Clinical Pharmacy Additional

Clinical Pharmacy additional
1. All of the following statements concerning upper respiratory infections are true, EXCEPT:
A. Most of these infections are caused by viruses
B. Symptoms may involve the sinuses throat, larynx and airways
C. Treatment is primarily symptomatic
D. Prevention usually is achieved by timely immunization
2. Which of the following would be the most appropriate form of management of a patient with moderate osteoarthritis of the
knee?
A. Antimalarial Drug D. Oral Corticosteroids
B. Colchicine E. Joint replacement surgery
C. Nonsteroidal anti-inflammatory drugs
3. All of the following are appropriate therapeutic regimens for a patient with acute gout, except:
A. maintenance of stable allopurinol dosage
B. administration of therapeutic doses of salicylates
C. injection of corticosteroid into inflamed joints
D. immobilization of inflamed joints
E. Application of ice over inflamed joints
4. A previously healthy, 68-year old woman develops auditory hallucinations. She cannot provide many details but believes her
mother is speaking to her. She has difficulty cooperating during the interview and physical examination which is unremarkable.
The most likely diagnosis is:
A. Complex partial seizures D. Hyperthyroidism
B. Alzheimer’s disease E. Peduncular Hallucinosis
C. Adverse medication effect
5. All of the factors listed below may play a role in the development of duodenal ulcer disease, except:
A. Spicy food ingestion D. Helicobacter pylori infection
B. Tobacco smoking E. Hyperparathyroidism
C. Genetic factors
6. Uncomplicated seasonal allergic rhinitis is associated with all of the following clinical features, EXCEPT:
A. Pruritus of the nose, palate and eyes D. Paroxysmal sneezing
B. Thin, watery nasal discharge E. Excess lacrimation
C. Reddened nasal mucosa
7. The diagnosis of iron deficiency anemia can be made with all of the following findings, except:
A. Absent marrow iron on biopsy stain
B. Low serum ferritin levels
C. Hypochromia and microcytosis in specific clinical settings
D. Response to iron therapy within 1 month
E. Megaloblastic findings on marrow examination
8. All of the following therapies are used for metastatic prostate cancer, except:
A. Estrogen D. Corticosteroids
B. Leuprolide E. Somatostatin analog
C. Orchiectomy
9. Prognostic factors in breast carcinoma include all of the following, except:

a. Estrogen receptor status d. Percentage of cells in s phase
b. Menopausal status e. Presence of lymph node metastasis in axillae
c. Size of primary tumor
10. Iron, a necessary dietary constituent, functions primarily:

A. in oxidation – reduction system C. In growth and repair of tissues
B. to maintain water and electrolyte balance D. To stimulate bone formation
11. Which of the following metallic ions is especially required in the blood clotting process?
A. Ba++ D. Mg++
+
B. Na E. K+
C. Ca++
12. The agent of which the following diseases is not transmitted from person to by droplets or droplet spray?
A. Pneumonia C. Meningitis E. encephalitis
B. Diphtheria D. Whooping cough
13. A reduction in acid secretions by the stomach. An increased tendency toward gastric carcinoma, atrophic glossitis and myelin
degeneration of peripheral nerves are characteristic findings with:
A. Thalassemia D. Pernicious anemia
B. Agranulocytosis E. Polycythemia Vera
C. Sickle cell anemia
14. An endocrine disease characterized by increased susceptibility to infection, increased fatigability, recessive inheritance and
polyuria is:
A. Acromegaly D. Cushing’s disease
B. Grave’s disease E. Hashimoto’s disease
C. Diabetes mellitus
15. Rubeola, Pertussis, poliomyelitis, and mumps have in common the fact that all are:
MANOR Review Center 137
A. Air-Borne diseases D. Primarily diseases of infants
B. Vector-Borne Diseases E. Prevented by acute immunization
C. Characterized by a toxemia
16. What type of leukocyte appears first and is present in Greatest numbers in an inflammatory focus soon after tissue injury has
occurred:
A. Plasma cell D. Lymphocyte
B. Eosinophil E. Monocyte
C. Neutrophil
17. Amphotericin B, Griseofulvin, and Nystatin are often useful in the treatment of:
A. Streptococcal Infections D. Tuberculosis
B. Fungi-diseases E. Cancer
C. Viral diseases
18. Metastasis is likely in which of the following neoplasms?
A. Adenoma C. Chondroma
B. Melanoma D. Papilloma
19. The leading cardiac cause of death is:

A. Mitral stenosis D. Hypertensive cardiovascular disease
B. Coronary heart diease E. Congenital animalies
C. Myocarditis
20. A positive tuberculin test means that the patient:

A. has active tuberculosis
B. Has subclinical infection
C. Is susceptible to tuberculosis
D. Has an immunity to tuberculosis as a result of a past infection
E. Has a hypersensitivity to the tubercle bacillus and its products
21. Cretinism is the result of a metabolic disturbance related to:

A. Hypothyroidism D. Hyperfunction of anterior pituitary
B. Hyperthyroidism E. Hyperfunction of anterior pituitary
C. Hypoparathyroidism
22. Rheumatic fever is a disease which:

A. Can result from a transient bacteremia by viridans Streptococci
B. Is preceded by a group A streptococcal infection of the heart
C. Develops as a sequela to group A streptococcal infections
D. Affects the glomeruli of the kidney
23. A fungal disease which may be confused with tuberculosis because it produces pulmonary calcifications:
A. amebiasis D. Actinomycosis
B. Candidias E. Histoplasmosis
C. Blastomycosis
24. The presence of glossitis, pallor, macrocytic anemia, hyperplasia of the bone marrow, achlorhydria, atrophy of the gastric
mucosa, and focal degenerative lesions of the dorsal and lateral columns of the spinal cord in a person older than middle-age
suggests the individual has had a deficiency of vitamin:
A. A D. B12
B. B1 E. C
C. B6
25. Gout is an example of a disturbance in the metabolism of:

A. Calcium C. Cholesterol
B. Purines D. Carbohydrates
26. Arguments against indiscriminate use of antibiotics as chemotherapeutic agents include the following, except:
A. Toxic effects of the antibiotics
B. Allergic reactions induced in patients
C. Development of drug resistance by an infectious agent
D. Secondary effects experienced due to creation of an imbalance in the normal body flora
E. The cost of medication
27. Which of the following antibiotics is effective in treating candidiasis?

A. Nystatin D. Griseofulvin
B. Bacitracin E. Penicillin
C. Tetracycline
28. Which of the following statements is correct regarding a patient recovered from hepatitis type B infection?
A. The virus will be excreted in the feces
B. The patient is a good candidate for blood donation
C. The patient will have protective immunity to all viral hepatitis
D. Detection of hepatitis B antigen in serum is indicative of the carrier state
29. Tetracycline antibiotics may stain children’s teeth between the ages of:
A. one month in utero and three years C. Birth and ten years
B. Six months in utero and eight years D. One and years
30. The amount of red blood cell destruction per day is best measured by the:
A. Hematocrit

B. Amount of iron excreted
C. Change in the red blood cell count
D. Amount of hemoglobin/100 ML blood
E. Amount of bile pigments excreted by the liver
31. A history of medication with which of the following drugs requires special consideration prior to general anesthesia?
A. Estrogen D. Phenacetin
B. Cortisone E. Diphenhydramine
C. Meperidine
32. The following are “Vital Signs” except:

A. Temperature D. Respiratory rate
B. Blood pressure E. Pulse
C. Heart rate
33. Differential white blood cell counts in the laboratory are useful in the diagnosis of:
A. Anemia D. Eosinophilia
B. Spherocytosis E. Thrombocytopenic purpura
C. Vitamin deficiency
34. The most effective agent for the treatment of respiratory depression due to overdose of barbiturates is:
A. Oxygen D. Metrazol
B. Caffeine E. Picrotoxin
C. Coramine
35. Administration of corticosteroids is contraindicated when there is a history of:

A. Psychosis D. Diabetes mellitus
B. Peptic ulcer E. Any of the above
C. Tuberculosis
36. Which of the following barbiturates, in therapeutic doses, is the longest acting?
A. Amytal D. Phenobarbital
B. Nembutal E. Pentothal
C. Secobarbital
37. Staphylococcal infections are:

A. Controlled in hospitals C. Difficult to treat because of drug-resistant strains
B. Readily responsive to penicillin D. Not disseminated by carriers
38. Completed patient hospital records or charts are the legal property of the:
A. Patient D. Patient representative (Lawyer)
B. Doctor-in charge E. Insurance Carrier
C. Hospital
39. Which of the following may be a feature of acromegaly

A. Crowded teeth D. Micrognathia
B. Large tongue E. Echma
C. Hypoglycemia
40. A patient is wide-eyed, very nervous with an increased systolic pressure, increased pulse rate, fine skin and hair, and loss of
body weight. He is probably suffering from:
A. Diabetes D. Hypothyroidism
B. Hyperpituitarism E. Hyperthyroidism
C.Hyperparathyroidism
41. When rendering first aid care to a severely injured person, priority should be given to:
A. Arresting hemorrhage
B. Recognition and treatment of shock
C. Recognition of associated head injuries
D. Establishing and maintaining a patient airway
42. A patient having a white blood count of 3,000 cells per cubic millimeter would be said to have:
A. Leukemia C. Leukopenia
B. Leukolysis D. Leukocytosis
43. What elements interfere with the activity of tetracycline?

A. Mg and Na C. Na and K
B. Mg and Ca D. Ca and B1
44. Serum hepatitis is caused by a/an:

A. Allergic reaction to serum D. Bacillus
B. Virus E. Reaction to a local anesthetic
C. Fungus
45. The characteristic lesion of herpes virus infections on the skin or mucous membrane is:
A. Necrosis D. Hyperkeratosis
B. Tumefaction E. Vesicle

C. Abscess
46. Which of the following has been determined to be the most cariogenic carbohydrate?
A. Starch D. Glycogen
B. Sucrose E. Dextranase
C. Glucose
47. Pernicious anemia is usually associated with:

A. Iron deficiency D. Microcytic anemia
B. Glossitis E. Gastric hyperacidity
C. Blue sclera
48. A seven-year-old girl has a temperature of 102 0 F. Her mother states the child has had an upper respiratory infection for
several days. Examination reveals a few small white dots surrounded by a reddish halo on the buccal mucosa. The oral
lesions most probably are indicative of:
A. Varicella D. Hand-foot-and-mouth disease
B. Rubeola E. Herpangina
C. Herpes Zoster
49. Administration of which of the following drugs would be contraindicated in patients with allergic bronchial asthma:
A. Atropine D. Propranolol
B. Methacholine E. Phentolamine
C. d-Tubocurarine
50. Which of the following antibiotics is most likely to cause depression of the bone marrow?
A. Streptomycin D. Penicillin G
B. Tetracycline E. Chloramphenicol
C. Amophotericin B
51. Which of the following drugs would be useful in treating the dermatologic manifestations of an allergic response?
A. Diazepam D. Atropine
B. Phenoxybenzamine E. Hexylresorcinol
C. Chlorpheniramine
52. Which of the following drug classes has been definitely established to be teratogenic in humans?
A. Salicylates D. Barbiturates
B. Antianginals E. Antineoplastic agents
C. Local anesthetics
D.
53. Which of the following adverse effects is most commonly associated with administration of an intravenous barbiturate?
A. Hypotension D. Renal failure
B. Hepatic Necrosis E. Nausea and vomiting
C. Respiratory Depression
54. Which of the following classes of drugs undergoes the least change in the body?
A. Alcohols D. Barbiturates
B. Salicylates E. Volatile anesthetics
C. Local anesthetics
55. The proper antibiotic to be employed prophylactically in a patient with rheumatic heart disease not receiving prophylactic
penicillin is:
A. Erythromycin D. Penicillin G
B. Lincomycin E. Penicillin V
C. Cephalosporin
56. Most Like-threatening adverse drug reactions affect the:

A. Central nervous system
B. Liver and Kidney system
C. Bronchial smooth muscle
D. Cardiovascular and respiratory system
E. Gastrointestinal tract
57. Aplastic anemia is a serious toxic effect, which particularly occurs after a course of treatment with which of the following
antibiotics?
A. Penicillin D. Tetracycline
B. Lincomycin E. Chlortetracycline
C. Chloramphenicol
58. Which of the following types of drug responses is least predictable in occurrence?
A. Side effect D. Idiosyncrasy
B. Tachyphylaxis E. Therapeutic action
C. Overdosage toxicity
59. Which one of the following is not considered an epinephrine use?

A. Control of local hemorrhage D. Use in allergic disorders
B. Decongestant E. Reduction of migraine episode
C. Use in combination with local anesthetics
60. The organs most prominently affected by B-blockers are:
A. Cardiovascular and CNS D. Heart and Bronchi
B. Stomach and kidney E. Liver and skin
D. Stomach and kidney
61. The responses of which one of the following drugs should be monitored when it is used simultaneously with propranolol?
A. Digoxin C. Chlorothiazide
B. Quinidine D. Insulin
62. In the selection of a B-blocker, which of the following is not a dominating factor?
A. The patient’s disease state
B. The cost of medication
C. The desirable pharmacokinetic effect of the drug
D. The most recently marketed drug
E. The desirable pharmacologic effect
63. In hypertensive crisis in a patient with a history of CHF, which one of the following agents should be the drug of first choice?
A. Diazoxide C. Hydralazine
B. Nitroprusside D. Trimethaphen
64. A diuretic specifically useful to induce diuresis in cases of poisoning is:

A. Hydrochlorothiazide C. Chlorthalidone
B. Triamterene D. Mannitol
65. A diuretic which could be used in patients with hypersensitivity to sulfonamide is:
A. Hydrochlorothiazide C. Ethacrynic acid
B. Furosemide D. Spironolactone
66. Which of the following groups of drugs does not aggravate congestive heart failure?
A. Estrogen C. Beta-blocking agents
B. Cardiac glycosides D. Corticosteroids
67. Which one of the digitalis preparations should be monitored carefully when simultaneously used with phenobarbital?
A. Digoxin C. Digitoxin
B. Quabain D. d-Lanatoside
68. Which type of angina pectoris is most likely to respond to drug therapy?
A. Stable angina C. Nocturnal angina
B. Unstable angina D. Prinzmetal
69. Which one of the following factors is most directly attributed to angina attacks?
A. Stress C. Myocardial ischemia
B. Heavy smoking D. Obesity
70. Which one of the following drugs is considered a “Risk factor” in a patient with history of angina pectoris?
A. Diazoxide C. Quinidine
B. Nitroprusside D. Hydrochlorothiazide
71. The newest group of drugs used in the treatment of angina pectoris:
A. Chewable isosorbide dinitrate C. Beta-blocking agents
B. Transdermal patches D. Calcium channel blockers
72. U-100 Insulin is:

A. Red B. White C. Orange D. brown
73. Which one of the following may increase the insulin requirements?
A. Increased physical activity C. Pregnancy
B. Increased food intake D. Acute infections
74. Which one of the following agents can be used QID/OD?

A. Ibuprofen B. Indomethacin C. Tolmetin D. Piroxicam
75. Which one of the following is not associated with rheumatoid arthritis?
A. Fatigue D. Joint swelling and pain
B. Anorexia E. Bleeding
C. Morning stiffness
76. The Drug most commonly recommended by most clinicians in rheumatoid arthritis is:
A. Motrin D. Phenylbutazone
B. Indomethacin E. Acetaminophen
C. Aspirin
77. Diagnosis of gout can only be confirmed by:

A. Presence of severe pain and inflammation in the big toe
B. Presence of hyperuricemia
C. Presence of monosodium urates in the synovial fluid
D. Vesicle-formation in the joints
78. Which of the following medications would have an equal effect on both the early asthmatic response and the late asthmatic
response?
A. Corticosteroids C. Theophylline
B. Albuterol D. Sodium Cromolyn
79. The only class of immunoglobulin that crosses the placenta:

A. IgA B. IgG C. IgM D. IgE E. IgD
80. Warfarin anticoagulation is used for a variety of cardiac conditions. Each of the following medications increases the
anticoagulant effect of warfarin, except:
A. Cimetidine D. Phenylbutazone
B. Quinidine E. Vitamin K
C. A-methyldopa
D.
81. Which of the following agents is associated with lupus like syndrome?
A. Captopril C. Propranolol
B. Hydralazine D. Minoxidil
82. Complications of heparin anticoagulation include all the following, except:

A. Vertebral Body Collapse D. Thrombosis
B. Hemorrhage E. Thrombocytopenia
C. Skin Necrosis
83. AIDS-related malignancies include all the following, except:

A. Cervical cancer D. Hodgkin’s disease
B. Gastric Carcinoma E. Kaposi’s sarcoma
C. CNS lymphoma
84. Drug of choice for ringworm infection is:

A. Nystatin C. Amphotericin B
B. Neomycin D. Griseofulvin
85. Anaphylactic shock to penicillin occurs:

A. Almost at once after administration
B. Between 6 to 12 Hours of administration
C. Between 4 to 6 hours of administration
D. After 12 hours of administration
E.
86. Which of the following agents is not effective against motion sickness?
A. Dimenhydrinate D. Promethazine
B. Meclizine E. Chlorpromazine
C. Diphenhydramine
87. Inflammation of the bladder:

A. Urethritis D. Pyelonephritis
B. Cystitis E. Urinitis
C. Prostatitis
88. Infection acquired after at least 2 days in the hospital:

A. Nosocomial infection D. Superinfection
B. Superficial infection E. Hirsutism
C. Secondary infection
89. A 91-year-old nursing home patient has Alzheimer’s Disease and congestive heart failure that is being treated with Digoxin.
The patient now is to be administered imipramine for depression. What is the best dose and regimen of imipramine for this
patient?
A. 10 mg BID initially, increased slowly into the therapeutic range
B. 25 mg TID, increased to 50 mg TID in 1 week
C. 75 mg at bedtime
D. 150 mg at bedtime
90. The most common organisms isolated from intra-abdominal infections are:
A. Escherichia coli and staphylococcus aureus
B. Escherichia coli and Bacteroides fragilis
C. Pseudomonas aeruginosa and bacteroides fragilis
D. Pseudomonas aeruginosa and staphylococcus aureus
91. Which of the following substances is the most effective agent against fungus infections of the mucous membrane?
A. Nystatin ointment D. Saturated magnesium sulfate
B. undecylenic acid E. 10% aluminum chloride solution
C. polymyxin ointment
92. The action of which of the following drugs will most likely be impaired by concurrent administration of tetracycline?
A. Chloramphenicol D. Erythromycin
B. Sulfonamide E. Penicillin
C. Lincomycin
93. The following are often seen in patients receiving chemotherapy for cancer, except:
A. oral ulcerations D. Alopecia
B. Delayed wound healing E. Elevated white cell count
C. increased susceptibility to infection
94. Abuse of which of the following drugs produces the greatest physiological and psychological damage?
A. LSD D. Marijuana
B. Cocaine E. Barbiturate
C. Alcohol
95. Which of the following drugs is a mild CNS stimulant useful in treating hyperkinetic children?
A. Caffeine D. Theophylline
B. Doxapram E. Nikethamide
C. Methyphenidate
96. Which of the following penicillins has the best gram negative spectrum?
A. Nafcillin D. Phenethicillin
B. Methicillin E. Ampicillin
C. Penicillin V
97. In a poorly treated diabetic individual. The degree of ketosis is closely correlated with the blood level of:
A. Amino acids C. Lipoprotein triglycerides
B. Free Fatty acids D. Lipoprotein phospholipids
98. A patient has no difficulty going to sleep at night, but awakens after a couple of hours and cannot get back to sleep. Which of
the following drug groups would be most appropriate to treat this condition:
A. Nitrous oxide D. tricyclic antidepressants
B. Phenothiazine compounds E. Benzodiazepine compounds
C. Sympathomi metic agents
99. Which of the following drugs is currently widely used in treating opioid-dependent individuals?
A. Codeine D. Meperidine
B. Alphaprodine E. Pentazocine
C. Methadone
100.Overdosage with certain steroids leads to manifestations of cushing syndrome: Hypertension, rounding of the face, hirsutism,
glycosuria and sodium retention. Which of the following steroids produces most the of the above effects?
A. Estradiol D. Testosterone
B. Prednisolone E. Progesterone
C. Diethylstilbestrol
101.A child shows evidence of poor growth, night blindness, dryness of the conjunctiva, keratinization of the cornea and a dry scaly
skin. Which preparation is indicated for therapy?
A. Calciferol D. Thiamine
B. Dried Yeast E. Pantothenic acid
C. Vitamin A
102.Which of the following pairs matches a drug with its appropriate therapeutic indication?
A A. Phenylhandantoin - Petit mal epilepsy
B B. Terbutaline – Bronchial asthma
C C. Physostigmine - Parkinson’s disease
D D. Tobucurarine - Myasthenia gravis
E E. Diphenhydramine – Sunburn
F
103.Antidiarrheal agents include all of the following, except:
A. Kaolin D. Magnesium Hydroxide
B. Paregoric E. Diphenoxylate
C. Activated charcoal
104.All of the following are valid therapeutic indications for the use of salicylates, except:
A. Fever D. Rheumatoid arthritis
B. Headache E. Pain of peptic ulcer
105.Acetaminophen has limited value in the treatment of rheumatoid arthritis because:

A. it frequently produces gastric irritation and bleeding
B. it is not potent enough as an analgesic
C. chronic usage may lead to renal damage
D. it lacks anti-inflammatory properties
E. It may cause methemoglobinemia
106.The most frequent symptom of overdosage which limits the amount of salicylate administered for arthritis is:
A. Tinnitus D. Fever
B. metabolic acidosis E. Respiratory alkalosis
C. Skin rash
107.All of the following are useful in the treatment of cough, except:

A. Noscapine D. Dextromethorphan
B. Potassium iodide E. Iodoquinol
C. Syrup of ipecac
108.Drugs to be avoided by the Parkinson’s patient include all of the following, except:
A. Reserpine D. Chlorpromazine
B. Trihexyphenidyl E. Pyridoxine
C. Physostigmine
109.A patient with severe diabetes is admitted to the hospital with ketoacidosis, markedly elevated blood sugar, and severe
dehydration. The most expedient treatment is:
A. Tolbutamide D. ORS
B. Acetohexamide E. Tolazamide
C. Crystalline zinc insulin
110.Generally speaking, which of the following best characterizes the alcohol abuser?
A. Satisfied, complacent, cooperative individual with suppressed hunger and reduced sexual desires
B. Satisfied but uncooperative individual with suppressed hunger and increased sexual desires
C. Quarrelsome, uncooperative individual with increased appetite and sexual desires
D. Quarrelsome, dissatisfied, uncooperative individual with a reduced capacity to make a contribution to
society
111.A prescription for an analgesic agent for a patient with peptic ulcer should not include which of the following?
A. Tylenol D. Aspirin
B. Pentazocine E. Sulindac
G C. Meperidine
H
112.Gastrointestinal activity may be modified by which of the following types of drugs?
A. Cathartics D. Ganglionic blocking agents
B. Opiates E. all of the above
C. Parasympathomimetics
113.Which type of laxative is usually recommended if chronic use is indicated?

A. Bulk forming C. Saline
B. Stimulant D. Lubricant
114.Which of the following minerals is especially required in the blood clotting process?
A. iron B. Sodium C. Calcium D. magnesium E. Potassium
115.Assume that all the following drugs “HIT” the pathogen involved in a particular infection. Which agent could most likely be
used safely at several times the usual dosage levels if necessary?
A. Penicillin B. Erythromycin C. Tetracycline D. Chloramphenicol E. Bacitracin
116.INSULIN
A. stimulates fat mobilization
B. stimulates gluconeogenesis
C. inhibits glycogen production from glucose
D. stimulates glucose transport across cell membranes
E. inhibits protein synthesis
117.The main therapeutic use of H2 receptor antagonists such as cimetidine in the treatment of:
A. migraine B. Bowel obstruction C. duodenal ulcer D. urinary retention
118.The following is used in the treatment of hypothyroidism:

A. perchlorate ion D. Propylthiouracil
B. Liothyronine E. 1311
C. Lugol’s solution
119.There is a sound scientific basis for each of the following clinical application of alcohol except:
A. reducing a fever B. sedation C. caloric nutrition D. Diuretic for edema E. antisepsis
120.Normal value range of hemoglobin for females:

A. 10-14 g/dl B. 12-16 g/dl C. 14-18 g/dl D. 16-20 g/dl E. 18-22 g/dl
121.These are specific signs and symptoms of iron-deficiency anemia, except:

A. Pale skin D. Cheilosis
B. Nail changes E. neurologic manifestations
C. Glossitis
122.Which is not a suitable iron therapy for iron deficiency anemia?

A. ferrous chloride D. ferrous sulfate
B. Ferrous fumarate E. Iron sorbitex
C. Iron dextran
123.Corticosteroids such as prednisone may be used for which type of anemia?

A. Aplastic anemia D. Pernicious anemia
B. Iron-deficiency anemia E. folate –deficiency anemia
C. Hemolytic anemia
124.Which is not true of diabetes mellitus?

A. chronic, systemic disorder D. Acute disorder
B. Alteration in lipid metabolism E. Alteration in protein metabolism
C. symptomatic glucose intolerance
125.Which is not a correct form of therapy for a diabetic patient?

A. avoid refined and simple sugars
B. limit cholesterol intake to less than 300 mg/day
C. anaerobic exercise such as weight lifting
D. high intake of fiber
E. Avoid abrasions
126.These are precautions and monitoring effects on insulin therapy, except:

A. may induce hypoglycemia D. may cause brain damage
B. local or systemic allergy E. not to be taken orally
C. lipohypertrophy and fibrosis
127.An autoimmune disorder resulting to hypothhyroidism:

A. Hashimoto’s thyroiditis D. Diabetes mellitus
B. Thalassemia E. Samoto’s thyroiditis
C. Sickle cell anemia
128.The use of these foods should be minimized to avoid enlargement of the thyroid gland, except:
A. cabbage D. Mustard
B. Peanut E. Carrot
C. Cauliflower
129.These are signs and symptoms of hypothyroidism, except:

A. Forgetfulness D. Irritability
B. Sensitivity to cold E. Lethargy
C. Unexplained weight gain
130.Precaution on the long term therapy of levothyroxine:

A. may cause grave’s disease D. may cause ketoacidosis
B. may cause plummer’s disease E. may cause myxedema coma
C. may cause thyrotoxicosis
131.A substance present in certain drugs and foods causing enlargement of the thyroid gland:
A. goitrin D. Progoiter
B. Goiter E. Thyroxine
C. Progoitrin
132.These are characteristics of myxedema coma, except:

A. dry, flaky, inelastic skin D. profuse sweating
B. Coarse hair E. Droop eyelid
C. Puffy face
133.In thyrotoxicosis, there is overactivity of the:

A. pituitary gland D. adrenal gland
B. Thyroid gland E. Pancreas
C. Parathyroid gland
134.Which is not true of Grave’s disease:

A. Occurs primarily in young women D. Diffuse toxic goiter
B. Slow upper lid closing E. Exophthalmos
C. Toxic nodular goiter
135.A cardiovascular agent useful for hyperthyroidism:

A. beta adrenergic blocking agents
B. Calcium channel blockers
C. Angiotensin converting enzyme inhibitors
D. Cholinergic agents
E. Vasodilators
136.Possible causes of hyperlipidemia except:

A. Hereditary traits D. Improper diet
B. Alcohol consumption E. Virus
C. Lack of exercise
137.The use of this drug may lead to hyperlipidemia:

A. Beta agonist D. Colestipol
B. Estrogens E. Probucol
C. neomycin sulfate
138.Which vitamin would you suggest for hyperlipidemia?

A. ascorbic acid C. Niacin E. Pyridoxine
B. Thiamine D. cyanocobalamin
139.A hyperlipidemic patient should undergo diet modification for how many months?
A. 1-3 months D. 9-12 months
B. 3-6 months E. 1 month
C. 6-9 months
140.What diet regimen would you recommend to a hyperlipidemic patient?

A. More total fat
B. More cholesterol
C. More saturated fat
D. More simple carbohydrates
E. More unsaturated fat and complex carbohydrates
141.The most common cardiovascular disorder is:

A. infective endocarditis D. arrhythmia
B. Angina pectoris E. Myocardiac infarction
C. Hypertension
142.Which variable is measured in hypertension?

A. heart rhythm D. electrical discharge
B. heart murmur E. venous blood pressure
I C. arterial blood pressure
143.Hypertension might be due to the following, except:

A. Renal disease D. Thyroid disease
B. Diabetes mellitus E. Adrenal disease
C. Hyperlipidemia
144.Which is not a predisposing factor to primary hypertension?

A. Stress D. Smoking
B. family history of essential hypertension E. Active life style
C. Obesity
145.Which diastolic reading of patient’s blood pressure is already classified as the start of severe hypertension?
A. 70-94 mm hg D. 115-above mm hg
B. 90-104 mm hg E. 150-1bove mm hg
C. 105-114 mm hg
146.An antineoplastic which causes congestive heart failure:

A. Doxorubicin D. Vincristine
B. Tamoxifen E. cisplatin
C. Methotrexate
147.The emergency treatment of patient with congestive heart failure:

A. Digitalis glycoside D. vasodilators
B. Bed rest E. Diuretics
C. inotropic agents
148.An antiepileptic agent used also as antiarrhythmic:

A. Phenobarbital D. Phenytoin
B. Diazepam E. Phensuximide
C. Valproic acid
149.Prominent characteristic of angina pectoris:

A. diuresis D. Skin pallor
B. Abnormal pulse rate E. weakness
C. squeezing chest pressure
150.Which analgesic is useful for patients with myocardial infarction?

