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Orion 17-25

Total questions: 40

Worksheet time: 20mins

Name
Class
Date
1.

In pregnancy, during which trimester can warfarin be used?

a)

first

b)

second

c)

third trimester

d)

avoided use in pregnancy

2.

A patient uses warfarin 10 mg and the INR is low. What is the most likely reason?

a)

Low dose

b)

Dietary factors

c)

Low bioavailability of warfarin

d)

Laboratory error

3.

Which of the following is used in prophylaxis of stroke?

a)

anticoagulant

b)

thrombolytic drug

c)

antiplatelet

d)

vasodilator

4.

Which of the following drugs induces thrombocytopenia?

a)

unfractionated heparin

b)

low-molecular-weight heparin

c)

warfarin

d)

aspirin

5.

Which of the following drugs is used to treat heparin-induced thrombocytopenia?

a)

unfractionated heparin

b)

low-molecular-weight heparin

c)

warfarin

d)

argatroban

6.

Medication for osteoporosis in menopausal women given monthly?

a)

zoledronic acid

b)

ibandronate

c)

raloxifene

d)

teriparatide

7.

Medication for osteoporosis in women given once per year?

a)

zoledronic acid

b)

ibandronate

c)

raloxifene

d)

alendronate

8.

Medication for osteoporosis in women given weekly?

a)

zoledronic acid

b)

ibandronate

c)

raloxifene

d)

alendronate

9.

Gold standard test for osteoporosis?

a)

dual-energy x-ray absorptiometry (DEXA)

b)

quantitative CT

c)

plain radiography

d)

bone scintigraphy

10.

Patient with osteoporosis: which is needed for diagnosis?

a)

X-ray

b)

MRI

c)

CT

d)

Ultrasound

11.

Which of the following osteoporosis drugs can cause esophageal ulcers?

a)

denosumab

b)

teriparatide

c)

alendronate

d)

zoledronic acid

12.

Which of the following medications for osteoporosis will significantly reduce the risk of hip fracture?

a)

phosphate

b)

risedronate

c)

raloxifene

d)

calcitonin

13.

A 65-year-old patient with osteomalacia has finger numbness, tingling, and burning of extremities. The doctor prescribed vitamin D and an IV calcium supplement. Which calcium salt was most likely prescribed?

a)

calcium citrate (21% calcium)

b)

calcium lactate (13% calcium)

c)

calcium gluconate (9% calcium)

d)

calcium phosphate (39% calcium)

14.

A 25-year-old man with leukemia is admitted to a hematology-oncology center. Who is allowed to read the patient file without additional permission?

a)

Patient’s cousin working as an outpatient nurse

b)

Medical resident in pediatrics exploring leukemia risk

c)

Clinical nutritionist assigned to calculate the patient’s requirements

d)

Pharmacy resident planning a research cell transplant

15.

Which of the following anti-neoplastic medications is known to cause bone marrow suppression?

a)

bleomycin

b)

vincristine

c)

doxorubicin

d)

l-asparaginase

16.

Which of the following is an alkylating anticancer agent?

a)

cyclophosphamide

b)

fluorouracil

c)

doxorubicin

d)

etoposide

17.

A 42-year-old woman with cancer refuses surgery or chemotherapy to protect her hair and beauty. What is the most appropriate suggestion for her?

a)

Start chemotherapy with very low doses and less frequency

b)

Proceed with surgery immediately

c)

Discuss risks and benefits with the patient and let her make the decision

d)

Force chemotherapy and suggest wearing hair extensions

18.

Which of the following anti-cancer alkaloids acts by stabilizing the microtubule polymer and protecting it from disassembly?

a)

paclitaxel

b)

colchicine

c)

vinblastine

d)

camptothecin

19.

Which recommendation helps reduce inadvertent intrathecal administration of vincristine?

a)

Dispense the syringe without a needle

b)

Dispense vincristine in a 60‑ml syringe

c)

Dispense vincristine in a mini bag instead of a syringe

d)

Dispense the vial for the nurse to prepare at the bedside

20.

What is the most common adverse reaction of doxorubicin?

a)

bone marrow depression

b)

hepatic toxicity

c)

cardiac toxicity

d)

skin necrosis

21.

What is the therapeutic indication for nilotinib?

a)

ulcerative colitis

b)

familial hyperlipidemia

c)

highly active and relapsing-remitting multiple sclerosis

d)

Philadelphia chromosome–positive chronic myelogenous leukemia

22.

