THERABy FINALLY LEVEL 5 THE LAST LEVEl E&E

Dr Mona
Complete , Scentific term :-
1 ) It's a type of emesis which is considered as a conditioned response
occurs when patient sights, smells, sounds
2) for moderately emetogenic regimens, prophylaxis with antiemetic
regimen must be given for ........ Days
3) cytotoxic drug cause hand foot syndrome
4) if the cancer patient treated by liplumumab check point inhibitor drs
must avoid use...
5) Eps is main adverse effect of .....and can be mitigated by....
6) lorazepam induce .... Which prevents anticipatory emesis
7) ……….is more common in patients on R- CHOP receving aprepitant
8) MOA of cannabinoids ....,..... Used for.... emesis
9) they are 2 metabolic adverse effects of olanzepine...,...
10) black box warning for olanzepine in older adults...
11) dexa can be used with aprepitant with 12mg on first day then complete
regimen in day 2,3by …....mg
12) dexa can be used with olanzepine in olanzepine containing regimens
with 12 mg in 1st day then complete regimen in day 2,3 with dose ...mg
12) in case of opioid naive patients experiencing severe pain.... should be
rapidly titrated
13) on opioid analgesic effective in patient with neuropathic pain ....and
that's due to its action on .... receptor
14) on opioid analgesic it's transdermal formulation give little or no action
in cachetic patient....
15) NSAIDS are CI in patients with...
16) alternative for morphine use in patients with renal disorders..
17) muscarinic blockers are used for mangement of nausea and vomiting
related to morphine...
18) d2 blockers can be used for mangement of nausea and vomiting caused
by morphine...
19) postmenopausal women with breast cancer has normal x ray and bone
scan she receive bisphosphonate , zolderinic a 4mg every ..... Month
20) main irreversible adverse event of bisphosphonate usually follows
adental or dental disorders....
21) bisphosphonate theraby should continue until the patient asubstanatial
decline in performance status meaning the patient has ………. in score
22) anti depressant used as adjuvant analgesic for neuropathic pain
(phantom limp pain(
23) …………Useful in pain caused by nerve compression or inflammation
bone pain or elevated ICP
24).... Adjuvant analgesic used for refractory muscles spasms
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25) Radionuclide used for bone pain caused by osteoplastic lesions

26) Note bisphosphonate, denozumab for osteolytic lesions while strantium
89 for osteoplastic lesions
27) ………is considered the most common dose limiting toxicity related to
cytotoxic chemotherapy
28) example for drugs that are non myeleosuppressive
29) 3 anticancer agents their second cycle given after 1.5-2 months (6/8)
weeks to ensure complete recovery of neutrophils
30) a patient's WBC 4500cells /mm3 segmented neutrophils 10 % band
neutrophils 5% what is the ANC
31) csf given 1-3 days after chemotherapy except... Given on the same day
of chemotherapy
32) short courses of adaily csf preferred to one dose of pegfilgrastim with...
33) dosage reduction is the first option instead of CSF after an episode of
neutropenia for..
34)……… Is the csf not approved for ttt of established neutropenia
35) ……….is the first line for muscle spasms in cancer patient
36) ESAs should be used only in……. cancer
37) MOA of dexrazoxane as chemoprotactant… ……...
38) total cumulative dose of mitoxantrone which is life time dosage any
addition of new dose cause cardio toxicity (lethal effect(
39) dose of Doxorubicin in relation to dose of dexrazoxane
40) dexrazoxane increase….... Toxicity of chemotherapy at dose>750mg
41) amifostine decrease the incidence of…... in patients with head and neck
cancer who are undergoing fractionated radiation therapy
42) amifostine used to prevent nephrotoxicity of… ……
43) to prevent nephrotoxicity of cisplatin the best clinical intervention is…
…..
44) ……..and ....... Are the most clinical significant toxicity of amifostine so
it's not often used
45) mesna prevent hemorrhagic cystitis of cyclophosphamide by binding
to..... metabolite
46) mesna must begin ....or..... Ifosfamide or cyclophosphamide and end
………...... Ifosfamide or cyclophosphamide
47) if patient dose of ifosfamide 1.2gm/m2 the dose of iv mesna will be
(…….-……..)mg/m2
44 ) toxic dose of MTX is greater than………..
49) folinic acid used to rescue normal cell from MTX toxicity
50) Leucovorin improve anticancer effect of……. in colorectal cancer
51) it's a carboxypeptidase enzyme approved for treating toxic MTX conc>
1mml

