PHARMACOLOGY
51. A patient receiving a class I antiarrhythmic agent on a chronic basis complains of fatigue, low-grade fever, and joint pain suggestive of systemic lupus erythematosus (SLE). The patient is most likely receiving
(a) Lidocaine
(b) Procainamide
(c) Quinidine
(d) Flecainide
(e) Propranolol
52. Which of the following drugs is a class IV antiarrhythmic that is primarily indicated for the treatment of supraventricular tachyarrhythmias?
(a) Lebutilide
(b) Mexiletine
(c) Diltiazem
(d) Quinidine
53. Which of the following agents has a direct effect on the AV mode, delaying calcium-channel depolarization?
(a) Lidocaine
(b) Diltiazem
(c) Bretylium
(d) Quinidine
(e) Lbutilide
54. Which of the following drugs is a class III antiarrhythmic agent that is effective in the acute management of atrial fibrillation or atrial flutter of recent onset?
(a) Bretylium
(b) Lbutilide
(c) Metoprolol
(d) Disopyramide
55. Which of the following groups of symptoms is most often associated with a patient who has right-sided heart failure?
(a) Nocturia, rales, paroxysmal nocturnal dyspnea
(b) Paroxysmal nocturnal dyspnea, pedal edema, jugular venous distention, hepatojugular reflux
(c) Jugular venous distention, hepatojugular reflux, pedal edema, shortness of breath
(d) Hepatojugular reflux, jugular venous Distension, pedal edema, abdominal distention
(e) Paroxysmal nocturnal dyspnea, jugular venous distention, abdominal distention, shortness of breath
56. Which of the following combinations of drugs, when used together, reduce both preload and afterload?
(a) Nitroglycerin and isosorbide dinitrate
(b) Hydralazine and isosorbide dinitrate
(c) Captopril and methyldopa
(d) Prazosin and angiotension II
57. When digoxin is used in a patient with congestive heart failure (CHF), it works by exerting a positive effect on
(a) Stroke volume
(b) Total peripheral resistance
(c) Heart rate
(d) Blood pressure
58. Because of proven beneficial effects on “cardiac remodeling”, these agents are now indicated as first line therapy in CHF patients. Which of the following is representative of this group of drugs?
(a) Hydrochlorothiazide
(b) Enalapril
(c) Furosemide
(d) Carvedilol
(e) Bumetanide
59. For treating the patient with congestive heart failure (CHF), which of the following dosages of dopamine is selected for its positive inotropic effects?
(a) 2.0 mg/kg/min
(b) 5–10 mg/kg/min
(c) 10–20 mg/kg/min
(d) 40 mg/kg/min
60. Milrinone is an example of
(a) Phosphodiesterase I inhibitor
(b) Phosphodiesterase II inhibitor
(c) Phosphodiesterase III inhibitor
(d) Phosphodiesterase IV inhibitor
61. Which of the following terms best describes the antagonism of leukotriene’s bronchoconstrictor effect (mediated at leukotriene receptors) by Terbutaline (acting α adrenoceptors) in a patient with asthma?
