Pharmacology Iii

Front 1

1. The bacterial enzymes that inactivate penicillins and cephalosporins are
A. mef efflux proteins.
B. DNA gyrases.
C. erm methylases.
D. beta-lactamases.
E. topoisomerases.

Back 1

D

Front 2

2. Among the enzymes responsible for synthesizing bacterial cell walls are
A. transpeptidases and carboxypeptidases.
B. ligases.
C. phospholipases.
D. esterases.
E. methyl formylases.

Back 2

A

Front 3

3. Imipenem is a unique beta-lactam because it
A. has a very short half life.
B. serves to inactivate both penicillin binding proteins and beta-lactamases.
C. acts on aminoglycoside transferases.
D. interferes with DNA segregation.
E. inhibits DNA gyrase, in addition to inhibiting beta-lactamase activity.

Back 3

B

Front 4

4. A known side effect of tetracyclines is that they
A. stain the enamel of teeth.
B. causes nail discoloration.
C. interferes with mental functions by inhibiting GABA transmission.
D. causes heart arrhythmias.
E. promote constipation.

Back 4

A

Front 5

5. While in general quinolones are safe antibiotics, a recognized side effects is
A. prolongation of the QT interval in the heart.
B. tinnitus.
C. ataxia.
D. incontinence.
E. constipation.

Back 5

A

Front 6

6. Pill dysphagia is seen with
A. tetracycline.
B. nitrofurantoin.
C. trimethoprim.
D. erythromycin.
E. sulfamethoxazole.

Back 6

A

Front 7

7. Interference with folate synthesis is seen with
A. clindamycin.
B. tetracycline.
C. chloramphenicol.
D. sulfamethoxazole.

Back 7

D

Front 8

8. Which of the following antibiotic classes interfere with bacterial protein synthesis?
A. Metronidazole
B. Quinolones
C. Penicillin
D. Macrolides

Back 8

D

Front 9

9. The most likely antibiotic to cause prolongation of the prothrombin time when patients are taking coumadin are
A. tetracycline.
B. chloramphenicol.
C. trimethoprim.
D. rifampin.

Back 9

D

Front 10

10. Which of the following drugs is NOT used to treat Mycobacterium tuberculosis?
A. Isoniazid
B. Rifampin
C. Ethambutol
D. Streptomycin
E. Quinolones

Back 10

E

Front 11

11. A known side effect of isoniazid is
A. tinnitus.
B. arthralgias.
C. hepatitis.
D. peripheral neuropathy.
E. Parkinson’s syndrome/disease.

Back 11

C

Front 12

12. Which of the following drugs should NOT be used to treat influenza in the first 36 hours?
A. Amantadine
B. Rimantadine
C. Erythromycin
D. Zanamivir (Relenza)

Back 12

C

Front 13

14. Which of the following drugs has NO antiinflammatory properties?
A. Aspirin
B. Rofecoxib (Vioxx)
C. Ibuprofen
D. Acetaminophen
E. Cortisol/Prednisone

Back 13

D

Front 14

17. Which of the following is the drug of first choice in treating trigeminal neuralgia?
A. Phenobarbital
B. Buspirone
C. Disulfiram
D. Carbamazepine
E. Naltrexone

Back 14

D

Front 15

18. The following receptors are all ligand-gated ion channels EXCEPT
A. GABAA receptor.
B. dopamine D2 receptor.
C. nicotinic acetylcholine receptor.
D. 5HT3 receptor.
E. NMDA (Glutamate receptor).

Back 15

B

Front 16

19. Benzodiazepines exert their anxiolytic effects by
A. enhancing the actions of dopamine.
B. inhibiting the actions of serotonin.
C. inhibiting dopamine reuptake.
D. enhancing the actions of GABA.
E. enhancing norepinephrine biosynthesis.

