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 of Probenacid used to treat chronic gout?
- Isoniazid
Increased systolic and pulse pressure - decreased diastolic pressure - and little change in mean pressure.
Inhibits reabsorption of uric acid.
1. Antiandrogen 2. Nausea 3. Vomiting

2. What is the formula for Clearance (CL)
CL= (rate of elimination of drug/ Plasma drug conc.)
Oral
check PFTs - LFTs - and TFTs
- NaHCO3

3. What is the MOA of the RT Inhibitors?
Inhibit RT of HIV and prevent the incorporation of viral genome into the host DNA
Long.
Beta 2 agonist; used as a long - acting agent for prophylaxis. Adverse effects are tremor and arrhythmia.
- Alkalating agent - testicular - bladder - ovary -& lung - Nephrotoxicity & CN VIII damage.

4. Digoxin v. Digitoxin: excretion?
Digoxin=urinary Digitoxin=biliary
It affects beta receptors equally and is used in AV heart block (rare).
hyperkalemia - endocrine effects (gynecomastia - anti - androgen)
Interferes with microtubule function - disrupts mitosis - inhibits growth

5. What is the category of drug names ending in - olol (e.g. Propranolol)
Irreversibly inhibits H+/K+ ATPase in stomach parietal cells.
Phase 1 = prolonged depolarization - no antidote - effect potentiated by anticholinesterase; Phase 2 = repolarized but blocked - an anticholinesterase is the antidote for this phase.
1. Antiandrogen 2. Nausea 3. Vomiting
Beta antagonist.

6. List the mechanism - clinical use - & toxicity of 6 MP.
- Penicillamine
Protamine Sulfate is used for rapid reversal of heparinization (positively charged molecule that binds to negatively charged heparin).
Because they require some residual islet function.
- inhibits HGPRT (pur. Syn.) - Luk - Lymph

7. What cholinomimetics might your pt be taking for his glaucoma
Protamine Sulfate is used for rapid reversal of heparinization (positively charged molecule that binds to negatively charged heparin).
Short.
Carbachol - pilocarpine - physostigmine - echothiophate
Selectively inhibit cyclooxygenase (COX) isoform 2 - Which is found in inflammatory cells nad mediates inflammation and pain; spares COX-1 Which helps maintain the gastric mucosa.

8. Is resistant to penicillinase?
Imipenem
Directly of indirectly aid conversion of plasminogen to plasmin Which cleaves thrombin and fibrin clots. (It is claimed that tPA specifically converts fibrin - bound plasminogen to plasmin.)
Clomiphene is a partial agonist at estrogen receptors in the pituitary gland. Prevents normal feedback inhibition and increses release of LH and FSHfrom the pituitary - Which stimulates ovulation.
Stimulates beta adrenergic receptors

9. What is the mechanism of action of NSAIDs other than Aspirin?
DOC in diagnosing and abolishing AV nodal arrhythmias
Gram + and Anerobes
Reversibly inhibit cyclooxygenase (COX I and COX II). Block prostaglandin synthesis.
1. Reliable (<1% failure) 2. Lowers risk of endometrial and ovarian cancer 3. Decreased incidence of ectopic pregnancy 4. Lower risk of pelvic infections 5. Regulation of menses

10. List the specific antidote for this toxin: Cyanide
Neutropenia (ticlopidine); reserved for those who cannot tolerate aspirin.
Protamine Sulfate is used for rapid reversal of heparinization (positively charged molecule that binds to negatively charged heparin).
Acetylates and irreversibly inhibits cyclooxygenase (COX I and COX II) to prevent the conversion of arachidonic acid to prostaglandins.
- Nitrate - hydroxocobalamin thiosulfate

11. What is a prerequisite for Acyclovir activation?
Centrally acting alpha agonist - thus causing a decrease in central adrenergic outflow - spairing renal blood flow
Acetylcholinesterase; ACh is broken down into choline and acetate.
In 4 half - lifes= (94%) T1/2 = (0.7x Vd)/CL
It must be Phosphorylated by Viral Thymidine Kinase

12. Dobutamine used for the tx of shock acts on Which receptors
Nifedipine - Verapamil - Diltiazem
1. Hypoglycemia (more common with 2nd - generation drugs: glyburide - glipizide) 2. Disulfiram - like effects (not seen with 2nd - generation drugs).
Beta1 more than B2
Oral

13. Which drug(s) cause this reaction: P450 inhibition(6)?
Captopril - Enalapril - Lisinopril
- Cimetidine - ketoconazole - grapefruit juice - erythromycin - INH - sulfonamides
Prevention of NSAID- induced peptic ulcers - maintains a PDA.
1. Mycobacterium tuberculosis 2. Delays resistance to Dapsone When used of Leprosy 3. Used in combination with other drugs

