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Worksheetsorion 77-93
Total questions: 114
Worksheet time: 57mins
Gene mutation of UGT1A1?
atazanavir
lamivudine
zidovudine
Which of the following is the exact date for a drug to be safely taken if its expiration date is December 2018?
December 1, 2018
December 15, 2018
December 31, 2018
January 1, 2019
Which of the following concepts are most of public health strategies based on?
Primary prevention
Secondary prevention
Clean water and food
Ideal healthy community
Public health is the science of protecting the health of a community. Which population from the following list is their target?
People at risk of being sick
Injured and sick people
Mothers and children
Entire community
What resource should be used when searching for the most current clinical trials on the use of novel anticoagulants for pulmonary embolism?
Pharmacotherapy, the pathophysiologic approach
PubMed
UpToDate
Micromedex
A 55-year-old man brings a prescription for Oxycontin in April. The script from a doctor is dated December 17 of the previous year and allows five refills. What quantity of fill(s) are likely to be received by the patient today?
1 today + 1 refill
0 today + 0 refill
1 today + 2 refill
1 today + 0 refill
How many phases of clinical trials are required to approve a new drug?
1 phase
2 phase
3 phase
4 phase
A patient is started on codeine 15 mg orally as needed for postoperative pain. One day after starting codeine, the patient presents to the Emergency Department with confusion, headache, and shortness of breath. Which of the following most likely describes the patient's genotype?
slow metabolizer of CYP2D6
slow metabolizer of CYP2C9
rapid metabolizer of CYP2C9
rapid metabolizer of CYP2D6
Which of the following genetic testing results might derive a potential benefit from trastuzumab therapy in a breast cancer patient?
TPMT positive activity
VKORC1 genotype positive
HER2/gene genotype positive
HLA-B*5801 genotype positive
Breast cancer. The gene HER2 is negative; which agent can we use?
Letrozole
Trastuzumab
Which of the following is most likely to be associated with heartburn?
paracetamol
chlorpheniramine
potassium chloride
magnesium/aluminum hydroxide
Which of the following medications is the most appropriate for nausea induced by the anti‑parkinson’s drug bromocriptine?
itopride
domperidone
Which of the following is the main feature of celiac disease?
Malabsorption of proteins
Increased protein degradation
Decreased excretion of proteins
Decreased breakdown of protein
A 39‑year‑old woman presents with epigastric burning and pain for the last 6 months and reports an allergy to beta‑lactam antibiotics. An office‑based urea breath test is performed to diagnose Helicobacter pylori infection and is positive. Which of the following is the most appropriate treatment regimen?
Levofloxacin and lansoprazole for 14 days
Omeprazole, clarithromycin, and amoxicillin for 10 days
Omeprazole, clarithromycin, and metronidazole for 14 days
Omeprazole, bismuth subsalicylate, tetracycline, and azithromycin for 14 days
Which of the following regimens is most appropriate to prevent constipation in a patient starting on morphine for pain?
docusate and senna
bisacodyl and lactulose
polyethylene glycol and Metamucil
methylnaltrexone and magnesium sulfate
Which of the following medications can cause pneumonia as a side effect?
Lisinopril
Metformin
Simvastatin
Omeprazole
A 7‑year‑old girl presents with moderate dehydration due to vomiting. Based on the following lab results, what is the most suitable replacement fluid?
0.9% sodium chloride
5% dextrose with sodium bicarbonate
0.9% sodium chloride with potassium chloride
5% dextrose/0.225% sodium chloride with potassium
Which of the following drugs can be safely recommended to a patient suffering from chronic constipation?
Glycerol suppository
Ispaghula husk
Bisacodyl
Senna
Which of the following regimens is the treatment of choice for a patient who develops a gastric ulcer caused by Helicobacter pylori infection?
famotidine and amoxicillin
lansoprazole and clarithromycin
misoprostol, clarithromycin, amoxicillin
clarithromycin, amoxicillin, and lansoprazole
Which of the following areas in the brain is the main target for metoclopramide to produce antiemetic activity?
pituitary gland
meso‑limbic brain area
nigro‑striatal brain area
chemoreceptor trigger zone
Which of the following most likely is the action of histamine?
constriction of capillaries
paralysis of skeletal muscle
elevation of blood pressure
stimulation of gastric secretion
Which of the following is the mechanism by which bisacodyl laxative relieves constipation?
Causing colon relaxation
Acting as a surfactant to soften the stool
Absorbing water and forming a gelatinous mass
Stimulating enteric nerves to increase colonic contractions
Which of the following is the mechanism of action of loperamide’s antidiarrheal effect?
Binding bile acids
Blocking cholinergic receptors
Activation of the opioid receptors
Activation of alpha‑2 adrenergic receptors
Which drug should be used for both bone and gastrointestinal tract problems?
calcium gluconate
calcium carbonate
metoclopramide
omeprazole
A patient has severe gastric pain radiating to the right upper quadrant with vomiting; the pain radiates to the back and gets worse with fatty meals. What is the most likely cause?
pancreatic disease
gallstones
hepatic disease
When should omeprazole be taken?
Morning with meal
Night before sleep
As needed
Stimulate adrenergic
Which of the following tests can be used to confirm Helicobacter pylori?
Urea breath test
Stool antigen assay
EGD with biopsies
Serologic testing
Which one of the following medications can a gynecologist prescribe to a patient?
tamoxifen
fingolimod
anastrozole
misoprostol
Which of the following hormones maintains the concentration of water in the body?
vasopressin (antidiuretic hormone)
thyrotropin
adrenocorticotropin
luteinizing hormone
Which of the following hormones stimulates mammary gland development and milk production?
prolactin
oxytocin
corticotropin
growth hormone
Type of hypersensitivity for drug‑induced hemolytic anemia?
cytotoxic reaction
immediate sensitivity reaction
Which of the following immunoglobulin activates complement system?
IgM
IgE
IgA
IgG
An 8-year-old child had difficulty in breathing, swelling of lips and tongue, and fainted after eating a piece of cake containing nuts. Which type of hypersensitivity reaction is the child exhibiting?
Immune-complex
Delayed hypersensitivity
Cytotoxic hypersensitivity
Immediate hypersensitivity
Which white blood cell type is the target of human immunodeficiency virus during acquired immune deficiency syndrome (AIDS)?
CD1 lymphocytes
CD2 lymphocytes
CD3 lymphocytes
CD4 lymphocytes (T lymphocytes)
Which of the following represents the immunity acquired by giving a living organism with attenuated virus?
Local immunity
Passive immunity
Natural active immunity
Artificial active immunity
Which of the following is the first antibody to be produced in a new infection?
IgM
IgG
IgA
IgE
A 28-year-old woman with Crohn’s disease was treated with high-dose intravenous corticosteroids, converted to oral drugs, and started on infliximab, a tumor necrosis factor-α inhibitor. Which test should be performed prior to infliximab?
HIV screening
Influenza screening
Hepatitis C screening
Tuberculosis screening
To which of the following is the major histocompatibility complex unique?
Each cell
Each organ
Each species
Each individual
A 27-year-old man with hepatitis C virus infection has elevated alanine aminotransferase and aspartate aminotransferase and mild fibrosis on liver biopsy (see lab results). Which drug should be avoided in his case?
Amoxicillin
Pregabalin
Cephalexin
Methotrexate
Which of the following is used for the treatment of neovascular (wet) age-related macular degeneration?
Aflibercept
Latanoprost
Muromonab
Gemtuzumab
Which of the following drugs is associated with progressive multifocal leukoencephalopathy?
Bisoprolol
Pregabalin
Doxycycline
Natalizumab
Which of the following is the site of action for aflibercept?
Fibroblast growth factor
Human chorionic gonadotropin
Brain-derived neurotrophic factor
Vascular endothelial growth factor-A
Which of the following is involved in type 2 hypersensitivity (cytotoxic hypersensitivity reaction)? Note: type 1 involves IgE.
IgE
IgG
T lymphocytes
Macrophages
Which drug is used in organ transplantation?
Cyclosporine
Azithromycin
Ibuprofen
Metformin
Immune cells have a Y shape. Antibodies attach to which part?
Hinge side
Consistent H side
Variable H side
Consistent L side
Variable L and H side
An 8-year-old child had difficulty in breathing, swelling of lips and tongue, and fainted after eating cake containing nuts. Which type of hypersensitivity reaction is the child exhibiting?
Immune-complex
Delayed hypersensitivity
Cytotoxic hypersensitivity
Immediate hypersensitivity
Case with food allergy: what type of response is this?
Immediate hypersensitivity
No immediate hypersensitivity
What is secondary prevention?
