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Pharmacy Prep
Evaluating Exam
Review and Guide
Q&A
MUST PASS July 2016
Misbah Biabani, Ph.D
Director
Toronto Institute of Pharmaceutical Sciences (TIPS) Inc.
Toronto, ON M2N K7
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Foreword by
Misbah Biabani, Ph.D
Coordinator/Director, Pharmacy Prep
Toronto Institute of Pharmaceutical Sciences (TIPS) Inc
4789 Yonge St. Suites 417
Toronto ON M2N 5M5, Canada
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Content
Abbreviations
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Human anatomy
PHARMACY PREP
HUMAN ANATOMY
1. What is an opposite of anterior view?
A. Ventral view
B. Posterior view
C. Lateral view
D. Medial view
E. Supination
Ans. B
Tips. Ventral (anterior) is opposite to Dorsal (posterior) and the lateral is opposite to medial.
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Human anatomy
Ans. D
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Gastrointestinal System
PHARMACY PREP
GASTROINTESTINAL SYSTEM
1. A person with Vitamin B12 deficiency due to intrinsic factors. Should take?
A. Vitamin B 12 supplements
B. Vitamin B 12 IM inj.
C. Vitamin B 12 oral
D. Vitamin B 12 inj. and folic acid
Ans. B
2. PPI & H 2 RAs act on?
A. G cells
B. Gastrin
C. Parietal cell
D. Hydrochloric acid
Ans. C
3. Which of the following may increase excessive acid secretion in patient with?
A. high carbohydrate diet
B. high protein diet
C. High liquid diet
D. High salt diet
E. All of the above
Ans. b
4. What is the main cause of dyspepsia?
A. GERD
B. Peptic ulcers
C. Reflux esophagitis
D. Gastric cancer
Ans. B
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Gastrointestinal System
A. Ulcer
B. GERD
C. Appendicitis
D. Angina
E. All of the above
Ans. A
Tips: Epigastric pain is a symptom of Ulcer. (less likely GERD), GERD is heartburn, this could be
regurgitation of acid into esophagus to throat.
7. Fistula or granulomas or skip patches occurs in?
A. Irritable bowel disease
B. Ulcerative colitis
C. Crohn's disease
D. Gastritis
E. GERD
Ans. C
8. Hyper acid secretion caused by?
A) Heart burn (reflux of gastric content into esophagus)
B) Peptic ulcers (H. pylori)
C) Ulcerative colitis (inflammatory)
D) Zollinger Ellison syndrome
E) GIT cancers
Ans. D
Tips. Zollinger-Ellison Syndrome occurs when gastrin secreted by non-beta cell tumors of
pancreas.
9. A regular customer of your pharmacy, is taking treatment of osteoarthritis. Recently got
gastritis? What is correct?
A) Patient is using acetaminophen
B) Patient is using corticosteroids
C) Patient is using NSAIDs
D) Patient is using methotrexate
E) Patient has heartburn
Ans. C
10. What is the most sensitive and specific means to diagnose the cause of dyspepsia?
A. Endoscopy
B. CT scan
C. Magnetic resonance imaging
D. Urea Breath Test
E. Esophagogastroduodenoscopy
Ans. A
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Gastrointestinal System
11. Which of the following bacteria can cause chronic peptic ulcer disease?
A. E. coli
B. H. pylori
C. S. aureus
D. S. pneumonia
E. Candida infections
Ans. B
12. What is the laboratory test confirm the peptic ulcer disease caused by H. pylori?
A. Endoscopy
B. CT scan
C. Magnetic resonance imaging
D. Urea Breath Test
E. Esophagogastroduodenoscopy
Ans. D
13. All GI conditions are associated with GI bleeding symptoms? except
A) GI cancer
B) Pancreatitis
C) Gastritis
D) Crohn's disease
E) Ulcerative colitis
Ans. b
Tips. Pancreatitis has no GI bleeding and pancreatitis symptoms are upper abdominal pain
that radiates into back. It may aggravated by eating, especially foods high in fat. Tender
abdomen, nausea and vomiting and increased heart rate.
14. What type of hernia is common in seniors or elderly?
A) heital hernia
B) sliding hernia
C) Para esophageal hernia
D) None of the above
Ans.A
15. Polypeptides and caffeine stimulates secretion of?
A. parietal cells
B. vitamin B 12
C. gastrin
D. chyme
E. amylase
Ans. C
16. When parietal cells are stimulated, they secrete?
A. Intrinsic factor and gastrin
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Gastrointestinal System
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Nervous System
PHARMACY PREP
Nervous System
1. Which part of brain that controls important cognitive skills in humans, such as emotional
expression, problem solving, memory, language?
A. Frontal lobe B. Occipital lobe C. Temporal lobe D. Parietal lobe E. Brainstem
Ans. A
4. Which part of brain that controls important cognitive skills in humans, such as emotional
expression, problem solving, memory, language?
A. Frontal lobe
B. Occipital lobe
C. Temporal lobe
D. Parietal lobe
E. Brainstem
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Nervous System
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Cardiovascular System
PHARMACY PREP
CARDIOVASCULAR SYSTEM
1. Which of the following cardiovascular disease is the most commonly associated with
atherosclerotic plaques?
A. Angina
B. Myocardial infarction
C. Deep vein thrombosis
D. Ischemic stroke
E. All of the above
Ans. e
Tips: if stable plaque than commonly cause angina, if plaque is ruptured than cause
inflammation can lead to MI.
2. What is the most common cause of arteriosclerosis is?
A) high LDL B) Smoking
C) Hypertension D) emotional stress E) all of the above
Ans. A
3. Clarithromycin cause QT prolongation, it associated?
A. Atrial depolarization
B. ventricular depolarization
C. Atrial tachycardia
D. side effects of drugs
Ans. B
4. A patient with atrial fibrillation, have characteristic effect on ?
A. affect on QRS wave
B. affect on P wave
C. affect on T wave
D. affect on Q-T prolongation
Ans. B
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Cardiovascular System
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Endocrine System
PHARMACY PREP.
ENDOCRINE SYSTEM
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Endocrine System
C) Physical activities
D) Heavy meals
E) Acute illness
Ans . C
6. Which of the following stimulates secretion of calcitonin hormone from
thyroid gland?
A) hypocalcemia
B) hypercalcemia
C) Hypokalemia
D) Hyperkalemia
E) hypertension
Ans. B
7. 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
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PHARMACY PREP
RENAL DISORDERS
1. Reabsorption of drugs in kidney does NOT depend on:
A. Flow rate
B. Tonicity
C. Tubular secretion
D. pH
E. Metabolism
Ans. C
2. Prerenal acute renal failure (ARF) is characterized as?
A) Inadequate blood circulation (perfusion) to the kidneys
B) Excessive blood perfusion to the kidney
C) Excessive drug elimination
D. Bladder cancer
E) All of the above
Ans. A
3. All of the following drug cause metabolic alkalosis, except?
A. ACIDzolamide
B. Thiazides
C. hydrochlorothiazide
D. Loop diuretics
E. Furosemide
Ans. A
4. A man with history of severe diarrhea, the loss of HCO 3 - from GI tract causes a
decrease in blood [HCO 3 -], and increase CO 2 his values are thus this man has? pH = 7.25,
pCO 2 = 24 mmHg, [HCO 3 -] = 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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C. ACE Inhibitors like captopril may cause hypokalemia
D. Spironolactone may cause hyperkalemia
E. Hydrochlorothiazide may cause hypokalemia
Ans. C
6. A regular customer of your pharmacy, age 55 yo, medication profile include Ramipril
10 mg, valsartan 5 mg, and recently doctor added spironolactone. Patient diet include
excessive intake of bananas. All of the following are pharmacist concern, except?
A. Ramipril
B. Valsartan
C. Spironolactone
D. Age 55 yo
E. Bananas
Ans. D
7) Which of the following is the least preferable combination antihypertensive in a
patient whose K+ levels are 5.5 mEq/L?
A) Ramipril/Hydrochlorothiazide
B) Valsartan/Amlodipine
C)Perindropril/spironolactone
D) Losartan/Hydrochlorothiazide
E) Amlodipine/Atorvastatin
Ans. C
8.Characteristics of nephrotic symptoms, include all except?
A) Proteinuria
B) Hypoalbuminemia
C) edema
D) Hyperalbuminemia
E) hyperlipidemia
Ans: D
9.A patient eGFR declined significantly and doctor suspect chronic kidney diseases. All of
the following are associated with chronic kidney disease, except?
A. Intravenous radiographic contrast
B. NSAIDs or COX-II inhibitors
C. Volume depletion
D. Strict blood pressure or blood glucose control
E. Aminoglycosides
Ans. D
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C) Bilirubin
D) Albumin
E) LDH
Ans. C
Tips. The liver cirrhosis diagnosis can be confirmed by a liver biopsy (removal of a tissue
sample for examination under microscope). CT scan and ultrasound may show that liver
is shrunken or abnormalities.
Alcoholic liver disease can result into liver cirrhosis. Trans aminases AST to ALT ratio
>2:1 strongly suggest alcohol abuse.
6. MK is a 50 year old man diagnosed for ascites. Which of the following are causes of
ascites, except
A) Tuberculosis
B) Abdominal surgeries
C) Congestive heart failure
D) Stroke
E) Liver cirrhosis
Ans. D
Tips. Stroke is cerebrovascular conditions and not associated with chronic liver disease
ascites.
7. Drugs that causes cholestatic jaundice side effects?
A) Cotrimoxazole
B) Erythromycin base
C) Erythromycin lactobacillus
D) Probiotics
E) Erythromycin estolate
Ans: E
8. Liver enzymes like cytochrome CYP450 cause drug metabolism in liver. What is NOT
related to drugs that are metabolized in liver?
A) metabolism effects by tissue binding
B) metabolism changes with liver blood circulation
C) metabolism changes with intrinsic activity
D) metabolism effected by chronic liver diseases
E) oxidative metabolism is catalyzed by cytochrome CYP450.
Ans: C
9. Hepatitis B is transmitted by all, except?
A) contact with blood and its products
B) sexual transmission
C) contact oral secretion
D) sharing needle
E) blood transfusion
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Ans. C
Tips: oral secretion contact can cause hepatitis A.
10. Phase II metabolic reaction glucoronidation is effected by
Enterohepatic recirculation. Which of the following drugs are effected?
A) drugs that undergoes phase II metabolism
B) estrogen/progestins oral contraceptive pills
C) drugs with phase I metabolism
D) Drug with first pass metabolism
E) Lipid soluble drugs
Ans: A
11. What is the most common cause of alcoholic liver diseases?
A. Corticosteroids therapy
B. Acetaminophen toxicity
C. Alcohol abuse
D. Ascites
E. Wilson's disease
Ans. c
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Respiratory System
PHARMACY PREP.
RESPIRATORY COMPLICATIONS
1) Emphysema is?
A) COPD
B) Fibrosis
C) Bronchitis
D) Airway disease
E) None of the above
Ans. A
2. Dyspnea means
A. Painful muscle spasms
B. Pain in the heart
C. Pain in extremities
D. Painful breathing
E. Painful menstruation
Ans. D
3. Condition characterized by a irreversible form of airflow obstruction is
known as:
A. Aneurism
B. Emphysema
C. Embolism
D. Cirrhosis
E. Jaundice
Ans. D
4. Asthma is a condition of respiratory tract that may be aggravated by?
A) Allergens
B) Cold weather
C) Exercise
D) Emotional stress
E) All are correct
Ans. E
5. The MOST well known characteristic symptom of asthma include:
A. Wheezing
B. Mucosal edema
C. Cough
D. Chest tightness
E. Tachycardia
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Respiratory System
Ans. A
6. All are correct concerning the action of corticosteroids in asthma status, EXCEPT:
A. Suppress the inflammatory response
B. Decrease production of inflammatory mediators
C. Decrease airway responsiveness to inflammation
D. Relieve brochocontriction
E. Increase -agonist receptors response
Ans. E
7. The capacity of inhalation is depends on the volume of?
a) alveoli
B) total lung capacity
C) airways
D) Bronchus
E) Bronchial cavity
Ans. B
Tips: Total lung capacity is the volume in the lungs after a maximal inspiration.
Total lung capacity includes tidal volume, inspiratory reserve volume, Expiratory volume
and residual volume.
8. Peak flow meter is test to determine asthma severity for patient at home. This test
measures?
A) The highest forced expiratory flow
B) Volume that has been exhaled at the end of the first second (FEV 1 ).
C) Total lung capacity
D) Expiration rate
E) Inspiration rate
Ans. A
9. Spirometer is device used in clinics to diagnose asthma? Spirometer measures?
A) The highest forced expiratory flow
B) Volume that has been exhaled at the end of the first second (FEV 1 ).
C) Total lung capacity
D) Expiration rate
E) Inspiration rate
Ans. b
10. Factors that decrease the respiration except:
A. Mucosal edema
B. Increase brachial secretion
C. Increase ventilation
D. Bronchospasm
Ans: C
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Respiratory System
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Urinary System
Pharmacy Prep
Urinary System
1. Which of the following is NOT a symptom of benign prostatic hyperplasia?
A. Frequent urine
B. Nocturia
C. Irritation
D. Jet urination
E. All of the above
Ans. D
Tips: in BPH normal stream of urination is not possible.
2. Which of the following is NOT a symptom of urinary tract infection?
A) Increase in urinary frequency
B) Burning sensations
C) Fever
D) Bactiurea
E) Weight loss
Ans. E
3. What is the most common type of UTI?
A. Complicated UTI
B. Uncomplicated UTI
C. Cystitis
D. Pylonephritis
E. Ureteritis
Ans. C
Tips. cystitis is bladder infection, and the most common.
4. What is the most common agent that cause UTI?
A. S.aureus
B. P. aeruginosa
C. E. coli
D. Syphilis
E. Gonorrhea
Ans. C
5. What is the drug of choice to treat cystitis?
A. Amoxicillin
B. Cefixime
C. Cotrimoxazole
D. Nitrofurontoin
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Urinary System
E. Trimethoprim
Ans.c
6. What is the distinguishing symptom of complicated UTI?
A. High fever
B. blood in urine
C. dysurea
D. frequent urination
Ans. b
7. What is the drug of choice to treat benign prostatic hyperplasia?
A. Doxazosin
B. Tadalafil
C. Finasteride
D. Saw palmetto
E. oxybutynin
Ans. c
8. All of the following used to treat BPH? except
A. Doxazosin
B. Tadalafil
C. Finasteride
D. Saw palmetto
E. oxybutynin
Ans. E
9. Which of the following is stress incontinence?
A) Relaxed pelvic floor
B) Urethral blockade
C) inability void urine
D) Urgency of urine
E) Urinary retention
Ans: A
10. What is the most common pathogen associated with cystitis?
A. S. aureus
B. Gonorrhea
C. Chlamydia
D. E. coli
E. Shigella sp
Ans. D
11. Which of the following medical conditions cause difficulty to urination in stream?
A. Urinary tract infections
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Urinary System
B. Prostatitis
C. Benign prostatic hyperplasia
D. Urinary incontinence
E. Cystitis
Ans: C
12. Hyperplasia is?
A. Increased in cell size
B. Increased in cell numbers
C. Decreased in cell size
D. Decreased in cell numbers
E. Increase cell size and numbers
Ans. B
13. Hypertrophy
A. Increased in cell size
B. Increased in cell numbers
C. Decreased in cell size
D. Decreased in cell numbers
E. Increase cell size and numbers
Ans. A
14. Which of the following cause tumors?
A. hypertrophy
B. hyperplasia
C. Atrophy
D. hyperacidity
Ans. b
15. KP is a 37 year old women. Presents to doctor with symptoms of frequent urination at
work place. Doctor has diagnosed with urinary incontinence. Her social history, denies
taking alcohol and smoking. She is mother of 2 children and gave a birth to her 3rd child
recently a month ago. What type of incontinence?
A) Urge incontinence
B) Overflow incontinence
C) Stress incontinence
D) Urinary tract infection
16. What drugs are least likely used in patient with urinary incontinence?
A. oxybutynin
B. diuretics
C. amitriptyline
D. All of the above
ans. B
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Urinary System
17. Urinary incontinence in children is defined as repeated daytime or night time voiding
urine into the bed or cloths. It is termed as?
A. Bed sores
B. Bed wetting
C. Wetting Phenomenon
D. All of the above
Ans. B
18. Enuresis is bed wetting is treated by?
A. Diuretics
B. Desmopressin
C. Fluoxetine
D. Diphenhydramine
Ans. B
Tips: Desmopressin is antidiuretic hormone analog.
19. Tamsulosin is used to treat benign prostatic hyperplasia symptoms. It blocks alpha 1a
receptors and facilitates urine flow?
A) coronary arteries
B) bladder arteries
C) prostate arteries
D) cerebral arteries
E) all of the above
Ans. B
20. Testosterone to dihydrotestosterone is catalyzed by 5-alpha reductase. The
dihydrotesterone cause prostate growth. What drugs inhibit 5-alpha reductase and
reduce prostate size?
A) Alpha blockers
B) tamsulosin
C) terazosin
D) androgen agonist
E) androgen antagonist
Ans. E
Tips. Finasteride is an androgen antagonist. The drug of choice for BPH. Finasteride and
dutasteride are androgen antagonist. act by inhibiting 5-alpha reductase.
21. Which of the following is least likely associated with UNCOMPLICATED urinary
tract infections?
A. dysurea
B. urinary urgency
C. fever
D. turbid urine
E. urinary frequency
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Urinary System
Ans. d
Ans.D
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Human anatomy
PHARMACY PREP
The Eye
1. 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
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Human anatomy
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Human anatomy
Ans: A
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Human anatomy
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Human anatomy
Ans. B
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Human anatomy
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Human anatomy
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Human anatomy
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Human anatomy
Ans. c
An optometrist prescribed ciprofloxacin drops 2 gtt OD for
10 days. What is correct?
A. Instill 2 drops in both eye for 10 days
B. Instill 2 drops in affected eye for 10 days
C. Take ciprofloxacin 500 mg daily for 10 days
D. Instill 2 drops in right eye for 10 days
Ans. D
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Human anatomy
B. clindamycin
C. azithromycin
D. clarithromycin
E. cephalexin
ans. a
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3. Hematocrit is?
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Biochemistry
PHARMACY PREP
BIOCHEMISTRY
A. omega 3
1
COOH
D. EPA E) DHA
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Biochemistry
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Biochemistry
D) Phenyl alanin
E) Acetyl CoA
Ans. C
11. Heme containing enzymes are formed from protoporphyrin. What are the
examples of heme containing enzymes or proteins?
A) hemoglobin
B) myoglobin
C) cytochrome oxidase
D) all of the above
Ans. D
12. Which of the following is the rate limiting step in atherosclerosis formation?
A. HMG-COA to mevalonate formation
B. Mevalonate to cholesterol formation
C. Low density lipoprotein formation'
D. Lipid synthesis
Ans. A
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Nutrition
PHARMACY PREP
NUTRITION
1) Choose correct answer about linolenic acid and linoleic acid:
A) Linolenic acid is should be taken with diet.
B) Linolenic acid and linoleic acid have only difference of double bond in chemical
structure.
C) Linolenic acid is omega 3 essential fatty acid
D) Linoleic acid omega 6 essential fatty acid
E) All of the above
Ans. E
Tips. Linolenic is omega 3 essential fatty acids. Omega 3 has three double bonds at
position, 9, 12 and 15. Whereas omega 6 has two double bonds at position 9 and 12.
2. Rhodopsin is an eye pigmentation present in rods photoreceptor. Transform the
following conversion of 11 retinal to produce night vision?
A. 11-Cis-retinal to 11-trans retinal
B. 11-Trans retinal to 11-cis retinal
C. 13-Cis retinal to 13- trans retinal
D. 13 trans retinal to trans retinal
E. 12 cis retinoic acid to trans retinoic acid
Ans: A
3. Which of the following vitamin should you recommend for smokers?
A. Vitamin A
B. Vitamin B
C. Vitamin C
D. Vitamin D
E. Vitamin E
Ans. C
4 What vitamin overdose could cause toxicity?
A. Vitamin A
B. Vitamin B
C. Vitamin C
D. Vitamin D
E. Vitamin E
Ans. A
5. A breast fed infant should recieved which of the following vitamin drops?
A. Vitamin A drops
B.Vitamin B 12
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Nutrition
C.Vitamin C
D.Vitamin D drops
E. Vitamin E drops
Ans. D
6. Age over 70 years and elderly commonly have deficiency of vitamin?
A. Vitamin B1
B.Vitamin B 12
C. Vitamin B 6
D. Vitamin D
E. Vitamin K
Ans. B
7. A person is allergic to gluten, which of the following should not recommend?
A. Milk
B. Rice
C. Wheat
D. Wine
E. Eggs
Ans. C
8. What is the closes option to breast milk for infant at age of 3 mo?
A. Formula milk
B. Cow based formula milk
C. Soy based formula milk
D. Lactose free formula milk
E. Cow milk
Ans. B
9.Inadequate intake of vitamin D over 50 years age can cause?
A. renal disease
B. osteoporosis
C. osteoarthritis
D. hypercalcemia
E. Hyper vitamin D syndrome
Ans. B
10. Nephrolithiasis caused by?
A. Deficiency of vitamin D
B. Deficiency of Vitamin A
C. Overdose of vitamin A
D. Overdose of vitamin B 12
E. Overdose of vitamin D
Ans. E
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Nutrition
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Microbiology
PHARMACY PREP
MICROBIOLOGY
1. 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 to 50% aerobic
E. There is no bacteria in lower gut
Ans . A
2. The 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
3. The following organism least likely causes pneumonia:
A. S. pneumonia
B. M. pneumonia
C. H. influenza
D. M. catharhalis
E. E. coli
Ans. E
4.Toxic shock syndrome (TSS) is caused by:
A) E. coli
B) Gonorrhea
C) S. aureus
D) Syphilis
E) Chlamydia
Ans. C
5. Which of the following NOT associated with Toxic shock syndrome?
A. Tampons
B. Condoms
C. Contraceptive sponges
D. Intra uterine devices (IUD)
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Microbiology
9. MK is a 27 year old man presents with persistent ear pain for last 2 days and
associated with drainage. Pharmacist refer patient to physician because?
A. otitis externa caused by P. aeruginosa and S. aureus
B. Because it is associated with drainage
C. Because ruptured tympanic membrane
D. because ear pain with drainage could be perforation of tympanic membrane or
drainage from middle ear.
E. Because it can cause hearing loss
Ans.D
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Microbiology
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E. RNA
2. Translation occurs:
A) Before transcription
B) After transcription
C) Same time as transcription
D) in mitochondria
E) in chromosomes
Ans. A
3. Hemophilia type A results from deficiency of
clotting factor?
A) factor 5
B) factor10 C) factor 8
D) factor 2
Ans. C
E) factor 9
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
Ans. C
m
w
X
X
xx
xx
xy
xy
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PHARMACY PREP
PHARMACOGENETICS
1) What is definition of Pharmacogenetics?
A) The pharmacogenetics is integration of pharmacology and genetics.
B) The study of pharmacogenetics allows designing and developing drugs that are customized
to each persons genetic mark up.
C) The pharmacogenetics also utilized to study cytochrome enzymes that are responsible for
drug interactions.
D) The pharmacogenetics identifies the genetic variation that cause drug cause differences in
drug response.
E) All of the above
Ans. E
2. What is SNP?
A. Single nucleotide polymorph
B. Single nucleotide pharmacogenetic
C. Single genetic markup
D. Single genetic variation
E. Single nucleotide product
Ans. A
Tips. The SNP is single nucleotide polymorphism (SNP). It occurs when one base pair of
nucleotide replaces another. A single base differences that exist between individual. This is
the most common genetic variation in DNA.
3. If you know person genetics mark up, and target a medicine is defined as?
A. pharmaceutics
B. biotechnology
C. Nanotechnology
D. Pharmacogenetics
E. Molecular biology
Ans. D
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Immunology
PHARMACY PREP.
IMMUNOLOGY and Immunizations
1. Which of the following is a pro-inflammatory cell responsible for initiation of an acute
inflammation?
A. Eosinophils
B. Platelets
C. Mast cells
D. Basophiles
E. Neutrophils
Ans. C
2 Poison ivy is what type of hypersensitive reactions?
A) Type I
B) Type II
C) Type III
D) Type IV
E) Type V
Ans. E
3. A 70 yo elderly patient is treated with antibiotics for 7 days. However, still have signs
of symptoms of infections such as fever. The patient neutrophil count is still increased
over 70%. What kind of infections patient have?
A. parasitic
B. viral
C. fungal
D. inflammation
E. bacterial
Ans. E
4. All of the following can transmit HIV, except?
A) Sexual contact
B) Maternal transmission
C) Drug abuse and sharing needle
D) cut and wounds contact
E) Orofecal
Ans. E
5. A HIV patient currently has CD 4 T cell count is 300. What treatment doctor may target
for prophylaxis?
A. M. Tuberculosis
B. Cytomegalvoirus
C. Pneumocytisis pneumonia jerovicii or carinii
D. Non-Hodgkins lymphoma
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Immunology
E. Kaposis sarcoma
Ans. A
6. What is true about immunoglobulin structure?
A. consist of protein and amino acids sequence
B. Consist of long chain amino acids and disulfide bond linkage
C. Consist of long chain and small chain protein linked with disulfide bonds bridge
D. Consist of specific amino acids selective sites of infections.
E. Humoral antibody structures
Ans. C
7. What is average life span of survival for HIV patient?
A. 10 yrs
B. 11 yrs
C. 1-2 yrs
D. 2-3 yrs
E. 20-30 yrs
Ans. D
8. A customer of your pharmacy travelling to mountain. She has history of anaphylaxis.
Which of the following product pharmacist should recommend to take?
A) Travelers diarrhea Dukoral vaccine
B) Hepatitis A vaccine
C) Flu vaccine
D) DEET mosquito repellant
E) Epipen
Ans.
9.All of the following are NOT recommended for flu vaccine, except?
A) Child under 6 months age
B) A person allergy to eggs
C) Person with currently acute bronchitis symptoms
D) Pregnant
E) Person with current symptoms of pneumonia
Ans. D
10. Which of the following populations is LEAST considered high risk for influenza so
that vaccination with influenza vaccine is not necessary?
A) Person age > 5 yrs to 50 yrs
B. Residents of long-term care facilities (e.g., nursing homes)
C. Patients with diabetes mellitus
D. Patients over the age of < 65 yo
E. Patients with COPD or asthma
Ans. A
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Immunology
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Biotechnology
PHARMACY PREP
BIOTECHNOLOGY
1. Herceptin (Trastuzumab), is
A. Treatment of HER2-overexpressing metastatic breast cancer
B. Tumor necrosis factor alpha inhibitor
C. Glycoprotein inhibitor
D. Interleukin
E. Interferon's
Ans: A
7. Filgrastim is?
A. Colony stimulating factor
B. Erythropoietin's
C. Interferon's
D. Human growth hormones
E. Monoclonal antibodies
Ans: A
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Biotechnology
8) Operlaveukin is?
A) Interleukin 11
B) Colony stimulating factor
C) Interleukin 3
D) Interleukin 2
E) Epoeitin
Ans. A
HAMA is?
A)
B)
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Biotechnology
Murine antibody
D) Humanized antibody
E) Human antibody
Ans. B
C)
Mouse
100%
mouse
Example
drugs produced
by murine
antibody?
Muromonab,
Chimeric
25% mouse
Humanized
10% mouse
Human
100%
human
drugs produced
by 5 chimeric
antibodies?
Rituximab,
abciximab,
drug produced by 12
Humanized
antibody?
(transgenic)
Trastuzumab,
drug produced
by 4 human
antibody?
Adalimumab
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capromab
Biotechnology
infliximab,
cetuximab,
basiliximab.
omalizumab,
daclizumab
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Toxicology
PHARMACY PREP
TOXICOLOGY
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Toxicology
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Toxicology
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Toxicology
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Toxicology
47. B
BIBLIOGRAPHIC REFERENCE
1- COMPREHENSIVE PHARMACY REVIEW Lippincott William & Wilkins Fourth edition
2- CPS-COMPENDIUM OF PHARMACEUTICALS AND SPECIALITIES - Canadian Pharmacist
Association 2001 edition.
3- MEDICAL DICTIONARY Dorlands illustrated 27th edition.
4- PHARMACY PREP Lectures series & study guide for Evaluating Examination-TIPS 2003/2004
5- THERAPUTIC CHOICES Canadian Pharmacist Association -Third edition
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Toxicology
6- USP DI Drug Information for the Health Care Professional15th edition Volume I.
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PHARMACY PREP.
PHARMACOKINETICS
PHARMACOKINETIC FORMULAS
Vd = D/Cp
Cp = D/Vd
D = Vd x Cp
V d = CL T /K el
t 1/2 = 0.693 /K el
K el = 0.693/t 1/2
1) A dose of 240 mg was given to a patient, his total body clearance is 3.5 L/min and
the drug excreted unchanged in the urine is 80 mg. What is his non-renal clearance?
a) 240 ml/min
b) 2.3 L/min
c) 3.3 L/min
d) 1.16 L/min
e) 160 ml/min
Ans. B
Renal clearance is drug excreted unchanged or metabolized in urine.
CL T = CL R +CL NR
CL NR = CL T - CL R
240 mg................3.5 L
80 mg....................?
=1.16 L
= 3.5 - 1.16 = 2.3L
or
3.5/240 mg = ?/80 mg
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A)
B)
C)
D)
E)
Ans. B
3.A dose was given, the plasma concentration was 64 mg, t 1/2 =0.7 hrs. After 7 hours
from the initial dose, what is the drug's concentration?
a) 0.0mg
b) 1mg
c) 2mg
d) 3mg
e) 4mg
Ans. A
Tips. 64 --> 32 --> 16 -->8-->4 -->2-->1-->0.5 -->0.25 -->0.125-->0.06
or
C = C o . e-kt
K = 0.693/t 1/2
K = 0.693/0.7 = 0.999
C = 64 x e(-0.999x7) = 0.06
or
ln C = -kt + ln C o
How to use calculator (Sharp EL-510RN)
Enter 64
Multiply
Enter 2ndF
Enter ex
Enter (
Enter (-)
Enter
Enter )
Enter =
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4. A 40 year old patient who weighs 70 kg, needs intravenous infusion of amoxicillin. The
desired C ss of drug is 15mg/dL. The physician ordered antibiotic infused for 10 hours.
Amoxicillin has t 1/2 = 1 hour and Vd = 9L.
What rate of iv is recommended for this patient? (no loading dose was given);
A. 135 mg/hr
B.936 mg/hr
C. 1000 mg/hr
D. 333 mg/hr
E. 400 mg/hr
Ans. B
Tips:
C ss = R___
K x Vd
R = Rate of infusion
K = first order elimination constant
V d = volume of distribution
R = C ss x k x V d
R = 15 0.693 x 9000 =
100 1 hour
= 935.54 mg/hr
5) If the rate of infusion of the drug is 500 mg q8h and clearance is 7.3 L/hr. Find steady
state concentration
a) 85.6 mg/L
b) 856 mg/L
c) 8.56 g/L
d) 8.56 mg/L
e) 68.4 mg/L
C ss = rate of infusion/clearance
Ans. D
Css = R/CL
CL = R/Css
R = Css x CL
CL = K x Vd
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6. For an effective antimicrobial to treat UTI it must be all, except?
A) low level of protein binding
B) short biological half life thus can reach high concentration rapidly
C) high distribution in body
D) high distribution in urinary tract
E) highly active against gram negative bacteria
Ans. D
7. A drug was found to have zero order kinetic 100 mg after 6 days
long it will take to eliminate the entire drug from the body?
a) 100 days
b) 200 days
c) 300 days
d) 600 days
e) 900 days
Ans. d
99 mg. How
8. A patient was given 100 mg drug orally. The drug absorbs at rate of 10 mg/min and
follows zero order kinetics. After 5 min how much drug will be absorbed?
A. 10 mg
B. 50 mg
C. 75 mg
D. 100 mg
Ans. b
9. A patient was given 100 mg drug orally. The drug absorbs at rate of 10 mg/min and
follows zero order kinetics. How long it takes to absorb all the drug?
A. 10 min
B. 50 min
C. 75 min
D. 100 min
Ans. A
10. Ampicillin in 5% dextrose degrades by first order kinetic, at rate constant of 0.026
h. What is the shelf life of ampicillin?
a) 4 hr
b) 8hr
c) 2hr
d) 16hr
e) 12hr
Tips. T 90 = 0.105/K
T 90 = 0.105/0.026 = 4hrs
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11. Approximately 50% of cloxacillin is excreted unchanged in the urine. If the normal
dosage schedule for cloxacillin is 125 mg q6h, a patient with renal function 20% of
normal should receive?
a) 25 mg q6h
b) 31.25 mg q6h
c) 62.5 mg q6h
d) 75 mg q6h
e) 125 mg q12h
Tips:d
Renal
Cloxacillin 50%
62.5
Non renal
50%
mg
62.5 mg
12.5 mg
62.5 mg
or
50-20 = 30%
50% .............125
30%................?
12. Drug which dose is 1500 mg is given every 24 hours. The renal clearance of this
drug is 1.2 mg/dL. Calculate the clearance in ml/min.
a) 98.6 ml/min
b) 76.8 ml/min
c) 86.8 ml/min
d) 66.8 ml/min
e) 43.6 ml/min
Ans. C
Tips
1.2 mg...........100 mL
1500 mg..........?
= 125,000 mL for Q24h (1440 min)
125,000............1440 min
? mL.........................min
= 86.8 ml/min
or
1.2 mg --------100 ml
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1500 mg---------X
X = 125000 mls
X---------------1 min
X = 86.8 ml/min
or
125000 ml/1440 min = 86.6 ml/min
13. If a drug is 50% metabolized and half life drugs is 1 hr . What is the percentage of
blood concentration after 4hrs?
a) 50%
b) 25%
c) 12.5%
d) 6.25%
e) 3.12%
Ans. D
Tips: 100 50% --> 25 -->12.5 --> 6.25%-->
or
Drug concentration = 100%
t 1/2 (decrease the drug by half) = 50%
2 t1/2
t1/2
t1/2 = 6.25%
14. A new antifungal was given at a dose of 5mg/Kg by a single intravenous bolus
injection to a 32 years old female who weighed 75Kg. The antifungal has an
elimination half life of 2 hours and apparent volume of distribution of 0.28L/Kg.
What is the initial plasma drug concentration in this patient?
a) 36 mg/L
b) 1.8 mg/L
c) 17.8 mg/L
d) 1.79 mg/L
e) 19 mg/L
Ans. C
C p = D o C p = 5 mg/Kg = 17.8mg/L
Vd
0.28L/kg
15. Following the anterior information, calculate the predicted plasma concentration at
8 hours after the dose:
a) 15mg/L
b) 111mg/L
c) 11.1mg/L
d) 1.11mg/L
e) 2.64mg/L
Ans. D
Cp initial = 17.9mg/L and elimination t 1/2 is 2hours
Cp = 17.9 after 2 hours = 8.95
Cp = 8.95 after 2 hours = 4.47
Cp = 4.47 after 2 hours = 2.23
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Cp = 2.23 after 2 hours = 1.11 IN 8 HOURS
16. Following the same anterior information, calculate how much drug remains in the
patient body, 8 hours after the administrated dose:
a) 23mg
b) 112mg
c) 100mg
d) 15.3mg
e) 84.4mg
Ans. A
75%
Let us assume the following characteristics of the drug in a 70kg man.
