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Pharmacology Teaching and Research
0441


 

Pharmacology 3 - Examination Preparation:

                                                                            MBChB 3 and BDS 3

                                                      MCQ, Match Questions and Descriptive Questions:


RESPIRATORY:

Regarding montelukast:

1.    Use for treatment of atopic asthma

2.    Leukotriene receptor antagonist

3.    Leukotriene modifier

4.    Used for immediate bronchodilation

5.    Extensively metabolized in the liver

 

A=1,4,5           B=1,2,3,5           C=2,3,5        D=1,2,4,5    E=All of the above

 

Regarding cetirizine:

1.    Use for treatment of allergic rhinitis

2.    Antihistamine

3.    Cause bronchoconstriction

4.    Cause increase mucus production

5.    Mainly excreted in urine

 

A=1,2,3           B=2,4,5              C=3,4,5          D=1,2,5      E=1,2,4,5

 

Regarding codeine phosphate:

1.    Use for cough suppression

2.    Block cysteinyl leukotriene-1-receptor

3.    Analgesia is a therapeutic effect

4.    Partly metabolized to morphine in liver

5.    Use for treatment of acute bronchospasm

 

A=1,3,4         B=2,4,5              C=2,3,4        D=1,2,3,4    E=All of the above

 

Regarding zafirlukast:

1.    Classified as an antihistamine

2.    Extensively metabolized in the liver

3.    Increase the anticoagulant effect of warfarin

4.    Levels can be lowered by erythromycin

5.    Levels are not affected by theophylline

 

A=1,3,5           B=2,4,5     C=1,3,4,5       D=2,3,4         E=2,3,4,5


Short-acting β2-adrenergic agonists:

1.    Salbutamol

2.    Montelukast

3.    Tiotropium bromide

4.    Zafirlukast

5.    Azelastine

 

A=1              B=1,2         C=1,2,3         D=1,2,3,4           E= All of the above

 

Long-acting β2-adrenergic agonists:

1.    Ciclesonide

2.    Salmeterol

3.    Beclometasone

4.    Flutacosone

5.    Formoterol

 

A=3,4,5           B=4,5       C=2,3,5        D=2,5        E=1,2,4,5

 

 Inhaled corticosteroid(s):

1.    Budesonide

2.    Ciclesonide

3.    Ipratropium bromide

4.    Fluticasone

5.    Montelukast

 

A=1,3,5           B=2,3,5          C=3,4          D=1,2,4          E=5

 

Short-acting anticholinergic:

1.    Ipratropium bromide

2.    Codein phosphate

3.    Cetirizine

4.    Fexofenadine

5.    Oxymetazoline

 

A=1                   B=2               C=3             D=4             E=5

 

Long-acting anticholinergic(s):

1.    Loratadine

2.    Phenylephrine

3.    Tiotropium bromide

4.    Ipratropium bromide

5.    Codeine phosphate

 

A=1,2             B=1,2,3             C=3           D=4            E=4,5

 

 Leukotriene modifiers:

 1.   Fluticasone

 2.   Budesonide

 3.   Montelukast

 4.   Zafirlukast

 5.   Beclometasone

 

 A=1,2,3          B=3,4              C=4,5           D=1,2,4,5     E=All of the above

 

 

Antihistamine (H 1-Receptor Blockers):

1.    Salmeterol

2.    Levocabastine

3.     Codein phosphate  

4.    Cetirizine

5.     Loratadine

 

A=2,4,5      B=1,2          C=1,2,3        D=1,2,3,4     E=All of the above

 

α-Adrenergic Agonists:

1.     Phenylephrine

2.    Dextromethorphan

3.     Guaifenesin 

4.    Salbutamol

5.     Oxymetazoline

 

A=1,3,4             B=1,2,4      C=1,5          D=1,4,5              E=1,3,4,5

 

Regarding salbutamol:

1.    Used in treatment of acute asthma

2.    Long-Acting β2 Adrenergic Agonists

3.      Blocks H 1-Receptors

4.    Short-Acting β2 Adrenergic Agonist

5.     Metabolized in gastrointestinal wall and liver

 

A=1,3,4        B=2,5           C=3,4,5                 D=1,4,5               E=1,2,3,4

ANS

Which of the following can be used in the management of neuropathic pain:

1.       Carbamazepine

2.       Phenytoin

3.       Pregablin

4.       Amitriptyline

5.       Valproic acid

 

A=1,3,4               B=3,4,5        C=2,3,4          D=2,4,5       E=1,2,5


The following are true with (about) selective serotonin re-uptake inhibitors (SSRI) antidepressants:

1.       Reboxetine is an SSRI

2.       Fluoxetine has a longer half-life compared to other paroxetine

3.       An increased risk of upper gastrointestinal tract bleed with SSRIs

4.       Fluoxetine is regarded as first choice SSRIs in children and adolescents

5.       Decreased level of carbamazepine with concomitant use with fluoxetine

 

A=1,2,3                 B=2,3,4,5               C=2,3,4               D=2,3,5                 E=1,2,3,4

 

 

The following are therapeutic uses of benzodiazepines:

1.       Euphoria

2.       Anterograde amnesia

3.       Reduction in the spasticity of skeletal muscle

4.       Hypnosis

5.       Management of acute alcohol withdrawal

 

A=1,2,3,5               B=2,3,4,5   C=1,3,5        D=1,3,4        E=1,2,3,4

 

The following drug is correctly associated with its effects:

1.       Benzodiazepines – analgesia

2.       Moclobemide-depression

3.       Lithium-epilepsy

4.       Ethosuximide – “floppy baby syndrome”

5.       Zolpidem – narcolepsy

 

A=1             B=2           C= 3            D= 4            E= 5

 

The following drugs are used in the treatment of schizophrenia:

1.        Quetiapine

2.       Risperidone

3.       Clozapine

4.       Fluoxetine

5.       Paroxetine

 

A=2,5          B=1,3          C=4,5                   D=1,2,3                E= 3,4,5

 

Correctly associate the drugs with their side-effects:

1.       Haloperidol – extrapyramidal effects

2.       Amitriptyline – weight loss

3.       Clozapine – agranulocytosis

4.       Phenytoin-Steven-Johnson Syndrome

5.       Phenobarbital-Steven-Johnson Syndrome

 

A=3,4,5        B=1,2,3        C=1,2,5                  D=4,5          E=1,3,4,5

 

Correctly associate the mechanism of action of the following drugs:

1.       Risperidone  - stabilization of neuronal sodium channels

2.       Haloperidol  - dopamine 2 receptor antagonist

3.       Diazepam     - serotonin receptor modifier

4.       Venlafaxine   - selective serotonin and noradrenaline re-uptake inhibitor

5.       Amitriptyline - stabilization of triptyline receptors

 

A=1             B=2             C=3             D=4           E=5

 

The following are side effects of tricyclic antidepressants:

1.       Decreased appetite

2.       Dry mouth

3.       Confusion

4.       Bulimia nervosa

5.       Tachycardia

 

A=2,3,5               B=1,2,4        C=3,4,5        D=1,4,5        E=2,3,4

 

Choose the correct associations:

1.        Lithium – bipolar affective disorder

2.       Date rape drug - flunitrazepam

3.       Carbamazepine – P 450 enzyme induction

4.       Lamotrigine – monotherapy in epilepsy

5.       Fluoxetine – inhibits the P450 enzyme system

 

A=1,2          B=2,3            C=3,4            D=4,5          E=All of the above

 

 

The following are all classified as anti-epileptic drugs:

1.       Vigabatrin

2.       Orphenadrine

3.       Valproic acid

4.       Oxcarbazepine

5.       Sertraline

 

A=1,2,5            B=2,3           C=1,4,5          D=4,5        E=1,3,4

 

The following can be used to alleviate skeletal muscle spasms:

1.       Meprobamate

2.       Methocarbamol

3.       Amitriptyline

4.       Diazepam

5.       Carbamazepine

 

A=1,2,5            B=2,3           C=3,4,5           D=2,4,5        E=1,2,4



The following are true:

1.       Folic acid in epilepsy management is given during pregnancy to prevent headache     

2.       The therapeutic aim in Parkinson’s disease is to improve dopaminergic function in the substantia  nigra                                                              

3.       The therapeutic aim of treating epilepsy is to decrease neuronal activity

         in specific areas in the motor cortex       

4.       All anti-epileptics are safe during pregnancy

5.       In schizophrenia there is a dysfunction of mesolimbic or meso-cortical dopaminergic neuronal pathway

 

