Clinical Pharmacology
Mock Exam
Course Introduction
Clinical Pharmacology is the scientific study of drugs and their clinical use in humans, focusing on the interactions between medications and the body to optimize therapeutic efficacy and minimize adverse effects. This course delves into principles such as absorption, distribution, metabolism, and excretion of drugs, as well as pharmacodynamics and pharmacokinetics. It explores the rational use of medicines, personalized therapy, drug safety, clinical trials, and the regulatory framework governing drug development and approval. Students will gain a comprehensive understanding of how drugs are selected, dosed, and monitored for various diseases and diverse patient populations, equipping them with essential knowledge for evidence-based clinical practice.
Recommended Textbook
Pharmacology An Introduction 7th Edition by Henry Hitner PhD
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Chapter 1: Introduction to Pharmacology
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Sample Questions
Q1) The _____ of 1970 was designed to regulate the dispensing of drugs that have the potential to be misused.
A) Federal Food Drug and Cosmetic Act
B) Federal Pure Food and Drug Act
C) Federal Comprehensive Drug Abuse Prevention and Control Act
D) Regulated Health Professions Act
Answer: C
Q2) Identify a difference between agonists and antagonists.
A) Agonists bind to specific receptors to trigger a drug action, while antagonists bind to specific receptors to block a drug action.
B) Agonists bind to receptors and prevent them from being activated, while antagonists bind to receptors to activate them.
C) Agonists bind to a specific receptor site in the body, while antagonists can bind to any receptor site in the body.
D) A typical example of an agonist is naloxone, while a typical example of an antagonist is morphine.
Answer: A
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Chapter 2: Pharmacokinetics and Factors of Individual
Variation
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Sample Questions
Q1) Identify the drug that is available as a transdermal patch system.
A) Nitroglycerin
B) Clonidine
C) Estrogen
D) All of the above
Answer: D
Q2) Select the most appropriate reason why a patient with cirrhosis of the liver may not get the therapeutic response expected from the medication that she is taking.
A) The patient's ability to absorb drugs is impaired.
B) The patient's ability to distribute drugs throughout the body is impaired.
C) The patient's ability to metabolize drugs is impaired.
D) The patient's ability to maintain bioavailability of drugs is impaired.
Answer: C
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4
Chapter 3: Geriatric Pharmacology
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Sample Questions
Q1) The term used to describe the situation that involves multiple drug prescriptions is
A) pharmacotherapy
B) polypharmacy
C) therapeutic duplication
D) monotherapy
Answer: B
Q2) In comparison to the members of other age groups,members of the geriatric population are:
A) less likely to consume drugs.
B) more likely to experience the adverse effects of a drug.
C) less likely to suffer from toxicity.
D) more likely to benefit from the therapeutic effects of the drug.
Answer: B
Q3) One way to improve compliance for a patient with arthritis would be to:
A) encourage the patient to take medication on an empty stomach.
B) suggest not using child safety caps on medication bottles.
C) encourage the patient to read medication information literature.
D) allow the patient to identify the drugs he requires on his own.
Answer: B
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Chapter 4: Math Review and Dosage Calculations
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Q1) Select the correct volume of a drug required to administer a dosage of 5 mg/kg for a patient who weighs 88 pounds and is 12 years old.The drug is available as a 1-g tablet,which will be mixed in enough water to make 100 ml of final solution (W/V).
A) 12 ml
B) 20 ml
C) 37 ml
D) 42 ml
Q2) A drug order contains 500 mg of a drug to be administered every day.The drug is available as 200-mg tablets.How many tablets should be administered per day?
A) 1 tablet
B) 2 tablets
C) 2.5 tablets
D) 3.5 tablets
Q3) Use metric system equivalents to select the quantity equal to 3 g.
A) 3000 mg
B) 50 grains
C) 0.003 kg
D) All of these
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Chapter 5: Autonomic Nervous System
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Sample Questions
Q1) The neurotransmitter common to both preganglionic nerve fibers in the sympathetic and parasympathetic nervous system is:
A) norepinephrine.
B) acetylcholine.
C) epinephrine.
D) serotonin.
Q2) How do parasympathetic nerves differ from sympathetic nerves?
A) Parasympathetic nerves innervate blood vessels, whereas sympathetic nerves do not.
B) Parasympathetic nerves are less active than sympathetic nerves during periods of rest.
C) Parasympathetic nerves cannot be individually stimulated, whereas sympathetic nerves can.
D) Parasympathetic nerves do not release the neurotransmitter norepinephrine, whereas sympathetic nerves do.
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Chapter 6: Drugs Affecting the Sympathetic Nervous System
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Sample Questions
Q1) Analyze the common dosage ranges of the alpha-adrenergic blocking drugs,and select the correct common daily dosage range of tamsulosin (Flomax)for treatment of benign prostatic hyperplasia in males.
