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[FINALS] LU4 2018 > Ther 201 Greatest Hits > Flashcards

Ther 201 Greatest Hits Flashcards

1
Q 
1) Drugs used in the treatment of Parkinson’s disease are primarily mediated by which of the following dopamine receptors?
A. D1
B. D2
C. D3
D. D4
A

B

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2
Q 
2) Which of the following conditions would respond to treatment with metoprolol?
A. Physiologic tremor
B. Essential tremor
C. Tourette’s syndrome
D. Wilson’s disease
A

B

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3
Q 
3) Which of the following is used to prevent the peripheral conversion of levodopa to dopamine increasing its bioavailability?
A. Levodopa
B. Carbidopa
C. Pramipexole
D. Bromocriptine
A

B

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4
Q 
4) Which of the following drugs used in the treatment of Parkinson’s disease is a selective, reversible, peripherally-acting COMT inhibitor?
A. Tolcapone
B. Entacapone
C. Selegiline
D. Pramipexole
A

B

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5
Q 
5) Which of the following drugs used in the treatment of Parkinson’s disease is a non-ergot dopamine agonist with the same efficacy as bromocriptine?
A. Tolcapone
B. Carbidopa
C. Pergolide
D. Ropirinole
A

D

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6
Q 
6) The following drugs may cause elevation in creatine kinase (random lang ‘to, sorry haha)
A. Metoprolol
B. Colchicine
C. Steroid
D. Amlodipine
A

B

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7
Q 
7) In case of overdose, alkalinization of urine increases excretion of unchanged drug in which of the following antiepileptic medications?
A. Clonazepam
B. Carbamazepine
C. Phenobarbital
D. Lorazepam
A

C

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8
Q 
8) A patient with hepatic failure develops several episodes of generalized seizures. Based on pharmacokinetics, which of the following would best be suited for this patient?
A. Ethosuximide
B. Valproic acid
C. Topiramate
D. Carbamazepine
A

C

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9
Q 
9) Which of the following anti-epileptic drugs has a mechanism of action by affecting release?
A. Phenobarbital
B. Phenytoin
C. Levetiracetam 
D. Lamotrigine
A

C

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10
Q 
10) Which of the following anti-epileptic drugs has a mechanism of action affecting reuptake?
A. Vigabatrin
B. Tiagabine
C. Topiramate
D. Oxcarbazepine
A

B

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11
Q 
11) Which of the following anti-epileptic drugs has a mechanism affecting metabolism?
A. Vigabatrin
B. Tiagabine
C. Topiramate
D. Oxcarbazepine
A

A

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12
Q 
12) Which of the following has no evidence of efficacy for bipolar depression?
A. Anticonvulsants
B. Antidepressants
C. Antipsychotics
D. Lithium
A

B

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13
Q 
13) Benzodiazepines facilitate the binding of this neurotransmitter to its receptor
A. Dopamine
B. GABA
C. Norepinephrine
D. Serotonin
A

B

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14
Q 
14) Antagonism of this receptor leads to EPS (extrapyramidal symptoms)
A. Acetylcholine
B. Dopamine
C. GABA
D. Histamine
A

B

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15
Q 
15) A 40/M was suspicious of the wife having relationships outside marriage. He could not sleep thinking about the extramarital affair. He thinks other people are out to get him without basis. The drug of choice:
A. Olanzapine
B. Alprazolam
C. Paroxetine
D. Lithium
A

A

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16
Q 
16) 25/F with history of repeated slashing of the wrist, boredom, impulsivity has associated manic episodes. Which of the following medication would best treat the patient?
A. Quetiapine
B. Mirtazapine
C. Haloperidol
D. Lamotrigine
A

D

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17
Q 
17) Propranolol has been found useful for symptoms of heightened arousal in anxiety due to its effect on
A. Dopamine
B. Norepinephrine
C. Serotonin
D. GABA
A

B

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18
Q 
18) An antidepressant which works by disinhibiting release of norepinephrine and serotonin
A. Duloxetine
B. Fluoxetine
C. Mirtazapine
D. Trimipramine
A

C

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19
Q 
19) A mood stabilizer with evidence of efficacy for both manic and depressive phases of bipolar disorder
A. Carbamazepine
B. Lamotrigine
C. Lithium carbonate
D. Valproic acid
A

C

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20
Q 
20) A short-acting, non-benzodiazepine hypnotic
A. Alprazolam
B. Diazepam
C. Lorazepam
D. Zolpidem
A

D

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21
Q 
21) Inflow of this ion into the cell is facilitated with benzodiazepines
A. Calcium
B. Chloride
C. Magnesium
D. Potassium
A

B

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22
Q 
22) An antidepressant which works by blocking reuptake of norepinephrine and serotonin
A. Duloxetine
B. Fluoxetine
C. Mirtazapine
D. Moclobemide
A

A

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23
Q 
23) A mood stabilizer with a very narrow therapeutic index
A. Carbamazepine
B. Lamotrigine
C. Lithium carbonate
D. Valproic acid
A

Answer: C. In the trans, and besides the other drugs are anti-seizure drugs.

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24
Q 
24) Which of the following has no evidence of efficacy for bipolar depression?
A. Anticonvulsants
B. Antidepressants
C. Antipsychotics
D. Lithium
A

B

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25
Q

25) What is the standard MDT for paucibacillary leprosy cases?
A. Rifampicin, clofazimine for 6 months
B. Rifampicin, moxifloxacin, dapsone for 12 months
C. Rifampicin, dapsone for 6 months
D. Rifampicin, clarithromycin, dapsone for 6 months

A

C

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26
Q 
26) Your leprosy patient on the 3rd month of standard MDT complains of cracked skin on his legs. He has not been exposed to the sun frequently. Which drug caused this skin change?
A. Rifampicin
B. Dapsone
C. Prednisone
D. Clofazimine
A

D

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27
Q 
27) Azoles act as antifungal agents by:
A. Inhibiting glucan synthesis
B. Inhibiting lanosterol synthesis
C. Blocking ergosterol synthesis
D. Blocking squalene synthesis
A

C

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28
Q 
28) Which of the following drugs may cause acneiform eruption?
A. Paracetamol
B. Amoxicilin
C. Phenytoin
D. Mefanamic acid
A

C

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29
Q

29) The following are true about treatment of scabies
A. Application of a scabicide that is usually left on the body overnight
B. Permethrin cream and lindane lotion are examples of medications that can be used for pediculosis capitis
C. Neurotoxicity is a concern with the use of sulfur lotion
D. Ivermectin is an oral preparation that can be used in treating scabies in pregnant women
E. Sulfur lotion needs to be applied for 2 consecutive nights

A

Answer: A (While permethrin cream is effective for pediculosis capitis, lindane only has poor efficacy. Neurotoxicity is not a concern with the use of sulfur lotion because it is the medication given to pregnant women. Ivermectin is avoided in pregnant women. Sulfur lotion needs to be applied for 3 nights.)

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30
Q

30) Treatment for ecthyma gangrenosum
A. Localized and few lesions: Mupirocin 2% ointment TID x 7 days
B. Widespread lesions: systemic antibiotics (cloxacillin adults, 500 mg QID)
C. IV aminoglycosides
D. Cephalexin: children 25-50 mg/kg/day in divided doses QID

A

C

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31
Q 
31) Which of the following drug has the most profound effect on osteoblasts?
A. Calcium
B. Calcitonin
C. Bisphosphonates
D. Teriparatide
A

D

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32
Q 
32) Which of the following is the most common adverse event in patients taking bisphosphonates?
A. Esophagitis
B. Necrosis of the jaw
C. Femoral shaft fracture
D. Kidney stones
A

Answer: A (pero the most serious is B. According to the feedback, this is why you instruct patients on bisphosphonates to remain upright for 30 minutes after taking the drug.)

