BASIC MEDICAL SCIENCES

Pharmacology of Renal System and Diuretics

1) Osmotic diuretics are contraindicated in
a) Increased intracranial tension
b) Increased intraocular tension
c) Established acute renal failure
d) Poisonings

2) The antidiuretic action of Desmopressin is due to activation of:
a) V 1a receptor
b) V 2 receptor
c) V 1b receptor
d) V1 and V2 receptor

3) Furosemide increases the excretion of all of the followings except
a) Sodium
b) Potassium
c) Uric acid
d) Calcium and magnesium


4) A group of college students is planning a mountain climbing trip. Which of the following drugs would be appropriate for them to take to prevent mountain sickness?
a) Acetazolamide
b) Furosemide
c) Hydrochlorothiazide
d) Spironolactone

5) Drug of choice for nephrogenic diabetes insipidus is:
a) Lypressin
b) Terlipressin
c) Desmopressin
d) Vasopressin


6) Which of the following agent is very effective in the treatment of hepatic edema?
a) Chlorthalidone
b) Triamterene
c) Furosemide
d) Spironolactone

7) All of the following drugs are nephrotoxic except
a) Amphotericin
b) Lithium
c) Metronidazole
d) Cocaine

8) The dose related toxicity of loop diuretics is:
a) Allergic reaction
b) Deafness
c) Hypomagnesemia
d) Hyperuricemia

9) Aminoglycosides induced nephrotoxicity is in the order of
a) Gentamicin> Tobramycin>Amikacin>Netilmicin> Streptomycin
b) Streptomycin > Tobramycin >Amikacin>Netilmicin > Gentamicin
c) Gentamicin > Amikacin > Netilmicin > Tobramycin > Streptomycin
d) Tobramycin > Amikacin>Netilmicin> Streptomycin > Gentamicin

10) All of the followings are non-renal actions of anti-diuretic hormone except
a) a neurotransmitter in central nervous system
b) promotes haemostasis
c) is a potent vasoconstrictor
d) increases the permeability of the membrane to water

Multiple Choice Answers

1-c) Established acute renal failure

2-b) V 2 receptor

3-c) Uric acid

4-a) Acetazolamide

5-c) Desmopressin

6-d) Spironolactone

7-c) Metronidazole 

8-b) Deafness

9-a) Gentamicin> Tobramycin>Amikacin>Netilmicin> Streptomycin

10-d) increases the permeability of the membrane to water 

11-a) Flavoxate

12-b) Hyperkalemia

13-b) Chlorothiazide

14-d) a and b

15-a) Loop diuretics

16-d) All of the above

17-a) Acetazolamide: epithelial sodium channel blockers

18)-c) Bleeding esophageal varices 

19-a) Terlipressin 

20-c) Distal nephron hypertrophy

Pharmacology of Endocrine Disorders, Thyroid Disorders and Diabetes

1) Which of the following drug and its mechanism of action is incorrect?
a) Sulfonylureas: promotes insulin release from the β cells of pancreas
b) Biguanides: improves target cell response to insulin without increasing pancreatic insulin secretion
c) Thiazolidinediones: promotes insulin release from the β cells of pancreas
d) α-glucosidase inhibitors: reversible inhibition of membrane bound α glucosidase in the intestine

2) Followings are the side effects of insulin except
a) Lipodystrophy
b) Hypoglycemia
c) Local injection site reactions
d) Anorexia

3) Following statements about type I diabetes are/is true except:
a) Shows classic symptoms of insulin deficiency as polydipsia, polyphagia, polyuria
b) Age of onset is commonly over 35 years of age
c) Obesity is usually present
d) Absolute deficiency of insulin caused by destroyed β cells
e) a, c and d
f) a and d

4) In case of heart failure with history of Type II diabetes, which of the following drugs would be a poor choice in controlling diabetes?
a) Glipizide
b) Pioglitazone
c) Metformin
d) Acarbose

Cardiovascular system

1. All of the following agents are high ceiling diuretics except:
a. Furosemide
b. Amiloride
c. Torsemide
d. Ethacrynic acid

2. Which of the following statement is true for ACE inhibitors?
a. ACE inhibitors reduce both cardiac preload and afterload, thereby decreasing cardiac work
b. ACE inhibitors increase both angiotensin II and bradykinin levels
c. ACE inhibitors decrease both angiotensin II and bradykinin levels
d. None of the above

3. Choose the correct antihypertensive agents and its mechanism of action:
a. Furosemide: inhibition of epithelial sodium transport at the late distal and collecting ducts
b. Losartan: increases aldosterone secretion causing sodium and water retention
c. Clonidine: acts centrally as an a2 agonist causing inhibition of sympathetic vasomotor center
d. a and c
e. a, b and c

