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WorksheetsORION 128-144
Total questions: 111
Worksheet time: 56mins
Septic shock patient unresponsive to fluid and CKD; what will you give?
vasopressin
dopamine
norepinephrine
Which of the following treatment anaphylaxis shock? 1) Epinephrine 2) Corticosteroid 3) Antihistamine
Monotherapy
Triple therapy
Binary therapy
A 7-year-old girl is brought to the clinic with complaint of itchy scalp. Examination shows lice infestation. What is the best management?
permethrin
magic mouth wash
ketoconazole shampoo
dimethicone lotion
A 16-year-old girl presents with severe recalcitrant nodular acne. Which of the following drugs is recommended for treatment?
Estrogen
Isotretinoin
Clindamycin 1%
Tretinoin 0.05%
What is Z in statistics?
dependent
independent
sample size
standard score or standard deviations
p value ?
> significant clinical
< significant statical
> significant statical
< significant clinical
Which one of the following measures can be classified as a central tendency?
Confidence intervals
Standard deviation
Sampling error
Validity
A researcher reported the data using the chart shown in the image. What is the name of this chart?
Pie chart
Histogram
Forest plot
Funnel plot
From the following data of the highest in cm of 11 pediatric patients: 103, 107, 110, 124, 129, 131, 136, 140, 142, 145, 150. What does the value 131 represent?
Mode
Mean
Median
Confidence interval
In statistical testing, which of the following is the interpretation of the result of a statistical test denoted P?
the null hypothesis H0 is rejected if P > 0.05
the null hypothesis H0 is accepted if P < 0.05
the null hypothesis H0 is rejected if p < 0.05
the null hypothesis H0 is accepted if p > 0.05
Which of the following is used to determine the significance of the result?
p value
odds ratio
hazard risk
relative risk
Which of the following reflect the significance of sample evidence?
The p-value
The F-ratio
Value of alpha
The importance of the sample
Which of the following is the interpretation of a P-value of 0.05?
There is 0.05% probability that the result is due to random chance
There is 5% probability that the results are due to random
There is 50% probability that the results are due to random
There is 95% probability that the results are due to random
Which of the following best describes prednisone pharmacological activity?
A uricosuric agent
An anesthetic agent
An antipyretic agent
An anti-inflammatory agent
Which of the following glucocorticoids has the lowest potency?
Prednisone
Triamcinolone
Hydrocortisone
Dexamethasone
Which of the following exhibits highest anti-inflammatory potency?
prednisone
triamcinolone
hydrocortisone
Betamethasone
Which of the following is the disadvantage of conducting randomized controlled trial?
Expensive
High possibility of bias
Difficult to control confounders
Cannot be used for hypothesis testing
Which of the following is the type of studies considers data from multiple studies of different designs to draw conclusions?
Case Series
Double-blind study
Systematic review
Consensus statement
The authors report two isolated gastro-intestinal tuberculosis in renal transplant recipients that illustrates the difficulty of making this diagnosis and a brief review of the literature on its clinical presentation, diagnosis and therapeutic approach. What is the type of study in the above-mentioned abstract?
Case-series
Cohort studies
Case-control studies
Cross-sectional studies
Scenario: A study located a group of subjects with lymphoma and went to identify which subjects are smokers and which are not. Which of the following study designs is used to conduct the study in the scenario?
Case-series
Cross-sectional study
Prospective cohort study
Retrospective cohort study
A group of patients with diabetes were interviewed to determine they are currently eating fast food or not. Which epidemiological study design is this?
Cohort
Case-control
Cross-sectional
Randomized control trial
Which of the following study design is the best to use to assess the awareness on the usage of vitamin D supplements among people of Jeddah?
Cohort study
Case report study
Case control study
Cross sectional study
Which of the following studies represent a cost-effectiveness study?
Comparing costs for 2 therapeutically equivalent products
Comparing costs and savings of a pharmacokinetic service diabetes clinic
Comparing patients achieving control as the outcome for 2 antihyperglycemic drugs
Comparison of costs of 2 chemotherapy regimens with the best supportive care
Which of the following situation demonstrates a direct association pharmacoepidemiologic study? The study reveals that it is not a false association
The regression provides misleading statistical evidence.
The association between two variables is a result of another.
The association between the two attributes is not through attributes
Which of the following studies are more susceptible to recall bias?
Retrospective cohort
Prospective cohort study
Randomized controlled trial
Non-randomized controlled trial
Which of the following studies represent cost-effectiveness analyses study?