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33
Q 
33) Which of the following drugs serve as the first choice for treatment of early rheumatoid arthritis (RA)?
A. NSAIDs
B. Glucocorticoids
C. Methotrexate
D. Anti-TNF
A

Answer: C (NSAID is just an adjunct, steroids are for something sorry I couldn’t decipher the recording, anti-TNF is second line if unresponsive to methotrexate)

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34
Q 
34) Which of the following drugs is NOT used in osteoarthritis?
A. Acetaminophen
B. Topical NSAIDS
C. Oral steroids
D. Opiods
A

C

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35
Q 
35) Which drug is useful in the treatment of acute as well as intercritical gout?
A. Oral steroids
B. Colchicines
C. Allopurinol
D. Febuxostat
A

B. (C and D are not given in acute gout)

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36
Q

36) Identify the correct drug and adverse event pairing
A. Colchicine and Stevens-Johnson reaction
B. Allopurinol and diarrhea
C. Methotrexate and mucositis
D. Glucocorticoids and infertility

A

C

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37
Q 
37) In suspected septic arthritis of the knee, what is the recommended empirical antibiotic?
A. Amikacin
B. Ceftrioxone
C. Oxacillin
D. Penicillin
A

C (because S. aureus is the most common etiologic agent)

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38
Q 
38) Which of the following medical modalities is recommended in managing most closed injuries of the upper extremity?
A. Analgesics
B. Antibiotics
C. Steroids
D. Vitamins
A

A

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39
Q 
39) The following drugs are known to be ototoxic except for
A. Kanamycin
B. Ofloxacin
C. Carboplatin
D. Aspirin
A

B

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40
Q 
40) Initial drug of choice in management of moderate to severe acute rhinitis
A. Oral anti-histamine
B. Intranasal steroid
C. Topical decongestant
D. Oral leukotriene receptor agonist
A

B

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41
Q 
OS 213 Cardiology
Quiz
41) Which of the following drugs can lengthen the effective refractory period by blocking the potassium channel?
A. Procainamide
B. Sotalol
C. Metoprolol
D. Quinidine
A

B

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42
Q 
42) Which of the following is an incorrect match of a drug class in the Vaughn-Williams Classification and the medication?
A. Class I --------- Propafenone
B. Class II -------- Flecainide
C. Class III --------Sotalol
D. Class IV ------- Verapamil
A

B

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43
Q 
43) The following anti-arrhythmic drug class is characterized by marked sodium channel blockade with minimal effect on the action potential duration
A. Class IA
B. Class IB
C. Class IC
D. Class II
A

C

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44
Q 
44) Which of the following drugs is the drug of choice for terminating ventricular tachycardia in the setting of ischemic heart disease?
A. Propafenone
B. Mexiletine
C. Amiodarone
D. Flecainide
A

C

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45
Q 
45) Adenosine is a drug of particular use in cases of supraventricular tachycardia. Use of the drug leads to what:
A. Opening of the sodium channels
B. Opening of the potassium channels
C. Closing of the sodium channels
D. Closing of the potassium
A

B

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46
Q 
46) An example of a mainstay drug for the acute relief of angina pectoris is
A. Metoprolol
B. Nitroglycerine
C. Nifedipine
D. Captopril
A

B

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47
Q 
47) The following drugs does not reduce myocardial oxygen demand
A. Metoprolol
B. Enalapril
C. Digoxin
D. Verapamil
A

C

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48
Q 
48) The following is not a known effect of nitrates
A. Increases venous capacitance
B. Decreases ventricular preload
C. Increases left ventricular size
D. Dilates coronary arteries
A

C

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49
Q 
49) Which of the following is a calcium channel blocker that can slow down the heart rate and may be used in patients with angina pectoris and hypertension?
A. Felodipine
B. Amlodipine
C. Nifedipine
D. Diltiazem
A

D

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50
Q 
50) This drug when given can decrease the myocardial demand for oxygen by prolonging the diastolic filling time of the coronary arteries
A. Atenolol
B. Isosorbide 5-mononitrate
C. Amlodipine
D. Magnesium
A

A

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51
Q 
Mega Exam
51) Drugs that may be used in patients with coronary artery disease EXCEPT
A. Metoprolol
B. Clopidogrel
C. Amlodipine
D. Nifedipine
A

D

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52
Q 
52) A 52 year old male executive consulted for elevated BP of 150/90. Further examination showed an elevated cholesterol level and glucose intolerance. You would advise this patient to start
A. Diuretic
B. Beta-blocker
C. ACE inhibitor
D. Calcium channel blocker
A

B or C

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53
Q 
53) Which group/s of drugs is NOT used in hypertension?
A. ACE inhibitors
B. Beta blocker
C. Digitalis
D. Diuretics
A

C

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54
Q 
54) A calcium channel blocker with higher affinity to smooth muscles than cardiac tissue that may cause reflex tachycardia
A. Diltiazem
B. Fenoldopam
C. Nifedipine
D. Verapamil
A

C

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55
Q 
55) Hydrocholorthiazide was prescribed for a 50 year old man. Side effect of this drug?
A. Hyperglycemia
B. Hyperkalemia
C. Hyperuricemia
D. Metabolic alkalosis
A

Answer: A (Actually all except B are effects of this drug since it is NOT a potassium-sparing diuretic)

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56
Q 
56) A patient in heart failure was given a diuretic which can cause hyperchloromic metabolic acidosis, gynecomastia, impotence, and benign prostatic hyperplasia. The drug is most likely
A. Bumetanide
B. Furosemide
C. Hydrochlorothiazide
D. Spironolactone
A

D

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57
Q

57) Which of the following is TRUE of digoxin
A. It has a short half-life of 4 hours
B. It has minimal drug interactions
C. It is primarily metabolized in the liver
D. It has a narrow therapeutic range

A

D

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58
Q 
58) A drug for heart failure which can decrease heart rate and has been proven to reduce mortality
A. Bisoprolol
B. Dobutamine
C. Enalapril
D. Furosemide
A

A

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59
Q 
59) Prazosin was given to a 63 year old male patient presenting with both hypertension and prostatic hypertrophy. Prazosin selectively blocks which adrenergic receptor?
A. Alpha-1
B. Alpha-2
C. Beta-1
D. Beta-2
A

A

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60
Q 
60) A potent vasodilator which can cause cyanide accumulation
A. Fenoldopam
B. Hydralazine
C. Minoxidil
D. Nitroprusside
A

D

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61
Q

61) Which of the following is true of aspirin?
A. It is a reversible inhibitor of cyclooxygenase
B. It is a simple organic acid with a pKa of 2.0
C. It is rapidly hydrolyzed to acetic acid and salicylate by esterases
D. Acidification of the urine increases the rate of excretion of free salicylates

A

Answer: C (It is an irreversible inhibitor of COX, it has a pKa of 3.5 at 25C, you alkalinize the urine to address aspirin overdose.)

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62
Q

62) A 5 year old male operated on for ventricular septal defect with severe pulmonary hypertension was given milrinone postoperatively to prevent low cardiac output syndrome. The following is TRUE of milrinone
A. It inhibits phosphodiesterase 5
B. It increases cGMP in the smooth muscle
C. It causes vasoconstriction
D. It increases cAMP in the cardiac muscle

A

Answer: D – It inhibits PDE3, not 5. It increase cAMP, not cGMP. It causes vasodilation.

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63
Q

63) Which patient would benefit in the use of fibrinolytic agents?
A. Any patient with STEMI who presents within 12 hours of symptoms
B. Any patient diagnosed with NSTEMI
C. Any patient with MI who was brought to a facility who has an expert in doing PCI
D. A patient who has allergies to penicillin and streptokinase
E. AOTA

A

Answer: A (Fibrinolysis isn’t recommended in NSTEMI patients. If you have an expert capable of doing PCI, this is the better treatment option. Allergy to streptokinase might mean you have allergies to other fibrinolytic agents.)

