1) A 55-year-old woman with a history of atrial fibrillation is admitted to the emergency department following a syncopal episode. She reports accidentally ingesting twice her daily dose of levothyroxine (synthetic thyroxine) for the past week. Physical exam reveals a heart rate of 140 beats per minute and a fine tremor in her hands. Laboratory results show elevated free T4 levels and normal TSH levels. Which of the following findings is the MOST concerning complication of her thyroxine overdose?
A. Development of Graves' disease
B. Acute kidney injury
C. Electrolyte imbalances
D. Thyroid storm
E. Agranulocytosis
2) The most prevalent type of antibody found in maternal plasma that has role in fetal protection and has long-lasting nature is likely;
a- Immunoglobulin M
b- Immunoglobulin G
c- Immunoglobulin A
d- Immunoglobulin E
e- Immunoglobulin D
3) Among the following oral anticoagulants, which one usually requires a lead-in period with a parenteral anticoagulant (like heparin) for 5-10 days before starting the medication to achieve effective blood thinning (therapeutic anticoagulation)?
A. Dabigatran
B. Edoxaban
C. Apixaban
D. Rivaroxaban
E. Warfarin
4) Identify the well-known culprit bacterium that plays a significant role in the development of dental caries (cavities)?
a- Escherichia coli
b- Streptococcus
c- Streptococcus mutans
d- Listeria monocytogenes
e- Corynebacterium diphtheria
5) The coordinated interaction between the hypothalamus, anterior pituitary, and adrenal cortex results in the production and delivery of the hormone called 'cortisol'. What is expected after this hormone is released in the body?
a- decreased inflammation
b- decreased protein breakdown
c- increased gluconeogenesis
d- increased insulin release
e- both a and c
6) The following is NOT the key characteristic of normal erythrocytes?
a- They contain a protein named hemoglobin that carries oxygen and carbon dioxide
b- Erythrocytes typically have a biconvex disc shape
c- Mature erythrocytes lacks nucleus, mitochondria, and other organelles
d- Erythrocytes are highly flexible, allowing them to deform as they pass through capillaries and other narrow blood vessels without rupturing
e- Erythropoietin, the hormone responsible for the formation of new erythrocytes, is released by the kidneys
7) If a patient has a history of seizures or is at risk of developing them, prescribing which class of antidepressants can be considered as they are likely to have the least effect on seizure threshold compared to other classes of antidepressants?
A) Tricyclic antidepressants (TCAs)
B) Monoamine oxidase inhibitors (MAOIs)
C) Selective serotonin reuptake inhibitors (SSRIs)
D) Serotonin-norepinephrine reuptake inhibitors (SNRIs)
E) Atypical antidepressants
8) What are the characteristic features of Pityriasis Versicolor?
A) Raised, itchy, red patches with central clearing
B) Circular, scaly, erythematous plaques with a central depression
C) Fine, powdery, hypopigmented or hyperpigmented patches on the skin
D) Linear streaks of vesicles on an erythematous base
E) Large, fluid-filled blisters on an erythematous background
9) Which of the following substances is most likely to interfere with the effectiveness of Warfarin (a blood thinner)?
A) Ginkgo
B) Omeprazole
C) St. John's Wort
D) Cranberry juice
E) Levothyroxine
10) What is the alcohol concentration in parts per million (ppm) found in the bloodstream of a reckless driver, if it comprises 0.1% alcohol?
(A) 100 ppm
(B) 1000 ppm
(C) 10 ppm
(D) 250 ppm
(E) 100,000 ppm
11) Drug / Drug class that typically does not require dose adjustment in renal impairment;
a- Linezolid
b- Beta-blockers
c- Digoxin
d- atorvastatin
e- all of the above
12) A 2-year-old child with frequent ear infections is undergoing diagnostic tests to determine the cause. Laboratory results show a significant decrease in serum IgA levels. Which of the following statements is MOST consistent with this finding?
A. The child is likely to have a weakened immune response to respiratory infections
B. The child is more susceptible to allergic reactions
C. The child's body is overproducing antibodies
D. The child's B cells are not functioning properly
E. The child has a severe autoimmune disease
13) Which of the following antidepressants is/are considered relatively safe during pregnancy?
a- Fluoxetine
b- Nortriptyline
c- Doxepine
d- Duloxetine
e- both a and d
14) Cystic fibrosis (CF) is an inherited genetic condition. Which of the following statements is INCORRECT about the inheritance of CF in children?
a- If both parents are carriers of the CF gene, there is a 25% chance of having a child with CF
b- A child would need to inherit a mutated gene from any one of the parents to contract CF
c- People who are carriers of CF typically have no symptoms and are unaware of their carrier status
d- There's no chance of having a child with CF, if only one parent is a carrier
e- If only one parent is a carrier, there is a 50% chance of having a child who is a carrier
15) A pregnant patient experiencing tonic-clonic seizures is currently taking valproic acid. What is the most appropriate course of action?
a) Discontinue valproic acid and switch to an alternative anticonvulsant medication
b) Continue valproic acid treatment and add iron supplements
c) Proceed with valproic acid and prescribe a multivitamin supplement
d) Maintain valproic acid therapy while supplementing with a higher dose of folic acid than what's typically recommended for pregnant women not taking this medication
e) Reduce the dosage of valproic acid and closely monitor serum levels
16) Which of the following statements about the pharmacokinetics of warfarin is correct?
A) Warfarin is primarily excreted unchanged by the kidneys.
B) The half-life of warfarin is approximately 24 hours.
C) Warfarin is highly bound to plasma proteins.
D) Warfarin has a rapid onset of action.
E) Warfarin's anticoagulant effect is immediate upon administration.
17) Which of the following drugs acts as a partial agonist at nicotinic acetylcholine receptors and is used for smoking cessation?
A) Varenicline
B) Bupropion
C) Nicotine
D) Clonidine
E) Nortriptyline
18) Which of the following drugs inhibits the sodium-glucose co-transporter 2 (SGLT2) in the kidney, leading to increased glucose excretion in the urine?
A) Metformin
B) Pioglitazone
C) Canagliflozin
D) Glipizide
E) Sitagliptin
19) Which of the following antimicrobial agents inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit?
A) Ciprofloxacin
B) Gentamicin
C) Doxycycline
D) Azithromycin
E) Vancomycin
20) Which of the following antihypertensive drugs acts as an angiotensin II receptor blocker (ARB)?
A) Lisinopril
B) Amlodipine
C) Hydrochlorothiazide
D) Losartan
E) Metoprolol
21) The oxidative process that generates a free radical from a lipid is termed:
a. termination
b. reduction
c. initiation
d. oxidation
e. ionization
22) Which of the following drugs is primarily metabolized by CYP2D6 and has significant drug-drug interactions due to this pathway?
A) Warfarin
B) Omeprazole
C) Codeine
D) Losartan
E) Acetaminophen
23) Identify the one statement that is FALSE among the following?
a. the upper part of the tongue also contributes to the sense of smell
b. bronchioles are the endpoint of respiration
c. the diaphragm contracts to pull air in during inhalation and relaxes to push air out during exhalation
d. the trachea (windpipe) is located in front of the esophagus (food pipe)
e. chemoregulation is the automatic control of breathing based on the levels of oxygen and carbon dioxide in the blood
24) Which of the following drugs is most likely to cause the adverse effect of gingival hyperplasia?
A) Phenytoin
B) Metformin
C) Lisinopril
D) Atorvastatin
E) Furosemide
25) Muscle contraction facilitated by the binding of calcium to calmodulin is characteristic of which type of muscle?
A) Smooth muscle
B) Skeletal muscle
C) Cardiac muscle
D) Striated muscle
E) Myofibrillar muscle
26) Which of the following bulk-forming laxatives is considered safe for use during all trimesters of pregnancy?
A) Polyethylene glycol (PEG)
B) Lactulose
C) Psyllium
D) Bisacodyl
E) Docusate sodium
27) Which of the following medications is contraindicated in patients with a history of sulfa allergy?
A) Penicillin
B) Furosemide
C) Clindamycin
D) Metronidazole
E) Azithromycin
28) Regarding the use of Sodium Picosulfate during pregnancy, which of the following is true?
A) It is absolutely safe and recommended during all trimesters.
B) It is contraindicated throughout pregnancy.
C) It should be used with caution and only under medical supervision.
D) It is the first-line treatment for constipation in pregnant women.
E) It has been proven to cause fetal malformations.
29) A 22-year-old man has a fractured femur after falling off a motorcycle. To control his pain, morphine is chosen as a treatment. What properties of morphine make it a good choice for this patient?
a- It has no anti-inflammatory properties
b- It has a quick onset of action and a longer duration of effect
c- It has a slow onset of action
d- It may cause histamine release
e- It is non-addictive
30) Which of the following medications works by inhibiting the late sodium current (INa) in cardiac cells?
A) Amiodarone
B) Ranolazine
C) Dofetilide
D) Sotalol
E) Digoxin
31) Which of the following amino acid residues is known for having a side chain that can be methylated rather than phosphorylated?