A 40-year-old woman with breast cancer has elevated topoisomerase. Which drug should be used?

a)

cyclophosphamide

b)

melphalan

c)

irinotecan

d)

methotrexate

23.

Immune system works an important role in cancer treatment by which mechanism?

a)

macrophage

b)

cytotoxic

c)

complex

d)

humoral

24.

Prevention of breast cancer: which option is correct?

a)

vitamin A 100

b)

vitamin D 200

c)

none of them

d)

vitamin A plus vitamin D

25.

Cysteine in a chemotherapy agent provides which benefit?

a)

increase target

b)

increase effects

c)

increase solubility

d)

more information needed

26.

Acetaminophen is an antipyretic and analgesic drug. It binds to a cytosolic protein. Which type of bond is formed between the protonated amine of acetaminophen and the carboxylic acid of the aspartate residue of the protein?

a)

ionic bond

b)

covalent bond

c)

hydrogen bond

d)

van der Waals interaction

27.

Which of the following molecules contains a double bond?

a)

CH3

b)

CNH

c)

C2H2

d)

C2H4

28.

Quinine has complicated stereochemistry (see image). Which pharmacological activity will the drug possess if the stereochemistry at the indicated position changes from R to S?

a)

anticancer

b)

antimalarial

c)

anticoagulant

d)

antiarrhythmic

29.

Which of the following can be used safely in a patient with sulfa allergy?

a)

gliclazide

b)

furosemide

c)

sulfamethoxazole

d)

sodium thiosulfate

30.

The structure of a norepinephrine–serotonin reuptake inhibitor (NSRI) is shown. Which structural modification can transform this drug into a selective norepinephrine reuptake inhibitor (SNRI) analogue?

a)

quaternization of the side chain amino group

b)

transformation of the side chain amino group into a primary amine

c)

replacement of the side chain N,N-dimethylamino group with a hydroxyl group

d)

demethylation of the side chain tertiary amino group to yield a secondary amino group

31.

Thalidomide exists in two conformations with different pharmacological and toxicological activities (see image). Which term most appropriately describes the two conformations of thalidomide?

a)

Isomers

b)

Epimers

c)

Enantiomers

d)

Diastereomers

32.

A structure of glibenclamide (glyburide) is shown (see image). Which of the following pharmacophore does glibenclamide (glyburide) contain?

a)

Benzenesulfate urea

b)

Benzenesulfinyl urea

c)

Benzenesulfhydryl urea

d)

Benzenesulphonyl urea

33.

Aspirin is a well-known antiplatelet agent (see image). What is the role of the acetyl group in its antiplatelet activity?

a)

It represents a good leaving group to form the active salicylic acid.

b)

It provides hydrogen binding with a tyrosine moiety on the COX binding site.

c)

It provides covalent binding with a serine moiety found on the COX binding site.

d)

It provides hydrophobic binding with a tryptophan moiety on the COX binding site.

34.

In the codeine structure, what is the effect of replacing the methoxyl group (boxed) with a hydroxyl group?

a)

Decrease in analgesic activity

b)

Decrease in addiction activity

c)

Reduction in the antitussive activity

d)

Lower affinity to morphine receptors

35.

The structure of erythromycin is shown (see image). Which of the following explains why erythromycin is sensitive to acidic pH?

a)

The presence of a lactone group in the ring

b)

The presence of two basic sugars at positions 3 and 5

c)

The presence of six methyl groups at alternate positions of the macrolide ring

d)

Ketal formation between hydroxyl groups (6 and 12) and the ketone at position 9

36.

Which of the following polymorphic enzyme is responsible for the conversion of codeine to morphine?

a)

CYP2D6

b)

CYP2C9

c)

CCR5 coreceptor

d)

N-Acetyltransferase

37.

Structures of four antidepressant drugs are shown labeled 1–4 (see image). Which of the following antidepressant structure undergoes a photo-oxidation reaction upon exposure to light?

a)

1

b)

2

c)

3

d)

4

38.

Among the NSAIDs shown (see image), which of the following has minimal possible gastric side effects?

a)

Ibuprofen

b)

Celecoxib (selective COX-2)

c)

Indomethacin

d)

Diclofenac

39.

Which of the following is the most common cause of drug instability?

a)

Oxidation

b)

Racemization

c)

Epimerization

d)

Decarboxylation

40.

Which of the following molecules contains a double bond?

a)

CH3

b)

CNH

c)

C2H2

d)

C2H4

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