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64
Q 
64) A patient with rheumatic heart disease in severe heart failure was given furosemide at the ER. The following conditions must be anticipated with the use of this drug
A. Diuresis
B. Hypotension
C. Hypokalemia
D. AOTA
A

D

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65
Q 
65) Which of the following is an example of a direct thrombin inhibitor?
A. Hirudin
B. Bivalirudin
C. Lepirudin
D. AOTA
E. NOTA
A

D

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66
Q 
66) 48/F diagnosed with rheumatic heart disease since she was 10 years old. The 12 L ECG showed atrial fibrillation in controlled ventricular rate. She had been on warfarin for 4 years now. During one of her visits, she requested she be put on a different drug because she finds it painful to have her blood extraction every week.  You read that there is a new developed drug that does not require regular protime evaluation. What is the drug?
A. Bivalirudin
B. Abciximab
C. Prasugrel
D. Dabigatran
E. Tirofiban
A

D

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67
Q 
67) Which of the following adrenergic agonists can cause vasoconstriction at a relatively lower dose?
A. Dopamine
B. Dobutamine
C. Epinephrine
D. Norepinephrine
A

Answer: D – Dopamine is less selective compared to norepinephrine. Dobutamine causes vasodilation. Epinephrine causes vasodilation at lower doses, vasoconstriction at higher doses.

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68
Q

68) Which of the following is the mechanism of action of abciximab?
A. It irreversibly blocks the cyclooxygenase enzyme
B. Blocks the ADP receptor P2Y12
C. Inhibits cross-bridging of platelets
D. Inactivates one of the active sites of thrombin molecule
E. Promotes clot lysis

A

B

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69
Q

69) Which of the following is the advantage of low molecular weight heparin compared to UFH?
A. LMWH has more effect on thrombin
B. LMWH prolongs PT
C. LMWH does not prolong APTT
D. High likelihood of heparin induced thrombocytopenia
E. NOTA

A

C

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70
Q 
70) Which of the following is not the same class of drug?
A. Abciximab
B. Tirofiban
C. Clopidogrel
D. NOTA
A

Answer: C or D (it depends on how broadly you define “class.” They are all anti-platelet medications, but A and B are Gp IIb/IIIa inhibitors while C is a thienopyridine.)

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71
Q 
71) Which fibrinolytic drug is a nonglycosylated deletion mutant of wild type tissue plasminogen activator?
A. Reteplase
B. Alteplase
C. Streptokinase
D. Urokinase
A

A

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72
Q 
72) Which drug is used if a patient experiences heparin-induced thrombocytopenia?
A. Bivalirudin
B. Lepirudin
C. Argatroban
D. AOTA
A

D

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73
Q 
73) Group of drugs used in chronic congestive heart failure EXCEPT
A. ACE inhibitors
B. Beta blockers
C. Calcium channel blockers
D. Diuretics
A

C

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74
Q

74) Which of the following is TRUE of digoxin
A. It has a short half-life of 4 hours
B. It has minimal drug interactions
C. It is primarily metabolized in the liver
D. It has a narrow therapeutic range

A

D

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75
Q 
75) An alpha-2 agonist which can cause hemolytic anemia
A. Guanethidine
B. Methyldopa
C. Reserpine
D. Phentolamine
A

Answer: B? (Actually clonidine is more associated with hemolytic anemia, but the others aren’t even alpha-2 agonists.)

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76
Q

76) Hexamethonium was one of the first drugs used in hypertension but has currently been abandoned. The following is/are TRUE of this drug
A. Irreversibly blocks nicotinic receptors
B. Activates parasympathetic and inhibits sympathetic ganglia
C. Cause intolerable toxicities including urinary retention and severe orthostatic hypertension
D. AOTA

A

Answer: C (It competitively, not irreversibly, blocks nicotinic receptors on both parasympathetic and sympathetic ganglia.)

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77
Q 
77) Which of the following anti-hypertensive drugs are known for “first-dose phenomenon” causing precipitous drop in standing BP after the first dose?
A. Alpha-1 blockers
B. Alpha-2 blockers
C. Calcium channel blockers
D. Beta-blockers
A

Answer: A (the sins)

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78
Q 
78) Which of the following is the main side effect of aspirin?
A. Gastric ulcers
B. Hepatotoxicity
C. Renal toxicity
D. Asthma
A

Answer: A – a side effect of NSAIDs are the formation of ulcers

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79
Q 
OS 213 Pulmonology
79) The most effective controller medication in persistent asthma available at present is
A. Inhaled glucocorticosteroids
B. Inhaled short-acting beta2 agonist
C. Leukotriene modifier
D. Long-acting beta2 agonist
E. Theophylline
A

A

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80
Q 
80) What is the most effective reliever medication for asthma?
A. SABA
B. SAMA
C. Theophylline
D. Inhaled glucocorticoids
A

A

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81
Q 
81) Drug that is considered to be a specific phosphodiesterase-4 (PDE-4) inhibitor
A. Theophylline
B. Roflumilast
C. Doxofylline
D. Montelukast
A

B

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82
Q 
82) Single drug of choice as controller in asthma
A. Inhaled LABA
B. Inhaled LAMA
C. LRA
D. ICS
E. OCS
A

D

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83
Q 
83) Which of the following is not a bronchodilator?
A. Theophylline
B. Salmeterol
C. Montelukast
D. Ipatropium bromide
A

Answer: C
Remember that the bronchodilators are BAM. B- beta agonists (salbumatol, salmeterol, etc.), A – anti-cholinergics (ipratropium bromide and tiotropium), M – methylaxanthines (theophylline)

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84
Q 
84) What is the only long-acting anticholinergic agent available on the market?
A. Montelukast
B. Ipatropium bromide
C. Doxofylline	
D. Tiotropium
A

Answer: D
A isn’t even a bronchodilator, as explained in the previous number. C is a methylxanthine. B is a short-acting anticholinergic.

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85
Q

85) An effective mucolytic agent would be able to
A. Decrease chloride transport to the airway lumen
B. Decrease the sol and increase the gel layer of the mucus
C. Break the disulfide bonds of the mucoprotein strands
D. Increase parasympathetic stimulation to decrease mucous production

A

C

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86
Q 
86) Drug of choice for the treatment of paragonimiasis
A. Albendazole
B. Ivermectin
C. Pyrantel pamoate
D. Praziquantel
A

D

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87
Q 
87) The two most potent first line anti-TB drugs
A. Streptomycin and isoniazid
B. isoniazid and ethambutol
C. rifampicin and ethambutol
D. isoniazid and rifampicin
E. Rifampicin and pyrazinamide
A

D

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88
Q

88) Which statement is false regarding antimicrobial therapy
A. Choice of antibiotics for empiric therapy include considering the site of infection and age of the patient
B. Collection of specimens for diagnosis should be performed after starting antimicrobial therapy
C. An appropriate antibiotic with the narrowest spectrum possible should be used
D. One should not rush to use new antibiotics unless they have clear advantages over older ones
E. Adjunctive therapies may be as important as antimicrobial therapies

A

Answer: B – Collection of specimens should be done prior to starting treatment because it will affect the bacteria you may find in a specimen

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89
Q

89) True of rifampicin EXCEPT
A. It is a potent inducer of CYP450 system
B. Increased isoniazid hepatotoxicity
C. May cause withdrawal symptoms in narcotic addicts under methadone
D. It causes peripheral neuropathy
E. It can cause redman syndrome

A

Answer: D – This refers to isoniazid.

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90
Q

90) Which is a FALSE statement about pyrazinamide?
A. Addition of this drug has decreased the duration of treatment to six months
B. It can only be given IM or IV
C. Adverse effects include hepatotoxicity and hyperuricemia
D. It is a synthetic analog of nicotinamide
E. Adult dose is 25 mg/kg daily

A

Answer: B – All the firstline TB drugs, HRZE, can be taken orally.

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91
Q 
91) Which of the following drugs can cause pleural effusion
A. Amiodarone
B. Carbamazepine	
C. Imatinib
D. Cotrimoxazole
E. Aspirin
A

A

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92
Q 
92) Bronchodilator therapies for asthma include the following EXCEPT
A. Inhaled corticosteroids
B. Beta2-agonists
C. Anti-cholinergics
D. Theophylline
A

Answer: A. Again, remember that the bronchodilators are BAM. Beta-2 agonists (salbutamol, salmeterol), anti-cholinergics (ipratropium bromide, tiotropium), and methylxanthine (theophylline).

93
Q 
OS 214 Gastrointestinal Pharmacology
93) Hepatotoxic metabolite excessively formed from the metabolism of paracetamol in cases of drug overdose.
A. Glutathione
B. Anti-LKM2
C. NAPQI
D. CYP2E1
A

C

94
Q

94) Which is TRUE of antacids
A. It has a delayed onset of action of about 2 hours
B. It has a long duration of action of about 12 hours
C. It should be given 1 and 3 hours after meals
D. It does not affect absorption of other medications

A

C

95
Q 
95) An enkephalinase inhibitor which does not alter motility or duration of intestinal transit while decreasing secretion of water and electrolytes
A. Attapulgite
B. Lubiprostone
C. Racecadotril
D. Zinc
A

C

96
Q 
96) Which of the following inhibits 90-98% of 24 hour acid secretion
A. Antacid
B. H1 antagonist
C. H2 antagonist
D. Proton pump inhibitor
A

D

97
Q 
97) Cimetidine was given to a 35 year old male for his gastritis. Adverse effects of this drug include
A. Increased libido
B. Gynecomastia
C. Priapism
D. Increased sperm count
A

B

98
Q 
98) An antimetabolite with immunosuppressive properties used for the induction and maintenance of remission of IBD
A. Natalizumab
B. Sulfasalazine
C. Prednisone
D. 6-mercaptopurine
A

D

99
Q 
99) The following is an opioid-derivative, anti-diarrheal drug that has selective action in the GIT, reduces frequency of passage of feces and duration of illness
A. Bismuth subsalicylate
B. Loperamide
C. Lactulose
D. Senna
A

B

100
Q 
100) A 42 year old call center agent with allergy to penicillins underwent endoscopy and tested positive for H. pylori infection. He was started on omeprazole and two antibiotics which may include the following
A. Moxifloxacin
B. Mefloquine
C. Minocycline
D. Metronidazole
A

D

101
Q 
101) A potent laxative which increases peristalsis but can cause dependence and colonic atony and dilatation when used chronically
A. Bisacodyl
B. Lactulose 
C. Magnesium sulfate
D. Methylcellulose
A

A

102
Q 
102) A 5HT4 agonist used in female patients with irritable bowel syndrome
A. Domperidone
B. Dopamine
C. Erythromycin
D. Tegaserod
A

D

103
Q 
103) Lactulose, a non-absorbale disaccharide used for constipation, causes what type of diarrhea?
A. Secretory
B. Infectious
C. Inflammatory
D. Osmotic
A

Answer: D (The other type of diarrhea is dysmotile, besides those mentioned above)

104
Q 
104) Side effect of propranolol, a non-selective beta blocker used in the treatment of portal hypertension
A. Bronchoconstriction
B. Tachycardia
C. Increased libido
D. Weight loss
A

A

105
Q 
105) The mainstay of management in autoimmune hepatitis
A. PEG IFN
B. Prednisone
C. Entecavir
D. Azathioprine
A

B

106
Q 
106) The following are prokinetics EXCEPT
A. Domperidone
B. Metoclopramide
C. Loperamide
D. Erythromycin
A

C

107
Q 
107) Works in decreasing portal hypertension by decreasing splanchnic circulation
A. Epinephrine
B. Norepinephrine
C. Somatostatin
D. NOTA
A

C

108
Q

OS 215 Obstetrics and Gynecology/Reproduction
108) The usual first line pharmacologic agent for treatment of oligomenorrhea in infertility
A. Estrogen
B. Clomiphene citrate
C. Letrozole
D. Pioglitazone

A

B

109
Q 
109) Adjunct to ovulation induction in PCOS patients EXCEPT
A. Aromatase inhibitors
B. Metformin
C. Human menopausal gonadotropin
D. Cyclic progesterone
A

B

110
Q 
110) Characteristic of a drug effective in the treatment of bacterial vaginosis is best described by which of the following?
A. Broad spectrum
B. Empiric
C. Anti-anaerobe
D. Potent
A

A

111
Q 
111) The following drug can be used to stimulate ovulation
A. Mestranol
B. Tamoxifen
C. Estradiol
D. Letrozole
A

Answer: D (this is an aromatase inhibitor sometimes used as an adjuvant to clomiphene citrate)

112
Q 
112) When given to a pregnant woman, this drug may cause vaginal carcinoma in the offspring during puberty
A. Clomiphene
B. Danazol
C. Ethinyl estradiol
D. Mestranol
E. Diethylstilbestrol
A

E

113
Q

113) Medroxyprogesterone acetate has the following action
A. Inhibits the replenishment of estrogen receptors in the cell
B. Activates aromatase enzyme
C. Increases progesterone receptors
D. Induces 5-alpha reductase

A

C

114
Q

114) What is the mechanism of action of COCs?
A. The estrogenic agent suppresses LH and the progestational agent suppresses FSH
B. The estrogenic agent suppresses FSH and the progestational agent suppresses LH
C. The estrogenic and progestational agents suppress LH
D. The estrogenic and progestational agents suppress FSH

A

Answer: B? (We’re not sure – Riza and Abby) (Tama sila! According to the trans, just remember that after E is F – estrogen inhibits FSH, therefore progesterone inhibits LH)

115
Q

115) Third generation low dose combined hormonal contraceptives will include the following
A. 50 ug of ethinyl estradiol plus norgestimate
B. 20 ug of ethinyl estradiol plus dimethisterone
C. 35 ug of ethinyl estradiol plus desogestrel
D. 30 ug of ethinyl estradiol plus drospirenone

A

Answer: C (A is wrong because 50 ug of estradiol would be first gen OCP without norgestimate which is a 3rd gen progestin component of OCP. B pertains to second gen. D pertains to fourth gen.)

116
Q 
116) The most appropriate drug that can be used for contraception by lactating mothers 
A. Clomiphene
B. Progestin only pills
C. Combined OCPs
D. Cyclic progestins
A

B

117
Q

117) The CORRECT combination of drug and its mechanism of action
A. Flutamide – androgen synthesis inhibitor
B. Clomiphene – estrogen synthesis inhibitor
C. Mifepristone – progesterone synthesis inhibitor
D. Letrozole – estrogen receptor antagonist
E. Spironolactone – androgen receptor antagonist

A

Answer: E
Correct pairing: flutamide – androgen receptor antagonist, clomiphene – estrogen receptor antagonist, mifepristone – progesterone receptor antagonist, letrozole – aromatase inhibitor)

118
Q

Exam 2
118) Anti-asthma treatment in pregnancy is ____________ from non-pregnant
A. Different
B. Same

A

B

119
Q 
119) Which of the following is a correct pairing?
A. Multivitamins - B
B. Captopril - A
C. Amoxicillin - B
D. Isotretinoic acid - C
A

