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MODULE 4 Flashcards

1
Q

WHAT IS THE ANTIDOTE FOR BENZODIAZEPINE TOXICITY?

a. Flumazenil
a. Atropine
b. Naloxone
c. Thiamine

A

Flumazenil

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2
Q

THE FOLLOWING ARE CHARACTERISTIC OF BENZODIAZEPINE TOXICITY?

a. Not protein bound
b. Undergo enterohepatic recirculation
c. Highly lipid soluble and does not pass quickly into the brain
d. Poorly absorbed in the gastrointestinal
tract

A

Undergo enterohepatic recirculation

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3
Q

A 40 year old hunter came at the ER after ingestion of mushroom for dinner. He manifested with abdominal pain, diarrhea and noted to have decreased output and elevated liver enzymes during the course of treatment.
What is the possible type of mushroom that the
patient ingested?

a. Gyromitrin
b. Coprine
c. Muscarine
d. Cyclopeptides

A

Cyclopeptides

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4
Q

WHICH TYPE OF MUSHROOM IS ASSOCIATED WITH HYPERACTIVITY, DELIRIUM AND COMA MIRANDA

a. Gyromitrin
b. Psilocybin
c. Muscarine
d. Muscimol

A

Muscimol

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5
Q

POISONING?
WHICH IS NOT SEEN IN YELLOW PHOSPHOROUS MIRANE

a. Hypercalcemia
b. Hypokalemia
c. Hypocalcemia
d. Hyperphospatemia

A

Hypercalcemia

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6
Q

PERIPHERAL NEUROPATHY AND OPTIC NEURITIS IS DUE TO THE DEPLETION OF MIRAND

a. Thiamine
b. GABA
c. Pyridoxine
d. Glutathione

A

Pyridoxine

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7
Q

A TYPE OF MUSHROOM POISONING
THAT CAN CAUSE DISULFIRAM-LIKE REACTION WITH ETHANOL.

a. Chlorophyllum molybdites
b. Muscarine
c. Coprine
d. Cyclopeptide

A

Coprine

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8
Q

A 24 F admitted for generalized tonic clonic convulsions noted 30 minutes prior to admission. Empty wrappers for 20 tablets of odinah were found in the bedroom where the relatives had found her convulsing. She was rushed to a nearby hospital where an iv line was inserted and diazepam 5mg iv was given. She was subsequently transferred to pgh. She experienced 3 episodes of convulsion during the transport to pgh. On physical examination, the patient would not open her eyes when her name was called; she had no verbal output; her arms and legs would flex a little when deep sternal pressure was applied. BP was 120/80. Hr 118/min rr 32/mint 38degc. pupils 4mm ebrtl. harsh breath sounds with rhonchi on the right mid lung field urine was
noted to be reddish in color. no localizing signs were noted on neurologic examination rest of the pe was unremarkable. patient has an ngt in place as well as an iv line that is running with 1 liter d5w at 20qtt/min. upon completing your
examination, the patient goes into generalized tonic-clonic convulsions again. Which is the mechanism of action of this poisoning?

a. Glycine inhibition
b. Enhanced excitatory amino acid
neurotransmission
c. Adenosine antagonism
d. Inhibition of GABAergic tone

A

Inhibition of GABAergic tone

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9
Q

A 25 YEAR OLD FEMALE FROM BULACAN CAME IN DUE TO DIFFICULTY OF BREATHING. FIVE HOURS PRIOR TO THE CONSULTATION, PATIENT INTENTIONALLY INGESTED 20 TABLETS OF 80MG/TABLET, MULTI COLORED DRUGS USED BY HER
FATHER AS MAINTENANCE. SHE THEN DEVELOPED VAGUE EPIGASTRIC PAIN AND VOMITING ON THEIR WAY TO THE NEAREST HOSPITAL, PATIENT NOTED TO BE DROWSY, TACHYPNEIC WITH PERSISTENCE OF ABDOMINAL PAIN
ASSOCIATED SEIZURES LASTING FOR 30 SECONDS. AT THE ER, BP 120/70 MMHG, HR 120 BPM, RR 30 CPM T 36.7°C, OSATS 98%. PATIENT ADMITTED AND WORK-UP.
WHAT IS THE MECHANISM OF TOXICITY OF THE ABOVE POISONING?

