Sunday, January 13, 2008

8 - pharmacology mcqs - 13 to 24

13) Drug induced parkinsonism is treated by

a. Carbidopa

b. Bromocriptine

c. Benzhexol

d. Selegiline

Answer : C) Benzhexol

Reference: KDTripathi 5th Edition Page 388

14) Drug with high degree of Photosensitivity is

a. Tetracycline

b. Doxycycline

c. Minocycline

d. Methacycline

Answer : b) Doxycline

Reference: KDTripathi 5th Edition Page 672

15) Minoxidil

a. Topical Application is used in Alopecia

b. Acts on Arteriolar smooth muscles causing relaxation

c. Leads to Sodium Retention

d. All of the above

Answer : D) All of the above

Reference: KDTripathi 5th Edition Page 513

16) Thrombolytic therapy with Streptokinase is Contraindicated in all of the following except

a. Supra ventricular Tachycardia

b. Recent Trauma

c. Recent Cerebral Bleeding

d. Recent Surgery

Answer : a) Supra ventricular Tachycardia

Reference: KDTripathi 5th Edition Page 571

17) Carbenazolone Sodium

a. Promotes Ulcer Healing

b. Slows down Prostaglandin degradation

c. Derived from Glycyrrhetinic Acid

d. All of the above

Answer : d) All of the above

Reference: KDTripathi 5th Edition Page 597

18) Treatment of Lepra Reaction includes

a. Thalidomide

b. Steroids

c. Clofazamine

d. All of the above

Answer : D) All of the above

Reference: KDTripathi 5th Edition Page 714

19) Drug used for treatment of Methicillin Resistant Staphylococcus Aureus

a. Teicoplanin

b. Vancomycin

c. Both

d. None

Answer : C) Both

Reference: KDTripathi 5th Edition Page 691

20) Which is obtained from a natural source Naturallly acquiring product –

a. Physostigmine

b. Pilocarpine

c. Heparin

d. All of the above

Answer : D) All of the above

Reference: KDTripathi 5th Edition Page 81, 561

Physostigmine occurs naturally in Calabar or Ordeal bean, Ripe seed of Physostigm venenosum, Heparin in Liver and granulocytes of mast cells, Sulfonamides in Azo dyes, Liq.paraffin in Hydrocarbons.

