Module 2. Clinical Pharmacy in gastroenterology, hepatology, hematology, endocrinology, аllergology.
Text test questions:
1. The major synthetic estrogens are following, EXCEPT:
A. Dienestrol
B. Diethylstilbestrol
C. Benzestrol
D. * Estradiol
E. All of the above
2. Which of the following statements about estrogens are True:
A. Estrogens are required for normal sexual maturation and growth of the female
B. Estrogens decrease the rate of resorption of bone
C. Estrogens enhance the coagulability of blood
D. * All of the above
E. None of the above
3. Indications of synthetic estrogens are following, EXCEPT:
A. Primary hypogonadism
B. Postmenopausal hormonal therapy
C. Hormonal contraception
D. * For treatment of simple obesity
E. None of the above
4. Main complications of estrogens’ therapy include the following:
A. Postmenopausal uterine bleeding
B. Breast tenderness
C. Hyperpigmentation
D. * All of the above
E. None of the above
5. Tamoxifen is:
A. Antiprogestin
B. Antiandrogen
C. * Antiestrogen
D. Androgen
E. None of the above
6. Main contraindications of estrogens’ therapy include the following:
A. Estrogen-dependent neoplasmas such as carcinoma of the endometrium or carcinoma of the
breast
B. Undiagnosed genital bleeding
C. Liver disease
D. * All of the above
E. None of the above
7. Progesterone is secreted by:
A. Ovarian follicles
B. * Corpus luteum
C. Granulosa and theca cells
D. All of the above
E. None of the above
8. The major natural progestin is:
A. Estradiol
B. Estron
C. * Progesterone
D. Estriol
E. None of the above
9. Which of the following statements about progestins is True:
A. Progesterone is rapidly absorbed following administration by any route
B. In the liver, progesterone is metabolized to pregnanediol and conjugated with glucuronic acid.
C. Significant amounts of progestins and their metabolites are excreted in the urine
D. * All of the above
E. None of the above
10. Noncontraceptive clinical uses of progestins are following:
A. Hormone replacement therapy
B. Dysmenorrhea
C. Endometriosis
D. * All of the above
E. None of the above
11. All of the following statements about oral contraceptives are true, EXCEPT:
A. The “combination pill” contains both estrogen and progestin
B. Ethinyl estradiol and mestranol are commonly used in oral contraceptives
C. The “minipill” contains progestin alone
D. * The “triphasic pill” contains estrogen, progestin, and luteinizing hormine
E. All of the above
12. The drug of choice for treatment of anaphylactic shock is:
A. Noradrenaline.
B. Naphthyzine.
C. Isadrine.
D. * Adrenaline.
E. Anapriline.
13. Main effect of ganglion- blockers is:
A. * Decrease of vessels’ tone.
B. Increase of vessels’ tone.
C. Decrease intraocular pressure.
D. Analeptic action.
E. Bronchial spasm.
14. What is the way of noradrenalin using?
A. * Intravenous.
B. Intramuscular.
C. Per oral.
D. Subcutaneous.
E. Intracutaneous.
15. What is the effect of noradrenalin using?
A. Vasodilating.
B. * Vasoconstrictive.
C. Bronchodilating.
D. Bronchoconstrictive.
E. Analeptic.
16. Which of the following agents is a respiratory analeptic?
A. Piracetam
B. Sydnocarb
C. * Bemegride
D. Pantocrin
E. Morphine
17. Adaptogens cause:
A. Improvement of efficiency using physical loads and acceleration of recovery after the load
B. Stimulation of respiratory and vasomotor centers
C. Temporary relief of the feeling of tiredness, facilitating the professional work and fighting
somnolence
D. * Increased resistance towards stress situations and adaptation to extreme conditions
E. None of the above
18. Which of the following agents is a general tone-increasing drug of plant origin?
A. Meridil
B. * Eleuterococci’s extract
C. Pantocrin
D. Caffeine
E. T-activin
19. Indicate a general tone-increasing drug, which is an agent of animal origin?
A. * Pantocrin
B. Amphetamine
C. Sydnocarb
D. Camphor
E. All of the above
20. Cordiamine is useful in the treatment of:
A. Hypotension
B. Coronary insufficiency
C. Respiratory insufficiency
D. * All of the above
E. None of the above
21. Tick the drug influencing the blood flow which is related to antiplatelet agents:
A. Heparin
B. * Aspirin
C. Pyracetam
D. Tanakan
E. Indometacin
22. Which of the following drugs is related to anticoagulants and may be useful in disorders of cerebral
circulation?
A. Aspirin
B. Trimetazidine
C. Cinnarizine
D. Nicergoline
E. * Heparin
23. Antiaggregants are used in disorders of brain circulation for:
A. Stimulation of the metabolic processes in neurons
B. Dilation of cerebral vessels
C. * Improving the microcirculation in cerebral tissue
D. All the above
E. None of the above
24. Immediate allergy reaction (type I allergic reaction) is:
A. * An allergic or immune response that begins within a period lasting from a few minutes to
about an hour after exposure to an antigen to which the individual has been sensitized
B. An allergic reaction that becomes apparent only hours after contact
C. An allergic reaction that results from the formation of antigen-antibody complexes between a
foreign antigen and IgM or IgG immunoglobulins. (It occurs during blood transfusion reactions
and in hemolytic disease of the newborn)
D. An allergic reaction that is due to the presence of elevated levels of antigen-antibody complexes
that cause tissue damage
E. None of the above
25. Delayed allergy reaction (type IV allergic reaction) is:
A. An allergic or immune response that begins within a period lasting from a few minutes to about
an hour after exposure to an antigen to which the individual has been sensitized
B. * An allergic reaction that becomes apparent only hours after contact
C. An allergic reaction that results from the formation of antigen-antibody complexes between a
foreign antigen and IgM or IgG. (It occurs during blood transfusion reactions and in hemolytic
disease of the newborn)