a. Central stimulation of the respiratory center
b. Depletion of Glutathione
c. Central stimulation of hypothalamic region
d. Depletion of GABA

A

Central stimulation of hypothalamic region

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10
Q

WHAT IS THE ANTIDOTE USED IN THE TREATMENT OF OPIATE TOXICITY?

a. Flumazenil
b. atropine
c. Naloxone
d. Thiamine

A

Naloxone

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10
Q

WHAT IS THE GOAL OF ANTIDOTAL THERAPY IN MORPHINE POISONING?

a. Reinstitution of adequate spontaneous ventilation.
b. Reversal of consciousness.
c. All of the above
d. None of the above

A

Reinstitution of adequate
spontaneous ventilation.

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11
Q

EG, 3-YEAR, FEMALE WAS BROUGHT
TO THE EMERGENCY ROOM FOR
ABDOMINAL PAIN ANDAPPARENTLY WELL, PLAYING WITH HER 6-YEAR OLD BROTHER THE MEDICATIONS
THEIR PREGNANT MOTHER BOUGHT FOR SUPPLEMENT. WHEN THEY WERE CALLED FOR SNACKS, THE YAYA NOTICED THAT EG WAS NAUSEATED AND COMPLAINED
OF ABDOMINAL PAIN. THIS WAS
FOLLOWED VOMITING OF BROWNISH MATERIAL.
AT THE ER, THE CHILD’S VITAL SIGNS ARE NORMAL AND SHE FELT MILD ABDOMINAL PAIN WITH NO MORE NOTE OF VOMITING, PATIENT WAS NOT DEHYDRATED. WHAT’S THE DIAGNOSIS FOR THE PATIENT?

a. Aspirin Overdose
b. Ferrous sulfate toxicity
c. Mefenamic Overdose
d. Paracetamol Overdose

A

Ferrous sulfate toxicity

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12
Q

WHAT IS THE MECHANISM OF ACTION OF THE ANTIDOTE GIVEN TO A PATIENT WITH IRON POISONING?

a. Inert complex formation
b. Competitive inhibition at receptor site
c. Bypassing the effect of the poison
d. Accelerated detoxification

A

Inert complex formation

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13
Q

THE FOLLOWING ARE THE MECHANISM OF TOXICITY OF METHAMPHETAMINE EXCEPT?

a. Release of catecholamines
b. Increased breakdown of catecholamines at the synapse
c. Decreased breakdown of catecholamines at the synapse
d. Decreased reuptake of catecholamines at the synapse

A

Increased breakdown of
catecholamines at the synapse

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14
Q

SUBSTANCE OF ABUSE THAT CAN CAUSE INDIVIDUALS TO HAVE DISSOCIATIVE STATE?

a. PCP
b. LSD
c. XTC
d. MAP

A

PCP

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15
Q

THIS SUBSTANCE OF ABUSE ACTS ON MUSCARINIC AND OPIATE RECEPTORS AND USUALLY USE TO MAINTAIN ANESTHESIA AND ANALGESIA WHILE PRESERVING PHARYNGEAL REFLEXES AND RESPIRATORY FUNCTION

a. Phencyclidine
b. LSD
c. Shabu
d. Ketamine

A

Ketamine

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16
Q

A 14 YEAR OLD MALE CAME IN DUE TO HALLUCINATIONS. PATIENT WENT TO HIS BARKADA AND WAS GIVEN WITH A CIGARETTE MADE FROM TALAMPUNAY. HE THEN DEVELOPED AGITATION, FLUSHING OF THE SKIN AND HALLUCINATIONS AFTER THE SESSION. HIS MOTHER NOTED THE UNUSUAL BEHAVIOR OF HER SON THUS SOUGHT CONSULT. AT THE EMERGENCY ROOM VITAL SIGNS REVEALED T-39, BP 140/100, CR-120S, DILATED PUPILS. WHAT IS THE POSSIBLE DIAGNOSIS OF THE PATIENT?

a. Angel dust
b. Methamphetamine
c. Angel’s Trumpet
d. Marijuana

A

Angel’s Trumpet

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17
Q

IT IS A CHOLINESTERASE INHIBITOR USED FOR THE TREATMENT OF DATURA METEL TOXICITY.

a. Pyridostigmine
b. Physostigmine
c. Atropine
d. All of the above

A

Physostigmine

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18
Q

A 35 YEAR OLD MALE INGESTED A SEAFOOD MEAL AT A CHINESE RESTAURANT WHERE HE HAD BAKED AND STEAMED OYSTER AND MUSSELS(TAHONG). SHE ORDERED ENOUGH FOR HIS FAMILY OF 4, ATE SOME OF IT, AND HAD THE REST BAGGED TO BE BROUGHT HOME. 1 HOUR LATER, THE PATIENT DEVELOPED DIARRHEA, VOMITING, AND ABDOMINAL CRAMPS. HE HAD MOTOR INCOORDINATION ASSOCIATED WITH PERIORAL NUMBNESS, TINGLING AND BURNING SENSATION OF LIPS AND TONGUE. WHAT IS YOUR ASSESSMENT?

a. Paralytic Shellfish Poisoning
b. Pufferfish poisoning
c. Histamine Poisoning
d. Ciguatera Poisoning

A

Paralytic Shellfish Poisoning

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19
Q

THIS TOXIN CAUSES AN INCREASED INTRACELLULAR CALCIUM, HYPOTENSION AND SHOCK BUT IS THE ONLY WATER SOLUBLE TOXIN.

a. Maitotoxin
b. Scaritoxin
c. Okadaic toxin
d. Palytoxin

A

Maitotoxin

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20
Q

Which histamine receptor is involved in acid release to stomach lumen?

a. H1 RECEPTOR
b. H2 RECEPTOR
c. H3 RECEPTOR
d. Both A and B

A

H2 RECEPTOR

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21
Q

Which of the following is used for erectile dysfunction?

a. Lubipristone
b. Alprostadil
c. H3 receptor
d. Both A and B

A

Alprostadil

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22
Q

Which if the following is true regarding drug absorption?

a. Drugs bound to albumin are readily distributed to tissues.
b. There is a high surface area for absorption in the stomach compared to the intestines.
c. Unionized from of drugs are readily excreted
d. Absorption of Drug X (acidic) occurs when the pH in the organ is less than the pka of the drug.

A

Absorption of Drug X (acidic) occurs when the pH in the organ is less than the pka of the drug.

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23
Q

Nitric oxide action on smooth muscle:

a. Triggers the formation of cAMP to constrict smooth muscles
b. Triggers the formation of IP to relax smooth muscles.
c. Triggers the formation of cGMP to relax smooth muscles.
d. Triggers the formation of DAG to constrict smooth muscles

A

Triggers the formation of cGMP to
relax smooth muscles.

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24
Q

Activation of what G-protein stimulates adenylyl cyclase?

a. Gi
b. Gq
c. Gs
d. Go

A

Gs

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25
Q

Activation of what G-protein inhibits adenylyl cyclase?

a. Gi
b. Gq
c. Gs
d. Go

A

Gi

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26
Q

Which of the following blocks the effect by binding to sites other than the active site of the receptor?

a. competitive antagonist
b. allosteric agonist
c. allosteric antagonist
d. Inverse agonist

A

allosteric antagonist

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26
Q

Which of the following drugs promotes sodium entry into the cell?

a. Pancuronium
b. Succinylcholine
c. Diazepam
d. Baclofen

A

Succinylcholine

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27
Q

Which of the following inhibit acetylcholine esterase?

a. Pancuronium
b. Vesamicol
c. Pilocarpine
d. Neostigmine

A

Neostigmine

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28
Q

Which of the following is used to diagnose myasthenia gravis?

a. Pancuronium
b. Edrophonium
c. Echothiopate
d. Bethanecho

A

Edrophonium

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28
Q

Which of the following is a parasympathetic effect?

a. Peristalsis
b. Dry mouth
c. Relaxation of uterus
d. Increased heart rate

A

Peristalsis

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29
Q

Which of the following is true regarding the baroreceptor reflex?

a. In response the low blood pressure signaled by baroreceptor triggers the release of Acetylcholine.
b. Acetylcholine release increases blood pressure.
c. In response to high blood pressure signaled by baroreceptor triggers the release of acetylcholine
d. Norepinephrine release decreases
blood pressure

A

In response to high blood pressure signaled by
baroreceptor triggers the release of acetylcholine