A) 0.4-0.8 mg PO
B) 1-5 mg PO
C) 10 mg PO
D) 1-8 mg PO
Q2) Use the moderate-dose range of 2-10 mcg/kg/min to determine the appropriate dose range of dopamine that would result in increased cardiac output for a patient who weighs 176 pounds.
A) 2.4-12 mg/hr
B) 9.6-48 mg/hr
C) 19.2-96 mg/hr
D) None of these are correct.
Q3) What is the disadvantage of using norepinephrine as a drug?
A) It cannot be used to produce beta-adrenergic drugs.
B) It stimulates all alpha and beta receptors.
C) It must be administered by injection.
D) It provides a very long duration of action.
Page 8
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Chapter 7: Drugs Affecting the Parasympathetic Nervous System
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Q1) Which of the following statements is true of direct-acting cholinergic drugs?
A) They bind to muscarinic receptors and produce effects similar to those of acetylcholine.
B) They primarily work to inhibit the enzyme acetylcholinesterase.
C) They increase the activity of acetylcholine at all muscarinic and nicotinic receptor sites.
D) They significantly increase the concentration of acetylcholine in the synaptic cleft of all cholinergic nerve endings.
Q2) Identify an accurate statement about anticholinergic drugs.
A) They prevent acetylcholine from binding to cholinergic receptors and producing an effect.
B) They are used to enhance the effects of acetylcholine.
C) They can be used to decrease heart rate and atrioventricular conduction.
D) They are useful in the treatment of Alzheimer's disease.
Q3) Myasthenia gravis is diagnosed by the intravenous injection of:
A) edrophonium.
B) neostigmine.
C) pyridostigmine.
D) ambenonium.
Page 9
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Chapter 8: Drugs Affecting the Autonomic Ganglia
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Sample Questions
Q1) Which of the following can cause a sudden drop in blood pressure or orthostatic hypotension for a patient being treated with mecamylamine?
A) A change in body position
B) A sudden decrease in dosage of mecamylamine
C) A pre-existing condition such as mental depression
D) A temporary stoppage in the delivery of the drug
Q2) Implementing a treatment plan that includes ganglionic blocking drugs and vasodilators could lead to a drug interaction resulting in _____.
A) additive anticholinergic effects
B) additive vasodilating effects
C) antagonism of anticholinergic effects
D) additive antiadrenergic effects
Q3) What is the main effect of ganglionic blockers on the gastrointestinal system?
A) Increased blood pressure
B) Decreased intestinal secretions
C) Increased urination
D) Decreased cardiac output
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Chapter 9: Skeletal Muscle Relaxants
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Sample Questions
Q1) Which of the following types of drugs inhibits muscle contraction at the neuromuscular junction or within the contractile process?
A) Spasmolytics
B) Peripheral skeletal muscle relaxants
C) Parasympathomimetic drugs
D) Cholinergic drugs
Q2) _____ is the principal inhibitory neurotransmitter within the brain.
A) Serotonin
B) Dopamine
C) Acetylcholine
D) Gamma-aminobutyric acid (GABA)
Q3) The discontinuation of intrathecal baclofen therapy should be gradual in order to prevent:
A) severe hypotension.
B) hyperglycemia.
C) rebound spasticity.
D) hypernatremia.
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11
Chapter 10: Local Anesthetics
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Sample Questions
Q1) An overdose of local anesthetics can lead to central nervous system (CNS)excitation.Which of the following should be used to reverse the effects of the overdose?
A) Barbiturates and diazepam (Valium)
B) Epinephrine and diazepam (Valium)
C) Barbiturates and epinephrine
D) None of the above
Q2) Identify the type of impulse that sensory nerves carry to the brain.
A) Heat and cold
B) Pain
C) Touch
D) All of the above
Q3) Why do local anesthetics that are given by injection occasionally contain epinephrine?
A) Epinephrine acts as a preservative in maintaining an extended shelf life.
B) Epinephrine counteracts the vasodilation that occurs with local anesthetic use.
C) Epinephrine counteracts the vasoconstriction that occurs with local anesthetic use.
D) None of the above are true.
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Chapter 11: Introduction to the Central Nervous System
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Q1) Which area of the cerebral cortex has most likely been affected in a person who has developed speech problems as a result of a head injury?
A) The parietal lobe of the cerebral cortex
B) The temporal lobe of the cerebral cortex
C) The frontal lobe of the cerebral cortex
D) The occipital lobe of the cerebral cortex
Q2) Jacob's body is not stimulated by pain or temperature.Which of the following regions of his brain is most likely damaged?
A) The hypothalamus
B) The pons
C) The medulla oblongata
D) The thalamus
Q3) The _____ is referred to as the master gland of the body.
A) pineal gland
B) pituitary gland
C) thyroid gland
D) thymus gland
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Chapter 12: Sedative-Hypnotic Drugs and Alcohol
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Sample Questions
Q1) Steve has a sleep disorder and is prescribed pentobarbital for two weeks.After the first week,Steve notices that the medication has a diluted effect,and he is unable to feel the same hypnotic effects of the drug as he did during the first week.This effect is termed
A) drug addiction
B) REM rebound
C) drug tolerance
D) automatism
Q2) Which of the following best explains automatism?
