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1. A new drug was studied in 30 healthy volunteers to determine the basic pharmacokinetic parameters. An intravenous bolus dose of 200 mg was administered and blood samples were analyzed at time intervals. The initial plasma concentration was determined to be about 5 mg/L. The volume of distribution of this new drug is approximately 1. 10 L 2. 20 L 3. 30 L 100.0% 4. 40 L 5. 50 L 2. Which of the following statements about drug distribution is most likely correct? 100.0% 1. The process of movement of the drug into different body compartments 2. The process of movement of the drug out of different body compartments 3. The process of conversion of the drug structure in different body compartments 4. The process of change of the drug form in different body compartments 5. The process of reduction of the drug amount in different body compartments 3. The following statements on bradykinin are true, except 100.0% 1. It's action can be blocked by bradykinin1–8 (des-Arg9-bradykinin) 2. It's action can be blocked by icatibant 3. It's synthesis can be blocked by aprotinin 4. It is the pain producer in acute pancreatitis 5. It's inflammatory actions are potentiated by prostaglandins 4. A patient has been receiving IV infusion of an antibiotic for the treatment of bacterial infection. The clearance of this drug is 50 ml/min. The expected therapeutic steady-state plasma concentration is 4 µg/ml. What will be the infusion rate? 1. 500 µg/min 100.0% 2. 200 µg/min 3. 100 µg/min 4. 50 µg/min 5. 20 µg/min 5. The gatekeeper gene for colon carcinogenesis is 1. p53 2. Rb 100.0% 3. APC 4. NF1 5. hMSH2 6. Which is human DNA oncogenic virus: 1. Hepatitis C virus 100.0% 2. Hepatitis B virus 3. Human T-cell leukaemia virus type I 4. Human T-cell leukaemia virus type II 5. Human immunodeficiency virus (HIV) 7. The anti-inflammatory actions of glucocorticoids involve all of the following, except 1. Binding to a cytoplasmic glucocorticoid receptor 2. Inhibit COX-2 transcription 100.0% 3. Inhibit lipocortin-1 transcription 4. Inhibit iNOS transcription 5. Inhibit cytokine transcription 8. For a weak acid drug with a pKa of 3.5. What percentage of a given dose will be in the lipophilic form at a stomach pH of 2.5? 1. 99% 100.0% 2. 90% 3. 50% 4. 9% 5. 5% 9. All of the following are common sites for metastases EXCEPT : 1. Bone 100.0% 2. Cartilage 3. Liver 4. Brain 5. Lung 10. Of the following mechanisms, which one is not involved in the edemous state associated with liver cirrhosis? 1. portal hypertension 100.0% 2. hypocoagulable state 3. hypoproteinemia 4. low serum albumin levels 5. increased capillary pressure 11. Which is mismatch repair gene associated with Hereditary nonpolyposis colon carcinoma (HNPCC)? 1. BAX 2. p53 3. BRCA1 4. BRCA2 100.0% 12. 5. hMLH1 Which one of the following statement on codeine is correct? 1. It is a metabolite of morphine. 2. It has a plasma half life of 12 hours. 3. All of its actions are not reversed by naloxone. 100.0% 4. It can be used to suppress cough. 5. It does not cause respiratory depression. 13. The consequences of a drug depositing into body fat may 1. cause hysteresis effect 100.0% 2. prolong duration of action 3. enhance drug elimination 4. increase drug metabolism 5. reduce onset time of action 14. How may half-lives it may take to eliminate about 97% of the original single dose? 1. 2 2. 3 3. 4 100.0% 4. 5 5. 6 15. To which of the following effects of morphine does tolerance not develop (at least not to a large extent)? 0.0% 1. Sleepiness 2. Analgesia 3. Respiratory depression 0.0% 4. Euphoria 5. Constipation 16. Which of the following features is not associated with a rapid growth? 100.0% 1. low S-phase fraction 2. Ki-67 expression 3. PCNA expression 4. Overexpression of growth factors 5. Overexpression of growth factor receptors 17. The following statements on platelet-activating factor are true, except 1. It causes shape change in platelets 2. It causes release of mediators in platelets 3. It is produced via the action of phospholipase A2 4. It can activate phospholipase A2 100.0% 18. 