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30
Q

Which of the following inhibit synthesis of norepinephrine?

a. Metyrosine
b. Hemicholinium
c. Amphetamine
d. Imipramine

A

Metyrosine

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31
Q

GABA neurotransmitter facilitates what part of action potential?

a. Neutralization
b. Depolarization
c. Repolarization
d. Hyperpolarization

A

Hyperpolarization

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32
Q

The following neurotransmitters are excitatory in function, Except:

a. Serotonin
b. GABA
c. Dopamine
d. Acetylcholine

A

GABA

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33
Q

Which of the following is an intermediate-acting benzodiazepine?

a. Alprazolam
b. Triazolam
c. Diazepam
d. Thiopental

A

Alprazolam

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34
Q

Which of the following is an ultra-short-acting barbiturate?

a. Phenobarbital
b. Pentobarbital
c. Amobarbital
d. Thiopental

A

Thiopental

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34
Q

What is the main problem in schizophrenia?

a. Too much dopamine
b. Too low dopamine
c. Too much insulin
d. Too low glutamate

A

Too much dopamine

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35
Q

Which dopamine pathway is associated with motivation, pleasure, reward and seeking behaviors?

a. Tuberoinfundibular pathway
b. Mesolimbic pathway
c. Mesocortical pathway
d. Nigrostriatal pathway

A

Mesolimbic pathway

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36
Q

Which of the following inhibit acetylcholine release to decrease peristalsis?

a. Methylcellulose
b. Loperamide
c. Bismuth subsalicylate
d. Senna

A

Loperamide

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37
Q

Which of the following is a stimulant laxative?

a. Lactulose
b. Methylcellulose
c. Castor oil
d. Lubiprostone

A

Castor oil

38
Q

Which of the following has high affinity to Dopamine D2 receptor?

a. Haloperidol
b. Chlorpromazine
c. Risperidone
d. Clozapine

A

Haloperidol

39
Q

Which of the following is a traditional antipsychotic?

a. Ziprasidone
b. Haloperidol
c. Clozapine
d. Aripiprazole

A

Haloperidol

40
Q

Which of the following is an amide used as a local anesthetic?

a. Procaine
b. Lidocaine
c. Isoflurane
d. Propofol

A

Lidocaine

41
Q

Which of the following is an ester used as a local anesthetic?

a. Procaine
b. Lidocaine
c. Isoflurane
d. Propofol

A

Procaine

42
Q

Antidote for warfarin toxicity:

a. Dicumarol
b. Protamine sulfate
c. Aspirin
d. Vitamin K

A

Vitamin K

42
Q

Vitamin K dependent factors, Except:

a. Factor X
b. Factor VIII
c. Factor VII
d. Factor II

A

Factor VIII

43
Q

Ca channel blocker, Except:

a. Diltiazem
b. Nifedipine
c. Amiodarone
d. Verapamil

A

Amiodarone

44
Q

Nitroglycerin is clinically used as an:

a. Anti-hypertensive agent
b. Anti-coagulant
c. Anti-arrhythmic agent
d. Anti-angina agent

A

Anti-angina agent

45
Q

A plasminogen activator:

a. Warfarin
b. Heparin
c. Streptokinase
d. Dicumarol

A

Streptokinase

46
Q

A lipoprotein that is a major triglyceride carrier:

a. Chylomicrons
b. VLDL
c. LDL
d. HDL

A

Chylomicrons

47
Q

Class Ill anti-arrhythmic drugs are:

a. Cat+ channel blockers
b. K+ channel blockers
c. Na+ channel blockers
d. Beta receptor blockers

A

K+ channel blockers

48
Q

Valsartan site of action.

a. Angiotensinogen
b. Angiotensin I
c. Angiotensin II
d. Angiotensin Il receptor

A

Angiotensin Il receptor

49
Q

Associated with decrease absorption of fat-soluble vitamins.

a. Niacin
b. Pravastatin
c. Gemfibrozil
d. Cholestyramine

A

Cholestyramine

50
Q

Sulfonylureas, Except:

a. Glipizide
b. Metformin
c. Tolbutamide
d. Tolazamide

A

Metformin

51
Q

Used to monitor compliance in IDDM:

a. Glycosylated Hgb
b. Random blood sugar
c. Glucose tolerance test
d. Post prandial sugar test