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52 ) Leucovorin adminstration should be separated from glucarbidase

administration by .... hrs
53 ) humoral hypercalcaemia related to...
54 ) corrected ca+2 =(...)×.8.....+
55 ) patient serum ca+2 = 13mg/dl , albumin=2gm/dl , the patient Bp=90/60,
HR=140 beats , what is the best ttt for this patient?
56 ) TLS can occur spontaneously in ... without being triggered by the
administration of chemotherapy
57 ) the drug that preferred for TTT rather than prophylaxis due to high
cost in TLS is....
58 ) ………..is recombinant urate oxidase that converts uric acid into
allantoin
59) ……....,…….,……….. patients are unable to take allopurinol
60 ) cold compress for extravasation caused by.... While heat pack for...
61 ) ……..is an anti dot for extravasation caused by Doxorubicin
62 ) topical.... For anthracylines extravasation
63 ) extravasation of Ac in currative cancer can be managed by....
Note dexrazoxane not preferred for currative cancer
64 ) diarrhea and colitis caused by ipilumumab can be resolved by....
65 ) ……..is used for acute irinotecan induced diarrhea while...for delayed
case
66 ) inflixmab cannot be use in case of autoimmune…………. so we
use…….... instead of it
67) corticosteroid not for.... give no response
Case:
Mr SG, a 46-year-old patient, was diagnosed with Dukes’ C colon cancer
several months ago. Since then he has undergone a left hemicolectomy. He
is currently receiving capecitabine monotherapy as adjunct treatment. He
telephones the pharmacy department for advice on how to cope with the
side effects he is currently experiencing.
Q1: What side effects are commonly associated with capecitabine?
Q2: What advice should be given to him?
Q3 : How can manage N/V caused by capcetapine?
Case:
A 50-year-old man is in the clinic to receive his third cycle of R-CHOP
(rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone)
for non-Hodgkin lymphoma. He is very anxious, with nausea and vomiting
lasting for about 12 hours after his previous cycle of chemotherapy. The
antiemetic regimen he received for his previous cycleof chemotherapy was
granisetron 1 dose plus dexamethasone 1 dose administered 30 minutes
before chemotherapy.
Q1-The chemotherapy regimen is........emetogenic
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Q2: Which regimen is most appropriate for the patient to receive on day 1
of the next cycle of chemotherapy?
A. Granisetron 1 dose plus dexamethasone 1 dose administered 30 minutes
before chemotherapy.
B. Dolasetron 1 dose plus dexamethasone 1 dose administered 30 minutes
before chemotherapy.
C. Palonosetron 1 dose plus dexamethasone 1 dose plus lorazepam 1 dose
administered 30 minutes before chemotherapy.
D. Metoclopramide 1 dose plus dexamethasone 1 dose plus aprepitant 1
dose administered 30 minutes before chemotherapy.
Case:
A 60-year-old woman was recently given a diagnosis of advanced non–small
cell lung cancer. She is going to begin treatment with cisplatin 100 mg/m2
plus vinorelbine 30 mg/m2.
Q1: Which one of the following is an appropriate antiemetic regimen for
preventing acute emesis?
A. Aprepitant plus ondansetron plus dexamethasone.
B. Aprepitant plus prochlorperazine plus dexamethasone.
C. Aprepitant plus granisetron plus ondansetron.
D. Lorazepam plus ondansetron plus metoclopramide.
Q2: Which one of the following is an appropriate regimen for anticipatory
nausea and vomiting?
A. Aprepitant plus dexamethasone.
B. Aprepitant plus metoclopramide.
C. Ondansetron plus dexamethasone.
D. Aprepitant plus ondansetron plus dexamethasone plus lorazepam.
Case:
A 75-year-old man has metastatic prostate cancer. The main sites of
metastatic disease are regional lymph nodes and bone (several hip lesions).
He experiences aching pain with occasional shooting pains. The latter are
thought to be the result of nerve compression by enlarged lymph nodes. He
has been taking oxycodone-APAP 5 mg 2 tablets every 4 hours and
ibuprofen 400 mg every 8 hours. His current pain rating is 8/10, and he
states that his pain cannot be controlled.
Q1: Which one of the following choices is the best recommendation to
manage his pain at this time?
A. Increase oxycodone-APAP to 7.5 mg, 2 tablets every 4 hours.
B. Increase oxycodone-APAP to 10 mg, 2 tablets every 4 hours.
C. Discontinue ibuprofen and add morphine sustained release every 12
hours.
D. Discontinue oxycodone-APAP and add morphine sustained release every
12 hours.
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Q2: Which one of the following is the most appropriate adjunct medication
for this patient’s pain?
A. Naproxen.
B. Single-agent (single ingredient) APAP.
C. Gabapentin.
D. Baclofen.
Case:
AS is a70-year-old man presented to hospital with new on-set back pain.
The patient had metastatic prostate cancer for 3 years ago, the cancer
metastasized to bone but asymptomatic , he is non smoker.he reported a 5-
week history of persistant burning shooting pain in his lower lumbar
region, this pain become worse at night and was 8/10 on pain rating scale,
the pain had not been reliefed on ibuprofen or acetaminophen
Q1: How can control this pain!?
A-increase dose of ibuptofen or paracetamol
B-give sustained release morphine
C-give him combination of(oxycodone with paracetamol and ibuprofen(
D-stop ibuprofen and paracetamol
Case:
A 50-year-old woman is receiving adjuvant chemotherapy for stage II
breast cancer. She received her third cycle of doxorubicin and
cyclophosphamide (AC) 10 days ago. Her CBC today includes WBC
600/mm3, segmented neutrophils 60%, band neutrophils 10%, monocytes
12%, basophils 8%, and eosinophils 10%. She is afebrile.
Q1: Which one of the following best represents this patient’s ANC?
A. 600/mm3.
B. 360/mm3.
C. 240/mm3.
D. 420/mm3.
Q2: Given this ANC, which one of the following statements is most
appropriate?
A. The patient should be initiated on a CSF.
B. The patient should begin prophylactic treatment with either a quinolone
antibiotic or trimethoprim/sulfamethoxazole.
C. The patient, who is neutropenic, should be monitored closely for signs
and symptoms of infection. D. Decrease the doses of doxorubicin and
cyclophosphamide with the next cycle of treatment.
Case:
A60-year-old woman is receiving adjuvant chemotherapy for stage 2 small
lung cancer .after receiving her second cycle of chemotherapy she is
hospitalized with febrile neutropenia. she is scheduled to receive the third
cycle of chemotherapy
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Q1- what is the best ttt recommended for this patient?

Q2-if this cancer is non-curable, what is first line to manage her
neutropenia?
Case:
GF is 50-year-old man with lung cancer, he received his third cycle with
cisplatin/paclitaxel, he is presented to hospital today with a temperature of
104 F. His CBC is WBC 600 cells/mm3 , segmented neutrophils 50% , band
neutrophils 10%, basophils 20% , eosinophils 5% , monocytes 15% and his
platelet count is 99,000 cells/mm3 .his BP is 110/60 mm Hg, heart rate is 80
beats /minute , and respiratory rate is normal.
‫فيها ركزوا دكاتره ي مهمه دي انكيس‬
Q1- calculate ANC?
Q2- which is the best intervention for this patient?
Case: An 18-year-old man is about to begin chemotherapy for acute
lymphoblastic leukemia. On today’s complete CBC, his hemoglobin is
7g/dL, and he is experiencing fatigue.
Q1 : Which is the best treatment recommendation?
A. Initiate epoetin.
B. Administer transfusion of packed red blood cells (RBCs).
C. Delay chemotherapy treatment until hemoglobin recovers. D. Reduce
chemotherapy doses to prevent further decreases in hemoglobin.
Case: A 50-year-old woman with breast cancer. She is receiving her third
cycle of adjuvant chemotherapy, her Hgb is 8 g/dl. She is fatigue and this
fatigue affect her daily activities .
Q1 : which is the best ttt for this case?
Case:
A 38-year-old woman has a history of Hodgkin lymphoma. Two years ago,
she completed six cycles of ABVD chemotherapy (i.e., doxorubicin,
bleomycin, vinblastine, and dacarbazine). Each cycle included doxorubicin
50 mg/m2. Recently, she was given a diagnosis of stage IV breast cancer.
She will be initiated on doxorubicin 50 mg/m2 and cyclophosphamide 500
mg/m2 for four cycles.
Q1: Which one of the following statements is most applicable?
A. The patient has not reached the appropriate cumulative dose of
doxorubicin to consider dexrazoxane.
B. The patient has reached the appropriate cumulative dose of doxorubicin
to consider dexrazoxane.
C. The patient should not receive any more doxorubicin because she is at an
increased risk of cardiotoxicity.
D. The patient should not receive dexrazoxane because of the possibility of
increased myelosuppression.
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Q2: Which one of the following is the best sequence for administering
mesna and ifosfamide?
A. Mesna before ifosfamide and then at 4 and 8 hours after ifosfamide
B. Ifosfamide before mesna and then at 4 and 8 hours after mesna.
C. Mesna and ifosfamide beginning and ending at the same time.
D. Mesna on day 1 and ifosfamide on days 2–5.
Case:
A 65-year-old man with metastatic non–small cell lung cancer is brought to
the clinic by his fam-ily because of alterations in his mental status.
Pertinent laboratory values include a serum calcium concentration of 12
mg/dL and an albumin concentration of 2 g/dL.
Q1 : Which therapy is best for this patient’s altered mental status due to
hypercalcemia of malignancy?
A. Calcitonin 4 units/kg every 12 hours.
B. Furosemide 20 mg orally.
C. Dexamethasone 10 mg orally two times a day.
D. Zoledronic acid 4 mg intravenously
DR ESLAM
Case : R.K. is a 71-year-old white woman with a history of rheumatoid
arthritis who smokes ½ pack/day. She takes calcium 1200 mg orally per day
in divided doses and vitamin D 600 international units/day orally. She is 63
inches (160 cm) tall and weighs 140 lb (64 kg). Her calculated creatnine
clearance is 60-70mls/min. Her BMD T-score is −2.6 at the hip and −2.1 at
the spine. Her FRAXscore indicates she has a 10-year probability of a
major osteoporotic fracture of 22% and a 10-year probability of a hip
fracture of 11%.
Q1: Which statement best describes the correct diagnosis for R.K.?
A. She has normal BMD of the spine.
B. She has low bone mass (osteopenia) of the hip.
C. She has osteoporosis of the hip.
D. She has severe osteoporosis of the spine.
Q2: Which is the best therapy for R.K.?
A. No further treatment is required; continue calcium 1200 mg/vitamin D
600 international units/day orally.
B. Teriparatide 20 mcg subcutaneously daily and continue calcium 1200
mg/vitamin D 600 international units/day orally.
C. Miacalcin nasal spray 1 spray (200 international units) in one nostril
daily; continue calcium 1200 mg/ day orally and increase vitamin D to 800
international units/day orally.
D. Risedronate 35 mg orally every week; continue calcium 1200 mg orally
per day and increase vitamin D to 800 international units/day orally.