A) Drug-induced hangover effect resulting from benzodiazepine use
B) Drug-induced heightened tolerance resulting from benzodiazepine use
C) Drug-induced confusion that can lead to barbiturate drug overdose
D) None of the above
Q3) Select the stage of the sleep cycle that corresponds with the ability to dream.
A) NREM stage 1
B) REM
C) NREM stage 2
D) None of the above
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Chapter 13: Antipsychotic and Antianxiety Drugs
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Q1) Which of the following is not a method of treating parkinsonism which may develop from the continued use of a phenothiazine?
A) Reducing the dosage of phenothiazine
B) Completely stopping the use of phenothiazine for treatment
C) Administering a dopamine agonist
D) Administering a centrally acting anticholinergic drug
Q2) The _____ is involved with emotional and behavioral responses associated with reward,punishment,anger,fear,and anxiety.
A) medulla oblongata
B) limbic system
C) reticular formation
D) spinal cord
Q3) Which of the following atypical antipsychotic drugs cause significant anticholinergic,alpha-adrenergic blocking,or antihistaminic actions as side effects?
A) Aripiprazole
B) Risperidone
C) Clozapine
D) Olanzapine
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15
Chapter 14: Antidepressants,psychomotor Stimulants,and
Lithium
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Sample Questions
Q1) A patient has been taking amitriptyline for 5 to 6 days,but she is still experiencing the feelings of depression.She wants the doctor to change her medication because she feels that the drug is not working.After doing research on amitriptyline,you tell the patient that:
A) amitriptyline is working, but the full antidepressant effect can take as long as 2 to 4 weeks to develop.
B) amitriptyline is not working and the doctor will change her medication.
C) amitriptyline is working, but the full antidepressant effect can take as long as 7 to 10 days to develop.
D) None of the above are correct.
Q2) Select the statement that is not consistent with the mechanism of action or adverse effect profile of the SSRI mirtazapine (Remeron).
A) Mirtazapine decreases the release of norepinephrine and serotonin.
B) Mirtazapine has potent antihistaminic actions.
C) Mirtazapine antagonizes serotonin 5HT<sub>2</sub> and 5HT<sub>3</sub> receptors.
D) Mirtazapine use has been associated with weight gain.
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Chapter 15: Psychotomimetic Drugs of Abuse
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Q1) Which of the following symptoms will a person who is under the influence of lysergic acid diethylamide (LSD)most likely experience?
A) Piloerection
B) Decreased blood pressure
C) Bradycardia
D) Pupillary contraction
Q2) Cocaine produces less intense effects when administered _____.
A) intravenously
B) orally
C) parenterally
D) intranasally
Q3) Marijuana resin is extracted from the plant _____.
A) Acacia polyacantha
B) Cannabis sativa
C) Nicotiana tabacum
D) peyote
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Chapter 16: Antiepileptic Drugs
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Sample Questions
Q1) Despite the risks of developing serious adverse effects,a drug that is used to treat partial seizures in patients who do not respond to other drugs is _____.
A) gabapentin (Neurontin)
B) topiramate (Topamax)
C) felbamate (Felbatol)
D) valproic acid (Depakene)
Q2) Select the correct FDA pregnancy category for carbamazepine (Tegretol).
A) Pregnancy Category B
B) Pregnancy Category C
C) Pregnancy Category D
D) Pregnancy Category X
Q3) When analyzing an EEG,a medical professional can determine that the patient has had a petit mal seizure by focusing attention on a(n):
A) upward electrical spike wave of approximately 3 seconds.
B) flat-line of approximately 3 seconds.
C) downward electrical spike wave of approximately 3 seconds.
D) flat-line of approximately 6 seconds.
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Chapter 17: Antiparkinson Drugs
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Sample Questions
Q1) The symptoms of Parkinson's disease include all of the following except:
A) hypertension.
B) increased sweating.
C) drooling.
D) urinary disturbances.
Q2) The adverse effects of anticholinergic drugs include all of the following except:
A) dry mouth.
B) rapid heartbeat.
C) diarrhea.
D) mydriasis.
Q3) A reduction in tremors and muscular rigidity can be directly accomplished with the administration of:
A) a cholinergic drug.
B) an anticholinergic drug.
C) a COMT inhibitor.
D) a dopamine antagonist.
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19
Chapter 18: General Anesthetics
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Q1) Which of the following statements is true of the action of the anesthetic agents nitrous oxide,propofol,and ketamine?
A) Nitrous oxide, propofol, and ketamine antagonize NMDA receptors, thereby blocking cation movement and depolarization.
B) Nitrous oxide, propofol, and ketamine bind to NMDA receptors and facilitate the movement of potassium ions out of a cell.
C) Nitrous oxide, propofol, and ketamine hyperpolarize the lipid membrane and open the chloride ion channel.
D) None of these are correct.