Vaccination
Immunization
Do exercise
Blood test
Which immunoglobulin is frequently found elevated in asthmatic patients?
IgA
IgE
IgM
IgD
Which cells have antibody on their surface?
B cell
T cell
T helper
T killer
Which part of immunoglobulin attaches to the B cell?
Light chain
Heavy chain
Which part of immunoglobulin attaches to antigen?
Light chain
Heavy chain
Which of the following drugs is considered an enzyme inhibitor that may affect the metabolism of other drugs?
Phenytoin
Furosemide
Cimetidine
Theophylline
Major toxic effect of chloramphenicol in infants is due to lack of which enzyme?
Glucuronyltransferase enzyme (gray baby syndrome)
B-methyltransferase enzyme
During prescription verification, a pharmacist identified a drug interaction in a 23-year-old woman diagnosed with urinary tract infection and prescribed an antibiotic. Which antibiotic is the best option to avoid harm?
Cephalexin
Ciprofloxacin
Nitrofurantoin
Trimethoprim–sulfamethoxazole
Which antibiotic is used for surgical prophylaxis of colorectal surgeries?
Ampicillin
Cefoxitin
Linezolid
Augmentin
Which of the following is the first-line treatment for malaria caused by Plasmodium falciparum in Saudi Arabia?
Quinine
Primaquine
Artesunate
Doxycycline
A 57-year-old man presents with 2 days of high fever, muscle and bone aches, headache, and loss of appetite, with recent close contacts with a friend who had influenza. Which management is best?
Amoxicillin 500 mg PO every 8 hours for 10 days
Azithromycin 500 mg PO once daily for 3 days
Amoxicillin–clavulanic acid 1 g PO every 12 hours for 1 week
Support treatment (fluids, rest, antihistamine, paracetamol)
Which condition is a serious adverse reaction of fluoroquinolone therapy?
Eczema
Bleeding
Depression
Q–T interval prolongation
Which is the reason doxycycline should be avoided in children less than 12 years?
High toxicity
Low tolerability
Risk of bleeding
Teeth discoloration
Which disease can cause latent infection?
Polio
Measles
Rubella
Varicella–zoster
Which topical antibiotic ointment can be used in MRSA infection?
Vancomycin ointment
Mupirocin ointment
Case: Escherichia coli with chronic kidney disease. Which dosing regimen is most appropriate?
Ciprofloxacin 400 mg IV every 12 hours
Ciprofloxacin 400 mg IV every 24 hours
Meropenem 500 mg IV every 8 hours
Meropenem 500 mg IV every 12 hours
A patient has severe endocarditis with Staphylococcus aureus on vancomycin, but sensitivity testing shows susceptibility only to linezolid, which is not FDA-approved for endocarditis. What is the best management?
Increase vancomycin dose
Add gentamicin to vancomycin
Switch to linezolid off-label
Stop antibiotics and observe
Antibiotics that inhibit protein synthesis at the 30S ribosomal subunit affect which process?
Elongation
Initiation
Termination
Antibiotics that inhibit protein synthesis at the 50S ribosomal subunit have which effect?
Elongation
Initiation
Termination
Which of the following are encapsulated bacteria?
Streptococcus pneumoniae
Lactobacillus acidophilus
Mycobacterium tuberculosis
Salmonella Typhi
Which of the following can be used for UTI infections?
Garlic
Cranberry
Echinacea
Ginko
What is the adverse effect of fluoroquinolones?
QT prolongation
Rash
Increase blood pressure
Constipation
A case about a child has pin worm infection. Which of the following is the best drug of choice?
Mefloquine
Albendazole
Doxycycline
Metronidazole
A case about a girl has sore throat (mild) without any infection or other symptoms. What should you advise her?
Gargle with salt and water
Clindamycin
Antihistamine
Ceftriaxone IV every 12 hours
Use in the prevention of RSV in neonate?
Palivizumab
Ostumab
Months infant have RSV?
Supportive
Palivizumab
Which of the following is a characteristic for facultative anaerobic?
Only grow anaerobically
Only grow in the presence of oxygen
An anaerobe but can grow in the absence of oxygen
Require simultaneous presence of aerobic and anaerobic environments for growth
A 36-year-old man not known to have any medical illness diagnosed recently with an active pulmonary tuberculosis. Which of the following is the best regimen to start?