D. An allergic reaction that is due to the presence of elevated levels of antigen-antibody complexes
that cause tissue damage
E. All of the above
26. Immunodeficiency:
A. A localized protective reaction of tissue to irritation, injury, or infection, characterized by pain,
redness, swelling, and sometimes a loss of function
B. * A disorder or deficiency of the normal immune response
C. A disease resulting from an immune reaction produced by an individual's white blood cells or
antibodies acting on the body's own tissues or extracellular proteins
D. All of the above
E. None of the above
27. H1 histamine receptor subtype is distributed in:
A. * Smooth muscle, endothelium and brain
B. Gastric mucosa, cardiac muscle, mast cells and brain
C. Presynaptically in brain, mesenteric plexus and other neurons
D. All of the above
E. None of the above
28. H2 histamine receptor subtype is distributed in:
A. Smooth muscle, endothelium and brain
B. * Gastric mucosa, cardiac muscle, mast cells and brain
C. Presynaptically in brain, mesenteric plexus and other neurons
D. All of the above
E. None of the above
29. Most tissue histamine is sequestered and bound in:
A. Granules in mast cells or basophils
B. Cell bodies of histaminergic neurons
C. Enterochromaffin-like cell of the fondus of the stomach
D. * All of the above
E. None of the above
30. These categories of histamine H1 antagonists are noted for sedative effects, EXCEPT:
A. * Piperidines; i.e. Loratadine, Fexofenadine
B. Ethanolamines (aminoalkyl ethers); i.e. Dimedrol, Clistin
C. Ethylenediamines; i.e. Suprastine
D. Phenothiazines; i.e. Diprazine, Promethazine
E. All of the above is true
31. Which category of histamine H1 antagonists is recognized for as second-generation antihistamines?
A. Alkylamines (propylamines); i.e. Brompheniramine
B. * Piperidines; i.e. Loratadine, Fexofenadine
C. Ethylenediamines; i.e. Suprastine
D. Phenothiazines; i.e. Promethazine
E. None of the above
32. These histamine H1 antagonists are recognized for as second-generation antihistamines, EXCEPT:
A. Astemizole
B. desloratadine
C. Loratadine (Claritin)
D. Cetirizine (Zyrtec)
E. * Suprastine
33. Indication for administration of histamine H1 antagonists is:
A. Prevention or treatment of the symptoms of allergic reactions (rhinitis, urticaria)
B. Motion sickness and vestibular disturbances
C. Nausea and vomiting in pregnancy (“morning sickness”)
D. * All of the above
E. None of the above
34. Indications for administration of histamine H1 antagonists are the following EXCEPT:
A. Prevention of the symptoms of allergic reactions
B. Treatment of the symptoms of allergic reactions (rhinitis, urticaria)
C. * Management of seizure states
D. Nausea and vomiting in pregnancy (“morning sickness”)
E. Treatment of sleep disorders
35. Side effect of first-generation histamine H1 antagonists is:
A. Aplastic anemia
B. Vomiting, tinnitus,
C. Decreased hearing
D. * Sedation
E. Gastric ulcers and upper gastrointestinal bleeding
36. Immunosupressive effect of glucocorticoids is caused by
A. * Reducing concentration of lymphocytes (T and B cells) and inhibiting function of tissue
macrophages and other antigen-presenting cells
B. Suppression of cyclooxygenase II expression that results in reducing amount of an enzyme
available to produce prostaglandins
C. Activation of phospholipase A2 and reducing prostaglandin and leukotriene synthesis
D. All of the above
E. None of the above
37. Antiallergic effect of glucocorticoids is caused by:
A. Suppression of leukocyte migration and stabilizing lysosomal membranes
B. Reverse the capillary permeability associated with histamine release
C. Suppression of the immune response by inhibiting antibody synthesis
D. * All of the above
E. None of the above
38. The Immunosuppressive agent is:
A. Corticosteroids
B. Cyclosporine
C. Tacrolimus (FK 506)
D. * All of the above
E. None of the above
39. Class of cyclosporine A is:
A. Interferons
B. * Immunosuppressive agents
C. Monoclonal antibodies
D. Immunoglobulins
E. Glucocorticoids
40. Side effect of cyclosporine A is:
A. Tremor
B. GI disturbance
C. Hepatotoxicity
D. * All of the above
E. None of the above
41. Side effect of cyclosporine A is:
A. * Tremor
B. Anorexia
C. Chills
D. Myalgia
E. All of the above
42. Side effect of cyclosporine A is:
A. Diarrhea
B. Headache
C. * GI disturbance
D. Immunosuppression
E. All of the above
43. Indication of cyclosporine A is:
A. Secondary immunodeficiency
B. Hairy cell leukemia
C. Primary immunodeficiency
D. * Idiopathic nephrotic syndrome
E. All of the above
44. Class of I.V. IgG preparation is:
A. Monoclonal antibodies
B. Immunosuppressive agents
C. Interferons
D. * Immunoglobulins
E. None of the above
45. Half-life of I.V. IgG preparation is:
A. 25-35 minutes
B. 19 hours
C. 4 - 16 hours
D. * 21 days
E. 3 days
46. Mechanism of action of I.V. IgG preparation is:
A. Inhibits CD3 receptor
B. Inhibits calcineurin
C. Complement-mediated cytolysis of T lymphocytes
D. * Compete for Fc receptors with autoantibodies
E. None of the above
47. Indication for I.V. IgG preparation administration is:
A. Kaposi's sarcoma
B. Acute rejection of organ transplant
C. Condyloma acuminatum
D. * Prophylaxis of certain infections
E. Viral hepatitis
48. Cytotoxic agents are the following EXCEPT:
A. Azathioprine
B. * Cyclosporine
C. Leflunomide
D. Cyclophosphamide
E. All of the above
49. Monoclonal antibodies is:
A. Trastuzumab
B. Rituximab
C. OKT-3
D. * All of the above
E. None of the above
50. The indication for interferon gamma administration is:
A. Idiopathic nephrotic syndrome
B. Hepatitis C virus infection
C. * Chronic granulomatous disease
D. Hairy cell leukemia
E. Hepatitis B virus infection
51. The side effect of interferon gamma is:
A. Hypertension
B. Pulmonary edema
C. Nephrotoxicity
D. * Fatigue
E. All of the above
52. Half-life of interferon gamma is:
A. 21 days
B. 19 hours
C. 4 - 16 hours
D. * 25-35 minutes
E. 24 hours
53. Half-life of interferon alpha is:
A. 18-24 hours
B. * 4-16 hours
C. 25-35 minutes
D. 21 days
E. 3 days
54. The indication for interferon alpha administration is:
A. Hepatitis C virus infection
B. Kaposi's sarcoma
C. Condyloma acuminatum
D. * All of the above
E. None of the above
55. Indication for interferon alpha administration is:
A. Autoimmune diseases
B. Rheumatoid arthritis
C. Organ transplantation
D. * Hepatitis C virus infection
E. None of the above
56. Indication for interferon alpha administration is:
A. Prophylaxis of sensitization by Rh antigen
B. Rheumatoid arthritis
C. * Kaposi's sarcoma
D. Chronic granulomatous disease
E. Chronic pancreatitis
57. Immunomodulating agent is:
A. Sirolimus (rapamycin)
B. * Levamisole
C. Tacrolimus
D. All of the above
E. None of the above
58. Mechanism of action of levamisole is:
A. Inhibits CD3 receptor
B. Complement-mediated cytolysis of T lymphocytes
C. Substitution for patient's defiecient immunoglobulins
D. * Increase the number of T-cells
E. All of the above
59. Secretory products of pancreatic beta-cells are:
A. Glucagon, proglucagon
B. * Insulin, C-peptide, proinsulin, islet amyloid polypeptide (IAPP)
C. Somatostatin
D. Pancreatic polypeptide (PP)
E. All of the above
60. Insulin is:
A. A glycoprotein with a molecular weight of 6000
B. * A small protein with a molecular weight of 5808 having disulphide linkage
C. A fructoolygosaccharide
D. A catecholamine
E. None of the above
61. Insulin is a polypeptide hence:
A. It is resistant to destruction by gastric juice
B. * It is destroyed by gastric juice
C. It is not a polypeptide
D. It is metabolized immediately by cellular enzymes
E. None of the above
62. The primary reason for a physician to prescribe human insulin is that:
A. It has a faster onset of action than other insulins
B. It has a shorter duration of action than other insulins
C. * It can be given to patients who have an allergy to animal insulins
D. It is more effective in preventing the complications of diabetes than animal insulins
E. All of the above
63. Diabetic coma is treated by the administration of:
A. Insulin lente
B. Glucose
C. * Crystalline insulin
D. Oral anti-diabetic drugs.
E. All of the above
64. Sulphonylureas act by:
A. Reducing the absorption of carbohydrate from the gut
B. Increasing the uptake of glucose in peripheral tissues
C. Reducing the hepatic gluconeogenesis
D. * Stimulating the beta islet cells of pancreas to produce insulin
E. All of the above
65. Currently used second-generation sulfonylureas include the following, EXCEPT:
A. Glyburide (Glibenclamide)
B. Glipizide (Glydiazinamide)
C. Glimepiride (Amaril)
D. * Tolbutamide (Orinase)
E. All of the above
66. Currently used oral hypoglycemic thiazolidinediones include the following, EXCEPT
A. Pioglitazone (Actos)
B. Rosiglitazone (Avandia)
C. * Troglitazone (Rezulin)
D. All of the above
E. None of the above
67. Thiazolidinediones act by:
A. * Diminishing insulin resistance by increasing glucose uptake and metabolism in muscle and
adipose tissues
B. Reducing the absorption of carbohydrate from the gut
C. Stimulating the beta islet cells of pancreas to produce insulin
D. All of the above
E. None of the above
68. Alpha-glucosidase inhibitors act by:
A. Diminishing insulin resistance by increasing glucose uptake and metabolism in muscle and
adipose tissues
B. * Competitive inhibiting of intestinal alpha-ghucosidases and modulating the postprandial
digestion and absorption of starch and disaccharides
C. Reducing the absorption of carbohydrate from the gut
D. Stimulating the beta islet cells of pancreas to produce insulin
E. All of the above
69. Which of the following oral hypoglycaemic drugs stimulates both synthesis and release of insulin
from beta islet cells:
A. * Glibenclamide
B. Phenformin
C. Buformine
D. Metformin
E. All of the above
70. The action of insulin is potentiated by:
A. Sulphonylureas
B. Glucagon
C. * Biguanides
D. None of the above
E. All of the above
71. Biguanides are used in the following conditions, EXCEPT:
A. As a supplement to sulphonylurea, where it is insufficient to give good results
B. In over weight diabetics
C. To reduce insulin requirements
D. * In case of hyperglycemic shock
E. All of the above
72. Which of the following agents is/are important hormonal antagonists of insulin in the body?
A. Glucagon
B. Adrenal steroids
C. Adrenaline
D. None of the above
E. * All of the above
73. Glucagon can be used in the following situations, EXCEPT:
A. Severe hypoglycemia
B. * Severe hyperglycemia
C. Endocrine diagnosis
D. Beta-blocker poisoning
E. None of the above
74. Main complications of insulin therapy include the following:
A. Hypoglycemia
B. Insulin allergy
C. Lipodystrophy at an injection site
D. * All of the above
E. None of the above
75. Tick the main approach of peptic ulcer treatment:
A. Neutralization of gastric acid
B. Eradication of Helicobacter pylori
C. Inhibition of gastric acid secretion
D. * All the above
E. None of the above
76. Gastric acid secretion is under the control of the following agents EXCEPT:
A. Histamine
B. Acetylcholine
C. * Serotonin
D. Gastrin
E. All of the above
77. Indicate the drug belonging to proton pump inhibitors:
A. Pirenzepine
B. Ranitidine
C. * Omeprazole
D. Trimethaphan
E. Metoclopramid
78. Which of the following drugs is an agent of substitution therapy?
A. Gastrin
B. * Hydrochloric acid
C. Hystamine
D. Carbonate mineral waters
E. Bradikinin
79. Choose the drug which is a H2-receptor antagonist:
A. Omeprazole
B. Pirenzepine
C. Carbenoxolone
D. * Ranitidine
E. Loratadine
80. All of the following drugs are proton pump inhibitors EXCEPT:
A. Pantoprozole
B. Omeprazole
C. * Famotidine
D. Rabeprazole
E. Esomeprazole
81. Indicate the drug belonging to M1-cholinoblockers:
A. Cimetidine
B. Ranitidine
C. * Pirenzepin
D. Omeprazole
E. Pantoprazole
82. Which of the following drugs may cause reversible gynecomastia?
A. Omeprazole
B. Pirenzepine
C. * Cimetidine
D. Sucralfate
E. Lansoprazole
83. Tick the drug forming a physical barrier to HCL and Pepsin:
A. Ranitidine
B. * Sucralfate
C. Omeprazole
D. Pirenzepine
E. Loratadine
84. What term is used to describe a decrease in responsiveness to a drug which develops in a few
minutes?
A. Refractoriness
B. Cumulative effect
C. Idiosyncrazy
D. Tolerance
E. * Tachyphylaxis
85. Tachyphylaxis is:
A. A drug interaction between two similar types of drugs
B. * Very rapidly developing tolerance
C. A decrease in responsiveness to a drug, taking days or weeks to develop
D. An unexpected reaction to a drug
E. None of the above
86. Idiosyncratic reaction of a drug is:
A. A type of hypersensitivity reaction
B. A type of drug antagonism
C. * Unpredictable, inherent, qualitatively abnormal reaction to a drug
D. Quantitatively exaggerated response
E. The ability of a substance to cause cancer
87. Which drug is an analog of prostaglandin E1?
A. * Misoprostol
B. De-nol
C. Sucralfate
D. Omeprazole
E. Ranitidine
88. Select the drug stimulating the protective function of the mucous barrier and the stability of the
mucous membrane against damaging factors:
A. De-nol
B. Ranitidine
C. * Misoprostol
D. Omeprazole
E. Gastrocepine
89. Most of drugs are antacids EXCEPT:
A. * Misoprostol
B. Maalox
C. Mylanta
D. Almagel
E. Sodium bicarbonate
90. Indicate the drug that cause metabolic alkalosis:
A. * Sodium bicarbonate
B. Cimetidine
C. Pepto-Bismol
D. Carbenoxolone
E. Maalox
91. Choose the drug that causes constipation:
A. Sodium bicarbonate
B. * Aluminium hydroxide
C. Calcium carbonate
D. Magnesium oxide
E. None of the above
92. All of the following drugs stimulate appetite EXCEPT:
A. Vitamins
B. Bitters
C. * Fepranone
D. Insulin
E. Caffeine
93. All of the following drugs intensify gastrointestinal motility EXCEPT:
A. * Papaverine
B. Metoclopramide
C. Domperidone
D. Cisapride
E. Tegaserod
94. Choose an emetic drug of central action:
A. Ipecacuanha derivatives
B. Promethazine
C. Tropisetron
D. * Apomorphine hydrochloride
E. None of the above
95. Tick the mechanism of Metoclopramide antiemetic action:
A. H1 and H2-receptor blocking effect
B. M-cholinoreceptor stimulating effect
C. * D2-dopamine and 5-HT3-serotonin receptor blocking effect
D. M-cholinoblocking effect
E. H2-receptor blocking effect
96. Select the emetic agent having a reflex action:
A. * Ipecacuanha derivatives
B. Apomorphine hydroclorid
C. Chlorpromazine
D. Metoclopramide
E. Ranitidine
97. All of the following drugs are antiemetics EXCEPT:
A. Metoclopramide
B. Ondansetron
C. Chlorpromazine
D. * Apomorphine hydrochloride
E. None of the above
98. All of these drugs reduce intestinal peristalsis EXCEPT:
A. Loperamide
B. * Cisapride
C. Methyl cellulose
D. Magnesium aluminium silicate
E. None of the above
99. The mechanism of stimulant purgatives is:
A. Increasing the volume of non-absorbable solid residue
B. * Increasing motility and secretion
C. Altering the consistency of the feces
D. Increasing the water content
E. All of the above
100. Select the drug which inhibits peristalsis:
A. Castor oil
B. Bisacodyl
C. * Loperamide
D. Sorbitol
E.
101.
A.
B.
C.
D.
E.
102.
A.
B.
C.
D.
E.
103.
A.
B.
C.
D.
E.
104.
A.
B.
C.
D.
E.
105.
A.
B.
C.
D.
E.
106.
A.
B.
C.
D.
E.
107.
A.
B.
C.
D.
E.
108.
A.
B.
C.
D.
E.
109.
A.
B.
Mannit
Choose the drug affecting the biliary system and relaxing Oddy sphincter:
Cholosas
Oxaphenamide
* No-spa
Cholenzyme
Castor oil
All of the following are normally involved in the pathogenesis of heart failure EXCEPT:
A cardiac lesion that impairs cardiac output
An increase in peripheral vascular resistance
* A decrease in preload
An increase in sodium retention
An increase in water retention
Which of these groups of drugs is used for asthma treatment?
Methylxanthines
M-cholinoblocking agents
Beta2 – agonists
Steroids
* All of the above
Tick the drug belonging to non-selective beta2-adrenomimics:
Salbutamol
* Isoprenaline
Salmeterol
Terbutaline
All of the above
Select the side effect characteristic for non-selective beta2-adrenomimics:
Depression of the breathing centre
* Tachycardia
Peripheral vasoconstriction
Dry mouth
All of the above
Pick out the bronchodilator drug related to xanthine:
Atropine
Ipratropium
Orciprenaline
Adrenaline
* Theophylline
Pick out the bronchodilator drug belonging to sympathomimics:
Isoprenaline
* Ephedrine
Atropine
Phormoterol
Salbutamol
The mechanism of methylxanthines action is:
* Inhibition of the enzyme phosphodiesterase
Beta2-adrenoreceptor stimulation
Inhibition of the production of inflammatory cytokines
Inhibition of M-cholinoreceptors
Inhibition of COX-oxygenase
Which of the following M-cholinoblocking agents is used especially as an anti-asthmatic?