4. Which of the following is a direct renin inhibitor?
a. Olmesartan
b. Eplerenone
c. Aliskiren
d. None of the above

5. Choose the cardio selective b-adrenergic blockers.
a. Atenolol
b. Propranolol
c. Betaxolol
d. Cartelol

6. The cellular action of calcium channel blockers is
a. They inhibit Na + - Ca 2+ exchanger in cardiac and smooth muscles
b. They interact with the L-type voltage gated channel
c. Their interaction with the sodium pump results in the inhibition of calcium transport
d. Their interaction with the membrane phospholipids results in a nonselective decrease in ion transport

7. Followings are the pharmacological management of myocardial infarction to prevent future attacks
a. Platelet inhibitors
b. b-blockers
c. Control of hyperlipidemia
d. All of the above
e. None of the above

8. The cellular mechanism of action of digoxin is:
a. Inhibition of cAMP synthesis
b. Inhibition of b-adrenergic stimulation
c. Inhibition of ATP degradation
d. Inhibition of Na + K + ATPase

9. Which of the following drugs provide significant relaxation of smooth muscles of both venules and arterioles?
a. Nifedipine
b. Diazoxide
c. Sodium nitroprusside
d. Minoxidil

10. Which of the following drugs is not used for the management of congestive heart failure?
a. Enalapril
b. Nifedipine
c. Propranolol
d. Digoxin

11. Which of the following class of anti-arrhythmic drug suppresses abnormal automaticity and permit the sinoatrial node to again assume the role of dominant pacemaker?
a. Class I
b. Class II
c. Class III
d. Class IV

12. The anticoagulant effect of heparin is explained by
a. Chelation of calcium ion
b. Reduction of vitamin k dependent factor
c. Activation of antithrombin III
d. Activation of plasmin

13. If quinidine and digoxin are administered concurrently, what effect does quinidine have on digoxin?
a. Plasma concentration of digoxin is increased
b. Absorption of digoxin from gastrointestinal tract is decreased
c. Effect of digoxin on AV node is antagonized
d. Metabolism of digoxin is prevented

14. The specific antidote for Heparin is;
a. Pralidoxime
b. Protamine sulphate
c. Vitamin K
d. EDTA

15. The therapeutic benefit of propranolol in angina is believed to be primarily due to:
a. Reduced production of catecholamines
b. Decreased requirement of myocardial oxygen
c. Increased sensitivity to catecholamines
d. Increased peripheral resistance

16. Low concentration of nitrates cause dilation of:
a. Large arteries
b. Veins
c. Precapillary sphincters
d. Arterioles

17. Following is the mechanism of action of HMG-CoA reductase inhibitors
a. Competitive inhibition of HMG-CoA reductase
b. Reduction in endogenous cholesterol synthesis
c. Up-regulation of LDL receptor activity
d. None of above
e. All of the above

18. Nicotinic acid is;
a. Lipid modifying agent
b. Thrombolytic
c. Anticoagulant
d. Antiplatelet agent

19. A 46-year old man has been successfully treated with a thiazide diuretic for the last 5 years. Over the last 4 months, his diastolic pressure has steadily increased, and he has been kept on additional antihypertensive medication. He complains of several instances of being unable to achieve an erection and that he is no longer able to complete 3 sets of tennis. Which of the following second antihypertensive drug is most likely to cause the above mentioned complains?
a. Metoprolol
b. Captopril
c. Losartan
d. Nifedipine

20. Which of the following drug is a K+ channel opener?
a. Amiodarone
b. Nicorandil
c. Nifedipine
d. Captopril

Multiple Choice Answers
1-d) Ethacrynic acid
2- a) ACE inhibitors reduce both cardiac preload and afterload, thereby decreasing cardiac work
3- d)
4-c) Aliskiren
5-a) Atenolol
6-b) They interact with the L-type voltage gated channel
7-d) All of the above
8-d) Inhibition of Na + K + ATPase
9-c) Sodium nitroprusside
10-b) Nifedipine
11-a) Class I
12-c) Activation of antithrombin III
13-a) Plasma concentration of digoxin is increased
14-b) Protamine sulphate
15-b) Decreased requirement of myocardial oxygen
16-b) Veins
17-e) All of the above
18-a) Lipid modifying agent
19-a) Metoprolol
20-b) Nicorandil

Antimicrobials: Cell wall synthesis and protein synthesis inhibitors

Multiple Choice Questions

4) Following statement about Clavulanic acid, Sulbactam and Tazobactam are true except:
a) Antibiotic activity of beta-lactamases is inhibited by beta-lactamases
b) Inhibits beta-lactamases and can be administered with penicillinase sensitive penicillins
c) Co-administered with carbapenems to block carbapenemase inactivation
d) Typically co-administered with the cephamycin

5) The following cephalosporin is associated with bleeding complications
a) Cefotaxime
b) Cefuroxime
c) Cefotetan
d) Cefazolin

