SELECTED MODULE TESTS IN PHARMACOLOGY
Iv. Lambev, V. Ilieva[1]
Thetestshavetheaimtocheckcurrentlystudent’sknowledgeand ability toconcentrate. Theirstructureisconvenientforcreating computerprograms. Questionsinthetestsandthe possibleanswersarechosenaftercarefulassessment. Every module test consists of 25 questions.Every question has four possible answers.Tests have 1–3 answers/question. Тhe number of the correct answers is equal to the number of the incorrect answers.Correct answers should be crossed out with “X”. One minis provided for doing every question.Tests are done if the number of the correct answers is at least 60%.
Scoring when the total number of the correct answers is 50
Correct answers / Assessment of the test29 / 2.00 (poor)
30 / 3.00 (satisfactory)
32 / 3,25
33 / 3.50
34 / 3.75
35 / 4.00 (good)
37 / 4.25
38 / 4.50
39 / 4.75
40 / 5.00 (very good)
43 / 5.25
45 / 5.50
48 / 5,75
50 / 6.00 (excellent)
(1) General pharmacology
1. The metabolic reactions from first phase include: A. Acetylation. B. Sulfoconjugation. C. Glucuroconjugation. D. Oxidation, reduction and hydrolysis.
2. Pharmacodynamics studies: A. Drug effects. B. Mechanisms of drug action. C. Drugs elimination. D. How organisms change drugs.
3. Pharmacokinetics studies: A. Absorption, distribution and elimination of drugs. B. How drugs act on organisms. C. How drugs are prescribed. D. How organisms change drugs.
4. Point out the correct statements: A. Drug effect is a molecular phenomenon. B. Drug action and drug effect are identical terms. C. Drug effect includes the functional and sometimes morphological changes in organs and systems, caused by certain action. D. Drug effect can be observed and studied.
5. Which of these drugs have non specific action: A. Laxatives. B. Hormones. C. Alkaline salts, neutralizing gastric hydrochloric acid. D. Insulin.
6. The specific action of drugs is due to affecting: A. DNA. B. Microbial organelles. C. The drug dosage form. D. Target lipid macromolecules.
7. Which of the following are referred to the target protein macromolecules, responsible for the specific drug action: A. Enzymes. B. Carrier molecules. C. Microbial organelles. D. Receptors.
8. Agonists are ligands which: A. Have affinity. B. Block receptors. C. Have intrinsic activity. D. Do not have intrinsic activity.
9. Effects of which receptors are demonstrated a few hours after their activation? A. G-protein coupled. B. Ionotropic receptors. C. Tyrosine kinase receptors. D. Nuclear receptors.
10. G-protein coupled receptors control calcium ion channels and that is why they influence: A. Membrane excitation. B. Mediator exocytose. C. Protein biosynthesis. D. Muscular contractility.
11.G-protein coupled receptors control calcium ion channels and that is why they DON'T influence: A. Membrane excitation. B. Mediator exocytose. C. Protein biosynthesis. D. Muscular contractility.
12. Action which is directed against the cause of the disease is called: A. Patogenetic. B. Substituting. C. Stimulating. D. Etiological.
13. Elimination of drugs includes: A. Absorption. B. Metabolism. C. Distribution. D. Excretion of drugs and their metabolites.
14. Different forms of passive transport of drugs are: A. Filtration. B. Pinocytosis. C. Passive diffusion. D. Convection.
15. The main ways of parenteral administration of drugs are: A. Oral. B. By injection. C. Rectal. D. Percutaneous.
16. The main way of enteral administration of drugs is: A. Oral. B. By injection. C. Rectal. D. Permucоus.
17. Point out the incorrect statement: A. The drug distribution in the organism depends on the way they are applied, their pK and organ perfusion. B. AUC means “area under the curve” time/concentraion. C. t1/2β means biological half-life. D. In diabetes mellitus patient’s compliance does not have importance for the efficacy of treatment.
18. Point out the pharmacokinetic parameters: A. Bioavailability. B. Volume of distribution. C. Dosing interval. D. pH of environment.
19. It is characteristic for protein-connected drug molecules that: A. They cross membranes. B. They aren’t metabolized. C. They are pharmacologically inactive. D. They serve as storage.
20. Point out the barrier systems which have protective functions in the organism and are connected mainly with distribution of drugs: A. Bloodmilk barrier. B. Blood alveolar barrier. C. Blood brain barrier. D. Placental barrier.
21. Point out drugs which are enzyme inducers: A. Chloramphenicol. B. Disulfiram. C. Phenytoin. D. Phenobarbital.
22. Which are the factors of drugs affecting their kinetic and action? A. Physical properties. B. Body weight of patient. C. Chemical structure. D. Dose.
23. Which are the factors of organism affecting drugs’ kinetic and action? A. Atmospheric pressure. B. Body weight of patient. C. Sex. D. Type of dosage form.
24. What of the following is important for the action of drugs on newborns? A. Immaturity of synapses in CNS. B. Increased activity of glucuronyltransferase. C. The low concentration of beta-glucuronidase in gastrointestinal tract. D. Decreased activity of glucuronyltransferase.
25. Point out the correct statements: A. The drug Aspirin® does not increase the menstrual bleeding. B. Oral antidiabetic preparations, hormonal contraceptives, tetracyclines, amino glycosides and other drugs, harmful to the fetus should not be taken during pregnancy.C. Mothers who nurse their children should not take opiate analgesics, anxiolytics (diazepam, etc.), tetracyclines. D. Phenobarbital and digitalis glycosides have long t1/2.
(2) Drugs acting on CNS
1. Which of the following is characteristic feature of Galantamine: A. It activates cholinesterase. B. It is administered in postoperative atony of the bowels or urinary bladder. C. It is effective in bronchial asthma. D. It is effective in myasthenia gravis.
2. Atropinе like adverse reactions are observed in the treatment with: A. M-cholinomimetics. B. M-cholinolytics. C. Tricyclic antidepressants. D. Phenothiazine neuroleptics.
3. In connection with biorhythms, the therapeutic efficacy of cholinolytics is higher during: A. The day. B. The night. C. Winter. D. Summer.
4. Skeletal muscle relaxation, caused by the administration of competitive(non-depolarizing) neuromuscular blocking drugs can be stopped by i.v. administration of: A. Suxamethonium. B. Galantamine. C. Lorazepam. D. Neostigmine.
5. The positive cardioinotropic effect of adrenaline decreases in the presence of: A. Prazosin. B. Propranolol. C. Atenolol. D. Metoprolol.
6. Point out the selective β2-adrenomimetic: A. Dobutamine. B. Salbutamol. C. Isoprenaline. D. Ephedrine.
7. Point out the incorrect statement concerning beta-blockers: A. They decrease the myocardial contractility. B. They slow down heart rate. C. They suppress rennin secretion. D. They cause bronchodilation.
8. Cardioselective beta1-blockers are: A. Atenolol. B. Propranolol. C. Carvedilol. D. Nebivolol.
9. Point out the drugs effective in hyperbilirubinemia in newborns: A. Nitrazepam. B. Phenobarbital. C. Glutethimide. D. Estazolam.
10. Which of the following is characteristic feature of carbamazepine: A. It inhibits the potential-depending sodium channels in CNS. B. It activates NMDA-glutamatergic receptors in CNS. C. It is effective in grand mal, epileptic change in personality and neuralgias. D. It is enzyme inhibitor.
11. Gingival hyperplasia and hemorrhagic gingivitis may occur in continuing therapy with: A. Phenobarbital. B. Bupropion. C. Phenytoin. D. Biperiden.
12. Point out the antiepileptic drugs which are enzyme inducers: A. Sodium valproate. B. Carbamazepine. C. Phenobarbital. D. Phenytoin.
13. Point out the drugs which increase dopamine in the brain and improve the symptoms of akinesia in Parkinsonism: A. Co-beneldopa (Madopar®). B. Chlorpromazine. C. Trihexyphenidyl. D. Co-careldopa (Sinemet®).
14. Which of the following drugs are effective in neuroleptic Parkinsonism: A. Central dopaminergic drugs. B. Central cholinolytics. C. Alfa-blocking agents. D. Opioid analgesics.
15. The antipsychotic effect of neuroleptics is connected mainly with the blockade of D2-receptors in: A. The trigger zone. B. The limbic system. C. The spinal cord. D. The arterioles.
