Test your basic knowledge |

USMLE Step 1 Pharmacology

Subjects : health-sciences, usmle-step-1

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. What is the mechanism of action and clinical use of the antiandrogen Flutamide?
- acetylation - glucuron. - & sulfation - Conjugation - Polar product
Flutamide is a nonsteroidal competitive inhibitor of androgens at the testosterone receptor - used in prostate carcinoma.
1. RNA pol inhibitor 2. Revs up P450 3. Red/orange body fluids 4. Rapid resistance if used alone
Overdose produces hepatic necrosis; acetaminophen metablolite depletes glutathione and forms toxic tissue adducts in liver.

2. How are Sulfonamides employed clinically?
Blocks Norepi - but not Dopamine
1. Peptic ulcer 2. Gastritis 3. Esophageal reflux 4. Zollinger - Ellison syndrome
Gram + - Gram - - Norcardia - Chlamydia
1. Meningococcal carrier state 2. Chemoprophylaxis in contacts of children with H. influenzae type B

3. What is the category and mechanism of action of Zileuton in Asthma treatment?
Antileukotriene; blocks synthesis by lipoxygenase.
Edrophonium
1. Addison's disease 2. Inflammation 3. Immune suppression 4. Asthma
- Chloramphenicol

4. Which RT inhibitor causes Megaloblastic Anemia?
Close K+ channels in Beta - cell membrane leading to cell depolarization causing insulin release triggered by increase in Calcium ion influx.
Warfarin interferes with the normal synthesis and gamma - carboxylation of vitamin K- dependent clotting factors II - VII - IX - and X - Protein C and S via vitamin K antagonism.
AZT
Gram + and Anerobes

5. Dobutamine used for the tx of shock acts on Which receptors
- inhibits HGPRT (pur. Syn.) - Luk - Lymph
- Lithium
- aminoglycosides - loop diuretics - cisplatin
Beta1 more than B2

6. What is the category - mechanism of action - and particular use of beclomethasone and prednisone in Asthma treatment?
Penicillin.
Delirium - Tremor - Nephrotoxicity
Pentamidine
Corticosteroids; prevent production of leukotrienes from arachodonic acid by blocking phospholipase A2. Drugs of choice in a patient with status asthmaticus (in combination with albuterol.)

7. Which RT inhibitors cause Lactic Acidosis?
Increases coumadin metabolism
Gram - rods: Klebsiella species - Pseudomonas species - Serratia species
1. Acarbose 2. Miglitol
Nucleosides

8. Why would dopamine be useful in treating shock?
block Na+ channels in the cortical collecting tubule
Irreversibly inhibits H+/K+ ATPase in stomach parietal cells.
Receptors = D1=D2>beta>alpha - thus increasing heart rate (beta) and blood pressure (alpha vasoconstriction) while maintaining kidney perfusion (dopamine receptors)
Give an antichloinesterase - neostigmine - edrophonium - etc

9. Which drug(s) cause this reaction: Gynecomastia (6)?
- Cimetidine - ketoconazole - spironolactone - digitalis - EtOH - estrogens
Local anesthetic.
- MT polymerization stabilizer - Ovarian & breast CA - Myelosupperession & hypersensitivity.
Activates antithrombin III

10. Which drug(s) cause this reaction: Oto and Nephrotoxicity (3)?
- aminoglycosides - loop diuretics - cisplatin
Dry flushed skin - due to inhibition of sympathetic post - ganglionic blockade on muscarinic receptors of sweat glands. All others are opposite of What would be expected.
Inhibits CMV DNA polymerase
Lovastatin - Pravastatin - Simvastatin - Atorvastatin

11. Antiarrhythmic class IV- toxicity?
constipation - flushing - edema - CV effects (CHF - AV block - sinus node depression) - and torsade de pointes (Bepridil)
NO
- Alkalating agent - testicular - bladder - ovary -& lung - Nephrotoxicity & CN VIII damage.
Aminoglycosides - Tetracyclines

