1、1 / 9Institute of Pharmaceutical Sciences SCHOOL OF PHARMACEUTICAL SCIENCESSOUTHERN MEDICAL UNIVERSITYFINAL EXAMINATION FOR PHARMACOLOGYPAPER 1AUTUMN SEMESTER, 2007Undergraduate of Preclinical MedicineSTUDENT NAME: ROLL NUMBER: SUBJECT (TITLE): COURSE CODE:QUALITY CHECK SIGNATURE:INSTRUCTIONS: PLEAS
2、E READ THE FOLLOWING INSTRUCTIONS CAREFULLY BEFORE PROCEEDING1. Write your name and roll number (on the right top of each answer sheet) CLEARLY;2. This is your final examination, please write carefully;3. The examination paper MUST NOT be taken out of the examination room;4. Read the directions care
3、fully before answering each question;5. Pens and erasers may be used, but calculators, cell phones are forbidden;6. WEIGHTING: This paper consists of TWO sections. Allocation of marks is listed as follows. Students are advised to use the marking system as a guide to the amount of time to be used on
4、each question.DATE: Class hours:TIME: Examination Paper Designer:Sections Section A: 60 MCQs Section B:Answer Questions TotalMarks 60 40 100ResultsCorrectorMarks：2 / 9SECTION A: MULTIPLE CHOICE QUESTIONS (601=50)Directions: Each question in this section is a multiple-choice question with five answer
5、 choices. Read each question carefully and choose the ONE best answer. Record your answer on the answer document in the space that corresponds to the question number. Completely fill in the space that has the same letter as the answer you have chosen. Use only a No. 2B lead pencil.1. Receptors are m
6、acromolecules that(A) Are designed to attract drugs(B) Are resistant to antagonists(C) Exist as targets for physiological neurotransmittersand hormones(D) Are only on the outer surface of cells(E) Are only inside of cells2. Which of the following chemical bonds would createan irreversible combinatio
7、n of an antagonistwith its receptor?(A) Ionic bond(B) Hydrogen bond(C) Van der Waals bond(D) Covalent bond(E) None of them3. The body has developed defense mechanisms that reduce the amount of foreign chemicals, such asdrugs, that enter the body. One of the more prominent of these mechanisms is an e
8、fflux transport systemthat pumps some drugs back into the intestinal lumen following absorption into the enterocytes and that is responsible for the lack of complete absorption of some drugs. This efflux transport system is:(A) Facilitated diffusion(B) P glycoprotein(C) Cytochrome P450 3A(D) Pinocyt
9、osis(E) None of them4. Concerning regulation of CYP-mediated drug metabolism, all of the following statements are true EXCEPT(A) Drugs that competitively inhibit CYP enzymes cause a decrease in concentrations of the object(original) drug.(B) Induction of drug-metabolizing enzymes results in a decrea
10、se in concentrations of the object (original) drug, thus potentially reducing efficacy.(C) Induction of drug-metabolizing enzymes frequently requires the synthesis of new enzyme protein and thus may not occur immediately upon introductionof the inducing agent.(D) Mechanism-based inactivation results
11、 in irreversible inactivation of the enzyme that lasts for the duration of the enzyme molecule.(E) None of them5. Drug presence in breast milk is most likely for:(A) Drugs highly bound to plasma proteinsMarks：3 / 9(B) Lipid-soluble molecules(C) Large ionized water-soluble molecules(D) Acidic compoun
12、ds(E) None of them6. For a drug such as piroxicam with a 40-hour halflife and being dosed once daily (i.e., every 24 hours), steady state will be reached shortly following which DOSE (not which half-life)?(A) 1st dose(B) 3rd dose(C) 5th dose(D) 8th dose(E) 12th dose7. It is well established that mos
13、t drugs taken by pregnant women are capable of crossing the placenta and reaching the developing fetus. The placenta itself can aid in the protection of the fetus from excessive exposure to drugs in the maternal circulation by(A) Impairing diffusion of lipid soluble drugs(B) Preventing the passage o
14、f drugs having a molecular weight under 250(C) Playing a role as a site of drug metabolism(D) Secreting drugs from the fetal circulation to the maternal circulation(E) None.15. A dental technician begins to display symptoms, including tremors, depression, and insomnia.Which of the following chemical
15、s present in the workplace may be responsible for the symptoms?(A) Solvents used in dental adhesives(B) Fluoride used in oral rinses(C) Mercury used in the preparation of amalgams(D) Lidocaine used as an anesthetic(E) None17. You are a staff physician at a major chemical manufacturing company. A wor
16、ker on the maintenance crew has complained of being light-headed and tired occasionally at work and that if it occurs, it clears up after he leaves for the day. He was asked to write down where he had worked on the days this occurred; these are listed below. In which of these areas is he most likely
17、 to have exposures that would cause these symptoms?(A) Herbicide production area(B) Insecticide packaging area(C) Label printing area(D) Kitchen area of the cafeteria(E) None18. When does a conflict of interest occur?(A) When an individuals private goals are inconsistent with that persons official r
