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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5648_Библиотеки_им_академика_М_И_Перельмана.pdf
342 Pharmaceutical Chemistry
299. Which organism causes the most dangerous form of malaria?
(a) Giardia lamblia (b) Plasmodium ovale
(c) Leishmania donovani (d) Plasmodium falciparum
300. The prolonged persistence of malarial parasite in man indicates that:
(a) Antibody produced during the previous attack was not destroyed.
(b) Trophozoites are found in the capillaries of internal organs.
(c) Malarial parasite has changed its surface antigens.
(d) The person has contracted recurrent infections.
301. The germ plasmodium was discovered by:
(a) Sir Ronals Ross (b) Golgi
(c) Charles Laveran (d) Patric Manson
302. The sexual cycle of plasmodium is completed in:
(a) RBC (b) The gut of mosquito
(c) Liver cells (d) Salivary gland of the mosquito
303. Malarial parasite is best obtained from a patient:
(a) An hour after rise of temperature.
(b) While temperature is rising sharply.
(c) After 24 hours when temperature is normal.
(d) After temperature becomes normal.
304. Which of the following is not a synthetic drug to cure malaria?
(a) Quinine (b) Paludrin
(c) Pamaquine (d) Plasmochin
305. Vaccination in malaria has not been successful because:
(a) Plasmodium produces antitoxins.
(b) Plasmodium produces minute bodies.
(c) It does not produce antibodies and antitoxins.
(d) None of the above
306. Quartan malaria is caused by:
(a) Plasmodium vivax (b) Plasmodium ovale
(c) Plasmodium malariae (d) Plasmodium falciparum
307. Which is the right time to obtain a good amount of malaria parasite from patients?
(a) At the time when the temperature becomes normal.
(b) At the time when temperature rises with shivering.
(c) Five hours after the temperature comes down to the normal.
(d) Just before the rise in temperature.
Multiple-Choice Questions and Answers 343
308. Malignant tertian malaria is caused by:
(a) Plasmodium vivax (b) Plasmodium ovale
(c) Plasmodium malariae (d) Plasmodium falciparum
309. Mild and weak malaria is caused by which one of the following?
(a) P. ovale (b) P. vivax
(c) P. falciparum (d) P. malariae
310. Why does only female anopheles mosquito cause malaria?
(a) Because females are evolutionarily designed to be cruel.
(b) Because females need blood from vertebral host to nourish eggs.
(c) Males find it difficult to suck blood.
(d) Blood is the only diet for female mosquitoes.
311. Which of the following 4- amino quinoline is used for malaria as well as in rheumatoid
arthritis and causes reversible retinal damage?
(a) Chloroquine (b) Pyrimethamine
(c) Mefloquine (d) Amodiaquine
312. Which of the following can be used in pregnancy to treat malaria?
(a) Quinine (b) Primaquine
(c) Chloroquine (d) Pyrimethamine
313. In patients suffering with malaria, shivering occurs at the time of:
(a) Schizonts on reticulocytes.
(b) Entry of schizonts in the RBC.
(c) Release of merozoites that form RBCs with toxins.
314. How do antibacterial drugs like doxycycline and sulphadoxine work against
protozoal plasmodium parasite?
(a) Mechanism unknown (b) By affecting apicoplast enzymes
(c) By peroxide formation (d) None of these
315. The duration of erythrocytic cycle of malaria is:
(a) 24 hours (b) 48 hours
(c) 72 hours (d) Variable
316. Malaria parasite is:
(a) Digenetic (b) Monogenetic
(c) Polygenetic (d) None
317. Which of the following drugs is not used for chemoprophylaxis of malaria?
(a) Chloroquine (b) Artesunate
(c) Proguanil (d) Mefloquine
344 Pharmaceutical Chemistry
318. If malaria is not treated, outcomes could include:
(a) Death (b) Anemia
(c) Heart failure (d) Both (a) and (b)
319. Inside mosquitoes, plasmodium reproduces:
(a) Sexually (b) Asexually
(c) Unisexually (d) Bisexually
320. Which of the following drug acts on the exo-erythrocytic stage in the life cycle of
malaria parasite?
