Pharm Exam with answers
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Pharmacology
Fall Session 2014
Washington University of Health and Science
Exam II
Covering: Drugs acting on the Autonomic Nervous System and Central Nervous System
October 28, 1024
By signing, I do hereby swear that I have neither given nor received any assistance from another
classmate or any other resources in the completion of this exam. This exam is solely my own work.
_____________________________________
Student signature
___________________
Date of the exam
Choose the best option for each answer. Each question is worth __ points. Remember the 110% rule You know the information!
Just take a deep breath, focus, and allow your mind to find the answer!
1. Which of the following is correct of parasympathetic simulation?
a. Decrease in intestinal motility
b. Contraction of sphincter of urinary bladder
c. Inhibition of bronchial secretion
d. Increase in heart rate
e. Contraction of sphincter muscle in the iris of the eye/miosis
2. A patient on a diagnostic test for myasthenia gravis would be expected to have improved neuromuscular function after
being treated with . . . ?
a. Donepezil
b. Edrophonium
c. Atropine
d. Echothiophate
e. Neostigmine
3. Of the following cholinergic agents, which has the least side effects and the strongest ability to decrease salivation?
a. Scopolamine
b. Pilocarpine
c. Physostigmine
d. Acetylcholine
e. Carbachol
4. A 50-yr old male farm worker is brought to the ER. He was found confused in the orchard and has since lost conscientious.
HR 45 bpm, BP 80/40, sweating and salivating profusely. Which of the following treatments in indicated?
a. Neostigmine
b. Atropine
c. Edrophonium
d. Acetylcholine
e. Trimethaphan
5. Depolarizing neuromuscular blockers are associated with which of the following?
a. Initial activation of ACh receptor and depolarization of the motor end plate
b. Effects are reversed by acetycholinesterase inhibitiors
c. Intermediate to long duration of action
d. Bind but do not activate ACh receptor
e. Most of these agents have minimal cardiovascular effects
6. Which of the following drugs, when given intravenously, can decrease blood flow to the skin, increase blood flow to the
skeletal muscle and increase the force and rate of cardiac contraction?
a. Epinephrine
b. Isoproterenol
c. Norepinephrine
d. Phenylephrine
e. Terbutaline
7. An elderly patient is brought into the ER in acute heart failure. Which of the following would worsen their condition?
a. Epinephrine
b. Isoproterenol
c. Albuterol
d. Norepinephrine
e. Dobutamine
8. A 60 year old asthmatic man comes in for a checkup and complains that he is having some difficulty in “starting to urinate”.
On PE you find an enlarged prostate and BP of 160/100. Which of the following medications would be most useful for
treating both of his conditions?
a. Doxazosin
b. Labetalol
c. Phentolamine
d. Propranolol
e. Isoproterenol
9. Which one of the following combinations of anti-parkinson drugs is an appropriate therapy?
a. Entacapone, Carbidopa, Levodopa
b. Entacapone, Carbidopa, Amantadine
c. Entacapone. Carbidopa, Pramipexole
d. Entacapone, Selegiline, Ropinirole
e. Selegiline, Carbidopa, Ropinirole
10. Levodopa causes nausea, hypotension and cardiac arrhythmias. Which of the following can decreases these side effects?
a. Entacapone
b. Carbidopa
c. Amantadine
d. Pramipexole
e. Selegiline
11. Modest improvement in the memory of Alzheimer’s patients may occur with which of the following receptors being made
more active/potent/less blocked?
a. Serotonergic
b. Cholinergic
c. Adrenergic
d. GABAergic
e. Serotonergic
12. Which of the following statements is NOT correct regarding Benzodiazepines?
a. Benzodiazepines enhance the binding of ϒ-aminobutyric acid to its receptor, which increases the permeability
of chloride
b. Benzodiazepines do not relieve pain but may reduce the anxiety associated with pain
c. Benzodiazepines cause sedation but are still used for sleep disorders
d. Benzodiazepines produce general anesthesia and therefore are not safe
e. Benzodiazepines take effect within hours of administration
13. A 45 yr old man who has been injured in a car accident is brought into the ER. His blood alcohol level on admission is 275
mg/dL. (Legal limit of intoxication is 80 mg/dL (0.08 g/dL). Hospital records show that he has prior
hospitalizations for alcohol related seizures. His wife confirms that he has been drinking heavily
for 3 weeks. What treatment should be provided to the patient if he goes into withdrawals ?
a.
b.
c.
d.
e.
