1 Biomedical Sciences Q&A

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Canadian Pharmacy Review

Misbah Biabani, Ph.D Director Toronto Institute of Pharmaceutical Sciences (TIPS) Inc. Toronto, ON M2N K7

Professional Exams Preparation Center 5460 Yong St. Suites # 209 and 303, Toronto, ON, M2N 6K7 WWW.PHARMACYPREP.COM 416-223-PREP (7737) / 647-221-0457/416-696-2455 Toronto Institute of Pharmaceutical Sciences Inc. © 2000- 2008 TIPS Inc. All Rights Reserved.

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Canadian Pharmacy Review Disclaimer

Your use and review of this information constitutes acceptance of the following terms and conditions: The information contained in the notes intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor or pharmacist can provide you with advice on what is safe and effective for you. Pharmacy prep make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, Pharmacy prep do not assume any responsibility or risk for y our use of the pharmacy preparation manuals or review classes. In our teaching strategies, we utilize lecture-discussion, small group discussion, demonstrations, audiovisuals, case studies, written projects, role play, gaming techniques, study guides, selected reading assignments, computer a ssisted instruction (CAI), and interactive video discs (IVD). Our preparation classes and books does not intended as substitute for the advise of ®

NABPLEX . Every effort has been made made to ensure that the information provided herein is not ®

directly or indirectly obtained from PEBC previous exams or copyright material. These references are not intended to serve as content of exam nor should it be assumed that they are the source of previous examination questions. ©2000-2008 TIPS. All rights reserved. Foreword by Misbah Biabani, Ph.D Coordinator, Pharmacy Prep Toronto Institute of Pharmaceutical Sciences (TIPS) Inc 5460 Yonge St. Suites 209 and 303 Toronto ON M2N 6K7, Canada


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Canadian Pharmacy Review Disclaimer

Your use and review of this information constitutes acceptance of the following terms and conditions: The information contained in the notes intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor or pharmacist can provide you with advice on what is safe and effective for you. Pharmacy prep make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, Pharmacy prep do not assume any responsibility or risk for y our use of the pharmacy preparation manuals or review classes. In our teaching strategies, we utilize lecture-discussion, small group discussion, demonstrations, audiovisuals, case studies, written projects, role play, gaming techniques, study guides, selected reading assignments, computer a ssisted instruction (CAI), and interactive video discs (IVD). Our preparation classes and books does not intended as substitute for the advise of ®

NABPLEX . Every effort has been made made to ensure that the information provided herein is not ®

directly or indirectly obtained from PEBC previous exams or copyright material. These references are not intended to serve as content of exam nor should it be assumed that they are the source of previous examination questions. ©2000-2008 TIPS. All rights reserved. Foreword by Misbah Biabani, Ph.D Coordinator, Pharmacy Prep Toronto Institute of Pharmaceutical Sciences (TIPS) Inc 5460 Yonge St. Suites 209 and 303 Toronto ON M2N 6K7, Canada


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Content Abbreviations

Part I: Biomedical sciences 1. Cell Physiology and human skeleton 2. Gastrointestinal anatomy, physiology and Pathophysiology 3. Neurophysiology, and Pathophysiology 4. Cardiovascular anatomy, physiology and Pathophysiology 5. Endocrine physiology and Pathophysiology 6. Renal physiology and electrolyte disorders 7. Liver Function and Pathophysiology 8. Blood composition and anemia 9. Biochemistry 10. Clinical Biochemistry 11. Nutrition 12. Microbiology 13. Genetics and Molecular Biology 14. Pharmacogenomics 15. Immunology 16. Immunizations (vaccines) 17. Biotechnology 18. Toxicology


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Cell Physiology and Human anatomy

PHARMACY PREP CELL PHYSIOLOGY AND HUMAN SKELETON 1-Phenobarbital (acidic) pH is 3.4 and pKa is 3.4, what percent drug will ionized in the body. A-90% B-99% C-100% D-50% E-10% Ans-D Comments: pH – pKa = 0 is 50% ionized and 50% unionized. If PH = pKa is 50% drug is ionized and 50% unionized. 2- If the pKa of weak base drug is 4.4 and you have an ambient temperature with pH 7.4 I-The drug will be almost completely ionized II-The drug will be rapidly excreted III-The drug will not be ionized neither excreted a) I only b) III only c) I and II only d) II and III only e) All are correct Ans-B Comments: 99.9% drug is unionized and do not excrete. 0.09% drug is ionized excrete but slow. 3- Absorption of water-soluble drug: a) Well absorbed all over the body b) Cross BBB very fast c) Poor absorption through BBB d) Poor absorption through placenta e) C and D are right Ans- E Comments: The drug cannot be too acid or too base or too water-soluble or too lipid soluble because these interfere with the absorption. Complectly water-soluble drug will have poorly absorption through blood brain barrier and through placenta because these tissues are lipid constituted and water-soluble drugs tends to cross these barrier very slow due to have no affinity with these barriers. 4- Fick’s law is a theory very used in pharmacokinetic that describes: a) The movement of the molecules across barriers b) The stability of a drug molecule in room temperature c) The rate of drug absorption versus the rate of drug elimination d) The process of bioavailability of drugs e) The drugs mechanism of action at its receptor site Copyright © 2000-2008 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions sessions conducted by PharmacyPrep. PharmacyPrep.

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Ans- A Comments: Fick’s

law is a theory very used in pharmacokinetic that describes the movement of the molecules across barriers 5. According to the Noyes-Whitney equation, which of the following statements is not true? a) The greater the difference in concentration across the diffusion layers the faster the dissolution rate. b) Decreasing surface area increases dissolution rate. c) The greater the solubility, the greater the dissolution rate. d) Agitation will generally increase dissolution rate. Ans: B 6. Etiology is concerned primarily with a) Symptomology b) Racial origin c) Causation d) Language facility Ans-C 7. Movement of limb or body part closer to or towards the mid line of the body is a) Abduction b) Adduction c) Extension d) Flexion e) Eversion Ans: B 8- Planes and Sections of the body: separates the body into unequal right and left portions is referred as: A-Sagittal plane B-Midsagittal plane C-Coronal plane D-Parasagittal plane E-Oblique Ans-D Tips: Sagittal plane Separates the body into right and left portions Midsagittal plane (Median plane) separates the body/body part into equal right/left portions Parasagittal plane separates the body into unequal right and left portions. Coronal plane separates the body/body-part into anterior and posterior portions. Transverse plane divides the body/body-part into superior and inferior portions. Oblique plane  passes through the body/body-part at an angle 9-Hip joints are? A-Pubis, illium, ischium B-Scapula, illium and Ischium

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C- Humerus, Illium, and Ischium D- Ligament, Humerous, scapula Ans-A 10-What is the other name of blind spot? A-Optic disc B-Retina C-Cornea D-Optic nerve E-None of the above Ans-A 11-What is the rate-limiting step in ophthalmic drops? A-Optic disc B-Retina C-Cornea D-Optic nerve E-None of the above Ans-C 12-At night dark, what is the active part in retina? A-Cones B-Rods C-Cones and rods D-Optic nerve E-Cornea Ans-B 13-All of the following hormones are released from anterior pituitary gland, except? A-Leutinizing hormone B-Follicular stimulating hormones C-Antidiuretic hormone D-Prolactin hormone E-Thyroid stimulating hormone Ans-C 14-Dyspnea means: A-Pain in muscles B-Difficulty breathing (laboured breathing) C-Painful heart D-Painful breathing E-Shortness breathe Ans-B

15-Pernicious anemia


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A-Due to deficiency intrinsic factor thus no oral vitamin B12 absorption B-Due to deficiency of vitamin B12, administer oral vitamin B12 C-Due to deficiency of folic acid supplements, administer folic acid supplements D-Due to deficiency of iron supplements, administer iron supplements E-Due to deficiency of vitamin B12 and folic acid supplements Ans-A


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Gastrointestinal anatomy, physiology and Pathophysiology

PHARMACY PREP GASTROINTESTINAL ANATOMY, PHYSIOLOGY AND PATHOPHYSIOLOGY 1-Steatorrhea is results due to? A-Fat absorption impaired B-Indigestion of carbohydrate C-Secretion of vitamin A, D, E and K D-Excessive absorption of lipids E-None of the above Ans-A 2-Cystic fibrosis is? A-Disorder of pancreatic secretion B-Disorder lung function C-Disorder of bones D-Disorder of electrolyte imbalance E-disorder of bladder Ans-A 3-The lower part of gut contain the following microorganisms A-10-50% anaerobic B-90-95% anaerobic C-10-50% aerobic D-90-95% aerobic E-lower part of gut does not have any microbes Ans-B 4-What is most basic in gastrointestinal tract? A-Esophegus B-Stomach C-Small intestine D-Colon E-Mouth Ans-D


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Neurophysiology and Pathophysiology

PHARMACY PREP NEUROPHYSIOLOGY AND PATHOPHYSIOLOGY 1-The pharmacological actions of the following drug and action combinations are not suitable: A-Physostigmineconvulsions B-Pilocarpinereduces intraocular pressure C-Acetylcholinereduce HR and CO D-Bethanechol stimulates atonic bladder E-Carbachol decreases epinephrine production Ans-E Comment: carbachol stimulates the production of epinephrine 2-A 45-year-old male patient with high blood pressure and prostatic hyperplasia should not take? A-Terazosin B-Propranolol C-Benztropine D-Captopril E-Losartan Ans-C 3-Which one of the following drug does not resemble in side effect of the other drugs and may cause diarrhea: A-Atropine B-Scopolamine C-Benztropine D-Edrophonium E-Ipratropium AnsTips: All of the above are anticholinergic, except edrophonium which is a cholinergic agonist. 4-All of the following can be used in urinary incontinence, EXCEPT: A-Atropine B-Amitriptyline C-Nortriptyline D-Ipratropium bromide E-Doxazocin Ans-E 5-All of the following drugs have miosis side effect EXCEPT: A-Atropine B-Carbachol C-Isoflurophate D-Neostigmine E-Pilocarpine Copyright © 2002-2008 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by Pharmacy Prep.

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Ans-A Tips: Atropine cause mydriasis 6-All of the following are correct combinations except: A-Succinyl cholinedepolarizes neuromuscular end plates B-Ipratropium adjunctive treatment in asthma with albuterol C-Neostigmine reverse the effect of non depolarizing tubocurarine D-Atropinemay act on peripheral and central cholinergic receptors E-Atracurarium induce histamine release (side effect). Ans-C 7-Sumatriptan is widely used in migraine treatment by acting as: a) 5HT1D/1B Agonist b) GABA-A c) BZ-1 d) Enkephalin e) Dopamine Ans-A

8-Enkephalins are: A-Benzodiazepine receptors B-Peptide type of opioid neurotransmitter C-Opioid receptors D-Peptides in cell cycle E-Regulates pain function E-Enzymes that metabolize opioids Ans-B

9-Which of the following is the precursor of no repinephrine A-Epinephrin B-Dopamine C-Dopa D-Tyrosin E-Histamine Ans-B Tips: Tyrosine  dopa  dopamine  norepinephrine  epinephrine 10-Which of the following is the precursor of e pinephrine A-nor epinephrine B-Dopamine C-Dopa D-Tyrosin E-Histamine

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Ans-A 11-The following amino acid is the precursor of serotonin A-Tyrosine B-Histamine C-Tryptophan D-Indole acetic acid E-Glycine Ans-C Tips: Tryptophan  hydroxytryptophan  Serotonin 12-The following drug completely blocks the sodium ion channels, and abolishes action potential. A-Bungarotoxin B-Tetradotoxin C-Digoxin D-Carbamazepine E-Phenytoin Ans-B 13-Malathion (a organophosphate) is a pesticide, classified as: I-Cholinergic antagonist II-Cholinergic indirect irreversible antagonist III-Organophosphates A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-B 14-The organophosphates used as insecticides, act by which of the following mechanism: A-Increasing acetylcholine by combination B-Increasing acetylcholinesterase action C-By forming a very stable complex with acetylcholinesterase D-Reacting at the cholinergic receptor E-All of the above Ans-C 15-Pancuronium classified as: A-Cholinergic agonist B-NMJ depolarizing blocker C-Adrenergic agonist D-Comparative non-depolarizing blocker E-Adrenergic antagonist


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Ans-D Tips: comparative non depolarizing blockers 16-The following drug can be used in open angle glaucoma; I-Timolol II-Pilocarpine III-Latanoprost A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-E 17-Mechanism of action of pilocarpine in glaucoma treatment: A-Inhibits the secretion of ophthalmic fluid B-Lowers the intraocular pressure (IOP) by opening the trabecular meshwork around Schlemm’s canal by activating ciliary muscle of eye C-Stimulates the secretion of saliva, results in reduction of IOP D-It bind mainly nicotinic receptors and causes lower IOP E-Less effective in lowering the IOP. Ans-B 18-All of the following are side effects of neostigmine, EXCEPT: A-Salivation B-Flushing C-Convulsions D-Diarrhea E-Abdominal motility Ans-C Tips: Neostigmine contain quaternary amine salt structure and cannot cross blood brain barrier, therefore have no CNS side effects. Physostigmine can cross blood brain barrier and have convulsion side effects, and indicated in glaucoma. 19-All of the following can be used in smoking cessation, EXCEPT: A-Wellbutrin (bupropion) B-Zyban (bupropion) C-Nicotine transdermal patch D-Nicotine inhaler E-Nicotine gum Ans-A Tips: Wellbutrin is indicated as antidepressants 20-Atropine overdose can be treated by: A-Methyldopa B-Scopolamine


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C-Physostigmine D-Neostigmine E-organophosphates Ans-D 21-All of the following drugs have diarrhea as side effect EXCEPT: A-Neostigmine B-Bethanechol C-Atropine D-Physostigmine E-Acetylcholine Ans-C Tips: atropine is anticholinergic and the other drugs are cholinergic agonist.


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Cardiovascular anatomy, Physiology and pathophysiology

PHARMACY PREP CARDIOVASCULAR ANATOMY, PHYSIOLOGY AND PATHOPHYSIOLOGY 1-Absolute refractory period (ARP) reflects the time during which no action potential can be initiated regardless of how much inward current are supplies. The ARP begins and ends at/ A-Phase I to Phase 2 B-Phase 0 to phase 1 C-Phase 1 to phase 2 D-Phase 1 to phase 3 E-Phase 2 only Ans-D 2-Angiotensin-converting enzyme (ACE) catalyzes the conversion of Angiotensin I to Angiotensin II, primarily in? A-Kidney B-Blood C-Lungs D-Liver E-Heart Ans-C 3-Which of the following statement is incorrect about vasopressin (antidiuretic hormone ADH)? A-It is potent vasoconstrictor that increase TPR in arterioles B-Increase water resorption by renal distal tubule and collecting ducts. C-ADH released when atrial receptors detect the decrease in blood volume D-All of the above E-None of the above Ans-D 4-Which of the vasoactive hormone causes arterial constriction? A-histamine B-Bradykinin C-Prostaglandin D-Thromboxane A2 E-Prostacyclin Ans-D 5-Myocardial contractility is best correlated with the intracellular concentration of 2+ A-Ca + B-Na + C-K D-Cl 2+ E-Mg AnsCopyright © 2002-2008 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by Pharmacy Prep.

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Cardiovascular anatomy, Physiology and pathophysiology

Ans-A Tips: Myocardial cell contractions depends on the intracellular Ca2+. Which regulated by calcium ion entry across the cell membrane during the plateau of the action potential. 6-Aldosterone is secreted by adrenal cortex. What is incorrect about aldosterone? A-Increases sodium chloride (NaCl) reabsorption by the renal distal tubules thereby increase blood volume and arterial pressure B-It causes vasoconstriction of the arterioles, thus increase TPR and mean arterial pressure C-Angiotensin II stimulates the synthesis and secretion of aldosterone by the adrenal cortex D-all of he above E-none of the above Ans-D


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Endocrine Anatomy, Physiology, and Pathophysiology

PHARMACY PREP ENDOCRINE ANATOMY, PHYSIOLOGY AND PATHOPHYSIOLOGY 1-Thyroid stimulating hormone (TSH) secretes from? A-Anterior pituitary gland B-Posterior pituitary gland C-Thyroid gland D-Parathyroid gland E-None of the above Ans-A 2-Aromatized ring A is present in? A-Progesterone B-Etrogen C-Testosterone D-Androgen E-aldosterone Ans-B 3-Primary adrenocorticcal insufficiency can lead to: A-Cushing syndrome B-Myxidema C-Addison disease D-Graves disease E-Hashimoto disease Ans-C 4-What is incorrect about comparison of insulin and glucogon A-Insulin ↓ blood glucose levels and glucogon ↑ blood glucose levels B- ↑ blood glucose levels stimulates production of insulin C-↓ blood glucose levels stimulates production of glucagons D-Insulin increase glucose uptake and glycogen formation E-Insulin causes hyperkalemia Ans-e 5-In pregnancy progesterone is produced by? I-Corpus luteum II-Placenta III- Pituitary gland a) I only b) III only c) I and II only d) II and III only e) All are correct Ans-C Copyright © 2002-2008 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by Pharmacy Prep.

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6-Intracellular enzyme that generate free radicals include: A-Cisteine B-Superoxide desmutase C-Hydrogen peroxide D-Hydroxyl ion E-None of the above Ans-B 7-Free radicals include: I-Hydrogen peroxide II-Benzoyl peroxide III-Superoxide desmutase a) I only b) III only c) I and II only d) II and III only e) All are correct Ans-C 8-Calcium ion is: A-Intracellular ion B-Extracelluar ion C-Extracelluar anion D-Intracellular anion E-None of the above Ans-B 9-Amenorrhea may be described as: A-Impotence B-Premenstrual symptoms C-Menopause D-Painful menstruation E-Missing menstruation Ans-E Tips: Amenorrhea is absence of menstruation Dysmenorrhea is painful menstruation

10-Primary dysmenorrhea is caused by: A-Decreased levels of prostaglandin B-Increased levels of prostaglandin c-Endometriosis D-Improper posture E-None of the above Ans-B


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11-A wasting due to lack of nutrition to a body part is? A-Hypertrophy B-Atrophy C-Aplasia D-Hyperplasia E-Gernotopia Ans-B Tips: wasting is loss of function and tissue death. 12-Dyspnea means: A-Pain in muscles B-Painful breathing C-Painful heart D-Painful lung E-Pain in bone joints Ans-B 13-Hyperthyroidism causes? A-slow speech B-impaired memory C-hyperexcitability D-decreased mental capacity E-somnolence Ans-C


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PHARMACY PREP RENAL DISORDERS 1-Factors that my increase the risk of renal failure may include: a) Hemorrhage b) Heart diseases c) Oliguria d) Pulmonary edema e) All are correct Ans-E 2-The shock and airway edema of anaphylaxis may be best treated by administration of which of the following agents? a) Salbutamol b) Diphenhydramine c) Adrenaline d) Acetazolamine e) Aminiphyline Ans-C 3-Characteristics of nephrotic syndrome may include all o f the following, EXCEPT: a) Protein urea b) Hypoalbuminemia c) Edema d) Hyperalbuminemia e) Hyperlipidemia Ans-D 4-Cholecystitis, normally characterized by edema and congestion to severe infection with gangrene and perforation is an inflammation of: I- Gallbladder II- Liver III- Heart a) I only b) III only c) I and II only d) II and III only e) All are correct Ans-A Tips: Cholecystitis is an inflammation of gallbladder. Its acute form is normally characterized by edema and congestion to severe infection with gangrene and perforation. 5. All of the following statements about renal failure are correct EXCEPT: a) Increased total body clearance Copyright © 2000-2008 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep.

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Pharmacyprep.com b) Increase drug half life c) Decrease body clearance d) Affect drugs that excrete via kidneys e) Drugs metabolized via liver are the least to be affected Ans: A 6. Secretion of potassium ions by the distal tubule will be decreased by a) Metabolic alkalosis b) A high potassium diet c) Hyperaldosteronism d) Spironolactone administration e) Thiazide administration Ans: D + Tips: Spironolactone diuretics act at distal tubules and prevents K secretion, thus it causes hyperkalemia. 7-Azotemia means? A-Increase in nitrogen waste in body B-Increase in nitrogen waste in urine C-Decrease in nitrogen waste in body D-Decrease in nitrogen waste in urine E-No change in nitrogen Ans-A Tips: renal disease (glomerular filtration), decrease excretion of urea into urine, that leads to urea retention in blood, it is referred as azotemia or uremia. -

8-A man with history of severe diarrhea, the loss of HCO 3 from GI tract causes a decrease in blood [HCO3 ], his values is: Thus this man has? PH = 7.25 Pco2 = 24 mmHg [HCO3-] = 10 mEq/L A-Metabolic alkalosis B-Metabolic acidosis C-Respiratory acidosis D-Respiratory alkalosis E-Normal acid base status Ans-B


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Liver Function and Diseases

PHARMACY PREP LIVER PHYSIOLOGY AND PATHOPHYSIOLOGY 1-Hepatitis A mainly cause by: A-Sexual contact B-Blood transfusion C-Food and drink contamination D-Traveling abroad E-Oro-fecal Ans-C 2-Which of the following is NOT a chronic hepatitis infections? A-Hepatitis A B-Hepatitis B C-Hepatitis C D-Hepatitis B and C E-None of the above Ans-A 3-Travelers should receive, the following vaccinations, except? A-Hepatitis A B-Hepatitis B C-Dukoral D-Gerdasil E-None of the above Ans-D 4-Acetominophen hepatotoxicity can be reduced by: A-Glucuronidation B-Glutathione conjugation C-Acetylation D-Sulfate conjugation E-Methylation Ans5-Which of the following non-toxic product of glutathione conjugation? A-Acetylcysteine B-cysteine C-Mercapturic acid D-Glutathione conjugation E-Glutathione only Ans-C


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Liver Function and Diseases

Tips: Hepatitis vaccination is recommended for travelers. Dukoral is oral vaccine for travelers diarrhea. Gerdasil is vaccine human papilloma virus (HPV), which is administered in teenagers to prevent cervical cancer.


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Blood and Anemia

PHARMACY PREP BLOOD AND ANEMIA 1-Microcytic anemia is characterized as? A-Iron deficient anemia B-Vitamin B12 deficient anemia C-Folate deficient anemia D-Sickle cell anemia E-Pernicious anemia Ans-A 2-A 75 year old elderly person have deficiency of cyanocobalamine, this can lead to: I-Megalobastic anemia II-Mycrocytic anemia III-Intrinsic factor A-I only B-III only C-I and II Only D-II and III only E-All of the above Ans-A 3-Megaloblastic anemia may be caused due to a result of: I-Folic acid deficiency II-Vitamin B12 deficiency III-Iron deficiency a) I only b) III only c) I and II only d) II and III only e) All are correct Ans- C Comments: Iron deficiency is called mycrocystic anemia while megaloblastic anemia is a deficiency of cyanocobalamin and folic acid. 4-Filgrastin is: A-Interleukin B-Colony stimulating factor C-Tumor necrosis factor D-Oprelvekin E-Erythropoietins Ans-B 5-The MOST common cause for megaloblastic an emia is a) Gastric bleeding Copyright © 2000-2008 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep.

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Blood and Anemia

b) Lack of dietary iron c) Lack of dietary folic acid d) Lack of dietary pyridoxine e) Lack of absorption of vitamin B12 Ans-C 6-Hematocrit is? A-Circulating iron storage B-Measures the total iron binding capacity C-Measures the total free iron D-Mean volumen of iron E-It is transferrins Ans-A 7-Which of the following blood cells cannot be distinguished from basophils? A-Neutrophils B-White blood cells C-Eosinophils D-Red blood cells (RBC) E-Mast cells Ans-e


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Biochemistry Test

PHARMACY PREP BIOCHEMISTRY

1-Glycine reaction is normally mediated by: a) Acetyl Coenzyme A b) UDP Glucoronyl tranferase c) PAPS- Phosphoadenosine-5-Phosphosulfate d) Sulfotranferase e) GST-Glutathione S-Transferase 2- Abundant element in the interstitial fluid may include: a) Potassium b) Sodium c) Magnesium d) Calcium e) Chloro 3- Which is responsible for NO in vivo? a) Argenine b) Tryptophan c) Guanine d) Thiamine e) Leucine 4- Enzyme that enables DNA fragments from different sources to be joined: a) DNA polymerase b) DNA gyrase c) DNA ligase d) RNA transferase e) None of the above 5- Which of the followings are types of RNA? I- RNAt - RNA transferase II- RNAm – RNA mensager III-RNAr – RNA ribossome a) I only b) III only c) I and II only d) II and III only e) All are correct 6- Which vitamin is/are fat-soluble? I- Vitamin E II- Vitamin K

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Biochemistry Test

III- Vitamin B a) I only b) III only c) I and II only d) II and III only e) All are correct 7-Which of the following vitamin is not water-soluble? a) Vitamin B b) Vitamin C c) Vitamin D d) Folic acid e) Riboflavin 8- The most abundant metal ion in human body a) Iron b) Magnesium c) Aluminum d) Phosphorous e) Potassium 9- Which of the following is considered the normal potassium serum in human body? a) 2.0 to 3.5mEq/L b) 3.5 to 5.0mEq/L c) 5.0 to 7.5mEq/L d) 3.5 to 7.5mEq/L e) 3.0 to 6.0mEq/L 10- Which of the following is considered normal sodium serum in human body? a) 35 to 47 mEq/L b) 147 to 150 mEq/L c) 135 to 147mEq/L d) 75 to 135 mEq/L e) 125 to 145 mEq/L 11- Which of the following is considered as essential vitamin for breast-feed babies? a) Vitamin A b) Vitamin B c) Vitamin C d) Vitamin D e) Vitamim E 12- Which of the following hormone acts on cell wall? a) Insulin b) Prolactin c) Cortisol


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Biochemistry Test

d) Estrogen e) Alanine 13- Which of the following vitamins has tetrahydrofolate coenzyme activity based on its pteridine ring? a) Thiamine b) Vitamin D c) Vitamin K d) Folic acid e) Pyridoxine 14- What is correct regarding the formation of proteins? a) Formed by condensation of peptic bond b) Geometric sequence of amino acids c) The formation occurs by complexation of amino acids d) Proteins are formed from carbohydrates e) None of the above is right 15- Which is the strongest endogenous analgesic-pain producer in human body? a) Leukotriene b) Enkephalin c) Bradykinin d) Cytokine e) Angiotensin 16- Which of the following is considered the FIRST precursor of vitamin A formation? a) Retinoic acid b) Carotene c) Cobalt d) Calciferol e) Pantothenic acid

17- Biological catalysts responsible for supporting almost all of the chemical reactions that maintain human life process: a) Nucleic acid b) Amino acids c) Carbohydrates d) Oligopeptides e) Enzymes 18- Which of the following statements is/are correct regarding enzymes? I-Enzymes are proteins II- Enzymes are catalyst because they are never altered during a reaction III- Michaelis-Menten theory describe the enzymatic reactions a) I only


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Biochemistry Test

b) III only c) I and II only d) II and III only e) All are correct 19- Zwintter ion reacts with a substrate as: a) Neutral ion b) Proton acceptor ion c) Proton donor ion d) Anionic e) Cationic 20- Correct statements regarding mutation may include : I- Cell division II- Change in genotype III- Change in DNA replication altering the gene a) I only b) III only c) I and II only d) II and III only e) All are correct 21- Which pyrimidine base is not present in DNA? a) Thiamine b) Adenine c) Uracil d) Cytosine e) Guanine 22- The codon sequence Adenine-Guanine-Cytosine-Uracil is seen in I- RNAs II- DNAs III- Both DNAs and RNAs a) I only b) III only c) I and II only d) II and III only e) All are correct 23- Shaped network present in the cell between nucleus and cell wall: a) Ribossomes b) Endoplasmic reticulum c) Mitocondria d) Cell membrane e) Nucleotide


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Biochemistry Test

24- The Michaelis-Menten equation-Enzymatic reactions will appears ZERO order when: a) The substrate concentration is much smaller than Km b) When Km is much smaller than the substrate concentration c) When Vmax is much smaller than Km d) When Vmax is much larger than Km e) When Km approaches Vmax 25- Which vitamin can be classified as hormone? a) Vitamin D b) Vitamin D3 c) Vitamin E d) Vitamin K e) Vitamin B12 26- False statement regarding vitamin D3 metabolism include: a) Vitamin C facilitates absorption of vitamin D3 in the liver b) Hydroxylation of D3 is in kidney c) Hydroxylation of is D3 in the liver d) Parathyroid hormone activate metabolism of vitamin D3 in the kidney e) Skin activates synthesis of vitamin D3 by sunlight 27- Hydrolysis of fixed oils may yields: a) Saturated + Unsaturated acids b) Glycerol + Fatty acids c) Glucose + Fatty acids d) Fatty acids + Triglycerideos e) None of the above 28- Example of compound that is phospholipid include: a) Glycogen b) Leucine c) Lecithin d) Hyaluronic acid e) Phenylalanine 29- In an enzymatic reaction, addition of competitive inhibitor leads to: a) Increase the rate of reaction b) Decrease the rate of reaction c) Same rate of reaction d) Decrease rate and increase substrate concentration e) Decrease both rate and substrate concentration

30- Which of the following is the end products of ANAEROBIC reactions? a) Pyruvic acid


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Biochemistry Test

b) CO2 c) CO2 + H2O d) Lactic acid e) Proteins

CORRECT ANSWERS BIOCHEMESTRY 1- A Comments:

Glycine reaction is a reaction mediated by acetyl Coenzyme A.

2- B Interstitial fluid is situated between parts or in the interspaces of a tissue therefore outside the cells. Sodium is the most abundant element outside the cells therefore in the interstitial fluid.

Comments:

3- A Comments:

Argenine is an essential amino acid responsible for N.

4- C DNA ligase is an enzyme that enables DNA fragments from different sources to be joined. Comments:

5- E Comments:

All, RNA transferase, RNA mensager and RNA ribosome are types of RNAs.

6- C Comments:

All vitamins B and vitamin C are water-soluble.

7- C Comments:

Vitamin A, D, E and K are fat-soluble vitamins.

8- A Comments:

Iron is the most abundant metal ion in human body.

9- B Comments:

Normal potassium serum in human body range between 3.5 to 5.0mEq/L.

10- C Comments:

Normal sodium serum in human body range between 135 to 147mEq/L

11- D Comments:

The most essential vitamin for breast-feed babies is vitamin D.

12- A


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PharmacyPREP.COM Comments:

Biochemistry Test

Insulin is a hormone that acts on cell wall

13- D Folic acid is a vitamin B9 that has tetrahydrofolate coenzyme activity based on its pteridine ring. Comments:

14- A Proteins are formed by a reaction between amino acids called condensation between peptid bonds. Comments:

15- C Comments:

Bradykinin is the strongest endogenous analgesic-pain producer in human

body. 16- B Comments:

Vitamin A is formed from retinoic acid that is formed from beta-caroteno.

