4th quiz exam 1425-2005.doc

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4th Quiz Examination
4th YEAR MEDICINE
DEPARTMENT OF PHARMACOLOGY
FACULTY OF MEDICINE – KAAU - ACADEMIC YEAR 1425/26 H
Saturday 24 – 1 – 1426 H / 5 – 3 – 2005G.
12.00 – 1.00 PM.
INSTRUCTIONS

1- WRITE YOUR NAME and fill in the COMPUTER SERIAL NUMBER on the computer
answer sheet .
2- Select the SINGLE BEST ANSWER for all of the following MCQ questions on the
answer sheet provided. PLEASE ANSWER ALL QUESTIONS, THERE IS NO
PENALTY FOR GUESSING.
3- Use a NUMBER 2 PENCIL and fill in the correct answer space COMPLETELY AND
DARK .
4- At the end of the test put your answer sheet inside this test booklet and turn it in .
NAME ( IN ENGLISH )
---------------------------------------------------------------------------------- NAME ( IN ARABIC )
----------------------------------------------------------------------------------- COMPUTER #
------------------------------------------------- Short Answers
MCQs ( 35)
SECTION I : MCQs (one mark each)

1- The anticancer drugs kill:
A. Certain number of the tumor cells. B. All the cells. C. Resting cells. D. Certain percentage of the cells. E. A + D.
2- Methotrexate is:
A. Cell-cycle non-specific anticancer drug. B. Cell-cycle specific anticancer drug. C. Alkylating agent. D. Topoisomerase inhibitor. E. Antibiotic anticancer drug.
3- Methotrexate acts by inhibition of:
A. Thymidylate synthetase. B. DNA polymerase. C. Dihydrofolate reductase. D. Inosine monophosphate dehydogenase. E. Adenyl succinase.
4- The main toxic effect of cyclophosphamide is:
A. Alopecia. B. Fever. C. Liver toxicity. D. Hypersensitivity. E. Hemorrhagic cystitis.
5- Iron chelators can be used as protective agents against:
A. Doxorubicin-induced cardiotoxicity. B. Mercaptopurine-induced bone marrow depression. C. Trastusumab-induced hypersensitivity. D. Methotrexate-induced hemorrhage. E. Vincristine-induced neurotoxicity.
6- 6-mercaptopurine (6-MP) acts by inhibition of:
A. Adenyl succinase. B. IMP dehydrogenase. C. Dihydrofolate reductase. D. Thymidylate synthetase. E. A+B.
7- Trastusumab is used in the treatment of metastatic breast cancer with:
A. High expression of HER2. B. Low expression of HER2. C. No expression of HER2. D. B + C . E. Others.
8- Vincristine is:
A. S-phase acting drug. B. M-phase arrester. C. G1-phase acting drug. D. G2-phase arrester. E. G0-phase arrester.
9- The main toxic effect of cisplatin is:
A. GIT bleeding. B. Liver toxicity. C. Nephrotoxicity. D. Cardiotoxicity. E. Hypersensetivity
10- The most effective drug for immunosuppression of rejection of allografted
kidney is:
A. Azathioprine. B. 5-FU. C. Cyclophosphamide, D. Cyclosporine. E. Vincristine.
11- Which of the following is NOT a CCS agent?
A. 6-MP. B. 5-FU. C. Busulfan. D. Vincristine. E. Ara-c.
12- Mycophenolate mofetil acts by:
A. Inhibition of IMP dehydrogenase. B. Inhibition of DHFR. C. Inhibition of topoisomerase I. D. Inhibition of topoisomerase II. E. Inhibition of DNA polymerase.
13- All of the following statements regarding penicillins and cephalosporins are
correct EXCEPT:
A. Peniciilin G has limited antibacterial activity and is susceptible to beta-lactamases. B. Ampicillin is the drug of choice for the treatment of Pseudomones aeruginosa infections. C. First-generation cephalosporins are more effective against staphylococcal infections than are third-generation cephalosporins. D. Methicillin is an antistaphylococcal penicillin. E. Ceftriaxone is a third-generation cephalosporin with a long-half life and has good penetration into bone.
14- Which of the following antibiotics is INCORRECTLY matched with an
appropriate clinical situation?
A. Ticarcillin : Urinary tract infection caused by Pseudomonas aeruginosa. B. Procaine penicillin G : Syphilis caused by Treponema pallidum. C. Ampicillin : Typhoid fever caused by Salmonella typhi. D. Penicillin G : Pneumonia caused by Klebsiella pneumoniae. E. Cefoxitin : Gynecological sepsis caused by Bacteroides fragilis.