A) Lysine
B) Glutamine
C) Serine
D) Threonine
E) Cysteine
32) Herd immunity is crucial in preventing outbreaks of infectious diseases in a community. Which of the following benefits of high herd immunity is primarily related to protecting individuals who are at higher risk due to medical conditions or age?
A) It improves vaccine efficacy.
B) It ensures the availability of vaccines.
C) It prevents the spread of diseases to those unable to be vaccinated.
D) It increases the number of available healthcare providers.
E) It reduces the frequency of vaccine side effects.
33) Which mechanism best describes how Abatacept functions?
A) Activating adenosine receptors
B) Interacting with CD80/86 on antigen-presenting cells
C) Blocking B cell receptors
D) Stimulating T cell receptors
E) Binding to MHC Class II on B cells
34) A 52-year-old man with a history of some medical condition is prescribed a combination therapy of fenofibrate and nicotinic acid. What is the primary target of this medication combination?
A. Lowering blood pressure
B. Treating vitamin deficiency
C. Reducing blood sugar levels
D. Managing blood clotting disorders
E. Controlling high blood cholesterol
35) Which of the following medications is most likely to increase the activity of a cytochrome P450 enzyme?
A) Phenytoin
B) Erythromycin
C) Ketoconazole
D) Ciprofloxacin
E) Fluoxetine
45) In response to a drop in systemic blood pressure, which of the following physiological responses is most likely to occur to help normalize blood pressure?
A) Increased release of antidiuretic hormone (ADH)
B) Decreased cardiac output
C) Dilation of systemic veins
D) Increased secretion of atrial natriuretic peptide (ANP)
E) Decreased renin production
49) A patient receives a continuous IV infusion of Drug X at a rate of 3 mg/min. Drug X has a half-life of 2 hours and a volume of distribution of 100 L. What is the expected steady-state concentration of Drug X in plasma?
A) 0.8 mg/L
B) 1.2 mg/L
C) 1.6 mg/L
D) 2.0 mg/L
E) 2.4 mg/L
50) Which neurotransmitter is most closely associated with the regulation of mood and is often targeted by antidepressant medications?
a. Dopamine
b. Serotonin
c. Acetylcholine
d. Norepinephrine
e. GABA
51) The contraction mechanism in cardiac muscle involves the binding of calcium to which protein?
A) Troponin
B) Tropomyosin
C) Myosin
D) Actin
E) Calmodulin
56) Which of the following is true regarding the spleen's function?
A) It stores and concentrates bile.
B) It is the primary site of red blood cell production in adults.
C) It filters blood and recycles iron.
D) It produces digestive enzymes.
E) It regulates blood glucose levels.
57) Which of the following is the primary function of the vas deferens in the male reproductive system?
A) Production of sperm
B) Transport of sperm from the epididymis to the ejaculatory ducts
C) Secretion of testosterone
D) Nourishment of sperm
E) Storage of sperm
58) Which of the following best describes the mechanism of action of the monoclonal antibody Rituximab?
A) It binds to CD20 on B cells
B) It inhibits TNF-alpha
C) It activates complement proteins
D) It blocks interleukin-2 receptors
E) It binds to CD3 on T cells
60) Which of the following conditions is most likely to cause a shift in the location of the spleen?
A) Hepatomegaly
B) Splenomegaly
C) Ascites
D) Pancreatitis
E) Cholecystitis
61) Which of the following organisms responsible for community-acquired pneumonia is linked with the highest mortality rate in adults?
A) Legionella pneumophila
B) Mycoplasma pneumoniae
C) Moraxella catarrhalis
D) Streptococcus pneumoniae
E) Pseudomonas aeruginosa
63) Which of the following laxatives should be avoided during pregnancy due to its potential to induce uterine contractions?
A) Psyllium
B) Docusate sodium
C) Polyethylene glycol (PEG)
D) Castor oil
E) Lactulose
64) Which of the following terms best describes the process in which a solid substance absorbs moisture from the atmosphere and forms a solution?
A) Deliquescence
B) Efflorescence
C) Crystallization
D) Hygroscopicity
E) Desorption
65) Which of the following organisms is a facultative intracellular pathogen?
A) Mycobacterium tuberculosis
B) Escherichia coli
C) Streptococcus pyogenes
D) Staphylococcus epidermidis
E) Pseudomonas aeruginosa
66) In CNS, the internal capsule which is a major white matter structure that contains important pathways primarily connects which of the following structures?
A) The cerebral cortex and the thalamus
B) The frontal and parietal lobes
C) The cerebral cortex and the brainstem
D) The cerebral cortex and the spinal cord
E) The cerebellum and the pons
67) The two structures shown represent different stereoisomers. Which type of stereoisomerism do these structures illustrate?
