MIDTERMS: Reviewer Flashcards
A 73 year old male has been self-medicating a drug for his insomnia for one month. He
has since missed 2 days of the medication due to his busy schedule. While in a meeting,
he was noted to be irritable, anxious, and most of the time cursed his colleagues. What
condition is the patient experiencing?
A. Cerebrovascular disease
B. Delusion of grandeur
C. Physiologic dependence
D. Psychological dependence
C. Physiologic dependence
A 41 year old female for elective surgery was given IV dose of Thiopental. In 10 seconds
the patient was already sedated. The drug’s rapid effect is most likely attributed to:
A. Drug dose
B. Lipid solubility
C. Route of administration
D. Tolerance
B. Lipid solubility
A 45 year old male with chronic active hepatitis B was prescribed the standard dose of
Zaleplon for his insomnia. The following morning the relative noted difficulty in waking
up the patient. This is most likely caused by this drug’s property:
A. Active metabolite
B. Enzyme activity
C. Impaired hepatic metabolism
D. Short half life
C. Impaired hepatic metabolism
A 32 year old male was prescribed with this drug which has the ability of increasing sleep
time as well as decreasing REM sleep.
A. Eszopiclone
B. Triazolam
C. Zaleplon
D. Zolpidem
A. Eszopiclone
Which first-generation antiseizure medication works by enhancing the effects of GABA
and is often limited by sedation and tolerance issues?
A. Phenytoin
B. Clonazepam
C. Lamotrigine
D. Levetiracetam
B. Clonazepam
Which of the following is a first-generation antiseizure medication commonly used to
treat status epilepticus?
A. Gabapentin
B. Diazepam
C. Lamotrigine
D. Topiramate
B. Diazepam
A 41 year old female was given Thiopental for her elective surgery. The patient was
easily aroused after the surgery. What property of the drug is responsible for this?
A. Hepatic metaboism
B. Lipid solubility
C. Rapid elimination
D. Rapid tissue redistribution
D. Rapid tissue redistribution
A 25 year old male has been taking Zolpidem 1 tab nightly for one month to aid his
insomnia caused by anxiety. He decided to increase the dose to two tabs nightly thinking
it was not making him fall asleep easily recently. The patient may be experiencing what
effect of the drug?
A. Addiction
B. Physiologic dependence
C. Psychological dependence
D. Tolerance
D. Tolerance
Which drug is a broad-spectrum anti-epileptic agent also used for bipolar disorder and
migraine prophylaxis?
A. Lamotrigine
B. Gabapentin
C. Valproic acid
D. Vigabatrin
A 2 year old female was brought to the ER due to loss of consciousness and decreased
respiratory rate. It was noted that she ingested 15 tablets of Midazolam. What is the
next best step to reverse the drug effect?
A. Endotracheal intubation
B. Gastric lavage
C. IV Flumazenil
D. IV Naloxone
C. IV Flumazenil
. A 52 year old male admitted at the ICU for myocardial infarction was given standard dose
of IV Diazepam for his anxiety. He was then noted to be lethargic with markedly
decreased cardiac rate. What best explains this occurrence?
A. Circulatory collapse
B. Depressed transmission at the skeletal neuromuscular junction
C. Inhibition of epileptiform electrical activity
D. Linear dose-response
A. Circulatory collapse
The mechanism of action of this drug involves binding particularly at the a1 subunit of
GABAA receptor.
A. Chlordiazepoxide
B. Clorazepate
C. Eszopiclone
D. Midazolam
D. Midazolam
. This property of Phenobarbital best explains its sedative-hypnotic action.
A. Alkalinization of the urine increases its elimination
B. Binds at the a1 and B2 subunits of GABAA receptor
C. Increases duration of chloride channel opening
D. Inhibits glutamic acid neurotransmission
C. Increases duration of chloride channel opening
Which antiseizure medication can cause visual field defects as a potential side effect?
A. V igabatrin
B. Carbamazepine
C. Ethosuximide
D. Valproic acid
A. V igabatrin
Which second-generation antiseizure medication is specifically used to treat seizures
associated with Lennox-Gastaut syndrome?
A. Zonisamide
B. Biguanides
C. Rufinamide
D. Phenytoin
C. Rufinamide
What is the primary mechanism of action of phenytoin (Dilantin) in treating seizures?
A. Enhances GABA activity
B. Blocks NMDA receptors
C. Stabilizes sodium channels
D. Inhibits calcium channels
C. Stabilizes sodium channels
- Which among the following antacids, may cause constipation?
A. Sodium bicarbonate
C. Magnesium hydroxide
B. Calcium carbonate
D. Aluminum hydroxide
D. Aluminum hydroxide
What is an alternate drug for the newly-diagnosed focal seizures?
A. Levetiracetam
B. Gabapentin
C. Topiramate
D. Phenytoin
A. Levetiracetam
Which anti-epileptic drug works by enhancing the inhibitory effects of GABA at GABA-A
receptors?
A. Phenytoin
B. Carbamazepine
C. Phenobarbital
D. Topiramate
C. Phenobarbital
Which anti-epileptic drug is known to cause gingival hyperplasia as a side effect?
A. Phenytoin
B. Carbamazepine
C. Valproic acid
D. Lamotrigine
C. Valproic acid
Which drug is commonly used as an adjunctive treatment for partial seizures and is
known for its minimal drug interactions?
A. Phenytoin
B. Lamotrigine
C. Gabapentin
D. Carbamazepine
A. Phenytoin
Which of the following is the prodrug of H2 receptor antagonist?
A. Cimetidine
C. Famotidine
B. Ranitidine
D. Nizatidine
D. Nizatidine
. Risk for community acquired respiratory infection may be seen in which of the following drugs?
A. Cimetidine
C. Sucralfate
B. Omeprazole
D. Bismuth
B. Omeprazole
Which of the following is an example of anticholinergic agent used to decrease gastric acid secretion?
A. Atropine
B. Misoprostol
C. Ranitidine,
D. Pantoprazole
A. Atropine
. Which of the following is TRUE regarding Sucralfate?
A. Forms a protective gel within the stomach that adheres to ulcers
B. A disaccharide that exerts a cytoprotective effect on the stomach mucosa
C. Constipation is a side effect
D. All of the above
D. All of the above
Which of the following is an example of opioid derivative used to treat diarrhea?
A. Loperamide
C. Both A and B
B. Diphenoxylate
D. None of the above
C. Both A and B
. Which of the following anti diarrheal drugs acts by sequestering and binding bile acids within the GI tract?
A. Cholestyramine
B. Colestipol
C. Colesevelam
D. All of the above
D. All of the above
Which of the following is an example of a stimulant laxative?
C. Lactulose
A. Psyllium
D. None of the above
B. Bisacodyl
B. Bisacodyl
Which of the following is TRUE regarding Bulk forming laxatives?
A. Methylcellulose is an example
C. Both A and B
B. Absorbs water and swell within the Gl tract
D. None of the Above
stimulating peristalsis
C. Both A and B
Which of the following is an example of anti emetic?
C. Both A and B
A. Scopolamine
B. D2 blockers
D. None of the above
C. Both A and B
Which of the following drug class for the treatment of constipation act by facilitating entry of water into the fecal mass leading to softening of stool thus permitting easier defacation?
C. Stimulant Laxative
A. Lubricants
B. Bulk Forming laxatives
D. Hyperosmotic laxative
A. Lubricants
Which of the following is NOT TRUE regarding cholelitholytic agents?
A. Ursodiol is an example
B. Decreases cholesterol content of bile
C. Effective in treatment of calcified gallstones
D. May help dissolve gallstones that are supersaturated with cholesterol .
C. Effective in treatment of calcified gallstones
Which of the following is TRUE regarding Metoclopramide, a dopamine receptor antagonist?
A. Enhances the peripheral effects of
C. One of the side effects are extrapyramidal
acetylcholine
symptoms
B. Stimulates motility in the upper GI tract
D. All of the above
D. All of the above
Which of the following is TRUE regarding proton pump inhibitors?
A. They should be taken with an empty
C. It irreversibly binds with H+K+ ATPase pump
stomach.
D. All of the above
B. Omeprazole is the prodrug
D. All of the above
Which among the following mucosal protective agents, can also cause uterine contraction?
A. Bismuth subcitrate
C. Sucralfate
B. Bismuth subsalicylate
D. Misoprostol
D. Misoprostol
Which of the following is the treatment for H.pylori infection?
A. Metronidazole + Clarithromycin
B. Metronidazole + Omeprazole
C. Clarithromycin + Omeprazole
D. Amoxicillin + Clarithromycin + Omeprazole
D. Amoxicillin + Clarithromycin + Omeprazole
This is considered as a Benzodiazepine antagonist.
A.Flumazenil
B. Flurazepam (Benzodiazepine)
C. Phenobarbital (Barbiturates)
D. Zolpidem (acts on a subset of the benzodiazepine receptor family)
A.Flumazenil
Which of the following drugs used to treat peptic ulcer disease can have endocrine side effects such as gynecomastia, galactorrhea and reduced sperm count?
A. H2 receptor blocker
C. Proton Pump Inhibitors
B. Antacids
D. Mucosal Protective agents
A. H2 receptor blocker
. Which of the following is TRUE regarding systemic side effects of antacids?
A. They can cause metabolic alkalosis
C. Both A and B
B. They can cause Hypercalcemia and milk alkali
D. None of the above.
syndrome
C. Both A and B
. Which of the following is TRUE regarding digestants?
A. Examples are amylase, trypsin and lipase
C. Bile salts are example
B. Used in the treatment of cystic fibrosis
D. All of the above
D. All of the above
Which of the following anti diarrheal is CORRECTLY matched?
A. Clonidine: Stimulate Alpha 2 receptor in the.
Gl tract
B. Octreotide :Inhibits the secretion of serotonin
C. Both A and B
D. None of the above
C. Both A and B
This prolongs the time that the chloride channels remain open.
C. GABA
A. Barbiturates
D. Zolpidem: acts on a subset of the benzodiazepine receptor family
B. Benzodiazepines: increase the frequency of opening of chloride ion channels → hyperpolarization
A. Barbiturates
Characteristic of a sedative agent.
A. Encourage the onset and maintenance of sleep
B. Reduce anxiety and exert a calming effect
C. Leads to loss of consciousness with absence of response to pain
D. More pronounced CNS depression
A. Encourage the onset and maintenance of sleep
Benzodiazepines enhance relaxation and sleep by boosting the effect of this neurotransmitter.
C. Glutamate
A. Chloride
D. Glycine
B. GABA
B. GABA
Diazepam is indicated in the following.
C. Sedation
A. Muscle strain
B. Muscle spasm
D. All of the choices
D. All of the choices
Abrupt discontinuation of benzodiazepine may produce this kind of symptom.
C. Tolerance
A. Addiction
D. Withdrawal
B. Dependence
D. Withdrawal
Low doses of Barbiturates may lead to this effect.
C. Death (higher dose)
A. Anesthesia (higher dose)
D. Sedation
B. Coma (higher dose)
D. Sedation
Combination with barbiturates with this/ these drug/s may potentiate CNS depression.
C. Anticonvulsants
A. Antihistamines
D. All of the choices
B. Alcohol
D. All of the choices
Mechanism of action of this drug group is through inhibition of neuronal reuptake of norepinephrine and serotonin.
B. SNRI
C. SSRI (selectively inhibit serotonin reuptake)
D. TCA
D. TCA
This drug’s short duration of action has lower risk for developing residual or “hangover” effects.
A. Diazepam (BZ, Bind to the BZD binding site on the GABA receptor)
C. Lorazepam (develops little or no tolerance with prolonged use)
B. Phenobarbital (Barbiturates, DURATION)
D. Zolpidem
D. Zolpidem
Mechanism of action of Buspirone.
A. GABA receptor antagonist (Flumazenil)
B. Partial serotonin receptor agonist
C.Increases duration of opening of chloride channels (Barbiturates)
D. Increases frequency of opening of chloride channels (Benzodiazepines)
B. Partial serotonin receptor agonist
This is TRUE about Zolpidem.
A. Benzodiazepine (hypnotic non-benzodiazepine)
B. Has withdrawal effect (absence of withdrawal effects)
C. May cause seizure (effects: nightmares, agitation, headache, GIT upset, dizziness, and daytime
drowsiness)
D. Produces hypnosis
D. Produces hypnosis
Defined as the need to take more of a drug to exert the same effect.
A. Addiction
B. Dependence
C.Tolerance
D. Withdrawal
C.Tolerance
This drug acts on the serotonin receptor.
A. Buspirone
B. Diazepam(Benzodiazepine)
C.Phenobarbital (Barbiturates)
D. Zaleplon (new hypnotics)
A. Buspirone
This is NOT classified as amine neurotransmitter.
A. Dopamine
B. GABA
C. Norepinephrine
B. GABA
. Fluoxetine is classified as a prototype of this drug group.
A. MAOI
B. SNRI
C.SSRI
D. TCA
C.SSRI
Antidepressant that can be used to treat fibromyalgia.
A. MAOI
B. SNRI
C. SSRI
D. TCA
B. SNRI
This nonselective antidepressant tends to have more interactions with other drugs and may also be more harmful during overdose.
