Pharmacy PT1 April 2025 PDF - Topnotch Medical Board Prep

TOPNOTCH MEDICAL BOARD PREP PHARMACOLOGY PRACTICE TEST 1 BY TOPNOTCH PHARMACOLOGY TEAM For inquiries visit www.topnotchboardprep.com.ph or https://www.facebook.com/topnotchmedicalboardprep/ This handout is only valid for April 2025 PLE batch. This...

TOPNOTCH MEDICAL BOARD PREP PHARMACOLOGY PRACTICE TEST 1 BY TOPNOTCH PHARMACOLOGY TEAM For inquiries visit www.topnotchboardprep.com.ph or https://www.facebook.com/topnotchmedicalboardprep/ This handout is only valid for April 2025 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly. Which is NOT an adverse effect following the long- IMPORTANT LEGAL INFORMATION term use of dexamethasone? A. Osteoporosis 7. The handouts, videos and other review materials, provided by Topnotch Medical Board B. Gastric ulcer disease Preparation Incorporated are duly protected by RA 8293 otherwise known as the C. Increased risk of infection Intellectual Property Code of the Philippines, and shall only be for the sole use of the person: a) whose name appear on the handout or review material, b) person subscribed to Topnotch D. Diabetes insipidus Medical Board Preparation Incorporated Program or c) is the recipient of this electronic How does bisoprolol lower blood pressure in patients communication. No part of the handout, video or other review material may be reproduced, with hypertension? shared, sold and distributed through any printed form, audio or video recording, electronic medium or machine-readable form, in whole or in part without the written consent of A. Increasing renin release from the kidneys 8. Topnotch Medical Board Preparation Incorporated. Any violation and or infringement, B. Increasing cardiac output whether intended or otherwise shall be subject to legal action and prosecution to the full extent guaranteed by law. C. Blocking catecholamine reaction on receptors D. Decreasing intravascular volume DISCLOSURE Sarah is a call center agent complaining of excessive The handouts/review materials must be treated with utmost confidentiality. It shall be the facial hair. Which drug is NOT used to control hirsutism? responsibility of the person, whose name appears therein, that the handouts/review A. Flutamide materials are not photocopied or in any way reproduced, shared or lent to any person or 9. disposed in any manner. Any handout/review material found in the possession of another B. Testosterone person whose name does not appear therein shall be prima facie evidence of violation of RA C. Cyproterone acetate 8293. Topnotch review materials are updated every six (6) months based on the current D. Spironolactone trends and feedback. THIS HANDOUT IS NOT FOR SALE! How do statins cause kidney failure? A. Direct kidney damage 10. B. Hepatorenal syndrome PRACTICE TESTS NOMENCLATURE 1. Priority practice tests are practice tests based on the main handout. These will help quiz C. Rhabdomyolysis you of what you have understood and remembered and where you need to focus more on D. Severe vasoconstriction you next reading 2.Legacy practice tests are practice tests based on previous board exam feedback and can Julian has been prescribed exenatide as an adjunct be used to help solidify knowledge on a certain subject and have a glimpse of how treatment for his Type 2 Diabetes Mellitus. The benefits questions are asked in the actual board exam of exenatide in DM includes the following, EXCEPT: 11. A. It slows down gastric emptying rate This handout is only valid for the April 2025 PLE batch. B. It reduces appetite and promotes satiety This will be rendered obsolete for the next batch C. It increases insulin secretion since we update our handouts regularly. D. It increases glucagon secretion Which antibiotic will have activity against methicillin- resistant Staphylococcus aureus? PHARMACOLOGY PRACTICE TEST 1 A. Cefoxitin 12. (Legacy Practice Test) B. Ceftaroline Contributors: Jasper Ian A. Alindayu, MD, Daniel Alexander C. Ceftazidime D. Cefpirome D. Go, MD, and Denzel C. Umerez, MD What statement is FALSE about acarbose? A. Used in the treatment of diabetes mellitus What statement is FALSE about teriparatide? 13. B. Inhibits the enzyme alpha glucosidase A. It can be used in patients with vitamin D deficiency C. Inhibits fatty acid synthase 1. B. Increased risk of osteosarcoma D. It is given before meals C. It can be used for life What glandular secretion is NOT affected by D. It can cause hypercalcemia and hypercalciuria acetylcholine administration? Among the following drugs, which does not have A. Gastric acid nicotinic effects? 14. B. Insulin A. Pyridostigmine C. Tear 2. B. Pilocarpine D. Saliva C. Methacholine What is an advantage of erythromycin over D. Carbachol azithromycin? What is the mechanism of action of glycopyrronium A. Higher tissue concentration bromide that is a drug that may be used in combination 15. B. Once-a-day dosing with formoterol for bronchial asthma? C. Shorter duration of treatment 3. A. It inhibits phosphodiesterase D. Low cost of treatment B. It is an adrenergic agonist Jun is diagnosed to have pneumonia caused by the C. It stabilizes mast cell membranes atypical organism, Mycoplasma pneumoniae. What D. It is a cholinergic antagonist can be prescribed for this patient? Which is NOT a contraindication to the use of 16. A. Clavulanic acid streptokinase in a patient who suffered an acute B. Fosfomycin myocardial infarction? C. Vancomycin 4. A. Ischemic stroke D. Azithromycin B. Previous cerebrovascular event How does tamoxifen retard tumor growth in breast C. Active menstruation cancer? D. Suspected aortic dissection A. It acts as a potent progestin What is FALSE about oseltamivir? 17. B. It acts as an estrogen antagonist A. It prevents the release of new viral particles C. It prevents estrogen synthesis in the ovary B. Common side effects includes nausea and D. It has androgenic activity vomiting What drug can effectively lyse a clot after an acute 5. C. Competitive inhibitor of influenza's thrombotic episode? neuraminidase enzyme A. Dabigatran D. It is ineffective in decreasing length of 18. B. Enoxaparin hospitalization C. Streptokinase Which is a contraindication to the use of streptokinase D. Clopidogrel in a patient who suffered an acute myocardial What is the mechanism of action of the drug infarction? probenecid used in the treatment of gout? 6. A. Chronic liver failure A. Providing reduced inflammation B. Peptic ulcer disease 19. B. Increase elimination of uric acid C. Diabetes mellitus C. Mitotic inhibitor D. Chronic kidney failure D. Inhibit xanthine oxidase TOPNOTCH MEDICAL BOARD PREP PHARMACOLOGY PRACTICE TEST 1 TOPNOTCH PHARMACOLOGY TEAM Page 1 of 16 For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected] This handout is only valid for the April 2025 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly.  TOPNOTCH MEDICAL BOARD PREP PHARMACOLOGY PRACTICE TEST 1 BY TOPNOTCH PHARMACOLOGY TEAM For inquiries visit www.topnotchboardprep.com.ph or https://www.facebook.com/topnotchmedicalboardprep/ This handout is only valid for April 2025 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly. What drug is improperly paired with its side effect when Among the drugs listed, which does NOT interact given concomitantly with amphotericin B? with isosorbide mononitrate to cause marked A. Diuretics - increased risk of kidney disease hypotension? 20. B. Bevacizumab - hypertension 32. A. Sildenafil C. Flucytosine - increased toxicity of flucytosine B. Propranolol D. Corticosteroids - increased risk of hypokalemia C. Nifedipine Girlie consults your clinic and complains that she D. Verapamil cannot sleep. What drug can be given to help her Suxamethonium chloride is inactivated due to its sleep? metabolism by which enzyme? 21. A. Theophylline A. Catechol-O-methyl transferase 33. B. Diazepam B. Monoamine oxidase C. Methylprednisone C. Phosphate dehydrogenase D. Fluoxetine D. Butyrylcholinesterase What is the MOST potent and consistently effective What is a possible side effect of taking metoclopramide? anti-inflammatory agent used for bronchial asthma? A. CVD / stroke A. Beta-adrenergic agonist 34. B. Bone fracture 22. B. Non-steroidal anti-inflammatory agent C. Agranulocytosis C. Corticosteroid D. Tardive dyskinesia D. Cholinergic antagonist Darla has been taking warfarin for the last ten years. Which of the following drugs is used to induce After her regular laboratory checkup, it was noted that ovulation in patients who wish to be pregnant? her INR was 5.5. Which of the following vitamins should A. Aminoglutethimide be given to counteract the thrombotic effects of 23. B. Bicalutamide 35. warfarin? C. Clomiphene A. C D. Cyproterone B. A What side effect is associated with albendazole? C. D A. Elevated creatinine D. K 24. B. Flushing How does tamsulosin work in the treatment of benign C. Pruritus prostatic hyperplasia? D. Abdominal pain A. 5-alpha reductase inhibitor 36. How is bronchodilation achieved by ipratropium B. Beta-2 adrenergic receptor agonist bromide in the management of bronchial asthma? C. Alpha-1 adrenergic receptor antagonist A. Sympathetic receptor agonism D. Cholinergic receptor antagonist 25. B. Cholinergic antagonism What is the effect of methotrexate in the treatment of C. Phosphodiesterase inhibition rheumatoid arthritis? D. Histamine receptor antagonism A. Blunting immune response but no effect on Joe has been on warfarin for the last 12 months but regression of disease 37. was not monitored. Which diagnostic test should B. Slowing down disease progression you order? C. Treating inflammation but has no effect on the 26. A. Digibind level underlying cause B. Platelet count D. Promoting the development of infection C. Prothrombin time Which drug for the treatment of Parkinson's disease D. Partial thromboplastin time works by acting as an agonist for dopamine receptors? In the treatment of NSAID-induced gastritis, how A. Levodopa 38. does misoprostol work? B. Carbidopa A. Antacid C. Pergolide 27. B. H+/K+ ATPase inhibitor D. Tolcapone C. PGE1 analogue What drug inhibits the production of breast milk and D. H2 blocker should be avoided by breastfeeding mothers? Which of the following genital infections is A. Domperidone 39. azithromycin not effective for? B. Haloperidol A. Lymphogranuloma venereum C. Metoclopramide 28. B. Herpes Simplex D. Ethinyl estradiol C. Chancroid In addition to diuresis, spironolactone can be used for D. Granuloma inguinale which condition? What drug can cause paradoxical tachycardia in A. Hypermagnesemia 40. patients? B. Hyperglycemia A. Norepinephrine C. Hyperkalemia 29. B. Propranolol D. Hirsutism C. Nitroglycerin What drug is used in benign prostatic hyperplasia that is D. Clonidine associated with reduction of prostate size? Which of the following is a non-selective alpha- A. Tamsulosin 41. adrenergic receptor antagonist? B. Finasteride A. Prazosin C. Cefuroxime 30. B. Tamsulosin D. Bethanechol C. Yohimbine Which of the following is NOT an effect associated with D. Phenoxybenzamine milrinone? Clinton is a 16-year-old teenager complaining of a A. Positive inotropic action 42. unilateral swelling on his right testicle accompanied B. Vasoconstriction by a burning sensation on urination. If left C. Fall in peripheral vascular resistance untreated, this can lead to infertility. What is the D. Inhibits phosphodiesterase III 31. treatment of choice for this patient? What is an extended spectrum penicillin that can be A. Azithromycin given without a beta-lactamase inhibitor? B. Cefuroxime A. Carbenicillin 43. C. Cefixime B. Piperacillin D. Doxycycline C. Ticarcillin D. Ampicillin TOPNOTCH MEDICAL BOARD PREP PHARMACOLOGY PRACTICE TEST 1 TOPNOTCH PHARMACOLOGY TEAM Page 2 of 16 For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected] This handout is only valid for the April 2025 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly.  TOPNOTCH MEDICAL BOARD PREP PHARMACOLOGY PRACTICE TEST 1 BY TOPNOTCH PHARMACOLOGY TEAM For inquiries visit www.topnotchboardprep.com.ph or https://www.facebook.com/topnotchmedicalboardprep/ This handout is only valid for April 2025 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly. Which statement is FALSE about infliximab? 56. Jericho was rushed to the Emergency Room after A. It can cause the reactivation of Hepatitis B feeling severe crushing chest pain. Which drug can infection relieve pain in patients experiencing myocardial 44. B. It is a monoclonal antibody that blocks TNF-alpha infarction? C. Its use is rarely associated with side effects A. Paracetamol D. It is used in the management of rheumatoid B. Dextromethorphan arthritis C. Diclofenac 45. What drug is hydrolyzed by acetylcholinesterase? D. Morphine A. Bethanechol 57. What drug antagonizes muscarinic receptors? B. Methacholine A. Carbachol C. Muscarine B. Atropine D. Pilocarpine C. Nicotine 46. Which among the following listed medications does D. Pilocarpine NOT increase the risk of nephrotoxicity with the use of 58. What drug is used in the management of benign gentamicin? prostatic hyperplasia? A. Cisplatin A. Cholinergic antagonist B. Penicillin B. Beta-2 agonist C. Amphotericin C. Alpha-1 blocker D. Vancomycin D. 1-alpha reductase inhibitor 47. Prescribe the appropriate drug to prevent vomiting in 59. Which statement is TRUE about benzodiazepines? patients with severe vomiting. A. Use of benzodiazepines are associated with an A. Omeprazole increased risk of suicide B. Dicycloverine B. Short term use is associated with formation of C. Ondansetron memories of new material or amnesia D. Vancomycin C. Aggression or behavioral disinhibition can 48. Joy was diagnosed to have septic arthritis. Gram stain occasionally occur with the use of of the synovial fluid secured through arthrocentesis Benzodiazepines revealed gram-negative cocci. What should be given to D. Long term use of benzodiazepines is her? associated with decreasing effectiveness and A. Penicillin G physical dependence B. Vancomycin 60. Which of the following inhibits phosphodiesterase C. Azithromycin type 3 and is used in patients suffering from D. Ceftriaxone intermittent claudication? 49. Which receptor is not affected by methylergometrine? A. Coumarin A. Dopamine B. Cilostazol B. Alpha-adrenergic C. Sildenafil C. Serotonin D. Doxofylline D. Oxytocin 61. Which statement regarding aztreonam is 50. Cabergoline is used in the treatment of what specific INCORRECT? condition? A. It has no use for infections with anaerobe A. Cushing's disease organisms. B. Prolactinoma B. It belongs to the monobactam family of C. Hyperthyroidism antibiotics. D. Pituitary dwarfism C. Serious side effects include Clostridium difficile 51. What drug that acts by both increasing bone infection. deposition and reducing bone resorption by D. It is used to treat infections caused by gram- osteoclast? positive organisms. A. Raloxifene 62. Which drug class can be used to decrease B. Alendronate extrapyramidal symptoms associated with the use C. Denosumab of typical antipsychotics? D. Strontium A. Sympathetic antagonist 52. Which statement is FALSE regarding infliximab as a B. Cholinergic agonist treatment for rheumatoid arthritis? C. Sympathetic agonist A. It is a chimeric IgG monoclonal antibody D. Cholinergic antagonist B. It neutralizes the biologic activity of TNF-alpha 63. What statement is FALSE regarding teriparatide? C. It is a receptor-construct fusion protein A. It activates osteoblasts D. It can lyse cells involved in inflammatory process B. It is an anabolic agent promoting bone 53. Which drug is LEAST recommended for the treatment formation of benign prostatic hyperplasia? C. It is like biological calcitonin A. Terazosin D. Off-label use is to speed fracture healing B. Silodosin 64. Tramadol exerts its effect on pain by reacting with C. Phenoxybenzamine A. Steroid receptors D. Tamsulosin B. Serotonin receptors 54. What is the MOST common adverse effect associated C. Mu-opioid receptors with the use of loperamide? D. The enzyme cyclooxygenase A. Headache 65. What is the mechanism of action of amphotericin B? B. Diarrhea A. Inhibiting fungal DNA synthesis C. Urinary retention B. Inhibiting fungal cP450 D. Constipation C. Disruption of fungal mitotic spindles 55. What drug is used as an adjunct to thallium or D. Affecting fungal cell wall integrity technetium in myocardial perfusion scintigraphy or 66. Which of the following is an N-methyl D aspartate nuclear stress test in patients unable to undergo stress (NMDA) receptor blocker and is used in the testing with exercise? treatment of dementia? A. Ephedrine A. Donepezil B. Epinephrine B. Sertraline C. Atropine C. Cabergoline D. Adenosine D. Memantine TOPNOTCH MEDICAL BOARD PREP PHARMACOLOGY PRACTICE TEST 1 TOPNOTCH PHARMACOLOGY TEAM Page 3 of 16 For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected] This handout is only valid for the April 2025 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly.  TOPNOTCH MEDICAL BOARD PREP PHARMACOLOGY PRACTICE TEST 1 BY TOPNOTCH PHARMACOLOGY TEAM For inquiries visit www.topnotchboardprep.com.ph or https://www.facebook.com/topnotchmedicalboardprep/ This handout is only valid for April 2025 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly. 67. Which of the following is NOT associated with 79. What side effect is associated with conivaptan? sucralfate use? A. Decrease net fluid loss A. It provides protective barrier at the ulcer surface B. Vasoconstriction B. It promotes secretion of proteins and bile C. Increased urine output C. It acts as an acid buffer for 6-8 hours D. Increased urine osmolality D. It prevents back diffusion of hydrogen ions 80. What is a TRUE statement regarding 68. What is INCORRECT about penicillins? aminoglycosides? A. Carbenicillin has activity against Pseudomonas. A. Used for empiric treatment of gram-positive B. Flucloxacillin is degraded by penicillinase. pneumonia C. Mechanism of action is by inhibiting cell wall B. Is absorbed well from the gastrointestinal synthesis. tract D. Clavulanic acid is added to protect against C. It is effective in infections with gram-negative penicillinase. organisms 69. What effect is NOT associated with the use of D. Can be used as a single agent for febrile liraglutide? neutropenia A. Delays gastric emptying rate 81. Azithromycin does not have activity for which B. Increase sugar elimination organisms? C. Increase insulin secretion A. Gram-positive D. Decrease glucagon secretion B. Anaerobe 70. What drug has an antagonistic effect on progesterone C. Gram-negative receptors? D. Atypical A. Cyproterone 82. A patient was rushed to the ER for an overdose of B. Drospirenone diazepam. What antidote should be given? C. Ulipristal acetate A. Pralidoxime D. Milrinone B. Atropine 71. The patient's blood culture just came in revealing the C. Acetylcysteine presence of Pseudomonas aeruginosa. Prescribe the D. Flumazenil appropriate antibiotic. 83. Phenylephrine is a drug used for nasal congestion. A. Ciprofloxacin Which is an INCORRECT statement about this drug? B. Vancomycin A. It causes vasoconstriction of arteries and veins C. Ceftriaxone B. It is an alpha-1 adrenergic agonist D. Roxithromycin C. It can cause pupillary vasodilation 72. In the treatment of muscle spasm, orphenadrine D. It can cause orthostatic hypotension works by antagonizing which receptor? 84. What is butamirate used for? A. NMDA A. Conjunctivitis B. Muscarinic B. Ear discharge C. Dopamine C. Rhinorrhea D. Histamine D. Cough 73. Which effect is NOT seen when ethinyl estradiol is 85. Which is NOT a side effect associated with the use of taken by a male patient? ranitidine? A. Gynecomastia A. Higher risk of pneumonia in hospitalized B. Erectile dysfunction patients C. Infertility B. Paradoxical gastrointestinal bleeding D. Hypergonadism C. Higher risk of developing food allergies 74. What is the LEAST likely side effect of domperidone? D. Vitamin B12 deficiency A. Galactagogue 86. What side effect is NOT associated with use of B. Gastric prokinetic benzodiazepines in the elderly? C. Antiemetic A. Increased fall accidents D. Drowsiness B. Increased blood pressure 75. Julienne, 30/F presents with acute pyelonephritis. C. Impaired motor coordination Which of the following intravenous drugs is D. Increased daytime sedation inappropriate? 87. What is a TRUE statement regarding trimethoprim / A. Carbapenem sulfamethoxazole? B. Amikacin A. It works by inhibiting DNA gyrase activity. C. Fosfomycin B. It is safe to use in children less than 2 years of D. Fluoroquinolone age. 76. A boy continuously scratches his anal area. Fecalysis C. It is effective in the treatment of pneumocystis revealed pinworm infection. The following pneumonia. antiparasitic can be given, EXCEPT ___. D. Its use is safe during pregnancy. A. Mebendazole 88. Among the listed drugs, which is a nonselective B. Metronidazole muscarinic receptor agonist? C. Pyrantel pamoate A. Nicotine D. Albendazole B. Acetylcholine 77. Selina was given piperacillin-tazobactam for a severe C. Ipratropium bromide infection but developed secondary fungal infection. D. Bethanechol What is NOT a contributory factor in the development 89. What antibiotic has been shown in animal studies to of the secondary fungal infection? cause arthropathy in children? A. Diabetes mellitus A. Aminoglycosides B. Antibiotic use B. Fluoroquinolones C. Bronchial asthma C. Macrolides D. Dexamethasone D. Tetracycline 78. What drug used in angina pectoris produces 90. Which of the following is a non-dihydropyridine cardioprotective effect by acting as an ATP-sensitive calcium channel blocker? potassium channel agonist? A. Atenolol A. Felodipine B. Verapamil B. Lisinopril C. Nitroglycerin C. Irbesartan D. Felodipine D. Nicorandil TOPNOTCH MEDICAL BOARD PREP PHARMACOLOGY PRACTICE TEST 1 TOPNOTCH PHARMACOLOGY TEAM Page 4 of 16 For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected] This handout is only valid for the April 2025 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly.  TOPNOTCH MEDICAL BOARD PREP PHARMACOLOGY PRACTICE TEST 1 BY TOPNOTCH PHARMACOLOGY TEAM For inquiries visit www.topnotchboardprep.com.ph or https://www.facebook.com/topnotchmedicalboardprep/ This handout is only valid for April 2025 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly. 91. What is the treatment for a patient with Parkinson's However, the use of teriparatide is limited to 2 years (Choice C disease? is incorrect) due to the increased risk of osteosarcoma (Choice A. Risperidone B). B. Levodopa C. Pregabalin Among the following drugs, which does not have D. Tyramine nicotinic effects? 92. Which should be monitored by a physician in a patient A. Pyridostigmine taking triple anti-TB medications? 2. B. Pilocarpine A. CBC C. Methacholine B. Kidney Function Test D. Carbachol Answer: B C. Liver Function Test D. ESR Choices B, C, and D are direct-acting cholinomimetics (drugs with acetylcholine-like effects that act at the acetylcholine 93. What is the drug of choice for the treatment of receptor). They can be differentiated through their spectrum of lymphogranuloma venereum in a 25-year-old pregnant action: whether they act on muscarinic or nicotinic woman? cholinoceptors, or both. Choice A is an indirect-acting A. Doxycycline cholinomimetic by inhibiting acetylcholinesterase. B. Amoxicillin Pilocarpine is a muscarinic receptor agonist that only acts on a C. Azithromycin subtype of muscarinic receptor (M3) found on the iris sphincter D. Cotrimoxazole muscle. 94. Side effects seen with the use of antihistamines in the Pyridostigmine and carbachol (Choices A & D) act on both treatment of emesis are the following, EXCEPT? muscarinic and nicotinic receptors while methacholine (Choice A. Dry mouth C) acts predominantly on muscarinic receptors with little effect B. Confusion on nicotinic receptors. C. Bradycardia D. Sedation What is the mechanism of action of glycopyrronium 95. How can vitamin D improve the blood levels of calcium bromide that is a drug that may be used in and address osteoporosis? combination with formoterol for bronchial asthma? A. Increases renal excretion of calcium 3. A. It inhibits phosphodiesterase B. Increases bone resorption B. It is an adrenergic agonist C. Increases calcium absorption from the GI tract C. It stabilizes mast cell membranes D. Increases calcium release from parathyroid gland D. It is a cholinergic antagonist 96. Mifepristone is effective in aborting pregnancy by Answer: D inhibiting receptor interaction with ___. Glycopyrronium bromide is a cholinergic A. Prolactin antagonist/parasympatholytic (Choice D). It blocks the B. Prostaglandin muscarinic receptors in bronchial smooth muscles to counter C. Cortisol excessive bronchoconstriction, hence its use in bronchial D. Progesterone asthma and COPD. Formoterol is a long-acting β2-agonist with a 97. How is sertraline effective in major depressive quick onset of action (Choice B is incorrect). disorders and other psychiatric disorders? Phosphodiesterase inhibitors (Choice A) such as the A. It inhibits the enzyme monoamine oxidase methylxanthine theophylline, and mast cell stabilizers (Choice enzyme C) such as cromolyn sodium are distinct classes of drugs that B. It acts as agonist on serotonin receptors may also be used in the treatment of bronchial asthma. C. It increases the release of serotonin on the synaptic cleft Which is NOT a contraindication to the use of D. It inhibits the reuptake of serotonin by the streptokinase in a patient who suffered an acute presynaptic bulb myocardial infarction? 98. What side effect leads to poor compliance with 4. A. Ischemic stroke misoprostol use? B. Previous cerebrovascular event A. Flushing C. Active menstruation B. Headache D. Suspected aortic dissection C. Diarrhea Answer: C D. Edema Clear contraindications for thrombolysis include: 99. Where does the absorption of omeprazole occur? o Active internal bleeding EXCEPT menses (Choice C is A. Stomach incorrect) B. Cecum o Cerebrovascular hemorrhage at any time C. Large intestines o Non-hemorrhagic stroke or other cerebrovascular event D. Small intestines within the past year (Choices A & B) 100. What drug irreversibly inhibits acetylcholinesterase? o Marked hypertension (SBP >180 mmHg and/or a A. Demecarium DBP>110mmHg) at any time during the acute presentation B. Physostigmine o Suspicion of aortic dissection (Choice D) C. Edrophonium D. Parathion What is FALSE about oseltamivir? A. It prevents the release of new viral particles B. Common side effects includes nausea and DISCUSSION vomiting What statement is FALSE about teriparatide? 5. C. Competitive inhibitor of influenza's A. It can be used in patients with vitamin D neuraminidase enzyme deficiency D. It is ineffective in decreasing length of 1. B. Increased risk of osteosarcoma hospitalization Answer: D C. It can be used for life D. It can cause hypercalcemia and hypercalciuria Oseltamivir interferes with release of progeny influenza A and B Answer: C virus from infected host cells (Choice A) by competitively Teriparatide is a recombinant parathyroid hormone that acts inhibiting neuraminidases produced by the virus (Choice C), through the PTH receptors to increase bone formation. It can be halting the spread of infection with the respiratory tract. used in patients with vitamin D deficiency (Choice A), and its Initiating a 5 to 7-day course of therapy within 48 hours after known toxicities include hypercalcemia and hypercalciuria the onset of illness may decrease duration of symptoms, as well (Choice D). as duration of viral shedding and viral titer (Choice D is incorrect). Common side effects include nausea and vomiting (Choice B). TOPNOTCH MEDICAL BOARD PREP PHARMACOLOGY PRACTICE TEST 1 TOPNOTCH PHARMACOLOGY TEAM Page 5 of 16 For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected] This handout is only valid for the April 2025 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly.  TOPNOTCH MEDICAL BOARD PREP PHARMACOLOGY PRACTICE TEST 1 BY TOPNOTCH PHARMACOLOGY TEAM For inquiries visit www.topnotchboardprep.com.ph or https://www.facebook.com/topnotchmedicalboardprep/ This handout is only valid for April 2025 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly. Which is a contraindication to the use of How do statins cause kidney failure? streptokinase in a patient who suffered an acute A. Direct kidney damage myocardial infarction? 10. B. Hepatorenal syndrome 6. A. Chronic liver failure C. Rhabdomyolysis B. Peptic ulcer disease D. Severe vasoconstriction C. Diabetes mellitus Answer: C D. Chronic kidney failure Answer: B Muscle toxicity from statins ranges from myopathy, myalgia, myositis, and rhabdomyolysis. The primary mechanism of statin therapy- Relative contraindications for thrombolysis include: induced rhabdomyolysis is believed to be a decrease in ubiquinone o Current use of anticoagulants (INR ≥2) (coenzyme Q) produced by the HMG-CoA pathway. Choices A, B, and o Recent (10 min) cardiopulmonary resuscitation Note that giving fibrates with statins increases the risk for myopathy o Known bleeding diathesis and rhabdomyolysis. o Pregnancy o A hemorrhagic ophthalmic condition (e.g. hemorrhagic Julian has been prescribed exenatide as an adjunct diabetic retinopathy) treatment for his Type 2 Diabetes Mellitus. The benefits o Active peptic ulcer disease (Choice B) of exenatide in DM includes the following, EXCEPT: o History of severe hypertension that is currently adequately 11. A. It slows down gastric emptying rate controlled B. It reduces appetite and promotes satiety o Recent administration of streptokinase within the preceding C. It increases insulin secretion 5 days to 2 years due to the risk of an allergic reaction D. It increases glucagon secretion Answer: D Which is NOT an adverse effect following the long- term use of dexamethasone? Exenatide reduces post-meal glucose excursions. It lowers glucagon A. Osteoporosis levels (Choice D is incorrect), increases glucose-mediated insulin 7. B. Gastric ulcer disease release (Choice C), slows gastric emptying (Choice A), and decreases C. Increased risk of infection appetite (Choice B). D. Diabetes insipidus Answer: D Which antibiotic will have activity against methicillin- resistant Staphylococcus aureus? Dexamethasone makes the gastric mucosa susceptible to A. Cefoxitin ulceration (Choice B) by inhibiting prostaglandin synthetase 12. B. Ceftaroline and peroxidase. It also suppresses the immune system placing C. Ceftazidime the patient at risk for infection (Choice C). Steroid use may D. Cefpirome inhibit bone formation and may lead to the development of Answer: B osteoporosis (Choice A). Diabetes insipidus (Choice D) is not a known adverse effect Ceftaroline is a novel fifth-generation cephalosporin, which following the long-term use of dexamethasone. exhibits broad-spectrum activity against Gram-positive bacteria, including MRSA and extensively resistant strain. How does bisoprolol lower blood pressure in patients Choice A, C, and D belong to the second, third, and fourth with hypertension? generations of cephalosporins, respectively. They do not have A. Increasing renin release from the kidneys antimicrobial activity against MRSA. 8. B. Increasing cardiac output Fifth-generation cephalosporins have good activity against C. Blocking catecholamine reaction on receptors MRSA while 4th generation cephalosporins have good activity D. Decreasing intravascular volume against Pseudomonas. Mnemonic: 5th Gen (Highest Gen) are Answer: C high ROLlers = CeftaROLine, CeftobipROLe. Bisoprolol reduces cardiac output (Choice B is incorrect), What statement is FALSE about acarbose? inhibits renin release by the kidneys (Choice A is incorrect), A. Used in the treatment of diabetes mellitus and decreases sympathetic outflow from vasomotor centers 13. B. Inhibits the enzyme alpha glucosidase in the brain (Choice C). It blocks β1-receptors and reduces C. Inhibits fatty acid synthase myocardial oxygen demand. Bisoprolol, Carvedilol, D. It is given before meals Metoprolol, and Nebivolol are also shown to reduce mortality Answer: C in heart failure. Decreasing intravascular volume (Choice D) is the Acarbose is an anti-hyperglycemic agent (Choice A) that inhibits mechanism by which diuretics reduce blood pressure in intestinal alpha glucosidase (Choice C is incorrect) and reduces hypertensive patients. conversion of starch and disaccharides to monosaccharides. It is usually given before meals or at the beginning of a meal (Choice D) to Sarah is a call center agent complaining of excessive decrease postprandial hyperglycemia. facial hair. Which drug is NOT used to control hirsutism? A. Flutamide What glandular secretion is NOT affected by 9. B. Testosterone acetylcholine administration? C. Cyproterone acetate A. Gastric acid 14. B. Insulin D. Spironolactone Answer: B C. Tear D. Saliva In women, androgens (e.g. testosterone, DHEA, DHT, Answer: B androstenedione) can produce changes like those observed Acetylcholine binds to cholinergic receptors. It stimulates gastric in the prepubertal male. These include growth of facial and secretions (Choice A) and increases secretion of sweat, salivary body hair, deepening of the voice, enlargement of the clitoris, (Choice D), and lacrimal glands (Choice C). frontal baldness, and prominent musculature. Glucose is the major regulator of insulin release. Flutamide (Choice A) is a nonsteroidal competitive inhibitor at the androgen receptor which decreases steroid binding. What is an advantage of erythromycin over Cyproterone acetate (Choice C) is an androgen receptor azithromycin? blocker which also exerts progesterone-like effects by acting A. Higher tissue concentration 15. B. Once-a-day dosing on the progesterone receptor. Spironolactone (Choice D) is an androgen receptor and 17α- C. Shorter duration of treatment hydroxylase/17,20-lyase inhibitor. D. Low cost of treatment Answer: D TOPNOTCH MEDICAL BOARD PREP PHARMACOLOGY PRACTICE TEST 1 TOPNOTCH PHARMACOLOGY TEAM Page 6 of 16 For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected] This handout is only valid for the April 2025 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly.  TOPNOTCH MEDICAL BOARD PREP PHARMACOLOGY PRACTICE TEST 1 BY TOPNOTCH PHARMACOLOGY TEAM For inquiries visit www.topnotchboardprep.com.ph or https://www.facebook.com/topnotchmedicalboardprep/ This handout is only valid for April 2025 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly. Azithromycin is a superior drug compared to erythromycin. Unlike A synergy (NOT toxicity) between amphotericin B and erythromycin, azithromycin does not have significant drug-drug flucytosine has been demonstrated in both in vitro and in vivo interactions. It also achieves higher tissue concentration (Choice A), experiments. It may be related to enhanced penetration of the may be taken in once-a-day dosing (Choice B) and is taken for a flucytosine through amphotericin-damaged fungal cell shorter period (Choice C). The only downside is that azithromycin membranes. may be five times more expensive than erythromycin (Choice D). Diuretics (Choice A) may cause acute kidney injury through various mechanisms such as overdiuresis (depleting the Jun is diagnosed to have pneumonia caused by the intravascular volume). atypical organism, Mycoplasma pneumoniae. What Bevacizumab (Choice B) is a vascular endothelial growth factor can be prescribed for this patient? (VEGF) that causes hypertension through reduction of vascular 16. A. Clavulanic acid density and production of nitric oxide causing vasodilation. B. Fosfomycin Corticosteroids (Choice D), particularly mineralocorticoids, C. Vancomycin cause hypokalemia through increased potassium excretion in D. Azithromycin the kidney. Answer: D Girlie consults your clinic and complains that she Atypical pneumonias (Mycoplasma, Chlamydia, Legionella) may be cannot sleep. What drug can be given to help her treated with tetracyclines, macrolides, or quinolones. Azithromycin, sleep? Clarithromycin, and Erythromycin are macrolides. The rest of the A. Theophylline choices do not have coverage against atypical organisms. 21. B. Diazepam C. Methylprednisone How does tamoxifen retard tumor growth in breast D. Fluoxetine cancer? Answer: B A. It acts as a potent progestin Theophylline is a maintenance medication that may be used to 17. B. It acts as an estrogen antagonist treat asthma and COPD. As a member of the xanthine family, it C. It prevents estrogen synthesis in the ovary is structurally like caffeine, which explains why some people D. It has androgenic activity report difficulty with sleep while taking this drug. (Choice A is Answer: B incorrect) Some patients also report difficulty with sleeping after taking Tamoxifen is a selective estrogen receptor modulator with a corticosteroids and fluoxetine. (Choices C and D are incorrect) complex mode of action. It is an antagonist in breast tissue, but Diazepam (Choice B) is a benzodiazepine classified as a sedative a partial agonist in endometrium and bone. It blocks the binding hypnotic. of estrogen to ER in ER-positive cells. It does not affect progesterone receptors (Choice A is incorrect) What is the MOST potent and consistently effective and estrogen synthesis (Choice C is incorrect), and does not act anti-inflammatory agent used for bronchial asthma? on androgen receptors (Choice D is incorrect). A. Beta-adrenergic agonist 22. B. Non-steroidal anti-inflammatory agent What drug can effectively lyse a clot after an acute C. Corticosteroid thrombotic episode? D. Cholinergic antagonist A. Dabigatran Answer: C 18. B. Enoxaparin Inhaled corticosteroids are the treatment of choice in preventing C. Streptokinase asthma exacerbation in patients with persistent asthma. They reverse D. Clopidogrel capillary permeability and reverse the eosinophilic airway Answer: C inflammation which causes symptomatic exacerbations of asthma. Streptokinase is a tissue plasminogen activator analog and is the Beta-adrenergic agonists and cholinergic antagonists (Choices A & D) only thrombolytic drug among the choices. It converts are used to reverse acute bronchospasm but DO NOT EXERT an anti- plasminogen to plasmin, which degrades the fibrin and inflammatory effect. It is worth noting, however, that long-acting fibrinogen leading to thrombolysis. beta-2 agonists (LABAs) can improve the response to corticosteroids. Dabigatran (Choice A) is a direct thrombin inhibitor and NSAIDs (Choice B) are not indicated in the treatment of bronchial provides anticoagulation in patients with heparin-induced asthma and can otherwise precipitate symptoms of asthma in some thrombocytopenia (HIT). patients. Enoxaparin (Choice B) is a low-molecular-weight heparin (LMWH) that binds and potentiates the effect of antithrombin III Which of the following drugs is used to induce on factor Xa and is used for immediate anticoagulation. ovulation in patients who wish to be pregnant? Clopidogrel (Choice D) is an antiplatelet agent that acts as a A. Aminoglutethimide blocker of the P2Y12 receptor and is usually given as dual 23. B. Bicalutamide antiplatelet therapy with aspirin. C. Clomiphene D. Cyproterone What is the mechanism of action of the drug Answer: C probenecid used in the treatment of gout? Clomiphene is a weak estrogen that also acts as a competitive A. Providing reduced inflammation inhibitor of endogenous estrogens since it is a partial agonist of 19. B. Increase elimination of uric acid estrogen receptors in the pituitary. It has been found useful as C. Mitotic inhibitor an ovulation-inducing agent. D. Inhibit xanthine oxidase Choice A is a “first-generation aromatase inhibitor” used in the Answer: B treatment of breast and prostate cancer and Cushing’s Probenecid inhibits URAT1 and increases uric acid excretion by syndrome but has largely been superseded by newer and safer preventing the reabsorption of uric acid in proximal convoluted agents. tubule. Choice B is an androgen receptor antagonist used in the Choices A and C refer to colchicine, another important drug used treatment of prostate cancer. in the treatment of gout. Choice D is a synthetic progestin, with weak anti-androgen Choice D refers to the mechanism of action of drugs allopurinol activity. and febuxostat. What side effect is associated with albendazole? What drug is improperly paired with its side effect when A. Elevated creatinine given concomitantly with amphotericin B? B. Flushing A. Diuretics - increased risk of kidney disease 24. C. Pruritus 20. B. Bevacizumab - hypertension D. Abdominal pain C. Flucytosine - increased toxicity of flucytosine Answer: D D. Corticosteroids - increased risk of hypokalemia Answer: C TOPNOTCH MEDICAL BOARD PREP PHARMACOLOGY PRACTICE TEST 1 TOPNOTCH PHARMACOLOGY TEAM Page 7 of 16 For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected] This handout is only valid for the April 2025 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly.  TOPNOTCH MEDICAL BOARD PREP PHARMACOLOGY PRACTICE TEST 1 BY TOPNOTCH PHARMACOLOGY TEAM For inquiries visit www.topnotchboardprep.com.ph or https://www.facebook.com/topnotchmedicalboardprep/ This handout is only valid for April 2025 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly. Albendazole causes selective degeneration of cytoplasmic What drug can cause paradoxical tachycardia in microtubules by inhibiting microtubule polymerization in patients? intestinal and tegmental cells of intestinal helminths and larvae. A. Norepinephrine It is generally well tolerated, but it can cause abdominal distress, 29. B. Propranolol headaches, fever, fatigue, alopecia, increases in liver enzymes C. Nitroglycerin and pancytopenia. D. Clonidine The rest of the choices are not known side effects of albendazole. Answer: C How is bronchodilation achieved by ipratropium An indirect effect of nitroglycerin consists of compensatory bromide in the management of bronchial asthma? responses to decreased arterial pressure often resulting in A. Sympathetic receptor agonism tachycardia and increased cardiac co