USMLE QUESTIONS BANK 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moreGeneral Pediatric-related - MCQs 1-10Page 1 of 66 Loading...1. Which of the following drug belongs to lincosamide antibiotics? Ciprofloxacin Sulbactam Oxytetracycline Clindamycin Linezolid Loading...2. A 70-year-old woman, having had an appendectomy 25 years ago, is brought to the emergency room with severe abdominal pain. The patient describes the pain as being crampy and colicky. She also says that the pain seems to increase and then improve on its own. She has already vomited 10 times since the pain started in the morning. She has also not had a bowel movement since last 2 days or passed flatus in last couple of days. Physical examination shows that the abdomen is distended slightly. Auscultation of the abdomen shows peristaltic rushes and high-pitched bowel sounds. Tympanic abdomen is revealed during percussion. The patient is also diffusely tender with palpitation but there is no rebound tenderness. Rectal examination also shows an absence of stool. What would be the likely diagnosis? Gastroenteritis Pancreatitis Diverticulitis Intestinal obstructionRead moreThe following represents an essential element to an effective quality council? Loading...3. Which of these medications is the most appropriate treatment of malignant hyperthermia? Acetaminophen Ibuprofen Dantrolene Indomethacin Loading...4. Which one of the following drugs is a inhibitors of the P-GP (glycoprotein) efflux pumps? Amiodarone All of the above Linezolid A & B Digoxin Loading...5. A group of drugs bind to a receptor but do not produce any pharmacological effect is called: Antagonist Agonist Partial agonist Loading...6. The antimuscarinic drug used for motion sickness as well as for blockage of short-term memory? Phenylephrine Atropine Pirenzepine Physostigmine Scopolamine Loading...7. A 25-year-old man is brought by police for screaming and attaching neighbors. His temperature is 102.4 F, his respiratory rate is 30/min, his pulse is 110/min, his blood pressure is 170/90 and his pupils are dilated. He suddenly becomes unresponsive and requires resuscitation. Which of the following substances is most likely was taken? Heroin Morphine Ethanol Cocaine Loading...8. Which of the following are the characteristics of Dressler’s syndrome? Stasis, hypercoagulability and endothelial damage Hypotension, distant heart sounds and jugular vein distention (JVD) Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Loading...9. Which one of the following statements about the Digoxin is wrong? A cardiac glycosides None of these Has a half-life of 36 hours Inhibit Na+/K+ exchange Positive Inotropic drug Loading...10. Cinchonism is a possible side effect of which one of the following drugs? Metoclopramide Quinidine Isoniazid Enflurane Loading...11. Which of the following substances increases absorption of iron in the intestine? Riboflavin Ascorbic acid Folic acid Cyanocobalamin Loading...12. A drug that elevate bronchial smooth muscle cAMP leading to decreased intracellular calcium and prompt bronchodilation. Epinephrine Albuterol Clonidine Phenylephrine Dipivefrin Loading...13. Which one of the following adverse effects of calcium channel blockers is wrong? Hypotension Fatigue Diarrhea Vertigo Loading...14. A 38 year old man is brought to the emergency room because of palpitation and shortness of breath for 4 hours. He travelled to Brazil two years ago on a business trip. He was bitten there by a fly and was treated by analgesics for a few weeks due to fever and headaches. On examination, heart rate is 150 with shifting of the apex to the left. Imaging studies and further investigations show cardiomyopathy. What is the organism most likely responsible for this condition? Trichophyton rubrum Ascaris lumbricoides Streptococcus pyogenes Trypanosoma cruzi Staphylococcus aureus Loading...15. An 82-year-old man is brought to the clinic by his son who is concerned about his father’s mental status. He told you that his father has recently become more forgetful and angry. He doesn’t remember recent events and he gets frustrated when he fails to complete simple tasks. On examination, the patient is unkempt. His vital signs are within normal limits. Mini-mental status test scores 12/30. MRI of the brain shows some areas of degeneration in the temporal lobe. What is the most appropriate treatment of this condition? Fluoxetine Diazepam Metoclopramide Citalopram Donepezil Loading...16. A drug that belongs to proton pump inhibitor is one of the following? Sulbactam A & B Ethacrynic Acid Rosiglitazone Lansoprazole Loading...17. Which one of the following drugs is used to treat helminthic infections for cestodes? Thiabendazole Albendazole Ivermectin Praziquantel Mebendazole Loading...18. Which one of the following conditions is the most likely cause of acute lower gastrointestinal bleeding in patients older than 40? Varicose veins Colorectal cancer Ulcerative colitis Diverticulosis Loading...19. Thrombocytopenic purpura (TTP) is the adverse effect of the following drug? Both A & B Abciximab Clopidogrel Ticlopidine All of the above Loading...20. A 3-month-old girl is brought to the clinic due to weakness and pallor for one week. History claims that she was born after premature delivery. She is normal in development and growth. She is breastfed and her immunizations are up to date. What is the most appropriate treatment? Vitamin D supplement Milk formula instead of breastfeeding Iron supplement Vitamin C supplement Loading...21. Which one the following parts of the large intestine is extraperitoneal? Transverse colon Descending colon Sigmoid colon Cecum Loading...22. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefepime Cefadroxil Cefaclor Ceftazidine Loading...23. Which one of the following conditions most likely shows lower than normal erythrocyte sedimentation rate (ESR)? Pregnancy Polycythemia Multiple myeloma Giant cell arteritis Loading...24. Which of the following disorders is most likely related to body dysmorphic disorder? Generalized anxiety disorder Obsessive compulsive disorder Malingering Post-traumatic stress disorder Loading...25. Which of the following insects is the victor responsible for transmission of Rocky Mountain spotted fever? Flea Mite Louse TickPage 2 of 66 Loading...26. A 55-year-old woman presents to the emergency room for a cut wound on her hand. While she was cutting a piece of meat, she lost control of the knife resulting in a longitudinal wound in her hand. Bleeding stopped after a few minutes. Now she is concerned about tetanus vaccination. Records show that she received all the doses of tetanus-diphtheria (Td) and the last one was 4 years ago. What is the appropriate therapy for prophylaxis of tetanus in this patient? Tetanus toxoid Tetanus immunoglobulin Tetanus toxoid followed by tetanus immunoglobulin after 5 days No further therapy Tetanus toxoid and tetanus immunoglobulin Loading...27. You are the physician in charge of a nursing home where several patients develop influenza A symptoms. None of the residents received flu vaccine yet. What is the best next step of action? Administer flu vaccine plus oseltamivir for 2 weeks to all residents Administer flu vaccine to all residents Treat only patients with oseltamivir until their symptoms subside Administer oseltamivir for 2 weeks to all residents Loading...28. The following drug is a peripheral dopamine-1 receptor agonist? Hydralazine Minoxidil Fenoldopam Alpha-Methyldopa Loading...29. Which of the following is the mechanism of action of misoprostol for the treatment of peptic ulcer? Formation of a protective coating of the ulcer beds Increased mucus and bicarbonates secretion and decreased HCL secretion Suppression of secretory responses to food stimulation Direct inhibition of the proton pump Loading...30. A drug that inhibit the guanosine triphosphate formation thus preventing viral mRNA capping and RNA dependent RNA polymerase blockage? Both A & B All of the above Oseltamivir Amantadine Ribavirin Loading...31. Heteroaryl acetic acid drug is following? Tolmetin Indomethacine Piroxicam Nabumetone Ibuprofen Loading...32. Which test of the following is used to evaluate acute exacerbation of asthma? Chest x-ray Complete blood count Pulse oximetry Pulmonary function tests Loading...33. Which one of the following conditions is associated with Acanthosis Nigricans? Diabetes mellitus Hemochromatosis Diabetes insipidus Amyloidosis Loading...34. Which one of the following conditions is most likely affects the lungs of a patient with Parkinsonism? Atherosclerosis Arteriosclerosis Embolism Thrombosis Loading...35. A 73-year-old patient with multiple myeloma has been treated with high doses of doxorubicin. Which of the following may develop during this treatment? Bladder hemorrhage Cardiomyopathy Hemolytic anemia Papilledema Loading...36. Which of the following is the most common cause of sudden death in patients with diabetes mellitus? Gangrene Hyperosmolar coma Cerebral hemorrhage Myocardial infarction Loading...37. A 23 year-old woman presents to the emergency room with severe lower right abdominal pain for the last six hours. She had intermittent lower abdominal pain for three days but never been severe like this time. Her last menstrual period was three months ago and before that she had regular 28 day periods. On physical examination, her vital signs are within normal limits and she has a local tenderness on the lower abdomen with no rebound. On pelvic examination, there is a tender small-sized mass felt in the right vaginal fornix. What is the most likely diagnosis? Endometriosis Ovarian cyst Pelvic abscess Acute appendicitis Ectopic pregnancy Loading...38. Which of the following is the most common cause of adverse drug reactions? Non-compliance Idiosyncrasy Dosage discrepancy Allergic reaction Loading...39. A 16-year-old high school student presents to the office with her mother for consultation. Her mother admits that her daughter is sad because she broke up with her friend recently. Yesterday, she tried to cut her wrist but her brother screamed and they stopped her. The girl does not make eye contact and her head is bent down through the interview. She tells the doctor that she does not want to live anymore. She refuses to answer any question and declined physical examination. What is the most appropriate next step of management for this patient? Refer to the psychiatric clinic next day Advise family that it is a normal reaction and keep an eye on her Prescribe antidepressant and follow up in a week Refer to the social worker Admit to the hospital Loading...40. Outpatient prophylaxis of superior ventricular tachycardia (SVT) is best accomplished by which of the following medications? Procainamide Diltiazem Lidocaine Adenosine Loading...41. Which of the following receptors is inhibited by ondansetron to treat nausea following chemotherapy? Serotonin 5-HT receptors Dopamine receptors Muscarinic receptors Nicotinic receptors Loading...42. Following drug consists of an aromatic derivative ring in the structural formula? Simvastatin Colestipol Atorvastatin Pravastatin Lovastatin Loading...43. Atropine causes:? Tachycardia followed by bradycardia Only bradycardia Only tachycardia Bradycardia followed by tachycardia No effect on Heart Loading...44. Which of the following organs is the most commonly affected one by a blunt trauma to the abdomen? Liver Small intestine Spleen Large intestine Loading...45. Congenital heart diseases are defects of the heart and/or great arteries that are present at birth. They may be manifested at birth or hidden until later in life. Cyanosis is an important sign to diagnose and differentiate between types of congenital heart disease. What is the most common congenital heart disease? Patent ductus arteriosus Transposition of the great arteries Atrial septal defect Tetralogy of Fallot Ventricular septal defect Loading...46. A drug that inhibits the M2 protein ion channel and its ability to modulate intracellular PH? Ribavirin Rimantadine Acyclovir Zanamivir Loading...47. Decreased production of which type of collagen may result in osteogenesis imperfecta? Type III Type I Type II Type IV Loading...48. A 26-year-old pregnant woman visits her primary care physician for routine examination. Her examination is normal. Her blood group is O, Rh-negative. Administration of which of the following should prevent the development of related fetal complications? Ferrous sulfate Folic acid derivatives Rh (D) immune globulin Wide spectrum antibiotics Loading...49. Which one of the following drugs decreases endogenous hepatic production of glucose? Sitagliptin Metformin Acarbose Pioglitazone Loading...50. M1 Receptors are primarily located in: Exocrine glands, vessels (smooth muscles & endothelium) Skeletal muscle neuromuscular endplates Cerebral cortex, Sympathetic ganglia, myenteric ganglia Postganglionic neurons Myocardium, smooth musclesPage 3 of 66 Loading...51. Which of the following is the most important risk factor for coronary artery disease? High LDL cholesterol Obesity High total cholesterol Low HDL cholesterol Loading...52. Which one of the following parts of the cell is the site of steroid synthesis? Golgi apparatus Smooth endoplasmic reticulum Peroxisome Rough endoplasmic reticulum Loading...53. Which of the following drugs has the least CNS side effects? Ganciclovir Rimantadine Amantadine Zidovudine Acyclovir Loading...54. A 33-year-old butcher comes to the clinic because he developed eye problems. On taking history, the patient states that he eats raw hamburgers in a regular basis. The physician orders Sabin-Feldman dye test and the results come back positive. Which is the most likely cause of this patient’s condition? Giardiasis Toxoplasmosis Trichinosis Schistosomiasis Loading...55. Which of the following pathological signs is the first visible one in atheroma formation? Calcification Fatty streak Thrombus Hemorrhage Loading...56. An old man presents with acute severe back pain, tachycardia, hypotension and syncope. Which of the following is the most likely diagnosis? Pulmonary embolism Acute mesenteric ischemia Acute myocardial infarction Rupture of abdominal aortic aneurysm Loading...57. A 23-year-old man presents to the emergency room complaining of massive watery diarrhea for 6 hours. He doesn’t have any vomiting or abdominal pain. Stool culture reveals a curved; gram negative rod which secretes an enterotoxin contains subunit A and a binding subunit B. What is the most likely reason for this patient’s massive diarrhea? Increased production of cAMP Deficiency in the brush border enzymes Destruction of the absorptive epithelium Increased motility of the small intestine Decreased production of cAMP Loading...58. Which of the following drug contain sulfonamide structure in the structural formula? None of these Mefenamic acid Celecoxib Meloxicam Acetaminophen Loading...59. A middle aged male represents with an edematous circular skin lesion of black eschar. Which of the following bacteria is the most likely the causative organism of this condition? Bacillus anthracis Pneumonitis aeruginosa Streptococcus viridans Staphylococcus aureus Loading...60. A 2-week-old boy is brought for persistent vomiting of non-bilious material after feeding. The boy is lysergic and dehydrated. Examination reveals presence of an olive-sized mass in the epigastric area moving with peristalsis. What is the most likely diagnosis? Pyloric stenosis Esophageal atresia Meckel’s diverticulum Duodenal atresia Loading...61. Which one of the following drugs is a Tetracycline? Cefepime Doxycycline Cefdinir Cefadroxil Loading...62. Which of the following benefits is achieved as a result of adding progesterone to estrogen in HRT? Decrease bone resorption Increase the effect of estrogen on the heart Decrease the effect of estrogen on the breast Decrease the occurrence of endometrial cancer Loading...63. A 48 year-old man, who visited his daughter in London last week, complains of sudden severe pain and swelling in his right leg during his flight back to the USA. He is taken to the hospital and ultrasound is performed. It reveals femoral vein thrombosis. What is the most likely contributed to this finding? Alcohol abuse Immobilization Hypothyroidism Hypertension Daily aspirin Loading...64. Aminoglycosides inhibit protein synthesis through targeting which of the following? mRNA RNA polymerase Peptidoglycan units 30S ribosomal subunits Loading...65. Ganglion blocker drug is following? Atracurium Nicotine Mecamylamine B & C Atropine Loading...66. Long Acting Insulin is one of the following? Glulisine Glargine Aspart NPH Loading...67. When a intravascular clot started floating in the blood termed as one of the following option? All of above Thrombus Embolus Coagulation Loading...68. A 48-year-old man complains of acute pain in his right big toe. He has a history of gout and takes treatment for it. Recently, he was diagnosed with hypertension and started treatment 2 weeks ago. Which one of these drugs is most likely responsible for his recent complaint? Verapamil Captopril Hydrochlorothiazide Metoprolol Loading...69. A 59-year-old man visits his physician for his yearly routine examination. He mentions that his exercise tolerance had been reduced over the last year. He also notes that he experiences shortness of breath and chest pain when he is ascending his home stairs although he lives on the second floor. He smokes 1-2 packs of cigarettes every day for 35 years. He drinks socially and uses recreational drugs occasionally. On examination, his vital signs are as follows: pulse 86/min, blood pressure 138/86 and his BMI is 30. His cardiac examination is unremarkable. He has family history of hypercholesterolemia and coronary disease. His laboratory tests show abnormal lipid profile (LDL Cholesterol: 230 mg/dL and HDL: 32 mg/dL). What is the most likely vascular pathology in this patient? Medial calcific sclerosis Atherosclerosis Deep venous thrombosis Hyperplastic arteriosclerosis Loading...70. Deficiency of which of the following enzymes most likely result in the development of Cori disease? Debranching enzyme (alpha-1,6-glucoside) Lysosomal alpha-1,4 glucosidase Glucose-6-phosphatase Muscle glycogen phosphorylase Loading...71. A 58-year-old man takes verapamil for hypertension and angina. Which of the following is a common adverse effect of high dose of this drug? Sexual dysfunction Diarrhea Constipation Hyperglycemia Loading...72. A 68 year-old man with a long history of poorly controlled diabetes presents to his physician complaining of pain and drainage in his left ear. His vital signs are within normal limits. The pinna of his left ear is tender. The external meatus is swollen and covered with purulent drainage. What is the most likely organism responsible for his condition? Pseudomonas aeruginosa Streptococcus pneumoniae Moraxella catarrhalis Haemophilus influenzae Candida albicans Loading...73. Which one of the following drugs is used to treat asthma? Repaglinide Theophylline Hydrochlorothiazide Indanyl carbenicillin Ezetimibe Loading...74. A drug induces rapid depolarization of the membrane inhibiting the intracellular synthesis of DNA, RNA, and protein? Daptomycin Aztreonam Imipenem Vancomycin Loading...75. Which one of the following muscles is most likely at risk due to injury of the pelvic floor during delivery of a large-size baby? Coccygeus Iliococcygeus PubococcygeusPage 4 of 66 Loading...76. A 6-year-old boy presents with fever, malaise, cough, running nose and conjunctivitis. His past medical history indicates that he did not receive any immunizations due to his parents’ religious belief. On examination, his temperature is 102.7 F and there are white spots on a red base close to his second molar teeth. He also has non-pruritic, maculopapular rash on his face, behind his ears and spreading to his chest. What is the most likely diagnosis? Measles Chicken pox German measles Mumps Smallpox Loading...77. Which of the following are the major sites for heme synthesis? Bone marrow and kidney Bone marrow and spleen Bone marrow and liver Kidney and spleen Kidney and liver Loading...78. A 28-year-old woman with a history of normal delivery 3 days ago after an uneventful pregnancy is admitted to the ICU because of high fever and foul-smelling vaginal discharge. General examination reveals temperature of 103.3 F, pulse 96/min and blood pressure 100/70 mmHg. Pelvic examination reveals bloody yellowish discharge and dilated, enlarged and bulky cervix. What is the next step of action? MRI of the pelvis Observation and waiting for the results of blood culture CT scans of the abdomen and pelvis Blood samples and intravenous antibiotics Oral ampicillin and gentamicin Loading...79. A 30-year-old pregnant woman visits her obstetrician’s clinic at 10 weeks gestation. The patient has a history of type 1 diabetes and is worried that her condition may cause some complications in her pregnancy. From the list below, advise your patient that all of the following are a potential risk of type 1 diabetes in pregnancy EXCEPT which one? Fetal malformations Preterm labor Having to undergo a cesarean section Spontaneous abortions in the first trimester Loading...80. Which of the following statements is true about warfarin? Liver is the main site of action of warfarin Toxicity of warfarin is treated by protamine sulfate Warfarin acts by activation of antithrombin Warfarin is monitored by PTT Loading...81. A disease in which blood vessels become inflamed and this inflammation leads to restriction of blood flow to organs and tissues also sometimes permanently damage organs is called? Steven-johnson syndrome Reye syndrome Ductus arteriosus Hypotrichosis Churg Strauss syndrome Loading...82. Which one of the following is the most common etiology of abdominal aortic aneurysm in the United States? Cystic medial necrosis Rheumatic heart disease Turner syndrome Atherosclerosis Loading...83. Which of the following medications is used in opioid overdose? Naloxone Norepinephrine Phencyclidine Flumazenil Loading...84. A baby is born with a protruding saclike lesion on the lower back. Examination reveals decreased sensations and reduction of tone and strength of both lower extremities. Which of the following is the most appropriate next step in management? Urgent surgical interference Immediate lumber puncture Manual compression of the lesion Broad spectrum antibiotics to avoid meningitis Loading...85. Which one of the following drugs has a synergistic effect with Flucytosine? Amphotericin B Nystatin Caspofungin Griseofulvin Loading...86. A patient with cystic fibrosis is treated by gene therapy. Which of the following types of cells should be targeted as host cells? Germ cells Epithelial cells Hemopoietic stem cells T-cells Loading...87. Which one of the following drugs is a calcium channel blocker (Class IV)? Amiodarone Procainamide Carvedilol Verapamil Loading...88. Which of the following is the main role of colchicine in treating acute attack of gout? Reduction of gout symptoms and pain Decreased uric acid absorption Inhibition of xanthine oxidase Increased uric acid excretion Loading...89. Which of the following is the most abused drug for all ages in the United States? Marijuana Methamphetamine Cocaine Alcohol Loading...90. EXPLANATION: It is positive in this patient. Tinel sign is reproduction of pain by tapping or percussion on the medial nerve. Anti-cyclic citrullinated peptide Erythrocyte sedimentation rate (SER) Cervical spine x-ray Rheumatoid factor Loading...91. Bioavailability of a medication is maximal when it has which of the following factors? High lipid solubility High ionization High plasma binding High water solubility Loading...92. A neonate presents by renal failure and pulmonary hypoplasia. What is your diagnosis? Niemann-Pick disease Pompe disease Recessive polycystic kidney disease Phenylketonuria Loading...93. An Acrobat player fell from a height of about 30 feet on her back during her performance and sustained a serious injury. Her thoracic and abdominal muscles are completely paralyzed. She is still able to breathe as the diaphragm is not paralyzed by this injury. What is the most likely level of her injury? First lumbar Seventh cervical Second cervical Fifth thoracic Third lumbar Loading...94. A 56 year old man is taken to the emergency room after having grand mal seizure during a staff meeting. He has no history of seizure but he complains lately of recurrent headaches on the morning and decrease in intensity later in the day. Laboratory investigations and imaging studies are performed. Which of these tests will confirm the diagnosis of glioblastoma multiform? Brain biopsy MRI of the brain Head CT scan CSF analysis Loading...95. Which one of the following drugs inhibit the enzyme phosphodiesterase which inactivate the cAMP? Warfarin Argatroban Dipyridamole Aminocaproic acid Loading...96. A 54 year old man presents to the emergency room complaining of progressive shortness of breath for 3 weeks. He has a long history of left sided heart failure treated by enalapril. Chest x-ray reveals bilateral pulmonary edema. After receiving the appropriate treatment, he is hospitalized for further investigations. Which of these findings is most likely revealed after further investigations? Normal arterial O2 partial pressure Decreased pulmonary artery pressure Normal respiratory function tests Increased pulmonary venous pressure Normal arterial CO2 partial pressure Loading...97. Which of the following findings is consistent with a case of right lung atelectasis? Trachea is deviated to the left Trachea is deviated to the right Trachea is not deviated (normal location) Loading...98. Deferoxamine is an antidote used for toxicity of the following? Calcium bicarbonate Atropine Isoniazid Iron Loading...99. Which of the following markers identifies B lymphocytes in a blood sample treated with different fluorescent-labeled antibodies? CD4 CD19 CD8 CD3 Loading...100. A 20-year-old exchange male student from Greece presents to the office for evaluation. Two days ago, he noticed yellow discoloration of his conjunctiva. His family history is significant for hemolytic anemia due to glucose-6-phosphate dehydrogenase deficiency. Which one of these findings is most likely revealed in this patient’s workup? Dark brown urine Increased urobilinogen in urine Increased bilirubin in urine Clay colored stool Increased plasma unconjugated bilirubinPage 5 of 66 Loading...101. Which one of the following drugs is associated the most to tardive dyskinesia after use for years? Olanzapine Chlorpromazine Risperidone Aripiprazole Loading...102. Which of the following drugs has/have beneficial role in Torsades de pointes ? Magnesium Sulfate b & c Amiodarone Propranolol Eplerinone Loading...103. Which one of the following drugs has a relatively lowest potential to induce drowsiness? Loratadine Fexofenadine Cetirizine Acrivastine Loading...104. Which of the following substances is used in mercury poisoning? Methylene blue Flumazenil Succimer Fomepizole Loading...105. Which one of the following parts of fallopian tube is the widest and the most common site for fertilization? Ampulla Infundibulum Isthmus Loading...106. Reflex tachycardia caused by systemic albuterol can be blocked by which of the following medications? Dobutamine Metoprolol Prazosin Phenylephrine Loading...107. Which one of the following conditions is characterized by painless blisters on the back of the hands and hyperpigmentation of the face? Dermatitis herpetiformis Herpes zoster Porphyria cutanea tarda Contact dermatitis Loading...108. Pancreatic exocrine secretions empty into the duodenum through which one of the following? Duct of Santorini Accessory pancreatic duct Common bile duct Duct of Wirsung Loading...109. Which of the following drug belongs to the Oxazolidinone class of Antibiotics? Linezolid Oxytetracycline Ciprofloxacin Erythromycin Sulbactam Loading...110. Which of the following statements is true about live attenuated vaccine? No booster is needed for live attenuated vaccines They only induce humoral immunity Close contacts of influenza patients can be safely vaccinated with live attenuated vaccine It is mainly used for immunocompromised patients Loading...111. Which one of the following antibacterial drugs is a protein synthesis inhibitor drug? Cefuroxime Aztreonam Chloramphenicol Vancomycin Loading...112. Which one of the following is a fat-soluble vitamin? Thiamine Riboflavin Retinoid Ascorbic acid Loading...113. A person who is a bus driver suffering from seasonal allergy. To relieve his seasonal allergy which drug is the drug of choice for this bus driver? Triplodine Loratadine Carbinoxamine Cyproheptadine Promethazine Loading...114. Which one of the following fractures is incomplete and involving the cortex of only one side of the bone? Osgood-Schlatter disease Nursemaid’s elbow Torus fracture Greenstick fracture Loading...115. Which one of the following effects is correlated to direct beta1-adrenoreceptor stimulation? Vasoconstriction Bronchodilation Tachycardia Bradycardia Loading...116. A 30-year-old man tells you that when he carries a heavy lift, his muscle gives up all of a sudden. Which of the following actions is responsible for abrupt cessation of skeletal muscle contraction? Activation of Golgi tendon organs Lower blood supply to the muscle Activation of muscle spindles Activation of lower motor neuron Loading...117. An old patient underwent percutaneous coronary intervention due to anterior myocardial infarction. Now, his ejection fraction is 45. Which of the following medications increases his survival? Furosemide Atenolol Lisinopril Digoxin Loading...118. 5-FdUMP a false nucleotide inhibits thymidylate synthetase decreasing thymidylic acid(an essential DNA component) is MOA of following drug? Flucytosine Nystatin Amphotericin B Ketoconazole Loading...119. Which one of the following medications is a non-selective beta receptor agonist? Phenylephrine Ephedrine Isoproterenol Epinephrine Loading...120. Which of the following Diuretic drugs contain cyclic sulfonamide Except? Indapamide Methylchlorothiazide Bendroflumethiazide Chlorothiazide Hydrochlorothiazide Loading...121. A 68 year-old woman complains of fever, anorexia and right flank pain for 2 days. She vomited twice today. On physical examination, her temperature is 101.3 F and there is moderate tenderness on the right costovertebral angle. Her urinalysis shows leukocytes and pus cells. What is the most appropriate next step of management? Collect blood and urine samples for culture Schedule MRI of the abdomen and pelvis Hospitalization and intravenous antibiotics Outpatient wide spectrum antibiotics and schedule a visit after 3 days Schedule Intravenous pyelogram Loading...122. What is the antidote to organophosphates toxicity? Atropine Pralidoxime B & C Dimercaprol All of above Loading...123. Which one of the following drugs is a calcium channel blocker (Class IV)? Verapamil Amiodarone Carvedilol Procainamide Loading...124. Which one of the following stain is most likely relevant to diagnose Cryptococcus neoformans? Giemsa stain India ink stain Silver stain Ziehl-Neelsen stain Loading...125. Which of the following drug is Leukotriene Antagonist? Montelukast Ipratropium Bromide Sodium Cromoglycate Terbutaline SalbutamolPage 6 of 66 Loading...126. A 78 year-old patient is admitted to the hospital for treatment of pneumonia. On the third day, the nurse noticed that his heart rate is 150/min. and blood pressure is 116/86 mmHg. The patient is stable with no chest pain or shortness of breath. His ECG shows saw tooth pattern with no other abnormalities. What is the most appropriate next step of management of this patient? Perform electric cardioversion Start heparin Order cardiac enzymes Start metoprolol Refer to a cardiologist Loading...127. A drug that inhibits replication of the influenza A virus by interfering with viral attachment and uncoating? Zidovudine Oseltamivir Nevirapine Rimantadine Acyclovir Loading...128. Which of the following is the checkpoint in cell development that is affected by ionizing radiation? G0/G1 S/G2 G2/M G1/S Loading...129. Which of the following antibiotics is the most appropriate one to treat a case of Legionella pneumonia? Clindamycin Metronidazole Erythromycin Vancomycin Loading...130. A 55 year-old man presents to his physician complaining of sinusitis, chest pain and productive cough for 2 weeks. His sputum is mixed with blood. He also has pain and swelling of hands and feet for 3 months. On examination, he has synovitis of proximal interphalangeal joints of both hands. His laboratory tests reveal anemia, elevated ESR, elevated creatinine and positive c-ANCA. Urinalysis shows red blood casts and proteinuria. Chest x-ray shows multiple nodules in both lungs. What is the most likely diagnosis? Systemic lupus erythematosus Acute glomerulonephritis Rheumatoid arthritis Miliary tuberculosis Wegener granulomatosis Loading...131. Administration of spironolactone and furosemide leads to which of the following? Reduce potassium loss Reduce sodium loss Increase potassium loss Reduce magnesium loss Loading...132. Hydralazine is used to treat one of the following disease? Malaria Stomach Ulcer Diabetes Viral infection High Blood pressure Loading...133. A female patient presents to the emergency room with a suspicious ruptured abdominal aortic aneurysm. Which of the following is the appropriate test needed at this situation? Abdominal CT scan Abdominal X-ray Abdominal ultrasonography Abdominal MRI Loading...134. A drug that belongs to Loop Diuretics is one of the following? A & B Bumetanide Bumetanide All of the following Furosemide Loading...135. Which one of the following drugs is the most effective for nausea and vomiting of pregnancy? Meclizine Loratadine Ondansetron Cimetidine Loading...136. Mechanism of action of Ticlopidine is following? Inhibit COX-1 Inhibit ADP mediation Decrease Calcium levels Inhibit COX-2 Inhibit glycoprotein receptors Loading...137. Which one of the following contraceptive methods is contraindicated in women with a history of deep venous thrombosis (DVT)? Depo-Provera injections Norplant Intrauterine contraceptive device (IUD) Combined oral contraceptive Loading...138. Which of the following signs of infective endocarditis appears as small, tender nodules on the finger and toe pads? Splinter hemorrhages Roth’s spots Janeway lesions Osler nodes Loading...139. Which of the following medications is most likely prescribed in cases of asthma associated with chronic environmental allergies? Oral fexofenadine Oral montelukast Albuterol inhaler Fluticasone nasal spray Loading...140. Which one of the following drugs is a Thiazide Diuretic? Fenofibrate Ezetimibe Torsemide Indanyl carbenicillin Atorvastatin Loading...141. Which of the following is the most common complication of diverticulosis? Obstruction Diverticulitis Perforation Bleeding Loading...142. Which one of the following tests is recommended in follow up for a patient receiving anti-tuberculous treatment (isoniazid and rifampin)? Renal function tests Amylase and lipase tests Liver function tests Blood glucose test Loading...143. Which of the following leads to toxic reactions when a drug is taken repeatedly? Tolerance Tachyphylaxis Cumulative action Absorption disorder Loading...144. A pregnant female presents on her third trimester with painless, bright bleeding without uterine contractions. It stopped after about one hour. Examination of the fetus reveals no distress. Which of the following is the most appropriate next step? Vaginal examination Hospitalization and observation until labor Immediate delivery Transabdominal ultrasonography Loading...145. An anticancer agent 6-mercaptopurine metabolism disturbed by following drug due to which dose is reduced? Sulfinpyrazone Probenecid Allopurinol Colchicine Loading...146. Which one of the following agent is a insulin? Desmopressin Torsemide Somatostatin Atorvastatin Glulisine Loading...147. Which one of the following nicotinic antagonist drugs has the ability to lower blood pressure, a vasodilator? Succinylcholine Ipratropium Tubocurarine Trimethaphan Loading...148. A young female presents with areas of erythema and itching over the skin of her hands, arms and legs two hours after she ate nuts. Which of the following immunological reactions is the most likely responsible? Complement activity Anaphylaxis Cell mediated hypersensitivity Immune complex deposition Loading...149. Which of the following correctly describes unstable angina? Angina occurs at rest Angina following strenuous exercise Angina relieved by rest Loading...150. Coagulation factor VIII is produced by which of the following cells? Splenic macrophages Hepatic cells Juxtaglomerular cells Endothelial cellsPage 7 of 66 Loading...151. A 20-year old female student represents with a 1-week history of nausea, vomiting and anorexia. She returned 2-weeks ago from a trip to Guatemala. On physical examination, her temperature was 100.3 F, clear chest and she has mild jaundice and a palpable tender liver. Her CBC was normal and her liver function tests are as follows: Serum total bilirubin 3.1 mg/dL. Serum aspartate aminotransferase 1100. Serum alanine aminotransferase 1900. Serum alkaline phosphatase 112. What is the most likely lab test to confirm your diagnosis? DNA for Epstein-Burr virus Serum anti-mitochondrial antibodies Antibody to hepatitis C virus IgM antibody to hepatitis A virus Antibody to hepatitis B surface antigen Loading...152. Which one of the following drugs is the most effective in improvement of ascites? Digoxin Lisinopril Spironolactone Hydrochlorothiazide Loading...153. A 26 year old woman is brought to the emergency room due to 2-hour history of hematemesis. She was invited to a banquet at her work and she vomited twice with a considerable amount of blood. Her medical, surgical and family histories are unremarkable. She visits her dentist regularly for recurrent dental caries. She doesn’t smoke or drink alcohol. Her pulse is 100/min, blood pressure is 104/66 and her temperature is 97.8 F. Abdomen is soft, non-tender with no organomegaly. Her laboratory tests are as follows: Serum sodium 136 meq/L. Serum potassium 2.6 meq/L. Serum chloride 84 meq/L. Serum bicarbonate 38 meq/L. Endoscopic examination reveals erosive esophagitis without any scars or adhesions. What is the most likely diagnosis? NSAID-induced esophagitis Mallory-Weiss syndrome CREST syndrome Bulimia nervosa Staphylococcal food poisoning Loading...154. The tracheal tube is originated from which of the following structures? Foregut Ductus arteriosus Third pharyngeal arch Fourth pharyngeal arch Loading...155. Which one of the following drugs belongs to inhibitors of viral coating? Acyclovir Nevirapine Amantadine Oseltamivir Zidovudine Loading...156. Which of the following is the appropriate treatment of a moderate case of acne vulgaris? Benzyl peroxide Oral isotretinoin Oral antibiotic and topical therapy Topical antibiotic Loading...157. Which one of the following types of cells is programmed to destroy cells the fail to display MHC class 1 antigen properly? Natural killer cells CD4 lymphocyte CD8 lymphocyte B lymphocyte Loading...158. Food allergies are typically causing which one of the following immunologic abnormalities? Cell-mediated hypersensitivity Immune-complex deposition Complement activation Localized anaphylaxis Loading...159. A 42-year-old man complains of rash and itching. He has no fever, headache or myalgia. On examination, there is maculopapular rash on the abdomen, palms of the hands and soles of the foot. There are also hypertrophic wart-like lesions around the anal area. Cervical, occipital and inguinal lymph nodes are enlarged. CBC shows marked increase in lymphocytes. What is the most appropriate laboratory test to confirm his diagnosis? Stool and urine analysis Serology for Human papilloma virus VDRL for syphilis Biopsy of the anal lesions Nucleic acid amplification test for chlamydia Loading...160. Thrombosis of the appendicular artery is significant due to compression by inflammatory edema. This artery arises directly from which of the following arteries? Inferior mesenteric artery Right colic artery Superior mesenteric artery Ileocolic artery Loading...161. Which one of the following drugs belongs to alkylating agent? Capreomycin Lamivudine Dacarbazine Indanyl carbenicillin Gemcitabine Loading...162. A 30-year-old man is brought to the emergency room for alcohol intoxication. His blood alcohol level is 250 mg/dL. He refused to take any medications and insisted on leaving the hospital. What is the most appropriate response to this patient? We will call the police if you don’t take treatment You have to sign consent to leave We cannot release you before you become sober You can leave anytime if you want Loading...163. A drug that belongs to DPP-IV inhibitors is one of the following? Sitagliptin Ethacrynic Acid A & B Sulbactam Rosiglitazone Loading...164. A 63-year-old man with a history of atrial fibrillation visits the clinic for evaluation of his current medications. His physician orders laboratory tests including prothrombin time. Which one of these drugs is used to reduce the possibility of blood clotting in this patient through its action on the enzyme epoxide reductase? Warfarin Streptokinase Heparin Dipyridamole Aspirin Loading...165. A 78 year-old patient is admitted to the hospital for treatment of pneumonia. On the third day, the nurse noticed that his heart rate is 150/min. and blood pressure is 116/86 mmHg. The patient is stable with no chest pain or shortness of breath. His ECG shows saw tooth pattern with no other abnormalities. What is the most appropriate next step of management of this patient? Refer to a cardiologist Start metoprolol Perform electric cardioversion Start heparin Order cardiac enzymes Loading...166. Which of the following agents should a patient take for a stuffy, runny nose? Clonidine Metoprolol Albuterol Oxymetazoline Terbutaline Loading...167. Which drug belongs to the Quinoline methanol antimalarial class? Pyrimethamine Quinidine Mefloquine Quinine Chloroquine Loading...168. A 34 year old woman visits her physician with a complaint of severe headache for two months. She took several kinds of analgesics with no significant improvement. Her headache is worse in the morning and improved by doing day activities. Imaging studies and laboratory tests confirm the diagnosis of pituitary adenoma. Which of the following is the most likely effect of this tumor on vision? Bitemporal hemianopsia Homonymous hemianopsia Binasal hemianopsia Superior hemianopsia Loading...169. A 32-year old woman presents with burning micturition, frequency and pain in the suprapubic region. There is no fever, vaginal discharge or pruritus. She had no similar episodes and she is not taken any medications. Which of the following is the most likely causative organism of this condition? Staphylococcus aureus Escherichia coli Campylobacter Streptococcus viridans Loading...170. An 18-year-old male complains of nausea and slight icterus for 2 weeks. Medical, surgical and family histories are unremarkable. Physical examination reveals slight jaundice and tenderness on the right upper side of the abdomen. Laboratory findings include positive IgM anti-HAV and marked elevation of ALT and AST levels. What is the appropriate management of this patient at this time? Supportive treatment Acyclovir Interferon alfa HBV vaccine Famciclovir Loading...171. A female patient is found to have an absent right kidney. Which of the following may also be found in this patient? Pelvic testis Unicornuate uterus Absent right ovary Imperforate hymen Loading...172. Antipseudomonal penicillin is one of the following? Carbenicillin Amoxicillin Methicillin Penicillin G Loading...173. A newborn infant presents with cleft palate and hypocalcemia. Genetic testing of the blood shows 22q 11.2 deletion. Which of the following is the most likely diagnosis? Down syndrome DiGeorge Syndrome Stickler syndrome Turner’s syndrome Loading...174. Which one of the following is the main mechanism of absorption of most drugs in the gastrointestinal tract (GIT)? Facilitated transport Pinocytosis Passive diffusion Endocytosis and exocytosis Loading...175. A 27-year-old man complains of 2-week history of watery diarrhea and 5 lb. weight loss. He had no similar episodes in the past, did not travel recently, did not eat out or take antibiotics. He quit smoking last month after 1 PPD for 5 years. His family history is significant of some relatives who are diagnosed with inflammatory bowel syndrome. His examination reveals diffuse mild abdominal tenderness and hyperactive bowel sounds. Stool analysis is negative for blood and ova. What is in the history and/or examination could support the diagnosis of ulcerative colitis rather than Crohn’s disease in this patient? Having first attack in his twenties Family history of inflammatory bowel syndrome Negative stool analysis Smoking cessation History of diarrhea and weight lossPage 8 of 66 Loading...176. A 69 year-old man with a long history of poorly controlled diabetes presents to his physician complaining of pain and drainage in his left ear. His vital signs are within normal limits. The pinna of his left ear is tender. The external meatus is swollen and covered with purulent drainage. What is the most likely organism responsible for his condition? Moraxella catarrhalis Candida albicans Homophilus influenzae Streptococcus pneumoniae Pseudomonas aeruginosa Loading...177. Rapid Acting Insulin is one of the following? Glargine Glulisine NPH Regular Loading...178. A young boy presents with multiple skin lesions for more than a year. He is sensitive to sun and biopsies of some of his lesions show squamous cell carcinoma. Which of the following mutations is most likely present in this condition? Point mutation Nonsense mutation Thymidine dimers Missense mutation Loading...179. During newspaper delivery, a boy walked into the Out Patient Department (OPD) with a history of having palpitations since morning. His pulse and heart rate were difficult to count. He was immediately shifted to the Intensive Care Unit (ICU) and an urgent electrocardiogram (ECG) was taken which showed narrow complex tachycardia with a heart rate of 194 per min and absence of P waves. His blood pressure was 100/73 mmHg. He was comfortable at rest with no distress and not in cardiac failure. Carotid sinus massage was tried, which failed to convert Supraventricular Tachycardia. He was diagnosed with paroxysmal supraventricular tachycardia. Which of the following drugs would you think is the drug of the first choice in this situation? Adenosine Verapamil Amiodarone Propranolol Lidocaine Loading...180. Which of the following is a frequent side effect of amphetamine? Diarrhea Depression Constipation Hair loss Loading...181. Which one of the following drugs causes inhibition of viral neuraminidase? Ribavirin Oseltamivir A & B Zanamivir A & C Amantadine Loading...182. Which of these conditions is known as pulsus paradoxus? A difference in blood pressure for more than 10 mmHg between both arms A difference of 10/min between right and left radial pulse A difference of 10/min between radial and femoral pulse A fall of systolic blood pressure for more than 10 mmHg during inspiration Loading...183. Which of the following locations is the most common for Koplik’s spots of measles? Soft palate Hard palate Buccal mucosa Tongue Loading...184. Which of the following cell types is responsible for forming the blood brain barrier (BBB)? Astrocytes Oligodendrocytes Microglia Schwann cells Loading...185. Which of the following drug belongs to Sulfonylureas? Tolbutamide Urae Niacin Oxacillin Cefoxitin Loading...186. Which of the following leukocytes have nuclei of 3-5 lobes and azurophilic light-pink small granules in their cytoplasm? Neutrophils Basophils Plasma cells Monocytes Loading...187. Insulin dependent Diabetes mellitus? Gestational Diabetes mellitus Pseudo hypoglycemia A & D Type 2. Diabetic mellitus Type 1 diabetes Mellitus Loading...188. Clopidogrel belongs to which of the following class of antiplatelet agents? Polyamines Theinopyridines Glycoproteins inhibitors Fabric acid derivatives Dipyridamole Loading...189. Which one of the following disease is caused by bite of infected ticks? Lyme disease Mycoplasma Pneumonia Cholera Rocky mountain spotted fever Loading...190. Which of the following antibiotics is the most appropriate treatment of mycoplasma pneumonia? Doxycycline Gentamicin Ampicillin Azithromycin Loading...191. Which one of the following enzymes catalyzes the transformation of testosterone into DHT? 17α-hydroxylase Aromatase 5 α-reductase Cholesterol side chain cleavage enzyme (CYP11A1) Loading...192. Which of the following conditions is characterized by the presence of periventricular calcified densities on brain imaging? Cytomegalovirus infection Toxoplasmosis Down syndrome Huntington’s disease Loading...193. A drug that is used to treat HIV infections is one of the following? Niclosamide Etidronate Praziquantel Cladribine Atazanavir Loading...194. Which one of the following anticonvulsant drugs in used only in the treatment of absence seizures? Ethosuximide Levetiracetam Lorazepam Carbamazepine Loading...195. A 19 year old college student is brought to the emergency room with a police officer because of a cut wound on his arm. The student was arrested during committing a robbery at a convenient store. His record shows two fights with his neighbors on different occasions because he used to hit their pets. He also had two incidence of shoplifting. Which is the most likely diagnosis? Histrionic personality disorder Obsessive compulsive disorder Borderline personality disorder Conduct disorder Antisocial personality disorder Loading...196. Foci of hemorrhage and necrosis in which of the following parts of the brain is characteristic of Wernicke’s encephalopathy? Mamillary bodies Basal ganglia Anterior pituitary Posterior pituitary Loading...197. A drug is more effective when combined with Flucytosine to treat candidiasis or cryptococcosis? Amphotericin B Griseofulvin Itraconazole Caspofungin Loading...198. A certain drug has a high serum protein binding. Which of the following is increased as a result of injecting this drug? Renal excretion Liver metabolism Drug interaction Distribution of the drug Loading...199. Which one of the following drugs is a Meglitinide drug? Hydrochlorothiazide Indanyl carbenicillin Repaglinide Ezetimibe Fenofibrate Loading...200. An old man complains of progressive back pain and joints pain for 10 years. There is enlargement in distal interphalangeal joints, osteophytes on the vertebral bodies and sclerosis with narrowing of multiple joint spaces. What is your diagnosis? Rheumatoid arthritis Gout Osteoarthritis OsteomyelitisPage 9 of 66 Loading...201. Which of the following conditions is an indication for interferon gamma? Chronic myeloblastic leukemia Hepatitis A Chronic granulomatous disease Glomerulonephritis Loading...202. A 29 year-old man presents to his physician complaining of fatigue and lethargy for the past 3 days after he came back from a hiking trip in Northern California. During the trip, he noticed a rash on his left arm. The rash was smaller but now it’s expanding in size. On examination, the rash looks round with central clearing. What is the most likely organism involved in this condition? Borrelia burgdorferi Staphylococcus aureus Rickettsia prowazekii Meningococci Treponema pallidum Loading...203. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Capecitabine Naftifine Miconazole Ibandronate Voriconazole Loading...204. A 24-year-old woman visits her physician for consultation about human papillomavirus (HPV) vaccine. She has been sexually active since she was a senior in high school with multiple partners. She had her last Pap smear last year and it was normal. On examination, there are multiple vaginal non-tender wart-like projections. What is the best advice concerning HPV vaccine to this patient? No need for the vaccine as long as Pap smear is normal She can only take the vaccine later after full recovery She already has HPV infection so, no need for the vaccine HPV vaccine is essential to treat the current infection She already has HPV infection but she should take the vaccine for other strains of HPV Loading...205. A 65 year-old farmer presents to your clinic complaining of shortness of breath for 6 months. Last 2 weeks he noticed that he has to get up several times during the night to be able to breath. He proudly tells you that he had never visited a doctor before although he smokes and drinks every night. On physical examination, there is displaced point of his maximum impulse, rales over both lungs and enlarged liver. Echo shows both right and left ventricular dilation and EF 30%. Laboratory test are normal except high bilirubin, AST 245 and ALT 180. What is the initial cause of this patient presentation? Smoking Alcohol Chronic hypertension High cholesterol Lyme disease Loading...206. Which one of these apoproteins is associated with chylomicrons? Apo A Apo C-II Apo D Apo B-48 Apo E Loading...207. A 39-year-old woman presents with an inflamed ulcer on the sole of her foot not healed for 2 months. Peripheral sensations are reduced bilaterally. Elevation of which of the following laboratory tests most likely explains this condition? Serum creatinine Blood glucose Alanine aminotransferase (ALT) Urinary sodium Loading...208. An 80-year-old woman develops chest pain on second day after hysterectomy. Which of the following is the most likely diagnosis? Myocardial infarction Right bundle branch block Acute pericarditis Pulmonary infarction Loading...209. Tazobactam belongs to the one of the following class? Cephalosporin Penicillins Monobactams Carbapenems Beta lactamase inhibitor Loading...210. A 65 year-old woman presents to the emergency room for transient loss of consciousness. While she was walking with her husband today, she felt lightheaded and lost her consciousness for a few minutes then, she made a full recovery. On examination, her pulse is 86/min. and her blood pressure is 148/82. On auscultation, there is a systolic ejection murmur heard at the 2nd right intercostal space and radiates to the carotids. Lungs are clear bilaterally. What is the most likely diagnosis? Mitral stenosis Pulmonic stenosis Aortic stenosis Aortic insufficiency Mitral regurgitation Loading...211. Which of the following is the epithelial covering of vocal cords? Simple cuboidal Simple columnar Simple squamous Stratified squamous Loading...212. Chronic Daily ingestion of 5 g or more acetaminophen for longer than 1 month causes? Hypersensitivity to NSAIDs GI disturbance Bleeding compilations Hypersensitivity to Salicylates Liver damage Loading...213. One of the following statements about the use of scopolamine is wrong? produce excitement at high doses Short term memory blocker Belladonna Alkaloid Shorter duration of action as compared to atropine in CNS Used for Motion sickness Loading...214. Which of the following methods is the most likely to demonstrate spores? India ink stain Gram stain Acid-fast stain Malachite green stain Loading...215. Which one of the following drugs is commonly contributing to hypokalemia? Lisinopril Furosemide Spironolactone Verapamil Loading...216. A patient requires quinidine to treat his atrial arrhythmia, which of the following drugs should be administered prior to it to prevent the deleterious effects? Amiodarone Digoxin Mexalitine Acetaminophen Loading...217. An organophosphate drug that has a side effect of cataracts? Edrophonium Acetylcholine Neostigmine Echothiophate Donepezil Loading...218. A 28-year-old man presents to the emergency room after a bar fight in which he was shot. He is mildly distressed but oriented to place and time. Neurological examination reveals weakness of the right extremities with loss of touch, position and vibratory sensations on the same side accompanied by loss of pain and temperature on the left side. What is the most likely diagnosis? Brown-Sequard syndrome Conus medullaris syndrome Central cord syndrome Anterior cord syndrome Transverse myopathy Loading...219. Which of the following errors is considered if the researcher states that there is no difference when one exists? Type 1 error Type II error Loading...220. Which one of the following drugs is a loop Diuretics drug? Chlorthalidone Bumetanide Acetazolamide Amiloride Loading...221. Which of the following drug contain the Sulfahydril group in the structural formula? Lisinopril Quinapril Enalapril Captopril Ramipril Loading...222. Reye syndrome causes brain and liver damage in children with viral infections like chickenpox and flu. this disease is linked with the following drug? Mefenamic acid Aspirin Ketorolac Acetaminophen None of these Loading...223. CLASS II drugs of the Antiarrhythmic drugs interfere with one of the following options? Beta adrenoceptors Blockers Ca+ channel blockers K+ channel blockers Na+ channel blockers Loading...224. A 54-year-old woman with a 6-year history of type 2 diabetes visits her physician for a regular examination. She was initially treated with oral hypoglycemic but her HbA1c had gotten worse so, her physician switched to insulin last year. Six-month ago, she had surgery in her wrist to release compression caused by carpal tunnel syndrome. Now, she complains of progressive increase in her feet size. Examination reveals coarse facial features with prominent supraorbital ridge. What is the most appropriate test to help reach the diagnosis of this case? Dexamethasone suppression test Measurement of thyroid stimulating hormone (TSH) Assessment of insulin-like growth factor 1 (IGF-1) Fasting serum glucose test Measurement of HbA1c Loading...225. Which form of dosage has a high rate of bioavailability? Syrup Control released drugs Capsules Suspension TabletPage 10 of 66 Loading...226. Which one of the following is the class of aliskiren? Corticotropin Interior pituitary hormone Angiotensin receptor blocker Direct renin inhibitor ACE inhibitor Loading...227. When a blood clot adhere to vessel wall this is called as one of the following? Thrombus All of the above Embolus Coagulation Loading...228. A drug that belongs to thiazolidinediones is one of the following? A & B Sulbactam Ethacrynic Acid Rosiglitazone Cefazolin Loading...229. A scientific researcher is classifying some drugs according to their actions on different receptors. One of these drugs binds to its receptor without producing any action. Partial agonist Inverse agonist Agonistis drug should be classified as what? Antagonist Loading...230. A drug that belongs to proton pump inhibitor is one of the following? Omeprazole Rosiglitazone Sulbactam Ethacrynic Acid A & B Loading...231. A middle aged woman is evaluated for gait problems. On examination, her ability to touch her nose while her eyes closed fails and so, touching the heel of one toe to the toe of the other. Which of the following locations is the most likely affected? Ankle and elbow joints Frontal lobe Cerebellum Parietal lobe Loading...232. What is the most likely explanation of this finding? Beta-naphthylamine is directly carcinogenic to human bladder Human urinary glucuronidase splits beta-naphthylamine into glucuronic acid and a toxic metabolite. Detoxification of beta-naphthylamine by glucuronic acid conjugation. Metabolism of beta-naphthylamine by human cytochrome 450 system in the liver Loading...233. Which one of the following tests is diagnostic for acromegaly? Serum insulin-like growth factor-1 (IGF-1) Fasting blood glucose level Serum growth hormone level Serum cortisol level Loading...234. Which one of the following viruses most likely causes aplastic crisis in sickle cell disease? Rotavirus Hepatitis C virus Herpes simplex virus Parvovirus B19 Loading...235. Which of the following side effects is the most common after prolonged use of SSRIs? Headache Insomnia Sexual dysfunction Nausea Loading...236. A 4-year old girl is brought to the clinic by her mother complaining of fever and abdominal pain since yesterday. Today, she looks uncomfortable during micturition. On examination, her temperature is 99.4, her pulse is 100/min. and her suprapubic area is soft and tender. Her blood analysis shows increased neutrophils. Her urinalysis is positive for organisms and leukocytes. What is the drug of choice for this condition? Ciprofloxacin Chloramphenicol Rifampin C0-trimoxazole Loading...237. An 82-year-old man is brought to the clinic by his son who is concerned about his father’s mental status. He told you that his father has recently become more forgetful and angry. He doesn’t remember recent events and he gets frustrated when he fails to complete simple tasks. On examination, the patient is unkempt. His vital signs are within normal limits. Mini-mental status test scores 12/30. MRI of the brain shows some areas of degeneration in the temporal lobe. What is the most appropriate treatment of this condition? Citalopram Donepezil Fluoxetine Diazepam Metoclopramide Loading...238. About Nateglinide; All are true, except? Hypoglycemia less common than with Sulfonylureas Decrease insulin resistance release insulin decrease postprandial hypoglycemia Loading...239. Which one of the following conditions is the most common cause of aortic stenosis in the the elderly patients? Subacute bacterial endocarditis Bicuspid aorta Calcification of the aortic valve Rheumatic fever Loading...240. Which one of the following medications acts at the proximal tubule of the kidney? Spironolactone Acetazolamide Furosemide Hydrochlorothiazide Loading...241. Deficiency of which of the following enzymes is associated with von Gierke’s disease? Hexosaminidase A α-1,4-phosphorylase Glucose-6-phosphatase Phosphofructokinase-1 Loading...242. A person( 57 years) suffering from atrial arrhythmia is treated with one of the following drugs and during treatment, he complains of having dizziness, Headache, and tinnitus. Which drug is involved? Amiodarone Verapamil Quinidine Aspirin Propranolol Loading...243. Which one of the following drugs is a Inducer of the P-GP (glycoprotein) efflux pumps? Digoxin Amiodarone Erythromycin Rifampin All of the above Loading...244. Which statement is true regarding action of lung surfactant? It affects more large alveoli than sma alveoli It elevates surface tension forces and decreases compliance It lowers surface tension and decreases compliance It lowers surface tension and increases compliance Loading...245. A 30-year-old man presents to the emergency room with excruciating chest pain and shortness of breath for an hour. Past, surgical and familial histories are unremarkable except that his father died of heart attack at the age of 32. Imaging studies and laboratory tests confirm the diagnosis of myocardial infarction. What is the most likely precipitation factor contributing to his condition? Type II diabetes Familial hypercholesterolemia Alcohol abuse Atherosclerosis Loading...246. Which of the following drugs is an ergosterol synthesis inhibitor? Ampicillin Acyclovir Ketoconazole Ritonavir Loading...247. A 25 year old woman presents to her physician at 28 weeks of gestation with general itching for one week. Itching is worse at night and more prominent at soles and palms. She has no history of allergy or dermatological diseases. She is compliant with regular examinations and her pregnancy is uncomplicated. Her physical and obstetric examinations are unremarkable. Laboratory tests reveal normal full blood count, renal function tests and blood coagulations tests. Her liver function tests are as follows: ALT 47 IU/L AST 55 IU/L Alkaline phosphatase 356 IU/L Total bilirubin 1.9 Bile acids 15 micromol/L Serology for hepatitis is negative What is the best treatment for this woman’s itching? Diphenhydramine Hospitalization and induction of labor No treatment and repeat liver function tests in a week Ursodeoxycholic acid and vitamin K Loading...248. Which one of the following drugs is the first line medication in transplant immunopharmacology? Cyclosporine Sulfasalazine Thalidomide Methotrexate Loading...249. A disease characterized as recurrent and persistent abdominal discomfort and abdominal pain? GERD A & B Dyspepsia Peptic Ulcer disease Loading...250. Which of the following drugs is most likely protective against the toxicity of doxorubicin? Vitamin C Mensa Leucovorin DexrazoxanePage 11 of 66 Loading...251. Which of the following statements is true about innate immunity? Resistance persists through generations Highly specific and refined over time Its main components are T cells, B cells and circulating antibodies Its main secreted proteins are immunoglobulins Loading...252. A newborn presents with absence of the contents of left scrotal sac. There is no other abnormality. Which of the following is the most likely diagnosis? Agenesis Undescended testis Hypopituitarism Hypospadias Loading...253. Which of the following is a characteristic finding in isopropanol poisoning? Ketosis without acidosis Blindness due to ocular accumulation Elevated anion gap Elevated serum BUN and creatinine Loading...254. Which of the following parts of the stomach has a dome-shaped appearance and lies superior to the lower end of esophagus? Body Pylorus Fundus Antrum Loading...255. Pemphigus is an autoimmune skin disease associated with which of the following structures? , Tight junctions Desmosomes Gap junctions Cell matrix junctions Loading...256. The functions of insulin include the following except one? Uptake of Amino acids into a cell inhibit the production of glucose from the liver increase breakdown of fat to Ketone bodies Cellular Uptake of plasma glucose Loading...257. Heteroaryl acetic acid drug is following? Indomethacine Ibuprofen Diclofenac Nabumetone Piroxicam Loading...258. Which one of the following statements about the functions of histamine is incorrect? Stimulate gastric acid secretion Constriction of bronchioles Cause itching and pain increase peripheral resistance Loading...259. Gluconeogenesis is a metabolic process in which glucose is generated from non-carbohydrate carbon substrates. Which one of the following substrates does NOT share its carbon in glucose skeleton but rather contributes as an energy source for gluconeogenesis? Oxaloacetate Alpha-ketoglutarate Fumarate Succinyl CoA Acetyl CoA Loading...260. Amylin hormone is released from one of the following cells? Pancreatic Alpha cells juxtaglomerular cells Pancreatic Beta cells Pancreatic Delta cells Loading...261. A 34-year old woman delivered a girl at her 37-week gestational age through a normal delivery two hours ago. Examination of the newborn girl reveals pink skin, red reflex in both eyes, high arched palate, webbed neck, swollen hands and feet and widely spaced nipples. Heart and lungs auscultation is unremarkable except for a systolic murmur below the left scapula. Which of the following congenital heart diseases is most likely found in this patient? Tetralogy of Fallot Atrial septal defect Transposition of great vessels Ventricular septal defect Coarctation of the aorta Loading...262. Which of the following muscles are responsible for primary abduction of the arm at the shoulder joint? Coracobrachialis and deltoid Deltoid and supraspinatus Supraspinatus and infraspinatus Deltoid and infraspinatus Loading...263. Which of the following substances is responsible for growth of the prostate at puberty? Progesterone Testosterone Estrogen Dihydrotestosterone Loading...264. A 75-year-old man presents to his physician for a routine examination. He has a history of hypertension, hypercholesterolemia and osteoarthritis. He takes atenolol, simvastatin and ibuprofen as needed. His pulse is 76/min and irregular. Blood pressure is 130/74. Physical examination and imaging studies are normal except for asymptomatic atrial fibrillation. What is the most appropriate next step in management of this patient? Start heparin Start warfarin Assurance and follow up in 3 months Start aspirin Start low molecular weight heparin and warfarin Loading...265. Which of the following is the earliest abnormal test after infection with hepatitis B? Serum bilirubin Anti-hepatitis B antibodies ALT Surface antigen Loading...266. A 62 year-old man complains of fever and diminished consciousness for 2 days. He has been healthy all his life and he doesn’t take any medications. On examination, he responds inconsistently to commands. His temperature is 103 F, pulse 110/min and blood pressure is 80/56 mmHg. His physical examination is otherwise normal. There is no bleeding. Laboratory test are as follows: Hemoglobin: 12 g/dl Hemophilia b Hemophilia aat is the most likely diagnosis? Idiopathic thrombocytopenic purpura Disseminated intravascular coagulation Thrombotic thrombocytopenic purpuraukocyte count: 25,000 – 80% neutrophils Platelet count: 20,000 Loading...267. A 40 year old woman with a history of type 1 diabetes presents to the clinic for left ear pain and fullness. She also complains of decrease of hearing on the affected side. The patient didn’t measure her blood sugar for 6 months although she has glucometer at home. Her temperature is 99.8 F. Examination reveals tenderness and erythema of the left targus extending to the left side of the face. It also reveals edema of the left external auditory meatus with inflammatory debris. The tympanic membrane appears intact and mobile. Her blood glucose is 340 mg/dL. What is the most appropriate next step in management? Empiric oral antibiotic therapy and follow up in one week Hospitalization for intravenous antibiotics and control of diabetes Antibiotic ear drops and follow up in three days Initiation of left myringotomy and induction of topical treatment Loading...268. Which of the following beta blockers has the longest duration of action? Nadolol Propranolol Metoprolol Sotalol Loading...269. Which one of the following drugs is a prostaglandin that suppresses gastric acid secretion? Cimetidine Rabeprazole Sucralfate Misoprostol Loading...270. A 400 mg dose of a drug was administered and 200 mg of it was eliminated after two hours. Which of the following is the amount of drug left after six hours if the drug follows first-order elimination kinetics? 50 mg 0 mg 25 mg 75 mg Loading...271. Which of the following is NOT considered an indication for HIV testing? Recent positive test of a partner Homosexuality Semen donor Patients with symptoms of AIDS Loading...272. Receptors have a high sensitivity for which of the following drug? Epinephrine Norepinephrine All of these A & B Isoproterenol Loading...273. A 12-year-old female is evaluated for enlarged phallus at puberty. Examination reveals no breast development, a blind vaginal pouch and no uterus. Laboratory tests show normal levels of testosterone and estrogen and very low levels of dihydrotestosterone (DHT). What is the most likely diagnosis? Turner’s syndrome Female pseudohermaphrodite Male pseudohermaphrodite True hermaphrodite Loading...274. Incretin mimetic is one of the following? Pramlintide Furosemide Exenatide A & B Bumetanide Loading...275. Which of the following is higher in athletics than in non-athletics in resting conditions? Cardiac output Stroke volume Oxygen consumption Heart ratePage 12 of 66 Loading...276. Which type of bias is reflected when individuals with severe disease are uncovered because they die first? Confounding bias Measurement bias Late-look bias Selection bias Loading...277. Following drugs should be avoided in patients with heart failure? ACE inhibitors CCBs B-blocker Diuretic Inotropic drugs Loading...278. What is the genetic abnormality related to Cri-du-chat-syndrome? Deletion of phenylalanine in position 508 Trisomy 18 Mutations of the fibrillin gene on chromosome 15 Deletion of short arm of chromosome 5 Loading...279. Cholestatic Jaundice is the adverse effect of the following drug? Cefepime Clindamycin Chloramphenicol Erythromycin Loading...280. A 33-year-old woman presents to the clinic for her regular yearly physical examination. She has a long history of depression and takes fluoxetine regularly for two years. Which amino acid is the precursor of the neurotransmitter affected by this drug? Glutamate Methionine Glycine Phenylalanine Tryptophan Loading...281. Which one of the following drugs is a Proteas inhibitor? Delavirdine Maraviroc Atazanavir Indanyl carbenicillin Abacavir Loading...282. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is no chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Cardioversion Aspirin Refer to cardiologist Heparin Metoprolol Loading...283. Which of the following is the most prominent side effect of scopolamine? Profuse sweating Miosis Bradycardia Mydriasis Loading...284. Which one of the following drugs is tertiary amine antispasmodic? Dicyclomine Propantheline Oxybutynin Cyclopentolate Biperiden Loading...285. Which of the following disorders is considered a nephrotic syndrome? Alport syndrome IgA nephropathy (Berger disease) Goodpasture syndrome Minimal change disease Loading...286. A 47-year-old man with a history of chronic renal failure presents to the clinic for a follow up after a kidney transplant three weeks ago. His surgery was successful and his transplanted kidney started producing urine right after the operation. However, today his urine output drops and his serum creatinine begins to rise. There is no fever or dysuria. Urinalysis shows no abnormality. Biopsy from the transplanted kidney shows cellular infiltrate of cytotoxic cells (CD8). What is the most likely diagnosis of this condition? Chronic rejection Hyperacute rejection Acute rejection Acute pyelonephritis Normal reaction Loading...287. A 30 year-old woman with a history of Grave’s disease presents to her physician for a routine evaluation. She was treated 2 years ago with radioactive iodine. Three months later, she was prescribed levothyroxine 0.125 mg. On her last evaluation, six months ago, her doctor lowered her dose to 0.088 mg due to decrease of TSH level. Today, her lab tests show increase in T4 and T3 and very low TSH and positive TSH receptor antibodies. Ectopic thyroid tissueat is the most likely diagnosis? Cancer thyroid Hashimoto’s disease Radioactive induced thyrotoxicosis Incomplete ablation of thyroid gland Loading...288. Which of the following is most likely characteristic of oral route of administration? It has the fastest onset of effect It is the most appropriate route to interact with most of the emergencies Absorption of the drug depends on the GIT function Most of oral medications reach the bloodstream through the liver Loading...289. Which one of the following is the most common cause of ruptured aortic aneurysm? Hypertension Cardiomyopathy Atherosclerosis History of intravenous drug use Loading...290. A 26-year-old woman complains of left flank pain and fever for 2 days. She has a history of two episodes of urinary tract infections in the past three years treated with trimethoprim-sulfamethoxazole. She is married, sexually active and takes contraceptive pills. Her last menstrual period was 5 days ago. On physical examination, her pulse is 100/min., blood pressure is 120/80 and her temperature is 103 F. She has left costovertebral angle tenderness on palpation. What is the best next step of management? Collection of urine and blood cultures MRI of the kidney Admission to the intensive care unit (ICU) CT scan of abdomen and pelvis Administration of wide spectrum antibiotics Loading...291. Which one of the following drugs is most likely to cause severe bone marrow depression? Cyclosporine Tacrolimus Prednisone Sirolimus Loading...292. A 24-year-old woman visits her physician for consultation about human papillomavirus (HPV) vaccine. She has been sexually active since she was a senior in high school with multiple partners. She had her last Pap smear last year and it was normal. On examination, there are multiple vaginal non-tender wart-like projections. What is the best advice concerning HPV vaccine to this patient? She already has HPV infection so, no need for the vaccine HPV vaccine is essential to treat the current infection She can only take the vaccine later after full recovery No need for the vaccine as long as Pap smear is normal She already has HPV infection but she should take the vaccine for other strains of HPV Loading...293. Gray baby syndrome is the adverse effect of the following drug? Chloramphenicol Clindamycin Quinupristin Linezolid Loading...294. Which one of the following glucocorticoids is short acting? A & B Betamethasone Prednisone Cortisone Amiloride Loading...295. Control of diabetes is most likely determined by which one of the following laboratory tests? Hemoglobin A1C Urinary glucose content Random blood glucose Fasting blood glucose Loading...296. A patient is having symptoms of nausea and vomiting after cancer Chemotherapy. Which of the following drug is the drug of choice for this patient to relieve his symptoms of Vomiting and nausea? Diphenhydramine Ondansetron Ranitidine Hydroxyzine Promethazine Loading...297. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ethambutol Amphotericin B Ibandronate Furosemide A & B Loading...298. Which one of the following maneuvers is recommended to deliver the baby arms in breech delivery? Mauriceau-Smellie-Veit maneuver Lovest maneuver Prague maneuver Pinard maneuver Loading...299. Stimulation of hepatic microsomal cytochrome p450 enzymes can cause which one of the following? Increased metabolism of certain drugs Decreased metabolism of certain drugs Increased intestinal absorption of certain drugs Enhancement of excretion of some drugs Loading...300. Generally, Passive diffusion of Water-soluble drugs inside the cell membrane occurs by one of the following processes? Penetrate through aqueous pores Readily move due to lipid solubility Readily move across by active transport Readily move across by facilitated diffusionPage 13 of 66 Loading...301. Which of the following hormone belongs to the posterior pituitary? Oxytocin A & B Urofollitropin Furosemide Somatrem Loading...302. A 73-year-old man with a history of benign prostatic hyperplasia (BPH) presents to the emergency room complaining of repeated falls. His wife admits that during the past 3 weeks he has had unsteady gait, urinary incontinence and memory disturbances. His medical, surgical and family histories are unremarkable. He has never smoked or taken any recreational drugs. He drinks alcohol socially. His laboratory tests are all normal. A CT scan of the head shows slightly enlarged ventricles and slightly compressed gyri. What is the most likely diagnosis of this patient’s condition? Anterior pituitary adenoma Alzheimer’s disease Normal pressure hydrocephalus Middle cerebral artery stroke Trauma to the head due to elderly abuse Loading...303. Which of the following chemotherapeutic agents is specific for the M phase of the cell cycle? Daunorubicin Mechlorethamine Hydroxyurea Cytarabine Vincristine Loading...304. Carbonic anhydrase enzyme is present in the epithelial cells of one of the following part functional zones of the nephron? The proximal convoluted tubules The ascending loop of Henle The distal convoluted tubules The descending loop of Henle The collecting tubule and duct Loading...305. Which of the following is characteristic of Hodgkin lymphoma and differentiates it from non-Hodgkin lymphoma? Peripheral nodes are most likely involved Associated with HIV and autoimmune disease Affects mostly old age Reed-Sternberg cells Loading...306. A 43-year-old man presents to your clinic for a follow up after colon biopsy taken last week. He has a history of constipation and blood in stools for 6 months. Biopsy reveals colon cancer. After you told him the bad news, he looked down and told you that constipation was not that bad. He seeks more investigations because he does not think that he has cancer. What is the emotional stage experienced by this patient at this time? Bargaining Depression Acceptance Denial Anger Loading...307. A 27 year old man presents with a 3 month history of heartburn and epigastric discomfort. His symptoms are exaggerated after meals especially if he eats spicy food. He takes no medications, doesn’t smoke or drink alcohol. He exercises regularly and has an active lifestyle. On physical examination, he has slight epigastric tenderness. His routine lab tests are normal What is the most appropriate intervention at this time? Esophageal manometry Upper endoscopy Trial of a proton-pump inhibitor Barium swallow 24-hour pH monitoring Loading...308. A patient complains of worsening diarrhea over the past three months. He has a history of recurrent urinary tract infection and joint pain affects numerous joints. A urine sample shows pneumaturia. Which of the following is the most likely cause of this patient’s symptoms? Renal stones Enterovesical fistula Pseudomembranous colitis Ulcerative colitis Loading...309. At low doses, one of the following drugs irreversible inhibit thromboxane production in platelets leading to a decrease in platelets aggregation? Ticlopidine Aspirin A & B Clopidogrel Loading...310. A 37-year-old man visits his physician with complaints of sore throat, fever and muscle aches for 4 days. Throat swab is negative. His physician discussed with him the use of antibiotics in his case. The patient had read in an old magazine that one of the antibiotics is effective but the his physician explains that this antibiotic is highly nephrotoxic. Which one of these antibiotics is the most nephrotoxic? Rifampin Methicillin Cloxacillin Ampicillin Amoxicillin Loading...311. A 9-month- old girl is brought by her grandmother to the clinic for routine examination. She told you that the girl is totally fine but she noticed yellow discoloration of her teeth. The physician asks if her mother took any medications during her pregnancy. She remembers that she was taking an antibiotic for bronchitis. Which of these antibiotics is the most likely responsible for this condition? Cephalexin Tetracycline Ampicillin Erythromycin Chloramphenicol Loading...312. A 6 year old girl presents to the emergency room with her mother for a deep wound on her right forearm. Her mother tells you that her daughter was playing at school today and wounded herself when she fell on a big rock. When you ask her about her vaccination, she tells you that her daughter had all her vaccinations before the school started this year. What is the most appropriate therapy for this girl? Both tetanus toxoid and antitoxin Tetanus toxoid Neither tetanus toxoid or antitoxin Tetanus antitoxin Loading...313. What is the most common cause of abdominal aortic aneurysm? Atherosclerosis Post-operative Post-inflammatory Complication of coronary artery disease Loading...314. Which of the following medications is considered a selective beta-1 adrenergic agonist? Dopamine Dobutamine Prazosin Amrinone Loading...315. Which of the following causes pancreatitis? All of the above Didanosine L-asparaginase Exenatide Azathioprine Loading...316. Which one of the following is a anterior pituitary hormone? Torsemide Urofollitropin Atorvastatin Fenofibrate Desmopressin Loading...317. Which of the following is the main reaction of hepatic cytochrome P-450 in metabolism? Binding with glucuronic acid Hydroxylation Methylation Binding with glutathione Loading...318. Which of the following medications prevents cholesterol absorption at small intestine brush border? Fenofibrate Colestipol Niacin Ezetimibe Loading...319. A 46 year old woman with systemic lupus erythematosus presents to the clinic for follow up. She takes prednisone daily for 3 months. Her condition is stable and she has no complaints since her last visit 3 months ago. She smokes a pack of cigarette daily for 15 years. She said that she is not faithful on her diet and exercise program. On physical examination, her pulse is 84/min; blood pressure is 140/90, no cardiac or pulmonary abnormalities and no organomegaly. Blood glucose and serum lipidsat is the most appropriate lab test you should order on this visit? Serum thyroid stimulating hormone Serum cortisol Blood urea nitrogen and serum creatinine Loading...320. A 1-year-old girl is brought to the pediatrician by her parents due to poor growth and skeletal abnormalities. Laboratory investigations show microcytic anemia and higher concentration of hemoglobin A2. Which is the most likely diagnosis? Sickle cell anemia Iron deficiency β-thalassemia Lead poisoning Loading...321. An athletic girl presents with amenorrhea for 3 weeks. Pregnancy test is negative and her vital signs are within normal limits. Which is the most likely cause of this amenorrhea? Estrogen deficiency Testosterone deficiency Progesterone deficiency Thyroid hormone deficiency Loading...322. Antihistamine agent with nonsedative effect from the chemical class of piperazine is the following? Cyproheptadine Cetirizine Fexofenadine Promethazine Hydroxyzine Loading...323. A 62-year-old man visits his physician with a complaint of a breast lump. On examination, there is no fever and vital signs are within normal limits. There is a hard lump in his right breast and nipple retraction. What is the most appropriate next step of action? Ultrasound guided biopsy Whole body CT scan Mammography MRI of the chest X-Ray of the chest Loading...324. Which one of the following drugs works through inhibition of acetyl-cholinesterase enzyme and used in myasthenia gravis? Montelukast Neostigmine Atropine Noradrenaline Loading...325. A 20-year-old male athlete complains of pain and weakness of his right arm. He had a successful surgery on his knee last week. He has been walking with the aid of crutches since then. On examination, he is unable to extend his right arm at the elbow or the hand at the wrist. There is also a sensory deficit over the dorsolateral area of the right hand. Neurological examination is otherwise normal. Which nerve is most likely related to his symptoms? Suprascapular nerve Median nerve Ulnar nerve Radial nerve Axillary nervePage 14 of 66 Loading...326. Which of the following correctly describes permissive drug interaction?ich of the following drugs is the effective treatment of benzodiazepines toxicity? Effect of drug A and drug B is equal to the sum of their individual effects Decrease in response of a drug after repeated administration Presence of drug A is required for full effect of drug B Effect of drug A and drug B is greater than the sum of their individual effects Loading...327. The effect of two medications is greater than the sum of their individual effects explains which of the following drug interactions? Synergistic Tachyphylaxis Additive Permissive Loading...328. Prolonged vomiting results in which one of the following findings? Metabolic acidosis with hypernatremia Metabolic acidosis with hyperkalemia Metabolic alkalosis with hyperkalemia Metabolic alkalosis with hypokalemia Loading...329. Which one of the following drugs has irritation of the respiratory tract and should avoid in severe reactive asthma? Rimantadine Amantadine None of these Zanamivir Oseltamivir Loading...330. A) Bupropion Haloperidol Ethosuximide Methylphenidate Loading...331. A 24-year-old man with a history of HIV infection develops pallor and increasing fatigue. Laboratory tests confirm the diagnosis of acute lymphoblastic leukemia. Which one of these chemotherapeutic agents is used for this patient without causing further damage to his immune system? Vincristine Cisplatin Chlorambucil Ifosfamide Procarbazine Loading...332. A 12-year-old boy with a history of cystic fibrosis develops dyspnea, cough and fever. His temperature is 103.1 F, his pulse is 120/min and his oxygen saturation is 85%. Lung examination reveals bilateral rhonchi. What is the appropriate antibiotic treatment? Ampicillin and gentamicin Ampicillin Vancomycin Ceftazidime and gentamicin Ceftazidime Loading...333. Which one of the following cranial openings is located at the greater wing of sphenoid and contains the middle meningeal artery? Foramen ovale Foramen rotundum Foramen spinosum Foramen lacerum Loading...334. Which of the following drug belongs to H2 histamine receptor blocker? Cefoxitin Nizatidine Niacin Oxacillin Glimepiride Loading...335. Which of the following conditions most likely be presented with primary amenorrhea? Turner syndrome Pregnancy Pituitary adenoma Loading...336. Indinavir belongs to the class of following drugs? Antibiotics Antiviral Anti malaria Antiprotozoal Antipyretic Loading...337. Which one of the following drugs associated with nephrotoxicity? Ethambutol Capreomycin Rifampin Isoniazid Loading...338. Which one of the following drugs is worst for causing gastric irritation? Aspirin Misoprostol Diclofenac Sulindac Acetaminophen Loading...339. Which of the following is the most common etiology of type II diabetes? Insulin receptor deficiency Altered hormone-receptor complex Low insulin production Increased hepatic glycogen breakdown Loading...340. A 69-year-old man presents to the clinic with his wife for evaluation of his memory problem. His wife tells you that her husband has begun to forget recent events insidiously since last year. He forgets recent conversations and recent appointments. He is no longer able to manage his checkbook and daily budget as he used to do. He has no history of general medical condition and he only takes baby aspirin daily. His examination is normal. Mini mental status examination reveals prominent memory loss. MRI shows a few areas of cerebral atrophy. Which of the following is the most likely diagnosis? Alzheimer’s disease Lewy body dementia Old age dementia Vascular dementia Creutzfeldt-Jakob disease Loading...341. Which of the following muscles are the primary abductors of the arm at the shoulder? Deltoid and infraspinatus Deltoid and biceps Deltoid and coracobrachialis Deltoid and supraspinatus Loading...342. Which of the following cells of the ovary secretes inhibin, follistatin and activin? Theca interna cells Surface epithelial cells Theca externa cells Granulosa cells Loading...343. Which one of the following agents prolongs the duration of nerve block when combined with a local anesthetic? Isoproterenol Dobutamine Atropine Epinephrine Loading...344. Which one of the following anti-acne drugs act by induction of apoptosis in sebaceous glands? Isotretinoin Azelaic acid Tetracycline Benzoyl peroxide Loading...345. A drug that effects the thyroid hormone is one of the following? Bumetanide Furosemide A & B Sulbactam Thyroxine Loading...346. Which one of the following drugs is Quaternary compound antispasmodic? Propantheline Oxybutynin Cyclopentolate Dicyclomine Biperiden Loading...347. Maraviroc belongs to the class of following drugs? Antiprotozoal Antiviral Antifungal Antipyretic Anti malaria Loading...348. Which one of the following hypertensive drug is poisonous when given orally? Minoxidil Fenoldopam Hydralazine Sodium nitroprusside Loading...349. An old woman is having difficulty in holding or keeping her head up. She also mentions that she experiences fatigue in her hands shortly after washing dishes. Physical examination reveals neck flexion weakness as well as proximal weakness in the arms. Which of the following is the initial diagnosis for her condition? Spinal cord compression Myasthenia gravis Meningitis Peripheral neuropathy Loading...350. In case of constrictive pericarditis, examination reveals increased jugular venous pressure with inspiration. Which of the following is considered positive in this patient? Kussmaul sign Raynaud’s phenomenon S3 gallop Hepatojugular refluxPage 15 of 66 Loading...351. A 50 year-old man presents to the clinic with a long history of heartburn after eating, exaggerated when he is lying down and lessened when he takes antacids. Endoscopy reveals a large irregular, erythematous area in the lower esophagus. Esophageal motility studies reveal dysfunction of the lower esophageal sphincter (LES). Which of the following most likely leads to increase in the resting pressure of LES? Caffeine Protein Fat Chocolate Alcohol Loading...352. Which one of the following statements of tetracycline is wrong? Avoid in Pregnancy Deposition in bones and teeth Causes GIT disturbance Bind with 50S ribosomal subunit Loading...353. Which of the following locations is the most common site of gastrinoma? Pancreas Ileum Stomach Liver Loading...354. A drug that is used for Hypotrichosis of the eyelashes? Treprostinil Epoprostenol Bimatoprost Carboprost Dinoprostone Loading...355. Miconazole belongs to the following type of drugs class? Antibiotics Anti malaria Antipyretic Antifungal Antiviral Loading...356. Which one of the following macrolide drugs has a short half-life of 2 hours? Erythromycin Clarithromycin Azithromycin Telithromycin Loading...357. Which of the following is the classic electrocardiogram (ECG) finding in atrial flutter? S-T segment elevation in leads II. III and aVF S-T segment elevation in anterior leads (V1-V4) Diffuse S-T segment elevation Sawtooth P waves Loading...358. Which one of the following drugs is associated with elevated liver function test results? Rifampin Isoniazid Capreomycin Ethambutol Loading...359. Which one of the following conditions is characterized by joint space narrowing and osteophyte formation while bone density appears