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Case:
A 72-year-old woman (height 66 inches, weight 82 kg), whose medical
history is significant for rheumatoid arthritis, type 2 diabetes, GERD, and
hypothyroidism, presents to the clinic with inflammation of the joints of the
hands and stiffness lasting 1–2 hours in the morning. She is a smoker. Her
current medications include pantoprazole 40 mg daily, metformin 850 mg
twice daily, levothyroxine 100 mcg daily, folic acid 1 mg daily, methotrexate
12.5 mg weekly, naproxen 500 mg twice daily, calcium 600 mg twice daily,
and vitamin D 1000 units twice daily. Her laboratory tests show a negative
rheumatoid factor but positive anti–cyclic citrullinated peptides. The
physician determines that this is a flare of moderate disease.Three months
later, the patient has responded to therapy. A bone mineraldensity T-score
of –2.0 is reported from her latest scan. Her vitamin D concentration is 40
ng/mL.
Q1: Which recommendation would be most appropriate to help reduce the
risk of major osteoporotic fractures in this patient?
A. Give raloxifene 60 mg daily.
B. Give risedronate 35 mg weekly.
C. Give teriparatide 20 mcg subcutaneously daily.
D. Increase to calcium 600 mg and vitamin D 2000 mg twice daily.
Case:
An 85-year-old man presents with pain from hip OA. He has hypertension,
coronary artery disease, and BPH. For his OA, he has been taking
acetaminophen 650 mg three times daily. He reports that acetaminophen
helps but that the pain persists and limits his ability to walk.
Q1:Which is the best next step for this patient?
A. Change acetaminophen to celecoxib.
B. Add hydrocodone.
C. Change acetaminophen to ibuprofen.
D. Add glucosamine.
Case:
A 72-year-old woman (height 66 inches, weight 82 kg), whose medical
history is significant for rheumatoid arthritis, type 2 diabetes, GERD, and
hypothyroidism, presents to the clinic with inflammation of the joints of the
hands and stiffness lasting 1–2 hours in the morning. She is a smoker. Her
current medications include pantoprazole 40 mg daily, metformin 850 mg
twice daily, levothyroxine 100 mcg daily, folic acid 1 mg daily, methotrexate
12.5 mg weekly, naproxen 500 mg twice daily, calcium 600 mg twice daily,
and vitamin D 1000 units twice daily. Her laboratory tests show a negative
rheumatoid factor butpositive anti–cyclic citrullinated peptides. The
physician determines that this is a flare of moderate disease.

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Q1: Which would be the most appropriate intervention for this patient’s
rheumatoid arthritis?
A. Change naproxen to prednisone 20 mg daily.
B. Change methotrexate to 25 mg intramuscularly.
C. Switch methotrexate to leflunomide 20 mg daily.
D. Add sulfasalazine 500 mg twice daily and hydroxychloroquine 400 mg
daily.
Case:
A 50-year-old woman presents to clinic with her fourth gouty attack in the
last year, her last attack was for a week; for that attack, she took colchicine
and it was effective, now, her pain in her left knee and interphalanges of
her left hand. Scr is normal, serum urate is 10(normal range is 1.5-6mg/dl)
herBMIis 29. There is no tophi, she has hypercholesterolemia and takes
rosuvastatin.
Q1 what is the best ttt for her gouty attack?
Q2 once her acute attack has resolved, which anti-inflammatory regimen is
most appropriate for prophylaxis in this case?
Q3 for how long will the patient take prophylactic anti-inflammatory and
what is the goal of uric acid level?
Case:
S.R is a 73 -year-old woman with a history of rheumatoid arthritis. Tscore
of - 2 at hip fractures. Her FRAX score indicates she has 10year probability
of a major osteoprotic fracture of 15%and 10year probability of a hip
fracture of 1% which is the best ttt for SR?
A)Alendronate 70mg orally weekly
B)ibandronate
C)Teriparatide 20mcg subcutanously daily
D)Ca 1000mg and Vit D 600 IU daily
E) Ca 1200 mg and Vit D 800 IU daily
Case
A60 year old man presents with his third gouty attack in the past year.his
last attack was 1month ago, for which he took colchicine with good
response. His pain is his left knee and fourth paroximal interphalangeal
joint on his left hand. He has tophi. The pain started about 10hour ago. He

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rates his pain as 8/10which is most appropriate for ttt of this acute gouty
attack?
A) prednisone 40mg daily every 8hours
B)Colchicine 1.2mg ,then 0,6 mg in hour, then0,6 mg every12hours
C)Naproxen 750 mg then250 mg every 8 hours
D)intra-articular triamcinolone injection of all affected joints
E)Colchicine 1,2mg plus naproxen 750 mg every 8 hours
DR MAHMOUD
MS
1) multiple sclerosis name is due to:
a-the disease occurs in many areas.
b-gliosis plaques with sclerosed flexture
c-result from many causes
d-a,b are correct.
2)all of the following are risk factors of MS;
a-family history b-epstein barr virus c-Vit D deficiency d-all
if the above
3)symptoms of MS may interfere with diagnosis of epilepsy ;
a-MS hug. b-babinski sign c-spasticity of muscle d-paroxysmal
symptoms
4)Band like sensation of tightness around the torso;
a-babiniski sign b-MS hug c- hypoesthasia
5)saltatory nerve impulse in....axon while continuous nerve impulse
in.....axon
a- myleinates, demyleinated
b-Demyleinated, myleinated
c- myleinated, myleinated
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6)electric shock-like sensation, self limited but may persist for years;
a-diplopia. b-lhermitte's symptom c-facial myokymia
7)very breif lancinating facial pain often triggered by an afferent input
from the face or teeth ;
a-facial myokymia b-trigeminal neuralagia c-ms hug
8) bladder dysfunction , difficulty in initiating or stopping the urinary
stream is due to........dysynergia
a-ureter-detrusor
b-detrusor-urethra
c-detrusor -internal sphincter.
d-none of the above
9-Discrete attacks of neurological dysfunction evolve over days to weeks,
there is substantial recovery
a-RMS
b-SPMS
c-PPMS
10)patient not experience any attacks but rather steadily decline in function
from disease on-set
a-RMS
b-SPMS
c-PPMS
11-acute new lesions /plaques in MRI is.....MS
a-active b-RMS c-none of the above
12-Assesses neurological function in afferent or efferent CNS pathways
using computer to measure CNS electric potential evoked by repetitive
stimulation of nerves
a-MRI. b-CT. c-evoked potential

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13-immunoglobulin increased in CSF in patient with MS;

a-IgM. b- IgA. c- IgG
14)- cells that are responsible for synthesis of mylein sheath is
a-monocytes b-oligodendrocytes c-
astrocytes
15) To manage infusion reactions if almetuzumab, we use
a-aspirin. b- corticosteroids c-stopping drug.
16)-we should avoid live vaccines during ttt with almetozumab, complete all
vaccines.........before initiating ttt
a-6weeks. b-4-weeks. c-6months
17)The only drug can be used for ttt of Ms during pregnancy
a- almetuzumab. b-DMF. c- fingolimod
18)TO accelerate elimination of Teriflunomide we use;
a- cholestyramine b-activated charcoal c-acetylcystein d-a,b
are correct
19).......IS opportunistic JCV viral CNS infection result in death or
permanent disability may occur after long term ttt of MS using ......
a-PML/Natalizumab
b-infusion reaction /almetuzumab
c-herpes /natalizumab
20)Abs usually produced in patient with long term use of B-INF make the
druh ineffective
a-neutralizing Abs. b-autoimmune Abs. c-none of the
above
21)MOA of glatiramer acetate;
a-increase type 1helper T-cells, increase type2helper T-cells
b-decrease type1, increase type2
c-decrease type1, decrease type2
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22)MOA of ozanimode ;
a-bind to CD52 on T-cells
b-bind to S1P receptor on Tcell
c-antioxidant, cytoprotective
23)Case;
E.M is 27year old woman with MS for 2years ago, she takes Teriflunomide,
she wants to have a baby, what should she do?
a-discontiue teriflunomide
b-accelerate its elimination using cholestyramineand activated charcoal
c-two serum conc below0,02 taken 14days apart
d-all of the above
24)contraindications to be used in patient with myocardial infraction
a-fingolumide b-ozanimod c-siponimod d-all of the
above
25)after varicella zoster vaccine, patient should wait......to intiate
fingolimode
a-6weeks b-4weeks. c-4months
26)contraindicated in patient with hepatitis B virus is...
a- fingolimode b-acrelizumab c-B-INF
27)patient with MS has severe fatigue,which of the following can improve
this fatigue?
a-assistive devices b-amantadine c-methylphenidate d-a,b ,c
are correct

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ADHD
1-most children with ADHD have at least ine of the following disorders;
a- oppositional defiant disorders
b-TICs
c-anxiety disorder
d- all of the above
2-it's a disorder that involves repetitive movements or unwanted sounds
can't be controlled
a-tourette syndrome or tics
b-parkinsonism
c-schizophrenia
3-ttt with stimulant medications at.....age reduce risk of abuse
a-adolescence b- younger c-older adults
4-even stimulant medications have the same mechanism, some children
with ADHD respond better to one type than another
a-true. b-false
5- behavioral effects are proportional to the rates of methyl phenidate
absorption into CNS
a-first pass effect b-Ramp effect. c-none of the above
6-........not recommended for patients with known structural heart defects
a- methylphenidated
b-amphetamine
c- atomexetine
7-non stimulant medications........evidence than stimulants
a-more b-less c-the same
8-adverse effects of viloxazine as it induce
a-mania. b-depression. c- increase BP, HR d- all of the above
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9- black box warning of atomoxetin in children and adolescents

