Download Clinical pharmacology of anti-infectives and nonsteroidal_англ

Module 2. Clinical pharmacology of anti-infectives and nonsteroidal and steroidal anti-inflammatory
facilities. Clinical pharmacology of facilities, influencing on CNS and GI way
Text tests tasks
1. Alternative antimicrobial drug(s) for treating penicillin-resistant S. aureus:
A. *vancomycin (Vancocin)
B. nafcillin (Nafcil, Unipen)
C. methicillin (Staphcillin)
D. vancomycin, nafcillin & methicillin
E. none of the above
2. Antibiotic's clearance from the body most likely influenced by severe hepatic disease:
A. Penicillins
B. clindamycin (Cleocin)
C. rifampin (Rimactane)
D. *clindamycin & rifampin
E. none of the above
3. Associated with "gray baby syndrome" which is characterized by pallor, cyanosis, and even death.
A. tetracyclines
B. *chloramphenicol (Chloromycetin)
C. third-generation cephalosporins
D. tetracyclines & chloramphenicol & B
E. none of the above
4. Which of the following drugs are generally considered to be bactericidal in vitro: cephalosporins;
penicillins; aminoglycosides; clindamycin?
A. *cephalosporins, penicillins, aminoglycosides
B. cephalosporins, aminoglycosides
C. penicillins, clindamycin
D. clindamycin only
E. all of the above
5. The drug of choice for methicillin-resistant Staphylococcus aureus is:
A. oxacillin
B. gentamicin
C. *vancomycin
D. piperacillin
E. None of the above
6. The drug of choice for Streptococcus pneumonia (pneumococcus) in a patient with no drug allergies
is:
A. erythromycin
B. *penicillin
C. vancomycin
D. ceftriaxone
E. gentamicin
7. Aminoglycosides are: excreted renally; bactericidal; potentially toxic to the auditory and vestibular
portions of the eighth cranial nerve; potentially nephrotoxic?
A. excreted renally, bactericidal, potentially toxic to the auditory and vestibular portions of the
eighth cranial nerve
B. excreted renally, potentially toxic to the auditory and vestibular portions of the eighth cranial
nerve
C. bactericidal, potentially toxic to the auditory and vestibular portions of the eighth cranial
nerve
D. potentially nephrotoxic only
E. *All of the above
8. Clindamycin is: associated with diarrhea; active against anaerobes; active against some gram-positive
organisms; active against some gram-negative organisms?
A. *associated with diarrhea, active against anaerobes, active against some gram-positive
organisms
B. associated with diarrhea, active against some gram-positive organisms
C. active against anaerobes, active against some gram-negative organisms
D. active against some gram-negative organisms only
E. All of the above
9. The route by which isoniazid is usually administered is:
A. *oral
B. intramuscular injection of solution
C. intramuscular injection of suspension
D. subcutaneous injection of solution
E. intravenous
10. Rifampin is used mainly in the treatment of:
A. cholera
B. typhoid fever
C. *tuberculosis
D. rickettsial diseases
E. pseudomonas infections
11. Impaired vision is an adverse effect of:
A. carbenicillin
B. *ethambutol
C. rifampin
D. colistin
E. cycloserine
12. Various drugs may induce vitamin deficient states as an undesirable side effect. Vitam B6
(pyridoxine) deficiency may be related to taking:
A. estrogen-containing oral contraceptives
B. colchicine
C. *isoniazid
D. All of the above
E. None of the above
13. Most adults who are at high risk of developing pulmonary tuberculosis should be treated with:
A. isoniazid 100 mg/day for 6 months
B. *isoniazid 300 mg/day for 12 months
C. ethambutol 400 mg/day for 12 months
D. rifampin 600 mg/day for 24 months
E. No treatment is necessary
14. An antitubercular agent which is associated with the development of ocular toxicity is:
A. rifampin
B. *ethambutol
C. isoniazid
D. streptomycin
E. para-aminosalicylic acid
15. Which of the following antitubercular agents is associated with the development of ototoxicity?
A. rifampin
B. ethambutol
C. isoniazid
D. *streptomycin
E. para-aminosalicylic acid
16. Which of the following antibiotics is most closely associated with the development of ocular
toxicity?
A. kanamycin
penicillin G
tetracycline
isoniazid
*ethambutol
17. Which of the following antibiotics is most closely associated with the development of hepatitis?
A. kanamycin
B. penicillin G
C. tetracycline
D. *isoniazid
E. ethambutol
18. Which of the following antibiotics is most closely associated with the development of renal and
ototoxicity?
A. *kanamycin
B. penicillin G
C. tetracycline
D. isoniazid
E. ethambutol
19. Which of the following agents used in the treatment of pulmonary tuberculosis has the side effect of
loss of perception of the color green?
A. isoniazid
B. rifampin
C. *ethambutol
D. streptomycin
E. para-amino salicylic acid
20. Which of the following agents used in the treatment of pulmonary tuberculosis has a toxicity of
producing a lupus-like syndrome?
A. *isoniazid
B. rifampin
C. ethambutol
D. streptomycin
E. para-amino salicylic acid
21. Isoniazid-induced liver damage:
A. occurs primarily in patients under 30 years of age
B. occurs with increased frequency in patients receiving concomitant ethambutol therapy
C. *is probably due to the formation of a toxic hydrazine metabolite that binds to liver protein
D. is frequently associated with allergic manifestations such as eosinophilia, fever, and rash
E. All of the above
22. Tubercle bacilli exist in tuberculous patients in three pools extracellular,intracellular, and necrotic
caseum. The only drug which is bactericidal for all three is:
A. isoniazid
B. ethambutol
C. pyrazinamide
D. *rifampin
E. streptomycin
23. All of the following are considered primary drugs in the current therapeutic approaches to the
treatment of tuberculosis EXCEPT:
A. streptomycin
B. *para-aminosalicylic acid
C. isoniazid
D. rifampin
E. ethambutol
24. Which of the following antitubercular drugs has hyperuricemia as one of its well-documented
untoward effects?
B.
C.
D.
E.
streptomycin
isoniazid
cycloserine
rifampin
*pyrazinamide
25. Which of the following is a bactericidal antitubercular drug that has an inhibitory action on cell wall
synthesis?
A. *isoniazid
B. rifampin
C. ethambutol
D. streptomycin
E. para-aminosalicylic acid
26. Ethambutol has become a primary treatment drug in the therapy of tuberculosis because of its
infrequent side effects. The only significant toxic effect is:
A. bone marrow suppression
B. renal tubular damage
C. *retrobulbar neuritis
D. hepatitis
E. Stevens-Johnson Syndrome
27. Rifampicine is used mainly in the treatment of :
A. Cholera
B. Typhoid fever
C. *Tuberculosis
D. Rickettsial diseases
E. Pseudomonas infections
28. Patients having a history of a severe, immediate reaction to penicillin:
A. may be given a cephalosporin without concern
B. have a definite risk of reaction to any cephalosporin
C. have a low risk of having a reaction to a broad spectrum antipseudomonal penicillin
D. have a high risk of hypersensitivity to a broad spectrum antipseudomonal penicillin
E. *have a definite risk of reaction to any cephalosporin & have a high risk of hypersensitivity
to a broad spectrum antipseudomonal penicillin
29. Tetracyclines:
A. are bacteriostatic in vitro
B. are bacteriocidal in vitro
C. are effective against rickettsial
D. interfere primary with cell wall synthesis
E. *are bacteriostatic in vitro & are effective against rickettsial
30. What agents are antiviral:
A. Interferonum
B. Biochinolum
C. Oxolinum
D. Remantadinum
E. *Interferonum, Oxolinum & Remantadinum
31. Choose the necessary component of therapy of pneumonia complicated by pleurisy with effusion:
A. Inhibitors of proteinases;
B. Diuretic;
C. *Pleurocentesis;
D. Antiviral therapy;
E. Cardiac glycosides.
32. Choose the necessary component of therapy of pneumonia complicated by pleurisy with effusion:
A. Inhibitors of proteinases;
B. Diuretic;
A.
B.
C.
D.
E.
C. *Antibiotics;
D. Antiviral therapy;
E. Cardiac glycosides.
33. Once daily anti-HIV/AIDS non-nucleoside reverse transcriptase inhibitor
A. *stavudine (Zerit, d4T)
B. efavirenz (EFV; Sustiva)
C. zalcitabine (Hivid, ddc)
D. indinavir (Crixivan)
E. All of the above
34. Mycobacterium avium prophylaxis in HIV patients
A. rifabutin (Mycobutin)
B. dapsone/pyrimethamine (Daraprim)
C. azithromycin (Zythromax)
D. *rifabutin & azithromycin
E. All of the above
35. Rationale for antiviral treatment of acute HIV patients (initial viremia):
A. *reduction in rate of viral mutation
B. decrease severity of acute disease
C. both
D. neither
E. None of the above
36. Severe systemic Candida infection in HIV patients:
A. nystatin (Mycostatin)
B. fluconazole (Diflucan)
C. i.v. amphotericin B (Fungizone, Amphotec) then oral fluconazole (Diflucan)
D. *fluconazole & i.v. amphotericin B (Fungizone, Amphotec) then oral fluconazole (Diflucan)
E. None of the above
37. Most common fungal infection in HIV patients
A. Cryptococcosis
B. *candidiasis
C. histoplasmosis
D. Cryptococcosis & candidiasis
E. All of the above
38. Acute treatment of cryptococcal infections in HIV patients
A. clindamycin (Cleocin)
B. trimethoprim-sulfamethoxazole (Bactrim)
C. *amphotericin B (Fungizone, Amphotec) + flucytosine (Ancobon)
D. oral itraconazole (Sporanox)
E. All of the above
39. Agents useful in treating mycobacterial infections in HIV patients:
A. clarithromycin (Biaxin)
B. ethambutol (Myambutol)
C. amikacin (Amikin)
D. *all of the above may be useful
E. None of the above
40. Properties of tetracycline (Achromycin):
A. inhibitor of bacterial cell wall synthesis
B. *drug of choice in treating typhus
C. cleared primarily by the liver
D. inhibitor of bacterial cell wall synthesis & drug of choice in treating typhus
E. None of the above
41. Suitable for treatment of bacterial meningitis caused by H. Influenzae:
A. *cefotaxime (Claforan)
cephalexin (Keflex)
cephalothin (Keflin)
cefadroxil (Duricef, Ultracef)
None of the above
42. More likely to cause polyneuritis in patients who are"slow acelators"; this antibiotic is inactivated by
the liver.
A. clindamycin (Cleocin)
B. *isoniazid (INH)
C. nafcillin (Nafcil, Unipen)
D. vancomycin (Vancocin)
E. None of the above
43. This antibiotic may cause hemolysis if prescribed to a patient with glucose-6-phosphate
dehydrogenase deficiency:
A. penicillin V (Pen-Vee K, Veetids)
B. neomycin
C. Augmentin ( amoxicillin (Amoxil Polymox) and clavulanic acid)
D. *sulfisoxazole (Gantrisin)
E. None of the above
44. Special concerns in using antimicrobials in newborns and young children:
A. Sulfonamides can be safely given to newborns
B. Tetracyclines should not be administered to children betlow the age of eight
C. Newborns should not be given chloramphenical because they are unable to metabolize the
drug adequately.
D. *Tetracyclines should not be administered to children betlow the age of eight & newborns
should not be given chloramphenical because they are unable to metabolize the drug
adequately.
E. None of the above
45. Antibacterials regarded as generally safe to prescribe in pregnancy.
A. Erythromycins
B. Cephalosporins
C. Tetracyclines
D. *Erythromycins & Cephalosporins
E. Erythromycins, Cephalosporins & Tetracyclines
46. Ototoxicity and nephrotoxicity associated with this antibiotic:
A. cefotaxime (Claforan)
B. *amikacin (Amikin)
C. aztreonam (Azactan)
D. ceftriaxone (Rocephin)
E. amikacin & aztreonam
47. Aminoglycosides antibacterial
A. Hetacillin
B. Aztreonam
C. *gentamicin (Garamycin)
D. vancomycin (Vancocin)
E. gentamicin & hetacillin
48. FALSE statement about penicillin G
A. treatment of choice for viridans group streptococcal endocarditis.
B. Pen G and Pen V are the two natural penicillins.
C. Pen G can be combined with procaine, extending drug half-life
D. *Pen G most effective when given orally
E. Treatment of choice for viridans group streptococcal endocarditis & Pen G and Pen V are the
two natural penicillins
49. Inhibits bacterial cell wall synthesis:
B.
C.
D.
E.
Streptomycin
*vancomycin (Vancocin)
doxycycline (Vibramycin, Doryx)
gentamicin (Garamycin)
None of the above
50. Synergistic antimicrobial combination:
A. amoxicillin-clavulanate
B. ampicillin –streptomycin
C. *sulbactam-ampicillin
D. All of the above
E. None of the above
51. Mechanism of action: amoxicillin (Amoxil Polymox)
A. inhibits bacterial cell wal biosynthesis
B. interferes with transpeptidation preventing peptidoglycan chain crosslinking.
C. Inhibits protein synthesis
D. *inhibits bacterial cell wal biosynthesis & interferes with transpeptidation preventing
peptidoglycan chain crosslinking.
E. None of the above
52. Combination of metronidazole (Flagyl) and penicillin in treating an abscess caused by beta-lactamase
producing Bacteriodes and anaerobic streptococci is an example of:
A. synergistic drug treatment
B. antagonistic drug effects
C. *additive drug effects
D. none of the above
E. synergistic drug treatment & additive drug effects
53. Beta-lactamase inhibitor:
A. vancomycin (Vancocin)
B. sulbactam
C. clavulanate
D. *Sulbactam & clavulanate
E. None of the above
54. Antifungal polyene macrolide that preferentially binds to fungal ergosterol which alters cellular
permeability.
A. Ketoconazole
B. *amphotericin B
C. Flucytosine
D. Grisefulvin
E. Clotrimazole
55. An azole most commonly used for topical treatment of candidiasis:
A. amphotericin B
B. *clotrimazole
C. Griseofulvin
D. Flucytosine
E. none of the above
56. Polyene macrolide only used topically, due to systemic toxicity; active against most Candida species-most commonly used for suppression of local candidal infection.
A. Miconazole
B. Terbinafine
C. *nystatin
D. Fluconazole
E. Flucytosine
57. Of ketoconazole, itraconazole, and fluconazole--most likely to cause increased arrhythmogenic
effects of astemizole or terphidine
A.
B.
C.
D.
E.
A.
B.
C.
D.
E.
*Ketoconazole
Itraconazole
Fluconazole
Ketoconazole & Itraconazole
Itraconazole & Fluconazole
58. Inhibition of fungal squalene epoxidase is this antifungal drug's mechanism of action:
A. Ketoconazole
B. Fluconazole
C. *terbinafine
D. Nystatin
E. Ketoconazole & Fluconazole
59. More serious adverse effects: itraconazole (azole) or flucytosine (pyrimidine analogue):
A. *Flucytosine
B. Itraconazole
C. None of the above
D. Flucytosine & Itraconazole
E. Fluconazole
60. Most potent of the presently available anti-fungal azoles:
A. Fluconazole
B. *itraconazole
C. Ketoconazole
D. Both Fluconazole & Ketoconazole
E. None of the above
61. Azole most likely to get into the cerebral spinal fluid (CSF):
A. Ketoconazole
B. Itraconazole
C. *Fluconazole
D. Both Ketoconazole & Itraconazole
E. None of the above
62. Given by i.v. administration, the drug of choice for nearly all life-threatening mycotic infections-usually used as the initial induction regimen
A. Ketoconazole
B. Itraconazole
C. Flucytosine
D. *Amphotericin B
E. Nystatin
63. Topical allylamine(s) used for treating tinea cruris and tinea corporis:
A. Terbinafine
B. Naftifine
C. *Both
D. Neither
E. None of the aboth
64. Properties of tetracycline (Achromycin):
A. inhibitor of bacterial cell wall synthesis
B. *dug of choice in treating typhus
C. cleared primarily by the liver
D. inhibitor of bacterial cell wall synthesis & dug of choice in treating typhus
E. none of the above
65. Suitable for treatment of bacterial meningitis caused by H. influenza:
A. *cefotaxime (Claforan)
B. cephalexin (Keflex)
C. cephalothin (Keflin)
D. cefadroxil (Duricef, Ultracef)
E. none of the above
66. More likely to cause polyneuritis in patients who are"slow acelators"; this antibiotic is inactivated by
the liver.