Atropine
* Ipratropium
C. Platiphylline
D. Metacin
E. None of the above
110. Indicate the side effect of Theophylline:
A. Bradycardia
B. * Increased myocardial demands for oxygen
C. Depression of respiratory centre
D. Elevation of the arterial blood pressure
E. All of the above
111. All of the following drugs are inhaled glucocorticoids EXCEPT:
A. Triamcinolone
B. Beclometazone
C. * Sodium cromoglycate
D. Budesonide
E. Fluticazone
112. Choose the drug belonging to membrane stabilizing agents:
A. Zileutin
B. * Sodium cromoglycate
C. Zafirlucast
D. Montelucast
E. Budesonide
113. Indicate the drug which is a leucotriene receptor antagonist:
A. Sodium cromoglycate
B. * Zafirlucast
C. Zileutin
D. Triamcinolone
E. Zopiclon
114.
Indications of glucocorticoids are following, EXCEPT:
A. Gastrointestinal diseases (inflammatory bowel disease)
B. * Postmenopausal hormonal therapy
C. Inflammatory conditions of bones and joints (arthritis, bursitis, tenosynovitis)
D. Skin diseases (atopic dermatitis, dermatoses, localized neurodermatitis)
E. All of the above
115. The main mechanism of most drugs absorption in GI tract is:
A. Active transport (carrier-mediated diffusion)
B. Filtration (aqueous diffusion)
C. Endocytosis and exocytosis
D. * Passive diffusion (lipid diffusion)
E. None of the above
116. Pick out the appropriate alimentary route of administration when passage of drugs through liver
is minimized:
A. Oral
B. Transdermal
C. * Rectal
D. Intraduodenal
E. All of the above
117. Which route of drug administration is most likely to lead to the first-pass effect?
A. Sublingual
B. * Oral
C. Intravenous
D. Intramuscular
E. Rectal
118. What is characteristic of the oral route?
A. Fast onset of effect
B. * Absorption depends on GI tract secretion and motor function
C. A drug reaches the blood passing the liver
D. The sterilization of medicinal forms is obligatory
E. All of the above
119. In case of liver disorders accompanied by a decline in microsomal enzyme activity the duration
of action of some drugs is:
A. Decreased
B. * Enlarged
C. Remained unchanged
D. Changed insignificantly
E. Remained unchanged or changed insignificantly
120. The most specific agent for prevention of asthma is:
A. * Salbutamolum
B. Libexinum
C. Adrenalini hydrochloridum
D. Pertussinum
E. Mucaltinum
121. Proposed cellular mechanisms of theophylline's action include:
A. translocation of intracellular calcium
B. those mediated by increasing accumulation of intracellular cyclic AMP
C. those mediated by blockade of receptors for adenosine
D. * All of the above
E. None of the above
122. Theophylline clearance may be reduced by:
A. phenobarbital
B. warfarin
C. tobacco smoking
D. phenytoin
E. * ciprofloxacin
123. Regarding its actions, cromolyn is best described as:
A. bronchodilator
B. anticholinergic
C. beta agonist
D. * inhibitor of mast cell degranulation
E. glucocorticoid
124. Beta-2 selective adrenergic agonists include all EXCEPT:
A. terbutaline
B. albuterol
C. metaproterenol
D. * isoproterenol
E. pirbuterol
125. Adverse effects of beta-2 adrenergic bronchodilators include all of the following EXCEPT:
A. nervousness
B. headache
C. tachycardia
D. tremulousness
E. * lethargy
126. Which of the following work through cholinergic receptor antagonism?
A. theophylline
B. cromolyn
C. ephedrine
D. * ipratropium
E. salmeterol
127. Which of the following pharmacologic agents antagonize adenosine?
A. * theophylline
B. glucocorticoids
C. cromolyn sodium
D. propranolol
E. terbutaline
128. When comparing the relative adrenergic effects of the following drugs, the one which would
have the bronchodilative effect at normal doses is:
A. terbutaline
B. epinephrine
C. isoproterenol
D. isoetharine
E. * norepinephrine
129. Asthmatic patients could experience bronchoconstriction problems with which of the following
agents?
A. * isoproterinol (Isuprel)
B. digoxin (Lanoxin)
C. pindolol (Visken) –
D. dextromethorphan
E. labetalol
130. Which of the following can be administered orally and by inhalation?
A. Epinephrine
B. Albuterol
C. Pirbuterol
D. * Terbutaline
E. Isoproterenol
131. Which of the following is not true about Salmeterol?
A. administered by inhalation
B. long acting anti-asthmatic with a duration of 12 hours
C. * can lead to transient increase in PaO2, especially in poorly ventilated lung tissue
D. associated with improvement in patients homozygous for glycine at the B-16 locus of the betareceptor
E. none of the above
132. Which of the following is not true about Ipratropium bromide:
A. Anticholinergic agent administered by inhalation
B. better bronchodilator than Atropine
C. * better anti-asthmatic than Epinephrine
D. has no effect on mucocilliary clearance
E. none of the above
133. Which of the following asthma severity categories has a treatment including inhaled low-dose
steroid, cromolyn, nedocromil, zafirlukast or zileuton?
A. Mild intermittent asthma
B. * Mild persistent asthma
C. Moderated persistent asthma
D. Severe persistent asthma
E. Exercise-induced asthma
134. Which of the following, along with Formoterol, is a long acting anti-asthmatic?
A. Albuterol
B. * Salmeterol
C.
D.
E.
135.
A.
B.
C.
D.
E.
136.
A.
B.
C.
D.
E.
137.
A.
B.
C.
D.
E.
138.
A.
B.
C.
D.
E.
139.
A.
B.
C.
D.
E.
140.
A.
B.
C.
D.
E.
141.
A.
B.
C.
D.
E.
142.
A.
B.
C.
D.
E.
143.
Metaproterenol
Terbutaline
Pirbuterol
Which of the following is a short acting leukotriene synthesis (5-lipoxygenase) inhibitor?
* Zileuton
Zafirlukast
Montelukast
Omalizumab
Theophyline
Which one of the following drugs is a selective beta2-agonist?
Epinephrine
Norepinephrine
* Salbutamol
Isoproterenol
Dobutamine
Which of the following antibiotics is most closely associated with the development of hepatitis?
kanamycin
penicillin G
tetracycline
* isoniazid
ethambutol
Isoniazid-induced liver damage:
occurs primarily in patients under 30 years of age
occurs with increased frequency in patients receiving concomitant ethambutol therapy
* is probably due to the formation of a toxic hydrazine metabolite that binds to liver protein
is frequently associated with allergic manifestations such as eosinophilia, fever, and rash
All of the above
Cromolyn, regarding its actions, is best described as:
bronchodilator
anticholinergic
beta agonist
* inhibitor of mast cell degranulation
glucocorticoid
Indicate the group of drugs, stimulating intestine motility
* Anticholinesterases
M-cholinoblockers
Ganglioblockers
Amara (bitters)
Anorexigenous
Indicate the group of drugs, oppressing intestine contraction
M-cholinomimetics
* M-cholinoblockers
Anticholinesterases
N-cholinomimetics
Adrenoblockers
The indications for prescribing of H2 – histamine blockers
Hypoacidic gastritis
Anorexia
Acute cholecystitis
* The ulcerous disease of the stomach and duodenum
Stomatitis
Which drug belongs to the antacid?
A.
B.
C.
D.
E.
144.
A.
B.
C.
D.
E.
145.
A.
B.
C.
D.
E.
146.
A.
B.
C.
D.
E.
147.
A.
B.
C.
D.
E.
148.
A.
B.
C.
D.
E.
149.
A.
B.
C.
D.
E.
150.
A.
B.
C.
D.
E.
151.
A.
B.
C.
D.
* Aluminii hydroxydum
Ranitidin
Atropine sulfas
Cimetidine
Pancreatinum
Ranitidine, drug used for treatment of ulcer disease, block
GABA-receptors
Adrenergic receptors
M-cholinoreceptors
* H2-histamine receptors
N-cholinoreceptors
Which drug belongs to the laxatives?