-Therapeutic effective plasma concentration: 2.0mg/L
-Biologic half-life: 80minutes
-Apparent volume of distribution: 0.70Kg/L
18. What is the recommended rate of infusion for this drug?
a) 85mg/min
b) 58mg/min
c) 0.85mg/min
d) 8.5mg/min
e) 0.085mg/min
Ansss
K = 0.693/80min = 0.0087
Vd = 0.70 x 70Kg = 49L
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21. Drug A bind to 28% with protein, when given at dose 150 mg/day. If given to 300
mg/day, what % of drug A bind with protein. Mol.wt of protein is more than drug A.
A-56%
B-28%
C-14%
D-80%
E-60%
Ans-B
22. Two drugs that metabolized by the kidney and liver. Which one has first pass
metabolism?
drug x
drug y
CL t
1100
460
CL r
110
20
Vd
3.3
2
ProteinBinding
85%
90%
A) Drug x = oral
B) drug y = oral
C) drug y = rectal
D. drug x = rectal
Ans. B
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23. Mr. Florence Backs is a 72-year-old patient weighing 71.8 kg who is taking
aminophylline 250mg by i.v. at stat. and then was given immediately by i.v. drip at a rate
of 40mg/hour. Theophylline level at stat = 7.5mg/ml and V d of theophylline is 0.5L/kg.
What is the expected serum concentration after the initial dose?
a. 5.55mcg/ml
b. 13.1mcg/ml
c. 7.5mcg/ml
d. 6.8mcg/ml
Ans-B
What is the expected serum concentration after the initial dose?
Co = Dose x F x S
Vd
= 250 x 1 x 0.8
(0.5) (71.8 kg)
= 5.55 ug/ml
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Form
Tablet
Solution (control)
Injection (control)
a) 0.25
b) 0.38
c) 0.50
d) 0.66
e) 0.90
Ans. A
Drug Dose
Dose
100 mg po
100 mg po
50 mg IV push
AUC (g/ml/mL/h)
20
30
40
Product Company
Dosage Form
A
A
B
B
Parenteral Injection
Tablet
Tablet
Capsule
Dose Administered
10 mg IV
20 mg po
20 mg po
15 mg po
Cumulative Urinary
Amount (mg)
9.4
12.0
8.2
6.8
29. Using the above data the absolute bioavailability of Company B tablets is best
estimated to be
a)
b)
c)
d)
25%
40%
44%
68%
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e) 87%
Ans. C
Tips: The best measure of absolute bioavailability is considered to be AUC of iv. Because
AUC iv is not available for this drug, the next best comparison will be the cumulative
drug amount found in the urine.
Because iv dose was 10 mg, whereas the oral tablet dose was 20mg, a correction factor
of 2 x is needed.
Cumulative amount is 20 mg injected.
9.4 x 2 = 18.8
8.2/18.8 = 0.44 or 44%
30. Patient on phenytoin therapy. Therapeutic level is 10 20 mg/L. Blood level of
phenytoin is within therapeutic range. But still patient shows some side effects of
phenytoin Following is blood phenytoin analysis?
13.6 mg/L morning
14.2 mg/L evening
What is reason increase level of phenytoin
A-Phenytoin toxicity
B-Phenytoin has very strong protein binding
C-Liberation of drug from protein binding
D-None of the above
Ans-C
31. If blood flow to liver decrease?
A-Affects intrinsic metabolism
B-Reduce protein binding of drug
C-Increase protein binding of drug
D-Reduce metabolism of drugs
E-Do not change metabolism of drug
Ans. D
32. A drug completely renally eliminates, it depends on all pharmacokinetic factors,
except?
A. drug half life
B. Volume of distribution
C. Hepatic clearance
D. Renal function
E. rate of infusion
Ans. C
33. Steady state concentration is factor of
a. AUC B. half life C. plasma protein binding D. dose
Ans. B
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PHARMACY PREP.
RATES AND ORDERS OF REACTIONS
Plot of log of concentration against time produces a straight line with a:
A. Slope of K/2.303
B. Slope of K/t 1/2
C. Slope of K o
D. slope of K/2.303
E. slope of K/0.693
Ans. A
2. The time it takes to infused drug to reach plasma steady state concentration (Css)
depends on:
I-Elimination half-life of drug.
II-Fraction of free excreted in urine
III-Plasma concentration curve
A. I only B. III only C. I and II only D. II and III only E. All of the above
Ans. a
3. A drug with zero order reaction eliminating, which is independent of initial
concentration, What is correct about slope?
A. k o
B. k/2.303
C. 0.693/k
D. 1/ka
E. None
Ans. A
4. Use of loading dose?
I-To achieve therapeutic concentration immediately
II-Loading dose = desired concentration x V d
III-Steady state will be achieved immediately and maintained
A. I only B. III only C. I and II only D. II and III only E. All of the above
Ans. E
5. Time to reach steady state is determined by the?
A) Elimination half life
B) Loading dose
C) Maintenance dose
D) The absorption rate
E) dose interval
ans. A
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6.A drug completely renally eliminated. The patient has renal failure. This drug is hepatic
metabolized. What will happen to drug?
A. Drug metabolite accumulates in blood
B. Drug is completely in metabolized in liver
C. Drug is completely eliminate renally
D. Drug is completely protein bound
E. Drug have linear kinetic
Ans. A
7. What is correct about a drug with first order elimination?
A) drug elimination depends on initial concentration
B) drug elimination depends on time only
C) drug elimination depends and concentration and time
D) drug elimination depends renal and hepatic function
E) drug elimination depends on renal function only
Ans. B
8. What is correct about a drug with zero order elimination?
A) drug elimination depends on initial concentration
B) drug elimination depends on time only
C) drug elimination does NOT depends and concentration and time
D) drug elimination depends renal and hepatic function
E) drug elimination depends on renal function only
Ans. b
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PHARMACY PREP
PHARMACODYNAMICS
1. Competitive (reversible) antagonism
Ag (agonist) + E + Ag*(antagonist) AgE + Ag*E
If we use more concentration of Ag what happen?
A. Concentration of AgE increase and Ag*E decrease
B. Concentration of Ag*E increase and AgE decrease
C. Concentration of AgE and Ag*E decrease
D. Concentration of AgE and Ag*E increase
E) No change in AgE and Ag*E rate
Ans. A
Competitive (equilibrium)
Competitive inhibitors are molecules that
bind to the same site as the substrate
preventing the substrate from binding as
they do so but are not changed by the
enzyme.
Parallel rightward shift of agonist dose
response curve shift.
Q. Intensity of response depends on
concentration of both agonist and
antagonist.
The same maximal response is attained by
increasing the dose of agonist
27-1
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Medicinal Chemistry
PHARMACY PREP.
MEDICAL CHEMISTRY
H3C
CH3
CH3
HO
HO
OH
CH3
N
OH
OH
Terfinadine
A) 1 B) 2
Ans.B
Fexofenadine
C-3
D) 4
E) None
4. If a drug chemical structure has 3 chiral carbons. How many optical isomers are
possible?
A) 2
B) 4
C) 8
D) 9
E) 12
Ans. C
2n = 22
=2x2=4
n= number of chiral centers
23 = 2 x 2 x 2 = 8
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Medicinal Chemistry
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Pharmacy Prep
MEDICINAL CHEMISTRY OF AUTONOMIC NERVOUS SYSTEM
1.What is incorrect about structure activity of acetylcholine agonist?
A) acetylcholine dissociate into acetyl and choline by acetylcholinesterase enzyme
B) methanocoline has one extra methyl group than Ach
C) Carbacholine has one carbmate group
D) Bethanacholine has one carbamate and methyl group than Ach
E) acetylcholine is the major neurotransmitter of sympathetic system
Ans: E
2.What is incorrect in catecholamine biosynthesis?
A) tyrosine is the precursor
B) dopamine produce norepinephrine hydroxylation
C) epinephrine produce norepinephrine by methylation
D) levodopa catalyzed by dopadecarboxylase to dopamine
E) norepinephrine catalyzed by methyl transferase to epinephrine
Ans: C
3)The difference between dopamine and amphetamine?
A) one methyl group
B) one hydroxyl group
C) 2 hydroxyl group and 1 methyl group
D) 2 methyl group and 1 hydroxyl group
E) One methyl and one hydroxyl group
NH2
HO
Dopamine
OH
OH
CH3
NH2
NH2
CH3
OH
CH3
CH3
Amphetamine
Dextroamphetamine
Ephedrine
H
CH3
CH3
Pseudoephedrine
CH3
CH3
Methamphetamine
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HO
COOH
11
A) Prostaglandin E
B) Prostaglandin F
C) Prostaglandin G
D) Prostaglandin H
E) Prostaglandin I
Ans. A
7.Morphine analgesic action is due to mu receptors by hydrogen bonding of?
A) Endorphine peptides
B) Enkephalin peptides
C) Leukotrienes
D) prostaglandins
E) histamines
Ans. B
8.Morphine analgesic actions is mainly produced due to?
A. mu, kappa, and delta receptors
B. mu, and kappa agonist
C. mu agonist
D. mu, and delta agonist
E. kappa and delta agonist
ans. C
9.Naloxone is an opioid antagonist and blocks the actions of?
A. mu, kappa, and delta receptors
B. mu, and kappa receptors
C. mu receptors
D. mu, and delta receptors
E. kappa and delta receptors
Ans. C
10.Synthetic estrogen like diethyl stilbenes gives?
A) enantiomers
B) diastereomers
C) geometric isomers
D) optical isomers
E) confirmers
Ans. c
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PHARMACY PREP.
MEDICINAL CHEMISTRY AND PHARMACOLOGY OF CARDIOVASCULAR SYSTEM
1. What is incorrect about site of action of diuretics?
A) carbonic anhydrase and osmotic diuretics like acetazolamide act on proximal tubule
B) loop diuretics act on loop of henle
C) Thiazides act on distal convoluted tubule
D) Potassium sparing act on collecting duct
E) Potassium sparing diuretic act on proximal tubule
Ans. E
2. Diuretics effect on acid and base balance of blood. What is incorrect?
A) thiazides and loop cause metabolic alkalosis
B) acetazolamide cause hyperchloremic metabolic acidosis
C) spironolactone cause intracellular alkalosis
D) acetazolamide decrease intraocular pressure
E) Furosemide may cause metabolic acidosis
Ans. E
3.) Diuretic characterized for
A. Acetazolamide
B. Spironolactone
C. Hydrochlorothiazide
D. Furosemide
E. Triamterene
Ans. D
an
4.. Imidazoline is a molecular structure that contains a heterocyclic ring and belongs the
molecular structure of:
A. Prazosin
B. Nifedipine
C. Atropine
D. Clonidine
E. Allopurinol
Ans. D
5. Which of the following cardiovascular medications chemically classified as glycoside?
A. Digoxin
B. Warfarin
C. Nitrates
D. Nitrites
E. Cholestyramine
Ans. A
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D. Nitrol
7) What functional group is responsible for metallic taste or taste changes in captopril?
A) Sulfonamide
B) Sulfide
C) Sulfhydril group
D) Proline ring
E) Carbamate group
Ans. A
8) Pyridine is a mono heterocyclic compound very important in the activity of many
eren r s e
ec ar s r c re -dihydropyridine is found in:
A. Verapamil
B. Digoxin
C. Clonidine
D. Nifedipine
E. Diltiazem
Ans. D
9. Thrombolytics (fibrinolytic) agents are contraindicated in?
a. Myocardial infarction
B. Ischemic stroke
C. Bleeding from the GIT
D. Pulmonary embolism
E. Deep vein thrombosis
ans. C
10 ce a a
e a car n c an
rase
re c an
r c r
a e a a e
diuretic have an identical molecular group very important in their structure knows as:
A. Sulfonamide group
B. Pyrimidine group
C. Purine group
D. Pyrrolidine group
E. Ether group
Ans. A
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11. Which of the following statements regarding HEPARIN is/are right
I. It is a muc
sacar e r an c ac
resen na ra n an ss es es ec a
lungs and liver.
II. It has anticoagulant proprieties that inhibit the conversion of prothrombim to
thrombin and fibrinogen to fibrin
III. It has antithrombin III as it co-factor
A. I only B. III only C. I and II only D. II and III only E. All are correct
O
HS - H2C
CH3
CO2H
A) Diuretics
B) Angiotensin converting enzyme (ACE) Inhibitors
C) Calcium channel blockers
D) Selective Serotonin Receptor Inhibitors
E) Angiotensin Receptor Blockers (ARBs)
Ans. B
13) What is incorrect about ACE Inhibitors?
A) sulfhydril group is present in captopril
B) captopril and fosinopril are NOT prodrugs because these do not require hydrolysis to
produce active products
C) it essential to have esterase for the activation of ACEi.
In
re en r a n an
ens n II
E) Angiotensin II is strong vasodilator
Ans. E
Tips: Angiotensin II is strong vasoconstrictor
14
sa
an s s n ra
r
a
rea
reports cough. What is incorrect?
A) recommend to see doctor to change to ARBs
B) recommend cough suppressant dextromethorphan
C) ARBs have no cough SEs
c
s n ce
ra
n ns n
E) CCBs have no cough side effects
Ans: B
er ens n recen
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15) What is active pharmacophore in Angiotensin receptor blockers?
N
Imidazole ring (essential)
Cl
N
OH
Tetrazole ring
N N
N
N
H
Losartan
A) Tetrahydropyrazole ring
B) On position 2 ethyl alcohol on imidazole ring
C) Two ring structure
D) Alkyl long chain on imidazole ring
E) AT 1 receptors
Ans. B
16) HMG Co A reductase inhibitor like statins effective lowers LDL. What is incorrect?
-dihydroxycarboxylate is essential for SARs
B) Myopathy SE is e ass c a e
s a ns
s s
n re
-MM
C) Initial SEs include stomach upset like diarrhea
a ns ncrease er en
es s
n r
s
E) Statins combined with niacin decrease the risk of myopathy
Ans: E
17
sa
ear
a e patient has been prescribed amlodipine 10 mg daily. After 2
ee s
n a n
s a en re r s
re en n
ee ea ac e
s n r
an a a n
ar ac s s s ec ese are s e e ec
a
ne
c
of the following is not side effects of CCBs?
A) ankle edema
B) flushing
C) headache
D) palpitation
E) dry mouth
Ans. E
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18) Which of the following drugs represent the structure below?
A. Leukotriene antagonists
B. Beta blockers
C. Coumarins
D. Calcium channel blockers
E. Benzodiazepines
Ans: D
19 n na rec a e
e erc se r e
A. Propranolol
B. Nitroglycerine SL
C. Diltiazem
D. Nifedipine
Ans-B
Tips: nitroglycerine SL or spray
na s ress r
ce
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22.Factor Xa selective inhibitor is?
A. Dabigatran
B. Warfarin
C. Tinazaparin
D. Apixaban
E.Heparin
Ans. D
23.Nitrates produce smooth muscle vascular relaxation by producing?
A. Nitric acid
B. Nitric oxide
C. Nitrates
D. Vasodilator
ans. B
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MEDICINAL CHEMISTRY AND PHARMACOLOGY OF PYCHIATRIC AND NEUROLOGICAL
DISORDERS
1. What are the physiological function of serotonin?
A) mood
B) Sleep
C) platelet aggregation
D. weight
E. All of the above
Ans. E
2.What is NOT a side effect of SSRIs?
A) GI bleeding
B) insomnia
C) nausea and vomiting
D) sexual dysfunction
E) anticholinergic SEs
Ans: E
3.What is incorrect about SSRIs?
A) if combine with MAOi, can cause serotonin syndrome
B) fluoxetine has long half life, thus have no serotonin syndrome
C) Abrupt discontinuation of SSRIs can cause withdrawal symptoms
D) Do not combine SSRIs with other SSRIs
E) SSRIs require washout period
Ans. B
4. Which of the following SSRI least likely associated with withdrawal symptoms?
A. Trazodone B. Amitriptyline C. Phenelzine D. Fluoxetine E. Mirtazapine
Ans. d
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6.MP is 20 yo man using lithium carbonate 400 mg QID for the treatment of manic depression.
Patient presents with tremors. All of the following drugs increase lithium toxicity by
increasing lithium serum concentration, except
A. Ramipril
B. Naproxen
C. Caffeine
D. Hydrochlorothiazide
Ans. C
7. Which of the following drug combination least likely cause serotonin syndrome?
A. Phenelzine and fluoxetine
B. Phenelzine and amitriptyline
C. Phenelzine and Tranylcypromine
d. Bupropion and trazodone
E. Selegiline and tramadol
Ans. e
Tips. bupropion and trazodone have weak affect on serotonins, thereby less likely serotonin
syndrome. The most likely are combination with MAOi like C.
8. Which of the following is least likely side effect of haloperidol?
A. drowsiness
B. loss of appetite
C. weight gain
D. dizziness/fainting
E. Parkinsonism
Ans. A
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10. Which of the following is correct about dibenzazepine drugs like clozapine and
quetiapine?
A. Act more effectively on D 2 receptors than 5HT 2
B. Acts more effective on 5HT 2 than D 2 receptors
C. Acts more effective on 5HT 2 and M 1
D. Acts more effectively on D 2 and 5HT 2 , H 1 , M 1 and alpha1
E. acts on D 2 receptors only
Ans. B
11. Tobacco smoking?
A. induce CYP3A4
B. induce CYP1A2
C. inhibit CYP3A4
D. inhibit CYP1A2
E. Substrate of CYP1A2
Ans.A
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MEDICINAL CHEMISTRY AND PHARMACOLOGY OF ENDOCRINE SYSTEM
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PHARMACY PREP
MEDICINAL CHEMISTRY AND PHARMACOLOGY OF RESPIRATORY DRUGS
1. Drug that may cause bronchospasm?
A. Ipratropium
B. Tiotropium
C. Betaxalol
D. Salbutamol
E. Montelukast
Ans.C
2. An asthma patient using salbutamol PRN but her asthma is not controlled. What drug is
added next?
A. Salmeterol
B. Fluticasone inhaler
C. Prednisone oral
D. Montelukast
E. Theophylline
Ans. b
3. A patient using salbutamol for the past 6 months, but asthma is not controlled. Which drug is
added next?
a. Increase salbutamol dose
B. Inhaled corticosteroids
C. Formterol
D. Oral prednisone
Ans. b
4.In asthma patient concomitant anti-inflammatory therapy (inhaled corticosteroids) should be
part of regimen if?
A. Salbutamol needs to be used >3 times per week (not including its use to prevent exercise
induced asthma).
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6. COPD patient currently using salbutamol PRN, ipratropium PRN, tiotropium daily,
theophylline bid and Formoterol daily.
Which of the following drug is the pharmacist concern?
A) salbutamol B) ipratropium C) tiotropium D) formoterol
E) theophylline
ans. E
Tips. Theophylline can cause tachycardia, tremors, nervousness, insomnia, abdominal cramps,
Nausea and vomiting.
7.A 50 yr old COPD patient exacerbations, which of the following antibiotics is least likely used?
a. amoxicillin B. cotrimoxazole C. azithromycin D. doxycycline E. ciprofloxacin
Ans. E
Tips. ciprofloxacin is least likely used for respiratory tract infections. However respiratory tract
fluroquinolones levofloxacin and moxifloxacin can be used.
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PHARMACY PREP
MEDICINAL CHEMISTRY AND PHARMACOLOGY OF MUSCULOSKELETAL DRUGS
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What analgesics drugs are NOT used to treat acute gout attacks?
A) allopurinol
B) acetaminophen
C) colchicine
D) dexamethasone
E) indomethacin
Ans. b
Prednisone used in treatment of gout arthritis (intra articular inj.) and severe asthma
(oral). What is correct?
A) gout patient may have more systemic SEs
B) asthma patient may have more systemic SEs of steroid
C) Asthma & gout patient have same SEs
D) Only gout patient have prednisone SEs
E) None of the above
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B. Murine MAB
C. Mice MAB
D. Chimeric MAB
D. Human MAB
Ans.d
Q. Bisphosphonates are?
A. osteoclasts
B. Osteoblast
C. Pyrophosphate
D. Phosphoric acids
E. calcium phosphate
Ans. c
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Pharmacy Prep
MEDICINAL CHEMISTRY AND PHARMACOLOGY OF ANTIMICROBIALS
MP is 49-year-old women using calcium carbonate 500 mg QD and bring a new prescription of
ciprofloxacin 500 mg BID for 3 days to treat UTI. What is appropriate?
a) Skip calcium supplements for 3 days and take ciprofloxacin
b) Take ciprofloxacin morning and supper time and take calcium 2 tab morning.
C) take ciprofloxacin morning 2 tab and calcium 2 tab at supper time
D) Take ciprofloxacin morning and supper and calcium 2 tab at noon.
Ans. D
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PHARMACY PREP.
METABOLISM
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BIOPHARMACEUTICS
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Ans. A
3. Determine the F value for a capsule AUC 20 mg/dL/hour with 100 mg dose when i.v
of same drug AUC is 25 mg/dL/hour with 100 mg dose.
A. 20%
B. 60%
C. 40%
D. 80%
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E. 100%
Ans. D
AUC po x 100
AUC iv
= 80%
4. Determine the F value for a capsule AUC 20 mg/dL/hour with 50 mg dose when i.v of
same drug AUC is 25 mg/dL/hour with 100 mg dose.
A-20%
B-60%
C-40%
D-80%
E-160%
Ans. E
AUC po x 100
AUC iv
AUC po = 20 x 2 = 40 mg = 1.6 x 100 = 160%
25 mg
5. Two drugs to be pharmaceutical equivalent, the drugs must:
I-contain same exipient
II-Contain it salts
III-Same therapeutic moiety
A. I only B. III only C. I and II only D. II and III only E. All of the above
ans. d
Physiochemical factors affecting the rate and extent of drug distribution includes?
a) plasma protein binding
b) types of surfactant in preparation
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c) the partition coefficient the drug
d) percent of ionization
e) Intracellular binding
Ans. d
Area under the curve (AUC) of drug is double, the affect on clearance
A. Drug clearance is doubled
B. Drug clearance is increases
C. Drug clearance is decreases
D. Drug clearance does not change
Ans. C
Tips. AUC = (dose x F)/clearance
or
clearance = (dose x F)/AUC
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Physical Pharmacy
PHARMACY PREP.
PHYSICAL PHARMACY
1. Which of the following equations can be used to easily calculate the pH. of a buffer
solutions constituted of a weak acid and its salts.
A. Hixson-Crowell equation
B. Arrhenius equation
C. Stokes equations
D. Henderson-Hasselbalch equation
E. Noyes-Whitney equation
Ans. D
Tips: Henderson-Hasselbalch equations used to mathematically calculate the pH of a
buffer solution.
2. Arrhenius equation is used when we need calculate the:
A. pKa of an acid solution
B. Stability of a drug at room temperature
C. pH of a buffer solution
D. Rate of ionization of a drug
E. Solubility of a solution
Ans. B
Tips: Arrhenius equation is used to calculate the stability of a drug at room
temperature.
3. All are characteristics of a polymorph drug, EXCEPT:
A. It has a two different physical form
B. It melts in some determinate temperature, normally high temperatures (>30C)
C. Theobroma oil is a classic example of polymorph drug
D. Polymorph drugs are widely used as suppository base
E. Polymorph drugs melt in very low temperature (<10C)
Ans. E
Tips: Polymorph drug has two different physical form depending the currently
temperature that they are present, normally melting in high temperatures (>30C), and
keeping solid in low temperature (<10C). Theobroma oil or cocoa butter is a classic
example of polymorph drug
4. What is correct about buffer?
A. acid and base mixture
B. base and acid mixture
C. weak acid and salt of acid mixture
D. weak base and strong acid mixture
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Physical Pharmacy
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Pharmaceutical Excipients
PHARMACY PREP
PHARMACEUTICAL EXCIPIENTS
Ans. A
Q. Ascorbic acid?
I. Acidifying agent
II. water soluble antioxidant
III. Water soluble vitamin
A. I only B. III only C. I and II D. II and III E. I, II,II
Ans.E
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PHARMACY PREP
RHEOLOGY
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PHARMACY PREP
PHARMACEUTICAL DOSAGE FORMS
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PHARMACY PREP.
DRUG DELIVERY SYSTEMS
1. What is incorrect about transdermal drug delivery systems?
A. Drugs with long half life are preferred
B. Transdermal drugs after topical application on skin surface have systemic absorption
C. Transdermal drugs are absorbed by diffusion method
D. Systemic absorption is maintained throughout the dosing interval
E. Transdermal patches is essential to contact with skin
Ans. A
2. What is TRUE about enteric coating tablet dosage form?
A. It protects from the drug moisture, light or air
B. it mask the taste or odor of the drug
C. It improves the appearance of the tablet
D. It may affect the release rate of the drug
E. It minimize the contact between the drug and the gastric region and gastric content
Ans. E
Tips. Enteric coated tablet do not allow for dissolution in the acid pH environment of the
stomach. Instead in the it dissolved in less acidic pH like small intestine.
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PHARMACY PREP.
PHARMACEUTICAL ANALYSIS
1. By addition of a solute, solubility of non-electrolytes is decreased. This is:
A. Common ion effect
B. Disintegration
C. Salting out
D. Salting in
E. None of the above
2. Which of the following compound is known as amphiprotic solvent?
A. Methanol
B. Water
C. Acetic acid
D. Ethanol
E. All are right
3. Molecular ion (M+) or molecular weight is detected by:
A. Colorimetry
B. Mass spectroscopy
C. Spectrophotometry
D. Spectrometry
E. Ultraviolet detectors
4. Determination of alcohol in blood in done by:
A. HPLC
B. TLC
C. Reverse phase HPLC
D. Gas chromatography & Mass spectroscopy (GC-MS)
E. Mass spectroscopy
5. Mass spectroscopy is used to:
A. Detect traces of unknown chemical structure
B. Structure elucidation of unknown chemical
C. Traces in environmental samples
D. Drug traces in blood samples
E. All of the above
6. All of the following detector are used in High Performance Liquid Chromatography
(HPLC): EXCEPT:
A. Diode Array Detector
B. UV detector
C. Refractive Index detector
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D. Gamma Rays
E. Radioactive detector
7. Mechanism of action of Thin Layer Chromatography (TLC) is by:
A. Gas absorption
B. Column theory
C. Capillary action
D. High pressure extraction
E. Temperature range theory
8. Lyophilization (freeze dry method) technique used in:
I- Sterilization of liquids and solids
II- Sterilization of solids only
III- To dry heat-sensitive wet powders
A. I only B. III only C. I and II only D. II and III only
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C. Increase in conductivity
D. Lowering of freezing point
E. Magnitude of vapor pressure
14. The colligative proprieties of a solution are related to:
A. The total number of solute particles
B. pH of the solution
C. Number of ions
D. Ratio of number of ions and number of molecules
E. Number of non-ionized molecule
15. Colligative proprieties are important in determining:
A. pH
B. Tonicity
C. Solubility
D. Stability
E. Sterility
18. Atoms with the same number of protons are known as:
A. I only B. III only C. I and II only D. II and III only E. All are correct
19. Instrument used to measure specific gravity by floating in a liquid:
A. Picnometer
B. Hydrometer
C. Thermometer
D. Thermostat
E. Tensiometer
20. Instrument used to measure quantity of two liquids with equal volume:
A. Picnometer
B. Hydrometer
C. Thermometer
D. Thermostat
E. Tensiometer
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21. Solvents can be classified as:
A. Amphiprotic
B. Protophilic
C. Aprotic
D. Protogenic
E. All are correct
22. Kind of solvent where acids and bases are produced, react and dissociates producing
such anion or cation species is called:
A. Amphiprotic solvent
B. Protophilic solvent
C. Aprotic solvent
D. Protogenic solvent
E. Inert solvent
23. Correct statements regarding TITRATION include:
I- Determination of a given component in a solution by addition of a liquid reagent of
known strength until a given endpoint is reached.
II- Non-aqueous titration can be used in the assay of some materials that cannot be
easily titrated in aqueous system.
III- Titration is a chromatographic method of substance separation.
A. I only B. III only C. I and II only D. II and III only E. All are correct
24. The end point of a titration analysis is characterized by:
A. Change in color
B. Change in solubility
C. Change in pH
D. Change in dispersability E. Change in particles aggregation
25. Considerations that should be taken in selecting a solvent for an assay analysis:
A. Nature and solubility of the sample under investigation
B. Side reactions should not occur between the sample in analysis and the solvent
C. The solvent should be pure, low toxic and inexpensive
D. Solvent should have a high dielectric constant
E. If the sample is a weak acid the solvent should also be a weak acid
26. Solvent used in the assay of levodopa and methyldopa includes:
A. Acetic acid
B. Pyridine
C. Chloroform
D. Formic acid
E. Dimethyl formamide
27. Dimethyl formamide is a solvent used in the assay of which of the following drugs?
A. Adrenaline
B. Sulfonamides
C. Cimetidine
D. Chlortalidone
E. Levodopa
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28. Which of the following spectroscopic method is used in detection of nanogram
amount of unknown substance?
A. Microspectroscopy
B. Nanospectroscopy
C. Spectroscopy
D. Microscopy
E. None of the above
29. Gel electrophoresis is based on separation of;
A. Micro molecules
B. Electric charges
D. electrolysis
E. Molecular weight
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PHARMACEUTICAL ANALYSIS
ANSWERS
1. Ans: C
Tips: Salting out is characterized when the addition of a solute in a solution cause the
decrease of solution solubility, when the addition of a solute cause the increase of
solubility is called salting in.
2. Ans: E
Tips: Amphiprotic is a type of solvent where acids and bases are produced. It reacts and
dissociates producing such anion and/or cation species.
3. Ans: B
Tips: M+ molecular ion is detected by mass spectroscopy that determines the molecular
weight of the sample.
4. Ans: D
Tips: Gas chromatography is a chromatographic method used to separate volatile
organic compounds as alcohol, hydrocarbons and aerosols.
5. Ans: D
Tips: Mass spectroscopy may be used as adjunct in gas chromatography.
6. Ans: D
Tips: X-rays are not used as detectors in HPLC
7. Ans: C
Tips: TLC-Thin Layer Chromatography is a very fast and simple chromatographic method
that separates organic compounds, progress of organic reactions, and tests the purity of
products by capillary theory.
8. Ans: B
Tips: Freeze dryer is used for the conversion of wet powders to dry powders.
9. Ans: D
Tips: Radiation is the most appropriated sterilization method for hormones; the only
exception is testosterone that is normally sterilized by dry heat sterilization.
10. Ans: C
Tips: Ethylene oxide sterilization is a very effective technique that combines heat and
moisture having a very high penetration power to sealed containers.
11. Ans: A
Tips: Amphetamines can be extracted from plasma by ether.
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12. Ans: E
Tips: HPLC- High Performance Liquid Chromatography is a method that utilizes highpressure pumps to increase efficiency in the separation. The mobile phase is normally
an aqueous solution and the particles size of the stationary phase definitely alters the
effect of resolution.
13. Ans: C
Tips: Colligative properties in physical chemistry, depending on the number of molecules
present in a given space, rather than on their size, molecular weight or chemical
constitution. The colligative properties of solutions are osmotic pressure, boiling point
elevation, freezing point depression, and vapor pressure lowering.
14. Ans: A
Tips: Colligative properties in physical chemistry of a solution, depending on the number
of molecules present in a given space, rather than on their size, molecular weight or
chemical constitution.
15. Ans: B
Tips: 15- Colligative proprieties are important in determining the tonicity of the
solution. The colligative properties of solutions are osmotic pressure, boiling point
elevation, freezing point depression, and vapor pressure lowering
16. Ans: C
Tips: The only function of plates in TLC is support the mobile phase that moves by
capillary mechanism through the stationary phase (plates).
17. Ans: A
Tips: Buffers are added to the solutions exactly to avoid the change in the solutions pH,
therefore if added to the solution will not affect the reaction.
18. Ans: B
Tips: In physical chemistry, isotopes are atoms with the same number of protons.
Isotones with the same number of neutrons and isobaros with the same number of
mass.
19. Ans: B
Tips: Hydrometer is an instrument used to measure specific gravity by floating in a
liquid: Hydrometer (SWIM in water)
20. Ans: A
Tips: Picnometer is an instrument used to measure quantity of two liquids with equal
volume
21. Ans: E
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Tips: Solvents play an important rule in determining acid/base properties in a solution
and may be classified depending of their chemical structure and activity as Solvents can
be classified as amphiprotic, protophilic, aprotic and protogenic.
22. Ans: A
Tips: Amphiprotic solvent as water, acetic acid, methanol and ethanol are kind of
solvents where acids and bases are produced, react and dissociates producing such
anion or cation species.
23. Ans: C
Tips: Titration is a determination of a given component in a solution by addition of a
liquid reagent of known strength until a given endpoint is reached. Non-aqueous
titration can be used in the assay of some materials that cannot be easily titrated in
aqueous system.
24. Ans: A
Tips:
The end point of a titration analysis is characterized by change in color.
Commonly used indicators include triphenyl methane group corants and azo group
corants.
25. Ans: E (QUES. Need to fix)
Tips: In order to chose the proper solvent to be used in an analysis we need to consider
some important points as the nature and solubility of the sample under investigation,
and make sure that no any side reaction between the sample in analysis and the solvent
will happen. The solvent should be pure, low toxic, inexpensive and have a high
dielectric constant.
26. Ans: D
Tips: Formic acid is a solvent used in non-aqueous titration in the assay of levodopa and
methyldopa
27. Ans: B
Tips: Dimethyl formamide is a solvent used in non-aqueous titration in the assay of
sulfonamides, allopurinol and acetazolamide.
28. Ans: C
Tips: mass spectroscopy methods
29. Ans: B
30. Ans: A
31. Ans: A
32. Ans: B
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BIBLIOGRAPHIC REFERENCE
1- COMPREHENSIVE PHARMACY REVIEW Lippincott William & Wilkins Fourth edition
2- CPS-COMPENDIUM OF PHARMACEUTICALS AND SPECIALITIES - Canadian Pharmacist
Association 2001 edition.
3- MEDICAL DICTIONARY Dorlands illustrated 27th edition.
4- PHARMACY PREP Lectures series & study guide for Evaluating Examination-TIPS 2003/2004
5- THERAPUTIC CHOICES Canadian Pharmacist Association -Third edition
6- USP DI Drug Information for the Health Care Professional15th edition Volume I.
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PHARMACY PREP
CANADIAN HEALTHCARE SYSTEM
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1. All of the following are regulated as schedule 2 drug in harmonized drug schedule,
except?
A. Lactulose B. Vitamin B 12 inj. C. Dukoral
D. Mupirocin E. Ferrous gluconate
Ans.d
2. A customer of your pharmacy comes for early refill of lorazepam. What is
appropriate action?
