PHARMACOLOGY
1. â-Aminoethylimidazole is?
(a) 2-methyl histamine
(b) Histamine
(c) 2-pyridyl ethylamine
(d) 4-methyl histamine
2. Agents that often cause vasoconstriction include all of the following except
(a) Angiotensin II
(b) Methysergide
(c) PGF2α
(d) Prostacyclin
3. Inflammation is a complex tissue reaction that includes the release of cytokines, leukotrienes, prostaglandins, and peptides. Prostaglandins involved in inflammatory processes are produced from arachidonic acid by
(a) Cyclooxygenase 1
(b) Cyclooxygenase 2
(c) Glutathione – S – transferase
(d) Lipoxygenase
4. A 60-year-old woman has glaucoma following cataract surgery. Which of the following can be used to reduce intraocular pressure?
(a) Leukotriene LTD4 or its analogs
(b) Prostaglandin E2 or its analogs
(c) Prostaglandin F2α or its analogs
(d) Slow-reacting substance of anaplylaxis (SRS-A)
5. Which of the following is a reversible inhibitor of platelet cyclooxygenase?
(a) Alprostadil
(b) Aspirin
(c) Ibuprofen
(d) LTC4
6. Vasodilation by prostaglandins involves
(a) Arterioles
(b) Precapillary sphincters
(c) Postcapillary venules
(d) All of the above
7. Fentanyl transdermal patches have been used postoperatively to provide transdermal analgesia. The most dangerous adverse effect of this mode of administration is
(a) Cutaneous reactions
(b) Diarrhea
(c) Hypertension
(d) Relaxation of skeletal muscle
8. Opioid analgesics are either contraindicated or must be used with extreme caution in several clinical situations. For morphine, such situations do not include
(a) Aqueous diffusion
(b) Aqueous hydrolysis
(c) Lipid diffusion
(d) Special carrier transport
9. Following is an example of paraaminophenol NSAID
(a) Diclofenac
(b) Acetaminophen
(c) Piroxicam
(d) Celecoxib
10. This drug, which does not activate opioid receptors, has been proposed as a maintenance drug in treatment programs for opioid addicts; a singly oral dose will block the effects of injected heroin for up to 48 hours
(a) Amphetamine
(b) Buprenorphine
(c) Naloxone
(d) Naltrexone
11. Relationship between arterial blood pressure (BP), cardiac outpur (CO) and peripheral vascular resistance (PVR) can be described as
(a) BP = COxPVR
(b) BP = CO/PVR
(c) BP = PVR/CO
(d) None of the above
12. If a fibrinolytic drug is used for treatment of acute myocardial infarction, the adverse drug effect that is most likely to occur is
(a) Acute renal failure
(b) Development of antiplatelet antibodies
(c) Encephalitis secondary to liver dysfunction
(d) Hemorrhagic stroke
13. Increased serum levels of which of the following may be associated with a decreased risk of atherosclerosis?
(a) Very low-density lipoproteins (VLDL)
(b) Low-density lipoproteins (LDL)
(c) Intermediate – density lipoproteins (IDL)
(d) High-density lipoproteins (HDL)
14. If the patient has a history of gout, which of the following drugs is most likely to exacerbate this condition?
(a) Colestipol
(b) Gemfibrozil
(c) Lovastatin
(d) Niacin
15. After being counselled about lifestyle and dietary changes, the patient was started on atorvastatin. During his treatment with atorvastatin, it is important to routinely monitor serum concentrations of
(a) Blood urea nitrogen (BUN)
(b) Alanine and aspartate aminotransferase
(c) Platelets
(d) Red blood cells
16. Six months after beginning atorvastatin, the patient’s total and LDL cholesterol concentrations remained above normal and he continued to have anginal attacks despite good adherence to his antianginal medications. His physician decided for niacin. The major recognized mechanism of action of niacin is
(a) Decreased lipid synthesis in adipose tissue
(b) Decreased oxidation of lipids in endothelial cells
(c) Decreased secretion of VLDL by the liver
(d) Increased endocytosis of HDL by the liver
17. Following drugs act on imidazoline receptor
(a) Moxonidine
(b) Dexmedetomidine
(c) Tizanidine
(d) All of the above
18. Which one of the following drugs increase digoxin plasma concentration by a pharmacokinetic mechanism?
(a) Captopril
(b) Hydrochorothiazide
(c) Lidocaine
(d) Quinidine
19. A 55-year-old patient currently receiving other drugs for another condition is to be started on diuretic therapy for mild heart failure. Thiazides are known to reduce the excretion of
(a) Diazepam
(b) Fluoxetine
(c) Imipramine
(d) Lithium
20. A hypertensive patient has been using nifedipine for some time without untoward effects. If he experiences a rapidly developing enhancement of the antihypertensive effect of the drug, it is probably due to
(a) Concomitant use of antacids
(b) Foods containing tyramine
(c) Grapefruit juice
(d) Induction of drug metabolism
21. A drug lacking vasodilator properties that is useful in angina is
(a) Isosorbide dinitrate
(b) Metoprolol
(c) NIfedipine
(d) Nitroglycerin
22. Aldosterone release is stimulated by
(a) Angiotensin I
(b) Angiotensin
(c) Angiotensin III
(d) Both (b) and (c)
23. Which one of the following drugs is used in the treatment of male impotence and activates prostaglandin E1 receptors?