Pepsin
* Radicis Rhei
Ranitidin
Atropine sulfas
Apomorphinum
Which of the following substances has its major activity as a saline cathartic?
sodium bicarbonate
methylcellulose
* sodium phosphate
castor oil
mineral oil
The correct statement regarding sucralfate:
pharmacologic action is to reduce gastric acid secretion by antagonizing gastrin
enhances N+-K+ ATPase
antagonizes acetylcholine
* most common side effects is constipation
increases gastric motility
Correct statement regarding metoclopramide:
central nervous system dopamine receptor agonist
peripheral blockage of acetylcholine at muscarinic synapse
decreases lower esophageal sphincter pressure
* adverse effects include dystonic or extrapyramidal effects
increases motility of colon
In general, mechanisms of laxation include:
adding bulk to the stool
increasing peristaltic activity
emulsifying aqueous and fatty substances with stool
lubricating the passage of stool
* All of the above
Appropriate indications for and/or uses of laxatives include:
prevent straining at the stool in patients with cardiovascular disease
bulk forming agents for diverticular disease
treatment of drug overdose
* All of the above
None of the above
Which of the following substances is most likely to cause systemic alkalosis?
* sodium bicarbonate
methylcellulose
sodium phosphate
castor oil
E. mineral oil
152. Saline cathartics, such as sodium sulfate or magnesium sulfate:
A. are safe in patients with renal failure
B. are readily absorbed from the gastrointestinal tract
C. are slower acting than bulk-forming laxatives
D. * act by increasing intestinal volume, hence stimulating peristaltic action
E. lower the surface tension of the feces to facilitate fecal hydration
153. Adverse effect(s) of laxatives:
A. electrolyte disturbances (hypernatremia, hypokalemia)
B. dehydration
C. spastic colitis with stimulant laxatives
D. gastrointestinal obstruction with bulk forming agents
E. * All of the above
154. In esophagitis, elevation of the head of the bed, abstinence from ethanol and tobacco, and small
frequent meals are all useful adjunctive therapeutic measures. Other useful therapy may include all
of the following EXCEPT:
A. omeprazole
B. metoclopramide
C. maalox
D. cimetidine
E. * amitriptyline
155. Drug which exerts anti-peptic ulcer effects through histamine-2 receptor antagonism:
A. sucralfate
B. * ranitidine
C. metoclopramide
D. omeprazole
E. Misoprostol
156. The substance which is principally an emollient laxative is:
A. bran
B. methylcellulose
C. magnesium hydroxide
D. phenolphthalein
E. * mineral oil
157. Agents of potential use in peptic ulcer disease include:
A. muscarinic antagonists
B. proton pump inhibitors
C. antacids
D. prostaglandins
E. All of the above
158.
Possible drug interactions: Aluminium hydroxide antacids tend to interfere with the
gastrointestinal absorption of:
A. cephalexin
B. penicillin G
C. erythromycin
D. chloramphenicol
E. * tetracycline
159. Indicate which of the following substances has its major activity as a stimulant cathartic
A. sodium bicarbonate
B. methylcellulose
C. sodium citrate
D. * castor oil
E. mineral oil
160. One mechanism to reduce gastric acid secretion is by blocking the K+-Na+ATPase pump in the
parietal cell. One drug that has this pharmacologic action is:
A. misoprostol
B. pirenzepine
C. * omeprazole
D. serotonin
E. isoniazid
161. The amount of sodium, phosphate or magnesium contained in an antacid should be assessed
when selecting an antacid for patients with:
A. renal insufficiency
B. congestive heart failure
C. ascitis
D. * All of the above
E. None of the above
162. The concomitant administration of calcium and/or magnesium antacids to patients receiving one
of the tetracycline drugs may have which of the following effects upon the action of the
tetracycline:
A. enhances the action
B. causes no significant change
C. * decreases the action
D. increases toxicity
E. suppresses hypersensitivity reactions
163. Which of the following substances has its major activity as a saline cathartic?
A. Sodium bicarbonate
B. Aluminium hydroxide
C. * Magnesium sulfate
D. Calcium carbonate
E. All of the above
164. All these Drugs are cause obstipation Except:
A. Anticholinergic agents
B. Ca2+ channel antagonists
C. Opioids
D. Tricyclic antidepressants
E. * Muscarinic agonists
165. Plant fiber (a laxative, purgative)
A. Decrease the bulk of the stools
B. increases the bowel transit time
C. * slowly distends the wall of the colon
D. increases the effective caloric content of the diet
E. takes down water and swells
166. Lactulose
A. is a monosaccharide
B. is broken down in the small intestine by bacteria
C. is build to unabsorbed organic anions which retain fluid
D. produces laxative effects after 2-3 hours
E. * is of particular value in the treatment of hepatic encephalopathy
167. Lactulose is of particular value in the treatment of encephalopathy:
A. * as it discourages the proliferation of ammonia producing organisms
B. as it increases the absorption of ammonia
C. as it decreases chronic portal hypertension
D. as it treatment fever
E. as it improves functions of CNS after absorption from the GIT
168.
A.
B.
C.
D.
E.
169.
A.
B.
C.
D.
E.
170.
A.
B.
C.
D.
E.
171.
A.
B.
C.
D.
E.
172.
A.
B.
C.
D.
E.
173.
A.
B.
C.
D.
E.
174.
A.
B.
C.
D.
E.
175.
A.
B.
C.
D.
E.
176.
A.
B.
Magnesium sulfate
is a laxative which acts within 1-2 days
dilates the gallbladder and relaxes the sphincter of Oddi
decreases the secretion of cholecystokinin
decreases gastric, intestinal and pancreatic secretion
* should be given in dilute solution to a fasting individual
Senna alcaloids (anthraquinones)
* act directly on the intramucosal plexus of the gut wall
take about 8 minutes to produce an effect
should be given to pregnant women
should be given to nursing mothers
can not induce diarrhea with excessive loss of water and electrolytes
Glycerol (in the form of rectal suppositories)
is useless if a rapid effect is required
* acts as a rectal stimulant due to local irritant action
cannot be used in children
rectal suppositories promote colonic evacuation in 30 hours
exerts severe diarrhea with loss of water and electrolytes
In the treatment of acute diarrhea
antibiotics are worst avoided in non-pathogenic diarrhea
antibiotics are worst avoided in viral gastroenteritis
oral rehydration should not be used for initial therapy
electrolytes and glucose should not be supplemented for initial therapy
* oral rehydration and electrolytes supplementation are required particularly in children and in
the elderly
All these drugs are increasing intestinal transit time Except:
codeine (an opioid)
morphine (an opioid)
loperamide
diphenoxylate
* fysostigmin
Peptic ulcer disease
is an acute disorder
* characterized by frequent recurrences
comprises bones
the incidence of duodenal ulcers is four to five times lower than that of gastric ulcer
affects approximately 50% of the population
All these are major factors of known importance for the etiology of ulceration Except
acid-pepsin secretion
mucosal resistance to attack by acid and pepsin
* the age
effects of non-steroidal anti-inflammatory drugs
the presence of Helicobacter pylori
Acid secretion
is produced by endocrine cells in the gastric antrum cells
* is stimulated by gastrin
is inhibited by acetylcholine
is inhibited by histamine
is stimulated by prostaglandin E
Antacids:
* react with gastric acid to form a neutral salt
produce sweating
C.
D.
E.
177.
A.
B.
C.
D.
E.
178.
A.
B.
C.
D.
E.
179.
A.
B.
C.
D.
E.
180.
A.
B.
C.
D.
E.
181.
A.
B.
C.
D.
E.
182.
A.
B.
C.
D.
E.
183.
A.
B.
C.
D.
E.
184.
A.
B.
C.
D.
E.