Q2) Which of the following anesthetics has an antiemetic effect on the patient?
A) Propofol
B) Methohexital
C) Ketamine
D) Etomidate
Q3) Describe the objective of using anesthesia during surgical procedures.
A) Rapid, smooth induction and maintenance of the patient in Stage IV
B) Rapid, smooth induction and maintenance of the patient in Stage III
C) Rapid, smooth induction and maintenance of the patient in Stage II
D) None of these are correct.
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Page 20
Chapter 19: Opioid Narcoticanalgesics
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Sample Questions
Q1) Identify an adverse effect associated with the use of analgesics.
A) Diarrhea
B) Tachycardia
C) Constipation
D) Polyuria
Q2) Identify an accurate statement about opioid analgesics.
A) The majority of the opioid analgesics are used to induce preoperative sedation.
B) Opioid analgesics can only relieve mild to moderate pain.
C) It is held that opioid analgesics can relieve virtually any type of pain.
D) The use of opioids for postoperative pain can increase the risk of bleeding.
Q3) Which of the following changes takes place when opioids bind to their mu receptors?
A) Calcium ion channels on presynaptic neurons close.
B) The release of glutamate increases.
C) Postsynaptic mu receptor binding closes potassium ion channels.
D) Calcium ions flow into the cells.
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21
Chapter 20: Nonnarcotic Analgesics
Anti-Inflammatory,and Antigout Drugs
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Q1) What is the mechanism of action of allopurinol (Zyloprim)in preventing the formation of uric acid in the body?
A) Allopurinol specifically alters the ability of phagocytes to attack uric acid crystals.
B) Allopurinol blocks prostaglandin stimulation of the central nervous system, so uric acid formation is blocked.
C) Allopurinol is a noncompetitive inhibitor of xanthine oxidase, so uric acid formation is blocked.
D) None of the above are correct.
Q2) Penny has a headache,so she takes a 250-mg tablet of aspirin to alleviate the pain.After a while,she begins to feel nauseous.What is the reason for this occurrence?
A) Aspirin causes a buildup of COX-2 inhibitors in the body.
B) Aspirin is known to irritate the stomach mucosal lining.
C) A dose of 250 mg is double the recommended dose for an adult.
D) A headache is not an indication for the use of aspirin.
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Chapter 21: Cardiac Glycosides and the Treatment of
Congestive Heart Failure
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Sample Questions
Q1) A patient with atherosclerosis will also have:
A) hyperglycemia.
B) hypercholesterolemia.
C) hypotension.
D) hypoglycemia.
Q2) In the context of cardiac nerve supply,the sympathetic nervous system:
A) decreases the activity of the SA node, the AV node, and the myocardium.
B) releases the neurotransmitter acetylcholine.
C) has little effect on myocardial contraction.
D) becomes active when the body needs to expend energy during the "fight or flight" reaction.
Q3) Which of the following statements is true of an electrocardiogram (ECG)?
A) The P wave of an ECG represents the depolarization of the ventricles.
B) The QRS wave of an ECG represents the depolarization of the atria.
C) The T wave represents the repolarization of the ventricles.
D) The QT interval represents the time required for passage of an electrical impulse from the SA node through the AV node.
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Page 23
Chapter 22: Antiarrhythmic Drugs
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Q1) What does the presence of excessive ST segment and T wave depression on an ECG indicate?
A) Excess of aldosterone in the body
B) Excess of antidiuretic hormone in the body
C) Digoxin toxicity
D) Bilirubin toxicity
Q2) Which of the following adverse effects is generally associated with venodilators but not with arterial dilators?
A) Nausea
B) Postural hypotension
C) Headache
D) Vasomotor flushing
Q3) _____ enhances the action of digoxin and can lead to arrhythmias.
A) Hyperkalemia
B) Hyperglycemia
C) Hypercalcemia
D) Hypocholesterolemia
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24
Chapter 23: Antianginal Drugs
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Q1) Dr.Cooper notices some irregularities in Alex's heartbeat.After a thorough examination,he diagnoses Alex with ventricular arrhythmia.Dr.Cooper advises Alex to start taking a Class 1A antiarrhythmic drug in an extended-release tablet form once every 12 hours.On being asked about the drug's mechanism of action by an assistant,Dr.Cooper states that the drug slows conduction in the heart and prolongs the cardiac refractory period.Based on the information provided in this scenario,which of the following drugs has Dr.Cooper most likely prescribed?
A) Sotalol
B) Amiodarone
C) Esmolol
D) Procainamide
Q2) Which of the following is true of Class 2 antiarrhythmic drugs?
A) They tend to shorten the cardiac refractory period.
B) They increase the excitability, conduction, and automaticity of ventricular muscle.
C) They decrease heart rate, atrioventricular (AV) conduction, and automaticity of the sinoatrial (SA) and AV nodes.
D) They are mainly indicated for arrhythmias that originate below the AV node.
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Chapter 24: Diuretics
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Q1) Unlike nondihydropyridines,dihydropyridines:
A) have very little direct actions on the heart.