6) A 26-year old male returns home from a holiday and complains of three days of dysuria and a purulent urethral discharge. He is diagnosed to be a case of gonorrhea. Which of the following is an appropriate treatment?
a) Ceftriaxone IM
b) Streptomycin
c) Gentamicin
d) Vancomycin IV

7) Redman syndrome is toxicity associated with
a) Amoxicillin
b) Daptomycin
c) Linezolid
d) Vancomycin

8) Cilastatin is given along with Imipenem for the following reason:
a) Inhibition of beta-lactamases thus preventing inactivation of Imipenem
b) Blocking of bacterial transpeptidase and preventing degradation of Imipenem
c) Decreasing hydrolysis of Imipenem
d) Inhibition of renal tubular dipeptidase thus preventing hydrolysis of Imipenem by renal tubular dipeptidase

9) A 72 years old man who was administered Penicillin intravenously developed generalized urticaria, swelling of lips, hypotension, and bronchospasm within 5 minutes. The first choice of treatment is to administer
a) High dose hydrocortisone tablet
b) Chlorpheniramine injection
c) Adrenaline injection
d) Isoprenaline injection

10) Followings are the penicillinase-resistant penicillin except:
a) Carbenicillin
b) Methicillin
c) Nafcillin
d) Cloxacillin

11) Which of the following antibiotic acts as a protein synthesis inhibitor?
a) Erythromycin, Chloramphenicol
b) Vancomycin, Cephamycin
c) Gentamicin, Tetracycline
d) Options a and c
e) Options b and c

12) Ototoxicity, vestibulo-toxic impairment, and nephrotoxicity are seen as major adverse effects of
a) Aminoglycosides
b) Macrolides
c) Fluoroquinolones
d) All of the above

13) Gray baby syndrome in neonates can be caused by
a) Penicillin
b) Chloramphenicol
c) Quinolones
d) Sulphonamides

14) Fanconi syndrome can be caused by
a) Tetracycline
b) Quinolones
c) Sulphonamide
d) Penicillin

15) Following cephalosporins can cross the blood-brain barrier and therefore can be used in the treatment of meningitis except
a) Ceftazidime
b) Ceftriaxone
c) Cefotaxime
d) Cefixime

16) Random use of broad-spectrum antibiotic is contraindicated. They
a) Are extremely nephrotoxic
b) Can produce dependency and psychogenic symptoms
c) Can induce anaphylactoid reactions
d) Can interfere with indigenous microbiota

17) All of the followings are the adverse effects of tetracycline except:
a) Ototoxicity
b) Phototoxicity
c) Fatal hepatotoxicity
d) Yellow discoloration of teeth

18) Which of the following group of antibiotics show bacteriostatic action?
a) Fluoroquinolones
b) Aminoglycosides
c) Macrolides
d) Monobactams

19) Which of the following group of antibiotics in accordance with structure and mode of action to penicillin?
a) Chloramphenicol
b) Polymyxins
c) Cycloserines
d) Cephalosporins

1-a) Penicillin: inhibition of cell wall synthesis 

2-b) They all have a β-lactam ring as a part of their biological interaction

3-d) Oral absorption

4-b) Inhibits beta-lactamases and can be administered with penicillinase sensitive penicillins

5-c) Cefotetan

6-a) Ceftriaxone IM

7-d) Vancomycin

8-d) Inhibition of renal tubular dipeptidase thus preventing hydrolysis of Imipenem by renal tubular dipeptidase

9-b) Chlorpheniramine injection

10-a) Carbenicillin

11-d) Options a and c

12-a) Aminoglycosides

13-b) Chloramphenicol 

14-a) Tetracycline

15-d) Cefixime

16-d) Can interfere with indigenous microbiota

17-a) Ototoxicity

18-c) Macrolides

19-d) Cephalosporins

Multiple Choice Question on Antimicrobial Agents

1) Which of the following antibiotic acts by inhibition of nucleic acid synthesis?
a) Penicillin
b) Quinolones
c) Sulphonamides
d) Cephalosporin

2) Followings are the second-generation quinolones except:
a) Gatifloxacin
b) Enoxacin
c) Ofloxacin
d) Ciprofloxacin

3) Which of the followings are the drug interactions of quinolones is correct?
a) Antacids, calcium supplements decrease the absorption of quinolones
b) Quinolones enhance the metabolism of theophylline
c) Antacids, calcium supplements increase absorption of quinolones
d) Increased metabolism of warfarin and caffeine

4) The mechanism of action of Trimethoprim is:
a) Inhibition of enzyme dihydropteroate synthetase
b) Activation of enzyme dihydrofolate reductase
c) Inhibition of enzyme dihydrofolate reductase
d) Activation of enzyme dihydrofolate reductase

