英文药理学考卷样题.doc

1 9 InstituteInstituteInstitute ofofof PharmaceuticalPharmaceuticalPharmaceutical SciencesSciencesSciences SCHOOLSCHOOLSCHOOL OFOFOF PHARMACEUTICALPHARMACEUTICALPHARMACEUTICAL SCIENCESSCIENCESSCIENCES SOUTHERNSOUTHERNSOUTHERN MEDICALMEDICALMEDICAL UNIVERSITYUNIVERSITYUNIVERSITY FINALFINALFINAL EXAMINATIONEXAMINATIONEXAMINATION FORFORFOR PHARMACOLOGYPHARMACOLOGYPHARMACOLOGY PAPERPAPERPAPER 1 1 1 AUTUMNAUTUMNAUTUMN SEMESTER SEMESTER SEMESTER 200720072007 UndergraduateUndergraduateUndergraduate ofofof PreclinicalPreclinicalPreclinical MedicineMedicineMedicine STUDENTSTUDENTSTUDENT NAMENAMENAME ROLLROLLROLL NUMBERNUMBERNUMBER SUBJECTSUBJECTSUBJECT TITLE TITLE TITLE COURSECOURSECOURSE CODECODECODE QUALITYQUALITYQUALITY CHECKCHECKCHECK SIGNATURESIGNATURESIGNATURE INSTRUCTIONSINSTRUCTIONSINSTRUCTIONS P P P LEASELEASELEASE READREADREAD THETHETHE FOLLOWINGFOLLOWINGFOLLOWING INSTRUCTIONSINSTRUCTIONSINSTRUCTIONS CAREFULLYCAREFULLYCAREFULLY BEFOREBEFOREBEFORE PROCEEDINGPROCEEDINGPROCEEDING 1 1 1 WriteWriteWrite youryouryour namenamename andandand rollrollroll numbernumbernumber on on on thethethe rightrightright toptoptop ofofof eacheacheach answeransweranswer sheet sheet sheet CLEARLYCLEARLYCLEARLY 2 2 2 ThisThisThis is is is youryouryour finalfinalfinal examination examination examination pleasepleaseplease writewritewrite carefully carefully carefully 3 3 3 TheTheThe examinationexaminationexamination paperpaperpaper MUSTMUSTMUST NOTNOTNOT bebebe takentakentaken outoutout ofofof thethethe examinationexaminationexamination room room room 4 4 4 ReadReadRead thethethe directionsdirectionsdirections carefullycarefullycarefully beforebeforebefore answeringansweringanswering eacheacheach question question question 5 5 5 PensPensPens andandand eraserseraserserasers maymaymay bebebe used used used butbutbut calculators calculators calculators cellcellcell phonesphonesphones areareare forbidden forbidden forbidden 6 6 6 WEIGHTING WEIGHTING WEIGHTING ThisThisThis paperpaperpaper consistsconsistsconsists ofofof TWOTWOTWO sections sections sections AllocationAllocationAllocation ofofof marksmarksmarks is is is listedlistedlisted asasas follows follows follows StudentsStudentsStudents areareare advisedadvisedadvised tototo useuseuse thethethe markingmarkingmarking systemsystemsystem asasas a a a guideguideguide tototo thethethe amountamountamount ofofof timetimetime tototo bebebe usedusedused ononon eacheacheach question question question DATE DATE DATE ClassClassClass hours hours hours TIMETIMETIME Examination Paper Designer SectionsSectionsSections SectionSectionSection A A A 606060 MCQsMCQsMCQs SectionSectionSection B B B AnswerAnswerAnswer QuestionsQuestionsQuestions TotalTotalTotal MarksMarksMarks606060404040100100100 ResultsResultsResults CorrectorCorrectorCorrector Marks 2 9 SECTIONSECTIONSECTION A A A MULTIPLE CHOICE QUESTIONS 60 1 50 Directions Each question in this section is a multiple choice question with five answer choices Read each question carefully and choose the ONE best answer Record your answer on the answer document in the space that corresponds to the question number Completely fill in the space that has the same letter as the answer you have chosen Use only a No 2B lead pencil 1 Receptors are macromolecules that A Are designed to attract drugs B Are resistant to antagonists C Exist as targets for physiological neurotransmitters and hormones D Are only on the outer surface of cells E Are only inside of cells 2 Which of the following chemical bonds would create an irreversible combination of an antagonist with its receptor A Ionic bond B Hydrogen bond C Van der Waals bond D Covalent bond E None of them 3 The body has developed defense mechanisms that reduce the amount of foreign chemicals such as drugs that enter the body One of the more prominent of these mechanisms is an efflux transport system that pumps some drugs back into the intestinal lumen following absorption into the enterocytes and that is responsible for the lack of complete absorption of some drugs This efflux transport system is A Facilitated diffusion B P glycoprotein C Cytochrome P450 3A D Pinocytosis E None of them 4 Concerning regulation of CYP mediated drug metabolism all of the following statements are true EXCEPT A Drugs that competitively inhibit CYP enzymes cause a decrease in concentrations of the object original drug B Induction of drug metabolizing enzymes results in a decrease in concentrations of the object original drug thus