Back 16

D

Front 17

20. Disulfiram, a drug used in treating alcohol abuse, exerts its effects primarily by
A. blocking activation of the GABAA receptor.
B. inhibiting activation of the NMDA glutamate receptor.
C. blocking serotonin reuptake.
D. inhibiting dopamine reuptake.
E. blocking aldehyde dehydrogenase.

Back 17

E

Front 18

21. Anticonvulsants exert their effects by all of the following mechanisms EXCEPT
A. depressing the action of dopamine.
B. modifying the activity of voltage-gated Na+ channels.
C. enhancing the action of gamma-aminobutyric acid (GABA).
D. depressing the action of glutamate.
E. inhibiting both voltage-gated Na+ channels and thus enhancing GABAA receptor activity.

Back 18

A

Front 19

22. Gingival hyperplasia is a common side effect of
A. phenytoin.
B. tiagabine.
C. morphine.
D. gabapentin.
E. carbamazepine.

Back 19

A

Front 20

23. Which of the following statements concerning benzodiazepines is NOT correct?
A. The duration of action of a benzodiazepine can be dependent on the half-life of an active metabolite.
B. Benzodiazepines inhibit glutamate receptor activation.
C. Benzodiazepines can be sedating.
D. Benzodiazepines cause short-term memory impairment.

Back 20

B

Front 21

24. Which of the following statements about Carbidopa, a drug used to treat Parkinson's disease, is CORRECT?
A. Carbidopa crosses the blood-brain barrier.
B. Carbidopa activates dopamine beta-hydroxylase.
C. Carbidopa inhibits aromatic L-amino acid decarboxylase.
D. Carbidopa inhibits monoamine oxidase.
E. Carbidopa is converted to the false transmitter carbidopamine.

Back 21

C

Front 22

25. All of the following statements about antipsychotics are correct EXCEPT
A. most classical antipsychotic drugs block dopamine receptors in the brain.
B. some of atypical antipsychotics act at serotonin receptors.
C. antipsychotics act within a few days.
D. antipsychotics can cause Parkinsonian-like side effects.
E. dopamine agonists exacerbate schizophrenia.

Back 22

C

Front 23

26. Bacteria can rapidly evolve to develop resistance to antibiotics by all of the following mechanisms EXCEPT
A. inactivation of enzymes that metabolize antibiotics.
B. altering the structure of the target of the antibiotic.
C. expressing efflux pumps for the antibiotic.
D. altering porin channels.
E. secretion of antitoxins.

Back 23

A

Front 24

27. Which of the following drugs is contraindicated in women of child-bearing age?
A. Aspirin
B. Prednisone
C. Misoprostol
D. Ibuprofen
E. Acetaminophen

Back 24

C

Front 25

28. A patient who has been taking large quantities of aspirin might show increased postoperative bleeding because aspirin inhibits
A. synthesis of thromboxane and prevents platelet aggregation.
B. synthesis of prostacyclin and prevents platelet disaggregation.
C. synthesis of prostaglandin and prevents production of blood platelets.
D. thrombin and prevents formation of the fibrin network.
E. intestinal absorption of vitamin K and prevents synthesis of blood clotting factors.

Back 25

A

Front 26

29. Which of the following pharmacologic actions is NOT produced by prostaglandins?
A. Pyrexia
B. Uterine contraction
C. Decreased gastric acid secretion
D. Increased renal vasoconstriction
E. Decreased sensitivity to pain

Back 26

D

Front 27

30. Which of the following conditions or effects does NOT result from prolonged treatment with corticosteroids?
A. Gastric ulcer
B. Osteoporosis
C. Hyperglycemia
D. Skeletal muscle atrophy
E. Redistribution of body fat

Back 27

A

Front 28

31. All of the following agents useful for treatment of rheumatoid arthritis can be used simultaneously with anakinra EXCEPT
A. sspirin.
B. celecoxib (Celebrex).
C. infliximab (Etanercept).
D. methotrexate.
E. prednisone.

Back 28

C

Front 29

32. The most prominent acute toxic effect associated with acetaminophen use is
A. hemorrhage.
B. renal nephropathy.
C. hepatic necrosis.
D. gastric ulceration.
E. respiratory alkalosis.

Back 29

C

Front 30

33. Benzodiazepines are used primarily to treat which of the following conditions?
A. Psychosis
B. Depression
C. Anxiety
D. Parkinson’s disease
E. Trigeminal neuralgia

Back 30

C

Front 31

34. Which of the following drugs or classes of drugs does NOT bind to or interact with GABAA receptors?
A. Barbiturates
B. Benzodiazepines
C. Catecholamines
D. Ethanol

Back 31

C

Front 32

35. Tetracycline antibiotics are considered “broad-spectrum” antibiotics because they are effective against all of the following EXCEPT
A. most Gram-positive bacteria growing aerobically
B. most Gram-negative bacteria growing anaerobically
C. mycobacteria
D. fungal pathogens

Back 32

D

Front 33

36. All of the following can be used to treat depression EXCEPT
A. SSRI’s.
B. monoamine oxidase inhibitors.
C. gabapentin.
D. tricyclic antidepressants.

Back 33

C

Front 34

37. All of the following statements concerning cephalosporins are correct EXCEPT
A. they are effective inhibitors of cell wall synthesis.
B. most oral anaerobic bacteria are insensitive to cephalosporins.
C. they contain a modified beta-lactam ring.
D. they are related to penicillins.

Back 34

B

Front 35

38. Which of the following classes of antibiotics can cause ototoxicity at high doses?
A. Tetracyclines
B. Vancomycin
C. Aminoglycosides
D. Penicillins
E. Erythromycin

Back 35

C

Front 36

39. All of the following statements concerning prostanoid synthesis via the COX-1 isoform of cyclooxygenase are correct EXCEPT
A. COX-1 expression is constitutive.
B. arachidonic acid is the primary substrate of COX-1.
C. COX-1 is expressed primarily in macrophages, monocytes and the vascular endothelium.
D. the downstream prostanoid synthases are soluble cytosolic enzymes.
E. aspirin and ibuprofen selectivity inhibit COX-1 versus COX-2.

Back 36

C

Front 37

40. Among the following receptor types, antipsychotic drugs primarily antagonize
A. GABAA receptors.
B. catecholamine receptors.
C. glutamate receptors.
D. acetylcholine receptors.
E. dopamine receptors.

Back 37

E

Front 38

44. Which of the following agents inhibits the release of arachidonic acid from the membrane?
A. Ibuprofen
B. Acetaminophen
C. Benzodiazepines
D. Corticosteroids
E. Cephalosporins

Back 38

D

Front 39

22. Which of the following drugs is contraindicated in women of child-bearing age?

A. Aspirin
B. Prednisone
C. Ibuprofen
D. Misoprostol
E. Naproxen

Back 39

D

Front 40

23. All of the following drugs are antiinflammatory EXCEPT

A. ibuprofen.
B. naproxen.
C. acetaminophen.
D. aspirin.
E. cortisol.

Back 40

C

Front 41

24. Which of the following conditions or effects does NOT result from prolonged treatment with corticosteroids?

A. Gastric ulcer
B. Osteoporosis
C. Hyperglycemia
D. Skeletal muscle atrophy
E. Redistribution of body fat

Back 41

A

Front 42

28. Which of the following agents is an opioid antitussive with minimal problems of dependence or addiction?

A. Codeine
B. Dextromethorphan
C. Guaifenesin
D. Hydrocodone
E. Oxycodone

Back 42

B

Front 43

29. Which of the following classes of drugs has been used with moderate success for neuropathic pain?

A. Antiarrhythmic drugs
B. Dopamine agonists
C. Opioid antagonists
D. Corticosteroids
E. Serotonin receptor antagonists

Back 43

E

Front 44

30. All of the following terms have a distinct medical meaning or definition EXCEPT

A. opioid.
B. opiate.
C. dependence.
D. addiction.
E. narcotic.

Back 44

E

Front 45

31. All of the following effects can be produced by administration of an opioid EXCEPT

A. suppression of cough reflex.
B. elevation of mood.
C. constriction of pupils.
D. inhibition of vomiting.
E. stimulation of release of histamine from mast cells.

