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Pharmacology Exam for Grade 2005 Oversea Students (Exam 2) — Jan 11th, 2008 Part ⅠChoice Questions (50 points, 1/item) Type A (only one answer is correct) 1. The main reason for the combination use of L-dopa with carbidopa is A. to increase the absorption of L-dopa B. to inhibit L-dopa decarboxylation in the periphery C. to inhibit MAO D. to inhibit COMT E. to increase L-dopa converting to dopamine directly 2. Which is the drug of choice for status epilepticus? A.magnesium sulfate B.carbamazepine C.ethosuximide D.diazepam E.phenylbutazone 3. Which of the following analgesic drugs can be used for artificial hibernation? A.morphine B.methadone C.pethidine D.fetanyl E.anadol 4. Which of the following statements about phenytoin sodium is WRONG? A. has a sedative effect B. can be used for patients with epilepsy C. can be used to treat patients with arrthymia D. can be used to manage patients with trigeminal neuralgia E. can cause gingival hyperplasia 5. The mechanism of anti-inflammatory effect of NSAIDs is to A. inhibit biosynthesis of PGs in centre nervous system B. promote biosynthesis of PGs in centre nervous system C. inhibit biosynthesis of PGs in inflammatory sites D. promote biosynthesis of PGs in inflammatory sites E. promote biosynthesis of LTs (leukotriens) in inflammatory sites 6. Which of the following statement is NOT aspirin’s adverse reaction? A.nausea and vomitting B.anti-rhumatic effect C.aspirin asthma D.Reye’s syndrome E.allergic response 7. All of the following actions about morphine are true EXCEPT A. constipation B. dilating pupil C. inhibition of respiration D. sedation E. analgesia 8. The antiplatelet mechanism of aspirin is A. inhibiting synthesis of TXA2 in platelet B. inhibiting synthesis of TXA2 in endothelium C. promoting synthesis of PGI2 in platelet D. promoting synthesis of PGI2 in endothelium E. promoting synthesis of PGE2 in endothelium 9. Which of the following drug is ineffective in the treatment of rheumatic arthritis? A. aspirin B.phenylbutazone C. sodium salicylate D. acetaminophen E. indomethacin 10. Antiparkisonism agents do NOT include A. Amantadine B. chlorpromazine C. Levodopa D. artane E. selegiline 11. A drug that can be used in the treatment of parkinsonism and also attenuate the reversible extrapyramidal side effects of chlorpromazine is A.amantadine B.levodopa C.artane D.bromocriptine E.selegiline 12. The drug choice in the treatment of grand mal epilepsy is A. phenytoin sodium B. ethosuximide C. diazepam D. sodium valproate E. arbamazepine 13. Which of the following statements about morphine is INCORRECT? A. It is used therapeutically to relieve pain caused by severe head injury. B. Its withdrawal symptoms can be relieved by methadone. C. It causes constipation. D. It is most effective by parenteral administration. E. It rapidly enters many body tissues, including the fetus of a pregnant woman. 14. All of the following statement about glucocorticoids are true EXCEPT A. inhibiting both the early and the late manifestation of inflammation B. affecting all types of inflammatory reactions C. inhibiting the amount of neutrophil D. inhibiting the release of arachidonic acid E. inhibiting granulation tissue formation 15.Vit K is a substance to prevent or reduce bleeding caused by A. heparin B. aspirin C. urokinase D. streptokinase E. dicoumarin 16.Which of the following mechanisms best accounts for the anti-thyroid effect of methylthiouracil? A. Inhibiting peroxidase and decreasing the thyroxin synthesis B. Inhibiting the thyroid releasing C. Inhibiting the absorption of iodine D. Interfering with the utilization of iodine E. Decomposing the thyroxin 17. Which of the following mechanisms best accounts for the anticoagulant effect of heparin? A. Binding antithromin Ⅲand accelerating the deactivation of coagulant factors consequently B. Interfering with the utilization of Vit k and decreasing synthesis of