1 A 25 y.o. patient is treated with parenteral Aminoglycoside for a Pseudomonas aeruginosa infection. They require immediate surgery. They are premedicated with Midazolam. Dithylinum (Succinylcholine) is administered for intubation, with skeletal muscle paralysis maintained during surgery with Pancuronium (Arduanum). Anesthesia is maintained with N2O, Isoflurane. What is the most likely outcome of having the aminoglycoside in the perioperative setting along with all these other drugs? A. Acute hepatotoxicity from an Aminoglycoside-Isoflurane interaction B. Antagonism of Diazepam and sedative effects C. Increased or prolonged response to
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A 25 y.o. patient is treated with parenteral Aminoglycoside for a Pseudomonas aeruginosa infection. They require immediate surgery. They are premedicated with Midazolam. Dithylinum (Succinylcholine) is administered for intubation, with skeletal muscle paralysis maintained during surgery with Pancuronium (Arduanum). Anesthesia is maintained with N2O, Isoflurane.
What is the most likely outcome of having the aminoglycoside in the perioperative setting along with all these other drugs? A. Acute hepatotoxicity from
an Aminoglycoside-Isoflurane interaction B. Antagonism of Diazepam and sedative effects C. Increased or prolonged response to neuromuscular
blockers D. Enhanced aminoglycoside toxicity to host cells E. Reduced risk of cardiac arrhythmias
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A 37 y.o. patient, suffering an obliterating endarteritis of the legs, receives Phenylin in a dose of 60 mg/kg. Because of convulsion development (brain trauma is in anamnesis), Phenobarbital had been given, after the cancellation of which the nasal bleeding occurred at the patient. The given complication is connected with:
A. Conjugation of phenylin with a glucuronic acid B. Inhibition by phenobarbital of enzymes microsomal
oxidations in a liver C. Induction by phenobarbital of enzymes microsomal
oxidations in a liver D. Oxidative deamination of phenylin E. Aliphatic hydroxylation of phenobarbital
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For prevention remote relapses of For prevention remote relapses of 4-days 4-days malariamalaria a 42 y.o. patient was given a 42 y.o. patient was given PrimaquinePrimaquine. .
On the 3-d day of the treatment with On the 3-d day of the treatment with therapeutic dosestherapeutic doses of the drug patient of the drug patient experienced abdominal pain, cardiac pain, experienced abdominal pain, cardiac pain, dyspepsia, generalized cyanosis.dyspepsia, generalized cyanosis.
What is the reason of these adverse effectss of What is the reason of these adverse effectss of the drugthe drug? ?
A. Cumulation of the therapeutic agentA. Cumulation of the therapeutic agent BB.. Slowing down of drug’s secretion with urine Slowing down of drug’s secretion with urine CC. . Decreasing of activity of liver microsomal Decreasing of activity of liver microsomal
enzymesenzymes DD.. Genetic deficiency of Genetic deficiency of Glucose-6-phosphate Glucose-6-phosphate
dehydrogenasedehydrogenase EE.. Potentiation of the drug’s action by other Potentiation of the drug’s action by other
therapeutic agent. therapeutic agent.
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A 28 y.o. woman has just returned from a A 28 y.o. woman has just returned from a trip to Southeast Asia. Over the past 24 h trip to Southeast Asia. Over the past 24 h she has developed shaking, rigors, and tshe has developed shaking, rigors, and too 40.540.5oo C. C.
A blood smear reveals A blood smear reveals Plasmodium vivaxPlasmodium vivax..
Which of the following agents should be Which of the following agents should be used to eradicate the used to eradicate the Extraerythrocytic Extraerythrocytic PhasePhase of the organism of the organism??
AA. . Pyrimethamine (Chloridine)Pyrimethamine (Chloridine) BB. . ChloroquineChloroquine CC.. PrimaquinePrimaquine D. TetracyclineD. Tetracycline E. Quinacrine (Acrichinum)E. Quinacrine (Acrichinum)
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We give an ‘effective dose’ of We give an ‘effective dose’ of atropineatropine to a to a person who is poisoned with an person who is poisoned with an acetylcholinesterase inhibitoracetylcholinesterase inhibitor..