5. It is derived from arachidonic acid Which one of the following diseases does not involve histamine 1. Allergic rhinitis 2. Asthma 3. Gastric ulcer 4. Allergic reactions 100.0% 19. 5. Fever Which one of the following can be used to treat gastric ulcer 1. Diphenhydramine 2. Promethazine 3. Astemizole 100.0% 4. Ranitidine 5. Mequitazine 20. A selective COX-2 inhibitor 100.0% 1. would be expected to produce fewer gastric complications than indomethacin. 2. mainly reduces inflammation by inhibiting the migration of neutrophils from the vessel lumen into the surrounding tissue. 3. has a lower IC50 against COX-1 than against COX-2. 4. lowers body temperature in a feverish patient by blocking prostaglandin E receptors in the hypothalamus. 5. reduces the production of PGE2 only. 21. Morphine can be used for all of the following therapeutic purposes, EXCEPT 100.0% 1. To relieve the pain caused by a severe head injury. 2. To provide sedation and analgesia as part of balanced anaesthesia. 3. To relieve the postoperative pain of abdominal surgery. 4. To relieve the pain of traumatic injuries. 5. To relieve acute pulmonary oedema caused by left-side heart failure. 21. For a weak basic drug with a pKa of 8.0, a ratio of the total drug concentration between the tubular fluid (pH of 7.0) and the plasma (pH 7.4) compartment is about 2:1. If the tubular fluid is acidified to pH 5.0, this ratio will be about 1. 2:1 2. 20:1 100.0% 3. 200:1 4. 400:1 5. 2000:1 22. The oncogenes can not be activated by : 100.0% 1. Deletion 2. Point mutation 3. Amplification 4. Translocation 5. Change in regulation of expression 23. "The triple response" produced by histamine involve all of the following, except 1. A reddening response due to dilation of small arterioles 100.0% 2. A wheal response due to decreased permeability of post-capillary venules 3. A flare response due to "axon-reflex" 4. Release of neuropeptides from sensory nerve fibres 5. Vasodilatation due to the release of neuropeptides 24. Which one of the following is not an action of the corticosteriods 1. Affect water and electrolyte balance 2. Affect protein metabolism 3. Affect carbohydrate metabolism 100.0% 4. Increase endogenous synthesis of corticosteroids 5. Suppress body defense mechanisms 25. Ultraviolet light (UV) causes which type(s) of genetic damage in skin cancers? 100.0% 1. P53 gene mutations 2. P16 gene methylation 3. overexpression of C-myc 4. Deletion of DCC gene 5. Abl-bcr translocation 26. The following clinical conditions may be complicated by shock, except for: 1. cardiac arrhythmias 2. severe diarrhea 3. pulmonary embolus 100.0% 4. viral hepatitis 5. septicemia 27. Which of the following statements about pharmacokinetic parameters is most correct? 1. In the first-order kinetic process, the rate of elimination is constant regardless of the administered dose 2. Bioavailability means the amount of the administered dose of a drug that reaches the systemic circulation 3. Total clearance accounts for both hepatic metabolism and urinary excretion of the intact drug and its metabolites 4. AUC is the graphic area under a plot of drug concentration in plasma versus time after a single dose of a drug 100.0% 28. 5. First-pass effect refers the elimination of drug that occurs during drug absorption in the gut Which of the following statements about clearance is most correct? 1. Clearance refers to the amount of drug removed by the body 2. Clearance depends upon the blood flow and drug-protein binding 3. Renal clearance is a sum of glomerular filtration, tubular secretion and reabsorption 4. Hepatic clearance is inversely proportional to the extraction ratio in the liver 100.0% 5. Metabolism-limited clearance indicates a drug with a relatively low extraction ratio in the liver 29. Which of the following statements about nonsteroidal anti-inflammatory dugs NSAIDs is true? 1. Celecoxib is effective in inhibiting platelet functions. 