B) block the influx of sodium ions in cardiac muscle.
C) block the influx of calcium ions into vascular smooth muscle.
D) have prominent effects on the heart.
Q2) Which of the following explains the inability of the nitrates to act as coronary dilators during angina?
A) Arteriolar dilation is greater than venodilation is at low-dose ranges.
B) Nitrates do not act on vascular smooth muscle.
C) The most common route of administration is sublingual.
D) The arteries are already maximally dilated by ischemia.
Q3) Identify the mechanism of action of the calcium channel blockers in the treatment of angina and coronary artery disease.
A) Prevention of influx of calcium ions into vascular smooth muscle
B) Increase in blood pressure to increase calcium ion concentration in blood
C) Relaxation of vascular smooth muscle
D) Reversal of the effects of sympathetic activation
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Chapter 25: Antihypertensive Drugs
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Q1) Dr.Lee is treating a patient who suffers from an edema.She decides to use acetazolamide to help the patient.Which of the following is most likely to be a side effect of using acetazolamide?
A) Hyponatremia
B) Hyperkalemia
C) Hyperchloremia
D) Hypouricemia
Q2) _____ diuretics are used to improve renal failure due to increased load and to reduce intracranial pressure.
A) Potassium-sparing
B) Osmotic
C) Loop
D) Thiazide
Q3) _____ is used to achieve urologic irrigation.
A) Mannitol
B) Glycerin
C) Methazolamide
D) Isosorbide
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Chapter 26: Anticoagulants and Coagulants
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Q1) Compare the blood pressure throughout the systemic vasculature,and select the true statement.
A) Pressure is highest in the large veins and lowest in the large arteries.
B) The largest pressure decrease occurs across the capillaries, indicating that they are the site of highest vascular resistance.
C) The largest pressure decrease occurs across the arterioles, indicating that they are the site of highest vascular resistance.
D) Pressure is highest in the arterioles and lowest in the venules.
Q2) Essential hypertension differs from secondary hypertension in that:
A) the cause of essential hypertension is unknown.
B) essential hypertension is an acute disease.
C) essential hypertension requires no treatment.
D) the occurrence of essential hypertension is almost negligible.
Q3) Which of the following drugs is a calcium channel blocker?
A) Diltiazem
B) Chlorothiazide
C) Propranolol
D) Clonidine
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28
Chapter 27: Nutrition and Therapy
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Q1) Which anticoagulant's mechanism of action involves an inhibition of platelet aggregation?
A) Heparin
B) Warfarin
C) Streptokinase
D) Aspirin
Q2) Patients on oral anticoagulant therapy should be monitored by which tests?
A) PTT or APTT
B) Routine blood and platelet counts
C) Attention to all potential bleeding sites
D) Protime (PT) or INR
Q3) What are the two groups into which heparins are classified?
A) Standard (unfractionated) heparin and low-molecular-weight heparin
B) Standard (unfractionated) heparin and high-molecular-weight heparin
C) Low-molecular-weight heparin and high-molecular-weight heparin
D) Low-molecular-weight heparin and fractionated heparin
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Chapter 28: Hypolipidemic Drugs
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Q1) When Ella discovers that she is unable to see things in relatively low light, she visits Dr. Brody for a medical checkup. Upon examination, Dr. Brody notes that Ella has very dry skin and a relatively low rate of epithelial cell growth. He attributes these symptoms to a vitamin deficiency. From which of the following vitamin deficiencies is Ella most likely suffering?
A) Vitamin E
B) Vitamin C
C) Vitamin A
D) Vitamin D
Q2) Which of the following statements is true of vitamin A?
A) Provitamin A is converted to retinol in the stomach.
B) A deficiency of vitamin A can lead to night blindness.
C) Vitamin A usage leads to increased sebum production.
D) None of these are correct.
Q3) The fat-soluble vitamins are _____.
A) vitamins A, D, E, and K
B) vitamins A, B, D, and E
C) vitamins A, B, C, and D
D) vitamins A, B, D, and K
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Chapter 29: Antianemic
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Q1) Which of the following statins carries a significantly high risk of causing muscle impairment?
A) Atorvastatin
B) Rosuvastatin
C) Cerivastatin
D) Simvastatin
Q2) Why is unstable plaque more dangerous than stable plaque?
A) Unlike stable plaque, unstable plaque is associated with an increased likelihood of hemorrhage that can lead to shock.
B) Unlike stable plaque, unstable plaque is associated with an increased likelihood of hemorrhage that can lead to arrhythmias.
C) Unlike stable plaque, unstable plaque is associated with thrombus formation that can cause hypertension.
D) Unlike stable plaque, unstable plaque is associated with thrombus formation that can block blood flow and tissue oxygenation.
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Chapter 30: Antiallergic and Antihistaminic Drugs
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Q1) Which of the following statements is true of cobalamin (vitamin B<sub>12</sub>)?
A) Cobalamin is primarily found is green vegetables and fruits.
