Pharmacology MCQs: July 2 nd
1.
Regarding histamine
a.
b.
c.
d.
e.
2.
Histamine
a.
b.
c.
d.
e.
3.
d.
e.
Cisapride
Sucralfate
Metaclopromide
Bethanechol
Neostigmine
Regarding drugs which act on the colon
a.
b.
c.
d.
e.
7.
They can be used to treat systemic mastocytosis
They are capable of >90% reduction in gastric acid secretion after a single dose
Up to 20% of ulcers may fail to heal with 4 weeks of conventional H2 antagonist/antacid
treatment
Cimetidine may cause reversible gynaecomastia and confusional states as side effects
All of the above are true
Agents promoting GI motility (i.e are prokinetic) include all of the following EXCEPT
a.
b.
c.
d.
e.
6.
Diphenhydramine
Cyproheptadine
Pyrilamine
Loratadine
Promethazine
Regarding H2 antagonists
a.
b.
c.
5.
Causes increased BP via potent vasoconstricting effects
Stimulates gastric acid secretion
Is produced by bacteria in ciguatera fish causing GI upset and cvascular effects
Has insignificant effects on nerve endings
All of the above are correct
All of the following H1 antagonists may cause moderate- marked sedation EXCEPT
a.
b.
c.
d.
e.
4.
H1 receptors occur in cardiac muscle
H2 receptor blockers include promethazine
Adrenaline is a physiologic antagonist of histamine
Histamine works on bronchiolar smooth muscle to bronchodilate it
Brain H3 receptors are predominantly postsynaptic
Lactulose is a stimulant laxative
Diphenoxylate is a weak analogue of fentanyl
Loperamide is safe for use in patients with diarrhoea from ulcerative colitis
Senna has a delayed onset of action
Kaolin is an adsorbent and is more effective in treatment of diarrhoea than loperamide or
diphenoxylate
All of the following drugs / diseases cause prolonged QT interval / potentially lethal ventricular
arrhythmias when combined with astemizole EXCEPT
a.
b.
c.
d.
e.
Rifampicin
Patients with liver disease
Ketoconazole
Erythromycin
Itraconazole
8.
H2 antagonists
a.
b.
c.
d.
e.
9.
Irreversibly compete with histamine at H2 receptor sites
Also bind to H1 receptors
Famotidine inhibits the cytochrome P450 system
Ranitidine may increase bioavailability of ethanol by >40% in normal individuals
Ranitidine is 7 times more potent than famotidine in treatment of duodenal ulcers
Cimetidine may increase the pharmacologic effect of all of the following EXCEPT
a.
b.
c.
d.
e.
Lignocaine
Ketoconazole
Warfarin
Phenytoin
Barbiturates
10. Regarding drugs affecting serotonin
a.
b.
c.
d.
e.
Sumatriptan is a serotonin antagonist
Buspirone is a 5HT1a agonist
Cyproheptadine is a competitive serotonin blocker in doses of 120 to 160 mg/day
Ketanserin blocks 5HT receptors and B receptors
Ondansetron is a 5 HT 2 antagonist
11. Regarding the ergot alkaloids
a.
b.
c.
d.
e.
Bromocriptine has profound effects on uterine smooth muscle stimulation
Methysergide is a peptide alkaloid
Ergotamine constricts most human blood vessels and is short acting
PCP is an ergot alkaloid
Ergotism may be defined as a spectrum of hallucinations, convulsions and “fiery limb pains”
12. All of the following drugs stimulate renin release EXCEPT
a.
b.
c.
d.
e.
Clonidine
Nitroprusside
Isoproterenol
Alpha antagonists
Thiazides
13. All of the following vasoconstrict EXCEPT
a.
b.
c.
d.
e.
Vasopressin
Ergotamine
Angiotensin 2
Substance P
Endothelin
14. Regarding NSAIDs
a.
b.
c.
d.
e.
Aspirin reversibly acetylates and blocks platelet cyclo oxygenase
Piroxicam has the shortest half life of all the NSAIDS
Serious haematological problems have occurred with indomethacin use
Ibuprofen is excreted predominantly unchanged in the urine
Naproxen = selective COX 2 inhibitor
15. Methyxanthines (theophylline)
a.
b.
c.
d.
e.
Have negative chronotropic/inotropic effects
Have antidiuretic effects
Inhibit the enzyme phosphodiesterase at high concentrations
Theophylline has less selective smooth muscle effects compared with caffeine
Have no effect on skeletal muscle
16. All of the following pairings are correct EXCEPT
a.
b.
c.
d.
e.
PGE1 = vasodilation
PGE2 = relaxes gut longitudinal muscle
PGF 2 alpha = bronchoconstricts
PGF2alpha = oxytocic actions
PGI 2 = inhibits platelet aggregation
17. PGE 1 has all of the following effects EXCEPT
a.
b.
c.
d.
e.
Maintains patent ductus in some congenital heart disease
Contracts intestinal smooth muscle
Vasodilates
Inhibits platelet aggregation
Decreases water and sodium excretion by the kidney
18. Regarding drugs used to treat asthma
a.
b.
c.
d.
e.
