Therapeuticmcq200

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20142015
THERAPEUTICS
Multiple Choice Questions
VOLUME 1
The Essential Choice For Pharmacy Exams

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Therapeutics
Multiple-choice questions
Multiple choice questions is the basis of most of the entrance exams in all fields of study and by
looking at the performance the evaluator can understand the level of knowledge of the students in
that particular subject or category. This form of evaluation is widely accepted in most of the study
field’s .multiple choice questions are generally prepared by qualified specialist after intense prepara-
tion. Making the question is as hard as answering .mostly the questions are not based on single text-
book or reference. The person who makes the questions does intense research before come up with
the questions. The question making is based on multiple reference and the author should specify the
reference to the students so that they can go through the relevant textbook
Type of questions
There are different kinds of multiple choice questions some are simple and others are complex. Sim-
ple multiple choice question has got not more than five options with single correct answer where
as in the complex form there would be multiple answers so knowing one answer is not enough to
answer the questions. In complex form of MCQS the student needs to know wrong answer also in
order to get it correctly
Example of simple MCQ
1)Diuretics adverse effects include the following except
A) hyponatraemia – sometimes severe, especially in the elderly;
B) hyperuricaemia – most diuretics reduce urate clearance
C) hyperglycaemia – thiazides reduce glucosetolerance:at high doses
D) hypercalcaemia – thiazides reduce urinary calcium ion clearance
E) hypercholesterolaemia – high-dose thiazides
Example of complex multiple choice question
2) Which of the following is correct about anti-inflammatory action of NSAIDS
I seen with short treatment duration
II response is seen with higher doses
III usually requires several days of therapy
A) I only
B) II only
C) I and II
D) II and III
E) I, II and III
How to answer the questions
Answering the questions are sometimes very tricky and students need extreme knowledge and some
logical thinking about the answer.one of oldest method is to eliminate the possible wrong answer
and narrowing the options. While studying or answering students need to aware the importance of
current working practice guideline in order to make a judgement.
Preparation
Try to gather as many examples as you can of old papers and previous examples of Mcqs used by
the department or school in question in the past. Do not, however, try to memorise hundreds of
responses to questions which does not work in the mcqs where logical thinking is essential. The
factual Knowledge you will gain will be superficial and dissociated. It is better to look for the Topic
areas that recur frequently and ensure that you have a deeper knowledge of these Topics.
Revise with friends and colleagues so that they may come up with different technique and topics
that you may missed to study. You can share knowledge and techniques. Familiarise yourself with
the optical reader cards that you will be using to record your Answers in the exam. Examples should
be available from the examinations office or you can get from the official website .You should know
what type of mcq is being set for you. Will there be negative Marking? How much time will you

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have and how many questions will there be?On the dayCheck that your understanding of the mcq
format is correct. It is negative marking, There are 300 questions, and i have two hours to complete
this. Always read the stem for Each question carefully. Have you understood the question? Are there
any ambiguities? If So ask an invigilator who will alert an examiner. There are usually one or two in
the Room. Allocate three quarters of the time to answering the questions and a period at the End to
checking answers and accuracy
.

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Therapeutics
1)Diuretics adverse effects include the following except
A) hyponatraemia – sometimes severe, especially in the elderly;
B) hyperuricaemia – most diuretics reduce urate clearance
C) hyperglycaemia – thiazides reduce glucosetolerance:at high doses
D) hypercalcaemia – thiazides reduce urinary calcium ion clearance
E) hypercholesterolaemia – high-dose thiazides
F) hypocalcaemia- at high dose
2)Bulk- forming laxatives characteristics include the following except
A) natural bulk-forming laxatives is psyllium and malt soup extract
B) synthetic bulk-forming laxatives are methylcellulose and polycarbophil
C) should not be used in obstructing bowel lesion intestinal strictures, or crohn's disease
D) not to use for more than 1 week to treat constipation;
E) used on a long- term basis for prevent ion.
F) use short term for acute constipation
3 )Ace inhibitors adverse effects include the following except
A) first-dose hypotension.
B) dry cough –due to kinin accumulation stimulating cough afferents
C) hyperkalaemia in patients with hepatic impairment
D) fetal injury – acei cause renal agenesis/failure in the fetus, resulting in oligohydramnios
E) urticaria and angio-oedema –due to increased kinin concentration
F) functional renal failure in patients with renal artery stenosis
4)Angiotensin receptor stimulation causes following except
A) vasoconstriction
B) cell growth
C) sodium and fluid retention
D) sympathetic activation
E) vasodilation
5-Cardiac glycosides( digitalis ) characteristics includes following except
A) digitalis blood level of 0.8 To 1.2 Ng/dl is required for action
B) increasing contractility(positive inotropy) while decreasing heart rate (negative chronotropy)
C) fat-soluble steroid that crosses the blood-brain barrier and enhances vagaltone.
D) works directly on the heart through an actionon the sodium–potassium (na –k ) atpase
E) decreases contractility and enhances vagaltone
6-Schizophrenia pathophysiology includes following except
A) positive symptoms associated with da receptor hyperactivity
B) positive symptoms and cognitive symptomsmay be most closely related to da receptor hypofunc-
tion in the prefrontal cortex
C) deficiency of glutamatergic activity produces symptoms similar to those of dopaminergic hyper-
activity
D) higher whole blood 5-ht concentrations in schizophrenia
E) negative symptoms and cognitive symptomsmay be most closely related to da receptor hypofunc-
tion in the prefrontal cortex
7-Anti hypertensive drugs includes following except
A) angiotensin-converting enzyme inhibitors (acei) and
B) angiotensin at1 receptor antagonists (sartans
C) beta-adrenoceptor antagonists;
D) calcium channel antagonists;
E) potassium channel blocker
F) diuretics.

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8-Fibric acids(fibrates) characteristics include the following except
A) gemfibrozil, fenofibrate, clofibrate are fibrates
B) gemfibrozil reduces the synthesis of vldl and hdl
C) gemfibrozil increases the rate of removal of triglyceride-rich lipoproteins from plasma.
D) gi complaints, rash , dizziness, and transient elevations in transaminase levels and alkaline phos-
phatase are the side effects
E) clofibrate and, less commonly, gemfibrozil may enhance the formation of gallstones
F) fibrates may potentiate the effects of oral anticoagulants,
9- Classification of antiarrhythmic drugs includes following except
A) ia (quinidine,procainamide ,disopyramide)
B) ib (lidocaine ,mexiletine,lignocaine)
C) ic (flecainide,propafenone ,moricizine)
D) ii (β-blockers)
E) iii( amiodarone,dofetilide,sotalol,ibutilide)
F) iv (verapamil,diltiazem)
10- Ezetimibe characteristics includes following except
A) ezetimibe interferes with the absorption of cholesterol from the intestine,
B approved as both monotherapy and for use with a statin.
C) it reduces the free ldl by increasing the metabolism
D) should be reserved for patients unable to tolerate statin therapy or those who do not achieve
satisfactory lipid lowering with a statin alone.
E) when used alone, it results in an approximate 18% reduction in ldl cholesterol.
11- Atrial fibrillation treatment facts include the following except
A in haemodynamically stable patients, a rhythm-control treatment strategy is preferred for patients
with paroxysmal atrial fibrillation
B rate-control is not preferred for those with permanent atrial fibrillation.
C digoxin is usually only effective for controlling the ventricular rate at rest
D ventricular rate can be controlled with a beta-blocker or diltiazem or verapamil
E digoxin only be used as monotherapy in predominantly sedentary patients
12 -Schizophrenia symptoms include following except
A positive symptoms include hallucinations,behavior disturbance (disorganized or catatonic), and
illusions.
B negative symptoms include alogia (poverty of speech), avolition, affective flattening, anhedonia,
ataxia and social isolation.
C cognitive dysfunction includes impaired attention, working memory, and executive function.
D positive symptoms include delusions, disorganized speech (association disturbance),
13- Supraventricular arrhythmias statements include the following except
A) af is characterized as an extremely rapid (400 to 600 atrial beats/min and disorganized atrial
activation
B) atrial flutter is characterized by rapid (270 to 330 atrial beats/min) but regular atrial activation.
C) supraventricular arrhythmias arising from the sinus node include sinus tachycardia and sinus
bradycardia
D)sinus tachycardia the rate is 100–150 beats per minute with abnormal p-waves and pr interval
E)sinus bradycardia- rate is less than 60 beats per minute
With normal complexes
14- Calcium-channel blockers adverse effects include the following except
A nifedipine causes flushing and headache.
B negative inotropic effect of verapamil exacerbates cardiac failure
C constipation is common with verapamil.

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Therapeutics
D nifedipine -baroreflex activation causes tachycardia, which can worsen angina
E flushing and headache are not related to the peak plasma concentration. Slow-release preparations
are used combact this problem
15) Diabetes mellitus characteristics include following except
A diagnosed by measuring fasting or random blood-glucose concentration and occasionally by oral
glucose tolerance test
B type 1 diabetes- deficiency of insulin following autoimmune destruction of pancreatic betA)cells.
C type 1 diabetes require administration of insulin.
D type 2 diabetes, is due to reduced secretion of insulin or to peripheral resistance to the action of
insulin or to a combination of both
E patients may be controlled on diet alone, only require oral antidiabetic drugs in type 2 dm
16) Facts about alpha-adrenoceptor antagonists include the following except
A alpha blockers include phenoxybenzamine,doxazosin and prazosin
B prazosin is a selective α1-blocker,short elimination half-life.
C prazosin is limited by severe postural hypotension
D doxazosin is longer lasting, permitting twice daily use
E doxazosin i is useful in men with mild symptoms from benign prostatic hypertrophy.
17) Facts about insulin include the following except
A regulates carbohydrate,fat, and protein metabolism.
B insulin is not inactivated by gastro-intestinal enzymes, and therefore need not be given by injec-
tion;
C subcutaneous insulin injections cause lipodystrophy but can be minimised by using different injec-
tion sites in rotation
D insulin is usually injected into the upper arms, thighs, buttocks, or abdomen
E insulin requirements may be increased by infection, stress, accidental or surgical trauma, and dur-
ing puberty
Question no:16 answer
18) Intermediate- and long-acting insulins characteristics include the following except
A soluble insulin can be mixed with intermediate and long-acting insulins (except insulin detemir
and insulin glargine)
B given once daily, particularly in elderly patients.
C isophane insulin is a suspension of insulin with protamine
D protamine zinc insulin is usually given once daily with short-acting (soluble) insulin.
E insulin glargine and insulin detemir are both longacting human insulin analogues
F insulin glargine is given once daily and insulin detemir is given twice daily
Question :no: 17 ,answer :b
19) Facts about hypertension include the following except
A hypertension is risk factors for ischaemic heart disease, stroke, renal failure and heart failure
B arterial blood pressure is determined by cardiac output, peripheral vascular resistance
C diastolic hypertension is common in the elderly.
D renal disease (vascular,parenchymal or obstructive) is a cause of arterial hypertension
E severe hypertension causes glomerular sclerosis,
Manifested clinically by proteinuria and reduced glomerular filtration,
Question no:18 - answer :f
20) Angiotensin-converting enzyme inhibitors characteristics include the following except
A) renal protective benefits in diabetic and/or hypertensive patients
B) block the breakdown of bradykinin
C) elaboration of more kinins and less angiotensin ii
D) induce a cough as a result of the decrease in kinins.
Question no:19 answer :c