Comparing costs for 2 therapeutically equivalent products
Comparing costs and savings of a pharmacist services versus
Comparing patients achieving control as the outcome for 2 anti-hyperglycemic drugs
Comparison of costs of 2 chemotherapy regimen with the cost using best supportive care
Which of the following terms measures the association between the exposure and the outcome?
P value
Risk ratio
Standard deviation
Confidence interval
In pharmacoeconomic studies, the costs (inputs) for types of analyses are measured in dollars but the pharmacoeconomic method selected will depend on how the outcomes are measured. Which of the following analysis describes the method when patient preferences for alternative treatments are being considered as the outcome?
Cost-Minimization
Cost-Effectiveness
Cost-Benefit
Cost-Utility
A researcher gathered all vitamin E studies from the past ten years. Vitamin E was used for a variety of conditions, and the populations studied as well as the vitamin E formulations and doses were all different. The researcher compared the incidences of cardiovascular-related mortality in those taking vitamin E supplements versus those that did not. Which of the following best describes this type of study?
Meta analysis
Cohort study
Observational study
Controlled clinical trial
If a study follows a group of smokers and a group of non-smokers over time and observes which individuals eventually develop lymphoma, what is this study design called?
Retrospective cohort study
Prospective cohort study
Cross-sectional study
Case-series
Which of the following is an intervention study?
Cohort
Ecological
Case-Control
Randomized Clinical Trial
Researchers compare a group of people who have diabetes with people who have no diabetes and look back in time to identify characteristics that differ between the groups. Which study design is described?
Prospective cohort
Case-Control
Experimental
Randomized clinical
Which of the following is the appropriate definition of pharmacoepidemiology?
The study of chronic diseases
The study of infectious diseases in large populations
The study of the use of and effects of drugs in large numbers of people
The study of the distribution and determinants of diseases in populations
A study investigated whether drinking coffee leads to coronary heart disease and found a correlation between the two variables. However, drinkers are more often smokers than the average, there is correlation between drinking coffee and nicotine consumption, and there is a strong causal correlation between smoking and the incidence of heart disease. Which type of bias affects this study’s results?
Measurement errors
Hawthorne effect
Information bias
Confounding
Which section of a research paper describes the aims and objectives?
Method
Discussion
Introduction
Data analysis
A 70-year-old man has been prescribed several medications eliminated by the kidney. His body weight is 80 kg and serum creatinine is 0.194 mmol/L ( 2.2mg/dL ). Which equation is most appropriate to calculate his creatinine clearance?
Schwartz
Shull et al
Counahan–Barratt
Cockcroft and Gault
In 2017, a research paper published in NEJM reported outcomes with canagliflozin, an SGLT2 inhibitor, on cardiovascular, renal, hospitalization, and death events. Which statement about canagliflozin is correct?
Exacerbates albuminuria
Causes cardiovascular deaths
Increases the chance of fatal strokes
Has protective effect against cardiovascular deaths
Which study design is most appropriate for investigating a rare disease?
Case–control study
Cohort study
Cross-sectional study
Randomized controlled trial
In an observational study about the relationship between eating fatty food and obesity, what is the nature of the relationship that can be concluded?
Association
Causality
A study that investigates if drinking coffee leads to coronary heart disease found a correlation between two variables. However, drinkers are more often smokers than average, and there is a correlation between drinking coffee and nicotine consumption, as well as a strong causal correlation between smoking and the incidence of heart disease. Which type of bias affects this study’s results?
Measurement
Information bias
Confounding
The authors report two isolated gastrointestinal tuberculosis cases in renal transplant recipients that illustrate the difficulty of making this diagnosis and include a brief review of the literature on its clinical presentation, diagnosis, and therapeutic approach. What is the type of study in this abstract?
Case series
Cohort study
Case-control study
Cross-sectional study
What is the best study design to determine side effects of drugs?
Case-control study
Cohort study
Systematic review
Randomized controlled trial
Which is the best study design for a rare disease?
Case-control study
Cohort study
Systematic review
Case series
Which is the best type of study to investigate a risk factor?
Case-control study
Cohort study
Prospective cohort study
Case series
A study is considered ethical if:
You get approval from the ethics committee
You rely on numbers
You obtain volunteer consent
Which population is primarily studied in phase I clinical trials?
Healthy participants
Patients with a single disease
Patients with multiple diseases
Patients in real-world practice
Which one of the following designs could be deemed a study?
Cohort
Clinical trials
Case-control
Cross-sectional
Patient has burn in finger. What is the appropriate immediate treatment?
Ice
Ointment
Running water
A 33-year-old woman with no underlying medical condition came to a clinic with complaints of dysuria, urinary frequency and urgency, and suprapubic tenderness. She was diagnosed with urinary tract infection and treated with trimethoprim/sulfamethoxazole. Which of the following is an objective parameter to assess the effectiveness of drug therapy?
Resolution of back pain, decrease in cough frequency
Improved ability to concentrate
Normalization of white blood cells
A 3-year-old girl with symptoms of cough for the past 2 days came to the clinic with her mother. She has no fever and no other symptoms. Which of the following is the appropriate recommendation?
Vicks
Honey
Diphenhydramine
Dextromethorphan
Which of the following lifestyle measures help in reducing chronic constipation?
Increasing physical activity
Taking iron supplementation
Drinking 4–5 cups of coffee daily
Consuming more protein, especially red meat
A 48-year-old man is receiving parenteral nutrition (PN) with the following daily intravenous infusion schedule: at 21:00 start PN at a rate of 40 ml/hr for 1 hour; at 22:00 increase PN to a rate of 80 ml/hr for 12 hours; at 10:00 reduce PN to a rate of 40 ml/hr for 1 hour; at 11:00 stop PN. Which of the following best describes the mode of PN administration in this patient?
Continuous PN
Peripheral PN
Home PN
Cyclic PN
Which of the following is the best treatment for a 75 year-old woman with urinary incontinence?
Imipramine
Oxybutynin
Duloxetine
Doxazosin
Which of the following vitamin deficiencies lead to stomatitis?
Vitamin A
Vitamin B2
Vitamin D
Vitamin E
Which of the following drug can be used to treat myasthenia gravis?
Chloroprocaine
Pyridostigmine
Rapamycin
Nadolol
What is the clinical use for acetylcysteine?
Cough suppressant
Hemostatic
Mucolytic
Laxative
Which of the following conditions is treated with desmopressin?
Psoriasis
Endometriosis
Nocturnal enuresis
Attention deficit disorder
A 37-year-old man presents with tinnitus and transient hearing loss. Meniere's disease is diagnosed. Which of the following is the most appropriate management?
Cycloserine
Flucytosine
Betahistine
Diphenoxylate
Which of the following is the most common side effect of diphenhydramine (Benadryl)?
Cough
Angina
Diarrhea
Drowsiness
A 300 mg tablet of the herbal medicine Aesculus (Horse Chestnut) contains 22% of aescin. Which of the following disease can be treated effectively with this pharmaceutical preparation?
Hemorrhoids
Gastric ulcer
Cardiac arrhythmias
Which of the following vitamin deficiency causes Pellagra disease?
Niacin (vit b3)
Biotin
Riboflavin
Cyanocobalamin
Which of the following statements best describes drug dependence?
Discontinuation of the drug will produce withdrawal symptoms.
Action of one drug is dependent on the presence of another drug.
Discontinuation of the drug will not produce withdrawal symptoms.
Patients progressively require increasingly larger doses of a drug to achieve the same effect.
Which of the following increases the risk of aspiration during enteral feeding administration?
Continuous feeding regimens
High gastric residual prior to feeding
Feeding with high-carbohydrate content
Feeding a patient while in the upright position
A 26-year-old woman, part of the national swimming team, complains of lack of energy for a couple of months. The training sessions are now becoming more challenging for her. She eats a balanced vegetarian diet. She has experienced heavy menstrual bleeding in the last year. Laboratory results: Hgb 9¨ (normal 1¨20–160 ), MCH 2¨2 (normal 2¨8–33 ), MCV 7¨0 (normal 8¨0–95 ), reticulocyte count 0¨.2 (normal 0¨.2–1.2 ), platelets 3¨50 (normal 1¨50–400 ), WBC 5¨ (normal 4¨.5–10.5 ), total iron binding capacity 6¨5 (normal 9¨–30.4 ). What would be the best recommendation?
Iron tablets with ascorbic acid
Iron tablets on an empty stomach
Slow-release iron tablets with food
Iron tablets with a cup of coffee or tea
Stomatitis due to deficiency ?
vitamin C
vitamin B2
vitamin E
What is the drugs we do not give old people ?
amlodipine
metoprolol
metoclopramide
On of the following medications is not affecting the potassium level ?
salbutamol
digoxin
insulin
sodium polystyrene sulfonate
fosinopril
Before dispensing of TPN which drug should be discontinue ?
propofol
dexmedetomidine
glycylcycline (tetracycline)
fentanyl
Patient is with difficulty in urine, he was previously with urine incontinence, he is feeling dizziness and hypertensive, his bp is 140/90. He is taking Lisinopril, HCTZ and Oxybutynin, which is possible intervention ?