17- E Enzymes are biological catalysts responsible for supporting almost all of the chemical reactions that maintain human life process, and accelerate reactions by lowering the energy of the transition state.

Comments:

18- E Enzymes are proteins or biological catalysts responsible for supporting almost all of the chemical reactions. They are called catalyst because are never altered during a reaction. Michaelis-Menten theory describes the enzymatic reactions.

Comments:

19- A Zwintter ion is a neutral ion with two charges, positive and negative, that reacts neutrally with a substrate.

Comments:

20- D Mutation is a permanent transmissible change in the genetic material, usually in a single gene. Comments:

21- C Comments:

Uracil is only present in RNAs.

22- A The codon sequence Adenine-Guanine-Cytosine-Uracil is seen in RNAs only. DNAs differ only in the presence of Thiamine instead of uracil.

Comments:

23- B Endoplasmic reticulum is a shaped network present in the cell between nucleus and cell wall. Comments:


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Biochemistry Test

24- E The Michaelis-Menten equation-Enzymatic reactions will appears ZERO order when Km approaches Vmax and FIRST order when the substrate concentration is smaller than Km. Comments:

25- B Vitamin D3 man be classified as hormone

Comments:

26- A Comments: Vitamin

C does not interfere with absorption of vitamin D3 in the liver.

27- B Comments: Glycerol

and fatty acids are the end products of hydrolysis of fixed oils.

28- C Comments: Lecithin

is a phospholipid

29- C Comments: Addition

of competitive inhibitor in an enzymatic reaction does not alter the

rate of reaction. 30- D Comments: Pyruvic

acid is the end product of anaerobic reactions

31- C Comments:

CO2 and H2O are the end products of aerobic reactions.

32- C Comments: Histadiol,

cysteine, aspartame and glutamine are examples of non-essential

amino acids 33- E Comments:

Glycine is not an essential amino acid.

34- B Comments: Urea

is the end product of proteins.

35- C Comments: Purine

is the end product of uric acid.

36- E Comments:

Enzymes of Kreb’s cycle, enzymes of respiratory pathway as well cytochrome oxidase and enzymes of fatty acid cycle are present in the mitochondria structure of the cell.


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Biochemistry Test

37- D Comments:

Glucase is the main carbohydrate present in the human blood.

38- B Jenus green is a laboratory test that detects the presence of mitochondria in the living cell 39- A Comments: Maltase and cellulose are both carbohydrates not synthesized during human metabolism, however maltase is disaccharide and cellulose is a polysaccharide carbohydrate. Comments:

40- C β-carotene is the precursor of vitamin A. The transformation reaction happens in the liver by oxidation. Comments:


28

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Clinical Biochemistry

PHARMACY PREP

CLINICAL BIOCHEMISTRY 1-Thyroid Replacement therapy for hypothyroidism should be monitored by: A-Free T4 B-Sensitive TSH assay C-Free thyroxine assay D-Total thyroxin E-None of the above Ans2-Serum TSH are elevated in? A-Hyperthyroidism B-Hypothyroidism C-Hyperparathyroidism D-Hypoparathyroidism Ans-B 2-What are the normal chloride levels in body? A-95-105mEq/L B-100-125mEq/L C-100-200mEq/L D-125-150mEq/L E-200-250mEq/L Ans-A 3. Which of the following plasma proteins has the GREATEST ability to bind drugs a) Albumin b) Fibrinogen c) Hemoglobin d) Gamma globulin e) Beta lipoprotein Ans: A 4. Which of the following is not the correct match: A-Hypoparathyroidism hypocalcimia B-Hypoparathyroidism  hyperphosphetemia C-Hyperparathyroidism  hypercalcemia D-Hyperparathyroidism  causes deficiency phosphates E-Hyperparathyroidism  causes deficiency of calcium Ans-E


29


Clinical Biochemistry

5. All of the following are tests are used in monitoring hypothyroidism EXCEPT; A-Sensitive TSH assay B-Thyrotropic (TSH) stimulation test C-Free thryoixine index (FTI) D-Total thyroxine (TT4) E-Resin triiodothyronine uptake (RT3U ) Ans-B 6-Which of the following is NOT decreased in elderly? A-Creatinin clearance B-Serum creatinin C-Blood urea nitrogen D-Albumin E-Adipose tissue Ans-E


30


Nutrition

PHARMACY PREP

NUTRITION 1-Vitamin A is: I-Retinol II-Retinal III-Retinoic acid A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-E Tips: Vitamin A is mixture of retinol (alcohol), retinal (aldehyde) and retinoic acid (acid). 2-Precursor of vitamin A: I-Carotinoids II-Retinol III-Retinal A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-A 3-Source of vitamin A I-Fish II-Green vegetables III-Carrots A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-E 4-Forms of vitamin A found in rods of retina: A-Cis-retinal B-Trans retinal C-Rhodopsin D-Retinoic acid Ans5-Topical acne treatment tretinoin (Retin A) is: Copyright © 2000-2008 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep.

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Nutrition

I-13-cis retinoic acid II-12-isomer of retinoic acid III-13-trans retinoic acid A-I only B-III only C-I and II only D-II and III only E-All of the above Ans- B Tips: Topical Tretinoin is 13-Trans retinoic acid (RetinA) TTT; Oral isotretinoin is 13cis retinoic acid (accutane) 6-Which of the following drugs that cause vitamin B6 deficiency: I-Isoniazid II- Penicillamine III- Resins A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-C Tips: Penicillamine and Isoniazid may cause vitamin B6 deficiency. 7-Which of the following should be avoided with vitamin B6? A-Isoniazid B-Penicillamine C-Levodopa D-Dopamine E-Carbidopa Ans-C 8-Which of the following vitamin decreases in chronic alcoholics? A-Vitamin A B-Vitamin B1 (Thiamine) C-Vitamin C D-Vitamin B12 E-Vitamin E Ans-B 9-Which of the following vitamin decreases in smokers? A-Vitamin A B-Vitamin B C-Vitamin C D-Vitamin D E-Vitamin E


32


Nutrition

Ans-C 10-Which vitamin structure is related to steroidal hormone structures? A-vitamin A B-vitamin B C-Vitamin C D-Vitamin D E-Vitamin E Ans11-Ergocalceferol is: A-Vitamin C B-Vitamin D2 C-Vitamin D3 D-Vitamin E E-Vitamin K Ans-B 12-Cholecalciferol: A-Vitamin C B-Vitamin D2 C-Vitamin D3 D-Vitamin E E-Vitamin K Ans-C 13-Vitamin: A-It is cofactor B-It is inorganic substance C-It is catalyst D-It is organic substance E-It is enzyme Ans-D 14-Chemical ring structure in folic acid that binds to para aminobenzoic acid is; A-PABA ring B-pteridine ring C-Glutamate D-Quinolone ring E-Epoxide ring Ans-B 15- Elderly have deficiency of vitamins? A-Vitamin A B- Vitamin B C- Vitamin C


33


Nutrition

D- Vitamin D E- Vitamin E 16-Smokers have deficiency of vitamins? A-Vitamin A B- Vitamin B C- Vitamin C D- Vitamin D E- Vitamin E Ans-C 17-What vitamin could cause toxicity? A-Vitamin A B- Vitamin B C- Vitamin C D- Vitamin D E- Vitamin E Ans-A 18-Vegetarians have deficiency of vitamins? A-Vitamin A B- Vitamin B12 C- Vitamin C D- Vitamin D E- Vitamin E Ans-B 19-A breast fed infant should recieved which of the following vitamin drops? A-Vitamin A B- Vitamin B12 C- Vitamin C D- Vitamin D E- Vitamin E Ans-D 20-Age over 50 years and elderly have deficiency of vitamin? A-Vitamin A B- Vitamin B12 C- Vitamin C D- Vitamin D E- Vitamin E Ans-B 21-Chronic renal disease can cause deficiency of? A-Vitamin A B- Vitamin B12


34


Nutrition

C- Vitamin C D- Vitamin D E- Vitamin E Ans-D Tips: Chronic renal deficiency can cause deficiency of vitamin D3 i.e 1, 25 dihydroxy ergocalceferol which is activ vitamin D. 22-Which of the following condition have deficiency of vitamin B1(thiamine) A-smoking B-old age C-chronic alcoholism D-Infants E-Pregnancy Ans-c 23-Vitamin B12 deficiency are more common in? A-smoking B-old age C-chronic alcoholism D-Infants E-Pregnancy Ans-B


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Infectious Diseases

PHARMACY PREP

MICROBIOLOGY 1-Which of the following are the correct statement about Staphylococcus aureus I-It contains techoic acid II-Gram stain test is positive III-It contains lipopolysaccharide layer A-I only B-III only C-I and II only D-II and III only E-All are correct Ans-C 2-Obligate anaerobic bacteria: I-Generate oxygen II-Generate superoxide dismutase III-Do not generate carbohydrates A-I only B-III only C-I and II only D-II and III only E-All are correct Ans-B 3-Colon is large intestine which contains, which of the following type of bacteria: A-95% to100% anaerobic B-95 to 100% aerobic C-30 to 50% anaerobic D-30-50% aerobic E-There is no bacteria in lower gut. Ans-A 4-Which of the following clinical condition is the prophylactic use of anti bacterial is NOT required? A-Preoperative treatment for GI conditions B-Frequent respiratory diseases C-Preoperative treatment of hip surgeries D-Prevention of meningitis among individuals in close contact with infected patients E-Patient with tooth surgeries or tooth removed. Ans-B

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Infectious Diseases

Tips: Certain clinical situation require the use of antibiotics for prevention rather than treatment of infections, such as: Prevention of strep infections in patient with rheumatic heart disease Patient under going dental extraction, who have prosthetic devices such as heart valve etc. Prevention of Tuberculosis, meningitis (close contacts) Prior to certain surgical procedures. HIV infected pregnant woman 5-Drugs used in the treatment of meningitis are all of the following, EXCEPT: a) Penicillins b) Cephalosporins c) Gentamicin d) Streptomycin e) Sulfonamides Ans- D tips: Streptomycin is not used in the treatment of meningitis. The main treatment of bacterial meningitis may include penicillins, cephalosporins and vancomycin while viral meningitis is mainly treated by acyclovir IV. 6-Most common causative organism of community-acquired pneumonia (CAP) is: A-S. pneumonia B- M. pneumonia C- H. influenza D-S. aureus E- E .coli Ans-A 7-The following organism least likely causes pneumonia: A-S. pneumonia B- M. pneumonia C- H. influenza D- M.catharhalis E- E. coli Ans-E 8-Bacteria that cause community acquired pneumonia infections include: I-S.pneumonia II- H.influenza III- M.catarrhalis A-I only B-III only C-I and II only D-II and III only E-All are correct



