Qmu Module 4 Cohd

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MODULE 4

2011 MCQ MANIA + ESSAYS SWAYS QMU 2011



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mcq mania

1. The following are true about cell injury EXCEPT

a. The type of stimulus determine the cell’s response to injurious agents.

b.

Glucose in hypertonic solution can cause cell injury.c. A cell undergoing caseous necrosis shows amorphous granular structureless basophilic

debris.

d. Autolysis is seen in liquifactive necrosis is spinal cord cell

2. What is the main cause of cloudy swelling?

a. Cell loss its integrity

b. Disturbance in the active transport of water outside the cell

c. Mitochondria which has been damaged and become swollen

d. Cell that are incapable of maintaining ionic and fluid homeostasis

3. What can you observe grossly on enzymatic fat necrosis?

a. Chalky white areas

b. Yellow-gray and rubbery

c. White yellowish and cheesy-like

d. Semiliquid

4. The following are true about cell injury except

a. Type of stimulus determine cell response to injurious agents

b. Glucose in hypetonic solution can cause cell injury

c. A cell undergoing caseous show amorphous granular structureless basophilic debris

d. Autolysis is seen in liquifactive necrosis in spinal cord cell

5. Why is the brain undergo liquifactive necrosis?

a. Easily exposed to mechanical injury

b. Contains many neurons

c. Many blood supply

d. Contain many lysosomal enzyme

6. Common cause of cell injury and death is

a. Immunologic reaction

b. Extreme temperature

c. Mechanical trauma

d. Hypoxia

7. Determine whether the statement is true or false

a. Prolonged cell ischiemia can lead to reversible cell changes

b. Free radicals are highly stable particles with odd number of electron s in their outer shells

c. Mild fatty change does not effect the gross appearance of liver

d. Nucleus of liver cells in case of fatty change appears microscopically centered



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8. All of the following are effects of ATP depletion except

a. Cloudy swelling

b. Accumulation of lactic acid and inorganic phosphate

c. Increase protein synthesis

d. Increase cytosolic ca 2+

9. Increased cytosolic ca2+ can stimulate all of the following except

a. ATPase

b. Protease

c. Endonuclease

d. Lipase

10. All of these are false except

a.

Inflammation has no setbacksb. Immune reaction causes inflammation

c. Inflammation can cope with strong injurious agent

d. Radiation do not cause inflammation reaction

11. Function of fibrin is ....

a. Attract leucocytes to ground zero

b. Provide food for leucocyte

c. Prevent spread of inflammation

d. Dilute toxin

12. All of the above are special types of abscess except

a. Carbuncle

b. Style

c. Cellulitis

d. Furuncle

13. The organelle that mainly effected by albuminous degeneration

a. Golgi apparatus

b. ER

c. Nucleus

d. Mitochondria

14. Purulent inflammation does not clot on standing because

a. Excessive tissue destruction by toxins

b. Fibrinogen content is destroyed by proteolytic enzymes

c. Chemotactic agent affect neutrophils

d. Neutrophils are killed by bacteria form pus



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15. Which is the following is true regarding sources of septic emboli in systemic pyemia

a. Septic ulceration of the colon

b. Phlegmonous appendicitis

c. Suppurative otitis media

d. Infected piles

16. Below are the possible gross appearance of papilloma except

a. May be sessile or pedunculated

b. Compound with thick and short branches

c. Villous with thin long slender filament

d. Projects above the surface of the mucus membrane and attains a pedicle due to contraction

of viscus

17. All of the following are non functioning adenoma except

a. Suprarenal gland

b. Breast

c. Lacrimal glands

d. Intestine

18. The following are true except

a. Rate of growth tumour is influenced by hormones for hormonally responsive tissue

b. Neoplasm has completely or partial loss of regulation of mitosis and cell regulation

c. Benign tumour are dangerous someone if the produce excess hormones

d.

Pleomorphic, hyperchromatic cell with well formed blood vessel are characteristic of malignant cells

19. Which is true about neuroma and schwanoma ?

a. Sixth cranial nerve is the commonest site

b. They are malignant tumours

c. They may present single

d. They arise from sheath of nerve

20. The following are true regarding malignant cell except

a. Retain their function of their counterpart for well differentiated tumours

b. Grow by infiltrative manner by destroying, invading and encapsulated

c. May contain tripolar spindle fibre during mitosis

d. Show wide variations of shape of nuclei and sizes

21. Why does calcification occurs in death tissue?

I. Presence of growth factor

II. Organic phosphates

III. Acidity

IV. Presence of bacteria



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a. II only

b. II and III

c. I and II

d. III and IV

22. Which is false regarding dystropic calcification?

a. Presence of abnormalities in calcium metabolism

b. Normal Ca2+ serum

c. Due to local changes in tissues

d. Can be seen at degenerative tumours

23. What is false regarding effects of metastatic calcification?

a. May result in ischemia in small vessels i.e skin

b. Nephrocalcinosis

c.

