Adrenergic

1- The following indication/s of epinephrine is/ are entirely due to its effect:
A. Anaphylactic shock D. Epistaxis
B. Cardiac Arrest E. C and D
C. To prolong action of local Anesthetics

2- The following adverse effect of blockers is not due to -1 blockade:

A. Bradycardia .
B. Heart failure.
C. Hypertriglyceridaemia.
D. Prolongation of insulin-induced hypoglycemia.

3- The following adverse effect of blockers is not due to 2 blockade:

A. Bronchospasm.
B. Prolongation of insulin-induced hypoglycemia.
C. Cold extremities.
D. Hypotension

4. Non- selective B with vasodilator effect 2ry to blockade

A. Labetalol
B. Carvedilol
C. Nebivolol
D. Propranolol
E. A or B

5. A patient with severe hypotension is given intravenous norepinephrine. Which of the

following drugs antagonizes both the vascular and cardiac actions of the drug?
A. Atenolol C. Carvedilol
B. Esmolol D. Celiprolol E. Prazosin

6. Salbutamol replaced epinephrine in treatment of bronchial asthma because

A. It seldom induces tremors or tolerance on long term use.
B. Longer duration of action since it is not metabolized by MAO or COMT.
C. No cardiac complications in regular doses.
D. Can be given by many routes
E. All except A

7. - mediated antihypertensive effects of bisoprolol do not include:

A. Decrease renin release
B. Resetting of baroreceptors
C. Negative inotropic & chronotropic effects
D. Vasodilatation of skeletal blood vessels

8. The following is/are not true concerning anti-anginal effects of -blockers

A. Reduction in blood pressure
B. Reduction in heart rate & myocardial contractility.
C. Stimulation of lipolysis resulting in increased fatty acid utilization.
D. Coronary vasodilation increasing myocardial O2 supply in vasospatic angina
E. C and D

1
Cross match (each sympathomimetic with its clinical use)
D9. Eye and Nasal Decongestant A. Salbutamol
A10. Threatened abortion B. NE
B11. Septic shock C. Epinephrine
C12. Gingival retraction cord D. Phenylephrine

Q13: Phenylephrine may lead to

A. Hypertension
B. Bradycardia
C. Rebound nasal congestion
D. Atrophic rhinitis
E. All of the above

Q14: Alpha Methyl dopa is associated with all of the following except:
A. Dry Mouth
B. Tolerance
C. Weight gain
D. Sexual dysfunction
E. Anxiety

Q15: Depression may be due to

A. Propranolol
B. Methyl Dopa
C. Doxazocin
D. A+B
E. All of the above

Q16: Sexual dysfunction may be due to

A. Propranolol
B. Methyl dopa
C. Doxazocin
D. A+B
E. All of the above

Q17. Non selective alpha and beta blocker

A. Carvidalol
B. Phenoxybenzamine
C. Labetalol
D. A+C
E. All of the above

Q18. Essential HTN with BPH is preferred to be managed with

A. Metoprolol
B. Phenoxybenzamine
C. Doxazocin

2
 D. None of the above

Q19. Pregnancy + HTN is preferred to be managed with

A. Alpha Methyl dopa
B. Carvidalol
C. Phenylephrine
D. Yohimbine

Q20: Regarding sympathomimetics in dentistry choose the correct sentence

A. Felypressin are used instead of epinephrine in cardiac patient
B. Terlipressin is acting on V1 receptor
C. Gingival cord is impregnated with epinephrine and zinc or Al salts
D. Phenylephrine applied topically during gingival surgery
E. All of the above

Cross match the following adrenergic drugs to their indications

B21. 2 agonists A. Chronic refractory HF/acute HF/ cardiogenic shock
A22.1 agonists B. Asthma/threatened abortion/premature labor
D23.1 agonists C. Thyroxicosis
E24.2 agonists D. Fundus examination/allergic conjunctivitis
E. Hypertension

Q25: Toxicity of sympathomimetic drugs include

A. Sloughing
B. Dependence
C. Myocardial infarction
D. Coma
E. All of above

Q26. The following difference/s between propranolol & other - blockers is/are True
A. Betaxolol has no membrane-stabilizing activity, thus preferred in glaucoma as it does not
induce corneal anesthesia
B. Carvedilol has vasodilator, useful in hypertension & in chronic heart failure.
C. Bisoprolol is cardioselective with less risk of Raynaud's phenomenon and less delay in
recovery from hypoglycemia.
D. All of the above

Q27. Hydrophilic beta blockers have a long duration of action

A. Bisoprolol C. Metoprolol
B. Atenolol D. None of the above

Q28. Metabolic actions of propranolol include all of the following except:

A. Plasma K
B. Plasma TG
C. Insulin release
D. HDL
E. Lipolysis

3
Q29. Therapeutic uses of propranolol secondary to B2 Blockade
A. Hypertension
B. Vasospastic angina
C. Social anxiety disorder
D. Essential tremor
E. Arrhythmias

Renal

Q1. Loop diuretics are preferred to thiazides in

A. Fluid overload due to heart failure
B. Resistant hypertension due to volume expansion
C. Sulfonamide hypersensitivity
D. A and B
E. All of the above

Q2. All of the following statements are correct except:

A. Spironolactone antagonizes aldosterone receptor- decreasing synthesis of a protein that
stimulates Na+ pump.
B. Amiloride acts independent of aldosterone , blocking Na+ channels directly.
C. Vasodilator action of thiazides is the basis for their antihypertensive effect
D. Loop diuretics lead to excretion of 5-10% of filtered Na

Q3. In CHF with hyponatremia due to excess ADH, the most useful diuretic is:
A. Mannitol
B. Acetazolamide
C. Furosemide
D. Spironolactone.

Q4. Complications of thiazide diuretic therapy include the following except:

A. Hyperlipidemia & glucose intolerance
B. Hyponatremia., hypokalemia & metabolic alkalosis.
C. Hypercalcuria
D. Hyperuricemia.

Q5. Frusemide and hydrochlorothiazide have opposite effects on

A. Potassium excretion.
B.. Magnesium excretion
C. Calcium excretion
D. Uric acid excretion

Q6. In the management of severe hypercalcemia, the most useful therapy is:
A. Spironolactone plus saline infusion.
B. Mannitol plus saline infusion.
C. Furosemide plus saline infusion.
D. Hydrochlorothiazide plus saline infusion.

4
Q7. Furosemide is useful for the treatment of the following conditions except:
A. Acute pulmonary edema C. Hypertensive encephalopathy
B. Acute renal failure D. Hypercalcuria

Q8. Triamterene differs from spironolactone in all the following except

A. Block Na+ channels directly independent of aldosterone
B. Triamterene has a more delayed onset of action & is longer acting
C. It is preferred to spironolactone in treatment of hypokalemia and hypomagnesemia.
D. It does not induce gynecomastia as it has no antiandrogenic effect

Q9. The following statements about triamterene are correct except:

A. It is a weak diuretic with short duration of action.
B. Its used in hypokalemia and hypomagnesemia
C. It can produce gynecomastia.
D. It can produce metabolic acidosis.

Cross Match each diuretic with its inhibitory effect on reabsorption & site of action
A10. Frusemide A. 2 Cl-/Na+/K+ / ascending limb of loop of Henle
C11. Thiazides B. Na+/K+/H+ exchange/ distal tubule
B12. Spironolactone C. NaCl / early part of distal tubule

Cross Match
C13. Frusemide A. Used in Ca stone due to hypercalcuria
A14. Hydrochlorothiazide B. Used in hypomagnesemia
B15. Amiloride C. Used in hypercalcemia

Q16. K loosing diuretics include

A. Torsemide
B. Thiazides
C. Carbonic anhydrase inhibitors
D. Osmotic diuretics
E. All of the above

Q17. K Sparing diuretics include

A. Amiloride
B. Triamterene
C. Spironolactone
D. Eplerenone
E. All of the above

Q18. Spironolactone is the 1st choice in treatment of

A. Hypertension
B. Heart failure
C. Hyperaldosteronism
D. Hypercalcemia

5
 E. None of the above

Q19. Adverse effects of Bumetanide include all of the following except

A. Ototoxicity
B. Impotence
C. Thrombosis
D. Hypocalcemia
E. Hypersensitivity

Q20. Adverse effects of thiazide include all of the following except

A. Sleep disturbances
B. Sulfa hypersensitivity
C. Impotence
D. Metabolic acidosis
E. Glucose intolerance

Q21. NSAIDs have the following renal adverse reaction except:

A. Reduced glomerular filtration in hypovolemic patients.
B. Salt and water retention
C. Hypokalemia.
D. Low dose aspirin results in hyperuricemia.
E. Analgesic nephropathy

Q22. The following can cause hypokalemia except:

A. NSAIDs
B. Amphotericin
C. Salbutamol
D. Corticosteroids.

Q23. All of the following drugs cause metabolic acidosis except:

A. Metformin. C. Spironolactone.
B. NSAIDs D. Thiazides.

Angina

Q1. Nitrates reduce work done by heart in angina mainly through

A. Reducing heart rate
B. Redistribution of blood to subendocardial ischemic areas
C. Vasodilation of stenosed large epicardial coronary arteries & collaterals
D. Vasodilation of venules with reduction of venous return & preload

Q2. Long acting nitrate preparation with no 1st pass hepatic metabolism
A. Nitroglycerin
B. Isosorbide dinitrate
C. Isosorbide mononitrate
D. B or C

6
Q3. Nitrate preparation used for termination of an acute attack of angina
A. Nitroglycerin
B. Isosorbide dinitrate
C. Isosorbide mononitrate
D. A or B

Q4. Reduction of heart rate by beta blockers in angina

A. Blunts the increase in heart rate & blood pressure during exercise
B. Controls heart rate at rest (50- 60 /min)
C. Increases diastolic period resulting in increased coronary filling in diastole
D. Reduces reflex tachycardia and worsening of angina by nitrates
E. All of the above

Q5. Worsening of anginal pain may result from:

A. Abruptly stopping nitrates
B. Reflex tachycardia caused by nitrates
C. Administration of beta blockers in vasospastic angina
D. Administration of beta blockers with intrinsic sympathomimetic activity
E. All of the above

Q6. Nitrates & nifedipine share all the following adverse reactions except
A. Headache & flushing C. Reflex tachycardia
B. Hypotension D. Ankle edema

12. Hypotension, heart failure, bradycardia & heart block are adverse reactions of
A. Verapamil
B. Digoxin
C. Amlodipine
D. Nifidipine

13. Beta blockers & calcium channel blockers share all the following indications except
A. Angina
B. Hypertension
C. Supra ventricular arrhythmia
D. Peripheral vascular diseases

14. Constipation is an adverse effect of

A. Verapamil C. Atropine E. Quinidine
B. Digoxin D. A and C

15. Gingival enlargement may be occurred with

A. Verapamil
B. Diltiazem
C. Nitrate
D. Ivabradine
E. Nifidipine

16. Regarding trimetazidine, choose the incorrect sentence

A. It is known as a metabolic anti-anginal drug
B. Given in combination with other anti-anginal

7
 C. Should be avoided in patient with Parkinsonism
D. Used cautiously with Beta blockers

17. Regarding Ivabradine, choose the incorrect sentence

A. Selectively inhibits Pacemaker
B. CI with CCBs
C. Used cautiously with Beta blockers
D. All of the above

For the following patients, chose the most suitable nitrate compounds:
18. Prophylactic therapy in patient with GIT troubles
19. Prophylactic therapy with oral preparation.
20. A patient with persistent chest pain and admitted to CCU
21. A patient with acute attack of angina

Glyceryl trinitrate NG/ Or ISDN Transdermal ISMN

ivi sublingual patch Oral
3 4 1 2

Cross match each of nitrates' adverse effect to its possible cause:

22-Rapid tolerance C A-Vasodilation of meningal arteries
23-Worsening of angina D B-decrease venous return and COP
24-Throbbing headache A C-Consumption of SH group
25-Hypotension E D-reflex tachycardia
26-Syncope B E- Arteriodilatation

Select the most appropriate anti angina drug for each case (a drug can be chosen only
once)
A- Ivabradine B- Trimetazidine C- Diltiazem D- ISMN
27-A patient has Parkinson disease and his heart rate is 50-60 beats/minute (D)
28-A patient with vasospastic angina (C)
29-A patient with heart rate 75 beats/minute despite full dose of metoprolol (A)

Q30: Drugs decreasing atherosclerosis and risk of MI include

A- Clopidogrel (Anti-platelet)
B- Statins (Hypolipidemic)
C- ACEI
D- All of the above

Q31: 1st choice in long term prophylaxis in patient with vasospastic angina is
A- Beta Blockers
B- Trimetazidine
C- CCBs
D- None of the above

8
Q32: 1st choice in maintenance therapy for chronic angina is
A- Ivabradine
B- Captopril
C- Beta Blocker
D- ISMN

Q33: 1st choice in maintenance therapy for patient with chronic angina and bronchial
asthma
A- Trimetazidine
B- CCBs
C- Beta Blockers
D- Ivabradine

Q34: Management of dental patient with myocardial ischemia, Choose the wrong
sentence
A- Appointment should be short, minimal stressful and at early afternoon
B- Persistent pain require hospitalization, oxygen and 325 mg Aspirin
C- Cardiac dose of epinephrine should not exceed 4 cartridges of 1:200.000
D- Avoid epinephrine in patient on Beta Blockers
E- None of the above

Q35: Platelet aggregation and thromboembolism are enhanced by

A. Oral Bacteria (P.Gingivalis)
B. Frusemide
C. Alpha 2 stimulation
D. A+B
E. All of the above

Hypertension

Q1: Drug induced HTN include

A. Contraceptives
B. NSAIDs an Glucocorticoids
C. Liquorice
D. OTC cold Medicines
E. All of the above

Q2: Combination therapy is recommended if BP

A. Is >20/10 mmHg above goal
B. 1st line standard is Long acting CCBs + Long acting ACEIs or ARBs
C. Start by sequential if BP <20/10 mmHg
D. A+B
E. All of the above

9
Q3: Classes of drugs for initial montherapy include all of the following except:
A. Low dose thiazide
B. Long acting CCBs
C. ACEIs/ ARBs
D. Beta Blockers

Q4: Favorable indications for low dose thiazide include all of the following except
A. Isolated systolic HTN
B. HTN with osteoporosis and elderly
C. HTN with recurrent calcium stones
D. HTN with Hypercalcemia

Q5: Adverse effects may be occurred with low dose thiazides

A. Sleep disturbance
B. Impotence
C. Sulfonamide Hypersensitivity
D. A+B
E. All of the above

Q6: Absolute CI for thiazides is

A. Sleep disturbances
B. Sulfonamide hypersensitivity
C. Impotence
D. Metabolic alkalosis
E. Glucose intolerance

Q7: Loop diuretic is needed in hypertensive patient in the following situations

A. Fluid overload
B. Heart Failure
C. Renal disease
D. Resistant HTN
E. All of the above

Q8: Beta blockers is needed if HTN is associated with

A. Angina or Post MI
B. AF
C. Hyperthyroidism
D. Essential tremors
E. All of the above

Q9: Vasodilator Beta Blockers include

A. Carvidalol
B. Nebivolol
C. Metoprolol
D. A+B

11
 E. All of the above

Q10: Regarding Beta Blocker in treatment of HTN; it may lead to

A. Impaired glucose tolerance
B. risk of DM
C. CVS mortality
D. risk of coronary heart disease
E. All of the above

Cross Match (regarding ACEIs adverse effects)

B11. Most common A. Taste disturbances
C12. Serious B. Chronic dry cough
A13. Less common C. Bone Marrow depression
D14. Most serious D. Angioedema

Q15: Only ACEIs given SL in Hypertensive urgency is

A. Captopril
B. Lisinopril
C. Enalapril
D. Ramipril

Q16: Captopril can be used in the following cases

A. HF
B. Ischemic heart disease (Prophylactic)
C. Acute MI
D. HTN with DM, HF or CKD
E. All of the above

Q17: Valsartan may lead to all of the following except

A. Acute renal failure (In hypovolemia or renovascular HTN)
B. Angioedema
C. Cough
D. Hyperkalemia
E. Teratogenicity

Q18: Hypertensive Urgency is preferred to be managed by

A. Clonidine
B. Captopril
C. Atenolol
D. Frusemide
E. All of the above

Q19: Hypertensive emergencies is preferred to be managed by all of the following except

A. Labetalol
B. NG
C. Nitroprusside

11
D. Captopril

Q20: Regarding choice of Anti-Hypertensives, choose the wrong sentence

A. Patient with HTN+PVD (Better to prescribe CCBs, Better to avoid BBs)
B. Patient with HTN+BA (Better to prescribe CCBs, Better to avoid BBs)
C. Patient with HTN+DM (Better to prescribe low dose thiazide or ACEI)
D. Pregnant female with HTN (Better to avoid ACEIs and diuretic)
E. Patient with HTN with vasospastic angina (Better to prescribe BBs)

Q21: Patient with Isolated systolic HTN should be treated by

A. CCBs or ACEIs
B. Low dose thiazide or CCBs
C. BBs or CCBs
D. ACEIs or ARBs

Q22. A pregnant hypertensive patient should not receive

A. Thiazides C. Candesartan
B. Captopril D. All of the above

Q23. In a diabetic hypertensive patient, the least preferred drug is

A. Low dose thiazides C. Lisinopril
B. Propranolol D. Candesartan

Q24. The least likely antihypertensive mechanism of amlodipine is

A. Peripheral arterial vasodilatation and decreased peripheral resistance.
B. Negative inotropic & chronotropic effects
C. Diuretic action due to increased renal blood flow
E. Decreased aldosterone secretion preventing fluid retention

Q25. The following produce/s bradycardia or heart block:

A. Captopril
B. Nifedipine
C. Verapamil
D. Bisoprolol
E. C and D

Q26. The following is/are Not True concerning diuretics in congestive heart failure
A. Loop diuretics are of choice but thiazides are added in case of refractoriness to loop
diuretics
B. Spironolactone reduces mortality by 30%
C. Reduction in afterload is the main beneficial effect of diuretics.
D. Sulfonamide hypersensitivity occurs with thiazides but not with frusemide
E. C & D

Q27. In atrial fibrillation, the following control ventricular rate by blocking AVN:
A. Procainamide C. Digoxin E. All except A
B. -blockers D. Verapamil

12
Cross match each hypertensive case to its most suitable drug therapy
A28. Hypertension during labor A. Labetalol
D29. Hypertension with peripheral vascular disease B. Nitroprusside
C30. First choice in isolated systolic hypertension C. Thiazides
B31. Hypertensive crisis with acute heart failure D. Amlodipine

Q32. ACEIs have all the following advantages Except:

A. They induce no change in heart rate
B. They preserve renal function
C. They induce no change in potassium level
D. They reduce cardiovascular mortality

Q33. The main target of antihypertensive treatment is to

A. Improve the exercise tolerance
B. Lower ABP below 120/80
C. Protect vital body organs
D. Prevent atherosclerosis

Q34. The main mechanism of antihypertensive action of beta blockers is

A. Suppression of renin release
B. Negative inotropic & chronotropic effects
C. Resetting of baroreceptors
D. Central & peripheral sympatholytic effects

Q35. An asthmatic hypertensive may be given all the following Except

A. Thiazides
B. Propranolol
C. Candesartan
D. Amlodipine

Q36. A hypertensive patient with angina may be given all the following except
A. Pindolol C. Amlodipine
B. Bisoprolol D. Metoprolol

Q37. A hypertensive patient with heart failure may be given all the following except
A. Thiazides C. Candesartan
B. Lisinopril D. Verapamil

13
DM Calcium Corticosteriods

Cross Match the following insulin preparations to their method of administration

1. Glargine D A. SC twice/d.
2. NPH A B. SC 3-4 times/d.
3. Lispro /Aspart C C. SC 15 minutes before meals.
4. Regular/ Crystalline Zinc B D. SC once /d

5. The following insulin preparation is not correctly matched to its advantages

A. Glargine: increases compliance & less immunogenic.
B. NPH: most widely used preparation that can be mixed with regular insulin.
C. Lispro: better postprandial glycemic control with less risk of hypoglycemia.
D. Aspart: can be used IV or IM in emergencies e.g. ketoacidosis.

6. The most serious adverse effect of insulin is:

A. Hypoglycemia
B. Insulin resistance
C. Lipohypertrophy.
D. Hyperkalemia

7. A Selective estrogen receptor modulator exhibiting agonistic action on bone

A. Repaglinide. C. Raloxifene.
B. Ranitidine. D. Ribaverin

8. The following is not an adverse effect of corticosteroids

A. Osteoporosis specially of lumber vertebra.
B. Hyperkalemia.
C. Alkalosis.
D. Hyperglycemia.

9. The following is not an adverse effect of excess mineralocorticoids

A. Na+ and water retention.
B. Acidosis.
C. Aggravation of CHF associated myocardial fibrosis.
D. Rise in blood pressure.

10. A long-acting corticosteroid preparation with potent anti-inflammatory effect but

devoid of mineralocorticoid activity
A. Fluodrocortisone C. Prednisolone.
B. Dexamethazone. D. B and C.

11. Dexamethazone differs from prednisolone in that it is:

A. Longer acting. C. More selective.
B. More potent. D. All of the above.

12. The antistress effects of corticosteroids in bleeding, trauma, septic & anaphylactic
shock is due to
A. Increased vasoconstrictor effect of catecholamines.
B. Increased glucose level, providing energy to counteract stress.
C. Anabolic effect. .

14
 D. A and B.

Cross Match the following antidiabetic drugs to their mechanism of action

C13. Repaglinide A. inhibit gluconeogenesis; decreased hepatic glucose output
A14. Metformin. B. Agonist for PPAR- receptor
D15. Acarbose C. Blocks pancreatic- cell ATP-sensitive K+ channels.
B16. Rosiglitazone D. -glucosidase inhibitor .

17. Long acting antidiabetic that rapidly associates & dissociates from receptors resulting
in rapid decrease in blood sugar & low risk of hypoglycemia & CVS side effects.
A. Repaglinide. C. Acarbose.
B. Glimipride. D. Rosiglitazone .

18. The following contraindications to sulfonylureas are indications to insulin except

A. IDDM.
B. DM with stress, pregnancy, lactation & emergency.
C. DM with severe liver or renal disease.
D. Past history of allergy to sulfa compounds.

19. Choose the correct statement about repaglinide:

A. It is a long acting oral hypoglycemic drug.
B. Taken before a meal, it limits postprandial hyperglycemia in type 2 D M.
C. It lowers blood glucose in both type 1 and type 2 diabetes mellitus.
D. It acts by opening K+ channels in myocytes and adipocytes.

20. Which of the following statements about metformin is correct:

A. Weight gain is a common and unwanted side effect.
B. Lactic acidosis occurs frequently, but it is seldom serious.
C. Metformin-induced hypoglycemia seldom occurs.
D. Useful, as monotherapy, for both type I and type 2 diabetes.

