Sunday, 13 December 2015

100 Top Pharmacology Objective Type Questions And Answers

1- Which of the following statements concering the treatment of acute myocardial infarction is correct?
1) A pansystolic murmur developing within the first 24 hours does not require further investigation.
2) Dipyridamole therapy reduces reinfarction within the first year.
3) Heparin is beneficial if given with streptokinase.
4) Prophylactic lignocaine given in the first 48 hours is effective in preventing ventricular fibrillation
5) Treatment with a dihydropyridine calcium antagonist is associated with increased cardiovascular mortality.

2- A 30 year old male presented with a paranoid psychosis accompanied by visual hallucinations which resolved over the next three days. Which one of the following is the most likely diagnosis?
1) Alcohol withdrawal.
2) Diazepam dependence.
3) Fluoxetine overdose.
4) Heroin withdrawal.
5) Smoking cannabis.

3- Which ONE of the following oncerning Insulin is correct?
1) acts via a similar mechanism as steroid receptors
2) causes an increased glucose-protein transport on the endoplasmic reticulum
3) can be detected in the lymph
4) interacts with the nuclear membrane
5) is synthesised in the alpha cells of islets of Langerhans

4- In which of the following circumstances would the treatment of anaemia with erythropeitin still be expected to be effective?
1) Aluminium toxicity
2) Folate deficiency
3) Hyperkalaemia
4) Infection
5) Iron deficiency

5- A 70-year-old male is referred by his GP for management of recently diagnosed congestive heart failure. The patient has a history of poorly controlled hypertension. Over the last three months he has been aware of deteriorating shortness of breath, fatigue, and orthopnea. Over the last month he had been commenced on Digoxin (62.5 micrograms daily), Frusemide (80 mg daily), and amiloride 10 mg. On examination he has a pulse of 96 bpm regular, a blood pressure of 132/88 mmHg. His JVP was not raised, he had some scattered bibasal crackles on auscultation with a displaced apex beat in the anterior axillary line, 6th intercostal space. Auscultation of the heart revealed no murmurs and he had peripheral oedema to the mid tibia. Investigations showed:
electrolytes normal serum urea concentration 17 mmol/l (NR 2-8 mmol/l) creatinine 175 micromol/l (NR 55-110) Serum digoxin 0.7 ng/mL {therapeutic: 1.0-2.0}
One month previously his urea had been 11 mmol/l and creatinine 110 micromol/l. An ECG reveals left ventricular hypertrophy and Chest X-ray shows cardiomegaly and calcified aorta.
What is the most appropriate next step in management?
1) Add an ACE inhibitor to the current regimen
2) Add atenolol at a dose of 25mg daily
3) Increase digoxin to 0.25 mg daily
4) Increase frusemide to 80 mg twice daily
5) Maintain on current therapy.

6- Which one of the following drugs works by inhibiting the tumour necrosis factor?
1) cyclosporin
2) infliximab
3) methotrexate
4) montelukast
5) sulphasalazine

7- Which of the following is NOT associated with hyponatraemia and hyperkalaemia?
1) Acute hypoadrenalism
2) Carbenoxolone therapy
3) Co-Amilofruse therapy
4) Congestive cardiac failure.
5) Type IV renal tubular acidosis

8- A 70 year old male was receiving amiodarone 200 mg daily for intermittent atrial fibrillation. However, he was aware of tiredness and lethargy. He appeared clinically euthyroid with no palpable goitre. Investigations revealed:
Serum free T4 23pmol/L (9-26)
Serum total T3 0.8 nmol/L (0.9-2.8)
Serum TSH 8.2 mU/L (<5)
Which of the following statements would explain these results?
1) Abnormal thyroxine binding globulin
2) Amiodarone-induced hypothyroidism
3) 'sick euthyroid' syndrome
4) Spontaneous hypothyroidism
5) TSH secreting pituitary adenoma

9- There is presently no known effective treatment for a chronic disease. A new treatment is known to be effective in animal models and shows promise in short-term studies in patients. There is some theoretical concerns regarding possible hepato- and bone marrow toxicity although thus far, no toxicity have been observed in studies.
What is the most appropriate next step in the drug's development?
1) A case control study
2) No further studies should be done and drug development should be stopped
3) An open study
4) A randomised double blind placebo controlled study
5) A randomised single blind placebo controlled study

10- A 51-year-old female is referred by her GP over concerns about osteoporosis. She had a hysterectomy and oophorectomy because of uterine fibroids one year ago, after which she developed hot flushes that now have stopped. Her elderly mother recently fractured the neck of her femur and the patient is worried about the possibility that she too will fracture her hip later in life. She is otherwise well, is a non-smoker drinks about 5 units of alcohol weekly and has a healthy diet.
Examination reveals a fit thin female with a BMI of 18, her blood pressure is 122/88mmHg and breast examination is normal. Which of the following would you recommend for her?
1) Bisphosphonates
2) Calcitonin
3) Combined Oestrogen and progesterone therapy
4) Unopposed Oestrogen therapy
5) Vitamin D

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