Coordinator :Prof. Husni Twaij
Internal Examiner : / / Faculty of Pharmacy
Department of Clinical Sciences
Student Name: Student Number:
Course Name: Pharmacology 11 Semester: 2 of Academic Year 2009 / 2010
Course Number: 511320 Section: 1 Date:1/6 / 2010
Final Exam Time two hours
Information for Candidates
1. This examination paper contains … questions, totaling. 50… marks.
2. The marks for parts of questions are shown in round brackets.
Notes to Candidates
1. You should attempt all questions.
2. You should write your answers clearly.
Part I. Basic Notions
Objectives. The aim of the questions in this part is to evaluate the required minimal student knowledge and skills. Answers in the pass category represent the minimum acceptable standard.
//////////Question: 1- Select the one lettered answer of all the following questions:
*- The Aminoglycoside related antibiotic used for gonorrhea in
patients who are allergic to penicillin or whose gonococci are
resistant to other drugs is
A. Netilmicin. B. Kanamycin.
C. Sisomicin. D. Spectinomycin.
*- All of the following Aminoglycosides are mainly giving by oral
EXCEPT
A. Amikacin. B. Neomycin.
C. Kanamycin. D. Paromomycin.
*- All of the following statements concerning Amikacin are
correct EXCEPT
A. It is resistant to many enzymes that inactivate gentamicin and
tobramycin.
B. It can be used for multidrug- resistant Mycobacterium tuberculosis.
C. It is consider safe drug with negligible Nephrrotoxicity & Ototoxicity.
D. It is semi- synthetic derivative of Kanamycin.
*- The most Nephrotoxic Aminoglycosides are all of the following
EXCEPT
A. Neomycin. B. Tobramycin.
C. Streptomycin. D. Gentamicin.
*- All of the following statements regarding Aminoglycosides are
corrects EXCEPT
A. They are bacteriostatic antibiotic act by irreversible inhibition of the
protein synthesis of the microorganism.
B. Synergism is resulted from giving them with Beta-lactam & or
Vancomycin antibiotics.
C. The trough serum concentration should be less than 2ug/ml.
D. The dose regimen should be adjusted according to creatinine
Clearance or with a serum creatinine level.
*- All of the following statements concerning Gentamicin are
correct EXCEPT
A. It is mainly used by I.V. rout by a dose of 5-6mg/kg/d.
B. It is applied in sever infection s (Sepsis & pneumonia) caused by
Gram negative bacteria that are resistant to other drugs.
C. It is inactive for endocarditis due to streptococci or Enterococci
either alone or in combination with penicillin G.
D. It is also used by topical application as a solution or cream &
ointment in therapy of infected wounds or burns.
*- The Aminoglycoside which is used orally for the treatment of
amebiasis or parenterally for visceral lishmaniasis is
A. Paromomycin. B. Streptomycin.
C. Tobramycin. D. Neomycin.
*. Sulfonamide of choice for the treatment of acute
Toxoplasmosis is
A. Sulfadoxine + pyrimethamine.
B. Sulfadiazine + pyrimethamine +Folinic acid 10mg/d.
C. Sulfapyridine + pyrimethamine.
D. Sulfadiazine + trimethoprim.
*. All of following are adverse effects of Sulfonamide EXCEPT
A. Allergic reaction (Fever, skin rashes).
B. Steven-Johnson syndrome.
C. Crystalluria & Obstruction.
D. Qt prolongation & arrhythmia.
*. The drug of choice for the treatment of pneumocystis
pneumonia is
A. Sulfadiazine (1g) + Trimethoprim (160mg).
B. Sulfamethoxazole (400mg) +Trimethoprim (80mg) by oral rout twice daily
C. Sulfamethoxazole (100mg/kg) + Trimethoprim (20mg/kg) by I.V. rout.
D. Sulfadiazine 1g qid + Pyrimethamine 75mg loading dose then25mg/d.
*. All of the following are the clinical uses of Co-Trimoxazole
EXCEPT
A. Prostatitis. B. P.jiroveci pneumonia.
C. Mycoplasma pneumoniae. D. Shigellosis & Salmonella infections.
E. Complicated urinary tract infections.
*. All of the following statement related to Fluoroquinolones
are correct EXCEPT
A. They are a bactericidal agent against gram + & gram- bacteria.
B. They should be given 2 hours before or 4 hours after di-valent or tri-
valent cations including antacids.
C. Dose adjustment for renal failure is not necessary for moxifloxacin.
D. They are safely used in pregnancy & patients of all age.
*.All of the following statements concerned with Fluoroquinolones clinical application are correct EXCEPT
A. Gonococcal infections (Ciprofloxacin, &Levofloxacin.) are no longer used.
B. Urinary tract infection ( All of them except Moxifloxacin.).
C. Tuberculosis (Ciprofloxacin or levofloxacin, of Moxifloxacin.).
D. Respiratory tract infection (Norfloxacin).
E. Eradication of meningococci from carriers (Ciprofloxacin or Levofloxacin or
Moxifloxacin.)
*. All of the following are the adverse effects of
Fluoroquinolones EXCEPT
A. Nausea, vomiting & diarrhea.
B. Hepatitis (Ciprofloxacin)
C. Q.T, prolongation (gemifloxacin, Gatifloxacin, moxifloxacin, levofloxacin).
D. Photosensivity (Lomefloxacin & pefloxacin).
*. Cephalosporins are not active against two of the
following microorganism.
A. Klebsiella pneumonia.
B. Listeria monocytogenes.
C. Staphylococci strains.
D. Escherichia coli.
E. Enterococci.
*. Which of the following statements related to Cefazolin
antibiotic is not correct?
A. It is a first generation cephalosporin.
B. It is drug of choice for surgical prophylaxis.
C. It is given by oral rout 0.5g qid .
D. It is the least toxic drug used for K. pneumonia.
*. All of the following are clinical uses of the Cefuroxime
EXCEPT
A. It is used to treat pneumonia.
B. It is used in therapy of lower respiratory tract infections.
C. It is used in Sinusitis & otitis.
D. It is most effective in the treatment of meningitis caused
by pseudomonas aeruginosa.
*. The doses of all of the following Cephalosporins are
adjusted in patients with renal insufficiency EXCEPT
A. Ceftriaxone & Cefoperazone.
B. Cefotaxime & Cefixime.
C. Cefazolin & Cefadroxil.
D. Cefotetane & Cefmetazole
*. Two of the followings were considered drugs of first- line for the treatment of gonorrhea.
A. Ceftriaxone 125mg/d i.v.
B. Cefixime 400mg/d orally.
C. Cefotaxime 1g/d i.v..
D. Cefoxitine 15mg/kg/d i.v.
E. Cefaclor 1g/d orally.
*. All of the following Meningitis can be treated by third
generation cephalosporins EXCEPT
A. Pneumococcal meningitis.
B. Meningococcal meningitis.
C. Listeria monocytogenical meningitis.
D. H influenzae meningitis.
*. All of the following statements regarding Cefepime are
correct EXCEPT
A. It is a fourth generation cephalosporin.
B. It is useful in treatment of enterobacter infections.
C. Its clinical application is similar to the third generation cephalosporin.
D. It is used by oral rout & excreted via bile.
*. All of the following are the adverse effects of penicillins
EXCEPT
A. Allergic reactions such as anaphylactic shock etc.
B. Hemolytic anemia.
C. Neutropinia & glucose intolerance are caused by Oxacillin.
D. Interstitial nephritis caused by methicillin.
*. All of the following penicillins are given orally I hour
before or after meals EXCEPT
A. Azlocillin. B. Pipericillin.
C. Ticarcillin. D. Ampicillin.
E. Amoxicillin.
*. All of the following penicillins are anti –pseudomonas
aeruginosa infections EXCEPT
A. Carbenicillin indanyl sodium. B. Ticarcillin.
C. Pipericillin. D. Amoxicillin.
E. Mezlocillin.
*. All of the following penicillins are resistant to
staphylococcal beta-lactamase EXCEPT
A. Methicillin. B. Nafcillin.
C. Pipericillin. D. Cloxacillin.
E. Oxacillin.
*. Dosage adjustment is not required for all of the
following penicillins EXCEPT
A. Nafcillin. B. Dicloxacillin.
C. Oxacillin. D. Ticarcillin.
E. Cloxacillin.
*. Ureidopenicillins are active on all of the following
bacterial EXCEPT
A. K.pneumonia. B.Enterobacter species.
C. P. aeruginosae. D. Staphylococcus aerus.
*. Penicillin G is the drug of choice for infections caused
by all of the following bacteria EXCEPT
A. Treponema pallidum. B. Streptococci & meningococci.
C. H.influnzae. D. Enterococci .
E. Clostridium species.
*. All of the following antibiotics are bactericidal act via
interfering with specific step in bacterial cell wall
synthesis EXCEPT
A. Tetracyclines. B. Vancomycin.
B. Penicillins. D. Carbapenems.
E. Cephalosporins. F. Cycloserine.
*. All of the following cephalosporins causes sever
Disulfiram-like reactions EXCEPT
A. Cefamandole. B. Cefotetane.
C. Ceftriaxone. D. Cefoperazone.
E. Cefmetazole.
*. Drug of first choice for treatment of enterobacter
infections is
A. Meropeneme. B. Vancomycin.
C. Tazobactam. D. Aztreonam.
*. All of the following statements are related to
Carbapenems EXCEPT
A. Imipenem has slightly greater activity against gram-negative aerobes
& slightly less activity against gram-positive.
B. Ertapenem is not effective against P aeruginosa & should not be used
For the treatment of infections caused by that organism.
C. Aminoglycoside giving simultaneously with some carbapenems
For the treatment of infections caused by P.aeruginosa.
D. The most common adverse effects which are more common with
Imipenem are skin rash, nausea & vomiting.
E. Patients allergic to penicillins may be allergic to carbapenems as well.
*. All of the following statements concerned with
Vancomycin are correct EXCEPT
A. It is used by oral route for the treatment of antibiotic associated
diarrhea.
B. Its main route of administration is I.V. for the treatment of sepsis or
endocarditis caused by methicillin-resistant staphylococci.
C. It is also used alone in therapy of meningitis that caused by highly
penicillin –resistant strain of pneumococcus.
D. Its main adverse effect are red man or red neck, phlebitis etc.
*. The antibiotic which is used in therapy of
uncomplicated lower urinary tract infection in women
& it safe in pregnancy is
A. Polymyxin. B. Carbapenems.
C. Cycloserine. D. Fosfomycin.
E. Cefoperazone.
*. All of the following statements related to Bacitracin are
correct EXCEPT
A. It is limited for topical use.
B. It is active against gram –negative microorganism.
C. It produces marked Nephrrotoxicity if it reaches the systemic circulation.
D. It is usually used in combination with neomycin or polymyxin.
*. All of the following differences between Clarithromycin &
Azithromycin are correct EXCEPT
A. Azithromycin should be administered I hour before or 2 hours after
meals while Clarithromycin not.
B. Azithromycin is free from drug interaction in contrast to
Clarithromycin.
C. Clarithromycin is highly active against Chlamydia than
Azithromycin.
D. Azithromycin has a longer duration of action than Clarithromycin.
*. All of the following statements are related to Telithromycin EXCEPT
A. It is a ketolides differ from erythromycin by substitution of a 3-keto
group for the neutral sugar.
B. Many Macrolide-resistant strains are susceptible to ketolides.
C. It is administered once daily dose of 800mg.
D. It has no drug interaction.
*. Erythromycin is the drug of choice in all of the following
bacterial infections EXCEPT
A. Corynebacterial infections (diphtheria, corynebacterial sepsis,
erythrasma) .
B. Respiratory, neonatal, ocular, or genital chlamydial infections.
C. Acne.
D. Community acquired pneumonia.
*. All of the following are the adverse effects of
Erythromycin EXCEPT
A. Anorexia & nausea. B. Diarrhea.
C. Liver toxicity. D. Vestibular reaction (Vertigo).
*. The absorption of two of the following tetracycline is
not impaired by food
A. Chlortetracycline B. Doxycycline.
C. Oxytetracycline. D. Minocycline.
E. Methacycline. F. Demeclocycline.
*. Dose adjustment is required in patient with renal
failure taking any of the following tetracycline
EXCEPT
A. Minocycline. B. Doxycycline.
C. Oxytetracycline. D. Methacycline.
*. Absorption of all tetracycline is impaired by all of the
metals , drugs or stomach pH EXCEPT
A. Ca & Mg ions. B. Ferric ion.
C. Antacids. D. Dairy product.
E. Alkaline pH. F. Acidic pH.
*. Tetracycline is the drug of choice in infection with all of
following microorganisms EXCEPT.
A. Mycoplasma pneumoniae. B. Chlamydia.
C. Rickettsiae. D. M.tuberculosis.
*. The adverse effects of Tetracycline are all of the following
EXCEPT
A. Pseudomembranous enterocolitis. B. Bone & teeth deformity.
C. Hepatic necrosis. D. Red cell suppression.
*. Which of the following Tetracycline is only giving by I.V. route
A. Doxycycline. B. Tigecycline.
C. Methacycline. D. Demeclocycline.
*. All of the following statements related to Clindamycin
are correct EXCEPT
A. It is used in combination with aminoglycoside or cephalosporin to treat penetrating wounds of the abdomen & the gut.
B. It replaces erythromycin for prophylaxis of endocarditis in patient
undergoing dental procedures.
C. It adverse effects are impairment of liver function, neutropenia,
& enterocolitis, etc..
D. It is a bactericidal for most of organism except Clostridium difficile.
*. All of the following statements related to
Chloramphenicol are correct EXCEPT
A. A gray baby syndrome is an adverse effect which can be avoided
in premature infants by a dosage limited to 50mg/kg/d.
B. A dose independent aplastic anemia is a serious
adverse effects of its application by any route.
C. It is contraindicated with penicillins & aminoglycoside.
D. It used topically for the treatment of non chlamydial eye infections.
* . A regimen of choice for eradication of H pylori infection is
A. PPI + Bismuth subsalicylate + Tetracycline + Metronidazole.
B. PPI + Bismuth subcitrate + Metronidazole + Tetracycline.
C. PPI + Clarithromycin + Amoxicillin.
*. The OTC antidiarrheal agent is
A. Loperamide.
B. Diphenoxalate.
C. Octreotide.
D. Alosetron.
*. Which of the following glucocorticoids is associated with lowest
incidence of side effect?
A. Prednisolone. B. Betamethasone.
C. Dexamethasone. D. Triamcinolone.
*. Which of the following antithyroid agents is preferable to be
used in pregnancy?
A. Methimazole. B. Propylthiouracil.
C. Iodine. D. Radioactive iodine.
*. All of the following insulin are rapid acting insulin EXCEPT
A. Insulin Lispro. B. Insulin Aspart.
C. Insulin glulisine. D. Insulin Detemir.
*. Which of the following oral antidiabetic drug cause reduction in
Vitamin B12 absorption?
A. Metformin. B. Pioglitazone.
C. Miglitol. D. Nateglinide.
Question II
Objectives. The aim of the questions in this part is to evaluate that the student has some basic knowledge of the key aspects of the lecture material and can attempt to solve familiar problems.
///////////Question: 2-.Answer all of the following miscellaneous questions.
*. Meningitis caused by P. aeruginosa should be treated
by a combination of ……………………………………..
& ……………………………
*. The double –strength tablets of Co-Trimoxazole
composed of ……………… &………………………..
and used twice daily in patients with…………………...
*. Which tetracycline inhibits the action of ADH? & what
is its most common & special adverse effect ?
……………………………………………………………..
……………………………………………………………