Mock Tests Quiz Maker – Yexel Exams: Leading Pharmacy Exam Prep in Australia for KAPS

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152

Mock Test 1

1 / 20

1. Which of the following choices would not be appropriate in treating nausea and vomiting associated with motion sickness?

A. Metoclopramide

B. Hyoscine hydrobromide

C. Prochloperazine

D. Promethazine

E. A and C

F. C and D

Your Answer is Wrong.Correct Answer is E.

Motion sickness is an unpleasant condition that occurs when persons are subjected to motion or the perception of motion. It results in the common symptoms of nausea, no vertiginous dizziness, and malaise
Pharmacological treatment includes:
1. Scopolamine, an anticholinergic, is used for the prevention of motion sickness and for acute treatment
2.Antihistamines: Cinnarizine, Cyclizine, Meclizine, Promethazine
3. Sympathomimetics: Amphetamine, ephedrine
4. Caffeine
5. Ondansetron
6. Benzodiazepines

Your Answer is correct

2 / 20

2. Which drug does not interact with NSAIDs?

A. Methotrexate

B. Warfarin

C. Antihypertensive agents

D. Diphenhydramine

E. None of the above

Your answer is Wrong . Correct Answer : D

NSAIDs can significantly decrease methotrexate clearance, enhance the effect of warfarin, and blunt the hypotensive effect of hypertensive medications. There is no known interaction with diphenhydramine.

Your Answer is correct.

3 / 20

3. A patient's urine culture is positive for vancomycin resistant enterococcus faecium. He is treated with Linezolid 600 mg iv q12h. After 2 days on his new antibiotic, he has developed a major drug interaction. His home medications are fluconazole, citalopram, furosemide, metoprolol, aspirin, and lisinopril. Which of the following is the major sign/symptom of this drug interaction?

A. Thrombocytopenia

B. Serotonin syndrome

C. Torsades de pointe

D. Hypertensive crisis

E. Jaundice

Your Answer is Wrong. Correct Answer : B

Linezolid is weak inhibitor of MAO enzymes and Citalopram is a SSRI.
The use of citalopram in combination with linezolid results in a serious drug interaction producing the serotonin syndrome. Risk rating X- avoid this combination.

Your Answer is correct.

4 / 20

4. Which of the following medications is MOST extensively cleared unchanged by the renal route?

A. Digoxin

B. Phenytoin

C. Naproxen

D. Paracetamol

Your Answer is wrong. Correct answer : A

Paracetamol is metabolised extensively in the liver and excreted in the urine mainly as inactive glucuronide and sulphate conjugates. Less than 5% is excreted unchanged.
1 to 5% of phenytoin is excreted unchanged in the urine. The remainder is metabolized by the hepatic P450 enzyme system, predominantly CYP2C9 and CYP 2C19, and CYP3A4. All its metabolites are inactive.
Naproxen is eliminated following biotransformation to glucuroconjugated and sulphate metabolites which are excreted in urine, with only a small amount of the drug being eliminated unchanged.
Water soluble drug like digoxin elimination is primarily depends on kidney and most of the patients more than 80% of digoxin is eliminated unchanged in urine. Renal failure decreases the clearance of digoxin, and may cause accumulation to toxic levels.

Your Answer is correct.

5 / 20

5. Which ONE of the following suppository bases is immiscible with body fluids?

A. Gelatin

B. Polyethylene glycol

C. Glycerinated gelatin

D. Cocoa butter

E. Macrogol base

Your answer is wrong. Correct answer : D

Cocoa butter is the fat from the seeds of Theobroma cacao (chocolate beans). It may be obtained either by expressing the oil from the seeds or by solvent extraction. Chemically, it is a mixture of triglycerides of saturated and unsaturated fatty acids, primarily stearic, palmitic, oleic, lauric, and linoleic. It is a mellow, yellowish solid with a mild odor and bland taste. It is a solid at room temperature but melts at body temperature with a melting point of 31° to 34°C.

Your asnwer is correct.

6 / 20

6. Which of the following is not true about liquid Paraffin?

A. Sparingly soluble in alchohol

B. Is made of unsaturated hydrocarbons

C. Not soluble in water

D. Soluble in chloroform

Your answer is wrong. Correct Answer is B.

Liquid paraffin, also known as paraffinum liquidum or Russian mineral oil, it is a transparent, colourless, nearly odourless, and oily liquid that is composed of saturated hydrocarbons derived from petroleum.

Your answer is correct.

7 / 20

7. Clozapine is metabolized in the body by:

A. CYP3A4

B. CYP2D6

C. CYP1A2

D. CYP2C9

Your answer is wrong. Correct answer is C.

Clozapine is metabolized primarily by CYP1A2, with additional contributions by CYP2C19, CYP2D6 and CYP3A4.

Your answer is correct.

Clozapine is metabolized primarily by CYP1A2, with additional contributions by CYP2C19, CYP2D6 and CYP3A4.

8 / 20

8. Which of the following is most appropriate regarding biotransformation reaction?

A. Can occur in the kidney

B. Only occurs in the liver

C. Biotransformation reaction is same in all mammalian species

D. None of the above

Your answer is wrong. Correct answer is A.

Most drugs must pass through the liver, which is the primary site for drug metabolism.
Other sites of drug metabolism include epithelial cells of the gastrointestinal tract, lungs, kidneys, and the skin.

Your answer is correct

9 / 20

9. Among NSAIDS aspirin is unique because it:

A. Irreversibly inhibits its target enzyme

B. Prevents episodes of gouty arthritis with long-term use

C. Reduces fever

D. Reduces the risk of colon cancer

E. Selectively inhibits the COX-2 enzymes spectrophotometry

Your answer is wrong. Correct answer is A.

Aspirin is non-selective and irreversibly inhibits both forms of COX enzymes. Chemically aspirin is a acetylated salicylate, and acetylating the serine residue of COX enzyme is responsible for the irreversible inhibitory action.

Your answer is Correct.

10 / 20

10. A 55-year-old male with kidney stones has been placed on a diuretic to decrease calcium excretion. However, after a few weeks, he develops an attack of gout. Which diuretic was he taking?

A. Furosemide

B. Hydrochlorothiazide

C. Spironolactone

D. Triamterene

Your answer is wrong. Correct answer is B.

By increasing calcium reabsorption from the luminal membrane into the interstitium in exchange for sodium, thiazides reduce urine calcium levels and increase blood calcium. If indicated, this effect of thiazide diuretics makes thiazides useful for nephrolithiasis and osteoporosis treatment.
Thiazide diuretics are also associated with elevated serum uric acid (SUA) levels. They increase direct urate reabsorption in the proximal renal tubules.

Your answer is correct.

11 / 20

11. Cold sores are typically caused by:

A. HSV-1

B. HSV-2

C. Varicella zoster

D. HIV

E. None of the above

Your answer is wrong. Correct answer is A.

Cold sores - also called fever blisters - are a common viral infection. They are tiny, fluid-filled blisters on and around your lips, caused by certain strains of the herpes simplex virus (HSV). HSV -1 usually causes cold sores.

Your answer is correct.

12 / 20

12. Conformation of organic molecules is most commonly determined by which of the following analytical methods?

A. Nuclear magnetic resonance

B. Optical rotation

C. pk determinations

D. Biological assay

E. Mass spectrophotometry

Your answer is wrong. Correct answer is A.

Nuclear magnetic resonance (NMR) spectroscopy provides by far the highest resolution of any of the widely used spectroscopic methods. NMR spectra can often provide distinct peaks for each chemically different hydrogen or carbon atom in a molecule, thus providing a wealth of information for structure elucidation.

Your answer is correct.

13 / 20

13. Pyrantel pamoate is used for treatment of:

A. Athletes foot

B. Nickel poisoning

C. Nematode infestations

D. Toxoplasmosis

Your answer is wrong. Correct Answer is C.

Pyrantel pamoate acts as a depolarizing neuromuscular blocking agent, used to treat a number of parasitic worm infections (Nematode infections). This includes roundworm, hookworm and pinworm infections.

Your answer is correct.

14 / 20

14. Estradiol undergoes which of the following phase 2 metabolism reaction:

A. Glucronidation + Amino acid conjugation

B. Glucronidation + Sulfation

C. Acetylation

D. Glutathione conjugation

Your answer is wrong. Correct answer is B.

Sulfation is the primary conjugation reaction for substrates with phenol groups or aliphatic alcohols and Glucuronidation is one of the most important reactions for the elimination of xenobiotics from the body, Glucuronidation involves the reaction of uridine 5′-diphosphoglucuronic acid with one of a number of possible functional groups, such as R-OH, R-NH2, R-COOH, and others.
The parent estrogens, estrone and estradiol are reversibly inter-converted, catalysed by the 17 beta hydroxy steroid dehydrogenase enzyme. They are also converted to catechol estrogens including 2-hydroxestrogens, 4-hydroxestrogens, 16-hydroxestrone. or estriol through the action of CYP enzymes. Catechol estrogens, in turn are metabolized to 2-methoxyestrogens and 4-methoxyestrogens. Estrone, catechol estrogens, and methoxyestrogens can be conjugated to glucuronic acid and sulfate.

Your answer is correct.

15 / 20

15. Lactulose is a disaccharide composed of:

A. Glucose + Fructose

B. Glucose + Glucose

C. Galactose + Fructose

D. Glucose + Galactose

E. Cellulose derivative

Your answer is wrong. Correct answer is C.

Lactose is a disaccharide (2 sugars) made up of glucose and galactose where as Lactulose, also known as 1,4 beta galactoside-fructose, is a non-absorbable synthetic disaccharide made up of galactose and fructose.
Lactulose is a laxative taken to treat constipation and It is also taken to help a severe liver disease called hepatic encephalopathy.

Your answer is correct.

16 / 20

16. Drug A is full agonist for a specific receptor system; drug B is a competitive antagonist for the same receptor system. If increasing doses of drug B are co-administered with drug A, drug B will:

A. Increase the apparent Emax of drug

B. Reduce the apparent Emax of drug A.

C. Increase the apparent EC50 of drug

D. Reduce the apparent EC50 of drug A.

Your answer is wrong. Correct answer is C.

Increasing doses of agonist can displace the competitive antagonist → eventually produce Emax but EC50
increases (decrease in potency).

Your answer is correct.

Increasing doses of agonist can displace the competitive antagonist → eventually produce Emax but EC50
increases (decrease in potency).

17 / 20

17. All of the following adverse drug events are reported for pioglitazone (a thiazolidinedione), except:

A. Exacerbation of CHF

B. Resumption of ovulation

C. Edema

D. Upper respiratory infection

E. Megaloblastic anemia

Your answe is wrong. Correct answer is E.

Megaloblastic anaemia is a reported adverse drug effect for metformin, but not for Pioglitazone. Adverse effects of thiazolidinediones includes:
Edema and Congestive Heart Failure
Weight Gain
Increased fracture risk
Bladder Cancer
Hepatotoxicity
Diabetic Macular Edema
Increased ovulation rate
Teratogenic Effects
Increased risk of any pneumonia or lower respiratory tract infection

Your answer is correct.

18 / 20

18. Which type of anemia is seen in patients with rheumatoid arthritis, that is unrelated to drug therapy?

A. Microcytic, Hypochromic

B. Normochromic, normocytic

C. Normochromic, Macrocytic

D. Hypochromic, Macrocytic

Your answer is wrong. Correct anser is B.

Patients with rheumatoid arthritis often have a normocytic, normochromic anaemia, commonly referred to as an anemia of chronic disease.
In fact, anaemia has been reported to occur in as many as 60% of all rheumatoid arthritis, only surpassed in occurrence by joint symptoms. This anaemia does not respond to drug therapy (i.e., iron therapy). Sometimes, this may produce a diagnostic dilemma because patients on NSAIDs may develop gastric irritation with chronic blood loss, which would lead to iron deficiency anaemia. Other blood tests can help differentiate these two types of anaemia-for example, serum iron to iron binding capacity and mean corpuscular volume (usually decreased in iron deficiency).

Your answer is correct.

19 / 20

19. What condition usually increases the rate of drug dissolution for a tablet?

A. Increase in the particle size of the drug

B. Decrease in the surface area of the drug

C. Use of the ionized, or salt, form of the drug

D. Use of the free acid or free base form of the drug

E. Use of sugar coating around the tablet

Your answer is wrong. Correct answer is C.

The ionized, or salt, form of a drug is generally more water soluble and therefore dissolves
more rapidly than the nonionized (free acid or free base) form of the drug. According to the
Noyes-Whitney equation, the dissolution rate is directly proportional to the surface area and
inversely proportional to the particle size. Therefore, an increase in the particle size or a decrease in the surface area slows the dissolution rate

Your anser is correct.

20 / 20

20. Which patient is at potential risk for Digoxin toxicity?

A. Patient with a calcium of 8.9

B. Patient taking furosemide 20mg IV twice a day

C. Patient with a potassium level of 3.8

D. Patient presenting with painful muscle spasms and positive Trousseau's sign

Your answer is wrong. Correct answer is B.

Digoxin blocks the sodium/potassium ATPase pump.
Digoxin toxicity causes hyperkalaemia or high potassium. The sodium/potassium ATPase pump normally causes sodium to leave cells and potassium to enter cells. Blocking this mechanism results in higher serum potassium levels.
Electrolyte abnormalities that can induce/worsen the digoxin toxicity are hypokalaemia, hypomagnesemia, and hypercalcemia.
Furosemide is a loop diuretic that causes hypomagnesemia and hypokalaemia, in states of hypokalaemia or low potassium, digoxin toxicity is actually worsened because digoxin normally binds to the ATPase pump on the same site as potassium. When potassium levels are low, digoxin can more easily bind to the ATPase pump, exerting the inhibitory effects.
As mentioned above, digoxin toxicity can cause hyperkalaemia. Recall that the treatment for hyperkalaemia causing ECG changes is usually intravenous calcium administration; however, in the setting of digoxin toxicity and hyperkalaemia, giving IV calcium may be potentially fatal

Your answer is correct.

Your score is

The average score is 52%

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Mock Test 2

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1. A 62-year-old man presents to the emergency Department with vague aches and pains, fatigue, stable serum creatinine of 1.8 mg/dl, and a serum [K+] of 6.7 mEq/L. The most likely cause of the acute hyperkalemia is:

A. Insulin therapy

B. Amphotericin B

C. NSAIDs

D. Aminoglycosides

Your answer is wrong. Correct answer : C

Normal urine potassium excretion is dependent on two conditions; adequate sodium delivery to the collecting duct and the presence of aldosterone. Cyclooxygenase inhibition by NSAIDs (especially COX-2 Inhibitors) can cause hyperkalaemia. Secretion of renin by cells in the afferent glomerular arterioles and by cells of the macula densa in the early distal tubule appears to be mediated in part by locally produced prostaglandins. As a result, prostaglandin synthesis inhibition can lead to low plasma renin activity and low levels of aldosterone in plasma. The rise in the potassium is very small in healthy subjects, but pre-existent mild to moderate azotaemia, potassium supplementation, potassium sparing diuretics, ACE inhibitor and/or angiotensin receptor blocker, diabetes, heart failure, old age is associated with an increased risk of the condition.

Your answer is correct.

2 / 20

2. Which of the following is true for moderate to severe Crohn's Disease?

A. Azathioprine is the drug of choice for initial therapy.

B. Budesonide is appropriate maintenance therapy.

C. Oral corticosteroids are the drugs of choice for initial therapy.

D. Methotrexate has no role in CD therapy.

E. Topical aminosalicylates are appropriate maintenance therapy.

Your answer is wrong. Correct answer : C

Moderate to severe disease initially requires oral corticosteroid therapy. Corticosteroids have no role in maintenance therapy. Topical amino salicylates may be used as adjuncts in colonic CD. Methotrexate is used as maintenance therapy for moderate to severe CD.

Your answer is correct.

3 / 20

3. Which of the following is correct regarding concomitant administration of Aspirin and Methotrexate?

A. Salicylates block the renal tubular secretion of methotrexate

B. Aspirin and Methotrexate can increse the risk of pulmonary toxicity

C. Aspirin reduces peak serum concentration of Methotrexate

D. All of the above

Your answer is wrong. Correct answer : A

Methotrexate is often combined with non-
steroidal anti-inflammatory drugs (NSAIDs) or acetyl salicylic acid(aspirin).
Aspirin may influence renal function by the inhibition of renal prostaglandin synthesis which may lead to a reduction in renal blood flow and the glomerular filtration rate and decrease the excretion of methotrexate, also aspirin compete with methotrexate for renal tubular secretion and block the secretion of methotrexate.
Aspirin decreases the renal clearance of methotrexate by affecting the glomerular filtration and tubular secretion.
Aspirin also displaces methotrexate from protein binding sites

Your answer is correct.

4 / 20

4. Which of the following antibiotics is used for the prophylxis of traveller's diarrhoea?

A. Azithromycin

B. Minocycline

C. Ciprofloxacin

D. Amikacin

Your answer is wrong. Correct answer is C.

Traveller's diarrhoea (TD) is the most common ailment affecting persons from industrialized countries who visit developing areas. The most causative organism is enterotoxigenic Escherichia coli, followed by Campylobacter jejuni, Shigella species, and Salmonella species.
Prophylaxis
(Only in travellers who are immunocompromised and in those with chronic intestinal disorders or a history of disabling bouts of TD)
>Bismuth subsalicylate - 2 tablets QID (chewed)
>Ciprofloxacin - 500 mg OD
>Rifaximin - 200 mg OD/BD
Treatment
>Fluoroquinolones (Ciprofloxacin, Levofloxacin)
>Macrolides (Azithromycin)
>Rifaximin
+
>Antimotility agent (Loperamide)
>Oral rehydration salts (ORS)

Your answer is correct

5 / 20

5. Which is the following antihypertensive medication is not suitable in patients with history of depression?

A. Losartan

B. Thiazide

C. Methyldopa

D. Diazoxide

Your answer is wrong. Correct answer is C.

Depression is associated with a catecholamine (CAs) deficiency in the brain. The catecholamine theory makes the following predictions: drugs which destroy/ decrease the CAs should produce depression and drugs which increase CAs should alleviate depression.
Centrally acting sympatholytic block sympathetic activity by binding to and activating alpha2 (α2)-adrenoceptors. Stimulation of central alpha-2 receptors causes decreased secretion of catecholamines through a negative feedback mechanism.
There is now compelling evidence that both reserpine and alpha-methyldopa can induce or worsen depression through their actions on the central nervous system. beta-Blockers have also been implicated, but the data supporting the link between these drugs and depression are not as certain. Guanethidine, clonidine, hydralazine, and prazosin appear to pose little risk in causing depression, although rare occurrences have been reported. Diuretics, calcium channel blockers, and angiotensin converting enzyme (ACE) inhibitors appear to have the lowest association with depression and are therefore the drugs of choice when depression is a risk.

Your answe is correct.

6 / 20

6. On exposure to air aminophylline solutions may develop:

A. Crystals of theophylline

B. A gas

C. Precipitate of ethylenediamine

D. A straw colour

Your answer is wrong. Correct answer is A

Xanthine derivatives, aminophylline and theophylline are considered to be respiratory smooth muscle relaxants, but also have other pharmacologic actions. Aminophylline differs from theophylline only by the addition of ethylenediamine to its structure and may have different amounts of molecules of water of hydration.
Aminophylline for injection should be stored in single-use containers in which carbon dioxide has been removed. It should also be stored at temperatures below 30°C and protected from freezing and light. Upon exposure to air (carbon dioxide), aminophylline will absorb carbon dioxide, lose ethylenediamine and liberate free theophylline which can precipitate out of solution. Do not inject aminophylline solutions that contain a precipitate or visible crystals.
Aminophylline for injection is reportedly compatible when mixed with all commonly used IV solutions, but may be incompatible with 10% fructose or invert sugar solutions.

Your answer is correct.

7 / 20

7. A 45-year-old man experiences an acute myocardial infarction. On the following day he is treated with an intravenous antiarrhythmic agent to prevent multifocal premature ventricular contractions and he experiences a seizure. What is the most likely cause of the seizure?

A. Ventricular asystole

B. Systemic hypotension

C. Lidocaine toxicity

D. Ventricular tachycardi

E. Cardiac embolization

Your answer is wrong. Correct answer : C

Lidocaine is indicated for the acute management of ventricular arrhythmias in patients with myocardial infarction/ischemia.

Your anwer is correct.

Lidocaine is indicated for the acute management of ventricular arrhythmias in patients with myocardial infarction/ischemia.

8 / 20

8. All the following agents are commonly associated with photosensitivity except?

A. Ciprofloxacin

B. Ibuprofen

C. Sulfonamides

D. Cefazolin

E. Frusemide

Your answer is wrong. Correct answer: D

Medications that cause Photosensitivity

Anti infectives
Tetracyclines (Doxycycline)
Fluroquinolones (Ciprofloxacin)
Sulfonamides
Anti-malarials (Quinine, Chloroquine, Hydroxychloroquine)

NSAIDs
Ibuprofen
Naproxen
Piroxicam

Diuretics
Frusemide
Bumetanide
Hydrochlorothiazide

Reinoids
Isotretinoin
Acitretin

Oral Hypoglycemics
Sulfonylureas (eg, Chlorpropamide, glipizide, glyburide)

Antipsychotics
Phenothiazines (eg, chlorpromazine, fluphenazine)
Thioxanthenes (eg, chlorprothixene)

Targeted Therapy
Vemurafenib
Dabrafenib
Imatinib
Vendetanib

Miscellaneous
Amiodarone
Diltiazem
Enalapril
Dapsone
Voriconazole

Your answer is correct.

Medications that cause Photosensitivity

Anti infectives
Tetracyclines (Doxycycline)
Fluroquinolones (Ciprofloxacin)
Sulfonamides
Anti-malarials (Quinine, Chloroquine, Hydroxychloroquine)

NSAIDs
Ibuprofen
Naproxen
Piroxicam

Diuretics
Frusemide
Bumetanide
Hydrochlorothiazide

Reinoids
Isotretinoin
Acitretin

Oral Hypoglycemics
Sulfonylureas (eg, Chlorpropamide, glipizide, glyburide)

Antipsychotics
Phenothiazines (eg, chlorpromazine, fluphenazine)
Thioxanthenes (eg, chlorprothixene)

Targeted Therapy
Vemurafenib
Dabrafenib
Imatinib
Vendetanib

Miscellaneous
Amiodarone
Diltiazem
Enalapril
Dapsone
Voriconazole

9 / 20

9. A patient diagnosed with glaucoma the goal treatment option is to "move fluid out" (increase uveoscleral outflow without effect on aqueous humor formation), which medication is preferred:

A. Betaxolol

B. Acetazolomide

C. Timolol

D. Latanoprost

Your answer is wrong. Correct answer : D

Mechanism of action of drugs used in Glaucoma
(1) Beta- blockers:
e.g.: Timolol, carteolol (non-selective), Betaxolol (cardio selective)
MOA: Decreases the production of aqueous humor by acting on epithelium of ciliary body
(2) Carbonic anhydrase inhibitors
e.g.: Dorzolamide, Brinzolamide (Topical), Acetazolamide (Systemic)
MOA: Decreases production of aqueous humor by blocking carbonic anhydrase enzyme required for production of bicarbonate ions.
(3) Prostaglandin analogues
e.g. : Latanoprost, Travoprost, Bimatoprost
MOA: Increase uveoscleral outflow of aqueous humor
(4) Adrenergic agonists
e.g.: Apraclonidine, Brimonidine, Dipivefrin
MOA: Decrease aqueous humor production through vasoconstriction of ciliary blood vessels and increases uveoscleral outflow.
(5) Cholinergic agonists
e.g.: Carbachol, Pilocarpine
MOA: Increases aqueous humor outflow through trabecular meshwork by causing miosis
(6) Osmotic agents
e.g.: Mannitol, Glycerol
MOA: Decreases IOP in acute conditions by decreasing vitreous volume

10 / 20

10. Which of the following in its parenteral form is life saving at least in severe status asthmaticus and acts by inhibiting phospholipase A2?

A. Epinephrine

B. Cromolyn

C. Aminophylline

D. Prednisone

E. Ipratropium

Your answer is wrong. Correct answer : D

Glucocorticoids are the lifesaving treatment for status asthmaticus. These agents can decrease mucus production, improve oxygenation, reduce beta-agonist or theophylline requirements, and activate properties that may prevent late broncho constrictive responses to allergies and provocation.
Prednisone decreases inflammation by suppressing the production of leukotrienes and the migration of polymorphonuclear leukocytes and by reducing capillary permeability.

Your answer is correct.

11 / 20

11. Which one of the following general characteristics is not true for alkaloids?

A. Contain nitrogen in the molecule

B. Have good alcohol solubility

C. Have pKa less than 7

D. Often exhibit stereoisomerism

E. Have poor water solubility

Your answer is wrong. Correct answer : C

Most of the alkaloids have pKa above 7. Therefore, they are weak bases. Alkaloids shows poor water solubility. Stereoisomerism is common in alkaloidal structures.

Your answer is correct.

Most of the alkaloids have pKa above 7. Therefore, they are weak bases. Alkaloids shows poor water solubility. Stereoisomerism is common in alkaloidal structures.

12 / 20

12. A 30-year-old male is diagnosed to be human immunodeficiency virus (HIV) positive. His CD4+ count is 200 cells/mm3 and his viral load is 10,000 copies/mL. In addition to receiving antiviral therapy, which of the following is indicated to protect him against pneumonia due to Pneumocystis jiroveci?

A. Trimethoprim

B. Ciprofloxacin

C. Cotrimoxazole

D. Clindamycin

E. Sulfamethoxazole

Your answer is wrong. Correct answer : C

Pneumocystis (carinii) jiroveci Pneumonia is the most common opportunistic infection in persons infected with HIV.
Treatment:
1.Trimethoprim-sulfamethoxazole 15--20 mg/kg IV or PO in 3 or 4 divided doses. (Drug of choice)
2. Pentamidine isoethionate 3-- 4 mg/kg IV daily
3. Clindamycin + Primaquine 600- -900 mg q6--8h IV or PO
4. Prednisone 40 mg PO bid, 1-5 days

Your answer is correct.

13 / 20

13. Which of the following is a prophylactic agent in tension-type headache?

A. Amitriptyline

B. Sumatriptan

C. Acetaminophen

D. Naproxen

E. Codeine

Your answer is wrong. Correct answer : A

Tension Type Headache

Age of Onset: before 20 years

Peak: between 20 and 50 years.

Diagnostic criteria: mild-to-moderate bilateral pain characterized as dull, no pulsating tightness or pressure; absence of nausea, vomiting, and aura; mild or absent phonophobia and photophobia; and headache not worsened by exertion.

Prophylaxis: Amitriptyline

Acute treatment options: acetaminophen, ibuprofen, naproxen sodium, ketoprofen, and diclofenac.
Other options: IM Ketorolac, parenteral chlorpromazine with or without diphenhydramine, and metoclopramide with or without diphenhydramine.

Note: Triptans, opioids, and muscle relaxants have no role in the treatment of tension-type headaches.

Your answer is correct.

Tension Type Headache

Age of Onset: before 20 years

Peak: between 20 and 50 years.

Prophylaxis: Amitriptyline

Note: Triptans, opioids, and muscle relaxants have no role in the treatment of tension-type headaches.

14 / 20

14. Which of the following medications is NOT effective for the treatment of P. aeruginosa urinary tract infection?

A. Trimethoprim-sulfamethoxazole

B. Norfloxacin

C. Ciprofloxacin

D. Methenamine mandelate

E. All of the above are effective

Your answer is wrong. Correct answer : A

A complicated UTI caused by P. aeruginosa can be treated with methenamine and fluroquinolones. TMP-SMX is not active against P. aeruginosa. It is active against most gram negative Enterobacteriaceae, which makes it useful an empiric therapy for uncomplicated UTI.

Your answer is correct.

15 / 20

15. All of these drugs can cause ototoxicity except:

A. Furosemide

B. Capreomycin

C. Streptomycin

D. None of the above

Your answer is wrong. Correct answer : D

Drugs causing Ototoxicity
1. Aminoglycosides: (amikacin, gentamicin, neomycin, streptomycin, tobramycin, capreomycin)
2. ASA
3. Loop diuretics (bumetanide, ethacrynic acid, furosemide)
4. Macrolides (azithromycin, clarithromycin, erythromycin)
5. PDE 5 inhibitors (sildenafil, tadalafil, vardenafil)
6. Quinine
7. Tetracyclines (doxyxycline, minocycline)
8. Platinum compounds (cisplatin, carboplatin, oxaliplatin)

Your answer is correct.

16 / 20

16. Which one of the following classes of antidiabetics doesn't cause profound hypoglycemia?

A. Biguanides

B. Sulfonylureas

C. Insulin

D. Meglitinides

Your answer is wrong. Correct answer :

Metformin has little effect on blood glucose in normoglycemic states. It does not stimulate the release of insulin or other islet hormones and therefore, rarely causes hypoglycaemia.

Your answer is correct.

Metformin has little effect on blood glucose in normoglycemic states. It does not stimulate the release of insulin or other islet hormones and therefore, rarely causes hypoglycaemia.

17 / 20

17. Which of the following drugs causes least withdrawal effects?

A. Temazepam

B. Triazolam

C. Alprazolam

D. Diazepam

Your answer is wrong. Correct answer : D

Dependence can develop if high doses of benzodiazepines are given for a prolonged period. All benzodiazepines are controlled substances. Abrupt discontinuation of these agents results in withdrawal symptoms, including confusion, anxiety, agitation, restlessness, insomnia, tension, and (rarely) seizures.

Benzodiazepines with a short elimination half-life, such as triazolam and alprazolam, induce more abrupt and severe withdrawal reactions than those seen with drugs that are slowly eliminated such as flurazepam and diazepam

Your answer is correct.

18 / 20

18. Which of the following anticonvulsants is metabolized to phenobarbital?

A. Vidarabine

B. Primidone

C. Ethosuximide

D. Levetiracetam

E. Zonisamide

Your answer is wrong. Correct answer : B

PRIMIDONE is metabolized to phenobarbital and phenylethylmalonamide (PEMA), both active metabolites. with anti-epileptic activity. It is effective against partial and generalized tonic-clonic seizures.

Your answer is correct.

19 / 20

19. Which of the following decrease serum theophylline concentration?

A. Clarithromycin

B. Ketoconazole

C. Smoking

D. Cimetidine

Your answer is wrong. Correct answer : C

???????????????????????????? ???????????????? ???????????????????? ????????????????????????????????????????????????
■ ???????????????????????????? ???????????????? ???????????????????????????????? ???????????????????????????????????????????????? ????????????????????????????????????
Carbamazepine
Phenobarbital
Phenytoin
Rifampin
Smoking (marijuana and tobacco)
■ ???????????????????????????? ???????????????? ???????????????????????????????? ???????????????????????????????????????????????? ???????????????????????????????????? (???????????????????????????????? ????????????????????????)
Congestive heart failure
Cimetidine
Fluoroquinolones (ciprofloxacin)
Macrolides (clarithromycin, erythromycin)

Your answer is correct.

20 / 20

20. Which of the following is associated with autoinduction?

A. Phenobarbital

B. Phenytoin

C. Valproic acid

D. Carbamazepine

Your answer is wrong. Correct answer : D

Carbamazepine has an autoinduction metabolism property, which means that if
the dose is increased twofold, blood levels increase less than twofold because of increased metabolism.

Your answer is correct.

Carbamazepine has an autoinduction metabolism property, which means that if
the dose is increased twofold, blood levels increase less than twofold because of increased metabolism.

Your score is

The average score is 59%

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/20

Mock Test 3

1 / 20

1. Sulphonamide potency is decreased when co-administration with:

A. Oral hypoglycaemic agents

B. Local anaesthetics - derivatives of Para aminobenzoic acid

C. Local anaesthetics - derivatives of benzoic acid

D. Non-narcotic analgesics

Your answer is wrong. Correct answer : B

Sulphonamides are structural and competitive analogues of PABA in this reaction and inhibit the formation of DHF when present in adequate concentrations. Since this action is competitive, increased concentrations of PABA can overcome the inhibition.

Your answer is correct.

2 / 20

2. Which of the following beta-blockers has intrinsic sympathomimetic activity (ISA)?

A. Bisoprolol

B. Timolol

C. Pindolol

D. Propranolol

Your answer is wrong. Correct answer : C

Beta blockers such as Carteolol, pindolol, penbutolol, celiprolol, oxprenolol, labetalol and acebutolol differ from other beta blockers as they possess intrinsic sympathomimetic activity (ISA), which means they mimic the effects of epinephrine and norepinephrine and can cause an increase in blood pressure and heart rate. ISA's have smaller effects in reducing resting cardiac output and resting heart rate, in comparison to drugs that do not possess ISA.

Your answer is correct.

3 / 20

3. A "shake and bake reaction" is a response to the administration of which of these drugs?

A. Flucytosine

B. Ketoconazole

C. Amphotericin B

D. Caspofungin

Your answer is wrong. Correct answer : C

Amphotericin B is a polyene medication, which works by binding to ergosterol in fungal cell membranes. It forms membrane pores, causing electrolytes to leak, killing the fungal cell. It is used for serious, systemic mycoses. It can lead to the side effects of fever and chills, nephrotoxicity, hypotension, hypokalaemia, arrhythmias, anaemia and IV phlebitis. Amphotericin B can acutely lead to high fever and shaking chills, which led to the "shake and bake" terminology.

Your answer is correct.

4 / 20

4. Which of these drugs should be avoided 48 - hours before/after use of IV contrast media?

A. Phenytoin

B. Metformin

C. Voriconazole

D. Pyridostigmine

Your answer is wrong. Correct answer : B

Intravascular administration of iodinated contrast media to patients who are receiving metformin, an oral antidiabetic agent, can result in lactic acidosis. However, this rare complication occurs only if the contrast medium causes renal failure, and the patient continues to take metformin in the presence of renal failure. Because metformin is excreted primarily by the kidneys, continued intake of metformin after the onset of renal failure results in a toxic accumulation of this drug and subsequent lactic acidosis. To avoid this complication, metformin must be withheld after the administration of the contrast agent for 48 hours, during which the contrast-induced renal failure becomes clinically apparent. If renal function is normal at 48 hours, the metformin can be restarted.

Your answer is correct.

5 / 20

5. Acetazolamide - works by acting at which part of the nephron?

A. Proximal tubule

B. Loop of Henle

C. Distal tubule

D. Collecting duct

Your answer is wrong. Correct answer : A

Carbonic anhydrase enzyme is predominantly located in epithelial cells of PCT and catalyses the dehydration of H2CO3 to CO2 at luminal membrane and subsequent rehydration of CO2 to H2CO3 in cytoplasm of PCT cells. H2CO3 is converted to H and HCO3 in the cytoplasm, and HCO3 reabsorbed on the interstitial membrane with Na, and H secreted via Na/K transporter on the luminal membrane by blocking this enzyme, acetazolamide blunt NaHCO3 reabsorption and cause diuresis. They also reduce renal secretion of H in the PCT.

Your answer is correct.

6 / 20

6. Purple glove syndrome is a side effect of which of these drugs?

A. Phenytoin

B. Digoxin

C. Chloramphenicol

D. Vancomycin

Your answer is wrong. Correct answer : A

Purple glove syndrome (PGS) is a rare complication of intravenous (IV) phenytoin administration that is characterized by delayed soft tissue injury of the skin adjacent to the site of IV phenytoin infusion. PGS may occur with or without extravasation of IV phenytoin.

Your answer is correct.

7 / 20

7. The compounds whose molecules are shown below would have:

A. the same melting points

B. different melting points

C. equal but opposite optical rotations

D. More than one of the above

E. None of the above

Your answer is wrong. Correct answer : B

Diastereomers can have different physical properties and reactivity. They have different melting points and boiling points and different densities. They have two or more stereo centres.

Your answer is correct.

Diastereomers can have different physical properties and reactivity. They have different melting points and boiling points and different densities. They have two or more stereo centres.

8 / 20

8. A 55-year-old patient currently receiving a drug for a psychiatric condtion is to be started on diuretic therapy for mild heart failure. Consideration should be given to the fact that thiazides are known to reduce the excretion of which of the following?

A. Diazepam

B. Fluoxetine

C. Imipramine

D. Lithium

E. Trifluoperazine

Your answer is wrong. Correct answer : D

Thiazide diuretics have a significant potential to increase serum lithium concentrations. These diuretics induce a natriuresis that leads to a compensatory increase in the reabsorption of lithium (Lithium act as a monovalent cation similar to Na) in the proximal tubule.

Your answer is correct.

9 / 20

9. The antimicrobial action of the Amikaccin can best be explained on the basis of:

A. Competitive antagonism of purine precursors

B. Inhibition of the incorporation of PABA into dihydrofolic acid precursors

C. Inhibition of protein synthesis by binding to 30 s ribosome subunit

D. Inhibition of protein synthesis by binding to 50 s ribosome subunit

E. Inhibition of Topoisomerase IV enzyme

Your answer is wrong. Correct answer :

Amikacin is a aminoglycoside antibiotic that is transported into the bacterial cell through an oxygen dependent system and binds to 30s ribosomal subunit and interfere with the assembly of the functional ribosomal apparatus or cause the 30s subunit to misread the genetic code, thus inhibits the protein synthesis.

Your answer is correct.

10 / 20

10. Which of the following is not a diagnostic test for cystic fibrosis?

A. Sweat chloride test

B. FEV1 value

C. CFTR gene test

D. Liver fucntion test

E. ECG

Your answer is wrong. Correct answer : E

The diagnostic tests for cystic fibrosis include newborn screening, CFTR genetic testing, sweat chloride test, FEV1 value, liver function tests etc, but not ECG

Your answer is correct.

The diagnostic tests for cystic fibrosis include newborn screening, CFTR genetic testing, sweat chloride test, FEV1 value, liver function tests etc, but not ECG

11 / 20

11. Bacteria responsible for the most episodes of infectious diarrhea include all the following except:

A. E. coli

B. Shigella

C. Pseudomonas

D. Campylobacter

E. Salmonella

Your answer is wrong. Correct answer : C

Several types of bacteria can enter your body through contaminated food or water and cause diarrhoea. Common bacteria that cause diarrhoea include Campylobacter, Escherichia coli (E. coli), Salmonella, and Shigella. Parasites that cause diarrhoea include Cryptosporidium enteritis, Entamoeba histolytica and Giardia lamblia. Many viruses cause diarrhoea, including norovirus and rotavirus.

Your answer is correct.

12 / 20

12. The absorption rate of a drug is most rapid when the drug is formulated as:

A. Controlled-release tablet

B. Hard gelatin capsule

C. Compressed tablet

D. Solution

E. Suspension

Your answer is wrong. Correct answer : D

For a drug in solution, no dissolution is required before absorption. Consequently,
compared with other drug formulations, a drug in aqueous solution has the highest
bioavailability rate and is often used as the reference preparation for other formulations

Your answer is correct.

13 / 20

13. A new anti-hypertensive drug is in Phase III Clinical Trial. Norepinephrine does not produce any significant effect in BP & HR when given in the presence of this drug. The new drug is?

A. Prazosin

B. Clonidine

C. Metoprolol

D. Carvedelol

Your answer is wrong. Correct answer : D

Norepinephrine is a sympathomimetic amine that binds to α1, α2, ẞ1 and ẞ3 receptors, but does not bind to ẞ2 receptors. It causes α1 mediated intense vasoconstriction of most of vascular beds, leading to rise in BP and ẞ1 mediated stimulation of myocardium (increased heart rate, increased work and oxygen consumption, increased cardiac output). But unlike Epinephrine, NE does not produce compensatory vasodilation via β2 on blood vessels supplying skeletal muscles. But in the presence of the 'new anti-hypertensive drug', Norepinephrine does not produce any significant change in BP and HR. It indicates that the new trial drug is able to block both α1 and β1 mediated effects of Norepinephrine. Carvedilol is a beta and alpha-1 adrenoceptor blocker.

Your answer is correct.

14 / 20

14. What is not true of G protein-coupled receptors:

A. Bradykinin, serotonin, prostaglandins and chemokines act on it

B. All G-protein coupled receptors are not metanotropic receptors

C. Protein Kinase activation is mediated through cAMP

D. Gq activation can stimulate phospholipase C

E. ẞ2 adrenergic receptors may be activated by G proteins

Your answer is wrong. Correct answer : B

G-protein coupled receptors are among the largest and most diverse receptor families in mammalian genomes. They consist of seven membrane-spanning helices, an extracellular ligand binding domain and an intracellular domain made of a heterotromeric protein with a G- protein (GDP) molecule attached to it.
All GPCR receptors are metabotropic receptors that are activated by ligand binding. Various signalling molecules including light, hormones, amines, neurotransmitters, and lipids can bind to GPCRs.
Inflammatory mediators like bradykinin, serotonin, prostaglandins, chemokines etc., can act on it. Agonist binding is followed by a change in the conformation of the receptor and depending on the type of G protein to which the receptor is coupled, a variety of downstream signalling pathways can be activated.
Typically, Gαs stimulates adenylyl cyclase and converts ATP to cyclic AMP (cAMP) levels. Increased cAMP mediates activation of protein kinase A(PKA).
Gαq family members activate phospholipase C (PLC), which cleaves phosphatidylinositol bisphosphate (PIP2) into diacylglycerol and inositol triphosphate (IP3), and mediates the activation of PKC and intracellular calcium release. Beta adrenergic receptors are examples of Gs coupled receptors

Your answer is correct.

15 / 20

15. Which of the following CYP450 enzyme is responsible for metabolising S-Warfarin?

A. CYP1A2

B. CYP3A4

C. CYP2C9

D. CYP2C19

Your answer is wrong. Correct answer : C

The anticoagulant drug warfarin occurs as a pair of enantiomers that are differentially metabolized by human cytochromes P450 (CYP). R-warfarin is metabolized primarily by CYP1A2, CYP3A4 and CYP2C19. S-warfarin is metabolized primarily by CYP2C9 to 7-hydroxywarfarin

Your answer is correct.

16 / 20

16. Which of the following best describes GI side effects of antacids containing magnesium and calcium salts?

A. Mg causes constipation; Ca causes diarrhoea

B. Both cause diarrhoea

C. Both cause constipation

D. Mg causes diarrhoea; Ca causes constipation

E. Neither has GI side effects

Your answer is wrong. Correct answer : D

Magnesium containing antacids causes diarrhoea and aluminium and calcium containing antacids causes constipation.

Your answer is correct.

Magnesium containing antacids causes diarrhoea and aluminium and calcium containing antacids causes constipation.

17 / 20

17. Lisinopril may cause hemodynamically mediated kidney disease by preventing which of the following compensatory mechanisma by the kidney?

A. Vasodilation of the afferent arteriole

B. Vasodilation of the efferent arteriole

C. VAsoconstriction of the afferent arteriole

D. Vasodilation of both the afferent and the efferent arterioles

E. Vasoconstriction of the efferent arteriole

Your answer is wrong. Correct answer : E

Angiotensin-converting enzyme inhibitors may contribute to development of AKI in patients with conditions resulting in prerenal kidney disease (e.g., conditions resulting in decreased perfusion of the kidney, hypovolemia, heart failure, liver disease, and so forth). ACEIs prevent the compensatory vasoconstriction of the efferent arteriole mediated by angiotensin II that occurs in an attempt to increase GFR.

Your answer is correct.

18 / 20

18. All of the following are possible side effects of low dose Nicotine (through smoking tobacco) EXCEPT?

A. Increased sweating

B. Stimulation of rate and depth of breathing

C. Stimulation of catecholamine release from adrenal medulla

D. Bradycardia

E. Nausea and vomiting

Your answer is wrong. Correct answer : D

Low doses of Nicotine (those in the range of inhaled cigarette smoke, 1-2 mg) stimulate ganglionic nicotinic receptors and also sensory receptors in the lungs. These effects usually cause increased sweating, ventilatory rate, the secretion of epinephrine from the adrenal medulla which contributes to elevations in heart rate, cardiac output and increased arterial pressure.
These cardiovascular effects dominate the vagal mediated slowing which occurs through stimulation of parasympathetic ganglia cells. Nicotine stimulation of sensory receptors in the gut causing increased peristalsis, usually gives the first time smoker some nausea and possibly vomiting. Thus, the answer is D. Bradycardia

Your answer is correct.

19 / 20

19. Which of the following antiarrhythmic agents requires dosage adjustment in patients with impaired renal function?

A. Amiodarone

B. Lidocaine

C. Digoxin

D. Verapamil

Your answer is wrong. Correct answer : C

When prescribing cardiac glycosides for patients with renal failure, one should consider the different pharmacokinetics of the two most important glycosides, digoxin and digitoxin. With decreasing creatinine clearance, the total body clearance as well as the renal clearance of digoxin is reduced and elimination half-lives are prolonged, whereas the elimination half-life of digitoxin is unchanged. Despite its long elimination half-life, administration of digitoxin is favoured in renal impairment because of its insensitivity to changes in renal function.

Your answer is correct.

20 / 20

20. A 54-year-old man with rheumatoid arthritis started to take methotrexate (25mg once a week).Which of the following represents the best way to decrease potential liver toxicity with methotrexate while achieving optimal therapeutic benefit?

A. Add 1-3 mg of folic acid per day to the patient's regimen.

B. Add Leucovorin injection to the patient's regimen.

C. Add Leflunomide to the patient's regimen.

D. Decrease the dose of Methotrexate to 25 mg once monthly.

Your answer is wrong. Correct answer : A

The addition of folic acid to the methotrexate regimen has been demonstrated to reduce the risk of liver toxicity. Lowering the dose of methotrexate is likely to decrease risk but is also likely to decrease its effectiveness. Leucovorin, an injectable formulation of folate, is used only to reverse methotrexate toxicity.

Your answer is correct.

Your score is

The average score is 62%

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YEXEL

Q - BANK

Yexel Exams extensive question bank gives you the ultimate practice in KAPS Exam preparation by combining the most repeated questions with enhanced explanations and review materials.

A KAPS-prep module combining expertise, goal-based training, and flexibility.

info@yexelexams.org

YexelExams

+61 478 393 733

Quick Links

Home

Courses

Study Materials

Yexel Q - Bank

Mock Tests

Social Share

Yexel Exams extensive question bank gives you the ultimate practice in KAPS Exam
preparation by combining the most repeated questions with enhanced explanations and review materials.