1. Which of the following statements about the autocoid 5-hydroxytryptamine is FALSE?

It(s)
A. Is also called serotonin
B. Precursor molecule is tryptophan
C. Can be metabolized to melatonin
D. Catabolic end product is 5-hydroxyindoleacetic acid (5-HIAA)
E. Is broken down by the enzyme catechol-o-methyl transferase
2. Which of the following 5-hydroxytryptamine receptors are regarded as fast acting?
A. 5-HT1
B. 5-HT2
C. 5-HT3
D. 5-HT4
E. 5-HT7
3. 5-hydroxytryptamine containing neurons in the CNS reside in which of the following nuclei?
A. Ventral Tegmental area
B. Substantia nigra
C. Hippocampus
D. Dorsal Raphe nucleus
E. Striatum
4. Which of the following is a 5-HT3 receptor antagonist used in as an antiemetic?
A. Ondansetron
B. Buspirone
C. Ergotamine
D. Sumatriptan
E. LSD
5. Which of the following 5-hydroxytryptamine related drugs work by enhancing its
extracellular concentration?
A. Buspirone
B. Ergotamine
C. Fluoxetine
D. Sumatriptan
E. LSD
6. Which of the following drugs can cause or trigger release of histamine from cells?
A. Chlorpromazine
B. Promethazine
C. Morphine
D. Fentanyl
E. Diclofenac
7. Which of the following drugs is a histamine H3 inverse agonist?
A. Pitolisant
B. Cimetidine
C. Famotidine
D. Promethazine
E. Chlorpheniramine
8. Which of the histamine receptors mediate(s) its sedative effect?
A. H1
B. H2
C. H3
D. H4
 E. All of the above
9. Which of the following drugs is regarded as a weak opioid?
A. Morphine
B. Methadone
C. Pethidine
D. Codeine
E. Fentanyl
10. Kaseem (40 year old) who is a known addict is brought to the emergency room comatose
and diagnosed with opioid overdose. Which of the following drugs will be used to revive
Kaseem?
A. Morphine
B. Tramadol
C. Fentanyl
D. Naloxone
E. Methadone
11. All of the following drugs may be used in the management of neuropathic pain EXCEPT:
A. Carbamazepine
B. Amitriptyline
C. Diclofenac
D. Pregabalin
E. Gabapentin
12. Which of the following does not contribute to the pain associated with most ischemic heart
disease?
A. Release of K+ ions from necrotizing myocytes
B. Release of adenosine
C. Sensitive of nociceptors by released products of breakdown
D. Release of acids anaerobic respiration
E. None of the above
13. Which of the following is not a contraindication for the use of betablockers?
A. Bronchial asthma
B. Dyslipidemia
C. Diabetes mellitus
D. Left ventricular failure
E. Peripheral vascular spasm
14. Which of the following is not a neurohormone that is implicated in the remodeling of the
heart.
A. Aldosterone
B. Noradrenaline
C. Acetylcholine
D. Vasopressin
E. Angiotensin II
15. Aspirin should not be used in children because:
A. It may precipitate Reye’s syndrome in the presence of viral infection
B. Is a non-selective COX inhibitor
C. Does not taste well
D. It is difficult to formulate infant dosage forms
E. All of the above
16. All of the following drugs are classified as opioid EXCEPT:
 A. Morphine
B. Pethidine
C. Fentanyl
D. Tramadol
E. Ketoralac
17. Which of the following drugs is regarded as an opioid antagonist?
A. Naltrexone
B. Diacetylmorphine
C. Fentanyl
D. Tramadol
E. Oxycodone
18. Which of the following is not a direct major determinant of myocardia oxygen demand of
coronary artery disease patient?
A. Heart rate
B. Myocardial contractility
C. Ejection fraction
D. Intra-myocardial wall tension
E. None of the above
19. One type of hyperlipoproteinemia is characterized by elevated plasma levels of
chylomicrons, normal plasma levels of β-lipoproteins, pancreatitis and the inability of any
known drug to reduce lipoprotein levels. This dyslipidaemia is phenotypically represented
as?
A. Type I dyslipidaemia
B. Type IIa dyslipidaemia
C. Type III dyslipidaemia
D. Type IV dyslipidaemia
E. Type V dyslipidaemia
20. A drug is administered with the intent of lowering a patient’s elevated LDL and total
cholesterol levels, and raising HDL levels. The drug inhibits cholesterol synthesis by inhibiting
3-hydroxy-3-methylglutarylcoenzyme A ([HMG CoA] reductase). Which of the following
drugs best fits this description and works by the stated mechanism of action?
[Link]
B. Cholestyramine
C. Lovastatin
D. Nicotinic acid (niacin)
E. Probucol
21. A 44-year-old obese man has extremely high plasma triglyceride levels, but cholesterol levels
are within normal limits. Following treatment with a drug specifically indicated for
hypertriglyceridemia, triglyceride levels decrease to almost normal. Which of the following
agents is most likely to have caused this desired change?
A. Atorvastatin
B. Cholestyramine
C. Cholesterol
D. Ezitemibe
E. Gemfibrozil
22. A serious adverse effect of HMG CoA reductase inhibitors (statins) is myopathy
(rhabdomyolysis). The incidence and severity of myopathy is higher in patients with hepatic
 and renal diseases. Which of the following statins can be used safely in a patient with a
preexisting liver disease?
A. Lovastatin
B. Simvastatin
C. Rosuvastatin
D. Pravastatin
E. Atorvastatin
23. In giving drug administration instructions to a patient on an antitussive, which of the
following antitussives will you characterized as capable of causing numbness of the tongue,
mouth, and throat when the capsules are broken or chewed?
A. Dextromethorphan
B. Benzonatate
C. Methylmorphine
D. Pholcodeine
E. All of the above
24. Opioid antitussives are generally contraindicated in premature babies and neonates; the
pharmacological rational can be attributed to?
A. Increase CNS and respiratory stimulant effects
B. Precipitate hiccups
C. Severe CNS and respiratory depression
D. Drug teratogenicity
25. In which of the following conditions are diuretics not used typically?
A. Hypertension
B. Gouty arthritis
C. Liver failure
D. Glaucoma
26. The following diuretic should be used only through the intravenous route
A. Mannitol
B. Frusemide
C. Chlorthalidone
D. Acetazolamide
27. Which of the following diuretics may be used clinically for treatment of metabolic alkalosis?
A. Mannitol
B. Bendrofluazide
C. Chlorthalidone
D. Acetazolamide
28. Neprilysin is an important mediator in the prevention of heart failure BECAUSE Neprilysin
activator; sacubitril prevents the breakdown of natriuretic peptide desirable in promoting
water excretion to relieve congestion in heart failure. E

29. Carvedilol is a drug of choice for the management of heart failure BECAUSE Carvedilol is a
beta selective adrenergic blocker. C

30. Angiotensin II together with catecholamines form the core of the neurohormonal model of
heart failure BECAUSE Increased aortic pressure is directly proportional to afterload and wall
tension and is mostly mediated by angiotensin II and catecholamines. A
31. Co-administration of digitoxin and warfarin can induce toxicity BECAUSE Digotoxin and
warfarin will produce an additive effect on the heart causing toxicity. C

32. Ventricular fibrillation is a fatal form of arrhythmia BECAUSE Fibrillating ventricles only
quaver and are unable to either pump blood to the body or the lungs. A

33. Procainamide is a Na+ channel blocker that converts an area of unidirectional block into an
area of bidirectional block BECAUSE Procainamide unlike quinidine has toxic effects of
Torsade De pontes. C

34. Lidocaine in hypoxic tissue has quinidine-like effects BECAUSE Lidocaine enhances antegrade
conduction thereby eliminating unidirectional blockade. A

35. Lactic acidosis accentuates the effect of lidocaine a class 1B anti-arrhythmic drug, ADD
BECAUSE Increasing local acidity leads to trapping of lidocaine within the cells for prolong
action. A

36. Minimum effective dose of Methimazole is recommended in pregnant women BECAUSE

Methimazole, although crosses the placenta has no evidence of neonatal thyroid
abnormalities. E

37. Carbimazole is contraindicated in pregnant women BECAUSE Carbimazole crosses the

placenta and it is strongly associated with congenital malformations. E

38. Propylthiouracil is preferred over methimazole in lactating women BECAUSE Propylthiouracil

is less excreted in breast milk due to its extensive protein binding D

39. Propylthiouracil is the preferred over methimazole in the first trimester of pregnancy
BECAUSE Propylthiouracil is extensively bound to plasma protein and do not cross the
placenta. C

40. Propranolol is preferred over carvedilol in treatment of hyperthyroid patients BECAUSE

Propranolol has additional effect of ameliorating exophthalmos of hyperthyroidism. C

41. A chronic kidney disease patient with hypoalbuminemia may have diminished biological
effect of calcium BECAUSE Hypoalbuminemia decreases plasma total calcium concentration.
42. A patient with metabolic acidosis may experience diminished biological effects of calcium
BECAUSE Metabolic acidosis decreases the concentration of ionized calcium.

43. Calciferol is preferred in the treatment of vitamin D deficiency in patients with chronic liver
disease BECAUSE Calciferol does not require activation by metabolism in the liver.

44. Calcitonin is used in the treatment of Paget’s disease BECAUSE Calcitonin stimulates
osteoclast activity in the bone to remove calcium from plasma and deposit into bone.

45. Hypercalcemia and hypophosphatemia may be a consequent of hyperparathyroidism

BECAUSE Hyperparathyroidism decreases renal excretion of calcium and increases renal
excretion of phosphates.

46. Hyperparathyroidism can lead to osteoporosis BECAUSE Hyperparathyroidism directly

stimulates osteoblast mediated release of calcium from bones.

47. Bisphosphonates are recommended in the treatment of hyperparathyroidism

BECAUSE Bisphosphonates significantly decreases parathyroid hormones and serum calcium
levels.

48. NSAIDs may trigger asthmatic attack and should be avoided in asthmatic patients BECAUSE
NSAIDs inhibits cyclooxygenases and thus prostaglandins PGE-2 and PGI-2 synthesis.

49. Salbutamol (an anti-asthmatic drug) can also be used in the treatment of hypokalemia
BECAUSE Salbutamol stimulate beta-2 receptors and increase intracellular movement of
potassium.

50. Glucocorticoids inhibits inflammation and hence reduce edema and mucus secretion in
asthmatic patients BECAUSE Glucocorticoids inhibit lipocortin which induces phospholipase
A2 and thus stimulate arachidonic acid and eicosanoids synthesis.

51. Budesonide/Formoterol combination inhaler is a preferred controller medication for mild

chronic asthma BECAUSE Budesonide/Formoterol produces a synergistic effect through
upregulation of beta-2 receptors by Formoterol
52. Which of the following drugs have short duration of action, confusion and convulsion as
ADRs?
A) Lidocaine.
B) Mexiletine.
C) Flecainide.
D) Quinidine.

53. All the following are adverse effect of amiodarone except:

A) Cinchonism.
B) Hypothyroidism.
C) Hyperthyroidism.
D) Pulmonary fibrosis.

54. Which of the following can be treated with Lidocaine?

a. Paroxysmal supraventricular tachycardia.
b. Atrial fibrillation.
c. atrial flutter.
d. Ventricular tachycardia.
55. Which of the following is the dominant effect of amiodarone?
A) Prolongation of AP.
B) Increase duration of refractory period by blocking K+ channels.
C) Vasodilating effect.
D) Additional class Ia, II and IV.
56. Which of the following drugs is very effective in ventricular arrhythmias but also could cause
Proarrhythmia?
A) flecainide.
B) Esmolol.
C)Atropine.
D) Metoprolol
57. Which of the following drugs could cause tosades de pointes arrhythmia even within the
normal therapeutic range?
A) Atropine.
B) Lidocaine.
C) Dronedarone.
D) Quinidine.
ANTILIPIDEMICS
58. The major lipids include the following except?
a. Glycerophospholipids
b. Lipoprotein
c. Triacylglycerol
d. Cholesterol
59. The classification of lipoproteins is based on all except?
a. Electrophoretic mobility
b. Apolipoprotein type
c. Density after separation
d. None of the above
60. LP(a) lipoprotein is formed from LDL and the (a) protein is linked by ?
a. Glycosidic bond
b. Phosphodiester bond
c. Sulfide bond
d. Disulfide bond
61. LP(a) levels is determined chiefly by ….
a. Atherosclerotic plagues
b. Coronary artery disease
c. Genetic factors
d. Age
62. The nascent HDL is impregnated with cholesterol by ….
a. LCAT
b. CETP
c. SR-BI
D. ABCA1
63. Which of the ff esterifies the free cholesterol to form HDL…..
a. LCAT
b. SR-BI
c. ABCG1
D. CETP
64. Transfer of cholesterol to LDL and VLDL is done by ….
a. CETP
b. ABCA1
c. LCAT
d. SR-BI

65. HDL exchange cholesterol through …………..with the liver.

a. ABCG1
b. SR-BI
c. CETP
d. LCAT
66. Primary site of action of the statins is ……
a. Liver
b. Kidney
c. Stomach
d. Lungs
67. Pravastatin and simvastatin are chemically modified derivatives of……
a. Lovastatin
b. Atorvastatin
c. Fluvastatin
d. Rosuvastatin
68. All the following are structurally distinct synthetic compounds except…….
a. Lovastatin
b. Atorvastatin
c. Fluvastatin
d. Rosuvastatin
69. Which of the following statins action is not affected by enzyme inhibitors or inducers……
a. Prasvastatin
b. Lovastatin
c. Fluvastatin
d. Rosuvastatin
70. Bile binding resins includes the following except……..
a. Colestipol
b. Cholestyramine
c. Colesevelam
d. Ezetimibe
71. Which of the following apolipoproteins levels is decreased by the fibrates………
a. Apo A-I
b. Apo B
c. Apo C-III
d. Apo A-II
72. Which of the following fibrates is a prodrug?
a. Gemfibrozil
b. Fenofibrate
c. Clofibrate
d. Bezafibrate

73. All but one of the following is a fibrate…….

a. Ezetimibe
b. Gemfibrozil
c. Colesevelam
d. Niacin
74. Fibrates are contraindicated in patients with…….
a. Diabetes
b. Heart failure
c. Gall bladder disease
d. Hypertension
75. …… is the most effective agent in increasing HDL levels.
a. Niacin
b. Gemfibrozil
c. Atorvastatin
d. Ezetimibe

76. Niacin mechanism, of actions includes all except……

 a. In adipose tissue, niacin inhibits the lipolysis of TG by hormone-
sensitive lipase
b. In liver, increases TG synthesis & inhibits hepatic VLDL secretion
which decreases LDL & Lip(a) production
c. Increased VLDL clearance (enhances LPL activity)
d. Decreased HDL catabolism (increasing HDL cholesterol plasma levels)
77. The intense cutaneous flush caused by niacin use is treated with?
a. Aspirin pretreatment
b. Ibuprofen
c. Aspirin posttreatment

d. Laropiprant

78. Which of the following occurs during treatment with niacin

a. Hypercalcemia
b. Hyperkalaemia
c. Hypernatremia
d. Hyperuricaemia
79. Ezetimibes mechanism of action is
a. Inhibit HMG-COA reductase
b. Inhibit cholesterol transfer
c. Binds to bile acids

d. Inhibit cholesterol absorption

80. The major cause of atherosclerosis and atherosclerosis-associated conditions

a. Coronary heart disease (CHD),
b. Ischemic cerebrovascular disease
c. Peripheral vascular disease
d. Cardiovascular disease
81. Most effective and best-tolerated agents for treating dyslipidaemia
a. Statins
b. Bile binding resins
c. Niacin
82. d. Fibrates
83. Which of the following statins is not metabolized by CYP3A4?
a. Lovastatin
b. Simvastatin
c. Atorvastatin
d. Rosuvastatin
84. Which of the following is a synthetic antioxidant?
a. Resveratrol
b. B-catechin
c. Selenium

d. Probucol

85. CETP Inhibitors include all except?

a. Torcetrapib
b. Anacetrapib
 c. Dalcetrapib
d. Alirozumab
86. Which of the following is PCSK9 inhibitor
a. Torcetrapib
b. Anacetrapib
c. Dalcetrapib
d. d. Alirozumab

87. The statins is used in the management of dyslipidaemias BECAUSE their primary site of
action is the liver.

88. The fibrates decreases triacylglycerol levels by increasing the expression of lipoprotein lipase
BECAUSE they bind to PPARᵞ

89. Statins have cardioprotective properties BECAUSE increase the susceptibility of lipoproteins
to oxidation.
90. The HDL cholesterol is called ‘Good cholesterol’ BECAUSE it carries cholesterol away from
the arteries and back to the liver.
91. The hormone responsible for the porosity of the collecting duct is Vasopressin (ADH
92. Dorzalamide and brinzolamide are mixed with B-blockers (Timolol) to treat glaucoma.
93. The classification of diuretics is best done according to the Site of action in the nephron
94. The route of administration for osmotic diuretics e(mannitol) is *parenteral if given Oral will
cause Osmotic diarrhea
95. Which of the following stage act by inhibiting the coupled Na/K/cl
96. co- transporter in the loop of Henle
A. Aldactone
B. Furosemide
C. Indapamide
D. Amiloride
97. Loop diuretics are the most efficacious hence have a high ceiling thus higher doses produces
stronger dieresis than lower doses
98. Spironolactone and its metabolite……… competitively antagonise aldosterone
A. triamterene
B. Amiloride
C. Canrenone
D. Indapamide
99. Diuretics combination preparations and are anti-hypertensive drugs.

A. Dyazide= triametrene + HCT

B. Aldactazide=Spironolactone+HCT
C. Moduretic= Amulonde + HCT

100. Which of the following drugs has hypernatremia(high concentration of sodium in the
blood) as an adverse condition.
A. Acetazolamide
B. mannitol
C. furosemide
D. metolazone
101. Which of the following diuretics may be used clinically for treatment of metabolic
alkalosis?
A. Mannitol
B. Frusemide
C. Bendrolluazide
D. Chlorthalidone
E. Acetazolamide
102. The potassium sparing diuretic, Aldactone:
A. Acts by increasing the synthesis of sodium channel proteins
B. Antagonises aldosterone
C. Increases the synthesis of
Na*/ K*-ATPases
D. Elicits effect once treatment has began
E. Is produced from canrenone
103. Which of the following NSAIDs has greater inhibitory selectivity for COX-1 than COX-
2?
A. Flurbiprofen
B. Indomethacin
C. Diclofenac
D. Celecoxib
104. Which of the following two cyclooxygenase isoenzymes is constitutively expressed?
A. COX-1
B. COX-2
105. Which of the following statements about NSAIDs is true?
A. Most NSAIDs are weak acids
B. Most NSAIDs are metabolised by the liver into inactive metabolites
C. Oxicams tend to have the longest half-lives of all NSAIDs
D. All of the above
106. Which of the following statements best explains the mechanism of the antipyretic
effect of NSAIDs?
A. Inhibition of prostaglandin biosynthesis in peripheral tissues
B. Decreased interleukin concentration in the hypothalamus
C. Blockade of oxidative phosphorylation in skeletal muscle
D. Inhibition of prostaglandin biosynthesis in the hypothalamus
E. Blockade of prostaglandin receptors in the hypothalamus
107. A child with severe asthma is being treated with high doses of inhaled
corticosteroids. Which of the following adverse effects is of particular concern?
A-Hypoglycemia.
B- Hirsutism.
C- Growth suppression.
 D- Cushing syndrome.
E- Cataract formation.
108. Which of the following is not a synthetic DMARDS?
A. Methotrexate
B. Leflunomide
C. Sulphasalazine
D. Infliximab
109. Ibuprofen is more potent as anti-inflammatory than aspirin because it is irreversible
inhibitor for COX enzymes. (assertion)
110. Which of the following is an aryl acetic acid derivatives
A. Ibuprofen
B. Meloxicam
C. Diclofenac
D. Ketorolac