Which structure will continue to be overacted Which structure will continue to be overacted by the excess by the excess acetylcholineacetylcholine after this drug is after this drug is givengiven??
A. Airway smooth muscleA. Airway smooth muscle B. S-A node of the heartB. S-A node of the heart C. Salivary and lacrimal glandsC. Salivary and lacrimal glands D. D. Skeletal muscleSkeletal muscle E. Vascular smooth muscleE. Vascular smooth muscle
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Pharmacokinetics includes all of the following processes EXEPT:
A. Absorption B. Distribution C. Biotransformation D. Elimination E. Clinical use
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The breadth of therapeutic action is a The breadth of therapeutic action is a range of dosesrange of doses::
AA. . From average therapeutic dose to From average therapeutic dose to minimum toxic doseminimum toxic dose
BB. . From single dose to course doseFrom single dose to course dose CC. . From minimum effective (threshold) From minimum effective (threshold)
dose to minimum toxic dosedose to minimum toxic dose DD. . From single dose to daily doseFrom single dose to daily dose EE. . From minimum effective dose to From minimum effective dose to
average toxic doseaverage toxic dose
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The formation of a secondary mediator is The formation of a secondary mediator is obligatory in membrane-intracellular obligatory in membrane-intracellular mechanism of hormone action. Point out the mechanism of hormone action. Point out the substance that is unable to be a secondary substance that is unable to be a secondary mediatormediator::
A. A. Glycerol Glycerol B. DiacylglycerolB. Diacylglycerol C. cAMPC. cAMP D. CaD. Ca2+2+
E. Inositol-1,.4,5-triphosphateE. Inositol-1,.4,5-triphosphate
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If the drug substance or toxin If the drug substance or toxin inhibits inhibits synthesis of ATPsynthesis of ATP, what mechanism of , what mechanism of penetration through the cell membrane is penetration through the cell membrane is blocked?blocked?
A. PinocytosisA. Pinocytosis B. Passive diffusion B. Passive diffusion C. Filtration C. Filtration D. D. Active transportActive transport E. Simplified diffusionE. Simplified diffusion
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How pharmacological activity of a drug How pharmacological activity of a drug with high affinity to plasma protein with high affinity to plasma protein will be altered at will be altered at hypoalbuminemiahypoalbuminemia? ?
AA. . Will greatly decreaseWill greatly decrease B. Will slightly decreaseB. Will slightly decrease C. C. Will increaseWill increase D. Will not changeD. Will not change E. Will disappearE. Will disappear
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How to explain the reduction of effects of How to explain the reduction of effects of euphyllinum in the interaction with euphyllinum in the interaction with Phenobarbital Phenobarbital ??
AA. . Inhibition of enzymes of the liverInhibition of enzymes of the liver BB. . Antagonist effectAntagonist effect CC. . TachyphylaxisTachyphylaxis DD. . IdiosyncrasyIdiosyncrasy EE. . Activation of enzymes of the liverActivation of enzymes of the liver
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A patient with increased sensitivity to A patient with increased sensitivity to sulfonamides sulfonamides needs tooth extraction. needs tooth extraction. What What local anestheticlocal anesthetic has to be used? has to be used?
A. CocaineA. Cocaine B. Dicaine (tetracaine)B. Dicaine (tetracaine) C. Anesthesine (benzocaine)C. Anesthesine (benzocaine) D. D. LidocaineLidocaine E. Novocaine (procaine)E. Novocaine (procaine)
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Which of the following drugs Which of the following drugs incorrectlyincorrectly matches a matches a cholinergic agonistcholinergic agonist with a with a pharmacologic actionpharmacologic action??
A. Physostigmine: stimulates atonic bladderA. Physostigmine: stimulates atonic bladder B. Carbachol: induces release of epinephrine B. Carbachol: induces release of epinephrine
from the adrenal medullafrom the adrenal medulla C. Acetylcholine: decreases heart rate and C. Acetylcholine: decreases heart rate and
cardiac outputcardiac output D. Pilocarpine: reduces intraocular pressureD. Pilocarpine: reduces intraocular pressure E. E. Proserine (Neostigmine): decreases Proserine (Neostigmine): decreases
intestinal motilityintestinal motility
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A 43 y.o. patient has been administered A 43 y.o. patient has been administered pentaminepentamine for hypertensive crisis. for hypertensive crisis.
