بسم الله الرحمن الرحيم
University of Khartoum
Faculty of Medicine
Department of Medicine
Pharmacology
4th Year Medicine
Pharmacology Final Exam. 12/9/ 2012
Name………………………………………………..Index No………………………
Time allowed: 3 hours
Part One
Instructions to the candidates:
Write your full name and index number in the space allocated in the
answer paper.
Select the letter of the best answer. List your answers in the answer
sheet provided.
1. What type of drug is propranolol?
a. Anticonvulsive
b. Antihypertensive
c. Antinauseant
d. Antihistamine
e. Antipyretic
2. Angiotensin converting enzyme (ACE) inhibitors are associated with
a high incidence of which of the following adverse reactions?
a. Hepatitis
b. Hypokalemia
c. Dry cough.
d. Proteinuria
e. Hirsutism
3. Cimetidine slows the metabolism of many drugs because it inhibits
the activity of
a. Monoamine oxidase (MAO)
b. Cytochrome P450
c. Tyrosine kinase
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d. Hydrogen–potassium–adenosine triphosphatase (H,K,ATPase)
e. Phase II glucuronidation reactions.
4. The approved indication for misoprostol
a. Reflux esophagitis
b. Regional ileitis
c. Ulcerative colitis
d. Prevention of gastric ulceration in patients using large doses of aspirin-like
drugs
e. Pathologic hypersecretory conditions such as Zollinger-Ellison syndrome
5. Which of the following adverse effects is NOT commonly seen with
Cholinergic antagonists?
a. Blurred vision
b. Confusion
c. Miosis
d. Constipation
e. Urinary retention
6. The drug chloramphenicol is risky for which of the following?
a. Neonates
b. Geriatric patients
c. Adult males
d. Obese patients
e. Congestive heart failure patients
7. A 69-year-old male with angina develops severe constipation following
treatment with
a. Propranolol
b. Captopril
c. Verapamil
d. Dobutamine
e. Nitroglycerin
8. The cholinesterase inhibitor that is used in the diagnosis of myasthenia
gravis is
a. Pyridostigmine.
b. Malathion
c. Edrophonium.
d. Physostigmine.
e. Ambenonium
9. Omeprazole, an agent for the promotion of healing of peptic ulcers,
has a mechanism of action that is based on
a. Prostaglandins
b. Gastric secretion
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c. Pepsin secretion
d. H,K,ATPase
e. Anticholinergic action
10. A male patient is brought to the emergency department following
ingestion of an unknown substance. He is found to have an elevated
temperature, hot and flushed skin, dilated pupils, and tachycardia. Of the
following drugs, which would most likely cause these findings?
a. Propranolol
b. Methylpredinisolone
c. Prazosin
d. Guanethidine
e. Atropine
11. Neostigmine will effectively antagonize skeletal muscle relaxation
produced by
a. Pancuronium
b. Succinylcholine
c. Diazepam
d. Baclofen
e. Nicotine
12. A 35 year old depressive patient who was taking a tricyclic antidepressant also
got clonidine to manage his hypertension. The possible drug interactions may
show:
a. Reappearance of depressive symptoms.
b. Increased respiratory depression.
c. Increased blood pressure.
d. Decreased blood pressure.
e. Increased Anticholinergic activity.
.
13. The mechanism of action of butolinum toxin is
a. Mimic the action of acetylcholine.
b. Prevention of release of acetylcholine.
c. Potentiation of the action of cholinesterase.
d. Inhibition of the action of cholinesterase.
e. Prevention of synthesis of acetylcholine.
14. Which of the following drugs is contraindicated in diabetic patient:
a. Hydralazine.
b. Prazosin.
c. Guanethidine.
d. Propranolol
e. Methyldopa.
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15. Pralidoxime chloride is a drug that
a. Reduces the vesicular stores of catecholamines in adrenergic and dopaminergic
neurons
b. Blocks the active transport of choline into cholinergic neurons
c. Reactivates cholinesterases that have been inhibited by organophosphate
(cholinesterase inhibitors)
d. Stimulates the activity of phospholipase C with increased formation of inositol
triphosphate
e. Inhibits the reuptake of biogenic amines into nerve terminals
16. The skeletal muscle relaxant that acts centrally.
a. Gallamine
b. Baclofen
c. Pancuronium
d. Cyclobenzaprine
e. Dantrolene
17. All of the following drugs are used topically in the treatment of chronic
glaucoma. Which of these agents reduces intraocular pressure by
decreasing the formation of the aqueous humor?
a. Timolol
b. Echothiophate
c. Pilocarpine
d. Isofluorphate
e. Physostigmine
18. The skeletal muscle relaxant that acts directly on the contractile
mechanism of the muscle fibers is
a. Gallamine
b. Baclofen
c. Pancuronium
d. Cyclobenzaprine
e. Dantrolene
19. Choose the unwanted effects of clonidine:
a. Parkinson’s syndrome
b. Sedative and hypnotic effects
c. Agranulocytosis and a plastic anemia
d. Dry cough and respiratory depression
e. Bradycardia
20. Direct action of acetylcholine include all the following except
a. Miosis.
b. Vasodilatation.
c. Bradycardia.
d. salivation
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e. Contraction of urinary bladder sphincter.
21. All the following statements about cholinesterases are correct except
a. Edrophonium is a reversible inhibitor with a brief duration of action
b. Organophosphate covalently bind to the enzyme for long duration.
c. Neostigmine is direct cholinomimetic.
d. Parlidoximes are reactivators of the enzyme.
e. Reactivation is possible if the enzyme inhibitor complex has not
“aged”.
22. Miosis could be obtained by local application of each of the
following except
a. Physostigmine.
b. Ephedrine.
c. Echothiophate.
d. Carbachol.
e. Pilocarpine.
23. The mechanism of action of Phentolamine involves:
a. Activation of β-receptors.
b. Specific activation of α-receptors.
c. Blockade of α1-receptors.
d. Blockade of β2 receptors.
e. Non-selective α-adrenergic blockade.
24. The best agent for differentiation between Myasthenia crisis (Insufficient
therapy) and cholinergic crisis (Excessive therapy) is:
a. Atropine.
b. Physostigmine.
c. Ecothiophate.
d. Pyridostigmine.
e. Edrophonium.
25. A 61 year old lady suffering from Deep Vein Thrombosis ( DVT) in her left thigh
was well maintained on Warfarin but now suddenly reported back for her severe
nose bleeding. She must be immediately treated with:
a. Factor VIII.
b. Vitamin K.
c. Protamine.
d. Alteplase.
e. Aminocaproic acid.
26. This drug reduces blood pressure by acting on vasomotor centers in the CNS:
a. Labetalol
b. Clonidine
c. Enalapril
d. Nifedipine
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e. Propranolol
27. A 62-year-old male with chronic obstructive lung disease is given
ipratropium as part of his therapeutic regimen. What is the mechanism of
action of ipratropium?
a. Inhibition of airway muscarinic receptors
b. Inhibition of 5-lipoxygenase
c. Breakdown of mucus
d. Inhibition of mediator release
e. Inhibition of phosphodiesterase
Which of the following drugs is considered to be most effective in relieving .28
?and preventing ischemic episodes in patients with variant angina
a. Propranolol
b. Nitroglycerin
c. Sodium nitroprusside
d. Nifedipine
e. Isosorbide dinitrate
29. If quinidine and digoxin are administered concurrently, which of the
following effects does quinidine have on digoxin?
a. The absorption of digoxin from the GI tract is decreased
b. The metabolism of digoxin is prevented
c. The concentration of digoxin in the plasma is increased
d. The effect of digoxin on the AV node is antagonized
e. The ability of digoxin to inhibit the NaK-stimulated ATPase is reduced
30. Which of the following reactions is phase II and NOT phase I?
a. Oxidations
b. Reductions
c. Conjugations
d. Deaminations
e. Hydrolyses
31. Which of the following is an example of a drug acting directly through
receptors?
a. Protamine binds stoichiometrically to heparin anticoagulants
b. Adrenergic beta blockers for thyroid hormone-induced tachycardia
c. Epinephrine for increasing heart rate and blood pressure
d. Cancer chemotherapeutic agents
e. Mannitol for subarachnoid hemorrhage
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32. A 54-year-old female is treated for essential hypertension with an
antihypertensive that controls her blood pressure. One day, she comes to
the emergency department with chest pain, tachycardia, anxiety, and a blood
pressure of 240/140 mmHg. She has not taken her medication for two days. Which
antihypertensive can account for her findings?
a. Clonidine
b. Propranolol
c. Doxazosin
d. Minoxidil
e. Prazosin
33. Which of the following is unlikely to occur with low concentrations
of nitroglycerin?
a. Decreased heart rate
b. Decreased end-diastolic blood pressure
c. Decreased myocardial oxygen demand
d. Decreased preload and after load
e. Increased coronary blood flow
34. A 76-year-old female with an eight-year history of CHF that has been
well controlled with digoxin and furosemide develops recurrence of dyspnea
on exertion. On physical examination, she has sinus tachycardia,
rales at the base of both lungs, and pitting edema of the lower extremities.
Which agent could be added to her therapeutic regimen?
a. Dobutamine
b. Hydralazine
c. Minoxidil
d. Prazosin
e. Enalapril
35. A 61-year-old female has intermittent bouts of chest pain on exertion
of two months’ duration, associated with numbness and tingling in the
fourth and fifth fingers of her left hand. An ECG is normal. She is placed on
propranolol, which relieves her symptoms. What cardiovascular effect did
the drug have?
a. It decreased production of catecholamines
b. It dilated the coronary vasculature
c. It decreased the requirement for myocardial oxygen
d. It increased peripheral vascular resistance
e. It increased sensitivity to catecholamines
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36. The blood pressure of a 65-year-old male is well controlled by a calcium
channel blocker that is used to treat his essential hypertension. When
placed on Cimetidine to control symptoms related to gastroesophageal
reflux disease (GERD), he has episodes of dizziness. How does cimetidine’s
effect on calcium channel blockers account for the dizziness?
a. It increases their rate of intestinal absorption
b. It decreases their plasma protein binding
c. It decreases their volume of distribution
d. It decreases their metabolism by Cytochrome P450
e. It decreases their tubular renal secretion
37. In a hypertensive patient who is taking insulin to treat diabetes,
which of the following drugs is to be used with extra caution and advice to the
patient?
a. Hydralazine
b. Prazosin
c. Guanethidine
d. Propranolol
e. Methyldopa
38. An effective antidiarrheal agent that inhibits peristaltic movement is
a. Clonidine
b. Bismuth subsalicylate
c. Oral electrolyte solution
d. Atropine
e. Diphenoxylate
39. A 15 year old boy with Type-1 Diabetes Mellitus has been admitted in
emergency with severe hyperglycemia, Ketoacidosis, the most appropriate drug to
control rapidly the severe Ketoacidosis is:
a. Glyburide.
b. Tolbutamide.
c. Crystalline Zinc Insulin.
d. Isophane Insulin.
e. Ultralente Insulin.
40. What determines the degree of movement of a drug between body
compartments?
a. Partition constant
b. Degree of ionization
c. pH
d. Size
e. All of the above
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Name………………………………………………………………….. Index No………
Part Two
1.Give example of a drug with the following action:
1. Cardioselective calcium channel blocker……………
2. Cough suppressant…………………………………
3. Mucolytic…………………………………………..
4. Leukotriene receptor antagonist……………………
5. Mast cell stabilizer…………………………………
6. Non systemic antacid ………………………………
7. Intravenous glucocorticoid used in asthma…………
8. Potassium sparing diuretic………………………….
9. Non selective α blocker……………………………..
10.β1 antagonist………………………………………..
11.Antimuscarinic used in motion sickness…………….
12.Antimuscarinic used in asthma……………………
13.Antimuscarinic used in peptic ulcer………………
14.Antidote for organophosphate poisoning……………
15.Antidote for digoxin toxicity…………………
16.Antidote for warfarin toxicity…………………
17.Stimulant laxative………………..
18.Fibrinolytic agent………….
19.Intravenous anticoagulant…………….
20.Lipid lowering agent that reduces triglycerides……………….
2.Write short notes about the following:-
1- - Mechanism of action of sulphonylurease:-
……………………………………………………………………………………
…………………………………………………………………………………..
…………………………………………… ………………………………
…………………………………………………………………………
…………………………………………………………………………
2- Mechanism of action of theophylline:-
1- ……………………………………………………………………………………
2- ……………………………………………………………………………………
3- ……………………………………………………………………………………
4- ………………………………………………………………………………………
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3- Therapeutic uses of proton pump inhibitor:-
a- ……………………………. . b- ………………………………………….
c- ……………………………… d- ………………………………………….
e-………………………………...
4- Therapeutic uses of nitroglycerine:-
a- ……………………………. . b- ………………………………………….
c- ……………………………… d- ………………………………………….
e-………………………………...
5- Therapeutic uses of calcium channel blockers:-
a-………………………………… b- …………………………………………
c- ………………………………… d- ……………………………………
6- Contraindication of atropine:-
a-………………………………… b- …………………………………………
c- ………………………………… d- ………………………………………
7- Indication of thyroxine:-
a- ……………………………. . b- ………………………………………….
c- ……………………………… d- ………………………………………….
8- Adverse effects of oral contraceptives:-
a- ……………………………. . b- ………………………………………….
c- ……………………………… d- ………………………………………….
e-………………………………... f- ………………………………………….
9- Adverse effects of captopril:-
a- ……………………………. . b- ………………………………………….
c- ……………………………… d- ………………………………………….
e-………………………………... f- ………………………………………….
10. Institute the therapy of chronic heart failure for the following stages:
1. Stage 1 or A:………………………………………………………………………
2. Stage 2 or B.: …………………………………………………………………..
3. Stage 3 or C: …………………………………………………………………….
4. Stage 4 or D : …………………………………………………………………
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Name………………………………………………………………….. Index No………
11- Adverse effects of morphine:-
a- ……………………………. . b- ………………………………………….
c- ……………………………… d- ………………………………………….
e-………………………………... f- ………………………………………….
12- Indication of diuretics:-
a- ……………………………. . b- ………………………………………….
c- ……………………………… d- ………………………………………….
e-………………………………... f- ………………………………………….
13- Mechanism of action of local anaesthetics:-
…………………………………………………………………………………………
…………………………………………………………………………………………
…………………………………………………………………………………………
14- Write short account about one of the following:
a. Classify anxiolytic drugs giving an example for each class
1. ………………………………………………………………………………
2. …………………………………………………………………………………..
3……………………………………………………………………………………….
4. ………………………………………………………………………………………
5. ……………………………………………………………………………………….
b. Classify drugs that are used in treatment of Parkinsonism
giving an example for each class
1. …………………………………………………………………………………..
2. …………………………………………………………………………………..
3……………………………………………………………………………………….
4. ………………………………………………………………………………………
5. ……………………………………………………………………………………….
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