(a) Pharmacologic antagonist
(b) Partial agonist
(c) Physiologic antagonist
(d) Chemical antagonist
62. If therapy with multiple drugs causes induction of drug metabolism in your asthma patient, it will
(a) Result in increased smooth endoplasmic reticulum
(b) Result in increased rough endoplasmic reticulum
(c) Result in decreased enzymes in the soluble cytoplasmic fraction
(d) Require 3-4 months to reach completion
63. The Symptoms of allergen-mediated asthma result from which of the following?
(a) Increased release of mediators from mast cells
(b) Increased adrenergic responsiveness of the airways
(c) Increased vascular permeability of bronchial tissue
(d) Decreased calcium influx into the mast cells
64. Which of the following will result from Blockade of H2 receptors?
(a) Decreased camp in cardiac muscle
(b) Increased camp in cardiac muscle
(c) Decreased IP3 in gastric mucosa
(d) Increased IP3 in gastric mucosa
(e) Increased IP3 in smooth muscle
65. Toxicities of H2 antihistamines include which one of the following?
(a) Blurred vision
(b) Diarrhea
(c) Orthostatic hypotension
(d) P450 inhibition
66. A patient undergoing cancer chemotherapy is vomiting frequently. A drug that might help in this situation is
(a) Bromocriptine
(b) Cimetidine
(c) Ketanserin
(d) Ondansetron
67. Which of the following is most useful in the treatment of hyperprolactinemia?
(a) Bromocriptine
(b) Cimetidine
(c) Ergotamine
(d) Ketanserin
68. Drugs that can dilate bronchi during an acute asthmatic attack include all of the following except
(a) Epinephrine
(b) Terbutaline
(c) Nedocromil
(d) Theophyline
69. Which of the following is a nonselective but very potent and efficacious bronchodilator that is not active by the oral route?
(a) Aminophyline
(b) Cromolyn
(c) Epinephrine
(d) Ipratropium
70. Which of the following is a prophylactic agent that appears to stabilize mast cells?
(a) Aminophyline
(b) Cromolyn
(c) Epinephrine
(d) Ipratropium
71. Which of the following is a direct bronchodilator that is most often used in asthma by the oral route?
(a) Aminophyline
(b) Cromolyn
(c) Epinephrine
(d) Ipratropium
72. Acute exacerbations of asthma can be triggered by all of the following except
(a) Bacterial of viral pneumonia
(b) Hypertsensitivity reaction to penicillin
(c) Discontinuation of asthma medication
(d) Hot, dry weather
73. Which of the following has overdose toxicity that includes insomnia, arrhythmias, and convulsions?
(a) Aminophyline
(b) Cromolyn
(c) Epinephrine
(d) Ipratropium
74. Which of the following is a very longacting β2 – selective agonist that is used for asthma prophylaxis?
(a) Aminophyline
(b) Cromolyn
(c) Epinephrine
(d) Salmeterol
75. Which one of the following drugs is most suitable for management of essential tremor in a patient who has pulmonary disease?
(a) Diazepam
(b) Levodopa
(c) Metoprolol
(d) Propranolol
76. Which of the following is most effective in the treatment of peptic ulcer disease?
(a) Bromocriptine
(b) Cimetidine
(c) Ergotamine
(d) Ketanserin
77. Which laxative should not be used to treat acute constipation because of its slow onset of action?
(a) Glycerin
(b) Bisacodyl suppository
(c) Psyllium
(d) Milk of magnesia
78. Which of the following–if given intravenously–will cause increased gastrointestinal motility and diarrhea?
(a) Angiotensin II
(b) Bethanechol
(c) Bradykinin
(d) Renin
79. A peptide that causes increased capillary permeability and edema is
(a) Angiotensin II
(b) Bradykinin
(c) Captopril
(d) Histamine
80. A vasodilator that can be inactivated by proteolytic enzymes is
(a) Angiotensin I
(b) Isoproterenol
(c) Histamine
(d) Vasoactive intestinal peptide
81. Which of the following is released in traumatized tissue, causes pain and edema, and is inactivated by angiotensin converting enzyme?
(a) Angiotensin I
(b) Angiotensin II
(c) Atrial natriuretic peptide
(d) Bradykinin
82. Which of the following is a decapeptide precursor of a vasoconstictor substance?
(a) Angiotensin I
(b) Angiotensin II
(c) Atrial natriuretic peptide
(d) Bradykinin
83. Which is not a risk factor for hyperphosphatemia and death from sodium phosphate enemas when used in children?
(a) Renal insufficiency
(b) Hirschsprung’s disease
(c) Anorectal malformations
(d) Children 6 to 12 years of age
84. Which of the following is the most potent vasodilator discovered to date and is found in high concentration in the thyroid?
(a) Angiotensin I
(b) Angiotensin II
(c) Atrial natriuretic peptide
(d) Calcitonin gene-related peptide
85. Which of the following statements adequately describes bulk-forming laxaties?
(a) Can cause diarrhea if not taken with water
(b) Are derived from polysaccharides and rersemble fiber (bran) in mechanism of action
(c) Onset of action is in 4–8 hours
(d) Produce much more complete evacuation of constipation than stimulant products
86. Which one of the following compounds not a hormone?
(a) Bromocriptine
(b) Somatomedin
(c) Somatotropin
(d) Thyroxine
87. Which one of the following hormones not synthesized in the hypothalamus?
(a) Corticotropin–releasing hormone
(b) Luteinizing hormone
(c) Oxytocin
(d) Thyrotropin–releasing hormone
88. An important difference between leuprolide and the new drug ganirelix is that ganirelix
(a) Can be administered as an oral formulation
(b) Can be used alone to restore fertility to hypogonadal men and women
(c) Immediately reduces gonadotropin secretion
(d) Initially stimulates pituitary production of LH and FSH
89. A 27-year-old woman with amenorrhea, infertility, and galactorrhea was treated with a drug that successful restored ovulation and menstruation. Before being given the drug, the woman was carefully questioned about previous mental health problems, which she did not have. She was advised to take the drug orally. The drug used to treat this patient was probably.
(a) Bromocriptine
(b) Desmopressin
(c) Human gonadotropin hormone
(d) Leuprolide
90. Who is least likely to be treated with somatropin?
(a) A 3-year-old cow on a diary farm
(b) A 4-year-old girl with an XO genetic genotype
(c) A 4-year-old boy with chronic renal failure and growth deficiency
(d) A 10-year-old boy with polydipsia and polyuria
91. Hormones that are useful in the diagnosis of endocrine insufficiency include
(a) Corticotropin-releasing hormone
(b) Cosyntropin
(c) Gonadotropin–releasing hormone
(d) All of the above
92. All of the following substances are endogenous topic hormones secreted by the pituitary gland except
(a) Somatotropin
(b) Human chorionic gonadotropin (HCG)
(c) Follicle-stimulating hormone (FSH)
(d) Thyroid-stimulating hormone (TSH)
93. Which of the following drugs is least likely to be used as part of a controlled ovarian hyperstimulation protocol?
(a) Human chorionic gonadotropin
(b) Leuprolide
(c) Menotropins
(d) Pergolide
94. Actions of thyroxine do not include
(a) Acceleration of cardiac rate
(b) Decreased glomerular filtration rate
(c) Fine tremor of skeletal muscles
(d) Increased appetite
95. Effects of iodide salts given in large doses do not include
(a) Decreased size of the thyroid gland
(b) Decreased vascularity of the thyroid gland
(c) Decreased hormone release
(d) Increased 131I uptake
96. Current criteria used in the diagnosis of diabetes mellitus (DM) include all of the following symptoms except
(a) Fasting hyperglycemia
(b) Polyuria
(c) Polydipsia
(d) Tinnitus
97. The most useful glucose test used in monitoring diabetes mellitus (DM) therapy is
(a) Urine monitoring
(b) Blood monitoring
(c) Renal function monitoring
(d) Cardiovascular monitoring
98. Which of the following statements concerning insulin replacement therapy is most accurate?
(a) Most commercial insulin products vary little with respect to time, course, and duration of hypoglycemic activity
(b) Regular insulins cannot be mixed with NPH (isophane insulin suspension)
(c) Regular insulin cannot be given intravenously
(d) Counting or regulating carbohydrate consumption is a necessity for all diabetic patients
99. A mass of adipose tissue that develops at the injection site is usually due to the patients neglect in rotating the insulin injection site. This is known as
(a) Lipoatrophy
(b) Hypertrophic degenerative adiposity
(c) Lipohypertrophy
(d) Atrophic skin lesion
100. Sulfonylureas are a primary mode of therapy in the treatment of
(a) Insulin–dependent (type 1) diabetes mellitus (DDM) patients
(b) Diabetic patients experiencing severe hepatic or renal dysfunction
(c) Diabetic pregnant women
(d) Non-insulin-dependent (type 2) DM patients
