Download מבחן גמר בנוירולוגיה - 2008

Basic Pharmacology 2008
1. All but which of the following statements concerning clinical trials are correct
a. Phase I trials are carried out on small number of healthy volunteers
b. Phase II trials are carried out on small number of patients suffering
from the disease which the drug is intended to treat
c. Phase III trials are intended to verify the safety of the drug and its side
effects and does not concern with efficacy of drug
d. Data concerning the side effects of the drug is collected during phase
IV after the initial marketing of the drug
e. Drug efficacy is still unknown after completing phase I trials
 Correct answer: c
2. All but which of the following statements concerning Toxic reaction to drugs
are correct
a. Tachycardia caused by anti-asthmatic drug with muscarinic effect is
similar to B ("Bizarre") type toxic reaction
b. anaphylactic reaction to Penicillin is an example of type I
hypersensitivity
c. postural hypotension due to Prazosin administration is an example of
type A ("anticipated") toxic reaction
d. It is possible that some of the toxic reaction to a drug will not appear
even after the drug was given to 2,000 patients
e. Hematologic reactions such as hemolytic anemia and agranulocytosis
may be cause by type II, III or IV hypersensitivity reactions
 Correct answer: a
3. Which of the following statements concerning the effect of the autonomic
nervous system of the respiratory system is correct?
a. β2 adrenergic receptors exist in the bronchiolar smooth muscle
b. The bronchiolar smooth muscle does not respond to adrenalin because
no adrenergic receptors are present in it
c. the bronchiolar smooth muscle is innervated by sympathetic post
ganglionic nerves
d. stimulation of the parasympathetic nerve branches of the bronchiolar
smooth muscle will cause broncho-constriction
e. stimulation of the sympathetic nerve branches of the bronchiolar
smooth muscle will cause excessive mucous secretion
 Correct answer: a
4. Which of the following phenomena is unexpected following injection of
adrenalin?
a. A rise in release of Renin from the kidney which would have been
blocked if β1 blocker was administered prior the injection of adrenalin
b. Arterial and venous vasoconstriction
c. A fall in nor-adrenalin release from the post ganglionic sympathetic
nerve due to agonistic effect on α2 receptors
d. Negative Inotrophic effect on an isolated heart extraction
e. Contraction of the urinary bladder sphincter
 Correct answer: d
5. Which of the following is the expected cardiovascular response following
injection of phenylephrine?
a
b
c
d
e
Systolic Blood pressure
↑
↑
↑
↓
↑
Diastolic Blood pressure
↑
↑
↓
↓
↓
Heart rate
↑
↓
↓
↑
↑
 Correct answer: b
6. All but which of the following are expected following stimulation of the
sympathetic nervous system?
a. Diarrhea
b. Increase in cardiac sinus rhythm due to an increase in the speed of
slow depolarization in phase IV of the action potential
c. A rise in conduction speed
d. Relaxation of the smooth muscle in the bowl wall
e. Myosis do to contraction of the circular smooth muscle of the Iris
 Correct answer: b, e, question canceled
7. All but which of the following are expected following stimulation of the
parasympathetic nervous system?
a. Increased peristalsis
b. Improved focusing of vision on a near object
c. Excessive salivation
d. Decrease in Atrial action potential duration
e. Decrease in the secretion of gastric acid
 Correct answer: e
8. Which of the peptides listed below matches the following description best:
secreted in combination with acetylcholine following stimulation of the
parasympathetic nervous system and causes vasodilatation
a. Bradykinin
b. Substance P .
c. Enkephalin
d. Neuropeptide Y (NPY)
e. Vasoactive intestinal peptide (VIP)
 Correct answer: e
9. Which of the following enzymes is located in the external membrane of
mitochondrion in the distal end of the post ganglionic sympathetic axon?
a. Dopamine beta-hydroxylase
b. Tyrosine hydroxylase
c. Monoamine oxidase
d. Tryptophan hydroxylase
e. Aromatic amino acid decarboxylase
 Correct answer: c
10. All but which of the following are expected following systemic administration
of Adrenalin
a. Dermal vasoconstriction
b. Decrease in blood potassium levels
c. Decrease in pancreatic glucagon secretion
d. Increase in the disassembly of triglycerides to FFA
e. Decrease in pancreatic Insulin secretion
 Correct answer: c
11. A 30 year old patient has been suffering from episodes of hypoglycemia and
low blood pressure. Blood examinations demonstrated a very low level of
DOPAC and elevated levels of Dopamine MHPG, metanephrine and
normetanephrine. What could be a possible explanation?
a. Lack of tyrosine hydroxylase
b. Lack monoamine oxidase
c. Excessive catechol O-methyltransferase activity
d. Lack of dopamine beta-hydroxylase
e. Excessive tyrosine hydroxylase activity
 Correct answer: d
12. Which of the following molecules is not present in and is not related to neuron
inclusion bodies of the post ganglionic sympathetic neurons?
a. VMAT
b. (uptake 1) NET
c. Proton pump
d. Dopamine beta-hydroxylase
e. None of the above
 Correct answer: b
13. Which of the following statements concerning the synthesis of adrenalin in the
adrenal medullary chromafin cells is correct?
a. Adrenalin is synthesized from nor-adrenaline in the cytoplasm in a
process mediated by the enzyme PNMT(phenethanolamine-Nmethyltransferase)
b. Adrenalin is synthesized inside inclusion bodies cytoplasm in a process
mediated by the enzyme beta hydroxilase
c. Adrenalin is synthesized from Dopamine in the cytoplasm cytoplasm
in a process mediated by the enzyme beta hydroxilase
d. Adrenalin is synthesized from nor-adrenaline which is absorbed from
the plasma, because Chromafin cells are incapable of producing Noradrenaline
e. None of the above
 Correct answer: a
14. Which of the peptides listed below matches the following description best:
Would raise blood pressure when injected to a sedated animal only if it wasn’t
treated with reserpine previously. It is metabolized by mono-amine oxydase
a. Tyramine
b. Amphetamine
c. Noradrenaline
d. Phenylephrine
e. Alpha-methylnoradrenaline
 Correct answer: a
15. Which of the following agents has the weakest agonist effect on β1 adrenergic
receptors?
a. Adrenaline
b. Noradrenaline
c. Salbutamol
d. Dobutamine
e. Isoprenaline
 Correct answer: c
16. Which of the peptides listed below matches the following description best: A
neuronal blocker which inhibits response to stimulation of post ganglionic
sympathetic nerve by preventing the release of neurotransmitter, without
agonisitic effect on α or β adrenergic receptors
a. Clonidine
b. Guanethidine
c. Prazosin
d. Alpha-methylnoradrenaline
e. Propranolol
 Correct answer: b
17. Which of the drugs listed below matches the following description best: A
selective hydrophilic β1 blocker, with no agonistic effect and with no blocking
effect on rapid sodium channels
a. Metoprolol
b. Propranolol
c. Pindolol
d. Atenolol
e. Carvedilol
 Correct answer: d
18. Which of the following statements is correct :
a. Administration of Prazosin increases HDL/LDL ratio
b. Administration of Propranolol increases HDL/LDL ratio
c. Prazosin worsens the situation of an existing BHP (benign prostatic
hyperplasia)
d. DM is a contraindication for using beta blockers to treat Hypertension
e. A prolonged administration of beta blockers is not useful for
alleviating hypertension
 Correct answer: a
19. All but which of the following cause effective relief in Angina Pectoris
a. A drop in the Oxygen demand of the heart during effort
b. A drop in the preload
c. Vasodilatation of myocard collaterals
d. Vasodilatation of venous capacitance vessels
e. A drop in the after load
 Correct answer: e
20. Which of the phenomena listed below is expected following the administration
of selective PDE-3 (phosphodiesterase type 3) inhibitors?
a. General peripheral Vasodilatation (fall in TPR)
b. Positive Inotrophic effect
c. Selective vasodilatation of the corpora cavernosa
d. a + b
e. b + c
f. a + b +c
 Correct answer: d
21. All but which of the phenomena listed below is expected following the
administration of Verapamil?
a. Peripheral vasodilatation, more profoundly in veins
b. Negative Inotrophic effect
c. Bradycardia
d. A fall in AV node conduction speed
e. Worsening of an existing GERD
 Correct answer: a
22. Which of the following mechanisms is responsible to the Relaxation of
vascular smooth muscle by NO
a. Binding and activation of adenylate cyclase
b. Binding and inhibition of adenylate cyclase
c. Binding and activation of MLCK
d. Binding and activation of guanylate cyclase
e. Binding and activation of MLCP
 Correct answer: d
23. Which of the following statements is correct :
a. The generation of NO from sodium nitroprusside requires enzymatic
activity
b. Clonidin causes venous vasoconstriction not arterial vasoconstriction
c. Vasodilator activity of sodium nitroprusside requires the presence of
endothelial cells
d. Vasodilator activity of Salbutamol does not require the presence of
endothelial cells
e. Bio-availability of PO nitroglycerine approaches 100%
 Correct answer: d
24. All but which if the phenomena listed below is expected following the
administration of Digoxin?
a. Bradycardia
b.
c.
d.
e.
Positive Inotropic effect
Prolongation of atrial refractory period
A fall in AV node conduction speed
A rise in free intra-cellular calcium concentration in the myocytes
 Correct answer: c
25. Which of the following statements concerning Calcium channel blockers is
correct?
a. Verapamil is useful in the prevention of pain related to stable angina
pectoris
b. Nifedipine is useful in the prevention of pain related to stable angina
pectoris
c. Diltiazem only affects the blood vessels and does not affect the heart
d. Verapamil causes Tachycardia due to its direct effect on the SA node
e. Generally speaking CCB’s affect the cardiac muscle but not the
smooth muscles
 Correct answer: a
26. Which of the following are cardiac effects of β adrenergic agonists?
a. Phosphorilation of L-type Calcium channels and enhancement of Ca++
entry into cells
b. Inhibition of protein kinase A (PKA)
c. Increase in the phosphorilation of phospholamban and as a result
inhibition of the Calcium channel in the SR (sarcoplasmic reticulum)
d. a + b
e. a + b + c
 Correct answer: a
27. All but which if the phenomena listed below might be expected following the
administration of morphine?
a. Mydriasis
b. Histamine release and pruritus
c. Fall in rate and volume of breathing
d. Suppression of coughing
e. Constipation
 Correct answer: a
28. Which of the following best describes methadone
a. Antagonist for all types of Opiate receptors
b. Selective Agonist of kappa type Opiate receptors
c. An Opiate which crosses body membranes and BBB effectively
d. An efficient Opiate, absorbed effectively following PO administration,
initiation and termination of action slow in comparison to Morphine
e. Effective as a cough reliever, does not cause pain alleviation nor
euphoria
 Correct answer: d
29. Which of the following statements concerning the pharmaco-kinetics of
Opiates is correct:
a. Morphine is hardly absorbed in the bowl and therefore must be
injected
b. Morphine is metabolized in the liver to metabolites which are all
inactive
c. Heroin crosses the BBB faster than Morphine
d. Morphine does not cross the placenta and therefore can be used in
pregnant women
e. Pethidine inactivation rate is in the newborn is more rapid then
Morphine’s
 Correct answer: c
30. Which of the following drugs can be used to treat Opiate s overdose?
a. codeine
b. dextromethorphan
c. naloxone
d. pentazocine
e. diazepam
 Correct answer: c
31. All but which of the following statements concerning the pharmacology of
Opiates are correct:
a. Their analgesic effect includes activation of a the descending
(meullary-dorsal horn) serotonergic pathway
b. Agonists of kappa type Opioate receptors (i.e. Pentazocine) have an
improved analgesic effect and a reduced risk of causing dependency
c. Pharmacologic actions of Opiates includes Pre synaptic reduction of
neurotransmitter release and post synaptic activation of IRK
potassium channels
d. Activation of opiate receptors adjacent to G protein promotes the
activity of adenylate cyclase
e. Morphine is an agonist of the δ, κ and μ opiate receptors
 Correct answer: d
32. Which of the following effects of Morphine may cause addiction to this drug?
a. Physical dependency
b. Sedation
c. Euphoria
d. Dysphoria
e. Pain alleviation
 Correct answer: c
33. All but which of the following statements concerning GABAergic neurons are
correct?
a. GABA is a derivative of glucose metabolism
b. Activation of GABA A receptors causes chloride influx into the neuron
c. Barbiturates bind GABA A receptors
d. GABA is always inhibitory
e. Alcohol competes with benzodiazepines on bonding to GABA A
receptors
 Correct answer: e
34. Which of the following drug classes id used to treat early symptoms of
Alzheimer’s disease?
a. cholinesterase inhibitors
b. Anti-Histamines
c. benzodiazepines
d. Anti-cholinergic
e. NMDA agonists
 Correct answer: a
35. Which of the following is the action mechanism of Fulmazenil
a. Muscarinic receptor antagonist
b. NMDA receptor antagonist
c. Inhibition of Calcium entry into neurons
d. MAO inhibitor
e. Benzodiazepine antagonist
 Correct answer: e
36. Which of the following prevents the reentry of Amphetamine into nerve cells
a. Glutamate
b. GABA
c. Acetylcholine
d. Dopamine
e. None of the above
 Correct answer: d
37. Typical antipsychotics (e.g. haloperidol) do not cause:
a. Extra pyramidal symptoms
b. Improvement in Psychotic state
c. Improvement in Apathy
d. Lactation abnormalities
e. None of the above
 Correct answer: c
38. Which of the following permits the action of D-serine 38:
a. Its ability to bind GABA receptors
b. Its ability to block NMDA canal
c. Its ability to bind the co-agonistic site of NMDA
d. Its ability to activate Glycine receptors
e. Its ability to block chloride channels
 Correct answer: c