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Module. Drug Therapy. Text test questions: 1 The drug applied at the case of hypersusceptibility to nitroglycerine for removing attack of angina pectoris A. Aspirin B. Atropine C. Piracetame D. Papaverine E. * Molsidomine 2 All of the following statements concerning nitroglycerin are correct EXCEPT: A. It causes an elevation of intracellular cGMP. B. It undergoes significant first-pass metabolism in the liver. C. It may cause significant reflex tachycardia. D. * It significantly decrease AV conduction. E. It can cause postural hypotension. 3 The clot aggregation blocker oppressing the adenosine absorption and reducing its enzyme destruction A. Papaverine B. Propranolol C. Reserpine D. * Dipiridamole E. Trental 4 What group does Trimetazidine belong to? A. Adrenomimetics B. Cholinoblockers C. * Cardioprotectors D. Sympatholitics E. Diuretics 5 The cardioselective beta-adrenoblocker A. * Bisoprolol B. Adrenalin C. Riboxinum D. Enalapril E. Nifedipine 6 The drug applied for the medical treatment of ischemic heart disease A. Sympatholitics B. * beta-adrenoblockers C. alpha-adrenoblockers D. Myorelaxants E. M-cholinomimetics 7 Which of the following adverse effects is associated with nitroglycerin? A. Hypertension B. * Throbbing headache C. Bradycardia D. Sexual dysfunction. E. Anemia. 8 Which drug belongs to the beta-adrenoblockers’ group? A. Nitroglycerine B. * Metoprolol C. Captopril D. Nifedipine E. Furosemidum 9 All of the following mechanisms of action correctly match a drug EXCEPT: 10 11 12 13 14 15 16 17 A. Quinidine: Blocks Na+ channels B. Brethylium: Blocks K+ channels C. Verapamil: Blocks Ca++ channels D. Propranolol: Blocks beta-adrenoreceptors E. * Procainamide: Blocks K+ channels. The action of nitroglycerine and others organic nitrates is caused by A. The blockade of potassium channels B. The blockade of sodium channels C. The blockade of calcium channels D. * The release of nitrogen oxyde in the vessel walls E. The excitation of beta2 -adrenoreceptors vessels The efficiency of Nifedipine at arterial hypertension is caused by A. * The dilation of vessels B. The rise of myocardium contractility C. The decline of renine production D. The decline of diuresis E. The rise of diuresis Which drug belongs to the Calcium-channel blocker group? A. Papaverinum B. Atenolol C. * Verapamil D. Furosemidum E. Anaprilinum The drug applied for the medical treatment of ischemic heart disease A. alpha-adrenoblockers B. Sympatholitics C. Diuretics D. M-cholinomimetics E. * Nitrates Which one of the following statements is INCORRECT? A. Lidocaine must be given parenterally. B. * Lidocaine is used mainly for atrial arrhythmias. C. Procainamide is associated with a reversible lupus phenomenon. D. Quinidine is active orally. E. All antiarrhythmic drugs can suppress cardiac contractions. The basic principle of Nifedipine action A. It rises the activity of potassium channels B. It blockades beta2-adrenoreceptors C. The release of nitrogen oxide D. * It blockades the calcium channels L-type E. It blockades beta1 -adrenoreceptors The basic effect of nitroglycerine A. Strengthening diuresis B. * Dilation of arterioles and venules C. Oppression of heart contraction D. Anti-inflammatory action E. Rise of myocardium contractility The drug related to the group of calcium antagonists A. Reserpine B. Apressinum C. * Nifedipine D. Prazosinum E. Papaverini hydrochloridum 18 Which drug decreases the demand in oxygen due to the blockade of the sympathetic innervation? A. Molsidomin B. * Atenolol C. Pentoxiphylline D. Papaverinum E. Nitroglycerine 19 An efficiency of beta-adrenoblockers at angina pectoris is explained by A. * The removal of the sympathetic influences on the heart because of the blockade of the betaadrenoreceptors B. The expansion of the coronal vessels C. The increase of sympathetic influences on the heart D. The increase of cardiac abbreviations E. The decline of thrombocyte aggregation 20 Which one of the following statements is INCORRECT? A. Quinidine prolongs repolarization and the effective refractory period. B. Mexiletine shortens repolarization and decreases the effective refractory period. C. * Propranolol increases phase 4 depolarization. D. Verapamil shortens the duration of the action potential. E. Amiodarone prolongs repolarization. 21 The drug, applied sublingually at the attack of angina pectoris A. Isosorbide dinitrate B. Riboxinum C. Pentoxiphylline D. Atenolol E. * Nitroglycerinum 22 The drug of the group of nitrates with the prolonged action at the ischemic heart disease A. Validolum B. Losartan C. * Sustac D. Magnesium sulfate E. Captopril 23 Which drug belongs to the group of beta-adrenoblockers A. Nitroglycerine, Molsidomine B. * Nebivolol, Atenolol C. Pentoxiphylline, Papaverinum D. Nifedipine, Verapamil E. Captopril, Enalapril 24 Which drug belongs to the group of calcium ions antagonists? A. Molsidomine, Nitroglycerine B. Anaprilinum, Atenolol C. Pentoxiphylline, Papaverinum D. * Amlodipine, Verapamil E. Captopril, Enalapril 25 Which one of the following statements about antiarrhythmic drugs is CORRECT? A. * They may act by converting unidirectional block to a bidirectional block. B. They often cause an increase in cardiac output. C. As a group they have mild side effects. D. They all affect Na+ channels in the cell membrane. E. They are equally useful in atrial and ventricular arrhythmias. 26 Which drug belongs to the inhibitors of ACE A. Nitroglycerine, Molsidomine B. Anaprilinum, Atenolol C. Pentoxiphylline, Papaverinum 27 28 29 30 31 32 33 34 35 D. Nifedipine, Verapamil E. * Lisinopril, Enalapril Indicate the antiarrhythmic drug A. Nitroglycerin B. Isosorbiti dinitras C. Sustac D. Validolum E. * Procainamide (Novocainamide) Indicate the antiarrythmic drug which exerts membrane-stabilizing action. A. * Quinidine sulfate B. Isadrinum C. Digoxin D. Nitroglycerin E. Atenolol Indicate the antiarrytmic drug of adrenoblockers group A. Amiodaron B. * Metoprolol C. Verapamil D. Asparcam E. Nitroglycerin. Indicate the peculiarities of the action of quinidine upon heart. A. * Increase of the effective refractory period. B. Decrease of the effective refractory period. C. Increase of the conduction of myocardium. D. Inhibition of the conduction of myocardium. E. Increase of the cardic automatism. The major drawback to antianginal use of propranolol is: A. * Exacerbation of congestive heart failure B. Increased blood pressure C. urine retention D. blurred vision E. diabetes-like hyperglycemia Indicate the mechanism of verapamil action. A. Blockade of beta-adrenoceptors of the heart. B. * Blockade of calcium channels of the cardiomyocyte membranes. C. Blockade of potasium channels of myocytes. D. Inhibition of phosphodiesterase . E. Inhibition cholinesterase. Indicate the pharmacological effect of verapamil. A. Cardiotonic effect. B. Hypertensive effect. C. * Antiarrhythmic effect. D. Diuretic effect. E. Antibacterial effect. Which drug is used for ischemic heart disease, hypertension and cardiac arrhythmias? A. * Bisoprolol B. Sustac C. Nitroglycerine D. Novocainamidum E. Validolum To indicate the possible side effect of Propranolol? A. * Bronchial spasm B. Tachycardia 36 37 38 39 40 41 42 43 44 C. Rise of arterial pressure D. Ortostatic collapse E. Development of tolerance Why Novocainamide can’t inject intravenously quickly? A. Cause tachycardia B. * Cause decreasing of arterial pressure C. Cause hypertension D. Depress respiration E. Have short acting period Ventricular premature depolarizations. What agent is indicated? A. Isosorbide dinitrate B. * Disopyramide C. Propranolol D. Nifedipine E. Nitroglycerin What antiarrhythmic drug is paraaminobenzioc acid derevate? A. * Novocainamidum B. Quinidinum C. Verapamilum D. Xycainum E. Dipheninum What antiarrhythmic drug has local anaesthetic activity? A. Novocainamidum B. Quinidinum C. Verapamilum D. * Xycainum E. Dipheninum For treatment of what arrythmias Lidocaine is the most effective? A. * Ventrical tachyarrhythmia B. Atrium tachyarrhythmia C. Atrio-ventrical block D. Sino-auricular block E. Chronic paroxismal arrhythmia For treatmant of what kind of arrythmia cardiac glycosides are contraindicated? A. * Ventricula tachyarrhythmia B. Atrium tachyarrhythmia C. Extrasystolia D. Flutering of atrium E. Chronic paroxismal arrhythmia Isosorbide dinitrate is used: A. Antiarrhythmic action is via alpha-adrenergic blockade B. Ventricular premature depolarizations C. * Angina pectoris prophylaxis D. Conversion of atrial fibrillation to sinus rhythm E. Treatment of ventricular fibrillation What medicine is a drug of choice for treatment of ventricular arrythmia? A. Novocainamidum B. Quinidinum C. * Xycainum D. Dipheninum E. Verapamilum When quinidine is administered to a patient with atrial fibrilation? A. the ventricular rate may increase dangerously 45 46 47 48 49 50 51 52 53 B. arterial hypotension usually results if the drug is administered intravenously C. thrombi attached to fibrillating atria may embolize A. * all are correct B. none are correct To indicate medication of Nitroglycerine of prolong action A. * Sustac B. Amoidaronum C. Molsidominum D. Fenigidinum E. Anaprilinum Indicate the side effect of nitroglycerine A. Itching of skin B. Bradicardia C. Rise of arterial pressure D. * Headache E. Intestine atony Which antianginal drug provokes bronchial spasm? A. Sustac B. * Propranolol C. Nitroglycerine D. Fenigidinum E. Molsidominum Why during attack of angina pectoris Sustac is not prescribed orally? A. Brief action B. Causes tachycardia C. * Long latent period D. Causes hypotension E. Causes tolerance Indication to Sustac. A. * Prophylaxis of attacks of angina pectoris B. Removal of attacks of angina pectoris C. Medical treatment of acute heart attack D. Medical treatment of high blood pressure illness E. Medical treatment of paroxismal tachycardia Agents which may lower circulating plasma lipids include: A. Clofibrate B. Nicotinic acid C. Cholestyramine D. Dextrothyroxine E. * All are correct Which medication is drug of choice at attack of angina pectoris? A. Sustac B. Molsidominum C. * Nitroglycerine D. Anaprilinum E. Fenigidinum Which from the antianginal agents can be applying for the removal and for prophylaxis of attacks of angina pectoris? A. * Trinitrolong B. Nitroglycerine C. Sustac D. Corvatonum E. Validolum 54 Why is not it impossible to apply nitroglycerine in case of high intracranial pressure? A. Increase arterial pressure B. Causes bradycardia C. * Increase intracranial pressure D. Decrease intracranial pressure E. Provoke angina pectoris 55 Increases transmembrane action potential duration: A. Lidocaine B. * Quinidine C. Atenolol D. Digoxin E. Esmolol 56 Which from agents is used for ischemic heart disease and hypertension? A. * Nifedipine B. Sustac C. Nitroglycerine D. Novocainamaidum E. Aspirine 57 Indicate possible side effect of propranolol? A. Hypertension B. Tachycardia C. * Bradycardia D. Оrtostatic collapse E. Development of tolerance 58 The patient suffers on the ischemic heart disease. Which from the adopted antianginal drugs has coronary dilation and antiplatelet action? A. * Dipiridamolum B. Acetylsalicylic acid C. Validolum D. Nitroglycerine E. Molsidominum 59 To note the drug for “controlled hypotension” A. Reserpinum B. Anaprilinum C. Methyldopa D. * Hygronium E. Sibasonum 60 Extensively metabolized by circulating enzymes: A. Quinidine B. Lidocaine C. Nicotinic acid D. Cholestyramine E. * Neither 61 To indicate mechanism of Са2+ antagonists hypotensive action A. Decrease the tonus of vasomotor centers B. Block the postsynaptic beta-adrenoreceptors C. Block the sympathetic ganglions D. * Block the calcium channels E. Stimulate the production of prostaglandins 62 Which one of the following is the most common side effect of antihyperlipidemic drug therapy ? A. Elevated blood pressure B. * Gastrointestinal disturbance C. Neurological problems 63 64 65 66 67 68 69 70 71 D. Heart palpitations E. Migraine headaches To indicate side effect of Clophellinum (Clonidine) A. Increasing of arterial pressure B. Increasing of intraocular pressure C. * Dryness in the mouth D. Increasing of glands secretion E. Increasing of intestine motility To indicate the antihypertensive drug used for the medical treatment of hypertensive disease with tachycardia and extrasystoles. A. Methyldopa B. Reserpinum C. * Bisoprolol D. Clophelinum E. Dibazolum What diuretic is used for the removal of hypertensive crisis? A. * Furosemide B. Mannitum C. Triamteren D. Dichlothiazide E. Spironolactonum To indicate the drug – blocker of angiotensin converting enzyme. A. Anaprilinum B. * Lisinopril C. Methyldopa D. Reserpinum E. Dibazolum To indicate– calcium channels blocker hypotensive drug A. * Nifedepine B. Captopril C. Reserpinum D. Anaprilinum E. Dibazolum Mechanism of enalapril action A. Blocks alpha-adrenoreceptors B. * Blocks carboxypeptidase C. Blocks M-cholinoreceptors D. Has diuretic action E. Has sympatholytic action Which one of the following drugs decreases de novo cholesterol synthesis by inhibiting the enzyme 3hydroxy-3-methylglutaryl CoA reductase? A. Clofibrate B. Niacin C. Cholestyramine D. * Lovastatin E. Gemfibrozil To indicate diuretic drug that is used for the removal of hypertensive crisis. A. Oxytocine B. Dichlothiazide C. Triamteren D. Spironolactonum E. * Furosemide To indicate what diuretics is used in the complex therapy of hypertensive crisis. 72 73 74 75 76 77 78 79 A. Spironolactonum B. * Furosemide C. Manit D. Dichlothiazide E. Triamterene Which is a NOT a common side effect of nitroglycerin? A. * Blurred vision B. Flushing C. Headache D. Hypotension E. Hypertension Calcium channel blockers reduce myocardial oxygen demand by reducing afterload, which is: A. Blood volume within the heart B. Pressure within the heart C. * Pressure against which the heart must pump D. Contractility of the heart muscle E. Oxygen demand of the heart Which of the following nitrate preparations or dosage forms has the longest duration of action? A. Sublingual nitroglycerin B. Sublingual isosorbide dinitrate C. Oral isosorbide dinitrate D. * Transdermal nitroglycerin patch E. Validolum In order to prevent the development of tolerance, the pharmacist instructs the patient to: A. Apply the nitroglycerin patch every other day B. Switch to sublingual nitroglycerin when the patient's systolic blood pressure elevates to >140 mm Hg> C. * Apply the nitroglycerin patch for 14 hours each and remove for 10 hours at night D. Use the nitroglycerin patch for acute episodes of angina only E. Apply the nitroglycerin patch 2 times per day Binds bile acids in the intestine, thus preventing their return to the liver via the enterohepatic circulation: A. Niacin B. * Clofibrate C. Cholestyramine D. Probucol E. Lovastatin Before administering isosorbide mononitrate, a priority assessment would include: A. Serum electrolytes B. Blood urea nitrogen (BUN) and creatinine C. * Blood pressure D. Level of consciousness E. Pressure within the heart Cause a decrease in liver triacylglycerol synthesis by limiting available free fatty acids needed as building blocks for this pathway: A. Cholestyramine B. * Niacin C. Clofibrate D. Probucol E. Lovastatin The patient asks how nitroglycerin should be stored while traveling. The pharmacist's best response would be: A. "You can protect it from heat by placing the bottle in an ice chest." B. * "It's best to keep it in its original container away from heat and light." 80 81 82 83 84 85 86 87 C. "You can put a few tablets in a resealable bag and carry in your pant's pocket." D. "It's best to lock them in the glove compartment of your car to keep them away from heat and light." E. "Keep the tablets locked in a safe place until you need them." Patient teaching regarding sublingual nitroglycerin should include which of the following statements: A. "You can take up to five doses every 3 minutes for chest pain." B. "Chew the tablet for the quickest effect." C. "Keep the tablets locked in a safe place until you need them." D. * "Sit or lie down after you take a nitroglycerin tablet to prevent dizziness." E. "You can protect it from heat by placing the bottle in an ice chest." What is the best way to prevent tolerance to nitrates when using the transdermal patches? A. Leave the old patch on for 2 hours when applying a new patch B. Apply a new patch off for 24 hours once a week C. Leave the patch off for 24 hours once a week D. * Remove the patch at night for 8 hours, and then apply a new patch in the morning E. Leave the patch off for 12 hours once a week An annoying side effect of ACE inhibitors that may be minimized by switching to an angiotensin receptor blocking agent includes: A. Orthostatic hypotension B. * A dry, nonproductive cough C. Fatigue D. Hypokalemia E. Hyperkalemia Which of the following should not be taken concurrently with ACE inhibitors? A. Lasix B. Morphine C. * Potassium D. Natrium E. Vicasolum Inhibits 3-hydroxy-3-methylglutaryl CoA reductase, the rate-limiting step in cholesterol synthesis: A. * Lovastatin B. Niacin C. Cholestyramine D. Clofibrate E. Probucol The doctor would plan to administer which of the following calcium channel blocking agents to a patient with cerebral arterial spasms following a subarachnoid hemorrhage? A. amlodipine (Norvasc) B. diltiazem (Cardizem) C. * nimodipine (Nimotop) D. verapamil (Calan) E. furosemidum When explaining different medication regimens to treat hypertension during a community education program, it would be accurate to state that African-Americans probably respond best to which combination of medications? A. ACE inhibitors and diuretics. B. * Diuretics and calcium antagonists C. Diuretics and beta-blockers D. ACE inhibitors and beta-blockers E. All of the above Labetalol and carvedilol are classified as: A. Beta-blocking agents B. Alpha1-blocking agents C. * Combined alpha- and beta-blocking agents 88 89 90 91 92 93 94 95 96 D. Calcium channel blockers E. Fibrinolytics The pharmacist would monitor for reflex tachycardia in a patient receiving which classification of antihypertensive agents? A. Calcium channel blockers B. Cardioselective beta-blockers C. Nonselective beta-blockers D. * Direct-acting vasodilators E. Neuroleptics ACE inhibitors and angiotensin receptor blockers both work to decrease blood pressure by: A. Preventing the formation of angiotensin II B. Enhancing sodium and water resorption C. Increasing the breakdown of bradykinin D. * Inhibiting aldosterone secretion E. All of the above Which one of the following drugs is useful in treating tachycardia? A. Phenoxybenzamine B. Isoproterenol C. Phentolamine D. * Propranolol E. Prazosin What diuretic has potassium-sparing action? A. Furosemide B. Mannitol C. Dihlothiazid D. * Triamterene E. Urea Equilibrium between plasma and tissue levels for quinidine is reached: A. * in 1 or 2 days B. in approximately 1 wk C. in 1–3 wk D. in just a few minutes E. in 2 h What diuretic is used for forced diuresis? A. Dihlothiazid B. Triamterene C. Spironolactone D. * Furosemide E. Diacarb What diuretic is belonging to osmotic diuretics? A. Spironolactone B. * Mannitol C. Furosemide D. Dihlothiazid E. Triamterene The patient has cranial trauma. The brain edema threat developed in the postoperative period. To prescribe drug for the removal of this complication. A. Spironolactone B. Papaverini hydrochloride C. * Furosemide D. Dihlothiazid E. Diacarb Equilibrium between plasma and tissue levels for amiodarone is reached: A. * in 1–3 wk B. in 1 or 2 d C. in approximately 1 wk D. in just a few minutes E. in 2 h 97 Equilibrium between plasma and tissue levels for IV lidocaine is reached: A. * in just a few minutes B. in 1 or 2 d C. in approximately 1 wk D. in 1–3 wk E. in 2 h 98 Drowsiness, paresthesias, muscle twitching, convulsions, changes in mental status (eg, confusion), hypersensitivity reactions (eg, urticaria, edema, anaphylaxis) – adverse effects of: A. * Lidocaine B. Phenytoin C. Propranolol D. Disopyramide E. Verapamil 99 Adverse effects of nitrates are: A. * hypotension, dizziness, tachycardia B. bradycardia, bronchospasm, heart failure C. peripheral edema, headache, heart failure D. nausea and constipation E. lightheadedness, weakness, peripheral edema 100 GI problems—nausea, vomiting, flatulence, constipation or diarrhea, abdominal discomfort are the most common adverse effects of: A. * dyslipidemic drugs B. calcium channel blockers C. beta-adrenergic blocking agents D. nitrates E. all of the above 101 Which of the following adverse effects is associated with nitroglycerin? A. Bronchospasm B. * Throbbing headache C. Bradycardia D. Sexual dysfunction. E. Anemia. 102 All of the following statements concerning nitroglycerin are correct EXCEPT: A. It causes an elevation of intracellular cGMP. B. It undergoes significant first-pass metabolism in the liver. C. It may cause significant reflex tachycardia. D. * It can not cause throbbing headache. E. It can cause postural hypotension. 103 Which of the following adverse effects is associated with nitroglycerin? A. Hypertension B. * Increasing of intracranial pressure C. Bradycardia D. Sexual dysfunction. E. Anemia. 104 Nitroderm is used: A. Antiarrhythmic action is via (-adrenergic blockade B. Ventricular premature depolarizations C. * Angina pectoris prophylaxis D. Conversion of atrial fibrillation to sinus rhythm E. Treatment of ventricular fibrillation 105 Which one of the following is a specific alpha-adrenergic antagonist: A. Atenolol B. Timolol C. Labetalol D. * Terazosin E. Sotalol 106 Agent, that inhibits 3-hydroxy-3-methylglutaryl CoA reductase, the rate-limiting step in cholesterol synthesis: A. * Pravastatin B. Niacin C. Cholestyramine D. Clofibrate E. Probucol 107 Adverse effects of organic nitrates are: A. nausea and constipation B. bradycardia, bronchospasm, heart failure C. peripheral edema, headache, heart failure D. * throbbing headache, dizziness, tachycardia E. lightheadedness, weakness, peripheral edema 108 What diuretic is used for the removal of hypertensive crisis? A. Dichlothiazide B. * Furosemide C. Spironolactonum D. Mannitum E. Triamteren 109 Indicate the antiarrytmic drug from of adrenoblockers group A. Nitroglycerin B. Amiodaron C. * Metoprolol D. Verapamil E. Asparcam 110 The drug related to the group of calcium antagonists A. Apressinum B. Prazosinum C. * Amlodipine D. Reserpine E. Papaverini hydrochloridum 111 Factors causing a susceptibility to urinary tract infect include: A. urinary tract obstruction B. diabetes mellitus C. pregnancy D. * All of the above E. None of the above 112 In the nephrotic syndrome: A. the prognosis is better in males than in female patients B. * a generalized edema is present, favourable treatment includes the management of any underlying disease C. an intermittent microscopic hematuria suggests advanced parenchymal damage D. the administration of steroids is always ineffective E. All of the above 113 Mechanism of action of cardiac glycosides A. B. C. D. E. Block the activity of COX2 Cause the dilatation of coronary vessels Block the beta-adrenoreceptors Block the calcium channels * Block the activity of adenosine-tryphosphatase (ATP-ase) 114 Dose of which of the following may not be altered with deranged value of GFR? A. * Cefipime B. Cefoperazone C. Cefuroxime D. Tetracycline E. All of the above 115 A drug that can selectively supress automaticity in Purkinje fibers compared to the sinus node: A. verapamil B. atenolol C. diltiazem D. propranolol E. * lidocaine 116 Carbonic anhydrase inhibitor A. furosemide (Lasix) B. bumetanide (Bumex) C. * acetazolamide (Diamox) D. chlorothiazide (Diuril) E. spironolactone (Aldactone) 117 About 35% of the filtered load of sodium chloride is reabsorbed here: A. thin limb -- --loop of Henle B. collecting duct C. distal convoluted tubule D. * thick ascending limb -- loop of Henle E. cortical collecting tubule 118 A drug, or class of drugs, that has been documented to reduce mortality following a myocardial infarction: A. Class Ia antiarrhythmics B. Class Ic antiarrhythmics C. * Class II antiarrhythmics D. Class III antiarrhythmics E. digoxin 119 Mechanism of action: spironolactone (Aldactone) A. through osmotic effects B. through enzyme inhibition C. * through interaction with hormonal receptors D. all of the above E. none of the above 120 GI upset, tinnitus and cinchonism are common side effects of: A. lidocaine B. digoxin C. propranolol D. * quinidine E. amiodarone 121 Diuretics acting on specific membrane transport proteins: A. loop diuretics B. thiazides C. amiloride (Midamor) D. triamterene (Dyrenium) E. * all of the above 122 An antiarrhythmic drug with the most "non-selective" mechanism of action: A. lidocaine B. Quinidine C. Propranolol D. Sotalol E. * amiodarone 123 Diuretic mechanism(s): A. through osmotic effects (preventing water reabsorption) B. enzyme inhibition C. interaction with hormonal receptors D. * all of the above E. none of the above 124 Loop diuretics -- effects on ionic excretion: A. * increased sodium excretion, increased calcium loss B. decreased magnesium loss C. decreased potassium loss D. all of the above E. none of the above 125 A primary mechanism by which Class I antiarrhythmic drugs produce their therapeutic effect in patients with ventricular arrhythmias: A. Block L-type Ca channels B. Block beta-adrenergic receptors C. * Increase the Effective Refractory Period D. Increase vagal tone to the AV node E. Increase the dispersion of refractoriness 126 Primary indications for treatment of cardiac arrhythmias include all of the following EXCEPT: A. * Arrhythmias that reduce cardiac output B. Arrhythmias that are prone to degenerate into more serious arrhythmias C. Arrhythmias that cause vascular stasis D. Arrhythmias that increase the risk of stroke E. Monomorphic premature ventricular beats 127 A side effect of furosemide that can increase the automaticity of ectopic cardiac pacemakers: A. hypercalcemia B. hyperkalemia C. * hypokalemia D. hyponatremia E. hypothyroidism 128 In the treatment of exertional angina: A. * nitroglycerin reduces O2 demand by decreasing preload B. nitroglycerin increases O2 supply by dilating atherosclerotic vessels C. attacks frequently occur during sleep D. nitroglycerin increases cardiac myocyte cAMP levels E. beta blocking agents have no beneficial action 129 Diltiazem: A. * decreases calcium entry through L type channels B. increases total peripheral resistance C. increases cardiac output D. increases heart rate E. increases gastrointestinal motility 130 A drug effect that is produced by therapeutic doses of both propranolol and amiodarone is blockade of: A. cardiac Na channels B. C. D. E. cardiac K channels * beta-adrenoceptors alpha-adrenoceptors L-type Ca channels 131 The most common cellular mechanism responsible for production of cardiac arrhythmias in patients with ischemic heart disease: A. * Hypokalemia B. depressed automaticity C. sick sinus syndrome D. reentrant excitation E. hormonal imbalance 132 Mechanism of action: acetazolamide (Diamox) A. through osmotic effects B. * through enzyme inhibition C. interacting with hormonal receptors D. all of the above E. none of the above 133 In a patient with a high risk for coronary artery disease (LDL cholesterol 200 mg/dL, normal tryglycerides), the best lipid lowering drug would be: A. nicotinic acid B. gemfibrozil C. atorvastatin D. colestipol E. * cholestyramine 134 Pharmacological blockade of sodium and chloride cotransport at the distal convoluted tubule: A. bumetanide (Bumex) B. furosemide (Lasix) C. * chlorothiazide (Diuril) D. triamterene (Dyrenium) E. none of the above 135 What diuretic has potassium-sparing action? A. Urea B. Furosemide C. Mannitol D. Dihlothiazid E. * Triamterene 136 Indicate the antiarrythmic drug which exerts membrane-stabilizing action. A. Atenolol B. * Quinidine sulfate C. Nitroglycerin D. Digoxin E. Isadrinum 137 What diuretic is used for forced diuresis? A. Dihlothiazid B. Triamterene C. Spironolactone D. * Furosemide E. Diacarb 138 Nitrates relieve angina pain by reducing preload, which is: A. * Oxygen demand of the heart B. Pressure within the heart C. Blood volume within the heart D. Pressure against which the heart must pump E. Contractility of the heart muscle 139 What diuretic is belonging to thiazide diuretics? A. Spironolactone B. Mannitol C. Furosemide D. * Dihlothiazid E. Triamterene 140 Acetazolamide (Diamox) A. inhibits carbonic anhydrase B. may produce metabolic acidosis C. increases potassium secretion D. * all of the above E. none of the above 141 Indicate the Verapamil possible side effect, as antiarrhythmic drug A. Tachycardia B. Bronchospasm C. Stenocardia D. Mouth dryness E. * Decrease of artery pressure (hypotension) 142 Osmotic diuretic is A. furosemide (Lasix) B. bumetanide (Bumex) C. * mannitol (Osmitrol) D. thiazides E. None of the above 143 Nifedipine and verapamil both A. * cause coronary vasodilation B. depress atrioventricular nodal conduction C. cause reflex tachycardia D. stimulate calcium entry into cells 144 Primary site of action of loop diuretics: A. distal tubule B. collecting duct C. thin descending limb of the loop of Henle D. * thick ascending limb of the loop of Henle E. at the site of glomerular filtration 145 Loop diuretics are: A. * rapidly absorbed B. eliminated by renal secretion only C. eliminated by glomerular filtration only D. loop diuretics act on the interstitial side of the principal cell E. indomethacin (Indocin) increases loop diuretic clearance 146 Which of the following agents is selective for beta1-adrenergic receptor? A. Metaproterenol B. Propranolol C. * Metoprolol D. Terbutalin E. Timolol 147 Loop diuretics: Effects on magnesium and calcium excretion A. increase in magnesium secretion B. increase in calcium secretion C. hypomagnesemia in patients (prolonged loop diuretic use) D. No hypocalcemia in patients (prolonged loop diuretic use) E. * all of the above 148 Selective blockade of beta1-adrenergic receptors: A. Labetalol B. Prazosin C. Timolol D. * Atenolol E. Sotalol 149 Furosemide (Lasix) toxicity: A. * ototoxicity B. hypouricemia C. hypermagnesemia D. severe fluid overload E. hypernatremia 150 Agent is a specific alpha-adrenergic antagonist: A. * Prazosin B. Timolol C. Labetalol D. Atenolol E. Sotalol 151 Indicate the peculiarility of Furosemide action A. Slow effect development B. * Fast effect development C. The duration of action (10-14 days) D. Low diuretic activity E. It doesn’t influence K concentration in the blood 152 Indicate the diuretic of immediate diuretic action influencing the ascending part of Henle loop: A. Euphyllinum B. Spironolactonum C. * Furosemidum D. Triamterenum E. Diacarbum 153 Labetalol is: A. * a selective alpha-adrenergic antagonist as well as a nonspecific beta-adrenergic antagonist B. is a specific alpha-adrenergic antagonist C. is a nonspecific beta-adrenergic antagonist D. is a selective beta1-adrenergic blocker E. Neither 154 To indicate marching 8-oxychinoline for the medical treatment of urinary infections. A. Rifampine B. * Nitroxoline C. Biseptol D. Ampicilline E. Furosemide 155 Which of the following agents is pure beta1-adrenergic agonists? A. Albuterol B. Propranolol C. * Bisoprolol D. Isoproterenol E. Timolol 156 To indicate quinolone derivated , which is used mainly at infections of urinary tract. A. * Nalidixic Acid B. Biseptol C. Furosemide D. Aspirine E. All of the above 157 Weakness or dizziness, especially with activity or exercise – adverse effects of: A. * Propranolol B. Phenytoin C. Lidocaine D. Disopyramide E. Verapamil 158 Adverse effects of beta-adrenergic blocking agents are: A. * bradycardia, bronchospasm, heart failure B. hypotension, dizziness, lightheadedness C. headache, heart failure, pulmonary edema, D. nausea and constipation E. hypotension, dizziness, tachycardia 159 Adverse effects of calcium channel blockers are: A. * dizziness, lightheadedness, peripheral edema, constipation B. bradycardia, bronchospasm, heart failure C. hypotension, tachycardia, headache D. palpitations and headache E. hypotension, dizziness 160 Calcium channel blockers with prolong action: A. Nifedipine B. Verapamil C. Diltiazem D. * Amlodipine E. Nebivolol 161 Which of the following agents is selective for beta1-adrenergic receptor? A. Metaproterenol B. Propranolol C. * Nebivolol D. Terbutalin E. Esmolol 162 Call calcium channel blockers with prolong action: A. * Felodipine B. Verapamil C. Diltiazem D. Nifedipine E. Nebivolol 163 Amlodipine and verapamil both A. * cause coronary vasodilation B. depress atrioventricular nodal conduction C. cause reflex tachycardia D. stimulate calcium entry into cells 164 Which of the following agents is selective for beta1-adrenergic receptor? A. Salmeterol B. Propranolol C. * Bisoprolol D. Terbutalin E. Timolol 165 Which one of the following drugs is useful in treating tachycardia? A. * Bisoprolol B. Isoproterenol C. Phentolamine D. Phenoxybenzamine E. Prazosin 166 Weight gain & edema occur in patients with congestive heart failure in response to: A. * increased aldosterone levels B. increased diuresis C. decreased renin levels decreased total peripheral resistance D. decreased venous capacitance 167 The mechanism by which digoxin causes a positive inotropic effect on heart tissue is by: A. increasing ATP hydrolysis B. stimulating the Na/K pump C. * increasing