A) Enantiomerism
B) Diastereoisomerism
C) Geometric isomerism
D) Conformational isomerism
E) Structural isomerism
68) Which of the following pairs of compounds best illustrates the concept of diastereoisomerism?
A) (R)-2-butanol and (S)-2-butanol
B) Cis-2-butene and trans-2-butene
C) D-glucose and D-galactose
D) L-alanine and D-alanine
E) Ethanol and dimethyl ether
69) Which of the following is the primary mechanism of action of Sodium Picosulfate?
A) Inhibits sodium-potassium ATPase
B) Stimulates the enteric nerves to cause peristalsis
C) Increases water absorption in the colon
D) Blocks serotonin receptors in the GI tract
E) Binds to opioid receptors in the GI tract
70) Which of the following muscle groups is primarily innervated by the femoral nerve, playing a critical role in stabilizing and moving the leg?
A) Quadriceps muscles
B) Calf muscles
C) Hamstring muscles
D) Gluteal muscles
E) Abductor muscles
71) Norepinephrine is often used in the treatment of septic shock because it:
A) Increases heart rate by stimulating beta-1 adrenergic receptors.
B) Causes vasodilation in skeletal muscle.
C) Enhances cardiac output by increasing stroke volume.
D) Induces peripheral vasoconstriction by stimulating alpha-adrenergic receptors.
E) Reduces pulmonary artery pressure.
72) A compound formed by the reaction of a hydroxyl group and a carboxyl group within the same molecule is called:
A) Lactone
B) Amide
C) Ether
D) Alcohol
E) Ketone
73. Which of the following is a key requirement for vaccine cold chain management?
A) Vaccines must be stored in a freezer at all times
B) Diluents and vaccines should always be stored together
C) The temperature for storing vaccines should be between 2-8°C
D) Vaccines can be stored at room temperature temporarily
E) All vaccines must be stored at sub-zero temperatures
74) Which of the following systems is primarily used in pharmacies to manage and track medication dispensing and inventory control?
A) Pharmacy Inventory System (PIS)
B) Medication Management System (MMS)
C) Point of Sale (POS) system
D) Automated Prescription System (APS)
E) Universal Inventory Tracking System (UITS)
76) Enkephalins are released by which of the following structures?
a. Pituitary gland
b. Hippocampus
c. Cerebellum
d. Periaqueductal grey matter
e. Pineal gland
77) Which of the following factors most significantly affects the physical stability of an oil-in-water emulsion in vitro when the drug is contained in the dispersed phase?
A) Concentration of the preservative
B) Drug's molecular mass
C) Size of the particles in the internal phase
D) Emulsifier's affinity for water
E) Type of thickening agent used
78) Question: Cortisone is a steroid hormone with the chemical formula C₂₁H₂₈O₅. Which of the following statements about its structure is correct?
A. Cortisone contains a total of 21 carbon atoms, arranged in a linear chain with multiple hydroxyl groups attached.
B. The structure of cortisone includes four fused rings, specifically three cyclohexane rings and one cyclopentane ring, with various functional groups such as hydroxyl and ketone groups.
C. Cortisone is characterized by a single aromatic ring with alternating double bonds and a carboxyl group.
D. The molecular structure of cortisone consists of a branched chain of carbon atoms with multiple double bonds and a single hydroxyl group.
E. Cortisone has a polycyclic structure with three benzene rings and one cyclohexane ring, including hydroxyl and ketone groups.
79) Which of the following drugs or vaccines requires storage in the deep freezer?
A) Ganciclovir
B) Influenza vaccine
C) Hepatitis B vaccine
D) Zoster vaccine
E) Diluents for MMR vaccine
80. Automation in pharmacies has led to increased efficiency. However, which of the following statements is false?
A) Automation eliminates prescription filling errors completely
B) Technicians must adhere to strict policies when filling automated devices
C) Automation assists with inventory tracking
D) Pharmacists remain responsible for verifying the accuracy of prescriptions
E) Automation can improve workflow and reduce human error
A) Automation eliminates prescription filling errors completely
B) Technicians must adhere to strict policies when filling automated devices
C) Automation assists with inventory tracking
D) Pharmacists remain responsible for verifying the accuracy of prescriptions
E) Automation can improve workflow and reduce human error
86) Which of the following is a limitation of bar code technology in hospital settings?
A) Helps to identify the nurse administering the drug
B) Ensures correct medication administration
C) Not all medications contain a bar code
D) Decreases patient safety
E) Improves tracking of medication history
87) Which of the following best describes the formation of a hemiacetal?
