Exam 2008 +

7/28/2019 Exam 2008 +

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Cairo University

Faculty of Pharmacy

Department of Clinical Pharmacy

4th

year students 2008

Community pharmacy and Pharmacy Practice

Final Exam:

•

1. answer sheets2The red one, starts from question number 1 to question number 100

The green one, starts from question number 101 to question number 200

2.

3. answer sheet

4.

5. Answer Sheet

6.markers

Question I: Select the Most Appropriate Answer (only one) by Blackening the Circle with

the Corresponding Letter in the Provided Answer Sheet1. OTC medications:

a. Don’t mask symptoms of disease b. Can lead to overdose

c. Are intended for relief of major ailmentsd. Cannot be harmful

2. Cold is characterized by:

a. Slow onset

b. No or mild fever

c. Runny nose

d. All of the above

3. Rhinitis medicamentosa an occur with:

a. Topically applied sympathomimetics

b. Oral sympathomimetics

c. Topically applied antihistamines

d. Oral antihistamines

4. Nasal sprays are preferable for:

a. Adults

b. Children over 6 years

c. Children under 6 years

d. a & b

5. Sputum is described as "pink and frothy" in:

a. Hypertension

b. Hyperthyroidism

c. Heart failure

d. Liver disease

6. Demulcents are suitable for the management of cough in:

a. Pregnant women

b.

Children

c. Diabetics

d.

a & b

7. Levels of Theophylline in the blood are reduced by:

a. Smoking

b. Phenytoin

c. Rifampicin

d. All of the above

8. Associated with nausea and vomiting:

a. Migraine

b. Tension headache

c. Sinusitis

d. Temporal arteritis

9. It is the analgesic of choice for children under 12 years:

a. Aspirin b. Paracetamol

c. Ketoprofend. Codeine

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10. Feverfew is a herb which has been used in the prophylaxis of:a. Migraine

b. Cold and flu

c. Cough

d. Sore throat

11. Injuries in which the muscle is torn or damaged are called:

a. Sprains

b. Strains

c. Bursitis

d. Fibrositis

12. Acts as counter-irritant and rubefacient:a. Camphor

b. Turpentine oil

c. Methyl nicotinate

d. All of the above

13. Sodium cromoglycate is used for the treatment of:

a. Allergic conjunctivitis

b. Infective conjunctivitis

c. Corneal ulcers

d. Iritis

14. A disease in which the cornea swells, becoming hazy and causing impaired vision and haloes around

eye:

a. Conjunctivitis

b. Glaucoma

c. Corneal ulcers

d. Iritits

15. Treatment of otitis externa involves the use of:

a. Astringent ear drops

b. Antibacterial ear drops

c. Anti-inflammatory ear drops

d. All of the above

16. Treatment of otitis media involves the use of:

a. Oral antibiotics

b. Topical or oral decongestants

c. Topical steroids

d. a & b

17. Glue ear may result from:

a. Recurrent otitis media b. Recurrent otitis externa

c. Waxy ear d. All of the above

18. Has no prodromal phase:

a. Classical migraine

b. Common migraine

c. All of the above

d. None of the above

19. The patient should avoid taking the following medicine near bedtime:

a. Aspirin

b. Paracetamol

c. Ephedrine

d. Promethazine

20. Should never be recommended for anyone who is driving:

a. Aspirin

b. Paracetamol

c. Ephedrine

d. Promethazine

21. Has analgesic and antipyretic effects but little or no anti-inflammatory action:

a. Aspirin

b. Paracetamol

c. Ibuprofen

d. a & c

22. Heparinoid and hyaluronidase are used in the treatment of:

a. Strains and sprains

b. Cold and flu

c. Sore throat

d. Headache

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23. Can be taken as cough suppressant:a. Codeine

b. Guaiphenesin

c. Ipecacuanha

d. b & c

24. Can be taken as expectorant:

a. Codeine

b. Guaiphenesin

c. Ipecacuanha

d. b & c

25. Reasons for high incidence of adverse drug reactions in elderly patients include:a. Polypharmacy

b. Compliance

c. Increased sensitivity to drugs

d. All of the above

26. All of the following contribute to age related alterations in drug distribution EXCEPT:

a. Decrease in total body water

b. Greater ratio of lean muscle mass to adipose tissue

c. Decrease in albumin

d. Reduced volume of distribution of water-soluble drugs

27. The best documented age-related physiologic change is:

a. Hearing loss b. Decline in renal function

c. Decline in hepatic functiond. All of the above

28. In elderly patients, benzodiazepines:

a. Have a prolonged elimination half life

b. Tend to accumulate

c. Have a high potential for adverse effects

d. All of the above

29. Elderly patients with hypertension are candidates for treatment with any antihypertensive drug

group EXCEPT:

a. Thiazide diuretics

b. β-blockers

c. ACE inhibitors

d. They can take any of the above

30. Because neonates are relatively achlorhydric, they can have:

a. Increased bioavailability of basic drugs.

b. Unpredictable absorption of acidic drugs

c. Increased bioavailability of drugs normally degraded in the stomach

d. All of the above

31. In neonates, lipid soluble drugs may be left insoluble and unabsorbed in the intestine because:

a. Decreased bile acid production

b. Low levels of lipases

c. Both a & b

d. Neither a nor b

32. Acidic drugs bind to:

a. Albumin

b. Alpha-1-acid glycoprotein

c. Both a & b

d. Neither a nor b

33. In the presence of endogenous substances, significant increase in free plasma concentration of drugs

occurs only when:

a. The displaced drug more than 90% bound to plasma proteins

b. Metabolism of the displaced drug is rate-limited

c. Both a & b

d. Neither a nor b

34. In renal elimination, tubular reabsorption is:

a. An active process

b. A passive process

c. Can be active or passive

d. Is not active or passive

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46. The normal adult respiratory rate is:a. 44 breaths per minute

b. 20 to 30 breaths per minute

c. 16 to 25 breaths per minute

d. 12 to 20 breaths per minute

e. 22 to 44 breaths per minute

For each numbered function (47-49). Select the one lettered class of instrument (a, b, c, d or e) Most

closely associated with it. Each lettered class may be selected once, more than once, or not at all.

47. To investigate retinopathy48. To assess breath sound

49. Bone conduction test

a. Ophthalmoscope

b. Otoscope

c. Stethoscope

d. Sphygmomanometer

e. Tuning fork

50. Nails and nail beds are evaluated for which of the following?

a. Clubbing

b. Cyanosis

c. Trauma

d. All of the above

e. None of the above

51. "Regularly irregular" heart betas can be detected in all of the following EXCEPT:

a. Premature ventricular contraction

b. Second degree heart block

c. Atrial fibrillation

d. Premature atrial contraction

e. None of the above

For each numbered description (52-56). Select the one lettered class of heart sound (a, b, c, d or e) Most

closely associated with it. Each lettered class may be selected once, more than once, or not at all.

52. Presystolic gallop

53. Protodiastolic gallop54. Created by mitral and tricuspid valve closure

55. Created by the aortic and pulmonic valve closure

56. It is normal in children and young adults

a. Dup

b. Lub

c. S3

d. S4

57. One of the following systems cannot be normally palpated:

a. Abdomen

b. Cardiovascular

c. Lymph nodes

d. Face

e. Chest

58. For mentally impaired patients:

a. Assume that the patient is incapable of participation in their health care

b. Communicate clearly and directly with the patient

c. Limit the length of the interaction to the shortest possible period

d. b & c

e. All of the above

59. Which one of the following is not important consideration when writing medical record notes:

a. Use black ink b. Title the note with a specific heading

c. Document the facts and avoid judgment

d. Begins the note on an unused pagee. All of the above

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60. The best way to deal with antagonistic patients is to do which of the following:a. Avoid them

b. Suggest less expensive alternative medications

c. Speak slowly and distinctly

d. Limit the length of each interaction

e. All of the above

Question II: Read carefully and write in Your Answer Sheet the Letter (T) for the True

Answer or (F) for False (incorrect answers cancel true ones)1. A combination of local anti-inflammatory and anesthetics is first drug of choice to treat difficulty in

ingestion associated with inflammation of the pharynx. ( )

2. Sore throat is generally caused by a viral infection that is self-limiting within a week. ( )

3. A thrush can occur as a result of bacterial infection in babies or associated with immune-deficiency

problems and requires referral. ( )

4. Glandular fever occurs in teenagers and is characterized by inflammation of the throat associated with

enlarged glands and axillae and presence of creamy exudates. ( )

5. Poor inhalation techniques or administration of large doses of steroids aerosols may result in candida

infection and inflammation of the throat. ( )

6. A combination of Benzydamine, Benzocaine and Chlorhexidine in the form of mouthwash is very useful in

treatment of sore throat. ( )

7. Animal hairs and house dust are the major allergens causing seasonal allergic response. ( )

8. Allergic reactions can occur only in young age and usually associated with family history. ( )

9. Allergic rhinitis is characterized by a runny nose, nasal congestion, sneezing and watery eyes. ( )

10. Astemizole is a non-sedating antihistaminic with a short duration of action and is usually used for treatment

of hay fever. ( )

11. Antihistaminics are used to alleviate nasal congestion associated with hay fever. ( )

12. Sodium cromoglycate can be used to prevent seasonal allergic reaction and must be started 2-3 weeks

before hay fever season. ( )

13. Major Aphthous ulcers are characterized by the appearance of fresh crops of ulcers tend to emerge beforethe original crop has healed. ( )

14. Minor Aphthous ulcers are more common in women especially before menstrual cycle and usually stop

before pregnancy. ( )

15. Buccal hydrocortisone pellets can be used to decrease inflammation and pain associated with mouth ulcers.

( )

16. Obesity, smoking, bending down and eating large meals are among the factors that can aggravate heartburn

symptoms. ( )

17. Regurgitation is the forced expulsion of gastric contents through the mouth as a result of cancer or peptic

ulcer. ( )

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18. Calcium channel blockers, nitrates and Tricyclic antidepressants can induce heartburn symptoms. ( )

19. Sodium bicarbonate should be avoided by hypertension patients suffering from heartburn. ( )

20. Duodenal ulcer is characterized by a local pain in the upper abdomen especially after eating and aggravated

by NSAIDs and smoking. ( )

21. The presence of single or multiple stones in the bile duct may result in biliary colics especially after fatty

stricture. ( )

22. Atypical angina is chartered by a severe pain that is felt in the lower chest or upper abdomen especially

after a fatty meal. ( )

23. For a longer duration of action, antacids are best administrated one hour before meals. ( )

24. Beside their acid neutralization effect aluminum salts can cause osmotic diarrhea that can help relieving

slight constipation that may be associated with heartburn. ( )

25. Aspirin, antibiotics and digoxin are nauseating drugs therefore better taken with foods. ( )

26. Continuous use of stimulant laxative such as methylcellulose may result in atonic colon therefore they

should not be used for more than one week. ( )

27. Lubricant laxatives act by coating and softening the feces and preventing further absorption of water in the

colon so keep the feces moist and lubricated. ( )

28. Constipated pregnant women are best treated with bulk laxatives and increased dietary fiber intake. ( )

29. Multi-drug regimens are major cause of constipation in elderly patients. ( )

30. Diarrhea caused by salmonella usually occurs one day after ingestion of uncooked or contaminated foodand should be treated with erythromycin. ( )

31. In children, diarrhea may result from air borne viral infection and may be associated with fever, runny nose

and sore throat. ( )

32. Chronic diarrhea may be due to Crohn's syndrome characterized by colon spasms and alteration in bowel

habits. ( )

33. Oral rehydration therapy is the standard treatment for any type of acute diarrhea and can be prepared using

water or carbonated beverages. ( )

34. Anal fissures associated with hemorrhoids can be managed by correcting constipation and administration of

a local anesthetics cream. ( )

35. Suppositories can be used for continuous contact with weak irritants in detergents for a long period. ( )

36. Housewives eczema results from continuous contact with weak irritants in detergents for a long period.

( )

37. A mixture of calamine and 1% menthol may be useful as antibacterial to prevent microbial growth and

secondary bacterial infection in contact dermatitis. ( )

38. Acne occurs mainly in teenagers as a consequence of increase in androgen secretions during puberty. ( )

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39. Inflammatory lesion resulting from acne such as pustules can be easily treated by application of Benzoyl

peroxide cream for duration of two weeks. ( )

40. Resorcinol can be used for acne treatment although some studies showed that it may have comedogenic

action. ( )

41. A combination of Benzoyl peroxide and Miconazole would be the drug of choice for treatment of cane.

( )

42. Acne patients should not be exposed to sunlight and must not eat any fatty foods. ( )

43. Pigmented skin cancer can be secondary to warts and is characterized by an irregular, wavy outline and a

small ulcer that never seems to heal. ( )

44. Babies with scabies infection on their backs, faces or scalps can be treated by application of lindane on

those body parts but only with soft brush. ( )

45. Diabetic patient with athlete's foot o\infection should be referred to GP due to impaired circulation or

innervations of the feet. ( )

46. Compound benzoic acid ointment is the drug of choice for treatment of athlete's foot. ( )

47. Athlete's foot patient should wear leather shoes or open toed sandals and change socks daily as a part of

their treatment. ( )

48. German measles exert significant problems only if transmitted from a child to his pregnant mother in early

pregnancy. ( )

49. The symptoms of the common cold usually last for 3-5 days while that of flu last for about 7 days. ( )

50. Over-the-counter medications should be given the same care and respect given to prescription. ( )

51. Serum creatinine is a good predictor of renal function for all age groups. ( )

52. Phase I metabolic reactions are relatively stable (unchanged) over age. ( )

53. When initiating drug therapy in the elderly, start low and titrate slowly. ( )

54. Geriatric patients can have atypical presentations of adverse drug reactions. ( )

55. The main site for absorption of acidic drugs in the stomach. ( )

56. A fast rate of gastric emptying can reduce the extent of drug absorption. ( )

57. Formula-fed infants empty their stomach twice as fast as breast-fed infants. ( )

58. The skin of a full-term neonate has barrier properties to drug absorption similar top adult skin. ( )

59. In neonates, the ability to conjugate most groups in phase II reactions is reduced except for sulfate group.

( )

60. Normal corneal reflex should be unilateral. ( )

61. When testing the patient's visual field, you use your own visual field for comparison. ( )

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62. Pharmacy practice involves diagnosis, drug prescribing, selection and utilization reviews. ( )

63. For proper communication use the correct title and try to guess whether the adults are married or single.

( )

64. Pharmacists must be able to communicate with patients with special needs. The patient is responsible for

recognizing the special situation and having the flexibility to ensure appropriate communication. ( )

65. Intra-abdominal structures may be more palpable if the abdomen is obese or distended by fluids. ( )

66. The risk of lung cancer is reduced to one half just after five years of smoking cessation. ( )

67. Combined birth control pills are proved to be more effective than IUD. ( )

AnswersI) MCQs:

1 B 21 B 41 C

2 D 22 A 42 D

3 A 23 A 43 B

4 D 24 D 44 B5 C 25 D 45 A

6 D 26 B 46 D

7 D 27 B 47 A

8 A 28 D 48 C

9 B 29 B 49 E

10 A 30 D 50 D

11 B 31 C 51 C

12 D 32 A 52 D

13 A 33 C 53 C

14 B 34 C 54 B

15 D 35 A ( ) 55 A

16 D 36 B 56 C

17 A 37 D 57 C

18 B 38 B 58 B

19 C 39 C 59 D

20 D 40 D 60 D

II) T & F:1 F 21 T 41 T 61 T

2 T 22 F 42 F 62 F

3 F 23 F 43 F 63 F

4 T 24 F 44 F 64 F

5 T 25 T 45 T 65 F

6 T 26 F 46 F 66 F ( )

7 F 27 T 47 T 67 F ( )

8 F 28 T 48 T

9 T 29 T 49 F

10 F 30 F 50 T

11 F 31 T 51 F

12 T 32 F 52 F

13 F ( ) 33 F 53 T

14 T ( ) 34 T 54 T

15 T 35 F 55 F

16 T 36 T 56 T

17 F 37 F 57 F

18 T 38 T 58 T

19 T 39 F 59 T20 F 40 F 60 F

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Question I: Select the Most Appropriate Answer (only one) by Blackening the Circle with

the Corresponding Letter in the Provided Answer Sheet

1. :

c.

d.

a.

b.

2. :

c.

d.

a.

b.

3. :

c.

d.

a.

b.

4. :

c.

d.

a.

b.

Question II: Complete the following sentences

1.

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5.

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7.

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………………...

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24. 6 ……………..………………………………. …………………….

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25.

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26.

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27.

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28.

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30.

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31.

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