Professional Documents
Culture Documents
1. An AIDS patient, who is being treated with multiple drugs, develops breast hypertrophy,
central adiposity, hyperlipidemia, insulin resistance and nephrolithiasis. If these changes are
related to his drug treatment, this drug belongs to which group of anti-retroviral drugs?
a) Nucleoside Reverse Transcriptase Inhibitors (NRTIS)
b) Non-nucleoside Reverse Transcriptase Inhibitors (NNRTIS)
c) Fusion Inhibitors
d) Protease Inhibitors
e) Integrase Inhibitors
1. A 35 year old HIV positive male patient comes to the OPD with complaint of anorexia,
nausea and vomiting and abdominal pain. His abdomen is tender in the epigastric area.
Laboratory results reveal a raised serum amylase activity and a preliminary diagnosis is made
of acute pancreatitis. Which of the following anti-retroviral drugs has the patient most likely
been taking?
a) Saquinavir
b) Zidovudine
c) Didanosine
d) Efavirenz
e) Enfuvirtide
2. A 40 year old HIV positive patient is receiving HAART regimen (Highly active anti-
retroviral therapy). Four weeks after initiating therapy, he comes to the emergency
department complaining of severe pain in the flank, nausea and frequent urination. Which
one of the following drugs is most likely the cause of his symptoms?
a) Zidovudine
b) Indinavir
c) Efavirenz
d) Nevirapine
e) Nelfinavir
3. A 30 year old man is recently diagnosed with HIV and therapy is started. After the first
week of therapy, the patient complains of headaches, irritability, and nightmares. Which one
of the following anti-retroviral drugs is most likely to be causing these symptoms?
a) Efavirenz
b) Indinavir
c) Lamivudine
d) Nevirapine
e) Stavudine
4. A 35 year old woman is diagnosed with chronic hepatitis B infection and therapy is
initiated. Just after a few hours she comes to the emergency department complaining of fever,
chills and muscle aches. Which one of the following drugs most likely caused these
symptoms?
a) Lamivudine
b) Adefovir
c) Entecavir
d) Interferon alfa
e) Ribavirin
6. A 60 year old man with known history of Parkinson’s disease is to receive prophylaxis
against Influenza A virus. He is given a drug that is useful against Parkinson’s disease as well
for prophylaxis against influenza. The drug with which of the following mechanisms of
action is most likely to have been given?
Q20. Clindamycin:
a) is chemically related to macrolides
b) binds to 30S ribosomal subunit
c) is not recommended for oral route
d) cross-resistance may be observed between macrolides and Clindamycin
e) is excreted in breast milk
Q23. in a patient with culture-positive enterococcal endocarditis who has failed to respond to
vancomycin because of resistance, the treatment most likely to be effective is:
a) clarithromicin
b) erythromycin
c) linezolid
d) minocycline
e) Ticarcillin
Q24. A 24 year old male patient is suffering from peptic ulcer. He was advised anti-peptic
ulcer drugs including doxycycline. Which one of the following statements about doxycycline
is false?
a) it is bacteriostatic
b) it is excreted mainly in the feces
c) it is used in Lyme disease
d) it has a long elimination half-life
e) it is more active than tetracycline against H. Pylori
Q25. A 12 years old female patient came to pediatrician suffering from headache, high grade
fever, moderate chest pain, joint pain and drowsy. When doctor got history, he was told to
take diazepam 2.5 mg by patient 15 hours ago. Actually it was already a diagnosed case of
pneumonia and she was on drug treatment including streptogramin. Concerning
streptogramins, which one of the following statements is false:
a) they are active against methicillin-resistant staphylococci
b) they may cause a syndrome of arthralgia and myalgia
c) they are used in the management of infections caused by vancomycin-resistant
enterococci
d) they are associated with post antibiotic effect
e) they induce formation of hepatic drug-metabolizing enzymes
Q26. Telithromycin:
a) is cell wall synthesis inhibitor
b) is a ketolide structurally related to macrolides
c) it binds very loosely to ribosomes so it is good substrate for bacterial efflux pumps that
mediate resistance
d) is used in Lyme disease mainly
e) is used in pneumonia as drug of 1st choice
Q28. A 33 years old male patient has been diagnosed mycoplsma pneumoniae infection. He
was treated by one of the broad spectrum antibacterial drug group tetracycline 2 gram TID
for 21 days. What may be most appropriate toxicity?
a) anemia
b) hepatic necrosis
c) thrombocytosis
d) alopecia
e) sleeplessness
Q29. an elderly debilitated patient has a fever believed to be due to an infection. He has
extensive skin lesions, scrapings of which reveal the presence of large numbers of gram-
positive cocci. The most appropriate drug to use for treatment of this patient is:
a) amoxicillin
b) salbactam
c) cefoxitin
d) nafcillin
e) penicillin G
Q30. A 21 year old man was seen in a clinic with a complaint of dysuria and urethral
discharge of yellow pus. He has a painless clean-base ulcer on the penis and nontender
enlargement of the regional lymph nodes. Gram stain of the urethral exudates showed gram
negative diplococci within polymorphonucleocytes. The patient informed the clinic staff that
he was unemployed and had not eaten a meal for two days. The most appropriate treatment of
gonorrhea in this patient is:
a) amoxicillin orally for 7 days
b) vancomycin intramuscularly as a single dose
c) ceftriaxone intramuscularly as a single dose
d) tetracycline orally for 7 days
e) procaine penicillin G intramuscularly as a single dose plus one gram of probenecid
Q31. Eighty years old male patient having 73 Kg body weight was suffering from fever,
headache and lumbar pain since last 7 days. He was examined in clinic. Gram stain of the
smear of CSF revealed gram positive rods resembling diphtheroids. The antibiotic regimen
for empiric treatment would include:
a) Erythromycin
b) Ticarcillin
c) Cefotetan
d) Cefazolin
e) Ampicillin
Q32. A 25 year old male presents to the medical OPD with complaint of cough and low grade
fever since the last 3 months. Laboratory tests show sputum positive for acid fast bacteria.
Which of the following combination of drugs is most likely to be administered at the start to
this patient?
a) Streptomycin, Isoniazid, Rifampicin and Pyrazinamide
b) PAS, Pyrazinamide and Rifampicin
c) Pyrazinamide, Ethambutol and Isoniazid
d) Streptomycin and Rifampicin
e) Streptomycin alone
Q33. A 25 year old male has been given treatment for pulmonary tuberculosis for 2 months
as initial phase. Now he comes to the OPD for medication for the continuation phase. Which
of the following drugs will he most likely be given for the continuation phase?
a) Pyrazinamide and Isoniazid
b) Ethambutol and Streptomycin
c) Isoniazid and Rifampicin
d) Rifampicin and Streptomycin
e) Ethambutol and Pyrazinamide
Q34. A young man 26 years old is started treated for pulmonary tuberculosis. He comes to
the medical OPD after 1 week with complaint of orange red colored urine and sweat and
tears. Which of the following drugs is most likely causing these symptoms?
a) Streptomycin
b) Rifampicin
c) Ethambutol
d) Pyrazinamide
e) Thiacetazone
Q35. A 30 year old male with known TB infection and taking medication since 1 month
comes to the Eye OPD with complaint of visual disturbances including decreased visibility
and slight color blindness. If these symptoms are due to his drug treatment, which one of the
following drugs is most likely the cause of his symptoms?
a) Streptomycin
b) Ciprofloxacin
c) Ethambutol
d) Rifampicin
e) Isoniazid
Q36. A 35 year old male recently diagnosed with tuberculosis and is started on medication.
After a few days he comes to the emergency department a few hours after taking a meal at
McDonald’s with severe pain in the big toe. Blood tests show a very high uric acid level.
Which of the following drugs most likely caused these symptoms?
a) Streptomycin
b) Rifampicin
c) Isoniazid
d) Amikacin
e) Pyrazinamide
Q37. A 40 year old male taking medication for tuberculosis since the last 2 months comes to
the ENT OPD with complaint of hearing problems and ringing in the years. The drug with
which of the following mechanisms of action is most likely causing these symptoms?
a) Binds to 30 S Ribosome subunit & inhibits initiation complex
b) Inhibits DNA Dependent RNA Polymerase
c) Inhibits synthesis of mycolic acid
d) Inhibits synthesis of arabinoglycan subunits
e) Inhibits DNA Gyrase
Q38. A 35 year old female taking medication for tuberculosis and oral contraceptives comes
to the Gynaecology OPD with complaint of amenorrhea. Laboratory test shows a positive
pregnancy test. Which one of the following drugs most likely caused her to become
pregnant?
a) Rifampicin
b) Pyrazinamide
c) Streptomycin
d) Ethambutol
e) Isoniazid
Q39. A 45 year old male with diagnosed chronic liver disease gets infected with the
tuberculosis. Which one of the following drugs would be most safe for this patient for the
treatment of tuberculosis?
