3395 Krok-1 Pharmacology icon

3395 Krok-1 Pharmacology




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13. A patient with nephrotic diabetes insipidus is best treated with which of the following?

A. Ethacrynic acid.

B. Triamterene.

C. Furosemide.

D. Spironolactone.

*E. Hydrochlorthiazide.

14. A 50-year-old male with pitting oedema of the ankles develops gynecomastia and erectile dysfunction while being treated with which of the following agents?

A. Amilorode.

B. Furosemide.

S. Hydrochlorthiazide.

D. Triamterene.

*E. Spironolactone.

15. From the list of diuretic drugs choose the agent that is most useful for the treatment of acute pulmonary oedema:

A. Triamterene.

B. Hydrochlorthiazide.

C. Amiloride.

D. Spironolactone.

*E. Furosemide.

16. From the list of diuretic drugs choose the agent that is most useful for the treatment of acute hypercalcemia:

A. Triamterene.

B. Amiloride.

C. Furosemide.

D. Spironolactone.

*E. Hydrochlorthiazide.

17. From the list of diuretic drugs choose the agent that is most useful for the treatment of essential hypertension:

A. Triamterene.

B. Amiloride.

C. Furosemide.

D. Spironolactone.

*E. Hydrochlorthiazide.

18. The most widely used agent for the treatment of acute gouty arthritis is:

A. Phenylbutazone.

B. Allopurinol.

C. Probenecid.

D. Indomethacin.

*E. Colchicine.

19. The mechanism by which probenecid lowers plasma levels of uric acid is by:

A. Promoting tubular reabsorption of uric acid.

B. Inhibiting production of uric acid in the liver.

C. Promoting tubular secretion of uric acid.

D. Inhibiting breakdown of purines to uric acid.

*E. Inhibiting proximal tubular reabsorption of uric acid.

20. Allopurinol reduces serum urate levels by:

A. Promoting tubular reabsorption of uric acid.

B. Promoting the active secretion of uric acid in kidneys.

C. Impairing renal urate reabsorption.

D. Decreasing metabolism of uric acid.

*E. Inhibiting uric acid synthesis.

21. The solution of some drug was introduced to pregnant woman for prevention of premature delivery. This drug is also known as anticonvulsant, hypotensive, cholagogic, and laxative drug. Contraction of uterus and pain stopped, soothing effect occurred. What drug has been prescribed to woman?

A. Salbutamol.

B. Oxytocin.

C. Fenoterol.

D. Ergometrine maleate.

*E. Magnesium sulfate.

22. A patient with chronic cardiovascular insufficiency had signs of lungs oedema. What diuretic should be prescribed to the patient for the fast elimination of this condition?

A. Triamterene.

B. Spironactone.

C. Clopamide.

D. Diacarbum (acetazolamide).

*E. Furosemide.

23. The significant decrease of blood pressure has developed in patient in the result of diuretic overdose. Choose the group of hypertensive drugs which is preferable for using to this patient.

A. N-cholinomimetics.

B. Cardiac glycosides.

C. Analeptics.

D. Adrenomimetics.

*E. Plasma substitutes.

24. A patient with pulmonary oedema is delivered to resuscitation unit. What drug should be administered to patient for decreasing of blood pressure in small circle of circulation and for decreasing of circulating blood volume?

A. Acetylcysteine.

B. Unithiole.

C. Sulfacyl-sodium.

D. Metronidazole.

*E. Furosemide.

25. Ascites has developed in patient with cirrhosis. Indicate the drug which should be administered to him for excretion of humor from body.

A. Aminazine.

B. Potassium chloride.

C. Heparin.

D. Atropine sulfate.

*E. Furosemide.

26. Identify laxative drug which can be used for reflex increasing of uterus contractions in cases of insufficient labor activity.

A. Sustac.

B. Bisacodyl.

C. Magnesium sulfate.

D. Vaseline.

*E. Castor oil.

27. In spite of treatment with cardiotonics and thiazide diuretic a patient suffering from chronic cardiac failure still presents with edemata and faces a risk of ascites. What medication should be administered in order to increase the diuretic effect of the above mentioned drugs?

A. Manithol.

B. Amiloride.

C. Furosemide.

D. Clopamide.

*E. Spironolactone.


^ Drugs Influencing Erythro- and Leucopoesis


1. Methotrexate (structural analogue of the folic acid which is competitive inhibitor of the dihydrofolate reductase) is prescribed for treatment of the malignant tumour. On which level does me-thotrexate hinder synthesis of the nucleic acid?

A. Transcription.

B. Reparation.

C. Replication.

D. Processing.

*E. Mononucleotide synthesis.

