3rd DENTAL PHARMACOLOGY REVISION(Final 2012) Endocrine MCQs 1- Which of the following drugs is used for prophylaxis of peptic ulcer associated with the use of NSAIDs? A-Misoprostol B-Dinoprostone C-Carboprost D-Alprostadil 2-A 70-year-old man has a history of peptic ulcer disease. He has recently experienced swelling and inflammation in jaw .His dentist wants to begin therapy with NSAIDs. Which one of the following drugs might also be prescribed along with the NSAIDs to reduce the risk of activation this patient's ulcer disease? A. Misprostol B. Allopurinol C . Probencid D. Sulindac 3-Your patient calls the office complaining that your last prescription has caused severe diarrhea, which of the following is frequently associated with increased GIT motility and diarrhea? A. Corticosteroids B.Leukotriene LTB4 C.Misoprostol D.Timolol 4-Which of the following antihistamine is most effective agent in preventing motion sickness and nausea? A-Cyclizine B-Loratadine C-Terfenadine D-Desloratidine 5- All the following drugs are used in prophylaxis of migraine headache EXCEPT:A-Aspirin B-β-blocker propranolol C-Tricyclic antidepressant amtriptyline D-Anticonvulsant divalproex 6-A 43-year-old ship's captain complained of seasonal allergies. Which one of the following would be indicated? A-Cyclizine B-Doxepin C-Doxylamine D-Fexofenadine 1 Hyperglycemia and sometimes diabetes. 11. Loss of bone and muscle tissue. B-Lipoxygenase.All the followings are inhibitors of adrenocorticoid biosynthesis or function 2 . C.Sumatriptan succinate is effective for the treatment of acute migraine headaches by acting as:A. C. An antagonist at β1 and β2 adrenergic receptors. An inhibitor of prostacyclin synthase.Chronic treatment with large doses of prednisolone may result of the following EXCEPT:A-Reduction of endogenous secretion of adrenocorticotropic hormone (ACTH). Increased susceptibility to infections. C.Corticosteroids exert anti-inflammatory action by inhibiting the following enzyme: A-Cyclooxygenase. B-Renal transplant. D. D-Increased bone density. 0. 9.The pharmacological category of loratidine is: A. B. C-Phosopholipase –A2. A selective antagonist at histamine (H1) receptors. D. H2 antagonist (H2 blocker). 14. 8. A selective agonist at 5-hydroxytryptamine 1D (5HT1D) receptors. They exert their effect by binding to receptors in the cell membrane. C-Rheumatoid arthritis. They are contraindicated in glaucoma. D. They are useful in the treatment of refractory asthma. 13.Corticosteroid therapy is practically mandatory in the following condition:A-Septic shock.Exfoliative dermatitis.7. Non-sedating antihistamine (H1 Blocker). B. B-Increase the susceptibility to infections. 12.Side effects of systemic glucocorticoid use can include all of the following EXCEPT: A. Antiarrhythmic. B. B. D. C-Hyperglycemia. Histamine and serotonin antagonist. C. D-Phosphodiasterase. They may produce peptic ulcers. 10.All of the following statements about glucocorticoids are correct EXCEPT: A. Renal failure. C.Long acting insulin preparation has fatty acid side chain which enhances association to albumin is: A. It stimulates insulin release from pancreatic f3. Pioglitazone. C. D. Diarrhea.Which of the following statements is true for therapy with insulin glargine? A-It is primarily used to control post-prandial hyperglycemia. increases release of endogenous insulin. B. GET disturbances.cells. Detemir. It inhibits α-glucosidase in the intestinal brush border. Which of the following drugs would be a poor choice in controlling her diabetes? A. D. D. 17. Nasopharyngitis and headache 18. D. Glargine. B. Miglitol.Spironolactone D. Increases target tissue sensitivity to insulin. Acarbose. B. B. Inhibition of the peroxisome proliferative-activated receptor-gamma nuclear receptor ( PPAR-v ). C. It can cause hypoglycemia. Abdominal cramping.Eplerenone C. Glipizide.Which of the following is true concerning the oral hypoglycemic agent acarbose? A. Pioglitazone. B. What is the mechanism of action of pioglitazone? A. Exenatide.60-year-old diabetic male is treated with pioglitazone. D. 3 . 