12. Adverse effects of Captopril?
Butyrophenone (neuroleptic).
Acts as a wide spectrum carbapenem
- Chloramphenicol - benzene - NSAIDS - PTU - phenytoin
fetal renal toxicity - hyperkalemia - Cough - Angioedema - Proteinuria - Taste changes - hypOtension - Pregnancy problems - Rash - Increased renin - Lower Angiotensin II (CAPTOPRIL)

13. How would you reverse the effect of a neuromuscular blocking agent?
Epinephirine(Alpha1 -2 and Beta 1 -2)
Give an antichloinesterase - neostigmine - edrophonium - etc
Bacitracin - Vancomycin
- Alkalating agent - NHL - Breast - ovary - & lung. - Myelosuppression - & hemorrhagic cystitis.

14. What is the category - desired effect - and possible mechanism of Theophylline in treating Asthma?
for RSV
Methylzanthine; desired effect is bronchodilation - may cause bronchodilation by inhibiting phosphodiesterase - enzyme involved in degrading cAMP (controversial).
- Chloramphenicol
VACUUM your Bed Room'

15. What is an occasional side effect of Aztreonam?
GI upset
nausea - headache - lupus - like syndrome - reflex tachycardia - angina - salt retention
Giant Roundworm (Ascaris) - Hookworm (Necator/Ancylostoma) - Pinworm (Enterobius)
Staphlococcus aureus

16. Does Heparin have a long - medium - or short half life?
Short.
With an amino acid change of D- ala D- ala to D- ala D- lac
Inhibits NaCl reabsorption in the early distal tubule. Decreases Ca2+ excretion.
Md= (CpxCL)/F Cp= plas. Conc. CL=clear. F=bioaval.

17. What is the memory key for the effect of magnesium hydroxide overuse?
Liver
Mg = Must go to the bathroom.
Digoxin=urinary Digitoxin=biliary
Reversibly inhibits cyclooxygenase - mostly in CNS. Inactivated peripherally.

18. List the specific antidote for this toxin: Salicylates
Penicillin - Ampicillin - Ticarcillin - Pipercillin - Imipenem - Aztreonam - Cephalosporins
- reduction - oxy - & hydrolysis - H2O sol. Polar product - P450
pulmonary fibrosis - corneal deposits - hepatotoxicity - skin deposits resulting in photodermatitis - neurologic effects - consitpation - CV (bradycardia - heart block - CHF) - and hypo - or hyperthyroidism.
- Alkalinize urine & dialysis

19. Is toxicity rare or common whith Cromolyn used in Asthma prevention?
NO HYPERURICEMIA - NO SULFA AllERGY; same as furosemide otherwise
RESPIre
Rare.
Rash - Pseudomembranous colitis

20. What drug is used to diagnose myasthenia gravis?
Praziquantel
1. Antipyretic 2. Analgesic 3. Anti - inflammatory 4. Antiplatelet drug.
edrophonium (extremely short acting anticholinesterase)
Tetracycline - Doxycycline - Demeclocycline - Minocycline

21. What is the clinical use for Sildenafil (Viagra)?
1. Meningococcal carrier state 2. Chemoprophylaxis in contacts of children with H. influenzae type B
Digitoxin 70% Digoxin 20-40%
block Na+ channels in the cortical collecting tubule
Erectile dysfunction.

22. What is the possible mechanism and effect of Metformin in treating diabetes?
- Ammonium Chloride
Mechanism unknown; possibly inhibits gluconeogenesis and increases glycolysis; effect is to decrease serum glucose levels
- Phenytoin
Sulfonamides - Trimethoprim

23. What is the mechanism of action of Misoprostol?
Misoprostol is a PGE1 analog that increases the production and secretion of the gastic mucous barrier.
Hemicholinium inhibits the transport of choline into the nerve - thus inhibiting formation of ACh.
- Chloramphenicol - benzene - NSAIDS - PTU - phenytoin
- Normalize K+ - Lidocaine - & Anti - dig Mab

24. What is the only depolarizing neuromuscular blocking agent?
Diarrhea
The PT.
Pyridoxine (B6) administration
Succinylcholine

25. What is the MOA of Aztreonam?
Staphlococcus aureus and Clostridium difficile (pseudomembranous colitis)
Inhibits cell wall synthesis ( binds to PBP3). A monobactam
Impairs the synthesis of vitamin K- dependent clotting factors
NE acts presynaptically on alpha -2 receptors to inhibit its own release. ACh also acts presynaptically through M1 receptors to inhibit NE release.