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21) Antithyroid drugs characteristics include the following except
A) used for hyperthyroidism either to prepare patients for thyroidectomy or for long-term manage-
ment.
B) carbimazole is the most commonly used drug in hypothyroidism
C) act primarily by interfering with the synthesis of thyroid hormones
D) propylthiouracil should be reservedfor patients who are intolerant of carbimazole or for those
who suffer sensitivityreactions to carbimazole
22) Angiotensin receptor blocker charateristics include the following except
A) fetal renal toxicity is a sideeffect
B) half-lives of most arb are long enough to permit once daily dosing.
C) action mediated by the angiotensin ii subtype 1 (at1) receptor.
D) losartan has an inactive metabolite.
Question no:21 answer:b
23) Facts about β-adrenergic blockers include the following except
A) a β-blocker should be administered early in the care of patients with ste acs (within the first 24
hours) and continued indefinitely.
B) reduces heart rate, myocardial contractility, and bp, thereby decreasing myocardial oxygen
demand.
C) the reduced heart rate by beta blocker increases diastolic time thus improving ventricular filling
and coronary artery perfusion.
D) β-blockers is appropriate for patients presenting with decompensated heart failure
E) a short-acting drug such as metoprolol or esmolol should be administered iv initially in ste acs(st-
segmentelevation acute coronary syndrome)
24) Antipsychotic drugs characteristics include the following except
A) act by interfering with dopaminergic transmission in the brain by blocking dopamine d2 receptors
B) patients should receive antipsychotic drugs for 4–6 weeks before the drug is deemed ineffective
C) antipsychotic drugs should also be used with caution in parkinson’s disease , epilepsy ,depression,
myasthenia
Gravis, prostatic hypertrophy,
D) antipsychotic drugs may be contra-
Indicated in comatose states,heart failure, cns depression, and
Phaeochromocytoma.
E) in elderly patients with dementia,
Antipsychotic drugs are associated with an increased risk of
Stroke or transient ischaemic attack
Question: 23 answer d
25) Insulin detemiror insulin glargine may be considered for those except
A) who require assistance with injecting insulin
B) whose lifestyle is significantly restricted by recurrent symptomatic hyperglycaemia
C) who would otherwise need twice-daily basal insulin
Injections in combination with oral antidiabetic drugs
D) who cannot use the device needed to inject isophane insulin
26) Neuroleptic malignant syndrome charateristics include the following except
A) neuroleptic malignant syndrome symptoms (hyperthermia, fluctuating level of consciousness,
muscle rigidity, and autonomic dysfunction with pallor, tachycardia, labile blood pressure, sweating,
and urinary incontinence)
B) discontinuation of the antipsychotic is essential in neuroleptic malignant syndrome because there

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Therapeutics
is no proven effective treatment
C) cooling, bromocriptine, and dantrolene have been used in neuroleptic malignant syndrome
D) the syndrome, which usually lasts for 5–7 days after drug discontinuation, may be unduly pro-
longed if depot preparations have been used.
E) treated with anti muscarinic agents
Question no:25 answer :b
27) Charateristics of diurectics include the following except
A) loop diuretics block the na –k –2cl symporterin the ascending limb of the loop of henle
B) loop diuretics increase in urinary excretion of h and k can lead to arrhythmias
C) spironolactone inhibits the binding of aldosterone to cytosolic mineralocorticoid receptors in the
epithelial cells in the late distal tubule and collecting collecting duct of the kidney.
D) potential side effect of spironolactone is hyperkalemia
E) spironolactone blocking sodium and water excretion while retaining potassium
Question no:26 answer :e
28) Facts about antipsychotic treatments include the following except
A) clozapine is used for schizophrenia when other antipsychotics are ineffective or not tolerated
B) prescribing of more than one antipsychotic drug at the
Same time is recommended
C) chlorpromazine has a marked sedating effect and is useful for treating violent patients without
causing stupor
D) agitated states in the elderly can be controlled with a dose of 10 to 25 mg once or twice daily of
chlorpromazine
E) flupentixol and pimozide are less sedating than chlorpromazine.
F) sulpiride in high doses controls florid positive symptoms,
But in lower doses it can have an alerting effect on
Apathetic withdrawn schizophrenics.
Question no: (27) answer :e
29) Carbimazole facts include the following except
A) carbimazole is given in a dose of 150 to 400 mg daily;
B) dose is continued until the patient becomes euthyroid, usually after 4 to 8 weeks and the dose is
then gradually reduced to a maintenance dose of 5 to 15 mg.
C) therapy is usually given for 12 to 18 months
D) children may be given carbimazole in an initial dose of 250 micrograms/kgthree times daily
E) rashes and pruritus are common but they can be treated with antihistamines without discontinuing
therapy
F) all patients should be advised to report any sore throat immediately because of the rare complica-
tion of agranulocytosis
Question no(28) answer :b
30) Facts about bipolar disorder treatment include the following except
A) long-term treatment of bipolar disorder should
Continue for at least two years from the last manic
Episode and up to five years if the patient has risk
Factors for relapse
B) an antidepressant drug may also be required for the treatment of co-existing depression
C) benzodiazepines (such as lorazepam) may be helpful in the later stages of treatment for behav-
ioural disturbance or agitation;
D) benzodiazepines should not be used for long periods because of the risk of dependence
Question no(29) answer :a
31) Thyrotoxic crisis (‘thyroid storm’) treatments include the following except
A) emergency treatment with intravenous administration of fluids
B) propranolol (5 mg)

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C) hydrocortisone (10 mg every 6 hours, as sodium succinate),
D) oral iodine solution and carbimazole or propylthiouracil which may need to be administered by
nasogastric tube.
Question no(30) answer :c
32) Camp-elevating agents characteristics include the following except
A) intracellular camp levels resuilt in an decrease in contractility.
B) camp-elevating agents include -adrenergic agonists (e.G., Dobutamine) or the phosphodiesterase
inhibitors milrinone (corotrope) and amrinone(inocor)
C) used in acutely ill patients in the intensivecare unit
D) milrinone or amrinone increases camp levels by preventing its degradation by cardiac myocyte
phosphodiesterases
E) long-term continuous use has been associated with an increase in mortalityin chf.
33) Angiotensin receptor blockers characteristics include the following except
A) angiotensin receptor blockers includes losartan, candesartan, irbesartan, valsartan).
B) long-acting drugs (e.G. Candesartan)produce good 24-hour control
C) arb has the adverse effect of dry cough
D) an acei or a sartan is preferred over other anti-hypertensive drugs in diabetic patients
34) Glycoprotein iib/iiia receptor inhibitors charateristics include the following except
A) abciximab,eptifibatide and tirofiban are glycoprotein iib/iiia receptor inhibitors
B) used for patients undergoing primary pci who have received fibrinolytics.
C) should not be administered to ste acs patients who will not be undergoing pci.
D) may increase the risk of bleeding, especially if given in the setting of recent (<4 hours) adminis-
tration of fibrinolytic therapy
E) abciximab, in combination with aspirin, a thienopyridine, and ufh (administered as an infusion
for the duration of the procedure), reduces mortality and reinfarction without increasing the risk of
major bleeding
35) Antidepressant drugs treatment facts include the following except
A) antidepressant drugs should not be used routinely in mild depression, and psychological therapy
should be considered initially
B) drug treatment of mild depression may also be considered in patients with a history of moderate
or severe depression
C) since there may be an interval of 2 weeks before the antidepressant action takes place, electrocon-
vulsive treatment may be required in severe depression when delay is hazardous or intolerable
D) during the first few weeks of treatment, there is an
Increased potential for agitation, anxiety, and suicidal
Ideation
E) ssris are better tolerated and are safer in overdose than
Other classes of antidepressants and should be considered
First-line for treating depression
F) in patients with unstable angina or who have had a recent myocardial infarction, sertraline has
been shown to be unsafe
Question no(34) answer :b
36) Bipolar disorder treatments facts include the following except
A) antipsychotic drugs (normally olanzapine, quetiapine,
Or risperidone) are useful in acute episodes of mania and hypomania
B) if the response to antipsychotic drugs is inadequate, lithium or valproate may be added.
C) an antipsychotic drug may be used concomitantly

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Therapeutics
With lithium or valproate in the initial treatment
Of severe acute mania
D) olanzapine can be used for the long-term management
Of bipolar disorder either as monotherapy, or in combination with lithium or valproate if the patient
has frequent relapses or continuing functional impairment.
E) high doses of haloperidol or flupentixol may be hazardous
When used with lithium; reversible toxic encephalopathy has been reported
Question no(35) answer :f
37) Drugs used in the management of asthma include the following except
A) beta1 agonists
B) antimuscarinic bronchodilators
C) theophylline,
D) corticosteroids
E) cromoglicate and nedocromil
F) leukotriene receptor antagonists
And, in specialist centres, omalizumab
Question no(36) answer :e
38) Bulk- forming laxatives characteristics include the following except.
A) bulk- forming laxatives are natural or synthetic polysaccharide derivatives
B) adsorb water to soften the stool and increase bulk,
C ) work only in the small intestine
D) the onset of action is slow (12-24 hour and up to 72 hours )
E) best used to prevent constipation
39) Salicylates characteristics include the following except
A) relieve mild to moderate pain and reduce inflammation
And fever .
B) analgesic and anti - inflammatory actions of aspirin results from both the acetyl and the sal icylate
portions of the drug
C) actions of other sal icylates (e.G., Sodium salicylate, salicylsal icyl ic acid, choline sal icylate)
result only from the salicylate port ion of the agents.
D) inhibit cyclooxygenase, the enzyme that is responsible for the formation of precursors of prostag-
landins (pgs) and thromboxanes from arachidonic acid
E) analgesia is produced mainly by blocking the peripheral generation of pain impulses mediated by
thromboxanes and other chemicals
F) antipyretic action is by salicylates action on the hypothalamic heat - regulating center to produce
peripheral vasodilat ion, which results from the inhibition of prostaglandin synthesis
Question no(38) answer . C
40) Insulin characteristics include the following except
A) insulin requirements may be increased in patients with hepatic impairment
B) insulin requirements may fall in patients with renal impairment and therefore dose reduction may
be necessary.
C) the short-acting insulin analogues, insulin aspart and insulin lispro, are not known to be harmful,
and may be used during pregnancy and lactation
D) short-acting injectable insulins (soluble insulin, insulin
Aspart, insulin glulisine, and insulin lispro) can also be
Given by continuous subcutaneous infusion using a
Portable infusion pump.
Question no(39) answer . E
41) Omega-3 polyunsaturated fatty acids characteristics include the following except
A) (from fish oil), most commonly eicosapentaenoic acid (epa),

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B) reduce cholesterol, triglycerides, ldl, and vldl and may elevate hdl cholesterol.
C) not useful in patients with hypertriglyceridemia,
D) thrombocytopenia and bleeding disorders have been noted, especially with high doses (epa,
Question no(40) answer . A
42) Atrial fibrillation characteristics include the following except
A) managed by either controlling the ventricular rate or by attempting to restore and maintain sinus
rhythm.
B) all patients with atrial fibrillation should be assessed for their risk of stroke and thromboembo-
lism,
C) thromboprophylaxis given if necessary
D) all haemodynamically unstable patients with acuteonset
Atrial fibrillation should undergo electrical cardioversion
E) intravenous amiodarone, or alternatively flecainide, can be used in life-threatening cases when
electrical cardioversion is delayed
43) Treatments for asthma in pregnancy include the following except
A) drugs for asthma should preferably be administered by inhalation to minimise exposure of the
fetus
B) inhaled drugs, theophylline, and prednisolone can be taken as normal during pregnancy and
breast-feeding
C) prednisolone is the preferred corticosteroid for oral administration since very little of the drug
reaches the fetus
D) oxygen should be given immediately to maintain arterial oxygen saturation of 94–98% and
prevent maternal and fetal
Hypoxia.
E) an intravenous beta2 agonist, aminophylline,
Or magnesium sulphate can not be used during pregnancy
F) severe acute exacerbations of asthma can have an adverse effect on pregnancy and should be
treated promptly in hospital with conventional therapy,
44) Sulfonylureas characteristics include the following except
A) act mainly by augmenting insulin secretion and consequently are effective only when some
residual pancreatic beta-cell activity is present
B) considered for patients who are notoverweight, or in whom metformin is contra-indicated or not
tolerated.
C) glibenclamide, a short-acting sulfonylurea, is associated
With a greater risk of hypoglycaemia;
D) glibenclamide,should be avoided in the elderly, and shorter-actingalternatives, such as gliclazide
or tolbutamide, should
Be used instead
E) sulfonylureas should be omitted on the morning of surgery; insulin is required because of the
ensuing hyperglycaemia in these circumstances.
45) Management of severe acute asthma include the following except
A) all patients with severe acute asthma should be given high-flow oxygen (if available) and an
inhaled short-acting beta2 agonist via a large-volume spacer or nebuliser
B) give 2–10 puffs of salbutamol 100 micrograms/metered inhalation, each puff inhaled separately
via a large-volume spacer,and repeat at 10–20 minute intervals or as necessary.
C) a systemic corticosteroid shouldbe given. For adults, give prednisolone 40–50 mg bymouth for at
least 5 days, or intravenous hydrocortisone (preferably as sodium succinate) 100 mg every 6 hours
D) for children, give prednisolone 1–2 mg/kg by mouth (max.
400 Mg) for up to 3 days, or longer if necessary,

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Therapeutics
E) in severe or life-threatening asthma, also consider initial treatment with ipratropium by nebuliser,
46) Antidiabetic drugs characteristics include the following except
A) used for the treatment of type 2 diabetes mellitus.
B) prescribed only if the patient fails to respond adequately to at least 3 months’ restriction of energy
and carbohydrate intake and an increase in physical activity.
C) for patients not adequately controlled by diet and oral hypoglycaemic drugs, insulin may be
added to the treatment regimen or substituted for oral therapy
D) when insulin is added to oral therapy, it is generally given at bedtime as isophane or long-acting
insulin, and
E) when insulin replaces an oral regimen it may be given as once -daily injections of a biphasic
insulin (or isophane insulin mixed with soluble insulin), or a multiple injection regimen.
F) complications of insulin therapy weight gain may be
Reduced if the insulin is given in combination with metformin.
Question no(45) answer . D
47) Beta-blockers characteristics include the following except
A) propranolol is useful for rapid relief of thyrotoxic symptoms
B) may be used in conjunction with antithyroid drugs or as an adjunct to radioactive iodine
C) beta-blockers are not useful in neonatal thyrotoxicosis and in supraventricular arrhythmias due to
hyperthyroidism
D) propranolol has been used in conjunction with iodine to prepare mildly thyrotoxic patients for
surgery
48) Treatment of acute attacks of gout include the following except
A) nonsteroidal anti-inflammatory drugs (nsaids), colchicine, and acth are the mainstays of treat-
ment.
B) when comorbidities limit the use of nsaids or colchicine, a preferred option may be an intra-artic-
ular steroid injection, particularly when a large, easily accessible joint is involved
C) patients should be instructed to go on a diet if not obese, to stop drinking beer, and to avoid
purine-rich foods.
D) therapy to control the underlying hyperuricemia generally is contraindicated until the acute attack
is controlled (unless kidneys are at risk because of unusual uric acid load).
E) if attacks are recurrent or evidence of tophaceous or renal disease is present, therapy for control of
hyperuricemia is indicated
49) Pharmacologic treatment of osteoarthritis include the following except
A) for hand osteoarthritis,use 1 or more of the following:topical capsaicin topical nonsteroidal anti-
inflammatory drugs (nsaids), including trolamine salicylate,oral nsaids,tramadol
B) for patients 75 years and older,not recommends the use of topical rather than oral nsaids.
C) for knee osteoarthritis,recommends using 1 of the following: acetaminophen,oral nsaids,topical
nsaids,tramadol,intra-articular corticosteroid injections
D) for hip osteoarthritis recommends using 1 or more of the following for initial
management:acetaminophen,oral nsaids,tramadol,intra-articular corticosteroid injections
50) Dmards characteristics include the following except
A) dmards can retard or prevent disease progression and, thus, joint destruction and subsequent loss
of function.
B) until the full action of dmards takes effect, anti-inflammatory or analgesic medications may be
required as bridging therapy to reduce pain and swelling.
C) early treatment of ra (ie, within months of onset) with dmards can not only retard disease progres-
sion more efficiently than later treatment, but it may also induce more remissions.

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D) mtx alone or in combination with other agents has become the standard of care for mild ra.
E) use of hydroxychloroquine may decrease the risk of diabetes in patients with ra.
Question no(49) answer . B
51) Drugs to treat osteoporosis include the following except
A) first-line agents: alendronate, risedronate, zoledronic acid, denosumab
B) second-line agent: ibandronate
C) second- or third-line agent: raloxifene and teriparatide
D) last-line agent: calcitonin
E) treatment for patients with very high fracture risk or in whom bisphosphonate therapy has failed:
teriparatide
52) Nonsteroidal anti-inflammatory drugs characteristics include the following except
A) indomethacin is the traditional nsaid of choice for acute gout (unless the patient is elderly, be-
cause of the potential for adverse cns effects in this age group),
B) do not use aspirin in gout because it can alter uric acid levels and potentially prolong and inten-
sify an acute attack.
C) avoid nsaids in patients who have a history of peptic ulcer disease or gi bleeding, patients with
renal insufficiency,
D) nsaids are prescribed at full dosage for 12-15 days to control the acute attack
E) gout symptoms should be absent for at least 2 days before the nsaid is discontinued
F) avoid nsaids patients with abnormal hepatic function, patients taking warfarin (selective cox-2
inhibitors can be used), and patients in the intensive care unit who are predisposed to gastritis.
53) Pharmacologic treatment of osteoarthritis include the following except
A) begin treatment with acetaminophen for mild or moderate osteoarthritic pain without apparent
inflammation
B) if the clinical response to acetaminophen is not satisfactory or if the clinical presentation of oste-
oarthritis is inflammatory, consider using an nsaid.
C) use the lowest effective dose or intermittent dosing if symptoms of osteoarthritis are intermittent,
then try full doses if the patient’s response is insufficient.
D) topical nsaid preparations, can be particularly useful in patients with symptomatic osteoarthritis
that is limited to a few sites or in patients who are at increased risk for adverse events with systemic
nsaids.
E) in patients with moderate pain, consider the analgesic tramadol
F) in patients at an elevated risk for gi toxicity from nsaids include a proton-pump inhibitor or
misoprostol to the treatment regimen and use selective cyclooxygenase (cox)-2 inhibitor celecoxib
instead of a nonselective nsaid.
54) Janus kinases (jaks) inhibitors characteristics include the following except
A) inhibition of jaks reduces production of proinflammatory cytokines central to ra
B) tofacitinib (xeljanz) is an i v jaks inhibitor as second-line treatment for moderate-to-severe active
ra
C) the indication is specific for patients who have had an inadequate response to, or are intolerant of,
methotrexate.
D) tofacitinib may be given as monotherapy or in combination with methotrexate or other nonbio-
logic dmards.
E) tofacitinib should not be used in combination with biologic dmards or potent immunosuppressive
agents (eg, azathioprine, cyclosporine).
55) Bisphosphonates characteristics include the following except
A) they have been employed for only prevention. Oral and intravenous options are available

14www.pharmaqz.com
Therapeutics
B) alendronate (fosamax) is approved for the treatment of osteoporosis in men, in postmenopausal
women, and in patients with glucocorticoid-induced osteoporosis.
C) the treatment dose of alendronate is 70 mg/wk, to be taken sitting uprightwith a large glass of
water at least 30 minutes before eating in the morning.
D) the combination alendronate/vitamin d3 (fosamax plus d) is indicated for the treatment of oste-
oporosis in men to increase bone mass
E) elderly patients who use proton pump inhibitors in conjunction with alendronate have a dose-
dependent loss of protection against hip fracture
F) intravenous bisphosphonates are excellent choices for patients intolerant of oral bisphosphonates
or for those in whom adherence is an issue.
56) Alpha-adrenergic receptor blockers characteristics include the following except
A) nonselective alpha-blockers - phenoxybenzamine
B) selective short-acting alpha-1 blockers - prazosin, alfuzosin, indoramin
C) selective long-acting alpha-1 blockers - terazosin, doxazosin, slow-release (sr) alfuzosin.
D) partially subtype (alpha-1b)–selective agents – tamsulosin, silodosin
57) Benign prostatic hyperplasia (bph) characteristics include the following except
A) alpha-adrenergic receptor–blocking agents should theoretically increase resistance along the blad-
der neck, prostate, and urethra by relaxing the smooth muscle and allowing passage of urine.
B) transurethral resection of the prostate (turp) has long been accepted as the criterion standard for
relieving bladder outlet obstruction (boo) secondary to bph.
C) patients with bph who often have milder lower urinary tract symptoms (luts) are initially treated
with medical therapy.
D) luts secondary to bph is believed to be related to the smooth-muscle tension in the prostate
stroma, urethra, and bladder neck.
58) Hypercalcemia treatment characteristics include the following except
A) volume repletion with isotonic sodium chloride solution is an effective short-term treatment for
hypercalcemia
B) administration of loop diuretics blocks na+ and calcium reabsorption in the talh.
C) oral phosphate also can be used to form insoluble calcium phosphate in the gut.
D) immobilization aggravates hypercalcemia. Whenever possible, weightbearing mobilization
should be encouraged.
E) bisphosphonates inhibit osteoclastic bone resorption and are effective in the treatment of hyper-
calcemia due to conditions causing increased bone resorption and malignancy-related hypercalcemia.
F) pamidronate and etidronate can be given i m, while risedronate and alendronate may be effective
as oral therapy.
59) Severe hypocalcemia treatment characteristics include the following except
A) supportive treatment (ie, iv fluid replacement, oxygen, monitoring) often is required prior to
directed treatment of hypocalcemia
B) calcium carbonate 10% solution delivers higher amounts of calcium and is advantageous when
rapid correction is needed, but it should be administered via central venous access.
C) calcium infusion drips should be started at 0.5 Mg/kg/hr and increased to 2 mg/kg/hr as needed,
with an arterial line placed for frequent measurement of ionized calcium
D) patients with cardiac arrhythmias or patients on digoxin therapy need continuous electrocardio-
graphic (ecg) monitoring during calcium replacement because calcium potentiates digitalis toxicity.
E) treatment with calcium and vitamin d for 1-2 days prior to parathyroid surgery may help prevent
the development of severe hypocalcemia.
F) measure serum calcium every 4-6 hours to maintain serum calcium levels at 8-9 mg/dl.
Question no(58) answer . F

