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FINAL MOCK TEST 1

1) What is sequential therapy?


A. Begin with iv antibiotic therapy and change to oral antibiotics
B. Begin with oral antibiotic therapy and change to iv therapy
C. Combine therapy of IV antibiotic and oral antibiotics
D. Prolong iv therapy
E. Prolong oral therapy
Ans.A

2 What is function of Corpus collasum in brain?


A. Part of brain control voluntary and non voluntary function
B. A nerve fiber connect right and left hemisphere of brain
C. A nerve fiber connect mid brain to corpus collasum
D. A nerve fiber connect front lobe to mid lobe
Ans. B
3. A Physician writes prescription to own use or family member for
emergence?
a. Unethical
B. Illegal
C. Physician can prescribe in emergence
D. Physician to refer to emergency
Ans. C

4.What is the first line therapy for onychomycosis?


A. Itraconazole B. Terbinafine C. Fluconazole D.Cicloperox E.
Clotrimazole
Ans. B
1st line 2nd line 3rd line
Onychomycosis Terbinafine Itraconazole fluconazole
Athletes foot Clotrimazole Miconazole Tolnaftate
vaginalCandidiasis Clotrimazole Nystatin/miconazole
Oral thrush Nystatin liquid
Dandruff Ketoconazole Selenium sulfide

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Tips: Systemic antifungals are the most effective treatment, with meta-
analyses showing mycotic cure rates of 76% for terbinafine, 63% for
itraconazole with pulse dosing, 59% for itraconazole with continuous dosing,
and 48% for fluconazole. Concomitant nail debridement further increases cure
rates. Topical therapy with ciclopirox is less effective; it has a failure rate
exceeding 60%. Several nonprescription treatments have also been evaluated.
Laser and photodynamic therapies show promise based on in-vitro evaluation,
but more clinical studies are needed. Despite treatment, the recurrence rate of
onychomycosis is 10% to 50% as a result of reinfection or lack of mycotic cure.

5. Enzyme inducers? except


A.Carbamazepine B. Phenytoin C. Phenobarbital D Oxcarbazepine
E. Clarithromycin
Ans. E
Tips: Macrolides are CYP3A4 inhibitors. Read chapter
metabolism.

6) Doctor prescribed 20 mEq of K for a patient. Hospital pharmacy


potassium salt preparation container labeled in mg. How many mg of
potassium should be taken? (M.W. K+ is 39)
A) 600 mg B) 358 mg C) 780 mg D) 480 mg
E) 320 mg
Ans. C
Tips
1 mEq= 39 mg K

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20 mEq x 39 mg = 780 mg K

7) You have 20 ml ampoule having a concentration of 0.75%


and you need to prepare 250 ml solution having a
concentration of 0.125%, so what the volume of liquid
needed to dilute the solution.
A) 41.67 ml B) 250 ml C) 75 ml D) 125 ml
Ans. A
Tips. C 1 V 1 = C 2 V2
0.75 x V = 0.125 x 250.
V = (0.125x250)/0.75
Therefore V = 41.67

8) A clinical trial report shows that a control drug gives side effects in
50 patients among 500 and test drug gives 25 among 500 patients.
Find the number needed to treat?
A) 20 B) 200 C) 2000 D) 100 E) 50
Ans. A
Tips:
(50/500) x 100 = 10%
(25/500) x 100 = 5%
ARR = 10-5 = 5%
NNT = 1/ARR = (1/5) x 100 = 20
Absolute risk reductions Relative risk

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ARR = CER-EER RRR = (CER-EER)/CER
NNT = 1/ARR
NNH = 1/ARI

9. An average Canadian pharmacy cost goods sold was


$1.500,000 and closing inventory was $400,000. What is the
opening inventory?
A. 1.500,000 B. $200,000 C. $800,000 D. $400,000 E.
350,000
Ans. D
Tips: The closing inventory is the same as opening inventory.

10) You have 40 mg/mL of a stock solution of triamcinolone,


and are asked to prepare 200 mL of solution at a final
concentration of 3.75 mg/mL triamcinolone. How much
stock solution would you need?
a) 9.4 b) 14.1 c) 18.8 d) 28.1 e)
37.5
Ans. C
Working.

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i. 200 mL of 3.75 mg/mL solution will contain
(200 x 3.75) = 750 mg of triamcinolone
ii. 750 mg triamcinolone is contained in 750/40 =
18.75 mL

11. Venlafaxine?except
A. The drug of choice for major depressive disorder
B. The alternate option for hot flushes in post menopause
C. Hypotension is the major side effect concern
D. Velafaxine is a SNRI
E. Venlafaxine initial dose is 35 mg daily
Ans.c
Tips: high dose >225 mg/day of venlafaxine cause
hypertension.

12) HAMA stands for?


A) Human antigen Mouse antibody

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B) Human anatomy and mouse anatomy
C) Human antibiotics developed from mouse
D) Human Assay for Mouse antigens
E) Human AntiMouse Antibody
Ans. E
Tips. HAMA is human antimouse antibody. Hypersensitivity and infusion-
related reactions, with or without the development of human antimouse
antibodies (HAMAs), are generally greatest with murine antibodies and least
with humanized antibodies also known chimeric antibodies. Example infliximab.

13) Type 4 hypersensitive reaction is triggered by T cells by acting


on?
A) Neutrophil
B) Ig E
C) Ig M
D) T cell receptors
E) Ig G
Ans. E

Tips. T cell binds with Ig G on T-cell surface, thus cause hypersensitive

reaction.

14) Passage of stratum corneum from transdermal drug


delivery system depends on?
a. Osmosis
B. Diffusion

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C. Partition
D. Protein assisted absorption
Ans. B

15) In schizophrenic patient with Alzheimer and Parkinson disease if


haloperidol is used. Because haloperidol:
A) Is high potent neuroleptic with less extra pyramidal effect
B) Is high potent neuroleptic with less anticholinergic effect
C) Is high potent neuroleptic with less sedation
D) Is least potent neuroleptic with high extra pyramidal side effects
E) Is least potent neuroleptic with high anticholinergic effect
Ans. C
Tips. Haloperidol is the high potency typical antipsychotics however
has less sedation (antihistamine) side effect.

16) In hospital emergency error high dose of heparin is


administered. What is used to reverse the effect?
A. fresh frozen plasma
B. vitamin K injection
C. Oral vitamin K
D. Protamine sulphate
E. Daunosumab
Ans. d

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17) A women comes to your pharmacy explains her
symptoms of vaginal irritation, yellow and fishy odor
discharge, which of the following can be cause of these
symptoms?
A) Candida infection B) Viral infection C) Fungal D)
Bacterial infections E) Allergic
Ans. D
Tips. Odor discharge and yellow color discharge are typical
symptoms of bacterial or Trichomonas symptoms. However
pruritus is the typical symptoms candida infections.

18) A woman phoned the pharmacist and told him that her husband has
swallowed 20 tabs of acetaminophen 325 mg. What is the proper advice?
A) Ask her wait and watch, he will be ok
B) Induce emesis-using ipecac
C) Call the poison center to ask for advice
D) Take him to the emergency department
E) Call doctor to ask what to do
Ans. C
Tips. The overdose of symptoms acetaminophen toxicity within 24 hours is
nausea and vomiting.
Symptoms:
Phase I (12-24 hrs) nausea, vomiting, anorexia, and sweating
Phase II (1-4 days) No symptoms (asymptomatic)
Phase III (2-3 days in untreated patient): nausea, abdominal pain, liver failure,
coma and death.
Treatment for more than 7 g in adults, 100 mg/kg in children
treatment is recommended. elderly and alcoholic patient higher
chance of toxicity. Within 2 hrs toxicity should be treated by ipecac

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or gastric lavage. The N-acetyl cysteine is an antidote is used for
patients with toxic blood levels .

19) All of the following are the risk factors for deep vein thrombosis,
except?
A. estrogen therapy B. Immobility C. pregnancy D. malignancy
E. osteoarthritis
Ans. E
T= trauma H= hormones (OCP) R= road accidents O =operation
(cholestectomy); M = malignancy B = blood dysorders
(polycythemia); O = obesity, old age, orthopedic surgery S= serious
illness, I= immobilization S= splenectomy.

20. What laboratory values should be periodically monitored on a


patient that has just been prescribed valproic acid to generalized
seizure?
A. Complete blood counts
B. Liver function test
C. Renal function

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D. Blood pressure
E. Triglycerides
Ans. B
Tips. Valproic acid is hepatotoxicity require liver function test
monitoring.

21. JP is 35 year old man. He has been diagnosed hypertension, high


triglycerides and high blood sugar levels. He became health
conscious and he recently quit smoking. Which of the following is
NOT a withdrawal symptoms?
A. weight gain B. constipation C. blurred vision D. Craving E.
Headache
Ans. C
Tips. Smoking cessation symptoms includes. Severe craving, anxiety
or irritability, restlessness, nervousness, difficulty with
concentration. Sleep disturbance, headaches, increase appetite
(weight gain) or eating habit and constipation.

22) How many mEq of Mg2+ are present in 50 ml of 20%


MgSO 4 solution? (MW of MgSO4 246 g)
A. 31.56
B. 81.30
C. 101.52

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D. 41.25
E. 2.60%
Ans. B
50ml of 20% MgSO4 = 10 g
Equivalent weight = 246/2 = 123 g
Total mEq of Mg2+ = (10/123)x1000 = 81.30 mEq

23. Addition of permeability enhancer to increase of permeation of


drug from transdermal drug delivery system (TDDS) by which
mechanism?
A. Change lipid content in the skin by solubilising lipid content within
stratum corneum
B. Change of skin absorption system by decreasing diffusion of drug
in to system
C. Interact with skin to decrease the flux
D. Decrease diffusion coefficient
E. Increasing the water content of stratum corneum
Ans.A
Tips. Stratum corneum contain 50-80% water. The permeability
enhancer (surfactants) increase lipid content of stratum corneum
thus enhance absorption of topical drugs.

24. What is correct about vaccination?


A. Dukoral vaccine is given 3 months before travel

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B. Pneumococcal vaccine is given annually
C. Flu vaccine is not given for children age 6 months to 5 years
D. Tetanus toxoid is given every 10 years up to adolescent
E. Hepatitis vaccine is NOT recommended to travelers
Ans. D.
Tips.
Dukoral. 2 dosage 1 week apart, first dose 2 wks before travel.
Pneumococcal vaccine q5 to 10 yrs.
Vaccine
Flu vaccine annually
pneumococcal 5-10 y
Dukoral Effective up to 3 yrs
Hepatitis A and B
Gardasil 12-26 yo
Zostavax >55 yo

25) In insurance plan drug price is $29.00 and $6.00 prescription fee.
Every time this patient pays $2.00 for each prescription what is it
called?
a. Coinsurance
b. Co-payment
c. Prescription fee
d. Gross margin
Ans. B
Tips. Each time patient pays specific amount is co-payment.
Deductible Co-payment Co-insurance
Pay onetime in the Pay each time for every Each time you share the
beginning of every year. prescription expenses

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26) A 60 year old patient is suffering from CHF. He is taking Captopril
25 mg tid and Carvedilol 25mg bid. His LVEF 35%, BP 115/82,
Creatinine clearance 65 ml/min, Serum potassium 6.15 mmol/L,
Serum sodium= 140 mEq/L. If doctor considering to treat edema.
Which of the followings should not be added to this patient?
A) Digoxin
B) Furosemide
C) Spironolactone
D) Hydrochlorothiazide
E) All of the above
Ans. C
Tips: Lab results of potassium (normal K levels to 3.5 to 5 mmol/L)
shows 6.15 mmol/L thus adding potassium sparing agent like
spironolactone may increase potassium. Therefore avoid
spironolactone.

27) Which of the following is the most common symptom of benign


prostatic hyperplasia?
A. strong urinary stream
B. Urinary frequency

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C. Jet urination
D. turbid urine
E. Hypovolemia
Ans. B

28) A 52 yo women using Synthroid 75 mcg daily dose. Recently her


blood test done it showed her 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
Ans. D
Tips. TSH are less than 0.4 mU/L is indicator of overdose of
Synthroid, thus decrease dose.

29) A researcher develops a new drug to prevent the common cold in


children over the of two. 1000 children received placebo and 1000
received the drug. During the one-year follow up the research
diagnosed colds in 2.5% of the kids on placebo and in 2% of the
active treatment. What is the absolute risk reduction?

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A) 0.5% B) 20% C) 10% D) 40% E) 5%
Ans. A
Tips. Absolute risk reduction (ARR) = EER CER : 2.5%-2% = 0.5%

30) DVT patient should be always monitor for symptoms of?


A. Pulmonary embolism B. Blood pressure C. high cholesterol D.
blood glucose E. age
Ans.A

31. Which kind of arrhythmias caused by increased temperature?


A. ventricular premature depolarization
B. ventricular tachycardia
C. Paroxysmal arrhythmias
D. Ventricular hypertrophy
E. Atrial fibrillation
Ans. C

32) What drug decrease mortality and morbidity in congestive heart


failure?
a. enalapril B. captopril c. digoxin D. amlodipine E.
metoprolol and enalapril
Ans. E

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Tips: The first line therapy for CHF is ACEi and BBs.

33) Which of the followings is used as an emulsifying agent?


A. Petrolatum
B. Triethanolamine oleate
C. Aluminum acetate
D. Witepsol
E. Sodium alginate
Ans. B

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33. What is the drug of choice for secondary prevention of stroke with atrial
fibrillation?
A. warfarin B. ASA 81 mg C. clopidogrel 75 mg D. Dipyradamol 200
mg + ASA E. Ticarugrel
Ans. A

34) If Drug A 500 mg sustain release product is given every 12 hours


and Drug B 250 mg of immediate release product is given every 12
hours, assuming the bioavailability of product is the same.
A. Drug A and drug B, AUC will be equivalent at steady state
B. Drug A and drug B Cmax will be equivalent at steady state
C. Drug A and drug B Tmax will be equivalent at steady state
D. Drug A and drug B AUC, Cmax, Tmax will be equivalent at steady
state
Ans. A

35) Necrosis is?


A. death of tissue due to lack of O2
B. death of liver cells
C. death of bone cells
D. death of nerve cells

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E. All of the above
Ans. A
Tips: cardiac tissue ischemia (O 2) infarction necrosis

36) What is the drug of choice to treat Chlamydia infections?


A. Cefixime
B. Ceftriaxone
C. Ciprofloxacin
D. Azithromycin
Ans. D

36) What has +ve inotropic effect?


A. Propranolol
B. Dobutamine
C. Enalapril
D. Nadolol
E. Nifedipine
Ans. b

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37) A 75-year-old patients suffering from pneumonia. Her daughter
is looking after her. She has 2 children at home. Doctor hesitates to
give flu shot to the patient. What will doctor do?
A) Immunize other family member
B) Send him to nursing home
C) Do not gives flu shot to others
D) Flu vaccine is irrelevant
E) Refer to emergency
Ans: A

38) Cholesterol is synthesized in?


A) Blood circulation
B) Liver
C) Bacterial cell wall
D) lymphatic system
E) Adipose tissue
Ans. B
Tips: endoplasmic reticulum of cell. More commonly in liver cells.
Most bacterial do NOT synthesize cholesterol.

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39) If a pediatric patient is to receive ampicillin oral suspension,
which of the following is NOT important?
A) Affix label of expiration date
B) Affix an auxiliary "shake well before use" label
C) Ensure the patient is NOT allergic to penicillin's
D) Use aseptic techniques to reconstitute the medication
E) Label store in refrigerator
Ans. D
Tips. All extemporaneous preps should contain expiration date. All
oral preps need NOT to prepare in sterile conditions. Only
parenteral, chemo and ophthalmic products require sterile
conditions.

40) What is incorrect about benzodiazepines?


A) Agents lacking 3-hydroxyl group undergo phase I metabolism
B) Most long-acting agents form intermediate metabolite
C) Agents with 3-hydroxyl group are easily metabolized by phase II
metabolism
D. Benzodiazepine have diazepine ring
E. Benzodiazepine are analogs of benzazepine
Ans. E
Tips. benzazepines are 2nd gen antipsychotics such as clozapine,
quetiapine.

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41) A pharmacist adds 400 ml of alcohol (95%) v/v to a 1 litre
of a mouthwash formula. What is the new percentage of
alcohol present if the ordinary mouthwash was labelled as
12% v/v of ethanol?
A) 36% B) 40% C) 45% D) 50%
Ans. A
(400 ml) (95 %) + 1000 ml (12%) = (1400 ml) (X%)
380 + 120 = (1400 ml) (X%)
X% or (X/100) = (500/1400)
X = 35.7

42) Find the absolute bioavailability of comp B tab

Company Dose form Dose Cumulative urinary amount


admin.
A Parenteral 10 mg i.v. 9.4
A Tab 20 mg po 12.0
B Tab 20 mg po 8.2
B Cap 15 mg 6.8
A) 0.94 B) 9.4 C) 0.44 D) 8.2
Ans. C
Absolute Bioavailability = (AUC oral/dose)/AUC iv/dose
=( 8.2/20)/ (9.4/10)
= 0.42/0.94 = 0.44

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43. What is the property of drug that can be found in high
concentration in breast milk?
A. low molecular weight
B. low lipid solubility
C. high protein binding
D. high acidic drugs
Ans. A
Tips
Drug Factors effects on excretion of drug into breast milk;
PKa (dissociation constant)
Molecular size
Lipid solubility
Oral bioavailability
Long acting drugs
Basic drugs

44) A patient weighs 70 kg with normal renal function is injected


with an IV drug for 10 hours. The desired plasma concentration is 15
mg/dL. T of drugs is 1 hr and an apparent volume of distribution is
9 Litres. What is the rate of infusion for this patient?
a) 936 mg/hr
b) 1350 mg/hr
c) 468 mg/hr
d) 93.6 mg/hr
e) 135 mg/hr

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Ans. A
Tips: Vd = 9 L 90 dL k = 0.693/t 1/2
T = 1 hr = 0.693/1
C ss = 15 mg/dL = 0.693
R = C ss x V d x K el
= 15mg/dl x 90 dl x k el
= 935.55 mg/hr

45) How many milliosmoles of calcium chloride are represented in


147 ml of a 10% w/v calcium chloride solution? (MW of CaCl2. 2H2 O
= 147)
A) 300 mOsmol B) 3 mOsmol C) 30 mOsmol D) 200 mOsmol
E-100 mOsmol
Ans. A
(147 x 10)/100 = 14.7 ml
[(14.7 ml x 3)/147] x 1000 = 300 mOsmol

46) A cancer patient is suffering from Anemia due to his


chemotherapy. Which drug is recommended for his
condition?
A) Filgrastim
B) Rituximab
C) Epoetin alfa
D) Interleukin-11
E) Iron + Folic Acid
Ans. C

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47) Patient using bisphosphonates should be monitored for all
except?
A. Calcium levels
B. vitamin D levels
C. Bone pain
D. DXA test
E. Lung function test
Ans. E
Tips: DXA: Dual energy X-ray Absorptiometry is used for measuring
bone mineral density. The normal T score -1. If -2.5 is osteoporosis.

48) Which of the following is the drug of choice to treat secondary


prevention of cardiogenic stroke?
A) ASA B) Warfarin C) statins D) Beta blockers E) ACEi
Ans. B

49) A prescriber considering to prescribe carbamazepine for the


treatment of simple partial seizure. What is correct?

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A. Carbamazepine, has non-linear kinetics and so complicated dose
adjustment
B. Phenytoin, has non-linear kinetic at high doses so complicated
dose adjustment
C. Carbamazepine and phenytoin has non-linear kinetics
D. Phenytoin has linear kinetic so dose adjustment is complicated.
Ans. B

50.Which of the following blood pressure a medication therapy


should be initiated to treat uncomplicated blood pressure?
A. 120/80
B. 130/85
C.140/90
D.160/90
E. 180/100
Ans. C
Tips.
Blood pressure.
120/80 Normal
140/90 Treatment or blood pressure therapy should begin
130/80 Treatment in DM, renal disease should begin

51. Emergency contraception?


A. delays ovulation (release of egg from an ovary into a fallopian tube)
B. Removes an embryo from uterus

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C. removes fetus from embryo
D. delays pregnancy
Ans. a
Tips: emergency contraceptive prevents conception by delaying ovulation.

52) Gluathione (GSH) is a tripeptide that contain unusual tripeptide


linkage between aminoacids of?
HS
O
H
HOOC N COOH
N
H
NH2 O
Glutatione

A) L-Glutamic acid, L-Cysteine and glycine


B) L-Glutamic acid, L-Cysteine and valine
C) L-Glutamic acid, L-Cysteine and isoleucine
D) L-Glutamic acid, L-Cysteine and tryptophan
E) L-Glutamic acid, L-Cysteine and phenyl alanine
Ans. A
Tips: N-acetylcysteine binds with HS-cysteine and activate
metabolism of toxic intermediate.

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53) Which gland does aldosterone secrete from?
A) Anterior pituitary gland
B) Adrenal Cortex
C) Pancreas
D) Hypothalamus
E) None of the above
Ans. B
Adrenal cortex inner layer testosterone
Middle layer corticosteroids
Outer layer aldosterone
Adrenal medulla epinephrine (adrenaline)

54) Inadequate blood circulation (perfusion) to the kidneys, which


leaves them unable to clean the blood properly, is characterized as?
A-Intrinsic acute renal failure B) Post renal acute renal failure
C) Prerenal acute renal failure D) Chronic renal failure
E-Chronic liver failure
Ans. C
Tips. Prerenal ARF is characterized by inadequate blood circulation
(perfusion) to the kidneys, which leaves them unable to clean the
blood properly. Many patients with prerenal ARF are critically ill and
experience shock (very low blood pressure). There often is poor
perfusion within many organs, which may lead to multiple organ
failure.

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55) You have a perpetual inventory record in the hospital for
narcotics and controlled drugs. The following is/are true:
A) It is a continuous record.
B) Purchases added and products delivered are subtracted.
C) Products when returned from the ward are added to the
perpetual.
D) All of the above.
E) None of the above.
Ans. D

56) When filling a prescription for Tylenol with codeine 30 mg, a


pharmacist should do all the following, except?
A) Fill the prescription as a verbal narcotic preparation
B) Affix a auxiliary label cautioning against performing tasks
requiring alertness or driving
C) Verify that patient is NOT allergic to acetaminophen or codeine
D) Inform the patient refills are only provided as doctor prescribed.
E) Ask patient to monitor constipation and recommend senna or
docusate
Ans. D
Tips. Tylenol # 3 are narcotic preps or verbal narcotics and straight
narcotics have no repeats.

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57) In a DNA, if a base sequence is AGT, what is the
complimentary paired base sequence?
A) ACG B) GUC C) AAC d)TCU e) TCA
Ans. E

Tips. A--T, G -- C, T --A are complimentary pairs.

58) A patient taking OCP and have spot vaginal bleeding on day 14 to 16.

What is cause?
A. Deficiency of estrogens
B. Deficiency of progestin
C. Deficiency of estrogen and progestin
D. Deficiency of androgen
E. Deficiency of hCG
Ans. B

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59) Which of the following is the overdose symptom of levothyroxine?
A. weight gain
B. constipation
C. hair loss
D. oily skin
E. sensitive to cold
Ans. d

60) Psychotic patients non compliant and unreliable in taking


medication. Which of the following strategy enhance compliance?
A) Recommend long acting or depot dosage forms
B) Education geared towards patient becoming more informed about
their illness.
C) Recommend rapid dissolving dosage form
D) Recommend non pharmacotherapy like cognitive behavioral
therapy
E) Hospitalization
Ans. A

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61. MP is 70 yo women with Parkinsonism, her treatment for Parkinsonism is
responding well. Recently her dr. diagnosed with atrial fibrillation and prescribed
amiodarone 200 mg daily. Which of the following test should be monitored after
initiating amiodarone therapy?
A. blood pressure
B. Tardive dyskinesia
C. Serum TSH
D. Rigidity
E. Dystonia
Ans.c

62) Protein C and its cofactors S?


