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. List the mechanism - clinical use - & toxicity of 5 FU.
- S- phase anti - metabolite Pyr analogue - Colon - solid tumors - & BCC/ - Irreversible myelosuppression
Reversibly inhibit cyclooxygenase (COX I and COX II). Block prostaglandin synthesis.
Aluminum sucrose sulfate polymerizes in the acid environment of the stomach and selectively binds necrotic peptic ulcer tissue. Acts as a barrier to acid - pepsin - and bile.
GI distress - Tooth discoloration and Inhibition of bone growth in children - Fanconi's syndrome - Photosensitivity

2. Esmolol - short or long acting?
very short acting
GI distress - Skin rash - and Seizures at high plasma levels
Suramin
Sulfonamides - Trimethoprim

3. For Heparin What is the Onset of action
1. Cimetadine 2. Ranitidine 3. Famotidine 4. Nizatidine
Rapid (seconds)
vasodilator - increases cGMP to induce smooth muscle relaxation (arterioles>veins; afterload reduction)
Blocks viral penetration/uncoating; may act to buffer the pH of the endosome

4. What is the effect of epinephrine infusion on bp and pulse pressure?
- Normalize K+ - Lidocaine - & Anti - dig Mab
Increased systolic and pulse pressure - decreased diastolic pressure - and little change in mean pressure.
SLUD (salivation - Lacrimation - urination - Defecation)as well as airway secretion - GI motility - acid secretions
Primaquine

5. ACE inhibitors - clinical use?
hypertension - CHF - diabetic renal disease
Beta - lactamase cleavage of Beta - lactam ring
1. Hypoglycemia (more common with 2nd - generation drugs: glyburide - glipizide) 2. Disulfiram - like effects (not seen with 2nd - generation drugs).
They inhibit reuptake of NE at the nerve terminal (as does cocaine).

6. Bretyllium - toxicity?
- Barbiturates - phenytoin - carbamazipine - rifampin - griseofulvin - quinidine
VACUUM your Bed Room'
hyperkalemia - endocrine effects (gynecomastia - anti - androgen)
new arrhythmias - hypotension

7. Explain differences between full and partial agonists(2).
cinchonism: HA - tinnitus - thrombocytopenia - torsade de pointes due to increased QT interval
- Act on same receptor - Full has greater efficacy
Bactericidal for: Gram + rod and cocci - Gram - cocci - and Spirochetes
Penicillin.

8. What is the memory key to remember Which pathway (extrinsic vs. intrinsic) and Which lab value Warfarin affects?
WEPT: Warfarin affects the Extrinsic pathway and prolongs the PT.
Inhibit RT of HIV and prevent the incorporation of viral genome into the host DNA
- Glucocorticoid withdrawal
Acute coronary syndrome; coronary stenting. Decreases the incidence or recurrence of thrombotic stroke.

9. How does dantrolene work?
blocking the beta adrenergic receptor leads to decreased cAMP - and decreased Ca2+ flux
Abortifacient.
Prevents the release of calcium from the sarcoplasmic reticulum of skeletal muscle.
1. Taken daily 2. No protection against STDs 3. Raises triglycerides 4. Depression - weight gain - nausea - HTN 5. Hypercoagulable state

10. Which drug(s) cause this reaction: Torsade de pointes (2)?
- Class III antiarrhythmics (sotalol) - class IA (quinidine)
In treatment of malignant hyperthermia - due to concomitant use of halothane and succinylcholine. Also in neuroleptic malignant syndrome - a toxicity of antipsychotic drugs.
1. Mycobacterium tuberculosis 2. Delays resistance to Dapsone When used of Leprosy 3. Used in combination with other drugs
Increased systolic and pulse pressure - decreased diastolic pressure - and little change in mean pressure.

11. What are the Macrolides used for clinically?
cortical collecting tubule
- Upper respiratory tract infections - pneumonias - STDs: Gram+ cocci (streptococcal infect in pts allergic to penicillin) - Mycoplasma - Legionella - Chlamydia - Neisseria
Polymyxins
Acts as a wide spectrum carbapenem

12. What is the clinical use for Warfarin?
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.)
Chronic anticoagulation.
Protease Inhibitors and Reverse Transcriptase Inhibitors
- Chloramphenicol - benzene - NSAIDS - PTU - phenytoin

13. As an Anes you want to use a depolarizing neuromuscular blocking drug on your pt - What do you use
Acetaminophen has antipyretic and analgesic properties - but lacks anti - inflammatory properties.
Succinylcholine
- Penicillamine
Can affect absorption - bioavailability - or urinary excretion of other drugs by altering gastric and urinary pH or by delaying gastric emptying.

14. What is a mnemonic to remember Amantadine's function?
Polymyxin B - Polymyxin E
Blocks Influenza A and RubellA; causes problems with the cerebellA
Prevents the release of calcium from the sarcoplasmic reticulum of skeletal muscle.
As PABA antimetabolites that inhibit Dihydropteroate Synthase - Bacteriostatic

15. What cholinomimetic is useful in the diagnosis of Myasthenia Gravis
Edrophonium
AZT
Zidovudine (AZT) - Didanosine (ddI) - Zalcitabine (ddC) - Stavudine (d4T) - Lamivudine (3TC)
Norepinephrine

16. What conditions would you use dantrolene?
Oral treatment of superficial infections
In treatment of malignant hyperthermia - due to concomitant use of halothane and succinylcholine. Also in neuroleptic malignant syndrome - a toxicity of antipsychotic drugs.
- Chlorpromazine - thioridazine - haloperidol
Treatment of hypertension - especially with renal disease (lowers bp centrally - so flow is maintained to kidney).

17. What is clinical use for Carbenicillin - Piperacillin - and Ticarcillin?
Pseudomonas species and Gram - rods
Topical and Oral - for Oral Candidiasis (Thrush)
Interstitial nephritis
Botulinum

18. Which drug(s) cause this reaction: Cardiac toxicity?
- Daunorubicin & Doxorubicin
Lipoxygenase
sedation - sleep alterations
Flecainide - Encainide - Propafenone

19. Which drug(s) cause this reaction: Hot flashes?
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.
Mg = Must go to the bathroom.
- Tamoxifen
1. Cimetadine 2. Ranitidine 3. Famotidine 4. Nizatidine

20. Name three Antiarrhythmic drugs in class IC.
The PTT.
Flecainide - Encainide - Propafenone
- Tricyclic antidepressants
Quinolones

21. List the specific antidote for this toxin: Cyanide
- Nitrate - hydroxocobalamin thiosulfate
Inhibits reabsorption of uric acid.
for RSV
Gram + and Anerobes

22. What is Ketoconazole specifically used for?
- Acetaldehyde - Nausea - vomiting - headache - & hypotension
sedation - sleep alterations
Blastomyces - Coccidioides - Histoplasma - C. albicans; Hypercortisolism
Bacitracin - Vancomycin

23. Acetazolamide - toxicity?
hyperchloremic metabolic acidosis - neuropathy - NH3 toxicity - sulfa allergy
- S- phase anti - metabolite folate analogue - Luk - Lymp - sarc - RA - & psoriasis / - Reversible myelosuppression
Post - op and neurogenic ileus and urinary retention - myasthenia gravis - and reversal of neuromuscular junction blockade (post - op) through anticholinesterase activity.
DOC in diagnosing and abolishing AV nodal arrhythmias

24. Adverse effects of Reserpine?
Protease inhibitor.
- S- phase anti - metabolite folate analogue - Luk - Lymp - sarc - RA - & psoriasis / - Reversible myelosuppression
sedation - depression - nasal stuffiness - diarrhea
Stimulating beta receptors stimulates heart rate - but beta receptor induced vasodilation reduces peripheral resistance.

25. What is the effect of norepinephrine on bp and pulse pressure?
Increases mean - systolic - and diastolic bp - while there is little change in pulse pressure.
Inhibits CMV DNA polymerase
- Methotrexate - 5 FU - 6 mercaptopurine
Binds Ergosterol - forms Membrane Pores that Disrupt Homeostatis

26. What are the major structural differences between Penicillin and Cephalosporin?
Nitrates
glaucoma - urinary alkalinization - metabolic alkalosis - altitude sickness
Cephalosporin: 1) has a 6 member ring attached to the Beta lactam instead of a 5 member ring 2)has an extra functional group ( attached to the 6 member ring)
Ganciclovir is more toxic to host enzymes

27. List the mechanism - clinical use - & toxicity of Vincristine.

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

28. Explain potency in relation to full and partial agonists(2).
Triple sulfas or SMZ
Tubocurarine - atracurium - mivacurium - pancuronium - vecuronium - rapacuronium
- partial agonist can have increased - decreased - /A21or equal potency as full agonist. - Potency is an independent factor.
Pentamidine

29. What cholinergic inhibitor acts by directly inhibiting Ach release at the presynaptic terminal
local anesthetic. CNS stimulation or depression. CV depression.
Oral
Botulinum
Atropine pts are suffering from Cholinestrase inhibitor poisining (Nerve gas/Organophosphate poisining)

30. What are four clinical activities of Aspirin?
Ceftriaxone
- Physostigmine salicylate
1. Antipyretic 2. Analgesic 3. Anti - inflammatory 4. Antiplatelet drug.
Malaria (P. falciparum)

31. What do you treat Nematode/roundworm (pinworm - whipworm) infections with?
propanolol - esmolol - metoprolol - atenolol - timolol
Mebendazole/Thiabendazole - Pyrantel Pamoate
Inhibits IMP Dehydrogenase (competitively) - and therefore blocks Guanine Nucleotide synthesis
Beta antagonist.

32. Name four Antiarrhythmic drugs in class III.
impotence - asthma - CV effects (bradycardia - CHF - AV block) - CNS effects (sedation - sleep alterations)
Blocks Peptide Bond formation at the 50S subunit - Bacteriostatic
1. Tolbutamide 2. Chlorpropamide 3. Glyburide 4. Glipizide
Sotalol - Ibutilide - Bretylium - Amiodarone

33. What organisms does Griseofulvin target?
- Oxalic acid - Acidosis & nephrotoxicity
Cardiac glycoside (inotropic agent).
Teratogenic - Carcinogenic - Confusion - Headaches
Dermatophytes (tinea - ringworm)

34. Which drug(s) cause this reaction: Gingival hyperplasia?
Neomycin
Inhibits Viral DNA polymerase
- Phenytoin
Acute coronary syndrome; coronary stenting. Decreases the incidence or recurrence of thrombotic stroke.

35. Furosemide - clinical use?
1. Weight gain 2. Hepatotoxicity (troglitazone)
edematous states (CHF - cirrhosis - nephrotic syndrome - pulm edema) - HTN - hypercalcemia
- Methotrexate - 5 FU - 6 mercaptopurine
Modification via Acetylation - Adenylation - or Phosphorylation

36. Cocaine casues vasoconstriction and local anesthesia by What mechanism
Indirect agonist - uptake inhibitor
- Clindamycin
Same as penicillin. Extended spectrum antibiotics
Ipratropium

37. What is the mechanism of Leuprolide?
Modification via Acetylation
Tendonitis and Tendon rupture
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
Digitoxin 70% Digoxin 20-40%

38. What is the definition of zero - order kinetics? Example?
cholestyramine - colestipol
- Glucagon
- Chloramphenicol - benzene - NSAIDS - PTU - phenytoin
- Constant AMOUNT eliminated per unit time. - Etoh & ASA

39. What is the mechanism of action of Sildenafil (Viagra)?
Inhibits cGMP phosphodiesterase - casuing increased cGMP - smooth muscle relaxation in the corpus cavernosum - increased blood flow - and penile erection.
for RSV
- Nitrate - hydroxocobalamin thiosulfate
toxic

40. Adverse effects of ganglionic blockers?
- aminoglycosides - loop diuretics - cisplatin
severe orthostatic hypotension - blurred vision - constipation - sexual dysfunction
diuretics - sympathoplegics - vasodilators - ACE inhibitors - Angiotensin II receptor inhibitors
Nitrates

41. What is the mechanism of action of Colchicine used to treat acute gout?
Depolymerizes microtubules - impairing leukocyte chemotaxis and degranulation.
1. Kidney transplantation 2. Autoimmune disorders (including glomerulonephritis and hemolytic anemia)
- Infections - Trauma - Seizures - CO - Overdose - Metabolic - Alcohol (IT'S COMA)
Irreversibly inhibits H+/K+ ATPase in stomach parietal cells.

42. What populations are Floroquinolones contraindicated in? Why?
CMV - esp in Immunocompromised patients
1. Bleeding 2. Teratogenicity 3. Drug - drug interactions
Pregnant women - Children; because animal studies show Damage to Cartilage
hyperkalemia - endocrine effects (gynecomastia - anti - androgen)

43. What are common toxicities associated with Tetracyclines?

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

44. How is Leishmaniasis treated?
- Halothane - Valproic acid - acetaminophen - Amantia phalloides
TMP- SMZ
Pentavalent Antimony
Inhibits IMP Dehydrogenase (competitively) - and therefore blocks Guanine Nucleotide synthesis

45. Name five Antiarrhythmic drugs in class II?
toxic
propanolol - esmolol - metoprolol - atenolol - timolol
Flecainide - Encainide - Propafenone
Gram + and Anerobes

46. Which drug(s) cause this reaction: Neuro and Nephrotoxic?
Sotalol - Ibutilide - Bretylium - Amiodarone
- polymyxins
edematous states (CHF - cirrhosis - nephrotic syndrome - pulm edema) - HTN - hypercalcemia
Increased systolic and pulse pressure - decreased diastolic pressure - and little change in mean pressure.

47. Which diuretics decrease urine Ca2+?
Penicillin - Ampicillin - Ticarcillin - Pipercillin - Imipenem - Aztreonam - Cephalosporins
- A57Blue lines in gingiva & long bones - Encephalopathy & Foot drop - Abdominal colic / - Sideroblastic anemia
thiazides - amiloride
Dopamine; causes its release from intact nerve terminals

48. Common toxicities associated with Griseofulvin?
Teratogenic - Carcinogenic - Confusion - Headaches
Immediate anticoagulation for PE - stroke - angina - MI - DVT.
1. Meningococcal carrier state 2. Chemoprophylaxis in contacts of children with H. influenzae type B
1. Heavy bleeding 2. GI effects (n/v - anorexia) 3. Abdominal pain

49. What is the category of drug names ending in - zosin (e.g. Prazosin)
1. Tolbutamide 2. Chlorpropamide 3. Glyburide 4. Glipizide
Alpha -1 antagonist
Blocking muscarinic receptors in the circular fibers of the eye - results in unopposed action of radial muscles to dilate.
1. Acarbose 2. Miglitol

50. What effect would atropine have on a patient with peptic ulcer disease?
compensatory tachycardia - fluid retention - lupus - like syndrome
Theoretically it could be used to block the cephalic phase of acid secretion (vagal stimulation).
Succinylcholine
Sotalol - Ibutilide - Bretylium - Amiodarone