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ORION May 2023 (1-17)

Total questions: 119

Worksheet time: 3570secs

Name
Class
Date
1.

Mortality of children was 8 in 2012 and 6.4 in 2017. This mean?

a)

More hospital open

b)

Improve health

c)

Nothing, more information need

2.

What database do insurance companies use?

a)

C.L.U.E. database

b)

Comprehensive Loss Underwriting Exchange

3.

Sources of data in insurance companies?

a)

CLAIMS

b)

Health data

c)

Information collection

4.

Which of the following error detection strategies result in limiting detection?

a)

bar-coding

b)

trigger tools

c)

voluntary reporting

d)

mandatory reporting

5.

Mid goal to long term future goal?

a)

Mission

b)

Vision

c)

Plan

6.

Preventive and curative institution?

a)

primary

b)

secondary

c)

tertiary

d)

specialty

7.

Mission and vision can be present in which strategy?

a)

Planning

b)

Organization

c)

Strategic

8.

Long term plan use all aspects in organization

a)

strategy

b)

operation

c)

organization

9.

Pharmacist wrote email to another pharmacist to ask add medication to the formulary in the hospital. This is consider as?

a)

Inter institutional

b)

Intra institutional

c)

Written communication

d)

Non Verbal communication

10.

Head of pharmacy decide to make group to arrange formulary drugs in hospital?

a)

organizing

b)

planning

c)

Leading

11.

Who's responsible for accreditation of health care system?

a)

SFDA

b)

WHO

c)

MOH

d)

CBAHI

12.

You received a prescription on a plain paper. What to do?

a)

Tell the manager

b)

Talk to the prescriber and don't dispense

13.

Pharmacist manager screamed on one of the pharmacist who dispensed wrong medication in front of all the staff. What is the good response?

a)

he should punish him in separate area

b)

ask for a meeting with the staff

c)

cut from his salary

d)

Try to find the cause of the error and set solutions

14.

Which of the following is the function of the pharmacy and therapeutic committee in a hospital?

a)

Responsible for poison management

b)

Monitor the adverse reaction reporting

c)

Monitor the medication error reporting

d)

Responsible for drug formulary management

15.

Which of the following distribution systems works better for medicine requiring a higher level of control?

a)

Bulk ward stock

b)

Direct procurement

c)

Automated dispensing (or unit dose system)

d)

Individual medication order

16.

Which of the following committees is dedicated to developing and maintaining a list of approved medicine for the hospital medicines for the hospital use?

a)

Medical records

b)

Medication audit

c)

Quality assurance

d)

Pharmacy and therapeutics

17.

Which of the following is the definition of management?

a)

The art of maximizing profitability

b)

The art of maximizing productivity

c)

The art of maximizing possibilities

d)

The art of maximizing predictability

18.

A 65-year-old man presents to the pharmacy for a refill his medications. On review of his refill history, the pharmacist noticed that he does not refill his medications regularly. Upon asking him, the patient stated that he has multiple medications that require complex administration. Which of the following non adherence factors affecting above patient?

a)

Patient related factors

b)

Provider related factors

c)

Health care system factors

d)

Medication and condition factor

19.

Which of the following need to be considered first by a pharmacist in order to rationalize drug therapy decisions?

a)

Care plan

b)

Follow-up evaluations

c)

Pharmacotherapy workup

20.

It is the broad range of health care services provided by in order to optimize therapeutic outcomes for individual patients. Which of the following is the term used to describe the above-mentioned definition?

a)

Pharmaceutical care

b)

Medication counseling

c)

Medication reconciliation

d)

Medication therapy management

21.

Free medical sample drugs (formulary or non-formulary) are provided by pharmaceutical sales representatives to physicians or members of the health care team. Which of the following is the most appropriate recommended policy for dealing with sample drugs?

a)

Dispense them directly to the patient

b)

Keep them with the rest of original items

c)

Keep in outpatient clinics or nursing units

d)

Exclude them from in-patient pharmacy, drug store or doctors' offices

22.

The hierarchy is showing Hospital X organizational chart. A pharmacist assigned as a clinical pharmacist in neuroscience ward. Which of the following managerial position will the coworker re submitting a complaint?

a)

Pharmacy Director

b)

Medical affair Director

c)

Neuroscience ward director

d)

Clinical pharmacy department Head

23.

Most on prescription?

a)

Patient name - mrn - date

b)

Phystion name - number - signature

c)

Patient name - age - sex - diagnosis

d)

all above

24.

Which of the following medication has a side effect metallic taste?

a)

cefuroxime

b)

azithromycin

c)

ciprofloxacin

d)

metronidazole

25.

