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5/28/2018

HAAD EXAM
MATERIAL
PHARMACY

§ We combined all the questions we could remember from our


exam in 28th of May 18 (3 different visions). Most were repeated
from previous exams. We added more MCQs and details to the
questions and some notes in green to justify our answers.
§ 100 computer-based MCQs - 120 minutes.
§ No calculators, pens or papers allowed, so practice the
calculations well.
§ Some questions are repeated more than once in the exam
§ Please DOUBLE-CHECK our answers in this version.
Helpful Resources:
- Lipincott Pharmacology (VERY useful)
- Lexicomp
- UpToDate
- Lang
- American board material – Pharmacotherapy preparatory
review and recertification course
- BNF
- IDSA guidelines /CDC









Good Luck


1. Patient has chronic gout and had a recent kidney transplant; which is suitable for
him?
a) Allopurinol
b) Colchicine
c) Febuxostat
d) 4th option

2. Case scenario about female patient have Chronic GOUT was weak & dizzy & fatigue
and another problems like she can’t raise her hand and having some blood disorders
like agranulocytosis and leucopenia with hematuria and proteinuria which anti gout
are probably to cause this Side effects:
a) Allopurinol
b) Colchicine
c) Probencid

3. Patient with gout history present to ER with gouty attack, which NSAID is
contraindicated?
a) Acetylsalicylic acid
b) Sulindac
c) Ibuprofen

4. When patient take prophylaxis therapy for gout: (came as 4 statements and then
in the choices combinations of them for example: a only, a&b. b&d and so on …)
a) more than One attack per year
b) Association with Kidney stones
c) Urate excretion 500 mg
d) Blood urea level 10mg/dl
* (d is wrong as asymptomatic hyperuricemia does not need treatment-
Medescape)

5. Aspirin difference from other NSAIDS?
a) has cardio beneficial effect
b) irreversible COX inhibitor
c) can't stop arthritis progression
d) Used in Kawasaki disease (not sure if it was one of the choices, can't
remember the last choice)
* (came as 4 statements and then in the choices combinations of them for
example: a only, a&b, b&d, and so on …)

6. NSAID has CNS side effects:
a) celecoxib
b) sulindac
c) nabumetone
d) mefenamic acid
* (please check if it is b or d; sulindac has CNS SE, and mefenamic acid is associated
with CNS toxicity)

7. Aspirin overdose symptoms are all of the following except:
a) Hypothermia*
b) Metabolic acidosis
c) Respiratory depression
d) convulsions

8. NSAID given for patent ductus arteriosus (PDA):
a) Indomethacin
b) Sulindac

9. NSAIDS contraindicated with sulfa sensitivity:
a) Celecoxib
b) Ibuprofen
c) naproxen
d) indomethacin

10. Selective COX inhibitor: Celecoxib

11. Paracetamol:
a) small risk of Reyes syndrome
b) great anti-inflammatory
c) inhibit PG in CNS
d) no platelet action (aspirin has antiplatelet action)
* (came as 4 statements and then in the choices combinations of them for example: a
only, a&b. b&d and so on …)

12. Which drug is most likely to cause pseudomembranous colitis?
a) Clindamycin

13. What is the organism that causes pseudomembranous colitis?
a) C difficle

14. Best treatment for C. diff?
a) Metronidazole
b) Vancomycin

15. Which is best used for the treatment of MRSA?
a) Vancomycin
b) Amikacin
c) Azithromycin

16. patient with pharyngitis, the pt was penicillin allergic but the organism is
penicillin sensitive, injectable antibiotics is not preferred in this situation, what
is the safest and effective alternative:
b) Cephalosporin
c) Azithromycin
d) Tetracycline

17. Drug known to be given as single dose for 3 days for ear-nose-throat infections:
a) azithromycin
b) Penicillin

18. Which is most likely to cause rash following penicillin administration?
a) Penicillin G
b) Penicillin V
c) Ampicillin
d) Amoxicillin

19. Female taking UTI medication, after few days she developed rashes and red
spots on hands, face, (they mean to say exposed areas) what medication she's
on? They attached a hand that shows red spots with the question SE of:
a) ciprofloxacin (if we consider it photosensitivity)
b) amoxicillin

20. Antibiotic that can resist B lactamase producing bacteria:
a) cefopodoxime
b) cepoperazone
c) Azithromycin
d) cefazoline
*Please double-check

21. DOC for meningitis:
a) Ceftriaxone
b) Tetracycline
c) Chloramphenicol

22. least used for beta lactamase producing bacteria
a) amoxicillin +clavulinic acid
b) Dicloxacillin
c) Erythromycin
d) Doxycyclin
*Please double-check

23. Type of penicillin that cannot be administered IV:


a) Penicillin G
b) Penicillin V

24. DOC of pregnant woman with UTI: it was a case


A) Cefuroxime
b) Cephalexin

25. Vancomycin red man syndrome is caused by the release of: Histamine

26. Which of the following no need for antibiotic dose adjustment:
a) hypercholesterolemia
b) elderly patient
c) renal disease patient
d) AIDS

27. baby 3- days old treated for infection and developed respiratory depression and
blue color. Which antibiotic can cause this: chloramphenicol

28. Broad spectrum antibiotic (case) Used for G+ and G- bacteria: amoxicillin


29. The use of broad spectrum/ long term use of antibiotic can cause which
infection
a) heleicobacter pylori
b) E.coli
c) shigella
d) Clostridium difficle

30. Antibiotic cause ear problem (ototoxicity) needs audiometry: amikacin

31. Bacteria can resist this antibiotic by:
a) enzyme production
b) cell wall
c) …)
d…

32. Valacyclovir benefit over acyclovir:
a) better bioavailability (true its 55% but acyclovir is 20%)
b) better tolerance (true as taken twice daily not 5 times like acyclovir)
c) less renal impairment
d) all of them
*Double check

33. Acyclovir is not effective in for which virus: ( double check, Lippincott says it
a) is not used in EBV, Uptodate says CMV)
b) Herpes simplex
c) Epstein-barr virus
d) CMV
e) herpes zoster
*Double check, Lippincott says it is not used in EBV, Uptodate says CMV

34. What is the antiviral that’s the most suitable for HSV encephalitis infection?
a) acyclovir
b) foscanet

35. Mechanism of action of acyclovir:
a) DNA polymerase inhibitor.
b) RNA polymerase
c) transcriptase

36. Mitochondrial toxicity, ANTIVIRUAL used:
a) Lamivudine
b) Amatidine
c) Zidovudine

37. Antiviral used in HBV (hepatitis B virus):
a) Lamivudine
b) Amatidine
c) Zidovudine
d) Stavudine

38. Beta blockers are used in all the following except:


a) Migraine
b) Bronchial asthma
c) Hyperthyroidism

39. β- blocker SE except
a) Glyconeogensis
b) Hyperglycemia
c) Hypertriglyceridemia

40. Which is the longest acting ophthalmic beta blocker?
a) Timolol (not sure)
b) Livobunolol
b) Carteolol
e) Betaxolol
*Please double-check if a or b

41. Timolol is contraindicated in all the following except
a) HTN
b) Congestive Heart failure
c) Bronchial asthma

42. Bb with no intrinsic sympathomimetic activity:
a) propranolol
b) Acebutalol
c) Pindolol

43. Action of dobutamine:
a) direct activation of beta and alpha receptors
b) Indirect action on NA
c) action on dopamine receptors
* if it was dopmaine not dobutamine then all answers are true

44. Digoxin is CI in:
a) Complete heart block
b) ventricular tachycardia
*it is CI in ventricular fibrillation and ventricular arrythemia not tachycardia

45. All decrease the effect of digoxin except:
a) captopril
b) cycloserine
c) azithromycin
d) cephalexin
* a,c,d all increase but the most serious interaction is with azithro. no interaction
with cycloserine

46. Digoxin cannot be used in which condition:
a) Complete Heart failure and atrial fibrillation.
b) Along with ACEI and diuretics
c) ventricular diastolic failure
d) ventricular systolic dysfunction (used)

47. Digoxin MOA is: Positive inotropic effect

48. Main mechanism of action of digoxin:
a) Na-K-ATPase inhibitor

49. Mechanism of action of Digitalis all is true expect:
a) Inc. contractility
b) Dec. vascular resistance
c) Reduce ventricular rate in atrial fibrillation
d) Have modify effect on autonomic nervous system

50. Hospitalized patient in the ICU and suffers from severe hypertension and was
admitted because of angina, which the suitable antihypertensive for him?
a) Metoprolol
b) Hydralazine
c) Clonidine
d) Methyldopa
* Hydralazine increases the risk of angina and the pt had severe HTN but not
emergency HTN so the use of metoprolol is fine I think.

51. Which is not used in prinzmetal angina:
a) Atenolol
b) Nifedipin
c) Nitroglycerin
d) Diltiazem
*causes reflex techycardia

52. How to counteract the increased risk of angina due to hydralazine given to ICU
patients?
a) Nitroglycerin
b) Na nitrosurripde

53. Nitroglycerin not use in route of administration:
a) Oral
b) Buccal
c) Transdermal
d) Sublingual

54. Patient with hypertension put on antihypertensive drug, after few months
developed heart failure manifested as reduction in heart rate and contraction,
which antihypertensive drug patient put on:
a) Lisinopril
b) Verpamil
c) Prozosin
d) Thiazide diuretic

55. Patient admitted to ER with chest pain, diagnosed as prinzmetal angina ,


regarding this angina which is true :
a) Occur at rest not associated with physical activity
b) Associated with artery spasm
c) Associated with atherosclerosis
d) Not responsive to nitroglycerin and CCB
All true except D

56. Side effect of all antiarrhythmic :
a) Blurred vision
b) Torsade de points

57. Patient admitted with arrhythmia ,regarding arrhythmia which is true:
a) Most common cause is re-entry
b) Antiarrhythmia safer than operation
c) Most treatment is CCB and NA channel blocker
d) SA is pace of heart contraction
A,C,D –TRUE

58. Long case have arrhythmia+ COPD can use except
a) Digitalis
b) Verpamil
c) Amiodarone
d) Diltiazem

59. Case about patient taking propranolol as cardio-protective in myocardial
infarction, all of the following are effects of propranolol except:
a) Reduce infarct size
b) Increased O2 demand
c) Decreases mortality and morbidity

60. A 70-yr old diabetic patient on oral hypoglycemics and suffering from
hypertension, which of the following antihypertensive drugs is not
recommended:
a) Losartan
b) Enalapril
c) Hydrochlorothiazide
d) Atenolol

61. Which agent is given to reverse the toxicity of MTX?
a) folinic acid
b) folic acid

62. Which SE of methotrexate is not reversed by leucovorin?
a) Hepatotoxicity
b) Nephrotoxicity
c) Neurotoxicity
d) Interstitial pneumonia
*Please double-check as according to Lang, hepatotoxicity is reversed.

63. 11 years old child with with oliguria after MTX, what is the proper treatment :
a) Hemodialysis
b) Hydration
c) alkalization with urine

case about immunosuppressive:

64. Which one work in M phase: vinblastine (no vincristine)

65. Which one least to cause myelosuppression: bleomycin

66. What to use instead of vincristine: paclitaxel

67. Which one will cause rales and cough: bleomycin

68. Patient with HIV, the CD4 less than:
a) 200
b) 400
c) 500
d) 600

69. CD4 bind to which antigen in the HIV positive Pt:
a) T lymphocyte
b) lymphocyte
c) macrophages
d) natural killer

70. Sulfasalazine should be given with which supplement: Folic acid

71. Not for crohn's disease:
a) Adliximab
b) Infliximab
c) certolizumab
d) Ustikenumab or Golimumab (can't remember but both used)
e) Etanercept

72. Drug suppresses T lymphocytes:
a) Etanercept (suppress TNF not t lymphocytes)
b) adalimumab
c) Infliximab (suppress TNF

73. Azathioprine SE not dose related:
a) bone marrow depression
b) hepatotoxicity
c) Infection
d) Pancreatitis

74. All are DMARDs except:
a) prednisolone
b) methotrexate

75. Treatment of mailgnant glioma:
a)methotrexate
b)dacarbazine
c)6-mercaptopurine
d)carmustine

76. Patient on cyclophosphamide has developed hematuria due to release of
which substance:
a) phosphoramide mustard
b) Acrolein
c) Mensa

77. Etoposide causes DNA damage through inhibition:
a) Topoisomerase I
b) Topoisomerase II
c) Topoisomerase III
d) Topoisomerase IIII

78. Letrozole: (came as 4 statements and then in the choices combinations of them
for example: a only, a&b. b&d and so on …)
a) mild androgenic SE
b) aromatase inhibitor
c) does not cause endometriosis (true as it treat endometriosis)
d) no need corticosteroid co administration ( Double check this one)

79. Maximum duration for the use of tamoxifen is:
a) 2 years
b) 5 years
c) 7 years
d) 10 years

80. Patient was on cyclosporine and changes to tacrolimus) Tacrolimus comparison
with Cyclosporine all answers are true except: (came as 4 statements and then
in the choices combinations of them for example : a only, a&b, b&d and so on …)
– better to double check each point
a) more potent
b) less nephrotoxicity and neurotoxicity
c) longer duration
d) lower rejection rates
* I think the answer is a and b, please double-check

81. Cyclosporine is more toxic in which route:
a) oral
b) IV
c) IM
d) SC

82. Patient take DMARDs and after 2 weeks have eye problem which drug cause
that: (I am not sure it was in my exam)
a) sulfalazine
b) hydroxyquine

83. Enfuvirtide added to HIV patient regimen what true about it:
a) integrase inhibitor.
b) S)C
c) cant used without reconstitution
d) low side effects
*a is wrong it is an infusion inhibitor

84. Dose not promote hyperglycemia:
a) NSAID
B) Diuretic
c) opioid
d) nicotinic acid
b) salicylates
c) Cimetidine

85. Does not potentiate the effects of sulphonylurea:
a) DiazoxideWhich Insulin type that's its reaction time is not effected by site of
administration?
a) Glargine (Lantus)
b) Isophane (Humuline)
c) Aspart

86. Insulin that cannot be given as an IV:
a) Lispro (rapid acting)
b) Aspart (rapid acting)
c) Glulisine (rapid acting)
d) isophane

87. All indications of diabetes except: (came as 4 statements and then in the
choices combinations of them for example : a only, a&b. b&d and so on …)
a) Polyuria and unexplained weight loss
b) Random blood glucose of 200
c) Fasting blood glucose of 140
d) Blood glucose level of 200, 2 hours post oral glucose intake

88. Insulin secretion form:
a) B cell
b) Alpha cell

89. Which drug has least effect of hypoglycemia? (if acrabose is there choose it)
a) metformin
b) glibenclamide

90. Action of insulin except:
a) Decrease glucose production in liver
b) Decrease liver glucose uptake
c) Insert glucose in muscle and adipose tissue answer

91. Adipose tissue and skeletal glucose transporter: GLOUT4

92. Diabetic patient with Nephropathy complications, this called
a) Macrovascular complications
b) Microvascular complications
c) Neurological

93. Medication for prophylaxis of migraine for a patient young patient: propranolol

94. Sumatriptan is: not used in the coronary artery disease, recurrent attacks is
common after first dose, less nausea than with ergotamine.

95. Thrombocytopenia caused by chemo therapy is treated with: Oprelvekin

96. Used for anemia:
a) folic acid
b) B12
C) iron
d) erythropoietin
e) ALL

97. Which drug is high alert and should always be properly labeled and separated:
Epinephrine inj (epipen)

98. A child took peanut butter and he’s allergic to peanut; he developed rashes and
urticarial. What type of allergic reaction is this?
a) Type 1
b) Type 2
c) Type 3
d) Type 4

99. Patient got stung by bee, suffered from severe bronchospasm, and severe
hypersensitivity reaction, which drug is most suitable for this case:
a) Dopamine
b) Norepinephrine
c) Epinephrine
d) Antihistaminic

100. Ipratropium approved for:
a) Maintaining COPD
b) Asthma

101. The best advice to a patient taking corticosteroid inhaler for asthma (came as 4
statements and then in the choices combinations of them for example : a only,
a&b. b&d and so on …)
a) Take rapid breath after pressing the inhaler
b) Hold your breath for 10 seconds after complete inhalation
c) rinse your mouth with water after using the inhaler
d) keep one finger distance between your lips & the inhaler

102. Side effect that most people who take B2 agonist may have:
a) Hypokalemia
b) Tremors
c) hypomagnesia

103. Cromolyne sodium mechanism: decrease mast cell degranulation

104. after you open an inhaler, it will be valid for: 3 months

105. A child suffered from acute asthma attack and diagnosed with asthma which
single treatment for long term use to prevent exacerbations of asthma:
a) Salmeterol
b)Ipratrobuim
c)Salbutamol
d) Corticosteroid

106. Smoker with COPD, what is the drug of choice:
a) Busonide
b) Ipratopium
c) Theophyllin
d) Montelukast

107. Medication in an Inhalation route can be used for long term to control
asthma:
a) Salmeterol
b) Budesonide
c) salbutamol

108. What is antiphlogistic agent?
a) Cooling by evaporation
b) Makes the skin oily
c) irritates the skin and makes it red
d) do not remember

109. Treatment of glaucoma with heart edema: acetazolamide

110. What is true about antiglaucoma: Reduce intraocular pressure

111. Pilocarpine used in all of the following except:
a) acute attack of closed angle of glaucoma
b) standard drug for close angle glaucoma
c) used alternatively with mydriatic to separate the iris
d) standard one for open angle glaucoma

112. Patient with glaucoma taking ecothiophate, what’s the reoccurring side
effect?
a) Tonic pupil
b) Cataract
c) Strabismus

113. Mydratic used to determine the true refractory error of the eye:
a) Atropine
b) Tropicamide


114. Prostaglandin anti-glaucoma drug approved for eye lash Hypotrichosis:
a) bimatoprost
b)latanoprost,
c)travoprost
d)Ilosopt

115. Malathion is associated with a delayed toxicity (neurotoxicity) that happens
occasionally, which enzyme inhibition is associated with it?
Acetylcholinesterase

116. Which is NOT a non-mast cell that produce histamine?
a) Adipose tissue
b) CNS cells
c) Epidermis
d) GI cells

117. all are signs of atropine toxicity except:
a) constriction of the pupil
b) Dry mouth
c) hot skin (increase temp)
d) Tachycardia
e) Constipation

118. Temp of refrigeration: 2-8

119. Titanium dioxide protects from sun mechanism:
a) Absorbs UV
b) Reflects UV

case about immunosuppressive:
120. Pt taking isoniazid, ethambutol, rifampicin, pyrazinamide, which is least to
cause urine discoloration? Ethambutol

121. Mutation is the DNA dependent RNA polymerase causes resistance to which
drug? Rifampicin

122. Pharmaceutical equivalent EXCEPT:
a) Same rate and extent of absorption
b) same route
c) same active ingredient

123. Generic drug means:
I name of active ingredient
II drug that is not manufactured by the original company
III drug that is not under the protection by patent from the original company
a) I
B) II, III

124. Patient came to the pharmacy, he was angry and shouting he want to buy a
medicine but as a pharmacist following the roles only can give (medicine Sold):
Original Packet / pack / leaflet / strip
- ALL

125. Patient with low Hb, low small RBCs, which medicine can decrease the cell
size plus iron
a) Vitamin B12
b) folic acid
c) erythropoietin

126. Emulsion preparation and it is homogenous but with oil droplet on the glass
,The emulsion will reform on shaking this is called:
a) Oiling
b) creaming
c) Cracking

127. Emulsions undergoing different temperatures by increasing the temperature
so what the effect will happen to it
-oiling
-Molting
-Caking
-cracking

128. For tablet preparation all can be used except :
a) Wet granulation method
b) Dry granulation method
c) Compressed
d) Incompressed

129. least likely to be seen in a typical tablet formulation: volatile solvent

130. effects of all of the following not mediated by the action of a receptor except:
a) Chlosgramine
b) AL.OH
c) Mannitol
d) Neostigmine

131. Semi control is: CDB class B

132. Case of patient had injury and result in HIB 6 months ago, what is the least
effective in his case
a) Interferon
b) HBV Vaccine
c) HBV immunoglobulin
*must be given with 24 hours to maximum of 7 days after exposure - CDC

133. Histamine autorecepteor found neurons: H3

134. Adipose tissue and skeletal glucose transporter: GLOUT4

135. All renally excreted except: fosinopril

136. Semicontrol drug what is true : licensed GP can prescribe for 30 days with no
refill, specialist prescribe for 30 days with one refill, the Rx valid duration is no
more than 3 days from the date of Rx, all ( answer is all)

137. Controlled drug: licensed GP can prescript for only 3 days, refill must not be
issued for control medicine , duration of Rx to be dispense is no more than 2
days from the date of Rx, all (answer is all)

138. Which treatment is more safely for outpatient with pulmonary embolism
a)heparin only
b)heparin + fendaparinux
c)fendaparinux + low molecular weight heparin
d)fendaparinux + heparin + low molecular weight heparin

139. Leprosy treatment resistance due to:
a)treatment with one drug
b) lepromatous leprosy
inherent resistant
d) all
140. Pt was using pilocarpine for previous 3 years and suddenly she suffered from
breathing difficulty what is best to give manage he condition:
a) atropine
b) Ephinephrine

141. Pt with electroconvulsent and severe psychosis best anesthesia;
a) halothane
b) methohexital

142. Best anesthesia for a cardiac surgery with cardia problem:
a) fentanyl
b) morphine
c) Lidocaine
d)propoxaphen

143. Not used in atrial fibrillation:
a) Lidocaine
b) quinidine,
c) procainamide,
d) flecaninde

144. Drug associated with life threatening hyperkalemia: spironolactone

145. What type of antagonists is phenoxybenzamine: irreversible

146. Pt has sickle cell an suffered from painful symptoms and side effect what
medicine can be helpful: hydroxurea

147. Tablet not using disintegrating, lubricant agent to slow its dissolution:
effervesant tablet

148. Topical treatment for hair loss(baldness) for 25 years old male: Minoxidil.

149. Injectable anticoagulant mechanism of action:
a) potentiate anti thrombin III effect… as injectable is heparin
b) antiplatelet aggregation
c) inhibit coagulation factors synthesis

150. NOT FIRST LINE treatment for TB:
a) streptomycin
b) INH
c) Rifampicin
d) pyrazinamide

151. Facilitated diffusion is : need transported down chemical gradient similar to
P glycoprotein found in the intestine and does not need energy

152. Sumatriptan is: not used in the coronary artery disease, can suffer from
recurrent attack after first dose, less nausea than with ergotamines

153. All SE of desipramine except: bradycardia

154. Pt was taking botox injection for wrinkels in her face , what is a common SE:
a) respiratory paralysis
b) Strabismum
c) Blepharospasm
* Please check the percentages of prevalence as the Q said “common” SE. I do
not think the answer is a

155. Estrogen used in menopause women; ethenylestradiol

156. Site where gastric histamine is secreted : enterochromafin like cells

157. The main acid drug carrier in plasma: albumin

158. All of the following are properties of controlled release drugs except: low cost

159. A drug that has high risk for thrombosis and MI; celecoxib

160. Patient taking INH,Methotrexate and amiodarone What he may have as side
effect of these medications:
a) Pancytopenia
b) liver cirrhosis

161. Drug used in athletes foot:
a) griseofulvin
b) clotrimazole
c) nystatin

162. Conductivity test ,dilution test, dye test used for :
a) Suspension
b) Emulsion
c) Foam
d) Gel

163. Conductivity in emulsion, the dispersed phase for such emulsion is:
a) Aqueous
b) Non aqueous
c) Aqueous and non-aqueous
d) Oily

164. Which is true about dry gum emulsion:
a) Ratio 4:2:1
b) Water gum and oil are added together and triturated slowly
c) Oil and gum are triturated and water added slowly

165. Emulsion inversion: Conversion of W/O emulsion to O/w emulsion and vice
versa

166. Foam in pharmacy spray:
a) Topical
b) Burn dressing
c) Rectal
d) All

167. Advantage of IV route is true: (without except)
a) Used in emergency
b) Dose can be titrated
c) Fastest
d) Safe and convenient
A ,B,C---TRUE

168. Affect dissolution rate, absorption rate, content uniformity and stability:
a) Particle size
b) Size distribution
c) Interaction with surface molecule
All

169. Particle size affect the following :
a) Solubility
b) Dissolution
c) Content uniformity
d) Suspendabililty
e) Penetrability
ALL

170. 50% alcohol is to be diluted with purified water, how many parts of purified
water (0% alcohol) to prepare 20% preparation:
a) 20 parts 50% alcohol + 30parts water
b) 30 part alcohol +20 part water.
c) 50 part alcohol+50 part water

171. Case: Parkinson’s symptoms:
i Tremor & agitation
ii Difficulty to initiate & voluntary movements
iii Abnormalities in postural and normal position
All

172. Best drug to decrease the exacerbation IBS: prednisolone

173. Carvidopa used with levodopa to: Inhibit peripheral conversion to dopamine

174. Effect of levodopa decreased with which vitamin:
a) B12
b) B6
c) B2
d) B3

175. Effect of levodopa on body diminished :
a) After less than 3 yrs
b) After 2 yrs
c) After 3 yrs up to 5 yrs
d) after 5 yrs

176. Drug not used in Parkinson:
a) Levodopa
b) Bromocriptine
c) Chlorthalidone

177. Antiviral used for influenza and Parkinson:
a) Amantidine
b) Lamuvidine
c) Zidovudine

178. Non-competitive ACH except:
a) Rivastigmine
b) Tacrine
c) Donazepil
d) Galantamine

179. Regarding Fluoxetine:
a) Half life is 50 hrs
b) Have a metabolite as active as the prodrug
c) Used in bulimia nervosa
d) Undergo first pass effect
e) All

Case about patient recently widowed, is suffering from severe depression, is taking
imipramine

180. TCA mechanism inhibit / TCA block the uptake of :
a) NE
b) 5HT
c) 5HT & NE
d) Dopamine
181. Alprazolam (Xanax) (CDA) :in steel cupboard well closed well

182. TCA metabolized by: CYP450
183. TCA act on all ,EXCEPT:
a) alpha adrenoreceptor
b) beta adrenoreceptor
c) muscarinic receptor
d) Histamine receptor

184. TCA used in all except:
a) panic attack
b) Schizophrenia
c) Migraine
d) Neuropathic pain

185. For treating morphine dependence all of the following except :
Buprenorphine
a) Clonidine
b) Codiene
c) Methadone

186. Patients admitted with morphine over dose what is the appropriate
treatment:
a) Naletraxone
b) Methadone
c) Prozethacain
* Please check as there was no naloxone in the choices

187. Morphine cause tolerance except:
a) Respiratory depression
b) Euphoria
c) c) Pin point pupil

188. Meperidine not suitable for use long time because:


a) Nephrotxicity
b) Neurotoxicity
c) Cardiotoxicity

189. Treatment of Status Epilepsy: Phenytoin

190. In absence seizure all of the following prescribed except:


a) Ethosuxamide
b) Diazepam
c) Lamotrigine
d) Carbamezapine

191. In pregnancy all are avoided except:-
a) Phenytoin
b) Phenobarbital
c) Valproic acid
d) Clonazepam

192. In absence seizure all of the following prescribed except:
a) Ethosuxamide
b) Valproate
c) Lamotrigine
d) Phenytoin

193. All can use in acute Mania ,Except: Chlorpromazine

Diagram 1

194. Drug above MTC will show :
a) Toxicity
b) Side effect
195. Drug below MEC will be:
a) Toxic
b) Ineffective
196. High Therapeutic index mean: No side effect
197. Conc. at CMAX. is 23.5 ,the T will be:
a) 2hrs
b) 3hrs
c) 4hrs
d) 5hrs
Diagram 2

198. T max of IV curve : zero
199. Tmax of oral curve : 4 hr
200. Assume zero order for iv curve what will
be the t half: 12hr
201. The colored area reflect: AUC
202. Which is true: Onset of IV is faster than oral


Diagram 3

203. Time of drug remain in the body: 24hrs
204. What is colored area: Area under the
concentration-time curve
205. MTC: Minimum toxic concentration
206. MEC: Minimum effective concentration
207. Goal: to keep drug concentration between MTC and MEC

208. phenytoin S.E. all , Except :
a) Gingival hyperplasia
b) Nystagmus
c) Nephrotoxicity
d) Steven-Johnson syndrome

209. Pt is taking anti-seizure medication and wants to stop it, which of the
following low recurrence:
a) EEG abnormalities
b) Frequent seizure attack
c) Cerebral known lesions
d) Seizure began at early age

210. How many mg to give a 27kg child if the dose is 1.2mg/kg: 32mg

211. Regarding prazocin:
i) Have first dose effect
ii) Most patients not developed tolerance to this effect
iii) First dose effect not decrease with decreasing dose
iiii) Not usually occur in most patients
* Please check as there was a choice u can choose i & ii

212. SIADH (syndrome of inappropriate antidiuretic hormone secretion) cause all


of the following except:
a) Hyponatremia
b) Hypernatremia
c) Water excess
d) Inadequate vasopressin production

213. All of the following are side effects of thiazide diuretics except:
a) Hyponatremia
b) Hypocalcaemia
c) Hyperuricemia
d) Hypervolemia

214. Loop diuretics are contraindicated in all of the following except:
a) Renal diseases
b) Sensitivity to sulfonamides
c) Anuria despite using loop diuretics
d) Na and water depletion

215. Pseudoephedrine except options :
a) Mixed agonist
b) Short action
c)Synthetic analogue
d) Tachphalaxis on repeated administration
* please double check

216. DOC for pregnant hypertension:
a) methyldopa
b) Hydralazine

217. Patient taking ACEl which antacid should not be used?
a) Calcium carbonate
b) Magnesium
c) Aluminum
d) Potassium bicarbonate due to high risk of hyperkalemia

218. Case patient taking procarbazine. Which amino acid is contraindicated:
a)phenylalanine
b)tyramine
c)valine
d)leucine

219. Patient with arrhythmia given medication that decrease the velocity and force
of contractility which one of this drugs:
a) Verapamil
b) Enalapril

220. Long case about patient diagnosed with MI and arrhythmia discharged from
the hospital 10 days ago which drug is suitable :
a) Verapamil
b) Lidocaine
c) Quinidine
d) Sotalol

221. Which of the following is not true about dry cough associated with ACEI :
a) Mediated by bradykinin and substance p
b) In women more than men
3- Develops within 6 months
c) Dose related

222. Patient with infection sensitive to tetracycline , pt is renal impaired Which one
of tetracyclines is suitable for him:
a) Doxycycline
b) Minocycline
c) Tetracycline

223. All the following drugs decrease B blockers activity except ;
a) Phenytoin
b) Phenobarbital
c) Rifampin
d) Fluoxetine

224. Bacteria move by: Flagella

225. Chest x ray show what like to cause this infection: M. avium complex.

226. Primaquine is contraindicated in all of the following except:
a) SLE,RA
b) G6PD deficiency
c) Lactating female
d) Pregnancy

227). pro-kinetic drug has anti emetic effect:
a) domepridone
b) Cisapride

228. Prevent remission in IBD (Inflammatory bowel disease): Infliximab

229. Charcoal used in poisoning due to which properties:
a) Adsorption
b) Absorption
c) Metabolism
d) Excretion

230. Pt. have lower HDL and lower dyslipidemia management :
a) Atorvastatin
b) Niacin
c) Fenofibtates
d) Rosuvastatin

231. Used in motion sickness: Scopolamine



232. Antacid used in ICU(intensive care unit):
a) Proton pump inhibitor
b) Anti-H2
c) Prostaglandin analogue
d) Sucralfate

233. Which of the following is not fungus:
a) Yeast
b) Mushroom
c) Mucor
d) Escherichia

234. Immune reconstitution inflammatory syndrome except:
a) Not effected by glucocorticoids or anti-inflammatories
b) The action of antiviral starts
c) Patient start to respond to treatment

235. In myasthenia gravis which is true except:
a) Autoimmune disease against Ach receptors
b) Diagnosed by edrophonium
c) Not treated with corticosteroids

236. TB. medication, flu,PYZ,RMP ,which is the SE. of INH : Peripheral neuropathy

237. Which of the following is CI in Parkinson’s: Haloperidol

238. B adrenergic agonist least effect: Begin prostatic hypertrophy

239. The drug of choice for absence seizure: Ethosuximide

240. the main reason why we use more than one medication inTb regimen with:
a) prevent resistance
b) less SE
c) more patient compliance (not sure it was in choices)/or better tolerance (not
sure if it was there)
d) All of them


241. Picture of nail with thick texture and brown discoloration, Nail fungal infection
DOC:
a) Fluconazole
b) Terbinafine
c) Griseofulvin

242. Contraceptive contraindicated with lactating mother:
a) Progestin alone
c) combination*
d) copper T (loop)
e. condoms

243. Female is menopause, she experiences hot flushes, developed spinal
osteoporosis which to use?
a) Alendronate
b) Estrogen and progesterone
c) progestin

244. Factors affect cerebro-spinal fluid (CSF) penetration Except:
a) lipid solubility
b) water solubility
c) Molecular weight
d) Plasma protein binding

245. IBS (irritable bowel syndrome) symptoms and the physician advised the
patient to eliminate dairy products from diet for about 3 months.
a) chronic constipation (not sure)
b) chronic diarrhea
c) alternatively constipation and diarrhea

246. Used in motion sickness except:
a) Hyoscine (scopolamine)
b) Meclizine
c) Promethazine HCL
d) Propamide

247. Which is not given for constipation?
a) Lactulose
b) Loperamide
c) Na-Pico sulfate
d.) Docusate sodium

248. All of the following cause constipation except:
a) Bisacodyl
b) Morphine
c) Calcium
d) ACEI

249 A patient suffers from esophagus reflex , which additional symptoms if
happened the patient should be referred to cardiologist?
a) mild pain in arms
b) pain in central abdominal
c) pain that spread to jaws, neck, shoulders and arms
d) pain in illu fosse "something like this"

250. Patient has a problem in bowel emptying, he develops pain while passing stool,
Which is the least likely condition to cause this constipation?
a) Bowel obstruction
b) IBD
c) Carcinoma
d) hyperthyroidism ( as it cause bowel movements and diarrhea )

251. Pharmacist monitoring of drug dispensing and refill will give an idea about:
a) Drug utilization
b) Drug disposal
c) Drug adherence

252. What’s the type of study that’s MOST reliable?
a) Cohort randomized trials
b) Case study
c) Case report
d) case series

253. What’s the type of study that’s LEAST reliable?
a) Cohort randomized
b) Case study
c) Case report
d) Case series

254. Manufacturer recall of medication from pharmacy is called:
a) Voluntary call
b) Immediate recall
c) involuntary call

255. patient with ED (erectile dysfunction) and take Sildenafil which one is absolute
CI with sildenafil: isosorbide dinitrate

256. A physician wants to switch a terminally-ill patient from slow release morphine
sulphate tablets, 15 mg twice daily, to a liquid morphine sulphate dosage form
because the patient has difficulty in swallowing tablets. If a morphine sulphate
solution containing 5 mg per mL is prescribed q4h, what volume should be
dispensed for a 20 day supply to provide the same pain relief as the tablet
regimen?
a) 20 ml
b)40 ml
c)60 ml
d)120 ml

257. Case of female who has panic when she has to speak to audience. Treatment
of acute panic attack:
a) benzodiazepines
b) TCAs
c) antipsychotics
D)SSRIs
e) Buspirone

258. True about SSRIs:
a) Best For long term use
b) Effect takes 1-4 weeks to occur
c) Can't be used as first line for anxiety disorders
d) ….

259. Benzodiazepines EXCEPT:
a) Muscle relaxants
b) Anxiolytics
c) Antrograde amnesia
d) antipsychotics

260. DOC for status epilepticus:


a) clonazepam
b) diazepam
c) Phenobarbital

261. DOC with b blockers in aortic dissection
a)minoxidil
b)hydralazine
c)diazoxide
d)sodium nitroprusside

262. Contraindicated in CHF :
a) hydrochlorothiazide
b) Nefidipine (as it will cause reflex tachycardia worsening the case)
c) captopril
d) digoxin

263. Enalapril, which is not beneficial effect:
a) decrease inotropic effect
b) decrease renin release
c) decrease angiotensin effect

264. Case of patient using 4 drugs ( enalapril, simvastatin, amiodarone? ..) , which
one of them can cause dry cough: Enalapril

265. Not enalapril SE:
a) Dry cough
b) Angioedema
c) hypokalemia
d) postural hypotension

266. Ramipril physiological actions (something like that)
a) Hypokalemia
b) Low level of potassium
c) Increased renin in plasma *
d) Angiotensin II receptor inhibitor

267. ACEI can increase level of ?
a) sodium
b) potassium
c) calcium
d) magnesium

268. Hypertension emergency which one to use:


a) sodium nitroprusside
b) Clonidine
C) Captopril

269. Which one would reduce BP in 2 hours?
a) Atenolol
b) Captopril
*according to Lang the answer is ramipiril but it was not in the choices so I think
it should be captopril since it is same class

270. Which of the following causes tachycardia:
a)Propranolol
b)verapamil
c)diltiazem
d)isosorbide dinitrate

271. Which anti TB drug cause urine discoloration (reddish coulour): a. Rifampicin

272. When giving ethambutol for a long duration, continuous follow-up/check-up is


necessary because of this condition:
a) Renal failure
b) Liver dysfunction
c) vision problem ( ocular toxicity )

273. Pt dose is 1.2mg/kg the pt wt is 27kg what is the dose; 32mg (a.2*27)

274. Pt take infusion of 200mg/500ml in rate of 0.5mg/ml (or something like that
any way u will not need) what is the concentration of solution in
microqram/ml : 400 ml

275. How ml u need to add to 1ml of 1:1000 to converted to 1:2500: 1.5 ml
c1v1 = c2v2 (find v2 then subtract v2-v1)

276. How many gram of 5% ointment will be prepared from 2 gm :
40 2*100/5)

277. How many gram will be in 250 ml of 5% solution : 12.5g (250 *5 /100)

278. Dose pt.75 mg ,How ml. 125mg /5ml solution : 3ml (75 *5/125)

279. 10 ml ampoule of 3% drug how many mls required to give 150mg dose? 5ml
(3*10/100=0.3g in 10mg so 150*10/300mg)

280. If dose of drug is 0.2 ml, How many dose will be in 15ml :
75ml (15ml /0.2 ml)

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