15- The mechanism of antibacterial action of cephalosporins involves:
A. Inhibition of the synthesis of precursors of peptidoglycans. B. Interference with the synthesis of ergosterol. C. Inhibition of beta-latamases. D. Binding to cytoplasmic receptor proteins. E. Inhibition of transpeptidation reactions.
16- Which of the following statements about imipenem is most accurate?
A. The drug has narrow spectrum of antimicrobial action. B. It is used in fixed combination with sulbactam. C. Imipenem is highly susceptible to beta-lactamases produced by Enterobacter species. D. Imipenem is active against methicillin-resistant staphylococci (MRSA). E. In renal dysfunction, dosage reduction is necessary to avoid seizures.
17- In a patient with culture-positive enterococcal endocarditis who has failed to
respond to vancomycin because of resistance, the treatment most likely to be
effective is:
A. Clarithromycin. B. Minocycline. C. Gentamicin. D. Linezolid. E. Co-trimoxazole.
18- Tetracyclines would be least effective in treating which of the following
diseases?
A. Streptococcal infections. B. Rickettsia. C. Acne. D. Cholera E. Rocky Mountain spotted fever.
19- Which of the following statements about the clinical uses of aminoglycosides is
false?
A. Owing to their polar nature, aminoglycosides are not absorbed following oral administration. B. The spectrum of antimicrobial activity of aminoglycosides includes Bacteroides fragilis. C. Aminoglycosides are often used in combination with cephalosporins in the empiric treatment of life-threatening bacterial infections. D. Netilmycin is more likely to be effective than streptomycin in the treatment of a hospital-acquired infection caused by Serratia marcescens. E. Gentamicin is used with ampicillin for synergetic effects in the treatment of enterococcal endocarditis
20- The combination of trimethoprim and sulfamethoxazole is effective against
which of the following opportunistic infection in the AIDS patient?
A. Disseminated herpes simplex. B. Cryptococcal meningitis. C. Toxoplasmosis. D. Oral candidiasis. E. Tuberculosis.
21- A patient who has mild to moderate ulcerative colitis. The most appropriate drug
to use in the patient is:
A. Ciprofloxacin B. Ganciclovir. C. Metronidazole. D. Sulfasalazine. E. Trimethoprim-sulfamethoxazole.
22- It is now recommended that trovafloxacin be reserved for treatment of life-
threatening infections because:
A. Bacterial resistance to the drug is very common. B. Complete liver failure has occurred. C. It is very expensive. D. Its use is associated with torsade de piontes arrhythmia. E. Nephrotoxicity is dose limiting.
23- The primary reason for the use of drug combination in the treatment of T.B. is
to:
A. Ensure patient compliance with the drug regimen. B. Reduce the incidence of adverse effects. C. Delay or prevent emergence of resistance. D. Enhance activity against metabolically inactive mycobacteria. E. Provide prophylaxis against other bacterial infections.
24- Which of the following anti T.B. drugs is most likely to interfere with the action
of oral contraceptive drugs?
A. Ethambutol. B. Isoniazid. C. Pyrazinamide. D. Streptomycin. E. Rifampin.
25- Which of the following statements about fluconazole is most accurate?
A. It inhibits demethylation of lanosterol. B. It is highly effective in the treatment of aspergillosis. C. It does not penetrate the blood brain barrier. D. Its oral bioavailability is less than that of ketoconazole. E. It is a potent inducer of hepatic drug-metabolizing enzymes.
26- The dose-limiting toxicity of amphotericin B is:
A. Renal tubular acidosis. B. Myelosuppresion. C. Infusion-related adverse effects. D. Hypotension. E. Hepatitis.