5) All of the following combinations are true except:
a) Ciprofloxacin: inhibition of DNA gyrase
b) Polymyxin B: inhibition of 50s protein synthesis
c) Erythromycin: inhibition of 50s protein synthesis
d) Sulphonamide: inhibition of folic acid

6) Cotrimoxazole is a combination of drugs
a) Sulphonamide + Chloramphenicol
b) Sulphonamide + Lincomycin
c) Sulphonamide + Trimethoprim
d) Sulphonamide + Tetracycline

7) Following adverse effects are shown by the corresponding drugs are true except
a) Chloramphenicol: gray baby syndrome
b) Cefoperazone: disulfiram-like reactions
c) Tetracycline: Fanconi syndrome
d) Sulphonamide: red man syndrome

8) The following statement about quinolones is true except:
a) Inhibition of DNA gyrase
b) Gemifloxacin and Clinafloxacin are 4th generation quinolone
c) Norfloxacin is 1st generation quinolone and used in the treatment of UTI
d) Second generation quinolone has increased activity against gram-positive bacteria including S. pneumoniae

9) Ciprofloxacin should not be used with theophylline because 

a) It decreases the efficacy of theophylline
b) It increases the toxicity of theophylline
c) Decreases absorption of theophylline
d) Decreases the efficacy of ciprofloxacin

10) Prolonged therapy of …………………………… leads to the development of pseudomembranous colitis
a) Amikacin
b) Clindamycin
c) Streptomycin
d) Vancomycin

11) By binding to the fungal ergosterol and alters its cellular permeability is the mechanism of action of ……………………….
a) Ketoconazole
b) Griseofulvin
c) Clotrimazole
d) Amphotericin B

12) Most commonly used antifungal topically for suppression of local candida infection is …………………
a) Miconazole
b) Fluconazole
c) Nystatin
d) Flucytosine

13) The type of drug interactions between flucytosine and amphotericin B is ………………………
a) Synergism
b) Antagonism
c) Potentiation
d) Additive

14) Which antifungal acts by non-competitive inhibition of squalene epoxidase thereby inhibition of ergosterol synthesis?
a) Flucytosine
b) Griseofulvin
c) Terbinafine
d) Ketoconazole

15) For the treatment of tinea cruris and tinea corporis, which topical allylamine(s) can be used?
a) Terbinafine
b) Naftifine
c) Both
d) None of the above

16) Gynecomastia and menstrual irregularities are the adverse effects of ………………
a) Terbinafine
b) Flucytosine
c) Griseofulvin
d) Ketoconazole

17) Followings are the correct combination of drug and its mechanism of action except:
a) Polyenes: binds to and disrupt the fungal cell membrane
b) Griseofulvin: blocks intracellular microtubules
c) Allylamines: inhibition of squalene epoxidase and blocks ergosterol formation in the cell membrane
d) Flucytosine: inhibition of cytochrome P450 dependent 14 α-demethylase and blocks ergosterol formation in the cell membrane

18) Flucytosine acts by
a) Inhibition of thymidylate synthetase leading to inhibition of DNA synthesis
b) Disruption of the mitotic spindle during metaphase by interacting with fungal microtubules
c) Inhibition of squalene epoxidase and blocks ergosterol formation in the cell membrane
d) None of the above

19) The most potent azoles antifungal is ………………….
a) Itraconazole
b) Fluconazole
c) Ketoconazole
d) Miconazole

20) Followings are the drug interactions of Ketoconazole except:
a) Inhibition of the metabolism of cyclosporine thereby increasing its toxicity
b) Enhanced metabolism of Astemizole and Terfenadine thereby decreasing arrhythmias
c) Cimetidine interferes with Ketoconazole absorption by increasing gastric pH
d) Rifamycins increase Ketoconazole hepatic metabolism

Multiple Choice Answers
1-b) Quinolones
2-a) Gatifloxacin
3-a) Antacids, calcium supplements decrease the absorption of quinolones
4-c) Inhibition of enzyme dihydrofolate reductase
5-b) Polymyxin B: inhibition of 50s protein synthesis
6-c) Sulphonamide + Trimethoprim
7-d) Sulphonamide: red man syndrome
8-d) Second generation quinolone has increased activity against gram-positive bacteria including S. pneumoniae
9-b) It increases the toxicity of theophylline
10-b) Clindamycin
11-d) Amphotericin B
12-c) Nystatin
13-a) Synergism
14-c)Terbinafine
15-c) Both
16-d) Ketoconazole
17-d)  Flucytosine: inhibition of cytochrome P450 dependent 14 α-demethylase and blocks ergosterol formation in the cell membrane
18-a) Inhibition of thymidylate synthetase leading to inhibition of DNA synthesis
19-a) Itraconazole
20-b) Enhanced metabolism of Astemizole and Terfenadine thereby decreasing arrhythmias