Rifampin alone
Isoniazid alone
Isoniazid plus rifampin
Isoniazid, rifampin, ethambutol and pyrazinamide
A 23-month-year-old, 14-kg infant is brought to the hospital with signs and symptoms of bacterial meningitis. The baby attends day care and has a history of acute otitis media. A blood and CSF culture were ordered and pending. Which of the following is the empirical therapy for acute bacterial meningitis?
Doxycycline plus linezolid
Ampicillin plus gentamicin
Cefuroxime plus ciprofloxacin
Ceftriaxone or cefotaxime plus vancomycin
Which of the following micro-organisms causes typhoid fever?
Shigella
Flavivirus
Salmonella
Treponema pallidum
Which of the following describes the transmission mode of coronavirus?
Respiratory route
Blood-borne route
Contaminated food and drinks
Direct contact with patient saliva
A 24-year-old male presented to the hospital with a skin infection. The microbiology technician received a sample from this patient; the sample in a special media was incubated over 24 hours and showed Staphylococcus aureus. The microbiologist used disk diffusion method to determine the susceptibility of different antibiotics (see image). What is the most sensitive antibiotic?
Ampicillin (Amp)
Vancomycin (Van)
Methicillin (Meth)
Penicillin (Control)
Which of the following bacteria is involved in the development of dental caries?
Streptococcus mutans
Listeria monocytogenes
Streptococcus
Corynebacterium diphtheria
What is the main method transmission of Brucella species?
Airborne
Blood transfusion
Contact with infected person
Ingestion of unpasteurized milk/milk products
A pregnant woman is travelling to a high risk malarial country. Which antimalarial prophylactic agent carries the most fetal risk in pregnant women?
Mefloquine
Doxycycline
Chloroquine
Atovaquone–proguanil
Which of the following viral infections best describes chronic infection?
Infection in which host cell dies due to interference with normal cellular function
Infections in which there is uncontrolled growth or immortalization of the host cell
Infection in which virus persists within the host cell but new virions are not synthesized
Infection in which virus persists within the host cell and continues to replicate the virions
A 28-year-old pregnant female in labor is admitted to the hospital. She tested positive for Group B streptococcus colonization at her 36-week appointment. She has a penicillin allergy and her culture are resistant to both clindamycin and erythromycin. What is the recommended treatment for this patient?
Cefazolin
Penicillin G
Ceftriaxone
Vancomycin
A 7-year-old boy presents with complain of itchiness around the anus at night. Lab tests revealed Enterobius vermicularis infection (pin worm infection). Which of the following is the most appropriate management?
Fluconazole
Praziquantel
Pantoprazole
Mebendazole
Drugs may accumulate in tissues as result of their physicochemical characteristics or special affinity of the tissue for the drug. Which of the following parts of the body does tetracycline accumulate?
Liver
Bone
Muscle
Adipose tissue
A 55-year-old woman presents with symptoms of Helicobacter pylori infections. She was previously treated with the classical amoxicillin, clarithromycin, omeprazole regimen. The physician is unable to obtain susceptibility testing for the Helicobacter pylori but the pattern of local antimicrobial resistance to penicillin's is well known. What would be the optimal treatment for her?
Amoxicillin 1 g, clarithromycin 500 mg, and metronidazole 500 mg plus omeprazole 20 mg BID for 14 days
Amoxicillin 1 g, clarithromycin 500 mg, and metronidazole 500 mg plus omeprazole 40 mg BID for 14 days
Bismuth subsalicylate 525 mg QID and tetracycline 500 mg QID plus metronidazole 500 mg and omeprazole 40 mg BID for 14 days
Bismuth subsalicylate (2) and doxycycline 100 mg QID plus metronidazole 500 mg TID and omeprazole 40 mg BID for 14 days
A 16-month-old baby with bronchopulmonary dysplasia is admitted to the Pediatric Intensive Care Unit with respiratory distress requiring in (see lab results). What is the best management?
Cefuroxime
Palivizumab
Corticosteroid
Intravenous fluids and supportive care
What is the description of viruses that live as parasites on bacteria?
Fungi
Lichens
Commensals
Bacteriophage
Which of the following is a β-lactamase enzyme?
Plasmid
Pyrogens
DNA gyrase
Carbapenemase
Which of the following Clostridium spp. is linked to the development of pseudomembranous colitis?
