REVISION 3

Both papers recent

recalls

Dr/Ahmed Gad
www.newpetc.com
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Dr. Ahmed Gad

1- Which of the following conditions is contraindicated with the use of Betaxolol?
a) Hypertension
b) Asthma
c) Diabetes
d) Migraine headaches

2- Penicillins cephalosporin cross sensitivity

a) 4-10%
b) 10-20%
c) 20-30%
d) 100%

3- Which drug is metabolized by both phase I & phase II and excreted as

glucuronide
a) Diazepam
b) Glimepiride
c) Paracetamol
d) Digoxin

4- 2 g KCl in 500 ml infusion with infusion rate of 100 ml/hr., How many mEq/ min?
(Mwt of KCl = 74.5)
a) 0.089 mEq/min
b) 0.0053 mEq/min
c) 0.026 mEq/min
d) 0.04 mEq/min

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5- Compensation of respiratory acidosis

a) Hypoventilation
b) Increase bicarbonate excretion
c) Increase reabsorption of bicarbonate
d) Hyperventilation

6- Treatment of renal artery stenosis:

a) Methyl dopa
b) Tamsulosin
c) Ramipril
d) Nitroglycerin

7- TCA least effect:

a) Insomnia
b) Weight gain
c) Blurred vision
d) Dry mouth

8- In asthma:
a) ↑ airway passage resistance
b) ↓ airway passage resistance
c) The alveoli in the lungs become permanently enlarged and damaged
d) An inflammation of the airways

9- Which of the following should not be crushed?

a) Cyproheptadine tab
b) Omeprazole enteric coated tab
c) Abacavir tab
d) Ascorbic acid effervescent tab

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10- Calculate the daily dose (3 times/day) for 2 years old child, 12 kg in weight
receive 120 mg/5ml bottle of paracetamole:
a) 50 ml
b) 75 ml
c) 22.5 ml
d) 7.5 ml

11- If the patient must take low Na⁺ salt, then change to:
a) AlCl3
b) KCl
c) KI
d) CaCl2

12- Pilocarpine cause:

a) Mydriasis
b) Miosis
c) Mythenia gravis.
d) Glaucoma

13- Which of the following is wrong?

a) Monitor with INR for warfarin therapy.
b) Monitor with anti Xa factor for apixaban.
c) Idarucizumab reverse the action of dabigatran.
d) Rivaroxaban given for patient with CrCl <15 ml/minute.

14- Which one is not caused by decreasing dopamine, an increase in acetylcholine?

a) Ataxia.
b) Hyperreflexia
c) Rigidity.
d) Bradykinesia

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15- PTH + vit D what they do:

a) They ↑ bone resorption + ↓ excretion of Ca⁺²
b) They ↓ intestinal absorption of Ca⁺²
c) They ↑ bone resorption + ↑ excretion of Ca⁺²
d) PTH ↑ bone metabolism and vit ↓bone resorption

16- All the following are time-dependent antibiotics except:

a) Metronidazole
b) Vancomycin
c) Macrolides
d) Clindamycin

17- Which drug does not used for the treatment of tenosynovitis?
a) Azathioprine
b) Ibuprofen
c) Ceftriaxone
d) Dexamethasone

18- Mechanism of Propranolol in angina:

a) Block cardiac effect of catecholamine.
b) Increase preload.
c) Increase cardiac contractility.
d) Block sodium ions to enter myocardium.

19- Mechanism of action of nifedipine.

a) Binding to voltage dependent receptor on vascular smooth muscle.
b) Enhance calcium influx through the channel.
c) Sodium channel blocker.
d) Block β1 receptor on the cardiac muscles.

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20- For left AV valve, which is wrong?

a) Closed when ventricular ejection.
b) Opened when ventricular filling.
c) Opened when atrial filling.
d) Closed when atrial filling.

21- Which drug cause leukopenia?

a) Warfarin.
b) Diclofenac
c) Cyclosporin
d) Propranolol

22- Vaccine that should be taken every year for 65y male
a) Hepatitis B vaccine.
b) Pneumococcal vaccine.
c) Varicella zoster vaccine .
d) Influenza vaccine.

23- Which vaccine is a live virus vaccine?

a) Inactivated polio vaccine
b) Mumps vaccine
c) Hepatitis B vaccine
d) Hemophilus influenzae type B (Hib) vaccine

24- A vaccine which is not taken in immunocompromised patients

a) Rabies vaccine.
b) Flu vaccine.
c) yellow fever vaccine.
d) Pneumococcal vaccine.

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25- Colchicine:
a) Cause constipation.
b) Colchicine + simvastatin → cause myopathy.
c) Colchicine is an inducer to CYP2C19 and P-glycoprotein.
d) Colchicine cause dose independent side effect.

26- Alendronate class is:

a) Opiate analgesic .
b) Bisphosphonate (like Pyrophosphate)
c) Tetrahydro folic acid.
d) Calcium Phosphate.

27- If a drug has a half-life of 6 hours, how much quantity of the drug would remain
after 24 hours?
a) 25%
b) 12.5%
c) 6.25%
d) 3.125%

28- which ring is present in digoxin:

a) Steroidal ring
b) Pyrrole ring
c) Naphthalene ring
d) Anthracene ring

29- Which of the following is predominately excreted as an unchanged drug

a) Propoxyphene
b) Phenytoin
c) Acamprosate calcium
d) Codeine

30-Most of the phenytoin excreted through:

a) Liver
b) Kidney
c) Skin
d) Lung
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31-Which of the following drugs is known to increase the serum level of

rivaroxaban?
a) Aspirin
b) Simvastatin
c) Amiodarone
d) Metformin

32-The recommended regimen for uncomplicated gonococcal infection of the

cervix, urethra, or rectum among adults and adolescents is:
a) Ceftriaxone 500 mg IM in a single dose + doxycycline 100 mg orally twice daily
for 7 days
b) Cefixime 800 mg orally in a single dose + azithromycin 1 g orally in a single
dose
c) Spectinomycin 2 g IM in a single dose +doxycycline 100 mg orally twice daily
for 7 days
d) Gentamicin 240 mg IM in a single dose + azithromycin 2 g orally in a single
dose

From 33-38: A 35-year-old man who weighs 70 kg and has normal renal function
needs an intravenous infusion of the antibiotic Carbinicillin. The desired
steady state plasma drug concentration is 15 mg/dL. The physician wants the
antibiotic to be infused into the patient for 10 hrs. Carbinicillin has an
elimination half-life (t½) of 1 hr and an apparent volume distribution (VD) of 9
L in this patient.

33- Assuming that no loading dose was given, what rate of intravenous infusion is
recommended for this patient?
a) 93.6 mg/hr
b) 135.0 mg/hr
c) 468.0 mg/hr
d) 936.0 mg/hr

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34- Assuming that no loading intravenous dose was given, how long
after the initiation of the intravenous infusion would the plasma drug
concentration reach 95% of the theoretic steady-state drug concentration?
a) hrs
b) 3.3 hrs
c) 4.3 hrs
d) 6.6 hrs

35- What is the recommended loading dose?

a) 135.0 mg
b) 468.0 mg
c) 936.0 mg
d) 1350.0 mg

36- To infuse the antibiotic as a solution containing 10g drug in 500 mL 5% dextrose,
how many millilitres per hour of the solution would be infused into the
patient?
a) 10.0 mL/hr
b) 46.8 mL/hr
c) 100.0 mL/hr
d) 936.0 mL/hr

37- What is the total body clearance rate for Carbinicillin in this patient?
a) 100 mL/hr
b) 936 mL/hr
c) 4862 mL/hr
d) 6237 mL/hr

38- If the patient’s renal clearance for Carbinicillin is 86 mL/min, what is the hepatic
clearance for Carbinicillin?
a) 108 mL/hr
b) 1077 mL/hr
c) 3840 mL/hr
d) 5160 mL/h

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From 39-41: A new cardiac glycoside is developed for oral and intravenous
administration. The drug has an elimination half-life (t½) of 24 hrs and an
apparent volume of distribution (VD) of 3 L/kg. The effective drug
concentration is 1.5 ng/ml. Toxic effects of the drug are observed at drug
concentrations>4 ng/ml. The drug is bound to plasma proteins at
approximately 25%. The drug is 75% bioavailable after an oral dose.

39- What is the oral maintenance dose, if given once a day, for a 68-year-old man
who weighs 65 kg and has congestive heart failure (CHF) and normal renal
function?
a) 0.125 mg
b) 0.180 mg
c) 0.203 mg
d) 0.270 mg

40- What is the loading dose (DL) for this patient?

a) 0.270 mg
b) 0.293 mg
c) 0.450 mg
d) 0.540 mg

41- If the drug is available in tablets of 0.125 mg and 0.250 mg, what is the patient’s
plasma drug concentration if he has a dosage regimen of 0.125 mg every 12
hrs?
a) 1.39 ng/mL
b) 1.85 ng/mL
c) 2.78 ng/mL
d) 3.18 ng/mL

42- The rate of potassium chloride infusion:

a) 100 mEq/hr.
b) 200 mEq/hr.
c) 40 mEq/hr.
d) 10 mEq/hr.

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43- Definition of molarity:

a) Number of moles of solute in ml of solution.
b) Number of moles of solute present in one litre of solution.
c) Number of equivalence of solute in one litre of solution.
d) Number of milliosmoles of solute present in one litre of solution.

44- Which of the following is not a rare side effect of aspirin?

a) Agranulocytosis
b) Erythema multiforme
c) Urticaria
d) Haemorrhagic vasculitis

45- Which of the following is a sign of aspirin toxicity?

a) Hyperkalaemia
b) Tinnitis.
c) Proteinuria
d) Renal failure.

46- The class of dipyridamole is.

a) Anti-epileptic.
b) Antiplatelets
c) Anticoagulant
d) Antihyperlipidemic.

47- Which disease does not initiated by inflammation of synovial fluid?

a) RA.
b) OA.
c) MS.
d) Gout.

48- Which of the following is the least appropriate statement about phenol?
a) Phenol has a hydroxyl group attached to a benzene ring.
b) Phenol is prone to dehydration.
c) Phenol has a pka of about 10.
d) Phenol can form hydrogen bonds with water.

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49- Women who have heart failure, hypertension and incontinence need
to treat for HF
a) Captopril.
b) Furosemide.
c) Nifedipine.
d) Atenolol.

50-Epinephrine is given with local anaesthetics to :

a) Enhance their action by vasoconstriction
b) Increase the absorption of local anesthetics
c) Decrease the side effect of local anesthetics
d) Decrease the metabolism of local anesthetics

51-All are risk factors of atherosclerosis except:

a) Smoking
b) Family history
c) HTN and Hyperlipidemia
d) Rheumatic fever

52-The purpose of combined drug treatment of TB :

a) Prevention of proliferation of drug-resistant organisms
b) To increase the duration of the combined drugs
c) To enhance the absorption of isoniazide
d) To improve the efficacy of the drug

53- Which of the following is contraindicated in pregnancy:

a) Fluticasone
b) Clozapine
c) Lisinopril
d) Nystatin

54-All the following drugs can cause disulfiram like action when administered with
alcohol except:
a) Isoniazide
b) Sulfonamide
c) Paracetamol
d) Ketoconazole
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55-All are true about epoprostenol except:

a) In the treatment of pulmonary hypertension
b) It is a prostaglandin analogue
c) Is administered only by IM route
d) Can cause flushing and headache

56-All are true about the Racemic mixture except:

a) An optically active compound because it has a chiral carbon
b) Optically inactive compound because it has an equal amount of d and l
isomers
c) Mixture of optically active isomers
d) Mixture of two diastereomers

57-Oxidation of secondary alcohols gives:

a) Carboxylic acid
b) Ketone
c) Aldehyde
d) Ether

58-Ketoprofen is:
a) Acetic acid derivative
b) Salicylic acid derivative
c) Propionic acid derivative
d) Benzoic acid derivative

59-Which is the best way to get the maximum benefit of amoxicillin to take:
a) High-fat meal
b) High carbohydrate meal
c) With 200ml water
d) With milk

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60-Which of this medication does not have active metabolite:

a) Temazepam
b) Fluxetine
c) Famciclovir
d) Amiodarone

61-Which of the following can be used to treat constipation or chronic, watery

diarrhoea?
a) Hyperosmolar laxatives
b) Bulk-forming laxatives
c) Saline laxatives
d) Stimulant laxatives

62-All are glucocorticoids except:

a) Prednisone
b) Betamethasone
c) Dexamethasone
d) Aldosterone

63-Which of the following drugs is known not to interact with Warfarin?

a) Acetylsalicylic acid
b) Trimethoprim-sulfamethoxazole
c) Rifampin
d) Diphenhydramine

64-The most common waste product of protein is:

a) Amino acid
b) Urea
c) Uric acid
d) Createnin

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65-Purified water USP may not be used in

a) syrups
b) topical preparations
c) parenteral preparations
d) elixirs

66-All are causing photosensitivity except:

a) Amiodarone
b) sulphonamides
c) Azathioprine
d) Thiazides

67-A drug used for microalbumiuria in diabetic patient:

a) Verapamil
b) Irbisartan
c) Metformin
d) Aripiprazole

68-Acrabose maximum daily dose:

a) 600 mg daily
b) 50-100 mg daily
c) 300 mg daily on divided doses
d) 60 mg daily

69- Exposure to 220-250nm wavelength leads to:

a) DNA damage
b) Cell lysis
c) Impair protein synthesis
d) Electrolyte imbalance

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70- Drug used for cold and runny nose and working for long time
a) Fexofenadin
b) Diphenhydramine
c) Chloepheniramine maleate
d) Promethazine

71- Roxithromycin maximum dose:

a) 150 once daily
b) 300 mg twice daily
c) 150 mg twice daily
d) 150 mg three times daily

72- All are contraindications of Sumatriptan except:

a) History of ischemic heart disease
b) Taking phenelzine
c) Uncontrolled hypertension
d) Diabetic patients

73- Which of the following agents needs to be administered with

Dihydroergotamine:
a) Ibuprofen.
b) IV Metoclopramide.
c) Sumatriptan.
d) Paracetamol.

74- Procaine hydrochloride is metabolized by:

a) Hydrolysis
b) Reduction
c) Oxidation
d) Ionization

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Case Study: from 75 to 78:-

Mrs, Smith has recently been diagnosed with
hypertension and hypercholesterolemia. She presents
to your pharmacy today with new prescriptions for
hydrochlorothiazide and simvastatin. She asks to speak with the pharmacist when
she picks up her medication. she asks several questions about her new
regimen and inquiries about the lipid-lowering agent.
75- The main side effect of simvastatin is:
a) Rhabdomylosis
b) Constipation
c) Increase heart rate
d) Insomnia

76-All the following are metabolic effect of hydrochlorothiazide except:

a) Increase potassium excretion
b) Hyperglycemia
c) Hyperuricemia
d) Hypotriglyceridemia

77- After two weeks, Mrs. Smith come to the pharmacy with some skin reactions after
she exposed to the sun at the previous weekend, which of here medications is
responsible for this effect:
a) Simvastatin
b) Losartan
c) HCTZ
d) Pioglitazone

78- Mrs. Smith has some symptoms of peripheral edema and shorten on here breath
with chronic coughing and wheezing. The physician asked you about which of
here medications is contraindicated with here newly diagnosed case:
a) Simvastatin
b) Losartan
c) HCTZ
d) Pioglitazone

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79-The layer of skin that has the greatest effect on percutaneous

absorption of drugs is
a) Subcutaneous layer
b) Stratum germinatum
c) Dermis
d) Stratum corneum

80- All are true about penciclovir except:

a) Oral penciclovir is more effective than topical
b) It is an active metabolite of Famciclovir
c) Used in the treatment of cold sores
d) Patients should apply the cream every 2 hrs while awake for 4 days

81- The structure present is for?

a) Aniline.
b) Naphthalene.
c) Phenylethylamine.
d) Aminobenzene.

82- A 51-year-old woman with symptoms of major depression also has angle-closure
glaucoma. Which of the following antidepressants should be avoided in this
patient?
a) Amitriptyline.
b) Sertraline.
c) Bupropion.
d) Mirtazapine.

83- Role of cabergoline in Parkinson's:

a) Relieves symptoms of Parkinson's Disease including shaking, stiffness and loss
of muscle control
b) selectively inhibits monoamine oxidase type B
c) a dopamine decarboxylase inhibitor
d) metabolic precursor of dopamine
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84- Best action for barbiturate toxicity:

a) Vit C for urinary elimination.
b) Ipecac alkaloid.
c) Flumazenil.
d) Support respiration.

85- CYP450 are in?

a) Endoplasmic reticulum.
b) Nucleus.
c) Mitochondria.
d) Golgi Apparatus.

86- Which of the following agents is considered a first-line

treatment for narcolepsy?
a) Atomoxetine.
b) Clonidine.
c) Temazepam.
d) Modafinil.

87- Amphetamines are contraindicated in patients with all

of the following conditions except:
a) Cardiovascular disease.
b) Glaucoma.
c) Hypertension.
d) Obesity.

88- Which may cause reflex tachycardia and/or postural

hypotension on initial administration?
a) Atenolol.
b) Hydrochlorothiazide.
c) Metoprolol.
d) Prazosin.

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89- Which can precipitate a hypertensive crisis following abrupt

cessation of therapy?
a) Clonidine.
b) Diltiazem.
c) Enalapril.
d) Losartan.

90- A patient returns to her health care provider for routine monitoring 3 months
after her hypertension regimen was modified. Labs reveal elevated serum
potassium. Which is likely responsible for this hyperkalemia?
a) Chlorthalidone.
b) Clonidine.
c) Furosemide.
d) Losartan.

91- An alcoholic male has developed hepatic cirrhosis. To control the ascites and
edema, which should be prescribed?
a) Acetazolamide.
b) Furosemide.
c) Hydrochlorothiazide.
d) Spironolactone.

92-Which best describes the action of ACE inhibitors on the failing heart?
a) ACE inhibitors increase vascular resistance.
b) ACE inhibitors decrease cardiac output.
c) ACE inhibitors reduce preload.
d) ACE inhibitors increase aldosterone.

93- What is the most common adverse effect associated with fixed-dose
hydralazine/isosorbide dinitrate?
a) Diarrhea.
b) Drug-induced lupus.
c) Headache.
d) Heartburn.

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94- Erythromycin activity is due to:

a) Lactone ring.
b) Pyran ring.
c) Amino group.
d) Hydroxyl groups.

95-Which must heparin bind to in order to exert its anticoagulant effect?

a) GP IIb/IIIa receptor.
b) Thrombin.
c) Antithrombin III.
d) von Willebrand factor.

96-Which of the following is the most appropriate initial oral agent for management
of type 2 diabetes in patients with no other comorbid conditions?
a) Glipizide.
b) Insulin.
c) Metformin.
d) Pioglitazone.

97- Permethrin 5% used for:

a) Head louse
b) Scabies
c) Urticaria
d) Acne

98- Which of the following is a weakest acid:

a) Boric acid pka 9.24
b) Acetic acid pka 4.76
c) salicylic acid pKa 2.98
d) formic acid pKa 3.75

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99- To prepare a buffer system of PH 4 use

a) Boric acid pka 9.24
b) lactic acid, pka=3.86
c) Acetic acid pka 4.76
d) phosphoric acid pKa 2.16

100- Valproate exposure in pregnancy has also been associated with a risk of:
a) Hepatotoxicity
b) Abortion
c) Spina bifida
d) Alopecia

101- All are symptoms of Cushing syndrome except :

a) Weight loss
b) Fatty deposits around the base of the neck
c) Purple tretch mark
d) Thining skin

102- Pagett’s disease can be treated by all except:

a) Alendronate
b) Calcitonine
c) Ibandronate
d) Pyridoxime

103- Bromhexine not used as

a) Antitussive
b) Mucolytic agent
c) For chronic asthma and bronchitis
d) Productive cough

104- The bond between alcohol and water is:

a) Covalent bond
b) Hydrogen bond
c) Ionic bond
d) Coordinate bond
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105- Phase II metabolism involves:

a) Oxidation
b) Reduction
c) Hydrolysis
d) Conjugation

106- Blood from lung come to heart through

a) Right atrium
b) Left atrium
c) Right ventricle
d) Left ventricle

107- Diphenoxylate is used as:

a) Laxative
b) Antihypertensive
c) Antihistaminic
d) Antidiarrheal

108- The most appropriate counseling for a female taking oral contraceptive and
Doxicyclin:
a) Use a second method of contraception while taking Doxycyclin.
b) Increase the dose of Doxicyclin
c) Change the oral contraceptive to another method
d) Take Doxicyclin with milk to increase its absorption

109- Which one of the following statements is true?

a) Nonionized species of drugs are more lipid soluble than the ionized species
b) Ionized species partition more readily than nonionized species of drugs across
cell membranes.
c) Ionization of drugs does not affect lipid solubility.
d) Only lipid-soluble molecules readily cross cell membranes.

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110- An example of transporter proteins which are embedded in the

lipid bilayer of cell membranes is:
a) P-glycoprotein
b) CYP3A4
c) Adenosine triphosphate
d) Alanine

111- Which one of the following drugs is not readily absorbed from the skin when
administered by transdermal route?
a) Nitroglycerin
b) Clonidine
c) Nicotine
d) Paracetamol

112- Huntington's disease leads to:

a) Increase excitatory neurotransmitter
b) Decrease of GABA release
c) Decrease acetyl choline production
d) Decrease dopamine release

113- If the pka of a weakly acidic drug equals the pH of the medium, then according
to Henderson- Hasselbalch equation the amount of ionized and nonionized
species will be:
a) 50 % ionized and 50 % nonionized
b) 40 % nonionized and 60 % ionized
c) 40 % ionized and 60 % nonionized
d) 70 % nonionized and 30 % ionized

114- Which one of the following formulations provides the slowest rate of drug
absorption as compared with the others?
a) Syrup
b) Elixir
c) Aqueous solution
d) Tablet
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115- Interaction between lithium and NSAIDs, NSAIDs will cause:

a) ↓Reabsorption of lithium.
b) ↑Excretion of lithium.
c) ↓ Blood flow to kidney leading to accumulation of lithium.
d) ↓ Lithium level due to ↑ its reabsorption.

116- Which of the following is not antioxidant?

a) Ascorbic acid
b) Nitrogen
c) Tocopherols
d) Sodium sulfite

117- Activated charcoal is used in some antidotes because of which of its properties?
a) Neutralizing
b) Emetic
c) Absorptive
d) Adsorptive

118- The excretion of Ibuprofen is:

a) Excreted unchanged in the urine.
b) Excreted unchanged in bile.
c) Excreted as glucuronide conjugate in urine.
d) Is 90% excreted as a free drug in urine.

119- The decrease in kidney perfusion is due to. :

a) Decrease efferent.
b) Increase afferent.
c) Decrease afferent.
d) No change.

120- Which of the following is require a loading dose?

a) Phenytoin.
b) Morphine
c) Ibuprofen
d) Paracetamol

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❖ Transdermal patches:

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❖ Common medications and their antidotes

❖ Some drugs associated with hepatic failure:

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❖ Some drugs associated with renal failure:

❖ Some drugs associated with folic acid deficiency:

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❖ Drug of choice for hypertension with coexisting conditions

❖ Important drug doses

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Answers

1 B 26 B 51 D 76 D 101 A
2 A 27 C 52 A 77 C 102 D
3 A 28 A 53 C 78 D 103 A
4 A 29 C 54 C 79 D 104 B
5 C 30 B 55 C 80 A 105 D
6 C 31 C 56 A 81 C 106 B
7 A 32 A 57 B 82 A 107 D
8 A 33 D 58 C 83 A 108 A
9 B 34 C 59 C 84 D 109 A
10 C 35 D 60 A 85 A 110 A
11 B 36 B 61 B 86 D 111 D
12 B 37 D 62 D 87 D 112 B
13 D 38 B 63 D 88 D 113 A
14 B 39 D 64 B 89 A 114 D
15 A 40 D 65 C 90 D 115 C
16 A 41 A 66 C 91 D 116 B
17 A 42 C 67 B 92 C 117 D
18 A 43 B 68 A 93 C 118 C
19 A 44 C 69 A 94 A 119 C
20 C 45 B 70 A 95 C 120 A
21 C 46 B 71 C 96 C
22 D 47 C 72 D 97 B
23 B 48 B 73 B 98 A
24 C 49 D 74 A 99 B
25 B 50 A 75 A 100 C

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REVISION 3 DR/AHMED GAD