A

Glycosylated Hgb

52
Q

The following are side effects of insulin, Except:
a. Hypoglycemia
b. Tachycardia
c. Diaphoresis
d. Hyperglycemia

A

Hyperglycemia

53
Q

The following are prophylactic drugs for bronchial asthma, Except:

a. Zafirlukast
b. Nedocromil Na
c. Cromolyn Na
d. Ipratropium

A

Ipratropium

54
Q

Sulfonylureas act by:

a. Increasing glucagon’s level
b. Decreases insulin receptor binding
c. Stimulate B cells to secrete insulin
d. Inhibit glycogenolysis

A

Stimulate B cells to secrete
insulin

55
Q

A bronchodilator that acts as a phosphodiesterase inhibitor.

a. Salmeterol
b. Ipratropium
c. Theophylline
d. Ketotifen

A

Theophylline

56
Q

Drug of choice for Methicillin Resistant Staphylococcus.

a. Vancomycin
b. Erythromycin
c. Cefalexin
d. Penicillin

A

Vancomycin

57
Q

A long acting B2 agonist

a. Terbutaline
b. Salmeterol
c. Salbutamol
d. Levalbuterol

A

Salmeterol

58
Q

The following are the chronic complication of diabetes, Except:

a. Diabetic ketoacidosis
b. Neuropathy
c. Retinopathy
d. Nephropathy

A

Diabetic ketoacidosis

59
Q

The following are bronchodilators, Except

a. Salbutamol
b. Zileuton
c. Ipratropium
d. Theophylline

A

Zileuton

59
Q

Act as a mycolic acid synthesis inhibitor.

a. Ethambutol
b. Cefuroxime
c. Isoniazid
d. Penicillin G
e. NOTA

A

Isoniazid

60
Q

The following promote insulin secretion, Except:

a. Glinides
b. Sulfonylureas
c. Incretin mimetics
d. SGLT2 inhibitor

A

SGLT2 inhibitor

60
Q

Mechanism of action of sulfonamides

a. Inhibit folic acid synthesis
b. Cell wall synthesis
c. Protein synthesis inhibitor
d. Alter cell membrane permeability

A

Inhibit folic acid synthesis

61
Q

The following are the inhalation corticosteroids, Except.

a. Prednisone
b. Fluticasone
c. Beclomethasone
d. Triamcinolone

A

Prednisone

62
Q

Adverse effect of B2 agonist like salbutamol, Except

a. Tachycardia
b. Hyperglycemia
c. Bronchoconstriction
d. Hypokalemia

A

Bronchoconstriction

63
Q

The following are penicillin resistant, Except.

a. Oxacillin
b. Nafcillin
c. Ampicillin
d. Clavulanic acid

A

Ampicillin

64
Q

A Finding of a Temperature 39°C and a BP 160/100, is a:

A. Lesion
B. Syndrome
C. Symptoms
D. Signs

A

Signs

65
Q

A particular disease with combined signs and symptoms:

A. Lesion
B. Syndrome
C. Etiology
D. Morphology

A

Syndrome

66
Q

A following are the form of endocytosis, EXCEPT:

A. Exocytosis
B. Pinocytosis
C. Phagocytosis
D. NOTA

A

Exocytosis

67
Q

Pain in inflammation

A. Rubor
B. Tumor
C. Dolor
D. Functio laesa

A

Dolor

68
Q

An abrupt, unexpected increase of new disease in a localize area:

A. Pandemic
B. Epidemic
C. Endemic
D. Prevalence

A

Epidemic

69
Q

A blood pressure of 145/95 is classified as:

A. Normal
B. Prehypertension
C. Stage I hypertension
D. Stage II hypertension

A

Stage II hypertension

70
Q

Commonly associated with 1-antitrypsin deficiency

A. Bronchitis
B. Emphysema
C. Hyaline membrane disease
D. ARDS

A

Emphysema

71
Q

The following may lead to septic shock, except
-serious condition that occurs when a body-wide infection leads to dangerously low blood pressure

A. Post burn infection
B. Myocardial infarction
C. Appendicitis
D. Pneumonia

A

Myocardial infarction

72
Q

WBC most commonly involved in parasitic infection

A. Monocytes
B. Neutrophils
C. Eosinophils
D. Lymphocytes

A

Eosinophils

73
Q

Immunity conferred by antiserum

A. Naturally acquired passive immunity
B. Naturally acquired active immunity
C. Artificially acquired passive immunity
D. Artificially acquired active immunity

A

Artificially acquired passive immunity

74
Q

Indicates the instantaneous rate of change of drug concentration that depends on the current concentration through the half-life remain constant, no matter how high the concentration.

a. Non-linear PK
b. Linear PK
c. Saturated PK
d. Unsaturated PK

A

Linear PK

74
Q

The rate at which the drug appears in the blood stream is known as?

a. Biopharmaceutics
b. AUC
c. Bioavailability
d. Biologic half-life

A

Bioavailability

75
Q

A cell or a cell component where the final interaction between the drug and receptor takes place?

a. Receptor
b. Biophase
c. Unit membrane
d. Muscle

A

Biophase

75
Q

the LADMER system is employed in?

a. A development of new active compounds
b. The adjustment of dosage regimen
c. The determination of effective dose sizes
d. AOTA

A

AOTA

76
Q

A rate limiting factor in the dissolution of a drug is

a. Disintegration of the tablet
b. Thickness of the tablet
c. Content uniformity
d. Local effect

A

Disintegration of the tablet

77
Q

The first step which determines the onset of action, rate of absorption & availability is

a. Liberation
b. Distribution
c. Excretion
d. Absorption

A

Liberation

78
Q

It describes the diffusion-controlled rate of drug dissolution

a. Henderson-Hasselbalch equation
b. Fick’s Law of Diffusion
c. Michaelis-Menten equation
d. Noyes-Whitney equation

A

Noyes-Whitney equation

79
Q

Narrow therapeutic window considers the following, except:
a. Inherent potency of the drug
b. Dosing strengths
c. Clearance of the drug
d. Target plasma drug concentration
e. NOTA

A

NOTA

80
Q

Dose dumping is a problem in the formulation of

a. Compressed tablet
b. Hard gelatin capsule
c. Modified release drug products
d. Soft gelatin capsule

A

Modified release drug products

81
Q

The ionization constant of drug is important in bioavailability since it determines the following, except:

a. Aqueous solubility
b. Dissolution rate
c. pH of the medium
d. Rate of transport

A

pH of the medium

82
Q

Mechanism of absorption of drugs are in order of their importance such as:

a. Active transport-passive diffusion-convective transport
b. Convective transport- active transport-passive diffusion
c. Passive diffusion-convective transport- active transport
d. Active transport-passive diffusion-active transport

A

Passive diffusion-convective
transport- active transport

83
Q

In general, the form of a drug that can be absorbed faster is:

a. ionized form
b. unionized form
c. Protein bound
d. both polar & non polar

A

unionized form

83
Q

This refers to the drug concentration range between the minimum effective concentration & the minimum toxic concentration:

a. Onset
b. intensity
c. duration of action
d. therapeutic window
e. narrow therapeutic window

A

therapeutic window

84
Q

The integral of drug level over time from zero to infinity is.

a. biologic half-life
b. AUC
c. bioavailability
d. biopharmaceutics

A

AUC

85
Q

Acetylsalicylic Acid as a blood thinner is eliminated by;

a. zero order
b. first order
c. third order
d. fourth order

A

zero order

86
Q

A theory that states that affinity is the combination of a drug molecule with a receptor:

a. Hypothesis of Ariens & Stephenson
b. Hypothesis of Paton
c. Lock & Key Theory
d. Hypothesis of Clark

A

Hypothesis of Clark

87
Q

A drug which possesses affinity & intrinsic activity:

a. agonist
b. antagonist
c. full antagonist
d. partial agonist

A

agonist

88
Q

Volume of serum or blood completely cleared of the drug per unit time.

a. Volume of distribution
b. Clearance
c. Elimination
d. Plasma concentration

A

Clearance

89
Q

A fructose polysaccharide used as a
standard reference in the measurement of GFR.

a. Chitosan
b. Inulin
c. Cellulose
d. Chitin

A

Inulin

90
Q

Most commonly used formula for creatinine clearance

a. Cockroft & Gault
b. Henderson-Hasselbalch
c. Noyes Whitney
d. Jelliffe Equation

A

Cockroft & Gault

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