16. Phenothiazine neuroleptics have the following pharmacological effects: A. Antipsychotic. B. Anticonvulsant. C. Vegetolytic. D. Emetic.
17. Point out the phenothiazine neuroleptics: A. Chlorpromazine. B. Trifluoperazine. C. Chlorprothixene. D. Thioridazine.
18. The mechanism of action of benzodiazepines is due to: A. Stimulation of specific receptors in CNS, localized in the α-subunit of GABAA receptors. B. Facilitation of GABA presynaptic release. C. Activation of GABA metabolism. D. Increasing of GABA mediated chloride influx in CNS.
19. Diazepam has the following effects: A. Anxiolytic. B. Central muscle relaxing. C. Anticonvulsant. D. Convulsant.
20. Drug dependence could be developed in continuing therapy with: A. Phenobarbital. B. Bromazepam. C. Levodopa. D. Opioid analgesics.
21. Which of the following are tricyclic antidepressants? A. Amitriptyline. B. Fluoxetine. C. Moclobemide. D. Clomipramine.
22. Piracetam is characterized by: A. Increased tolerance of the brain for hypoxia. B. Improved memory. C. Stimulation of ATP synthesis in CNS. D. Rapidly achieved effect.
23. Point out the correct statements concerning morphine: A. Activates μ, κ and δ opioid receptors. B. Blocks μ receptors. C. Psychic and physical dependence is not developed with its application. D. It is applied in chronic neoplastic pain syndromes.
24. Which of the following are synthetic opioid analgesics: A. Fentanyl. B. Codeine. C. Morphine sulfate. D. Pethidine (Meperidine).
25. Halogenated inhaled anаesthetics volatile liquids are: A. Lidocaine. B. Sevoflurane. C. Isoflurane. D. Propofol.
(3) Drugs acting on cardiovascular system and fibrinolysis
1. Which of the following drugs are used for the treatment of heart failure: A. Digitalis glycosides. B. ACE inhibitors. C. Thiazides or loop diuretics. D. Verapamil.
2. Trimethazidine is metabolotropic cardioprotective agent, which: A. Protects the membrane of the cardiac myocyte. B. Decreases the ATP synthesis. C. Supplies energy for Na+/K+ pump and improves the left ventricle function. D. Increases acidosis in ischemic tissues.
3. Point out the correct statements, concerning Digoxin: A. It is a cardiac glycoside, derived from D. purpurea. B. Blocks membrane magnesium dependent Na+/K+ ATP-ase. C. It is effective in chronic heart failure with normal or accelerated heart rate and atrial fibrillation. D. Does not cumulate.
4. Which of the following drugs are applied in acute heart failure with cardiogenic shock? A. Metoprolol. B. Dobutamine. C. Dopamine. D. Verapamil.
5. Which of the following drugs are effective in supraventricular arrhythmias? A. Verapamil. B. Adenosine. C. Phenytoin. D. Lidocaine.
6. Point out the preparation, which is effective in ventricular tachyarrhythmia during acute myocardial infarction: A. Chinidine. B. Adenosine. C. Propafenone. D. Lidocaine.
7. Amiodarone is characterized by: A. Has short t1/2. B. Has weak negative inotropic effect. C. It is used in supraventricular and ventricular tachyarrhythmias. D. After prolonged treatment pulmo- and thyreotoxicity can be developed.
8. Point out the antiishemic drugs, which are NO donors: A. Metoprolol. B. Amlodipine. C. Glyceril trinitrate. D. Isosorbide dinitrate.
9. Point out different dosage forms of glyceril trinitrate, effective in anginal and hypertensive emergencies: A. Verapamil. B. Nitroglycerin. C. Nifedipine. D. Nitrolingual spray.
10. The adverse reactions of glyceril trinitrate include: A. Headache. B. Decreasing of intraocular pressure. C. Tolerance. D. Hypertension.
11. Beta-blockers: A. Cause reversal of left ventricular hypertrophy. B. They diminish myocardial oxygen consumption through decrease heart rate and reduce the force of cardiac contraction. C. Act against stress. D. Decrease lipids in the blood.
12. Point out the cardioselective beta-blocker, releasing NO: A. Carvedilol. B. Prazosin. C. Enalapril. D. Nebivolol.
13. ACE inhibitors are characterized by: A. They are used for the treatment of arterial pressure and heart failure. B. They increase the left ventricular hypertrophy. C. They decrease proteinuria. D. They have teratogenicity.
14. Calcium channel blockers of the dihydropyridine group, used in hypertension are: A. Diltiazem. B. Amlodipine. C. Felodipine. D. Verapamil.
15. Point out the thiazide diuretics: A. Furosemide. B. Hydrochlorothiazide. C. Chlorthalidone. D. Spironolactone.
16. Point out thiazide diuretics and their analogues which does not affect metabolism and has vasodilating effect: A. Mannitol. B. Hydrochlorothiazide. C. Torsemide. D. Indapamide.
17. ACE inhibitors can cause: A. Dry cough. B. Skin rashes, itching and angioedema. C. Orthostatic hypotension. D. Hypertensive state.
18. Point out the ACE inibitors: A. Clonidine. B. Reserpine. C. Perindopril. D. Trandolapril.
19. AT1-blockers: A. Inhibit the vasoconstricting effect of angiotensin II on its receptors. B. Have vasodilating effect and decrease blood pressure. C. Stimulate the vasoproliferative effect of angiotensin II. D. Are worse tolerated than ACEIs.
20. Cerebral vasodilators are: A. Flunarizine. B. Nimodipine. C. Vinpocetine. D. Valsartan.
21. Point out blocker of the hydroxylmethylglutaryl CoA reductase, which is metabolized without the participation of cytochrome P450: A. Atorvastatin. B. Pravastatin. C. Detralex®. D. Lovastatin.
22. Point out the drug, which after prolonged use could lead to myalgia, myositis and acute renal failure: A. Atorvastatin. B. Endotelon®. C. Troxerutin. D. Heparin.
23. Which the following is an antiplatelet agent: A. Aspirin® in low daily doses. B. Warfarin. C. Alteplase. D. Aspirin® in high daily doses.
24. Fibrinolytics are: A. Warfarin. B. Reteplase. C. Atorvastatin. D. Alteplase.
25. Which of the following drugs are low molecular heparin fractions, used for prophylaxis of thromboembolic states in orthopedic and abdominal surgery: A. Dalteparin. B. Fraxiparine®. C. Acenocoumarol. D. Warfarin.
(4) Endocrine drugs and drugs affecting metabolism
1. Point out the ovulation inducing drugs: A. Gonadotropines. B. GnRH analogues (Gonadotrophin releasing hormone) C. Estrogens. D. Progesterone.
2. Point out agents, acting on gonads with central mechanism of action, used for inhibition of lactation after birth: A. Bromocriptine. B. Prolactin. C. Dihydroergocryptine. D. Oxytocin.
3. Estrogens are used: A. In amenorrhea and infertility. B. For stimulation of uterine contractions in dysfunctional labour. C. In estrogen-dependent breast cancer. D. In prostate carcinoma.
4. Progestins are used: A. In induction of ovulation in anovulatory menstrual cycles. B. For the treatment of abnormal uterine bleeding. C. In liver damages. D. In thrombophlebitis.
5. Point out the monophasic hormonal contraceptives for oral administration: A. Logest®. B. Mirena®. C. Postinor-Duo®. D. Lindynette®.
6. The anovulatory effect of hormonal contraceptives may be diminished in co-medication with: A. Phenobarbital. B. Carbamazepine. C. Mannitol. D. Rifampicin (Rifampin).
7. Hormonal contraceptives can lead to: A. Pain in the breasts. B. Alopecia. C. Orthostatic hypotension. D. Thrombophlebitis.
8. Hormonal contraceptives are contraindicated in: A. Genital and breast carcinoma. B. Liver diseases. C. Arterial hypotension. D. Pregnancy.
9. Testosterone preparations are used in the treatment of: A. Hypogonadism in men. B. Hypogonadism in women. C. Prostate carcinoma. D. Hormonal-dependent breast carcinoma.
10. Point out preparation with estrogen, gestagen and androgen activity, effective in postmenopausal osteoporosis: A. Activelle®. B. Klimonorm®. C. Tibolone. D. Pausogest®.
11. Oxytocin is used: A. For induction of labour in post-term pregnancy. B. In esophageal variceal haemorrhage. C. In primary and secondary dysfunctional labour. D. To stop lactation.
12. Point out a preparation, used in pituitary nanism (growth hormone deficiency): A. Somatotrophin. B. Somatostatin. C. Octreotide. D. Terlipressin.
13. Which of the following drugs are used in hypothyroidism? A. Levothyroxine. B. Propylthiouracil. C. Levothyroxine plus Potassium iodide. D. Thiamazole.
14. Triiodothyronine and thyroxine are characterized by: A. They cross the placental barrier. B. They decrease metabolic processes. C. They increase adrenergic receptors’ sensitivity. D. They are used in hypothyroidism.
15. Point out the correct statements: A. Insulin activates specific thyrosine-kinase receptors. B. Glucocorticoids block specific nuclear receptors. C. Insulin increases glucosae influx in skeletal musles, adipose tissue, cardiac muscle and uterus. D. Insulin activates specific G-protein coupled receptors.
16. Point out insulin preparation with rapid and short action: A. Actrapid® HM. B. Mixtard® HM.
C. Humulin N®. D. Insulin glargine (Lantus®).
17. Insulin preparations can lead to: A. Allergic reactions (relatively rare). B. Transitory presbiopia. C. Hyperglycaemia. D. Local lipodistrophy.
18. Point out sulfonylurea antidiabetic drugs: A. Gliclazide (Diaprel MR®). B. Acarbose (Glucobay®). C. Metformin. D. Glipizide (Glucotrol XL®).
19. The anti-inflammatory effect of glucocorticoids is connected with: A. Stimulation of lipocortin synthesis. B. Decreasing of lisosomes’ membrane permeability. C. Increasing of hyaluronidase activity. D. Inhibiting of genes, encoding inflammatory cytokines secretion.
20. Glucocorticoids are included in the complex treatment of the following diseases: A. Collagen vascular disorders. B. Allergic reactions. C. Peptic ulcer disease. D. Dermatoses.
21. Clucocorticoids are contraindicated in: A. Tissuue and organ transplantation. B. Adrenocortical insufficiency (Addison’s disease). C. Osteoporosis. D. Viral and mycotic infections.
22. Point out glucocorticoid preparation for venous administration in anaphylactic shock: A. Betamethasone (Celestone®). B. Orlistat (Xenical®). C. Aminophylline. D. Nemybacin H®.
23. Which drug is applied for the treatment of megaloblast anaemia? A. Tocoferol. B. Retinol. C. Chloramphenicol. D. Cyancobalamin.
24. Point out preparation, effective in vitamin D resistant rickets: A. Cholecalciferol. B. Ascorbic acid. C. Calcitriol. D. Phytomenadion (Phytonadion).
25. Point out preparation with uricostatic activity: A. Calcitonin. B. Acidum alendronicum (Fosamax®). C. Allopurinol. D. Raloxifen (EvistaHM).
(5) Antimicrobial agents
1. Beta-lactam antibiotics have the following mechanism of action: A. They inhibit bacterial wall synthesis. B. They disrupt bacterial membrane permeability. C. They inhibit DNA polymerase. D. They inhibit neuraminidase.
2. Which of the following groups of penicillins have broad spectrum of action? A. Biosynthetical penicillins. B. Aminopenicillins. C. Ureidopenicillins. D. Carboxypenicillins.
3. Point out the broad spectrum antimicrobial agent, inhibiting alcohol metabolism: A. Mannitol. B. Metronidazole. C. Chloramphenicol. D. Disulfiram.
4. Point out drugs with antihelicobacter activity: A. Amoxicillin. B. Metronidazole. C. Gentamicin. D. Clarithromycin.
5. Point out the drug, which is effective in aerobic infections: A. Praziquantel. B. Amikacin. C. Chloroquine. D. Metronidazole.
6. The 24 h dose of amoxicillin for children is: A. 10 mg/kg. B. 5 mg/kg. C. 50–100 mg/kg. D. 1 g/kg.
7. Tinidazole is applied orally for the treatment of urogenital trichomoniasis once time in adults in dose of: A. 100 mg/kg. B. 2 g. C. 500 mg. D. 10 mg/kg.
8. Which of the following groups of antibiotics are resistant to beta-lactamase? A. Ureidopenicillins. B. Isoxazolyl penicillins. C. Cephalosporines of IV generation. D. Glicopeptides.
9. Benzylpenicillin is not suitable for the treatment of: A. Scarlet fever, rheumatic fever, erysipelas. B. Lues. C. Influenza. D. Meningococcial infection.
10. Co-amoxiclav (Augmentin™) is: A. Sulbactam protected ampicillin. B. Clavulanate protected amoxicillin. C. Tazobactam protected piperacillin. D. Sulbactam protected cefoperazone.
11. Protein synthesis in microorganisms is inhibited by: A. Beta-lactams. B. Tetracyclines. C. Macrolides. D. Lincosamides.
12. Which of the following are broad spectrum antimicrobial agents? A. Tetracyclines. B. Macrolides. C. Fluorquinolones. D. Aminoglycosides.
13. Regular check of creatinine clearance is necessary in administration of: A. Aminoglycosides. B. Cephalosporines. C. Aminopenicillins. D. Sulfomethoxazole/Trimetoprim.
14. Tetracyclines do not reach therapeutic plasma concentrations when applied together with food and preparations containing the following ions: A. Ferrous. B. Calcium. C. Magnesium. D. Sodium.
15. Food significantly decreases the intestinal absorption of: A. Erythromycin. B. Ampicillin. C. Tubocurarine. D. Mannitol.
16. Chloramphenicol and sulfonamides replace from plasma proteins: A. Indirect anticoagulants. B. Insulin. C. Bilirubin. D. Mannitol.
17. Which drugs can be used during pregnancy if necessary without any risk for the mother and the fetus? A. Benzylpenicillins. B. Erythromycin. C. Doxycycline. D. Co-Trimoxazole.
18. Point out the correct statements concerning fluorquinolones: A. They inhibit DNA gyrase. B. They have broad antibacterial spectrum. C. They are metabolized with the participation of N-acetyltransferase. D. Their bioavailability after oral administration is low.
19. The main mechanisms of action of antiviral agents are: A. Inhibition of neuraminidase. B. Inhibition of viral proteases. C. Inhibition of reverse transcriptase (DNA polymerase). D. Inhibition of cyclooxygenase.
20. Point out neuraminidase inhibitors, effective in influenza, caused by influenza virus A or B: A. Zanamivir. B. Fluconazole. C. Oseltamivir (Tamiflu®). D.Vaxigrip®.
21. Point out the dru, effective in Pneumocystis carinii pneumonia in AIDS patients: A. Chloroquine. B. Nystatin. C. Rimantadine. D. Co-Trimoxazole.
22. Point out drugs suitable for the treatment and prophylaxis of all forms of malaria: A. Itraconazole. B. Chloroquine. C. Ketoconazole. D. Mebendazole.
23. Point out the thiazole antimycotic drug: A. Itraconazole. B. Chinine. C. Ketoconazole. D. Albendazole.
24. Which of the following antibacterial agents are mainly excreted in the breast milk? A. Erythromycin. B. Tetracyclines. C. Chinine. D. Sulfonamides.
25. Drugs enzyme inducers are: A. Chloramphenicol. B. Griseofulvin. C. Rifampicin. D. Metronidazole.
CORRECT ANSWERS OF THE SELECTED MODULE TESTS IN PHARMACOLOGY
(1) General pharmacology:1. D. 2.A, B. 3.A, D. 4. A, C, D. 5. A, C. 6 A, B. 7. A, B, D. 8. A, C. 9. D. 10. A, B, D. 11. C. 12. D. 13.B, D. 14. A, C.15.B, D. 16.A. 17.D. 18. A, B, C. 19. B, C. D. 20. C, D. 21. C, D. 22. A, C, D. 23. B, C. 24. A, D. 25. B, C, D.
(2) Drugs acting on CNS:1.B, D. 2. B, C, D. 3. B. 4. B, D. 5. B, C, D. 6. B. 7. D. 8. A, D. 9. B.10. A, C. 11. C. 12. B, C, D. 13. A, D.14. B. 15. B. 16.A, C. 17. A, B, D. 18. A, D. 19. A, B, C. 20. A, B, D. 21. A, D. 22. A, B, C. 23. A, D. 24. A, D. 25. B, C.