A) Anticoagulants
B) Thrombolytic
C) Localize clot
D) Dissolve the clot
E) increase vitamin K clot factors effect
Ans. C

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63) Two generic brands of drugs with equal strength are
given orally. Tablet A results in AUC 250 (mg/L)x hour and
Tablet B results in an AUC 500 (mg/L) x hour. Which product
has better bioavailability?
A. Tablet A has higher bioavailability
B. Tablet B has higher bioavailability
C. Tablet A and Tablet B has equal bioavailability
D. Tablet A has high bioavailability then Tablet B
Ans. B

64. The following tamoxifen structure is an example of?

A. optical isomer B. geometric isomer C. analog D.


enantiomer E. diasteroisomer
Ans, B

65. Bone formation is done by?


A. denosumab
B. alendronate
C. Ralaxofine
D. Teripertide
E. Residronate
Ans. D

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Tips:
Bisphophonate: inhibit osteoclast and increase BMD
Teriperatide: increase bone formation.
Raloxofine: bone growth by increasing estrogen

66) Muromonab (OKT3) is monoclonal antibody indicated?


A) Renal, cardiac and hepatic graft rejection
B) Neutropenia associated with cancer chemotherapy
C) Thrombocytopenia associated with cancer chemotherapy
D) Anemia associated with chronic renal diseases
E) None of the above
Ans. A

67. A patient has been prescribed combination of clopidogrel 75 mg


and Aspirin 325 mg, this is indicated in patients who have had?
A. ST-segment elevation myocardial infarction.
B. Congestive heart failure
C. Acute stroke
D. Transient Ischemic stroke
E. Stable angina
Ans. A

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68) How many grams of 60% w/w HCl acid should be added to 100 g
of 40% w/w HCl acid to prepare 400 g of 55% w/w HCl acid?
a) 300 g b) 250 g c) 150 g d) 100 g e) 50 g
Ans. A

60 15 (60%)
55
40 5 (40%)
-----------
20
400 : 20 = X : 15 ; 400/20 = X/15; 400 x15/20 = X
X= 300 g

69) You are giving ZnCl2 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) Isotonic b) Hypertonic c) Hypotonic d) Iso-osmotic
e) Isotonicity cannot be finding.
Ans. C
Tips. (0.7 x 0.16) + (0.1 x 0.32)+ (1.1 x 0.5) = 0.0694
= 0.0112 + 0.0032 + 0.055
NaCl = 0.9/100 = 0.009>0.00694 = Hypotonic

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70) 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

71) What is the sensitivity of a balance that can weight 120


mg of a substance and has a permissible error of 5%?
a) 6 mg b) 16 mg c) 66 mg d) 26 mg e) 1.6 mg
Ans. A SR = Weight x Error 15 = weight x 5/100 = 6
mg

72) If the rate of infusion of the drug is 750 mg q6hours and


clearance is 8.3 L/hr. Find steady state concentration.
a) 15.06 g/L b) 15 mg/L c) 150 mg/L d) 90 mg/L
e) 24.7 mg/L

Ans: B Css = Rate of infusion = 750/6 = 15 mg/L

36
Clearance 8.3

73. A patient clinical presentation include coarse features,


dry skin, hair, bradycardia and hypertension may be?
A. hypothyroid
B. hyperthyroid
C. hypoglycemia
D. hyperglycemia
E. hypo corticosteroid
Ans. A

74) Which one of the followings is a -lactamase inhibitor?


A) Cloxacillin
B) Linezolid
C) Clindamycin
D) Clavulanic acid
E) Pentamidine
Ans. D

37
75.Which of the following infection prevents recurrent
middle ear infection in children?
A. Flu vaccine B. Polio vaccine C. Measles vaccine D.
pneumococcal vaccine
Ans. D

76) Which of the following drugs give side effects like


depression, bradycardia and bronchospasm?
A) Salbutamol
B) Propranolol
C) Prazosin
D) Digoxin
E) Amiodarone
Ans. B
Tips. BB that penetrate in brain cause CNS side effects.

77. Which of the following bacteria is the most common cause of


middle ear infection in children?
A. H. influenza B. S. pneumonia C. M. catarrhalis D. E. coli
Ans. B

38
78) Mechanism of bisphophonates?
A. Inhibit osteoclast formation
B. Inhibit osteoblast formation
C. Increase osteoclast formation
D. increase osteoblast formation
E. All of the above
Ans. A

79) To avoid dispensing error, pharmacist can check and verify all of
the followings before dispensing a prescription, except:
A) Patients name, address and date of birth
B) Name of the drug prescribed
C) Drug strength
D) Directions for use
E) Manufacturers name
Ans. E

39
80) A patient call the pharmacy asking why his heart medication is yellow
instead of the usual white color. Upon investigation, it is discovered that the
prescription was filled with digoxin 0.125 mg instead 0.25 mg strength. Which
of the following is the most appropriate action to take?
A) Tell patient to take two tablets daily
B) Tell patient cut the tablets in half and take one half tablet daily
C) Ask the patient to call doctor immediately to inform inappropriate intake of
digoxin and document
D) Explain the situation to patient and ask the patient to bring the medication
to replace with correct and document the error.
E) Prepare a new prescription with 0.25 mg strength and inform the patient
that pharmacy manager is solely responsible for accuracy of prescription
Ans. D

81) A prescription direction says tabs ii stat pc; tab i pc od. In this
prescription, the term od can be differently meant as
A-Right ear
B-Left ear
C-Both the eyes
D-Left eye
E-Right eye
Ans. E
Tips. o.d or OD

40
82) What dosage form of drug is preferred post cataract
management?
A. oral B. Injection C. Topical D. Sublingual
E. OTIC
Ans. C

83) 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

84) 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

85) Rasagiline is IRREVERSIBLE selective MAOi type B


inhibition, it irreversible action is due essential moiety
present as?

41
A) propargylamine B) alkylamine C) catecholamine D)
dihydroxyl group
Ans. A
Tips: propargylamine group is essential for irreversible action
of Rasagiline and selegiline.

86) Sequence of blood flow through heart to brain?


A. left ventricular aorta carotid artery
B. right ventricular aorta carotid artery
C. left ventricular aorta pulmonary artery
D. right ventricular aorta carotid artery
Ans. A

87) A patient is taking salbutamol and fluticasone. He brings a new


prescription of propranolol. What type of interaction is expected?
A) Drug and Disease interaction B) Drug and food interaction
C) Drug and Drug interaction D) Both A & B E) Both A & C
Ans. E
Tips. Salbutamol is beta 2 agonist and propranolol is beta 2 blockers.
cause drug-drug interactions. Propranolol can worsen asthma thus
drug and disease interactions.

42
88) Which of the following is an essential building block of
folate antagonist (PABA) and antimetabolites anticancer drug
methotrexate?
A. Purine analog guanine and adenine
B. Pyrimidine analog cytosine, thymine, and uracil
C. Para aminobenzoic acid
d. nucleotide analog
Ans. C
Tips: methotrexate and 5-FU are PABA analogs

89) The most important enzyme in a polymer chain reaction


(PCR) reaction is called?
A. Reverse transcriptase
B. DNA restrictive polymerase
C. Taq polymerase
D. Lyase
E. Ligase
Ans. C
Tips. Taq polymerase enzyme is produced from Thermos
aquaticus bacteria and is used in PCR.

43
90) 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.

91) A nurse gave wrong medication to patient. Which step would be


appropriate?
A. complain to doctor
B. Formally report to ward supervisor
C. Report to pharmacy manager
D. Report to ISMP
E. Report to Health Canada
Ans. B

92. Which enzyme is require for virus to escape already infected


cell to new cell?
A. Nucleoaminadase B. reverse transcriptase C. nucleo
polymerase D. RNA polymerase
Ans. B

44
93) According to institute of safe medication practice (ISMP)
guidelines, which of the following is the least confusing
abbreviation?
A) q4h B) per os c) q.d d) g e) mg
Ans. A
Tips. q6h or qid

94)A pharmacist would like to make a compound prescription where


he needs to mix 1% of camphor into white petroleum. Which would
be the appropriate technique to be used by the pharmacist
a) Trituration
b) Levigation
c) Pulverization by intervention
d) Geometric dilution
e) Attrition
Ans. B
Tips. Camphor (pulverize with ethanol) gives eutectic mixture.
Ointment slab take white petrolatum and pulverize camphor
geometric dilution

45
95) Zero order, except
A. Independent of concentration
B. Time dependent
C -dc/dt = Ko
D. Slope k/2.303
E. Example Photochemical degradations
Ans. D

96) Which one is incorrect among the following drug-side


effect relations?
A) Amphetamine-Weight gain
B) Verapamil- Constipation
C) Prazosin-Postural hypotension
D) Atorvastatin-Myalgia
E) Zopiclone-Metallic taste
Ans. A

46
97) You have 20 ml ampoule having a concentration of 0.75% and
you need to prepare 250 ml solution having concentration of 0.125%,
so what the volume of liquid needed to dilute the solution?
A) 75 ml B) 42 ml C) 250 ml D) 125 ml E) 20 ml
Ans. B
How to solve:
C1 x V 1 = C 2 x V 2
0.75 x V 1 = 0.125 x 250
Therefore V 1 = 41.67 ml

98) All are tertiary literatures, Except:


A. Compendium of Therapeutic choice
B. Remington
C. Medline
D. Martindale
E. Compendium of Therapeutic Minor Ailment
Ans. C
Tips. Text books are tertiary literature and Medline is an
index therefore it is secondary literature.