27- Examples of antimicrobial drug synergism established at the clinical level do not
include:
A. Amphotericin B and flucytocine in cryptococcal meningitis. B. Penicillin and tetracyclines in bacterial meningitis. C. Carbenicillin and gentamicin in pseudomonal infections. D. Rifampin and vancomycin in enterococcal infections. E. Trimethoprim-sulfamethoxazole in coliform infections.
28- Metronidazole is LEAST likely to be effective in the treatment of:
A. Amebiasis. B. Infections resulting from Bacteroides fragilis. C. Pneumocystosis. D. Pseudomembranous colitis. E. Trichomoniasis.
29- All of the following drugs are active against nematodes. Which one causes
muscle paralysis by activating receptors for the inhibitory transmitter GABA?
A. Albendazole. B. Diethylcarbamazine. C. Mebendazole. D. Pyrantal pamoate. E. Ivermectin.
30- All of the following statements about antiviral drugs are correct EXCEPT:
A. The anti HIV drugs (NNRTIs) do not require metabolic activation. B. Didanosine (NRTI) used in HIV infection may cause pancreatitis. C. Interferon-α is used in the management of hepatitis B and C. D. Acyclovir is the treatment of choice for influenza infections. E. Zidovudine must be converted to the nucleotide form to express its antiviral activity.
31- Which of the following drugs is most likely to be effective in the treatment of
genital herpes?
A. Acyclovir. B. Amantadine. C. Foscarnet. D. Ritonavir. E. Zanamivir.
32- In which one of the following infections are the fluoroquinolones ineffective?
A. UTIs due to a β-lactamase-producing strain of klebsiella. B. Exacerbation of chronic bronchitis due to Moraxella catarrhalis. C. Urinary tract infections due to E.coli. D. Pneumonia due to Streptococcus pneumoniae. E. UTIs due to Pseudomonas aeruginosa.
33- All of the following statements regarding the macrolide antibiotics are correct
EXCEPT:
A. Erythromycin base is destroyed by gastric acidity and so is used in estrified forms. B. The oral absorption of clarithromycin may be enhanced by the presence of food. C. Azithromycin has less activity against H.influenzae and M. catarrhalis than erythromycin. D. Erythromycin does not readily penetrate the CSF. E. Erythromycin inhibits the hepatic metabolism of theophylline and warfarin.
34- Which of the following statements about amebicides is the most accurate?
A. Diloxanide furoate is a systemic amebicide. B. Metronidazole has little activity in the gut lumen. C. Emetine is the drug of choice for mixed infections. D. Paromomycin is effective in extraintestinal amebiasis. E. Diloxanide furoate is not absorbed to any extent when it is taken orally.
35- Regarding chemotherapy of trypanosomiasis, all of the following statements are
accurate EXCEPT:
A. Melarsoprol is used in the treatment of the late stages of trypanosomal infections with CNS involvement. B. Suramin is effective in the prophylaxis of African trypanosomiasis. C. Pentamidine is effective against Pneumocystis carinii. D. Nifurtimox is only effective in the treatment of acute T.cruzi infections. E. Pentamidine can penetrate CSF and is used against the meningoencephalitic stage of trypanosomiasis. SECTION II- SHORT ANSWERS

I- Comment on the followings:

A. Aspirin-Methotrexate interaction. ( 3 marks)

B. Cyclophosphamide-MESNA interaction. ( 3 marks)



II- Answer the following short questions:

A. Describe in brief the mechanism of action of chloroquine. ( 3 marks)
B. List three uses of chloroquine. ( 3 marks)
C. List three drugs that are used in the treatment of chloroquine-resistant malaria.
( 3 marks)
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