2. Acetylsalicylic acid is converted to salicylate for actions. 3. Aspirin allergy is due to production of antibodies against aspirin. 4. NSAIDs can lower normal body temperature. 100.0% 5. Ibuprofen is a competitive inhibitor of cyclooxygenase. 30. A child has accidentally ingested a large quantity of tablets containing a neuroleptic drug. He is conscious on admission to hospital. Which of the following drugs would be most effective to prevent the potential absorption of the neuroleptic agent? 1. metoclopramide 2. Domperidone 3. Apomorphine 4. Cisplatin 100.0% 31. 5. Syrup of ipecacuanha Complications of acute myocardial infarction include the following, except for: 1. cardiac arrhythmias 2. hemopericardium 3. cerebral embolism 4. pulmonary edema 100.0% 5. dissecting aneurysm of aortic arch 32. A patient is brought to the emergency department having just overdosed aspirin, in this situation: 1. More of the drug would be absorbed from stomach than small intestine 100.0% 2. More of the drug would be trapped in the blood than in the stomach 3. More of the drug would be eliminated by inhibition of metabolising enzymes 4. Urinary excretion would be accelerated by administration of NH4Cl 5. Tubular reabsorption would be enhanced by administration of NaHCO3 33. One of the following describes severe dysplasia correctly : 1. Tumor cells infiltrate the basement membrane 100.0% 2. Epithelial cells are severely atypical but are bound by the basement membrane 3. Metastasis may occur to the lymph nodes but not liver 4. It is a form of hamartoma 5. Epithelial cells may be multi-layered but are well differentiated 34. in: Xeroderma pigmentosum is due to inherited germline mutation of genes involving 1. Mismatch repair (MMR) 100.0% 2. Nucleotide excision repair (NER) 3. Base excision repair (BER) 4. Double strand breakage (DSB) repair 5. Recombination repair 35. A new developed drug with the volume of distribution of 4 L is most likely to 100.0% 1. mainly distribute in the plasma compartment 2. widely distribute through the whole body 3. deposit into body fats due to its high lipid solubility 4. mainly distribute in the extracellular compartment 5. mainly distribute in the intracellular compartment 36. Which of the following proteins is important in prolonging the G1 phase of cell cycle: 1. Ki-67 antigen 100.0% 2. P53 protein 3. bcl-2 4. EBER 5. VEGF 37. Aromatic amines, azo dyes are potent carcinogens of which one of following cancer types? 1. Nasopharyngeal carcinoma 2. Leukemia 100.0% 3. Bladder cancer 4. Hepatocellular carcinoma 5. Lung cancer 38. Which one of the following statements concerning autacoids is false 1. They are local hormones 2. They may act in a paracrine fashion 3. They may act in an autocrine fashion 100.0% 4. They have long-lasting actions at short range 5. They include histamine, eicosanoids, and kinins 39. Which of the following statements about drug absorption is most likely correct? 1. The process of the drug administered entering into GI tract 2. The process of the drug administered entering into intracellular fluids 3. The process of the drug administered leaving the systemic circulation 4. The process of the drug administered entering into different body compartments 100.0% 5. The process of the drug administered entering into the systemic circulation 40. Which of the following statements about concentration–time profiles for a single orally administered drug within its one t½ is most correct? 