What is the type of anemia Lack of intrinsic factor?

a)

Megaloblastic anemia

b)

Pernicious anemia

c)

Hemolytic anemia

d)

Aplastic anemia

26.

Which of the following anesthetics drug has a higher risk of causing hepatic toxicity?

a)

propofol

b)

ketamine

c)

isoflurane

d)

nitrous oxide

27.

Which of the following is the advantage of using intravenous anesthetic drug?

a)

Produce fast onset of anesthesia

b)

Helps in maintaining anesthesia

c)

Increases the minimum alveolar concentration (MAC) of the anesthetic drugs

d)

Produce less cardiovascular and respiratory suppression

28.

Which of the following is the mode of action of Phentolamine?

a)

beta-adrenergic blocker

b)

beta-adrenergic agonist

c)

alpha-adrenergic agonist

d)

alpha-adrenergic blocker (non selective alpha blocker)

29.

Which of the following is a consequence of stimulation of α1-Adrenoceptors?

a)

A flushing Adrenergic Receptors

b)

increased heart rate

c)

elevated blood pressure

30.

Which drug is used to treat an anaphylactic reaction?

a)

Atropine

b)

Adrenaline

c)

Isoprinosine

d)

Phentolamine

31.

Which of the following is a property of amphetamine?

a)

It does not cross the blood brain barrier

b)

It stimulates the release of stored acetylcholine

c)

It stimulates the release of stored norepinephrine

d)

It stimulates the release of five hydroxytryptophan (5-HT)

32.

A 25-year-old driver was held for reckless driving and confronting a policeman. He is too confident, talkative, restless and continuously walking around the hall. Which of the following is the drug that the driver is abusing?

a)

Diazepam

b)

Theophylline

c)

Amphetamine

d)

Lysergic acid diethylamide (LSD)

33.

What is the pharmacological classification of Ipratropium bromide?

a)

Beta agonist

b)

Alpha agonist

c)

Cholinergic agonist

d)

Antimuscarinic agent

34.

Which of the following is a consequence of stimulation of α1-adrenoceptors?

a)

Flushing

b)

Increased heart rate

c)

Constricted bronchioles

d)

Elevated blood pressure

35.

Which of the following describes the mechanism of action of rivastigmine?

a)

Cholinesterase inhibitor

b)

Alpha-1 receptor inhibitor

c)

Serotonin reuptake inhibitor

d)

Angiotensin converting enzyme inhibitor

36.

Drug to reverse action of Atropine?

a)

Physostigmine

b)

Benztropine

c)

Disulfiram

d)

Propranolol

37.

Catechol amine with COMT?

a)

Rapid metabolism

b)

Slow metabolism

38.

A 21-year-old patient went through respiratory depression after receiving an anesthetic agent. Which of the following agents will counteract post-anesthetic respiratory depression?

a)

Morphine

b)

Picrotoxin

c)

Diazepam

d)

Thiopental

39.

Which of the following drugs would decrease the amount of minimum alveolar concentration (MAC) for an anesthetic drug?

a)

Diazepam

b)

Buspirone

c)

Ephedrine

d)

Loratadine

40.

Which of the following anesthetic drugs has a higher risk of causing anemia?

a)

Propofol

b)

Ketamine

c)

Isoflurane

d)

Nitrous oxide

41.

Which depolarizing neuromuscular blocker is less potent than tubocurarine?

a)

Succinylcholine (Anectine)

b)

Rocuronium (Zemuron)

c)

Pipecuronium (Arduan)

d)

Doxacurium (Nuromax)

42.

Which of the following is heparin antidote?

a)

Protamine Sulphate

b)

Octreotide

c)

N-Acetylcysteine

d)

Naloxone Hydrochloride

43.

What is the antidote for heparin toxicity?

a)

Protamine sulfate

b)

Sodium salicylate

c)

Naloxone

d)

Glucagon

44.

Which of the following situation is most likely to be controlled by administering parenteral calcium as an antidote?

a)

Hypokalemia

b)

Verapamil overdose

c)

Heroine intoxication

d)

Cocaine intoxication

45.

A 55-year-old man presents with excessive bronchial and oconasal secretions. History revealed exposure to an organophosphate insecticide. Which of the following is the best management?

a)

Atropine IV

b)

Diphenhydramine orally

c)

Pralidoxime intramuscularly

d)

Physostigmine intramuscularly

46.

In case a patient develops toxicity from midazolam, which of the following medications can be given as an antidote?

a)

Atropine

b)

Flumazenil

c)

Amifostine

d)

Acetylcysteine

47.