What is the action mechanism of the What is the action mechanism of the drug?drug?
A. Stimulation of M-cholinoceptorsA. Stimulation of M-cholinoceptors B. Inhibition of M-cholinoceptorsB. Inhibition of M-cholinoceptors C. Inhibition of M-,N-cholinoceptorsC. Inhibition of M-,N-cholinoceptors D. Stimulation of N-cholinoceptorsD. Stimulation of N-cholinoceptors E. E. Inhibition of N-cholinoceptorsInhibition of N-cholinoceptors
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At complex narcosis (general anesthesia) At complex narcosis (general anesthesia) protocol during stomach resection, a patient protocol during stomach resection, a patient has got has got
an injection of an injection of tubocurarine chloridetubocurarine chloride as as a a myorelaxant (neuromuscular blocker).myorelaxant (neuromuscular blocker). What What agent–antagonistagent–antagonist should be administered should be administered
to the patient for restoration of his self-to the patient for restoration of his self-driven respiration?driven respiration?
A. EtimizolA. Etimizol B. Dithyline (Succinylcholine)B. Dithyline (Succinylcholine) C. AtropineC. Atropine D. D. Proserine (Neostigmine)Proserine (Neostigmine) E. BenzohexoniumE. Benzohexonium
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During surgical operation a patient has During surgical operation a patient has developed symptoms of developed symptoms of dithylin dithylin (succinylcholine)(succinylcholine) overdosage. overdosage.
What treatment is necessary to provide to What treatment is necessary to provide to
the patient?the patient? A. A. Blood transfusion Blood transfusion B. B. NorepinephrineNorepinephrine CC. . Proserine (Neostigmine)Proserine (Neostigmine) D. GalantamineD. Galantamine E. Atropine sulfateE. Atropine sulfate
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A patient had to go through an operation. A patient had to go through an operation. Doctors introduced himDoctors introduced him dithylinum dithylinum (listenone)(listenone) and performed intubation. and performed intubation.
After the end of operation and cessation of After the end of operation and cessation of anesthesia the independent respiration anesthesia the independent respiration wasn’t restored. Which enzyme deficit wasn’t restored. Which enzyme deficit prolongs the action of muscle relaxant?prolongs the action of muscle relaxant?
A. Succinate dehydrigenaseA. Succinate dehydrigenase B. K-Na-adenosine triphosphataseB. K-Na-adenosine triphosphatase C. CarbanhydraseC. Carbanhydrase D. D. Pseudocholinesterase Pseudocholinesterase E. N-acetyltransferaseE. N-acetyltransferase
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ANTIDOTESANTIDOTESMorphineMorphine - - NaloxoneNaloxoneNitroglycerine -Nitroglycerine -Methylene blue Methylene blue Paracetamole (Acetaminophen) - Paracetamole (Acetaminophen) -
Symptoms of Symptoms of cardiac glycosides toxicitycardiac glycosides toxicity have been developed in a patient with have been developed in a patient with chronic congestive heart failure. What chronic congestive heart failure. What agent should be administered to agent should be administered to decrease adverse effects of cardiac decrease adverse effects of cardiac glycosides?glycosides?
A. NovocainamidA. Novocainamid B. DipiroximB. Dipiroxim C. EthimisolC. Ethimisol D. Atropine sulfateD. Atropine sulfate E. E. Potassium chloridePotassium chloride
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Which of the following drugs is Which of the following drugs is appropriate and generally regarded appropriate and generally regarded as most effective for as most effective for relieving and relieving and preventing ischemic episodespreventing ischemic episodes in in patients with patients with variant anginavariant angina??
A. A. Nifedipine Nifedipine B. LovastatineB. Lovastatine C. PropranololC. Propranolol D. TramadolD. Tramadol E. E. NitroglycerinNitroglycerin
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Which of the following drugs can Which of the following drugs can relieve relieve angina pectorisangina pectoris by decreasing by decreasing myocardial work, but may precipitate myocardial work, but may precipitate congestive heart failure? congestive heart failure?
