Download CHOOSE THE SINGLE BEST ANSWER

CHOOSE THE SINGLE BEST ANSWER
1. Which of the following drugs is a short acting non-benzodiazepine used for the short-term
treatment of insominia?
A. Diazepam
B. Midazolam
C. Zolpiden
D. Flumazenil
E. Buspirone
2. Which of the following nerve fibers is least susceptible to local anesthetic
block?
A. A-alpha fibers
B. A-beta fibers
C. Preganglionic autonomic fibers
D. C fibers
3. Which of the following may be used for the long term management of a patient at risk for
ventricular tachycardia (Sudden Death Syndrome) who is not a candidate for an Implantable
Cardiac Defibrillator?
A. Nifedipine
B. Digitalis
C. Amiodarone
D. Lidocaine
E. Atropine
4. In humans, tolerance develops to which of the following effects of morphine?
A. Respiratory depression
B. Seizures
C. Constipation
D. Miosis
E. Cough suppression
5. Administration of which of the following may be used to reverse excessive anti-coagulation with
Coumadin?
A. Heparin
B. Fibrinogen
C. Plasmin
D. Vitamin K
E. Ca +2
6. Statins reduce plasma cholesterol because they
A. increase bile acid synthesis
B. increases bile acid excretion
C. decrease cholesterol biosynthesis
D. decrease LDL catabolism
E. increase lipoprotein lipase (LPL) activity
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7. Cardiac dilatation in a patient with congestive heart failure is frequently associated with a
decreased ejection fraction. Treatment with which of the following drugs may be a useful
strategy to reverse ventricular dilatation?
A. Nifedipine
B. Metoprolol
C. Furosemide
D. Norepinephrine
E. Amiodarone
Matching: From the following list select the best drug for each description below. Each may be
used once, more than once, or not at all.
A. Carbamazepine
B. Ethosuximide
C. Phenobarbital
D. Valproic acid
E. Diazepam
8.
Drug of choice for patients with absence seizures without tonic-clonic seizures
9.
Weight gain, hair loss and fetal malformations are notable adverse effects of this
drug
10. The most serious adverse effect associated with the use of clozapine is
A. agranulocytosis
B. respiratory depression
C. hyperthermia
D. spina bifida
E. cardiac arrhythmia
11. Calcium channel blockers such as Verapamil are used to prevent angina in patients with coronary
artery disease because they
A. decrease heart rate
B. decrease renal rennin secretion
C. increase Total Peripheral resistance (TPR)
D. prevent Na+- retention
E. decrease cardiac contractility
12. The antiarrhythmic activity of lidocaine is based on its ability to
A. shorten the effective refractory period
B. lower the resting potential of cardiac myocytes
C. inhibit the activity of K+-channels
D. inhibit the reactivation of Na+ channels
E. decrease intracellular Ca+2 in cardiac myocytes
13. Which of the following drugs may be used to increase cardiac output in a patient with pulmonary
edema secondary to myocardial infarction?
A. Amiodarone
B. Dobutamine
C. Metoprolol
D. Verapamil
E. Spironolactone
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14. Which of the following drugs is metabolized by liver microsomal zymes (dealkylation) to a
long-acting (> 50 hours), active metabolite?
A. Triazolam
B. Diazepam
C. Lorazepam
D. Oxazepam
E. Chlorazepate
13. Inhibition of which of the following enzymes leads to flushing and headache after ingestion of
even small amounts of ethanol?
A. Alcohol dehydrogenase
B. Monoamine oxidase
C. Dopa decarboxylase
D. Aldehyde dehydrogenase
E. Heroin hydrolase
16. Clofibrate is most effective at reducing plasma levels of
A. triglycerides
B. LDL cholesterol
C. HDL cholesterol
D. total cholesterol
E. bile acids
17. Which of the following drugs produce vasodilation by hyperpolarizing smooth muscle cells?
A. Minoxidil
B. Captopril
C. Nitroprusside
D. Nifedipine
E. Prazosin
18. L-dopa administered to a patient with Parkinson's disease results in activity of the
direct pathway and activity of the indirect pathway from the striatum via the globus
pallidus to the thalamus
A. increased, increased
B. increased, decreased
C. decreased, decreased
D. decreased, increased
19. A patient who presents with muscle rigidity, autonomic instability and profound hyperthermia is
most likely taking which of the following drugs?
A. Bromocriptine
B. Dantrolene
C. Haloperidol
D. Amitryptyline
E. Carbamazepine
20. The beneficial effects of carvedilol in patients with heart failure is due to its ability to
A. increase cardiac contractility
B. decrease heart rate
C. increase Na+ retention
D. increase afterload
E. increase angiotensin II activity
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21. A persistent cough, which is a common side effect of therapy with an Angiotensin Converting
Enzyme inhibitor (ACE inhibitor) is due to
A. impaired inactivation of bradykinin
B. increased circulating levels of angiotensin I
C. decreased aldosterone production
D. decreased cardiac afterload
E. Na+-retention
22. Malignant hyperthermia
A. is usually treated with succinyl choline
B. is a genetic disorder involving mutations in the GABAB receptor
C. can be triggered by volatile anesthetics in susceptible patients
D. results in a toxic reaction to opioids
E. reduces the metabolism of intravenous anesthetics
Matching. From the following list select the best drug for each effect described below. Each
drug may be used once, more than once or not at all.
A. Naltrexone
B. Meperidine
C. Pentazocine
D. Diphenoxylate
E. Codeine
23. _____ Used to treat moderate pain, this drug is a mu-receptor opioid antagonist and
kappa-receptor opioid agonist that is contraindicated in the treatment of
myocardial infarction
24. _____ Metabolism of this drug results in a toxic metabolite with no analgesic activity
that may accumulate to cause central nervous system excitation an seizures
25. _____ An antidiarrheal drug that doesn't cross the blood-brain barrier
26. _____ Used to treat moderate pain, this drug is an effective antitussive agent that in
overdose may cause seizures
27. Phenytoin
A. reduces the refractory period for neuronal depolarization
B exhibits variable inter-patient absorption
C. is generally administered prior to lorazepam to treat status epilepticus
D. is the drug of choice for patients with absence seizures and coexisting tonic-clonic
seizures
E. decreases the time that voltage-sensitive sodium channels remain in their inactive
state.
28. Ethyl substitution of the intermediate chain of an amide local anesthetic molecule would
result in an increased:
A. allergenicity
B. potency
C. carcinogenicity
D. mutagenicity
E. hydrophilicity
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29. In contrast to naltrexone, naloxone
A. has a short duration of action
B. does not cause psychological dependence
C. does not precipitate withdrawal
D. has opioid agonist activity
E. is only administered orally
30. In patients with chronic atrial fibrillation, which of the following drugs may be used to decrease
the risk of embolic stroke?
A. Heparin
B. Coumadin
C. Glycoprotein Ilb/IIIa Inhibitors
D. Tissue Plasminogen Activator
E. Aspirin
31. Nitroglycerine produces vasodilation by
A. increasing nitric oxide synthase activity
B. increasing intracellular cGMP
C. decreasing bradykinin
D. increasing intracellular cAMP
E. increasing intracellular Ca2+
32. Which of the following drugs inhibits peripheral catechol-o-methyltransferase (COMT) and is
used to increase the bioavailability of L-dopa?
A. Selegiline
B. Carbidopa
C. Entacapone
D. Pramipexole
E. Amantadine
Matching. From the following list select the best drug for each effect described below. Each
drug may be used once, more than once or not at all.
A. Fluoxetine
B. Imipramine
C. Trazadone
D. Phenelzine
E. Lithium
33. _____ The incidence and severity of polyuria induced by this drug is increased by a
salt-restricted diet
34. _____ This drug is a monoamine oxidase inhibitor (MAOI)
35. _____ An active metabolite of this drug substantially prolongs its half-life (half-life --14
days)
36. Class III anti-arrhythmic such as d, l-sotalol are used in patients with an Implantable Cardiac
Defibrillator
A. to prevent bradycardias
B. to increase the effectiveness of the defibrillator
C. to prevent polymorphic ventricular tachycardias ("toursades de pointes")
D. as a back-up for defibrillator failure
E. to decrease the frequency of discharges
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37. Fluphenazine-induced gynecomastia is a result of the action of fluphenazine on the
A. amygdala
B. substantia nigra
C. occipital cortex
D. thyroid gland
E. anterior pituitary
Matching. Each drug may be used once, more than once, or not at all.
A. Amitryptyline
B. Sumatriptan
C. Ergotamine
D. Methylsergide
E. Propranolol
38. _____ A drug used for the prevention of migraine headaches. It is contraindicated
in patients with prostatic hypertrophy, narrow-angle glaucoma,
uncontrolled seizures, or cardiac conduction defects.
39._____ Treatment with this drug to abort a migraine headache may result in peripheral
vasoconstriction with numbness, tingling and cyanosis of the fingers and toes
40. _____ This drug is contraindicated for migraine patients with asthma
41. Which of the following is appropriate therapy for long-term rate control (ventricular response
rate) for patients with chronic atrial fibrillation?
A. Implantable Cardiac Defibrillator
B. Cardiac Pacemaker
C. Lidocaine
D. Metoprolol
E. Adenosine
42. The duration of use of nitroprusside is limited by
A. its short half-life
B. hyperkalemia
C. elevated blood pressure
D. reduction in hydroxycobalamin
E. accumulation of thiocyanate
43. The use of Digitalis in patients with congestive heart failure is generally restricted to those
patients who are symptomatic after treatment with diuretics, beta-blockers and ACE inhibitors
because of the
A. development of hypersensitivity
B. high cost of therapy
C. frequent incidence of toxicity
D. need for parenteral administration
E. need for concurrent anti-arrhythmic therapy
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Matching. From the following list select the drug that best matches each statement below. Each
drug may be used once, more than once or not at all.
A. LSD (d-lysergic acid diethylamide)
B. Marijuana (delta-9 tetrahydrocannabinol)
C. Cocaine
D. Heroin
E. Ethanol
44. _____ Altered perceptions and visual hallucinations are this drug's most
characteristic effects
45. _____ Discontinuation of this drug after 10 hours of nearly continuous use may result in
severe anxiety, depression and increased appetite
46. _____ This drug increases neuronal chloride conductance by gamma-amino butyric acid
(GABA)
47. _____ This drug inhibits uptake of dopamine by neuronal prejunctional transporters
48. _____This drug may acutely cause severe hypothermia, due to vasodilation, in cold
environments
49. The antiplatelet activity of Aspirin is based on its ability to inhibit
A. ADP receptors
B. cAMP phosphodiesterases
C. Anti-thrombin III
D. cyclooxygenases
E. Adenylate cyclase
Matching - For the drug listed below, select the CNS pathway or CNS site of action that is
targeted to achieve its therapeutic effect. Each drug may be used once, more than once, or not
at all.
A. Chemoreceptor trigger zone
B. Mesocortical pathway
C. Vomiting center
D. Nigrostriatal pathway
E. Tuberoinfundibular pathway
50. _____ Risperidone
51. _____ L-dopa
52. Glycoprotein IIb/IIIa Inhibitors work by blocking which of the following platelet receptors?
A. Thrombin Receptor
B. Fibrinogen receptor
C. ADP Receptor
D. Thromboxane A2 receptor
E. Plasminogen receptor
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53. Of the following, Fluoxetine is most likely to cause
A. sedation
B. postural hypotension
C. cardiac arrhythmias
D. sexual dysfunction
E. tyramine-induced hypertension/stroke
54. The selective activity of Tissue Plasminogen Activator is based on its ability to bind to
A. plasmin
B. thrombin
C. endothelial cells
D. platelets
E. fibrin
55. A major adverse effect of benzodiazepines when they are used to treat insomnia is
A. bradykinesia
B. acute dystonia
C. neuroleptic malignant syndrome
D. decreased libido
E. anterograde amnesia
56. Intravenous administration of morphine may acutely cause
A. biliary tract pain (colic)
B. vomiting
C. sedation
D. itching
E. All of the above
57. Which of the following has the least effect on myocardial contractility?
A. verapamil
B. nifedipine
C. felodipine
D. bepridil
58. Which of the following is an adverse effect of statin therapy?
A. gallstones
B. pancreatitis
C. rhabdomyolysis
D. tremor
E. constipation
59. Which of the following drugs is most likely to be the cause of a prolongation of the PR-interval
on the EKG?