Which of the following is the precursor for 5-hydroxytryptamine?

a)

Proline

b)

Alanine

c)

Glutamine

d)

Tryptophan

48.

Which of the following enzymes regulate supercoiling of DNA?

a)

Helicases

b)

Primases

c)

Topoisomerases

d)

Reverse transcriptase

49.

Where does the electron transport chain reaction pathway take place?

a)

Cell cytoplasm

b)

Golgi apparatus

c)

Outer mitochondrial membrane

d)

Inner mitochondrial membrane

50.

Which of the following vitamin deficiency can cause scurvy?

a)

Vitamin A

b)

Vitamin B6

c)

Vitamin C

d)

Vitamin D

51.

The diagram shows the role of a vitamin as a coenzyme for cystathionine synthase and cystathionase enzymes which catalyze the transsulfuration of methionine to cysteine. Which of the following is the vitamin indicated by the star in the figure?

a)

B2

b)

B3

c)

B5

d)

B6

52.

pH difference between extracellular and intracellular fluid is

a)

Nil

b)

0.2

c)

0.4

d)

0.8

53.

Role of ATP

a)

Energy carrier

b)

Oxygen carrier

c)

Amino acid carrier

54.

Which is cytokine

a)

Leukotriene

b)

Adrenaline

c)

Gonadotropin

55.

Which process does insulin work on or increase?

a)

Glycogenolysis

b)

Glyconeogenesis

c)

Glucogenesis

d)

Ketogenesis

e)

Glycogenesis

56.

The synthesis of glycogen from glucose is called

a)

Glycogenesis

b)

Glycogenolysis

c)

Gluconeogenesis

d)

Glycolysis

57.

How many ATP molecules are produced for every glucose?

a)

12

b)

24

c)

38

58.

Which amino acid is given for anorexia?

a)

Alanine

b)

Arginine

c)

Valine

59.

Starch is digested in saliva by?

a)

Amylase

b)

Lipase

60.

Which is a polysaccharide?

a)

Glucose

b)

Glycogen

c)

Glucagon

61.

Which of the following is the precursor for 5‑hydroxytryptamine (serotonin)?

a)

Proline

b)

Alanine

c)

Glutamine

d)

Tryptophan

62.

How many ATP molecules are produced for every glucose molecule?

a)

12

b)

24

c)

38

63.

Which process does insulin increase?

a)

Glycogenolysis

b)

Glycogenesis

c)

Gluconeogenesis

d)

Ketogenesis

64.

Krebs cycle is for production of?

a)

ATP

b)

DNA

c)

Ketone bodies

d)

Lactate

65.

DNA ligase enzyme is for ligation of?

a)

mRNA with tRNA

b)

Two mRNA molecules

c)

Two tRNA molecules

d)

Two DNA strands

66.

Glucosamine is used for?

a)

Osteoporosis

b)

Osteomyelitis

c)

Osteoarthritis

67.

Where does the electron transport chain reaction occur?

a)

Cell cytoplasm

b)

Golgi apparatus

c)

Outer mitochondrial membrane

d)

Inner mitochondrial membrane

68.

How many amino acids are in the human body?

a)

20

b)

30

c)

40

69.

Which parameter is used when a patient is given a statin and there is rhabdomyolysis?

a)

Creatine kinase

b)

CrCl

70.

What is the purpose of mitochondria?

a)

Synthesis of DNA

b)

Synthesis of RNA

c)

Produce ATP

71.

Which is a complex protein?

a)

Pr

b)

Sec

c)

Tri

d)

Quaternary in structure

72.

Acetyl‑CoA to form malonyl‑CoA uses which vitamin?

a)

Biotin (B7)

b)

Riboflavin

c)

Pyridoxine

d)

Nicotinamide

73.

Which coenzyme is used by cystathionine synthase and cystathionase that catalyze the transfiguration of methionine to cysteine?

a)

B2

b)

B3

c)

B5

d)

B6

74.

Acetyl‑CoA and citric acid cycle use which vitamin?

a)

B6

b)

B12

c)

B2

d)

B9

75.

Which is the carrier in the Krebs cycle?

a)

Oxaloacetate

b)

NADH

c)

Citric acid

d)

Acetyl‑CoA

76.

Number of ATP in glycolysis?

a)

1

b)

22

c)

24

d)

2

77.

What is the function of small nuclear (snRNAs) in protein synthesis?

a)

Act as catalyst

b)

Modifies mRNA molecules

c)

Genetic blueprint for the protein

d)

Translates genetic code to amino acid

78.