intracellular Na and Ca D. sensitizing the heart to catecholamines E. inhibiting the Na/H exchanger 168 A drug that is NOT known to increase the effect or toxicity of digoxin when given concominantly: A. furosemide B. verapamil C. amiodarone D. * propranolol E. quinidine 169 A drug used in the treatment of systolic congestive heart failure and produces its effects by inhibiting the cardiac Na/K pump: A. Furosemide B. Nifedipine C. captopril D. clonidine E. * digoxin 170 In the treatment of congestive heart failure, choose a drug that would reduce dyspnea and pulmonary edema by decreasing the left ventricular preload: A. Hydralazine B. propranolol C. * isosorbide dinitrate D. Dobutamine E. digoxin 171 Sodium nitroprusside: A. * is used to lower blood pressure in a hypertensive emergency B. increases smooth muscle cAMP levels C. has a slow onset and long duration of action D. is given orally E. inhibits nitric oxide formation 172 To indicate the antihypertensive drug used for the medical treatment of hypertensive disease with tachycardia and extrasystoles. A. Reserpinum B. Methyldopa C. * Bisoprolol D. Clophelinum E. Dibazolum 173 To indicate the possible side effect of propranolol? A. * Bronchial spasm B. Tachycardia C. Ortostatic collapse D. Rise of АP E. Development of tolerance 174 To indicate an antihypertensive drug from the calcium channels blockers. A. B. C. D. E. Anaprilinum Captopril Dibazolum * Nifedipine Reserpinum 175 Acebutolol is A. * Beta-adrenoreceptor antagonist B. Calcium channel blocker C. Beta-adrenoreceptor agonist D. Angiotensin II receptor antagonists E. ACE inhibitor 176 The patient suffer from hypertensive disease with bradiarrhythmia. What drug is necessary to prescribe? A. Papaverinum B. Platyphyllini hydrotartras C. Ceftriaxone D. * Methyldopa E. Paracetamol 177 Indicate the Verapamil possible side effect, as antiarrhythmic drug A. Tachycardia B. Bronchospasm C. Stenocardia D. Mouth dryness E. * Decrease of artery pressure (hypotension) 178 What diuretic has potassium-sparing action? A. Furosemide B. Mannitol C. Dihlothiazid D. * Triamterene E. Urea 179 What diuretic is used for forced diuresis? A. Dihlothiazid B. Triamterene C. Spironolactone D. * Torasemide E. Diacarb 180 Treatment of digoxin overdose may include all the following EXCEPT A. withdrawal of digoxin B. intravenous injection of Fab fragments of digitalis antibodies C. potassium supplements D. antiarrhythmic drugs E. * cholestyramine to break enterohepatic circulation 181 The administration of digoxin to a patient with congestive heart failure results eventually in a decrease in all of the following parameters EXCEPT A. heart rate B. end-diastolic pressure C. arteriolar resistance D. * AV node refractoriness E. renal sodium and water retention 182 Each of the following agents is useful to treat diastolic heart failure EXCEPT: A. lisinopril B. * digoxin C. verapamil D. furosemide E. carvedilol 183 Which of the following maneuvers is the most likely to improve renal perfusion in a patient treated for acute cardiac failure? A. administration of phenylephrine B. administration of propranolol C. injection of esmolol D. * administration of dopamine E. administration of epinephrine 184 The drugs whose international common name ends in - sentan such as bosentan, are: A. ACE (angiotensin converting enzyme) inhibitors B. progestogens C. * antagonists of endothelin receptors D. agonists of adenosine receptors E. directly acting cholinomimetic drugs 185 Clonidine lowers blood pressure: A. by inhibiting alpha-1 adrenergic receptors B. by inhibiting angiotensin converting enzyme C. * by stimulating central alpha-2 adrenergic receptors D. by inhibiting endothelin receptors E. by inhibiting beta-adrenergic receptors 186 Sartan: the drugs whose international common name ends by the suffix - sartan are: A. antineoplastic agents B. antiemetic agents C. antihypertensive drugs D. * angiotensin II receptor antagonists E. enkephalin receptor antagonists 187 Pril: the drugs whose international common name ends in the suffix – pril are: A. anorectics B. inhibitors of type V phosphodiesterases C. * ACE (angiotensin converting enzyme) inhibitors D. agonists of alpha- adrenergic receptors E. antidiarrheal drugs 188 During treatment, a patient develops a drug-induced dry cough. The drugs possibly responsible for this cough are: A. codeine B. diclofenac C. * perindopril D. Acetaminophen E. All of the above 189 A side effect of furosemide that can increase the automaticity of ectopic cardiac pacemakers: A. hypercalcemia B. hyperkalemia C. * hypokalemia D. hyponatremia E. hypothyroidism 190 Antihypertensive drug belonging to the same class: A. Doxazosin (Cardura), prazosin (Minipress), metoprolol (Lopressor) B. * nifedipine (Procardia, Adalat), verapamil (Isoptin, Calan), diltiazem (Cardiazem) C. Clonidine (Catapres), guanabenz (Wytensin),terazosin (Hytrin) D. Lisinopril (Prinvivil, Zestril), fosinopril (Monopril), guanadrel (Hylorel) E. None of the above 191 Mechanism of action: prasosin (Minipress) A. B. C. D. E. * alpha-1 receptor blocker beta receptor blocker phosphodiesterase inhibitor calcium channel blocker none of the above 192 Side effects of this antihypertensive agent includes tachycardia, angina, reversible lupus-like syndrome A. propranolol (Inderal) B. mecamylamine (Inversine) C. * hydralazine (Apresoline) D. Diazoxide (hyperstat) 193 Vasoconstriction, aldosterone secretion, and renin release suppression occur upon activation of the renin-angiotensin-aldosterone system. How would captopril (Capoten) affect these responses? A. * blocks all three B. blocks only vasoconstriction C. blocks all except vasoconstriction D. no effect E. Block renin release 194 Antihypertensive drug LEAST likely to elevate serum lipids: A. propranolol (Inderal) B. metoprolol (Lopressor) C. chlorothiazide (Diuril) D. * diltiazem (Cardiazem) E. Both chlorothiazide and propranolol 195 Mechanism of action: prazosin (Minipress) A. * alpha-1 receptor blocker B. beta receptor blocker C. phosphodiesterase inhibitor D. calcium channel blocker E. none of the above 196 Mechanism of action: diltiazem (Cardiazem) A. phosphodiesterase inhibitor B. * blockade of calcium channels C. alpha-1 receptor antagonists D. beta-1 receptor antagonist E. all of the above 197 I.v. route of administration; few side effects; effective in treating hypertensive crisis: A. nifedipine (Procardia, Adalat) B. * nitroprusside sodium (Nipride) C. nicardipine (Cardene) D. all of the above E. none of the above 198 Total peripheral resistance (TPR) is a determining factor for mean arterial pressure, i.e. Mean arterial pressure (MAP) = cardiac output x total peripheral resistance (TPR). What are correct relationships between norepinephrine, minoxidil, and lisinopril and TPR? A. minoxidil: TPR increases B. fosinopril: TPR increases C. * norepinephrine: TPR increases D. phenoxybenzamine: TPR increases E. None of the above 199 Ganglionic blocker A. prazosin (Minipress) B. hydralazine (Apresoline) C. * mecamylamine (Inversine) D. nicardipine (Cardene) E. None of the above 200 Minoxidil (Loniten) administration produces arteriolar vasodilation with little effect on capacitance vessels. Drug(s) acting similarly: A. nitroprusside sodium (Nipride) B. propranolol (Inderal) C. * hydralazine (Apresoline) D. all of the above E. None of the above 201 Blocks both alpha and beta receptors: A. timolol (Blocadren) B. * labetalol (Trandate, Normodyne) C. propranolol (Inderal) D. diazoxide (Hyperstat) E. all of the above 202 Hypertensive emergencies: indicated using of A. diltiazem (Cardiazem) B. * nitroprusside sodium (Nipride) C. reserpine D. phenylephrine (Neo-Synephrine) E. all of the above 203 ACE inhibitor is A. nifedipine (Procardia, Adalat) B. * captopril (Capoten) C. timolol (Blocadren) D. methyldopa (Aldomet) E. None of the above 204 Antihypertensive: action based on inhibition of norepinephrine release from adrenergic nerve endings: A. propranolol (Inderal) B. * guanadrel (Hylorel) C. mecamylamine (Inversine) D. phentolamine (Regitine) E. None of the above 205 Causes of hypertension: A. Cushing's disease B. oral contraceptives C. acromegaly D. polycystic kidney disease E. * all of the above 206 Starling's Law and related matters: A. As blood volume returning to the hard increases,ventricular dilation is reduced B. Generally, increase preloaded an increase contractility lead to decreased stroke volume C. * According to Starling's Law, increased ventricular stretch usually leads to increased myocardial contractility D. all of the above E. None of the above 207 The most specific agent for prevention of asthma is: A. * Salbutamolum B. Libexinum C. Adrenalini hydrochloridum D. Pertussinum E. Mucaltinum 208 Drugs that may decrease theophylline clearance include: A. * Cimetidine, ciprofloxacin B. ranitidine C. phenytoin D. None of the above E. All of the above 209 Theophylline clearance may be reduced by: A. phenobarbital B. warfarin C. tobacco smoking D. phenytoin E. * ciprofloxacin 210 Factors which are important to consider in selecting a maintenance dose of theophylline in a patient include all of the following EXCEPT: A. smoking history B. concomitant medication administration C. presence of congestive heart failure or cor pulmonale D. presence of hepatic failure E. * presence of renal insufficiency 211 Manifestations of theophylline toxicity may include all of the following EXCEPT: A. tremors B. seizures C. tachyarrhythmias D. vomiting E. * hyperkalemia 212 In the case of an oral overdose of theophylline, clearance may be enhanced by: induction of emesis A. * oral pulse dose charcoal B. administration of cimetidine C. lavage of nasogastric contents D. forced diuresis E. None of the above 213 Regarding its actions, cromolyn is best described as: A. bronchodilator B. anticholinergic C. beta agonist D. * inhibitor of mast cell degranulation E. glucocorticoid 214 Beta-2 selective adrenergic agonists include all EXCEPT: A. terbutaline B. albuterol C. metaproterenol D. * isoproterenol E. pirbuterol 215 Adverse effects of beta-2 adrenergic bronchodilators include all of the following EXCEPT: A. nervousness B. headache C. tachycardia D. tremulousness E. * lethargy 216 Which of the following work through cholinergic receptor antagonism? A. isoetharine B. cromolyn C. ephedrine D. * ipratropium E. salmeterol 217 Which of the following pharmacologic agents antagonize adenosine? A. * theophylline B. glucocorticoids C. cromolyn sodium D. propranolol E. terbutaline 218 Theophylline, ethacrynic acid, and furosemide: A. interfere with active renal tubular reabsorption of sodium B. * increase urine volume C. are not effective in the treatment of congestive heart failure D. decrease excretion of sodium in the urine E. may precipitate in renal tubules and cause acute angiospastic necrosis 219 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 220 Examples of autoimmune diseases A. rheumatoid arthritis B. insulin-dependent diabetes mellitus C. systemic lupus erythematosis D. rheumatoid arthritis & systemic lupus erythematosis E. * all of the above 221 Which of the following asthma severity categories has a treatment including inhaled low-dose steroid, cromolyn, nedocromil, zafirlukast or zileuton? A. Mild intermittent asthma B. * Mild persistent asthma C. Moderated persistent asthma D. Severe persistent asthma E. Exercise-induced asthma 222 Which of the following drugs acts through a cytosolic receptor? A. Cromolyn sodium B. * Beclomethasone C. Zafirlukast D. Omalizumab E. None of the above 223 Which of the following corticosteroids is used for quick relief from asthma? A. Triamcinolone B. * Dexamethasone C. Budesonide D. Beclomethasone E. Fluticasone 224 Which of the following is not true about Salmeterol? A. administered by inhalation B. long acting anti-asthmatic with a duration of 12 hour C. * can lead to transient increase in PaO2, especially in poorly ventilated lung tissue D. associated with improvement in patients homozygous for glycine at the B-16 locus of the betareceptor E. none of the above 225 Which of the following is not true about Ipratropium bromide: A. Anticholinergic agent administered by inhalation B. better bronchodilator than Atropine C. * better anti-asthmatic than Epinephrine D. has no effect on mucocilliary clearance E. none of the above 226 Which of the following is not a quick relief medication for asthma? A. Epinephrine B. Ipratropium bromide C. Prednisolone D. * Flunisolide E. All of the above 227 The following is not true of beta-2 adrenergic agonists: A. cause bronchodilation by decreasing cytosolic Ca2+ B. cause hypotension C. * decrease mucocilliary activity D. decrease bronchial vascular permeability E. increase heart rate 228 Which of the following can be administered orally and by inhalation? A. Epinephrine B. Albuterol C. Pirbuterol D. * Terbutaline E. Isoproterenol 229 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 230 The drug of choice for methicillin-resistant Staphylococcus aureus is: A. oxacillin B. gentamicin C. * vancomycin D. piperacillin E. None of the above 231 Tetracyclines: A. are bacteriostatic in vitro B. are bactericidal in vitro C. are effective against rickettsiae D. * are bacteriostatic in vitro, are effective against rickettsiae E. interfere primarily with cell wall synthesis 232 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 233 Aminoglycosides are: A. excreted renally B. bactericidal C. potentially toxic to the auditory and vestibular portions of the eighth cranial nerve D. potentially nephrotoxic E. * All of the above 234 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 235 Rifampin is used mainly in the treatment of: A. cholera B. typhoid fever C. * tuberculosis D. rickettsial diseases E. pseudomonas infections 236 Impaired vision is an adverse effect of: A. carbenicillin B. * ethambutol C. rifampin D. colistin E. cycloserine 237 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 238 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 239 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 240 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 241 Which of the following antibiotics is most closely associated with the development of ocular toxicity? A. kanamycin B. penicillin G C. tetracycline D. isoniazid E. * ethambutol 242 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 243 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 244 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 245 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 246 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 247 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 248 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 249 Which of the following antitubercular drugs has hyperuricemia as one of its well-documented untoward effects? A. streptomycin B. isoniazid C. cycloserine D. rifampin E. * pyrazinamide 250 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 251 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 252 Rifampicine is used mainly in the treatment of : A. Cholera B. Typhoid fever C. * Tuberculosis D. Rickettsial diseases E. Pseudomonas infections 253 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 254 What agents are antiviral: A. Interferonum B. Biochinolum C. Oxolinum D. Remantadinum E. * Interferonum, Oxolinum & Remantadinum 255 Choose the necessary component of therapy of pneumonia complicated by pleurisy with effusion: A. Inhibitors of proteinases; B. Diuretic; C. * Antibiotics; D. Antiviral therapy; E. Cardiac glycosides. 256 Most common fungal infection in HIV patients A. Cryptococcosis B. * candidiasis C. histoplasmosis D. Neither E. All of the above 257 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 258 Properties of tetracycline (Achromycin): A. B. C. D. E. 259 A. B. C. D. E. 260 A. B. C. D. E. 261 A. B. C. D. E. 262 A. B. C. D. E. 263 A. B. C. D. E. 264 A. B. C. D. E. 265 A. B. C. D. E. 266 A. B. C. inhibitor of bacterial cell wall synthesis * drug of choice in treating typhus cleared primarily by the liver All of the above None of the above Suitable for treatment of bacterial meningitis caused by H. Influenzae: * cefotaxime (Claforan) cephalexin (Keflex) cephalothin (Keflin) cefadroxil (Duricef, Ultracef) None of the above Antibiotic's clearance from the body most likely influenced by severe hepatic disease: Penicillins clindamycin (Cleocin) rifampin (Rimactane) * clindamycin & rifampin None of the above Associated with "gray baby syndrome" which is characterized by pallor, cyanosis, and even death. Tetracyclines * chloramphenicol (Chloromycetin) third-generation cephalosporins Tetracyclines & chloramphenicol None of the above Special concerns in using antimicrobials in newborns and young children: Sulfonamides can be safely given to newborns 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. * 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 None of the above Antibacterials regarded as generally safe to prescribe in pregnancy. Erythromycins Cephalosporins Tetracyclines * Erythromycins & Cephalosporins All of the above Ototoxicity and nephrotoxicity associated with this antibiotic: cefotaxime (Claforan) * amikacin (Amikin) aztreonam (Azactan) ceftriaxone (Rocephin) cefotaxime & amikacin Aminoglycosides antibacterial is Hetacillin Aztreonam * gentamicin (Garamycin) vancomycin (Vancocin) gentamicin & aztreonam FALSE statement about penicillin G treatment of choice for viridans group streptococcal endocarditis. Pen G and Pen V are the two natural penicillins. Pen G can be combined with procaine, extending drug half-life D. * Pen G most effective when given orally E. All of the above 267 Inhibits bacterial cell wall synthesis: A. Streptomycin B. * vancomycin (Vancocin) C. doxycycline (Vibramycin, Doryx) D. gentamicin (Garamycin) E. None of the above 268 Mechanism of action: amoxicillin (Amoxil) 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. interferes with transpeptidation preventing peptidoglycan chain crosslinking & Inhibits protein synthesis 269 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 270 Beta-lactamase inhibitor: A. vancomycin (Vancocin) B. sulbactam C. clavulanate D. * sulbactam & clavulanate E. None of the above 271 Antifungal polyene macrolide that preferentially binds to fungal ergosterol which alters cellular permeability. A. Ketoconazole B. * amphotericin B C. Flucytosine D. Grisefulvin E. Clotrimazole 272 An azole most commonly used for topical treatment of candidiasis: A. amphotericin B B. * clotrimazole C. Griseofulvin D. Flucytosine E. none of the above 273 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 274 Inhibition of fungal squalene epoxidase is this antifungal drug's mechanism of action: A. Ketoconazole B. Fluconazole C. * Terbinafine D. Nystatin E. Ketoconazole & Fluconazole 275 Most potent of the presently available anti-fungal azoles: A. Fluconazole B. * Itraconazole C. Ketoconazole D. Both Fluconazole & Ketoconazole E. None of the above 276 Azole most likely to get into the cerebral spinal fluid: A. Ketoconazole B. Itraconazole C. * Fluconazole D. Both Ketoconazole & Itraconazole E. None of the above 277 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 278 Properties of tetracycline: A. inhibitor of bacterial cell wall synthesis B. * dug of choice in treating typhus C. cleared primarily by the liver D. All of the above E. none of the above 279 Females often complaine: odorless, white or yellow cheesy discharge with itching A. Chalymida B. Syphilis C. Chalmdyia D. * Candidias E. none of the above 280 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 281 Bactericidal drugs that act by inhibiting DNA gyrase A. Aminoglycoside B. * Fluoroquinolones C. Macrolides D. Rifamycins E. Sulfonamides 282 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 283 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 284 Inhibits the formation of folic acid by competing with PABA for dihydropteroate synthase A. Metronidazole B. Rifampin C. * Sulfamethoxazole D. Trimethoprin E. Linezolid 285 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 286 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 287 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 288 Which form of resistance to the effect of antimicrobial drugs is specific to beta-lactam type antibiotics A. Decreased drug uptake B. Methylation of the antibiotic’s receptor C. Decreased metabolic activation D. Altered amount of drug receptor E. * Increased enzymatic destruction of the antibiotic 289 The combination of sulfamethoxazole and trimethoprim is a useful drug for treating urinary tract infections. 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 290 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 291 Which of the following antimicrobial drugs is bactericidal A. Azithromycin B. Doxycycline C. Erythromycin D. * Gentamicin E. Tetracycyline 292 Which of the following antimicrobials 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 293 The drug of choice for methicillin-resistant Staphylococcus aureus is: A. oxacillin B. gentamicin C. * vancomycin D. piperacillin E. None of the above 294 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 295 Which of the following is the general mechanism of action for erythromycin? 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 296 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 297 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 298 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 ?-lactamases. D. * Certain individuals may have an allergic response to it. E. All of the above 299 What crucial feature of a penicillin is involved in its mechanism of action? A. B. C. D. E. Carboxylic acid * beta-lactam ring Acyl side chain Thiazolidine ring All of the above 300 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 301 What drugs are present in the preparation Augmentin? A. Ticarcillin and clavulanic acid B. Ampicillin and sulbactam C. Ampicillin and clavulanic acid D. * Amoxicillin and clavulanic acid E. None of the above 302 Which of the following antibiotics is a macrolide? A. Chloramphenicol B. Doxycycline C. * Erythromycin D. Streptomycin E. None of the above 303 Which of the following antibiotics is a tetracycline? A. Chloramphenicol B. * Doxycycline C. Streptomycin D. Erythromycin E. None of the above 304 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 305 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 306 The most specific agent for treatment of petit mal epilepsy is: A. carbamazepine B. phenytoin C. gabapentin D. * ethosuximide E. primidone 307 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 308 The drug of choice in initiating chronic treatment of grand mal epilepsy is: A. phenobarbital B. ethosuximide C. phenacemide D. diazepam E. * carbamazepine 309 Gingival hyperplasia is a common side effect of: A. procainamide B. * phenytoin C. digitalis D. indomethacin E. guanethidine 310 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 311 Which one of following is an appropriate therapeutic use for imipramine? A. Insomnia. B. Epilepsy C. * Bed—wetting in children D. Glaucoma. E. Mania 312 MAO inhibitors are contraindicated with all of the following EXCEPT: A. Indirect adrenergic agents, such as ephedrine. B. Tricyclic antidepressants. C. Beer and cheese. D. * Aspirin. E. Dopamine. 313 All of the following are observed in patients taking neuroleptic agents EXCEPT: A. Sexual dysfunction. B. * Increased blood pressure. C. Altered endocrine function. D. Constipation. E. Orthostatic hypotension. 314 In the treatment of acute diarrhea A. antibiotics are worst avoided in non-pathogenic diarrhea B. antibiotics are worst avoided in viral gastroenteritis C. oral rehydration should not be used for initial therapy D. electrolytes and glucose should not be supplemented for initial therapy E. * oral rehydration and electrolytes supplementation are required particularly in children and in the elderly 315 Neostigmine will effectively antagonize skeletal muscle relaxation produced by: A. * Tubocurarine B. Succinylcholine C. Diazepam D. Baclofen E. Nicotine 316 The reversible cholinesterase inhibitor indicated in the treatment of Alzheimer disease is: A. * Rivastigmine B. C. D. E. Levodopa Neostigmine Pyridostigmine Acetylcholine Direct-acting cholinomimetic drug that is lipid-soluble and often used in the treatment of glaucoma 317 is: A. Acetylcholine B. Timolol C. Betaxolol D. * Pilocarpine E. Physostigmine 318 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 319 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. * alpha1-adrenergic receptors C. alpha2-adrenergic receptors D. alpha3-adrenergic receptors E. None of the above 320 Which of the following drugs is a selective inhibitor of MAO type B? A. Neostigmine B. Selegiline C. * Bromocriptine D. Carbidopa E. Entacapone 321 The drug of choice for the treatment of anaphylactic shock is: A. * Epinephrine B. Norepinephrine C. Isoproterenol D. Orciprenaline E. Atropine 322 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 323 Which one of the following drugs is a selective beta2-agonist? A. Epinephrine B. Norepinephrine C. * Salbutamol D. Isoproterenol E. Dobutamine 324 The nonselective beta-adrenergic blocking agent that is also a competitive antagonist at alpha1adrenoreceptors is: A. Timolol B. Atenolol C. Propranolol D. Pindolol E. * Carvedilol 325 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 326 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 327 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 328 All the following benzodiazepines are biotransformed to active metabolites EXCEPT: A. Alprazolam B. Diazepam C. * Oxazepam D. Clorazepate E. Chlordiazepoxide 329 Which one of the following is described as a competitive benzodiazepine receptor antagonist? A. Pralidoxime B. Bromazepam C. Midazolam D. Triazolam E. * Flumazenil 330 All the following compounds are indicated for the treatment of psychoses EXCEPT: A. Chlorpromazine B. Risperidone C. * Fluoxetine D. Haloperidol E. Clozapine 331 The preferred treatment of status epilepticus is IV administration of: A. Chlorpromazine B. * Diazepam C. Succinylcholine D. Ethosuximide E. Selegiline 332 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 333 Which one of the following is an antidepressant agent that selectively inhibits serotonin (5HT) uptake? A. B. C. D. E. Selegiline * Fluoxetine Maprotiline Desipramine Amitriptyline 334 Aspirin may be fatal in taken in sufficient quantity. The syndrome of fatal salicyate overdose in children is characterized by A. marked hypotermia secondary to an antipyretic effect B. * fever, tinnitus C. peripheral oedema D. None of the above E. All of the above 335 Common adverse reactions of corticosteroidal therapy are: A. bradycardia, mental dullness B. anorexia, polyuria C. tachycardia, insomnia D. * “moon face”, obese trunk E. All of the above 336 The chemotherapeutic agent also used orally for severe forms of arthritis is A. 5-fluorouracil (5-FU) B. * methotrexate (Mexate) C. cyclophosphamide (Cytoxan) D. cisplatin (Platinol) E. All of the above 337 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 338 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 339 Symptoms of salicylism: A. Tinnitus B. decreased hearing C. vertigo D. None of the above E. * All of the above 340 Phases of inflammation: A. chronic inflammation B. immune response C. acute inflammation D. chronic inflammation & acute inflammation E. * All of the above 341 Released at sites of tissue injury: A. Kinins B. complement components C. cytokines D. neuropeptides E. * all of the above 342 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 343 Mediator in acute inflammation, pain A. Histamine B. Serotonin C. Leukotrienes D. * bradykinin E. none of the above 344 Mediator of chronic inflammation (for example rheumatoid arthritis) A. Histamine B. * interleukin-1 C. Bradykinin D. Neuropeptides E. Serotonin 345 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 346 Initial drug of choice for treating most articular and musculoskeletal disorders (because of low-cost, safety, and efficacy) A. * Aspirin B. Diclofenac C. Indomethacin D. Phenylbutazone E. Glucocorticoids 347 Concerning salicylates: A. sodium salicylate an aspirin: equally effective as anti-inflammatory agents B. aspirin: maybe 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 348 Acute attacks of gouty arthritis may occur early in treatment with allopurinol because: A. allopurinol increases urate synthesis B. * urate crystals move from tissue to plasma C. allopurinol increases release of chemotactic factors D. None of the above E. All of the above 349 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 350 Effective in management of mild to moderate pain, when anti-inflammatory action is not necessary A. penicillamine (Cuprimine) B. sulfasalazine (Azulfidine) C. * acetaminophen (Tylenol, Panadol) D. etodolac (Lodine) E. piroxicam (Feldene) 351 Probably the initial step in acute gouty arthritis attack: A. polymorphonuclear leukocytes migration into the joint B. increased numbers of mononuclear phagocytes (macrophages) C. * urate crystals phagocytosis by synoviocytes D. prostaglandin, lysosomal &, interleukin 1 release E. None of the above 352 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 353 Reduces uric acid synthesis: for management of gout A. colchicine B. probenecid C. sulfinpyrazone (Anturane) D. * allopurinol E. oxaprozin 354 Aspirin mechanism of action: anti-platelet effects: A. promotes platelet aggregation B. activates thromboxane synthesis C. * snhibits thromboxane synthesis D. all of the above E. none of the above 355 Factors accounting for rheumatoid arthritis incidence: A. Genetics B. Climate C. Urbanization D. * All of the above E. None of the above 356 At low doses required to inhibition of thymidylate synthase, an enhanced adenosine release A. Chloroquine B. Gold C. * methotrexate D. cyclophosphamide E. ketorolac 357 Aspirin and antipyresis: A. aspirin -- best available drug for reducing fever (in the absence of contraindications to its use recurrent B. aspirin -- more effective in lowering elevated temperature than normal body temperature C. aspirin-induced temperature reduction is caused by vasodilation D. * All of the above E. None of the above 358 Phases of inflammation: A. acute inflammation B. the immune response C. chronic inflammation D. * All of the above E. None of the above 359 Advantages of other NSAIDs compared with aspirin: A. B. C. D. E. generally less expensive less gastric irritation potentially better compliance (e.g. naproxen, sulindac) generally less expensive & less gastric irritation * less gastric irritation & potentially better compliance (e.g. naproxen, sulindac) 360 Aspirin: A. inhibits prostaglandin synthase B. inhibits cyclooxygenase C. decreases prostaglandin formation D. decreases thromboxane A2 formation E. * All of the above 361 Mediators of chronic inflammation in rheumatoid arthritis: A. IL-1 B. IL-2 C. IL-3 D. TNF alpha E. * All of the above 362 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 363 Approximate prevalence of rheumatoid arthritis: A. * 1 % B. 5 % C. 7 % D. 10 % E. 15 % 364 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 365 NSAID primarily promoted as an analgesic, not as an anti-inflammatory agent: A. Piroxicam B. Ibuprofen C. Naproxen D. * Ketorolac E. Sulindac 366 Drug associated with the hepatic/renal toxic metabolite: N-acetyl-p-benzoquinone A. Diclofenac B. Meclofenamate C. Indomethacin D. * Acetaminophen E. Aspirin 367 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 368 Which of the following describes an agonist? A. substance that brings about a change in biologic function through its chemical action B. * A drug that binds to a receptor and stimulates cellular activity C. A drug that binds to a receptor and inhibits or opposes cellular activity D. A drug directed at parasites infecting the patient E. None of the above 369 What determines the degree of movement of a drug between body compartments? A. Partition constant B. Degree of ionization C. pH D. Size E. * All of the above 370 Which of the following is NOT a protein target for drug binding? A. * Side of action (transport) B. Enzymes C. Carrier molecules D. Receptors E. Ion channels 371 Which of the following is an example of a drug acting directly through receptors? A. Protamine binds stoichiometrically to heparin anticoagulants B. Adrenergic beta blockers for thyroid hormone-induced tachycardia C. * Epinephrine for increasing heart rate and blood pressure D. Cancer chemotherapeutic agents E. Mannitol for subarachnoid hemorrhage 372 What type of drug is propranolol (Inderal)? A. Anticonvulsive B. * Antihypertensive C. Antinauseant D. Antihistamine E. Antipyretic 373 What type of drug is amlodipine? A. * Ca++channel blocker B. Adrenergic beta-blocker C. ACE inhibitor D. Blocks beta-receptors in heart myocardium E. Diuretic 374 Which of the following is considered the class? A. Propranolol B. Inderal C. * Adrenergic beta-blocker D. “off label” use E. Blocks beta-receptors in heart myocardium 375 Which of the following cases would be contraindicated for propranolol (Inderal)? A. Hypertension B. Essential tremor C. Angina D. Tachycardia E. * Asthma 376 Which of the following adverse effects (side-effects) is NOT commonly seen with