A) A reaction between an aldehyde and a water molecule
B) A reaction between a ketone and an alcohol
C) A reaction between an ester and a hydroxyl group
D) A reaction between an alcohol and a carboxylic acid
E) A reaction between a ketone and an amine
88) In which abdominal region is the spleen primarily located?
A) Right iliac region
B) Left iliac region
C) Left hypochondriac region
D) Right hypochondriac region
E) Umbilical region
89) What is the primary consequence of lipid peroxidation in biological membranes?
a. Increased fluidity
b. Decreased permeability
c. Loss of membrane integrity
d. Enhanced signal transduction
e. Increased membrane thickness
90) Which of the following is an example of a drug that acts as a reversible inhibitor of monoamine oxidase A (MAO-A)?
A) Phenelzine
B) Selegiline
C) Moclobemide
D) Tranylcypromine
E) Isocarboxazid
91) Which of the following antibiotics would be ineffective against an organism that lacks a cell wall?
A) Vancomycin
B) Azithromycin
C) Doxycycline
D) Ciprofloxacin
E) Tetracycline
92) Which type of lung cell is primarily involved in the repair and regeneration of alveolar epithelial surfaces after injury, in addition to producing pulmonary surfactant?
A) Type I alveolar cells
B) Type II alveolar cells
C) Clara cells
D) Macrophages
E) Ciliated cells
94) Which of the following amino acids has a side chain that includes a sulfur atom and can form disulfide bonds?
A) Cysteine
B) Methionine
C) Tyrosine
D) Glutamine
E) Asparagine
95) Which of the following anatomical structures is primarily responsible for the production of male hormones?
A) Adrenal cortex
B) Seminal vesicles
C) Prostate gland
D) Bulbourethral glands
E) Testes
96) Which of the following is a potential side effect of Sodium Picosulfate?
A) Hyperkalemia
B) Hypertension
C) Diarrhea
D) Weight gain
E) Respiratory depression
97) Which of the following organisms is classified as an obligate intracellular bacterium, rendering it resistant to antibiotics that target cell walls?
A) Pseudomonas aeruginosa
B) Mycoplasma pneumoniae
C) Chlamydophila pneumoniae
D) Bacillus anthracis
E) Clostridium difficile
98) Which of the following best describes the role of RNA polymerase during transcription?
a. It synthesizes DNA from an RNA template
b. It unwinds the DNA double helix and synthesizes RNA
c. It splices introns out of the mRNA transcript
d. It translates mRNA into a polypeptide chain
e. It synthesizes tRNA molecules from a DNA template
99) What organism is primarily responsible for causing Pityriasis Versicolor?
A) Malassezia furfur
B) Candida albicans
C) Trichophyton rubrum
D) Staphylococcus aureus
E) Streptococcus pyogenes
100) A 72-year-old patient with a history of heart failure arrives at the emergency room with hypertensive crisis. Which of the following medications is LEAST likely to be included in their initial IV infusion for blood pressure control?
A) Labetalol
B) Nicardipine
C) Fenoldopam
D) Hydralazine
E) Nitroglycerin
Note: More MCQs coming. Your support is vital for this website to continue.
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Answer Keys
MCQ # - Correct option
1- D
2- b
3- A
4- c
5- e
6- b
7- C
8- C
Explanation:
A) Incorrect. Raised, itchy, red patches with central clearing are more characteristic of conditions like psoriasis or eczema, rather than Pityriasis Versicolor.
B) Incorrect. Circular, scaly, erythematous plaques with a central depression are more indicative of conditions like tinea corporis (ringworm), rather than Pityriasis Versicolor.
C) Correct. Pityriasis Versicolor typically presents as fine, powdery, hypopigmented or hyperpigmented patches on the skin, often in areas of increased sebum production, such as the chest, back, and shoulders.
D) Incorrect. Linear streaks of vesicles on an erythematous base are more characteristic of conditions like contact dermatitis or herpes simplex virus infection.
E) Incorrect. Large, fluid-filled blisters on an erythematous background are more indicative of conditions like bullous pemphigoid or pemphigus vulgaris, rather than Pityriasis Versicolor.
9- C
The answer is: C) St. John's Wort
Here's why:
- Warfarin works by inhibiting vitamin K, which is essential for blood clotting.
- St. John's Wort, an herbal supplement sometimes used for depression, may induce enzymes in the liver that metabolize Warfarin faster. This can potentially reduce the amount of Warfarin available to exert its anticoagulant effect, thereby decreasing its effectiveness.
The other options have a lesser impact on Warfarin:
- A) Ginkgo: While Ginkgo might have some blood-thinning properties, it's not a well-established antagonist of Warfarin.
- B) Omeprazole: This medication used for stomach ulcers might have minor interactions with Warfarin, but it's not a major antagonist.