A. clindamycin (Cleocin)
B. *isoniazid (INH)
C. nafcillin (Nafcil, Unipen)
D. vancomycin (Vancocin)
E. none of the above
67. Alternative antimicrobial drug(s) for treating penicillin-resistant S. aureus:
A. vancomycin (Vancocin)
B. nafcillin (Nafcil, Unipen)
C. methicillin (Staphcillin)
D. *All of the above
E. none of the above
68. Antibiotic's clearance from the body most likely influenced by severe hepatic disease:
A. penicillins
B. clindamycin (Cleocin)
C. rifampin (Rimactane)
D. *clindamycin & rifampin
E. none of the above
69. Associated with "gray baby syndrome" which is characterized by pallor, cyanosis, and even death.
A. tetracyclines
B. *chloramphenicol (Chloromycetin)
C. third-generation cephalosporins
D. All of the above
E. none of the above
70. This antibiotic may cause hemolysis if prescribed to a patient with glucose-6-phosphate
dehydrogenase deficiency:
A. penicillin V (Pen-Vee K, Veetids)
B. neomycin
C. Augmentin ( amoxicillin (Amoxil Polymox) and clavulanic acid)
D. *sulfisoxazole (Gantrisin)
E. none of the above
71. Special concerns in using antimicrobials in newborns and young children:
A. sulfonamides can be safely given to newborns
B. ttracyclines should not be administered to children betlow the age of eight
C. newborns should not be given chloramphenical because they are unable to metabolize the
drug adequately.
D. *sulfonamides can be safely given to newborns & newborns should not be given
chloramphenical because they are unable to metabolize the drug adequately.
E. none of the above
72. Antibacterials regarded as generally safe to prescribe in pregnancy.
A. erythromycins
B. cephalosporins
C. tetracyclines
D. *erythromycins & cephalosporins
E. none of the above
73. Ototoxicity and nephrotoxicity associated with this antibiotic:
A. cefotaxime (Claforan)
B. *amikacin (Amikin)
C. aztreonam (Azactan)
D. ceftriaxone (Rocephin)
E. All of the above
74. Aminoglycosides antibacterial
A. hetacillin
B. aztreonam
C. *gentamicin (Garamycin)
D. vancomycin (Vancocin)
E. all of the above
75. FALSE statement about penicillin G
A. treatment of choice for viridans group streptococcal endocarditis.
B. pen G and Pen V are the two natural penicillins.
C. pen G can be combined with procaine, extending drug half-life
D. *pen G most effective when given orally
E. none of the above
76. Inhibits bacterial cell wall synthesis:
A. streptomycin
B. *vancomycin (Vancocin)
C. doxycycline (Vibramycin, Doryx)
D. gentamicin (Garamycin)
E. none of the above
77. Synergistic antimicrobial combination:
A. amoxicillin-clavulanate
B. ampicillin -streptomycin
C. sulbactam-ampicillin
D. *all of the aove
E. none of the above
78. Mechanism of action: amoxicillin (Amoxil Polymox)
A. inhibits bacterial cell wal biosynthesis
B. interferes with transpeptidation preventing peptidoglycan chain crosslinking.
C. *inhibits bacterial cell wal biosynthesis & interferes with transpeptidation preventing
peptidoglycan chain crosslinking.
D. inhibits blood cell
E. none of the above
79. Combination of metronidazole (Flagyl) and penicillin in treating an abscess caused by beta-lactamase
producing Bacteriodes and anaerobic streptococci is an example of:
A. synergistic drug treatment
B. antagonistic drug effects
C. *additive drug effects
D. all of the above
E. none of the above
80. Beta-lactamase inhibitor:
A. vancomycin (Vancocin)
B. sulbactam
C. clavulanate
D. *sulbactam & clavulanate
E. none of the above
81. Antifungal polyene macrolide that preferentially binds to fungal ergosterol which alters cellular
permeability.
A. ketoconazole
B. *amphotericin B
C. flucytosine
D. grisefulvin
E. clotrimazole
82. An azole most commonly used for topical treatment of candidiasis:
A. amphotericin B
B.
C.
D.
E.
*clotrimazole
griseofulvin
flucytosine
none of the above
83. Polyene macrolide only used topically, due to systemic toxicity; active against most Candida species-most commonly used for suppression of local candidal infection.
A. miconazole
B. terbinafine
C. *nystatin
D. fluconazole
E. flucytosine
84. Of ketoconazole, itraconazole, and fluconazole--most likely to cause increased arrhythmogenic
effects of astemizole or terphidine
A. *ketoconazole
B. itraconazole
C. fluconazole
D. all of the above
E. none of the above
85. Inhibition of fungal squalene epoxidase is this antifungal drug's mechanism of action:
A. ketoconazole
B. fluconazole
C. *terbinafine
D. nystatin
E. all of the above
86. More serious adverse effects: itraconazole (azole) or flucytosine (pyrimidine analogue):
A. *flucytosine
B. itraconazole
C. clot blood
D. all of the above
E. none of the above
87. Most potent of the presently available anti-fungal azoles:
A. fluconazole
B. *itraconazole
C. ketoconazole
D. all of the above
E. none of the above
88. Azole most likely to get into the cerebral spinal fluid (CSF):
A. ketoconazole
B. itraconazole
C. *fluconazole
D. all of the above
E. none of the above
89. Given by i.v. administration, the drug of choice for nearly all life-threatening mycotic infections-usually used as the initial induction regimen
A. ketoconazole
B. itraconazole
C. flucytosine
D. *amphotericin B
E. nystatin
90. Topical allylamine(s) used for treating tinea cruris and tinea corporis:
A. terbinafine
B. naftifine
C. *terbinafine & naftifine
D. amphotericin B
E. none of the above
91. 10-30 years postexposure - cardiac and neurologic destruction
A. Syphilis
B. Syphilis Primary
C. *Syphilis Teritiary
D. Syphilis Secondary
E. none of the above
92. Diagnoised with viral culture
A. Syphilis
B. Chalymida
C. *Candidias
D. All of the above
E. none of the above
93. Females: odorless, white or yellow cheesy discharge with itching
A. Chalymida
B. Syphilis
C. Endometriosis
D. *Candidias
E. none of the above
94. Treat with Metronidazole (Flagyl)
A. Tonsilytis
B. Angina
C. All of the above
D. *Trichomanas Vaginalis
E. none of the above
95. Diagnoised with tissue culture, MictoTak, chlamydiazyme
A. Candidias
B. Syphllis
C. Chalmdyia
D. *Chalymida
E. none of the above
96. Chancre, highly infectious
A. *Syphilis Primary
B. Syphilis
C. Syphilis Teritiary
D. Syphilis Secondary
E. none of the above
97. The following structure is a protease inhibitor. What is the name of the structure?
A. *Ritonavir
B. Lovastatin
C. Amicacin
D. Metronidasole
E. all of the above
98. A bacteriostatic antimicrobial that inhibits protein synthesis by blocking attachment of aminoacyi tRNA to the A site on the 30S bacterial ribosome
A. Aminoglycosides
B. Fluoroquinolones
C. Metronidazole
D. Sulfonamide
E. *Tetracycline
99. Bactericidal drugs that act by inhibiting DNA gyrase
A. Aminoglycoside
B.
C.
D.
E.
*Fluoroquinolones
Macrolides
Rifamycins
Sulfonamides
100.
Binds to the 50 s bacterial ribosome and prevents the translocation step in protein synthesis
A. Aminoglycosides
B. Daptomycin
C. Linezolid
D. *Macrolides
E. Metronidazole
101.
Binds to the 30s bacterial ribosome and blocks the initiation step in protein synthesis. May
cause miscoding
A. *Aminoglycosides
B. Daptomysin
C. Linezolid
D. Metronidazole
E. Rifampin
102.
Inhibits the formation of folic acid by competing with PABA for dihydropteroate synthase
A. Metronidazole
B. Rifampin
C. *Sulfamethoxazole
D. Trimethoprin
E. Linezolid
103.
Binds to specific receptors located in the bacterial cytoplasmic cell membrane and inhibits
transpeptidase enzymes, preventing cross linking of peptidoglycan chains in the cell wall
A. *Cephalosporins
B. Daptomycin
C. Linezolid
D. Metronidazole
E. Rifampin
104.
Binds to the D-Ala-D-Ala terminal end of peptidoglycan side chains, resulting in inhibition of
transglycosylation and disruption of cross-linking in the cell wall
A. Chloramphenicol
B. Clavulanic
C. Imipenem
D. *Vancomycin
E. Metronidazole
105.
Combination of these two drugs would produce an antagonistic (undesirable) antimicrobial
effect when treating an infection
A. Amoxicillin+ gentamicin
B. Cephalexin+ gentamicin
C. Sulfamethoxazole+ trimethoprim
D. *Tetracycline + amoxicillin
E. Vancomycin+ gentamicin
106.
Which of the following drug combinations would produce a synergistic effect
A. Amoxicillin+ ampicillin
B. Cephalexin+ penicillin V
C. Sulfamethoxazole+ trimethoprim
D. Vancomycin+ gentamicin
E. *Sulfamethoxazole+ trimethoprim and Vancomycin+ gentamicin
107.
Which form of resistance to the effect of antimicrobial drugs is specific to beta-lactam type
antibiotics
A. Decreased drug uptake
Methylation of the antibiotic’s receptor
Decreased metabolic activation
Altered amount of drug receptor
*Increased enzymatic destruction of the antibiotic
108.
The combination of sulfamethoxazole and trimethoprim is a useful drug for treating UTIs.
Bacterial resistance to trimethoprim occurs primarily by
A. Acetylation of trimethoprim
B. Acetylation of the drug receptor
C. Decreased bacterial uptake
D. *Upregulation of dihydrofolate reductase
E. Upregulation of beta-lactamase
109.
Bacterial resistance to this drug results from a plasmid mediated mechanism that results in an
altered ribosomal binding site within the bacteria
A. Ampicillin
B. *Azithromycin
C. Penicillin
D. Piperacillin
E. Vancomycin
110.
Which of the following antimicrobial drugs is bactericidal
A. Azithromycin
B. Doxycycline
C. Erythromycin
D. *Gentamicin
E. Tetracycyline
111.
Macrolides and tetracyclines are bacteriostatic while aminoglycosides are bactericidal. This
difference results from some reasons
A. Aminoglycosides binding to ribosomes is stronger almist irreversible
B. Aminoglycosides can cause misreading of mRNA, resulting in build-up of toxic proteins
C. Aminoglycosides cause DNA damage. While tetracycline and macrolides do not
D. Bacteria develop a rapid tolerance to tetracyclines and macrolides
E. *A and B
112.
Which of the following antinmicrobials is taken up into bacteria by an oxygen-dependent
mechanim and is therefore ineffective against anaerobic organisms
A. Cefoxitin
B. Clindamycin
C. *Gentamicin
D. Metronidazole
E. Ticarcillin
113.
Which of the following drugs are generally considered to be bactericidal invitro:
cephalosporins; penicillins; aminoglycosides; clindamycin?
A. *cephalosporins, penicillins, aminoglycosides
B. cephalosporins, aminoglycosides
C. penicillins, clindamycin
D. clindamycin only
E. All of the above
114.
Aminoglycosides: are very popular; are well absorbed from the gastrointestinal tract; do not
penetrate pulmonary secretions well; do not appear in urine in high concentrations?
A. are very popular, are well absorbed from the gastrointestinal tract, do not penetrate pulmonary
secretions well
B. *are very popular, do not penetrate pulmonary secretions well
C. are well absorbed from the gastrointestinal tract, do not appear in urine in high concentrations
D. do not appear in urine in high concentrations only
E. All of the above
B.
C.
D.
E.
115.
The drug of choice for methicillin-resistant Staphylococcus aureus is:
A. oxacillin
B. gentamicin
C. *vancomycin
D. piperacillin
E. None of the above
116.
Tetracyclines: are bacteriostatic in vitro; are bactericidal in vitro; are effective against
rickettsiae; interfere primarily with cell wall synthesis?
A. are bacteriostatic in vitro, are bactericidal in vitro, are effective against rickettsiae
B. *are bacteriostatic in vitro, are effective against rickettsiae
C. are bactericidal in vitro, interfere primarily with cell wall synthesis
D. interfere primarily with cell wall synthesis only
E. All of the above
117.
Chloramphenicol is associated with: pancytopenia; gray-baby syndrome; reversible erythroidsuppression of bone marrow; renal failure?
A. *pancytopenia; gray-baby syndrome; reversible erythroid-suppression of bone marrow
B. pancytopenia; reversible erythroid-suppression of bone marrow
C. gray-baby syndrome; renal failure
D. renal failure only
E. All of the above
118.
Cavalier use of antibiotics in the hospital setting may be associated with: increased cost;
increased toxicity; alteration of hospital flora; increased incidence of infections?
A. increased cost; increased toxicity; alteration of hospital flora;
B. increased cost; alteration of hospital flora;
C. increased toxicity; increased incidence of infections
D. increased incidence of infections only
E. *All of the above
119.
The drug of choice for Streptococcus pneumonia (pneumococcus) in a patient with no drug
allergies is
A. erythromycin
B. *penicillins
C. vancomycin
D. ceftriaxone
E. gentamicin
120.
Aminoglycosides are: excreted renally; bactericidal; potentially toxic to the auditory and
vestibular portions of the eighth cranial nerve; potentially nephrotoxic?
A. excreted renally; bactericidal; potentially toxic to the auditory and vestibular portions of the
eighth cranial nerve;
B. excreted renally; potentially toxic to the auditory and vestibular portions of the eighth cranial
nerve;
C. bactericidal; potentially nephrotoxic
D. potentially nephrotoxic only
E. *All of the above
121.
Clindamycin is: associated with diarrhea; active against anaerobes; active against some grampositive organisms; active against some gram-negative organisms
A. *associated with diarrhea; active against anaerobes; active against some gram-positive
organisms
B. associated with diarrhea; active against some gram-positive organisms
C. active against anaerobes; active against some gram-negative organisms
D. active against some gram-negative organisms only
E. All of the above
122.
Circumstances associated with allergy to penicillins may include: maculopapular or urticarial
rash; anaphylaxis; anaphylactic reaction to penicillin skin-tests; exposure to penicillins in food?
maculopapular or urticarial rash; anaphylaxis; anaphylactic reaction to penicillin skin-tests;
maculopapular or urticarial rash; anaphylactic reaction to penicillin skin-tests;
anaphylaxis; exposure to penicillins in food
exposure to penicillins in food only
*All of the above
123.
Aminoglycosides: must be dosed on the basis of renal function; are primarily active against
gram-negative aerobes; are not active against anaerobes; penicillin may be synergistic against
enterococcus?
A. must be dosed on the basis of renal function; are primarily active against gram-negative
aerobes; are not active against anaerobes
B. must be dosed on the basis of renal function; are not active against anaerobes
C. are primarily active against gram-negative aerobes; penicillin may be synergistic against
enterococcus
D. penicillin may be synergistic against enterococcus only
E. *All of the above
124.
