Pharmacology Past Paper PDF

[INDEX] 1. DIABETES …………………… 2 2. RHEUMATOLOGY…………..8 3. HEPATOLOGY………………12 4. HEMATOLOGY……………..14 5. GASTERO-ENTROLOGY….17 6. ENDOCRINE ………………..24 7. GERIATRIC …………………31 8. RENAL ……………………….37 1  1- If u have renal failure by which mechanism it affects insulin 2- Mecha...

[INDEX] 1. DIABETES …………………… 2 2. RHEUMATOLOGY…………..8 3. HEPATOLOGY………………12 4. HEMATOLOGY……………..14 5. GASTERO-ENTROLOGY….17 6. ENDOCRINE ………………..24 7. GERIATRIC …………………31 8. RENAL ……………………….37 1  1- If u have renal failure by which mechanism it affects insulin 2- Mechanism of action of insulin degludic 3- Glimepiride interferes with which of these drugs a) INH b) Rifampicin 4- Glipenclamide side effect in renal insufficiency Hypoglycemia 5- oral anti Diabetic do join pain a) Semagliptin b) Acarbose c) Metformin d) Sitagliptin 6- old diabetic man use dapaglflazon and other drug which complication most occure a) Hypotention b) hypoglycemia c) renal dysfunction d) Bleeding 7- how detimir act for long time... a) microcrystalline perception b) bind to albmin in s.C tissue c) form of multi_hexamers chains 8- female takes warfirin and has stroke,she recently takes Dyslipidimic drug is... a) Atorvastatin b) Fenofibrate c) niacin d) Ezetimibe 2 9- Diabetic pt with creatinine 2,what is the drug to be used a) Warfarin b) Chlorothiazide c) Dilatiazem d) Don't remember the right answer 10- What is the most likely adverse reaction to dapagliflozin in an elderly patient? a) Hypoglycemia b) Deterioration of kidney function c) Hypotension d) Acute pancreatitis 11- What could explain the extended duration of action of insulin detemir a) Binding of insulin to albumin in the subcutaneous tissue fluid b) Formation of chains of di-hexamers of insulin in subcutaneous tissue c) Binding of insulin molecules to protamine d) Formation of a precipitate of hexamers of insulin in subcutaneous fat 12- Which statin is eliminated mainly by renal excretion? a) Simvastatin b) Atorvastatin c) Rosuvastatin d) Pravastatin 13- Which lipid lowering drug increas:the risk of bleeding from warfarin therapy? a) Evolocumab b) Niacin c) Fenofibrate d) Ezetimibe 3 14- drug that increase the bleeding effect of a) Warfarin b) Fenofibrate c) Niacin d) Simvastatin 15- druq totally excreted by the kidney a) Pravastatin b) Rosuvastatin c) Atorvastatin 16- drug that lead to hypoglycemia when used with a) Fluoxetine b) Glimepiride c) Repaglinide d) Metformin 17- drug that make disabling joint pain a) Sitagliptin b) Pioglitazone 18- most serious effect of dapaglifozin in elderly a) renal injury b) Hypotension 19- the long action of insulin detmire is a) Di hexamers in SC tissue b) Bind to protamine c) Bind to albumin in the SC tissue 4 20- Which antidiabetic drug has a higher risk of hypoglycemia if taken with fluoxetine? a) Sitagliptide b) Glimepiride c) Repaglinide d) Pioglitazone 21- Which oral antidiabetic drug could produce disabling joint pain? a) Dapaglifliozin b) Pioglitazone c) Semaglutide d) Sitagliptin 22- What is the most likely adverse reaction to dapaglhflozin in an elderty diabetic patient? a) Hypoglycemia b) Deterioration of kidney function c) Hypotension d) Acute pancreatitis 23- What could explain the extendeddutation of ation of action of insulin detemir? a) Binding of insulin to albumin in the subcutaneous tissue fluid b) Formation of chains of di-hexamers of insulin in subcutaneous tissue c) Biding of insulin molecules to protamine x d) Formation of a precipitate of hexamers of insulin in subcutaneous fat 5 24- Which statin is eliminated mainly by renal excretion? a) Simyantatin b) Atorvastatin c) Rosuvastatin d) Pravastatin 25- Which lipid Iowering drug increase the risk of bleeding from warfarin therapy? a) Evolocun b) Niacin c) Fenofibrate d) Ezetimibe 26- A male patient presents to emergency unit with Cerebral embolism.His medical report show he is taking warfarin for atrial fibrillation. The attending physician suspected that a drug recently added to his medication could responsable for the patient's new presentation.What could this suspected drug be? a) Rousovastin b) Allopurinol c) Cholestyramine d) Glipizide 27- Which antidiabetic drug can decrease body weight in diabetic patients? a) Sitagliptin b) Semaglutide c) Glimepiride d) Pioglitazone 6 28- Which oral antidiabetic drug acts by delaying the breakdown and absorption of dietary carbohydrates? a) Pioglitazone b) Glipizide c) acarbose d) Sitagliptin 29- Which anti-gouty drug acts by inhibition of tubulin polymerization a) Indomethacin b) Prednisone c) Colchicine d) Allopurinol 30- Which drug increases urinary excretion of uric acid? a) Allopurinol b) Indomethacin c) Aspirin d) Probenecid 31- Which of the following drugs is most useful for the treatment of chronic hypercalcemia in Paget's disease? a) Furosemide b) Zoledronate c) Raloxifene d) Teriparatide 32- A 55-year-old female has been diagnosed with postmenopausal osteoporosis. She has a past medical history of liver disease, erosive esophagitis, and hypothyroidism. Which group of osteoporotic drugs should be used cautiously in this patient? a) Calcium salts b) Vitamin D analogs c) Biphophonatel d) Selective estrogen receptor modulators 7  1- On giving leflunomide We should follow which of the following liver enzyme 2- How Methylnalterxone affect morphine in which mechanism a) Constipation b) Analgesic c) Euphoria d) respiratory depression 3- Naproxen side effect on furosemide a) increase its excretion in urine b) interfere with its absorbtion c) activate aldosteron d) decrease salt and water retention 4- Patient has moderate Crohn's disease presented with alopecia, which drug cause this alopecia : a) Metronidazole b) Cyclosprine c) Methotrexate d) Infliximab 5- Which clinical condition should be excluded before celecoxib prescription a) Peptic ulcers b) Coronary heart disease c) Bronchial asthma 8 6- Matching (DAMARDs mechanism of action ) a) Increase adenine secretion from immune compliment cell b) Inhibition of dihydroortate dehydrogenase enzyme c) Inhibition of inosine monophosphate dehydrogenase d) Formation of a complex of cyrosolic protein e) Inhibition of il-6 1- MFM answer is ….. a) b) c) d) e) 2-Toclizumab answer is…… a) b) c) d) e) 7- Mehtotrexate is less effective with... a) Cimetidine b) Rosuvastatin c) Omeprazole d) Aminosalycelat 8- pt was on an analgesic that causes sever constipation, What are the possible other adverse effects a) Cough and pulmonary edema b) Respiratory depression and vomiting 9- deforming joint pain a) Pioglitazone b) Sitagliptin c) Other 10- Analgesic for mild mascluskeletal pain a) Ketrolac b) Codiene c) Declofenac 9 11- Cancer patient on analgesic, he developed severe constipation, what other adverse effects could occur Respiratory depression and vomiting 12- analgesic used for treatment of mild muscuskeletal pain a) Indomethacin b) diclofenac c) Naproxen 13- drug used to treat addict opiod patient a) Naloxan b) Methylnaltrexone c) Methadone 14- Cancer patient take analgesic since one month and come with constipation what other manifestation he may have? a) gastritis, gastric ucer b) Respiratory depression 15- which drug need opthalmic examination every period? a) Hydroxychloroquine b) mycophenolate mofetile c) Leflunomide d) Methotrexate 16- Which drug could increase the risk of methotrexate adverse reactions? a) Furosemide b) Enalapril c) Pantoprazole d) Metformin 17- Drug which need ophthalmology examination Hydroxycholroquine 10 18- What is the reason for prescribing Folinic acid to a rheumatoid patient treated with methotrexate? a) To reduce risk of adverse effects with metheate b) To enhance methotrexate oral bioavailability c) To slow down methotrexate loss by renal tubules d) To act synergistically with methotrexate on inflammatory cell 19- Which of the following is the main adverse effect of azathioprine? a) Hepatotoxicity b) Hyperuricemia c) Bone marrow suppression d) Diabetes Mellitus 20- What is the main risk of use of bupivacaine as a local anesthetic in a patient with advanced liver disease? a) Cardiac anhythmia b) Hypertension c) Anaphylaxis d) Respiratory depression (For questions 21 & 22) Theme: drugs for chronic pain a) Venalfaxine b) Pregablin c) Desipramine d) Lidocaine e) Tramadol From the above list, match the drug with its mechanism of action. 21- Blocking of neuronal presynaptic alpha-2-delta calcium channels. 22- Blocking of neuronal serotonin and norepinephrine reuptake with agonistic activity at the μ opioid receptor. 11 1- Drug for treatment of postoperative intra ocular pressure a) Mannitol b) Acetazelomide ** 2- Naproxen side effect on furosemide a) increase its excretion in urine b) interfere with its absorbtion c) activate aldosteron d) decrease salt and water retention 3- Side effect of (drug from ACEi) is Hyperkalemia 4- Which of the following decreases the efficacy of furosemide a)....lol(beta blocker) b) Indomethacin 5- How can furesamide help in acute HF a) pulmonary venodilation b) increase CO c) increase renal blood flow 6- Hypertensive drug not used in gout is Hydrocholrothiazide 7- Anti hypertensive drug in diabetic patients RAAS Inhibitor 8- Furesmide used in acute Heart failure as it is a) powerfull diuretic b) inc renal blood flow c) pulmonary venodilatation 12 9- What is drug cause hyperkalemia Eplerenone 10- Patient on chlorothiazide, what is drug that dec it's action Indomethazine 11- What is the explanation of resistance to loop diuretics in chronic kidney disease? a) Decrease glomerular filtration rate b) Competition with urea for basal organic transporter c) Stimulation of apical organic transporter d) Enhancement of passive tubular reabsorption 12- A chronic heart failure male patient on medications presents with a complaint of enlargement of his breast. Which one of his medications could be responsible for this patient's complaint? a) Metoprolol b) Captopril c) Furosemide d) Spironolactone 13- Which investigation should be recommended for patients on ramipril and eplerenone? a) Serum calcium level b) Serum uric acid level c) Serum potassium level d) Serum glucose level 14- What is the characteristic of idiosyncratic drug induced liver injury a) Can occur with any dose b) Predictable c) Presented only by hepatocellular manifestations d) Occur due to drug cumulative effect 13 1- Drug that can't be used with iron supplements a) Ibuprofen b) Levofloxacin 2- A pregnant female on heparin and complains of bleeding from gum the best to choose is : a) Lowering the dose b) Replace with rivaroxaban c) Give her protamine sulfate d) Stop heparin 3- Man who is one oral iron complains of black stool and git upsets..The best choice to do is to : a) To stop the supplement b) To replace it with parental supplement c) To take it with antacid d) To take it after meal 4- What is the drug indicated to reverse streptokinase-induced bleeding? a) Tranexamic acid b) Vitamin K1 c) Protamine sulfate d) Idarucizumab 5- a patient taking levofloxacin after 4 hours we should given Iron sulphate 14 6- Patient is presented with epigastric pain and he was on oral lron supplement (ferrous sulphate) for IDA. What to do a) Change into parental b) Replace with ferrous fumarate c) Take the oral every other day 7- pt is taking levofloxacin it's recommended to take which drug afterit by 4 hours Iron supplement 8- When to switch into parenteral lron Celiac disease 9- Patient taking ferrous sulphate (GIT intolerance) what is the best to do:- a) Take it every other day b) Replace it with ferrous fumarate c) Can't remember 10- Patient on ferrous sulphate, he has severe GIT symptoms, he could a) replace with ferrous fumarate b) take drug every other day c) Change to parentral iron 11- Indication for paranteral iron intake a) heavy menstruation b) Pregnancy c) celiac disease 12- Doctor prescribed levofloxacin drug for patient with respiratory tract infections, what drug must be taken after levofloxacin by 4 hours Iron supplement 15 13- A patient presented to outpatient clinic with complaints of epigastric pain. His medication history includes ferrous sulphate for iron deficiency anemia. What is the most appropriate advice to be given to this patient? a) Stop ferrous sulphate and shift to parenteral iron sucrose b) Take ferrous sulphate with histamine receptor blocker c) Take ferrous sulphate every other day d) Replace ferrous sulphate by ferrous fumarate 14- What clinical condition could lead to the preference of the parenteral iron gluconate for iron deficiency anemia? a) Heavy menstruation b) Celiac disease c) Pregnancy d) Concomitant vitamin B12 deficiency 15- What is the main mechanism of action of deferoxamine? a) Reversal of cellular toxic effects of iron b) Slows the iron absorption from the GIT c) Forms a non-toxic complex with ferric iron d) Increase the excretion of iron in bile 16  1- why do we give antacid? a) relieve symptoms b) heal ulcer c) prevent ulcer d) Rapid action 2- Hypomagnesemia is a side effect of which drug a) Bismuth b) Misoprptol c) Sucralfate d) PPI ** 3- Treatment of metastatic carcinoid tumor? a) Octreotide *** b) Somatotropin c) Desmopressin 4- Treatment of diarrhea that come from metastatic carinoid tumor a) Octreotide b) Somatotropin 5- How Methylnalterxone affect morphine in which mechanism a) Constipation b) Analgesic c) Euphoria d) respiratory depression 6- doctor will prescibe Brufen, what to give with to avoid ulcer? a) PPi b) Bismuth c) sucrulfate 17 7- To maintain Crohn's disease treatment after failure of 5-asa : a) Azathioprine*** b) Methotrexate c) Infliximab 8- Patient has moderate Crohn's disease presented with alopecia, which drug cause this alopecia : a) Metronidazole b) Cyclosprine c) Methotrexate d) infliximab 9- A patient started to take NSAID.What is the appropriate drug he should take: Omeprazole(for prophylaxis against drug induced peptic ulcer) 10- Antacids are used for: a) Treatment of peptic ulcer. b) Relief of gastric pain. ** 11- A drug used for induction of remission of UC disease: Cyclosporine. 12- A drug used for maintenance of CD: Azathioprine. 13- After percutaneous coronary intervention for myocardial infarction, a 68-year-old patient was prescribed a combination of clopidogrel and small dose aspirin. Which drug should be prescribed to this patent to mimize the risk of gastro-intestinal adverse reaction? a) Misoprostol b) Ranitidine c) Lansoprazole d) Bismuth 18 14- What is the therapeutic benefit of antacids in peptic ulcer discase? a) Prevent ulcer replace b) Rapid pain relief c) Ulcer healing d) Control bleeding from ulcer 15- Which of the following is a characteristic feature of lansoprazole? a) It should be given three times daily for prolonged acid suppressive effect For b) It is a cytochrome P 450 inhibitor c) Its dose should be reduced in renal insufficiency d) It can be used in prophylaxis against NSAIDs induced ulcer 16- A male patient presented to the andrology department complaining of infertility.Semen analysis showed a decrease in sperm count. His medical records revealed that he had been taking a drug to treat ulcerative colitis.What could be that drug? a) Prednisolone b) Sulfasalazine c) Metronidazole d) Mesalamine 17- Which drug could be administrated topically for initial therapy of mild ulcerative colitis confined to the rectum? a) Adalimumab b) 5-ASA c) Budesonide d) Azathioprine 19 18- ppi take along time of action because a) slow release formulation b) irreversible action c) long short have live d) take time for metabolism 19- Which prodrug used for rapid improvement U.C.... a) Olsalasine b) Metronidazole c) Methorixate d) azathioprine 20- why ppl work for long period as it a) irreversible inactivation of the pump b) Has long elemention period 21- misoprostol action a) decrease HCI secretion b) Promote mucosal defense c) netaralization of secreted HCL 22- prodrug drug that has a rapid treatment of ulcerative coli a) Azathioprine b) Methotrexate c) Olsazaine d) metronidazo 23- why ppl work for long period as it a) irreversible inactivation of the pump b) Has long elemention period 24- sulfasalazine is formed of mesalamine and Sulphapyridine 20 25- methotrexate toxicity occur when used with which drug? Pantoprazole 26- What is the mechanism of action of misoprostol? a) Neutralization of the secreted acid b) Decrease gastric acid secretions c) Promotion of mucosal defenses 27- What is the prodrug used for rapid improvement of the symptoms of ulcerative colitis? a) Metronidazole b) Methotrexate c) Olsalazine d) Azathioprine 28- What is the factor responsible for prolonged duration of action of proton pump inhibitors? a) Long elimination half life b) Irreversible of drug action c) Availability as slow-release formulation d) Formation of active metabolite 29- Which molecule is combined with mesalamine to increase its delivery to site of action? a) Beta-alanine b) Sulphapyridine c) Alginic acid d) Magnesium trisilicate 21 30- A 27- year -old is going in a red sea cruise next week. He asks his family physician to prescribe to him a drug to prevent his usual complaint of unpleasant sensation of nausea during such trips? a) Metoclopramide b) Ranitidine c) Scopolamine d) Prochlorperazine 31- Which antiemetic drug could be associated with prolongation of Q-T interval? a) Nabilone b) Scoplamine c) Dowvlamine d) Ondansetron 32- A 65-year-old patient presented to outpatient clinic complaining of less than twice bowel movements per week, straining, hard stools and incomplete evacuation since 3 months. What would be the most appropriate laxative for this patient? a) Psyllium b) Magnesium sulphate c) Balanced polyethylene glycol d) MethyInaltrexone 33- Which drug can be given as one of the pre-anesthetic medications for emergency operations? a) Sucralfate b) Calcium carbonate c) Ranitidine d) Misoprostol 22 34- Which drug could increase the risk of methotrexate adverse reactions? a) Furosemide b) Ranitidine c) Enalapril d) Pantoprazole 23  1- The best drug for long term replacement therapy for hypothyroidism. a) Liotrix b) Liothyronine c) potassium iodide d) thyroxine 2- Best choice for anti thyrotoxicosis long term : a) L-thyroxin b) Liotrix c) Liothyronine d) Liothyronine 3- mechanism specific to propylthiouracil? Peripheral conversion t4 to t3 10) 4- Side effect of glucocorticoid? a) Pulmonary fibrosis hepatoxicity hypertension b) Hypertension hyperglycemia gastritis *** c) Osteoporosis bronchospasm 5- Which drug is preferred for long-term replacement therapy of hypothyroidism? a) Potassium iodide b) Liothyronine c) L-thyroxine 6- Least potent glucocorticoid : a) Prednisone b) Hydrocortisone c) Cortisone d) Methylprednisolone 24 7- Which adverse reactions are associated with long-term glucocorticoid treatment? a) HTN, gastric ulceration, hyperglycemia b) Hepatoxicity, pulmonary fibrosis, HTN c) Hypoglycemia, hypercalcemia, palmar hyperkeratosis d) Osteoporosis, infection, bronchospasm 8- which has the weakest anti inflammatory effect? a) Hydrocortisone*** b) Triamcinolone 9- Which of the following mechanisms is specific for PTU rather than methimazole? a) Inhibition of secretion of TSH b) Blocking of oxidative processes c) Blocking of coupling of iodotyrosines d) Inhibition of peripheral conversion of T4 to T3 10- A patient is taking long term corticosteroids. What is the possible adverse effects: a) Liability for infection, hyperglycaemia and gastric ulcer.*** b) Liability for infection, hyperglycaemia and lung fibrosis. 11- Which hormone can be used to differentiate between primary and secondary adrenal insufficiency? a) Corticotropin b) Somatotropin c) Somatostatin d) Hydrocortisone 25 12- Why is prednisone use preferred over other corticosteroids during pregnancy? a) It crosses poorly through placental barrier b) It is rapidly metabolized by placental enzymes c) It is not activated by fetal liver d) It is rapidly excreted by fetal kidneys 13- Which drug could increase urinary excretion of calcium? a) Vasopressin b) Hydrocortisone c) Estradiol d) Testosterone enanthate 14- What drug is used pre-operatively to decrease the risk of bleeding daring thyroidectomy? a) Propranolol b) Propylthiouracil c) Lugol's iodine d) Prednisone 15- A 28-year-old patient is receiving methimazole for hyperthyroidism for four months. Now,she becomes pregnant. What is the best decision for this patient regarding antithyroid therapy? a) Stop methimazole and follow up thyroxine level b) Decrease the dose of methimazole throughout the pregnancy c) Replace methimazole with carbimazole throughout the pregnancy d) Replace methimazole with propyithiouracil in the first trimester 26 16- Triamcinolone has most potency than hydrocortisone due to a) more effective b) used in lower concentration c) less side effects d) treat autoimmune diseases 17- drug used yo decrease the thyroid bleeding intra operative... a) RAI b) Ithyroxine c) iodine salts d) liotrixin 18- Which drug is used before thyroidectomy for the fear of bleeding a) Lugol iodide b) PTU c) Corticosteroid 19- When we say that triamcilone is more efficient than hydrocortisone that mean a) Has more potency b) Used in smaller concentrations c) More suitable 20- Pt with down syndrome short stature ,drug used to induce growth a) CRH b) Somatotropin c) Somatostatin 21- hydrocortisone uses a) Hypocalcemia b) Cerebral edema,she,anti inflammat c) UC,peptic ulcer,hypercalcemia 27 22- Why we don't use PTU in 2nd and 3rd trimester Hapatotoxic 23- drug used in short stature turner patient a) Somatostatin b) Somatotropin 24- propyl thiouracil is contraindicated in the 2nd and 3rd trimester due to …. Impairment of liver function 25- drug used before surgery to prevent the bleeding during operation a) iodide salt b) propranolol c) radioactive iodine 26- why triamcinolone is more potent than hydrocortisone a) more in effectiveness b) Used in the lower concantration 27- glucocorticoid can be used in treatment of a) Hypoglycemia, hypocalcemia,gastric ulcer b) Cerebral edema, SLE, transplantation reaction c) osteoporosis.HTN 28- Which drug can be used for treatment of a short child with turner's syndrome? a) Corticotropin b) Somatotropin c) Somatostatin d) Octreotide 28 29- Which clinical conditions could be treated with glucocorticosteroids? a) Ulcerative colitis ,gastric ulceration, hypercalcemia b) osreoprosis ,pulmonary fibrosis,hypertensive emergency c) hypoglycemia,hypocalcemia ,bronchospasm d) cerebral edema,systemic lupus ,transplantaion rejection 30- What is the rationale for administration of a synthetic glucocorticoid in congenital adrenal hyperplasia? a) Inhibition of aldosterone synthesis b) Recovery of normal immune function c) Prevention of hypoglycemia d) Suppression of ACTH secretion 31- Which steroid has the highest anti-inflammaton potency? a) Hydrocortisone b) Dexamethasone c) Fludrocortisone d) Prednisone 32- What is the primary mechanism of action of propylthiouracil? a) Inhibiting the secretion of TSH b) Accelerating the peripheral metabolism of T3 c) Inhibiting the peroxidase enzyme d) Decrease the proteolytic release of thyroid hormone 33- Which adverse reaction limits the use of propylthiouracil in the second and third trimester of pregnancy? a) Fetal hoypothyroidism b) Agranulocytosis c) Impairment of liver function d) Hemolytic anemia 29 34- Which of the following is an adverse effect to progestins? a) Hypotension b) Endometrial cancer c) Acne d) Gallbladder stone 30  1- Oral Antiplatelet drug used for myocardial infarction vorapaxar 2- How does cholestyramine decrease the anticoagulant effect of warfarin a) It induces warfarin metabolism b) It forms insoluble complex with warfarin c) It increases the formation of hepatic coagulation factors d) It increases the platelet aggregation 3- which is Oral antiplatelet: a) Tirofiban b) Bivaluridin c) Dabigtran d) Vorapaxar** e) Altepase (Tirofiban is intravenous) 4- Oral antiplate drug used in MI: a) Vexapar b) Dabigatran c) Tirofiban d) Warfarin 5- A pregnant female on heparin and complains of bleeding from gum the best to choose is: a) Lowering the dose b) Replace with rivaroxaban c) Give her protamine sulfate d) Stop heparin 31 6- A thrombolytic during the 1st 6 hours of acute MI a) Vorapaxar b) Warfarin c) Dabigatran d) Tirofiban e) Alteplase 7- Which drug interferes with warfarin a) Fibrates b) Niacin c) Statin 8- why do we give low doeses of asprin for antiplatelet effect? a) preserve endothelial prostacycline b) avoid ulcer 9- Clarithromycin can cause bleeding in a patient taking warfarinby which mechanism: inhibiting cytochrome P450 eenzyme10- 10- A fibrinolytic drug can be taken orally: a) Alteplase b) Streptokinase 11- What is the mechanism of action of rivaroxaban a) A direct ithibitor of factor Xa b) An inhibitor of hepatic synthesis of coagulation factors c) A stimulator of the activity of antithrombin IIT d) An inhibitor of activity of plasminogen activator 32 12- A 60-year-old female patient is admitted to hospital for orthopedic surgery. Postoperatively,she was given an intravenous infusion of unfractionated heparin, On the third day, she developed deep venous thrombosis despite adequate heparin doses.Her platelets'count is 150 x10°/D (N:300x 10°/L).Which drug could be used to control her condition? a) Warfarin b) Enoxaparin c) Dabigatran d) Clopidogrel 13- What is an advantage of the use of low molecular weight heparin? a) Its effect could be monitored by INR b) It is used during cardiac intervention c) It is given by oral route d) It is used safely during pregnancy 14- an antiplatelet medication that inhibits 2a 3b a) Aspirin b) Clopidogrel c) Tirofiban d) vorapaxar 15- a patient had cerebral embolism while having Warfarin Cyp450 indicers 16- which thrompolytic drug llb\llla inhibitor a) Vorapaxan b) Dibagtran c) Tirofiban d) Ticagrelol 33 17- which cause dyspnea a) Vorapaxan b) Dibagtran c) Tirofiban d) ticagrelol 18- female takes warfirin and has stroke, she recently takes Dyslipidimic drug which is.. a) Atorvastatin b) Fenofibrate c) Niacin d) ezetimibe 19- Anti platelet bind reversibly a) Aspirin b) Clopedogil c) Ticagrelor 20- Anti plt bind to GP 2b/3a a) Vorapexar b) Titofiban c) Ticagrelor 21- Drug that antagonise PAR1 a) Vorapexar b) Ticagrelor 22- Advantage of alteplase over streptokinase a) Pt with recent surgery b) Short half life 34 23- Pt was on anti coagulant for his atrial flatter came with thrombosis,on history he mentioned taking another medication recently a) Rosuvastatin b) Cholestramine 24- Why alteplase is preferred over streptokinase? a) Less cost b) Longer half life c) no time limitation for its readminstration d) Safe after recent abdominal surgery 25- Which antiplatelet drug reversibly binds its receptor? a) Clopidogrel. b) Aspirin c) Prasugrel. d) Ticagrelor. Theme:Antithrombotic agents a) Vorapaxar b) Aspirin c) Dabigatran d) Tirofiban e) Ticagrelor Lead in:For each of the following mechanism of action,select the relevant drug list above. 26- Blocks glycoprotein Ilb/llla receptors of platelet aggregation pathway tirofiban 27- Inhibits protease-activated receptor-1 vorapexar 35 28- Which antipsychotic drug has the lowest risk of tardive dyskinesia? a) Chlorpromazine b) Haloperidol c) Clozapine d) Quetiapine 29- Which of the following is a pharmacological action of diazepam? a) Decrease pain sensation b) Relieve of hallucinations and delusion c) Decrease skeletal muscle tone d) Loss of remote memory 30- Which benzodiazepines would be prescribed for a short period to a patient with early insomnia? a) Diazepam b) Triazolam c) Clonazepam d) Alprazolam 31- What is the mechanism of action of rivaroxaban? a) A direct inhibitor of factor Xa b) An inhibitor of hepatic synthesis of coagulation factors c) A stimulator of the activity of antithrombin Ill d) An inhibitor of activity of plasminogen activator 32- Why Alteplase is preferred over streptokit? a) less expensive b) Non-antigenic c) Has a longer duration of action d) Fibrin-non specific 36 1- Asthmatic patient with hypertension and tachycardia came to you.Wh is the best appropriate antihypertensive drug for her ? a) Atenolol b) Captopril c) verapamil*** 2- Which of the following is an ADR for amlodipine? a) Foot swelling b) Constipation c) Lupus-like syndrome d) Hyperkalemia e) Postural hypotension 3- Side effect of (drug from ACEi) is hyperkalemia. 4- Naproxen side effect on furosemide a) increase its excretion in urine b) interfere with its absorbtion c) activate aldosteron d) decrease salt and water retention 5- side effects of DHB CCB? a) foot edema b) postural hypotension 37 Matching(for adverse effects) a) Foot swelling b) Constipation c) Lupus like syndrome d) Hyperkalemia e) Postural hypotension 6- Captopril (d) hyperkalemia** 7- Amlodipine (a) foot swelling** 8- Which drug is used for treatment of htn a) Hydrochlorothiazide** b) Furosemide c) Spironolactone d) Amiloride 9- A drug can cause hyperkalemia: Captopril** 10- An uncontrolled hypertensive patient with sinus tachycardia is taking ACEI. What is the best drug for him: a) Amlodipine. b) Verapamil.**(non-dihydropyridine). 11- patient with resistant hyper tension ( taking 3 drugs) what to add a) Dexacin ( alpha blocker) b) Rosuvastatin c) Nefidipine 12- Hypertensive pt presented with gouty symptoms, what is the drug a) Hydrochlorothiazide b) Verapamil thiazide can cause gout 38 13- Diabetic patient with creatinine 2 ,what is the drug to be used a) Warfarin b) Chlorothiazide c) Dilatiazem d) Don't remember the right answer 14- Patient on 3 antihypertensive drugs with no response as his B.p 160/90, he could take Doxazosin 15- Anti hypertensive drug in diabetic patients RAAS inhibitor 16- Furesmide used in acute Heart failure as it is a) powerfull diuretic b) inc renal blood flow c) pulmonary venodilatation 17- What is the main advantage of nebivolol over bisoprolol? a) Its selectivity for beta-t receptors b) Its vasodilating effect c) lis inhibitory effect on renin release d) Its central inhibitory effect on sympathetic outflow 18- An asthmatic patient presents with hypertension and tachycardia. What is the most appropriate antihypertensive drug that should be prescribed to him? a) Atenolol b) Enalapril c) Nifedipine d) Verapamil 39