A. Mefenamic acid D. Aspirin
B. Acetaminophen E. meperidine
C. Morphine
151.Patients on corticosteroid therapy should be given the following precautions, except:

A. Appetite stimulation D. hypertension
B. Fluid and sodium retention E. Hyperkalemia
C. Hyperacidity
152.An incurable disease for which treatment is only palliative:

A. Primary parkinsonism D. Arrhythmia
B. Infective endocarditis E. Drug addict
C. pernicious anemia
153.Which is not a characteristic of Parkinsonism:

A. Muscle rigidity D. Tremor
B. ambivalence E. postural instrability
C. Bradykinesia
154.Treatment of Parkinsonism:
A. drug therapy D. occasionally surgery
B. Physical therapy E. all of these
C. Psychological support
155.Which instruction regarding the dose of anticholinergic should be told to a Parkinsonian patient?
A. Start with a low dose and gradually increase the dose
B. Start with a high dose and gradually lower the dose
C. Start and finish with the same dose
D. Start with a low dose and abruptly double the dose
E. No instruction needed
156.The mainstay of Parkinsonism therapy:

A. Dopamine precursor D. Indirect acting dopamine agonist
B. Anticholinergic E. Physical Therapy
C. Direct acting Dopamine agonist
157.The most common psychiatric disorder:

A. Parkinsonism D. Epilepsy
B. Schizophrenia E. Meningitis
C. Affective disorder
158.Characteristics of schizophrenia, except:

A. Hallucinations D. Abnormal motor behavior
B. Detachment from reality E. Lack of PEP
C. Diminished or inappropriate affect
159.A disorder involving disruption of thought and disintegration of personality:

A. Parkinsonism D. Unipolar disorder
B. Epilepsy E. Bipolar disorder
C. Schizophrenia
160.One of its causes is stress or the loss of one’s relative

A. Schizophrenia D. Seizure
B. Affective disorder E. Convulsion
J C. Parkinsonism
K
161.The most common prophylactic measure used worldwide to prevent tuberculosis:
A. Isoniazid D. Rifampicin
B. Streptomycin E. Bacillus Calmette Guerin vaccine
L C. Ethambutol
M
162.This is rarely used as a laboratory test for tuberculosis:
A. Chest x-ray C. Bacteriological exmination
B. Tuberculin testing D. hematology test
163.Mode of transmission of gastrointestinal infection:

A. Dust
B. Consumption of contaminated food and water
C. Aerosolized droplets
D. Mosquito bite
164.CBC should be monitored regularly for those patients taking:

A. Phenytoin D. Isoproterenol
B. Bisacodyl E. Minocycline
N C. Acetylcysteine
O
165.Among the following drug of choice for acute attack of gout is:
A. Allopurinol D. Probenecid
B. Colchicine E. Iron
C. Phenylbutazone
166.Which of the following drugs is not useful in the treatment of cardiac failure?
A. Digoxin D. Amrinone
B. Esmolol E. Dobutamine
C. Dopamine
167.In the treatment of Parkinsonism the patient is not likely to be benefited with which of the following drugs?
A. Amantadine D. Pergolide
B. Chlorpromazine E. Lovodopa
C.Trihexyphenidyl
168.Which of the following drugs characteristically produces throbbing headache?

A. Procainamide D. Glyceryl trinitrate
B. Propranolol E. Nifedipine
C. Verpamil
169.The absorption of iron from the gastrointestinal tract is increased in the presence of which of the following substances?
A. Phosphates D. Ascorbic Acid
B. Coffee E. Eggs
C. Tetracycline
170.All of these antibiotics are useful for gastroenteritis, except:

A. Ampicillin D. Chloramphenicol
B. Co-trimoxazole E. Penicillin
C. Ciprofloxacin
171.Salicylates are useful in the following conditions, except:

A. Gout
B. Fever, headache, neuralgia
C. Acute rheumatic fever
D. Rheumatic arthritis
E. Venous thrombosis, embolism, coronary thrombosis
172.Preferred route of insulin is:

A. Oral D. Intramuscular
B. Sublingual E. Inhalation
C. Subcutaneous
173.Antihyperlipidemic agents are used to reduce the concentration of the following, except:
A. High density lipoprotein D. Triglycerides
B. Low density lipoprotein E. Cholesterol
C. Very low density lipoprotein
174.Anemia resulting from decreased blood cells production:

A. Pernicious anemia C. Hemolytic anemia
B. Aplastic anemia D. Folate-Deficiency anemia
175.Which is not effective for patients with sustained disabling arthritis?

A. Penicillamine D. Auronofin
B. Sulfasalazine E. Hydroxychloroquine
C. NSAID
176.Which is NOT A CLINICAL manifestation of gastroenteritis?

A. Fever D. Diarrhea
B. Vomiting E. Night Sweats
C. Abdominal Pain
177.In Pernicious anemia:

A. Gastric mucosa doest not produce intrinsic factor and this leads to Vitamin B 12 deficiency
B. Patient is hypersensitive to iron
C. Iron absorption is interfered
D. It is because of poor dietary iron and vitamin B12 contents
178.These are therapeutic agents for hypothyroidism, except:

A. Propranolol D. Thyroglobulin
B. Radioactive iodine E. Thyroidectomy
C. Propylthiouracil
179.Thrombolytic agents such as streptokinase are useful for patients with:

A. Myocardial infarction D. Angina pectoris
B. Hypertension E. Arrhythmia
C. Congestive heart failure
180.All of the following are complications of untreated diabetes mellitus, except:

A. Gangrene D. Hypertension
B. Increased perception of pain and temperature E. Nephropathy
C. Atherosclerosis
181.Levodopa should not be taken with the following drugs, except:

A. Pyridoxine C. MAOI
B. Carbidopa D. Antipsychotics
182.Which of the following drugs do not lead to hyperuricemia and gout?

A. Cytotoxic agents D. Ethambutol
B. ASA E. Acetohexamide
C. Diuretics
183.The drug of choice in the treatment of arrhythmia caused by digitalis intoxication:

A. Phenylephrine D. Methyldopa
B. Phenyton E. Clonidine
C. Hydralazine
184.Which of the following should not be given to a patient taking streptomycin?

A. Acetazolamide D. Chlorthalidone
B. Ethacrynic acid E. Mannitol
C. Triamterene
185.Oral Hypoglycemic agents:

A. Are preferred to insulin preparations in severe diabetes
B. Are as effective as insulin in the treatment of all types of juvenile diabetics
C. Are valuable in the treatment of mild, stable and maturity onset type of diabetes
D. Are very effective for ketoacidosis
186.In schizophrenic syndrome there is primarily:

A. increased cholinergic activity C. Increased Dopaminergic activity
B. decreased cholinergic activity D. Decreased dopaminergic activity
187.Deficiency of Vitamin B12 in the body leads to:

A. Hemolytic anemia, anorexia, loss of weight
B. Microlytic anemia, loss of appetite
C. Megaloblastic anemia, subacute combine degeneration and epithelial tissue abnormality
D. Hypertrophy of skin, burning sensation of palm and sole
188.In unipolar depression:

A. Lithium is more effective than tricyclic antidepressants
B. Tricyclic antidepressants are more effective than lithium
C. Neither lithium nor tricyclic antidepressants are effective
D. Lithium and tricyclic antidepressants are equally effective
189.Iodide preparations can be used in the following situations, except:

A. In thyroid disorders D. as an expectorant
B. As an antiseptic E. in granulomatous lesions
C. In iodism
190.Schilling test is done for:

A. Diagnosis of pernicious anemia
B. Diagnosis of hemolytic anemia
C. Diagnosis of Thromocytopenic purpura
D. It is nonspecific test for all anemias
191.A diabetic on oral hypoglycemic drug chlorpropamide, suffered from enteric fever and was prescribed chloramphenicol. He
developed severe hypoglycemia. This is because:
A. Chloramphenicol itself has mild hypoglycemic effect
B. Chloramphenicol increases the absorption of chlorpropamide
C. Chloramphenicol causes the release of insulin
D. Chloramphenicol inhibits the metabolism of chlorpropamide
192.Which of the following chemotherapeutic agents is not useful in the treatment of acute exacerbations of chronic bronchitis?
A. Clindamycin D. Tetracycline
B. Amoxicillin E. Erythromycin
C. Co-trimoxazole
193.Which one of the following is not associated with rheumatoid arthritis?

A. Fatigue C. joint swelling and pain
B. Morning stiffness D. Weight gain
194.Which one of the following is not a “Trigger” mechanism for asthmatic attacks?
A. Antigens C. Infection
B. Drugs D. Light
C. Climate
195.Which of the following is NOT a diabetic complication?

A. Retinopathy D. Neuropathy
B. Cardiovascular complication E. Anemia
C. Nephropathy
196.The most commonly used diuretic in combination with antihypertensives:

A. hydrochlorothiazide C. Ethacrynic acid
B. Furosemide D. Amiloride
197.Which one of the following factors is most directly attributed to angina attacks?
A. Stress C. Heavy smoking
B. Myocardial ischemia D. Obesity
198.The prominent cause of infective endocarditis:

A. Viridans streptococci D. Staphylococci
B. Pseudomonas Aeruginosa E. Fungi
C. Serratia marcescens
199.All of these may lead to seizures except:

A. High fever in children
B. Embolism
C. Head trauma, intracranial neoplasms
D. Alcohol or drug withdrawal
E. Mumps, measles, influenza, meningitis, syphilis
200.Complication of seizures:
A. Absence seizures D. Grand mal
B. Petit mal E. Complex partial
P C. Status epilepticus
201.Phenobarbital is used for viral hepatitis to:

A. promote fatty acid synthesis
B. activate the enzyme prolyl hydroxylase
C. induce the production of glucoronyl transferase
202.Hardening of the liver characterized by the presence of nodule and fibrous tissue:
A. Hepatitis C. all of the above
B. Cirrhosis of the liver
203.Alcohol decreases collagenase resulting into:

A. Viral Hepatitis C. Alcoholic cirrhosis
B. Fatty Liver
204.A patient who is recovering from viral hepatitis should abstain from alcohol because:
A. it promotes fatty acid synthesis C. All of the above
B. It favors triglyceride accumulation
205.Aluminum and calcium salts inhibit the intestinal absorption of which of the following agents:
A. Isoniazid C. Tetracycline
B. Chloramphenicol
206.The following are the responsibilities of assistant chief pharmacist, except:

A. Prepare charges for drugs and other medications taken for used by the patient
B. Compound and dispense prescriptions
C. Receive deliveries of medicines
207.Hyperalimentation is indicated for:

A. Renal and hepatic failure C. All of the above
B. Chrohns disease
208.TPN is an intravenous administration of nutrients to:

A. achieve tissue failure C. all of the above
B. Catabolism
209.The most common complication of TPN is:

A. Catheter sepsis C. Air embolism
B. Hyperglycemia, Metabolic acidosis
210.One who records data on drug induced reactions occurring to hospitalized patients:
A. Adverse Drug reaction coordinator C. Drug information specialist
B. Clinical Investigation Coordinator
211.Congestive heart failure is precipitated by:

A. Infection C. All of the above
B. Pulmonary embolism
212.Control of congestive heart failure can be achieved by

A. reduction of cardiac workload C. All of these
B. Control of excessive salt and water retention
213.Most widely used diuretic for congestive heart failure:

A. thiazide C. Furosemide
B. Loop diuretic
214.Diuretics are prescribed for patients with heart failure because it:
A. decreases the amount of sodium in the body
B. increases myocardial contractility
C. all of the above
215.First antibiotic effective in the management of infective endocarditis:

A. Erythromycin C. penicillin
B. Chloramphenicol
216.Non-Selective B-adrenergic blocker:

A. Propranolol C. Atenolol
B. Acebutolol
217.Type of Angina Pectoris which can be precipitated by physical activity and relieved by rest and nitroglycerin:
A. Unstable angina C. Prinzmetal angina
B. Stable angina
218.Inflammation scarring of the heart valves triggered by a streptococcal infection:

A. rheumatic heart disease C. Angina Pectoris
B. Congestive heart failure
219.Medication(s) used for rheumatic fever:
A. Penicillin C. All of the above
B. Salicylates and steroids
220.The only anticholinergic drug used to treat asthma:

A. Ipratropium Bromide C. Biperiden
B. Benztropine
221.Bronchopneumonia is also known as:

A. Caterrhal pneumonia C. All of the above
B. Lobular pneumonia
222.Causative agent of tuberculosis:

A. M. Tuiberculosis hominis C. All of the above
B. M. tuberculosis bovis
223.Second line anti-tuberculosis drugs are the following, except:

A. Ethionamide, cycloserine, PAS C. PZA, Streptomycin, Ethambutol
B. Kanamycin, Viomycin, Capreomycin
224. WHO criterio for mild hypertension:

A. 145 and above/95-114 C. 140-160/80-114
B. 145 and ABOVE/130 & Above
225. True statement(s) regarding allopurinol:

A. It can inhibit xanthine oxidase C. All of the above
B. Decreases serum uric acid level
226. An infection caused by extraintestinal entamoeba histolytica can be effectively treated by:
A. Emetine, Chloroquine C. All of the above
B. Paromomycin
227.Most effective drug for the chronic treatment of partial seizures and generalized tonic clonic seizures is:
A. Diazepam C. Ethsuximide
B. Phenytoin
228.Most effective in acute treatment of migraine headache is:

A. Propranolol C. Ergotamine tartrate
B. Methysergide
229.Which of the following statements about ergotamine is TRUE?

A. It has vasoconstrictive properties that may account for its efficacy
B. It has adrenergic blocking properties that are responsible for its therapeutic benefit
C. It is well absorbed by the gastrointestinal mucosa
230.Ranitidine (Zantac) is effective in treating duodenal ulcer because it:

A. Strengthens the productive coating on the intestinal wall
B. Is an agonist at H1 receptors and therefore reduces pepsin secretion
C. Blocks histamine stimulation of gastric acid secretion by H2 blocker
231.Inflammation in the inner-membranous lining of the heart usually carried by bacteria and fungi:
A. Infective endocarditis B. Angina pectoris C. Congestive heart failure
232.Causative agent(s) of endocarditis:

A. Staph. Aureus B. Strep. pyogenes, strep. viridans C. all of the above
233.Clinical manifestation(s) of endocarditis:

A. Fever B. Embolic phenomena, anemia C. all of the above
234.Conditions caused by strep. organisms.

A. Rheumatic heart Disease B. Endocarditis C. All of the above
235.Physical and emotional stress can trigger the production of:

A. Asthma
B. Angina pectoris, congestive heart failure
C. all of the above
236.Congestive heart failure can be treated using:

A. Lanoxin B. Thiazide diuretics C. all of the above
237.Effects of digitalis on the heart:

A. Increases the force of contraction B. Decreases heart enlargement C. all of the above
238.Characterized by a wide variations over a short period of time in resistance to flow in intrapulmonary airways:
A. Chronic bronchitis B. Emphysema C. Asthma
239.Bronchodilators are used to treat:

A. Chronic bronchitis, emphysema B. Asthma C. All of the above
240.Prednisolone is used as:

A. Adrenergic stimulant B. Anti-inflammatory drug C. Bronchodilator
241.Etiologic factor(s) of emphysema:

A. Air pollution B. Aging and smoking C. all of the above
242. Bronchodilator Drug(s)

A. Aminophylline B. Terbutaline C. all of the above
243.A disease associated with excessive mucous production by the trachebronchial tree which results in airway obstruction:
A. Asthma B. Chronic Bronchitis C. Emphysema
244.Symptom(s) of chronic bronchitis:

A. Dyspnea, wheezing B. Sputum production C. all of these
245.Smoking contributes to the exacerbation or induction of:

A. asthma B. COPD C. all of these

246.To achieve the goals of Pharmacy Service Department, Pharmacist should:
A. Perform technical task B. Practice in patient care areas C. all of the above
B.
247.In monitoring drug therapy, this ensure that the patient receives drugs that are:
A. effective, safe B. least expensive C. all of these
248.All statements are FALSE, EXCEPT:

A. alcohol interferes with the digestion of food
B. Small blood vessels of the skin are constricted by alcohol
C. Alcohol,. Produces a sedative or depressant effect in the brain even with small amounts
249.Thiamine and tranquilizers are used in the treatment of alcoholism to:

A. Decrease anxiety
B. Correct dietary deficiency
C. Enhance hypoprothrombinemic effect
250.Tremors and rigidity are caused by:

A. generation of new cell B. Exposure to sunlight C. brain injury
251.Shaking palsy is manifested by:

A. Frequent urination C. Painful inflammation of the joint
B. Stooped posture
252.The following are precipitating factors of migraine, except:

A. Alcohol C. all of the above
B. Tyramine, sodium nitrate
253.Anticholinergic drug:
A. Cogentine B. Pariodel C. Sinemet
254.Akineton is used primarily to treat:

A. Parkinson’s disease B. Epilepsy C. Cataracts
255.Phenytoin is the drug of choice for the treatment of:

A. Tremor B. Seizure C. Rigidity
256.Parkinsonism is probably due to:

A. too little dopamine in the brain
B. too little levodopa in the brain
C. too little acetylcholine in the brain
257.Which of the following is a first generation sulfonylureas?

A. Glipizide B. Rastinon C. Glyburide
258.Which of the following is used to monitor blood glucose level:

A. Testape B. Benedict;’s solution C. Glucose meters
259.In Hyperglycemia, blood glucose level can reach to:

A. 100 mg/100 ml B. 80 mg/100 ml C. 180 mg/100 ml
260.Isophane insulin suspension is classified as:

A. Fast-acting insulin
B. Intermediate acting insulin C. Long acting insulin
261.Therapy for hyperglycemic coma include:

A. regular insulin
B. fluid and electrolytes C. all of the above
262.Cyclophosphamide is categorized as a:
A. Alkylating agent
B. Antimetabolite C. Natural product
263.Which of the following is secreted by by the thyroid gland?

A. corticotropin B. Gonadotropin C. Triidothyronine
264.What is the therapeutic use of proloid?

A. Plumber’s disease B. Myxedema C. Grave’s disease
265.Which of the following is a second generation oral hypoglycemic drug?

A. Orinase B. Tolinase C. Minidiab
266.Diabetes mellitus is caused by lack of:

A. Insulin B. Glucose C. Vasopressin
267.Which of the following is used to treat rheumatic arthritis?

A. Clinoril, Meclomen, Feldene
B. Auranofin C. All of the above
268.Motrin, used for arthritis, acts by:

A. stimulating the adrenal gland
B. Inhibiting prostaglandin synthesis C. inhibiting normal cell metabolis
269.Methotrexate is used as an antineoplastic agent and also used for the treatment of:
A. Hyperuremia B. Arthritis C. Goiter
270.Which of the following drugs prevents the formation of Tophi?

A. Xanthine oxidase inhibitors
B. Colchicine C. Sulfinpyrazone
271.Glipizide stimulates the release of:

A. Glucagon B. Glucose C. Insulin
272.Leukeran is classifed as:

A. Antibiotic B. Antimetabolite C. Alkylating agent
CHOOSE THE CORRECT ANSWER

A – if 1 and 3 are correct
B – if 2 and 4 are correct
C – 1,2 and 3 are correct
D – if 4 is correct
E – if all are correct
F – all are wrong
C 273. Stability of penicillins are generally inactivated in the presence of:
1. Heat 3. Metal ions
2. Alcohol 4. Gas
F 274. Cephalosporins well absorbed in the GIT and is not affected by food:
1. Cefaclor 3. Cephradine
2. Cephalexin 4. Cefadroxil
C 275. The following drugs are used orally in the treatment of otitis media:
1. Cefaclor 3. Cephradine
2. Cephalexin 4. Ciprofloxacin
A 276. Concurrent use of nephrotoxic agent such as the following may increase nephrotoxicity:
1. Aminoglycosides 3. Colelstin
2. Cephalosporins 4. Penicillin
E 277. Adverse effects reported with the various cephalosporins:

1. Hematologic effect 3. Phlebitis
2. CNS Toxicity 4. GI effects
C 278. Aminoglycosides are inactive against:

1. Fungi 3. Anaerobic Bacteria
2. Virus 4. Aerobic Gram negative bacteria
E 279. Aminoglycosides are used in the treatment of:

1. Bone
2. Skin and soft tissue infections
3. Respiratory diseases
4. Post-operative and intra-abdominal infection
C 280. Penicillinase-resistant penicillins;

1. Cloxacillin 3. Dicloxacillin
2. Nafcillin 4. Carbenicillin
E 281. Extended –spectrum M penicillins:

1. Piperacillin 3. Mezlocillin
2. Ticarcillin 4. Sulbenicillin
C 282. Aminopenicillins:
1. Amoxicillin 3. Bacampacillin
2. Ampicillin 4. Penicillin G
C 283. Penicillin should be used with caution in patient with history of:
1. Asthma 3. Urticaria
2. High fever 4. Meningitis
E 284. Glucocorticosteroids interact with:

1. Vaccines and Toxoids 3. Estrogens
2. Oral anticoagulants 4. Potassium Depleting drugs
E 285. Adverse effects of salbutamol:

1. Tachycardia 3. Tremor
2. Palpitation 4. Peripheral vasodilation
D 286. This drug/drugs stimulate all levels of the CNS:

1. Hydrocortisone 3. Salbutamol
2. Dexamethasone 4. Theophylline
E 287. The following drug/drugs may increase theophylline concentration:

1. Cimetidine 3. Propranolol
2. Allopurinol 4. Erythromycin
A 288. Inhibits bacterial protein synthesis and bacteriostatic:

1. Erythromycin 3. Clindamycin
2. Penicillin 4. Cephalosporins
D 289. It inhibits the sebaceous gland function and follicular keratinization:

1. Clindamycin 3. Erythromycin
2. Vancomycin 4. Isotretinoin
E 290. Route of transmission of Hepatitis A:

1. Direct personal contract 3. Poor sanitation
2. Uncooked shellfish 4. Contaminated water
E 291. Primary drugs for tuberculosis;

1. INH 3. Rifampicin
2. Streptomycin 4. Ethambutol
D 292. Can be used in combination with dapsone in the treatment of leprosy:

1. INH 3. PAS
2. Ethambutol 4. Rifampicin
C 293. Barbiturates interacts with:

1. CNS Depressants 3. Corticosteroids
2. Anticoagulants 4. Oral Contraceptives
D 294. Produces anticonvulsant effects in subhypnotic doses:

1. Phenytoin 3. Pentobarbital
2. Amobarbital 4. Phenobarbital
C 295. Considered as Opiate analgesic:

1. Morphine 3. Nalbuphine
2. Meperidine 4. Mefenamic acid
F 296. Considered as antidepressant:

1. Chlorpromazine 3. Fluphenazine
2. Perphenazine 4. Promethazine
E 297. Adverse effect/s of Benzodiazepines:

1. Drowsiness 3. Weakness
2. Ataxia 4. Vertigo
A 298. Diazepam interacts with:

1. Cimetidine 3. Disulfiram
2. Cephalosporin 4. Chloramphenicol
A 299. Advantages of Capsule over tablet:

1. It is easily assimilable 3. It is tasteless
2. It more stable 4. It is not Bulky
E 300. Factors affecting drug metabolism:

1. Genetics 3. Gender
2. Age 4. Disease
A 301. Cardiac Glycosides:

1. Digoxin 3. Deslanoside
2. Isosorbide 4. Nifedipine
E 302. Treatment of chronic obstructive pulmonary disease:

1. Anti-infective 3. Hydrocortisone
2. Theophylline 4. Oxygen Therapy
C 303. Pneumonia occurs in the following:

1. Extreme temperature exposures 3. Alcoholism
2. Malnutrition 4. Smoking too much
E 304. H2 receptor antagonize most of the smooth muscles like:

1. GIT 3. Bronchial muscle
2. Uterus 4. Large blood vessel
A 305. Mode of transmission of sexually transmitted diseases:

1. Parenteral 3. Sexual
2. using the toilet 4. Droplets
E 306. Treatment of sexually transmitted diseases:

1. Penicillin 3. Erythromycin
2. Tetracycline 4. Spectinomycin
C 307. Types of Penumonia:

1. Caused by Virus 3. Caused by pneumococcus
2. Bacterial pneumonia 4. Bronchial pneumonia
C 308. Drugs used in the treatment of ascaris:

1. Metronidazole 3. Tinidozole
2. Mebendazole 4. Piperazine
A 309. Drugs of choice for severe amoebic infection:

1. Metronidazole 3. Diloxanide
2. Mebendazole 4. Tinidazole
C 310. Drugs for primary-angle glaucoma treatment:

1. Pilocarpine 3. Timolol
2. Epinephrine 4. Ephedrine
A 311. Classified as natural thyroid:

1. Thyroglobulin 3. Dessicated thyroid
2. Levothyroxine 4. L-Triidothyronine
B 312. Transmission for tubercle bacilli are thru:

1. Food
2. Aerosolized droplets expectorated from person with TB
3. Association with person who has the disease
4. Direct inoculation through the skin
5.
B 313. An IV infusion is superior to IM in analgesia:
1. Butorphanol 3. Nalbuphine
2. Meperidine 4. Morphine
C 314. Non drug treatment for rheumatoid arthritis:

1. Rest 3. Exercise
2. Heat 4. Nutritional support
D 315. Considered as non-steroidal anti-inflammatory drug/s:

1. Aspirin 3. Codeine
2. Acetaminophen 4. Sulindac
D 316. UTI Clinical syndrome for female:

1. Prostatitis 3. Cystitis
2. Pyelonephritis 4. Urethritis
D 317. Affect fetus producing discoloration of fetal unerrupted teeth:

1. Chloramphenicol 3. Erythromycin
2. Ampicillin 4. Tetracycline
C 318. Signs and symptoms of gonorrhea:

1. Milky discharge 3. Urinary frequency
2. Painful urination 4. Coughing
A 319. Infections that occur in urinary tract:

1. Cystitis 3. Prostatitis
2. Cholecystitis 4. Pancreatitis
B 320. Compounds whose absorption may be reduced by food:

1. Cephalexin 3. Isoniazid
2. Tetracycline 4. Metronidazole
321. Compounds whose absorption may be increased by food:

A. Griseofulvin C. Rifampicin
B. Nitrofurantoin D. None
322. Poorly absorbed thus have to be given by injection:

A. Cephalothin C. Cephalexin
B. Cephaloridine D. None
323.Chloramphenicol/Phenytoin combinaton ____ serum phenytoin level:

A. Increases C. No effect
B. Decreases
324.Significantly absorbed after oral administration:

A. Amphotericin C. Ketoconazole
B. Nystatin
325.Class effect of NSAID’s is to abolish the diuretic effect of thiazide, except:

A. Sulindac C. Ibuprofen
B. Indomethacin D. None
326.The major adverse effect of this group of drugs is its gastro intestinal effect:
A. Antibiotics C. Antituberculosis
B. NSAID’s

327. The most potent of the digitalis glycosides is:
A. Digoxin C. Digitoxin
B. Deslanoside D. None
328. The following drugs are potassium-losing diuretics, except:

A. Bumetanide C. Spironolactone
B. Furosemide
329.Reduces the efficacy of oral contraceptives:

A. Rifampicin C. Barbiturates
B. Phenytoin D. All
330.Oral contraceptive/Pethidine combination produces:

A. Possible increased analgesia C. no effect
B. CNS depression D. Both
331.All of these are ulcerogenic, except:

A. Corticosteroids C. Antacids
B. Aspirin D. NSAID’s
332.The following are pro-drugs, except:

A. Bacampicillin C. Methicillin
B. Metampicillin D. None
333.Withdrawn from the market due to reported severe adverse reactions:

A. Zomepirac C. Oxyphenbutazone
B. Phenylbutazone
334.MAOI Antidepressants/Pethidine combination will produce:

A. Excitation and rigidity C. all of these
B. Hypertension and Hyperpyrexia D. none
335.Enhances the effect of barbiturates:

A. Alcohol C. Pethidine
B. MAOI D. ALL
336.Barbiturates increase the metabolism of the following drugs;

A. Metronidazole C. Both
B. Estrogens D. None of these
337.Spironolactone:
A. Is a steroid C. Both of the above
B. Increase sodium excretion D. none of the above
338.These diuretics tend to elevate the blood sugar level in diabetics and prediabetics:
A. Ethacrynic acid C. none of the above
B. Furosemide D. both of the above
339.Cimetidine increases plasma level of the following drugs, except:

A. Metoprolol C. Atenolol
B. Propranolol
340.Affects hepatic drug metabolism:

A. Ranitidine C. Famotidine
B. Cimetidine D. All
341.A Cardio-selective beta-blocker:

A. Alprenolol C. Metoprolol
B. Betaxolol D. All
342.The following are alkylating antineoplastic agents, except:
A. Busulfan C. Cisplatin
B. Chlorambucil D. Vincristine
343.The following are thyramine-containing comounds hence, caution should be observed when taking with MAOI:
A. Sherry D. All
B. Yeast E. Both B and C
C. Cheese
344.The following are sedative antihistamines, except:

A. Astemizole C. Promethazine
B. Chlorpheniramine D. None
345.Aspirin interaction includes:

A. Displaces coumarins from plasma protein-binding sites
B. Reduce plasma prothrombin in large doses
C. Both
D. A only
346.Aspirin Interaction includes:

A. Reduces insulin requirements C. Both

B. Antagonizes probenecid D. None
347.In patients taking diclofenac, lithium salts should be:

A. Increased C. dose retained
B. Reduced
348.Amoxicillin/Theophylline combination:
A. Requires adjustment of amoxicillin dose
B. Requires increase of theophylline dose
C. Both of these
D. None of these
349.Stability is less than 24 hours:

A. Cefamandole C. Cefoperazone
B. Cefazolin D. none of these
350.Among the complications of penicillin therapy includes:

A. Anaphylactic shock C. Super infections
B. Cross –sensitivity to all D. all of these
351.Penicillinase and acid-resistant penicillins include the following, except:

A. Cloxacillin C. Phenoxymethylpenicillin Pen V
B. Nafcillin D. None of these
352.Tetracycline/Penicillin combination will produce:

A. Synergism C. Additive effect
B. Potentiation D. None of these
353.Action of ferrous sulfate on doxycycline:

A. Lowers the serum concentration of Doxycycline
B. Shorten its serum half-life
C. Both
D. None of these
354.Heparin:
A. Prevents clotting of blood and neutralized by protamine
B. Its prolonged use will cause urinary calcium loss
C. Both of these
355.Among the present oral anticoagulants this drug has now of little use:
A. Dicumarol C. both
B. Warfarin D. none of these
356.These drugs potentiate the effect of anticoagulants, except:

A. Alcohol C. All
B. Allopurinol D. None
C. Steroids
357.The following drug/s may not be given safely with anticoagulants, except:
A. Sulindac C. Aluminum magnesium hydroxide
b. Naproxen D. None
358.Chloramphenicol potentiates the action of anticoagulants by:

A. impairment of absorption of Vitamin K
B. inhibition of coumarin metabolism in the liver
C. Both of the above
D. None of the above
359.The following are alkalinizing potassium salts, except:

A. Potassium citrate C. potassium chloride
B. Potassium acetate D. potassium gluconate
360.The following are calcium antagonists, except:

A. Nifedipine C. Nicardipine
B. Felodipine D. None
361.Affected by food in the stomach so should be given with food one hour before meals:
A. Captopril C. Cilazapril
B. Enalapril
362.Non-selective beta-blockers are the following, except:

A. Pindolol C. Nadolol
B. Metoprolol D. None
363.Comes only as an oral preparation:

A. Ranitidine C. Nizatidine
B. Famotidine D. Cimetidine
364.The following are H2 receptor antagonists, except:

A. Tagamet C. Losec
B. Zantac D. Axid
365.Calcium channel blockers are the following, except:

A. Verapamil C. Gemfibrozil
B. Diltiazem
366.An alpha receptor blocking agent:

A. Epinephrine C. Prazosin
B. Reserpine D. Aminophylline
367.Drug of choice for pseudomembranous colitis:

A. Cephalexin C. Vancomycin
B. Erythromycin
368.Can penetrate the blood brain barrier?

A. Cefoperazone C. Cefamandole
B. Ceftriaxone D. None
369.Antagonizes the sedative effect of Benzodiazepines:

A. Clorazepate C. flumazenil
B. Flupentixol D. None
370.Oral contraceptive/corticosteroid combination produces:

A. Enhance anti-inflammatory effects C. both
B. retard metabolism D. None of these
371.Used in the treatment of manic disorders, except:
A. Carbamazepine C. Acetazolamide
B. Lithium
372.Stimuli for mast cell histamine release:

A. Opioids B. Neurotransmitters C. Peptides D. All
373.The following are non-sedating antihistamine, except:

A. Loratidine B. Ketotifen C. Cetirizine D. None
374.All of the following have low therapeutic index, except:

A. Gentamicin B. Digoxin C. Penicillin
375.Common adverse reactions of contrast media are, except:

A. Mild urticaria B. Nausea C. Vomiting D. None
376.Characteristics of contrast media, except:

A. Acidic B. Iodinated C. Highly Osmolar D. None
377.Concomittant administration of Astemizole and Erythromycin or ketoconazole will result in:

A. Cardiac arrythmias C. Both
B. Diarrhea D. None
378.MAO enzymes inactivates:

A. Adrenaline B. Noradrenaline C. Serotonin D. All
379.MAO inhibitors enhance action of the following drugs:

A. General Anesthetics C. Both
B. Alcohol D. None
380.Ketorolac is an NSAID which may precipitate or exacerbate:

A. Asthma D. None
B. Acute renal failure E. all
C. GI Bleed
381.Treatment of acute diarrhea includes:
A. Stool binding agents C. Oral rehydrating solution
B. Antivomiting drugs
382.The following drugs loss some of their potency due to sorption to plastic materials, except:
A. Diazepam C. Isosorbide Dinitrate
B. Chloroquine D. None
383.Insulin usually classified as a:

A. Hormone C. Phospholipid
B. Enzyme D. None of these
384.MAO is classified as a:
A. protein inhibitor C. Enzyme
B. Complexing agent D. None
385.A substance found commonly in fermented foods which can interact with MAO inhibitors:
A. Tyramine C. Tyrosine
B. Histidine D. All of these
386.Regular use of sublingual nitrates (Nitroglycerin) is likely to result in:

A. Peptic ulcer C. Respiratory impairment

B. tolerance
387.Prolonged use of Phenylbutazone is usually contraindicated because it is potential for producing:

A. blood dyscracias C. Damage to the auditory nerve
B. Damage to the optic nerve D. All of the above
388.Humulin N is used primary to treat:

A. Ulcer C. Colitis
B. Diabetes D. Manic disorders
389.Zantac (Glaxo) is used primarily to treat:

A. Gout C. Hyperacidity
B. Cardiac insufficiency D. All
390.Zyloprim is used primarily to treat:

A. Gout C. allergies
B. Pain D. None of these
391.Hypaque is:
A. Contrast media C. Antineoplastic
B. Anti-ulcer drug
392.The action of digitalis is enhanced by:

A. Calcium C. Potassium
B. Magnesium D. iron
393.The least bound of the penicillins in blood serum:

A. Ampicillin C. Penicillin V
B. Cephalosporin
394.Felodipine (Astra) is a:
A. Calcium antagonist C. Diuretic
B. ACE inhibitors
395.Cilazapril (Roche) is classified as a:

A. Calcium antagonist C. Diuretic
B. ACE inhibitors D. None
396.Ultra-short acting barbiturates are used primarily as:

A. Preanesthetic medication C. Both of these
B. Antispasmodic agent D. None of these
397.Lithium carbonate is used mainly to treat:

A. gastritis C. manic disorder
B. Minor anxiety states
398.Pancuronium bromide is used as a pre-anesthetic medication:

A. To increase muscle relaxation C. To enhance rapidity of action
B. To increase duration of action
399.Complication of diabetes:
A. Blindness C. Gangrene
B. Kidney failure D. All
400.Classical signs and symptoms of diabetes:

A. Polyuria C. Fatigue
B. Polydipsia D. All of these
401.Mechanism of action of barbiturates in controlling seizure disorders:
A. Inhibit mono and polysynaptic transmission and seizure threshold in the cortex
B. Stabilize neuronal membranes
C. Affect Thalamus
402.The major risk of patient experiencing depressive episodes:

A. Suicide C. overdosage of antidepressant
B. Loss of appetite D. None of these
403.The primary mechanism of action of ibuprofen:

A. inhibits prostaglandin synthesis C. All of these
B. stimulate platelet aggregation D. none of these
404.Common side effects of phenytoin therapy:

A. Nystagmus and ataxia C. All of these
B. Gingival hyperplasia
405.Quinidine Gulocnate And Quinidine sulfate may be classified as:

A. Chemical equivalents C. Generic equivalent
B. Therapeutical alternatives D. All of the above
406.Urinary alkalinization may be indicated for the treatment of an overdosage of this drug:
A. Acetaminophen C. Phenobarbital
B. Amphetamine D. All
407.To calculate loading dose, one must first determine:

A. Body clearance C. Both of the above
B. Volume of distribution D. none of the above
408.The following procedure is not useful in the treatment of acute Digoxin toxicity:
A. Cholestyramine C. Potassium administration
B. Calcium administration D. all of the above
409.The following are MAO inhibitors, except:

A. Pargyline C. amphetamine
B. Isocarboxasid D. None of these
410.A major problem associated with the use of MAO inhibitors is:
A. Severe hypotension C. Overdosage of the drug
B. Severe hypertensive response D. None of these
411.Classical signs of pre-eclampsia include:

A. Hypertension with proteinuria
B. Hepatic and general vascular involvement
C. Both A and B
412.Tetracycline is contraindicated for children because:

A. it causes discoloration of teeth C. Both of the above
B. Severe gastric disturbance D. none of the above
413.This drug can increase the serum levels of penicillin:

A. salicylates C. Antacids
B. Probenecid D. Kaolin
414.Primary reason why enteric coated tablets is unpredictable in drug therapy:

A. pH C. failure to release the drug
B. premature release of drug D. varying thickness of coat
415.Manner of sterilization of plastic:

A. heat sterilization C. ethylene oxide
B. steam under pressure D. boiling
416.Increased tissue storage has this effect on the biological half-life of drug:
A. increases it C. decreases it
B. makes it erratic D. no effect
417.Effect of plasma protein binding on elimination of drugs:

A. Slows it down C. changes the route of elimination
B. Hastens it D. No significant effect
418.Weakly basic drugs are best eliminated in this condition:

A. Alkaline urine C. neutral urine
B. Acid urine D. none of these
419.Which of the following drugs is generally considered the drug of choice in treating status epilepticus?
A. Phenobarbital D. Paraldehyde
B. Amobarbital (amytal) E. Diazepam (Valium)
C. Phenytoin (Dilantin)
420.A syndrome strongly resembling systemic lupus erythematosus (SLE) is an adverse reaction associated with:
A. Hydralazine (Apresoline) D. Methyldopa (Aldomet)
B. Reserpine E. Guanethidine (Ismelin)
C. Diazoxide (Hyperstat I.V.)
421.The Antihypertensive effect of guanethidine (Ismelin) is inhibited by:

A. Diazepam (Valium) D. Probenecid (Benemid)
B. Amitriptyline (Elavil) E. Nitrofurantoin (Furadantin)
C. Hydrochlorothiazide (Hydro-diuril)
422.In terms of its major pharmacologic effect, Metoprolol (Lopressor) is most similar to:
A. Isoproterenol (Isuprel) D. Hydrochlorothiazide (Hydro-Diuril)
B. Metaproterenol (Alupent) E. Propranolol (Inderal)
C. Guanethidine (Ismelin)
423.When dispensing a new prescription, for what drug should the pharmacist advise the patient that he may experience a large fall
in blood pressure following the first dose?
A. Methyldopa (Aldomet) D. Reserpine (Serpasil)
B. Prazosin (Minipress) E. Propranolol (inderal)
C. Clonidine (Catapress)
424.The ganglionic blocking agents are not extensively used as antihypertensive because:
A. They cannot be administered orally
B. Of their long duration of action
C. They do not selectively block sympathetic ganglia
D. Their hypotensive effect is unpredictable and slow in onset
E. Both A and d are correct
425.Diazoxide (Hyperstat) is administered:

A. Orally D. By IV infusion
B. Intramuscularly E. Either C or D
C. By rapid IV injection
426.Which of the following antihypertensive would be most appropriate for a patient with renal insufficiency?
A. Guanethidine (Ismelin) D. Reserpine (Serpasil)
B. Methyldopa (Eldomet) E. Hydralazine (Apresoline)
C. Mecamylamine (Inversine)
427.Which of the following antihypertensive agents would probably be the best choice to use in combination with
hydrochlorothiazide in a hypertensive patient who is severely depressed?
A. Reserpine (serpasil) D. Methyldopa (aldomet)
B. Hydralazine (Apresoline) E. Clonidine (Catapres)
C. Guanethidine (Ismelin)
428.Benztropine (Cogentin is often given to patients taking the antipsychotic phenothiazines because Benztropine:
A. Reduces the dose of phenothiazine required
B. Is an anticholinergic drug that reduces the extrapyramidal side effects of the Phenothiazine
C. Eliminates the unpleasant GI irritation caused by the Phenothiazine
D. Is an antidepressant
E. Reduces got motility to ensure that the Phenothiazine is completely absorbed
429.Cholestyramine (Questran, Cuemid) will probably interefere with the gastrointestinal absorption of:
A. Chlorothiazide D. Tetracycline
b. Phenylbutazone E. All of the above
C. Phenobarbital
430.A clinically noticeable drug interaction resulting from the displacement of drug A by Drug B from common plasma protein-
binding sites is most often seen when:
A. Drug A has high association constant (K) for binding the protein
B. Drug B has a high association constant (K) for binding the protein is given in large doses
C. Drug B has a low association constant (K) for binding the proteina nd is given in large doses
D. Drug B is mote Toxic than Drug A
E. Drug is rapidly absorbed
431.The metabolism of which of the following compounds is altered in patient taking anticonvulsants?
A. Pyridoxine D. Renin
B. Folic acid E. Tyrosine
C. Riboflavin
432.When valproic acid (Depakene) is prescribed for Petit mal epilepsy in a patient who is already receiving phenobarbital:
A. The phenobarbital should be discontinued because phenobarbital will inactivate valproic acid
B. The dose of phenobarbital may have to be decreased because valproic acid will increase phenobarbital blood
levels
C. Ethosuximide (Zarontin) should also be prescribed
D. The valproic acid should be given in the morning and the phenobarbital should be given at bedtime
E. The dose of both drugs may have to be higher than usual because each drug enhances the metabolism of the other
433.Droperidol (Inapsine) is a butyrophenone derivative that is used as an:

A. Adjunct to anesthesia D. Analgesic
B. Antipsychotic alternative to haloperidol E. Emetic
C. Antihypertensive
434.A microorganism that is particularly dangerous to the eye is:
A. Aspergillus niger D. Pseudomonas Aeruginosa
B. Bacillus Subtilis E. Streptococcus thermophilus
C. Escherichia coli
435.Purulent boils in the ear are usually caused by specieis of:

A. Aspergillus D. Staphylococcus
B. Candida E. Streptococcus
C. Pseudomonas
436.The treatment of chouice for herpes simplex infection of the eyelids and conjunctiva is:
A. thiabendazole (Mintezol) C. Amphotericin (Baciguent)
B. Idoxuridine D. Carbenicillin (Pyopen)
437.Which of the following antifungal agents is ineffective against Candida organism?

A. Nystatin (Mycostatin) D. Amphotericin B (Fungizone)
B. clotrimazole (Lotrimin) E. Miconazole (Micatin)
C. Tolnaftate (Tinactin)
438.Methotrexate has been shown to be of Clinical use in the management of:

A. Psoriasis D. Fungal infections of the skin
B. Seborrhea E. Warts
C. Acne
439.Which of the following immuno suppressant drugs is a folic acid antagonist?

A. Azathioprine (Imuran) D. Cyclophosphamide(Cytoxan)
B. Methotrexate E. Nitrogen mustard
C. ^-mercaptopurine (Purinethol)
440.Which of the following agents is NOT administered intravenoulsy?

A. Thiopental sodium
B. Halothane
C. Ketamine HCI
D. Methohexital sodium
E. All of the above may be administered by the intravenous route
441.An importortant potential complication of corticosteroid therapy is:

A. Dissemination of local infection D. All of the above
B. Masking symptoms of an infection E. None of the above
C. Increased susceptibility to infection
442.The primary advantage of piroxicam (Feldene) over other nonsteroidal anti-inflammatory drugs (NSAIDS) is that it:
A. is relatively inexpensive
B. Acts by a different mechanism of action that may be additive to other NSAIDS
C. May be given on a once-a-day schedule
D. Can be taken with meals
E. Has essentially no gastrointestinal side effects
443.Which of the following arylalkanoic acid derivatives might be particularly useful in an arthritic patient who has difficulty
remembering to take her medication during the day?
A. Tolmetin (Tolectin) D. Naproxen (Naprosyn)
B. Fenoprofen (Nalfon) E. Both A and C
C. Ibuprofen (Motrin)
444.When dispensing the fluorouracil solution fluoroplex, the pharmacist should given the patient all of the following advice and
warning except:
A. apply with a nonmetallic applicator or fingertips
B. avoid prolonged exposure to sunlight
C. avoid exposure to ultraviolet light
D. cover infected area with an occlusive dressing after application
E. Erythema will usually occur after application
445.Which of the following best describes the condition known as hypoprothrombinemia?

A. A diminished blood supply to the brain
B. Blood clot formation in a peripheral blood vessel
C. A reduced capability for blood to clot
D. A low level of iron in the blood
E. A decrease in the production of red blood cells by the bone marrow
446.The reversal of anticoagulant-induced hypoprothrombinemia is most rapidly accomplished by the administration of:
A. Phytonadione (Aqua Mephyton)
B. Menadione
C. Menadione sodium Bisulfite (Hykinone)
D. Manadiol sodium Dihopshate (Synkayvite)
E. Fresh blood or plasma
447.A patient complains of a reddish discoloration of his urine, which of the following drugs would most likely produce such an
effect?
A. Gelusil D. Darvon
B. Pyridium E. Mandelamine
C. Gantrisin
448.Clomiphene Citrate (clomid) is used clinically in the treatment of:

A. Psoriasis D. Depression
B. Infertility E. Dysmenorrhea
C. Nausea
449.The In-home early pregnancy test (E.P.T.) by Warner-Chilcott assays for the presence of:
A. Estradiol D. Prolactin
B. Human Chorionic gonadotropin E. none of these
C. Progesterone
450.A positive EPT is indicated by:

A. A blue color in the urine after consuming the tablets
B. A color change in the test paper that has been dipped into the urine
C. A dark donut-shaped brownish ring in the tube
D. The formation of a precipitate in the tube
E. A red color in the urine-test solution mixture
451.A clinical investigation of a new drug consists of four phases. Phase I of the clinical testing involves administering the drug:
A. To animals to determine side effects of the drug
B. To animals for toxicity studies

C. By select clinicians to healthy volunteers
D. By select clinicians to patients suffering from the disease
E. By general practitioners to patients suffering from the disease
452.Which of the following best describes the common clinical manifestations of hypoparathyroidism?
A. Hypocalcemia and hypophosphatemia D. Hypercalcemia and hyperhosphatemia
B. Hypocalcemia and hyperphosphatemia E. None of the above
C. Hypercalcemia and Hypophosphatemia
453.Which of the following dyes has been found to be useful in the treatment and control of pinworm infestations in humans?
A. Sulfobromophthalein D. Fluorescein
B. Acriflavine E. Methylene Blue
C. Pyrvinium Pamoate
454.Tubocurarine should not be used in patients who are taking:

A. Aspirin D. Levodopa
B. Morphine E. Gentamicin
D. Indomethacin
455.Myxedema is what kind of state?

A. Hypothyroid D. Hyperparathyroid
B. Hypoparathyroid E. Normal Parathyroid
C. Hyperthyroid
456.A person with normal thyroid function is called:

A. Myxedematous D. Hypothyroid
B. Basal E. None of the above
C. Euthyroid
457.Which of the following should not be used in patients who are allergic to aspirin?
A. Florinal D. Motrin
B. Darvocet-N E. Mygesic
C. Butazolidin-Alka
458.Which of the following phrases best defines the clinical disorder known as Hemochromatosis?
A. a lack of circulating antibodies
B. Excessive storage of iron by the body
C. Abnormally shaped red blood cells
D. Diminished circulating blood volume
E. Absence of pigmentation in circulating red blood cells
459.A reversible cholestatic hepatitis with fever and jaundice that may be a specific hypersensitivity to the drug has been observed
as an adverse drug reaction inpatients taking erythromycin:
A. Stearate (Erythrocin filmtab)
B. Ethylsuccinate (Erythrocin granules0
C. Free base (E-mycin)
D. Estolate (Ilosone)
460.Which of the following sulfonamides is primarily indicated for decreasing intestinal bacterial flora?
A. Mafenide (Sulfamylon) D. Sulfamethiozole (Thiosulfil)
B. Sulfisoxazole (Gantrisin) E. Sulfamethoxazole (Gantanol)
C. Phthalylsulfathiazole (sulfathalidine)
461.The most important indication for vancomycin (Vancocin) is in what type of serious infections that do not respond to other
treatment:
A. Pneumococcal D. gonococcal
B. Staphylococcal E. Pseudomonal
C. StreptococcalG
462.Cimetidine (Tagamet) inhibits gastric acid secretion as a resu;t of what kind of activity?
A. Anticholinergic D. Antianxiety
B. Antiadrenergic E. Anorectic
D. Antihistamine
463. Penicilloyl –Polylysine is a substance used to:

A. Stabilize crystalline penicillin G preparations
B. Counteract allergic reactions to penicillin
C. Reduce the renal secretion of penicillin
D. Skin test patients for penicillin allergy
E. Manufacture the semisynthetic penicillins
464.A tricyclic amine that is used as an antiviral agent is:

A. Desipramine (Norpramin, Pertofrane)
B. Amantadine (Symmetrel)
C. 5 fluoruracil
D. Cytosine Arabinoside (Cytarabine, Cytosar)
E. Idoxuridine (Dendrid, Herplex, Stoxil)
465.Assuming that the causative organism in a specific urinary tract infection is equally sensitive to the following antibiotics, which
drug would be the poorest choice?
A. Tetracyctine HCI D. doxycycline (Vibramycin)
B. Oxytetracycline (Terramycin) E. Rolitetracycline (Syntetrin)
C. Methacycline (Rondomycin)
466.Spectinomycin (Trobicin) is indicated primarily as;

A. an alternative treatment for gonorrhea in patients who might be hypertensive to penicillin or whose
gonococci are resistant to penicillin
B. An antibacterial to treat urinary tract infection caused by organisms that are susceptible to gentamycin in patients with
impaired renal function
C. A broad-spectrum antibiotic for topical application to protect the injection site in patients on parenteral
hyperalimentation
D. An antitubercular drug to be used in combination with ethambutol or rifampin
E. A prophylactic antibiotic inpatients with rheumatic heart fever
467.The microbiologic Activity, clinical use, and adverse effects of spectrobid are essentially identical to those of:
A. Penicillin V (Pen-VEE) D. Methicillin (Staphcillin)
B. Ampicillin (Omnipen, Penbritin) E. Oxacillin (Bactocil, Prostaphlin)
C. Carbenicillin (Geopen, Pyopen)
468.Ticarcillin may be preferred to carbenicillin for patients with congestive heart failure (CHF), renal failure and hypertension
because it:
A. contains less doium than does carbenicillin
B. usually given in smaller doses than is carbenicillin
C. does not induce hypokalemia
D. Stimulates renal blood flow
E. Has broader spectrum than does carbenicillin
469.Isoniazid (Isonicotinic acid hydrazide, INH, Rimicon) is an antitubercular agent. Which of the following statements is correct for
isoniazid?
A. Cannot be used prophylactically in persons exposed to tubercular patients
B. One of the most potent antitubercular drugs
C. Pyridoxine antagonized the antitubercular action
D. Not metabolized in the liver
E. Must be use alone, other antitubercular drugs are inhibitory
470.The purpose of combined drugs treatment in tuberculosis is to:

A. Delay the emergence of drug resistance
B. Reduce the number of organisms that leave the body via the feces
C. Increase the tuberculostatic effects of the drugs
D. Reduce the duration of active therapy
E. Both A and C
471.Patients taking the antitubercular drug refampin in (rifadin)should be told that the drug:
A. May color their urine and sweat orange
B. May cause them to sunburn more easily
C. May produce nuasea and vomiting if alcoholic beverages are consumed
D. May cause diarrhea
E. Should be swallowed while (I.E. not chewed) to prevent staining of the teeth
472.Chloramphenicol (chloromycetin) is indicatted primarily in:

A. Thyphoid fever D. yellow fever
B. Rheumatic fever E. Amebiasis
B. tuberculosis
473.A penicillin derivative that is most closely related to ampicillin but has a much greater activity against pseudomonas is:
A. Methicillin (Staphcillin) D. Duicloxacillin (Dynapen)
B. Carbenicillin (Geocillin) E. Oxacillin (Prostaphlin)
C. Nafcillin (Unipen)
474.Antibiotic – induced pseudomembranous colitis is most commonly treated with:

A. Kaolin-Pectin (Kaopectate) D. Gentamicin (Garamycin)
B. Vancomycin (Vancocin) E. Sulfasalazine (Azulfidine)
C. Loperamide (Imodium)
475.When used to treat susceptible urinary tract infections, which one of the following anti-infective drugs will have its activity
increased in an alkaline urine?
A. Methenamine mandelate D. Gentamicin
b. Nitrofurantoin E. Nalidixic acid
C. tetracycline
476.A Fanconi-like syndrome has been associated with the use of outdated and degraded:
A. Ampicillin D. Cephaloglycin
B. doxycycline E. Clindamycin
C. tetracycline
477.The Aminoglycoside antibiotics are:

A. bactericidal for a wide range of gram-positive and gram negative microorganisms
B. Suitable for long-term treatment of chronic urinary tract infections
C. Metabolized by the liver
D. More effective in urinary tract infections when the urine is alkaline
E. Both A and D

478.The primary clinical advantage of Cefamandole (Mandol) over the older cephalosporins such as cephalothin (Keflin) is the fact
that cefamandole:
A. Has a wider antimicrobial spectrum
B. Is resistant to Beta-lactamase hydrolysis
C. Is much less protein-bound
D. Can be given on a twice-a-day schedule
E. Is relatively free of side effects
479.Which of the following cephalosporins is available in both oral and parenteral dosage forms:
A. Cephalexin (Keflex) D. Cefazolin (Ancef, Kefzol)
B. Cephradine(Velosef) E. Cephapirin (Cefadyl)
C. Cefamandole (Mandol)
480.A disadvantage of using cromolyn sodium powder for asthma:

A. its brief duration of action
B. The development of rebound bronchoconstriction
C. The rapid development of tachyphylaxis
D. The possibility of an initial effect of bronchoconstriction
E. Poor GI absorption after administration of the capsule dosage form
481.An asthmatic patient who is currently taking tedral tablets (t.i.d.), Prednisone 5 mg (q.i.d.) and medihaler –180 (p.r.n.) gives you
a prescription for vanceril inhaler. The directions on the prescription are “One inhalation p.r.n. breathing difficulty”. The most
appropriate action for you to take is:
A. fill the prescription
B. consult with the physician advising that vanceril (Beclomethasone) is a prohylactic drug that should be taken regularly
C. Consult with the physician advising him that prednisone should be discontinued before vanceril therapy is
initiated
D. Consult with the patient, advising him to stop using the medihaler-ISO
E. Carefully observe the patient for obvious signs of corticosteroid toxicity and consult with the physician if necessary
482.A common name for the antidiuretic hormone elaborated by the posterior pituitary gland is:
A. Norepinephrine D. Vasopressin
B. Renin E. Secretin
C. Luteotropic hormone
483.Which of the following is true of lithium carbonate (Eskalith, Lithane)?

A. Indicated in the treatment of severe manic-depressive psychoses
B. May only be administered by the intramuscular route
C. Onset of action occurs within two hours of the first administered dose
D. Should be administered with a diuretic to minimize edema formation
E. Usually given to adult patients in single daily doses
484.Patients on lithium carbonate therapy should be advice:

A. To drink plenty of water to avoid crystalluria
B. To stop taking the drug if they experience mild side effects
C. Not to restrict their normal dietary salt intake
D. Not to take the drug during the manic phase of their cycle
E. Not to take the drug with food
485.Hemolytic anemia due to erythrocyte deficiency of glucose –6- phosphate dehydrogenase (G-6-PD) would most likely be
precipitated by:
A. Primaquine D. Phenytoin (dilantin)
B. Ascorbic acid E. Gentamicin (Garamycin)
C. Isoniazid (INH)
486.Phentolamine (Regitine) is used as a diagnostic agent for:

A. Pheochromocytoma D. Myasthenia gravis
B. Gastric function E. Glaucoma
C. Pituitary function
487.The range of values for clinical laboratory tests reported as normal may vary among different laboratories because of
differences in:
A. Testing procedure
B. Individuals examined
C. Conditions under which the specimens are routinely collected
D. Conditions under which the specimens are preserved
E. All of the above
488.The anticoagulant action of Heparin is monitored by the:

A. Platelet count
B. Activated partial thromboplastin time
C. Prothrombin time
D. Bleeding time
E. Antiplatelet clotting time
489.Two hours after receiving his last dose of Heparin (9000 Units IV), a patient begins bleeding from his gums after brushing his
teeth. What is the most appropriate therapeutic action?
a. Inject 10 mg of phytonadione (Aqua Mephyton) intravenously
b. Inject 60 mg of protamine sulfate intravenously
c. Inject 30 mg of protamine sulfate intravenously
d. Swab a small amount of epinephrine 1:100 unto the gum tissue to produce local vasoconstriction
e. Wait for the anticoagulant effect to subside
490.A 40-year-old woman with a history of deep vein thrombosis is stabilized on 5 mg of warfarin daily. She is again admitted to the
hospital because of a suspected duodenal ulcer. In addition to the drug listed below, her warfarin is maintained at 5 mg, daily.
After several days, her prothrombin time increases 27 seconds to 80 seconds (control value is 11 seconds). Which of her
medicines may be responsible for this increase in PT time)
A. Acetaminophen (Tylenol) – 650 mg Q 4H p.r.n.
B. Cimetidine (Tagamet) – 300 mg q.i.d.
C. Milk of Magnesia – 30 ml H.s.
D. Diazepam (valium) 5 mg q.i.d.
E. Ampicillin (omnipen)-250 mg q.i.d.
491.Which of the following would be considered to be a blood sugar concentration within normal limits for a fasting adult?
A. 100 mg/dl D. 400 mg/dl
B. 200 mg/dl E. 500 mg/dl
C. 300 mg/dl
492.Which of the following drugs can interfere with the diagnosis of pernicious anemia?
a. Pyridoxine D. Ascorbic acid
B. Menadione E. Folic acid
C.thiamine
493.The Direct Van Den Berg Test measures:

A. Conjugated Bilirubin in the blood
B. Unconjugated bilirubin in the blood
C. Total bilirubin in the blood
D. Unconjugated bilirubin in the urine
E. Total bilirubin in the urine
494.A patient who has recently suffered a myocardial infarction will most likely have elevated serum levels of:
A. Creatine Phosphokinase (CPK) D. Alkaline phosphatase
B. Amylase E. Cholinesterase
C. Acid Phosphatase
495.A white cell differential count is a laboratory procedure that:

A. determines the relative proportions of the various white blood cells
B. Determines the relative proportions of whites cells to red cells
C. Differentiates between iron-deficient and folic acid-deficient anemia
D. Differentiates immature from mature white blood cells
E. Differentiates normal from abnormal white blood cells
496.Urine determinations of catecholamines and their metabolites are useful in the diagnosis of:
A. Primary aldosteronism D. Hyperthyroidism
B. Pheochromocytoma E. Cushing’s syndrome
C. Phenylketonuria
497.The Hematocrit (HCT) measure the:

A. total number of blood cells per volume of blood
B. number of red blood cells per volume of blood
C. percentage of red blood cells per volume of blood
D. weight of hemoglobin per volume of blood
E. weight of red blood cells per volume of blood
498.Which of the following is not a white blood cell or leukocyte?