The following structure (ritonavir) is a protease inhibitor. What feature of the protease
enzyme was the inspiration for the design of this particular structure?
A. The presence of a flap region over the active site
B. The presence of isoleucine residues in the flap region
C. The presence of aspartyl groups in the active site
D. *The symmetrical nature of the active site
E. All of the above
125.
Which of the following is an enzyme carried within the nucleocapsid of the flu virus?
A. Hemagglutinin
B. *RNA polymerase
C. DNA polymerase
D. Neuraminidase
E. All of the above
126.
Which of the following is the general mechanism of action for erythromycin?
A. A.Inhibition of a metabolic enzyme
B. Inhibition of cell wall synthesis
C. *Disruption of protein synthesis
D. Inhibition of nucleic acid transcription and replication
E. None of the above
127.
Which of the following is the general mechanism of action for fluoroquinolones?
A. Inhibition of a metabolic enzyme
B. Inhibition of cell wall synthesis
C. Disruption of protein synthesis
D. *Inhibition of nucleic acid transcription and replication
E. None of the above
128.
Trimethoprim is often administered alongside a sulfonamide as a preparation known as cotrimoxazole. Which of the following sulfonamides is used?
A. *Sulfamethoxazole
B. Sulfathiazole
C. Sulfadoxine
D. Sulfadiazine
E. None of the above
129.
What is the name of the following penicillin?
A. Nafcillin
B. Penicillin G
C. *Penicillin V
D. Methicillin
E. All of the above
A.
B.
C.
D.
E.
130.
Which of the following statements is true regarding the properties of benzylpenicillin?
A. It is a bacteriostatic agent.
B. It is active over a wide range of bacterial species.
C. It is resistant to beta-lactamases.
D. *Certain individuals may have an allergic response to it.
E. All of the above
131.
What crucial feature of a penicillin is involved in its mechanism of action?
A. Carboxylic acid
B. *beta-lactam ring
C. Acyl side chain
D. Thiazolidine ring
E. All of the above
132.
What reaction is catalysed by a beta-lactamase enzyme?
A. The final cross linking reaction of a bacterial cell wall
B. The hydrolysis of the acyl side chain from penicillin structures
C. *The hydrolysis of the four membered ring present in penicillins
D. The biosynthesis of the penicillin structure from amino acids
E. None of the above
133.
The following structure (methicillin) was an important penicillin that was introduced in the
nineteen sixties to counter the threat of penicillin resistant strains of S. Aureus. Which of the
following statements is true regarding the above structure?
A. *There is no electron withdrawing group on the side chain, and so it is acid sensitive.
B. It can be taken orally.
C. It is more active than penicillin G.
D. It has a broader spectrum of activity compared to penicillin G.
E. None of the above
134.
What would be the effect of replacing the methoxy groups in methicillin with ethoxy groups?
A. Activity would increase
B. *esistance to enzymatic hydrolysis would increase
C. Activity against a broad spectrum of bacterial strains would increase
D. Stability to acid catalysed hydrolysis would increase
E. None of the above
135.
Which of the following statements is accurate in explaining why Gram negative bacteria are
generally more resistant to penicillins than Gram positive bacteria?
A. Gram negative bacteria have a thicker cell wall
B. *Gram negative bacteria have an outer hydrophilic membrane that acts as an extra barrier
C. Gram negative bacteria can concentrate ß-lactamase enzymes in the periplasmic space
D. Gram negative bacteria produce smaller quantities of transpeptidase enzyme
E. None of the above
136.
What role does the acetoxy group at the 3-position of cephalosporins have in enhancing
antibacterial activity?
A. It acts as a steric shield and masks enzymatic attack at the ?-lactam ring.
B. *It acts as a good leaving group when the beta-lactam ring is opened.
C. It takes part in a transesterification reaction with the carboxylic acid group at position 4
D. It increases the reactivity of the beta-lactam ring by neighbouring group participation.
E. None of the above
137.
The following structure is a first generation cephalosporin. What is the name of the structure?
A. Cefazolin
B. Cefoxitin
C. Cefuroxime
D. *Cefalexin
E. All of the above
138.
What drugs are present in the preparation Augmentin?
Ticarcillin and clavulanic acid
Ampicillin and sulbactam
Ampicillin and clavulanic acid
*Amoxicillin and clavulanic acid
None of the above
139.
The structure is administered along with a penicillin in a preparation known as Tazocin or
Zosyn. Which penicillin is used?
A. Amoxicillin
B. *Piperacillin
C. Ampicillin
D. Methicillin
E. None of the above
140.
Which of the following antibiotics is a macrolide?
A. Chloramphenicol
B. Doxycycline
C. *Erythromycin
D. Streptomycin
E. None of the above
141.
Which of the following antibiotics is a tetracycline?
A. Chloramphenicol
B. *Doxycycline
C. Streptomycin
D. Erythromycin
E. None of the above
142.
The following structure is a synthetic antibacterial agent called ciprofloxacin. What is the
most likely mechanism of bacterial resistance to the above structure?
A. Modified target enzyme
B. Enzymatic modification of the structure
C. *Efflux mechanisms
D. Increased production of target enzymes
E. All of the above
143.
What advantage does cidofovir have over aciclovir as an antiviral agent?
A. It has better oral bioavailability.
B. It is less polar.
C. *It has a broader spectrum of activity.
D. It has less side effects.
E. All of the above
144.
The HIV protease enzyme is symmetrical, whereas mammalian proteases are not. What
significance might this have?
A. Inhibitors of the HIV protease enzyme must also be symmetrical.
B. *It may be possible to design inhibitors that prove selective for the HIV protease over
mammalian proteases.
C. Only symmetrical substrates are cleaved by HIV protease.
D. There is no significance.
E. All of the above
145.
What was the initial lead compound used in the design of saquinavir?
A. L-prolyl-L-phenylalanine
B. *L-phenylalanyl-L-proline
C. L-phenylalanyl-L-phenylalanine
D. L-prolyl-L-proline
E. None of the above
146.
Which of the following is the primary site of activity for the drug Warfarin?
A. Kidney
A.
B.
C.
D.
E.
B.
C.
D.
E.
*Liver
Blood
Heart
All OF the above
147.
Which of the following drugs is associated with the reaction of hepatitis?
A. Valproic acid
B. Quinidine
C. *Isoniazid
D. Ethosuximide
E. All OF the above
148.
Drugs most often used in the treatment of petit mal epilepsy include:
A. ethosuximide
B. phenytoin
C. sodium valproate
D. All of the above
E. *Ethosuximide & sodium valproate
149.
The most specific agent for treatment of petit mal epilepsy is:
A. lisinopril
B. midocalm
C. vit. C
D. *ethosuximide
E. metoclopramide
150.
Phenytoin may have adverse effects on the hematopoietic system. All of the following have
been reported EXCEPT:
A. macrocytic anemia
B. hepatosplenomegaly
C. folic acid deficiency
D. lymphadenopathy
E. *leukemia
151.
The drug of choice in initiating chronic treatment of grand mal epilepsy is:
A. ketamine
B. furosemide
C. cimetidine
D. dilthiazem
E. *carbamazepine
152.
Gingival hyperplasia is a common side effect of:
A. procainamide
B. *phenytoin
C. digitalis
D. indomethacin
E. guanethidine
153.
Carbamazepine is considered to be a primary drug for treatment of all types of epilepsy except
absence seizures. Its indications and proposed mechanism of action are most closely related to:
A. *phenytoin
B. phenobarbital
C. ethosuximide
D. primidone
E. diazepam
154.
Anticonvulsants which have active metabolites include: phenytoin; primidone; Phenobarbital;
carbamazepine?
A. phenytoin; primidone; Phenobarbital
B. phenytoin; Phenobarbital
C. *primidone; carbamazepine
D. carbamazepine only
E. All of the above
155.
Carbamazepine toxicities include: (A) water retention; (B) dystonia and myoclonus; (C)
diplopia, blurred vision, and vertigo; (D) gingival Hyperplasia?
A. *water retention; dystonia and myoclonus; diplopia
B. water retention; diplopia
C. dystonia and myoclonus; gingival Hyperplasia
D. gingival Hyperplasia only
E. All are correct
156.
Prolonged dilantin use may lead to:
A. vitamin A deficiency
B. hypoglycemia
C. folic acid, iron, and vitamin C deficiency
D. *abnormality in folic acid metabolism
E. thiamine deficiency
157.
Visual disturbances (such as "halos" on objects) are a side effect of which of the following
anticonvulsants?
A. *trimethadione
B. phenytoin
C. phenacemide
D. phenobarbital
E. ethosuximide
158.
Antiarthritic drugs not presently known to interact with phenytoin therapy include: salicylates;
cyclophosphamide; phenylbutazone; gold?
A. salicylates; cyclophosphamide; phenylbutazone
B. salicylates; phenylbutazone
C. *cyclophosphamide; gold
D. gold only
E. All of the above
159.
The liver function test most frequently elevated in patients taking phenytoin is:
A. *gamma-glutamyl transpeptidase (GGTP)
B. serum glutamic oxaloacetic transaminase (SGOT)
C. serum glutamic pyruvic transaminase (SGPT)
D. lactic acid dehydrogenase (LDH)
E. alkaline phosphatase
160.
Which of the following drugs (including metabolites) would achieve steady state blood level
concentrations earliest assuming a loading dose is not given?
A. phenytoin
B. primidone
C. *valproate
D. phenobarbital
E. ethosuximide
161.
Drugs known to be effective for generalized tonic-clonic seizures include: phenytoin;
primidone; carbamazepine; valproic acid?
A. phenytoin; primidone; carbamazepine
B. phenytoin; carbamazepine
C. primidone; valproic acid
D. valproic acid only
E. *All of the above
162.
Drugs which have been shown to be effective for the chronic management of absence seizures
include: phenytoin; valproate; primidone; ethosuximide?
A. phenytoin; valproate; primidone
B. phenytoin; primidone;
C. *valproate,ethosuximide
D. ethosuximide only
E. All of the above
163.
Which of the following anticonvulsants is (are) administered as a single daily dose: valproic
acid; phenobarbital; carbamazepine; phenytoin?
A. valproic acid; phenobarbital; carbamazepine
B. valproic acid; carbamazepine
C. *phenobarbital,phenytoin
D. phenytoin only
E. All of the above
164.
The most appropriate drug for treatment of generalized tonic-clonic (grand mal) is:
A. *valproate
B. methylphenidate
C. ethosuximide
D. diazepam
E. trimethadione
165.
Drugs useful in the management of temporal-lobe epilepsy include:
A. trimethadione
B. carbamazepine
C. phenytoin
D. diazepam
E. *Trimethadione, carbamazepine
166.
Which of the following anticonvulsants can be administered as a drug and is also a metabolite
of one of the other agents?
A. phenytoin
B. *phenobarbital
C. primidone
D. carbamazepine
E. ethosuximide
167.
The generic anticonvulsant diphenylhydantoin is now officially called phenytoin. Common
adverse effects of chronic phenytoin therapy include all of the following EXCEPT:
A. gingival hyperplasia
B. morbilliform skin rash
C. hirsutism
D. *hypoglycemia
E. ataxia
168.
Phenytoin toxicity can cause:
A. behavioral changes
B. increased frequency of seizures
C. gingival hyperplasia
D. *All of the above
E. None of the above
169.
Which of the following substances has its major activity as a saline cathartic?
A. sodium bicarbonate
B. methylcellulose
C. *sodium phosphate
D. castor oil
E. mineral oil
170.
The correct statement regarding sucralfate:
A. pharmacologic action is to reduce gastric acid secretion by antagonizing gastrin
B. enhances N+-K+ ATPase
C. antagonizes acetylcholine
D. *most common side effects is constipation
E. increases gastric motility
171.
A.
B.
C.
D.
E.
172.
A.
B.
C.
D.
E.
173.
A.
B.
C.
D.
E.
174.
A.
B.
C.
D.
E.
175.
A.
B.
C.
D.
E.
176.
A.
B.
C.
D.
E.
177.
A.
B.
C.
D.
E.
178.
A.
B.
C.
D.
E.
179.
A.
B.
C.
Correct statement regarding metoclopramide:
central nervous system dopamine receptor agonist
peripheral blockage of acetylcholine at muscarinic synapse
decreases lower esophageal sphincter pressure
*adverse effects include dystonic or extrapyramidal effects
increases motility of colon
In general, mechanisms of laxation include:
adding bulk to the stool
increasing peristaltic activity
emulsifying aqueous and fatty substances with stool
lubricating the passage of stool
*All of the above
Which of the following substances is most likely to cause systemic alkalosis?
*sodium bicarbonate
methylcellulose
sodium phosphate
castor oil
mineral oil
Saline cathartics, such as sodium sulfate or magnesium sulfate:
are safe in patients with renal failure
are readily absorbed from the gastrointestinal tract
are slower acting than bulk-forming laxatives
*act by increasing intestinal volume, hence stimulating peristaltic action
lower the surface tension of the feces to facilitate fecal hydration
Adverse effect(s) of laxatives:
electrolyte disturbances (hypernatremia, hypokalemia)
dehydration
spastic colitis with stimulant laxatives
gastrointestinal obstruction with bulk forming agents
*All of the above
Drug which exerts anti-peptic ulcer effects through histamine-2 receptor antagonism:
sucralfate
omeprazole
metoclopramide
*ranitidine
misoprostol
The substance which is principally an emollient laxative is:
bran
methylcellulose
magnesium hydroxide
phenolphthalein
*mineral oil
Laxatives may aid in the treatment of portal systemic encephalopathy by:
increasing stool pH
increasing coliform bacteria
*decreasing protein contact time with GI mucosa
All of the above
None of the above
Agents of potential use in peptic ulcer disease include:
muscarinic antagonists
proton pump inhibitors
antacids
D. prostaglandins
E. *All of the above
180.
The physician must always be aware of possible drug interactions. Aluminum hydroxide
antacids tend to interfere with the gastrointestinal absorption of:
A. cephalexin
B. penicillin G
C. erythromycin
D. chloramphenicol
E. *tetracycline
181.
Prostaglandins E2 inhibit the secretion of gastric acid and stimulate the secretion of mucus.
One adverse effect limiting the wide use of prostaglandins for gastric disease is:
A. headache
B. thrombocytopenia
C. gynecomastia
D. *diarrhea
E. seizures
182.
An agent which promotes defecation without increasing peristalsis is:
A. castor oil
B. phenolphthalein
C. *docusate sodium
D. cascara
E. milk of magnesia
183.
Cimetidine reduces the clearance of all of the following EXCEPT:
A. theophylline
B. phenytoin
C. warfarin
D. *digoxin
E. quinidine
184.
Antacids having a relatively non-systemic effect include:
A. aluminum hydroxide
B. sodium bicarbonate
C. calcium carbonate
D. All of the above
E. *aluminum hydroxide and calcium carbonate
185.
Which of the following substances has its major activity as an stimulant cathartic?
A. sodium bicarbonate
B. methylcellulose
C. sodium citrate
D. *castor oil
E. mineral oil
186.
One mechanism to reduce gastric acid secretion is by blocking the H+-Na+ ATPase pump in
the parietal cell. One drug that has this pharmacologic action is:
A. misoprostol
B. pirenzepine
C. *omeprazole
D. serotonin
E. isoniazid
187.
The concomitant administration of calcium and/or magnesium antacids to patients receiving
one of the tetracycline drugs may have which of the following effects upon the action of the
tetracycline:
A. enhances the action
B. causes no significant change
C. *decreases the action
D. increases toxicity
E. suppresses hypersensitivity reactions
188.
A.
B.
C.
D.
E.
189.
A.
B.
C.
D.
E.
190.
A.
B.
C.
D.
