Download Grade 2008-2010 final exam-A

Pharmacology Exam for Grade 2008 Pakistan Students
(Exam 2) —
Part Ⅰ Single Choice Questions （50 points）
1. Which of the following most directly describes the mechanism of action of
digitalis?
A. Increases the intracellular level of ATP
B. Stimulates production of cAMP
C. inhibits sodium-potassium ATPase
D. decreases intracellular sodium concentration
E. Decreases release of calcium from the sarcoplasmic reticulum
2. Which one of the following drugs decreases de novo cholesterol biosynthesis by
inhibiting the enzyme HMG CoA reductase?
A. Niacin
B. Gemfibrozil
C. Lovastatin
D. Cholestyramine
E. Probucol
3. Among the following antihypertensive drugs, which can cause dry cough easily？
A. verapamil
B. captopril
C. losartan
D. propranolol
E. nifedipine
4. The antihypertensive mechanism of diuretics for long-term treatment is:
A. increasing water and sodium excretion from the kidneys.
B. decreasing sodium concentration in vascular smooth muscle cell
C. increasing the activity of rennin
D. decreasing the activity of rennin
E. decreasing the secretion of aldosterone
5. Which of the followings is NOT the characteristics of ACEI ?
A. it can be used in mild, moderate and severe hypertension
B. it does not cause reflective quick heart rate
C. it not only improves life quality, but also decreases mortality
D. it will not cause disorder of lipid metabolism
E. it will not affect glucose metabolism
6. Which of the following antianginal drugs is harmful to patients with variant
angina?
A. Verapamil
B. Nifedipine
C. Nitroglycerin
D. Propranolol
E. Aspirin
7. The mechanism of vasodilation of nitroglycerin is
A. vasodilating directly
B. blocking α receptor
C. producing NO
D. stimulating β2 receptor and causing vasodilation
E.stimulating adenyl cyclase to increase intracellular cAMP concentration.
8. Which of the following drugs is the best choice for variant angina?
A. propranolol
B. nitroglycerin
C. calcium channel blocker
D. carvedilol
E. procainamide
9. The followings belong to the adverse effects of ACE inhibitors EXCEPT:
A. hypotension
B. dry cough
C. hyperglycaemia
D. hyperkalemia,
E. angioedema
10. Which of the following antiatherosclerotic drugs has antioxidant effect?
A. Acipimox
B. Gemfibrozil
C. Lovastatin
D. Cholestyramine
E. Probucol
11. All of the following statement about glucocorticoids are true EXCEPT
A. inhibiting both the early and the late manifestation of inflammation
B. affecting all types of inflammatory reactions
C. inhibiting the amount of neutrophil
D. inhibiting the release of arachidonic acid
E. inhibiting granulation tissue formation
12. Vit K is a substance to prevent or reduce bleeding caused by
A. heprin
B. aspirin
C. urokinase
D. streptokinase
E. dicoumarin
13.Which of the following mechanisms best accounts for the anti-thyroid effect of
methylthiouracil？
A. Inhibiting peroxidase and decreasing the thyroxin synthesis
B. Inhibiting the thyroid releasing
C. Inhibiting the absorption of iodine
D. Interfering with the utilization of iodine
E. Decomposing the thyroxin
14. Which of the following mechanisms best accounts for the anticoagulant effect of
heparin?
A. Binding antithromin Ⅲ and accelerating the deactivation of coagulant factors
consequently
B. Interfering with the utilization of Vit k and decreasing synthesis of coagulant
factors
C. Inhibiting the platelet aggregation
D. Inhibiting the activity of thrombase
E. Antagonizing the effect of thromba
15. Which of the following statements about insulin is NOT true?
A. It can be administrated orally
B. It can be used in some psychotic disorders
C. Hypoglycemia is its’ most common adverse reaction
D. It can be used in IDDM and NIDDM
E. It can cause anaphylactic reaction
16. All of the following statements about cimetidine are true except
A. An H2-receptor blocker
B. used in peptic ulcer
C. reduced the secretion of gastric acid
D. little adverse reactions
E. recurrence is rare after treatment is stopped
17. The patients with bronchial asthma can not be given
A. adrenaline
B. ephedrine
C. aspirin
D. aminophylline
E. salbutamol
18. Which is the best scheme for treatment of megaloblastic anemia
A. folic acid
B. folic acid plus ferrous sulfate
C. Vit B12
D. folic acid plus Vit B12
E. Vit B12 plus ferrous sulfate
19. Prednisolone (a kind of GCS) may cause all the following effects EXCEPT
A. water and sodium retention
B. negative balance of nitrogen
C. peptic ulcer
D. epileptic attack
E. hypoglycemic effects
20. Which of the following mechanisms BEST accounts for the anti-thyroid effect of
high concentrations of iodine
A. Inhibiting peroxidase and decreasing the thyroxin synthesis
B. Inhibiting the thyroid hormones release
C. Inhibiting the absorption of iodine
D. Interfering with the utilization of iodine
E. Decomposing the thyroid hormones
21. Which of the following statements about antibiotics is TRUE?
A. the cephalosporins inhibit cell wall synthesis by inhibiting β-lactamases
B. tetracyclines inhibit cell wall synthesis
C. quinolones inhibit protein synthesis by interacting with the 30s ribosomal
subunit
D. sulfonamides inhibit DNA gyrase of bacteria
E. erythromycin inhibits protein synthesis by interacting with the 50s ribosomal
subunit
22. Which of the following drugs is the first choice in treating mycoplasma
pneumonia?
A. tetracycline
B. azithromycin
C. gendamycin
D. cefaclor
E. kanamycin
23. Which of the following drugs have no effect on pseudomonas aeruginosa
infection?
A.the third generation cephalosporins
B. tetracycline
C. netilmicin
D. ciprofloxacin
E. carbenicillin
24. Sulfonamides act synergistically with TMP because
A. sulfonamides inhibit the metabolism of TMP
B. TMP inhibit the metabolism of sulfonamides
C. both drugs act at the same step in inhibiting folic acid synthesis
D. both drugs act at different steps in inhibiting folic acid synthesis
E. none of the above
25. Which of the following drugs is the drug of choice for the treatment of
osteomyelitis caused by G+ bacteria?
A. penicillin G
B. carbenicillin
C. chloramphenicol
D. clindamycin
E. ciprofloxacin
PART Ⅱ Please explain the following pharmacological terms（20 points,4/item）
1. post-antibiotic effect
2. chemotherapy
3. antibacterial spectrum
4.chemotherapeutic index
5. superinfection
PART ⅢAssay Questions （30 points, 10/item）
1. Why are the ACEI used as regular therapeutic drugs in the treatment of CHF at
present?
2. Please compare the anticoagulant mechanisms of heparin and oral anticoagulants.
3.Please describe the characteristics of four generations of cephalosporins.
Answers:
Part Ⅰ
1.C
2.C
3.B
4.B
5.E
14.A 15.A 16.E 17.C
6.D
7.C
8.C
18.D 19.E 20.B
9.C
10.E
11.C
12.E
13.A
21.E 22.B 23.B 24.D 25. D
Part Ⅱ
1.Postantibiotic effect (PAE): Persistent suppression of bacterial growth after limited
exposure to an antimicrobial agent
2.chemotherapy is the drug treatment for the diseases caused by bacteria and the other
pathogenic microorganisms, parasites and tumor cells.
3.Antimicrobial spectrum :is the scope that an antimicrobial drug kills or suppresses
the growth of microorganisms
4. CI=LD50/ED50, used to judge the value and safety of a chemotherapeutic drug
5.Superinfection: modify the normal flora , living in vagina or enteron or oral cavity,
with
suppression
susceptible
microorganiams,
overgrowth
of
unsusceptible
microorganiams can cause various new infections.
Part Ⅲ
1. Why are the ACEI used as regular therapeutic drugs in the treatment of CHF at
present?
1)Inhibit ACE
(1) decreased the formation of angiotensin II both in circulation and local
tissue
(2) decreased aldosterone secretion and decreased salt & water retention
(3) decreased degradation of bradykinin
2)
reduce
sympathetic
activity
by
decreased
angiotensin-mediated
norepinephrine release
3) Inhibit proliferation and hypertrophy of cardiac myocytes and vascular
smooth muscle cells, reverse myocardial and vascular remodeling
4)ACEI are used as first-line agents for CHF therapy and decrease mortality,
prevent and reverse myocardial remodeling. no reflex tachycardia (unlike
vasodilators), therefore safe for use in persons with ischemic heart disease.
2. Please compare the anticoagulant mechanisms of heparin and oral anticoagulants.
(1)Mechanism of heparin: enhance the anticoagulative activity of ATⅢand accelerate
inactivation of clotting factors (Ⅱa, Ⅸa, Ⅹa, Ⅺa, Ⅻa ) .
Because ATⅢ is plasma serine protease inhibitor, it is an α-globulin that inhibits
protease, and several active clotting factors belong to serine protease (including
factorⅡa, Ⅸa, Ⅹa, Ⅺa, Ⅻa ).
(2)Mechanism of oral anticoagulants: antagonizing Vitamin K→ inhibiting the
synthesis of clotting factor Ⅱ, Ⅶ, Ⅸ, Ⅹ.
Because several of the protein clotting factors (including FactorⅡ, Ⅶ, Ⅸ, Ⅹ) that
are involved in the coagulation reactions depend on vitamin K as a cofactor in their
complete synthesis by the liver.
3.Please describe the characteristics of four generations of cephalosporins.
first
second
third
fourth
G+
+++
++
+
+++
G-
+
++
+++
++++
P.aeruginosa
-
-
+
++
anaerobes
-
±
+
++
Stability to
-
++
+++
++++
+
-
-
β-lactamase
nephrotoxcity ++