Answer: C – Correct pairing: Multivitamins A, Captopril D, Isotretinoic acid X

Category Description
A Controlled human studies show no fetal risks
B Animals studies show no risk to the fetus but no controlled human studies have been conducted, or animal studies show a risk to the fetus but well-controlled human studies do not
C No adequate animal or human studies have been conducted, or adverse fetal effects have been shown in animals but no human data are available
D Evidence of human fetal risk exists, but benefits may outweigh risks in certain situations (ex. life-threatening disorders, serious disorders for which safer drugs cannot be used or are ineffective)
X Proven fetal risks outweigh any possible benefit

120
Q 
120) Which of the following is NOT TRUE?
A. Lithium – cardiac defects
B. Thalidomide – kernicterus
C. Streptomycin – ototoxicity 
D. Captopril – renal dysgenesis
A

B

121
Q 
121) Period of development where exposure to toxicant may be lethal or have no effect at all
A. Peri-implantation
B. Organogenesis
C. Fetal development
D. All of the above
A

B

122
Q 
122) A 15 y/o primigravid on her 16th week of pregnancy noticed curd-like discharge on her underwear. She reports itchiness. Microscopy showed yeast infection. Treatment of choice:
A. Oral oseltamivir
B. Topical metronidazole
C. Clotrimazole vaginal suppository
D. Topical prednisolone
A

Answer: C – yeast is a fungal infection, therefore an anti-fungal is warranted

123
Q 
123) This hormone is responsible for decreasing gut motility in pregnancy thus affecting absorption
A. Estrogen
B. Progesterone
C. Relaxin
D. hCG
A

Answer: B – In pregnancy, the rise in progesterone leads to delayed gastric emptying and prolonged small bowel transmit time by 30-50%. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3982119/)

124
Q 
124) Changes that may affect drug distribution in a pregnant patient
A. Decreased cardiac volume
B. Decreased minute ventilation
C. Increased glomerular filtration rate
D. All of the above
A

Answer: C – There is increased cardiac volume and increased minute ventilation during pregnancy.

125
Q 
125) FDA drug classification that reports pre-clinical and clinical safety in pregnancy (Category)
A. A
B. B
C. C
D. D
A

A

126
Q 
126) Anti-TB drug that is NOT safe in pregnancy
A. Isoniazid
B. Streptomycin
C. Rifampicin
D. Ethambutol
A

Answer: B – “All 4 first line drugs have an excellent safety record in pregnancy and are not associated with human fetal malformations.” And of course we know that the first-line anti-TB meds are HRZE (isoniazid, rifampicin, pyrazinamide, ethambutol)
(http://www.ncbi.nlm.nih.gov/pubmed/11444726)

127
Q

127) In prescribing drugs in pregnancy
A. Choose the older drug that has proven track record of safety
B. Prioritize pharmacologic therapy as complementary medicine has no role
C. Topical route of administration is always less efficacious
D. All of the above

A

A

128
Q 
128) All of the following drugs may be given for hypertension in pregnancy EXCEPT:
A. Metoprolol
B. Atenolol
C. Hydralazine
D. Methyldopa
A

A

129
Q 
129) Phocomelia and Amelia are hallmark malformations caused by this agent:
A. Lithium
B. Fluoroquinolone
C. Thalidomide
D. None of the above
A

C

130
Q 
131) This drug is given to prevent neural tube defects
A. Folic acid
B. Ferrous sulfate
C. Zinc
D. Calcium
A

A

131
Q 
132) In which of the following drugs of endometriosis is bone pains a common complaint? 
A. GnRH agonist
B. Danazol
C. DMPA
D. Oral contraceptive
A

Answer: C - Medroxyprogesterone/DMPA is administered by injection every 3 months, subcutaneously. Depo-Provera can cause loss of bone mineral density, a condition associated with osteoporosis, but GnRH agonists (ex. leuprolide, used in the short term treatment of endometriosis) may cause even more bone thinning.
(http://pennstatehershey.adam.com/content.aspx?productId=10&pid=10&gid=000074#adamHeading_10)
Danazol is a cytochrome P450 inhibitor of enzymes involved in gonadal steroid synthesis, used in the treatment of endometriosis and fibrocystic disease of the breast. Side effects are androgenic, such as deepening of the voice and hirsutism.

132
Q 
133) Mechanism through which betamethasone reduces hyaline membrane disease
A. Increased prostaglandin production
B.  Delays premature birth
C. Increased surfactant production
D. Increased cytokine production
A

C

133
Q 
134) Several antihypertensive drugs have been used in the treatment of preeclampsia. All of the following may be given EXCEPT
A. Beta blockers
B. Calcium channel blockers
C. Vasodilators
D. Diuretics
A

Answer: C (First-line agent is methyldopa, second-line agents include nifedipine, a CCB, and hydralazine, third-line agents are alpha and beta adrenergic blockers (prazosin for the former, the lols for the latter)) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1768605/

134
Q 
Exam 3
135) Medical management of symptoms associated with benign prostatic hypertrophy aimed to relax smooth muscles of the bladder outlet include
A. 5-alpha reductase inhibitors
B. Androgen receptor inhibitors
C. Calcium channel blockers
D. Alpha-adrenergic receptor blockers
A

D

135
Q

136) The recommended initial treatment for a 45 year old male complaining of inability to sustain erection with an estimated intravaginal ejaculation latency time (IELT) of less than 1 minute is/are
A. Dapoxetine only
B. PDE5 inhibitors only
D. Dapoxetine + PDE5 inhibitors
D. Dapoxetine + PDE5 inhibitors + psychotherapy

A

Answer: B (Start with oral therapy first, with phosphodiesterase 5 inhibitors such as sildenafil and tadalafil. Dapoxetine is used in premature ejaculation, not ED)

136
Q 
137) The drug of choice in the treatment of premature ejaculation is:
A. Fluoxetine
B. Sertraline
C. Dapoxetine
D. Paroxetine
A

C

137
Q

138) Dapoxetine inhibits ejaculation by which of the following mechanisms
A. It increases the synaptic levels of serotonin
B. It produces significant penile hypoesthesia thus prolonging the latency time to ejaculation
C. It works by relaxing and dilating the blood vessels to the corpora cavernosa
D. It decrease sensorium to delay ejaculation

A

Answer: A – it is an selective serotonin reuptake inhibitor

138
Q 
139) Which of the following can be safely prescribed to a patient diagnosed with angina maintained on isosorbide mononitrate complaining of ED?
A. Sildenafil
B. Vardenafil
C. Tadalafil
D. Intraurethral alprostadil
A

D

139
Q

140) Correct statement regarding principles of HRT use
A. HRT effective in perimenopause to regulate menstrual cycle
B. HRT is still the most effective therapy for vasomotor and estrogen-deficiency related urogenital symptoms
C. Risk and benefits are the same for women around time of menopause and those who are older
D. AOTA

A

D

140
Q

141) Indication of HRT use as recommended by FDA
A. Prevention of osteoporosis
B. Treatment of mild vasomotor symptoms
C. Treatment of mild LVD
D. Prevention of moderate vaginal dryness

A

A

141
Q 
142) Absolute contraindication/s to the use of HRT include/s 
A. Undiagnosed vaginal bleeding
B. Recent myocardial infarction
C. Suspected breast CA
D. AOTA
A

D

142
Q

143) Which is correct?
A. Perimenopause is marked by irregularity of the menstrual cycles
B. The administration of large amounts of estrogen will lower the FSH levels to premenopausal concentrations
C. A BMI of >30 is a risk factor for osteoporosis
D. AOTA

A

A

143
Q

144) True of use of risedronate for the management of osteoporosis
A. Prevents vertebral fracture
B. Prevents hip fracture
C. Prevents vertebral and hip fracture

A 
C
Therapy	Decreases vertebral fracture rates	Decreases hip fracture rates	Most common side effect
ERT/HRT	Yes	Yes	Breakthrough bleeding
Alendronate	Yes	Yes	Gastric ulceration
Risedronate	Yes	Yes	Upper GI symptoms
Raloxifene	Yes	No	Hot flushes
Calcitonin 	Yes	No	Nasal irritation
144
Q 
145) Choose the best route of administration for 60/F with fatty liver, and elevated liver enzymes
A. Oral (tablet)
B. Non-oral (patch)
C. Vagifem (vaginal tablet)
D. Any of the above
A

Answer: C – The more localized the action of the medication, the better.

145
Q

OS 215 Endocrinology (Pituitary disorders, dyslipidemia, diabetes)
146) Which of the following drugs can increase prolactin levels?
A. Calcium channel blocker verapamil
B. Dopamine agonist pergolide
C. Glucocorticoid prednisone
D. Proton pump inhibitor omeprazole

A

Answer: A (B can lower prolactin levels)

146
Q 
147) Your patient presenting with secondary amenorrhea who was diagnosed with prolactinoma already has normal menses but her prolactin level is still 40ug/L. This was repeated after another month and it is still 45 ug/L. She is currently on bromocriptine 2.5 mg 1 tablet once a day for the last 6 months and the dose is well tolerated. The next step should be
A. Do an MRI
B. Increase the dose
C. Send the patient for surgery
D. Stay on the same dose
A

B

147
Q

148) Which of the following states is TRUE regarding the use of bromocriptine?
A. Achievement of normal fertility is not a realistic endpoint of treatment with bromocriptine
B. Bromocriptine should be started at the maximum effective therapeutic dose right away to achieve the treatment targets
C. Bromocriptine should be taken with food to minimize adverse effects
D. Diarrhea is the most common gastrointestinal side effect with use of bromocriptine

A

C

148
Q

149) Which of the following is the mechanism of action of octreotide for the treatment of GH-secreting tumors?
A. Competes for the IGF-1 receptor
B. Competitive inhibition for the GH receptor
C. Dopaminergic agonist inhibiting GH secretion
D. Somatostatin-like effect inhibiting the release of GH

A

D

149
Q 
150) The following drugs can potentially decrease the cortisol levels in Cushing’s syndrome EXCEPT
A. Aminoglutehtimide
B. Ketoconazole
C. Metyrapone
D. Octreotide
A

D

150
Q 
151) The following drug is a dopamine agonist
A. Cabergoline
B. Octreotide
C. Pegvisomant
D. Somatropin
A

Answer: A (the other drug is bromocriptine)

151
Q 
152) In replacing hormones in an adult patient with acute presentation of panhypopituitarism, the following is the first drug which should be given in order of priority
A. Growth hormone
B. Intravenous dexamethasone
C. Intravenous hydrocortisone
D. Levothyroxine or thyroid hormone
A

C

152
Q 
153) When screening for endocrine hypertension, which antihypertensive interferes least with diagnostic testing?
A. Angiotensin receptor blockers
B. Beta blockers
C. Calcium blockers
D. Diuretics
A

C

153
Q

154) The following medications can cause hyperglycemia
A. L-asparaginase, tacrolimus, and glucocorticoid
B. Glucocorticoid, cyclosporine, and thiazolidinedione
C. Alpha-glucosidase inhibitor, L-asparaginase, and cyclosporine
D. Thiazolidinedione, biguanide, and alpha-glucosidase inhibitor

A

A

154
Q 
155) Which of the following insulins is/are not approved for the treatment of gestational diabetes mellitus?
A. Insulin glulisine
B. Neutral protamine Hagedorn
C. Regular insulin
D. Insulin lispro
A

A

155
Q 
156) This apo-protein contained in LDL, VLDL, IDL, and Lp (a) is the ligand of LDL receptors in the liver and the peripheral tissues
A. B-100
B. B-48
C. A-I
D. E
A

A

156
Q 
157) Lipoprotein associated with atherosclerosis and localized in atherosclerotic plaques with a unique apoprotein structurally similar to plasminogen; it inhibits plasminogen activation, and promotes thrombosis
A. HDL
B. IDL
C. Lp (a)
D. VLDL
A

C

157
Q

158) Statins can decrease LDL levels by which of the following mechanism?
A. Stimulation of HMG-CoA reductase
B. Decrease in synthesis of triglycerides
C. Upregulation of LDL receptors in the hepatocyte
D. Increase in fatty acid oxidation

A

C

158
Q 
159) A patient taking amiodarone and macrolide antibiotic but will highly benefit from a statin should be prescribed
A. Atorvastatin
B. Pravastatin
C. Simvastatin
D. Rosuvastatin
A

B

159
Q

160) Which of the following is TRUE about statin toxicity
A. Hepatotoxicity may manifest as a precipitous fall in LDL
B. Elevation of liver enzymes is an indication to stop therapy even in the absence of symptoms
C. Generalized skeletal muscle pain, tenderness, or weakness are common side-effects which do not necessitate further examination
D. AOTA

A

A

160
Q 
161) Which of the following transcriptionally up-regulates lipoprotein lipase, apoA-I and apoA-II, downregulates apoCIII, and is a drug of choice for lowering triglycerides
A. Colestipol
B. Ezetimibe
C. Fenofibrate
D. Simvastatin
A

B

161
Q 
162) A patient with high LDL and low HDL was given niacin to decrease cardiovascular risk. The side-effects/toxicities of this drug include which of the following
A. Cutaneous vasoconstriction
B. Hypoglycemia
C. Hyperuricemia
D. Renal failure
A

C

162
Q 
163) A female taking a drug to decrease LDL cholesterol developed night blindness, easy bruisability, and heavy menstrual bleeding suspected to be due to vitamin deficiency. The patient is most likely taking what drug for dyslipidemia
A. Atorvastatin
B. Colestipol
C. Gemfibrozil
D. Niacin
A

B

163
Q 
164) A patient with jaundice was admitted for fever with ALT 5x the normal. A random blood sugar test showed a value of 278 mg/dl. On repeat before breakfast, it was still 259 mg/dl. The ideal drug to use is
A. Metformin
B. Insulin
C. Linagliptin
D. Acarbose
A

B

164
Q 
165) The following types of insulin can specifically address prandial or meal-related elevation of blood sugar
A. NPH insulin
B. Insulin glargine
C. Insulin aspart
D. Insulin detemir
A

C

165
Q 
166) Drug of choice for a 12 year old overweight type 2 diabetic
A. Insulin
B. Acarbose
C. Metformin
D. Sulfonylurea
A

C

166
Q 
167) Drug which causes glucose independent insulin secretion
A. Acarbose
B. Piglitazone
C. Glimepiride
D. Sitagliptin
A

C

167
Q 
168) Weight gain is an expected side effect or adverse drug reaction of this drug
A. Saxagliptin
B. Voglibose
C. Glipizide
D. Metformin
A

C

168
Q

169) The following are expected side effects of the drug sitagliptin
A. Decreased glucagon secretion from the alpha cells of the pancreas
B. Decreased bioavailability and blood levels of endogenous GLP-1
C. Increased hepatic glucose production
D. Increased insulin secretion from the beta cells during fasting

A

A

169
Q 
170) During the “Habagat” flooding the supplies of insulin syringes could not be delivered to the district hospital so all that was available were tuberculin syringes. If 36 units of insulin is to be injected, how many ml of this liquid should be aspirated into the syringe?
A. 0.036 ml
B. 0.36 ml
C. 3.6 ml
D. 36 ml
A

B

170
Q 
171) You have a patient who is taking a combination of anti-diabetic agents to try to control his blood sugar. One of his tablets is taken 3x a day just before meals. Which drug is this most likely to be?
A. Metformin
B. Repaglinide
C. Acarbose
D. Pioglitazone
A

B or C

171
Q

172) A patient was injected with insulin last night at around 8 pm just before he had dinner. He woke up at 3 am with cold sweats, confusion, and tremulousness. You confirm hypoglycemia through capillary testing. This is most probably the type of insulin that was injected
A. Insulin glargine
B. Regular human insulin
C. NPH or neutral protamine Hagedorn insulin
D. Insulin aspart

A

Answer: C (B and D have short effects, A has no peaks or troughs)

172
Q 
173) This type of insulin cannot be mixed with other insulins or with IV fluid due to acidic pH
A. Insulin glulisine
B. Insulin glargine
C. Insulin lispro
D. Regular insulin
A

B

173
Q 
174) You are the clerk admitted a patient to the Internal Medicine wards due to decompensated congestive heart failure. The patient is previously on regular OPD follow up and already has a set of medications that he has brought. The resident asks you to audit his medications list and continue only those that are safe. Which of the following anti-diabetic medications will you retain?
A. Pioglitazone
B. Metformin
C. Glibenclamide
D. Insulin glargine
A

D

174
Q 
175) You have a diabetic patient who is using various anti-diabetic agents. Recently her renal function deteriorated so that her estimated GFR is only 30% and she is beginning to have edema or swelling of her feet. Which of the following drugs can you still safely maintain and not discontinue?
A. Metformin
B. Glimepiride
C. Pioglitazone
D. Sitagliptin
A

D

175
Q

176) The same patient above was subsequently shifted to insulin. Her renal function continued to deteriorate over several months. What do you anticipate will happen to her dose of insulin if renal function continues to worsen?
A. Her dose will increase since insulin requirements will increase with worsening GRF
B. Excretion or clearance of insulin will be decreased and hence, insulin requirements will diminish
C. It will be unchanged
D. It will either increase or decrease (not predictable)

A

B

176
Q 
177) Drug of choice for an elderly 70 year old diabetic due to low risk of hypoglycema and no risk for systemic adverse effects
A. Glipizide
B. Pioglitazone
C. Acarbose
D. Insulin
A

C

177
Q 
178) Based on efficacy criteria, which among the following drugs is considered the most effective in lowering HbA1c?
A. Megletinides/glinides
B. DPP4 inhibitors
C. Biguanides
D. Thiazolidinediones
A

Answer: C (by as much as 1-2%)

178
Q 
179) Which of the following drugs has a glucose-dependent mechanism of action which suppresses glucagon and stimulates insulin production?
A. Megletinides/glinides
B. Biguanides
C. Incretins or Incretin-based therapy
D. Thiazolidinediones
A

C

179
Q 
180) Weight loss is an expected side effect of this drug
A. Dapagliflozin
B. Gliclazide
C. Pioglitazone
D. Insuline glargine
A

A

180
Q 
181) Which of the following drugs has a “do not prescribe” recommendation from some of the clinical practice guidelines due to excessive hypoglycemia?
A. Glipizide
B. Glibenclamide
C. Metformin
D. Repaglinide
A

B

181
Q 
182) A newly diagnosed 42 year old patient with an FBS of 130 and HbA1c of 7.3% during the first visit will likely receive the following treatment
A. Metformin
B. Acarbose
C. Diet and exercise
D. Pioglitazone
A

A and C

182
Q 
183) The following is an expected side effect of an SGLT-2 inhibitor when given among diabetic individuals
A. Diarrhea
B. Lactic acidosis
C. Weight gain
D. Genital fungal infections
A

D

183
Q

OS 215 Endocrinology (Hyper/hypothyroidism, thyroid storm, osteoporosis)
184) The following drugs inhibit the peripheral conversion of T4 to T3
A. Methimazole
B. Saturated solution of potassium iodide
C. Lithium
D. Glucocorticoids

A

D

184
Q 
185) The most life threatening adverse reaction of thoanamides
A. Vasculitis
B. Skin rash
C. Agranulocytosis
D. Lupus-like reaction
A

C

185
Q 
186) Drug of choice for treatment of hyperthyroidism
A. Levothyroxine
B. Beta blockers
C. Propylthiouracil
D. Methimazole
A

D

186
Q 
187) Test which is used to monitor the adequacy of pharmacologic treatment of hypothyroidism
A. Free T4
B. Free T3
C. TSH
D. Thyroglobulin
A

C

187
Q 
188) Drug that inhibit the release of preformed thyroid hormones
A. Propranolol
B. Hydrocortisone
C. Lithium
D. Methimazole
A

C

188
Q

189) The following drugs inhibit the peripheral conversion of T4 to T3 EXCEPT
A. Dexamethasone
B. Methimazole
C. Propylthiouracil
D. Saturated solution of potassium iodide

A

B

189
Q

190) The following is true regarding the use of anti-thyroid drugs (thionamides) among patients with Graves’ disease
A. Success rate is high in using thionamides to achieve remission
B. Normalization of thyroid function is expected in two weeks
C. It is an approach to prepare patients for RAI or surgery
D. Beta-blockers are needed by all patients with Graves’ disease

A

C

190
Q 
191) The most common side-effect of thionamide drugs
A. Jaundice
B. Joint pains
C. Agranulocytosis
D. Pruritus
A

D

191
Q

192) Proper course of action in a patient who developed agranulocytosis secondary to methimazole
A. Shift methimazole to PTU
B. Continue methimazole but decrease the dose to less than 40 mg/day
C. Administer RAI upon admission for ablation of the goiter
D. Discontinue thionamides permanently

A

D

192
Q 
193) You have a patient with hyperthyroidism who will undergo elective surgery in the form of hysterectomy. She started anti-thyroid drug treatment today. The approximate time when you will repeat her thyroid function tests to document achievement of euthyroidism is in:
A. Two weeks
B. 2-3 months
C. 4-6 weeks
D. 6 months
A

C

193
Q

194) A patient with goitrous hypothyroidism is receiving 100 mcg levothyroxine for treatment. Her current TSH after 6 weeks of treatment is already 3.5 mIU/L (NV 0.4-4.5 mIU/L). What can you conclude about her treatment?
A. You have not yet met your target; the dose is inadequate
B. She is already euthyroid; the dose is adequate
C. The dose is too much and needs to be reduced
D. You are unsure about the adequacy of the dose; will repeat TSH

A

B

194
Q

195) Your 72 year old patient underwent thyroidectomy for suspicion of thyroid CA. The biopsy is benign but your post-operative TSH one month after surgery is 34 mIU/L (NV 0.4-4.5 mIU/L). Which of the following is true about the correct initial dose of levothyroxine?
A. Start full dose at 100 mcg once a day
B. Start at half the dose and titrate gradually
C. Start with the suppressive dose of 150 mcg
D. There is no need to start levothyroxine at this point

A

B

195
Q 
196) You have a 24/F at the ER manifesting with fever, agitation, and difficulty of breathing, You suspect thyroid storm and pneumonia. The following drugs should be given EXCEPT
A. PTU (propylthiouracil)
B.  High dose iodides
C. Beta blockers
D. Aspirin
E. Hydrocortisone
A

D

196
Q 
197) You have a patient in thyroid storm who has diastolic dysfunction as the cause of her congestive heart failure. You want to slow down the cardiac rate by giving propranolol but she has asthma. Which of the following drugs can be given as an alternative?
A. Amlodipine
B. Verapamil
C. Captopril
D. Nifedipine
A

B

197
Q 
198) What drug acutely inhibits the release of preformed thyroid hormone, making it very useful in the treatment of thyroid storm?
A. PTU (propylthiouracil)
B. Iodides
C. Propranolol
D. Dexamethasone
A

B

198
Q 
199) What is the effect of risedronate on bone tissue?
A. Antiresorptive
B. Estrogenic
C. Calciotropic
D. Phosphaturic
A

A

199
Q 
200) What is the effect of tamoxifen on bone tissue?
A. Antiresorptive
B. Estrogenic
C. Calciotropic
D. Phosphaturic
A

B

200
Q

201) Which of the following statements is TRUE?
A. Teriparatide is able to induce antiresorptive action by binding to RANKL and inhibiting its ability to activate osteoclasts
B. Denosumab stimulates IGF-1 production and activates bone remodeling
C. Raloxifene reduces bone turnover and bone loss in postmenopausal women
D. Estrogen reduces the secretion of IGF-1 and IL-6 to cause an increase in osteoblastic activity

A

C

201
Q

202) Which among the following may have a contraindication to raloxifene use in postmenopausal osteoporosis?
A. A 57 year old who was admitted in the last month for sudden onset right sided heart failure
B. A 55 year old whose sister was found to have invasive ductal carcinoma of the left breast at age 49
C. A 45 year old who underwent lumpectomy of the left breast for ductal carcinoma in situ
D. A 58 year old who discontinued ibandronate after 3 months of intake due to epigastric and retrosternal discomfort

A

A

202
Q 
202) Calcium supplement that has the most amount of elemental calcium at equivalent doses
A. Calcium lactate
B. Calcium gluconate
C. Calcium carbonate
D. Calcium citrate
A

C

203
Q 
203) Considered as first line anti-catabolic agent for various cases of osteoporosis
A. Bisphosphonates
B. Salmon calcitonin
C. Raloxifene
D. Teriparetide
A

A

204
Q 
204) The most feared side effect/adverse drug reaction of alendronate
A. Esophageal cancer
B. Osteonecrosis of the jaw
C. Venous thrombophlebitis
D. Renal impairment
A

B

205
Q

205) True statement regarding the use of bisphosphonates
A. They are usually given indefinitely for postmenopausal osteoporosis
B. Ibandronate given once monthly has been proven to decrease risk for hip and spine fracture
C. Patients who take this drug should not lie down after taking it
D. Can be taken together with calcium supplements after meals

A

C

206
Q 
206) The drug of choice for prevention of osteoporosis in the general population
A. Bisphosphonates
B. Omega-3 fatty acids
C. Calcium with Vitamin D tablets
D. Calcium tablets
A

C

207
Q 
OS 216 Immunology
207) The most common ocular presentation of allergies to non-steroidal anti-inflammatory drugs (NSAIDs):
A. Angioedema
B. Congestion
C. Lacrimation
D. Pruritus
A

Answer: A. Angioedema

208
Q 
208) The first chemotherapeutic drugs against HIV infection target this molecule:
A. Reverse transcriptase
B. Integrase
C. Protease
D. CD120
A

Answer: A. Reverse transcriptase

209
Q

209) The following are true of asthma medications EXCEPT
A. Oral corticosteroids are used for regular maintenance treatment
B. Inhaled corticosteroids reduce airway inflammation, control symptoms, and reduce future risks such as exacerbations, and decline in lung function
C. Beta2 agonists are for relief of breakthrough symptoms including worsening asthma or exacerbations
D. NOTA

A

Answer: A – Inhaled corticosteroids dapat

210
Q 
210) A 6 month old female develops a flare up of atopic dermatitis in the inguinal area. Which topical corticosteroid would you choose to give her?
A. Hydrocortisone cream
B. Betamethasone valerate cream
C. Mometasone furoate cream
D. Mometasone furoate ointment
A

Answer: A – You want a cream instead of an ointment in order to moisturize the lesions, hence D is out. You want to use the mildest steroid as possible, hence A is the best answer.

211
Q 
211) Drug of choice for urticaria is
A. First generation antihistamine
B. Second generation antihistamine
C. Leukotriene antagonist
D. Oral corticosteroids
A

A

212
Q 
212) Other agents that may be given for urticaria unresponsive to standard treatment include
A. ACE inhibitor
B. Aspirin
C. Beta lactam antibiotics
D. Cyclosporin
A

D

213
Q 
213) Which of the following effects of histamine is NOT reversed by the administration of epinephrine?
A. Tachycardia
B. Diarrhea
C. Hypotension
D. Bronchoconstriction
A

A

214
Q 
214) Which of the following drugs CANNOT be safely combined or given IV with epinephrine? 
A. Aminophylline
B. Dopamine
C. Diltiazem
D. Dobutamine
A

A

215
Q 
215) Which of the following drugs is less likely to cause rebound congestion in allergic rhinitis?
A. Topical phenylephrine
B. Oral pseudoephedrine
C. Topical xylometazoline
D. Topical oxymetazoline
A

B

216
Q 
216) Which of the following drugs used in the treatment of allergic rhinitis would cause hypotension?
A. Xylometazoline
B. Phenylephrine
C. Ephedrine
D. Phenylpropanolamine
A

A

217
Q 
217) Which of the following drugs used in the treatment of allergic rhinitis is less likely to cause mucosal damage?
A. Phenylephrine
B. Ephedrine
C. Xylometazoline
D. Oxymetazoline
A

B

218
Q 
218) Which of the following is NOT an indication for the use of epinephrine?
A. Bronchospasm
B. Anaphylactic reactions
C. Angle-closure glaucoma
D. Added to local anesthetics
A

C

219
Q 
219) Epinephrine can be given via the following routes EXCEPT
A. Subcutaneous
B. IM
C. Intra-arterial
D. Endotracheal
A

C

220
Q 
220) Which of the following decongestants releases stored catecholamines, has some direct action on receptors and has good oral bioavailability, and can cause significant CNS stimulation?
A. Phenylephrine
B. Ephedrine
C. Oxymetazoline
D. Pseudoephedrine
A

B

221
Q

221) Less likely to cause rebound congestion but may induce adverse systemic events
A. Topical decongestants
B. Oral decongestants
C. Both topical and oral decongestants
D. Does not refer to either topical or oral decongestants

A

B

222
Q

222) Contraindicated in patients who are taking MAO inhibitors
A. Topical decongestants
B. Oral decongestants
C. Both topical and oral decongestants
D. Does not refer to either topical or oral decongestants

A

C

223
Q 
223) Histamine-1 antagonists are useful in the treatment of itching and edema associated with allergies. Which of the following is NOT an H1-antagonist?
A. Chlorphenamine
B. Fexofendadine
C. Ranitidine
D. Astemizole
A

C

224
Q 
224) Which antihistamine has been withdrawn due to increased cardiovascular events due to prolongation of the QT interval?
A. Loratidine
B. Fexofenadine
C. Terefenadine
D. Cetirizine
A

C

225
Q

225) The following adverse effect of glucocorticoids is attributed to its interaction and activation of the mineralocorticoid receptor
A. Hyperglycemia or high blood sugar
B. Osteoporosis
C. Easy bruising and thinning of the skin
D. Hypertension

A

Answer: D – Activation of the mineralocorticoid receptor leads to sodium retention and thus vascular volume expansion, increasing blood pressure.

226
Q

226) The following are correct indications for giving systemic steroids EXCEPT
A. Anaphylactic shock
B. Myeloproliferative diseases (blood disorders)
C. Allergic contact dermatitis on the wrist after wearing a bracelet containing nickel
D. Primary adrenal insufficiency after bilateral adrenal tuberculosis

A

C

227
Q

227) Which of the following is true about hydrocortisone
A. It is a long acting agent
B. It is the preferred steroid in anaphylaxis
C. It has very little anti-inflammatory activity
D. It has minimal mineralocorticoid activity

A

B

228
Q

228) The following are expected effects of steroids EXCEPT
A. Decreased calcium absorption in the gut
B. Increased glucose uptake by muscles
C. Decreased synthesis of prostaglandins and leukotrienes
D. Protein catabolism

A

Answer: B – Steroids inhibit glucose uptake by muscles

[FINALS] LU4 2018 (9 decks)

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