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Infectious Diseases

Ans-E 9-The most common cause of Urinary tract infections include: A- N. gonnorhea B- E. coli C-Chlamydea D-S. pneumonia E- M. catarhalis Ans-B 10-The most common cause of traveller’s diarrhea is: A-Protozoa B- E.coli C-Salmonella sp. D-Shigella E-Corynebacterium Ans-B 11-Lyme disease a tick born infections commonly occur in the months of July-August and in the area of Mississippi river valley, is caused by: A-Treponema pallidum B- B. burgdorferi C-Dermatophyte D-Giardia lamblia Ans-B 12-Which of the following is the most common cause of nosocomial infections: I-S. aureus II- P. aeruginosa III- E. coli A-I only B-III only C-I and II only D-II and III only E-All are correct Ans-C Tips: nosocomial infections = hospital acquired infections. 13-Drug of choice for nosocomial infection that caused by P. aeruginosa. A-Ciprofloxacin B-Aminoglycosides C-Amoxicillin D-Erythromycin E-Cephalosporins Ans-B



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Infectious Diseases

14-Clindamycin, may cause severe diarrhea, this condition can be treated by: A-Pepto-Bismol B-Loperamide C-OTC antidiarrheal D-Metronidazole E-Oral rehydration salts Ans-D 15-Which of the following is mycolic acid synthesize inhibitor? A-Rifampin B-Ethambutol C-Isoniazid D-Cotrimazole E-Ketoconazole Ans-C 16-Syphilis infections can occur with; A- E. coli B-Salmonella C-T. pallidum D-Spirochete E-Diphtheria Ans-C 17-The fungal infection that commonly occurs on skin between foot toes is: A-Jack itch B-Onychomycosis C-Athletes foot D-Thrush E-Ringworm Ans-C Tips: Jack itch is fungal infections commonly occ urs on foot toe Onchomycosis is fungal nail infections. Thrush is fungal infections mainly cau sed by Candida albicans . Ringworm is a fungal infections, it caused by dermatophytes (it is not a worm) 18-Toxic shock syndrome (TSS) is caused by: A- E. coli B-It is type of UTI C-S. aureus D-It is type of STD E-It is not a infection Ans-C 19- Pseudomembranous colitis is a condition that occurs as result of antibiotics use, is caused by: A-C. tetani



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Infectious Diseases

B-C. difficile C-C. botulinum D-C. perfringes E-All of the above Ans-B 20-All of the following cause food poisoning EXCEPT: A- E. coli B-Solmonella sp C-Shigella sp D- Nisseria E-C. botulinum Ans-D 21-Seasonal flu is caused by: I- Influenza A II- Influenza B III-H. Influenza type B only A-I only B-III only C-I and II only D-II and III only E-All are correct Ans-C Tips: Influenza A and B are virus that cause seasonal flu and H. influenza is gram –ve bacteria commonly cause pneumonia and otitis media 22-Hepatitis A viral infections may spread by: I-Sexual contact II-Blood transfusion III-Food contamination A-I only B-III only C-I and II only D-II and III only E-All are correct Ans-B 23-The common cold (runny nose) is caused by: A-Influenza A B-Influenza B C-Rhinovirus D-Pox virus E-Papilloma virus Ans-C Tips: Rhino has runny nose



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Infectious Diseases

24-Hepatitis B and C are viral infections may spread by? I-Sexual contact II-Blood transfusion III-Food contamination A-I only B-III only C-I and II only D-II and III only E-All are correct Ans-C 25-Which of the following not associated with Toxic shock syndrome? A-Tampons B-Condoms C-Contraceptive sponges D-intra uterine devices (IUD) E-None of the above Ans-B



42


Pharmacy Prep Review Questions

PHARMACY PREP

GENETICS AND MOLECULAR BIOLOGY 1-What base is not found in deoxyribose nucleic acid (DNA): A-Thymine B-Adenine C-Guanine D-Cytosine E-Uracil Ans-E Tips: Uracil is not found in DNA. Uracil is present in RNA. 2-Translation occurs: A-Before transcription B-After transcription C-Same time as transcription D-None of the above Ans-B 3-Glycoproteins are linked to: A-DNA B-RNA C-mRNA D-Carbohydrates E-Lipids Ans-D Comments: glycoproteins are linked to carbohydrates 4-An enzyme that cleaves deoxyribonucleic acid (DNA) at a specific site is called: I-Trypsin II-Restrictive ribonuclease III-Restrictive endonuclease A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-B Tips: Restrictive endonuclease cleaves the DNA at a specific site. 5-Coupling of two DNA helicals is: A-Lyase B-Ligase C-Endonuclease Copyright © 2000-2008 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep.

42



D-Ribonuclease E-Reverse Transcriptase Ans-B Tips: ligase is coupling of DNA helicals where as lyase is splitting of helicles. 6-Separating two DNA helicals is: A-Lyase B-Ligase C-Endonuclease D-Ribonuclease E-Reverse Transcriptase Ans-A 7-Which of the following is NOT a type of RNA; A-mRNA B-tRNA C-cRNA D-rRNA E-None of the above Ans-C Tips: RNA classified as rRNA, tRNA and mRNA. However, there is no cRNA. 8-Which of the following is the highest percen t of RNA type: A-mRNA B-tRNA C-cRNA D-rRNA E-dRNA Ans-D Tips: rRNA80%, tRNA15%, mRNA5% 9-Which of the following is recombinant DNA A-rDNA B-R-DNA C-cDNA D-mDNA E-tDNA Ans-A Tips: rDNA is recombinant DNA 10- A woman carrying hemophilia and has a child from a man with hemophilia. Which of the following is NOT her child? a) A girl with hemophilia b) A boy with hemophilia c) A girl having no gene of hemophilia d) A girl having the gene of hemophilia Copyright © 2000-2008 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep.

43

www.Pharmacyprep.com e) A boy having no hemophilia Ans-C X X XX X XX


Y XY XY

XX = Women with hemophilia XY = Man with hemophilia XY = Man with NO hemophilia XX = Women with hemophilia carrier 11. Bases found in DNA is/are I-Uracil II-Cytosine III-Thymine a) I only b) III only c) I and II only d) II and III only e) All of the above Ans: D 12-Hemophilia A results from deficiency of factor? A-V B-X C-VIII D-II E-XI Ans-C


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PHARMACY PREP

GENETICS AND MOLECULAR BIOLOGY 1-What base is not found in deoxyribose nucleic acid (DNA): A-Thymine B-Adenine C-Guanine D-Cytosine E-Uracil Ans-E Tips: Uracil is not found in DNA. Uracil is present in RNA. 2-Translation occurs: A-Before transcription B-After transcription C-Same time as transcription D-None of the above Ans-B 3-Glycoproteins are linked to: A-DNA B-RNA C-mRNA D-Carbohydrates E-Lipids Ans-D Comments: glycoproteins are linked to carbohydrates 4-An enzyme that cleaves deoxyribonucleic acid (DNA) at a specific site is called: I-Trypsin II-Restrictive ribonuclease III-Restrictive endonuclease A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-B Tips: Restrictive endonuclease cleaves the DNA at a specific site. 5-Coupling of two DNA helicals is: A-Lyase B-Ligase C-Endonuclease Copyright © 2000-2008 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep.

42



D-Ribonuclease E-Reverse Transcriptase Ans-B Tips: ligase is coupling of DNA helicals where as lyase is splitting of helicles. 6-Separating two DNA helicals is: A-Lyase B-Ligase C-Endonuclease D-Ribonuclease E-Reverse Transcriptase Ans-A 7-Which of the following is NOT a type of RNA; A-mRNA B-tRNA C-cRNA D-rRNA E-None of the above Ans-C Tips: RNA classified as rRNA, tRNA and mRNA. However, there is no cRNA. 8-Which of the following is the highest percen t of RNA type: A-mRNA B-tRNA C-cRNA D-rRNA E-dRNA Ans-D Tips: rRNA80%, tRNA15%, mRNA5% 9-Which of the following is recombinant DNA A-rDNA B-R-DNA C-cDNA D-mDNA E-tDNA Ans-A Tips: rDNA is recombinant DNA 10- A woman carrying hemophilia and has a child from a man with hemophilia. Which of the following is NOT her child? a) A girl with hemophilia b) A boy with hemophilia c) A girl having no gene of hemophilia d) A girl having the gene of hemophilia Copyright © 2000-2008 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep.

43

www.Pharmacyprep.com e) A boy having no hemophilia Ans-C X X XX X XX


Y XY XY

XX = Women with hemophilia XY = Man with hemophilia XY = Man with NO hemophilia XX = Women with hemophilia carrier 11. Bases found in DNA is/are I-Uracil II-Cytosine III-Thymine a) I only b) III only c) I and II only d) II and III only e) All of the above Ans: D 12-Hemophilia A results from deficiency of factor? A-V B-X C-VIII D-II E-XI Ans-C


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PHARMACY PREP PHARMACOGENETICS 1-What is definition of Pharmacogenetics? A-The pharmacogenomics is integration of pharmacology and genetics. B-The study of pharmacogenomics allows to design and develop drugs that are customized to each person’s genetic mark up. C-The pharmacogenomics also utilized to study cytochrome enzymes that are responsible for drug interactions. D-All of the above E-None of the above Ans-D 2. Bases found in both DNA and RNA is/are I. Cytosine II. Adenine III. Guanine a) I only b) III only c) I and II only d) II and III only e) All of the above Ans: E 3. Enzymes that catalyze coupling of two molecules are classified as a) Hydralases b) Ligases c) Oxidoreductases d) Transferases e) Isomerases Ans: B

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Immunology and Toxicology

PHARMACY PREP

.

IMMUNOLOGY AND TOXICOLOGY 1- The FALSE statement about vaccines is/are: I- It is given only after the person suffer exposition to the virus II- Passive vaccines promote immunization for short period o f time III- Active vaccines promote long-term immunization a) I only b) III only c) I and II only d) II and III only e) All are correct 2- Differences between passive and active immunization: I- Passive enhance and active stimulate the patient’s immune response. II- In passive antibody injection are given and in active antigen injections are given III- Passive is effective for some months while active is longe r lasting a) I only b) III only c) I and II only d) II and III only e) All are correct 3- Correct statement regarding α-Fetoprotein-AFP include I- Produced by the fetal liver II- May cause hepatocellular carcinoma III Cause death of fetus a) I only b) III only c) I and II only d) II and III only e) All are correct 4- A woman carrying hemophilia and has a child from a man with hemophilia. Which of the following is NOT her child? a) A girl with hemophilia b) A boy with hemophilia c) A girl having no gene of hemophilia d) A girl having the gene of hemophilia e) A boy having no hemophilia 5- All of the following can be differentiated from a mast cell, EXCEPT a) Eosinophil Copyright © 2000-2008 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep.

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b) Basophile c) Neutrophil d) Platelet e) Erythrocytes 6- Basophiles, neutrophils and eosinophils are originated from a) Myeloblasts b) Lymphoblasts c) Monoblasts d) Proerythroblasts e) Megakarioblasts 7- Which of the following is/are considered autoimmune disorders? I- Grave’s disease II- Systemic Lupus Erythromatosus III- Osteoporosis a) I only b) III only c) I and II only d) II and III only e) All are correct 8- True statements regarding the use of monoclonal antibodies include which of the following? I- Flu-like symptoms commonly occurs at the start of therapy II- T-cells are blocked from initiating the rejection process III- Orthoclone is a human immunoglobulin product a) I only b) III only c) I and II only d) II and III only e) All are correct 9- Which of the following is not related to lymphocytes? a) Lymph nodes b) Thymus gland c) Thoracic duct d) Spleen e) Thyroid gland 10- Attenuated viruses used for vaccination: I- Poliomyelitis virus II- MMR-Mumps, measles and rubella virus III- Influenza a) I only b) III only


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c) I and II only d) II and III only e) All are correct 11- Drugs that stabilize mast cells are used in the treatment of: a) Organ implants rejection b) Cancer therapy c) Allergic rhinitis d) Asthma e) Myocardial infaction 12- All of the following biological are used for active immunization, EXCEPT: a) Bacterial vaccine b) Bacterial antigen c) Multiple antigen preparations d) Toxoids e) Toxins 13- Correct statements regarding Technetium 99m may include? I- Is the most used radionuclide in nuclear pharmacy II- It is produced by the radioactive decay of molybdenum-99 III- It has a half-life of 6hours a) I only b) III only c) I and II only d) II and III only e) All are correct 14- Correct statements regarding Klein filter syndrome include: I- Male with enlarge breast, small testis and infertility II- The male has 3 chromosomes III- Chromosomes forming XXY, presence of one extra female chromosome. a) I only b) III only c) I and II only d) II and III only e) All are correct 15- Correct statements regarding infantile genetic agranulocytosis include? I- Type I hypersensitivity II- Caused by a decrease in bone marrow activity III- Treatment can be done by transfer of WBCs or large doses of antibodies (immunoglobulins) a) I only b) III only c) I and II only


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d) II and III only e) All are correct 16- Which of the following is the organ responsible for the immune system? a) Thymus b) Lymphoid organ c) Megakaryocyte d) Lynphocyte e) Spleen 17- The “key” operative of immune system is known as: a) Megakaryocytic b) Monocyte c) Lymphocyte d) Proerythrocyte e) Myelocyte 18- Which of the following is/are types of lymphoc ytes? I- B cells II- T cells III- Natural killer cell a) I only b) III only c) I and II only d) II and III only e) All are correct 19- The stem cell of immune system are developed in: a) Bone marrow b) Lymphoid organ c) Liver d) Spleen e) Lymph nodes 20- Which of the following is a pro-inflammatory cell responsible for initiation of an acute inflammation? a) Eosinophils b) Platelets c) Macrophages d) Basophiles e) Neutrophils


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21- Antidote of mercury may include: a) Dimercaprol b) EDTA c) Deferoximine d) Succimer e) Naloxone 22- Which of the following is a benzodiazepinics antagonist: a) Naloxone b) Physostigmine c) Flumazenil d) Naltrexone e) Penicillamine 23- What would be the best treatment for cyanide poisoning? a) Antivenin b) Sodium thiosulfite c) Acetylcystein d) Oxygen therapy e) Sodium bicarbonate 24- Carbon monoxide can be highly toxic because it easily binds to: I- Hemoglobin II- Myoglobin III- Cytochrome oxidase a) I only b) III only c) I and II only d) II and III only e) All are correct 25- Acetaminophen toxicity most well know complication is: a) Cardiovascular failure b) Pulmonary edema c) CNS lethargy d) Liver necrosis e) Sedation 26- Salicylate toxicity treatment include which of the following? I- Alkalinization of urine with sodium bicarbonate II- Decontamination with syrup of IPECAC until 30 minutes of overdose III- CHARCOAL every 6 hours a) I only b) III only c) I and II only


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d) II and III only e) All are correct 27- Hyperphosphatemia is best treated by: a) Magnesium hydroxide b) Calcium carbonate c) Aluminium hydroxide d) Sodium Bicarbonate e) Sodium phosphate 28- Correct statements regarding IPECAC may include: I- It has an emetic effect when large doses are administrated II- It has a expectorant effect when small doses (1 to 2mls) is administrated III- Used in decontamination procedures during toxic treatments a) I only b) III only c) I and II only d) II and III only e) All are correct 29- The organophosphates commonly found in insecticides are thought to act by witch of the following mechanisms? a) Combining with acetylcholine b) Potentiating the action of acetylcholinesterase c) Forming a very stable complex with acetylcholinesterase d) Reacting at the cholinergic receptor e) Preventing the release of acetylcholine from the nerve ending 30- all of the following can be recognized as atropine poisoning, EXCEPT: a) Dry skin b) Mydriasis c) Flushed appearance d) Diarrhea e) Delirium 31-Poison ivy is what type of hypersensitive reactions? A-Type I B-Type II C-Type III D-Type IV E-Hypersensitive reaction caused by poison ivy plant


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CORRECT ANSWERS

IMMUNOLOGY AND TOXICOLOGY

1- A Vaccines can be given as prophylaxis before the person suffers exposition to the microorganisms. Comments:

2- E Passive vaccines: Normally IV and IM injections of antibodies to enhance patient’s immune competence; protection depends on serum half-life of the injected antibody that may be effective for days or months. Active vaccinations: Normally IV, IM, SC and oral administration of antigen to stimulate the immune response. Immunity is long lasting. Comments:

3- C -Fetoprotein-AFP is produced by the fetal liver and may cause hepatocellular carcinoma of fetus, however it does not cause the death of fetus. Comments:

α

4- C If the mother and father have hemophilia their child may not have the disease hemophilia but the child will have the gene of the disease. Comments:

5- B Basophile is a pro-inflammatory cell that initiates acute inflammation and cannot be differentiated from mast cells. Comments:

6- A Basophiles, neutrophilis and eosinophiles are leukocytes-White Blood CellsWBC originated from myeloblasts. Comments:

7- C Osteoporosis is not an autoimmune disorder. It is a disease characterized by the loss of bone mass. Comments:

8- C Monoclonal antibodies can deliver toxins specifically to cancer cells and destroy them. They are also used with radioisotopes to diagnose and visualize cancer cells and may cause flu-like symptoms in the beginning of the treatment. Comments:

9- E Thyroid gland is not part of lymphocytes. Lymphocytes include: Tonsils and adenoid gland, thymus, lymphonodes, spleen, bone marrow and lymphatic vessels. Comments:

10- C Copyright © 2000-2008 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep.

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Attenuated vaccines are made from whole microbes that have been killed by heat or chemical. MMR-Mumps, Measles, Rubella virus and TB-Mycobacterium are live vaccines. Comments:

11- C Drugs that stabilize mast cells are normally used in the treatment of allergic rhinitis as per example cromoglycanate. Comments:

12- E Toxins are used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms therefore cannot be used for vaccination. Comments:

13- E Is the most used radionuclide in nuclear pharmacy. This radionuclide is produced by the radioactive decay of molybdenum-99. A generator is a devise used to separate a short half-life radionuclide from the longer-lived parent nuclide, while retaining the parent to produce more of the daughter nuclide. In this way, short half-life nuclides can be made available continuously at great distances from the sites of generator production. Technetium-99m has a half-life of 6hours Comments:

14- E Klein filter syndrome is a condition where the male have enlarged breast, small testis and infertility. The male chromosome is constituted of 3 chromosomes forming XXY, presence of one extra female chromosome. Comments:

15- D It is an autosomal recessive disorder characterized by the early onset of recurrent, severe pyogenic infections, especially of the skin and lung, total absence of neutrophilis in the blood or presence in reduced numbers, absolute monocytosis and eosinophilia, markedly decreased numbers of mature neutrophilic precursors in the bone marrow. Comments:

16- B Lymphoid organ is the organ responsible for the immune system concerned with growth, development and deployment of lymphocytes. Comments:

17- C Comments:

Lymphocytes are WBC-White Blood Cells, the key operative of immune

system. 18- E Lymphocytes are WBC-White Blood Cells found in the blood and in many other part of body and may include B and T cells, and natural killer cells. Comments:

19- A


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Steam cells are blood cells progenitor, or mother cell, having the capacity for both replication and differentiation originated from bone marrow. Comments:

20- D Comments: Basophilis

are white blood cells and pro-inflammatory cell responsible for initiation of an acute inflammation. It also stimulated the release of heparin and histamine 21- A Comments: Antidote

of elemental mercury inhalation is dimercaprol and inorganic salt mercury gastrointestinal absorption the antidote may be dimercaprol and penicillamine as well. 22- C Comments:

Flumazenil is a benzodiazepinic antagonist therefore used as antidote in benzodiazepinic overdoses. 23- B Comments: Treatment

for cyanide poisoning may be done by sodium thiosulfite, amyl and sodium nitrile as well. 24- E Comments: Carbon

monoxide can be highly toxic due to its ability to rapidly bind to hemoglobin, myoglobin and cytochrome oxidase. Essential components for the vital functions in human body. 25- D Comments: The

main and more serious implication concerning acetaminophen toxicity is

liver necrosis 26- E Comments: Salicylate

toxicity treatment can first be done by control of the vital functions following administration of sodium bicarbonate to alkalinize the urine and correct the acidosis, decontamination with syrup of IPECAC until 30 minutes of overdose and CHARCOAL every 6 hours may be considered. In case of failure of these methods, hemodialysis should be considered. 27- C Comments: Aluminum

hydroxide causes hypophosphatemia as side effect therefore may be used in the treatment of hyperphosphatemia. 28- E Comments: IPECAC

is a gastric decontaminant agent used in the treatment of overdoses and poisonings of many different agents. It acts by inducing vomiting and is best used within 60 minutes of agent ingestion. It also has an expectorant effect when used in very low doses.


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29- C Comments: Organophosphates

are substances commonly found in insecticides in very toxic to humans due to formation of a very stable complex with acetylcholinesterase 30- D Comments: Constipation

is a common side effect of atropine poisoning, therefore we should not consider diarrhea as atropine symptoms of overdose. 31-D


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PHARMACY PREP

IMMUNIZATION 1-Which of the following populations is NOT con sidered high risk for influenza so that vaccination with influenza vaccine is not necessary? A-Patients with more than six colds per year B-Residents of long-term care facilities (e.g., nursing homes) C-Patients with diabetes mellitus D-Patients over the age of 65 E-Patients with COPD or Asthma F-A 30-year-old nurse working in health care facility G-A 22 year-old young patients in long term care facility Ans-A 2-Flu season in Canada? A-March to December B-October to April C-November to December D-October to Mid November E-October through November Ans-B 3-Flu immunization season in Canada? A-November to April B-October to Mid November C-October to April D-October through December E-October through April Ans-B 4-Flu vaccine active against, which of the following virus. I-Influenza A II-Influenza B III- H.influenza type A a) I only b) III only c) I and II only d) II and III only e) All are correct Ans-C Tips: Flu vaccine is effective against influenza A and B. H.influenza is a gram –ve bacterial infections, flu vaccine is ineffective against bacterial infections. 5-What is incorrect statement about Oseltamavir (Tamiflu)? Copyright © 2000-2008 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep.

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A-Oseltamavir is effective against A and B B-Oseltamavir is neuramidase inhibitor C-Oseltamavir is used in treatment of influenza A and B D-Oseltamavir therapeutic antiviral spectrum is limited to influenza A o nly E-Treatment is particularly useful high risk patient who have not been vaccinated. Ans-D 6-Who should not receive flu shot? I-Allergies to eggs II-Child under 6 months age III-Pregnant women a) I only b) III only c) I and II only d) II and III only e) All are correct Ans-C 7-Which of the following population least likely to receive flu shots: A-Elderly over 65 years B-A 23-year-old worker in long term care facility C-A 44 year with asthma condition D-A 25 year old nurse working in elderly home E-A 45 year old worker in hotel Ans-E 8-Hepatitis B vaccine provides immunity against: I-Hepatitis A II-Hepatitis D III-Hepatitis B a) I only b) III only c) I and II only d) II and III only e) All are correct Ans-D Tips: Hepatitis B patient is susceptible to he patitis D. 9-Poison ivy causes contact dermatitis, which of the following type of hype rsensitive reaction: A-Type 1 B-Type 2 C-Type 3 D-Type 4 E-Type 5 Ans-D


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10-Dukoral vaccine is indicated for travelers to prevent? I-Travelers diarrhea II-Cholera III-Hepatitis A and B a) I only b) III only c) I and II only d) II and III only e) All are correct Ans-C


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Biotechnology

PHARMACY PREP

BIOTECHNOLOGY 1-Interferons are good examples of: I-Cytokines II-Biotechnological products III- Colony stimulating factors (CSF) A-I only B-III only C-I and II only D-II and III only E-All of the above Ans2-Erythropoeitins are? A-Colony stimulating factors B-Circulating iron storage C-Interleukin D-immunosuppressant E-biotechnological products Ans-A 3-Hematocrit is? A-Circulating iron storage B-Measures the total iron binding capacity C-Measures the total free iron D-Mean volumen of iron E-It is transferrins Ans4-What is correct about erythropoeitins? I- Epoeitin alpha are used for anemia associated chronic kidney diseases. II-Helps in to production of RBCs III-Produced in bone marrow A-I only B-III only C-I and II only D-II and III only E-All of the above Ans-C 5-Erythropoeitins are produced from? A-kidney B-Liver C-Bone marrow D-Muscles Copyright © 2000-2008 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep.

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Biotechnology

E-Thymus gland Ans-A 6-Filgrastin is a CSF indicated in the treatment of? A-renal, cardiac and hepatic graft rejection B-neutropenia associated with cancer chemotherapy C-thrombocytopenia associated with cancer chemotherapy D-anemia associated with chronic renal diseases E- chemotherapy induced neutropenia Ans-E 7-Filgrastin is? A-Colony stimulating factor B-Erytropoeitins C-Interferons D-Human growth hormones E-Monoclonal antibodies Ans-A 8-operlaveukin is? A-Interleukin 11 B-CSF C-interleukin 3 D-interleukin 2 E-epoeitin Ans-A 9-Operlaveukin is indicated for? A-thrombocytopenia B-Bone marrow suppression C-acute graft rejection D-neutropenia E-growth factor Ans-A

10- Muromonab (OKT3) is monoclonal antibody indicated? A-renal, cardiac and hepatic graft rejection B-neutropenia associated with cancer chemotherapy C-thrombocytopenia associated with cancer chemotherapy D-anemia associated with chronic renal diseases E-None of the above Ans-A 11-CD4 cells represents? A-helper T cells


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Biotechnology

B-suppresor T cells C-cytotoxic T cells D-immunoglobulins E-None of the above Ans-A 12-A HIV patient how long life span is? A-1 to 2 years B-2 to 3 years C-3 to 4 years D-4 to 5 years E-Can live longer than 10 years Ans-B


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PHARMACY PREP TOXYCOLOGY

1- Antidote of mercury may include: a) Dimercaprol b) EDTA c) Deferoximine d) Succimer e) Naloxone 2- Which of the following is a benzodiazepinics antagonist: a) Naloxone b) Physostigmine c) Flumazenil d) Naltrexone e) Penicillamine 3- What would be the best treatment for cyanide poisoning? a) Antivenin b) Sodium thiosulfite c) Acetylcystein d) Oxygen therapy e) Sodium bicarbonate 4- Carbon monoxide can be highly toxic because it easily binds to: I- Hemoglobin II- Myoglobin III- Cytochrome oxidase a) I only b) III only c) I and II only d) II and III only e) All are correct 5- Acetaminophen toxicity most well know complication is: a) Cardiovascular failure b) Pulmonary edema c) CNS lethargy d) Liver necrosis e) Sedation 6- Salicylate toxicity treatment include which of the following? I- Decontamination with syrup of IPECAC until 30 minutes of overdose II- CHARCOAL every 6 hours III- Alkalinization of urine with sodium bicarbonate Copyright © 2000-2008 TIPS Inc. Unauthorized reproduction of this manual is prohibited. This manual is being used during review sessions conducted by PharmacyPrep.

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a) I only b) III only c) I and II only d) II and III only e) All are correct 7- Hyperphosphatemia is best treated by: a) Magnesium hydroxide b) Calcium carbonate c) Aluminium hydroxide d) Sodium Bicarbonate e) Sodium phosphate 8- Correct statements regarding IPECAC may include: I- It has an emetic effect when large doses are administrated II- It has a expectorant effect when small doses (1 to 2mls) is administrated III- Used in decontamination procedures during toxic treatments a) I only b) III only c) I and II only d) II and III only e) All are correct 9- The organophosphates commonly found in insecticides are thought to act by witch of the following mechanisms? a) Combining with acetylcholine b) Potentiating the action of acetylcholinesterase c) Forming a very stable complex with acetylcholinesterase d) Reacting at the cholinergic receptor e) Preventing the release of acetylcholine from the nerve ending 10- All of the following can be recognized as atropine poisoning, EXCEPT: a) Dry skin b) Mydriasis c) Flushed appearance d) Diarrhea e) Delirium 11- Antidote for atropine poisoning may include: a) Physostigmine b) Aminophillim c) Pralidoxine d) Flumazenil e) Dimercaprol 12- Poison Ivy can be treated by which of the following agents?


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I- Topical antipruritic II- Antihistaminics III- Systemic antibiotics a) I only b) III only c) I and II only d) II and III only e) All are correct 13- A patient is stabilized on heparin as anticoagulant. After one hour of administration of the drug, he exercised bleeding from his gums, while he was brushing his teeth. The pharmacist can advise him to take: a) Ascorbic acid b) Vitamin K c) Protamine sulfate d) Warfarin e) Quinolone 14- N-acetylcysteine may be the antidote of choice for which of the following agents? a) Aspirin b) Warfarin c) Digoxin d) Lead e) Acetaminophen 15- Dimercaprol (BAL) + mercury (Hg) combination ch aracteristics include: I- Dimercaprol is the best antidote for elemental mercury inhalation poisoning II- They form a stable complex excreted renally III- Penicillamine is an alternative when mercury suffer GIT absorption a) I only b) III only c) I and II only d) II and III only e) All are correct 16- Naloxone is the best antidote for which of the following overdose agents? a) Opioid overdose b) Heavy metal overdose c) Benzodiazepinics overdose d) Organophosphate overdose e) Digitalis overdose 17- Management and characteristics of Digoxin toxicity may include: I- May cause heart failure, cardiac dysrrhythmias, nausea, anorexia, vomiting, and confusion II- Treated by decontamination and supportive therapy


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III- Treated with a digoxin specific antidote known as FAB antibodies a) I only b) III only c) I and II only d) II and III only e) All are correct 18- Death due to cyanide poisoning is due to: a) Cyanide-RBCs complex formation b) Cyanide-hemoglobin complex formation c) Cyanide inhibiting of cytochrome oxidase d) Cyanide increasing hemoglobin levels e) Coronary vessel oclusion 19- The toxicity of methyl alcohol is due to formation of: a) Ketones b) Formic acid c) Free alcohol radicals d) Ethylene e) Aldehyde 20- Acetaminophen toxicity is due to: a) Oxidation stress b) Active metabolite c) Free radical chain d) Reactive metabolite e) Reduction of metabolite 21- Salicylate toxicity excessive respiration is due to: I- Excess production of CO2 II- Pulmonary irritation III- Central stimulation in the brain a) I only b) III only c) I and II only d) II and III only e) All are correct 22- Grayish mouth and loose of teeth are toxic symptoms of: I- Fe salts poisoning II- Cu poisoning III- Lead poisoning a) I only b) III only c) I and II only d) II and III only


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e) All are correct 23- Vomiting (emesis) is contra indicated if poisoning is due to: I- Bleaching II- Gasoline III- Light petroleum a) I only b) III only c) I and II only d) II and III only e) All are correct 24- Universal antidote is a mixture of: I- Activated charcoal II- Magnesium oxide III- Tannic acid a) I only b) III only c) I and II only d) II and III only e) All are correct 25- Amphetamines overdose is best treated with administration of: a) Salicylates b) Benzodiazepinics c) Barbiturates d) Naloxone e) B and C are right. 26- True statements regarding the treatment of hyperkalemia: I- If change in ECG is detected give Ca to counteract the excess of K on the heart II- Bicarbonate and insulin administration can shift K from extra to intracellular III- Enema of kafexolate (exchange resin) or dialysis helps to remove excess of K from the body a) I only b) III only c) I and II only d) II and III only e) All are correct 27- Cardiovascular drug that overdose can cause cyanide intoxication include: a) Nitrates b) Nitroglycerin c) Nitroprusside d) Isosorbide e) Isosorbide dinitrate


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28- Lead poisoning can be treated by: I- BAL-Dimercaprol II- EDTA-Edentate III- Penicillamine a) I only b) III only c) I and II only d) II and III only e) All are correct 29- Specific antidote for iron preparations overdose include: a) Dimercaprol b) Deferoxamine c) Penicillamine d) Naloxone e) Sucimmer 30- Atropine, an anticholinergic drug is used as antidote in the poisoning treatment of: a) Organophosphates b) Heavy metal c) Salicylates d) Tricyclic antidepressants e) Iron 31- Treatment of tricyclic antidepressants overdose is done by all the following procedures, EXCEPT: a) Control the seizures and cardiotoxicity b) Administration of benzodiazepinics or phenytoin to control seizures c) Activated charcoal can be used d) MAO antidepressants can helps to overcome the patient’s seizure e) Control acidosis with administration of sodium bicarbonate 32- Specific antidote used for poisoning caused by snake and black spider bits a) Deferoxamine b) Ancrod c) Antivenin d) Psysostigmine e) Naloxone 33- Best treatment for carbon monoxide intoxication: a) Alkalinization of urine b) Oxygen therapy c) Supportive therapy d) Acidification of urine e) Gastric lavage


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34- Which of the following is the isoniazide antidote? a) Vitamin A b) Bitamin B6 c) Vitamin B12 d) Folic acid e) Vitamin E 35- Which of the following is considered the warfarin antidote? a) Vitamin K b) Heparin c) Protamine d) Filgrastin e) Vitamin E 36- The major first step in the initial management of ANY intoxication and poisoning is the supportive care treatment that involve: a) Detoxification b) Decontamination c) Hydration d) Evaluation and support of vital function (Airway, Breath and Circulation-ABC) e) Toxicology laboratory tests 37- General management in treating patients with depressed mental status include: I- Treat hypoglycemia with 50mls of dextrose 50% II- Administration of thiamine 100mg IV push III- Administration of naloxone a) I only b) III only c) I and II only d) II and III only e) All are correct 38- Decontamination procedures may include: a) Gastric lavage b) Emesis c) Administration of activated charcoal d) Administration of adsorbent agents e) All are correct 39- Intravenous calcium administration is used in which of the following situations? a) Verapamil overdoses b) Cocaine overdose c) Verapamil overdose and hyperkalemia d) Hyperkalemia e) Nifedipeno overdose


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40-What metabolic reaction saturation can lead to acetaminophen toxicity? A-Glucuronidation B-Sulfonation C-Oxidation D-Glutathione conjugation E-Reduction Ans-A 41-Ethanol metabolizes to acetic acid by the enzyme called? A-Alcohol dehydrogenase B-Alcohol reductase C-Glucorunidation D-Alcohol decarboxylation Ans-A 42-Glutathione conjugation produce the product called? A-Mercapturic acid B-Sulfonation C-Oxidation D-Glutathione conjugation E-Reduction Ans-a 43-Which of the following is antidote of ASA? A-N-acetyl cysteine B-Flumazenil C-Pentoxifilin D-Nalaxone E-None of the above 44-Heparin antidote is? a) Vitamin K b) Heparin c) Protamine sulphate d) Filgrastin e) Vitamin E

CORRECT ANSWERS TOXICOLOGY

1- A Comments: Antidote

of elemental mercury inhalation is dimercaprol and inorganic salt mercury gastrointestinal absorption the antidote may be dimercaprol and penicillamine as well.


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2- C Comments:

Flumazenil is a benzodiazepinic antagonist therefore used as antidote in benzodiazepinic overdoses. 3- B Comments: Treatment

for cyanide poisoning may be done by sodium thiosulfite, amyl and sodium nitrile as well. 4- E Comments: Carbon

monoxide can be highly toxic due to its ability to rapidly bind to hemoglobin, myoglobin and cytochrome oxidase. Essential components for the vital functions in human body. 5- D Comments: The

main and more serious implication concerning acetaminophen toxicity is

liver necrosis 6- E Comments: Salicylate

toxicity treatment can first be done by control of the vital functions following administration of sodium bicarbonate to alkalinize the urine and correct the acidosis, decontamination with syrup of IPECAC until 30 minutes of overdose and CHARCOAL every 6 hours may be considered. In case of failure of these methods, hemodialysis should be considered. 7- C Comments: Aluminum

hydroxide causes hypophosphatemia as side effect therefore may be used in the treatment of hyperphosphatemia. 8- E Comments: IPECAC

is a gastric decontaminant agent used in the treatment of overdoses and poisonings of many different agents. It acts by inducing vomiting and is best used within 60 minutes of agent ingestion. It also has an expectorant effect when used in very low doses. 9- C Comments: Organophosphates

are substances commonly found in insecticides in very toxic to humans due to formation of a very stable complex with acetylcholinesterase 10- D Comments: Constipation

is a common side effect of atropine poisoning, therefore we should not consider diarrhea as atropine symptoms of overdose. 11- A Comments: Physostigmine

is considered as the best antidote for atropine poisoning and for antihistaminic overdose as well.


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12- E Comments:

Poison Ivy can be treated by topical antipruritic, oral antihistaminic and systemic corticosteroids in case of severe poisoning. 13- C Comments: Protamine

sulfate is the recommended antidote for heparin

14- E Comments:

N-acetyl-cysteine is the specific antidote for acetaminophen overdose or

poisoning. 15- E Comments: Antidote

of elemental mercury inhalation is dimercaprol and inorganic salt mercury gastrointestinal absorption the antidote may be dimercaprol and penicillamine as well. 16- A Comments: Naloxone

is a pure opioid antagonist used in opioids overdose.

17- E Comments:

Digoxin toxicity may cause heart failure, cardiac dysrrhythmias, nausea, anorexia, vomiting, and confusion. The first step in the treatment of overdoses should include decontamination and supportive therapy. Digoxin has a specific antidote known as FAB antibodies (Digibind). 18- B Comments:

Death due to cyanide poisoning is primarily due to cyanide-hemoglobin complex formation. 19- B Comments:

The toxicity of methyl alcohol is mainly due to formation of formaldehyde.

20- D Comments: Acetaminophen

toxicity is mainly due to reactive metabolite.

21- A Comments: 21-

Salicylate toxicity excessive respiration is due to excess production of

CO2. 22- B Comments: Lead

poisoning is mainly characterized by grayish mouth and loose of teeth. The best antidote for lead poisoning includes dimercaprol, edentate, penicillamine and succimer. 23- E


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Comments: Vomiting

induction normally done by administration of IPECA is contra indicated if poisoning is due to bleaching, gasoline, light petroleum and/or any other corrosive substance. 24- E Comments: Universal

antidote is a mixture of activated charcoal, magnesium oxide and

tannic acid. 25- E Comments: The

main concerning in amphetamines overdose is the control of the seizures that can be done by either benzodiazepinic or barbiturate agents. 26- E Comments: Hyperkalemia

should be immediately treated if change in ECG is detected; give Ca to counteract the excess of K on the heart and other treatments may be considered such as bicarbonate and insulin administration that can shift K from extra to intracellular. Alternative treatment of hyperkalemia include enema of kafexolate (exchange resin) or dialysis that helps to remove excess of K from the body. 27- C Comments:

Nitroprusside is a direct vasodilator agent widely used in cardiovascular complications. It over dosage may lead to cyanide intoxication because its end metabolism product is cyanide. 28- E Comments:

The best antidote for lead poisoning includes dimercaprol, edentate, penicillamine and succimer. 29- B Comments:

Deferoxamine is the only specific antidote used as antidote for iron preparations overdose or poisoning. 30- A Comments:

Atropine is considered to be the best antidote in the treatment of organophosphates poisoning 31- D Comments:

MAO antidepressants administration in tricyclic antidepressant overdoses would intensify the overdose of the patient and would increase the chances of the patients in develop a syndrome called “serotoninergic syndrome”. 32- C Comments: Antivenin

is the antidote of choice in poisoning due to bits of snake and black

spider. 33- B


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Comments: Oxygen

therapy is the most appropriate method to treat carbon monoxide intoxication avoiding it to bind to hemoglobin. 34- B Comments:

Vitamin B6 also known as pyridoxine is considered the best antidote in isoniazide overdoses. 35- A Comments: Vitamin

K is considered the specific antidote for warfarin overdose.

36- D Comments:

Evaluation and support of vital function such as airway, breath and circulation should be considered as the major first step in the initial management of any intoxication and poisoning. 37- E Comments: Patient

with depressed mental status and unknown drug overdose should be general treated by control of hypoglycemia with 50mls of dextrose 50%, administration of thiamine 100mg IV push and administration of naloxone 38- E Decontamination procedures involve removal of the ingesting agent with gastric lavage, emesis by IPECA administration, and adsorbent agents administrationcharcoal. Comments:

39- C Comments:

Verapamil overdose associated with hyperkalemia may be treated by intravenous calcium administration 43-E Tips: there is no antidote for ASA, as overdose have to treat by alkaline diuresis using NaHCO3. 44-C

BIBLIOGRAPHIC REFERENCE

1- COMPREHENSIVE PHARMACY REVIEW – Lippincott William & Wilkins – Fourth edition 2- CPS-COMPENDIUM OF PHARMACEUTICALS AND SPECIALITIES - Canadian Pharmacist Association – 2001 edition.


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th

3- MEDICAL DICTIONARY – Dorland’s illustrated – 27 edition. 4- PHARMACY PREP – Lectures series & study guide for Evaluating ExaminationTIPS - 2003/2004 5- THERAPUTIC CHOICES – Canadian Pharmacist Association -Third edition th

6- USP DI – Drug Information for the Health Care Professional–15 edition – Volume I.


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1 Biomedical Sciences Q&A

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