Which of the following pairs represents the purines nitrogenous bases?

a)

Adenine (A) and uracil (U)

b)

Cytosine (C) and uracil (U)

c)

Adenine (A) and guanine (G)

d)

Cytosine (C) and guanine (G)

79.

Which of the following is the process of breaking down glycogen?

a)

Glycolysis

b)

Glycogenesis

c)

Glycogenolysis

d)

Gluconeogenesis

80.

Which of the following inhibits gluconeogenesis?

a)

Insulin

b)

Glucagon

c)

Epinephrine

d)

Glucocorticoid

81.

Which of the following is a non‑essential amino acid?

a)

Lysine

b)

Valine

c)

Cysteine

d)

Isoleucine

82.

Which of the following inhibits gluconeogenesis?

a)

Insulin

b)

Glucagon

c)

Epinephrine

d)

Glucocorticoids

83.

Which carbohydrate produces more energy?

a)

Glucose

b)

Maltose

c)

Sucrose

d)

All produce the same amount of energy per gram

84.

Which of the following compounds is the urea cycle a biochemical reaction that produces urea from?

a)

Sucrose

b)

Glucose

c)

Glycogen

d)

Ammonia (NH3)

85.

A water-soluble vitamin catalyzes the carboxylation of acetyl-CoA to form malonyl-CoA, which is required for the synthesis of fatty acids (see image). Which of the following vitamins plays this role?

a)

Biotin (B7)

b)

Riboflavin

c)

Pyridoxine

d)

Nicotinamide

86.

Which of the following is a function of alcohol dehydrogenase enzyme?

a)

Accelerates the reduction of ethanol

b)

Accelerates the addition of hydrogen to ethanol

c)

Accelerates the addition of phosphate to ethanol

d)

Accelerates the removal of hydrogen from ethanol

87.

Which of the following enzymes is responsible for forming DNA copy from RNA?

a)

Reverse transcriptase

b)

DNA polymerase

c)

Helicase

d)

Primase

88.

Which of the following is a potential serious side effect that is common among all anticoagulant agents?

a)

Hypokalemia

b)

Major bleeding

c)

Liver dysfunction

d)

Renal dysfunction

89.

Which of the following is an example of a parenteral direct thrombin inhibitor?

a)

Enoxaparin

b)

Argatroban

c)

Fondaparinux

d)

Unfractionated heparin

90.

Which of the following antiplatelets is contraindicated in patients with transient ischemic attack (TIA) or stroke?

a)

Prasugrel

b)

Ticagrelor

c)

Clopidogrel

91.

Which of the following antiplatelet agents has the highest risk of causing dyspnea?

a)

Prasugrel

b)

Ticagrelor

c)

Clopidogrel

d)

Dipyridamole

92.

Which of the following is the recommended anticoagulation strategy for an atrial fibrillation patient with a CHAD2DS2-VACS score of 5?

a)

Aspirin

b)

Dabigatran

c)

Clopidogrel

d)

No anticoagulation

93.

Which of the following could lead to a decrease in international normalized ratio (INR) in a patient on warfarin therapy?

a)

Decrease the consumption of dietary vitamin K

b)

Carbamazepine therapy

c)

Cotrimoxazole therapy

d)

Metronidazole therapy

94.

Which of the following is the preferred anticoagulant therapy during hemodialysis procedure?

a)

Enoxaparin

b)

Dabigatran

c)

Rivaroxaban

d)

Unfractionated heparin (UFH)

95.

A 51-year-old man diagnosed with pulmonary embolism is planned for warfarin and started combination with warfarin until INR is therapeutic (see lab result). Weight 80 kg; Height 160 cm; Creatinine 85 μmol/L (normal 44–115 μmol/L); Creatinine clearance 103 μmol/L (normal 70–103 μmol/L). Which of the following enoxaparin dose regimen should the patient receive?

a)

Enoxaparin 30 mg SC every 24 h

b)

Enoxaparin 40 mg SC every 24 h

c)

Enoxaparin 80 mg SC every 12 h

d)

Enoxaparin 160 mg SC every 12 h

96.

Which of the following medications is an anticoagulant agent?

a)

Aspirin

b)

Warfarin

c)

Clopidogrel

d)

Streptokinase

97.

Which of the following is the mechanism of action of apixaban?

a)

An indirect inhibitor of thrombin

b)

An indirect inhibitor of factor Xa

c)

A direct inhibitor of thrombin

d)

A direct inhibitor of factor Xa

98.