coagulant factors C. Inhibiting the platelet aggregation D. Inhibiting the activity of thrombase E. Antagonizing the effect of thrombin 18.Which of the following factors interferes with the absorption of ferrous agents? A. Gastric acid B. Vit C C. Foodstuff with abundant calcium and phosphate D. Fructose in foodstuff E. Cysteine 19. Which of the following drugs can protect gastric mucosa and eliminate Helicobacter Pylori? A. Proglumide B. Colloidal bismuth subcitrate C. Omeprazole D. Cimetidine E. Sucralfate 20. Which is the best scheme for treatment of megaloblastic anemia A. folic acid B. folic acid plus ferrous sulfate C. Vit B12 D. folic acid plus Vit B12 E. Vit B12 plus ferrous sulfate 21.Which of the following statements about insulin is NOT true? A. It can cause hyperglycemic reaction B. It can’t be administrated orally C. Its mechanism of action is through intracellular receptor pathway D. It can be used in IDDM and NIDDM E. It can cause anaphylactic reaction 22.Which of the following drugs can be used to treat cretinism? A. methylthiouracil B. propylthiouracil C. methimazole (tapazole) D. carbimazole E. thyroxin 23.All of the following are indications of glucocorticoids EXCEPT A. rheumatic arthritis B. bronchial asthma C. peptic ulcer D. endotoxic shock E. childhood acute leukemia 24. Which one of the following statements about heparin is true ? A. Mild anticoagulative effect B. Slow onset of effect C. No anticoagulative effect in vitro D. Possessing anticoagulative effect in vitro E. It can be administrated orally 25.The antiasthmatic effect of salbutamol is attributed to A. stimulation of β2 receptor B. blockade of M-receptor C. activation of guanylate cyclase D. increase of intracellular cGMP E. inhibition of phosphodiesterase 26. Which of the following is the most important approach in preventing peptic ulcers from recurrence? A. coating the ulcer crater B. eradicating infection with H. Pylori C. inhibiting secretion of gastric acid at the proton pump D. blocking receptor activation of gastric acid secretion E. neutralizing secreted gastric acid 27. Under which of the following conditions is mannitol contraindicated? A. Glaucoma B. Chronic heart failure C. Oliguria caused by shock D. Before colonoscopy E. Edema 28. Which drug is effective in warfarin-induced hemorrhage? A. tranexamic acid B. vitamin K C. vitamin B12 D. protamine sulfate E. epinepherin 29.A 60-year-old male alcoholic treated for type Ⅱdiabetes mellitus develops lactic acidosis . Which of the following oral hypoglycemic agents might cause this adverse effect? A. Glyburide B. Metformin C. Acarbose D. Rosiglitazone E. Chlorpropamide 30.Omeprazole, an agent for the promotion of healing of peptic ulcers, has a mechanism of action that is bases on A. Prostaglandins B. Gastric secretion C.Pepsin secretion D. H+-K+-ATPase E. Anticholinergic action 31. All of the following are true about hydrochlorothiazide EXCEPT A. It can be used to treat hypercalcinuria B. It can lead to hypoglycemia C. It can increase the secretion of K+ then cause hypokalemia D. It can decrease blood pressure mildly E. It can decrease the urinary output of diabetes insipidus patients 32. Which of the statements about thiourea is WRONG? A. They inhibit synthesis of thyroxine B. They have immunosuppressive effect C. Propylthiouracil stimulates T4 transform to T3 D. They can cause thyroid enlargement when long term used E. They can excrete from milk and pass through placenta barrier 33. Which of the following drugs is the drug choice in treating pneumonia caused by Legionella? A. tetracycline B. azithromycin C. gentamicin D. cefuroxime E. amoxycillin 34. The major adverse effect about chloramphenicol is A. allergic reaction B. gastrointestinal tract reaction C. aplastic anemia D. hepatic necrosis E. renal toxicity. 35. The drug of choice in the treatment of epidemic cerebrospinal meningitis is A. ampicillin B. SMZco C. chloramphenicol D. SD E. penicillin 36. Metronidazole can not be used to treat patients with A. trichomoniasis B. amebic dysentery C. rheumatic arthritis D. infection caused by anaerobe E. giardiasis 37. Which of the following statements about the mechanism of action of antibiotics is most accurate? A. aminoglycosides bind to receptors on the 50s ribosomal subunit to prevent attachment of aminoacyl-tRNA B. cephalosporins inhibit the synthesis of precursor of the linear peptidoglycan chain of the cell wall C. fluoroquinolones inhibit DNA-dependent RNA polymerase D. the bactericidal action of penicillin is partly due to their activation of autolytic enzymes E. vancomycin inhibit peptidyl transferases involved in cell wall synthesis 38. Which of the following drugs may cause superinfections? A. penicillin G B. streptomycin C. erythromycin D. tetracycline E. neomycin 39. Which of the following drugs prevents synthesis of cell wall, but does not belong to β-lactam antibiotics ? A. penicillin G B. vancomycin C. aztreonam D. cefaclor E. amoxycillin 40. All of the following antibiotics act by interfering with protein synthesis EXCEPT A. tetracycline B. streptomycin C. chloramphenicol D. ampicillin E. clindamycin 41. A drug that inhibits DNA-dependent RNA polymerase and can be used to treat patients with tuberculosis is A. isoniazid B. streptomycin C.rifampicin D.ethambutol E.ciprofloxacin 42.Why is vitamin B6 usually prescribed with isoniazid(INH)? A. it acts as a cofactor of isoniazid B. it prevents some adverse reaction of INH therapy C. it has antituberculosis effect D. it prevents metabolism of INH E. it decreases the occurrence of drug resistance 43. Which of the following agents may cause damage to growing cartilage? A. fluoroquinolones B. Sulfonamides C.aminoglycosides D. cephalosporins E. tetracyclines 44. Which of the following drugs is the drug of choice for the treatment of osteomyelitis caused by Staphylococcus auerus ? A. penicillin B. polymyxin B C. chloramphenicol D. clindamycin E. ciprofloxacin 45. A 75-year-old woman hospitalized for pneumonia and treated with an intravenous antibiotic. On day three, she develops severe diarrhea. Stool is positive for Clostridium difficile toxin. What is the best treatment? A. clindamycin B. cefaclor C. metronidazole D. erythromycin E. doxycycline 46. Sulfonamide act synergistically with trimethoprim because A. sulfonamides inhibit the metabolism of trimethoprim B. trimethoprim inhibit the metabolism of sulfonamides C. both drugs act at the same step in inhibiting folic acid synthesis D. both drugs act at different steps in inhibiting folic acid synthesis E. none of the above . 47. All of the following properties are exhibited by aminoglycosides EXCEPT A. they are poorly absorbed from gastrointestinal tract B. they have bactericidal properties C. they can achieve adequate serum levels after oral administration D. they bind to the 30S ribosomal subunit E. they are not accumulated by anaerobic microorganisms 48.Clavulanic acid can inhibit which one of the following enzymes? A.Dihydrofolate synthetase B.peptidoglycan synthetase C.β-lactamase D.DNA polymerase E.dihydrofolate reductase 49. A 45-year-old female being treated for a chronic UTI develops acute alcohol intolerance. Which of the following agents could have caused this intolerance? A. cefoperazone B. amoxicillin C. SMZ D. norfloxacin E. tetracycline 50. A patient with a pneumonia has a sputum culture that is positive for a staphylococcal strain that is -lactamase-positive. Which is the best choice of penicillin therapy in this patient? A. ampicillin B. oxacillin C. penicillin V D. penicillin G E. carbenicillin PART ⅡAssay Questions (50 points) 1. Please describe the pharmacological effects of chlorpromazine. (15 points) 2. Please compare the effects of heparin and the coumarin anticoagulants. (10 points) 3. Please describe the adverse effects of glucocorticoids.(15 points) 4. What are the shared adverse reactions of aminoglycosides? (10 points)