Biomedical Sciences Questions - Pharmacy Prep PDF

Pharmacy Prep Biomedical Sciences Q&A Misbah Biabani, Ph.D Director Toronto Institute of Pharmaceutical Sciences (TIPS) Inc. Toronto, ON M2N K7 Pharmacy Prep Professiona...

Pharmacy Prep Biomedical Sciences Q&A 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 415-417 Toronto ON M2N 5M5, Canada WWW.PHARMACYPREP.COM 416-223-PREP (7737) / 647-221-0457 Toronto Institute of Pharmaceutical Sciences Inc. © 2000- 2019 TIPS Inc. All Rights Reserved. Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is strictly prohibited and it is illegal to reproduce without permission. This manual is being used during review sessions conducted by PharmacyPrep  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. ©2000-2019 TIPS. All rights reserved. Foreword by Misbah Biabani, Ph.D Coordinator, Pharmacy Prep Toronto Institute of Pharmaceutical Sciences (TIPS) Inc 4789 Yonge St. Suites 415-417 Toronto ON M2N 5M5, Canada Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is strictly prohibited and it is illegal to reproduce without permission. This manual is being used during review sessions conducted by PharmacyPrep Part 1: Biomedical Sciences 15% 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 and Ear 11. Blood and Anemia 12. Biochemistry 13. Fluids, Electrolytes and Nutrition 14. Microbiology 15. Cell and Molecular Biology 16. Pharmacogenetics 17. Immunology and Immunizations 18. Biotechnology 19. Toxicology Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is strictly prohibited and it is illegal to reproduce without permission. This manual is being used during review sessions conducted by PharmacyPrep Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is strictly prohibited and it is illegal to reproduce without permission. This manual is being used during review sessions conducted by PharmacyPrep  Human Anatomy HUMAN ANATOMY 1. What is the opposite of anterior view? opposite opposite A. Ventral view Abduction Adduction B. Dorsal view Extension Flexion C. Lateral view Lateral Medial Dorsal (posterior) Ventral (anterior) D. Medial view Proximal Distal E. Distal view Prone Supine Ans: B 2. Abduction is an anatomical movement of: A. A muscle, which moves a body part away from the midline of the body. B. A muscle, which moves a body part toward the midline of the body. C. A muscle, which moves a body part downward the body. D. A muscle, which moves a body part upward the body. Ans: A Tips: abduction is moving away from middle line. 3. Adduction is an anatomical movement of: A. A muscle, which moves a body part away from the midline of the body. B. A muscle, which moves a body part toward the midline of the body. C. A muscle, which moves a body part downward the body. D. A muscle, which moves a body part upward the body. Ans: B 4. Movement of limb or body part closer to or towards the mid line of the body is: A. Abduction B. Adduction C. Extension D. Flexion Ans: B 5. Planes and sections of the body: Separates the body into equal right and left portions is referred to as: A. Sagittal plane B. Mid-sagittal plane C. Coronal plane D. Parasagittal plane Ans: B Tips: Sagittal plane separates the body into right and left portions Midsagittal plane (Median plane) separates the body/body part into equal right/left portions Parasagittal plane separates the body into unequal right and left portions. Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being 1-1 used during review sessions conducted by PharmacyPrep.  Human Anatomy Coronal plane separates the body/body-part into anterior and posterior portions. Transverse plane divides the body/body-part into superior and inferior portions. Oblique plane passes through the body/body-part at an angle 6. Epithelial tissue is present in all of the following EXCEPT: A. Sweat gland B. Milk gland C. Endocrine gland D. Blood vessel E. Bile Ans: D Tips: Blood vessel, arteries, veins, and capillaries have endothelial cells. Epithelial tissue: Covering/lining or glandular, are 2 basic types endocrine "ductless" produce hormones. Exocrine have ducts, sweat, oil, saliva, bile enzymes, mucin (mucus). 7. Intramuscular injections are often given in the following areas, EXCEPT: A. Deltoid muscle of the arm B. Vastus lateralis muscle of the thigh C. Ventrogluteal muscle of the hip D. Biceps muscle of the inner arm E. Dorsogluteal muscle of buttock Ans: D Tips: The most typical site for vaccine is deltoid muscle of the arm. 8. All of the following have skeletal muscles, EXCEPT: A. Arm B. Biceps Tips: Heart is made of cardiac tissues. Arm, biceps, triceps and C. Triceps foot is consisting of skeletal muscle. D. Heart E. Quadriceps Ans: D 9. Anterior excruciate ligament is found in? A. Shoulder B. Knee C. Hip D. Ankle E. Arm Ans: B Tips: Anterior excruciate ligament connects to femur, tibia and patella. Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being 1-2 used during review sessions conducted by PharmacyPrep.  Human Anatomy 10. What cavity has lumbar vertebrae? A. Ventral cavity B. Dorsal cavity C. Thoracic cavity D. Abdominal cavity E. Pelvic cavity Ans: B Tips: dorsal cavity consist of cranial cavity and vertebral cavity. 11. Pelvic cavity consists of all, EXCEPT: A. Rectum B. Reproductive organs C. Urinary bladder D. kidney E. Uterus Ans. D Tips: Kidney are present in abdominal cavity. 12. The pelvis bones, or hip joints have? A. Pubis, ilium, and ischium B. Scapula, ilium and ischium C. Humerus, ilium, and ischium D. Ligament, humerus, scapula Ans: A Tips: Hip consists of pubis, ilium and ischium bones. Humerus bone connects from shoulder to elbow. 13. Which of the following does NOT include the cranial bones? A. Facial bones B. Parietal C. Temporal D. Occipital “PEST OF” E. Ethmoid Parietal (2), Ethmoid, Sphenoid, Ans: A Temporal (2), Occipital, AND Frontal. 14. All of the following are in facial bones, EXCEPT: A. Lacrimal B. Mandible C. Vomer D. Hyoid Ans: D Tipd: Hyoid bone is horse shoe shape bone situated in anterior middle line of neck. Facial bones: Nasal (2), Lacrimal (2), Inferior nasal concha (2), Maxilla (2), Mandible (1), Vomer (1), zygomatic (2) and Palatine (2). Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being 1-3 used during review sessions conducted by PharmacyPrep.  Human Anatomy 15. "Articulations" refer to: A. Bone formation B. A joint between two bones C. Bone death D. Structures on bones where muscles attach Ans: B Tips: A joint between two bones is referred to as articulations. 16. Which of the following opposites of anatomical views are incorrect? A. Dorsal and frontal (ventral) B. Lateral and medial C. Prone and Supine D. Sagittal and para sagittal Ans: D 17. Which of the following is not part of the axial skeleton? A. Femur B. Sternum C. Mandible D. Sacrum Ans: A 18. Incomplete closure of the vertebral column results in: A. Kyphosis B. Scoliosis C. Sinusitis D. Spina bifida Ans: D 19. Which of the following joint is "multiaxial ball and socket " type? A. Hip joints B. Knee joints C. Elbow joint D. Shoulder and hip joint Ans: D 20. What are the following muscle fibers that help in muscle contraction? A. Actin and myosin B. Myosin and inhibin C. Inhibin and actin D. Actin, myosin and inhibin Ans: A Tips: Actin and myosin fibers cause contractions. Inhibin is a hormone released from maturing follicles and corpus luteum. Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being 1-4 used during review sessions conducted by PharmacyPrep.  Human Anatomy 21. A muscle which can both flex the hip and extend to the knee is? A. Sartorius B. Rectos femoris C. Semimembranosus D. Biceps femoris Ans: A Tips: The posterior muscle group is made up of the muscles that extend (straighten) the thigh at the hip. These muscles include the gluteus maximus muscle (the largest muscle in the body) and the hamstrings group, which consists of the biceps femoris, semimembranosus, and semitendinosus muscles. 22. Which of the following physical activity is NOT a weight bearing exercise? A. Walking B. Jogging C. Running D. Swimming Ans: D 23. All are examples of weight bearing joints, EXCEPT: A. Hip joints B. Knee joints C. Skull joints D. Shoulder joints Ans: C 24. Which of the following bones is not part of the cranium? A. Sphenoid B. Palatine C. Ethmoid D. Occipital Ans: B Tips: The palatine bones are two irregular bones of the facial skeleton in many animal species. Together with the maxillae they comprise the hard palate. They are situated at the back part of the nasal cavity between the maxilla and the pterygoid process of the sphenoid bone. 25. Which of the following exercises provide the least help in the prevention of osteoporosis or improvement of bone mineral density? A. Jogging B. Walking C. Rope jumping D. Swimming Ans: D Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being 1-5 used during review sessions conducted by PharmacyPrep.  Human Anatomy 26. Melanin is a dark color light sensitive pigment that is found in skin which protects us from? A. Microorganism B. UV radiation C. Excretion of minerals D. Thermal regulation Ans: B 27. Which of the following has incorrect combination of bones to a specific organ? A. Pubic, ilium and ischium B. Radius, ulnar and humerus C. Femur and tibia and fibula D. Ball-and-socket joint, hinge joint Ans: D Tips: Ball -and-socket joints are found in the shoulder and hips. Hinge joints are in knees. 28. Synovial joints include all EXCEPT: A. Hinge joint (elbow joint) B. Saddle joint (thumb joint) C. Gliding joint (wrist joint) D. Neck bones E. Knee joint Ans: D Tips: Ligaments are type of fibrous bones surrounded with synovial fluids in joints such as hip, elbow, thumb, wrist, and knee joints. 29. Popliteal vein pain is an indicator of? A. Deep vein thrombosis B. Intermittent claudication C. Raynaud’s phenomenon D. Coronary artery pain Ans: A 30. What is perleche? A. Dry lips B. Cuts in lips C. Cuts at corner of mouth D. White fluid secretion at the corners of the mouth Ans: C 31. Which of the following is a muscle fiber? A. Femur B. Patella C. Starch Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being 1-6 used during review sessions conducted by PharmacyPrep.  Human Anatomy D. Actin Ans: D 32. Ligaments? A. Connect bone to bone B. Connect bone to muscle BONE TO BONE = LIGAMENT C. Connect to muscle to muscle BONE TO MUSCLE = TENDON D. Connect arteries to bones Ans: A 33. A sprain is an injury to? A. Bones B. Tissues C. Ligament D. Cartilage E. Muscles Ans: C Tips: A sprain is an injury to a ligament caused by over stretching or twisting. The ankle is a common area for sprains. It is mainly the lateral ligaments of the joints that are involved. 34. A strain is an injury to? A. Bones B. Ligament C. Cartilage D. Muscles E. Tendons Ans. D Tips: Strain is an injury to a muscle also, which is also referred as torn or pulled muscle. 35. What organ is found on the left side of the body? A. Liver Right upper Left upper B. Spleen Gallbladder, pancreas Spleen C. Appendix D. Gall bladder Right lower Left lower E. Pancreas Appendix Sigmoid colon Ans: B IBS, IBD, Prostatitis, colorectal Left lower Refer to physician cancer, pelvic inflammatory quadrant disease. Urinary obstructions IBS, IBD, gastroenteritis, ectopic Periumbilical Refer to physician pregnancy IBS, IBD, appendicitis Right lower Refer to Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being 1-7 used during review sessions conducted by PharmacyPrep.  Human Anatomy quadrant physician/emergence Dyspepsia, GERD, pancreatitis Left upper Liver, (hepatitis), gallbladder Right upper (cholecystitis), pancreatitis. 36. What medications cause femur bone pain? A. Proton pump inhibitors B. Antihistamine C. Bisphosphonates D. Anticholinergic Ans: C 37. What is normally found in all connective tissues? A. Albuminoids B. Lipids C. Polysaccharide D. All of the above Ans: D 38. What is true about sciatic nerve? A. Innervate all foot B. Innervate the hips C. Innervate buttock large muscle D. Innervate the quadriceps Ans: A 39. Which of the following bones is considered a sesamoid bone? A. Sternum B. Ethmoid C. Femur D. Patella Ans: D Tips: Sesamoid bones are embedded into tendons or soft bones of knee joints. The patella and fabella are sesamoid bones. 40. Which of the following is not associated with pelvic area? A. Cystitis B. Urethritis C. Pyelonephritis D. Abdomen E. Inguinal hernia Ans. D Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being 1-8 used during review sessions conducted by PharmacyPrep.  Gastrointestinal System GASTROINTESTINAL SYSTEM 1. What are the parts of small intestines in sequence from stomach to rectum? A. Duodenum, jejunum and ileum DJI = Duodenum, jejunum and ileum B. Jejunum, duodenum and ileum C. Ileum, duodenum and jejunum D. Duodenum, ileum and jejunum Ans: A 2. The lower part of gut contains the following microorganisms. A. 10 to 50% anaerobic B. 90 to 99% anaerobic C. 10 to 50% aerobic D. 90 to 99% aerobic Ans: B Tips: The colon has the highest anaerobic bacteria, and it can range from 90 to 99%. 3. When piece of GI organ pushes up through the diaphragm opening in to chest, it is called? A. Hernia hiatus B. Hernia inguinal C. Umbilical hernia D. Femoral hernia Ans: A 4. Which part of the GI tract has the least pH? A. Esophagus B. Stomach C. Small intestine D. Colon Ans. B Tips: The stomach has the least pH, which makes it the most acidic ranging from pH 1.5 to 3.5. 5. What is the most basic (alkaline) section of the gastrointestinal tract? A. Esophagus B. Stomach C. Small intestine D. Colon Ans: D Tips: Colon is the most basic part of the GI tract. Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 2-1  Gastrointestinal System 6. Intrinsic factor is released from? A. G cell B. Stomach C. Parietal cell D. Mucus cell E. Pancreas Ans: C Tips: Parietal cells (also known as oxyntic or delomorphous cells), are the epithelial cells that secrete hydrochloric acid (HCl) and intrinsic factor. They are located in the gastric glands found in the lining of the fundus and in the body of the stomach. They contain an extensive secretory network (called canaliculi) from which the HCl is secreted by active transport into the stomach. 7. Deficiency of parietal cell can cause? A. Deficiency of vitamin D B. Deficiency of vitamin K C. Achlorhydric D. Chlorhydric Ans: C Tips: Tips: Parietal cell produce HCL and intrinsic factors. Achlorhydria or hypochlorhydria refers to states where the production of hydrochloric acid in gastric secretions of the stomach and other digestive organs is absent or low, respectively. 8. A patient with intrinsic factor deficiency developed megaloblastic anemia (pernicious anemia). What is the correct recommendation? A. Oral vitamin B 12 supplements B. Antacids with vitamin B 12 C. Vitamin B 12 injections D. Vitamin B 12 with acidic drugs Ans: C 9. Maltase breaks down maltose to? A. Glucose +fructose A. Glucose +fructose  sucrase B. Glucose + glucose B. Glucose + glucose  maltase C. Glucose + Starch C. Glucose + Starch  amylase D. Glucose + lactose D. Glucose + galactose lactase E. Starch + sucrose E. Starch + sucrose  alpha glucosidase Ans. B Tips: Maltase is the enzyme that breaks down maltose to two glucose units. Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 2-2  Gastrointestinal System ENZYME CARBOHYDRATE PRODUCT Amylase Starch and glycogen Maltose Maltase Maltose Glucose + glucose Sucrase Sucrose Glucose + Fructose Lactase Lactose Glucose + galactose 10. Celiac disease is caused by? A. Deficiency of gluten B. H. pylori infection C. It is type of inflammatory bowel disease D. None of the above Ans: D Tips: Celiac disease is due to sensitivity to gliadin fraction of ingested gluten, resulting in immunologically mediated inflammatory damage to the lining of the small intestine in genetically predisposed individuals. The inflammation may lead to malabsorption by reducing the amount of surface area available for absorption of nutrients, fluids and electrolytes. 11. Steathorrhea can result to? A. Fat absorption impaired B. Indigestion of carbohydrate C. Secretion of vitamin A, D, E and K D. Excessive absorption of lipids Ans: C Tips: Steatorrhea can result into excessive secretion of fat soluble vitamins A, D, E and K. Drugs like Orlistat (Xenical) can cause steatorrhea. 12. Ulcerative colitis occurs at? A. Colon B. Stomach C. All GI tract D. Small intestine Ans: A 13. Excessive acid secretion causes? A. Crohn’s disease B. Peptic ulcers C. Ulcerative colitis (inflammatory) D. H. pylori ulcers E. Irritable bowel disease Ans: B 14. Irritable bowel syndrome (IBS) symptoms include all, EXCEPT: A. Diarrhea B. Constipation Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 2-3  Gastrointestinal System C. GI bleeding D. Bloating E. GI upset Ans: C Tips: Irritable bowel syndrome (IBS) is a chronic disorder with symptoms of bloating, cramps, constipation/ diarrhea, N&V symptoms. On the other hand, Inflammatory Bowel Disease (IBD) and (Crohn's disease and UC) may cause bleeding and diarrhea. 15. Cystic fibrosis is a? A. Disorder of pancreatic secretion. B. Disorder lung function. C. Disorder of bones. D. Disorder of electrolyte imbalance. Ans: B Tips: Cystic fibrosis (CF) is the most common, fatal genetic disease affecting young Canadians. CF is a multi-organ disease affecting primarily the lungs and the digestive system. In the lungs, CF causes severe breathing problems. A build-up of thick mucus makes it difficult to clear bacteria and leads to cycles of infection and inflammation, which damage the delicate lung tissues. They must follow a demanding daily routine of physical therapy to keep the lungs free of congestion and infection. In the digestive tract, CF makes it extremely difficult to digest and absorb adequate nutrients from food. 16. Why are most drugs absorbed from the small intestine? A. Because drug first enters the small intestine. B. Because small intestine has large surface area. C. Because small intestine is not acidic. D. Because small intestine is small. Ans: B Tips: The large surface area of the small intestine is due to the unique structural features of its inner wall or mucosa that is covered in wrinkles or folds called plicae circulares, from which microscopic finger-like pieces of tissue called villi project, and each villus also has finger-like projections called microvilli. The small intestine also has rugae that allow distention and contraction. These features are designed to increase the amount of surface area available for the absorption of nutrients, and to limit the loss of said nutrients to intestinal fauna. 17. Crohn’s disease commonly occurs at the? A. Colon B. Stomach C. Terminal small intestine and colon D. Small intestine Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 2-4  Gastrointestinal System Ans: C Tips: Crohn’s commonly occurs at terminal small intestine and colon. 18. Which of the following protein digestive enzyme is released from pancreas into the small intestine? A. Pepsin B. Trypsinogen C. Maltase D. Sucrase Ans: B Tips: Pancreas produces 3 enzymes amylase, trypsin and lipase and released as pancreatic juice into the small intestine. The other enzymes produced in cells converting villi in small intestine’s ileum are maltase, sucrase, lactase, peptidase, and lipase. 19. Ribonuclease catalyzes? A. RNA to nucleoside B. RNA to DNA C. RNA to nucleotide D. RNA to mRNA E. DNA to nucleotide Ans: C Tips: Ribonuclease is catalyzing enzyme of nucleotide formation from ribonucleic acid. 20. To prevent gastritis in patient taking NSAID for long time use, which of the following is appropriate? A. Give prophylactic antacids. B. Give prophylactic Proton pump inhibitor. C. Avoid long term use of NSAIDs. D. Change NSAID to Acetaminophen. Ans: B Tips: Prophylactic use PPI or misoprostol is recommended to prevent GI problems in patient using long term NSAIDs. 21. A regular customer of your pharmacy is taking treatment of osteoarthritis. Recently, she experienced gastritis? What is correct? A. Patient is using Acetaminophen. B. Patient is using corticosteroids. C. Patient is using NSAIDs. D. Patient is using Methotrexate. Ans: C Tips: Osteoarthritis patients use NSAIDs to treat joint pain. However, this can cause gastritis as a side effect. Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 2-5  Gastrointestinal System 22. What food/diet induces HCl secretion? A. Carbohydrate B. Fat C. Proteins D. Vitamins Ans: C Tips: Proteins stimulate gastrin production and gastrin secretes HCl from parietal cells. 23. About Calcium, all are correct, EXCEPT: A. Calcium is absorbed in all parts of small intestine. B. Two mechanisms of absorption are active transport and passive absorption. C. Lactose and vitamin D enhance calcium absorption. D. The efficacy of absorption increases as calcium intake increases. Ans: D Tips: The efficacy of absorption decreases as calcium intake increases. High doses of Calcium supplements like 1500 mg have to be divided 500 mg tid. 24. What is not true about the gastrointestinal system in elderly populations? A. Increased pH B. Deficiency of intrinsic factors C. Increase GI motility D. Deficiency of Vitamin B 12 E. Vitamin B12 injection is recommended Ans: C 25. A customer of your pharmacy presents with a prescription of Loperamide and Lactulose. He is experiencing abdominal pain and bloating. He has hard-bullet like stools followed by diarrhea. He may be experiencing? A. Ulcerative colitis B. Crohn’s disease C. Inflammatory bowel disease D. Irritable bowel syndrome Ans: D Tips: Ref: CTC e-therapeutics Symptoms of IBS include abnormal stool frequency (a) 3 bowel movements per day; abnormal stool form (c) lumpy/hard stool or (d) loose/watery stool; (e) defecation straining; (f) urgency or also feeling of incomplete bowel movement, passing mucus and bloating. 26. What is true about Sucralfate? A. Cytoprotective or mucosal protective agent. B. Do not take with antacids as sucralfate requires acidic stomach. C. Take on an empty stomach. D. All of the above Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 2-6  Gastrointestinal System Ans: D 27. Mechanism of action of Sucralfate? A. Acts as a barrier preventing acid contact to ulcers. B. Acts by neutralization. C. Inhibits H 2 receptors and prevents HCl secretion. D. Inhibit proton pump inhibitors. Ans: A 28. A person with ASA allergy should avoid taking all EXCEPT? A. Bismuth subsalicylate B. Ibuprofen C. Naproxen D. Acetaminophen Ans: D Tips: Person with ASA allergy must avoid all NSAIDS and COX-II inhibitors. Bismuth subsalicylate contains salicylates and this can have cross allergy. 29. What is true about Bismuth subsalicylate? A. Indicated for the prevention and treatment of diarrhea. B. Have antibacterial action by stimulation of mucus. C. May give dark tongue and stools. D. May be used in ASA allergy. E. A, B and C only Ans: E 30. Bismuth subsalicylate darkens stools by? A. Bismuth decreases bisulfate and has adsorption action. B. It is a side effect. C. As antidiarrheal drug. D. Prevents traveller’s diarrhea Ans: A 31. What is NOT a symptom of irritable bowel syndrome? A. Constipation B. Bleeding from gut C. Nausea and vomiting D. abdominal cramps, and pain Ans: B 32. Anemia due to iron deficiency includes all, EXCEPT: A. Peptic ulcer B. Pregnancy C. Menstruation Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 2-7  Gastrointestinal System D. GERD E. NSAID associated GI bleeding Ans: D 33. A patient has osteoarthritis using medication for pain. Now patient developed gastritis. What drugs patient may be on? A. Morphine B. Codeine C. NSAIDS D. ASA 81 mg Ans: C 34. Which of the following GI conditions is NOT associated with GI bleeding? A. Gastritis B. Gastroenteritis C. Pancreatitis D. GI cancer E. Inflammatory bowel disease Ans: C Tips: Pancreatitis has no GI bleeding and pancreatitis symptoms are upper abdominal pain that radiates into the back. It may be aggravated by eating, especially foods high in fat. It is characterized by tender abdomen, nausea and vomiting and increased heart rate. 35. Chronic alcoholism may cause? A. Gastritis B. Crohn's disease C. Peptic ulcer D. GI cancer Ans: A Tips: NSAIDs, smoking and chronic alcoholism cause gastritis. Gastritis causes inflammation of the GI lining. The most common cause of gastritis in Canada is due to chronic alcoholism. 36. Which of the following bacteria can cause chronic peptic ulcer disease? A. E. coli B. H. pylori C. S. aureus D. S. pneumonia Ans: B 37. What is the laboratory test to confirm the peptic ulcer disease caused by H. pylori? A. Endoscopy B. CT scan Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 2-8  Gastrointestinal System C. Urea Breath Test (UBT) D. Esophagogastroduodenoscopy Ans: C Tips: UBT is the confirmation test for H. pylori associated ulcers as it is highly sensitive and specific. 38. What type of hernia is common in seniors or elderly? A. Hiatal hernia B. Sliding hernia C. Para esophageal hernia D. Inguinal or groin hernia Ans: D Tips: Inguinal or groin hernia is the most common in middle to elderly age people. 39. Fistula or granulomas or skip patches occur in? A. Irritable bowel disease B. Ulcerative colitis C. Crohn's disease D. Gastritis Ans: C 40. Polypeptides and caffeine stimulate secretion of? A. Parietal cells B. Vitamin B 12 C. Gastrin D. Chyme Ans: C 41. When parietal cells are stimulated, they secrete? A. Intrinsic factor and gastrin B. Intrinsic factor and HCl C. Intrinsic factor and HCO 3 D. Intrinsic factor and mucus Ans: B 42. A patient of your pharmacy, recently had gastrectomy and ileum was removed. Which of the following can be deficient? A. Iron leading to Iron deficiency anemia. B. Calcium due to deficiency of vitamin D. C. Vitamin B 12 due to deficiency of intrinsic factor. D. Vitamin K due to deficiency if GI bacteria. Ans: C 43. Innervation of Vagal nerve cause? Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 2-9  Gastrointestinal System A. Constipation B. Diarrhea C. Urinary retention D. Urinary incontinence Ans: B Tips: vagal nerve act as parasympathetic (cholinergic) nerve cause diarrhea. Anticholinergic drugs cause constipation. 44. Achlorhydric patient decreases absorption of? A. Cyanocobalamin B. Calcium carbonate C. Iron supplements D. Nutrient E. Food Ans: B Tips: achlorhydric is a state of less acidic; calcium carbonate has higher absorption in chlorhydric. Calcium citrate does not require acidic environment for absorption. 45. What is the first line treatment for GERD? A. Aluminum antacids B. Calcium antacids C. Omeprazole D. Ranitidine Ans: C Tips: Ref CTC e-therapeutics PPIs are the drugs of choice in most GERD patients with or without mucosal injury and for extraesophageal manifestations. 46. 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 Ans: A Tips: Ref: CTC e-therapeutics Endoscopy is most appropriate in dyspeptic patients with 1 or more of the following: >50 years of age; alarm signs such as vomiting, bleeding, anemia, weight loss and dysphagia; or failure to respond to initial management strategies Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 2-10  Gastrointestinal System 47. What is present in gastrointestinal tract (GIT)? A. PGE1 Arachidonic acid B. PGE2 ↓ C. PGF2 alpha Prostaglandin (PG) PGE1 and PGE2 D. A and B protects GI mucosa. Ans: D Tips: PGE1 analogs misoprostol is for gastric mucosal protection. 48. What is incorrect about digestive enzymes? A. Protease breaks down proteins. B. Amylase breaks down carbohydrates. C. Lipase breaks down fats. D. Nuclease breaks down proteins. Ans: D Tips: Nucleic acid digestion is catalyzed by Nuclease and Nucleosidase. Proteins digestion is catalyzed by Pepsin, Trypsin, and Peptidases. Carbohydrate digestion is catalyzed by salivary amylase, pancreatic amylase, altase Fat digestion is catalyzed by Lipase. 49. All of the following digestive enzymes are produced from the pancreas, EXCEPT: A. Pancreatic amylase B. Trypsin C. Lipase D. Gastrin E. Nuclease Ans: D Tips: Gastrin is produced from stomach’s G-cell. Pancreatic enzymes include pancreatic amylase, Trypsin, Lipase, Nuclease, and Nucleosidase. 50. A patient presented with epigastric pain after meals and this awakens him at night. He experiences heartburn that is not responded by antacids. Pharmacist referred patient because patient may be experiencing? A. GERD B. Peptic ulcer C. Ulcerative colitis D. Crohn’s disease Ans: B Tips: peptic ulcer symptoms are epigastric pain after meals. GERD has no pain but mainly heartburn. 51. Correct statements regarding the characteristics of hernias may include: A. It is a protrusion of a loop of an organ or tissue normally through the GI area Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 2-11  Gastrointestinal System B. Hernia hiatus is a herniation of stomach through the esophageal hiatus of diaphragm C. Strangulated hernia is an incarcerated hernia that is so tightly constricted as to compromise the blood supply of the contents of the hernia sac. D. All are correct Ans: D Tips: Hernia is a protrusion of a loop of an organ or tissue normally through the GI area. Hernia hiatus is a herniation of the stomach through the esophageal hiatus of the diaphragm. Strangulated hernia is an incarcerated hernia that is so tightly constricted as to compromise the blood supply of the contents of the hernia sac. 52. Which of the following influences the release of pancreatic juice and bile? A. Cholecystokinin and secretin B. Secretin and gastrin C. Cholecystokinin and gastrin D. Renin and cholecystokinin Ans: A Tips: Cholecystokinin stimulates pancreas and bile from the gallbladder. Secretin is released into the blood stream and acts on the acinar cells of the pancreas to secrete water and bicarbonate into the pancreatic ducts that drain into the duodenum. 53. Gastric emptying slowed by all the following, except? A. Fatty food B. Vigorous exercise C. Hot meal D. Hunger E. Emotional stress Ans. C Tips Factors promote stomach emptying Factors Inhibit gastric emptying Gastric volume (increase food volume in Duodenal distention, stomach promotes gastric emptying. High intensity, intermittent exercise can slow gastric emptying Clear liquids empty rapidly than solid Fats and proteins breakdown in small food intestine Protein empty fastest than Temperature cold liquids (4c) empty carbohydrate and then fats slowly Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 2-12  Nervous System NERVOUS SYSTEM 1. Which part of the brain controls important cognitive skills in humans, such as emotional expression, problem solving, memory, language (mesolimbic pathways)? A. Frontal lobe B. Occipital lobe C. Temporal lobe D. Parietal lobe Ans: A 2. Blood brain barrier is present at? A. Endothelial cells lining capillaries in cerebrospinal tissues. B. Epithelial cells lining cerebrospinal tissues or capillaries. C. Epithelial cell lining cerebral artery capillaries. D. In blood circulations capillaries. Ans: A 3. What is the difference between nociceptive pain and nerve pain? A. The nerve pain is slower or chronic. B. Nociceptive pain does not involve myelin sheets. C. Nerve pain affects the vertebral spinal column. D. Nerve pain are neuralgia or neuropathic pain E. All of the above Ans: E 4. Only acts on sympathetic nervous system? A. Heart B. Eye C. Gall bladder D. Tongue E. Gastrointestinal tract Ans: D 5. A man is unable to hold a typing paper between his index and middle finger. Which of the following nerves was likely injured? A. Radial nerve B. Median nerve C. Ulnar nerve D. Axillary nerve Ans: B Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is 3-1 being used during review sessions conducted by Pharmacy Prep.  Nervous System Tips: Median nerve compressed at the wrist in numbness or pain between the index and middle finger. 6. Dyskinesia is associated with? A. Cerebrum B. Cerebellum C. Spinal cord D. Thalamus Ans: B 7. Which part of the brain controls respiration? A. Corpus collasum B. Cerebellum C. Medulla oblongata D. Thalamus Ans: C Tips: Medulla oblongata is the part of the brainstem that helps regulate autonomic function (involuntary organ function) breathing, heart and blood vessel function, digestion, sneezing, and swallowing. 8. A patient has difficulty in chewing and is also experiencing problems during mastication. What cranial nerve is responsible for mastication? A. Vagus B. Olfactory C. Glossopharyngeal D. Optic E. Trigeminal Ans: E 9. MP is 30-yo man who presents at your pharmacy with high fever and muscle stiffness. Pharmacist refers patient to the emergency. Patient is likely using which of the following medication? A. Bromocriptine Dopamine antagonist: Haloperidol, is used B. Tetracycline schizophrenia (psychosis). These drugs C. Haloperidol increase body temperature and cause D. Fluoxetine Neuroleptic malignant syndrome. E. Phenelzine Ans: C 10. Which of the following is NOT a Parkinson’s disease symptoms? A. Tremors B. Rigidity C. Dyskinesia D. Tardive dyskinesia Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is 3-2 being used during review sessions conducted by Pharmacy Prep.  Nervous System Ans: D Tips: Tardive dyskinesia is associated with extra pyramidal symptoms caused by antipsychotic drugs like haloperidol. However, Parkinson’s disease does not cause tardive dyskinesia. 11. Vagus nerve innervates? A. Vision B. Auditory function C. Laryngeal D. Defecation Ans: D 12. Which of the following is NOT a sensory (somatic) nerve? A. Ulnar B. Radial C. Esophageal nerve D. Sciatic Ans: C 13. Which of the following statement is correct about sciatic nerve? A. It passes through the neck down to the buttocks. B. It passes through the posterior thigh and all of the leg and foot. C. It passes through the elbow to wrist. D. It passes through knee down to foot. Ans: B Tips: Sciatic nerve is the branch of sacral plexus. It divides into tibial and common fibular nerves, which supplies the muscles of the posterior thigh and all of the leg and foot. 14. Damage of the axillary nerve is thought to cause? A. Paralysis of the fifth finger B. Impaired sensation C. Numbness of extremities D. Inability to bend elbow Ans: D Tips: Axillary nerve supplies deltoid and teres minor muscles, shoulder joint, and skin on back of the arm. 15. Damage to radial nerve can cause? A. Inability to move neck B. Inability to move shoulders C. Inability to move wrist and fingers D. Inability to move toes Ans: C Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is 3-3 being used during review sessions conducted by Pharmacy Prep.  Nervous System Tips: Radial nerve is a branch of brachial plexus. It supplies the triceps brachii, brachioradialis, and muscle of the extensors compartment of forearm. Radial nerve palsy (wrist drop) is caused by prolong compression of radial nerve, which runs along the underside of bone in the upper arm. It is also called Saturday night palsy. It usually improves once the pressure is relieved. 16. A CNS disease where the myelin sheath of motor neurons is degenerating or being destroyed, which interferes with neuronal impulses? A. Parkinson's Disease B. Multiple sclerosis C. Alzheimer's dementia D. Fibromyalgia Ans: B 17. Betahistine is the drug of choice for Meniere’s disease and it is a: A. Histamine agonist B. Histamine antagonist C. First generation antihistamine D. Anticholinergic Ans: A 18. Lesions of substantia nigra are caused by destruction of dopaminergic neurons that occur in patient with? A. Alzheimer's disease B. Migraine C. Meniere's disease D. Parkinson's Disease Ans: D 19. Involuntary functions are controlled by? A. Cerebellum B. Cerebrum C. Cortex D. Hypothalamus Ans: B 20. Dopaminergic pathways are associated with? A. Occipital lobe B. Middle lobe C. Frontal lobe D. Temporal lobe Ans: C Tips: Dopaminergic pathways are associated with frontal lobes Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is 3-4 being used during review sessions conducted by Pharmacy Prep.  Nervous System 21. Compression of ulnar nerve at the elbow will cause? A. Numbness of small fingers B. Wrist drops C. Inability move elbow D. Inability to move shoulder Ans: A Tips: Cubital tunnel syndrome (ulnar nerve compression in elbow). Ulnar nerve innervates small fingers. 22. All of the following drugs have CNS side effects, EXCEPT: A. Rifampin B. Cefuroxime sodium C. Diphenhydramine D. Ipratropium Ans: D 23. Which of the following medical condition is associated with behavioral problem? A. Restless leg syndrome B. Dementia C. Schizophrenia D. Alzheimer’s disease Ans: C Tips: Behavioral problems include major depression, mania, and schizophrenia. 24. The area of the brain associated with Alzheimer’s disease? A. Frontal lobe B. Temporal lobe C. Occipital lobe D. Brain stem Ans: A 25. What is nystagmus? A. Eye adjustment problem B. Rapid eye movement C. Eye imbalance D. Eye visual fixation problem E. Vestibular problem Ans: B 26. Which of the following drug has nystagmus as side effect due to CNS toxicity? A. Carbamazepine B. Valproic acid C. Lamotrigine D. Phenytoin Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is 3-5 being used during review sessions conducted by Pharmacy Prep.  Nervous System Ans: D Tips: Phenytoin toxicity side effect is nystagmus. 27. Which of the following antibiotics can be used to treat meningitis? A. Tetracycline B. Rifampin C. Vancomycin D. Metronidazole Ans: B 28. Radial nerve passes through what region? A. Arm B. Shoulder C. Wrist D. Forearm E. Chest Ans: D 29. Injury to axillary nerve results in loss of sensation over? A. Arm B. Shoulder C. Wrist D. Elbow Ans: D Tips: Injury to axillary nerve causes inability to bend elbow. 30. Sensory receptors differ from pain receptors such that they: A. Are less affected by morphine analgesic dose. B. Unmyelinated C. Response is more delayed. D. Ends in ventral spine Ans: A Tips: Sensory Receptors are specialized neurons or nerve endings that respond to changes in the environment by converting energy from a specific stimulus into an action potential (a process known as transduction). Pain receptors are any one of the many free nerve endings throughout the body that warn of potentially harmful changes in the environment, such as excessive pressure or temperature. The free nerve endings constituting most of the pain receptors are located chiefly in the epidermis and in the epithelial covering of certain mucous membranes. They also appear in the stratified squamous epithelium of the cornea, in the root sheaths and the papillae of the hairs, and around the bodies of sudoriferous glands. The terminal ends of pain receptors consist of unmyelinated nerve fibers that often anastomose into small knobs between the epithelial cells. Any kind of stimulus, if it is intense enough, can stimulate the pain receptors in the skin and the mucosa, but only radical changes in pressure and certain chemicals can stimulate the pain receptors in the viscera. Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is 3-6 being used during review sessions conducted by Pharmacy Prep.  Nervous System 31. MP is a 30-year-old patient who presented at your pharmacy for refill of Risperidone. Pharmacist counselled him in the counseling room. The pharmacist noticed that the patient got up several times and sat, and at one point, he went out of the counseling room but returned a few moments later. Patient may be experiencing, which of the following condition? A. Parkinson’s symptoms B. Alzheimer symptoms C. Tardive dyskinesia D. Akathisia Ans: D Tips: Akathisia = restlessness or cannot sit still. 32. All are involved in the knee jerk reflex EXCEPT: A. Sensory nerves B. Motor neurons C. Quadriceps D. Calcaneous bone Ans: D Tips: foot of the tarsus is a bone of the heel bone. Image result for calcaneus bone The calcaneus, also called the heel bone, is a large bone that forms the foundation of the rear part of the foot. The calcaneus connects with the talus and cuboid bones. The connection between the talus and calcaneus forms the subtalar joint. 33. Cerebrospinal fluid (CSF) circulates through all of the following, EXCEPT: A. Corpus callosum B. Lateral ventricles in brain C. 4th ventricles D. Cerebral aqueduct E. Central Canal Ans: A 34. Which of the nerve plexuses serve the shoulder and arm? A. Sacral B. Cervical C. Phrenic D. Brachial Ans: D 35. What innervates sciatic nerve? A. Innervates whole foot B. Innervates hips C. Innervates large muscle of buttock Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is 3-7 being used during review sessions conducted by Pharmacy Prep.  Nervous System D. Innervate quadricep Ans. C 36. Destruction of radial nerve cause? A. Difficulty straightening elbow B. Difficulty moving shoulders C. Effecting knee function D. Effecting index fingers E. Effect on wrist function Ans. E 37. Cell for regeneration myelin sheath? A. Schwan cell B. Myoglia C. Dendritic cells D. Neurons E. Nephrons Ans. A Tips: Demyelination is observed in multiple sclerosis. Schwan cells are main glial cells of the peripheral nervous system which wrap around axons of motor or sensory neurons to form myelin sheath. 38. In blood brain barrier the Mono amino oxidase enzyme carries out A. oxidative deamination metabolic reactions B. Cytochrome oxidation C. Catalysis of proteins D. Oxidation of lipids E. Oxidation of carbohydrates Ans. A 39. Lewy bodies are proteins in nerve are present in? A. Parkinsonism B. Psychosis C. Depression D. Epilepsy E. Multiple sclerosis Ans. A Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is 3-8 being used during review sessions conducted by Pharmacy Prep.  Cardiovascular System CARDIOVASCULAR SYSTEM 1. Absolute refractory period (ARP) reflects the time during which no action potential can be initiated regardless of how much inward current are supplies. The ARP begins and ends at. A. Phase I to Phase 4 B. Phase 0 to phase 1 C. Phase 1 to phase 2 D. Phase 1 to phase 3 E. Phase 2 and 3 only Ans: D 2. Pathway of blood from systemic circulation to liver? A. Mesenteric vein and portal vein B. Portal artery and hepatic vein C. Portal vein and hepatic artery D. Hepatic vein and portal artery Ans. A 3. What is incorrect about lymphatic system? A. Has No duct vessels or lymphatic valves B. Connect between arteries and veins C. Plasma proteins are absent D. Consist of WBC E. Platelets and red blood cells are absent Ans. A Tips: Lymphatic structures are lymphatic duct, lymphatic vessels, thymus, spleen, lymph nodes, lymphatic capillaries. 4. Change in cardiac automaticity (spontaneous activity initiated by cardiac cells generating periodic oscillations) is most directly associated with change in which slope of myocardial action potential? A. Phase 0 B. Phase I C. Phase 2 D. Phase 3 E. Phase 4 Ans. A 5. Which of the following is not related to lymphocytes? A. Lymph nodes B. Thymus gland 4-1 Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep.  Cardiovascular System C. Thoracic duct D. Spleen E. Thyroid gland Ans. E Tips: Thyroid gland is not part of lymphocytes. Lymphocytes include: Tonsils and adenoid gland, thymus, lymph nodes, spleen, bone marrow and lymphatic vessels. 6. Which of the vasoactive hormone causes arterial constriction? A. Antihistamines B. Bradykinin C. Prostaglandin D. Thromboxane A 2 E. Prostacyclin Ans: D 7. Myocardial contractility is best correlated with the intracellular concentration of A. Free Ca2+ B. Free Na+ C. Free K+ D. Free Cl- E. Free Mg2+ Ans: A 8. Aldosterone is secreted by adrenal cortex. What is incorrect about aldosterone? A. Increases sodium chloride (NaCl) reabsorption by the renal distal tubules thereby increase blood volume and arterial pressure B. It causes vasoconstriction of the arterioles, thus increase TPR and mean arterial pressure. C. Angiotensin II stimulates the synthesis and secretion of aldosterone by the adrenal cortex D. K+ excretion from renal distal tubule and water retention along with Na+ E. Acts as long-term regulator or blood pressure Ans: B 9. Repolarization process produces? A. Negative charge in cell B. Sodium ion influx C. Chloride efflux D. Excessive positive charge inside cell E. Excessive negative and positive charge inside cells Ans. A Tips: in repolarization state cell goes negative charge. 4-2 Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep.  Cardiovascular System 10. What disease is NOT associated thrombus in circulatory system? A. Acute coronary syndrome B. Acute stroke C. Stable angina D. Ischemic heart diseases E. Raynaud phenomenon Ans. E 11. Embolus is? A. Floating blood clot B. A blood clot at site of plaque C. Fibrin clot D. Bulging of arteries E. Hemorrhage Ans: A 12. The electrical activity occurred during depolarization and repolarization transmitted through electrodes attached to the body and transformed by an electrocardiograph (ECG) in to series of waveforms. The "QRS" wave indicates? A. Atrial depolarization B. Ventricular depolarization C. Atrial repolarization D. Ventricular repolarization E. Plateau Ans. B Tips. QRS is activation ventricles, P wave indicate activation atrium and T wave is recover wave. 13. Q-T prolongation (prolong interval) can cause? A. Atrial fibrillation B. Supraventricular fibrillation C. Ventricular fibrillation or ventricular tachycardia D. Arrhythmias E. None of the above Ans. C 14. Which of the following conditions risk factor is NOT related to first degree relative (family history)? A. Premature cardiovascular disease B. Type 2 Diabetes C. Coronary artery diseases D. Dyslipidemia E. Hepatitis Ans: E 4-3 Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep.  Cardiovascular System 15. Which of the following is the indicator of ventricular activation? A. P wave B. Q wave C. Q-T wave D. QRS wave E. T wave Ans: D 16. Which of the following medical conditions patient is recommended to self care by using of tight stockings? A. coronary artery disease B. Heart failure C. Stroke D. Deep vein thrombosis E. All of the above Ans: D 17. Atrial fibrillations ECG or changes in electrode potential curve shows absence or change of? A. P wave B. QRS wave Atrial fibrillation is the major risk factor for stroke. C. T wave (blood clot or thrombus in brain or cerebral artery) D. QT wave E. U wave Ans: A Tips: Atrial fibrillation is regularly irregular atrial rate that can change P wave. Atrial fibrillation is the major risk factor for stroke. Frequent P waves appears in atrial fibrillation. 18. Which one of the following ECG wave are associated with ventricular depolarization? A. P wave B. QRS wave C. T wave D. QT interval prolongation E. U wave Ans: B There are three waves. QRS is activation ventricle depolarization. P wave indicate activation atrium or atrial depolarization. T wave is recovering wave. 19. Which of the following cardiovascular disease is the least commonly associated with atherosclerotic plaques? A. Angina B. Myocardial infarction C. Congestive heart failure D. Ischemic stroke 4-4 Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep.  Cardiovascular System E. Raynaud's phenomenon Ans. E Tips: Raynaud’s phenomenon is due to vascular constriction in limbs. Atherosclerosis leads to formation of plaques and facilitate blood clot formation. The most common conditions associated with atherosclerosis are angina, myocardial infarction, deep vein thrombosis and stroke, however Raynaud’s phenomenon is due to vascular constriction in limbs. If stable plaque than commonly cause angina, if plaque is ruptured than cause inflammation can lead to MI. 20. 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 21. A patient diagnosed with atrial fibrillation. What is correct? A. P wave is absent B. P and QRS wave is absent C. QRS wave is affected D. T wave is affected E. QT prolongation Ans. A 22. A client at pharmacy blood pressure monitor shows 140/80 and his home blood pressure monitor shows 160/85. What is appropriate to do? A. Refer to doctor to get prescription of hypertension treatment B. Tell patient to check second time blood pressure at pharmacy C. Tell patient to go to emergence D. Tell patient to check blood pressure at home again E. Tell patient to not to worry Ans. B 23. Which of the following blood pressure patient will begin pharmacotherapy for blood pressure management? A. 140/80 B. 140/85 C. 140/90 D. 130/80 E. 130/85 Ans. C 24. MP is 50-year old women with type 2 DM for the 5 years. Recently she has been diagnosed with hypertension. Her doctor considering to initiate antihypertensive therapy, because, her blood pressure is? A. Greater than 140/90 4-5 Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep.  Cardiovascular System B. Greater than 130/80 C. Greater than 135/90 D. Greater than 130/85 E. Greater than 120/80 Ans. B Tips: The target blood pressure in diabetic patient and chronic kidney disease should 3 mg/mL B. Hypoalbuminemia C. Edema D. Hyperalbuminemia E. hyperlipidemia Ans: A 26.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 media B. NSAIDs or COX-II inhibitors C. Volume depletion D. Strict blood pressure or blood glucose control E. Aminoglycosides Ans. D Copyright © 2000-2018 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 6-6  Renal Disorder 27. Severe renal disease stage 5. The creatinine clearance? A. 6 times a year, except A. Topical acyclovir B. Oral acyclovir C. It heals by itself D. Topical protectant docosanol E. Very hard violent surgery Ans: E Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 14-10  Microbiology 49. 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 50. Which of the following infections is NOT related to virus? A. Prion disease B. Measles C. Shingles D. Keratoconjunctivitis E. Cold sore Ans: A Tips: Prion is a small infectious particle composed of abnormal folded protein. Prion disease. (Creutzfeldt-Jakob) caused by prions. Or transmissible spongiform encephalitis. It can occur in human and animals (mad cow disease). 51. 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 52. E. coli is? A. gram negative bacilli B. gram positive bacilli C. gram negative cocci D. gram positive cocci Ans: A Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 14-11  Microbiology Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 14-12  Cell and Molecular Biology CELL AND MOLECULAR BIOLOGY 1. Centrosomes? A. Centrosomes contains acid hydrolyzing enzyme B. Centrosomes are main organizing microtubule center 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. Ans: B Tips: Centrosomes are organizing microtubule center Lysosome contains acid hydrolyzing enzyme. Endoplasmic reticulum contains protein (rough) and lipid (smooth) synthesis. Ribosomes are primary site for biological protein synthesis. Peroxisomes contain enzymes that produces and decomposes hydrogen peroxides. Peroxisomes breakdown long chain fatty acids. 2. Genetic information is stored on? A. RNA B. DNA C. Gene D. chromosome E. Ribosome Ans: C 3. What base is NOT found in ribonucleic acid (RNA): A. Thymine B. Adenine C. Guanine D. Cytosine E. Uracil Ans: A 4. The DNA exists as a double helix in which polynucleotide chains consist of a sequence of nucleotides linked together by phosphodiester bonds, joining adjacent deoxyribose moieties. The hydrogen bonding between holds the two polynucleotide strands together bases in opposing strands called as the complementary base-pairing. What is incorrect base-pairs complimentary pair? A. Adenine (A) is always paired with Thymine (T) B. Guanine (G) is always paired with Cytosine (C) C. Adenine (A) is always paired with Cytosine (C) D. Cytosine (C) is always paired with Guanine (G) Ans: C Tips: AT and GC is always compliment Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 15-1  Cell and Molecular Biology 5. Glycoprotein are conjugated proteins; these proteins are linked to: A. DNA B. RNA C. mRNA D. Carbohydrates E. Lipids Ans: D Tips: glycoproteins are linked to carbohydrates 6. An enzyme that cleaves deoxyribonucleic acid (DNA) at a specific site is called: A. A Trypsin B. Restrictive ribonuclease C. Restrictive endonuclease D. Plasmid E. reverse transcriptase Ans: C Tips: Restrictive endonuclease cleaves the DNA at a specific site. 7. What is incorrect? A. DNA replication; DNA  DNA B. Transcription: DNA RNA C. Translation: RNA Proteins D. Reverse transcription DNAmRNA Ans: D 8. Anticodons are present on? A. DNA B. mRNA C. tRNA D. rRNA E. All of the above Ans: C 9. What is true about codon? A. present in tRNA B. consist of 3 nucleotide base that express one amino acid C. c. Segment of DNA express gene D. Antisense oligonucleotide Ans: B 10. Which of the following is the highest percent of RNA type? A. mRNA B. tRNA Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 15-2  Cell and Molecular Biology C. cRNA D. rRNA E. dRNA Ans: D Tips: rRNA80%, tRNA15%, mRNA5% 11. Which of the following is recombinant DNA A. rDNA B. R-DNA C. cDNA D. mDNA E. tDNA Ans: A Tips: rDNA is recombinant DNA 12. All are related polymer chain reaction (PCR), except? A. DNA magnification B. Endonuclease C. DNA polymerase D. Taq polymerase E. Thermos aquaticus Ans: B 13. 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 14. In the manufacture of drugs via DNA technology, the DNA material is microscopically inserted into the: A. Cytoplasm B. Nucleus C. Endoplasmic reticulum D. Cell wall E. Cell membrane Ans: B 15. 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 Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 15-3  Cell and Molecular Biology 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 XX = Women with hemophilia w XY = Man with hemophilia X XX XY XY = Man with NO hemophilia X XX XY XX = Women with hemophilia carrier 16. Bases found in DNA is/are I. Uracil II. Cytosine III. Thymine A. I only B. III only C. I and II only D. II and III only E. All are correct Ans: D 17. What is not a complimentary pair? A. G-C B. T-A C. A-G D. A-U E. C-G Ans: C 18. What is codon? A. specific set of three bases are codons and these are expressed at transcription 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 19. What is cDNA? A. DNA template produced by mRNA, is complementary DNA (cDNA) 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 Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 15-4  Cell and Molecular Biology 20. Functions of restrictive endonuclease include? A. Cut DNA into piece B. Cut RNA into pieces C. Cut DNA and RNA into pieces D. Join DNA pieces E. Join RNA pieces Ans: A Tips: The enzymes of bacteria restrict the replication of viral genome but cutting the DNA into pieces. 21. Antisense technology targets? A. Codons that stop 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: B 22. Which of the following is NOT related to plasmid? A. Bacteria B. Virus C. DNA D. Eukaryotic cell E. Prokaryotic cell Ans: D Tips: eukaryotic cells have linear DNA. Circular DNA is plasmid and only present in prokaryote cells. 23. 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. D.T-G and G-C E. A-U and G-C Ans: D Tips: All of the above are complementary pairs except T-G and G-C 24. What is NOT used in inserting DNA sample into a plasmid? A. DNA B. Plasmid C. DNA ligase D. Topoisomerase II E. All of the above Ans: D Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 15-5  Cell and Molecular Biology 25. Single or unpaired chromosome is referred as? A. Hapten B. Haploid C. Diploid D. Immunogens E. Antigen Ans: B Tips: Single chromosomes is referred as haploid and present in prokaryotes. Paired chromosome is diploid and present in eukaryotes. 26. Low molecular weight compounds that act as immunogens after chemically complexing to a larger molecule or cell surface. A. Hapten B. Haploid C. Diploid D. Immunogens E. Antigen Ans: A 27. What base is NOT found in deoxyribose nucleic acid (DNA)? A. Thymine B. Adenine C. Guanine D. Cytosine E. Uracil Ans: E Tips: Uracil is not found in DNA. Uracil is present in RNA. 28. 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 29. Complimentary DNA (cDNA) produced from? A. mRNA B. tRNA C. Cell Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 15-6  Cell and Molecular Biology D. Gene E. rRNA Ans: A 30. Which of the following cell organ in eukaryotic cells cholesterol synthesis takes place? A. Mitochondria B. Ribosome C. Centrosome D. Endoplasmic reticulum E. Cytoplasm Ans: D 31. Antisense RNA targets specific viral or microbial nucleic acid sequences that interfere with normal replication and expression. The antisense technology targets? A. Tcell B. B Cell C. DNA D. mRNA E. cDNA Ans: D 32. Nucleotide is? A. Phosphate and sugar B. Sugar- base - phosphate C. Sugar and base D. Base- c 1 -sugar-c 5 -phosphate E. Base- c 5 -sugar-c 1 -phosphate Ans: D 33. Conversion of nucleoside to nucleotide by? A. Double bond B. Sugar C. Purine base D. Ribose E. Phosphate Ans: E 34. Gene therapy can be used to treat? A. Cancers B. Sickle cell anemia C. Hemophilia D. All of the above Ans: D Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 15-7  Cell and Molecular Biology Tips: Sickle cell anemia affects hemoglobin of RBC and it is genetic carrier gene disease. 35. A cDNA library contains clones representing which of the following? A. mRNA B. repeated DNA C. Introns D. tRNA E. rRNA Ans: A 36. Which of these supportive agents may have greater risk than benefit in patients with cancer when the goal is cure due to the potential increased risk of tumor progression? A. Antiemetics B. Colony Stimulating Factor (CSF) C. Corticosteroids D. Erythropoietin-Stimulating Agent E. Oprelvekin (IL-11) Ans: D Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 15-8  Pharmacogenetics PHARMACOGENETICS 1. What is the definition of Pharmacogenetics? A. Pharmacogenetics is the 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. Codeine is metabolized by CYP2D6 to active product as morphine. A person with slow metabolizer gene of CYP2D6. What is correct? A. Need less dose of codeine for analgesic effect. B. Need high dose of codeine for analgesic effect. C. Need normal dose of codeine for analgesic effect. D. Codeine should be avoided in slow metabolizer of CYP2D6. Ans: B Tips: Codeine won’t efficiently metabolize to morphine, so codeine dosage may have to be increased. 3. 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 a single nucleotide polymorphism (SNP). It occurs when one base pair of nucleotide replaces another. These are single base differences that exist between individual. This is the most common genetic variation in DNA. 4. Enzymes that catalyze coupling of two molecules are classified as A. Hydrolases B. Ligases C. Oxidoreductases D. Transferases E. Isomerases Ans: B Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 16-1  Pharmacogenetics 5. 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 6. Trastuzumab is used for? A. A HER 2 RNA protein inhibitors used for breast cancer B. Contraceptives C. Rheumatoid arthritis D. Chemotherapy E. Crohn's disease Ans. A 7. All of the following are biological derived drugs, except? A. Infliximab B. Anakinra C. Trastuzumab D. Insulin E. Methotrexate Ans: E 8. Rituximab is used for the treatment of? A. Cell follicular lymphoma B. contraceptives C. Rheumatoid arthritis D. Chemotherapy E. Crohn's disease Ans: A Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 16-2  Immunology IMMUNOLOGY and Immunizations 1. What is not physiological barrier for innate immunity? A. Tear B. Salivary amylase C. Inflammation D. Skin E. Mucus Ans. B 2. Which is not considered as a physiological barrier to body surfaces? A. skin B. mucus membrane C. tears D. gastric secretions E. Salivary amylase Ans. e Tips: Salivary amylase break down starch to carbohydrates. Gastric secretions provide hostile environment to many microorganisms. 3. The FALSE statement about vaccines is/are: I. It is given only after the person suffer exposition to the virus II. Passive vaccines promote immunization for short period of time III. Active vaccines promote long-term immunization A. I only B. III only C. I and II only D. II and III only E. I, II and III Ans. A Tips: Vaccines can be given as prophylaxis before the person suffers exposition to the microorganisms. 4. Differences between passive and active immunization: I. Passive enhance and active stimulate the patient’s immune response. II. In passive antibody injection are given and in active antigen injections are given III. Passive is effective for some months while active is longer lasting A. I only B. III only C. I and II only D. II and III only Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 17-1  Immunology E. I, II and III Ans. E Tips: Passive vaccines: Normally IV and IM injections of antibodies to enhance patient’s immune competence; protection depends on serum half-life of the injected antibody that may be effective for days or months. Active vaccinations: Normally IV, IM, SC and oral administration of antigen to stimulate the immune response. Immunity is long lasting. 5. Correct statement regarding α-Fetoprotein-AFP include I. Produced by the fetal liver II. May cause hepatocellular carcinoma III. III Cause death of fetus A. I only B. III only C. I and II only D. II and III only E. I, II and III Ans. C Tips: α-Fetoprotein-AFP is produced by the fetal liver and may cause hepatocellular carcinoma of fetus, however it does not cause the death of fetus. 6. 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 Tips: If the mother and father have hemophilia their child may not have the disease hemophilia but the child will have the gene of the disease. 7. All of the following can be differentiated from a mast cell, EXCEPT A. Eosinophil B. Basophile C. Neutrophil D. Platelet E. Erythrocytes Ans. B Tips: Basophile is a pro-inflammatory cell that initiates acute inflammation and cannot be differentiated from mast cells. 8. Basophiles, neutrophils and eosinophils are originated from A. Myeloblasts Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 17-2  Immunology B. Lymphoblasts C. Monoblasts D. Proerythroblasts E. Megakaryoblasts Ans. A Tips: Basophiles, neutrophils and eosinophils are leukocytes-White Blood Cells-WBC originated from myeloblasts. 9. Which of the following is/are NOT considered autoimmune disorders? A. A Grave’s disease B. Systemic Lupus Erythromatosus C. Osteoporosis D. Hoshimoto disease E. Type 1 Diabetes Ans. C Tips: Osteoporosis is not an autoimmune disorder. It is a disease characterized by the loss of bone mass. 10. True statements regarding the use of monoclonal antibodies include which of the following? I. Flu-like symptoms commonly occurs at the start of therapy II. T-cells are blocked from initiating the rejection process III. Orthoclone is a human immunoglobulin product A. I only B. III only C. I and II only D. II and III only E. I, II and III Ans. C Tips: Monoclonal antibodies can deliver toxins specifically to cancer cells and destroy them. They are also used with radioisotopes to diagnose and visualize cancer cells and may cause flu-like symptoms in the beginning of the treatment. 11. Which of the following is not related to lymphocytes? A. Lymph nodes B. Thymus gland C. Thoracic duct D. Spleen E. Thyroid gland Ans. E Tips: Thyroid gland is not part of lymphocytes. Lymphocytes include: Tonsils and adenoid gland, thymus, lympho nodes, spleen, bone marrow and lymphatic vessels. Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 17-3  Immunology 12. Attenuated viruses used for vaccination: I. Poliomyelitis virus II. MMR-Mumps, measles and rubella virus III. Influenza A. I only B. III only C. I and II only D. II and III only E. I, II and III Ans. C Tips: Attenuated vaccines (LIVE) are made from whole microbes that have been killed by heat or chemical. MMR-Mumps, Measles, Rubella virus and TB-Mycobacterium are live vaccines. 13. Drugs that stabilize mast cells are used in the treatment of: A. Organ implants rejection B. Cancer therapy C. Allergic rhinitis D. Asthma E. Myocardial infaction Ans. C Tips: Drugs that stabilize mast cells are normally used in the treatment of allergic rhinitis as per example cromoglycate. 14. All of the following biological are used for active immunization, EXCEPT: A. Bacterial vaccine B. Bacterial antigen C. Multiple antigen preparations D. Toxoids E. Toxins Ans. E Tips: Toxins are used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms therefore cannot be used for vaccination. 15. Which of the following is useful to STIMULATE antibody production? A. An adjuvant B. A hapten C. Antiserum D. Purified antigen E. Crude antigen Ans. D Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 17-4  Immunology 16. Correct statements regarding Klein filter syndrome include: I. Male with enlarge breast, small testis and infertility II. The male has 3 chromosomes III. Chromosomes forming XXY, presence of one extra female chromosome. A. I only B. III only C. I and II only D. II and III only E. I, II and III Ans. E Tips: Klein filter syndrome is a condition where the male have enlarged breast, small testis and infertility. The male chromosome is constituted of 3 chromosomes forming XXY, presence of one extra female chromosome. 17. Correct statements regarding infantile genetic agranulocytosis include? I. Type I hypersensitivity II. Caused by a decrease in bone marrow activity III. Treatment can be done by transfer of WBCs or large doses of antibodies. A. I only B. III only C. I and II only D. II and III only E. I, II and III Ans. D Tips: It is an autosomal recessive disorder characterized by the early onset of recurrent, severe pyogenic infections, especially of the skin and lung, total absence of neutrophil in the blood or presence in reduced numbers, absolute monocytosis and eosinophilia, markedly decreased numbers of mature neutrophilic precursors in the bone marrow. 18. Which of the following is the organ responsible for the immune system? A. Thymus B. Lymphoid organ C. Megakaryocyte D. Lynphocyte E. Spleen Ans. B Tips: Lymphoid organ is the organ responsible for the immune system concerned with growth, development and deployment of lymphocytes. 19. The “key” operative of immune system is known as: A. Megakaryocytic B. Monocyte C. Lymphocyte D. Proerythrocyte Copyright © 2000-2019 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep. 17-5  Immunology E. Myelocyte Ans. C Tips: Lymphocytes are WBC-White Blood Cells, the key operative of immune system. 20. Which of the following is/are types of lymphocytes? I. B cells II. T cells III. Natural killer cell A. I only B.. III only C. C. I and II only D. D. II and III only E. E. I, II and III Ans. E Tips: Lymphocytes are WBC-White Blood Cells found in the blood and in many other part of body and may include B and T cells, and natural killer cells. 21. The stem cell of immune system is developed in: A. Bone marrow B. Lym