18、esponsibilities (B) When an individuals research interests are in conflict with the research of an individual in another institution or corporation(C) When two researchers want to do research in the same area but there is only enough available funding for one researcher to do the research adequately
19、(D) When an individual has a conflict between his or her research interests and the requirements set forth by the Nuremberg Code(E) None19. All of the following types of cells are innervated by the autonomic nervous system EXCEPT:(A) Smooth muscle of blood vessels(B) Skeletal muscle(C) Sinoatrial no
20、de(D) Salivary glands4 / 9(E) Intestinal smooth muscle20. This question is based on the information provided in the accompanying diagram. Shown is the effect of applying norepinephrine on the arterial pressure of an isolated (in vitro) segment of artery from an experimental animal before and after a
21、dding drug X to the tissue. Drug X is present during the second application of norepinephrine. Drug X is most likely:(A) Guanethidine(B) Propranolol(C) Cocaine(D) Prazosin(E) Atropine21. A patient has developed glaucoma that is refractory to noncholinergic therapies. You decide to prescribe eyedrops
22、 containing pilocarpine, but you are concerned about the patients ability to self-administer the drops. The most sensitive indicator of excessive administration of pilocarpine is(A) An increased heart rate(B) A decreased heart rate(C) Mental confusion(D) Constriction of the pupil(E) None22. Which of
23、 the responses to atropine listed below is most likely to be different in an elderly versus a young patient?(A) Inhibition of sweating(B) Tachycardia(C) Mydriasis(D) Drowsiness(E) None23. Digitalis functions to improve congestive heart failure by(A) Induction of emesis(B) Activation of _-adrenergic
24、receptors(C) Improving survival in patients of heart failure(D) Binding to and inhibiting the NaK ATPase enzyme in cardiac myocytes(E) Deactivation of the angiotensin receptor24. A 45-year-old woman has had recurrent episodes of atrial fibrillation. She is receiving phenytoin and quinidine to contro
25、l the atrial fibrillation. She is also taking a low dose of diazepam for insomnia and estrogen replacement therapy.You learn today that she has been receiving ciprofloxacin for a urinary track infection.The reason for her appointment today is that she has been having ringing in the ears, headache, n
26、ausea, and blurred vision. She tells you that she is also having trouble hearing the television. You suspect drug toxicity.The most likely agent is(A) Ciprofloxacin(B) Estrogen(C) Phenytoin(D) Diazepam(E) Quinidine25. A patient comes to your office with effort-induced angina and resting tachycardia.
27、You choose the following drug to treat the patient because it slows heart rate by blocking L-type calcium channels in the SA node:(A) Verapamil(B) Propranolol(C) Nitroglycerin(D) Isosorbide dinitrate5 / 9(E) Metoprolol26. Metoprolol would produce which beneficial effect in a patient with secondary a
28、ngina?(A) A decrease in preload(B) An increase in collateral blood flow(C) An increase in afterload(D) An increase in diastolic filling time(E) An increase in blood flow through a concentricStenosis27. The most potent vasoconstrictor known is(A) Bradykinin(B) Angiotensin II(C) Angiotensin IV(D) Natr
29、iuretic peptide(E) Endothelin28. Which of the following statements most accurately characterize the cellular action of the calcium channel blockers?(A) Their interaction with membrane phospholipids results in a nonselective decrease of ion transport.(B) They inhibit the Na_Ca_ exchanger in cardiac a
30、nd smooth muscle.(C) They interact at three distinct sites at the Ltype voltage-gated calcium channels.(D) Their interaction with the sodium pump results in an inhibition of calcium transport.(E) None29. All of the following adverse effects are likely to occur with long-term use of calcium channel b
31、lockers EXCEPT(A) Skeletal muscle weakness(B) Flushing(C) Dizziness(D) Headache(E) None30. Which of the following antihypertensive drugs is contraindicated in a hypertensive patient with a pheochromocytoma?(A) Metyrosine(B) Labetalol(C) Prazosin(D) Phenoxybenzamine(E) Guanethidine31. When a patient
32、is treated with a thiazide diuretic for hypertension, all of the following are likely EXCEPT:(A) The fall of blood pressure that occurs in the first 2 weeks of therapy results from a decrease of extracellular volume.(B) The sustained fall in blood pressure that occurs after several weeks of therapy
33、is due to a decrease of intravascular resistance.(C) After the blood pressure is reduced, hypokalemia remains a complication.(D) Hyperuricemia may occur.(E) Hypoglycemia may occur.32. Which of the following statements describe why warfarin is not used to prevent blood coagulation in blood collection
34、 devices used at blood donating centers?(A) Warfarin does not bind to plastic tubing or glass.(B) The anticoagulant effect of warfarin occurs only in vivo.6 / 9(C) Warfarin is a prodrug, which must be activated in the liver into the active compound. (D) The gastric enzymes needed to convert Rwarfari
35、n into S-warfarin are unstable near plastic.(E) Warfarin is chemically unstable and is degraded unless made fresh and used immediately.33. Agents that potentiate the actions of GABA in the brain will likely have which of the following effects?(A) Elevate blood pressure(B) Provide sedation(C) Cause s
36、eizures(D) Relieve pain(E) None34. Frequently vasoconstrictors are combined with local anesthetics to delay absorption of the anesthetic from its injection site. What is the most widely employed agent?(A) Dopamine(B) Phenylephrine(C) Levonordefrin(D) Epinephrine(E) Cocaine35. Opisthotonos is a convu
37、lsive condition that is often associated with the ingestion of strychnine. This condition is associated with all of the following EXCEPT(A) Antagonism of the inhibitory amino acid neurotransmitter glycine(B) The predominance of glycine as an inhibitory amino acid transmitter in the spinal cord(C) An
38、tagonism of the inhibitory amino acid neurotransmitter GABA(D) The convulsions lead to tonic extension of the body and all limbs(E) None36. A 54-year-old man is scheduled for an elective colonoscopy that will take approximately 20 minutes. Which of the following drugs would be most likely to produce
39、 the desired anesthesia and anterograde amnesia?(A) Buspirone(B) Zephalon(C) Midazolam(D) Chlordiazepoxide(E) Hydroxyzine37. Many anticonvulsant drugs, as a major part of their mechanism of action, block the sodium channel, but other effective agents do not use this mechanism. Which of the following
40、 anticonvulsants has the ability to block T-calcium currents as its primary mechanism of action?(A) Ethosuximide(B) Phenytoin(C) Topiramate(D) Carbamazepine(E) Lamotrigine38. Which of the following antidepressants is most selective for inhibition of neuronal reuptake of serotonin?(A) Mirtazapine (Re
41、meron)(B) Venlafaxine (Effexor)(C) Bupropion (Wellbutrin)(D) Sertraline (Zoloft)(E) Imipramine (Tofranil)39. Which of the following statements about antidepressant medications is most appropriate?(A) They all have a delay of approximately 48 hours for onset of benefit.(B) There are large differences
42、 in efficacy among individual agents.7 / 9(C) Some benefit is expected in 65 to 80% of patients treated with an antidepressant for major depression.(D) The major contribution of the newer antidepressants lies in the marked improvement in duration of action.(E) None40. Which of the following agents p
43、ossesses pharmacological actions characterized by high antipsychotic potency, high potential for extrapyramidal toxicity, and a low likelihood of causing sedation?(A) Thioridazine(B) Haloperidol(C) Flumazenil(D) Clozapine(E) Carbamazepine41. An advantage of celecoxib over most other NSAIDs is(A) Les
44、s inhibition of PGE2 effects on the gastric mucosal(B) Less risk of bronchospasm and hypersensitivity reactions(C) Once-daily dosing allows the patient convenience(D) Less risk of harm to the developing fetus in the third trimester(E) Greater degree of efficacy in the treatment of rheumatoid arthrit
45、is42. Allopurinol reduces serum urate levels by(A) Promoting the active secretion of uric acid in kidneys(B) Inhibiting uric acid synthesis(C) Impairing renal urate reabsorption(D) Decreasing metabolism of uric acid(E) None43. The antigen-mediated release of histamine can(A) Be inhibited by the bind
46、ing of histamine to H3-receptors on mast cells(B) Be stimulated by _2-adrenoceptor agonists(C) Be initiated by organic bases such as morphine without prior sensitization(D) Occur only in the tissues, not in the blood(E) Produce pain and itching through an effect on sensory nerve endings44. The under
47、lying pathophysiology of asthma is best described by which of the following statements?(A) Asthma is a psychosomatic disorder.(B) Asthma is caused by an aberrant response to vaccinations.(C) Asthma is a disease of airway inflammation.(D) Asthma is a disorder of the lung parenchyma.(E) Asthma is an i
48、nfectious disease.45. Symptoms typically produced by inhaled _-adrenoceptor agonists include which of the following?(A) Tachycardia, dizziness, and nervousness(B) Dysphonia, candidiasis, and sore throat(C) Dyspepsia and Churg-Strauss syndrome(D) Nausea, agitation, and convulsions(E) Muscle tremor, t
49、achycardia, and palpitations46. A 62-year-old woman on hemodialysis is scheduled for a screening colonoscopy.Which should be prescribed for her colonic preparation?(A) Visicol(B) Fleet Phospho soda(C) Magnesium citrate(D) Dulcolax(E) GoLYTELY8 / 947. Several very useful dermatological agents are derived directly from plants.A compound occurring in the May apple is(A) Interferon_-2b(B) Mycophenolate mofetil(C) Methotrexate(D) 6-Thioguanine(E) Podophyllotoxin4