Drug for treatment of Gastrointestinal disease 

Multiple Choice Question

20) Choose the correct drug and its mode of action combinations
a) Liquid paraffin: stool softener
b) Bisacodyl: osmotic purgative
c) Lactulose: osmotic purgative
a) Ispaghula: bulk-forming

Multiple Choice Answers

1-d) Sucralfate 

2-b) Its bioavailability is not affected by food 

3-b) Cimetidine 

4-d) Aluminum antacids cause constipation and magnesium antacids cause diarrhea 

5-c) Chlorpromazine 

6-d) Cimetidine

7-c) Glossitis 

8-a) Ivermectin 

9-d) Docusate sodium 

10-d) All of the above 

11-d) Lactulose 

12-c) Does not undergo first-pass metabolism 

13-d) 5-HT4 antagonism 

14-a) Hyoscine 

15-e) a, b and c 

16-d) Metoclopramide 

17-a) Lactulose 

18-d) Acute diarrhea 

19-a) Adsorbents increase the absorption of drugs like digoxin, quinidine, clindamycin, and hypoglycemic agents 

20-b) Bisacodyl: osmotic purgative 

Drug for the treatment of Respiratory Disease

Multiple Choice Question

(Bronchial asthma, Tuberculosis, Antihistaminic, and Cough therapy)

1) All of the followings are selective β2-agonist except:
a) Isoprenaline
b) Salbutamol
c) Terbutaline
d) Formeterol

2) All of the following combinations of drug and its mechanism of action is correct except:
a) Salbutamol: stimulation of β2 receptor causing bronchodilation
b) Sodium cromoglicate: mast cell stabilization
c) Zafirlukast: leukotriene modulators
d) Theophylline: non-selective β2 receptor stimulation causing bronchodilation

3) Which of the following statement about Salmeterol is not true?
a) It acts by relaxing muscles in the airways to improve breathing
b) It is a short-acting selective β2 agonist
c) Salmeterol inhalation is used to prevent asthma attacks
d) Salmeterol inhalation is used to treat COPD including emphysema and chronic bronchitis

4) Which of the following inhibits acetylcholine-mediated bronchospasm?
a) Theophylline
b) Ephedrine
c) Ipratropium
d) Salmeterol

5) All of the following statements about the use of glucocorticoids in asthma is true except:
a) Reduces bronchial inflammation and hyperactivity to stimuli
b) Have delayed onset of action
c) Given as prophylactic medications, used alone or combined with β-agonists
d) They are bronchodilators

6) Systemic corticosteroids are indicated in the following conditions EXCEPT:
a) Mild episodic asthma
b) Severe chronic asthma
c) Status asthmaticus
d) To prevent neonatal respiratory distress syndrome


7) Which one of the following is not a side effect due to systemic corticosteroids?
a) Adrenal suppression
b) Fluid retention, weight gain, hypertension
c) Hyperglycemia
d) Sleep disorders

8) All of the following statements about histamine is true except:
a) Increases blood pressure
b) Stimulates gastric acid secretion
c) Causes dilatation of capillaries
d) Causes constriction of bronchial smooth muscles

9) Isoniazid-induced liver damage:
a) Occurs primarily in patients under 30 years of age
b) Occurs with increased frequency in patients receiving concomitant ethambutol therapy
c) is probably due to the formation of a toxic hydrazine metabolite that binds to liver protein
d) is frequently associated with allergic manifestations such as eosinophilia, fever, and rash.

10) Development of peripheral neuritis is associated with …………………
a) Rifampin
b) Ethambutol
c) Isoniazid
d) Streptomycin

11) Which of the following is the drug of choice in the treatment of productive cough?
a) Dextromethorphan
b) Pholcodine
c) Bromhexine
d) Noscapine

12) Astemizole and terfenadine may cause fatal arrhythmia when used in combination with some macrolides or antifungal agents. They
a) Lengthen QT interval via direct action on cardiac H2 receptors
b) Increase metabolism of macrolide antibiotics
c) Cause accumulation of these agents following inhibition of CYP3A4, a cytochrome p450 enzyme
d) Exacerbate histamine-induced hypotension causing increased cardiac oxygen demand during reflex tachycardia

13) Which one of the following statements about cough is correct?
a) Cough must always be treated with an anti-tussive regardless of its cause
b) Codeine is effective in the treatment of productive cough
c) Pentoxyverine is especially well suited to treat cough in infants
d) Angiotensin II receptor blockers can cause cough

14) Choose the correct statement about rifampin:
a) It is the most active drug on slow-growing tubercle bacilli
b) Its antitubercular efficacy is lower than that of isoniazid
c) It is active against many atypical mycobacteria
d) It does not effectively cross the blood-CSF barrier


15) What is a serious adverse reaction caused by ethambutol?
a) Stomach upset
b) Eye damage
c) Gout
d) Hepatotoxicity

16) Choose the correct drug and its mechanism of action combination:
a) Rifampicin: inhibits bacterial DNA-dependent RNA polymerase
b) Pyrazinamide: interferes mycobacteria fatty acid synthesis and inactivates mycobacteria at alkaline pH
c) Ethambutol: Interferes with mycolic acid synthesis
d) Isoniazid: Inhibits arabinosyl transferases involved in cell wall biosynthesis

17) The following anti-tubercular drug is a potent CYP-P450 enzyme inducer:
a) Isoniazid
b) Ethambutol
c) Rifampicin
d) Pyrazinamide

18) Which of the following pharmacologic agents antagonizes adenosine?
a) Theophylline
b) Glucocorticoids
c) Cromolyn sodium
d) Terbutaline

19) All of the following statements about antihistaminic are correct EXCEPT:
a) Some histamine H1 receptor antagonists are used in the prophylaxis and treatment of motion sickness
b) Promethazine possesses anti-emetic, sedative and anti-muscarinic activity
c) Histamine H1 receptor antagonists inhibit the release of histamine
d) Histamine H1 receptor antagonists are effective in the treatment of hay fever

20) An anti-tubercular drug which is bacteriostatic to resting organism is………….
a) Pyrazinamide
b) Isoniazid
c) Ethambutol
d) Rifampicin

Multiple Choice Answers
1-a) Isoprenaline
2-d)Theophylline: non-selective β2 receptor stimulation causing bronchodilation
3-b) It is a short-acting selective β2 agonist
4-c) Ipratropium
5-d) They are bronchodilators
6-a) Mild episodic asthma
7-d) Sleep disorders
8-a) Increases blood pressure
9-c) is probably due to the formation of a toxic hydrazine metabolite that binds to liver protein
10-c) Isoniazid
11-c) Bromhexine
12-c) cause accumulation of these agents following inhibition of CYP3A4, a cytochrome p450 enzyme
13-d) Angiotensin II receptor blockers can cause cough
14-c) It is active against many atypical mycobacteria
15-b) Eye damage
16-a) Rifampicin: inhibits bacterial DNA-dependent RNA polymerase
17-c) Rifampicin
18-a) Theophylline
19-c) Histamine H1 receptor antagonists inhibit the release of histamine
20-b) Isoniazid

Author: Ronak Shrestha

Drug for treatment of Musculoskeletal disease
Multiple Choice Question on 

1-d) All of the above
2- d) Options a, b and c
3-a) Zero-order
4-d) All of the above
5-b) Enhances the uricosuric effects of probenecid and sulphinpyrazone
6-a) Nimesulide
7-c) Indomethacin
8-d) Aspirin
9-a) N-acetylcysteine
10-c) Ketorolac
11-b) The COX-2 inhibitors show anti-inflammatory activity similar to that of traditional NSAIDs
12-d) Allopurinol
13-d) Can be used as a pain medication to relieve other causes of pain
14-a) High dose probenecid decreases the proximal tubular reabsorption of uric acid
15-b) Succinylcholine
16-b) Allopurinol potentiates the effect of Azathioprine and 6-mercaptopurine
17-b) hepatocellular necrosis
18-a) Dihydrofolate reductase
19-c) Decreased risk of bleeding due to increased platelet aggregability
20-a) Mivacurium

Drugs targeting Autonomic Nervous System (Cholinergic, Muscarinic, Adrenergic)

Multiple Choice Questions 

Introduction to Pharmacology, Pharmacodynamics, and Pharmacokinetic 

Multiple Choice Question 

1) A molecule that interacts as an activator or inhibitor and brings about a change in the biological function through its chemical actions is known as …………………………
a) Hormone
b) Neurotransmitter
c) Protein
d) Drug

2) The action of the drug on the body is known as ……………………….
a) Pharmacokinetic
b) Pharmacodynamic
c) Pharmacology
d) Pharmacotherapeutics

3) Which one of the following statements is correct?
a) Weak bases are absorbed efficiently across the epithelial cells of the stomach
b) Co-administration of atropine speed up the absorption of a second drug
c) Drugs showing a large Vd can be efficiently removed by dialysis of the plasma
d) Weak acids are absorbed efficiently across the epithelial cells of the stomach

4) The desired physicochemical properties of drugs are:
a) Ionized, less plasma protein bound, lipid soluble
b) Unionized, less plasma protein bound, lipid soluble
c) Unionized, highly plasma protein bound, lipid soluble
d) Unionized, highly plasma protein bound, lipid-insoluble

5) Which of the following statement about receptor is not true?
a)  It determines the quantitative relations between dose or concentration of drug and pharmacologic effects.
b) Responsible for the selectivity of drug action.
c) Mediates the actions of pharmacological agonists and antagonists.
d) None of the above

