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 enzymes are inhibited by NSAIDs - acetaminophen and COX II inhibitors?
- ACE inhibitors (Losartan>no cough)
cyanide toxicity (releases CN)
Cyclooxygenases (COX I - COX II).
Md= (CpxCL)/F Cp= plas. Conc. CL=clear. F=bioaval.

2. Name the common Fluoroquinolones (6)
Methylzanthine; desired effect is bronchodilation - may cause bronchodilation by inhibiting phosphodiesterase - enzyme involved in degrading cAMP (controversial).
Ciprofloxacin - Norfloxacin - Ofloxacin - Grepafloxacin - Enoxacin - Nalidixic acid
YES
all of them

3. What are the nondepolarizing neuromuscular blocking drugs?
edematous states (CHF - cirrhosis - nephrotic syndrome - pulm edema) - HTN - hypercalcemia
They inhibit reuptake of NE at the nerve terminal (as does cocaine).
Tubocurarine - atracurium - mivacurium - pancuronium - vecuronium - rapacuronium
very short acting

4. Ethacrynic Acid - clinical use?
increased AP duration - increased ERP increased QT interval. Atrial and ventricular.
HSV - VZV - EBV - Mucocutaneous and Genital Herpes Lesions - Prophylaxis in Immunocompromised pts
Inhibit steroid synthesis - used in the treatment of polycystic ovarian syndrome to prevent hirsutism.
Diuresis in pateints with sulfa allergy

5. What enzyme does Zileuton inhibit?
depresses ectopic pacemakers - especially in digoxin toxicity
Lipoxygenase
Delirium - Tremor - Nephrotoxicity
Hypersensitivity reactions

6. What are four clinical uses of glucocorticoids?

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

7. Antiarrhythmic class IV- effects?
Bismuth and Amoxicillin or Tetracycline; against Helobacter pylori
Keratin containing tissues - e.g. - nails
1. Hydrocortisone 2. Predisone 3. Triamcinolone 4. Dexamethasone 5. Beclomethasone
decrease conduction velocity - increase ERP - increase PR interval

8. What is the MOA for Vancomycin?
constipation - flushing - edema - CV effects (CHF - AV block - sinus node depression) - and torsade de pointes (Bepridil)
diuretics - sympathoplegics - vasodilators - ACE inhibitors - Angiotensin II receptor inhibitors
1) Chloramphenical = bacteriostatic 2) Erythromycin = bacteriostatic 3) Lincomycin = bacteriostatic 4)cLindamycin = bacteriostatic
Inhibits cell wall mucopeptide formation - Bactericidal

9. What is the only depolarizing neuromuscular blocking agent?
- S- phase anti - metabolite Pyr analogue - Colon - solid tumors - & BCC/ - Irreversible myelosuppression
Large anionic polymer - acidic
1. Significant: nephrotoxicity 2. Peripheral neuropathy 3. Hypertension 4. Pleural effusion 5. Hyperglycemia.
Succinylcholine

10. How do spare receptors effect the Km?
1. Heavy bleeding 2. GI effects (n/v - anorexia) 3. Abdominal pain
1. Better bioavailability 2. 2 to 4 times longer half life 3. Can be administered subcutaneously 4. Does not require laboratory monitoring
- ED 50 is less than the Km (less than 50% of receptors)
Epinephrine

11. What are the products and their toxicities of the metabolism of ethanol by / alcohol dehydrogenase?
hypokalemia - slight hyperlipidemia - hyperuricemia - lassitude - hypercalcemia - hyperglycemia
- Hypersensitivity reactions - Hemolysis - Nephrotoxicity (tubulointerstitial nephritis) - Kernicterus in infants Displace other drugs from albumin (e.g. - warfarin)
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.
- Acetaldehyde - Nausea - vomiting - headache - & hypotension

12. What is the clinical use for Nystatin?
cholestyramine - colestipol
Neutropenia (ticlopidine); reserved for those who cannot tolerate aspirin.
- Haloperidol - chlorpromazine - reserpine - MPTP
Topical and Oral - for Oral Candidiasis (Thrush)

13. Beta Blockers - BP?
1. Cimetadine 2. Ranitidine 3. Famotidine 4. Nizatidine
- Act on same receptor - Full has greater efficacy
decrease
Diuresis in pateints with sulfa allergy

14. Common toxicities associated with Griseofulvin?
- Tetracycline
vascular sm. Mus.: Nifedipine>Diltiazem>Verapamil
Prophylaxis for Influenza A - Rubella; Parkinson's disease
Teratogenic - Carcinogenic - Confusion - Headaches

15. What effect would atropine have on the preganglionic sympathetic activation of sweat glands? Would this person sweat?
None. No - because atropine would block the postganglionic muscarinic receptors involved in sweat gland stimulation.
Hormone synthesis inhibition (Gynecomastia) - Liver dysfunction (Inhibits CYP450) - Fever - Chills
GnRH analog with agonist properties When used in pulsatile fashion and antagonist properties When used in continuous fashion - causing a transient initial burst of LH and FSH
Acetaminophen has antipyretic and analgesic properties - but lacks anti - inflammatory properties.