185.
are Ineffective at healing duodenal ulcer
are very effective at healing gastric ulcers
its effect on acid secretion lasts for long (5 hours)
Antacids include:
misoprostol
orlistat
cimetidine
sucralfate
* aluminium salts (hydroxide, phosphate, glycinate)
Sodium bicarbonate (an antacid)
acts only locally
* excessive doses produce systemic alcalosis
produces carbon monoxide by reacting with hydrochloric acid
causes belching and distension of the large intestine
sodium intake need not to be considered in patients with hypertension or heart failure
Magnesium and aluminium salts
do undergo absorption so are effective locally
magnesium salts are constipating, aluminium salts may produce diarrhea
can not reduce the rate and extent of absorption of other drugs
aluminium salts should not be used with caution with any renal compromise
* magnesium and aluminium salts are taken 1-3 hours after meals and at bedtime
H2 lytics:
at least 4 days treatment is required to achieve healing
pain is relieved within 4 weeks treatment
include morphine , tramadol
* include nizatidine, ranitidine, famotidine
include pirenzepine
Ranitidine (ZANTAC)
has higher affinity for cytochrome P 450 than cimetidine
is less expensive than cimetidine
* is preferable to cimetidine in the elderly
has a similar profile of action to paracetamol
increases the plasma levels of theophylline
Pirenzepine
* is an M1 muscarinic receptor antagonist
can not cause mild difficulty with accomodation and dry mouth
can not alter the rate of absorption of other drugs if given concurrently
can be used in patients with concomitant glaucoma
can be used in patients with pyloric stenosis and prostatic enlargement
Omeprazol
is an irreversible stimulator of the proton pump
can be used only for healing gastric ulcer
Is for women only
is taken once weekly
* degrades in the presence of moisture. Capsules are supplied in special containers
Misoprostol
* is a synthetic analog of prostaglandin E1
produces gastric acid secretion
causes Stricture in the submucosa
decreases production of protective mucus
is indicated especially in pregnancy
Sucralfate
A.
B.
C.
D.
E.
186.
A.
B.
C.
D.
E.
187.
A.
B.
C.
D.
E.
188.
A.
B.
C.
D.
E.
189.
A.
B.
C.
D.
E.
190.
A.
B.
C.
D.
E.
191.
A.
B.
C.
D.
E.
192.
A.
B.
C.
D.
E.
193.
A.
B.
C.
D.
is less effective than cimetidine
is not so effective in symptom relief
antacids are contraindicated
contains aliminium, diarrhea can not be induced
* in severe renal failure accumulation is a potential hazard.
Cisapride
inhibits motility of the GIT
decreases rate of gastric emptying
is not used in gastroesophageal reflux
* is used in dyspepsia and delayed gastric emptying
is used in diarrhea
Metoclopramide is effective for:
preoperative vomiting
vestibular disturbances
motion sickness
headache
* facilitation of duodenal intubation and endoscopy
Constipation
results from increased peristaltic activity in the intestinal tract.
occurs only if one does not have a bowel movement at least once a day.
leads to decreased salt and water absorption from the large intestine.
* symptoms can be artificially induced by increasing the volume of the large intestine.
All of the above
The pancreas
is only an endocrine gland.
secretes enzymes in response to an increased plasma glucose concentration.
* neutralizes the hydrochloric acid secreted by the stomach.
produces bile.
None of the above
Gastrin
* stimulates acid secretion in the stomach.
secretion is blocked by the products of protein digestion in the stomach.
secretion is stimulated by acid in the duodenum.
is responsible for the chemical or gastric phase of intestinal secretion.
stimulates acid secretion in the intestine.
The activities of the GI tract, movement and secretion, are controlled by
the sympathetic nervous system.
the parasympathetic nervous system.
* local nerve reflexes initiated in the nerve plexus layer of the GI tract.
the medulla.
All of the above
The presence of fat in the duodenum causes
acid indigestion.
decreased acid production.
increased gastrin release.
* contraction of the gallbladder.
None of the above
The basic type of movement that occurs in the small intestine is
peristalsis.
mass movement.
churning.
* segmentation
E. all of the above
194. Most of the nutrients absorbed from the GI tract pass immediately into the portal venous system
and are processed by the liver. This is possible because almost all absorption occurs through
A. the lower section of the stomach.
B. the top section of the large intestine.
C. * the small intestine.
D. the ileum.
E. All of the above
195. Histamine-2 antagonists act to
A. block the release of gastrin.
B. selectively block histamine receptors, reducing swelling and inflammation.
C. * selectively block H2 receptor sites, leading to a reduction in gastric acid secretion and
reduction in overall pepsin production.
D. are effective only with long-term use.
E. none of the above
196. H2 receptors are found throughout the body, including
A. in the nasal passages, upper airways, and stomach.
B. in the CNS and upper airways.
C. in the respiratory tract and the heart.
D. * in the heart, CNS, and stomach.
E. In the lungs
197. The H2 receptor blocker of choice for a patient with known liver dysfunction would be
A. cimetidine.
B. famotidine.
C. * nizatidine.
D. ranitidine.
E. None of the above
198. Acid rebound is a condition that occurs when
A. * lowering gastric acid to an alkaline level stimulates the release of gastric acid.
B. raising gastric acid levels causes heartburn.
C. combining protein, calcium, and smoking greatly elevates gastric acid levels.
D. eating citrus fruit neutralizes gastric acid.
E. All of the above
199. Misoprostol (Cytotec) is a prostaglandin that is used to
A. prevent uterine contractions.
B. * prevent NSAID-related gastric ulcers in patients at high risk.
C. decrease hyperacidity with meals.
D. relieve the burning associated with hiatal hernia at night.
E. All of the above
200.
The rate of drug absorption is greatest in:
A. * The small intestine
B. The large intestine
C. The stomach
D. All of the above
E. The small intestine & the large intestine
201.
Which of the following antibiotics is a tetracycline?
A. Chloramphenicol
B. * Doxycycline
C. Streptomycin
D. Erythromycin
E. None of the above
202.
Drug distribution may depend on tissue perfusion:
A.
B.
C.
D.
E.
Highly vascular organs rapidly acquire a drug
Highly vascular organs acquire a drug slowly
Levels of a drug in bone may rise quickly due to its high vascularity
Levels of a drug in bone may rise slowly due to its reduced vascularity
* Highly vascular organs rapidly acquire a drug & levels of a drug in bone may rise slowly due
to its reduced vascularity
203.
Correct statements about glucocorticoids include all of the following, EXCEPT:
A. Effects of glucocorticoids are mediated by widely distributed glucocorticoid receptors that are
members of the superfamily of nuclear receptors.
B. Glucocorticoids have dose-related metabolic effects on carbohydrate, protein, and fat
metabolism.
C. * Glucocorticoids have pro-inflammatory effects.
D. Glucocorticoids have catabolic effects in lymphoid and connective tissue, muscle, fat, and skin.
E. Glucocorticoids have antiallergic effects
204.
A drug allergy occurs:
A. When too much drug has accumulated in an individual
B. * When the body sees the drug as an antigen and an immune response is established against the
drug
C. An unwanted but predictable response to a drug
D. None of the above
E. All of the above
205.
H. pylori is known to be a common cause of both duodenal and gastric ulcers, in a patient
affected by H. pylori, the current regimen of choice is a two week course of triple therapy with
Bismuth, Tetracycline and
A. Loperamide
B. Cimetidine
C. * Metronidazole
D. Pirenzepine
E. Sucralfate
206.
H2 antagonists are markedly safe drugs and relatively have a low incidence of side-effects.
The most common side-effects being diarrrhoea, confusion and headaches and excitement in
elderly patients, but one has weak anti-androgenic effects that can result in gynecomastia and
impotence. What drug is this
A. * Cimetidine
B. Despramine
C. Famotidine
D. Nizatidine
E. Ranitidine
207.
An inexpensive H2 antagonist known to interfere with a wide variety of drugs metabolized by
multiple forms of P-450
A. * Cimetidine
B. Famotidine
C. Nizatidine
D. Ranitidine
E. Loratadine
208.
What additional agent, in addition to a H2 antagonist and PPI, could help treat oesophagitis by
coating necrotic tissue with a protective barrier and thereby promote healing of the ulcer
A. Calcium Carbonate
B. Diphenoxylate
C. Loperamide
D. Pirenzepine
E. * Sucralfate
209.
Metoclopramide exerts its effects on the lower oesophageal sphincter tone and increases the
rate of GI emptying and has anti-emetic effect by serving as
A. Anti-Histamine
B. Cholinergic stimulant
C. Dopamine D2 antagonist
D. GI Irritant
E. * Cholinergic stimulant & Dopamine D2 antagonist
210. Antibiotic's clearance from the body most likely influenced by severe hepatic disease:
A. Penicillins
B. clindamycin (Cleocin)
C. rifampin (Rimactane)
D. * clindamycin & rifampin
E. None of the above
211.
While H2 antagonists can reduce 24hr acid secretion by 60-70%, a class of drugs can that are
much more effective inhibitors of acid secretion by >90% are
A. Cimetidine
B. Metronidazole
C. Misoprostol
D. * Omeprasol
E. Sucralfate
212. Which of these diseases is associated with chronic diarrhea?
A. Celiac disease
B. Irritable bowel syndrome
C. Diabetes
D. Asthma
E. * Celiac disease & irritable bowel syndrome
213.
Indication for glucocorticoids is:
A. Chronic (Addison’s disease) and acute adrenocortical insufficiency
B. Organ transplants (prevention and treatment of rejection – immunosuppression)
C. Inflammatory conditions of bones and joints (arthritis, bursitis, tenosynovitis).
D. * All of the above
E. None of the above
214.
Diarrhea is defined as ____ or more loose stools per day
A. 1
B. 2
C. * 3
D. All of the above
E. None of the above
215.
Patients with cholera pass stools that resemble _____.
A. * Rice water
B. Stools with blood
C. Anchovy sauce
D. Apple jelly
E. All of the above
216.
The most common complication of diarrhea is _____.
A. Intestinal perforation
B. * Dehydration
C. Septicemia
D. Seizures
E. All of the above
217.
Signs of dehydration are
A. Sunken eyes
B. Excessive thirst
C. Reduced urination
D. * All of the above
E. None of the above
218.
Which of these are signs of anemia?
A. * Pale gums
B. Dark circles under the eyes
C. Bleeding
D. Numbness in hands and feet
E. All of the above
219. To note vitamin which stimulates hemopoesis.
A. Tocoferolum.
B. Ergocalciferolum.
C. * Cyanolocobalaminum.
D. Retinolum.
E. Riboflavin.
220. To name a vitamin drug, which is antagonist of indirect action anticoagulants.
A. * Vitamin К.
B. Tocoferolum.
C. Tiamin.
D. Cyanolocobalaminum.
E. Riboflavin.
221. Which drug is basic for the medical treatment of pernicious megaloblastic anaemia?
A. * Cyanocobalaminum.
B. Folic acid.
C. Fercoven.
D. Coamid.
E. Iron lactase.
222. Cyanocobalamin (vitamin B12) is indicated for the treatment of:
A. Acute lymphocytic leukemia.
B. * Pernicious anemia.
C. Bone marrow suppression.
D. Optic nerve atrophy.
E. All of the above.
223. What drug from the narcotic analgesic group does have the least ulcer action?
A. Butadion.
B. Voltaren.
C. Indometacin.
D. * Meloxicam.
E. Naproxen.
224. In oncologic patient the cellular immunity decreased after the radial therapy. Prescribe the
proper drug.
A. Prodigiosan.
B. Interferon.
C. * Т-aktivin.
D. Betaferon.
E. Reaferon.
225. Immunodepressive action of prednisolon is due to:
A. Activating a synthesis of inhibitors of proteases.
B. Depression of collagen production.
C. * Decreasing of Т-lymphocytes level in the blood, limitation of cytotoxic influence of Тlymphocytes (killers) on В-lymphocytes.
D. Depression of synthesis of mucopolysacharides.
E. Decreasing of activity of plasmin.
226. Nonsteroid anti-inflammatory drugs are effective in case of medical treatment of rheumatism
thanks to their power to depress:
A. * Cyclooxygenase-2.
B. Phospholipase-А2.
C. Cyclooxygenase-1.
D. Adenilatcyclase.
E. Peroxydase.
227. Most nonsteroidal antiinflammatory drugs (NSAIDs) work by:
A. Ameliorating pain perception.
B. Increasing the supply of natural endorphins.
C. Increasing blood flow to painful areas.
D. * Inhibiting prostaglandin production.
E. Stimulate prostaglandin production.
228. The advantage of cyclooxygenase-2 (COX-2) inhibitors over other NSAIDs is that they:
A. Have a longer duration of action.
B. Are less likely to cause hepatic toxicity.
C. * Do not decrease the cytoprotective lining of the stomach.
D. Have a more rapid onset of action.
E. Decrease the cytoprotective lining of the stomach.
229. What agent is used for hemorrhagic diatheses treatment?
A. Vit. A.
B. Vit. C.
C. Vit. E.
D. * Vit. K.
E. Vit. D.
230. What preparation belong to antifibrinolytic?
A. * Acidum aminocapronicum.
B. Pantothenic acid.
C. Proserinum.
D. Acidum salicylicum.
E. Acidum nicotinicum.
231. Examples of autoimmune diseases
A. rheumatoid arthritis
B. insulin-dependent diabetes mellitus
C. systemic lupus erythematosis
D. none of the above
E. * all above
232. Glucocorticoid effects:
A. inhibition of leukotriene production
B. inhibition of prostaglandins
C. increased chemotaxis
D. * inhibition of leukotriene production & inhibition of prostaglandins
E. all of the above
233. Alkylating agent; destroys proliferating lymphoid cells; in low doses -- for effective against
autoimmune disorders including systemic lupus erythematosus
A. azathioprine (Imuran)
B. methotrexate
C. * cyclophosphamide (Cytoxan)
D. antilymphocyte globulin (ALG)
E. all the above
234. Cytotoxic agents with immunosuppressive properties:
A. cyclophosphamide (Cytoxan)
B. vincristine (Oncovin)
C. methotrexate
D. cytarabine (ARA-C)
E. * all the above
235. Structural analog/antimetabolite: cytotoxic immunosuppressive drug:
A. vincristine
B. cyclophosphamide
C. * azathioprine
D. none of the above
E. all of the above
236. Clinical uses of immunosuppressive drugs:
A. organ transplantation
B. hemolytic disease of the newborn
C. autoimmune disorders
D. none of the above
E. * all of the above
237. The following is not true about corticosteroids:
A. have anti-inflammatory activity
B. highly lipophillic
C. decrease the quantity and viscosity of mucus secretions
D. * decrease the synthesis of adrenergic mediators
E. decrease the transcription of genes coding for pro-inflammatory cytokines
238. Which of the following drugs used in the treatment of gout acts by preventing the migration of
granulocytes:
A. Allopurinol
B. Sulfinpyrazone
C. * Colchicine
D. Indomethacin
E. Cyclosporine
239. Etanercept produces its antirheumatic effects by direct
A. Inhibition of cAMP phosphodiesterase in monocytic lineage leukocytes
B. Selective inhibition of COX-2
C. Enhancement of leukotriene synthesis at the expense of prostaglandin synthesis
D. * Reduction of circulating active TNF-alpha levels
E. Inhibition of the production of autoantibodies
240. Status asthmaticus is best described by which of the following statements?
A. Status asthmaticus is well-controlled asthma.
B. * Status asthmaticus is a life-threatening exacerbation of asthma.
C. Status asthmaticus is best treated with inhaled controller medication, such as cromolyn sodium
or a leukotriene modulator.
D. Status asthmaticus always resolves without drug treatment.
E. Status asthmaticus occurs without warning in patients whose asthma symptoms are stable and
well controlled.
241. The standard treatment regimen for asthma is best described by which of the following?
A. Theophylline and exercise
B. Inhaled beta2-adrenoceptor agonists only
C. Inhaled corticosteroids only
D. * A combination of inhaled bronchodilators and inhaled corticosteroids
E. Oral corticosteroids
242. Gastric acid secretion is stimulated by the presence of
A.