A. Digoxin
B. Lidocaine
C. Furosemide
D. Enalapril
E. Amiodarone
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60. The mechanism of action of ezetimibe is to
A. increase bile acid synthesis
B. decrease intestinal cholesterol absorption
C. decrease HMG-CoA reductase activity
D. increase LDL catabolism
E. increase Apolipoprotein B 100 biosynthesis
61. The anticoagulant activity of heparin is due to
A. activation of anti-thrombin III
B. inhibition of the gamma-carboxylation of coagulation factors
C. chelation of plasma Ca+2
D. the degradation of plasminogen
E. the inhibition of endothelial cell cyclo-oxygenase activity
62. In contrast to thioridazine, risperidone does NOT cause
A. postural hypotension
B. blurred vision
C. sexual dysfunction
D. hyperprolactinemia
63. Which of the following can be an unwanted side effect of prolonged therapy with Amiodarone?
A. corneal deposits
B. lupus syndrome
C. bronchospasm
D. gynecomastia
E. skin ulcers
64. The drug from the following list that is most likely to cause acute dystonia is
A. Risperidone
B. Chlorpromazine
C. Thioridazine
D. Promethazine
E. Haloperidol
65. In the ventricular myocyte, repolarization of the cell is due to
A. closure of the Na+-Channels
B. opening of the K+-channels
C. extrusion of K+ from the cell by the Na+, K+ - ATPase
D. activation of the Ca+2 channels
E. activation of the Na+ / Ca+2 exchange pump
66. Lithium is thought to inhibit hormone- stimulated phospholipid turnover by directly inhibiting
A. adenylyl cyclase
B. monoamine oxidase
C. inositol diphosphate phosphatase
D. inositol trisphosphate
E. phospholipase C
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67. Amitryptyline
A. generally reverses symptoms of depression within 24 hours after its
administration
B is likely to produce arrhythmias in overdose
C. raises the threshold for seizures
D. blocks neuronal reuptake of glutamate
E. acutely increases neuronal release of serotonin
68. Digitalis increases cardiac contractility by
A. inhibiting the myocardial Na+, K+-ATPase
B. activating L-type Ca+2-Channels
C. activating myocardial adenylate cyclase
D. inhibiting cardiac phosphodiesterase
E. delaying Phase III repolarization in ventricular myocytes
69. Which of the following local anesthetics is associated with production of methemoglobinemia?
A. bupivacaine
B. levobupivacaine
C. lidocaine
D. tetracaine
E. prilocaine
70. Which of the following may be a side effect of long-term therapy with Procainamide?
A. Pulmonary fibrosis
B. Lupus syndrome
C. Polymorphic ventricular tachycardia ("toursades de pointes")
D. Hemorrhage
E. Hypokalemia
Matching. Choose the single best answer from the list below. Each choice may be used once,
more than once, or not at all
A. Halothane
B. Thiopental
C. Propofol
D. Ketamine
E. Nitrous Oxide
71. _____ An anesthetic which is a bronchodilator
72. _____ A rapidly acting IV anesthetic which does not accumulate in tissues
73. _____ An inhalation anesthetic that does not elicit surgical anesthesia
74. _____ An anesthetic which sensitizes the myocardium to catecholamines
75. _____ An anesthetic which can produce hallucinations during recovery
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76. In contrast to amphetamine, cocaine
A. has a long duration of action
B. is self-administered by smoking
C. when used chronically results in a high degree of tolerance
D. is detected in drug screens as benzoylecgonine, a plasma esterase
metabolite
E. is more likely to result in necrotizing arteritis
77. Bradycardia as a complication of therapy with a cardiac glycoside such as digoxin is due to
A. activation of the Baroreceptor Reflex pathway
B. blockade of beta -adrenergic receptor activity
C. increased cardiac contractility
D. increased vagal tone
E. hypervolemia
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ANSWERS:
1
C
31
B
63
A
2
A
32
C
64
E
3
C
33
E
65
B
4
A
34
D
66
C
5
D
35
A
67
B
6
C
36
E
68
A
7
C
37
E
69
E
8
B
38
A
70
B
9
D
39
C
71
D
10
A
40
E
72
C
11
E
41
D
73
E
12
D
42
E
74
A
13
B
43
C
75
D
14
B
44
A
76
D
15
D
45
C
77
D
16
A
46
E
17
A
47
C
18
B
48
E
19
C
49
D
20
B
50
B
21
A
51
D
22
C
52
B
23
C
53
D
24
B
54
E
25
D
55
E
26
E
56
E
27
B
57
C
28
B
58
C
29
A
59
A
30
B
60
B
61
A
62
B
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