E.
191.
A.
B.
C.
D.
E.
192.
A.
B.
C.
D.
E.
193.
A.
B.
C.
D.
E.
194.
A.
B.
C.
D.
E.
195.
A.
B.
C.
D.
E.
196.
A.
B.
Which one of following is an appropriate therapeutic use for imipramine?
Insomnia.
Epilepsy
*Bed—wetting in children
Glaucoma.
Mania
MAO inhibitors are contraindicated with all of the following EXCEPT:
Indirect adrenergic agents, such as ephedrine.
Tricyclic antidepressants.
Beer and cheese.
*Aspirin.
Dopamine.
All of the following are observed in patients taking neuroleptic agents EXCEPT:
Sexual dysfunction.
*Increased blood pressure.
Altered endocrine function.
Constipation.
Orthostatic hypotension.
Which of the following substances has its major activity as a saline cathartic?
Sodium bicarbonate
Aluminium hydroxide
*Magnesium sulfate
Calcium carbonate
All of above
In general, mechanisms of laxation include:
adding bulk to the stool
increasing peristaltic activity
emulsifuing aqenons and fatty substances with stool
lubricating the passage of stool
*all of the above
Drug which exerts anti-peptic effects through histamine-2 receptor antagonism:
Denol
*Ranitidine
Omeprasole
Aluminium hydroxide
All of above
All these Drugs are cause obstipation Except:
Anticholinergic agents
Ca channel antagonists
Opioids
Tricyclic antidepressants
*Muscarinic agonists
Plant fiber (a laxative, purgative):
Decrease the bulk of the stools
increases the bowel transit time
*slowly distends the wall of the colon
increases the effective caloric content of the diet
takes down water and swells
Lactulose:
is a monosaccharide
is broken down in the small intestine by bacteria
C. is build to unabsorbed organic anions which retain fluid
D. produces laxative effects after 2-3 hours
E. *is of particular value in the treatment of hepatic encephalopathy
197.
A.
B.
C.
D.
E.
198.
A.
B.
C.
D.
E.
199.
A.
B.
C.
D.
E.
200.
A.
B.
C.
D.
E.
201.
A.
B.
C.
D.
E.
202.
A.
B.
C.
D.
E.
203.
A.
B.
C.
D.
E.
204.
A.
B.
C.
D.
E.
205.
Lactulose is of particular value in the treatment of encephalopathy:
*as it discourages the proliferation of ammonia producing organisms
as it increases the absorption of ammonia
as it decreases chronic portal hypertension
as it treatment fever
as it improves functions of CNS after absorption from the GIT
Magnesium sulfate:
is a laxative which acts within 1-2 days
dilates the gallbladder and relaxes the sphincter of Oddi
decreases the secretion of cholecystokinin
decreases gastric, intestinal and pancreatic secretion
*should be given in dilute solution to a fasting individual
Senna alcaloids (anthraquinones, the sennosides A and B):
*act directly on the intramucosal plexus of the gut wall
take about 8 minutes to produce an effect
should be given to pregnant women
should be given to nursing mothers
can not induce diarrhea with excessive loss of water and electrolytes
Glycerol (in the form of rectal suppositories):
is useless if a rapid effect is required
*acts as a rectal stimulant due to local irritant action
cannot be used in children
rectal suppositories promote colonic evacuation in 30 hours
exerts severe diarrhea with loss of water and electrolytes
Changes after prolonged use of laxatives:
the colon becomes narrow
the colon exerts increased activity
sodium depletion can not be induced (hypotension, secondary aldosteronism)
hyperkalemia can be induced (weakness, polyuria)
*changes are due to prolonged use of stimulant laxatives
In the treatment of acute diarrhea:
antibiotics are worst avoided in non-pathogenic diarrhea
antibiotics are worst avoided in viral gastroenteritis
oral rehydration should not be used for initial therapy
electrolytes and glucose should not be supplemented for initial therapy
*oral rehydration and electrolytes supplementation are required particularly in children and in
the elderly
In patients with diarrhea the following can be used Except:
antibiotics to treat systemic illness
antibiotics in evidence of bacterial infection
* antidiarrheal drugs decreasing intestinal transit time
antidiarrheal drugs increasing bulk and viscosity of the gut contents
opioids, antimuscarinics
All these Drugs are increasing intestinal transit time Except:
codeine (an opioid)
morphine (an opioid)
loperamide
diphenoxylate
*fysostigmin
Peptic ulcer disease:
A.
B.
C.
D.
E.
206.
A.
B.
C.
D.
E.
207.
A.
B.
C.
D.
E.
208.
A.
B.
C.
D.
E.
209.
A.
B.
C.
D.
E.
210.
A.
B.
C.
D.
E.
211.
A.
B.
C.
D.
E.
212.
A.
B.
C.
D.
E.
213.
A.
B.
C.
D.
is an acute disorder
*characterized by frequent recurrences
comprises bones
the incidence of duodenal ulcers is four to five times lower than that of gastric ulcer
affects approximately 50% of the population
All These are major factors of known importance for the etiology of ulceration Except:
acid-pepsin secretion
mucosal resistance to attack by acid and pepsin
*the age
effects of non-steroidal anti-inflammatory drugs
the presence of Helicobacter pylori
Acid secretion:
is produced by endocrine cells in the gastric antrum cells
*is stimulated by gastrin
is inhibited by acetylcholine
is inhibited by histamine
is stimulated by prostaglandin E
Antacids:
*react with gastric acid to form a neutral salt
produce sweating
are ineffective at healing duodenal ulcer
are very effective at healing gastric ulcers
its effect on acid secretion lasts for long (5 hours)
Antacids involve:
balsalazide
orlistat
cimetidine
sucralfate
*aluminium salts (hydroxide, phosphate, glycinate)
Sodium bicarbonate (an antacid):
acts only locally
*excessive doses produce systemic acidosis
produces carbon monoxide by reacting with hydrochloric acid
causes belching and distension of the large intestine
sodium intake need not to be considered in patients with hypertension or heart failure
Magnesium and aluminium salts:
do undergo absorption so are effective locally
magnesium salts are constipating, aluminium salts may produce diarrhea
can not reduce the rate and extent of absorption of other drugs
aluminium salts should not be used with caution with any renal compromise
*magnesium and aluminium salts are taken 1-3 hours after meals and at bedtime
H2 lytics:
at least 4 days treatment is required to achieve healing
pain is relieved within 4 weeks treatment
include morphine , tramadol
*include nizatidine, ranitidine, famotidine
include pirenzepine
Cimetidine (BELOMET, TAGAMET):
Is effective on lungs
*action on cytochrome P450 results in high plasma concentrations of theophylline and opioid
analgesic
binds to androgen receptors and so can cause impotence and gynecomastia
is more active than ranitidine
E. is ineffective in treatment both of duodenal and gastric ulcers
214.
A.
B.
C.
D.
E.
215.
A.
B.
C.
D.
E.
216.
A.
B.
C.
D.
E.
217.
A.
B.
C.
D.
E.
218.
A.
B.
C.
D.
E.
219.
A.
B.
C.
D.
E.
220.
A.
B.
C.
D.
E.
221.
A.
B.
C.
D.
E.
222.
A.
B.
C.
Ranitidine (ZANTAC):
has higher affinity for cytochrome P 450 than cimetidine
is less expensive than cimetidine
*is preferable to cimetidine in the elderly
has a similar profile of action to paracetamol
increases the plasma levels of theophylline
Pirenzepine:
*is an M1 muscarinic receptor antagonist
is an ACE inhibitor
is a diuretic
is H2-blocker
is a beta-blocker
Omeprazol:
is an irreversible stimulator of the proton pump
can be used only for healing gastric ulcer
Is for women only
is taken once weekly
*degrades in the presence of moisture. Capsules are supplied in special containers
Misoprostol:
*is a synthetic analog of prostaglandin E1
produces gastric acid secretion
causes Stricture in the submucosa
decreases production of protective mucus
is indicated especially in pregnancy
Sucralfate:
is less effective than cimetidine
is not so effective in symptom relief
antacids are contraindicated
contains aliminium, diarrhea can not be induced
*in severe renal failure accumulation is a potential hazard.
Cisapride:
inhibits motility of the GIT
decreases rate of gastric emptying
is not used in gastroesophageal reflux
*is used in dyspepsia and delayed gastric emptying
is used in diarrhea
Betahistidine (BETASERC) and cinnarizine (Stugeron):
are not antagonists of the H1 and H3 receptors
betahistidin can not be used for vertigo
*cinnarizin is effective in motion sickness
betahistidin is effective in drug induced vomiting
cinnarizin is effective in radiation sickness
All these are Dopamine antagonists- antiemetics Except:
domperidon (MOTILIUM)
*emetine
metoclopramide (CERUCAL)
phenothiazines
butyrophenones
Metoclopramide is effective for:
preoperative vomiting
vestibular disturbances
motion sickness
D. headache
E. *facilitation of duodenal intubation and endoscopy
223.
5-HT3 receptor antagonists are:
A. famotidine
B. scopolamine
C. *granisetron
D. nabilone
E. cimetidine
224.
Neostigmine will effectively antagonize skeletal muscle relaxation produced by:
A. *Tubocurarine
B. Succinylcholine
C. Diazepam
D. Baclofen
E. Nicotine
225.
The reversible cholinesterase inhibitor indicated in the treatment of Alzheimer disease is:
A. *Rivastigmine
B. Amlodipine
C. Verapamil
D. Cimetidine
E. Ipratropium
226.
Direct-acting cholinomimetic drug that is lipid-soluble and often used in the treatment of
glaucoma is:
A. Acetylcholine
B. Timolol
C. Betaxolol
D. *Pilocarpine
E. Physostigmine
227.
Acetylcholine is the normal neurotransmitter at all of the followings sites EXCEPT:
A. nerve endings to the adrenal medulla
B. sympathetic ganglia
C. neuromuscular junction
D. parasympathetic ganglia
E. *sympathetic neuroeffector junction
228.
Atropine and scopolamine will block all the effects of acetylcholine listed below EXCEPT:
A. bradycardia
B. salivary secretion
C. bronchoconstriction
D. *skeletal muscle relaxation
E. miosis
229.
Of the many types of adrenergic receptors found throughout the body, which is most likely
responsible for the cardiac stimulation observed following an intravenous injection (IV) of
epinephrine?
A. beta1-adrenergic receptors
B. µ1-adrenergic receptors
C. *alpha1-adrenergic receptors
D. alpha 2-adrenergic receptors
E. alpha 3-adrenergic receptors
230.
Which of the following drugs is a selective inhibitor of MAO type B?
A. Indapamid
B. Furosemid
C. *Bromocriptine
D. Nitroglicerin
E. Gastrocepin
231.
The drug of choice for the treatment of anaphylactic shock is:
A. *Epinephrine
B. Norepinephrine
C. Isoproterenol
D. Orciprenaline
E. Atropine
232.
All the following statements are accurate characterizations of ephedrine EXCEPT that it:
A. is used as decongestant:
B. can cause insomnia, restlessness, agitation, and tremor
C. can increase systemic blood pressure
D. *is rapidly biotransformed by both COMT and MAO
E. will relax the smooth muscle of the bronchial tree
233.
All the following statements are true concerning dobutamine EXCEPT that it:
A. is a selective agonist at alpha1-adrenergic receptors
B. *activates dopaminergic receptors in renal and mesenteric vascular beds
C. is used to increase cardiac output in patients with severe cardiac failure
D. must be given by IV administration
E. may cause tachycardia and anginal pain
234.
Which one of the following drugs is a selective beta2-agonist?
A. Epinephrine
B. Norepinephrine
C. *Salbutamol
D. Isoproterenol
E. Dobutamine
235.
The nonselective ?-adrenergic blocking agent that is also a competitive antagonist at ?1adrenoreceptors is:
A. Timolol
B. Atenolol
C. Propranolol
D. Pindolol
E. *Carvedilol
236.
Propranolol is indicated for use in patients with all the following conditions EXCEPT:
A. hypertension
B. angina pectoris
C. *bronchial asthma
D. migraine headache
E. supraventricular and ventricular arrhythmias
237.
Which one of the following statements best describes the mechanism of action of
benzodiazepines?
A. Benzodiazepines block GABA uptake
B. Their inhibition of GABA transaminase leads to increase of GABA
C. Benzodiazepines block glutamate receptors in the brain
D. *They increase frequency of opening of chloride ion channels that are coupled to GABAA
receptors
E. They are direct-acting GABA receptor agonists in the CNS
238.
The hypnotic drug facilitates the inhibitory action of GABA, but it lacks of anticonvulsant or
muscle relaxing properties, is:
A. Buspirone
B. Diazepam
C. Flurazepam
D. Phenobarbital
E. *Zolpidem
239.
All the following benzodiazepines are biotransformed to active metabolites EXCEPT:
Alprazolam
Diazepam
*Oxazepam
Clorazepate
Chlordiazepoxide
240.
Which one of the following is described as a competitive benzodiazepine receptor antagonist?
A. Pralidoxime
B. Bromazepam
C. Midazolam
D. Triazolam
E. *Flumazenil
241.
All the following compounds are indicated for the treatment of psychoses EXCEPT:
A. Chlorpromazine
B. Risperidone
C. *Amlodipine
D. Haloperidol
E. Clozapine
242.
The most likely mechanism involved in the antiseizure activity of carbamazepine is:
A. *block of sodium ion channels
B. block of GABA uptake
C. facilitation of GABA action on chloride ion channels
D. glutamate receptor antagonism
E. inhibition of GABA transaminase
243.
The preferred treatment of status epilepticus is IV administration of:
A. Metoclopramide
B. *Diazepam
C. Succinylcholine
D. Zopiclon
E. Selegiline
244.
Carbidopa is useful in the treatment of Parkinson’s disease because it:
A. is a precursor of levodopa
B. is a dopaminergic receptor agonist
C. *prevents peripheral decarboxylation of levodopa
D. prevents breakdown of dopamine
E. promotes a decreased concentration of levodopa in the nigrostriatum
245.
With respect to pramipexole, which of the following statements is accurate?
A. activates D2-receptors
B. commonly a first-line therapy for Parkinson’s disease
C. may cause postural hypotension
D. not an ergot derivative
E. *all of the above
246.
Which one of the following is an antidepressant agent that selectively inhibits serotonin (5HT)
uptake?
A. Simvastatin
B. *Fluoxetine
C. Misoprostol
D. Loratadine
E. Augmentin
247.
Common adverse reactions of corticosteroidal therapy are:
A. bradycardia, mental dullness
B. anorexia, polyuria
C. tachycardia, insomnia
D. *“moon face”, obese trunk
A.
B.
C.
D.
E.
E. All of the above
248.
The chemotherapeutic agent also used orally for severe forms of arthritis is:
5-fluorouracil (5-FU)
*methotrexate (Mexate)
cyclophosphamide (Cytoxan)
cisplatin (Platinol)
All of the above
249.
The agent with immune boosting activity yet recently implicated with causing severe
depression and suicidal ideation is:
A. echinacea
B. *interferon
C. dronabinol (Marinol)
D. megestrol (Megace)
E. All of the above
250.
What adverse effects are associated with chronic use of systemic corticosteroids?
A. Candidosis
B. *Gastrointestinal complications
C. Hypotension
D. Hypoglycemia
E. All of the above
251.
For a 6-year-old child with fever, what NSAIDs would be preferred?
A. aspirin
B. *acetaminophen
C. indomethacin
D. ibuprofen
E. All of the above
252.
Phases of inflammation:
A. chronic inflammation
B. immune response
C. acute inflammation
D. acute inflammation & chronic inflammation
E. *acute inflammation, chronic inflammation & immune response
253.
