peripheral neuritis. This was improved by giving Pyridoxine. The drug taken must have been:A. Ethambutol C. IsoniazidB. Rifampicin D. Para-aminosalicylic acid


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91. A patient with elevated cholesterol level is also taking warfarin for his deep venous thrombosis. The lipid lowering agent that may enhance the effect of Warfarin is:A. nicotinic acid C. cholestyramineB. lovastatin D. gemfibrozil


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92. A known diabetic patient was brought to the ER unconscious with random blood sugar of 900 mg/dl. ABG study showed metabolic acidosis. Which of the following preparation is appropriate?A. regular insulinB. insulin zinc preparationC. isophane zinc suspensionD. potassium zinc insulin suspension


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93. Which of the following corticosteroids has the greatest anti-inflammatory potency relative to cortisol?A. Prednisone C. AldosteroneB. Dexamehtasone D. Triamcinolone


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94. A 30-year old G2P1 patient suffers experiences a regular and increasingly frequent contractions at 6 months of gestation. Which of the following agents may help in this case?A. Terbutaline C. PropanololB. Nicotine D. Tacrine


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95. The primary mechanism underlying the resistance of gram positive organism to macrolide antibiotic is:A. methylation of binding site on the 50S ribosomal

subunitsB. formation of esterases that hydrolyzed the lactone

ringC. formation of drug-inactivating acetyltransferaseD. decrease drug permeability of the cytoplasmic

membrane


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96. A prescription that has the generic name enclosed in a parenthesis and written below the brand name can be interpreted as:A. violative prescription B. imposiible prescriptionC. erroneous prescriptionD. correct prescription

C Generic Act of the Philippines

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97. The onset and duration of action NPH insulin are extended by protamine because:A. it decreases the rate of insulin absorptionB. it blocks insulin metabolism in the liverC. it is a basic compound and combines with insulin

by charge interactionsD. it is slowly degraded proteolytically releasing the

bound insulin


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98. The following anti-anginal drugs are vasodilators, EXCEPT:A. Felodipine C. MetoprololB. Nitroglycerin D. Diltiazem


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99. Which is a direct effect of nitrates when given in the usual doses for the management of angina?A. increased preload B. increased afterloadC. increased cardiac contractilityD. decreased preload


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100. The mechanism of action of OmeprazoleA. inhibits H+-K+ ATPase pumpB. promotes prostaglandin formationC. blocks action of histamine of H2 receptorsD. neutralizes acid by increasing the pH of gastric

secretion

A Goodman and Gilman 8th ed p.902-904

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Board Questions in Pharmacology