Antimuscarinic agents are much more potent than B2 agonists in reversing asthmatic
bronchospasm
Salmeterol has a duration of action of 4 – 6 hours
Isoproterenol is a potent bronchodilator but may cause cardiac arrhythmias
Cromolyn sodium is an excellent agent for treatment of an acute asthma attack
Aminophylline contains 66 % theophylline by weight
Answers Pharm 2nd July
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
C
B
D
E
B
D
A
D
E
B
E
A
D
C
C
B
E
C
Physiology MCQs: July 2 nd
Respiratory
1.
Regarding the lung
a.
b.
c.
d.
e.
2.
All of the following pairings are correct (assuming normal person at rest) EXCEPT
a.
b.
c.
d.
e.
3.
Metabolic alkalosis
Respiratory alkalosis with partial renal compensation
Metabolic acidosis
Respiratory acidosis
Mixed respiratory/metabolic alkalosis
All of the following states decrease lung compliance EXCEPT
a.
b.
c.
d.
e.
7.
Decreased pH
Increased temperature
Carbon monoxide
Increased 2.3 DPG
Increased pCO2
This blood gas picture reveals which of the following?
PH = 7.52, pCO2 = 20 mmHg, pO2 = 120 mmHg, bicarb = 16 mmol/l
a.
b.
c.
d.
e.
6.
Bradykinin
Serotonin
Noradrenaline
Angiotensin 1
Vasopressin
All of the following shift the oxygen dissociation curve to the right EXCEPT
a.
b.
c.
d.
e.
5.
Tidal volume = 500 ml
Alveolar ventilation = 7500 ml
Pulmonary blood flow = 5000 ml/min
Functional residual capacity = volume of gas in lung after normal expiration
Physiologic dead space = 150 ml
Which of the following substances is activated by passage through the pulmonary circulation?
a.
b.
c.
d.
e.
4.
There are about 300 million alveoli in the human lung
The terminal bronchioles are the smallest airways without alveoli
Anatomic dead space = 150 ml
Alveoli are about 0.3 mm in diameter
All of the above are true
Lung fibrosis
Increased pulmonary venous pressure
Long period of time where the lung is unventilated
Emphysema
Alveolar oedema
Regarding airway resistance
a.
b.
c.
d.
e.
The Poiseulle equation denotes pressure volume characteristics for turbulent flow
The very small bronchioles are the major site of resistance to airflow
Decreased pCO2 in alveolar gas causes an increase in airway resistance
As lung volume reduces, airway resistance reduces also
Contraction of bronchial smooth muscle by stimulation of adrenergic receptors increases
airway resistance
8.
Regarding control of ventilation
a.
b.
c.
d.
e.
9.
The apneustic centre lies in the medulla
The central chemoreceptors respond to changes in oxygen concentrations
The chemoreceptors in the aortic bodies respond to a fall in arterial pH
Peripheral chemoreceptors respond to decreases in arterial pO2
The most important factor in control of ventilation under normal conditions is the pO2 of the
arterial blood
Alveolar ventilation in a male with a respiratory rate of 10/min and tidal volume of 600 ml is
a.
b.
c.
d.
e.
1000ml
1750 ml
3000ml
4500ml
6000ml
10. At high altitudes all of the following things occur in an effort to acclimatise EXCEPT
a.
b.
c.
d.
e.
Hypoventilation
Polycythaemia
Increased numbers of capillaries per unit volume in peripheral tissues
O2 dissociation curve shifts to right
Pulmonary vasoconstriction
11. With respect to regional gas exchange in the upright lung
a.
b.
c.
d.
e.
Ventilation is greater at the top of the lungs
Perfusion is much greater at the top of the lungs compared with the bases
Ventilation/perfusion ratio is abnormally high at the top of the lungs
PO2 is highest at the bases of the lungs
PH is highest at the bases of the lungs
12. Regarding ventilation
a.
b.
c.
d.
e.
Normal FEV1 is 70% of FVC
FEV1 is decreased much more than FVC in patients with lung fibrosis
FEV1 is dependent on expiratory effort
FVC in an average healthy person is about 3100 ml
FEV1 is about 42% of FVC in a patient with obstructive lung disease
13. You are up very high where barometric pressure is 447 mmHg. What is the partial pressure of
oxygen in the air up there?
a.
b.
c.
d.
e.
0.5 mmHg
40 mmHg
80 mmHg
120 mmHg
150 mmHg
14. Regarding oxygen transport
a.
b.
c.
d.
e.
The predominant way oxygen is transported in the blood is as dissolved oxygen
1 gram of pure Hb can combine with 1.34 - 1.39 ml of oxygen
An anaemic patient has a lowered arterial pO2 because the Hb is low
CO2 is 200 times more soluble than oxygen
The CO2 dissociation curve is less steep than that of oxygen
Answers: Physiology July 2nd
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
E
B
D
C
B
D
C
D
D
A
C
E
C
B