47
99) What correct instructions should be labelled in the
following preparation?
Salicylic acid 2%
Lactic acid 6 ml
Flexible collodion ad 30 ml
A- Flexible collodion is extremely flammable.
B- Tightly close the container to prevent ether and alcohol.
C- Keep away from fire
D- All of the above
E- None of the above
Ans. D

100. Mercaptopurine are chemical analog of?


a. Purine antagonist
B. Pyrimidine antagonist
C. Folic acid antagonist
D. Nucleotide analog
Ans. A
Tips. Mercaptopurine are purine (adenine and guanine)
analogs, 5-FU is analog of pyrimidine bases (cytocil, uracil,
and thiamine) and methotrexate is an example folate
antagonist.

48
101) 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
Ans. E
Tips: Mass spectrometer detects molecular structures based
molecular weight ions. Thus this can be used for unknown
chemical structures.

102) A patient with renal clearance 120 mg/ml and now changed 200
mg/ml, because?
A. Increase tubular secretion
B. Decreased tubular section
C. Increased reabsorption
D. Decreased glomerular filtration
E. None of the above
Ans. A

49
103. Hospital pharmacy hiring a pharmacy technician for IV
reconstitution. She has been asked, if nurse advise about administration
of drug and for the same pharmacist differs in advise. What is
technician opinion?
A. accept pharmacist advise
B. accept nurse advise
C. do not accept nurse and pharmacy and do due diligence
D. Call doctor and ask for advise
E. accept both nurse and pharmacist
Ans. A

104) Mr. Masons mother is a patient of your pharmacy. Now Mr. Mason
wants to admit her into a rehabilitation centre. He thinks that it will help her
to improve her health condition. He requests you to talk to his mother. Both of
you have tried to convince her to go there. Although she thinks that it will not
make any difference and she does not want to go there. Which ethics have you
applied (uphold) as a pharmacist?
a) Paternalism
b) Beneficence

50
c) Autonomy
d) Veracity
e) Justice
Ans: b

105) A patient is taking prednisone for 3 months, which is


true?
A. Avoid taking with grapefruit juice
B. Do not stop taking it suddenly
C. Take with meals
D. Take an empty stomach
E. Take with full glass of water
Ans. b

106) A new patient came to your pharmacy with a


prescription of a narcotic from a walk-in clinic and it is,
written in to be used, AS DIRECTED. What would you do?
A. Dispense the prescription
B. Call the clinic to know direction of use
C. Call the clinic to verify the prescription
D. Send the patient to another pharmacy
E. Call the clinic to know the exact amount
Ans. C

51
Tips. Narcotic prescription should specify exact "mitte" or
direction should be clearly state frequency and days.

107) What is incorrect about schedule III drugs?


A) Prescription not required
B) Bacitracin
C. Nicotine patch
D. Folic acid
E. Tylenol # 1
Ans. E

108) A diabetic patient came to you complaining about his


hyperglycemia; you noticed that he is buying a rich chocolate, sugar
candies and food containing high carbohydrates. What should you
do?
A) Advice him and explain the risks and ask her see her
physician/Display high sugar/caffeine content product
B) Let him decide what he wants
C) Try to forbid him from buying those items
D) Refer her to doctor
E) Refer her to emergency
Ans. A
Tips. First ask patient is it for you?

52
109) In renal failure CaCO3 is given to treat?
A. hyperphosphetemia
B. Hypophosphetemia
C. Hyperkalemia
D. Hypokalemia
E. Hypercalcemia
Ans. a

110) A senior pharmacy technician has a worked in a community pharmacy for


10 years. He is well trained and welcomes new learning opportunities. His
manager now wants to delegate a new technical project to him, should:
I. Discuss suggested steps to accomplish the project
II. Negotiate a time schedule for completion of the project
III. Provide support and follow up as required
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
Ans. E

53
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.

111.Which of the following is the incorrect statement?


A. Aqueous humour is formed from ciliary body
B. Tears are produced by lacrimal gland
C. Ear wax is produced by ceremonial gland
D. Cold sore are related to HSV 1
E. Mouth ulcers are related HSV 2
Ans. E
Tips. vestibular glad, moist in ear. Sebaceous gland produce sebum and cause acne. Salivary
gland. Debecutus gland in rectum cause pressure atrophy.
Secreting glands
ciliary body
lacrimal gland
ceremonial gland
Sebaceous gland
Salivary gland.

112) Cochrane collaboration databases are?


A. Evidenced based medicine database
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

54
113) A clinical trial application must be submitted to health
Canada prior to?
A) Preclinical laboratory studies in animals
B) Phase 2 clinical trial but after phase 1
C) Phase 3 of clinical studies but after phase 2
D) Phase 4 of clinical studies but after phase 3
E) Phase 1 clinical trails
Ans: E

114) Anabolic steroid used for to enhance athletes


performance are regulated as?
A. narcotics
B. control drug part 1
c. control drug Part II
D. control drug part III
E. targeted substances

Ans, D

55
115) Vitamin C contains?
A. drug identification number
B. Product identification number
C. Natural product number
D. Homeopathic Number
E. Pseudo DIN
Ans. C
Tips: all natural products, vitamins and nutritional supplements have
NPN.

116) When only the patient does not know whether he is


taking the drug or placebo, the trial is called:
A) Single blind B. Un blinded C. double blind D-triple
blind
E-Randomization
Ans. A

56
117) How many 500 mg tablets of Ciprofloxacin HCl is
required to prepare 240 ml of 2% Ciprofloxacin HCl solution?
A. 5 Tablets B. 10 Tablets C.20 Tablets D. 25 Tablets
E)30 Tablets
Ans. B

118) Find out the ratio of ionized to unionized species of


drug at pH 7 (pKa = 5)
A) 100 B) 150 C) 1 D) 10 E) 1000
Ans. A
Tips.
pH = pKa + Log (salt/acid)
7 = 5 + Log salt/acid
Log salt/acid = 2
salt/acid = 102 = 100

119) All are correct about Irritable Bowel Syndrome, Except?

57
A) It is associated with a greater risk of stomach cancer.
B-Stress may aggravate IBS
C-Avoiding candies, gums and caffeine help to improve the
condition
D-It may be constipation or diarrhea predominant
E-Abdominal pain or discomfort is the most common
characteristic
Ans.A

120) A 33 years old patient with diabetes type I. He is taking basal insulin NPH
30/70 40U in the morning and 50U at night, and using Insulin IR 200U BID
(morning and bedtime). His blood glucose level is as such:
Morning Noon Supper Bedtime
3-5 7 5 8
(A) Reduce IR dose in the morning and increase IR dose in the evening
(B) Change Insulin NPH to insulin glargine (Lantus)
(C) Avoid giving insulin IR and keeps him on basal insulin NPH
(D) Reduce insulin NPH dose at night, and increase insulin NPH in the morning
(E) None of the above
Ans. D
TIPS. The regular (IR) insulin has no effect on the morning and night
level. It may have in the afternoon or early morning. However the
basal insulin should be adjusted, taking into consideration no change
in the diet or physical exercise.

58
121) A pharmacy dispensing error dispensed Pradaxa (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
Ans. C
Tips. Pradaxa is a new anticoagulant dabigatran act as factor Xa
inhibitor. However Plavix is clopidogrel an antiplatelets drugs. So
increase risk of bleeding

122) A patient had a recent MI, but he like stop smoking. What is
contraindicated?
A. bupropion b. vareniciline C. NRT D. clonidine E. cold
turkey method
Ans. C

123) A pharmacist can effectively prevent dispensing error by


checking the following?
A) Patient date of birth
B) Drug identification number (DIN)
C) Color of pills

59
D) Shape of pills
E) Physician name
Ans. B

124) What is incorrect about, iron supplements?


A) The highest elemental iron supplement is = ferrous fumarate
B) The highest iron supplement that have GI absorption = ferrous
gluconate
C)The iron supplement common side effect = constipation
D)The iron supplements preferable taken = empty stomach
E) The iron supplements + vitamin C = decrease iron absorption
Ans. E
Tips. Vitamin C or ascorbic acid increase iron absorption.
Fe.fumerate 33%
Fe. sulphate 20%
Fe.gluconate 12%

125). Beta carotene undergoes oxidative cleavage to partially


produce vitamin A in gastrointestinal tract by which of the enzyme?

60
A. CYP450
B. Alcohol dehydrogenase
C. Dioxygenase
D. CYP3A4
E. Oxidative deamination
Ans. C

126) What is incorrect about sitagliptin (Januvia)?


A- Inhibitor of dipeptidyl peptidase enzyme (DPP-4) that enhances
the incretin hormone
B- Can cause hypoglycemia with sulfonylureas
C- Not used in type I diabetes, there is no clinical studies
D- Can be taken with or without food
E- Drug of choice for the type I diabetes mellitus
Ans. E
Tips: T2DM therapy sequence
Metformin sulfonylureas insulin or gliptins or GLP-1 or
SGLT2 inh
T1DM therapy: insulin

127.All of the following drug formulation are contain osmotic


pump design technology? except
A. Enteric coated ASA
B. verapamil (Covera HS)
C. methylphenidate (Concerta)

61
D. Glipizide (Glucotrol)
E. Oxybutynin (Lyrenel XL)
Ans. A

128) An angry father comes to your pharmacy. He has found oral


contraceptives in his 14 years old daughters drawer. He accuses you of loosing
social values and supporting his daughter to get derailed. He wants to see her
profile right now. What would you do?
A) Tell him, that you cannot breach confidentiality
B) Just ignore him and call your junior pharmacist to manage the situation
C) Show him the daughters profile, as he seems to be a very responsible father
D) Tell him to talk to his daughter and to ask her why she is taking the
medication.
E) Tell him to bring his daughter with him, then he can see the profile
Ans. D

129) MK is 50 year old occasional customer of your pharmacy approaches for


refill of rosuvastatin 20 mg tab daily for 3 months. While discussion MK, his
wife is nurse and checked his blood pressure at home and it was 150/90.
Pharmacist advised him to check his blood pressure in pharmacy monitor.
Pharmacy blood pressure monitor shows 155/90. What is appropriate action?
A) Ask how did his wife checked his blood pressure
B) Refer to doctor for further assessment
C) Should be referred emergence for urgent treatment
D) Recommend low dose hydrochlorothiazide 25 mg until see his doctor
E) Recommend self-care measure like reduce salt intake and physical activity

62
Ans. B

130) If patient used Lasix (furosemide) instead of Losec


(omeprazole). What problem is expected?
A) Hyperglycemia
B) Hyperthyroidism
C) hypotension
D) Hypercalcemia
E)None
Ans. C
Tips. Lasix is furosemide can cause hypotension. Losec is
omeprazole.

131) What is NOT a clinical presentation of insecticide poisoning?


A) diarrhea
B) diaphoresis
C) Urination
D) Miosis
E) Constipation
Ans: E
Tips: Anticholinesterase toxic symptoms are lacrimation, salivation,
sweating, diarrhea, miosis, urination, vomiting, and shortness of
breath (DUMBLESS)

63
132) Which of the following ophthalmic conditions required referral
to doctor?
A) Red eye B) Pain in eye C) Blurred vision D) Dry eyeE) B and C
Ans. E

133. The following structure non super imposable on its mirror


images, shows R and S configuration. This optical isomerism is
defined as?

A. diasteromers B. optical isomers C. enantiomers D. Geometrical


isomers
Ans. C

134) A prescription for codeine 15 mg


Give 60, I tab/day 30 days x1
Is this prescription acceptable?
a) No, because refills are not allowed
b) No, because part fill are not allowed
c) Yes, because the total amount is clear
d) Yes, because the amount is easily identifiable

Ans.c

64
135) A patient is 5 years old child was kept on a regimen of and
fluticasone 1 puffx2. Patient is suffering with daytime coughing twice
weekly, and wakes up once weekly. The patients asthma was still
not under control. What is appropriate dosage form is recommended
to children <8 year age?
A-Turbuhaler
B. Nasal spray
C. Meter dose inhaler and aerochamber
D) Handihaler
E) Diskus
Ans. C

136) Low molecular weight compounds that act as


immunogens after chemically complexing to a larger
molecule or cell surface is called:
A. Hapten B. Haploid C. Diploid D. Immunogens
E. Antigen
Ans-A

137) Special access program (SAP) is used to?

65
A) To obtain drugs that are not approved to sale in Canada
B) To obtain compassionate drugs from manufacturer
C) To obtain illegal drugs or street drug from health Canada
D) To obtain drug that do not have safety information
E) To obtain narcotics and control drugs form health Canada
Ans. A
Tips. Health Canada special access program (SAP), provides
drugs that are NOT approved in Canada or investigational
drugs by special request from prescribers.

138) What is the pharmacist concern in patient using fixed ratio insulin?
A) Exercise before insulin dose
B) Snacks between meals
C) Patient compliance
D) Patient age
E) Types of insulin
Ans. B

138). What is the most common side effect of bupropion?


A. Nausea B. skin rash c. Insomnia D. dry mouth E. dizziness
Ans. d
Tips: Dry mouth (19%); nausea (15%), insomnia (10%), constipation
10%

139) The Pharmaceutical and Therapeutics (PT) committee is


responsible for all, EXCEPT

66
A) The evaluation and selection of all drugs currently in use in
the hospital
B) Setting of use for all medications in the hospital
C) Setting standards with that third party
D) Evaluating drugs based on drug studies, available literature
and financial considerations.
E) Education program for staffs
Ans. C

140. The following chemical structure is the type of essential fatty


acids?
15 12 9 1
COOH

A. Linolenic acid B) Lenoleic acid C) Omega 6 D) DHA E) EPA


Ans. A
Linolenic acid = omega 3 = three double bond
Linoleic acid = omega 6 = two double bond

67
141. 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

142) A patient 16 year old with Community Acquired Pneumonia. He


has allergy to penicillin. The following medication may be given to
him to treat his pneumonia:
A) Imipenem-Cilastatin B) Ciprofloxacin C) Cefixime D)
Cloxacillin E. Doxycycline
Ans. E
Tips. The drug of choice in CAP is amoxicillin, doxycycline,
azithromycin, clarithromycin. If allergic to penicillin can use
doxycycline, azithromycin and clarithromycin. Respiratory tract
quinolone levo and moxifloxacin are used for pneumonia.

68
143) If physician name is not readable in prescription, what is
the appropriate action?
A. Call physician
B. Ask patient first
C. Ignore and process prescription
D-Look in computer
E. Write doctor name
Ans. B

144. What clinical study is useful to gather data about a


pandemic disease occurred 10 years ago?
A. Systemic reviews
B. Cross over study
C-Cohort study
D-Case control study
E-Parallel study
Ans-D

69
145) All of the following factors effects on renal creatinine clearance or
estimated GFR, except
A. age
B. stable serum creatinine
C. body weight
D. height
E. race
Ans. d
Tips: Estimated GFR MDRD (Modification of Diet in Renal Disease) depends on
factors CrCl, gender, age, and race
GFR (mL/min/1.73 m2)=186x(SCr)-1.154x(age)-0.203
X(0.742 if female)x (1.210 if African American)

The Modified Cockcroft and Gault equation is a commonly used formula to


estimate creatinine clearance (ClCr) using a stable serum creatinine level and
patient demographics (e.g., age, gender, weight).

1.2 (140age) (weight in kg)


ClCr (mL/min) =
Serum creatinine (mol/L)
For females, multiply the result by 0.85.
Modification of creatinine clearance estimates may be required in some patients. The accuracy of using the
serum creatinine value to predict creatinine clearance is influenced by diseases (e.g., cirrhosis), clinical
conditions (e.g., malnutrition, obesity, spinal cord injuries) and dietary intake (e.g., high consumption of meat).

146) A union negotiating the wages, working hours, and


conditions on behalf of pharmacist with company?

70
A) Arbitration
B) Mediation
C) Collective Bargaining
D) Arguing
E) Consulting
Ans. C

147) Which of the following vitamin is the key in production of


collagen?
A. Vitamin K B. Vitamin D C. Vitamin A D. Vitamin C
E. Vitamin B 12
Ans. D

148. A patient brings you a prescription for 16 mEq KCl. Your


pharmacy has 600 mg KCl (MW 74.5) controlled release tablets. How
many tablets are needed for this patient?
a) 0.5 tablets

71
b) 1 tablets
c) 2 tablets
d) 4 tablets
e) 5 tablets
Ans: C
Working. use the formula MEq = (mg x valence)/(molecular weight)
)Each tablets contains: (600 x1)/(74.5) = 8.05 mEq
Patient needs 16 mEq = 2 tablets

149) Total parenteral solutions number components, the long


duration of contact time and exposure to ambient temperature and
light increase potential for incompatibility. The interaction of
Calcium and Phosphate (PO4) to form CaPO4, can results into fine
white particles that create milky solution. This incompatibility can
described as?
A) Therapeutic incompatibility
B) Physical incompatibility
C) Chemical incompatibility
D) All of the above
Ans. B
Tips: PC

150) A patient currently using dexamethasone eye drops daily for


3 to 4 wks after eye surgery. Another eye doctor prescribed
tobramycin/dexamethasone 2 gtts for 10 days. What is pharmacist
concern?
A. Tobramycin
B. dexamethasone

72
C. duration of therapy
D. prescription from other doctor
Ans. B

151. What is the most reliable study in the following?


A. Randomized clinical trials
b. Randomized double blind clinical trials
C. Stratified clinical trials
D. Observational studies
E. Cohort studies
Ans. b

152. What is correct about phase 2 clinical trials?


A. Healthy population is tested for pharmacokinetics
B. Disease population is tested for effectiveness
C. Large group is tested to eliminate type 2 error
D. Drug is approved for market
E. Post marketing surveillance and pharmacovigilance
Ans. B

153. What is correct about pharmacovigilance?


A. Health Canada MedEffect program release advisories to
healthcare professional about a new side effects of drugs in post
marketing surveillance
B. Health Canada MedEffect program send recall notice about drugs
with defect in manufacturing and packaging.
C. Health Canada gathers information about drugs unknown adverse
drug reactions

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D. Health Canada MedEffect program inform about drugs withdrawn
from market
E. All of the above
Ans. C

154. MP is a pharmacy manager. He was told about a mistake made


by a technician. What will be the proper action as pharmacy
manager?
a) Complain to college of pharmacy about mistake
b) Do a private meeting with the concerned person.
c. Do a meeting for all staff and discuss the incidence
D. Report mistake to institute of safe medication practices Canada
E. Report mistake to the Health Canada MedEffect
Ans. B

155. All of the following is indicator of non adherence of medications


by the patient? Except
A. Patient filling prescription higher interval than it should be
B. Patient filling prescription less frequently than it should be
C. Patient filling only filling partial medication from the all the list of
chronic therapy
D. Patient not filling on time as prescribed
E. Patient fills medications as prescribed by the doctor
Ans. E

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156. A economic analysis that compares the relative costs and
outcomes in effect unit of two or more drugs is described as?
A. Cost minimization analysis
B. Cost effective analysis
C. Cost utility analysis
D. All of the above
Ans. B

157. A patient is abusing medication, what do you do as a


pharmacist?
A. talk to patient and inform this could cause harm to his health
B. talk with doctor about medication abuse by patient
C. talk to patient first and talk to doctor
D. document in pharmacy computer about medication abuse
E. Report to ISMP
Ans. c

158.A customer of your pharmacy was prescribed warfarin 2.5 mg daily. She
is currently using St. John wart to improve her mood related problem. What
is true?
A. St. John wart increase INR

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B. St. John wart decrease INR
C. No change in INR
D. Combination potentiate bleeding
E. Combination cause serotonin syndrome
Ans. b

159. A regular customer of your pharmacy currently using


hydrochlorothiazide 50 mg daily for the treatment of hypertension. She is
looking for some natural product therapy to improve her quality of life.
Which of the following is pharmacist concern?
A. St. John wart B.Ginseng C.Garlic pills D.Licorice E.Saw palmetto
Ans. D

160. Symptoms of Parkinsons disease associated with excessive?


A. inhibition of thalamocorticoneurons
B. excitation of thalamocorticoneurons
C. inhibition of subthalamic neurons
D. dopaminergic transmission
E. Inhibition of output structure of basal ganglia
Ans. E
The basal ganglia are responsible for voluntary motor, procedural learning,
and eye movement as well as cognitive and emotional functions.

161. Contact lens solutions that contain papain are?


A) Surfactants
B) Protein or enzyme cleaners
C) Wetting agents or artificial tears
D) Soft lens
E) Rigid gas permeable lens
Ans. B
Tips: Papain and pancreatin enzymes are present in enzyme or protein
cleaners are used in contact lens solutions.

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Surfactants. Disinfect and remove contaminants.
Protein cleaners or enzyme cleaners contain papain, pancreatin, or subtilism.
Remove protein deposits by catalysing the natural breakdown of debris into
simple compounds.
Wetting and rewetting solutions. Produce cushioning and lubricant effect
between lens and eyelid, between eye and cornea (removes dryness).

162. A 30 yr old woman walks into pharmacy. She want to buy over
the counter pain reliever to treat migraine. All of the following are
migraine symptoms, except?
A) Hemicranial throbbing pain
B) Pain is so bad so that one cannot do usual activity and effect on
quality of life.
C) Nausea and Vomiting
D) Photophobia and get worse around light
E) Facial and shoulder pain
Ans: E
Tips. Facial pain are trigeminal neuralgia. It is not symptom of
migraine. Nauseas vomiting, hemi cranial throbbing pain are classical
symptoms. Shoulder and upper back pain can be present in
fibromyalgia.

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163. Cholecystokinin (CCK)?
A. released from duodenum when fats and proteins digested
B. released from lung upon emphysema
C. released from lungs in COPD
D. Increase appetite by digestion of food
E. Increase prokinetic effect
Ans. A
Tips CCK does fat-absorption (breakdown)

164. Insulin mixed with albumin?


A. Insulin albumin conjugate release insulin slowly
B. Insulin saturated with albumin to minimize hypotensive affect
C. Short acting insulin consist of albumin
D. Delay the onset of action of insulin
E. Insulin absorption increases
Ans. A

165. Which of the following high levels usually indicates iron deficiency?
A. Mean cell volume (MCV)
B) Hematocrit (Hct)
C) Hemoglobin
D) Serum ferritin
E) Total iron binding capacity (TIBC)
Ans. E

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166. Homocysteine level increase?
a. indicate liver problems
B. cardiovascular problems
C. kidney problems
D. lung problems
Ans.b

167. The federal government's roles in health care include all the
below EXCEPT

a) Regulation of pharmaceuticals

b) Consumer safety

c) Disease surveillance and prevention

d) Planning and implementation of health promotion and public


health initiatives

e) Primary care and emergency services

Ans, E

Tips: Primary care immunization and hospitals, emergencies are paid


by provincial taxes

168. Which of the following is increased in bruising after heating?

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A. albumin
B. bilirubin
c. platelet
D. globulin
Ans. D

169. What test is used to diagnose pneumonia?


A. CBC
B. neutrophils
C. monocytes
D. Chest x-ray
e. Basophils
Ans. d

170. All of the following drug taken an empty stomach, except


a. levothyroxine
B. Alendronate
C. Omeprazole
D. Metformin
E. Zafirlukast
Ans. D

171. What is INCORRECT about sunscreen?

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A. Sunscreen products containing PABA need to avoid by the individuals, who
are allergic to benzocaine, sulfonamides, or thiazides.
B. Sunscreen can cause contact dermatitis and photosensitive reactions
C. The UV light is the least between the hours of 10:00 am to 4:00 pm
D. Organic sunscreen absorb UV light
E. Inorganic physical sunscreen reflect and scatter UV light
Ans. C
UV-A protection is important in person using sunscreen.

172. Health professionals, adverse reactions detected through cases should


report to?
A. Canada vigilance program
B.ISMP
C. Candian Institute of Health
D. Canadian pharmacy association
E. Provincial college of pharmacy
Ans.A

173. Which of the following is NOT extra pyramidal symptoms?


A. Tardive dyskinesia B. Rigidity C. Tremor D.
Dystonia E. Vivid dreams
Ans. E

174. . Which of the following is NOT require to monitor chest X-ray ?


A. Methotrexate b. Amiodarone C. Bleomycin D.
Bromocriptine E. Clozapine
Ans. E

175. Smoking?
A. enzyme inhibitor

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B. enzyme inducer
c. metabolic substrate
D. Digestive enzyme
e. catalyst
Ans. b
Tips: smoking is a CYP1A2 inducer

176. Which of the following oral glaucoma therapy?


A. Timolol B. Latanoprost C. Bimotoprost D. Acetazolamide E.
Pilocarpine
Ans. D

177. What is optimal temperature of cold chain?


A. 2 C B. 3 C C. 4 C D. 5C E. 8C
Ans. d

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178. What method of sterilization is used as terminal
sterilization?

A.dry heat,

B.moist heat,

C.Filtration,

D.radiation,

E.gas

Ans. C

179. MP is a 50 yo man with uncontrolled COPD. Currently using salbutamol


PRN and tiotropium daily. His COPD is not controlled and feels very tired and
shortness of breath. Pharmacist preparing pharmaceutical opinion
recommends?
A. Increase dose of salbutamol
B. Increase dose of tiotropium
C. Addition of theophylline
D. Addition of formeterol
E. Addition of fluticasone
Ans. D

Copd treatment:
Salbutamol PRN or ipratropium PRN tioptroium LABA (formeterol)
theophylline

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180 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

181. Morphine?
A. effective nociceptive pain only
B. effective neuropathic pain only
C. effective in nociceptive and touch pain
D. effective only in mild to moderate pain
E. effective in head injury pain
Ans. C

182. a nurse practitioner prescribed sitagliptine 50 mg daily for


diabetic patient. What is appropriate?
A. process, dispense and document
B. tell patient to contact to doctor to get a new prescription
c. call nurse and inform this is not in the scope of nurse practice
D. complain of college of nursing

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Ans. a

183. What drug does not require replacement in pituitary failure?


A. Calcitonin
B. Cortisol
C. Thyroxin
D. Oxytocin
E. Vasopressin
Ans. d

184. Secondary hypogonadism is related to?


A. Anterior pituitary
B. Posterior pituitary
C. Hypothalamus
d. estrogen
e. progestins
Ans. A
Hypogonadism is deficiency of testosterone.
Primary is due to organ disability.

185. What is an example of activities are designed to completely


prevent a disease which is categorized as primary level of health
promotion activities?
A. use of beta blockers to help remodel the heart in congestive heart
failure
B. colonoscopy to detect small cancerous polyps
C. Immunization against pneumonia or influenza
D. Prophylaxis antibiotics for endocarditic
Ans. c

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186. Categorical (nominal) data?

a. height b. weight c. range d. temperature.


Ans. C
There are four types of data (measurement scales); nominal, ordinal,
interval and ratio.
Nominal: mode, and frequency of distribution (counts)
Ordinal: median, mode, frequency of distribution, the order of value is
known
Interval: mean, median, mode, frequency, the order value, difference
between each value; can add and subtract values
Ratio: mean, median, mode, frequency, the order value, difference between
each value; can add and subtract values; can multiply and divide.

187. Weakest clinical trial is?


a. Cochrane library
b. meta-analysis
c. systemic review of randomized trials
D. systemic review of case study trials
Ans. d

188. All of the following measures can help improving adherence, except?
A. Providing private counseling area
B. Use plain language
C. Ask about taking medication at each visit
D. Work with physician simplifying regimen
E. Use medication adherence scale
Ans. A

189. Nociceptive pain are caused by?

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A. Psychological factors
B. Injury to body tissue
C. Damage to nerve
D. Diabetes
E. Post herpetic infection
Ans. B
Tips. Nociceptive are due injury to body tissue, throbbing pain
(migraine).

190. Which of the following drug dispensing error can be most serious
concern?
A. Infliximab
B. Methotrexate
C. Fluoxetine
D. Olanzapine
E. Lamisil
Ans. B
191. What of the following is the safest prescription according to dangerous
ISMP abbreviations?
a- Latanoprost i gtt TID

b- Vitamin D 400 IU daily

c- ciprofloxacin PO od

d- Warfarin .5 mg qd am

e- Prednisone 5.0 mg prn


Ans. A

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192. DAUNOrubicin prescription mistakenly dispensed for DOXOrubicin. This
sound alike name error can be minimized by?
A. Reading prescription generic names
B. using Tallman letter in names
C. Confirming with prescriber
D. Clarifying with patient
E. Keeping away from in the shelf

Ans. B

193. What is not found in Compendium of


pharmaceutical specialties?
A. iron supplements
B. Vaccine monograph
C. Antacids drug interactions with tetracycline
D. Calcium supplements interactions with levothyroxine
E-nonprescription drugs and self-care
Ans. E

194. What is empathy?


A. ability to understand others problem
B. ability to share others problems
C. ability to understand and share other feelings or emotions
D. ability to care other persons problems
E. ability to offer patient care

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Ans. c

195. Which one of these statements is judging comment


rather than empathy?

A. You seems concerned with the drug side effects

B. you seem overwhelmed by the amount of medication

C. Dont worry lots of patients are like you

D. Dont worry I understand we can make it easy for you


Ans. c

196. Innate barrier is?


A. language barrier
B. preventing before actually it happens
C. First barrier in a process
D. Last barrier in process
E. internal barrier
Ans. C
Tips: Blood brain barrier is an innate to barrier toxic drugs
entering in CNS.

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197.What is the drug of choice to treat Chlamydia infections?
A. Cefixime
B. Ceftriaxone
C. Ciprofloxacin
D. Azithromycin
Ans. D
Tips. Azithromycin is the drug of choice to treat chlamydia infection.

198. Pharmacy manager occasionally should do progressive


discipline, what it mean?
A. Progressive discipline is a formal process of increasingly severe
consequences for dealing with issues of misconduct in the workplace.
B. Giving verbal warning for disciplinary action upon misconduct by employee
in workplace
C. Giving written warning for disciplinary action upon misconduct by employee
in workplace
D. Termination of employee upon misconduct by employee in workplace
Ans. A
Tips: Progressive discipline is a formal process of increasingly severe consequences for
dealing with issues of misconduct in the workplace. Increasingly severe consequences are
used to give the employee incentive to improve. However, if the employee continuously
fails to make the necessary changes, the end result of a progressive discipline process is
termination of employment

199. Non selective vasodilator effect on artery & vein?


A. Verapamil B. Amlodipine C. Na nitroprusside D.
Hydrochlorothiazide E. Ramipril
Ans. C

200. Colorectal cancer?


A. Prostate specific antigen
B. Fecal occult blood test

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C. X-ray
D. Pap smear test
E. Epigastric pain
Ans. B

Over 160 Excellent


Over 130 good
<110 Must improve

Vitamin E once reduced in cell, then which vitamin in body converts it by reduction
active form again?

Physician writes prescription to own use or family member for emergence?


A. Unethical
B. Illegal
C. Physician can prescribe in emergence
D. Physician to refer to emergency
Ans. c

A 72 yo patient of your pharmacy comes to prescription filled he has hypertension


and had recent MI. which of the following combination is recommended for his
option?

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A. Metoprolol 50 mg + lisinopril 20 mg /day
B. Atenolol 25 mg/day + irbesartan 150 mg/day
C. HCTZ 50 mg/day + amlodipine 2.5 mg
D. Diltiazem 120 mg.day + captopril 25 mg.day
A. III and IV
B. II and III
C. I and II
D. Iv only
Ans.c

What is true about ophthalmic preparation in surgery?


A. It is packed in single dose container
B. It is sterile and used with normal saline
C.

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