A. Basophil D. Reticulocyte
B. Eosinophyl E. Lymphocyte
C. Monocyte
499.The Bromsulphalein (BSP) excretion test is a measure of:

A. Liver function D. Kidney function
B. Thyroid function E. Circulation time
C. Pancreatic function
500.A unit dose package is one that contains:

A. one discrete pharmaceutical dosage forms (E.G., one tablet, one ampule, etc)
B. Solid dosage forms only
C. The exact amount of medication necessary to fill a prescription (E.G. 30 tablets in a sealed container)
D. The exact dose of drug ordered for a given patient
E. A 24-supply of a specific drug that is sent to a nursing unit
501.The therapeutic value of electroconvulsive therapy (ECT) is due to the:

A. convulsion itself
B. electric current itself
C. antipsychotic medication administered immediately after the convulsion
D. Rapid succession of intense pain followed by intense relaxation
E. Enhanced memory of the events that precipitated the psychosis
502.Patients about to undergo electroconvulsive therapy (ECT) are usually given succinylcholine to:
A. Reduce the severity of the central nervous system (CNS) discharge
B. Modify muscular contractions to prevent injury to the patient
C. Lengthen the duration of the convulsion
D. Prevent hyperventilation due to anxiety
E. Make the patient unaware of the shock
503.The intentional administration of intravenous fluid into subcutaneous tissue is called:

A. Infilatration D. Hemodialysis
B. Venoclysis E. Hemolysis
C. Hypodermoclysis
504.Intermittent IV therapy is used to:

A. avoid anticipated or potential stability or compatibility problems
B. Reduce the potential of thrombophlebitis
C. Promote better diffusion of some drugs into tissues because of the greater concentration gradient
D. Both A and C
E. All of the above
505.Parenterally administered electrolytes are usually ordered in:

A. equivalents D. Millimoles
B. Milliequivalents (MEQ) E. Microgram (UG)
C. Milligrams percent (MG % or MG/DL)
506.A drug information source that consists of microfiche copies of papers published in medical and pharmaceutical journals is:
A. Current contents/clinical practice
B. De Haen Drug Information system
C. Index Medicus
D. International Pharmaceutical Abstracts
E. IOWA Drug information service
507.Which of the following is the best example of an automated drug information retrieval system?
A. Medlars
B. Paul de Haen drug information systems
C. Index Medicus
D. IPA
E. FDA Clinical experience Abstracts
508.Martindale’s extra pharmacopoeia is most similar in content to:

A. Facts and Comparisons D. United States dispensatory
B. Physician’s Desk Reference E. United States Pharmacopoeia
C. National Formulary
509.Generally, drug literature abstracts are most appropriately used to:

A. Provide the individual requesting the information with written documentation
B. Provide detailed answers to specific questions
C. Answer general question
D. Provide a rapid response to questions
E. Identify those articles which are likely to contain the desired information
510.Kernicterus is a drug-induced disorder that may occur in the neonate following therapy with which of the following drugs?
A. Isoniazid (INH) D. Gentamicin (Garamcin)
B. Sulfisoxazole (Gantrisin) E. Promethazine (Phenergan)
C. Phenytoin (Dilantin)
511.Generally, the presence of impaired renal function or overt renal failure in a patient reduces his requirements for:
A. all drugs
B. Drugs that are reabsorbed from the kidney tubules
C. Drugs that are directly excreted or whose active metabolites are excreted by the kidney
D. Drugs that are metabolized by the liver but are excreted by the kidney
E. Both C and D
512.A common result of “slow metabolic acetylation” of isoniazid therapy:

A. enhanced sensitivity to therapy and toxicity
B. peripheral neuropathy that is resistant to pyridoxine therapy
C. slow metabolism and reduced therapeutic response
D. slow metabolism and enhanced therapeutic response
E. slow acetylation but normal therapeutic response
513.Electrolytes should not be added to intravenous solutions of amphotericin B (fungizone) because:

A. The solution is hypertonic by itself
B. They will precipitate (salt-out) the drug
C. They will lower the PH and hasten the decomposition of the drug
D. All of the above
E. None of the above
514.Which of the following enzymes would be elevated in acute pancreatitis?

A. Alkaline Phosphatase D. Creatinine Phosphokinase
B. Acid Phosphatase E. Amylase
C. Lactic dehydrogenase
515.The cation most prevalent in the extracellular fluid of the human body is:
A. Sodium D. Phosphate
B. Chloride E. Potassium
C. Magnesium
516.It implies the practice of pharmacy in the presence of patients:

A. Community C. Manufacturing
B. Hospital D. Clinical
517.The following are clinical functions of pharmacist, except:

A. Participate in in-service and patient education program
B. Assessing for drug interactions and adverse effects
C. Taking quarterly physical inventory
D. Preparation of medication history
E. All
518.Nursing duty not common to all shifts in any patient care area:
A. Administering regularly schedule medication
B. Taking progress notes
C. Transcribing medication order
D. Taking vital signs
E. All
F. None
519.Having a professional obligation to disseminate drug information appropriately:

A. Teacher C. Salesclerk
B. Medical Practitioner D. Pharmacist
520.The Provision of advise on therapeutic matters to patients or members of the health care team:
A. Communication C. Counseling
B. Consulting D. Drug Monitoring
521.The Coordinator of patient care:

A. Administrator C. Nurse
B. Pharmacist D. Physician
522.That level of patient care devoted to those with long-term illnesses or disabilities:
A. Chronic care C. Self-care
B. Counselling D. Acute care
523.Patient care unit having a rapid turnover, early morning physician rounds and busier on weekdays than on weekends:
A. Intensive C. Surgical
B. Medical D. Obstetric
524.All of the following should be monitored by the pharmacist except:

A. IV admixture incompatibilities C. Drug - drug interaction
B. Latrogenic disease D. Adverse Drug reaction
525.Distribution of patients to various units of a hospital may be determined by all of the following, except:
A. Admitting physician
B. Attending nurse
C. Diagnosis
D. Type of Accommodation preferred by the patient
526.Interviewer’s role may be described or defined as, except:

A. Making judgment about the patient C. Showing interest
B. Showing concern D. Showing respect
527.The most convenient time for the Pharmacist to discuss the importance of patient’s take home medication:
A. Clinical interview C. Admission interview
B. Discharge interview D. Medical interview
528.Major dimensions of clinical interview:

A. Interpersonal experience D. Personal experience
B. Scientific inquiry E. Both A and B
C. Communication F. All
529.Before entering the patient’s room, the pharmacist should not:

A. Note the patient’s social & occupational history
B. Know the physical condition of the patient
C. Make a mental preparation
D. Learn the ID of the patient
E. None
530.Primary means to achieve the goal of clinical interview:

A. Literary skill C. Culinary skill
B. Effective communication D. Counseling
531.Not a professional responsibility of the pharmacist:

A. Inform the patient on the hazardous effect of smoking
B. Refer the patient to health personnel or health agency if necessary
C. Instruct the patient in the use of appliances
D. Clarify patient’s understanding of medication dosage
E. None
532.Purpose of clinical interview:

A. Benefit the pharmacist
B. Benefit the patient
C. To obtain the patient’s medication History
D. Both B & C
E. All
533.Phase of clinical interview where the pharmacist summarize and make recommendation to patient:
A. Middle
B. Termination
C. Initial
534.Components of scientific inquiry include:

A. Determining if the patient is allergic to medication
B. Determining if the patient knows why he is taking the medication
C. Determining if the patient is smoking/drinking alcoholic beverages
D. Determining if the patients takes someone else medicine
E. All
535.Best type or mode of questioning during the middle phase of interview:

A. Questions answerable with yes or no
B. Open question
C. Open-ended question
D. Direct question
E. Any type
536.A common disease affecting teenagers primarily, which is precipitated by occlusion of the duct-draining sebaceous glands:
A. Psoriasis C. Acne vulgaris
B. Urticaria D. Photoallergic reaction
537.Diagnostic test for iron deficiency:

A. low wbc C. Low creatinine
B. Low serum ferritin D. None of the given
538.Which is not a sign and symptom of DM?

A. Delayed wound healing C. dryness of the skin
B. blurred vision D. Excessive hunger and thirst
539.Most appropriate for transient or short-term insomnia:

A. Benzodiazepines C. Amino acids
B. Hypnotics D. Barbiturates
540.The most commonly used agent for the self-treatment of everyday situational anxiety:
A. barbiturates C. Antihistamine
B. antipsychotics D. alcohol
541.Fear and avoidance of being alone in public places is known as:

A. Social Phobia C. Agorophobia
B. Simple phobia D. Hydrophobia
542.Angina pectoris is caused by lack of:

A. Ca B. Oxygen C. K D. C02
543.All of the following are possible treatment for traveler’s diarrhea except:
A. Anti-infective agents C. Rehydration
B. Antimotility agents D. Magnesium citrate
544.Sulfonyureas are a primary mode of therapy in the treatment of:

A. Insulin-dependent DM Patients
B. Diabetic patients experiencing severe hepatic or renal dysfunction
C. Patients with diabetic ketoacidosis
D. Non-insulin dependent DM patients
545.After being absorbed from the intestine, iron is carried through the blood in the form of:
A. Ferritin C. Hemosiderin
B. Transferrin D. Apotransferrin
MATCHING TYPE:
ABOVE NORMAL OF: INTERPRETATION
E 546. Uric acid A. Diabetes mellitus
G 547. Ammonia B. Bone Metastasis
A 548. Glucose C. Heavy metal poisoning
I 549. Lymphocytes D. Polycythemia Vera
C 550. Basophils E. Gout
H 551. WBC F. Osteoblastic bone disease
D 552. RBC G. bleeding in the bowel
F 553. Alkaline Phosphatase H. Infection
J 554. Eosinophils I. Viral Disorder
B 555. Calcium J. Allergy and parasitic disorder
LETTER ONLY
F 556. Ibuprofen A. UTI
B 557. Diazepam B. Anxiety
J 558. Verapamil C. Bronchodilator
C 559. Aminophylline D. Antiviral & Antineoplastic
E 560. Haloperidol E. Delusions & Hallucinations
G 561. Cyclophosphamide F. Dysmenorrhea
I 562. Hydrochlorothiazide G. Chronic Lymphocytic Leukemia
H 563. Lithium H. Manic Episodes
A 564. Methenamine I. High Blood Pressure
D 565. Interferon J. Ca Channel Blocker
Interpretation of case report (Answer 566-576 Using the following information).

A 52-year-old man with a history of peptic ulcer presented with vague symptoms of weakness, fatigability, anorexia, weight loss
and gastrointestinal pain. Physical examination revealed the skin and mucous membrane to be pale. The sclera appeared blue or
pearly white, and there was slight tenderness in the epigastric area. Laboratory findings include (Normal values in parenthesis):
Hemoglobin 9.3 GM/DL (14-18)
RBC 4.3 x 106/mm3 (4.6 – 6.2)
Serum Iron 39 MCG/DL (80-160)
Red Blood cells appeared smaller than normal with very pale appearing centers.
566.The symptoms, signs and laboratory finding in this patient suggest:

A. Pernicious anemia C. Hypochromic microcytic anemia
B. Megaloblastic anemia D. Aplastic anemia
C.
567.Pernicious anemia is primary related to a deficiency of:
A. Pyridoxine D. Folic acid
B. Intrinsic factor E. Conjugase enzymes
D. Iron
568.Pernicious anemia is most easily and commonly treated by:

A. Oral administration of vitamin B12
B. Oral administration of intrinsic factor
C. I.M. Administration of vitamin intrinsic factor
D. I.M. administration of vitamin B12
E. I.V. Administration of Vitamin B12
569.Megaloblastic anemia is associated with a deficiency of:

A. folic acid D. Intrinsic factor
B. Pyridoxine E. Iron
C. Vitamin B12
570.Hypochromic microcytic anemia is also known as:
A. aplastic anemia D. Pernicious anemia
B. iron deficiency anemia E. Sickle cell anemia
C. Hemolytic anemia
571.Mr. Jones appear to suffer from:

A. insufficient iron in his diet C. achlorhydria
B. A recurrence of his peptic ulcer D. none of the above
572. Mr. Jones would probably be treated with:

A. An antacid D. Parenteral iron
B. Oral iron E. all of the above
C. An antacid and oral Iron
573. Iron administration might mimic which of the following signs possibly associated with peptic ulcer?
A. Melena (Black tarry, stools) C. Gastric discomfort
B. Constipation D. All of the above
574.Oral iron preparations should not be given concurrently with which of the following drugs?
A. Digoxin D. Antacid
b. Tetracycline E. Both B and D
C. Lasix
575.Which of the following drug(s) has/have been associated with inducing folic acid depletion?
A. Oral contraceptives D. Phenytoin
B. Primadone E. All of the above
C. Methotrexate
576.Which of the following agents is the safest to recommend if a patient with severe pain due to periodic headaches was allergic to
ASA which induced bronchospasm and rhinitis?
A. Ecotrin D. Meclofenamate
B. Acetaminophen E. any of the above are ok
C. Iburpofen
577.Which of the following would not enhance monitoring of hypertensive patient?

A. Continued patient education
B. Positive reinforcement
C. Assessment of compliance
D. Frequent blood pressure checks
E. Assumption of a passive role by the pharmacist
578.Hypertension is a persistent diastolic pressure of:

A. 110 mm Hg or higher D. 50 mm Hg or higher
B. 70 mm Hg or higher E. none of the above
C. 90 mm Hg or higher
579.Fatigue, lethargy and weakness are caused by the loss of which ion?
A. Sodium D. magnesium
B. Lithium E. Potassium
C. Calcium
580.General treatment measures for CHF include:

A. Weight loss D. All of the above
B. Sodium restriction E. Both A and C
C. Bed rest
581.Which of the following is not a sign or symptom occurring in CHF?

A. Bradycardia D. Decrease exercise capacity
B. shortness of breath E. Edema
C. Hepatomegaly
582.An osmotic diuretic is:

A. Diamox D. Midamor
B. Mannitol E. Enduronyl
C. Lasix
583.Adverse effects associated with thiazides are:

A. Hypokalemia D. Hypovolemia
B. Hyperuricemia E. All of the above
C. Hyperglycemia
584.What is the initial drug of choice for atrial tachycardia?

A. Verapamil D. Quinidine
B. Edrophonium E. None of the above
C. Physostigmine
585.The calcium channel blockers are:

A. Class I Antiarrhythmic drugs D. Class IV Antiarrhythmic Drugs
B. Class II Antiarrhythmic drugs E. Class V Antiarrhythmic drugs
C. Class III Antiarrhythmic drugs
586.The blood concentration of which of the following cations would normally rise if a patient become hypophosphatemic?
A. Sodium D. iron
B. Magnesium E. Calcium
C. Potassium
587.Pyrvinium pamoate (Povan) tablets:

A. May cause nausea, vomiting, diarrhea or dizziness
B. Should not be used in patients with inflammatory GIT conditions
C. Will usually stain the stool red for several days after treatment
D. All of the above
588.Which of the following is specific for the measurement of glucose?

A. Benedict’s solution D. Testape
B. Acetest Tablets E. Ketostix
C. Clinitest tablets
589.Which of the following is an example of a delusion?

A. Hearing strange voices
B. Seeing someone who is not really there
C. The feeling that ants are crawling all over the body
D. The lack of any emotional response to any situation
E. The belief that an advertisement on TV is speaking directly to the individual with a secret message.
590.The four “A’S” that Bleuler use to characterize schizophrenia include all of the following, except:
A. Anxiety D. Autism
B. Ambivalence E. Alteration of effect
C. Association defect
591.Schizophrenia, according to the biologic theory, is thought to be due to:

A. Excess of acetylcholine D. Dopamine deficiency
B. Excess of dopamine E. Zinc deficiency
C. Excess of calcium
592.The symptoms of asthma result from:

A. increased release of performed mediators from mast cells
B. increased adrenergic responsiveness of the airways
C. increased vascular permeability of bronchial tissue
D. decreased calcium influx into the mast cell
E. decreased prostaglandin production
593.Acute exacerbations of asthma can be triggered by all of the following, except:

A. Bacterial or viral pneumonia
B. Hypersensitivity reaction to penicillin
C. Discontinue of asthma medication
D. Hot, Dry weather
E. Stressful emotional events
594.The selection of an oral theophylline product depends primarily on:

A. The % of the theophylline content of the product
B. Pre-existing disease states
C. Theophylline half life
D. Concurrent asthma medication
E. Age of patient
595.Which of the following drugs is available OTC for the treatment of nausea and vomiting:
A. Dimenhydrinate D. Scopolamine
B. Perphenazine E. Danthron
C. Prochlorperazine
596.In the emergency room, the preferred first line of therapy for asthma is:
A. Theophylline D. Chromolyn sodium
B. -agonist E. Anthistamine
C. Corticosteroids
597.The most frequent dose limiting adverse effect associated with cancer chemotherapy is:
A. Alopecia D. Myelosuprresion
B. Mucositis E. Renal dysfunction
C. Nausea and vomiting
598.Most of the clinically available anticancer agents have an underlying mechanism of action that acts as:
A. cell-growth inhibitors
B. stimulation of natural body defense mechanisms
C. interference with cell wall production
D. inhibition of cancer cell nutrient absorption
E. receptor-site blockade of cancer cell secretions
599.The most common infective organisms frequently present in COPD are:

A. S. aureus D. Klebsiella
B. H. Influenzae E. Both B and C
C. Streptococcus Pneumoniae
600.The major risk to patients experiencing depressive episodes is:

A. Toxic serum levels of antidepressants drug
B. Suicide
C. Loss of appetite
D. Insomnia
E. Impaired memory
601.Uncontrolled HPN may lead to:

A. Raynaud’s disease D. Nephrotic syndrome
B. Cirrhosis E. Congestive heart failure
C. Crohn’s disease
602.The antiestrogen drug, Tamoxifen, is used in the Treatment of:

A. Hodgkin’s disease C. Breast cancer
B. Bladder cancer D. colorectal cancer
603.What is the daily recommended allowance of elemental iron for an adult?

A. 0.1 mg D. 100 mg
B. 1.0 mg E. 1 G
C. 10 mg
604.In which of the following conditions is iron supplement indicated?

A. primary hemochromatosis
B. patients receiving multiple blood transfusions
C. pregnancy
605.Which of the following statements regarding emphsema is false?

A. characterized by destruction of alveolar spaces
B. small airway obstruction, airway trapping
C. frequently associated with smoking history
D. characterized by increased sputum production
606.Propranolol has been approved to treat:

A. Hypertension D. Migraine headache
B. Angina pectoris E. Any of the above
C. cardiac arrhythmias
607.Which of the following agents may be used to prevent or modify infections with the viruses of hepatitis, poliomyelitis?
A. Gamma globulin D. clofazimine
B. Diphenylthiourea E. Ditophal
C. amithiozone
608.The most common cause of traveller’s diarrhea is bacterial infection with escherichia coli, prophylactic ___taken daily can
prevent traveller’s diarrhea:
A. Pen G D. Neomycin
B. Amoxicillin E. Isoniazid
C. Doxycycline
609.After a swimming class, a 21-year-old patient developed symptoms that were compatible with a mild upper respiratory infection.
However, the nasal discharge has continued for 2 weeks and he is complaining of a headache at this time. The most effective
drug therapy for the management of his illness:
A. Pen V D. Phenylpropranolamine
B. Oxymetazoline E. chlorpheniramine
610.Hepatitis may be detected by all of the following, except:

A. The presence of jaundice D. Incrase bilirubin
B. Increase SGOT E. none of the above
C. Increase SGPT
611.The generic name of aldactone is:

A. Triamterene D. Amiloride
B. Spironolactone E. benzthiazide
C. Polythiazide
612.CSF is obtained by:

A. Phlebotomy C. Lumbar puncture
B. Paracentesis D. Clean catch urine
613.Isoniazid is very active against:
A. Streptococci D. Vibrio
B. Staphylococci E. Escherichia
C. Mycobacter
614.Type of endocarditis which involves a more virulent organisms and resist the body’s natural defense mechanism:
A. Acute endocarditis C. Right aided endocarditis
B. Subacute endocarditis
615.Oral rehydrating solution is composed of:

A. glucose C. Citrate or bicarbonate
B. Sodium chloride D. All
616.A common name for the antidiuretic hormone elaborated by the posterior pituitary gland:
A. Norepinephrine C. Luteotropic hormone
B. Vasopressin D. Secretin
617.The aminoglycoside antibiotics are:

A. Bactericidal for a wide range of gram positive and gram negative microorganisms
B. Suitable for long term treatment of chronic urinary tract infection
C. Metabolized by the liver
D. All of the above
618.Iron deficiency anemia maybe the result of:

A. Lack of HCL in the stomach C. all of the above
B. Excessive menstrual bleeding
619.Sickle cell anemia is a disorder occurring exclusively in:

A. Black people C. Southern Spanish
B. Italians
620.Causative agent of amebiasis:

A. Klebsiella C. Entamoeba Histolitica
B. Staphylococcus
621.The following are signs and symptoms of viral Hepatitis, except:

A. Anorexia, yellow discoloration of the skin
B. Dysuria
C. All of the above
622.Treatment of amebiasis:
A. Penicillin and chloramphenicol C. all of the above
B. Metronidazole
623.All can be considered as management of alcoholic liver disease, except:

A. Penicillin therapy C. Bedrest
B. Nutritional supplement
624.Represents a group of medication that are placed in the nursing station at which there may be no direct charge to the patient:
A. Charge floor stock system C. all of the above
B. Non-charge floor stock system
625.TPN is administered:
A. Peripherally C. all of the above
B. Orally
626.Hallmark symptom of chronic bronchitis:

A. Wheezing C. Dyspnea
B. Excessive cough
627.Keystone treatment of pulmonary tuberculosis:

A. streptomycin C. Isoniazid
B. Rifampin
628.Second major drug commonly used for the treatment of tuberculosis:

A. Streptomycin C. Isoniazid
B. Rifampin
629.Long standing hypertension leads to tissue Damage in all of the following, organs, except:
A. Heart, Kidney C. Brain
B. Lungs
630.In Inventory control, the turnover rate is calculated by which formula?

A. Annual purchases/annual inventory
B. Annual purchases – annual inventory
C. Annual Purchases * Annual inventory
631.Failure of the heart to deliver adequate quantities of blood to the metabolizing tissues;
A. Angina pectoris C. Congestive heart failure
B. Rheumatic heart disease
632.Reduction of water and sodium can be achieved by means of:

A. Reduction of fluid intake C. all of the above
B. Diuretics
633.Methylxanthine drug:
A. Epinephrine C. Isoproterenol
B. Theophylline
634.Advantages of unit dose distribution system:

A. Increased drug waste pilferage C. None of the above
B. Increased medication errors
635.Which of the following is an inappropriate therapeutic use for the prophylaxis of classic migraine headache?
A. methysergide C. Lithium
B. Clonidine
636.Which of the following hormones is secreted by the thyroid gland?

A. Corticotropin C. Triiodothyronine
B. Gonadotropin

1. Two-thirds to three-fourths of acute respiratory illnesses are caused by viruses. Upper Respiratory Tract Infections
include--Pharyngitis, laryngitis, rhinitis, and sinusitis. Viral infections are generally mild and self-limited, so
treatment is not usually necessary. Experimental vaccines to certain viral serotypes have been prepared.
However, their usefulness is questionable because of the multitude of serotypes and the vagueness of the
mechanisms of immunity (Harrison’s 15th, Chap.18 and 30).
2. (C) Drug therapy for osteoarthritis (OA) today is palliative. NSAIDS decrease joint pain and improve mobility in
patients with OA (Harrison’s 16th, p.2042)
3. Salicylates (e.g. ASA) inhibit tubular secretion of uric acid when given low doses (e.g.less than 2g/day) of aspirin.
At high doses, may cause uricosuria (Shargel)
4. (B) Alzheimer’s Disease is a progressive brain disorder that causes a gradual and irreversible decline in memory,
language skills, perception of time and space, and, eventually, the ability to care for oneself (Encarta 2005)
5. The cause and effect between hyperthyroidism and duodenal ulcer is unclear. In multiple endocrine neoplasia
(MEN) types 1 patients with hyperparathyroidism, duodenal ulcer may be the result of associated pancreatic
tumors, which secrete excessive quantities of gastrin (Harrison’s 15th ed).
Factors involved in the development of duodenal ulcer:
 (A)Spicy food—(or food in general) may increase gastric acid production
 (B)Tobacco-- There is higher incidence of duodenal ulcers among smokers than with non smokers. Also,
smoking appears to decrease healing rates, impair response to therapy, and increase ulcer-related
complications (e.g. perforation). The mechanism for increased ulcer susceptibility among smokers is still
unknown.
 (C)Genetic--First-degree relatives of duodenal ulcer patients are 3x as likely to develop ulcer, but the
probable role of H. pylori infection in contacts is a main consideration. Consequently, the role of genetic
predisposition in common peptic ulcer diseases has not been proven.
 (D) Helicobater pylori- this microbe is able to facilitate gastric residence, induce mucosal injury, and
avoid host defense. Different strains of H. pylori produce different virulence factors (Harrison’s 15th,
Chap.285).
6. Weeds, grasses and trees that depend on wind for cross-pollination produce ample amounts of pollen for wide
distribution to provoke seasonal allergic rhinitis. Allergic rhinitis is characterized by sneezing, rhinorrhea,
obstruction of the nasal passages; conjunctival, nasal, and pharyngeal itching; and lacrimation (Harrison’s 15 th,
Chap.310)
7. (E) Iron deficiency anemia is characterized by hypochromic microcytic red cells and not megaloblastic findings
(Harrison’s 16th, 588-590)
8. Therapies for metastatic prostate cancer:
(A)Estrogen—decreases serum testosterone levels. Diethylstilbestrol (3 mg/d) produces castrate levels of
testosterone in 1 to 2 weeks and is inexpensive.
(B)Leuprolide—is a GnRH(gonadotropin releasing hormone) analogue. It lowers serum testosterone levels. It
initially produce a rise in luteinizing hormone (LH) and follicle-stimulating hormone (FSH), followed by a
downregulation of receptors in the pituitary gland, which effects a chemical castration.
(C)Orchiectomy—is the surgical removal of one or both testicles. Surgical orchiectomy is the "gold standard"
but is the least preferred by patients.
(Harrison’s, 15th, Chap. 95); (Goodman and Gilman, Chap.51)
9. The following are the prognostic variables of breast cancer:

 The most important prognostic variables are provided by tumor staging. The size of the tumor and the
status of the axillary lymph nodes provide reasonably accurate information on the likelihood of tumor
relapse.
 Other prognostic variables that influence disease-free and overall survival:
-Estrogen and progesterone receptor status-Tumors that lack either or both of these receptors are
more likely to recur than tumors that have them.
-“Several studies suggest that tumors with a high proportion (more than the median) of cells in
the S phase pose a greater risk of relapse and that chemotherapy offers the greatest survival benefit for these
tumors. For this reason, some clinicians use S-phase assessment as a deciding factor for instituting adjuvant
therapy when other pathologic features are unclear. Assessment of DNA content in the form of ploidy is of
modest value, with nondiploid tumors having a somewhat worse prognosis”.
-Histologic classification--Tumors with a poor nuclear grade have a higher risk of recurrence than
tumors with a good nuclear grade.
-Molecular changes in the tumor are also useful. Tumors that overexpress erbB2 (HER-2/neu) or
have a mutated p53 gene have a worse prognosis.
-A tumor must generate a neovasculature to grow. The presence of more microvessels in a tumor
is associated with a worse prognosis.
(Harrison’s, 15th ed, Chap.59)
10. “Ferrous iron is absorbed by duodenal and jejunal cells, oxidized to ferric iron, and bound to ferritin. It is then
slowly released, binds to plasma transferrin (an iron-specific globulin) and other proteins, and is transported to
tissues”. (Harrison’s 15th, Chap. 396)
11. Calcium is important for teeth and bones (as a calcium hydroxyphosphate), and in many body fluids (as complex
proteinaceous compounds) essential to muscle contraction, the transmission of nerve impulses, and the clotting of
blood. (Microsoft ® Encarta ® Reference Library 2005)
12. (E) Encephalitis refers to any infectious disease of the human central nervous system characterized by
inflammation of the brain.
Most types of encephalitis are caused by viral infection of the central nervous system. An infected arthropod
ingests a blood meal from a human and infects the host. The initial period of viremia is thought to originate most
commonly from the lymphoid system. Viremia leads to CNS invasion.(Microsoft Encarta 2005); (Harrison’s 15th
ed)
13. (D) Pernicious anemia is associated with a marked decrease in intestinal absorption of cobalamin (vitamin B 12)
due to an absence of gastric parietal cell intrinsic factor required for cobalamin absorption (Harrison’s 15th,
Chap.286).
14. (C) In diabetes mellitus (DM), because cells cannot use glucose, other biomolecules such as fats and proteins are
broken down and used to meet the energy requirements of the body. As a result of proteins loss, there is decrease
ability to fight infections.
The 3 cardinal manifestations of DM are polyuria (excessive urination), polydipsia (excessive thirst that results
from water loss), and polyphagia (because of inability to use sugars, and loss of proteins and fats from the body)
(Marieb, p.282)
15. (E) Rubeola and mumps--MMR (measles, mumps, rubella) vaccine; Poliomyelitis—Poliovirus vaccine, inactivated
(IPV) or Oral poliovirus vaccine (OPV); pertussis—DTP(diphtheria, tetanus, pertussis) (Katzung, 1052-1053)
16. (C) Acute inflammation primarily involves neutrophils, while chronic inflammation involves infiltration with
mononuclear cells, which include macrophages, lymphocytes and plasma cells (Robbin’s Pathology, p. 47-79)
17. Systemic antifungal agents are Amphotericin B, Flucytosine, Imidazoles, Nystatin, Terbinafine and Griseofulvin.
Topical anitfungals are Amphotericin B,Butenafine, Butaconazole, Ciclopirox, Clioquinol, Clotrimazole, Econazole,
Gentian violet, Ketaconzole, Miconazole, etc. (Shargel, 845-855)
18. (B) Melanoma is a malignant tumor, most often on the skin, that contains dark pigment and develops from a
melanin-producing cell (melanocyte). Malignant tumors are likely to metastasize.
Adenoma, chondroma and papilloma are all benign.
Adenoma refers to a benign tumor of a gland.
Chondroma refers to a benign abnormal growth of the cartilage.
Papilloma is a benign tumor of the skin or mucous membrane projecting from a surface. Ex. wart
(Microsoft® Encarta® Reference Library 2005)
19. Data from postmortem examinations of Sudden Cardiac Death victims matches the clinical observations on the
prevalence of coronary heart disease as the major structural etiologic factor. More than 80% of SCD victims have
pathologic findings of coronary heart disease (Harrison’s 15th, Chap. 39).
20. (E) TB skin test is an example of of type IV cell-mediated hypersensitivity (Prescott, p.638)
(A) Cretinism, deficiency disease caused by congenital absence of thyroxine, a hormone secreted by the thyroid
gland, and characterized by defective mental and physical development.
21. (C) Rheumatic fever develops as a result of untreated or insufficiently treated Group A Streptococcus
(Streptococcus pyogenes) disease. Rheumatic fever can be considered an autoimmune disease. S.pyogenes
contains antigens similar to host cell antigens. Antibodies, which are formed against these bacterial antigens bind
to cross reactive host cell antigens and cause immune injury to host cell tissues (Delisle and Tomalty).
22. (E) Histoplasma capsulatum reach the alveoli on inhalation and are transformed there to budding forms. After
some time, an intense granulomatous reaction occurs. Caseation necrosis or calcification may mimic tuberculosis
(Harrison’s 15th, Chap.201).
23. (D) refer to #13
24. (B) Gout is a metabolic disorder caused by excessive uric acid (product of purine metabolism) production and
deposition in joints leading to painful swelling (Encarta 2005).
25. (E) The cost of medicine
26. Candidiasis is a fungal infection caused by Candida. Choices B, C,and E are antibacterial agents, therefore, not
effective against Candidiasis. Choice D (griseofulvin)---although an antifungal, is ineffective against Candida
(Shargel, p.1003).
27. “After infection with Hepa B virus, the first virologic marker detectable in serum is HBsAg (Hepatitis B surface
antigen). Circulating HBsAg precedes elevations of serum aminotransferase activity and clinical symptoms and
remains detectable during the entire icteric or symptomatic phase of acute hepatitis B and beyond. In typical
cases, HBsAg becomes undetectable 1 to 2 months after the onset of jaundice and rarely persists beyond 6
months. After HBsAg disappears, antibody to HBsAg (anti-HBs) becomes detectable in serum and remains
detectable indefinitely thereafter”.
“Generally, in persons who have recovered from hepatitis B, anti-HBs and anti-HBc(anti-Hepatitis B core antigen)

persist indefinitely” (Harrison’s Chap.295).
28. When tetracycline is given during the second half of pregnancy, in infancy, and in childhood up to 8 years of age, it
causes both a permanent discoloration of the teeth and enamel hypoplasia (Harrison’s 15th, Chap.31).
29. The tetrapyrrole pigment bilirubin is a breakdown product of heme (ferroprotoporphyrin IX). 70 to 80% of the 250 to
300 mg of bilirubin produced each day is derived from the hemoglobin breakdown in senescent red blood cells
(Harrison’s 15th, Chap.45).
30. (B) Cortisone
31. (C) The efficiency of a person’s circulatory system is obtained by taking arterial pulse and blood pressure. Arterial
pulse, blood pressure, respiratory rate and body temperature are collectively termed as vital signs (Marieb, 338)
32. Leukocytes or white blood cells (WBC) include neutrophils, T and B lymphocytes, natural killer (NK) cells,
monocytes, eosinophils, and basophils. Leukocytes are the major cells comprising inflammatory and immune
response (Harrison’s 15th, Chap.64).
33. (A) Barbiturate overdose causes severe respiratory depression. The treatement includes artificial respiration and
purging of the stomach (Lippincott, 98)
34. (E) Corticosteroids may induce psychotic reactions, and therefore should be used with caution in patients with
history of psychotic disease.
Corticosteroids inhibit the immune system and the inflammatory response. Their use is associated with an
increased susceptibility to infection and a risk for reactivation of latent tuberculosis. They should be administered
only if absolutely necessary and simultaneously with suitable and effective antimicrobial or antifungal therapy.
There is a considerable debate associating the use of glucocorticoids and risk of peptic ulcer. However, the
mechanism is still not elucidated.
These drugs may exacerbate hyperglycemia in patients with diabetes. (Goodman and Gilman)
35. Phenobarbital (Luminal) is an example of a long-acting barbiturate.
Amobarbital (Amytal)—intermediate-acting
Pentobarbital (Nembutal)—short-acting
Secobarbital (Seconal)—short-acting(Shargel, p.276)
Refer to MANOR handout (Pharmacolgy, p.2) for the classification of Barbiturates
36. Methicillin-resistant strains of Staph. aureus are widely distributed among hospitals and are increasingly isolated
from community-acquired infections. (Goodman and Gilman)
37. (C) Hospital
38. Acromegaly results from hypersecretion of growth hormone after long-bone growth has ended. A person with
acromegaly has the following features:
 Acral bony overgrowth results in frontal bossing, increased hand and foot size, mandibular enlargement
with prognathism, and widened space between the lower incisor teeth.
 Soft tissue swelling results in increased heel pad thickness, increased shoe or glove size, ring tightening,
characteristic coarse facial features, and a large fleshy nose.
 Other commonly encountered clinical features: hyperhidrosis, deep and hollow-sounding voice, oily skin,
arthropathy, kyphosis, carpal tunnel syndrome, proximal muscle weakness and fatigue, acanthosis
nigricans, and skin tags. Generalized visceromegaly occurs, including cardiomegaly, macroglossia, and
thyroid gland enlargement.
Macroglossia=large tongue (Harrison’s 15th, Chap.328)
39. Hyperthyroidism or Graves' disease, results to elevated metabolism and activity. This condition is associated with
exophthalmos, or bulging of the eyes. The usual treatment is to administer an antithyroid drug, such as
propylthiouracil, or a dose of radioactive iodine, which is concentrated in the thyroid gland and destroys some of
the tissue.(Harrson’s; Encarta ® )
40. Evaluating and supporting vital functions (airway, breathing and circulation) are the mandatory first steps in the
initial management of patients (Shargel, p.451)
41. The WBC (white blood cell) count refers to the number of WBCs in a cubic millimeter of whole blood. Normal
values range from 4,000-11,000 WBC/mm3 . Leukopenia is an abnormal reduction in the number of WBC (below
the normal range) (Shargel, p.695)
42. Tetracycline absorption is reduced by dairy products, iron preparations, antacids, and laxatives containing
aluminum, calcium, or magnesium (Shargel, p.838)
43. Hepatitis is a blood system disease caused by different types of hepatitis virus—hepatitis A virus, hepatitis B virus,
etc. (Delisle and Tomalty)
44. Herpes simplex presents as red papules of fluid containing vesicles then appear, and these eventually burst and
form a crust. (Shargel, p.543)
45. Dental caries are formed by the growth and implantation of cariogenic microbes (cariogenic=causing caries).
Foods with high concentration of refined sugar (e.g. sucrose) increases the risk of dental caries. By the action of
bacterial plaque, sucrose is converted into volatile acids, which destroy the hydroxyapatite component of the teeth
(Shargel, p.538)
46. Refer to questions and discussion in #13 and 24
47. Measles (rubeola) is a highly contagious, acute, respiratory disease. It begins with a 2- to 4-day respiratory
prodrome of malaise, cough, coryza, conjunctivitis with lacrimation, nasal discharge, and increasing fever [with
temperatures as high as 40.6°C (105°F). Before the onset of the rash, Koplik's spots appear (1- to 2-mm blue-
white spots on a bright red background). Koplik's spots are typically located on the buccal mucosa alongside the
second molars. They are pathognomonic of measles (pathognomonic=they are not associated with any other
infectious disease). The characteristic erythematous, nonpruritic, maculopapular rash of measles begins at the
hairline and behind the ears, spreads down the trunk and limbs to include the palms and soles, and often becomes
confluent (Harrison’s 15th, Chap.194).
48. Phentolamine is a non-selective adrenergic blocker, it blocks the adrenergic receptors such as alpha and beta
receptors. Since the lungs are primarily mediated by beta-2 receptors, administration of phentolamine is
contraindicated in patients with allergic bronchial asthma (Shargel) (Lippincott, 71-72).
49. Chloramphenicol affects the hematopoietic system in two ways: by a dose-related toxic effect that presents as
anemia, leukopenia, or thrombocytopenia, and by an idiosyncratic response manifested by aplastic anemia,
leading in many cases to fatal pancytopenia (Goodman and Gilman, Chapter 47).
50. Among the choices, Chlorpheniramine is the only anti-histamine. Histamaine is a mediator allergic response
(Lippincott).

51. Teratogenic drugs cause physical defects in a developing fetus. The following are examples of teratogenic and
potentially toxic drugs:
-antineoplastic agents
-Vitamin A derivaties -anticonvulsants
-ACE-inhibitors -lithium
-Warfarin and warfarin derivatives -Antibiotics
-Estrogen and androgens -Ethanol
-Other hormonal agents: ex.antithyroid drugs
-finasteride
(Shargel, p.679-680)
52. In severe intoxication of barbiturates, the patient is comatose; respiration is affected early. Breathing may be either
slow or else rapid and shallow. Superficial observation of respiration may be deceptive because it may not
correlate to actual minute volume and to the degree of respiratory acidosis and cerebral hypoxia (Goodman and
Gilman, Chapter 17)
53. Inhalational anesthetics are absorbed and primarily excreted through the lungs (Shargel, 267). Most inhalational
anesthetics are rapidly eliminated from the body (Lippincott, 110-111).
54. (E) Penicillin V
55. When cardiovascular and repiratory system are affected, immediate death ensues.
56. Refer to #50 discussion.
57. (D)Idiosyncracy is an unusual or exaggerated reaction to a drug or food (Encarta 2005).
Tachyphylaxis is a decrease in the number of receptors due to movement of receptors from cell surface into the
cell, also known as down-regulation. It may also be due to decrease sensitivity to receptors. Most commonly
affected receptors are beta-receptors. Side effect is an undesirable secondary effect of a drug or other form of
medical treatment (Encarta 2005)
58. Common uses of epinephrine are: relieve respiratory distress due to bronchospasm, to provide rapid relief of
hypersensitivity reactions to drugs and other allergens, and to prolong the action of local anesthetics. Also, it is
used in restoring cardiac rhythm in patients with cardiac arrest and as a topical hemostatic agent on bleeding
surfaces such as in the mouth.
Epinephrine is a non-selective adrenergic agonists. Alpha -1 adrenegic agonists are also commonly used as
nasal decongestanst. (Goodman and Gilman, Chapter 10)
59. Beta-Adrenergic receptors were subdivided into beta1 (myocardium) and beta2 (smooth muscle, bronchi, and
other sites).Since beta-blockers, particularly non-selective ones, affects both beta 1 and beta 2, therefore the
appropriate answer is (D) heart and bronchi.(Goodman and Gilman, Chapter 6)
60. Beta blockers can have varying effects on glucose levels:
 Mask the signs of hypoglycemia by blunting reflex tachycardia
 Potentiate hypoglycemia by inhibiting glycogenolysis and glucagons release
 Promote hyperglycemia by inhibiting insulin secretion and decreasing insulin tissue sensitivity (Shargel,
p.356)
61. In selecting a drug, it is not wise to choose a newly marketed drug because of the unknown side-effects, toxicities,
and drug interactions associated with the drug.
62. Sodium nitroprusside is used primarily to treat hypertensive emergencies.
Diazoxide (Hyperstat IV) was initially used for the treatment of hypertensive emergencies, but sodium
nitroprusside soon replaced diazoxide as the drug of choice for this indication. Diazoxide still holds a place in the
treatment of hypertensive emergencies in situations in which accurate infusion pumps are not available and close
monitoring of blood pressure is not feasible (Goodman and Gilman, Chapter 33).
63. Osmotic diuretics, such as Mannitol, are used to maintain urine flow after acute toxic ingestion of substances
capable of inducing acute renal failure. They are the mainstay of treatment for patients with increased intracranial
pressure, or acute renal failure due to shock, drug toxicities, and trauma (Lippincott, page 233)
64. Ethacrynic acid can be safely given to patients with sulfonamide allergy (Shargel, page 10 86), because this drug
is not a sulfonamide derivative.
Loop diuretics can be divided into anthranilic acid derivatives having sulfonamide substituents (e.g. furosemide,
bumetanide), or aryloxyacetic acids without a sulfonamide substituent (e.g. ethacrynic acid).
Hydrochlorothiazide cannot be used because it is a sulfonamide derivative.
(Shargel, 322-325)
65. Cardiac glycosides (e.g. digoxin) are used as an inotropic agents. Inotropics enhance the contractility of cardiac
muscles. Unlike beta-blockers, it is not associated with exacerbation of CHF. Progressive dysrythmia is one of its
main cardiac effects (Lippinccott, page 160).
Drugs that may exacerbate or precipitate congestive heart failure(CHF) and thus, should be avoided are: NSAIDs,
alcohol, beta-blockers, calcium channel blockers, and some anti-arrhythmic drugs (Lippinott, page 155)
Estrogen is contraindicated for patients with CHF because of its cardiovascular effects, such as hypertension,
increased incidence of thromboembolic disease, stroke and myocardial infarction (Shargel, page 342).
Beta-blockers—In this question, choice (C) beta-blocker may be a one of the possible answers. While abrupt
administration of large doses may intensify heart failure (especially acute HF), the administration of gradually
increasing doses has been reported to improve HF symptoms, and to reduce all-cause death, in patients
receiving ACE-inhibitors. Metoprolol, Bisoprolol and Carvedilol have been shown to improve survival in HF
patients (Harrison’s 16th, page 1375).
66. Digitoxin is metabolized extensively by the liver before excretion in the feces. Since Phenobarbital is an enzyme
inducer, therefore, digitoxin metabolism will be affected unlike digoxin, ouabain, which are eliminated renally.
67. Stable or classic angina--usually caused by exertion, emotional stress, or heavy meal usually. It is usually relieved
by rest, nitroglycerin, or both.
Unstable angina has decreased response to rest or nitroglycerin. Angina decubitus or nocturnal angina occurs in
the recumbent position, this type of angina is not related to either rest or exertion. Nitrates like nitroglycerin may
relieve paroxysmal nocturnal dyspnea associated with nocturnal angina. Prinzmetal’s angina, also known as
vasospastic or variant angina are relieved by calcium-channel blockers. Nitroglycerin may not provide relief
(Shargel, page 714-715).
68. Angina Pectoris is a symptom of reduced oxygen supply to the heart muscle. It is usually caused by narrowing or
obstruction of the coronary artery (myocardial ischemia). (Harrison’s 16th, page 1434)

69. Diazoxide is known to cause reflex sympathetic response that can lead to angina (Katzung, p. 169)
70. Medical therapy for unstable angina involves nitrates, beta blockers, and heparin, which are effective in controlling
pain, and aspirin, which reduces mortality. Because vasospasm occurs in some patients with unstable angina,
Ca2+ channel blockers offer an added approach to the treatment of unstable angina (Goodman and Gilman
Chap.32)
71. (C) Orange
72. The most common adverse reaction to insulin is hypoglycemia. This may result from an overdose, from a
mismatch between the time of peak delivery of insulin and food intake, or from superimposition of additional factors
that increase sensitivity to insulin (adrenal insufficiency, pituitary insufficiency) or that increase insulin-independent
glucose uptake (exercise). (Goodman and Gilman)
73. Piroxicam has a half-life of 42-76 hours, permitting once-daily dosing, which should favor its compliance (Katzung,
p.588)
74. Rheumatoid Arthritis symptoms include: malaise and anorexia, accompanied by symmetrically tender and swollen
joints. Morning stiffness of greater than 1-hour duration is an almost a constant feature of inflammatory arthritis
and may serve to distinguish it from other noninflammatory joint disorders. (Harrison’s 16th, page1970)
75. “The first step in the management of rheumatoid arthritis is the use of aspirin and other nonsteroidal anti-
inflammatory drugs (NSAIDs) and simple analgesics to control the symptoms and signs of the local inflammatory
process. These agents are rapidly effective at mitigating signs and symptoms, but they appear to exert minimal
effect on the progression of the disease”.
76. Demonstration of monosodium urate crystals in the synovial fluid of affected joints is a defenitive diagnosis of
gouty arthiritis. (Shargel, page 1004)
77. Cromolyn sodium is an effective anti-inflamatory agent but is not useful in acute asthmatic attacks because it is not
a direct bronchodilator. (Lippincott, page 220)
78. IgG: placental transfer, also secondary antibody for most antjpathogen responses
IgA: Secretory immunoglobulin; IgM: Primary antibody responses; IgE: allergy, antiparasitic response; IgD: marker
for mature B cells. ( Harrison 16th, page 1922)
79. Oral anticoagulants (e.g. warfarin) are Vit K antagonists which produce their anticoagulant effect by interfering with
the cyclic interconversion of Vit K and Vit K epoxides.
Knowing this, it can be deduded that the procoagulant effect of Vit K would interfere with the anticoagulant effect of
warfarin.
80. Several drugs provoke a lupus-like syndrome that usually resolve when the drug is withdrawn such as:
procainamide, hydralazine, quinidine, methyldopa, isoniazid, phenytoin, and chlorpromazine. (Shargel, page 190)
81. Skin necrosis is not an associated complication of heparin therapy. Rather it is a rare complication of coumarin
anticoagulants. Skin necrosis reflects a temporal imbalance between the anticoagulant protein C and one or more
of the procoagulant factors and is exaggerated in patients who are partially deficient in protein C or protein S.
Hemorrhage--is the primary untoward effect of heparin.
Thrombocytopenia-- (platelet count <100,000/l) occurs in 1% to 5% of patients 7 to 14 days after initiation of full-
dose or low-dose heparin therapy. It is reversible after discontinuation of the drug.
Thrombosis--In a minority of patients, heparin-induced thrombocytopenia is associated with thrombotic

complications, including arterial thrombosis with platelet-fibrin clots.
Vertebral body collapse--Osteoporosis resulting in spontaneous vertebral fractures can occur (Goodman and
Gilman, Chap.54).
82. The neoplastic diseases seen with an increased frequency in patients with HIV infection are Kaposi’s sarcoma,
non-Hodgkin’s lymphoma, Hodgkin’s disease, multiple myeloma, leukemia, melanoma, and cervical, brain,
testicular,oral, lung and anal cancer. (Harrison’s 16th, page 1120)
83. Oral griseofulvin is the approved drug of choice for tinea capitis, disseminated tinea corporis, and onychomycosis.
( Goodman and Gilman, Chap.64)
84. “Type I, or anaphylactic, reactions are mediated by IgE antibodies. The main targets of this type of reaction are the
gastrointestinal tract (food allergies), the skin (urticaria and atopic dermatitis), the respiratory system (rhinitis and
asthma), and the vasculature (anaphylactic shock). These responses tend to occur quickly after challenge with an
antigen to which the individual has been sensitized and are termed immediate hypersensitivity reactions”
(Goodman and Gilman, Chap. 4).
85. The drugs used for the treatment of motion sickness are antihistamines (e.g. dimenhydrinate, meclizine,
promethazine, and diphenhydramine) and anticholinergics (e.g scopolamine). (Harrison’s 15 th, Chape.41,Table 41-
2)
Although scopolamine, given orally, parenterally, or transdermally, is the most effective of all drugs for the
prophylaxis and treatment of motion sickness, some H1 antagonists are useful in a broad range of milder conditions
and offer the advantage of fewer adverse effects. ( Goodman and Gilman Chapter 25)
Chlorpromazine is the prototype of neuroleptic/anti psychotic agents. (Lippincott page 127)
86. Cystitis is the inflammation of the urinary bladder, often caused by infection.
Microsoft® Encarta® Reference Library 2005. ©
87. Nosocomial infection are infections originating, acquired, or occurring in a hospital
88. When treating outpatients, the initial doses of tricyclics (imipramine) may vary from 10 mg to 75 mg) on the first
day of treatment depending on the patient’s size and tolerance for acute effects. For hospitalized patients, the
conservative regimen is not required and the initial doses should be around 100mg. After 2 or 3 days at these
levels, doses may be increased in increments of 25 mg every 2 nd or 3rd day until a maximum of 150mg is reached.
This dose will place most patients within the presumed range of therapeutic plasma concentration katzung, p.491)
89. “While enteric gram-negative bacilli such as E. coli, are most commonly encountered in intra-abdominal infections,
gram positive organism such as streptococci, enterococci, or even pneumococci are sometimes found” in intra-
abdomnal infections. (Harrison 16th, page 750). Although Bacteroides fragilis accounts for only 0.5% of the normal
colonic flora, it is the anaerobe most frequently isolated from intra-abdominal infections (Harrison, page 751).
90. Nystatin is a polyene macrolide. It is available in creams, ointments, suppositories, and other forms for application
to skin and mucous membranes. It is not absorbed to a significant degree from skin, mucous membranes, or GI
tract, hence, it has little significant toxicity (Katzung, p.786).
91. In 1952, Jawetz and Gunnison concluded that bacteriostatic antibiotics (e.g., tetracyclines, erythromycin,
chloramphenicol) often antagonize the action of a bactericidal drug (e.g., beta-lactam antibiotics, vancomycin,
aminoglycosides), because bacteriostatic antibiotics inhibit cell division and protein synthesis, which are processes
required for the bactericidal effect of most bactericidal agent. (Goodman and Gilman, Chapter 43)
92. Toxicity of chemotherapy includes: Bone marrow suppression – Infection (WBC are the most affected of about 6-
12 hours), bleeding due to thrombocytopenia, anemia and fatigue. Dermatologic toxicity – alopecia, necrosis of
tissue called vesicants, dryness and sensitivity to light. GI toxicity – nausea and vomiting, stomatitis. etc.
(Shargel, page 1107-1110)
93. “Beverage alcohol is probably responsible for more overdose deaths than any other drug”. Harrison’s, Chap.387)
94. Methylphenidate, an amphetamine derivative, is used to improve behavioral problems related with attention deficit
syndrome, and reduce the hyperkinesias that the children demonstrate. With the use of this drug, the child’s
attention is prolonged, allowing him to function better in school. (Lippincott, page 104)
95. Aminopenicillins (e.g Ampicillin) have a wider spectrum of activity, thus, these drugs are also known as broad-
spectrum penicillins. Methichillin, nafcillin, oxacillin, cloxacillin and dicloxacillin are penicllinase-resistanst
penicillins. Their use is restricted with penicillinase-producing staphylococci. Pen V and Pen G, are primarily used
for gram positive and gram negative cocci, gram positive bacilli, and spirochetes. (Lippincott, page 300).
Refer to MANOR Pharmacolgy handouts on Antibiotics for more information.
96. In Type 2 DM, the presence of even minimal blood levels of endogenous insulin usually prevents the breakdown of
fats and subsequent ketonemia and ketoacidosis. (Shargel, page 1035) Ketosis is a condition caused by
abnormally high levels of ketone bodies in the blood as a result of the metabolism of fats instead of carbohydrates
for energy . Microsoft® Encarta® Reference Library 2005. ©
97. All benzodiazepines used to treat anxiety also have sedative property. The three most commonly prescribed
benzodiazepines for insomnia are: Flurazepam (long-acting), temazepam (intermediate-acting) and triazolam
(short-acting). (Lippincott, pages 90-91).
98. Methadone is used in the controlled withdrawal of addicts from opioids such heroin and morphine. Methadone
causes milder and slower withdrawal syndrome than morphine. (Lippincoot, page 139)
99. Prednisone, which is reduced to prednisolone, is associated with the development of Cushing’s syndrome
( syndrome related to cortisol hypersecretion). (Lippincott)
100.The following are some of the symptoms of Vitamin A deficiency : hyperkeratotic skin lesions, night blindness
(inability to see in dim light), dryness of the eyes, xerosis, and Bitot spots, which are white patches of keratinized
epithelium appearing on the sclera. (Harison’s, 15th, Chap.75)
101.Terbutaline is a beta-2 agonist that relaxes the bronchial musculature, while causing less direct cardiac stimulation
than nonselective beta-agonists (Goodman and Gilman, Chapter 10)
Phenylhydantoin--treatment of complex partial and generalized tonic-clonic seizures(Goodman and Gilman,
chapter 20). Ethosuximide is used primarily in the treatment of petit mal seizures (Lippincott page 143-146).
Physostigmine reversibly inhibits Acetylcholinesterase, which is the enzyme responsible for the degradation of
acetylcholine. Thus, if you inhibit the aforementioned enzyme, you increase Acetylcholine levels. Parkinson’s
disease is correlated with low levels of dopamine and high levels of acetylcholine (Lippincott, page 42).
Tubocurarine combines with nicotinic cholinergic receptor and thus, competitively blocks Acetylcholine. It is used
to assist in the diagnosis of myasthenia gravis. The use of tubocurarine for this purpose is potentially hazardous.
Myasthenia gravis is a neuromuscular disease characterized by weakness and marked fatigability of skeletal
muscle, caused by an autoimmune response primarily to the ACh receptor at the postjunctional end-plate
(Goodman and Gilman, Chapter 9).
Redness due to sunburn, is not due to histamine release, rather it is a superficial burn involving the epidermis.
Therefore, antihismines are not effective in treating this condition (Shargel, page 564).
102.Magnesium hydroxide is mainly used an antacid. Diarrhea is one of its side effects. Magnesium salts are saline
laxatives that act by promoting osmotic gradient to pull water into the small and large intestines, which results to
increase volume, and thus, distention of the intestinal lumen causing increase peristalsis and bowel motility
(Shargel, pahe 608).
103.Aspirin exerts its analgesic, antipyretic, and anti-inflammatory effects by inhibiting the production of prostaglandins
(which is the mediator for inflammation and pain), however, prostaglandin also functions as a mucoprotectant in
the stomach lining, therefore, aspirin use may lead to decrease mucoprotection, and eventually peptic ulcer
(Shargel, page 589).
104.Acetaminophen has analgesic and antipyretic actions. However, it does not significantly inhibit peripheral
prostaglandin synthesis, which accounts for its relative lack of anti-inflammatory activity, and thus cannot be used
for rheumatoid arthritis. This is because rheumatoid arthritis is an inflammatory condition (Lippincott, page 412))
105.Aspirin, also known as acetyl salicylic acid, causes salicylism—characerized by nausea, vomiting, marked
hyperventilation headache, mental confusion, dizziness, and tinnitus (ringing and roaring in the ears) (Lippincott,
page 408)
106.Iodoquinol, is an iodine-contaning compound used in the treatment of amebiasis (Goodman and Gilman, Chap.
41).Iodine containg compounds may cause cough because of irritation of the mucous glands of the respiratory
cough that leads to productive cough (Goodman and Gilman, chap. 56).
107.Trihexyphenidyl, due to its antimuscariunic action is used in the treatment of parkinsonism. However, it is less
effective compared to levodopa, and thus, is only used as an adjuvant.
Physostigmine-refer to number 102
Reserpine binds tightly to storage vesicles, which are responsible for concentrating and storing norepinephrine
and dopamine. Reserpine makes the storage vesicles dysfunctional, and as a result, catecholamines leak into the
cytoplasm, where they are destroyed by monoamine oxidase, and little or no active transmitter is discharged from
nerve endings when they are depolarized (Goodman and Gilman, Chapter 33).
Chlorpromazine is the oldest representative of the phenothiazine-thioxanthene group of antipsychotic agents. It
acts by blocking of CNS and peripheral dopamine receptors (Lippincott, page 128; Goodman and Gilman,
Chap.18).
Pyridoxine or vitamin B6, should not be used for patients on levodopa therapy because it increases the peripheral
breakdown of levodopa and diminishes its effectiveness (Lippincott, page 86).
108.Crystallne zinc insulin or regular insulin is a short-acting soluble insulin preparation. It is gven SQ or IV (in
emergencies) and lowers blood sugar levels within minutes. It is the only insulin preparation suitablefor IV
administration. (Lippincott page 258)
109.(D) Quarrelsome, dissatisfied, uncooperative individual with a reduced capacity to make a contribution in the
society.
110.Refer to 104.
111.Cathartics—increase GI motility. Opiates—constipation. Parasympathomimetics—increase GI motility and
secretion. Ganglionic Blocking Agents—constipation (Lippincott, page 48-49).
112.Bulk-forming laxatives have few side effects and minimal systemic effects.
Stimulant laxatives---chronic use can lead to cathartic colon, which results to a poorly functioning colon and
results to systems resembling ulcerative colitis (Shargel, page 609).
113.Refer to number 11.
114.Penicillins are relatively safe compared to the other drugs. It is an example of a drug with a large therapeutic index.
Thus it is safe and common to give doses in excess (about 10-fold excess) of that which is minimally required to
achieve desired response. (Lippincott page 23)
115.The following are the cellular actions of insulin:
(The important target tissues for regulation of glucose homeostasis by insulin are liver, muscle, and fat, but
insulin exerts potent regulatory effects on other cell types as well. )
-insulin is the primary hormone responsible for controlling the uptake, utilization, and storage of cellular nutrients.
- Insulin's anabolic actions include the stimulation of intracellular utilization and storage of glucose, amino acids,
and fatty acids, while it inhibits catabolic processes, such as the breakdown of glycogen, fat, and protein. It
accomplishes these general purposes by stimulating the transport of substrates and ions into cells, promoting the
translocation of proteins between cellular compartments, activating and inactivating specific enzymes, and
changing the amounts of proteins by altering the rate of transcription of specific genes
(Goodman and Gilman, Chapter 60).
116.Histamine exerts its effects by binding to two types of receptors—H1 and H2 receptors. H2 receptors mediates
gastric acid secretion, thus, agents that block H2 receptors (e.g. cimetidine) are useful for ulcer treatment
(Goodman and Gilman, 420-421).
117.Choices A, C, D. E are all used for hyperthyroidism. Choice (B) Liothyronine or T3, is used for hypothyroidism
(Shargel, page 1059-1075).
118.The following are the clinical application of alcohol or ethanol :
Reducing a fever-- Ethanol cools the skin when it is allowed to evaporate, and ethanol sponges therefore are
used to treat fever.
Sedation-- Alcohol is widely employed for its hypnotic and antipyretic effects.
Antisepsis--Ethanol (50% to 70% by volume) is employed as a rubbing agent on the skin of bedridden patients to
prevent decubitus ulcers. It also is used to decrease sweating and is an ingredient of many anhidrotic and
astringent lotions. Ethanol still remains the most popular skin disinfectant (Goodman and Gilman, Chapter 17).
Caloric nutrition--One gram of ethanol=29.7 kJ (7.1 kcal) of energy, and a drink contains between 293.0 and
418.6 kJ (70 and 100 kcal) from ethanol and other carbohydrates. However, alcohol is devoid of minerals,
proteins, and vitamins. Furthermore, it interferes with absorption of vitamins in the small intestine and decreases
their storage in the liver (e.g. folate (folacin or folic acid), pyridoxine (B 6), thiamine (B1), nicotinic acid (niacin, B3),
and vitamin A). (Harrison’s 15th, Chap.387)
119.Hemoglobin test measures the grams of hemoglobin contained in 100ml (1 dL) or 1 L of whole blood and provides
an estimate of the oxygen-carrying capacity of the red blood cells. The normal values are: MEN--14-18g/dL;
WOMEN—12-16g/dL (Shargel, p.694)
120.“Signs related to iron deficiency depend upon the severity and chronicity of the anemia in addition to the usual
signs of anemia¾fatigue, pallor, and reduced exercise capacity. Cheilosis (fissures at the corners of the mouth)
and koilonychia (spooning of the fingernails) are signs of advanced tissue iron deficiency”. (Harrison’s 15th,
Chap.105)
121.For the managementof iron deficiency anemia, multiple preparations (oral and parenteral) are available ranging
from simple iron salts to complex iron compounds designed for sustained release throughout the small intestine.
Oral—ferrous sulfate, ferrous fumarate, ferrous gluconate, polysaccharide iron
Parenteral—iron dextran (Harrison’s 15th, Chap.105)
122.Patients with autoimmune destruction of erythrocytes (i.e., hemolytic anemia with a positive Coombs' test) are
treated with prednisone (1 mg/kg per day) (Goodman and Gilman, Chap.59)
123.Choice D is incorrect. Diabetes mellitus is a chronic disorder.
124.One of the complications of Diabetes mellitus is peripheral neuropathy. Patients with significant peripheral
neuropathy, with loss of protective sensitive of the feet should limit weight bearing exercise. Repetitive exercise on
insensitive feet can lead to ulceration and fractures (Shargel, page 1039).
125.The following are the precautions and effects of insulin therapy:
Hypoglycemia-- The most common adverse reaction to insulin is hypoglycemia. This may result from overdose,
from a mismatch between the time of peak delivery of insulin and food intake, or from additional factors that
increase sensitivity to insulin (adrenal insufficiency, pituitary insufficiency) or that increase insulin-independent
glucose uptake (exercise).
Local or systemic allergy—common if the source of insulin is pork or other animals. Uncommon nowadays
because of the use of human insulin but may still occur as a result of reactions to the small amounts of
aggregated or denatured insulin, to minor contaminants, or because of sensitivity to other components added to
insulin formulation (protamine, Zn2+, phenol, etc.). The most frequent allergic manifestations are IgE-mediated
local cutaneous reactions.
Lipohypertrophy and fibrosis—“Atrophy of subcutaneous fat at the site of insulin injection (lipoatrophy) is probably
a variant of an immune response to insulin, whereas lipohypertrophy (enlargement of subcutaneous fat depots)
has been ascribed to the lipogenic action of high local concentrations of insulin.” (Goodman and Gilman, Chapter
60)
Not to be taken orally—insulin preparations are administered SQ or IV.