6) The efficacy of agonist is reduced without affecting its potency is found in ………………….
a) Antagonism.
b) Noncompetitive
c) Competitive
d) Non-competitive and competitive
d) Inverse

7) Which of the following statement about competitive antagonism is true?
a) Can cause a parallel shift to the right in a drug-response curve for agonist
b)  Can be reversed by increasing dose of agonist
c) Appear to decrease the potency of the agonist
d) All of the above
e) None of the above

8) Which of the following effect can be seen in competitive antagonism in a drug-response curve?
a) Non-parallel left shift
b) Non-parallel right shift
c) Parallel right shift
d) Parallel left shift

9) Agonists have
a) Affinity to receptors only
b) Affinity and maximal intrinsic activity
c) Affinity but no intrinsic activity
d) Affinity and submaximal intrinsic activity

10) The IV administration of drugs are
a) 100% bioavailable
b) Rapidly absorbed
c) Undergoes the first-pass metabolism
d) Rapidly excreted by renal

11) The concentration of a drug required to produce 50% of that drug’s maximal effects is termed as ……………….
a) Efficacy
b) Potency
c) Affinity
d) Bioavailability 

12) For a drug given orally, the principal site of drug absorption is ……………………
a) Stomach
b) Small intestine
c) Oesophagus
d) Large intestine

13) Biotransformation of the drugs may lead to all of the following except
a) Inactive metabolite from an active drug
b) Active metabolite from an active drug
c) Active metabolite from an inactive drug
d) Inactive metabolite from inactive drug

14) Depot of the drug can be formed by …………………….
a) Subcutaneous and intramuscular route
b) Intravenous route
c) Subcutaneous route
d) Intradermal and subcutaneous route

15) Conjugation of a drug with glucuronic acid via glucuronosyl transferase with result in all of the following except
a) production of a more water-soluble moiety that is more easily excreted
b) a drug with a different pharmacological mechanism of action
c) a new compound that may also possess pharmacologic activity
d) a drug molecule that may undergo enterohepatic recirculation and reintroduction into the bloodstream

18) All of the following concerning the blood-brain barrier (BBB) and the passage of drugs from the systemic circulation to cerebrospinal fluid (CSF) is true except
a) ionized drugs are likely to cross into the CSF than unionized drugs
b) the higher the lipid solubility of a drug, the more likely it will cross into the CSF
c) inflammation of the meninges improves the likelihood that drugs will cross the BBB as compared to an uninflamed state

17) P glycoprotein serves to pump back the drugs into the systemic circulation from endothelial cell linings of the BBB
The following log dose-response curve show that

a) Drug A and B have equal potency
b) Drug B and C have equal efficacy
c) Drug A and B have equal efficacy
d) Drug A and C have the same affinity and efficacy

18) Phase II metabolism associated with a genetic polymorphism is ………………………….
a) Acetylation
b) Oxidation
c) Reduction
d) Glutathione conjugation

19) When the same dose of a drug is repeated at half-life intervals, the steady-state plasma drug concentration is reached after:
a) 2-3 half-lives
b) 4-5 half-lives
c) 6-7 half-lives
d) 8-10 half-lives

20) An ‘orphan drug’ is
a) A very cheap drug
b) A drug which has no therapeutic use
c) A drug which acts on orphan receptors
d) A drug needed for treatment or prevention of a rare disease

Multiple Choice Answers
1-d) Drug
2-b) Pharmacodynamic
3-d) Weak acids are absorbed efficiently across the epithelial cells of the stomach
4-a) Ionized, less plasma protein bound, lipid soluble
5-d) None of the above
6-a) Noncompetitive
7-d) All of the above
8-c) Parallel right shift
9-b) Affinity and maximal intrinsic activity
10-a) 100% bioavailable
11- b) Potency
12- b) small intestine
13- d) Inactive metabolite from inactive drug
14-a) Subcutaneous and intramuscular route
15-b) a drug with a different pharmacological mechanism of action
16-a) ionized drugs are likely to cross into the CSF than unionized drugs
17-b) Drug B and C have equal efficacy
18-a) Acetylation
19-b) 4-5 half-lives
20-d) A drug needed for treatment or prevention of a rare disease

Pathogenic Viruses, Structure, and Function  

Multiple Choice Question

7) Yellow fever and dengue fever virus both belong to which family group of the viruses?
a) Picornaviruses
b) Retroviruses
c) Flaviviruses
d) Paramyxoviruses

8) What are the general features of the Polio virus? Select all the correct options given below.
a) It is a capsid virus
b) The mode of transmission is fecal-oral route
c) It has the RNA genome
d) Larger than Rotavirus