- D) Cranberry juice: Some studies suggest cranberry juice might interfere with Warfarin's action, although the evidence is not conclusive. It's best to discuss consumption with your doctor.
- E) Levothyroxine: This medication used for hypothyroidism typically doesn't significantly affect Warfarin's action.
10- B
Solution:
To convert the concentration of alcohol from a percentage to parts per million (ppm), you can use the fact that 1% = 10,000 ppm.
Given that the blood of the reckless driver contains 0.1% alcohol, we can calculate the concentration in parts per million as follows:
0.1% alcohol = 0.1 × 10,000 ppm = 1000 ppm
So, the correct answer is (B) 1000 ppm.
11- e
12- A
13- e
14- b
15- d
16- C) Warfarin is highly bound to plasma proteins.
Explanation:
A) Incorrect. Warfarin is metabolized by the liver and its metabolites are excreted in the urine.
B) Incorrect. The half-life of warfarin is typically between 20 to 60 hours.
C) Correct. Warfarin is highly bound to plasma proteins, particularly albumin, which affects its distribution and duration of action.
D) Incorrect. Warfarin has a delayed onset of action because it affects the synthesis of clotting factors, which takes time.
E) Incorrect. The anticoagulant effect of warfarin is not immediate; it typically takes several days to achieve a therapeutic effect.
17- A) Varenicline
Explanation:
A) Correct. Varenicline is a partial agonist at nicotinic acetylcholine receptors and is used to aid smoking cessation by reducing withdrawal symptoms and the rewarding effects of nicotine.
B) Incorrect. Bupropion is an atypical antidepressant that also aids in smoking cessation but does not act as a partial agonist at nicotinic receptors.
C) Incorrect. Nicotine is a full agonist at nicotinic acetylcholine receptors.
D) Incorrect. Clonidine is an alpha-2 adrenergic agonist used for hypertension and opioid withdrawal, not smoking cessation.
E) Incorrect. Nortriptyline is a tricyclic antidepressant sometimes used off-label for smoking cessation, but it does not act on nicotinic receptors.
18- C) Canagliflozin
Explanation:
A) Incorrect. Metformin primarily works by decreasing hepatic glucose production and improving insulin sensitivity.
B) Incorrect. Pioglitazone is a thiazolidinedione that improves insulin sensitivity.
C) Correct. Canagliflozin is an SGLT2 inhibitor that increases urinary glucose excretion by inhibiting glucose reabsorption in the kidney.
D) Incorrect. Glipizide is a sulfonylurea that stimulates insulin secretion from the pancreas.
E) Incorrect. Sitagliptin is a DPP-4 inhibitor that enhances the incretin system, increasing insulin secretion and decreasing glucagon levels.
19- D) Azithromycin
Explanation:
A) Incorrect. Ciprofloxacin is a fluoroquinolone that inhibits DNA gyrase.
B) Incorrect. Gentamicin is an aminoglycoside that binds to the 30S ribosomal subunit.
C) Incorrect. Doxycycline is a tetracycline that also binds to the 30S ribosomal subunit.
D) Correct. Azithromycin is a macrolide that inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit.
E) Incorrect. Vancomycin inhibits cell wall synthesis by binding to the D-alanyl-D-alanine terminus of cell wall precursors.
20- D) Losartan
Explanation:
A) Incorrect. Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor.
B) Incorrect. Amlodipine is a calcium channel blocker.
C) Incorrect. Hydrochlorothiazide is a thiazide diuretic.
D) Correct. Losartan is an angiotensin II receptor blocker (ARB) that prevents angiotensin II from binding to its receptors, thus lowering blood pressure.
E) Incorrect. Metoprolol is a beta-blocker that reduces heart rate and cardiac output.
21- C
22- C) Codeine
Explanation:
A) Incorrect. Warfarin is primarily metabolized by CYP2C9.
B) Incorrect. Omeprazole is primarily metabolized by CYP2C19.
C) Correct. Codeine is primarily metabolized by CYP2D6 to its active form, morphine, and can have significant drug-drug interactions with CYP2D6 inhibitors.
D) Incorrect. Losartan is primarily metabolized by CYP2C9.
E) Incorrect. Acetaminophen is metabolized primarily through conjugation reactions and to a lesser extent by CYP2E1.
23- B
24- A. Phenytoin
Explanation:
A) Correct. Phenytoin, an anticonvulsant, is well-known for causing gingival hyperplasia as a side effect.
B) Incorrect. Metformin does not typically cause gingival hyperplasia; it is mainly associated with gastrointestinal side effects.
C) Incorrect. Lisinopril is an ACE inhibitor and does not cause gingival hyperplasia.
D) Incorrect. Atorvastatin is a statin and does not cause gingival hyperplasia.
E) Incorrect. Furosemide is a loop diuretic and does not cause gingival hyperplasia.
25- A) Smooth muscle
26- C) Psyllium
Explanation:
A) Incorrect. Polyethylene glycol is generally considered safe but not specifically a bulk-forming laxative.
B) Incorrect. Lactulose is an osmotic laxative, not a bulk-forming laxative.
C) Correct. Psyllium, a bulk-forming laxative, is considered safe for use during all trimesters of pregnancy.
D) Incorrect. Bisacodyl is a stimulant laxative and is typically used with caution during pregnancy.
E) Incorrect. Docusate sodium is a stool softener, not a bulk-forming laxative.
27- B. Furosemide
Explanation:
A) Incorrect. Penicillin is a beta-lactam antibiotic and does not contain a sulfa moiety.
B) Correct. Furosemide is a sulfonamide diuretic and can cause allergic reactions in patients with a history of sulfa allergy.
C) Incorrect. Clindamycin is a lincosamide antibiotic and does not contain a sulfa moiety.
D) Incorrect. Metronidazole is a nitroimidazole antibiotic and does not contain a sulfa moiety.
E) Incorrect. Azithromycin is a macrolide antibiotic and does not contain a sulfa moiety.
28- C) It should be used with caution and only under medical supervision.
Explanation:
A) Incorrect. It is not absolutely safe and is not recommended as the first-line treatment.
B) Incorrect. It is not absolutely contraindicated but should be used with caution.
C) Correct. Sodium Picosulfate should be used with caution during pregnancy and only under medical supervision.
D) Incorrect. It is not the first-line treatment for constipation in pregnant women; bulk-forming laxatives are generally preferred.
E) Incorrect. There is no conclusive evidence proving it causes fetal malformations, but caution is still advised.
29- b) Morphine is ideal for this patient because it has a quick onset of action, which means it will work quickly to relieve his pain. It also has a longer duration of effect, which means it will continue to relieve his pain for a longer period of time. Morphine is a powerful opioid painkiller that is very effective in controlling severe pain.
30- B. Ranolazine
Explanation:
A) Incorrect. Amiodarone primarily blocks potassium channels but also affects sodium and calcium channels.
B) Correct. Ranolazine inhibits the late sodium current (INa) in cardiac cells, which helps reduce ischemic symptoms in angina.
C) Incorrect. Dofetilide is a class III antiarrhythmic that blocks potassium channels.
D) Incorrect. Sotalol is a class III antiarrhythmic that also has beta-blocking properties.
E) Incorrect. Digoxin inhibits the sodium-potassium ATPase pump, not the late sodium current.
31- A) Lysine
Explanation:
Lysine has a side chain that can be methylated by various methyltransferases. Phosphorylation typically occurs on serine, threonine, or tyrosine residues.
32- C) It prevents the spread of diseases to those unable to be vaccinated.
Explanation: High herd immunity helps to shield individuals who cannot be vaccinated, such as those with certain medical conditions or very young children, by reducing the overall spread of the disease within the community.
33- B
34- E
35- A) Phenytoin
36-
37-
38-
39-
40-
41-
42-
43-
44-
45- A) Increased release of antidiuretic hormone (ADH)
Explanation: In response to decreased blood pressure, the body often increases the release of antidiuretic hormone (ADH), which helps to retain water and increase blood volume, thereby aiding in the restoration of normal blood pressure.
46-
47-
48-
49- C) 1.6 mg/L
50- b. Serotonin
51- A) Troponin
52-
53-
54-
55-
56- C) It filters blood and recycles iron.
57- B) Transport of sperm from the epididymis to the ejaculatory ducts
58- A) It binds to CD20 on B cells
59-
60- B) Splenomegaly
61- E) Pseudomonas aeruginosa
Explanation:
Pseudomonas aeruginosa is associated with a higher mortality rate in community-acquired pneumonia, particularly in patients with compromised immune systems or underlying chronic conditions.
However, Streptococcus pneumoniae (Option D) is also a common cause of community-acquired pneumonia and can have significant mortality, especially in older adults or those with comorbidities, but Pseudomonas aeruginosa is generally associated with more severe cases and worse outcomes.
62-
63- D) Castor oil
64- A) Deliquescence
65- A) Mycobacterium tuberculosis
66- C) The cerebral cortex and the brainstem
Explanation:
The internal capsule is a major white matter structure in the brain that connects the cerebral cortex with the brainstem (including the medulla). It carries both motor and sensory information between these areas, facilitating communication between the cortex and lower brain regions.
