Kabarak University DCMED 228 Clinical Pharmacology II Past Paper PDF 2020/2021

**KABARAK UNIVERSITY** **UNIVERSITY EXAMINATIONS** **[MAIN CAMPUS]** **[SECOND TRIMESTER 2020/2021 ACADEMIC YEAR]** **[EXAMINATION FOR DIPLOMA IN CLINICAL MEDICINE]** **[DCMED: 228 CLINICAL PHARMACOLOGY II.]** **STREAM: Y2S2 TIME: 9:00-12:00PM** **EXAMINATION SESSION: JAN. -- APRIL DATE: 11/0...

**KABARAK UNIVERSITY** **UNIVERSITY EXAMINATIONS** **[MAIN CAMPUS]** **[SECOND TRIMESTER 2020/2021 ACADEMIC YEAR]** **[EXAMINATION FOR DIPLOMA IN CLINICAL MEDICINE]** **[DCMED: 228 CLINICAL PHARMACOLOGY II.]** **STREAM: Y2S2 TIME: 9:00-12:00PM** **EXAMINATION SESSION: JAN. -- APRIL DATE: 11/05/2021** **READ INSTRUCTIONS CAREFULLY** 1. The examination paper has **THREE (3)** sections. \[Total 100 Marks\] 2. Write your college number on all sheets of paper used 3. SECTION A has Multiple Choice Questions. \[40 Marks\] 4. SECTION B has Short Answer Questions. \[30 Marks\] 5. SECTION C has Long Answer Questions. \[30 Marks\] 6. Answer questions in the BOOKLET provided. Begin each of the questions in section C in a new page of the answer booklet. **[SECTION A-MULTIPLE CHOICE QUESTIONS. (40MARKS)]**The "minipill"containing only a progestin, rather than combination estrogen-progestin oral contraceptive, was developed because progestin alone a. Results in less depression and cholestatic jaundice b. Is a more effective contraceptive agent than the two combined c. Results in a more regular menstrual cycle d. Is thought to be less likely to induce cardiovascular disorders 1. Tamoxifen is used to treat some breast cancers because of its ability to a. Utilize its androgenic properties in retarding tumor growth b. Enhance glucocorticoids treatment c. Act as an estrogen antagonist d. Act as a potent progestin 2. The following are adverse effects of corticosteroids **except** a. Hyperglycaemia b. Maintain the integrity of inflammatory response c. Osteoporosis d. Aggravate schizophrenia 3. Inhalation corticosteroids include all the following **except** a. Beclomethasone b. Budesonide c. Flunisolide d. Prednisolone 4. The preferred thyroid preparation for maintenance replacement therapy is which of the following drugs? a. Desiccated thyroid b. Liothyronine c. Protirelin d. Levothyroxine 5. False concerning Metformin an oral diabetic agent a. May cause lactic acidosis. b. Is particularly useful in alcoholic diabetic patient. c. Should be discontinued before major elective surgery. d. Cause anorexia and weight loss. 6. Which of the following **is not** a member of the second generation Secretagogue a. Chlopropamide b. Glimepride c. Glibenclamide d. Glipizide 7. Which of the following **is false** regarding Gliclazide a. Is a sulphonylurea. b. Hypoglycemia can be reversed by intramuscular glucagons. c. Should not be prescribed concurrently with metformin. d. Stimulates appetite. 8. A 22-year-old female carrying a preterm pregnancy (33 weeks) is in labor. Which of the following drugs can be given to the mother to promote fetal lung maturity? a. Betamethasone b. Fludrocortisone c. Metyrapone d. Spironolactone 9. Which of the following is untrue about insulin a. Insulin is a polypeptide hormone of complex structure. It plays a significant role in regulation of carbohydrate, fat and protein metabolism. b. Insulin is activated by G.I.T enzymes hence must be given by orally. c. The subcutaneous route is usually ideal in most cases but insulin can be given by IV and IM routes. d. It is injected into the upper arms, thighs, buttocks or abdomen. 10. Which of the following is true about Loperamide a. Is a natural opiate (opioid derivatives). b. Used in management of traveler's diarrhea when combined which antimicrobials. c. Has half-life of 8 hours. d. Is equally potent as morphine in management. 11. All the following agents include cholinesterase inhibitors **except** a. Neostigmine b. Pyridostigmine c. Amphetamine d. Physiostigmine 12. NSAID-non steroidal anti-inflammatory drugs effects include all the following **except** a. Analgesics b. Anti-pyretic c. Anti-inflammatory d. Anti-leukotriene 13. The following agents can be used in treatment of rheumatic diseases **except** a. Azathioprine b. Methotrexate c. Loperamide d. Chloroquine 14. Adverse effects of aspirin include all the following **except** a. Reduced bleeding time b. Tinnitus c. Urticaria d. Bronchospasm 15. Which of the following NSAID'S**are not** Propionic acid derivatives a. Ibuprofen b. Naproxen c. Ketoprofen d. Diclofenac 16. A 65-year-old female has swelling and pain in several of the interphalangeal (IP) joints of her hand. X-ray examination reveals arthritic changes. Which agent **should not be** prescribed? a. Indomethacin b. Acetaminophen c. Diclofenac d. Piroxi 17. The following is true about the effects of adrenaline **except** a. Vasoconstriction b. Bronchoconstriction c. Increased heart rate. d. It is likely to cause cardiac arrhythmias. 18. The following are true about Physiostigmine**except:** a. It is a reversible cholinesterase b. It does not penetrate the blood-brain barrier c. It acts on the muscarinic receptors d. It causes miosis 19. False concerning maintenance treatment of gout a. Inhibition of uric acid formation from purines by xanthine oxidase inhibition is necessary b. Promotion of urate excretion in the urine is useful c. NSAIDS and colchicines are useful in the acute management of gout d. Cessation of alcohol intake is important. 20. Corticosteroids pharmacological effects include the following **except** a. Prevent rejection by immunosuppression b. Pulmonary diseases --No role Bronchial asthma c. Nephrotic syndrome d. Atopic dermatitis 21. Metformin a biguamide is contraindicated in the following cases **except** a. Hepatic impairment b. Diabetic coma c. Severe dehydration d. Non-insulin dependent diabetes mellitus 22. Which of the following are catecholamines a. Salbutamol b. Salmeterol c. Dopamine d. Ephedrine 23. The following include the clinical uses of alpha blockers **except** a. Migraine b. Benign prostate hypertrophy c. Hypotension d. Hypertension 24. Which of the following agents is a true uricosuric agent a. Probenecid b. Colchicine c. Allopurinol d. Indomethacin 25. Which of the following is **false** about ergotamine a. Ergotamine is completely absorbed from the GIT and intravenous administration may be preferred in acute attack of migraine. b. It has a half-life of 2 hours and is extensively metabolized in the liver. c. Ergotamine interacts with several neurotransmitter receptors including alpha-adrenergic, serotonergic and dopaminergic receptors. d. It directly stimulates vascular smooth muscle causing constriction of both arteries and veins and depresses vasomotor centres in the brain 26. True with regards to Tramadol **except** a. Tramadol is as effective as pethidine for post-operative pain and morphine for moderate chronic pain. b. Tramadol is a centrally acting analgesic that acts by binding on m receptors and adrenergic pathways pharmacokinetics. c. Well absorbed for GIT with 30% is excreted unchanged in urine d. Has no analgesic and antipyretics effect. 27. The listed agents below all include opioid antagonists **except** a. Naloxone b. Naltrexone c. Nalmefene d. Tramadol 28. **Diamorphine (heroin)** a. Diamorphine is a synthetic drug made from morphine. b. Diamorphine (diacetyl morphine) is rapidly converted within minutes to morphine and 6-monocetyl morphine, a metabolite of both drugs. c. The effects of heroin are due to action of morphine and 6-monoacetylmorphine d. Has a less rapid onset of pain relief than morphine because it is less lipid soluble and hence enters the brain less readily 29. Pethidine differs from morphine as follows **except: -** a. Does not suppress cough b. Does not cause constipation c. Pupils not constricted d. Has a long duration of action 30. The following drugs are used in acidification of urine **except** a. Ammonium chloride b. Ascorbic acid c. Sodium bicarbonate d. Arginine hydrochloric acid 31. Below statement explains well about urinary pH **except** a. Urine pH is used to classify urine as either dilute acid or base solution b. The glomerular filtrate of blood is usually acidified by kidney. c. Urine pH varies between the extremes of 4.6 and 8.2. This affects the amount of drugs reabsorbed from the renal tubular lumen by passive diffusion. d. Relief discomfort in UTI 32. Among the drugs given below which one **is not used** in treatment of kidney stones? a. Pethidine b. Ergometrine c. Morphine d. Atropine 33. Among the following drugs which one **is not a**Phosphodiastease type 5 (PDE5) inhibitor? a. Apomorphine b. Sildenafil c. Tadalafil d. Vardenafil 34. The following are causes of erectile dysfunction **except** a. Alcohol abuse b. Over sexual activity c. Psychological factors d. Drugs 35. The below statements are true about oxytocin **except** a. It has no effect to antidiuretic hormone in urine output b. Increases the force and frequency of uterine contractions c. Increases electrical activity of myometrial cell membrane d. oxytocin is a peptide neurotransmitter in the hypothalamus and brain where it is used to regulate autonomic nerves 36. One of the following drugs **is not used** in urinary TB a. Rifampicin b. Isoniazid c. Prednisolone d. Hydrochlorothiazide 37. Listed below are indications of diuretics **except** a. Vitamin B deficiency b. Oliguria due to renal failure c. Acute pulmonary oedema d. Barbiturate poisonin 38. Which of the following is a uricosuric drug a. Nitrofurantoin b. Acetyl salicylic acid (ASA) c. Norflaxicin d. Paracetamol 39. Which one of the following drugs is associated with reduced libido a. Frusemide b. Mannitol c. Spironolactone d. Acetazolamide **[SECTION B: SHORT ANSWER QUESTIONS (30 MARKS)]** **ANSWER ALL QUESTIONS.** 1. Outline any **TEN (10)**indications of atropine (5Marks) 2. Outline with relevant example in each the classification of non-selective Cox inhibit (5 Marks) 3. State any **FIVE (5)**clinical uses of non -- steroidal anti -- inflammatory agents (5Marks) 4. State the mechanisms of action of hormonal contraceptives (5 Marks) 5. Outline any **TEN(10)**complications associated with prolonged use of steroids (5 Marks) 6. Class citing examples the classifications of Oral hypoglycemic agents (5 Marks) **[SECTION C: LONG ASSAYS QUESTIONS (30 MARKS)]** **ANSWER ALL QUESTIONS.** 1. Discuss morphine under the following sub-headings a. Pharmacokinetics (5 Marks) b. Indications (6 Marks) c. Contraindications (4 Marks) 2. A diuretic is any substance which increases urine volume and solute excretion a. Outline the indications of a diuretic (5 Marks) b. Classify diuretics giving relevant examples (10 Marks)