21. The following does not result in weight gain

A. Repaglinide
B. Metformin.
C. Glibenclamide.
D. Insulin

22. The following does not result in weight gain

A. Repaglinide
B. Acarbose.
C. Rosiglitazone.
D. Insulin

23. The following is not an indication of vitamin D

A. Prevention and cure of rickets in children & osteomalacia in adults.
B. Osteoporosis.
C. Hypoparathyroidism.
D. Hypercalcemia

15
24. The following increase bone formation in osteoporosis except
A. Ca2+ & Vitamin D
B. Anabolic Steroids.
C. Teriparatide.
D. Cyclic Estrogen

25. The following are used in hypercalcemia except

A. Calcitonin.
B. Glucocorticoids.
C. Teriparatide.
D. Alendronate.

26. A vitamin D preparation that does not require renal activation:

A. Calcitriol. C. Dihydrotachysterol.
B. Alfacalcidiol. D. A & B.

27. Which of the following results on intermittent administration of low dose PTH
A. Impaired Ca absorption in gut.
B. Inhibition of 1-hydroxylase.
C. Net increase in bone formation.
D. Net increase in bone resorption.

28. Marked muscle tetany after thyroidectomy can be quickly reversed by

A. Calcitonin.
B. Calcium gluconate.
C. Parathyroid hormone.
D. Vitamin D.

29. A drug that decreases serum calcium level, used in osteoporosis & hypercalcemia
A. Calcitonin.
B. Estrogen.
C. Parathyroid hormone.
D. Prednisone.

30. The following is not true concerning bisphosphonates

A. Decreases bone turnover in Pagets disease of bone.
B. Alendronate increases bone mineral density in osteoporosis.
C. Esophagitis is its most serious adverse effect & is reduced if taken with a full glass of
water while sitting upright.
D. May be safely given in renal dysfunction.

31. The following decrease bone resorption in osteoporosis except

A. Calcitonin.
B. Raloxifine.
C. Teriparatide.
D. Alendronate.

16
Fungi
1. All the following antifungals are correctly matched to their mechanisms EXCEPT:
A. Griseofulvin / inhibits mitosis.
B. Ketoconazole /inhibits cytochrome P450 dependent demethylase.
C. Terbinafine / induces pore formation disrupting cell membrane permeability.
D. Flucytosine / interferes with nucleic acid synthesis.

2. Amphotericin- B is characterised by all the following EXCEPT:

A. Used for systemic fungal infections
B. Poor GIT absorption
C. Nephrotoxic
D. Forms pores in cell membrane disrupting fungal cell membrane permeability
E. Induces hyperkalemia

3. Oral flucytosine is given with amphotericin-B in Cryptococcal meningitis to:

A. Decrease resistance to flucytosine
B. Decrease CYP450 enzyme inhibition by Amphotericin-B
C. Decrease amphotericin dose & hence its nephrotoxicity
D. A & C

4. During administration of ketoconazole we should avoid

A. Ranitidine C. Antacids
B. Amphotericin B D. All of the above

5. All the following are true concerning fluconazole EXCEPT

A. Antacids or H2 blockers could be taken safely with fluconazole.
B. Reaches CSF thus could be given in fungal meningitis.
C. Given as single dose increasing patient compliance.
D. Less specific to fungal cytochrome P450 compared to ketoconazole

6. Ketoconazole is used in:

A. Deep fungal infection 2nd line to Amphotericin-B C. Cancer prostate
B. Cushing disease D .All of the above

7. Which of the following statement is true concerning caspofungin:

A. Inhibits synthesis of glucose polymer of fungal cell membrane
B. Used in candidiasis & aspergillosis refractory to amphotericin-B
C.It is highly toxic antifungal drug
D. It may produce GIT upset & flushing after its oral administration

8. Which of the following statement is unmatched?

A. Griseofulvin / fungisatic & enzyme inducer/ decreases warfarin level
B. Ketoconazole / fungistatic & enzyme inhibitor/ increases pheytoin level
C. Metronidazole / amebicidal & enzyme inhibitor/ increases warfarin level
D. Amphotericin-B / fungicidal & enzyme inducer/ decreases warfarin level

9. All the following are true about terbinafine EXCEPT:

A. Inhibits squalene epoxidase enzyme
B. More effective than Griseofulvin
C. No inhibition of hepatic CYP450 enzyme

17
 D. Safe as it is used only topically in dermatophyte infections

10. Which of the following is NOT TRUE about nystatin?

A. Too toxic for systemic use
B. Given both oral and topical in vaginal candidiasis
C. Very irritant if applied topically in cutaneous candidiasis
D. A polyene that forms pores in fungal cell membrane

Opioid + Local Anesthesia

1. All the following are involved in the mechanism of action of morphine Except
A. Most effects are mediated by activation of kappa receptors.
B. Inhibition of calcium influx resulting in inhibition of transmitter release.
C. Increase in K outflux resulting in hyperpolarization of neuronal membrane.
D. Reduction of emotional response to pain.

2. Indications of morphine do not include:

A. Analgesic in cancer pain.
B. Acute pulmonary edema in acute left ventricular failure & myocardial infarction
C. In anesthesia
D. Severe pain following head injury.

3. Most serious adverse effects of morphine

A. Dependence.
B. Respiratory depression.
C. Hypertension.
D. A and B

4. The following is not common between pethidine & tramadol:

A. Analgesics.
B. Action completely reversed by naloxone.
C. Less respiratory depression than morphine.
D. Increase risk of convulsions with high doses.

5. Neuropathic pain may be managed by

A. Tricyclic antidepressants. C. Carbamazepine E. All of the above
B. Gabapantin D. Tramadol

6. The following is not true concerning codeine:

A. Inhibits cough center in medulla.
B. Less potent antitussive than morphine.
C. Diarrhea is a troublesome side effect.
D. Analgesic.

7. The following is not common between pethidine & buprenorphine :

A. Analgesic effect in severe pain.
B. Respiratory depression is increased by increasing dose.
C. Nausea & vomiting.
D. Constipation

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8. Pethidine differs from morphine in all the following Except :
A. It is preferred for long term treatment of chronic pain
B. It is less liable to cause asphyxia neonatorum
C. It is less liable to cause biliary colic
D. It has atropine like action.

9. The following concerning naloxone is not correct:

A. Has a shorter half life than its agonist.
B. Given orally.
C. Given in anesthesia to reverse CNS depression of its agonist.
D. It is a specific antagonist to opioid receptors.

10. Which of the following is an opioid used in management of heroin withdrawal?

A. Buspirone.
B. Bupropion.
C. Buprinorphine.
D. Bromocriptine.

11. Neuroleptanalgesia may be induced by

A. Fentanyl / Midazolam
B. Midazolam /Droperidol
C. Fentanyl /Domperidone
D. Fentanyl /Droperidol

12. Conscious sedation may be induced by

A. Fentanyl / Midazolam
B. Midazolam /Droperidol
C. Fentanyl /Domperidone
D. None of the above

13. Dentists avoid extraction in infection because of all the following Except:
A. Fear of spread of infection.
B. Infection decreases extracellular unionized form of local anesthetics.
C. Infection reduces crossing of local anesthetics inside nerve cell.
D. Infection increases extracellular unionized form of local anesthetics.

14. The following is not true concerning ester type local anesthetics:
A. Shorter acting than amides.
B. Less liable to induce allergy.
C. Less liable to systemic toxicity than amides.
D. Procaine is a member of this group.

15. The following is not true about local anesthetics:

A. Adding sodium bicarbonate increases activity of local anesthetics.
B. Bupivacaine is short acting.
C. Lidocaine is an amide.
D. Benzocaine is used as a surface anesthetic.

16. The following is not true about cocaine:

A. It is a local anesthetic.

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B. Acute toxicity may result in convulsions.
C. It is a potent vasodilator.
D. Chronic abuse results in psychosis.

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