a-dementia. b- suicidal ideation. c-Tics
10-non-stimulants should be withdrawn slowly to avoid rebound
hypertension
a-clonidine. b-amohetamine. c-guanfacine d-a,c are
correct
11- anti-depressants may be used for ttt of ADHD, contraindicated with
epilepsy
a-bupropion b-Desipramine. c-atomexetin
12-anti-depressants used for ttt of ADHD,ECG is recommended before
initiation of therapy
a- imipramine. b-nortriptyline c-guanfacine.
13-M.A is 5year old child with ADHD, first line of ttt is;
a- behavioral. b- methylphenidate c-combination of a
and b
14- E.A is 16year old with ADHD, first line of ttt is
a-behavioral. b-methylphenidate. c- combination
of a And b
15-H.F is 10 year old child with ADHD, first line of ttt is;
a-behavioral.
b-methylphenidate.
c- combination of a And b
‫ي دكاتره دول اهم حاجه ف‬treatment recommendations ‫ ع االدويه وال‬ADHD‫ركزوا ف‬
‫انجزء ده‬
stimulant drugs ‫ومجابتش نتيجه استخذم انذوا انتاني من‬stimulant ‫نى قانك استخذم دوا من‬
non stimulants‫قبم ماتروح ل‬

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Dementia
1) it's an acute condition in which fluctuation in awareness and alertness
occurs over the day
a) dementia b) dystonia c) delirium. D) dyskinesia
2) decline in cognition and interfere with social and work functions
A) MCI b) dementia c) delirium
3) ........is the most common type of dementia
A) AD b) PD c) MCI d) lewy body dementia
4) deficit in cognition but not interfere with social and work functions
A) AD b) delirium c) MCl d) dementia
5) most types of dementia are.............. few are..........
A) reversible, reversible
B )reversible, irreversible
C) irreversible , reversible
6).......... is a type of dementia occurs due to chronic hypoperfusion , usually
occurs with 3-6 months of stroke
A) MCl. B) AD. C) vascular dementia
7) typical anti-psychotic should be avoided in .......,...... Types of dementia
A) MCI and vascular
B) lewybody dementia and dementia of advanced PD
C) frontotemporal dementia and AD
8) PD onset causes decline in cognition lead to a type of dementia
A) lewybody dementia b) MCI c) dementia of advanced PD
9) SSRIs or trazodone maybe beneficial in it
A) lewybody dementia. B) MCI. C) frontotemporal dementia

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 THERABy FINALLY LEVEL 5 THE LAST LEVEl E&E

11) reversible causes of dementia in which symptoms improve after

surgical placement of ventricular shunt
A) NPH b) depression c) hypothyroidism
11) assessment tool of dementia relies on verbal and the language skills, so
less accurate for poorly educated persons
A) SLUMS b) MMSE c)MOCA d) MINI -COG
12) assessment tool includes adjustment of scores for lower educational
Status
A) SLUMS b) MMSE c)MOCA d) MINI -COG
13) ...... Assessment tools less reliant on verbal or language skills requires
training for assessment
A) SLUMS b) MMSE c)MOCA d) MINI -COG
14) tau protein......., B amyloid protein.... In concentration in CSF
A) increased, increased
B) increased, decreased
C) decreased, increased
15) tau protein and B amyloid concentration ...........within brain itself
A) decreased. B) increased. C) not affected
16) stage of AD in which some short term memory and IADLS loss
A) mild. B) moderate c) severe
17) stage of AD in which patient need around the clock care
A) mild. B) moderate c) severe
18) provide ketone bodies as an energy source for brain instead of glucose
uptake which is reduced in ad
A) caprylidene TGs b) omega 3 c) vit B12

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 THERABy FINALLY LEVEL 5 THE LAST LEVEl E&E

19) it's a CIS drug induced nausea vomiting and diarrhea which seem
more intense than other CIS
A)donepezil b) galantamine c)memantin d) rivastigmin
21) NMDA antagonist that block glutamate transmission give no benefits
in mild ad so used for moderate to severe case
A) rivastigmine b) memantin c) galantamine d) clozapine
21) all of the following are adverse effects of CIS except
A) nausea vomiting diarrhea
B) insomnia, dizziness
C) syncobe , orthostatic hypotension
D) tachycardic arrythmia
22)Combination therapy...... compared to single therapy of AD
A) has greated benefit
B) has sight or no benefit
C) has less benefit
23) MOA of aducanumab
A)anti amyloid monoclonal antibody
B) acetyl cholinesterase inhibitor
C) NMDA antagonist
D) biological DMARD
24) aducanumab has got accelerated approval for .....dementia
A) MCI or mild
B) lates stages
C) severe AD
D) rheumatoid arthritis