a) Isoniazid
b) Rifampin
c) Pyrazinamide
d) Ethambutol
e) Ethionamide
Q40. A 48 year old male is diagnosed with tuberculosis and has been treated for 2 months
with isoniazid and rifampicin with good response. But the patient develops numbness and
paresthesias in the extremities. What will you most likely do next?
a) Add pyridoxine
b) Stop isoniazid
c) Add vitamin E
d) Replace rifampin with ethambutol
e) Replace isoniazid with streptomycin
Q41. A 30 year old male presents with history of fever occurring in a step-ladder fashion for
the last 10 days. He also feels abdominal pain after taking meals. Lab tests show decreased
TLC count and a positive Widal test. The drug which is most likely to be given acts by which
one of the following mechanisms?
a) Ciprofloxacin
b) Ampicillin
c) Cotrimoxazole
d) Cefixime
e) Azithromycin
Q42. A 35 year old pregnant woman presents to the gynecology department with complaint
of pain with rising fever since the last 5 days. Lab tests show gram negative bacilli and widal
test comes out positive. Which one of the following drugs will most likely be administered?
a) Ciprofloxacin
b) Levofloxacin
c) Ofloxacin
d) Norfloxacin
e) Ampicillin
Q43. A 27 year old male football player gets injured in a match. He comes to the emergency
department with pain and swelling near the ankle. On examination, there is small wound with
a tender swelling near the ankle joint. Further tests reveal tendon rupture with tendonitis
setting in. Which one of the following antibiotics, if required, will most probably not be given
to this patient?
a) Ceftriaxone
b) Clarithromycin
c) Aminoglycoside
d) Ciprofloxacin
e) Amoxicillin
Q44. A 40 year old male comes to the medical OPD with symptoms of cough & fever
for the last few days. Sputum culture shows presence of gram positive cocci. Which one of
the following Fluoroquinolones is most likely to be administered to this patient?
a) Ciprofloxacin
b) Norfloxacin
c) Ofloxacin
d) Gatifloxacin
e) Levofloxacin
Q45. A 50 year old patient comes to the emergency department, a day after he has been
administered an antibiotic for an on-going infection, with complaint of palpitations. ECG
reveals prolonged QT interval. Which one of the following Fluoroquinolones most likely
caused this adverse effect?
a) Ciprofloxacin
b) Norfloxacin
c) Levofloxacin
d) Ofloxacin
e) Gatifloxacin
Q47. A patient with watery stools is diagnosed as suffering from amebic dysentery. He is
given a drug that causes a metalic taste in the mouth which drug may be given.
a) Iodoquinol
b) Diloxanide furate
c) Metronidazole
d) Pentamiline
e) Emetine.
Q48. The reason for giving Metronidazole for oropharyngeal infection is due to its good
activity against:
a)Gram positive cocci
b)Gram Negative cocci
c)Gram positive bacilli
d)Gram negative bacilli
e)Anaerobes like B. fragilis
Q49. Patient comes to emergency with the complaints of marked visual and auditory
abnormities, vomiting diarrhea abdominal pain & skin rashes. From the history of the
patient it was revealed that he took some drug for the treatment of fever. What could be
probable diagnosis?
a)Cinchonism
b)Acute gastro enteritis
c)Cholera
d)Typhoid fever
e)Acid peptic disease
Q50. A 37 year old male is having repeated episodes of fever with chills with blood smear
positive for malaria since last one year. He was given chloroquine each time & the fever
subsided. Which of the following drugs would you add with chloroquine this time?
a)Artemether
b)Mefloquine
c)Malarone
d)Primaquine
e)Halofantrine
Item Number: 9623 correct answer: 5 category: Inotropes/Vasodilators
1. Digitalis glycosides slows the heart rate in patients with systolic
dysfunction as a result of all of the following EXCEPT:
1. direct action of digitalis on the AV node to slow conduction
2. indirect effect of enhanced vagal tone on AV node
3. enhanced parasympathetic outflow from the CNS through an indirect
mechanism
4. diminished sympathetic tone which is high as a compensatory mechanism in
heart failure
5. enhanced responsiveness of the SA and AV node to norepinephrine through
an indirect mechanism
Psychotropics
Item Number: 11667 correct answer: 4 category: Psychotropics
1. The symptoms of tardive dyskinesia will acutely improve with:
1. administration of diphenhydramine
2. administration of amantadine
3. administration of bromocriptine
4. increase of neuroleptic dose
5. All of the above