Cyclooxygenase isozyme responsible for prostaglandin synthesis by cells involvet in
inflammation:
A. COX-I
B. *COX-II
C. Both COX-I & COX-II
D. None of the above
E. Prostaglandin E
254.
Released at sites of tissue injury:
A. Kinins
B. complement components
C. cytokines
D. neuropeptides
E. *all of the above
255.
Among these mediators: most significant increase in vascular permeability:
A. Prostaglandins
B. Bradykinin
C. Serotonin
D. *leukotrienes
E. all of the above produce similar increases in vascular permeability
256.
Mediator in acute inflammation:
A. Histamine
A.
B.
C.
D.
E.
Serotonin
Leukotrienes
*Bradykinin
None of the above
257.
Mediator of chronic inflammation (for example rheumatoid arthritis):
A. Histamine
B. *interleukin 1
C. Bradykinin
D. Neuropeptides
E. Serotonin
258.
Most nonsteroidal antiinflammatory drugs:
A. *inhibit prostaglandin biosynthesis
B. weak organic bases
C. probably increase production of free radicals
D. mainly associated with guanylyl cyclase interactions
E. all the above
259.
nitial drug of choice for treating most articular and musculoskeletal disorders (because of lowcost, safety, and efficacy):
A. *Aspirin
B. Diclofenac
C. Indomethacin
D. Phenylbutazone
E. Glucocorticoids
260.
Concerning salicylates:
A. sodium salicylate an aspirin: equally effective as anti-inflammatory agents
B. aspirin: may be more effective for analgesia
C. aspirin: hydrolyzed to acetic acid plus salicylate by tissue and blood esterases
D. urine alkalinization: increases free salicylate excretion
E. *all of the above
261.
Acute attacks of gouty arthritis may occur early in treatment with allopurinol (Zyloprim,
Purinol) because:
A. allopurinol (Zyloprim, Purinol) increases urate synthesis
B. *urate crystals move from tissue to plasma
C. allopurinol (Zyloprim, Purinol) increases release of chemotactic factors
D. allopurinol increases urate synthesis & urate crystals move from tissue to plasma
E. all of the above
262.
Rational indication(s) for allopurinol (Zyloprim, Purinol) administration:
A. chronic tophaceous gout;when tophi reabsorption more rapid with uricosuric agents
B. when probenecid or sulfinpyrazone cannot be used
C. presence of renal functional impairment
D. in a patient with recurrent renal stones
E. *all of the above
263.
Previously most popular drug for treating inflammation of acute gouty arthritis - NSAIDs now
more commonly used because of diarrhea associated with earlier medication:
A. allopurinol (Zyloprim, Purinol)
B. *colchicine
C. probenecid (Benemid)
D. sulfinpyrazone (Anturane)
E. acetaminophen (Tylenol, Panadol)
264.
Effective in management of mild to moderate pain, when anti-inflammatory action is not
necessary:
A. penicillamine (Cuprimine)
B. sulfasalazine (Azulfidine)
B.
C.
D.
E.
C. *acetaminophen (Tylenol, Panadol)
D. etodolac (Lodine)
E. piroxicam (Feldene)
265.
Probably the initial step in acute gouty arthritis attack:
polymorphonuclear leukocytes migration into the joint
increased numbers of mononuclear phagocytes (macrophages)
*urate crystals phagocytosis by synoviocytes
prostaglandin, lysosomal &, interleukin 1 release
None of the above
266.
Probable direct effect of colchicine (mechanism of action):
A. direct membrane stabilization
B. *binds to intracellular tubulin -- preventing/reducing microtubule formation
C. decreases purine synthesis directly
D. prevents IL-1 release directly
E. none of the above
267.
Reduces uric acid synthesis: for management of gout:
A. Colchicine
B. probenecid (Benemid)
C. sulfinpyrazone (Anturane)
D. *allopurinol (Zyloprim, Purinol)
E. oxaprozin (Daypro)
268.
Site(s) of action: probenecid (Benemid):
A. Loop of Henle
B. *proximal tubule - middle segment
C. Both
D. Neither
E. None of the above
269.
Mechanism of action: aspirin-platelet effects explains by:
A. promotes platelet aggregation
B. activates thromboxane synthesis
C. *Inhibits thromboxane synthesis
D. All of the above
E. None of the above
270.
Factors accounting for rheumatoid arthritis incidence:
A. Genetics
B. Climate
C. urbanization
D. *All of the above
E. None of the above
271.
Mediator most likely to promote pain:
A. Histamine
B. Serotonin
C. *bradykinin
D. Prostaglandins
E. leukotrienes
272.
At low doses required to inhibition of thymidylate synthase, an enhanced adenosine release:
A. Chloroquine
B. Gold
C. *methotrexate
D. cyclophosphamide to
E. ketorolac
273.
Mediator promoting greatest increase in vascular permeability, associated with acute
inflammation:
A.
B.
C.
D.
E.
Serotonin
Prostaglandins
Bradykinin
*leukotrienes
All of the above
274.
Aspirin and antipyresis:
A. elevation of body temperature is typically a useful defense mechanism
B. aspirin -- best available drug for reducing fever (in the absence of contraindications to its use
recurrent
C. aspirin -- more effective in lowering elevated temperature than normal body temperature
D. aspirin-induced temperature reduction is caused by vasodilation
E. *aspirin -- best available drug for reducing fever (in the absence of contraindications to its use
recurrent, aspirin -- more effective in lowering elevated temperature than normal body
temperature, aspirin-induced temperature reduction is caused by vasodilation
275.
Advantages of other NSAIDs compared with aspirin:
A. generally less expensive
B. less gastric irritation
C. potentially better compliance (e.g. naproxen, sulindac)
D. generally less expensive & less gastric irritation
E. *less gastric irritation & potentially better compliance (e.g. naproxen, sulindac)
276.
Aspirin:
A. inhibits prostaglandin synthase
B. inhibits cyclooxygenase
C. decreases prostaglandin formation
D. decreases thromboxane A2 formation
E. *All of the above
277.
Mediators of chronic inflammation in rheumatoid arthritis:
A. IL-1
B. IL-2
C. IL-3
D. TNF alpha
E. *All of the above
278.
Effective in managing acute gouty arthritis and ankylosing spondylitis; also accelerates
closure of patent ductus arteriosus in premature infants:
A. Gold
B. Ketorolac
C. Phenylbutazone
D. Methotrexate
E. *indomethacin
279.
Approximate prevalence of rheumatoid arthritis:
A. *1%
B. 5%
C. 7%
D. 10%
E. 15%
280.
Analgesic effects of aspirin:
A. peripheral action (inflammation)
B. subcortical site of action
C. activates thromboxane synthesis
D. *peripheral action (inflammation) & subcortical site of action
E. subcortical site of action & activates thromboxane synthesis
281.
Correct drug-drug interactions:
A. aspirin -- acetazolamide: enhanced salicylate intoxication
A.
B.
C.
D.
E.
aspirin -- spironolactone: reduced spironolactone activity
aspirin -- probenecid: increased uricosuric activity
aspirin -- phenytoin: increased free phenytoin serum levels
*aspirin -- acetazolamide: enhanced salicylate intoxication, aspirin -- spironolactone: reduced
spironolactone activity & aspirin -- phenytoin: increased free phenytoin serum levels
282.
NSAID primarily promoted as an analgesic, not as an anti-inflammatory agent:
A. Piroxicam
B. Ibuprofen
C. Naproxen
D. *Ketorolac
E. Sulindac
283.
Drug associated with the hepatic/renal toxic metabolite: N-acetyl-p-benzoquinone:
A. Diclofenac
B. Meclofenamate
C. Indomethacin
D. *Acetaminophen
E. Aspirin
284.
Generation of specific immunity requires antigen-presenting cells, APCs, including:
A. lymphocytes
B. macrophages
C. Langerhans cells
D. Lymphocytes & macrophages
E. *Lymphocytes, macrophages & Langerhans cells
285.
Produced by TH1 subsets of T helper lymphocytes:
A. interferon-gamma
B. interleukin-2
C. tumor necrosis factor beta
D. interferon-gamma & interleukin-2
E. *interferon-gamma, interleukin-2 & tumor necrosis factor beta
286.
Typically associated with B cell proliferation and differentiation into antibody-secreting
plasma cells:
A. tumor necrosis factor beta
B. interferon-gamma
C. *IL-4 (interleukin 4)
D. IL-2 (interleukin 2)
E. all of the above
287.
Inhibits antigen recognition of B-cell:
A. Prednisone
B. Azathioprine
C. Methotrexate
D. *Rho(D) immune globulin
E. Tacrolimus
288.
Antilymphocyte antibodies:
A. binds to the surface of T cells
B. acts mainly on small, long-lived peripheral lymphocytes
C. may be used in induction of immunosuppression
D. may be obtained by hybridoma technique for monoclonal antibody generation
E. *all of the above
289.
Drugs with a bacteriostatic effect in regular doses include:
A. tetracyclines
B. None of the above
C. sulfamethoxazole and trimethoprim (Sumetrolim)
D. erythromycin
B.
C.
D.
E.
E. *All of the above
290.
Factors causing a susceptibility to urinary tract infect include:
urinary tract obstruction
diabetes mellitus
None of the above
*All of the above
pregnancy
291.
The use of which of the following should be avoided in patients receiving monoaminooxidase inhibitor therapy:
A. cheese
B. imipramine (Melipramin)
C. None of the above
D. pethidine (Dolargan)
E. *All of the above
292.
Penicillin administration is the appropriate therapy in which of the following complications of
syphilis?
A. *meningitis
B. aneurysm of the aorta
C. interstitial keratitisD. none of the above
E. the generalized paralysis of psychotic patients
293.
Haloperidol:
A. has marked extrapyramidal side effects
B. has a marked antiemetic effect
C. can be used to substitute for phenothiazine derivatives in patients who become jaundiced
following phenothiazine administration
D. *all of the above
E. none of the above
294.
Indications of penicillamine therapy include:
A. systemic sclerosis
B. primary biliary cirrhosis
C. hemosiderosis
D. *all of the above
E. none of the above
295.
The side effects of corticosteroids include:
A. a loss of collagen
B. decreased leukocyte migration
C. avascular bone necrosis
D. *all of the above
E. none of the above
296.
Osteoporosis:
A. causes an elevation of the serum calcium concentration
B. typically causes elevation of the alkaline phosphatase activity
C. *causes pain in the bones
D. improves during bed rest
E. the response to calcium substitution therapy is usually positive
297.
Barbiturates, if continuously administered can:
A. induce physical dependence
B. cause relaxation of skeletal muscles
C. cause ataxia
D. *all of the above
E. none of the above
298.
Immunosuppressive therapy is suitable in which of the following conditions?
A.
B.
C.
D.
E.
psoriatic arthritis
*psoriatic arthritis + rheumatoid arthritis
persistent viremia
rheumatoid arthritis
all of the above
299.
A widely used drug that supresses cellular immunity, inhibits prostaglandin and leukotriene
synthesis, and increases the catabolism of IgG antibodies is:
A. Cyclophosphamide
B. Cyclosporine
C. Infliximab
D. Mercaptopurine
E. *Prednisone
A.
B.
C.
D.
E.
Situational tasks
1. Which of the following are true regarding cephalosporins? "third generation" cephalosporins are
generally more active against gramnegative organisms; cephalosporins may depress beta-lactamase in
certain organisms; (Enterobacter, pseudomonas, serratia) causing production of the enzyme to increase
markedly; the enzyme in part B above binds to the cephalosporin; enterococcus is never reliably sensitive
to any available cephalosporin.
A. "third generation" cephalosporins are generally more active against gramnegative organisms;
cephalosporins may depress beta-lactamase in certain organisms; (Enterobacter, pseudomonas,
serratia) causing production of the enzyme to increase markedly; the enzyme in part B above binds to
the cephalosporin;
B. "third generation" cephalosporins are generally more active against gramnegative organisms; the
enzyme in part B above binds to the cephalosporin;
C. cephalosporins may depress beta-lactamase in certain organisms; (Enterobacter, pseudomonas,
serratia) causing production of the enzyme to increase markedly; enterococcus is never reliably
sensitive to any available cephalosporin.
D. enterococcus is never reliably sensitive to any available cephalosporin only
E. *All of the above
2. Aminoglycosides: are very popular; are well absorbed from the gastrointestinal tract; do not penetrate
pulmonary secretions well; do not appear in urine in high concentrations.
A. are very popular; are well absorbed from the gastrointestinal tract; do not penetrate pulmonary secretions well
B. *are very popular; do not penetrate pulmonary secretions well
C. are well absorbed from the gastrointestinal tract; do not appear in urine in high concentrations.
D. do not appear in urine in high concentrations only
E. All of the above
3. Some potential barriers to successful treatment of an abscess-cavitary infection with an aminoglycoside
include: inactivation of aminoglycoside by an acidic medium; binding of the drug by pus; decreased
ability of the drug to penetrate the abscess because of poor vascularity; inactivation of aminoglycoside by
alkaline medium.
A. *inactivation of aminoglycoside by an acidic medium; binding of the drug by pus; decreased ability
of the drug to penetrate the abscess because of poor vascularity
B. inactivation of aminoglycoside by an acidic medium; decreased ability of the drug to penetrate the
abscess because of poor vascularity
C. binding of the drug by pus; inactivation of aminoglycoside by alkaline medium.
D. inactivation of aminoglycoside by alkaline medium only
E. All of the above
4. Cefazolin is generally preferred among the first-generation cephalosporins, because it: has a favorable
pharmacokinetic profile; has a longer half-life than comparable drugs; may be dosed every 8 hours;
costs less for a hospital to utilize, since it may be given less frequently than comparable drugs/
A. has a favorable pharmacokinetic profile
B. has a longer half-life than comparable drugs
C. may be dosed every 8 hours
D. costs less for a hospital to utilize, since it may be given less frequently than comparable drugs
E. *All of the above
5. Penicillin: has a half-life of about 30 minutes; is primarily excreted renally; has an average duration of
about 26 days when administered in the; benzathine form; readily enters CSF when meninges are
normal. Choose the correct
A. *has a half-life of about 30 minutes; is primarily excreted renally; has an average duration of about 26 days
when administered in the;
B. has a half-life of about 30 minutes; is primarily excreted renally;
C. is primarily excreted renally
D. benzathine form
E. All of the above
6. Chloramphenicol is associated with: pancytopenia; gray-baby syndrome; reversible erythroidsuppression of bone marrow; renal failure?
A.
B.
C.
D.
*pancytopenia; gray-baby syndrome; reversible erythroid-suppression of bone marrow;
pancytopenia; gray-baby syndrome
reversible erythroid-suppression of bone marrow; renal failure
renal failure
E. All of the above
7. Prophylactic antibiotics in the United States are associated with: increased incidence of infections in
some cases; decreased incidence of infections in some cases; increased cost in some cases; decreased
cost in some cases.
A. increased incidence of infections in some cases
B. decreased incidence of infections in some cases
C. increased cost in some cases;
D. decreased cost in some cases
E. *All of the above
8. Vancomycin: is a treatment for clostridium difficile-induced diarrhea; is useful in treating methicillinresistant staphylococci; is potentially ototoxic, requires a dosage adjustment when administered to
patients with impaired renal function?
A. is a treatment for clostridium difficile-induced diarrhea; is useful in treating methicillin-resistant
staphylococci;
B. is potentially ototoxic
C. is useful in treating methicillin-resistant staphylococci; is potentially ototoxic
D. requires a dosage adjustment when administered to patients with impaired renal function
E. *All of the above
9. Cavalier use of antibiotics in the hospital setting may be associated with: increased cost; increased
toxicity; alteration of hospital flora; increased incidence of infections?