cholinergic antagonists? A. Blurred vision B. Confusion C. * Miosis D. Constipation E. Urinary retention 377 The drug chloramphenicol (Chloromycetin) is risky for which of the following? A. * Neonates B. Geriatric patients C. Adult males D. Obese patients E. Congestive heart failure patients 378 Which of the following are the two modifying factors that contribute to why women have higher blood peak concentrations of alcohol than men when consuming equivalent amounts? A. Lower blood volume & increased hormones B. Lower fat content & more gastric alcohol dehydrogenase (ADH) C. Higher fat content & more gastric alcohol dehydrogenase (ADH) D. Lower fat content & less gastric alcohol dehydrogenase (ADH) E. * Higher fat content & less gastric alcohol dehydrogenase (ADH) 379 Pharmacokinetics is the effect of the ____ and pharmacodynamics is the effect of the ____. A. Drug on a drug; Body on the drug B. Body on the drug; Drug on a drug C. Drug on the body; Body on the drug D. * Body on the drug; Drug on the body E. Drug on a drug; Drug on a drug 380 Which of the following is NOT an action of the body on a drug? A. Absorption B. Distribution C. Metabolism D. Excretion E. * Side effects 381 If a drug is 80% bound to blood elements or plasma proteins, what part is considered the free form? A. * 20% B. 40% C. 50% D. 80% E. 100% 382 If a patient misses three doses of their daily drug, which of the following (in general) is the best solution? A. Take a 4x dose at the next dose time B. Wait 3 more days (week total) then return to normal regimen C. * Do nothing and continue normal regimen D. Setup an appointment to have the patient evaluated E. Prescribe a higher dosage pill so missed doses will have less effect 383 Which of the following is NOT needed for drug bioequivalence? A. Same active ingredients B. Same strength or concentration C. Same dosage form D. Same route of administration E. * Same side effects 384 For intravenous (IV) dosages, what is the bioavailability assumed to be? A. 0% B. 25% C. 50% D. 75% E. * 100% 385 Although morphine is well-absorbed when administered orally, how much of the drug is metabolized on its first pass through the liver? A. * 90% B. 70% C. 50% D. 30% E. 10% 386 Which of the following is NOT a pharmacokinetic process? A. Alteration of the drug by liver enzymes B. Drug metabolites are removed in the urine C. Movement of drug from the gut into general circulation D. * The drug causes dilation of coronary vessels E. The drug is readily deposited in fat tissue 387 Which of the following can produce a therapeutic response? A drug that is: A. Bound to plasma albumin B. Concentrated in the bile C. Concentrated in the urine D. Not absorbed from the GI tract E. * Unbound to plasma proteins 388 A patient presents with an overdose of acidic Aspirin. The drug ____ can be given to ____ the pH of the urine and trap the Aspirin, preventing further metabolism. A. * NaHCO3; Increase B. NaHCO3; Decrease C. NH4Cl; Increase D. NH4Cl; Decrease E. None of the above 389 A patient presents with an overdose of alkaline Codeine. The drug ____ can be given to ____ the pH of the urine and trap the Codeine, preventing further metabolism. A. NaHCO3; Increase B. NaHCO3; Decrease C. NH4Cl; Increase D. * NH4Cl; Decrease E. None of the above 390 Bioavailability (F) is the fraction or percentage of administered drug that reaches the systemic circulation via a given route as compared to what route? A. Oral B. * IV (intravenous) C. IO (intraosseous) D. CSF (cerebrospinal fluid) E. Whatever route attains the target drug concentration in plasma (CT) 391 What organ is responsible for metabolism in the “first pass effect”? A. Brain B. Heart C. Kidney D. * Liver E. Spleen 392 Which of the following routes of administration is the most convenient, although may have a bioavailability anywhere from 5-100%? A. * PO (oral) B. IV (intravenous) C. IM (intramuscular) D. SQ (subcutaneous) E. Transdermal 393 Which of the following enteral administration routes has the largest first-pass effect? A. SL (sublingual) B. Buccal C. Rectal D. * Oral E. None of the above 394 Which of the following administration routes is not often used, is painful, and has a risk of infection and adhesion? A. EPI (epidural) B. IA (intraarterial) C. * IP (intraperitoneal) D. IV (intravenous) E. IO (intraosseous) 395 Which of the following is NOT an advantage of prolonged release medications? A. Less frequent administration B. Therapeutic effect overnight C. Lower incidence of side effects D. Patient compliance E. * More fluctuation in plasma concentration 396 Which of the following would receive drug slowly? A. Liver B. Brain C. * Fat D. Muscle E. Kidney 397 What type of drugs can cross the blood-brain barrier? A. Large and lipid-soluble B. Large and lipid-insoluble C. * Small and lipid-soluble D. Small and lipid-insoluble E. None of the above 398 Basic drugs, such as lidocaine, bind primarily to which of the following plasma proteins? A. alpha-1-fetoprotein (AFP) B. Gc-Globulin (GcG) C. Albumin D. * alpha 1-acid glycoprotein (AAG) E. Transcortin 399 A decrease in drug-protein binding will lead to which of the following? A. Decrease in the unbound drug concentration B. Increase in free drug C. * Increase in rate of drug elimination D. Decrease in volume of distribution E. None of the above 400 Which of the following locations can accumulate lipid-soluble drugs, has little or no receptors, and can hold distributed drugs like barbiturates? A. Liver B. Kidney C. Brain D. * Fat E. Fetus 401 Which of the following locations has high blood flow and is a site of excretion? A. Liver B. * Kidney C. Brain D. Fat E. Fetus 402 What is the approximate lag time for equilibration between maternal blood and fetal tissues? A. 20 mins B. * 40 mins C. 1 hour D. 2 hours E. 6 hours 403 Elderly patients often have ____ muscle mass and thus a(n) ____ Vd (volume of distribution). A. More; Increased B. More; Decreased C. Less; Increased D. * Less; Decreased E. None of the above 404 Most drugs are active in their ____ form and inactive in their ____ form. A. * Non-polar; Polar B. Polar; Non-polar C. Water-soluble; Lipid-soluble D. Lipid-insoluble; Water-insoluble E. Neutral; Neutral 405 Which of the following metabolically active tissues is the principle organ for drug metabolism? A. Skin B. Kidneys C. Lungs D. * Liver E. GI Tract 406 What is the goal of the P450 system (microsomes pinched off from endoplasmic reticulum)? A. Metabolism of substances B. Detoxification of substances C. Increasing pH of compartments containing substances D. Decreasing pH of compartments containing substances E. * Metabolism of substances & Detoxification of substances 407 The direct-acting plasminogen activator is: A. streptokinase B. * urokinase C. epsilon-aminocaproic acid D. anistreplase E. heparin 408 The antithrombotic drug which inhibits cyclooxygenase enzymes is: A. prednisone B. dipyridamole C. tranexamic acid D. * aspirin E. ticlopidine 409 The mechanism of action of mini-dose heparin is correctly described by: A. factor X is more sensitive to heparin than are other serine protease factors B. mini-dose heparin is useful prophylactically rather than during active clot formation C. by inhibiting factor X activation, a relative block of the clotting cascade develops, with less thrombin formed D. * All of the above E. None of the above 410 The correct statement about fibrinolytic agents is: A. B. C. D. E. 411 A. B. C. D. E. 412 A. B. C. D. E. 413 A. B. C. D. E. 414 A. B. C. D. E. 415 A. B. C. D. E. 416 A. B. C. D. E. 417 A. B. C. D. E. 418 A. B. C. D. E. streptokinase acts directly to activate plasminogen * urokinase acts directly to activate plasminogen tissue-type specific plasminogen activator is more fibrin specific than streptokinase side effects of t-PA include skin rash, allergic reactions, and development of antibodies have been shown to increase mortality when given in the setting of an acute myocardial infarction Following drugs stimulate erythrogenesis EXCEPT: Iron dextran Vitamine B12 * Methotrexate Folic acid Aspirin Which drug does not influence leucopoiesis? Filgrastim * Erythropoetin Doxorubicin Methotrexate All of the above Iron deficiency anemia leads to: pallor fatigue dizziness exertional dyspnea * All of the above Tick the drug for parenteral iron therapy: Ferrous sulfate * Fercoven Ferrous lactate Ferrous fumarate All of the above Indicate the drug which increases absorption of iron from intestine: Cyanocobalamin Folic acid * Ascorbic acid Erythropoetin All of the above The drugs used for oral administration EXCLUDE: Ferrous sulfate * Fercoven Ferrous lactate Ferrous fumarate None of the above Pernicious anemia is developed due to deficiency of: Erythropoetin * Vitamin B12 Iron Vitamin B6 Vitamin C Select the drug used for pernicious anemia: Ferrous lactate * Cyanocobalamin Iron dextran Ferrous gluconate Vitamin E 419 A. B. C. D. E. 420 A. B. C. D. E. 421 A. B. C. D. E. 422 A. B. C. D. E. 423 A. B. C. D. E. 424 A. B. C. D. E. 425 A. B. C. D. E. 426 A. B. C. D. E. 427 A. B. C. D. An adverse effect of oral iron therapy is: Anemia Thrombocytopenia Headache * Constipation Hypertension Choose the drug which contains cobalt atom: Folic acid Iron dextran * Cyanocobalamine Ferrous gluconate Furosemid Tick the drug used in aplastic anemia: Fercoven Cyanocobalamine * Epoetin alpha Folic acid Methotrexate Folic acid is recommended for treatment of: * Megaloblastic anemia Shock Hypertension Leukemia None of the above Select the drug of granulocyte colony-stimulating factor: * Filgrastim Methotrexate Erythropoetin Doxorubicin Methotrexate All of the following groups of drugs are for thrombosis treatment EXCEPT: Anticoagulant drugs * Antifibrinolitic drugs Fibrinolitic drugs Antiplatelet drugs None of the above Pick out the drug belonging to anticoagulants of direct action: Aspirin * Heparin Dicumarol Phenprocoumon None of the above Tick the drug used as an oral anticoagulant: Heparin Daltreparin * Dicumarol Enoxaparin Fraxiparin Which of the following drugs has low-molecular weight? Dicumarol * Enoxaparin Phenprocoumon Heparin E. Aspirin 428 Indicate the drug belonging to antagonists of heparin: A. Aspirin B. Dicumarol C. Dalteparin D. * Protamine sulphate E. Iron dextran 429 All of the following drugs are indirect acting anticoagulants EXCEPT: A. Dicumarol B. Warfarin C. * Dalteparin D. Phenindione E. None of the above 430 Which of the following drugs belongs to coumarin derivatives? A. Heparin B. Enoxaparin C. Dalteparin D. * Warfarin E. Aspirin 431 Heparin is effective when administred: A. Orally B. * Parenterally C. Sublingually D. All of the above E. None of the above 432 All of these drugs are antiplatelet agents EXCEPT: A. Aspirin B. * Urokinase C. Ticlopidine D. Clopidogrel E. Dipiridamol 433 Mechanism of aspirin action is: A. Converts inactive plasminogen into active plasmin B. * Inhibits COX and thus thromboxane synthesis C. Enhances the interaction between antitrombin III and both thrombin and the factors involved in the intrinsic clotting cascade D. Inhibits the glycoprotein IIb/IIIa complex E. All of the above 434 Which of the following drugs is an inhibitor of platelet glycoprotein IIb/IIIa receptors? A. Aspirin B. Clopidogrel C. Ticlopidine D. * Abciximab E. Heparin 435 Which of the following drugs is fiibrinolytic? A. Ticlopidine B. * Streptokinase C. Aspirin D. Warfarin E. Heparin 436 Fibrinolytic drugs are used for following EXCEPT: A. Central deep venous thrombosis B. Multiple pulmonary emboli C. * Heart failure D. Acute myocardial infarction E. All of the above 437 Indicate the drug belonging to fibrinoliytic inhibitors: A. * Aminocapronic acid B. Ticlopidine C. Streptokinase D. Vitamin K E. Vitamin C 438 Aminocapronic acid is a drug of choice for treatment of: A. Acute myocardial infarction B. * Bleeding from fibrinolytic therapy C. Heart failure D. Multiple pulmonary emboli E. All of the above 439 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 440 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 441 Correct statement regarding metoclopramide: A. central nervous system dopamine receptor agonist B. peripheral blockage of acetylcholine at muscarinic synapse C. decreases lower esophageal sphincter pressure D. * adverse effects include dystonic or extrapyramidal effects E. increases motility of colon 442 In general, mechanisms of laxation include: A. adding bulk to the stool B. increasing peristaltic activity C. emulsifying aqueous and fatty substances with stool D. lubricating the passage of stool E. * All of the above 443 Appropriate indications for and/or uses of laxatives include: A. prevent straining at the stool in patients with cardiovascular disease B. bulk forming agents for diverticular disease C. treatment of drug overdose D. * All of the above E. None of the above 444 Which of the following substances is most likely to cause systemic alkalosis? A. * sodium bicarbonate B. methylcellulose C. sodium phosphate D. castor oil E. mineral oil 445 Saline cathartics, such as sodium sulfate or magnesium sulfate: A. are safe in patients with renal failure B. C. D. E. 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 446 Adverse effect(s) of laxatives: A. electrolyte disturbances (hypernatremia, hypokalemia) B. dehydration C. spastic colitis with stimulant laxatives D. gastrointestinal obstruction with bulk forming agents E. * All of the above 447 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 448 Drug which exerts anti-peptic ulcer effects through histamine-2 receptor antagonism: A. sucralfate B. ranitidine C. metoclopramide D. * omeprazole E. misoprostol 449 The substance which is principally an emollient laxative is: A. bran B. methylcellulose C. magnesium hydroxide D. phenolphthalein E. * mineral oil 450 Laxatives may aid in the treatment of portal systemic encephalopathy by: A. increasing stool pH B. increasing coliform bacteria C. * decreasing protein contact time with GI mucosa D. All of the above E. None of the above 451 Agents of potential use in peptic ulcer disease include: A. muscarinic antagonists B. proton pump inhibitors C. antacids D. prostaglandins E. * All of the above 452 Possible drug interactions: Aluminium hydroxide antacids tend to interfere with the gastrointestinal absorption of: A. cephalexin B. penicillin G C. erythromycin D. chloramphenicol E. * tetracycline 453 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 454 An agent which promotes defecation without increasing peristalsis is: A. castor oil B. phenolphthalein C. * docusate sodium D. cascara E. milk of magnesia 455 Cimetidine reduces the clearance of all of the following EXCEPT: A. theophylline B. phenytoin C. warfarin D. * digoxin 456 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 457 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 458 One mechanism to reduce gastric acid secretion is by blocking the K+-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 459 The amount of sodium, phosphate or magnesium contained in an antacid should be assessed when selecting an antacid for patients with: A. renal insufficiency B. congestive heart failure C. ascites D. * All of the above E. None of the above 460 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 461 Which of the following substances has its major activity as a saline cathartic? A. Sodium bicarbonate B. Aluminium hydroxide C. * Magnesium sulfate D. Calcium carbonate E. All of the above 462 In general, mechanisms of laxation include A. adding bulk to the stool B. increasing peristaltic activity C. emulsifuing aqenons and fatty substances with stool D. lubricating the passage of stool E. * all of the above 463 Drug which exerts anti-peptic effects through histamine-2 receptor antagonism: A. Denol B. * Ranitidine C. Omeprasole D. Aluminium hydroxide E. All of above 464 For treatment of heartburn patient regularly used some powder. After a week of drug using vomiting, nausea, abdomen pain, fibrillation, shallow and slow breathing, alkalosis. What drug used patient? A. * Natrii hydrocarbonas B. Aluminium hydroxide C. Magnesium sulfate D. Omeprasole E. Calcium carbonate 465 All these Drugs are cause obstipation Except: A. Anticholinergic agents B. Ca channel antagonists C. Opioids D. Tricyclic antidepressants E. * Muscarinic agonists 466 Plant fiber (a laxative, purgative) A. Decrease the bulk of the stools B. increases the bowel transit time C. * slowly distends the wall of the colon D. increases the effective caloric content of the diet E. takes down water and swells 467 Lactulose A. is a monosaccharide B. 