21) Mechanism of action of Aspirin is inhibition of

a. Thromboxane A2 Synthesis

b. Phosphodiesterase

c. HMG- CoA Reductase

d. Pancreatic Lipase

Answer : A) Thromboxane A2 Synthesis

Reference: Harper 27th Edition Page 204

22) Folic acid

a. Is also called as Pteroyl Glutamic Acid

b. Is useful in Carriage of one Carbon atom moiety

c. Tetra hydro folate is the active form

d. All of the above

Answer : d) All of the above

Reference: Chaterjee 6th Edition Page 174

23) Gene therapy is used for all the following except

a. Gene Addition

b. Gene Correction

c. Modify Vascular Biology

d. None

Answer : d) None

Reference: Harrison 16th Edition Page 392

24) Local Anaesthetics act by

a. Blocking Na and Preventing depolarisation

b. Inhibiting Aldose reductase

c. Increasing degradation of Adrenaline

d. None of the above

Answer : a) Blocking Na and Preventing depolarisation

Reference: KDTripathi 5th Edition Page 321

7 - pharmacology mcqs - 1 to 12

1) Actions of opiates in man are all except

a. Constipation

b. Mydriasios

c. Vomiting

d. Analgesia

Answer : b) Mydriasis

Reference: Tripathi 5th Edition Page 421

2) Drug of choice for Prophylaxis of meningococcal meningitis is

a. Rifampicin

b. Penicillin

c. Erythromycin

d. Septran

Answer : a) Rifampicin

Reference: Tripathi 5th Edition Page 701

3) Gray Baby syndrome is caused by

a. Chloramphenicol

b. Cycloserin

c. Kanamycin

d. Thioacetazone

Answer : a) Chloramphenicol

Reference: Tripathi 5th Edition Page 675

4) Which of the following is a Cholestatic drug

a. Erythromycin

b. Phenothiazines

c. Oral Contraceptives

d. All of the above

Answer : d) All of the above

Reference: Harrison 15th Edition Page 434

5) Ceftriaxone is

a. II Generation short acting

b. III generation long acting

c. active against beta lactamase

d. IV generation used orally

Answer : b) III Generation Long Acting

Reference: Tripathi 5th Edition Page 665

6) Treatment of bacterial vaginosis. Drug of choice is

a. Ampicillin

b. Metronidazole

c. Ciprofloxacin

d. Fluconazole

Answer : Metronidazole

Reference: Dutta Gynaec 2nd Edition Page 151

7) Bioavailability is defined as

a. The percentage of drug that is detected in the systemic circulation after its administration

b. The volume of plasma completely cleared of a specific compound per unit time and measured as a test of kidney function.

c. Both

d. None

Answer : The percentage of drug that is detected in the systemic circulation after its administration

Reference: Tripathi 5th Edition Page 15

8) Which of the following is a Prodrug

a. Enalapril

b. Dopamine

c. AMpicillin

d. Prednisolone

Answer d) Enalapril:

Reference: Tripathi 5th Edition Page 20

9) Cyclosporine side effect all except

a. Post-transplant lymphoproliferative disorders (PTLDs),

b. nephrotoxicity

c. tremors

d. Hypotension

Answer : d) Hypotension

Reference: Tripathi 5th Edition Page 788

10) True about Sumatriptan

a. Antagonist of Serotonin

b. Interacts with alpha and beta adrenergic receptors

c. Has antimigranic activity

d. Can be used in a patient with Ischemic Heart disease

Answer : Has antimigranic activity

Reference: Tripathi 5th Edition Page 153

11) Anticholine esterase with effect on CNS

a. Physostigmine

b. Neostigmine

c. Dacrine

d. Edrophonium

Answer :physostigmine ( check )

Reference: Tripathi 5th Edition Page

12) DOC for Herpes

a. Acyclovir

b. Zidovudine

c. Indinavir

d. Ribavarin

Answer : a) Acyclovir

Reference: Tripathi 5th Edition Page 726

6 - inhaled corticosteroids mcqs

Question 1
Ideal inhaled corticosteroid should have:
High pulmonary residence time
High protein binding after leaving the lungs
High systemic clearance
All the above---------------

Question 2
Which statement is not true with regard to corticosteroid receptors?
They are intracellular
Same receptor mediates both beneficial and adverse effects of coticosteroid
There are no coticosteroid receptors in the eye lens
None of the above-----------------

Question 3
The latest addition to the list of inhaled corticosteroid is:
Ciclesonide-------------
Budesonide
Beclomethasone dipropionate
Fluticasone propionate

Question 4
Which of the following formulations gives the highest drug deposition in the lungs?
Powder
Suspension
Solution----------
Is equal with all of the above

Question 5
Of the following, which drug has highest receptor affinity?
Fluticasone propionate--------------
Dexamethasone
Beclomethasone dipropionate
Desisobutyryl – ciclesonide

Question 6
Which of the following corticosteroids is inhaled in pharmacologically inactive form?
Beclomethasone dipropionate------------
Fluticasone propionate
Dexamethasone
None of the above

Question 7
Which of these statements is false? In approved dosages inhaled corticosteroids:
Inhibit proliferation of inflammatory cells
Do not suppress endogenous cortisol release
Do not cause osteoporosis
None of the above-------------

Question 8
Which of these statements is true? In approved dosages inhaled corticosteroids cause:
Weight gain
Glaucoma
Cataract
None of the above------------

