38873407
Questão 1
Questão
Sugammadex is a new drug that reverses the action of rocuronium and certain other skeletal musclerelaxing agents (nondepolarizing neuromuscular blocking agents). It appears to interact directly with the rocuronium molecule and not at all with the rocuronium receptor. Which of the following terms best describes sugammadex?
Responda
-
Chemical antagonist
-
Noncompetitive antagonist
-
Partial agonist
-
Physiologic antagonist
-
Pharmacologic antagonist
Questão 2
Questão
You are the only physician in a clinic that is cut off from the outside world by violent storms, flooding, and landslides. A 15-year-old girl is brought to the clinic with severe asthmatic wheezing. Because of the lack of other drugs, you decide to use intravenous theophylline for treatment. The pharmaco- kinetics of theophylline include the following average param- eters: Vd 35 L; CL 48 mL/min; half-life 8 h. If an intravenous infusion of theophylline is started at a rate of 0.48 mg/min, how long would it take to reach 93.75% of the final steady- state concentration?
Responda
-
Approximately 48 min
-
Approximately 24 h
-
Approximately 32 h
Questão 3
Questão
Which drug used in the maintenance treatment of patients with tonic- clonic or partial seizure states increasef many drugs including both phenytoin and warfarin?
Responda
-
Clonazepam
-
Eszopiclone
-
Triazolam
-
Phenobarbital
-
Buspirone
Questão 4
Questão
A 20-year-old male patient scheduled for hernia surgery was anesthetized with halothane and nitrous oxide; tubocurarine was provided for skeletal muscle relaxation. The patient rapidly developed tachycardia and became hypertensive. Generalized skeletal muscle rigidity was accompanied by marked hyperthermia. Laboratory values revealed hyperkalemia and acidosis. This unusual complication of anesthesia is most likely to be caused by
Responda
-
Acetylcholine release from somatic nerve endings at skeletal muscle
-
Activation of brain dopamine receptors by halothane
-
Antagonism of autonomic ganglia by tubocurarine
-
Toxic metabolites of nitrous oxide
-
Calcium released within skeletal muscle
Questão 5
Questão
A significant number of patients started on ACE inhibitor therapy for hypertension are intolerant and must be switched to a different class of drug. What is the most common manifestation of this intolerance?
Responda
-
Angioedema
-
Glaucoma
-
Headache
-
Incessant cough
-
Ventricular arrhythmias
Questão 6
Questão
Actions and clinical uses of muscarinic cholinoceptor agonists include which one of the following?
Responda
-
Bronchodilation (treatment of asthma)
-
Miosis (treatment of narrow angle glaucoma)
-
Decreased gastrointestinal motility (treatment of diarrhea)
-
Decreased neuromuscular transmission and relaxation of skeletal muscle (during surgical anesthesia)
-
Increased sweating (treatment of fever)
Questão 7
Questão
A child requires multiple minor surgical procedures involving the nasopharynx. Which drug has high surface local anesthetic activity and intrinsic vasoconstrictor actions that reduce bleeding in mucous membranes?
Responda
-
Bupivacaine
-
Cocaine
-
Lidocaine
-
Mepivacaine
-
Tetracaine
Questão 8
Questão
Oral medications are popular for the treatment of asthma in children because young children may have difficulty with the proper use of aerosol inhalers. Which of the following is an orally active inhibitor of leukotriene receptors?
Responda
-
Albuterol
-
Aminophylline
-
Ipratropium
-
Zafirlukast
-
Zileuton
Questão 9
Questão
On her release from the hospital, the patient is advised not to rely solely on oral contraceptives to prevent pregnancy because they may be less effective while she is being maintained on antimycobacterial drugs. The agent most likely to interfere with the action of oral contraceptives is
Responda
-
Amikacin
-
Ethambutol
-
Pyrazinamide
-
Isoniazid
-
Rifampin
Questão 10
Questão
A 19-year-old college student has well-controlled asthma but on reporting to the college health clinic, complains of a sore throat. On examination, he has typical signs of thrush, a fungal infection with Candida albicans. The asthma controller medication most likely to be associated with Candida infection is:
Responda
-
Albuterol by aeroso
-
Ipratropium by inhaler
-
Beclomethasone by aerosol
-
Prednisone by mouth
-
Theophylline in long-acting oral form
Questão 11
Questão
Which of the following drugs is the most effective in the emergency management of malignant hyperthermia?
Responda
-
Atropine
-
Dantrolene
-
Haloperidol
-
Succinylcholine
-
Vecuronium
Questão 12
Questão
A 17-year-old patient complains that he develops wheezing and severe shortness of breath whenever he takes aspirin for headache. Increased levels of which of the following may be responsible, in part, for some cases of aspirin hypersensitivity?
Responda
-
Alprostadil
-
Leukotriene LTC4
-
PGE2
-
Prostacyclin
-
Thromboxane
Questão 13
Questão
The primary mechanism of resistance of Gram-positive organisms to macrolide antibiotics including erythromycin is
Responda
-
Changes in the 30S ribosomal subunit
-
Methylation of binding sites on the 50S ribosomal subunit
-
Formation of esterases that hydrolyze the lactone ring
-
Formation of drug-inactivating acetyltransferases
-
Decreased drug permeability of the cytoplasmic membrane
Questão 14
Questão
Tolcapone may be of value in patients being treated with levodopa- carbidopa because it
Responda
-
Activates COMT
-
Decreases the formation of 3-O-methyldopa
-
Inhibits monoamine oxidase type A
-
Inhibits neuronal reuptake of dopamine
-
Releases dopamine from nerve endings
Questão 15
Questão
A 46-year-old male patient has Cushing’s syndrome due to an adrenal tumor. Which of the following drugs would be expected to reduce the signs and symptoms of this man’s disease?
Responda
-
Betamethasone
-
Cortisol
-
Fludrocortisone
-
Ketoconazole
-
Triamcinolone
Questão 16
Questão
Which of the following is an antagonist at NK1 receptors and is used to prevent or reduce chemotherapy-induced nausea and vomiting?
Responda
-
Angiotensin I
-
Aprepitant
-
Bradykinin
-
Brain natriuretic peptide
-
Enalapril
Questão 17
Questão
If ampicillin and piperacillin are used in combination in the treatment of infections resulting from Pseudomonas aeruginosa, antagonism may occur. The most likely explanation is that
Responda
-
Ampicillin is bacteriostatic
-
Ampicillin induces beta-lactamase production
-
Autolytic enzymes are inhibited by piperacillin
-
Piperacillin blocks the attachment of ampicillin to penicillin-binding proteins
-
The 2 drugs form an insoluble complex
Questão 18
Questão
Certain drugs can cause severe hypotension when combined with nitrates. Which of the following interacts with nitroglycerin by inhibiting the metabolism of cGMP?
Responda
-
Atenolol
-
Hydralazine
-
Nifedipine
-
Sildenafil
-
Terbutaline
Questão 19
Questão
A 28-year-old office worker suffers from intense migraine headaches. Which of the following is a serotonin 5-HT1D/1B agonist useful for aborting an acute migraine headache?
Responda
-
Bromocriptine
-
Cimetidine
-
Ketanserin
-
Ephedrine
-
Sumatriptan
Questão 20
Questão
Which of the following agents, when used in combination with other anti- HIV drugs, permits dose reductions?
Responda
-
Efavirenz
-
Procainamide
-
Verapamil
-
Ritonavir
Questão 21
Questão
A 4-year-old child is brought to the hospital after ingesting pills that a parent had used for bacterial dysentery when traveling outside the United States. The child has been vomiting for more than 24 h and has had diarrhea with green stools. She is now lethargic with an ashen color. Other signs and symptoms include hypothermia, hypotension, and abdominal distention. The drug most likely to be the cause of this problem is
Responda
-
Ampicillin
-
Azithromycin
-
Chloramphenicol
-
Doxycycline
Questão 22
Questão
Flumazenil will counteract the action of each of the following drugs :except
Responda
-
Alprazolam
-
Buspirone
-
Diazepam
-
Eszopiclone
-
Zaleplon
Questão 23
Questão
A 20-year-old woman is taking over-the-counter diphenhydramine for severe hay fever. Which of the following adverse effects is she most likely to report?
Responda
-
Muscarinic increase in bladder tone
-
Nausea
-
Nervousness, anxiety
-
Sedation
-
Vertigo
Questão 24
Questão
A 73-year-old man with a history of a recent change in his treatment for moderately severe hypertension is brought to the emergency department because of a fall at home. Which of the following drug groups is most likely to cause postural hypotension and thus an increased risk of falls?
Responda
-
ACE inhibitors
-
Alpha1-selective receptor blockers
-
Arteriolar dilators
-
Beta1-selective receptor blockers
-
Calcium channel blockers
Questão 25
Questão
A 23-year-old woman is admitted to the emergency department with difficulty breathing. Examination reveals significant laryngeal edema. Past medical history indicates that she suffers from recurrent episodes of angioneurotic edema with release of histamine and other mediators. Which of the following drugs is the most effective physiologic antagonist of histamine in smooth muscle?
Responda
-
Epinephrine
-
Loratadine
-
Ondansetron
-
Ranitidine
-
Sumatriptan
Questão 26
Questão
A 16-year-old girl has paroxysmal attacks of rapid heart rate with palpitations and shortness of breath. These episodes occasionally terminate spontaneously but often require a visit to the emergency department of the local hospital. Her ECG during these episodes reveals an AV nodal tachycardia. Which of the following drugs would be most suitable for prophylaxis of future episodes of acute AV nodal tachycardia?
#Foucous:- prophylaxis !!!!!
Responda
-
Adenosine
-
Flecainide
-
Amiodarone
-
Propranolol
-
Verapamil
Questão 27
Questão
A 60-year-old woman comes to the emergency department with atypical chest pain. Her ECG reveals ventricular tachycardia with rare normal sinus beats, and ST-segment elevation. Troponin C levels are markedly increased, suggesting myocardial damage. A diagnosis of myocardial infarction is made, and the woman is admitted to the cardiac intensive care unit. Her arrhythmia will probably be treated initially with:
Responda
-
Adenosine
-
Digoxin
-
Lidocaine
-
Quinidine
-
Verapamil
Questão 28
Questão
All of the following factors influence the action of local anesthetics :except
Responda
-
Acetylcholinesterase activity in the region of the injection site
-
Blood flow through the tissue in which the injection is made
-
Dose of local anesthetic injected
-
The use of vasoconstrictors
-
Tissue pH
Questão 29
Questão
A 56-year-old man has hypertension and an enlarged prostate, which biopsy shows to be benign prostatic hyperplasia. He complains of urinary retention. Which of the following drugs would be the most appropriate initial therapy?
Responda
-
Albuterol
-
Atenolol
-
Metoprolol
-
Prazosin
-
Timolol
Questão 30
Questão
Which of the following is a direct-acting cholinomimetic that is lipid- soluble and is used to facilitate smoking cessation?
Responda
-
Varenicline
-
Physostigmine
-
Neostigmine
-
Bethanechol
-
Acetylcholine
Questão 31
Questão
Which of the following is the best-documented mechanism of beneficial action of cardiac glycosides?
Responda
-
A decrease in calcium uptake by the sarcoplasmic reticulum
-
An increase in systolic cytoplasmic calcium levels
-
A modification of the actin molecule
-
An increase in a late transmembrane sodium current
-
A block of cardiac β adrenoceptors
Questão 32
Questão
Which of the following has been shown to prolong life in patients with chronic congestive failure in spite of having a negative inotropic effect on cardiac contractility?
Responda
-
Carvedilol
-
Digoxin
-
Dobutamine
-
Enalapril
-
Furosemide
Questão 33
Questão
A 60-year-old patient complains of paresthesias and occasional nausea associated with one of the drugs she is taking. She is found to have hyperchloremic metabolic acidosis. She is probably taking
Responda
-
Acetazolamide for glaucoma
-
Amiloride for edema associated with aldosteronism
-
Furosemide for severe hypertension and heart failure
-
Hydrochlorothiazide for hypertension
-
Mannitol for cerebral edema
Questão 34
Questão
The pharmacokinetic process or property that distinguishes the elimination of ethanol and high doses of phenytoin and aspirin from the elimination of most other drugs is called
Responda
-
Distribution
-
Excretion
-
First-pass effect
-
Zero-order elimination
Questão 35
Questão
A 65-year-old woman with impaired renal function and a necrotic ulcer in the sole of her right foot is admitted to the ward from the emergency department. She has longstanding type 2 diabetes mellitus and you wish to examine her retinas for possible vascular changes. Which of the following drugs is a good choice when pupillary dilation—but not cycloplegia—is desired?
Responda
-
Isoproterenol
-
Norepinephrine
-
Phenylephrine
-
Pilocarpine
-
Tropicamide
Questão 36
Questão
A patient with parkinsonism is being treated with levodopa. He suffers from irregular, involuntary muscle jerks that affect the proximal muscles of the limbs. Which of the following statements about these symptoms is most accurate?
Responda
-
Coadministration of muscarinic blockers prevents the occurrence of dyskinesias during treatment with levodopa
-
Drugs that activate dopamine receptors can exacerbate dyskinesias in a patient taking levodopa
-
Dyskinesias are less likely to occur if levodopa is administered with carbidopa
-
Symptoms are likely to be alleviated by continued treatment with levodopa
-
The symptoms are usually reduced if the dose of levodopa is increased
Questão 37
Questão
A 38-year-old man is being treated for HIV-induced acquired immunodeficiency syndrome (AIDS). When abacavir therapy is begun, he develops a severe skin rash. Which of the following pharmacogenomic diagnoses might explain this skin rash?
Responda
-
CYP2D6*3 (PM)
-
CYP3A5*3 (PM)
-
HLA-B*57:01 (EM)
-
SLCO1B1*5 (PM)
Questão 38
Questão
A 65-year-old woman has been admitted to the coronary care unit with a left ventricular myocardial infarction. She develops acute severe heart failure with marked pulmonary edema, but no evidence of peripheral edema. Which one of the following drugs would be most useful?
Responda
-
Digoxin
-
Minoxidil
-
Furosemide
-
Propranolol
-
Spironolactone
Questão 39
Questão
A 9-year-old child is having learning difficulties at school. He has brief lapses of awareness with eyelid fluttering that occur every 5–10 min. Electroencephalogram (EEG) studies reveal brief 3-Hz spike and wave discharges appearing synchronously in all leads. Which drug would be effective in this child without the disadvantages of excessive sedation or tolerance development?
Responda
-
Clonazepam
-
Diazepam
-
Gabapentin
-
Phenobarbita
-
Ethosuximide
Questão 40
Questão
With chronic use in seizure states, the adverse effects of this drug include coarsening of facial features, hirsutism, and gingival hyperplasia.
Responda
-
Carbamazepine
-
Ethosuximide
-
Phenytoin
-
Tiagabine
-
Zonisamide
Questão 41
Questão
Which of the following is an accepted therapeutic indication for the use of antimuscarinic drugs?
Responda
-
Chronic obstructive pulmonary disease (COPD)
-
Botulinum poisoning
-
Glaucoma
-
Postoperative urinary retention
-
Atrial fibrillation
Questão 42
Questão
An NO-containing molecule that releases nitric oxide in the blood is:
Responda
-
Citrulline
-
Histamine
-
Isoproterenol
-
Nitroprusside
-
Nitroglycerin
Questão 43
Questão
Certain drugs can cause severe hypotension when combined with nitrates. Which of the following interacts with nitroglycerin by inhibiting the metabolism of cGMP?
Responda
-
Atenolol
-
Hydralazine
-
Isosorbide mononitrate
-
Nifedipine
-
Sildenafil
-
Ranolazine
Questão 44
Questão
A 32-year-old woman with hypertension wishes to become pregnant. Her physician informs her that she will have to switch to another antihypertensive drug. Which of the following drugs is absolutely contraindicated in pregnancy?
Responda
-
Atenolol
-
Losartan
-
Methyldopa
-
Nifedipine
-
Propranolol
Questão 45
Questão
A 54-year-old man comes to the emergency department with acute chest pain, nausea, sweating, and shortness of breath. The patient has a history of recreational drug use and reports using cocaine, heroin, and alcohol earlier in the day. Temperature is 36.1°C (97°F), pulse is 101/min, respirations are 22/min, and blood pressure is 150/100 mm Hg. The medication typically used to treat this acute condition is currently contraindicated for this patient. Which of the following physiologic responses would occur if the contraindicated Beta blocker) medication were given?
Responda
-
Unopposed vascular smooth muscle relaxation
-
Unopposed vascular smooth muscle contraction
-
Unopposed cardiac muscle contraction
-
Unopposed cardiac muscle relaxation
Questão 46
Questão
Which one of the following is characteristic of nifedipine treatment in patients with essential hypertension?
Responda
-
Competitively blocks angiotensin II at its receptor
-
Decreases calcium efflux from skeletal muscle
-
Decreases renin concentration in the blood
-
Decreases calcium influx into smooth muscle
-
Decreases calcium flux into the urine
Questão 47
Questão
Which of the following is a leukotriene receptor blocker?
Responda
-
Alprostadil
-
Aspirin
-
Ibuprofen
-
Leukotriene LTC4
-
Montelukast
-
Zileuton
Questão 48
Questão
After several cycles of chemotherapy, the patient was found to have a high resting pulse rate. A noninvasive radionuclide scan revealed evidence of cardiomyopathy. The drug that is most likely responsible for the cardiac toxicity is:
Responda
-
Cyclophosphamide
-
Doxorubicin
-
Flurouracil
-
Methotrexate
-
Tamoxifen
Questão 49
Questão
A 16-year-old girl has paroxysmal attacks of rapid heart rate with palpitations and shortness of breath. These episodes occasionally terminate spontaneously but often require a visit to the emergency department of the local hospital. Her ECG during these episodes reveals an AV nodal tachycardia. The antiarrhythmic of choice in most cases of acute AV nodal tachycardia is
Responda
-
Adenosine
-
Amiodarone
-
Flecainide
-
Propranolol
-
Verapamil
Questão 50
Questão
A 38-year-old man who is obese complains of an extremely painful, swollen metatarsophalangeal joint of his left big toe. He has had two similar attacks in the past 4 years. The physician prescribes febuxostat. Which of the following describes febuxostat's mecha-nism of action?
Responda
-
Anti-inflammatory
-
Inhibition of leukocyte migration
-
Inhibition of urate reabsorption
-
Inhibition of xanthine oxidase
-
Upregulation of urate metabolism
Questão 51
Questão
A 36-year-old man with multiple medical problems including diabetes, hypertension, and morbid obesity is hospitalized for treatment of a vancomycin-resistant Enterobacter infection. Recent blood cultures are positive. He is given quinupristin/dalfopristin intrave-nously through the antecubital vein. Which of the following sequelae is most likely?
Responda
-
Arthritis
-
Hepatic dysfunction
-
Muscle fatigue
-
Renal failure
-
Venous irritation
Questão 52
Questão
Ampicillin and amoxicillin are in thesame group of penicillins.However, there are important differences.Which of the following beststates how amoxicillin differs fromampicillin?
Responda
-
Has better oral bioavailability, particularlywhen taken with meals
-
Is effective against penicillinase-producing organisms
-
Is a broad-spectrum penicillin
-
Does not cause hypersensitivity reactions
-
Has great antipseudomonal activity
Questão 53
Questão
A 69-year-old man is admitted to the hospital for management of a pulmonary embolus for which he receives heparin. Five days later, he reports bilateral leg swelling and pain. Ultrasonography reveals bilateral occlusive thrombi in the popliteal veins.Platelet count is 27,000/mm3, prothrombin time is 12 sec, and activated partial thromboplastin time is 65 sec. His heparin is discontinued. Administration of which of the following medications is the best next step in treatment (for the patient without monitoring) ?
Responda
-
Vitamin K
-
Aspirin
-
Protamine sulfate
-
Direct thrombin inhibitor
-
Warfarin
Questão 54
Questão
A 29-year-old woman is undergoing an elective laparoscopic cholecystectomy. After being sedated, she is given a muscle relaxant intravenously. Just after administration of this drug, the patient's arms and legs twitch briefly. Which of the following drugs was most likely administered?
Responda
-
Dantrolene
-
Rocuronium
-
Lidocaine
-
Succinylcholine
-
Fentanyl
Questão 55
Questão
A 36-year-old man with multiple medical problems including diabetes, hypertension, and morbid obesity is hospitalized for treatment of a vancomycin-resistant Enterobacter infection. Recent blood cultures are positive. He is given quinupristin/dalfopristin intravenously through the antecubital vein. Which of the following sequelae is most likely?
Responda
-
Arthritis
-
Hepatic dysfunction
-
Muscle fatigue
-
Renal failure
-
Venous irritation
Questão 56
Questão
A 44-year-old man comes to the clinic using crutches due to the abrupt onset of an exquisitely painful, swollen, erythematous, and warm right metatarsophalangeal. Two months ago, he developed mild peripheral edema and was started on a new medication that may cause decreased urine calcium excretion. On physical examination, his right toe is tender, erythematous, and warm to the touch. Which of the following antihypertensive medications was most likely responsible for this patient’s findings?
Responda
-
Furosemide
-
Hydrochlorothiazide
-
Nifedipine
-
Lisinopril
-
Prazosin
Questão 57
Questão
A 50-year-old man has a history of frequent episodes of renal colic with calcium-containing renal
stones. A careful workup indicates that he has a defect in proximal tubular calcium reabsorption, which results in high concentrations of calcium salts in the tubular urine. The most useful diuretic agent in the treatment of recurrent calcium stones is
Responda
-
Chlorthalidone
-
Diazoxide
-
Ethacrynic acid
-
Mannitol
-
Spironolactone
Questão 58
Questão
Patient with hypertension he has symptoms like inflammation and pain in the pig tone what is the drug that he used: افهم
Responda
-
inhibiting of sodium in the distal convoluted tubule (thiazide)
-
!
Questão 59
Questão
patient with pulmonary disease and have high blood pressure and high pulse which drug is contraindicated? افهم
Responda
-
Alfa agonist
-
beta antagonist
-
non selective B blocker
Questão 60
Questão
Patient have high blood pressure and Renal failure which drug should not be given. افهم
Responda
-
angiotensin covering enzyme inhibitor
-
!
Questão 61
Questão
Drug prophylaxis for av tachycardia:
Responda
-
verapamil
-
phenytoin
-
Carbamazepine
-
Luoprolide
-
Adenocine
Questão 62
Questão
Patient is having epilepsy and take drug for seizures also work in voltage-gated calcium:
Responda
-
clozapine and carbamazepine and another drug was suggested
-
!!
Questão 63
Questão
Patient is take anti epileptic drug (valporic acid) put symptoms are not relief which drug can be used for partial seizures:
Responda
-
Carbamazepine
-
phenytoin
-
Phenoberbital
Questão 64
Questão
Mechanism of digoxin : increase in ejection fraction
Responda
-
decreases HR
-
!
Questão 65
Questão
Patient have epilepsy and take over dose of diazepam the symptoms relief with flumazenil
explained this on a curve:
Responda
-
capitative antagonist
-
!!
Questão 66
Questão
Antipsychotic drugs (ALZHEIMER )that in supine position increase blood pressure in siting positive decrease BP:
Responda
-
in the answer need the mechanism of the drug (risperidone)
-
!!
Questão 67
Questão
Inticancer drug that inhibits myosis:
Responda
-
- paclitaxel, docetaxel, vinblastineمنهن و
-
!!
Questão 68
Questão
Pregnant Woman experience hemorrhage she has given petamethasone which is mechanism of this drug :
Responda
-
this drug for lung reduce respiratory distress syndrome in fetus
-
!!
Questão 69
Questão
Patients is taking drug for arrhythmias he developed pulmonary disease:
Responda
-
ب بخلص طويل الجوابvia potassium channel blockers ( amiodarone )
-
!!
Questão 70
Questão
Patient which hypertension taking diuretic he experiences fatigue pills (vertigo) which substances is
increased in this patient:
Responda
-
bicarbonate HCO3 BUT THR other OPTIONS WAS SODIUM, potassium, chloride I think he toke furosemide
-
furosemide
Questão 71
Questão
Patient how is taking antipsychotic drug - and his mother have history of anxiety disorder developed muscle rigidity what drug he used that caused this symptoms?
Responda
-
Haloperidol
-
!!
Questão 72
Questão
Grapes fruit Which drug should not take with which anticoagulants drug :
Responda
-
factor 1 / factor | factor 11 / factor 5
-
!!
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