ARAB BOARD Q BANK OF

OPHTHALMOLOGY

PHARMACOLOGY

(2011 to 2017)
Arab Board Ophthalmology Part 1 Pharmacology

2011

1. All the following will increase the absorption of a drug from an eye drop except? 1. Answer. B

A. Increasing the interval between administering two eyedrops. B, Lipophilic

B. Increasing hydrophilic properties of the drug.
C. Nasolacrimal compression.
D. Eyelid closure.
E. Preadministration of a topical anesthetic.

2. In a steroid responder, which agent is most likely to raise intraocular pressure: 2 Answer. C

A. Prednisolone.
B. Fluorometholone.
C. Dexamethasone.
D. Loteprednol.
E. Medrysone.

3. NSAID agents will NOT affect the production of: 3. Answer. A

A. Leukotrienes.
B. Thrmboxane.
C. Prostaglandins.
D. Prostacyclins.
E. None of the above.

4. A patient allergic to penicillin is likely to cross react to a cephalosporin at a rate of: 4. Answer A

A. 10%
B. 20%
C. 25%
D. 30%
E. 40%

5. One of the following is most likely to cause an allergic reaction when applied
topically to the eye: 5. Answer C
A. amikacin
B. Gentamicin Allergic conjunctivitis is most
common with topical
C. Neomycin neomycin, occurring in up to
D. Kanamycin 8% of patients.
E. None of the above causes a reaction

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Arab Board Ophthalmology Part 1 Pharmacology

6. Ptosis can result from which agent: 6. Answer B/C

Both are Adrenergic
A. Pilocaroine blockers that may cause
B. Guanethidine Muller’s muscle slight
C. Thymoxamine paralysis. I would
D. Carbachol choose B as it is used to
E. Dorzolamide treat graves associated
lid retraction
7. All the following are used as preservatives in topical eyedrops except: 7. Answer E

A. EDTA
B. Chlorhexidine
C. Benzalkonium chloride
D. Sorbic acid
E. Zinc sulphate

8. One of the following antiepileptic agents cause visual field constriction:

8. Answer D
A. valproic acid
D, irreversible
B. Carbamazepine
peripheral visual field
C. Phenytoin loss in 30% of users
D. Vigabatrin
E. Diazepam

9. Retinal detachment mostly occurs with the use of:

9. Answer A&B
A. Pilocarpine 1%
B. Ecothiophate
C. Atropine
D. Brimonidine
E. Cyclopentolate

10. Regarding the following immunosuppressant agents and their mode of action,
all the following combinations are correct Except: 10. Answer C
A,B Tacrolimus is 10-100
A. Cyclosporine inhibits IL-2 production
times more potent
B. Tacrolimus inhibits IL-2 production
than cyclosporine and
C. Azathioprine blocks RNA transcription
both leads to inhibition of
D. Methotrexate inhibits dihydrofolate reductase
T cells
E. Mycophenolate is selective for the lymphocytes
C, it inhibits DNA and
RNA synthesis

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Arab Board Ophthalmology Part 1 Pharmacology

11. All the following are true regarding topical mast cell stabilizers Except:
11. Answer D
A. Mast cell stabilizers do not help relieve acute allergic attacks
B, 2 to 3 weeks
B. Used for at least 3 weeks before deciding on clinical efficacy
C. Drops usually sting
D. Can be used when wearing contact lenses
E. Work best if treatment is begun prophylactically

12. All the following are true regarding Rifabutin Except: 12. Answer B

A. used mainly against Mycobacterial infection B, non-

B. Causes mainly a granulomatous uveitis in HIV patients granulomatous
C. Less likely to produce synechia uveitis
D. Causes uveitis and associated with hypopyon
E. Inhibits RNA polymerase

13. the earlier sign of toxicity related to regional lignocaine is:

13. Answer D
A. Dizziness
B. Slurred speech
C. Aggressive behavior
D. Numbness
E. Convulsions

14. Regrading drug toxicity and the eye all are true except:
14. Answer A
A. Thioridazine causes an exudative maculopathy A, causes pigmentary
retinopathy
B. Tamoxifen causes crystalline deposit at the macula
C. Deferoxamine causes an optic neuropathy C, causes pigmentary
retinopathy too
D. Digoxin affects color vision
E. Canthaxanthine causes maculopathy

15. Which of the following inhibits the reuptake of noradrenaline at nerve endings: 15. Answer A

A. Cocaine
B. Phenylephrine
C. Apraclonidine
D. Brimonidine
E. hydroxyamphetamine

16. Alpha adrenergic receptors are most concentrated in:

16. Answer D
A. Iris dilator A, D & E have alpha
B. Iris sphincter receptors but mostly
C. Ciliary process epithelium BVs are most
D. Conjunctival blood vessels concentrated
E. Muller’s muscle

