Pharmacology Multiple Choice Questions with Answers

61 A 2 week old male child is brought to casualty by his concerned parents with diarrhoea and vomiting. He is the first child of a young couple. Examination reveals few features besides obvious dehydration. He is noted to have a penile length of 3.5cms. Which of the following is the most appropriate inital treatment for this patient?

[A] Cow's milk allergy is the most likely diagnosis

[B] gluten-enteropathy should be excluded

[C] Requires urgent treatment with oral steroids

[D] Requires urgent treatment with IV normal saline

Answer: Requires urgent treatment with IV normal saline

62 A 33 year old epileptic female presents with visual problems. Examination reveals a constriction of visual fields to confrontation. Which of the following may be responsible for her visual deterioration?

[A] Vigabatrin

[B] Lamotrigine

[C] Gabapentin

[D] Phenytoin

Answer: Vigabatrin

63 Which of the following doses of prednisolone is equivalent in its glucocorticoid potency to 20mg of hydrocortisone.

[A] 2 mg

[B] 5 mg

[C] 10 mg

[D] 15 mg

Answer: 5 mg

64 Which of the following concerning the conjugation of bilirubin is correct?

[A] is catalysed by a glucuronyl transferase

[B] occurs in the Kupfer cells of the liver

[C] is increased by valproate

[D] is inhibited by rifampicin

Answer: is catalysed by a glucuronyl transferase

65 A new drug is being studied to find the most appropriate dose in a dose response study. Small doses of the drug lead to a linear increase in serum drug concentration. At higher doses there is an exponential rise in serum drug concentration. Which of the following best describes the pharmacokinetic properties of this new drug?

[A] first order kinetics

[B] first pass effect

[C] long plasma half life

[D] saturation kinetics

Answer: saturation kinetics

66 Which of the following antiarrhythmic drugs may be used in the treatment of long QT syndrome?

[A] Amiodarone

[B] Atenolol

[C] Flecainide

[D] Propofanone

Answer: Atenolol

67 A 21 year old female with epilepsy is well controlled on sodium valproate 600mg bd and had been taking oral contraceptives for three years. She presented to her general practitioner 12 weeks pregnant. Which of the following is correct?

[A] An alternative anticonvulsant should be used in place of sodium valproate

[B] Interaction of sodium valproate with the oral contraceptive increased the risk of pregnancy

[C] The dose of sodium valproate should be increased

[D] There is an increased risk of a neural tube defect in her fetus

Answer: There is an increased risk of a neural tube defect in her fetus

68 The following are the causes of drug induced hepatitis except:

[A] Isoniazid

[B] Amiodarone

[C] Pyrazinamide

[D] Ethambutol

Answer: Ethambutol

69 Which of the following is true concerning oral hypoglycaemic agents?

[A] Acarbose promotes insulin secretion in response to meals

[B] Chlorpropamide induces liver enzymes

[C] Glibenclamide is excreted unchanged by the kidney

[D] Metformin inhibits hepatic gluconeogenesis

Answer: Metformin inhibits hepatic gluconeogenesis

70 Which of the following is the oral hypoglycaemic agent Rosiglitazone?

[A] A Perixisome Proliferator Activating Receptor (PPAR)-alpha agonist

[B] A Peroxisome Proliferator Activating Receptor (PPAR)-gamma agonist

[C] A Sulphonylurea

[D] A Biguanide

Answer: A Peroxisome Proliferator Activating Receptor (PPAR)-gamma agonist

71 A firm 2 to 3 cm mass is palpable in the upper outer quadrant of the right breast of a 52-year-old woman. There are no palpable axillary lymph nodes. A lumpectomy with axillary node dissection is performed and the breast lesion is found to have positive immunohistochemical staining for HER2/neu (c-erb B2). Staining for oestrogen and progesterone receptors is negative. Which of the following additional treatment options is most appropriate, based upon these findings?

[A] Radical mastectomy

[B] St John's wort

[C] Tamoxifen

[D] Trastuzumab

Answer: Trastuzumab

72 In which of the following have randomised controlled trials shown that long-term oxygen therapy (LTOT) reduces mortality?

[A] Asthma

[B] Cor pulmonale due to chronic airflow obstruction

[C] Cryptogenic fibrosing alveolitis

[D] Cystic fibrosis

Answer: Cor pulmonale due to chronic airflow obstruction

73 In the treatment of osteoporosis, which of the following best describe the drug Raloxifene?

[A] A Bisphosphonate

[B] A Calcium Receptor Modulator

[C] An Estrogen

[D] A Selective Estrogen Receptor Modulator

Answer: A Selective Estrogen Receptor Modulator

74 A 50-year-old lady suffers with migraine. She smokes 20 cigarettes a day. She has found that paracetamol 1 g was not always effective in relieving her pain. Which of the following factors is the most likely to account for this problem?

[A] altered volume of distribution

[B] delayed gastric emptying

[C] first pass metabolism

[D] hepatic enzyme induction

Answer: delayed gastric emptying

75 Which one of the following is correct regarding long-acting beta-2 agonists?

[A] Can be used to prevent activity-induced symptoms without anti-inflammatory therapy.

[B] Become less effective over time (tolerance).

[C] Are beneficial in acute viral croup.

[D] Protect against allergen challenge for up to 48 hours.

Answer: Can be used to prevent activity-induced symptoms without anti-inflammatory therapy.

76 Baclofen

[A] acts directly on skeletal muscle

[B] causes rhabdomyolysis

[C] reduces cerebral but not spinal spasticity

[D] cause hallucinations when withdrawn

Answer: cause hallucinations when withdrawn

77 A 55-year-old woman was found to have ++ glycosuria and had a maternal history of Type II diabetes mellitus. She was a smoker of 20 cigarettes per day. Examination reveals no specific abnormalities apart from a BMI of 30. Blood pressure was 132/88 mmHg.

Investigations reveal:

serum creatinine 80 µmol/L (60 – 110)

plasma glucose (fasting) 11.3 mmol/L (3.0 – 6.0)

total serum cholesterol 5.5 mmol/L (<5.2)

HDL cholesterol 1.4 mmol/L (>1.55)

What is most likely to improve her life expectancy?

[A] Metformin 500 mg bd

[B] Ramipril 10 mg daily

[C] Simvastatin 10 mg daily

[D] Stopping smoking

Answer: Stopping smoking

78 Which of the following is NOT associated with hyponatraemia and hyperkalaemia?

[A] Acute hypoadrenalism

[B] Carbenoxolone therapy

[C] Co-Amilofruse therapy

[D] Congestive cardiac failure.

Answer: Carbenoxolone therapy

79 With regard to poisoning / overdose:

[A] Phenobarbitone causes a metabolic acidosis

[B] Ethylene glycol causes a metabolic alkalosis and renal failure

[C] Aspirin causes acidosis due to hypoventilation

[D] Methanol causes a metabolic acidosis with an increased anion gap

Answer: Methanol causes a metabolic acidosis with an increased anion gap

80 Which of the following statements concering the treatment of acute myocardial infarction is correct?

[A] A pansystolic murmur developing within the first 24 hours does not require further investigation.

[B] Dipyridamole therapy reduces reinfarction within the first year.

[C] Heparin is beneficial if given with streptokinase.

[D] Treatment with a dihydropyridine calcium antagonist is associated with increased cardiovascular mortality.

Answer: Treatment with a dihydropyridine calcium antagonist is associated with increased cardiovascular mortality.

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