Medicine                                                  

Sohag University                                                                                                                                               

                                                                  Pharmacology Department

                                                                 Date: 27 /8/2012

                                                                       Time allowed: 3 hours

 

Pharmacology Examination For Third Year

Medical Student

(I):

Answer only FOUR questions from the following:          (40 marks)

 

1-SULFONAMIDES: Mechanism of action, therapeutic uses and main side effects.

 

2-GLUCORTICOIDS : Therapeutic uses, side effects, containdications and precautions to be taken during its therapy.

 

3-NITROGLYCERINE: mechanism of action, cardiovascular effects, untoward effects and therapeutic uses.

 

4-BETA-LACTAM ANTIBIOTICS: Classification, discuss the mechanism of action, pharmacokinetics, therapeutic uses and adverse effects of the most common used group.

 

5-FIBRINOLYTIC (THROMBOLYTIC) are commonly used in emergency practice. Explain their mechanism of action, therapeutic uses, adverse effects, contraindications and precautions of their therapy.

 

 

 

 

 

(II):

Answer ALL the following short questions                      (60marks)

 

6-Adverse effects of INSULIN.

 

7-BROMOCRIPTINE: Clinical indications and contraindications.

 

8-Low molecular weight HEPARINS.

 

9-PARACETAMOL: Pharmacokinetics, side effects, toxicity and therapeutic uses.

 

10-METHOTREXATE: Mechanism of action and how to overcome its resistance.

 

11- Mechanism of action and side effects of MACROLIDES giving examples.

 

12-Side effects and therapeutic uses of FUROSEMIDE.

 

13-AMPHOTERICINE B: Mechanism of action, therapeutic uses and side effects.

 

14- Prophylactic treatment of MIGRAINE.

 

15-SUCCINYLCHOLINE: Mechanism of action ,therapeutic uses and toxicity.

 

16-Precaution with MORPHINE therapy.

 

17-Mechanisms of synergism of ANTIBACTERIAL COMBINATION.

 

 

 

 

 

(III):

For each one of the following,select either true (T) or false (F) statement                                                              (20 marks)

1-Ideal general anaesthetic should produce rapid  and smooth induction as well as prompt recovery.

2- caster oil is a stimulant laxative.

3- Tricyclic antidepressant drugs are effective in treatment bullimia nervosa.

4-Methadone is useful for treatment of acute toxicity of morphine.

5-Ketamine used mainly in high risk elderly patients and shock.

6-Sulfonylureas are indicated in case of diabetic pregnancy women.

7-Rosiglitazone enhance insulin sensitivity and reduce resistance at site of insulin action.

8-Cortisone is not effective when prescribed for topical application.

9-Biliary excretion increases duration of some drugs like estrogen.

10-Tolerance means much dose is needed to get the same previous response.

11- Prolonged ethambutol treatment may impair vestibular function and result in inability to mentain equilibrium.

12-Mifepristone is an adrenal cortical antagonist.

13-Clomiphene citrate is an ovulation induced agent.

14-Chemical antagonism appears when two drugs produce opposite effects on the different physiological function.

15-Isoniazide metabolism is controlled by genetic polymorphism.

16-I.V. administration of diazepam is useful in treatment of convulsion.

17-Idiosyncrasy is an adverse reaction which results from previous sensitization to a particular chemical compound.

18-Quinidine is a potassium channel blockade used in treatment of supraventricular dysrhysmias .

19-Anticoagulant used in vitro include: heparin, EDTA, citrate and warfarin.

20-In case of pregnancy, warfarin as anticoagulant is contraindicated.

 

 

(IV):

Select the most appropriate answer for the following MCQS:

                                                                                      (10marks)

21-Concerning omeprazol, all the following statement are true EXCEPT:

a-It is prodrug and should be activated in the body.

b-Activated in acidic medium.

c-When reach the stomach after oral administration, it crosses the parietal cell membrane to inhibit the proton pump.

d-Just one single dose inhibit 95%-100% of gastric secretion.

 

22-Cimitidine in high doses produces all the following EXCEPT:

a-An antiandrogenic effect.

b-Induces hepatic microsomal enzyme.

c-Causes headache and myalgia.

d-Has a prolactogenic effect.

 

23-Lidocaine has all the following true statements EXCEPT:

a-Can be used in atrial fibrillation.    

b-Local anaesthetic.   

c-Blocks sodium channels.

d- Can  be used in ventricular arrhythmias.

 

24-Sotalol has all the following true effects EXCEPT:

a-Blocks potassium channels. 

b-Shortens repolarization with decreased action potential duration. c-Non selectively blocks –adrenergic receptors.

d-Can be used in treatment of ventricular and supraventricular arrhythmias.

 

25-Verapamil has all the following true statements EXCEPT:

a-Block calcium channels.

b-Decreases A-V conduction. 

c-Drug of first choice for supraventricular tachycardia.

d-Can cause postural hypotension.

 

 

26-Gum hyperplasia is a side effect of only ONE of the following:

a-Ethosuxamide.                           b-Lamotrigine. 

c-Phenytoin.                                  d-Clonazepam.

 

27-Addition of Carbidopa to levodopa in treatment of parkinsonism would lead to:

a- Inhibition of central dopa decarboxylase enzyme.

b- Improvement of GIT absorption.

c- Inhibition of peripheral dopa decarboxylase enzyme.

d- All the above.

 

28-All the following are prokinetic drugs EXCEPT:

a-Metochlopramide.                     b-Domperidone.

c-Phenothaizines.                          d-Cisapride.

 

29-Pheochromocytoma can be diagnosed by ONE of the following drugs:

a- Propranolol.                                 b- Tolazoline.

c- Phenoxybenzamine.                     d- Clonidine.

 

30- All the following drugs can be used in treatment of hyperthyroidism EXCEPT:

a-Carbimazole                                  b-Methimazol

c-Ketoconazole                                 d-Propylthiouracil

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

V-Clinical cases

I-An adult man who was diagnosed as a patient with congestive heart failure (CHF) :                 (10 Marks)

 

31-Which ONE of the following drugs is used in the mangment of this case:

  1. a) Virapamil. b)Propranolol.         
  2. c) Captopril.  d) Epinephrin.     

 

32- Your answer to the previous question was based on that this drug acts through ONE of the following mechanisms:

  1. a) Ca++ channel blockers. b) Non selective β-Agonist.
  2. c) Direct stimulation of the cardiac muscle.

d)Inhibition of   the converting enzyme.

 

33-The drug selected in question (31) has all the following adverse effect EXCEPT :

a)Hypotension.                        b)Disturbing dry cough.

c)Angioneurotic edema          d)  Hypokalemia.                     

 

34-The following drugs are also used in the treatment of heart failure EXCEPT :

  1. a) Epinephrin. b)Spironolactone.

c)Losartan.                                   d) Carvedilol.

 

35- The drug selected in question (34) is contraindicated in all the following EXCEPT :

a)Hypertension.                           b)Diabetes millitus.

c)Hyperthyroidim.                       d)Anaphylactic shock.   

 

 

 

 

 

II-An adult man was suffered from acute attack of expiratory dyspnea, cough and expiratory wheezing, he was diagnosed as bronchial asthma.                               (10 Marks)

 

36-ONE of the following drugs was prescribed to relieve his acute attack of asthma:

  1. a) Propranolol.                                b)Morphine.

   c)Cromolyn sodium.                                  d)Salbutamol.

         

37-Your proper answer of the last question was based on that this drug acts on ONE of the following mechanism.

a)Inhibition of beta1 and beta2 adrenoreceptors.

b)Selective stimulation of alpha2 adrenoreceptors.

c)Selective stimulation of beta2 adrenoreceptors.

d)Selective inhibition of beta1 adrenoreceptors.

 

38- ONE of the side effect of the drug selected in question (36) is:

  1. a) Orthostatic hypotension. b) Severe bradycardia.
  2. c) Frequent tremors. d) Dry mouth.

 

39-For avoidance of the recurrence of the acute attack of bronchial asthma; ONE of the following drugs was administerc)Cromolyn sodium.                     d)Ephedrine.

 

40-The patient suddenly developed a severe acute attack of bronchial asthma; which did not respond to usual measures. ONE of following drugs was administered.

a)Subcutaneous epinephrine.  

b)Intravenous prednisone after that oral prednisone for several days.

c)Intravenous morphine.                       d)All the above.

 

 ed:

a)Epinephrine.                              b)Isoprenaline.