21.Methimazole 15. 16. Neutral protamine Hagedorn. C. Ketoconazole B. Decreases intestinal absorption of glucose.EXCEPT? A. B. It increases insulin actions in peripheral tissues. C. Glyburide. C. 20. Sitagliptin. D.Which of the following hypoglycemic drug is DPP-IV inhibitor? A. Lispro.64-year-old woman with a history of type 2 diabetes is diagnosed with heart failure. 19.The main side effect of sitagliptin is: A. Lupus erythematous-like syndrome 27. C.Diabetic ketoacidosis coma should be treated initially by intravenous or intramuscular injection of: A-Isophane insulin suspension B-Regular Insulin C-Ultralente insulin D-Insulin zinc suspension 23.Thrombotic thrombocytic purpura D. B.Hyperthyroidism can be treated by all of the following EXCEPT? A. Iodide. It blocks the release of hormones from thyroid glands. 25.Which of the following best describes the effect of propylthiouracil on thyroid hormone production? A. D-It is effective by inhalation. D-Tacrine. B.B-it should not be combined with any other insulin. 24. Omeprazole. D. C. D. a serious toxicity associated with the thioamides is:A.Agranulocytosis B. C-Iodide. It blocks release of thyrotropin-releasing hormone. 22. Methimazole. B.Some patients who are taking high doses of a bisphosphonate for paget's disease of the bone develop an endocrine-metabolic disorder. C-Pharmcokinetically. D. 28. It blocks iodination and coupling of tyrosines in thyroglobulin to form thyroid hormones. Surgical removal of the thyroid gland. Propylthiouracil.Propylthiouracil has the same therapeutic indication as: A. Triiodothyronine. Which of the following is the most likely disorder? A-Hyperparathyrodism B-Hyperthyrodism 4 .Myopathy C. It prevents the release of thyroid hormone from thyroglobulin. 26-Though rare. there is no peak activity and the activity lasts about 24 hours.All of the following drugs used in thyroid storm EXCEPT: A-Propranolol. B-Propylthiouracil. Methoxamine. Azathoprine. C. Calcitriol.A 67 year old man with chronic kidney disease was found to have an elevated serum PTH and a low conc. Which of the following drugs is most likely resulted in this failure? A. E. Choose from the following for questions 32. Calcitonin. of 25. Calcitriol. B-Mifepristone C-Propylthiouracil.Competitive antagonist at corticosteroids receptors (B) Anticancer Drugs 1.C-Diabetes mellitus D-Cushing's disease 29-A 58-year-old male has been effectively treated for Paget disease for approximately 6 months. D. The most likely drug used in treatment is: A. He is now beginning to experience renewed bone pain and radiologic evidence of advancing disease. 32-Has the same therapeutic potential as Methimazole.34 A.Heparin.hydroxy-vitamin D. Which one of the following is a peptide hormone that prevents bone resorption and is available as a nasal spray? A.X-ray of a 58 year postmenopausal woman revealed low bone mineral density.33. Furosemide. B. 31.Which of the following anticancer drugs can be used for the treatment of brain tumors? A-Lomustine B-Busulfan 5 .Raloxifene 30. Cinacalcer. Warfarin. C. Cortisol.Alendronate B. D. D-Ketoconazole. Gallium nitrate.Calcitonin C. C. B. (C) 33-An adrenocorticoid biosynthesis inhibitors. (D) 34. Cholecalciferol.Dihydrotachysterol D. D-G2/M phase. D-Cell cycle specific and cell cycle non specific drugs. B-Tumor mass and sensitivity to anticancer drugs. D-Topoisomerase II.With increasing concentrations of local anesthetic.Cimetidine C.Loratidine D. 4.Ondansertron CNS MCQs 1. A drug that might help in this situation is A.6-MP acts by inhibition of: A-Dihydrofolate reductase. 