(a) Alprostadil
(b) Fluoxetine
(c) Mifepristone
(d) Sildenafil
24. A treatment of angina that consistently decreases the heart rate and can prevent vasospastic angina attacks is
(a) Isosorbide dinitrate
(b) Nifedipine
(c) Nitroglycerin
(d) Verapamil
25. In a patient receiving digoxin for congestive heart failure, condition that may facilitate the appearance of toxicity include
(a) Hyperkalemia
(b) Hypernatremia
(c) Hypocalcemia
(d) Hypomagnesemia
(e) All of the above
26. Activation of endothelin receptor ETA, leads to
(a) Vasoconstriction
(b) Bronchoconstriction
(c) Aldosterone release
(d) All of the above
27. Methylxanthine drugs such as aminophylline cause which one of the following?
(a) Vasoconstriction in many vascular beds
(b) Decrease in the amount of cAMP in mast cells
(c) Bronchodilation
(d) Activation of the enzyme phosphodiesterase
28. Drugs used in asthma that often cause tachycardia and tremor include
(a) Beclomethasone
(b) Cromolyn sodium
(c) Ipratropium
(d) Metaproterenol
29. Following potassium sparing diuretic inhibits action of aldosterone
(a) Amiloride
(b) Triamterene
(c) Spironolactone
(d) All of the above
30. In patients with chronic granulomatous disease which of the following agents increases the synthesis of tumor necrosis factor, leading to activation of phagocytosis?
(a) Aldesleukin
(b) Cyclosporine
(c) Filgrastim
(d) Interferon gamma
31. The mechanism of action of cyclosporine involves
(a) Activation of calcineurin
(b) Binding to cyclophilin to cause inhibition of a cytoplasmic phosphatase
(c) Blockade of interleukin – 2- receptors
(d) Inhibition of phospholipase A2
32. Which one of the following drugs predictably prolongs the PR interval and increases cardiac contractility?
(a) Digoxin
(b) Lidocaine
(c) Propranolol
(d) Quinidine
33. Which of the following is the drug of choice for management of cardiac arrhythmias that occur in digitalis toxicity?
(a) Amiodarone
(b) Lidocaine
(c) Propranolol
(d) Sotalol
34. A 54-year-old woman with severe hypercholesterolemia is to be treated with a combination of niacin and atorvastatin. With this drug combination, it is important that the patient be monitored closely for signs of
(a) Agranulocytosis
(b) Gallstones
(c) Lactic acidosis
(d) Myopathy
35. Regarding verapamil, which one of the following statements is false?
(a) Angina pectoris is an important indication for the use of verapamil
(b) Contraindicated in the asthmatic patient
(c) Relaxes vascular smooth muscle
(d) Slows the depolarization phase of the action potential in AV nodal cells
36. What drug is used to prevent embolism in the lung and during myocardial infarction?
(a) Alteplase
(b) Human growth hormone
(c) Granulocyte–macrophage colony stimulating factor (GM–CSF)
(d) EPOGEN (EPO)
37. Which of the following cardiovascular agents is classified chemically as a glycoside?
(a) Nifedipine
(b) Digoxin
(c) Flecainide
(d) Cholestyramine
(e) Warfarin
38. Inhibition of carbonic anhydrase results in
(a) Abolition of NaHCO3 reabsorption in proximal tubule
(b) Enhanced of NaHCO3 reabsorption in proximal tubule
(c) Enhanced NAHCO3 secretion in distal tubule
(d) None of the above
39. Which of the following cyclotron produced radiopharmaceuticals is used for assessing regional myocardial perfusion as part of an exercise stress test?
(a) Thallous chloride 201TI USP
(b) Sodium iodide 123I
(c) Gallium citrate 67Ga USP
(d) Indium 111In pentetate
40. Mary has a family history of heart disease and wonders if garlic would be beneficial to her. Which of the following statements is correct about garlic?
(a) Enteric-coated tablets release their contents in the stomach
(b) Side effects include heartburn, flatulence, and sweating
(c) The safety of garlic in pregnancy is unknown
(d) Garlic does not interact with warfarin
41. Exertion–induced angina, which is relieved by rest, nitroglycerin, or both, is referred to as
(a) Prinzmetal’s angina
(b) Unstable angina
(c) Classic angina
(d) Variant angina
42. Myocardial oxygen demand is increased by all of the following factors except
(a) Exercise
(b) Smoking
(c) Cold temperatures
(d) Propranolol
43. Which of the following agents used in prinzmetal’s angina has spasmolytic actions, which increase coronary blood supply?
(a) Nitroglycerin
(b) Nifedipine
(c) Timolol
(d) Isosorbide mononitrate
44. The oral absorption of following osmotic diuretic is negligible
(a) Glycerin (b) Mannitol
(c) Isosorbide (d) All of the above
45. Maximal medical therapy for treating angina pectoris is represented by which of the following choices?
(a) Diltiazem, verapamil, nitroglycerin
(b) Atenolol, isoproterenol, diltiazem
(c) Verapamil, nifedipine, propranolol
(d) Isosorbide, atenolol, diltiazem
46. The term ischemic heart disease (IHD) is used to designate all of the following conditions except
(a) Angina pectoris
(b) Sudden cardiac death
(c) Congestive heart failure (CHF)
(d) Arrhythmias
47. Which of the following thrombolytic agents would be appropriate at this time?
(a) Anisoylated plasminogen streptokinase activator complex (APSAC)
(b) Streptokinase (SK)
(c) Recombinant tissue-type plasminogen activator (t-PA)
(d) All above
48. Strong anticholinergic effects limit the antiarrhythmic use of
(a) Quinidine
(b) Procainamide
(c) Tocainide
(d) Disopyramide
49. Following loop diuretic is a phynoxy acetic acid derivative
(a) Furosemide
(b) Bumetanide
(c) Ethacrynic acid
(d) All of the above
50. Following potassium sparing diuretic is a mineralocorticoid receptor antagonist
(a) Amiloride
(b) Triamterene
(c) Spironolactone
(d) All of the above
Answers