Back 45

D

Front 46

32. Which of the following agents is LEAST likely to produce either physical dependence or addiction?

A. Codeine
B. Morphine
C. Oxycodone
D. Hydrocodone
E. Tramadol

Back 46

E

Front 47

43. All of the following are signs of CNS toxicity from local anesthetics EXCEPT

A. vertigo.
B. flushing (of the skin).
C. tinnitus.
D. circum-oral numbness.
E. garrulousness.

Back 47

B

Front 48

44. Compared to local anesthesia, general anesthesia has all of the following advantages EXCEPT

A. patient cooperation is not completely essential.
B. the patient is unconscious.
C. amnesia regarding the surgery/trauma.
D. titration of the level of anesthesia is easier.
E. cardiovascular toxicity is more easily avoided.

Back 48

E

Front 49

45. For volatile anesthetics, the rapidity of onset of anesthesia is determined primarily by

A. lipid solubility.
B. the rate of liver metabolism.
C. the blood:gas partition coefficient.
D. solubility in muscle.
E. metabolism by blood pseudocholinesterases.

Back 49

C

Front 50

46. All of the following are potential adverse effects of general anesthetics EXCEPT

A. pneumothorax with nitrous oxide.
B. malignant hyperthermia.
C. fulminant hepatic necrosis with halothane.
D. coma.
E. peripheral pain sensitization with volatile anesthetics.

Back 50

E

Front 51

47. Compared to most other parenteral anesthetics, midazolam has the desirable property of producing

A. loss of consciousness.
B. analgesia.
C. decreased salivation.
D. amnesia.
E. lack of hallucination upon recovery.

Back 51

D

Front 52

49. Which of the following drugs is highly likely to cause skin rash and allergic reactions when applied topically?

A. Antibiotic ointments
B. Benzocaine
C. Lubriderm
D. Selenium sulfide
E. Hydrocortisone

Back 52

B

Front 53

50. Which of the following drugs or groups of drugs are responsible for the most accidental overdoses?

A. Heroin and similar “narcotics”
B. Alcohol
C. OTC drugs such as analgesics and antihistamines
D. OTC vitamins

Back 53

C

Front 54

54. A patient who has been taking large quantities of aspirin might show increased postoperative bleeding because aspirin inhibits

A. synthesis of thromboxane and thus prevents platelet aggregation.
B. synthesis of prostacyclin and thus prevents platelet disaggregation.
C. synthesis of prostaglandin and thus prevents production of blood platelets.
D. thrombin and thus prevents formation of the fibrin network.
E. intestinal absorption of vitamin K and thus prevents synthesis of blood clotting factors.

Back 54

A

Front 55

55. All of the following bind to opioid receptors EXCEPT

A. endorphins.
B. enkephalins.
C. naloxone.
D. triptans.
E. dynorphins.

Back 55

D

Front 56

30. Analgesic agents are primarily distinguished from anesthetic agents in that:
A. Analgesics are administered orally and anesthetics by intravenous injection.
B. Analgesics are more selective for inhibition of the sensation of pain, relative to other sensory modalities.
C. Analgesics have a lower therapeutic index than anesthetics.
D. Analgesics primarily act directly at synapses in the spinal cord, whereas anesthetics act in the brain.
E. Anesthetics are more selective for inhibition of A-delta and C fibers than analgesics.

Back 56

B

Front 57

60. Which of the following age groups exhibits the highest frequency of accidental overdose with OTC drugs?
A. Adolescents (10-19 yo)
B. Geriatric patients (>70 yo)
C. Older adults (50-70 yo)
D. Young adults (20-50 yo)
E. Young children (5-9 years old)

Back 57

D