3
Arab Board Ophthalmology Part 1 Pharmacology

17. All the following are examples of a pro-drug except: 17. Answer E

A. Dipivefrin B, & travoprost

B. Latanoprost
C. Valacyclovir
D. Gancyclovir
E. Acyclovir

18. Which fluoroquinolone is known to causes white corneal deposits:

18. Answer B
A. Ofloxacin
B. Ciprofloxacin
C. Levofloxacin
D. Gatefloxacin
E. moxifloxacin

2013

19. The factors that determine the amount of medication to penetrate the cornea
19. Answer. C
include all of the following Except:
A, Drug volume not
A. Drug concentration
concentration
B. Viscosity
C. Preservative type C, Benzalkonium
D. Surfactant chloride is the most
E. Solubility common

20. Which of the following is a direct acting cholinergic agonist?

20. Answer. C
A. Physostigmine
B. Isoflurophate
C. Bethanechol
D. Pralidoxime
E. Edrophonium

21. Which of the following medications can be used in diagnosing Adie tonic pupil?
21. Answer. A

A. Pilocarpine 0.12%
B. Pilocarpine 1.0%
C. Pilocarpine 2.0%
D. Pilocarpine 4.0%
E. Pilocarpine 6.0%

4
Arab Board Ophthalmology Part 1 Pharmacology

22. Which of the following medications can be given intraocularly to lower the IOP
22. Answer. C
and to induce miosis?
C, usually its given
A. Physostigmine intracameral post-
B. Pilocarpine surgery
C. Acetylcholine
D. Isoflurophate
E. Neostigmine

23. Which of the following medications can be associated with retinal tears and
23. Answer. D
retinal detachments?
A. Acetazolamide
B. Cyclopentolate
C. Atropine
D. Pilocarpine
E. Latanoprost

24. Direct acting cholinergic agonists, can lower IOP by:

24. Answer. C
A. Decreasing aqueous production
B. Contraction of the circular fibers of the ciliary muscles to open the trabecular D, they decrease
meshwork uveoscleral outflow
C. Contraction of the longitudinal fibers of the ciliary muscles to open the trabecular
meshwork.
D. Increasing uveoscleral outflow
E. All of the above

25. Which of the following medications is contraindicated in acute angle closure

25. Answer. D
glaucoma?
A. Latanoprost D, it causes miosis which
leads to forward
B. Dexamethasone 1%
displacement of iris-lens
C. Prednisolone acetate 1% diaphragm causing
D. Pilocarpine 4% pupillary block and
E. Brimonidine 1% closing the angle further

26. Which of the following is not a side effect that can occur with cholinergic agonists?
26. Answer. D
A. Diarrhea
D. Miosis
B. Diaphoresis
C. Urinary urgency
D. Mydriasis
E. Nausea

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Arab Board Ophthalmology Part 1 Pharmacology

27. The duration of action of cyclopentolate hydrochloride is:

27. Answer. D
A. 2-4 hr
B. 4-8 hr
C. 6-12 hr
D. 1 day
E. 4 days
28. Which of the following is a correct statement that describes the duration of action
28. Answer. C
of these medications?
A, 7-14 days
A. Atropine 3 days
B, 3 days
B. Homatropine 1 days
C. Tropicamide 4-6 hrs D, 7 days
D. Scopolamine 4-7 hrs
E. Phenylephrine 1-2 days E. 5 hours

29. Which of the followings is usually used to reverse the toxicity of muscarinic
29. Answer. C
antagonists?
A. Pilocarpine 1%
Or Neostigmine
B. Pilocarpine 2%
C. Physostigmine 0.25%
D. Physostigmine 2.5%
E. Pilocarpine 4%

30. In which of the following medications a potassium level should be checked in

30. Answer. D
chronic use?
A. Brimonidine
B. Betoptic
C. Acyclovir
D. Acetazolamide
E. Moxifloxacin

31. All of the following antiviral agents Except: 31. Answer. D

A. Trifluridine
B. Vidarabine
C. Acyclovir
D. Voriconazole
E. Gancyclovir

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Arab Board Ophthalmology Part 1 Pharmacology

2014

32. Side effects of direct cholinergic against include all the following except:
A. Poor dark adaptation. 32. Answer. E
B. Decreased vision in older patients. E, induced myopia
C. Headache in younger patients.
D. Possible aggravation or induction of angle-closure glaucoma
E. induced hyperopia

33. Which one of the following concerning antibiotic mechanisms is False:

33. Answer. D
A. Sulfonamides act by inhibiting bacterial DNA synthesis
B. Chloramphenicol use is associated with aplastic anemia when used orally D, requires aerobic
C. Tetracycline is poorly water soluble transport to enter the
D. Aminoglycoside efficiency is strictly dependent on anaerobically supported cell > not effective
antibiotic uptake against anaerobes
E. erythromycin acts by inhibiting bacterial protein synthesis and streptococci

34. Which one of the following concerning the ocular antiviral agents is False:
34. Answer. D
A. Vidarabine is an analog of adenin, whereas idoxuridine and trifluridine are
analogs of thymidine
B. Triflueridine is more soluble than vidarabine or idoxuridine
C. Triflueridine is the most effective of the three
D. Cross-resistance to different agents is commonly seen
E. Trifluridine has the least corneal toxicity
35. Adrenergic agonists generally; one is true
35. Answer. E
A. Increase aqueous production, decrease out-flow facility and increase IOP
Effect of dipivefrine
B. Increase aqueous production, increase out-flow facility and increase IOP
and alpha agonists
C. Increase aqueous production, increase out-flow facility and decrease IOP
D. Decrease aqueous production, decrease out-flow facility and decrease IOP
E. decrease aqueous production, increase out-flow facility and decrease IOP

36. Regarding oral chloral hydrate, all are true Except:

36. Answer. A
A. Best given on an empty stomach
B. Its analgesic effect starts within 1 minute
C. Has no effects IOP level both in normal and glaucomatous eyes
D. Its mechanism of action is not well known
E. Contraindicated in patients with marked renal impairment

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Arab Board Ophthalmology Part 1 Pharmacology

37. Which of the following aminoglycosides is most resistant to bacterial enzymatic inactivation:
A. Amikacin 37. Answer. A
B. Gentamicin
amikacin is semisynthetic
C. Tobramycin aminoglycoside, which is
D. Kanamycin refractory to most
E. Neomycin aminoglycoside modifying
enzymes. amikacin is the least
sensitive to inactivation by this
38. Topical anesthetics, all are true except: mechanism.

A. Produce analgesia for approximately 10-30 minute 38. Answer. C

B. May have antimicrobial effects
C. The action is more rapid in myelinated nerve C, rapid in
D. Inhibit epithelial mitosis and migration unmyelinated
E. Cause epithelial loosening and erosions

39. Which of the following agent is relatively contraindicated in patients with

history of depression: 39. Answer C
A. Pilocarpine Beta blockers may
B. Mannitol also cause depression
C. Acetazolamide
D. Latanoprost
E. Apraclonidine

40. A major objection to Benzalkonium chloride as an ophthalmic preservation

40. Answer. E
is its:
It’s alkaline pH 8
A. Incompatibility with Pilocarpine
B. Limited activity against Pseudomonas aeruginosa
C. Instability in the presence of methylcellulose
D. Instability in the presence of ethylenediaminetetraacetic acid (EDTA)
E. Corneal epithelial toxicity in formulation above pH 7.5

41. Regrading latanoprost (Xalatan) all are true except:

41. Answer. C
A. Increase uveoscleral outflow of aqueous humor
B. Selective P-GF2a analogue
C. Contraindicated in contact lens wearers
D. Conjunctival hyperemia is a known side effect
E. May cause iris hyperpigmentation

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Arab Board Ophthalmology Part 1 Pharmacology

42. Regrading Acetazolamide all are true Except: 42. Answer. B

A. Inhibits an enzyme which uses H2O as a substrate

B. Cause Na retention
C. Might cause hyperchloremic metabolic acidosis
D. Cause hypokalemia
E. Hypercalciuria is a well-known side effect

43. Which best describes chloramphenicol:

43. Answer. B/D
A. Inhibits cell wall formation
E, Rare side effect
B. High lipid soluble
C. Effective in treating anaerobic infections
D. Renal excretion
E. Gray baby syndrome is a common side effect that occurs in neonates

44. All the following mydriatic agents have cycloplegic action except:
44. Answer. B
A. Cyclopentolate
B. Physostigmine
C. Atropine
D. Homatropine
E. Tropicamide

45. Regarding local anesthetics, all the following statements are true Except:
45. Answer. C
A. They block the potentiation of action potential of the nerves B, local anaesthetics
B. Contain a hydrophilic amino group consists of three
C. When combined with adrenaline, are more likely to cause a systemic reaction components: a lipophilic
D. That contain adrenaline have a longer duration of action. aromatic group, an
intermediary link and a
E. Such as bupivacaine have a relatively slow rate of onset of effect
hydrophilic amine group

2015

46. The least appropriate statement regarding in the periocular injection is: 46. Answer. C

A. Bypass conjunctival and corneal epithelium leading to better intraocular penetration

B. Therapeutic level is reached in the posterior segment
C. Especially useful for high lipid soluble drugs
D. Retrobulbar alcohol is used for chronic pain in the blind eye
E. Medications can be delivered to local site of action such as Cystoid macular edema

9
Arab Board Ophthalmology Part 1 Pharmacology

47. The least appropriate statement regarding the cholinergic agents is: 47. Answer. D

A. Nicotinic agents are supplied by somatic motor nerves

B. Direct acting agents, act on the receptor to elicit excitatory post synaptic potential
C. Muscarinic agents are supplied by postganglionic parasympathetic nerves
D. Indirect agents enhance deactivation of acetylcholine
E. Direct acting agonists increase accommodation

48. One of the following is seen with the α 1 adrenoreceptor stimulation:

48. Answer. B
A. Vasodilatation
B. Increase blood pressure
C. Miosis
D. Dilatation of the internal sphincter of the bladder
E. Decrease peripheral resistance

49. The least likely indication for the use of carbonic anhydrase inhibitor is: 49. Answer. C
A. Pseudotumor cerebri
B. Acute angle closure glaucoma
C. Renal stones
D. Cystoid macular edema
E. Chronic forms of glaucoma

50. All are side effect of prostaglandin analogues except: 50. Answer. D
A. Increase pigmentation of light iris
B. Uveitis
C. Cystoid macular edema
D. Loss of eyelashes
E. Conjunctival hyperemia

2016

51. Which drug, achieves a higher aqueous level when administered as ointment
51. Answer. B
rather than drop:

A. Tropicamide
B. Tetracycline
C. Prednisolone
D. Penicillin
E. Pilocarpine

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Arab Board Ophthalmology Part 1 Pharmacology

52. The least appropriate statement about acyclovir: 51. Answer. C

A. Inhibits growth of virus by competitively inhibiting viral DNA polymerization

B. Acts as a DNA chain terminator
C. Is present in an active form
D. Causes herpes simplex virus growth inhibition with minimal systemic toxicity
E. Can be used topically

53. A child 8 years old with esotropia on cholinergic drugs will experience:
53. Answer. C
A. Urinary retention
B. Constipation
C. Miosis induced myopia
D. Dry mouth
E. Increase the severity of accommodative esotropia

54. Regarding alpha 1 – adrenergic receptors, which is true?

54. Answer. A
A. Mediate skeletal muscle contraction
B. Stimulation causes vasodilatation
C. Causes miosis
D. Drugs acting on these receptors are accentuated by cocaine
E. Stimulation decreases blood pressure

55. Regarding viscoelastic agents, which is true: 55. Answer. A

A. Has physical property to resist flow and deformation

B. Optically opaque
C. Used in cataract surgery only
D. Hydrophobic
E. Should be left inside the eye at the end of surgery

56. Most correct answer about ganciclovir: 56. Answer. A

A. Used for CMV retinitis C. I.V only

B. It is present in an active form D. DNA polymerase
C. Best way of administration is orally
D. It inhibits viral RNA polymerase E. more toxic
E. It is less toxic than acyclovir

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Arab Board Ophthalmology Part 1 Pharmacology

57. When you prescribe b-blocker drops for old patients you should ask about: 57. Answer. B

A. Vertigo B. blocker
B. Heart problems contraindications:
C. Nausea
1. Asthma
D. Headache
2. Cardiogenic shock
E. Bleeding tendency 3. Cardia failure
4. chronic obstructive
lung disease

58. Side effects of adrenergic agonists include: 58. Answer. B

A. Last growth
B. Dry mouth
C. Metallic taste in mouth
D. Bronchospasm
E. Macular edema

59. Which drug should not be prescribed for home use: 59. Answer. D

A. Atropine
B. Steroid
C. Cycloplegics
D. Aneasthetic drops
E. Antibiotic

60. Which one of the following drugs is a medriatic agent only: 60. Answer. D

A. Tetracaine
B. Naphazolene
C. Alopatidine
D. Phenylephrine
E. Cyclosporine

61. Regarding topical apraclonidine, which is true? 61. Answer. B

C. pruritus, dry mouth,
A. It decreases uveoscleral outflow taste disturbance
B. It used for temporary intraocular pressure control post YAG laser capsulotomy
C. Has no local side effects
D. Causes mild ptosis
E. Induces miosis

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Arab Board Ophthalmology Part 1 Pharmacology

62. Which is a prostaglandin analogue: 62. Answer. C

A. Brinzolamide
B. Methazolamide
C. Travoprost
D. Apraclonidine
E. Brimonidine

63. Regarding betaxolol, which is true: 63. Answer. A

A. Is a cardioselective beta adrenergic antagonist C. Block uveoscleral

B. Developed to avoid cardiac complications of timolol outflow
C. Increases uveoscleral outflow
D, 20–30%
D. Decreases IOP more than 35%
E. Its peak of activity is 7 hours

64. Answer. E
64. Regarding mannitol, which is true:
A. I.V only
A. Given in a dose of 2g/kg body weight orally
B. Causes urinary retention B. diuresis
C. Is safe in heart failure C. C.I in heart disease
D. Decreases aqueous production
E. Increases trabecular outflow

65. One of the following is not a benefit of using a combined medication in

glaucoma: 65. Answer. A
A. Reduce efficacy
B. Convenience
C. Better compliance
D. Reduce cost
E. Weakly additive effect in lowering JOP

66. Regarding Mydriatic agents, which is true? 66. Answer. B

A. Antagonist
A. Mydriasis is caused by cholinergic agonists C. prevent noradrenaline
B. Synthetic anticholinergics are less effective mydriatics than belladonna alkaloid reuptake from nerve
C. Cocaine causes mydriasis by increasing noradrenaline release from nerve terminal
terminal D. miosis
D. Thymoxamine causes mydriasis E. miosis
E. Heroin produces mydriasis

13
Arab Board Ophthalmology Part 1 Pharmacology

67. Antibiotics that act on cell wall include which one of the following:

A. Chloramphenicol 67. Answer. B

B. Vancomycin
A. Inhibit protein synthesis
C. Sulphonamid
D. Tetracycline B. Inhibit cell wall synthesis
E. Erythromycin
C. Inhibit nucleic acid synthesis
D/E. Inhibit protein synthesis

2017

68. Acetylcholine esterase inhibitors, muscarinic agonists such as pilocarpine, 68. Answer. A
and β blockers, are among the drugs used to manage many patients with
glaucoma. They also share properties that are particularly relevant to patients D, adrenergic or
with asthma. Which of the following statements summarizes best what that muscarinic receptors
relevance is? OR H 1 receptor not 3

A. Contraindicated, or pose great risks, for people with asthma

B. Degranulate mast cells, cause bronchoconstriction
C. Tend to raise intraocular pressure in patients who have both glaucoma and asthma
D. Trigger bronchoconstriction by directly activating III histamine receptors on airway smooth muscle cells

69. The successful treatment of infectious diseases is based on the principle of

elective toxicity. Which of the following antimicrobial agents is the most 69. Answer. C
toxic to humans?

A. Bacitracin
B. Cephalosporin
C. Mitomycin
D. Vancomycin

70. Which of the following responses to sympathetic nerve discharge is mediated

at the effector cell by acetylcholine? 70. Answer. D

A. Decreased blood flow in the skin

B. Increased blood glucose
C. Increased heart rate
D. Increased sweating

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Arab Board Ophthalmology Part 1 Pharmacology

71. A 62-year-old man presents to the emergency room with an acute onset of aphasia 71. Answer. D
and hemiparesis. A computed tomography (CT) scan reveals an increase in
intracranial fluid. Which of the following solutions will be most effective in
reducing intracranial pressure following hemisphere stroke?

A. 250 mmol glycerol

B. 250 mmol glucose
C. 350 mmol urea
D. 350 mmol mannitol

72. A patient with hypothyroidism following thyroidectomy will require lifelong 72. Answer. A
hormone replacement therapy. Which of the following agents generally would be most
suitable?

A. Levothyroxine(T4)
B. Liothyronine
C. Liotrix
D. Protirelin
73. A patient presents with food poisoning that is attributed to botulism
(Botulinum toxin poisoning). Which of the following is a correct 73. Answer. A
characteristic, finding, or mechanism associated with this toxin? B, works on postganglionic
parasympathetic nerve
A. Complete failure of all cholinergic neurotransmission endings and postganglionic
B. Impairment of parasympathetic, but not sympathetic, nervous system activation sympathetic nerve endings
C. Massive overstimulation of all structures having muscarinic cholinergic receptors that release acetylcholine
D. Selective paralysis of skeletal muscle

74. A 10- week old infant is diagnosed with meningitis. A lumbar puncture
reveals numerous neutrophils and gram- positive rods. She is admitted to the 74. Answer. B
hospital and started on IV β-lactams. Which of the following targets would
most likely play a role in the development of resistance to the antibiotics?

A. DNA gyrase
B. Penicillin-binding proteins (PBPs)
C. Reverse transcriptase
D. RNA polymerase

75. In persons suffering from severe anaphylactic shock from a bee sting, 75. Answer. B
the drug of choice for restoring circulation and relieving angioedema is
which of the following?

A. Dopamine
B. Epinephrine
C. Isoproterenol
D. Norepinephrine

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Arab Board Ophthalmology Part 1 Pharmacology
76. Answer. A/B
Generally, mydriatics are relatively contraindicated in
acute closure glaucoma
76. Which of these drugs is contraindicated in acute angle closure glaucoma? If ACG is primary (no ant. Rotation of CB) due to
phakic pupillary block / angle crowding / shallow AC
A. Cyclopentolate (e.g. hyperope, >60 yrs) > can give pilocarpine 1-2% for
B. Pilocarpine 4% short term specially for refractory closure after laser and
do not give cycloplegics
C. Mannitol 20% If ACG is secondary (e.g. PAS, aphakia, pseudophakic
D. Beta blocker block, NVG, choroidal edema) > can give cycloplegic
for post. rotation of CB & decrease inflammation +
don’t give pilocarpine as it increases the unwanted ant.
rotation of CB
77. The least appropriate statement regarding the periocular injection is:
77. Answer. C
A. it bypasses conjunctival and corneal epithelium leading to better intraocular penetration C, Low
B. Therapeutic level is reached in the posterior segment
C. Especially useful for high lipid soluble drugs
D. Medications can be delivered to local site of action such as Cystoid macular edema

78. The least likely side effect of prostaglandin analogues are:

78. Answer. C
A. Uveitis
B. Cystoid macular edema C, hypertrichosis
C. Loss of eyelashes
D. Conjunctival hyperemia

79. Apraclonidine hydrochloride:

79. Answer. C
A. α 1 & α 2
A. Is α 1 adrenergic against
B. Prevent
B. Stimulate release of norepinephrine at nerve terminal
D. Decrease
C. Decrease aqueous production
D. Increase episcleral venous pressure

80. Regarding IV hyperosmotic agents, the least appropriate statement is:

80. Answer. D
A. Can cause tissue necrosis if extravasates
B. IV administration produces rapid onset of action A, IV urea
C. Has been associated with subarachnoid hemorrhage E, IV urea causes
D. In semiconscious patients there is a risk of bladder distension phlebitis
E. Urea can be used orally in elderly patients

81. At tissue level, the glucocorticoids promote one of the following: 81. Answer. B
A. Capillary proliferation
B. Hypothermia
C. Edema
D. Vascular congestion
E. Fibroblast proliferation

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Arab Board Ophthalmology Part 1 Pharmacology

82. The least likely medication to increase intraocular pressure is: 82. Answer. D
A. Subtenon triamcinolone D, flurbiprofen sodium
B. Intraocular dexamethasone (NSAID) has no significant
effect upon intraocular
C. Topical flurometholone pressure
D. Topical flurbiprofen sodium
Systemic and inhaled or nasal
E. Nasal steroid spray steroid are less likely to
cause IOP rise

83. The least likely side effect of aspirin is: 83. Answer. D
A. Headache
B. Tinnitus
C. Mental confusion
D. Deep vein thrombosis
E. Hyperventilation

84. Regarding Mast cell stabilizers the least appropriate statement is: 84. Answer. C
A. Prevent calcium influx across mast cell membrane
B. Prevent mast cell degranulation
C. Provide immediate relief of allergy symptoms
D. Lodoxamide is more potent than sodium cromoglycate
E. Burning, stinging and discomfort are the most reported side effects

85. The least likely use of Mitomycin C is in:

A. Treatment of conjunctival intraepithelial neoplasia 85. Answer. D
B. Post photorefractive keratectomy
C. Preventing recurrence of pterygium
D. Adjunctive in the treatment of corneal perforation
E. Glaucoma surgery

86. Penicillin G is: 86. Answer. C

A. Highly effective against gram negative rods C, inactivated by
B. Neisseria gonorrhea is very sensitive to this penicillin gastric juice
C. Inactivated in the stomach
D. Rapidly metabolized in the liver D, renal excretion
E. Has a long half life

17
Arab Board Ophthalmology Part 1 Pharmacology

87. Regarding second generation cephalosporine, the least appropriate statement is:
87. Answer. C

A. Cefuroxime belongs to this group

B. Cefuroxime is valuable in the treatment of Nisseria gonorrhea
C. Developed to expand the gram positive coverage
D. Cefuroxime has great activity H influanzea
E. Cefuroxime has good penetration of blood brain barrier

88. Apraclonidine hydrochloride: 88. Answer. A / C

A. An adrenergic agonist
B. Stimulates release of norepinephrine at nerve terminals
C. Decreases aqueous production
D. Increases episcleral venous pressure
E. Effective for long term use

89. Steroid induced elevation of the intraocular pressure is:

89. Answer. E
A. Seen 3 days after initiation of steroids therapy
B. Seen with topical steroids only
C. Refractory to treatment by anti-glaucoma drops
D. 40% develop pressure higher than 31 mmHg
E. Individual intraocular pressure elevation in response to steroids is highly
dependent on the strength and frequency of therapy.

90. Regarding topical antiviral agents:

90. Answer. A
A. Idoxuridine is a structural analogue of thymidine.
B. Trifluridine is the least soluble
C. Cross resistance is common amongst trifluridine and idoxuridine.
D. Idoxuridine is used to treat stromal herpetic keratitis in the absence of epithelial
involvement only.
E. Acyclovir accumulates in health cells more than infected cells

91. Regarding Local anesthetics the least appropriate statement is:

91. Answer. B
A. Biphasic weak bases
B. Act on the cell membrane by maintaining a high permeability to sodium ions
C. Exhibit antimicrobial properties
D. Administration topically cause desquamation of corneal epithelium
E. No cross hypersensitivity between different classes

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Arab Board Ophthalmology Part 1 Pharmacology

92. The least appropriate statement regarding chloramphenicol is:

92. Answer. B
A. Easily penetrates the blood brain and blood aqueous barriers
B. When administered topically does not cause aplastic anemia
C. Effective in the treatment of typhoid fever
D. Is used in the treatment of pneumonia
E. Is bacteriostatic

93. The least appropriate statement regarding antifungals is:

93. Answer. E
A. Nystatin is useful in treatment of enteric candidiasis
B. Fluconazole is the drug of choice for CNS infection with Cryptococcus
C. Flucytosine is usually used in combination with amphotericine B
D. Miconazole can be administered topically, subconjunctival, orally and parentally
E. Ketoconazole is known to be toxic to the eye when administered orally.

94. Regarding Topical cyclosporine 0.05% use, the least appropriate statement is:
94. Answer. B
A. Used in the treatment of dry eye.
B. Systemic absorption may be a concern in pediatric age group when used in the
treatment of vernal keratoconjunctivitis
C. Is preservative free.
D. Can repopulate the goblet cell.
E. Decrease conjunctival epithelial cell turnover

95. Which of the following is false regarding the tetracycline’s family: 95. Answer. D

A. They are produced by streptomycin species B, both passive &

B. They enter bacteria by active transport active
C. They inhibit protein synthesis by binding to 30 S ribosomal subunit
D, high lipophilic >
D. Doxycycline are less lipophilic
crosses BBB
E. The use of tetracycline decrease the efficacy of birth control

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RANDOM 1

96. Concerning the extraocular muscle fibers, one of the followings is false:
96. Answer. A

A. The dosage of succinylcholine to depress the twitch response in skeletal muscle is

greater than that for extraocular muscle.
B. Nondepolarizing agents produce a competitive block.
C. Depolarizing agents produce a noncompetitive block.
D. The block that produced by nondepolarizing agents is antagonized by
cholinesterase inhibitors.
E. The block that produced by depolarizing agents is enhanced by
cholinesterase inhibitors.

97. Effect of drugs on eyelids, all are correct Except: 97. Answer. A/E

A. Guanethidine can be used to widen of the palpebral fissure.

B. Botulinum toxin inhibits release of acetylchline from presynaptie terminals.
C. Botulinum toxin is used in the treatment of blepharospasm.
D. Edrophonium acts as an indirect nicotinic agonist in the tensilon test.
E. The partial ptosis of horner’s syndrome is reversed by topical cocaine.

RANDOM 2

98. Mitomycin-C is antifibrotic agent that:

98. Answer. C
A. Inhibits RNA synthesis
B. Cross link RNA
C. Inhibits DNA synthesis
D. Change the PH of the fibroblast and by that it prevents the cells growth
E. None of the above

99. The percentage of patients that have allergy to penicillin and may have a cross
99. Answer. D
reactivity with cephalosporin is:
A. 2%
B. 4%
C. 6%
D. 8%
E. 16%

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100. Which of the following antibiotics is a drug of choice for infections caused by 100. Answer. D
penicillinase producing Staph. Aureus? Penicillinase-resistant
penicillins
A. Amoxicillin include dicloxacillin, met
B. Ampicillin hicillin, oxacillin,
C. Piperacillin and nafcillin.
D. Naficillin
E. Ticracillin

101. Which of the following cephalosporins is known for its greater ability to 101. Answer. A

penetrate the blood-brain barrier?

A. Cefotaxime
B. Cefoperazone
C. Cefoxitin
D. Cefazolin
E. Cephalexin

102. Which of the following antibiotics produce their effect by inhibiting the protein synthesis by binding to 30S
ribosomal subunit?
A. Etracyclines 102. Answer. A
B. Penicillins
C. Cephalosporin third generation Tetracyclines
D. Cephalosporins second generation
E. Amoxicillin

103. Which of the following antibiotics should not be given to children:

103. Answer. B
A. Aminoglycosides
B. Tetracyclines
C. Eminipinim
D. Cephalosporins
E. Emoxycillin

104. All of the following are local ocular complications of glucocorticoids Except:
104. Answer. C
A. Glaucoma
C, posterior
B. Exacerbation of bacterial and viral infections
subcapsular
C. Nuclear sclerosis cataract
D. Ptosis
E. Mydriasis

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105. Which of the following antibiotics work by inhibiting DNA gyrase?

105. Answer. E
A. Aminoglycosides
B. Tetracyclines
C. Sulfonamides
D. Chloramphenicol
E. Fluoroquinolones

106. Which of the following side effects is not related to aminoglycosides?

106. Answer. D
A. Nephrotoxicity
B. Vestibular dysfunction
C. Auditory dysfunction
D. Temporary visual field defects
E. Allergic reaction

_________________________________ THE END_________________________________

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2016

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2017

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2018

?Which is not antihistamine or mast cell stabilizer

✔ Ketorolac

Olopatadine
Lodoxamide

Ketotofen fumarate

:Which has longest duration of action

Lidocaine

✔ Bupivocaine

Procaine

?Which cause follicular conjunctivitis

Carbachol
Alphagan
Timolol

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:Steroids cause all except

Ptosis
Cataract

✔Scleral thinning

Infection

Pilocarpine mechanism of action

?Which is not anitiviral

Aciclovir

✔ Flucytosine

Vidarabine

:Betaxolol is

✔ Beta 1 blocker

Beta 2 blocker

Alpha agonist

Which one is false regarding alphagan

✔ Nonselective alpha agonist

Decrease aqueous production

Can be given with timolol

:Which is not Amohotericin side effect

Diabetes

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Cardiac arrest
GI upset
Thrombocytopenia

CAI can not be given in except :

-chronic liver failure
-nephrolithiasis
-with digoxin
-with diuretics

Which of those aminoglycosides is more resistant to bacteria?

Genta
Amikacin
Tobra
Kanamycin

Which of thoses antibiotics is the most lipophilic?

Pharmacokinetics, what increase absorbtion of the drop:

High lipid solubility
High PH
Low viscosity

After viterectomy:
-it is 10% of it is water
-antibiotics and vegef can spread between vitrous and AC
-
Anti VEGEF r:
-glycoprtiens
-has 9 monomers

-affect venules

2019

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2020

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2021

Phenylpherine 10% , safe to be used in one scenario :

a) -medically free less than 10 years

b) -any child less than 4 years
c) -12 year child with history of febrile seizure at age of 1 year
d) -premature with rigid pupil

Phenylephrine 10% is not safe below 12 years... So the answer is 12 year old child with hx of febrile convulsion.... The
option A is not the best answer although it is not wrong 100%...

In malignant hyperthermia , one false

a) -use Na bicarbonate
b) -Ice cooling and ice IV fluid used
c) -Dantrolene
d) -hyperventilation with 100% o2 mask
e) -manage BP and HR.

For the malignant hyperthermia question... Misleading question! .... But I think the best answer is A as those patients may
have metabolic acidosis but sodium bicarbonate is not the first line in managing them.. And the other options are on the
first line management... I mean sodium bicarb is an option but not mandatory for all patients...

Which of these patients shouldn’t withheld their medications before cataract surgery even if they were NPO ?

a) -CHF patient with bradycardia on digoxin.

b) -female with mitral valve prolapse on Ab prophylaxis for endocarditis.
c) -Diabetic on Insulin.
d) -anxious male taking anticonvulsant

I think the answer is D; anxious male on anticonvulsant... As all other options can be managed intraoperatively with
medications.. Except status epilepticus which may occur at induction in the case of GA or even during Sx with LA due to
stress.. Even in practice, we usually refuse operating on a patient who is not taking his anticonvulsant medication while
We may operate on other situations...

Ecothiopate eye drop , when used , anesthetic should avoid using one of the following :

-suxamethonium) succinylcholine(

-lidocain

The answer is suxamethonium because ecothiophate prolong the action of suxamethonium considerably which may lead
to prolonged respiratory depression

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