(a) Primaquine (b) Mepacrine
(c) Paludrine (d) Chloroquine
321. Larvae breathe through:
(a) Feeding brushes (b) Pair of air floats
(c) Pair of spiracles (d) Pair of gills
322. The antimalarial drug having a gametocidal effect is:
(a) Mefloquine (b) Primaquine
(c) Doxycycline (d) Sulfonamides
323. The gametocytes in the life cycle of malarial parasite are formed in:
(a) Stomach of female anopheles
(b) Stomach of male anopheles
(c) Blood of man
(d) Salivary gland of anopheles
324. The antimalarial drug which is tissue schizonticidal is:
(a) Mefloquine (b) Chloroquine
(c) Quinidine (d) Primaquine
325. In the cycle of malarial parasites, micro-gametes and macro-gametes are formed in:
(a) Liver of man
(b) Salivary gland of female Anopheles
(c) RBC of man
(d) Gut of female Anopheles
326. The group of antibiotics having an antimalarial effect is:
(a) Aminoglycosides (b) Tetracyclins
(c) Carbapenems (d) Penicillins
327. Which of these phases of malarial parasite is the target for prophylactic treatment?
(a) Pre-erythrocytic phase in liver (b) Erythrocytic phase
(c) Exo-erythrocytic phase (d) Any of the above
Multiple-Choice Questions and Answers 345
328. In the clinical diagnosis of malaria, which of the following stain(s) is/are used?
(a) Giemsa stain (b) Wright stain
(c) Gram’s stain (d) Both (a) & (b)
329. Which of the following enzyme deficiency should be ruled out before starting
Primaquine therapy?
(a) G6PD (Glucose 6 phosphate dehydrogenase)
(b) Lysosomal enzymes
(c) Pancreatic lipase
(d) Pancreatic amylase
330. In infections with the malarial parasites, lysolecithin is secreted to destroy infected
RBCs. Which one of the following secretes it?
(a) Spleen (b) Plasmodium
(c) WBC (d) Liver
331. Antimalarials which is/are dihydrofolate reductase inhibitors are:
(a) Chloroquine (b) Chloroguanide
(c) Trimethoprim (d) (a) and (c)
332. Cinchonism side effect is seen with which of the following antimalarial drugs?
(a) Quinine (b) Chloroquine
(c) Primaquine (d) Mefloquine
333. Quinine which is used for malaria treatment is extracted from:
(a) Cinchona (b) Cinnamon
(c) Coriander (d) Quircus
334. The most common side effect of quinine is:
(a) Deafness (b) Come
(c) Headache (d) Respiratory depression
335. Which form of quinine is used as an antimalarial drug?
(a) Levo (b) Dextro
(c) Meso (d) Both (a) and (b)
336. Passage of dark urine is a side effect of which antimalarial drug?
(a) Pyrimethamine (b) Primaquine
(c) Proguanil (d) Both (b) and (c)
337. Artemisinin is:
(a) Monoterpene (b) Sesquiterpene
(c) Diterpene (d) None
338. Which derivative of artimisinin is soluble in water?
(a) Artemether (b) Artesunate
(c) Both (d) None
346 Pharmaceutical Chemistry
339. Eradication of P. vivax infection is best accomplished using:
(a) At least one month treatment with chloroquine.
(b) At least two weeks treatment with chloroquine.
(c) Adopting a wait and see policy and treating recurrent attacks vigorously with
quinin or chloroquin or atovaquone/proguanil.
(d) Using primaquine alone or in combination with chloroquin.
340. Quinolone resistance is becoming an important consideration in treating diarrhoea
due to:
(a) Isospora belli (b) Cyclospora belli
(c) Cryptosporidium parvum (d) Campylobacter jejuni
341. Trimethoprim-sulfamethoxazole (TMP-SMX, co-trimoxazole) is an excellent treatment
for diarrhoea due to:
(a) Recurrent amoebiasis (b) Cryptosporidium parvum
(c) Non-cholera vibrio (d) Cyclospora cayetanesis
342. Erythromycin is very useful in treating:
(a) Legionnaires disease (b) Shigella
(c) S. Typhi (d) Myiasis
343. Which of these drugs is the latest addition to the list fo antimalarials?
(a) Mepacrine (b) Primaquine
(c) Artemisinin (d) Pyrimethamine
344. Artemisinin group of drugs attack which phase of malarial parasite life cycle in
humans?
(a) Pre-erythrocytic phase (In liver) (b) Erthrocytic phase
(c) Exo-erythrocytic phase (d) All of the above
345. According to WHO recommendations, if artesunate is given for less than seven days,
treatment should be followed by a therapeutic dose of:
(a) Mefloquine (b) Pyrimethamine
(c) Chloroquine (d) Quinine
346. Artesunate can be given in combination with:
(a) Mefloquine (b) Chloroquine
(c) Sulfadoxine-Pyrimethamine (d) All of the above
347. Which one of the following antimalarial drugs is a blood schizonticide against all
four types of malarial parasites, is gametocidal against all forms except Plasmodium
falciparum and is also used for suppressive prophylaxis but is not active against liver
stage malarial parasites?
(a) Artemether (b) Chloroquine
(c) Mefloquine (d) Primaquine
Multiple-Choice Questions and Answers 347
348. Loading dose of chloroquine is required because it:
(a) Has high tissue binding (b) Has high lipid solubility
(c) Is rapidly excreated by the kidneys (d) Has more entry into infected RBCs
349. Artemisinin is a derivative of Chinese herbal medicine. All are true, except:
(a) Rapidly acting blood schizonticide against all human plasmodium.
(b) Least toxic among all antimalarial drugs.
(c) An alternative to primaquine as gametocidal.
(d) Metabolized to dihydroartimisinin, an active metabolite.
350. WHO has approved which of the following regimens for multidrug resistant P.
falciparum?
(a) Artemether plus halofantrine
(b) Artemether plus mefloquine
(c) Artemether plus amodiaquine
(d) Artemether plus sulfadoxine plus pyrimethamine
351. The travellers visiting areas endemic for chloroquin resistant malaria are
recommended to have prophylactic treatment. A cost effective, safe and excellent
result treatment is
(a) Quinine (b) Mefloquine
(c) Artesunate (d) Pyrimethamine
352. The following drug given concurrently can enhance toxicity of digoxin:
(a) Metoclopramide (b) Quinidine
(c) Magnesium hydroxide (d) Phenobarbitone
353. The mechanism of action of cyclosporine involves:
(a) Activation of calcineurin.
(b) Binding to cyclophilin to cause inhibition of a cytoplasmic phosphatase.
(c) Blockade of interleukin-2 receptors.
(d) Inhibition of phospholipase A2.
354. Which one of the following drugs predictably prolongs the PR interval and increases
cardiac contractility?
(a) Digoxin (b) Propranolol
(c) Quinidine (d) Verapamil
355. Dopamine is useful in the treatment of cardiogenic shock because it: (a) selectively
dilates renal and mesenteric vascular beds, (b) does not induce peripheral
vasoconstriction, and (c) decreases the force of myocardial contraction.
(a) (a) (b) (c)
(c) (a) & (b) (d) (a), (b) & (c)
348 Pharmaceutical Chemistry
356. A 54-year-old woman with severe hypercholesterolemia is to be treated with a
combination of niacin and atorvastatin. With this drug combination, it is important
that the patient is monitored closely for signs of:
(a) Gallstones (b) Lactic acidosis
(c) Myopathy (d) Thyrotoxicosis
357. Regarding verapamil, which one of the following statements is false?
(a) Angina pectoris is an important indication for the use of verapamil.
(b) Contraindicated in the asthmatic patient.
(c) Relaxes vascular smooth muscle.
(d) Used in the management of supraventricular tachycardias.
358. Advantage of Salbutamol over other bronchodilators is:
(a) Long acting (b) More potent
(c) Less side effect (d) Fast acting
359. All of the following statements regarding Verapamil are true, except:
(a) It increases heart rate.
(b) It blocks L-type Ca-channels.
(c) It depresses cardiac contractility.
(d) It relaxes coronary artery smooth muscle.
360. Which drug has E-adrenergic blocking activity?
(a) Lidocaine (b) Sotalol
(c) Flecainide (d) Verapamil
361. Which drug is contraindicated in patients with moderate to severe heart failure?
(a) Verapamil (b) Nifedipine
(c) Both (a) and (b) (d) None of the above
362. A Class IC antiarrhythmic drug is :
(a) Lidocaine (b) Flecainide
(c) Sotalol (d) Verapamil
363. A Class II antiarrhythmic drug is:
(a) Lidocaine (b) Flecainide
(c) Propranolol (d) Verapamil
364. A Class II antiarrhythmic drug is:
(a) Lidocaine (b) Flecainide
(c) Sotalol (d) Verapamil
365. A Class IV antiarrhythmic drug is:
(a) Lidocaine (b) Flecainide
(c) Sotalol (d) Verapamil
Multiple-Choice Questions and Answers 349
366. A Class IV antiarrhythmic drug is:
(a) Quinidine (b) Propranolol
(c) Sotalol (d) Verapamil
367. Digoxin (Lanoxin, Lanoxicaps) is useful in treating high ventricular rates in patients
with arterial fibrillation because:
(a) Digoxin (Lanoxin, Lanoxicaps) increases cardiac contractility.
(b) Digoxin (Lanoxin, Lanoxicaps) slows conduction through the AV node,
therefore it reduces heart rate.
(c) Digoxin (Lanoxin, Lanoxicaps) is a good drug for stopping arterial fibrillation.
(d) Digoxin (Lanoxin, Lanoxicaps) is metabolized in the liver.
368. In a normal foetus shortly before birth, which of the following vessel(s) or heart
chamber would contain the most highly oxygenated blood?
(a) Pulmonary trunk (b) Right ventricle of the heart
(c) Common carotid arteries (d) Ductus arteriosus
369. Congenital heart disease most frequently results from:
(a) Mutant genes
(b) Rubella virus
(c) Genetic and environmental factors
(d) Foetal distress
370. In membranous VSD there is a shunting of blood:
(a) From the left ventricle to the right ventricle.
(b) From the left atrium to the right atrium.
(c) From the left ventricle to the left atrium.
(d) From the left ventricle to the right atrium.
371. A glycone is essential for:
(a) Half-life (b) Metabolism
(c) Plasma protein binding (d) Cardiotonic action
372. Sugar molecule in the structure of glycosides influences:
(a) Toxic properties (b) Cardiotonic action
(c) Pharmacokinetic properties (d) All of the above
373. Classical angina pain has the following characteristics, except:
(a) Associated with vomiting.
(b) The pain is of strangulating nature.
(c) May radiate to the left arm, chin or epigastrium.
(d) Often occurs with exercise, emotional stress or during meals and is relieved with
rest.
350 Pharmaceutical Chemistry
374. Stroke volume is:
(a) Heart rate × End systolic volume
(b) Heart rate × End diastolic volume
(c) End-diastolic volume -End systolic volume
(d) End-systolic volume - End diastolic volume
375. Which of the following cardiovascular agents is classified chemically as a glycoside?
(a) Nifedipine (b) Digoxin
(c) Cholestyramine (d) Warfarin
376. Mary has a family history of heart disease and wonders if garlic would be beneficial
to her. Which of the following statements is correct about garlic?
(a) Enteric-coated tablets release their contents in the stomach.
(b) Side effects include heartburn, flatulence, and sweating.
(c) The safety of garlic in pregnancy is unknown.
(d) Garlic does not interact with warfarin.
377. Increased serum levels of which of the following may be associated with a decreased
risk of atherosclerosis?
(a) Very low-density lipoproteins (VLDL)
(b) Low-density lipoproteins (LDL)
(c) Intermediate–density lipoproteins (IDL)
(d) High-density lipoproteins (HDL)
378. After being counselled about lifestyle and dietary changes, the patient was started
on atorvastatin. During his treatment with atorvastatin, it is important to routinely
monitor serum concentrations of
(a) Blood urea nitrogen (BUN) (b) Platelets
(c) Red blood cells (d) Uric acid
379. Which one of the following drugs increases digoxin plasma concentration by a
pharmacokinetic mechanism?
(a) Captopril (b) Hydrochlorothiazide
(c) Quinidine (d) Sulfasalazine
380. A hypertensive patient has been using nifedipine for some time without untoward
effects. If he experiences a rapidly developing enhancement of the antihypertensive
effect of the drug, it is probably due to
(a) Concomitant use of antacids
(b) Foods containing tyramine
(c) Grapefruit juice
(d) Induction of drug metabolism
381. A drug lacking vasodilator properties that is useful in angina is:
(a) Isosorbide dinitrate (b) Metoprolol
(c) Nitroglycerin (d) Verapamil
Multiple-Choice Questions and Answers 351
382. The following drug is used to reduce the frequency of angina pectoris as well as to
terminate an acute attack:
(a) Digoxin (b) Furosemide
(c) Enalapril (d) Amrinone
383. The action of digitalis is enhanced by:
(a) Sodium (b) Calcium
(c) Magnesium (d) Potassium
384. Aldosterone release is stimulated by:
(a) Angiotensin I (b) Angiotensin
(c) Angiotensin III (d) Both (b) and (c)
385. Which of the following drugs is used in the treatment of male impotence and
activates prostaglandin E1 receptors?
(a) Alprostadil (b) Fluoxetine
(c) Mifepristone (d) Sildenafil
386. Antianginal drugs afford the following benefit/benefits:
(a) Terminate anginal attacks.
(b) Decrease the frequency of anginal attacks.
(c) Retard the progression of coronary artery disease.
(d) Both (a) & (b)
387. Overuse of digitalis may result in:
(a) Cummulative poisoning (b) Tolerance
(c) Addiction (d) Physical dependence
388. A treatment of angina that consistently decreases the heart rate and can prevent
vasospastic angina attacks is:
(a) Isosorbide dinitrate (b) Verapamil
(c) Nitroglycerin (d) Propranolol
389. In a patient receiving digoxin for congestive heart failure, condition that may
facilitate the appearance of toxicity include:
(a) Hyperkalemia (b) Hypernatremia
(c) Hypocalcemia (d) Hypomagnesemia
390. Exertion–induced angina, which is relieved by rest, nitroglycerin, or both, is referred
to as:
(a) Prinzmetal’s angina (b) Unstable angina
(c) Classic angina (d) Variant angina
391. The oral absorption of .................... is negligible.
(a) Glycerin (b) Mannitol
(c) Isosorbide (d) All of the above