B) Strict vegetarians are more likely to develop a deficiency of cobalamin.
C) The anemia resulting from cobalamin deficiency is a microcytic hypochromic anemia.
D) Cobalamin has recognized therapeutic value in the treatment of hepatitis, allergies, and sterility.
Q2) A patient should not take cimetidine within 2 hours of taking cobalamin to treat his or her anemia because:
A) cimetidine decreases gastric acid so that cobalamin cannot combine with available gastric intrinsic factor, impairing but not totally inhibiting the absorption of cobalamin.
B) cimetidine stops the production of gastric acid so that cobalamin cannot combine with available gastric intrinsic factor, totally inhibiting the absorption of cobalamin.
C) cimetidine suppresses the bone marrow and interferes with red blood cell maturation so that cobalamin cannot function in these cells.
D) None of these are correct.
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Chapter 31: Bronchodilator Drugs and the Treatment of Asthma
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Sample Questions
Q1) The side effects associated with antihistaminics are _____.
A) hypertension and urinary incontinence
B) sedation and xerostomia
C) agitation and insomnia
D) narcolepsy and bradycardia
Q2) The use of antihistamines is contraindicated for _____.
A) children weighing less than 65 pounds
B) women who have children younger than 4 years of age
C) people who are allergic to tree pollen
D) dehydrated children
Q3) In patients with asthma,what role do H<sub>1</sub>-receptors play in the bronchioles?
A) Contraction of bronchiolar smooth muscle
B) Dilation of bronchiolar smooth muscle
C) Innervation of bronchiolar smooth muscle
D) Relaxation of bronchiolar smooth muscle
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Chapter 32: Respiratory Pharmacology, treatment of
Asthma and Copd
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Q1) Which of the following statements is true of ipratropium bromide (Atrovent)?
A) It has a quick onset and prolonged duration of action.
B) It is a quaternary derivative of atropine.
C) It causes several adverse effects.
D) It is a nonselective beta drug.
Q2) Select the group of drug agents that are listed in increasing order of their duration of action.
A) Albuterol (Proventil), Salmeterol/fluticasone (Advair), Tiotropium (Spiriva)
B) Salmeterol/fluticasone (Advair), Albuterol (Proventil), Tiotropium (Spiriva)
C) Albuterol (Proventil), Tiotropium (Spiriva), Salmeterol/fluticasone (Advair)
D) Tiotropium (Spiriva), Albuterol (Proventil), Salmeterol/fluticasone (Advair)
Q3) Which of the following is an expectorant available over the counter and is used for the relief of an unproductive cough?
A) Mucinex
B) Mucosil
C) Potassium citrate
D) Ammonium chloride
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Page 34
Chapter 33: Agents That Affect Intestinal Motility
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Q1) Julian is diagnosed with Zollinger-Ellison syndrome and presents with symptoms such as gastric acid hypersecretion.Which of the following drugs should be used to treat Julian?
A) Cimetidine
B) Omeprazole
C) Metoclopramide
D) Antacids
Q2) Identify the mechanism of action by which NSAIDs cause peptic ulcers.
A) Blockade of prostaglandins that inhibit gastric secretions
B) Blockade of receptors that promote the fight-or-flight response
C) Stimulation of histamine receptors on parietal cells
D) Stimulation of H<sub>1</sub>-receptors on smooth muscles of the gastrointestinal tract
Q3) What are the two types of receptor antagonists that are used as antiemetics?
A) Serotonin 5-HT<sub>3</sub> and NK<sub>1</sub>
B) Serotonin 5-HT<sub>2</sub> and H<sub>1</sub>
C) D<sub>2</sub> and M<sub>1</sub>
D) H<sub>1</sub> and M
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35
Chapter 34: Introduction to the Endocrine System
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Sample Questions
Q1) Identify the long-term impact of chronic diarrhea.
A) Accumulation of sodium and potassium in the blood
B) Dehydration and electrolyte imbalance
C) Relaxation of the external anal sphincter due to weakening of impulses from the brain
D) All of these
Q2) Simon is going to travel to another country on a business trip.He is informed by his colleagues that the water supplied in that region is unlikely to be pure and that people who have previously visited the place have suffered from diarrhea.Simon wants to know how he can avoid the onset of diarrhea while on his business trip.Which of the following drugs would you ask Simon to take prophylactically?
A) Lotronex
B) Pepto-Bismol
C) Imodium
D) All of these
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36
Chapter 35: Introduction to the Endocrine System Adrenal
Steroids
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Sample Questions
Q1) Which of the following statements is true of the hormones in the posterior pituitary lobe?
A) They are secreted when the hypothalamus produces releasing hormones.
B) They are produced in the posterior lobe of the pituitary gland.
C) They are stored in the hypothalamus until they are needed.
D) They travel from the hypothalamus to the posterior lobe down nerve axons.
Q2) Steve,a 16-year-old,suffers from stunted growth.His doctor prescribes mecasermin for his condition.Which of the following statements is most likely to be true of Steve's condition?
