Evaluating Questions

Canada Evaluation Examination Test Page 1 of 200
1.
Which cant be a type of pharmacy ownership:
a. Franchise
b. Limited company
c. Leasehold
d. Partnership
e. Ownership
C
2.
Pharmacy brand franchised by the pharmacist: (Jul-2006)
Used banner contains the brand of the mother company (Sign board)
3.
4PS marketing plan all true EXCEPT: (Jul-2006)
a. Product
b. Place
c. Promotion
d. Price
e. Personal
E
4.
Intellectual property , privacy data from clinical: (Jul-2006)
a. Data of patient to be paid to another
b. Prescription involved to a third party
All??
5.
Medication dispensing error increased by all EXCEPT: (Jul-2006)
a. Decreased Number of pharmacy Tec
b. Decreased interruption of pharmacist
B
6.
Prior authorization of drug which not covered by insurance, the pharmacist
should: (Jul-2006)
Approve from the insurance before dispensing
7.
Rules regulating of pharmacies in Canada by:
Territory authorities
8.
P.O.S. (Jul-2006) Point of sales
P.S.O. Pharmacy sales only
9.
Pharmacist counseling to patient is: (Jul-2006)
a. Humanistic
b. Prescription cost
c. Customer satisfaction
A
10.
Visual Merchandising is: (Jul-2006)
Visual Selling
11.
Medication label must contain: (Jul-2006)
Drug identification number (DIN)
12.
What is IDA:
Reference book for formulation
13.
A supervisor of pharmacy demand regular seeing of the pharmacist and his
assistant:
This is appraisal form
14.
A manager of the pharmacy wrote a paper for requirements for a position in his
pharmacy, the job and the person to title the job is called: (Jul-2006)
a. Job description
b. Job delegation
A
15.
A patient went to an emergency clinic at night and came with a prescription in
which the signature is not obvious, the pharmacist should:
a. Call the emergency clinic to ask for the physician name
b. Ask the patient about the name of the physician
c. Use the name of the family doctor
A+B
16.
Who must be referred to the physician:
a. If the blood pressure is 160/100
b. If the blood pressure is 160/100 using the patients instrument
c. If the blood pressure is 160/100 using the pharmacist instrument
All
17.
Tofranil is prescribed by:
Control book
18.
Nitrazipam is classified as:
Registration prescription
19.
Pharmacoeconomics: (Jul-2006)
a. Determines the introductory price of the drug
b. Determines the drugs required to be introduced in the market
c. Related the cost to efficacy (cost effective analysis)
C
20.
Hospitals has its own formulary to:
Tell the doctors about drugs of best benefit when compared to cost
21.
When the pharmacist distribute work according to the abilities and responsibilities
this is called:
Delegation
22.
Authorization:
The responsibility of the pharmacist who handle this authority
23.
Validation means:
To prove that a system does what it purposes to
24.
Pharmacist can do all the following EXCEPT:
Verify the diagnosis

25.
Vicarious liabilities of the pharmacist :
An innocent master may be held responsible for the harm caused to a third person
by the torsion acts of his servants while they are acting within the scope of their
employment.
HE WHO ACTS THROUGH ANOTHER ACTS HIMSELF
26.
Diabetic patient want to treat himself by adjusting diet and exercise. He is on
Metformin medication. Pharmacist advice him by all EXCEPT:
To make a plane with him to decrease the drug gradually
27.
Case take Rosiglitazone & Metformin come to the pharmacy ask about new
medicine instead of the regimen. The pharmacist role is all EXCEPT: (Jul-2006)
Discuss with the patient the improvement in using the new medicine
28.
Pharmacist Change penicillin to amoxicillin: (Jul-2006)
a. Therapeutic substitution
b. Generic substitution
c. Cost substitution
A
29.
A seven years old girl, takes bactericin for treatment of impetigo pharmacist
should counsel her mother by:
a. Bactericin is an antibacterial
b. It should not be taken orally
c. Impetigo is common in her age
d. Wash with soap and water
B+C
A pustular inflammatory disease of the skin, highly contagious, seen often in infants
and young children
30.
Who decides the prices of OTC products in the pharmacy:
The pharmacy
31.
Pricing of the product under control of: (Jul-2006)
a. Territory
b. Province
c. Canada health
C
32.
Patient on hormone replacement therapy (Estrogen) then stopped: (Jul-2006)
Should follow pharmacist advice
33.
Pharmacist dispense medicine for all patient together:
a. Paternalism
b. Autonomy
c. Loyalty to patient
??
34.
Definition of pharmaceutical care: (Jul-2006)
a. Effective use of health care recourses
b. +ve customer outcomes
c. Access pharmaceutical care
B
35.
Pharmacist goes to the physician for a new drug with: (Jul-2006)
a. Internet paper
b. Magazine Time
c. Yahoo
d. Good man & Gillman
e. Coshan Library
A
36.
Who is responsible for drug pricing in Canada:
a. Health care department
b. Medical drug pricing review
c. Provincial department & drug department
d. Pharmacy that sell the drug
C
37.
A pharmaceutical company wants to record its inventory of a new drug or
molecule, it presents for a:
a. Logo
b. Copyright
c. Trade mark
d. Brand name
e. Print
D
38.
When a pharmacist thinks about opening a new pharmacy he thinks about:
a. Traffic
b. Demographic location
c. Hardware store competition
A+B
39.
In case of pharmacist make a mistake, the court will:
Send licensing body to accord a report
40.
Director who puts certain rules and expects his subordinates to follow him
without exception is:
a. Autocratic
b. Perocrautic
c. Consultant
A
41.
A man comes to your pharmacy having the prescription of his friend, pharmacist
should:
a. call the patient to know if he has allergies
b. call the patients doctor to know if he has allergies
c. ask the patient next time about allergies he has
A+B
42.
Patient that you know had a minor operation & the doctor gave him codeine and
it finished. He came for more, what would you do:
a. Tell him to go to a walk-in clinic & ask for prescription
b. Give him codeine

c. Give him something which is not controlled with same effect

A
43.
When dispensing a drug to a patient which of the following is used in counseling
information:
- Labeling (written information)
- Verbal information
44.
When the pharmacist does not inform the patient of a brand change, this is
against the ethical principal of:
Veracity
45.
The ethical principle of veracity requires that:
a. We respect the rights of others to make choices
b. We act with honesty, without deception.
c. We avoid, remove or prevent harm.

d. We do good to patients.
e. We act with fairness.
B
46.
MT, a pharmacy technician, has worked in a community pharmacy for 5 years. He
is well-trained and welcomes new learning opportunities. His manager, now
wanting to delegate a new technical project to him, should:
I discuss suggested steps to accomplish the project.
II negotiate a time schedule for completion of the project.
III provide support and follow-up as required.
a. I only
b. III only
c. I and II only
d. II and III only
e. I, II and III
E
47.
Due to culture difference you knew that you cant talk to a woman about a
sensitive issue that she has a UTI, what will you do: (Jul-2006)
a. Take her in a private room and explain to her
b. Ask your colleague pharmacist to explain to her
c. Let a female pharmacist to talk to her if applicable

d. Ask her husband for permission and explain to both of them together
C+D
48.
Financial statement of the total income minus expenses:
Net income
49.
Cost = ..
End inventory =
Sales through year= ..
Then turnover rate = sales/largest inventory
50.
Type one error:
False +ve (the data show difference but actually no difference is present)
51.
Type II error:
False ve (The data show no difference but actually difference is present)
52.
What is the acceptable rate of prescription turn over:
a. 5
b. 1.5
c. 0.5
d. 2.5
A
53.
Vitamins are:
Organic cpd (not organic and inorganic) that act as co-enzyme in metabolic process
54.
Which is true for vitamin deficiency:
Vitamin A Night blindness + Keratinization
Vitamin E some deficiency anemia in neonates
Vitamin D Rickets
Vitamin K Hemorrhage
Water soluble= Vit B Fat soluble
B1= Thiamine B6= Pyridoxine A D E K
B2= Riboflavin B12= Cyanocobolamine
B3= Nicotinic acid, Niacin B1=CHO, B3=Protein, B5=FA, B6=AA
55.
Megavitamin therapy:
Excessive intake of multivitamin to overcome deficiency of daily requirements
56.
Thiamine (B1) deficiency cause:
a. Beriberi
b. Nerve degeneration
A In those who eat large quantities of polished rice, wheat & alcohol
Symptoms include weakness, neuritis, and in severe cases, mental disturbance and
heart failure. It can be cured by giving large doses of vitamin B.
B1 Daily requirement: [Adult = > 0.6-4.5 mg / Children = > 0.4mg] oral, IM, SC
Occurs naturally in: Liver + Yeast
B2 (Riboflavin):
- Acts as H carrier w plays an imp role in energy metabolism
+
- Absorbed from upper GIT

Deficiency:
1) Cracks in the corner of the mouth (Cheilosis)
2) Glossitis
3) Photophobia
4) Keratitis (as Vit A)
5) Toxicity of embryo in pregnant
Daily requirements: [Adult = > 1 mg / Children = > 0.6mg] oral, IM, SC

Never given alone always in combination with other B complex
57.
Niacin causes flushing, so:
a. Change to niacin amide
b. Take a course of ASA before starting niacin

c. Start niacin in low doses then increase gradually
All
58.
Nicotinic acid can cause LDL so:
a. Shift to nicotinamide
b. Take aspirin before taking nicotinic acid
c. Begin with lower doses nicotinic acid then increase dosage
A
59.
Nicotinic acid is: LDL TC TG
a. Pyrimidine ring
b. Pyridine ring
c. Pteridine ring
B
B3 (Niacin, Nicotinic acid, Nicotinamide):

Nicotinic acid Nicotinamide
- Acts as H+ carrier coenzyme for protein metabolism & production of ATP
Side effects:
1) Vasodilatation flushing (so use nicotinamide instead)
2) Hyperuricemia (CI in gout)
3) Dose > 3gm/day cholesterol (nicotinamide has no effect)
4) glucose
Deficiency: Pellagra [Rash + Mental confusion + Photophobia + GIT irritation +
Weakness + Schizophrenia (subclinical pellagra)]
Pellagra = ddd (dermatitis + diarrhea + dementia)
Daily requirements: [Adult = > 6 mg / Children = >4 mg]

{60 mg Tryptophan (essential amino acid) = 1 mg nicotinic acid}
B6 (Pyridoxine):
Co-enzyme in amino acid metabolism

-
Essential for production of GABA in brain
-
Deficiency:
1) Convulsions 2) Dermatitis
3) Neuritis 4) Iron deficiency anemia
Drug interaction that lead to B6:
1) Oral contraceptive + Pregnancy deplete B6 so B6 must be supplied
2) Hydralazine, INH & Penicillamine metabolism of Tryptophan B6
L-dopa + B6 stimulate dopa-decarboxylase L-dopa (so CI in Parkinsonism)
60.
The most thermolabile factor in Vit B complex is:
a. Riboflavin
b. Biotin
c. Thiamine
d.Folic acid
e.Niacin
C
61.
Vitamin B12:
a. needs intrinsic factor for its absorption
b. it is important in prescription to treat Megaloblastic anemia
c. its increase causes nausea and circulatory collapse
A+B
62.
Achlorohydria (decrease HCL) accompanied with: (Jul-2006)
a. Folic acid
b. Vit B12
c. Niacin
d. Thiamine
B
63.
Genetic Anemia: (Jul-2006)
Thalassemia
64.
Megaloblastic anemia is due to deficiency of:
Vit B12 and Folic acid
65.
Test for Pernicious anemia:
Schilling test
- Take oral Vit B12 labeled with Co57 or Co58:
If appears in feces due to deficiency of intrinsic factor
in urine due to deficiency if Vit B12 (because its absorbed)
B12 (Cyanocobolamine):
1) Imp for maintenance of Myelin sheath deficiency cause neuritis
2) Imp for production of Epithelial cell + Normal growth + Nutrition of GIT
mucosa, tongue & vagina
3) Need intrinsic factor for its absorption
- Mainly stored in organ meat (liver 1ml liver extract = 10 mg B12
Deficiency deficiency of folic acid Megaloblastic anemia

RBCs = Large size Platelets = giant
WBCs = Poly-segmented nucleus Bone marrow = large RBCs
Pernicious anemia (Addisons anemia):

- Due to deficiency of intrinsic factor no absorption of Vit B12
- Leads to: 1) Atrophy Peripheral + Gastric mucosal
2) Glossitis 3) Achlorohydria ( HCl secretion)
66.
TTT of Pernicious anemia:
Vit B12 (if we give folic acid it will mask it) IM or SC (oral =no value no intrinsic)
67.
TTT of Megaloblastic anemia:
Vit B12 + folic acid
68.
Parietal cells responsible for: (intrinsic factor)
a. Absorption of iron
b. Absorption of vitamin B12
c. Secretion of HCl
All
69.
Intrinsic Factor is secreted from: (Jul-2006)
- parietal cells of stomach responsible of absorption of Vit B12 (extrinsic factor)
- Deficiency of intrinsic factor leads to Pernicious anemia
The intrinsic Factor:

* It is a gastric secretion (glycoprotein in nature) formed in parietal cells of stomach
* It is essential for Vit B12 absorption
*** So drug of choice for Pernicious anemia is Vit B12 IM or SC
*** Dont use folic acid mask the signs of pernicious anemia
Folic Acid (Vit B8)

- Present in Yeast & liver
- Daily dose = 50 g
- Essential for: Synthesis of Purine & Pyrimidine nucleotides
- Deficiency Megaloblastic Hematopoiesis (formation of blood)
- Mask the symptoms of pernicious anemia but not prevent progression or signs
of neurological symptoms
Pantothenic acid (B5) Choline Biotin (B7)

Panthenol
Converted to Co-A Synthesized in the body Synthesized by bacterial
enzyme = essential for from Methionine floral or taken with food
- synthesis of Acetyl Co-A essential for synthesis of 1) Involved in some fatty
- fatty acid metabolism Phosphatidyl choline acid synthesis &
Used: involved in: carboxylation reactions
1) local to heal wounds 1) Lipid transport 2) Large amount of egg
2) IM motility (post- 2) Acetyl choline synthesis white cause its deficiency
operative paralytic ileus)
70.
In iron deficiency anemia, all are correct EXCEPT:
a. Female are more than males
b. Oral iron is better than parenteral
c. Oral iron is same like parenteral

B
71.
In iron deficiency anemia, which is true:
a. Almost microcytic hypochromic anemia are with iron deficiency anemia
b. Iron is present in all preparations used for megaloblastic anemia TTT
c. Use the parenteral besides oral to treat iron deficiency

A+C
With regard to iron deficiency:

72.
Women are more susceptible to anemia (microcytic) more than men
73.
Best dose for iron deficiency:
- 6 months TTT with 300 mg/day imferon IM black stool
- continue therapy after remission for 6-12 months
Imferon = iron (ferric hydroxide Fe2O3) + dextran
74.
Microcytic anemia is treated by:
Iron preparation
75.
Iron salts, which is true:
a. Used in megaloblastic anemia
b. Require intrinsic factor
c. High dose cause liver collapse

C b+c????
76.
Ferrous conversion (Ferric to Ferrous) occurs by:
- Gastric acid (Fe3+ Fe2+)
- Ascorbic acid is given along
- Not take antacid
77.
Which of the following gives false +ve result for Coombs test:
Vitamin C + methyl dopa
(A test upon the blood to detect the presence of Rh antibodies agglutination of
sheep RBCs) (Also called Antiglobulin test AGT)
78.
Which of the following can inhibit iron salts absorption:
Antacid so it is advisable to take iron 1 hour before antacid
79.
Haemochromatosis:
Excessive storage of iron by the parenchymal tissue tissue damage
80.
Vitamin used for collagen synthesis:
Vit C
81.
Low Vit C inhibit absorption of:
Fe salts (it is a reducing agent maintain iron in Ferrous Fe2+ form that is
absorbable + form a soluble absorbable chelate with Ferric Fe3+ form)
Vit C:
-Present in Green vegetables + Citrus fruits
-Present in women > men
- Imp: 1) in red-ox reactions 2) collagen 3) Antioxidant met-hemoglobinemia
4) antidote for alcohol overdose (activates alc dehydrogenase enz)
- Gives false +ve glucose in urine (Clinitest) w depends on reducing CuSO4
by glucose
Deficiency Scurvy disease
1) Gum bleeding 2) lesions in teeth, bones & blood vessels
- Toxicity: 1) UTI stone formation 2) Diarrhea
3) Ingestion of 10 gm/day followed by sudden withdrawal Frank symptoms of
Scurvy (appears in newborns when their mothers ingest large amounts of Vit C
& stop suddenly)
Dose: Adult = > 150 mg/day Children = 20 mg/day
82.
Vit which when decreases causes dry hair and skin:
Vit A
83.
Retinol is prepared from:
a. carotene
b.Retinoic acid
c. Thiamine
A
84.
carotene is the precursor of:
Retinol
85.
Conversion of carotene to Vit A is carried out in:
a. Liver
b. Pancreas
c. Spleen
d. Thymus
e. Adrenal cortex
A
86.
Keratolytic:
a. Retinoic acid
b. Retinol
c. Vitamin C
A+B
87.
Vitamin A derivative used in treatment of acne:
Retinoic acid (13-Trans retinoic acid = topically, Cis-retinoic = orally)
88.
Acne female should be treated with: (Jul-2006)
a. Tetracycline
b. Cyproterone (Diane)
c. Isotritenoin
All
89.
Vit A derivative is used as exfoliating agent:
Retinoic acid
Uses of Vit A:
1) Psoriasis 2) Acne 3) Night Blindness (Nyctalopia)
4) Ichllyrosis (skin pigmentation = dark area on skin)
Deficiency:
1] Nyctalopia 2] Loss of appetite
3] Keratinization of epithelial cells (cornea) + all mucous membrane infection
of epithelial cells
- Vit A Do NOT cross placenta
- Zinc 8-9 mg/day is essential for: 1) Maintenance of Vit A in plasma

2) Mobilization of Vit A from the liver
- Vit E + Vit A absorption & tissue storage of Vit A
Toxicity of Vit A:
1) Children: Hyperostosis (bone hypertrophy = size)
2) Peeling of skin 3) Nystagmus 4) Headache
5) Lymph node enlargement
- Daily dose: Adults = 3000 IU Children = 1300-2600 IU

(1 IU = 0.3 mcg Retinol = 0.6 mcg carotene)
- Any drug containing Vit A should NOT exceed:

In adults= 1600 - 10,000 in children= not less than 1000 IU
(In any Rx never exceed 10,000 IU)
90.
Acne is treated with:
a. Fucidic acid
b. Penicillin
c. Tetracycline
C
Minocycline long acting tetracycline used resistant staph. infections
Doxycycline & Minocycline low renal clearance < tetracycline not used in UTI
91.
Which vitamin is classified as hormone:
Vit D3 (cholecalcefirol) it resembles parathormone in that they both Ca2+ in blood
92.
What is the importance of vitamin D:
Regulation of Ca & P level in blood
93.
Vitamin D used in renal bile:
Alfacalcidol
94.
Which stimulate the release of Calcitonin:
a. Hypercalcemia
b. Increase Vit D conc
c. Hypocalcaemia
B
Calcitonin (secreted from thyroid gland)= hypocalcemic hormone parathormone
95.
Which is NOT true about Vitamin D3 metabolism:
a. Vitamin C facilitates absorption of Vitamin D3 in liver
b. Hydroxylation at C25 occurs in liver ( 25-hydroxyl)
c. Hydroxylation at C25 occurs in kidney ( 1,25-dihydroxy)
d. Parathyroid hormone activate metabolism of vitamin D3 in the kidney
e. Skin activates synthesis of vitamin D3 by sunlight
C
96.
Hypercalcemia occur due to all EXCEPT:
a. Increase in sunlight
b. Increase Vit D
c. Granuloma
C
97.
Hypercalcemia occur due to all EXCEPT:
a. Hypervitaminosis D3
b. Tumors
c. Pagets disease
d. Granulomatous disease
e. Chronic diarrhea with inflammatory bowel
E d+e??
98.
Vitamin used in breast feeding baby:
a. A
b. D
c. K
d. E
e. B2
B
Vit D3:
-is completely absorbed from GIT
- Absorption depends on (Hepatic + Biliary functions)
- Drugs that HME Vit D3 (due to elimination)
Actions: Parathormone like actions
1) GIT absorption of Ca
2) tubular reabsorption of Ca
3) mobilization of Ca from bones into blood
Deficiency: due to exposure to sunlight (UV) + dietary deficiency
Children Rickets Adults Osteomalacia (soft bones) + Hypoparathyrodism
Toxicity:
1) Hypercalcemia
2) Myocardial infarction
3) Digitalis toxicity
4) Deposition of Ca in soft tissue (Kidney stone)
5) Mental retardation
6) Diarrhea
Dose: 400 IU = 10 mcg Calcefirol (1 IU Vit D3 = 0.025 mcg Vit D2)
Uses: 1) Hypoparathyrodism 2) Rickets
Lasix CI with Vit D3 deficiency & hypocalcaemia because it Ca
99.
Tocopherol is:
Vitamin E (antioxidant in oily solutions)
Sodium bisulphite (as Vit C, EDTA= aqueous)

100.
Antioxidant (reducing agent)
101.
-lipoid acid is:
a. Analgesic
b. Anti-tumor
c. Antioxidant
d. Antihyperglycemic
C
102.
Which one of the following is not antioxidant:
a. Ascorbic acid
b. Sodium bisulphate
c. EDTA
d. Tocopherol
e. Sodium benzoate
E = preservative
103.
Which is antioxidant:
a. Tocopherol
b. Benzalkonium chloride
c. Methyl cellulose
A
104.
Aqueous antioxidant includes:
a. Sodium bisulphite
b. Ascorbic acid
c. EDTA
d. All of the above
D
105.
Non-aqueous antioxidant includes
Vitamin E
Monothioglycerol is used as:

106.
Antioxidant in parenteral procaine/Penicillin G
Mercapturic acid result from reaction with:

107.
Glutathione
Which enzyme protects the cell from damage: (Jul-2006)

108.
Glutathione
109.
Which is useful for cell integrity:
- Glutathione
- Vitamin E
110.
Glutathione tri-peptide consists of: (Jul-2006)
a. Glutamate
b. Aspartate
c. Glycine
d. Cytosine
A+C+D
Vit E:
- Present naturally in Green vegetables + eggs + meat
- Uses= 1) Absorption of Vit A 2) Antioxidant in oily solutions
- Its carried in plasma by -lipoproteins
- Safe in large dose
- Daily requirement: 5-10 IU
- Incompatible with minerals as Fe & Ca
Deficiency:
1) Male sterility
2) Habitual abortion in females
3) Deficiency anemia
4) Muscular dystrophy
111.
Smoke cessants are:
a. Naloxone
b. Nitroderm
c. Zyban
d. Rigitine
C +D
112.
Smokers suffer from deficiency of:
113.
Smoking cessation is potentiated with: (Jul-2006)
a. Vit E
b. Vit D
c. Vit C
C
XX chromosome deficiency (syndrome) is found (diagnosed) in:

114.
Bar Body (found in mouth cavity in Female only)
XXY= Kleinfelter ( develop of the seminiferous tubules in testis)

XO= Turner syndrome
Downs syndrome:
Mongolism (extra chromosome)
Acromegaly:
Secretion of pituitary gland abnormal shape of bones of face, skull, hands & feet
Adams-Stokes disease:
Slowed heart action causing sudden heart block, associated with attacks of fainting
and convulsions
Albrights disease:
Fibrous dyplasia (abnormal growth) of bones & cartilage
Cooleys disease: (anemia)

Defect in the production of Hb due to hereditary erythroplastic anemia.
(Undevelopment of the body, enlarged spleen, jaundice and destruction of RBCs)
Menieres disease:
Tinnitus, dizziness and vertigo due to upset in Na metabolism Removal of salt from
the diet sometimes relieves the symptoms
Raymonds disease: (affect women>men)

Chronic constriction and spasm of the blood vessels in the fingers, toes, tip of the
nose white + cold. It occasionally leads to gangrene of the affected part.
Stein Leventhial syndrome:

Secretion of androgens from the ovary
Hives = urticaria
Nystagmus = involuntary rapid movement of eye ball (horizontal, vertical or mixed)

Hyperhydrosis = sweating
Hyperkinesia = movement
Hyperthesia = sensitivity to stimulation Hypothesia
Myclomus = muscle twitching
Myositis = inflammation of voluntary skeletal muscles (SE of statins)
Phlebitis = inflammation of veins
Spondylitis = inflammation of vertebra
Dysphoria = restlessness
115.
XX chromosome syndrome means:
It is an excess X if XXY Kleinfelter syndrome in men
If XX Female fetus
116.
Cochlea disturbance causes all EXCEPT:
a. Vertigo
b. Tinnitus
c. Involuntary movement
d. Nystagmus (Rapid Eye movement)
C
117.
Glossitis is:
Inflammation of tongue (glossa = tongue)
118.
Blephritis is:
Inflammation of the eye lid
119.
Peyronie's disease:
Reported with Metoprolol = penis becomes painful when erected
A fibrous inflammation of the shaft of the penis resulting in a deformity (a bend) of
the organ
120.
What is pannus:
a. Liquid and semisolid accumulation under the skin
b. Glandular accumulation under the skin
c. Synovial proliferation
C
A layer of vascular fibrous tissue extending over the surface of a specialized structure e.g. the
cornea; the condition of having such a layer
The growth of tiny blood vessels and other tissue in the cornea of the eye, thus
obscuring vision
What is the Crohns disease:

121.
Regional enteritis (inflammation of intestinal tract by infection of the irritating food)
An ulcerative condition of the small and large bowel, characterized by areas of

granulomas along with the ulcers; also known as 'granulomatous enterocolitis. The
disease is to be distinguished from ulcerative colitis, which is strictly limited to the
large bowel.
What is Brights disease:

122.
Glomerulonephritis (Inflammation of the kidneys, or chronic nephritis)
123.
Hypothyroidism is due to:
a.
Hashimotos disease
b.
Treatment by I131
c.
Graves disease
A+B
124.
Which is related to hypothyroidism:
a. Cushing syndrome ( cortisone)
b. Addison disease ( cortisone)
c. Graves disease ( thyroxin)
d. Myasthenia gravis ( Ach)
e. Myxodema (Hypothyroidism)
E = Gulls disease = 1) dry skin 2) wt gain 3) loss of hair
4) body temp 5) slow body function +
slow pulse
125.
Graves disease is:
- Hyperthyroidism
- And is treated by: Thiouracil - Methimazole
126.
anti-thyroid hormone drug treat: (Jul-2006)
a. Graves
b. Cretinism (Hypothyroidism)
A
All is accompanied with edema EXCEPT:

127.
Hyperthyroidism
128.
Suspects of hyperthyroidism what test should he ask for:
a. T4 in urine
b. TSH
A
129.
Thiouracil is used in:
TTT of Graves disease (hyperthyroidism)
By:
- Inhibiting de-iodination of T4 to T3
- Inhibit de-ionization of T4
It is used for:
Heart rate, fatigue and nervousness
130.
Methimazole mechanism of action:
- Inhibit I oxidation to I
- +
- Inhibit I incorporation into tyrosyl residue (conversion of T 4T3)

+
131.
Hyperparathyroidism:
Stimulation of osteoblasts
a.
Stimulation of osteocytes
b.
c. Stimulation of chromocytes
A
Parathyroid Ca in blood (from bones) PO4 in blood
132.
Bone remodeling by: (Jul-2006)
a. Osteoblast
b. Osteoclast
B
Calcitonin action:
133.
Regulates Ca2+ in blood due to hyper-parathyroidisim in Pagets disease
Calcitonin used to treat:

134.
Pagets disease = parathyroid calcitonin leading to Ca2+ in blood

Secreted from thyroid gland
135.
Secretion of Ca from parathyroid in case of renal failure is in:
a. Distal tubule
b. Loop of Henle
c. Proximal tubules
A
136.
Secretion of calcium from parathyroid in case of kidney failure is in:
a. Glomerulus
b. Distal tubule
c. Renal tubule
C? B?
137.
Alendronate is:
a. Biphosphanate
b. Prevent the formation and dissociation of hydroxy apatite
c. Used in osteoporosis, Pagets disease
All
138.
Osteoporosis aggravated by or (occurs due to):
- Corticosteroid
- Menopause
139.
Osteoporosis is aggravated by deficiency of: (Jul-2006)
a. Estrogen
b. Antiandrogen
c. Cortisone
A
Estraderm is used for:

140.
TTT osteoporosis
141.
Osteoporosis may be due to:
a. Decrease androgens
b. Chronic corticosteroid use
c. Decrease of estrogen
B+C
142.
Risk factors for Osteoporosis:
I. Smoking
II. Menopause
III. No exercise
All
Lead toxicity leads to:

143.
Microcytic hypochromic anemia (also Iron deficiency)
Loss of teeth and grayish mouth indicates:

144.
Lead toxicity
145.
Ancrode:
a. Its a snake venom
b. It inhibits aggregation of platelets
c. It is a heparin agonist
d. Inhibits fibrinogen
e. Can replace heparin in its anticoagulation effect
All
146.
Factor that usually increase with arthrosclerosis:
a. Tryptophan
b. Histidine = precursor of histamine
c. Homocysteine
d. Phenol alanine
e. Tyrosine
C
Arthrosclerosis:
Abnormal thickening and hardening of the walls of arteries
Atherosclerosis:
A form of arteriosclerosis characterized by the deposition of fatty material in the
lining of the arteries
147.
In HPLC:
a. The stationary phase is non polar
b. The mobile phase is polar
c. Material to be extracted is very polar
A+B
148.
Reversed phase HPLC:
a. Mobile phase is non polar
b. Stationary phase is non polar
c. Substance to be separated is very polar
A
Advantage of HPLC :
149.
Analyze drug and its metabolites

150.
Reversed phase HPLC:
a. Use of a mobile phase reversed to normal one
b. polarity of mobile phase will retention time
c. surface area by particle size will not affect resolution
A+B
151.
Which detector can NOT be used in HPLC:
a. Flame ionization
b. Mass spectrometer
c. Electrochemical
All
In HPLC particle size affects:

152.
Resolution
153.
Which is not in HPLC:
a. Gas carrier
b. Mobile phase
c. Inline filter
A+C Also septum inlet system
The separation in HPLC means:

154.
The separation of one analytic from other in substance mixture
155.
Which does not affect resolution in HPLC:
a. Column height
b. Mobile phase
c. Stationary phase
d. Recorder
D
156.
Which is not component of HPLC:
- XOD5 column
- Inline filter
- Septum inlet system
- Flame ionization, mass spectrometer, electrochemical detector
157.
In flame ionization:
a. Gas carrier should be He or N2
b. The gas carrier do not ionized
c. The gas exposed ionized

B+C
In TLC which is used as spraying agent for Amphetamine:

158.
Ether
Primary amine is revealed in TLC with:

159.
Sulphuric acid and alcohol
160.
Mechanism of TLC (Thin Layer Chromatography) depends on:
Capillary theory (organic solvent elution) silica gel (Stationary phase)
161.
In TLC: (Thin layer chromatography) (Jul-2006)
a. Organic phase is moving, silica gel is stationary
b. Organic phase is stationary, silica gel is moving
c. Water phase is moving
d. Water phase is stationary
A
162.
To increase separation in Gel chromatography:
a. Increase area
b. Remove impurities
All
163.
Gel chromatography affected by: (Jul-2006)
a. Molecular weight
b. Diffusablility
B
164.
In paper chromatography cellulose fibers have:
a. High affinity for water (non organic solvent)
b. Low affinity to organic solvent
c. Low affinity to water
A+B Also: (solute is in paper phase)
In gel chromatography, resolution depends on:

165.
Particle size
Determination of alcohol in blood by:

166.
Gas chromatography
167.
Gas chromatography:
a. use a derivative of substance which is volatile at high temp
b. gases used are not for ionization of substances
c. effluent gas can pass through flame ionization detector
All
168.
What role play cellulose in paper chromatography:
It retains the water (polar solvent)
169.
In paper chromatography:
a. Water has affinity for cellulose
b. Organic phase has affinity for cellulose
A
Silica gel chromatography depends on:

170.
Partition coefficient between solvent and silica gel
Mass spectrum used in:

171.
GLC detectors (Gas Liquid Chromatography)
172.
Stationary phase for GLC:
Poly dimethyl cellosan PDMC (Polydimethyl siloxane)
Detector Mass spectrum
Gel chromatography:
173.
Large molecules are eluted while small one are retained
174.
M+ Molecular ion is detected by:
a. Colorimetry
b. Spectrometry
c. Spectrophotometry
B
The base peak in mass spectroscopy indicates:

175.
Peak of solvent = peak of solute
Molecular ion (M+) in mass spectrum which is true:

176.
More abundance in mass spectrum

More technological aspects FAB
Amorphous form is:

177.
More absorbed than crystalline form
178.
Polymorphism:
E.g. Theobroma oil: Exist in several crystalline forms each with a different m.p.
179.
Which dont have crystal lattice:
a. solution
b. amorphous solid
c. crystal
A+B
Co-precipitation results from addition of solute very quickly while:

180.
Cooling
181.
Slow addition of precipitant together with vigorous stirring of the hot solution
during addition:
a. Induces the formation of fine easily filterable particles
b. Induces the formation of coarse easily filterable particles
c. Induces the formation of fine difficultly filterable particles
d. Induces the formation of coarse difficultly filterable particles
e. None of the above
E
182.
In gravimetric assay, pH is adjusted to:
a. Complete precipitation
b. Get fine filterable particle
c. Prevent unwanted precipitants
d. Favorable pH for precipitation
A+C
The purpose of assay:

Put a chemical reaction to form an insoluble subs which is then filtered off, pH is
adjusted to:
- Ensure that the ppt is in higher form of purity

- Ensure the specificity of the assay
- Ensure that certain potential impurities remain in soln.
Advantages of Fluorometric assay over Spectrophotometric:

1. Extremely sensitive of quantitative cpds
2. 200 times more sensitive > absorption Spectrophotometry
3. Widely used in quantitative assay of Vit B
4. Spectrophotometry is not good to assay small quantities of drug
contaminants bcz amount injected is very small contaminants < 3%
are not detected
Flame photometer: measure ions quantitatively

Na Yellow flame Ca Brick red
K Purple Ba Green Pb Blue
Nuclear Magnetic Radiation (NMR):
- Used for identification of chemical substance
- Based on the fact that Different molecular arrangement have
Different magnetic spin characteristics
Refractometric method of analysis:
- Depends on Density difference between 2 substances
Nephlometry:
Based on Reflection of light used for suspensions
Colorimetry:
Measurement of absolute light at a given wave length
183.
Aminophylline causes:
a. Diuresis
b. Ascites
A
184.
Bioequivalent drugs in Canada should have:
a. Same color, physical appearance
b. Same dose in the same dosage form
c. Same rate and extent of absorption
C
185.
Which cant be crushed as thus will change its bioavailability:
a. osmotic coated tablets
b. chewable tablets
c. sugar coated tab
A+C
Collyrium means:
186.
Eye wash
187.
Bioavailability of ophthalmic preparations can be increased by:
a. Substrate to increase viscosity
b. Sticking agent (polymer)
c. Increasing the volume of inserted drug
A
Bioavailability in ophthalmic soln:

188.
Near zero 1-5%
Rate limiting step in ophthalmic: (Jul-2006)

189.
Cornea
190.
Which is correct in ophthalmic solution:
a. Parabens are not used in ophthalmic
b. Polyvinyl alcohol in ophthalmic preparation to viscosity
All
Sterilization of an ophthalmic solution in a community pharmacy by:

191.
0.22 m filter
192.
The pore size of the bacterial filters are:
a. 50 nm
b. 500 nm
c. Non of the above
C = 0.22 nm
193.
Hydroxypropyl cellulose:
Increase contact time ( viscosity) in ophthalmic prep
194.
Which is used in elongation of the time in eye products:
Polyvinyl alcohol (liquifilm)
195.
Ophthalmic solution must be:
Isotonic
196.
A patient referred to the ophthalmologist if he suffers from:
a. Red eye
b. Pain
c. Blurred vision
B+C
197.
All are true in ophthalmic solution EXCEPT:
a. Low and mild buffer capacity
b. Acid pH
c. Should be isotonic
d. Has antimicrobial preservative
B
Eye could not accommodate more than:

198.
0.3 nm of eye drop
Ophthalmic drops:
199.
0.01-0.02 ml, tear = 0.007 ml
Benzalkonium chloride is used in ophthalmic preparations as:

200.
Preservative In nasal drops to adjust pH to reduce irritation

Antimicrobial preservative is effective if resterilize the soln in less than 1 hr
Combination of Benzalkonium + EDTA effective most m.o. including

pseudomonas resistant to Benzalkonium alone
Benzalkonium chloride becomes inactive in the presence of:

201.
Soap (Na stearate)
Stye (Hordeolum):
202.
Staphylococcus eye disease = an abscess or boil on the eyelid
203.
Which is most lipophylic barrier in eye:
a. Eye lids
b. Conjunctiva
c. Aqueous humor
d. Cornea
D
204.
Xalatan (Latanoprast) side effects:
a. Pigmentation (make eye more brough)
b. Increase thickening in eye lasher, darkening and lengthening
A
205.
Carbachol and Bethanecol (K type) = choline esters:
a. Bethanecol have an extra methyl
b. Both are carbamate esters
c. Carbachol have an extra methyl
A+B
206.
Eye drops with : Red cap Mydriasis , Green cap miosis
Eye pupil Parasympathetic = miosis Sympathetic = mydriasis
207.
In which of the following tissues is the action of ACH is NOT described as
nicotinic:
Circular muscle of iris
90% of all cases of glaucoma are:

208.
Wide angle due to closure of canal of Shlem
Which is not given in narrow angle glaucoma (closed angle):

209.
- Adrenaline
- Guanethidine
- Antazoline
- Phenyl ephrine
- Homatropine + cyclopentolate
Cause mydriasis blindness
Closed angle glaucoma (narrow angle) = IOP due to block of pupilary
Wide angle (open angle) = due to closure of canal of Shlem
Adrenaline is contraindicated with:

210.
Narrow angle glaucoma as it causes mydriasis & may cause blindness

May be used in open angle production of aqueous humor & drainage
211.
Drug of choice for narrow angle glaucoma:
a. Physostigmine (eserine) + Pilocarpine miosis
b. Carbachol (0.5-1% E.D.) ACH ester (replacement to Pilocarpine resistant)
c. Demecarium (reversible cholinesterase inhibitor)
d. Homatropine (drv of atropine)
A+B + Phospholine iodide (ethothiophate) cholinesterase inhibitor
+ Timolol (B-blocker) production of Aq humor
Pilocarpine when instilled into eye causes:

212.
Miosis
IOP by contraction of sphincter muscle drainage of aqueous humor
Atropine (miotic effect starts = 15-30 min, IOP = 2-4 hrs)
Ocusert = drug delivery system (special located reservoir of Pilocarpine) chronic
open angle glaucoma
213.
Advantages of Timolol maleate over Pilocarpine in glaucoma:
1. IOP by production of Aq humor Pilocarpine contraction of sphincter
muscle drainage
2. Duration = 24 hrs Pilocarpine 4-8 hrs
3. No effect on vision Pilocarpine miosis
What is the effect of b-blocker on the intraocular pressure:

214.
Decrease ( IOP)
215.
Loss of power of ciliarys muscle in eye: (Jul-2006)
a. Glaucoma
b. Cycloplegia
B
216.
Atropine sulphate + Methyl paraben + Benzalkonium chloride is:
a. Ophthalmic solution
b. Ophthalmic suspension
A
Used to remove protein from contact lens:

217.
Papain (mixture of proteolytic enzymes obtained from the unripe fruit and latex of
the pawpaw)
Preservative for contact lens solution:

218.
Thiomersal
SAA in contact lenses:

219.
Wetting of solid prevent dryness
220.
Which is used in otic solutions to increase its bioavailability: (Jul-2006)
a. Ethyl alcohol
b. Glycerol
c. Methyl alcohol
B
Glycerol is used as: (Jul-2006)

221.
Humectant + organic solvent for internal use
222.
Which form prevents bioavailability problem:
a.Uncoated tablet
b.Enteric coated tablet
c.Suspension
B
223.
Parts of drug show better bioavailability based on:
a. Ionization
b. pKa
c. Favorable pH
d. Dissolution
D
224.
Which usually comes with Azotemia: (Jul-2006)
a. BUN
b. Protein urea
c. Creatinine
A+C
Uremia (poisoning secondary to disease or poor function of the kidneys) NH3
225.
Glycosilated Hb is used to:
Diagnose Diabetes mellitus
226.
Diabetes Type I: (Jul-2006)
a. Insulin Dependant
b. Take frequent meals
c. Supposed to ketoacidosis
All
Ketoacidosis is determined by all EXCEPT:

227.
Lactic acid
228.
In juvenile diabetes all are true EXCEPT:
a. Genetic & hereditary factors
b. Ketoacidosis
c. Absolute insulin deficiency
d. Obese
D
229.
Cause ketoacidosis: (Jul-2006)
a. Type I diabetes
b. Starvation (fasting)
c. Hyper-insulinemia
A+B
Acarbose mechanism of action: (Jul-2006)

230.
Glucose absorption from GIT
231.
Glimepiride mechanism of action: (Jul-2006)
Sulphonyl urea
232.
In case of Ketoacidosis, which is found in urine:
a. Ketone bodies (acetoacetate) (acetone B-hydroxy butyric acid)
b. Glucose
c. Acetone excreted via lung
A+B
233.
Acidosis is caused by:
- Methyl alcohol
- Acetazolamide
- Starvation
- Juvenile Diabetes
234.
Metabolic acidosis can be detected by:
- CO2
- HCO3
When HCO3 pH = metabolic alkalosis

When HCO3 pH = metabolic acidosis
When CO2 pH = respiratory acidosis
When CO2 pH = respiratory alkalosis
Regulation of the body pH (Regulation of acidosis):

1) immediate local adjust by the buffers in body fluid
2) Kidney + Lung deposition of acid (H+)
235.
Metabolic acidosis cause all EXCEPT:
Diuretic
236.
Alkalosis is detected by:
a. pCO2
b. pO2
c. pCO2
d. pO2
C+D {CO2 is acidic}
Patient with diabetic coma and ketoacidosis come to the hospital, he can be
237.
treated by:
Crystalline Zn Insulin IV
238.
Metformin is contraindicated with:
- Alcohol (lactic acidosis)
- Cimetidine (DI)
239.
Which antihypertensive is used for diabetic:
a. Prazosin
b. Atenolol
c. Captopril
d. Diuretic
A + C
240.
Which cause hypoglycemia includes all EXCEPT: (Jul-2006)
a. Sulphonylurea
b. Insulin
c. Biguanides
C (Metformin) glucose absorption from GIT
Which is not hypoglycemic:

241.
Metformin
242.
Which antidiabetic agent cant be used with patient predisposed to lactic acidosis:
a. Glybride
b. Metformin
c. Tolbutamide
d. Chlorpropamide
B
Tolbutamide is:
243.
Sulphonyl urea, oral hypoglycemic
Chlorpropamide is not used (contraindicated) with (long acting antidiabetic)

244.
Ethanol, Why?
- Ethanol has hypoglycemic effect
- Chlorpropamide has {Disulfuran} like effect inhibit {alcohol
dehydrogenase} enz responsible for metabolism of acetaldehyde
accumulation of acetaldehyde
Mechanism of action of Rosiglitazone:

245.
Tissue response to insulin (insulin sensitizer) SE = liver damage
246.
Mechanism of action of sulfonylurea:
1.
Increase insulin secretion from pancreas
2.
increase insulin sensitivity in cells
3.
increase insulin binding to receptors
4.
decrease glycogen formation
Mechanism of action of insulin:

1. utilization of glucose by peripheral tissue
2. storage of glucose glycogen in liver + skeletal muscle
3. its = Anabolic protein synthesis
4. fat catabolism + lipogenesis ( obesity)
5. gluconeogenesis (conversion of amino acid glucose)
Complication of insulin:
1. Hypoglycemia due to high dose
TTT: sugar by mouth / Glucose IV / Glucagon IM
2. Allergy desensitization must be done in this case by giving small doses
of insulin then it gradually till reach therapeutic level
Oral Hypoglycemic
Sulphonyl urea Biguanides Others
1. Chlorpropamide Metformin 1. Acarbose (Glucobay)
2. Tolbutamide 2. Thiazolidinediones:
3. Gliclazide (Diamicron) a. Pioglitazone (Actos)
4. Glibenclamide (Daonil) b. Rosiglitazone (Avandia)
5. Glimepiride (Amaryl)
6. Glipizide (Minidiab)
7. Gliquidone
Insulin Onset Duration

Crystalline Zn (soluble=clear=
1. Fast only insulin can be taken IV) 0.5-1 hr 6-8 hrs
Diabetic ketoacidosis
2. Intermediate Isophane (NPH, lent) 2 hrs 18-24 hrs
3. Long Protamine Zn (ultra lent) 7 hrs 28-36 hrs
247.
A patient with juvenile diabetes should:
- Have insulin therapy
- Eat according to caloric diet
248.
Why insulin is injected subcutaneously:
To avoid tissue damage
Closed vial of regular insulin can be used until labeled expiry date, if the vial:
249.
Refrigerated 2-80C not more than 24 months
250.
What is the rate limiting step in absorption of insulin from subcutaneous
injection:
a. Passive diffusion into the blood vessel
b. Active diffusion into the blood vessel
A
251.
Long acting insulin:
Ultra lent (Protamine)
252.
Gauge number of syringe refer to:
a. External diameter of needle
b. Volume in the needle
c. Bevel size
d. Total length of the syringe
e. Size of needle
A
Insulin pump is used to:

253.
Supply insulin during night
254.
Long term monitor of DM is by:
a. HbA1C
b. Ketonuria
c. Glycemia
d. Glucosuria
A
255.
Monitor Diabetes compliance with:
a. Glucosuria
b. HbA1C
c. Glycemia
All
256.
We increase the dose of insulin in:
a. Stress
b. Surgery
c. Infection
d. Pregnancy
All
257.
Human insulin can stay at room temperature without degradation for:
a. One month
b. Six month
c. One year
A
258.
Intermediate insulin is a mixture of:
b. 100% amorphous
c. 100% crystalline
d. Crystalline Zn 70%:30% amorphous insulin
e. Crystalline Zn 30%:70% amorphous insulin
f. Crystalline Zn 50%:50% amorphous insulin
D
259.
Insulin shock in unconscious patient is treated by:
Glucagon injection
260.
Hormone act on cell membrane OR act on surface receptor: (Jul-2006)
a. Estrogen
b. Insulin
c. Progesterone
B
Fasting blood glucose:

261.
3.5 mosmol/L (4.4-6.6 mmol/L) [mg/dl (18) mmol/L] diabetic = >11 mmol/L
Threshold of glucose is:

262.
3.5 L/min
263.
When a normal person takes a large amount of glucose after fasting what will
occur:
Increase glucose tolerance test to 200 mg/dl then to normal level in 1 hr
264.
Compared with normal glucose tolerance curve, the blood glucose versus time in
a diabetic has:
a. A high peak
b. Peak occurs later
c. Peak decreases more slowly
All
3 parameters of significance in glucose tolerance curve:

a) The peak concentration of glucose in blood
b) Time required to reach peak
c) Rate of glucose decline
In DM: a) Peak is higher

b) Time to reach peak is slower
c) Decline more slowly than a normal person
Fasting blood glucose: Normal = 90-120 mg/100ml Diabetic > 120 mg/100ml
Calories / 1gm:
Protein, CHO 4 Kcal
Ethanol 7 Kcal
Fat 9 Kcal
265.
What is specific for fasting glucose test if glucose level will increase but not more
than 200mg/100ml or mmol
a. There will be ketosis
b. There will be glucosuria as in diabetics
A
266.
Which affect glucose tolerance:
a. Hydrochlorothiazide
b. Enalapril
A
267.
Which interfere with glucose test in urine:
a. Vit C
b. Cephalosporin
c. L-dopa
d. Penicillin
e. Ampicillin
f. Salicylates
All
268.
Which of the following gives +ve reducing results with copper salts in the test of
glucose in urine:
a. Testape
b. Clinistix
c. Diastix
d. Benedicts soln
e. Clinitest Fehling
D+E
Urine glucose test: 1) Testape + Clinistix + Diastix contain glucose oxidase

2) Benedict + Clinitest copper reduction method
Ketone test in urine: 1) Acetest 2) Ketostix
269.
Which of the following gives +ve glucose test:
Vitamin C (Ascorbic acid)
Fehling:
270.
Red with glucose & acetaldehyde
Long term diabetes complications:

271.
a. Neuropathy
b. Retinopathy
c. Cardiopathy
d. Nephropathy
e. Metabolism of fat so TC TG VLDL
??
K=KIDNEY N=NERVES I=EYE V=VEINS S=SKIN
272.
In a drug with slow clearance, protein binding will cause:
a. slower clearance
b. enhance clearance
c. affect metabolism
A
273.
Low cardiac output with increased extravascular fluid will cause:
a. increase clearance
b. increase glomerular filtration
A+B
In late conditions of liver failure:

274.
I. Albumin
II. Prothrombin
III. Bilirubin
All
Antihypertensives:
1. Diuretics 4. ACEI
2. Depressants of sympathetic 5. Ca channel
activity
3. Direct vasodilators
1. Diuretics:
A. Carbonic anhydrase inhibitors: Proximal tubule = Acetazolamide
(Diamox)
- Inhibit reabsorption of HCO3- weak diuretic effect
- Used for: Glaucoma Petit mal epilepsy Alkalinization of urine
- Side effects: Acidosis Hyperchloremia crystalluria
- CI: Liver cirrhosis
B. Loop diuretic: Ascending Loop of Henle = Furosemide

- Inhibit Na+/Cl-/K+ exchange in loop of Henle resulting in retention of
Na+ & Cl- & Water in the tubule
- Uses: Acute pulmonary edema acute renal failure
- SE: ( uric acid LDL) + ( Ca K Mg)
- Drug interactions: NSAID Aminoglycosides
C. Thiazides: Distal tubule = Hydrochlothiazide Indapamide

- Inhibit reabsorption of Na+ urinary Na+ + no water reabsorption

Na+ in blood stimulates aldosterone w tries to compensate the
loss of Na+ by Na+/K+ exchange Hypokalemia
- Uses: mild CHF
- SE: ( Glucose uric acid Ca LDL) + ( K Mg)
D. K-sparing: Collecting tubule (Convoluted)

Spironolactone = slow onset (4 days) used in liver cirrhosis
Compete with aldosterone at the collecting tubule (aldosterone is responsible
for secretion of K+ & reabsorption of Na+)
Amiloride-Triametrene (weak alone) used e hydrochlorothiazide = Moduretic

Block the Na+ channel by inhibition of Na+/K+ exchange
SE: Hyperkalemia
E. Osmotic diuretic (Manitol-urea) proximal tubule + loop of Henle

- Osmolarity of glomerular filtration prevent water reabsorption
2. Sympatholytics:
A. 2-stimulants:
B. Anti-Adrenergic:
** Guanethidine:
- Very potent antihypertensive IV = triphasic response ( BP)
- Oral = systolic + diastolic
- Uses: HTN + open angle Glaucoma (CI in closed angle)
- SE: Postural hypotension Ejaculation failure Nasal congestion
- CI: HTN due to Phaeochromocytoma
- DI: TCA Amphetamine
** Reserpine:
- Uses: HTN psychosis in high doses
- SE: Salivation diarrhea night mares depression feminization wt
gain
- CI: Depression peptic ulcer
- DI: MAO
C. -blockers:
Selective heart) with minor (bronchi)effect:
Atenolol - Metoprolol (Lopressor) - Acetobutolol
Non Selective &

Propranolol (not used in asthma or DM)
- Used in (HTN + Tachycardia) +excreted by liver (can be used in renal
failure)
- contraction force + bradycardia + blood flow to all tissues (xpt brain) +
TG HDL + Anxiolytic + bronchoconstriction
Uses: MI HTN Arrhythmia prevent anginal attack Phaeochromocytoma
SE: bronchospasm hypotension - insulin hypoglycemic effect
night mares GIT disturbance skin rash fatigue
CI: Asthma CHF hypotension
DI:
- CAN be used with TCA
- Enzyme inducers (Phenytoin, barb, Rifampicin) plasma conc
- Enzyme inhibitors (Cimetidine) plasma c onc (its met by liver)
- Combination e Verapamil bradycardia Heart failure AV block
- NSAIDs antihypertensive effect
Others non selective:

- Pindolol blocker with intrinsic - Oxprenolol
sympathomimetic activity - Esmalol short acting
- Timolol glaucoma - Labetalol &
- Alprenolol - Nadolol long acting + non
- Sotalol selective cant be used with
asthma
D. -blockers:
- Prazosin (Minipress) first dose syncope
E. Ganglion blockers: Trimetaphan

- Are not used as antihypertensive they block sympathetic +
parasympathetic neurotransmission atropine-like side effects =
(dry mouth + visual accommodation + urine retention)
- BP HR continuous IV in HTN emergency
3. Direct vasodilators:
A. Areteriodilators: {Hydralazine Diazoxide Minoxidil}
- Hydralazine + B-blocker to avoid tachycardia + diuretic to prevent Na &
water retention
- Diazoxide IV in HTN Emergency
- Minoxidil oral = extremely potent SE = Hirsutism
B. Arterio + Venodilators: Na Nitroprusside

- Used in hypertensive encephalopathy produce short term + rapid BP
- SE: nausea vomiting sweating headache palpitation
- Prolonged use accumulation of CN
- Give with caution in hepatic & renal pt
4. ACEI: drug of choice for diabetic + HTN

If B.P. kidney releases RENIN ACE Converts Ag I Ag II
(1. Strong vasoconstrictor 2. stimulate aldosterone Na & H2O retention BP)
a. Captopril (Capoten)
b. Enalapril (Renitec) Benazepril Perindopril (Coversyl)
c. Lisinopril (Zestril) for kidney patients
Adv of ACEI: NO EFFECT ON:
- Reflex tachycardia
- Glucose tolerance
- Blood uric acid
- Cholesterol level
SE: Hypotension + K + Cough (due to effect of Bradykinin on bronchial mucosa)
+ Skin rash + headache
CI: Pregnancy Renal failure hypotension

Drug interaction: K sparing diuretics hyperkalemia NSAID
Ag II receptor antagonist:
- Losartan (Cozaar) - Valsartan (Diovan) - Kandisartan (Atacand)
- Edisartan (Aprovel)
Adv no cough (avoid in pregnancy)
5. Ca channel:
- Verapamil (Isoptin) Nifedipine (Adalat) Diltiazem Amlodipine (Norvasc)
Uses: prophylaxis of angina Arrhythmia - HTN
Lisinopril has No:

275.
Hyperlipidemic effect
276.
Which diuretic causes hypo-Calcemia:
a. Furosemide
b. Hydrochlorothiazide hypercalcemia
c. Spironolactone K-sparing
d. Acetazolamide CAI + systemic acidosis + sulphonamide
A
277.
Carbonic anhydrase inhibitor & sulfa drugs both have common group which is:
a. Sulphoxide group
b. Sulphonamide group
B
278.
Carbonic anhydrase example: (Jul-2006)
a. Dorzolamide
b. Acetazolamide
All Dorzolamide =Trusopt (eye drops) + Acetazolamide (Diamox Tab)
279.
Spironolactone excreted from: (Jul-2006)
Distal tubules
280.
Diuretic least cause hypokalemia: (Jul-2006)
Spironolactone
Diuretic dont cause hyperlipidemic and hyperglycemic effect:

281.
Indapamide + spironolactone
Diuretic used with captopril:

282.
Hydrochlorothiazide
Diuretic used with spironolactone:

283.
Indapamide
284.
Hyperaldosteronism can be treated by:
Spironolactone
285.
Aldosterone is located in:
a. Adrenal cortex
b. Adrenal medulla
286.
Aldosterone:
a. decrease spironolactone hyperkalemia
b. decrease spironolactone hypokalemia
c. no effect on spironolactone hypokalemia
A
287.
Spironolactone competes with aldosterone at:
Collecting tubule
288.
Triametrene act on:
a. Collecting tubule
b. Upper loop of Henle
c. Lower loop of Henle
d. Proximal tubule
A K sparing = Triametrene + Amiloride + Spironolactone
289.
Prolonged use of diuretics causes:
a. Hypoglycemia
b. Hyperuricemia (enhanced tubular reabsorption of solutes including uric acid)
c. Alkalosis (due to large amount of Cl- lost in urine Hypochloremia + distal
reabsorption of Na+ in exchange of K+ & H+)
d. Sexual dysfunction
B + C + D
All cause urine retention EXCEPT: (Jul-2006)

290.
Propranolol
An increase in K+, Na+, Cl- in urine is due to:

291.
An increase in K and Na in urine detected as result of taking:

292.
Thiazides
293.
At which pH hydrochlorothiazide is most stable:
pH 2
294.
Thiazide side effects:
- Decrease glucose tolerance
- inhibit renal secretion of uric acid (precipitate gout)
- alkalosis (Systemic acidosis = urine alkaline + blood acidosis)
295.
Side effects of thiazides:
a. Hypokalemia
b. Hypouricemia
c. Hypoglycemia
A
296.
Side effects of thiazides includes all EXCEPT:
a. Hypokalemia
b. Hypocalcaemia
c. Hyperglycemia
d. Hyperuricemia
B
Thiazide Hyper-Calcemia Furosemide Hypo-Calcemia

Hyper-Uricemia = Thiazide + Furosemide loop diuretic (so CI in pts with Vit D
def)
THIAZIDE = [Uric acid Ca2+ Glucose] [K+]
Acetazolamide (CAI systemic acidosis) & Sulfamethoxazole, both are:

297.
Sulphonamides
Diuretic make acidosis in blood:

298.
Diuretic which make hyperchloremic systemic acidosis:

299.
Acetazolamide (CAI) sulphonamide group
Ticrinofen is:
300.
Diuretic with no increase in uric acid has uricosuric activity
301.
ACE inhibitor predominant in nature substrate for Angiotensin 1: (Jul-2006)
a. Heart
b. Lung
c. Liver
?? Kidney
302.
ACE inhibitor side effect:
- Dry cough - Agranulocytosis
- Hypotension - Rash
- Acute renal failure - Disguisia (Temporary loss of
- Cholestatic jaundice taste sensation) = metallic taste
Syncope means:
303.
Temporary loss of consciousness
304.
Syncope TTT:
- Amphetamine
- Methyl phenadate (Retalin) CNS stimulants
305.
Atenolol can make these side effects:
a. Hypotension
b. Tremors
c. Visual disturbance
A
306.
Hypertension patient taking Captopril for his hypertension, he is suffering from
dry cough, he can change to:
a. Losartan, Irebesatan Angiotensin receptor blocker
b. Enalapril ACEI = dry cough
c. Hydrochlorothiazide CI in diabetes
d. Atenolol B-blocker CI in diabetes
A
307.
Male take Enalapril for his hypertension and the doctor write Prazosin for
prostate, the pharmacist should ask about what while filling second prescription:
(Jul-2006)
a. His blood pressure

b. Dry cough
A+B
308.
A patient with hypertension taking Atenolol then he takes Prazosin, what are the
side effects:
a. Visual disturbance
b. Tremors
c. Hypotension
C
Drug cause rebound hypertension:

309.
- Clonidine (Catapress)
- Methyl dopa
Clonidine acts:
1) Centrally by inhibition of vasomotor center
2) Peripherally release of NA
3) Not to be withdrawn suddenly may cause rapid rise in b.p
4) Cause depression (night mares)
310.
TTT with -adrenergic blocker as antihypertensive is limited due to:
(Prazosin=Minipress)
- Hypotension with tachycardia (Syncope after 1st dose)
- Postural hypotension
311.
Pergolide side effect: (ergot derivative dopaminergic action)
- Hypotension
- Syncope
If Phenyl ephrine is given IM to increase BP, which of the following is used to

312.
decrease BP:
Phenyl ephrine is -agonist (Do NOT HR) blocked by
- Irreversible-antagonist = Phenoxybenzamine + diabenamine

- Reversible-antagonist = Tolazoline + Phentolamine
Large dose of Phenylephrine (prisoline) leads to:

313.
Severe Hypertension
TTT by = {Phentolamine} = -blocker
314.
According to the chemical formulation of Phenoxybenzamine how does it act as
an alpha-antagonist and which part is involved chemically:
- The molecular configuration is directly responsible for blockade.
- 3o Amine which cyclizes to form reactive ethylene-imonium intermediate +
highly reactive carbonium ion formed when the 3 membered ring brakes
315.
Thrombolytic agent after surgery never given to:
a. A patient older than 65 years
b. Patient with hypertension
c. Patient with gastric bleeding less than six months ago
C
316.
When we cant take cardiac output:
a. Angina
b. Hypertension
c. Thromboembolism
d. Epilepsy
A
317.
Nifedipine nucleus is: (Jul-2006) (also Clozapine + Diazepine)
1, 4 Dihydropyridine
Nifedipine may cause:

318.
Ankle edema
Acute attack of angina ca be treated by:

319.
Isosorbide dinitrate (sublingual) & Nitroglycerine (cream)
320.
Which waken angina:
a. Warm environment
b. Fright
c. Exercise
d. Cold weather
B+C+D
321.
In acute attack of angina which drug we give:
a. Propranolol
b. Nitroglycerine
c.Isosorbide dinitrate
B
322.
Which drug is used in prophylaxis of angina
- Nifedipine
- Diltiazem
- Verapamil
- Dipyridamol (peripheral vasodilator)
323.
Which Ca Channel increase the heart rate:
a. Verapamil
b. Diltiazem
c. Nifedipine
C
324.
Patient with angina and CHF preferably use:
Nifedipine
Aldomet (methyl dopa) can be replaced in pregnancy by:

325.
ACE inhibitor (Capto Enala Lisino Rami Perinde PRILE)
Hypertension + Tachycardia:
326.
Propranolol
327.
Angina + CHF we use:
Nifedipine
In High blood pressure with Cardiac failure we use:

328.
Prazosin
In Hypertensive Emergencies we use:

329.
Diazoxide IV
In Hypertension and CHF we use In:

330.
Prazosin & Captopril
In Moderate Hypertension and CHF we use:

331.
Hydrochlorothiazide
Which is used in mild hypertension:

332.
Hydrochlorothiazide
Which is used in moderate hypertension:

333.
Captopril
Which is used in severe hypertension:

334.
Diazoxide
335.
In hypertension of renal origin which antihypertensive is used:
a. Clonidine
b. Hydralazine
c.Captopril
C
336.
Arterial dilators include:
a. Diazoxide
b. Minoxidil
c. Hydralazine
d. All
D S.E. reflex Tachycardia
337.
Minoxidil leads to:
- Hypotension
- Excessive hair growth
- Weight gain
- Na & water retention
338.
Which is not co-related to angina:
a. Myocardial infarction
b. Coronary heart disease
c. Anemia
d. Hypertension
C
339.
Venous pooling is caused by which of the following: (Jul-2006)
a. Nitroglycerine
b. Sodium Nitroprusside
c. Hydralazine
d. Methyl Dopa
e. Isosorbide dinitrate
A+E
340.
In CHF accumulation of blood occurs in:
a. Lungs
b. Liver
c. Kidney
d. Vena cava
e. Pulmonary artery
f. Lower extremities
D
Which antihypertensive causes CNS depression:

341.
Reserpine depletion of CA + lethargy ( vitality) + sedation + nightmares
342.
A hypertensive patient suffers from depression should not given all the following
EXCEPT:
a. Reserpine
b. Clonidine
c. Methyl dopa
d. Guanethidine
e. Hydralazine
E direct vasodilator = TTT of HTN pt with renal failure + depression
343.
-blocker used in hepatic failure:
Nadolol Pindol- Atenolol
-blocker used in renal failure:

344.
Propranolol
Isoproterenol (B-agonist but no effect on alpha) effect:

345.
Cardiac output BP
346.
Beta-agonist drug with no effect on alpha-receptor:
347.
Which of the following drugs when given causes blood pressure to fall but causes
heart rate to increase:
a. Propranolol
b. Isoproterenol
c. Phenyl ephrine
d. Ephedrine
e. Carbachol
B HR BP
Isoproterenol: vascular resistance diastolic B.P. B.P. Venus return

(+) INOTROPIC effect HR & Insulin secretion & Bronchodilation
348.
Difference between Captopril and Enalapril:
Captopril increase serum urea Enalapril
349.
Patient took Atenolol + Sildenafil he may suffer: (Jul-2006)
a. Hypotension
b. Visual disturbance
c. Tremors
A+B
350.
Drugs that induce liver microsomal enzyme increase their own metabolites and
this accounts for:
Tolerance
Patient with renal failure and normal liver function, he is found sensitive to drug,
351.
a good explanation is:

High accumulation of metabolites
352.
Factors increasing the risk of renal failure:
I. Hemorrhage
II. Hyperphosphatemia
III. Heart disease CHF
II
Renal failure, which is true:

353.
Associated with Hyper-Phosphatemia ( PO4-)
354.
Which of the following NOT happen in chronic renal failure:
a.
Hyper K+
b.
Hyper PO4
c.
Hyper Ca2+
d.
Hypertension
C
355.
Which is the cause of pre-renal failure:
a. CHF
b. Non-steroidal anti-inflammatory excessive use
c. Severe hemorrhage
All
356.
Pre-renal failure could be due to:
I. Severe hypotension
II. NSAI drugs
III. Congestive HF
All
357.
Nephrotoxicity:
- Aminoglycosides
- Bleamycin
- Cyclosporine
- Vincristine
358.
Nephrotic syndrome is characterized by:
- Protein urea
- Hypoalbuminemia
359.
Hypoalbuminemia which of the following is not related to it:
a. Renal failure
b. Hyponatremia
c. Liver failure
d. Edema
B
360.
Drugs cause protein urea:
- Captopril Enalapril
- Gold salts
- Penicillamine
- Carbamazepine (Tegretol)
361.
Drugs cause night mares:
- Propranolol
- Reserpine
- Clonidine
- Methyl dopa
- Buspiron
362.
Nitroglycerine spray:
- Spray under/on the tongue
- Dont shake
- Dont inhale
To evaluate nitroglycerin effect by all EXCEPT:

363.
Prothrombin time
364.
In coronary insufficiency, which of the following is not a common symptom:
a. Heart burn with nausea
b. Headache
c. Pain in arms and legs
d. Shortness of breath
e. Fatigue
B
365.
Tamsulosin is used as:
I. Antihypertensive
II. Prostatic cancer
III. Prostate benign hypertrophy
III Omnic blocker like cardura
366.
reductase inhibitor:
Finasteride prostatic hyperplasia (Proscar) class X pregnancy
367.
Drugs used in treatment of prostatic cancer all EXCEPT: (Jul-2006)
a. Anastrazole
b. Flutimide
A
Anastrazole = Aromatase Inhibitor used for estrogen-receptor positive tumors
(prevent conversion of androgen to estrogen)
368.
Prostatic hypertrophy cause all EXCEPT: (Jul-2006)
Polyuria
369.
Prostatic hyperplasia, hyperplasia means: (Jul-2006)
Increase no of cells
Which of the following drugs is contraindicated with benign hyperplasia:

370.
(Parkinson): (Jul-2006)
a. Bromocriptine (Parlodel)
b. Levodopa
c. Finasteride
d. Benzatropine
e. Amantadine
D
371.
Mechanism of action of clofibrate:
a. LDL
b. Very low side effects
c. Safe in pregnancy
A
Antihyperlipidemics:
1. Nicotinic acid (Vit B3) 1955 inhibit VLDL synthesis LDL
Many side effects:
Hepatotoxicity + Glucose + limited LDL + pruritis + flushing
2. Cholestyramine 1961 bile binding resin LDL + may VLDL

Side effect = very bitter taste + constipation + cholesterol gall stones
Drug interactions: anticoagulant thiazides- Barb
3. Fibrates 1965: (Fibric acid drv)

Clofibrate (Atromid) Fenofibrate (Lipanthyl) Gemfibrozil (Lopid)
CI: Hepatic + renal dysfunction
Side effect: Nausea, dyspepsia, diarrhea
Drug Interactions: anticoagulants
4. Statins 1988 HMG-CoA (3-Hydroxy-3Methyl-Glutar-coenzyme A)

LDL + TG + total cholesterol + HDL
Atorvastatin (Lipitor) Simvastatin (Zocor) Parvastatin (Lipostat)
Fluvastatin (Lescol) Lovastatin (Mevacor) Rosuvastatin (Crestor)
Side effects: Myositis (myotoxicity = inflammation of skeletal muscles)
CI: Pregnancy, lactation
372.
Hyperlipidemia usually occurs with:
I. Hypertension
II. Diabetes
III. Over 60 years
All
373.
Cholestyramine is used as:
- Antihyperlipidemic (Questran)
- Drug of choice for pregnant women
Cholestyramine is:
374.
a. bile acid
b. synthesis of cholesterol
c. Very slowly absorbed
A bile acid binding resin
Cholestyramine is
1) Anion exchange resin 3) prevent reabsorption of bile acids
2) 4o ammonium chloride 4) binds many organic cpds (warfarin,
Chlorothiazide, Phenobarbital, Penicillin)
375.
Which of the following data is right:
I. cholesterol < 5.2 mmol/L
II. HDL > 0.9 mmol/L
III. TG > 3.2 mmol/l
I, II
376.
Which of the statins needs to be taken with food to increase bioavailability:
a. Atorvastatin
b. Simvastatin
c. Lovastatin
B+C
377.
Control blood flow centrally:
a. Noradrenalin
b. Adenosine
c. PO2
d. PCO2
A
378.
At rest which organ receives higher blood supply:
a. Kidney
b. Heart
c. Liver
d. Brain
C = 27% then A = 22%
379.
Tricuspid valve:
The valve located between the right atrium and right ventricle of the heart prevent
the back-flow of blood from ventricles into atria during systole (Mitral valve =left)
Semilunar valves (aortic & pulmonary):

380.
Prevent the back-flow of blood from aorta & pulmonary arteries into the ventricles
during diastole
In case of left ventricular failure blood pour in:

381.
Lung
Right ventricular failure pools in liver
During refractory period of the heart:

382.
No response to any stimulus
383.
When there is absolute RP, if you apply another stimulus, what will be effect on
muscle:
It will remain in the existing state
384.
Refractory period:
Absolute RP:
- Starts due to phase I (early rapid repolarization) & ends at the start of phase
3 (final rapid repolarization)
- During which the cell can NOT respond to any stimulus
Relative RP:
- Occurs during phase 3
- During which the cell can respond to any stimulus
(As repolarization response)
Phase 0 (rapid depolarization)

Na ions enter the cell through fast channels cell membranes charge changes from
ve to +ve
Phase 1 (early rapid repolarization)
Fast sodium ions channels close K ions leave the cell the cell rapidly repolarize
(return resting potential)
Phase 2 (plateau)
Ca ions enters through slow channels + K exit
Phase 3 (final rapid repolarization)
K pumped out cell ve again
Phase 4 (slow depolarization)
Cell return to resting state K inside + Na & Ca outside
Normal ECG:
P-wave ATRIAL depolarization
PR interval represents the spread of impulse from the atrium
QRS VENTRICULAR depolarization
ST segment phase 2 (absolute refractory period = part of ventricular
depolarization)
T-wave phase 3 (ventricular repolarization)
B.P.= CO X Peripheral Resistance
CO = Stroke Volume X HR
Stroke volume = difference in volume of the ventricle between systole & diastole
N.B. atria are supplied with both sympathetic & para ventricles symp only
CPK = creatine phosphokinase:

385.
Enzyme present in muscles in CHF used for diagnosis of CHF
The cause of toxic shock syndrome:

386.
Staphylococcus aureous
Shock and airway edema of anaphylaxis are best treated with:

387.
Adrenaline
388.
Introptin:
a. increase cardiac output
b. increase renal perfusion
All
An important advantage of using dopamine in cardiac shock is:

389.
a. Will not cross BBB and cause CNS problems

b. Has no effect on & receptors
c. Produce dose dependent increase in cardiac output and renal perfusion
d. Will not increase blood pressure
e. Can be given orally
C IV infusion
Shock= generalized hypoperfusion state CO = B.P. + renal perfusion
Slow rate ++ D1 receptor in RENAL vessel vasodilatation + renal blood flow
Moderate rate ++ 1 receptor in HEART CO
High rate ++ receptor vasoconstriction reverse the effect of renal blood
vessels & b.p.
390.
Dopamine is more polar than amphetamine since:
It contain 2 (OH) gps and less CH3
391.
Tone of the heart = 90-105 m volt
392.
A sudden increase in critical blood pressure leads to:
Reflex bradycardia
393.
In ischemic myocardium, infarction occurs leading to release of:
a. Adrenaline
b. serotonin
c. ACH
d. adenosine
C has direct effect on coronary arteries (M3 receptors) vasodilatation
394.
Tachycardia means:
Fast heart rate usually > 100 beat/min
Tachycardia Leads to:
1. High temperature
2. Stimulation of heart by autonomous nerves
3. Toxic condition
HR 10 beats/min by 1oF
Vagus nerve HR autonomous
Atrial flutter (low frequency):
EXTREMELY rapid contraction of the atrium (200-300 beat/min)
Atrial fibrillation (high frequency):
EXTREMELY rapid contraction of the atrium + uncoordinated contraction the atrial
pumping stops effectiveness of the heart to 25-30%
Ventricular fibrillation (death):
When the ventricles are dilated OR Purkinji system is blocked (w conduct the
impulse of the heart to all the ventricles) impulse not transmitted
Due to: 1) Coronary insufficiency
2) Compression from an arthrosclerosis
Overcomed by: 1. Implantation of pace maker
2. Cardiac massage
Bradycardia:
395.
Slowed HR < 60/min
Complete heart block:

396.
Ventricles beat slower than atrium?

Beats of Auricles & ventricles are both blocked
397.
The major predictor of death in chronic obstruction airway disease COAD:
a. FEVI (Forced Expiratory Volume in one second)
b. Rate of smoking
c. Number of attacks
d. Deficiency of 1-antityrosine
A
398.
Digoxin: (Jul-2006)
a. Decrease smooth muscle contraction
b. Decrease O2 consumption
c. Increase contractility
B+C
399.
The most effective cardiotonic compound in digitalis is:
a. Digoxin alkaloid
b. Digoxin glycoside
c. Digoxin aglycon
B
400.
What is the main action of digitalis therapy in CHF:
1.
Conduction Velocity in atrial muscle predominates over its vagotonic
effect (increased conduction)
2.
O2 consumption
3.
availability of Ca2+ Contractility refractory period
4.
slow pace maker
Indications of Digoxin: Contraindications:

1) CHF 1) AV block
2) Atrial flutter 2) Ventricular abnormalities
3) Paroxysmal
atrial tachycardia
4) Atrial
fibrillation (supra ventricular arrhythmia)
Digitalis toxicity (S.E.) is:
1. Dysrythmia (due to loss of K from 3. Premature atrial fibrillation
myocardium) terminating with ventricular 4. A.V. block
fibrillation 5. Paroxysmal atrial tachycardia
2. Premature ventricular fibrillation 6. Ventricular tachycardia
Extra Cardiac S.E.:
1. Vomiting (due to action on CTZ) 5. Fatigue
2. Diarrhea 6. Photophobia & hazy vision (yellow
3. Anorexia vision)
4. Weakness 7. Dizziness & headache
8. Massive overdose cause =delusion,
coma
401.
Digoxin level is increased by all EXCEPT:
a. Erythromycin
b. Primaquine
c. Cholestyramine
C (bile acid binding resin)
402.
Digoxin is affected by:
a. Erythromycin
b. Primaquine
c. Cholestyramine
A+B
403.
Myocardial infarction MI all are true EXCEPT:
a. Nausea & vomiting
b. Sweating
c. Severe headache
d. Chest pain
e. Heart burn
C
404.
Digoxin is contraindicated in:
I. AV block
II. Supraventricular arrhythmia caused by Wolf-Parkinson
III. Ventricular abnormalities
I+III
Indicated for CHF + Supraventricular arrhythmia especially Atrial fibrillation +
atrial flutter + Paroxysmal atrial tachycardia
405.
Side effects of digoxin:
a. Vomiting
b. Arrhythmia
c. Fatigue
d. Diarrhea
All
406.
Which of the following are the side effects of digoxin:
a. Diarrhea
b. A-V block
c. Anorexia
All
Side effects of digitalis:

407.
Vomiting + diarrhea
408.
Digitalis toxicity involves all EXCEPT: (as o.c.)
a. Nausea & vomiting
b. Vision change
c. Constipation
d. Ventricular tachycardia
C
409.
Digoxin dysrythmia is due to:
- Toxic manifestation
- Dose related leading to Ventricular fibrillation
- Due to intracellular K+ TTT = certain diuretic + cortical steroid
- Cardiac irregularities, e.g. Coupled Beats, = signal for reduction in digitalis
dosage.
410.
Dose of digoxin is:
0.125 0.25 mg /daily
411.
Disopyramide cause: (Jul-2006)
a. Ca Channel blocker
b. Na Channel blocker
B (Antiarrhythmic as quinidine conduction repolarization)
Arrhythmia may be caused by:

412.
Catecholamines (arrhythmia= abnormal heart beat)
Arrhythmia cause:
413.
In temperature (paroxysmal arrhythmia)

414.
Drugs used arrhythmia:
a. Na channel blocker: * Quinidine + Procainamide + Disopyramide
* Lidocaine + Phenytoin
b. -blocker
c. K channel blocker: Amiodarone
d. Ca channel blocker: Verapamil + Nifedipine + Diltiazem (also used TTT of
paroxysmal ventricular tachycardia)
415.
A person with fever will have the following:
a. Paroxysmal tachycardia
b. Bradycardia
A
416.
Why does blood pressure increase after moderate exercise:
Due to increased venous return (due to sympathetic stimulation of B2 receptors in
arterioles vasodilatation reflex HR)
417.
Following moderate exercise the blood pressure is normally higher than normal
due to:
a. Release of Acetyl choline
b. Increase in Angiotensin-Renin activity
B
418.
Contraindication of Verapamil:
a. AV block
b. Constipation
A
Quinidine side effect:

419.
Cinchonism + not used in myasthenia gravis
420.
Repeated arrhythmia means:
a. Tacky arrhythmia
b. Paroxysmal arrhythmia
c. Ventricular arrhythmia
B
Extremely rapid heart beat, anywhere from 150 to 250 beats per minute, coming on
suddenly and lasting several minutes to several hours. The condition is encountered
often in highly emotional young people
421.
Lignocaine in arrhythmia is given:
a. Topical
b. local
c. IV
C
422.
Ciprofloxacin cause all these interactions EXCEPT:
a. Disulfuran like reactions = Flagyl (flushing, N&V, tachycardia, palpitation)
b. Worsen the effect of NSAID on CNS
A?
423.
Ciprofloxacin is taken once daily because:
a. Action continues even after the drug disappear from plasma
b. Half life longer than 12 hours
c. Plasma level-effect relationship is not clear
A+B
424.
Why Aminoglycosides are taken once daily:
a. Due to long t1/2
b. Due to accumulation in tissues
c. Their effect lasts after the drug is gone
C
425.
Aminoglycosides are effective against:
a. G+ve
b. G-ve
c. Both
C
All are aminoglycoside EXCEPT:

426.
a. Tobramycin
b. Gentamycin
c. Streptomycin
d. Amican
e. Vancomycin
f. Spectinomycin
E
Gentamycin + streptomycin:
1) may produce neuromuscular block
2) may enhance blockage of skeletal muscle relaxant (Tubucurarine)
Gentamycin:
- Most useful aminoglycoside
- TTT of serious infection infections (encephalitis) caused by Pseudomonas
aeroginosa (Carbinicillin can be used but develop resistance)
Tetracycline and aminoglycoside are excreted by:

427.
Glomerular filtration they also both act by protein synthesis
Which of the following is aminoglycoside antibiotic:

428.
Amikacin
Norfloxacin (quinolone) + Rifampicin act on the plasmid in micro

organisms (inhibit DNA synthesis)
Penicillin + Cephalosporin inhibit cell wall synthesis
(bactericidal)
Sulfa (bacteriostatic) inhibit folic acid synthesis
Tetracycline + Aminoglycosides + inhibit protein synthesis
Chloramphenicol + Macrolides
Antifungal + Amphotericin B+ Polymyxin inhibit cell membrane synthesis
Side effects
Penicillin 1. Anaphylactic shock (within 20 min)
2. Accelerated reaction = urticaria +
edema (1-2 days)
3. Delayed reaction = urticaria (3 days)
Aminoglycosides 1. Ototoxicity (irreversible)
2. Nephrotoxicity (reversible)
3. NMB action (reversible)
4. Skin reactions
Erythromycin osteolate, INH, 1. Hepatotoxicity
Tetracycline Fanconi syndrome 2. GIT problems
Chloramphenicol 1. Grey baby syndrome (due to immature
liver enzymes in infants)
2. Yellow teeth (pregnant women)
3. Blood dyscrasia (idiosyncratic aplastic
anemia = most fatal +Agranulocytosis)
Sulfa, Nalidixic acid, Primaquine, Hemolytic anemia (G6PD)
Probenicid
429.
Which is considered Quinolone:
Vit K
Antibiotic suspension which does not need refrigeration:

430.
Erythromycin osteolate (azithromycin)
431.
Which AB dont Need refrigeration after reconstitution: (Jul-2006)
a. Amoxicillin
b. Cephalexine
c. Cephuroxime exutile
d. Clarithromycin
D
432.
Clarithromycin belong to which category: (Jul-2006)
a. Erythromycin
b. Ampicillin
c. Amoxicillin
d. Penicillin
A
Erythromycin osteolate side effects:

433.
Reversible Cholestatic hepatitis + jaundice + fever due to osteolate salt

Stearate is preferable (Also=Do not need refrigeration + taken on empty stomach)
434.
Antibiotic taken on empty stomach:
- Erythromycin
- Cefalexin
- Azithromycin
- Amoxicillin (on empty or no)
435.
Take with or without food:
Amoxicillin Ampicillin without food
436.
Drugs used in treatment of meningitis are all EXCEPT:
a. Penicillin
b. Cephalosporin
c. Gentamycin
d. Sulfa drugs
e. Streptomycin
E passes BBB only when meninges are inflamed
437.
Meningitis & encephalitis are difficult in their treatment due to: (Jul-2006)
a. Flu like
b. Need vertebral injection (Intracranial)
c. Caused by toxin
d. AB cannot pass
B
438.
Trimethoprim compete with folic acid, which is true:
a. Trimethoprim inhibit dihydrofolate reductase
b. Trimethoprim has higher affinity to receptor
c. Trimethoprim has larger size
A+B
439.
Trimethoprim + Sulfamethoxazole:
I. Same t
II. Synergistic effect
III. Shake well
All
Succinyl sulfa-thiazole: not absorbed from GIT used to intestinal bacteria
Sulfa drugs inhibit m.o. by:

440.
Inhibit folic acid synthesis (competitive inhibition)
METABOLISM Acetylation at p-amino gp

N4 must be free if CH3 = loose activity
441.
Which sulfa drug potentiate action of trimethoprim: (Jul-2006)
Sulfamethoxazole compete with PABA to form folic acid (essential for bacterial
cell)
Trimethoprim inhibit dihydrofolate reductase enzyme w converts folic into folinic

acid (essential for DNA synthesis in the bacterial cell)
442.
Which antibiotic pass BBB:
Chloramphenicol
Tetracycline
Penicillin
Rifampicin
Sulpha
Dont pass Streptomycin
443.
Which of the following antibiotics is a absorbed/crosses CSF:
a. Erythromycin
b. Penicillin
c. Chloramphenicol
d. Tetracycline
C (cerebro-spinal fluid)
444.
Factors that are important for a drug to reach CSF for TTT of meningitis:
a. o/w partition coefficient
b. dose
c. lipid solubility
d. plasma protein binding
e. pKa
f. All of the above
g. None of the above
F
Drugs which are poorly lipid soluble and ionized at pH of blood:

445.
Penetrate CNS very slowly
Penicillin is metabolized by:

446.
Penicillinase enzyme penicilloic acid
On which part of the penicillin molecule the oxidase act:

447.
Side chain
448.
On which part of the penicillin molecule -lactamase act:
-lactam ring
Short acting of penicillin due to: (or short t1/2)

449.
Due to high rate of renal tubular excretion
Which is the example of drug with tubular secretion:

450.
Penicillin
Penicillin V is excreted by:

451.
Renal tubular excretion
452.
The following can be used for g ve bacteria EXCEPT:
a. Norfloxacin
b. Penicillin G
c. Doxycycline
d. Azithromycin
B
453.
Which of the following is classified as a broad spectrum antibiotic:
a. Ampicillin
b. Penicillin G
c. Na methicillin
d. Na cloxacillin
A
454.
The organism against which Erythromycin or Penicillin V is prescribed is:
a. S. aureous
b. E. coli
c. Group A staph.
d. Haemophylus
C
There is a cross sensitivity between penicillin and:

455.
Cephalosporin
- They have similar broad of spectrum = Ampicillin
- Resistant to penicillinase
- Used instead of penicillin in Staph aureous (g+ve) infections
456.
Methicillin pKa= 1.5
Oxacillin pKa= 2
Penicillin pKa= 3
Dicloxacillin pKa= 5
Which has higher effect to penetrate bacterial wall?
Dicloxacillin
457.
Clostridium dificelle diarrhea treatment: (Jul-2006)
a. Metronidazole
b. Vancomycin
B
What is right about antibiotics:

458.
a. Most staph. aureous develop resistance to B-lactam

b. Staph. could change penicillin binding protein and hence develop resistance
c. Vancomycin is used in methicillin resistance m.o.
All
Vancomycin:
- G+ve cocci esp. [Nisseria + clostridia + severe staph. + Pseudomonas]
- Never oral too toxic for routine use used for resistant infections IV
- Used also for Pseudo-membrane colitis (layer of exudate, esp. on the
mucosa or conjunctiva, resembling a membrane)
In Augmentin, the role of clavulonic acid is:

459.
Lactamase inhibitor
lactam antibiotic act by:

460.
Inhibition of cell wall synthesis

461.
Antibiotic given once daily:
- Zithromax
- Doxycin
- Tavanic (Levofloxacin)
462.
Cefuroxime is:
NOT a 3rd generation cephalosporin (2nd generation)
Penicillin
- Staph gp + Pseudomonas produce
penicillinase enzyme
- R1 substitution affect solubility +
stability
- R substitution affect stability of -
lactam ring
- Salts are more soluble oral
- Esters (procaine, benzathine) poorly
soluble IM
- 1 Unit Pen G = 0.6 g
Penicillinase Acid-Labile Penicillin G
Sensitive (benzyl)
Acid- Ampicillin
Resistant
Amoxicillin
Carbinicillin
Ticarcillin
Phenoxy
methyl (PenV)
Penicillinase Acid-Labile Methicillin
Resistant
Acid- Oxacillin
Resistant
Cloxacillin
Dicloxacillin
Naficillin
463.
Antibiotic not used orally:
Streptomycin + Penicillin G
464.
Penicillin + tetracycline antagonism
Antacid and penicillin:

465.
Decrease effect of penicillin
466.
Which m.o. causes mitral valve prolapse:
467.
In dental problems, endocarditis due to m.o.:
Streptococcus viridians Amoxicillin is given for prophylaxis
- TTT {erythromycin} or {Penicillin V = long course}
- During infection fever tend to peak in late after noon (10 pm : 6 am)
Penicillinase resistant penicillins are:

468.
Oxacillin (cloxa + dicloxa+ Methi + Nafi cillin)
Which antibiotic is penicillinase resistant but not acid resistant:

469.
Methicillin
Which antibiotic is acid resistant but penicillinase sensitive:

470.
Ampicillin
Which antibiotic is both acid and penicillinase resistant:

471.
Cloxacillin
Pen G administered on empty stomach 1 hour before meals to:

472.
To maximize bioavailability
473.
Grey baby syndrome occurs with:
Chloramphenicol
Due to circulatory collapse + excessive serum concentration of unconjugated
chloramphenicol maintained for several days due to immaturity of drug metabolizing
enzymes in children
Antibiotic not taken in children under 12 years:

474.
Chloramphenicol
475.
Tetracycline side effect:
Fanconi syndrome
An inherited type of anemia, usually coming on in childhood. It may be accompanied
by dwarfism, crossed-eyes, mental defects, and other abnormalities
[TC upon aging (high humidity + high Temp) Epi-anhydro-TC + Anhydro-TC
(amber-to-brown semisolid=toxic) N&V + Renal damage =
(Protein-urea + acidosis + aminoaciduria)] Its Reversible
476.
One of the major side effects of tetracycline in pregnant women:
Baby with yellow teeth
Probenicid increase action of:

477.
Penicillin because it reabsorption of penicillin

Both are uricosuric
Which drug affect the plasmid in micro organisms ( DNA synthesis):

478.
Norfloxacin
Diphtheria caused by: CBD

479.
Corynbacterium
Test for immunity for diphtheria:

480.
Schicks test:
Toxin is injected ID (intra-dermal) local redness = +ve (non immune
person = susceptible to disease)
Plaque:
481.
Yersinia pestis transmitted by rats, fleas
482.
M.o. affect neonatal eye in Canada:
483.
Conjunctivitis in neonates in Canada is caused by:
- Chlamydia tracomotus
- Nisseria gonorrhea
TTT= {erythromycin} or {AgNO3}

Gm ve bacilli
Normal flora of Nose- Throat Vaginal cervix (less common)
484.
Causes of conjunctivitis is:
a. Viral
b. Bacterial
c. Allergy
All
485.
Which organism is least detected in meningococcal neonate:
a. H. influenza
b. S. aureous
c. E. coli
B
- Neonatal period 0-1 month E. coli
- 1 month 4 years H. influenza + strep
- Adult Streptococcus pneumonia + Staph
486.
Meningitis in adult is caused by:
Nisseria meningitis
487.
Sinusitis is due to:
a. Streptococcus pneumonia
b. Hemophilus influenza
c. Streptococcus pyogens
A+B
If make culture of m.o. of middle ear will NOT appear:

488.
Clostridium
489.
What damage is common with pathogen and human host cells:
Cell membrane
In otitis media which pathogen is NOT easily detected when aspiration of ear is
490.
performed:
Most common m.o. isolated from middle ear
- Streptococcus pneumonia
- Hemophilus influenza
Less frequently:
- Group A Hemolytic pneumonia
- Nisseria catari
- Streptococcus aureous
- Gm ve coliforms = E. coli + Klebsiella pneumonia + Pseudomonas
aeroginosa
491.
Gram +ve bacteria include:
Streptococci
492.
Mastaditis & Sinusitis is caused by:????487
a. Streptococcus pyogens
b. Streptococcus pneumonia Meningitis in adult
Gentamycin is used in treating eye infection caused by:

493.
Pseudomonas aeroginosa
Syphilis caused by:

494.
Treponema palladium+ Chancre
Treponema palladium causes: (Jul-2006)

495.
Chancre + Plaque = syphilis
496.
Organisms causing genital diseases:
a. Treponema palladium syphilis
b. Nisseria gonorrhea
c. Molluscum contagiosum
d. Chlamydia
All
497.
Most communicable disease all EXCEPT: (Jul-2006)
a. Botulism
b. Hepatitis
c. Influenza
A
498.
What is cholera caused by:
Vibrio cholera (Gm ve bacilli produces Exotoxin)
Rabies:
499.
- Acute Fatal Infectious Viral disease of animals (dog, fox, cat)

- Characterized by involvement of CNS resulting in paralysis and finally death
- Transmitted by bite of the animal (Saliva)
Negri bodies inclusion bodies (spherical. eosinophilic) found in brain of rabid
animal & people. Formed due to allergic reaction
Tularemia:
- Transmitted by bites of flees & ticks reservoir = rodents (rats, rabbits) &
semi-aquatic mammals (musk rats) = bacterium Francisella tularensis (febrile
disease)
- TTT = Streptomycin + tetracycline
Botulism caused by:

500.
Exotoxin poisoning by Clostridium botulinum = G+ve

- Found in soil and GIT of domestic animals
- Grow under anaerobic condition in raw improperly canned preserved foods
(especially meat + non-acidic vegetables)
- Destroyed by boiling for 10 minutes
- TTT = Antitoxin for type A & B
501.
Gas gangrene caused by:
a. Clostridium perfringens
b. Clostridium welchii
c. Clostridium novyi
A Type A if type K all necrotizing effect (devitalizing tissue)
Tetanus clostridium tetani TTT by Vancomycin
All = 1) anaerobic 2) g +ve rods 3) produce Exotoxin 4) resistant to heat
Mantoux test :
502.
Test for TB (tuberculin test)

Small amount of tuberculin injected if local swelling person subjected to TB
(Vaccine for TB = BCG)
Tuberculosis is caused by (which cause granulomas):

503.
Mycobacterium
504.
Mycobacterium causes:
a. Liquefied necrosis
b. Gaseous necrosis
c. Gangrenous necrosis
B
Prophylaxis of T.B.:
505.
INH (Isoniazide Hydrazide)

TTT of TB:
Isoniazide Rifampicin Pyrazinamide Ethambutol Streptomycin
1) Initial phase (2 months) I+R+P or E or S
2) Continuous phase (4 months) I (300mg/day) + R (600mg/day)
3) Other choices:
a. I+R+P for 2 month then I+R for 4 months 2 times/week
b. I+R+P+(E or S) daily for 2 weeks then 2 times/week for 1 month

then I+R 2 times/week for 4 months
c. I+R+P+(E or S) 3 times/week for 6 months
Rifater tab= I 50mg + R 120mg + P 300mg
Penicillin doesnt act on Mycophytes:

506.
Penicillin is not effective against:

507.
Mycobacterium, because they dont have cell wall (we use macrolides)
Acid fast bacteria: TB= they differ from all other m.o. in:
1) contain high conc of Fatty acids
2) presence of mycolic acid & waxy substance
Macrolides:
Erythromycin, Clindamycin, Clarithromycin, Lincomycin
- Drug of choice for penicillin-sensitive patients
- Effective Legionnaire disease + Mycobacterium
- Can be used during pregnancy
- Lincomycin + Clindamycin restricted for anaerobic infections cause
serious diarrhea + colitis (pseudo-membrane)
508.
Which organisms are anaerobic:
a. Streptococcus pyogens
b. Clostridium
c. Enterobacter
B+C
509.
Scabies is eradicated by
a. Gamma benzene hexa chloride
b. Benzyl benzoate
c. Pyrethrine and piperinyl butoxide
A + B
510.
Lindane cream:
a. used for head and body lice shampoo
b. used for TTT of scabies cream or lotion = single use
B
511.
Anthralin cream (for psoriasis)
a. Photosensitive
b. Stain
c. Refrigerator
B
Scabies in 2 years child OTC TTT:

512.
- Kwellada - Benzyl benzoate - Eurax - Sulfur
513.
Scabies is caused by:
Mites
514.
Typhus is transmitted by:
Is transmitted by body lice (rickettsia)
TTT: Chloramphenicol - Tetracycline

- A disease caused by Rickettsia (R. prowazekii)
- It has no relation to typhoid fever and is often caused by the bite of infected
body lice.
- Seen in epidemic form, especially when hygienic precautions are at low ebb,
as during wartime.
- It is characterized by high fever, headache, a body rash, mental confusion,
with sudden recovery in about two weeks.
- In severe cases, death ensues. Protection against this disease can be
obtained through vaccination.
Any of a group of acute infectious fevers caused by rickettsia, often transmitted by lice or fleas,
and characterized by a purple rash, headaches, and usu. delirium; esp. the classical epidemic
form, transmitted by lice. Also typhus fever. Also called spotted fever
N.B. Virus & Rickettsia differ from bacterial cell they cant live outside living
tissue bacteria can grow on synthetic media
What causes typhoid fever:

515.
Salmonella typhosa carrier in gall bladder, UT

- It enters the body through infected water, milk, food, seafood or by contagion
from a person harboring the typhoid germs.
- It causes high fever, ulcers of the intestine, diarrhea, headache, weakness,
hemorrhages, etc.
- It takes six to eight weeks to subside and is often accompanied by
complications and relapses.
- Protection against this disease can be obtained by a series of typhoid
vaccinations.
*** In culture media will not ferment lactose & sucrose (as shigella) + no gas
production
Shigella:
- Non-lactose fermenting entero-bacteria (as salmonella)
- Cause Bacillus shigellosis = dysentery (severe diarrhea)
Rocky Mountain spotted fever:

- Caused by rickettsia
- Transmitted by ticks man & animals
- TTT: Tetracycline + Chloramphenicol
516.
Rheumatic fever is caused by:
Streptococcus -hemolytic species
517.
What causes Scarlet fever:
Streptococcus -hemolytic species scarlet rash + strawberry tongue
TTT: sulfa + penicillin
518.
What causes Malta fever:
Brucellosis TTT: streptomycin + tetracycline
It causes: in cattle abortion in man undulant fever (up & down)
Yellow fever:
A tropical disease caused by an Arbovirus and transmitted by mosquitoes,

characterized by fever and jaundice and leading to degeneration of the liver and
kidneys endemic in tropical climate
Vaccine (D17 vaccine) live attenuated immunity < 1 year
(Sabin vaccine as polio)
Weils disease:
Jaundice caused by infection with a spirochete germ. It lasts for several weeks and
then clears up Leptospira ictero-hemorrhegia
Trench mouth: Vincent's infection

Ulceration of the gums and mucous membranes of the throat caused by a specific
germ Borrelia vincenti, highly found in mouth along with Borrelia buccalis
Thrush:
Inflammation of the buccal cavity caused by fungus infection (monilia) [often
seen in children] it can be diagnosed by white patches on the tongue and
membranes of the mouth TTT: Nystatin
Hansens disease is:

519.
Leprosy Mycobacterium leproe TTT=dapsone
520.
Nosocomial infection:
- most common E. coli
- pseudomonas
- Klebsiella, serratia, proteus, Candida
- Staphylococcus aureous
521.
Nosocomial infection can be prevented by:
a. Hand washing
b. Proper use of antibiotics
c. Isolation of infected person
d. Using aseptic technique
D
Most common UTI is caused by:

522.
a. Gm +ve cocci
b. Gm -ve cocci
c. Gm +ve bacilli
d. Gm -ve bacilli
D E. coli
UTI antibiotic to be effective it must be:
1) Highly active against g-ve bacilli
2) Low protein binding
3) Low t1/2 (to produce rapid conc. in urine)
4) Low Vd
523.
Most common urinary tract m.o.:
E. coli
Most common urinary tract infection occur for:

524.
Pregnant women
In urinary tract infection, the organism is isolated after mixing:

525.
Midstream urine
Mode of transmission of Herpes simplex:

526.
Lesions (direct contact)
Herpes Zoster:
- By contact or- by droplet infection
- Acute infection of CNS formation of very painful vesicular eruption in the
area of affected nerve
Herpes simplex: affects
1) Oral (kissing) stomatitis
2) Eye keratoconjunctivitis
3) Penis & vulva vesicular lesions
4) Fingers paranchia
5) Skin chicken pox
All are bacterial infection EXCEPT:

527.
Rubella virus
Rubella is:
528.
German measles
Shingles disease is caused by:

529.
Herpes Zoster
530.
Shingles disease:
a. It is a disease in the peripheral nervous system
b. It is a disease in the central nervous system
A
531.
Which is used in chicken pox:
a. Calamine
b. Oath bath
c. Phenhydramine
A+B
532.
Acyclovir used in:
a. AIDS
b. Herpes simplex
c. HIV
B
533.
Acyclovir is used in treatment of all EXCEPT:
A. Herpes simplex
B. Herpes encephalitis
C. Herpes zoster
D. Varicella
B
534.
Which of the following is not sexually transmitted disease:
a. Chlamydia trichomatis
b. Ureaplasma urealyticum
c. Moxcellium contagiosum
d. Herpes simplex
e. Syphilis
B+C
535.
Herpes simplex cause infection of the eye lid & conjunctivitis is treated by:
Iodoxiuridine (eye oint or sol.) never oral as it inhibits DNA replication (selectivity
to viral cell > host cell)
Epstein-Barr virus (EBV = Lysteria monocytogens) Herpes virus

Causing Mononucleosis ( no. of Monocytes > normal)
Interferon glycoprotein complex inhibit virus replication

Amantadine antiviral + TTT Parkinsonism (release dopamine)
Vidrabine (Vira A) antiviral believed to viral replication
Herpes simplex + herpes encephalitis
Emetine HCl is used for:

536.
Entamoeba histolytica
537.
Shistosoma causes:
Liver cirrhosis
Shistosomiasis is treated by:

538.
Praziquantel
539.
What is the treatment of tap worms:
Niclosamide
Quinacrine not used in TTT of tape worms in patients with history of
Psoriasis or Psychosis
Thiobendazole (Mintezol) whipworm, hook worm, trichurus, strongyloids
Which drug used as anthelmentic:

540.
Pavomate (Pyruvinium pomoate)
Hookworm: Anclystoma duodenalis parasite can enter body through intact skin
of feet blood circulation lining of intestine sucks blood severe anemia
Formites: non living material (cloths, needle, syringe) that can transmit diseases
541.
Bacteria and pyuria are characteristics of:
UTI
542.
In the deepest area under the plaque, there might be:
a. Anaerobic bacteria
b. Aerobic bacteria
c. Plaque prones
All
543.
Copious purulent mucous accompany:
a. Chronic bronchitis
b. Emphysema
A
544.
Anaerobic bacteria : Aerobic bacteria in colon: (Jul-2006)
a. 50% : 50%
b. 60% : 60%
c. 10% : 90%
d. 90% : 10%
e. 10% : 90%
D
545.
Bacterial flora present in: (Jul-2006)
a. Bile
b. Colon
c. Stomach
d. Duodenum
??d I think
546.
Which is the most abundant cytochrome in the GIT intestine:
a. Cytochrome A
b. Cytochrome B19
c. Cytochrome P453A4
d. Cytochrome E
C
547.
Patient should take a prophylaxis from Streptococcus viridians in case of:
a. Prosthetic valve
b. Previous endocarditis
c. Myocardial infarction
d. Dental procedures
D
Transmission of influenza virus:

548.
Respiration
Influenza vaccine may cause allergy because:

549.
A protein (killed vaccine)
550.
When influenza vaccine is given:
All seasons
551.
Vaccination is given for each of the following EXCEPT:
a. Measles
b. H. influenza B
c. H. influenza A
d. Hepatitis A passive vaccination only
e. Hepatitis B
C
Active vaccination:
552.
Does not give long lasting immunization cause it need booster doses
Killed passive Attenuated active
553.
Attenuated viruses used for vaccination are:
a. Poliomyelitis virus
b. Mycobacterium TB (BCG)
c. MMR
All
Live attenuated Polio + TB + MMR

Toxoids Diphtheria + tetanus (= DPT but only P killed) P= pertussis
Killed Hemophilus B (no vaccine for HIA) + Hepatitis (A+B) + Rabies + Cholera +
Pertussis (whooping cough)
Active immunity Passive immunity
We give antigen (toxoid) body We give Anti-toxin ready made
develops it own antibodies immunity (Gamma globulin)
IM or S.C. (1-2 months) e.g.
Toxoid = detoxified toxin (antigen) measles, chicken pox
Need booster dose IV or IM therapeutic effect
Endogenous vaccine: prepared from patients own organisms
Mumps: ( ) incubation period = 2-3 weeks

Biovax II: mixture vaccine of mumps + rubella
Small pox vaccine:

- Killed vaccine
- Prepared by making glycerol susp of vesicles
Rabies vaccine:
- Killed vaccine
- To ensure its killed test for non infectious in rabbits
- Immune globulin advantage over anti-rabies serum less allergic reactions
Tetanus vaccine:
Should be given IM or SC effect lasts for 10 days
Sabin vaccine:
- Live attenuated for polio = pink = oral
- Better than >> Salk vaccine
Toxoid:
Obtained from culture filtrate of viable organism Exotoxin + formaldehyde
inactive toxin (=toxoid) used for immunization
Antitoxin:
- Antibodies produced bacterial toxin or others (as scorpion & snack venom)
- Usually bounded to globulin fraction from animal from which they are
prepared or taken
554.
Which patient is chronic carrier:
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
B+C
555.
Which of carriers is predisposed to infection:
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
B+C
556.
TTT of N. gonorrhea:
- Pen G. + probenicid drug of choice
- Ceftriaxone (Rocephin) single dose
- Spectinomycin in pt sensitive to penicillin (2gm IM single dose)
- Tetracycline
557.
Drugs used in prophylaxis of malaria:
- Chloroquine
- Primaquine
- Quinine (Not Quinidine heart)
- Mefloquine
- Pyrimethamine
- Fansidar (Sulfadoxine + Pyrimethamine 500/25)
2 weeks before exposure + 4-6 weeks after leaving the endemic region
Primaquine = most effective + least toxic
Man with his child is traveling to an area with malaria & planned to spend there 4
558.
weeks. Supposed that one tablet contain 100 mg & dose weekly is 200mg, how
many tablets required: (Jul-2006)
Malaria dose is once weekly
Time = 2 weeks before travel + 4 weeks stay + 4weeks after return (PROPHYLAXIS)
= 10 WEEKS = 200X10= 2000mg
2 persons 2000x2 = 4000mg/100mg one tablet =40 tablet
559.
17 years old girl with athletes foot use: (Jul-2006)
Tolnaftate or clotrimazole
Desenex ointment:
560.
Antifungal athletes foot = Zn undecylinate
561.
Which is NOT active against fungal infection:
a. Nystatin
b. Clotrimazole
c. Metronidazole
d. Gerisofulvin
e. Ketoconazole
C
Diaper Rash: (Jul-2006)

562.
Not cleaned with alcohol

563.
Diaper dermatitis:
a. Can be complicated by fungal infection
b. Primarily in breast fed infants
c. Primarily in neonates (less than 1 month)
All A+B
564.
Uncomplicated diaper rash can be treated by: (Jul-2006)
a. Nystatin
b. Petrolatum
c. ZnO
All
565.
In Baby dryness which is not useful indication: (Jul-2006)
a. Sunken eye
b. Dry skin
c. No tears
d. Skin treasure
??
566.
Which taken for antifungal in scalp:
a. Tar
b. Miconazole
c. Cortisone
A+B
Ring worm is:

567.
Dermatophyte 1) Tinea capitis in scalp

2) Tinea pedis athletes foot
3) Tinea ungium nails (onchomycrosis)
4) Tinea crusis in groin
TTT Tolnaftate + Gerisofulvin = Dermatophytes only

Candida + Dermatophytes Clotrimazole + Econazole + Miconazole + Ketoconazole
Candicidin (Candeptin):
Antibiotic has antifungal action esp vaginal candidiasis
Which one is more susceptible to Candida infection:

568.
Teenager with mouth ulcer
569.
Candida is associated with all EXCEPT: (Jul-2006)
a. Cheese Secretion
b. Fishy odor
c. Itching
d. Inflammation
e. Low PH
E
570.
Trichomonus Vaginalis is caused by:
Flagellated protozoa (Genital flagellates Genus Trichomonus)
{TTT= Metronidazole}
571.
Leucorrhea:
Treated with 0.25% acetic acid douche

A whitish discharge from the vagina, often caused by a fungus infection
(Trichomonus vaginalis)
- Acetic acid bladder irrigator
- Boric acid mild antiseptic (eye, topically or vaginally)
- Tannic acid astringent (in burns & wounds)
- Undeclynic acid (Desenex) antifungal (ring worm + athletes foot
fungistatic)
- Trans-Retinoic acid acne = topical cis =oral
- PABA sunscreen (Enrlichs test)
572.
Lady with vaginitis advice:
- Dont use nylon underwear
- Topical nystatin
- Acetic acid vaginal douche
- frequent douche to avoid recurrence
573.
m.o. causes non specific vaginitis:
Hemophilus TTT: Ampicillin 500 mg qid 6-10 days
574.
Clotrimazole and Warfarin interaction:
a. Increase the release of vitamin K from intestinal bacteria
b. Interact with Warfarin metabolism
c. Interact by displacement Warfarin from protein binding site
All
These tablets affect each other activity by a way other than absorption:
575.
Warfarin + Cimetidine (Cimetidine = liver ME)
576.
Clotrimazole interact with vitamin K by:
Affect on intestinal bacterial flora
577.
Ketoconazole is contraindicated in all EXCEPT:
a. Warfarin
b. Cimetidine
c. Dextromethorphan
d. Theophylline
C
Transplantation is rejected due to:

578.
Gamma globulin cellular immunogenicity T cells
Human body rejects organ transplant, why:

579.
T-cells
Immunoradiology measures:
580.
Antigen (Ag)
Mode of transmission of Hepatitis A is by:

581.
- Direct personal contact

- Fecal and oral route
- Food and water
Hepatitis B is by:
- Sexual transmission
- Blood and blood products
582.
G+ve & g-ve differ in:
Cell wall structure
G+ve = Techoic acid + peptidoglycans (Blue)
G-ve = Lipo-polysaccharide + peptidoglycans (Red)
Gram stain = Crystal violet I2 alcohol (decolorize g-ve) Sofranin (red)
Mordant substance that fixes bacterial stains & become permanent
Eukaryotic cell differ from prokaryotic cell in:

583.
a. Prokaryotic contain nuclear membrane

b. Genetic material in eukaryotic is present in different organ (for multiplication)
c. Differ in cytoplasm
d. Cell wall composition
B+D
Eukaryotic (G+ve) = Nuclear membrane + ER + Mitochondria No Chromosome
Prokaryotic (G-ve) = No nuclear membrane + no ER + no Mitochondria +
1 chromosome only
584.
The m.o. with techoic acid in its cell wall:
a. Staph. Aureous
b. E. coli
c. Chlamydia
A
585.
Difference between human cell and bacterial cell lies in:
Cell wall
Which is responsible for biotransformation enzymes:

586.
Mitochondria
587.
Enzyme action is in:
a. Endoplasmic reticulum
b. Golgi bodies
c. Mitochondria
d. Cytochrome
A
588.
Mitochondria contains :
- Cytochrome C
- Cytochrome oxidase
- Succinic acid oxidase
589.
The presence of mitochondria in the living cell can be detected by:
a. Neutral red
b. Methylene blue
c. Jenus Green
d. Phenol phthaline
e. Non of the above
C
Mitochondria is:
590.
The power house of the cell
591.
In the typical cell, the mitochondria contains:
a. Cytochrome oxidase
b. Succinic oxidase
c. Cytochrome
d. All of the above
D all enzymes of aerobic oxidation
592.
Monocytes resemble:
a. Neutrophils
b. Basophiles
c. Lymphocytes
d. Eosinophile
C
Mast cells can not be differentiated from:

593.
Basophiles
594.
Mast cells contain: H + H
- Histamine
- Heparin
595.
Intra-articular means:
In joint space
Intrathecal in spinal fluid
Intrasynovial joint fluid
The tubes in the cell cytoplasm is:

596.
The thin tubular network in the cell that participate in biotransformation is:
597.
The endoplasmic reticulum
- Drug biotransformation takes place in almost any tissue of the body.

- The most important organ is the LIVER
- The most important site in the liver is the E.R. which is broken into
MICROSOMES when the liver is homogenized
598.
Which is not related to lymphocytes:
a. Spleen
b. Thoracic duct
c. Thyroid gland
d. Pancreas
C+D
Lymphatic system includes:
- Spleen+ Thoracic duct + Thymus gland + Lymph nodes + Tonsils + cisterna chyli
599.
Lymphocytes & lymphatic system do all EXCEPT: (Jul-2006)
a. Produce lymphocytes
b. Transfer fat from stomach to spleen
c. Absorb fat soluble vitamin

C
600.
Between the particulate & miceller constituents of cell, exist an aqueous phase
which contains:
a. Soluble protein
b. Organic substance such as glucose
c. Cellular active products
d. Electrolytes
e. All of the above
E
601.
Bacteria are characterized by absence of:
a. Flagella
b. Mitochondria
c. Nuclide
d. Nucleus
D
602.
The main carbohydrate in the body:
d-Glucose
Sucrose (disaccharide) = glucose + fructose
603.
The only disaccharide synthesized during human metabolism is:
a. Maltose
b. Lactose & sucrose
c. Fructose & glucose
d. Cellulose
e. Erythrose
A
604.
Keratin is a:
a. Protein
b. Albuminoid
c. Glutelin
d. Peptin
e. Ketone
B Keratin present in hair & nail
605.
Which of the following is available in all connective tissue:
a. Mucoid
b. Lipids
c. Albuminoid
d. All of the above
A Substance resembling mucin, esp. a proteoglycan
606.
Which does not undergo biodegradation (not biodegradable):
Poly-l-lactic acid
Lecithin is:
607.
Phospholipid
Emulsifying agent for lipids:

608.
Lecithin
Essential amino acid:

609.
Methionine Histadine Thionine

Isoleuocine Tryptophan
Leuocine Methionine
Lysine not synthesized by the body
610.
Auto-oxidation of drug is due to:
- Free radicals
- Chain reaction
611.
Protein denaturated by:
- heat
- shaking
- exposure to air
- dilution
- chemo reagent
- X-ray
612.
Protein kinase:
- Activated by cAMP
- Has a regulatory sub units
- Function is limited by certain enzymes
613.
Protein which is NOT involved in muscle contraction:
a. Tropsonin
b. Myosin
c. Inhibin
d. Myotropin
C
614.
Protein + PEG:
a. Increase renal clearance
b. Decrease immunization
c. Increase biodegradation
d. Increase duration of action ( degradation)
D
615.
By using isoelectric points which are different in electrophoretic process:
It can differentiate or separate between protein amino acids or different proteins
The migration of molecules or colloidal particles through a liquid or gel under the influence of an
applied electric field; a technique employing this to separate, identify, or measure the components
of protein mixtures
616.
In the electrophoretic process at a pH below the isoelectric point (7), a protein
will:
a. Migrate to ve pole
b. Migrate to +ve pole

c. Exhibit no migration
d. Form a Zwitter ion
e. Non of the above
A (-ve pole IEP 7 +ve pole) at pH = IEP protein will ppt (no migration)
Action potential is:

617.
The electrical changes which are associated with

Conduction of a nerve impulse or
Contraction of a muscle
That may be visualized by the use of cathode ray oscillograph
618.
Zeta potential:
Potential difference that exists across the electrical double layer at the interface of a
solid and a liquid
Dielectric constant:
If we put Ionic reactant in a solvent with low dielectric constant
Rate of reaction will be slower than a high dielectric constant solvent
Hydrometer :
619.
Measures specific gravity (g) of a fluid by floating in a liquid
Pyconometer measures:
620.
Measure the weight of 2 liquids with equal volume (determine sp gravity= wt/vol)
- It is a container used as specific gravity bottle with known capacity (10, 25 or

100 ml) so that the weight of water it will contain is already known.
- Specific gravity is also a ratio expressed decimally of the volume of the
substance to the volume of an equal weight of another liquid taken as
standard, both having the same temperature.
- Water is standard for most liquids.
621.
An important enzymatic reaction involved in muscular contraction:
a. Glucose-6-phosphate reaction
b. Glycogenolysis
c. ATP creatine trans-phosphorylase reaction
d. Enolase reaction
C
LD50 is: (median lethal dose)

622.
Dose which kills 50% of the experimental animals
Thermal death point:

When all bacteria of a given species are killed after 10 min of exposure to heat
How to kill spores:

1) Moist heat = 100oC + 15-30 min for 3 successive days
2) Autoclaving = 121oC + 20 min
Growth sequence of bacterial cell:
-
Bacteria + suitable media + suitable temp
growth
- Growth curve divided into 4 phases:
a. Lag phase (slow)
b. Logarithmic phase (accelerated)
c. Stationary phase (exponential)
d. Decline phase (death)
Bubble point test:
Used to check leakage of bacterial filter
623.
Laminar flow which is true:
a. Persons must be away 6 inches to all airflow
b. Vertical is more safe for the operator
All
Autoclaving:
624.
Sterilization by steam 15 min at 1210C
625.
All about sterilization are true EXCEPT:
a. Dry heat is better than steam in killing m.o.
b. Steam is used at temp 121
c. Steam is used for ointments and waxes
C
626.
Supersaturated steam is better than:
Dry heat in sterilization
627.
Ethylene oxide is used for (by alkylation):
- Sterilization of chemical waste products
- Has high penetration power to sealed plastic containers
Polypropylene syringes autoclavable
Busher automatic injector filled hypodermic syringe automatically administer
628.
Lyophylization process is:
a. More effective than dialysis in protein solution purification
b. Is generally not advisable for solution of proteins
c. Used for sterilization of some drugs by dehydration
C
Freeze drying = Loss of water at low temperature (change of moisture to vapor)
Sterilization of certain hormones by:

629.
Radiation TESTOSTERONE DRY HEAT
Means of protection of proteins:

630.
Lyophylization
Mineral oil is sterilized by:

631.
Dry heat
632.
Sterilization of antineoplastic:
- Vertical laminar flow hood
- Negative pressure technique

633.
-fetoprotein cause:
Liver carcinoma
634.
-fetoprotein elevates in:
a. 1ry biliary obstruction
b. Secondary biliary obstruction
c. Acetaminophen poisoning
d. Hepatoma
D
Which nucleotide base is NOT present in DNA:

635.
Uracil
Nucleic acid = Polymer of Pyrimidine + Purine bases linked to
Ribose OR Deoxy-ribose sugar + PO4 gp. (base + sugar + PO4)
DNA base pairs= A-T, C-G (Adenine-Thionine) (Cytosine-Guanine)
RNA base pairs = A-U, C-G (Uracil)
636.
Which included in RNA:
a. t-RNA
b. m-RNA
c. r-RNA
All
DNA replication enzyme:

637.
DNA Ligase (catalyze the formation of bond between two substrate molecules
coupled with hydrolysis of pyrophosphate bond in ATP or similar energy donor)
638.
The nucleic acids RNA & DNA play an important role in the biosynthesis of
protein. The sugar inherent in their structure is:
a. Glucose
b. Sucrose
c. Fructose
d. Sorbose
e. Non of the above
E (RNA = ribose, DNA= Deoxy-ribose)
Mutagenic is:
639.
Genetic change in DNA caused by mutagenesis
mRNA is formed by:

640.
RNA polymerase
641.
Cell-cycle specific antineoplastic agents act on:
a. DNA synthesis (S-phase)
b. Mitosis
c. RNA synthesis
A
642.
Treatment of cell cycle specific chemotherapy:
a. Cross linking with DNA
b. Affect transcription
c. Affect mitosis
All
643.
Nabilone-canabinoid used in cancer chemotherapy:
To control nausea & vomiting antiemetic
Vinca act on:

644.
Mitotic spindle formation
645.
Vincristine mechanism of action:
a. Alkylating agent
b. Topoisomerase function
c. Bind to DNA spindle
C
646.
Toxicity of neoplastic chemotherapy:
a. Alopecia
b. Bone marrow depression
c. GIT bleeding, ulcer, nausea , vomiting
d. Nephrotoxicity, immunosupression, teratogenicity, abortion
All
647.
Chemotherapy:
a. Nausea and vomiting due to action on chemo trigger zone
b. Some may develop tolerance to nausea and vomiting
A
648.
In cancer chemotherapy, usually drugs act as antimetabolite which are:
a. 6-Mercaptopurine
b. Methotrexate
c. Thiouracil
d. All of the above
D
649.
Which may give false +ve result in 5HIAA test for carcinoma:
a. NaCl
b. Glyceryl guicalate
c. Tetracycline
d. Mephenesin
e. Ampicillin
B+D (5-Hydroxy-Indol Acetic Acid)
650.
Which of the following enhances the activity of Azathioprine (Imuran) by
enzymatic oxidation inhibition:
a. Allopurinol
b. Elase
c. Dipyridamol
d. Trimethoprim
e. Tranyl cypromine
A
Hodgkin's disease :
651.
TTT by Procarbazine
A malignant disease involving the lymph nodes and, eventually, the spleen and liver
What is polycythemia treated with:

652.
Sodium P32 No RBCs (bone marrow cancer)
A disease characterized by too many red blood cells. It is associated with an enlarged
spleen, hemorrhages from the nose, mouth, intestinal tract, etc.
Antineoplastic drugs:
1) Antimetabolites = Interfering with DNA:
Interfere with cell synthesis of essential components (by competing with
the natural synthesis of the enzyme involved)
Interfere with synthesis of un-natural cell constituents
- Methotrexate folic acid antagonist
- 6-Mercaptopurine Purine antagonist
- 5-Flurouracil + Cytarabine (Cytosine arabinoside) Pyrimidine antagonist
5-Fluorouracil (cytotoxic)
Modified Pyrimidine similar to Uracil & Thiamine IV + Lotion & cream =
EFUDEX Roche (TTT of pre-malignant actinic keratosis) actinic = light
NOT ORAL irregular absorption IV in case of colon, rectum, breast &
ovaries cancer
Interfere with RNA synthesis
2) Antibiotics: (Cytotoxic drugs)

Inhibit DNA synthesis stomach, colon, pancreas, breast, bladder cancer
- Actinomycin-D
- Mithramycin (Mithracin)
- Doxorubicin (Adriamycin)
- Mitomycin (Mutamycin)
3) Inhibiting protein synthesis: L-asparaginase = Leukemia
4) Alkylating agents = Interfering with replication & translation of DNA:

Highly reactive can alkylate (bind covalently) with DNA
Interfere with mitosis (cell replication) Producing
(Chromosomal damage + mutation + suppression of immune response)
- Nitrogen Mustard (Mechlorethamine) = IV infusion
- Chlorambucil (Leukeran) = oral
- Cyclophosphamide (Cytoxan) = oral or IV
- Melphalan (Alkeran) = oral
- Busulfan (Myleran) = oral
5) Interfering with mitotic spindle formation:

Vinca alkaloid (Vincristine + Vinblastine) block microtubular pptn
(necessary for mitosis) = bind with the tubulin so interfere with the assemble
of spindle protein during mitosis
6) Hormones:
- Corticosteroids lymphocytic leukemia
- Androgens breast cancer
- Estrogens prostatic cancer
- Progestins endometrium carcinoma
7) Miscellaneous:
a. Procarbazine (Natulane) used for TTT of Hodgkins disease
b. Nitros-urea GIT carcinoma
c. L-Asparaginase
8) Radioactive isotopes:
Elements that emit & ionizing radiation ONLY are used in
chemotherapy
They act by:
a. Inhibition of mitosis
b. Inhibition of bone marrow
c. Chromosomal mutation + fetal abnormalities
d. Affect reproductive system amenorrhea in female + sterility in male
1. Iodine 131: 3. Sodium P32

- t1/2 = 8 days NaI131 = oral - t1/2 = 14.3 days oral or IV
- Emit radiation - Emit radiation only
- used for hyperthyroidism + thyroid - used for Polycythemia (bcz its conc in
cancer bone marrow + spleen + lymph nodes
2. Gold 198: 4. Cobalt
- t1/2 = 2.7 days IV
- Emit radiation
653.
Technetium 99 (Tc99) is used to scan:
- Lung (macroaggregated albumin)
- Liver (solid colloid)
- Spleen
- Kidney (Glycoceptate)
- Brain
- Thyroid eliminated from lungs within 12-14 days
654.
What is NOT true for Tc99:
a. It is eliminated from the lungs in 30 days
b. Its half life is 6 hours
c. It is eluted in a Tc generator from radioactive decay of Molybdenum 99
d. It is in the form of sodium pertechnitate
e. It decays by gamma radiation
A
Radium Ra226 never used as source of radiation or tracer:

1) very long t1/2
2) very high retention time in body
Cobalt Co57 & 58 mostly used test for pernicious anemia
Radioisotope generator:
It is an ion exchange column on which a nuclide has been adsorbed

Isotope:
Chemical element which has the same chemical properties but different atomic mass
same no. of protons but different no. of neutrons
Mesoprostol is:
655.
Prostaglandin analogue PEG1
Mesoprostol is contraindicated in:

656.
Pregnancy
To terminate pregnancy we give prostaglandins with:

657.
Tamoxifen (anti-estrogen)
One of these medicine is used in abortion:

658.
Oxytocin
Premature labor is prevented by:

659.
Terbutaline B2 agonist (Butalin)
660.
Anti-estrogens:
- Tamoxifen
- Clomiphene
The most effective algesic is:

661.
Prostaglandins Bradykinin
662.
The greatest algesic agent is:
a. Bradykinin
b. Angiotensin
A
663.
Two most important autacoids (local hormones) are:
- Histamine
- Prostaglandins
664.
What is the effect of Cortisone:
- Hyperglycemia glucose tolerance + gluconeogenesis
- immunity
- Suppression of pituitary function
- Osteoporosis
- growth
- Hypokalemia
Corticosteroid do all EXCEPT:

665.
Decrease gluconeogenesis
Production of glucose from amino acid is called: (Jul-2006)

666.
Gluconeogenesis
667.
Corticosteroid long use causes:
a. Hypoglycemia
b. Cushing Syndrome (Moon Face)

c. Addisons disease
d. Osteoporosis
B+D
Hypofunction of adrenal cortex leads to:

668.
Decrease corticosteroids leads to:

669.
Addisons disease
Which % of hydrocortisone dont need prescription:

670.
0.05%
17-betamethasone valerate is more active than betamethasone because:

671.
Higher partition coefficient
Benison gel = betamethasone benzoate
A steroid with the least Na retention:

672.
Betamethasone + Dexamethasone
Relative Potency Eq. dose (mg) Na retention effect

Hydrocortisone 1 20 2
Cortisone 0.8 25 2
Prednisolone 4 5 1
Methyl prednisolone 5 4 -
Betamethasone 25 0.8 -
Dexamethasone 30 0.75 -
Prednisone is metabolized in body into:

673.
Prednisolone
674.
Prednisone may produce all the following EXCEPT:
a. Water retention
b. Muscle weakening
c. Hypoglycemia
C
Woman taking 2 mg corticosteroid and once she takes 4 mg, what should she do:
675.
Nothing and rest at bed
676.
Prednisolone TTT leads to:
a. Mood change
b. Bone destruction
c. Inhibition of growth
All
Prednisone dose regimen:

677.
0.6mg/Kg/day
The starting dose of treatment of rheumatoid arthritis by Methotrexate is:

678.
7.5 mg/week
679.
Patient take Methotrexate to prevent ulcer as side effect, he can take:
a. Folic acid
b. Niacin
c. Folinic acid (prevent mucosytis & myolosupression)
A
680.
Which drug is a modified antirheumatic:
a. Cortisone
b. Methotrexate
A
681.
All are right in rheumatic arthritis EXCEPT:
I. Autoimmune disease
II. E
III. Happen ONLY in weight bearing joint
III
Refecoxib is:
682.
Anti-Cox2
683.
Celecoxib can be taken in case of:
I. Osteoarthritis
II. Rheumatoid arthritis
III. Chronic muscle pain
I+II
Celecoxib:
684.
I. inhibit Cycloxygenase II
II. inhibit Cytochrome oxidase P450
III. antiplatelet aggregation
I
ASA inhibit Cox I+II
Steroid inhibit PG by inhibit Phospholipase enzyme
685.
A patient has allergy on taking Celecoxib this is due to:
a. Sulphonamide
b. Renal failure
c. CHF
A
686.
in NSAIDs toxicity, all are true EXCEPT:
a. Increased gastric problems when taken in combination with others
b. Photosensitivity
c. Blood dyscrasia
B
Most dangerous NSAID:

687.
Indomethacin
688.
Indomethacin is used as:
- Analgesic
- Antipyretic
- Anti-inflammatory (Inhibit prostaglandin secretion)
Diflunisal acts by:

689.
PG inhibitor = Dolobid also Zomax
Zomeprac Na:
690.
Analgesic = Cox inhibitor
Sulindac (Clinoril):
691.
NSAID similar to Indomethacin in structure

Must not take aspirin while TTT with Sulindac
692.
Piroxicam use in chronic rheumatoid arthritis:
- Produce GIT trouble
- Given once daily
Piroxicam act by:

693.
Acetylation of cyclo-oxygenase enzyme
Brufen is:
694.
Propionic acid derivative
Metal chelates used in rheumatic arthritis:

695.
Penicillamine
Metal used in rheumatoid arthritis:

696.
Gold
Ion not used therapeutically:

697.
Lead
Penicillamine is used as:

698.
Chelating agent to various metals: Lead + Copper

Wilsons disease:
Cu in body
Bed sores are due to:

699.
Pressure atrophy
In the treatment of Rheumatoid arthritis the salicylates provide:

700.
Only analgesic and anti-inflammatory effect
701.
Capsaicin is
a. Pepper extract
b. Used as analgesic
c. Capsicum extract
d. Produce heat
B+C+D
702.
Which drug is gout modifying drug:
a. Cortisone
b. Methotrexate
B not all?
Methotrexate: folic acid antagonist (antimetabolite)

Used for [1] Psoriasis ( remission in 70% of patients) [2] Rheumatoid arthritis
Action of morphine:
703.
1. Inhibit neuronal activity

2. Analgesic
3. Respiratory depression
4. Change in mood
5. Sedation
6. Miosis (pin-point pupil)
7. Nausea + vomiting (due to stimulation of CTZ)
8. Antitussive
9. Endocrine effect: inhibit release of FSH & LH
Peripheral effects OF MORPHINE:
1. Histamine release arteriolar + venous dilatation
Hypotension + Flushing + Increased loss of hair
2. Contraction of smooth muscles in biliary and bladders sphincter
3. Increase tone of GIT, biliary tract and ureter the intraluminal pressure in
these sphincters is increased and there may be spasm also inhibition of the
ACH release from mesenteric plexus causes marked reduction in propulsive
peristaltic movement resulting in constipation this is the basis of
antidiarrheal effect of opioid
704.
Morphine use is restricted to:
a. Acute pain
b. Antispasmodic
c. Cough sedative
A
We will use Naloxone in the poisoning of:

705.
Morphine
Test for Addiction:
By S.C. injection rapid mydriasis + precipitation of the abstinence syndrome
Which is NOT true for Naloxone:

706.
Antagonizes Phenobarbital action on respiration

(Correction: it is morphine antagonist not Phenobarbital)
Naloxone:
- Block or reverse the action of narcotic analgesics
- Antagonizes the respiratory depression of morphine
Tolerance for Narcotics is due to:

707.
Decreasing duration of analgesia in chronic pain, i.e. increasing dose of opiate to

maintain analgesia
Dose which is considered large dose:

708.
Morphine 6 times daily

Which of these is NOT occurring naturally:

709.
Diamorphine = diacetyl morphine = heroine
Enkephalins (& endorphins) which is NOT true:

710.
Responsible for pain

= They are endogenous PEPTIDE (in nerve endings) = opiate-like analgesic action
711.
Opiates action is due to affecting:
I. Hippocampus
II. Brain stem
III. Spinal cord
III
Morphine acts on: [1] Hypothalamus [2] Medulla [3] CTZ
[4] Spinal cord [5] Cerebral cortex
712.
Which is not side effects of Morphine:
- Dilatation of eye pupil (mydriasis)
- Diarrhea
-
713.
Patient with ulcerative colitis if treated with morphine:
Perforation in intestine
714.
The levo isomer of Propoxyphene is used as:
a. Antitussive
b. Urinary antiseptic
c. Analgesic
d. Anti-inflammatory
C (opiate agonist) = Darvon
715.
The dextro form of Levorphanol is used as:
a. Antitussive
b. Urinary antiseptic
c. Analgesic
d. Anti-inflammatory
A (Dextromethorphan)
716.
Patient who take Dextromethorphan... contraindicated with: (Jul-2006)
a. Paroxetine
b. Moclobemide
A+B
717.
Female with breast cancer, she is used to take Tamoxifen, Psyllium, combination
of acetaminophen-caffeine-codeine, her daughter is coming today of
hydromorphone and lactulose, the most important concern for the pharmacist is:
a. To inform her for the new side effects
b. To inform her that the new medication may worsen the constipation
c. He should counsel her for the new dose regimen
d. Irrational changing the prescription
A
718.
An 80 years old woman well known for the pharmacist, the doctor write a
prescription for Percosit (Oxycodone) for surgery and then he writes
Hydromorphone and lactulose. Her daughter come to fill the prescription, the
pharmacist great concern is about:
a. The constipation effect of the drug

b. The drug may cause addiction
c. The dose of each drug and its side effect
C
719.
A woman of 75 years old and she is well known for the pharmacist, the doctor
write a prescription for Percosit (Oxycodone) but the drug finished and she calls
the pharmacist on Saturday morning, what the pharmacist should do?
a. Fill all the drug for her
b. Recommend another non prescription drug that contain codeine
c. Tell the woman to go to walk-in clinic
d. Give the woman dose for this two days and tell her to talk to her doctor on
Monday
e. Call the doctor at service medical phone
D
A 35 year old, require a non prescription drug to help him to sleep, the
720.
pharmacist advised him to take Diphenydramine 25mg h.s.:

He must take it 30 min before sleep
721.
Young patient need a sleep aid, advice him first to:
- Try regular sleep
- Regular exercise
722.
Which instructions should be given for a patient with insomnia:
I. Try to take naps at afternoon
II. Exercise regularly
III. Take warm shower before sleeping
II+III
Analgesics are classified into:

I. Non-narcotic (NSAID)= e.g. ASA act on the THALAMUS
II. Narcotics = morphine + drv act on the THALAMUS + CORTEX
a. Morphine:
- Opium alkaloid
- Contraindicated in: 1) asthma it releases histamine + serotonin
2) Ulcerative colitis intestinal perforation
3) Pulmonary heart disease
- Side effects= Pin point pupil blocked by Atropine
- Do not affect uterine contraction
- To be active must be in levo (-) form
- In poisoning Gastric lavage is essential morphine is excreted in
stomach
b. Naloxone:
- Pure antagonist no analgesic Narcotic antidote
c. Codeine:
- It is Methyl-morphine = analgesic effect of morphine
- Low respiratory + addiction effect

- Antitussive
d. Oxycodone & Hydrocodone:
- Analgesic effect like morphine + addictive
- Used as supp
e. Heroine:
- Diacetyl morphine = Diamorphine does not exist naturally
- 10 times more potent > morphine + less antitussive & constipating
- Used for experiment work only high addiction
f. Levorphanol:
- 5 times more potent > morphine + longer duration
- Used IV in morphine poisoning
- Its dextro form = Dextromethorphan antitussive + no analgesic
g. Ethyl morphine:
- Least analgesic eye drops
h. Mepridine (Pethedine):
- 1/10 morphine analgesic effect
- Shorter duration
- Some respiratory depression
- Less constipation + less addiction
- No antitussive + No miosis
i. Darvon Propoxyphene (non-narcotic):
- Less analgesic < codeine + no addiction
- Structurally related to methadone but < 12-15 times in potency
Ethyl morphine Least analgesic eye drops

Oxymorphone Highest analgesic
Pentazocine Mixed agonist antagonist
Hydromorphone Suppositories
Methadone TTT of morphine addiction
Mepridine 1/10 morphine
Nalorphane (Naloxone) Antidote= narcotic antagonist
723.
Which is true about codeine:
a. Has no analgesic effect
b. Best for children
c. Unlike morphine to cause addiction when given as antitussive based on dose
frequency
B+C
724.
Codeine is used as:
- Analgesic
- Antitussive
Which is true for codeine:

725.
Addiction does not occur in case of antitussive doses
726.
Codeine as when given as antitussive is best for children:
Is unlike to cause addiction based on dose frequency
Which may cause opiate withdrawal symptoms in a patient with morphine

727.
dependence:
Mepridine = 1/10 morphine potency
728.
This structure is:
= Mepridine (Morphine drv)

a. Antibacterial
b. Anticholinergic
c. Antidepressant
d. Anesthetic
D
729.
Which of the following you give to a patient tolerant to morphine:
a. Heroine
b. Methadone
c. Morphine
d. Mepridine
D
Morphine patient can be substituted by:

730.
Methadone
731.
Mepridine toxicity which is true:
a. Naloxone is given until restoration of respiration
b. Naloxone is given 2 doses
c. Naloxone is not repeated
A
Drug of choice for constipation:

732.
Na docusate (stool softener)
733.
Constipation of morphine is treated by all EXCEPT:
a. Senna
b. Sodium docusate
c. Milk of magnesia
d. Bisacodyl
e. Psyllium
C
Laxatives
1. Docusate Stool softener
2. Mg(OH)2 enema By osmosis
3. Mineral oil Lubrication
4. Polaxamer 188 SAA of stool = stool softener
5. Bisacodyl (dulcolax) Stimulation of intestinal wall
6. Psyllium Produce bulky stool ( water content)
Bisacodyl enteric coated = to avoid gastric irritation

Not given with milk or antacid (1 hour) = cause premature dissolution
gastric irritation
734.
Elder patient with chronic constipation makes bowel movement 3 times/week,
what you give him:
a. Stimulant laxative
b. Advice to exercise
c. Take more fiber diet
d. Give stool softener = Na Docusate
e. Drink warm water t.i.d
D c+d???
In general when a patient over 50 comes to your pharmacy complaining of

735.
constipation, what do you suggest to give him:

High fiber diet
Liquid paraffin is used as:

736.
Emollient laxative
Lactulose SE= laxative:

737.
NH3 in blood
738.
Heavy castor oil: I2 value=
0
739.
Mineral oil is NOT used as cathartic because:
a. It interferes with absorption of fat soluble vitamins
b. Leak past anal sphincter
c. Interferes with healing of wounds in anorectal area
d. Lipid pneumonia when mineral oil gains access to lungs
e. Indigestible
A
740.
Mineral oil is:
- Chronic use decrease absorption of fat soluble vitamins (ADEK)
- Used as laxative
- Must be taken on empty stomach
- Not dissolved in acid
Heavy mineral oil:

741.
a. Absorbed and toxic

b. Chronic use may inhibit absorption of fat soluble vitamins
c. May cause aspiration pneumonitis
B+C
N.B. mineral oil is immiscible with alcohol
2 immiscible liquids are separated by:

742.
Fractional distillation
Vegetable oil + egg yolk, egg yolk act as:

743.
Emulsifying agent
744.
Essential oil is:
Volatile oil used as perfume
745.
Oil used in injection: Vegetable oils
a. Sesame oil
b. Linseed oil
c. Peanut oil
d. Cotton seed oil
e. Olive oil
f. Corn oil
All NO castor oil or mineral oil
In parenteral nutrition we use: (Jul-2006)

746.
Theobroma oil & olive oil
747.
Which is used for non-infective diarrhea:
a. Bismuth subsalicylate (Pepto-Bismol) For Travelers diarrhea
b. Atropine incorporated in Diphenoxylate to discourage abuse
c. Loperamide
C
Treatment of Acute diarrhea:

748.
Anti-motility drug Codeine phosphate + Morphine + Loperamide + Diphenoxylate
Polycarbophil safest antidiarrheal absorb large amount of water stool

formation + no effect on digestive enzymes or nutrients (not absorbed systematic)
749.
Bismuth subsalicylate is used in chronic diarrhea, act by:
a. Inhibit protein by local action
b. Has adsorbent properties
c. Salicylate portion has antidiarrheal action due to inhibition of PG synthesis
which is a mediator of intestinal secretions
d. Bloke the stool due to inhibition of bisulphite
e. GIT hemorrhage
B
Diphenoxylate (lomotil) Loperamide (Imodium)
Mepridine analogue Related to Diphenoxylate but not
Mepridine analogue
Taken 4 times (short duration) Taken 2-3 times (more potent +
rapid+ prolonged action)
No analgesic activity No analgesic activity
GIT propulsion GIT propulsion
CNS depression No CNS depression
Not used more than 5 days No tolerance + No dependence
Not recommended for children Does not stimulate opiate receptor
No withdrawal action
What is chilblains:
750.
Frostbite
Swelling and congestion of the skin due to cold + poor circulation; associated with
burning and itching. Seen most often on the front of the legs and hands.
What is Epistaxis:
751.
Nose bleeding
Stenosis: (Jul-2006)
752.
Narrowing of blood vessels
Aneurism:
753.
Abnormal dilatation of blood vessels
Enuresis:
754.
Involuntary discharge of urine during sleep

Cunningham clamp: device to stop urine flow in male enuresis
755.
Polyischemia is due to
Tissue necrosis
Pale ischemia is due to:

756.
Organ tourniquet
757.
Passage of the drug through the striatum corneal from the transdermal drug
depends on:
a. Osmosis
b. Diffusion
c. Partition
B
758.
In per-cutaneous absorption all are correct EXCEPT:
a. Major absorption occur via skin appendages
b. Absorption occurs by both diffusion and partition
B
759.
Rate limiting step in transdermal diffusion:
a. Liver metabolism
b. Kidney
c. Diffusion through skin
C
760.
Transdermal patches are used to:
a. Avoid first pass effect
b. Control the release of the drug
c. Can be used for very low and very high potency drugs
A
761.
Transdermal dosage form is used for:
a. Drugs with small t1/2
b. Potent drugs
c. Drugs with no first pass effect
A+B
762.
Nitroglycerin patches:
a. Should be used on dry area

b. If hypersensitivity we recommend to put cortisone
c. Rotation of site of application
All
763.
Passive diffusion:
Ficks law
Which is NOT true about diffusion:

764.
Transfer from low to high concentration gradient
Which layer regulates absorption of drug in skin:

765.
Cornium stratum
766.
Which decrease clearance of drug:
a. Active secretion
b. Tubular secretion
c. Tubular perturbation
d. Tubular reabsorption
D
767.
Agents used to avoid damage of drugs during freeze drying are called:
a. Lyprotectants
b. Humectants
c. Surfactants
d. Wetting agents
A
768.
Chloramphenicol is not advised for use because:
a. Its high cost
b. Does not cross BBB
c. Toxicity to pregnant woman
d. Cause aplastic anemia
e. Not effective
D
769.
Stat chart relationship between ligand and receptor diagram (or graph) quantities
is relating to:
a. amount of ligand bound to the receptor detected by the detector
b. confirm the identity of the material detected
c. can substitute the calibration of your instrument
A
770.
Which metal is present in body in highest concentration:
a. Zinc
b. Magnesium
c. Iron
d. Copper
C
771.
Which is not affected by presence of food:
a. Lofenalac
b. Prednisolone
c. Ampicillin
d. Cephalosporin
A
Long standing paranoid delusions:

772.
Schizophrenia
Drugs used to treat Schizophrenia has action of:

773.
Dopamine D2 antagonist
Mechanism of action of phenothiazine:

774.
Dopamine antagonist DA
Long term use extra pyramidal effects Parkinsonism
Which is the least sedating phenothiazine:

775.
Least sedating neurolyptic:

776.
Haloperidol
The phenothiazine with least side effects:

777.
Thioridazine (Melleril)
Phenothiazine with analgesic effect Metho-tri-perazine
Phenothiazine with anticholinergic effect Etho-pro-pazine (Parsidol)

TTT of tremors & rigidity of Parkinsonism
Cloxapine and chlorpromazine are:

778.
Dibenzapine and phenothiazine
Guanethidine causes:
779.
Postural hypotension response to the drug is greater in the erect position than in
supine position (= characteristic effect of CNS sympathetic blocker)
Phenothiazine causes orthostatic hypotension
Guanethidine action (adrenergic receptor blocker):

By direct action on arterioles = dilated + CNS effect (it replaces NA at nerve
endings NA in CNS = Antidepressant = relaxation)
TCA absorption of Guanethidine no antihypertensive effect
MAO= breakdown of {adrenaline + NA + 5-HT} (hydroxy-tyramine = serotonin)
MAO Inhibitors are not used with:

780.
Benzodiazepine
Nerve pill:
781.
Phenelzine (Hydrazine drv. of MAOI)

(Drug food interaction occurs in: Phenelzine with tyramine hypertensive crisis)
MAO Inhibitor + Tyramine (cheese, beer, yogurt, wine):

782.
Hypertensive crisis
TTT = {Na Nitrosis + diazoxide rapid IV}

Due to accumulation of Tyramine (not destroyed by MAO) NA release bp
Also MAOI + Guanethidine = Hypertensive crisis

Guanethidine releases NA from storage vesicles into cytoplasm where it is
deaminated by MAO so by MAOI no degradation of NA will NA
Moclobemide (Aurorix) & Paragyline (Entomyl) are: (Jul-2006)

783.
MAOA Inhibitor
784.
Side effects of MAOI used for atypical depression:
- Insomnia
- Orthostatic hypotension and dizziness
- Dry mouth
- Irritability
785.
Lithium:
a. Used in all forms of depression and Mania
b. Needs more than one week before appearance of effect
c. Has low safety margin
B+C only bipolar mania
Remember:
- Used to treat Bipolar affective disorder (manic depression + psychosis)
- The Na level Lithium level in the blood and vice versa pt should
NOT restrict Na diet intake if Na will excretion of Li accumulation +
toxic level of Li
- Not recommended in patient with renal failure and heart disease
N.B.:
Manic depression is a state of over-activity of Catecholamines transmission
Li enhances the destruction of CA
786.
Drug used in mania:
Lithium Carbonate
787.
Lithium is NOT used for:
Mild biogenic depression
Used in (manic depression, psychosis, bipolar disorder)
788.
Antidepressant selectively serotonin reuptake:
- Fluoxetine
- Trazadone (similar to Fluoxetine but not SSRI)
789.
Which antidepressant you prescribe for cancer patient who is on opiate
(morphine):
Trazadone
Trazadone (Desyrel, Trazolan):

- Cyclic antidepressant
- Much less anticholinergic & CVS side effects
- It acts by SRI TCA act on NA
790.
Selective serotonin inhibitor are:
- Fluoxetine (Prozac)
- Paroxetine (Paxil)
- Citalopram
- Fluvoxamine (Luvox) (Faverin)
- Sertaline (Lustral)
{Venlafaxime (Efexor) SNRI}
791.
Fluoxetine long action is due to:
a. Active metabolite (Nor-fluoxetine)
b. High plasma t1/2
c. High plasma protein binding (94%)
d. Less liver metabolism (extensively metabolized in liver)
D
Fluoxetine is: (Jul-2006)

792.
SSRI
793.
Patient on fluoxetine & suffer impotence, you can advice him to take:
(Jul-2006)
??
794.
Which of the following anti-depressant could be stopped gradually: (Jul-2006)
a. Fluoxetine
b. Citalopram
c. Fluvoxamine
d. Venlafaxime
All
795.
Which is a long acting antidepressant:
a. Fluoxetine
b. Paroxetine
c. Fluvoxamine
d. Citalopram
All
796.
Serotonin is made by:
a. Transamination of Tryptophan
b. Hydroxylation at position 5
c. Hydroxylation at position 6
d. Decarboxylation then by Hydroxylation at position 5
e. Decarboxylation then by Hydroxylation at position 6
D
797.
Serotonin is involved in all EXCEPT: (Jul-2006)
a. Sleep
b. Motor activity
c. Mood
d. Temperature
A
798.
The use of which drugs with serotogenic agent may cause serotonin syndrome:
a. MAO Inhibitor
b. Tricyclic antidepressants
All
if patient is taking nerve pills he should not use:

799.
Phenyl propanolamine
(Sympathomimetic + decongestant + weight controller + appetite)
800.
Most used in OTC weight control:
a. Phenyl propanolamine (PPA)
b. Benzocaine
A
801.
Anorexia nervosa (Symptoms): (Jul-2006)
a. Excessive exercise
b. Fear of weight gain
B
802.
Engomar:
Tension headache
Tension headache all are true EXCEPT:

803.
Characterized by neck stiffness and fever
804.
Migraine is characterized by:
a. Pain decrease after exercise
b. Severe pain
c. Throbbing pain
B+C
805.
Mechanism of action of Sumatriptan (somatropine) = imigrain
- Block effect of serotonin
- Selective 5HT1D & 5HT1B agonist
806.
Metyrosine is used in treatment of (Demser):
Phaeochromocytoma inhibit CA synthesis
A tumor of the adrenal gland often associated with markedly increased blood
pressure. Surgical removal of the growth is followed by clearing of symptoms.
807.
About buspiron:
a. It causes night mares
b. Has no sedative effect at therapeutic doses
c. It is better to use lozenges to overcome dry mouth
All
vvSide effects of neurolyptic overdose or Phenothiazines:

808.
Tardive Dyskinesia
Tardive Dyskinesia all are true EXCEPT:

809.
Reversed by anticholinergic CI
Treatment of tardive dyskinesia include all EXCEPT:

810.
Anticholinergic TTT= Large dose of L-dopa + neurolyptic drug holiday
811.
Tardive dyskinesia is:
- Defect in voluntary movement, and active movement is painful
- Due to long term use of phenothiazine
Primary symptoms of T. Dyskinesia:

812.
Movement (protrusion) of the tongue
PARKINSONISM
813.
Parkinsonism causes:
a. Tremors
b. Tardive dyskinesia
c. Gene deficient
A
814.
Parkinsonism complications are:
a. Dopamine blocker
b. Tremors
c. Tardive dyskinesia
d. Gene deficient
A+B+C
815.
Symptoms associated with parkinsonism:
a. Dry mouth
b. Drowsiness
c. Constipation
d. Muscular rigidity and tremors at rest
D
816.
What induces parkinsonism:
a. Haloperidol
b. Phenothiazines (chlorpromazine)
c. Clopidogril
d. Benzodiazepine
A+B
817.
Drugs used in treatment of parkinsonism:
a. Ropinrole D2 agonist
b. Cogentin Benzatropine mesylate Ach

c. Levodopa/carbidopa converted to dopamine in CNS
All
818.
Which is antiparkinsonism:
I- Ropinrole
II- Bromocriptine
III-Pramipexole
All
Parkinsonism disease is characterized by:

819.
Deficiency of Dopamine in the nigrostriatal pathway
820.
Which drug is effective orally in Parkinsonism:
a. Reserpine antihypertensive
b. Chlorpromazine major tranquilizer
c. Dopamine antihypertensive
d. Haloperidol tranquilizer
e. Amantadine stimulate release of dopamine
E
821.
The action of Benzatropine (Cogentin) in Parkinsonism:
Ach in stratum nigra = correct DA/ACH balance
Its anticholinergic CI in TD, EPS (due to phenothiazines long term use)
822.
Which drug can cause peripheral side effects or Parkinson-like symptoms:
823.
Drugs inducing parkinsonism:
- Haloperidol (butyrophenone)
- Chlorpromazine (phenothiazine)
In 70-80% of patients the neurolyptics (antipsychotic) cause extrapyramidal signs

EPS = (Stiffness, short steps, ramped handwriting, tremor, akinesia (lack of
movement) = which mimic Parkinsonism)
824.
Levodopa:
a. A small portion is transported to the CNS and converted to a substance which
acts on neurons
b. Inhibits dopa decarboxylase
A
Use of levo DOPA (L-DOPA) in parkinsonism is due to: (Jul-2006)

825.
Small part penetrates BBB & is metabolized to dopamine by decarboxylase
L-dopa is given with carbidopa:

826.
Carbidopa inhibit dopa-decarboxylase enzyme w degrade L-DOPA before entering

CNS
827.
L-dopa not given with vitamin B6:
Vitamin B6 increase dopa decarboxylase
828.
Alzheimer is due to:
Deficiency of Acetyl choline in CNS
Myasthenia Gravis:
Auto-immune disease muscle weakness + rapid fatigue due to ACH + High
anticholinesterase at neuromuscular ends
- Diagnosis by Edrophonium (competitive non-depolarizing NMB)
- TTT = Neostigmine to ACH
Which of the following is most effective in absence seizure (petit mal):

829.
a. Clonazepam (Rivotril)
b. Phenytoin (Epanutin)
c. Valproic acid (Depakine)
d. Ethosuximide (Zarontin) (or Methosuximide = Clenotin)
e. Carbamazepine (Tegretol)
D = Drug of choice if not mentioned so its Valproic acid (depakine)
N.B. Phenobarbitone petit mal epilepsy so contraindicated
Phenobarbitone + Valproic acid phenobarbitone 40 times dose must be
830.
Valproic acid is related to:
a. Phenytoin
b. Petit mal epilepsy
c. Grand mal epilepsy
B
831.
In grand mal epilepsy we use (Tonic-clonic):
a. Barbiturates (or Phenobarbital) (Luminal)
b. Phenytoin
c. Valproic acid
A+B
Best TTT: Primidone (Mysoline) all anticonvulsant causes disturbance of folic
acid metabolism (Phenytoin, Primidone, Phenobarbitone)
832.
In status epilepsy we give: (Repeated attacks of epilepsy occurring one after
another)
a. Diazepam IV (not infusion) = Valium
b. Phenobarbital
c. DPH (Di-phenyl hydantoin) = phenytoin
d. General anesthesia
A it has no respiratory depression Barbiturates
+ No hypotensive phenytoin
Epilepsy is due to:

833.
Deficiency of GABAA (the main inhibitory neurotransmitter in the brain = prevent

convulsions) Vit B6 GABA convulsions
834.
Early symptoms of epilepsy:
- Part of brain is involved
- Sensory seizure or focal motor seizure
- Patient is conscious
Myoclonic Seizures Absence seizures (petit mal) Tonic clonic (grand mal)
1. Valproic 1. Ethosuximide 1. Phenytoin

2. Clonazepam 2. Valproic 2. Phenobarbital
3. Clonazepam 3. Valproic
4. Carbamazepine
Partial seizures Second line antiepileptic
1. Gabapentin (Neurontin) 4. Tiagabine (Gabitril) 1. Acetazolamide
2. Lamotrigin (Lamictal) 5. Topiramate (Topamax) 2. Corticosteroid
3. Pregabalin (Lyrica) 6. Vigabatrin (Sabril)
835.
Phenobarbital is used as its salts so:
To increase its solubility
GABAa exert its effect by:

836.
Major inhibitory neurotransmitter
837.
What drug is used in febrile seizures in children:
- Valproic acid
- Phenobarbitone
- Antipyretic
Prevent febrile convulsions:

838.
Antipyretic
839.
Phenobarbitone induces liver microsomal enzymes when used chronically what
should be done:
Increase Dose
Which anticonvulsant when used for long time increase its own clearance:
840.
Phenobarbitone HME
Enzyme inducer Enzyme inhibitor

a. BZ 1. Cimetidine
b. Barb - Phenobarbital 2. Omeprazole
c. Phenytoin 3. SSRI
d. Rifampicin (TB) 4. MAOI
e. Alcohol (acute intake) 5. Alcohol (chronic intake)
f. Carbamazepine (Tegretol) 6. Allopurinol
g. Smoking 7. Phenyl butazone (gout blood dyscrasia)
h. Gerisofulvin 8. Chloramphenicol
9. Ciprofloxacin
10. Erythromycin
11. INH (TB)
12. Diltiazem + Verapamil (Ca channel
blocker)
13. Quinidine (antiarrhythmic)
841.
Phenobarbitone:
TTT of neonatal jaundice (by HME Glucouronide conjugation production
of bilirubin binding protein)
842.
Phenobarbital decrease the effect of others drugs by:
Liver microsomal enzyme inducer
Drugs which increase level of phenytoin:

843.
Chloramphenicol + cycloserine + INH + disulfuran + Metronidazole + Aspirin +

Cimetidine
844.
Phosphenytoin is converted to phenytoin by:
a. Esterase
b. Phosphatase
c. Amidase
B
845.
Phenytoin increase blood glucose level by:
a. Enhancing degradation of insulin
b. Increase glucose absorption
c. Increase glycogen release
d. Decreasing insulin release
e. B and C
D
846.
Which accelerate the metabolism of phenytoin:
Folic acid
847.
Mode of action of phenytoin:
Alters Na ion concentration by promotion of Na efflux
848.
Side effects of phenytoin:
- Gingival hyperplasia
- Steven Johnsons syndrome (same as Allopurinol+ Sulfa)
- Hirsutism
- Acne
- Ataxia inability of voluntary movements
- Hepatitis
- Hyperglycemia ( insulin)
- Megaloblastic anemia
Zidovudine side effects:

849.
Anemia N&V Headache Diarrhea Bone marrow depression

Ataxia Rash Malaise Myalgia
Cyclophosphamide side effect is:

850.
Hemorrhagic cystitis
851.
Classic side effect of amitriptylene is:
a. CNS stimulation
b. Prolong QRS complex
c. Insomnia
All
852.
Systemic Lupus Erythematosus is side effect of:
a. Hydralazine
b. Procainamide
c. Digoxin
A+B Also: Carbamazepine + Chlorpromazine + Penicillamine
853.
Agranulocytosis is side effect of cell of the following EXCEPT:
a. Sulfa
b. Methimazole
c. Heparin
C = in no. of WBCs due to bone marrow defect
854.
Agranulocytosis (agranyolocytopenia) is the side effect of:
a. Hypersensitivity type I
b. Hypersensitivity type II
c. Hypersensitivity type III
B
855.
Which is right about benzodiazepines (Valium-Ativan = anxiety, Epilepsy):
a. Potential drug abuse
b. Affect normal control of sleep ( REM sleep)
c. After long use then stop it lead to epilepsy
All
856.
Which of the following make drug abuse:
a. Tylenol no. 1
b. Caffeine
c. Isopropyl alcohol
A
857.
Benzodiazepines act on: (Jul-2006)
a. GABAa receptors
b. GABAb receptors
c. Adrenergic receptors
d. 5HT receptors
A
858.
Shortest action anesthetic benzodiazepine is:
- Triazolam inactive metabolites (least t1/2) but not fastest
- Lorazepam (if Triazolam not written)
Fastest action benzodiazepine is:

859.
Midazolam (Non-volatile General anesthesia) = Dormicum
Barbiturate that pass BBB:

860.
Thiopental
Which drug block Cl- channel:

861.
Benzodiazepine
862.
Which block Na+ at the skin:
Lidocaine
863.
All are Na-channel blocker EXCEPT:
a. Lidocaine
b. Phenytoin
c. Tetratoxin Cl- channel blocker
d. Procaine
e. Carbamazepine
C same as BZ
864.
Benzodiazepine & barbiturates:
a. Make Chloride channels open
b. Act on the same sites
A ?????
Antihistamine and anti-anxiety:

865.
Hydroxyzin = Atrax
Oral Antihistaminic not taken with: (Jul-2006)

866.
Amitriptylene (Not taken with anything has allergic activity)
867.
Of the following anti-anxiety agents, which one has the greatest degree of
antihistaminic action:
a. Diazepam
b. Hydroxyzin
c. Memprobamate
d. Chlorodiazepoxide
e. Oxazepam
B
868.
Pre-anesthetic medication are used for:
- Reduce anxiety + reduce side effects of anesthesia
- Skeletal muscle relaxation
- Block vagal reflex
- Inhibit salivary and respiratory tract secretions
869.
Pre-anesthetic medication are:
- Morphine (Narcotic analgesic)
- Diazepam (Benzodiazepine) To reduce anxiety
- Atropine Scopolamine (Anticholinergic) To block vagal reflex + inhibit
salivary and respiratory secretions
Dropridol (related to haloperidol) used as adjuvant to anesthesia
1) Produce sedation 2) post-operative nausea & vomiting
870.
Inhalation anesthesia include:
- Halothane
- Cyclopropane
- Nitrous oxide
- Ethyl ether
Non-volatile General anesthesia: Midazolam
871.
Concentration of inhalation anesthetic is:
NO 20-30%
When anesthesia occur:

872.
When appropriate concentration or Partial Pressure of the anesthetic agent is

present in brain tissue
873.
Inhalation anesthetic action is based on:
a. Concentration in alveolar sac
b. Partial pressure in alveolar sac
c. Partial pressure in the brain
C
874.
Inhaled anesthetic with shortest duration of action:
NO
Inhaled anesthesia can be determined by:

875.
Concentration of drug in alveoli airway
876.
The particle size of inhalation must be:
a. 0.1-1 micron < 1
b. 2-5
A
The particle size of aerosol must be:

877.
2-6
An anesthetic with short duration due to high distribution is:

878.
Thiopental
Drug of choice to induce sleep in pediatric and geriatric:

879.
Chloral hydrate
Which type of the local anesthetic is most effective:

880.
The most lipophylic
Which is favorable for general anesthesia in case of liver dysfunction:

881.
NO excreted from lung
Hypnotic of choice in renal failure:

882.
Paraldehyde excretion = lung
883.
Hypnotic of choice in insomnia:
Flurazepam
Agents acting on CNS
a. Hypnotics
b. Epilepsy (seizures)
c. Parkinsonism
d. Antipsychotic (major tranquilizers)
e. Antianxiety (minor tranquillizers)
f. Antidepressants
g. CNS stimulant
h. Narcotic analgesics
1. Hypnotics:
884.
Drugs that cause hypnosis by suppression of Reticular Activating System RAS in
the brain
885.
Classified into:
a) Barbiturates: = drv of barbituric acid
Duration Absorption from GIT
Thiopental
Ultra short 15 min Irregular so used IV anesthesia
Hexobarbital
Pentobarbital
Short acting 3 hours Rapid
Secobarbital
Intermediate Amobarbital 4-6 hours Fairly rapid
Phenobarbital
Long acting 6-8 hours Slow
Barbital
b) Non-Barbiturate:
1. Benzodiazepines:
Act on GABA receptors (block Cl- channel) facilitate the entry into the neuron and
produce inhibitory effect
(Flurazepam- Triazolam- Temozepam- Diazepam=Valium)
2. Chloral hydrate:
Metabolized first in tissue into Tri-chloro-ethol = potent hypnotic oxidized in
kidney + liver inactive form = excreted
*** Hypnotic of choice in pediatric & geriatric ***
3. Paraldehyde:
Oral or IV excreted by lungs Contraindicated in Lung + Liver disease
*** Hypnotic of choice in renal failure ***
4. Glutathemide Chemically related to Phenobarbital high addiction potential
5. Methyl prylone: Oral = sedative/hypnotic = according to the dose
6. Zapeclon, Zalpidem, Zaleplon (new)

7. Antihistamines (Promethazine)
2. Epilepsy:
1. Barbiturates narrow safety margin
2. Deoxy-barbiturate
3. Hydantoin: Phenytoin mephenytoin
4. Succinamides: Ethosuximide Methosuximide
5. Benzodiazepines: Diazepam Chlorazepate Clonazepam (Rivotril)
6. Others: Valproic acid Carbamazepine (used in pregnancy)
3. Parkinsonism:
1. L-dopa / carbidopa (Sinemet)
2. Benzatropine (Cogentin) Anticholinergic (+ procyclidine + orphenidine)
3. Amantadine (Symmetral) oral = stimulate release of dopamine
4. Bromocriptine (Parlodel) dopamine agonist
5. Antihistamine = Diphenhydramine (Benadryl)
6. Phenothiazine (Etho-pro-pazine = Parsidol) with anticholinergic effect
4. Antipsychotics: (Major Tranquilizers) = block Dopamine receptor
1. Phenothiazine: Chlorpromazine (Largactil)
Trifluoperazine (Stellazine)
Promethazine (Phenergan)
Prochloroperazine (Stemetil)
Fluphenazine (Modecate)
2. Reserpine (Rawolfia alkaloid)
3. Butyrophenone: Haloperidol Trifluopridol Dropridol (used as adjuvant
For anesthesia)
4. Thioxanthenes: Flupentixol (Flunaxol) Chlorothioxan (Taractan)
5. Atypical: Sulpiride (Dogmatil) Resperidone (Respiredal) Pimozide
(Orap)
Chlorpromazine (Largactil )
Uses: 1) Schizophrenia 2) Intractable hiccup

3) Vomiting due to chemotherapy (not effective in motion sickness)
Side effects: 1) Tardive dyskinesia + Parkinsonism 2) Dry mouth
3) Wt gain 4) Orthostatic hypotension 5) Jaundice
6) Skin rash 7) Neurolyptic malignant syndrome
Drug interactions: 1) Alcohol, BZ, Barb, TCA sedative effect
2) Antagonize antihypertensive effect of Guanethidine
- More potent than chlorpromazine but cause retinal toxicity
Trifluoperazine (Stellazine) better than Thioridazine
Butyrophenone:
Haloperidol Dropridol Side effects= Extra pyramidal signs (Parkinsonism)
5. Antianxiety: (minor tranquillizers = anxiolytics)

1. BZ drv:
Benzodiazepines drv
Short Acting Triazolam
t1/2= 2-4 hrs Midazolam
Intermediate Lorazepam (Ativan)
t1/2= 3-24 hrs Alprazolam (Xanax)
Oxazepam (Serax)
Long Chlorodiazepoxide (Librium) for alcohol withdrawal
t1/2 > 24hrs Diazepam (valium)
Chlorazepate (Tranexene)
Side effects of BZ: (no extrapyramidal)
1) Appetite + wt gain 2) Drowsiness 3) Skin rash
4) Menstrual irregularities 5) Ovulation failure 6) Ejaculation failure
2. Buspiron (Buspar)
3. Diphenyl methane drv: Hydroxyzin (Atrax) (antihistamine + analgesic)
Benactyzine
4. Propanediol drv: Meprobamate - Phenaglycodol
6. Antidepressants:
1. MAOI:
A. Non-selective (MAOA+MAOB) B. Selective (Reversible)

Phenelzine (Nardil )= nerve pill

Moclobemide (Aurorix)
Hydrazine drv
Isocarboxazide (Marplan )
Tranylcypromine (Parnate)
Non-hydrazine drv
Paragyline (Entomyl)
Drug interactions: +Tyramine = hypertensive crisis TTT: Phentolamine
- Barb - Guanethidine - TCA
2. TCA: inhibit uptake NA & serotonin

Imipramine (Tofranil) Nortriptylene (Aventyl)
Amitriptylene (Tryptizol) Doxepin (Sinequar)
Desipramine (Norpramin )
Protryptaline (Vivactyl)
Clomipramine (Anafranil) Trimipramine (Surmontil)
Drug interactions: MAO Guanethidine Clonidine
Alcohol effect
Side effects: 1) Atropine like 2) Postural hypotension 3) MI + arrhythmia
4) Tremors
3. SSRI:
Fluoxetine (Prozac) Sertaline (Lustral=Zoloft)
Paroxetine (Seroxat)(Paxil) Fluvoxamine (Luvox) (Faverin)
Citalopram (Cipram)
They dont have Atropine-like effects TCA + No problem with tyramine
Drug interactions: - TCA toxicity
- With MAO serotonin syndrome (tremors + hyperthermia)
4. Second generation antidepressant (Tetracyclic):
Trazadone (Trazolan) = SRI + Maprotiline (Ludiomil) = NRI
5. New:
Venlafaxime (Efexor) = SNRI Nefazodone (Dutonin) = SRI
Flupentixol (Flunaxol) Tryptophan (Optimax)
Mirtazapine (Zispin) Reboxatine (Edromax) = NRI
7. CNS Stimulants:
1. Xanthine drv: Caffeine Theophylline
2. Amphetamine gp: Amphetamine + Methamphetamine + Phenmetrazine
Dexamphetamine + Fenfluoramine CNS depression
3. Methyl Phenadate (Retalin)
4. Cocaine
5. Modanifil (Provigil)
8. Narcotic Analgesics:
Morphine, Codeine, Hydrocodone, Oxycodone, Heroin, Hydromorphone, Levorphanol
Propoxyphene, Tramadol, Pethedine,Diamorphine, Mepridine, Methadone,Pentazocine
Phenazocine, Diphenoxylate(Lomotil), Fentanyl, Alfentanyl, Sufentanyl, Papaveretum
886.
Which is the degradation process of Desipramine:
a. Demethylation
b. Alkylation
c. Hydrolysis
A
887.
Shortest action anesthetic barbiturate drug is:
888.
Fastest acting barbiturates:
889.
Which barbiturate is rapidly distributed:
Thiopental
890.
Metabolism of local anesthetic takes place in:
Liver (Amide type = lidocaine)
Local anesthetic that it is safe in liver disease:

891.
Procaine tetracaine cocaine (ester linkage) metabolized by cholinesterase
892.
Stage IV in general anesthesia is:
a. Analgesia = 1
b. Delirium = 2
c. Surgical anesthesia = 3
d. Respiratory paralysis = 4
D
General Anesthetic
Volatile (inhaled) Non Volatile (IV)
NO + Halothane + Cyclopropane Thiopental + Midazolam + Ketamine HCl
Lipophylic to cross BBB

Most = (Hydrophilic gp + Ester or amide gp + lipophylic aromatic moiety)
Both forms are essential:
o Hydrophilic part ionized block the nerve
o Lipophylic part unionized for penetration
1) Block nerve impulse conduction
2) Cause interference with the change in permeability to Na ions by
stabilization of cell membrane
LOCAL ANESTHETIC
Ester-linkage Amide-linkage
Procaine + tetracaine + cocaine Lidocaine
Short acting ( -- by cholinesterase) Long acting (not -- by cholinesterase)
Safe in liver disease Not used in liver disease (metabolized in
Need epinephrine to prolong their liver)
action No need for epinephrine
893.
Drug that cause neuromuscular blockage:
Tubucurarine
(Also: Pancronium = competitive non-depolarizing neuromuscular blocker)
894.
What is neostigmine used for:
Myasthenia Gravis (Also Pyridostigmine)
895.
Sympathomimetic drugs:
a. Increase drainage of the aqueous humor
b. Decrease production of the aqueous humor
c. Inhibits carbonic anhydrase enzyme

A+B
896.
M1 and M2 muscarinic receptors are similar in:
I. both consist of 7 subunits
II. both have same length in cytoplasm
II
897.
For a sympathomimetic drug to be effective it should:
a. Fit in receptor
b. Bind to plasma protein
c. Compete at site of release of the transmitter
A
898.
Succinyl choline acts by:
a. Resting state inhibition of nicotinic acetyl choline receptors
b. Direct effect centrally
c. Depolarizing competitive action on nicotinic acetyl choline receptors
A (Depolarizing non-competitive)
899.
Which of the following is competitive inhibitor of ACH:
a. Carbachol
b. Edrophonium
c. Succinyl choline
d. Pancronium
e. Tubucurarine
B+D+E
Which acts by competitive inhibition as neuromuscular blocker:

900.
Competitive inhibition of Acetyl choline:

901.
Pancronium
Neuromuscular Blockers
902.
W
Competitive Non-depolarizing Depolarizing Non-competitive
h
- Pancronium -Succinyl choline i
- d-Tubucurarine (Curare Alkaloid) -Decamethonium c
- Gallamine depolarizing of Na channel h
- Alcuronium (nicotinic agonist)
Prevent opening of Na channel
Uses:
- In surgery muscular relaxation (pre-anesthetic)
- In convulsions
- Diagnosis of Myasthenia gravis (Edrophonium)
stimulates adrenaline from adrenal medulla:
- Nicotine
- Acetyl choline in large dose
903.
Neurotransmitters, which are true:
a. Secreted in the cell only
b. Cause excitatory effect only in postsynaptic
c. Secreted and degraded outside the cell only
d. Can pass BBB

C
904.
Adrenergic antihistamines are:
a. blockers
b. 1 stimulants
c. 2 stimulants
d. blockers
C
Receptor Response
Heart 1 HR +inotropic
Arteries Constriction
Dilatation
GIT secretion
Bronchi Bronchodilatation
Uterus Relaxation
905.
If the drug is weak base, to increase its renal excretion which of the following
agents should be used:
a. NH4Cl
b. NaHCO3
c. Ascorbic acid (Vit C)
d. Sod. Biphosphate
A+C acidification of urine
906.
An acidifier of urine:
a. Citric acid
b. Ascorbic acid
c. Sodium bicarbonate
B
907.
Urine acidifier:
- Vit C
- NH4Cl
908.
Urine alkalinizer:
- Citrate
- NaHCO3
N-acetyl cysteine is antidote for:

909.
Acetaminophen toxicity (IV must be used within 12 hours)
910.
Salicylate toxicity: (Jul-2006)
a. Increase CO2
b. Decrease bicarbonate
B causing metabolic acidosis compensated e respiratory alkalosis due to
the hyperventilation a+b??
911.
ASA toxicity is treated with: (Jul-2006)
a. Taking sodium bicarbonate 1.2% alkalinization of urine
b. By treatment of hyperventilation
c. Acetaminophen
A+B
Symptoms: 1) Hyperventilation 2) Tinnitus 3) Mental confusion 4) Headache
5) Dimness of vision 6) Sweating 7) Bleeding
Severe poisoning + Dialysis
Barbiturate toxicity:
a. Alkalinization of urine
b. Forced Diuresis
c. Dextran (in case of hypotension)
BZ = safe if given 50-100 times the therapeutic dose
Amphetamine toxicity:
1. Acidification
2. Barbiturate or CPZ (to control CNS stimulation)
3. -blocker (to control hypertension)
4. Gastric lavage
ASA in the GIT will undergo:

912.
Hydrolysis
Which of the following is hydrolyzed in the stomach:

913.
Aspirin
914.
In aspirin toxicity which is required:
a. NAHCO3
b. Ipeca
c. Respiratory support
All
Acetaminophen structure: (Jul-2006)

915.
Cause depletion of glutathione (Review the structure)
916.
Acetaminophen toxicity causes:
a. Liver necrosis
b. Hepatic complication due to active metabolite
c. Prothrombin time
A+B
Necrosis:
917.
Death of the areas of tissues or bone surrounded by healthy parts (death in mass)
It is Death of tissue, as that caused by bacterial infection.
It is the death or decay of (part of) an organ or tissue due to disease, injury, or
deficiency of nutrients; mortification.
Necrobiosis:
918.
Gradual degeneration in depth of tissues

It is the natural death of certain types of bodily cells or tissue, with preservation of
some characteristics of the living state.
The process of gradual degeneration or death in the cells of the body
Necrosin:
919.
A substance obtained from inflamed tissue which induce inflammatory changes in

normal tissues
The difference between Acetaminophen and Aspirin:

920.
The anti-coagulation + Anti-inflammatory effect
921.
Acetaminophen is used to replace ASA in case of:
a. Fever
b. Pain
c. Antirheumatic
A+B
922.
The use of Acetaminophen instead of aspirin is indicated when:
a. In case of problem in coagulation of blood
b. Allergy to aspirin
c. Peptic ulcer
All
923.
Child with fever all are true EXCEPT: (Jul-2006)
a. Acetaminophen can be used safely instead of aspirin
b. Ibuprofen can not be taken cause of Reyes syndrome
c. Non drug treatment is to dress the child with tight dressing & try to warm it
d. Chills are correlated to the rapidity of the temperature fluctuation rather than
the temperature itself
B
924.
Mechanism of lowering body temperature by ASA:
Inhibits PG synthesis at the hypothalamus (thermo-regulatory centre) and in the
periphery (acts on subcortical sites of CNS = hypothalamus)
Dantrolone Na (Dantrium) IV used in Malignant Hyperthermia

(Skeletal muscle relaxant)
925.
Which of these can help regulate body temperature:
a. Urine
b. Skin
c. Sweat gland
d. All
D
926.
Antipyretic effect of ASA is:
a. Vasodilatation? sweating
b. Inhibit PG synthesis
c. Inhibit temperature setting point in hypothalamus
C b? inhibit pg synthesis at hypothalamus)
927.
The most dangerous side effect of ASA in children:
Reyes syndrome
A set of symptoms seen in some children following a viral infection, such as

chickenpox or influenza.
Symptoms include mental confusion, vomiting, convulsions, occasional coma, and
respiratory failure.
The cause of the condition is unknown and no specific treatment exists.
Reyes syndrome:
928.
Caused by ASA in infants and children (Brown swelling and fatty liver)
Mechanism of drug interaction with ASA:

929.
Displacement of other drugs bound to serum
In heparin bleeding we use as antidote:

930.
Protamine sulphate
931.
Pralidoxime is antidote for:
a. Atropine
b. Organo phosphorus compounds
B
Flumazenil is antidote for: (Jul-2006)

932.
Benzodiazepine Alprazolam
Malathion:
933.
Organo phosphorus compounds (insecticide)
Chlorophenothane:
934.
DDT
935.
Chlorodiazepoxide used in:
Alcohol withdrawal + acute & chronic anxiety (better than BZ) (Librium = Roche)
936.
Antidote for organo-phosphorus compounds:
Atropine antagonize muscarininc effect
+ Pralidoxime forms a complex with the phosphorus prevent it from reaching
the enzyme
+ Barbiturates to treat convulsions
What is antidote for Iron poisoning:

937.
Deferoxamine (Desferal)
What is antidote for copper poisoning:

938.
Penicillamine
What is antidote for methanol and ethylene glycol poisoning:

939.
Ethanol
What is antidote for ethanol:

940.
Chlorodiazepoxide
941.
What is antidote for morphine:
Naloxone
EDTA is used as antidote for:

942.
a. Lead
b. Arsenic
c. Mercury
A+B
EDTA = 1. Antioxidant in aqueous sol + oral prep 4. Pb poisoning
2. Preservative in ophthalmic soln 5. Chelate (tetravalent)
3. for titration
Ca disodium edetate is used for:

943.
Pb poisoning
944.
EDTA can chelate Ca2+ and Fe3+ in the following proportions:
a. One mole of Ca2+ + one mole Fe3+
b. 2 moles of Ca2+ + 2 moles Fe3+
c. 3 moles of Ca2+ + 3 moles Fe3+
d. None of the above
A
BAL (dimercaprol) is used as:

945.
Hg toxicity due to formation of non-toxic ring complex w rapidly excreted
Hg mechanism of poisoning:
946.
Binds with SH group
947.
Death due to cyanide toxicity results from:
a. Cyanide hemoglobin complex formation
b. Cyanide combining with the RBCs
c. Inhibition of Cytochrome oxidase (respiratory enzyme)
d. Coronary vessel occlusion
e. Non of the above
C
948.
Increase of oxygen cause convulsions and is treated by:
a. Glutamic acid decarboxylase
b. Dehydrogenase
c. Sulphoxide
?
949.
Cyanide toxicity can be treated by:
- Na Thiosulphate
- Na bisulphate
- Na nitrate
- Amyl Nitrate
950.
CO toxicity is treated by:
O2
Carbon monoxide poisoning is characterized by:

951.
Lack of O2 in the erythrocytes

- Hb + CO Carboxy Hb = incapable of carrying O2

- Hb has higher affinity to CO >> O2
952.
Universal antidote:
Activated charcoal + MgO +Tannic acid
N.B. Charcoal dont adsorb Cyanide, DDT, boric acid and ferrous sulfate
Not given with Ipeca will adsorb Ipeca no vomiting
953.
In what poisoning there should be no emesis:
a. Bleaches
b. Gasoline
c. Iron salts
d. Organic acids
A+B+D Emesis will lead to aspiration pneumonitis
Also no emesis in case of convulsions + coma + corrosives+ barbiturates
954.
Atropine poisoning can be recognized by all EXCEPT:
Diarrhea
Atropine Side Effects are:
- Dry mouth - Flushed appearance
- Dry skin - Delirium & restlessness
- Constipation - Mydriasis
Sulfasalazine:
955.
Less side effects than sulfapyrizine
H2-receptor antagonist side effect is:

956.
Gynecomastia (used to treat peptic ulcer)
957.
The side effects of corticosteroids depend on all EXCEPT:
a. skin pigmentation
b. age
c. dose
d. frequency
A
958.
Which is used in weakness of erection:
I. Alprostadil
II. Papaverine
III. Cocaine
I+II
959.
Propylene glycol PG 45% in a prescription:
a. Co-solvent
b. Antioxidant
c. Solvent
d. Preservative
e. Humectant
C+D+E
Benzyl alcohol 5%:

960.
Co solvent
0.9% preservative
40% solubilizing agent
961.
PABA (pKa = 2.4) with para nitro group, enters the body, can be in all EXCEPT:
a. Stomach (pH=2)
b. Duodenum (pH=3.5)
c. Intestine (pH=5.5)
d. Blood (pH=7.4)
A
962.
Solution of 0.1 g Ca gluconate + equal 0.16 NaOH w/v, the prep will be:
a. Isotonic
b. Hypotonic
c. Hypertonic
C
Nomogram is used to:

963.
Determine the dose regimen
Metyropone:
964.
Used in diagnosis of anterior pituitary function
TSH secreted from: (Jul-2006)

965.
Anterior pituitary ACTH + FSH + LH + TSH + GH + prolactin

Posterior ADH + Oxytocin (used in abortion)
Which is not secreted from anterior pituitary gland: (Jul-2006)

966.
ADH
Pharmacological effect of ADH:

967.
Water reabsorption at collecting tubule
968.
Which increase water permeability at collecting tubule:
969.
Which increase H2O reabsorption at the collecting tubule:
a. ADH (vasopressin)
b. Aldosterone
A
970.
Decrease of ADH leads to:
- Polyuria
- Thirst
971.
Elixir:
a. Flavored hydroalcoholic solution
b. For external use only
A
972.
Which of the following need shaking before use:
a. Budesonide (Pulmicort) (Flovent)
b. Ipratropium (Atrovent)
c. Flixotide (Fluticasone)
A+B
973.
Which aggravate or predisposed factor of asthma: (Jul-2006)
a. Genetic
b. Smoking
c. Environmental
All
Alprenolol:
974.
Most neubilized
975.
Acute attack of asthma we use: (Jul-2006)
a. Ipratropium bromide
b. Salbutamol
c. Theophylline
B
976.
Which used in acute bronchial asthma: (Jul-2006)
a. Montelukast
b. Salmeterol
c. Salbutamol
C
977.
Patient is asthmatic taking Fluticasone & Salmeterol, the case is worsen, advice
him:
a. Take Ipratropium
b. Oral corticosteroids
c. Spray corticosteroid
A+B (Fluticasone=Flixotide) (Salmeterol=Servent)
(Ipratropium=Atrovent shake)
Fluticasone Inhaler counseling, all are true EXCEPT: (Jul-2006)

978.
Dont rinse with water
979.
Theophylline dose must be adjusted when given concomitantly with:
I. Erythromycin
II. Salbutamol
III. Phenobarbital
I+III plasma conc
980.
Theophylline loading dose is given to all EXCEPT:
a. Children under 12 years
b. Smokers
c. Fever cases
d. Neonates
D
981.
Aminophylline is:
a. CNS depressant
b. Diuretic
B CNS stimulant
982.
Sotalol can be used with:
I. Anuric patient (as it is excreted via kidney)
II. In asthmatic patient
III. Diabetic patient B-blockers CI in asthma & DM
None
983.
Pulmonary thromboembolism is:
a. Rarely embolism occur
b. Usually leads to sudden death
c. Caused by arteriosclerosis
d. Varicose veins are the cause
B+D
984.
Lung toxicity NOT caused by: (Jul-2006)
a. Pulmonary fibrosis
b. Methotrexate
c. Bleamycin
A
985.
Pulmonary fibrosis NOT caused by: (Jul-2006)
Digitalis
What is drug of choice in acute asthma:

986.
What is drug of choice for allergy induced bronchospasm:

987.
Adrenaline SC
Zofrilokast (also Montelukast):

988.
Block Leukotrienes receptors = leukotriene antagonist
989.
Leukotrienes are:
- compounds with double bonds
- has special receptor
990.
All are right about leukotrienes EXCEPT:
a. They act on certain receptor
b. They are produced by lipoxygenase enzyme
c. They are derived from arachidonic acid
None
991.
Zofrilokast as leukotriene antagonist is used:
To decrease the dose of oral cortisone
H2 receptor antagonists are used to treat:

992.
Peptic ulcer
H2 antagonist structure:
993.
Similar to histamine with modified side chain

994.
H1 antagonist differ from H2 antagonist in all EXCEPT:
a. H1 antagonist pass CNS more
b. They are structurally different
A? or B
995.
H1 antagonist differ from H2 antagonist:
I. Both metabolized in vivo
II. Both are water soluble
III. Both pass BBB
I+II
996.
H1 receptor antagonists are used for:
- Asthma
- Nausea
997.
Anti-asthmatic drugs are mainly:
stimulants
998.
Wheezing & cough, which are better on treatment:
a. Chronic bronchitis
b. Asthma
B
999.
Cromolyn disodium:
- prophylactic in allergic rhinitis
- Intal is used as prophylactic of asthma +adjuvant to cortisone in TTT of
chronic asthma
1000.
Sodium cromoglycate (Intal) is used for
a. Acute asthmatic attack
b. Vasodilatation
c. Bronchodilatation
d. Prophylaxis of asthma
e. Anaphylaxis
D
Anaphylaxis = immediate hypersensitivity
1001.
Drug used to stabilize mast cell can be used in treatment of:
Allergic rhinitis
Aluminum acetate is used as:

1002.
Astringent in hemorrhoids
Burrows solution:
1003.
Aluminum acetate topical solution used as astringent + antiseptic in M.W
Epinephrine:
1004.
Local vasoconstrictor (hemorrhoids + epistaxis)

S.C. bronchodilator (acute asthma)
1005.
Increased doses of O2 is toxic because it inhibit which enzyme:
a. Glutamine transyclase
b. Cytochrome oxidase
B
The highest pH in GIT occurs in:
1006.
Colon=8
1007.
Mesoprostol is:
a. PEG1
b. PEG2
A
1008.
Mesoprostol, what is the nature of Mesoprostol: (Jul-2006)
a. Steroid
b. Peptide
c. Amino acid
d. Ecosinoic acid
A
1009.
Old person compared to an adult all decrease EXCEPT:
- Blood urea nitrogen ( BUN)
- Lean body mass (LBM)
- Serum creatinine creatinine clearance
1010.
Which affect drug absorption from skin in elder:
- Age
- Hydration
- Damage of skin
1011.
Young adult and elderly patients differ in:
a. Higher volume of digoxin in elder
b. Lower volume of digoxin in elder
c. Less clearance of amino glycoside in elder
B+C
1012.
In old age which of the following decreases:
1. Muscle
2. GFR
3. Plasma Albumin
4. Total body fluid
5. Blood flow to different organs
6. Brain weight
7. Kidney-spleen-pancreas-lungs & liver becomes smaller
8. Blood vessels lose elasticity
9. Cardiac output decreases
Clearance = Volume of blood that is completely cleared from a drug per unit time
ClT = Drug elimination / plasma conc
Creatinine clearance test:

determining kidney function better than >> Serum creatinine & BUN
for measuring glomerular filtration rate GFR
Normal Cr Cl in adult 70 kg = 100-120 ml/min

Elderly < 70 ml/min
Male = (140 - age) (wt) / 72 mg/L

Female = Male X 0.85
Pheno-sulpho-phthaline:
1013.
Kidney function (PSP)
Phenol phthaline (phenol red):

1014.
Determination of Kidney function
1015.
BUN kidney function = 8-18 mg N2/100ml
Uric acid = 2-8 mg/100ml
Sulphabromo-phthaline:
1016.
Liver function (SPT)
SGOT =
1017.
Serum Glutamic Oxaloacetic transaminase (AST aspartate amino transferase)

SGPT =
Serum Glutamic Pyruvic transaminase (ALT Alanine amino transferase)
Both liver function tests
Bromsulphalein test:
1018.
Failure of the liver to eliminate 95% injected Bromsulphalein (chemical) is an

indication of impaired liver function
Test to differentiate between conjugated and unconjugated bilirubin:

1019.
Van Der Bergh's test

(A blood test to determine whether jaundice is caused primarily by liver disease or
by obstruction of the bile ducts leading to the intestines)
1020.
Severe liver dysfunction leads to: (Jul-2006)
I. Decreased albumin
II. Increased Bilirubin
All
1021.
Liver cirrhosis is characterized by:
- Ascites
- Jaundice
- Bleeding
1022.
Ascites:
- Peritoneal retention of fluid (accumulation of fluids in the abdomen)
- Treated by spironolactone (in case of no renal failure)
- Sign of liver cirrhosis
Edema is:
1023.
Excessive accumulation of watery fluid in the tissues

1024.
Liver cirrhosis is considered in case of:
a. Bleeding
b. Jaundice
c. Ascites
C (may be due to Shistosomiasis or alcoholism)
Not all ?
1025.
Alcoholic cirrhosis causes: (Jul-2006)
Ascites in peritoneal cavity
1026.
Liver function indication: (Jul-2006)
a. Alkaline Phosphatase
b. Aspartate Aminotransferase
c. Alanine Aminotransferase
All (ALP AST ALT)
Alcoholic cirrhosis: (Jul-2006)

1027.
Abdominal distention
Blood supply to liver from: (Jul-2006)

1028.
Portal Vein
If renal excretion rate of drug is 600 ml/min so:

1029.
The drug is excreted by BOTH glomerular filtration and active tubular excretion
1030.
Endogenous assay of glomerular filtration is done by: (Jul-2006)
a. Serum Creatinine conc
b. Creatinine clearance
c. Inulin
B
What is true if renal clearance is increased:

1031.
Glomerular filtration is increased (GFR)
1032.
Glomerular disease is characterized by all EXCEPT:
a. Protein urea
b. Pyuria
c. Edema
d. Ascites
e. Oligurea
D
1033.
Glomerular disorder result in: (Jul-2006)
a. Protein urea
b. Oligurea
All
1034.
Hypovolemia causes all EXCEPT:
a. Ascites
b. Pulmonary edema
c. Oligurea (passage of small amount of urine)
d. Loss consciousness
pKa =3, reach duodenum (pH=6)

1035.
Nearly completely ionized
pKa =6, reach duodenum (pH=6)

1036.
50% ionized
Which control blood supply to the brain: (Jul-2006)

1037.
Epinephrine
The main blood supply to the brain is:

1038.
Internal carotid artery + vertebral artery (brain + nose + internal ear + forehead)
External carotid artery front & back neck + face + meningas + middle ear +
thyroid + tongue
1039.
Vertebral artery supplies:??? Look to previous q
- Neck
- Cerebrum (anterior part of the brain, responsible for voluntary activity and mental
processes)
What is true about hypophyseal portal system (hypophysis = pituitary gland):

1040.
It begins and ends in capillary
1041.
Sciatic nerve supply:
All foot branches
a. The muscle of the hip
b. Its branches supply the other regions of the foot
c. Legs
All
1042.
Hernia is:
a. Umbilical hernia
b. Inguinal hernia (direct, indirect)
c. Hiatus hernia
All
Hernia is:
1043.
a. Proliferation of the viscera

b. Proliferation of the peritonea
c. Proliferation of the inguinal
d. Proliferation of the diaphragm
All
Chymopapain:
Proteolytic enzyme used for therapy of herniated lower back disks
Hiatus Hernia:
1044.
Proliferation of diaphragm (through the opening where the esophagus passes)

Peritoneum:
1045.
Strong colorless membrane lining the abdomen
1046.
Which is not found in cranial bone:
a. Ethmoid
b. Frontal
c. Hyoid attached to tongue
d. Maxilla
e. Occipital
C
In skull diagram the zygomatic bone is in:

1047.
Contact with sphenoid bone + frontal + temporal + maxilla
All in nasal cavity EXCEPT:

1048.
Septum
1049.
Which does NOT connect to the nasal cavity:
a. Frontal sinus
b. Sphenoid sinus
c. Maxillary sinus
B
1050.
Which of the following does not drain into nasal cavity:
a. Sphenoid duct
b. Maxillary duct
c. Septum (A partition between two structures or cavities, as the nasal septum)
d. Frontal duct
C
1051.
Which blood vessel supply the nasal cavity:
a. Sphenopalative
b. Ethmoidal
A
1052.
Popliteal is part of:
a. wrist
b. arm
c. knee
d. shoulder
C
1053.
Popliteal pain predispose
a. Myocardial infarction
b. Stroke
1054.
Pain and limping due to circulating insufficiency called:
a. Phlebitis
b. Myalgia
c. Thrombophlebitis
d. Claudication
D
Damage of the axillarys nerve is tough to produce:

1055.
Inability to bend the elbow
Severing of radial nerve causes:

1056.
Wrist drop (Designating or situated on the outer (thumb) side of the forearm)
Serrafumex:
1057.
Largest muscle (serratus muscle)
1058.
Skeletal Muscle do all EXCEPT: (Jul-2006)
a. Form Body shape
b. Protect organs
c. Form Erythrocytes
C
1059.
All secrete in the duodenum EXCEPT:
a. Adrenal
b. Bile
c. Pancreas
d. Stomach
A
1060.
Which does NOT secrete in intestine:
a. Adrenal gland
b. Parotid gland (salivary gland at the angle of the jaw)
c. Thyroid gland
A
1061.
Which of the following does NOT excrete in duodenum:
a. Adrenal gland
b. Parotid gland
A+B
1062.
Which of the following opens in the duodenum:
a. Bile duct
b. Pancreatic duct
c. Adrenal gland
d. Parotid gland (large salivary glands situated just in front of each ear)
e. Non of the above
A+B parotid opens or not?
Drug which does NOT cause relaxation of smooth muscles:

1063.
Cromolyn sodium
1064.
Not found in dermis:
- Keratinized tissue
- Melanin ( in epidermis)
- Skeletal muscle
Dermis contains:
- Collagen - Fibroblast
- Elastin - Nerves
- Mast cells
Degree of burns
First Only epidermis erythemea + pain + No blister
TTT: cold water or ice
Second Epidermis + part of dermis blisters + pain
Skin will regenerate
Third Entire skin no blisters + leathery appearance of skin
Permanent skin grafting is necessary
Fourth All skin + underlying tissues
Black skin danger of infection
Electron withdrawing:
1065.
Decrease pKa pH =acidic electron donating pKa basic
1066.
Which detected by presence of autoxidation:
1067.
Which is responsible for N in NO in body:
1068.
The source of N2 in NO is:
L-Arginine enzyme change N to NO vasodilatation
1069.
Nasal absorption compared to GIT:
a. The nasal route has larger area for absorption
b. The nasal route has rapid clearance by mucillary
c. The nasal route has higher blood supply
B+C
Difference between nasal route and intestinal route:

1070.
Nasal is faster & high blood flow
1071.
To avoid parallax during liquid measurement:
a. Read at eye level
b. Use a suitable size measure

A
Sublimation is:
1072.
The conversion of solid state to vapor state directly without passing through liquid
state
Loss of moisture:
1073.
Efflorescence
Hygroscopic = aDsorption of moisture glycerol
Deliquescence = substance aBsorbs water become liquid = cacao butter
1074.
To modify adsorption:
I. surface area
II. Remove impurities
III. temp to increase rate of reaction
I+II
1075.
To prevent surface adsorption in biotechnological products:
a. Sorbitol
b. NaCl
c. Vit E
?
Monoclonal antibody used for renal rejection:

1076.
OKT3
1077.
Active drug induce 5% effect in patient, Placebo induce 3% effect in patients,
Then the true effect of drug is:
2%
Person has uncomplicated UTI, which is not true:

1078.
Has fever and chills
1079.
All symptoms associated with influenza EXCEPT:
a. Fever
b. Chills
c. Fatigue
d. Loss of appetite
e. Diarrhea
E
Which enzyme affect Allopurinol:

1080.
Xanthine oxidase
1081.
During treatment with Allopurinol the dose of which must be adjusted:
- Theophylline
- Mercaptopurine (anticancer)
- Anticoagulants (Heparin, dicumarol)
Allopurinol = Xanthine oxidase inhibitor (which convert xanthine to uric acid)

-
Mercaptopurine is metabolized by Xanthine oxidase toxicity of
Mercaptopurine
- Inhibit liver microsomal enzymes Theophylline must be adjusted
- Used in chronic gout (Prophylaxis) NOT in Acute Gout
S.E. = Stevens Johnson syndrome + Hepatotoxicity
1082.
All are used in acute gout EXCEPT:
a. Colchicine
b. Prednisone
c. Indomethacin
d. Phenyl butazone
e. Acetaminophen
E
1083.
Colchicine can give false +ve result for test of:
a. Glucose
b. Uric acid
c. Urates
d. Ketones
e. RBCs
C (ionized form of uric acid)
Phenyl butazone:
1084.
Blood dyscrasia (imbalance = Abnormalities) acute gout
1085.
Sulphapyrazone, Sulphonyl pyrazone is used as:
- Inhibit renal tubular re absorption of uric acid (uricosuric as probenicid)
- Inhibition of Uricase enzyme
Drug contraindicated in Acute gout:

1086.
Allopurinol (chronic only)
1087.
Which causes Photosensitivity:
a. Clotrimazole
b. Tetracycline
c. Accutane
d. Thyroxin
e. Penicillin
A+B+C
1088.
Which drug taken with plenty of water: (Jul-2006)
a. Clotrimazole
b. Allopurinol
c. Fosamax
All
1089.
Fosamax dose regimen: (Jul-2006)
a.Once Daily
b.Once Weekly
A+B
1090.
Woman carry hemophilia, her husband is hemophilic too, all the following are true
EXCEPT: (Jul-2006)
a. Male having hemophilia
b. Female having hemophilia
c. Female having no gene for hemophilia
d. Male having no hemophilia
e. Female having gene for hemophilia
C (Girl without hemophilia X-linked)
1091.
All are patient drug problem EXCEPT:
Improvement of patient condition on treatment
1092.
Patient with kidney function 50%, if kidney function decrease to 20%:
a. Reduce to half dose
b. Reduce to half dose, double time interval
B
Time to reach Css depend on:

1093.
Elimination t1/2
Css depends on:

1094.
t1/2
During constant rate of IV infusion, at Css, the rate of elimination equal:

1095.
The rate of infusion
Rate of elimination by :
1096.
Renal reabsorption
Which is incorrect about 1st order kinetics:

1097.
t1/2 independent of concentration because t1/2 depends on conc
Zero order kinetics:

1098.
Does not depend on concentration
1099.
The rate of 1st order kinetics is:
a.
dt/dx=Kc
b.
dt/dx=K
c.
dt/dx=Kc-2
d.
None of the above
D
Cp=C0.e-kt Cp= conc. of drug, Dose = e-kt, Log Cp vs. time will give:
1100.
A graph of C= Co.e-kt will give:

1101.
Straight line with negative slope (1st order reaction)
For elimination constant (K), if we plot log:

1102.
Form straight line with ve slope

1103.
t1/2 can be used in:
a. Determination of time to reach steady state concentration
b. Determination of the elimination time from the body
c. Determine extent of absorption
A+B
Concentration of drug in blood is helpful in:

1104.
Calculation of volume of distribution
Ab = Vd X Cp
Vd= Ab/Cp Ab=amount of drug absorbed Cp= conc. of drug in blood
Why do we start treatment with a loading dose:

1105.
To reach the therapeutic dose faster
Loading dose = Vd X Cp / S X f
S= Portion salt of salt form in the active drug
F = fraction of dose absorbed
Zero order 1st order

-dc/dt = Kc
-dc/dt = K
C=Coe-kt
t1/2 = changing t1/2 (constant) = 0.693/K
Rate of elimination or absorption =
Dependent on conc.
Not dependent on conc.
Slope = straight line ve slope
Compartment = body site or fluid that may contain the drug
One compartment model assumes no distribution phase
Two compartment model absorption distribution elimination

Closed model Open model
Describe distribution Describe elimination

Have 2 rate constants only Have more than 2
Equilibrium may occur Complete equilibrium does not occur
t1/2 1) Renal failure 2) New born & infants (incomplete enzyme system)
it is independent of the initial conc of the drug

constant for each drug
A drug to be bioavailable:
1106.
Must reach systemic circulation
1107.
Relative bioavailability = AUC of the dosage form / AUC of the reference
Absolute bioavailability = AUC oral / AUC IV (F-Value)
Which drug is the nearest to other drug in bioavailability:

1108.
Drug A: Cmax = 1000 Tmax= 2

Drug B: Cmax = 950 Tmax= 2.1
Drug C: Cmax = 1150 Tmax= 3.1
A+B
1109.
200 mg drug if taken IV: AUC= 130, IP: AUC= 62, OP: AUC=28, then this drug
is:
a. Extensively cleared in systemic circulation
b. Extensively metabolized by the first pass effect
B
Dose= 200 mg and AUC= in one day and it take same dose after 11 days then:
1110.
AUC still the same
Drug absorption will continue even after peak blood level is reached but the
rate of absorption will be < rate of elimination
Doubling the dose will not double the height of the curve double the AUC
(extent of absorption)
The difference between the peak & trough (lowest conc in the curve) is
greatest when the drug is given at dose intervals >> t1/2
Absorption rate of different dosage forms:

1111.
Solution > chewable tab > susp > powder > cap > tab > coated tab > enteric
Compared to the sublingual tablet, nitroglycerin oint provide:

1112.
More prolonged effect
Lipid soluble drug:

1113.
Rate of dissolution is the rate limiting step
Dose dumping:
1114.
Modified release dosage form
Drug with narrow safety margin:

1115.
IV infusion
1116.
If an orally administered drug appears in the feces this might be due to:
a. Incomplete absorption
b. May be excreted through bile
All
IVY poisoning cause: (Jul-2006)

1117.
Contact dermatitis
1118.
Poison Ivy is treated by:
- Calamine
- Aluminum acetate
- Antihistamine
1119.
Mechanism of Orlistat:
Phospholipase inhibitor (upper & lower intestine)
1120.
Which drug is present in chewable tables: (Jul-2006)
Amoxicillin
1121.
Metronidazole is effective in all EXCEPT:
a. Trichomoniasis
b. Amoebiasis
c. Gonorrhea
C
1122.
Osmotic dialysis is effective with:
a. Low molecular weight substance
b. Larger volume of distribution
c. High Protein binding
A
1123.
Dialysis should be for substance of:
I. Low molecular weight
II. Small volume of distribution
III. Low protein binding
All
1124.
Amount of gas reach CNS determined by:
a. Partial pressure (pCO2)
b. pO2
A
Given to you a prescription and the signature is:

1125.
Stat 5, 2.5 bid for 7 days. How many ml HC will take:

Stat = means at once 5+ 2.5*2*7= 5+35 = 40
qid pc hs:
1126.
4 times daily, after meals, at bed time
1127.
The following prescription is received in a community pharmacy:
Losec 20 mg
S: Take 1 tab BID
M: 2 weeks
Which of the following is correct labeling for this prescription?
a. Take one tablet twice weekly (28 tablets)
b. Take one tablet twice weekly (4 tablets)
c. Take two tablets twice daily (56 tablets)
d. Take one tablet twice daily (28 tablets)

e. Take one tablet twice daily (14 tablets)
D
1128.
Acyclovir dosage forms:
a. Tablets
b. Capsule
c. Topical
d. Syrup
e. Suspension
f. Injection
A+C+E
1129.
All are used in skin allergy EXCEPT:
a. Loratadine
b. Cetrizine
c. Cimetidine
d. Hydroxyzin (Atrax = antihistamine + antianxiety)
C
Testosterone
1130.
Phenol
Cotton seed oil
This soln is:
a. Aqueous
b. Oily solution
c. Oily suspension
d. Aqueous suspension
B
Phenol 0.5%
1131.
Cimetidine HCl
Water for injection
What is the role of Phenol in the preparation?
Preservative
1132.
Case take warfarin dose less than that required leads to no obvious bleeding
take: (Jul-2006)
a. Vit K IV
b. Vit K IM
c. Vit K oraly
??
1133.
Deep vein thrombosis with pregnant woman: (Jul-2006)
1134.
Deep vein thrombosis DVT without pulmonary embolism is treated by:
a. Tissue plasminogen activator
b. Streptokinase
c. Urokinase
d. Heparin
e. Warfarin
D
Alteplase is:
1135.
Plasminogen activator
1136.
Which one displaces warfarin from its binding sites:
a. Sulfa
b. Phenyl butazone
c. Clofibrate
d. ASA
All
1137.
What affects platelet aggregation:
a. ASA
b. Clopidogril
c. Ticlopidine
All
1138.
Warfarin action increased by:
Deficiency of Vitamin K
1139.
Warfarin site of action: (Jul-2006)
a. Liver
b. Heart
c. Vascular endothelium
C
1140.
Assay of warfarin in vivo depends on: (Jul-2006)
a. Warfarin con in plasma
b. Vit K in plasma
c. Activated partial thromboplastin time
C this test is 4heparin ????
1141.
Heparin acts:
a. in vivo only
b. in vivo & in vitro
B
1142.
Mechanism of action of Heparin
- Block conversion of fibrinogen into fibrin
- Acts in vitro and in vivo
- Inhibit thromboplastin (Antithrombin)
{Inhibit thrombin and activate anti-thrombin III}
Drugs affecting blood:

Intact tissue prostacyclines thrombin thromboxane stabilized platelet
1.
Platelet aggregation inhibitor:
a. Aspirin: drug of choice for prophylaxis
b. Ticlopidine (Ticlid): SE= Neutropenia (Neutrophils), 2nd choice after
aspirin
c. Clopidogril (Plavix): SE= bleeding, CytP450
d. Dipyridamol (Persantin): used in combination with warfarin in
prosthetic heart valve
2.
Anticoagulants:
Heparin Warfarin (coumarin)
Inhibit conversion of : Inhibit utilization of Vit K in the
Prothrombin to thrombin by formation of Prothrombin & Factors
thromboplastin 7,9,10
Fibrinogen to fibrin by
thrombin
1. Can be used in pregnancy 1. CI in pregnancy
2. Antidote = Protamine SO4 (SC or 2. Antidote = Vit K (oral)
IV)
3. Used in emergency 3. In prophylaxis
4. Rapid onset ( duration = 4hrs) 4. Long duration of action (2-5 days)
5. Inhibit thrombin III & 5. Inhibit Prothrombin formation
thromboplastin
6. Antacid has no effect 6. Antacid effect ( absorption)
(Heparin is highly acidic)
*** Enoxaprin:
- Low mol wt heparin no reduction of Antithrombin III activity upon chronic
or intermittent use
- Only S.C.
- TTT of DVT (deep vein thrombosis)
Warfarin effect by * Enzyme inhibitor (Cimetidine)

* Protein binding drugs (Aspirin + sulfa)
* Antacid
Effect Enzyme inducer (Phenobarbital)
Blood is prevented from clotting by:

1) Removing Ca
2) Addition of mixture of (Na, K, NH4) which will react with Ca Ca citrate
3) After administration to a patient citrate is rapidly destroyed by liver
Normal clotting ability again
Vitamin K:
K1 = Phytoquinon (plant origin)
K2 = Menaquinon (Natural origin bacterial flora in GIT)
K3 = Menadion (Synthetic water soluble)
Uses: 1) essential for production of Prothrombin in liver w is essential for clotting

formation 2) Antidote for warfarin toxicity
Deficiency 1) Hemorrhage 2) Prothrombin time
Toxicity: Children 1) Hemorrhage anemia 2) Kernictrus 3) Bilirubin

Adult liver function leading to jaundice
N.B. xxs use of antibiotics oral will inhibit normal flora in GIT (responsible for
synthesis of Vit K Vit K deficiency)
3. Thrombolytics:
- IV only
- TTT of acute MI, peripheral arterial thrombosis
- CI: pt with healing wounds pregnancy history of cerebrovascular accident
**Alteplase:
- Selective Plasminogen activator by recombinant DNA technology
- Better than >> Streptokinase Urokinase very short t1/2 = 5min
**Aniotreplase: long t1/2 = 90 min
Anticoagulant drug of choice in pregnant women: (Jul-2006)

1143.
Heparin (short term prophylaxis of thrombosis and arterial embolism)
All are teratogenic EXCEPT:

1144.
Heparin
1145.
Heparin acts:
a. Like coumarin
b. Oral
c. Acts on cell steps of coagulation system
d. Of benefit in arterial blood clot
1146.
Anticoagulant drug of choice in patient taking antacid (peptic ulcer):
Warfarin antacid does not affect warfarin absorption?!!!!
It has been mentioned that the antacid increases the effect of warfarin
1147.
Which is normally found in blood:
1148.
Which blood clotting factor is found flowing in the blood:
a. Prothrombin
b. Thrombin
c. Fibrinogen
d. Fibrin
A+C
Prothrombin time give idea about:

1149.
Intrinsic coagulation increased by ASA
Prothrombin time (Normal = 8-12 sec) (+ Anticoagulant 24-30 sec)

Activated Coagulation time (ACT) = 3-5 min
Activated Partial Thromboplastin Time (APTT) = 30-45 sec
+ Anticoagulant = 45-60 sec used to monitor heparin therapy
Hypo-prothrombinemia: induced by anticoagulants

TTT: 1) Fresh blood or plasma 2) Vit K
Powder surface area is determined by:

1150.
Determination of adsorption capacity by:

1151.
Gas adsorption
Powder which promotes flow of material during tablet manufacturing:

1152.
Glidant talc
1153.
Not involved in tablet manufacturing problems:
a. Capping separation of the bottom & top of the tab
b. Lamination separation of the tab into 2 or more layers
c. Picking sticking (due to excess moisture)
d. Sticking
e. Mottling unequal color distribution
f. Peeling
F
1154.
ASA is very sensitive to water, thats why we use which procedure in
manufacturing:
a. Direct compression
b. Dry compression
c. Granulation with starch paste
d. Dry granulation
A+D
1155.
Tablet disintegrants:
a. Function by drawing water from GIT into tab swelling disintegrate
b. Include starch & its derivative, cellulose & its derivatives, clays and cation
exchange resin
c. A portion of it is added and lubricant to prepared granulation double

disintegration
d. Main portion is added to drug diluent mixture before granulation
All
1156.
In physical evaluation of the tablets we evaluate:
a. Potency
b. Hardness
c. Dissolution
B+C
Sealing sub coat in tablets:

1157.
Shellac
1158.
Why tablets are coated:
- To mask unpleasant odor
- To mask bitter taste
1159.
Which is/are true about enteric coated tablet:
a. They are protected from moisture
b. They are protected from gastric acid and juice
B
1160.
Dissolution rate of tablets is increased by:
a. Decreasing particle size
b. Decreasing amount of disintegrant
c. Decreasing temperature
A
1161.
Which occur when tablet reach stomach:
a. Absorb water
b. Swelling
c. Hydrolysis aspirin
d. Disintegrate
A+B+D
Substances used as fillers (diluent) in preparation of tablets:

1162.
- Lactose
- Manitol bulking + sweetening agent = in chewable tab
- CaPO4
- Starch
- Sugar
Binder = acacia + starch
Disintegrant = cellulose + starch
Lubricant = Glidant = talc
Methyl stearate is used as:

1163.
Lubricant (Also Mg Stearate)
What is the use of cellulose in formulations:

1164.
Diluent
What is the use of talc in formulations:

1165.
Glidant
1166.
Sustained release formulation is:
a. Single dose is a convenient dosage form to patient and nurses
b. Maintain therapeutic effect for longer period than can be obtained after
administering conventional single dose
c. The maxima in drug concentration is shown with multiple dose administration
are eliminated with a more economical utilization of drug and fewer side
effects because higher blood levels cause higher side effects
d. Eliminates the fall of drug concentration below MED, so patient is receiving a
therapeutically adequate amount of drug at all times
e. The elimination of maxima reduces the total amount of the drug needed to
obtain MED (continuity of the desired response)
All
1167.
Wurster Process:
Coating of tablets
400 qid tablet / 800 bid sustained release, the difference is:
1168.
The sustained release has less peak trough difference
Sustained release tablets:

1169.
a. Uniform dose
b. compliance to patient
c. side effects
All
Also - total daily dose - accumulation of drug - loss of activity
- bioavailability
1170.
Immediate release compared to sustained release: (Jul-2006)
a. Slower absorption
b. Slower clearance
c. Slower volume of distribution
A
Sustained release form have no value in:

1171.
a. Drugs having long t1/2

b. Drugs having short t1/2
c. Drugs having very short t1/2
A+C Also (narrow safety margin + very high potency + poor solubility)
Rate limiting step drug release from the dosage form
1172.
Which is added to soft gelatin capsule to increase its elasticity:
a. Glycerol
b. Isopropyl alcohol
c. Methyl cellulose
A
Which is used in soft gelatinous capsules shell to give it plasticity:

1173.
Gelatin
1174.
Role of mineral oil in sulfur ointment:
Levigating agent
Method to decrease the particle size:

1175.
a. Levigation
b. Trituration
c. Percolation
d. Maceration
A not all ????
Trituration: PS of powder in a mortar with a pestle very fine powder
Levigation: PS by adding a small amount of liquid or oint. base to make a paste

then rubbed with pestle ( PS = SA)
Pulverization: PS by using a 2nd agent that can be easily removed

e.g. camphor + alcohol alcohol easily evaporated camphor finely subdivided
Percolation: extraction process by descend of suitable solvent through a

column of drug
Maceration: extraction process soak a drug in solvent till cellular structure is
penetrated & the soluble constituent is dissolved
1176.
Levigation:
- Reduce particle size of a powdered drug to a smooth paste with an agent
called levigating agent with should be compatible with the powdered drug.
- A process of wetting and smoothing
- By addn of mineral oil or glycerol in sulpher oint to form paste
1177.
Levigation depends on:
a. Particle size
b. Ointment base
A+B
Base of vaginal suppository:

1178.
Propylene glycol {PG}

Dilute vaginal ovules lactose
1179.
Which of the suppository base is used in both oil and water soluble drugs:
a. Glycerin
b. Glycerinated gelatin
c. Cocoa butter
d. Propylene glycol (PG)
D
In suppositories, the excipient is:

1180.
Propylene glycol PG
1181.
Which of the following alcohols is used in formulations:
a. Isopropyl alcohol
b. Ethanol
c. Methanol
B
Emulsifying agent:
Cpd interfacial tension and forms a film at the interface stabilize emulsion
Stabilizers:
Dont form acceptable emulsion when used alone they assist stabilizing the
product e.g. viscosity
Natural SAA
Acacia Gelatin
Tragacanth Methyl
Agar cellulose
Pectin CMC
Synthetic SAA
Non ionic Anionic Cationic
Na Lauryl sulphate Benzalkonium chloride
Span (Sorbitan ester)
Di-octyl Na 1%
w/o
Sulfosuccinate Acetyl pyridinium
Tween (Polysorbate) o/w
Soap chloride
Resist add nod acid &
electrolyte
Spherical liquid droplet in another liquid is:

1182.
Emulsion
1183.
Not included in emulsion problems:
a. Cracking
b. Flocculation
c. Creaming
d. Aggregation
A
Which is NOT used to protect the emulsion physically:

1184.
Antioxidant
1185.
Creaming in emulsion is due to:
a. Droplet size
b. amount of SAA
A reversible by shaking
1186.
SAA is:
a. Hydrophilic
b. Hydrophobic
c. Lipoohobic
d. Amphiphilic
D
1187.
Span is used as:
SAA w/o emulsion
Tween:
1188.
o/w emulsion
1189.
To decrease creaming in emulsion:
- particle size
- density difference
- interfacial tension
- viscosity
1190.
Which form gel emulsification:
- Bentonite
- Acacia
- Agar
1191.
Which is not polysaccharide: (Jul-2006)
a. Cellulose
b. Acacia
c. Bentonite
d. Na alginate
C
What is bentonite magma:

1192.
Suspending agent
1193.
In gel medication, we can use all EXCEPT:
a. Bentonite
b. Carbachol
c. Methyl cellulose
d. Carrageen
D
Gel structure is formed by:

1194.
Bentonite
What kind of agent would be if we have HLB = 10-18

1195.
Solubilizing agent + o/w emulsion
1196.
A substance which has HLB = 10-18 forms:
a. Good w/o emulsion
b. Good o/w emulsion
c. Solubilization
B+C
The dihydrate substance is stable at:

1197.
9-14 mmHg
1198.
HEPTA-hydrate substance under 14 mmHg will be:
Efflorescent ( deliquescent = hygroscopic)
Remember:
HLB 1-9 w/o emulsion
HLB 10-18 o/w emulsion
HLB 0-3 = antifoaming

HLB 7-9 = wetting agent
HLB 13-15 = detergent
HLB 10-18 = Solubilizing
Cold cream= white wax + spermaceti + almond oil or mineral oil + Hot soln of Na
borate mixing till cool
1199.
Which increase wetting of substance:
a. Benzyl alcohol
b. Polysorbate
B
1200.
If contact angle is < 90 can be wetted
If contact angle is = 90 the substance is wetting
The substance which decrease contact angle:

1201.
Wetting agent
Which decrease tension between solid and liquid:

1202.
Solubilizing or wetting agent
Cation = + Anion = -
Sodium stearate is:

1203.
Sodium lauryl Sulphate is:

1204.
Anionic surfactant
1205.
Surface active agent:
a. Hydrophobic and hydrophilic part
b. Classified as cationic and anionic
c. React as acid and base
A+B
1206.
Methyl cellulose surfactant is:
a. Non-ionic
b. Cationic
c. Anionic
A
1207.
Na stearate is:
a. Cationic surfactant
b. Anionic surfactant
c. Hydrophobic surfactant
d. Non ionic surfactant
B same as = Tri-ethanol-amine
Soap is:
1208.
a. Na salt of fatty acid

b. Ca salt of fatty acid
c. K salt of fatty acid
A
Strearic acid (C18 saturated fatty acid) no double bonds = CH3(CH2)16-COOH
Hydrolysis of fixed oil yields:

1209.
Glycerol + fatty acid

Waxes FA + high molecular wt alcohol
inorganic acid + organic acid:

1210.
Soap
1211.
Which is used in o/w ointment:
a. Polyethylene
b. Acacia
c. Carboxy methyl cellulose CMC
All
Aggregation of the suspending agent is called:

1212.
Micelles
Critical micelle colloidal form of hydrophilic surfactant is:

1213.
Above CMC the surface tension is constant

> CMC surface tension is constant
< CMC surface tension
Natural emulsifying agent:

1214.
Acacia
Sorbitan monopalmitate:
1215.
Emulsifying agent w/o emulsion
Thermodynamic flow is:

1216.
Second flow
1217.
Sedimentation, which is true:
a. Larger particle size has higher sedimentation rate
b. Decrease density decreases sedimentation
c. Increase in sedimentation with decrease viscosity

All
1218.
Sedimentation rate increase in suspension when: (Jul-2006)
a. Decrease viscosity
b. Increase viscosity
A
Non Newtonian cpd which when increase shear will increase difficulty of susp to
1219.
flow is:
Dilatant (starch susp, ZnO)
Plastic = + stress (until yield value) viscosity + flow (ZnO in mineral oil)
Pseudoplastic = + stress (no yield value) - viscosity (acacia + CMC)
Dilatant = + stress + viscosity - flow
Newtonian = + stress = viscosity
Plastic (+ 0 - ) Pseudoplastic (+ -) Dilatant (+ +)
1220.
What kind of Rheuology is it:
Pseudoplastic Newtonian Dilatant Plastic

Shear thinning +0 ++ +0-
(+ -)
1221.
In intramuscular injection which is least required:
a. Plastic
b. Pseudoplastic
c. Dilatant
C
Poorly soluble drugs required to be prepared as suspension, their sedimentation