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 468 Lactulose is of particular value in the treatment of encephalopathy: A. * as it discourages the proliferation of ammonia producing organisms B. as it increases the absorption of ammonia C. as it decreases chronic portal hypertension D. as it treatment fever E. as it improves functions of CNS after absorption from the GIT 469 Magnesium sulfate A. is a laxative which acts within 1-2 days B. dilates the gallbladder and relaxes the sphincter of Oddi C. decreases the secretion of cholecystokinin D. decreases gastric, intestinal and pancreatic secretion E. * should be given in dilute solution to a fasting individual 470 Senna alcaloids (anthraquinones, the sennosides A and B) A. * act directly on the intramucosal plexus of the gut wall B. take about 8 minutes to produce an effect C. should be given to pregnant women D. should be given to nursing mothers E. can not induce diarrhea with excessive loss of water and electrolytes 471 Glycerol (in the form of rectal suppositories) A. is useless if a rapid effect is required B. * acts as a rectal stimulant due to local irritant action C. cannot be used in children D. rectal suppositories promote colonic evacuation in 30 hours E. exerts severe diarrhea with loss of water and electrolytes 472 All these drugs are increasing intestinal transit time Except: A. codeine (an opioid) B. morphine (an opioid) C. loperamide D. diphenoxylate E. * fysostigmin 473 Peptic ulcer disease A. is an acute disorder B. * characterized by frequent recurrences C. comprises bones D. the incidence of duodenal ulcers is four to five times lower than that of gastric ulcer E. affects approximately 50% of the population 474 All these are major factors of known importance for the etiology of ulceration Except A. acid-pepsin secretion B. mucosal resistance to attack by acid and pepsin C. * the age D. effects of non-steroidal anti-inflammatory drugs E. the presence of Helicobacter pylori 475 Acid secretion A. is produced by endocrine cells in the gastric antrum cells B. * is stimulated by gastrin C. is inhibited by acetylcholine D. is inhibited by histamine E. is stimulated by prostaglandin E 476 Antacids: A. * react with gastric acid to form a neutral salt B. produce sweating C. are Ineffective at healing duodenal ulcer D. are very effective at healing gastric ulcers E. its effect on acid secretion lasts for long (5 hours) 477 Antacids include: A. balsalazide B. orlistat C. cimetidine D. sucralfate E. * aluminium salts (hydroxide, phosphate, glycinate) 478 Sodium bicarbonate (an antacid) A. acts only locally B. * excessive doses produce systemic alcalosis C. produces carbon monoxide by reacting with hydrochloric acid D. causes belching and distension of the large intestine E. sodium intake need not to be considered in patients with hypertension or heart failure 479 Magnesium and aluminium salts A. do undergo absorption so are effective locally B. magnesium salts are constipating, aluminium salts may produce diarrhea C. can not reduce the rate and extent of absorption of other drugs D. aluminium salts should not be used with caution with any renal compromise E. * magnesium and aluminium salts are taken 1-3 hours after meals and at bedtime 480 H2 lytics: A. at least 4 days treatment is required to achieve healing B. pain is relieved within 4 weeks treatment C. include morphine , tramadol D. * include nizatidine, ranitidine, famotidine E. include pirenzepine 481 Ranitidine (ZANTAC) A. has higher affinity for cytochrome P 450 than cimetidine B. is less expensive than cimetidine C. * is preferable to cimetidine in the elderly D. has a similar profile of action to paracetamol E. increases the plasma levels of theophylline 482 Pirenzepine A. * is an M1 muscarinic receptor antagonist B. can not cause mild difficulty with accomodation and dry mouth C. can not alter the rate of absorption of other drugs if given concurrently D. can be used in patients with concomitant glaucoma E. can be used in patients with pyloric stenosis and prostatic enlargement 483 Omeprazol A. is an irreversible stimulator of the proton pump B. can be used only for healing gastric ulcer C. Is for women only D. is taken once weekly E. * degrades in the presence of moisture. Capsules are supplied in special containers 484 Misoprostol A. * is a synthetic analog of prostaglandin E1 B. produces gastric acid secretion C. causes Stricture in the submucosa D. decreases production of protective mucus E. is indicated especially in pregnancy 485 Sucralfate A. is less effective than cimetidine B. is not so effective in symptom relief C. antacids are contraindicated D. contains aliminium, diarrhea can not be induced E. * in severe renal failure accumulation is a potential hazard. 486 Cisapride A. inhibits motility of the GIT B. decreases rate of gastric emptying C. is not used in gastroesophageal reflux D. * is used in dyspepsia and delayed gastric emptying E. is used in diarrhea 487 Metoclopramide is effective for: A. preoperative vomiting B. vestibular disturbances C. motion sickness D. headache E. * facilitation of duodenal intubation and endoscopy 488 Drugs with a bacteriostatic effect in regular doses include: A. tetracyclines B. C. D. E. None of the above sulfamethoxazole and trimethoprim (Sumetrolim) erythromycin * All of the above 489 The use of which of the following should be avoided in patients receiving monoamino-oxidase inhibitor therapy: A. cheese B. imipramine (Melipramin) C. None of the above D. pethidine (Dolargan) E. * All of the above 490 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 491 Which of the following conditions is associated with true hematuria? A. urinary tract tuberculosis B. acute cystitis C. renal infarction D. none of the above E. * all of the above 492 Which of the following signs can be attributed to an iron deficiency anemia? A. a pale color of the sclera B. hepatosplenomegaly C. glossodynia (pain in the tongue) D. * all of the above E. none of the above 493 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 494 Indications of penicillamine therapy include: A. systemic sclerosis B. primary biliary cirrhosis C. hemosiderosis D. * all of the above E. none of the above 495 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 496 Digitalis therapy: A. is contraindicated in atrial tachycardia B. * elongates the effective refractory period of the AV node C. is likely to cause intoxication with a concomitant hyperkalemia D. is contraindicated in cor pulmonale E. is effective in hypertrophic obstructive cardiomyopathy 497 Possible therapeutic interventions in thyrotoxic crisis include: A. the administration of beta-blockers B. immediate propylthiouracil treatment C. the administration of iodine D. * all of the above E. none of the above 498 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 499 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 500 Megaloblastic anemia is a possible side-effect of: A. carbamazepine therapy B. primidone (Sertan) therapy C. methotrexate therapy D. sulfamethoxazole and trimethoprim (Sumetrolim) therapy E. * all of the above 501 Possible initial symptoms of diabetes mellitus include: A. polydipsia B. polyuria C. severe pruritus D. * all of the above E. none of the above 502 In the nephrotic syndrome: A. A generalized edema is present B. the administration of steroids is always ineffective C. favourable treatment includes the management of any underlying disease D. * a generalized edema is present + favourable treatment includes the management of any underlying disease E. none of the above 503 In acute pyelonephritis: A. * a common symptom is shaking chills B. the absence of any lumbar pain excludes the diagnosis C. an intravenous pyelogram is necessary for the diagnosis D. to confirm the diagnosis, a hemoculture should routinely be made E. all of the above 504 Immunosuppressive therapy is suitable in which of the following conditions? A. psoriatic arthritis B. * psoriatic arthritis + rheumatoid arthritis C. persistent viremia D. rheumatoid arthritis E. all of the above 505 Which of the following statements about nitroglycerin are correct? A. only topical application is effective in Raynaud's disease B. C. D. E. it causes paroxysmal nocturnal dyspnea as a side-effect it relieves the pain caused by diffuse esophageal spasms * it might relieve pain in biliary colic it alleviates the symptoms of bronchial asthma 506 Laboratory findings characteristic for early nephrotic syndrome include: A. a serum albumin level which is lower than 25 g/1 B. a decreased fibrinogen level C. an elevated serum cholesterol level D. * a serum albumin level which is lower than 25 g/1 + an elevated serum cholesterol level E. all of the above 507 The mechanism of anticancer action of fluorouracil is A. Arrest in the G2phase of the cell cycle because of interference with the normal function of topoisomerase enzymes B. Cross-linking of the double stranded DNA and the resulting inhibition of DNA replication and transcription C. * Cytotoxicity resulting from metabolite that interferes with production of dTMP D. Irreversible inhibition of dihydrofolic acid reductase E. Selective inhibition of DNA polymerase 508 A drug that is used in the combination therapy of testicular cancer and is associated with nephrotoxicity is A. Beomycin B. * Cisplatin C. Etoposide D. Leuprolide E. Vinblastine 509 All of the following agents has been used in drug regime for the treatment of breast carcinoma. Which one has specific activity in a subset of female breast cancer? A. Anastrozole B. Doxorubicin C. Fluoxymesterone D. Methotrexate E. * Trastuzumab 510 This antimetabolite inhibits DNA polymerase and is one of the most active drugs in leukemias. Although myelosuppression is dose limiting the drug may also cause cerebellar dysfunction, including ataxia and dysartria. A. Bleomycin B. * Cytarabin C. Dacarbazine D. Doxorubicin E. Etoposide 511 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 512 Which of the anticancer drug causes hyperviscosity syndrome: A. Vinblastine B. * L-Asparaginase C. 5-FU D. Methotraxate E. cyclophosphamide 513 A. B. C. D. E. 514 A. B. C. D. E. 515 A. B. C. D. E. 516 A. B. C. D. E. 517 A. B. C. D. E. 518 A. B. C. D. E. 519 A. B. C. D. E. 520 A. B. C. D. E. 521 A. B. C. D. What drug is mostly used for the treatment of chronic lymphatic leukemia? * Chlorambucil Prednisone Cyclophosphamide Myleran Penicillin Which of these groups is the most likely to experience anemia? Men * Women Teenagers Older adults None of the above How does anemia affect the body? * The body is less able to absorb oxygen from the lungs Blood becomes thin Tissues retain fluids None of the above All of the above The body needs an adequate supply of which of these in order for red blood cells to mature normally? Oxygen vitamin C * vitamin B-12 and folic acid Carbon dioxide None of the above All of the following may cause microcytic hypochromic anaemia, except: * Vitamin B12 deficiency Thalassemia Iron deficiency Gastrointestinal bleeding Lactation The sign of iron deficiency anaemia are all of the following except: Increase in iron binding capacity Decrease in serum ferritin level Decrease in serum iron level Decreased MCV * Hyper-segmented neutrophils The sign of megaloblastic anaemia is: Increase in iron binding capacity Decrease in serum ferritin level Decrease in serum iron level Decreased MCV * Hyper-segmented neutrophils The earliest sign of iron deficiency anaemia: Increase in iron binding capacity * Decrease in serum ferritin level Decrease in serum iron level Decreased MCV Transferrin saturation All of the following statements are true about sickle cell disease except Vaso-occlusive crisis Aplastic Crisis * Hypertensive crisis Sequestration Crisis E. Hyperhemolytic crisis 522 Which is not seen in a chronic case of Sickle cell anemia: A. Hepatomegaly B. Pulmonaryhypertension C. Cardiomegaly D. Splenomegaly E. * Peripheral neuropathy 523 Commonest acute presentation of sickle cell anaemia is: A. Priapism B. * Bone pain C. Fever D. Splenomegaly E. Pulmonary hypertension 524 All of the following are the signs of anemia EXCEPT A. Malaise B. Dyspnea on exertion C. Increasing cardiac output D. Palpitations E. * Dyspepsia 525 All of the following are the signs of anemia except A. Malaise B. Pallor C. Increasing cardiac output D. Palpitations E. * Dysphagia 526 For diagnosis of anemia clinicians request all of the following except A. Complete blood counts B. Red blood cells C. * Leukocyturea D. Hemoglobin level E. MCV 527 When the cause of anemia is not obvious, clinicians use all of the following tests except A. Ferritin B. Serum iron C. * Fibrinogen D. Serum vitamin B12 E. RBC folate level 528 Normocytic anemia are all of the following except A. Acute blood loss B. Anemia of chronic disease C. Aplastic anemia (bone marrow failure) D. Hemolytic anemia E. * Vitamin B12 deficiency 529 The average blood volume for an adult is about A. 45 liters B. 450 ml C. 5 gallons D. * 5 liters E. 3 liters 530 Each body function is correctly matched with the corresponding function of the blood on the right EXCEPT A. respiration - transports oxygen and carbon dioxide B. * immune defense - platelet factors initiate clotting C. acid-base balance - buffers acids and bases D. thermoregulation - allows heat to escape from the body at the skin E. Blood viscosity is due to the presence of the plasma proteins and erythrocytes. 531 Which statement concerning blood viscosity is CORRECT? A. The viscosity of blood is 4.5 to 5.5 higher than the viscosity of water. B. * Blood viscosity is due to the presence of the plasma proteins and erythrocytes. C. The higher the blood viscosity the harder the heart has to work to move blood through the vessels D. Anemia increases blood viscosity. E. Hypocoaculation increases blood viscosity. 532 Other than water, the most common component of plasma is A. Chloride B. Urea C. * Protein D. Sodium E. Calcium 533 Decrease in numbers of red blood cells or hemoglobin within red blood cells: A. * Anemia B. Erythrocytosis C. Thrombocytosis D. Leukemia E. Leukocytosis 534 Which of the following statements concerning the diagnosis of pernicious anemia is true? A. The presence of antiparietal-cell antibodies is diagnostic of pernicious anemia B. Hematologic response to folate therapy alone rules out pernicious anemia as the cause of megaloblasticanemia C. Hyperkalemia may be a consequence of vitamin B12 therapy D. Bone marrow examination would be expected to reveal marked depletion of erythrocyte precursors in persons with untreated pernicious anemia E. * Serum gastrin levels usually are elevated in persons with pernicious anemia 535 Which type of anemia has a 54-year-old man with artificial aortic value and fatigue, palpitations, tachypnea on exertion, jaundice? A. Iron deficiency anemia, B. Megaloblastic anemia, C. * Hemolytic anemia D. Folic acid deficiency anemia, E. B12 vitamin deficiency anemia 536 A 20 yrs adult presents with severe hypoplastic anemia. What is most effective treatment? A. alpha-interferon B. IL-2 C. ATG therapy D. * Bone marrow transplantation E. Prednisone 537 Which of signs is characteristic for hemolytic anemia? A. * Jaundice B. Pale lips C. Sore mouth D. Weakness E. Fatigue Situational tasks: 1. Patient entered the cardiologic department with the attack of angina pectoris, where a medical treatment was appointed to him. After injection of medicines patient noted a strong headache and nausea. For what 2. 3. 4. 5. 6. 7. 