3. B. B-Topoisomerase I. Alkylating agents. 5.Gemcitabine 7-A patient undergoing cancer chemotherapy is vomiting frequently. B-S-Phase.Bromocriptine B. 6.motor fibers--sensory fibers D-Sensory fibers----motor fibers ----pain fibers 6 .Paclitaxel is an anticancer drug which is active at: A-G1 phase.Which of the following anticancer drugs is tyrosine kinase inhibitor? A-Imatinib B-Methotrexate C-Cyclophosphamide D. C. Bleomycin peptide antibiotics. C-Slowly proliferating and rapidely proliferating cells. C-GO phase. the order of blocking effect is: A-Pain fibers------sensory fibers----motor fibers B-Sensory fibers ----pain fibers----motor fibers C-Pain fibers --.Which of the following classes of anticancer drugs is cell cycle non-specific? A. C-Adenyl succinase and inosine monophosphate dehgydrogenase. Antimetabolites.C-5-FU D-Adriamycin 2. Plant alkaloids.Gembertizian equation is the relation between : A-Number of cells and the time. D. Cocaine.2.6. (C) 8-Halogenated anesthetics may produce malignant hyperthermia in: A-Patients with poor renal function B-Patients allergic to the anesthetics C-Pregnant women D-Patients with a genetic defect and receiving succinlycholine 9-Which of the following is a potent analgesic but a weak anesthetic? A-Methoxuflurane B-Succinylcholine 7 .Local anesthetic that cannot be used topically. B.7 A. Prilocaine. B.Which of the following drugs can cause methemoglobinemia when used in larger doses for regional anesthesia? A.A child requires multiple minor procedures in the nasopharynx.Which of the following drugs has high surface activity and vasoconstrictor action that reduce bleeding in mucous membranes? A-Lodocaine B-Procaine C-Cocaine D-Bupivacaine 4.Local anesthetic has high surface activity and vasoconstrictor actions that reduce bleeding in mucous membrane. 5.Which of the following local anesthetics is useful for topical ( surface ) administration only? A-Procaine B-Bupivacaine C-Benzocaine D-Lidocaine 3. Choose from the following for questions 5.Local anesthetic having high cardiotoxic and arrhythmogenic potential. Lidocaine C. Procaine. Cocaine. Bupivacaine D. C. Prilocaine. (A) 7. Bupivacaine. (B) 6. D. An intravenous bolus dose of thiopental usually leads to loss of consciousness within 10-15 s. MAC values decrease in elderly patients B. Exhaled rapidly.Propofol in comparison to thiopental sodium: A. Nitrous oxide has an extremely low MAC value D. Simultaneous use of opioid analgesics increases the MAC for inhaled anesthetics C.Benzodiazepines differ from barbiturates in those benzodiazepines A. Facilitate the action of gama-aminobutyric acid (GABA) on neuronal chloride 8 . Megaloplastic anemia is a common adverse effect in patients exposed to nitrous oxide for periods longer than 2 hours. If no further drugs are administered. This is because thiopental is: A. Can cause muscle rigidity 15. There is a direct association between the use of nitrous oxide and malignant hyperthermia. Redistributed from brain to other body tissues. B. Cannot be used for induction of anesthesia B.Which statement concerning anesthetic MAC value is accurate? A. Has a longer elimination half-life C. C. 12. Rapidly metabolized by hepatic enzymes.C-Diazepam D-Nitrous oxide 10-Barbiturates exert the following actions EXCEPT: A-Anticonvulsant B-Analgesic C-Antianxiety D-Respiratory depressant 11.Which of the following statements concerning nitrous oxide is accurate? A. 13. the patients will regain consciousness in just a few minutes. B. Is not accompanied by postoperative vomiting D. It is a useful component of anesthesia protocols because of its lack of cardiovascular depression. A good substrate for renal tubular secretion. It is the most potent of inhaled anesthetics. D. C. D. MAC give information about the slope of dose response curve 14. The ER resident administers pentazocine for the pain. Nausea and vomiting. Hypothyroidism.Opioid analgesics are contraindicated in all the following clinical conditions Except: C. B. Have anticonvulsant activity A. Constipation. Potentiate GABA action on GABA A receptors D. Benzodiazepine receptor block 17-Tolerance does not develop to which of the following action of morphine? A. (OR Miosis) B. D. 18. 19. has been proposed as a maintenance drug treatment in treatment programs for opioid addicts. 16.Fentanyl D.Loperamide 21-Which drug does not activate opioid receptors. May induce physical dependence B.Amphetamine B.channels. GABA A receptor block B. Have a higher margin of safety than barbiturates. with a single oral dose will block the effects of injected heroin for up to 48 hours? A.Codeine C. C. The patient is probably tolerant to pentazocine B. Pentazocine is a strong u receptor agonist 20-You are on your way to take an examination in pharmacology course and you suddenly get an attack of diarrehea. Adrenal insufficiency. D. Pulmonary edema.If you stop at a nearly drugstore for an over-the — counter opioid with antidiarheal action.Benzodiazepines anxiolytic and hypnotic effects are mediated through: A. And. Euphoria. GABA A receptor stimulation C.Buprenorphine 9 .A patient known to be a heroin addict comes to the ER with a painful stab wound. The drug may precipitate a withdrawal state C. Why is this not a good idea? A. Biliary tract surgery. Pentazocine is a weaker analgesic than codeine D. Sedation. D. C. you will be asking for A. Dextromethorphan B. The COX-2 inhibitors show anti-inflammatory activity similar to that of the traditional NSAIDs. Amantadine D. Acyclovir. The COX-2 inhibitors decrease platelet function C. Tetracycline. 2.5. Co-trimoxazole. Which of the following anti —CMV drugs is likely to cause additive myelosuppression with zidovudine ? A.A 70-year-old alcoholic male with poor dental hygiene is to have his remaining teeth extracted for subsequent dentures. D. Hyperthermia B. Hypertension D. Clindamycin. Amoxicillin. The COX-2 inhibitors showed greater analgesics activity than traditional NSAIDs B. 3.An HIV — positive woman is diagnosed with CMV retinitis.Naltrexone D.In a patient who has an established hypersensitivity to metronidazole. Enfuveritide D. C. D. Vancomycin.6 A. the most appropriate drug to use for the management of pseudomembranous colitis is A. C. Ampicillin. C. The COX-2 inhibitors do not affect kidney D.C.Methicillin B. B.Penicillin 10 . Foscarnet. Doxycycline. B. She has been on HAART regimen containing zidovudine . Hyperventilation C.Propoxyphene 22. Penicillin V. Choose from the following for questions 4.Manifestations of acute salicylate intoxication include all of the following EXCEPT: A. Chemotherapy 1. Chloramphenicol C. Convulsions 23-Which of the following statements concerning COX-2 inhibitors is correct? A. B. The dentist decides that his medical history warrants prophylactic antibiotic therapy prior to the procedure and prescribes: A. He has mitral valve stenosis with mild cardiac insufficiency. Ganciclovir. 8. central adiposity.11. Sulfamethoxazole.Clavulanic acid 10-Used prophylactically against influenza A is thought to act by Preventing uncoating of viral DNA . Reverse transcriptase.A patient is to undergo insertion of a hip prosthesis. lamivudine. C. (C) Choose from the following for questions 7. (A) Choose from the following for questions 10. B.4. the most likely cause is A. an inhibitor of the enzyme dehydropeptidase. (B) 9-Used prophylactically in dental patient with prosthetic heart valves. D. TMP-SMX. D. its administration is associated with a higher incidence of bleeding.Bacitracin C. D. lamivudine. (C) 11-A β-lactamase inhibitor used in combination with amoxicillin to treat infections caused by β. RNA polymerase. (A) 6. (A) 13-Oseltamivir and zanamivir are available for treatment of infections due to influenza A and B. indinavir.Cefotetan C. Vancomycin B. including AZT. Vancomycin. Thymidine kinase. develops breast hypertyrophy. To avoid postoperative infection with methicillin — resistant staphylococcus aureus which is the following antibiotic the surgeon should select? A. Azidothymidine. Imipenem D. If these changes are related to his drug treatment. hypaerlipidemia.Chloramphenicol B. B. (C) 8-A drug. The mechanism of their antiviral action is inhibition of A. C.An antiretroviral drugs used in the treatment of HIV infection by blocking the fusion of host and HIV membrane. 15.lactamase producing bacteria.Bacitracin 7-It is combined with cilastatin. (D) 12-May cause grey syndrome in neonates. C. Imipenim / cilastatin. Indinavir. Neuraminidase 14-An AIDS patient who is being treated with multiple drugs.9 A. insulin resistance. Ampicillin. B.Its most important adverse effect of the drug is bone marrow toxicity. Gentamycin / piperacillin. 11 . and nephrolithiasis. (B) 5-Effective in treatment of infections caused by penicillinase-producing staphylococci.12 A.Amantadine D. .Tetracyclines can cause all the following Except : A. but she has a history of severe aspirin sensitivity manifest as intense bronchoconstriction. Terbinafine. the nail beds of both great toes were infected. Superinfection with yeast and moulds. and X C-Warfarin does not across the placental barrier D-Warfarin anticoagulant action can be antagonized by Phenobarbital 3-Excessive bleeding from heparin overdose can be treated with A-Streptokinase B-Protamine sulfate C-Aspirin D-Aminocaproic acid 4.A 22. Which one of the following antifungal agents would be most appropriate for this patient ? A. Amphotericin B. D.year old male developed an athlete's foot. 12 . B. Caspofungin. Dental and bone hypoplasia in children. Upon examination. 17. C. Hepatitis. Aspirin would be a preferred treatment.16. Fluconazole.The most appropriate drug for parenteral administration to treat deep venous thrombosis is: A. Photosensetization. What would be a suitable alternative to the aspirin? A-Streptokinase B-Dipyridamole C-Clopidogrel D-Aminocaproic acid 2-All of the following statements regarding the use of warfarin are correct EXCEPT: A-The main adverse effect of Warfarin is bleeding B-Warfarin action involves inhibition of the synthesis of prothrombin and factors VII. Cardiovascular 1-A 64-year-old woman has had episodes if transient ischemic attacks. C. Peripheral neuritis. Clopidogrel. E. B.IX. D.. A 65-year-old man is brought to the emergency department 30 min after the onset of right-sided weakness and aphasia (difficulty of speaking). Is less likely to cause neutropenia C. Has a shorter duration of action B. To prevent a recurrence of this disease. Lepirudin. C. BInhibition of the synthesis of vitamin K-dependant coagulation factors.The mechanism of action of alteplase is: AActivation of plaminogen to plasmin. Will have a greater anti-platelet effect 13 . C-Barbiturates. the patient's symptoms resolved completely. the patient is most likely to be treated indefinitely with A. D. 6.Factor VIII D. Heparin. clopidogril A. Warfarin D.Alteplase C.Abciximab B.Imaging studies ruled out cerebral embolism as the cause of his acute symptoms of stroke. D-Enalapril. DAntagonism of ADP receptor. B-Organophosphates. 7-Prompt administration of which of the following drugs is most likely to improve this patient's clinical outcome? A. Relative to ticlopidine .B.Tranexamic acid is a specific antidote of: A-Fibrinolyic drugs. Is more likely to induce antiplatlet antibodies D. Streptokinase 8-Over the next days. 5. CGlycoprotein lib/Illa receptors antagonist. he may be treated with clopidogrel. Aminocaproic acid B. Aspirin C. Lepirudin 9-If the patient is unable to tolerate the drug identified in question 88. Ticlopidine.