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60) Hyperkalemia treatment & management characteristics include the following except
A) perform an ecg to look for cardiotoxicity. Administer intravenous calcium to ameliorate cardiac
toxicity,
B) remove potassium-containing salt substitutes. Examine the patient's diet. Change the diet to a
low-potassium tube feed or a 2-g potassium ad-lib diet.
C) enhance potassium uptake by cells to decrease the serum concentration.Parenteral glucose and
insulin infusions are very effective in enhancing potassium uptake.
D) continuous infusions of insulin and glucose-containing intravenous fluids can be used for pro-
longed effect.
E) correct metabolic alkalosis with sodium bicarbonate. In patients with chronic renal failure.
F) if the acidosis is severe, then a trial of parenteral sodium bicarbonate therapy is warranted.
61) Treatment of mild to moderate alzheimer disease include the following except
A) cholinesterase inhibitors (cheis) and mental exercises are used in an attempt to prevent or delay
the deterioration of cognition in patients with ad.
B) centrally acting cheis prevent the breakdown of acetylcholine. Agents have been approved as
follows:tacrine,donepezil , rivastigmine (exelon, exelon patch),galantamine (razadyne, razadyne er)
C) cholinergic systems that modulate information processing in the hippocampus and neocortex are
impaired later in the course of ad
D) tacrine has potential hepatotoxicity and hence requires frequent blood monitoring. Since the other
cheis have become available, tacrine has rarely been prescribed.
E) cheis do not address the underlying cause of the degeneration of cholinergic neurons, which
continues during the disease.
62) Migraine headache treatment include the following except
A) analgesics used in migraine include acetaminophen, nonsteroidal anti-inflammatory drugs
(nsaids), and narcotic analgesics (eg, oxycodone, morphine sulfate).
B) 5-hydroxytryptamine–1 (5-ht1) agonists (triptans) and/or opioid analgesics, alone or in combina-
tion with dopamine antagonists (eg, prochlorperazine [compazine]), are used for mild pain.
C) the 2 categories of migraine-specific oral medications are triptans and ergot alkaloids.
D) all the triptans are most effective when taken early during a migraine and all may be repeated in 2
hours as needed, with a maximum of 2 doses daily
E) while different formulations of a specific triptan may be used in the same 24-hour period, only 1
triptan may be used during this timeframe
F) the longer-acting triptans (eg, frovatriptan, naratriptan) may be used continuously for several days
(mini-prophylaxis) to treat menstrual migraine
63) Colchicine characteristics include the following except
A) colchicine therapy must be initiated within 24 hours of onset of the acute attack to be effective
B) colchicine causes adverse gi effects, particularly diarrhea and vomiting, in 80% of patients.
C) the new zealand medicines and medical devices safety authority is as follows: 1 mg loading dose
followed by 0.5 (0.6) Mg every 6 hours, up to a maximum of 2.5 Mg/24 hours and 6 mg over 4 days
in gout treatment
D) colchicine should not be used if the glomerular filtration rate (gfr) is less than 10 ml/min, and the
dose should be decreased by at least half if the gfr is less than 150 ml/min
E) colchicine should also be avoided in patients with hepatic dysfunction, biliary obstruction, or an
inability to tolerate diarrhea.
64) Duloxetine characteristics include the following except
A) duloxetine is a selective serotonin-norepinephrine reuptake inhibitor
B) duloxetine has been found to be effective in treating osteoarthritis pain.[
C) used in patients with knee osteoarthritis who had persistent moderate pain despite optimized nsaid

16www.pharmaqz.com
Therapeutics
therapy,
D) duloxetine was also associated with significantly more nausea, dry mouth, diarrhea, fatigue, and
decreased appetite
65) Bisphosphonates characteristics include the following except
A) oral bisphosphonates include risedronate (actonel) or risedronate delayed-release (atelvia),
B) ibandronate (boniva) is another bisphosphonate that can be given orally once a week
C) risedronate reduced vertebral fractures by 41% and nonvertebral fractures by 39% over 3 years
D) ibandronate is also available as an intravenous formulation that is given every 3 months
66) Alpha-1–receptor blockade characteristics in benign prostatic hyperplasia include the following
except
A) alpha-blocker therapy has been shown to reduce the overall long-term risk for acute urinary reten-
tion (aur) or bph-related surgery.
B) tamsulosin is considered the most pharmacologically uroselective of the commercially available
agents because of its highest relative affinity for thealpha-1a receptor subtype.
C) a new alpha-1a receptor selective blocker, silodosin is indicated for treatment of the signs and
symptoms of bph
D) the efficacy of the titratable alpha-blockers doxazosin and terazosin is dose-dependent
E) the higher the dose of doxazosin and terazosin , the more likely the adverse events (orthostatic
hypotension, dizziness, fatigue, ejaculatory disorder, nasal congestion)
67) Interferon beta-1b therapy characteristics include the following except
A) it is indicated for the treatment of relapsing forms of ms to reduce the frequency of clinical
exacerbations
B) it has shown efficacy in patients who have experienced a first clinical episode of ms and have mri
features consistent with ms
C) interferon beta-1b is administered every other day i v by self-injection
D) the most frequently reported adverse reactions include asthenia, depression, flu-like symptoms,
hypertonia, increased liver enzymes, injection site reactions, leukopenia, and myasthenia.
E) interferon beta-1b can be coadministered with analgesics or antipyretics to help with the occur-
rence of flu-like symptoms.
68) Corticosteroids characteristics include the following except
A) corticosteroids can be given to patients with gout who cannot use nsaids or colchicine
B) . Steroids can be given orally, intravenously, intramuscularly, intra-articularly, or indirectly via
acth.
C) acth at 40 iu im can be given to induce corticosteroid production by the patient's own adrenal
glands
D) prednisone can be given at a dose of approximately 400 mg for 1-3 days and then tapered over
approximately 2 weeks
E) intra-articular, long-acting (depot) corticosteroids are particularly useful in patients with a
monoarticular flare to help reduce the systemic effects of oral steroids.
F) ensuring that the joint is not infected prior to injecting intra-articular corticosteroids is particularly
important
69) Allopurinol characteristics include the following except
A) allopurinol is also associated with the drug rash with eosinophilia and systemic symptoms (dress)
syndrome
B) dress syndrome is a delayed-hypersensitivity response occurring 1 week after beginning allopu-
rinol.

17www.pharmaqz.com
C) in most patients, start at 100 mg per day (50 mg in patients with renal insufficiency) and adjust
the dose monthly according to the uric acid level until the goal of a uric acid level of 6 mg/dl or less
is achieved
D) allopurinol should be discontinued in patients who develop a rash.
70) Intra-articular corticosteroid injections characteristics include the following except
A) intra-articular injection of a corticosteroid or sodium hyaluronate (ie, hyaluronic acid [ha] or
hyaluronan), may provide pain relief and have an anti-inflammatory effect on the affected joint.
B) infected joint fluid and bacteremia are contraindications to steroid injection.
C) in patients with osteoarthritic knee pain, steroid injections generally result in clinically and statis-
tically significant pain reduction as soon as 1 week after injection
D) for hip osteoarthritis, the effectiveness of corticosteroid injection, with benefits often lasting as
long as 3 months.
E) it is usually recommended that no more than 5 injections per year be delivered to any individual
osteoarthritic joint.
F) systemic glucocorticoids have no role in the management of osteoarthritis.
71) Treatment options for tension-type or migraine headacheinclude the following except
A) paracetamol, aspirin and nsaids are useful first-line treatments in adults
B) solution formulations are not preferable: patients with migraine have impaired absorption due to
gastric stasis
C) avoid aspirin in children under 18 years. Use paracetamol or ibuprofen instead
D) avoid combination analgesics containing codeine. They may may have more adverse effects and
can slow absorption of other medications.
E) a sedating antihistamine may be useful if bed rest is desired
F) physical therapy such as massage, stretching, heat and postural correction can relieve tensiontype
headache.
72) Gastro-oesophageal reflux disease treatment options include the following except
A) diagnosis can be confirmed through a clear symptom response to therapy.
B) initial therapy with a proton pump inhibitor (ppi) is appropriate for the majority of patients.
C) if a standard daily dose results in symptom control within one week, the diagnosis will be con-
firmed
D) in 80% of people, pantoprazole 20 mg daily will lead to complete relief of heartburn, acid regur-
gitation and pain on swallowing at 4 weeks.
E) if symptom relief is not immediate, adjuvant therapy with an antacidmay be required initially.
F) the traditional step-up approach from triallingantacids, then h2 antagonists, then ppis may take
weeks to achieve symptom control
73) Use of medication in tension-type or migraine headache include the following except
A) paracetamol. Do not take more than 4 g/24 hours (8 x 500 mg tablets or 8 x 665 mg tablets
B) paracetamol is contained in many products: overdosing may be prevented by carefully checking
the ingredients in all products
C) use only one nsaid at a time (excluding low-dose aspirin).
D) response to nsaids varies and it may be necessary to try a
Number of agents to determine the one that is most effective;
E) use the lowest effective dose of nsaids for the shortest possible time.
74) Gastro-oesophageal reflux disease treatment characteristics include the following except
A) pantoprazole. Recommended dose for initial therapy is 20 mg daily for two weeks.

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Therapeutics
B) h2 antagonists. Due to risk of accumulation, consider dose reduction in severe renal impairment
C) antacids. Optimum effect if taken half an hour after meals
D) separate administration with other medications by at least two hours is required because the
antacids may affect their absorption
75) Nsaids use in dysmenorrhea include the following except
A) nsaids are the most commonly used treatments for dysmenorrhea
B) nsaids decrease menstrual pain by decreasing intrauterine pressure and increasing pgf2alpha
levels in menstrual fluid.
C) patients receiving these medications should be monitored for more serious adverse effects, includ-
ing gi bleeding and renal dysfunction.
D) nsaids are contraindicated in patients with renal insufficiency, peptic ulcer disease, gastritis,
bleeding diatheses, and aspirin hypersensitivity.
E) to avoid inadvertent exposure to these agents during early pregnancy, nsaids should be started at
the onset of menstrual bleeding.
F) diclofenac, ibuprofen, ketoprofen, meclofenamate, mefenamic acid, and naproxen are the nsaids
specifically approved by the us food and drug administration (fda) for treatment of dysmenorrhea
76) Ear, nose, and oropharynx infection treatment include the following except
A) pericoronitis-metronidazolesuggested duration of treatment 3 days or until symptoms resolve
alternative, amoxicillin suggested duration of treatment 3 days or until symptoms resolve
B) gingivitis: acute necrotising ulcerative-metronidazole suggested duration of treatment 3 days or
until symptoms resolve
Alternative, amoxicillin suggested duration of treatment 3 days or until symptoms resolve
C) periapical or periodontal abscess-amoxicillin suggested duration of treatment 3 days alternative,
metronidazole suggested duration of treatment 3 days
D) periodontitis-metronidazole alternative, doxycycline
77) Urinary tract infection treatment include the following except
A) pyelonephritis: acute ,a broad-spectrum cephalosporin or a quinolone and duration of treatment
10–14 days
B) prostatitis: acuteciprofloxacin or ofloxacin and duration of treatment 28 days
C) prostatitis: acute,alternative, trimethoprim and suggested duration of treatment 28 days
D) urinary-tract infection: ‘lower’ trimethoprim or nitrofurantoin and suggested duration of treat-
ment 17 days,
E) urinary-tract infection: ‘loweralternative, amoxicillin1 or oral cephalosporin and suggested dura-
tion of treatment 7 days,
78) Endocarditis:treatment include the following except
A) flucloxacillin (or benzylpenicillin if symptoms severe) + gentamicin
B) if cardiac prostheses present, or if penicillin-allergic, or if meticillin-resistant staphylococcus
aureus suspected, vancomycin + rifampicin + gentamicin
C) endocarditis caused by staphylococci give flucloxacillin
D) add rifampicin for at least 2 weeks in prosthetic valve endocarditis.Suggested duration of treat-
ment at least 4 weeks (at least 6 weeks for prosthetic valve endocarditis)
E) if penicillin-allergic or if meticillin-resistant staphylococcus aureus, vancomycin + rifampicin
79) Benzylpenicillin characteristics include the following except
A) benzylpenicillin sodium (penicillin g) is inactivated by
Bacterial beta-lactamases

19www.pharmaqz.com
B) it is effective for many streptococcal (including pneumococcal), gonococcal, andmeningococcal
infections and also for anthrax
C) benzylpenicillin is the drug of first choice for
Pneumococcal meningitis
D) although benzylpenicillin is effective in the treatment of tetanus, metronidazole is preferred
E) benzylpenicillin is inactivated by gastric acid and absorption from the gut is low; therefore it is
best given by injection
F) benzathine benzylpenicillin is used for the treatment of early syphilis and late latent syphilis; it is
given by intramuscular injection
80) Hormonal contraceptives levonorgestrel implants characteristics include the following except
A) levonorgestrel implant releases approximately 80 mcg of levonorgestrel per 24 hours during the
first year of use,
B) release of the progestational agent by diffusion provides effective contraception for 5 years.
C) contraceptive protection begins within 48 hours of insertion if inserted during the first week of the
menstrual cycle.
D) the rods are inserted subcutaneously, usually in the woman's upper arm, where they are visible
under the skin and
Can be easily palpated
81) Loop diuretics characteristics include the following
A) block the na –k –2cl symporterin the decenting limb of the loop of henle
B) increase in urinary excretion of h and k can lead to arrhythmias
C) increase in urinary excretion of na and k can lead to arrhythmias
D) increase in urinary excretion of h and na can lead to arrhythmias
E) increase in urinary excretion of ca and k can lead to arrhythmias
82) Spironolactone characteristics include the following except
A) inhibits the binding of aldosterone to cytosolic mineralocorticoid receptors
B) potential side effect is hyperkalemia
C) blocking sodium and water retention
D) retaining potassium
E) potential side effect is hypokalemia
83)Short-acting insulins characteristics include the following
A) subcutaneously, soluble insulin has a rapid onset of action (30 to 60 minutes), and a duration of
action of up to 18 hours.
B) i v , soluble insulin has a rapid onset of action (30 to 60 minutes), and a duration of action of up
to8 hours.
C) subcutaneously, soluble insulin has a rapid onset of action (60 to 120 minutes), and a duration of
action of up to8 hours.
D) subcutaneously, soluble insulin has a rapid onset of action (30 to 60 minutes), and a duration of
E) subcutaneously, soluble insulin has a rapid onset of action (15 to 30 minutes), and a duration of
84) Ezetimibe characteristic includes the following
A) ezetimibe interferes with the absorption of cholesterol from the stomach,
B) ezetimibe interferes with the absorption of triglicerides from the intestine,
C) ezetimibe interferes with the absorption of cholesterol from the intestine,
D) ezetimibe increases the absorption of cholesterol from the intestine,

20www.pharmaqz.com
Therapeutics
E) ezetimibe interferes with the absorption of fats from the intestine,
85) Nonsteroidal anti-inflammatory drugs characteristics include the following
A) avoid nsaids in patients who have a history of peptic ulcer disease or abdominal pain, patients
with renal insufficiency,
B) avoid nsaids in patients who have a history of diabetes or gi bleeding, patients with renal insuf-
ficiency,
C) avoid nsaids in patients who have a history of peptic ulcer disease or gi bleeding, patients with
migrane
D) avoid nsaids in patients who have a history of peptic ulcer disease or gi bleeding, patients with
renal insufficiency,
E) avoid nsaids in patients who have a history of peptic ulcer disease or gi bleeding, patients with
liver failure
86) Mifepristone characteristics include the following
A) it causes contraction of the cervix and increases the sensitivity of the myometrium to the action of
prostaglandins.
B) it causes dilatation of the cervix and decreases the sensitivity of the myometrium to the action of
prostaglandins
C)it causes dilatation of the pelvis and increases the sensitivity of the myometrium to the action of
prostaglandins
D)it causes dilatation of the cervix and increases the sensitivity of the endometrium to the action of
prostaglandins
E)it causes dilatation of the cervix and increases the sensitivity of the myometrium to the action of
prostaglandins
87)Diabetes mellitus characteristics include the following
A) type 1 diabetes, is due to reduced secretion of insulin or to peripheral resistance to the action of
B) type 2 diabetes, is due to reduced secretion of insulin or to peripheral resistance to the action of
C) type 2 diabetes, is due to increased secretion of insulin or to peripheral resistance to the action of
D) type 1 diabetes, is due to increased secretion of insulin or to peripheral resistance to the action of
E) type 2 diabetes, is due to reduced secretion of insulin or to peripheral resistance to the action of
glycogen or to a combination of both
88) Diabetes mellitus characteristics include the following
A)type 2 diabetes is the deficiency of insulin following autoimmune destruction of pancreatic beta
cells and type 1 diabetes require administration of insulin.
B) type 1 diabetes is the deficiency of insulin following autoimmune destruction of pancreatic beta
C)type 1 diabetes is the deficiency of glycogen following autoimmune destruction of pancreatic beta
D) type 1 diabetes is the deficiency of insulin following autoimmune destruction of pancreatic beta
cells and type 1 diabetes require administration of oral antidiabetic drugs
E)type 1 diabetes is the deficiency of insulin following autoimmune destruction of pancreatic beta
Question no(87) answer .B
89)Diabetes mellitus characteristics include the following
A)a measure of the total glycosylated (or glycated) haemoglobin (hba2 ) or a specific fraction (hba1c
) provides a good indication of glycaemic control over the previous 2–3 months.

21www.pharmaqz.com
B)a measure of the total glycosylated (or glycated) haemoglobin (hba1 ) or a specific fraction (hba1d
C) a measure of the total glycosylated (or glycated) haemoglobin (hba1 ) or a specific fraction
(hba1c ) provides a good indication of glycaemic control over the previous 2–3 months...
D) a measure of the total glycosylated (or glycated) haemoglobin (hba2 ) or a specific fraction
(hba1c ) provides a good indication of glycaemic control over the previous 3–6 months.
E)a measure of the total glycosylated (or glycated) haemoglobin (hba1 ) or a specific fraction (hba1c
90)Insulin characteristics include the following
A)insulin is inactivated by gastro-intestinal enzymes, it must therefore be given by i v
injection;subcutaneous insulin injections cause lipodystrophy
B)insulin is inactivated by gastro-intestinal enzymes, it must therefore be given by injection;i v
insulin injections cause lipodystrophy
C)insulin is not inactivated by gastro-intestinal enzymes, it must therefore be given by
injection;subcutaneous insulin injections cause lipodystrophy
D)insulin is inactivated by gastro-intestinal enzymes, it must therefore be given by oral ;subcutane-
ous insulin injections cause lipodystrophy
E)insulin is inactivated by gastro-intestinal enzymes, it must therefore be given by
injection;subcutaneous insulin injections cause lipodystrophy...
91) Sulfonylureas characteristics include the following
A) glibenclamide, a short-acting sulfonylurea, is associated
With a greater risk of hypoglycaemia; it should be avoided in the elderly
B) glibenclamide, a long-acting sulfonylurea, is associated
With a greater risk of hyperglycaemia; it should be avoided in the elderly
C)glibenclamide, a long-acting sulfonylurea, is associated
With a greater risk of hypoglycaemia; it should not be avoided in the elderly
D) glibenclamide, a long-acting sulfonylurea, is associated
With a greater risk of hypoglycaemia; it should be avoided in the elderly...
E) glibenclamide, a long-acting sulfonylurea, is associated
With a greater risk of hypoglycaemia; it should be avoided in the adults
92)Diabetes mellitus treatment characteristics include the following
A)sulfonylureas can encourage weight loss so metformin is considered the drug of choice in obese
patients.
B)sulfonylureas can encourage weight gain so metformin is considered the drug of choice in non
obese patients.
C)sulfonylureas can encourage weight gain so metformin is considered the drug of choice in obese
patients...
D)sulfonylureas can encourage weight gain so sulfonylureas is considered the drug of choice in
obese patients.
E)metformin can encourage weight gain so metformin is considered the drug of choice in non obese
patients.
Question no(91) answer .D
93)Nateglinide and repaglinide characteristics include the following
A)inhibit insulin release and both drugs have a rapid onset of action and short duration of activity
B)stimulate insulin release and both drugs have a rapid onset of action and short duration of activity..
C)stimulate insulin production and both drugs have a slow onset of action and short duration of
activity
D)block insulin release and both drugs have a slow onset of action and short duration of activity
E)stimulate insulin release and both drugs have a rapid onset of action and long duration of activity

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Therapeutics
94) Pioglitazone, characteristics include the following
A)pioglitazone, increases peripheral insulin resistance, leading to a reduction of blood-glucose
concentration
B)pioglitazone, reduces peripheral insulin resistance, leading to a reduction of blood-glucose con-
centration..
C)pioglitazone, reduces peripheral insulin secretion , leading to a reduction of blood-glucose concen-
tration
D)pioglitazone, reduces peripheral insulin resistance, leading to a increase of blood-glucose concen-
tration
E)pioglitazone, increases peripheral insulin secretion, leading to a reduction of blood-glucose con-
centration
95) Acarbose, characteristics include the following
A)an inhibitor of intestinal alpha glucosidases, increases the digestion and absorption of starch and
sucrose
B)an inhibitor of intestinal alpha glucosidases, delays the digestion and absorption of fats and
sucrose
C)an inhibitor of stomach alpha glucosidases,
Delays the digestion and absorption of starch and protein
D)an inhibitor of intestinal alpha glucosidases,
Delays the digestion and absorption of starch and sucrose..
E)an inhibitor of intestinal alpha glucosidases,
Delays the digestion and absorption of lipids
96) Metformin characteristics include the following
A)metformin improves insulin resistance, may aid weight
Reduction, and metformin can provoke lactic acidosis in patients with renal impairment,
B)metformin improves insulin sensitivity, may aid weight
Reduction, and metformin can provoke lactic acidosis in patients with renal impairment,..
C)metformin improves insulin sensitivity, may aid weight
Gain , and metformin can provoke lactic acidosis in patients with renal impairment,
D)metformin improves insulin sensitivity, may aid weight
Reduction, and metformin can provoke lactic acidosis in patients with hepatic impairment,
E)metformin improves insulin resistance , may aid weight
Reduction, and metformin can provoke metabolic acidosis in patients with renal impairment,
97)Clinical manifestations of diabetes mellitus include the following
A) oliguria, polydipsia, polyphagia, and weight loss
B) polyuria, polydipsia, polyphagia, and weight gain
C) polyuria, polydipsia, polyphagia, and weight loss..
D) polyuria, dyspepsia, polyphagia, and weight loss
E) proteinuria, polydipsia, polyphagia, and weight gain
98) Diagnostic criteria of diabetes mellitus by the american diabetes association (ada) include the
following
A)a fasting plasma glucose (fpg) level of 126 mg/dl (7.0 Mmol/l) or less,
B)a fasting plasma glucose (fpg) level of 146 mg/dl (7.0 Mmol/l) or higher,
C)a fasting plasma glucose (fpg) level of 126 mg/dl (7.0 Mmol/l) or higher,..
D)a fasting plasma glucose (fpg) level of 126 mg/l (9.0 Mmol/l) or higher,
E)a fasting plasma glucose (fpg) level of 146 mg/dl (7.0 Mmol/l) or less

23www.pharmaqz.com
99) Dipeptidyl peptidase iv inhibitors characteristics include the following
A)dpp-4 inhibitors stop the action of incretin hormones by blocking its degradation and are given
once daily
B)dpp-4 inhibitors prolong the action of incretin hormones by activating its degradation and are
given once daily
C)dpp-4 inhibitors prolong the action of incretin hormones by blocking its degradation and are given
twice daily
D)dpp-4 inhibitors block the action of incretin hormones by blocking its degradation and are given
twice daily
E)dpp-4 inhibitors prolong the action of incretin hormones by blocking its degradation and are given
once daily..
100) Incretins characteristics include the following
A)incretins increase insulin release and synthesis from pancreatic beta cells and reduce glucagon
secretion pancreatic alpha cells..
B)incretins decrease insulin release and synthesis from pancreatic beta cells and reduce glucagon
secretion pancreatic alpha cells
C)incretins increase insulin release and synthesis from pancreatic beta cells and increase glucagon
D)incretins increase glucagon release and synthesis from pancreatic beta cells and reduce glucagon
E)incretins increase insulin release and synthesis from pancreatic beta cells and reduce insulin secre-
tion pancreatic alpha cells
101) Insulin characteristics include the following
A)insulin lower blood glucose by stimulating peripheral glucose metabolism and by inhibiting
hepatic glucose production;
B)insulin lower blood glucose by inhibiting peripheral glucose uptake and by inhibiting hepatic
glucose production
C)insulin lower blood glucose by stimulating peripheral glucose uptake and by stimulating hepatic
glucose production
D)insulin lower blood glucose by stimulating peripheral glucose uptake and by inhibiting hepatic
glucose production..
E)insulin lower blood glucose by stimulating peripheral glucose uptake and by inhibiting hepatic
glucose secretion
102) Amylinomimetics (pramlintide) characteristics include the following
A)pramlintide is a synthetic analogue of human amylase it slows gastric emptying, suppresses post-
prandial glucagon secretion, and regulates food intake
B))pramlintide is a synthetic analogue of human amylin it increase gastric emptying, suppresses
postprandial glucagon secretion, and regulates food intake
C))pramlintide is a synthetic analogue of human amylin it slows gastric emptying, suppresses post-
prandial glucagon secretion, and regulates food intake..
D))pramlintide is a synthetic analogue of human amylaseit slows gastric emptying, increases post-
prandial glucagon secretion, and regulates food intake
E))pramlintide is a synthetic analogue of human amylin it slows gastric emptying, suppresses post-
prandial glucagon secretion, and increses food intake
103) Exenatide characteristics include the following
A)a glucagonlike peptide-1 (glp-1) block incretin and promotes insulin secretion, suppresses gluca-

24www.pharmaqz.com
Therapeutics
gon, and slows gastric emptying
B)a glucagonlike peptide-1 (glp-1) mimics incretin and promotes insulin production, suppresses
glucagon, and increase gastric emptying
C)a glucagonlike peptide-1 (glp-1) mimics amylin and promotes insulin secretion, suppresses gluca-
D)a glucagonlike peptide-1 (glp-1) mimics incretin and promotes insulin secretion, suppresses gluca-
gon, and slows gastric emptying..
E)a glucagonlike peptide-1 (glp-1) mimics amylin and promotes insulin secretion, secreates gluca-
104)Diabetic complication characteristics include the following
A)gastroparesis is a problem in patients with type 2 diabetes mellitus .Use of metoclopramide may
be helpful and its use preferably should be limited to a few days at a time
B)gastroparesis is a problem in patients with type 1 diabetes mellitus use of metoclopramide may be
helpful and its use preferably should be limited to a few days at a time..
C)gastroparesis is a problem in patients with type 1 diabetes mellitus use of metoclopramide may not
be helpful and its use preferably should be limited to a few days at a time
D)gastroparesis is a problem in patients with type 2 diabetes mellitus use of metoclopramide may be
helpful and its use preferably should be continued for 3 months
E)gastroparesis is a problem in patients with type 1 diabetes mellitus use of metoclopramide may be
helpful and its use preferably should be continued for 6 months
105)Insulin regimens(once-daily regimen) characteristics include the following
A)short or intermediate-acting insulin is given at bedtime
It is suitable only for patients with type 2 diabetes
B)long- or short-acting insulin is given at bedtime
C)long- or intermediate-acting insulin is given in the morning
D)long- or intermediate-acting insulin is given at bedtime
It is suitable only for patients with type 2 diabetes..
E)long- or intermediate-acting insulin is given at bedtime
106) Diagnostic criteria by the american diabetes association (ada) for type 2 dm include the follow-
ing except
A) a random plasma glucose of 100 mg/dl (11.1 Mmol/l) or higher in a patient with classic symp-
toms of hyperglycemia or hyperglycemic crisis
B) a fasting plasma glucose of 200 mg/dl (11.1 Mmol/l) or higher in a patient with classic symptoms
of hyperglycemia or hyperglycemic crisis
C) a random plasma glucose of 300 mg/dl (11.1 Mmol/l) or less in a patient with classic symptoms
of hyperglycemia or hyperglycemic crisis
D) a random plasma glucose of 200 mg/dl (11.1 Mmol/l) or higher in a patient with classic symp-
toms of hyperglycemia or hyperglycemic crisis..
E) a random plasma glucose of 250 mg/dl (21.1 Mmol/l) or higher in a patient with classic symp-
toms of hyperglycemia or hyperglycemic crisis
A) soluble insulin by the im is reserved for diabetic ketoacidosis, and for fine control in serious ill-
ness and in the peri-operative period
B) nph insulin by the iv is reserved for diabetic ketoacidosis, and for fine control in serious illness
and in the peri-operative period

25www.pharmaqz.com
C) soluble insulin by the iv is reserved for diabetic neuropathy, and for fine control in serious illness
and in the peri-operative period
D) soluble insulin by the sc is reserved for diabetic ketoacidosis, and for fine control in serious ill-
ness and in the peri-operative period
E) soluble insulin by the iv is reserved for diabetic ketoacidosis, and for fine control in serious illness
and in the peri-operative period..
F) long acting insulin by the iv is reserved for diabetic ketoacidosis, and for fine control in serious
illness and in the peri-operative period
Question no(106) answer . Abce
108)Nateglinide and repaglinide characteristics include the following
A)stimulate insulin production,both drugs have a rapid onset of action and short duration of activity,
B)inhibit insulin release,both drugs have a rapid onset of action and short duration of activity,
C)stimulate insulin release,both drugs have a slow onset of action and short duration of activity,
D)stimulate insulin release,both drugs have a rapid onset of action and short duration of activity,..
E)stimulate insulin release,both drugs have a rapid onset of action
And long duration of activity,
Question no(107) answer .(E)
109)Diabetic neuropathy characteristics include the following
A)an antiemetic which promotes gastric transit, such as metoprolol or domperidone, is helpful for
gastroparesis associated with neuropathy
B)an antidiarrheal which promotes gastric transit, such as metoclopramide or domperidone, is help-
ful for gastroparesis associated with neuropathy
C)an antiemetic which promotes gastric transit, such as metoclopramide or domperidone, is helpful
for gastroparesis associated with neuropathy..
D)an antiemetic which promotes gastric transit, such as metoclopramide or domperidone, is helpful
for gastroparesis associated with nephropathy
E)an antiemetic which decrease gastric transit, such as metoclopramide or domperidone, is helpful
for gastroparesis associated with neuropathy
Question no(107) answer .(D)
110) Exenatide characteristics include the following
A)the recommended dose of exenatide is 30 mg once weekly by subcutaneous injection
B)the recommended dose of exenatide is 2 mg once day by subcutaneous injection
C)the recommended dose of exenatide is 20 mg once weekly by iv injection
D)the recommended dose of exenatide is 2 mg once weekly by subcutaneous injection..
E)the recommended dose of exenatide is 10 mg once weekly by iv injection
Question no(109) answer .(C)
111) Diabetic neuropathy characteristics include the following except
A) paracetamol or a non-steroidal anti-inflammatory drug such as ibuprofen may relieve mild to
moderate pain.
B) duloxetine is effective for the treatment of painful diabetic neuropathy
C) amitriptyline can be used if duloxetine is ineffective or unsuitable.
D) nortriptyline may be better tolerated than amitriptyline
E) if treatment with amitriptyline or duloxetine is adequate, treatment with pregabalin should be
tried..
112) Management of diabetic ketoacidosis include the following
A) established iv therapy with long-acting insulin analogues (insulin detemir or insulin glargine)
should be continued during treatment of diabetic ketoacidosis
B) established sc therapy with short-acting insulin analogues (insulin detemir or insulin glargine)
C) established sc therapy with long-acting insulin analogues (insulin detemir or insulin glargine)

26www.pharmaqz.com
Therapeutics
should not be continued during treatment of diabetic ketoacidosis
D) established sc therapy with long-acting insulin analogues (insulin detemir or insulin glargine)
should be continued during treatment of diabetic ketoacidosis..
E) established iv therapy with short-acting insulin analogues (insulin detemir or insulin glargine)
113) Dipeptidyl peptidase iv inhibitors characteristics include the following
A) saxagliptin, sitagliptin, and vildagliptin inhibit dipeptidylpeptidase-3 to increase insulin secretion
and lower glucagon secretion.
B)saxagliptin, sitagliptin, and vildagliptin inhibit dipeptidylpeptidase-4 to decrease insulin secretion
C)saxagliptin, sitagliptin, and vildagliptin activate dipeptidylpeptidase-3 to increase insulin secretion
D)saxagliptin, sitagliptin, and vildagliptin inhibit dipeptidylpeptidase-4 to increase insulin secretion
and lower glucagon secretion...
E)saxagliptin, sitagliptin, and vildagliptin inhibit dipeptidylpeptidase-4 to increase insulin secretion
and increase glucagon secretion.
114) Diabetic neuropathy characteristics include the following
A)treatment with morphine or oxycodone should be initiated without specialist supervision.
B)gabapentin and carbamazepine are sometimes used for the treatment of neuropathic pain.
C)treatment with morphine or oxycodone should be initiated only under specialist supervision.
D) b and c..
E) a and b
115) When glycaemic control is inadequate with existing treatment, pioglitazone can be added to the
follwing except
A) a sulfonylurea, if metformin is contra-indicated or not tolerated
B) metformin, if risks of hypoglycaemia with sulfonylurea are unacceptable or a sulfonylurea is
contraindicated or not tolerated
C) an exenatide tablet, if insulin is acceptable because of lifestyle or other personal issues..
D) a combination of metformin and a sulfonylurea, if insulin is unacceptable because of lifestyle or
other personal issues, or because the patient is obese
116)The thiazolidinedione characteristics include the following
A) pioglitazone, increases peripheral insulin resistance, leading to a reduction of blood-glucose
concentration
B)pioglitazone, reduces peripheral insulin resistance, leading to a reduction of blood-glucose con-
centration..
C)pioglitazone, reduces peripheral insulin sensitivity , leading to a reduction of blood-glucose
concentration
D)pioglitazone, reduces peripheral insulin resistance, leading to a increase of blood-glucose concen-
tration
E)pioglitazone, increases systemic insulin resistance, leading to a reduction of blood-glucose con-
centration
117) Acarbose characteristics include the following
A) an stimulant of intestinal alpha glucosidases, delays the digestion and absorption of starch and
sucrose, flatulence is a side-effect and it tends to decrease with time
B) an inhibitor of intestinal alpha glucosidases, increases the digestion and absorption of starch and
sucrose, flatulence is a side-effect and it tends to decrease with time

27www.pharmaqz.com
C) an inhibitor of intestinal alpha glucosidases, delays the digestion and absorption of fats and pro-
tein, flatulence is a side-effect and it tends to decrease with time
D) an stimulant of intestinal alpha glucosidases, delays the digestion and absorption of starch and
sucrose, flatulence is a side-effect and it tends to increase with time
E) an inhibitor of intestinal alpha glucosidases, delays the digestion and absorption of starch and
sucrose, flatulence is a side-effect and it tends to decrease with time..
Question no(116) answer .(B)
118)Management of diabetic ketoacidosis include the following
A)if systolic blood pressure is above 90mmhg give 500 ml sodium chloride 0.9% By intravenous
infusion over 10–15 minutes;
B)if systolic blood pressure is below 90mmhg give 500 ml sodium bicarbonate 0.9% By intravenous
C)if systolic blood pressure is below 90mmhg give 500 ml sodium chloride 0.9% By intravenous
infusion over 10–15 minutes;..
D)if systolic blood pressure is below 60mmhg give 500 ml sodium chloride 0.2% By intravenous
E)if systolic blood pressure is below 90mmhg give 500 ml sodium chloride 1.9% By intravenous
infusion over 10–15 minutes
A) insulin and its analogs increase blood glucose by stimulating peripheral glucose uptake, espe-
cially by skeletal muscle and fat, and by inhibiting hepatic glucose production
B) insulin and its analogs lower blood glucose by stimulating peripheral glucose uptake, especially
by skeletal muscle and fat, and by inhibiting hepatic glucose production..
C) insulin and its analogs lower blood glucose by blocking peripheral glucose uptake, especially by
skeletal muscle and fat, and by inhibiting hepatic glucose production
D) insulin and its analogs lower blood glucose by stimulating peripheral glucose uptake, especially
by skeletal muscle and fat, and by stimulating hepatic glucose production
E) insulin and its analogs lower blood glucose by blocking peripheral glucose uptake, especially by
skeletal muscle and fat, and by inhibiting hepatic glucose secretion
120) Thyroid hormones characteristics include the following
A) the pituitary gland inhibits the thyroid to make thyroid hormone,which is necessary for normal
growth and development, and it regulates cellular metabolism.
B) the pituitary gland stimulates the thyroid to make thyroid hormone,which is necessary for normal
growth and development, and it blocks cellular metabolism.
C) the pituitary gland stimulates the thyroid to make para thyroid hormone,which is necessary for
normal growth and development, and it regulates cellular metabolism.
D) the hypothalamus stimulates the thyroid to make thyroid hormone,which is necessary for normal
growth and development, and it regulates cellular metabolism.
E) the pituitary gland stimulates the thyroid to make thyroid hormone,which is necessary for normal
growth and development, and it regulates cellular metabolism...
121) Hyperthyroidism characteristics include the following
A) excess thyroid hormone causes an decrease in the metabolic rate that is associated with increased
total body heat production and cardiovascular activity (increased heart contractility, heart rate,
vasodilation).
B) excess thyroid hormone causes an increase in the metabolic rate that is associated with decreased
vasodilation).
C) excess thyroid hormone causes an increase in the metabolic rate that is associated with increased
total body heat production and cardiovascular activity (decreased heart contractility, heart rate,

28www.pharmaqz.com
Therapeutics
vasodilation).
D) excess thyroid hormone causes an increase in the metabolic rate that is associated with increased
vasodilation). ..
E) excess thyroid hormone causes an decrease in the metabolic rate that is associated with increased
total body heat production and cardiovascular activity (decreased heart contractility, heart rate,
vasodilation).
122) Symptoms of thyrotoxicosis include the following
A) nervousness,anxiety, decreased perspiration,heat intolerance,tremor,hyperactivity,palpitations,wei
ght loss despite increased appetite, reduction in menstrual flow or oligomenorrhea
B) nervousness,anxiety, increased perspiration,cold intolerance,tremor,hyperactivity,palpitations,wei
ght loss despite increased appetite, reduction in menstrual flow or oligomenorrhea
C) nervousness,anxiety, increased perspiration,heat intolerance,tremor,hyperactivity,palpitations,wei
ght loss despite increased appetite, reduction in menstrual flow or oligomenorrhea..
D) nervousness,anxiety, increased perspiration,heat intolerance,tremor,hyperactivity,palpitations,wei
ght gain despite increased appetite, reduction in menstrual flow or oligomenorrhea
E) nervousness,anxiety, increased perspiration,heat intolerance,tremor,hyperactivity,palpitations,wei
ght loss despite increased appetite,increase in menstrual flow or oligomenorrhea
123) Propylthiouracil characteristics include the following
A) propylthiouracil is second line drug of choice in life-threatening severe thyrotoxicosis because
ofof inhibition of t4 -to-t3 conversion.
B) propylthiouracil is still the drug of choice in life-threatening severe hypothyroidism because ofof
inhibition of t4 -to-t3 conversion.
C) propylthiouracil is still the drug of choice in life-threatening severe thyrotoxicosis because ofof
inhibition of t3-to-t4 conversion.
D) propylthiouracil is secondline drug of choice in life-threatening severe thyrotoxicosis because
ofof inhibition of t3 -to-t4 conversion.
E) propylthiouracil is still the drug of choice in life-threatening severe thyrotoxicosis because ofof
inhibition of t4 -to-t3 conversion…
124) Hyperthyroidism treatment characteristics include the following
A) under-treatment with antithyroid drugs can results hypothyroidism and should be avoided during
pregnancy because of fetal goitre
B) over-treatment with antithyroid drugs can results hypothyroidism and should be avoided during
pregnancy because of fetal goitre..
C) over-treatment with antithyroid drugs can results hyperthyroidism and should be avoided during
pregnancy because of fetal goitre
D) over-treatment with antithyroid drugs can results hypothyroidism and should be avoided during
pregnancy because of fetal death
E) under-treatment with antithyroid drugs can results hypothyroidism and should not be avoided dur-
ing pregnancy because of fetal goitre
A) iodine is used as an adjunct to antithyroid drugs for 10 to 14 days after partial thyroidectomy
B) iodine is used as an adjunct to levothyroxine for 10 to 14 days before partial thyroidectomy
C) iodine is used as an adjunct to antithyroid drugs for 10 to 14 days before partial thyroidectomy..
D) iodine is used as a substituent to antithyroid drugs for 10 to 14 days before partial thyroidectomy
E) iodine is used as an adjunct to levothyroxine drugs for 10 to 14 days after partial thyroidectomy

29www.pharmaqz.com
126) Carbimazole characteristics include the following
A) children may be given carbimazole in an initial dose of 250 milligrams/kg three times daily
B) children may be given carbimazole in an initial dose of 250 micrograms/kg three times daily..
C) children may be given carbimazole in an initial dose of 250 micrograms/kg one time daily
D) adults may be given carbimazole in an initial dose of 250 micrograms/kg three times daily
E) children may be given carbimazole in an initial dose of 150 micrograms/kg three times daily
127) Symptoms of thyrotoxicosis include the following
A) younger patients exhibit symptoms of more sympathetic activation, such as anxiety, hypoactivity,
and tremor,
B) older patients exhibit symptoms of more sympathetic activation, such as anxiety, hyperactivity,
and tremor,
C) younger patients exhibit symptoms of more sympathetic activation, such as depression, hyperac-
tivity, and tremor,
D) younger patients exhibit symptoms of more parasympathetic activation, such as anxiety, hyperac-
tivity, and tremor,
E) younger patients exhibit symptoms of more sympathetic activation, such as anxiety, hyperactivity,
and tremor,
A) the drug of choice for hypothyroidism in the nonpregnant woman is methimazole
B) the drug of choice for hyperthyroidism in the nonpregnant woman is methimazole
C) the drug of choice for hyperthyroidism in the pregnant woman is methimazole
D) the drug of choice for hyperthyroidism in the nonpregnant woman is radio active iodine
E) the drug of choice for hypothyroidism in the pregnant woman is methimazole
A) neurologic and pulmonary symptoms of thyrotoxicosis are relieved by beta-blocker therapy.
B) neurologic and cardiovascular symptoms of hypothyroidism are relieved by beta-blocker therapy.
C) neurologic and cardiovascular symptoms of thyrotoxicosis are relieved by beta-blocker therapy.
D) neurologic and cardiovascular symptoms of thyrotoxicosis are relieved by beta-agonist therapy.
E) psychiatric and cardiovascular symptoms of thyrotoxicosis are relieved by beta-blocker therapy.
A) propranolol has been used instead of iodine to prepare mildly thyrotoxic patients for surgery
B) propranolol has been used in conjunction with iodine to prepare mildly hypothyroid patients for
surgery
C) methimazole has been used in conjunction with carbimazole to prepare mildly thyrotoxic patients
for surgery
D) propranolol has been used in conjunction with iodine to prepare mildly thyrotoxic patients for
surgery
E) propranolol has been used in conjunction with propylthiouracil to prepare mildly thyrotoxic
patients for surgery
131) Thionamides( carbimazole and methimazole) characteristics include the following
A) need to continue taking for a short time,do not have to go to hospital to take ,less risk of thyroid
gland becoming underactive
B) need to continue taking for a long time,do not have to go to hospital to take ,less risk of thyroid
C) need to continue taking for a long time,do have to go to hospital to take ,less risk of thyroid gland
becoming underactive

30www.pharmaqz.com
Therapeutics
D) need to continue taking for a long time,do not have to go to hospital to take ,high risk of thyroid
E) need to continue taking for a long time,do not have to go to hospital to take ,less risk of thyroid
gland becoming overactive
A) most people only require a single dose of carbimazole treatment. If a further follow-up dose is
required it is usually given six-12 months after the first dosage
B) most people only require two doses of radioiodine treatment. If a further follow-up dose is
C) most people only require a single dose of radioiodine treatment. If a further follow-up dose is
D) most people only require a single dose of propylthiouracil treatment. If a further follow-up dose
is required it is usually given s 18-24 months after the first dosage
E) most people only require 2 doses of radioiodine treatment. If a further follow-up dose is required
it is usually given 3-6 months after the first dosage
133) Subclinical hyperthyroidism characteristics include the following
A) low or undetectable concentration of serum thyrotropin (trh) with normal free triiodothyronine
(ft3) and free thyroxine (ft4) levels
B) high or undetectable concentration of serum thyrotropin (tsh) with normal free triiodothyronine
C) low or undetectable concentration of serum thyrotropin (tsh) with high free triiodothyronine (ft3)
and free thyroxine (ft4) levels
D) low concentration of serum thyrotropin (trh) with high free triiodothyronine (ft3) and low free
thyroxine (ft4) levels
E) low or undetectable concentration of serum thyrotropin (tsh) with normal free triiodothyronine
134) Hypothyroidism characteristics include the following
A) lack of thyroid hormone production due to inadequate secretion of thyrotropin (ie, thyroid-stimu-
lating hormone [tsh]) from the pituitary gland
B) lack of thyroid hormone secretion due to inadequate secretion of thyrotropin (ie, thyroid-stimulat-
ing hormone [trh]) from the pituitary gland
C) lack of thyroid hormone secretion due to inadequate secretion of thyrotropin (ie, thyroid-stimulat-
ing hormone [tsh]) from the hypothalamus
D) lack of thyroid hormone secretion due to inadequate secretion of thyrotropin (ie, thyroid-stimulat-
ing hormone [tsh]) from the pituitary gland
E) lack of thyroid hormone secretion due to inadequate production of thyrotropin (ie,thyrotropin-
releasing hormone[tsh]) from the pituitary gland
135) Tsh ,t4 and t3 interpretation include the following except
A) high tsh normal t4 normal t3 -mild (subclinical) hypothyroidism
B) high tsh lowt4 low or normal t3- hyperthyroidism
C) low tsh normal t4 normal t3 - mild (subclinical) hyperthyroidism*
D) low tsh high or normalt4 high or normal t3-hyperthyroidism*
E) low tsh low or normalt4 low or normal t3 -nonthyroidal illness; rarely hypothyroidism due to
pituitary disease
136) Thyroid function tests characteristics include the following
A) in patients with secondary (pituitary dysfunction) and tertiary (hypothalamic dysfunction) hy-

31www.pharmaqz.com
pothyroidism both t4 and tsh levels are increased
B) in patients with secondary (pituitary dysfunction) and tertiary (hypothalamic dysfunction) hyper-
thyroidism both t4 and tsh levels are reduced.
C) in patients with secondary (pituitary dysfunction) and primary (hypothalamic dysfunction) hy-
pothyroidism both t4 and tsh levels are reduced.
D) in patients with secondary (pituitary dysfunction) and tertiary (hypothalamic dysfunction) hy-
pothyroidism both t4 and tsh levels are reduced.
E) in patients with primary (pituitary dysfunction) and tertiary (hypothalamic dysfunction) hypothy-
roidism both t4 and tsh levels are reduced.
137) Levothyroxine characteristics include the following
A) decreases basal metabolic rate, increases utilization and mobilization of glycogen store, promotes
gluconeogenesis
B) increases basal metabolic rate, increases utilization and mobilization of glycogen store, promotes
gluconeogenesis
C) increases basal metabolic rate, decreases utilization and mobilization of glycogen store, promotes
gluconeogenesis
D) increases basal metabolic rate, increases utilization and mobilization of glycogen store, decreases
gluconeogenesis
E) increases basal metabolic rate, increases utilization and mobilization of lipid store, promotes
gluconeogenesis
138) Hypothyroidism treatment characteristics include the following
A) to determine the right dosage of levothyroxine initially, check your level of tsh after two to three
months
B) to determine the right dosing interval of levothyroxine initially, check your level of tsh after two
to three months
C) to determine the right dosage of carbimazole initially, check your level of tsh after two to three
months
D) to determine the right dosage of ptu initially, check your level of tsh after two to three months
E) to determine the right dosage of levothyroxine initially, check your level of trh after two to three
months
A) synthetic t3 replacement should be taken in the morning, 30 minutes before eating.
B) synthetic t4 replacement should be taken in the evening, 20 minutes before eating.
C) synthetic t4 replacement should be taken in the morning, 30 minutes before eating.
D) synthetic t4 replacement should be taken in the morning, 30 minutes aftereating.
E) synthetic t3 replacement should be taken in the morning, 10 minutes before eating.
Question no(138) answer .(A)
A) long-term therapy has been associated with decreased bone resorption, especially in post-meno-
pausal women on greater than replacement doses
B) short-term therapy has been associated with increased bone resorption, especially in post-meno-
C) long-term therapy has been associated with increased bone resorption, especially in post-meno-
D) long-term therapy has been associated with increased bone resorption, especially in pre-menopau-
sal women on greater than replacement doses
E) long-term therapy has been associated with increased bone resorption, especially in elderly men
on greater than replacement doses

32www.pharmaqz.com
Therapeutics
141) Symptoms of hypothyroidism include the following
A) tiredness,weight loss,depression,being sensitive to the cold,dry skin and hair and muscle aches
B) tiredness,weight gain,depression,being sensitive to the cold,dry skin and hair andmuscle aches
C) tiredness,weight gain,depression,being sensitive to the heat,dry skin and hair andmuscle aches
D) tiredness,weight gain,depression,being sensitive to the cold,oily skin and hair and muscle aches
E) tiredness,weight loss,depression,being sensitive to the heat,dry skin and hair and muscle aches
142) Levothyroxine adverse effects include the following
A) arrhythmias,cramps,constipation,nervousness,tachycardia,
Tremor
B) arrhythmias,cramps,diarrhea,nervousness,bradycardia,
Tremor
C) arrhythmias,cramps,diarrhea,depression,tachycardia,
Tremor
D) arrhythmias,cramps,diarrhea,nervousness,tachycardia,
Tremor
E) arrhythmias,cramps,constipation,nervousness,bradycardia,
Tremor
143) Graves disease treatment include the following
A) radioactive iodine is first-line therapy, especially in elderly patients, and it can be performed in an
outpatient setting.
B) radioactive iodine is first-line therapy, especially in younger patients, and it can not be performed
in an outpatient setting.
C) radioactive iodine is first-line therapy, especially in younger patients, and it can be performed in
an outpatient setting.
D) radioactive iodine is second-line therapy, especially in younger patients, and it can be performed
in an outpatient setting.
E) radioactive iodine is first-line therapy, especially in pregnant patients, and it can be performed in
an outpatient setting.
144) Chronic (congestive) heart failure symptoms include the following
A) symptoms ofdizziness,dyspnea (shortness of breath), chest pain, syncope(loss of consciousness),
B) symptoms of fatigue,dyspnea (shortness of breath), chest pain, syncope(loss of consciousness),
C) symptoms of fatigue,apnea (shortness of breath), chest pain, syncope(loss of consciousness),
D) symptoms of fatigue,dyspnea (shortness of breath), chest pain, ataxia(loss of consciousness),
E) symptoms of allergy,dyspnea (shortness of breath), chest pain, syncope(loss of consciousness),
145) Digitalis action include the following
A) act on the (h –k ) atpase and increasing contractility(positive inotropy) while decreasing heart rate
(negative chronotropy)
B) act on the (na –k ) atpase and decreasing contractility(positive inotropy) while decreasing heart
rate (negative chronotropy)
C) act on the (na –k ) atpase and increasing contractility(positive inotropy) while increasing heart
D) act on the (ca –k ) atpase and decreasing contractility(positive inotropy) while decreasing heart
E) act on the (na –k ) atpase and increasing contractility(positive inotropy) while decreasing heart
146) Digitalis characteristics include the following

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