A. increased cost; increased toxicity;
B. increased cost; alteration of hospital flora;
C. alteration of hospital flora; increased incidence of infections
D. increased incidence of infections
E. *All of the above
10. Imipenem is a beta-lactam antibiotic which is neither a penicillin nor a cephalosporin. Correct
statements regarding imipenem include: it covers an extremely broad spectrum of microorganisms; it is
very active against many gramnegative rods; resistant pseudomonas may emerge during treatment; it
should not be given to patients having a history of allergic reactions to penicillin
A. it covers an extremely broad spectrum of microorganisms; it is very active against many gramnegative rods
B. resistant pseudomonas may emerge during treatment
C. it is very active against many gramnegative rods
D. it should not be given to patients having a history of allergic reactions to penicillin
E. *All of the above
11. Patients having a history of a severe, immediate reaction to penicillin: may be given a cephalosporin
without concern; have a definite risk of reaction to any cephalosporin; have a low risk of having a
reaction to a broad spectrum antipseudomonal penicillin; have a high risk of hypersensitivity to a broad
spectrum anti-pseudomonal penicillin
A. may be given a cephalosporin without concern; have a definite risk of reaction to any cephalosporin;
B. may be given a cephalosporin without concern; have a low risk of having a reaction to a broad spectrum
antipseudomonal penicillin
C. *have a definite risk of reaction to any cephalosporin; have a high risk of hypersensitivity to a broad
spectrum anti-pseudomonal penicillin
D. have a high risk of hypersensitivity to a broad spectrum anti-pseudomonal penicillin
E. All of the above
12. A ninety two year-old female was brought to the emergency room following an episode of low blood
pressure and disorientation at the nursing home. She had been refusing food and drank little. She was
provided i.v glucose and was rehydrated. Over the next few days her condition worsened with increasing
periods of incoherence. She exhibited hyperventilation with respiratory alkalosis and pulmonary
congestion. Her body temperature was slightly subnormal and she was hypotensive (75/40 mm Hg) and
tachycardic. Her pulmonary congestion worsened as did her blood gases. Digoxin was administered.
Blood cultures indicated the present of E. coli, leading to a definitive diagnosis of E. coli septicemia.
Which drug(s) would be appropriate to treat the septicemia?
A. cefotaxime (Claforan)
B. ceftriaxone (Rocephin)
C. aztreonam (Azactan)
D. *all of the above
E. None of the above
13. A sixty-year old male was recovering from bowel resection. The initial recovery period was
unremarkable. Late on the third post-operative day the patient began hyperventilating with respiratory
alkalosis. On the fourth post-operative day, the patient's condition rapidly worsened with a significant
elevation of temperature (104.9 F), profound hypotension (65/38 mm Hg) and tachycardia. Urine output
was very low with BUN and serum creatinine (5 mg%, which had increased from normal levels at
admission) were elevated. . Gram staining of sputum, which was purulent, indicated gram-negative rods.
WBC was 17000/mmseptic shock with a shift to the left. The diagnosis was fulminant bacteremia and
septic shock. What mechanism is most likely responsible for this patient's tachycardia?
A. Direct effects of bacterial endotoxins on the SA node
B. *Significant hypotension associated with low systemic vascular resistance.
C. bacterial endotoxins bind to muscarinic cholinergic receptors, thus removing the dominating
cholinergic tone in the heart.
D. patient anxiety
E. In direct effect of bacterial endotoxin on the SA node
14. A 23 years old patient is pregnant with a history of severe (anaphylactic) penicillin allergy. To prepare
her for an upcoming tooth extraction you prescribe an antimicrobial medication that can be taken
prophlaxis 2 hrs prior to the procedure. This medication is:
A. Cefaclor
B. Doxycycline
C. Erythromycin base
D. *Erythromycin stearate
E. Gentamycin
15. Mr.Antee Biatek, a 30 yr old woman is scheduled to undergo an exploration laparotomy to confirm the
diagnosis of an ectopic pregnancy. She has a history of several penicillin allergy. For prophylaxis prior to
her surgery you administer:
A. *Chloramphenicol
B. Erythromycin stearate
C. Gentamycin + vancomycin i.v
D. Rifampin
E. Streptogramins A+B (synercid)
16. Amphotericin B is a very useful agent for treating fungal infections. Correct statements regarding
amphotericin include: it is both hydrophilic and lipophilic; it binds to sterols in the fungal cell
membrane; a test dose should be administered before treatment begins; nephrotoxicity may occur?
A. it is both hydrophilic and lipophilic; it binds to sterols in the fungal cell membrane;
B. it binds to sterols in the fungal cell membrane; nephrotoxicity may occur
C. it is both hydrophilic and lipophilic; a test dose should be administered before treatment begins;
D. nephrotoxicity may occur
E. *All of the above
17. Sulfonamides: are competitive antagonists of PABA, and thereby decrease bacterial utilization of paraaminobenzoic acid in the synthesis of folic acid; do not affect mammalian cells, since they require preformed folic acid; are synergistic with trimethoprim, which inhibits dihydrofolate reductase (which
reduces dihydrofolate to tetrahydrofolate); can be antagonized by PABA?
A. are competitive antagonists of PABA, and thereby decrease bacterial utilization of paraaminobenzoic acid in the synthesis of folic acid; do not affect mammalian cells, since they require
pre-formed folic acid; are synergistic with trimethoprim, which inhibits dihydrofolate reductase
(which reduces dihydrofolate to tetrahydrofolate)
B. are competitive antagonists of PABA, and thereby decrease bacterial utilization of paraaminobenzoic acid in the synthesis of folic acid; are synergistic with trimethoprim, which inhibits
dihydrofolate reductase (which reduces dihydrofolate to tetrahydrofolate)
C. do not affect mammalian cells, since they require pre-formed folic acid; can be antagonized by
PABA
D. can be antagonized by PABA only
E. *All of the above
18. Circumstances associated with allergy to penicillins may include: maculopapular or urticarial rash;
anaphylaxis; anaphylactic reaction to penicillin skin-tests; exposure to penicillins in food?
A. maculopapular or urticarial rash
B. maculopapular or urticarial rash; anaphylactic reaction to penicillin skin-tests;
C. Anaphylaxis
D. exposure to penicillins in food
E. *All of the above
19. Aminoglycosides: must be dosed on the basis of renal function; are primarily active against gramnegative aerobes; are not active against anaerobes; penicillin may be synergistic against enterococcus?
A. must be dosed on the basis of renal function; are primarily active against gram-negative aerobes; are
not active against anaerobes
B. must be dosed on the basis of renal function; are not active against anaerobes
C. are primarily active against gram-negative aerobes; penicillin may be synergistic against
enterococcus
D. penicillin may be synergistic against enterococcus only
E. *All of the above
20. Dr. is a 52yr old male with vulvular disease that you are with clindamycin for prophylaxis against
endocarditis. You warn him that one of the known side effects of this drug is
A. hypotention
B. metallic taste
C. red urine
D. *superinfection of the colon
E. pruiritus
21. A week after initiating clindamycin therapy DR develops signs of a potentially fatal infection of the
colon. His tests reveal that his infection is due to clostridium difficile, to treat this new condition you
should initiate drug therapy with
A. a higher dose of clindamycin
B. gentamicin i.v
C. linezolid
D. *metronidazole
E. rifampin
22. After DR has largely recovered from his enterocolitis, you decide that he is well enough to be discharge
from the hospital. You give him a prescription for continued therapy with metronidazole and warn him
that his complaint of a metallic taste in his mouth is normal. In addition, you warn him to watch out for
A. *A disulfuram-like reaction
B. Color blindness
C. Red colored urine
D. Tinnitus
E. Yellow teeth
23. Imipenem is a beta-lactam antibiotic which is neither a penicillin nor a cephalosporin. Correct statements
regarding imipenem include: it covers an extremely broad spectrum of microorganisms; it is very active
against many gram negative rods; resistant pseudomonas may emerge during treatment; it should not be
given to patients having a history of allergic reactions to penicillin?
A. it covers an extremely broad spectrum of microorganisms; it is very active against many gram
negative rods; resistant pseudomonas may emerge during treatment;
B. it covers an extremely broad spectrum of microorganisms; resistant pseudomonas may emerge during
treatment;
C. it is very active against many gram negative rods; it should not be given to patients having a history
of allergic reactions to penicillin
D. it should not be given to patients having a history of allergic reactions to penicillin only
E. *All of the above
24. Which of the following are true regarding cephalosporins? "third generation" cephalosporins are
generally more active against gram-negative organisms; cephalosporins may depress beta-lactamase in
certain organisms (Enterobacter, pseudomonas, serratia) causing production of the enzyme to increase
markedly; the enzyme in part B above binds to the cephalosporin; enterococcus is never reliably
sensitive to any available cephalosporin
A. "third generation" cephalosporins are generally more active against gram-negative organisms
B. cephalosporins may depress beta-lactamase in certain organisms (Enterobacter, pseudomonas, serratia) causing
production of the enzyme to increase markedly
C. the enzyme in part B above binds to the cephalosporin;
D. enterococcus is never reliably sensitive to any available cephalosporin
E. *All of the above
25. Prophylactic antibiotics in the United States are associated with: increased incidence of infections in
some cases; decreased incidence of infections in some cases; increased cost in some cases; decreased cost
in some cases?
A. increased incidence of infections in some cases; decreased incidence of infections in some cases;
increased cost in some cases
B. increased incidence of infections in some cases; increased cost in some cases
C. decreased incidence of infections in some cases; decreased cost in some cases
D. decreased cost in some cases only
E. *All of the above
26. Penicillin: has a half-life of about 30 minutes; is primarily excreted renally; has an average duration of
about 26 days when administered in the benzathine form; readily enters CSF when meninges are normal?
A. *has a half-life of about 30 minutes; is primarily excreted renally; has an average duration of about 26
days when administered in the benzathine form
B. has a half-life of about 30 minutes; has an average duration of about 26 days when administered in
the benzathine form
C. is primarily excreted renally; readily enters CSF when meninges are normal
D. readily enters CSF when meninges are normal
27. only
A. All of the above
28. Vancomycin: is a treatment for clostridium difficile-induced diarrhea; is useful in treating methicillinresistant staphylococci; is potentially ototoxic; requires a dosage adjustment when administered to
patients with impaired renal function?
A. is a treatment for clostridium difficile-induced diarrhea; is useful in treating methicillin-resistant
staphylococci; is potentially ototoxic
B. is a treatment for clostridium difficile-induced diarrhea; is potentially ototoxic
C. is useful in treating methicillin-resistant staphylococci; requires a dosage adjustment when
administered to patients with impaired renal function
D. requires a dosage adjustment when administered to patients with impaired renal function only
E. *All of the above
29. Cefazolin is generally preferred among the first-generation cephalosporins, because it: has a favorable
pharmacokinetic profile; has a longer half-life than comparable drugs; may be dosed every 8 hours;
costs less for a hospital to utilize, since it may be given less frequently than comparable drugs?
A. has a favorable pharmacokinetic profile;
B. has a longer half-life than comparable drugs; may be dosed every 8 hours
C. has a longer half-life than comparable drugs;costs less for a hospital to utilize, since it may be given less
frequently than comparable drugs
D. costs less for a hospital to utilize, since it may be given less frequently than comparable drugs
E. *All of the above
30. Patients having a history of a severe, immediate reaction to penicillin: may be given a cephalosporin
without concern; have a definite risk of reaction to any cephalosporin; have a low risk of having a
reaction to a broad spectrum antipseudomonal penicillin; have a high risk of hypersensitivity to a broad
spectrum anti-pseudomonal penicillin
A. may be given a cephalosporin without concern; have a definite risk of reaction to any cephalosporin;
have a low risk of having a reaction to a broad spectrum antipseudomonal penicillin
B. may be given a cephalosporin without concern; have a low risk of having a reaction to a broad
spectrum antipseudomonal penicillin
C. *have a definite risk of reaction to any cephalosporin; have a high risk of hypersensitivity to a broad
spectrum anti-pseudomonal penicillin
D. have a high risk of hypersensitivity to a broad spectrum anti-pseudomonal penicillin only
E. All of the above
31. Amphotericin B is a very useful agent for treating fungal infections. Correctstatements regarding
amphotericin include: it is both hydrophilic and lipophilic; it binds to sterols in the fungal cell membrane;
a test dose should be administered before treatment begins; nephrotoxicity may occur
A. it is both hydrophilic and lipophilic; it binds to sterols in the fungal cell membrane; a test dose should
be administered before treatment begins
B. it is both hydrophilic and lipophilic; a test dose should be administered before treatment begins
C. it binds to sterols in the fungal cell membrane; nephrotoxicity may occur
D. nephrotoxicity may occur only
E. *All of the above
32. Sulfonamides: are competitive antagonists of PABA, and thereby decrease bacterial utilization of paraaminobenzoic acid in the synthesis of folic acid; do not affect mammalian cells, since they require preformed folic acid; are synergistic with trimethoprim, which inhibits dihydrofolate reductase (which
reduces dihydrofolate to tetrahydrofolate); can be antagonized by PABA?
A. are competitive antagonists of PABA, and thereby decrease bacterial utilization of para-aminobenzoic acid in
the synthesis of folic acid;
B. do not affect mammalian cells, since they require pre-formed folic acid;
C. are synergistic with trimethoprim, which inhibits dihydrofolate reductase (which reduces dihydrofolate to
tetrahydrofolate)
D. can be antagonized by PABA
E. *All of the above
33. A patient with pulmonary disease is taking prednisone. You begin her on phenytoin therapy for a newly
diagnosed seizure disorder. Two weeks later the patient returns to the clinic to see you and complains
that her pulmonary disease has worsened since she began the phenytoin therapy. A likely reason for this
new change is that phenytoin:
A. interferes with absorption of the prednisone
B. stabilizes cell membranes, preventing the prednisone from diffusing to the site of action
C. *accelerates hepatic degradation of the prednisone
D. induce renal excretory pathways, accelerating urinary excretion of the prednisone
E. activates the asthma directly
34. A 21-year-old male has been brought to the emergency room unconscious three hours after ingestion of a
large dose of barbiturate. The immediate method of management would be:
A. administer concentrated dextrose intravenously
B. perform hemodialysis immediately with an artificial kidney
C. administer an analeptic drug such as pentylenetetrazol
D. *maintain a clear airway and artificially assist ventilation if air
E. exchange is unsatisfactory
35. Failure of first-line drugs in the initial treatment of apparent pulmonary tuberculosis may have several
causes including poor patient compliance and atypical mycobacterial infections, the latter usually
requiring use of second-line drugs. All of the following are first-line drugs EXCEPT:
A. streptomycin
B. rifampin
C. *ethionamide
D. ethambutol
E. isoniazid
36. Pharmacokinetic blood level monitoring is apt to be most helpful for which of the following
anticonvulsants? Phenytoin; primidone; Phenobarbital; carbamazepine
A. phenytoin; primidone
B. primidone
C. primidone; phenobarbital
D. carbamazepine
E. *All of the above
37. Drugs which are effective in the management of petit mal seizures include: phenytoin; clonazepam;
primidone; valproate?
A. phenytoin
B. phenytoin; clonazepam
C. * clonazepam; valproate
D. valproate
E. All of the above
38. The administration of one drug may stimulate the metabolism of another drug (enzyme induction).
Phenobarbital is an example of such an enzyme inducer. The metabolism of which of the following drugs
may be affected by phenobarbital administration?
A. warfarin
B. phenytoin
C. digitoxin
D. *All of the above
E. None of the above
39. Some potential barriers to successful treatment of an abscess-cavitary infection with an aminoglycoside
include: inactivation of aminoglycoside by an acidic medium; binding of the drug by pus; decreased
ability of the drug to penetrate the abscess because of poor vascularity; inactivation of aminoglycoside
by alkaline medium?