8. group of antianginal drugs is character such side effect? A. Blockers of calcium channels B. Beta – adrenergic blockers C. Nitrates D. * Vasodilators action on the coronal vessels E. Beta – adrenergic stimulants The patient suffers from hypertensive disease with bradiarrhythmia. What drug is necessary to prescribe? A. * Platyphyllini hydrotartras B. Ceftriaxone C. Papaverinum D. Paracetamol E. Methyldopa The 45 years old patient has diagnosis Angina pectoris. Cardiosclerosis. Arrhythmia. Hypertensive disease. Choose the drug for treatment? A. * Nebivolol B. Suprastine C. Potassium chloride D. Strophantine E. Lidocaine At the patient after injecting drug for the medical treatment of hypertensive crisis tachycardia, and orthosthatic hypotension in the vertical position has developed. What drug was injected? A. Reserpine B. * Clophelinum C. Magnesium sulfate D. Dibazolum E. Verapamilum To the patient with hypertensive disease was prescribed a drug from the adrenotropic group. After some time the pressure normalized, but developed bradycardia (50 beats on minute) and the atrio-ventricular block. What drug was prescribed? A. * Propranolol B. Papaverinum C. Clophelinum D. Mesatonum E. Verapamilum The 45 years old patient with the hypertensive disease has been taking antihypertensive drug during 4 days. The blood pressure normalized but somnolence and dry cough developed. What drug has been taking the patient? A. Clophelinum B. Prazosinum C. * Enalapril D. Aspirine E. Adrenaline The 56 years old woman with hypertensive disease appealed to the doctor. Methyldopa was prescribed to her. Indicate a mechanism of action of this drug. A. * Violation of noradrenalin synthesis B. Increasing of acetylcholine synthesis C. Block of beta-adrenoreceptors D. Block of alpha-adrenoreceptors E. Depression of angiotensin converting enzyme activity Patient with diagnosis of pheochromocytoma suffers from the high blood pressure which outgrows in hypertensive crisis. What group of drugs will help in this situation? A. Beta- adrenoblockers B. Ganglionblockers C. Sympatolitics D. * Alpha-adrenoblockers E. Calcium channels blockers 9. During assessment of a patient diagnosed with pheochromocytoma, the doctor reveales a blood pressure of 210/110 mm Hg. The nurse would expect to administer which of the following medications? A. nadolol B. * phentolamine C. dobutamine D. verapamil E. validolum 10. In the patient with the considerable peripheral edema the by turns using of dihlothiazid, ethacrynic acid and Furosemide did not result in the considerable diuretic effect. The analysis of blood indicated the considerable increasing of aldosteron level. Prescribe drug for treatment. A. Mannitol B. * Spironolactone C. Clopamid D. Triamterene E. Amiloride 11. To the 55 years old man for the medical treatment of gout was prescribed etamid. What is the mechanism of uric actions of the drug? A. * Depression of reabsorbing of urinary acid B. Increasing of secretion of urinary acid C. Decreasing of production of urinary acid D. Depression of activity of ksantinoxydase E. Production of easy soluble salts 12. At the 46 years old patient with blink arrhythmia the edema of lungs began. What drug is necessary to inject in the first turn? A. * Furosemide B. Triamterene C. Verospirone D. Amiloride E. Euphylline 13. To the patient with edema of cardiac origin the doctor must prescribe diuretics. What drugs are contraindicated in this situation? A. Hypothiazid B. Spironolactone C. Furosemide D. * Mannitol E. Diacarb 14. In the patient with the considerable peripheral edema using of dihlothiazid did not result in the considerable diuretic effect. The analysis of blood indicated the considerable increasing of aldosteron level. Prescribe drug for treatment in this situation. A. Mannitol B. * Spironolactone C. Ethacrynic acid D. Furosemide E. Diacarb 15. In the complex medical treatment of hypertensive disease a diuretic was prescribed to the patient. In a few days the BP went down, but the signs of hypokaliaemia arose up. What drug could cause such complication? A. Triamterene B. Clofeline C. Enalapril D. Spironolactone E. * Furosemide 16. A patient with Type I diabetes presents with significant water retention and pulmonary congestion. Serum creatinine and potassium were significantly elevated. The diagnosis was advanced renal failure. A diuretic was given to treat water retention, but shortly thereafter the patient exhibited cardiac conduction changes which progressed to heart block and cardiac arrest. The diuretic which was determined to cause this event was probably: A. furosemide (Lasix) B. * triamterene (Dyrenium) C. chlorothiazide (Diuril) D. bumetanide (Bumex) E. None of the above 17. Patient, in unconsciousness, entered the admission office. The skin was cold, the pupils was miotic, his breathing was too hard and looked like Cheine-Stokes respiration; hypotension and overflowed urinary bladder were marked. What was he poisoned with? A. * Narcotic analgesics. B. Tranquilizers. C. Nonnarcotic analgesics. D. M-cholinoblockers. E. M-cholinomimetics. 18. The patient, who used prescribed preparation for a long time to treat acute respiratory diseases, suffered from headache, vertigo, and noise in his ears, nausea, pain in epigastria region. What preparation can cause such effects? A. Midantan. B. Vitamin C. C. Naphthysini. D. Bromhexini. E. * Acetylsalicylic acid. 19. The patient, who suffered from irritability, sleeplessness, rapid fatigability and pain in the heart, consulted a doctor. What preparation must be prescribed? A. * Tincture Valerianae. B. Sodium bromide. C. Aminasin. D. Droperidol. E. Phenazepam. 20. A 5-year-old child had an attack of palpitation with nausea, dizziness, generalized fatigue. On ECG: tachycardia with heartbeat rate of 220/min. Ventricle complexes are deformed and widened. P wave is absent. What medication is to be prescribed to provide first aid? A. * Lydocain B. Seduxen C. Novocainamides D. Strophantin E. Isoptin 21. A 46-year-old patient has ischemic heart disease, angina on exertion, II functional class. What is the drug of choice in treatment of acute attack? A. * Nitroglycerin sublingually B. Platelet inhibiting agents (aspirin) C. Spasmolitics (No-spa) IV D. Digitalis IV E. Sedative agents (Seduxenum) orally 22. A 52-year-old patient complains of intensive and prolonged retrosternal pains, decreased exercise tolerance for 5 days. Which of the following groups is the most useful? A. * nitrates B. dyslipidemic drugs C. diuretics D. digitalis E. ACE inhibitors 23. A 50-year-old patient was admitted to resusitation department with aqute myocardial infarction . Which one of the following drugs is uneffective in this case? A. Proranolol B. Nitroglycerin C. * Nifedipine D. Phentanyl E. Morfin 24. A 54-year-old patient, who suffers from ischemic heart disease, stable stenocardia II, heart insufficiency I, has an attack of ventricular tachycardia, Ps 180/min, AP – 80/50 mm Hg. Choose a correct treatment: A. * Lidocain, potassium chloride B. Mezaton, strofantin C. Verapamil, potassium chloride D. Digoxin E. ATP, cordaron 25. A 55-year-old men has stenocardia on exertion II. Taking of nitroglycerin potentiate a sever headache. Which of the following drugs is the most useful in this case? A. * Molsidomin B. Amiodaron C. Nifedipine D. Propranolol E. Verapamil 26. A 49-year-old patient has ischemic heart disease, angina on exertion, II functional class. What is the drug of choice in treatment of acute attack? A. No-spa IV B. Aspirin C. * Nitroglycerin sublingually D. Digitalis IV E. Seduxenum orally 27. A patient of 42 year has arterial hypertension with bradyarrhythmia. Which of the following drugs is necessary to administer? A. Klonidine B. * Nifedipine C. Diltiazem D. Bisoprolol E. Methyldopa 28. A 45-year-old women with diagnosis: Paroxysmal arrhythmia. Arterial hypertension II. Drug of choice for stopping attack: A. * Metoprolol B. Nitroglycerin C. Potassium chloride D. Digoxin E. Lidocain 29. A woman 56 years old with hypertension edema develops on lower extremities, moist wheezes in the lower parts of lungs. What must be administered in the complex therapy of the patient? A. Betaadrenomimetics, B. * Diuretics, C. Glucocorticoids, D. Preparations of calcium, E. M-cholinolitics. 30. A woman 51 years old has arterial hypertension. Which group of drugs may be used for her treatment? A. Betaadrenomimetics, B. * Angiotensin-converting enzyme inhibitors, C. Glucocorticoids, D. Preparations of calcium, E. M-cholinolitics. 31. A man 36, years old, has arterial hypertension. Which group of drugs may be used for treatment? A. Betaadrenomimetics B. Preparations of calcium, C. Glucocorticoids, D. * Calcium_channel inhibitors, E. M-cholinolitics. 32. Patients suffering from congestive heart failure will show signs and symptoms of peripheral vasoconstriction, moist skin, pale complextion because of: A. Na and water retention B. decreased renin release C. * increased sympathetic tone D. decreased vagal tone E. decreased aldosterone levels 33. A 59 year old patient with a history of systolic heart failure arrives in the ER with complaints of chest palpitations, nausea and GI upset. His chart indicates that he is currently taking digoxin, captopril, metoprolol and furosemide. A 12 lead ECG is recorded and reveals the presence of frequent runs of ventricular bigeminy. His echocardiogram indicates an ejection fraction of 40%. His blood tests indicate a serum potassium level of 4.0 mM, and an elevated digoxin level of 2.2 ng/ml. The most appropriate drug for treating this patient's arrhythmia would be: A. propranolol B. quinidine C. * lidocaine D. verapamil E. atropine 34. The 56 years old woman with hypertensive disease appealed to the doctor. Methyldopa was prescribed to her. Indicate a mechanism of action of this drug. A. Violation of noradrenalin synthesis B. * alpha-adrenoreceptors blockers C. Block of beta-adrenoreceptors D. Depression of angiotensin converting enzyme activity E. Increasing of acetylcholine synthesis 35. In the complex medical treatment of hypertensive disease a diuretic was prescribed to the patient. In a few days the blood pressure went down, but the signs of hypokaliaemia arose up. What drug could cause such complication? A. Triamterene B. Clofeline C. Enalapril D. Spironolactone E. * Furosemide 36. The patient has cranial trauma. The brain edema threat developed in the postoperative period. To prescribe drug for the removal of this complication. A. Spironolactone B. Papaverini hydrochloride C. * Furosemide D. Dihlothiazid E. Diacarb 37. In the patient with the considerable peripheral edema the by turns using of dihlothiazid, ethacrynic acid and furosemide did not result in the considerable diuretic effect. The analysis of blood indicated the considerable increasing of aldosteron level. Prescribe drug for treatment. A. Mannitol B. * Spironolactone C. Clopamid D. Triamterene E. Amiloride 38. At the 46 years old patient with blink arrhythmia the edema of lungs began. What drug is necessary to inject in the first turn? A. * Furosemide B. Triamterene C. Verospirone D. Amiloride E. Euphylline 39. An elderly male patient has essential hypertension, congestive heart failure, and type I insulin-dependent diabetes. His congestive failure developed secondary to coronary vascular disease associated with hyperlipidemia. What antihypertensive drug(s) may be most appropriate for this patient? A. Chlorothiazide (Diuril) B. * captopril (Capoten) C. propranolol (Inderal) D. metoprolol (Lopressor) E. none of the above 40. An elderly female patient has essential hypertension, congestive heart failure, and type I insulindependent diabetes. His congestive failure developed secondary to coronary vascular disease associated with hyperlipidemia. What antihypertensive drug(s) may be most appropriate for this patient? A. chlorothiazide B. * lisinopril C. propranolol D. metoprolol E. all of the above 41. A patient presents with a blood pressure of 160/110 mm Hg. The patient has a history of coronary vascular disease, resulting in angina, but has no evidence of congestive heart failure. The patient also has asthma and has been treated mainly using terbutaline, by aerosol inhalation Propranolol (Inderal) was prescribed to manage essential hypertension. Was this action appropriate? A. Propranolol (Inderal) is appropriate because it will reduce heart rate and cardiac output. Negative inotropism will help reduce the incidence of angina. It is an effective antihypertensive agent B. Propranolol (Inderal) is inappropriate because it is only useful in mild hypertension; a better drug would be minoxidil or hydralazine because they are more effective in lowering blood pressure C. Propranolol (Inderal) is appropriate because it is an effective, low-cost antihypertensive. It will augment the effects of terbutaline, an additional benefit D. * Propranolol (Inderal) is inappropriate because its use is contraindicated in a patient with asthma. E. All of the above 42. The patient with severe allergic bronchial asthma has been treated by oral drug during 7 months. Hypertension, “moon face”, obese trunk, oedema, insomnia occur. What drugs does he used? A. * Patient used one of orally used glucocorticoids, e.g. prednisolonum. B. Patient used one of beta-agonists. C. Patient used cromolynum. D. Patient used euphyllinum E. Patient used all above. 43. Patient 65 years old suffers from bronchial asthma. Adrenergic receptor activator is used for treatment, After two weeks of management a pain near heart, palpitation. How can these side effects be prevent? It is necessary to prescribe A. * selective beta2-adrenergic receptor stimulator, for example salbutamolum. B. glucocorticoids. C. theophylline. D. anticholinergics E. cromolyn sodium. 44. An 81-year-old female with arteriosclerotic heart disease and pulmonary emphysema was found to have significant bronchospasm. Her physician prescribed theophylline 400 mg every 12 hours. All of the following toxicities may be observed EXCEPT: A. cardiac arrhythmias B. nausea and vomiting C. agitation D. * sodium and water retention E. tremulousness 45. A patient complains of severe expiratory dyspnea, paroxysmal dry cough, general asthenia. This condition lasts for 28 hours and is not benefite after usage of salbutamol. Data of examination: the patient is staying and leaning against window-still, diffuse cyanosis add swelling of neck veins are observed, weezes are heard on the distance, by percussion bundbox sound is heard, by auscultation – weakened wesicular breathing, elongated expiration, difuse dry rales. Which medical preparation is the most important for the patient? A. beta-agonists, B. beta-blockers; C. Expectorants: D. M-cholinolithics, E. * Parenteral administrations of corticosteroids. 46. During auscultation of patient P., 60 years old, with chronic non-obstructive bronchitis, dry buzzling rales above all parts of the lungs were heard as well as weakened vesicular breathing. What medical preparation is it necessary to prescribe to the patient? A. Diuretics; B. Antitussive agents; C. * Expectorants; D. Broncholitics; E. beta-blockers. 47. A 56-yr-old man wheezes and coughs. He has tried to give up smoking, but he finds it very difficult. He is thin and healthy looking with a rounded chest. His breathing is noisy. His cough is unproductive. What treatment has to be prescribed? A. Amoxycillin B. Prednisolone C. * Ipratropium D. Salbutamol E. Bronchial lavage 48. A 20-yr-old woman presents with a week's history of fever, rigors arid productive rusty cough. CXR shows right lower lobe consolidation. Prescribe treatment A. Erythromycin B. Co-trimoxazole C. Prednisolone D. * Amoxicillin E. Salbutamol inhaler 49. 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 anti-pseudomonal penicillin E. * have a definite risk of reaction to any cephalosporin & have a high risk of hypersensitivity to a broad spectrum anti-pseudomonal penicillin 50. 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 51. A 23 years old patient is pregnant with a history of severe (anaphylactic) penicillin allergy. To prepare her for an upcoming tooth extraction a doctor prescribes an antimicrobial medication that can be taken prophylaxis 2 hrs prior to the procedure. This medication is A. Cefaclor B. Doxycycline C. Erythromycin base D. * Erythromycin stearate E. Gentamycin 52. Circumstances associated with allergy to penicillins may include: A. maculopapular or urticarial rash; B. anaphylaxis; C. anaphylactic reaction to penicillin skin-tests; D. exposure to penicillins in food E. * All of the above 53. A week after initiating clindamycin therapy a patient 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 54. Imipenem is a beta-lactam antibiotic which is neither a penicillin nor a cephalosporin. Correct statements regarding imipenem include: A. it covers an extremely broad spectrum of microorganisms; B. it is very active against many gram negative rods; C. resistant pseudomonas may emerge during treatment; D. it should not be given to patients having a history of allergic reactions to penicillin E. * All of the above 55. A patient with pulmonary disease is taking prednisone. A doctor begins her on phenytoin therapy for a newly diagnosed seizure disorder. Two weeks later the patient returns to the clinic to see the doctor 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 56. 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 of air E. exchange is unsatisfactory 57. Which of the following are true regarding cephalosporins? 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 58. 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 59. 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 60. 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 61. Appropriate indications for and/or uses of laxatives include: A. * All are correct B. prevent straining at the stool in patients with cardiovascular disease; C. bulk forming agents for diverticular disease; D. treatment of drug overdose; E. None of the above 62. 