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 THERABy FINALLY LEVEL 5 THE LAST LEVEl E&E

25) they are adverse effects of aducanumab

A) CNS hemosiderosis
B)microheamorrhage of brain
C) edema in brain
D) all of the above
Schizophrenia
1) all of the following are positive symptoms of schizophrenia except
A)delusion
B) disorganized behaviour and speach
C) hallucinations
D) apathy
2) ..... Is fixed false benefit involving misinter pretations of reality
A) hallucination
B) apathy
C) delusion
3) a condition of absence of awareness , it's the most common predictor of
non adherence
A)anosogaosia
B) apathy
C) hallucination
4) gradual development of symptoms that may be unindicted
A) acute phase
B) prodromal phase
C) stabilization phase

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 THERABy FINALLY LEVEL 5 THE LAST LEVEl E&E

5) significant positive symptoms are present requiring hospitalisation

A) acute phase
B) prodromal phase
C) stabilization phase
D) stable phase
6)......symptoms of a schizophrenia occur due to increasing dopamine level
or hypersensitivity of dopaminergic receptor while...... symptoms occur due
to hyperactivity of 5-HT3
7) they are adverse effects of typical anti-psychotic
A)EPS
B) orthostatic hypotension
C) hyper prolactinemia
D) all of the above
8) all are examples of atypical antipsychotic except
A) clozapine
B) olanzepine
C) quitiapine
D) haloperidol
9) has the ability to block 5 HT3 2A receptors
A) typical antipsychotic
B) a typical antipsychotic
10)..... and..... Have partial activity of 5-HT3 1A receptors
A) olanzepine and quitiapine
B)cariprazine and haloperidol
C)all of the above

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 THERABy FINALLY LEVEL 5 THE LAST LEVEl E&E

11).... and.... Have been associated with new DM and the metabolic
syndrome due to blocking of 5-ht3 receptor
A) clozapine, olanzepine
B) haloperidol , chlorpromazine
C) Atomoxetin, lorazepam
12)..... Are considered as the first line antipsychotics because of less risk of
tardive dyskinesia and EPS
A) FGAs typical
B) SGAs atypical
C) haloperidol
13) are 2 black box warnings of antipsychotics
A) dementia and suicidal thoughts
B) EPS and hypotension
C) renal failure
14) ....is a spasm of tongue, neck, back, these spasms may cause unnatural
positioning of the neck , abnormal eye movement
A) akathesia
B) dystonia
C) dyskinesia
15)..... is continuous restless, inability to sit still constant moving and treat
by ........ As first line
A) akathesia, propranolol
B) dystonia, anticholinergic
C) akathesia, BZD

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 THERABy FINALLY LEVEL 5 THE LAST LEVEl E&E

16)...is involuntary movements that occur with chronic use of anti psychotic
involves oro facial muscles and is often insidious
A) dyskinesia
B) tardive dyskinesia
C) dystonia
17) ....are used for TTT OF tardive dyskinesia
A) valbenazine and deutetrabenazine
B) tetrazepam + olanzepine
C) tetrabenazine and haloperidol
18) ..... Shouldn't be used to treat tardive dyskinesia as it may worsen
symptoms
A) valbenazine
B) anticholinergic
C) deutetrabenazine
19) autonomic disturbance , emergency adverse effects of FGAs with high
mortality rate
A)EPS
B)NMs
C) tardive dyskinesia
D) none of the above
20) endocrine disturbance due to blocking of dopamine receptor in tubero
fundibular pathway, lead to breast enlargement
A) hyper prolactinemia
B) tardive dyskinesia
C) DM

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 THERABy FINALLY LEVEL 5 THE LAST LEVEl E&E

21) partial agonist on D2 receptor may lower prolactin concentration

A) aripiprazole
B) brexipiprazole
C) cariprazine
D) all of the above
22) ...... Is difficulty to regulate the body temperature
A) dyskinesia
B) parkinsonism
C) hyper prolactinemia
23) smoking..... Metabolism of olanzepine, so we should.......dose
A) induce , increase
B) induce , decrease
C) inhibit, decrease
24) if the patient stop smoking we should .......dose of olanzepine
A) increase
B) decrease
C) not change
25) ....... Often used for psychosis associated with barkinson's disease
A) quitiapine
B) olanzepine
C) haloperidol

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