Anticancer

1.treatment of mailgnant glioma:

a.methotrexate

b.dacarbazine

c.6-mercaptopurine

d.carmustine

Note:

Glioma: is type of brain cancer it happens in glial cells

Ttt:1st line : temozolomide tablets and bevacizumab (IV)

2nd line like other types of brain caners :

carboplatin,carmastin,cisplatin,etc…

https://emedicine.medscape.com/article/1156030-treatment

https://www.cancer.gov/about-cancer/treatment/drugs/brain

https://www.cancer.org/cancer/brain-spinal-cord-tumors-
adults/treating/chemotherapy.html

 Carboplatin
 Carmustine (BCNU)
 Cisplatin
 Cyclophosphamide
 Etoposide
 Evorolimus
 Irinotecan
 Lomustine (CCNU)
 Methotrexate
 Procarbazine
 Temozolomide
 Vincristin
2.amino acid contraindicated with procarbazine:

a.phenylalanine

b.tyramine

c.valine

d.leucine

https://www.webmd.com/drugs/2/drug-6893/procarbazine-
oral/details/list-interaction-details/dmid-12/dmtitle-avoid-high-
tyramine-foods/intrtype-food

https://www.mayoclinic.org/drugs-supplements/procarbazine-oral-
route/precautions/drg-20067874

3. Patient on cyclophosphamid has developed hematuria due to

release of which :

a. phosphoramide mustard

b. Acrolein

c. Mensa

4. Etoposide causes DNA damage through inhibition:

a. Topoisomerase I

b. Topoisomerase II

c. Topoisomerase III

d. Topoisomerase IIII

CNS

5. Treatment of acute panic attack:

a. benzodiazepines

b. TCAs

c. antipsychotics

6. SSRIs:

a. most effective in chronic anxiety disorders

b. give effect 1-4 weeks. Wrong as (effect within 6-8weeks)

c. can't be first line for anxiety disorders

7. Benzodiazepines not:

a. muscle relaxants

b. anxiolytics

c. retrograde amnesia

d. antipsychotics

8. DOC for status epilepsy:

a. clonazepam

b. diazepam

CVS

9.DOC with b blockers in aortic dissection

a.minoxidil

b.hydralazine

c.diazoxide

d.sodium nitroprusside
N.B 1st line ttt b blocker ( may with na nitro prusside as the only V.D can
dilate arteries and viens , others dilate viens only)

2nd line cardioselective CCBs (diltiazem and verapamil)

https://www.ncbi.nlm.nih.gov/pubmed/1683074

https://en.wikipedia.org/wiki/Aortic_dissection#Medication

10. decrease effect of digoxine except :

a. captopril

b. cycloserine

c. azithromycin

d. other antibiotic (can't recall)

Serious - Use Alternative
 azithromycin + digoxin
azithromycin will increase the level or effect of digoxin by altering intestinal flora. Applies only
to oral form of both agents. Avoid or Use Alternate Drug.

Monitor Closely
 captopril + digoxin
captopril increases levels of digoxin by unspecified interaction mechanism. Use
Caution/Monitor.

This is from https://reference.medscape.com/drug-interactionchecker

11. Contraindicated in CHF :

a. hydrochlorothiazide

b. nefidipine (as it will cause reflex tachycardia worsening the case)

c. captopril

d. digoxin
12. Digoxin cannot be used in which condition:

a. Heart failure

b. Along with ACEI and diuretics

c. In ventricle atrial fibrillation

d. ventricular diastolic failure

e. ventricular systolic dysfunction (used)

13. Digoxin MOA is:

a. Positive inotropic effect

14. Enalapril not beneficial effect:

a. decrease inotropic effect

b. decrease renin release

c. decrease angiotensin effect

d. V.D by brady kinnin accumulation

15. Dry cough SE for:

Enalapril

16. Not enalapril SE:

a. Dry cough

b. Angioedema
c. hypokalemia

17. All are side effects of ACEI except:

a. Hypokalemia

b. Low level of potassium

c. dry cough

d. angioedema

18. Patient taking ACEl which antacid should not be used?

a. Calcium carbonate

b. Magnesium

c. Aluminum

d. Potassium bicarbonate due to high risk of hyperkalemia

19. Injectable anticoagulant mechanism of action:

A. potentiate anti thrombin3 effect… as injectable is heparin

b. antiplatelet aggregation

c. inhibit coagulation factors synthesis

20. DOC for pregnant hypertension:

a. methyl dopa

21. Hypertension emergency:

a. sodium nitroprusside
22- Which of the following causes tachycardia:

a.B blocker

b.verapamil

c.diltiazem

d.isosorbide dinitrate

23.patient with ED (erectile dysfunction) and take Sildenafil which

CI with sildenafil:

a. isosorbide dinitrate

ANTIBIOTICS & ANTI TB

24. Rash in exposed area (hands face & neck) SE of:

a. ciprofloxacin

b. amoxicillin

https://www.medicinenet.com/sun-
sensitive_drugs_photosensitivity_to_drugs/article.htm#what_is_the_tre
atment_for_a_photosensitizing_drug_reaction

25. Not used for MRSA (methicillin resistant staphylococcus aerus):

a. amoxicillin +clavulinic acid

b. Dicloxacillin

c. Erythromycin
d. Doxycyclin

26. Used for MRSA:

a. cefopodoxime (3rd)

b. cepoperazone (3rd)

c. Azithromycin

d. cefazoline (1st)

N.B Drugs used for MRSA (can treat MRSA or MRSA can't resist):

1< penicillins> amoxiciliin +clavulinic or ampicillin+sulbactam

Or ticarcillin or piperacillin +tazobactam and all oxaciliins

like:fluoxacillin , cloxacillin ,dicloxacillin and methicillin,nafacillin

2<cephalosporins> ceftazidim, ceftarolin, ceftabiperole

Cefipime and cefpirome ( all begin with cefta or cefp)

3<macrolides> like Azithromycin and clarithromycin Except Erythromycin

4<tetracyclines> like doxycycline & minocycline

5< for impetigo(topical) > like Bactroban(mupirocin) and fusidic acid.

6<Others> vancomycin , daptomycin, linezolid, Clindamycin, Tiecoplanin,

(TMP+SMX),(Quinapristin+daflopristine)

27. DOC for meningitis:

1. Ceftriaxone

2. Tetracycline

3. Chloramphenicol
28. Type of penicillin that cannot be administered IV:

a. Penicillin G

b. Penicillin V

29. Doc of pregnant woman with UTI: it was a case

A. Cefuroxime

(No penicillin nor cephalexin in the options)

30. What infection the previous antibiotic cause:

a. heleicobacter pylori

b. E.coli

c. shigella

d. Clostridium difficle

31. Which of the following no need for antibiotic dose adjustment:

a. hypercholesterolemia or hyperthyroidism

b. elderly patient

c. renal disease patient

d. AIDS

32. Grey baby syndrome SE for:

a. chloramphenicol

33. Broad spectrum antibiotic (case):

a. amoxicillin

34. Bacteria can resist this antibiotic by:

a. enzyme production

35. Grey color baby due to antibiotic:

a. chloramphenicol

36. Antibiotic cause ear problem (ototoxicity) needs audiometry:

a. streptomycin

Note: all aminoglycosides cause ototoxicity (gentamycin, amikacin,

tobramycin, neomycin and streptomycin)

37. TB regimen combination benefits:

a. treat resistance

b. less SE

c. more patient compliance (not sure it was in choices)

d. All of them

Search more for this Question

38. NOT FIRST LINE treatment for TB:

a. sreptomycin

b. INH

c. Rifampicin
d. pyrazinamide

e. ethambutol

39. Which anti TB drug cause urine discoloration:

a. Rifampicin

40. When giving ethambutol for a long duration, continuous follow-

up/check-up is necessary because of this condition:

a. Renal failure

b. Liver dysfunction

c. vision problem ( ocular toxicity )

ANTIVIRAL & ANTIFUNGAL

41.Enfuvirtide added to HIV patient regimen what true about it:

a. integrase inhibitor . Wrong as its fusion inhibitor

b. S.C

c. cant used without reconstitution True as its powder for reconstitution

d. low side effects (it was in all choices)

42.Valacyclovir benefit over acyclovir:

a.more bioavailability( true its 55% but acyclovir is 20%)

b.more patient compliance (true as taken twice daily not 5 times like
acyclovir)
c. can't remember

d. all of them

http://www.emedexpert.com/compare-meds/acyclovir-vs-
valacyclovir.shtml

43. Acyclovir is not effective in which viral infection:

a. Herpes zoster

b. Epstein-barr virus

C.CMV

d. herpes zoster

44. What is the antiviral that’s the most suitable for HSV infection?
a. acyclovir

45. Mechanism of action of acyclovir:

a. DNA polymerase inhibitor.