9) Which of the following virus have genome replication in the cytoplasm?
a) Orthomyxoviruses
b) Poxviruses
c) Herpesviruses
d) None of the above

10) Which of the following statement is most correct about Retroviruses?
a) It has the circular DNA
b) It is double-stranded DNA virus
c) Make DNA from RNA template
d) Viral DNA replicates in the host cytoplasm

11) All of the following are the properties of Paramyxoviruses, EXCEPT?
a) Its genome is segmented
b) It is an enveloped virus
c) The causative agent of mumps and measles
d) It is larger than Orthomyxoviruses in size

12) Which of the following is the largest virus?
a) Polio virus
b) Flu virus
c) Dengue virus
d) Smallpox virus

13) Which of the following virus genome is translated into polyprotein?
a) Smallpox virus
b) Yellow fever virus
c) Norwalk virus
d) All of the above

14) Which of the following virus use positive RNA template to replicate the genome?
a) Influenza virus
b) Epstein-Barr virus
c) Chikungunya virus
d) Human papilloma virus

15) Name the bacterial virus from the following options given below?
a) Tobacco mosaic virus
b) T4 bacteriophage
c) Ebola virus
d) Influenza B virus

Multiple Choice Answers
1-All of the above a, b, c, d
2-b) The outer layer of all viruses consists of a lipid membrane
3-d) Togaviruses
4-a) Papillomaviruses
5-b) Adenovirus
6-a) True
7-c) Flaviviruses
8-Option a, b & c
9-b) Poxviruses
10-c) Make DNA from RNA template
11-a) Its genome is segmented
12-d) Smallpox virus
13-c) Norwalk virus
14-a) Influenza virus
15-b) T4 bacteriophage

Opportunistic Mycoses, Candida albicans,Aspergillus flavus, Cryptococcus neoformans
Multiple Choice Questions

11) A 50 years old man suffered a burn injury in the right arm, after a few days he developed blisters and ulcers around the burnt area. When examined redness and swelling around the infected area is observed. Fungal infection was suspected and biopsy was done, direct microscopic examination showed thick, branched septate hyphae with a black round tip. In culture, cottony colonies can be observed after a few hours of incubation. Name the possible pathogen responsible for the infection?
a) Pneumocystis jeroveci
b) Rhizopus oryzae 
c) Coccidioides immitis
d) Aspergillus flavus

12) Which of the following antibiotics is most effective for the treatment for pulmonary aspergilloma?
a) Penicillin G
b) Fluconazole
c) Ketoconazole
d) Amphotericin B

13) Name the fungal infection which is most commonly seen in patients with advanced HIV/AIDS and the wart-like skin lesions often appear on the face?
a) Mucormycosis
b) Histoplasmosis
c) Penicillosis
d) Blastomycosis

14) Which of the following human fungal species also present in the lungs of animals, causes pneumonia in immunocompromised patients?
a) Aspergillus niger
b) Pneumocystis jiroveci 
c) Penicillium marneffei
d) All of the above

15) Which of the following fungi causes vaginal thrush?
a) Candida albicans 
b) Rhizopus oryzae
c) Candida tropicalis
d) Aspergillus fumigatus

1- a) Aspergillosis >
2- d) All of the above >
4- b) Rhizopus oryzae >
5- d) Candida albicans >
6- c) Cannot be isolated in laboratory >
7- b) Cystic fibrosis >
8- a) Cryptococcus neoformans >
9- d) Aspergillus flavus >
10-a) Nuts >
11-b) Rhizopus oryzae >
12-d) Amphotericin B >
13- c) Penicillosis >
14- b) Pneumocystis jiroveci >
15-a) Candida albicans >

Multiple Choice Question on 

Biochemical Assessment of Kidney

1) A 2 days old premature baby boy born to a 22-year-old woman develops pneumonia, the mother seems healthy although premature delivery during 35 weeks of gestation. The blood specimen is taken from the baby and cultured which shows bacterial growth with beta hemolysis. The mother develops urinary tract infection after giving birth, which could be the possible bacteria that transferred from the mother to the baby and caused infection?
a) Streptococcus pyogenes 
b) Streptococcus agalactiae 
c) Enterococcus faecalis
d) Streptococcus bovis 

1-b) Streptococcus agalactiae 

2-c) Streptococcus pyogenes
3-c) Impetigo 

4-b) Staphylococcus aureus 

5-d) It grows well in a high concentration of glucose media 

6-a) Streptococcus pneumoniae 

7-d) Streptococcus mutans

8- Option a), b) & c) 

9-a) Rheumatic fever

10-c) The morphological characteristics resemble that of S. pyogenes 

11-a) Enterococcus faecalis 

12-a) Endotoxins 

13-b) Enterococcus faecalis 

14-b) Aminoglycoside with penicillin 

15-a) Enterococcus faecium