normal? Osteoarthritis Gout Pseudogout Rheumatoid arthritis Loading...360. When you suggested to a mother to vaccinate her child with MMR on scheduled basis, she refused for religious belief. What is the most appropriate nest step? Proceed with immunization Report her to health authorities Explain to her with documentation the benefits and risks of immunization Obtain a court order Loading...361. A 43 year-old man presents to his physician with a complaint of progressive difficulty in swallowing solid food. He has a 10-year history of heartburn which increases with spicy food and relieves by antacids. He does not smoke or drink alcohol. His weight is the same since last visit six months ago. He is scheduled for endoscopy next week. What is the most likely initial diagnosis for this patient? Lower esophageal ring Achalasia Peptic esophageal stricture Diffuse esophageal spasm Cancer esophagus Loading...362. Which of the following is the most likely rout of transmission of herpes simplex virus-1? Respiratory secretions and saliva Sexual contact and perinatal Congenital transfusion Food contamination Loading...363. Which of the following is characteristic of Alzheimer’s disease? Nuclear atypia Neurofibrillary tangles Lewy bodies Negri bodies Loading...364. Which of the following is the central action of cocaine? Inhibition of reuptake of dopamine and epinephrine Stimulation of dopamine release Inhibition of phosphodiesterase Inhibition of reuptake of serotonin Loading...365. Which of the following statements correctly describes the therapeutic dose of medication? The amount of medication that produces maximal rate of distribution The amount of medication that produces the highest plasma concentration of the drug The amount of medication that produces the required effect in the majority of patients The amount of medication that produces minimal biological effect Loading...366. Which of the following is the most significant action of monoamine oxidase A? Metabolism of serotonin and epinephrine Metabolism of serotonin and dopamine Metabolism of norepinephrine, serotonin and tyramine Metabolism of dopamine Loading...367. A toddler swallowed a coin. Which of the following is the most common site of impaction of this coin? Esophagus Ileocecal junction Stomach Transverse colon Loading...368. A 45-year-old woman is sent to the emergency room from a vision center after examining her eyes to get new glasses. While she was in the waiting room, she developed severe ocular pain in her right eye and she started seeing halos around light. Which of these agents most likely is the reason for this patient’s condition? Neomycin Acetazolamide Pilocarpine Atropine Timolol Loading...369. In which one of the following locations a mural thrombus commonly occurs following myocardial infarction? Right ventricle Thoracic aorta Left ventricle Right atrium Left atrium Loading...370. Canrenone is an active metabolite of one of the following Diuretic drug? Furosemide Spironolactone Bumetanide Acetazolamide Triamterene Loading...371. Which one of the following valve abnormalities is related to intravenous drug abuse? Aortic stenosis Mitral stenosis Aortic regurgitation Tricuspid regurgitation Loading...372. Reabsorption of Na+ & Cl– in the distal convoluted tubules that results in retention of water in the tubules. Which of the following diuretic is used? Acetazolamide Spironolactone Bumetanide Chlorothiazide Furosemide Loading...373. Which one of the following drugs is a sodium channel blocker (Class I)? Verapamil Carvedilol Procainamide Amiodarone Loading...374. Which one of the following drugs is first generation flouroquinolone? Levofloxacin Moxifloxacin Ciprofloxacin Nalidixic acid Loading...375. A 40-year-old woman complains of swelling in her neck. Examination reveals a small, non-tender nodule in her thyroid. Which of the following is the best next step of action? T4 and TSH levels Fine needle aspiration Excisional biopsy Ultrasound of the thyroidPage 16 of 66 Loading...376. Which of the following is NOT an adverse effect of aspirin? Tolerance Renal problems Bleeding Gastritis Loading...377. Which of the following drug belongs to the Nonnucleoside reverse transcriptase inhibitor? Delavirdine Indanyl carbenicillin Atazanavir Maraviroc Abacavir Loading...378. A 55-year-old man has a long history of liver cirrhosis visits his physician with a new complaint. Recently he noticed abnormal lesion on his abdomen. His physician recognized these lesions as caput medusae. Which veins are most likely involved in this case? Splenic and external iliac veins Paraumbilical and epigastric veins Azygos and hemiazygos veins Esophageal venous plexus Superior, middle and inferior rectal veins Loading...379. Which one of the following agents is used to eradicate the organism's (Phthisis pubis) extraerythrocytic phase? Quinacrine Primaquine Chloroquine Pyrimethamine Chloroguanide Loading...380. Which of the following medications inhibits folic acid synthesis through its effect on dihydropteroate synthetase enzyme? Sulfonamides Trimethoprim Pyrimethamine Methotrexate Loading...381. Which of the following is the main site of action of HMG-CoA reductase inhibitors? Liver Kidney Blood GI tract Loading...382. A 46 year-old man underwent a kidney transplantation last week due to chronic renal failure. The surgery was successful and the transplanted kidney started to produce urine during the operation. Today, his urine examination shows high creatinine and low urinary output. He has no pain or fever. A biopsy taken from the transplanted kidney shows cellular infiltrate . Which of these cells is responsible for this patient’s recent condition? B Lymphocytes T-helper cells Fibrocytes Plasma cells Cytotoxic T cells Loading...383. Which of the following is the main mechanism of action of methylergonovine in treating postpartum hemorrhage? Strong vasoconstriction Forceful contraction of myometrium Blocking sympathetic stimulation Instant blood coagulation Loading...384. What is the pKa of a drug? The pH at which 50% of the drug is ionized and 50% unionized The pH at which 100% drug becomes completely ionized The pH at which 100% drug becomes completely unionized Loading...385. What is the mechanism of action of finasteride? Gonadotropin-releasing hormone analog Inhibition of 5-alpha-reductase Inhibition of testosterone negative feedback Stimulation of the posterior lobe of pituitary gland Loading...386. Which one of the following drugs is a Tetracycline? Cefepime Cefdinir Cefadroxil Minocycline Loading...387. Bones of calvarium and facial bones are formed by which one of the following types of ossification? Membranous ossification Endochondral ossification Loading...388. A 43 year-old man presents to his physician with a complaint of progressive difficulty in swallowing solid food. He has a 10-year history of heartburn which increases with spicy food and relieves by antacids. He does not smoke or drink alcohol. His weight is the same since last visit six months ago. He is scheduled for endoscopy next week. What is the most likely initial diagnosis for this patient? Diffuse esophageal spasm Peptic esophageal stricture Lower esophageal ring Cancer esophagus Achalasia Loading...389. A 19 year old college student is brought to the emergency room with a police officer because of a cut wound on his arm. The student was arrested during committing a robbery at a convenient store. His record shows two fights with his neighbors on different occasions because he used to hit their pets. He also had two incidence of shoplifting. Which is the most likely diagnosis? Conduct disorder Borderline personality disorder Histrionic personality disorder Antisocial personality disorder Obsessive compulsive disorder Loading...390. A 14-year-old student is brought to the emergency room complaining of severe abdominal pain. Diagnostic tests reveal high serum levels of δ-aminolevulinate and porphobilinogen and low level of uroporphyrinogen I synthetase in urine. Given the above test results, which of the following symptoms would be presented in this case? Hypotension Neuropsychiatric disturbances Polyphagia Stiff neck Loading...391. Which of the following is the most accurate test for multiple myeloma? Brain MRI Urine electrophoresis Bone marrow biopsy 24-hour urine calculation Loading...392. Which of the following medications should be given to a patient that exhibits severe adverse reactions after administration of IV midazolam? Protamine Naloxone Flumazenil Glucagon Loading...393. A 15-year-old male is brought to the emergency department for ataxia, hyperactivity, hallucinations, abusive language and nystagmus. Which of the following is most likely responsible for his condition? Amphetamines Phencyclidine (PCP) Barbiturates Cocaine Loading...394. Which of the following is the LEAST factor can lead to urinary tract infection? Pregnancy Diabetes mellitus Prolonged tetracycline therapy Urinary tract obstruction Loading...395. Which of the following medications reduces the effectiveness of oral contraceptives? Ketoconazole Carbamazepineich of the following medications is the best treatment of absence seizures? Omeprazole Ritonavir Loading...396. Gastric inhibitory peptide (GIP) and Glucagon-like peptide-1 (GLP-1) are secreted by? Intestine's Adrenal glands Kidney Liver Loading...397. Which one of the following drugs is effective against prolactin-secreting tumors? Bromocriptine Adrenaline Chlorpromazine Prazosin Loading...398. Stimulation of muscarinic receptors by pilocarpine is competitively inhibited by which of the following medications? Pralidoxime Physostigmine Edrophonium Atropine Loading...399. A 79-year-old woman complaining of persistent cough presents to the clinic for chest x-ray. A small nodule is detected on the x-ray. Biopsy of the nodule reveals adenocarcinoma containing progesterone receptors. Her past history is significant for endometrial carcinoma treated 2 years ago. What is the most effective treatment for this patient? Lobectomy Cytotoxic agents Progestin therapy Radiotherapy Loading...400. A 21 year-old college student complains of the appearance of yellowish coloration on her sclera. She mentions that she had been dizzy and weak for the last 3 days but did not feel any pain or fever and no change in stool color. Abdominal examination reveals normal bowel sounds and no tenderness or organomegaly. Laboratory tests show normal levels of liver enzymes and serum bilirubin. Which is the most likely initial diagnosis? Pancreatic cancer Obstructive jaundice Hemolysis Hepatocellular disease GallstonesPage 17 of 66 Loading...401. A 90-year-old man is hospitalized from falling and breaking his hip. He has been already in the hospital for 6 days when he developed a burning sensation upon urinating. An analysis of his urine shows plenty of gram positive cocci and leukocytosis. The attendant physician treats him with trimethoprim-sulfamethoxazole. However, the fever still persists. After 2 more days, the patient develops a diastolic murmur radiating to the axilla and a low-grade fever is still persisting. Out of the following, which would be the first line treatment for the cause of the possible infection? Piperacillin Vancomycin Gentamicin Ampicillin Loading...402. A 22-year-old man visits his physician for evaluation of new symptoms after the use of isoniazid treatment for TB. His skin is inflamed, had diarrhea and feeling like not himself. What is the vitamin deficiency responsible for this patient’s new symptoms? Niacin deficiency Folic acid deficiency Vitamin B12 deficiency Riboflavin deficiency Thiamine deficiency Loading...403. Aspirin is contraindicated in following disease? All of these Reye's syndrome Peptic ulcer Bleeding disorder A & B Loading...404. A crescendo-decrescendo murmur is heard during systole at the second right intercostal space and radiates to the carotid artery. Which one of the following findings is most likely seen on the chest X-ray? Left ventricular hypertrophy Boot-shaped heart Enlarged cardiac shadow in both directions Right ventricular hypertrophy Loading...405. Which of the following groups of drugs are useful for night terrors and sleepwalking? Tricyclic anti-depressants Benzodiazepines Barbiturates Alcohols Loading...406. A pregnant woman in her third trimester was in a motor vehicle accident presets to the ER. She is stable and no uterine bleeding or contractions. Fetal heart sounds are normal and placenta is intact. Which of the following is the best next step? Induction of labor Blood type and Rh testing Send her home and follow up the next scheduled visit Cesarean section Loading...407. An 8-month-old boy presents to the clinic with his mother. She tells you that her son had several bowel movements today and his stool was like red jelly. He vomited all food and water. He is also weak, fussy and holding his belly. He has no fever or signs of dehydration. On abdominal examination, there is a palpable abdominal mass in the right hypochondrium and emptiness in the right lower abdomen. Ultrasonography is performed to confirm the diagnosis. What is the next step of management for this patient? MRI of the abdomen Colonoscopy IV hydration and antibiotics Refer to surgery for bowel resection Contrast enema Loading...408. Lactic acidosis is the adverse effect of one of the following drugs? Aspirin Metformin Glyburide All of the above Loading...409. Which of these medications is contraindicated in a case of cardiogenic shock? Intravenous fluids Norepinephrine Dopamine Metoprolol Loading...410. Which one of the following oral anti-diabetic drugs is associated with lactic acidosis? Metformin Nateglinide Pioglitazone Glipizide Loading...411. Which of the following conditions may occur as a result of a long umbilical cord? Amnion nodosum Placenta previa Nuchal cord Abruptio placenta Loading...412. Estrogen is the female hormone due to which female sex organs and secondary sexual characteristics developed. Estrogen has the following adverse effects except? Thromboembolic disease Endometrial cancer Hepatic Adenoma Paresthesia Fluid retention Loading...413. Which of the following drug is a part of proton pump inhibitors? A & B Pantoprazole Mannitol Furosemide Acetazolamide Loading...414. Which one of the following tests is performed to determine if a fetus develops hemolytic disease of the newborn? Radioimmunoassay Hemoglobin electrophoresis Direct Coombs test Osmotic fragility test Loading...415. Which of the following enzymes is markedly elevated in primary biliary cirrhosis? Aspartate aminotransferase (AST) Alanine aminotransferase (ALT) Acid phosphatase Alkaline phosphatase Loading...416. Ceftriaxone belongs to the one of the following generation of the cephalosporin? 2nd generation 4th generation 1st generation 3rd generation Loading...417. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Succinylcholine Prazosin Benztropine Neostigmine Atropine Loading...418. Cephalexin belongs to the class of following drugs? Antibiotics Anti malaria Antipyretic Antiviral Antiprotozoal Loading...419. A 32-year-old woman with a long history of irregular menstrual periods visits her physician for consultation. She is married for 8 years and has been unable to conceive. Her menstrual period occurs once every 2-4 months. She had normal Pap smear last year. Her height is 5.2″. Her weight is 205 pounds. Her vital signs are within normal limits. She has acne and excessive facial hair. This patient is at risk of which one of the following diseases? Cervical cancer Endometrial cancer Ovarian cancer Liver cirrhosis Lung cancer Loading...420. Propranolol is used to treat one of the following diseases? Viral infection Malaria Stomach Ulcer High Blood pressure Diabetes Loading...421. Which of the following drug belongs to H2 histamine receptor blocker? Cimetidine Oxacillin Niacin Cefoxitin Glimepiride Loading...422. An 83-year-old man presents to the clinic with progressive pain and swelling of the left knee for 8 months. He has a history of well-controlled type 2 diabetes for 15 years. He does not smoke or take any recreational drugs. He drinks alcohol socially. His surgical and family histories are unremarkable. Physical examination reveals a medial parapatellar hard movable mass and limited movement of the left knee. Excisional biopsy of the mass reveals glossy white calcified deposits, which show positive birefringence under polarized light. What is the most likely diagnosis? Acute arthritis Pseudogout Osteoarthritis Osteosarcoma Gout Loading...423. A 36 year-old man presents to the emergency room asking for removal of software implanted in his body by his neighbor. He tells you that his x-wife is hiring this neighbor to spy on him. For the last 6 years he has been hearing them talking about him and all details of his life. He lives alone and he does not have any friends. He has no kids and one sister who do not visit him anymore since he accused her of spying on him. His physical examination and laboratory studies are unremarkable. Drug test is negative. What is the most likely diagnosis? Schizophrenia Brief psychotic disorder Bipolar disorder Schizophreniform disorder Major depressive disorder Loading...424. A 2-month-old child is brought to the clinic by his parents with a complaint of failure to thrive. During an examination, the baby suffers a seizure. Test of stat serum chemistries indicates hyperlipidemia, severe hypoglycemia, ketosis, and lactic acidosis. Hepatomegaly is also confirmed by both physical examination and CT scan. Which of the following conditions is the child suffering from based on these findings? Von Gierke disease Gaucher disease Niemann-Pick disease Pompe disease Loading...425. Counterregulatory hormone in diabetes that works against insulin include the following? Glucagon All of the above Cortisol Catecholamines Growth hormonePage 18 of 66 Loading...426. Regulation of which of the following regions is mostly dependent on extrinsic nerves? Large intestine Small intestine Lower esophagus Upper esophagus Loading...427. A 54 year-old man with a history of chronic obstructive pulmonary disease (COPD) presents by his son to the emergency room semi-unconscious with shortness of breath. He has nausea, diarrhea and restlessness for the last four hours. His arterial oxygen saturation is 88% with room air. His ECG shows normal sinus rhythm with non-specific changes in lateral leads. The patient uses albuterol inhalation, ipratropium bromide, theophylline and Lisinopril. Three days ago, he had an exacerbation of his COPD and was prescribed ciprofloxacin and supplemental oxygen at night and during ambulation. What is the most likely cause of this patient presentation to the ER? Interaction of ciprofloxacin to albuterol Interaction of ciprofloxacin to theophylline Interaction of ciprofloxacin to ipratropium bromide Interaction of ciprofloxacin to Lisinopril Interaction of ciprofloxacin to oxygen Loading...428. An 8-month-old boy presents to the clinic with his mother. She tells you that her son had several bowel movements today and his stool was like red jelly. He vomited all food and water. He is also weak, fussy and holding his belly. He has no fever or signs of dehydration. On abdominal examination, there is a palpable abdominal mass in the right hypochondrium and emptiness in the right lower abdomen. Ultrasonography is performed to confirm the diagnosis. What is the next step of management for this patient? Colonoscopy Refer to surgery for bowel resection IV hydration and antibiotics Contrast enema MRI of the abdomen Loading...429. Peripheral resistance is linked with one of the following issue? Fever Aids Blood pressure Headache Loading...430. An 18 year-old student visits her physician for a routine physical examination. She has no complaints. Physical examination is unremarkable except for a mid-systolic click followed by a late systolic murmur heard at the lower left sternal border and apex. The murmur duration increases in standing and shortens with squatting. Electrocardiogram (ECG) shows no abnormalities. Which of the following is the most likely diagnosis of this condition? Mitral stenosis Dilated cardiomyopathy Mitral valve prolapse Tricuspid regurgitation Aortic stenosis Loading...431. Which of the following is a poor prognostic sign of acute pancreatitis a day after initiation of hydration and appropriate treatment? Hematocrit drops by 4% Serum amylase of 900 IU/L Blood urea nitrogen (BUN) rises 6 mg/dL Random serum glucose of 70 mg/dL Loading...432. Which one of the following substances induces the closure of patent ductus arteriosus? Ibuprofen Indomethacin Prostaglandin E Estradiol Loading...433. A drugs inhibit the urate-anion exchanger in the proximal tubules that mediates urate reabsorption? Sulindac Allopurinol Colchicine Probenecid Loading...434. Which of the following drugs are carboxylate derivatives of ACEIs except? Quinapril Ramipril Enalapril Fosinopril Lisinopril Loading...435. The binding of a drug to plasma proteins will tend to: Increase its rate of biotransformation. Decrease its rate of glomerular filtration. Increase its concentration in the plasma. Increase its pharmacological activity Decrease half-life. Loading...436. Bleeding and thrombocytopenia is an adverse effects of one of the following drugs? Vitamin K Aprotinin Protamine sulphate Heparin Loading...437. Uric acid excretion is Increased by using one of the following options? All of the above Probenecid Sulfinpyrazone A & B Allopurinol Loading...438. A 12-year-old girl is brought to the emergency room with her parents. Consent form the parents is needed to proceed with the treatment. The parents speak Spanish and very little English. What is the best next step of action? Find any Spanish-speaking person in the clinic to interpret the instructions Try your best to explain the treatment plan to them Use electronic interpreting device to translate the instructions Speak to the boy to find out if he speaks English, and if he does, explain the instructions to him. Loading...439. A 48-year old man presents to the emergency room with severe headache and blurred vision. His blood pressure is 230/140. Ophthalmologic examination reveals blurred optic discs with indistinct margins. An intravenous drip of nitroprusside is started. What is the mechanism of action of this medication? Alpha adrenergic antagonist Ganglion blocker Beta adrenergic antagonist ACE inhibitor Direct smooth muscle vasodilator Loading...440. Which of the following is absolute contraindication of fibrinolytic therapy in MI? History of ischemic stroke 4 years ago History of hemorrhagic stroke 9 years ago History of hypertension History of diabetes Loading...441. A 35-year-old office worker complains of pain and numbness over the lateral side of the hand. It is worse at night and may awaken her from sleep. Examination reveals tingling over the median nerve distribution by compressing the opposing dorsal surface of the hand with the wrist flexed. Which of the following is the correct term of this test? Tinel test ELISA test Coombs test Phalen test Loading...442. Hemorrhagic cystitis may develop after the use of cyclophosphamide. Which one of the following drugs can reduce this risk? Mensa Infliximab Ampicillin Vitamin K Loading...443. Which of the following is a major complication of central retinal veins occlusion? Glaucoma Retinal detachment Lens subluxation Cataract Loading...444. A 43-year old cashier visits her physician with a complaint of severe pain for 3 months and a new onset of itching in her right leg. Examination reveals multiple varicosities on the medial side the right thigh and leg and an erythematous patch on the medial side of the knee. What is the most common precipitating factor for this condition? Excessive sweating Alcohol intake Prolonged standing Prolonged exposure to the sun Strenuous exercise Loading...445. Which of the following drugs are highly bound to albumin? Digoxin A & B Warfarin All of the above Ibuprofen Loading...446. A drug that inhibits the fungal squalene epoxidase thus decreasing the synthesis of ergosterol? Terbinafine Nystatin Griseofulvin Itraconazole Loading...447. Which one of the following drugs is a Thiazide Diuretic? Metolazone Indanyl carbenicillin Atorvastatin Ezetimibe Fenofibrate Loading...448. Na+ channel blockers belongs to the one of the following CLASS of Antiarrhythmic drugs? CLASS III CLASS II CLASS IV CLASS I Loading...449. A patient presents with vomiting, diarrhea and abdominal cramps a few hours after a picnic. Which is the causative organism? Clostridium difficile E-coli Staphylococcus aureus Streptococcus pyogenes Loading...450. Which of the following group of medications prolongs GABA activity in the brain? Barbiturates Benzodiazepines Alcohols MethamphetaminesPage 19 of 66 Loading...451. Which of the following histamine H1 antagonists is identified for its serotonin-blocking effect? Loratadine Fexofenadine Cyproheptadine Desloratadine Loading...452. A 76 year old woman comes to your office for a consultation. Yesterday, she had left hemiparesis for 30 minutes. She thought it was a stroke but now she is completely asymptomatic. She has a history of atrial fibrillation, angina and hypertension. She takes aspirin 81 mg and propranolol 80 mg. What is your appropriate initial management for this patient? Schedule MRI to the brain Schedule carotid duplex ultrasonography Obtain CT scan of the head Schedule another appointment whenever she has symptoms Schedule transesophageal echocardiography Loading...453. Which of the following hormone belongs to the oral diabetic agent? Furosemide Oxytocin Somatrem A & B Acarbose Loading...454. Which of the following is the best treatment of genuine stress incontinence? Intermittent self-catheterization Anticholinergic Surgical repair Urethropexy Loading...455. A 40-year-old man with a long history of intravenous drug addiction presents to the emergency room complaining of fever, anorexia, malaise, shortness of breath, cough and chest pain for 2 days. On physical examination, temperature is 102.7 F, Pulse is 110/min. and blood pressure is 110/66. Irregular erythematous nodules are seen on his hands and feet. Which of the following is most likely valvular lesion associated with this infection? Tricuspid valve regurgitation Mitral valve regurgitation Pulmonic valve stenosis Aortic valve stenosis Mitral valve stenosis Loading...456. Cimetidine is used to treat one of the following diseases? Malaria Stomach Ulcer Diabetes Blood pressure Viral infection Loading...457. A 33-year-old man presents to his physician to discuss his plans for treatment of hyperthyroidism. One of the options is potassium perchlorate. What is the mechanism of action of potassium perchlorate as anti-thyroid? Blocking of peroxidase catalyzed reactions Inhibition of the release of thyroid hormone from the thyroid gland Blocking of peripheral deiodination of T3 and T4 Blocking of coupling of iodotyrosines Competitive inhibition of iodide transport mechanism Loading...458. Which one of the following drugs is Nonsteroidal antiestrogens? Estradiol Exemestane Estradiol acetate Tamoxifen Estrogen Loading...459. Pharmacokinetics of a drug is defined as which one of the following? Effect of a drug on certain body systems Amount of drug needed to produce an effect The movement of a drug within the body Reaction of the body to a drug Loading...460. Fluconazole belongs to the class of following drugs? Antiviral Antibiotics Antiprotozoal Antifungal Antipyretic Loading...461. A patient with a history of diabetes presents with dark bronze skin pigmentation and multiple arthralgia. Which of the following would be detected in a joint aspirate? Negatively birefringent particles Monosodium urate crystals Copper Hemosiderin Loading...462. Ingestion of which of the following products may cause hypertensive crisis in patients taking MAO inhibitors? Tyramine-rich food Gluten-rich food Vitamin D and calcium Carbohydrates such as starch Loading...463. Which of the following findings distinguishes chronic renal failure from acute renal failure? High serum calcium History of elevated BUN History of elevated serum creatinine High serum sodium Loading...464. Varicella zoster vaccine is not recommended if an elderly patient already developed shingles. True False Loading...465. Action of incretin hormone GLP-1 is following except? slow gastric emptying Enhance appetite Inhibit inappropriate glucagon secretion Increase glucose-dependent insulin secretion Increase beta-cell growth Loading...466. Which of the following medications is the drug of choice for motion sickness? Benztropine Tolterodine Dicyclomine Scopolamine Loading...467. Which of the following locations is the site of action of furosemide to inhibit sodium reabsorption? Ascending limb of loop of Henle Distal convoluted tubules Descending limb of loop of Henle Collecting tubules Loading...468. Which of the following drug is a PGF2-Alpha analog? Dinoprostone Treprostinil Carboprost Epoprostenol Misoprostol Loading...469. A drug that is more effective in combination with itraconazole to treat chromoblastomycosis? Griseofulvin Flucytosine Amphotericin B Nystatin Loading...470. A 32-year-old woman with a history of generalized anxiety disorder develops numbness of her face particularly around her mouth. Physical examination and x-ray show no abnormalities other than markedly increased respiratory rate. Laboratory investigations are as follows: Elevated bicarbonate excretion2: 100 mmHg PCO2: 30 mmHg Elevated hydrogen ion excretion Elevated hydrogen ion concentrationich of these findings shows that the body is compensating to this condition? Elevated respiratory rate Elevated arterial PO2 Loading...471. In a case of methemoglobinemia, which one of the following is the most likely cause of the brown color of the patient’s blood? Reduced hemoglobin Decreased oxygen affinity Carbon monoxide Oxidized hemoglobin Loading...472. Which of the following substances is the risk factor in developing mesothelioma? Silica Asbestos Lead Copper Loading...473. Which of the following drugs has the shortest half-life and used in acute anxiety? Chlordiazepoxide Flurazepam Alprazolam Clonazepam Loading...474. Your 8-year-old daughter wakes you up in the middle of the night complaining of severe coughing. You bring the child to the doctor the next day and upon examination, the following is revealed: noisy breathing on inspiration, flaring of the nostrils, marked retractions of the chest wall, and a severe barking cough. She has also developed an upper respiratory tract infection. What would be the best diagnosis for the patient? Viral croup Asthma Bronchiolitis Foreign body stuck in the main bronchus Loading...475. What is the best treatment of gastroparesis in a diabetic patient? Omeprazole Gastric resection Metoclopramide VagotomyPage 20 of 66 Loading...476. Which one of the following substances is released by sympathetic postganglionic neurons which innervate renal vascular smooth muscle? Dopamine Epinephrine Acetyl choline Norepinephrine Loading...477. Which one of the following drugs is 2nd generation flouroquinolone? Moxifloxacin Ciprofloxacin Nalidixic acid Levofloxacin Loading...478. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ibandronate A & B Flucytosine Ethambutol Miconazole Loading...479. Which one of the following procoagulant factors is produced by the epithelial cells? Prostacyclin Fibrinogen Thromboxane A2 von Willebrand’s factor (vWF) Loading...480. Which one of the following drugs is a more effective drug and drug of choice for fungal infection with a shorter duration of therapy? Terbinafine Delavirdine Griseofulvin Itraconazole Loading...481. Which one of the following glucocorticoids is long acting? A & B Amiloride Betamethasone Cortisone Prednisone Loading...482. Which one of the following structures is involved in a case of tarsal tunnel syndrome? Deep peroneal nerve Tibial nerve Peroneal artery Anterior tibial artery Loading...483. Which one of the following drugs is the most fatal in suicidal overdose? Citalopram Phenelzine Imipramine Bupropion Loading...484. Which one of the following drugs is used to treat asthma? Indanyl carbenicillin Repaglinide Ezetimibe Montelukast Hydrochlorothiazide Loading...485. A 6-year-old girl is brought to her pediatrician by her mother for consultation. She said that her daughter is frequently bumping into chairs while walking or playing. On examination, she is found to have bitemporal hemianopia. CT scan shows calcification in the pituitary fossa. What is the most likely diagnosis of this condition? Craniopharyngioma Choriocarcinoma Germinoma Gangliocytoma Teratoma Loading...486. A 55 year-old man presents to the clinic because today he noticed that his left scrotum has suddenly gotten larger. He has no fever or pain. Examination reveals enlarged left scrotum with no tenderness or any signs of inflammation. There is a worm-like mass posterior to the left testicle. The mass illuminates and is not reducible on compression or when the patient lying down. What is the best next step in management? MRI of the pelvis Abdominal CT scan Urine culture Refer to surgery for urgent reduction Assurance and follow up in 2 weeks Loading...487. Which of the following statements is correct regarding the apex of the upright lung compared to its base? Ventilation/perfusion ratio is lower at the apex than at the base Alveoli are more compliant at the apex than at the base Alveoli are smaller at the apex than at the base Blood perfusion is lower at the apex than at the base Loading...488. Which of the following is the most serious contraindication of electroconvulsive therapy? Old age History of seizures History of fracture Meningioma Loading...489. Which of the following is the major indication of ondansetron in patients receiving chemotherapy? GERD Headache Nausea and vomiting Hair loss Loading...490. Which of the following agents most likely causes vasoconstriction? Histamine Bradykinin Nitric oxide Norepinephrine Loading...491. As physicians, we need to know some definitions in Genetics, which are related directly to our practice and guide us to diagnose and treat many genetic disorders. These items include genome, genotype, phenotype, genetic code, gene expression, etc. Which one of the following choices describes the definition of a phenotype? Genetic history of an organism DNA structure that determines the expression of a trait Physical location of a trait on a DNA molecule An observable physical or biochemical trait on an organism Loading...492. Which one of the following medications should be taken on an empty stomach and at least one hour before meals? Prednisone Aspirin Levothyroxine Propranolol Loading...493. A 23-year-old man visits his physician for routine examination. He has a history of HIV infection for 3 months and he is compliant with his medications. He is concerned about developing AIDS. Which of the following is the most useful test to address his concern? HIV p24 antigen CD4 lymphocyte count HIV antibody test HIV RT PCR Loading...494. Which one of the following drugs is associated with peripheral neuropathy? Rifampin Ethambutol Capreomycin Isoniazid Loading...495. A 50-year-old woman presents with palpitations and SOB. Her pulse is 140/min with irregular irregularity. Which of the following is the most likely finding in echocardiography? Left ventricular hypertrophy Mitral stenosis Right ventricular hypertrophy Dilated cardiomyopathy Loading...496. A 35-year-old unresponsive man is brought to the emergency room after an episode of agitation and confusion. He has a history of inadequately treated Graves’ disease. Physical examination reveals temperature of 102.5F. Blood pressure of 100/70 mm Hg, and pulse of 165 per minute. After stabilizing this patient, which of the following would be the best pharmacotherapy for treating his underlying condition? Propylthiouracil Iodine Levothyroxine Warfarin Dobutamine Loading...497. A 77-year-old man presents to the emergency room with a complaint of retention of urine. Carbachol is administered to stimulate bladder emptying. Which of the following is a prominent side effect of carbachol? Tachycardia Excessive salivation Dry skin Dilation of the pupils Delirium Loading...498. Dry or “sandy eyes” is seen after administration of large doses of which one of the following medications? Timolol Pilocarpine Atropine Carbacho Loading...499. Amphotericin B belongs to the class of following drugs? Antiviral Antibiotics Antipyretic Antiprotozoal Antifungal Loading...500. A study found that incidence of lung cancer in smokers is 230/100,000 and in non-smokers is 71/100,000. What is the relative risk for smokers? 71 230 2.3 3.2Page 21 of 66 Loading...501. Which one of the following statements about the use of Celecoxib is wrong? Selective inhibitor of COX-2 Causes kidney toxicity Inhibition is irreversible Half-life of 11 hours Loading...502. Serotonin Receptor linked with nausea and emesis? 5HT4 5HT³ 5HT5 5HT¹ 5HT² Loading...503. Which of these drugs inhibits epoxide reductase? Warfarin Heparin Streptokinase Aspirin Loading...504. An old patient complains of server pain in his right shoulder. He mentions that he had shingles on the same area of skin last week. Which of the following is the most appropriate treatment at this time? Carbamazepine Morphine Nortriptyline Ibuprofen Loading...505. Which one of the following structures provides the majority of noradrenergic innervation to the cerebral cortex? Caudate nucleus Raphe nucleus Locus coeruleus Substantia nigra Loading...506. Which of the following drug is the Antidote of Isoniazid? N-acetyl-cysteine Amyl Nitrate Pyridoxine Digibind Loading...507. In high doses, Aspirin lacks anti-platelet activity by which of the following phenomena Inhibits leukotrienes Stimulates leukotrienes Inhibits prostacyclins Stimulates thromboxanes Stimulates prostacyclins Loading...508. A 39 year-old man presents to the ER by his wife. They were watching TV when she noticed that her husband was confused and stumbling. He is not usually at home at this time but he did not feel good all the day. He used to drink every night with his friends at the bar but he did not go with them in the last two nights. He assumed that he is tired because he drank too much last time two days ago. He denied chest pain, shortness of breath or any abdominal symptoms. His CT scan is negative for any mass or bleeding. His lab tests show: Heart attackctose dehydrogenase 267 U/L What is the most likely diagnosis of this patient condition? Alcohol withdrawal Stroke Alcohol toxicity Loading...509. A patient with HIV history develops fecal urgency and bloody diarrhea. Which of the following is the most likely causative organism? Entamoeba histolytica Clostridium difficile Giardia lamblia Cytomegalovirus Loading...510. A 75-year-old man presents to his physician for a routine examination. He has a history of hypertension, hypercholesterolemia and osteoarthritis. He takes atenolol, simvastatin and ibuprofen as needed. His pulse is 76/min and irregular. Blood pressure is 130/74. Physical examination and imaging studies are normal except for asymptomatic atrial fibrillation. What is the most appropriate next step in management of this patient? Assurance and follow up in 3 months Start warfarin Start aspirin Start heparin Start low molecular weight heparin and warfarin Loading...511. Which of the following is the most common inherited cause of hypercoagulability? Factor V Leiden mutation Protein C deficiency Prothrombin gene mutation Congenital antithrombin III deficiency Loading...512. Ethacrynic acid belongs to one of the following classes of diuretics? Thiazide Diuretic Loop Diuretics Potassium-sparing diuretics Carbonic anhydrase inhibitors Loading...513. A 79-year-old woman presents with back pain for 3 months. Radiology of the spines shows compression of T11 and T12 vertebrae. There is no other lesion detected. Which of the following is the most likely diagnosis? Osteoporosis Osteosarcoma Metastatic adenocarcinoma Ewing sarcoma Loading...514. Which one of the following drugs causes a non-productive cough? Desmopressin Captopril Torsemide Somatostatin Atorvastatin Loading...515. A 12-year-old boy frequently experiences severe asthmatic attacks and becomes cyanotic, dyspneic, and agitated. Which of the following agents would be most likely used to prevent these attacks? Atropine Epinephrine Cromolyn sodium Scopolamine Loading...516. Which one of these conditions is most likely associated with peripheral lymphocytosis? Viral hepatitis Pyogenic bacterial infections Myocardial infarction Inflammatory bowel syndrome Loading...517. Which one of the following cardiac conditions occurs in about 25% of patients with systemic lupus erythematosus (SLE)? Aortic stenosis Ventricular myxoma Atrial hypertrophy Pericarditis Loading...518. In which one of the following parts of the GIT most of the ingested iron is absorbed? Stomach Ascending colon Duodenum Ileum Descending colon Loading...519. Which one of the following local anesthetics that causes local vasoconstriction and may leads to hypertension? Tetracaine Cocaine Etidocaine Lidocaine Loading...520. Polyuria is an adverse effect of which of the following drug? Vasopressin Desmopressin Conivaptan Oxytocin Loading...521. Which one of the following fetal structures transfer oxygenated blood from the umbilical vein to the inferior vena cava and becomes ligamentum venosum after birth? Umbilical artery Azygous vein Ductus venosus Ductus arteriosus Loading...522. Which one of the following medications is used for cases of Parkinson’s disease and influenza type A? Benztropine Amantadine Bromocriptine Ribavirin Loading...523. A 48 year-old man, who visited his daughter in London last week, complains of sudden severe pain and swelling in his right leg during his flight back to the USA. He is taken to the hospital and ultrasound is performed. It reveals femoral vein thrombosis. What is the most likely contributed to this finding? Daily aspirin Hypothyroidism Hypertension Immobilization Alcohol abuse Loading...524. Which one of the following drugs inhibits ribonucleotide reductase? Mycophenolate Hydroxyurea 5-Fluorouracil Ribavirin Loading...525. Organophosphorus poisoning can be treated with which of the following agents? Atenolol Atropine Ipratropium bromide PhysostigminePage 22 of 66 Loading...526. Prazosin blocks which of the following actions of epinephrine? Tachycardia Bronchodilation Mydriasis High stroke volume Loading...527. A 66-year-old man complains of difficult micturition and drippling at the end of urination. Laboratory investigations and imaging studies confirm the diagnosis of senile enlarged prostate and exclude prostate cancer. Which these drugs is the most appropriate for this patient? Tadalafil Finasteride Pergolide Abiraterone Flutamide Loading...528. Which of the following drugs is used after chemotherapy to increase the leukocyte count if it drops? Interleukin-2 Dexamethasone Prednisone Filgrastim Loading...529. Which of the following is the substance released from the parietal cells of the stomach? Pepsinogen Hydrochloric acid Mucus Gastrin Loading...530. Which of the following amino acids is a non essential? Glutamic acid Aspartic acid Histidine Alanine Asparagine Loading...531. Which one of the following cells is neuroendocrine and found within the epithelium of the bronchi? Macrophages K cells Clara cells Pneumocytes type II Pneumocytes type I Loading...532. Which one of the following is most likely normal in duodenal ulcer? Fasting serum gastrin Response of gastrin to food Pepsin secretion Parietal cell mass Loading...533. Which one of the following antibiotics is the empiric treatment of cellulitis in a diabetic patient? Amoxicillin Imipenem Neomycin Vancomycin Loading...534. PITUITARY HORMONE is synthesized in the pituitary gland. The pituitary gland is divided into two anatomical lobes, one of these lobes is called the Anterior lobe. The anterior lobe is also called as following? Uterohypophysis Adenohyperphysis Neurohyperphysis Neurohypophysis Adenohypophysis Loading...535. A 75-year-old man develops sudden onset of shortness of breath at the orthopedic department. He was admitted for suspected pathological fracture of femur 3 days ago. On examination, his pulse is 122, blood pressure 90/60, respiratory rate 34/min and oxygen saturation is 92%. Lung sounds are clear bilaterally. Heart rhythm is regular with no murmurs or gallops. What is the appropriate immediate step to improve this patient’s condition? Subcutaneous injection of epinephrine Intravenous injection of broad spectrum antibiotics Intravenous injection of heparin Electric cardioversion Call the cardiology attendant Loading...536. A 65 year old man presents to the clinic complaining of weakness and recurrent infections for 6 months. He has no significant medical, surgical or family history. Physical examination reveals multiple enlarged lymph nodes. Histopathology reveals excessive mature B cells that mark strongly with CD5 and CD23 and weekly with CD22. They also have weak expression of kappa chains on the plasma membrane. What is the most likely diagnosis? Chronic myeloid leukemia Hairy cell leukemia Chronic lymphocytic leukemia Acute lymphatic leukemia Sezary syndrome Loading...537. A 25-year-old woman presents to the clinic complaining of general aches for two years. Pain is getting worse over the past 3 months. Every morning, she has stiffness all over her body, which is usually relieved in about 5-10 min. She has no history of trauma or any medical condition. Her BMI is 21 and she has no rash or joint swelling. She has multiple tender points. All laboratory investigations are within normal limits. What is the most appropriate management of this patient? Perform electromyogram (EMG) Perform nerve conduction studies Start duloxetine Start prednisone Start hydrocodone Loading...538. Sjögren syndrome is characterized by a dry mouth and lack of tears. what is the recommended drug for this syndrome? Atropine Pilocarpine Cyclopentolate Tropicamide Bethanechol Loading...539. A 45-year-old man is rushed to the emergency room having severe headaches and recurrent fever started 1 week ago, a week after he came back from a trip to Africa. Physical examination reveals high fever and splenomegaly. Brain imaging reveals signs of cerebral involvement. Which of these following parasites is likely causing the patient’s symptoms? Plasmodium falciparum Plasmodium malariae Plasmodium vivax Babesia microti Loading...540. A 2-month-old child is brought to the clinic by his parents with a complaint of failure to thrive. During an examination, the baby suffers a seizure. Test of stat serum chemistries indicates hyperlipidemia, severe hypoglycemia, ketosis, and lactic acidosis. Hepatomegaly is also confirmed by both physical examination and CT scan. Which of the following conditions is the child suffering from based on these findings? Von Gierke disease Pompe disease Gaucher disease Niemann-Pick disease Loading...541. Which one of the following drugs is used to treat asthma? Hydrochlorothiazide Indanyl carbenicillin Ipratropium Ezetimibe Repaglinide Loading...542. Which one of the following urine electrolytes in the best to estimate extracellular fluid (ECF) volume in metabolic alkalosis? Urine sodium Urine urea Urine chloride Urine anion gap Loading...543. Which one of the following drugs is a Thiazide Diuretic? Atorvastatin Ezetimibe Indanyl carbenicillin Fenofibrate Indapamide Loading...544. You receive a phone call from the nurse of a nursing home telling you that your patient refused to take her medications for the third day. She is 75 years old, competent and has disability of both lower limbs. What is your best response to the nurse’s concern? Call her family and address this issue with them to find the best way to solve this problem to avoid any blame if something happens to her Tell the patient that if she doesn’t take her medications then, there is no need to take any future appointments Get help of the staff in the nursing home to force the patient to take her medications as you are responsible for any complications that could happen to her if she doesn’t take her medications. Ask the patient for the reason of refusal and don’t force her to take her medications Loading...545. Which of the following medications inhibits folic acid synthesis through its effect on dihydropteroate synthetase enzyme? Direct inhibition of the proton pump Suppression of secretory responses to food stimulation Formation of a protective coating of the ulcer beds Increased mucus and bicarbonates secretion and decreased HCL secretionich of the following is the mechanism of action of misoprostol for the treatment of peptic ulcer? Loading...546. Which of the following options is the adverse effect of Vancomycin? All of the above Chill's Fever Redman syndrome Phlebitis Loading...547. Which of the following agents reduce the blood levels of certain drugs through its action on hepatic P450 system? Guava juice St. John’s wart Grapefruit juice Kava Loading...548. A drug increase cAMP results in activation of protein kinase? Aspirin Dobutamine Tirofiban Clopidogrel Ticlopidine Loading...549. Which of the following is the most effective treatment of a case of an old man with benign prostatic hypertrophy (BPH)? Propranolol Doxazosin and finasteride Finasteride Doxazosin Loading...550. A 22-year-old man presents to the clinic due to excessive urination. He goes to the restroom almost every 15 minutes. His physical examination is otherwise normal. Laboratory tests show Serum Na: 140 mEq/Lat is the most likely diagnosis? Diabetes insipidus Psychogenic polydipsia Urinary tract infection Solute diuresis Diabetes mellitusine Na: 18 mEq/L Urine osmolality: 260 mOsm/kg after 4h fluid deprivation.Page 23 of 66 Loading...551. A 19-year-old man presents with syncope, dyspnea and chest pain with exercise. A crescendo-decrescendo murmur without carotid radiation is heard over the left sternal border. What is the most likely diagnosis? Mitral stenosis Hypertrophic cardiomyopathy Aortic stenosis Myocardial infarction Loading...552. Which one of the following factors is the most accurate measure for the severity of diabetic ketoacidosis? Urine ketones Serum glucose level Blood ketones Serum bicarbonate level Loading...553. Which one of the following types of cells is involved in foreign body reaction? Plasma cell Neutrophil Giant cell Eosinophil Loading...554. Which one of the following blotting procedures is the best for studying mRNA levels? Southern blot Southwestern blot Northern blot Western blot Loading...555. A drug that belongs to Loop Diuretics is one of the following? A & B Furosemide Cefazolin Sulbactam Bumetanide Loading...556. A drug that is a part of Aminoglycosides is following? Cefaclor Cefdinir Cefepime Tobramycin Loading...557. What is the meaning of Dose Dumping phenomenon? High dose of IV drugs Excess release of glucose Excess release of Insulin Excess release of control released drugs Excess release of gastric acid Loading...558. Which of the following drugs causes peripheral edema? Somatrem Oxytocin Amlodipine Labetalol A & B Loading...559. A 49-year-old man who is recently diagnosed with hypertension and has a history of bronchial asthma and Raynaud syndrome visits his physician for initiation of his treatment plan. In selecting the appropriate antihypertensive drug, which of the following is the best treatment for this patient? Atenolol Verapamil Captopril Diltiazem Metoprolol Loading...560. Anterior spinal artery arises from which of the following arteries? External carotid artery Basilar artery Vertebral artery Internal carotid artery Loading...561. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Pyrazinamide A & B Furosemide Rabeprazole Ibandronate Loading...562. Which of the following is the proper treatment for a case of chronic emphysema in a stable patient with a resting oxygen saturation of 86%? Continuous supplemental oxygen Albuterol inhaler as needed Supplemental oxygen at night Daily oral prednisone Loading...563. What is the most appropriate next step in management of a patient complaining of symptoms of GERD? Endoscopy Omeprazole Barium swallow Ranitidine Loading...564. Reversible neutropenia and thrombocytopenia is the adverse effect of following drug? Nystatin Amphotericin B Ketoconazole Flucytosine Loading...565. Which one of these drugs is associated with aplastic anemia? Chloramphenicol Penicillin Nitrofurantoin Metronidazole Loading...566. Which one of the following agent is a insulin? Aspart Atorvastatin Somatostatin Torsemide Desmopressin Loading...567. Which of the following cell types is responsible for forming the blood brain barrier (BBB)? Microglia Schwann cells Oligodendrocytes Astrocytes Loading...568. Which one of the following disorders is accompanied by blue sclera? Duchenne muscular dystrophy Osteogenesis imperfecta Systemic lupus erythematosus Neurofibromatosis type 2 Loading...569. Which one of the following conditions characterized by hemolytic episodes caused by increased erythrocyte sensitivity to complement lytic actions? Sickle cell anemia Hereditary spherocytosis Glucose-6-phosphate dehydrogenase deficiency anemia Paroxysmal nocturnal hemoglobinuria Loading...570. Which of the following should be added to premature infants of breast-feeding mothers after 2 month of age? Copper Zink Vitamin C Iron Loading...571. Administration of which one of the following substances most likely reverses the course of Wernicke-Korsakoff syndrome? Riboflavin Vitamin K Thiamine Niacin Loading...572. Which one of the following conditions is a long term complication of cystic fibrosis? Adenocarcinoma of the lung Bronchiectasis Pneumothorax Emphysema Loading...573. Type of hypoglycemia in which patient feels hypoglycemic symptoms but the blood glucose level is normal or slightly above normal? Pseudo hypoglycemia Type 1 diabetes Mellitus Type 2. Diabetic mellitus Gestational Diabetes mellitus Loading...574. Which one of the following drugs is a selective beta-1 agonist? Dobutamine Amrinone Digoxin Dopamine Loading...575. Which of the following is the most common cancer of the lower third of esophagus in non-alcoholic, non-smoker patients? Melanoma Sarcoma Squamous cell carcinoma AdenocarcinomaPage 24 of 66 Loading...576. Which one of the following is the most common cause of non-adherence to administration of prescribed drugs? Forgetfulness Food restrictions Frequent dosing Fear of addiction Loading...577. Which of the following medications acts to prevent cholesterol absorption at small intestine brush border? Gemfibrozil Cholestyramine Ezetimibe Colestipol Loading...578. What is the proper treatment of adrenal insufficiency? Adrenaline Prednisone Fludrocortisone Prednisone and fludrocortisone Loading...579. A 57-year-old man with a long history of type 2 diabetes visits the clinic for follow up. He takes metformin, aspirin and pravastatin. His blood pressure was high in the last 2 visits. He made lifestyle changes in the form of diet and exercise but they did not help in lowering his blood pressure. His BMI is 25% and his blood pressure today is 150/92 mmHg. What is the most appropriate treatment for this patient’s hypertension? Continue lifestyle modification for 3 months Minoxidil 30 mg daily Lisinopril 10 mg daily Metoprolol 25 mg daily Hydralazine 50 mg daily Loading...580. A concerned mother has brought her 8-year old girl to the gynecology clinic because of enlarged breasts. Her daughter has been feeling depressed as her schoolmates make fun at her for her large breasts. There has no axillary or pubic hair. There is no history of menarche. Her voice did not change. Her examination is completely normal. What is the most likely diagnosis? Androgen insensitivity syndrome Isolated premature thelarche Pituitary adenoma Congenital adrenal hyperplasia Precocious puberty Loading...581. Which of the following explains the benefit of lactulose in hepatic encephalopathy? Lactulose antagonize the action of ammonia on hepatic cells Lactulose converts to lactic acid by intestinal bacteria which decreases ammonia Lactulose removes circulating toxins from the blood Lactulose decreases stress of the liver to produce glucose Loading...582. Which one of the following substances is used to acidify the urine? Ammonium chloride Sodium bicarbonate Acetazolamide Loading...583. An antihyperlipidemic drug that consists of a closed six-membered lactone ring in the structural formula? Fluvastatin Atorvastatin Pravastatin Rosuvastatin Simvastatin Loading...584. Mechanism of action of Abciximab is following? Decrease Calcium levels Inhibit COX-1 Inhibit glycoprotein receptors Inhibit ADP mediation Inhibit COX-2 Loading...585. Two sisters, aged 40 and 45 years old, are brought to the emergency room presenting with severely dramatic pneumonia. When the lungs are examined, doctors are able to easily hear rales. The chest x-rays reveal that both sisters have bilateral and diffuse infiltrates. On taking down their history, it was observed that 2 weeks ago both sisters went hiking to a mountainous area where they explored a dusty cave. What would be the most likely causative agent of their condition? Blastomyces dermatitidis Hemophilic influenzae Coxsackie A virus Histoplasma capsulatum Loading...586. Which one of the following antihypertensive medications is NOT safe in pregnancy? Methyldopa Nifedipine Lisinopril Labetalol Loading...587. Acute decrease in response to a drug after initial or repeated intake is known as which of the following drug interactions? Additive Synergetic Tachyphylactic Permissive Loading...588. Which one of the following anti-arrhythmic drugs may lead the development of torsade de pointes at therapeutic doses? Quinidine Adenosine Lidocaine Propranolol Loading...589. Which one of the following viruses is responsible for the development of viral myocarditis? Mumps virus Coxsackie B virus Adenovirus Rhinovirus Loading...590. Blockage of ɑ1 and ɑ2 adrenergic receptors on the arteriolar beds lead to following? None Reduce peripheral resistance Increase renin secretion Increase renin secretion Increase peripheral resistance Loading...591. Cardiac glycosides are used in the treatment of congestive heart failure and atrial fibrillation. Given the differences between the cardiac glycosides in their length of action and organs of major excretion, the correct statement concerning the use of digitoxin is: gastrointestinal absorption of digitoxin is incomplete and highly variable within patients digitoxin is excreted primarily unchanged in the kidney with a half-life of about 24 hours digitoxin is only available as an oral preparation digitoxin is highly protein-bound in the serum digitoxin has a much higher incidence of toxicity in patients with renal disease Loading...592. What is the antidote to Atenolol? Pyridoxine Glucagon Flumazenil atropine Loading...593. A patient with a history of lower leg fracture presents with severe pain, paresthesia, pallor, poikilothermia, pulselessness and paralysis of the affected leg. Which of the following is the immediate treatment of this case? Referral to orthopedics Send home and observation Intravenous broad-spectrum antibiotics Fasciotomy and tissue perfusion Loading...594. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? A & B Furosemide Rabeprazole Ibandronate Isoniazid Loading...595. Which of the following proteins in the serum transport drugs? All of the above Organic anion polypeptides Albumin A & B Alpha-1 acid glycoprotein Loading...596. Which of the following is the best therapy for essential tremors? Propranolol Haloperidol Physiotherapy Metoclopramide Loading...597. Deficiency of which of the following enzymes results in elevated serum levels of alanine and lactate? Alanine aminotransferase Pyruvate dehydrogenase Glucose-6-phosphatase Lactate dehydrogenase Loading...598. The therapeutic indication of Clomiphene drug specifically is to treat the following disease? Treat osteoporosis Fluid retention Estrogen-dependent Breast Cancer Induce ovulation Thromboembolic disease Loading...599. Which type of hypersensitivity reaction develops from Mycobacterium tuberculosis? Type IV Type I Type III Type II Loading...600. Sensations to the external auditory meatus is innervated by which of the following nerves? Facial nerve Vagus nerve Auriculotemporal nerve Great auricular nervePage 25 of 66 Loading...601. Which of the following drug belongs to Sulfonylureas? Glimepiride Urae Niacin Oxacillin Cefoxitin Loading...602. A thiophene-containing agent that blocks the synthesis of leukotrienes by inhibiting 5_ lipoxygenase is the following? Montelukast Zileuton Zafirlukast Acetaminophen Loading...603. Which of the following is the next step to investigate oliguria in a catheterized patient? Measure urine specific gravity Start intravenous fluids Measure serum creatinine Irrigate the catheter Loading...604. Which one of the following tumors is commonly associated with mutations affecting tumor suppressor gene (APC) and TP 53? Colorectal adenocarcinoma Invasive ductal carcinoma of the breast Small cell carcinoma of the lung Hepatocellular carcinoma Loading...605. Which one of the following effects is caused by administration of mecamylamine? Tremors Tachycardia Hypertension Pupillary constriction Loading...606. Which of the following is the coagulation parameter affected by warfarin? Prothrombin time (PT) Bleeding time Partial thromboplastin time (PTT) Loading...607. Which of the following placental sites of insertion most likely predispose to an inverted uterus? Anterior Lower Fundal Posterior Loading...608. A young man complains of daytime sleeping, cataplexy and sleep paralysis. Which of the following is the best treatment? Zolpidem Diazepam Hydroxyzine Modafinil Loading...609. Which one of the following drugs is a thiazide diuretic drug? Bumetanide Acetazolamide Chlorthalidone Amiloride Loading...610. A study is conducted to evaluate the action of a new oral antidiabetic drug in patients with new onset type II diabetes. All patients involved in the study are informed that they would be treated with a new oral antidiabetic drug. They are divided into three groups and each group would be treated with a different dose. Drug assessment is determined based on testing serum glucose and HgA1C regularly throughout the study. Which of the following best describes this type of study? Randomized controlled trial Double blind clinical trial Case-control study Single blind clinical trial Cross sectional study Loading...611. In cases of atrial septal defect (ASD), foramen ovale is formed by incomplete development of which one of the following structures? Ostium secundum Septum primum Ostium primum Septum secundum Loading...612. Primitive spermatogenic germ cells are located in which one of the following sites? Seminal vesicles Vas deferens Seminiferous tubules Interstitium of the testes Loading...613. A-62-old woman presents to the ER in coma. Examination reveals temp of 90 F, pulse of 50, blood pressure of 100/60 and diffuse hyporeflexia. Thyroid gland is enlarged. What is the best next step? Rapid rewarming Obtain T4 and TSH and wait for results Begin intravenous fluids Intravenous levothyroxine and glucocorticoid Loading...614. A young man complains of little finger numbness and difficulty gripping things. Which of the following is the affected nerve root? Cervical 5 Cervical 8 Cervical 7 Cervical 6 Loading...615. Amphotericin B exerts its anti-fungal effect by which of the following mechanisms? Inhibition of fungal protein synthesis Alteration of cell membrane permeability Inhibition of cell wall synthesis Inhibition of fungal cell wall synthesis Inhibition of DNA synthesis Loading...616. Injury of the C8 and T1 at the lower portion of the brachial plexus most likely affects which one of the following nerves? Median nerve Ulnar nerve Axillary nerve Radial nerve Loading...617. Which one of the following anti-depressant drugs is contraindicated if the patient has a history of seizures? Venlafaxine Imipramine Fluoxetine Bupropion Loading...618. A 4-month-old boy is brought to the clinic for a routine examination. Which of the following vaccines should be administered at this visit? MMR DTaP Varicella Oral polio vaccine Loading...619. Autoantibodies to pancreatic islets Beta cells and insulin are found in the following types of Diabetes? Latent autoimmune diabetes of the adults Type 1 Diabetes mellitus A & C All of the above Type 2 Diabetes mellitus Loading...620. Which one of the following drugs is used for subcutaneous and systemic mycoses? Butoconazole Econazole Itraconazole Griseofulvin Loading...621. Which of the following is a serious complication of ergotamine? Headache Hypotension Depression Prolonged vasospasm Loading...622. Select Phenyl Alkylamine Calcium channel blocker drug? Nifedipine Diltiazem Verapamil Triamcinolone Triamterene Loading...623. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Indanyl carbenicillin Lamivudine Ezetimibe Gemcitabine Capreomycin Loading...624. A 58-year-old man presents to the clinic with sudden weakness of his right arm. He also complains of progressive difficulty breathing on exertion, palpitations and a low grade fever during the last month. Examination reveals elevated jugular venous pressure, a loud S1 and mid-diastolic rumbling murmur hard on fifth intercostal space. Transesophageal echocardiography (TEE) confirms the diagnosis. What is the most likely diagnosis? Vegetative valvular lesions Atrial myxoma Atrial thrombus Left ventricular wall aneurysm Loading...625. Which of the following drugs is used for respiratory virus infections? Capecitabine Miconazole Oseltamivir Ibandronate NaftifinePage 26 of 66 Loading...626. The effect of medications on parasympathetic function declines slowly in which one of the following organs? Heart Smooth muscles Glands Eye Loading...627. Which of the following factors directly stimulates the release of antidiuretic hormone (ADH)? Decreased extracellular fluid osmolality Decreased temperature Increased extracellular fluid osmolality Increased blood volume Loading...628. Hypertriglyceridemia and hypercholesterolemia are the adverse effects of following drugs? Nucleoside analogs Integrase inhibitors Entry inhibitors Protease inhibitors Loading...629. Which one of the following agents is a muscarinic cholinomimetic? Atropine Hexamethonium Tubocurarine Pilocarpine Loading...630. A 90-year-old man is hospitalized from falling and breaking his hip. He has been already in the hospital for 6 days when he developed a burning sensation upon urinating. An analysis of his urine shows plenty of gram positive cocci and leukocytosis. The attendant physician treats him with trimethoprim-sulfamethoxazole. However, the fever still persists. After 2 more days, the patient develops a diastolic murmur radiating to the axilla and a low-grade fever is still persisting. Out of the following, which would be the first line treatment for the cause of the possible infection? Vancomycin Piperacillin Gentamicin Ampicillin Loading...631. - - - disease is inherited disorder of copper metabolism characterized by reduced serum copper & increased cincentration of copper in brain & viscera parkinsons disorder wilsons disorder Gout restless legs syndrome Loading...632. A 72-year-old woman presents for her routine examination. She is healthy and exercising regularly. Her weight is 145 lb. and her height is 5’5. She has a family history of breast cancer. Her pulse is 70/min and blood pressure is 120/80. Her lipid panel is within normal limits. Which one of the following is the most likely risk factor to develop atherosclerosis in this woman? Weight Family history of breast cancer Blood pressure Exercise Age Loading...633. Which one of these drugs is more beneficial to treat hypertension in diabetic patients? Enalapril Verapamil Furosemide Amlodipine Loading...634. Which of the following types of sensations is carried to the thalamus by the anterolateral tracts after crossing the spinal cord? Position Vibrations Crude touch Fine touch Loading...635. Which one of the following drugs reduce the absorption of phosphate when taken with diet? Ezetimibe Hydrochlorothiazide Sevelamer Indanyl carbenicillin Montelukast Loading...636. A 7-year-old boy has a difficult time at school. He sleeps during most of the classes and doesn’t interact with his teachers in class. He is fighting with many of his classmates because of stealing their lunches but he has never started a fight. When teachers tried to contact his family, they found out that his family left a fake address and phone number. What is the most likely cause of this boy’s behavior? Child abuse Mental retardation Oppositional defiant disorder (ODD) Attention-deficit-hyperactive disorder (ADHD) Antisocial personality Loading...637. Amoxicillin inhibits which one of the following enzymes? Transpeptidase Squalene epoxidase Transglycosylase Beta lactamase Loading...638. A 52-year-old alcoholic man complains of painful lesions on his tongue and inside his mouth. He also has hyper-pigmented scales on his face and both hands. He is weak, forgetful and suffers of burning sensation in several parts of his body. He mentions that he has diarrhea for the last two months. Deficiency of which of these vitamins is responsible for this patient’s condition? Vitamin D Vitamin A Folic acid Vitamin C Vitamin B3 (niacin) Loading...639. A 32-year-old man with a history of HIV infection presents to the clinic complaining of fecal urgency and bloody diarrhea. The patient was diagnosed with pneumocystis jiroveci pneumonia 6 months ago. Which of these organisms is the most likely involved in this condition? Entamoeba histolytica Giardia lamblia Clostridium difficile cytomegalovirus Loading...640. Which of the following side effects is most likely associated to spironolactone? Hyperglycemia Hyperkalemia Hypercalcemia Metabolic alkalosis Loading...641. Reflex bradycardia caused by alpha-1-agonists is blocked by which of the following medications? Atropine Phenylephrine Adrenaline Metoprolol Loading...642. Which one of the following factors stimulates the renal secretion of renin? Decreased serum sodium ion concentration Increased pressure in the afferent glomerular arterioles Increased chloride ion concentration in the renal distal tubules Decreased pressure in the afferent glomerular arterioles Loading...643. Which one of the following antipsychotics has higher affinity to both dopamine and serotonin receptors? Fluphenazine Thioridazine Clozapine Haloperidol Loading...644. Which of the following is the mechanism of action of the main drug used for the treatment of high LDL cholesterol? Inhibition of cholesterol uptake by the liver Breakdown of adipose tissues Inhibition of HMG-CoA reductase Decreased synthesis of LDL receptors Loading...645. Carbonic anhydrase enzyme is present in the epithelial cells of one of the following part functional zones of the nephron? The descending loop of Henle The distal convoluted tubules The collecting tubule and duct The ascending loop of Henle The proximal convoluted tubules Loading...646. Which one of the following cholinomimetic agents is used in the challenge test for diagnosis of asthma? Pilocarpine Bethanechol Methacholine Carbachol Loading...647. Which one of the following statements correctly describes the inspiratory reserve volume? Volume of air that can still be inhaled in after a normal inspiration Volume of air that moves into the lung with each normal inspiration Volume of air that remains in the lung after a normal expiration Volume of air that present in the lung after maximal inspiration Loading...648. Which one of the following is the wrong statement about the use of Acetylcholine as a neurotransmitter? Acetylcholine has a positive chronotropic effect Neurotransmitter of somatic nerves In preganglionic fibers terminated at the adrenal medulla Neurotransmitter of parasympathetic nerves Rapidly inactivated by cholinesterase Loading...649. Which of the following is the active form of vitamin D? Cholecalciferol 1,25-dihydroxycholecalciferol 25-hydroxycholecalciferol 1-dihydroxycholecalciferol Loading...650. Which one of the following drugs is a neuromuscular blocker drug? Neostigmine Benztropine Pancuronium Mecamylamine AtropinePage 27 of 66 Loading...651. Which of the following drugs is used to treat pulmonary embolism? Dalteparin Niacin Tolbutamide Oxacillin Cefoxitin Loading...652. Which of the following is the main role of hydroxyurea in treatment of sickle cell anemia? Increase ability of HbS to bind 2.3-bisphosphoglycerate Decrease levels of HbF in red blood cells Increase levels of HbF in red blood cells Decrease oxygen affinity to HbS Loading...653. A 55-year-old woman visits her physician to consult about hormone replacement therapy (HRT).Her physician discuss with her the pros and cons of using HRT. Which one of these benefits is gained by the use of HRT? HRT decrease the risk of breast cancer HRT decrease the risk of coronary artery disease HRT decrease the risk of deep venous thrombosis HRT decrease the risk of hot flashes and vaginal dryness HRT decrease the risk of stroke Loading...654. Mitochondria are NOT found in which of the following organisms? Protozoa Fungi Viruses Yeasts Loading...655. Which one of the following drugs is a natural penicillin with a property of high acid stability than other naturally occurring penicillin? Amoxicillin Penicillin G Methicillin Penicillin V Loading...656. Which of the following group of medications prolongs GABA activity in the brain? Alcohols Barbiturates Benzodiazepines Methamphetamines Loading...657. A 65-year-old man presents with gradual low back pain increasing in intensity for the last six months. X-ray shows several osteoblastic lesions on lower vertebra and pelvic bones. Additional investigations reveal that those lesions are metastases. Which of these is most likely the primary cancer in this patient? Renal cell carcinoma Prostatic cancer Hodgkin’s lymphoma Chronic lymphocytic leukemia Thyroid follicular carcinoma Loading...658. Which of the following are side effects of Aspirin? Peptic ulcer diseased Urticaria Bronchoconstriction Metabolic acidosis All of the above Loading...659. Which of the following conditions is characterized by irregular blotchy patches of hyperpigmentation localized mostly on the face caused by sun exposure, pregnancy and contraceptive pills? Melasma Vitiligo Benign lentigo Freckles Loading...660. Which one of the following drugs is a potassium channel blocker (Class III)? Procainamide Verapamil Carvedilol Amiodarone Loading...661. If the prevalence of a disease is 10%, what is the chance that randomly selected 3 persons out of this population will all have the disease? 0.0.1 0.0001 0.001 0.1 Loading...662. Which one of the following types of cells myelinates axons of neurons of CNS? Schwann cells Oligodendroglia Astrocytes Microglia Loading...663. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Cycloserine Indanyl carbenicillin Aluminium hydroxide Nizatidine Ezetimibe Loading...664. Which of the following drug is a derivative of Acetic acid? Etodolac Diflunisal ketorolac Piroxicam Mefenamic Acid Loading...665. Intramuscular vitamin B12 should be prescribed after gastrectomy. Which of the following gastric cells is responsible for this replacement treatment? Parietal cells Chief cells G cells Goblet cells Loading...666. A 27 year-old woman presents to the clinic complaining of fatigue and constipation. She also notes recent cold intolerance and dry skin. Her obstetric history is significant for a full term vaginal delivery 6 months ago. Her past medical history is unremarkable except for fine tremors and mild palpitations 3 months ago that resolved spontaneously. On examination, her temperature is 97.3 F, her pulse is 54/min, her blood pressure is 120/80 and her thyroid gland is enlarged and not tender. Her thyroid panel shows low T4 and elevated TSH. What is the most likely effective treatment of this condition? Supportive treatment until it resolves Begin methimazole therapy Begin radioactive iodine Life-long levothyroxine Surgery and life-long levothyroxine Loading...667. Taste and visual disturbance is the adverse effect of the following drug? Nystatin Terbinafine Griseofulvin Miconazole Loading...668. Which of the following conditions could be a serious side effect of sumatriptan? Coronary vasospasm Torsades de pointes Cutaneous flushing Dilated cardiomyopathy Loading...669. Prolonged use of which one of the following diuretics can lead to hyperkalemia and gynecomastia? Furosemide Spironolactone Hydrochlorothiazide Acetazolamide Loading...670. Which of the following drug resembles sex steroids and act at other receptors causing gynecomastia and menstrual irregularities at high doses? Bumetanide Furosemide Acetazolamide Spironolactone Triamterene Loading...671. A 21 year old college student was playing basketball with his friends when he fell on his outstretched right hand with the palm down. He stood up and continued playing. After 2 days, he felt swelling and tenderness of his right palm without any deformity. On examination, there is tenderness to deep palpation on the snuff box of this right hand. What is the most likely diagnosis of this patient? Tear of opponens pollicis First metacarpal bone fracture Colles fracture Scaphoid fracture Loading...672. Which of the following drug is a derivative of N- arylanthranilic acid? Etodolac Piroxicam ketorolac Diflunisal Mefenamic Acid Loading...673. Which of the following drug belongs to H2 histamine receptor blocker? Famotidine Niacin Oxacillin Cefoxitin Glimepiride Loading...674. Which of the following is the best next step for a suspicious malignant melanoma? Excision with a safety margin Shave biopsy Excisional biopsy Observation Loading...675. What is the best first step of action for a case of posterior myocardial infarction? Stress test Aspirin 325 mg administration Metoprolol 60 mg administration Tissue plasminogen activatorPage 28 of 66 Loading...676. A middle-aged woman presents to the clinic complaining of visual difficulty. Examination is normal except one abnormal sign. When light is shined in the right eye, both pupils constrict while if it is shined in the left eye, both pupils dilate to the normal size. Which one of the following nerves is affected in this patient? Right oculomotor nerve Left optic nerve Left oculomotor nerve Right optic nerve Loading...677. Which one of the following neurologic drugs can cause diplopia, thickened gums and hirsutism? Phenytoin Valproic acid Carbamazepine Phenobarbital Loading...678. In a case of esophageal dysphagia, which one of the following is considered a mechanical obstruction versus motility disorder? Diffuse esophageal spasm Chagas disease Achalasia Extrinsic compression Loading...679. Which of the following drug prevents bacterial protein synthesis by binding to the 30s ribosomal subunit macrolides lincosamine penicillin tetracyclin Loading...680. Which of the following hormone belongs to the posterior pituitary? Urofollitropin Furosemide Somatrem Vasopressin A & B Loading...681. Which of the following drug belongs to Osmotic Diuretic? Urae Ampicillin Cefoxitin Niacin Oxacillin Loading...682. Which of the following drug belongs to Osmotic Diuretic? Mannitol Ampicillin Cefoxitin Niacin Oxacillin Loading...683. A patient represents with a neck mass. Which of the following suggests the possibility of cancer? History of hoarseness of voice for 3 months History of hypothyroidism Pain or tenderness Recent complaint of toothache Loading...684. Ketorolac is derived from which of the following class? Acetic acid derivative Salicylic Acid derivatives Propionic acid derivative Fenamic acid derivative Enolic acid derivative Loading...685. Which of the following conditions is most likely caused by over-secretion of growth hormone in adults (acromegaly)? Gastric adenocarcinoma Hypothyroidism Malignant melanoma Carpal tunnel syndrome Loading...686. Which of the following is the most likely mechanism of action of hydralazine in treating cardiovascular disorders? Parasympathetic stimulation Sympathetic antagonism Relaxation of arterial smooth muscle Decreased cardiac preload Loading...687. Which of the following laboratory tests is diagnostic for adrenal insufficiency? ACTH stimulation test Serum cortisol Serum ACTH CT scan of adrenal gland Loading...688. Which one of the following agents is insulin? Somatostatin Atorvastatin Desmopressin Torsemide Glargine Loading...689. Naphthalene ring containing Antihyperlipidemic drug in the structural formula is the following? Fluvastatin Simvastatin Atorvastatin Rosuvastatin Colestipol Loading...690. A woman, tested genetically for glucose-6-phasphate dehydrogenase deficiency, is found to have only one defective X chromosome. She is married to a man with normal X chromosome. She is pregnant with a female fetus. Which of the following is most likely expected in her baby girl? The baby has no chance to be a carrier The baby has 50% chance to clinically have the disease The baby has 100% chance to clinically have the disease The baby has 50% chance to be a carrier Loading...691. A week old female presents for her first checkup. Examination reveals jaundice and splenomegaly. Laboratory investigations show: Total bilirubin level: 27 mg/dL Direct bilirubin: 0.6 mg/dL Hgb: 10.1 g/dL Reticulocytes: 6% A blood smear shows burr cells and spherocytosis. Which of these tests will be positive in this patient? Metabisulfite test Schilling test Acid hemolysis test Coomb’s test Osmotic fragility test Loading...692. A 48-year-old woman is taken for autopsy after she is pronounced dead. Her family found her unresponsive and the ER team performed CPR but she didn’t respond. The autopsy reveals the cause of death as internal hemorrhage from an artery close to the posterior wall of the body of the stomach due to erosion of a gastric ulcer. Which of these arteries is most likely involved in this case? Left gastric artery Celiac trunk Right gastric artery Superior mesenteric artery Splenic artery Loading...693. Imidazoline derivative drug with Alpha1 adrenoceptors effect? Apraclonidine Oxymetazoline Brimonidine Clonidine Phenylephrine Loading...694. Which one of the following statements about the use of Aspirin is wrong? Repress the sensation of pain Inhibit inflammation Causes Interstitial nephritis Increases alveolar ventilation Loading...695. Which of the following conditions is characterized by the presence of smooth, painless, wart-like lesions on genital organs? Secondary syphilis Gonococcal infection Chlamydia infection Candida infection Loading...696. Amylin analog is one of the following? Pramlintide A & B Furosemide Bumetanide Levothyroxine Loading...697. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? 6-thioguanine Lamivudine Indanyl carbenicillin Capreomycin Ezetimibe Loading...698. Which of the following laboratory tests could be slightly increased in Gilbert’s syndrome? Bilirubin, direct Triglyceride Bilirubin, indirect Haptoglobin Loading...699. Autoantibodies to pancreatic islets Beta cells and insulin are found in one of the following types of Diabetes? Gestational Diabetes mellitus Pseudo hypoglycemia Type 1 Diabetes mellitus Type 2 Diabetes mellitus Loading...700. An enolic acid derivative of Nonsteroidal anti-inflammatory drugs also called? Propionic acid Oxicam derivative Acetic acid Salicylates N-arylanthranilic acidsPage 29 of 66 Loading...701. Which one of the following drugs belongs to an alkylating agent? Gemcitabine Capreomycin Streptozocin Lamivudine Indanyl carbenicillin Loading...702. A 32-year-old woman presents with a complaint of severe pain during menstruation. She is prescribed indomethacin. Which is the mechanism of action of this drug to reduce her pain? Inhibits the production of prostaglandin E2 Interferes with the production of leukotrienes Inhibits the production of Phospholipase A2 Stimulates the production of prostaglandin E2 Limits the production of histamine Loading...703. Lidocaine is an effective antiarrhythmic because of which of the following mechanisms? It block beta-receptors It prolongs PR interval It suppresses excitability in ischemic areas of the heart It blocks alpha-receptors It prolongs QT interval Loading...704. Secretion of which one of the following hormones is decreased due to renal failure? Insulin Thyroxin Erythropoietin Glucagon Loading...705. Which of the following is the most common primary disturbance of acid-base balance in pregnant women? Metabolic acidosis Respiratory acidosis Respiratory alkalosis Metabolic alkalosis Loading...706. What is the congenital heart disease most likely associated with Turner’s syndrome? Coarctation of the aorta Atrial Septal defect Transposition of the great vessels Ventricular septal defect Loading...707. Which one of the following drugs is the most effective in midazolam paradoxical reaction? Protamine Adrenaline Albuterol Flumazenil Loading...708. Which of the following is the drug of choice of anaphylactic shock? Phenylephrine Adrenaline Dopamine Diphenhydramine Loading...709. An agent that contains sulfonamide structure in structural formula and blocks cysLT¹ receptor thus blocking the effect of leukotrienes? Zafirlukast Acetaminophen Ergotamine Zileuton Loading...710. A young man complains of syncope, dyspnea and chest pain after exercise. A crescendo-decrescendo systolic murmur is heard over the left sternal border without radiation. What is the most likely etiology? Aortic regurgitation Aortic dissection Hypertrophic cardiomyopathy Aortic stenosis Loading...711. A patient presents with pruritic rash on his face, palms and soles, bloody diarrhea and abnormal liver tests two weeks after bone marrow transplantation. Which of the following is the mechanism of this condition? Activation of the donor T -lymphocytes Activation of the host T-lymphocytes Activation of the donor B-lymphocytes Development of liver failure Loading...712. Which of the following drug is a Dihydropyridine antihypertensive drug? Ethacrynic Diltiazem Bumetanide Carvedilol Amlodipine Loading...713. Which of the following is the main complication of sickle cell disease? Renal failure Hepatic failure Cerebral hemorrhage Autosplenectomy Loading...714. Which one of the following enzymes is associated with Lyesh-Nyhan syndrome? Adenosine deaminase Xanthine oxidase Ribonucleotide reductase Hypoxanthine-guanine phosphoribosyl transferase Loading...715. Which one of the following medications binds tumor necrosis factor (TNF-α) and used in the treatment of rheumatoid arthritis? Infliximab Methotrexate Paclitaxel Trastuzumab Loading...716. Nabumetone is a prodrug derived from which of the following class? Salicylic Acid derivatives Propionic acid derivative Enolic acid derivative Acetic acid derivative Fenamic acid derivative Loading...717. Which of the following procedures is used in case of Barrett esophagus without dysplasia? Endoscopic eradication Endoscopy and biopsy every 6 months Endoscopy and biopsy every 3 years Endoscopy and biopsy every 3 months Loading...718. Which of the following is the correct statement about the difference between a strain and a sprain? Strain affects muscles or ligaments while sprain affects tendons Strain affects ligaments while sprain affects muscles and tendons Strain affects muscles or tendons while sprain affects ligaments Strain affects tendons and ligaments while sprain affects muscles Loading...719. Chemotherapeutic agents use may result in the loss of individual neoplastic cells through which of the following mechanisms? Phagocytosis Coagulative necrosis Acute inflammation Apoptosis Loading...720. Which of the following drugs is used for respiratory virus infections? Miconazole Naftifine Zanamivir Ibandronate Capecitabine Loading...721. A young boy presents with echolalia, frequent eye blinking, repetitive frowning and head shaking to the left. These movements subside when he answers the questions or clears his throat. Which of the following is the most likely diagnosis? Huntington disease Tourette syndrome Parkinsonism Epilepsy Loading...722. A 4-year-old boy visits you in the clinic with his mother for evaluation of an increasing size of his genitalia. She tells you that her boy had aggressive behavior for the last six months. Besides progressive increase of the length of his penis, he has excessive pubic hair. On examination, his pulse is 80/min. and blood pressure is 140/92 mmHg. You send blood and urine samples for lab testing. What is the most likely initial diagnosis of this boy’s condition? C-11 hydroxylase deficiency Conn syndrome C-21 hydroxylase deficiency C-17 hydroxylase deficiency Loading...723. Which of the following explains the reason for the formation of atheroma at the bifurcations of arteries such as aorta and carotid? Cholesterol breakdown Endothelial dysfunction Regular blood flow Hypoxemia Loading...724. If a dose of the following drug is not properly adjusted it accumulates in neonates that interfere with the function of mitochondrial ribosomes? Amikacin Clindamycin Erythromycin Chloramphenicol Loading...725. Which of the following statements about the use of aminoglycoside is wrong? Bind to 50S subunit Accumulate in renal cortex Causes ototoxicity cross the placental barrier Accumulate in endolymph and perilymphPage 30 of 66 Loading...726. An empty scrotal sac is found upon examination of a newborn male. Which of the following is the most likely abnormality? Agenesis Hypogonadism Venous atresia Undescended testis Loading...727. A 54 year old man visits his physician for evaluation of low back pain. He has a history of lung cancer and he receives a combination of radiation and chemotherapy. His back pain started 3 months ago and now he complains of numbness and tingling in his lower limbs. What is the most likely cause of this patient’s back pain? Muscular spasm of paravertebral muscles Metastases to the vertebral column Primary osteosarcoma Paraneoplastic disease Loading...728. A 74-year-old man presents to the clinic with a complaint of palpitation and lightheadedness. Image studies revealed blockage of the artery to the SA node. This artery arises from which of these arteries? Posterior interventricular artery Left coronary artery Anterior interventricular artery Right coronary artery Circumflex artery Loading...729. An 18 year-old man presents to the office for evaluation of multiple swellings in his neck. On examination, he has multiple large lymph nodes in his neck. Neurological examination reveals poor coordination on walking. Biopsy of lymph node is positive for lymphoma. He is diagnosed with ataxia-telangiectasia. What is the etiology of this disorder? Defective DNA repair mechanisms Deletion of VHL gene on chromosome 3 Mutation in APC gene on chromosome 5 Mutation in the NF1 gene on chromosome 17 Mutation in PKD1 on chromosome 16 Loading...730. Which of the following is the currently drug of choice for the treatment of cutaneous anthrax? Penicillin Gentamicin Ciprofloxacin Azithromycin Loading...731. A 26-year-old man complains of cough, night fever, loss of weight, anorexia and night sweats for six weeks presents to his physician. Physical examination reveals vital signs within normal limits except for slight fever. Chest x-ray shows a small cavity in the right middle lobe and enlarged bronchopulmonary lymph nodes. Blood analysis reveals lymphocytosis and his sputum is positive for acid-fast bacilli. A treatment plan is discussed with the patient and he starts taking his medications.ich of these drugs acts by inhibition of formation of mycolic acid? Pyrazinamide Rifampin Isoniazid Ethambutol Streptomycin Loading...732. Which of the following defense mechanisms is most likely associated with paranoia? Splitting Projection Undoing Superego lacunae Loading...733. Beta-Blocker drug is following? Mecamylamine Atracurium Atropine Nicotine Pindolol Loading...734. Which of the following are the primary vessels responsible for the regulation of blood pressure? Veins Venuses Arteries Arterioles Capillaries Loading...735. Which one of the following statements about the use of Labetalol is incorrect? 3-6 hours duration of action Used as I.V infusion in emergency Selective Beta-1 blocker Doesn't cause reflex tachycardia Loading...736. The sympathomimetic which may promote diuresis by a direct effect on the kidney is: epinephrine norepinephrine Isoproterenol dopamine dobutamine Loading...737. A single injection of leuprolide was given to a man 2 weeks ago. Which of the following changes could be revealed today? Decreased testosterone production Increased testosterone production Increased LH receptors Increased FSH receptors Loading...738. Proliferation of endometrial glands results from stimulation by which one of the following hormones? Follicle stimulating hormone Estrogen Progesterone Androgen Loading...739. Which one of the following drugs can be used as a patch to avoid sea sickness? Nicotine Digoxin Scopolamine Adrenaline Loading...740. Which of the following is considered a dynamic stabilizer of the glenohumeral joint? Subscapularis muscle Glenoid fossa Coracohumeral ligament Inferior glenohumeral ligament Loading...741. A 64-year-old man complains of severe headache, dizziness, nausea and deterioration of vision. Workup shows a decrease in oxygen carrying capacity with no change in PO2 of arterial blood. Which of the following is most likely responsible for this patient’s symptoms? Nitrogen Sulfur dioxide Ozone Carbon monoxide (CO) Loading...742. A 56-year-old woman is found to have elevated intraocular pressure during a routine eye examination. Examination also reveals normal optic disc and open angle of the eye. Her doctor explains to her that her condition is probably due to increased secretion of aqueous fluid. This fluid is produced by which of the following structures? Epithelia cells of the cornea Endothelial cells of the cornea Epithelial cells of the retina Epithelial cells of the ciliary body Loading...743. Which of the following is the indication for surgical repair of abdominal aortic aneurysm (AAA)? Larger than 5.5 cm Larger than 3.5 cm Right after been diagnosed Located under the origin of renal arteries Loading...744. Pins and needles and numbness is the adverse effect of the following drug? Ethambutol Nystatin Streptomycin Isoniazid Loading...745. A 61-year-old man presents to the clinic due to dyspnea on exertion and palpitation for the last year. Last week, he started to feel chest pain when he was ascending a flight of stairs. He smokes a pack of cigarettes a day for 40 years. His vital signs are pulse 88, blood pressure 156/96 and his respiratory rate is 12/min. Laboratory tests shows high LDL cholesterol and low HDL cholesterol. Deep venous thrombosis Atherosclerosisich of the following is the most likely vascular abnormality involved in this condition? Medical calcific sclerosis Hyperplastic arteriosclerosis Loading...746. Which of the following drugs is beneficial in treatment of glaucoma through increased outflow of aqueous fluid by causing contraction of ciliary muscle? Cholinomimetics Diuretics Alpha agonists Beta blockers Loading...747. An 82 year-old woman who underwent right knee replacement yesterday develops new symptoms. Right after surgery, she was agitated, awake all night and refused to eat or take postoperative medications. Today she is still agitated and not oriented to time and place. What is the most appropriate management at this point? Restrain in bed and lorazepam administration Restrain in bed and haloperidol administration Sleep enhancement protocol and family support as well as haloperidol administration Diphenhydramine to enhance sleeping Refer to psychiatry department Loading...748. Which of the following is considered a limiting adverse effect of ACE inhibitors? Hypokalemia Acidosis Hyponatremia Hyperkalemia Loading...749. Which one of the following results of Tensilon test confirms the diagnosis myasthenia gravis Slow and gradual amelioration of symptoms No effect Rapid amelioration of symptoms Exaggeration of weakness Loading...750. A 55 year-old man underwent internal fixation of fractured femur after a motorcar accident and massive bleeding 24 hours ago. He was stable after the surgery and his urine output was normal after he received intravenous fluids. Now he complains of substernal chest pain and shortness of breath. On examination, His temperature is 98.8 F, Pulse is 110/min, blood pressure is 160/100 mmHg and his respiratory rate is 24/min. There is no jugular vein distention. His extremities have established pulses bilaterally and good perfusion. Auscultation reveals harsh systolic murmur across the precordium and crackles on both lung bases. ECG shows sinus tachycardia with delayed precordial transition and no other changes. Laboratory tests including cardiac enzymes are all normal. What is the most likely diagnosis? Pericardial effusion Septic shock Left bundle branch block Acute myocardial infarction Hypertrophic cardiomyopathyPage 31 of 66 Loading...751. Which one of the following drugs is a Meglitinide drug? Fenofibrate Hydrochlorothiazide Indanyl carbenicillin Nateglinide Ezetimibe Loading...752. Which of the following is the most common cause of acute mesenteric ischemia? Mesenteric vein thrombosis Vascular autoimmune disease Embolism Abdominal aortic aneurysm Loading...753. Which of the following is an epithelial tumor with a “stuck-on” appearance? Squamous cell carcinoma Actinic keratosis Seborrheic keratosis Basal cell carcinoma Loading...754. An indirect-acting adrenergic agonist is following? Acetylcholine Amphetamine Clonidine A & B Albuterol Loading...755. Which one of the following drugs treatment usually causes a decrease in intestinal flora? Diuretics Antibiotics Calcium supplements All of the above A & B Loading...756. Blanching and sloughing of skin is the adverse effect of one of the following Direct acting adrenergic agonists? Dopamine Isoproterenol Norepinephrine Dobutamine Epinephrine Loading...757. Which substance is degraded by COMT (Catechol-O-Methyl transferase)? Norepinephrine Catechol estrogens All of these Epinephrine Dopamine Loading...758. A CT scan of the chest shows a focal, wedge-shaped area of hemorrhage in a segment of the lung. Which of the following is the most likely cause of this finding? Atherosclerosis Arteriosclerosis Thrombosis Embolism Loading...759. A 58-year-old woman was hospitalized for 10 days after cholecystectomy. Today, examination reveals swelling and tenderness of her right leg. Diagnosis of femoral vein thrombosis is confirmed. Which of the following is the precipitating factor most likely contributes to this condition? Surgical complication Septicemia Immobilization Effect of medications Loading...760. Phentolamine and Tolazoline have similar structures to imidazoline Alpha Agonists due to lack of? None of these Hydrophilic substitutions on the aromatic ring Lipophilic substitutions on the aromatic ring Hydrophilic substitutions on the Cyclic ring Lipophilic substitutions on the Cyclic ring Loading...761. Which of the following types of receptors are associated with the slowest response time? Ion channel receptors G-protein coupled receptors Steroid receptors Transmembrane enzyme receptors Loading...762. One of the following statements about the use of succinylcholine is wrong? Act like Acetylcholine to depolarize junction Malignant hyperthermia with halothane causes Hyperkalemia Resistance to plasma cholinesterase prolonged apnea in patients deficient in cholinesterase Loading...763. A drug has a large volume of distribution because it accumulates in muscles? Clopidogrel Aspirin Digoxin Nitroglycerin Acetaminophen Loading...764. Which one of the following drugs belongs to an alkylating agent? Lamivudine Cladribine Fludarabine Gemcitabine Melphalan Loading...765. A 23-year-old man with a long history of duodenal ulcer has been treated with cimetidine (Tagamet) for 6 months. What is the mechanism of action of this drug? Stimulates H2 receptors Blocks H2 receptors Adds a protective membrane to gastric mucosa Inhibits H+,K+-ATPase Loading...766. Which one of the following reactions occurs between five days and three months after transplant? Delayed rejection Chronic rejection Acute rejection Hyperacute rejection Loading...767. Alcohol is oxidized in the liver by which one of the following enzymes? Alcohol reductase Alcohol decarboxylase Alcohol dehydrogenase Alcohol oxidase Loading...768. Indapamide belongs to the one of the following class of diuretics? Carbonic anhydrase inhibitors Potassium sparing diuretics Loop Diuretics Thiazide Diuretic Loading...769. A 28 year old woman visits her physician for evaluation of bilateral proximal muscle weakness and muscle pain. Her symptoms started last week and her pain is getting worse. Her records indicate alcohol abuse and cocaine addiction. She is HIV positive and she takes zidovudine. She also takes simvastatin for hypercholesterolemia. A muscle biopsy shows significant changes in mitochondrial histology. What is the most likely etiology of this patient’s condition HIV infection Simvastatin Zidovudine Cocaine addiction Alcohol abuse Loading...770. A 19-year-old man presents to the clinic with a complaint of tremors and incoordination. Serum transaminases are slightly elevated. Slit lamp examination shows brownish corneal deposits. What is the element directly involved in this condition? Iron Copper Zinc Lead Arsenic Loading...771. A 56-year-old man presents to the clinic due to recurrent attacks of severe pain in his right big toe for the last few weeks. During the attacks, his toe becomes painful, red, warm and swollen. Significant improvement occurs after treatment with colchicine. Synovial fluid analysis is performed to confirm the diagnosis. What is the most likely finding to confirm the diagnosis? Cloudy, reddish fluid, with leucocytes’ count equal to the blood count Negatively birefringent urate crystals Calcium pyrophosphate dehydrate crystals Cholesterol crystals Calcium oxalate crystals Loading...772. A 12-year-old girl visits her physician for follow up after treatment with methotrexate for acute lymphoblastic leukemia. Stool analysis reveals blood in stool. Her platelet count is very low. Which of these substances should be administered immediately? Deferoxamine Penicillamine Amitriptyline Leucovorin AVitamin K Loading...773. Which of the following drug is Phenoxy acetic acid derivative diuretic? Benzthiazide Torasemide Ethacrynic acid Chlorthalidone Furosemide Loading...774. A 24 year old medical student visits her physician for a refill of her treatment of depression. She is prescribed imipramine, a tricyclic antidepressant. During discussion of the treatment, her physician mentions that this drug undergoes first pass hepatic metabolism. The prescribed drug is most likely administered by which route? Intravenous Sublingualugs administered by intramuscular, intravenous, subcutaneous and sublingual routes reach the blood stream first before they are metabolized by liver enzymes. Oral Intramuscular Loading...775. Aldosterone is released from which part of the adrenal medulla? All of these Zona fasciculate Zona glomerulosa A & B Zona reticularisPage 32 of 66 Loading...776. Aldosterone production is reduced by using one of the following drugs? Diltiazem Erythromycin Aspirin Lisinopril Loading...777. Which of the following drugs appears unchanged in the urine? Amantadine All of the above Zanamivir A & B Oseltamivir Loading...778. Which one of the following drugs mediates histamine release from mast cells causing flushing? Caspofungin Terbinafine Griseofulvin Nystatin Loading...779. Which one of the following medications is used in cases of schizophrenia to treat involuntary movements caused by the use of antipsychotics such as haloperidol? Benztropine Chlorpromazine Lamotrigine Sertraline Loading...780. Which one of the following enzyme deficiencies is related to Tay-Sachs disease? Hexosaminidase A deficiency Arylsulfatase A deficiency Sphingomyelinase deficiency Glucocerebrosidase deficiency Loading...781. Which of the following drug can disrupt the enteric coating by increasing the Gastric PH? Glimepiride Sitagliptin Cefoxitin Omeprazole Oxacillin Loading...782. Which of the following statements correctly describe the lag time of a drug? Time from administration of the drug to reaching minimal effect concentration Time from administration of the drug to reaching maximal effect concentration. Time in which plasma concentration remains the same Time from administration of the drug to appearance in blood Loading...783. Which of the following indicates the probability that a person who has a positive test result actually has the disease? Attributable risk Specificity Positive predictive value Sensitivity Loading...784. Which one of the following drugs blocks the urinary excretion of penicillin which leads to prolonged high serum concentration? Chloramphenicol Probenecid Cimetidine Rifampicin Loading...785. A 62 year-old man complains of fever and diminished consciousness for 2 days. He has been healthy all his life and he doesn’t take any medications. On examination, he responds inconsistently to commands. His temperature is 103 F, pulse 110/min and blood pressure is 80/56 mmHg. His physical examination is otherwise normal. There is no bleeding. Laboratory test are as follows: Hemoglobin: 12 g/dl Disseminated intravascular coagulationukocyte count: 25,000 – 80% neutrophils Platelet count: 20,000at is the most likely diagnosis? Idiopathic thrombocytopenic purpura Thrombotic thrombocytopenic purpura Hemophilia a Hemophilia b Loading...786. A drug that belongs to Loop Diuretics is one of the following? Furosemide A & B Sulbactam Cefazolin Doripenem Loading...787. Which one of the following drugs is a Alpha Glucosidase inhibitors? Repaglinide Hydrochlorothiazide Indanyl carbenicillin Ezetimibe Acarbose Loading...788. Which of the following prostaglandin type also called prostacyclin? PGB PGA PGI2 PGE1 PGE Loading...789. Which one of the following is a fatal complication of multiple long bone fractures in a young age? Fat embolism Pericardial effusion Thromboembolism Deep venous thrombosis Loading...790. Which of the following differentiate neostigmine from pilocarpine? Stimulation of salivary glands Prolonged skeletal muscle contraction Stimulation of bowel motility Acceleration of heart rate Loading...791. Echothiophate, which is used mainly for ophthalmic actions inhibits: Monoamine Oxidase DOPA decarboxylase Acetylcholinesterase Catechol-O-methyltransferase (COMT) Tyrosine hydroxylase Loading...792. Which one of the following glucocorticoids is a short acting? Amiloride Betamethasone A & B Prednisone Hydrocortisone Loading...793. NucleoSide Reverse Transcriptase inhibitors(NRTIs) drug in Antiviral class? Acyclovir Nevirapine Saquinavir Zidovudine Amprenavir Loading...794. Which of the following drugs is neuraminidase inhibitor drug? Miconazole Ibandronate Naftifine Zanamivir Capecitabine Loading...795. A 26-year-old man with a history of HIV infection presents with fatigue and nuchal rigidity for 3 days. Lumber puncture shows increased leukocytes. India ink preparation detects which one of the following organisms? Toxoplasma gondii Aspergillus fumigatus Cryptococcus neoformans Streptococcus pneumonia Loading...796. Which of the following is the diagnostic test used when ultrasound is equivocal for cholecystitis? CT scan Abdominal x-ray Liver function tests HIDA scan Loading...797. A 70-year-old man develops chest pain 2 days after hip replacement. Which is the most likely diagnosis? Myocardial infarction Pulmonary embolism Cor pulmonale Bundle branch block Loading...798. Which of the following is the appropriate next step of action to parents who refuse to vaccinate their child? Obtain a court order Report to Department of Health Services (DHS) Explain the risks and benefits to them and document the conversation Proceed with immunizations Loading...799. A middle-aged woman presents with stabbing chest pain radiates to the back. She has a history of Marfan syndrome and poorly controlled hypertension. What is your diagnosis? Myocardial infarction Aortic dissection Pericarditis Hypertrophic cardiomyopathy Loading...800. Gynecomastia is the adverse effect of the following drug? Ketoconazole Flucytosine Fluconazole GriseofulvinPage 33 of 66 Loading...801. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is NO chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Heparin Metoprolol Aspirin Refer to cardiologist Cardioversion Loading...802. A 69-year-old man presents to the clinic with his wife for evaluation of his memory problem. His wife tells you that her husband has begun to forget recent events insidiously since last year. He forgets recent conversations and recent appointments. He is no longer able to manage his checkbook and daily budget as he used to do. He has no history of general medical condition and he only takes baby aspirin daily. His examination is normal. Mini mental status examination reveals prominent memory loss. MRI shows a few areas of cerebral atrophy. Which of the following is the most likely diagnosis? Lewy body dementia Creutzfeldt-Jakob disease Old age dementia Alzheimer’s disease Vascular dementia Loading...803. Which one of the following is the adverse effect of Heparin? All of the above Osteoporosis Hypersensitivity Thrombocytopenia Bleeding Loading...804. Which of the following organisms is responsible for antibiotic-associated colitis? Clostridium tetani Clostridium difficile Clostridium botulinum Clostridium perfringens Loading...805. Ca+ channel blockers belongs to the one of the following CLASS of Antiarrhythmic drugs? CLASS II CLASS IV CLASS I CLASS III Loading...806. Which one of the following is the adverse effect of ACE inhibitors? All of the above A & B hypokalaemia Skin rashes Dry cough Loading...807. A drug that inhibits the ergosterol synthesis causing disruption of membrane function and Increase permeability? Ketoconazole Amphotericin B Nystatin Flucytosine Loading...808. A 65-year-old man complains of lightheadedness when he gets off bed in the morning. He takes metoprolol and hydrochlorothiazide. Which of the following is the cause of his complaint? Hypertension Vasovagal reflex Aortic stenosis Antihypertensive therapy Loading...809. Which one of these drugs reverses both muscarinic and nicotinic effects of organophosphorus compounds by restoring cholinesterase? Atracurium Pralidoxime Atropine Physostigmine Loading...810. A 45 year-old man presents with progressive burning epigastric pain. He smokes and drinks alcohol socially. Physical examination, laboratory tests and imaging studies confirm the diagnosis of peptic ulcer. He is prescribed omeprazole. What is the effect of this medication that improves this condition? Anti-cholinergic effect Neutralization of gastric acid Blocking of H2 receptor Forming a layer to protect gastric mucosa Inhibition of H+/K+ ATPase pump Loading...811. Which of the following type of virus causes influenza? Orthomyxoviruses Herpesvirus Cytomegalovirus A & B Varicella zoster Loading...812. Which of the following tests is diagnostic in case of a 2-week old boy with persistent vomiting of non-bilious material after feeding? Chest x-ray Abdominal ultrasound Barium studies Esophagostomy Loading...813. Which of the following differentiates HIV virus from RNA tumor viruses? HIV virus is a retrovirus HIV virus contains the pol gene HIV virus has a cytolytic activity HIV virus contains 2 copies of RNA Loading...814. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? A & B Ibandronate Furosemide Caspofungin Ethambutol Loading...815. Which of the following drugs is used to inhibit viral neuraminidase? Capecitabine Acyclovir Zanamivir Naftifine Ibandronate Loading...816. A 2-year-old boy is brought to the emergency room by his mother. She tells you that her boy has been crying since she picked him up yesterday form the daycare. She thinks that he has abdominal pain. He vomited twice and he didn’t want to eat breakfast. There is no history of fever, rashes or any prior illnesses. On examination, there is a diffuse abdominal tenderness. Laboratory tests are significant for amylase of 1500 and lipase of 2500. What is the most likely etiology of this boy’s condition? Congenital annular pancreas Trauma Gallstones Viral infection Cystic fibrosis Loading...817. Which of the following medications is useful to distinguish nephrogenic from neurogenic diabetes insipidus? Acetazolamide Demeclocycline Desmopressin Hydrochlorothiazide Loading...818. Which of the following drug is Pyrazolone Derivative NSAID? Indomethacin Phenylbutazone Nimesulide Ketorolac Diclofenac Loading...819. Which one of the following drugs form insoluble chelates that are not absorbed? A & B All of the above Pioglitazone & Calcium Levofloxacin & magnesium Rabeprazole & Sitaglipton Loading...820. A drug that effects the thyroid hormone is one of the following ? A & B Triiodothyronine Bumetanide Sulbactam Furosemide Loading...821. Which one of the following drugs is contraindicated in a case of osteoporosis? Calcium oxalate Albuterol Simvastatin Prednisone Loading...822. Loss of individual cells by fragmentation of nuclei and cytoplasm caused by a chemotherapeutic agent is produced through which one of the following mechanisms? Acute inflammation Phagocytosis Mitochondrial poisoning Apoptosis Loading...823. Which one of the following anti-hypertensive medications is contraindicated in pregnancy? Nifedipine Methyldopa Ramipril Labetalol Loading...824. Which of the following drug is a part of proton pump inhibitors? A & B Furosemide Mannitol Acetazolamide Rabeprazole Loading...825. Which of the following drugs should NOT be initiated in case of acute decompensated heart failure? Potassium supplements Metoprolol Digoxin LisinoprilPage 34 of 66 Loading...826. Which one of the following types of drug interactions occurs when aspirin is given with acetaminophen? Tachyphylactic Synergistic Permissive Additive Loading...827. Which of the following drug belongs to Sulfonylureas? Cefoxitin Niacin Urae Oxacillin Glyburide Loading...828. Which one of the following conditions is NOT a common cause of vitamin B12 deficiency? Gastric bypass Malabsorption syndrome Diet deficiency of vitamin B12 Intrinsic factor deficiency Loading...829. Which of the following is most likely associated with normal vaginal pregnancy after a previous cesarean section (CS)? Previous CS is performed due to prolonged second stage Previous CS is performed due to breech presentation Previous CS is performed due to arrest of cervical dilation Previous CS is performed due to unknown cause Loading...830. Which of the following types of cells predominantly lines the conducting airways of the lung and is considered an important defense mechanism? Goblet cells Ciliated cells Endocrine cells Basal cells Loading...831. A 53-year-old man visits his physician with a complaint of erectile dysfunction. He is married for 20 years and they have two kids. He had never complained of his sexual performance until last month when he found out that he could not induce a full erection. He has no major health conditions and does not take any medications. He smokes one pack of cigarettes daily for 25 years. He does not drink alcohol or takes recreational drugs. What is the most likely etiology for this patient’s condition? Endocrine Trauma Vascular Pure psychogenic Infection Loading...832. The therapeutic indication of Tamoxifen Drug specifically is to treat one of the following diseases? Estrogen-dependent Breast Cancer Induce ovulation Fluid retention Treat osteoporosis Thromboembolic disease Loading...833. Which of the following predicts better prognosis in cases of breast cancer? Positive estrogen receptor No metastases in the nearest lymph nodes Family history of breast cancer Tumor stage 2 Loading...834. Which of the following conditions is associated with the presence of non-inflammatory follicular papules (comedones)? Pemphigus vulgaris Acne vulgaris Bullous pemphigoid Atopic dermatitis Loading...835. An 80-year-old man is diagnosed with severe atherosclerosis. He has been a heavy smoker for 62 years and also has a long history of hypercholesterolemia. Atherosclerotic occlusion of which of these arteries will cause insufficient perfusion of the urinary bladder? Internal iliac External iliac Inferior epigastric Lateral sacral Loading...836. Which one of the following substances is used to differentiate between central and nephrogenic diabetes insipidus? Cosyntropin Desmopressin Dexamethasone Cortisol Loading...837. Which of the following drug is a Non-dihydropyridine antihypertensive drug? Nifedipine Diltiazem Amlodipine Bumetanide Carvedilol Loading...838. Which of the following is the mechanism of action of metoclopramide? Dopamine D2-receptor antagonist Nicotinic receptor antagonist α-Adrenoceptor antagonist Serotonin reuptake reuptake inhibitor (SSRI) Loading...839. Which one of the following phases of the cell cycle is affected by binding p53 to DNA? M G2 G1 G0 Loading...840. Which one of the following glucocorticoids can cause sodium and water retention? Dexamethasone Betamethasone Cortisol Triamcinolone Loading...841. A 22-year-old woman presents to the clinic for a recurrent urinary tract infection. She is prescribed trimethoprim/sulfamethoxazole. What is the mechanism of action of this antimicrobial drug? Inhibition of folic acid synthesis Inhibition of bacterial wall synthesis Inhibition of bacterial protein synthesis Inactivation of bacterial toxins Inhibition of mycolic acid synthesis Loading...842. Vertebral artery arises from which one of the following arteries? Common carotid artery External carotid artery Internal carotid artery Subclavian artery Loading...843. Amiodarone is considered one of which of the following classes of anti-arrhythmic drugs? Class II Class III Class I Class IV Loading...844. Which of the following drug is a derivative of salicylic acid? Diflunisal Etodolac ketorolac Piroxicam Mefenamic Acid Loading...845. Which of the following drugs acts directly on dopamine receptors to improve the effects of Parkinson’s disease? Selegiline Amantadine Carbidopa Bromocriptine Loading...846. A 57-year-old man with a history of bleeding per rectum visits his physician to discuss the results of his recent CT colpography test. The test was positive for the presence of a colorectal polyp. The sensitivity and specificity of this test to detect a colorectal polyp is 75% and 90% respectively. What is the probability that this patient indeed has a colorectal polyp? 86% 84% 90% 88% 92% Loading...847. Which one of the following treatment most likely prevents meningeal leukemia in a young boy diagnosed with acute lymphoblastic leukemia? High dose of cortisone Cyclophosphamide Radiotherapy Intrathecal methotrexate Loading...848. Which one of the following may precipitate to an acute porphyria attack? Low carbohydrate diet High carbohydrate diet Vegetarian diet Mediterranean diet Loading...849. A patient with a recent history of meningitis develops headache, blurred vision and cognitive decline. CT scan shows enlarged ventricles. Which of the following is most likely responsible for this condition? Destruction of the gray matter Impaired CSF resorption Obstruction of cerebral aqueduct Excessive CSF production Loading...850. Paget disease of bone is characterized by which one of the following features? Increase osteoclastic activity only Decrease osteoclastic activity Increase both osteoblastic and osteoclastic activity Increase osteoblastic activity onlyPage 35 of 66 Loading...851. Which one of the following medical conditions is associated with an arthritis that resembles ankylosing spondylitis? Crohn’s disease Whipple disease Celiac disease Peptic ulcer Loading...852. A 40-year-old woman complains of fatigue, headache and generalized pain for 9 months. She presented to the clinic several times and had multiple negative workups. Her pain started as localized to her head, neck and shoulder but now it is generalized. On physical examination, there are multiple points of tenderness on bony prominences. What is the most likely prognosis of this condition? Slow progression to permanent disability Full recovery with radiation and chemotherapy Full recovery with multiple surgeries Symptomatic improvement with supportive therapy Full recovery with specific medical therapy Loading...853. Which one of the following tests can be used to distinguish between Folic acid and vitamin B12 deficiencies? Serum methionine level Serum cystathionine level Serum methylmalonate level Serum homocysteine level Loading...854. Bronchoconstriction results from stimulation of which one of the following receptor types? M3 cholinergic receptors Beta-2- adrenergic receptors M2 cholinergic receptors Alpha-1- adrenergic receptors Loading...855. Administration of clopidogrel with aspirin is an example of which of the following drug interactions? Tachyphylactic Additive Permissive Synergistic Loading...856. Following drug has a low therapeutic index? Ticlopidine Clopidogrel Aspirin Digoxin Abciximab Loading...857. Which of the following is the main step in treating alcoholic liver disease? Baclofen Disulfiram Abstinence Naltrexone Loading...858. An 80 mg dose of a drug was administered to a patient. 40 mg was eliminated during the first hour. This drug follows first-order elimination kinetics. Which of the following is the amount of the drug remains 3 hours after administration? 