Clostridium tetani
Clostridium difficile
Clostridium botulinum
Clostridium perfringens
Which is the best treatment for Staphylococcus aureus positive mastitis?
Cephalexin
Clindamycin
Ciprofloxacin
Nitrofurantoin
A nurse has an inquiry about the appropriate time to withdraw a trough gentamicin level for a patient. What is the best answer for her inquiry?
1 hour after gentamicin administration
30 minutes after gentamicin administration
1 hour before the scheduled gentamicin dose
30 minutes before the scheduled gentamicin dose
A 6-year-old boy is diagnosed with a pin-worm infection. Which of the following drugs should be used for treatment?
Mefloquine
Doxycycline
Albendazole
Pyrimethamine
What is the recommended prophylactic therapy for pregnant women colonized with group B streptococcus in labor with penicillin allergies at high risk for anaphylaxis?
Cefazoline
Linezolid
Penicillin G
Clindamycin or vancomycin
Which of the following might develop in association with high serum amikacin?
Bleeding
Ototoxicity
Liver failure
Visual changes
Which of the following infections is prevented with the administration of 0.5% erythromycin eye ointment in newly born infants?
Mycoplasmal conjunctivitis
Adenoviral conjunctivitis
Gonococcal ophthalmia
Chlamydial infection
Which of the following is the most appropriate empiric treatment for a patient with community-acquired pneumonia requiring admission to the hospital?
Doxycycline and azithromycin
Ceftriaxone and azithromycin
Moxifloxacin and ceftriaxone
Vancomycin and ceftriaxone
An 18-year-old healthy girl admitted to the hospital with a diagnosis of necrotizing pneumonia. She received vancomycin 1 g IV q12h and meropenem 1 g IV q8h. The trough level of vancomycin was 16 mcg/ml (normal range: 10–20 mcg/ml). Which of the following is the next appropriate step in management of this patient?
Continue the same treatment
Request a drug level for meropenem
Which of the following medications can cause hemolytic anemia in the newborn when used by a pregnant woman at full term?
amoxicillin
ciprofloxacin
azithromycin
nitrofurantoin
Which of the following classes of medications have been associated with the development of newborn kernicterus when used by pregnant women at full term?
Penicillin’s
Vancomycin
Cephalosporins
Sulfa containing medications
Which of the following mechanisms, cephalexin exerts antibacterial effects?
inhibition of protein synthesis
destruction of the bacterial cell nucleus
inhibition of bacterial cell wall synthesis
detergent effect on the bacterial cell membrane
Which of the following clinical conditions is treated with zanamivir?
cytomegalovirus disease
myocardial infarction
bacterial infection
acute influenza
Which of the following medications would inhibit uncoating of the viral RNA?
acyclovir
vidarabine
didanosine
rimantadine
Which of the following has similar antibacterial mechanism of penicillin?
neomycin
cephalexin
tetracycline
clindamycin
Which of the following best describes ceftazidime?
A third-generation cephalosporin which covers gram negative and gram-positive organisms
A second-generation cephalosporin which covers gram negative and gram-positive organisms
A first-generation cephalosporin which covers gram positive organisms
An amino penicillin
A 60-year-old woman is admitted to the hospital for surgery. Colonization of gram-negative bacteria occurred after surgery. Which of the following is the best management?
Cefprozil
Cephalexin
Ceftriaxone
Phenoxymethyl penicillin
Which of the following is an indication for ciprofloxacin?
Fever
Arthropathy
Tuberculosis
Inhalational anthrax
Which of the following drugs has poor oral bioavailability?
Cefixime
Amoxicillin
Vancomycin
Ciprofloxacin
Which of the following is the drug of choice for chlamydia infection?
Amikacin
Amoxicillin
Tetracycline
Azithromycin
Which of the following is the best treatment for staphylococcus aureus positive mastitis?
Cephalexin
Nitrofurantoin
Clindamycin
Ciprofloxacin
A case patient takes pyrazinamide, ethambutol, and rifampicin and develops problems in vision. Which drug is responsible for this side effect?
Pyrazinamide
Isoniazid
Ethambutol
Rifampicin
Pregnant with vaginal discharge due to Candida: which medication is appropriate?
fluconazole
clotrimazole
acyclovir
Lab results show hemoglobin and glucose in range except high white blood cell count. What is the most likely condition?
Anemia
Infection
hyperglycemia