A. Early refill of benzodiazepine are not allowed
B. Early refill of benzodiazepine are not allowed if prescriber specified repeat intervals.
C. Ask patient the reason for early refill
D. Do not dispense early refill because patient may abuse
E. Call prescriber to get early refill permission
Ans.c
3. Which of the following drug comply with the requirements of the Narcotic
Regulations?
A. Alprazolam
B. Tylenol # 1
C. Ketamine
D. Amphetamine
E. Methylphenidate
Ans. C
4. Which of the following drugs prescription refill/repeats are NOT allowed?
A. Benzodiazepine
B. Methylphenidate
C. Narcotic drugs
D. Hydrochlorothiazide/Ramipril
E. Lorazepam
Ans. C
5. What practitioners may legally cannot prescribe narcotics
A. Dentist
B. Veterinarian
C. Physician
D. Optometrist
E. Midwife
Ans. D
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6.A women, she recently moved into your pharmacy area from other neighborhood. She
comes with request to transfer her son prescription of methylphenidate from her
previous pharmacy. What is appropriate action?
A. Call other pharmacy get prescription transferred
B. Ask her to get a new prescription because it cannot be transferred
C. Give her part fill of methylphenidate
D. Tell her to call other pharmacy to request for Rx transfer
E. Talk to her and ask the reason for moving in this area
Ans. B
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1. A staff pharmacist reports about a pharmacy manager billing, excessive fee to long term
care. What is termed as?
A. conflict of interest
B. integrity
C. whistle blowing
D. revenge
Ans. c
2. A pharmacy owned by two partners. One of the partner billing excessively to long term
care. The partner was caught by college of wrong doing. The other partner claim he is not
aware of the fraud?
A. two partner are responsible for crime
B. the person who committed crime is responsible
C. two of them are not responsible
D. college of pharmacy is responsible
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PHARMACY PREP
PHARMACY MANAGEMENT
1. Pharmacy ABC has sales of prescription medication for the year 2013 to 2014. In
order to find out profit of pharmacy ABC, which of the following financial statement
may be useful:
I-Balance sheet
II-Retain earning statement III-Income statement
A. I only
B. III only
C. I and II only
D. II and III only
E. I, II, and III
2. All of the following include in income statement, EXCEPT:
A. Sales
B. Profit
C. Cost of goods sold D. Account payable E. Gross margin
3. Financial statement that is total income minus expenses is:
A. Income statement B. Profit statement C. Retained statement
E. Income sheet
D. Net income
4) Cost of goods for a drug is $10 and mark up is 30%. What is retail price? Prescription
fee is $10. What is the total amount customer pay?
A) $13
B) $10
C) $23
D) $22
E) $33
5. A financial statement that is used to determine the total value of Rxs drug sales for a
pharmacy during the course of a year is known as:
A. Income statement B. Profit statement C. Retained statement
D. Net
income
E. Balance sheet
6. Delegation includes:
I) Delegating a project to technician
II) Supervising technician in project
III) Monitoring completion of project
A. I only
B. III only
C. I and II only
E. I, II, III
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C. Point of sale
D. Point of submit
13. Computer software and hardware program very useful in pharmacies that combines
and track all the business information as product information, cash register, inventory,
stocks and so on.
A. Pharmacare system
B. Health Watch system
C. Point of sale (POS)
D. Universal Pharmacy system
E. Business update computer system
14. What is DIN:
A. Drug Identification Notice
B. Notice of compliance
C. Drug identification
number
D. Drug information number E. Drug Identity Notice
15. Which of the following is not a type of ownership?
A.
Incorporation
B.
Sole proprietorship
C.
Leasing
D.
Franchise
E.
Cooperative businesses
16. Which of the following is not a type of pharmacy?
A. Banner pharmacy
B. Franchise pharmacy
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C. Central fill pharmacy
D. Mail order pharmacy
E. Rental pharmacy license
17. Total sales of prescription drugs are $210,000 and cost of good sold is 180,000.
What is gross profit?
A. 71%
B. 14%
C. 50%
D. 20%
E. 25%
18. Net income is?
A. Total income from sales
B. Gross income + total expenses
C. Gross income - total expenses
D. Gross income + total expenses + current assets
E. Gross income + total expenses + current assets + Fixed assets
19. Which of the following business is easy to begin?
A. Incorporation
B. sole proprietorship
C. leasing
D. Franchise
E. Partnership
20. Which of the following is the most important in pharmacy location analysis:
A. Trading area
B. Market area analysis
C. Site consideration
D. Region
E. Geographical area
21. Which of the following is the most important in pharmacy site consideration:
A. Sales per square feet
B. Convenience and distance
C. Parking space
D. Physical characteristics of space
E. Use of ratios
22. What is the test marketing in pharmacy:
A. through new papers
B. through community papers
C. through TV
D. Door to door flyers
E. Distribution of flyer in mall
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23. Pharmacy ABC have sales of prescription medication for the year 2004 to 2005. In
order to find out profit of pharmacy ABC, which of the following financial statement
may be useful:
I-Balance sheet
II-Retain earning statement
III-income statement or profit & loss statement
A. I only
B. III only
C. I and II only
D. II and III only
E. I, II, and III
24. All of the following include as part of income statement, EXCEPT:
A. sales
B. profit
C. cost of goods sold D. account payable E. gross margin
25. Which of the following is not covered in total assets:
I-Pharmacy furniture
II-Account receivable
III-Account payable
A. I only
B. III only
C. I and II only
D. II and III only
26. The style of management in which owner of pharmacy store emphasizes the
development of detailed policies and written procedure for employees to observe at all
times is referred as:
A. bureaucratic work procedure are described in details policies and written
procedure.
B. autocratic Implementing personal opinion without consultations.
C. assertive
D. consultative with consultation
E. benevolent generous and kind
27. The inventory turnover rate is a measure of a pharmacys
A) liquidity
B. solvency
C. Efficacy
D. Profitability
28) The cost of goods sold is $150,000, at start of year $25,000 at the end of
year 50,000 the inventory capital. What is the turnover rate?
A) 4
B) 3
C) 2
D) 1
E) 5
29. The previous turnover rate was 6 and this year cost of good sold is $150,000, at start
of year $25,000 at the end of year 50,000 the inventory capital. What is the difference
of turn over rate this year from previous year?
A. 4
B) 3
C) 2
D. 1
E. 5
30. What is the normal turnover rate of retail pharmacy?
A. 3
B. 7
C. 5
D. 1
31. Turnover rate (TOR) is indicator of:
A. Profit
B. Efficiency
C. Loss
D. Inventory status
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E. Merchandising problems
32. In a market there is only one seller and there are many buyers. This competition
described as?
A. Monopoly
B. Monopolistic competition
C. Oligopoly
D. Oligopolistic competition
33. All of the following are essential of business, except?
A. Promotion
B. Place
C. Product
D. Price
E. Transportation
34. If you open a pharmacy in multicultural area, what you should do increase your
sales?
A. you have signs of multicultural
B. Hire technician from same cultures
C. Develop literature with different language
D. Offer help in different languages
35. Which of the following structure of pharmacies is difficult open and operate?
A. Sole ownership
B. Franchise C. Banner pharmacy D. Partnership
36. If pharmacy manager for 16 year he is doing all the job by himself, without taking
any idea and skills from other, what is that called?
A. Beaurocratic
B-Autocratic C-Independent
D-Assertive E-Submissive
ABC pharmacy has following figures appearing on its balance sheet.
Cost of goods sold
$500,000
Beginning inventory $200,000
Ending inventory
$220,000
Total current assets $150,000
Total fixed assets
$40,000
Total liabilities
$75,000
37. Inventory turnover rate for ABC pharmacy is
A. 4.3
B. 2.3
C. 3.5
D. 6.0
E. 8.0
38. Net worth of ABC pharmacy is
A. $195,000 B. $225,000 C. $115,000
D. $75,000
E. $110,000
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40. All of the following are important fundamental principles of marketing EXCEPT:
A. Product B. Price
C. Profession D. Promotion E. Place
41. If a pharmacy has an inventory turnover rate of 4 that means that the days of
inventory on hand is:
a) 73
b) 102 c) 24
d) 91
E. 265
42. Drug identification number is given to each drug that is sold in Canada. This is
assigned by the?
A. Pharmacy Manager
B. Manufacturer
C. Health Canada
D. Pharmacy owner
E. None of the above
43. Which is true about associate franchise, except?
A. Pharmacist own business but not physical assets.
B Central inventory management.
C. Guaranteed minimum annual salary and share profitability.
D. Initial capital investment or capital risk.
E. Franchise company supports all areas of operation
44. When pharmacy manager describes the position in pharmacy. The qualifications
required and the duties required in the position are called?
A. Job analysis
B. Job posting
C. Position allocation
D. Job description
E. Job finding
45. Inventory efficiency is measured by?
A. Net sales B. Liquidity
C. Solvency
46. A person brings prescription for 6 months of medical supplies, before he travels.
However, his insurance covers only 3 months. What is appropriate?
A. Insurance may cover for 3 months, rest a customer should pay
B. Call insurance, to verify if customer is covered for vacation supply
C. Do not dispense for 6 months
D. None of the above
47. A retail store general manager, what should we do all except?
A. reading resume
B. interviewing
C. Selecting candidate
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D. placing advertisement
E. responsible for narcotics
48. Canada Health Acts includes all, EXCEPT
A. Accessibility
B. Affordability
C. Universality of population covered
D. Public administration on non-profit basis
E. Comprehensiveness of insured service covered
49. What is merchandising?
A. Visual display of item in store
B. Point of sale system for tracking inventory
C. Point of sale system to tracking sales
D. Inventory management
E. Recall of products
50. It is one type of cost sharing plan in which patient has to pay a specified amount
during a specific period of time. Before benefits are paid by third party.
A. Co-payment
B. Co-insurance
C. Deductible D. Discount E. Bankruptcy
51. Banner franchise pharmacies include all, EXCEPT
A. Capital investment require because you own physical assets.
B. No fixed salary
C. Franchising company provide name and marketing
D. No capital investment required
E. No central purchase require
52. The characteristics of a chain pharmacies include all, EXCEPT
A. A chain is not necessarily a member of the Canadian Association of chain drug
stores.
B. An individual or corporation must own at least 3 stores to be considered a chain.
C. Head office directs all marketing and merchandising.
D. They employ pharmacy managers who are salaried employees of head office.
E. None of the above
53. A business plan requires all the following information, EXCEPT
A. Type of business
B. Location
C. Organizational structure
D. Competition strategy
E. 10 years plan
54. All the following is/are true with respect to the balance sheet, EXCEPT
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A.
B.
C.
D.
E.
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PHARMACY PRACTICE MANAGEMENT
ANSWERS:
1. Ans: B
2. Ans: D
3. Ans: D
Tips: Net income is the financial statement that is total income minus expenses.
4. Ans: C
Sales price = cost + [cost x %markup]
= $10 + [$10 x 0.3] = $13
= $13 + $10 = $23
5. Ans: A
Tips: Income statement is the financial statement used to determine the total value of
RXs drug sales for a pharmacy during the course of a year.
6. Ans: E
7. Ans: C
8. Ans: C
Tips: Job description is a description of all the work that should be done by the
employers in order of priority. The manager normally does it.
9. Ans: D
Tips: The pharmacist should always interact with the patient providing clear verbal
information such as explaining how to take the medication, side effects and therapy,
and completing the concealing with extra writing or sheet information.
10. Ans: E
Tips: Delegation of a job should include the suggested steps to accomplish the project; a
negotiation of time schedule for completion of the project and the person doing the
delegation should provide support and follow up as required.
11. Ans: B
12. Ans: C
13. Ans: C
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Tips: POS-Point of sale is a computer software and hardware program very useful in
pharmacies that combines and track all the business information such as product
information, cash register, inventory, stocks and so on.
14. Ans: C
15. Ans: C
Tips: Leasing (Renting) is not a form of enterprise.
16. Ans: E
17. Ans: B
Tips: [Sales - COGS/Sales] x 100
COGS = Cost of goods sold
Total sales $210,00 is 100%
Cost of goods sold is 180,000 is 85.5%
100%-85.5% = 14.5%
18. Ans: C
19. Ans: C
Tips: Leasing (Renting) is not a form of enterprise
20. Ans: B
21. Ans: E
Tips: use of ratios is frequently used rule of thumb in site considerations, this include
sales per square feet, number of prescription per patient, and average price for
prescription.
22. Ans: D
23. Ans: B
24. Ans: D
25. Ans: B
26. Ans: A
27. Ans: C
28. Ans: A
Tips: Turnover rate = COGS/average inventory
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Average inventory = (beginning inventory + closing inventory)/2
$150000/[$50,000 + $25000]/2 = 4
29. Ans: C
Tips: Average inventory = (beginning inventory + closing inventory)/2
$150000/[$50,000 + $25000]/2 = 4
this year TOR is 4, so previous year was 6.
30. Ans: C
31. Ans: B
32. Ans: A
33. Ans: E
Tips: there are 4 Ps; Place, Product, Price and promotion
34. Ans: C
35. Ans: A
36. Ans: C
37. Ans: B
Average inventory = $200,000+$220,000/2 = $210,000
Turnover rate = 500,000/210,000 =2.3
38. Ans: C
Tips: Net worth = Total assets total liabilities
($150,000+$40,000) - $75,000 = $115,000
39. Ans: B
40. Ans: C
Tips: There are 4 P of marketing = Product, Price, Promotion and place.
41. Ans: D
42. Ans: C
43. Ans: D
44. Ans: D
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45. Ans: D
46. Ans: B
47. Ans: E
48. Ans: B
49. Ans: A
Tips: Merchandising is visual display of products.
50. Ans: C
Deductible
Pay onetime in the
beginning of every year.
Co-payment
Pay each time for every
prescription
Co-insurance
Each time you share the
expenses
51. Ans: D
Associate franchise
Banner Franchise
No capital investment
Central distribution
Example: Shopper drug mart
Capital investment
No central distribution
Example: IDA
52. Ans: B
Tips: An individual or corporation must own 5 or more stores to be considered a chain.
53. Ans: E
Tips: 3-5 year plan is required.
54. Ans: C
Tips: At year end, every business must have a balance sheet prepared.
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PHARMACY PREP
PHARMACOECONOMICS
1. In the pharmacoeconomics considerations, the following aspects is the most
important:
A) Pharmacist
B) Hospital
C) Society
D) Doctor
E) Patient
2. Pharmacoeconomics means:
A. Analyses of cost and benefit of the drug therapy to the healthcare system and society
B. Cost of pharmaceutical dispensing fee
C. Cost of products sold in a pharmacy
D. Analyses of cost and benefit for the pharmacy business
E. Prices determined by the provincial authorities to be followed by the pharmacy
3. What is QALY?
A. Quantity Adjusted Life Year
B. Quality Adjusted Life Year
C. Quantity of Available for Long Year
D.Health related quantity of life
E. Quality of as per life year
4. What is HRQOL?
A. Health Related Quality Of Life
B. Health Related Quantity Of Life
C. Health Related Quantity Of Year
D. None of the above
5. Cost utility analysis (CUA) outcomes are measured in?
A. Quality unit
B. Cost unit
C. Natural unit
D. Quantity
E. Dollars
6. Pharmacoeconomic studies are used to analyze cost of drugs to:
A. Healthcare system
B. Society
C. Pharmacist
D. Pharmaceutical manufacturer
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7. Pharmacy manager wants to increase salary of staff pharmacy, do you consider all
except?
A. other pharmacist available to do his job
B. budget
C. pharmacist asking a raise
D. consider his experience
E. Life allowance
8. Cost Utility Analysis measures in terms of:
A. HRQL
B. QALY
C. Dollar
D. Financial consequences
9. Health related quality of life (HRQL) is an example of
A. Clinical outcome
B. Structural outcome
C. Economic outcome
D. Humanistic outcome
10. Cost utility analysis (CUA) outcome is measured in?
A. Quality unit
B. Cost unit
C. Natural unit
D. Quantity
E. Dollars
11. Pharmacoeconomic studies are used to analyze cost of drugs to:
A. Healthcare system
B. Society
C. Pharmacist
D. Pharmaceutical manufacturer
E. Physician
12. Pharmacy manager wants to increase salary of staff pharmacy, do you consider all
except?
A. other pharmacist available to do his job
B. budget
C. pharmacist asking a raise
D. consider his experience
E. Life allowance
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13. What is SF-36
A. Short-Form 36
B. Slow release 36
C. General health status
D. Short functions 36
E. Patient non clinical information
14. If two drugs have same effectiveness than selection is based on?
A. Cost effective analysis (CEA)
B. Cost utility analysis (CUA)
C. Cost minimization analysis (CMA)
D. Cost Benefit analysis (CBA)
E. Professional judgment of prescriber
15. Which attempts to define exactly how much good is achieved for each dollar spent?
A. Cost effective analysis (CEA)
B. Cost utility analysis (CUA)
C. Cost minimization analysis (CMA)
D. Cost Benefit analysis (CBA)
E. All of the above
16. Clinical parameters and cost effectiveness of two drugs can be compared by?
A. Cost effective analysis (CEA)
B. Cost utility analysis (CUA)
C. Cost minimization analysis (CMA)
D. Cost Benefit analysis (CBA)
E. All of the above
17) Review example of cost benefit analysis (CBA)
Drug A
Drug B
Cost
drug
$1000
$1100
Administration
$100
$10
Monitoring
$50
$0
Side effects
$75
$0
Total cost
$1225
$1110
Benefit
750
Days at work ($)
Extra months of life ($)
C/B = <1 is beneficial
C/B = 1 no benefit or no loss
C/B = >1 is loss
1200
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18. Review example of Cost effective analysis (CEA)
Drug A
Cost
dose
Hospitalization
Stay require
Total cost
Drug B
$300
$300
$300
$300
$600
$600
Outcome
Extra years of life
2
Cost effectiveness ratio: 600/2
$300
6
600/6
$100
$430
$0
$10
$15
Subtotal cost:
$455
$525
Antibiotic
80%
80%
effectiveness
Result = Cost Drug A>Cost of Drug B
Note: usually used for calculating different methods surgical techniques.
20. Review example cost utility analysis
A
Cost
Drug
Administration
Monitoring
Side effects
Total cost
$250
$75
$100
$100
$525
B
$430
$0
$10
$15
$455
Utilities
Extra years of life
Quality of life
2
0.33
3
0.25
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QALY
0.5
Cost utility ratio $525/0.5
$1050
0.40
$455/0.4
$1137
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PHARMACOECONOMICS
ANSWERS:
1. Ans: C
2. Ans: A
Tips: Pharmacoeconomics is the description and analysis of the costs of drug therapy to
health care system and society.
3. Ans: B
4. Ans: A
5. Ans: A
6. Ans: B
7. Ans: E
8. Ans: B
9. Ans: D
10. Ans: A
11. Ans: B
12. Ans: E
13. Ans: A
Tips: Short form 36 (SF-36) most frequently used in pharmacoeconomic general health
status instrument measuring 8 dimensions: physical functions, social functions, role
emotional, role physical, bodily pain, mental health, general health, and vitality.
Cost
14. Ans: C
15. Ans: A
16. A
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PHARMACY PREP
DRUG DISCOVERY AND DEVELOPMENT
1. What is correct about phase I clinical trials?
A. Healthy human volunteers are tested
B. Disease human volunteers are tested
C. Larger population than Phase II is tested
D. Drugs are approved for sale after phase III clinical trials.
2. All of the following are true about Phase III human clinical trial, EXCEPT?
A. Healthy human volunteers are tested
B. Disease human volunteers are tested
C. Larger population than Phase II is tested
D. Drugs are approved for sale after phase III clinical trials.
3. Medications that are prescribed and sold over the counter in Canada are approved by?
A. Canadian Health Act
B. NAPRA
C. Health Canada
D. Federal Government of Canada
E. Provincial governments
4. Healthy volunteers are tested in?
A. Pre clinical studies
B. Phase I clinical studies
C. Phase II clinical studies
D. Phase III clinical studies
E. Phase IV clinical studies
5. Which of the following is decisive phase in new drug approval
A. Pre clinical studies
B. Phase I clinical studies
C. Phase II clinical studies
D. Phase III clinical studies
E. Phase IV clinical studies
6. Who approves and authorizes the sale of medications in Canada?
A. Therapeutic Product Directorate of Health Canada
B. Food & Drug and Administration
C. Pharmacy manager
D. Pharmaceutical Manufacturer
E. National association of pharmacy regulatory authority (NAPRA)
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PHARMACY PREP
EPIDEMIOLOGY AND CLINICAL STUDIES
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PHARMACY PREP.
BIOSTATISTICS CALCULATIONS
1.What is incorrect about the relation of confidence interval and sample size
A. There is a relationship between sample size and the width of the confidence interval.
B. The general rule is that the width of the confidence interval will be proportional
to 1/ n, so to halve the interval you need 4 times the sample size.
C. Larger samples give more precise estimates with lower standard error and tighter
confidence intervals.
D. As the sample size increases, the interval and its width decrease, thus providing a
more precise estimate of the population value.
E. The larger the sample size the larger the confidence interval
Ans. E
Tips. The larger the sample size the
2. A study experiment event rate or treatment reduced 10% risk and control reduced
7.5% risk. What is absolute risk reduction?
A. 7.5%
B. 2.5%
C. 10%
D. 15%
Ans. B
ARR = EER-CER or 10-7.5 = 2.5%
NNT = 1/ARR = (1/2.5) x 100 = 40
NNT are always rounded up to the nearest whole number.
3. If a drug reduces the risk of a bad outcome from 50 per cent to 30 per cent. The ARR
is?
A. 50%
B. 30%
C. 20%
D.10%
Ans.
What is NNT?
1/0.2 = 5
4) The results of the trial of vasodilators in patient with congestive heart failure. The
mortality in the ACEi arm was 33% and in hydralazine plus nitrate group it was 39%.
What is absolute risk difference?
A) 0.86
B) 6%
C) 14%
D) 29% E) 3.3%
Ans. B
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5.In the above case how many patient do you need to treat to benefit one case (NNT)?
A. 10
B. 5
C. 6
D.17
Ans. D
6.A new drug absolute risk reduction is 4% for preventing stroke. Means?
A. Four patient in 100 actually benefit from new drug
B. Four patient of all study group benefit from new drug
c. New drugs four times better than old drug
D. New drugs is 4% better than old drug
ans. a
7.The NNT for the above case is 25, means?
A. 25 patient had to receive the new drug in order to one patient to benefit
B. New drug benefit 25 people patient in 100 patients
C. 25 patient had to receive the new drug in order to benefit 100 patients.
D. 100 patient had to receive the new drug in order to benefit 25 patients
Ans. A
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Pharmacy Prep
HOSPITAL PHARMACY
1. Director of pharmacy reports to?
A. CEO
B. president of hospital
C. board of trustees
D. pharmacy manager
E. vice presidents
Ans. e
2. What is not included in unit dose system?
A. package containing the amount of drug for one dose
B. Oral medications contain 24 hr dosages
C. contain individual drawer or tray for each patient
D. nurses prepare unit dosages
Ans. D
3. Which of the following is NOT responsibility of P&T committee
A. Formulating policies regarding selection and therapeutic use of drugs
B. Educates professional staff such as physician, pharmacist and nurse about matters related to
patient quality and safety of drugs.
C. Develops list of formulary
D. Develops generic and therapeutic equivalent list of drugs
E. Recommends therapies to patients
Ans. E
4. Listing of drug by their generic name followed by strength, form, toxicology, use &
recommended quantity dispensed
B. Prepared locally by its own clinical staff or P&T committee
C. Each hospital has their own formulary
D. Formulary is federal and all hospital in Canada has the same formulary
Ans. d
5. Which of the following is least likely done by the regulated pharmacy technician?
A. sterile preparation of IV
B. Checking formulary stability reconstituted IV preps
C. Preparing TPN
D. Final check before delivery to wards
E. Counseling to patients
Ans. E
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6. A hospital doctor ordered a drug that is not present in hospital formulary list. What is
appropriate action?
A. Dispense equivalent drug present in formulary
B. Check in non formulary list or order from community pharmacy
C. Call doctor to change the medication from list of formulary
D. Contact other hospital pharmacy to get the medication.
Ans. b
7. Hospital doctor prescribed amoxicillin 500 mg for 8 hourly administration. What is correct?
A. unit dose is dispensed with one dose of amoxicillin 500 mg one capsule
B. unit dose is dispensed with three capsule of amoxicillin 500 mg for an 8 hourly administration
C. unit dose is dispensed with nine capsule of amoxicillin 500 mg for 8 hourly for 3 days
administration
D. Call the doctor to clarify
Ans. b
8. Dispensing errors in hospitals can be minimized by
A. Automation
B. Computer generated prescription and eMAR
C. Continue education of hospital staff.
D. All of the above
Ans. D
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Pharmacy Calculations
PHARMACY PREP.
Basic CALCULATIONS
1.A child weighs 22 lbs, and doctor wants to give a drug 1 mg/kg/day bid, how much you
should give per day?
a. 10 mg/day
B. 5 mg/day C. 15 mg/day
D. 20 mg/day
Ans. a
2.A child weighs 22 lbs, and doctor wants to give 1 mg/kg/day bid drug, how much you
should give per dose?
a. 10 mg/dose
B. 5 mg/dose C. 15 mg/dose
D. 20 mg/dose
Ans. b
3.A patient weight 180 lbs has admitted to emergence for congestive heart failure and
severe edema. Patient was give furosemide iv infusion for the past 24 hours. After
discharge the patient weight was 173 lbs. How many kg patient weight is lost?
A. 7 kg
B.3.2 kg
C. 2.2kg
D. 172 kg
=
=
3.37
= 1.84 m2
= 750 mg/m2
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Pharmacy Calculations
5.Patient age 60 yo, weight 78 kg and height 184 cm. Doctor prescribed 5-flurouracil
300 mg/m2
BSA =
se
ac a e
se
ra a
1.99 mg/m2
er a
6.A chemotherapy protocol for a pt. body weight 68 kg and height 1.7 m. Chemo drug
leucovorin 400 mg/m2 is recommended what is daily dose?
c
= 1.79 m2
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Pharmacy Calculations
100 ........... 85
125.............?
= 106 g
164-106 = 58 g
9.Ampicillin 1 g drug. Add 6.8 ml sterile water to provide final concentration volume 8
mL. What is concentration of the reconstituted solution in the vial in mg/mL?
A. 8 mg/mL
B. 125 mg/mL
C. 100 mg/mL
D. 150 mg/mL
Unknown
Known
x mg/mL
1000 mg/8mL
1 ml/125 mg
= 4mL
11.A sterile methylprednisone powder vial contain 125 mg drug. Reconstituted by adding
1.8 mL of sterile water to final volume 2 mL. What is final concentration of reconstituted
solution in the per mg/mL?
A. 125 mg/mL
B. 62.5 mg/mL
C. 31.5 mg/mL
D.16.5 mg/mL
ans. B
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Pharmacy Calculations
2 mL ..................125 mg (known)
1 mL .................? (unknown)
uknown
x mg/ 1mL
known
125mg/2mL
x mg = (1 mL x 125 mg) / 2 mL
= 62.5 mg/mL
1g/100 mL
Xg = (1000 mL x 1g)/100 mL
= 10 g
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Pharmacy Calculations
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Dose Calculations
Dose Calculations
15 mg BID = 30 mg daily
For 20 days: 30 mg x 20 = 600 mg are dispensed
Solution contains 5 mg/ml. 600 mg are contained in 600/5 = 120 mL
Ans: E
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Dose Calculations
3. A patient is currently taking 220 mg anhydrous zinc sulfate. To receive the equivalent
amount of elemental zinc, how many milligrams of zinc sulfate heptahydrate (.7H 2 O)
would be patient need to take? (MW: zinc 65, ZnSO 4 161, H 2 O 18).
a) 123 mg
b) 220 mg
c) 300 mg
d) 392 mg
e) 545 mg
ZnSO4 = 161
ZnSO4 heptahydrate= (7x18 =126)
161+126 = 287
161..............220 mg
287................?
(220 x 287)/161
= 392
OR
Working:
i.
ii.
iii.
ZnSO 4
= 161
7H2O
= (7 X 18) = 126
ZnSO 4 7H2O = 161 + 126 = 287
iv.
Ans: D
4) A physician has prescribed 60 g of 0.01% fluocinolone acetonide cream. You have
available the commercially prepared cream containing 0.2% fluocinolone acetonine
(Synalar cream) and cream base (Dermabase ) for dilution. To prepare the Rx you
would require:
a) 1.2 g Synalar and 58.8 g Dermabase
b) 3 g Synalar and 60 g Dermabase
c) 0.3 g Synalar and 59.7 g Dermabase
d) 3 g Synalar and 57 g Dermabase
C1. V1 = C2. V2
0.01% x 60 g = 0.2% . V 2
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Dose Calculations
Ans: D
B is wrong, because 3 g Synalar and 60 g of Dermabase will give 63 g of total cream,
with a concentration of 0.0095% (0.006 / 63 x 100)
5. In the International System of Units (SI), most drugs levels are to be reported in the
units of micromoles/litre (mols/litre). The therapeutic concentration range for
theophylline (MW 180) is 10-20 g/mL. the SI equivalent would be:
a) 0.055- 0.11 mol/L
b) 27-55 mol/L
c) 55-110 mol/L
d) 110-220 mol/L
e) 180-360 mol/L
Working:
i.
Careful!!! Theophylline therapeutic concentration is given in
mol/mL, while answers are given in mol/L.
ii.
Convert therapeutic concentration to g/L: 10-20 mol/mL =
10,000 20,000 g/L
iii.
Lower parameter: 10 g/mol = 10,000 g/L = 10,000/180 = 55
mol/L
iv.
Upper parameter: 20 g/mL = 20,000 g/L = 20,000/180 =
111mol/L
Ans-C
6. Prednisolone each tablet containing 10mg. Taper 1/2 tablet every week .How tablets
are needed?
1st week = 7 tab
2nd week = 3.5 tab
10.5 tablet
7. A family of 1 adults (300 mg/wk) and 8-year-old child (75mg/wk), 14 year old
(225mg/wk) teenager, going for 2 weeks trip to malaria infections area. You have 300
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Dose Calculations
mg base drug. How many tablets will you give for whole family? (Prophylaxis require 4
weeks before trip, during trip and 2weeks after trip)
A-17 tablets
B-18 tablets
C-16 tablets
D-19 tablets
Ans. C
Total = 8 week therapy
Adult = 8 tablet
14 yo = 6 tablet (225 mg/wk)
8 yo = 2 tablet (75 mg/wk)
Total tablet = 16 tablets
8) A parenteral solutions used in hospital pharmacy. If 250 g of parenteral solution
dissolved in 1000 mL of glycerin (density of glycerin is 1.25 g/mL), the concentration of
parenteral solution is:
A) 26% w/w
B) 24% w/w
C) 16 % w/w
D) 20%w/w
TIPS:
D = M/V
Concentration = Solute
x 100
Solute + Solvent
=
250 g
x 100
250g+1250 g
= 16% w/w
M=DxV
M = 1.25 x 1000 mL = 1250 g
Then
250 g+1250 g = 1500 g (total volume)
(250g/250 g+1250 g) x100 = 16%
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Dose Calculations
17. Prednisolone each tablet containing 5mg. Start 35 mg and then taper by 5mg every 1
day. How many tablets are needed?
A-20 tab
B-56 tab
C-14 tab
D-28 tab
Tips: 7+6+5+4+3+2+1 = 28 tab
For above questions, how many days patient takes prednisone? 7days
17. Prednisolone each tablet containing 5mg. Start 35 mg and then taper by 5mg every 2
day. How many tablets are needed?
A-20 tab
B-56 tab
C-14 tab
D-28 tab
7+7+6+6+5+5+4+4+3+3+2+2+1+1 = 56 tab = 14 days
For the above questions. Patient take for how many days? 14 days
18) If three tablets contain 975 mg of ASA, how many grams of ASA would be contained
in 12 tablets?
A) 4g
B)325g
C) 3.9g
D) 39g
E) 390g
19) How many milliliters of a heparin sodium injection containing 200,000 heparin units
in 10 mL should be used to obtain 5,000 heparin units?
A-0.50mL
B-0.25mL
C-0.10mL
D-0.75mL
E-250mL
200,000 ---- 10 ml
5000
---- ?
5000 x 10 / 200,000 = 0.25 ml
20) A physician asks the pharmacist to compound codeine sulfate tablet triturates
containing 10 mg of codeine. The patient need a 5-day supplies and may take 1-2 q4-6h
PRN How much codeine is needed to fill this prescription?
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Dose Calculations
A. 300 mg
B.400 mg
C-600 mg
D-1200 mg
Ans: c
PRN = as needed or on demand
12 tab per day
for 5 days = 60 tab
each tab contain 10 mg
so
10 mg x 60 tab = 600 mg
23) Prednisolone each tablet containing 5 mg. Start 10 mg and then taper by 1/2 tab
every week. How many tablets are needed?
A-21 tab
B-56 tab
C-14 tab
D-28 tab
E-35 tab
Ans.
Tips: 14 tab+10.5tab+7tab+3.5 tab = 35 tab
2 tab daily x 7 d = 14 tab
1.5 tab daily x 7 d = 10.5 tab
1 tab daily x 7 d = 7 tab
1/2 tab daily x 7 d = 3.5 tab
5 tab x 7 days
How many weeks therapy?
26) Dexamethasone 8 mg bid x 7 days then taper by 1 mg twice day every 2nd day until
finish? Available strength 4 mg and 0.5 mg. Calculate how many tablets of both
strengths you will dispense?
A) 112 tablets of 4 mg or 800 tablets of 0.5 mg
B) 126 tablets of 4 mg or 1008 tablets of 0.5 mg
C) 56 tablets of 4 mg and 96 of 0.5 mg
D) 136 tablets of 4 mg or 990 tablets of 0.5 mg
E) Give both 44 of 4 mg and 96 of 0.5 mg tablets
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8 mg Bid
7 mg bid
6 mg bid
5 mg bid
4 mg bid
3 mg bid
2 mg bid
1 mg bid
Total
days
7d
2d
2d
2d
2d
2d
2d
2d
Dose Calculations
4 mg TAB
28
4
4
4
4
0
0
0
44
0.5 mg TAB
0
24
16
8
0
24
16
8
96
7 d x 16 mg = 112 mg = 28 tab of 4 mg
2 d x 7 mg bid =14 mg for 2 d 28 mg = 4 of 4 mg & 24 of 0.5 mg
2 d x 6 mg bid 24 mg = 4 of 4 mg and 16 of 0.5 mg
2 d x 5mg bid= 20 mg = 4 of 4 mg and 8 of 0.5 mg
2 d x 4mg bid =16 mg = 4 of 4 mg
2 d x 3 mg bid = 12 mg = 24 of 0.5 mg
2 d x 2 mg bid = 8 mg = 16 of 0.5 mg
2 d x 1 mg bid = 4 mg = 8 of 0.5 mg
Ans.
Tips. If you give both 44 of 4 mg and 96 of 0.5 mg
Total 224 mg
Total therapy 21 days
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Q& A
1) A prescription for hydrocrotisone cream 0.1%. Pharmacy has 0.25% available in 30 g tube.
How many grams diluents base (vanishing cream) should be added?
A) 30 g
B) 45 g
C) 50 g
D) 75 g E) 25 g
V2 = (C1 x V1)/C2
V2 = (0.25% x 30 g)/0.1%
V2 = 75 g
but the added tube contains 30 g
so the used base = 75 g - 30 g = 45 g
B) 3ml
C) 1ml
D) 0.35ml
Ans: B
Step1: determine the volume of final product. Since dexamethasone is 4mg/mL, a 1 ml vial have
4mg of drug
X ml/ 4 mg = 1 ml/1 mg = 4 mL
Step2: subtract the volume of concentrate from the total volume to determine the amount of
diluents needed.
4 ml-1ml = 3 mL
3.If a 600 ml of a 15% (v/v) solution of methyl salicylates in alcohol are diluted to 1500 ml what
will be the percentage strength.
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C2 = (C1xV1)/V2
C2 = (15 x 600 ml)/1500 mL
C2 = 6%
4) A physician has prescribed 60 g of 0.01% fluocinolone acetonide cream. You have available
the commercially prepared cream containing 0.2% fluocinolone acetonine (Synalar cream) and
cream base (Dermabase ) for dilution. To prepare the Rx you would require:
a)
b)
c)
d)
C1. V1 = C2. V2
0.01% x 60 g = 0.2% . V2
X = (60 g x 0.01)/ 0.2 = 3 g Synalar
Order is for 60 g - 3 g = 57 g dermabase
0.5
1.5
1
2.5
0.5
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6.Hydrocortisone 1% 60 g.
Your pharmacy has 2.5% hydrocortisone and petrolatum base. What fraction of each
hydrocortisone needed use to prepare above prescription
2.5%
1
1%
0%
1.5
2.5% HC = 24 g
petrolatum base = 36 g
7. How many milliequivalents of sodium is in 92 mg of NaCl salt? M.wt of Na = 23
mEq = [mg x valence]/(Mol.Wt)
mEq = 92/23
= 4 mEq
8) You are given ZnCl 2 0.7%, phenylephrine 0.1% and boric acid 1.1% with E values 0.16, 0.32
and 0.5 respectively. This solution will be:
A) Hypotonic
B) Hypertonic
C) Isotonic
D) Non isotonic
Solution.
[(0.7 x0.16] + [(0.1 x 0.32] + [ (1.1 x 0.5)]
= 0.112 + 0.032 + 0.55 = 0.694
= 0.9>0.69 = Hypotonic
How much NaCl required making isotonic solution?
0. 9 - 0.69 = 0. 21 or 2 mg
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9) Zinc sulfate is a two-ion electrolyte, dissociating 70% in weak solutions. Calculate its
dissociation factor.
ZnSO 4
Zn + SO 4 + ZnSO 4
70+ 70
+30
170/100 = 1.7
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Sterile Preparations
PHARMACY PREP
Brand and Generic Name Indexes
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PHARMACY PREP
PRESCRIPTION PROCESSING AND DISPENSING
1.A 65 yo customer at your pharmacy using nitroglycerine patch daily for the prevention
of coronary artery disease. If patient a new prescription. Which of the following Rx is the
pharmacist concern?
A. Nitroglycerine 0.3 mg SL tab
B. Nitroglycerine 0.4 mg SL spray
C. Sildenafil 50 mg as needed
D. Tylenol # 3 for as needed for pain
E. Ritonavir soft gelatin cap 100 mg daily
Ans. c
2.A very frequent customer at your pharmacy, request for 15 days supply of Lipitor 10
mg tablets because customer has no prescription and no refills of Lipitor. In the next few
hours he has to take a flight for vacation. Currently all walk-in-clinics are closed and his
physician is not available for prescription.? According to extended scope of pharmacy
practice pharmacist dispensed 15 days of drugs? This is defined as?
A. Adaptation
B. Advancing a drug
C. Pharmaceutical opinion
D. Professional discretion
E. Professional judgement
Ans.b
3.MP came from the British Columbia, during the journey he lost his medications. He
approaches at your pharmacy with a rough list of medication, he was using. The
pharmacy and doctor clinic is currently closed due to long weekend in BC. What is
appropriate?
A. dispense the list of medication
B. refer him to walk in clinic
C. refuse to dispense any medications
D. write prescription
E. dispense OTC medications
Ans. b
4.A 75 yo patient has been discharged from the hospital. Presents at your pharmacy with
the following discharge report prescription. What is the pharmacist concern?
a. Metformin 1000 mg, PO, evening with dinner and metformin 1000 mg, po, morning
with breakfast
B. Levodopa/carbidopa 25/100 mg, po, four times per day
C. Digoxin 120 mg once daily in the morning
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D. Donepezil 5 mg, po, daily
E. Tramadol 50 mg as needed for pain
Ans. c
5.Which of the following prescription is written incorrectly?
A. Pantoprazole 40 mg, po, daily before breakfast
B. Spironolactone 10 mg, po, daily
C. Acetaminophen 650 mg, every 4 hours
D. Fentanyl patch 50 mcg/hour daily
E. Alprazolam 0.5 mg SL tab daily at bedtime
Ans. d
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PHARMACY PREP
DRUGS IN SPECIAL POPULATIONS
1. Which of the following incorrect about elderly?
A. Increased pH of stomach secretion
B. Slow gastric emptying time
C. Reduced enzyme production
D. Increased excretion of renal elimination drugs
E. Decreased metabolism of drugs
Ans. D
2. Which of the following incorrect about pregnancy?
A. Increased pH of stomach secretion
B. Slows gastric emptying time
C. Increased enzyme production
D. Increased excretion of renal elimination drugs
E. Increased metabolism of drugs
Ans. A
3. which of the following is the most critical of organ development in pregnancy?
A. Biogenesis
B. Organogenesis (2 to 8 wks) or emryotoxic
C. Fetal Period (9wk to labor)
D. The first 15 -21 days (biogenesis)
E. Ninth week to birth
Ans. b
Tips.
Biogenesis - The first 15-21 days after fertilization. Cleavage, and germ layer formation.
Organogenesis 2-8 wks - The major organ start developing. (congenital defects)
Fetal period- at 9th wk, the embryo referred to as fetus.
4. when you considering medication therapy in pregnancy.
A. both mother and fetus must be considered
B. weigh risk and benefits
C. rule of thumb is lowest effective dose for shortest period
D. All of the above
ans.d
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PHARMACY PREP
CLINICAL TOXICOLOGY
1- An adult patient who ingested 30 acetaminophen tablets (325 mg/tab) 6 hours ago
should be treated with/by
A. EDTA infusion
B. Ipecac syrup
C. Activated charcoal
D. N-acetylcysteine
E- Probenecid
2. Glutathione conjugation are catalyzation is extremely important in preventing
toxicity from variety of drugs, toxic products are excreted as:
A) S-adenosyl transferase
B) Glutamic acid
C) Marcapturic acid
D) Mercaptopurines
E) Sulfadryl groups
3-A 33-year-old male receiving Acetaminophen 300 mg + codeine 30 mg + caffeine 15
mg (Tylenol # 3) for pain relief, which of the following laxative is appropriate choice for
constipation associated with codeine;
A-Sennakot
B-Bulk laxatives
C-Lactulose
D-Psyllium
E-Glycerine
4-A patient brings the prescription of amitriptyline 300 mg 3 months supply. Patient
medical history includes, major depression and in the past has 2 unsuccessful attempts
to suicide. What is the appropriate, a pharmacist should do?
A-Dispense 3 months supply of amitriptyline and caution about overdose symptoms.
B-Dispense in part fills or small quantities and ask patient pick up in parts every 15 days
C-Refuse the prescription and ask patient to see other doctor
D-Refer patient to other physician for mental assessment.
5-Overdose of acetaminophen is treated by?
A-N-acetylcysteine, administered within 1 hour
B-N-acetylcysteine, administered within 8 hours
C-N-acetylcysteine can be administered anytime after overdose
D-No antidote is available for acetaminophen overdose
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E-Sodium bicarbonate diuresis
6-What is daily maximum dose of acetaminophen?
A-10 g
B-4 g
C-7 g
D-1 g E-8 g
7- A grand mother gave 2 tbsp (250 mg/5ml) of amoxicillin suspension instead of 2 tsp
to a child 9 mo age. What is appropriate to do?
A-Monitor diarrhea
B-Refer to doctor
C-Refer to emergency
D-Call poison control center
E-Wait and watch
8- A 5 yr child swallowed 5 g of nystatin cream, what to do?
A-Monitor diarrhea
B-Refer to doctor
C-Refer to emergency
D-Call poison control center
E-Wait and watch
9- A regular customer of your pharmacy brings a prescription of amitriptyline 300 mg
daily for 3 mo. However patient profile shows he had attempted suicide in the past but
was not successful. What is appropriate to do?
A) recommend not to overdose
B) recommend to take as doctor prescribed
C) give a part fill of monthly dose
D) talk to doctor to prescribe other antidepressant
E) refuse to dispense
10- A grand mother gave 2 tbsp of amoxicillin of 500 mg/5ml bid instead of 2 tsp to a 9
month old child. What to do?
A) refer to emergency
B) refer to doctor
C) wait and see
D) recommend to skip next dose
E) contact regional poison control centre
11) A 2 yr old child swallowed nystatin 10 g suspension, What to do?
A) refer to emergency
B) refer to doctor
C) wait and see
D) recommend to skip next dose
E) not a concerned
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12) A doctor comes to your pharmacy and write a prescription for oxycontin 100 tablets
for himself? What to do?
A)dispense 50 tablets only
B)dispense 200 tablets only
C)it is illegal dispense narcotics to doctor
D)It is unethical to dispense narcotics for themselves
E)Refer doctor to Centre of addiction and mental health (CAMH)
13) A regular customer of your pharmacy, using recently picked up prescription of
Tylenol # 3 (acetaminophen 300 mg + codeine 30 mg + caffeine 15 mg) 90 tablets. Now
wants to buy acetaminophen 500 mg box of 200 tablets. What is the pharmacist
concern?
I) overdose
II) constipation
III) hepatotoxicity
A) I only
B) III only
C) I and II
D) II and III
E) I, II, III
14- Pharmacy tech received a phone call from your pharmacy customer. She has
swallowed 10 tablets of acetaminophen 500 mg. What is appropriate recommendation?
A) Suggest to take lots of fluids
B) refer to emergence
C) ask to contact poison control centre
D) ask wait and see
E) give N acetyl cysteine
15- What is the initial symptoms of acetaminophen toxicity?
A) stomach upset B) hepatotoxicity C) headache D) confusion E) vomiting
A child admitted to hospital following ingestion of overdose of aspirin and some other
OTC sleeping pills, which contain antihistamines, and anticholinergic drugs. The child is
in coma and flushed and flaccid. Her pupils were fixed and dilated. The lab results
indicated her blood aspirin drug levels are 5.8
H is 6. Her
an symptoms
r ne
also include deep and rapid respiration.
16) The symptoms of deep and rapid respiration may lead to:
A-Hypertension
B-Respiratory acidosis
C-Respiratory alkalosis
D-Increase in temperature
E-Reduction in temperature
Ans-C
Tips:
Respiratory Acidosis. This occurs due inadequate ventilation of CO 2 by lungs.
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Predisposing factor for respiratory acidosis:, Asthma, Beta blockers, Sleep apnea, CNS
depressants, Pulmonary edema or embolism, Cardiac arrest
RESPIRATORY ALKALOSIS. Due to increase in excretion of CO 2 However this condition is
not very common.
17) As result of aspirin mechanism, the child would likely to progress?
A-Metabolic acidosis
B-Metabolic alkalosis
C-Renal failure
D-Hyperglycemia
E-None of the above
Ans-A
18) In order to increase the excretion of aspirin from body, which of the following
should be administered:
A-Probenecid
B-Ammonium chloride
C-charcoal
D-Ipecac
E-Sodium bicarbonate
Ans-E
ANSWERS:
1- D
2. C
3- A
Tips: Stimulants laxative are the drug of choice for the treatment of constipation
associated with opioids use.
4-B
5- B
6- B
7- B
8- E
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9- C
10- E
Tips: serious toxicity is unlikely following large doses of amoxicillin. Acute ingestion of
large doses (250 mg/kg) of amoxicillin may cause nausea, vomiting, diarrhea, abdominal
pain. Acute oliguric failure and hematuria may occur following large doses
Reference: CPS 2009
11- C
Tips: Nystatin suspension have no systemic absorption, so overdose monitor symptoms
so wait and see.
12- D
13- E
14- C
15- E
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PHARMACY PREP
PHARMACY COMMUNICATION SKILLS
1) Which of the following is the most effective communication skill?
I-Verbal skills
II-Nonverbal listening skills
III-Verbal skills only
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
2-A pharmacist is required to give knowledge of drugs and supply the patient with
enough pieces of information to overcome the patient ignorance. This is done by:
a) Written information only
b) Verbal information only
c) Verbal and written information
d) Magazines and folders information
e) Video information
3-The most effective communication skills include?
A-Written only
B-Verbal and written
C-Verbal and non-verbal
D-Verbal only
E-Listening only
4-All of the following communication distractions, except:
A-Telephone
B-Language
C-Cell phone
D-Music
E-Television
5) A patient who does not speak English and you don't understand his language. How do
you resolve this problem?
A-Find a interpreter or translator
B-Patient problem do not worry
C-Pharmacist problem learn his language
D-Both pharmacist and technician problem
E) Use non verbal techniques
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6-A 90-year-old senior patient cannot hear, how to counsel?
A-Speak louder
B-Counsel in quite area of pharmacy
C-Give recorded tape of counseling
D-speak vivid and closer to customer
E-Dont speak to customer
7) As a pharmacist you should have speaking skills. All the following are true except:
A) Speak in a monotonous voice pitch.
B) Speak with precise language.
C) Write when verbal is not sufficient.
D) Greet the patient.
8) All the non verbal skills to use during telephone conversations except:
A) Give your full attention to phone call.
B) Put the patient on hold if you are busy.
C) Be prepared.
D) Smile
9) In non verbal communication you should:
A) Use appropriate body language.
B) Look down repeatedly.
C) Tilt to one side.
D) Have the barriers between you and the patient like at desk or counter.
10) A patient coming to take OTC cough syrup and pharmacist noticed that patient took
same medication yesterday, what you should do?
a. Tell her no more medication available
b. Ask her what medical conditions she needs the medication
c. Give her the name of the addiction group
d. Call the police
11) If you open a pharmacy in multicultural area, what will you do increase sales?
A) Display signs of different culture
B) Hire staff of different cultures
C) Offer only one culture service
D) Refuse all the customer who disagree with opinion
E) Offer services in different languages
12) What is the best marketing in pharmacy?
A) Advertise in national TV
B) Advertise in national news paper
C) Advertise door to door in neighborhood
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D) Advertise in mall
13) What are the characteristics of culturally competent pharmacist?
A) Understanding other cultures and respecting sensitive issues.
B) Offer services to all customers of different belief system
C) Offer privacy and confidentiality to customers of their personal information
D) All of the above
14) Customer of your pharmacy with kids. Parents discipline their kids but they are
beating and spanking? What to do?
A) Talk to parents and kids
B) Call police and inform about it
C) Call children society to protect kids
D) Ignore and let them go
15) Adult women come to your pharmacy to buy analgesics for her wounds. She seems
to physically and sexually abused what to do?
A) Call police
B) Ask her to go emergence
C) Refer to doctor
D) Give her police phone number to contact
E) Ask her to contact sexually abused support groups
16) Which of the following is NOT an environmental barrier?
A) Background noise
B) Telephone rings
C) Height of pharmacy counter
D) Dealing with a depressed patient
E) Loud music
ANSWERS:
1) C
2- C
3- B
4- B
Tips:The language can be barrier. However it is not distraction.
5. A
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6- D
7. A
Tips: It is boring to speak in a monotonous language
8. B
9. A
10) B
11) E
12) C
13) D
14) A
15) E
16) D
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Pharmacy PREP
ETHICAL STANDARDS
1. The ethical standard beneficence in pharmacy practice means:
A. Pharmacist act with justice
B. Pharmacist act with fairness
C. Pharmacist act with honesty and without deception
D. Pharmacist does well to patient
E. Pharmacist do prevent harm
2. The ethical standard nonmaleficence in pharmacy practice means:
A. Pharmacist act with justice
B. Pharmacist act with fairness
C. Pharmacist act with honesty and without deception
D. Pharmacist does well to patient
E. Pharmacist do prevent harm
3. The ethical standard veracity in pharmacy counselling means:
A. Pharmacist act with justice
B. Pharmacist act with fairness
C. Pharmacist act with honesty and without deception
D. Pharmacist does well to patient
E. Pharmacist do prevent harm
4. The ethical standard justice in pharmacy practice means:
A. Pharmacist act with equality
B. Pharmacist act with fairness
C. Pharmacist act with honesty and without deception
D. Pharmacist does well to patient
E. Pharmacist do prevent harm
5. Patient cannot afford to buy new medication that is not covered by his insurance
plan. Pharmacist called his doctor and asked him to change the medication into another
medication covered by the patients insurance plan. Which ethical principle did the
pharmacist follow?
A. Beneficence
B. Veracity
C. Justice
D. Nonmaleficence
E. Fidelity
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11. A father of teenage girl approach to your pharmacy. Asks if her teenage 16 yo
daughter using oral contraceptives? What ethical dilemma of pharmacist?
A. confidentiality and veracity
B. confidentiality and autonomy
C. confidentiality and beneficence
D. confidentiality and fidelity
E. confidentiality and justice
12. A father of teenage girl approach to your pharmacy. Asks if her teenage 16 yo
daughter using oral contraceptives? What ethical dilemma of pharmacist?
A. Veracity and confidentiality
B. Beneficence and confidentiality
C. Justice and confidentiality
D. Nonmaleficence and confidentiality
E. Autonomy and confidentiality
13. When can you break confidentiality?
A. patient who has HIV with partner
B. Patient inmate who broke the law
C. Patient who has Alzheimer's with care giver
D. A patient could be harmful to themselves and community risk
Ans. D
14. What is the principle of confidentiality does not break if a pharmacist disclose the
following medical conditions to the society?
A. diabetes B. Harm full
C. HIV
D. high BP
E. cancer
Ans. B
15. In which of the following situation you can break confidentiality of patient?
A. patient is suffering from HIV
B. patient is on parole
C. suspect patient can harm himself
D. patient is in jail
Ans. C
16. A 30 yo women comes to your pharmacy to buy oral contraceptives. While
conversation she says she found antiretroviral drugs in her husband bag. If her partner
has HIV. Your medication record show patient is HIV? What is appropriate to do?
I) Tell her to take HIV tests
II) Tell her to talk his doctor
III) Tell her that she got HIV infection from her partner
A. I only
B. III only
C. I and II only
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D. II and III only
E. All are correct
17. Can you release information to a prescriber if you have firsthand knowledge from
the third party or DUR about double doctoring?
A. Patient information is confidential
B. Let third part inform to prescriber
C. Yes, you can inform to prescriber because it is in circle of care
D. Ask patient first, before informing doctor
18. Pam is working in rural pharmacy. She is friend with all colleagues, including Chris.
Chris had vision problems in the past, but underwent laser surgery and now is ok. He
does not work pharmacy anymore, but Pam is still has his profile in her computer.
Should she date him?
19. Patient is using Terbutaline inhaler a lot. The pharmacist failed to advise patient to
see his doctor to add corticosteroids therapy to manage his condition. What is violated?
A. Beneficence B. Nonmaleficence C. veracity D. autonomy E. Paternalism
20) A patient has diagnosed with terminal ill cancer. His doctor advised him about his
serious illness. What ethical principle is followed?
A. Beneficence
B. Nonmaleficence
C. veracity
D. autonomy
E. Paternalism
21. Which of the following is express consent?
I) given verbally
II) written
II) given electronically
A) I only B) III only C) I and II only D) II and III only
22. A pharmacist Joe is being restricted from practice because of history of substance
abuse. Based on what the college makes this decision?
A. Incompetent B. Incapacity C. Negligence D. Mis-conduct E. accountability
23) A returned medication is placed on shelf by the technician? what you have to as
staff pharmacist?
A) talk to technician
B) inform to manager
C) complain to college of pharmacist
D) Discuss in meeting
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35) A lawyer calls to your pharmacy wants to get medication information of a divorced
spouse. Children? What to do?
A. Talk to lawyers, client and provide information
B. Refuse to provide information
C. Children information only can be shared by parents
D. Lawyer should provide official letter of patient authorization from adults
Ans. d
36) A phone call from emergency medical services, wants to a patient profile of patient
who is found unconscious in his apartment? What is appropriate action?
A) Ask ID of EMS and refuse to give patient information
B) Never trust any phone calls ask EMS to come personally to pharmacy.
C) Verify and give patient profile to EMS, it is in best interest of patient.
D) Ask EMS to contact to doctor of a patient to get information
E) Ask EMS to contact family member of patient.
37. A frequent customer, on benzodiazepine for long time, his doctor away and there
are no walk in clinics open. He wants to get some pills advance? What you do?
A. talk to that person
B. ask patient to see other doctor to get prescription
C. advance benzodiazepine
D. Refer to pharmacist
38. In what situation pharmacist call police?
I) forged prescription
II) Break - in happened
III) narcotic theft
A. I only B. III only C. I and II only D. II and III only
39) A father of two adults children and wife customer of your pharmacy, wants you to
print receipts of their medications for filing tax returns.
A) Get the authorization from wife and adult children
B) Receipts only without specifying medication just total amount can be printed to
father
C) Refuse to provide receipts
D) Ask to contact revenue Canada
Ans. A
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40. A physician called to pharmacy to get patient record of medications patient
investigational drugs receipt. Patient is under the care of the doctor. Pharmaceutical
company already paid to that doctor and as technician what you have to reply?
A. need patient authorization
B. If it is not legal way to give to doctor
C. print out investigational drug receipt to the doctor
D. tell doctor to contact with pharmaceutical company
41) Who sets the prices of patented medications?
A) Patented Medicine Price Review Board (PMPRB)
B) Health Canada
C) Manufacturer
D) Pharmacist associations
42. A patient consent may be essential in all, except?
A. To collect patient information
B. To release patient information to third parties
C. To publish clinical trial results of a anticancer drug
D. To prepare prescription by the technician of your pharmacy
E. None of the above
43. A 16 yr old girl brings a prescription of oral contraceptive pills. However, her parents
calls to your pharmacy and warns you to not dispense OCP to their daughter because
using contraception is against of their belief system. What parents actions are:
A. Justice
B. Paternalism
C. Fidelity
D. Beneficence E. Veracity
44) A woman comes to your pharmacy, ask if her husband has HIV? As your pharmacy
has her husband profile. He is HIV positive? What to do?
A) Do check for yourself and speak to your husband
B)Tell her yes! he has HIV
C) Don't tell her the truth
D) Tell her not to worry, HIV is treatable
Ans. a
45) The pharmacist preserves the confidentiality of information about individual patient
acquired in the course of his or her professional practice, and does not divulge this
information except where authorized by the patient or required by law. Which of the
following federal regulation protects personal health information of patient?
A)Canadian health act
B)Therapeutic directorate, health Canada
C)Institute of safe medication practices
D) Personal Health Information Protection Act
E) All of the above
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Ans: D
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17. C
Tips. Information can be shared in circle of care (if patient is under the care of a doctor,
pharmacist, nurse or caregivers).
18.
19. B
Tips. By not preventing harm. The nonmaleficence is violated
20. C
21. E
Tips. The consent can be obtained by three types express, implied, and informed.
22. B
Incompetent: lack of knowledge, skills, judgment
Incapacity: substance abuse or accidents
Negligence: working lower than standard
Misconduct: unethical
Accountability: legally and morally liable when carrying out duty
Advance directives = legal will
23. A
24. D
Tips. According to pharmacy technician standards of practice. A regulated technician or
pharmacy assistant cannot recommend prescription or non prescription therapies to
patient. Any clinical recommendations or counseling is CANNOT be performed by
pharmacy technicians.
25. A
26. B
27. C
28. B
29. D
30. C
31. C
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32. A
33. B
34. D
35. C
36. C
Tips: It is circle of care, you can share information after confirmation.
37. B
38) E
39) B
40) C
41. A
42. D
43. B
44. A pharmacist believes, using Plan B is against his faith. If a customer wants to use
plan B. would you dispense?
45. A physician write prescription for own use or family member for emergency?
46. A very frequent customer of your pharmacy, requests for 15 days supply of Lipitor
10 mg tablets. Next few hours he has to take a flight for vacation. Currently all walk in
clinics are closed and his physician is not available for prescription. Customer has no
prescription and no refills of Lipitor? If you dispensed what ethics are followed?
47. A patient of your pharmacy approaches to refill salbutamol inhaler. Patient asthma
is getting worse and using more frequent salbutamol. However pharmacist did not
suggest patient to see the doctor to get steroid inhaler prescription. What ethical
principles have been violated?
48. There are two customers of pharmacy, one customer all family members come to
your pharmacy. Other customer family members go to other pharmacy. A pharmacist
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takes NO copayment from a customer who comes with all family members, where as
customer comes as single persons pays co-payment, What ethical principle is violated?
49. A pharmacist refuses to dispense plan B, because of pharmacist beliefs are against of
using contraception?
50. A family two adults and one 16 yo daughter are customer of your pharmacy. one of
the family member comes to your pharmacy, ask for list medications their family
members using for the past 6 months. What to do?
A cancer patient has one month to live. Doctor did not inform the patient about cancer.
What ethical principles is broken?
A) Beneficence
B) Veracity
C) autonomy
D) Confidentiality
E) Paternalism
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Covenant relationship?
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Information resources
PHARMACY PREP
PHARMACY PRACTICE INFORMATION RESOURCES
1. The Canadian pharmaceutical reference CPS stands for:
A. Compendium of pharmaceutical Sciences
B. Compendium of Pharmaceutical Supplements
C. Compendium of Pharmaceutical Society
D. Compendium of Pharmaceutical Specialties
E. Compendium of Pharmaceutical Sources
2. A patient presents a prescription that requires the extemporaneous preparation of a
buffered eyedrop. Which of the following is the source for information on the correct
buffering of the eyedrop?
A. Facts and comparisons
B. The Merck manual
C. Pharmacy PREP index
D. Remingtons pharmaceutical sciences
E. Physicians desk reference
3. One of your regular patients comes to the pharmacy in search of Dogmatil for her
brother. He has just arrived from Singapore for a visit, but his medication was lost with
his luggage. She says her brother needs the medication for a CNS condition and
shouldnt go without it. She wants to know if he can get Dogmatil here. Which of the
following appropriate reference:
A. Canadian hospital journal
B. American hospital journal
C. Compendium of pharmaceutical specialties
D. Martindale, The complete drug reference
E. National formulary
4. Cochrane collaboration databases or collaborative library is the reference source of?
A. Evidenced based medicine information
B. A Canadian pharmacy journal
C. Collaboration of medical professionals
D. A natural products database
E. The group of people with same characteristics
Ans. A
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Information resources
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Information resources
B. indexes
C. abstracts
D. text books
E. TV and radio, internet
12. What information is NOT present in CPS?
A. Prescription drugs available in Canada
B. Drugs in dentistry
C. Drugs in pregnancy
D. Self care for nausea and vomiting
E. Prescription drug monographs
13. What information is NOT present in patient self care?
A. Antibiotics
B. Mouth hygiene in halitosis
C. choosing a sunscreen
D. self care for nausea and vomiting
E. treatment of nausea and vomiting in pregnancy
14. What is reference is used to recommend to initial therapy for hypertension?
A. CPS
B. Patient self care
C. hypertension clinical guidelines
D. Therapeutic choices
E. USP-DI vol.1
15. Which of the following resources would provide the most up-to-date answer when
checking if a drug is marketed in Canada?
A. e-CPS
B. CPS
C. PubMed
D. Martindales
E. USP-DI vol.1
16. CPS is?
A. primary literature
B. secondary literature
C. tertiary literature
D. All of the above
ans. c
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Information resources
ANSWERS:
1. D
2. D
3. D
4. A
5. B
6. D
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7. E
Tips: brands of over the counter products can be found in compendium of self care
products (CPSP)
8. D
9. D
10. D
11. A
12. D
13. A
14. C
15. A
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Medication Errors
PHARMACY PREP
MEDICATION ERRORS
1. Verbal prescriptions of drug "names sound like" drugs, can cause medication errors. What
should manager do to decrease the error EXCEPT:
A. Put them away from each other
B. Put label on vial (call for error)
C. Put in computer system alarm to work on dispensing
D. Technician ask patient for what disease being treated for
E. Make two persons double check before dispensing
2-Busy pharmacies a long line up in 15 customers, a person came he is insisting and fighting
with pharmacist, do dispense him first?
A-ignore that customer
B-dispense him first
C-dont dispense
D-just talk to him and explain there are other before you.
E-Call police
3) A very angry customer comes to your pharmacy and complains that you have dispensed
wrong medication. What is initial appropriate action?
I-offer private counselling area
II-check or verify medication
III-if there is dispensing error, apologize and correct it
A) I only
B) III only
C) I and II
D) II and III
E) I, II, III
4) In case of recall products, what is first thing to do?
A-Call all patient still using it and inform about recall
B-Inform the manager follow procedure for recall product
C-Post a sign in the pharmacy regarding recall product.
D-Inform doctor to stop dispensing this product in the future
E-Discard all product in waste container
5) Angry person walks in your pharmacy and complains that you have dispensed wrong
medications? What is appropriate first step in resolving this problem?
A-Apologise patient for dispensing error
B-Calm down patient
C-Acknowledge his anger, ask and verify what is error
D-Ignore and let him vent his anger
E-Acknowledge his anger and refer to doctor
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Medication Errors
13) A pharmacy dispensing error dispensed Pradox (dabigatran) instead of Plavix (clopidogrel).
If patient used. Which of the following problem expected?
A) Increase risk myocardial infarction
B) Increase risk of platelet aggregation
C) Increase risk of bleeding
D) Increase risk of blood clot formation
14) If patient used Lasix (furosemide) instead of Losec (omeprazole). What problem is
expected?
A) hyperglycemia B) hyperthyroidism C)hypotension D)Hypercalcemia E)None
15) A pharmacy technician prepared a prescription of Pradox instead of Plavix. What is the
appropriate strategies to prevent this error.
I) Advise technician to change to Plavix (clopidogrel)
II) Educate technician on drug name sound similar
III) Read label to patient while dispensing
A) I only B) III only C) I and II D) II and III E) I, II, III
16) A pharmacy intern receive a phone call from doctor for a new prescription. Dr want to
prescribe Losec. However pharmacy intern documented as Lasix. What is appropriate to
minimize this error?
A) Only pharmacist should take phone call for a new prescription
B) Pharmacy intern should require more training on sound like name drugs
C) Ask doctor to give generic name for the sound like name drugs
D) Ask doctor to fax prescription for sound like name drugs
E) Ask doctor to written prescription for all new prescriptions
17) Which of the following is NOT dangerous drug abbreviation?
A) od
B) qid
C) daily
D) IU
E) qd
18) What is recommended to write instead of "IU"
A) iu
B) units
C) international units
D) IU
E) I.units
19) What is the best recommendation to write prednisone and prednisolone to avoid errors.
A) prednisone and prednisolone
B) predniSONE and predniSOLONE
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Medication Errors
Medication Errors
ANSWERS:
1. Ans: D
2- Ans: D
3) Ans: E
4) Ans: B
5) Ans: C
6) Ans: D
Tips: Vicarious liability of pharmacist of dispensing
7) Ans: C
Tips: pharmacist should contact doctor to correct prescription.
8) Ans: B
9) Ans: A
10) Ans: B
11) Ans: C
12) Ans: C
13) Ans: C
Tips: Pradox is a new anticoagulant dabigatran act as factor Xa inhibitor. However Plavix is
clopidogrel an antiplatelets drugs. So increase risk of bleeding
14) Ans: C
Tips: Lasix is furosemide can cause hypotension. Losec is omeprazole.
Immodium (Loperamide) and Motilium (domperidone)
Dimenhydrinate and diphenhydramine
Cyclosporine and Cyclophosphomide
Proscar and Prozac
Lamisil (terbinafine) and Lamictal (lamotrigine)
15) Ans: E
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Medication Errors
16) Ans: C
17) Ans: C
18) Ans: B
19) Ans: C
Tips: Tallman letter can be used to avoid error
20) Ans: B
21) Ans: D
22 Ans:) D
23. Ans: D
24. Ans: B
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Sterile Preparations
PHARMACY PREP
Health Promotion and Disease Prevention
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Sterile Preparations
PHARMACY PREP
Collaboration and Teamwork
1. Pharmacist identify a potential drug related problem for patient and then provide the
prescriber with a clinical recommendation to resolve the problem, is described as?
A. Advancing
B. Adaptation
C. Pharmaceutical opinion
D. Beneficence
E. Regulations
Ans.c
2.Main goal of academic detailing is?
A. Advancing prescription
B. Providing pharmaceutical opinion
C. Enhancing prescription practices
D. Pharmaceutical care
E. Counseling patient
Ans. c
3.Unnecessary use or high dose of antibiotics cause?
A. Tolerance
B. Resistance
C. Dependency
D. Addiction
E. Ineffective therapy
Ans. b
4.A doctor switched patient to a new opioid therapy and started low dose. It is due to?
A. Tolerance
B. Resistance
C. Dependency
D. Addiction
E. Ineffective therapy
Ans. a
5. nurse practitioner can prescribe?
A. injections
B. narcotics
C. inhalational
D. all of the above
ans.d
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Sterile Preparations
PHARMACY PREP
STERILE PREPARATIONS
E-0.55 mm
9) What sizes of HEPA filters are used in laminar airflow hood that is used for parenteral
preparations?
A) 0.22 mm B-0.33 mm C-0.11 mm D) 0.44 mm
E) 0.55 mm
Ans-B
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1- You received a new drug in your pharmacy and the manufacture instructions tell you to
keep this drug in a cool place. Which temperature should you keep this drug?
a) <0 C b) 2 to 8 C
c) 8 to 15 C
d) 15 to 30 C
e) >30 C
2-All of the following antibiotics extemporaneous suspensions are stored at room
temperature, EXCEPT
A-Metronidazole
B-Clarithromycin
C-Azithromycin
D-Clindamycin
E-Cotrimoxazole
3) Insulin is stored at?
A-Room temperature
B-Refrigerator
C-Freezer
D-Deep freezer
E-Cool temperature
4) All vaccines should be stored in?
A-Room temperature
B-Refrigerator
C-Freezer
D-Deep freezer
E-Cool temperature
5) What is the optimal temperature for vaccine fridge is?
A. 5 C
B. 0C
C. 1 C
D. 2C
E. 3C
6) When should pharmacy staff defrost refrigerator?
A) More than 10 cm ice in the freezer compartment
B) More than 5 cm ice in the freezer compartment
C) More than 1 cm ice in the freezer compartment
D) It should be never defrosted
Ans. C
7. Storage of Dukoral should be:
A. At room temp
B. In the fridge
C. Away from light
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D. In a safe cabinet
Ans (B)
Tips: It is a vaccine.
8. All the drugs and supplies use in the sterile room should be unpack ?
A. After bringing into the sterile room
B. Before brining into the sterile room.
C. Anytime and anywhere can be unpacked
D. Manufacturer should not pack supplies that are used in sterile preps
Ans. B
9. The temp of the fridge in the pharmacy should be recorded at least
A. Once per day
B. Twice per day
C. Three times per day
D. Once every other day
Ans. (B)
Tips: It should be recorded once in the morning and once in the night
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PHARMACY PREP
PHARMACEUTICAL CARE AND DRUG RELATED PROBLEMS
1. What is the most important focus of pharmaceutical care?
A. The pharmacist
B. The patient
C. The prescription
D. The patient chart
E. Pharmacist salary
2. A 60-year-old patient with congestive heart failure who has been stabilized for 3
months on digoxin, furosemide, and potassium chloride is gradually placed on the
following additional medicines. Which of these drugs is most likely to cause a problem if
added to patient treatment?
A. Quinidine
B. Temazepam (restoril)
C. Meperidine hci (demerol)
D. Aspirin
E. Nitroglycerin
3. What is NOT a requirement of pharmaceutical care?
A. Prevention of disease
B. Cure of disease
C. Decrease of symptoms
D. Slowing of disease progression
E. Dispensing the cheaper drug
4. Which of the following does NOT included in drug related problems?
A. Adverse effects of drugs
B. Improper storage conditions
C. Receiving too little drug
D. Receiving inappropriate drug for condition
E. Dispensing error
5. A frequent customer of your pharmacy medical profile includes; metaprolol 50 mg,
metformin 500 mg tid, allopurinol 50 mg, ASA 81 mg daily for the past 3 yrs. Recently
doctor have started atorvastatin 40 mg daily. Which of the following drug may give
stomach upset?
A. Metaprolol
B. Metformin
C. Allopurinol
D. Atorvastatin
E. ASA
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6. A doctor has prescribed salbutamol inhaler prn for stuffy nose 3 months ago.
However, patient experiencing tremor and shaky for past 6 days. What to do?
A. Increase dose of salbutamol
B. Decrease dose of salbutamol
C. Ask patient how often use salbutamol puffs
D. Refer to doctor
E. Refer to emergency
7. A 65 yo COPD patient using ipratropium PRN inhalers and tiotropium once daily.
Complains dry mouth and dry eye. What to do?
A. refer to doctor
B. recommend use frequent sip of water or ice chips C)recommend to use artificial eye
drops
D. refer to emergency
E. B and C
8. A hypertensive patient who has COPD and who is non compliant would be best
treated with which of following beta blockers?
A. Propranolol
B. Atenolol
C. Esmolol
D. Timolol
9. A regular customer of your pharmacy brings a prescription of Advair (salmeterol +
fluticasone) bid. Currently patient profile has salbutamol prn and fluticasone bid. What
is appropriate action to do?
A. Counsel patient on how to use Advair device
B. Counsel patient to space Advair from fluticasone
C. Ask patient if doctor want him to discontinue fluticasone
D. Ask patient to discontinue fluticasone, as the same fluticasone is present in
combination product (Advair)
E. Ask patient if his asthma is uncontrolled
10. A doctor has prescribed oxycontin for prn 7days after appendectomy surgery. Which
of the following appropriate products to recommend?
A. mineral oil
B. psyllium
C. sennakot/stool softener D. stool softener only
E. Magnesium antacids
11. A pregnant women diagnosed UTI, and she allergic to penicillin, what is the drug of
choice?
A. Nitrofurontoin B. Fosphomycin C.Cephalosporin's D.Tetracycline E. Ciprofloxacin
12. A patient is using tetracycline for the treatment of acne. What is the best
counseling?
A. take with glass of water B. take with glass of milk C. must take empty stomach D.
take with glass orange juice E. avoid taking with antacids
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13. A patient is medication shows ramipril, nadolol, ASA and rosuvastatin. What are the
adverse effect may be related to ramipril?
A. bradycardia, bronchospasm, cardiac decompensation
B. skin rash, and proteinuria
C. postural hypotension, fever, positive Coombs' test
D. First dose syncope, postural hypotension, and palpitation
14. A patient is treated with hydrochlorothiazide 50 mg daily for uncomplicated
hypertension should be monitored regularly for altered plasma levels of?
I) increased levels of uric acid
II) increase levels of glucose
III) decreased level of potassium
A. I only B. III only C. I and II only D. II and III only E. All are correct
15. A patient had ileostomy surgery, which of the following dosage form is not used?
A. immediate release
B. sustain release
C. oral dosage form
D. intra venous
E. sublingual
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PHARMACY PREP
ADVERSE DRUG REACTIONS
1. Which of the following drugs give severe rebound hypertension?
A. prazocin B. propranolol
C. clonidine D. captopril E. enalapril
2. All of the drug cause orthostatic hypotension, except:
A. propranolol
B. prazocin
C. captopril D. doxazocin E. enalapril
3. Neuroleptic malignant syndrome side effects is not associated with?
A. haloperidol
B. Levodopa C. clozapine D. Chlorpromazine
E. Risperidone
4. Nitroglycerine patch comes off during shower, what is suitable action?
A. refer to the physician
B. put another patch
C. reapply the same patch
D. use glue and reapply the same patch
E. None of the above
5. Which of the following drug should not be taken if it is not effective with first dose?
A. Nitro glycerine spray
B. Nitro-glycerine SL
C. Beta blockers
D. Nifedipine
E. Sumatriptan
6. Drugs that gives bronchospasm?
A. Salbutamol
B. acebutolol
E. Ipratropium
C. Salmeterol
D. Formoterol
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D. Quetiapine
E. topiramate
9. Which of the following drugs priapism side effects, patient should report to doctor?
A. Trazodone
B. Sildenafil
C. fluoxetine
D. Alprostadil
E. All of the above
10. All of the following drugs can give pulmonary fibrosis, except?
A. Bromocriptine
B. Cisapride
C. Amiodarone
D. Ropinirole
E. Methotrexate
11. Headache is side effects of?
A. Amlodipine
B. Sumatriptan
E. Fluoxetine
C. Acetaminophen
D. Sildenafil
D. Verapamil
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E. Bloating
16. Phenytoin is associated with?
A. Gingival hyperplasia
B. Diarrhea
C. GI irritation
D. Nausea and vomiting
E. Bloating
17. Neutropenia is side effect of?
A. Clopidogrel
B. ASA
C. Ticlopidine
D. Warfarin
E. LMWH
18. Angioedema is associated with?
A. ACE I
B. ARBs
C. CCBs
D. A and B
E. Beta blockers
19. Lactic acidosis is associated with?
A. metformin
B. Chlorpropamide
C. Gliclazide
D. Roziglitazone
E. Acarbose
20. Torse de pointes is associated with?
A. Amiodarone
B. quinidine
C. Procainamide
D. all of the above
21. What is most common side effects of SSRIs?
A. Nausea and vomiting
B. Sexual dysfunction
C. Sedation
D. GI upset
E. weight gain
22. Bupropion side effects include?
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A. bulimia nervosa
B. anorexia nervosa
C. sexual dysfunction
D. weight gain
E. A and B
23. A 50 year old female currently she is on atorvastatin, and atenolol and Tylenol # 1 for
arthritic pains. She visit pharmacy complaining of diarrhea, which of the following medication
may associated to her problem:
A. Atenolol
B. Codeine in Tylenol
C. Tylenol
D. Atorvastatin
E. All of the above
24. All of the following drugs may require WBC or CBC monitoring, except?
A. clozapine B. ticlopidine C. levothyroxine D. propylthiouracil
E. methimazole
25. All of the following drugs give constipation side effect, except?
A. Atropine B. Ipratropium C. Tiotropium D. Scopolamine E. Donepezil
26. A 45 yo person using ramipril 10 mg daily for the treatment of hypertension. However,
hypertension was not controlled, and now doctor have added prazosin 10 mg daily. What is
the pharmacist concern?
A. potassium levels
B. low blood pressure
C. side effects of prazosin
D. drug interactions
E. patient age
27. A 72 yo person on atenolol and ASA 325mg, clopidogrel 75 mg, therapy. Recently
diagnosed with hypothyroidism. Doctor has recommend low dose, levothyroxine 12.5 mcg
daily dose. Why is the low dose given?
I)cardiovascular disease II)age III)drug interactions with atenolol, ASA and clopidogrel
A. I only
B. III only C. I and II D. II and III
E.I,II, III
28. A customer of your pharmacy using sumatriptan for migraine headache. However, this
person headache is not relieved after using sumatriptan. What is appropriate to do?
A. double the dose of sumatriptan
B. wait for 2 hour and try again sumatriptan
C. add other triptan with sumatriptan
D. Decrease dose and gradually increase the dose
E. Do not use sumatriptan
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33. Which of the following drug pharmacist should counsel to stop taking and contact doctor
immediately if you feel suicidal ideas?
A. Haloperidol
B. Mefloquine
C. Lisinopril
D.Hydrochlorothiazide
E. Isoniazid
Ans. B
34. What agency in Canada issue warning related adverse reactions for drugs in post
marketing surveillance?
A. Health Canada's, Med Effect
B. Institute of Safe Medication Practices Canada
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D. Dystonia
E. Vivid dreams
A. Methotrexate
Ans. E
b. Amiodarone
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2. Ans: A
3. Ans: B
4. Ans: C
5. Ans: E
6. Ans: B
7. Ans: E
8. Ans: E
9. Ans: B
10. Ans: D
11. Ans: A
12. Ans: C
13. Ans: B
14. Ans: B
15. Ans: C
16. Ans: A
17. Ans: C
18. Ans: D
19. Ans: A
20. Ans: D
21. Ans: A
22 Ans:. E
23. Ans: D
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24. Ans: C
25. Ans: E
Tips: all anticholinergic drug gives constipation side effect. However donepezil is
anticholinesterase (agonist) drug.
26. Ans: B
27. Ans: C
Tips: low dose levothyroxine is used in seniors and cardiovascular disease patient. However
no interactions with atenolol, ASA and clopidogrel
28. Ans: E
Tips: do not use triptans if no relief with first dose.
29. Ans: B
30. Ans: C
31. Ans: C
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Drug Interactions
PHARMACY PREP
DRUG & DRUG INTERACTIONS
1. A 55 year old male patient receiving warfarin for deep vein thrombosis, he get the
prescription of carbamazepine; which of the following drug interaction possible:
I-Carbamazepine decrease metabolism of warfarin
II-Carbamazepine is has not interaction with warfarin
III-Carbamazepine increase metabolism of warfarin
A. I only B. III only
C. I and II only D. II and III only E. All of the above
2. A 20 year old female patient currently on fluoxetine for depressive disorder, she get
the prescription of Tylenol # 3 for sever headache. Which of the following drug
interaction are possible:
A. Fluoxetine metabolism increases
B. Codeine metabolism increases
C. Fluoxetine metabolism decrease
D. Codeine metabolism decrease
E. No change and there is no drug interactions
3. A 40-year old female is regular customer of your pharmacy, her current medical
history include lovastatin. She brings prescription for her recent condition, Which of the
following medication is safe for her medical profile:
A. Erythromycin
B. Ketoconazole
C. Grapefruit juice
D. Niacin
E. Hydrochlorothiazide
4. Enzyme complex not working as a drug-metabolizing enzyme may include:
A. Cytocrome P-450
B. Cytocrome P450 3A4
C. Alcohol Dehidrogenase
D. UDP Glucoronyl Transferase
E. Cytocrome oxidase.
5. What is incorrect about tetracycline antibiotics:
I-Take with water and milk
II-Take with food
III- Must take empty stomach
A. I only B. III only
C. I and II only D. II and III only
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Drug Interactions
A. Altering GI flora
B. altering prothrombin time
C. increasing bleeding time
D. Increasing warfarin metabolism
14. A patient has migraine 3 to 4 times a months. Currently also diagnosed with benign
prostatic hyperplasia. Doctor has prescribed prazosin. Medical profile also includes
constipation. What drug is recommendation are suitable for migraine prophylaxis?
A. Amitriptyline
B.Verapamil
C. Propranolol
D. Sumatriptan
E. Nortriptyline
15. What over the counter drugs should be avoided with MAOIs?
A. Pseudoephedrine
B. Xylometazoline
C. Dextromethorphan
D. Food containing Tyramine
E. All of the above
16. Calcium supplement should separated 2 to 4 hrs from all, except?
A. Ciprofloxacin
B. Tetracycline
C. Alendronate
D. Thyroxin
E. Acetyl salicylic acid
17. All of the following are pharmacodynamic reactions, except?
A. Release of 5-ASA from sulfasalazine
B. Diuretic and insulin actions
C. Sedative with alcohol gives sedation
D. None of the above
18. A 60-year-old women-taking calcium supplement 500 mg tid. Recently doctor
prescribed ciprofloxacin 500 mg tid for 3 days. What is appropriate recommendation?
A. Take calcium supplement with 2 hours apart from ciprofloxacin
B. Skip calcium supplement during ciprofloxacin therapy
C. Skip ciprofloxacin and just take calcium supplements
D. Recommend other antibiotics such as ofloxacin
E. Calcium and ciprofloxacin can be combined
19. Tetracycline binds with?
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I-antacids
II-bi valent ions
III-tri valent ions
A. I only B. III only
Drug Interactions
20. A patient using atorvastatin 80 mg daily, also wants to use daily 1 glass of grapefruit
juice, what is pharmacist concern?
A. grapefruit juice induce CYP3A4
B. grapefruit juice inhibit CYP3A4
C. grapefruit juice is substrate for CYP3A4
D. grapefruit juice is essential for statin metabolism
E. grapefruit juice may decrease cholesterol
21. A patient using sildenafil 50 mg, should be cautious taking high dose of take the
following antihypertensive drugs
A. Amlodipine
B. Propranolol
C. Hydrochlorothiazide
D. Prazosin
E. Ramipril
22. Which of the following is incorrect?
A. Insulin plus physical exercise increase risk of hypoglycemia
B. Insulin plus alcohol intake increase risk of hypoglycemia
C. Insulin plus glyburide increase risk of hypoglycemia
D. Insulin plus alcohol increase risk of lactic acidosis
E. Insulin overdose can cause sweating, confusion and palpitation
23. A 60 year old women taking calcium supplement bid. Recently doctor prescribed
alendronate 70 mg/wk. What is appropriate recommendation?
A. Take together calcium supplements and alendronate 70 mg once weekly
B. Do not take calcium supplements during the therapy of alendronate
C. Separate calcium supplements 2 to 4 hours from the dose of alendronate
D. Do not use alendronate while taking calcium supplement therapy
24. A 56 yo female using levothyroxine 25 mcg daily and metformin 500 bid. She comes
to buy Calcium supplements to prevent osteoporosis. What is true statement?
A. levothyroxine, calcium supplement should be separated for 4 hours so take
levothyroxine empty stomach first thing in the morning.
B. avoid taking calcium supplements because she is using levothyroxine
C. Separate Ca supplement 4 hour from levothyroxine
D. take Ca supplement in morning and take levothyroxine in evening
E. Never take levothyroxine, metformin and calcium supplement together
25. A 56 yo female using metformin 500 bid, and ciprofloxacin 500 mg tid for 3days. She
comes to buy calcium supplements 1500 mg tid to prevent osteoporosis. What is true
statement?
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Drug Interactions
E. Vitamin D supplements
31. A regular customer, takes a glass of grapefruit juice daily. If medication profile have
amiodarone, atorvastatin, hydrochlorothiazide, amlodipine and ASA 81 mg daily. Which
of the following drug is the least concern?
A. atorvastatin
B. amlodipine
C. hydrochlorothiazide
D. amiodarone
32. Warfarin and carbamazepine drug interactions are categorized as?
A. metabolism inhibitors
B. Pharmacodynamic interaction
C. enzyme inducer
D. Pharmacokinetic interaction
E. Receptor & receptor interactions
33. A regular customer of your pharmacy. Brings a new prescription of sildenafil 50 mg.
Which of the following drugs in patient profile is the least concern?
A. Nitroglycerin SL spray
B. Nitroglycerin SL tablets
C. Nitroglycerin transdermal patch
D. Sodium nitroprusside
E. Warfarin 5 mg tablets
34. If the above patient profile have nitrates, what is the pharmacist concern?
A. priapism
B. double vision
C. headache
D. hypotension
E. mood changes
35. A patient medical profile include, metformin, gliclazide, rosuvastatin, and ASA 81
mg. Occasionally patient uses omega 3, 6,9 and multivitamin supplements. Patient is
chronic alcoholic, renal disease, and liver diseases. Recently patient discharged from
hospital after congestive heart failure. What is the least concern of pharmacist with
respect to metformin?
A. chronic alcoholism
B. renal disease
C. disulfuram like reactions
D. congestive heart failure
E. lactic acidosis
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Drug Interactions
36. A patient lifestyle include high proteins diet. Which of the following is the most
concern for the pharmacist?
A. theophylline
B. levodopa
C. renal disease
D. orlistat
E. liver diseases
37. All of the following drugs decrease efficacy of oral contraceptives, except?
A. Rifampin
B. Amoxicillin
C. Phenytoin
D. Gabapentin
E. Carbamazepine
Ans. d
Tips: antibiotics and antiepileptic drugs likely decrease efficacy of oral contraceptive
pills.
38.All of the following drug can be taken on an empty stomach, except
a. levothyroxine
B. Alendronate
C. Omeprazole
D. Metformin
E. Zafirlukast
Ans. D
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Drug Interactions
18. Ans: B
19. Ans: E
20. Ans: B
Tips: Grape fruit juice is potent inhibitor of the most common drug metabolizing enzyme
CYP3A4
21. Ans: D
22. Ans: D
23. Ans: C
24. Ans: A
25. Ans: C
26. Ans: C
27. Ans: A
Tips: azathioprine is metabolized by xanthine oxidase, thus reduce the dose of
azathioprine to 2/3 or 3/4
28. Ans: E
29. Ans: B
30. Ans: E
31. Ans: C
32. Ans: C
Tips: carbamazepine induce CYP 2C9 and 1A2, these enzymes are substrate of warfarin
33. Ans: E
34. Ans: D
35. Ans: C
36. Ans: C
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Clinical Biochemistry
PHARMACY PREP
CLINICAL BIOCHEMISTRY
1. Thyroid Replacement therapy for hypothyroidism should be monitored by:
A. Free T 4
B. Sensitive TSH assay
C. Free thyroxine assay
D. Total thyroxin
E. Serum TSH assay
2. Serum TSH is elevated in?
A. Hyperthyroidism
B. Hypothyroidism
C. Hyperparathyroidism
D. Hypoparathyroidism
E. Pheochromacytoma
3.
A.
B.
C.
D.
E.
Which of the following plasma proteins has the GREATEST ability to bind acidic drugs
Albumin
Fibrinogen
Hemoglobin
Alpha glycoproteins
Beta lipoprotein
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Clinical Biochemistry
E. Adipose tissue
7. Which of the following is NOT decreased in elderly?
A.fat content
B. lean body mass
C. kidney function
D. Glomerular filtration
E. Serum creatinine
8. What are the following lab test increase indicate myopathies?
A. Creatinin kinase (CK-MM)
B. Creatinin kinase (CK-BB)
C. Creatinin kinase (CK-MB)
D. ADH, AST, ALT & ALP
E. ALP & ALT
9. A patient using warfarin should be monitored for?
A. Creatinine kinase
B. Prothrombin time
C. Partial thromboplastin time (aPTT)
D-Liver Function Test (LFT)
E. Renal Function Test (RFT)
10) Which of the following laboratory investigations help to determine, myocardial
infarction?
A) Troponin-I and CK-MB
B) CK-MB, Troponin C and ECG
C) ECG, Troponin I, CK-MM
D) Troponin I, CK-MB, ECG
E) Troponin C, CK-MB, ECG
11. What are the following lab test increase indicate myocardial infarction?
A. Creatinine kinase B. Troponin T
C. Troponin I D. Troponin C E. ALP
12. A Patient with DVT was prescribed dalteparin. Which of the following lab test need
to monitor?
A. INR
B. aPTT
C. PT D. Vitamin K levels E. None of the above
13. Which of the following is used test calcium levels?
A. Parathyroid hormone
B. Calcitonin C. Thyroid hormone D. Sun exposure
14. A patient creatinine clearance is 300 ml/hr, it is a?
A. chronic renal disease
B. normal renal function
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Clinical Biochemistry
22) Which of the following is the major ketone increase in blood diabetic ketoacidosis?
A) Acetone
B) Beta hydroxy butyric acid
C) Ethyl and methyl ketone
D) Long change ketones
E) Acetyl acetic acid
23. All of the following drugs can increase CK-MM, except?
A. Rosuvastatin B. Benzfibrate C. Atorvastatin plus niacin D. Simvastatin E) Ramipril
24. A laboratory test indicated increased number of neutrophil. This may be due to?
A. Viral infections B. Inflammation C. Bacterial infection in sinusitis
D) Seasonal flu
E. Parasites infections
25. Decreased CD 4 count indicates?
A. Viral infections B. Inflammation C. Bacterial infection D. COPD E. Parasites
infections
25. A patient on vancomycin IV to treat MRSA. Which of the following lab test should be
monitored?
A. Liver function test
B. Complete blood count
C. Renal function test
D. Creatinine kinase
E. Chest X-ray
26) A patient is diagnosed with chronic bronchitis and pneumonia in COPD. Which of the
following is increased?
A. Basophills B. Neutrophil C. Lymphocytes
D. WBCs
E.RBCs
27. A patient laboratory shows increase in Eosinophills. This can be indicator of?
A. COPD
B. Infection C. Asthma D. pneumonia E. ulcer
28. A 55 yo patient using warfarin to treat deep vein thrombosis. Which of the following
factors increase risk of bleeding?
A. Using vitamin K supplements
B. Using ASA 650 mg for pain
C. Using dark green vegetables such as broccoli, avacado
D. Using supplements containing vitamin K
E. Using iron supplements
29. A patient serum thyroid function test (Serum TSH) shows, 10 mU/L. Doctor should
initiate therapy of?
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Clinical Biochemistry
A. methimazole
B. Propylthiouracil
C. Levothyroxine
D. Radioactive iodide
E. Lugol's solution
30) Which of the following test are used determine anemia?
A) MCV
B) Hematocrit
C) Serum ferritin
D) MCHC
E) TIBC
31. What is lab test are related to diagnosis of lupus like syndrome?
A. Increase ESR
B. Increase C-reactive proteins
C. Antinuclear antibody test
D. Associated with myalgia, arthralgia and fever
E. All of the above
32. Which of the following is NOT a lab investigation for rheumatoid arthritis?
A. Erythrocyte sedimentation rate (ESR)
B. C-reactive protein (cRP)
C. Rheumatic factor
D. Arthralgia
E. Bone Mineral Density
33. KP is a 50 year old man using atorvastatin 40 mg daily. Get muscle pain. Which of the
following lab test increase?
A) ALT
B) AST
C) CK-MB
D) CK-MM
E) Troponin I
34. KG is a 50 yo patient on rosuvastatin 20 mg daily. Recently complain muscle pain.
What is correct?
A) Pharmacist refers patient to doctor to check CK-mm
B) pharmacist refers patient to emergency
C) pharmacist tell patient stop rosuvastatin and refer to dr
D) pharmacist tell patient to reduce the dose of rosuvastatin
E) Pharmacist should change rosuvstatin to simvastatin
35. MP is 49 year old male a type 2 diabetic patient. Currently patient has uncontrolled
blood glucose. Which of the following are NOT related to diabetes or and glucometry
tests?
A. Glucose tolerance test
B. Fasting blood glucose test
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Clinical Biochemistry
C. HbA1c test
D. Urine ketone test
E. Serum Ferritin
36. A 70 year old patient is using heparin to prevent stroke. Doctor suspect patient has
hemorrhage. Doctor should consider monitoring?
A) INR
B) PT
C) aPTT
D) heparin assay
E) no lab test
37. Acetaminophen overdose associated with hepatotoxicity. This can increase the liver
transaminases. Which of the following are liver transaminases?
A. ALP, AST and ALT
B. ALP and AST
C. AST and ALT
D. ALT and ALP
E. Bilirubin
38. Which of the following liver enzyme are indicator or liver cirrhosis?
A. AST/ALT
B. Serum albumin
C. Prothrombin time D. Bilirubin
E. Alkaline. Phosphate
39. A patient presents with dark urine and muscle pain. Which of the following drugs
may be patient is on?
A) metronidazole
B) Rifampicin C) bismuth
D) lithium
E) Atorvastatin
40.What lab test is used to determine liver cirrhosis?
A. AST/ALT
B. serum albumin
C. prothrombin time
D.Bilirubin
E. Globulin
Ans. D
Tips. direct bilirubin, and urine bilirubin significant increased and AST/ALT minimally
increased in hepatocelluar jaundice, obstructive jaundice and liver cirrhosis.
41. what lab test is for viral hepatitis patterns?
A. AST/ALT
B. ALP
Ans. A
42. ESR is nonspecific test that is often used as screening tests for patients
with unexplained fever, arthritis and muscle symptoms. The ESR elevation
indicates, all of the following, except?
A. RA
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ans.e
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CLINICAL BIOCHEMISTRY
ANSWERS:
1. Ans: E
2. Ans: B
3.Ans: A
4. Ans: E
5. Ans: A
Tips: Cockgraft-gault equation is used to estimate creatinine clearance.
6. Ans: E
7. Ans: A
8. Ans: A
Tips: CK-MM indicator of skeletal muscle, CK-BB is for brain and CK-MB for cardio.
9.Ans: B
10) Ans. D
11. Ans: C
12. Ans: E
13. Ans: A
14. Ans: D
15.Ans: B
16) Ans. C
Tips: CrCl <50 ml/min is chronic renal disease
17.Ans: C
18. Ans: B
19. Ans: D
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20. Ans: B
21. Ans: B
22) Ans: B
23. Ans:E
24. Ans: C
25. Ans: C
Tips: vancomycin renal toxicity thus patient monitored for renal function tests.
25. Ans: D
26) Ans: B
Tips: chronic bronchitis is bacterial infection in COPD, so increase neutrophils.
WBCs
Normal
Indicator
Neutrophils
55% to 75%
Bacterial infection
Lymphocytes
20% to 40%
Viral infection
Monocytes
0% to 7%
Tuberculosis
Eosinophils
0% to 5%
Parasites infection
Basophils
0% to 1%
Inflammation, Allergies, Asthma,
27. Ans: C
Tips: Asthma and allergies increase esinophils and basophils.
28. Ans: B
29. Ans: C
30) Ans: C
31. Ans: E
32. Ans:E
33.Ans. D
34. Ans. C
35. Ans. E
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Clinical Biochemistry
36. Ans. C
37. Ans. C
Tips: AST and ALT are liver transaminase. Whereas ALP is alkaline phosphotase enzyme.
38. Ans. D
Tips. direct bilirubin, and urine bilirubin and alkaline phosphate significant increased and
AST/ALT minimally increased in hepatocelluar jaundice, obstructive jaundice and liver
cirrhosis.
39. Ans. E
Tips. this is symptoms of myopathies associated with statins.
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C-aPTT
D-A and B
E-All of the above
8) Hypothyroidism patient should be monitored
A-Decrease TSH
B-Elevated TSH
C-Elevated FT 3
D-Decreased FT 4
E-TBG
9) A 50-year-old male a regular customer of your pharmacy, his current medications
include: Hydrochlorthiazide, Furosemide 50 mg, and Digoxin 0.125 mcg
Which of the following he should be monitored?
I-Monitor K levels
II-Serum creatinin
III-Blood pressure
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
26) Which drugs patient may complain sandy and gritty feeling in eye? The pharmacist
recommends patent to consult doctor get eye exam
I) amiodarone
II) hydroxychloroquine
III) Quinidine
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
11) A 52 yo women using Synthroid 75 mcg daily dose. Recently her blood test done it
showed her serum TSH are less than 0.4 mU/L. What is the appropriate action to do?
A) Increase dose of Synthroid to 100 mcg
B) Double the dose Synthroid
C) Do not change the dose of Synthroid
D) Decrease dose of Synthroid
E)Recommend to take empty stomach
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12) A 68 yo male using warfarin 4 mg daily and currently his INR is 2 to 3. Recently he
cut his finger slightly with nail clipper. and had slightly bruise on his face. What is
appropriate action do?
A) Refer him to emergency
B) Ask him to discontinue warfarin and contact doctor immediately
C)give him first aid like band aid his finger nail.
D)Recommend vitamin K supplements
E)Recommend to increase dose of warfarin
13) A 45 yo man using rosuvastatin 20 mg daily and metformin 500 mg bid, gliclazide SL
30 mg daily. A doctor recommends monitoring of lab test for metformin?
I)Renal Function Test
II) Creatinine clearance
III) Liver Function Test
A) I only
B) III only
C)I and II
D)II and III
E)I, II, III
14) A 45 yo man using rosuvastatin 20 mg daily and metformin 500 mg bid, gliclazide SL
30 mg daily. A doctor recommends regular monitoring of lab test for rosuvastatin?
A)CK-mm B)LFT C)Renal function test D) B.P
E)ECG
15) Procainamide is type of?
A)ester type of local anesthetic
B)amide type of local anesthetic
C)it is gas general anesthetic
D)It is antiarrhythmic drug
E)It is potassium channel blocker
16) A 65 yo man using digoxin, hydrochlorothiazide, furosemide and ramipril for
congestive heart failure for the past one year. Which of the following laboratory test
require monitoring?
A)Na+
B)Cl C)K+ D)Ca2+
E)Mg2+
17)A 55 yo customer of your pharmacy. Currently on hydrochlorothiazide 75 mg daily,
metformin 500 mg tid, gliclazide 30 mg daily, and allopurinol 100 mg. Which of the
following is not monitored?
A)uric acid levels
B)glucose test
C)Blood pressure
D)ECG
E)CrCl
18) Which of the following diuretic may require Ca2+ monitoring?
A)hydrochlorothiazide B)spironolactone C)furosemide D)Acetazolamide E)Mannitol
19) A 45 yo man using rosuvastatin 20 mg daily and metformin 500 mg bid, glicalizide SL
30 mg daily. A doctor recommends regular monitoring of lab test for rosuvastatin?
A) LFT B) CK-mm C) CrCl D)glucose E)Renal function test
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20) Which of the following lithium serum levels gives lithium toxic symptoms?
A) > 1.5 mEq/L
B) < 1.5 mEq/L
C) > 2.0 mEq/L
D) > 3.0 mEq/L
E) > 4.0 mEq/L
21) A 45 yo man recently diagnosed with serum TSH 10 mU/L. However normal range of
serum TSH is 0.5 to 5 mU/L. This patient should be initiated?
A) hyperthyroidism therapy
B) hypothyroidisms therapy
C) Methimazole
D) Propylthiouracil
E) Radioactive therapy
22) A patient is using furosemide to treat congestive heart failure. Which of the
following electrolytes loss is NOT monitored?
A) Potassium
B) Calcium
C) Magnesium
D) Sodium
E) Aluminum
23) Which of the following does NOT required monitoring, serum TSH?
A) amiodarone
B) Prednisone
C) Levothyroxine
D) methyl prednisone
E) infliximab
24) A 70 yo patient is using hydrochlorothiazide 50 mg daily to treat hypertension.
Which of the following is NOT monitored?
A) uric acid
B) blood glucose
C) cholesterol (lipids)
D) hypocalcemia
E) hypokalemia
25)A 29 yo patient using lithium carbonate to treat manic depression. What is NOT monitored?
A) serum TSH
B) CBC
C) blood glucose levels
D) serum level of lithium
E) eye exam
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18) Ans: C
Tips: furosemide can cause hypocalcemia (loop loose calcium)
19) Ans: A
20) Ans: C
21) Ans: B
22) Ans: E
23) Ans: E
24) Ans: D
Tips: thiazides cause hypercalcemia or hyperGLUC. Whereas loop diuretics cause
hypocalcemia
25) Ans: E
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PHARMACY PREP
OTC DRUGS FOR DERMATOLOGICAL CONDITIONS
1-Incorrect statement about poison ivy treatment?
A-Hydrocortisone 0.5%
B-Calamine lotion
C-Antihistamine
D-Antibiotics
E-Oatmeal cream
2-Incorrect pharmacotherapy for psoriasis treatment?
A-Hydrocortisone 1%
B-Coal tar
C-Tazarotene
D- Antibiotics
E-UVA light + coal tar
3) What is incorrect about degree of burns classification?
A) 1st degree is superficial burns, that may cause by sunburn
B) 2nd degree is superficial and partial thickness burns that may cause by hot water, oil spills
and splashes
C) 3rd degree is the severe burns that can give lathery skin.
D) If it burn put burn part in cold water
E) If it burn put burn part in warm water
4-Incorrect statement about sunburn?
A-peak time of sunburn is 10:00 am to 4:00pm
B-High altitude has low sunburn
C-cloud do not protect sunburn
D-beach area may have more sunburn
E-Apply sunscreen before get into sun
5-What is incorrect about sunburn treatment?
A-Use cool baths or wet compresses with tap water or saline
B-Take plenty of fluids
C-Topical vitamin E applied two minutes after UV exposure may decrease erythema and
edema
D-Acetaminophen can relieve pain
E-Avoid NSAIDs for sunburn pain
6) What is incorrect about head lice treatment?
A-Permethrin 1% cream rinse apply to hair and scalp (1/2 to 1 bottle) and leave it on for 10
min then rinse.
B-Permethrin may repeat after 7 days if live head lice is observed.
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C-Zinc pyrethione
D-Hydrocortisone
E-Selenium sulfide
13-Which of the following is NOT a pharmacotherapy for acne?
A-Oral contraceptives
B-Corticosteroids
C-Tetracyclin
D-Retinoids
E-A and B
14-Which of the following is pharmacotherapy for acne in pregnancy?
A-Oral contraceptives
B-Erythromycin
C-Tetracycline
D-Retinoids
E-Minocycline
15) A 20 year old women treated with topical treatment for acne, however, it not treated,
which of the following is recommended?
A-Benzoyl peroxide
B-Tretinoin
C-Isotretinoin
D-Salicylic acid
E-None
16) Which of the following skin condition have symptoms of red scaly patches?
A) Psoriasis B) Dermatitis C) Acne D) Rosacea E) Urticaria
17) Characteristic of Rosacea symptoms is/are?
A. Pustules
B. Nodules
C. Pimples
D. Erythema E. Red scaly patches
18) Which of the following used to treat acne vulgaris?
I) retinol
II) cis/trans retinoic acid
III) Vitamin E
A) I only B) III only C) I and II only D) II and III E)all
19) What is NOT a symptoms of acne?
A) White head (comedon)
B) Black head (comedon)
C) Pimple
D) Postule
E) Red scaly patches
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20. What is appropriate socks for athletes foot and diabetic foot problems?
A. 100% cotton socks
B. Nylon socks
C. Synthetic fiber
D. Synthetic socks
E. Cotton (60% less) blend with synthetic fiber, nylon, acrylic or rayon
21. What is the drug of choice for head lice in child with seizures?
A. permethrin 1%
B. Lindane 1%
C. Sulfur 5%
D. Isopropyl mersteate
E. permethrin 5%
Ans. a
22. What is the drug of choice to treat mild acne with inflammation?
A. benzoyl peroxide
B. topical retinoids
C. Tetracycline
D. Clindamycin topical
E. Erythromycin topical
Ans. b
23.What is not related to acne?
A. popping white heads with hands cause pimples, infection, scarring.
B. small dark spots on skin are blackheads or open comedone
C. Pink or silvery scaly patches
D. acne forms popules, pustules
E. acne forms cysts and nodules
Ans. c
Tips. white head, pimples, popules, pustules, cysts and nodules are forms of acne. Pink and
silvery patches are psoriasis.
24. What is incorrect related to rosacea acne?
A. Erythema is present rosacea acne
B. Papulopustular lesions and eye involvement with or without
C. Drug of choice is metronidazole cream
D. Telangiectasia or facial edema or rhinophyma
E. Caused by Corynebacterium parvum
Ans. e
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25. What is appropriate socks for athletes foot and diabetic foot are recommended?
A. 100% cotton socks
B. Nylon socks
C. Synthetic fiber
D. Synthetic socks
E. Cotton (60% less) blend with synthetic fiber, nylon, acrylic or rayon
Ans. e
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3) Ans: E
st
1 degree
superficial burns, that may
cause by sunburn
BURNS CLASSIFICATION
2 degree
superficial and partial
thickness burns that may
cause by hot water, oil spills
and splashes
nd
3rd degree
severe burns that can give
lathery skin.
4- Ans: B
5- Ans: E
Head lice
6- Ans: E
7) Ans: B
8- Ans: C
Tips: Astringents such as calamine lotion, aluminum acetate, zinc oxide
9. Ans: C
Tips: The drug of choice to treat complicated diaper rash is clotrimazole 1% cream.
Uncomplicated diaper rash
Complicated diaper rash
Limited rash
Confluent tomato red plaques, white scaly border.
ZnO, petrolatum, hydrocortisone
Clotrimazole, miconazole, nystatin and ZnO,
hydrocortisone
10- Ans: B
11- Ans: A
Tips: snow, high altitude, and beach, mountains can give more sun burn.
12) Ans: D
13) Ans: B
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14- Ans: B
15) Ans: C
16) Ans: A
17) Ans: D
18) Ans: C
19) Ans: E Tips: Red scaly patches are symptoms of psoriasis.
20. Ans. E
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PHARMACY PREP
OTC AND PRESCRIPTION DRUGS FOR OPHTHALMIC, EAR AND MOUTH
DISORDERS
1. What is an optimal range of pH for ophthalmic products
A. 2-3
B. 4-5
C. 5-6
D. 6-8
E. 8-10
2. Opthalmic agents contraindicated in glaucoma patients include which of the following
substances:
A. antioxidants
B. decongestants
C. emollients D. antipruritics
E. All of the above
3. Which of the following lenses can be worn continuously for 6 days:
A. Soft lenses
B. Extended wear soft lenses
C. Frequent replacement soft lenses
D. Hard lenses
E. Soft and hard lenses
4. Image formed by lens received by:
A. iris
B. retina
C. sclera
D. conjunctiva
E. pupil
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15. Which of the following eye condition can be treated by non prescription therapy?
A. Eye pain
B. Vision changes
C. Blepharitis
D. Red eye
E. Foreign object in eye
Ans. D
16. What is incorrect about ophthalmic lens?
A. Soft lens are made of Hydroxyethyl methacrylate (HEMA)
B. Surfactant in lens solution prevent infection
C. Protein cleaners in lens solution remove protein deposits
D. Wetting agents in lens solution produce lubricant effect
E. Hard lens can wear for more than 24 hours
Ans. E
1.Ans: D
2. Ans: B
3. Ans: B
4. Ans: B
5. Ans: A
6. Ans: D
7. Ans: C
Tips: Calamine lotion (ZnO+FeO) and oatmeal bath and oral antihistamine can be helpful
in treatment of cold sores.
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8. Ans: D
Tips: Sympathetic agonist (sympathomimetics) increases IOP. Open angle glaucoma
(OAG) is due to increase in IOP and increase in H 2 O humor of eye or could be due
decrease in drainage of H 2 O humor in the eye. For the treatment of OAG sympathetic
blockers such as Timolol are effectively used to decrease IOP and H 2 O humor.
9. Ans: E
10. Ans: D
11. Ans: A
Tips: Diabetic retinopathy symptoms require referral to doctor
12. Ans: C
13. Ans: C
14. Ans: D
Tips: amiodarone gives ocular deposits SEs.
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PHARMACY PREP
OTC ANTIHISTAMINE, DECONGESTANTS AND ANTITUSSIVES
1) Which of the following is NOT an environmental measure to prevent allergic rhinitis:
A-Avoidance of window or attic fans
B-Avoid outdoor activities during pollen season
C-Shower or bath following outdoor activity to avoid contamination of bedding
D-Use air conditioning
E-Open windows over night to get fresh air.
2-Sympathomimetics decongestant acts as?
A-Vasoconstrictor
B-Vasodilator
C-Congestion
D-Anti-inflammatory actions
E-None of the above
3-Sympathomimetics decongestant can cause, all of the following complications, except?
A- Open angle glaucoma
B- hypertension
C- diabetics
D-Can cause rebound congestion in prolong use
E-Can cause vasodilatation
4) All of the following drugs gives bronchodilators, except
A-short acting beta2 agonist
B-long acting beta2 agonist
C-Propranolol
D-Salbutamol
E-Salmeterol
5-Opioids may be used as all the following agents, EXCEPT:
a) Antitussive
b) Analgesic c) Antidiarrheal
d) Anti-inflammatory
e) Pre-anesthetic
6-Alpha 1 agonist, phenylephrine has all of the following side effect EXCEPT:
A-vasoconstriction B-Headache C) orthostatic hypotension D-Arrhythmias
E-Mydriasis
7- Fexofenadine HCI (Allegra 12 Hour and Allegra 24 Hour) is classified as:
A-Histamine H 2 -Receptor Antagonist
B- Histamine H 1 -Receptor Antagonist
C-Proton Pump inhibitor (PPI)
D-Serotonin reuptake inhibitor (SSRI)
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PHARMACY PREP
OTC DRUGS FOR NAUSEA, VOMITING, CONSTIPATION, DIARRHEA,
HEMORRHOIDS AND HELMENTHS
1) A 60 yo customer of your pharmacy using oxycontin daily for severe pain after fracture.
What is the treatment best option for constipation?
I) Sennakot
a) I only
b) III only
c) I and II only
e) I, II, III
2- Psyllium (Metamucil) is a bulk-forming laxative agent. Patients using should get the
following instructions:
I- Avoid psyllium (Metamucil) in pregnancy
III- It should mix the dose with a glass of cool water or other fluid and drink it down quickly.
II-This should be followed with more fluids.
a) I only
b) III only
c) I and II only
d) II and III only
e) I, II, III
3)Antacids are normally used to equilibrate the stomach pH and protect the stomach from the
effect of acids. Which of the following antacids has a cathartic side effect?
a) Calcium carbonate
b) Dihydroxyaluminum sodium carbonate
c) Magnesium hydroxide
d) Calcium sulfate
e) Aluminum silicate
4- Which antihelmenthic drug is used to treat pin worm?
A-Pyremethamine
B-Pyridoxin
C-Streptomycin
D-Pyrivenium pamoate
E-Metronidazole
5- Lactulose is an osmotic laxative agent that may be used to treat:
I- Constipation
II- Portal-systemic encephalopathy
III- Renal tubular necrosis
a) I only
b) III only
c) I and II only
d) II and III only
6) A mother of 6 month old child approaches to your pharmacy. Her child has diarrhea. She is
also breast feeding her child, what is appropriate recommendation?
A) recommend ORS and ask to continue breast feeding
B) Recommend ORS and ask to stop breast feeding
C) Recommend ORS and refer to doctor
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D) Refer to emergency
E) Do nothing, it will be alright
7) Drug of choice for constipation induced by codeine?
A-Psyllium
B-Lactulose C-Sodium docusate D-Senna
E-Mineral oil
8) All of the following are self care measure should be recommended in hemorrhoids, except?
A. Increase high fibre diet B) Increase fluid intake
C) Avoid food on the run
D) Regularize toilet habits
e)Prolong stay on toilet seat
9) Drug of choice for constipation in pregnancy?
A-Psyllium
B-Lactulose
C-Sodium docusate
D-Senna
E-Mineral oil
14) All of the following are self care measure should be recommended in hemorrhoids,
except?
a)Increase high fiber diet
b)Increase fluid intake
C)Avoid food on the run
D)Regularize toilet habits
e) Prolong stay on toilet seat
15) Drug of choice for constipation in pregnancy?
A-Psyllium
B-Lactulose
C-Sodium docusate
D-Senna
E-Mineral oil
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D-Pilocarpine E-Trihexphenidyl
b) III only
e) I, II, III
23) A patient is buying Tylenol # 1, 200 tablets. Which of the following is pharmacist concern?
I) Constipation
a) I only
III) Addiction
c) I and II only
e) I, II, III
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24) A patient with terminal metastatic breast cancer gets the prescription of oxycontin and
Psyllium. Later after few days her daughter comes to pick a prescription of hydromorphone
and lactulose. What is pharmacist concern?
A) addiction potential B) False prescription C) Contraindication D) constipation E) Overdose
25) 1. What suggestions and advice should be given to the patient with pinworm infection?
I.
Treatment of pin worms should be taken for all members of the family
II.
Must not share under garments
III.
Must not share dishes
a) I only
b) III only
c) I and II only
d) II and III only
e) All of the above
26. What is the drug of choice to treat chemotherapy induced nausea and vomiting?
A. Ondansetron
B. Dexamethasone C. Lorazepam D. Metoclopramide E.
Dimenhydrinate
Ans. b
27. What is the drug of choice to treat constipation in children?
A. Castol oil
B. Senna
C. Biscodyl
D.Glycerine suppositories
Ans. d
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16) Ans: B
17) Ans: B
18) Ans: D
19) Ans: A
20) Ans: D
21. Ans: A
22) Ans: E
23) Ans: C
24) Ans: B
25) Ans: E
Tips: spreads by oral-fecal infestation.
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PharmacyPrep.Com OTC drugs for headache, sports injuries, pressure ulcers, and back pain
PHARMACY PREP
OTC DRUGS FOR HEADACHE, SPORTS INJURIES, PRESSURE ULCERS, AND LOW
BACK PAIN
1. Correct statement/s about ASA may include
I.
Low dose are used in heart problem
II.
Less potent than naproxen as an analgesic
III.
More potent than acetaminophen as analgesic
a) I only
b) III only
c) I and II only
d) II and III only
2-What is antidote of acetyl salicylic acid (ASA)?
A-N-acetylcysteine B-Flumazenil C-Naloxone
6-Which of the following is not a side effect of an opioids analgesic for example morphine:
a) C.V depression
b) Constipation
c) Sedation
d) CNS depression
e) Dilatation of eye pupil
7-A sports person has ankle sprain while playing ice hockey, what is inappropriate
recommendation?
A-Rest to injured part
B-Apply ice
C-Warm compress
D-Elevate injured area
E-Recommend OTC NSAIDs
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8) Mechanism of action of sumatriptan is?
A) 5HT 1b/d agonist
B) 5HT 1b/d antagonist
C) 5HT 3 antagonist
D) 5HT 3 agonist
E) 5HT 2 agonist
9) What is treatment for tension headache?
A) Triptans
B-Ergot alkaloids
C-Propranolol
E) Acetaminophen
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C. Damage to nerve
D. Diabetes
E. Post herpes infection
Ans. B
15. A patient with renal disease and has low back pain. What is the treatment option?
A. Diclofenac topical
B. Capsaicin
C. Oral NSAIDs
D. Methadone
E. Codeine
Ans. A
16. All of the following can be used to manage low back pain, except?
A. Tramadol
B. Acetaminophen
C. Diclofenac
D. Colchicine
E. Tramacet
Ans. D
17. A 12 yo boy got severe injury in his ankle during a soccer game. All of the following are
appropriate, except?
A. use acetaminophen for pain
B. use ibuprofen pain
C. Apply cold compress
D. Apply warm compress
E. Rest injured area
Ans. D
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OTC DRUGS FOR HEADACHE, SPORTS INJURIES, PRESSURE ULCERS, AND LOW
BACK PAIN
ANSWERS:
1. Ans: C
2- Ans: E
3- Ans: B
4. Ans: D
5. Ans: C
6- Ans: E
7- Ans: C
Tips: R-I-C-E is recommended approach for sports injuries.
R= rest to injured part, I = apply ice, C = cold compress, E = elevated injured part.
8) Ans: A
9) Ans: E
10) Ans: D
11) Ans: A
12) Ans: C
13) Ans: B
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PHARMACY PREP
ASTHMA AND COPD
1) Theophylline serum levels are monitored in neonates and infants because
A) They are poorly absorbed in systemic circulations
B) Drug has narrow therapeutic index
C) Slowest rate of clearance
D) Fastest rate of clearance
E) It is not used in neonates and infants
2) A patient is suffering from COPD and asthma. He is on theophylline, ranitidine and
now doctor prescribed ciprofloxacin which of the following is correct?
A) ranitidine have drug interaction with theophylline
B)Ciprofloxacin have drug interaction with theophylline
C)Ranitidine and ciprofloxacin both have drug interactions with theophylline
D) None of the above
3) Which of the following is NOT a side effect of theophylline?
A-Insomnia
B-Sedation
C-Appetite suppressant
D-None of the above
4) A 3 yr child was newly diagnosed with asthma. All of the following questions are
important to ask his mother EXCEPT:
A) Any cardiovascular problems?
B) Does other family member have asthma?
C) How often symptoms come?
D) Old asthma medication he used before?
E) How many times wake up in night due to symptoms
5) A 45 yo patient with emphysema and pain, and is not controlled, the doctor switched
him to morphine and his daughter came to pharmacy, you will call the doctor because:
a) You will ask to change the medication
b) To tell the dose of medication because its too much
c) To ask for written prescription of morphine
d) Her concern about constipation
6. What is true about Ipratropium?
I. Reversible competitive of anticholinergic
II. Synergistic with Theophylline in asthma
III. Quaternary ammonium compound
a. I only
b. III only
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34) Drugs are not affected by catecholamine O-methyl transferase (COMT) enzymes
except:
A. Salmeterol
B. Salbutamol
C. Metoproterenol
D. Terbutaline
35) Function as mast cell stabilizers:
A. Zafirlukast
B. Ipratropium
C. Prednisone
D. Nedocromil
36) Rx: Beclomethasone (Vanceril) inhaler: dispense # 1
Sig: ii puffs inhaled bid. In filling the prescription, the technician should:
A. Inform the patient that this is a corticosteroid that has many serious side effects.
B. Include the following specific directions on the label: Inhale 2 puffs into each nostril
3x a day
C. Provide the patient the package insert included with the inhaler
D. Tell the patient to use this inhaler only when he really needs it.
37) All of the following drugs can be indicated for the treatment of asthma EXCEPT:
A. Ipratropium
B. Metoprolol
C. Albuterol
D. Zafirlukast
38) A 45 yo patient with emphysema and pain, and is not controlled, the doctor switched
him to morphine and his daughter came to pharmacy, you will call the doctor because:
a) You will ask to change the medication
b) To tell the dose of medication because its too much
c) To ask for written prescription of morphine
d) Her concern about constipation
39) What is true about Ipratropium?
I.
Reversible competitive of anticholinergic
II. Synergistic with Theophylline in asthma
III. Quaternary ammonium compound
a) I only
b) III only
c) I and III only
d) II and III only
e) I, II, III
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B. Fluticasone inhaler
C. hydrocortisone injection
D. Long acting beta agonist
E. Tiotropium
Ans. b
54. What is the drug of choice for asthma in hospital emergency?
A. fluticasone
B. oral prednisone
C. hydrocortisone inj
D. topical steroid
E. oxygen
Ans. c
55. Which of the following is used for asthma attacks or exacerbations?
I. Salbutamol
II. Ipratropium
III. Theophylline
A. I only
B. III only
C. I and II
D. II and III
E. I,II,III
Ans.C
56. Dysphonia is side effect of?
A. ipratropium
B. Prednisone oral
C. Hydrocortisone injection
D. Formeterol
E. Fluticasone inhaler
ans. e
57. When do you use omalizumab?
A. Allergens induced asthma
B. excercise induced asthma
C. Drug induced asthma
D. Asthma maintenance therapy
E. All of the above
Ans. A
58. In COPD which of the following is least likely used?
A. Tiotropium
B. Salmeterol
C. Formeterol
D. Fluticasone inhaler
E.oral prednisone
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Ans. d
59. A copd patient prescribed theopylline. Which of the following least likely toxic
symptoms if theophylline serum levels are over 10-20 mcg/ml?
A.vomiting
B. tachycardia
C. sweating D. anxiety & restlness E.sedation
Ans. E
60. Which of the following least likely used in COPD or emphysema?
A. antibiotics B. salbutamol C. ipratropium D. theophylline E. ICS
Ans. E
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19. Ans: D
20. Ans: D
21) Ans: A
22)Ans: D
23)Ans: D
24) Ans: D
25) Ans: C ( it was B before)
26) Ans: A
27) Ans: A
28. Ans: C
29. Ans: D
30. Ans: B
31. Ans: A
32) Ans: D
33) Ans: B
34) Ans: A
Tips: Short acting is not affected by COMT enzyme because this is activated by non
COMT enzyme.
35) Ans: D
36) Ans: C
37) Ans: B
Tips: Asthma is characterized by increased responsiveness of trachea and bronchi to
various stimuli and narrowing of airways. It is associated with shortness of breath, chest
tightness, wheezing and coughing. The Beta-2 receptors stimulation generally dilates the
bronchial smooth muscles and helps in controlling asthma.
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38) Ans: D
39) Ans: E
Tips: Theophylline is added id doses not response to anticholinergic)
40) Ans: D
41) Ans: C
42) Ans: D
43) Ans: C
44) Ans: B
Tips: In an emergence situation, the most rapidly acting agent is used first. The choice of
route of administration depends on severity of attack.
45) Ans: A
46) Ans: E
47) Ans: E
48)Ans. B
49) Ans. A
50) Ans. A
51) Ans. D (no answer was given)
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Smoking Cessation
PHARMACY PREP
SMOKING CESSATION
C-Cold temperature
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Smoking Cessation
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Smoking Cessation
SMOKING CESSATION
ANSWERS:
1) Ans: C
2) Ans: B
3) Ans: D
4) Ans: D
Tips: bupropion has least sexual dysfunction among antidepressants.
5) Ans: B
6) Ans: A
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Sleeping Disorders
PHARMACY PREP
SLEEPING DISORDERS
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Sleeping Disorders
7) Which of the following drug has faster rebound insomnia side effects?
A) Triazolam B) Diazepam C) Oxazepam D) lorazepam E) Alprazolam
8) What benzodiazepines are preferable to treat the type of insomnia that is associated with
difficulty in falling in sleep?
A) Short acting B) Intermediate acting C) Long acting D) intermediate and long acting E)
short and long acting
9) MK is 50 year patient comes to pick up prescription of lorazepam 0.5 mg tab. Which of the
following statement is relevant?
A. Taking alcohol concomitant with lorazepam can cause severe sedation thereby avoid.
B) Take benzodiazepine with food
C) avoid taking with grapefruit juice
D) All of the above
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Sleeping Disorders
SLEEPING DISORDERS
ANSWERS
1) Ans: C
Tips: avoid exercise at least 2 to 3 hours before bedtime
2) Ans: B
3) Ans: D
4) Ans: A
5) Ans: C
Tips: Lethargy = fatigue; Hangover = disorientation; Sedation = sleepy; Somnolence = sleepy
6) Ans: D
7) Ans: A
8) Ans: A
9) Ans: A
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PHARMACY PREP
EATING DISORDER AND WEIGHT LOSS TREATMENTS
1. What is incorrect about anorexia nervosa?
I-It is characterized by deliberate loss of weight
II-refusal to maintain normal body weight, fear of weight gain and amenorrhea
III-Binge eating is common in anorexia nervosa
A-I only
B-III only
C-I and II only
D-II and III only E-All of the above
2-You notice Ms As, a young girl of normal weight, in the pharmacy purchasing laxatives. You
take the time to talk to her about her laxative use, and find that she has been binge eating
and using laxatives about three times per week for the last six months.
Based on this information, which of the following statements is most likely to be correct?
A. She may have bulimia nervosa of the non-purging type since she is not self-inducing
vomiting
B. She may have bulimia nervosa of purging type since she uses laxatives
C. She does not have bulimia nervosa, since she is of normal weight
D. She does not have bulimia nervosa, since her bingeing episodes are not frequent enough
3-What is overweight body mass index (BMI)
A. 18.5 to 24.9
B. 25.0 to 29.9
C. >30
D. <30
E. All of the above
4-What is obese body mass index (BMI)
A. 18.5 to 24.9
B. 25.0 to 29.9
C. >30
D. <30
E. All of the above
5-All of the following drugs are used to treat weight loss except?
A-Meridia
B) Orlistat
C-Bupropion D-Topiramate
E-Mirtazapine
6-Which of the following antidepressant should be avoided in bulimia an anorexia nervosa?
A-Venlafaxine
B-Fluoxetine
C-Bupropion
D-Mirtazapine
E-Paroxetine
7) What is body mass index (BMI)
A) Weight in kg/height in meter2
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1.Ans: B
2- Ans: B
3- Ans: B
Tips: BMI = weight/height2 = kg/m2
4- Ans: C
Tips: = kg/m2
5- Ans: E
6- Ans: C
7) Ans: A
Tips: BMI = weight/height2 = kg/m2
8- Ans: A
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PHARMACY PREP
GASTROINTESTINAL DISORDERS
1) Correct statements regarding the characteristics of hernias may include:
I-It is a protrusion of a loop of an organ or tissue normally through the GI area
II-Hernia hiatus is a herniation of stomach through the esophageal hiatus of diaphragm
III-Strangulated hernia is an incarcerated hernia that is so tightly constricted as to
compromise the blood supply of the contents of the hernia sac.
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
2- Misoprostol is used as mucosal protectants of GI and may be classified as:
a) PGE 1 analog
b) H 2 inhibitor
c) Proton pump inhibitor
d) NSAID
e) Antimuscarinic
3- Drugs are mainly metabolized in the GIT by many different reactions. The most
common drug reaction in the GIT may include:
a) Oxidation
b) Reduction
c) Hydrolysis
d) Dealkylation
e) Ionization
4. Acetyl salicylic acid (ASA) is one of the most used worldwide analgesics. Which of the
following reactions metabolizes it in the gastrointestinal tract and liver?
a) Oxidation
b) Hydrolysis
c) Reduction
d) Dealkylation
e) Deamination
5- Accumulation of fluids in the peritoneal cavity is normally known as:
a) Pannus
b) Starvation
c) Edema
d) Ascitis
e) Cholecystitis
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c) I and II only
d) II and III only
e) All are correct
12- Metoclopramide is a parasympathetic agent that may have which of the following
characteristics?
I- Cholinomimetic agent that stimulates motility of the stomach
II- Used in treatment of diabetes gastro paralysis and GERD
III- Used centrally as antiemetic during cancer chemotherapy
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
13- All of the following are correct statements regarding bile, EXCEPT:
a) It is secreted by the liver
b) It is poured into the small intestine via the bile ducts
c) It is constituted of bile acids, cholesterol, phospholipid, bilirrubin and electrolytes
d) Bile is acid due to its bicarbonate content
e) It is also responsible for the alkalinization of intestinal content
14) Proton Pump Inhibitors are irreversible direct inhibitors of K pump. Correct
statements regarding these drugs may include:
I- Used in gastric and duodenal ulcers
II- Omeprazole and lansoprazole are examples of proton pump inhibitors
III- They decrease stomach acid secretion
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
15- Zollinger-Ellison disease is a grave stomach disease. Drug of choice in the treatment
of Zollinger-Ellison diseases may include:
a) Ranitidine
b) Famotidine
c) Loratidine
d) Omeprazol
e) Antacids
16- Correct statements regarding the administration of antacids may include:
I- Taken 1hr before meals
II- Taken 3hrs after meals
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III- Taken 2hrs before bedtime
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
17- All of the following enzymes are found in saliva, EXCEPT:
a) Amylase
b) Ptyalin
c) Gastrin
d) Lysoenzyme
e) All are correct
18- Which of the following is/are examples of salivary glands?
I- Parotid
II- Submandibular
III- Sublingual
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
19- The digestive process is done in many different steps. The first step of digestion may
be taken in:
a) Mouth
b) Esophagus
c) Stomach
d) Small intestine
e) Large intestine
20- Wrong statement regarding stomach secretions may include:
a) Mucus is present in stomach as lubricant and protect surface from acid
b) Acids breakdown food, kill bacteria and convert pepsin to pepsinogen
c) Pepsinogen is also called chief cell
d) Gastrin is the one that inhibit acid secretion
e) The intrinsic factor in stomach is secreted from parietal cell
21- The small intestine is classified in three parts, the anatomical order division of small
intestine is known as:
a) Jejunum, duodenum and ileum
b) Ileum, jejunum and duodenum
c) Duodenun, jejunun and ileum
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d) Duodenun, ileum and jejunun
e) Jejunun, ileum and duodenun
22- Conditions that may be the main cause of duodenal ulcers include:
a) High motility of stomach
b) Bacterial migration
c) Squirting of acid stomach content into the duodenal wall
d) Reflux of stomach content into the esophagus
e) Hyperacidity of stomach
23- The pancreas is constituted of endocrine and exocrine glands. What is the function
of endocrine gland of pancreas?
a) Production of enzymes
b) Production of insulin
c) Production of proteins
d) Production of glycogen
e) Production of bile
24- Colon is the last part of the digestive system and may be anatomical divided in:
a) Ascending colon
b) Transverse colon
c) Descending colon
d) Sigmoid colon and rectum
e) All are correct
25- H 2 is involved in gastric acid and pepsin secretion. All of the following are examples
of H 2 inhibitors, EXCEPT:
a) Ranitidine
b) Nizatidine
c) Cimetidine
d) Omeprazole
e) Famotidine
26- H 2 inhibitors are used in the treatment of gastric hyper secretion and GI ulcers. One
of the most potent H 2 inhibitors may include:
a) Famotidine
b) Cimetidine
c) Ranitidine
d) Nizatidine
e) Promethazine
27- Example(s) of conditions that may be treated with H 2 inhibitors may include:
a) Gastric hyper secretion
b) Duodenal ulcers
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c) Zollinger-Ellison syndrome
d) Pain associated with GERD
e) All are correct
28- Proton pump inhibitors used in gastrointestinal complications are irreversible
inhibitors of:
a) Na+ pump
b) Na+/K+ pump
c) K+ pump
d) Cl- pump
e) Mg2+/K+ pump
29- The most common side effect during treatment with proton pump inhibitors may
include:
I- Headache
II- Diarrhea
III- GIT pain
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
30- Ulcers are complications of gastrointestinal tract. The risk of having ulcers is bigger
in people having which of the following conditions:
a) Smokers
b) Alcoholics
c) NSAID long-term treatment
d) Corticosteroids long-term treatment
e) All are correct
31- Examples of effective treatment of ulcers may include:
I- Antacids
II- H 2 inibitors
III- Proton pump inhibitors
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
32- Sulcrafate is used in gastrointestinal complications and may act as:
a) Antacid
b) H2 inibitor
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c) Mucosal protectant
d) Antisecretory prostaglandin analog
e) Proton pump inhibitor
33- Antacids are commonly used to neutralize gastric acid pH. Example of best antacids
constitution may include which of the following combinations?
a) Magnesium hydroxide only
b) Aluminum hydroxide only
c) Calcium carbonate only
d) Magnesium and aluminum hydroxide
e) Calcium and aluminum hydroxide
34- Antacids neutralize the gastrointestinal acid pH by which of the following
mechanism of action?
a) Reduce the concentration and total load of acid in the gastric content by increasing
gastric pH.
b) Inhibit (H+, K+)-ATPase enzyme system at the secretory surface of the gastric parietal
cell
c) Inhibit H 2 neurotransmitters
d) Inhibit gastrin secretion
e) Inhibit the conversion of pepsin to pepsinogen
35- Diarrhea is a common side affect seen with which of the following antacids?
a) Aluminun containing antacid
b) Magnesium containing antacid
c) Calcium containing antacid
d) Magnesium and aluminum containing antacid
e) Calcium and aluminum containing antacid
36- Constipation and/or diarrhea may be side effects of antacids therapy. Which of the
following antacids may have constipation as side effect?
a) Aluminun containing antacid
b) Magnesium containing antacid
c) Calcium and magnesium containing antacid
d) Magnesium and aluminum containing antacid
e) Calcium and aluminum containing antacid
37- Correct statements regarding the advantages of taken antacids mixtures of
aluminum and magnesium may include:
I- Provides more sustained action
II- Permit a lower dose of each compound
III- The constipation effect of aluminum may counter the diarrhea caused by magnesium
a) I only
b) III only
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c) I and II only
d) II and III only
e) All are correct
38- Laxative is normally contra-indicated during pregnancy. The only agent with laxative
effects that may be used during pregnancy include:
a) Senna
b) Magnesium hydroxide
c) Psyllium
d) Docusate sodium
e) Bisacodyl
39- Examples of stimulant laxative may include all of the following, EXCEPT:
a) Senna
b) Cascara
c) Bisacodyl
d) Lactulose
e) Castor oil
40- Common or regular diarrhea may best be treated by the administration of:
I- Loperamide
II- Aluminum hydroxide
III- Bismuth subsalicylate
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
41- Antidiarrheal agent that appears to be bactericidal to H. pylori being useful in the
treatment of duodenal ulcers and gastric ulcers associated with H. pylori:
a) Bismuth subsalicylate
b) Loperamide
c) Docusate sodium
d) Psyllium
e) Milk of magnesium
42- Drug(s) used for the short-term treatment of gastro esophageal reflux and peptic
ulcer diseases may include which of the following?
I- H 2 receptors antagonists
II- Proton pump inhibitors
III- Corticosteroids
a) I only
b) III only
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c) I and II only
d) II and III only
e) All are correct
43- One of the most frequent side effect seen with SULCRAFATE therapy may include:
a) Diarrhea
b) Constipation
c) Edema
d) Cramps
e) Vomiting
44- Metoclopramide can act as effective agent in the management of many different
conditions. Some characteristics of metoclopramide include:
I- It increases the rate of gastric emptying
II- It has both peripheral and central effect
III- It can induce Parkinsons disease
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
45- Drug of choice in treating NSAIDs-induced ulceration may include:
a) Ranitidine
b) Omeprazole
c) Misoprostol
d) Sulcrafate
e) Aluminium hydroxide
46- A 5-Aminosalicylate active metabolite drug used in the treatment of Crohns disease:
a) Lansoprazole
b) Famotidine
c) Misoprostol
d) Sulfasalazine
e) Omeprazole
47- Active metabolite of sulphasalazine may include:
a) Acid salicylic acid
b) Salicilyc acid
c) Salicylates
d) Aminosalicylate
e) 5-Aminosalicylate
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48- Sulfasalazine, a 5-Aminosalicylate active metabolite drug suffer its metabolism
mainly where?
a) Colon
b) Stomach
c) Small intestine
d) Duodenum
e) Esophagus
49) Lipase inhibitor used to treat obesity may include:
a) Diethylpropiom
b) Orlistat
c) Benzphetamine
d) Mazindol
e) Phenylpropanolamine
50- Which of the following drugs are available in a transdermal form for the prevention
of motion sickness?
a) Metoclopramide
b) Granisetron
c) Ondasetron
d) Scopolamine
e) Diphenhydramine
51- Simvastatin used in hypercholesteramia is characterized by which of the following
mechanism of action?
a) Inhibiting xanthine oxidase
b) Inhibiting HMG-CoA reductase
c) Inhibit acetylcholinesterase
d) Acting as a bile sequestrant
e) Interfering with fat absorption from GI
52- Lactulose is an osmotic laxative agent that may be used to treat:
I- Constipation
II- Portal-systemic encephalopathy
III- Renal tubular necrosis
a) I only
b) III only
c) I and II only
d) II and III only
e) I,II,III
53- The primary function of simethicone used in antacid products is to act as:
a) Suspending agent
b) Adsorbent
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c) Buffer
d) Anti-flatulent
e) Flavoring agent
54) Chronic alcoholism and smoking is risk factors of?
I) GERD
II) Gastritis
III) Crohn's disease
A) I only
B) III only
C) I and II
D) II and III E) I,II,III
56) What is correct about sucralfate?
A) taken after meals B) taken empty stomach C) Taken with antacids is more effective
D) It prevents heart burn E) It is taken with proton pump inhibitors
57) Which of the following is the drug of choice to treat Crohn's disease
A) Methotrexate B) azathioprine C) NSAIDS D. Infliximab E. 5ASA
58) A 34 yo male diagnosed with chronic gastritis and peptic ulcer disease. What
organism are possible cause?
A) E. coli
B) Helicobacter pilori
C) Giardia lamblia
D) Compylobacter jejuni
59) What drugs when administered with antacids, decrease the therapeutic efficacy?
I) Proton pump inhibitors (PPIs)
II) H 2 RA
III) Sucralfate
A) I only
B) III only
C) I and II
D) II and III E) I, II, III
60) A customer walks into your pharmacy and wants something for fast relief of heart
burn symptoms?
A) ranitidine 150 mg
B) cimetidine
C) Mg antacids
D) Omeprazole
E) sucralfate
61.Ulcer is the ulceration of mucosa and underlying structuresof the Upper GI caused
by?
a. increased acidic gastric secretion
b. decrease mucus production
c. H.pylori infection
D. all of the above
ans. d
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62. What is the drug of choice to treat inflammatory bowel disease?
A. budosenide
B. 5-ASA
C. budosenide inj.
D. Methotrexate
E. Infliximab
Ans. B
GASTROINTESTINAL DISORDERS
ANSWERS
1- Ans: E
Comments: Hernias is a protrusion of a loop of an organ or tissue normally through the
GI area. Hernia hiatus is a herniation of stomach through the esophageal hiatus of
diaphragm. Strangulated hernia is an incarcerated hernia that is so tightly constricted as
to compromise the blood supply of the contents of the hernia sac.
2- Ans: A
Comments: Misoprostol is a prostaglandin analogue that increases bicarbonate and
mucin release and reduces acid secretion.
3- Ans: C
Comments: The most common drug reaction in the GIT is hydrolysis because most of
the drugs have an ester and/or amide group attached to their molecular formula and/or
react with water contests in GIT.
4- Ans: B
Comments: Salicylate compounds are largely hydrolyzed in the GIT, liver and blood to
salicylate, which is further metabolized primarily in the liver.
5- Ans: D
Comments: Ascitis is an effusion and accumulation of serous fluid in the abdominal
cavity; called also abdominal or peritoneal dropsy.
6- Ans: D
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Comments: Karaya gum is used as skin adhesives and protective skin barriers in the
fitting and care of ostomy, colostomy appliances and in other conditions involving an
artificial stoma
7- Ans: C
Comments: Somatotropin is a hormone growth with no effect on gastric acid secretion.
8- Ans: C
Comments: Gastro-esophageal Reflux disease is a chronic, pathologic, potentially lifethreatening disease manifested by reflux of the stomach and duodenal contents into the
esophagus, which is principally characterized by heartburn and regurgitation
9- Ans: A
Comments: Acute hemorrhagic gastritis is an erosive inflammation of the stomach with
bleeding normally seen with chronic alcoholism.
10- Ans: C
Comments: Magnesium salts used in antacids cause diarrhea. It also may cause systemic
effect as hypermagnesemia.
11- Ans: A
Comments: Villi and microvilli are found in the small intestine and are formed of
capillaries that works in the absorption of digestive food to rich the venous and
capillaries drainage of the gut.
12- Ans: E
Comments: Metoclopramide can be classified as dopaminergic blocking agent,
gastrointestinal emptying adjunct, peristaltic stimulant and antiemetic agent. It can be
used in cancer chemotherapy avoiding nausea and vomiting as well in diabetes
gastroparesis.
13- Ans: D
Comments: Bile is a fluid secreted from the liver and poured into the small intestine via
the bile ducts. It constituted of conjugated bile acids, cholesterol, phospholipid, bilirubin
diglucuronide and electrolytes. Bile is also responsible for the alkalinization in the
intestinal content due to its bicarbonate content.
14- Ans: E
Comments: Proton-pump inhibitors are the ultimate mediator of gastric acid secretion
inhibition; they are specific inhibitors of H+, K+ ATPase enzyme system at the secretory
surface of the gastric parietal cells. The most widely used proton-pump inhibitors are
omeprazole and lansoprazole.
15- Ans: D
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Comments: Omeprazole is a proton-pump inhibitor is the drug of choice in treating
Zollinger-Ellison disease and reflux disease.
16- Ans: E
Comments: Antacids should be taken 1 hour before meals, 3 hours after meals and at
bedtime
17- Ans: C
Comments: Gastrin, also known as G-cell is present in the stomach and stimulates acid
secretion.
18- Ans: E
Comments: Salivary glands are composed of 3 pairs of glands: Parotid, submandibular
and sublingual gland.
19- Ans: A
Comments: The first step of digestion is done in the mouth by the salivary enzymes,
amylase, ptyalin and lysozyme.
20- Ans: D
Comments: Gastrin is responsible for the stimulation of gastric acid secretion
21- Ans: C
Comments: The small intestine is anatomically divided in Duodenum, Jejunum and
ileum.
22- Ans: C
Comments: Duodenal ulcers also known as peptic ulcers are mainly characterized by
squirting of acid stomach into the duodenal wall.
23- Ans: B
Comments: The pancreas has two different glands. 1-Exocrine, responsible for the
production of enzymes which go to the duodenum via the pancreatic duct and 2Endocrine gland, responsible for the production of insulin, the blood sugar regulator.
24- Ans: E
Comments: The colon is anatomically divided into: Ascending colon, transverse colon,
descending colon, sigmoid colon and rectum.
25- Ans: D
Comments: Omeprazole is a proton-pump inhibitor.
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26- Ans: A
Comments: Famotidine is the most potent H 2 blocker. It reduces the gastric acid in 94%
up to 10 hours.
27- Ans: E
Comments: H2 blockers can be used to treat gastric hyper secretion, duodenal ulcers,
Zollinger-Ellison disease and reduce pain associated with gastroesophageal reflux
disease.
28- Ans: C
Comments: Proton-pump inhibitors are irreversible direct inhibitor of potassium pump.
29- Ans: E
Comments: The most frequent side effect seen in the treatment with proton-pump
inhibitors are: Abdominal pain or colic, diarrhea or constipation, unusual tiredness,
muscle pain, headaches, dizziness and skin rashes
30- Ans: E
Comments: Long-term treatment with NSAIDs and corticosteroids definitely increase the
risk of ulcers disease because these drugs cause many different GI side effects as pain,
cramps, acidity of stomach and other GI motility effects. Ulcers are also increased in
alcoholism and in smokers due to irritation and destruction of gastric mucosa. Other
agents that may increase the incidence of ulcers are coffee, orange juice, fatty and spice
food and emotional stress.
31- Ans: E
Comments: The basic pharmacological choices in the treatment of ulcers include H2antagonists, proton-pump inhibitors, misoprostol and sucralfate. Ulcers associated with
H. pylori can be treated by triple therapy with omeprazole, clarithromycin and
amoxicillin.
32- Ans: C
Comments: Sucralfate acts as protective coating of the gastric mucosa, it is particularly
used in ulcerated areas.
33- Ans: D
Comments: The mixtures of aluminum and magnesium are the most widely used
combination of antacids, because they compensate the side effects of each other.
34- Ans: A
Comments: Antacids act neutralizing gastric acid, which increases the pH of refluxed
gastric contents and lower esophageal sphincter pressure.
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35- Ans: B
Comments: Diarrhea is the most common side effect seen with the administration of
magnesium hydroxide antacid. Aluminum and calcium carbonate cause constipation.
36- Ans: E (was A before)
Comments: Constipation is the most common side effect seen with the administration of
aluminum containing antacid. Magnesium is an antacid with cathartic side effect.
37- Ans: E
Comments: Magnesium and aluminum mixtures are commonly used together because
they provide more even sustained action than used as single agent and permit lower
dose of each compound. The constipation effect of aluminum may counter the diarrhea
caused by magnesium.
38- Ans: C
Comments: Therapeutically safe in pregnancy, psyllium is a bulk-forming agent used as
laxative, it contains plant matter that absorbs water and softens the stool.
39- Ans: D
Comments: Lactulose is an osmotic laxative.
40- Ans: E
Comments: Diarrhea caused by infections, toxins and drugs are mostly treated with
specific agents, however the regular diarrhea normally caused for stress or stomach
indisposition is best treated with loperamide, bismuth subsalicylate or aluminum
hydroxide.
41- Ans: A
Comments: Duodenal and gastric ulcers are often caused by H. pylori. The treatment
objective is eradication of the bacterium with combination of antibiotics and h2antagonists, however bismuth subsalicylate is also used because it appears to be
bactericidal to H. pylori in high doses concentration.
42- Ans: C
Comments: Corticosteroids are neither used in the treatment of GERD nor in the
treatment of peptic ulcers. They normally induce or make worsen the ulcer condition.
43- Ans: B
Comments: Sucralfate is used as protective coating of the gastro intestinal mucosa and
have constipation as its main side effect.
44- Ans: E
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Comments: Metoclopramide can be used as gastrointestinal emptying adjunct,
peristaltic stimulant, antiemetic agent and dopaminergic blocking agent, which may
induce Parkinsons disease due to the blockage of dopamine.
45- Ans: C
Comments: Misoprostol is a prostaglandin analogue that increases bicarbonate and
mucin release and reduces acid secretion. It is used to treat NSAID-induced ulceration.
46- Ans: D
Comments: Sulfasalazine is an 5-Aminosalicylate (5-ASA) active metabolite agent used as
the drug of choice in the treatment of crohns disease.
47- Ans: E
Comments: The pharmacologic action of sulfasalazine is seen through its active
metabolite 5-Aminosalicylate (5-ASA).
48- Ans: A
Comments: Sulfasalazine is metabolized in the colon by resident bacteria into 5-ASA and
sulfa pyridine. Sulfapyridine is absorbed while the 5-ASA remains in the colon.
49- Ans: B
Comments: Orlistat is a lipase inhibitor being used to treat obesity, it binds to
pancreatic and gastric lipase and inactivate the enzyme reducing the dietary absorption
of fat by about 30%.
50- Ans: D
Comments: Scopolamine is the only available transdermal drug used to treat motion
sickness.
51- Ans: B
Comments: Simvastatin is a statin (HMG-CoA reductase inhibitor) used as
antihyperlipidemic agent.
52- Ans: C
Comments: Lactulose is an osmotic laxative that can be used to treat constipation and
portal systemic encephalopathy as well.
53- Ans: D
Tips: Simethicone is mainly used in antacids preparations as antiflatulant agent (antigas).
54) Ans: E
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56) Ans: B
Tips: Sucralfate is taken empty stomach to have better action. Because it make barrier
on to ulcer and prevent acid contact. Avoid taking with food, antacids, H 2 RA, and PPIs.
57) Ans: E
58) Ans: B
59) Ans: E
60) Ans: E
BIBLIOGRAPHIC REFERENCE
1- COMPREHENSIVE PHARMACY REVIEW Lippincott William & Wilkins Fourth edition
2- CPS-COMPENDIUM OF PHARMACEUTICALS AND SPECIALITIES - Canadian Pharmacist
Association 2001 edition.
3- MEDICAL DICTIONARY Dorlands illustrated 27th edition.
4- PHARMACY PREP Lectures series & study guide for Evaluating Examination-TIPS 2003/2004
5- THERAPUTIC CHOICES Canadian Pharmacist Association -Third edition
6- USP DI Drug Information for the Health Care Professional15th edition Volume I.
A patient brings prescription for ciprofloxacin 500 mg bid for 3 days. Currently patient
calcium carbonate 500 mg tid. What is appropriate recommendation.
a) Separate 2 hr before and 4 hr after calcium supplement from ciprofloxacin dose
b) Skip using calcium supplements for 3 days till finish of ciprofloxacin
C) For 3 days combination of ciprofloxacin and calcium supplements does not affect
therapy
D) None of the above
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Diabetes Mellitus
PHARMACY PREP
DIABETES
1)What is incorrect about insulin's?
A-insulin Lispro is rapid acting
B-regular insulin's is available as iv and sc
C-NPH is intermediate acting insulin is available as iv and sc
D-Glargine is long acting insulin should not physically mix with other insulin
E-All insulin preps should be stored in refrigerator
2. What is/are NOT symptoms of hypoglycemia
A-sweating B-hunger
C-polyuria
D-fainting
E-fatigue
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Diabetes Mellitus
E-Repaglinide
D-Rosiglitazone
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Diabetes Mellitus
B-Chlorpropamide
C-Glyburide
D-Rosiglitazone
E-Acarbose
15) An obese patient with type II diabetic, a drug of choice is?
A-Metformin
B-Chlorpropamide
C-Glyburide
D-Insulin
16) A doctor prescribed metformin 1000 mg tid as initial treatment, what is anticipated
most common side effect?
A-Diarrhea
B-lactic acidosis
C-liver failure
D-Congestive heart
failure E-Renal failure
17) The risk of lactic acidosis, associated with metformin, is enhanced by?
I-Congestive heart failure
II-Renal disease
III-Alcohol intake
A-I only
B-III only
C-I and II only
D-II and III only
E-I, II, III
18) A obese patient has CHF, renal disease and drinks alcohol. Recently diagnosed with
type II DM, what is drug of choice?
A-Metformin
B-Chlorpropamide
C-Rosiglitazone
D-Acarbose
E-Glyburide
19) HbA1c is test shows blood sugar levels for?
A-the past 3 months
B- the past 6 months
C- the past 3 years
D- the past 3 days
E- the past 3 weeks
20) Sitagliptin (Januvia) act by?
A) Inhibiting DPP4 enhances incretin like GLP hormones
B) Inhibiting insulin
C) Inhibiting glucagon
D) Increasing incretin levels
E) Analog of incretin
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Diabetes Mellitus
D-Acarbose
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Diabetes Mellitus
D) Glargine
E) Detemir
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Diabetes Mellitus
DIABETES
ANSWERS:
1) Ans: C
2. Ans: C
Tips; sweating, hunger, dizziness, fainting, fatigue are symptoms of hypoglycemia.
Polyurea, polydipsea, polyphagea, neuropathic pains, and blurred vision are symptoms
hyperglycemia.
3- Ans: E
4- Ans: B
Tips: Acarbose impair the digestion of sucrose. Hypoglycemia in-patient taking acarbose
should be treated with glucose rather than sucrose.
5- Ans: E
6- Ans: D
Tips. Health Canada warning on rosiglitazone regarding increased risk of edema and
congestive heart failure.
7) Ans: A
8) Ans: C
9) Ans: D
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Diabetes Mellitus
Tips: Orlistat (Xenical) act as intestinal lipase inhibitor and prevents absorption of fat
soluble vitamins ADEK.
10- Ans: D
11- Ans: A
12- Ans: D
Tips: Metformin is a biguanide chemical class of medication , it does not have sulfa
group, and thus it can be used in sulfa allergy patients.
13- Ans: E
14- Ans: D
Tips: Rosiglitazone can be taken with or without meals, where as metformin.
Chlorpropamide, glyburide taken with food, and acarbose is taken with first bite of
meals.
15) Ans: A
16) Ans: A
17) Ans: E
18) Ans: D
Tips Metformin is contraindicated in renal, hepatic, diseases. Chlorpropamide dose
adjustment required in renal impairment and rosiglitazone is contraindicated in
congestive heart failure.
19) Ans: A
20) Ans: A
21) Ans: D
22) Ans: B
23) Ans: D
24) Ans: B
25) Ans: C
26) Ans: B
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Diabetes Mellitus
27. Ans: E
28. Ans: C
29. Ans: C (was D before)
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PHARMACY PREP
THYROID DISORDERS
1-Select incorrect combinations in the following pairs:
A-Antithyroid drugs thionamides (PTU, methimazole)
B-Antithyroid drugs Lugol's solution
C-Lugols solution 5%I +10% KI
D-Hypothyroidism Thyroxin (T 4 ) and liothyrosine (T 3 )
E-Hypothyroidism Graves disease
F-Hypothyroidism Hoshimoto thyroiditis
2-All of the following are the symptoms of hypothyroidism EXCEPT:
A-Weight gain
B-Fatigue
C-Impaired memory D-Constipation
E-Heat intolerance
3-Conversion of T 4 to T 3 is catalyzed by:
A-Tetraiodinase enzyme
B-Deiodinase enzyme
C-Triiodinase enzyme
D-Hydrogenase enzyme
E-Iodinase enzyme
4) Which of the following laboratory monitoring indicated hypothyroidism:
I) Elevated TSH levels
II) No change in TSH levels
III) Decreased TSH levels
a) I only
b) III only
c) I and II only
d) II and III only
e) I, II, III
5-All of the following are the symptoms of hyperthyroidism, EXCEPT:
A-weight gain
B-heat intolerance C-palpitation
D-diarrhea
E-anxiety
6-Which of the following condition is hyperthyroidism
I-Hoshimoto thyroiditis
II-Myxedema
III-Graves disease
a) I only
b) III only
c) I and II only
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d) II and III only
e) I, II, III
7-Lugol solution contain:
A-Iodine
B-KI 10%+Iodine 5%
C-KI
D-Radioactive iodine
E-Sodium iodide
8) A patient using Lugol's solution should be counseled:
A) Lugol's solution may cause stains
B)Use topical only
C) Used to treat hypothyroidism patients
D) Lugol's solution is tincture iodine
E) None of the above
9-Drug of choice in pregnancy for hyperthyroidism
A-Lugol's solution
B-Propylthiouracil
C-Methimazole
D-Levothyroxine
E-Liothyronine
10-Patient receiving levothyroxine (L-T4) (Synthroid) should monitor levels of:
A-INR
B-T4
C-TSH
D-PT
E-fT3
11- A woman with Graves disease. Doctor prescribed methimazole. All of the following
statements are true, EXCEPT:
a) This drug inhibits thyroid hormone
b) Onset of action is after 2 weeks synthesis
c) Do not stop the drug if there is a rash
d) Call the doctor if there are symptoms of infection
12- Instructions for Synthroid (levothyroxin) tablet.
A) Should not be taken with Iron supplements
B) Should not be taken within 4 hours of Ibuprofen
C) Should not be cut
D) Can be taken with or without food
E) The drug of choice for hyperthyroidism in pregnancy
Ans. A
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a)
b)
c)
d)
Cold tolerance
Tachycardia
Diarrhea
Weight loss
C-bradycardia
D-hair loss
C-Euthyroidism
C-Euthyroidism
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A)Increase dose of levothyroxine
B)Decrease dose of levothyroxine
C)Change treatment to other hormone
D)Double the dose of levothyroxine
22) What is true about levothyroxine?
A) take in the morning with breakfast
B) take in evening with supper
C) take in evening empty stomach
D) take in the morning empty stomach
E) take with full glass of milk
23) All of the following drugs are used to treat thyrotoxicosis, (Graves disease) except?
A) propylthiouracil
B) methimazole
C) Lugol's solution
D) Propranolol
E) Levothyroxine
24) All of the following are correct in hypothyroidism, except?
A) Total T 4 decrease
B) Free T 4 decrease
C) Total T 3 decrease
D) Serum TSH decrease
E) Free Thyroxin index decrease
25) Which of the following hormone is secreted from hypothalamus?
A) Thyroid stimulating hormone
B) Luteinizing hormone
C) Follicular stimulating hormone
D) Prolactin
E) Oxytosin
26) Which of the following stimulate calcitonin production from thyroid gland?
A) Hypocalcemia
B) Hypercalcemia
C) Hypokalemia
D) Hyperkalemia
E) Hypothyroidism
27) A customer of your pharmacy uses insulin to treat diabetes. she is active and
decided to jogging 5 km daily. What is correct suggestion?
A) Take insulin injection before exercise
B) Take insulin injection after exercise
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C) Take sandwich before exercise
D) Take sandwich after exercise
E) Stop taking insulin injections
28) Which of the following is NOT a hypothyroidism symptoms?
A) hypertension B) weight gain C) sensitivity to cold D) diarrhea E) dry skin
29) What is incorrect about hypothyroidism?
A) Patient using thyroid hormone therapy
B) Serum TSH is elevated more than 5 mU/L
C) TT 3 is increased
D) Patient is tiered and fatigue
E) Patient have often dry skin
30) A patient is on insulin therapy. Which of the following is NOT correct about
hypoglycemia?
A) Patient may be sweating
B) Patient blood glucose in lower than 4 mmol/L (fasting)
C) Patient have palpitation
D) Patient have confusion
E) Patient should increase insulin dose
31) An asthma patient excessive dose of prednisone. Which of the following can cause?
A) Graves disease
B) Hoshimoto disease
C) Addison disease
D) Cushing syndrome
E) Weight loss
32) A 49 yo women is using treatment of Synthroid 75 mcg daily for hypothyroidism. She
complains palpitation, weight loss and sensitivity to heat. What is appropriate?
A) refer doctor to increase dose of Synthroid 100 mcg
B) refer to doctor to decrease dose of Synthroid
C) hypothyroid symptoms so should refer to doctor
D) She may have some new problem so refer to doctor
E) None
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A) I only
B) III only
C) I and II
D) II and III
E) I, II, III
C-Euthyroidism
D-Hyperglycemia
35. Which of the following is the least likely decrease absorption of levothyroxine
A) Al antacids
B) Mg antacids
C) Diary products
D) Iron supplements
E) Low fiber diet
36. If you get prescription of thyroxin120 mcg daily as initial dose for senior patient.
What symptoms may expected?
A) hyperthyroidism
B) hypothyroidism
C) Parkinson's disease
D) Schizophrenic symptoms
E) Serotonin syndrome
THYROID DISORDERS
ANSWERS
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1- Ans: E
Tips: Graves disease is hyperthyroidism
2- Ans: E
3- Ans: B
4- Ans: A
5- Ans: A
Tips: in hyperthyroidism, there is weight loss
6- Ans: B
7- Ans: B
8- Ans: A
Tips: Lugol's solution is used as oral drops, Lugol's solution is indicated in
hyperthyroidism patients.
9- Ans: B
10- Ans: C
11- Ans: C
12- Ans: A
Synthroid should not be taken with aluminum hydroxide, cholestyramine resins,
colestipol, ferrous sulfate, sod. Polystyrene sulfonate, soybean flour (infant formula)
due to decreased absorption of levothyroxine from GI tract. May be given to children by
crushing the tab. and suspending them in a small amount of water, breast milk or nonsoybean based formula. Do not store the suspension for any period of time.
13- Ans: A
14- Ans: C
15- Ans: A
16- Ans: B
Tips: elevated serum TSH > 5 mU/L indicate hypothyroidism.
17- Ans: B
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18- Ans: E
19- Ans: B
20) Ans: E
Tips: increase serum TSH and decrease Free T4 and TT3
21) Ans: B
22) Ans: D
23) Ans: E
24) Ans: D
Tips: FT4, TT4, TT3 and FTI decrease in hypothyroidism, only serum TSH increase. For
hyperthyroidism, exactly opposite changes.
25) Ans: E
26) Ans: B
27) Ans: C
28) Ans: D
29) Ans: C
30) Ans: E
31) Ans: D
32. Ans: B
Tips: patient experiencing overdose or hyperthyroidism symptoms, may be due
overdose of levothyroxine. So refer to doctor to decrease dose of levothyroxine
33. Ans: D
Tips: In hyperthyroidism increase T4 and T3.
34. Ans: A
35. Ans: E
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Tips: Food and formula containing large amount of soybean, fiber, or iron should not be
used for administration of levothyroxine. However low fiber food does not interact with
thyroxin.
36. Ans: A
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PHARMACY PEP
CONTRACEPTION
1-Contraceptive methods that protect STDs such as, gonorrhea, syphilis, chlamydia, and AIDS?
A-Oral contraceptive
B-Condoms C-Contraceptive sponges
D-Vaginal cream
E-Plan B
2-A 18 year old women walks into pharmacy, wants to buy emergency contraception Plan-B.
Pharmacist on duty believes do not allow dispensing contraceptive, and refuse to give oral
contraceptives. What ethical principle is violated?
A-beneficence
B-Non maleficence
C-Autonomy
D-veracity
E-Justice
3) What is the most common side effects plan B?
A-abdominal pain
B-Constipation
C-Nausea and vomiting
D-vaginal bleeding
E-Deep vein thrombosis
4)If one contraceptive pill missed, recommend?
A-take two pills next day
B-take 3 pills next day
C-take one pill next day
D-use alternative method of protection for next week
E-Refer to doctor
5) A customer of your pharmacy she asking for your opinion to choose a contraceptive
method, that she does not want to use daily and convenience and also near future she has
plan to start family. What is the good contraceptive you recommend?
A)OCP B) Condoms C)Evra path D)Nuvaring E) contraceptive injections
6) Which of the following questions is appropriate to ask a customer who wants to buy plan
B?
I)when was the last period II) are you pregnant? III)how long ago the unprotected intercourse
A) I only B) III only C) I and II only D) II and III only E)I, II, III
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CONTRACEPTION
ANSWERS:
1- Ans: B
2- Ans: C
3) Ans: C
4) Ans: A
5) Ans: D
6) Ans: E
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7) Ans: E
Tips: STI are only prevented by condoms contraceptive methods
8) Ans: A
9) Ans: C ( no answer given before)
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PHARMACY PREP
GENITOURINARY CONDITIONS
1) Toxic shock syndrome is caused by:
A-E. coli
B-S. aureus
C-Chlamydia
D-Gonorrhea
E-Non gonococci
2-Toxic shock syndrome may have risk with the use of:
I-Tampons use
II-Diaphragm contraceptive
III-Condoms as contraceptive
A-I only
B-III only
C-I and II only
D-II and III only
E.I, II, III
3-Finastride is alpha reductase inhibitor, indicated in:
I-Benign prostate hyperplasia
II-Alopecia
III-Increase sexual function
a) I only
b) III only
c) I and II only
d) II and III only
e) E.I, II, III
4-All of the following are the benign prostate hyperplasia, (BPH) symptoms, EXCEPT:
A-Nocturia
B-Frequent urination
C-Jet urination
D-Urinary retention
E-Post void dripping
5-Correct statement about pre menstrual symptoms (PMS) include:
I-All women have PMS
II-Luteal phase of cycle have PMS
III-vitamins, and estrogens deficiency may cause PMS
a) I only
b) III only
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c) I and II only
d) II and III only
e) I, II, III
9. Urinary incontinence is NOT aggravated by:
A-Hydrochlorthiazide
B-Furosemide
C-Diphenhydramine
D-Acetazolamide
E-None of the above
10-Patient profile includes sildenafil 50 mg and brings a prescription of erythromycin for
5 days upper respiratory infections, what is appropriate advice?
A-call doctor to decrease dose of sildenafil 25 mg while using erythromycin
B-Stop using sildenafil while using erythromycin
C-Call doctor to change other antibiotic
D-all of the above
11) A 50 year old lady will begin to take Hormone Replacement Therapy. All of the
following questions will help achieved appropriateness of her medication EXCEPT:
A) Did she have any children?
B) When did you last monitor your lipids?
C) Hysterectomy
D) When is the last menstruation period?
12. A patient is being treated with UTI, what is important to treat?
I. Dysuria and burning
II. Vaginal candidiasis
III. Fever and flare ups
a. I only
b. III only
c. I and III only
d. II and III only
e. I, II, III
13) If a patient is not treated for asymptomatic sexually transmitted infections. What is
correct?
A) symptoms are obvious after few days
B) can cause pelvic pain and dysmenorrhea
C) can cause pelvic inflammatory disease and infertility
D) can cause endometrial cancer
E) can results in cervical cancer
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14) What is correct about premenstrual symptoms?
I) all women have premenstrual symptoms
II) pre menstrual symptoms occur during luteal phase
III) a natural product prime rose oil is used
A) I only
B) III only
C) I and II only
D) II and III only
E) I, II III
15) What is incorrect about toxic shock syndrome?
A) caused by infections of S. aureus
B) can cause by tampon use
C) Can cause by condom use
D) can cause by candida infections
E) Can cause cervical cap contraceptives
16) Which of following condition avoid using sildenafil?
A) patients experienced priapism
B) patient have reported visual disturbances
C) patient using nitrates
D) patient have diplopia
E) children or women with hypertension
17) A customer of your pharmacy presents with symptoms of vaginal discharge, yellow
and fishy odor.
A) Recommend over the counter antifungal drugs
B) Refer to doctor is appropriate because this bacterial infection
C) Recommend self care
D) None of the above
18) What is the mechanism action of finasteride?
A-Blockade of intestinal lipase
B-Blockade the conversion of estrogen to dihydroestrogen
C-Blockade of testosterone to dihydrotestosterone
D-Blockade of sebaceous glands
E-Blockade of hair growth
19) What period of menstrual cycle pre-menstrual symptoms (PMS) occur?
A-Follicular phase
B-Ovulation phase
C-Immediately after ovulation
D-Luteal phase
E-During menstruation
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20) Which of the following methods of contraception can prevent sexually transmitted
diseases
A-oral contraceptives
B-reservoir type contraceptive
C-Intrauterine devices
D-condoms
E-contraceptive sponges
21. What is not menopause symptom?
A. Nigh sweating
B. Hot flushes
C. Mood changes
D. vasomotor symptoms
E. Fever
ans. E
23.Estrogen vaginal suppositories are used as?
A. contraception
B. to treat acne
C. to treat endometriosis
D. to treat vasomotor symptoms
E. To treat sexual dysfunction
Ans. d
Tips: vasomotor symptoms are hot flushes, night sweating, vaginal dryness can be
treated estrogen vaginal suppositories.
24. Which of the following is NOT associated with toxic shock syndrome?
A. Tampon B. Cervical cap
C. contraceptive sponges D. condoms E. IUDs
Ans. D
25. Premenstrual symptoms occurs during?
A. Ovulation phase
B. Follicular phase
C. Luteal phase
D. menstruation
E. post menopause.
Ans.C
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26. What is the drug of choice to treat patient with vaginal pruritus, curdy vaginal
discharge, no odor and no color discharge?
A. Metronidazole vaginal cream
B. Metronidazole oral
C. Clotrimazole
D. Amoxicillin
E. Cotrimoxazole
Ans. C
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CORRECT ANSWERS
Genitourinary Conditions
1- Ans: B
2- Ans: C
3- Ans: C
4- Ans: C
5- Ans: D
9. Ans: C
Tips: diphenhydramine belongs to the ethanolamine class of antihistamines gives
anticholinergic side effects such as urinary retention, and induce sedation.
Hydrochlorothiazide, furosemide and acetazolamide are diuretics increase urinary
frequency.
10- Ans: A
11) Ans: A
12. Ans: E
13) Ans: C
14) Ans: D
15) Ans: C
16) Ans: C
17) Ans: B
Tips: Color discharge and fishy odor is indicator of bacterial infection, thus refer to
doctor.
18) Ans: C (no answer was given from 18-20)
19) Ans: D
20) Ans: D
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PHARMACY PREP.
BONES AND JOINT COMPLICATIONS
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Osteoporosis
PHARMACY PREP
OSTEOPOROSIS
1) These two components in bone are responsible for the hardness and pliability of bone:
a) osteoclasts & collagen
b) mineralized salts & osteocytes
c) mineralized salts & collagen
d) collagen & elastic fibres
e) collagen & mesenchyme
2) A fracture in the shaft of a long bone would be a break in the:
a) epiphysis
b) metaphysis
c) diaphysis
d) epiphyseal plate
e) mesenchyme
3) Yellow marrow consists of:
a) osteoprogenitor cells
b) blood cell progenitor cells
c) hyaline cartilage
d) adipose
e) spongy bone
4) Chondroblasts produce:
a) basement membranes
b) bone matrix
c) cartilage matrix
d) mesothelium
e) endothelium
5) These structures are at the center of compact bone lamellae and carry blood vessels along
the bone length:
a) Haversian canals
b) canaliculi
c) perforating canals
d) osteocytes
e) lacunae
6) The cell type that is responsible for maintaining bone matrix once it has formed is:
a) osteoclasts
b) chondrocytes
c) osteocytes
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Osteoporosis
d) fibroblasts
e) osteoblasts
7) Soft connective tissue membranes between the cranial bones at birth are:
a) an indication of microcephaly
b) frontal sinuses
c) epiphyseal plates
d) cribriform plates
e) fontanelles
8) Endochondral and intramembranous are two mechanisms of:
a) bone remodeling
b) embryonic skeletal ossification
c) controlling blood calcium levels
d) cartilage synthesis
9) The two pairs of bones that make up the hard palate are the right and left:
a) zygomatic and temporal
b) palatine and maxillae
c) maxillae and zygomatic
d) maxillae and mandible
10) The two bones that make up the posterior nasal septum are the:
a) nasal and lachrymal
b) inferior nasal choncae and vomer
c) vomer and ethmoid
d) ethmoid and sphenoid
11) Which of the following is the most serious or life-threatening:
a) deviated nasal septum
b) sinusitis
c) damaged cribriform plate
d) damaged or cleft palate
e) ruptured bursae
12)All of the following are the risk factors for osteoporosis, except?
A-Race
B-Family history
C-Obesity
D-Smoking
E-Excessive coffee intake
13- Importance of Vitamin D in osteoporosis:
I- Increase the absorption of calcium from the small intestine
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Osteoporosis
E- 2 g
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Osteoporosis
E)protein diet
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Osteoporosis
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Osteoporosis
OSTEOPOROSIS
ANSWERS:
1) Ans: C
2) Ans: C
3) Ans: D
4) Ans: C
5) Ans: A
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Osteoporosis
6) Ans: C
7) Ans: E
8) Ans: B
9) Ans: B
10) Ans: C
11) Ans: C
12) Ans: C
Tips: obesity or overweight is not a risk factor of osteoporosis. Race, family history, smoking,
excessive coffee intake, deficiency of estrogen, and sedentary lifestyle are some of the risk
factors.
13- Ans: E
Tips: Osteoporosis is characterized by the loss of bone mass. Vitamin D supplements have
been used in the treatment of osteoporosis because vitamin D increases the absorption of
calcium that is essential to reduce bone loss. Antacids interact with vitamin D in many ways,
magnesium containing antacids may lead to hypermagnesemia and aluminum containing
antacids have its levels increased leading to aluminum bone toxicity when currently used with
vitamin D.
14. Ans: E
Tips: Corticosteroids increase the risk of infections.
15- Ans: E
16- Ans: C
17- Ans: C
18- Ans: A
19- Ans: D
20- Ans: A
21- Ans: A
22- Ans: A
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Osteoporosis
23- Ans: B
24- A
25- Ans: E
Tips: protein diet like dietary are plant derived phytoestrogen present in soy proteins
26- Ans: C
27- Ans: A
28. Ans: E
29. Ans: C
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Osteoporosis
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Hypertension
PHARMACY PREP
HYPERTENSION
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Hypertension
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1) Which one of the following factors is most directly attributed to angina attacks?
A. Emotional Stress
B. Heavy smoking
C. Myocardial ischemia
D. Obesity
E. None of the above
2) Purple toe syndrome side effect is produced by:
A-Amiodarone
B-Reynaud phenomenon
C-Warfarin
D-Rifampin
E-Verapamil
3. Which medication CAN NOT BE used for prinzmetal angina (vasospastic angina)?
A. Amlodipine
B. Metoprolol
C. Acetyl salicylic acid
D. Verapamil
E. Diltiazem
4. Which effect of nitroglycerin is most likely responsible for its therapeutic action in angina
pectoris?
a. Dilation of coronary artery
b. Relaxation of peripheral vascular smooth muscle
c. Decrease myocardial after load
d. A and B
e. A and C
5.
a)
b)
c)
d)
e)
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10) All of the following are low molecular weight heparins (LMWH), except?
A-Enoxaparin
B-Dalteparin
C-Tinzaparin
D- Nadroparin
E-Heparin
11) What is not true about low molecular weight heparins
(LMWH)?
A-It act by inhibiting factor Xa
B-It is long acting than heparin
C-It does not require monitoring
D-It is contraindicated in pregnancy
E-It is used as once daily SC injection
12) Unstable/NSTEMI drug of choice?
A-Anticoagulants
B-LMWH
C-Heparin
D-Alteplase
E-Propranolol
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13) What is the drug of choice for ST segment elevated myocardial infarction (STEMI)?
A-Anticoagulants
B-LMWH
C-Heparin
D-Alteplase E-Propranolol
14) What is the drug of choice for stable angina?
A-Anticoagulants
B-LMWH
C-Heparin
D-Alteplase
E-beta blockers
15)Which of the following drug may cause bradycardia?
A-Nifedipine
B-Nitroglycerine
C-Amlodipine
D-Verapamil
E-Clonidine
16) Which of the following drug should be taken with food?
A-Fluvastatin B-Lovastatin C-Simvastatin D-Atorvastatin E-Rosuvastatin
17) What statin can be taken anytime of the day?
A-Fluvastatin
B-Lovastatin C-Simvastatin
D-Atorvastatin E-Rosuvastatin
18) What statin do not require dosage adjustment in renal disease patient?
A-Fluvastatin
B-Lovastatin C-Simvastatin
D-Atorvastatin
E-Rosuvastatin
19) Which of the following is NOT used for antiplatelets action?
A-ASA B-Ibuprofen C-Naproxen D-Pyroxicam E-Acetaminophen
20) What antiplatelets drugs is used for prophylactic for angina pectoris?
A-dipyridamol
b-metoprolol
c-nifedipine
D-all of the above
21. Which of the following is NOT associated with plaque formation?
A) Coronary artery disease
B) Angina
C) Stroke
D) Reynaud's phenomenon
E) intermittent claudication
22. Which of the following is recommended to minimize the warfarin dispensing error?
I) dose of warfarin should be indicated in milligrams
II) check the color of tablets
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B. Nifedipine
C. Nicardipine
D. Felodipine
E. Amlodipine
Ans: A
Tips: Diltiazem and Verapamil side effect is bradycardia
36) This drugs cause reflex tachycardia except:
A. Amlodipine
B. Nifedipine
C. Nicardipine
D. Felodipine
Ans: A
Tips: All dihydropyridine calcium channel blockers cause reflex tachycardia except amlodipine
37) Action of nitrates can be described as?
A. vasodilation
B. vasoconstriction
C. bronchoconstriction
D. Bronchodilatation
Ans: A
38) An imbalance between oxygen supply and oxygen demand in cardiac muscle may produce
a condition known as:
A. CHF
B. Heartburn
C. MI
D. Angina pectoris
Ans: D
39) Drugs may be used in acute myocardial infarction: except
A) Beta blocker
B) ACE inhibitor
C) Calcium channel blockers
D) Nitrates
E) Digoxin
Ans: E
40) What dose does Aspirin acts as antiplatelet?
A. 80 mg
B. 365 mg
C. 500 mg
D. 1 g
Ans: A
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43. An ambulatory patient, the most fastest acting nitroglycerine dosage form?
A. SL spray
B. SL tab
C. wafers
D. liquid
E. suspension
ans. a
44. What is the drug of choice to treat hypertension in angina?
A. beta blockers
B. CCBs
D. ACEi E. ARBs
Ans. A
45. What is true about echocardiogram (ultrasound)?
A. Determines site and severity of thrombus or wall motion abnormalities.
B. Measure heart rhythm
C. Measure angina severity
D. Measure biological marker
E. Measure exercise tolerance
Ans. A
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ANSWERS
Coronary artery diseases
1. C
2- C
3. B
Tips: TC page 275, avoid beta blockers in prinzmetal angina, beta blockers cause
vasoconstriction (vasospasm)
4. D
5. C
6. E
Tips: Verapamil act as coronary vasodilator by inhibiting calcium ion influx in coronary smooth
muscles, and it does negative inotropic effects.
7- B
8- E
9. B
10) E(was D before)
11) D
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12. A
13) D
14) E
15) D
16) B
Tips: Lovastatin should be always administered with food to increase Bioavailability, otherwise
it can decrease 30% Bioavailability.
17) D
Tips: Atorvastatin can be taken anytime of the day, because has long half life.
18) D
Tips: The best agent for renal disease patient is atorvastatin, because it has minimal renal
elimination, thus do not require dose adjustments. Simvastatin and lovastatin require dose
adjustment in severe renal diseases however it can be used in minor and moderate renal
diseases
19) E
20) A
21. D
22. C
23. B
24. B
25. B
26) Ans-D
Tips: Nitroglycerin increases synthesis of intracellular cGMP. However, mechanism of action
may not be discussed in counselling.
27) Ans-E
28) Ans-D
Tips: a drug that increases metabolism of the anticoagulant will lower the steady state plasma
concentration both free and bound form, where as one that displaces anticoagulant will
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increase plasma level of free form only, until elimination of drug as again lower it to steady
state levels.
29)Ans: C
30) Ans: D
31) Ans: B
32) Ans: A
33) Ans: A
34) Ans: D
35) Ans: A
Tips: Diltiazem and Verapamil side effect is bradycardia
36)Ans: A
Tips: All dihydropyridine calcium channel blockers cause reflex tachycardia except amlodipine
37) Ans: A
38) Ans: D
39) Ans: E
40) Ans: A
41) Ans: C
42) Ans: C
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PHARMACY PREP
STROKE
1. The artery that supply blood to brain from heart?
A. Internal carotid artery
B. Coronary artery
C. Suclavian artery
D. Brachial artery
E. Pulmonary artery
Ans. A
1.A client presents with following symptoms, Which of the following symptoms is the most
pharmacist concern, which require referral to emergency?
A. patient face changes to uneven
B. patient arm drifting down
C. patient speech changes to strange
D. severe unprovoked headache
E. All of the above
Ans. E
2) All of the following are initial symptoms of stroke include, Except?
A-headache
B-blurred vision
C-paralysis
D-seizure
Ans. E
E-Chest pain
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Arrhythmias
PHARMACY PREP
DYSARRHYTHMIAS
1. Embolus (clot) enters into common carotid artery and travels toward the brain due to atrial
fibrillation can increase risk?.
A. angina
B. Cardiogenic stroke
C. myocardial infarction
D. DVT
E. CHF
Ans.b
2. A distinct p-waves is seen in?
A. Atrial fibrillation
B. Atril flutter
C. Ventricular tachycardia
D. Sinus tachycardia
E. all of the above
Ans. A
3. Patient with atrial fibrillation. Which of the following is used to prevent risk of cardiogenic
stroke.
A. ASA
B. Warfarin C. ACEi
D. Beta blockers
E. Calcium channel blockers
Ans. B
4. What is not monitored in patient using amiodarone?
A. Serum TSH
B. Chest x-ray
C. Eye exam
D. Renal function test
E. Liver function test
Ans. d
5.What is the most important to monitor in patient using amiodarone?
A. Serum TSH
B. Chest x-ray
C. Eye exam
D. Renal fucntion test
E. Liver function test
Ans.A
6. What type arrhythmias digoxin is contraindicated?
A. Atrial fibrillation
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Arrhythmias
B.Atril flutter
C. Ventricular tachycardia
D. Sinus tachycardia
E. all of the above
Ans. C
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Arrhythmias
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1) Aneurysm is ?
A) bulging of arteries B) a blood clot c) a moving blot clot d)permanent enlargement of
alveoli E) None of the above
2) Thrombus is?
A) bulging of arteries B) a blood clot c) a moving blot clot d)permanent enlargement of
alveoli E) None of the above
3) Embolus is ?
A) bulging of arteries B) a blood clot c) a moving blot clot d)permanent enlargement of
alveoli E) None of the above
4) Symptoms of Reynaud phenomenon?
a) fingers spasm b) extremities turn to pale, or blue C)often in elderly D)all of the above
5) Symptoms of Intermittent claudication?
a) cold feet, B)pulses are absent, c) exercise induced cramping pain d)all of the above
6) Symptoms of Stroke?
A)headache B)confusion C)dizziness D)blurred vision E)all of the above
7) What are the symptoms of deep vein thrombosis?
A) Leg pain
B) swollen legs
C) tenderness
D) Calf pain
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11. Which of the following are the monitoring parameters of warfarin therapy?
I
Complete blood count (CBC)
II
PT (prothrombin time)
III
INR (international normalization ratio)
a. I only
b. III only
c. I and II
d. II and III
e. I, II, III
12-Which of the following drugs increase international normalized ratio (INR)?
A-Clotrimazole
B-Clindamycin
C-Azithromycin
D-Penicillin's
13) Which of the of the following can be used in a pregnant women with deep vein
thrombosis ?
A-Captopril B-Warfarin
C-Atorvastatin
D-Heparin
E-Rosuvastatin
14) Which of the following is NOT a low molecular weight heparins (LMWH)?
A-Dalteparin B-Heparin
C-Nadoparin
D-Enoxaparin
E-Tinazeparin
15) What is incorrect about Reynaud's phenomenon?
A- Reynaud's phenomenon in which arteries of fingers become spastic (vasospastic).
B-Reynaud's phenomenon may result from atherosclerosis, connective tissue disease,
ingestion of ergot alkaloids, or frequent use of vibrating tools.
C- Reynaud's phenomenon may result from peripheral artriel plaques formation
D) Reynaud's phenomenon symptoms fingers spasm, extremities turn to pale, or blue.
E- Reynaud's phenomenon non-pharmacological is minimizing cold exposure, and use warm
gloves
16)Which of the following the most important drug is used to prevent peripheral vascular
diseases?
A)Beta blocker
B)ACEI
C) warfarin D)digoxin
E)ASA
17) Which of the following the most important drug is used to treat peripheral vascular
diseases?
A)Beta blocker
B)ACEI
C) warfarin D)digoxin
E)ASA
18) Which of the following drug is least likely used to treat peripheral vascular diseases?
A)Beta blocker
B)ACEi
C) warfarin D)digoxin
E) ASA
19) Which of the following is incorrect statement?
A)Reynaud phenomenon symptoms occurs in limb extremities
B)Calcium channel blockers are the drug of choice
C)Arterial plaques are the risk factor for Raynaud phenomenon
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1)Ans: A
2) Ans: B
3) Ans: C
4) Ans: D
5) Ans: D
6) Ans: E
7) Ans: D
8) Ans: E
9) Ans: A
10. Ans: E
Tips: INR and PT is monitored for warfarin, aPTT for heparin, where as for LMWH these tests
are not effective
11. Ans: D
12- Ans: A
13) Ans: D
14) Ans: B
15) Ans: C
16) Ans: C
Tips: Anticoagulants like warfarin is commonly used to treat peripheral embolic disorders.
17) Ans: C
18) Ans: A
Tips: beta blocker cause vascular constriction thus it is contraindicated in peripheral vascular
diseases
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19) C Ans:
20) Ans: C
Tips. Combined oral contraceptive pills are combination of estrogen and progestin increase
platelet aggregation and thus increase risk of blood clot formation.
21) Ans: E
22) Ans: E
Tips: mobility or physical activity lower the risk of deep vein thrombosis
23) Ans: A
24) Ans: E
Tips: RF for above patient, except gender. other RFs include age > 40 yr, cancer, CHF, MI, and
obesity.
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Pharmacy Prep
ANTICOAGULANTS
1-Which of the following clotting factor is NOT inhibited by warfarin?
A-2
B-7
C-9
D-10
E-12
2. A drug is said to reach "steady state" when 5 half-lives have elapsed. In the case of warfarin
(a blood thinner), however, the steady state is dependent not upon the drug's half-life, but
upon the half-life of the clotting factors it inhibits. The clotting factors inhibited by warfarin
have the following half-lives:
Factor II - 50 hours
Factor VII - 6 hours
Factor IX - 24 hours
Factor X - 36 hours
Based on this information, how long will it take a patient to reach maximal anticoagulation?
A- 5 days
B-10 days
C- 15 days
D- 20 days
E-48 hours
3-The hematocrit (HCT) measures the
A. Total number of blood cells per volume of blood
B. Weight of red blood cells per volume of blood
C. Number of red blood cells per volume of blood
D. Weight of hemoglobin per volume of blood
E. Percentage of red blood cells per volume of blood
4) A patient is using injections of Dalteparin to treat deep vein thrombosis what is monitored?
A) aPTT B) antifactor Xa C) Prothrombin time D) international normalized ratio E) Heparin
assay
5) Which of the following oral anticoagulant approved to treat atrial fibrillation?
A) heparin B) dalteparin C)Tinzaparin D)Dabigatran E)all of the above
6) What is incorrect statement?
A) LMWH therapy are effective in preventing DVT
B) Heparin therapy require close monitoring than LMWH
C) Heparin is weight based intravenous therapy is used in acute DVT
D) Warfarin produce rapid anticoagulation than LMWH
E) Long term heparin therapy can cause osteoporosis side effect
7) What is incorrect statement?
A) LMWH have longer duration of action than heparin
B) LMWH once daily SC administration
C) LMWH do not require routine monitoring
D) Heparin has rapid anticoagulant effect
E) aPTT reflects changes in extrinsic pathway of the coagulation cascade
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8) Patient is hospitalized. Doctors initiated heparin iv infusion. What is incorrect about heparin
A) heparin dose is based on body weight
B) loading dose is 80 units/kg, and maintenance dose is 15 to 25 units/kg/hr.
C) Heparin is slower onset than LMWH
D) LMWH have longer half life
E) LMWH have predictable response thus not monitored
9) Over dose of heparin is treated by?
I) Stop heparin infusion
II) Protamine sulfate
III) oral vitamin K
A. I only
B. III only
C. I and II
D. II and III
E. I, II, III
10) Patient is receiving warfarin after discharged from hospital. He is receiving cotrimoxazole to
treat UTI. One may expect to see the INR (2 - 3)?
I) Increase
II) No change III) Decrease
A. I only
B. III only
C. I and II
D. II and III
E. I, II, III
11. What anticoagulant is used in emergency as iv dosage form?
A) Heparin
B) Low molecular weight heparins (LMWH)
C) Warfarin
D) Dabigatran
E. Apixaban
12. The mechanism of action of Acetylsalicylic acid that results in greater effect as an
antiplatelet drug is because of:
A. Selective COX I inhibitor
B. Selective COX II inhibitor
C. COX I and COX II inhibitor
D. Acetylate cyclooxygenase
13) Which of the following anticoagulant available as iv and sc injections
A. Heparin
B. LMWH
C. Warfarin
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D. Apixaban
E. Dabigatran
14) What should be monitored in heparin treatment?
A. INR (International Normalised Ratio)
B. Vitamin K
C. aPTT
D. Serum levels of Heparin
E. Prothrombin Time
15) Which of the following tests are used for antithrombotic therapy:
A. INR, Prothrombin time and aPTT
B. aPTT and Prothrombin Time
C. Heparin assay and a PTT
D.INR only
E. a PTT only
16) Which of the following is the drug of choice to treat deep vein thrombosis (DVT):
A) Warfarin
B. streptokinase
C. Heparin
D. LMWH
E. Rivaroxaban
17) What anticoagulants is safe in renal disease patients?
A. warfarin
B. dalteparin
C. Heparin
D. dabigatran
E. apixaban
18) In order to measure effectiveness of warfarin therapy, the following monitoring tests are
used:
A. INR, must be 2-3
B. Prothrombin test (PT)
C. aPTT
D. A&B
19) At what dose Aspirin has anticoagulant property
A. 80 mg
B. 325mg
C. 500 mg
D. 800 mg
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27) Which of the following vitamins is needed for proper blood clotting?
A. Vitamin A
B. Vitamin D
C. Vitamin E
D. Vitamin K
28) Which of the following OTC drugs is contraindicated for a patient taking warfarin?
A. Diphenhydramine
B. Loratadine
C. Psyllium
D. ASA
29) All of the following drugs should be carefully prescribed with aspirin EXCEPT:
A. Enoxaparin
B. Coumadin
C. Heparin
D. Metoclopramide
30) An overdose of warfarin can be treated by administering:
A. Vitamin K
B. Acetylcysteine
C. MESNA
D. Protamine sulfate
E. Sodium bicarbonate
31. What anticoagulants is safe in renal disease patients?
A. warfarin
B. dalteparin
C. Heparin
D. dabigatran
E. apixaban
Ans. A
32. What is rat poison?
A. Coumarin
B. warfarin
C. Heparin
D. LMWH
E. Dabigatran
Ans. A
33. What is incorrect about anticoagulants?
A. warfarin is preferable because antidote is readily available
B. warfarin is less preferable after surgeries because of increase risk of bleeding
C. warfarin require frequent monitoring
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ANTICOAGULANTS
ANSWERS:
1- Ans: E
2. Ans: B
Tips: maximal anticoagulation will be reached when all clotting factors are inhibited. This will
take approximately 10 days, since 50hrs (the half-life of the clotting factor taking the longest
time to reach steady) x 5 = 250 hours, which is 10.4 days.
3- Ans: E
Tips: Whole blood treated with anticoagulant is centrifuged in a calibrated hematocrit tube. The
volume ratio of the packed red blood cells to total blood volume is determined. The hematocrit
is normally 39 to 49 for men and 33 to 43 for women. The hematocrit value provides some
indication of both the number and size of the red blood cells present in an individual
4) Ans: B
5) Ans: D
Tips: Dabigatran an oral anticoagulants recently approved to treat atrial fibrillations. It is factor
Xa inhibitor. (competitive direct thrombin inhibitor).
6) Ans: D
7) Ans: E
8) Ans: C
Tips: Heparin iv infusion is faster onset than LMWH.
9) Ans: E
10) Ans: A
Tips: antibiotics potentiate anticoagulant effect : cotrimoxazole, erythromycin, metronidazole,
(other drugs: omeprazole, fluconazole, ketoconazole, cimetidine, amiodarone, quinidine,
vitamin E (large doses), acute phenytoin, thyroxin, acute alcohol also potentiate.
Reduce the clearance of warfarin, displacement from warfarin protein binding, decrease
intestinal flora
Drugs that inhibit anticoagulant effect: carbamazepine, penicillin, rifampin, cholestyramine,
barbiturates, high vitamin K, chronic alcohol use
11. Ans-A
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12. Ans: D
Tips: Aspirin is the only drug that irreversibly inhibits the enzyme. This action permits a longer
duration of action causing platelet aggregation and acetylation of cyclooxygenase.
13) Ans: A
14) Ans-C
15) Ans-A
16) Ans-D
Tips: LMWH is the drug of choice to treat DVT. Alternatively heparin is in emergency. The oral
anticoagulants are used for maintenance.
17) Ans. A
18) Ans-D
19) Ans-A
20) Ans: D
Tips: Ringing in the ear is associated with ASA, salicylates, quinine, and quinidine, but not
warfarin.
21) Ans: D
Tips: Metronidazole increases INR
22) Ans: A
Tips: Warfarin site of action is in vivo and heparin is either in vivo or in vitro
23) Ans: C
24) Ans: D
25) Ans: B
26) Ans: B
Tips: Chronic alcohol decreases INR while acute alcohol increases INR.
27) Ans: D
28) Ans: D
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29) Ans: D
Tips: Aspirin is a blood thinning agent indicated for prevention of heart stroke. It should be
carefully prescribed with other blood thinning agents
because of risks of bleeding. Lovenox (Enoxaparin), Coumadin (Warfarin), Heparin, Plavix
(Clopidrogel), Ticlid (Ticlopidine), Depakene (Valproic acid), Persantine (Dipyridamole), Mandol
(Cefamandole), Cefotan (Cefotetan), Cefobid (Cefoperazone) and Moxam (Moxalactam) are
agents that increase bleeding tendency in patients and should be carefully prescribed with
other blood thinning agents.
30) Ans: A
Tips: The overdose of Coumadin can be treated by administration of Vitamin K1 (Mephyton).
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Anxiety Disorders
PHARMACY PREP
ANXIETY DISORDERS
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Depression
PHARMACY PREP
DEPRESSION
E. NDRIs
Tips:
Antidepressants
Mirtazapine
Bupropion
Trazadone
Fluvoxamine
Sertraline
Fluoxetine
Moclobamide
Sedation
Drug interaction
Drug interaction.
Weight gain
Sexual dysfunction
C. 1 to 4 months
D. 1 to 4 years
Tips
4 A patient with major depression, doctor initiated fluoxetine. However patient did not
tolerated and there was no improvement. Doctor initiated phenelzine, a week later. After
patient started therapy for phenelzine, 4 days later the patient presented with fever, high
blood pressure, diarrhea, and confusion. What is the most likely cause?
A) Neuroleptic malignant syndrome
B) Hypertension crisis
C) Serotonin syndrome
D) Serotonin withdrawal syndrome
Ans: C
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Depression
Tips:
Serotonin symptoms
Autonomic
Diarrhea, Fever, Shivering,
change in BP, and & N, V
Neuromuscular Tremors, seizure, myoclonus,
Dysfunction
hyper reflexes
Cognitive
Agitation, Confusion,
hypomania
Withdrawal symptoms
Flu like fever, chills, dizziness, light
headed, N &V, sleep disturbances
Myalgia, lethargy, sensory
disturbances
Not present
Lithium Toxicity
Coarse hand tremor
Muscle twitching
Vomiting, severe drowsiness,
confusion, nystagmus, seizure,
Ataxia, cogwheel rigidity,
coma, death
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Antipsychotics
PHARMACY PREP
ANTIPSYCHOTICS
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Dementia
PHARMACY PREP
DEMENTIA
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Dementia
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Dementia
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Dementia
CORRECT ANSWERS
DEMENTIA
1) Ans: C
Tips: deficiency of acetylcholine and damage of brain cells in older age causes dementia.
2) C
3) E
4) E
Tips: Lifestyle factors like alcohol intake have no evidence worsening Alzheimer's.
5) C
6) E
Tips: old age is a risk factor for Alzheimer's dementia
7) Ans: B
8) Ans: A
9) Ans: E
Tips.Dementia is treated by acetylcholinesterase inhibitors i.e. cholinergic agonist, thus
produce cholinergic agonist side effects " DUMBLESS"
10) Ans: A
Tips: Drugs that increases Donepezil are inhibitors of CYP 2D6 or CYP 3A4. Drugs that
decreases Donepezil are inducers of CYP 2D6 or CYP 3A4.
11) Ans: C
12) Ans: A
13) Ans: E
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B-Phenytoin
C-Tiagabine
D-Topiramate
E-Phenobarbital
7)The most common side effects of anti seizure drugs:
I-Appetite and body weight changes
II-GI symptoms
III-Head ache and dizziness
A-I only
B-III only
C-I and II
D-II and III
8) Which of the following antiepileptic drugs has weight loss side effects:
A-Valproic acid
B-valproate
C-Phenytoin
D-Topiramate
E-Carbamazepine
9) A 25-year-old female patient taking gabapentin for neuropathic pain, which of the following
statement is/are true:
I-She should avoid taking oral contraceptive because, this drug decrease effectiveness of
gabapentin
II-Gabapentin chemical structure is not similar to GABA
III-Gabapentin chemical structure contains GABA structure.
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
10) Which of the antiseizure drug has weight loss side effects.
A-Topiramate
B-Carbamazepine
C-Phenytoin
D-Valproic acid
E-Gabapentin
11) A 25-year-old female patient taking gabapentin for neuropathic pain, which of the
following statement is not true:
A-She should avoid taking oral contraceptive because, this drug decrease effectiveness of
gabapentin
B-Gabapentin have advantage of the least drug interactions
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A-Gingival hyperplasia
B-Steven Johnson syndrome
C-Hirsutism
D-All of the above
E-A and C
19-Epilepsy cause due to deficiency of?
A-Sodium ion
B-GABA
C-Serotonin
D-Dopamine E-Acetylcholine
E-Phenytoin
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A-Anticholinergic
B-Sympathomimetics
C-Sympathetic blockers
D-Non dihydropyridine type of CCBs
E-All of the above
27) Treatment of epilepsy for?
A-Inhibiting GABA neurotransmitter
B-Stimulating NMDA neurotransmitter (N-methyl D-Aspartate)
C-Decrease firing threshold impulse
D-Stimulating sodium ion channels
E-Stimulating potassium ion channels
28) Valproic acid is used to treat?
I-Petit-mal (absent of seizure) II-Grand-mal (general seizure) III-Febrile seizure in children
A-I only B-III only
C-I and II only
D-II and III only
E-I, II,III
29. When changing from phenytoin syrup to phenytoin capsule, at same dose, change in
effect is due to
I.
Change in salt form
II.
Change in dose
III.
Change in dose elimination
A-I only B-III only
C-I and II only
D-II and III only
E-I, II,III
30) What is drug of choice for petit mal (absence) seizure?
A-Diazepam iv
B-Diazepam oral
C. Ethosuximide and valproic acid
D-Phenytoin
E-Carbamazepine
31) Side effects of phenytoin include?
I-Gingival hyperplasia, ataxia, nystagmus
II-Steven Johnsons syndrome
III-Hirsutism and acne
A-I only B-III only
C-I and II only
E-I, II,III
32) Epilepsy is resulted from the deficiency of?--> GABA action; Early symptoms of partial
seizures are?
I-Part of the brain
II-Sensory seizure or focal motor seizure
III-Patient is conscious
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A-I only
B-III only
E-I, II,III
39) Drugs that has least likely have drug interaction with oral contraceptives except:
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A.
B.
C.
D.
Gabapentin
Ethosuximide
Valproic acid
Lamotrigine
40) One side effect of Phenytoin is gingival hyperplasia, the best way to prevent it:
A. Use chlorhexidine wash
B. Use dental floss
C. Take Vitamin C
D. Gargle with water
41) Anti epileptic drug that doesnt cause weight gain?
A. Valproic acid
B. Lamotrigine
C. Topiramate
D. Phenobarbital
42) Phenytoin available in which of the dosage forms?
A. Injection
B. Capsule
C. Chewable tablets
D. All of the above
43) Valproic acid is the drug of choice for
A. Absence seizure
B. Myoclonus
C. Tonic
D. all of the above
44) Drug use as add on for patients nearly seizure free:
A. Gabapentin
B. Clobazam
C. Valproic acid
D. Phenytoin
45) Phenytoin metabolism is not inhibited by:
A. Sulfonamide
B. Isoniazid
C. Carbamazepine
D. Chloramphenicol
46) Divalproex is a mixture of:
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A.
B.
C.
D.
Gabapentin
Valproic acid
Sodium valproate
A and C
47) What drug inhibits glutamate and aspartate release and blocks sodium channels and
prevents repetitive firing:
A. Topiramate
B. Lamotrigine
C. Clobazam
D. Gabapentin
48) What antiepileptic is found in hospital emergence carts?
A. Diazepam iv
B. Chlorpromazine
C. Carbamazepine
D. Lithium
E) Phenytoin IV
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1) Ans: A
2. Ans: E
Tips: Grand mal Valproic acid, Complex partial Carbamazepine, Simple partial
Carbamazepine, Tonic-clonic Valproic acid, Absence seizure Ethosuximide, and Status
epilepticus Diazepam
3) Ans: A
4) Ans: D
5) Ans: C
6) Ans: D
Tips: topiramate is a derivative of fructose. Indicated as anti seizure drugpartial seizure,
tonic clonic seizures. Has high kidney stone formation side effect. Fibrates also causes gall
bladder stone formation
7) Ans: E
Tips: valproic acid and valproate increase appetite and may results in weight gain,
carbamazepine may cause dizziness and confusion.
8) Ans: D
9) Ans: B
10) Ans: A
11) Ans: A
Tips: Gabapentin do not decrease efficacy of oral contraceptives and can be used along with
oral contraceptives.
12) Ans: B
13) Ans: E
Tips: butterfly rash symptoms occurs in lupus erythromatus
14- Ans: D
15- Ans: D
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16- Ans: A
17- Ans: B
18- Ans: D
19- Ans: B
20- Ans: D
21- Ans: C
Tips; Ach receptors, in the CNS are present on less than 5% of the neuronal population.
22- Ans: A and B
23- Ans: B
24- Ans: C
25) Ans: E
26) Ans: A
27) Ans: A
28) Ans: C
Tips: valproic acid is the drug of choice for generalized seizures and also can be used for petit
mal seizures.
29. Ans: A
Tips: Phenytoin syrup 100mg- more potent 8% increase in drug content; Phenytoin caps
100mg free acid; Sodium salt of Phenytoin Dilantin caps.
30) Ans: C
31) Ans: C
32) Ans: A
33) Ans: C
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38) Ans: E
Tips: Phenytoin and Carbamazepine are not use in absence seizure
39)Ans: B
40)Ans: A
41)Ans: C
42)Ans: D
43)Ans: D
44) Ans: B
45) Ans: C
Tips: Carbamazepine stimulates phenytoin metabolism
46) Ans: D
47) Ans: B
48) Ans: A
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Parkinsons Disease
PHARMACY PREP
PARKINSONS DISEASE
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Parkinsons Disease
D-Levodopa preparations
E-MAO-A selective inhibitor
7) Which of the following is a COMT inhibitor?
A. Amantadine,
B. Bromocriptine,
C. Levodopa,
D. Selegiline
E. Entacapone
8) Why COMT inhibitors (Tolcapone, entacapone) always should used
with levodopa?
A-COMT inhibitor decrease metabolism of levodopa to 3-O-methyldopa
B-COMT inhibitors have synergistic action with levodopa
C-COMT inhibitors have additive action with levodopa
D-COMT inhibitors should not combine with levodopa
E-None of the above
9)All of the following statement is correct, except?
A-Deficiency of dopamine gives Parkinsons disease
B-Tardive dyskinesia is NOT a symptom of Parkinsons disease
C-Selegiline is a selective MAO- type B inhibitor
D-Tolcapone and entacapone are COMT inhibitor
E-Ropinarole and pramipexole are non-selective dopamine agonist
10-Tardive Dyskinesia is?
A-No movement or difficulty in movement
B-Involuntary movement of limbs, trunk, mouth and face
C-Slow movement
D-Rigidity
E-Postural instability
11)Which of the following antiviral drug indicated in Parkinson disease treatment:
A-Pergolide
B-Amantadine
C-Rimantadine
D-Selegiline
E-Entacapone
12) A 75 yo Parkinson's patient is on levodopa/carbidopa (Sinemet) therapy taking morning
and night time. However, recently patient experiencing rigidity and involuntary movement in
the evening before taking night time dose? It is characterized as?
A) fluctuation or on-off effect B) Dyskinesia C) Tardive dyskinesia D) Dystonia E) wearing
off effect
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Parkinsons Disease
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Parkinsons Disease
A. Tolcapone
B. Entacapone
C. Pergolide
D. A&B
22) Treatment of Parkinsons disease may be treated with all of the following agents, EXCEPT:
A. Amantadine
B. Selegiline
C. Pergolide
D. Donezepil
E. Pramipexol
23) Pramipexole and Ropinirole are categorized as?
A. Selective D 1 agonist
B. Non selective D 1 and D 2 agonist
C. Non selective D 1 and D 2 antagonist
D. Selective D 2 agonist
24) The following antiviral drug can be used in PD treatment:
A. Levodopa
B. levodopa/carbidopa
C. Pergolide
D. Amantadine
25) What is the most common side effect of levodopa?
A. Tremor
B. Dyskinesia
C. Hallucination
D. Hypotension
26) MP is a 75 year old patient diagnosed with Parkinson's disease. Doctor considering to
prescribe medication. What is the drug of choice for Parkinson disease is?
A. Levodopa
B. Carbidopa
C. A and B
D. Dopamine
E. Selegiline
27) Which of the following drug should be avoided in Parkinson's disease?
A. Oral contraceptive pills
B. Metochlopramide
C. B and D
D. Antipsychotic drug
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Parkinsons Disease
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Parkinsons Disease
35) Nausea and vomiting are adverse effects of Levodopa, how do you manage this?
A. Take levodopa with food
B. Take levodopa without food
C. Take it on empty stomach
D. Do not crash or chew
36) Which of the following is the suitable combination of drugs are initiated after as drug of
choice for Parkinson disease is?
A. Levodopa and carbidopa
B. Carbidopa and Dopamine
C. Levodopa and Tolcapone
D. Dopamine and Entacapone
37) Which of the following antiviral drug indicated in Parkinson disease treatment:
A. Valacyclovir
B. Amantadine
C. Acyclovir
D. selegiline
E. Interferon's
38) Parkinsons disease is caused by deficiency of?
A-Dopamine in brain
B-Acetylcholine
C-GABA in CNS
E-Histamines
D-Serotonin in brain
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Parkinsons Disease
Parkinson's Disease
ANSWERS
1- Ans: A
Tips: That is why Dopamine agonist & anticholinergics are effective
2- Ans: B
Tips: dyskinesia = slow movement, tardive dyskinesia = involuntary movement of mouth, face,
limbs and trunk. Akinesia = difficulty in movement.
3- Ans: B
4- Ans: E
Tips: Pseudo parkinsonism (TRAP) may be side effects of antipsychotics. Pseudo parkinsonism
may disappear after discontinuation of medication.
5- Ans: D
Tips: anticholinergic agents such as benztropine, diphenhydramine, and trihexyphenidyl are
use in treatment of EPS. Donepezil is acetyl cholinesterase inhibitor is not indicated in EPS
treatment.
6- Ans: B
Tips: MAO-B selective inhibitors; treatment for Parkinsons disease is: BALSAC =
Bromocriptine, Amantadine, Levodopa, Selegiline, Antimuscarinic (benztropine), and COMT
inhibitors
7) Ans: E
8) Ans: A
9) Ans: E
Tips: Ropinirole and pramipexole are selective D 2 agonist
10- Ans: B
11) Ans: B
12) Ans: E
13) Ans: A
14) Ans: D
Tips: End-of-dose wearing off gives on-off effect. This phenomenon is related to the increasing
loss neuronal storage capability of dopamine as well as short half life of dopa.
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Parkinsons Disease
15) Ans: B
16) Ans: D
17) Ans: E
18) D
19)Ans: A
20) Ans:B
21) Ans: D
Tips: COMT (Catecholamine O-Methyl transferase), the drugs names ends with capone.
COMT are indicated in Parkinson's disease
22) Ans: D
Tips: Donepezil is a drug for Alzheimers
23)Ans: D
24) Ans: D
25) Ans: B
26) Ans: C
27)Ans: C
28. Ans: A
29) Ans: B
30) Ans: A
31)Ans: B
32)Ans: A
33) Ans: D
34)Ans: A
Tips: To manage wearing off:Administer levodopa more frequently
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Parkinsons Disease
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Parkinsons Disease
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Antimicrobial agents
PHARMACY PREP
ANTI-INFECTIVE AGENTS ANTIBIOTICS
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1. What is the drug of choice to treat chemo induced nausea and vomiting
A. dexamethsone
B. Ondansetron
C. Metoclopramide
D. dimenhydrinate
Ans. a
2) Which of the following chemotherapeutic agent is categorized as low emitogenic?
A) Cisplatin B) Cyclophosphamide
C) Iphosphomide
D) Vincristine
Ans. D
3) Hemorrhagic cystitis results from irritation of the lining of the bladder by acrolein, a
metabolite of ifosfamide and cyclophosphamide. Acrolein can be inactivated by?
A-Mesna
B-Doxarazoxane
C-Chlropropamide
D-Erythropoeitins
E-None of the above
Ans. A
4) The drug of choice to treat delayed nausea and vomiting?
A-Ondansetron
B-Metoclopramide
C-Dexamethasone
D-Dimenhydrinate
E-Scopolamine
5) Cardio protective agent is?
A-Mesna
B-Dexorasoxane
Ans. B
C-Acroline
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Natural Products and Pharmacognosy
1) A customer of your pharmacy wants to buy ginkgo biloba to enhance memory. What to do?
A) give gingko biloba
B) do not recommend gingko
C) refer to doctor
D) refer to emergency
E) say there is no clinical evidence
2) A customer of your pharmacy wants to buy ginkgo biloba to enhance memory. Patient
currently on warfarin therapy . What to do?
A) give gingko biloba
B) do not recommend gingko because, has reports of drug interactions
C) refer to doctor
D) refer to emergency
E) say there is no clinical evidence
3) A customer of your pharmacy wants to buy garlic pills to treat borderline high cholesterol.
What to do?
A) give garlic pills
B) do not recommend garlic pills
C) refer to doctor
D) refer to emergency
E) say there is no clinical evidence
4. Which of the following herbal products can increase blood pressure?
A. Garlic
B. St. John wart
C. Licorice
D. Valerian
E. Feverfew
5. Health Canada approved Natural or herbal products are identified by?
A. Drug identification number
B. Product identification number
C. Natural Product number
D. Natural Health Products
E. Prescription number
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ANSWERS
Natural Products and Pharmacognosy
1) Ans: A
Tips: As long as patient is not medication and/or have no medical conditions that do not
interfere with natural products if this helps to alleviate their problems. I will give it to patient.
2) Ans: B
3) Ans: C
4. Ans: C
5. Ans. C
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