1.

Cimetidine:

a) lowers plasma creatinine

b) prolongs the prothrombin time
c) hastens gastric emptying
d) may potentiate the action of warfarin
e) may impair cardiac conduction

2. Acute intermittent porphyria:

a) is exacerbated by digoxin
b) is precipitated by sulphonamides
c) is precipitated by ethyl alcohol
d) is treated by parenteral lidocaine
e) contraindicates the use of thiopentone

3. The following are features of digoxin toxicity:

a) headache
b) nausea
c) abdominal pain
d) convulsions
e) coupled beats

4. Lidocaine can cause:

a) sedation
b) convulsions
c) slowed A-V conduction
d) prolongation of the cardiac action potential
e) shortening of the refractory phase

5. Features of severe aspirin overdose include:

a) tinnitus
b) metabolic acidosis
c) a reduction in the platelet count
d) haemolysis
e) hyperventilation

6. Atropine antagonises the action of:

a) some of the effects of morphine
b) acetylcholine at the neuromuscular junction
c) acetylcholine at sweat glands
d) trimetaphan at the autonomic ganglia
e) pilocarpine on the pupil

7. Toxic effects of sodium nitroprusside:

a) are not related to dose

b) are due to cyanide ions
c) are due to thiocyanate
d) are due to liver rhodanese
e) may be treated with vitamin B12

8. Pethidine:

a) causes less miosis than morphine

b) is metabolised to active substances with analgesic properties
c) has a longer duration of action than morphine
d) possesses atropine-like activity
e) has some local anaesthetic activity

9. The following are useful in the suppression of ventricular

ectopic beats:

a) digoxin
b) amiodarone
c) mexiletine
d) verapamil
e) bretylium

10. The following act directly on vascular smooth muscle by

altering calcium transport:

a) nicardipine
b) sodium nitroprusside
c) hydralazine
d) bendrofluazide
c) dantrolene

11. Metoclopramide:
a) has an action on gastric emptying opposed by atropine
b) causes prolactin release
c) is a phenothiazine
d) lowers the blood glucose
e) is a dopamine antagonist

12. Otoxicity can follow the administration of:

a) ethacrynic acid
b) gentamicin
c) frusemide
d) cefuroxime
e) streptomycin

13. Poisoning by organophosphorus compounds causes:

a) increased bronchial secretions

b) constipation
c) miosis
d) tetanus
e) tachycardia

14. Phenobarbitone:

a) is used in the treatment of grand mal epilepsy

b) may aggravate petit mal epilepsy
c) can produce skin rashes
d) is rapidly metabolised
e) has its effects terminated by redistribution

15. Testosterone derivatives are:

a) androgenic
b) diabetogenic
c) progestogenic
d) anabolic
e) carcinogenic

16. Buprenorphine:

a) causes little nausea and vomiting

b) has a respiratory depressant action antagonised by naloxone
c) is mostly metabolised in the liver
d) may cause withdrawal symptoms in morphine addicts
e) must be given parenterally

17. The following should not be discontinued abruptly:

a) cimetidine
b) propranolol
c) clonidine
d) amiodarone
e) digoxin

18. Sulphonylureas:

a) are used in maturity-onset diabetes

b) can cause hypoglycaemia
c) are suitable for the treatment of ketoacidosis
d) are an effective treatment for hyperglycaemia following total
pancreatectomy
e) can cause lactic acidosis

19. Hyoscine:

a) causes tachycardia
b) causes sedation
c) causes mydriasis
d) is an antiemetic
e) has a weaker antisialagogue effect than atropine

20. Salbutamol can cause:

a) tremor
b) an increase in uterine contractility
c) a worsening of intermittent claudication
d) hypokalaemia
e) tachycardia

ANSWERS

1. FFFTT
2. FTTFT
3. TTTTT
4. TTTFT
5. TTFFT
6. FFTFT
7. TTFFF
8. FTFTT
9. FTTFT
10. TTTFF
11. TTFFT
12. TTTFT
13. TFTFF
14. TTTFF
15. TTFTT
16. FFTTF
17. FTTFF
18. TTFFF
19. TTTTF
20. TFFTT

1. Dopamine:

a) may produce ventricular arrhythmias

b) increases mesenteric blood flow at high doses
c) crosses the blood-brain barrier
d) is synthesised from L-dopa
e) is inactivated in alkaline solution

2. The following increase the amount of calcium in cardiac

muscle:

a) halothane
b) adrenaline
c) diltiazem
d) nifedipine
e) trimetaphan

3. The following can be used safely in a patient on a

monoamine oxidase inhibitor:

a) morphine
b) pethidine
c) noradrenaline
d) amphetamine
e) adrenaline

4. Hyoscine hydrobromide causes:

a) antiemesis
b) somnolence
c) pupillary dilatation
d) tachycardia followed by bradycardia
e) extrapyramidal symptoms

5. Clonidine:

a) is an alpha-2 receptor agonist

b) is a dopamine antagonist
c) causes tachycardia
d) inhibits salivation
e) reduces the minimum alveolar concentration of halothane

ANSWERS

1.TTFTT
2.FTFFF
3.TFTFT
4.TTTTF
5.TFFTT

6. Hydralazine:

a) is metabolised by acetylation
b) is destroyed by plasma cholinesterase
c) can cause a lupus-like syndrome
d) stimulates the baroreceptor reflex
e) is contraindicated in pregnancy
7. The following are prodrugs:

a) suxamethonium
b) diamorphine
c) captopril
d) paracetamol
e) enalapril

8. The following drugs penetrate the blood-brain barrier:

a) physostigmine
b) dopamine
c) propranolol
d) glycopyrrolate
e) noradrenaline

9. Naloxone:

a) is an agonist at kappa receptors

b) is an antagonist at mu receptors
c) reverses ventilatory depression due to morphine
d) may precipitate opiate withdrawal symptoms
e) may cause pulmonary oedema

10. The following are precursors of adrenaline:

a) tyrosine
b) phenylalanine
c) dopamine
d) isoprenaline
e) noradrenaline

ANSWERS

6.TFTTF
7.FTFFT
8.TFTFF
9.FTTTT
10.TTTFT
11. The following affect gastric emptying:

a) diamorphine
b) diazepam,
c) metoclopramide
d) cisapride
e) omeprazole

12. Chlorpromazine:

a) can cause dystonic reactions

b) antagonises apomorphine-induced vomiting
c) is a dopamine antagonist at the chemoreceptor trigger zone
d) is a weak alpha-adrenergic agonist
e) undergoes extensive first-pass metabolism

13. Alfentanil:

a) is less lipid soluble than fentanyl

b) relaxes the sphincter of Oddi
c) has active metabolites
d) has a large volume of distribution
e) causes analgesia without sedation

14. Folic acid metabolism is impaired by:

a) nitrous oxide
b) sodium nitroprusside
c) sulphonamides
d) penicillin
e) trimethoprim

15. Significant agonist activity at opioid receptors occurs with:

a) clonidine
b) pentazocine
c) buprenorphine
d) ketamine (Ketamine has antagonist activity at µ opioid receptors,
but agonist activity at d and ? receptors)
e) naloxone

ANSWERS
11.TFTTF
12.TTTFT
13.TFFFF
14.TFTFT
15.FTTFF

16. Drug clearance by the body:

a) only refers to elimination by the kidney

b) refers to the volume of blood cleared of the drug in unit time
c) cannot exceed the glomerular filtration rate
d) may be influenced by renal tubular secretion
e) is the same as creatinine clearance

17. Dopexamine:

a) causes arterial vasoconstriction

b) is an agonist at dopaminergic D1 and D2 receptors
c) increases the force of myocardial contraction
d) increases renal blood flow
e) causes arrhythmias

18. Sodium valproate:

a) is effective in grand mal epilepsy

b) is effective in petit mal epilepsy
c) is safe in patients with liver disease
d) should not be given to children
e) increases brain concentrations of gamma-amino butyric acid (GABA)

19. The Chi-squared test:

a) is used to compare the frequencies of occurrence

b) requires the standard error of the mean to be calculated
c) does not require a knowledge of the number of degrees of freedom
d) should not be used for data with small groups
e) does not involve the null hypothesis

20. A placebo effect:

a) may occur in either treatment or control groups

b) occurs only in mentally ill patients
c) is likely to occur repeatedly in placebo reactors
d) can occur in up to 35% of patients
e) is not seen in double-blind trials

ANSWERS

16.FTFTF
17.FTTTT
18.TTFFT
19.TFFTF
20.TFTTF

1. The following act by blocking cholinergic receptors:

a) trimetaphan
b) hexamethonium
c) ouabain
d) benzhexol
e) physostigmine

2. Esmolol:

a) has a negative inotropic effect

b) has no intrinsic sympathomimetic activity
c) causes a dose-dependent fall in heart rate
d) increases airways resistance
e) may prolong the duration of action of suxamethonium

3. Enflurane:

a) is a halogenated methyl-ethyl ether

b) has a blood/gas solubility coefficient of 1.43
c) lowers intracranial pressure
d) increases the tone of the pregnant uterus
e) causes a decrease in systemic vascular resistance
4. Morphine:

a) causes histamine release

b) has no active metabolites
c) undergoes extensive first-pass hepatic metabolism
d) has an elimination half-life of 3-4 hours
e) may be antagonised by pentazocine

5. Uterine tone is:

a) increased by ketamine
b) decreased by halothane
c) increased by beta-2 antagonists
d) unaffected by suxamethonium
e) decreased by nifedipine

ANSWERS

1.TTFTF
2.TTTTT
3.TFFFT
4.TFTTT
5.TTTTT

6. Aspirin overdose causes:

a) thrombocytopenia
b) coma
c) metabolic acidosis
d) jaundice
e) pulmonary oedema

7. Non-depolarising neuromuscular blockers are potentiated

by:

a) lithium
b) diazepam
c) trimetaphan
d) magnesium
e) suxamethonium
8. Atropine:

a) crosses the blood-brain barrier

b) can cause an initial bradycardia
c) increases the rate of gastric emptying
d) increases conduction through the AV node
e) produces bronchoconstriction

9. Hepatotoxicity has been associated with:

a) diethyl ether
b) chloroform
c) cyclopropane
d) enflurane
e) halothane

10. The anticoagulant effect of warfarin:

a) is exerted directly on the blood

b) is slow in onset
c) can be reversed by vitamin K
d) is potentiated by phenylbutazone
c) is potentlated by barbiturates

ANSWERS

6.FTTFT (HYPOTHROMBINAEMIA AND INHIBITION OF PLATELET

AGGREGATION, BUT NOT THROMBOCYTOPENIA)
7.TFTTT
8.TTFTF
9.FTFTT
10.FTTTF

11. The following may be used in the treatment of digoxin

toxicity:

a) propranolol
b) lidocaine
c) phenytoin
d) calcium
e) potassium

12. Dobutamine:

a) is structurally similar to isoprenaline

b) activates adenyl cyclase
c) has a selective action on beta-1 adrenoreceptors
d) has a half-life of 2 minutes
e) increases the left ventricular end-diastolic pressure

13. Organophosphorus anticholinesterases:

a) have an irreversible action

b) phosphorylate cholinesterase
c) can have their action reversed in the early stages by atropine
d) are readily absorbed through the skin

14. The following factors encourage passage of a substance

across the cell membrane:

a) high lipid solubility

b) low concentration gradient
c) high molecular weight
d) negative hydrostatic pressure
e) high degree of ionisation

15. Amitriptyline in overdose causes:

a) cardiac arrhythmias
b) hypotension
c) restlessness
d) metabolic acidosis
e) jaundice

ANSWERS

11.TTTFT
12.TTFTF
13.TTTT
14.TFFFF
15.TTTTF
16. Low plasma cholinesterase activity:

a) is related to the patient's blood group

b) has no effect on the action of decamethonium
c) occurs with organophosphorus poisoning
d) prolongs the action of esmolol
e) occurs in malnutrition

17. Sulphonylureas:

a) acts by increasing insulin release

b) tends to produce weight loss
c) is suitable for use in pregnancy
d) is effective in correcting ketoacidosis
e) can produce hypoglycaemia

18. Side-effects of hydralazine include:

a) tachycardia
b) impotence
c) constipation
d) systemic lupus erythematosus
e) bronchoconstriction

19. The following are measures of scatter in statistical

analysis:

a) mean
b) standard error of the mean
c) standard deviation
d) range
e) p of less than 0.5

20. Statistical tests are used to:

a) eliminate observer bias

b) eliminate placebo effect
c) show that results are true
d) show that the results did not occur by chance
e) show that the results are clinically significant

ANSWERS

16.FFTTT
17.TFFFT
18.TFFTF
19.FTTTF
20.FFFTF

1. Nifedipine:

a) causes tachycardia
b) causes tremor
c) causes hypoglycaemia
d) can be given sublingually
e) dilates skeletal muscle arterioles

2. Tetracycline:

a) may be hepatotoxic in large doses

b) is extensively metabolised
c) is contraindicated in pregnancy
d) potentiates non-depolarising muscle relaxants
e) absorption is decreased by magnesium trisilicate

3. Neostigmine:

a) is eliminated entirely by the liver

b) causes foetal bradycardia when given to a pregnant woman
c) causes miosis
d) is a quaternary ammonium compound

4. The following drugs readily cross the placenta:

a) atracurium
b) lidocaine
c) bupivacaine
d) neostigmine
e) propranolol

5. In acute intermittent porphyria, the following, drugs may be

safely used:

a) etomidate
b) ketamine
c) midazolam
d) pethidine
e) cotrimoxazole

ANSWERS

1.TTFTT
2.TTTTT
3.FFTT
4.FTFFT
5.FFTTF

6. The following drugs are mainly eliminated from the body by

hepatic metabolism:

a) isoflurane
b) morphine
c) atracurium
d) suxamethonium
e) dopamine

7. The following have an elimination half-life of greater than 24

hours:

a) diazepam
b) midazolam
c) methadone
d) gelofusine
e) hydroxyethyl starch

8. Phenytoin:

a) shows first-order elimination kinetics

b) induces enzymes
c) causes hypotension
d) causes vitamin B2 deficiency
e) has a half-life of about 4 hours

9. L-dopa:

a) is more lipid soluble than dopamine

b) may produce postural hypotension
c) may cause nausea
d) may cause abnormal movements
e) is ineffective via the oral route

10. Toxicity from hyperbaric oxygen therapy can cause:

a) painful joints
b) pulmonary oedema
c) acute tubular necrosis
d) convulsions
e) bradycardia

ANSWERS

6.FTFFF
7.TFTFT
8.TTTFF
9.TTTTF
10.FTFTF

11. Atropine:

a) increases gut motility

b) is a mixture of d- and l-isomers
c) is equipotent with hyoscine
d) can cause bradycardia
e) crosses the blood-brain barrier

12. Beclomethasone:

a) can be given by aerosol inhaler

b) can cause candidiasis
c) is a fludrocortisone
d) increases the circulating cortisol concentration
e) is a bronchodilator

13. Dopamine receptor antagonists:

a) increase heart rate

b) are antiemetics
c) cause hypertension
d) cause extrapyramidal side-effects
e) increase lower oesophageal sphincter tone

14. The volume of stomach contents is reduced by:

a) sodium citrate
b) metoclopramide
c) cimetidine
d) atropine
e) pyridostigmine
15. The following drugs relax the pregnant uterus:

a) salbutamol
b) propranolol
c) noradrenaline
d) acetylcholine
e) dopamine

ANSWERS

11.FTFTT
12.TTFFT
13.FTFTT
14.FTTFT
15.TFFFF

16. Carbonic anhydrase inhibitors:

a) cause an alkaline urine to be produced

b) cause a metabolic acidosis
c) are more effective when given continuously than when given
intermittently
d) may lead to the formation of renal calculi
e) cause the intraocular pressure to rise

17. Osmotic diuretics:

a) are only effective if completely reabsorbed from the renal tubule

b) reduce intracranial pressure primarily by inducing a diuresis
c) produce a urine flow limited by glomerular filtration rate
d) can lead to pulmonary oedema if renal function is impaired
e) have a molecular weight of between 40,000 and 65,000 daltons

18. The following are ethers:

a) sevoflurane
b) halothane
c) desflurane
d) trichlorethylene
e) enflurane
19. Warfarin:

a) has a rapid onset of action

b) is readily excreted in the urine
c) is antagonised by salicylates
d) is potentiated by metronidazole
e) is antagonised by barbiturates

20. Salbutamol:

a) is a beta-1 selective adrenoreceptor agonist

b) acts on the lung only when given by the inhalational route
c) reduces the forced expiratory volume in asthmatics
d) produces vasodilatation in skeletal muscle
e) can produce hypokalaemia

ANSWERS

16.TTFTF
17.FFFTF
18.TFTFT
19.FFFTT
20.FFFTT