1. Drug concentration at the absorption site increases along the time 2. Drug concentration in the body increases along the time 100.0% 3. Amount of the metabolites increases along the time 4. Amount of the drug in the target increases along the time 5. Amount of the drug in the systemic circulation increases along the time 41. Pleomorphism means : 1. Increased mitotic figures 2. Variation in number of metaphase cells 3. Variation in staining of the cytoplasm 4. Variation in the cytoskeletons of the cells 100.0% 5. Variation in size and shape of the nuclei 42. Metoclopramides action to reduce chemotherapy-induced emesis most probably relates to 1. An ability to deplete 5-HT from the gastrointestinal tract 2. Its selective action to block peripheral dopamine receptors 100.0% 3. Its action to block central and peripheral 5-HT3 receptors 4. Its action to block peripheral 5-HT4 receptors 5. Its action to facilitate gastric motility 43. Sarcomas : 1. Are epithelial in characteristics 2. Usually have a very low mitotic count 100.0% 3. Are associated with deposition of connective tissues 4. Never metastasize 5. Possess tissues from all three germ layers 44. The following statements on leukotrienes are false, except 100.0% 1. LTA4 is the precursor for cyteinyl-containing leukotrienes 2. LTB4 is not a chemotactic agent 3. Zileuton is a leukotriene receptor antagonist 4. 15-lipoxygenase catalyses the biosynthesis of leukotriene 5. Leukotrienes are not important in asthma 45. Morphine binds to specific opioid receptors which 1. are found only in the nerve endings. 100.0% 2. carry seven transmembrane spanning domains in their structures. 3. enhance the influx of calcium into the cytoplasm when activated. 4. are integrated with ion channels. 5. increase the cellular cyclic AMP level when activated. 46. In renal edema (nephrotic syndrome), the following alterations contribute to the formation and maintenance of edema, except for: 1. abnormal glomerular capillary permeability 2. activated angiotensin-renin system 3. hyperalbuminuria 4. enhanced secretion of anti-diuretic hormone 100.0% 5. elevated blood glucose 47. Which one of the following statements concerning receptors that mediate the biological actions of histamine is false 1. H1 receptors mediate the "triple response" 2. H1 receptors mediate bronchoconstriction 3. H1 receptors are blocked by mepyramine 100.0% 4. H2 receptors are blocked by dimaprit 5. H3 receptors are blocked by thioperamide 48. Which of the following statements about drug metabolising enzymes is most correct? 1. FMO is an enzyme system catalysing the reduction of parent drugs 2. Cytochrome P450 system has very selective specificity towards parent drugs 100.0% 3. The activity of cytochrome P450 may change due to repeated use of a drug 4. Glucuronyltransferases mainly locate in the cytosolic fraction 5. Monoamine oxidases are responsible for the phase II metabolism of amines 49. The following are malignant EXCEPT : 1. Multiple myeloma 100.0% 2. Rhabomyoma 3. Lymphoma 4. Leukaemia 5. Melanoma 50. Which of the following is not true of paracetamol? 1. It is metabolized to a reactive intermediate which can be hepatotoxic. 100.0% 2. It possesses analgesic, antipyretic and strong anti-inflammatory properties. 3. It can be used in childhood fever. 4. It is an effective alternative to aspirin for the treatment of headache and fever. 5. It does not adversely affect platelet function. 51. Which one of the following descriptions of "Low risk Human papillomavirus (HPV)" is not correct? 1. HPV-6 is low-risk type HPV. 2. HPV-11 is low-risk type HPV. 3. Low risk HPVs are detected in Genital condylomas 100.0% 4. E7 protein derived from low risk HPVs binds to p53 tumor suppressor protein. 5. The viral genome is usually maintained in episomal form in cancer cells. 52. The features of malignant transformation do not include: 1. Loss of normal checkpoint mechanisms 2. Genetic instability 3. Progressive ?changes accumulate over time 4. Unregulated cell growth 100.0% 53. 5. Genetic homogeneity Which type of human gene is not oncogene : 1. Signal Transducing proteins 100.0% 2. Cyclin dependent kinases inhibitors (CDK Inhibitors) 3. Growth factors 4. Growth factors receptors 5. Nuclear transcription factors 54. The biosynthesis of prostaglandins does not require which one of the following 1. Phospholipase enzymes 2. Cyclo-oxygenase enzymes 100.0% 3. Lipoxygenase enzymes 4. Arachidonic acid 5. Cyclic endoperoxides 55. The protein encoded by C-MYC oncogene is a: 1. Cyclin 2. Growth factor 3. Growth factor receptor 100.0% 4. Transcription factor 5. Signal-transducing protein 56. Which of the following statements about phase II metabolites is most likely correct? 1. They are more easily reabsorbed by kidney tubules than phase I metabolites 100.0% 2. They have higher aqueous solubility than phase I metabolites 3. They have higher lipid solubility than the original drugs 4. They are only formed from phase I metabolites 5. They always excrete through biliary excretion 57. The following statements on cyclo-oxygenase (COX) enzymes are true, except 1. COX-1 produces prostaglandins and thromboxanes 2. COX-2 produces prostaglandins and thromboxanes 3. COX-1 is involved in normal homeostasis 4. COX-2 is involved in inflammation 100.0% 58. 5. COX-2 is a constitutive enzyme Which one of the following diseases should not be treated with hydrocortisone 100.0% 1. Fungal infection 2. Eczema 3. Asthma 4. Rheumatoid arthritis 5. Addison's disease 59. The success of P6 acupuncture as an anti-emetic treatment most probably involves 1. An inhibition of 5-HT release from enterochromaffin cells in the gastrointestinal tract 2. A reduction in the release of dopamine in the brain 100.0% 3. The release of endogenous opioids 4. The release of histamine 5. None of the above 60. Which of the following statements concerning the pharmacological control of pain is true? 1. Non steroidal anti-inflammatory drugs work mainly by inhibiting substance P release in the dorsal horn. 2. Opioids work by inhibiting bradykinin release in the brain stem. 3. Local anaesthetics inhibit transmission in the Aδ sensory nerves only. 100.0% 4. Narcotic analgesics normally cause sedation as well. 5. General anaesthetics do not reduce transmission in peripheral nerves. 61. Which of the following features is not typical of a malignant tumor? 1. vascular proliferation 2. infiltrative borders 100.0% 3. clear demarcation from adjacent tissue 4. necrosis 5. mitotically activ 62. One of the following mechanisms or conditions is not implicated in thrombosis: 100.0% 1. systemic hypertension 2. phlebitis of the leg 3. hypercoagulable state 4. ulceration of an atherosclerotic plaque 5. aneurysmal dilatation of artery 63. Which of the following features is not typical of a benign tumor? 1. rounded border 2. fibrous capsule 3. cells tend to be cohesive 4. resemble tissue of origin 100.0% 5. destruction of contiguous tissue 64. The major role of Rb gene is in regulating the cell cycle at 1. G0 phase 2. G1 phase 100.0% 3. G1/S checkpoint 4. S phase 5. G2/M checkpoint 65. Which of the following drug combinations would be useful to reduce chemotherapy-induced nausea and vomiting? 1. Diphenhydramine plus atropine 2. Domperidone plus metoclopramide 3. Prochloroperazine plus metoclopramide 100.0% 4. Granisetron plus methylprednisolone 5. Granisetron plus ondansetron 66. Which one of the following genes would not have an influence on apoptosis? 1. Bcl2 100.0% 2. E-cadherin 3. Capase 8 4. Fas 5. Fas-L 67. The mean clearance and volume of distribution of a new developed antipsychotic drug were determined in the phase I clinical trial to be 11.5 L/h and 500 L, respectively. What will be the mean half-life of the drug in these subjects? 