Pharmacy Prep Evaluating Exam Review and Guide PDF

www.pharmacyprep.com Canadian Pharmacy Review Pharmacy Prep Evaluating Exam Review and Guide Q&A MUST PASS July 2016 Misbah Biabani, Ph.D...

www.pharmacyprep.com Canadian Pharmacy Review Pharmacy Prep Evaluating Exam Review and Guide Q&A MUST PASS July 2016 Misbah Biabani, Ph.D Director Toronto Institute of Pharmaceutical Sciences (TIPS) Inc. Toronto, ON M2N K7 Pharmacy Prep Professional Exams Preparation Center 4789 Yonge St. Suites # 417 Toronto, ON, M2N 5M5 WWW.PHARMACYPREP.COM 416-223-PREP (7737) / 647-221-0457 Toronto Institute of Pharmaceutical Sciences Inc. © 2000 to 2016 TIPS Inc. All Rights Reserved. Copyright © 2000 to 2016 Tips Inc 1 www.pharmacyprep.com Canadian Pharmacy Review Disclaimer Your use and review of this information constitutes acceptance of the following terms and conditions: The information contained in the notes intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor or pharmacist can provide you with advice on what is safe and effective for you. Pharmacy prep make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, Pharmacy prep do not assume any responsibility or risk for your use of the pharmacy preparation manuals or review classes. In our teaching strategies, we utilize lecture-discussion, small group discussion, demonstrations, audiovisuals, case studies, written projects, role play, gaming techniques, study guides, selected reading assignments, computer assisted instruction (CAI), and interactive video discs (IVD). Our preparation classes and books does not intended as substitute for the advise of NABPLEX®. Every effort has been made to ensure that the information provided herein is not directly or indirectly obtained from PEBC® previous exams or copyright material. These references are not intended to serve as content of exam nor should it be assumed that they are the source of previous examination questions. ©2000 to 2016 TIPS Inc. All rights reserved. Foreword by Misbah Biabani, Ph.D Coordinator/Director, Pharmacy Prep Toronto Institute of Pharmaceutical Sciences (TIPS) Inc 4789 Yonge St. Suites 417 Toronto ON M2N 5M5, Canada Copyright © 2000 to 2016 Tips Inc 2 www.pharmacyprep.com Canadian Pharmacy Review Content Abbreviations Part I: Biomedical sciences 1. Human Anatomy 2. Gastrointestinal System 3. Nervous System 4. Cardiovascular System 5. Endocrine System 6. Renal System 7. Liver Function and Pathophysiology 8. Respiratory system 9. Urinary System 10. The Eye 11. Blood and anemia 12. Biochemistry 13. Clinical Biochemistry 14. Nutrition 15. Microbiology 16. Genetics and Molecular Biology 17. Pharmacogenomics 18. Immunology 19. Immunizations (vaccines) 20. Biotechnology 21. Toxicology Part II: Pharmaceutical Sciences 22. Basic Calculations 23. Pharmacy Calculations: Dosage 24. Pharmacy Calculations: Dilutions 25. Pharmacokinetics 26. Rates and Orders of Reactions 27. Pharmacodynamics Copyright © 2000 to 2016 Tips Inc 3 www.pharmacyprep.com Canadian Pharmacy Review 28. Basics of Medicinal Chemistry 29. Medicinal chemistry and Pharmacology of Drugs that act on autonomic nervous system 30. Medicinal chemistry and Pharmacology of Histamines, Serotonin, Prostaglandin and Non- Steroidal anti-inflammatory Drugs 31. Medicinal chemistry and pharmacology of cardiovascular drugs 32. Medicinal chemistry and pharmacology of psychiatric & neurological diseases 33. Medicinal chemistry and pharmacology Endocrine drugs 34. Medicinal Chemistry and Pharmacology of Respiratory Drugs 35. Medicinal Chemistry and Pharmacology of Musculoskeletal drugs 36. Medicinal Chemistry and Pharmacology of Antimicrobial 37. Drug Metabolism 38. Biopharmaceutics 39. Physical Pharmacy 40. Pharmaceutical Excipients 41. Rheology 42. Pharmaceutical Dosage Forms 43. Drug delivery Systems 44. Sterile Preparations 45. Extemporaneous Pharmaceutical Preparations 46. Pharmaceutical Analysis Part III: Social / Behavioural /Administrative Sciences 47. Bioethics and Professional ethics 48. Canadian Healthcare System 49. Canadian Pharmacy Regulations and administration 50. Social and Behavioural Aspects of Pharmacy Profession 51. Pharmacy Management 52. Pharmacoeconomics 53. Drug Information Resources 54. The new drug Approval Process 55. Basics of Clinical Research and Epidemiology 56. Biostatistics 57. Hospital Pharmacy Copyright © 2000 to 2016 Tips Inc 4 www.pharmacyprep.com Canadian Pharmacy Review Part IV: Pharmacy Practice/ Therapeutics and OTC Drugs 58. Generic and Brand Index 59. Prescription processing and Medication dispensing 60. Pharmaceutical Care and Drug Related Problems 61. Adverse Drug Reactions and Management 62. Drug Interactions 63. Therapeutic Drug Monitoring 64. Safety of medications in special populations 65. Identification and prevention of drug toxicity 66. Professional Pharmacy Communication Skills 67. Medication Errors 68. Pharmaceutical Preparation Storage Conditions 69. OTC and Prescription Drugs for Dermatological Disorders 70. OTC and Prescription Drugs for Ophthalmic, Ear and Mouth Disorders 71. OTC Drugs antihistamine, decongestants, antitussives, Expectorants 72. OTC Drugs for Nausea, Vomiting, Constipation, Diarrhea, and Hemorrhoids 73. OTC Drugs for Headache, Sports Injuries, Pressure Ulcers, Low Back Pain 74. Asthma and Chronic Obstructive Pulmonary Disease 75. Smoking cessation 76. Insomnia 77. Eating disorders 78. GERD, Ulcers, Inflammatory Bowel Disease and Irritable Bowel Syndrome 79. Diabetes Mellitus Type I and Type 2 80. Thyroid Disorders 81. Contraception 82. Reproductive, Gynaecologic and Genitourinary Disorders 83. Bone and Joint Complications 84. Osteoporosis 85. Hypertension 86. Coronary Artery Diseases 87. Stroke 88. Congestive Heart Failure 89. Cardiac Arrhythmias Copyright © 2000 to 2016 Tips Inc 5 www.pharmacyprep.com Canadian Pharmacy Review 90. Peripheral vascular diseases 91. Anticoagulants 92. Anxiety Disorder 93. Depression 94. Psychosis and schizophrenia 95. Dementia 96. Seizures and epilepsy 97. Parkinson’s Disease 98. Anti-microbial agents 99. Anticancer drugs and chemotherapy 100. Natural Products and Pharmacognosy Copyright © 2000 to 2016 Tips Inc 6 PharmacyPREP.com Human anatomy PHARMACY PREP HUMAN ANATOMY 1. What is an opposite of anterior view? A. Ventral view B. Posterior view C. Lateral view D. Medial view E. Supination Ans. B Tips. Ventral (anterior) is opposite to Dorsal (posterior) and the lateral is opposite to medial. 2. Epithelial tissue is present in all of the following except? A. sweat gland B. milk gland C. Endocrine gland D. Blood vessel Ans. D 2. All of the following have skeletal muscles, except? A. arm B. biceps C. triceps D. heart E. Foot Copyright © 2000-2015 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is 1-1 being used during review sessions conducted by PharmacyPrep. PharmacyPREP.com Human anatomy Ans. D Copyright © 2000-2015 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is 1-2 being used during review sessions conducted by PharmacyPrep. PharmacyPrep.Com Gastrointestinal System PHARMACY PREP GASTROINTESTINAL SYSTEM 1. A person with Vitamin B12 deficiency due to intrinsic factors. Should take? A. Vitamin B 12 supplements B. Vitamin B 12 IM inj. C. Vitamin B 12 oral D. Vitamin B 12 inj. and folic acid Ans. B 2. PPI & H 2 RAs act on? A. G cells B. Gastrin C. Parietal cell D. Hydrochloric acid Ans. C 3. Which of the following may increase excessive acid secretion in patient with? A. high carbohydrate diet B. high protein diet C. High liquid diet D. High salt diet E. All of the above Ans. b 4. What is the main cause of dyspepsia? A. GERD B. Peptic ulcers C. Reflux esophagitis D. Gastric cancer Ans. B 5. What is not symptoms associated with irritable bowel syndrome? A. chronic constipation B. abdominal pain C. Chronic diarrhea D. GI bleeding Ans. D 6. Epigastric pain is a symptom of Ulcer. (less likely GERD), GERD is heartburn, this could be regurgitation of acid into esophagus to throat. 2-1 PharmacyPrep.Com Gastrointestinal System A. Ulcer B. GERD C. Appendicitis D. Angina E. All of the above Ans. A Tips: Epigastric pain is a symptom of Ulcer. (less likely GERD), GERD is heartburn, this could be regurgitation of acid into esophagus to throat. 7. Fistula or granulomas or skip patches occurs in? A. Irritable bowel disease B. Ulcerative colitis C. Crohn's disease D. Gastritis E. GERD Ans. C 8. Hyper acid secretion caused by? A) Heart burn (reflux of gastric content into esophagus) B) Peptic ulcers (H. pylori) C) Ulcerative colitis (inflammatory) D) Zollinger Ellison syndrome E) GIT cancers Ans. D Tips. Zollinger-Ellison Syndrome occurs when gastrin secreted by non-beta cell tumors of pancreas. 9. A regular customer of your pharmacy, is taking treatment of osteoarthritis. Recently got gastritis? What is correct? A) Patient is using acetaminophen B) Patient is using corticosteroids C) Patient is using NSAIDs D) Patient is using methotrexate E) Patient has heartburn Ans. C 10. What is the most sensitive and specific means to diagnose the cause of dyspepsia? A. Endoscopy B. CT scan C. Magnetic resonance imaging D. Urea Breath Test E. Esophagogastroduodenoscopy Ans. A 2-2 PharmacyPrep.Com Gastrointestinal System 11. Which of the following bacteria can cause chronic peptic ulcer disease? A. E. coli B. H. pylori C. S. aureus D. S. pneumonia E. Candida infections Ans. B 12. What is the laboratory test confirm the peptic ulcer disease caused by H. pylori? A. Endoscopy B. CT scan C. Magnetic resonance imaging D. Urea Breath Test E. Esophagogastroduodenoscopy Ans. D 13. All GI conditions are associated with GI bleeding symptoms? except A) GI cancer B) Pancreatitis C) Gastritis D) Crohn's disease E) Ulcerative colitis Ans. b Tips. Pancreatitis has no GI bleeding and pancreatitis symptoms are upper abdominal pain that radiates into back. It may aggravated by eating, especially foods high in fat. Tender abdomen, nausea and vomiting and increased heart rate. 14. What type of hernia is common in seniors or elderly? A) heital hernia B) sliding hernia C) Para esophageal hernia D) None of the above Ans.A 15. Polypeptides and caffeine stimulates secretion of? A. parietal cells B. vitamin B 12 C. gastrin D. chyme E. amylase Ans. C 16. When parietal cells are stimulated, they secrete? A. Intrinsic factor and gastrin 2-3 PharmacyPrep.Com Gastrointestinal System B. Intrinsic factor and HCl C. Intrinsic factor and HCO 3 D. Intrinsic factor and mucus Ans. B 17. A patient of your pharmacy, recently had gastrectomy and ileum was removed. Which of the following can be deficient? A. Iron deficient anemia B. Calcium deficient due to deficiency of vitamin D C. Vitamin B 12 deficiency due to deficiency of intrinsic factor D. Vitamin K deficiency due to deficiency if GI bacteria E. All of the above Ans. C 2-4 PharmacyPrep.Com Nervous System PHARMACY PREP Nervous System 1. Which part of brain that controls important cognitive skills in humans, such as emotional expression, problem solving, memory, language? A. Frontal lobe B. Occipital lobe C. Temporal lobe D. Parietal lobe E. Brainstem Ans. A 2.Involuntary functions are controlled by? A. Cerebellum B. Cerebrum C. Cortex D. Hypothalamus Ans. B 3.Dopaminergic pathways are associated with? A. occipital lobe B. Middle lobe C. Frontal lobe D. Temporal lobe Ans. C 4. Which part of brain that controls important cognitive skills in humans, such as emotional expression, problem solving, memory, language? A. Frontal lobe B. Occipital lobe C. Temporal lobe D. Parietal lobe E. Brainstem Copyright © 2000-2015 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is 3-1 being used during review sessions conducted by Pharmacy Prep. PharmacyPrep.Com Nervous System 5. Patient is diagnosed with Alzheimer's dementia. The Alzheimer's is associated with? A. Temporal lobe B. Frontal lobe C. Occipital lobe D. Brain stem Ans. b Copyright © 2000-2015 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is 3-2 being used during review sessions conducted by Pharmacy Prep. PharmacyPrep.com Cardiovascular System PHARMACY PREP CARDIOVASCULAR SYSTEM 1. Which of the following cardiovascular disease is the most commonly associated with atherosclerotic plaques? A. Angina B. Myocardial infarction C. Deep vein thrombosis D. Ischemic stroke E. All of the above Ans. e Tips: if stable plaque than commonly cause angina, if plaque is ruptured than cause inflammation can lead to MI. 2. What is the most common cause of arteriosclerosis is? A) high LDL B) Smoking C) Hypertension D) emotional stress E) all of the above Ans. A 3. Clarithromycin cause QT prolongation, it associated? A. Atrial depolarization B. ventricular depolarization C. Atrial tachycardia D. side effects of drugs Ans. B 4. A patient with atrial fibrillation, have characteristic effect on ? A. affect on QRS wave B. affect on P wave C. affect on T wave D. affect on Q-T prolongation Ans. B Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. PharmacyPrep.com Cardiovascular System Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. www.Pharmacyprep.com Endocrine System PHARMACY PREP. ENDOCRINE SYSTEM 1. Characteristic symptoms of hypothyroidism may include all of the following, EXCEPT: A. Sensitivity to cold B. Heat intolerance C. Lethargy D. Constipation E. Weight gain Ans. B 2. A diabetic patient mistakenly taken double dose of insulin. Which of the following is NOT effect of excessive insulin administration? A) Sweating B. palpitation C. Confusion D. Diarrhea E. Fatigue Ans. D 3. Which of the following is NOT effect of excessive dose of levothyroxine? A. diarrhea B. Tachycardia C. sensitive to heat D. oily skin E. hypertension Ans. D 4. KCR is 49 yo women is using treatment of Levothyroxine (Synthroid) 75 mcg daily for hypothyroidism. She complains palpitation, weight loss and sensitivity to heat. What is appropriate? A) refer doctor to increase dose of Synthroid 100 mcg B) refer to doctor to decrease dose of Synthroid C) hypothyroid symptoms so should refer to doctor D) She may have some new problem so refer to doctor E) None Ans. B 5. MK is 30 year old female taking insulin for type 1 DM. Which of the following conditions decrease requirement of insulin dose? A) Pregnancy B) Infection Copyright protected by Tips Inc Protect copyright and prevent piracy 5-1 www.Pharmacyprep.com Endocrine System C) Physical activities D) Heavy meals E) Acute illness Ans. C 6. Which of the following stimulates secretion of calcitonin hormone from thyroid gland? A) hypocalcemia B) hypercalcemia C) Hypokalemia D) Hyperkalemia E) hypertension Ans. B 7. Thyroid stimulating hormone (TSH) secretes from? A. Anterior pituitary gland B. Posterior pituitary gland C. Thyroid gland D. Parathyroid gland E. None of the above Ans. A Copyright protected by Tips Inc Protect copyright and prevent piracy 5-2 Pharmacyprep.com PHARMACY PREP RENAL DISORDERS 1. Reabsorption of drugs in kidney does NOT depend on: A. Flow rate B. Tonicity C. Tubular secretion D. pH E. Metabolism Ans. C 2. Prerenal acute renal failure (ARF) is characterized as? A) Inadequate blood circulation (perfusion) to the kidneys B) Excessive blood perfusion to the kidney C) Excessive drug elimination D. Bladder cancer E) All of the above Ans. A 3. All of the following drug cause metabolic alkalosis, except? A. ACIDzolamide B. Thiazides C. hydrochlorothiazide D. Loop diuretics E. Furosemide Ans. A 4. A man with history of severe diarrhea, the loss of HCO 3 - from GI tract causes a decrease in blood [HCO 3 -], and increase CO 2 his values are thus this man has? pH = 7.25, pCO 2 = 24 mmHg, [HCO 3 -] = 10 mEq/L A. Metabolic alkalosis B. Metabolic acidosis C. Respiratory acidosis D. Respiratory alkalosis E. Normal acid base status Ans. B 5. What is incorrect about potassium levels? A. Chronic renal disease may cause hyperkalemia B. Adrenal cancer may cause hypokalemia Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 6-1 Pharmacyprep.com C. ACE Inhibitors like captopril may cause hypokalemia D. Spironolactone may cause hyperkalemia E. Hydrochlorothiazide may cause hypokalemia Ans. C 6. A regular customer of your pharmacy, age 55 yo, medication profile include Ramipril 10 mg, valsartan 5 mg, and recently doctor added spironolactone. Patient diet include excessive intake of bananas. All of the following are pharmacist concern, except? A. Ramipril B. Valsartan C. Spironolactone D. Age 55 yo E. Bananas Ans. D 7) Which of the following is the least preferable combination antihypertensive in a patient whose K+ levels are 5.5 mEq/L? A) Ramipril/Hydrochlorothiazide B) Valsartan/Amlodipine C)Perindropril/spironolactone D) Losartan/Hydrochlorothiazide E) Amlodipine/Atorvastatin Ans. C 8.Characteristics of nephrotic symptoms, include all except? A) Proteinuria B) Hypoalbuminemia C) edema D) Hyperalbuminemia E) hyperlipidemia Ans: D 9.A patient eGFR declined significantly and doctor suspect chronic kidney diseases. All of the following are associated with chronic kidney disease, except? A. Intravenous radiographic contrast B. NSAIDs or COX-II inhibitors C. Volume depletion D. Strict blood pressure or blood glucose control E. Aminoglycosides Ans. D Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 6-2 Pharmacyprep.com Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 6-3 PharmacyPrep.Com Liver Function and Diseases PHARMACY PREP LIVER PHYSIOLOGY AND CHRONIC LIVER DISEASES 1. Which of the following is NOT a chronic hepatitis infection? A. Hepatitis A B. Hepatitis B C. Hepatitis C D. Hepatitis B and C E. None of the above Ans. A 2) Obstruction of bile secretion into duodenum from liver is referred as? A. Cholestasis or cholestatitis B. Cholecystitis C) Cholelithiasis D. Hepatic encephalopathy E. Ascites Ans. A Tips. cholestasis is a reduction or stoppage of bile flow. The cause of cholestasis is acute hepatitis, alcoholic liver disease, primary biliary cirrhosis, hormonal changes in pregnancy, stones in bile duct, cancer of bile duct, pancreatitis. 3. All of the following are complications of cirrhosis, except? A. ascites B. liver cancer C. hepatic encephalopathy's D. edema E. diabetes ans. E 4. What are the common cause of liver cirrhosis? A. chronic alcohol B. hepatitis A C. chronic alcohol and hepatitis B & C D. Hepatitis B and C E. hypertension Ans. C 5. Liver cirrhosis is a type of end stage chronic liver disease (liver cirrhosis)? What clinical laboratory tests is used to diagnose ? A) ALT B) AST Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 7-1 manual is being used during review sessions conducted by PharmacyPrep. PharmacyPrep.Com Liver Function and Diseases C) Bilirubin D) Albumin E) LDH Ans. C Tips. The liver cirrhosis diagnosis can be confirmed by a liver biopsy (removal of a tissue sample for examination under microscope). CT scan and ultrasound may show that liver is shrunken or abnormalities. Alcoholic liver disease can result into liver cirrhosis. Trans aminases AST to ALT ratio >2:1 strongly suggest alcohol abuse. 6. MK is a 50 year old man diagnosed for ascites. Which of the following are causes of ascites, except A) Tuberculosis B) Abdominal surgeries C) Congestive heart failure D) Stroke E) Liver cirrhosis Ans. D Tips. Stroke is cerebrovascular conditions and not associated with chronic liver disease ascites. 7. Drugs that causes cholestatic jaundice side effects? A) Cotrimoxazole B) Erythromycin base C) Erythromycin lactobacillus D) Probiotics E) Erythromycin estolate Ans: E 8. Liver enzymes like cytochrome CYP450 cause drug metabolism in liver. What is NOT related to drugs that are metabolized in liver? A) metabolism effects by tissue binding B) metabolism changes with liver blood circulation C) metabolism changes with intrinsic activity D) metabolism effected by chronic liver diseases E) oxidative metabolism is catalyzed by cytochrome CYP450. Ans: C 9. Hepatitis B is transmitted by all, except? A) contact with blood and its products B) sexual transmission C) contact oral secretion D) sharing needle E) blood transfusion Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 7-2 manual is being used during review sessions conducted by PharmacyPrep. PharmacyPrep.Com Liver Function and Diseases Ans. C Tips: oral secretion contact can cause hepatitis A. 10. Phase II metabolic reaction glucoronidation is effected by Enterohepatic recirculation. Which of the following drugs are effected? A) drugs that undergoes phase II metabolism B) estrogen/progestins oral contraceptive pills C) drugs with phase I metabolism D) Drug with first pass metabolism E) Lipid soluble drugs Ans: A 11. What is the most common cause of alcoholic liver diseases? A. Corticosteroids therapy B. Acetaminophen toxicity C. Alcohol abuse D. Ascites E. Wilson's disease Ans. c Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 7-3 manual is being used during review sessions conducted by PharmacyPrep. PharmacyPrep.Com Respiratory System PHARMACY PREP. RESPIRATORY COMPLICATIONS 1) Emphysema is? A) COPD B) Fibrosis C) Bronchitis D) Airway disease E) None of the above Ans. A 2. Dyspnea means A. Painful muscle spasms B. Pain in the heart C. Pain in extremities D. Painful breathing E. Painful menstruation Ans. D 3. Condition characterized by a irreversible form of airflow obstruction is known as: A. Aneurism B. Emphysema C. Embolism D. Cirrhosis E. Jaundice Ans. D 4. Asthma is a condition of respiratory tract that may be aggravated by? A) Allergens B) Cold weather C) Exercise D) Emotional stress E) All are correct Ans. E 5. The MOST well known characteristic symptom of asthma include: A. Wheezing B. Mucosal edema C. Cough D. Chest tightness E. Tachycardia Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 8-1 manual is being used during review sessions conducted by PharmacyPrep. PharmacyPrep.Com Respiratory System Ans. A 6. All are correct concerning the action of corticosteroids in asthma status, EXCEPT: A. Suppress the inflammatory response B. Decrease production of inflammatory mediators C. Decrease airway responsiveness to inflammation D. Relieve brochocontriction E. Increase β-agonist receptors response Ans. E 7. The capacity of inhalation is depends on the volume of? a) alveoli B) total lung capacity C) airways D) Bronchus E) Bronchial cavity Ans. B Tips: Total lung capacity is the volume in the lungs after a maximal inspiration. Total lung capacity includes tidal volume, inspiratory reserve volume, Expiratory volume and residual volume. 8. Peak flow meter is test to determine asthma severity for patient at home. This test measures? A) The highest forced expiratory flow B) Volume that has been exhaled at the end of the first second (FEV 1 ). C) Total lung capacity D) Expiration rate E) Inspiration rate Ans. A 9. Spirometer is device used in clinics to diagnose asthma? Spirometer measures? A) The highest forced expiratory flow B) Volume that has been exhaled at the end of the first second (FEV 1 ). C) Total lung capacity D) Expiration rate E) Inspiration rate Ans. b 10. Factors that decrease the respiration except: A. Mucosal edema B. Increase brachial secretion C. Increase ventilation D. Bronchospasm Ans: C Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 8-2 manual is being used during review sessions conducted by PharmacyPrep. PharmacyPrep.Com Respiratory System Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 8-3 manual is being used during review sessions conducted by PharmacyPrep. www.pharmacyprep.com Urinary System Pharmacy Prep Urinary System 1. Which of the following is NOT a symptom of benign prostatic hyperplasia? A. Frequent urine B. Nocturia C. Irritation D. Jet urination E. All of the above Ans. D Tips: in BPH normal stream of urination is not possible. 2. Which of the following is NOT a symptom of urinary tract infection? A) Increase in urinary frequency B) Burning sensations C) Fever D) Bactiurea E) Weight loss Ans. E 3. What is the most common type of UTI? A. Complicated UTI B. Uncomplicated UTI C. Cystitis D. Pylonephritis E. Ureteritis Ans. C Tips. cystitis is bladder infection, and the most common. 4. What is the most common agent that cause UTI? A. S.aureus B. P. aeruginosa C. E. coli D. Syphilis E. Gonorrhea Ans. C 5. What is the drug of choice to treat cystitis? A. Amoxicillin B. Cefixime C. Cotrimoxazole D. Nitrofurontoin Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 9-1 www.pharmacyprep.com Urinary System E. Trimethoprim Ans.c 6. What is the distinguishing symptom of complicated UTI? A. High fever B. blood in urine C. dysurea D. frequent urination Ans. b 7. What is the drug of choice to treat benign prostatic hyperplasia? A. Doxazosin B. Tadalafil C. Finasteride D. Saw palmetto E. oxybutynin Ans. c 8. All of the following used to treat BPH? except A. Doxazosin B. Tadalafil C. Finasteride D. Saw palmetto E. oxybutynin Ans. E 9. Which of the following is stress incontinence? A) Relaxed pelvic floor B) Urethral blockade C) inability void urine D) Urgency of urine E) Urinary retention Ans: A 10. What is the most common pathogen associated with cystitis? A. S. aureus B. Gonorrhea C. Chlamydia D. E. coli E. Shigella sp Ans. D 11. Which of the following medical conditions cause difficulty to urination in stream? A. Urinary tract infections Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 9-2 www.pharmacyprep.com Urinary System B. Prostatitis C. Benign prostatic hyperplasia D. Urinary incontinence E. Cystitis Ans: C 12. Hyperplasia is? A. Increased in cell size B. Increased in cell numbers C. Decreased in cell size D. Decreased in cell numbers E. Increase cell size and numbers Ans. B 13. Hypertrophy A. Increased in cell size B. Increased in cell numbers C. Decreased in cell size D. Decreased in cell numbers E. Increase cell size and numbers Ans. A 14. Which of the following cause tumors? A. hypertrophy B. hyperplasia C. Atrophy D. hyperacidity Ans. b 15. KP is a 37 year old women. Presents to doctor with symptoms of frequent urination at work place. Doctor has diagnosed with urinary incontinence. Her social history, denies taking alcohol and smoking. She is mother of 2 children and gave a birth to her 3rd child recently a month ago. What type of incontinence? A) Urge incontinence B) Overflow incontinence C) Stress incontinence D) Urinary tract infection 16. What drugs are least likely used in patient with urinary incontinence? A. oxybutynin B. diuretics C. amitriptyline D. All of the above ans. B Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 9-3 www.pharmacyprep.com Urinary System 17. Urinary incontinence in children is defined as repeated daytime or night time voiding urine into the bed or cloths. It is termed as? A. Bed sores B. Bed wetting C. Wetting Phenomenon D. All of the above Ans. B 18. Enuresis is bed wetting is treated by? A. Diuretics B. Desmopressin C. Fluoxetine D. Diphenhydramine Ans. B Tips: Desmopressin is antidiuretic hormone analog. 19. Tamsulosin is used to treat benign prostatic hyperplasia symptoms. It blocks alpha 1a receptors and facilitates urine flow? A) coronary arteries B) bladder arteries C) prostate arteries D) cerebral arteries E) all of the above Ans. B 20. Testosterone to dihydrotestosterone is catalyzed by 5-alpha reductase. The dihydrotesterone cause prostate growth. What drugs inhibit 5-alpha reductase and reduce prostate size? A) Alpha blockers B) tamsulosin C) terazosin D) androgen agonist E) androgen antagonist Ans. E Tips. Finasteride is an androgen antagonist. The drug of choice for BPH. Finasteride and dutasteride are androgen antagonist. act by inhibiting 5-alpha reductase. 21. Which of the following is least likely associated with UNCOMPLICATED urinary tract infections? A. dysurea B. urinary urgency C. fever D. turbid urine E. urinary frequency Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 9-4 www.pharmacyprep.com Urinary System Ans. d Ans.D Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 9-5 www.PharmacyPrep.com Human anatomy PHARMACY PREP The Eye 1. What is the other name of blind spot? A. Optic disc B. Retina C. Cornea D. Optic nerve E. None of the above Ans: A 2) What is the rate-limiting step in ophthalmic drops? A. Optic disc B. Retina C. Cornea D. Optic nerve E. None of the above Ans. C Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is 10-1 being used during review sessions conducted by PharmacyPrep. www.PharmacyPrep.com Human anatomy 3. At night dark vision (dim light), what is the most sensitive for motion, photoreceptors in retina? A) Cones B) Rods C) Cones and rods D) Optic nerve E) Cornea Ans. B 14. The major light absorbing pigment in retinal photoreceptors is: a. rhodopsin b. melanin c. glutamate d. chlorophyll Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is 10-2 being used during review sessions conducted by PharmacyPrep. www.PharmacyPrep.com Human anatomy Ans: A 16) What is incorrect about sympathetic blockers, example timolol in treatment of glaucoma? A) Decrease glaucoma B) Decrease IOP by inhibiting formation of aqueous humor. C) Decrease IOP by increase outflow of aqueous humor. D) First line therapy for glaucoma E) Ophthalmic drops are available Ans. C Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is 10-3 being used during review sessions conducted by PharmacyPrep. www.PharmacyPrep.com Human anatomy MP is a 55 year old male using Timolol 1 gtts bid ou. If patient medication profile have the following drugs. Which of the following medications are the pharmacist concern? A) Hydrochlorothiazide B) Salbutamol C) Ramipril D) Metformin E) Levothyroxine Ans. B In the above prescription Timolol 1 gtt bid ou what is correct direction? A) instil one drop in both eyes B) instill one drop two times daily in both eyes C) Instill two drops once daily in both eyes D) Instill one drop two times daily in right eye E) Instill one drop two times daily in left eye Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is 10-4 being used during review sessions conducted by PharmacyPrep. www.PharmacyPrep.com Human anatomy Ans. B A prescription of ciprofloxacin+dexamethasone otic prep? What is correct statement? A. instill in eye only B. instill in ear only C. can be instilled in eye and ear D. taken orally E. applied topically Ans. B What is the drug of choice to treat open angle glaucoma? A. Latanoprost B. Latanoprost + timolol C. Timolol D. Ciprofloxacin ophthalmic E. Dexamethasone Ans. C Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is 10-5 being used during review sessions conducted by PharmacyPrep. www.PharmacyPrep.com Human anatomy A doctor prescribed timolol 1 gtt daily as directed. What is correct? A. Instill one drop in both eyes B. Instill one drop in left eye C. Instill one drop in right eye D. Instill one drop in affected eye E. Instill one drop in eye and ear Ans. D MK is a 55 year old asthma patient. Recently diagnosed for open angle glaucoma. Doctor is considering to prescribe therapy for glaucoma. Which of the following is least likely suitable? A) latanoprost B) Dorzolamide C) Acetazolamide D) Timolol E) Pilocarpine Ans. D Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is 10-6 being used during review sessions conducted by PharmacyPrep. www.PharmacyPrep.com Human anatomy 17. What are the more sensitive photoreceptors in eye? A. Cones B. rods C. rods and cones D. cataract E. pupil Ans: B All of the following drug have effect on eye, except? a) amiodarone B) hydrochloroquine C) rifampin D) ethambutol E) isotretinoin ans: B JP is a 50 year old asthma patient and also receiving treatment for hypertension and using metoprolol 50 mg daily. Recently diagnosed for Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is 10-7 being used during review sessions conducted by PharmacyPrep. www.PharmacyPrep.com Human anatomy glaucoma. Doctor considering to prescribe latanoprost to treat glaucoma. Why doctor want to choose prostaglandin analog? A) patient has asthma and also using metoprolol B) patient has hypertension also using metoprolol C) Patient has asthma and hypertension D) Patient is 50 year old, asthma and hypertension E) Patient has open angle glaucoma Ans. Which of the following is associated with aqueous humor? A. retina B. lens C. celiary muscle D. sweat glands E. tear duct Ans. C Q. What dosage form of drug is preferred post cataract management? A. oral B. Injection C. Topical D. Sublingual E. OTIC Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is 10-8 being used during review sessions conducted by PharmacyPrep. www.PharmacyPrep.com Human anatomy Ans. c An optometrist prescribed ciprofloxacin drops 2 gtt OD for 10 days. What is correct? A. Instill 2 drops in both eye for 10 days B. Instill 2 drops in affected eye for 10 days C. Take ciprofloxacin 500 mg daily for 10 days D. Instill 2 drops in right eye for 10 days Ans. D A patient currently using dexamethasone eye drops daily for 3 to 4 wks after eye surgery. Another eye doctor prescribed tobramycin/dexamethasone 2 gtts for 10 days. What is pharmacist concern? A. tobramycin B. dexamethasone C. duration of therapy D. prescription from other doctor Ans. b Q. What is the drug of choice for dental prophylaxis for a pt. having root canal treatment? A. amoxicillin Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is 10-9 being used during review sessions conducted by PharmacyPrep. www.PharmacyPrep.com Human anatomy B. clindamycin C. azithromycin D. clarithromycin E. cephalexin ans. a What is the drug of choice for dental prophylaxis for a pt. having root canal treatment. Pt. allergic to penicillin? A. amoxicillin B. clindamycin C. cloxacillin D. ciprofloxacin E. Cephalexin ans. B Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is 10-10 being used during review sessions conducted by PharmacyPrep. PharmacyPrep.Com Blood and Anemia PHARMACY PREP BLOOD AND ANEMIA 1. Microcytic anemia is characterized as? A. Hypochromic anemia B. Vitamin B 12 deficient anemia C. Folate deficient anemia D. Sickle cell anemia E. Decreased total iron binding capacity Ans: A 18) In microcytic anemia (iron deficient), all of the following decrease, except? A) Mean cell volume (MCV) B) Hematocrit (Hct) C) Hemoglobin D) Serum ferritin E) Total iron binding capacity (TIBC) Ans. E Tips. In microcytic anemia total iron binding capacity increase. Hematocrit is actual volume of RBCs in a unit volume of whole blood). 2. Megalobastic anemia is characterized as? A. Iron deficient anemia B. Vitamin B 12 or folic acid deficient anemia C. Folate deficient anemia D. Sickle cell anemia E. Pernicious anemia Ans: B 8. Which of the following is screening test is used to confirm iron deficient anemia? A. MCV B. Serum folate levels C. Serum ferritin levels D. RBC levels E. Transferrin level Ans. C Tips. The screening test for iron deficient anemia is a ferritin level. Iron deficient anemia is typically defined as ferritin level CO 2 + H20 l l (anaerobic) Lactate -----------------------> CO2 + H20 3. Linolenic acid is type of essential fatty acid? 15 12 9 1 COOH Alpha-Linolenic Acid (omega-3) A. omega 3 B. omega 6 C. Omega 9 D. EPA E) DHA 4. All of the following can cause denaturation of proteins, except? A) acids B) heating C) bases D) mechanical mixing E) Buffers Ans. E 5. Gluconeogenesis is? Copyright 2000-2016 TIPS Inc 12-1 PharmacyPREP.COM Biochemistry A) formation of glucose from glycogen B) formation of glucose from proteins C) formation of glucose from fats D) formation of glucose from fats and proteins E) formation of glucose from maltose Ans. D 6. KP is a 35 year old women is using ferrous gluconate to treat anemia. What decreases absorption of ferrous gluconate? A) Food B) Proton pump inhibitors C) citrus juice D) Apple juice E) grapefruit juice Ans: A 7. What is primary protein structure? A. linear sequence of amino acids B. Alpha helix C. Beta pleated sheet D. Protein consisting more than one protein chain E. Three dimensional structure Ans. A 8. The protein three dimensional structure and linked with disulphide bonds is? A. primary B. secondary C. tertiary D. quaternary Ans. C 9.Which of the following protein structure describes more than one amino acid chain? A. primary B. secondary C. tertiary D. quaternary Ans. D 10. What aminoacid is precursor for synthesis of –CH2- in tetrapyrrole structure of porphyrin ring in hemoglobin. A) alanin B) Tyrosine C) Glycine Copyright 2000-2016 TIPS Inc 12-2 PharmacyPREP.COM Biochemistry D) Phenyl alanin E) Acetyl CoA Ans. C 11. Heme containing enzymes are formed from protoporphyrin. What are the examples of heme containing enzymes or proteins? A) hemoglobin B) myoglobin C) cytochrome oxidase D) all of the above Ans. D 12. Which of the following is the rate limiting step in atherosclerosis formation? A. HMG-COA to mevalonate formation B. Mevalonate to cholesterol formation C. Low density lipoprotein formation' D. Lipid synthesis Ans. A Copyright 2000-2016 TIPS Inc 12-3 www.Pharmacyprep.com Nutrition PHARMACY PREP NUTRITION 1) Choose correct answer about linolenic acid and linoleic acid: A) Linolenic acid is should be taken with diet. B) Linolenic acid and linoleic acid have only difference of double bond in chemical structure. C) Linolenic acid is omega 3 essential fatty acid D) Linoleic acid omega 6 essential fatty acid E) All of the above Ans. E Tips. Linolenic is omega 3 essential fatty acids. Omega 3 has three double bonds at position, 9, 12 and 15. Whereas omega 6 has two double bonds at position 9 and 12. 2. Rhodopsin is an eye pigmentation present in rods photoreceptor. Transform the following conversion of 11 retinal to produce night vision? A. 11-Cis-retinal to 11-trans retinal B. 11-Trans retinal to 11-cis retinal C. 13-Cis retinal to 13- trans retinal D. 13 trans retinal to trans retinal E. 12 cis retinoic acid to trans retinoic acid Ans: A 3. Which of the following vitamin should you recommend for smokers? A. Vitamin A B. Vitamin B C. Vitamin C D. Vitamin D E. Vitamin E Ans. C 4 What vitamin overdose could cause toxicity? A. Vitamin A B. Vitamin B C. Vitamin C D. Vitamin D E. Vitamin E Ans. A 5. A breast fed infant should recieved which of the following vitamin drops? A. Vitamin A drops B.Vitamin B 12 Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 14-1 manual is being used during review sessions conducted by PharmacyPrep. www.Pharmacyprep.com Nutrition C.Vitamin C D.Vitamin D drops E. Vitamin E drops Ans. D 6. Age over 70 years and elderly commonly have deficiency of vitamin? A. Vitamin B1 B.Vitamin B 12 C. Vitamin B 6 D. Vitamin D E. Vitamin K Ans. B 7. A person is allergic to gluten, which of the following should not recommend? A. Milk B. Rice C. Wheat D. Wine E. Eggs Ans. C 8. What is the closes option to breast milk for infant at age of 3 mo? A. Formula milk B. Cow based formula milk C. Soy based formula milk D. Lactose free formula milk E. Cow milk Ans. B 9.Inadequate intake of vitamin D over 50 years age can cause? A. renal disease B. osteoporosis C. osteoarthritis D. hypercalcemia E. Hyper vitamin D syndrome Ans. B 10. Nephrolithiasis caused by? A. Deficiency of vitamin D B. Deficiency of Vitamin A C. Overdose of vitamin A D. Overdose of vitamin B 12 E. Overdose of vitamin D Ans. E Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 14-2 manual is being used during review sessions conducted by PharmacyPrep. www.Pharmacyprep.com Nutrition 11. What is the best source vitamin D A-Dairy product B. Milk product C. Dark green leafy vegetable D. Sunlight E. Sunscreen Ans.D Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 14-3 manual is being used during review sessions conducted by PharmacyPrep. PharmacyPrep.Com Microbiology PHARMACY PREP MICROBIOLOGY 1. Colon is large intestine which contains which of the following type of bacteria: A. 95% to100% anaerobic B. 95% to 100% aerobic C. 30 to 50% anaerobic D. 30 to 50% aerobic E. There is no bacteria in lower gut Ans. A 2. The most common causative organism of community acquired pneumonia (CAP) is: A. S. pneumonia B. M. pneumonia C. H. influenza D. S. aureus E. E. coli Ans. A 3. The following organism least likely causes pneumonia: A. S. pneumonia B. M. pneumonia C. H. influenza D. M. catharhalis E. E. coli Ans. E 4.Toxic shock syndrome (TSS) is caused by: A) E. coli B) Gonorrhea C) S. aureus D) Syphilis E) Chlamydia Ans. C 5. Which of the following NOT associated with Toxic shock syndrome? A. Tampons B. Condoms C. Contraceptive sponges D. Intra uterine devices (IUD) Copyright protected by Tips Inc Protect copyright and prevent piracy 15-1 PharmacyPrep.Com Microbiology E. None of the above Ans: B 6. Annually flu season in Canada. Flu is caused by? A. Influenza A only B. Influenza B only C. Influenza A and B D. Influenza A and Flu vaccine E. Flu vaccine only Ans. C 7. Which of the following infection are commonly associated in nosocomial infections? I) S. aureus II) P. aeruginosa III) C. difficle A. I only B. III only C. I and II only D. II and III only E. All are correct Ans. E 8. What is true about cervical cancer? I) caused by oral contraceptives pills II) caused by papilloma virus III) It is sexually transmitted infection A. I only B. III only C. I and II only D. II and III only E. All are correct Ans: D 9. MK is a 27 year old man presents with persistent ear pain for last 2 days and associated with drainage. Pharmacist refer patient to physician because? A. otitis externa caused by P. aeruginosa and S. aureus B. Because it is associated with drainage C. Because ruptured tympanic membrane D. because ear pain with drainage could be perforation of tympanic membrane or drainage from middle ear. E. Because it can cause hearing loss Ans.D Copyright protected by Tips Inc Protect copyright and prevent piracy 15-2 PharmacyPrep.Com Microbiology Copyright protected by Tips Inc Protect copyright and prevent piracy 15-3 www.Pharmacyprep.com Cell and Molecular Biology PHARMACY PREP CELL AND MOLECULAR BIOLOGY 1. What is difference in nucleotide and nucleoside? A. phosphate B. Sugar C. base D. DNA E. RNA Ans. A 2. Translation occurs: A) Before transcription B) After transcription C) Same time as transcription D) in mitochondria E) in chromosomes Ans. A 3. Hemophilia type A results from deficiency of clotting factor? A) factor 5 B) factor10 C) factor 8 D) factor 2 E) factor 9 Ans. C 4. A woman carrying hemophilia and has a child from a man with hemophilia. Which of the following is NOT her child? A. A girl with hemophilia B. A boy with hemophilia C. A girl having no gene of hemophilia D. A girl having the gene of hemophilia E. A boy having no hemophilia Ans. C m X Y w X xx xy X xx xy XX = Women with hemophilia XY = Man with hemophilia XY = Man with NO hemophilia XX = Women with hemophilia carrier 5. What is cDNA? A. DNA template produced by mRNA, is complementary DNA (cDNA) 16-1 www.Pharmacyprep.com Cell and Molecular Biology B. specific set of DNA and RNA C. specific set of DNA D. Specific set of DNA bases E. specific set of RNA bases Ans. A 6. Which of the following is NOT a complimentary base pair? A. G-C and A-T B. C-G and A-T C. G-C and T-A D.T-G and G-C E. A-U and G-C Ans. D 7. Information transfer from DNA to M-RNA is referred as? A. Transcription B. Translation C. DNA-gyrase D. protein synthesis E. DNA-Recombination Ans. A 8. Centrosomes? A) Centrosomes contains acid hydrolyzing enzyme B) Centrosomes are main organizing microtubule centre C) Centrosomes contain protein (rough) and lipid (smooth) synthesis d) Centrosomes are primary site for biological protein synthesis. E) Centrosomes are enzymes that produces and decomposes hydrogen peroxides. peroxisomes breakdown long chain fatty acids Ans. B Tips. Centrosomes are organizing microtubule centre Lysosome contains acid hydrolyzing enzyme. Endoplasmic reticulum contain protein (rough) and lipid (smooth) synthesis. Ribosomes are primary site for biological protein synthesis. Peroxisomes contains enzymes that produces and decomposes hydrogen peroxides. Peroxisomes breakdown long chain fatty acids. 9 Antisense RNA targets specific viral or microbial nucleic acid sequences that interferes with normal replication and expression. The antisense technology targets? A. Tcell B. B Cell C. DNA D. mRNA E. cDNA Ans. D 16-2 www.Pharmacyprep.com Cell and Molecular Biology 10. Transduction is? A. the process by which DNA is transferred from one bacterium to another by a virus B. Microbial nucleic acid sequences that interferes with normal replication and expression C. woman carrying hemophilia and has a child from a man with hemophilia. D. Information transfer from DNA to M-RNA is referred Ans. A Tips: Transduction is the process by which DNA is transferred from one bacterium to another by a virus. It also refers to the process whereby foreign DNA is introduced into another cell via a viral vector. 11. Antisense technology is? A) Codons that stops proteins synthesis are used to stop formation of defected proteins. B) Antisense technology targets mRNA C) Antisense technology target DNA synthesis D) Antisense technology target translation in protein synthesis E) A and B Ans. A 12. Enzymes that catalyze coupling of two molecules are classified as A. Hydralases B. Ligases C. Oxidoreductases D. Transferases E. Isomerases Ans. B 16-3  PHARMACY PREP PHARMACOGENETICS 1) What is definition of Pharmacogenetics? A) The pharmacogenetics is integration of pharmacology and genetics. B) The study of pharmacogenetics allows designing and developing drugs that are customized to each person’s genetic mark up. C) The pharmacogenetics also utilized to study cytochrome enzymes that are responsible for drug interactions. D) The pharmacogenetics identifies the genetic variation that cause drug cause differences in drug response. E) All of the above Ans. E 2. What is SNP? A. Single nucleotide polymorph B. Single nucleotide pharmacogenetic C. Single genetic markup D. Single genetic variation E. Single nucleotide product Ans. A Tips. The SNP is single nucleotide polymorphism (SNP). It occurs when one base pair of nucleotide replaces another. A single base differences that exist between individual. This is the most common genetic variation in DNA. 3. If you know person genetics mark up, and target a medicine is defined as? A. pharmaceutics B. biotechnology C. Nanotechnology D. Pharmacogenetics E. Molecular biology Ans. D Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. PharmacyPREP.Com Immunology PHARMACY PREP. IMMUNOLOGY and Immunizations 1. Which of the following is a pro-inflammatory cell responsible for initiation of an acute inflammation? A. Eosinophils B. Platelets C. Mast cells D. Basophiles E. Neutrophils Ans. C 2 Poison ivy is what type of hypersensitive reactions? A) Type I B) Type II C) Type III D) Type IV E) Type V Ans. E 3. A 70 yo elderly patient is treated with antibiotics for 7 days. However, still have signs of symptoms of infections such as fever. The patient neutrophil count is still increased over 70%. What kind of infections patient have? A. parasitic B. viral C. fungal D. inflammation E. bacterial Ans. E 4. All of the following can transmit HIV, except? A) Sexual contact B) Maternal transmission C) Drug abuse and sharing needle D) cut and wounds contact E) Orofecal Ans. E 5. A HIV patient currently has CD 4 T cell count is 300. What treatment doctor may target for prophylaxis? A. M. Tuberculosis B. Cytomegalvoirus C. Pneumocytisis pneumonia jerovicii or carinii D. Non-Hodgkins lymphoma Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 18-1 manual is being used during review sessions conducted by PharmacyPrep. PharmacyPREP.Com Immunology E. Kaposis sarcoma Ans. A 6. What is true about immunoglobulin structure? A. consist of protein and amino acids sequence B. Consist of long chain amino acids and disulfide bond linkage C. Consist of long chain and small chain protein linked with disulfide bonds bridge D. Consist of specific amino acids selective sites of infections. E. Humoral antibody structures Ans. C 7. What is average life span of survival for HIV patient? A. 10 yrs B. 11 yrs C. 1-2 yrs D. 2-3 yrs E. 20-30 yrs Ans. D 8. A customer of your pharmacy travelling to mountain. She has history of anaphylaxis. Which of the following product pharmacist should recommend to take? A) Travelers diarrhea Dukoral vaccine B) Hepatitis A vaccine C) Flu vaccine D) DEET mosquito repellant E) Epipen Ans. 9.All of the following are NOT recommended for flu vaccine, except? A) Child under 6 months age B) A person allergy to eggs C) Person with currently acute bronchitis symptoms D) Pregnant E) Person with current symptoms of pneumonia Ans. D 10. Which of the following populations is LEAST considered high risk for influenza so that vaccination with influenza vaccine is not necessary? A) Person age > 5 yrs to 50 yrs B. Residents of long-term care facilities (e.g., nursing homes) C. Patients with diabetes mellitus D. Patients over the age of < 65 yo E. Patients with COPD or asthma Ans. A Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 18-2 manual is being used during review sessions conducted by PharmacyPrep. PharmacyPREP.Com Immunology 11. Flu immunization season in Canada? A) November to April B) October to Mid November C) October to April D) October through December E) October through April Ans. B Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 18-3 manual is being used during review sessions conducted by PharmacyPrep. PharmacyPrep.Com Biotechnology PHARMACY PREP BIOTECHNOLOGY 1. Herceptin (Trastuzumab), is A. Treatment of HER2-overexpressing metastatic breast cancer B. Tumor necrosis factor alpha inhibitor C. Glycoprotein inhibitor D. Interleukin E. Interferon's Ans: A 6) Filgrastim is a granulocytes CSF indicated in the treatment of? A) renal, cardiac and hepatic graft rejection B) neutropenia associated with cancer chemotherapy C) thrombocytopenia associated with cancer chemotherapy D) anemia associated with chronic renal diseases E) chemotherapy induced anemia Ans. b 7. Filgrastim is? A. Colony stimulating factor B. Erythropoietin's C. Interferon's D. Human growth hormones E. Monoclonal antibodies Ans: A Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 20-1 manual is being used during review sessions conducted by PharmacyPrep. PharmacyPrep.Com Biotechnology 8) Operlaveukin is? A) Interleukin 11 B) Colony stimulating factor C) Interleukin 3 D) Interleukin 2 E) Epoeitin Ans. A 9) Operlaveukin (IL-11) is indicated for? A) Chemotherapy induced thrombocytopenia B) Bone marrow suppression C) Acute graft rejection D) Neutropenia E) Growth factor Ans. A 10. Muromonab (OKT 3 ) is monoclonal antibody is used for treatment of ? A) Renal, cardiac and hepatic graft rejection B. Neutropenia associated with cancer chemotherapy C. Thrombocytopenia associated with cancer chemotherapy D. Anemia associated with chronic renal diseases E. None of the above Ans: A HAMA is? A) Human antigen and Mouse antibody B) Human antimouse antibody Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 20-2 manual is being used during review sessions conducted by PharmacyPrep. PharmacyPrep.Com Biotechnology Murine antibody C) D) Humanized antibody E) Human antibody Ans. B Trastuzumab is produced by? A) Cell culture B) Monoclonal antibody method C) Chimeric monoclonal antibody D) murine monoclonal antibody E) Humanized monoclonal antibody Ans. E Tips. Transtuzumab is humanized MAB, which is produced from trangenic mice. Chimeric antibody chain is? A) humanized chain linked to mouse chain. B) Humanized chain linked to rat chain C) Humanized chain binding with different antigen D) One quarter the antibody is from one species origin where as the other 3 quarters from other species Ans. Mouse Chimeric Humanized Human 100% 25% mouse 10% mouse 100% mouse human Example drugs produced drug produced by 12 drug produced drugs produced by 5 chimeric Humanized by 4 human by murine antibodies? antibody? antibody? antibody? Rituximab, (transgenic) Adalimumab Muromonab, abciximab, Trastuzumab, Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 20-3 manual is being used during review sessions conducted by PharmacyPrep. PharmacyPrep.Com Biotechnology capromab infliximab, omalizumab, cetuximab, daclizumab basiliximab. Example of drug produced by 4 immunoadhesin (protein)? Etanercept, abatacept. Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 20-4 manual is being used during review sessions conducted by PharmacyPrep. www.Pharmacyprep.com Toxicology PHARMACY PREP TOXICOLOGY 2. Which of the following is a benzodiazepinics antagonist: A. Naloxone B. Physostigmine C. Flumazenil D. Naltrexone E. Penicillamine Ans. c Tips: Flumazenil is a benzodiazepinic antagonist therefore used as antidote in benzodiazepinic overdoses. 4) Carbon monoxide can be highly toxic because it easily binds to: A. Hemoglobin B. Myoglobin C. Cytochrome oxidase D. All are correct Ans. D 29) Specific antidote for iron preparations overdose include: A. Dimercaprol B. Deferoxamine C. Penicillamine D. Naloxone E. Sucimmer Ans. B Copyright © 2000-2011 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 21-1 manual is being used during review sessions conducted by PharmacyPrep. www.Pharmacyprep.com Toxicology 35) Which of the following is considered the warfarin antidote? A) Vitamin K B. Vitamin D C. Vitamin A D. Vitamin B 12 E. Vitamin E Ans. A What is initial symptoms of acetaminophen overdose? A. vomiting B. severe nausea and vomiting C. bleeding D. Jaundice E. liver failure Ans. A Tips: acetaminophen large doses can cause toxicity. Initially for 2 to 4 hr no symptoms. Then toxic symptoms can occur in 4 stages: Stage 1: vomiting can occur Stage 2: after 24 hr nausea, vomiting can get severe Stage 3: can cause toxicity, symptoms bleeding, jaundice. Stage 4: can recover or if not recovered it can cause liver failure 42. Glutathione conjugation produce the product called? A. Mercapturic acid B. Sulfonation C. Oxidation D. Glutathione conjugation E. Reduction Ans. A Copyright © 2000-2011 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 21-2 manual is being used during review sessions conducted by PharmacyPrep. www.Pharmacyprep.com Toxicology In hospital ward a nurse mistakenly administered high dose of heparin dose. Which of the following is used to treatment of overdose? A. Vitamin K oral B. Vitamin K injection C. Protamine sulphate D. Check INR Ans. C A grandmother administered 2 tbsp tid of amoxicillin 300 mg/5 ml instead of 2 tsp tid to 9 mo old child. What to do? A) refer to emergence B) refer to doctor C) wait and watch D) Give antidote E) Give oral rehydration solution Ans. B Copyright © 2000-2011 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 21-3 manual is being used during review sessions conducted by PharmacyPrep. www.Pharmacyprep.com Toxicology At your pharmacy dispensed wrong medication to patient by a relief pharmacist. You as pharmacy manager, the next day you realized the dispensing error happened. What is appropriate action? A. Inform the doctor B. Inform college of pharmacy C. Inform the head office of your pharmacy store D. Contact patient immediately and inform about error and tell bring medication back to pharmacy. E. Call immediately to relief pharmacist and inform him that he did dispensing error. Ans. D Patient brought wrong medication back to pharmacy. What is appropriate to do? A. Tell patient to make complain against pharmacist to college of pharmacy B. Change medication to correct medication and do not charge additional prescription fee. C. Ask patient if has taken medication and ask to continue if has no problems D. Change medication to correct medication and ask if patient if has taken medication and or any symptoms and document. E. Take back wrong medication from patient and ask to get a new prescription. Ans,D What is appropriate action after any dispensing error? Copyright © 2000-2011 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 21-4 manual is being used during review sessions conducted by PharmacyPrep. www.Pharmacyprep.com Toxicology A. Complain to college of pharmacy B. document and discuss with pharmacy team member about error and prevention strategies. C. make incident report to ISMP D. Tell pt. that we will refund prescription fee Ans. b 47. B BIBLIOGRAPHIC REFERENCE 1- COMPREHENSIVE PHARMACY REVIEW – Lippincott William & Wilkins – Fourth edition 2- CPS-COMPENDIUM OF PHARMACEUTICALS AND SPECIALITIES - Canadian Pharmacist Association – 2001 edition. 3- MEDICAL DICTIONARY – Dorland’s illustrated – 27th edition. 4- PHARMACY PREP – Lectures series & study guide for Evaluating Examination-TIPS - 2003/2004 5- THERAPUTIC CHOICES – Canadian Pharmacist Association -Third edition Copyright © 2000-2011 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 21-5 manual is being used during review sessions conducted by PharmacyPrep. www.Pharmacyprep.com Toxicology 6- USP DI – Drug Information for the Health Care Professional–15th edition – Volume I. Copyright © 2000-2011 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 21-6 manual is being used during review sessions conducted by PharmacyPrep. www.pharmacyprep.com PHARMACY PREP. PHARMACOKINETICS PHARMACOKINETIC FORMULAS Vd = D/Cp Cp = D/Vd D = Vd x Cp V d = CL T /K el t 1/2 = 0.693 /K el K el = 0.693/t 1/2 1) A dose of 240 mg was given to a patient, his total body clearance is 3.5 L/min and the drug excreted unchanged in the urine is 80 mg. What is his non-renal clearance? a) 240 ml/min b) 2.3 L/min c) 3.3 L/min d) 1.16 L/min e) 160 ml/min Ans. B Renal clearance is drug excreted unchanged or metabolized in urine. CL T = CL R +CL NR CL NR = CL T - CL R 240 mg................3.5 L 80 mg....................? =1.16 L = 3.5 - 1.16 = 2.3L or 3.5/240 mg = ?/80 mg 2. A drug hepatically metabolized and renally eliminates. Patient receiving this medication has chronic renal disease thus has low renal clearance. What is correct about drug affect? Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 1 manual is being used during review sessions conducted by PharmacyPrep. www.pharmacyprep.com A) metabolites excrete in stools B) metabolites accumulates in blood C) metabolites half life decrease D) hepatic metabolism decrease E) hepatic metabolism saturates Ans. B 3.A dose was given, the plasma concentration was 64 mg, t 1/2 =0.7 hrs. After 7 hours from the initial dose, what is the drug's concentration? a) 0.0mg b) 1mg c) 2mg d) 3mg e) 4mg Ans. A Tips. 64 --> 32 --> 16 -->8-->4 -->2-->1-->0.5 -->0.25 -->0.125-->0.06 or C = C o. e-kt K = 0.693/t 1/2 K = 0.693/0.7 = 0.999 C = 64 x e(-0.999x7) = 0.06 or ln C = -kt + ln C o How to use calculator (Sharp EL-510RN) Enter 64 Multiply Enter 2ndF Enter ex Enter ( Enter (-) Enter Enter ) Enter = Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 2 manual is being used during review sessions conducted by PharmacyPrep. www.pharmacyprep.com 4. A 40 year old patient who weighs 70 kg, needs intravenous infusion of amoxicillin. The desired C ss of drug is 15mg/dL. The physician ordered antibiotic infused for 10 hours. Amoxicillin has t 1/2 = 1 hour and Vd = 9L. What rate of iv is recommended for this patient? (no loading dose was given); A. 135 mg/hr B.936 mg/hr C. 1000 mg/hr D. 333 mg/hr E. 400 mg/hr Ans. B Tips: C ss = R___ K x Vd R = Rate of infusion K = first order elimination constant V d = volume of distribution R = C ss x k x V d R = 15 0.693 x 9000 = 100 1 hour = 935.54 mg/hr 5) If the rate of infusion of the drug is 500 mg q8h and clearance is 7.3 L/hr. Find steady state concentration a) 85.6 mg/L b) 856 mg/L c) 8.56 g/L d) 8.56 mg/L e) 68.4 mg/L C ss = rate of infusion/clearance Ans. D C ss = Rate of infusion = 500/8 = 8.56 mg/L Clearance 7.3 Css = R/CL CL = R/Css R = Css x CL CL = K x Vd A patient parameter include elimination rate contant 0.17 h-1 and volume of distribution 11.8 L. What is clearance? 2.02 L/h Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 3 manual is being used during review sessions conducted by PharmacyPrep. www.pharmacyprep.com 6. For an effective antimicrobial to treat UTI it must be all, except? A) low level of protein binding B) short biological half life thus can reach high concentration rapidly C) high distribution in body D) high distribution in urinary tract E) highly active against gram negative bacteria Ans. D 7. A drug was found to have zero order kinetic 100 mg after 6 days 99 mg. How long it will take to eliminate the entire drug from the body? a) 100 days b) 200 days c) 300 days d) 600 days e) 900 days Ans. d 8. A patient was given 100 mg drug orally. The drug absorbs at rate of 10 mg/min and follows zero order kinetics. After 5 min how much drug will be absorbed? A. 10 mg B. 50 mg C. 75 mg D. 100 mg Ans. b 9. A patient was given 100 mg drug orally. The drug absorbs at rate of 10 mg/min and follows zero order kinetics. How long it takes to absorb all the drug? A. 10 min B. 50 min C. 75 min D. 100 min Ans. A 10. Ampicillin in 5% dextrose degrades by first order kinetic, at rate constant of 0.026 h. What is the shelf life of ampicillin? a) 4 hr b) 8hr c) 2hr d) 16hr e) 12hr Tips. T 90 = 0.105/K T 90 = 0.105/0.026 = 4hrs Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 4 manual is being used during review sessions conducted by PharmacyPrep. www.pharmacyprep.com 11. Approximately 50% of cloxacillin is excreted unchanged in the urine. If the normal dosage schedule for cloxacillin is 125 mg q6h, a patient with renal function 20% of normal should receive? a) 25 mg q6h b) 31.25 mg q6h c) 62.5 mg q6h d) 75 mg q6h e) 125 mg q12h Tips:d Renal Non renal Cloxacillin 50% 50% 62.5 mg 62.5 mg 12.5 mg 62.5 mg or 50-20 = 30% 50%.............125 30%................? 12. Drug which dose is 1500 mg is given every 24 hours. The renal clearance of this drug is 1.2 mg/dL. Calculate the clearance in ml/min. a) 98.6 ml/min b) 76.8 ml/min c) 86.8 ml/min d) 66.8 ml/min e) 43.6 ml/min Ans. C Tips 1.2 mg...........100 mL 1500 mg..........? = 125,000 mL for Q24h (1440 min) 125,000............1440 min ? mL.........................min = 86.8 ml/min or 1.2 mg --------100 ml 125000 mls--------1440 min (60 min x 24 hrs) Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 5 manual is being used during review sessions conducted by PharmacyPrep. www.pharmacyprep.com 1500 mg---------X X---------------1 min X = 125000 mls X = 86.8 ml/min or 125000 ml/1440 min = 86.6 ml/min 13. If a drug is 50% metabolized and half life drugs is 1 hr. What is the percentage of blood concentration after 4hrs? a) 50% b) 25% c) 12.5% d) 6.25% e) 3.12% Ans. D Tips: 100 50% --> 25 -->12.5 --> 6.25%--> or Drug concentration = 100% t 1/2 (decrease the drug by half) = 50% 2 t1/2 t1/2 t1/2 = 6.25% 14. A new antifungal was given at a dose of 5mg/Kg by a single intravenous bolus injection to a 32 years old female who weighed 75Kg. The antifungal has an elimination half life of 2 hours and apparent volume of distribution of 0.28L/Kg. What is the initial plasma drug concentration in this patient? a) 36 mg/L b) 1.8 mg/L c) 17.8 mg/L d) 1.79 mg/L e) 19 mg/L Ans. C C p = D o C p = 5 mg/Kg = 17.8mg/L Vd 0.28L/kg 15. Following the anterior information, calculate the predicted plasma concentration at 8 hours after the dose: a) 15mg/L b) 111mg/L c) 11.1mg/L d) 1.11mg/L e) 2.64mg/L Ans. D Cp initial = 17.9mg/L and elimination t 1/2 is 2hours Cp = 17.9 after 2 hours = 8.95 Cp = 8.95 after 2 hours = 4.47 Cp = 4.47 after 2 hours = 2.23 Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 6 manual is being used during review sessions conducted by PharmacyPrep. www.pharmacyprep.com Cp = 2.23 after 2 hours = 1.11 IN 8 HOURS 16. Following the same anterior information, calculate how much drug remains in the patient body, 8 hours after the administrated dose: a) 23mg b) 112mg c) 100mg d) 15.3mg e) 84.4mg Ans. A D = 375mg after t/1/2 of 2 hours = 187.5mg after t1/2 of 2 hours = 93.75..Continue the same as the anterior question!!! After 8 hours you will have 23mg 17. Following the anterior information, how long after the dose is exactly 75% eliminated from the patient body? a) 2 hours b) 4 hours c) 6 hours d) 8 hours e) 10 hours Ans. B Initial dose = 375mg and elimination t1/2 is 2hours Cp = 375mg after rs a er rs 4 hours → 75% Let us assume the following characteristics of the drug in a 70kg man. -Therapeutic effective plasma concentration: 2.0mg/L -Biologic half-life: 80minutes -Apparent volume of distribution: 0.70Kg/L 18. What is the recommended rate of infusion for this drug? a) 85mg/min b) 58mg/min c) 0.85mg/min d) 8.5mg/min e) 0.085mg/min Ans- ss n K = 0.693/80min = 0.0087 Vd = 0.70 x 70Kg = 49L Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 7 manual is being used during review sessions conducted by PharmacyPrep. www.pharmacyprep.com 19. What is the total body clearance for this patient? a) 33L/min b) 43mls/min c) 43L/min d) 0.43L/min e) 0.43mls/min Ans. D CL T T = 0.0087 x 49 = 0.43L/min 20. Still following the information of the anterior questions, calculate the corresponding loading dose: a) 98mg b) 160mg c) 48mg d) 24mg e) 100mg 16- A LD = V ss 21. Drug A bind to 28% with protein, when given at dose 150 mg/day. If given to 300 mg/day, what % of drug A bind with protein. Mol.wt of protein is more than drug A. A-56% B-28% C-14% D-80% E-60% Ans-B 22. Two drugs that metabolized by the kidney and liver. Which one has first pass metabolism? drug x drug y CL t 1100 460 CL r 110 20 Vd 3.3 2 ProteinBinding 85% 90% A) Drug x = oral B) drug y = oral C) drug y = rectal D. drug x = rectal Ans. B Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 8 manual is being used during review sessions conducted by PharmacyPrep. www.pharmacyprep.com 23. Mr. Florence Backs is a 72-year-old patient weighing 71.8 kg who is taking aminophylline 250mg by i.v. at stat. and then was given immediately by i.v. drip at a rate of 40mg/hour. Theophylline level at stat = 7.5mg/ml and V d of theophylline is 0.5L/kg. What is the expected serum concentration after the initial dose? a. 5.55mcg/ml b. 13.1mcg/ml c. 7.5mcg/ml d. 6.8mcg/ml Ans-B What is the expected serum concentration after the initial dose? Co = Dose x F x S Vd = 250 x 1 x 0.8 = 5.55 ug/ml (0.5) (71.8 kg) 5.55 + 7.5 = 13.05 = 13.1 ug/ml 24. During gentamycin therapy which parameter would you measure? a. Creatinine clearance for renal toxicity (nephrotoxicity) b. serum creatinine, BUN, blood concentration c. auditory function because of ototoxicity d. all of the above Ans: D 25. What is correct about drug excretion in to breast milk? A. acidic drug excrete more than base drugs B. base drug excrete more than acidic drugs C. neutral drug excrete more than basic drugs D. drug excretion in to breast milk does not depends drug pH Ans. B 26. Absolute bioavailability is the result of comparing a. oral dosage from and IV dosage form b. oral bioavailability from and sublingual form c. oral bioavailability from and IM dosage form d. oral bioavailability from and rectal form Ans: A 27. What is the F value for an experimental drug tablet based on the following data? Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 9 manual is being used during review sessions conducted by PharmacyPrep. www.pharmacyprep.com Drug Dose Form Dose AUC (µg/ml/mL/h) Tablet 100 mg po 20 Solution (control) 100 mg po 30 Injection (control) 50 mg IV push 40 a) 0.25 b) 0.38 c) 0.50 d) 0.66 e) 0.90 Ans. A 28. If an oral capsule formulation of the drug A products a serum concentration-time curve having the same area under the curve as that produced by an equivalent dose of drug A given IV, it can generally be concluded that a) the IV route is preferred to the oral route b) the capsule formulation is essentially completely absorbed c) the drug is very rapidly absorbed d) all oral dosage forms of drug A will be bioequivalent e) there is not advantage to the IV route Ans. b Tips; if the AUC are same, it can be said that the total amount of drug delivered to the body by each dose form is equal. For oral dosage for 100% bioavailability does not mean that the drug has 100% absorption. Product Company Dosage Form Dose Administered Cumulative Urinary Amount (mg) A Parenteral Injection 10 mg IV 9.4 A Tablet 20 mg po 12.0 B Tablet 20 mg po 8.2 B Capsule 15 mg po 6.8 29. Using the above data the absolute bioavailability of Company B tablets is best estimated to be a) 25% b) 40% c) 44% d) 68% Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 10 manual is being used during review sessions conducted by PharmacyPrep. www.pharmacyprep.com e) 87% Ans. C Tips: The best measure of absolute bioavailability is considered to be AUC of iv. Because AUC iv is not available for this drug, the next best comparison will be the cumulative drug amount found in the urine. Because iv dose was 10 mg, whereas the oral tablet dose was 20mg, a correction factor of 2 x is needed. Cumulative amount is 20 mg injected. 9.4 x 2 = 18.8 8.2/18.8 = 0.44 or 44% 30. Patient on phenytoin therapy. Therapeutic level is 10 – 20 mg/L. Blood level of phenytoin is within therapeutic range. But still patient shows some side effects of phenytoin Following is blood phenytoin analysis? 13.6 mg/L morning 14.2 mg/L evening What is reason increase level of phenytoin A-Phenytoin toxicity B-Phenytoin has very strong protein binding C-Liberation of drug from protein binding D-None of the above Ans-C 31. If blood flow to liver decrease? A-Affects intrinsic metabolism B-Reduce protein binding of drug C-Increase protein binding of drug D-Reduce metabolism of drugs E-Do not change metabolism of drug Ans. D 32. A drug completely renally eliminates, it depends on all pharmacokinetic factors, except? A. drug half life B. Volume of distribution C. Hepatic clearance D. Renal function E. rate of infusion Ans. C 33. Steady state concentration is factor of a. AUC B. half life C. plasma protein binding D. dose Ans. B Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 11 manual is being used during review sessions conducted by PharmacyPrep. www.pharmacyprep.com PHARMACY PREP. RATES AND ORDERS OF REACTIONS Plot of log of concentration against time produces a straight line with a: A. Slope of –K/2.303 B. Slope of –K/t 1/2 C. Slope of –K o D. slope of K/2.303 E. slope of K/0.693 Ans. A 2. The time it takes to infused drug to reach plasma steady state concentration (Css) depends on: I-Elimination half-life of drug. II-Fraction of free excreted in urine III-Plasma concentration curve A. I only B. III only C. I and II only D. II and III only E. All of the above Ans. a 3. A drug with zero order reaction eliminating, which is independent of initial concentration, What is correct about slope? A. k o B. k/2.303 C. 0.693/k D. 1/ka E. None Ans. A 4. Use of loading dose? I-To achieve therapeutic concentration immediately II-Loading dose = desired concentration x V d III-Steady state will be achieved immediately and maintained A. I only B. III only C. I and II only D. II and III only E. All of the above Ans. E 5. Time to reach steady state is determined by the? A) Elimination half life B) Loading dose C) Maintenance dose D) The absorption rate E) dose interval ans. A Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 24 manual is being used during review sessions conducted by PharmacyPrep. www.pharmacyprep.com 6.A drug completely renally eliminated. The patient has renal failure. This drug is hepatic metabolized. What will happen to drug? A. Drug metabolite accumulates in blood B. Drug is completely in metabolized in liver C. Drug is completely eliminate renally D. Drug is completely protein bound E. Drug have linear kinetic Ans. A 7. What is correct about a drug with first order elimination? A) drug elimination depends on initial concentration B) drug elimination depends on time only C) drug elimination depends and concentration and time D) drug elimination depends renal and hepatic function E) drug elimination depends on renal function only Ans. B 8. What is correct about a drug with zero order elimination? A) drug elimination depends on initial concentration B) drug elimination depends on time only C) drug elimination does NOT depends and concentration and time D) drug elimination depends renal and hepatic function E) drug elimination depends on renal function only Ans. b Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 25 manual is being used during review sessions conducted by PharmacyPrep. www.pharmacyprep.com Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 26 manual is being used during review sessions conducted by PharmacyPrep. www.pharmacyprep.com PHARMACY PREP PHARMACODYNAMICS 1. Competitive (reversible) antagonism Ag (agonist) + E + Ag*(antagonist) AgE + Ag*E If we use more concentration of Ag what happen? A. Concentration of AgE increase and Ag*E decrease B. Concentration of Ag*E increase and AgE decrease C. Concentration of AgE and Ag*E decrease D. Concentration of AgE and Ag*E increase E) No change in AgE and Ag*E rate Ans. A Competitive (equilibrium) Non competitive (irreversible) Competitive inhibitors are molecules that Non competitive inhibitors are molecules bind to the same site as the substrate that bind to some other site on the preventing the substrate from binding as enzyme reducing its catalytic power. they do so but are not changed by the enzyme. Parallel rightward shift of agonist dose Flattening of dose response curve response curve shift. Q. Intensity of response depends on Q. Response depends on only on the concentration of both agonist and concentration of antagonist antagonist. The same maximal response is attained by Maximal response is suppressed increasing the dose of agonist 2. The k m value of an enzyme is numerically equal to, in first order kinetics A. Half the maximum velocity (V max ) expressed in moles/liter B. Velocity of a reaction divided by substrate concentration C. Substrate concentration in moles/liter necessary to achieve half the maximum velocity of a reaction D. Maximum velocity divided by half the substrate concentration in moles necessary to achieve maximum velocity E. Substrate concentration divided by velocity of a reaction Ans. C First order Km = 1/2 V max Zero order Km = V max 27-1 Pharmacyprep.com Medicinal Chemistry PHARMACY PREP. MEDICAL CHEMISTRY 1. Which of the following is the molecular structure of isotretinoin, used in oral treatment of acne? A. 13-CIS Retinoic acid B. 13-TRANS Retinoic acid C. 13-CIS-TRANS Retinoic acid D. Retinoic acid E. None of the above 2. What functional group is responsible for sulfa allergy A) Sulfonamide B) Sulfide C) Sulfhydril group D) Proline ring E) Carbamate group Ans. A 3.Fexofenadine, how many optical isomers are possible? O H3C H3C OH CH3 CH3 CH3 HO N HO N OH OH Terfinadine Fexofenadine A) 1 B) 2 C-3 D) 4 E) None Ans.B 4. If a drug chemical structure has 3 chiral carbons. How many optical isomers are possible? A) 2 B) 4 C) 8 D) 9 E) 12 Ans. C 2n = 22 =2x2=4 n= number of chiral centers 23 = 2 x 2 x 2 = 8 Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 28-1 manual is being used during review sessions conducted by PharmacyPrep. Pharmacyprep.com Medicinal Chemistry Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 28-2 manual is being used during review sessions conducted by PharmacyPrep. PharmacyPREP.Com Medicinal Chemistry of autonomic nervous system Pharmacy Prep MEDICINAL CHEMISTRY OF AUTONOMIC NERVOUS SYSTEM 1.What is incorrect about structure activity of acetylcholine agonist? A) acetylcholine dissociate into acetyl and choline by acetylcholinesterase enzyme B) methanocoline has one extra methyl group than Ach C) Carbacholine has one carbmate group D) Bethanacholine has one carbamate and methyl group than Ach E) acetylcholine is the major neurotransmitter of sympathetic system Ans: E 2.What is incorrect in catecholamine biosynthesis? A) tyrosine is the precursor B) dopamine produce norepinephrine hydroxylation C) epinephrine produce norepinephrine by methylation D) levodopa catalyzed by dopadecarboxylase to dopamine E) norepinephrine catalyzed by methyl transferase to epinephrine Ans: C 3)The difference between dopamine and amphetamine? A) one methyl group B) one hydroxyl group C) 2 hydroxyl group and 1 methyl group D) 2 methyl group and 1 hydroxyl group E) One methyl and one hydroxyl group NH2 HO Dopamine OH OH H OH H H NH2 CH3 N CH3 N CH3 N CH3 CH3 NH2 CH3 CH3 CH3 Amphetamine Dextroamphetamine Ephedrine Pseudoephedrine Methamphetamine A B C D E 4.Difference between pseudoephedrine and methyl amphetamine is? A) one methyl group B) one hydroxyl group C) 2 hydroxyl group and 1 methyl group D) 2 methyl group and 1 hydroxyl group Copyright © 2000-201 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual 24-1 is being used during review sessions conducted by PharmacyPrep. PharmacyPREP.Com Medicinal Chemistry of autonomic nervous system E) One methyl and one hydroxyl group Ans. b 5.What chemical reaction converts pseudoephedrine to crystal meth? A) Hydroxylation B) dehydroxylation C) Hydrolysis D) methylation E) Glucuronidation Ans. B 6.Beta blockade effect can be reversed by? A. metoprolol B. salbutamol C. prazosin D. propranolol E. pseudoephedrine ans. B Tips: beta blockade can be reversed by beta agonist by displacement from occupied receptors if large amount of agonist is given because all beta blockers are competitive antagonist. Copyright © 2000-201 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual 24-2 is being used during review sessions conducted by PharmacyPrep. PharmacyPrep.Com Medicinal Chemistry of autocoids and analgesics PHARMACY PREP MEDICINAL CHEMISTRY OF AUTOCOIDS AND ANALGESICS 1. The following groups are essential for antihistaminic pharmacological activity: I-Aromatic or heteroaromatic rings in structure II-Tertiary amines in structure III-Chain of alkyl group in structure A. I only B. III only C. I and II only D. II and III only E. I, II, III Ans. E 2. Ecosonides are? A. Leukotrienes B. Prostaglandins C. serotonins D.Histamines Ans. b 3.Ondansetron is? A. Serotonin type 1 antagonist B. Serotonin type 2 antagonist C. Serotonin type 3 antagonist D. Serotonin type 3 agonist Ans. C 4.Which of the following is an end product of glutathione conjugation in acetaminophen metabolism? A. N-benzoquinineamine B. Mercapturic acid C. Glutathione D. cysteine E. Glycine ans. B 5.Glutathione is? A. cysteine, glycine and lysine B. cysteine, glycine and tryptophan C. cysteine, glycine and glutamate D. Cysteine, glycine and isoleucine Ans. C Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being 25-1 used during review sessions conducted by PharmacyPrep. PharmacyPrep.Com Medicinal Chemistry of autocoids and analgesics 6.) The following structure is prostaglandin analogue of? O 9 COOH 11 HO A) Prostaglandin E B) Prostaglandin F C) Prostaglandin G D) Prostaglandin H E) Prostaglandin I Ans. A 7.Morphine analgesic action is due to mu receptors by hydrogen bonding of? A) Endorphine peptides B) Enkephalin peptides C) Leukotrienes D) prostaglandins E) histamines Ans. B 8.Morphine analgesic actions is mainly produced due to? A. mu, kappa, and delta receptors B. mu, and kappa agonist C. mu agonist D. mu, and delta agonist E. kappa and delta agonist ans. C 9.Naloxone is an opioid antagonist and blocks the actions of? A. mu, kappa, and delta receptors B. mu, and kappa receptors C. mu receptors D. mu, and delta receptors E. kappa and delta receptors Ans. C 10.Synthetic estrogen like diethyl stilbenes gives? A) enantiomers B) diastereomers C) geometric isomers D) optical isomers E) confirmers Ans. c Copyright © 2000-2016 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being 25-2 used during review sessions conducted by PharmacyPrep. www.pharmacyprep.com PHARMACY PREP. MEDICINAL CHEMISTRY AND PHARMACOLOGY OF CARDIOVASCULAR SYSTEM 1. What is incorrect about site of action of diuretics? A) carbonic anhydrase and osmotic diuretics like acetazolamide act on proximal tubule B) loop diuretics act on loop of henle C) Thiazides act on distal convoluted tubule D) Potassium sparing act on collecting duct E) Potassium sparing diuretic act on proximal tubule Ans. E 2. Diuretics effect on acid and base balance of blood. What is incorrect? A) thiazides and loop cause metabolic alkalosis B) acetazolamide cause hyperchloremic metabolic acidosis C) spironolactone cause intracellular alkalosis D) acetazolamide decrease intraocular pressure E) Furosemide may cause metabolic acidosis Ans. E 3.) Diuretic characterized for e a an a A. Acetazolamide B. Spironolactone C. Hydrochlorothiazide D. Furosemide E. Triamterene Ans. D 4.. Imidazoline is a molecular structure that contains a heterocyclic ring and belongs the molecular structure of: A. Prazosin B. Nifedipine C. Atropine D. Clonidine E. Allopurinol Ans. D 5. Which of the following cardiovascular medications chemically classified as glycoside? A. Digoxin B. Warfarin C. Nitrates D. Nitrites E. Cholestyramine Ans. A Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 31-1 manual is being used during review sessions conducted by PharmacyPrep. www.pharmacyprep.com 6. Nitroglycerine is classified as? A. Nitrites B. Nitrates C. Nitriles D. Nitrol E. None of the above Ans. B 7) What functional group is responsible for metallic taste or taste changes in captopril? A) Sulfonamide B) Sulfide C) Sulfhydril group D) Proline ring E) Carbamate group Ans. A 8) Pyridine is a mono heterocyclic compound very important in the activity of many eren r s e ec ar s r c re -dihydropyridine is found in: A. Verapamil B. Digoxin C. Clonidine D. Nifedipine E. Diltiazem Ans. D 9. Thrombolytics (fibrinolytic) agents are contraindicated in? a. Myocardial infarction B. Ischemic stroke C. Bleeding from the GIT D. Pulmonary embolism E. Deep vein thrombosis ans. C 10 ce a a e a car n c an rase re c an r c r a e a a e diuretic have an identical molecular group very important in their structure knows as: A. Sulfonamide group B. Pyrimidine group C. Purine group D. Pyrrolidine group E. Ether group Ans. A Copyright © 2000-2012 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This 31-2 manual is being used during review sessions conducted by PharmacyPrep. www.pharmacyprep.com 11. Which of the following statements regarding HEPARIN is/are right I. It is a muc sacar e r an c ac resen na ra n an ss es es ec a n lungs and liver. II. It has anticoagulant proprieties that inhibit the conversion of prothrombim to thrombin and fibrinogen to fibrin III. It has antithrombin III as it co-factor A. I only B. III only C. I and II only D. II and III only E. All are correct 12. What class of drug represents the following chemical structure? O HS - H2C N CH3 CO2H A) Diuretics B) Angiotensin converting enzyme (ACE) Inhibitors C) Calcium channel blockers D) Selective Serotonin Receptor Inhibitors E) Angiotensin Receptor Blockers (ARBs) Ans. B 13) What is incorrect about ACE Inhibitors? A) sulfhydril group is present in captopril B) captopril and fosinopril are NOT prodrugs because these do not require hydrolysis to produce active products C) it essential to have esterase for the activation of ACEi. In re en r a n an ens n II E) Angiotensin II is strong vasodilator Ans. E Tips: Angiotensin II is strong vasoconstrictor 14 sa an s s n ra r a rea er ens n recen reports cough. What is incorrect? A) recommend