1.

A patient with a long history of cardiovascular disease develops worsening ventricular

arrhythmias. Which of the following drugs is most likely to be the cause of the arrhythmia?
(A) Quinidine (B) Propanolol (C) Dobutamine (D) Methyldopa
2. A patient is admitted into the emergency room and manifests ventricular tachycardia following an
acute myocardial infarction (MI). This arrhythmia is life-threatening and must be controlled immediately.
Which of the following drugs would be best to quickly control the condition?
(A) Dobutamine (B) Digitalis (C) Quinidine (D) Lidocaine (E) Atropine
3. A woman who is undergoing an endocrine work-up to diagnose the cause of a large multinodular goiter
develops atrial fibrillation. Which of the following would be best to treat this arrhythmia?
(A) Verapamil (B) Propranolol (C) Digitalis (D) Bretylium (E) Tocainide
4. A 57-year-old man with atrial flutter is initially treated with quinidine to control the arrhythmia. He is
released from the hospital, and while his condition improves, sporadic arrhythmias continue. Which of the
following drugs might be used as an adjunct to quinidine in the treatment of the atrial flutter?
(A) Digitalis (B) Lidocaine (C) Procainamide (D) Nifedipine (E) Propranolol
5. A 66-year-old man presents to your office with a 5-month history of dry cough. He denies any other
symptoms. His past medical history includes a recent myocardial infarction (MI), after which he was
placed on several medications. He does not smoke, nor has he had a history of asthma. You decide that a
medication side effect is the most likely cause of this patient's symptoms. Which medication might this
be?
(A) Lisinopril (B) Nitroglycerin (C) Lovastatin (D) Digoxin (E) Quinidine
6. Since the side effects of the medication you prescribed preclude the patient in the above scenario from
taking it (Lisinopril), you switch him to therapy with an agent that is said to produce similar mortality
benefits, while working via a slightly different mechanism of action. What agent is it?
(A) Furosemide (B) Captopril (C) Losartan (D) Esmolol (E) Ezetimibe
7. A 54-year-old woman is diagnosed with congestive heart failure (CHF). You prescribe captopril, a
medication proven to reduce her mortality. This agent delivers several benefits to patients with CHF.
Which of the following effects is caused by this drug?
(A) It has a high affinity for angiotensin II receptors (B) It promotes increased peripheral vascular
resistance (C) It decreases cardiac output and increases afterload (D) It causes venodilation and induces
natriuresis (E) It increases preload
8. A 76-year-old man has suffered from atrial fibrillation for many years. This condition has been under
good control with amiodarone and diltiazem until recently, when he started experiencing palpitations and
came back to see you. You decide to start the patient on digoxin therapy. How does this medication
work?
(A) It decreases intracellular sodium and increases intracellular potassium (B) It lowers intracellular
calcium (C) It decreases stroke volume and cardiac output (D) It diminishes elimination of sodium and
water (E) It increases vagal activity and decreases sympathetic tone
9. A 75-year-old woman, who is admitted for the management of her recent stroke, develops increased
blood pressure, up to 195/105, with a heart rate of 95. Her physi- cian is worried about the possibility of
cere- bral hemorrhage into the preexisting infarct and decides to administer a fast-acting vasodilating
agent, which is also commonly used for severe decompensated congestive heart failure (CHF). Which
medication did the doctor use?
(A) Nitroprusside (B) Furosemide (C) Dobutamine (D) Losartan (E) Digoxin
10. A female patient with a history of bronchospasm complains she felt some shortness of breath that was
accompanied with feeling of nausea when playing in a softball game. During her history, she admits that
she has felt like that before when walking up a few flights of stairs. You schedule a stress test and the
results confirm stable angina. Which of the following drugs would be the best choice for long-term
management of this patient?