67- B) Diastereoisomerism
68- C) D-glucose and D-galactose
69- B) Stimulates the enteric nerves to cause peristalsis
Explanation:
A) Incorrect. This mechanism is related to other medications like cardiac glycosides.
B) Correct. Sodium Picosulfate is a stimulant laxative that works by stimulating the enteric nerves, leading to increased peristalsis and bowel movement.
C) Incorrect. This is more characteristic of bulk-forming or osmotic laxatives.
D) Incorrect. Blocking serotonin receptors is a mechanism for certain antiemetics.
E) Incorrect. Binding to opioid receptors is a mechanism for opioid agonists and antagonists.
70- A) Quadriceps muscles
Explanation: The femoral nerve primarily innervates the quadriceps muscles, which are crucial for knee extension and hip flexion, and essential for activities like walking, running, and climbing stairs.
71- D) Induces peripheral vasoconstriction by stimulating alpha-adrenergic receptors.
72- A) Lactone
73- C) The temperature for storing vaccines should be between 2-8°C
74- C) Point of Sale (POS) system
75-
76- D
77- C
78- B. The structure of cortisone includes four fused rings, specifically three cyclohexane rings and one cyclopentane ring, with various functional groups such as hydroxyl and ketone groups.
79- A) Ganciclovir
80- A) Automation eliminates prescription filling errors completely
81-
82-
83-
84-
85-
86- C) Not all medications contain a bar code
87- B) A reaction between a ketone and an alcohol
88- C) Left hypochondriac region
89- c. Loss of membrane integrity
90- C. Moclobemide
Explanation:
A) Incorrect. Phenelzine is an irreversible inhibitor of both MAO-A and MAO-B.
B) Incorrect. Selegiline is an irreversible inhibitor of MAO-B at low doses and MAO-A at higher doses.
C) Correct. Moclobemide is a reversible inhibitor of monoamine oxidase A (RIMA), used primarily for the treatment of depression.
D) Incorrect. Tranylcypromine is an irreversible inhibitor of both MAO-A and MAO-B.
E) Incorrect. Isocarboxazid is an irreversible inhibitor of both MAO-A and MAO-B.
91- A) Vancomycin
92- B) Type II alveolar cells
93-
94- A) Cysteine
Explanation:
Cysteine contains a thiol (-SH) group in its side chain, which allows it to form disulfide bonds that stabilize protein structures.
95- E) Testes
Explanation:
The testes are the primary site for the production of male hormones, particularly testosterone, which plays a crucial role in male reproductive development and overall health.
96- C) Diarrhea
Explanation:
A) Incorrect. Hyperkalemia is not a typical side effect of Sodium Picosulfate.
B) Incorrect. Hypertension is not associated with Sodium Picosulfate use.
C) Correct. Diarrhea is a common side effect of stimulant laxatives like Sodium Picosulfate.
D) Incorrect. Weight gain is not typically associated with Sodium Picosulfate.
E) Incorrect. Respiratory depression is not associated with the use of Sodium Picosulfate.
97- C) Chlamydophila pneumoniae
98- b. It unwinds the DNA double helix and synthesizes RNA.
99- A
Explanation:
A) Correct. Pityriasis Versicolor is primarily caused by the yeast-like fungus Malassezia furfur (also known as Malassezia globosa or Malassezia furfur). It is a normal component of the skin flora but can overgrow under certain conditions, leading to the characteristic skin changes seen in Pityriasis Versicolor.
B) Incorrect. Candida albicans is a yeast species primarily responsible for causing candidiasis, which typically manifests as oral thrush, vaginal yeast infections, or invasive candidiasis, rather than Pityriasis Versicolor.
C) Incorrect. Trichophyton rubrum is a dermatophyte fungus responsible for causing various types of tinea infections, including athlete's foot (tinea pedis) and ringworm (tinea corporis), but not Pityriasis Versicolor.
D) Incorrect. Staphylococcus aureus is a bacterium responsible for various skin infections, such as impetigo, cellulitis, and abscesses, but it is not associated with Pityriasis Versicolor.
E) Incorrect. Streptococcus pyogenes is a bacterium responsible for various infections, including strep throat and skin infections such as impetigo, but it is not associated with Pityriasis Versicolor.
100- D
Explanation:
- Labetalol, Nicardipine, Fenoldopam, and Nitroglycerin are all fast-acting medications used for rapid blood pressure reduction in hypertensive crisis.
- Hydralazine, while effective, can cause reflex tachycardia (increased heart rate) which might not be ideal for someone with a history of heart failure.
- The other options listed are more suitable for initial blood pressure control in this scenario.
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