126.Hashimoto’s thyroiditis, an autoimmune disorder, is a chronic lymphocytic disorder. It is one of the causes of
hypothyroidism. Other causes are: treatment of hyperthyroidism (radioactive iodine therapy, subtotal
thyroidectomy,surgery), inadequate iodine intake, and ingestion of foods with progoitrin (Shargel, p.1069).
127.Sporadic goiter is caused by the ingestion of foods containing progoitrin, which is inactive and converted by
hydrolysis to goitrin. Goitrin inhibits conversion of iodine to iodide and prevents iodide from binding to
thyroglobulin, hence, decreasing thyroid hormone production. Progoitrin has been isolated from: cabbage, kale,
peanuts, brussels sprouts, mustard, rutabaga, kohlrabi, spinach, cauliflower and horseradish (Shargel, p.1069)
128.Choices A, B, C, and E are signs and symptoms of hypothyroidism. Choice C (irritability) is a sign/symptom of
hyperthyroidism (Shargel, p.1070-1073).
129.Grave’s disease (Diffuse Txoic Goiter) is an autoimmune disorder where there are antibodies that bind to and
activate TSH receptors.
Plummer’s disease(ToxicNodular Goiter) is a result of one or more adenomatous nodules that secerete excessive
thyroid hormone, not caused by prolonged treatment with thyroxine.
Myxedema coma is associated with hypothyroidism, and thus is not related to prolonged treatment with
levothyroxine
130.Refer to # 128
131.The following are the characteristics of myxedema coma: choices A, B, C, and E, menorrhagia and loss of libido.
Choice D is a symptom of hyperthyroidism (Shargel, page 1070-1073).
132.Thyrotoxicosis is the geneal term applied to thyroid gland overactivity (Shargel, p.1073)
133.Grave’s disease is a diffuse toxic goiter, while toxic nodular goiter is a characteristic of Plummer disease (Shargel,
1073). Refer to #130.
134.Beta-blockers reduce some manifestations of hyperthyroidism such as tachycardia, sweating, nervousness, and
tremor. Also, beta-blockers (particularly Propranolol), inhibits the peripheral conversion of T4 to T3, which is the
active form and which is responsible for the many symptoms of thyroid hormones (Lippincott; Shargel, p.1074)
135.Harrison’s 15th, Chap.344
136.Oral contraceptives (estrogens)-increase triglycerides, increase VLDL and decrease HDL (Goodman and Gilman,
table 36-2)
137.Niacin, or nicotinic acid or vitamin B3, strongly inhibits lipolysis in adipose tissues, the primary producer of
circulating free fatty acids. It decreases LDL and increases HDL (Lippincott, p.210) (Shargel, p.717)
138.(B) 3-6 months
139.Katzung, p.569-570
140.Hypertension is the most common cardiovascular disease (Shargel, p.762)
141.Hypertension is elevated systemic blood pressure defined as systolic (systole=heart contraction that pumps blood
into the arteries) reading greater than or equal to 140 mmHg and a diastolic reading greater than or equal to 90
mmHg.(Shargel, p.762)
142.There are two types of hypertension: Essential or primary hypertension, and Secondary hypertension.
 Essential hypertension—aka Primary HPN; no specific cause identified. The predisposing factors-due to
unknown etiology, family history, racial predispositions, smoking, stress, Diabetes mellitus,
hyperlipidemia, obesity,
 Secondary hypertension-due to known cause; hypertension secondary to renal disease or adrenal
hyperfunction (Shargel, page 762-767).
143.Refer to 143.
144.The Classification of Hypertension has been modified by JNC-7. Refer to Dr. Imasa’s lecture on Hypertension.
145.Cardiotoxicity is a common adverse effect of doxorubicin (Lippicott, p.378)
146.Refer to #67.
147.Phenytoin is Class IB (together with Lidocaine, Mexiletine. Tocainide) anti-arrhthmic drug (Shargel, page 747)
148.Angina is characterized by sudden severe pressing substernal pain radiating to the left arm (Lippincott, p.175).
Refer to #68.
149.Morpine is used as analgesic for MI (MIMS 2005)
150.Corticosteroid therapy leads to hypokalemia (Goodman and Gilman, Chap.59)
151.Primary (idiopathic) parkinson’s disease has an unknown etiology , the treatment is only palliative, and the disease
is incurable (Shargel, p.907)
152.Ambivalence is the simultaneous existence of conflicting emotional attitudes toward a goal, object or person
(Dorland’s Medical Dictionary)
The symptoms of Parkinson’s disease are muscle rigidity, bradykinesia (slowness in performing voluntary
movements), tremor, and postural instability (Shargel, p.907-909)
153.For the neuroprotective treatment of Parkinson’s disease,give dopamine agonists, physical rehabilitation and
psychological rehabilitation, etc. (Shargel, p. 913-915)
154.Therapy should be started with a low dose and titrated up. The response is usually seen within a few days after
starting therapy (Shargel, page 913).
155.Anticholinergics are used as neuroprotective agents in Parkison’s disease. They decrease resting tremor.(Shargel,
p.913)
156.(C) Affective disorder
157.“Schizophrenia is a heterogeneous syndrome characterized by perturbations of language, perception, thinking,
social activity, affect, and volition. Patients may present with positive symptoms (such as conceptual
disorganization, delusions, or hallucinations) or negative symptoms (loss of function, anhedonia, decreased
emotional expression, impaired concentration, and diminished social engagement) and must have at least two of
these for a 1-month period and continuous signs for at least 6 months to meet formal diagnostic criteria. "Negative"
symptoms predominate in one-third of the schizophrenic population and are associated with a poor long-term
outcome and a poor response to drug treatment. However, marked variability in the course and individual
character of symptoms is typical.” (Harrison’s 15th, Chap.385)
158.Refer to # 158
159.(B) Affective disorder
160.Bacillus Calmette-Guerin (BCG) and its active component, muramyl dipeptide, are bacterial products that have
been shown to produce an immunostimulant effect. BCG (THERACYS; TICE BCG) is a viable attenuated strain of
Mycobacterium bovis; muramyl dipeptide is an active compound derived from BCG. It exert its primary effect on
the T cell. It is believed to also stimulate natural killer cells. (Goodman and Gilman).
161.The diagnosis of tuberculosis include: acid fast stain of the specimen, rapid culture using BACTEC radiometric
culture, PPD skin test, Chest X-ray, and PCR and DNA probes (Gladwin, p.110)
162.The mode of transmission of gastroenteritis is primarily through fecal-oral route (Gladwin, p.66-67)
163.Phenytoin can cause blood dyscrasias, nystagmus, and decreased mental function (Shargel, p.318)
164.The traditional drug for relieving pain and inflammation and ending the acute attack is Colchicine. It is most
effective when initiated 12-36 hours after symptoms begin. This drug impairs leukocyte migration to inflamed
areas, disrupt urate deposition and the subsequent inflammatory response (Shargel, page 1005).
165.Esmolol is a very shot-acting beta blocker administered intravenously for acute arrhythmia during emergency
situations (Lippincott, page 171).
166.Antipsychotic drugs, such as chlorpromazine are competitive inhibitors at a variety of receptors, but their
antipsychotic effects reflect competitive blocking of dopamine receptors. Therefore, patients with Parkisonism are
not likely to benefit from this drug, in fact, it may exacerbate parkinsonism (Lippincott, p127).
167.Glyceryl trinitrate is n example of organic nitrate. These compounds may produce acute toxicity as a direct
extension of therapeutic vasodilation such as throbbing headache, orthostatic hypotension, and tachycardia
(Katzung, p.185)
168.Substances designed to enhance the absorption of iron have been marketed, including surface-acting agents,
carbohydrates, inorganic salts, amino acids, and vitamins. Vitamin C or ascorbic acid is one of the most popular
(Goodman and Gilman, chap.53).
169.(Gladwin, p.66-67)
170.Aspirin is contraindicated because it competes with uric acid for the organic acid secretion mechanism in the
proximal tubule of the kidney. (Lippincot page 415)
171.Insulin usually is injected into the subcutaneous tissues of the abdomen, buttock, anterior thigh, or dorsal arm.
Absorption is usually most rapid from the abdominal wall, followed by the arm, buttock, and thigh. When insulin is
injected subcutaneously, there can be an initial "lag phase" followed by a slow but steadily increasing rate of
absorption. The initial lag phase almost disappears when a reduced concentration or volume of insulin is injected
(Goodman & Gilman, chap.60).
172.Antihyperlipidemic agents are used to reduce the concentration of choices (B) to (E) except (A) HDL-cholesterol
level (HDL is the “good” cholesterol carrier). In fact a good antihyperlipidemic agent also increases HDL level.
(lippincot page 210)
173.Aplastic Anemia is the complete suppression of bone-marrow activity with profound anemia, granulocytopenia, and
thrombocytopeni (Goodman & Gilman, chap.20)
174.NSAIDs are used to reduce joint pain and swelling, but they do not alter the course of the disease or prevent joint
destruction. Disease modifying agents or DMARDs (e.g. penicillmine, sulfalazine, auronofin,hydroxychloroquine)
are used to reduce or prevent joint damage and prevent joint infection (Shargel, p.995)
175.(E) Night sweats is not a clinical manifestation of gastroenteritis.
176.Katzung, p.541
177.Choices (A), (B), (C), (E) are therapeutic agents for HYPERthyroidism (not Hypo) Except (D) Thyroglobulin which
is a thyroid preparation used for Hypothyroidism. Other Hypothyroid preparations are: Liotrix, Thyroid USP, and
Thyrotropin (Shargel page 349)
178.Streptokinase, Urokinase, and Alteplase or tPA(tissue-type plasminogen activator) are examples of thrombolytic
agents. They are used to treat myocardial infarction and peripheral arterial thrombosis (Lippincott, p.201)
179.The major complications of diabetes, including premature atherosclerosis, intercapillary glomerulosclerosis,
retinopathy, nephropathy, hypertension, neuropathy (decrease perception of pain), and ulceration and gangrene of
the extremities. (Goodman and andGilman, Chap. 60)
180.Levodopa should not be taken with the following drugs:
(A) pyridoxine--increases the peripheral breakdown of levodopa and diminishes its effectiveness (Lippincott, page
86).
(C) MAOI—leads to Hypertensive crisis
(D) Antipsychotic-- inhibits antiparkinsonism effect
Carbidopa is used together with levodopa because it diminishes the metabolism of levodopa in the GI tract
and peripheral tissues, thus it increases the availability of levodopa to the CNS. (Lippincot page 85)
181.Drug-induced hyperuricemia may be caused by:

 Cytotoxic agents—increase uric acid concentrations by enhancing nucleic acid turn-over
 ASA--inhibit tubular secretion of uric acid when given in low doses (e.g.less than 2g/day) of aspirin. At
high doses, it cause uricosuria
 Diuretics (except spironolactone) may cause hypeuricemia by volume depletion, which causes increase
proximal tubular reabsorption; or by impaired tubular secretion of uric acid.
 Ethambutol-increase uric acid concentratios bycompeting with urate for tubular secretion (Shargel,
p.1002)
182.Arrythmias caused by digitalis toxicity are treated with phenytoin or lidocaine (Shargel, p.794)
183.Ethacrynic acid is a loop diuretic. Transient deafness has been reported with the use of this drug, therefore, it
should not be used with streptomycin, which is a known ototoxic agent. Instead, thiazide drugs could be used as a
substitute for ethacrynic acid (Shargel, p.771)
184.Oral hypoglycemic/oral antidiabetic agents are used as adjuncts to diet in treating Type 2 diabetes/adult onset-
diabetes or Non-Insulin dependent DM that cannot be controlled by diet alone (Shargel, p.355)
185.Schizoprenia has a strong genetic component, and probably reflects some fundamental biochemical abnormality,
possibly an overactivity of the mesolimbic dopaminergic neurons. (Lippincot page 127)
186.Anemias caused by Vit B12 and folic acid deficiency have a characteristic appearance of peripheral blood and
bone marrow called Megaloblastic anemia. Neurologic abnormalities may also occur in Vitamin B12 deficiency but
not in folic acid deficiency. (Katzung page 537)
187.The 2 most common mood disorder are:
Major depression--characterized by sadness, indifference or apathy, or irritability and is usually associated with
change in neurovegetative functions, including sleep patterns, appetite and weight, motor agitation or retardation,
fatigue, impairment in concentration and decision making, feelings of shame or guilt, and thoughts of death or
dying; Therapeutic agents commonly employed are TCA, MAOIs, Bupropion, Trazodone, Venlafaxine,
Nefazodone,
Bipolar Depression--is characterized by unpredictable swings in mood from mania (or hypomania) to depression.
Therapeutic agents commonly employed are Lithium (1st line therapy for the treatment and prevention of bipolar
disorders), Valproic acid, Carbamazepine, Lamotrigine, Gabapentin and Oxcarbazepine. (Harrison’s 15 th,
Chap.385; Shargel, 937-951)
188.Iodide preparations can be used in:
Thyroid disorders—used in the preoperative period in preparation for thyroidectomy and, in conjunction with
antithyroid drugs and propranolol, in the treatment of thyrotoxic crisis.
Antiseptic—iodine-alcohol solutions and iodine complexes have been used as antiseptics and disinfectants
(Encarta 2005)
Expectorant—iodide preparations act as irritant, stimulating the cough reflex
Granulomatous lesions—in the form of radioactive iodine
Iodism is a condition caused by iodine poisoning, therefore, iodine is not used in this condition
189.The diagnosis of a vitamin B12-deficiency state can be made by determination of the concentration of vitamin B12
in plasma. The Schilling test can be used to measure ileal absorption of vitamin B 12. This test is performed after
the oral administration of intrinsic factor can help to delineate the mechanism of the abnormality of absorption
(Goodman and Gilman, Chap.53); (Katzung, 541)
190.Chloramphenicol inhibits the metabolism of chlorpropamide leading to a prolonged action and intensified effect of
chlorpropamide (Shargel, p.842)
191.Antibiotic reatment is recommended for exacerbations of COPD (Chronic Obstructive Pulmonary Disease--
includes Chronic Boronchitis and Asthma) in ambulatory patients. Exacerbations include when there is worsening
of cough and dyspnea, purulent and increased sputum volume. Antibiotics for this condition include second-
generation cephalosporin, co-trimoxazole or trimethoprim/sulfamethoxazole, beta-lactam inhibitor (e.g.amoxiillin)
and macrolides(e.g.erythromycin) (Shargel, p.984)
192.In the early course of rheumatoid arthritis, symptoms include malaise and anorexia symmetrical tender and
swollen joints. Morning stiffness (for greater than or equal to 30 minutes) is one of the criteria for the diagnosis of
rheumatoid arthritis (Shargel, p.994)
193.Precipitating factors of an acute asthma excacerbation may include:
 Allergens (pollen, house dust mite, animal dander etc)
 Viral respiratory tract infection
 Emotions (anxiety, stress, hard laughter or crying)
 Environmental exposures (weather changes, cold air, cigarette smoking)
 Drugs (due to hypersensitivity or extension of pharmacologic effect)
(Shargel pages 956-957)
194.refer to # 180 
195.Thiazide diuretics (e.g.hydrochlorothiazide) are considered as initial choice of therapy for hypertension. Other
antihypertensives like ACE-inhibitors, angiotensin-receptor blockers, beta-blockers and calcium channel blockers
have all been recommended for patients who cannot receive thiazide diuretic or in combination with thiazides for
adequate control of blood pressure (Shargel, pp.768-770)
196.Angina pectoris is an episodic, reversible oxygen insufficiency, which is the most common form of ischemic heart
disease (Shargel, p.712)
197.Penicillin plus Streptomycin is effective for enterococcal endocarditis and 2-week therapy of viridians streptococcal
infection. (Katzung 755)
198.Epilepsy is a family of different recurrent seizure disorders that have in common the sudden, excessive and
disorderly discharge of cerebral neurons. It may be caused by tumors (intracranial neoplasms), head trauma or
injury, alcohol or drug withdrawal, meningeal infection and fever (Febrile seizure). Febrile seizures occur in young
children (3 months o 5 years). (Lippincott, p.143-144)
199.Status epilepticus is characterized by rapidly recurrent seizures (Lippincott, p.145)
200.In hepatitis, there is impairment of normal liver functions, which may lead to alteration of biotransformation.
Phenobarbital, a known enzyme inducer, may induce glucuronidation (Goodman and Gilman, Chap.1)
201.“Cirrhosis is a pathologically defined entity that is associated with a spectrum of characteristic clinical
manifestations. The cardinal pathologic features reflect irreversible chronic injury of the hepatic parenchyma and
include extensive fibrosis in association with the formation of regenerative nodules”(Goodman and Gilman,)
202.Alcoholic cirrhosis is only one of many consequences resulting from chronic alcohol ingestion, and it often
accompanies other forms of alcohol-induced liver injury, including alcoholic fatty liver and alcoholic hepatitis.
(Goodman and Gilman, Chap.298)
203.“Ethanol absorbed from the small bowel is carried directly to the liver, where it becomes the preferred fuel; NADH
accumulates and oxygen utilization escalates; gluconeogenesis is impaired (with a resulting fall in the amount of
glucose produced from glycogen); lactate production increases; and there is a decreased oxidation of fatty acids in
the citric acid cycle with an increase in fat accumulation within liver cells. In the healthy individual taking no
medications, these changes are reversible, but with repeated exposure to ethanol, more severe changes in liver
functioning are likely to occur. These include, in overlapping stages, fatty accumulation, alcohol-induced hepatitis,
perivenular sclerosis, and cirrhosis, with the latter observed in an estimated 15 to 20% of alcoholics” (Harrison’s,
Chap.387)
204.Dairy products, iron preparations, antacids and laxatives with aluminum, calcium, or magnesium can cause
reduced tetracycline absorption (Shargel, p.838)
205.(C) Receive deliveries of medicines
206.Parenteral nutrition is also called total parenteral nutrition (TPN) and hyperalimentation. It is used to meet the
patient’s nutritional requirements when the enteral route cannot supply the body’s requirements (e.g.inflammatory
bowel disease—Crohn’s disease ). Shargel, p.1133
207.(A) Achieve tissue failure (?)
208.Infectious complications are usually related to central venous catheter. This is related to sepsis secondary to
multiple catheter manipulations, contamination during insertion, or contamination during routine maintenance
(Shargel, p.1135)
209.(A) Adverse drug reaction coordinator
210.Heart failure (HF) is a complex clinical syndrome that results from any cardiac disorder, which impairs the
ventricle’s ability to deliver adequate quantities of blood to metabolizing tissues. It is not considered as an
independent diagnosis, but rather superimposed on an underlying cause. 2/3 of HF cases are caused by coronary
artery disease; the remaining 1/3 are due to other causes of myocardial stress—pulmonary embolism, infection,
trauma, preganancy, drug use/abuse, fluid overload, etc. (Shargel, p.785)
211.Heart failure requires a 2-pronged therapeutic approach, the overall goals of which are:
 To remove or mitigate the underlying cause or risk factors (refer to #210)
 To relieve the symptoms and improve pump function by:
-reduce metabolic demands though rest, relaxation and pharmacologic interventions
-reduce fluid volume excess through diet and pharmacologic interventions
-administration of a combination of: diuretics, ACE-ihibitors, beta-blockers, and digitalis
-promote patient compliance
-heart transplantation for appropriate patients
212.Refer to # 196.
213.Diuretics generally act by increasing sodium excretion or decreasing sodium reabsorption (Shargel,p.770-772)
214.Refer to #198
215.Propranolol blocks beoth beta-1 and beta-2 receptors. Acebutalol, Atenolol, and metoprolol selectively blocks beta-
1 receptors (Lippincott, p.79)
216.In the most common form of Stable (classic) angina, exertion, emotional stress, or a heavy meal usually
precipitates chest discomfort which is usually relieved by rest, nitroglycerin or both. (Shargel page 714)

217.Rheumatic fever is an autoimmune condition that follows Streptococcus pyogenes infection. In half of patients, an
inflammation of the heart damages the valves due to a misdirected response to streptococcal M protein (Tortora,
p.629)
218.Medications for rheumatic fever are the penicillins—Pen G, Pen V and Penicillase Resistant penicillin (Gladwin,
p.24-25). Salicylates are given to treat the arthritis of rheumatic fever. Some physicians believe that there is a role
for steroids in patients with severe carditis accompanied by congestive heart failure. However, neither salicylates
nor glucocorticoids influence the future development of valvular heart disease. (Harrison’s 15th )
219.Anticholinergics are generally less effective than beta-agonists for asthma. They block vagally mediated
contraction of the airway smooth muscle and mucus secretion. Ipratropium, a quaternary derivative of atropine, is
useful for patients unable to tolerate beta agonists (Lipincott, page 220). Biperidin and Benztropine are used for
parkinsonism (Lippincott, 87-88). (Goodman an Gilman, Chap.363)
220.(C) All of the above
222.The first-line anti-tubeculosis drugs are Rifampicin, Isoniazid, Pyrazinamide, Ethambutol and Streptomycin
(Gladwin, p.100) Alternative 2nd--line drugs in the treatment of TB: Ethionamide, Capreomycin, Cycloserine,
Aminosalicylic acid, Kanamycin, Amikacin, Ciprofloxacin, Ofloxacin, Rifabutin, Clofazimine. (Katzung 775-777)
223.The classification of hypertension has been modified by JNC-7, refer to Dr.Imasa’s lecture for HPN Classification.
224.Allopurinol is a purine analog that reduces the production of uric acid by competitively inhibiting the last two steps
in the biosynthesis of uric acid, which are catalyzed by xanthine oxidase (p.416)
225.Extraluminal amebiasis or systemic ambiasis is treated with the following drugs:
 Chloroquine—used in conjunction with metronidazole and diloxanide furoate is used in the treatment and
prevention of amebic liver abscess. This agent eliminates trophozoites in liver abscess, but is not useful
in treating luminal amebiasis.
 Emetine and Dihydroemetine—act by blocking the elongaion factor in protein synthesis. Emetine is
concentrated in the liver (Where it persists for a month after a single dose). The use of these alkaloids is
limited because o their toxicities (Lippincott, pp346-348).
226.Both phenytoin and carbamezepine are the preferred drugs for simple and complex partial seizures, tonic-
clonic/grand ml seizures. Choice A, Diazepam is the preferred drug for status epilepticus. Ethosuximide is the drug
of choice for absence seizures (Lippincott, pp.143-145)
227.In the past, Ergotamine has been the drug of choice for moderate-to-severe migraine. It is effective when given
during the prodromal stage. (Lippncott, p.427-428)
228.Ergotamine is a serotonin antagonist and vasoconstrictor (Lippincott, page 427).
229.Ranitidine is an H2-rceptor blocker. It competitively inhibits the action of histamine at parietal cell receptor sites,
reducing the volume and hydrogen ion concentration of gastric acid secretions. (Shargel page 1019)
230.The wall of the heart has three layers. The innermost layer is the endocardium. Endocarditis is the inflammation of
the endocardium (Tortora, p.628)
231.Staphylococcus aurues usually causes Acute bacterial endocarditis (a more rapidly progressive type). While
Subacute bacterial endocarditis(named because it develops slowly) is usually caused by Alpha-hemolytic
Streptococci, (Tortora page 628)
232.Clinical presentation of a patient with subacute bacterial endocarditis—slowly develops low grade fevers, fatigue,
anemia, and heart murmur secondary to heart valve destruction (Gladwin p.26)
233.Streptococccus pyogenes causes Rheumatic Heart disease; Lancefield Group D Streptococci (S.faecalis, S. bovis,
etc) and Viridans Streptococci causes subacute bacterial endocarditis (Gladwin, p.30)
234.Acute asthma exacerbation can be precipitated by exercise and emotions—anxiety, stress, hard laughter or crying
(Shargel, p.956-957). Stable or classic angina is caused by exertion and emotional stress (Shargel, p.714). In
heart failure, physical, and emotional excesses are also considered as precipitating causes--physical overexertion,
and emotional crises may precipitate HF in patients with heart disease who were previously compensated
(Goodman and Gilman,Chap.232).
235.CHF can be treated using: Digitalis glycosides, Diuretics, Vasodilators, ACE Inhibtors, Beta-Adrenergic blocking
agents, Calcium-channel blockers, Inotropic agents (Dopamine, Dobutamine, Inamrinone, Milrinone, Nesiritide)
(Shargel pages 792-799)
236.Digitalis is a positive inotropic agent (increase force of contraction), results to increase cardiac output, decrease
cardiac filling pressure, inc renal blood flow and decrease heart size. (Shargel, p. 793)
237.“Asthma is defined as a chronic inflammatory disease of airways that is characterized by increased
responsiveness of the tracheobronchial tree to a multiplicity of stimuli. It is manifested physiologically by a
widespread narrowing of the air passages, which may be relieved spontaneously or as a result of therapy, and
clinically by paroxysms of dyspnea, cough, and wheezing. It is an episodic disease, with acute exacerbations
interspersed with symptom-free periods.”(G and G, Chap.252).
“Chronic obstructive pulmonary disease (COPD) is the name of a group of chronic and slowly progressive
respiratory disorders characterized by reduced maximal expiratory flow during forced exhalation. Most of the
airflow obstruction is fixed, but a variable degree of reversibility and bronchial hyperreactivity may be seen.
COPD comprises emphysema and chronic bronchitis.
Emphysema is defined anatomically as a permanent and destructive enlargement of airspaces distal to the
terminal bronchioles without obvious fibrosis and with loss of normal architecture. Chronic bronchitis is defined
clinically as the presence of a cough productive of sputum not attributable to other causes on most days for at
least 3 months over 2 consecutive years.” (G and G, Chap 258).
238.Bronchodilators (e.g. beta-2 agonist Salbutamol) are effective for both COPD and asthma, because both
conditions involve bronchoconstriction (Shargel, pp.957-985)
239.Glucocorticoids (e.g. Prednisolone) reduce inflammation dramatically (Lippincott, p.275)
240.Etiologic factors of Emphysema and Bronchitis (COPD): cigarette smoking, exposure to irritants such as sulfur
dioxide (as in polluted air), noxious gases, organic or inorganic dusts, history of respiratory infections or bronchial
hyperreactivity, social, economic and hereditary factors. (Shargel page 980)
241.Aminopylline is a theophylline derivative (theophylline ethylenediamine). It is one of the most effective
bronchodilator. It has been shown to relieve airflow obstruction in acute asthma. Terbutaline is a beta-2 selective
adrenergic agonist, also a bronchodilator (Katzung, pp. 334,340).
242.Chronic bronchitis is characterized by excessive mucus production by the tracheobronchial tree which results in
airway obstruction due to edema and bronchial inflammation. (Shargel page 979)
243.Symptoms of Chronic bronchitis: Chronic productive cough (hallmark of chronic bronchitis), exertional dyspnea
that is progressive, rhonchi and wheezes, prolonged expiration, normal respiratory rate. The common habitus of
patients with chronic bronchitis is obese (Shargel, p.981)
244.refer to # 241
245.(B) Practice in patient care arease
246.(A) All of these
247.Alcohol interferes with the digestion of food. Chronic alcoholism may lead to atrophy of the gastric mucosa and
thus interferes with the absorption of food (Harrison’s 15th, Chap.287)
248.(A) decrease anxiety
249.Harrison’s 15th, Chap.369
250.(B) Stooped posture
251.Alcohol causes sedation and relief of anxiety (Katzung, p.374)
252.Cogentin is the brandname of Benztropine mesylate. It is indicated for arteriosclerotic, idiopathic, post-encephalitic
parkinsonism and drug-induced parkisnsonism (MIMS 2003, p.109)
253.Akineton is the brandname of Biperiden. It is indicated for parkinsonism and other extrapyramidal movement
disorders (MIMS 2003, p.109)
254.Phenytoin is used for partial seizure and general tonic-clonic seizures. It acts by blocking neuronal sodium and
calcium conductance, as well as calcium-mediated excitatory neurotransmission (Manor handout, Pharmacology,
pp.2-3)
255.The normal high concentration of dopamine in the basal ganglia of the brain is reduced in parkinsonism and the
pharmacologic attempts to restore dopaminergic activity with levodopa and dopamine agonists have been
successful in alleviating many of the clinical features of the disorder. (Katzung page 450)
256.(B) Rastinon
257.(C) Glucose meters
258.180mg/100mL or18mg/dL is referred to as the renal threshold for glucose which means that the blood glucose
levels have exceeded the reabsorptive capacity of the kidneys. The diagnosis for prediabetes in a nonpregnant
individual is a fasting plasma glucoe level > 110mg/dL and less than 126mg/dL or oral glucose tolerance test
(OGTT) plasma glucose > 140mg/dL <200mg/dL. (Shargel 1035-1037)
259.Intermediate-acting insulin: Semilente insulin suspension, Isophane insulin suspension (sometimes called NPH or
Neutral Protamine Hagedorn), lente insulin, insulin combinations. The delayed absorption of insulin is due to the
conjugation of insulin with protamine to form less soluble complex (Lippincott page 258-259)
260.In hyperglycemic, hyperosmolar, nonketotc syndrome there is insulin deficiency with concomitant insulin resistance
leading to hyperglycemia. If insulin is not administered, profound dehydration with very high glucose levels may
occur leading to coma and death. When glucoses is excreted into the urine, there is a resulting dehydration and
electrolyte abnormalities. ( Shargel 1035)
261.Cyclophosphamide is the most commonly used alkylating agent. Alkylating agents act by covalently binding to
nucleophilic groups on various cell constituents. (Lippincott 387-388)
262.The two major thyroid hormones are T3(triiodothyronine) and T4(thyroxine) (Lippincott, p.251)
263.Thyroglobulin (Proloid) is a partially purified extract of frozrn porcine or bovine thyroid. It contains both T3 and T4
(Shargel, p.349)
264.Minidiab is glipizide, a second generation sulfonylurea (MIMS)
265.Diabetes mellitus is due to the lack of insulin or resistance to insulin (Lippincott, p.266)
266.Clinoril is Sulindac. Feldene is Piroxicam. Clinoril, Feldene, and Mecolmen are all NSAIDs. NSAIDs are used in the
treatment of rheumatoid arthritis. (Katzung, p.599)
267.Motrin is Ibuprofen. Ibuprofen is an NSAIDs. NSAIDs inhibit cyclooxygenase, and thus inhibit prostaglandin
synthesis
268.Methotrexate is used in the treatment of rheumatoid arthritis for patients who have not responded adequately to
NSAIDs (Lippincott, p.415)
269.Uricosuric agents (Sulfinpyrazone and Probenecid) are employed to decrease the urate pool in patients with
tophaceous gout or in those with increasingly frequent gouty attacks (Katzung, p.597)
270.Glipizide is a second-generation sulfonylurea. Sulfonylureas stimulate insulin release from pancreatic beta cells,
reduce serum glucagons levels, and increase binding of insulin to target tissues and receptors (Lippincott, p.260)
271.Leukeran is Chlorambucil, an alkylating agent (Katzung, p.890). Refer to #262 for the mechanism of action of
alkylating agents.
272.(C)Heat, alcohol, and metal ions
273.(F) All are wrong
274.Otitis media, the infection of the middle ear, is caused by the following organisms: Streptococcus pneumoniae,
Haemophilus influenzae, and Moraxella catarrhallis. Cephalexin and Cephradine are 1 st generation
cephalosporins, which are commonly administered to treat gram positive and gram negative infection. Cefaclor, a
second generation cephalosporin is used in otitis media and sinusitis. (Shargel pages 537, 831-832)
275.Aminoglycosides are ototoxic and nephrotoxic (Katzung, p.753)
276.The cephalosporins produce the following adverse effects: Hematologic effect--bleeding may occur with
cefamandole or cefoperazone because of anti Vit K effects. Thrombophlebitis-- Local irritation can produce sever
pain after IM injection and thrombophlebitis after IV injection; GI effects—diarrhea.
Some cephalosporins may also produce disulfiram-like effect when ingested with alcohol (flushing, tachycardia,
hyperventilation and nausea). (Katzung page 735-736, Lippincott page 96, 306)
277.Aminoglycosides are used primarily in infections caused by gram-negative enterobacteria and in suspected sepsis.
They have little activity against anaerobic and facultative organisms (Shargel, p.824)
278.Aminoglycosides are used in the treatment of:
Bone—gentamicin, tobramycin, amikacin and netilmicin are usesd in osteomyelitis
Skin and soft tissue infection—neomycin is used for skin and mucus membrane infections.
Respiratory diseases—streptomycin is used in TB.
Postoperative and Intra-abdominal infection—neomycin is used for preoperative bowel sterilization. (Shargel
page 830)
279.Penicillase resistant penicillins are not hydrolyzed by staphylococcal penicillase, they are used primarily for
staphylococci that produce the aforementioned enzumes. The penicillase resistant penicillins are: methicillin,
nafcillin, and isoxazolyl penicillins (cloxacillin, dicloxacillin, and oxacillin) (Shargel, p.835)
280.Among the penillins, the Extended spectrum penicillins have the widest spectrum of activity. They are also called
anti-pseudomonal penicillins. Extended spectrum penicllins include: carboxypenicillins (carbenicillin, and ticarcillin)
and ureidopenicillins (mezlocillin and piperacillin) (Shargel, p.836)
281.Aminopenicillins have a wide spectrum of activity and thus they are called broad-spectrum penicillins.
Aminopenicillins include: Ampicillin, Amoxicillin, Bacampicillin,, and Cyclacillin (Shargel ,836)
282.Penicillin should be used with caution in patients with:
Asthma--Anaphylaxis caused by penicillin leads to bronchoconstriction
High fever and urticaria—may be manifestations of hypersensitivity reactions to penicillin (Shargel, p.835)
283.Interaction of Glucocorticoids
Vaccines and toxoids—glucocorticoids cause immunosuppression. Corticosteroids produce antiadhesion effects
(preventing movement of inflammatory cells from the circulation into tissue) that may further contribute to
immunosuppression. (Goodman and Gilman, Chap.52)
Oral anticoagulants (e.g. Warfarin)—glucocorticoids alter clotting factor disposition (Katzung, p.1061)
Estrogen—decreased metabolism of steroids leading to increased steroid effect (Katzung, p.1066)
Potassium depleting drug—hypokalemia (Goodman and Gilman, Chap.59)
284.Adverse effects of B2 adrenergic agonists (salbutamol):
“Tachycardia is a common adverse effect of systemically administered beta-adrenergic agonists. Stimulation of
heart rate occurs primarily via beta1 receptors. It is uncertain to what extent the increase in heart rate also is due
to activation of cardiac beta2 receptors or to reflex effects that stem from beta2-receptor-mediated peripheral
vasodilation. Skeletal muscle tremor is the most common adverse effect of the beta2-selective adrenergic
agonists”. (Harrison’s, 15th Chapter 10)
285.“In low and moderate doses, the methylxanthines (e.g. theophylline) cause mild cortical arousal with increased
alertness and deferral of fatigue” (Katzung, Chap.331)
286.Theophylline concentration is increased by drugs that cause hepatic enzyme inhibition (allopurinol, cimetidine,
and erythromycin). (Katzung, pp.1061-1069) Propranolol is extensively metabolized by the liver (Goodman and
Gilman, Chapter 10) and thus, may increase theophylline concentration by competing with hepatic enzymes.
287.Erythromycin and Clindamycin both inhibit protein synthesis by binding to the 50s ribosomal subunit. (Shargel,
p.833, 842) Penicilins and Cephalosporins both inhibit bacterial cell wall synthesis and are bactericidal (Shargel,
pp.831-834)
288.Isotretinoin is a Vitamin A derivative. Its exact mechanism of action is unknown, but has proven to decrease
sebum production and keratinization, and reduce the population of P.acnes. It is indicated for severe, recalcitrant
nodulocystic acne (Shargel, p.562)
289.Hepatitis A Virus (HAV) “is transmitted almost exclusively by the fecal-oral route. Person-to-person spread of HAV
is enhanced by poor personal hygiene and overcrowding; large outbreaks as well as sporadic cases have been
traced to contaminated food, water, milk, frozen raspberries and strawberries, and shellfish. Intrafamily and
intrainstitutional spread are also common.” (Harrison 15th, Chapter 295)
290.Refer t #223
291.“Rifampicin may be used in combination with dapsone for the treatment of leprosy” (Shargel,p.861)
292.Barbiturates interact with the following:

CNS depressants—leads to additive CNS depression
Anticoagulants—decrease anticoagulant effect by enzyme induction
Corticosteroids—increased corticosteroid metabolism
(Shargel, pp.1062-1063)
293.(D) Phenobarbital
294.Morphine, Meperidine and Nalbuphine are opiate analgesics (Shargel, p.282). Mefenamic acid is an example of
NSAID.
295.(A) Chlorpromazine, (B) Perphenazine (C) Fluphenazine, (D) Promethazine are all antipsychotics. Depression is
different from psychoses/schizophrenia, which produces disturbance in thought. All clinically useful antidepressant
drugs potentiate, either directly or indirectly, the actions of norepinephrine, dopamine, and/or serotonin levels.
While traditional antipsychotic (or antischizophrenic) competitively block dopamine receptors.
(Lippincott 119-142)
296.Adverse effects of benzodiazepines include drowsiness and confusion (two most common side effects of
benzodazepines). Ataxia occurs at high doses (Lippincott, p.92-93).Other relatively common side effects of
benzodiazepines--weakness, headache, blurred vision, vertigo, nausea and vomiting, epigastric distress, and
diarrhea; joint pains, chest pains, and incontinence may occur in a few recipients (Goodman and Gilman,
Chap.17).
297.Diazepam interacts with:
Cimetidine—decreases metabolism of diazepam (Katzung, p.1064)
Disulfiram—decreases metabolism of diazepam (Katzung, p.1066)
298.(A) Easily assimilable, tasteless
299.
300.Factors influencing drug metabolism: chemical structure, physiological or disease states, genetic variations, drug
dosage, nutritional status, age, gender, circadian rhythms, drug administration route. (Shargel pages 368-369)
301.Digoxin and Deslanoside are cardiac glycosides (Shargel, p.312)
302.Anti-infectives—used to treat exacerbations with suspected infections manifested by increase in volume or change
in color or viscosity of the sputum. Theophylline—bronchodilator. Corticosteroids—systemic, for acute COPD
exacerbations. Oxygen therapy--to reverse hypoxemia during exercise and at night (Shargel, p,982-985)
303.(C) extreme temperature exposure, malnutrition, alcholism
304.(E) GIT, uterus, bronchial muscle, large blood vessel
305.(A) parenteral, sexual
306.(E) Treatment depends on the etiologic agent.
307.(C) caused by virus, bacterial pneumonia, pneumococcus
308.(C) Metronidazole, Mebendazole, Tinidazole
309.Metronidazole has a direct amebicidal action. It is the preferred drug in amebic dysentery. Diloxanide is another
amebicidal agent, which is used to treat asymptomatic carriers of amebic cysts. (Shargel, p.857)
310.(C) Pilocarpine, epinephrine, timolol
311.Thyroglobulin (Shargel, p.349), Dessicated thyroid (Katzung, p. 625)
312.(B) aerosolized droplets expectorated from person with TB ; direct inoculation thru the sin
313.(B) Morphine, Meperidine
314.Nonpharmacologic treatment for rheumatoid arthritis—Regularly scheduled rest periods are important to reduce
physical stress on the joints. Physical and occupational therapy help patients maintain their activities of daily living
(Shargel, p. 995)
315.Sulindac is a non-selective NSAID.
316.Urethritis is the inflammation of the urethra
317.(D) tetracycline—this is discussed extensively in other numbers
318.“Gonorrhea is much more obvious in males, who develop an acute discharge of pus from the urethra. Scant at the
start, it becomes progressively thicker and heavier and causes frequent urination, often with a burning sensation.
Should the prostate become infected, the passage of urine is partly obstructed. In females the infection occurs in the
urethra, the vagina, or the cervix. Although discharge and irritation of the vaginal mucous membranes may be
severe, more often few or no early symptoms appear.”Microsoft ® Encarta ® Reference Library 2005. ©
319.Cystitis is the inflammation of the urinary bladder.
320.(B) Tetracycline, Metronidazole
321.Griseofulvin is a fungistatic drug derived from Penicillium species. The absorption of this drug is improved when it is
given with fatty foods (Katzung, p. 785)
322.Cephalothin is a first-generation cephalosporin. It is given IV or IM (Remington, p.1530) Cephalexin is given orally
(Remington, p.1529)
323.Chloramphenicol inhibits hepatic microsmal enzymes that metabolize phenytoin. Thus, the half-life and serum
concentration of phenytoin is increased. Other drugs affected are tolbutamide, chlorpropamide, and warfarin
(Katzung, p.745)
324.Ketoconazole is the first oral azole introduced into clinical use. It is available for systemic use in an oral formulation
that is best absorbed at low gastric pH (Katzung, p. 783-785)
325.Sulindac is a sulfoxide prodrug. It is active only after conversion to a sulfide by liver enzymes. The sulfide is
excreted into the bile and then reabsorbed from the intestines (Katzung, p.599) . The thiazides (formally called
benzothiazides) have an unsubstituted sulfonamide group (Katzung, .251)
326.At the usual dosage, the main adverse effect of NSAIDs is gastric upset or intolerance because of the inhibition of
prostaglandin, which serves for mucprotection (Katzung, p.583-584)
327.Digitoxin should be handled with exceptional care since it is highly potent (Remington, p.1286)
328.Spirinolactone is a potassium-sparing diuretic (Katzung, p.324)
329.Rifampicin, phenytoin and barbiturates are all enzyme inducers, thus, they increase the metabolism of oral
contraceptives leading to reduced efficacy of oral contraceptives (Ktzung, p.1063-1068)
330. Meperidine hydrochloride (brand names: PETHIDINE, DEMEROL, PETHADOL).This drug is an analgesic
(Goodman and Gilman; Katzung,)
331.Aspirin, corticosteroids, and NSAIDs are all ulcerogenic (Katzung, p.583-584, 644). Antacids are weak bases that
react with gastric acid to form water and salt, thus, diminishing gastric acidity. Antacids (aluminum and magnesium)
promote healing of duodenal ulcers (Lippincott, p.240)
332.Bacampicillin and Metampicillin are converted to ampicillin (Remington, p.1521)
333.(A) Zomepirac
334.Refer to #330. Monoamine oxidase inhibitors or MAOI interacts with narcotic analgesics to produce hypertension,
rigidity and excitation (Katzung, p.1067)
335.(D) All
336.(C) Both
337.Spirinolactone is a synthetic aldosterone antagonist. It competes withaldosterone. When this drug is given to the
patient, it antagonizes the activity of the hormone, resulting to potassium retention and sodium excretion (Lippincott,
p. 232)
338.(D)
339.Cimetidine decreases the metabolism and therefore increases plasma levels of beta blockers (e.g. propranolol,
metoprolol). Less or no effect on those cleared by thekidneys e.g. Atenolol (Katung, p.1065)
340.Cimetidine inhibits hepatic microsomal enzymes (Katzung, p.1064)
341.Katzung, p.165
342.Vincristine is a microtubule inhibitor (Lippincott, p.390)
343.Tyramine found in certain foods like aged cheese, chicken liver, beer, and red wine is normally inactivated by MAO
in the gut. Persons taking MAO inhibitors are unable to degrade tyramine and this leads to a release of large
amounts of catecholamines from nerve terminals, resulting to headaches, tachycardia, nausea, hypertension,
cardiac arrhythmias, and stroke. Therefore, patients taking MAOIs should avoid foods containing tyramine
(Lippincott, p.124)
344.Astemizole is an example of a second-generation (non-sedating) Histamine-1 antagonists (Goodman and Gilman,
Chap. 25)
345.Katzung, p. 1061-1062
346.Katzung, p. 1061-1062
347.NSAIDs (e.g. diclofenac) reduce rnal lithium excretion (Katzung, p. 1067)
348.(D) none of the above
349.Cefoperazone (half-life:2 hours) ca be injected every 8-12 hours in a dose 25-100 mg/kg/day
350. the complications of penicillin therapy are:
 Anaphylactic shock
 Cross-sensitivity to all—all peniillins are cross-sensitizing and cross-reacting. Any preparation containing
penicillin may induce sensitization
 Super-infections—secondary infections (e.g. vaginal candidiasis) may occur (Katzung, p.731-732)
351.Pen V or Phenoxymethylpenicillin is a natural penicillin with improved oral absorption. It is not a penicillase-resistant
penicillin (Manor Pharmacology handout on Anti-infectives)
352.Refer to 92
353.Absorptin of doxycycline is impaired by divalent cations like Fe, Mg and Ca; and Al (Katzung, p.746)
354.The excessive anticoagulant action of heparin is treated by discontinuing the drug. Protamine is a specific
antagonist indicated if bleeding occurs with heparin. This antagonist is a highly basic peptide that combines with
heparin as an ion pair to form a stable complex that does not have an anticoagulant activity.
Prolonged heparin therapy is associated with osteoprorosis and spontaneous fractures (Katzung, p.551)
355.Vitamin K antagonists except for warfarin are seldom used because of unfavorable pharmacologic properties or
toxicity. Dicumarol is incompletely absorbed and frequently causes GI symptoms (Katzung, p. 554)
356.The correct answer is NONE. All the drugs given potentiate or increase anticoagulant effect.
 Alcohol—acute alcohol intoxication causes increased hypoprothrombinemic effect.
 Allopurinol—increase hpoproythrombinemic effect by inhibiting hepatic drug-metabolizing enzymes
 Steroids—alter clotting factor disposition; increase anticoagulant effect (Katzung)