2. A nucleophilic attack on deoxyribonucleic acid that causes disruption of base pairing occurs as a result of the administration of:

A. Mercaptopurine.

B. Methotrexate.

C. Prednisolone.

D. Filgrastim.

*E. Cyclophosphamide.

3. Which of the following is a chemotherapeutic drug that possesses a mechanism of action involving alkylation?

A. Vincristine.

B. Fercoven.

C. Methotrexate.

D. Pentoxylum.

*E. Myelosan.

4. Binding to the enzyme dihydrofolate reductase is the mechanism of action for:

A. Vincristine.

B. Cyclophosphamide.

C. Molgramostim.

D. Sodium phosphate with radioactive isotope of 32P.

*E. Methotrexate.

5. Which of the following is considered to be the effective mechanism of action of the vinca alkaloids?

A. Inhibition of purine synthesis.

B. Damage and prevention of DNA repair.

C. Inhibition of DNA synthesis.

D. Inhibition of protein synthesis.

*E. Inhibition of the microtubules function.

6. A 34-year-old male with Hodgkin’s disease is treated with combined chemotherapy with the use of vinblastine. What is the mechanism of this drug action?

A. Scission of DNA strands.

B. Inhibition of dihydrofolate reductase.

C. Inhibition of enzymes involved in purine metabolism.

D. Inhibiotion of topoisimerase.

*E. Prevention of assembly of tubulin dimers onto microtubules.

7. A 45-year-old male on combination therapy for remission-maintenance acute lymphocytic leukemia develops suprapubic pain, dysuria, and haematuria. Evidence of haemorrhage and inflammation is apparent on cystoscopy of the urinary bladder. Which of the
following agents most likely caused these findings?

A. Vincristine.

B. Methotrexate.

C. Mercaptopurine.

D. Doxorubicin.

*E. Cyclophosphamide.

8. Which vitamin can mask the symptoms of pernicious anaemia by alleviating the anaemia but not preventing the neurological da-mage?

A. Vitamin D.

B. Niacin.

C. Vitamin B12.

D. Vitamin C.

*E. Folic acid.

9. Neurotoxicity is rarely dose limiting in cancer chemotherapy. The only antineoplastic agent that has a dose-limiting neurotoxicity is:

A. Methotrexate.

B. Cisplatin.

C. Bleomycin.

D. Doxorubicin.

*E. Vincristine.

10. Which class of drugs binds avidly to tubulin and cause arrest of cells in metaphase?

A. Antimetabolites.

B. Nitrogen mustards.

C. Alkylating agents.

D. Antiestrogens.

*E. Vinca alkaloids.

11. After the examination of a 40-year-old man the diagnosis of hypochromic anaemia was made. What drug should be prescribed for this patient?

A. Vikasolum.

B. Cyanocobalamine.

C. Pentoxylum.

D. Heparin.

*E. Fercoven.

12. A pregnant woman’s blood analysis revealed megaloblasts and a high colour index. The diagnosis is megaloblastic anaemia. What drug should be prescribed to the patient?

A. Coamidum.

B. Pyridoxine hydrochloride.

C. Nicotinic acid.

D. Ascorbic acid.

*E. Cyanocobalamine.


^ Antiagregants, Anticoagulants, and Drugs

Affecting Fibrinolysis


1. A patient with thrombophlebitis is administered the complex therapy, which influences different stages of clot-forming. Which of the given substances contributes to the restoration of the vascular permeability?

A. Acetylsalicylic acid.

B. Dipyridamole.

C. Heparin.

D. Neodycumarinum.

*E. Fibrinolysin.

2. Some drug had been prescribed to the patient with thromboembolism of lower extremities veins. In 2 days haemorrhages appeared on his skin. What drug was prescribed to the patient?

A. Phenylinum.

B. Dipyrodamole.

C. Acetylsalicylic acid.

D. Neodicumarinum.

*E. Heparin.

3. An 8-year-old child is being prescribed for tonsilectomy. The analysis of blood has shown that the time of blood coagulation is increased (up to 7 minutes). What drug should be included (5 days before the operation) into the complex of therapeutic agents of the preparatory period first of all?

A. Etamsylate.

B. Sodium chloride.

C. Aminocapronic acid.

D. Fibrinogen.

*E. Vikasolum.

4. A doctor recommended to patient, who had an acute myocardial infarction, to take acetylsalicylic acid in the dose 0.25 g once per 2–3 days during 3–4 months. What effect did the doctor count on?

A. Vasodilative.

B. Anti-inflammatory.

C. Antipyretic.

D. Analgesic.

*E. Antiaggregant.

5. Acetylsalicylic acid (75 mg, daily) is prescribed to the patient, who had myocardial infarction. What is the purpose of this prescription?