1. Approximately 5 h 2. Approximately 10 h 3. Approximately 15 h 4. Approximately 20 h 100.0% 5. Approximately 30 h 68. Hyperchromatism in cancer cells is determined by : 100.0% 1. Deep staining of the nuclei 2. Increased eosinophilia of cytoplasm 3. Increased mitotic figures 4. The presence of metastasis 5. Reticulin deposition as outlined by a silver stain 68. Which one of the following is not involve in the biosynthesis of kinins 1. Plasma kalikrein 2. Tissue kalikrein 100.0% 3. Kininase II 4. High-molecular-weight kininogen 5. Low-molecular-weight kininogen 69. DNA replication errors are repaired by the system of 100.0% 1. Mismatch repair (MMR) 2. Nucleotide excision repair (NER) 3. Base excision repair (BER) 4. Double strand breakage (DSB) repair 5. Recombination repair 70. Which of the following is a benign tumor? 100.0% 1. Leiomyoma 2. Lymphoma 3. Osteosarcoma 4. Adenocarcinoma 5. Transitional cell carcinoma 71. Which one of the following descriptions of "telomerase" or "telomeres" is not correct? 1. Telomeres caps of chromosome ends 2. Function of telomeres is to prevent DNA loss during DNA replication 0.0% 3. Telomeres provide a cellular clock for cell proliferation 4. Telomeres maintain the length stably in normal somatic cells 5. Telomerase activity is abnormally high in human cacners. 72. Which of the following statements about drug metabolism is most likely correct? 1. It has to be catalyzed enzymatically 2. It only occurs after drug entering the systemic circulation 3. It only occurs before drug entering the systemic circulation 4. It is always a detoxification process 100.0% 5. It enhances the drug excretion 73. Which of the following statement with regard to therapy with nonsteroidal anti-inflammatory drugs is correct? 1. In acute overdose, aspirin may be effectively eliminated from the body by acidic diuresis 2. Ibuprofen is a once-a-day medication due to its long metabolic half-life. 100.0% 3. Aspirin dosage of 2 tablets every 6 hours is unlikely to result in tinnitus. 4. Aspirin is the drug of choice for an acute attack of gout. 5. Gastric ulceration is a rare occurrence. 74. For a weak basic drug with a pKa of 9.9. What percentage of a given dose will be in the lipophilic form at the small intestine with pH of 7.9? 1. 99.9% 2. 99.0% 3. 90.0% 4. 9.99% 100.0% 5. 0.99% 75. Which one of the following statements concerning receptors that mediate the biological actions of prostanoids is false 100.0% 1. FP receptors mediate relaxation of the uterus in human 2. EP2 receptors mediate relaxation of vascular smooth muscles 3. EP3 receptors mediate gastric mucus secretion 4. IP receptors mediate vasodilatation and inhibit platelet aggregation 5. TP receptors mediate vasoconstriction and promote platelet aggregation 76. Which one of the following compounds is most likely to precipitate withdrawal in an heroin addict 1. Morphine 2. Methadone 100.0% 3. Pentazocine 4. Codeine 5. Fentanyl 77. Which one of the following cancer is associated with Epstein-Barr virus? 1. Small cell lung cacinoma 2. Cervical carcinoma 100.0% 3. Burkett's lymphoma 4. Renal cell carcinoma 5. Hepatocellular carcinoma 78. Which is not tumor suppressor gene in human tumors? 1. Rb 100.0% 2. Cyclin D1 3. P53 4. P16 (INK4a) 5. NF1 79. Which is not the feature of the "Initiation" step in the "Two-Hits" hypothesis? 1. Normal phenotype 2. No threshold 100.0% 3. Reversible 4. Cause permanent DNA damage 5. Fixed by DNA replication 80. Ampicillin is used orally for the treatment of bacterial infection. The clearance of ampicillin is about 139 ml/min. If the requested average steady-state plasma concentration is 4 µg/ml and it will be given 4 times per day. Assuming that the elimination of ampicillin is the first-order kinetic process and ampicillin is well absorbed. What will be the dose size for every maintenance dose? 100.0% 1. Approximately 200 mg 2. Approximately 250 mg 3. Approximately 280 mg 4. Approximately 300 mg 5. Approximately 350 mg 81. Which of the following statements about drug excretion is most likely correct? 1. The intact drug always excreted without metabolism 2. Phase II metabolites always undergo biliary excretion 100.0% 3. Phase I metabolites mainly excrete from urine 4. Weak acidic drugs attempt to undergo mammary excretion 5. Weak basic drugs attempt to excrete from alveolar expired air