46. Picture of nail with thick texture and brown discoloration, Nail fungal
infection DOC:

a. Fluconazole

b. Terbinafine

c. Griseofulvin

Note: According to the British Association of Dermatologists, the

guidelines goes by terbinafine OR itraconazole in the first line
NSAIDs

47. Paracetamol: a. small risk of Reyes syndrome (wrong as it has noooo

risk, the small risk is for aspirin)

b. anti-inflammatory

c. inhibit PG in CNS

d. no platelet action (aspirin has antiplatelet action)

48. Aspirin difference from other NSAIDS:

a. has cardio beneficial effect

b. irreversible COX inhibitor

c. can't stop arthritis progression

d. can't remember 4th option

49. NSAID has CNS side effects:

a. celecoxib

b. sulindac

c. nabumetone

d. mefenamic acid

https://www.ncbi.nlm.nih.gov/pubmed/27785820

50. Aspirin overdose symptoms are all of the following except:

a. Hypothermia*

b. Metabolic acidosis
c. Respiratory depression

d. convulsions

Note: Aspirin Poisoning signs are: * Common - ringing in the ears -

tachypnea , that causes respiratory alkalosis - Nausea, vomiting -
Metabolic acidosis (because of the tachypnea) *Severe - Pulmonary
Edema - Hyperthermia - Neurological effects: come, seizures, cerebral
edema - Renal failure

51. Patient with gout history present to ER with gouty attack, which
NSAID is contraindicated:

a. Aspirin.

b. sulindac

c. Ibuprofen

52. NSAID given for ductus arteriosus:

a. Indomethacin

b. sulindac

53. Selective cox-2 inhibitor:

a. celecoxib

54. When patient take prophylaxis therapy for gout:

a. more than One attack per year

b. Association with Kidney stones

c. ureate excretion 500 mg

d. blood urea level 10mg/dl

55.NSAIDS contraindicated with sulfa sensitivity:

a. Celecoxib

b. Ibuprofen

c. naproxen

d. indomethacin

HORMONES & DIABETES

56. Letrozole except:

a. mild androgenic SE

b. aromatase inhibitor

c. not cause endometriosis (true as it treat endometriosis)

d. no need corticosteroid co administration

57. Approved duration for the use of tamoxifen is:

a. 2 years

b. 5 years

c. 7 years

d. 10 years

58. Contraceptive contraindicated with lactating mother:

a. Progestin alone

c. combination*

d. copper T (loop)
e. condoms

Note:

Estrogen only 1st then Combination 2nd

59. Treatment of osteoporosis for menopausal woman:

a. Alendronate

b. Estrogen and progesterone

60. Which Insulin type that's its reaction time is not effected by site of
administration?

a. Glargine (Lantus)

b. Isophane (Humuline)

Note: • Lantus®, insulin administration sites may be rotated between

these three areas (1, 2, and 3) because the rate of absorption for
Lantus® is similar for all three

• Isophane The injection may start to start to work at different speeds

depending on the site you use.

61. Insulin that cannot be given as an IV:

a. Lispro (rapid acting)

b. Aspart (rapid acting)

c. Glulisine (rapid acting)

d. humuline (=NPH=isophane)( intermediate acting )

Note: #Short-acting insulin can be administered intravenously or

subcutaneously.
#Infusion Human regular insulin may be injected directly into the vein in
a hospital setting under close medical supervision only.

62. All indications of diabetes except:

a. Polyuria and unexplained weight loss

b. Random blood glucose of 200

c. Fasting blood glucose of 140

d. Blood glucose level of 200, 2 hours post oral glucose intake

63. Insulin secretion form:

a. B cell

b. Alpha cell

64. Which drug has least effect of hypoglycemia?

a. metformin

b. glibenclamide

Note: 1st acarbose >>> 2nd metformin

65. Action of insulin except:

a) Decrease glucose production in liver

b) Decrease liver glucose uptake

c) Insert glucose in muscle and adipose tissue answer

DMARDs

66. Drug suppresses T lymphocytes:

a. Etanercept (suppress TNF not t lymphocytes)

b. Abatacept

c. Infliximab (suppress TNF)

N.B Basiliximab and Daclizumab suppress t lymphocytes but not in

choices.

67. Not for chrons disease:

a. Adliximab

b. Infliximab

c. certolizumab

d. Ustikenumab or Golimumab (can't remember but both used)

e. Etanercept

68. Patient was on cyclosporine and changes to tacrolimus. Tacrolimus

comparison with Cyclosporine all answers are true except:

a. more potent

b. less nephrotoxicity ( as its more nephrotoxicity)

c. longer duration

69. Sulfasalazine should be given with which supplement:

a. Folic acid

70. Sulfasalazine prevents the absorption of which element:

a. Folate
71. Azathioprine SE not dose related:

a. bone marrow depression

b. hepatotoxicity

72. All DMARDs except:

a. prednisolone

73. Patient take DMARDs and after 2 weeks have eye problem
which drug cause that: (I am not sure it was in my exam)

a. sulfalazine

b. hydroxyquine

GIT & RESPIRATORY

74. Which is not given for constipation?

a. Lactulose (bulk laxative)

b. Loperamide (ttt of diarrhea)

c. Na-Pico sulfate (stimulant laxative)

d. Docusate sodium (stool softener laxative)

75. All of the following cause constipation except:

a. Bisacodyl (stimulant laxative)

b. Morphine

c. Calcium

d. ACEI
76. Patient has a problem in bowel emptying, he develops pain
while passing stool, Which is the least likely condition to cause this
constipation?

a. Bowel obstruction

b. IBD

c. Carcinoma

d. hyperthyroidism ( as it cause bowel movements and diarrhea )

77. pro-kinetic drug has anti emetic effect:

a. domepridone

b. Cisapride (prokinetic with no anti emetic effect)

78. IBS (irritable bowel syndrome) symptoms:

a. constipation

b. diarrhea

c. alternatively constipation and diarrhea

79. Used in motion sickness except:

a. Hyoscine (scopolamine)

b. Meclizine

c. Promethazine HCL

d. 4th option

Note: Used in motion sickness 1-cinnarazine 2-scopolamine

(hyoscine) 3-piperazine (stugeron) 4-promethazine (phenegran
,avomine)
80. Medication in an Inhalation route can be used for long term to
control asthma:

a. Salmeterol

b. Budesonide

c. salbutamol

d. isoprenaline

81. Cromolyne sodium mechanism:

a. decrease mast cell degranulation

82. Smoker with COPD, what is the drug of choice:

a. Busonide

b. Ipratopium

c. Theophyllin

d. Montelukast

83. Which of the following S.E of B2 agonist:

a. Hypokalemia

b. Tremors

84- The best advice to a patient taking corticosteroid inhaler for

asthma (you can choice more than 1 choice)

Take rapid breath after pressing the inhaler (a

Hold your breath for 10 seconds after complete (b

inhalation
rinse your mouth with water after using the inhaler (c

keep one finger distance between your lips & the inhaler (d

GLAUCOMA (e

85. Treatment of glaucoma with heart edema:

a. acetazolamide

86. Anti-glaucoma drug for eye lash Hypotrichosis:

a. bimatoprost

Miscellaneous

87. factors affect cerebro-spinal fluid (CSF) penetration Except:

a. lipid solubility

b. water solbility

c. Molecular weight

d. Plasma protein binding

88. Cyclosporine is more toxic in which route:

a. oral

b. IV

c. IM

d. SC
89. A Kid took peanut butter and he’s allergic to peanut; he
developed rashes and urticaria. What type of allergic reaction is
this?

a. Type 1

b. Type 2

c. Type 3

d. Type 4

90. Pharmacist monitoring of drug despising and refill will give an

idea about:

a. Drug utilization

b. Drug disposal

c. Drug adherence

91. What’s the type of study that’s MOST reliable?

a. Cohort randomized trials

b. Case study

c. Case report

d. case series

92- What’s the type of study that’s LEAST reliable?

a. Cohort randomized

b. Case study

c. Case report

d. Case series
93. Manufacturer recall of medication from pharmacy is called:

a. Voluntary call

b. Immediate recall

c. involuntary call

94. Which iron dose is questionable?

a. 120 mg for 20 kg child

b. 90 mg for 15 kg child

c. 21 mg for 7 kg infant

d. 30 mg for 6 kg infant

Note: child: every 1 kg 6mg but infant : every 1 kg 3mg

95- A physician wants to switch a terminally-ill patient from slow

release morphine sulphate tablets, 15 mg twice daily, to a liquid
morphine sulphate dosage form because the patient has difficulty
in swallowing tablets. If a morphine sulphate solution containing 5
mg per mL is prescribed q4h, what volume should be dispensed
for a 20 day supply to provide the same pain relief as the tablet
regimen?

a. 120 Ml

96. topical treatment for hair loss(baldness) :

a. Minoxidil