16. MOA: Block peptidoglycan synthesis
AZT
Polymyxins
Bacitracin - Vancomycin
Nephrotoxicity

17. List the specific antidote for this toxin: Opioids
Inhibits xanthine oxidase - decresing conversion of xanthine to uric acid.
- B51Naloxone / naltrexone (Narcan)
Same as penicillin. Act as narrow spectrum antibiotics
Ceftriaxone

18. Which drug(s) cause this reaction: Diabetes insipidus?
dry mouth - sedation - severe rebound hypertension
- Lithium
Botulinum
hypokalemia - slight hyperlipidemia - hyperuricemia - lassitude - hypercalcemia - hyperglycemia

19. What is the category of drug names ending in - oxin (e.g. Digoxin)
- Chloramphenicol - benzene - NSAIDS - PTU - phenytoin
Gram + cocci - Proteus mirabilis - E. coli - Klebsiella pneumoniae (PEcK)
Imipenem
Cardiac glycoside (inotropic agent).

20. What are Polymyxins used for?
Resistant Gram - infections
They activate the ciliary muscle of the eye (open angle) and pupillary sphincter (narrow angle).
- Barbiturates - phenytoin - carbamazipine - rifampin - griseofulvin - quinidine
- Hydralazine - Procainamide - INH - phenytoin

21. Which drug(s) cause this reaction: Disulfram - like reaction (4) ?
- Metronidazole - certain cephalosporins - procarbazine - sulfonylureas
Misoprostol is a PGE1 analog that increases the production and secretion of the gastic mucous barrier.
The PT.
Flutamide is a nonsteroidal competitive inhibitor of androgens at the testosterone receptor - used in prostate carcinoma.

22. What is the MOA of Griseofulvin?
severe orthostatic hypotension - blurred vision - constipation - sexual dysfunction
Interferes with microtubule function - disrupts mitosis - inhibits growth
Lovastatin - Pravastatin - Simvastatin - Atorvastatin
No - it inhibits the release of Nor Epi

23. These drugs acts indirectly by releasing strored catecholamines in the presynaptic terminal
Amphetamine and Ephedrine
NO
- Penicillamine
Chronic gout.

24. In coma situations you rule out What (7)?

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

25. What are the Anti - TB drugs?
propanolol - esmolol - metoprolol - atenolol - timolol
Rifampin - Ethambutol - Streptomycin - Pyrazinamide - Isoniazid (INH)
Epinephirine(Alpha1 -2 and Beta 1 -2)
Immediate anticoagulation for PE - stroke - angina - MI - DVT.

26. Ca2+ channel blockers - site of action?
GI disturbances.
Treatment of hypertension - especially with renal disease (lowers bp centrally - so flow is maintained to kidney).
Cell membrane Ca2+ channels of cardiac sarcomere
To inhibit renal Dihydropeptidase I and decrease Imipenem inactivation in the renal tubules

27. MOA: Block protein synthesis at 30s subunit
1) Chloramphenical = bacteriostatic 2) Erythromycin = bacteriostatic 3) Lincomycin = bacteriostatic 4)cLindamycin = bacteriostatic
Blocks translocation - binds to the 23S rRNA of the 50S subunit - Bacteriostatic
Aminoglycosides - Tetracyclines
Gram + - Gram - - Norcardia - Chlamydia

28. Explain potency in relation to full and partial agonists(2).
Mebendazole/Thiabendazole - Pyrantel Pamoate
- partial agonist can have increased - decreased - /A21or equal potency as full agonist. - Potency is an independent factor.
Modification via Acetylation
Fluconazole - Ketoconazole - Clotrimazole - Miconazole - Itraconazole

29. What is the mechanism of action of Probenacid used to treat chronic gout?
Dopamine; causes its release from intact nerve terminals
Inhibits reabsorption of uric acid.
Na/K ATPase
narcolepsy - obesity - and attention deficit disorder (I wouldn't recommend this)

30. What is an occasional side effect of Aztreonam?
Suramin
No
Digoxin=urinary Digitoxin=biliary
GI upset

31. How is Leishmaniasis treated?
- B51Naloxone / naltrexone (Narcan)
hypertension - angina - arrhythmias
- Fluoroquinolones
Pentavalent Antimony

32. Why would you use pralidoxime after exposure to an organophosphate?
Pralidoxime regenerates active cholinesterase.
Methicillin - Nafcillin - and Dicloxacillin
Bethanechol - Neostigmine - physostigmine
- Normalize K+ - Lidocaine - & Anti - dig Mab

33. Antiarrhythmic class IB- toxicity?
effective in torsade de pointes and digoxin toxicity
Penicillin - Cephalosporins - Vancomycin - Aminoglycosides - Fluoroquinolones - Metronidazole
local anesthetic. CNS stimulation or depression. CV depression.
narcolepsy - obesity - and attention deficit disorder (I wouldn't recommend this)

34. Which drug(s) cause this reaction: Neuro and Nephrotoxic?
Overdose produces hepatic necrosis; acetaminophen metablolite depletes glutathione and forms toxic tissue adducts in liver.
Peptic ulcer disease.
- polymyxins
diuretics - sympathoplegics - vasodilators - ACE inhibitors - Angiotensin II receptor inhibitors

35. What is the specific clinical use of Indomethacin in neonates?
Antileukotriene; blocks leukotriene receptors.
Those patients who are taking nitrates.
Potent immunosuppressive used in organ transplant recipients.
Indomethacin is used to close a patent ductus arteriosus.

36. Which cancer drugs work at the level of mRNA(2)?
Bismuth and Amoxicillin or Tetracycline; against Helobacter pylori
Inhibits NaCl reabsorption in the early distal tubule. Decreases Ca2+ excretion.
- Steroids - Tamoxifen
Fluconazole - Ketoconazole - Clotrimazole - Miconazole - Itraconazole

37. Resistance mechanisms for Chloramphenicol
It would increase to ~ 100 beats/min. Both sympathetic and vagal stimulation would be knocked out - but the SA node has an intrinsic pace of 100 beats/min - Which is normally checked by vagal stimulation.
depresses ectopic pacemakers - especially in digoxin toxicity
Modification via Acetylation
Protease inhibitor.

38. What is the MOA for Amphotericin B?
fetal renal toxicity - hyperkalemia - Cough - Angioedema - Proteinuria - Taste changes - hypOtension - Pregnancy problems - Rash - Increased renin - Lower Angiotensin II (CAPTOPRIL)
Tricyclic antidepressant.
sedation - depression - nasal stuffiness - diarrhea
Binds Ergosterol - forms Membrane Pores that Disrupt Homeostatis

39. Acetazolamide causes?

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

40. What is the MOA for Acyclovir?
Mg = Must go to the bathroom.
Inhibit viral DNA polymerase
Flutamide is a nonsteroidal competitive inhibitor of androgens at the testosterone receptor - used in prostate carcinoma.
- Physostigmine salicylate

41. Explain differences between full and partial agonists(2).
- Act on same receptor - Full has greater efficacy
Hydralazine and Minoxidil
It must be Phosphorylated by Viral Thymidine Kinase
Indirect agonist - uptake inhibitor

42. What is the category of drug names ending in - cillin (e.g. Methicillin)
Ataxia - Dizziness - Slurred speech
Penicillin.
Ciprofloxacin - Norfloxacin - Ofloxacin - Grepafloxacin - Enoxacin - Nalidixic acid
The PT.

43. What is the mechanism of action of Warfarin (Coumadin)?
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.
G6PD deficient individuals
- MT polymerization stabilizer - Ovarian & breast CA - Myelosupperession & hypersensitivity.
Fever/Chills - Hypotension - Nephrotoxicity - Arrhythmias

44. What are the side effects of Rifampin?
Systemic mycoses
Epinephrine
Minor hepatotoxicity - Drug interactions (activates P450)
Topical and Oral - for Oral Candidiasis (Thrush)

45. Does Ampicillin or Amoxicillin have a greater oral bioavailability?
Megaloblastic anemia - Leukopenia - Granulocytopenia
Inhibits Viral DNA polymerase
AmOxicillin has greater Oral bioavailability
AZT

46. Which drug(s) cause this reaction: Pulmonary fibrosis(3)?
proximal convoluted tubule - thin descending limb - and collecting duct
- Cloazapine - carbamazapine - colchicine - PTU
- Bleomycin - amiodarone - busulfan
Inhibt Assembly of new virus by Blocking Protease Enzyme

47. A fellow passenger on a Carnival cruise ship looks pale and diaphoretic - What antimuscarinic agent would you give them?
scopolamine
Gram - rods: Klebsiella species - Pseudomonas species - Serratia species
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.)
Suramin

48. What is the clinical use for Warfarin?
Chronic anticoagulation.
Forms toxic metabolites in the bacterial cell - Bactericidal
- Weak Acids>Alkinalize urine(CO3) to remove more - Weak bases>acidify urine to remove more
Ceftriaxone

49. What are Amantadine - associated side effects?
for RSV
Staphlococcus aureus
1. Weight gain 2. Hepatotoxicity (troglitazone)
Ataxia - Dizziness - Slurred speech

50. Which drug(s) cause this reaction: Drug induced Parkinson's (4) ?
- Haloperidol - chlorpromazine - reserpine - MPTP
- Methotrexate - 5 FU - 6 mercaptopurine
- Upper respiratory tract infections - pneumonias - STDs: Gram+ cocci (streptococcal infect in pts allergic to penicillin) - Mycoplasma - Legionella - Chlamydia - Neisseria
Gemfibrozil - Clofibrate