MODULE 4 Flashcards
WHAT IS THE ANTIDOTE FOR BENZODIAZEPINE TOXICITY?
a. Flumazenil
a. Atropine
b. Naloxone
c. Thiamine
Flumazenil
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
Undergo enterohepatic recirculation
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
Cyclopeptides
WHICH TYPE OF MUSHROOM IS ASSOCIATED WITH HYPERACTIVITY, DELIRIUM AND COMA MIRANDA
a. Gyromitrin
b. Psilocybin
c. Muscarine
d. Muscimol
Muscimol
POISONING?
WHICH IS NOT SEEN IN YELLOW PHOSPHOROUS MIRANE
a. Hypercalcemia
b. Hypokalemia
c. Hypocalcemia
d. Hyperphospatemia
Hypercalcemia
PERIPHERAL NEUROPATHY AND OPTIC NEURITIS IS DUE TO THE DEPLETION OF MIRAND
a. Thiamine
b. GABA
c. Pyridoxine
d. Glutathione
Pyridoxine
A TYPE OF MUSHROOM POISONING
THAT CAN CAUSE DISULFIRAM-LIKE REACTION WITH ETHANOL.
a. Chlorophyllum molybdites
b. Muscarine
c. Coprine
d. Cyclopeptide
Coprine
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
Inhibition of GABAergic tone
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
Central stimulation of hypothalamic region
WHAT IS THE ANTIDOTE USED IN THE TREATMENT OF OPIATE TOXICITY?
a. Flumazenil
b. atropine
c. Naloxone
d. Thiamine
Naloxone
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
Reinstitution of adequate
spontaneous ventilation.
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
Ferrous sulfate toxicity
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
Inert complex formation
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
Increased breakdown of
catecholamines at the synapse
SUBSTANCE OF ABUSE THAT CAN CAUSE INDIVIDUALS TO HAVE DISSOCIATIVE STATE?
a. PCP
b. LSD
c. XTC
d. MAP
PCP
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
Ketamine
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
Angel’s Trumpet
IT IS A CHOLINESTERASE INHIBITOR USED FOR THE TREATMENT OF DATURA METEL TOXICITY.
a. Pyridostigmine
b. Physostigmine
c. Atropine
d. All of the above
Physostigmine
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
Paralytic Shellfish Poisoning
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
Maitotoxin
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
H2 RECEPTOR
Which of the following is used for erectile dysfunction?
a. Lubipristone
b. Alprostadil
c. H3 receptor
d. Both A and B
Alprostadil
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.
Absorption of Drug X (acidic) occurs when the pH in the organ is less than the pka of the drug.
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
Triggers the formation of cGMP to
relax smooth muscles.
Activation of what G-protein stimulates adenylyl cyclase?
a. Gi
b. Gq
c. Gs
d. Go
Gs
Activation of what G-protein inhibits adenylyl cyclase?
a. Gi
b. Gq
c. Gs
d. Go
Gi
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
allosteric antagonist
Which of the following drugs promotes sodium entry into the cell?
a. Pancuronium
b. Succinylcholine
c. Diazepam
d. Baclofen
Succinylcholine
Which of the following inhibit acetylcholine esterase?
a. Pancuronium
b. Vesamicol
c. Pilocarpine
d. Neostigmine
Neostigmine
Which of the following is used to diagnose myasthenia gravis?
a. Pancuronium
b. Edrophonium
c. Echothiopate
d. Bethanecho
Edrophonium
Which of the following is a parasympathetic effect?
a. Peristalsis
b. Dry mouth
c. Relaxation of uterus
d. Increased heart rate
Peristalsis
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
In response to high blood pressure signaled by
baroreceptor triggers the release of acetylcholine
Which of the following inhibit synthesis of norepinephrine?
a. Metyrosine
b. Hemicholinium
c. Amphetamine
d. Imipramine
Metyrosine
GABA neurotransmitter facilitates what part of action potential?
a. Neutralization
b. Depolarization
c. Repolarization
d. Hyperpolarization
Hyperpolarization
The following neurotransmitters are excitatory in function, Except:
a. Serotonin
b. GABA
c. Dopamine
d. Acetylcholine
GABA
Which of the following is an intermediate-acting benzodiazepine?
a. Alprazolam
b. Triazolam
c. Diazepam
d. Thiopental
Alprazolam
Which of the following is an ultra-short-acting barbiturate?
a. Phenobarbital
b. Pentobarbital
c. Amobarbital
d. Thiopental
Thiopental
What is the main problem in schizophrenia?
a. Too much dopamine
b. Too low dopamine
c. Too much insulin
d. Too low glutamate
Too much dopamine
Which dopamine pathway is associated with motivation, pleasure, reward and seeking behaviors?
a. Tuberoinfundibular pathway
b. Mesolimbic pathway
c. Mesocortical pathway
d. Nigrostriatal pathway
Mesolimbic pathway
Which of the following inhibit acetylcholine release to decrease peristalsis?
a. Methylcellulose
b. Loperamide
c. Bismuth subsalicylate
d. Senna
Loperamide
Which of the following is a stimulant laxative?
a. Lactulose
b. Methylcellulose
c. Castor oil
d. Lubiprostone
Castor oil
Which of the following has high affinity to Dopamine D2 receptor?
a. Haloperidol
b. Chlorpromazine
c. Risperidone
d. Clozapine
Haloperidol
Which of the following is a traditional antipsychotic?
a. Ziprasidone
b. Haloperidol
c. Clozapine
d. Aripiprazole
Haloperidol
Which of the following is an amide used as a local anesthetic?
a. Procaine
b. Lidocaine
c. Isoflurane
d. Propofol
Lidocaine
Which of the following is an ester used as a local anesthetic?
a. Procaine
b. Lidocaine
c. Isoflurane
d. Propofol
Procaine
Antidote for warfarin toxicity:
a. Dicumarol
b. Protamine sulfate
c. Aspirin
d. Vitamin K
Vitamin K
Vitamin K dependent factors, Except:
a. Factor X
b. Factor VIII
c. Factor VII
d. Factor II
Factor VIII
Ca channel blocker, Except:
a. Diltiazem
b. Nifedipine
c. Amiodarone
d. Verapamil
Amiodarone
Nitroglycerin is clinically used as an:
a. Anti-hypertensive agent
b. Anti-coagulant
c. Anti-arrhythmic agent
d. Anti-angina agent
Anti-angina agent
A plasminogen activator:
a. Warfarin
b. Heparin
c. Streptokinase
d. Dicumarol
Streptokinase
A lipoprotein that is a major triglyceride carrier:
a. Chylomicrons
b. VLDL
c. LDL
d. HDL
Chylomicrons
Class Ill anti-arrhythmic drugs are:
a. Cat+ channel blockers
b. K+ channel blockers
c. Na+ channel blockers
d. Beta receptor blockers
K+ channel blockers
Valsartan site of action.
a. Angiotensinogen
b. Angiotensin I
c. Angiotensin II
d. Angiotensin Il receptor
Angiotensin Il receptor
Associated with decrease absorption of fat-soluble vitamins.
a. Niacin
b. Pravastatin
c. Gemfibrozil
d. Cholestyramine
Cholestyramine
Sulfonylureas, Except:
a. Glipizide
b. Metformin
c. Tolbutamide
d. Tolazamide
Metformin
Used to monitor compliance in IDDM:
a. Glycosylated Hgb
b. Random blood sugar
c. Glucose tolerance test
d. Post prandial sugar test
Glycosylated Hgb
The following are side effects of insulin, Except:
a. Hypoglycemia
b. Tachycardia
c. Diaphoresis
d. Hyperglycemia
Hyperglycemia
The following are prophylactic drugs for bronchial asthma, Except:
a. Zafirlukast
b. Nedocromil Na
c. Cromolyn Na
d. Ipratropium
Ipratropium
Sulfonylureas act by:
a. Increasing glucagon’s level
b. Decreases insulin receptor binding
c. Stimulate B cells to secrete insulin
d. Inhibit glycogenolysis
Stimulate B cells to secrete
insulin
A bronchodilator that acts as a phosphodiesterase inhibitor.
a. Salmeterol
b. Ipratropium
c. Theophylline
d. Ketotifen
Theophylline
Drug of choice for Methicillin Resistant Staphylococcus.
a. Vancomycin
b. Erythromycin
c. Cefalexin
d. Penicillin
Vancomycin
A long acting B2 agonist
a. Terbutaline
b. Salmeterol
c. Salbutamol
d. Levalbuterol
Salmeterol
The following are the chronic complication of diabetes, Except:
a. Diabetic ketoacidosis
b. Neuropathy
c. Retinopathy
d. Nephropathy
Diabetic ketoacidosis
The following are bronchodilators, Except
a. Salbutamol
b. Zileuton
c. Ipratropium
d. Theophylline
Zileuton
Act as a mycolic acid synthesis inhibitor.
a. Ethambutol
b. Cefuroxime
c. Isoniazid
d. Penicillin G
e. NOTA
Isoniazid
The following promote insulin secretion, Except:
a. Glinides
b. Sulfonylureas
c. Incretin mimetics
d. SGLT2 inhibitor
SGLT2 inhibitor
Mechanism of action of sulfonamides
a. Inhibit folic acid synthesis
b. Cell wall synthesis
c. Protein synthesis inhibitor
d. Alter cell membrane permeability
Inhibit folic acid synthesis
The following are the inhalation corticosteroids, Except.
a. Prednisone
b. Fluticasone
c. Beclomethasone
d. Triamcinolone
Prednisone
Adverse effect of B2 agonist like salbutamol, Except
a. Tachycardia
b. Hyperglycemia
c. Bronchoconstriction
d. Hypokalemia
Bronchoconstriction
The following are penicillin resistant, Except.
a. Oxacillin
b. Nafcillin
c. Ampicillin
d. Clavulanic acid
Ampicillin
A Finding of a Temperature 39°C and a BP 160/100, is a:
A. Lesion
B. Syndrome
C. Symptoms
D. Signs
Signs
A particular disease with combined signs and symptoms:
A. Lesion
B. Syndrome
C. Etiology
D. Morphology
Syndrome
A following are the form of endocytosis, EXCEPT:
A. Exocytosis
B. Pinocytosis
C. Phagocytosis
D. NOTA
Exocytosis
Pain in inflammation
A. Rubor
B. Tumor
C. Dolor
D. Functio laesa
Dolor
An abrupt, unexpected increase of new disease in a localize area:
A. Pandemic
B. Epidemic
C. Endemic
D. Prevalence
Epidemic
A blood pressure of 145/95 is classified as:
A. Normal
B. Prehypertension
C. Stage I hypertension
D. Stage II hypertension
Stage II hypertension
Commonly associated with 1-antitrypsin deficiency
A. Bronchitis
B. Emphysema
C. Hyaline membrane disease
D. ARDS
Emphysema
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
Myocardial infarction
WBC most commonly involved in parasitic infection
A. Monocytes
B. Neutrophils
C. Eosinophils
D. Lymphocytes
Eosinophils
Immunity conferred by antiserum
A. Naturally acquired passive immunity
B. Naturally acquired active immunity
C. Artificially acquired passive immunity
D. Artificially acquired active immunity
Artificially acquired passive immunity
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
Linear PK
The rate at which the drug appears in the blood stream is known as?
a. Biopharmaceutics
b. AUC
c. Bioavailability
d. Biologic half-life
Bioavailability
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
Biophase
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
AOTA
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
Disintegration of the tablet
The first step which determines the onset of action, rate of absorption & availability is
a. Liberation
b. Distribution
c. Excretion
d. Absorption
Liberation
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
Noyes-Whitney equation
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
NOTA
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
Modified release drug products
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
pH of the medium
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
Passive diffusion-convective
transport- active transport
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
unionized form
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
therapeutic window
The integral of drug level over time from zero to infinity is.
a. biologic half-life
b. AUC
c. bioavailability
d. biopharmaceutics
AUC
Acetylsalicylic Acid as a blood thinner is eliminated by;
a. zero order
b. first order
c. third order
d. fourth order
zero order
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
Hypothesis of Clark
A drug which possesses affinity & intrinsic activity:
a. agonist
b. antagonist
c. full antagonist
d. partial agonist
agonist
Volume of serum or blood completely cleared of the drug per unit time.
a. Volume of distribution
b. Clearance
c. Elimination
d. Plasma concentration
Clearance
A fructose polysaccharide used as a
standard reference in the measurement of GFR.
a. Chitosan
b. Inulin
c. Cellulose
d. Chitin
Inulin
Most commonly used formula for creatinine clearance
a. Cockroft & Gault
b. Henderson-Hasselbalch
c. Noyes Whitney
d. Jelliffe Equation
Cockroft & Gault