discontinue oxybutynin
discontinue lisinopril and oxybutynin
discontinue HCTZ and oxybutynin
continue all medications
Pt has HTN, DM, Asthma and he came because he has a cough and wheezing, and high blood glucose. What will you treat first ?
asthma then diabetes mellitus then hypertension
diabetes mellitus then asthma then hypertension
hypertension then asthma then diabetes mellitus
Pt has Crohn’s disease, he takes sulfasalazine but the symptoms get worse. What is the best option to ?
cyclosporine
acetaminophen
prednisone
A 74-year-old man with chest infection is admitted to a teaching hospital. The patient requires a chest X-ray. The chief resident orders bronchoscopy to be conducted; one reason is to allow an inexperienced intern to practice this technical procedure. Which of the following describes this action?
The senior physician should remain present when inexpen students make this procedure
beneficence by prioritizing the patient’s best interests
justice by fairly allocating training opportunities
nonmaleficence by avoiding unnecessary risk to the patient
Which one of the following side effects is associated with bisphosphonates use?
headache
blurred vision
hypotension
osteonecrosis of the jaw
An old patient has HF and HTN and he has runny nose and other symptoms. What is the best analgesic?
Diclofenac and diphenhydramine
Diclofenac and loratadine
paracetamol and pseudoephedrine
paracetamol and Oxymetazoline
A 56-year-old farmer man has a significant history of animal contacts (goats and sheep) and complains of low-grade fever (on/off) for 3 months, lethargy, anorexia, cough and weight loss. He seeks medical advice from a pharmacist at a local pharmacy in the village. He asks for over the counter (OTC) medications for his illness. Which of the following is the most appropriate recommendation?
doxycycline plus paracetamol for possible brucellosis
refer him to the nearest hospital for further investigation
ibuprofen 400 mg PO bid after food for 7 days for his fever
paracetamol 500 mg PO PRN until subside of his symptoms
Which of the following toxins can be used therapeutically?
aflatoxin
saxitoxin
α-bungarotoxin
botulinum toxin
A 60-year-old man presents with profound hypotension and tachycardia. He has been on nifedipine for hypertension and accidently took an overdose of it. Which of the following is the most appropriate management?
normal saline
insulin-dextrose
calcium gluconate
potassium chloride
A 2-year-old boy was found with an empty bottle of 100 chewable multivitamins. Each tablet contained 18 mg iron. He is asymptomatic at time of presentation to the emergency department. Which of the following is the most appropriate management?
administer activated charcoal and discharge after brief observation
observe at home with phone follow-up only
obtain an abdominal radiograph and begin whole bowel irrigation
administer intravenous N-acetylcysteine for potential hepatotoxicity
Which of the following methods of gastrointestinal decontamination would be most appropriate?
gastric lavage
activated charcoal
whole bowel irrigation
multi-dose activated charcoal
Which of the following is the most likely mechanism of carbon monoxide poisoning?
Inhibits the gag reflex
Paralyzes the muscles of the diaphragm
Decreases the oxygen-carrying capacity of the blood
Reacts with amino acids in the body to form ammonia
Which detoxification pathway is active in paracetamol toxicity?
Oxidation
Reduction
Conjugation with glucuronide
CYP-450 dependent glutathione
Which of the following is the antidote for cholinesterase inhibitor mild toxicity?
atropine
carnitine
deferoxamine
sodium thiosulfate
A 12-year-old boy is brought to the Emergency with inability to open eyes and difficulty in breathing after a snake bite. Examination shows anxiety, tachycardia, tachypnea, bilateral ptosis, no visible bite mark, and no limb swelling. Lab result: clotting time 20 minutes (normal 5–10 minutes). Which of the following is the next course of action?
keep the patient under observation
reassure the patient and send home with anxiolytic
give Anti-snake venom (ASV) plus Neostigmine and keep under observation
give Anti-snake venom (ASV) and keep under observation
Which of the following drug/substance would exacerbate the poisoning effects of acetaminophen?
Ethanol
Cimetidine
A 62-year-old patient, otherwise healthy, presented to the Emergency Department in a confused state after ingesting one green fruit of castor bean two hours earlier. He had one episode of vomiting, dry mouth, and bilaterally dilated pupils with sluggish reaction to light. He was treated symptomatically with activated charcoal. Which is the main active constituent responsible for the toxic effect of castor seeds?
Ricin
Barbaloin
Mezerein
Ergotamine
A graph represents a quantal dose–response curve of a drug. What is the median lethal dose (LD50) of the drug?
5
10
20
50
Which electrolyte disturbance leads to digoxin toxicity?
Na
K
Mg
Ca
Which drug requires ECG monitoring?
Oral digoxin
IV potassium
Doxorubicin
The Arabs traditionally used kohl for children. What is the harmful substance in kohl?
Lead
Mercury
Zinc
What is the recommended dose of IV N-acetylcysteine for a 6-year-old child?
2.5 mg/kg
20–15 mg/kg
An 81-year-old man presents with urinary hesitancy and difficulty for the past 1 month. He has a history of urinary incontinence, and his physician suspects benign prostatic enlargement. He is currently taking oxybutynin and lisinopril. Which intervention is most appropriate?
Discontinue oxybutynin
Discontinue lisinopril
Start alfuzosin
Start prazosin
Should drugs be freezing?
Interferon
Vaccine
Solution
A 65-year-old man asks about vaccination before he leaves for summer vacation next month. He brings his vaccination record for the past 4 years. Today's date: 05/31/2014. Table: DATE – 8/2011; Vaccination – Herps Zoster. DATE – Every year; Vaccination – Influenza. DATE – 10/2011; Vaccination – Pneumococcal. Which vaccination should this patient receive?
Influenza
Hepatitis A
Measles, Mumps, Rubella
Pneumococcal polysaccharide
Which of the following vaccines is contraindicated in a pregnant woman?
Polio vaccine
Influenza (inactivated) vaccine
Measles, Mumps, Rubella (MMR)
Tetanus, diphtheria, Pertussis (T dap)
Which of the following terms describes living microbe with reduced virulence, and used for vaccination?
Virulent
Dormant
Attenuated
Encapsulated
Which of the following vaccines is contraindicated in pregnant woman?
Hepatitis B
BCG vaccine
Polio vaccine
Meningococcal vaccine
Which of the following vaccines is recommended for people at the age of ≥65 years?
Hepatitis B vaccine
Pneumococcal vaccine
Meningococcal vaccine
DTaP vaccine (diphtheria, tetanus, pertussis)
A 33-year-old woman with history of migraine and hypothyroidism is a nurse with one son and is currently 15 weeks pregnant. She is concerned about vaccination and seeks your advice. Which of the following vaccines is contraindicated?
Hepatitis B
Inactivated influenza
MMR (measles, mumps, and rubella)
Which of the following age groups is inactivated polio recommendation?
Immediately after birth
Children up to 6 years old
Children more than 10 years old
Recommended for all age groups
A 33-year-old woman with history of migraine and hypothyroidism is a nurse with one son and is currently 15 weeks pregnant. She is concerned about vaccinations and seeks your advice. Which of the following vaccines is contraindicated?
Hepatitis B
Inactivated influenza
MMR (measles, mumps, and rubella)
Tetanus, diphtheria, and pertussis (Tdap)
A 55-year-old man is being treated with IV acyclovir for herpes simplex virus encephalitis. He wants to know if he can receive the varicella vaccine today. Which of the following should be the best response?
Yes, because it is important to prevent future HSV infection
Yes, because varicella vaccine is not related to HSV infection
No, because varicella vaccine may not work if given today
No, because he is currently acutely ill
Which of the following is most appropriate when giving hepatitis B vaccine to an unvaccinated patient?
1 dose vaccine intramuscularly
No vaccination is recommended
1 dose vaccine intramuscularly every year
3-dose vaccine series administered intramuscularly at 0, 1, and 6 months
Which of the following vaccines is recommended within the first twelve hours of birth?
Varicella
Hepatitis A
Hepatitis B
Measles, mumps, and rubella (MMR)
Which of the following vaccines is recommended to be given at birth in Saudi Arabia?
Rotavirus vaccine
Hepatitis A vaccine
Hepatitis B vaccine
A woman is pregnant in her third trimester. Which of the following vaccines can she receive?
Influenza
Varicella
MMR
Rota
Which of the following vaccines is used to prevent cervical cancer?
Zoster
Varicella
Human papilloma-virus
Tetanus, diphtheria, pertussis
Which of the following vaccinations needs to be proofed for persons working in a healthcare setting?
Tetanus
Varicella
Rota virus
Hepatitis B
Which of the following vaccines is specifically indicated for all pregnant women during each pregnancy, in addition to influenza vaccine?
Hepatitis B vaccine
Hepatitis A vaccine
Pneumococcal vaccines
Tetanus, diphtheria, pertussis
Which of the following could be stored in a freezing unit?
Insulin
Interferon
Varicella vaccine (Zoster VAX)
Human growth hormone
Which vaccine is recommended prior to pilgrimage (Hajj)?
Influenza + meningococcal (MCV)
HPV
PCV
MMR
Which vaccine has maximum age?
MMR
BCG
Rota
Measles