A) Steve has high levels of adrenocorticotropic hormone.
B) Steve has a swollen lymph node.
C) Steve has a pituitary tumor.
D) Steve has developed neutralizing antibodies to growth hormone.
Q3) _____ is used to treat acromegaly and is clinically valuable in the management of severe diarrhea and flushing associated with metastatic carcinoid tumors.
A) Octreopeptide
B) Lanreotide
C) Somatomedin
D) Somatotropin
Page 37
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Chapter 36: Gonadal Hormones and the Oral Contraceptives
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Q1) Identify an adverse effect of glucocorticoids.
A) Decrease in sweating
B) Decrease in appetite
C) Weight loss
D) Restlessness
Q2) What information must be given to a female patient who is on steroid therapy and who has just learned that she is pregnant?
A) If she is going to continue treatment, the infant will have to be monitored for adrenal function after birth.
B) Chronic maternal steroid use in the first trimester can result in a cleft palate in newborns (about 1 percent incidence).
C) If she is going to continue treatment, her dose will have to be reduced to the lowest possible effective dose.
D) All of these are correct.
Q3) In which of the following patients is the use of steroids contraindicated?
A)Patients suffering from gastrointestinal ulcers
B)Patients who have systemic fungal and local herpes infections
C)Patients suffering from renal disease
D)Patients suffering from colitis
Page 38
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Chapter 37: Drugs Affecting the Thyroid and Parathyroid Glands and Bone Degeneration
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Q1) Apart from individual patient risk factors,which of the following pairs of factors is associated with the potential for adverse effects during hormone replacement therapy?
A) Dose and increased prothrombin levels
B) Increased prothrombin levels and length of treatment
C) Dose and length of treatment
D) Hypertension and hypercholesterolemia
Q2) Which of the following hormones has an inhibitory effect on endometrial muscle contractions?
A) Estriol
B) Estradiol
C) Estrone
D) Progesterone
Q3) How does arteriosclerosis cause erectile dysfunction?
A) By altering psychomotor activity
B) By potentiating nerve excitability
C) By reducing the flow of blood throughout the body, including the penis
D) By decreasing the formation of clotting factors
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Page 39
Chapter 38: Pancreatic Hormones and Antidiabetic Drugs
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Sample Questions
Q1) Which of the following statements is true of the thyroid gland?
A) The cells of the thyroid gland absorb iodide and combine it with the amino acid tyrosine to make T<sub>3</sub> and T<sub>4</sub>.
B) The thyroid gland synthesizes and secretes five hormones that are essential for tissue growth and development.
C) The hormones of the thyroid gland directly influence the activity of only one peripheral tissue, bone tissue.
D) The thyrotropin-releasing hormone directly stimulates the thyroid gland to produce triiodothyronine (T<sub>3</sub>) and thyroxine (T<sub>4</sub>).
Q2) Which of the following is true of calcitonin?
A) Calcitonin is secreted in response to abnormally low levels of plasma calcium.
B) Calcitonin does not affect intestinal and renal calcium absorption.
C) Calcitonin is secreted by the parathyroid gland.
D) Calcitonin directly stimulates bone resorption. Calcitonin does not affect intestinal and renal calcium absorption, and its action does not require vitamin
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Chapter 39: Posterior Pituitary Hormones and Drugs
Affecting Uterine Muscle
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Sample Questions
Q1) Glucagon is secreted:
A) when GIP and GLP-1 are released.
B) when the beta cells secrete insulin.
C) when blood glucose levels are below normal.
D) after consuming a large meal.
Q2) Identify the most common adverse effect of insulin therapy.
A) Diarrhea
B) Blurred vision
C) Fainting
D) Convulsions
Q3) Hyperglycemia in diabetes mellitus is a direct result of:
A) GLUT1 transporter proteins not being able to form a glucose channel.
B) GLUT2 transporter proteins not being able to migrate to the plasma membrane.
C) GLUT3 transporter proteins not being able to form a glucose channel.
D) GLUT4 transporter proteins not being able to migrate to the plasma membrane.
Q4) Which of the following decreases insulin requirement (potentiates insulin)?
A) Alcohol
B) Smoking
C) Stress
D) Surgery
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Chapter 40: Antibacterial Agents
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Sample Questions
Q1) Use the Physicians' Desk Reference to determine the proper dosage of mifepristone (Mifeprex)given to induce abortion.
A) The proper dosage of mifepristone (Mifeprex) to induce abortion is 600 mg or 3 tablets (200 mg each) administered orally as a single dose.
B) The proper dosage of mifepristone (Mifeprex) to induce abortion is 300 mg or 3 tablets (100 mg each) administered orally as a single dose.
C) The proper dosage of mifepristone (Mifeprex) to induce abortion is 600 mg administered through IM injection.
D) None of these are correct.
Q2) Which of the following physical triggers is associated with water conservation?