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 63. What drug used patient? 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. A. * Natrii hydrocarbonas B. Aluminium hydroxide C. Magnesium sulfate D. Omeprasole E. Calcium carbonate 64. 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 65. To the patient with gout the doctor prescribed allopurinol. What pharmacological property of allopurinol is important in this situation? A. * Competitive inhibition of xantinoxydase. B. Increasing of evacuation of nitrogen substances. C. Acceleration of catabolism of pirimidinic nucleotides D. Decreasing of reutilization of pirimidinic nucleotides E. Increasing of synthesis of nucleic acids 66. 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. * Xantinoxydase B. Adeninphosphoriboziltransferase C. Hypoksantinphosphoriboziltransferase D. Guanindesaminase E. Adenosindesaminase 67. 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. 68. 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. 69. 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 beta-adrenergic receptors. D. Stimulation of M-cholinergic receptors. E. Stimulation of H-cholinergic receptors. 70. 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. 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. Hyper salivation 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. Diasepam 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. Apples B. * Cheese 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. All of the above 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 Tests questions to figures: 1. A. B. C. D. E. 2. A. B. C. D. E. 3. A. B. C. D. E. 4. A. B. C. D. E. 5. A. B. C. D. E. 6. A. B. C. D. E. 7. A. B. C. D. E. 8. A. B. C. D. Specify the group belonging of the drug anaprilin, shown in Figure 1: *Beta-adrenoblocker Alpha-adrenoblocker Alpha, beta-adrenomymetic Sympatholytic None of the above Specify the indications for use of the drug anaprilin indicated in Figure 1: Coronary heart disease, hypertension, heart rhythm disturbances *all of the above none of the above Specify the daily dose of the drug anaprilin indicated in Figure 1: *60-80 mg / day 120-240 mg / day 2-4 mg / day 0,5-1,5 g / day 5-10 mg / day Specify the way of using of the drug noradrenalin, shown in Figure 2: *IV IM Oral SQ IQ Noradrenaline (Figure 2) normally produces effects such as: increased heart rate, increased blood pressure, dilation of pupils, dilation of air passages in the lungs *all of the above What indications for using of the drug Noradrenaline (Figure 2)? *Acute hypotension Hypertension Heart failure Angina pectoris All of the above What indications for using of the drug adelphan, shown in Figure 3? *Hypertensive diseases Diabetes mellitus Hypertensive emergency Heart failure Arrhythmia The drug noradrenalin, shown in Figure 2, has _______________effect: Vasodilating *Vasoconstricting Bronchodilating Bronchospastic E. Analeptic 9. Important contraindications to norepinephrine, shown in Figure 2, are____ A. concomitant exposure to halothane anesthesia, B. hypersensitivity to the drug C. pregnancy D. lactation E. *all of the above 10. Specify the group belonging of the drug doxazosin (Cardura), shown in Figure 4 A. Beta-adrenomymetic B. *Alpha-adrenoblocker C. Beta-adrenoblocker D. Sympatholytic E. Alpha, beta-adrenomymetic 11. Doxazosin, shown in Figure 4, is used A. to treat hypertension B. to improve urination in men with benign prostatic hyperplasia C. to treat hypotension D. *to treat hypertension & to improve urination in men with benign prostatic hyperplasia E. None of the above 12. Specify common side-effects of Doxazosin, shown in Figure 4: A. Dizziness B. Headache C. Tiredness D. Swelling of the feet or lower legs E. *All of the above 13. Specify the group belonging of the drug propranolol, shown in Figure 6: A. Beta-adrenomymetic B. Alpha-adrenoblocker C. *Beta-adrenoblocker D. Sympatholytic E. Alpha, beta-adrenomymetic 14. Choose the correct statements about the drug arduan shown in Figure 9 A. *long-acting non-depolarizing neuromuscular blocking agent B. For inhaled narcosis C. Non-inhaled narcotic agent D. Barbiturates derivatives E. Drug with pronounced stage of excitation 15. Patient for induction of anesthesia intravenously entered drug thiopental, shown in Figure 10, then came laryngospasm, reinforced by the salivation. The introduction of which the drug could be prevented unwanted effects? A. Neostigmine B. Adrenaline HCl C. *Atropine sulfate D. Pirroxan E. Paracetamol 16. Indicate which group the drug cyclodol, is shown in Figure 11 belongs to: A. Antiepileptic B. Antiparkinsonian C. Antipsychotics D. Tranquilizers E. Antidepressants 17. The drug, represented on figure 13 (carbamazepine), belongs to: A. *Anti-epileptic B. C. D. E. 18. A. B. C. D. E. 19. A. B. C. D. E. 20. A. B. C. D. E. 21. A. B. C. D. E. 22. A. B. C. D. E. 23. A. B. C. D. E. 24. A. B. C. D. E. 25. A. B. C. D. E. 26. Antiparkinsonian Steroids Antidepressants Barbiturates What is carbamazepine (figure 13) used for? generalised tonic-clonic seizures and partial seizures trigeminal neuralgia bipolar affective disorder none of the above *all of the above The drug, represented on figure 14- diphenin (phenytoin), belongs to: Antiparkinsonian Steroids Antidepressants Barbiturates *Anti-epileptic The drug, represented on figure 15 (trifluoperazine), belongs to: Antiepileptic Antiparkinsonian *Neuroleptics Tranquilizers Antidepressants The drug, represented on figure 16 (phenazepam), belongs to: Antiepileptic Antiparkinsonian Neuroleptics *Tranquilizers Antidepressants The drug, shown on figure 17 (gidazepam), belongs to: Antiepileptic Antiparkinsonian Neuroleptics *Tranquilizers Antidepressants The drug, shown on figure 18 (amitriptyline), belongs to: Antiepileptic Antiparkinsonian Neuroleptics Tranquilizers *Antidepressants The drug, shown on figure 19 (Azaphen), belongs to: Antiepileptic Antiparkinsonian Neuroleptics *Antidepressants Tranquilizers Specify indications for the drug (сyclodol), shown in Figure 11 *Parkinson's Disease To prevent seizures insomnia alcoholism Myasthenia gravis Specify indications for the drug (teturam), shown in Figure 20 A. B. C. D. E. 27. A. B. C. D. E. 28. A. B. C. D. E. 29. A. B. C. D. E. 30. A. B. C. D. E. 31. A. B. C. D. E. 32. A. B. C. D. E. 33. A. B. C. D. E. 34. A. B. C. D. E. Drug abuse *Alcoholism Acute alcohol poisoning Acute poisoning with morphine Barbituromaniya With what are combined drug (teturam) indicated in Figure 20, in the treatment of alcoholism? apomorphine valerian phenobarbital morphine *ethyl alcohol Choose the correct statement for the drug nitrazepam, shown in Figure 21: *Sleeping pills Has hypotensive effect To remove an attack of epilepsy For the treatment of alcoholism Anticonvulsive effect Choose the correct statement for the drug diazepam, shown in Figure 22: Hypotensive agent Hypertensive agent *Antiepileptic agent Anticonvulsive agent For the treatment of alcoholism Choose the most typical side effect for the drug aspirin, shown in Figure 23 *Gastrointestinal ulcers Ototoxicity Nephrotoxicity Hepatotoxicity Edema Choose the indications for the drug naloxon, shown in Figure 24 Chronic morphine poisoning *Acute morphine poisoning Poisoning with atropine Poisoning with barbiturates None of the above Indicate the possible mechanism of analgesic effect of morphine (Figure 28): *Violation of synaptic transmission in the ways of pain in the central nervous system Antipyretic action Inhibition of formatting of pain mediators Decreasing of inflammations in peripheral tissues Disturbance of prostaglandin synthesis What agent administer for gastric lavage in case of poisoning with morphine (Figure 28)? Sodium permanganate Sodium hydrocarbonas Potassium chloride *Potassium permanganate Sodium carbonas Choose the correct statement for morphine, shown in Figure 28: Indicated in headache *Narcotic analgesic Hypotensive drug Indicated in toothache Tranquilizers 35. A. B. C. D. E. 36. A. B. C. D. E. 37. A. B. C. D. E. 38. A. B. C. D. E. 39. A. B. C. D. E. 40. A. B. C. D. E. 41. A. B. C. D. E. 42. A. B. C. D. E. 43. A. B. C. D. Show adverse side effect of anti-inflammatory agent butadion (Fig.25): *Dyspeptic pains Depressing of CNS Hypothermia Hypotension Allergic reactions The drug, shown on figure 26 (paracetamol), belongs to: *Analgesic-antipyretic Narcotic analgesic Tranquilizers Sedatives Neuroleptics Name indications for using of the agent (paracetamol), shown on figure 26: Stimulation and analgesia during labor *Headache Angina pectoris Acute poisoning with morphine Couph The drug, shown on figure 28 (morphine), belongs to: Analgesic-antipyretic *Narcotic analgesic Tranquilizers Sedatives Neuroleptics Choose the correct statement for morphine, shown in Figure 28: *Depresses the breathing center Antipyretic action Non-narcotic analgesic Sleeping pills Indicated for treatment of poisoning with alcohol Name indications for using of the agent (desmopressin), shown on figure 29: *Diabetes insipidus Diabetes mellitus Heart failure Acromegaly None of the above What disease is characterized by ,,moon face" (figure 32)? *Cushing's disease Obesity Feochromocytoma Glomerulonephritis Hyperparathyroidism In which of the listed diseases Xenical is used (Fig. 34)? Thyrotoxicosis *Obesity Acromegaly Hyperparathyroidism Hypoparathyroidism For the treatment of which disease parlodel is used (Fig.35)? *Hypophysis adenoma Feochromocytoma Obesity Hypoparathyroidism E. Hypothyroidism 44. For the prevention of which complication of diabetes mellitus is used berlipril, shown in Fig.41? A. *Diabetic nephropathy B. Diabetic angiopathy C. Diabetic cardiomyopathy D. All of the above E. None of the above 45. In Fig.42 shows berlithion which belongs to alpha-lipoic acid. Which of the following drugs does not belong to this group? A. *Cavinton B. dialipon C. Espa-lipon D. Tiohamma-turbo E. None of the above 46. What group of drugs belongs diroton (lisinopril) (Fig.44)? A. *ACE inhibitor B. Betablocker C. Ca++channel blocker D. Diuretic E. Angiotensin II blocker 47. For what purpose enap (enalapril) (Fig.45) is used in diabetes mellitus? A. *Prevention of nephropathy B. Treatment of hypertension C. Prevention of polyneuropathy D. Prevention of dismetabolic cardiomyopathy E. All of the above 48. For the treatment of which complication of diabetes mellitus gabagamma is used (Fig.46)? A. *Polyneuropathy B. Nephropathy C. Angiopathy D. Encephalopathy E. Retinopathy 49. What group of drugs belongs enalapril (Fig.45)? A. Betablocker B. Ca++channel blocker C. Diuretic D. *ACE inhibitor E. Angiotensin II blocker 50. Insulin Actrapyd in the figure 48 refers to ________________ insulin: A. *The short-acting B. The long-acting C. The ultrashort-acting D. Combined action E. None of the above 51. Insulin Humodarum R in the figure 49 refers to ________________ insulin: A. The ultrashort-acting B. *The short-acting C. The long-acting D. Combined action E. None of the above 52. Insulin Mixtard in the figure 53 refers to ________________ insulin: A. The ultrashort-acting B. The short-acting C. The long-acting D. *Combined action E. None of the above 53. To which group hypoglycemic drugs belongs drug glibenclamide (Fig.55)? A. *sulfonylurea derivatives B. biguanide derivatives C. thiazolidinedione derivatives D. Postprandial regulators of insulin secretion E. Drugs that reduce the absorption of glucose 54. To which group hypoglycemic drugs belongs Gliquidone (Fig.56)? A. Drugs that reduce the absorption of glucose B. *sulfonylurea derivatives C. biguanide derivatives D. thiazolidinedione derivatives E. Postprandial regulators of insulin secretion 55. To which group hypoglycemic drugs belongs metformine (Fig.57)? A. sulfonylurea derivatives B. *biguanide derivatives C. thiazolidinedione derivatives D. Postprandial regulators of insulin secretion E. Drugs that reduce the absorption of glucose 56. To which group hypoglycemic drugs belongs repaglinide (Fig.58)? A. sulfonylurea derivatives B. biguanide derivatives C. thiazolidinedione derivatives D. *Postprandial regulators of insulin secretion E. Drugs that reduce the absorption of glucose 57. To which group hypoglycemic drugs belongs Rosiglitazone (Fig.60)? A. sulfonylurea derivatives B. biguanide derivatives C. *thiazolidinedione derivatives D. Postprandial regulators of insulin secretion E. Drugs that reduce the absorption of glucose 58. To which group hypoglycemic drugs belongs pioglitazone (Fig.63)? A. sulfonylurea derivatives B. biguanide derivatives C. *thiazolidinedione derivatives D. Postprandial regulators of insulin secretion E. Drugs that reduce the absorption of glucose 59. To which group hypoglycemic drugs belongs acarbose (Fig.64)? A. sulfonylurea derivatives B. biguanide derivatives C. thiazolidinedione derivatives D. Postprandial regulators of insulin secretion E. *Drugs that reduce the absorption of glucose 60. Female patient 27 years old (Fig.65) complains on weight loss (7 kg during last month), increased irritableness, insomnia. On examination: reduced degree of nouruishment, pulse 92, rrhythmic character. AP 110/80 mm Hg. Observed ophthalmopathy. What disease is characterized by these symptoms A. Hypothyroidism B. *Diffuse toxic goiter C. Nodular goiter, euthyroidism D. Vascular dystonia E. Systemic lupus erhythematosus 61. Which group of drugs dexamethasone belongs (Fig.69)? A. Mineralocorticoids B. *Glucocorticoids C. Analgesics D. Nonsteoidal anti-inflammatory drugs E. Adrenomymetics 62. Describe the effect of the drug actovegin (Fig. 74) A. *Improves blood rheology B. Analgesic action C. Antiinflammatory action D. Cardioprotective effect E. Hypotensive action 63. Specify the group belonging of the drug amoxicillin (Fig. 76) A. Antiviral B. *Antibiotic penicillin group C. Fluoruquinalone D. Cephalosporine E. None of the above 64. The drug, represented on figure 5, belongs to: A. Beta-adrenomymetic B. *Opioid analgesic C. Beta-adrenoblocker D. Sympatholytic E. Alpha-, beta-adrenomymetic 65. Patient with chronic bronchitis uses represented on figure 7 agent for a long period (Fig.7). What adverse effects revealed in patient? A. Bradycardia B. Hypotension C. Independence D. Depressing CNS E. *Stimulating CNS 66. Make the previous diagnosis in patient (Fig. 32). A. *Cushing's disease B. Obesity C. Feochromocytoma D. Glomerulonephritis E. Hyperparathyroidism 67. Bromokriptin is used for what disease treatment? (Fig. 33) A. *Hypophysis adenoma B. Feochromocytoma C. Adrenal cortex adenoma D. Thyroid adenoma E. Hypophysis neuroblastoma 68. Indicate the diagnosis in patient 48 years old (Fig.36) A. *Acromegaly B. Gout C. Osteoarthrosis D. Rheumatoid arthritis E. Endocrine arthropathy 69. Indicate the diagnosis in patient 42 years old? (Fig.37) A. *Acromegaly B. Arthritis C. Osteoarthrosis D. Rheumatoid arthritis E. Endocrine arthropathy 70. Female patient 27 years old (Fig.65) complains on weight loss (7 kg during last month), increased irritableness, insomnia. On examination: reduced degree of nouruishment, pulse 92, rrhythmic character. AP 110/80 mm Hg. Cardiovasculary and pulmonary systems without changes. ÒÒH 0,1 mIU/l, Ò4 free 75 mmol/l. Peripheral edema not revealed. Make a diagnosis? A. *Diffuse toxic goiter B. Hypothyroidism C. Nodular goiter, euthyroidism D. Vascular dystonia E. Rheumatoid arthritis 71. Female patient 38 years old (Fig.66) complains on emotional lability, nervousness, insomnia, eyeglobes’ increasing, feeling of sand in eyes during last 2 years. What possible diagnosis? A. *Diffuse toxic goiter, endocrine ophthalmopathy B. Nodular goiter, endocrine ophthalmopathy C. Hypothyroidism, allergic conjunctivitis D. Diffuse goiter, euthyroidism E. Autoimmune thyroiditis, thyroid gland hyperfunction, endocrine ophthalmopathy. 72. What additional investigations should be performed in patient (Fig.67) to confirm a diagnosis? A. C-reactive peptide B. Thyroid-stimulating hormone, glycolised hemoglobin C. *Thyroid-stimulating hormone, thyroid hormone T4 D. X-ray of the scull E. Steroids 73. Make the previous diagnosis (Fig.68) A. Thyroid gland is not enlarged B. Diffuse goiter 1 degree C. Hipothyroidism D. Diffuse goiter 1 degree E. *Nodular goiter 74. Apparatus represented on Fig.70 is: A. *Glucometer B. Manometer C. Insulin pump D. Monitoring of insulin E. Tonometer 75. Call way of using for represented agent (Fig.72)? A. *Oral B. Intravenous C. Intramuscular D. Subcutaneous E. External 76. Represented on Fig.75 medicine is used for: A. *Cytoprotective effect on gastric mucosa B. Endobronchial protection C. Arterial pressure decreasing D. Reducing of edema E. Decreasing the sensitivity of CNS cough centers