B.
C.
D.
E.
* Gastrin and acetylcholine
Histamine and motilin
Norepinephrine and gastrin
Norepinephrine and histamine
Acetylcholine and pepsin
Situational tasks:
1. Ditiline (lystenone) injected to patient before operation and intubation conducted. After operation
2.
3.
4.
5.
6.
and stopping an anesthesia the independent breathing did not resume. Defect of what enzyme at the
patient’s organism does lengthen the duration myorelaxants’ action?
A. * Butirilcholinesterase of blood
B. Succinatedehydrogenase
C. Carboanhydrase
D. N-acetyltransferase
E. К-Nа-АТP–ase
The problem of skeletal muscle contraction exist at child after poliomyelitis. What medicine is
possible to prescribe?
A. * Galantamine hydrobromide
B. Platyphylline
C. Methacine
D. Atropine sulfate
E. Tubacurarine
For the patient with the femur fracture, for reducing of sceletal muscles tension during reposition of
bone, it is necessary to prescribe short acting myorelaxant.
A. * Dithyline
B. Anapriline
C. Tubacurarine
D. Atropine
E. Adrenaline
After operation of reposition of femur fracture when Tubacurarine was used, breathing of patient
did not resume. What is necessary to inject?
A. * Proserine
B. Platyphylline
C. Cyclodole
D. Atropine
E. Acetylcholine
At the patient after the short surgical operation with Dithyline after 30 minutes the depression of
breathing appeared, the tonus of muscles did not renewal. What is necessary to prescribe to this
patient?
A. * Blood transfusion
B. Hemodialysis
C. Hemosorbtion
D. Forced diuresis
E. Peritoneum dialysis
At the patient after the short surgical operation with Dithyline after 30 minutes the depression of
breathing appeared, the tonus of muscles did not renewal. The absence of what enzyme in the blood
serum caused this state?
A. * Butirilcholinesterase
B. Catalase
C. Acetylcholinesterase
D. Glucoso-6-phosphatase
7. The man appeared at the trauma department with diagnosis: fracture of femur with displacement.
8.
9.
10.
11.
12.
For reposition of bone physician used 10 ml of 2 % solution of Dithyline i/v, as a result protracted
apnoe and myorelaxation developed. Deficit of what enzyme caused such pharmacogenetic
enzymepatia?
A. * Pseudocholinesterase
B. Uridindiphosphoglucoronic transferase
C. Glucoso-6-phosphatdehydrogenase
D. Met-hemoglobinreductase
E. N-acetyltransferase
Patient with the acute stomach-ache, vomit, heavy breathing, shortness of breath, delivers in
intensive therapy. At the review of patient - skin moisture, hypersalivation, myosis, bradycardia,
muscular fascilation. From anamnesis it is known, that patient – toxin abuse, used the aerosols to
insects. To which group of agents, the substance that caused poisoning, belong?
A. N-cholinomimetic
B. М-choliniblockers
C. Myorelaxants
D. Ganglion-blockers
E. * Anticholinesterase agents
Patient with the complaints to dizziness, nausea, salivation and spastic stomach-aches was delivered
to the hospital. The diagnosis set: poisoning by the phosphor organic substance. What must be
included to the complex therapy?
A. * Atropine sulfate and Dipirixim
B. Tiosulfate sodium and Bemegridum
C. Tetacin-calcium and Unitiolum
D. Nalorphine hydrochloride and Bemegridum
E. Glucose and Bemegridum
The child by chance drank from the small bottle solution, which its grandmother used for the
medical treatment of glaucoma. It appeared, there was pilocarpinum hydrochloridum. The doctor
prescribed to the child an atropine sulfate. What mechanism lies in the basis of antydote action of
atropine?
A. * Influence on special receptors
B. Co-operation with cellular metabolits
C. Physico-chemical
D. Antienzymic
E. Enzymic
The 6 years old child got in hospital with the acute express symptoms of motive and linguistic
excitation, dryness in mouth, the bad swallowing, hoarse voice. A skin was dry, hot. Pupils were
extended, photophobia, tachycardia. From anamnesis it is known, that child eat some berries of
dark-violet color. Influencing of what toxic substance is cause of poisoning?
A. * Atropine
B. Pirenzepine
C. Pilocarpine
D. Platyphylline
E. Methacine
The patient with severe allergic bronchial asthma has been treated by oral drug during 7 months.
Hypertension, “moon face”, obese trunk, oedema, insomnia occur. What drugs does he used?
A. * Patient used one of orally used glucocorticoids, e.g. prednisolonum.
B. Patient used one of beta-agonists.
C. Patient used cromolynum.
D. Patient used euphyllinum
E. Patient used all above.
13. A 41-year-old man was admitted to the surgical department with the symptoms of acute
14.
15.
16.
17.
18.
19.
20.
pancreatitis: vomiting, diarrhea, bradycardia, hypotention, weakness, dehydration of the organism.
What medicine should be used first of all?
A. Etaperazine
B. No-spa
C. Platyphylline
D. Ephedrine
E. * Contrycal
A patient receiving intravenous cimetidine (Tagamet) for an acute ulcer problem needs to be
monitored for
A. GI upset.
B. gynecomastia.
C. * cardiac arrhythmias.
D. constipation.
E. Disbacteriosis
A nurse taking care of a patient who is receiving a proton pump inhibitor should teach the patient
A. to take the drug after every meal.
B. to chew or crush tablets to increase their absorption.
C. * to swallow tablets or capsules whole.
D. to stop taking the drug after 3 weeks of therapy.
E. to take the drug in the first part of day
Woman (60 years old), that suffers by arthritis of hip joint, took butadion for a long time. After
blood analysis the doctor abolished this drug. What complication did butadion cause?
A. * Agranulocytosis.
B. Anemia.
C. Leukemia.
D. Tromboembolic syndrome.
E. Disturbance of hemocoagulation.
Ms. Jones takes fexofenadine 60 mg twice a day for seasonal allergies. She comes to her physician
with a sinus infection and receives a prescription for erythromycin, a drug known to inhibit
CYP3A4. As a result of this drug interaction, you would expect Ms. Jones to
A. * Exhibit no changes in fexofenadine elimination
B. Exhibit decreased metabolism of erythromycin, with potential toxicity
C. Be at risk for development of torsades de pointes, due to decreased metabolism of fexofenadine
D. Exhibit decreased elimination of fexofenadine without risk of torsades de pointes
E. Exhibit moderate anticholinergic effects commonly seen with fexofenadine
Mr. Smith has severe motion sickness during air travel. He will be flying to Brazil next week, and
you would like to prescribe an antihistamine to prevent motion sickness. Which of the following
would be most effective?
A. Scopolamine
B. * Dimenhydrinate
C. Chlorpheniramine
D. Fexofenadine
E. Tripelennamine
A 36-year-old woman with severe erosive esophagitis is prescribed pantoprazole. One of the most
common adverse side effects of such therapy is which of the following?
A. Vomiting
B. Constipation
C. * Headache
D. Heartburn
E. Paresthesias
While taking a NSAID for arthritis, a 65-year-old man developed a gastric ulcer. He was prescribed
ranitidine for 8 weeks. This drug binds a receptor located where?
A. Nucleus
B. Nucleolus
C. Cytoplasm
D. * Cell membrane
E. Cell wall
21. A 20-year-old woman goes to the emergency department, stating that within the past hour she
ingested “a handful of sleeping pills.” She is still awake. Which of the following drugs can be given
to induce vomiting?
A. Metoclopramide
B. * Ipecac
C. Morphine
D. Promethazine
E. Ondansetron
22. A 17-year-old boy with a history of sulfa allergy is diagnosed with left-side ulcerative colitis after a
3-week history of bloody diarrhea and tenesmus. On examination he is afebrile and has no
abdominal tenderness. The appropriate drug therapy to institute initially is which of the following?
A. Metronidazole
B. Sulfasalazine
C. * Mesalamine
D. Cyclosporine
E. Prednisone