Question 9
Which of these is a side effect of oral but not of inhaled corticosteroids when given in recommended dosage?
Moon face
Increased risk of fracture
Disturbed carbohydrate metabolism
All of the above-------------

Question 10
Which of the following statements is not true with regard to use of inhaled corticosteroid ?
It should be used as first line therapy in asthma
It should be used as first line therapy in chronic obstructive pulmonary disease-------------
It should not be used in children
None of the above

Question 11
Inhaled corticosteroids are used as first line therapy in:
Mild persistent asthma
Moderate persistent asthma
Severe persistent asthma
All the above--------------

Question 12
Which of these statements is true with regard to growth in children with asthma?
Uncontrolled asthma can affect growth
Inhaled corticosteroid with low oral bioavailibility should be used
Inhaled corticosteroid in recommended dosage do not prevent children from reaching adult height
All the above------------

Question 13
What percentage of ciclesonide is deposited in the lung when delivered via the inhaled route?
10% - 20%
21% - 30%
31% - 40%
>50%-----------------

Question 14
Ciclesonide is the safest inhaled corticosteroid because:
Of low oro-pharyngeal deposition
It has high plasma protein binding
Of rapid clearance
All the above statements are true--------------

Question 15
Recommended dosage of ciclesonide in asthma is:
80 – 640 mcg once daily--------------
640 -800 mcg once daily
800 – 1000 mcg once daily
1000 – 1640 mcg once daily

Saturday, January 12, 2008

5 - diuretic resistance mcqs

Question 1
What is diuretic resistance?
Short-term decrease in response to a diuretic
Occurrence of braking phenomenon before edema is relieved--------------
Occurrence of braking phenomenon after edema is relieved
Any of the above

Question 2
Diuretic resistance can be due to
Reduced renal function
Reduced peak concentration of loop diuretic in the tubular fluid
Delayed peak concentration of loop diuretic in the tubular fluid
Any of the above------------


Question 3
In renal failure diuretic resistance can be due to
Reduced renal blood flow
Reduced sodium filtration
Accumulation of organic acids that inhibit tubular secretion of the diuretic
Any of the above------------

Question 4
Which of these drugs could lead to apparent diuretic resistance?
Non steroidal anti-inflammatory drugs----------
Prostaglandin E2
None of the above
Both of the above


Question 5
Loop diuretics reach the tubular lumen by
Glomerular filtration
Passive diffusion
Active secretion----------
All the above

Question 6
Chronic administration of loop diuretics results in hypertrophy and hyperplasia in the epithelial cells of the
Proximal convoluted tubule of nephron
Loop of Henle
Distal convoluted tubule of Nephron-------------
None of the above

Question 7
Which of these can overcome diuretic resistance in congestive heart failure?
Increasing the dose of diuretic
More frequent administration of the diuretic
Intravenous administration of the diuretic
All of the above--------------

Question 8
Which of these can be given in combination with a loop diuretic to achieve sequential nephron blockade?
Thiazide diuretic
Thiazide type diuretic
Potassium sparing diuretic
Any of the above--------------

Question 9
In a person requiring diuretic medication, the amount of sodium intake should be
<100mmol/day-----------
<150mmol/day
<200mmol/day
<250mmol/day

Question 10
In which of these conditions loop diuretic may be rendered ineffective after reaching the lumen due to high intraluminal albumin concentration?
Congestive heart failure
Nephrotic syndrome--------------
Hepatic cirrhosis
None of the above

Question 11
Metolazone is a
Thiazide diuretic
Thiazide type diuretic---------
Potassium sparing diuretic
Osmotic diuretic

Question 12
Metolazone is indicated in edema associated with
Congestive heart failure
Chronic kidney disease
Nephrotic syndrome
All the above-----------

Question 13
Which of the following statement is not true with regard to Metolazone?
It is ineffective when glomerular filtration rate is <30ml/min---------
It causes reabsorption of calcium
It inhibits the reabsorption of sodium and chlorine in the distal convoluted tubule of nephron
None of the above

Question 14
Which of the following diuretic can be used in any stage of kidney failure?
Metolazone-------------
Indapamide
Furosemide
None of the above

Question 15
Which of the following statements is true with regard to Metolazone?
Dosage adjustment is not required at any stage of chronic kidney disease
Diuretic effect is observed at doses ranging from 1mg to 25 mg
It exerts its action in the distal and proximal convoluted tubule of the nephron
All are true------------

4 - statins mcqs

Question 1
Apart from reducing cholesterol levels, statins also:
Reduce inflammation
Improve endothelial function
Stabilise atherosclerotic plaque
All the above------------

Question 2
Of the following patients, which group is more likely to have adverse effects of statins?
Elderly
Those receiving immunosuppressive drugs
Those receiving high doses of statins
All the above------------

Question 3
In people taking statins, transaminase values should be estimated:
Before starting therapy
12 weeks after initiation of therapy
At any elevation in dose
At all the above-----------------

Question 4
Which of the following statements is true? Coadministration of ezetimibe with 10mg atorvastatin:
Provides the same reduction in LDL-C as obtained with 80mg of atorvastatin----------------
Provides the same reduction in LDL-C as obtained with 60mg of atorvastatin
Provides the same reduction in LDL-C as obtained with 40mg of atorvastatin
Provides greater reduction in LDL-C as obtained with 80mg of atorvastatin

Question 5
Which of the following statements is true?
There is an increased risk of side effects with combination of statin and gemfibrozil as compared to statin and fenofibrate--------------
There is increased risk of side effects with combination of statin and fenofibrate as compared to statin and gemfibrozil
Increase in risk of side effects is similar when statin is given with fenofibrate or gemfibrozil
Risk of side effects is not increased when statin is given with fenofibrate or gemfibrozil

Question 6
For which statin, a lower dosage is recommended in Asians as compared to people from western countries?
Atorvastatin
Simvastatin
Rosuvastatin----------
Fluvastatin

Question 7
Which of the following statins should be given in the evening?
Atorvastatin
Simvastatin-------------
Rosuvastatin
All the above

Question 8
The therapeutic potential of statins might extend beyond cholesterol lowering and coronary artery disease to other inflammatory disorders such as:
Multiple sclerosis
Rheumatoid arthritis
Chronic kidney disease
All the above-----------------

Question 9
In patients with renal disease, statins benefit by:
Reducing hyperlipidaemia
Improving glomerular filtration rate(GFR)
Reducing proteinuria
All the above-------------

Question 10
When LDL-C drug is used to treat high risk persons or moderately high risk patients, the serum LDL-C should be reduced by at least:
5-10%
10-20%
20-30%
30-40%------------

Question 11
Which of the following statements is not true?
The beneficial effects of statin in ischemic stroke or transient ischemic attack (TIA) are independent of cholesterol levels
Statin treatment should be initiated soon after an ischemic stroke or TIA
There is no potential risk of recurrent haemorrhage with statins in patients with haemorrhagic stroke-----------------
From the standpoint of statin treatment, stroke or TIA should be considered a coronary heart disease risk equivalent

Question 12
In patients with acute coronary syndrome, statin should be given:
As early as possible-----------
After 24 hours
After stabilisation of patient’s condition
On discharge

Question 13
The principle benefit with statins in acute coronary syndrome are due to their:
Anti-inflammatory effects----------
Lipid lowering effects
Anti-hypertensive effect
Both a and b

Question 14
Which of the following statement is not true?
Statins are the first choice pharmacological therapy for diabetic dyslipidemia
Patients with type 2 diabetes may be canditate for statin therapy regardless of LDL cholesterol
Statin can be combined with fibrate or niacin for more comprehensive lipid control in diabetic patients.
As per latest NCEP guidelines, target LDL-C level in diabetic patients in the absence of cardiovascular disease should be 70 mg/dl-------------------

Question 15
Which of the following statement is not true?
Statins should be given to all patients with a prior atheromatous disease
Statins should be given to all patients at increased risk of cardiovascular disease irrespective of lipid profile
Statins should be given only to patients with cardiovascular disease with coexisting hyperlipidemia--------------
Statins should be given to all patients with a history of ischemic stroke.

3 - anti-coagulants mcqs

Question 1
Anticoagulants are indicated for an indefinite period in patients with:
Atrial fibrillation------------
Venous thromboembolism
High risk of myocardial infarction
All of the above

Question 2
Which of the following sentence is true with regard to warfarin?
Is a vitamin K antagonist------------
Is a thrombin inhibitor
Activates fibrinolysis
Binds to antithrombin III

Question 3
Which of the following is not an approved indication for warfarin therapy?
Atrial fibrillation
Heart valve replacement
Deep vein thrombosis
Peripheral artery disease--------------

Question 4
Time taken for observable anticoagulant effect of warfarin is:
6-12 hours
24-36 hours
2-7 days--------------
8-10days

Question 5
Which of the following is the recommended test to monitor the effect of oral anticoagulant therapy?
Thrombin time
International normalized ratio (INR)----------------
Bleeding time
Partial thromboplastin time (PTT)

Question 6
What is the most acceptable frequency of INR monitoring in a patient taking warfarin?
Initially thrice daily, then twice daily, then daily, then weekly, and then monthly
Initially twice daily, then daily, then weekly, and then monthly
Initially daily, then weekly, and then monthly
Initially twice per week, then weekly, then every two or three weeks, and then monthly----------

Question 7
What is the value of International normalized ratio (INR) above which warfarin does not provide any additional therapeutic benefit in most patients, but is associated with a higher risk of bleeding?
4.0----------
3.5
3.0
2.5

Question 8
Which of the following is used for reversal of anticoagulant effect of warfarin in case of life-threatening bleeding?
Platelets
Protamine
Vitamin K or Vitamin K dependant coagulation factors-----------
Any of the above

Question 9
Which of the following statement(s) concerning heparin is/are true?
It binds to antithrombin III leading to anticoagulant effect
It exhibits varying anticoagulant response
Heparin therapy is monitored with activated partial thromboplastin time (APTT)
All of the above-----------

Question 10
Which of the following is an advantage of low molecular weight heparin (LMWH) over unfractionated heparin?
Does not require monitoring of activated partial thromboplastin time
Has a greater bioavailibility
Given subcutaneously therefore can be administered in “out of hospital setting”
All of the above------------

Question 11
Low molecular weight heparins (LMWHs) do not require monitoring, but when necessary, which of the following is measured?
Anti-factor Xa level-------------
Thrombin time
Prothrombin time
Activated partial thromboplastin time (APTT)

Question 12
The anticoagulant effect of heparin is rapidly reversed with:
Protamine----------------
Infusion of vitamin K dependant coagulation factors
Packed red blood cells
Platelets

Question 13
Which of the following anticoagulant should not be given during pregnancy?
Warfarin-------------
Low molecular weight heparins (LMWHs)
Unfractionated heparin
All of the above

Question 14
Which of the following is correct with regard to patients taking warfarin undergoing surgery with minimal risk of bleeding?
Do not stop warfarin but check INR prior to surgery----------------
Switch over to heparin two days prior to surgery and restart warfarin after surgery
Switch over to heparin five days prior to surgery and restart warfarin after surgery
Switch over to heparin seven days prior to surgery and restart warfarin after surgery

Question 15
Anticoagulation in warfarin users at high risk of thromboembolism, undergoing surgery associated with high risk of bleeding involves:
Stop warfarin 4-5 days prior to surgery
Start with full dose unfractionated heparin or LMWH 2-3 days preoperatively
Restart regular warfarin therapy after surgery once adequate haemostasis is achieved
All of the above-----------

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