1222.
rate may be decreased by the addition of:

a. Non-ionic surface active agent
b. Thixotropic agent
c. Agent that increase viscosity
d. Shear thickening gel
e. Dilatant colloidal clay
B
Thixotropy= reversal property of gel becoming fluid (gel<->sol)
Viscosity = force of friction that tend to retard movement of fluid
Kinematic viscosity = ratio of absolute viscosity & density
Kinematic viscosity =
What are Azeotropes:
1223.
Azeotrophy = absence of any change in the composition of mixture of substances

when it is boiled under a given pressure
Azeotropic mixture= a mixture of constant composition & constant b.p.
Sulfa drugs to decrease precipitation:

1224.
We add thixotropic agent
Suspension is:
1225.
Two phase system in which the dispersed phase is solid and the continuous phase is
liquid
1226.
From the suspension problems all EXCEPT:
a. Flocculation
b. Aggregation
c. Adsorption
C
1227.
In flocculating system: (suspension)
I. Large volume of sediment
II. Re-dispersion upon agitation
III. Clear supernatant above the sediment
II+III
1228.
In a suspension settling of particles can be overcome by:
a. Adding non-ionic surface active agent
b. Increasing viscosity by adding shear thickening agent
c. Reducing particle size
d. None of the above
e. All of the above
E
Cardenoliodes are steroids bound to

1229.
Glycoside is a cardenolide +:
1230.
Sugar
Alkaloids are:
1231.
Natural plant products containing Nitrogen
Saponin is:
1232.
Glycoside
1233.
Which does not form H-bond:
a. Ester-water
b. Alcohol-water
c. Alcohol-acid
d. Ester-ester
D
Emphysema is: (Jul-2006)

1234.
Chronic obstruction of air way in lung = Destruction of alveoli in air spaces =

Permanent change to units of exchange gases (alveoli)
Calamine lotion is a mixture of Zinc oxide and:

1235.
Ferric oxide Fe2O3
Whitefield ointment is:

1236.
Salicylic acid + Benzoic acid
Conc. of alcohol in tincture Iodine is:

1237.
45%
= 2% Iodine + 2.4% NaI NaI is to prevent pptn if we add water
Iodine soln = I2 + NaI NaI3 (water soluble) same antibacterial activity
Dakins soln:
1238.
Na hypochlorite NaOCl disinfectant not antiseptic due to high alkalinity
70% of alcohol is used as:

1239.
Antiseptic on unbroken skin
Hydrogen peroxide antiseptic properties is dependent on:

1240.
Catalse enzyme 2 H2O2 2H2O + 2(O) oxidizes bacteria

- Official soln = 3% = 10 volume 20 volume (6%) = bleaches hair & fabrics
too strong for medical use
- Used for wounds cleaning + diluted 1:1 = M/W + ear wash
1241.
Hexyl resorcinol is better antiseptic than resorcinol because:
- Larger particle
- Higher partition coefficient o/w
Antisense is a group of:

1242.
Antibodies
Opsonin:
Antibodies which unit with bacteria (foreign body) & make them susceptible to
phagocytosis
Bacteriolysin:
Antibody which causes lysis of the bacteria (bacteriolysis)
Bacteriotropin:
Antibody which is not bactericidal but promote phagocytosis
Agglutinin:
Antibody + antigen antigen will clump together (visible aggregate) = this is called
agglutination & Antibody is called agglutinin
Precipitin:
Antibody + antigen visible ppt
Complement-fixation:
Antibody + antigen Antigen-antibody complex + Third non specific serum
constituent (known as complement) attract & fix the complement
Non sense drug is a group of:

1243.
Nucleotide analogue
1244.
Group of patients with same disease and same age are taking same medication,
this group is called:
a. Cluster
b. Segment
c. Cohort
C
Clinical study phase I. clinical test done on: (Jul-2006)

1245.
Safety with volunteer
Reliable study of distribution:

1246.
ANOVA study = analysis of variance
Odd ratio of people has side effect: (Jul-2006)

1247.
Number of patient Number of patient not

experience side effect experience side effect
Drug 12 32
placebo 4 40
??
1248.
Inside a hospital a survey has done to all pharmacists inside this hospital about
the future plan & job: (Jul-2006)
a. Randomized analysis
b. Randomized
c. Time series analysis
d. Survival outcome
?
1249.
Which of the following is not affected by food:
a. Cefuroxime axetile
b. Amoxicillin
B
1250.
Entropy is:
I. Due to Brownian movement
II. Measure of disorder
III. Energy available for drug work
II
The degree of disorder of a system, measured in terms of the natural logarithm of the probability
of occurrence of its particular arrangement of particles
1251.
Factors to be considered on giving a medication to nursing mother: (Jul-2006)
I. Time of feeding
II. Length of time of treatment
III. Partition of drug in milk
All
1252.
When the drug is displaced from its protein binding site by another drug, which
happen:
I. Increase renal elimination of displaced drug
II. Increase pharmacological effect of displaced drug
III. Increase liver metabolism of displaced drug
All
1253.
Formation of epitetracycline from tetracycline is called:
a. Isomerization
b. Mesomerization
c. Racemization
d. Epimerization
A C D
1254.
Which is true:
I. Man should eat folinic acid from plant source
II. Mammals and bacteria both have dihydrofolate reductase enzymes
III. Both mammals and bacteria have dihydropetisate synthetase enzymes
I+II
1255.
All the following cells are present in pancreas EXCEPT:
a. cells
b. cells
c. C cells
d. Delta cells
e. Sertoli cells
E
1256.
Hyalourinidase enzyme:
- Secreted by m.o. to destroy (breaks down) hyaluronic acid which binds cells
together so m.o. can pass easily
- Used to increase the penetrative qualities of certain injected medications
Allantoin:
1257.
Wound healing
(A substance extracted from amniotic fluid which surrounds the embryo. It is
sometimes used as a local application to promote healing of wounds and infections)
Congo red test:

1258.
A test to detect amyloid degeneration of organs or tissues

{A test which, when elevated, indicates the presence of degeneration (amyloidosis)
in certain such as the liver, kidney, spleen, etc}
Cross sensitivity to PABA:

1259.
Sulphonyl urea
PABA is used as:

1260.
Sun screen
Enrlichs test (PABA):

1261.
Blue violet Test for indol structure in alkaloids
Flexible collodion:
1262.
2% camphor + 3 % castor oil in collodion

Salicylic acid collodion removal of warts
1263.
A paste containing Karaya gum powder is utilized in ostomy patient:
To protect skin from stomal effluent

(Ostomy = permanent artificial opening in the body)
Bayles law:
1264.
P 1/V when T is constant
Charles law:
1265.
P T when V is constant
Avogadros number:
Equal volumes of gases under the same conditions of temperature & pressure
contains the same number of molecules
Parenteral test (Parental soln must be):

1266.
- pyrogen free
- sterile
- particle free
Some may have preservative or not
1267.
Tests for large volume parenteral:
a. Pyrogen free
b. Sterile
c. Preservative
A+B
Lumulus Test:
1268.
Pyrogen by measuring temp of injected animals (rabbits)
1269.
The major contamination in parental preparations is:
a. Raw material
b. Equipment
c. Person
d. Atmosphere
B
1270.
Removal of pyrogen from water by:
a. Filtration =0.22m filter
b. Distillation
c. Autoclaving
C
Pyrogen is:
1271.
Effect of m.o. growth cause in temp
1272.
Furosemide is stored in:
- Amber glass
- Away from light
Glass container Water Resistance is tested by:

Measuring the amount of alkali released & produce in pH that may stability
Leaching:
Release of container ingredients into the product

Diffusion:
Passage of a substance through a substance
Porosity:
Indicates small holes through which substance could pass
Protect from light means:

1273.
Reduces transmission in the range of 290-450 nm

Visible range of light = 4000-7000 Angstrom (above = IR, below = UV)
Thermometer:
1274.
Rectal >oral> axillaries
1275.
Cold place = 2-8oC
Cool place = 8-15oC
Controlled place = 15-30oC
Which has the osmotic pressure of blood:

1276.
280 mosmol/L = 0.9% NaCl & 5% Dextrose
Solution of boric acid & phenyl ephrine is:

1277.
Isotonic
NaCl = 0.9%, Dextrose = 5%, Boric = 1.72%
Ampicillin dissolved in 5% Dextrose can be kept for:

1278.
4 hours
Ampicillin dissolved in 0.9% Saline can be kept for:

1279.
8 hours
1280.
Which is hypotonic solution:
a. 0.7% w/v NaCl
b. 10% w/v NaCl
c. 20% w/v NaCl
A
What is given to increase the extracellular volume of fluid:

1281.
5% Dextrose
Dextran:
1282.
Plasma expander (to plasma volume)
The cation most prevalent in the extra cellular fluid of the human is:
1283.
Sodium
Which is given in dehydration:

1284.
NaCl or Glucose
Lytren:
- Orally administered ORS = Dextrose + KCl + Na + Ca + Mg salts
- Used to supply water and electrolytes in a balanced proportion to prevent
serious deficits from occurring in patient suffering from mild to moderate fluid
loss
KCl NaCl substitute = 1) same salty taste 2) Crystalline 3) Already exist in body
CI in severe kidney function + Oligurea

IV bolus of high conc K cardiac arrest
Slow K = KCl embedded in wax matrix
N.B. Parenteral electrolytes expressed in mEq
TTT of Hyperkalemia:
1. If theres change in ECG Give Ca2+ to counteract effect of K on heart
2. Bicarbonate or {Glucose + insulin} rapidly shift K from extracellular
(blood) to intracellular
3. Exchange resin (Kayexolate) or Dialysis
The most appropriate Kayexolate enema (50 gm in 70% Sorbitol)
Cytochrome P450 similar to hemoglobin:

1285.
Both have heme portions (4 portions)
Hb:
1286.
Chemoprotein
1287.
The metabolic degradation of Hb takes place in:
a. The reticulo-endothelial system RES
b. RBCs
c. Liver cells
d. Kidney tubules
e. All of the above
A
Porphongras:
1288.
Building of blood
1289.
The metabolic degradation of Hb leads to:
a. Formation of bile pigments
b. No oxidative clearage of porphyrin ring
c. Formation of urobilinogen
d. Formation of bilirubin
e. All of the above
E
1290.
Porphyrin are involved in building of:
a. Bone
b. Muscle
c. Teeth
d. Blood
e. Scar tissue
D (Ferrous porphyrin = true heme portion of Hb)
1291.
The amino acid that is an important precursor of Hb is:
a. Alanine
b. Protein
c. Glycine
d. Leuocine
e. Histadine
1292.
The non protein portion of Hb consists of:
a. 3 Heme units surrounding an iron atom
b. 4 Heme units surrounding an ferric ion
c. A ferrous complex of proto-porphyrin IX 4
d. 4 pyrole rings linked through a ferric mole
e. Non of the above
C
The most wide spread protein in the body is:

1293.
Albumin = 85%
K count in plasma:
1294.
3.5-5 mmol/L or mEq/L (N.B. not mg/L)
Na count in plasma:
1295.
135-145 mmol/L
1296.
RBCs count = 4-5 million/mm3
1297.
WBCs = 5000 -11,000 /mm3
1298.
Platelet = 150,000 300,000/mm3
1299.
Hemoglobin = 12-18gm/dl
1300.
Hematocrite value (% of RBCs) = male 40-54%
Female 38-45%
1301.
Life span of platelets:
7 days
RBCs= 120 days
1302.
After erythrocytes which is the highest count: (Jul-2006)
Platelets
1303.
Platelet originated:
MegaKaryoblast (megakaryocyte)
1304.
A patient blood group AB can take blood from:
a. A
b. B
c. O
All
1305.
more number of cells after RBC: (Jul-2006)
a. In Blood.. platelet
b. In bone ... Stem cells
??
Evans blue test:

1306.
Determination of blood volume
1307.
Highest blood pressure is in:
a. Veins
b. Venules
c. Arteries
d. Arterioles
C
1308.
Blood vessel with lowest b.p.:
1309.
During inspiration blood pressure is lowest in:
1310.
In which blood vessel the blood pressure would be the lowest:
Vena cava
Coronary arteries receive blood from:

1311.
Aorta
The blood going to the branches of coronary arteries has just passed:
1312.
Aortic valve
Blood freezes at:

1313.
-0.52oC
1314.
Which is more in plasma than interstial cellular fluid (extracellular):
a. Proteins
b. Na
c. Cl
A
Plasma contain:
1315.
50% Albumin
1316.
Which is present in plasma in highest quantity:
a. CO2
b. HCO3
B
1317.
Which is present in blood in higher concentration:
a. CO2
b. HCO3-
c. Protein
d. Na2+
C
1318.
Bicarbonate is more in:
a. Intestinal fluid
b. Plasma
A
????1314
1319.
What is the difference between intracellular and extracellular fluid and plasma:
Plasma contains more protein
1320.
Blood volume in adult is:
5L
Requirement of man from fluids daily:

1321.
1 Liter
Maximum volume of IV infusion per day:

1322.
4 L if > fluid overload
Expiration date of admixture is:

1323.
24 hrs (if kept 2-8oC to limit microbial growth)
in TPN preparations the ppt is due to: (Total parenteral nutrition)

1324.
Ca phosphate formation
K phosphate & Ca gluconate:

1) Conc of both to 20 mEq/L
2) Dissolve K phosphate first then add Ca gluconate slowly + stirring
Source of phosphate adult need = 10-15 mmol/day
Use of adrenaline with injectables is:

1325.
Vasoconstrictor prolong effect of drug
1326.
Which decrease absorption at site of injection:
a. Adrenaline
b. Temp
c. Massage
d. Cooling
A+D
1327.
When giving IM injection we usually use the upper side of the lateral thigh to:
a. The fear of injury of the sciatic vein
b. The fear of injury of the femoral vein
A
1328.
Better availability of I.M. injection is achieved by:
Rubbing
1329.
Hypodermoclysis:
IV fluid in SC infants + obese women
= Injection of fluids, usually saline (salt solution) beneath the skin
This method of supplying fluids has been replaced largely by the intravenous route.
Venoclysis:
1330.
IV infusion
Piggy-back concept intermittent therapy of antibiotic
Saves the patient from multiple injection
IV injection must not be suspension blocking blood vessel = clot
Lactated ringers (Hartmans soln) most closely related to extracellular fluid
Ringers injection = isotonic soln of electrolytes = Na, Cl, K, Ca
Diazepam if added to IV infusion ppt
Why topical medication has to be made isotonic:

1331.
To prevent irritation and hemolysis
Solution to be injected S.C. must be isotonic:

1332.
To prevent irritation at the site of injection (since it comes in contact with nerve)
I.M. injection is preferred over I.V. injection:

1333.
To avoid capillary damage
Heparin sodium injection:

1334.
Not IM May cause: 1) Local hematoma 2) very painful S.C. or IV
Ascorbic acid injection:

1335.
Highly acidic so add an alkali (NaOH, Na2CO3, NaHCO3) to adjust pH
Liposyn & intralipid:

1336.
Emulsion parenteral to provide FA not admixture provided alone
What is the disadvantage of using fluorinated drinking water:

1337.
Mottling of teeth (different color)
1338.
Antiplaque silica
Antitartar ZnCl or Zn citrate
Teeth whitening 10% carbamide peroxide
1339.
Betazol is used for clinical testing of:
a. Thyroid function
b. Gastric secretion
c. Glucose tolerance
d. Liver function
e. Kidney function
B
Azuresine:
1340.
Test for gastric secretion Achlorohydria ( HCl secretion)
D-xylose:
1341.
Diagnostic agent to evaluate intestinal absorption
What was labeled incorrectly in intestinal wall structure:

1342.
a. Mesentery
b. Sub mucosa
c. Mucosa
d. Muscularis mucosa
Correct order from inner towards outside is: c-d-b-a
1343.
Antacids are usually taken:
- 1-3 hours after food
- Repeated 3-4 times
Ideal antacid pH of stomach from 1 to 3.5 (which neutralize 90% of the acid +
proteolytic effect of pepsin completely inhibited at pH 4)
Acid rebound occurs with:

1344.
Calcium carbonate
Omeprazole mechanism of action:

1345.
Inhibit H+-K+ ATPase pump

(Form disulfide complex e sulfhydryl gp in the enzyme inactivation of H+ pump)
1346.
Symptoms of irritable bowel syndrome: (Jul-2006)
a. Alternative diarrhea & constipation
b. Vomiting
c. Abdominal distention
C
Esophageal reflux symptoms: (Jul-2006)

1347.
Epigastric pain
Helicobacter pylori predisposing factor of: (Jul-2006)

1348.
Peptic ulcer
1349.
To prevent heart burn & indigestion: (Jul-2006)
a. Lying on after meal
b. Not wearing tight shirt
c. Eat frequent small meals
d. No eat hot spicy meal
C+D
Rebound acidity takes place with:

1350.
CaCO3
All are taken with or without food EXCEPT:

1351.
Sucralfate TTT of duodenal ulcer
1352.
Gastric secretion decrease by all EXCEPT:
a. Acetyl choline
b. Gastrine
c. Histamine
d. Cortisone
All
1353.
Propantheline is:
- Synthetic Anti-cholinergic Anti-muscarininc competitive Ach blocker at
neuro-effector sites
- Also used as antacid
- S.E. = dry mouth + dry skin + urine retention + constipation + Tachycardia
as atropine
Used: 1) Peptic ulcer decreasing gastric secretion

2) Bladder spasm
3) Antispasmodic ( GIT motility)
Stimulation of gastric secretion is due to:

1354.
Protein
Which does not increase gastric acidity:

1355.
Somatostatin
Those increase:
- histamine
- gastrine
- cortisone
In case of renal failure with hyperphosphatemia which antacid is used:

1356.
Al(OH)3
Al(OH)3 antacid cause depletion of:

1357.
Phosphate it also causes constipation
Aluminum hydroxide antacid is used to treat:

1358.
Hyper-PO4
1359.
Esophageal reflux is due to:
I. Inflammation in the walls
II. Perforation of diaphragm
III. Hyperacidity of stomach
I+III
1360.
Which of the following is non systemic laxative antacid:
a. Al(OH)3
b. Mg(OH)2
c. NaHCO3
d. CaCO3
B = Epsom salt
Non systemic antacid with cathartic effect:

1361.
Mg(OH)2
Which is NOT true for the antacid Mg(OH)2:

1362.
Causes Constipation
Antacid with constipation effect:

1363.
Al(OH)3 causes hypophosphatemia
Drug used regularly in academia:

1364.
Na bicarbonate
Bismuth (DeNol) use in peptic ulcer to:

1365.
Has destructive effect on H. pylori
1366.
When taking antacid excretion of drug increases so this drug is:
a. weak acid
b. weak base
c. strong acid
d. strong base
A
1367.
The excretion of weakly acidic drugs, i.e. pKa= 3, will be more rapid in alkaline
urine due to:
a. All drugs are excreted more rapidly in alkaline urine
b. The drug will exist primarily in the unionized form which cant be easily
reabsorbed
c. The drug will exist primarily in the ionized form which cant be easily
reabsorbed
d. Weak acids cant be reabsorbed from kidney tubules
e. Active transport mechanisms function better in alkaline urine
C
If diabetic patient treated with anti-diabetic take antacid:

1368.
Increase the level of unchanged drug excreted in urine

(Antacid = base, antidiabetic= w.a.)
Patient taking antidiabetic and he is taking grape fruit juice, concentration

1369.
increased in urine after taking an antacid then this drug is:

A weak acid (grape fruit urine alkalinizer)
1370.
Drug food interaction occurs in:
I. Nifedipine & grape fruit juice
II. Phenelzine with tyramine hypertensive crisis
III. Warfarin & spinach
All
1371.
Ipecac is:
- Emetic in large dose (8-10 ml)
- Expectorant in small dose (1-2ml) not recommended in children < 6 yrs
Metoclopramide:
1372.
Dopamine antagonist which act centrally and peripherally anti-emetic Gastric

emptying
1) stomach motility
2) Used in TTT of diabetic gastroparesis ( gastric emptying)
3) Used in GERD
4) Antiemetic in cancer chemotherapy through 2 means:
a. Centrally central antiemetic (DA)
b. Peripherally through cholinomimetic effect
Gastric emptying by 1) vigorous exercise 2) pain 3) hot meal 4) emotion stress
Gastric emptying by 1) mild exercise 2) hunger 3) cold meal 4) dilute sol

5) laying on the right side
Effect of food on drug absorption:

1373.
Food gastric emptying rate drug absorption
Which drug is used for prophylaxis of motion sickness:

1374.
Cyclizine
1375.
Sincalid (Kinevac) is used as diagnostic aid to obtain a sample of:
a. Albumin
b. Gastric juice
c. Blood sugar
d. Ketones
e. Bile
E (contracts gall bladder & evacuate it)
1376.
Cholestasis:
- Is the obstruction of bile flow, by pptn of bile pigment within the bile canaculli
- There is an increased bile acid in BLOOD
Cholecystectomy:
1377.
Removal of gall bladder
Cholecystitis:
Inflammation in the gall bladder due to stones
Which drug is used to dissolve gall stones (cholethiasis)

1378.
Chenodiol = Chenodeoxycholic acid = natural bile acid dissolve stones rich in

cholesterol
- Gall stones are caused due to failure of cholesterol solubilization so its
ppted (Stone = bile acid + Chenodeoxycholic acid normal hepatic
metabolite of cholesterol)
- Chenodiol cholesterol & replace it result in gradual degradation of stone
- Chenodiol is ineffective calcified or- pigment containing stones.
1379.
Bile salts are:
- Steroid in nature
- Hydrophilic
- o/w emulsion
- Not absorbed
Paraben is used as:

1380.
Preservative in oral & topical solution but not in ophthalmic = irritant
1381.
Methyl paraben and propyl paraben are used together, why:
- Synergistic effect
- Effective over a wide range of pH
- Their activities may be reduced in the presence of Non-ionic Surfactant
1382.
What is colligative properties:
1383.
Properties of a substance that depend on the number of solute dissolved in the
solvent (dont depend on the type of the solute)
a. Lowering of vapor pressure
b. Lowering of osmotic pressure
c. Lowering of freezing point
d. Elevation of boiling point
1384.
Colligative properties are useful in determining:
a. Tonicity of the soln.
b. pH
c. Solubility
d. Sterility
e. Stability
1385.
Vapor pressure:
- Its the pressure of vapor above the boiling liquid
- It increase when solute increase
1386.
When the atmospheric pressure is equal to the vapor pressure, it is:
a. Evaporation
b. Distillation
c. Boiling point
C
In a mixture of the two volatile liquids in which the azeotrope has a higher vapor
1387.
pressure than individual component, then:

The azeotrope will distill faster
Amphiprotic solvent:
1388.
Behave as acid (loss proton) or as base (gain proton) e.g. Water
Aprotic solvent:
1389.
A solvent which has a weak proton donor and accepting property

Amphiprotic = gain or donate proton (Water)
Amorphous = not a crystalline
A very soluble means:

1390.
That 1 part solid will dissolve in < 1 part solvent

<1 = very soluble
1-10 = freely soluble
10-30 = soluble
30-100 = sparingly soluble
Two solids that melt when mixed together at room temp:

1391.
Eutectic mixture e.g. thymol + camphor
1392.
In the graph the critical solution temperature is:
a. b. c.
Temperature at which all the concentrations of solute are soluble in water
Max temp above which 2 immiscible liquids become miscible homogenous
solution, regardless to conc. of each (e.g. H2O & phenol)
b = conc (inside curve = 2 layer region, outside = 1 layer)
Eutectic point is:

1393.
The lowest melting point of any possible mixture of solids

1394.
Topical decongestant for pregnant woman:
a. Naphazoline
b. Oxymetazoline (drv of Naphazoline)
All
1395.
Pregnant woman suffers from: (Jul-2006)
a. Folic acid deficiency
b. Iron deficiency
c. Hypovolemia
A+B
1396.
All are true about placenta EXCEPT:
a. Contain blood veins which transfer drugs and nutrients
b. Contain enzyme for biotransformation
B
Factors affecting absorption of drug from placenta (also BBB):

1397.
Lipid solubility
Use of umbilical cord starts:

1398.
During which week the placenta starts full function:

1399.
8-10 weeks
Critical period of teratogenicity:

1400.
3-8 weeks
1401.
A patient with chronic simple reversible cystitis post-coital should: (Jul-2006)
I. use a diaphragmic birth control
II. drink plenty of water
III. void after sexual intercourse
II+III (Inflammation of urinary bladder after intercourse)
1402.
After fertilization what is secreted to keep corpus luteum in place for the next
months: (Jul-2006)
1403.
What helps in the implementation of fertilized ovule:
a. Estrogen
b. Progesterone
c. FSH
d. HCG (human chorionic Gonadotrophins)
A
At time of ovulation:
1404.
Both FSH & LH increase
Estrogen differ in ring number one because it is:

1405.
Aromatic
1406.
In TTT of PMS (menopause):
a. Testosterone alone with risk of cancer
b. Use progesterone and estrogen at intervals
c. Progesterone alone
d. Estrogen alone with risk of cancer
B
Anabolic testosterone taken orally:

1407.
Mesterolone (Proviron)
Oral contraceptives:
1408.
Benefits with birth control pills outweigh the risks
Benefits:
1. Protection from risk of pregnancy
2. Alleviation () of dysmenorrhea
3. Alleviation of premenstrual tension
4. Alleviation of heavy menses and irregular menses
5. Protection against iron deficiency anemia
6. Protection from pelvic inflammatory disease related to thickening of the
cervical mucous secretion, to stronger uterine contraction which prevent
ascending of bacteria into the uterus and fallopian tube
7. Lower incidence of ectopic pregnancy
8. Lower incidence of benign breast disease
9. Decreased risk of ovarian and endometrial cancer
Risks: CVS complications (venous thrombosis, hyperuria, cerebral disease stroke
and ischemic heart disease)
Contraceptives
1. Progesterone alone 2. Post-coital (morning after)
1409.
Small oral dose - Within 72 hours estrogen alone
1410.
Daily from the 1st day of menst cycle 25 mg bid for 5 days
continuous without interruption - OR estrogen + progesterone bid
1411.
Depot IM = 3 months every 12 hrs
1412.
also S.C. implants Mechanism:
MICRONOR - Alteration of Fallopian tubes motility
PROGESTA-SERT system IUD zero - Endometrium changes
order release of progesterone 1 year
3. Combined
Monophasic Biphasic Triphasic
1413.
Same conc of estrogen 2 different conc of
1415. 1417.
Phase 1: from 5th day
& progesterone in all the hormones in 21 pills for 6 days = low est (30g) +
pills low prog (50g)
1414.
From 5th day for 21 Made to be close to
1416.
1418.
Phase 2: for 10 days
day 7 days pill free estrogen/progesterone
ratio during menst est (40g) + prog (75g)
OVRAN
cycle
1419.
Phase 3: for 10 days
(ethinyl estradiol +
levonorgesterol) est (30g) + prog
(125g)
Mechanism of action:
1. inhibition of ovulation by Gonadotrophins secretions from ant pituitary
(estrogen FSH, progesterone LH)
2. viscosity of cervical mucous sperm penetration
3. interfere with cervix-uterus-fallop tubes contractions w are essential for
sperm transport to ovum
4. produce endometrial changes prevent implementation
What to do in case of:

Breakthrough bleeding, mid-cycle spotting, or Dysmenorrhea
estrogen &/or progesterone
xxs bleeding, late-cycle spotting progesterone &/or estrogen
Nausea, edema, Chloasma, breast tenderness estrogen
wt gain, hirsutism, depression progesterone
Side effects of o.c.:

1. Nausea + vomiting 8. b.p
2. Headache + migraine 9. bl gl
3. Diarrhea 10. wt + fluid retention
4. Depression 11. risk of venous thrombosis
5. Acne + hirsutism 12. possibility of vaginal infection
6. Breast tenderness 13. pigmentation of face
7. Amenorrhea + breakthrough
(Chloasma)
bleeding
14. Cholestatic jaundice
Drug interactions:
- ACEI - Antihypertensives antidiuretics - - Warfarin
B-blockers - Antidiabetics
- Rifampicin, antiviral, Antifungals, - RetinoidsTheophylline
cyclosporine, Ampicillin, tetracycline
- Antidepressant Antiepileptics
barbiturates
Estrogen Progesterone
Types 1. Natural: Estradiol
2. Semi-synthetic:
Ethinyl estradiol
3. Synthetic:
Diethyl stelbosterol
used in TTT of Senile vaginitis
Secretion corpus luteum corpus luteum

(foeto-placental unit) (in 2nd half of menstrual cycle)
Absorption skin + GIT (oral is limited due to 1420.
Not oral completely
rapid liver met) metabolized by liver (1st
pass effect)
1421.
IM short t1/2
Excretion Glucouronide & sulphate Glucouronide conjugation
Action 1. Growth of female sex characters
& organs (xpt clitoris)
2. Uterus: alone in proliferative phase together with estrogen
a) of menst cycle transforms endometrium to
Endometrium with progesterone in secretory phase & prepare it
secretory phase for implementation of fertilized
ovum
b) Myometrium growth & sensitivity to Oxytocin sensitivity to oxytocin
relaxation of uterus in late
pregnancy
3. Cervix thickness of cervical mucous + thickness of cervical mucous
more alkaline promote survival & becomes cellular sperm
& motility of sperm motility
4. Breast growth + fat deposition growth in estrogen-primed
mammary glands
5. Vagina: thickening of vaginal walls +render 4. Inhibits ovulation
vaginal secretion more acidic 5. body temp by 1 F in
middle cycle
6. Anterior Pituitary: 6. Competes with aldosterone
In early part of follicular phase of cycle at renal tubules inhibit Na
FSH & LH reabsorption
Before 24 hrs of ovulation
LH 9 hrs after in LH ovulation
At late stage -ve feedback mechanism
estrogen FSH & LH
Metabolic 1. Na & salt retention
Action 2. Anabolic action < testosterone
3. Ca deposition in bones (
parathormone)
4. blood coagulation by
factors 2, 7, 9, 10 &
Antithrombin time ( heparin)
Uses 1. Contraception 1. Contraception
2. Dysmenorrhea (painful 2. Dysmenorrhea
menstruation) 3. Amenorrhea
3. Menopausal disorders 4. Uterine bleeding
4. Uterine bleeding 5. Habitual abortion
5. Osteoporosis 6. Endometriosis
6. Prostate cancer 7. Endometrial carcinoma
7. Vaginitis (diethyl stilbosterol)
8. Hormonal Rep Therapy (HRT)
Female 65 years with HRT (Hormone replacement therapy) stop HRT estrogen.
1422.
What is your advice as a pharmacist? (Jul-2006)

Continue therapy?
1423.
Hormonal contraception act by:
a. Inhibit implantation
b. Delay ovulation
c. Inhibits tubular passage of sperms
All
Side effects of oral contraceptives EXCEPT:

1424.
Constipation
1425.
Side effects of oral contraceptives:
- Fluid retention
- Hypertension
- Depression
- Diarrhea
Woman taken combined contraceptive and has breakthrough bleeding, must

1426.
take:
High dose of estrogen oral contraceptive
1427.
Which drug does not interact with oral contraceptives:
a. Phenytoin
b. Carbamazepine
c. Warfarin
C ???????not b? refer to Di schedule
1428.
Which of the following drugs dont interact with oral contraceptives: (Jul-2006)
a. Phenytoin
b. Rifampicin
c. Retonavir
C
1429.
Drugs affecting oral contraception (OCP) all EXCEPT: (Jul-2006)
a. Ibuprofen
b. Erythromycin
c. Amoxicillin
A+C
1430.
Which does not affect contraceptive effect of OCP:
a. Phenytoin
b. Carbamazepine
c. Tetracycline
d. Sulfa
e. Amoxicillin
E Ampicillin
1431.
A patient taking oral contraceptive & the physician given her also
diphenhydramine to:
a. Prevent allergic reactions due to o.c.
b. Prevent skin rash
c. Prevent nausea & vomiting
C
1432.
Which can take oral contraceptive:
a. Woman with deep vein thrombosis
b. Hypertensive
c. Woman with depression
d. Epileptic woman
e. Pregnant woman
D
Estrogen in oral contraceptives can cause:

1433.
Embolus (thrombus formation) smoking that risk
1434.
Corpus albican:
- Mass of fibrous tissues replaces the regressing corpus luteum after rupture
of Graffian follicle
- Forms a white sac (albican) gradually decrease in size and disappear
- Found in females of child bearing age (not pregnant)
1435.
In post menopausal therapy:
a. Conjugated estrogen carry the risk of endometrial cancer
b. Progesterone alone is effective but does not help vaginal itching and dryness
c. Progesterone combined with estrogen reduces the chances of cancer
A+C
1436.
When corpus albican is found in the uterus, it can be said that:
a. The woman is of child bearing age
b. The woman is at puberty
c. The woman is pregnant
d. The woman is experiencing menopause
e. All of the above
A
1437.
Which of the following is soluble in water:
a. Glucocrticoid
b. Progesterone
c. Na salt of Glucocrticoid
C
What is gravida:
1438.
Number of times someone become pregnant
1439.
Which increase rate of reaction:
- rate of stirring
- remove product formed
- increase temp
- add catalyst
Zn & Ca differ in that:

1440.
Zn is looking for electron so it is Lewis acid molecule or ion that accepts an e-

pair from another atom and a base as a substance that donates an e- pair to be
shared with another atom
ZnSO4 is incompatible with:

1441.
MgCl2
Zn Oxide substitute 50 mg:

1442.
Cacao butter
1443.
Zinc makes coordinate bond more than calcium at receptor binding sites for some
enzymes because:
a. It has smaller size
b. Has free electrons in d shell
c. More hydrophobic
d. Act as Lewis base
B
1444.
Drug in its state of 1s2 2s1 2p2 is in:
a. Its ground state 1s2 2s2 2p1
b. Its excited state
c. Hybrid
B
Inactive enzyme form of enzyme:

1445.
Zymogene
Inactive enzyme precursor, which is converted into an enzyme when activated by another enzyme
In enzymatic reaction, addition of competitive inhibitor will lead to:

1446.
Slow rate of reaction
1447.
Removal of competitor inhibitor from a reaction:
a. Increases the rate of reaction
b. Decrease the rate of reaction
A
In competitive antagonism, increase of amount of substrate has what effect on

1448.
the rate of reaction:

Increase the rate of reaction
By addition of catalyst to the reaction:

1449.
Get the product rapidly
1450.
If K1> K2 & K3=0 D=Drug R= Receptor
So the drug D is: (Jul-2006)

Competitive antagonist
K1=K2 & K3 = 0 no complex is formed D= action agonist
K1>K2 & K3 = value competitive Agonist
K3>K1 competitive Agonist

K1<K2 & K3 = 0 competitive antagonist
Which is not right:

1451.
BH+ is a conjugate base
Which is conjugated acid-base:

1452.
H2CO3/CO3-
1453.
HCl + NH3 NH4Cl at equilibrium, when we add double amount of NH3 it will
lead to:
a. K of the reaction
b. K will remain constant (rate of R is but K is constant)
c. K of the reaction
B
HCl + H2O Reaction is:

1454.
Ionization Reaction
AB + A pptn due to:

1455.
Salting out
A + B AB, if A is decreased what will happen to the reaction rate:

1456.
Decreased
Phenol + NaOH reaction is:

1457.
Neutralization Reaction (Acid-base reaction) OR Electrophilic substitution
Phenol & water:

1458.
Miscible with water not soluble
Phenol is a weak acid than ortho-dinitro-phenol due to:

1459.
Inductive effect of NO2 (e- withdrawing)

Ortho & Para position electron withdrawal acidity
1460.
Phenols are acidic because they have:
a. Mesomeric interaction
b. Strong induction anion
c. Strong induction cation

A
1461.
Phenols are acidic due to:
a. Stable anion resonance
b. Stable cation resonance
c. Weak dissociation
A
1462.
A compound which is not isomer of hexane is:
a. n-Hexane
b. Iso-hexane
c. neo-hexane
d. 3-Me-pentane
e. Cyclohexane
f. Me-cyclopentane
E+F
Which of the following is -amino butyric acid:

1463.
CH2-CH2- CH2-COOH
l
NH2
Benzocaine with caffeine can form:

1464.
Ion-dipole
Benzocaine = weak carboxylic acid
Caffeine = weak base cyclic amide
1465.
Which is not a dipole:
a. CO2
b. O3
c. NH3
B
1466.
Which is free oxygen:
a. H2O2
b. O2
c. OH
B
Ozone is formed by:

1467.
Oxidation {O2 + O -CFC O3}
Fluorinated hydrocarbon are substituted with: (Jul-2006)

1468.
a. Hydrocarbon
b. Inert gas
c. Chlorofluorocarbon
d. HFA (hydrofloroalkane)
D To protect Ozone
Freon II = fluorinated hydrocarbon harmful for ozone, propellant gas (deodorants)
Pro-drug + bioactivation active drug

1469.
Active drug + biotransformation inactive metabolite
Prodrug, activated in body by:

1470.
Bioactivation
Usually metabolites are:

1471.
Have low o/w partition coefficient
Conjugation with Glucouronide results in: (Jul-2006)

1472.
Water soluble metabolite
Functional group metabolism occurs in:

1473.
Phase I metabolism
1474.
What is another name for metabolites which are present in the body:
1475.
A substance that exists naturally in the body is called:
Endogenous
1476.
When a drug is inactivated in liver it becomes:
a. More soluble in water
b. More soluble in lipid
c. pKa changes
d. The partition coefficient o/w becomes smaller
D not a+d?
1477.
Hydrolysis occur in:
- Amides
- Esters only
R-COOH metabolized by conjugation with:

1478.
Glycine
What type of reaction is when there is acetylation of sulphonamide occurring on

1479.
the amino group:

Phase II reaction
Metabolism is enhanced by:

1480.
Passive reabsorption
1481.
Drugs containing hydroxyl or carboxyl groups are detoxicated by:
a. Hippuric acid
b. Glucouronic acid
c. Acetylation
d. Reduction
e. Hydrolysis
B
1482.
Phase I includes:
a. Acetylation
b. Sulphoxidation
c. Conjugation
A+B
1483.
Phase I metabolism:
a. Called functionalization of the drug
b. Phase two must take place after phase I
All
Which step of metabolism is NOT in phase II:

1484.
Sulfoxidation
Phase I Phase II
Biotransformation involving Biotransformation by enzymes =

microsomal enzymes catalyzed by cytoplasmic + microsomal separately
cytochromes may or in combination
Activate or
Inactivate or 1. Conjugation
Leave activity of the drug 2. Acetylation
unchanged. 3. Hydrolysis in I & II
1. Aliphatic oxidation
2. Aromatic Hydroxylation Common conjugation reaction:
3. N-Dealkylation Glucouronidation, Glycine, Glutathione,
4. Oxidative Dealkylation Sulfonation, Methylation, Acetylation
5. S-Demethylation
6. Oxidative Deamination Conjugation needs:
a. High energy molecule (co-enzyme)
7. N-oxidation
8. N-Dehydroxylation b. Enzyme (transferase)
9. Sulfoxidation (Sulphoxide
formation)
In which new functional gp. is In which the functional gp of the
introduced into the molecule or original drug (or the metabolite formed
unmasked by: (oxidation, in phase I reaction) are masked by
reduction, hydrolysis) conjugation reaction
1485.
Oxidation in human is mediated by:
a. Ozone
b. Amylase
c. Tryptophan
d. Glucouronidase
e. Co-enzyme A
E
Which is NOT a metabolic enzyme:

1486.
Cytochrome A
Co-enzyme or factor involved in glycine conjugation:

1487.
Acetyl-CoA = S-acyl- CoA (Co enz for transyclase enz)
Which intervene with Glycine conjugation:

1488.
Acetyl CoA
1489.
Enzyme involved in glycine conjugation:
a. S-acyl coenzyme
b. Transyclase
c. Glutathione transferase
B
1490.
High energy molecule involved in Glucouronyl conjugation:
UDP-Glucouronic acid
1491.
Aromatase enzyme involved in:
Biosynthesis of estradiol (and other estrogens)
b
R-NH2 + a R-NH-CO-CH3, What is a & b:
1492.
a= Acetyl CoA
b= Acetyl Transferase mechanism of acetylation of amino gp
A reaction between an activated moiety and transferase enzyme is:

1493.
Biotransformation
The end product of protein:

1494.
Urea
In DM type I protein is converted to glucose wt lose
End product of anaerobic glycolysis:

1495.
Lactic acid (+ 2 ATP not biodegradable muscle cramp)

Aerobic= CO2 + H2O+ 36 ATP
1496.
Some tissues form lactic acid under aerobic conditions, this phenomena, specially
characteristic of tumor tissues is termed:
a. Aerobic glycolysis
b. Lactation
c. Oxidation
d. Oxidative phosphorylation
e. Non of the above
A
CH2CH2CH2C-CH2CH3
1497.
l
CH3
The compound is soluble in
a. Water
b. Aqueous HCl
c. Aqueous NaOH
d. Octane
e. All
D
1498.
What is the IUPAC name of the compound:
a. 2-methyl-4-isopropyl-2-hexene
b. 2,5-dimethyl-3-ethyl-4-hexene
c. 2,5-dimethyl-4-ethyl-2-hexene
d. 5-dimehtyl-3-(2-propyl)-hex-4-ene
e. 1,1,4-trimethyl-3-ethyl-1-pentene
C
1499.
Which of the following would be this compound dissolve in:
a. H2O
b. Aq-HCl
c. Aq-NaOH
d. Decane
D
1500.
What type of chemical instability (in vitro) might be predicted for this compound:
a. chemically non reactive
b. peroxide formation
c. addition of H2O across

d. Epoxidation
B
Which will react more in SN1 condition:

1501.
(CH3)3-C-Cl 3o halide SN2 in 1o halide
1502.
Which does not react with Br2 in CHCl3:
a. Cyclohexane
b. Aniline
c. Methane
d. Ethane
A
1503.
Which does not remove color of Br2 dissolved in CCl4:
a. Aniline
b. Acetone
c. Hexane
d. Hexene
C
Alkyl ketone prepared by:

1504.
Oxidation of 2o Alcohol + Hydration of alkynes (3=)
Browns reaction
1505.
To prepare 2ry alcohol

Alkenes Browns/ pH3 2ry alc.
Claisen condensation:
1506.
To prepare Di-carbonyl gp (2 C=O)
How can you prepare dicarbonyl gps (2 C=O):

1507.
Claisen condensation (2 CH3C=O-OC2H5 Et Acetate Et Acetoacetate)
1508.
Which compound can react to produce Schiffs base, but does not reduce Fehling
soln:
a. Acetaldehyde
b. Butyrophenone
c. Acetic acid
d. Ethyl alcohol
B = ketone
1509.
Addition of -alkyl to C=O group gives:
I. O-alkyl ether
II. C-alkyl ketone
All
Kind al alcohol obtained by hydroboration (HB3) of iso-butelene (methyl propene)

1510.
then oxidation (Browns reaction):

a. 1ry alcohol
b. 2ry alcohol
A
N.B. the same compound on hydration (Markonikov) 2ry alcohol
1511.
Which of the alcohols in the compound show a 3o alcohol:
1. 2. 3. 4.
1512.
What properties would you predict for this compound:
a. Inflammable
b. Insoluble in H2O
c. Soluble in H2O
d. Soluble in Aq-soln
C+D
1513.
What type of instability would be expected for the alcohol portion of the molecule
in the presence of an oxidizing agent:
a. Alc 2,3,4 would be oxidized to carboxylic acid
b. Alc 2 is stable and alc 3,4 oxidized to ketone
c. Alc 2 is stable while alc 3 oxidized to acid and alc 4 to ketone
d. All functional gps are stable to oxidizing agents
C
1514.
Which OH group will be oxidized easily to COOH:
1. 2. 3. 4.
1515.
What type of chemical bonds are possible between water and the compound:
a. Van Der Waals bonds

b. Hydrogen bond
c. Ion-ion bonds
d. Ion-dipole bonds
e. Dipole-dipole bonds
E
Not b???
London forces: induced dipole-induced dipole

Between non polar molecules w dont have dipoles theres asymmetric distribution
w induce transient dipole moment
Weak intra-molecular forces not true chemical bonding
Debye forces: dipole induced dipole interaction
Molecules have dipoles induce transient dipole moment
Van Der Waals forces: Permanent dipole interaction
It is the increase attraction between molecules as the no of atoms
H-bond: formed by H + highly electronegative atoms (F, N, O, Cl, S)
Ion-ion bond: (+) (-) interaction as in a.a. = Zwitter ion
1516.
Predict the solubility of the compound in the media given:
a. Water
b. Aq H2SO4
c. Aq KOH
All
1517.
Would you predict the compound shown to be soluble in:
a. Water
b. Aq HCl
All in vivo metabolism O-dealkylation
1518.
What in vitro (on the shelf) instability may be expected for this compound:
a. Peroxidation
b. Oxidation with strong oxidizing
c. Oxidation in the presence of air
d. Hydrolysis
e. Stable
A ether R-O-R (O) peroxide
The intermediate stage of methanol conversion is: (Jul-2006)

1519.
Formaldehyde damage to retina blindness
1520.
Which is formed by alcohol metabolism:
a. Alkenes
b. Alkynes
c. Aldehydes
C
1521.
Terminal hydroxylation is commonly followed by oxidation to aldehyde and then
to acid in:
a. Terminal alkyl chain
b. Benzylic methylene
A
1522.
Which give positive iodoform test:
a. Acetaldehyde
b. Ethyl alcohol
c. 2ry alcohol
d. Methyl ketone
All
1523.
What is the IUPAC name for the shown compound:
a. -methyl--phenyl--oxopentanal
b. 3-methyl-4-oxo-3-phenyl-pentanal
c. 3-methyl-3-phenyl-5-oxo-2-pentanone
d. 3-methyl-3-acetylphenyl acetaldehyde
B RCHO = aldehyde RCOR =ketone
1524.
Predict the vitro instability of this compound:
a. Oxidation of the ketone
b. Oxidation of the aldehyde to acid
c. Alkyl oxidation
d. Aromatic oxidation
e. Peroxide formation
B
1525.
Predict the vivo instability of this compound:
a. Conjugation
b. Aromatic hydroxylation
c. Oxidation of the aldehyde to acid
d. Ketone oxidation
e. Stable
B+C
Metabolism of 10, 20 Amines by:

1526.
1 oxidative deamination
0
20 Acetylation 30 stable
R-C-NH2 R-CO-NH2 RCHO + NH3, This reaction is called:

1527.
Deamination
Metabolism of Aromatic Amines by:

1528.
Hydroxylation
Metabolism of Phenol:
1529.
Hydroxylation + Methylation
Hinesburg Reaction (For amines) which react: a) 1o b) 2o c) 3o

1530.
3 does not react

o
Differentiate between 1ry, 2ry & 3ry amines:

1531.
Hing Bergest Reaction: 1ry (more acidic) product dissolves in NaOH

2ry (less acidic) product not dissolves in NaOH
3ry (not acidic) no reaction
How can we differentiate by simple reaction between 3ry or 1ry alcohol:

1532.
CrO4/SO4 oxidation reaction 3ry alc stable, 1ry alc= aldehyde
NH4++ OH- NH3 + H2O

1533.
According to Bronsted Lorry Theory, the above reaction is:

a. Ionization
b. Neutralization
c. Hydrolysis
B
1534.
Which Nitrogen is 3o amine:
1. 2. 3. 4. 5.
1535.
Which Nitrogen is least basic:
1. 2. 3. 4. 5.
1536.
Which Nitrogen is most basic:
1. 2. 3. 4. 5.
Basic: 4o>3o>2o>1o>Aromatic
What type of metabolism is possible at nitrogen 3:

1537.
No metabolism = sable
1538.
Which has more alkalinity in water:
1. 2. 3. 4. 5.
1539.
Nitrosamine:
a. R2N-N=O
b. OH-NR-N=O
A
1540.
NO2 gp in this structure is:
a. Nitrite group
b. Nitrate group
c. Nitro group
A
1541.
Nitroglycerine contains:
a. Nitrite group
b. Nitrate group
c. Nitro group
B
Given structures. Which is soluble in aqueous NaOH:

1542.
Carboxylic acid group -COOH
Given structures. Which is soluble in HCl:

1543.
Amine group NH2
Why carboxylic acid R-COOH are acidic while Alcohol ROH are not:
1544.
Because acids have a stable anion resonance while alcohol is not stable
Metabolism of:
1545.
Aspirin hydrolysis
Penicillin acid hydrolysis
L-dopa decarboxylation
Tetracycline complexation
CPZ (chlorpromazine) oxidation
Organic COOH glycine conjugation
Esters hydrolysis
Amides N-dealkylation
Aspirin hydrolysis Salicylic acid = converted to Salicyl-uric acid (in liver)
conjugation with Glucouronic acid phenolic Glucouronide Gentisic acid
Hemogentisic acid (end product)
SSRI metabolism: (Jul-2006)

1546.
N-Demethylation
Acetic acid is weak acid compared to formic acid due to:

1547.
Because methyl gp is e- donating gp
1548.
Perchloroacetic acid (CCl3-COOH) is more stronger than acetic acid because:
1549.
Why perchloric acid protonates acetic acid:
a. Because acetic acid accepts protons easily
b. Better oxidizing agent
c. It is a strong acid
d. It can protonate it
C+D
1550.
Which methyl group is oxidized to acid:
a. Benzylic
b. Terminal
c. Alicyclic
d. Aromatic
B
1551.
Which acid in the compound shown is the most acidic:amine????
1. 2. 3. 4. 5. Mineral acid
1552.
Which acid in the compound shown is the least acidic:
1. (Phenol) 2. 3. 4. 5.
1553.
Which organic acid in the compound shown is the most acidic:
1. 2. 3. 4. 5.
4 due to presence of F ions high electronegativity
1554.
Which type of metabolism is expected for functional gp 2:
a. Sulfate conjugation
b. Glucouronide conjugation
c. Methylation
d. Hydrolysis
e. Glutamine conjugation
B+E
1555.
Predict metabolism of this compound:
a. Oxidation (OH)
b. Reduction (NO2 gp)
c. Glucouronidation (-N-)
d. Deamination
A+B+C only 1o amines undergo deamination
1556.
Predict the solubility of this compound:
a. Soluble in water
b. Soluble in Aq HCl
c. Soluble in Aq NaOH
d. Soluble in all the above
e. Insoluble in all the above
E
1557.
Predict the in vitro instability of the compound:
a. Unstable in Aq acid due to ester hydrolysis
b. Unstable in Aq base due to amide hydrolysis
c. Unstable in Aq acid due to amide hydrolysis
d. Unstable in Aq base due to ester hydrolysis
A+D due to presence of C=O, O-O undergo hydrolysis acid + alcohol
1558.
Which if the compounds shown contains carbamate:
1. 3.
2.
4.
3 has ester (R-C=O-OR) + amide (R-C=O-N)
1559.
What metabolism is expected to compound 1:
a. Hydrolysis by esterase esters only
b. Hydrolysis by Amidase amides only
c. N-dealkylation 10 amine
d. Conjugation with Glucouronic acid or sulfuric acid for acids
e. Fairly stable
B+E
1560.
What metabolism is expected to compound 3:
a. Hydrolysis by esterase
b. Hydrolysis by Amidase
c. Peroxide formation
d. Conjugation with Glucouronic acid or sulfuric acid
A
1561.
Predict the solubility of the compound shown:
a. Soluble in water
b. Soluble in Aq HCl
c. Soluble in Aq NaOH
d. Soluble in all the above
e. Insoluble in all the above
B+C B due to salt formation at gp 3
C due to salt formation at gp 4 (aryl sulfonamide = w.a.)
1562.
Predict metabolism at position 1:
a. Oxidation
b. Reduction
c. Deamination
d. Conjugation
e. Stable
B
1563.
Predict metabolism at position 2:
a. Oxidation
b. Reduction
c. Deamination
d. Conjugation
e. Stable
A
Predicting solubility:
(1- Empirical method 2- Analytical method)
1) Empiric method:
- The chemical properties of a functional gp are not affected by the
presence of other chemical gps within the molecule
- Single functional gp (liberal method) no probability of INTRA-
molecular bonding (in the same molecule) BUT theres probability of
INTER-molecular bonds
E.g. Hexanol: binds to a 2nd molecule of hexanol through dipole-dipole bonding
So to dissolve hexanol we must break the dipole-dipole bonding (intermolecular)
so that water molecules can bond to functional gps
- Poly-functional gp (Conservative method) theres probability of

intramolecular bonding
Tyrosine
Solubility in water = 0.45 gm / 1 L

* Phenol gp solubilizes (6-7 carbons)
* Amino gp NH2 solubilizes (6-7 carbons)
* Carboxyl gp COOH solubilizes (5-6 carbons)
i.e. total solubilization potential = 17-20 C
*** But its almost insol although it contains only 9 C
Due to INTRA-molecular bonding Amino acid has ion-ion bonding Zwitter
ion effect (-COOH -H+ + NH2 -COO- + NH3+)
Result inability of the 2 functional gps to bind with water
BUT if we destroy the intra-molecular bonding by NaOH or HCl water soluble
Consider this compound contains two 3o amino gps
- On using the mono-functional gp method each 3o amino gp dissolve 7 C

i.e. the compound can dissolve 14 C (this cpd = 13 C) so water soluble
- On using poly-functional gp method each 3o amino gp will dissolve only 3 C
i.e. the compound can dissolve 6 C (this cpd = 13 C) so water insoluble
the FACT = cpd is soluble it contains similar functional gps no INTRA or INTER
molecular bonding present
- Liberal method CHO gp solubilize 5 C + 3o amino gp solubilize 7 C

i.e. cpd dissolve 5+7=12 C (as it contains 9 C so water soluble)
- Conservative method CHO gp solubilize 1 C + 3o amino gp solubilize 3 C
i.e. cpd dissolve 1+3=4 C (as it contains 9 C so water insoluble) CORRECT
2) Analytical method:
- Based on the Partitioning of a drug between Octanol (std lipophylic medium)
& water ( std hydrophilic medium)
log P = conc of drug in Octanol / conc of drug in water
- P = partition coefficient
Log P =
- = sum, =hydrophilic-lipophylic value of each fragment of the molecule
In order to use this method:
- Fragment the molecule into basic units
- Assign appropriate according to the atoms & gps present
** if +ve value of fragment is Lipophylic
** if -ve value of fragment is Hydrophilic

Normal log P value = +0.5
water soluble log P = +0.5 water insoluble
Calculation of log P Calculation of log P

Without IMHB Factor With IMHB
Salicylic Acid (intra-molecular H-Bonding)
Phenyl +2 +2
-OH -1 -1
-COO -0.7 -0.7
IMHB 0 +0.6
Sum +0.3 +0.9
Prediction Result Soluble Insoluble = correct
Conclusion IMHB water solubility
6 C 6 X 0.5 = 3 1 phenyl = 2
2 N 2 X -1 = -2 C=O = -0.7 Sum = +2.3
Prediction = water insoluble
If we add IMHB = +0.6 Sum = +2.9 more water insoluble
Grignard reagent:
1564.
R-Mg+X (R = alkyl donator) RX ether/Mg RMgX

- Very strong base >> OH, NH2 reactive to any H atom even H2O
- Powerful neucleophile add R- to +ve charged atoms & Mg+X to the ve
Duquenois Reagent:
- Test for cannabinoid alkaloid
- Reagent + H2SO4 + Marijuana (hashish) Blue (Intensity of color =
amount of Tetrahydrocannabinol present
Marquis reagent:
- Test for morphine in urine
- Reagent (=H2SO4 + HCHO) + opium alkaloid Purple complex
Strychnine:
+ H2SO4 + Pot dichromate (K2CrO4) Blue violet color
CHCl3 (Chloroform):
When oxidized Phosphogene very toxic gas
Zn insol ppt with Diphenyl-thio-carbazone
NH3 blue color with litmus paper (strong base)

Why cyclohexane doesnt react with Grignard reagent:

1565.
Because theres NO functional group OR double bond
Zwitter ion react with any substance as:

1566.
Neutral ion
1567.
Compound forms Zwitter ion at pH=7 then it is extracted by ethyl ether in the
form of:
a. Neutral form
b. Anion
c. Di-anion
d. Cation
e. Di-cation
A
1568.
A=? B=?
1569.
This compound is
{Chelate (Non toxic rapidly excreted)}
Remember:
- Chelate= a complex formation in drug interaction (e.g. Ca2++
Tetracycline)
- Chelates are used in chemotherapeutic treatment of metal
poisoning
1570.
What structure is this: X= O, S R= 2 aryl groups
Antihistamine
1571.
Structure activity relationship SAR of Antihistamine:
- They must have 30 amine (nitrogen)
- HC side chain they must have more than one aryl gp or hetero aryl or its
equivalent
X= O Ethanol amine (Phenhydramine)

CH Propyl amine (Chlorpheniramine)
N Ethylene diamine (Tripelennamine)
1) 3o N is essential for activity:
- 2o amines usually inactive
- N-CH3 > more potent than > - N-C2H5
2) CH2-CH2 (ethylene gp):

- Required for maximum activity
- Any slight modification decrease activity EXCEPT
Phenothiazine
Branched ethyl of Promethazine (Phenergan)
3) R1 & R2:
Must be one of the following
Aryl Hetero-aryl
Benzyl Hetero-benzyl
4) In case of ethanol amine & piperazine:
The maximum efficacy when R1 & R2 are benzhydril
An e- withdrawing gp (Cl) at the para-position enhance activity

e.g. Chlorpheniramine= 20 times more potent than pheniramine
5) Stereochemistry:
With propylamine the erythro" (+) isomer is 4 times more active than the
threo (-) isomer
Structure activity relationship SAR of Parasympathomimetics:

1572.
- They must have 30 amine (nitrogen) 4ry ammonium cpd

- N-methyl if 1 CH3 replaced by Ethyl activity by
if the 3 CH3 are replaced by Ethyl antagonist
- Add (-methyl) muscarinic nicotinic action (Methacholine)
- Add ( -methyl) nicotinic muscarininc
Structure activity relationship SAR of Sympathomimetics:
Phenyl Ethyl amine drv: e.g. Epinephrine inactive orally must be IV

-
Phenyl propyl amine: If the R in -position = CH3 orally active

-
(Amphetamine + Ephedrine)
CH3 substitution at position will:
1) CNS activity 2) pressor activity
3) Toxicity 4) Active orally
R substitution at N gp:
As the size of alkyl gp activity changes from predominant agonist
E.g. R = H (Nor-epinephrine)
CH3 + (epinephrine) C2H5 (isoprenaline)
Biosynthesis of catecholamines:
Structure activity relationship SAR of Benzodiazepines:
2-amino-4-oxide
Diazepam
(e.g. R2= Cl Chlorodiazepoxide)
- N-oxide is not essential for activity
- The main 5 structures requirements:
1) Position 1 (R3):
Alkyl gp or substituted gp no potent effect (N-dealkylated metabolite = active)
2) Position 2 R=H or CH3
3) Position 4,5 = bond

4) Position 5 (R1) phenyl gp with o-substitution of halogen activity
5) Position 7 (R2):
a] e- withdrawing gp essential for high potency (NO2>Br>Cl>F>>H)
b] e- donating gp activity (NH2)
Any other aryl substitution at 6,8,9 activity
Triazolo-benzodiazepines are the most potent currently available with a single
dose = 0.25 mg
Common metabolic pathway of clinically used Benzodiazepines:
Structure activity relationship SAR of Barbiturates:
1) Substitution at C5 affect lipid solubility (as substitution lipid sol )

- By chain length / chain branching / unsaturation / replacing
aryl by alkyl gp
- As length chain lipid solubility up to 9 C above
activity (6-9 C)
- Polar substitution in C5 activity (OH, -COOH water
sol )
2) Substitution at C2:
- Replacement at C2 of C=O by C=S lipid solubility + onset very quick +
duration very short (Thiopental = ultra short acting)
- Classification according to substitutes at C2 & C5:

C2 C5
Ultra short C=S 1 or 2 long unsaturated or branched
Short C=O Long unsaturated &/or branched
Intermediate C=O Short chain + saturated + branched
Long C=O Very short + saturated + not branched
3) N-alkylation solubility (e.g. Primidone)

4) Phenyl gp at C5 Anticonvulsant activity (e.g. Phenobarbital)
1573.
The compound which has the following formula:
(-)3-(3,4 dihydroxy-phenyl)-L-Alanine
Select the appropriate statement:

a. The compound is epinephrine
b. It is a dextrorotatory compound
c. It is a precursor of dopamine
d. It is used to treat hypertension
e. It is an essential amino acid
C L-dopa
1574.
A compound which has cis, trans isomers:
a. 1-Butene
b. 2-Butene
c. 3-Butyne
B
A compound with three asymmetric carbons (3 chiral centers without plan of

1575.
symmetry) will have:

2n 23= 8 isomers (Chiral C=means linked to 4 different gps)
1576.
Asymmetric carbon is optically active, so it is:
a. Chiral
b. Achiral
A
E, Z isomers are: (cis, trans)

1577.
Geometric isomers
Equal mixture of d & l forms:

1578.
Racemic mixture = optically inactive
1579.
Lemonin has a specific rotation -90 is:
a. Levorotatory
b. Dextrorotatory
c. Enantiomorphous
d. Meso substance
e. Optically inactive
A
Saccharometer:
1580.
Measures optical rotation
Types of isomers:
1) Positional (structural) = cis-trans
2) Enantiomers (optical isomers + not mirror image + 1 Chiral C) = d, l
3) Diastereomers (optical isomers + not mirror image + 2 Chiral C)
4) Stereoisomer (mirror image)
5) Conformational
Enantiomer:
- Optical isomers: (d, +) rotate plane polarized light to right (l, -) left
- 1 asymmetric C ONLY (attached to 4 different atoms)
- Not mirror image
(-) (+)
Diastereomers:
- Optical isomers
- 2 asymmetric C
- Not mirror image
e.g. Ephedrine & Pseudo-ephedrine = Diastereomers
N.B. ephedrine has 2 optical Enantiomers (pseudo-ephedrine also)
Ephedrine (cis) Pseudo-ephedrine (trans)
(-) (+) (+) (-)
Tautomerism:
Keto Enol (Uracil)
Homologues: length of side chain

Bioisosters: different only in presence of certain atom
What is conformational isomer:

1581.
Rotation around single bond

Non identical spatial arrangement of atoms in a molecule resulting from rotation of

one or more single bond
Ethane CH3-CH3
(Staggered) (Eclipsed)
Cyclohexane
Cyclohexane
(Boat) (Chair)
1582.
In 1,4-dimethyl-cyclohexane, the best conformational of the 2 methyl groups
when they are:
a. Equatorial, equatorial
b. Axial, axial
c. Axial, equatorial
A
Optical isomers which is NOT true:

1583.
Has distortion to its mirror image
1584.
These structures are
a. Homologues
b. Enantiomers
c. Bioisosters
A
1585.
These compounds are
{Bioisosters}
Which of the following is azo dye:

1586.
Pyridium (red dye) causes discoloration of urine used as UT analgesic
1587.
The formula which has color is
a. b. c.
(B-naphthol & -N=N azo dye)
1588.
This structure is:
a. Resonant form
b. Impossible
c. Zwitter ion
d. Ion pair
C
How many cyclopentane in steroid:

1589.
1 ring
1590.
In the following structures identify Estrogen:
a. b. c.
a= Estrogen
b= Progesterone
c= Testosterone
1591.
ROH + ? ROCOOCH3
1592.
The reagent in
CH3COOH/ Pyridine
Acetic acidpKa =...

1593.
Lactic acid pKa =...

Salicylic acid pKa =...
Arrange according to acidity from lowest to highest:
Acetic < lactic < Salicylic (high pKa = low acidity)
1594.
Which of the following is the strongest acid:
a. Acetic acid
b. Chloroacetic acid
c. CH3CH2NH2
B
1595.
Which of the following is a differentiating solution in non-aqueous titration:
a. Acetic anhydride
b. Quinine & quinidine
c. Glacial acetic acid
d. Acetonitrile
A+C
1596.
Why is mercuric acetate used in non-aqueous titration:
To produce protonation species
Used as Titrant in non-aqueous titration of Halo-amines (X-NH2) will offer
protonated species will speed of reaction (ppt Hg)
In sulphonamide titration, what is the role of dimethyl formamide:

1597.
Acts as basic solvent (H+ acceptor)
1598.
Though acetic acid is used for titration of bases, what is the base ion for titration
of perchloric acid:
a.
CH3COO-
b.
H2SO4
c.
H2O
d.
HCl
A
In the titration of codeine phosphate with glacial acetic acid/perchloric acid, color
1599.
change due to formation of:

H3PO4 the titrate result is (codeine H2PO4)
Hg acetate used in the assay of Haloamine to:

1600.
Non aqueous titration proton donor
1601.
In the assay of epinephrine HCl we add water, to extract the base we add:
a. 0.1 NaOH
b. 0.1 NaCl
c. 0.1 HCl
A
Heparin dose assay by:

1602.
Activated coagulation time
At acid-base titration, which affect the reaction:

1603.
Change in pH of the soln
Capacity of buffer to resist change in pH is due to:

1604.
Due to common ion effect
1605.
Mechanism of action of buffer system:
Donates H+ and gain H+
A+B+ + A+ this is called:

1606.
Common ion effect Buffer
1607.
Greater ability of buffer to resist change in pH (have a better buffer system):
a. Upon adding strong acid
b. Increase the conc of the weak acid & its salt in the solution
c. Use an acid with pKa near the desired pH
B+C
1608.
When pKa=pH it is:
- Half neutralization point
- Conc. of acid = conc. of salt
1609.
At cell membrane.. If equilibrium occur: (Jul-2006)
a. both equilibrium equal both sites
b. substance accumulate at the pH fewer (ionization)
c. ionized form penetrate membrane easily to reach equal conc
A+B
At equilibrium:
1610.
K1=K2 or rate of forward reaction = rate of backward reaction
1611.
In statistics, when the mean, median and mode are the same, the distribution is
called:
- Binomial
- The distribution is the same
1612.
Which is not included in statistical data:
a. Coefficient of variance
b. Range
c. Standard deviation
d. Rejected data
D
1613.
In statistics if 95% is standard deviation, the error is
a. 5.5
b. 0.5
c. 2.5
C
1614.
The error is always smaller than:
- Standard deviation
- Range
The standard deviation is always smaller than:

1615.
Error deviation
When the observation is 95%, the range is:

1616.
(+) (-) 5%
A line with zero slope value will be:

1617.
Parallel to X-axis
1618.
Normal population 95%, the average deviate is:
a. 5
b. 0.5
c. 2
C (99% 3 95% 2 68% 1)
Given to you, Mean= 0.52, S.D. = , Coefficient of variance=?

1619.
= SD/M x 100
What is the minimum quantity that can be weighed on balance with a sensitivity
1620.
of 6mg if an error of 5% is permissible:

1.2mg
SR = Qmin X Error
Balance Tests:
1) Arm test to confirm the 2 arms of the balance are equal in length
2) Rider test confirm accuracy of the calibrate beam at both 500 mg &
1 gm positions
3) SR min wt that will shift the indicator or mark by 1 unit
Class (A) = 6 mg class (B) = 30 mg
4) Shift test check the balance construction especially the arm & lever
Class Q wt have tolerance (+ or deviation) < SR of class (A) balance
Used in pharmacy
Class P wt more accurate than Q used in balance test
Molarity
M. Wt (gm) solute in 1 L solvent (no. of moles of solute in 1 L solvent)
2 soln with same Molarity have same no. of moles + same osmotic pressure
Solute must be unionized
Normality
No. of Eq Wt in 1 L solvent
= (M. Wt / valency) in 1 L solvent
Normality change with temp
MoLaLity
No. of moles in 1000g solvent
= (Wt (gm)/ M. Wt) solute in 1000g solvent
More frequently used because it is not affected by temp
Mmol = (Wt / M. Wt) X 1000
Osmolarity:
Mosmol/L = (mg/L)/ M. Wt. X no. of ions
Ex. Calculate the molality & osmolarity of 0.9% NaCl 1 L if the M. Wt. = 58.5
Soln. 0.9 g 100 ml

X g 1000 ml
X= 9 g
Molality = 9/58.5 X 1000 = 154 mmol
Osmolarity = 9000/58.5 X 2 = 308 mosmol/L
If (y = 1+2x2+3x3 ) and if x=1, then dx/dy =

1621.
= 0 + 4x + 9 x2 = 1+4+9 = 13
If we have equation (y=12x-3x2):

1622.
Where y=9 & x=1, what is the slope?

Slope = dy/dx = 12-6 = 6
Ionization constant of water: Kw= 1X10-14 pH of water = 7
A solution is to be adjusted to pH 8.8 by the use of a boric acid Na borate buffer.

1623.
What approximate ration of acid and salt is required? Ka = 5.8X10-10

pKa = -log Ka
pH = pKa + log [salt]/[acid]
8.8 = 9.236 + log [salt]/[acid]
[salt]/[acid] = 1 : 0.363
If the pKa of Phenobarbital = 7.4, what is the fraction of the drug that would be
1624.
ionized at pH = 8.4?
pH = pKa + log [salt]/[acid]
8.4 = 7.4 + log [salt]/[acid]
log [salt]/[acid] = 1
[salt]/[acid] = 10 : 1 90%
1625.
3 ,9 ,6 ,5 & 4 hrs what is the mean t1/2 = 3+9+6+5+4/5 = 5.4
If we have alcohol 95%, we want to prepare 12%, purified water to 60 ml, how
1626.
much alcohol we will use?

12 100
X 60 x= 60*12/100 = 7.2
95 100
7.2 x x = 7.2*100/95 = 7.6 ml
1 g of drug will give maximum level 4 mg%. At what time it will reach 12 mg% if
1627.
the dose is administered every 12 hours?

Never reached
1628.
Penicillin unit: 1U=0.6g
1629.
ln e-x = -x
1630.
y = 12x 3x2 dy/dx= 12 - 6x
1631.
y = 12x 3x2 WHEN Y=9, X=1, what is the slope? dy/dx=6

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Canada Evaluation Examination Test Page 1 of 200

Verify the diagnosis

b. Give him codeine

c. Give him something which is not controlled with same effect

b. We act with honesty, without deception.

c. We avoid, remove or prevent harm.

b. Ask your colleague pharmacist to explain to her

c. Let a female pharmacist to talk to her if applicable

- Absorbed from upper GIT

Daily requirements: [Adult = > 1 mg / Children = > 0.6mg] oral, IM, SC

b. Take a course of ASA before starting niacin

B3 (Niacin, Nicotinic acid, Nicotinamide):

- Acts as H+ carrier coenzyme for protein metabolism & production of ATP

Daily requirements: [Adult = > 6 mg / Children = >4 mg]

Co-enzyme in amino acid metabolism

2) Hydralazine, INH & Penicillamine metabolism of Tryptophan B6

L-dopa + B6 stimulate dopa-decarboxylase L-dopa (so CI in Parkinsonism)

Deficiency deficiency of folic acid Megaloblastic anemia

Pernicious anemia (Addisons anemia):

The intrinsic Factor:

Folic Acid (Vit B8)

- Essential for: Synthesis of Purine & Pyrimidine nucleotides

- Deficiency Megaloblastic Hematopoiesis (formation of blood)

Pantothenic acid (B5) Choline Biotin (B7)

b. Oral iron is better than parenteral

c. Oral iron is same like parenteral

b. Iron is present in all preparations used for megaloblastic anemia TTT

c. Use the parenteral besides oral to treat iron deficiency

With regard to iron deficiency:

Women are more susceptible to anemia (microcytic) more than men

b. Require intrinsic factor

c. High dose cause liver collapse

- Zinc 8-9 mg/day is essential for: 1) Maintenance of Vit A in plasma

- Daily dose: Adults = 3000 IU Children = 1300-2600 IU

- Any drug containing Vit A should NOT exceed:

Sodium bisulphite (as Vit C, EDTA= aqueous)

Antioxidant (reducing agent)

Monothioglycerol is used as:

Antioxidant in parenteral procaine/Penicillin G

Mercapturic acid result from reaction with:

Which enzyme protects the cell from damage: (Jul-2006)

XX chromosome deficiency (syndrome) is found (diagnosed) in:

Bar Body (found in mouth cavity in Female only)

XXY= Kleinfelter ( develop of the seminiferous tubules in testis)

Cooleys disease: (anemia)

Raymonds disease: (affect women>men)

Stein Leventhial syndrome:

Nystagmus = involuntary rapid movement of eye ball (horizontal, vertical or mixed)

What is the Crohns disease:

Regional enteritis (inflammation of intestinal tract by infection of the irritating food)

An ulcerative condition of the small and large bowel, characterized by areas of

What is Brights disease:

Glomerulonephritis (Inflammation of the kidneys, or chronic nephritis)

All is accompanied with edema EXCEPT:

- Inhibit I incorporation into tyrosyl residue (conversion of T 4T3)

Regulates Ca2+ in blood due to hyper-parathyroidisim in Pagets disease

Calcitonin used to treat:

Pagets disease = parathyroid calcitonin leading to Ca2+ in blood

Estraderm is used for:

Lead toxicity leads to: