PHARMACY MCQs

1. Cimetidine: a) lowers plasma creatinine c) hastens gastric emptying e) may impair cardiac conduction 2. Acute intermittent porphyria: a) is exacerbated by digoxin b) is precipitated by sulphonamides c) is precipitated by ethyl alcohol d) is treated by parenteral lidocaine e) contraindicates the use of thiopentone 3. The following are features of digoxin toxicity: a) headache b) nausea c) abdominal pain d) convulsions e) coupled beats b) prolongs the prothrombin time d) may potentiate the action of warfarin

4. Lidocaine can cause: a) sedation potential b) convulsions c) slowed A-V conduction e) shortening of the refractory phase d) prolongation of the cardiac action

5. Features of severe aspirin overdose include: a) Tinnitus b) metabolic acidosis e) hyperventilation 6. Atropine antagonises the action of: a) some of the effects of morphine c) acetylcholine at sweat glands e) pilocarpine on the pupil b) acetylcholine at the neuromuscular junction d) trimetaphan at the autonomic ganglia c) a reduction in the platelet count d) haemolysis

7. Toxic effects of sodium nitroprusside: a) are not related to dose d) are due to liver rhodanese 8. Pethidine: a) causes less miosis than morphine b) is metabolised to active substances with analgesic properties c) has a longer duration of action than morphine d) possesses atropine-like activity e) has some local anaesthetic activity 9. The following are useful in the suppression of ventricular ectopic beats: a) digoxin b) amiodarone c) mexiletine d) verapamil e) bretylium b) are due to cyanide ions c) are due to thiocyanate e) may be treated with vitamin B12

10. The following act directly on vascular smooth muscle by altering calcium transport: a) nicardipine b) sodium nitroprusside c) hydralazine d) bendrofluazide c) dantrolene

11. Metoclopramide: a) has an action on gastric emptying opposed by atropine c) is a phenothiazine d) lowers the blood glucose 12. Otoxicity can follow the administration of: b) causes prolactin release e) is a dopamine antagonist

a) ethacrynic acid

b) gentamicin

c) frusemide

d) cefuroxime e) streptomycin

13. Poisoning by organophosphorus compounds causes: a) increased bronchial secretions 14. Phenobarbitone: a) is used in the treatment of grand mal epilepsy c) can produce skin rashes e) has its effects terminated by redistribution 15. Testosterone derivatives are: a) androgenic b) diabetogenic c) progestogenic d) anabolic e) carcinogenic b) may aggravate petit mal epilepsy d) is rapidly metabolised b) constipation c) miosis d) tetanus e) tachycardia

16. Buprenorphine: a) causes little nausea and vomiting c) is mostly metabolised in the liver e) must be given parenterally b) has a respiratory depressant action antagonised by naloxone d) may cause withdrawal symptoms in morphine addicts

17. The following should not be discontinued abruptly: a) cimetidine b) propranolol c) clonidine d) amiodarone e) digoxin

18. Sulphonylureas: a) are used in maturity-onset diabetes b) can cause hypoglycaemia c) are suitable for the treatment of ketoacidosis d) are an effective treatment for hyperglycaemia following total pancreatectomy e) can cause lactic acidosis 19. Hyoscine: a) causes tachycardia b) causes sedation c) causes mydriasis e) has a weaker antisialagogue effect than atropine 20. Salbutamol can cause: a) tremor b) an increase in uterine contractility d) hypokalaemia e) tachycardia ANSWERS c) a worsening of intermittent claudication d) is an antiemetic

1. FFFTT 7. TTFFF 13. TFTFF 19. TTTTF

1. Dopamine:

2. FTTFT 8. FTFTT 14. TTTFF 20. TFFTT

3. TTTTT 9. FTTFT 15. TTFTT

4. TTTFT 10. TTTFF 16. FFTTF

5. TTFFT 11. TTFFT 17. FTTFF

6. FFTFT 12. TTTFT 18. TTFFF

a) may produce ventricular arrhythmias c) crosses the blood-brain barrier e) is inactivated in alkaline solution

b) increases mesenteric blood flow at high doses d) is synthesised from L-dopa

2. The following increase the amount of calcium in cardiac muscle:

a) halothane b) adrenaline c) diltiazem d) nifedipine e) trimetaphan 3. The following can be used safely in a patient on a monoamine oxidase inhibitor: a) morphine b) pethidine c) noradrenaline d) amphetamine e) adrenaline 4. Hyoscine hydrobromide causes: a) antiemesis b) somnolence c) pupillary dilatation d) tachycardia followed by bradycardia e) extrapyramidal symptoms