A. MAOI
B. SNRI
C.SSRI
D. TCA
D. TCA
This antidepressant can be dangerous if taken with foods that contain tyramine.
A. MAOI
B. SNRI
C.SSRI
D. TCA
A. MAOI
Which of the following is a correct definition of epilepsy
A. One episode of tonic-clonic generalized seizure
B. Recurrent episodes of sudden, transient disturbances in cerebral excitation
C. Influx of calcium ions lead to repolarization causing seizures
D. Increase in GABA causes seizures
B. Recurrent episodes of sudden, transient disturbances in cerebral excitation
Renal manifestation of Lithium toxicity includes the following.
A. Fatigue
B. Nausea
C. Polydipsia
D. Seizure
C. Polydipsia
Type of seizure characterized by generalized sustained muscle contraction with associated loss of consciousness
A. Atonic
B. Tonic
D. Clonic
C. Complex Partial
B. Tonic
This triggers the release of glutamate from the vesicles to the synaptic cleft
A. Opening of sodium gated channels
B.Opening of the low voltage activated calcium channels
C.Influx of calcium from the opening of high-voltage activated calcium channels
D. Bonding of glutamate to the AMPA receptors
C.Influx of calcium from the opening of high-voltage activated calcium channels
Which is NOT a first-generation anti-epileptic?
A.Valproate
B. Succinimides
C.Iminostilbenes
D.Zonisamide
D.Zonisamide
What is the primary effect of phenytoin?
A. Potentiate the inhibitory effect of GABA
B. Inhibit spontaneous firing in the thalamic neuron by limiting calcium entry
C.Blocks sodium channel in the firing neurons
D. Unclear
C.Blocks sodium channel in the firing neurons
First generation anti-epileptic that crosses the placenta and is considered teratogenic
C. Gabapentin
A. Leviteracetam
B. Tigabadin
D. Valproic Acid
D. Valproic Acid
First line drug for Absence seizure
A. Carbamazepine
B. Phenobarbital
C.Topiramate
D.Ethosuximide
D.Ethosuximide
Which of the following drugs lower neuronal excitability
A. Topiramate
B. Diazepam
C. Tigabadine
D. Vigabatrin
A. Topiramate
Which of the following drugs enhance neuronal inhibition?
A. Leviteracetam
B.Gabapentin
C.Pregabalin
D.Pentobarbital
D.Pentobarbital
First line medication for status epilepticus:
A. IV Phenytoin
B. IV Phenobarbital
C. IV Lorazepam
D. General anesthesia
C. IV Lorazepam
What is the primary mechanism of action of Benzodiazepines in seizure control
A. Sodium channel blockade
C. Calcium channel blockade
B. Increase GABAnergic activity
D. NMDA receptor antagonism
B. Increase GABAnergic activity
What is the primary pharmacologic action of Lamotrigine
A. Sodium channel inhibition
B.Inhibition of GABA uptake
С.Glutamate receptor antagonism
D.Calcium channel blockade
A. Sodium channel inhibition
AED that is used as an off-label drug for trigeminal neuralgia
A.Phenytoin
B. Valproic Acid
C.Carbamazepine
D. Diazepam
C.Carbamazepine
What is the mechanism of action of valproate that contributes to its efficacy in treating seizures
A. Blocks sodium channels
C. Increase GABA levels
B. Blocks calcium channels
D. All of the above
D. All of the above
AED that is used as an off-label drug for neuropathic pain
A. Phenytoin
B. Valproic Acid
C.Carbamazepine
D.Diazepam
A. Phenytoin
This drug binds to the SV2A protein found on the glutamate vesicle wall impairing the release of glutamate
A. Lamotrigine
B. Topiramate
C. Leviteracetam
D. Felbamate
C. Leviteracetam
One of the side effects of this drug include peripheral edema
A. Lacosamide
B. Leviteracetam
C. Gabapentin
D. Pregabalin
C. Gabapentin
Drug that can be used for Lennox-Gastaut syndrome
A. Felbamate
B. Gabapentin
C. Leviteracetam
D. Pregabalin
A. Felbamate
The following are factors for successful withdrawal of AEDs EXCEPT:
A. Seizure-free for at least 2 years while on medication
B. Good seizure control within 6 months of seizure onset
C. Normal neurological exam prior to withdrawal
D. Initial onset of seizures during childhood
B. Good seizure control within 6 months of seizure onset
Duration of tapering off medications prior discontinuation
A. 1 month
B. 2 months
C. 3 months
D. No need to taper prior discontinuation
C. 3 months
