74 a) Folie acid ) Iron dextran ) Cyanocobalamine 4) Ferrous gluconate 013. Tick the drug used in aplastic anemia: '3) Fercoven b) Cyanocobatemine ¢) Epoetin alpha 4) Folic acid 014. Folic acid is recommended for treatment of megaloblastic anemia. This statement is: a) True ») False 015, Select the drug of granulocyte colony-stimulating factor: «) Filgrastim b) Methotrexate ©) Erythropoetin 4) Doxorubicin PART IV Drugs used in disorders of coagulation (001. All ofthe following physiologic reactions are involved in the control of bleeding EXCEPT: 4) Platelet adhesion reaction ) Platelet release reaction ¢) Activation of the antifibrinolytic system 4) Triggering of the coagulation process (002, Which ofthe folowing substances is synthesized within vessel walls and inhibits thrombogenesis? ‘a) Thromboxane Az (TXA:) b) Prostacyclin (PGI) ©) Prostaglandin (PGE) 4) None of the above 003. Al ofthe folowing groups of drugs are for thrombosis treatment EXCEPT: 2) Anticoagulant drugs b) Antifibrinolitic drugs ©) Fibrnolitic drugs 4d) Antiplatelet drugs (004. Pick out the drug belonging to anticoagulants of direct action: 2) Aspirin b) Heparin ) Dicumarol 4) Phenprocoumon (005. Which of the following drugs has low-molecular weight? a) Dieumarol b) Enoxaparin ©) Phenprocoumon ) Heparin (006. indicate the drug belonging to antagonists of heparin: 8) Aspirin ) Dicumarol ©) Dalteparin 4) Protamine sutfate 007. Tick the drug used as an oral anticoagulant a) Heparin ) Daltreparin ¢) Dicumaro! 4) Enoxaparin (08. All ofthe following drugs are indirect acting anticoagulants EXCEPT: a) Dicumarol b) Warfarin ) Dalteparin 4) Phenindione (009. Which of the following drugs belongs to coumarin derivatives?75 a) Heparin b) Enoxaparin «) Dalteparin <) Warfarin (010, Heparin is effective when administred orally. This consideration is: a) True ») False O11, All of these drugs are antiplatelet agents EXCEPT: a) Aspirin b) Urokinase: ) Ticlopidine 4) Clopidogrel 012, The use of heparin is recommended for treatment of deep venous thrombosis, This statement is: a) True b) False 013. Mechanism of aspirin action is: ‘2) Converts inactive plasminogen into active plasmin b) Inhibits COX and thus thromboxane synthesis ‘¢) Enhances the interaction between antitrombin Ill and both thrombin and the factors involved in the intrinsic clotting cascade 4) Inhibits the glycoprotein lllla complex (014. Which doses of Aspirin may be mare effective in inhibiting Tromboxane A;? 'a) Low ) High 15. Which of the following drugs is an inhibitor of platelet glycoprotein Iibilla receptors? a) Aspirin ) Clopidogrel ©) Ticlopidine 4) Abciximab 016, Ticlopidine is an inhibitor of ADP-induced platelet aggregation. I's: a) True ) False 017. Which ofthe following drugs is fibrinolytic? a) Ticlopidine b) Streptokinase ©) Aspirin <) Warfarin 018, Mechanism of urokinase action is an inhibition of Thromboxane Az. This statement is: a) True b) False 019, Fibrinolytc drugs are used for following EXCEPT: 2) Central deep venous thrombosis, ) Multsle pulmonary emboli ) Heart failure 4) Acute myocardial infarction 020, Indicate the drug belonging to fibrnalitic inhibitors: 'a) Aminocapronic acid ) Ticlopidine ©) Streptokinase 4) Vitamin K |. Aminocapronic acid is a drug of choice for treatment of 'a) Acute myocardial infarction b) Bleeding from fibrinolytic therapy ©) Heart failure <) Mattie pulmonary emboli 022, Tranexamic acid is an analog of aminocapronic acid. I's: a) True ) False o76 PART V Drugs used for treatment of heart failure (001. All ofthe following are normally involved in the pathogenesis of heart failure EXCEPT: a) A cardiac lesion that impairs cardiac output ) An increase in peripheral vascular resistance ) A decrease in preload 4) An increase in sodium and water retention 002, All ofthe following are compensatory mechanisms that occur during the pathogenesis of congestive heart failure EXCEPT: 4) An increase in ventricular end-diastolic volume ) An increase in the concentration of plasma catecholamines, ‘) An increase in vagal tone 4) Increased activity ofthe renin-angiotensin-aldosterone system (003. All ofthe folowing are recommended at the intial stages of treating patients with heart falure EXCEPT: ‘a) Reduced salt intake b) Verapamil ©) ACE inhibitors 4) Diuretics (004, All ofthe following agents belong to cardiac glycosides EXCEPT: 2) Digoxin ») Strophantin « ‘c) Amrinone 4) Digitoxin 008. The non-glycoside positive inotropic drug is: 8) Digoxin, ) Strophantin K ¢) Dobutamine 6) Digitoxin (006, Sugar molecules in the structure of glycosides influence: ‘a) Cardiotonic action b) Pharmacokinetic properties ©) Toxic properties 4) Allof the above 007. Aglycone is essential for ‘) Plasma protein binding b) Halfite ) Cardiotonic action «) Metabolism (008. Choose the derivative ofthe plant Foxglove (Digitalis): a) Digoxin ») Strophantin « ©) Dobutamine 4) Amrinone (009. All ofthe following statements regarding cardiac glycosides are true EXCEPT: 2) They inhibit ine Na+/K+~ATPase and thereby increase intracellular Ca++ in myocardial cells, b) They cause a decrease in vagal tone €) Children tolerate higher doses of digitalis than do adults 4) The most frequent cause of digitalis intoxication is concurrent administration of diuretics that deplete K+ 010. An important action of digitalis isto increase vagal tone, Is a) True ) False - Digoxin is thought to increase intracellular concentrations of calcium in myocardial cells by indirectly slowing the action of the sodium-calcium exchanger. This consideration is: a) True 0) False (012. Compare the half-life of digoxin and the half-life of digitoxin ‘) Digoxin is greater than digitoxin b) Digitoxin is greater than digoxin 013. All ofthe folowing statements regarding cardiac glycosides are true EXCEPT: ‘) They inhibit the activity of the Naw/K+-ATPase b) They decrease intracellular concentrations of calcium in myocytes on«) They increase vagal tone 4) They have a very low therapeutic index 014. All ofthe folowing statements regarding cardiac glycosides are true EXCEPT: ‘) Digoxin is a mild inotrope ) Digoxin increases vagal tone ¢) Digoxin has a longer half-ife than digitoxin 4) Digoxin acts by inhibiting the Nav/k+ ATPase 015, The most cardiac manifestation of glycosides intoxication is 4) Atrioventricular junctional rhythm b) Second-degree atrioventricular blockade «) Ventricular tachycardia 4) All the above 016. The manifestations of glycosides intoxication are: a) Visual changes ) Ventricular tachyarthythmias ©) Gastrointestinal disturbances 4) All the above 017. For digitalis-nduced arrhythmias the following drug is favored a) Verapamil b) Amiodarone ) Lidocaine 4) Propanolol 018. in very severe digitalis intoxication the best choice is to use: a) Lidocaine b) Digibind (Digoxin immune fab) ©) Oral potassium supplementation 4) Reducing the dose of the drug 019. All ofthe following statements regarding cardiac glycoside-induced ventricular tachyarrhythmias are true EXCEPT: ‘) Lidocaine is a drug of choice in treatment ») Digibind should be used in Ife-threatening cases ) They occur more frequently in patients with hyperkalemia than in those with hypokalemia 4) They are more likely to occur in patients with a severely damaged heart 020. This drug is selective beta-1 agonist a) Digoxin b) Dobutamine (©) Amrinone 4) Dopamine |. Tolerance to this inotropic drug develops after a few days: 'a) Amrinone ) Amiodarone ) Dobutamine 4) Adenosine (022. This drug inhibits breakdown of cAMP in vascular smooth muscle: 2) Digoxin ) Dobutamine ¢) Amrinone <4) Dopamine. (023, This drug is useful for treating heart falure because it increases the inotropic state and reduces afterload ‘) Amiodarone b) Amrinone ©) Propanolol ) Enalapril (024, This drug acts by inhibiting type Il cyclic nucleotide phosphodiesterase: 8) Amiodarone b) Milrinone ©) Propanolol ) Enalapril 025. All of the folowing statements regarding inhibitors of ype Ill phosphodiesterase are true EXCEPT: a) They raise cAMP concentrations in cardiac myocytes 0) They reduce afterload ¢) They show significant cross-tolerance with beta-receptor agonists 0 778 4) They are associated with a significant risk for cardiae arrhythmias 026. All ofthe following drugs are used in the treatment of severe congestive heart failure EXCEPT: a) Verapamil ») Digoxin ©) Dobutarine 4) Dopamine 027. Drugs most commonly used in chronic heart failure are: 4) Cardiac glycosides ) Diuretics ©) Angiotensin-converting enzyme inhibitors 4) Allthe above 028. All ofthe following statements conceming angiotensin converting enzyme (ACE) inhibitors are true EXCEPT: ‘) They act by inhibiting the ability of renin to convert angiotensinogen to angiotensin I ») Enalapril is a prodrug that is converted to an active metabolite «) They reduce secretion of aldosterone 4) They can produce hyperkalemia in combination with a potassium-sparing diuretic 029. All ofthe folowing effects of ACE inhibitors may be useful in treating heart falure EXCEPT: ‘) They decrease afterload b) They increase circulating catecholamine levels ©) They reduce reactive myocardial hypertrophy ) They increase myocardial beta-1 adrenergic receptor density 030. All ofthe folowing statements conceming the use of angiotensin-converting enzyme (ACE) inhibitors in the treatment of hear falure are true EXCEPT 4) They improve hemodynamics by decreasing afterload b) They can increase plasma cholesterol levels. ©) They may slow the progression of heart failure by preventing myocardial and vascular remodeling 4) They are effective first-line agents in the treatment of chronic heart failure PART VI Antiarrhythmic agents (001. This drug is a Class IA antiarthythmic drug: a) Sotalol ») Propranolol ©) Verapamil 4) Quinidine (002, This drug is a Class IC antiarthythmic drug a) Flecainide ») Sotalol ©) Lidocaine 4) Verapamil 003. This drug is a Class IC antiarrhythmic drug a) Flecainide ) Sotalol ©) Lidocaine 4) Verapamil (004. This drug is a Class Il antiarrhythmic drug a) Flecainide b) Propranolol ©) Lidocaine 4) Verapamil (005. This drug is a Class Ill antiarrhythmic drug: a) Flecainide b) Sotalol ©) Lidocaine 4) Verapamil (06. This drug prolongs repolarization: a) Flecainide b) Sotalol ©) Lidocaine ¢) Verapamil (007. This drug is a Class IV antiarthythmic drug: