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Ethylmorphine
It is closely related to codeine which is methylmorphine,
and has antitussive, respiratory depressant properties
Extensive asthma—episode due to change in season
Intrinsic asthma-perennial, status asthmaticus is
common. It takes place whole year.
Nonopioid antitussives
Noscapine (narcotine): an opium alkaloid of the
benzoisoquinoline series, which depresses cough but has
no narcotic, analgesic or dependence inducing properties.
It is nearly equipotent antitussive as codeine, especially
useful in spasmodic cough. Headache and nausea occur
occasionally as side effect. It can release histamine and
produce bronchoconstriction in asthmatic patient.
Dextromethorphan
A synthetic central MDA (N-methyl D-aspartate)
receptor antagonist; the d-isomer has antitussive action
while/-isomer is analgesic. Dextromethorphan does
not depress mucociliary function of the airway mucosa
and is practically devoid of constipating action. Though
considered nonaddicting, some drug abusers indulge in it.
Antihistamines
Many H1 antihistamines have been conventionally added
to antitussive/expectorant formulations. They afford
relief in cough due to their sedative and anticholinergic
actions, but lack selectivity for the cough centre. They have
no expectorant property, may even reduce secretions by
anticholinergic action. They have been specially promoted
for cough in respiratory allergic states, though their lack
of efficacy in asthma is legendary.
Chlorpheniramine (2–5 mg), Diphenhydramine (15–25
mg) and Promethazine (15–25 mg; PIIENERGA 5 mg/5 ml
cli-. or) are commonly used. Second generation antihistamines like fexofenadine, loratadine, etc. are ineffective.
Bronchial asthma
It is characterized by hyperresponsiveness of tracheabronchial smooth muscles to a variety of stimuli resulting
in narrowing of air tubes often accompanied by increased
secretion mucosal, edema and mucous plugging.
Classification
1. Bronchodilators
2. Mast Cell Stabilizer
3. Corticosteroids
Bronchodilators:
Sympathomimetic: Adrenalin, Epinephrine, Salbutamol,
Terbutaline.
Methylxanthines: Theophyailline, Aminophylline.
Anticholinergic: Atropine, Ipratropium Bromide
Mast cell stabilizer
Sodium chromoglycolate.
Corticosteroid
Systemic: Hydrocortisone, Prednisolon.
Inhalation: Beclomethasone, Triamcinolone Fluticasone.
Treatment
1. Mild episodic asthma -only inhaled beta-2 agonist
2. Seasonal—regular inhaled cromoglycolate/inhaled
steroid 3–4 week before attack and continue three to
four weeks till season.
3. Moderate asthma—regular inhaled cromoglycolate or
inhaled steroid or oral beta-2 agonist or theophylline.
4. Severe—regular steroid + beta-2 agonist 3-4 times/day
oral theophylline or beta-2 agonise and steroid.
Status asthmaticus/ refractory asthma
a. Hydrocortisone—100 milligrams intravenous state
b. Nebulised—Salbutamol + Ipratropium
c. Oxygen inhalation
d. Treat chest injection, correct dehydration and acidosis
e. Salbutamol intramuscular
MULTIPLE CHOICE QUESTIONS
1. What is the generic name of Ventolin?
A. Fluticasone B. Salbutamol
C. Zafirlukast D. Epinephrine
2. Apnea stands for:
A. Slow breathing
B. Deep or rapid breathing
C. Respiration stops (heart failure)
D. Labored, or difficulty breathing
3. What is the upper respiratory composed of?
A. Bronchial tree, lungs, nasal cavities
B. Trachea, bronchial tubes, bronchial tree
C. Pharynx, larynx, trachea
D. Pharynx, larynx, nasal cavities, nose
4. Which of the following ingredients has neither
specic antitussive nor expectorant bronchodilator
action, but is commonly present in proprietary
cough formulations:
A.
Levalbuterol
B. Chlorpheniramine
C. Nedocromil
D. All
5. What is tachypnea?
A. Rapid breathing
B. Slow breathing
C. Labored or difficulty breathing
D. Deep and rapid breathing
6. What one is not a type of COPD?
A. Bronchitis B. Asthma
C. Emphysema D. Bronchiectasis
Section 1 Pharmacology
59
7. Select from the following mechanism of action of
methylxanthines at cellular/molecular level:
A.
Intracellular release of Ca2+
B. Antagonism of adenosine
C. Phosphodiesterase breakdown
D. All of the above
8. The following expectorant acts both directly on
the airway mucosa as well as reexly:
A.
Potassium iodide B. Guaiphenesin
C. Terpin hydrate D. Bromhexine
9. Which of the following is not found in the upper
respiratory tract?
A.
Oropharynx B. Palatine tonsils
C. Fauses D. trachea
10. The respiratory tract is lined with:
A. Simple squamous epithelium
B. Pseudostratified ciliated columnar epithelium
C. Stratified cuboidal epithelium
D. Simple ciliated columnar epithelium
11. Which of the following is a short acting leukotriene
synthesis (5-lipoxygenase) inhibitor?
A.
Zileuton B. Zafirlukast
C. Montelukast D. Omalizumab
12. The following is true about theophyline except
A. Adenosine receptor agonist
B. Causes tachycardia, bitterness and git
irritation
C. Used for long term control of asthma(e)
D. All of the above statements are true
13. A patient is taking some kind of RNA synthesis
inhibitor for the treatment ofamycobacterium
infection. They return back to the clinic extremely
worriedabout recent events. They claim their urine,
saliva, sweat, tears and feces are reddish orange in
color. What drug is the patient likely taking?
A.
Cycloserine B. Ethambutol
C. Rifampin D. Streptomycine
14. Which of the following is the first branching
of the bronchial tree that has gas exchanging
capabilities?
A.
Terminal bronchioles.
B. Respiratory bronchioles.
C. Alveoli
D. Segmental bronchi
15. Which of the following does not a part of
inspiration?
A.
The ribs move upward.
B. The diaphragm lifts up.
C. Increased anteroposterior dimensions of the
chest
D. The transverse dimensions of the thorax are
increased
Section 1 Pharmacology
16. What is the brand name for acetylcysteine?
60
A. Alupent B. Sudafed
C. Etibi D. Mucomyst
17. Bromhexine acts by:
A. Inhibiting cough centre
B. Irritating gastric mucosa and reflexly increasing
bronchial secretion
C. Depolymerizing mucopolysaccharides present
in sputum.
D. Desensitizing stretch receptors in the lungs
18. The following antiasthma drug is not a
bronchodilator:
A.
Ipratropium bromide
B. Theophylline
C. Formoterol
D. Sodium cromoglycate
19. Which of the following statements are false?
A. The larynx is also called the voicebox
B. The respiratory tract is also referred to as the
bronchial tree
C. Respiratory disease never reduces the ability to
speak in complete sentences
D. The cricoid cartilage is a major landmark for a
tracheotomy
20. How many lobes are there in the left lung?
A. 1 B. 2
C. 3 D. 4
21. Dextromethorphan is an:
A. Analgesic B. Antitussive
C. Expectorant D. Antihistaminic
22. Which of the following is not an antitussive?
A. Oxeladin
B. Clophedianol
C. Dextropropoxyphene
D. Dextromethorphan
23. All the following drugs destroy disulde bonds
of proteoglycans, which causes depolymerization
and reduction of viscosity of sputum, except:
A.
Acetylcysteine B. Ambroxol
C. Desoxiribonuclease D. Bromhexin
24. Select the correct statement about salmeterol:
A. It is a long acting selective β2 agonist bronchodilator
B. It is a bronchodilator with anti-inflammatory
property
C. It is a β blocker that can be safely given to
asthmatics
D. It is an antihistaminic with mast cell stabilizing
property
25. How much mucus is produced each day, on
average?
A.
125 ml B. 250 ml
C. 500 ml D. 175 ml
26. Bronchodilators are useful in cough:
A. Only when cough is nonproductive
B. Only when cough is associated with thick sticky
secretions
C. Only when reflex bronchoconstriction is
associated
D. Irrespective of nature of cough or associated
features
27. Which class of drugs are usefull in treatment of
bronchial asthma:
A.
Histamine H1 receptor antagonists
A. Platelet activating factor (PAF) antagonists
B. Leukotriene (cys LT1) receptor antagonists
C. All of the above
28. Select the fastest acting inhaled bronchodilator:
A. Ipratropium bromide
B. Formoterol
C. Salbutamol
D. Salmeterol
29. The exchanging of gases for the purpose of
producing energy is called _____.
A.
Breathing B. Respiration
C. Circulation D. Responsiveness
30. Select the incorrect statement about function of
the lungs?
A.
Metabolism
B. Serves as a reservoir of blood for the left
ventricle.
C. Facilitates the exchange of O2 and CO2 between
air and blood.
D. All of the above are true
31. Which of the following is not part of respiration?
A. Internal ventilation
B. External respiration
C. Pulmonary ventilation
D. Transport of gasesTop of Form
32. Anatomy is a term, which means the study of
_____.
A.
Physiology
B. Morphology
C. Cell function
D. Human functions
33. Which of the following terms describes the body's
ability to maintain its normal state? Anabolism
A.
Catabolism B. Tolerance
C. Homeostasis D. Metabolism
34. Following drugs directly activate the respiratory
center except:
A.
Bemegride B. Caffeine
C. Aethymizole D. Cytiton
35. In a patient of bronchial asthma, inhaled
salbutamol produces the following effect(s):
A.
Suppress antigen-antibody reaction in the lungs
B. Produces bronchodilatation
C. Reduces bronchial hyperreactivity
D. Both ‘B’ and ‘C’ are correct
36. Which of the following β2 agonist bronchodilators
is given by inhalation, and is suitable for both
terminating asthma attacks as well as for twice
daily prophylaxis:
A.
Terbutaline B. Bambuterol
C. Salmeterol D. Formoterol
37. Relatively higher dose of theophylline is required
to attain therapeutic plasma concentration in:
Smokers
A.
B. Congestive heart failure patients
C. Those receiving erythromycin
D. Those receiving cimetidine
38. Caffeine is more powerful than theophylline in
exerting the following action:
Bronchodilatation
A.
B. Cardiac stimulation
C. Diuresis
D. Augmentation of skeletal muscl contractility
39. Tick the drug which is a 5-lipoxygenase inhibitor:
A. Budesonide B. Sodium cromoglycate
C. Zileutin D. Beclometazone
40. Each of the following mature cells has a nucleus
except:
Lymphocyte B. Monocyte
A.
C. Erythrocyte D. Basophil
41. Which of the following is exible connective tissue
that is attached to bones at the joints? Adipose
Cartilage B. Epithelial
A.
C. Muscle D. Nerve
42. Most inspired particles such as dust fail to reach
the lungs because of the ________.
Ciliated mucous lining in the nose
A.
B. Abundant blood supply to nasal mucosa
C. Porous structure of turbinate bones
D. Action of the epiglottis
43. Which of the disorders below is characterized by
destruction of the walls of the alveoli producing
abnormally large air spaces that remain lled with
air during exhalation?
Pneumonia B. Tuberculosis
A.
C. Emphysema D. Coryza
44. Each of the following is located in the mediastinum
except the:
Aorta B. Heart
A.
C. Pancreas D. Trachea
45. Which of the following closes and seals off the
lower airway during swallowing?
Alveoli B. Epiglottis
A.
C. Larynx D. Uvula
46. Which of the following drugs is proteolytic
enzyme?
Potassium iodide B. Desoxiribonuclease
A.
C. Carbocysteine D. Acetylcysteine
47. Choose the correct statement about theophylline:
A. Its use in asthma has declined because of narrow
safety margin
B. Its dose needs to be reduced in smokers
C. It acts by increasing the formation of cAMP
D. Its plasma half-life is longer in children com-
pared to that in adults
Section 1 Pharmacology
61
48. Mucokinetic is a drug which:
A. Reduces airway mucus secretion
B. Increases airway mucus secretion
C. Makes respiratory secretions more watery
D. Stimulates mucociliary activity of bronchial
epithelium
49. The following antitussive is present in opium but
has no analgesic or addicting properties:
A.
Noscapine B. Codeine
C. Pholcodeine D. Ethylmorphine
50. Which of these groups of drugs is used for asthma
treatment?
A.
Methylxanthines
B. M-cholinoblocking agents
C. Beta-2 stimulants
D. All of the above
51. Antitussives act by:
A. Liquifying bronchial secretions
B. Raising the threshold of cough centre
C. Reducing cough inducing impulses from the
lungs
D. Both ‘B’ and ‘C’ are correct
52. The mechanism of Cytiton action is:
A. Direct activation of the respiratory center
B. The reflex mechanism
C. The mixed mechanism
D. None of the above
53. The respiratory membrane is a constituted from
________.
A.
Respiratory bronchioles and alveolar ducts
B. Alveolar and capillary walls and their fused
basement membranes
C. Atria and alveolar sacs
D. Respiratory bronchioles and alveolar sacs
54. ________ is responsible to hold the lungs into the
thorax wall.
A.
The intercostal muscles of the lung
B. The diaphragm
C. The visceral pleurae of the lungs
D. Surface tension from pleural fluid and negative
pressure in the pleural cavity
55. Tick out the drug belonging to non-narcotic
antitussives:
A.
Libexine
B. Tusuprex
C. Codeine
D. Aethylmorphine hydrochloride
56. Which of the following is located beneath the
diaphragm in the right upper quadrant of the
Section 1 Pharmacology
62
abdominal cavity?
Kidney B. Liver
A.
C. Spleen D. Stomach
57. Which of the following cavities are separated by
the diaphragm?
Abdominal and pelvic
A.
B. Cranial and spinal
C. Pericardial and pleural
D. Thoracic and abdominal
58. Indicate the expectorant with the reex mechanism:
A. Sodium benzoate
B. Derivatives of Ipecacucnha and Thermopsis
C. Trypsin
D. Ambroxol
59. Tick the antitussive agent with a peripheral effect:
A. Codeine
B. Tusuprex
C. Libexine
D. Glaucine hydrochloride
60. All of these drugs contain free sulfhydryl groups
except:
Acetylcysteine B. Ambroxol
A.
C. Bromhexin D. Trypsin
61. Constitution of air we breathe?
A. 23% oxygen, 77% nitrogen, 0.5% carbon dioxide
B. 21% nitrogen, 79% oxygen and 0.5% carbon
dioxide
C. 21% carbon dioxide, 79% oxygen and 0.5%
nitrogen
D. 21% oxygen, 79% nitrogen and 0.5% carbon
dioxide
62. Patients with which of the following diseases are
treated with injections of vitamin B12?
Bell's palsy B. Crohn's disease
A.
C. Graves' disease D. Pernicious anemia
63. Factors that influence the rate and depth of
breathing include ________.
Thalamic control
A.
B. Voluntary cortical control
C. Stretch receptors in the alveoli
D. Composition of alveolar ai
64. Which of the following provide the greatest
surface area for gas exchange?
Alveolar sacs
A.
B. Alveoli
C. Respiratory bronchioles
D. Alveolar ducts
65. What is symport?
A. Counter transport
B. Contransport
C. Carrier mediated diffusion
D. Solvent drug
66. Tick the drug belonging to non-selective beta2-
adrenomimics:
Salbutamol B. Isoprenaline
A.
C. Salmeterol D. Terbutaline
67. The smooth muscle stimulating action of 5-HT is
most marked in the:
A.
Bronchi B. Intestines
C. Ureter D. Billary tract
68. Pick out the bronchodilator drug related to
xanthine:
A.
Atropine B. Orciprenaline
C. Adrenaline D. Theophylline
69. All of the following statements about β- adrenergic
agonists used to treat asthma are correct except:
A.
Inhaled β-agonists used in clinical practice are
selective for β receptors at usual doses, but
become less selective at escalating doses
B. Inhaled β-agonists are functional antagonists
of constriction and result in relaxation of the
airway smooth muscle regardless of mechanism
of constriction
C. Repeated exposure to inhaled β-agonists results
in up-regulation of the β receptors which allows
for decreased doses over time
D. Long acting β-agonists are not used for acute
symptoms and are not intended as first-line
therapy for worsening asthma
E.
Long acting β-agonists are effective in controlling
night-time symptoms and exercise-induced
symptom
70. Select the side-effect characteristic for nonselective beta2-adrenomimics:
A.
Depression of the breathing centre
B. Tachycardia
C. Peripheral vasoconstriction
D. Dry mouth
71. Inhaled salbutamol is useful in bronchial asthma for:
A. Aborting/terminating asthma attacks
B. Round the clock prophylaxis of asthma
C. Status asthmaticus
D. All of the above
72. Unlike inspiration, expiration is a passive act
because no muscular contractions are involved.
Expiration, however, depends on two factors.
Which of the choices below lists those two factors?
A.
The recoil of elastic fibers that were stretched
during inspiration and the inward pull of
surface tension due to the film of alveolar
fluid
B. The expansion of respiratory muscles that were
contracted during inspiration and the lack of
surface tension on the alveolar wall
C. The negative feedback of expansion fibers used
during inspiration and the outward pull of
surface tension due to surfactant
D. Combined amount of CO2 in the blood and air
in the alveoli
73. If therapy with multiple drugs causes induction of
drug metabolism in your asthma patient, it will:
A.
Result in increased smooth endoplasmic
reticulum
B. Result in increased rough endoplasmic
reticulum
C. Result in decreased enzymes in the soluble
cytoplasmic fraction
D. Require 3–4 months to reach completion
74. Indicate the side effect of theophylline:
A. Bradycardia
B. Increased myocardial demands for oxygen
C. Depression of respiratory centre
D. Elevation of the arterial blood pressure
75. Acute exacerbations of asthma can be triggered by
all of the following except:
A.
Bacterial of viral pneumonia
B. Hypertsensitivity reaction to penicillin
C. Discontinuation of asthma medication
D. Hot, dry weather
76. A drug useful in the treatment of asthma but
lacking bronchodilator action, is:
A.
Cromolyn B. Ephedrine
C. Isoproterenol D. Metaproterenol
77. Calcium, potassium, and sodium are classied as
which of the following?
A.
Androgens B. Catecholamines
C. Electrolytes D. Prostaglandins
78. In the lungs, gas exchange occurs in tiny one-celled
air sacs called
A.
Alveoli B. Bronchi
C. Bronchioles D. Pleurae
79. Exhaled air, when compared with inhaled air,
contains more:
A.
Carbon dioxide and less oxygen
B. Nitrogen and less carbon dioxide
C. Oxygen and less carbon dioxide
D. Oxygen and less nitrogen
80. Budesonide is a:
A. Nonsteroidal anti-inflammatory drug
B. High ceiling diuretic
C. Inhaled corticosteroid for asthma
D. Contraceptive
81. Choose the drug belonging to membrane
estabilizing agents:
A.
Zileutin B. Sodium cromoglycate
C. Zafirlucast D. Montelucast
82. Indicate the drug which is a leucotriene receptor
antagonist:
A.
Sodium cromoglycate
B. Zafirlucast
C. Zileutin
D. Triamcinolone
83. Pick out the bronchodilator drug belonging to
sympathomimics:
A.
Isoprenaline B. Ephedrine
C. Atropine D. Salbutamol
84. How is the bulk of carbon dioxide carried in
blood?
A.
Chemically combined with the amino acids of
hemoglobin as carbaminohemoglobin in the red
blood cells
Section 1 Pharmacology
63
B. As the bicarbonate ion in the plasma after first
entering the red blood cells
C. As carbonic acid in the plasma
D. Chemically combined with the heme portion of
hemoglobin
85. Which of the following is not found on the right
lobe of the lung?
Middle lobe B. Cardiac notch
A.
C. Horizontal fissure D. Oblique fissure
86. Which of the following will result fromblockade
of H2 receptors?
A. Decreased camp in cardiac muscle
B. Increased camp in cardiac muscle
C. Decreased IP3 in gastric mucosa
D. Increased IP3 in smooth muscle
87. Which of the following is most useful in the
treatment of hyperprolactinemia?
A.
Bromocriptine B. Cimetidine
C. Ergotamine D. Ketanserin
88. Which of the following is a nonselective butvery
potent and efcacious bronchodilator that is not
active by the oral route?
Aminophyline B. Cromolyn
A.
C. Epinephrine D. Ipratropium
89. Oxygenated blood is carried to the heart by the:
A. Aorta
B. Carotid arteries C. Inferior vena cava
D. Pulmonary veins E. Superior vena cava
90. The point at which an impulse is transmitted
from one neuron to another neuron is called the
Dendrite:
A. Glial cell B. Nerve center
C. Synapse D. Terminal plate
91. Which of the following is a direct bronchodilator
that is most often used in asthma by the oral route?
A. Aminophyline B. Cromolyn
C. Epinephrine D. Ipratropium
92. Which of the following has overdosetoxicity that
includes insomnia, arrhythmias,and convulsions?
A. Aminophylline B. Cromolyn
C. Epinephrine D. Ipratropium
93. The National Institutes of Health (NIH) guidelines
for the treatment of asthma recommended
institution of routine inhaled corticosteroids when
patients are classied as having greater than or
equal to which type of asthma?
A. Mild intermittent B. Mild persistent
C. Moderate persistent D. Severe persistent
94. Bacteria that make either a fermentative or
respiratory set of enzymes are known as
A. Obligate anaerobes B. Obligate aerobes
C. Microacerophiles D. Facultative organisms
95. The symptoms of allergen-mediated asthma is
Section 1 Pharmacology
64
produced due to:
Increased release of mediators from mast cells
A.
B. Increased adrenergic responsiveness of the
respiratory tract
C. Enhanced vascular permeability of bronchial
tissue
D. Decreased calcium influx into the mast cells
96. The intensity of a person's voice depends on the
________.
Thickness of vestibular folds
A.
B. Length of the vocal folds
C. Strength of the intrinsic laryngeal muscles
D. Force with which air rushes across the vocal
folds
97. The alveolar walls are composed of type I and type
II cells. The junction of type II cell is to:
Release surfactant
A.
B. Trap dust particles
C. Production of mucus in the alveoli
D. Protection the alveoli from foreign in vaders
98. Complete the following statement using the
choices below. Air moves out of the lungs when
the pressure inside the lungs is:
Less than the pressure in the atmosphere.
A.
B. Greater than the pressure in the atmosphere.
C. Equal to the pressure in the atmosphere.
D. Greater than the intra-alveolar pressure
99. Which of the following M-cholinoblocking agents
is used especially as an anti-asthmatic?
Atropine B. Ipratropium
A.
C. Platiphylline D. Metacin
100. The symptoms of allergen-mediated asthma result
from which of the following?
Increased release of mediators from mastcells
A.
B. Increased adrenergic responsiveness of
theairways
C. Increased vascular permeability of bronchial
tissue
D. Decreased prostaglandin production
101. In the emergency department, the preferred rst-
line therapy for asthma exacerbation is:
Theophyline B. A corticosteroid
A.
C. Cromolyn sodium D. An antihistamine
102. Which of the following is used especially as a mast
cell stabiliser?
Atropine
A.
B. Sodium chromoglycolate
C. Platiphylline
D. Metacin
103. Which of the following maintains the patency
(openness) of the trachea?
Surface tension of water
A.
B. Surfactant
C. Cartilage rings
D. Pseudostratified ciliated epithelium
104. The relationship between the pressure and volume
of gases is given by ________.
Boyle's law B. Henry's law
A.
C. Charles' law D. Dalton's law
105. The statement, "in a mixture of gases, the total
pressure is the sum of the individual partial
pressures of gases in the mixture" paraphrases
________.
A. Henry's law B. Boyle's law
C. Dalton's law D. Charles' law
106. Which of the following tests is used at hometo
assess therapy and determine if a patient with
asthma should seek emergency care?
A. Forced expiratory volume in one second(FEV1)
B. Forced vital capacity (FVC)
C. Total lung capacity (TLC)
D. Peak expiratory flow rate (PEFR)
107. Which one of the following drugs is most suitable
for management of essential tremor in a patient
who has pulmonary disease?
A. Diazepam B. Levodopa
C. Metoprolol D. Propranolol
108. Indicate the drug belonging to antitussives of
narcotic type of action:
A. Glaucine hydrochloride
B. Aethylmorphine hydrochloride
C. Tusuprex
D. Libexine
109. Terbutaline has a preference for stimulation of
which of the following receptors?
A. Alpha B. Gamma
C. Beta 1 D. Beta 2
110. Fall in blood pressure caused by largerdoses of
histamine is blocked by:
A. H1 antihistaminics alone
B. H2 antagonist alone
C. Combination of H1 and H2 antagonists
D. None of the above
111. Choose the correct statement about bambuterol:
A. It is an orally acting bronchodilator
B. It is a prodrug
C. It inhibits the enzyme pseudocholinesterase
D. All of the above
112. In a patient of bronchial asthma, inhaled
salbutamol produces the following effect(s).
A. Inhibits antigen-antibody reaction in the lungs
B. Causes bronchodilatation
C. Reduces bronchial hyperreactivity
D. Both B and C
113. The capacity of an antihistaminic to produce
sedation depends on the following except
A. Relative affinity for central versus peripheralH1
receptors
B. Ability to penetrate blood-brain barrier
C. Individual susceptibility
D. Ratio of H1: H2 blockade produced by the drug
114. In patients of bronchial asthma inhaled
corticosteroids achieve the following except:
A. Reduce the need for bronchodilator medication
B. Control an attack of refractory asthma
C. Reduce bronchial hyperreactivity
D. Reverse diminished responsiveness to
sympathomimetic bronchodilators
115. Which of the following is a selective H1 receptor
agoinist?
A. 4-methyl histamine
B. Impromidine
C. 2-Thiazolyl ethylamine
D. Mepyramine
116. While prescribing the conventional H1
antihistaminics the patient should be advised to
avoid:
A. Driving motor vehicles
B. Consuming processed cheese
C. Strenuous physical exertion
D. All of the above
117. All of the following drugs are inhaled
glucocorticoids except:
A. Triamcinolone
B. Beclometazone
C. Sodium cromoglycate
D. Budesonide
118. Tachyphylaxis to many actions on repeated
injection is a feature of the following autacoid:
A. Histamine B. 5-Hydroxytryptamine
C. Bradykinin D. Angiotensin
119. Choose the drug belonging to membran
estabilizing agents:
A. Zileutin B. Sodium cromoglycate
C. Zafirlucast D. Montelucast
120. Bromhexine acts by:
A. Inhibiting cough center
B. Irritating gastric mucosa and reflexly increasing
bronchial secretion
C. Depolymerizing mucopolysaccharides present
D. Desensitizing stretch receptors in the lungs
121. The primary goals of asthma therapyinclude all
of the following except:
A. Maintain normal activity levels
B. Avoid adverse effects of asthma medications
C. Prevent acute exacerbations and
chronicsymptoms
D. Prevent destruction of lung tissue
122. The action of 5-Hydroxy tryptamine mediated by
the 5-HT3 receptor is:
A. Vasoconstriction B. Bradycardia
C. EDRF release D. Platelet aggregation
123. Bronchodilators are useful in cough:
A. Only when cough is non-productive
B. Only when cough is associated with thick sticky
secretions
C. Only when reflex bronchoconstriction
isassociated
D. Irrespective of nature of cough or associated
features
65
Section 1 Pharmacology
124. The antiasthma drug which cannot be administered
by inhalation is:
Theophylline B. Ipratropium bromide
A.
C. Budesonide D. Terbutaline
125. Surfactant helps to prevent the alveoli from
collapsing by ________.
Humidifying the air before it enters
A.
B. Warming the air before it enters
C. Interfering with the cohesiveness of water
molecules, thereby reducing the surface
tension of alveolar uid
D. Protecting the surface of alveoli from
dehydration and other environmental variations
126. For gas exchange to be efcient, the respiratory
membrane must be ________.
At least 3 micrometers thick
A.
B. 0.5 to 1 micrometer thick
C. Between 5 and 6 micrometers thick
D. The thickness of the respiratory membrane is
not important in the efficiency of gas exchange
127. 4 The 5-HT antagonist that has antihypertensive
property is:
Methysergide B. Cyproheptadine
A.
C. Ketanserin D. Ondansetron
128. Histamine is involved as a mediator in the
following pathological condition:
Cocaine B. Dibucaine
A.
C. Lidocaine D. Procaine
129. In an asthma patient treated with systemic
corticosteroids, bronchodilator drugs:
Are not needed
A.
B. Are contraindicated
C. May be used on ‘as and when required’ basis
D. Are ineffective
130. Which of the following drugs is neither
bronchodilator nor anti-inammatory, but has
antihistaminic and mast cell stabilizing activity?
Sodium cromoglycate
A.
B. Ketotifen
C. Beclomethasone dipropionate
D. Mepyramine maleate
131. Antitussives act by:
A. Liquifying bronchial secretions
B. Raising the threshold of cough centre
C. Reducing cough inducing impulses from the
Lungs
D. Both B and C
132. To be a useful inhaled glucocorticoid the drug
should have:
High oral bioavailability
A.
B. Low oral bioavailability
C. Additional bronchodilator activity
Section 1 Pharmacology
133. The most powerful respiratory stimulus for
66
D. Prodrug character
breathing in a healthy person is ________.
A.
Loss of oxygen in tissues
B. Increase of carbon dioxide
C. pH (acidosis)
D. pH (alkalosis)
134. In the plasma, the quantity of oxygen in solution
is ________.
Only about 1.5% of the oxygen carried in
A.
dissolved form
B. About equal to the oxygen combined with
hemoglobin
C. Greater than the oxygen combined with
hemoglobin
D. Not present except where it is combined with
carrier molecules
135. Chronic bronchitis is characterized by:
I. The destruction of central and peripheral
portions of the acinus
II. An increased number of mucous glands and
goblet cells
III. Edema and inflammation of the bronchioles
A. Only I is correct
B. Only III is correct
C. I and II are correct
D. II and III are correct
136. A 10-year-old child suffers from exercise induced
asthma: Which is the most suitable rst line drug
for regular prophylactic therapy?
Oral salbutamol
A.
B. Oral theophylline
C. Inhaled sodium cromoglycate
D. Inhaled beclomethasone dipropionate
137. Smooth muscle relaxation is due to space
stimulation of which type of histamine receptors:
H1 B. H2
A.
C. H3 D. All of the above
138. The most prominent and dose related side effect
of salbutamol is:
Rise in blood pressure
A.
B. Muscle tremor
C. Hyperglycaemia
D. Central nervous system stimulation
139. Following drugs directly activate the respiratory
center except:
Bemegride B. Caffeine
A.
C. Aethymizole D. Cytiton
140. The mechanism of Cytiton action is:
A. Indirect activation of the excretory center
B. The reflex mechanism
C. The produrg mechanism
D. None of the above
141. Which of the following statements is incorrect?
A. During fetal life, lungs are filled with fluid
B. Respiratory rate is lowest in newborn infants
C. Descent of the diaphragm results in abdominal
breathing
D. The chest wall becomes more rigid with
age
142. Which of the following is not an event necessary
to supply the body with O2 and dispose ofCO2?
Pulmonary ventilation
A.
B. Internal respiration
C. Blood pH adjustment
D. External respiration
143. Indicate the drug belonging to antitussives of
narcotic type of action:
Aethylmorphine hydrochloride
A.
B. Glaucine hydrochloride
C. Tusuprex
D. Libexine
144. Tick out the drug belonging to non-narcotic
antitussives:
Libexine
A.
B. Codeine
C. Tusuprex
D. Aethylmorphine hydrochloride
145. Indicate the expectorant with the reex mechanism:
A. Sodium benzoate
B. Trypsin
C. Derivatives of Ipecacuanha and Thermopsis
D. Ambroxol
146. Select the correct statement about the pharynx:
A. The pharyngeal tonsil is located in the
laryngopharynx.
B. The auditory tube drains into the nasopharynx.
C. The laryngopharynx blends posteriorly into the
nasopharynx.
D. The palatine tonsils are embedded in the lateral
walls of the nasopharynx.
147. Which respiratory-associated muscles would
contract if you were to blow up a balloon?
Internal intercostals and abdominal muscles
A.
would contract
B. Diaphragm would contract, external intercostals
would relax
C. External intercostals would contract and
diaphragm would relax
D. Diaphragm contracts, internal intercostals
would relax
148. Which xanthine derivative has no function in
asthma?
Theophylline B. Pentoxyphyllin
A.
C. Enprofylin D. None of the above
149. Tick the antitussive agent with a peripheral effect:
A. Codeine
B. Tusuprex
C. Libexine
D. Glaucine hydrochloride
150. Which of the following is not true of the respiratory
tract from the medium bronchi to the alveoli?
Cartilage gradually decreases and disappears
A.
at the bronchioles.
B. Resistance to air flow increases due to the
increase in cross-sectional diameter.
C. Proportionally, smooth muscle decreases
uniformly.
D. Lining of the tube’s changes from ciliated
columnar to simple squamous epithelium in
the alveoli.
151. Tidal volume is quantity of air ________.
A. Left in the lungs after forced expiration
B. Inhaled after normal inspiration procedure
C. Exchanged during normal breathing
D. Forcibly expelled after normal expiration
152. Which of the following drugs is proteolytic
enzyme?
Desoxiribonuclease B. Potassium iodide
A.
C. Carbocysteine D. Acetylcysteine
153. All the following drugs destroy disulde bonds
of proteoglycans, which causes depolymerization
and reduction ofviscosity of sputum, except:
Acetylcysteine B. Ambroxol
A.
C. Desoxiribonuclease D. Bromhexin
154. Which of the choices below determines the
direction of respiratory gas movement?
Solubility in water
A.
B. Partial pressure gradient
C. The temperature
D. Molecular weight and size of the gas molecule
155. The lung volume that represents the total volume
of exchangeable air is the ________.
Vital capacity
A.
B. Tidal volume
C. Inspiratory capacity
D. Expiratory reserve volume
156. Which of these groups of drugs is used for asthma
treatment?
Methylxanthines
A.
B. M-cholinoblocking agents
C. β2 - stimulants
D. All of the above
157. Tick the drug belonging to non-selective beta2-
adrenomimics:
Salbutamol B. Salmeterol
A.
C. Isoprenaline D. Terbutaline
158. Select the side-effect characteristic for nonselective beta2-adrenomimics:
Tachycardi
A.
B. Depression of the breathing centre
C. Peripheral vasoconstriction
D. Dry mouth
159. In fetal life, the lungs are lled with uid choose
the correct statement?
Respiratory exchanges are made via ductus
A.
arteriosus
B. Respiratory exchanges are not required in fetal
life
C. Respiratory exchanges are made via placenta
D. None of the above
Section 1 Pharmacology
67
160. Respiratory control centers are in the ________.
A. Midbrain and medulla
B. Medulla and pons
C. Pons and midbrain
D. Upper spinal cord and medulla
161. Pick out the bronchodilator drug related to
xanthine:
Atropine B. Orciprenaline
A.
C. Adrenaline D. Theophylline
162. Pick out the bronchodilator drug belonging to
sympathomimics:
Ephedrine B. Isoprenaline
A.
C. Atropine D. Salbutamol
163. Which of the following is not a stimulus for
breathing?
Rising carbon dioxide levels
A.
B. Rising blood pressure
C. Arterial PO2 below 60 mm Hg
D. Arterial pH resulting from CO2 retention
164. The amount of air that can be inspired above the
tidal volume is called ________.
Reserve air B. Expiratory reserve
A.
C. Inspiratory reserve D. Vital capacity
165. The mechanism of methylxanthines action is:
A. Inhibition of the enzyme phosphodiesterase
B. β2-adrenoreceptor stimulation
C. Inhibition of the production of inflammatory
cytokines
D. Inhibition of M-cholinoreceptors
166. All the following are employed in inhalation
therapy of asthma except:
A.
Beclomethasone B. Budesonide
C. Dexamethasone D. Triamcinolone
167. Which statement about CO2 is incorrect?
A.
Its concentration in the blood is decreased by
hyperventilation.
B. Its accumulation in the blood is associated with
a decrease in pH.
C. More CO2 dissolves in the blood plasma than
is carried in the RBCs.
D. CO2 concentrations are greater in venous blood
than arterial blood
168. Oxygen and carbon dioxide are exchanged in
the lungs and through all cell membranes by:
________.
A.
Osmosis B. Diffusion
C. Filtration D. Active transport
169. Indicate the side effect of theophylline:
A. Bradycardia
B. Increased myocardial demands for oxygen
C. Depression of respiratory centre
D. Elevation of the arterial blood pressure
ANSWER KEY
1. B 2. C 3. D 4. B 5. A 6. D 7. A 8. D 9. D 10. B 11. A 12. D 13. C 14. B
15. B 16. D 17. C 18. D 19. C 20. B 21. B 22. C 23. C 24. A 25. A 26. C 27. B 28. C
29. B 30. D 31. A 32. B 33. C 34. D 35. B 36. D 37. A 38. D 39. C 40. C 41. A 42. A
43. B 44. C 45. B 46. B 47. A 48. C 49. A 50. D 51. D 52. B 53. B 54. D 55. B 56. B
57. D 58. B 59. C 60. D 61. D 62. D 63. B 64. B 65. B 66. B 67. B 68. D 69. C 70. B
71. A 72. A 73. A 74. B 75. D 76. A 77. C 78. A 79. A 80. C 81. B 82. B 83. B 84. B
85. B 86. A 87. A 88. C 89. D 90. C 91. A 92. A 93. B 94. D 95. A 96. D 97. A 98. B
99. B 100. A 101. A 102. B 103. C 104. A 105. C 106. D 107. C 108. B 109. D 110. C 111. D 112. B
113. D 114. B 115. C 116. A 117. C 118. B 119. B 120. C 121. D 122. B 123. C 124. A 125. C 126. B
127. C 128. B 129. C 130. B 131. D 132. B 133. B 134. A 135. C 136. C 137. B 138. B 139. C 140. B
141. B 142. C 143. A 144. C 145. C 146. D 147. A 148. B 149. C 150. B 151. C 152. A 153. C 154. B
155. D 156. D 157. A 158. A 159. C 160. B 161. D 162. A 163. B 164. C 165. A 166. C 167. C 168. B
169. B
Section 1 Pharmacology
68