A=1,2          B=2,4           C=2,3,4                  D=2,3,5                E=2,4,5

 

 

The following statements are true about phenytoin:

1.       Confusion

2.       Safe in pregnancy

3.       Folate should be added during pregnancy

4.       Useful in treating status epilepticus in combination with diazepam

5.       Act on GABA receptors

 

A=2,4           B=1,2             #C=1,3,4           D=1,3,5          E=4,5

 

 

The following are true about valproic acid:

1.       Also used for prophylaxis of migraine                        

2.       Can be used in intractable hiccups

3.       Drug of first choice in the management of tonic-clonic seizures

4.       May be used to control acute manic phase of bipolar disorder

5.       It can be used to manage peripheral neuropathy.

A=1,2,5          #B=1,3,4           C=1,4,5            D=2,3,4         E=3,4,5

 

 

Which drugs are long-acting benzodiazepines?

1.               Flurazepam

2.               Alprazolam

3.               Oxazepam

4.               Diazepam

5.               Lorazepam

 

A=1,3,4             B=1,4              C=3,4,5        D=2,3,4        E=4,5

 

 GOUT, ARTHRITIS


A 45-year old male presents with a first attack of acute gout. The drug which should be avoided is:

1.       Corticosteroids

2.       Naproxen

3.       Aspirin

4.       Probenecid

5.       Colchicine

 

A=1                     B=2                      C=3                   D=4                     E=5

 

The following are acute toxicity effect of colchicine except:

 1.      Cerebral oedema

 2.      Multiple organ failure

 3.      Gastrointestinal toxicity

 4.      Paraplegia

 5.      Rhabdomyolysis

 

A=1                        B=2                      C=3                      D=4                            E=5

 

Which of the following anaesthetic drugs can produce dissociative anaesthesia:

1.       Ropivacaine

2.       Etomidate

3.       Midazolam

4.       Mivacurium

5.       Ketamine

 

A= 1                     B=2                       C=3                       D=4                     E=5

 

The following are adverse effects of morphine:

1.       Weight loss

2.       Histamine release

3.       Gynaecomastia

4.       Respiratory depression

5.       Anorexia

 

A=1,2                   B=2,4                   C=1,3                   D=3,5                   E=1,5

 

Which of the following local anaesthetics are classified as amides:

1.      Bupivacaine

2.       Cocaine

3.       Lignocaine

4.       Procaine

5.       Benzocaine

 

A=1,2                    B=2,3                   C=1,3                  D=2,4                   E=4,5 

 

The following drugs are classified as TNF-Alpha-blocking agents except:

1.       Golimumab

2.       Infliximab,

3.       Adalimumab

4.       Rituximab

5.       Certolizumab

 

A=1                  B=2                        C=3                           D=4                     E=5

 

The following are classified as medium acting opioids: 

 1.      Fentanyl 

 2.      Sufentanil 

 3.      Tramadol

 4.      Remifentanil  

 5.      Pethidine

 

A=1,2                  B=3,4                    C=4,5                   D=1,5                   E=1,4,2

 

Which of the following local anaesthetics are classified as esters:

 1.      Sufentanil

 2.      Cocaine

 3.      Procaine

 4.      Morphine

 5.      Pancuronium

 

A=1,2                   B=2,3                  C=3,4                   D=1,4                   E=1,5

                                      

Which of the following are adverse effects of ketamine:   

1.       Salivary and bronchial secretions        

2.       Hallucinations which might occur at induction       

3.       Ocular bleeding        

4.       Epistaxis       

5.       Lactic acidosis

 

A=1,2                  B=2,3                    C=3,4                    D=4,5                     E=1,5

 

The potency of inhaled anaesthetic is defined quantitatively as:

1.       Blood/gas partition coefficient

2.       Cerebrovascular resistance

3.       Minimum alveolar concentration

4.       Diffusion hypoxia

5.       Long shelf life

 

A=1                      B=2                      C=3                    D=4                     E=5

An 80 year old patient with asthma and low blood pressure requires anaesthesia for an emergency surgical procedure. Which of the following agents would be most appropriate for inducing anaesthesia in this patient?