357.NSAIDs (e.g. Sulindac and Naproxen) have documented clinical interactions with anticoagulants.
358.(C) both of the above. Refer to 323
359.Potassium chloride is a neutral salt.
360.Calcium chnnel blockers—Dihydoyridines end with “–dipine”. Verapamin (Diphenylalkylaime) and Diltiazem
(Benzothiazepine) are non-dihydropyridines.
361.Captopril should be taken with an empty stomach (1 hour before or 2 hours after meals). (MIMS 2003, A26)
362.Katzung, p.165
363.Nizatidne (Axid) is available only as an oralpreparation (Latzung, p. 1026)
364.(Brand names—generic names)Tagamet—Cimetidine; Zantac—Ranitidine; Axid—Nizatidne; Losec—Omeprazole
(Katzung, p. 1026; MIMS 2003 p.4)
365.Gemfibrozil is a congener of the first generation fibric acid derivative Clofibrate (Katzung). Verapamil and diltiazem
are calcium channel blockers.
366.Prazosin is an antihypertensive agent that exerts its action by blocking alpha-1 receptors (Katzung, p.165)
367.Vancomycin is used for potentially life-threatening antibiotic-associated colitis due to th overgrowth of Clostridium
difficile (Lippincott, p. 308)
368.Ceftriaxone is a 3rd generation cephalosporin capable of attaining high levels in the blood and CSF. It also has the
longest half-life that allows it to have a once a day dosing (Lippincott, p.94)
369.Flumazenil is a GABA receptor antagonist that can rapidly reverse the effects of benzodiazepines. This drug is
available only by IV administration (Lippincott, p.94)
370.Estrogen (oral contraceptives) decreases the metabolism of corticosteroid leading to increased corticosteroid effect
(Katzung, p.1066)
371.Acetazolamide is a CAI indicated for glaucoma, urinary alkalinization and metabolic alkalosis, acute mountain
sickness and as adjuncts for epilepsy and to increase urinary phosphate excretion (Katzung, p.246-249)
372.(C) petides
373.Non-sedating antihistamines belong to a new class of antihistamines. Ketotifen is an antihistaminic drug that has
been used as a prophylaxis for diverse allergic reactions (Katzung, p.939)
374.Penicllin is an example of a drug with a large therapeutic index (Lippincott, p.23)
375.Remington, p.1185
376.Remington, p. 1185
377.Erythromycin and Astemizole--Erythromycin has been reported to potentiate the effects of astemizole by interfering
with cytochrome P450-mediated metabolism of this drug (Goodman and Gilman, Chap. 47)
Ketoconazole and Astemizole--Rare, but potentially life-threatening, interactions between ketoconazole and the
non-sedating antihistamines like astemizole have been reported. Ketoconazole inhibits hepatic cytochrome P450
enzyme thus decreasing the metabolism of astemizole, prolonging the Q-T interval and leading to the possible
development of ventricular tachyarrhythmias (Goodman and Gilman, Chap.59)
378.Monoamine oxidase (MAO), a mitochondrial enzyme, is found in neural tissues, gut and liver. In neurons, it
functions as a “safety valve” to oxidatively deaminate and inactivate any excess dopamine, norepinephrine, and
serotonin that may leak out of synaptic vesicles when the neuron is at rest (Lippincott, p.123)
379.MAO inhibitors interfere with detoxification mechanisms for certain other drugs. They prolong and intensify the
effects of central-depressant agents, such as general anesthetics, and alcohol. (Goodman and Gilman, Chap.19)
380.NSAIDs are associated with the following untoward effects:
Asthma--Certain individuals display intolerance to aspirin and most NSAIDs; this is manifest by symptoms
as bronchial asthma to laryngeal edema and bronchoconstriction
Acute Renal Failure--NSAIDs have little effect on renal function of normal individuals, probably because the
production of vasodilatory prostaglandins has only a minor role in sodium-replete individuals. Whereas, these drugs
decrease renal blood flow and glomerular filtration rate in patients with congestive heart failure, hepatic cirrhosis
with ascites, chronic renal disease, or in those with hypovolemia; acute renal failure may be precipitated under
these conditions (Goodman and Gilman, Chap.27)
GI bleed--Many of the NSAIDs, with the exception of p-aminophenol derivatives, have a tendency to cause
gastrointestinal side effects, ranging from mild dyspepsia and heartburn to ulceration of the stomach or duodenum,
sometimes with fatal results. (Goodman and Gilman, Chap.27)
381.The major risk of diarrhea is dehydration. The administration of oral rehydration solutions usually suffice. (Goodman
and Gilman, Chap.38)
382.(B) Chloroquine
383.Insulin is a hormone produced by the beta cells of the islets of Langehans (Goodman and Gilman, Chap. 60)
384.Refer to #378
385.Refer to #343
386.Tolerance--Sublingual organic nitrates should be taken at the time of an anginal attack or in anticipation of exercise
or stress. This particular intermittent treatment results in reproducible cardiovascular effects. However, frequently
repeated or continuous exposure to high doses of organic nitrates leads to a marked attenuation in the magnitude of
most of their pharmacological effects .
“A special aspect of tolerance has been observed among individuals exposed to nitroglycerin in the
manufacture of explosives. If protection is inadequate, workers may experience severe headaches, dizziness, and
postural weakness during the first several days of employment. Tolerance then develops, but headache and other
symptoms may reappear after a few days away from the job--the "Monday disease."
“The most serious effect of chronic exposure is a form of organic nitrate dependence. Individuals without
demonstrable organic vascular disease have died suddenly or developed myocardial infarctions after a few days'
break in chronic exposure, and there are now well-documented cases with typical subjective and objective findings
of severe myocardial ischemia, relieved by nitroglycerin, during withdrawal from long-term exposure to an organic
nitrate. Coronary and digital arteriospasm during withdrawal and its relaxation by nitroglycerin also have been
demonstrated radiographically. Because of the potential problem of nitrate dependence, it seems prudent not to
withdraw nitrates abruptly from a patient who has received such therapy chronically”. (Goodman and Gilman,
Chapter 32)
387.When phenylbutazone is given, the patient should be closely supervised and his blood should be examined
frequently. This drug causes hypersensitivity reactions of the serum-sickness type, aplastic anemia, leukopenia,
agranulocytosis, and thrombocytopenia. (Goodman and Gilman, Chap. 27)
388.Humulin is an insulin preparation (Katzung, p.691)
389.Zantac is a brand name of Ranitdine. Ranitidine is a histamine-2 receptor blocker used for ulcer (Katzung, 1026)
390.Allopurinol (Zyloprim) is a xanthine oxidase inhibitor that exerts its action by preventing the conversion of
hypoxanthine to uric acid. It is used in the management of gout (Appleton, p.27)
391.(A) Contrast media
392.Toxic effects of the cardiac glycosides are enhanced by hypercalcemia (Goodman and Gilman, Chap.61)
393.(A) Ampicillin
394.Felodipine is a dihidropyridine calcium antagonist.
395.Cilazapril is an example of ACE-inhibitors. The names of ACE inhibitors end in “–prils”.
396.“A barbiturate with a duration of action appropriate to the requirements of surgery became available with the
introduction of thiopental (PENTOTHAL) by Lundy in 1935. The use of thiopental during general anesthesia
continues to exceed that of any other barbiturate. Other ultrashort-acting barbiturates include methohexital sodium
(BREVITAL SODIUM) and thiamylal sodium (SURITAL)”. (Goodman and Gilman, Chap. 14)
397.Lithium salts are used in the prophylaxis of manic-depressive patients and treating manic episodes (Lippincott,
pp.125)
398.Pancuronium is an example of a neuromuscular blocking agent (Goodman and Gilman, Chap.9)
399.Diabetes complications: retinopathy (disease of retina associated with damage of blood vessel), nephropathy
(kidney disorder), and neuropathy, ulceration and gangrene of the extremities (Goodman and Gilman, Chap. 60)
400.The classical signs of diabetes mellitus include polydipsia (excessive thirst), polyuria (excessive urination), and
polyphagia (excessive hunger). (Shargel, p.1036)
401.Barbiturates act throughout the CNS. The nonanesthetic doses preferentially suppress polysynaptic responses. The
site of inhibition is either postsynaptic (cortical and cerebellar pyramidal cells and in the cuneate nucleus, substantia
nigra, and thalamic relay neurons), or presynaptic (the spinal cord). Enhancement of inhibition occurs primarily at
synaptic neurotransmission mediated by GABA. (Goodman and Gilman, Chap. 17)
402.The lifetime risk of suicide in major affective disorders is 10% to 15% (Goodman and Gilman, Chap. 19)
403.Ibuprofen is an example of NSAID. NSAIDs act by inhibiting the cyclooxygenase enzyme responsible in
prostaglandin synthesis.
404.Phenytoin toxicity symptoms include CNS complaints, such as ataxia, nystagmus, or mental confusion, and gingival
hyperplasia (Goodman and Gilman, Chap. 25)
405.Therapeutic alternatives are drug products that contain the same therapeutic moiety but different salts, esters or
complexes or are different dosage forms (Shargel, p.135)
406.Acidic compounds such as phenobarbital and salicylates are cleared much more rapidly in alkaline than in acidic
urine.(Goodman and Gilman, Chap. 4)
407.Loading dose (DL) is the amount of drug that, when dissolved in the apparent volume of distribution (VD), produces
the steady state concentration (Css). (Shargel, p.117)
408.Refer to #392
409.Goodman and Gilman, Chap. 19
410.Refer to #343
411.(C) both A and B
412.Children receiving tetracycline may develop brown discoloration of the teeth. Also, tetracyclines produce
gastrointestinal irritation to varying degrees in some individuals (Goodman and Gilman, Chap. 47)
413.Probenecid decreases renal excretion of penicillin (Katzung, p.1068)
414.(C) failure to release the drug
415.Ethylene oxide acts by protein denaturation (Tortora, p.205)
416.Increased tissue storage leads to increased biologic half-life
417.(A) slows it down
418.Refer to #406
419.Status epilepticus is a neurological emergency. Benzodiazepines are potent and effective for the initial treatment of
status epilepticus. Diazepam and lorazepam are the most widely used benzodiazepines for this purpose. Diazepam
(approximately 0.2 mg/kg in adults) enters the brain quickly and stops seizures quickly. (Goodman and Gilman,
Chap. 20)
420.In a small percentage of users taking hydralazine, a syndrome clinically indistinguishable from systemicl lupus
erythematosus develops. Thus lupus-like sydome (fever, arthralgia, splenomegaly, edema, and presence of lupus
erytematosus cells in the peripheral blood) has also been associated with procainamide use (Appleton, p. 188)
421.After the upatake of the adrenergic nerve, guanethidine replaces norepinephrine in storage granules and
accumulates in the nerve in place of norepinephrine. After several days of guanethidine administration, the
sympathetic nerves no longer contain sufficient amounts of norepinephrine to maintain normal venomotor tone.
Tricyclic antidepressants inhibit the uptake of guanethidine into the adrenergic neuron, thereby inhibiting the
antihypertensive effect of guanethidine (Appleton, p. 188)
422.Metoprolol and Propranololare both beta-adrenergic blockers.
423.Prazosin is a peripheral vasodilator. The side effects of this drug include a fall n blood pressure, tachycardia and
loss of consciousness following the firs dose.
424.The use of ganglionic blocking agents for management of hypertension has been replaced by superior agents. Their
use is now limited to the short-term treatment of hypertension associated with dissecting aneurysm of the aorta and
to the production of controlled hypotension during surgery. (Goodman and Gilman, Chap. 9)
425.When diazoxide was first marketed, 300mg rapid injection was recommended. However, excessive hypotension can
be avoided by beginning in smaller doses (50-150 mg). Almost all patients respond to a maximum of three or for
doses. Alternatively, Diazoxide may be administered by intravenous infusion rates at 15-30 mg/min (Katzung, p169)
426.“Hydralazine is effective in reducing renal vascular resistance and in increasing renal blood flow to a greater degree
than are most other vasodilators. Therefore, hydralazine may be the vasodilator of choice in heart failure patients
with renal dysfunction who cannot tolerate an ACE inhibitor.” (Goodman and Gilman, Chap. 34)
427.Hydralazine would be the best choice because depression is a major side effect of reserpine, guanethidine,
methyldopa and clonidine (Appleton, p.189)
428.Benztropine mesylate (COGENTIN) and trihexyphenidyl hydrochloride (ARTANE, others) are tertiary-amine
muscarinic receptor antagonists that gain access to the CNS and are therefore the anticholinergic drugs used to
treat parkinsonism and the extrapyramidal side effects of antipsychotic drugs (Goodman and Gilman, Chap. 7)
429.Cholestyramine is a basic anion exchange resin. It is a quaternary ammonium chloride that exchanges the chloride
ion for the bile acids, which are negatively charged, thereby preventing their reabsorption. It binds many compounds
such as those listed in the question (Apleton, p. 189)
430.If drug B has a greater affinity (higher association constant) for specific protein binding sites than drug A, drug B will
have a tendency to displace drug A. Furthermore, if drug B is given in large doses, the degree of the displacement
will increase due to the greater amount of drug B competing with drug A. (Appleton)
431.Phenytoin, Primidone, and Phenobarbital are anticonvulsants that can alter folic acid metabolism (Appleton, p.189)
432.Concentrations of phenobarbital in plasma rise by as much as 40% when valproate is given concurrently. The
mechanism probably involves inhibition of phenobarbital metabolism. (Gooadman and Gilman, Chap. 20)
433.Droperidol is used as an adjunct to anesthesia (Goodman and Gilman, Chap. 14)
434.Pseudomonas aeruginosa can penetrate the cornea and lead to the destruction of the cornea and interior parts of
the eye. This may lead to blindness (Appleton, p. 189)
435.Staphylocccus can cause boils in the anterior portion of the external meatus of the ear (Appleton, p.189)
436.Idoxuridine, an antimetabolite, acts by inhibiting the replication of viral DNA. It is used in herpes simplex keratitis, a
viral disease that can lead to blindness (Appleton, p. 189)
437.Tolnaftate is ineffective against Candida. Miconazole, Clotrimazole, and Coclopirox olamine are broad0spectrum
antifungal agents with activity against Candida (Appleton, p.189)
438.Methotrexate is not curative. However, it suppresses psoriatic lesions and induces prolonged remissions (Appleton,
p. 189)
439.Methotrexate is a folic acid antagonists. It inhibits dihydrofolate reductase (Chapter 51)
440.Halothane is an example of inhalational anesthetic. (Goodman and Gilman, Chap. 14)
441.Corticosteroids suppress normal tissue responses to infection leading to increased susceptibility to infection, and
allowing further dissemination of existing infection. Because tissue responses to infection are suppressed,
subjective, objective, and laboratory infection manifestations may be masked (Appleton, p. 189-190)
442.Piroxicam has a long half-life (38 hours). (Appleton, p.190)
443.Naproxen has a long half-life. This may be useful for patients who have difficulty in complying with their dosing
schedules that require frequent dosing (Appleton, p.190)
444.“Fluorouracil is used topically for treatment of premalignant actinic keratoses. It prevents further development of
existing lesions and results in cosmetic improvement. If an occlusinve dressing is applied, there may be increased
incidence of inflammatory reaction in the adjacent normal skin. However, even without an occlusive dressing, such
responses occasionally occur in the skin that appears clinically normal. This is due to the presence of subclinical
actinic keratoses”. (Appleton, p.190)
445.(Appleton, p.190)
446.Fresh blood or plasma is required as a source of prothrombin in the rapid-reversal of drug-induced
hypothrombinemia. Vitamin K derivatives may be used if the situation is not urgent or as a supplement to fresh
blood or plasma (Appleton, p.190)
447.Phenazopyridine (Pyridium) is a red dye that causes discoloration of the urine. It is used as a urinary tract analgesic
(Appleton, p.190)
448.Clomiphene citrate is used for ovulatory disturbances that causes infertility.(Goodman and Gilman, Chap.57)
449.The body starts to produce human chorionic gonadotropin after conception takes place. Pregnancy kits assays for
the presence of this hormone in the urine (Appleton, p. 190)
450.(C) dark donut-shaped brownish ring on the tube
451.(C) By select clinicians to healthy volunteers
452.Hypoparathyroidism usually presents as a disorder of calcium metabolism wherein serum calcium levels of the
patient decrease and phosphate levels increase. To prevent the complications of hypocalcemia (e.g. tetany) calcium
supplements like calcium carbonate and lactate are prescribed (Appleton, p.190)
453.(C) Pyrivinium pamoate
454.Gentamicin and other aminoglycosides may produce neuromuscular blockade that can enhance the neuromuscular
blocking effects of tubocurarine (Appleton, p.191)
455.Hypothyroid state is characterized by: mental and physical retardation, dry sparse hair, thickening of the skin or
subcutaneous tissue, constipation, cold intolerance, anemia, and dry pale skin. (Appleton, p.191)
456.(C) euthyroid
457.Fiorinal contains aspirin (Appleton, p.191)
458.Hemochromatosis is an iron storage disorder characterized by excessive amounts of iron in the parenchymal
tissues. This results to tissue damage. (Appleton, p.191)
459.This syndrome is observed when erythromycin estolate is given to susceptible individuals for more than 10-14 days.
It has not been observed with the use of erythromycin free base or other erythromycin derivatives (Appleton, p.191)
460.(C) Phthalylsulfathiazole (sulfathalidine)
461.Vancomycin is used for methicillin-resistant staphylococci(Gladwin; Appleton, p.191)
462.Cimetidine acts by blocking histamine-2 receptors, thus decreasing gastric acid secretion (Appleton, p.191)
463.If penicllin allergy is uncertain, skin tests may be performed using benzyl-penicilloyl-polylysine. A negative reaction
to the test does not rule out a hypersensitivity reaction, but it indicates that anaphylaxis reaction is not likely to occur
with the penicillin administration. (Appleton, p.191)
464.Refer to #436
465.(D) Doxycycline (Vibramycin)
466.Although spectinomycin is active against a number of gram-negative bacterial species, it is inferior to other drugs
that targets the same microorganisms. Its therapeutic use is limited to the treatment of gonorrhea caused by strains
resistant to first-line drugs or if there are contraindications to the use of these drugs. (Goodman ad Gilman, Chap.
47)
467.Bacampicillin hydrochloride (SPECTROBID)-- 1-ethoxy-carbonyloxyethyl ester of ampicillin. (Goodman and Gilman,
Chap. 45)
468.Ticarcillin is a semisynthetic penicillin that is very similar to carbenicillin, but it is two to four times more active
against Pseud. aeruginosa. Furthermore, its doses are usually smaller. Ticarcillin is now the preferred
carboxypenicillin for the treatment of serious infections caused by Pseudomonas. (Goodman ad Gilman, Chap. 45)
469.(B) One of the most potent antitubercular drugs
470.Combined drug therapy is required to prevent the development of resistant organisms against a single drug. Also,
drug combination enhances the tuberculostatic effects of the individual drugs like in the combination of isoniazid and
streptomycin, wherein the combination is more tuberculostatic than either agent alone (Appleton, p. 192)
471.The color change in the urine and sweat is a harmless side-effect. The patient should be advised regarding it so as
not to be alarmed(Appleton, p. 192)
472.Even though chloramphenicol is still an important drug for the treatment of typhoid fever and other salmonella
infections, other, safer drugs are also effective. (Goodman and Gilman, Chap. 47)
473.Both are extended-spectrum penicillins.
474.Pseudomembranous colitis is severe condition of antibiotic therapy (e.g. Clindamycin, Lincomycin, and Ampicillin).
The etiologic agent is Clostridium difficile. Oral vancomycin in doses of 125-500 mg three-four times daily for 1-2
weeks is most commonly used. (Appleton, p. 192)
475.Following a single dose of an aminoglycoside, nearly 100% of subsequent doses is eventually recovered in the
urine. The antibacterail activity of aminoglycosides is reduced in acidic pH and hyperosmolarity (Goodman and
Gilman, Chap. 46)
476.“A clinical syndrome characterized by nausea, vomiting, polyuria, polydipsia, proteinuria, acidosis, glycosuria, and
gross aminoaciduria--a form of the Fanconi syndrome--has been observed in patients ingesting outdated and
degraded tetracycline. It results from a toxic effect on proximal renal tubules”. (Goodman and Gilman, Chap. 47)
477.Refer to #475
478.Cefamandole is a 2nd generation cephalosporin. Cephalothin is a first-generation cephalosporin. Therefore,
cefamandole could be expected to have a wider antibacterial spectrum (Goodman and Gilman)
479.Appleton, p. 192
480.(D) The possibility of an initial effect of bronchoconstriction
481.(C) Consult with the physician advising him that prednisone should be discontinued before vanceril therapy is
initiated
482.Appleton, p. 192
483.Refer to #397
484.The rate of lithium carbonate excretion is independent of urine flow and dietary sodium, but in the presence of
sodium deficiency, lithium excretion is markedly reduced leading to its accumulation and toxicity. Sodium intake
enhances lithium excretion. (Appleton, p. 193)
485.Primaquine and other oxidant drugs (probenecid and sulfisoxazole) increase the rate of glutathione oxidation. This
increases the intracellular demand for NADPH, which is required to maintain the reduced form of glutathione.
NADPH is produced from the reduction of NADP which is derived from the pentose phosphate pathway, where the
initial enzyme involved is glucose-6-phoshate dehydrogenase or G-6-PD. In patients with G-6-PD deficiency,
oxidized glutathione accumulates and disrupts the erythrocyte membrane integrity (Appleton, p. 193)
486.Phentolamine competitively blocks alpha-1 and alpha-2 receptors. I has been used in the diagnosis of
pheochromocytoma and other clinical conditions associated with excessive cathecholamine release (Lippincott, p.
72)
487.(E) All of the above
488.The anticoagulant effect of heparin is monitored by activated partial thromboplastin time (APTT). The usual
therapeutic goal is to prolong the APTT to 2-2.5 times that of the laboratory control (Appleton, p.193)
489.Heparin has a brief duration of action. Because of this, mild hemorrhage is usually treated with simply withdrawing
the drug. In severe hemorrhage, the use of protamine is essential (Appleton, p.193)
490.Cimetidine decreases the rate of hepatic metabolism of warfarin and thus, potentiates the effect of this
anticoagulant. There is elevation of plasma warfarin concentration and increase in the prothrombin time (Appleton,
p.193)
491.The normal fasting blood sugar values range from 80-129 mg/dL. (Appleton, p.193)
492.Administration of 0.4mgday or more of folic acid can stimulate reticulocytosis and improve anemia caused by
vitamin B12 deficiency. (Appleton, p.193)
493.(A) conjugated bilirubin in the blood
494.Creatine kinase (CK) is found predominantly in muscle tissue. Elevated serum levels of CK are found in muscle
damage caused by myocardial infarction, muscular dystrophy, muscle trauma, and muscular inflammation
(Appleton, p. 193)
495.The relative proportion of white blood cells give the physician a clue to the patient’s condition.
Increased eosinophils—parasitic and allergic conditions (refer to # 554)
Increased Neutrophils—most bacterial infections
Increased basophils—some blood dyscrasias
Increased Monocytes—Chronic infections e.g. tuberculosis (Appleton, p.193)
496.“Pheochromocytomas are tumors of the adrenal medulla and sympathetic neurons that secrete enormous quantities
of catecholamines into the circulation.” (Goodman and Gilman, Chap. 10)
497.The normal hematocrit is 39-49 for men and 33-43 for women (Appleton, p. 194)
498.A reticulocyte is an immature erythrocyte or red blood cell (Appleton, p. 194)
499.(A) liver function
500.(D) The exact dose of drug ordered for a given patient.
502.Since the muscular component of the convulsion is not essential for benefit from the electroconvulsive therapy,
neuromuscular blocking agents (e.g. succinylcholine) and thiopental are employed. (Goodman and Gilman, Chap.
9)
503.(C) hypodermoclysis
504.The administration of a drug by intermittent instead of continuous IV injection is accomplished over a few minutes
rather than hours. “Stability or compatibility problems are less likely to occur because the drug does not remain in
contact with the large-volume IV fluid for long periods of time. The potential for thrombophlebitis is reduced because
the drug is not in constant contact with the blood vessel tissue at the site of injection. Finally, the greater
concentration gradient produced by a more rapid injection may promote better diffusion of some drugs into tissues
(Appleton, p. 194)
505.Milliequivalents (MEQ) takes into consideration the chemical-combining capacity of various ionic species (Appleton,
p. 194)
506.(E) IOWA Drug information service
507.(A) medlars
508.Martindale’s Extra Pharmacopeia is divided into three parts:
First part: monographs on drugs and ancillary substances
Second part:supplementary discussion of new drugs, obsolete drugs, and miscellaneous substances
Third Part—lists formulas of OTC products sold in the United Kingdom (Appleton, p.194)
509.A drug literature often appear to provide sufficient details to answer some questions(Appleton, p. 194)
510.Kernicterus is a neurologic syndrome that involves deposition of damaging bile pigments into the basal ganglia of
the central nervous system. Bilirubin is a normal breakdown product of hemoglobin, which is generally conjugated in
the liver to a water-soluble glucoronide that is excreted in the bile. Neonates have a deficiency of the enzyme
glucuronyl transferase, and thus, they have a limited capacity to metabolize bilirubin.
The sulfonamides are capable of displacing the unconjugated bilirubin from protein-binding sites, and are
implicated in the development of kernicterus (Appleton, p.195)
511.Renal impairment or renal failure allows drugs that are directly excreted or whose active metabolites are excreted in
the kidney to accumulate in the blood. Reducing the dose or dosage schedule of these drugs prevents their
accumulation. (Appleton, p. 195)
512.“No significant difference in clinical response can be identified between patients who acetylate isoniazid slowly and
those who do so rapidly”. Choice B is incorrect. Although slow isoniazid acetylators are more likely to develop
peripheral neuropathy, they respond well with pyridoxine therapy (Appleton, p. 195)
513.(B) They will precipitate (salt-out) the drug.
514.Amylase is a pancreatic enzyme (Goodman and Gilman, Chap. 38)
515.Sodium is the most prevalent cation in the extracelllar fluid. Potassium is the most prevalent intracellular cation
516.(D) Clinical
517.(C) Taking quarterly physical inventory
518.(B) Taking progress notes
519.(D) pharmacist
520.Shargel, p.502
521.(D) Physician
522.(A) Chronic care
523.(C) Surgical
524.(B) Iatrogenic disease
525.(B) Attending nurse
526.(A) Making judgment about the patient
527.(B) Discharge interview
528.(E) Both A and B
529.(E) None
530.(B) Effective communication
531.(C) Instruct the patient in the use of appliances
532.(D) Both B and C
533.(B) Termination
534.(E) All
535.(C) Open-ended questions
536.Acne vulgaris is a disorder of the pilosebaceous unit of the face, chest, and back. Skin lesions usually start as open
or closed comedones, and progress into inflammatory papules and pustules. The pathogenesis of acne vulgaris
involves: increased sebum production; abnormal clumping of epithelial horny cells within the pilosebaceous unit;
and infection with Propioniacterium acnes (Shargel, p.558)
537.(B) low serum ferritin. Ferritin is the protein of iron storage, and it exists as individual molecules or in an aggregated
form. (Goodman and Gilman, Chap. 53)
In adults, iron store depletion may be recognized by a plasma ferritin of less than 12 ug per liter and the absence of
reticuloendothelial hemosiderin in the marrow aspirate. (Goodman and Gilman, Chap. 53)
538.Refer to # 400
539.(B) Barbiturates
540.(D) alcohol
541.A goraphobia is a condition characterized by an irrational fear of public or open spaces
542.(B) oxygen. This has been explained extensively in previous questions regarding angina.
543.(D) magnesium citrate
544.Oral antidiabetic agents such as sulfonylureas are used in conjunction with diet modification in Non-insulin-
dependent diabetes mellitus patients (Shargel)
545.Transferrin is the plasma protein for the internal exchange of iron (Goodman and Gilman, chap. 53)
546.“Gout is a metabolic disorder mainly affecting men in which excess uric acid is produced and deposited in the joints,
causing painful swelling, especially in the toes and feet “
547.Ammonia—bleeding in the bowel
548.“Diabetes mellitus is a disorder in which there is no control of blood sugar, through inadequate insulin production
(Type 1) or decreased cellular sensitivity to insulin (Type 2), causing kidney, eye, and nerve damage. “
“Type 1 develops in childhood and requires lifelong injection of insulin, while Type 2 develops in middle age and can
usually be controlled by diet and drugs”.
549.Shargel, p.695
550. refer to #495; WBC—infection (Shargel, p.695)
551.refer to #495
552.“Polycythemia is an abnormal increase in red blood cells, occurring on its own or in conjunction with other diseases,
especially of the respiratory or circulatory systems”
553.Alkaline phoshatase is primarily produced in the liver and bones. It is used to detect increased osteoblastic activity
that occur in conditions such as Paget’s disease, hyperparathyroidism, osteomalacia, etc. Serum alkaline
phosphatase levels are particularly sensitive to artial or mild biliary obstruction (Shargel, p. 697)
554.Eiosinopilia (increased nuber of eiosinophils) occur with acute allergic reactions (e.g. asthma, hay fever, drug
allergy) and parasitic infestations (e.g. trichinosis and amebiasis). (Shargel, p. 696)
555.Hypercalcemia or increased calcium concentration is usually associated with malignancy or metastatic diseases.
Other causes of hypercalcemia are: hyperparathyroidism, Paget’s disease, milk-alkali syndrome, granulomatous
disorders, thiazide diuretics, excessive calcium intake, or Vitamin D intoxication (Shargel, p.704)
556.Ibuprofen is an NSAID. NSAIDs are used as analgesics for dysenorrhea.
557.Diazepam is an example of a benzodiazepine. Benzodiazepines are among the most commonly prescribed drugs
worldwide; they are used mainly for the treatment of anxiety disorders and insomnia. (Goodman and Gilman, Chap.
24)
558.Verapamil is anondihydropyridine calcium-channel blocker.
559.Aminophylline is a theophylline salt. It is a bronchodilator used in the treatment of asthma (Goodman and Gilman,
Chap.28)
561.Beneficial results from cyclophosphamide use have been obtained in multiple myeloma; chronic lymphocytic
leukemia; carcinomas of the lung, breast, cervix, and ovary, etc. (Goodman and Gilman, Chap. 51)
562.As discussed in the previous question concerning thiazide, thiazide diuretics (e.g. hydrochlorothiazide) are useful in
the management of hypertensive patients. (Shargel)
563.Refer to # 397
564.“Methenamine is a urinary tract antiseptic that owes its activity to formaldehyde. “(Goodman and Gilman, Chap. 44)
565.“Interferons (IFNs) are potent cytokines that possess antiviral, immunomodulating, and antiproliferative actions”.
(Goodman and Gilman, Chap. 50)
566.Iron deficiency results to a characteristic microcytic (small red blood cell), hypochromic (pale center) anemia.
567.Pernicious anemia has been discussed extensively in previous questions. Pernious anemia is a severe form of
anemia, found mostly in older adults, that results from the body’s inability to absorb vitamin B 12. (Microsoft®
Encarta® Reference Library 2005. ©)
568.Vitamin B12 is also known as cyanocobalamin. Cyanocobalamin injection (REDISOL, RUBRAMIN PC, others) is a
clear aqueous red solution. Cyanocobalamin injection is safe when given by the intramuscular or deep
subcutaneous route, but it should never be given intravenously. (Goodman and Gilman, Chap. 53)
569.Megalobalstic anemia a type of anemia where the red blood cells are abnormally large because they fail to mature
properly. (megalobalstic=from megaloblast). Folate deficiency is one of the causes of megaloblastic anemia. Folate
deficiency is a common complication of diseases of the small intestine that interfere with folate absorption from food
and the recirculation of folate through the enterohepatic cycle. (Goodman and Gilman, Chap. 53);(Microsoft®
Encarta® Reference Library 2005. © )
570.Refer to # 566
571.(B) A recurrence of his peptic ulcer.
572.(C) An antacid and oral iron. Antacid for the ulcer and iron for anemia.
573.Oral iron side effects include heartburn, nausea, upper gastric discomfort, constipation, and diarrhea (Goodman and
Gilman, Chap. 53). Intake of iron preparations is associated with black pasty stools (MIMS 2003 p. 240)
574.Iron and tetracycline—Iron will chelate and thus,will interfere with the absorption of tetracyclines.(Goodman and
Gilman, Chap. 47) Iron and Antacids--many antacids cause a clinically significant decrease in the bioavailability of
iron (Goodman and Gilman, Chap. 37)
575.Folate deficiency may be caused by drugs that inhibit dihydrofolate reductase (e.g., methotrexate, trimethoprim) or
that interfere with the absorption and storage of folate in tissues (e.g., certain anticonvulsants, oral contraceptives).
These drugs are capable of lowering the concentration of folate in plasma and may cause a megaloblastic anemia
(Goodman and Gilman, Chap. 53)
576.(B) Acetaminophen
577.(E) Assumption of a passive role by the phamacist
578.Elevated systemic blood pressure is usually defined as “systolic reading greater than or equal to 140 mmHg and a
diastolic reading greater than or equal to 90 mmHg” (Shargel, p.762)
579.The clinical signs and symptoms of hypokalemia are: malaise, confusion, dizziness, ECG changes, muscle
weakness, etc. (Shargel, p.703)
580.(D) All of the above. The treatment goals for heart failure have been discussed in previous questions
581.Shargel, p. 790-791
582.Mannitol is an osmotic diuretic. Diamox is Acetazolamide, it is a carbonic anhydrase inhibitor. Lasix is furosemide, a
loop diuretic. Midamor is Amiloride, a potassium-sparing diuretic. (Goodman and Gilman)
583.Goodman and Gilman, chapter 33
584.Goodman and Gilman, chapter 35
585.Antiarrhythmic drugs:
 Class I—Na channel blockers
 Class II—Beta-blockers
 Class III-K channel blockers
 Class IV—Ca channel blockers (Lippincott, p. 167)
586.Shargel, p. 705
587.(D) All of the above
588.(D) Testape
589.Delusion refers to “persistent false belief held in the face of strong contradictory evidence, especially as a symptom
of psychiatric disorder “ (Microsoft® Encarta® Reference Library 2005)
590.(A) Anxiety
591.(B) Excess of dopamine
592.Asthma results from increase release of preformed mediators from mast cells.
593.(D) Hot, dry, weather
594.(A) The % of theophylline content of the product
595.Dimenhydrinate is an antihistamine.
596.(B) Beta-agonist
597.(D) myelosuppression. Refer to Manor handout on Cancer Chemotherapeutic Agents.
598.(A) cell growth inhibitors. Refer to Manor handout on Cancer Chemotherapeutic Agents.
599.Recall that the two major forms of COPD are Chronic Bronchitis and Emphysema. In Chronic Bronchitis, the airways
may be colonized by the following microorganisms: Streptococcus pneumoniae, Haemophilus infuenzae, Moraxella
catarrhalis, Staphylococcus aureus and Pseudomonas (Shargel, p. 980)
600.(B) Suicide
601.(E) Congestive Heart Failure
602.“Tamoxifen is the endocrine treatment of choice for postmenopausal women with metastatic breast cancer or at high
risk of recurrence from the disease”. (Goodman and Gilman, Chap. 51)
603.“Iron requirements are determined by obligatory physiological losses and the needs imposed by growth. Thus, the
adult male has a requirement of only 13 ug/kg per day (about 1 mg), whereas the menstruating female requires
about 21 ug/kg per day (about 1.4 mg).” (Goodman and Gilman, Chap. 53)
604.“In the last two trimesters of pregnancy, requirements increase to about 80 ug/kg per day (5 to 6 mg), and the infant
has similar requirements due to its rapid growth. These requirements must be considered in the context of the
amount of dietary iron available for absorption.” (Goodman and Gilman, Chap. 53)
605.Choice (D) increased sputum production is a characteristic of chronic bronchitis.
606.(E) Any of the above—(Goodman and Gilman, Chap. 10)
607.Gamma globulin is an example of purified immunoglobulin fraction. Goodman and Gilman, Chap. 52)
608.Doxycycline was used to reduce the incidence of travelers' diarrhea, especially that caused by enterotoxin-
producing strains of E. coli. (Goodman and Gilman, Chap. 47)
609.(A) Pen V
610.(E) none of the above. SGOT (serum glutamic-oxaloacetic transaminase) is also known as AST (Aspartate
aminotransferase). SGPT (serum glutamic-pyruvic transaminase) is also known as ALT( alanine aminotransferase).
(Shargel, p.697-69)
611.(B) Spirinolactone

612.Lumbar puncture (Harrison’s)
613.Isoniazid is used in the treatment of tuberculosis caused by Mycobacterium tuberculsis.
614.Acute endocarditis is caused by Staphylococcus aureus. This is discussed further in Rationale of Microbiology.
615.(D) All
616.(B) Vasopressin
617.Refer to Manor handout on Anti-Infectives.
618.Iron-deficiency anemia is caused by: Inadequate dietary intake of iron insufficient to meet normal requirements
(nutritional iron deficiency), blood loss, or some interference with iron absorption. (Goodman and Gilman, Chap. 53)
619.Sickle-Cell Anemia is a genetic disorder that produces an abnormal form of hemoglobin, called hemoglobin S, which
distorts red blood cells after they release oxygen in the tissues. These distorted cells are called sickled cells
(resembles sickle=crescent-shaped cutting blade used in agriculture). The National Institutes of Health reports that
this condition affects 72,000 people in the United States, primarily African Americans. (Microsoft ® Encarta ®
Reference Library 2005. ©)
620.(C) Entamoeba histolytica
621.(B) dysuria (pain or difficulty urinating)
622.Metronidazole is an effective amebicide. It is an agent of choice for the treatment of all symptomatic forms of
amebiasis. (Goodman and Gilman, Chap. 41)
623.(A) penicillin Therapy
624.(B) Non-charge stock system
625.TPN stands for total parenteral nutrition. The routes of administration for TPN are central venous route and
peripheral venous route (Shargel, p. 1133)
626.Shargel, p. 980
627.Isoniazid is the most important drug for the treatment of all types of tuberculosis. (Goodman and Gilman, Chap. 48)
628.(B) Rifampicin
629.(B) lungs
630.(A) Anual purchases/annual inventory
631.(C) Congestive heart failure—discussed in th previous quetions
633.Theophylline is 1,3-dimethylxanthine (Goodman and Gilman, Chap. 28)
634.(C) None of the above
635.(C) Lithium
636.There are two thyroid hormones T3 (triidothyronine) and T4(thyroxine). T3 is the active form, but T4 is produced in
greater amounts.
CLINICAL PHARMACY REFERENCES:

Delisle, Gloria, M.D. and Dr.Lewis Tomalty. Microbes in Motion III. (PC-CD-ROM Windows)
Gladwin, Mark, M. D.and Bill Trattler. Clinical Microbiology Made Ridiculously
Simple. 3rd ed. 2005. Miami, Florida: Medmaster.
Gennaro, Alfonso R. Remington: The Science and Practice of Pharmacy. 20th ed. 2000. USA: Lippincott
Williams and Wilkins
Hall, Gary D. and Barry S. Reiss. Appleton & Lange’s Review of Pharmacy. 6th ed. 1997.
USA: Appleton & Lange.
Hardman, Joel G. and Lee E. Limbird. Goodman and Gilman’s The Pharmacological
Basis of Therapeutics. 9th ed. 1996. ew York: McGraw Hill Co.
_______Goodman and Gilman’s The Pharmacological Basis of Therapeutics PBT 9th edition. (PC-CD-ROM Windows)
Harvey, Richard A. and Pamela Champe. Pharmacology. 2nd ed. 1997. Philadelphia:
Lippincott-Raven.
Kasper, Dennis L., M.D., et.al. Harrison’s Principles of Internal Medicine.16th ed. New
York: Mc-Graw Hill Medical Publishing Division. Page 2042.
_______Harrison’s Principles of Internal Medicine 15th, (PC-CD-ROM Windows)
Katzung, Bertram G. MD, Ph. Basic and Clinical Pharmacology. 7th ed. 1998. Singapore: McGraw-Hill
Book Co.
Kumar Vinay, MBBS, MD, FRCPath, et.al. Robbins and Cotran Pathologic Basis of
Diseases.7th ed.2005.Elsevier Inc., page 47-79)
Marieb, Elaine. Essentials of Human Anatomy and Physiology.6th ed. Singapore: Pearson
Eductaion Asia Ltd.p.282.
Microsoft ® Encarta ® Reference Library 2005. © 1993-2004 Microsoft Corporation. All rights reserved.
(Encyclopedia and Dictionary)
MIMS Philippine Pharmacy Guide. 2003.
PACOP Clinical Pharmacy questions
Prescott, Lansing M, et.al. Microbiology.2nd ed. Dubuque, Iowa:Wm.C.Brown
Publishers.page.638)
Shargel, Leon, et.al. Comprehensive Pharmacy Review.5th ed.2004.USA: Lippincott
Williams and Wilkins.page 695)
Tortora, J., et. Al. Microbiology: An Introduction. 7th ed. 2001. Perason education Asia Pte Ltd.


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9. Prognostic factors in breast carcinoma include all of the following, except:

10. Iron, a necessary dietary constituent, functions primarily:

19. The leading cardiac cause of death is:

20. A positive tuberculin test means that the patient:

21. Cretinism is the result of a metabolic disturbance related to:

22. Rheumatic fever is a disease which:

25. Gout is an example of a disturbance in the metabolism of:

27. Which of the following antibiotics is effective in treating candidiasis?

MANOR Review Center 138

32. The following are “Vital Signs” except:

35. Administration of corticosteroids is contraindicated when there is a history of:

37. Staphylococcal infections are:

39. Which of the following may be a feature of acromegaly

43. What elements interfere with the activity of tetracycline?

44. Serum hepatitis is caused by a/an:

MANOR Review Center 139

47. Pernicious anemia is usually associated with:

56. Most Like-threatening adverse drug reactions affect the:

59. Which one of the following is not considered an epinephrine use?

64. A diuretic specifically useful to induce diuresis in cases of poisoning is:

72. U-100 Insulin is:

74. Which one of the following agents can be used QID/OD?

77. Diagnosis of gout can only be confirmed by:

79. The only class of immunoglobulin that crosses the placenta:

82. Complications of heparin anticoagulation include all the following, except:

83. AIDS-related malignancies include all the following, except:

84. Drug of choice for ringworm infection is:

85. Anaphylactic shock to penicillin occurs:

87. Inflammation of the bladder:

88. Infection acquired after at least 2 days in the hospital:

105.Acetaminophen has limited value in the treatment of rheumatoid arthritis because:

107.All of the following are useful in the treatment of cough, except:

113.Which type of laxative is usually recommended if chronic use is indicated?

118.The following is used in the treatment of hypothyroidism:

120.Normal value range of hemoglobin for females:

121.These are specific signs and symptoms of iron-deficiency anemia, except:

122.Which is not a suitable iron therapy for iron deficiency anemia?

123.Corticosteroids such as prednisone may be used for which type of anemia?

124.Which is not true of diabetes mellitus?

125.Which is not a correct form of therapy for a diabetic patient?

126.These are precautions and monitoring effects on insulin therapy, except:

127.An autoimmune disorder resulting to hypothhyroidism:

129.These are signs and symptoms of hypothyroidism, except:

130.Precaution on the long term therapy of levothyroxine:

132.These are characteristics of myxedema coma, except:

133.In thyrotoxicosis, there is overactivity of the:

134.Which is not true of Grave’s disease:

135.A cardiovascular agent useful for hyperthyroidism:

136.Possible causes of hyperlipidemia except:

137.The use of this drug may lead to hyperlipidemia:

138.Which vitamin would you suggest for hyperlipidemia?

140.What diet regimen would you recommend to a hyperlipidemic patient?

141.The most common cardiovascular disorder is:

142.Which variable is measured in hypertension?

143.Hypertension might be due to the following, except:

144.Which is not a predisposing factor to primary hypertension?

146.An antineoplastic which causes congestive heart failure:

147.The emergency treatment of patient with congestive heart failure:

148.An antiepileptic agent used also as antiarrhythmic: