Mf-klausimai-2010-eng

1. Which drug is the drug of choice for “pulse steroid“ therapy? A. Methylprednisolonum B. Hydrocortisonum C. Prednisolonum D. Prednisonum 2. The most common side effect of ACE inhibitors is: A. Taste disturbances B. Dry cough C. Somnolence D. Hypokalemia 3. Allergic reactions are most common in the use of: A. Streptokinasum B. Urokinasum C. Alteplasum D. Reteplasum E. Tenecteplasum 4. Name drugs, which are used because they act positively on development of early and late asthmatic reaction. A. Theophyllinum and beta adrenergic agonists B. Theophyllinum and beta adrenergic antagonists E. Cromolinum, nedocromilum and theophyllinum 5. Which daily dose of aspirin should be used for the prevention of myocardial infarction? A. 75-150 mg B. 330-500 mg C. 0,5-1,0 g D. 1,0-3,0 g 6. The strongest action on cholesterol and LDL reduction in plasma has: A. Bile acid sequestrans B. Statins C. Nicotinic acid derivates D. Fibrates 7. Name the drugs that are used extensively currently due to effective inhibition of inflammatory component of asthma. A. Theophyllinum B. Beta-2 adrenergic agonists C. Ipratropium D. Corticosteroides E. No positive answer 8. The biggest risk of overdose is in the use of: A. Barbiturates and tricycle antidepressants (TCAs) B. Tranquillises C. Neuroleptics D. Selective Serotonin Reabsoption Inhibitors (SSRI) 9. Name the drug - Dopamine receptor antagonist for the prevention of nausea and vomiting: A. Aspirinum B. Cimetidinum C. Metoclopramidum D. Erythromycinum E. Bisacodylum 10. The most common side effect of amlodipine is: B. Dry cough C. AV Heart block D. Constipation E. Peripheral edema 11. Most rapid onset of action of nitroglycerine’s pharmaceutical form has: A. Sublingual tablet B. Slow release capsule C. Film coated tablet D. Transdermal disc 12. The longest duration of action of nitroglycerine’s pharmaceutical form has: A. Sublingual tablet B. Transdermal disc C. Film coated tablet D. Nitroglycerin ointment 13. What is the most useful method of administration of statins: A. Three times per day (without relation to meal) B. Once daily on evening ours C. Three times per day (30 min. before meal) D. Once daily on morning ours 14. Contraindication of β-adrenergic blockers: A. 2nd or 3rd degree of heart block B. Supraventricular tachycardia C. Mitral stenosis D. Hipertensión 15. The shortest half life of antiarrythmic medicine is for: 16. The highest risk of heart block is in the case of: A. Felodipinum B. Nifedipinum C. Nicardipinum D. Verapamilum 17. Effectiveness of oral contraceptives can be reduced and abnormal menstrual cycle can arise if the oral contraceptives are used together with: A. Acetaminofenum B. Aspirinum C. Digoxinum D. Ampicillinum E. Cimetidinum 18. “The Drug of choice” for the short term treatment of sleep disturbances is: A. Phenobarbitalum B. Diazepamum C. Medazepamum ar oxazepamum D. Clonazepamum E. Nitrazepamum ar triazolamum 19. Which drug is the drug of choice for the treatment of ulcerative colitis? A. Sulfasalazinum B. Acidum 5-aminosalicylicum C. Ibuprofenum D. Metoclopramidum 20. Omeprazole is: A. H2 receptor antagonist B. Cytoprotector C. Inhibitor of proton pump D. Anticholinergic medicine 21. Many patients with hepatic insufficiency and hepatic coma are treated with nonabsorbsable antimicrobials such as neomycin. Name the basis for this tactic: A. Antibiotic, inhibiting gut microorganisms, decreases the quantity of ammonia and other bacterial B. Antibiotic destroys microorganisms which are highly pathogenic C. Neomycin acts not only as antibiotic but also as a diuretic, causing transfer of fluids from D. Neomycin is indicated in case of ascending cholangit only, which could be the consequence of 22. Name the point when penicillin has weak antibacterial activity or no antibacterial activity at all: A. Treponema pallidum B. Actively dividing microorganisms C. Meningococci D. Actively non-dividing microorganisms 23. Which calcium antagonist has highest selectivity on vascular smooth muscles? A. Verapamilum B. Diltiazemum C. Nifedipinum D. Nicardipinum 24. ACE Inhibitors should been prescribed for the treatment of heart failure: A. In all cases in the absence of contraindications B. In the case of renal failure C. If heart failure is severe or moderate degree D. In the case when potasium excretion diuretics are prescribed E. When digitalis treatment is not effective 25. The risk of arrhythmias in healthy people on antiarrhythmics medicine treatment is: 26. The strongest anti-inflammatory action has: A. Hydrocortizonum (3mg) B. Dexamethazonum (3mg) C. Prednisolonum (3mg) D. Metylprednizolonum (3mg) 27. Oral contraceptives can decrease the effect of: A. Insulin B. Aminophyllinum C. Prednizolonum D. Diazepamum E. Dexamethazonum 28. Which dose of heparin is most effective in the prevention of thromboembolic disorders after elective gynecological or abdominal-thoracic surgery? A. Low-dose 10000 units/daily B. Medium-dose 20000 units/daily C. High-dose 30000 units/daily D. Very high-dose 40000 units/daily 29. Which medicine could worse the condition of closed angle glaucoma? A. Amitriptyllinum B. Fluoxetinum C. Diazepamum D. Sumatriptanum E. Chloramphenicolum 30. Which proposition describes Good Clinical Practice standard best? A. Each individual involved in conducting a trial should be qualified by education, training, and experience to perform his or her respective task(s) B. Before a trial is initiated, foreseeable risks and inconveniences should be weighed against the anticipated benefit for the individual trial subject and society C. The rights, safety, and well-being of the trial subjects are the most important Considerations of Investigator D. Good clinical practice (GCP) is an international ethical and scientific quality standard for designing, conducting, recording, and reporting trials that involve the participation of human subjects. Compliance with this standard provides public assurance that the rights, safety, and wellbeing of trial subjects are protected, consistent with the principles that have their origin in the Declaration of Helsinki, and that the clinical trial data are credible 31. Which proposition describes drug development time and costs best? A. 100.000 EUR/0.2% sales/1 month B. 1.000.000 EUR/0.6% sales/6 month C. 10.000.000 EUR/6% sales/6 years D. 900.000.000 EUR/14-16% sales/14 years 32. What type of testing is used in the preclinical phase of drug discovery? A. Computers based disease models B. Cellular methods C. Cellular tissues methods D. Laboratory animals’ method E. All listed 33. What characteristics of a new drug discovered goes for testing during preclinical phase: A. Pharmacokinetics in healthy volunteers B. New indications and pharmacodynamics in patients C. Side effects in patients with renal failure D. Bioequivalence and bioavailability E. Pharmacokinetics and pharmacodynamics of the new drug in computers based disease models, cellular tissues methods and laboratory animals’ methods 34. What type of clinical trials are going in phase I clinical trials: A. Pharmacokinetics trials in healthy volunteers B. Clinical trials for new indications C. Safety trials after drug authorization D. Trials on drug interactions E. Pharmacodynamics trials in elderly patients 35. What type of methods of clinical trials is going in phase II clinical trials? A. “Duble-blind” method B. “Blind” method C. Randomized method D. Controlled method 36. What type of clinical trials is going in phase III clinical trials? A. Preclinical safety trials B. Pharmacokinetics trials in healthy volunteers C. Bioequivalence and bioavailability trials D. Detailed trials on pharmacokinetics and pharmacodynamics in large group of 3000-5000 patients E. Pharmacodynamics trials in elderly patients 37. What type of clinical trials is going in phase IV clinical trials? A. Preclinical safety trials B. Pharmacokinetics trials in healthy volunteers C. Bioequivalence and bioavailability trials D. Detailed trials on pharmacokinetics and pharmacodynamics in large group of 3000-5000 patients E. New indications and safety trials after authorization A. It’s analytical methods that compare the value of one pharmaceutical drug to another or drug therapy to another health service in correlation to outcomes and it serves optimal healthcare resource allocation B. It’s settlement of margin of retail price for drugs C. It’s settlement of margin of whole price for drugs D. It’s treatment with the cheapest drug A. When investigational and comparative drugs have equal efficacy and equal tolerability and B. When two or more drugs or alternative health service have different costs and outcomes, that are C. When cost utility is evaluated in social aspect and results are measured in quality-adjusted life years D. When incremental cost-effectiveness ratio (ICER) is under evaluation A. When investigational and comparative drugs have equal efficacy and equal tolerability and B. When two or more drugs or alternative health service have different costs and outcomes and evaluation of incremental cost-effectiveness ratio (ICER) shows additional costs for additional benefit. The incremental cost-effectiveness ratio (ICER) is the ratio between the difference in costs and the difference in benefits of two interventions C. When cost utility is evaluated in social aspect and results are measured in quality-adjusted life years D. Cost analysis is performed in social aspect with calculation of costs that are not related to health service costs and benefits and these results are coming from outside health service budget A. When results are measured in quality-adjusted life years (QALYs) and additional costs are measured in terms of additional years of full health lived, using a measure such as quality-adjusted life years B. When investigational and comparative drugs have equal efficacy and equal tolerability and C. When two or more drugs or alternative health service have different costs and outcomes and evaluation of incremental cost-effectiveness ratio (ICER) shows additional costs for additional benefit. D. The incremental cost-effectiveness ratio (ICER) is calculation for one clinical outcome 42. Pharmacoeconomics analysis is doing evaluation of: A. Reduction in death B. Reduction in treatment complications C. Reduction in adverse drug reactions D. Reduction in disease symptoms E. Reduction in hospitalization F. All listed A. Costs for medicines B. Out patients costs C. Costs for hospitalization D. Costs for diagnostic procedures and laboratory tests E. Costs for adverse drug reactions treatment F. All listed 44. Nimesulide has more expressed adverse drug reaction than other NSAID’s: A. Hepatotoxic action B. Allergic reaction C. Renal failure D. Stomach ulcer E. Bleeding from stomach F. Agranulocitosis 45. Witch proposition describes “tolerance to nitrates” best? A. Tolerance to nitrates becomes after long term treatment and we have to increase dose of nitrates B. Tolerance to nitrates becomes in case when nitroglycerine in combination with the aspirin C. When patient use sublingual capsules together with nitroglycerine transdermal disc and effect is D. When nitroglycerine medications are used in 24 hours regime and there is not intermittent regime 46. Name the true sentence. The cardio selectivity of β-adrenergic blockers is: A. Therapeutic dose has action only on β1-adrenergic receptors B. Les risk of bronchospasm C. Les risk reduction in the peripheral circulation D. Relative selectivity. High dose has action on β2-adrenergic receptors two E. All listed 47. What is the maximum daily dose of paracetamol for the adult? 48. If the virus infection suspected, the use of aspirin is restricted due to: A. Reye syndrome B. Increase risk of hypothermic seizure C. Increase risk of hyperergic reactions D. Increase risk of stomach bleeding E. All listed events A. Geriatric patients are more sensitive to H2 blockers effect B. Geriatric patients are more sensitive to diuretic effect C. Geriatric patients are more sensitive to antibiotic effect D. Geriatric patients are more sensitive to benzodiazepines effect A. Geriatric patients are more sensitive to beta adrenoblockers effect B. Geriatric patients are less sensitive to beta adrenoblockers effect C. Geriatric patients are less sensitive to benzodiazepines effect D. Geriatric patients are less sensitive to calcium channels blocks effect A. In geriatric age, content of body water and lipids increases B. In geriatric age, content of body water and lipids does not change C. In geriatric age, content of body water increases while lipids - increases D. In geriatric age, content of body water decreases while lipids - increases A. In geriatric age, both phases of metabolism are disturbed B. In geriatric age, first phase of metabolism is disturbed C. In geriatric age, second phase of metabolism is disturbed D. In geriatric age, metabolism is not disturbed A. In geriatric age, T1/2 of majority of medicines is increased B. In geriatric age, T1/2 of majority of medicines is decreased C. In geriatric age, T1/2 of majority of medicines is unchanged D. In geriatric age, T1/2 of majority of medicines disappears 54. Which medicines are with the increased risk in geriatric age? A. There are no such medicines B. Medicines that have short T1/2, psychotropic and anticholinergic medicines C. Medicines that have long T1/2, psychotropic and anticholinergic medicines D. Inject able medicines A. All congenital abnormalities B. Congenital abnormalities when medicine was used during pregnancy C. Congenital abnormalities when medicine was used before fertilisation D. Death of fetus 56. Which antibiotics are safe for pregnant women? A. Penicillins B. Tetracyclins C. Fluoroquinolons D. Aminoglycosids 57. Which medicines are with increased risk for faint? A. Penicillins B. Glucocorticoids C. Neuroleptics D. Paracetamol 58. Rash on skin was observed after the start of using penicillin. After stopping of medicine, rash disappears. No other medicine is used. This type of adverse effect is described in package leaflet. Patient had rash in the past from the amoxicillin use. What is causal relationship? A. Direct B. Probable C. Possible D. Remote 59. After 2 days of using levodopa, nausea appeared. After stopping of medicine, nausea diminished but not disappeared. Patient was using diclofenac at the same time. This type of adverse effect is described in package leaflet. What is causal relationship to levodopa? A. Direct B. Probable C. Possible D. Remote 60. Adverse effect is observed in 3% of patients. What category of frequency is relevant to this effect? A. Very frequent B. Frequent C. Not frequent D. Rare E. Very rare 61. Which medicines most frequently cause allergy? A. Neuroleptics B. Antihypertensives C. Antibiotics D. Anticoagulants 62. Which medicines most frequently cause thrombocytopenia? A. Heparins B. Benzodiazepines C. Antidepressants D. Antiulcer medicines 63. Which medicines can most frequently damage kidneys? A. Heparin B. Benzodiazepines C. NSAIDs D. Antiulcer medicines 64. Which medicines can most frequently damage liver? A. Benzodiazepines B. Paracetamol C. Penicilines D. Cardiac glycosides 65. Which medicines disturb ability to drive? A. Benzodiazepines and antidepressants B. Paracetamol and neuroleptics C. Amiodarone and antiepileptics D. Cardiac glycosides and antiparkinsonics 66. Which adverse effect is most probably serious? A. If patient is not able to go working 20 days B. If patient experienced rash in 2/3 of body C. If patient was hospitalised for 3 days due to adverse effect D. If patient experienced shortness of breath 67. Which of adverse effects is most probably serious? A. If patient is not able to go working 15 days B. If patient experienced fatigue for 3 hours C. If patient was vomiting D. If patient has prolonged stay in hospital 68. The most rationale way for monitoring of therapeutic drugs effect: A. Character of patient’s complaints B. Establishment of objective symptoms (physical findings) C. Measurement of drug concentration D. Interpretation of clinical laboratory tests A. All methods, using for monitoring of therapeutic drugs effect, are expensive. B. Drug concentration is measured for all patients, which are treated with combination of drugs. C. Drug concentration should never replace clinical judgment D. Instrumental procedures are basal for monitoring of therapeutic drugs effect. 70. Common clinical methods for monitoring of therapeutic effect of antimicrobial drugs: A. Laboratory tests (blood and urine) B. Clinical assessment (pain, fever) and laboratory blood tests (white cells count, C reactive protein) C. Dynamic of X-ray data D. Dynamic of palpation and auscultation 71. What character of chest pain should be estimate during monitoring of therapeutic effect of antianginal drugs? A. Stabbing pain in left side, associated with breathing B. Long-lasting chest pain, beginning at rest C. Burning pain in the pit of the stomach at hunger D. Substernal pain at physical exertion, in the cold, in the wind, relieving after stopping exertion 72. Which findings can indicate effect of drugs, using for treatment of hypertension? A. Sodium concentration in blood B. Heart X-ray C. Arterial blood pressure D. ECG 73. Method for monitoring of antithrombotic effect of oral anticoagulants: A. Laboratory tests (International normalized ratio and Prothrombin index) B. Patient’s complaints C. Chest X-ray D. Echoscopy 74. Which findings can indicate effect of antihyperlipidemic drugs? A. Patient’s complaints B. Cholesterol plasma concentration C. Patient’s weighing D. ECG 75. Pediatric pharmacology is the mostly influenced by: A. Different aspects of pharmacokinetics in children B. Different aspects of pharmacodynamics in children C. Both 76. Absorption of drugs from injection site in severe sick hypotrophic children is: 77. Absorption of drugs in children from gastrointestinal tract in case of diarrhoea is: 78. Concentration of water-soluble drugs (e.g. aminoglicoside antibiotics) when dosing g/kg of body weight will be: A. Greater in younger children than in older B. Greater in older children than in younger C. The same 79. Concentration of fat-soluble drugs when dosing g/kg of body weight will be: A. Greater in younger children than in older B. Greater in older children than in younger C. The same 80. Drug efficacy in hypoalbuminemia in children is: 81. Liver metabolism of drugs in younger children comparing to adult patients is: 82. Renal excretion of drugs in younger children comparing to adult patients is: 83. Pharmacodynamics in children and adults. Please select correct statement: A. Pharmacodynamics of most drugs does not differ in children and adults B. Drug sensibility is more common in children than adults C. Drug resistance is more common in children than adults D. Allergic reactions more common in children than adults 84. Why is important to shake suspension for children before using? A. Drug distributes evenly in the bottle B. Because expected efficacy of the drug may decrease at the beginning of therapy C. Because of the increased risk of intoxication at the end of therapy D. All correct 85. Bioavailability is a term that defines amount of medicine that appears into: A. Stomach B. Liver C. Systemic circulation D. All mentioned places E. None of mentioned 86. The most precise definition of AUC is: A. This is theoretical meaning of absorption of medicine B. This is description of amount of medicine in cell C. This is description of changes of concentration in time D. This is description of concentration in mg/ml E. All definitions are correct 87. Which of drug absorption speed limiting process could be the first after taking tablet orally? A. Ionization of medicine B. Diffusion of medicine through epithelium of gastrointestinal tract C. Solubility of medicine in juice of gastrointestinal tract D. Solubility of medicine in blood E. Disintegration of tablet 88. Which of processes could be drug absorption speed limiting process after taking oral medicine form? Please choose most appropriate answer A. Disintegration of tablet B. Dissolution of active substance C. Diffusion of active substance through epithelium of gastrointestinal tract D. All processes E. None of processes are speed limiting 89. Where drug metabolism could take place? Please choose most appropriate answer A. Skin B. Lungs C. Liver D. Kidneys E. In all mentioned organs 90. Highest variability of bioavailability is possible in cases when medicine is A. Injected into skin B. Injected into vein C. Taken orally D. Taken sublingually E. Injected into muscles 91. 54 years old men, 90 kg, creatinine clearance (according to Cocroft-Gault) is 30 ml/min needs to be given gentamycin for treatment of Gram negative infection. What dose of Gentamycin would be most reasonable for this patient if the goal is to achieve 8 mg/ml maximal and 1 mg/ml minimal concentration? (Vd of gentamycin is 0.25 l/kg). A. 80 mg every 24 hrs B. 80 mg every 8 hrs C. 160 mg every 24 hrs D. 240 mg every 24 hrs 92. 85 years old men, 60 kg, creatinine clearance (according to Cocroft-Gault) is 20 ml/min is using 0.25 mg of digoxin tablets once daily for the treatment of atrial fibrillation. After one month of treatment sudden emesis and vomiting is experienced. After measurement of serum concentration it was found that digoxin concentration is 2.6 mcg/l. Is this a concentration that could be predictable? (Absorption of digoxin is 60%, clearance of digoxin (in ml/min/kg) is equal to creatinine clearance + 0.33). A. Yes B. No. Predicable concentration is 1.5 mcg/ml C. No. Predicable concentration is 2.0 mcg/ml D. No. Predicable concentration is 3.5 mcg/ml 93. 85 years old men, 85 kg, creatinine clearance (according to Cocroft-Gault) is 20 ml/min is using 0.25 mg of digoxin tablets once daily for the treatment of atrial fibrillation. After one month of serum concentration was measured and serum concentration was found to be 3.0 mcg/l. What dose should be given in order to achieve usual therapeutic concentration of 1.5 mcg/l? (Absorption of digoxin is 60%, clearance of digoxin (in ml/min/kg) is equal to creatinine clearance + 0.33). A. 125 mcg B. 150 mcg C. 175 mcg D. 200 mcg 94. During use of levodopa preparations, antiparkinsonic effect may be decreased in case of concomitant use of. A. Acetylsalicylic acid B. Ascorbic acid C. Pyridoxine hydrochloride D. All mentioned medicines effects levodopa E. None of mentioned medicines effects levodopa 95. Which medicine can not be missed with gentamycin sulfate in one syringe for intravenous use? A. Phenytoin B. Ticarcillin sodium C. Acetazolamide D. All mentioned medicines are allowed E. None of mentioned medicines is allowed 96. Cholestiramine disturbs absorption process in gastrointestinal tract. Therefore, it is not rational to use cholestiramine together with: A. Warfarin sodium B. Pyridoxine hydrochloride C. Combination with both mentioned medicines is allowed D. None combination is allowed 97. In case when medicine A is pushed from binding to plasma proteins by medicine B, this interaction most probably will be clinically significant when: A. Association constant with protein is high for A B. Association constant with protein is high for B C. Association constant with protein is high for B and B is used in high dosage D. All situations are relevant E. None of situations is relevant 98. In case hemorrhagic disturbance is caused by warfarin, this could be inhibited by: A. Dihydrotachisterol products B. Egocalciferol products C. Phytomenadion products D. All situations are possible E. None of situations is suitable 99. In case of treatment with high dosages of gentamycin, most dangerous combination is with: A. Doxicycline B. Torasemid C. Enalapril D. All are dangerous E. None is dangerous 100. In case of treatment with warfarin, most dangerous combination is with: A. Cimetidin B. Acetaminofen C. Enalapril D. All are dengeraous E. None is dengeraous 101. Cheese and other tyramine containing food are dangerous to patient who using: A. Selegelin B. Penicillin C. Acetaminofen D. All are dengerous E. None is dengerous 102. Patient who is using oral contraceptives, could be advised to use alternative methods of contraception in case of initiated treatment with: A. Rifampicin B. Gentamicin C. Acetaminofen D. In all mentioned cases alternative contraception should be recommended E. None of mentioned cases influences activity of oral contraceptives 103. Which medicine decreases efficacy of oral contraceptives and can cause menstrual cycle disturbance? A. Acetaminofen B. Aspirin C. Digoxin D. Ampicillin E. Cimetidin 104. Which anticonvulsant has half-life longer then 24 hr? A. Carbamazepin B. Valproic acid C. Phenytoin D. Oxcarbazepin 105. Which anticonvulsant does not influence cytochrom P450? A. Carbamazepin B. Valproic acid C. Phenobarbital D. Lamotrigin 106. Which anticonvulsant can cause dental hyperplasia? A. Carbamazepin B. Valproic acid C. Phenytoin D. Lamotrigin 107. Which anticonvulsant most frequently damages liver? A. Gapabentin B. Valproic acid C. Phenytoin D. Lamotrigin 108. Which anticonvulsant can cause hiponatremia? A. Carbamazepin B. Valproic acid C. Phenytoin D. Lamotrigin 109. Which medicine, concomitantly used with carbamazepin can increase blood concentration of carbamazepin? A. Erythromycin B. Nytroglicerin C. Aspirin D. Amoxicillin 110. Which medicine is a first choice for generalized epilepsy? A. Carbamazepin B. Valproic acid C. Phenytoin D. Lamotrigin 111. What effect can be expected in pregnant women if she is using antiepileptics? A. Abortion B. Teratogenic effect C. Mutagenic effect D. Cancerogenic effect 112. Which adverse effect can be expected after 5-7 years of using levodopa? A. Alopecia B. Disturbed memory C. Appearance of dyskinesias D. Possible liver cancer 113. Which adverse effect can be expected in geriatric patients using trihexyphenidi? A. Increased liver transaminases B. Bradicardia C. Appearance of dyskinesias D. Urine retention 114. What combinations with levodopa are not rational? A. Calcium channel blockers B. Beta adrenoblockers C. Neuroleptics D. Antiepileptics 115. Which medicine is most effective reliever of migraine pain? A. Morphine B. Metamizol C. Sumatriptan D. Aspirin 116. Which antiepileptic can damage kidneys if used together with lithium? A. Carbamazepine B. Lamotrigine C. Valproic sodium D. Gabapentine 117. What disease could be treated with antiepileptics? A. Insomnia B. N trigeminus neuralgia C. Hypertension D. Mb ulcerosus 118. What is relevant to concomitant use of two antiepileptics? A. Efficacy increase is small but adverse effect increase is more frequent B. Contraindicated use C. Efficacy increase is high and adverse effects are rare D. This is always first choice start 119. Which medicine is first choice for focal epilepsy? A. Phenytoin B. Lamotrigine C. Gabapentine D. Carbamazepine 120. Which medicine is suitable to treat Parkinsonism caused by neuroleptics? A. Levodopa B. Trihexsifenidil C. Selegilin D. Bromocriptin 121. What specific symptoms does migraine have? A. Aura, headache and vomiting B. Aura, headache and obstipation C. Headache and ache in earache D. Aura, headache and hypertension 122. Which medicine is suitable for prophylaxis of migraine attacks? A. Halloperidol B. Amitryptyline C. ACE inhibitors D. Tramadol 123. When sumatriptan is contraindicated? A. If migraine attacks are once a month B. If patient has coryza C. If patient has infarct of myocardium D. If patient has Mb ulcerosus 124. What medicines are most important for acute brain transitory ischemia attack treatment? A. Vasodilatators B. Antithrombotic medicines C. Lowering cholesterol level in blood D. Nicotine plasters, in order to achieve withdrawal from smoking 125. Which dose of aspirin is most suitable for prophylaxis of brain transitory ischemia attack? 126. What medicines are suitable for prophylaxis of insult? A. Aspirin B. Tissue plazminogen activator C. Heparin D. Dextran solutions 127. What aid you will give to patient with sudden disturbance of cerebral blood flow? A. Administer theophylline B. Administer heparin C. Instant refer to family doctor D. Administer aspirin and refer to emergency service 128. What medicine is most effective in case of first symptoms of transitory ischemia attack? A. Warfarin B. Clopidogrel C. Aspirin D. Ticlopidin 129. When warfarin should be used as a prophylactic agent against insult? A. Always B. Never C. In case of insufficiency of thrombocyte aggregation D. Young patients 130. What tests should be monitored in case of long-term use of heparin? A. Leucocyte count B. INR C. Glycemia D. Thrombocyte count 131. Which medicine is most effective in case of admittance to hospital within 2 hrs after the ischemic insult? A. Aspirin B. Clopidogrel C. Heparin D. Tissue plasminogen activator 132. Please name tolerance to benzodiazepines? A. Need to reduce a dose after some period after initiation of their use B. Need to increase a dose after some period after initiation of their use C. Abstinence development after withdrawal of use D. Development of urge to use after longer period of use 133. Which of these is the strongest sleeping medicine? A. Oxazepam B. Chlordiazepoxid C. Estazolam D. Lorazepam 134. What effect is not related to benzodiazepins? A. Myorelaxation B. Extrapyramidal effects C. Sedation D. Sleeping aid 135. Which of these has weakest effect on myorelexation? 136. Which of these is the best for panic attack? A. Clonazepam B. Estazolam C. Triazolam D. Zolpidem 137. Which of these medicines has smallest risk for abstinence syndrome in case of discontinuation treatment? A. Triazolam B. Midazolam C. Clonazepam D. Alprazolam 138. Which of these are weakest strengtheners of sedative effect of benzodiazepines? A. Antiepileptics B. Second generation H1 blockers C. Antipsychotics D. Alcohol 139. Which benzodiazepine should not be recommended for geriatric patient? A. Oxazepam B. Diazepam C. Temazepam D. Lorazepam 140. After abrupt stop of using lorazepam, tolerance developed. What is your tactic? A. Lorazepam should be taken and after 2 weeks another attempt of withdrawal should be taken B. Triazolam should be taken and after 2 weeks another attempt of withdrawal should be taken C. Little suffer, until symptoms diminish is advisable D. Clonazepam should be taken and afterwards slow tapering during 4 weeks should be undertaken 141. Which of these is not a benzodiazepine but acts benzodiazepins receptors? A. Zolpidem B. Estazolam C. Chlordezepoxid D. Alprazolam 142. Which antidepressant has the lowest sleep inducing potential? A. Maprotilin B. Doxepin C. Amitriptyline D. Sertralin 143. Which antidepressant does not induce psychomotor agitation? A. MAO inhibitors B. Imipramin C. Doxepin D. Maprotiline 144. Which antidepressant has the least frequent adverse effect? A. Doxepin B. Citalopram C. Imipramin. D. Amitriptyline 145. How long the first episode of depression should be treated in young patient? A. 6-9 months B. 1-2 months C. 3-4 months D. 6-9 weeks 146. Which antidepressant is the safest if patient has depression and there is a risk for suicide? A. Doxepin B. Imipramin C. Fluoxetin D. Amitriptyline 147. What interaction is possible during concomitant use of tricycle antidepressants and H1 blockers? A. Hepatotoxic effect B. Increased anticholinergic effect C. Diarrhea D. Increased risk of arrhythmia 148. What adverse effect is possible during concomitant use of antipsychotics and cholinesterase inhibitors (donepesil)? A. More frequent arrhythmia B. Quicker development of extra pyramidal effects C. Quicker dryness in mouth D. Quicker tachycardia 149. What other indication is for antipsychotics use? A. Treatment of Mb ulcerosus B. Treatment of allergy C. Treatment of insomnia D. Amelioration of emesis and vomiting 150. Which of these antipsychotics is most suitable for geriatric patients? A. Chlorpromasine B. Risperidone. C. Triflupromasine. D. Halloperidol A. Insomnia B. Mania C. Parkinsonism D. Episodes of depression 152. Why there is a contraindication for use MAO inhibitors concomitantly with other antidepressants? A. Due to possible increased sleeping effect B. Due to possible hypertensive crisis C. Due to possible bradycardia D. Due to possible extrapyramidal symptoms 153. Which of adverse effects is more frequent in case of concomitant use of antipsychotics and alfa adrenoreceptor blockers? A. Orthostatic hypotension B. Urine retention C. Sedation D. Mouth dryness 154. What motivation is for prescription of two antithrombotic agents in patients after PTCI and stent? A. Antithrombotic efficacy summarizes because of uniform mechanism of action B. Decreases frequency of adverse effects of each drug C. Increases antithrombotic efficacy because of different mechanism of action 155. Name correct transition from heparin to warfarin: A. Heparin prescribe together with warfarin 10 days B. After heparin to do 3 days interval without drugs C. Heparin prescribe together with warfarin 4 - 5 days D. Warfarin begin next day after stopping of heparin 156. How often we have to perform laboratory tests for monitoring of therapeutic effect of oral anticoagulants? A. During firs month – once every week, later – once every year B. During firs year - once every week C. During firs month – once every week, later – once every month D. From beginning of treatment - once every month 157. The therapeutic range of anticoagulant effect of warfarin is: A. INR – 0-1.8 B. INR – 4.5-6.0 C. INR – 2.0-4.5 D. INR – 2.0-3.0 158. Name the drug, effective for slowing heart rate: A. Quinidine B. Lidocaine C. Digoxin D. Adenosine 159. Name the drug, effective for treatment only of ventricular arrhythmia: A. Metoprolol B. Amiodarone C. Verapamil D. Lidocaine 160. Oral antidiabetic agents are used in? A. Only in adult patients in hyperglycemic conditions B. When diet and physical exercises are ineffective if hyperglycemia is detected C. In adolescents if moderate hyperglycemia is detected 161. Name the main mechanism of Metformin action: Increases glucose uptake in muscles Increases insulin secretion Decreases absorption of carbohydrates 162. Name the main mechanism of sulfonylcarbamides action: Increase insulin sensitivity Increase insulin secretion Decrease absorption of carbohydrates 163. Name the main mechanism of thiazolidinediones action Increase insulin sensitivity Increase insulin secretion Decrease absorption of carbohydrates 164. Name the main mechanism of meglitinides action A. Increase insulin sensitivity B. Increase insulin secretion C. Decrease absorption of carbohydrates 165. Name the main mechanism of acarbose action A. Increases insulin sensitivity B. Increases insulin secretion D. Decreases absorption of carbohydrates 166. What oral antidiabetic agent is drug of choice for type II diabetes? A. Metformin B. Gliclazide MR C. Pioglitazone 167. What is the main contraindication for metformin use? Renal failure (creatinine >150 mcmol/l); Liver failure Heart failure 168. What is the main contraindication for sulfonylcarbamide use? Renal failure Hepatic failure Heart failure 169. What is the best method of administration of Metformin? Starting with maximal doses and continue with maintain doses as an effect is achieved. The usual starting dose is one or two 500mg tablets or one 850mg tablet daily, which is gradually Metformin should be discontinued immediately in case of side-effects 170. The most rational use of sulfonylcarbamide is: In impaired beta-cell function In intact beta-cell function In insulin resistance 171. Possible combinations in case of intolerance to metformin: A. Sulfonylcarbamide and thiazolidinedione B. Sulfonylcarbamide and meglitinides C. Insulin and thiazolidinedione 172. The most physiologic profile of action is typical to: A. Monocomponent natural insulin B. Human insulin D. Insulin analogs E. Biphasic insulins 173. Which oral antidiabetic agent is first-chose medicine in type 2 diabetes mellitus and obesity? A. Metformin B. Pioglitazone C. Gliclazide D. Repaglinide 174. Which oral antidiabetic agent is first-chose medicine in type 2 diabetes mellitus and dislipidemia? Metformin Pioglitazone Glipizide Repaglinide 175. Name the oral antidiabetic agent with insulin sparing action in pancreas: Metformin Rosiglitazone Glibenclamide Repaglinide 176. Insulin requirement in case of elevated body temperature is: Stabile At first insulin requirement decreases then increases Hypersensitivity to the drug, pregnancy, lactation Heart failure Hypersensitivity to iodine preparation 178. Propylthiouracil is contraindicated in: A. Hypersensitivity to the drug B. Pregnancy C. Lactation 179. As euthyroid condition with thiamazole treatment is achieved: Thiamazole treatment is discontinued Thiamazole doses should be decreased to maintenance levels Levothyroxin is added to thiamazole 180. Targets of treatment of congenital hypothyroidism are: Keeping TSH at the lower normal level and free T4 – at the upper normal level Keeping TSH at the upper normal level and free T4 – at the lower normal level Reduction of TSH level and increasing of free T4 level 181. The most effective method for H. pylori eradication is: Triple treatment with proton pomp inhibitor, clarithromycin and amoxicillin or metronidazole Triple treatment with bismuth subsalycilate, tetracycline and metronidazole Double treatment with ranitidine bismuth citrate and clarithromycin Double treatment with omeprazole or lansoprazole with clarithromycin 182. The risk of gastrointestinal bleeding in peptic ulcer increases in use of: NSAIDs with beta-blockers or ACE inhibitors NSAIDs with steroids and oral analgetics Acetaminofen, steroids and oral contraceptives Acetaminofen 183. The highest risk of peptic ulcer is documented in: A. Piroxicam use B. Ibuprofen use C. Diclofenac use D. Meloxicam use 184. The most common H pylori resistance to one of the antibiotics: A. Metronidazole B. Clarithromycin C. Amoxicyllin Type III questions
Please choose the right answer
1. A – correct answer 1, 2, 3
2. B - correct answer 1, 3
3. C - correct answer 2, 4
4. D - correct answer 4
5. E – all correct
185. The results of blocking of β-adrenergic receptors: 1. Increase of peripheral vascular resistance. 2. Mask symptoms of hypoglycemia. 3. Reduction of heart output. 4. Increase in rennin synthesis. 1. Bradycardia 2. Constipation 3. Heart block 4. Reflex tachycardia 187. Name medicines for the treatment of paroxysm tachycardia: 1. Nifedipinum 2. Adenosinum 3. Lidocainum 4. Verapamilum 5. Labetololum 188. Name contraindications for the use of β-adrenergic receptors blockers: 1. Arterial hypertension 2. Sinus bradycardia 3. Sinus tachycardia 4. 2nd degree of heart block 5. Supraventricular extra systoles 189. Contraindications for the use of ACE inhibitors include: 1. Hyperkalemia 2. Hypersensitivity to the drug components 3. Both a. renalis stenosis 4. Previously therapy of diuretics 5. Renal failure 190. Hypersensitivity to heparin includes: 1. Thrombocytopenia 2. Necrosis in injection sites 3. Formation of white thrombi 4. Formation of red thrombi 5. Lymphocytosis 6. Anaemia 191 Name medicines with ototoxic side effects: 1. Furosemidum 2. Acidum aethacrynicum 3. Streptomycinum 4. Gentamycinum 192. Name penicillins mainly resistant to penicillinase? 193. The resorption of medicines in case of acute migraine episode can be increased by concomitant use of: 1. Metoclopramidum 2. Chlorpromazinum 3. Coffeinum 4. Morfinum 5. Aspirinum 194. Symptoms of late-appearing (Tardive Dyskinesia) can improve in case of: 1. Trihexyphenidilum use 2. Discontinuation of neuroleptics 3. Concomitant use of MAO inhibitors 4. Increase dose of neuroleptics 5. Concomitant use of levodopa 195. Chose right propositions of antiepileptic therapy: 1. Symptoms can improve after one month treatment 2. Treatment with several medicines is choice 3. Treatment can be discontinued if there are not episodes of seizures after 6 month therapy 4. Antiepileptic medicines can have interaction for the metabolism of other medicines in liver 196. What differences are between antidepressants of SSRI group and tricycle antidepressants (TCAs)? 1. Less common urinary retentions in patients with adenoma of prostate 2. Less risk of overdose 3. Less risk of arrhythmias 4. Greater efficacy 197. What medicines could be used for the prevention of ischemic stroke? 1. Dipyridamolum 2. Aspirinum 3. Aminophyllinum 4. Ticlopidinum 5. Acidum nicotinicum (i/v). 198. Side effects of haloperidol are most common that for chlorpromazine: 1. Constipation and dry mouth. 2. Sedation 3. Disturbances of menstrual cycle 4. Extra pyramidal symptoms 5. Galactorrhea 1. Neutropenia 2. Diarrhea 3. Skin rash 4. Elevation of cholesterol 5. Bleeding
200. Name the advantages of ticlopidine over aspirin:
1. Reduces adhesion and aggregation of platelet 2. Less costly 3. Equal in efficacy for man and women 4. No risk of neutropenia 201. What kind of actions should be started in case of acute episode of ischemic stroke? 1. Phenobarbitalum. 2. Aspirinum 3. Prednisolonum 4. Maintenance of optimal blood pressure 5. Phenitoinum 202. Medicines that should be avoided for patients that like herring, matured cheese, red vine: 1. Tricycle antidepressants (TCAs) 2. Strong neuroleptics 3. Atypical neuroleptics 4. MAO inhibitors 5. Benzodiazepines 203. Medicines that should be useful for the prevention of migraine attacks: 1. Sumatriptanum 2. Propranololum 3. Aminophyllinum 4. Amitriptyllinum 5. Clonidinum 204. Side effects of oral hormonal contraceptives are: 1. Ischemic stroke 2. Gall-bladder disturbances 3. Liver failure 4. Myocardial infarction 5. Thromboembolic disorders 205. Medicines for the treatment of acute attacks of migraine are: 1. Sumatriptanum 2. Propranololum 3. Ergotaminum 4. Amitriptillinum 5. Furosemidum 206. Side effects of chlorpromazine are more common than that of haloperidol: 1. Neurolepsia. 2. Impotence 3. Pharmacogenic parkinsonism 4. Dry mouth 5. Akathisia 207. As high neuroleptic potency as common side effects: 1. Allergic reactions 2. Constipation 3. Urinary retention 4. Underdose for the neurolepsia. 5. Galactorrhea 208. Diseases or conditions when oral contraceptives should be avoided: 1. Complicated diabetes 2. Surgery after 1 week with long immobilization after 3. Age over 35 year and smoking 4. Asthma bronchiale with acute episodes at night ours 5. Nonspecific ulcerative colitis 209. Quality of life and prognosis can be improved in patients with heart failure in case of: 1. Antioxidants 2. Digitalis 3. Phosphodiesterases inhibitors 4. ACE inhibitors 5. Calcium channel blockers 210. Atrial fibrillation can be caused by: 1. Alcohol 2. Aminophyllinum 3. Amfetaminum 4. Enalaprilum 5. ISDN 211. Medicines, which can be useful for the treatment of supraventricular tachycardia in patient with bronchial asthma 1. Nifedipinum 2. Adenosinum 3. Lidocainum 4. Verapamilum 5. Labetololum 212. Before examination student had excitation, diarrhea thus took 4 tablets of diazepam (5 mg). What results can he expect? 1. Less excitation 2. More mistakes 3. Improve symptoms of diarrhoea 4. Somnolence 5. Less sadness in case of negative mark. 213. During treatment of severe heart failure with hydrochlorotiazide several signs should be monitored: 1. Body weight and diuresis 2. Uric acid, glucose 3. Serum potassium 4. QRS voltage 5. PQ interval 214. Mechanism of action of nonsteroidal anti-inflammatory drugs includes: 1. Inhibition synthesis of COX-I 2. Inhibition synthesis of COX-II 3. Inhibition synthesis of leucotriens 4. Inhibition of CNS endorphins system 5. Direct inhibition of thermoregulation 215. Name the advantages of angiotensin receptors antagonists over the ACI inhibitors 1. More pronounced suppression of rennin-angiotensin system 2. Les risk of hypotension 3. Les risk of dry cough 4. Potassium level is not increased 5. All listed 216. Name the advantages of COX-II inhibitors over the traditional NSAIDs: 1. Les risk of ulcer 2. Les risk of stomach bleeding 3. Les risk of perforation 4. Les risk of thromboembolic complications 5. More pronounced pain and inflammation relief 217. Name the advantages of traditional NSAIDs over the COX-II inhibitors: 1. More pronounced pain relief 2. Les risk of hyperergic reactions 3. Les risk of gastrointestinal system 4. Les risk of thromboembolic and stroke complications 5. Les risk of hepatotoxic action 1. Costs for patient travelling to hospital 2. Hospitalization costs 3. Nursing costs 4. Lose of money due to illness 5. Out patient costs 219. The anticoagulant effect of warfarin increase in combination with: 1. Amiodarone 2. Estrogene 3. Statines 4. Vit K 5. Barbiturates 220. Differences of low molecular weight heparin in comparison with unfractionated heparin: 1. Better bioavailability after subcutaneous usage 2. Uncommon trombocytopenia 3. Longer half-life 4. Require more intensive laboratory monitoring 221. Hypersensitivity to heparin indicates: 1. Thrombocytopenia 2. Necrosis in injection sites 3. Formation of white thrombi 4. Lymphocytosis 5. Anemia 222. The effect of amiodarone on thyroid gland: 1. Does not exist 2. Can course hyperthyroidism 3. Normalizes thyroid function after thyroidytis 4. Can course hypothyroidism 5. Can improve thyroid function in districts with increased amount of 223. Name the antiarrhythmic drugs, safe for patients with heart failure: 1. Sotalol 2. Quinidine 3. Propafenone 4. Amiodarone 5.Verapamil 224. Name the drugs most often implicated as cause of proarrhythmia: 1. Beta-blockers 2. Sotalol 3. Amiodarone 4. Quinidine 5. Lidocaine 225. Criteria for estimation of efficacy of oral amiodarone: 1. The blood pressure 2. The heart rate 3. The function of thyroid gland 4. The frequency of arrhythmia 226. What are the main contraindications for thiazolidinedione use? 1. Renal failure 2. Hepatic failure 3. Heart failure 4. Hypertension 5. Dyslipidemia 227. Alfa-glucosidase inhibitors are contraindicated in: 2. Hepatic failure 3. Heart failure 4. Enterocolitis 5. Hypotension 228. Metformin should be discontinued immediately in the presence of: 1. Lactatacidosis 2. Recent myocardial infarction 3. Severe peripheral blood vessel disease 4. Hypertension 5. Hypotension 229. What are the difference between meglitinides and sulfonylcarbamides? 1. Meglitinides do not induce hypoglycemia; 2. Metiglinides decrease postprandial glycemia 3. Increase dyslipidemia 4. Meglitinides are taken 30 min. before meal 5. All listed 230. What are criteria for treatment change in DM? 1. HbA1C >7,5% 2. Postprandial glucose is more than > 9 mmol/l 3. Fasting glucose > 7 mmol/l 4. Fasting glucose < 7 mmol/l 5. HbA1C < 7,5% 231. The main advantages of thiazolidindiones: 1. More glucose lowering effect 2. Long-standing and beta-cell spearing effect 3. Improve lipid profile 232. Side-effects of thiazolidindiones: 1. Hepatotoxicity. 2. Heart failure. 3. Weight increase and edema. 233. Possible combinations of oral antidiabetic agents: 1. Metformin and sufonylcarbamide preparation. 2. Metformin with thiazolidinedione preparation. 3. Sulfonylcarbamide and thiazolidinedione. 4. Insulin and thiazolidinedione 234. Advantages of rapid action insulin analogs: 1. Produce more physiological insulin patterns.
2. Reduce risk of postprandial hypoglycemia.
3. May be taken with meal
4. More freedom in meal scheduling
5. All listed
235. Advantages of insulin glargine to human insulin of intermediate action: 1. Significant decreased risk of nocturnal hypoglycemia 2. Better fasting glucose control 3. Breakfast and lunch may be missed 4. Easy for use 5. Cheaper 236. What is an intensive insulin therapy? 1. Rapid-acting insulin analog injection with meal and 1 or 2 injection 2. One injection of biphasic insulin mixtures in the morning 3. Three injections of short-action human insulin before meal and 1 or 2 injections of intermediate-action human insulin. 4. Two injections of biphasic insulin mixtures in the morning and in 237. Possible interaction of propranolol and glibenclamide: 1. Insulin requirement increases, 2. Signs of hypoglycemia are stimulated, 3. Signs of hypoglycemia are masked, 4. No interaction. 238. Severe side effects of thiamazole are: 1. Agranulocytosis, thrombopenia, aplastic anemia 2. Hypoprothrombinemia, hypoproteinemia, hepatitis. 3. Vaskulitis 4. Glomerulonephritis 5. All listed 239. In case of H. pylori resistance to Clarithromycin and Metronidazole, plus Amoxicillin hypersensitivity, antibiotics used for eradication are: 1. Tetracycline 2. Fluorochinolon 3. Rifampicin 4. Cephalosporins 5. Aminoglycosids 240. Monitoring of blood concentration is necessary when: 1. Medicine with narrow therapeutic range 2. Medicine with high risk of side effects 3. High dose in life threatening situation 4. Long term therapy with medium size dose 241. Effectiveness of oral antidiabetic medicines is monitored by: 1. Palpitation of pancreas 2. Glucose concentration in blood 3. Weigh 4. HbA1C Clinical cases
242. 52 yr. old man was admitted to the hospital’s reception centre. He has swelled foot with an open wound. There is green colour, bad odour pus that is getting out of the wound. He trod upon nail 2 weeks ago. He has I type diabetes mellitus for 15 years, which complicated into neuropathy, smokes 1 pack per day; is allergic to penicillines (has a history of mild rash after injection). Upon admission, his T - 38°C, diminished sensitivity and deep tendon reflexes in legs, hot, swollen right foot, with purulent fluid from wound. Lab evaluation: Le 17 x 10 /l, glucose - 15,9 mmol/l (at 6 hrs.); in pus specimen: growth of Pseudomonas aeruginosa, foot rentgenography - destruction of bone tissue. Name the right answer? A. There is a complication of bad-controlled blood sugar level’s diabetes and it is enough to correct the treatment with insulin only. B. There is a right foot osteomyelitis, caused by Pseudomonas aeruginosa and needs treatment with ceftazidim and amikacin. C. It is suspected osteomyelitis in right foot, caused by Pseudomonas aeruginosa and needs treatment with antipseudomonal carbenicilline and cefazoline. 243. 40 - year old man has a dilated cardiomyopathy, phlebitis of the profound veins of the left leg and failure of both parts of the heart. Pulmonary embolism repeated for several times. After seven days therapy with thrombolysis and heparin 40000 IU/day administration clinical status improved shortly but episodes of pulmonary embolism repeats again. Lab of activated partial thromboplastin time (aPTT) started to decrease from 79 seconds to 22 seconds despite increased dose of Heparin. How can we improve treatment? A . Increase the dose of heparin till 60-80.000 IU per day. B . Add warfarin therapy. C . Add antithrombine III and fresh frozen plasma. D . Repeat thrombolysis and add aspirin 150 mg per day.

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