Which of the following can decrease the effect of warfarin?

a)

Antibiotics

b)

Paracetamol

c)

Multivitamins (contain vitamin K)

d)

Calcium supplement

99.

Which of the following best represents the activity of dipyridamole?

a)

It has fibrinolytic activity

b)

It has antifibrinolytic activity

c)

It is a platelet aggregation inhibitor

d)

It is a phosphodiesterase enzyme inducer

100.

What is the route of administration of enoxaparin?

a)

Intrathecal bolus

b)

Transdermal injection

c)

Subcutaneous injection

d)

Intramuscular injection

101.

Which of the following drugs can be used to lyse fibrin clots?

a)

Heparin

b)

Warfarin

c)

Enoxaparin

d)

Streptokinase

102.

Which of the following can decrease the effect of warfarin?

a)

Antibiotics

b)

Paracetamol

c)

Multivitamins

d)

Calcium supplement

103.

Which of the following medications produces antiplatelet effect by inhibiting adenosine diphosphate (ADP) receptors?

a)

Aspirin

b)

Abciximab

c)

Clopidogrel

d)

Streptokinase

104.

Which of the following is recommended regarding air bubble in the syringe for a patient starting on enoxaparin subcutaneous injection?

a)

Inject the dose with the air bubble

b)

Inject the air bubble if the volume is small

c)

Remove the air bubble to avoid wastage of the dose

d)

Remove air bubble and adjust volume before injection

105.

Which of the following is a potential serious side effect that is common among all anticoagulant agents?

a)

Hypokalemia

b)

Major bleeding

c)

Liver dysfunction

d)

Renal dysfunction

106.

Which of the following statements describes unfractionated heparin?

a)

Enolic acid derivative

b)

Propionic acid derivative

c)

Acetyl ester of salicylic acid

d)

Mucopolysaccharide polymers

107.

Which of the following is recommended regarding air bubble in the syringe for a patient starting on enoxaparin subcutaneous injection?

a)

Inject the dose with the air bubble

b)

Inject the air bubble if the volume is small

c)

Remove the air bubble to avoid wastage of the dose

d)

Remove air bubble and adjust volume before injection

108.

Risk factor causing deep vein thrombosis (DVT)?

a)

Age

b)

Food rich in vitamin K

c)

Surgery

109.

The recommended DVT prophylaxis duration for postpartum women with high risk of DVT is:

a)

3 weeks

b)

6 weeks

c)

3 months

d)

6 months

110.

Which of the following is a parenteral direct thrombin inhibitor?

a)

Argatroban

b)

Dabigatran

c)

Heparin

d)

Warfarin

111.

Which of the following antiplatelets works by inhibition of the adenosine diphosphate (ADP) receptor?

a)

Aspirin

b)

Abciximab

c)

Clopidogrel

d)

Streptokinase

112.

Which direct oral anticoagulant requires 5–10 days of prior anticoagulation (initial parenteral lead-in) before use?

a)

Edoxaban

b)

Apixaban

c)

Dabigatran

d)

Rivaroxaban

113.

How does ibuprofen inhibit the antiplatelet effect of aspirin?

a)

Irreversibly acetylates platelet COX-1 at a different site

b)

Ibuprofen bind to cox1 and hinder it's acetylation by aspirin

c)

Inhibits thrombin generation independent of COX

d)

Promotes aspirin metabolism via hepatic induction

114.

A patient on warfarin with a mechanical valve has an INR of 3.5. What should be done?

a)

No management

b)

Decrease the warfarin dose

115.

Neonate with coagulopathy: which vitamin K route will you use?

a)

Suppository

b)

Intravenous (IV)

c)

Subcutaneous (SC)

d)

Intramuscular (IM)

116.

Which antiplatelet is contraindicated in patients with transient ischemic attack (TIA)?

a)

Dipyridamole

b)

Clopidogrel

c)

Prasugrel

d)

Ticagrelor

117.

After warfarin initiation as an outpatient, when should INR monitoring occur?

a)

Next day

b)

2–5 days

c)

1 month

d)

3 months

118.

Treatments for pulmonary embolism: which regimen is appropriate?

a)

Enoxaparin 40 mg SC once daily

b)

Rivaroxaban

c)

Enoxaparin 1 mg/kg twice daily or 2 mg/kg once daily

119.

A patient taking warfarin 4.5 mg PO daily presents with INR of 5.1 without signs of active bleeding. What is the appropriate management?

a)

Hold warfarin and give vitamin K IV

b)

Hold warfarin and resume with lower dose

c)

Hold warfarin and give platelet

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