Impair parenchymal cell functiond. Rarely disturb gasseous exchange in alveoli

24. Below are commonest site for malignant melanoma except

a. Retina

b. Head

c. Extremities

d. Sole of foot and hands

25. These are true aboust basal cell carcinoma except

a. Floor covered by necrotic fluid

b. Tumour start as a firm nodule or papule

c. Edges are everted

d. Base is fixed and indurated

26. Which is the correct order of the process of tissue repair?

A. Angiogenesis – Scar Remodeling – Fibrosis

B. Scar Remodeling – Fibrosis – Angiogenesis

C. Fibrosis – Angiogenesis – Scar Remodeling

D. Angiogenesis –

Fibrosis –

Scar Remodeling

27. Below are the systemic factors which causes the delay of wound healing, EXCEPT

A. Protein malfunction

B. Vitamin C deficiency

C. Infection

D. Diabetes mellitus



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28. Which of the following complications of wound healing rarely occur?

A. Keloid

B. Neoplasia

C. Wound dehiscence

D. Proud flesh

Wide gap of scar

Presence of sepsis

Marked tissue loss and necrosis

29. The above characteristics of wound healing are of which intention?

A. First intention

B. Second intention

30.“Increase in the size of individual cells without increase in the number of cells”

The statement above refers to

A. Aplasia

B. Hypertrophy

C. Metaplasia

D. Agenesis

31. Agenesis is the complete absence of an organ or a part of an organ

A. True

B. False

32. This process of adaptation only occurs in organs which proliferation and mitosis are restricted.

What is the name of the adaptation process?

A. Hyperplasia

B. Hypoplasia

C. Dysplasia

D. Hypertrophy

33. Below are terms used to describe the growth abnormalities, EXCEPT

A. Hypoplasia

B. Aplasia

C. Atrophy

D. Agenesis

34. Which of the following is the drug produced from micro-organisms?

A. Insulin

B. Penicillin

C. Morphine

D.

Atropine



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35. All the following are the local routes of administration of drugs, EXCEPT

A. Topical

B. Injection

C. Inhalation

D. Sublingual

36. Below are parenteral routes of drug administrations, EXCEPT

A. Transdermal

B. Intradermal

C. Subcutaneous

D. Intravenous

37. Which of the following does not use inhalational route as the route of administration?

A.

Anesthetic gasesB. Volatile liquids

C. Therapeutic gases

D. Aqueous solutions

38. Below are the absorption principles of pharmacokinetics, EXCEPT

A. Lipid diffusion

B. Facilitated diffusion

C. Endocytosis and exocytosis

D. Biotransformation

39. Elimination half-life is useful for all below, EXCEPT

A. Estimating time to steady state

B. Determining the frequency of drug administration

C. Estimating the time required for drug removal

D. Estimating time for drug absorption

40. During the phase II of drug metabolism, the metabolite forms covalent linkage between one of

the functional group, EXCEPT

A. Sulfate

B. Glutathione

C. Carbonate

D. Acetate

41. Drugs transformed by during phase I does not lose pharmacological activity and become active

A. True

B. False



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42. Which below is the classification of the chemical mediators?

A. Nitric oxide

B. Neuropeptides

C. Eicosanoids

D. All of the above

43. Below are the actions of H1 receptors of histamine, EXCEPT

A. Stimulation of adrenal medulla

B. Vasodilation

C. Stimulation of nerve endings

D. Stimulation of gastric acid secretion

44. The kinetic mechanism of second generation of histamine receptor H1 blockers are as below,

EXCEPT

A. Absorbed orally

B. Metabolized in the liver

C. Crosses the blood brain barrier

D. Short acting

45. The isoenzyme COX – I is constitutively expressed

A. True

B. False

46. All of these are true about neoplasm EXCEPT

a.

It is an abnormal new growth of cell independent of physiologic growth stimulib. It is characterized by partial or complete loss of cell regulation only

c. It has no useful purpose

d. The surrounding tissue is not coordinated with its growth

47. What is the biological behavior of benign tumor?

I. Grows slowly

II. Do not interfere with the person’s well being to certain extend

III. If the tumors produce harmful substances, it can cause death

a. I and II

b. I and III

c. II and III

d. All of the above

48. All of these true about malignant tumors

a. More rapidly growing

b. It is form by parenchymal neoplastic cells

c. Can cause death although effectively treated

d. Can destroy and infiltrate the normal structure



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49. All of these are NOT the characteristics of benign tumor EXCEPT

a. Grow by expansion

b. The cells are wide range of parenchymal differentiation

c. The cells loss their polarity

d. Tumors implants continuous with primary tumors possibly in remote tissue

50. The most accurate example of benign tumors is

I. Squamous cell papilloma

II. Squamous cell carcinoma

III. Rhadmyoma

IV. Lymphoma

a. I and II

b. III and IV

c. I and III

d. II and III

51. The FALSE statement about malignant tumorsa. It grows destroy and penetrates the surrounding tissue

b. Formed of undifferentiated cells

c. It contain large polypoid nucleus or multiple nuclei

d. Develop a fibrous capsule

52. All of these are malignant tumor EXCEPT

a. Adenocarcinoma

b. Neurofibroma

c. Lymphoma

d. Leukaemia

53. In the mechanism of metastasis, all of these are true about EXCEPT

a. In lymphatic’s spread , it can occur by lymphatics permeation

b. Metastasis can occur along the nerves which is called inoculation

c. The most favorite method of spreading by sarcoma is blood spread

d. Choriocarcinoma metastasis by blood spread

54. The _________ the differentiation, the ____________ number of mitosis, the ________ the

grades

a. Higher, lower, lower

b. Lower, lower, higher

c. Higher, higher, lower

d. Lower, lower , higher

55. The most ACCURATE statement about special forms of neoplasia

a. Papillary serous cystadenoma is one of its form

b. There are malignant change in the epithelial cells but without invasion of the basement

membrane

c. One of these type are malignant tumors which are locally invasive and destructive

d. They can also arising from totiptental germ cells



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56. The FALSE statement about squamous cell carcinoma

a. It can arises from mucous membrane that are lined with stratified squamous epithelium

b. It has an intermediate zone of polygonal cells resembling the prickle cell layer

c. It has geographic appearance

d. In between their cell nests, there is fibrous stroma, containing blood vessels and

lymphocytes

57. In comparison carcinoma, sarcoma

a. Being separated by a variable amount of connective tissue

b. More vascular with hemorrhage and necrosis

c. Usually forms a bulky mass

d. Arises from mesenchymal tissue

58. All of these are true about etiology of cancer EXCEPT

a. It can be direct acting carcinogen which include anticancer agents

b. Human T-cell leukemia is the example of chemical carcinogens

c.

Ultraviolet rays can cause squamous cell carcinoma and malignant melanomad. Aniline dye is one of the procarcinogens

59. Which is FALSE about principal target of gene damage?

a. Growth promoting oncogenes

b. Growth inhibitory cancer suppressor genes

c. Gene that regulate apoptosis

d. Genes promoting proto-oncogenes

60. All of these is true about cancer suppressor genes EXCEPT

a. Increasing of the genes can cause cancer

b.

Alteration of PT53 can cause cancerc. When PT53 fails to arrest cell proliferation, it can cause cancer

d. Inactivation of PT53 can cause cancer

61. The acquired pre-neoplastic disorders are

I. Hepatocellular carcinoma

II. Leukoplakia of oral

III. Chronic atrophic gastritis

IV. Squamous cell carcinoma

a. I and II

b. II and III

c. I,II,III

d. All of the above

62. All of these are problems associated with malignancies EXCEPT

a. Anemia

b. Loss of nutrition

c. Leukemia

d. Paraneoplastic syndromes



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63. The most accurate statement about intramuscular route is

a. Drug absorption is slower in subcutaneous injection than intramuscular injection

b. Drug given may available as depot preparation only

c. IM injection is suitable for injecting highly irritant drug

d. Example of IM injection is insulin for treatment of diabetes insipidus

64. The FALSE statement about transdermal is

a. Drug is applied to skin

b. Producing an effect as intravenous injection

c. It is often used for sustained delivery

d. Applied as transdermal patch

65. All of these true about absorption of drug EXCEPT

a. The most important type of diffusion is lipid diffusion

b. It is the passages of drug from site of action to systemic circulation

c. Very hydrophilic drug are not well absorbed

d.

Oral drug administration does not give complete absorption

66. If the volume of distribution (Vd) of a drug is 200L and the amount of drug given is 4mg, what is

the concentration of the drug in blood plasma?

a. 0.2 mg/L

b. 2 mg/L

c. 0.002 mg/L

d. 0.02 mg/L

67. When all drug-receptors complexes have been all used, it give the maximum response which is

known as efficacy.

a.

Trueb. False

68. In pharmacokinetic antagonism

a. Two drug combine in solution, thus the effect of the active drug is lost

b. It is one type of reversible competitive antagonism

c. A situation which the antagonist effectively reduce the concentration of the active drug at

the site of action

d. Interaction of two antagonists that act independently of each other

69. Drug that should be avoid by females is

a. Phenobenzamine

b. Salicylates

c. Strong purgatives

d. Cholaamphenicol

70. The false mechanism of tolerance is

a. Alteration in concentration of the drug that reaches receptors

b. Alteration in the number function of receptors

c. Changes in components of response distal to receptor

d. Exaggerated response to the drug



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Essays sways

1.

Enumerate causes of accumulation of triglyceride in liver2. Describe cell changes in necrosis

3. Enumerate causes of chronic inflammation

4. Role of lymphatics in inflammation

5. Discuss methods of tumour spread

6. Enumerate the causes, types and pathogenesis of cell injury

7. Give differences between fatty change and stromal fatty infiltration (page 34, 35, 50)

8. Give account on the differences between necrosis and apoptosis (page 43)

9. Define gangrene and discuss the differences between dry and wet gangrene (page 44, 46)

10. Elaborate the effects of depletion of ATP in pathogenesis of cell injury (page 30)

11. Give explanation about the local signs of acute inflammation

12. What is the different between exudates and transudates

13. Explain the fate of acute inflammation for non suppurative inflammation

14. Tabulate and differentiate between acute and chronic inflammation

15. Give explanation the beneficial and harmful effects of inflammation



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Answers

1. C 14. B 27. C (page 105) 40. C (page 59)2. B 15. C 28. B (page 106) 41. B (page 59)

3. C 16. D 29. B (page 104) 42. D (page 66)

4. C 17. A 30. B (page 119) 43. D (page 66)

5. D 18. D 31. A (page 121) 44. C (page 66)

6. D 19. D 32. D (page 119) 45. A (page 69)

7. F,F,T,F 20. B 33. C (page 120) 46. B

8. C 21. B 34. B (page 53) 47. D

9. D 22. A 35. D (page 54) 48. C

10. B 23. C 36. A (page 57) 49. A

11. C 24. C 37. D (page 57) 50. C

12. C 25. C 38. D (page 59) 51. D

13. D 26. D (page 100) 39. D (page 59) 52. B

53. B 66. D

54. A 67. A

55. A 68. C

56. C 69. A

57. A 70. C

58. B

59. D

60. A61. B

62. C

63. A

64. B

65. B

Essays

1) -excessive entry of fats to liver i.e starvation & corticosteroids & hypelipemia

-interference of conversion of fatty acids to phosphorous and cholestrol i.e lead to increase

conversion of triglyceride

-increase esterification of fatty acids to triglycerides due to increase of alcohol

-decrease apoprotein synthesis i.e which is necessary release of triglyceride eeg hypoxia

-inhibition of fatty acids oxidation i.e hypoxia

2) -cytoplasm -increase eosinophillia because loss of RNA

-cell boundaries are obliterated and indistinguishable

-vacuolization because of lysosomal enzyme

-calcification may occur

-nucleus-karyorrhexis,pyknosis or karyolysis



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3) -it may follow acute inflammation - persistence of stimuli, interference of healing process

-De Novo chronic inflammation – persistence infection by microbes (low toxicity but evoke

immune response)

-prolonged exposure to non-degradable but toxic substances eg. Asbestos, silica-autoimmune eg. Rheumatoid athritis

4) -filter ECF

-lymphatic system + reticulo-endothelial system (spleen&lymph nodes) = secondary line of

defence

-lymph flow in inflammation is increased and helps to drain the oedema from EC spaces

-if severe, lymph nodes will be inflamed to compensate severity.

5) -direct spread(invade surrounding)

-lymphatic spread – along lymphatic vessels to nodes by permeation(side-by-side in a

column) or embolization(small mass carried by lymph fluid)-lymph spread preferred by carcinomas

-blood spread – preferred by sarcoma – from lymphatics, thoracic duct and nodes around

veins

-certain carcinomas have tendency invasion of veins – hepatocellular, choriocarcinoma and

renal cell carcinoma

-natural passages i.e tubes eg. Ureter,fallopian,bronchi

-transcoelomic spread – through serous cavity i.e pleura, peritoneum e.g carcinoma of

stomach to ovaries

-inoculation – defect in surgery eg. Scapel of surgeon transfered malignant cell to other

organs

-perineural – along the nerves

6) Causes of cell injury:

1. Hypoxia

2. Physical agents

3. Chemical agents and drugs

4. Biologic agents

5. Immunologic reaction

6. Genetic derangement

7. Nutritional imbalance

8.

Aging

Types of cell injury:

1. Irreversible

2. Reversible



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Pathogenesis:

Results from functional and biochemical abnormalities in essential cellular components. The

most important targets of injurious stimuli are:

1. Aerobic respiration

2. Cell membrane integrity

3. Enzymatic and protein synthesis

4. Cytoskeleton

5. Integrity of genetic apparatus

7) FATTY CHANGE STROMAL FATTY

INFILTRATION

Occurs in cells involved in or

dependent on fat metabolism

Occurs in stromal connective

tissue cells

Causes 1. Excessive entry of FA acids

into the liver,

2. Interference of conversion of

FA to phospholipids,

3. increased esterification of FA

to TGA,

1. Excessive intake

especially of fat and

CHO exceeding energy

requirement,

2. Endocrinal cause

Site 1. Hepatocytes,

2. myocardial cells and

3. skeletal muscles

1. Abdominal wall,

2. buttocks,

3. retroperitoneal tissue

8) NECROSIS APOPTOSIS

Affects a group cells, so it can be detected

grossly

Affected single cells. Cannot be detected

grossly

The cells in necrotic areas swell with

disintegration of the cell organelles

Plasma membrane is disrupted

Cells are reduced in size. Chromatin

condensed, intact organelles and formation

of apoptotic bodies

Plasma membrane is intact

Inflammation surrounding the necrotic areas No inflammation

Always has a pathologic role Considered as physiologic means of

eliminating of unwanted cells. It may be

pathologic after some forms of injury

specially DNA damage



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9) Gangrene: Necrosis of tissues with superadded putrification

DRY GANGRENE WET GANGRENE

Cause Arterial occlusion Sudden arterial and venous

occlusion

Sites Exposed parts Internal organs and

extremities

Progress Slow putrification Rapid putrification

Evaporation Occurs leading to tissue mummification Does not occur leading to

tissue edema

Defensive lines Lines of demarcation and separation

are present

No limiting defensive lines

Spread Slow spread Rapid spreadAssociated

toxemia

Mild toxemia Severe toxemia

10) 1. Intracellular accumulation of water and electrolytes, due to dysfunction of energy –

dependent sodium pump in the plasma membrane

2. Increased intracellular calcium due to disturbance of the energy – dependant activity of

cell membrane

3. Switch to anaerobic metabolism through glycolysis

11) Explanation of local signs of acute inflammation (pg78)

a. Redness (rubor) is caused by vascular dilatation and opening of all closed capillaries

b. Hotness (calor) is caused by arteriolar dilatation and increased blood flow to affected part

c. Swelling (tumor) is caused by vascular dilatation and accumulation of inflammatory exudates

d. Pain (dolor) is caused by irritation of the nerve endings by the products of inflammation

e. Loss of function is due to pain and tissue damage



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12) Differences between exudate and transudate (pg77)

EXUDATE TRANSUDATEPROTEIN

CONTENT

High: >1gm% Low: <1gm%

TYPES OF

PROTEIN

Plasma protein including fibrinogen Small molecules mostly albumin

TENDENCY TO

COAGULATION

Positive Negative

SPECIFIC GRAVITY >1020 <102G

NUMBER OF

CELLS

Many Few

MECHANISM Increased vascular permeability

Caused by increase hydrostatic pressure

or decreased osmotic pressure in

presence of normal vascular

permeability

CAUSE Inflammation

Hypoproteinemia

Heart failure

Lymphatic congestion

13) Fate of acute inflammation which is non-supperative inflammation (pg 90-91)

Healing by complete resolution

a. Means returning back to normal

b. This can occur when

- There is a minimal tissue damage

- There is rapid elimination of causative agent

- The tissue is capable of regeneration

c. Complete resolution occurs through digestion of the fibrin, resorption of inflammatory

exudates by blood vessels and lymphatics and removal of the cell debris by phagocytes



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Healing by scarring or fibrosis (organization)

This occur when

Acute inflammation occurs in tissues which do not regenerate

Acute inflammation is associated with excessive tissue destruction

There is a excessive exudation associated with delay in its absorption

Progression to chronic inflammation

This occur when the acute inflammatory response does not resolve owing either to

Persistence of the injurious agent

Interference in the normal process of healing

Superadded suppuration

It occurs due to supperadded infection with pyogenic microorganisms

Spread

14) Different between acute and chronic inflammation (pg 74, 75, 78, 95, 96)

Both of them can be differentiate by:

Definition

Nature and origin of cells in acute and chronic inflammation

Fate of the inflammation

15) Beneficial and harmful effect of inflammation (pg74)

Beneficial

Elimination of the causative agent and resultant dead tissue

Dilution of toxins

Prepare tissue for repair

Harmful

Cause edema

If inflammation occur at vital organ such as brain and larynx, this can lead to fatal condition



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more

The study of effects of drugs on the body , it’s mode of action

,indications, unwanted effects is called

a) Pharmacotherapeuticsb) Pharmacodynamics *

c) Pharmacokinetics

d) Pharmacopeias

Clinical use of the drug and the drug of choice in different medical

problems is called

a) pharmacotherapeutics *

b) pharmacodynamics

c) Pharmacokinetics

d) Pharmacopeias

The study of the effect of the body on the drug ,its metabolism

.distribution, elimination is called

a) pharmacotherapeutics

b) pharmacodynamics

c) Pharmacokinetics *

d) Pharmacopeias

Dictionary or official list containing names of drugs ,their degree of

purity ,dosage, effects, mode of action, methods of administration, side

effects is called

a) pharmacotherapeutics

b) pharmacodynamics

c) Pharmacokinetics

d) Pharmacopeias *

We use genetic engineering as a source of drugs as in :

a) Heparin

b) Aspirin

c) Human insulin *

d) Morphine

Pencilium is a........... that use as a source of penicillin

a) Plant

b) Animal

c) Mineral

d) Microorganism *



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In all Routes of drug may avoid 1st pass metabolism except :

a) Oral *

b) Rectal

c) I.V

d) Sublingual

Agonist is n agent that can bind to a receptor to elicit a response :

a) True *

b) False

The maximal response produced by the drug is called

a) Potency

b) Therapeutic index

c) Efficacy *d) Antagonism

........... is often expressed as the dose that gives 50% of the maximal

response , ED50

a) Efficacy

b) Agonist

c) Antagonism

d) Potency *

Therapeutic index is a measure of drug safety ,thus the lower theindex the safer is the drug

a) True

b) False *

Heparin and protamine sulphate are examples of :

a) Functional antagonism

b) Chemical antagonism *

c) Receptor blockage

d) No receptor antagonism

The reduction of anticoagulant effect of warfarin by an agent

which accelerate its hepatic metabolism such as phenobarbitone an

example for


b) Chemical antagonism

c) Pharmacokinetic antagonism *




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Phenoxybenzamine and adrenoceptors give an example for :

a) functional antagonism


c) Antagonism by Receptor blockade *


In competitive antagonism ........... is changed

a) Efficacy

b) Potency *

c) Agonist

d) Therapeutic index

In non equilibrium antagonism .......... is changed

a) Efficacy *b) Potency

c) Agonist

d) Therapeutic index

Histamine and adrenaline ( OR cortisone and insulin ) give an

example for

a) functional antagonism *


c) Antagonism by Receptor blockade


Strong purgatives should be avoided during

a) Labour

b) Pregnancy *

c) Menstruation

d) Lactating

.......... should be avoided during menstruation because it increase

bleeding :

a) Uterine stimulants

b) Tetratomic drugs

c) Salicylates *

d) Chloramphenicol

Drug should be avoided during lactation :

a) uterine stimulants

b) Tetratomic drugs

c) Salicylates

d) Chloramphenicol *



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Females usually require the same dose as males

a) True *

b) False

The drugs that should be used cautiously in young age that :

a) Suppress growth

b) Affect brain or bone maturation

c) Greatly bind to plasma protein

d) All of the above *

Morphine cause depression of fetal respiration so should’nt use

during

a) Labour *

b) Pregnancy

c) Menstruationd) Lactating

Circadian rhythms can affect how we respond to drugs

a) True *

b) False

In liver diseases we increase the dose of drugs depend on hepatic

metabolism

a) True

b) False *

....... is abnormal response to the therapeutic dose of the drug due to

genetic difference in metabolism

a) Idiosyncrasy *

b) Hypersensitivity

c) Tolerance

d) In tolerance

....... is abnormal response to the therapeutic dose of the drug due to

antigen -antibody reaction

a) Idiosyncrasy

b) Hypersensitivity *

c) Tolerance

d) In tolerance

Decreased normal pharmacological response to the drug with its

continued administration is called

a) Idiosyncrasy

b) Hypersensitivity

c) Tolerance *

d) In tolerance



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.......... occur when rate of drug administration exceeds the rate of its

elimination

a) Idiosyncrasy

b) Hypersensitivity

c) Toleranced) Cummulation *

Cigarette smoking is a psychological dependence

a) True *

b) False

Addiction is physiologic dependence only

a) True

b) False *

The effect of two drugs is the algebraic summation is called

a) Antagonism

b) Addition *

c) Synergism

d) Potentiation

The effect of two drugs is more than their algebraic summation is

called

a) Antagonism

b) Addition *

c) Synergism

d) Potentiation

Caffeine and paracetamol give an example for :

a) Antagonism

b) Addition

c) Synergism

d) Potentiation *

Paracetamol and aspirin give an example for :

a) Antagonism

b) Addition *

c) Synergism

d) Potentiation



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Barbiturate and alcohol give an example for :

a) Antagonism

b) Addition

c) Synergism *

d) Potentiation

Morphine and naloxone give an example for :



c) Competitive antagonism *

d) Non receptor antagonism

Cimetidine is an enzyme inducer that lead to increase metabolism

a) Trueb) False *

Chloramphenicol is an enzyme inhibitor that lead to decrease

metabolism

a) True *

b) False

Barbiturates are enzyme inducer that lead to increase metabolism

a) True *b) False

.............is the passage of drugs from the site of administration to

systemic circulation

a) Metabolism

b) Absorption *

c) Distribution

d) Elimination

The drug concentration gradient is the driving force of the

a) Lipid diffusion

b) Endocytosis

c) Aqueous diffusion *

d) Exocytosis

Lipid diffusion depends on :

a) Degree of lipid solubility drug

b) Degree of ionization

c) Both a and b *

d) None of the abov



MOD 4 : COHD

24

Facilitated diffusion is an energy requiring process

a) True

b) False *

Very hydrophilic drugs are not well absorbed because cannot crosslipid cell membrane

a) True *

b) False

Rectal route of administration always avoid 1st pass metabolism

a) True

b) False *

All route of administration have bioavailability < 1 except :

a) Oral

b) Rectal

c) I.V *

d) Sublingual

Major plasma protein important for drug binding include :

a) Albumin

b) Lipoprotein

c) Glycoproteind) All of the above *

The ratio between the amount of the given drug and the

concentration of the drug in blood or serum is called :

a) Clearance

b) Elimination

c) Volume of distribution *

d) bioavailability

........... is the volume of plasma cleared off the drug per unit time

a) Clearance *

b) Elimination

c) Volume of distribution

d) bioavailability

the time required to decrease the amount of drug in body by ½ during elimination is called

a) Clearance

b) Elimination half life *


d) Bioavailability



MOD 4 : COHD

25

To reach about 95% of a new steady state..... half-lives are required

a) 8

b) 5

c) 4 *

d) 2

.......... of drugs to more hydrophilic molecules is required for

elimination from the body

a) Clearance

b) Elimination half life


d) Biotransformation *

In phase I of biotransformation :

a) Active metabolites directly excreted in the urine

b) React with endogenous compound to form water soluble conjugates

c) Both a and b *

d) None of the above

Example of phase I reactions in biotransformation :

a) Oxidation

b) Reduction

c) Hydrolysis


In phase II of biotransformation parent drug or metabolite

participate in reaction that form covalent linkage between a parent compound functional group and

a) Acetate

b) Glutathione

c) Sulphate

d) Amino acid

e) All of the above *

Nitric oxide synthetized in :

a) Macrophages

b) Endothelium

c) CNS


Nitric oxide has many actions such as:

a) Vasodilatation

b) Immune regulation

c) Neurotransmitter




MOD 4 : COHD

26

.......... may prevent excessive production of NO in septic shock

a) Sildenafil

b) NO donor

c) NO synthesis inhibitor *d) Interferons

Glucocorticoids block all the known pathways of eicosanoids

a) True *

b) False

Lipo-oxygenase enzyme converts arachidonic acid to :

a) Leukotrienes *

b) Prostaglandinsc) Thromboxane

d) Both b and c

Cyclooxygenase enzyme converts arachidonic acid to :

a) Leukotrienes

b) Prostaglandins

c) Thromboxane

d) Both b and c *

......... are oxygenated products of polyunsaturated long chain fattyacids

a) NO

b) Cytokines

c) Eicosanoids *

d) Amino acids

......... is the most abundant precursor of eicosanoids

a) Cephalin

b) Arachidonic *

c) Lecithin

d) Stearic

...... is a constitute iso-enzyme important for gastric cytoprotection

a) COX I *

b) COXII

c) NSAIDs

d) TXA2



MOD 4 : COHD

27

NSAIDs activate both Isoenzyme COXI and COXII

a) True

b) False *

........ are important mediators of inflammation and allergy

a) Leukotrienes

b) Prostaglandins

c) Thromboxane

d) Both a and b *

....,.... cause vasodilation

a) PGI2, PGE2 *

b) TXA2, PGF2

c) COXIa) COXII

........ cause vasoconstriction

a) PGE2

b) TXA2, PGF2 alpha *

c) COXI

d) COXII

....... relax smooth muscles

a) PGE1 *

b) TXA2, PGF2

c) COXI

d) COXII

...... have oxytocic effect

a) PGI2

b) PGF2 *

c) COXI

d) COXII

....... inhibits gastric secretion

A) PGI2 ,PGE1 *

B) TXA2, PGF2

C) COXI

D) COXII

NOTE: PGI2 >>> vasodilatation, inhibit gastric secretion

PGE1>>> relax smooth muscles, inhibit gastric secretion

PGE2 >>> vasodilatation

PGF2 >>>> have potent oxytocic effect



MOD 4 : COHD

28

Histamine stored bound to granules in

a) Mast cells

b) Brain

c) Enterochromatin cells of GIT


....... is a physiological antagonist of histamine

a) Corticosteroids

b) Adrenaline *

c) Mast cells

d) Cromolyn

Mast cell stabilizers as ......... inhibit degranulation of mast cells

a) Corticosteroids

b) Adrenaline

c) Mast cellsd) Cromolyn *

............ suppress the effects antigen antibody reaction

a) Corticosteroids *

b) Adrenaline

c) Mast cells

d) Cromolyn

Second generation of competitive inhibition of histamine

at H1 receptors has short acting

a) True

b) False *

First generation of competitive inhibition of histamine at

H1 receptors cross blood brain barrier

a) True *

b) False

Second generation of competitive inhibition of histamine

at H1 receptors may cause cardiac arrhythmias

a) True *

b) False

............. are actions of kinins

a) Arteriolar dilating effect

b) Pain mediator

c) Both a and b

d) None of the above



MOD 4 : COHD

29

............ is one of vasoconstrictor peptides

a) Kinin

b) Bardykinin

c) VIP

d) Angiotensin II *

......... is one of vasodilating peptides

a) Kinin

b) Bardykinin

c) VIP

d) CGRP

e) All of the above *

......... are proteins or large peptide mediators released by

the cells of the immune system

a) Eicosanoides

b) NSAIDs

c) Cytokines *

d) Prostaglandins

The cytokines super family include

a) Interleukins

b) Interferons

c) Growth factors

d) Chemokinese) All of the above *

Cytokines act in a complex interconnecting network on

a) Leucocytes

b) Mast cells

c) Osteoclasts


........ is important primary inflammatory cytokines

a) Interleukin 1

b) TNF

c) IFNs

d) Both a and b *

..... has antiviral activity

a) Interleukin 1

b) IFNs beta

c) IFNs alpha

d) Both b and c *



MOD 4 : COHD

......... has significant immunoregulatory functions

a) Interleukin 1

b) IFNs –y *

c) IFNs alpha

d) Both b and c

....... is used in treatment of chronic hepatitis B and C

a) Interleukin 1

b) IFNs beta * ( interferon )

c) IFNs alpha

d) Both b and c

Cytokines can act on haemopoietic stem cells

a) True *

b) False

Qmu Module 4 Cohd

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Transcript of Qmu Module 4 Cohd