A. Reduction of body temperature.

B. Reduction of inflammation.

C. Reduction of pain.

D. Dilation of coronary vessels.

*E. Reduction of thrombocytes aggregation.

6. Vicasolum is prescribed to patient during several days before planned surgery concerning an ulcer of stomach. What is the mechanism of vicasolum action?

A. Drug binds the calcium ions.

B. Drug decreases vessels permeability.

C. Drug oppresses fibrinolysis.

D. Drug oppresses aggregation of thrombocytes.

*E. Drug increases blood clotting in the result of increasing of prothrombin synthesis.

7. A patient with myocardial infarction is delivered to resuscitation unit. What drug should be administered to the patient for prevention of thrombi formation?

A. Dimedrole.

B. Chingaminum.

C. Thyroxine.

D. Biseptol-480.

*E. Heparin.

8. Patient with angina pectoris is treated with acetylsalicylic acid in daily dose 100 mg daily. What is the aim of therapy with acetylsalicylic acid in this case?

A. Decrease of cholesterol level.

B. Inhibition of blood clotting.

C. Dilation of coronary vessels.

D. Decrease of prothrombin level.

*E. Inhibition of platelet aggregation.


^ ANTIMICROBIAL, ANTIFUNGAL,

ANTIVIRAL, AND ANTIPROTOSOAL DRUGS


Antiseptics and Disinfectants


1. To prepare an operative field a doctor used dichlorinated biguanid derivative. It is the most active local antiseptic, that shows fast and strong bactericidal action on gram-negative and gram-positive bacteria. What drug is this?

A. Unithiole.

B. Brilliant green.

C. Furacilinum (nitrofural).

D. Phenasalum.

*E. Chloramine.

2. For the processing of the burn surface of the patient’s skin a specific drug was used. Its antiseptic properties are provided by free oxygen that reacts with organic substances. What drug is this?

A. Sodium hydrocarbonate.

B. Furacilinum.

C. Chlorhexidine bigluconate.

D. Boric acid.

*E. Potassium permanganate.

3. Profuse foam appeared when dentist put hydrogen peroxide on the mucous membrane of the oral cavity. What enzyme caused such activity?

A. Cholinesterase.

B. Methemoglobin reductase.

C. Glucose-6-phosphate dehydrogenase.

D. Acetyltransferase.

*E. Catalase.

4. A patient with mercury poisoning was admitted to the toxicological department from the chemical industry. What drug should be used?

A. Nalocone.

B. Enterosorbent.

C. Isonitrosine.

D. Activated carbon.

*E. Unithiole.

5. A patient with abscess of the cat wound applied to the traumatological department. The wound was washed with 3% hydrogen peroxide to be cleaned from the pus. Foam was not observed. What caused inefficiency of the drug?

A. Pus in the wound.

B. Shallow wound.

C. Low concentration of H2O2.

D. Inherited insufficiency of erythrocyte phosphate dehydrogenase.

*E. Inherited insufficiency of catalase.

6. A patient working at a chemical plant was admitted to the toxicological department with mercury poisoning. What medicine should be used?

A. Isonitrosine.

B. Enterosorbent.

C. Activated carbon.

D. Naloxone.

*E. Unithiole.

7. A 38-year-old man who poisoned himself with mercury dichloride was taken to the admission room in grave condition. What antidote should be immediately introduced?

A. Atropine.

B. Nalorphine.

C. Dipiroxime.

D. Isonitrosine.

*E. Unithiole.

8. A patient has applied to doctor with complaints of multiple purulent rashes on the skin of extremities. What antiseptic should be prescribed to him?

A. Heparin.

B. Insulin.

C. Prednisolone.

D. Sibazon.

*E. Alcoholic solution of iodine.


Antibiotics


1. A 19-year-old patient has primary syphilis. He gets a complex therapy. Benzylpenicillin sodium is a part of this therapy. What is the mechanism of this drug action?

A. Blockade of DNA synthesis.

B. Blockade of cytoplasm proteins synthesis.

C. Blockade of thiol enzyme groups.

D. Blockade of RNA synthesis.

*E. Blockade of microbe membrane peptidoglycane synthesis.

2. A 27-year-old woman has dropped penicillin containing eye drops. In few minutes there appeared feeling of itching, burning of skin, lips and eyelids oedema, whistling cough, decreasing of blood pressure. What antibodies take part in the development of this allergic reaction?

A. IgA and IgM.

B. IgG and IgD.

C. IgM and IgD.

D. IgM and IgG.

*E. IgE and IgG.

3. A patient was admitted to the infection unit with diagnosis of bacterial dysentery. On laboratory examinations it was revealed that causative element is sensitive to many antimicrobial medicines, but patient has anaemia. What drug is contraindicated to the patient?

A. Furazolidone.

B. Enteroseptol.

C. Ampicillin.

D. Phthalazol.

*E. Levomycetin.