5. Clonidine: a) is an alpha-2 receptor agonist d) inhibits salivation ANSWERS 1.TTFTT 2.FTFFF

b) is a dopamine antagonist c) causes tachycardia e) reduces the minimum alveolar concentration of halothane 4.TTTTF 5.TFFTT

3.TFTFT

6. Hydralazine: a) is metabolised by acetylation b) is destroyed by plasma cholinesterase c) can cause a lupus-like syndrome d) stimulates the baroreceptor reflex e) is contraindicated in pregnancy 7. The following are prodrugs: a) suxamethonium b) diamorphine c) captopril d) paracetamol e) enalapril 8. The following drugs penetrate the blood-brain barrier: a) physostigmine b) dopamine c) propranolol d) glycopyrrolate e) noradrenaline 9. Naloxone: a) is an agonist at kappa receptors b) is an antagonist at mu receptors c) reverses ventilatory depression due to morphine d) may precipitate opiate withdrawal symptoms e) may cause pulmonary oedema 10. The following are precursors of adrenaline: a) tyrosine b) phenylalanine c) dopamine d) isoprenaline e) noradrenaline ANSWERS 6.TFTTF

7.FTFFT

8.TFTFF

9.FTTTT

10.TTTFT

11. The following affect gastric emptying:

a) diamorphine b) diazepam, c) metoclopramide d) cisapride e) omeprazole 12. Chlorpromazine: a) can cause dystonic reactions b) antagonises apomorphine-induced vomiting c) is a dopamine antagonist at the chemoreceptor trigger zone d) is a weak alpha-adrenergic agonist e) undergoes extensive first-pass metabolism 13. Alfentanil: a) is less lipid soluble than fentanyl b) relaxes the sphincter of Oddi c) has active metabolites d) has a large volume of distribution e) causes analgesia without sedation 14. Folic acid metabolism is impaired by: a) nitrous oxide b) sodium nitroprusside c) sulphonamides d) penicillin e) trimethoprim 15. Significant agonist activity at opioid receptors occurs with: a) clonidine b) pentazocine c) buprenorphine d) ketamine (Ketamine has antagonist activity at opioid receptors, but agonist activity at d and ? receptors) e) naloxone
ANSWERS 11.TFTTF 12.TTTFT 13.TFFFF 14.TFTFT 15.FTTFF

16. Drug clearance by the body: a) only refers to elimination by the kidney b) refers to the volume of blood cleared of the drug in unit time c) cannot exceed the glomerular filtration rate d) may be influenced by renal tubular secretion e) is the same as creatinine clearance 17. Dopexamine: a) causes arterial vasoconstriction b) is an agonist at dopaminergic D1 and D2 receptors c) increases the force of myocardial contraction d) increases renal blood flow e) causes arrhythmias 18. Sodium valproate:

a) is effective in grand mal epilepsy b) is effective in petit mal epilepsy c) is safe in patients with liver disease d) should not be given to children e) increases brain concentrations of gamma-amino butyric acid (GABA) 19. The Chi-squared test: a) is used to compare the frequencies of occurrence b) requires the standard error of the mean to be calculated c) does not require a knowledge of the number of degrees of freedom d) should not be used for data with small groups e) does not involve the null hypothesis 20. A placebo effect: a) may occur in either treatment or control groups c) is likely to occur repeatedly in placebo reactors e) is not seen in double-blind trials ANSWERS 16.FTFTF 17.FTTTT 18.TTFFT 19.TFFTF 20.TFTTF b) occurs only in mentally ill patients d) can occur in up to 35% of patients

1. The following act by blocking cholinergic receptors:

a) trimetaphan b) hexamethonium c) ouabain d) benzhexol e) physostigmine 2. Esmolol: a) has a negative inotropic effect b) has no intrinsic sympathomimetic activity c) causes a dose-dependent fall in heart rate d) increases airways resistance e) may prolong the duration of action of suxamethonium 3. Enflurane: a) is a halogenated methyl-ethyl ether b) has a blood/gas solubility coefficient of 1.43 c) lowers intracranial pressure d) increases the tone of the pregnant uterus e) causes a decrease in systemic vascular resistance 4. Morphine: a) causes histamine release b) has no active metabolites c) undergoes extensive first-pass hepatic metabolism d) has an elimination half-life of 3-4 hours e) may be antagonised by pentazocine 5. Uterine tone is: a) increased by ketamine b) decreased by halothane c) increased by beta-2 antagonists d) unaffected by suxamethonium e) decreased by nifedipine ANSWERS 1.TTFTF 2.TTTTT 3.TFFFT 4.TFTTT 5.TTTTT

6. Aspirin overdose causes: a) thrombocytopenia b) coma c) metabolic acidosis d) jaundice e) pulmonary oedema 7. Non-depolarising neuromuscular blockers are potentiated by: a) lithium b) diazepam c) trimetaphan d) magnesium e) suxamethonium 8. Atropine: a) crosses the blood-brain barrier b) can cause an initial bradycardia c) increases the rate of gastric emptying d) increases conduction through the AV node e) produces bronchoconstriction 9. Hepatotoxicity has been associated with: a) diethyl ether b) chloroform c) cyclopropane d) enflurane e) halothane 10. The anticoagulant effect of warfarin: a) is exerted directly on the blood b) is slow in onset c) can be reversed by vitamin K d) is potentiated by phenylbutazone c) is potentlated by barbiturates

ANSWERS 6.FTTFT (HYPOTHROMBINAEMIA AND INHIBITION OF PLATELET AGGREGATION, BUT NOT THROMBOCYTOPENIA) 7.TFTTT 8.TTFTF 9.FTFTT 10.FTTTF 11. The following may be used in the treatment of digoxin toxicity: a) propranolol b) lidocaine c) phenytoin d) calcium e) potassium 12. Dobutamine: a) is structurally similar to isoprenaline b) activates adenyl cyclase c) has a selective action on beta-1 adrenoreceptors d) has a half-life of 2 minutes e) increases the left ventricular end-diastolic pressure 13. Organophosphorus anticholinesterases: a) have an irreversible action b) phosphorylate cholinesterase c) can have their action reversed in the early stages by atropine d) are readily absorbed through the skin 14. The following factors encourage passage of a substance across the cell membrane: a) high lipid solubility b) low concentration gradient c) high molecular weight d) negative hydrostatic pressure e) high degree of ionisation 15. Amitriptyline in overdose causes: a) cardiac arrhythmias b) hypotension c) restlessness d) metabolic acidosis e) jaundice ANSWERS 11.TTTFT 12.TTFTF 13.TTTT 14.TFFFF 15.TTTTF

16. Low plasma cholinesterase activity: a) is related to the patient's blood group b) has no effect on the action of decamethonium c) occurs with organophosphorus poisoning d) prolongs the action of esmolol e) occurs in malnutrition 17. Sulphonylureas: a) acts by increasing insulin release b) tends to produce weight loss c) is suitable for use in pregnancy d) is effective in correcting ketoacidosis e) can produce hypoglycaemia 18. Side-effects of hydralazine include: a) tachycardia b) impotence c) constipation d) systemic lupus erythematosus e) bronchoconstriction 19. The following are measures of scatter in statistical analysis: a) mean b) standard error of the mean c) standard deviation d) range e) p of less than 0.5 20. Statistical tests are used to: a) eliminate observer bias b) eliminate placebo effect c) show that results are true d) show that the results did not occur by chance e) show that the results are clinically significant ANSWERS

16.FFTTT

17.TFFFT

18.TFFTF

19.FTTTF

20.FFFTF

1. Nifedipine: a) causes tachycardia b) causes tremor c) causes hypoglycaemia d) can be given sublingually e) dilates skeletal muscle arterioles 2. Tetracycline: a) may be hepatotoxic in large doses b) is extensively metabolized c) is contraindicated in pregnancy d) potentiates non-depolarising muscle relaxants e) absorption is decreased by magnesium trisilicate 3. Neostigmine: a) is eliminated entirely by the liver b) causes foetal bradycardia when given to a pregnant woman c) causes miosis d) is a quaternary ammonium compound 4. The following drugs readily cross the placenta: a) atracurium b) lidocaine c) bupivacaine d) neostigmine e) propranolol 5. In acute intermittent porphyria, the following, drugs may be safely used: a) etomidate b) ketamine c) midazolam d) pethidine e) cotrimoxazole ANSWERS 1.TTFTT 2.TTTTT 3.FFTT 4.FTFFT 5.FFTTF

6. The following drugs are mainly eliminated from the body by hepatic metabolism: a) isoflurane b) morphine c) atracurium d) suxamethonium e) dopamine 7. The following have an elimination half-life of greater than 24 hours: a) diazepam b) midazolam c) methadone d) gelofusine e) hydroxyethyl starch 8. Phenytoin: a) shows first-order elimination kinetics b) induces enzymes c) causes hypotension d) causes vitamin B2 deficiency e) has a half-life of about 4 hours 9. L-dopa: a) is more lipid soluble than dopamine b) may produce postural hypotension c) may cause nausea d) may cause abnormal movements e) is ineffective via the oral route 10. Toxicity from hyperbaric oxygen therapy can cause: a) painful joints b) pulmonary oedema c) acute tubular necrosis d) convulsions e) bradycardia ANSWERS 6.FTFFF 7.TFTFT 8.TTTFF 9.TTTTF 10.FTFTF

11. Atropine: a) increases gut motility b) is a mixture of d- and l-isomers c) is equipotent with hyoscine d) can cause bradycardia e) crosses the blood-brain barrier 12. Beclomethasone: a) can be given by aerosol inhaler b) can cause candidiasis c) is a fludrocortisone d) increases the circulating cortisol concentration e) is a bronchodilator 13. Dopamine receptor antagonists: a) increase heart rate b) are antiemetics c) cause hypertension d) cause extrapyramidal side-effects e) increase lower oesophageal sphincter tone 14. The volume of stomach contents is reduced by: a) sodium citrate b) metoclopramide c) cimetidine d) atropine e) pyridostigmine 15. The following drugs relax the pregnant uterus: a) salbutamol b) propranolol c) noradrenaline d) acetylcholine e) dopamine ANSWERS 11.FTFTT 12.TTFFT 13.FTFTT 14.FTTFT 15.TFFFF

16. Carbonic anhydrase inhibitors: a) cause an alkaline urine to be produced b) cause a metabolic acidosis c) are more effective when given continuously than when given intermittently d) may lead to the formation of renal calculi e) cause the intraocular pressure to rise 17. Osmotic diuretics: a) are only effective if completely reabsorbed from the renal tubule b) reduce intracranial pressure primarily by inducing a diuresis c) produce a urine flow limited by glomerular filtration rate d) can lead to pulmonary oedema if renal function is impaired e) have a molecular weight of between 40,000 and 65,000 daltons 18. The following are ethers: a) sevoflurane b) halothane c) desflurane d) trichloroethylene e) enflurane 19. Warfarin: a) has a rapid onset of action b) is readily excreted in the urine c) is antagonised by salicylates d) is potentiated by metronidazole e) is antagonised by barbiturates 20. Salbutamol: a) is a beta-1 selective adrenoreceptor agonist b) acts on the lung only when given by the inhalational route c) reduces the forced expiratory volume in asthmatics d) produces vasodilatation in skeletal muscle e) can produce hypokalaemia ANSWERS 16.TTFTF 17.FFFTF 18.TFTFT 19.FFFTT 20.FFFTT