A. *inactivation of aminoglycoside by an acidic medium; binding of the drug by pus; decreased ability
of the drug to penetrate the abscess because of poor vascularity;
B. inactivation of aminoglycoside by an acidic medium
C. binding of the drug by pus; inactivation of aminoglycoside by alkaline medium
D. inactivation of aminoglycoside by alkaline medium
E. All of the above
40. A patient you are following in the hospital is not responding to appropriate doses of phenytoin therapy
(blood level 1.8 mg/dl). The decision is made to begin phenobarbital therapy immediately. The docent
requests that you suggest a loading regimen for this 70-kg male patient to achieve a blood level of 2.0
mg/dl within 24 hours (volume of distribution of phenobarbital = 0.75 l/kg). Your suggestion would be:
A. 15 mg
B. 150 mg
C. 1.5 mg/kg
D. *1000 mg
E. It is not possible to calculate regimen without additional data
41. Treatment of complex partial (temporal lobe) seizures generally requires the use of: phenytoin;
Phenobarbital; carbamazepine; ethosuximide?
A. *phenytoin; Phenobarbital; carbamazepine;
B. phenytoin
C. Phenobarbital; ethosuximide
D. ethosuximide
E. All of the above
42. Drugs known to increase the concentration of phenytoin when given concomitantly include:
carbamazepine; enteral feedings; quinidine gluconate; disulfiram?
A. enteral feedings
B. carbamazepine; enteral feedings;
C. quinidine gluconate
D. *disulfiram only
E. All of the above
43. In the differential diagnosis of hirsutism, drug-induced hirsutism must be considered. A drug which is
known to include hirsutism as a side- effect is:
A. thallium
B. heparin
C. cephalosporins
D. *phenytoin
E. diazepam
44. Variability in absorption represents one potential source for variation in steady state blood levels.
Anticonvulsants associated with variable absorption include: primidone; phenytoin; ethosuximide;
carbamazepine?
A. primidone; phenytoin
B. ethosuximide
C. *phenytoin; carbamazepine
D. carbamazepine
E. All of the above
45. A Patient you began on carbamazepine recently has returned to your office complaining of headache,
vomiting, and dizziness. The patient is mildly confused. Laboratory data were: sodium 112 mEq/L,
potassium 3.9 mEq/L, chloride 90 mEq/L, BUN 12 mg/dl and albumin 3.2 G/dl (normal values for lab:
sodium 135-148, potassium 3.0-5.3, chloride 96-107, BUN 7-22, albumin 3.8-4.8). Which of the
following best explains this patient's symptomatology? carbamazepine-Induced megaloblastic anemia;
carbamazepine-Induced hyponatremia; carbamazepine-Induced cerebellar degeneration; carbamazepineInduced central nervous system toxicity (blood level related)
A. carbamazepine-Induced megaloblastic anemia; carbamazepine-Induced hyponatremia;
carbamazepine-Induced cerebellar degeneration
B. carbamazepine-Induced megaloblastic anemia; carbamazepine-Induced cerebellar degeneration
C. *carbamazepine-Induced hyponatremia; carbamazepine-Induced central nervous system toxicity
(blood level related)
D. carbamazepine-Induced central nervous system toxicity (blood level related) only
E. All of the above
46. Grand mal epilepsy can be effectively treated in some patients with: phenytoin; carbamazepine;
Phenobarbital; valproate?
A. phenytoin
B. carbamazepine
C. Phenobarbital; valproate
D. valproate
E. *All of the above
47. A 26-Year-old female suffering from complex partial seizures is receiving treatment with phenytoin 400
mg (blood level 11 mg/L), and carbamazepine 600 mg/day (blood level 5.3 mg/L). She currently reports
having two or three seizures every three to four months. Despite treatment with lo/Ovral (norgestrel 0.3
mg with ethinyl estradiol 30 mcg), she has learned that she is pregnant. Possible reasons for this
complication include: poor compliance with the lo/Ovral; increased pituitary gonadotropin secretion
secondary to phenytoin; anticonvulsant induced microsomal enzyme induction, causing more rapid
metabolism of the lo/Ovral; increased pituitary gonadotropin secretion secondary to carbamazepine?
A. poor compliance with the lo/Ovral; increased pituitary gonadotropin secretion secondary to
phenytoin; anticonvulsant induced microsomal enzyme induction, causing more rapid metabolism of
the lo/Ovral
B. *poor compliance with the lo/Ovral; anticonvulsant induced microsomal enzyme induction, causing
more rapid metabolism of the lo/Ovral
C. increased pituitary gonadotropin secretion secondary to phenytoin; increased pituitary gonadotropin
secretion secondary to carbamazepine
D. increased pituitary gonadotropin secretion secondary to carbamazepine only
E. All of the above
48. Phenytoin is hydroxylated by liver microsomes. The amount of drug oxidized is: increased by chronic
administration of carbamazepine; decreased by simultaneous administration of isoniazid; (C) decreased
by concurrent administration of disulfiram; increased by simultaneous administration of
chloramphenicol?
A. *increased by chronic administration of carbamazepine; decreased by simultaneous administration of
isoniazid; decreased by concurrent administration of disulfiram
B. increased by chronic administration of carbamazepine; decreased by concurrent administration of
disulfiram
C. decreased by simultaneous administration of isoniazid; increased by simultaneous administration of
chloramphenicol
D. increased by simultaneous administration of chloramphenicol only
E. None of the above
49. Your patient is a 35-year-old epileptic who takes phenytoin 300 mg daily and primidone 500 mg every
eight hours daily. He visits you in clinic complaining of a recent (Past 1-2 days) increase in seizure
frequency. He claims to be very compliant with his medicine and states that he took his last dose 1.5
hours prior to his clinic visit. Following chart review you request stat drug levels. These are reported
back to you as phenobarbital=12 mcg/mL (15-40), primidone=0 (5-12), and phenytoin=5 mcg/mL (1020). Statements which could explain the drug levels observed include: an unusually high degree of
hepatic microsomal enzyme induction; compliance is questionable...you strongly suspect that he has
taken no medicine for the past two days; the patient did take both of his seizure medicines 1.5 hours
before his clinic visit; however, he probably did not take any for 3-4 days before that time
A. an unusually high degree of hepatic microsomal enzyme induction; compliance is questionable...you
strongly suspect that he has taken no medicine for the past two days; the patient did take both of his
seizure medicines 1.5 hours before his clinic visit
B. an unusually high degree of hepatic microsomal enzyme induction; the patient did take both of his
seizure medicines 1.5 hours before his clinic visit
C. *compliance is questionable...you strongly suspect that he has taken no medicine for the past two
days; however, he probably did not take any for 3-4 days before that time
D. he probably did not take any for 3-4 days before that time only
E. All of the above
50. A patient comes to the office complaining of sore, enlarged gums. She is currently taking medication for
hypertension and phenobarbital and phenytoin for seizures. The fibrous hyperplasia is most probably due
to:
A. *phenytoin
B. excessive brushing of teeth
C. propranolol
D. staphylococci infection of gums
E. phenobarbital
51. Since it's introduction in 1938, Phenytoin has been a major anticonvulsant drug in the treatment of
epilepsy. Phenytoin therapy has been shown to be of value for which of the following seizure types?
complex partial seizures (psychomotor); generalized tonic clonic; elementary partial (focal); absences
A. *complex partial seizures (psychomotor); generalized tonic clonic; elementary partial (focal)
B. complex partial seizures (psychomotor); elementary partial (focal)
C. generalized tonic clonic; absences
D. absences only
E. All of the above
52. Correct statements concerning valproic acid toxicity include: VPA has been associated with thinning of
the hair; VPA has been associated with benign essential tremor; VPA has been associated with
thrombocytopenia; VPA has been associated with hepatitis, which usually occurs within the initial six
months of therapy?
A. VPA has been associated with thinning of the hair; VPA has been associated with benign essential
tremor; VPA has been associated with thrombocytopenia;
B. VPA has been associated with thinning of the hair; VPA has been associated with thrombocytopenia;
C. VPA has been associated with benign essential tremor; VPA has been associated with hepatitis,
which usually occurs within the initial six months of therapy
D. VPA has been associated with hepatitis, which usually occurs within the initial six months of therapy
only
E. *All are correct
53. Correct statements concerning the use of diazepam for the emergency management of status epilepticus
include: diazepam should be given intravenously to ensure a rapid onset of action; diazepam should be
given slowly to minimize the potential cardiovascular and respiratory complications (Max OF 5 mg/min);
diazepam should not be expected to provide long-term control in status epilepticus because serum levels
of the drug fall secondary to its extensive distribution in the body; diazepam should be used only for
status epilepticus of the tonic-clonic (grand mal) type?
A. *diazepam should be given intravenously to ensure a rapid onset of action; diazepam should be given
slowly to minimize the potential cardiovascular and respiratory complications (Max OF 5 mg/min);
diazepam should not be expected to provide long-term control in status epilepticus because serum
levels of the drug fall secondary to its extensive distribution in the body
B. diazepam should be given intravenously to ensure a rapid onset of action; diazepam should not be
expected to provide long-term control in status epilepticus because serum levels of the drug fall
secondary to its extensive distribution in the body
C. diazepam should be given slowly to minimize the potential cardiovascular and respiratory
complications (Max OF 5 mg/min); diazepam should be used only for status epilepticus of the tonicclonic (grand mal) type
D. diazepam should be used only for status epilepticus of the tonic-clonic (grand mal) type only
E. All of the above
54. You prescribe phenytoin for a young girl with epilepsy. Her mother calls one month later to inquire
about possible side effects. All of the following may be side effects EXCEPT:
A. nystagmus
B. ophthalmoplegia
C. gingival hyperplasia
D. ataxia
E. *None of the above; all are possible side effects
55. Appropriate indications for and/or uses of laxatives include: prevent straining at the stool in patients
with cardiovascular disease; bulk forming agents for diverticular disease; treatment of drug overdose;
to induce daily bowel movements in normal healthy individuals?
A. *prevent straining at the stool in patients with cardiovascular disease; bulk forming agents for
diverticular disease; treatment of drug overdose
B. prevent straining at the stool in patients with cardiovascular disease
C. bulk forming agents for diverticular disease
D. to induce daily bowel movements in normal healthy individuals
E. All of the above
56. In esophagitis, elevation of the head of the bed, abstinence from ethanol and tobacco, and small frequent
meals are all useful adjunctive therapeutic measures. Other useful therapy may include all of the
following EXCEPT:
A. omeprazole
B. metoclopramide
C. bethanechol
D. cimetidine
E. *amitriptyline
57. The basic approach to the patient with either acute or chronic hepatic encephalopathy is aimed at
reducing the ammonia load presented to the central nervous system. Elimination of protein from the diet,
cathartics, enemas, neomycin and lactulose (a disaccharide) have been used to accomplish this goal.
Correct statements regarding the mechanism of action of lactulose include:
A. reduced fecal Ph by the breakdown products of lactulose leads to reduced ammonia absorption via
non-ionic diffusion
B. the decreased fecal pH increases bacterial assimilation of ammonia
C. lactulose induces an osmotic diarrhea which diminishes fecal stasis and reduces nitrogenous
substrates
D. All of the above
E. *reduced fecal Ph by the breakdown products of lactulose leads to reduced ammonia absorption via
non-ionic diffusion; lactulose induces an osmotic diarrhea which diminishes fecal stasis and reduces
nitrogenous substrates
58. The amount of sodium, phosphate or magnesium contained in an antacid should be assessed when
selecting an antacid for patients with: renal insufficiency; congestive heart failure; ascites; peptic ulcer
disease?
A. *renal insufficiency; congestive heart failure; ascites
B. renal insufficiency
C. congestive heart failure, peptic ulcer disease
D. ascites
E. All of the above
59. Pharmacologic effects of antacids include: increase gastric pH; reversible inactivation of pepsin at pH >
6; increase or decrease gastric motor activity; decrease lower esophageal pressure?
A. increase gastric pH
B. * increase gastric pH; increase or decrease gastric motor activity
C. reversible inactivation of pepsin at pH > 6; increase or decrease gastric motor activity;
D. decrease lower esophageal pressure
E. All of the above
60. For treatment of heartburn patient regularly used some powder. After a week of drug using vomiting,
nausea, abdomen pain, fibrillation, shallow and slow breathing. Biochemical examination show alkalosis.
What drug used patient?
A. *Natrii hydrocarbonas
B. Aluminium hydroxide
C. Magnesium sulfate
D. Omeprasole
E. Calcium carbonate
61. True statement concerning the pharmacologic effects of salicylates include: salicylates are thought to
exert their activity at least partially by inhibiting prostaglandin synthetase; high-dose salicylate therapy
(more than 5 g /day) lowers the serum uric acid concentration; the effect of salicylates upon platelet
aggregation is irreversible unlike that of other non-steroidal anti-inflammatory drugs; salicylate overdose
is potentionally fatal, however, promt administration of acetylcystein will avert this danger?
A. *salicylates are thought to exert their activity at least partially by inhibiting prostaglandin synthetase;
high-dose salicylate therapy (more than 5 g /day) lowers the serum uric acid concentration; the effect
of salicylates upon platelet aggregation is irreversible unlike that of other non-steroidal antiinflammatory drugs
B. salicylates are thought to exert their activity at least partially by inhibiting prostaglandin synthetase; high-dose
salicylate therapy (more than 5 g /day) lowers the serum uric acid concentration;
C. the effect of salicylates upon platelet aggregation is irreversible unlike that of other non-steroidal antiinflammatory drugs
D. salicylate overdose is potentionally fatal, however, promt administration of acetylcystein will avert this danger
E. All above
62. A doctor is caring for a client with a diagnosis of rheumatoid arthritis who is receiving sulindac (Clinoril)
150 mg po twice daily. Which finding would indicate to the doctor that the client is experiencing a side
effect related to the medication?
A. *nausea
B. photophobia
C. fever
D. tingling in the extremities
E. All of the above
63. A client is taking famotidine (Pepcid) asks the doctor what would be the best medication to take for a
headache. The doctor tells the client that it would be best to take:
A. *aspirin (acetylsalicylic acid, ASA)
B. ibuprofen (Motrin)
C. acetaminophen (Tylenol)
D. naproxen (Naprosyn)
E. All of the above
64. To the patient with gout the doctor prescribed allopurinol. What pharmacological property of allopurinol
is important in this situation?
A. *Competitive inhibition of ksantinoxydase.
B. Increasing of evacuation of nitrogen substances.
C. С. Acceleration of catabolism of pirimidinic nucleotides
D. Decreasing of reutilization of pirimidinic nucleotides
E. Е. Increasing of synthesis of nucleic acids
65. At the 42 years old man with gout the concentration of urinary acid in the blood increased. For the
decline of level of urinary acid allopurinol was prescribed to him. What enzyme is allopurinol
competitive inhibitor of?
A. *Ksantinoxydase
B. Adeninphosphoriboziltransferase
C. Hypoksantinphosphoriboziltransferase
D. Guanindesaminase
E. Adenosindesaminase
66. The patient, who suffered from irritability, sleeplessness, rapid fatigability and neurosis has been
diagnosed. What agents can be prescribed?
A. Anapriline.
B. Sodium chloride.
C. Aminasine.
D. Atropine.
E. *Sibasone.
67. The patient, who suffered from anxiety, fear, hesitancy Sibasone has been prescribed. What is the
mechanism of its tranquilizing activity?
A. *Interaction with benzodiazepine receptors.
B. Interaction with adrenergic receptors.
C. Interaction with cholinergic receptors.
D. Interaction with serotonin receptors.
E. Interaction with dophaminergic.
68. The patient, who suffered from hyper excitability, irritability, sleeplessness was prescribed phenazepam.
What is the mechanism of its action?
A. *Stimulation of benzodiazepine receptors.
B. Stimulation of GABA (gamma amino butyric acid) receptors.
C. Stimulation of adrenergic receptors.
D. Stimulation of M-cholinergic receptors.
E. Stimulation of H-cholinergic receptors.
69. The patient, suffered from schizophrenia, was prescribed aminazine for delusion and hallucinations
reducing. What is the mechanism of its antipsychotic action?
A. *Block adrenergic dophaminergic receptors in CNS.
B. Stimulate adrenergic dophaminergic receptors in CNS.
C. Stimulate cholinergic receptors in CNS.
D. Block cholinergic receptors in CNS.
E. Inhibition of re-uptaking of MAO.
70. After examining the patient was prescribed a remedy that is used in case of neurosis or neurosis-like
situation, hyper excitability and irritability. What pharmacological group does this remedy belong to?
A. Analgetics.
B. *Anxiolytics.
C. Analeptics.
D. Antipsychotics.
E. CNS stimulants.
71. The patient instead aminasine was prescribed another neuroleptic. What drug belongs to this group?
A. *Haloperidole.
B. Phentanile.
C. Paracetamol.
D. Sibasone.
E. Morphine.
72. The physician monitors a patient taking an antipsychotic medication for side effects, including:
A. Hypersalivation
B. Hypetension
C. Diarrhea
D. *Extrapyramidal syndrome
E. Cramps
73. At the hands of nurse, working at the psychiatric unit during two years symptoms of neurodermatitis
appears. What drug can cause such adverse effect?
A. *Aminazine.
B. Morphine.
C. Paracetamol
D. Atropine.
E. Diasepame
74. For the patient with depression was prescribed Nialamide. The physician informed patient about
necessity to remove from the diet during of medical treatment:
A. *Cheese
B. Apples
C. Potatoes
D. Cabbages
E. Pears.
75. To the patient for the removal of depressed syndrome was prescribed inhibitor of monooxygenase
(MAO). What food products are necessary to remove from the patient?s diet?
A. *Hard sorts of cheese, bananas, peanut
B. Cabbages, cucumbers, tomatoes
C. Millet, buckwheat
D. Milk porridges,
E. Honey, fruits
76. The old patient complains to headache, dizziness, rapid fatigue, worsening a memory. In anamnesis is
cranial-cerebral trauma. What pharmacological group is necessary to prescribe?
A. Hypnotics
B. Neuroleptics
C. Tranquilizers
D. *Nootrops
E. Analgetics
77. The physician notes lithium on a patient's drug history upon admission. The physician would suspect that
this patient suffers from:
A. Obesity
B. Abstinent syndrome
C. Renal disorder
D. *Manic episodes
E. Diabetes mellitus
78. The problem of skeletal muscle contraction exist at child after poliomyelitis. What medicine is possible
to prescribe?
A. *Galantamine hydrobromide
B. Platyphylline
C. Methacine
D. Atropine sulfate
E. Tubacurarine
79. After operation of reposition of femur fracture when Tubacurarine was used, breathing of patient did not
resume. What is necessary to inject?
A. *Proserine
B. Platyphylline
C. Cyclodole
D. Atropine
E. Acetylcholine
Тests questions to figures
1. Agent acts directly at site 6 to diminish tissue injury: (see figure 45)
A. tacrolimus
B. cyclosporine (Sandimmune, Neoral)
C. *prednisone (Deltasone)
D. dactinomycin (Cosmegen)
E. methotrexate
2. Act(s) at site 2, reducing proliferation (see figure 45)
A. prednisone (Deltasone)
B. tacrolimus
C. azathioprine (Imuran)
D. prednisone & tacrolimus
E. * all of the above
3. Inhibit(s) at differentiation/synthesis step (see figure 45):
A. prednisone (Deltasone)
B. cyclophosphamide (Cytoxan)
C. *dactinomycin (Cosmegen)
D. methotrexate
E. azathioprine (Imuran)
4. Acts at three sites: antigen recognition site, proliferation step, and differentiation/synthesis steps: (see
figure 45)
A. prednisone (Deltasone)
B. *antilymphocyte globulin & monoclonal anti-Tcell antibodies
C. RHo(D) immune globulin
D. cyclophosphamide (Cytoxan)
E. all of the above
5. Acts at antigen recognition site: (see figure 45)
A. prednisone (Deltasone)
B. tacrolimus
C. azathioprine (Imuran)
D. *RHo(D) immune globulin
E. cyclophosphamide (Cytoxan)
6. What are indications to application represented on figure 46 drug?
A. Hypertension
B. Hypotension
C. *Headache
D. Vertigo
E. Constipation
7. What are contraindications to application represented on figure 46 drug?
A. Arterial hypertension
B. *Hypersensitivity
C. Diabetes mellitus
D. Pregnancy
E. None of the above
8. What are side effects caused by represented on figure 46 drug?
A. *Skin rashes
B. Myopathy
C. Insomnia
D. Hypotension
E. Arrhythmia
9. Specify maximal day's dose of the preparation represented on figure 46:
A. 500 mg
B. 1.0 g
C. *1.5 g
D. 2 g
E. 3 g
10. The drug, represented on figure 46, belongs to:
A. *Anti-inflammatory drugs
B. Antiarrhithmic Drugs
C. Antacids
D. Diuretics
E. Antiviral drugs
11. What are contraindications to application represented on figure 47 drug?
A. Arterial hypertension
B. Diabetes mellitus
C. *Ulcerative disease of GI
D. Arrhythmia
E. None of the above
12. What are side effects caused by represented on figure 47 drug?
A. Nausea
B. Vomiting
C. Anorexia
D. Diarrhea
E. *All of the above
13. Specify maximal day's dose of the preparation represented on figure 47:
A. 50 mg
B. 100 mg
C. 150mg
D. *200 mg
E. 250 mg
14. The drug, represented on figure 47, belongs to:
A. Anesthetics
B. Antacids
C. Diuretics
D. *Anti-inflammatory drugs
E. Antiviral drugs
15. What are indications to application represented on figure 48 drug?
A. Osteoarthritis
B. Rheumatoid arthritis
C. Fever
D. All of the above
E. * Osteoarthritis & Rheumatoid arthritis
16. What are contraindications to application represented on figure 48 drug?
A. *Allergy to sulfonamides
B. Diabetes mellitus
C. Hypertension
D. Arrhythmia
E. None of the above
17. What are side effects caused by represented on figure 48 drug?
A. Abdominal pain
B. Vomiting
C. Dyspepsia
D. Diarrhea
E. *All of the above
18. The drug, represented on figure 48, belongs to:
A. NSAIDs more selective for inhibition of COX-1
B. Anesthetics
C. *NSAIDs more selective for inhibition of COX-2
D. Slow-acting anti-inflammatory drugs
E. Antiviral drugs
19. Specify maximal day's dose of the preparation represented on figure 48:
A. 100 mg
B. 200 mg
C. 600mg
D. *800 mg
E. 250 mg
20. What are indications to application represented on figure 49 drug?
A. *Chronic constipations
B. Nausea
C. Hyperacidity
D. Hypoacidity
E. None of the above
21. What are contraindications to application represented on figure 49 drug?
A. Hypertension
B. Diabetes mellitus
C. *Hypersensitivity
D. Arrhythmia
E. None of the above
22. The drug, represented on figure 49, belongs to:
A. *Laxatives
B. Antidiarrheal drugs
C. Antiemetic drugs
D. H2-receptor antagonists
E. Antacids
23. What are side effects caused by represented on figure 49 drug?
A. Tachycardia
B. *Abdominal pain
C. Skin rashes
D. Myopathy
E. All of the above
24. Specify maximal day's dose of the preparation represented on figure 49:
A. 45 ml
B. 30-50 ml
C. *150-190 ml
D. 90 ml
E. 75 ml
25. What are indications to application represented on figure 50 drug?
A. Osteoarthritis
B. Asthma
C. Hepatitis
D. Uveitis
E. *All of the above
26. What are contraindications to application represented on figure 50 drug?
A. *Osteoporosis
B. Diabetes mellitus
C. Arrhythmia
D. None of the above
E. All of the above
27. What are side effects caused by represented on figure 50 drug?
A. Tachycardia
B. *Steroid diabetes
C. Hypotension
D. All of the above
E. None of the above
28. Specify maximal day's dose of the preparation represented on figure 50:
A. 10 mg
B. 20-30 mg
C. *100 mg
D. 40-50 mg
E. 80 mg
29. The drug, represented on figure 50, belongs to:
A. NSAIDs
B. *Steroid hormones
C. Antibiotics
D. Antiviral drugs
E. COX2-inhibitors
30. What are indications to application represented on figure 51 drug?
A. Osteoporosis
B. Hyperglycemia
C. Shock
D. Relief of inflammatory symptoms
E. * Shock & Relief of inflammatory symptoms.
31. What are side effects caused by represented on figure 51 drug?
A. Diabetes
B. Ulcerative disease
C. CNS disturbances
D. Osteopenia
E. *All of the above
32. Indicate maximal day's dose per os of the preparation represented on figure 51:
A. 4.5 mg
B. 10 mg
C. 20-25 mg
D. 30 mg
E. *10-15 mg
33. The drug, represented on figure 51, belongs to:
A. *Steroid hormones
B. COX2-inhibitors
C. NSAIDs
D. Antibiotics
E. Antiviral drugs
34. What are indications to application represented on figure 52 drug?
A. Cholecystitis
B. Pneumonia
C. Bronchitis
D. Prostatitis
E. *All of the above
35. What are contraindications to application represented on figure 52 drug?
A. Mycosis
B. Hypersensitivity
C. Arrhythmia
D. All of the above
E. *A&B
36. What are side effects caused by represented on figure 52 drug?
A. Vomiting
B. Anorexia
C. Stomach pain
D. Skin rashes
E. *All of the above
37. Indicate maximal day's dose of the preparation represented on figure 52:
A. 0.1 g
B. 0.2 g
C. 0.3 g
D. 1.0 g
E. *2.0 g
38. The drug, represented on figure 52, belongs to:
A. A narrow spectrum antimicrobial drug
B. *A broad spectrum antimicrobial drug
C. A extended spectrum antimicrobial drug
D. A & B
E. B & C
39. What are indications to application represented on figure 53 drug?
A. Hypertension
B. Headache
C. *Pneumonia
D. Constipation
E. All of the above
40. What are contraindications to application represented on figure 53 drug?
A. *Infectious mononucleosis
B. Arterial hypertension
C. Diabetes mellitus
D. Pregnancy
E. Mycosis
41. What are side effects caused by represented on figure 53 drug?
A. *Vomiting
B. Myopathy
C. Insomnia
D. Hypotension
E. Arrhythmia
42. Indicate maximal day's dose of the preparation represented on figure 53:
A. 1.0 g
B. 2.0 g
C. *3.0 g
D. 4.0 g
E. 5.0 g
43. The drug, represented on figure 53, belongs to:
A. Sulfonamides
B. Antifungal Drugs
C. Antiviral Drugs
D. Anithelmintic Ddugs
E. *Antibiotic Agents
44. What are indications to application represented on figure 54 drug?
A. Cholecystitis
B. Pneumonia
C. Otitis
D. Prostatitis
E. *All of the above
45. What are contraindications to application represented on figure 54 drug?
A. Systemic mycosis
B. Hypersensitivity
C. *Hepatic insufficiency
D. All of the above
E. None of the above
46. What are side effects caused by represented on figure 54 drug?
A. Vomiting
B. Stomach pain
C. Myopathy
D. * Vomiting & Stomach pain
E. None of the above
47. Indicate maximal day's dose of the preparation represented on figure 54:
A. 0.5-1.0 g
B. 1.0-2.0 g
C. *2.0-3.0 g
D. 3.0-4.0 g
E. 4.0-4.05 g
48. The drug, represented on figure 54, belongs to:
A. Sulfonilamides
B. Aminoglycosides
C. *Macrolides
D. beta-Lactams
E. None of the above
49. What are indications to application represented on figure 55 drug?
A. Blastomycosis
B. AIDS-associated histoplasmosis
C. Candidemia
D. Cryptococcosis
E. *All of the above
50. What are contraindications to application represented on figure 55 drug?
A. *Hypersensivity
B. Leucopenia
C. Ulcer
D. Arterial hypertension
E. Diabetes mellitus
51. What are side effects caused by represented on figure 55 drug?
A. Dyspepsia
B. Hypokalemia
C. Hypertension
D. Edema
E. *All of the above
52. Indicate maximal day's dose of the preparation represented on figure 55:
A. 100 mg
B. 200 mg
C. *400 mg
D. 100-200 mg
E. 500 mg
53. The drug, represented on figure 55, belongs to:
A. Antibiotics
B. Antiviral drugs
C. *Antifungal agents
D. Antituberculosis drugs
E. None of the above
54. What are indications to application represented on figure 56 drug?
A. Pneumonia
B. Sepsis
C. Peritonitis
D. Endocarditis
E. *All of the above
55. What are contraindications to application represented on figure 56 drug?
A. Diabetes mellitus
B. Infectious mononucleosis
C. Arterial hypertension
D. *Hypersensitivity to cephalosporins
E. Mycosis
56. What are side effects caused by represented on figure 56 drug?
A. Allergic manifestations
B. Candidosis
C. Arthralgia
D. * All of the above
E. None of the above
57. Indicate maximal day's dose of the preparation represented on figure 56:
A. 2.0 g
B. 4.0 g
C. *6.0 g
D. 8.0 g
E. 10.0 g
58. The drug, represented on figure 56, belongs to:
A. Penicillins
B. *Cephalosporins
C. Carbapenems
D. Monobactams
E. None of the above
59. What are indications to application represented on figure 57 drug?
A. Tuberculosis
B. Onichomycosis
C. *Pneumonia
D. None of the above
E. All of the above
60. What are contraindications to application represented on figure 57 drug?
A. Anemia
B. Ulcer
C. Pregnancy & lactation
D. Diabetes mellitus
E. *Vomiting & diarrhea
61. What are side effects caused by represented on figure 57 drug?
A. Arthralgia
B. Collaps
C. Skin rashes
D. Platelet dysfunction
E. *All of the above
62. The drug, represented on figure 57, belongs to:
A. Carbapenems
B. *Penicillins
C. Macrolides
D. Tetracyclines
E. Aminoglycosides
63. Indicate maximal day's dose of the preparation represented on figure 57:
A. 500 mg
B. 1.0 g
C. 2.0 g
D. *3.0 g
E. 4.0 g
64. What are indications to application represented on figure 58 drug?
A. Meningitis
B. Sepsis
C. Osteomyelitis
D. Endocarditis
E. *All of the above
65. What are contraindications to application represented on figure 58 drug?
A. Anemia
B. Leucopenia
C. Ulcer
D. *Pregnancy & lactation
E. Diabetes mellitus
66. The drug, represented on figure 58, belongs to:
A. Fluoroquinolones
B. Antiviral drugs
C. Antifungal agents
D. Antiprotozol Drugs
E. *Antibiotics
67. What are side effects caused by represented on figure 58 drug?
A. Hepatic insufficiency
B. Vomiting
C. Hypersensitivity
D. Diabetes mellitus
E. *A & B
68. Indicate maximal day's dose of the preparation represented on figure 58:
A. 1.0 g
B. 1.5 g
C. *2.0 g
D. 2.5 g
E. 3.0 g
69. What are indications to application represented on figure 59 drug?
A. *Duodenal ulcer
B. Colitis
C. Pneumonia
D. Osteoporosis
E. None of the above
70. The drug, represented on figure 59, belongs to:
A. Sulfonilamides
B. Aminoglycosides
C. *Inhibitors of the H+/K+- ATPase proton pump
D. Macrolides
E. ß-Lactams