1.       Propofol

2.       Thiopental

3.       Midazolam

4.       Ketamine

5.       Lorazepam

 

A=1                       B=2                      C=3                        D=4                       E=5

 

 

Ibuprofen may be used in the following conditions:

1.       Dysmenorrhoea

2.       Peptic ulcer

3.       Rheumatoid arthritis

4.       Osteoarthritis

5.       Gastroesophageal reflux disease

 

A=1,2,3                  B=2,3,5                 C=1,3,4                D=1,2,5                E=2,4,5

 

 

The following drugs are non depolarizing muscle relaxant except:

1.       Atracurium

2.       Cisatracurium

3.       Succinylcholine

4.       Vecuronium

5.       Rocuronium

 

A=1                     B=2                      C=3                  D=4                     E=5

 

 

The following are adverse effects of propofol:

1.       Weight gain

2.       Insomnia

3.       Gynaecomastia

4.       Apnoea following induction

5.       Pain at the injection site

 

A=1,2                   B=1,3                    C=2,3                   D=3,4                   E=4,5

 

The following are classified as intravenous induction agents except:

1.              Thiopentone

2.              Propofol

3.              Ketamine

4.              Etomidate

5.              Indomethacin

A=1            B=2             C=3            D=4                      E=5 


MATCH:


Match the description in column B with the corresponding information in column A.

 

Column A:                                                                              

A.        Diphenhydramine

B.        Cetirizine

C.        Zarfirlukast

D.        Triamcinolone

E.        Formoterol

F.        Montelukast

 

Column B:

1.          Second generation antihistamine         

2.           Intranasal corticosteroid                    

3.          Inhibitor of cytochrome P-450            

4.          First generation antihistamine            

5.          Long-term treatment of asthma                 

6.          Leukotriene receptor antagonist                

 

                                                                        


Match the following drugs with their appropriate description.

 

A.              Topiramate                                                                                  

B.              Imipramine                                                                                   

C.              Ethosuximide                                                                              

D.              Amantadine                                                                                 

E.              Clozapine

 

1.            Agranulocytosis                         

2.             Absence seizures                        

3.             Lennox-Gastaut syndrome          

4.             Parkinson’s disease                     

5.             Nocturnal enuresis                            

 

 

 Match the following drugs with their appropriate description. Each answer may be used more than once or not at all:

 

A.      Levodopa                                                                                     

B.      Fluoxetine                                                                                    

C.      Phenytoin                                                                                    

D.      Lithium                                                                                            

E.       Reserpine

 

 

1.            Bipolar affective disorder            

2.            Schizophrenia                             

3.            Major depressive disorder           

4.            Parkinson’s disease                     

5.            Tonic-clonic seizures                       

           


Match the following classification with its appropriate drug. Each drug may be used more than once or not at all:

 

A.      Succinylcholine  

B.       Abatacept

C.      Sevoflurane

D.      Tocilizumab

E.       Rituximab

 

1.     T-cell-modulating biologic           

2.     B-cell cytotoxic agent                            

3.     Anti-IL6 receptor antibody                    

4.     Inhalational agent                                 

5.     Depolarizing muscle relaxant agent       

     

 

 Match the mechanism of actions for the following drugs. Each drug may be used more than once or not at all:

 

A.      Midazolam

B.       Colchicine

C.      Probenecid

D.      Allopurinol

E.      Paracetamol

 

 

1.     Inhibits prostaglandin synthesis                                                                       

2.     Act on GABA  A receptors increasing membrane conductance of chloride ions   

3.     Inhibits leukocyte entry into affected joint in acute gout                                     

4.     Inhibits xanthine oxidase                                                                                  

5.     Reduce tubular reabsorption of uric acid 


DESCRIPTIVE QUESTIONS   


Name three drugs classified as intranasal corticosteroids.                                                             (3)

Name three inflammatory mediators.                                                                                           (3)

Why is Levodopa and Carbidopa given together in the management of Parkinson’s disease?  (3)

Name three therapeutic uses of selective serotonin re-uptake inhibitors.                                   (3)

Describe the mechanism of action of benzodiazepine.                                  (2)

List four contraindications of succinylcholine.                                                                              (4)

List three adverse effects of aspirin.                                                                                  (3)