A. A. Phentolamine Phentolamine B. SthrophanthineB. SthrophanthineC. C. MetoprololMetoprololD. AtropineD. AtropineE. EnalaprilE. Enalapril
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The advantages of The advantages of metoprolol metoprolol over over propranolol propranolol include all of the following include all of the following exceptexcept::
A. Less likely to provoke bronchoconstrictionA. Less likely to provoke bronchoconstriction B. B. More likely to be effective More likely to be effective
in sinus tachycardiain sinus tachycardia C. More likely to be effective in sinus C. More likely to be effective in sinus
bradycardiabradycardia D. Less likely to produce temporary rise in D. Less likely to produce temporary rise in
peripheral resistance at the start of therapyperipheral resistance at the start of therapy E. Less likely to produce sudden rises in BP E. Less likely to produce sudden rises in BP
after physical exertionafter physical exertion
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A 27 y.o. male with angina pectoris was A 27 y.o. male with angina pectoris was admitted to a cardiologic department. admitted to a cardiologic department.
A A phosphodiesterase inhibitorphosphodiesterase inhibitor was included was included toto
the complex therapy of the patient. the complex therapy of the patient. Concentration of what substance will Concentration of what substance will
increase in the cardiac muscle?increase in the cardiac muscle?A. DiacilglycerolA. DiacilglycerolBB. . ATPATPCC. . Cyclic-AMPCyclic-AMP DD.. GMP GMPEE.. AMP AMP
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In a patient with hypertension at regular In a patient with hypertension at regular use of an use of an antihypertensive agentantihypertensive agent, ,
coughcough has appeared. has appeared.
What agent can cause the given adverse What agent can cause the given adverse effect?effect?
A. PrazosinA. Prazosin B. Verapamil B. Verapamil C. Clophelinum (Clonidinum) C. Clophelinum (Clonidinum) D. DichlothiasidumD. Dichlothiasidum E. E. EnalaprilEnalapril
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A A dentist prescribed an agent stimulating dentist prescribed an agent stimulating salivation to a patient with salivation to a patient with xerostomiaxerostomia. . Indicate the drug:Indicate the drug:
A. A. PilocarpinePilocarpine B. Dithylinum (suxamethonium)B. Dithylinum (suxamethonium) C. ArmineC. Armine D. ScopolamineD. Scopolamine E. AtropineE. Atropine
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A 45 y. o. patient has been prescribed A 45 y. o. patient has been prescribed DigoxinDigoxin to treat chronic heart failure. to treat chronic heart failure.
What is the What is the mechanism of action of mechanism of action of DigitoxinDigitoxin?? A. Stimulates production of cAMPA. Stimulates production of cAMP B. Decreases intracellular Na+ concentrationB. Decreases intracellular Na+ concentration C. Increases the intracellular level of ATPC. Increases the intracellular level of ATP D. D. Inhibition of Na+/K+ ATPaseInhibition of Na+/K+ ATPase E. Decreases release of Ca2+ from the E. Decreases release of Ca2+ from the
sarcoplasmic reticulumsarcoplasmic reticulum
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A patient with a cardiac arrhythmia is being A patient with a cardiac arrhythmia is being treated for a long time with treated for a long time with AmiodaroneAmiodarone. . This drug can cause biochemical changes This drug can cause biochemical changes and clinical signs and symptoms that and clinical signs and symptoms that resemble those associate with which of the resemble those associate with which of the following diseasefollowing disease??
A. A. Hypothyroidism Hypothyroidism B. Addisonian crisisB. Addisonian crisis C. Parkinsonian syndromC. Parkinsonian syndrom D. Stealing syndromeD. Stealing syndrome E. Cushing’s syndromeE. Cushing’s syndrome
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Indicate the mechanism of antiarrhythmical Indicate the mechanism of antiarrhythmical action of action of Amiodaronum Amiodaronum ((CordaronumCordaronum):):
AA. . Blockade of alfa–adrenoceptors of Blockade of alfa–adrenoceptors of the myocardiumthe myocardium
BB.. Blockade of Ca Blockade of Ca2+2+ channels of channels of the cardiomyocyte membranes the cardiomyocyte membranes
CC. . Blockade of beta–adrenoceptors of Blockade of beta–adrenoceptors of the myocardiumthe myocardium
DD. . Blockade of Blockade of KK++ channels channels of of the cardiomyocyte membranesthe cardiomyocyte membranes
EE. . Blockade of NaBlockade of Na++ channels of the channels of the cardiomyocyte membranescardiomyocyte membranes
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The half life of The half life of digoxindigoxin is is::
A. 5 days A. 5 days
B. 24 hoursB. 24 hours
C. C. 36 hours36 hours
D. 12 hoursD. 12 hours
E. 8 hoursE. 8 hours
[[DigitoxinDigitoxin - 5 days - 5 days
StrophanthineStrophanthine – 8 hours] – 8 hours]
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A 24 y.o. patient complains of unpleasant A 24 y.o. patient complains of unpleasant sensations in the heart region, and attacks sensations in the heart region, and attacks of weakness and loss of consciousness.of weakness and loss of consciousness.
Inspection of the patient’s ECG had revealed Inspection of the patient’s ECG had revealed the presence of II degree AV block. the presence of II degree AV block.
Specify a drug, which should be used in the Specify a drug, which should be used in the situation:situation:
Digitoxin Digitoxin (1 tab tid) had been prescribed to a (1 tab tid) had been prescribed to a patient with chronic (congestive) heart patient with chronic (congestive) heart failure.failure.
In 15 days, the signs of intoxication developed In 15 days, the signs of intoxication developed in the patient – bradyarrhythmia, distrurbance in the patient – bradyarrhythmia, distrurbance of AV conduction, upset of colour vision.of AV conduction, upset of colour vision.
What could cause the specified phenomena?What could cause the specified phenomena?
AA. . ToleranceToleranceB. Functional cumulationB. Functional cumulationCC. . PotentiationPotentiationDD. . Material cumulation Material cumulation EE. . SummationSummation
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In homozygous mice with defect of the In homozygous mice with defect of the gene-coding frame of a gene-coding frame of a beta1—beta1—adrenoreceptorsadrenoreceptors, it has been probed , it has been probed action of an agent on inotropic action of an agent on inotropic function of heart. What agent will function of heart. What agent will lose the activity in these conditions?lose the activity in these conditions?
AA. . DigoxinDigoxin
BB. . AmrinoneAmrinone
CC. . StrophanthinStrophanthin
DD. . PropranololPropranolol
E. E. DopamineDopamine
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A patient has been administered A patient has been administered LevodopaLevodopa in complex therapy of in complex therapy of Parkinson diseaseParkinson disease..
What changes does this drug produce What changes does this drug produce
in the CNSin the CNS??A. Blocks central cholinoreceptorsA. Blocks central cholinoreceptors B. Decreases dopamine mediationB. Decreases dopamine mediationC. Stimulates dopamine receptorsC. Stimulates dopamine receptorsD. Blocks dopamine receptorsD. Blocks dopamine receptorsE. E. Enhances dopamine mediationEnhances dopamine mediation
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A patient suffers from severe A patient suffers from severe postoperativepostoperative pseudomonadespseudomonades infection. What of the following infection. What of the following antibiotics in this case? antibiotics in this case?
A. DoxycyclineA. DoxycyclineB. Benzylpenicillin B. Benzylpenicillin C. ErythromycinC. ErythromycinD. CephazolinD. CephazolinE. E. Amicacin sulfateAmicacin sulfate
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A patient requires an antibiotic that is A patient requires an antibiotic that is the most effective against the most effective against Pseudomonas aeruginosaPseudomonas aeruginosa..
Which drug is the quinolone of choiceWhich drug is the quinolone of choice??A. A. Ciprofloxacin Ciprofloxacin B. OfloxacinB. OfloxacinC. LomefloxacinC. LomefloxacinD. NorfloxacinD. NorfloxacinE. EnoxacinE. Enoxacin
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A young boy presents the infestation A young boy presents the infestation with with Taenia saginataTaenia saginata (tapeworm). (tapeworm).
Which drug is the most appropriate to Which drug is the most appropriate to administeradminister??A. MebendazoleA. MebendazoleB. B. PraziquantelPraziquantelC. ChloroquineC. ChloroquineD. TetracyclineD. TetracyclineE. PenicillinE. Penicillin
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A 15 y.o. boy was admitted to the A 15 y.o. boy was admitted to the hospital with polytrauma in hospital with polytrauma in unconscious state, unconscious state, BP 95/70 mm Hg, BP 95/70 mm Hg, HR 72/min, HR 72/min, RR 30/min, Superficial breathing RR 30/min, Superficial breathing
Choose the drug for general anaesthesia:Choose the drug for general anaesthesia:A. Phthorotanum (halothane)A. Phthorotanum (halothane)B. Hexenalum (hexobarbital)B. Hexenalum (hexobarbital)C. PropanididC. PropanididD. Thiopental natriumD. Thiopental natriumE. E. KetamineKetamine
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A A water-solublewater-soluble cardiac glycoside has cardiac glycoside has been prescribed to a patient.been prescribed to a patient.
What concomitant pathology can What concomitant pathology can promote a cumulation of water-soluble promote a cumulation of water-soluble cardiac glycosides?cardiac glycosides?
AA. . Liver failureLiver failure
BB. . Renal failureRenal failure
CC. . Hyperacide gastritisHyperacide gastritis
DD. . Hypoacidic gastritisHypoacidic gastritis
EE. . HypothyroidusmHypothyroidusm
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A patient with a A patient with a severe arthritissevere arthritis will be will be placed on long-term therapy with placed on long-term therapy with IndomethacinIndomethacin. .
Which of the following drugs is the Which of the following drugs is the most appropriate choice to administer most appropriate choice to administer as an as an add-on (adjunctadd-on (adjunct) to prevent ) to prevent gastric ulcers caused by this NSAIDgastric ulcers caused by this NSAID??
A liquidator of a breakdown at a nuclear A liquidator of a breakdown at a nuclear power plant who was irradiated power plant who was irradiated complained about vomiting that occurs all complained about vomiting that occurs all of a sudden. of a sudden.
What medication should be prescribedWhat medication should be prescribed??
A. Aeron A. Aeron
B. ContricalB. Contrical
C. OmeprazoleC. Omeprazole
D. AtropineD. Atropine
E. E. MetoclopramidMetoclopramid
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Which one of the following actions can Which one of the following actions can hydrochlorothiazide hydrochlorothiazide produce?produce?
A. HyperkalemiaA. Hyperkalemia
B. HypocalciemiaB. Hypocalciemia
C.C. Hyperuricemia Hyperuricemia
D. Hypoglycemia in diabetic D. Hypoglycemia in diabetic patientspatients
E. Hypolipidemia E. Hypolipidemia
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Which drug is primarily used in Which drug is primarily used in
AmebiasisAmebiasis and and LeishmaniasisLeishmaniasis as as well as well as Anaerobic Bacterial Anaerobic Bacterial infectionsinfections??
A doctor administered A doctor administered AllopurinolAllopurinol to a 37 to a 37 y.o. man with the symptoms of y.o. man with the symptoms of goutgout. .
What pharmacological action of What pharmacological action of AllopurinolAllopurinol ensures therapeutical effectensures therapeutical effect??
A. By inhibiting leukocyte migration into A. By inhibiting leukocyte migration into jointjoint
B. B. By inhibiting By inhibiting uric aciduric acid synthesis synthesis
C. By increasing uric acid excretionC. By increasing uric acid excretion
D. By inhibiting D. By inhibiting uric acid uric acid biotransformationbiotransformation
E. By general anti-inflammatory effectE. By general anti-inflammatory effect
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There is a pregnant woman in a delivery There is a pregnant woman in a delivery room that on term of gestation should room that on term of gestation should already have labors. The uterus cervix is already have labors. The uterus cervix is not opened at inspection. not opened at inspection.
Indicate an agent for acceleration of uterus Indicate an agent for acceleration of uterus cervix ripening and for stimulation of cervix ripening and for stimulation of parturition activityparturition activity::
A. A. Prostin E2 (Dinoprostone)Prostin E2 (Dinoprostone)