26. What is the major toxic side effect of Penicillin?
Hypersensitivity reactions
Quinolones
Nonspecific beta - agonist; desired effect is the relaxation of bronchial smooth muscle (Beta 2). Adverse effect is tachycardia (Beta 1).
Beta -2 agonist.

27. What is the category of drug names ending in - triptyline (e.g. Amitriptyline)
Inhibition of 50S peptidyl transferase - Bacteriostatic
1. Mycobacterium tuberculosis 2. Delays resistance to Dapsone When used of Leprosy 3. Used in combination with other drugs
Alpha -1 antagonist
Tricyclic antidepressant.

28. Name common Polymyxins
Polymyxin B - Polymyxin E
Ipratropium
Constant FRACTION eliminated per unit time.(exponential)
1. Antiandrogen 2. Nausea 3. Vomiting

29. What are common side effects of RT Inhibitors?
Reversible block of histamine H2 receptors
BM suppression (neutropenia - anemia) - Peripheral neuropathy
not a sulfonamide - but action is the same as furosemide
- Dimercaprol - succimer

30. List the mechanism - clinical use - & toxicity of Bleomycin.
- DNA intercalator - testicular & lymphomas - Pulmonary fibrosis mild myelosuppression.
- Dimercaprol - succimer
Praziquantel
Systemic mycoses

31. Which receptors does phenylephrine act upon?
hyperaldosteronism - K+ depletion - CHF
- Cimetidine - ketoconazole - spironolactone - digitalis - EtOH - estrogens
Dermatophytes (tinea - ringworm)
alpha -1 > alpha -2; used as a pupil dilator - vasoconstrictor - and for nasal decongestion

32. Which drug(s) cause this reaction: Diabetes insipidus?
Pentavalent Antimony
Warfarin interferes with the normal synthesis and gamma - carboxylation of vitamin K- dependent clotting factors II - VII - IX - and X - Protein C and S via vitamin K antagonism.
- Lithium
Inhibit DNA Gyrase (topoisomerase II) - Bactericidal

33. As an Anes you want to use a depolarizing neuromuscular blocking drug on your pt - What do you use
Succinylcholine
Prevention of NSAID- induced peptic ulcers - maintains a PDA.
1) Serious Gram - infections resistant to other Beta lactams 2) Meningitis (most penetrate the BBB)
GI upset - Superinfections - Skin rashes - Headache - Dizziness

34. List the mechanism - clinical use - & toxicity of Cisplatin.
Rheumatoid and osteoarthritis.
- Alkalating agent - testicular - bladder - ovary -& lung - Nephrotoxicity & CN VIII damage.
impotence - exacerbation of asthma - CV effects - CNS effects - may mask hypoclycemia
Digitoxin 168hrs Digoxin 40 hrs

35. What are two types of drugs that interfere with the action of Sucralfate and why?
Sucralfate cannot work in the presence of antacids or H2 blockers because it requires an acidic environment to polymerize.
- Oxalic acid - Acidosis & nephrotoxicity
Post - op and neurogenic ileus and urinary retention - myasthenia gravis - and reversal of neuromuscular junction blockade (post - op) through anticholinesterase activity.
competitive inhibirot of aldosterone in the cortical collecting tubule

36. List the mechanism - clinical use - & toxicity of Prednisone.

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

37. Antiarrhythmic class IB- effects?
decrease AP duration - affects ischemic or depolarized Purkinje and ventricular system
check PFTs - LFTs - and TFTs
for RSV
GI disturbances.

38. Classes of antihypertensive drugs?
- Glucocorticoid withdrawal
diuretics - sympathoplegics - vasodilators - ACE inhibitors - Angiotensin II receptor inhibitors
Nonspecific beta - agonist; desired effect is the relaxation of bronchial smooth muscle (Beta 2). Adverse effect is tachycardia (Beta 1).
Blocks Peptide Bond formation at the 50S subunit - Bacteriostatic

39. Digoxin v. Digitoxin: half life?
fetal renal toxicity - hyperkalemia - Cough - Angioedema - Proteinuria - Taste changes - hypOtension - Pregnancy problems - Rash - Increased renin - Lower Angiotensin II (CAPTOPRIL)
Digitoxin 168hrs Digoxin 40 hrs
Amphotericin B - Nystatin - Fluconazole/azoles
decrease

40. Which of these three drugs will cause a reflex bradycardia in your pt (Norepi - Epi - or Isoporterenol)
- Weak Acids>Alkinalize urine(CO3) to remove more - Weak bases>acidify urine to remove more
Gemfibrozil - Clofibrate
Norepinephrine
- Metronidazole - certain cephalosporins - procarbazine - sulfonylureas

41. How would hemicholinium treatment affect cholinergic neurons?
Alpha -1 antagonist
Inhibit Ergosterol synthesis
- B51Naloxone / naltrexone (Narcan)
Hemicholinium inhibits the transport of choline into the nerve - thus inhibiting formation of ACh.

42. For Warfarin What is the Mechanism of action
Impairs the synthesis of vitamin K- dependent clotting factors
Inhibits DNA dependent RNA polymerase
Acetylcholinesterase; ACh is broken down into choline and acetate.
1. Hydrocortisone 2. Predisone 3. Triamcinolone 4. Dexamethasone 5. Beclomethasone

43. While at a tail gait party - you bite into a sandwich that a yellow jacket is also enjoying. Knowing your allergy to this creature - What should you do?
Gram + and Anerobes
Epinephrine to treat anaphylaxis. Also useful if you have open angle glaucoma - asthma - or hypotension.
Competitive inibitor of progestins at progesterone receptors.
Large anionic polymer - acidic

44. Verapamil has similar action to?
Nephrotoxicity
Beta Blockers
Penicillin.
Diuresis in pateints with sulfa allergy

45. IV Penicillin
cardiac muscle: Verapamil>Diltiazem>Nifedipine
Penicillin - G
No - warfarin - unlike heparin - can cross the placenta.
Gram - rods: Klebsiella species - Pseudomonas species - Serratia species

46. What are five toxicities associated with Tacrolimus (FK506)?
DHPG (dihydroxy-2- propoxymethyl guanine)
1. Significant: nephrotoxicity 2. Peripheral neuropathy 3. Hypertension 4. Pleural effusion 5. Hyperglycemia.
INH: Injures Neurons and Hepatocytes
Give an antichloinesterase - neostigmine - edrophonium - etc

47. What are Amantadine - associated side effects?
Dopamine
Ataxia - Dizziness - Slurred speech
- Sulfonamides - INH - ASA - Ibuprofen - primaquine - nitrofurantoin /- pyrimethamine - chloramphenicol
CL= (rate of elimination of drug/ Plasma drug conc.)

48. Ganciclovir associated toxicities?
Leukopenia - Neutropenia - Thrombocytopenia - Renal toxicity
Beta adrenergic receptors and Ca2+ channels (stimulatory)
Albuterol - tertbutaline
Anaerobic infections (e.g. - B. fragilis - C. perfringens)

49. Ca2+ channel blockers - clinical use?
1. Mycobacterium tuberculosis 2. Delays resistance to Dapsone When used of Leprosy 3. Used in combination with other drugs
- B51Naloxone / naltrexone (Narcan)
hypertension - angina - arrhythmias
Inhibit Ergosterol synthesis

50. What parasites are treated with Pyrantel Pamoate (more specific)?
- Chlorpromazine - thioridazine - haloperidol
Giant Roundworm (Ascaris) - Hookworm (Necator/Ancylostoma) - Pinworm (Enterobius)
Hemolysis (if G6PD deficient) - Neurotoxicity - Hepatotoxicity - SLE- like syndrome
Beta 2 agonist; desired effect is the relaxation of bronchial smooth muscle (Beta 2). Use during acute exacerbation.