Buspirone
None
Phenobarbital
Phenytoin
Lorazepam
14. A very agitated young lady was brought to the ER by the police. Psychiatric examination reveals that she has snorted
cocaine several times in the last few days, the last time being 10 hrs previously. She was given a drug that sedated her and
she fell asleep. The drug that was used to counter this patient’s apparent cocaine withdrawal was most likely . . .?
a. Phenobarbital
b. Lorazepam
c. Cocaine
d. Hydroxyzine
e. Fluoxetine
15. The potency of inhaled anesthetics is defined quantitatively as . . .
a. Volatility index
b. Sensitivity factor
c. Cerebrovascular resistance
d. Minimum alveolar concentration
e. Blood/gas partition coefficient
16. Local Anesthetics . . .
a. In their ionized form interact with the protein receptor of calcium channels
b. Affect only small, unmyelinated nerve fibers
c. Have either an amide or an ester linkage
d. Are unaffected by pH of the tissue and pKa of the drug
e. Have either a lipophilic or a hydrophilic group
17. A 25 yr old woman has a long history of depressive symptoms accompanied by body aches. Physical diagnosis and lab
tests are unremarkable. Which of the following drugs might be most useful for this patient?
a. Fluoxetine
b. Duloxetine
c. Sertraline
d. Mirtazapine
e. Phenelzine
18. Which of the following antidepressants has a potent anti-muscarinic activity and therefore should not be used in a patient
with glaucoma?
a. Bupropion
b. Duloxetine
c. Sertraline
d. Mirtazapine
e. Amitriptyline
19. An adolescent male is newly diagnosed with schizophrenia. Which of the following neuroleptic agents may improve his
apathy and blunted affect?
a. Chlorphromazine
b. Fluphenazine
c. Haloperidol
d. Risperidone
e. Thioridazine
20. Which of the following antipsychotic drugs has a sedative effect?
a. Chlorphromazine
b. Fluphenazine
c. Haloperidol
d. Risperidone
e. Thioridazine
21. A heroin addict entered a rehab facility that requires she takes methadone. Methadone has been found to be effect
because . . ?
a. It is an antagonist at the morphine receptors
b. It is a non-narcotic
c. It is longer acting than heroine and has milder withdrawals than heronie
d. It does not cause constipation
e. It is nonaddictive
22. The pain of patient with bone cancer has been managed with a morphine pump. Unfortunately, he has now become
tolerant to the morphine. Which of the following may help to alleviate his pain?
a. Codeine
b. Burprenorphine
c. Meperidine
d. Methadone
e. Fentanyl
23. A 36 yr old man has been smoking two pack of cigarette a day for the last 20 years. He is concerned that his health has
deteriorated, and he has a persistent hacking cough. He also states that he doesn’t want to “get lung cancer and die, like
my father did.” Has tired nicotine patches with no success and wants to know if there is any “pill” he could try. What
medication could you recommend?
a. Mitazapine
b. Citalopram
c. Phenelzine
d. Buspirone
e. Bupropion
24. A 5 yr old child is admitted to the hospital with a low-grade fever and a persistent cough that has resulted in vomiting
episodes following prolonged coughing spells. His throat culture is negative, his fever has resolved, and all that is left is a
slight cough. He is discharged from the hospital by the pediatrician who recommends an over-the-counter opioid
antitussive. Which of the following does he recommend?
a. Tramadol
b. Propoxyphene
c. Loperamide
d. Dextromethorphan
e. Naloxone
25. A patient sees an otolaryngologist with complaints of recurrent sinusitis. The surgeon decides to perform sinus surgery to
debride the scarred sinus tissue. During the procedure the surgeon elects to use an agent that had good local anesthesia
as well as vasoconstrictive properties. What agent might he use?
a. Cocaine
b.
c.
d.
e.
Procaine
Tetracaine
Lidocaine
Mepivacaine
26. A 16-yr old boy is brought to the ER at 4am by his friends, who report that the patient was at an all-night rave party and was
agitated, hyperactive and hypersexual. They physician learns that the boy took several pills, which his friends thought
were “ecstasy” (methylenedioxymethamphetamine). Which of the following describes the mechanism of this “party” drug?
a. Antagonistic activity at the N-methyl-d-aspartate (NMDA) receptor for glutamic acid
b. Binding to the cannabinol CB1 receptor
c. Increased release of dopamine and nor-epinephrine
d. Mimics the action of acetylcholine
e. Agonist at postjunctional serotonin receptors
27. What is the mechanism of action of cocaine?
a. Propagation of action of nor-epinephrine by inhibiting its active transport from the synapse
b. Oxidative deamination of nor-epinephrine in nerve terminals and the effector cells
c. Inhibition of metabolism of nor-epinephrine in nerve terminals
d. Potentiation of tyrosine hydroxylase, the rate-limiting enzyme in the synthesis of norepinephrine
e. Promotion of release of nor-epinephrine from adrenergic nerve endings
28. Oxybutynin works by
a. Inhibiting acetylcholinesterase at muscarinic and nicotinin receptors
b. Causing a neuromuscular blockade
c. Antagonizing α1-adrenoceptors
d. Binding to muscarinic receptors
e. Activating β2- adrenoceptors
29. Which of the following medications is used to prevent premature labour?
a. Tamsulosin
b. Cevimeline
c. Atracurium
d. Tolterodine
e. Terbutaline
30. What significant side effect of terazosin should the doctor warn a 69-yr old patient about?
a. Bronchospasm
b. Postural hypotension
c. Heart failure
d. Sedation
e. Drug abuse
31. Which of the following drugs is used to diagnose myasthenia gravis?
a. Atropine
b. Neostigmine
c. Bethanechol
d. Enrophonium
e. Pralidoxime
32. Pilocarpine reduces intraocular pressure in patients with glaucoma because it
a. Activates nicotinic cholinoceptors
b. Blocks muscarinic cholinoceptors
c. Selectively inhibits peripheral activity of sympathetic ganglia
d. Inhibits acetylcholinesterase
33. A drug that acts at prejunctional α2-adrenoceptors and is used to treat hypertension is
a. Clonidine
b. Methoxamine
c. Metaproterenol
d. Dobutamine
e. Dopamine
34. Receptor actions of acetylcholine are mimicked by nicotine at which of the following sites?
a. Adrenal medullary chromaffin cells
b. Urinary bladder smooth muscle cells
c. Iris circular (constrictor) muscle
d. Heart sinoatrial pacemaker cells
35. Muscarinic cholinoceptor agonists may cause vasodilation through the release of endothelial…
a. Histamine
b. Norepinephrine
c. Acetylcholine
d. Nitric oxide
36. In contrast to propranolol, metoprolol
a. Is used for the management of hypertension
b. Has a greater selectivity for β2- adrenoceptors
c. May be beneficial for the acute treatment of migraine headache
d. Is less likely to precipitate bronchoconstriction in patients with asthma
37. Which of the following neurotransmitters interacts with guanethidine?
a. Acetylcholine
b. Epinephrine
c. Dopamine
d. Norepinephrine
e. Serotonin
38. What class of medications does bethanechol belong to?
a. Nicotinic blockers
b. α- Agnoists
c. β1-blockers
d. β2-blockers
e. Muscarinic agonists
39. Which of the following agents, when applied topically to the eye, would cause both mydriasis and cycloplegia?
a. Phenylephrine
b. Carbachol
c. Prazosin
d. Atropine
40. The direct cardiac effects of dobutamine would be blocked by which one of the following agents?
a. Prazosin
b. Metoprolol
c. Clonidine
d. Isoproterenol
Exam II for Pharmacology Finished!!!
Fall Session 2014
Washington University of Health and Science
Exam II
Covering: Drugs acting on the Autonomic Nervous System and Central Nervous System
October 28, 1024
By signing, I do hereby swear that I have neither given nor received any assistance from another
classmate or any other resources in the completion of this exam. This exam is solely my own work.
_____________________________________
Student signature
___________________
Date of the exam
Choose the best option for each answer. Each question is worth __ points. Remember the 110% rule You know the information!
Just take a deep breath, focus, and allow your mind to find the answer!
1. Which of the following is correct of parasympathetic simulation?
a. Decrease in intestinal motility
b. Contraction of sphincter of urinary bladder
c. Inhibition of bronchial secretion
d. Increase in heart rate
e. Contraction of sphincter muscle in the iris of the eye/miosis
2. A patient on a diagnostic test for myasthenia gravis would be expected to have improved neuromuscular function after
being treated with . . . ?
a. Donepezil
b. Edrophonium
c. Atropine
d. Echothiophate
e. Neostigmine
3. Of the following cholinergic agents, which has the least side effects and the strongest ability to decrease salivation?
a. Scopolamine
b. Pilocarpine
c. Physostigmine
d. Acetylcholine
e. Carbachol
4. A 50-yr old male farm worker is brought to the ER. He was found confused in the orchard and has since lost conscientious.
HR 45 bpm, BP 80/40, sweating and salivating profusely. Which of the following treatments in indicated?
a. Neostigmine
b. Atropine
c. Edrophonium
d. Acetylcholine
e. Trimethaphan
5. Depolarizing neuromuscular blockers are associated with which of the following?
a. Initial activation of ACh receptor and depolarization of the motor end plate
b. Effects are reversed by acetycholinesterase inhibitiors
c. Intermediate to long duration of action
d. Bind but do not activate ACh receptor
e. Most of these agents have minimal cardiovascular effects
6. Which of the following drugs, when given intravenously, can decrease blood flow to the skin, increase blood flow to the
skeletal muscle and increase the force and rate of cardiac contraction?
a. Epinephrine
b. Isoproterenol
c. Norepinephrine
d. Phenylephrine
e. Terbutaline
7. An elderly patient is brought into the ER in acute heart failure. Which of the following would worsen their condition?
a. Epinephrine
b. Isoproterenol
c. Albuterol
d. Norepinephrine
e. Dobutamine
8. A 60 year old asthmatic man comes in for a checkup and complains that he is having some difficulty in “starting to urinate”.
On PE you find an enlarged prostate and BP of 160/100. Which of the following medications would be most useful for
treating both of his conditions?
a. Doxazosin
b. Labetalol
c. Phentolamine
d. Propranolol
e. Isoproterenol
9. Which one of the following combinations of anti-parkinson drugs is an appropriate therapy?
a. Entacapone, Carbidopa, Levodopa
b. Entacapone, Carbidopa, Amantadine
c. Entacapone. Carbidopa, Pramipexole
d. Entacapone, Selegiline, Ropinirole
e. Selegiline, Carbidopa, Ropinirole
10. Levodopa causes nausea, hypotension and cardiac arrhythmias. Which of the following can decreases these side effects?
a. Entacapone
b. Carbidopa
c. Amantadine
d. Pramipexole
e. Selegiline
11. Modest improvement in the memory of Alzheimer’s patients may occur with which of the following receptors being made
more active/potent/less blocked?
a. Serotonergic
b. Cholinergic
c. Adrenergic
d. GABAergic
e. Serotonergic
12. Which of the following statements is NOT correct regarding Benzodiazepines?
a. Benzodiazepines enhance the binding of ϒ-aminobutyric acid to its receptor, which increases the permeability
of chloride
b. Benzodiazepines do not relieve pain but may reduce the anxiety associated with pain
c. Benzodiazepines cause sedation but are still used for sleep disorders
d. Benzodiazepines produce general anesthesia and therefore are not safe
e. Benzodiazepines take effect within hours of administration
13. A 45 yr old man who has been injured in a car accident is brought into the ER. His blood alcohol level on admission is 275
mg/dL. (Legal limit of intoxication is 80 mg/dL (0.08 g/dL). Hospital records show that he has prior
hospitalizations for alcohol related seizures. His wife confirms that he has been drinking heavily
for 3 weeks. What treatment should be provided to the patient if he goes into withdrawals ?
a.
b.
c.
d.
e.
Buspirone
None
Phenobarbital
Phenytoin
Lorazepam
14. A very agitated young lady was brought to the ER by the police. Psychiatric examination reveals that she has snorted
cocaine several times in the last few days, the last time being 10 hrs previously. She was given a drug that sedated her and
she fell asleep. The drug that was used to counter this patient’s apparent cocaine withdrawal was most likely . . .?
a. Phenobarbital
b. Lorazepam
c. Cocaine
d. Hydroxyzine
e. Fluoxetine
15. The potency of inhaled anesthetics is defined quantitatively as . . .
a. Volatility index
b. Sensitivity factor
c. Cerebrovascular resistance
d. Minimum alveolar concentration
e. Blood/gas partition coefficient
16. Local Anesthetics . . .
a. In their ionized form interact with the protein receptor of calcium channels
b. Affect only small, unmyelinated nerve fibers
c. Have either an amide or an ester linkage
d. Are unaffected by pH of the tissue and pKa of the drug
e. Have either a lipophilic or a hydrophilic group
17. A 25 yr old woman has a long history of depressive symptoms accompanied by body aches. Physical diagnosis and lab
tests are unremarkable. Which of the following drugs might be most useful for this patient?
a. Fluoxetine
b. Duloxetine
c. Sertraline
d. Mirtazapine
e. Phenelzine
18. Which of the following antidepressants has a potent anti-muscarinic activity and therefore should not be used in a patient
with glaucoma?
a. Bupropion
b. Duloxetine
c. Sertraline
d. Mirtazapine
e. Amitriptyline
19. An adolescent male is newly diagnosed with schizophrenia. Which of the following neuroleptic agents may improve his
apathy and blunted affect?
a. Chlorphromazine
b. Fluphenazine
c. Haloperidol
d. Risperidone
e. Thioridazine
20. Which of the following antipsychotic drugs has a sedative effect?
a. Chlorphromazine
b. Fluphenazine
c. Haloperidol
d. Risperidone
e. Thioridazine
21. A heroin addict entered a rehab facility that requires she takes methadone. Methadone has been found to be effect
because . . ?
a. It is an antagonist at the morphine receptors
b. It is a non-narcotic
c. It is longer acting than heroine and has milder withdrawals than heronie
d. It does not cause constipation
e. It is nonaddictive
22. The pain of patient with bone cancer has been managed with a morphine pump. Unfortunately, he has now become
tolerant to the morphine. Which of the following may help to alleviate his pain?
a. Codeine
b. Burprenorphine
c. Meperidine
d. Methadone
e. Fentanyl
23. A 36 yr old man has been smoking two pack of cigarette a day for the last 20 years. He is concerned that his health has
deteriorated, and he has a persistent hacking cough. He also states that he doesn’t want to “get lung cancer and die, like
my father did.” Has tired nicotine patches with no success and wants to know if there is any “pill” he could try. What
medication could you recommend?
a. Mitazapine
b. Citalopram
c. Phenelzine
d. Buspirone
e. Bupropion
24. A 5 yr old child is admitted to the hospital with a low-grade fever and a persistent cough that has resulted in vomiting
episodes following prolonged coughing spells. His throat culture is negative, his fever has resolved, and all that is left is a
slight cough. He is discharged from the hospital by the pediatrician who recommends an over-the-counter opioid
antitussive. Which of the following does he recommend?
a. Tramadol
b. Propoxyphene
c. Loperamide
d. Dextromethorphan
e. Naloxone
25. A patient sees an otolaryngologist with complaints of recurrent sinusitis. The surgeon decides to perform sinus surgery to
debride the scarred sinus tissue. During the procedure the surgeon elects to use an agent that had good local anesthesia
as well as vasoconstrictive properties. What agent might he use?
a. Cocaine
b.
c.
d.
e.
Procaine
Tetracaine
Lidocaine
Mepivacaine
26. A 16-yr old boy is brought to the ER at 4am by his friends, who report that the patient was at an all-night rave party and was
agitated, hyperactive and hypersexual. They physician learns that the boy took several pills, which his friends thought
were “ecstasy” (methylenedioxymethamphetamine). Which of the following describes the mechanism of this “party” drug?
a. Antagonistic activity at the N-methyl-d-aspartate (NMDA) receptor for glutamic acid
b. Binding to the cannabinol CB1 receptor
c. Increased release of dopamine and nor-epinephrine
d. Mimics the action of acetylcholine
e. Agonist at postjunctional serotonin receptors
27. What is the mechanism of action of cocaine?
a. Propagation of action of nor-epinephrine by inhibiting its active transport from the synapse
b. Oxidative deamination of nor-epinephrine in nerve terminals and the effector cells
c. Inhibition of metabolism of nor-epinephrine in nerve terminals
d. Potentiation of tyrosine hydroxylase, the rate-limiting enzyme in the synthesis of norepinephrine
e. Promotion of release of nor-epinephrine from adrenergic nerve endings
28. Oxybutynin works by
a. Inhibiting acetylcholinesterase at muscarinic and nicotinin receptors
b. Causing a neuromuscular blockade
c. Antagonizing α1-adrenoceptors
d. Binding to muscarinic receptors
e. Activating β2- adrenoceptors
29. Which of the following medications is used to prevent premature labour?
a. Tamsulosin
b. Cevimeline
c. Atracurium
d. Tolterodine
e. Terbutaline
30. What significant side effect of terazosin should the doctor warn a 69-yr old patient about?
a. Bronchospasm
b. Postural hypotension
c. Heart failure
d. Sedation
e. Drug abuse
31. Which of the following drugs is used to diagnose myasthenia gravis?
a. Atropine
b. Neostigmine
c. Bethanechol
d. Enrophonium
e. Pralidoxime
32. Pilocarpine reduces intraocular pressure in patients with glaucoma because it
a. Activates nicotinic cholinoceptors
b. Blocks muscarinic cholinoceptors
c. Selectively inhibits peripheral activity of sympathetic ganglia
d. Inhibits acetylcholinesterase
33. A drug that acts at prejunctional α2-adrenoceptors and is used to treat hypertension is
a. Clonidine
b. Methoxamine
c. Metaproterenol
d. Dobutamine
e. Dopamine
34. Receptor actions of acetylcholine are mimicked by nicotine at which of the following sites?
a. Adrenal medullary chromaffin cells
b. Urinary bladder smooth muscle cells
c. Iris circular (constrictor) muscle
d. Heart sinoatrial pacemaker cells
35. Muscarinic cholinoceptor agonists may cause vasodilation through the release of endothelial…
a. Histamine
b. Norepinephrine
c. Acetylcholine
d. Nitric oxide
36. In contrast to propranolol, metoprolol
a. Is used for the management of hypertension
b. Has a greater selectivity for β2- adrenoceptors
c. May be beneficial for the acute treatment of migraine headache
d. Is less likely to precipitate bronchoconstriction in patients with asthma
37. Which of the following neurotransmitters interacts with guanethidine?
a. Acetylcholine
b. Epinephrine
c. Dopamine
d. Norepinephrine
e. Serotonin
38. What class of medications does bethanechol belong to?
a. Nicotinic blockers
b. α- Agnoists
c. β1-blockers
d. β2-blockers
e. Muscarinic agonists
39. Which of the following agents, when applied topically to the eye, would cause both mydriasis and cycloplegia?
a. Phenylephrine
b. Carbachol
c. Prazosin
d. Atropine
40. The direct cardiac effects of dobutamine would be blocked by which one of the following agents?
a. Prazosin
b. Metoprolol
c. Clonidine
d. Isoproterenol
Exam II for Pharmacology Finished!!!