(A) Nitroprusside (B) Sildenafil (C) Metolazone (D) amilodipine (E) Propranolol
11. Bioavailability of an agent is maximal when the drug has which of the following qualities?
A. Highly lipid soluble
B. More than 100 Daltons in molecular weight
C. Highly bound to plasma proteins
D. Highly ionized
12. Which of the following describes the first-pass effect?
A. Inactivation of a drug as a result of the gastric acids.
B. Absorption of a drug through the duodenum.
C. Drug given orally is metabolized by the liver before entering the circulation.
D. Drug given IV accumulates quickly in the central nervous system (CNS).
13. A 16-year-old teenager is going on his first deep sea fishing trip and is using a scopolamine patch to
ward off sea sickness. Which of the following is the most likely adverse effect he will experience?
A. Bradycardia
B. Drowsiness
C. Miosis
D. Urinary urgency
14. Which of the following actions of epinephrine are blocked by prazosin?
A. Bronchial dilation
B. Increased cardiac stroke volume
C. Increased heart rate
D. Mydriasis
15. Furosemide acts to inhibit Na+ reabsorption in which of the following locations?
A. Ascending limb of the loop of Henle
B. Collecting duct
C. Descending limb of the loop of Henle
D. Distal convoluted tubule
16. A 55-year-old man with congestive heart failure is noted to be taking furose- mide each day. Which of
the following is most likely to be found in the serum?
A. Decreased potassium level
B. Decreased uric acid level
C. Elevated magnesium level
D. Low bicarbonate level
17. A 26-year-old woman complains of the abrupt onset of her chest pounding. She is diagnosed with
paroxysmal atrial tachycardia. Which of the following is the most effective agent for converting
paroxysmal atrial tachycardia to normal sinus rhythm?
A. Adenosine
B. Atropine
C. Digoxin
D. Lidocaine
18. The therapeutic effect of haloperidol is mediated, at least in part, by its blockade of which of the
following receptors?
A. α-Adrenoceptors
B. Dopamine D2 receptors
C. Histamine H1 receptors
D. Muscarinic receptors
19. A 30-year-old man is being treated with isoniazid chemoprophylaxis for an exposure to TB. Which of
the following antidepressant agents inhibits hepatic microsomal enzymes to cause clinically significant
drug-drug interactions?
A. Fluoxetine
B. Imipramine
C. Phenelzine
D. Trazodone
20. A 22-year-old man is diagnosed with bipolar mood disorder and is started on lithium. The therapeutic
action of Li+ is thought to be caused by direct inhibi- tion of which of the following?
A. Inositol monophosphatase
B. Inositol trisphosphate (IP3)
C. Diacylglycerol (DAG)
D. Muscarinic cholinoreceptors
21. Carbamazepine used to manage seizures requires a significant dose adjustment with continuous
administration
(A) True
(B) False
22. Morphine is not metabolized to an active agent with analgesic activity?
(A) True
(B) False
23. QTc prolongation is a potentially fatal adverse effect associated with Methadone
(A) True
(B) False
24. Benzodiazepines bind to GABAA receptors to increase chloride influx and to decrease stimulation of
neurons by excitatory neurotransmitters.
(A) True
(B) False
25. Local anesthetic action is a result of blockade of the movement of Calcium ion channel?
(A) True
(B) False
26. An allergic reaction is most likely to occur with amide-type local anesthetics like procaine because of
the metabolic formation of the allergen, paraaminobenzoic acid
(A) True
(B) False
27. Alcohol is oxidized by Alcohol dehydrogenase
(A) True
(B) False
28.Cocaine is a drug of abuse that blocks the dopamine uptake transporter?
(A) True
(B) False
29. First-generation agents that cause sedation have been used as sleeping aids, and some have antiemetic
effects.
(A) True
(B) False
30. Sumatriptan, a 5-HT1D receptor agonist, inhibits the activity of adenylyl cyclase and decreases cAMP
accumulation that results in contraction of arterial smooth muscle, especially in carotid and cranial
circulation.
(A) True
(B) Fals