A) Thirst and reduction in blood volume
B) Thirst and sweating
C) Sweating and reduction in blood volume
D) Excessive vomiting, sweating, and thirst
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Chapter 41: End of Chapter Questions
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Sample Questions
Q1) Which of the following is an ideal candidate for chemoprophylaxis?
A) An individual who has had a heart valve surgery and has to undergo a dental procedure
B) A patient scheduled to have hip replacement surgery
C) An individual not responding to her current antibiotic treatment
D) A patient with uncontrollable diarrhea
Q2) Which antibiotics can be used for bowel sterilization prior to surgery?
A) Penicillins and macrolides
B) Aminoglycosides and sulfonamides
C) Cephalosporins and fluoroquinolones
D) Tetracyclines and aztreonam
Q3) Which antibiotics can cause photosensitivity as a reaction?
A) Macrolides and fluoroquinolones
B) Chloramphenicol and metronidazole
C) Tetracyclines and sulfonamides
D) Isoniazid and pyrazinamide
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Chapter 42: Antifungal and Antiviral Aidsdrugs
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Sample Questions
Q1) Which of the following has been developed as a new class of ergosterol biosynthetic inhibitor for the treatment of Tinea pedis?
A) Terbinafine (Lamisil)
B) Fluconazole (Diflucan)
C) Griseofulvin (Grifulvin V)
D) Ketoconazole (Nizoral)
Q2) Maya has been taking itraconazole as part of her treatment regimen.Maya should notify her physician immediately for further evaluation and discontinuation of antifungal therapy if she:
A) accidentally takes a tetracycline 2 hours after the itraconazole dose.
B) takes the itraconazole dose with a meal.
C) performs tasks requiring manual dexterity successfully.
D) becomes pregnant during the treatment period.
Q3) What is the effect of the azole drugs on the action of warfarin?
A) The azole drugs completely inhibit the action of warfarin and should, therefore, not be taken together.
B) The azole drugs prolong the anticoagulant action of warfarin.
C) The azole drugs speed the anticoagulant action of warfarin.
D) None of these are correct.
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Page 44
Chapter 43: Antiprotozoal and Anthelmintic Drugs
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Sample Questions
Q1) A desirable feature of metronidazole is its ability to:
A) limit its effect to certain regions of the body.
B) distribute over a wide range of tissues systemically.
C) be well tolerated in patients with severe liver disease.
D) cross the placenta.
Q2) In order to avoid toxoplasmosis,pregnant women should stay away from a cat's litter box during:
A) only the first trimester.
B) the first and second trimester.
C) only the third trimester.
D) all three trimesters.
Q3) What should be avoided so that a disulfiram-like reaction will not be experienced by a patient on metronidazole?
A) Dairy product
B) Alcohol
C) Antacid
D) Iron supplement
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Chapter 44: Antiseptics and Disinfectants
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Sample Questions
Q1) James is asked to disinfect an isolation ward.The patient who had previously occupied the ward suffered from tuberculosis.James is asked to wear rubber gloves and ensure that the disinfectant does not make contact with his eyes and mucous membranes.Which of the following chemicals is James using to disinfect the room?
A) Triclosan
B) Sodium hypochlorite
C) Ethyl alcohol
D) Povidone-iodine
Q2) _____ is defined as a permanent black discoloration of skin and mucous membranes caused by prolonged use of silver protein solutions.
A) Eschar
B) Lyse
C) Argyria
D) Botulism
Q3) Chlorhexidine is used:
A) to treat second- and third-degree burns.
B) to fumigate operating rooms.
C) as an ophthalmic irrigant.
D) as a mouthwash for aphthous ulcers.
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Page 46
Chapter 45: Antineoplastic Agents
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Q1) Marvin is diagnosed with lung cancer and is being treated with chemotherapy.He is hydrated and administered mesna disulfide before the antineoplastic drug.Marvin is being treated with _____.
A) busulfan
B) procarbazine
C) ifosfamide
D) carboplatin
Q2) Which of the following approaches is commonly used to treat cancer?
A) Surgery
B) Radiation
C) Chemotherapy
D) All of these
Q3) A medication that can be taken prophylactically by women who have a family history of developing breast cancer is:
A) anastrozole.
B) tamoxifen.
C) rituximab.
D) flutamide.
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Chapter 46: Immunopharmacology
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Sample Questions
Q1) Which of the following diseases is an immune-based disease that is treated by suppressing the immune response?
A) Multiple sclerosis
B) Myasthenia gravis
C) Systemic lupus erythematosus
D) All of these
Q2) Logan is diagnosed with rheumatoid arthritis.He is prescribed a drug that is to be taken orally.Logan is informed by his doctor that the drug has a half-life of 15 days.He also explains that he may experience diarrhea.Which of the following drugs has Logan been prescribed?
A) Arava
B) Betaseron
C) Rapamune
D) Leukine
Q3) _____ is an immunomodulating agent that is used to treat anal warts.
A) Neupogen
B) Alferon N
C) Actimmune
D) Intron A
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Page 48