4. A patient was admitted to the infection unit with diagnosis of bacterial dysentery. On laboratory studies it was revealed that causative element is sensitive to many antimicrobial medicines, but patient had anaemia. What medicine was contraindicated to the patient?

A. Phthalazol.

B. Enteroseptol.

C. Furazolidone.

D. Ampicillin.

*E. Levomycetinum (chloramphenicol).

5. A patient with pneumonia was treated with antibiotics for a long period. After treatment patient complains of frequent and watery stool, abdominal pain. What is the reason of intestine function disorder?

A. Bacteria toxins influence.

B. Antibiotic toxic influence on the GIT.

C. Hereditary enzyme defect.

D. Autoimmune reaction development.

*E. Intestinal disbacteriosis development.

6. A 60-year-old patient was admitted to the surgical department because of infection caused by blue pus bacillus (^ Pseudomonas aeruginosa) which is sensitive to penicillin antibiotics. Indicate which of the given penicillins has marked activity to the Pseudomonas aeruginoca?

A. Methacillin.

B. Benzylpenicillin.

C. Phenoxymethylpenicillin.

D. Oxacillin.

*E. Carbenicillin disodium.

7. A 50-year-old patient with typhoid fever was treated with levomycetin. The next day his condition became worse, temperature raised to 39.6 0C. What caused the worsening?

A. Allergic reaction.

B. Secondary infection addition.

C. Irresponsiveness of an agent to the levomycetin.

D. Reinfection.

*E. The effect of endotoxin agent.

8. Penicillin-induced epilepsy has developed in a 28-year-old patient in the result of antibiotic therapy. What drug can cause this complication?

A. Isoniazid.

B. Doxicicline.

C. Rifampicin.

D. Amoxicillin.

*E. Benzylpenicillin sodium.

9. Serious generalized septic infection menacing to life has developed in patient. What of the listed groups of chemotherapeutic agents should be used in this case?

A. Macrolides.

B. Tetracyclines.

C. Sulfonamides.

D. Laevomycetin.

*E. Cephalosporines.

10. Treatment course of bacterial pneumonia included benzylpenicillin sodium salt. What is the mechanism of its antimicrobial action?

A. Inhibition of the cholinesterase activity.

B. Antagonism with the paraaminobenzoic acid.

C. Inhibition of the intracellular protein synthesis.

D. Inhibition of the microorganisms enzymes SH-groups.

*E. Inhibition of cell wall synthesis of the microorganism.

11. A patient suffering from stomach ulcer has been treated with antacid drug almagel. For acute bronchitis treatment he was prescribed antibiotic methacicline. However, within the next 5 days the fever didn’t fall, cough and sputum nature remained unchanged. A physician came to the conclusion that the drugs were incompatible. What type of drug incompatibility is the case?

A. Direct antagonism.

B. Pharmaceutic.

C. Pharmacokinetic, biotransformation stage.

D. Pharmacodynamic.

*E. Pharmacokinetic, absorption stage.

12. As a result of durative antibiotic therapy a 37-year-old patient developed intestinal dysbacteriosis. What type of drugs should be used in order to normalize intestinal microflora?

A. Vitamins.

B. Sulfanilamides.

C. Bacteriophages.

D. Autovaccines.

*E. Eubiotics.

13. A doctor prescribed cephalosporin antibiotic to the patient after appendectomy for infection prevention. Antimicrobial activity of this group of antibiotics is based upon the disturbance of the following process:

A. Choline esterase block.

B. Ribosome protein synthesis.

C. Energy metabolism.

D. Nucleic acid synthesis.

*E. Microbial wall formation.


^ Sulfonamides. Synthetic Antimicrobial Drugs


1. Gonorrhoea was revealed in the patient on bacterioscopy of the smear from urethra. Taking into account that medicines for gonorrhea are fluorquinolones, patient should be prescribed:

A. Fluorouracil.

B. Urosulfanum.

C. Furasolidone.

D. Cefazolin.

*E. Ciprofloxacin.

2. A patient with pneumonia has intolerance to antibiotics. Which of the combined sulfanilamide drug should be prescribed to this patient?

A. Sulfacylum-natrium.

B. Streptocid.

C. Aethazol.

D. Sulfadimethoxine.

*E. Biseptol.

3. Relative granulocytopenia is observed in patient after course of treatment with sulfonamides. It is known that patient has tendency to allergies. Which immunologic process is the cause of granulo-cytopenia?

A. Increased activity of macrophages.

B. Decrease of immunologic tolerance.

C. Formation of immunologic complexes in blood.

D. Increased activity of killer lymphocytes.

*E. The lyses of leucocytes which are acquired from antigenic properties.
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