14. In What population does Gray Baby Syndrome occur? Why?
1. Cimetadine 2. Ranitidine 3. Famotidine 4. Nizatidine
- Flumazenil
Premature infants - because they lack UDP- glucuronyl transferase
Clavulanic acid

15. What is the MOA of Amantadine?
Aminoglycosides
Mycobacterium tuberculosis - the only agent used as solo prophylaxis against TB
- Ethosuxamide - sulfonamides - lamotrigine
Blocks viral penetration/uncoating; may act to buffer the pH of the endosome

16. Steady state concentration is reached in __ number of half - lifes
In 4 half - lifes= (94%) T1/2 = (0.7x Vd)/CL
- S- phase anti - metabolite Pyr analogue - Colon - solid tumors - & BCC/ - Irreversible myelosuppression
They activate the ciliary muscle of the eye (open angle) and pupillary sphincter (narrow angle).
No. Atropine is used to reduce urgency in mild cystitis. So it would aggravate the urinary retention.

17. Mannitol - clinical use?
ARF - shock - drug overdose - decrease intracranial/intraocular pressure
- Estrogen receptor antagonist - Breast CA - increased endometrial CA risk
- Methotrexate - 5 FU - 6 mercaptopurine
Protease Inhibitors and Reverse Transcriptase Inhibitors

18. Which antimicrobials inhibit protein synthesis at the 50S subunit? (4)
1) Chloramphenical = bacteriostatic 2) Erythromycin = bacteriostatic 3) Lincomycin = bacteriostatic 4)cLindamycin = bacteriostatic
Sulfonamide Loop Diuretic. Inhibits ion co - transport system of thick ascending loop. Abolishes hypertonicity of the medulla - thereby preventing concentration of the urine.
- Daunorubicin & Doxorubicin
- aminoglycosides - loop diuretics - cisplatin

19. What are three possible complications of Heparin therapy?
for RSV
Mycobacterium tuberculosis - the only agent used as solo prophylaxis against TB
1. Bleeding 2. Thrombocytopenia 3. Drug - drug interactions
Terminal D- ala of cell wall replaced with D- lac; Decreased affinity

20. How does a competitive antagonist effect an agonist?
first dose orthostatic hypotension - dizziness - headache
Rifampin
Inhibits IMP Dehydrogenase (competitively) - and therefore blocks Guanine Nucleotide synthesis
- Shifts the curve to the right - increases Km

21. Does Ampicillin or Amoxicillin have a greater oral bioavailability?
Vd= (Amt. of drug in body/ Plasma drug conc.)
- inhibits HGPRT (pur. Syn.) - Luk - Lymph
- Ethosuxamide - sulfonamides - lamotrigine
AmOxicillin has greater Oral bioavailability

22. K+ sparing diuretics - clinical use?
- Weak Acids>Alkinalize urine(CO3) to remove more - Weak bases>acidify urine to remove more
Inhibt Assembly of new virus by Blocking Protease Enzyme
- Alkalating agents+cisplatin - Doxorubicin+Dactinomycin - Bleomycin - Etoposide
hyperaldosteronism - K+ depletion - CHF

23. What is the category of drug names ending in - azol (e.g. Ketoconazole)
Decreases synthesis of Mycolic Acid
edrophonium (extremely short acting anticholinesterase)
Increases coumadin metabolism
Antifungal.

24. What are two Alpha - glucosidase inhibitors?
1. Acarbose 2. Miglitol
Short.
- Protamine
cinchonism: HA - tinnitus - thrombocytopenia - torsade de pointes due to increased QT interval

25. How does NE modulate its own release? What other neurotransmitter has this same effect?
Aplastic anemia (dose independent) - Gray Baby Syndrome
NE acts presynaptically on alpha -2 receptors to inhibit its own release. ACh also acts presynaptically through M1 receptors to inhibit NE release.
Hypersensitivity reactions
Methylzanthine; desired effect is bronchodilation - may cause bronchodilation by inhibiting phosphodiesterase - enzyme involved in degrading cAMP (controversial).

26. What type of neurological blockade would hexamethonium create?
Md= (CpxCL)/F Cp= plas. Conc. CL=clear. F=bioaval.
proximal convoluted tubule - thin descending limb - and collecting duct
Hexamethonium is a nicotinic antagonist - and thus is a ganglionic blocker.
- Alkalating agent - NHL - Breast - ovary - & lung. - Myelosuppression - & hemorrhagic cystitis.

27. As an Anes you want to use a depolarizing neuromuscular blocking drug on your pt - What do you use
BM suppression (neutropenia - anemia) - Peripheral neuropathy
Carbachol - pilocarpine - physostigmine - echothiophate
- Dimercaprol - succimer
Succinylcholine

28. What are three possible toxicities of NSAID usage?
It must be Phosphorylated by Viral Thymidine Kinase
Inhibit DNA Gyrase (topoisomerase II) - Bactericidal
1. Renal damage 2. Aplastic anemia 3. GI distress
- Protamine

29. What is the major toxic side effect of Penicillin?
As PABA antimetabolites that inhibit Dihydropteroate Synthase - Bacteriostatic
Cell membrane Ca2+ channels of cardiac sarcomere
No - warfarin - unlike heparin - can cross the placenta.
Hypersensitivity reactions

30. Why is there a drop in systolic - mean - and diastolic bp with infusion of isoproterenol?
YES
Quinidine - Amiodarone - Procainamide - Disopyramide
Binds 30S subunit and prevents attachment of aminoacyl - tRNA - Bacteriostatic
Stimulating beta receptors stimulates heart rate - but beta receptor induced vasodilation reduces peripheral resistance.

31. List the specific antidote for this toxin: TPA & Streptokinase
hyperchloremic metabolic acidosis - neuropathy - NH3 toxicity - sulfa allergy
edrophonium (extremely short acting anticholinesterase)
- Aminocaproic acid
GI upset - Superinfections - Skin rashes - Headache - Dizziness

32. Antiarrhythmic class II- effects?
Edrophonium
1. Addison's disease 2. Inflammation 3. Immune suppression 4. Asthma
decrease the slope of phase 4 - increase PR interval (the AV node is particularly sensitive)
1) Aminoglycosides = bactericidal 2) Tetracyclines = bacteriostatic

33. Is toxicity rare or common whith Cromolyn used in Asthma prevention?
check PFTs - LFTs - and TFTs
CL= (rate of elimination of drug/ Plasma drug conc.)
Rare.
It inhibits release of NE.

34. What is the lab value used to monitor the effectiveness of Heparin therapy?
Atropine pts are suffering from Cholinestrase inhibitor poisining (Nerve gas/Organophosphate poisining)
The PTT.
Irreversibly inhibits H+/K+ ATPase in stomach parietal cells.
cardiac depression - peripheral edema - flushing - dizziness - constipation

35. What are four H2 Blockers?
1. Antipyretic 2. Analgesic 3. Anti - inflammatory
1. Cimetadine 2. Ranitidine 3. Famotidine 4. Nizatidine
Verapamil - Diltiazem - Bepridil
Ipratropium

36. Ganciclovir associated toxicities?
Dopamine
Hormone synthesis inhibition (Gynecomastia) - Liver dysfunction (Inhibits CYP450) - Fever - Chills
- MT polymerization stabilizer - Ovarian & breast CA - Myelosupperession & hypersensitivity.
Leukopenia - Neutropenia - Thrombocytopenia - Renal toxicity

37. List the specific antidote for this toxin: Iron
- Deferoxamine
The PT.
GI intolerance (nausea - diarrhea) - Hyperglycemia - Lipid abnormalities - Thrombocytopenia (Indinavir)
Penicillin - Cephalosporins - Vancomycin - Aminoglycosides - Fluoroquinolones - Metronidazole

38. What is the mecanism of action of the COX-2 inhibitors (celecoxib - rofecoxib)?
- Tricyclic antidepressants
- reduction - oxy - & hydrolysis - H2O sol. Polar product - P450
Selectively inhibit cyclooxygenase (COX) isoform 2 - Which is found in inflammatory cells nad mediates inflammation and pain; spares COX-1 Which helps maintain the gastric mucosa.
Pseudomonas species and Gram - rods

39. What is the category of drug names ending in - navir (e.g. Saquinavir)
Sotalol - Ibutilide - Bretylium - Amiodarone
Binds ergosterol - Disrupts fungal membranes
- Oxalic acid - Acidosis & nephrotoxicity
Protease inhibitor.

40. What is the memory key for the effect of magnesium hydroxide overuse?
- Estrogen receptor antagonist - Breast CA - increased endometrial CA risk
Mg = Must go to the bathroom.
1. Suppresses organ rejection after transplantation 2. Selected autoimmune disorders.
Penicillin.

41. Common side effects associated with Clindamycin include?
No - hemicholinum block the uptake of Choline and thus Ach synthesis
thiazides - amiloride
Pseudomembranous colitis (C. difficile) - fever - diarrhea
loop diuretics - spironolactone

42. What drug is used to diagnose myasthenia gravis?
vascular sm. Mus.: Nifedipine>Diltiazem>Verapamil
Norepinephrine (Alpha1 -2 and beta 1)
Local anesthetic.
edrophonium (extremely short acting anticholinesterase)

43. What effect would atropine have on the preganglionic sympathetic activation of sweat glands? Would this person sweat?
Overdose produces hepatic necrosis; acetaminophen metablolite depletes glutathione and forms toxic tissue adducts in liver.
- Tricyclic antidepressants
Bismuth and Amoxicillin or Tetracycline; against Helobacter pylori
None. No - because atropine would block the postganglionic muscarinic receptors involved in sweat gland stimulation.

44. What is action of insulin in the liver - in muscle - and in adipose tissue?
No - warfarin - unlike heparin - can cross the placenta.
1. In liver - increases storage of glucose as glycogen. 2. In muscle - stimulates glycogen and protein synthesis - and K+ uptake. 3. In adipose tissue - facilitates triglyceride storage.
Penicillin - Ampicillin - Ticarcillin - Pipercillin - Imipenem - Aztreonam - Cephalosporins
Muscarinic antagonist; competatively blocks muscarinic receptors - preventing bronchoconstriction.

45. Clinical use of Isoniazid (INH)?
Doxycycline - because it is fecally eliminated
The only local anesthetic with vasoconstrictive properties.
Mycobacterium tuberculosis - the only agent used as solo prophylaxis against TB
Staphlococcus aureus and Clostridium difficile (pseudomembranous colitis)

46. What are the products and their toxicities of the metabolism of Ethylene Glycol by / alcohol dehydrogenase?
Yes - it does not cross the placenta.
- Oxalic acid - Acidosis & nephrotoxicity
Ceftriaxone
not a sulfonamide - but action is the same as furosemide

47. For Heparin What is the Duration of action
loop diuretics - spironolactone
distal convoluted tubule (early)
Dobutamine has more of an affintiy for beta -1 than beta -2 - and is used for treating heart failure and shock. Albuterol and terbutaline is the reverse - and is used in treatment of acute asthma.
Acute (hours)

48. Name four Antiarrhythmic drugs in class III.
1. Hot flashes 2. Ovarian enlargement 3. Multiple simultaneous pregnancies 4. Visual disturbances
Sotalol - Ibutilide - Bretylium - Amiodarone
Headache - flushing - dyspepsia - blue - green color vision.
Spironolactone - Triamterene - Amiloride (the K+ STAys)

49. What organism is Imipenem/cilastatin the Drug of Choice for?
Enterobacter
Botulinum
Nephrotoxicity (esp. with Cephalosporins) - Ototoxicity (esp. with Loop Diuretics)
- Cimetidine - ketoconazole - spironolactone - digitalis - EtOH - estrogens

50. What are two conditions in Which COX-2 inhibitors might be used?
Rheumatoid and osteoarthritis.
1. Hot flashes 2. Ovarian enlargement 3. Multiple simultaneous pregnancies 4. Visual disturbances
Inhibit viral DNA polymerase
Bacitracin - Vancomycin

Sorry!:) No result found.

Can you answer 50 questions in 15 minutes?

Major Subjects
Tests & Exams AP CLEP DSST GRE SAT GMAT	Certifications CISSP go to https://www.isc2.org/ PMP ITIL RHCE MCTS More...	IT Skills Android Programming Data Modeling Objective C Programming Basic Python Programming Adobe Illustrator More...	Business Skills Advertising Techniques Business Accounting Basics Business Strategy Human Resource Management Marketing Basics More...
Soft Skills Body Language People Skills Public Speaking Persuasion Job Hunting And Resumes More...	Vocabulary GRE Vocab SAT Vocab TOEFL Essential Vocab Basic English Words For All Global Words You Should Know Business English More...	Languages AP German Vocab AP Latin Vocab SAT Subject Test: French Italian Survival Norwegian Survival More...	Engineering Audio Engineering Computer Science Engineering Aerospace Engineering Chemical Engineering Structural Engineering More...
Health Sciences Basic Nursing Skills Health Science Language Fundamentals Veterinary Technology Medical Language Cardiology Clinical Surgery More...	English Grammar Fundamentals Literary And Rhetorical Vocab Elements Of Style Vocab Introduction To English Major Complete Advanced Sentences Literature Homonyms More...	Math Algebra Formulas Basic Arithmetic: Measurements Metric Conversions Geometric Properties Important Math Facts Number Sense Vocab Business Math More...	Other Major Subjects Science Economics History Law Performing-arts Cooking Logic & Reasoning Trivia

Test your basic knowledge |

USMLE Step 1 Pharmacology

Sorry!:) No result found.

Can you answer 50 questions in 15 minutes?

Let me suggest you:

Browse all subjects

Browse all tests

Most popular tests

Major Subjects

Tests & Exams

Certifications

IT Skills

Business Skills

Soft Skills

Vocabulary

Languages

Engineering

Health Sciences

English

Math

Other Major Subjects

Browse all subjects

Browse all tests

Most popular tests