potentially reducing efficacy C Induction of drug metabolizing enzymes frequently requires the synthesis of new enzyme protein and thus may not occur immediately upon introduction of the inducing agent D Mechanism based inactivation results in irreversible inactivation of the enzyme that lasts for the duration of the enzyme molecule E None of them 5 Drug presence in breast milk is most likely for A Drugs highly bound to plasma proteins Marks 3 9 B Lipid soluble molecules C Large ionized water soluble molecules D Acidic compounds E None of them 6 For a drug such as piroxicam with a 40 hour halflife and being dosed once daily i e every 24 hours steady state will be reached shortly following which DOSE not which half life A 1st dose B 3rd dose C 5th dose D 8th dose E 12th dose 7 It is well established that most drugs taken by pregnant women are capable of crossing the placenta and reaching the developing fetus The placenta itself can aid in the protection of the fetus from excessive exposure to drugs in the maternal circulation by A Impairing diffusion of lipid soluble drugs B Preventing the passage of drugs having a molecular weight under 250 C Playing a role as a site of drug metabolism D Secreting drugs from the fetal circulation to the maternal circulation E None 15 A dental technician begins to display symptoms including tremors depression and insomnia Which of the following chemicals present in the workplace may be responsible for the symptoms A Solvents used in dental adhesives B Fluoride used in oral rinses C Mercury used in the preparation of amalgams D Lidocaine used as an anesthetic E None 17 You are a staff physician at a major chemical manufacturing company A worker on the maintenance crew has complained of being light headed and tired occasionally at work and that if it occurs it clears up after he leaves for the day He was asked to write down where he had worked on the days this occurred these are listed below In which of these areas is he most likely to have exposures that would cause these symptoms A Herbicide production area B Insecticide packaging area C Label printing area D Kitchen area of the cafeteria E None 18 When does a conflict of interest occur A When an individual s private goals are inconsistent with that person s official responsibilities B When an individual s research interests are in conflict with the research of an individual in another institution or corporation C When two researchers want to do research in the same area but there is only enough available funding for one researcher to do the research adequately D When an individual has a conflict between his or her research interests and the requirements set forth by the Nuremberg Code E None 19 All of the following types of cells are innervated by the autonomic nervous system EXCEPT A Smooth muscle of blood vessels B Skeletal muscle C Sinoatrial node D Salivary glands 4 9 E Intestinal smooth muscle 20 This question is based on the information provided in the accompanying diagram Shown is the effect of applying norepinephrine on the arterial pressure of an isolated in vitro segment of artery from an experimental animal before and after adding drug X to the tissue Drug X is present during the second application of norepinephrine Drug X is most likely A Guanethidine B Propranolol C Cocaine D Prazosin E Atropine 21 A patient has developed glaucoma that is refractory to noncholinergic therapies You decide to prescribe eyedrops containing pilocarpine but you are concerned about the patient s ability to self administer the drops The most sensitive indicator of excessive administration of pilocarpine is A An increased heart rate B A decreased heart rate C Mental confusion D Constriction of the pupil E None 22 Which of the responses to atropine listed below is most likely to be different in an elderly versus a young patient A Inhibition of sweating B Tachycardia C Mydriasis D Drowsiness E None 23 Digitalis functions to improve congestive heart failure by A Induction of emesis B Activation of adrenergic receptors C Improving survival in patients of heart failure D Binding to and inhibiting the Na K ATPase enzyme in cardiac myocytes E Deactivation of the angiotensin receptor 24 A 45 year old woman has had recurrent episodes of atrial fibrillation She is receiving phenytoin and quinidine to control the atrial fibrillation She is also taking a low dose of diazepam for insomnia and estrogen replacement therapy You learn today that she has been receiving ciprofloxacin for a urinary track infection The reason for her appointment today is that she has been having ringing in the ears headache nausea and blurred vision She tells you that she is also having trouble hearing the television You suspect drug toxicity The most likely agent is A Ciprofloxacin B Estrogen C Phenytoin D Diazepam E Quinidine 25 A patient comes to your office with effort induced angina and resting tachycardia You choose the following drug to treat the patient because it slows heart rate by blocking L type calcium channels in the SA node A Verapamil B Propranolol C Nitroglycerin D Isosorbide dinitrate 5 9 E Metoprolol 26 Metoprolol would produce which beneficial effect in a patient with secondary angina A A decrease in preload B An increase in collateral blood flow C An increase in afterload D An increase in diastolic filling time E An increase in blood flow through a concentric Stenosis 27 The most potent vasoconstrictor known is A Bradykinin B Angiotensin II C Angiotensin IV D Natriuretic peptide E Endothelin 28 Which of the following statements most accurately characterize the cellular action of the calcium channel blockers A Their interaction with membrane phospholipids results in a nonselective decrease of ion transport B They inhibit the Na Ca exchanger in cardiac and smooth muscle C They interact at three distinct sites at the Ltype voltage gated calcium channels D Their interaction with the sodium pump results in an inhibition of calcium transport E None 29 All of the following adverse effects are likely to occur with long term use of calcium channel blockers EXCEPT A Skeletal muscle weakness B Flushing C Dizziness D Headache E None 30 Which of the following antihypertensive drugs is contraindicated in a hypertensive patient with a pheochromocytoma A Metyrosine B Labetalol C Prazosin D Phenoxybenzamine E Guanethidine 31 When a patient is treated with a thiazide diuretic for hypertension all of the following are likely EXCEPT A The fall of blood pressure that occurs in the first 2 weeks of therapy results from a decrease of extracellular volume B The sustained fall in blood pressure that occurs after several weeks of therapy is due to a decrease of intravascular resistance C After the blood pressure is reduced hypokalemia remains a complication D Hyperuricemia may occur E Hypoglycemia may occur 32 Which of the following statements describe why warfarin is not used to prevent blood coagulation in blood collection devices used at blood donating centers A Warfarin does not bind to plastic tubing or glass B The anticoagulant effect of warfarin occurs only in vivo 6 9 C Warfarin is a prodrug which must be activated in the liver into the active compound D The gastric enzymes needed to convert Rwarfarin into S warfarin are unstable near plastic E Warfarin is chemically unstable and is degraded unless made fresh and used immediately 33 Agents that potentiate the actions of GABA in the brain will likely have which of the following effects A Elevate blood pressure B Provide sedation C Cause seizures D Relieve pain E None 34 Frequently vasoconstrictors are combined with local anesthetics to delay absorption of the anesthetic from its injection site What is the most widely employed agent A Dopamine B Phenylephrine C Levonordefrin D Epinephrine E Cocaine 35 Opisthotonos is a convulsive condition that is often associated with the ingestion of strychnine This condition is associated with all of the following EXCEPT A Antagonism of the inhibitory amino acid neurotransmitter glycine B The predominance of glycine as an inhibitory amino acid transmitter in the spinal cord C Antagonism of the inhibitory amino acid neurotransmitter GABA D The convulsions lead to tonic extension of the body and all limbs E None 36 A 54 year old man is scheduled for an elective colonoscopy that will take approximately 20 minutes Which of the following drugs would be most likely to produce the desired anesthesia and anterograde amnesia A Buspirone B Zephalon C Midazolam D Chlordiazepoxide E Hydroxyzine 37 Many anticonvulsant drugs as a major part of their mechanism of action block the sodium channel but other effective agents do not use this mechanism Which of the following anticonvulsants has the ability to block T calcium currents as its primary mechanism of action A Ethosuximide B Phenytoin C Topiramate D Carbamazepine E Lamotrigine 38 Which of the following antidepressants is most selective for inhibition of neuronal reuptake of serotonin A Mirtazapine Remeron B Venlafaxine Effexor C Bupropion Wellbutrin D Sertraline Zoloft E Imipramine Tofranil 39 Which of the following statements about antidepressant medications is most appropriate A They all have a delay of approximately 48 hours for onset of benefit B There are large differences in efficacy among individual agents 7 9 C Some benefit is expected in 65 to 80 of patients treated with an antidepressant for major depression D The major contribution of the newer antidepressants lies in the marked improvement in duration of action E None 40 Which of the following agents possesses pharmacological actions characterized by high antipsychotic potency high potential for extrapyramidal toxicity and a low likelihood of causing sedation A Thioridazine B Haloperidol C Flumazenil D Clozapine E Carbamazepine 41 An advantage of celecoxib over most other NSAIDs is A Less inhibition of PGE2 effects on the gastric mucosal B Less risk of bronchospasm and hypersensitivity reactions C Once daily dosing allows the patient convenience D Less risk of harm to the developing fetus in the third trimester E Greater degree of efficacy in the treatment of rheumatoid arthritis 42 Allopurinol reduces serum urate levels by A Promoting the active secretion of uric acid in kidneys B Inhibiting uric acid synthesis C Impairing renal urate reabsorption D Decreasing metabolism of uric acid E None 43 The antigen mediated release of histamine can A Be inhibited by the binding of histamine to H3 receptors on mast cells B Be stimulated by 2 adrenoceptor agonists C Be initiated by organic bases such as morphine without prior sensitization D Occur only in the tissues not in the blood E Produce pain and itching through an effect on sensory nerve endings 44 The underlying pathophysiology of asthma is best described by which of the following statements A Asthma is a psychosomatic disorder B Asthma is caused by an aberrant response to vaccinations C Asthma is a disease of airway inflammation D Asthma is a disorder of the lung parenchyma E Asthma is an infectious disease 45 Symptoms typically produced by inhaled adrenoceptor agonists include which of the following A Tachycardia dizziness and nervousness B Dysphonia candidiasis and sore throat C Dyspepsia and Churg Strauss syndrome D Nausea agitation and convulsions E Muscle tremor tachycardia and palpitations 46 A 62 year old woman on hemodialysis is scheduled for a screening colonoscopy Which should be prescribed for her colonic preparation A Visicol B Fleet Phospho soda C Magnesium citrate D Dulcolax E GoLYTELY 8 9 47 Several very useful dermatological agents are derived directly from plants A compound occurring in the May apple is A Interferon 2b B Mycophenolate mofetil C Methotrexate D 6 Thioguanine E Podophyllotoxin 48 Which commercial product would you prescribe for a recovering alcoholic A Act B Plax C Total D Peridex E Listerine 49 Choose the best answer Selective toxicity is A What the drug does to the patient B What the patient does to the drug C What the pathogen does to the patient D What the drug does to the pathogen E What the pathogen does to the drug 50 A 24 year old AIDS patient is interested in starting chemoprophylaxis for Pneumocystis pneumonia PCP and cerebral toxoplasmosis He has no drug allergies Which of the following prophylactic agents is appropriate for the prevention of both PCP and cerebral toxoplasmosis A Nitrofurantoin B Trimethoprim sulfamethoxazole C Norfloxacin D Methenamine E Nalidixic acid 51 A 32 year old man with quadriplegia and neurogenic bladder was admitted to the hospital from a long term care facility The patient had vomiting fever and cloudy urine A year ago the patient developed urticaria wheezing and hypotension within an hour after his first dose of nafcillin Subsequently his penicillin skin test was positive During the current admission the physician examiner noted fever quadriplegia and chronic indwelling bladder catheter Laboratory tests revealed leukocytosis in blood and urine Urine stain showed gram negative rods and urine culture grew P aeruginosa Which of the following drugs would be most appropriate for this patient A Ampicillin sulbactam B Aztreonam C Cefazolin D Imipenem cilastatin E Piperacillin tazobactam 52 Parents brought their 3 year old boy to the outpatient clinic because of a facial rash Today the patient was one of several children sent home from day care because of similar rashes Physical examination revealed a normal healthy boy