20 mg 10 mg None 30 mg Loading...859. Which of the following esophageal disorders is the most likely a complication of HIV infection? Adenocarcinoma Candida esophagitis Esophageal varices Achalasia Loading...860. If the half-life of a certain drug is 5 hours, how long it takes until the drug level reaches 25% of the initial dose? 5 hours 10 hours 7.5 hours 15 hours Loading...861. Which of the following is the mechanism of action of flumazenil in the treatment of lorazepam toxicity? Stimulation of dopamine receptors Inhibition of alpha adrenoceptors Competitive inhibition at benzodiazepine receptors Noncompetitive inhibition of benzodiazepine receptors Loading...862. Which of the following type of virus causes chickenpox? A & B Herpesvirus Orthomyxoviruses Cytomegalovirus Varicella zoster Loading...863. Amylin consecrated with insulin has the following actions except? Suppress appetite Delayed gastric emptying time Decrease postprandial glucagon secretion Increase beta-cell growth Loading...864. A 62-year-old woman visits her physician for a routine physical examination. She has a long history of lower back pain and she takes ibuprofen as needed. She also takes levothyroxine for hypothyroidism. She exercises daily for 30 minutes and follows a regular diet. On examination, her pulse is 45/min. Holter monitor reveals a regular pulse ranging from 40-80 pulse/min. Her thyroid-stimulating hormone is within normal limits. What is the best management for this patient at this point? Repeat Holter monitor examination Refer to a cardiologist Reassurance and follow up visits Pacemaker implantation Perform exercise stress test Loading...865. Which of the following is responsible for the wrinkled appearance of the scrotum? Thickened keratinized epithelium Tunica albuginea Dartos fascia Pampiniform plexus Loading...866. Which of the following joint conditions is characterized by narrowing of joint space and formation of osteophytes? Rheumatoid arthritis Osteoarthriti Pseudo-gout Gouty arthritis Loading...867. A 40-year-old man presents with shortness of breath after a motor vehicle accident. Examination reveals decreased breath sounds in the right side, hypotension and subcutaneous emphysema. What is the most likely diagnosis? Injury to the myocardium Injury to the lung tissue Injury to the right bronchus Injury to the esophagus Loading...868. Following is the Structural analog of the aldosterone antagonist spironolactone with androgenic activity but to a little extent? Bicalutamide Megestrol Acetate Fluoxymesterone Drospirenone Mifepristone Loading...869. Which of the following autoantibodies is associated with diffuse scleroderma? Anti-SSB Anti-DNA topoisomerase 1 Anti-SSA Anti-histone Loading...870. Which of the following medications is selectively used in NSAID-induced gastric ulcer? Cimetidine Bismuth Misoprostol Famotidine Loading...871. Which one of the following antibiotics has NO effect on anaerobes? Tobramycin Clindamycin Metronidazole Ampicillin Loading...872. A 12-year old child is brought to his psychiatrist for an evaluation of abnormal behavior. His teachers contacted his parents several times because he always cheats and lies at school. He also shoots family dog with his BB gun although he gets in trouble doing that. He has no remorse on hitting other kids and has no concern about others’ feelings. Which of the following is the most likely diagnosis? Schizophrenia Attention-deficit hyperactivity disorder (ADHD) Bipolar disorder Conduct disorder Loading...873. Which one of the following drugs results in disulfiram- like action when it is accompanied with alcohol? Cimetidine Ampicillin Cefotetan Dipyridamole Loading...874. Mechanism of action of Aspirin is following? Decrease Calcium levels Inhibit COX-1 Inhibit glycoprotein receptors Inhibit ADP mediation Inhibit COX-2 Loading...875. A patient with acute appendicitis complains of abdominal pain. Which of the following chemical mediators are responsible for this pain? Leukotriene and interlukin-1 Tumor necrosis factor and IgG Prostaglandin and bradykinin Histamine and serotoninPage 36 of 66 Loading...876. Which one of the following is NOT a factor in Apgar Scoring System? Reflex irritability Heart rate Skull dimensions Respiration Loading...877. A drug that is used to treat HIV infections is one of the following? Etidronate Cladribine Niclosamide Praziquantel Tenofovir Loading...878. A patient comes with constipation, incontinence, and a fall in blood pressure. He is being treated for cardiac arrhythmias. Which drug is most likely related to these complaints? Amiodarone Verapamil Quinidine Propranolol Loading...879. A patient presents to the ER with acute myocardial infarction. After administration of aspirin and oxygen what is the nest step of action? Send for echocardiography Initiate perfusion therapy Check cardiac biomarkers Administer metoprolol Loading...880. Which of the following drug has Ocular effects like mydriasis and fixed far vision? Mecamylamine Timolol Phentolamine Phenylephrine Neostigmine Loading...881. A young man was stuck on his leg by a falling rack a week ago. Today, a purple bruise developed on the site of injury. Which one of the following substances is responsible for the color at the site of injury? Hemosiderin Bilirubin Melanin Thromboplastin Loading...882. Which one of the following drugs is a proton pump inhibitor drug? Misoprostol Rabeprazole Cimetidine Sucralfate Loading...883. Which one of the following studies measures heritability and influence of environmental factors? Cohort study Case-control study Adoption study Cross-sectional study Loading...884. A drug that blocks the glycoprotein GP IIb/IIIa receptors of platelets? Clopidogrel Aspirin Dipyridamole Ticlopidine Tirofiban Loading...885. A young man is involved in a car accident which results in laceration to some great vessels and is admitted for surgery. Which of the following organs is the LEAST affected by loss of blood for a an extended period of time? Brain Retina Liver Small intestine Skeletal muscles Loading...886. A 60-year-old man complains of sudden onset of fever, jaundice, right upper abdominal pain and ascites. Liver biopsy shows areas of swelling and necrosis with neutrophilic infiltration. What is the diagnosis? Acetaminophen toxicity Fatty liver Budd-Chiari syndrome Alcoholic hepatitis Loading...887. A) Atropine Penicillamine Dimercaprol Flumazenil Loading...888. Which one of the following symptoms is most likely found in Parkinson’s disease? Chorea Intention tremors Cogwheel rigidity Visual hallucinations Loading...889. A drug is used in severe alcohol poisoning is the following drug? Fomepizole DIGIBIND Calcium Gluconate Amyl Nitrate Loading...890. Which of the following tests would most likely indicates the etiology of vitamin B12 deficiency anemia? Coomb’s test Complete blood count (CBC) Schilling test Osmotic fragility test Loading...891. Which of the following is the most frequent and irreversible side effect of typical anti-psychotics? Dystonia Tardive dyskinesia Anxiety Akathisia Loading...892. A 9-month-child who was delivered after premature labor and is feeding on cow milk and orange juice. What is the predicted deficiency? Vitamin CVitamin D Iron Calcium Loading...893. The World Health Organization develops health care services to help low-economic countries to improve the quality of primary health care for elderly people. What is the most common cause of death in low-economic countries? HIV/AIDS Lower respiratory tract infections Diarrheal diseases Stroke Ischemic heart disease Loading...894. Which of the following pathological terms describes the disordered, non-neoplastic cell growth? Dysplasia Metaplasia Neoplasia Anaplasia Loading...895. Which one of the following drugs belongs to 3st generation Cephalosporins? Cefepime Cefadroxil Cefaclor Cefdinir Loading...896. Which of the following medications may cause acquired angioedema within days to weeks after starting it? Benazepril Clopidogrel Aspirin Propranolol Loading...897. Administration of which one of the following medications can lead to the development of hemolytic anemia? Hydralazine Verapamil Quinidine Propranolol Loading...898. Which one of the following drugs belongs to Antidiarreals? Methyl cellulose Indanyl carbenicillin Nizatidine Ezetimibe Atorvastatin Loading...899. Which of the following features are most likely seen in a case of Takayasu arteritis? Blindness and pulseless upper extremities Major organ failures Febrile lymphadenopathy with rah Blanching and cyanosis of the fingers and toes Loading...900. Which of the following drug belongs to Osmotic Diuretic? Furosemide Mannitol A & B Ampicillin UreaPage 37 of 66 Loading...901. Dose related bone marrow depression is the adverse effect of following drug? Probenecid Ketoconazole Caspofungin Flucytosine Loading...902. Which of the following drugs causes Rhabdomyolysis as an adverse effect? Dronedarone Amikacin Simvastatin Digoxin Warfarin Loading...903. Which one of the following defines the drug efficacy? The minimal amount of drug administered that leads to toxicity The dose of a drug needed to produce a maximal effect The capacity a drug to affect a condition irrespective of the dose The impact of the drug on a wide range of patients Loading...904. Which of the following is the most common cause of nasal obstruction and bleeding in adolescents? Papilloma Nasal polyps Angiofibroma Nasal cancer Loading...905. Which one of the following drugs is used to treat hyperphosphatemia? Alendronate Sodium polystyrene sulfonate A & B Sevelamer Metamucil Loading...906. A 10-year-old boy is brought to the emergency room by his mother due to a long active seizure. He was hospitalized two months ago for status epilepticus and was prescribed valproic acid. What is the first step of action? Airway stabilization and 100% oxygen Intravenous fluids Gastric lavage Intravenous injection of haloperidol Electroencephalogram (EEG) Loading...907. Prophylaxis in HIV patients with TMP-SMX should be initiated at which of the following CD4 counts? Under 200 Under 300 Under 50 Under 100 Loading...908. Indirectly acting reversible cholinergic agonist drug? Acetylcholine Tacrine Echothiophate Pilocarpine Loading...909. A liposomal preparation of which one of the following medications may reduce the incidence of renal toxicity? Amphotericin B Ketoconazole Acyclovir Vancomycin Loading...910. A 37-year-old woman presents to the office for a consultation about family planning. She is married for 11 years and she has never had any extra-marital relationships. They have been tested negative for HIV infection. She hopes to become pregnant and to stop using condoms. She had normal Pap smears for the past 18 years. The last Pap smear was 1 year ago. When does she need to have her next Pap smear? in 3 years During this visit in 1 year in 6 months in 2 years Loading...911. A 69-year-old male with angina develops severe constipation following treatment with: Dobutamine Captopril Propranolol Nitroglycerin Verapamil Loading...912. Low doses of one of the following drugs produce sedation, but at high doses it produces excitement? Atropine Phenylephrine Physostigmine Pirenzepine Scopolamine Loading...913. Which one of the following medications is the best recommended for induction of medical abortion? Progesterone Mifepristone Estrogen Ergotamine Loading...914. Which one of the following drugs has a beta effect (vasodilation) at low doses but when the dose is increased it causes vasoconstriction (Alpha effect) at high doses? Clonidine Isoproterenol Methoxamine Metaproterenol Epinephrine Loading...915. Serotonin Receptor which acts presynaptically at Serotonergic and adrenergic neurons to reduce neurotransmitter release is following? 5HT4 5HT² 5HT³ 5HT¹ 5HT5 Loading...916. A 6-year-old girl is brought to her pediatrician by her mother for consultation. She said that her daughter is frequently bumping into chairs while walking or playing. On examination, she is found to have bitemporal hemianopia. CT scan shows calcification in the pituitary fossa. What is the most likely diagnosis of this condition? Choriocarcinoma Germinoma Gangliocytoma Craniopharyngioma Teratoma Loading...917. What is the antidote of Verapamil? Epinephrine Both C & D can be used Pyridostigmine Calcium Atropine Loading...918. Aztreonam belongs to the one of the following class? Penicillins Cephalosporin Monobactams Carbapenems Loading...919. A drug has black box warning due to severe hematologic ADRs? Digoxin Ticlopidine Aspirin Clopidogrel Dipyridamole Loading...920. Which of the following is the most effective role of probenecid in treating gout? Probenecid decreases production of uric acid Probenecid decreases secretion of uric acid Probenecid decreases reabsorption of uric acid Probenecid decreases inflammation of affected joints Loading...921. A 35-year-old man complains of pain and swelling in the sacro-coccygeal region. Which of the following is the most likely diagnosis? Liposarcoma Suppurative hidradenitis Pilonidal abscess Perianal abscess Loading...922. A 40 year-old woman presents to her regular physician for evaluation of a left adrenal mass. This mass was seen by accident last week on a CT scan during a visit to the emergency room for abdominal pain. Her vital signs, physical examination and review of systems are all normal. Her past history and family history are unremarkable. What is the first step in management for this patient? Perform a needle biopsy Refer to surgery for removal of the adrenal mass Order MRI of the mass Order hormonal assay to evaluate if the mass is functional or not Assure the patient and schedule another CT scan after 6 months Loading...923. Which one of the following statements about the functions of ACE inhibitors is wrong? Increase vasodilation of vascular smooth muscle Increase level of bradykinin Decrease output of the sympathetic nervous system Increase retention of sodium and water Loading...924. A 1-day old full term baby of a 23-year old mother who was delivered yesterday by normal vaginal delivery is coughing, choking and ejecting the formula from his nose and mouth. He also turns blue during feeding. What is the primary diagnosis of this boy? Imperforate anus Tracheoesophageal fistula Tracheomalacia Pyloric stenosis Tetralogy of Fallot Loading...925. Beta-Blocker drug is following? Mecamylamine Atracurium Metoprolol Atropine TacrinePage 38 of 66 Loading...926. A 29-year-old man underwent bone marrow transplantation two weeks ago. Yesterday he developed diarrhea with occult blood and rashes all over his face, hands and feet. Examination reveals jaundice and maculopapular rashes on his face, palms and soles. What are the most likely cells activated in this case? Donor B-lymphocytes Donor T-lymphocytes Host B-lymphocytes Host T-lymphocytes Loading...927. A cytokine that induces proliferation of antigen-primed T cells along with enhancing the activity of NK cells? Tissue necrosis factor-alpha Interleukin-2 (IL-2) Interferon-gamma Interleukin-1 (IL-1) Loading...928. Which one of the following conditions most likely shows lower than normal erythrocyte sedimentation rate (ESR)? Polycythemia Giant cell arteritis Multiple myeloma Pregnancy Loading...929. A 40-year-old male presents with dysphagia of fluids and solids for 2 months. Which of the following is the most appropriate next step of action? Barium swallow Motility studies Endoscopy Acid perfusion test Loading...930. A 45-year-old man is rushed to the emergency room having severe headaches and recurrent fever started 1 week ago, a week after he came back from a trip to Africa. Physical examination reveals high fever and splenomegaly. Brain imaging reveals signs of cerebral involvement. Which of these following parasites is likely causing the patient’s symptoms? Plasmodium vivax Babesia microti Plasmodium falciparum Plasmodium malariae Loading...931. A 23-year-old woman represents to her physician with ptosis, meiosis and anhidrosis in the left eye. Which one of the following drugs is used to determine whether this lesion is preganglionic or postganglionic? Cocaine Epinephrine Phenylephrine Albuterol Atenolol Loading...932. A 5-year-old girl with a mass in her neck is brought to the clinic for an evaluation. Her mother says that this mass appeared 6 months ago and is increasing in size. There is no pain or discomfort. On examination, the mass is in the midline, inferior to the hyoid bone. Laboratory tests reveal normal thyroid panel. Surgery is recommended after a CT scan is performed. What is the most likely diagnosis? Branchial cleft cyst Ectopic thyroid gland Lipoma Dermoid cyst Thyroglossal duct cyst Loading...933. Which of the following treatments should be used in cases of methanol or ethylene glycol poisoning? Pyridoxine Ethanol Sodium bicarbonate Glucagon Loading...934. Studies are done on normal volunteers for phase 1 clinical trials of a new drug. The volume of distribution and clearance has been measured. The researchers now are calculating the half-life of the drug. Assuming that the volume of distribution is 60 L and the clearance is 3 L/hour, what is the approximate half-life of this drug? 18 hours 6 hours 12 hours 14 hours 1/2 an hour Loading...935. A fenamic acid derivative of Nonsteroidal anti-inflammatory drugs also called? N-arylanthranilic acids Salicylates Oxicam Propionic acid Acetic acid Loading...936. A 47-year-old man with a history of chronic renal failure presents to the clinic for a follow up after a kidney transplant three weeks ago. His surgery was successful and his transplanted kidney started producing urine right after the operation. However, today his urine output drops and his serum creatinine begins to rise. There is no fever or dysuria. Urinalysis shows no abnormality. Biopsy from the transplanted kidney shows cellular infiltrate of cytotoxic cells (CD8). What is the most likely diagnosis of this condition? Acute pyelonephritis Chronic rejection Normal reaction Acute rejection Hyperacute rejection Loading...937. Which of the following adverse effects of L-dopa is the most likely the reason to limit the use of it? Depression Nausea and occasional vomiting Dyskinesia Orthostatic hypotension Loading...938. Which one of the following indicates drug resistance? No or minimum effect on a microorganism due to genetic mutation Altered effect of the drug when used with another drug Response to a drug decreases after repeated use Induction of liver metabolism Loading...939. A drug that act as laxative is one of the following? Sulbactam Furosemide Lactulose A & B Bumetanide Loading...940. To diagnose myasthenia gravis we use? Malathion Physostigmine Pralidoxim Ambenonium Edrophonium Loading...941. Which one of the following differentiates exudate from transudate? High osmotic pressure Few leukocytes High specific gravity Low protein content Loading...942. A 22-year-old man visits the clinic for evaluation of fever, headache and dry cough for 7 days. His medical history is unremarkable and he takes no medications. He had no previous similar episodes. On examination, temperature is 101.3 F, pulse is 88/min. and blood pressure is 100/60 mmHg. On auscultation, his lungs are clear bilaterally. X-ray shows diffuse infiltration in the lower lobes of both lungs. What is the most likely causative organism? Fungi Mycoplasma Mycobacteria Streptococci Rickettsia Loading...943. A 70-year-old man is brought to the doctor having a sudden onset of severe lower back pain. Upon conducting a physical examination of the patient, severe kyphosis is revealed. An x-ray of the back shows a compression fracture in the lumbar area of a vertebral body. This is followed by marked thinning of the bones as well. Laboratory tests measuring serum calcium, alkaline phosphatase, phosphorus, and parathyroid hormone levels, all come back within the normal range. What is the most likely reason behind the bone changes in the patient? Osteopetrosis Osteoporosis Osteomalacia Osteitis fibrosa cystica Loading...944. A 26 year old woman is brought to the emergency room due to 2-hour history of hematemesis. She was invited to a banquet at her work and she vomited twice with a considerable amount of blood. Her medical, surgical and family histories are unremarkable. She visits her dentist regularly for recurrent dental caries. She doesn’t smoke or drink alcohol. Her pulse is 100/min, blood pressure is 104/66 and her temperature is 97.8 F. Abdomen is soft, nontender without organomegaly. Her laboratory tests are as follows: Serum sodium 136 meq/L. Serum potassium 2.6 meq/L. Serum chloride 84 meq/L. Serum bicarbonate 38 meq/L. Endoscopic examination reveals erosive esophagitis without any scars or adhesions. What is the most likely diagnosis? Mallory-Weiss syndrome Bulimia nervosa CREST syndrome Staphylococcal food poisoning NSAID-induced esophagitis Loading...945. Which one of the following is an antimuscarinic agent? Neostigmine Echothiophate Pralidoxime Scopolamine Tacrine Loading...946. Which one of the following local anesthetics can NOT be given parenterally due to its physicochemical properties? Benzocaine Etidocaine Procaine Mepivacaine Loading...947. Which of the following is the most likely finding on a biopsy of a case of chronic bronchitis? Abundant mucus with plugging of the bronchioles Non-caseating granuloma Caseating granuloma Interstitial fibrosis Loading...948. Which one of the following drugs is a 2nd generation Cephalosporin? Cefaclor Cefdinir Cefprozil All of the above A & B Loading...949. Which of the following substances lines the vesicles that involved in LDL uptake by hepatocytes? Laminin Transferrin Chylomicrons Clathrin Loading...950. Which of the following is the mechanism of action of cromolyn for asthmatic patients? Inhibits phosphodiesterase Prevents degradation of mast cells Blocks adenosine receptors in bronchial smooth muscle Inhibits COX 2Page 39 of 66 Loading...951. Immune-related problem is one of the following? Aids Fever Headache High Blood pressure Loading...952. A 21-year-old medical student with a history of asthma presents to the clinic for medication refill. He discussed with his physician the pros and cons of treatment with theophylline. One of the disadvantages of using theophylline is low toxic threshold. Which of these drugs is used to treat theophylline toxicity? Atenolol Furosemide Albuterol Epinephrine Digoxin Loading...953. A 21-year-old pregnant woman visits her physician for a prenatal visit. Ultrasonography shows neural tube defects. The patient was not compliant with her medications. Assuming that the condition is caused by deficiency of a certain nutrient, which one of these abnormalities would be seen as well? Normochromic normocytic anemia Macrocytic anemia with neurological signs Coagulation disorder Macrocytic anemia Microcytic anemia Loading...954. In which of the following Diuretic, cyclic sulfonamide is replaced by an Amide? Chlorthalidone Hydrochlorothiazide Bendroflumethiazide Chlorothiazide Methylchlorothiazide Loading...955. A 32-year old diabetic woman delivered a large baby after difficult vaginal delivery. At labor, the head emerged first and then the shoulders were stuck behind the bony pelvis. The obstetrician had to use some tools and maneuvers to deliver the baby. The baby had a good cry and red pink color but his right arm was not moving. It was hanging on his side with medial rotation. Which of these nerve roots are most likely affected? C5 and C6 C8 and T1 C7 and C8 C6 and C7 Loading...956. Which one of the following drugs decreases Glucose absorption? Rasagiline Glipizide Metformin Miglitol Loading...957. A 55 year-old man presents to the clinic because today he noticed that his left scrotum has suddenly gotten larger. He has no fever or pain. Examination reveals enlarged left scrotum with no tenderness or any signs of inflammation. There is a worm-like mass posterior to the left testicle. The mass illuminates and is not reducible on compression or when the patient lying down. What is the best next step in management? Urine culture Abdominal CT scan MRI of the pelvis Assurance and follow up in 2 weeks Refer to surgery for urgent reduction Loading...958. Which of the following is the most common complication of otitis media? Meningitis Hearing loss Brain abscess Drum perforation Loading...959. One of the following statements is not right about the production of Acetylcholine? Uptake of choline is a rate-limiting step Acetylcholine rapidly hydrolyzed by Acetylcholinesterase Acetylcholine is metabolized by COMT Acetylcholine released by an increase in calcium level Neurotransmitter in vesicles are called varicosities Loading...960. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefaclor Cefepime Ceftizoxime Cefadroxil Loading...961. A 78-year-old woman presents to the office with her daughter. Last week, she fell twice while she was walking with her daughter. She was not shaking or lost her consciousness and she got up in a minute. Her medical history is significant for hypertension and osteoarthritis. She takes Lisinopril daily and ibuprofen as needed. She also takes diphenhydramine to help her sleeping during the night. Her vital signs are within normal limits on sitting and standing. All her laboratory tests are within normal ranges. Her mini-mental status test is normal. What is the best explanation for this patient’s fallings? Old age Alzheimer’s disease Side effect of one of her medications Postural hypotension Osteoarthritis Loading...962. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Capreomycin Ezetimibe Capecitabine Indanyl carbenicillin Lamivudine Loading...963. Which of the following tests is most likely used to rule out congestive heart failure in a case of cardiomegaly during pregnancy? Arterial blood gas Echocardiography MRI of the chest Electrocardiogram (ECG) Loading...964. One of the following statements is false about the functions of epinephrine? Hyperglycemic effect Strengthen the contractility of the myocardium Bronchodilation Increased blood supply to the kidney Increase in systolic blood pressure Loading...965. Acetazolamide and other carbonic anhydrase inhibitors act at which part of the kidney? Descending loop of Henle Distal tubule Proximal tubule Collecting duct Loading...966. A 68 year-old woman complains of fever, anorexia and right flank pain for 2 days. She vomited twice today. On physical examination, her temperature is 101.3 F and there is moderate tenderness on the right costovertebral angle. Her urinalysis shows leukocytes and pus cells. What is the most appropriate next step of management? Schedule Intravenous pyelogram Schedule MRI of the abdomen and pelvis Hospitalization and intravenous antibiotics Collect blood and urine samples for culture Outpatient wide spectrum antibiotics and schedule a visit after 3 days Loading...967. Which of the following drug belongs to Carbonic anhydrase inhibitors? Mannitol A & B Urea Acetazolamide Furosemide Loading...968. Which one of the following drugs is a 2nd generation Cephalosporin? Cefadroxil Cefdinir Cefoxitin Cefepime Loading...969. Which one of the following types of necrosis is most likely associated with myocardial infarction? Caseous Coagulative Fibrinoid Liquefactive Loading...970. Amantadine belongs to the class of following drugs? Antipyretic Antibiotics Antiprotozoal Anti malaria Antiviral Loading...971. Which of the following side effect occurs in most of the patients when Alkylating agents and antimetabolites drugs are given in a therapeutically effective dose? Nausea Myelosuppression Gastrointestinal toxicity Gonadal toxicity Thinning of hair Loading...972. Which one of the following conditions is characterized by high blood pressure, hypokalemia and elevated renal potassium? Waardenburg syndrome Liddle syndrome Tay-sachs disease Fanconi syndrome Loading...973. A 2-year-old boy originally from Egypt is diagnosed with anemia after he took antibiotics for the treatment of otitis media. He has two brothers and one sister. One of his brothers was diagnosed with anemia when he was two years old. His parents were given a list of food and drugs that could be associated with this type of anemia. What is the mode of inheritance of this condition? X-linked recessive Autosomal recessive Autosomal dominant Multifactorial Mitochondrial Loading...974. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Indanyl carbenicillin Aluminium hydroxide Nizatidine Capreomycin Ezetimibe Loading...975. Which of the following are the characteristics of Virchow’s triad? Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Hypotension, distant heart sounds and jugular vein distention (JVD) Stasis, hypercoagulability and endothelial damagePage 40 of 66 Loading...976. Which one of the following lipid-lowering agents can cause skin flushing and pruritus? Gemfibrozil Atorvastatin Niacin Cholestyramine Loading...977. A 43-year-old man visits his physician concerned about finding traces of bright red blood on toilet paper after he wipes. His stool has normal color and not mixed with blood. His medical and surgical histories are unremarkable. He has no family history of colon cancer. What is the most appropriate next step in management? Colonoscopy Anoscopy Fecal occult blood test Barium enema Sigmoidoscopy Loading...978. Ibuprofen belongs to one of the following class? Oxicam derivative Propionic acid Acetic acid derivative Fenamates Loading...979. What is the mechanism of action of zileuton? Inhibition of leukotriene production Inhibition of mediator release Inhibition of calcium (Ca2+) channel activity Inhibition of cytokine production Inhibition of muscarinic receptor action Loading...980. Which one of the following cells lines the alveoli and secretes the surfactant? K cells Macrophages Pneumocytes type I Pneumocytes type II Clara cells Loading...981. A 62-year-old woman is noted to have open-angle glaucoma. She inadvertently applies excessive pilocarpine to her eyes. This may result in which of the following? Dilation of blood vessels Constipation Decreased gastrointestinal motility Mydriasis Bronchial smooth muscle dilation Loading...982. A 60-year-old woman presents with severe tearing abdominal pain, nausea and dizziness. The patient is pale and lethargic with blood pressure of 80/50 and diffuse abdominal tenderness. There is no past history of similar episodes. What is the next step? Exploratory laparotomy Ultrasound Laparoscopy Amylase and lipase levels Loading...983. A college student presents to the emergency room with burns involving about 10% of his body surface and localized to his upper chest and right arm. His vital signs are within normal limits. The lesions are painful, erythematous and swollen. Application of pressure produces blanching and is painful. Which of the following is the best next step in management? Broad spectrum antibiotics Surgical debridement and grafting Cleaning, dressing and analgesics Admission to hospital Loading...984. A 19-year-old woman presents with nausea and vomiting. Her last menstrual period was 6 weeks ago. Which of the following is the best next step in management? Beta-HCG Urinalysis Serum electrolytes Complete blood count Loading...985. Liposomal preparation of one of the following drugs decreases the risk of nephrotoxicity? Ethambutol Isoniazid Nystatin Amphotericin B Loading...986. Which one of the following statements about dobutamine is incorrect? Increase contractility Avoid in acute heart failure Increase myocardial cAMP Positive inotropic effect Loading...987. Which of the following substances is responsible for growth of the prostate at puberty? Progesterone Estrogen Dihydrotestosterone Testosterone Loading...988. Which one of the following drugs is a neuromuscular blocker drug? Mecamylamine Atropine Neostigmine Benztropine Succinylcholine Loading...989. A 34-year-old woman presents with weakness, easy fatigability and numbness and tingling of her arms and legs. CBC reveals pancytopenia and marked increase in the MCV of erythrocytes. More investigations reveal chronic atrophic gastritis. What is the most likely diagnosis? Folic acid deficiency anemia Iron deficiency anemia Vitamin B12 deficiency Aplastic anemia Loading...990. Which one of the following drugs belongs to drugs for hepatic viral infections? Ezetimibe Adefovir Indanyl carbenicillin Aluminium hydroxide Capreomycin Loading...991. Which of the following is the classic electrocardiogram (ECG) finding in inferior myocardial infarction (MI)? S-T segment elevation in leads II. III and aVF Sawtooth P waves Diffuse S-T segment elevation S-T segment elevation in anterior leads (V1-V4) Loading...992. A 35-year-old man with a history of Marfan syndrome presents to the emergency room complaining of chest pain radiating to his upper back between shoulder blades. His blood pressure is 170/90 mmHg in his right arm and 90/60 in left arm. His pulse is 98/min. Cardiac examination reveals regular rhythm with diastolic murmur on the left lower sternal border. Lung examination reveals clear bilateral breath sounds. An echocardiogram shows dissection of the thoracic aorta involving the left subclavian artery. Which of these is the recommended immediate drug of choice? Calcium gluconate Clopidogrel Heparin Sodium nitroprusside Labetalol Loading...993. Which of the following is the effect of digoxin on a case of heart failure? Decreased stroke volume and vagal activity Increased sympathetic tone and decreased vagal activity Rapid conduction through AV node Increased stroke volume and cardiac output Loading...994. Which of the following is the most likely developmental defect associated with tetralogy of Fallot? Transportation of the great vessels Patent ductus arteriosus Anterosuperior displacement of the infundibular septum Bicuspid pulmonary artery Loading...995. Which of the following errors is considered if the researcher states that there is no difference when one exists? Type II error Type 1 error Loading...996. What is the most common cause of epididymitis in males older than 35 years of age? Gonococci Streptococci E Coli Chlamydia Loading...997. What is the antidote to snake bites? Pralidoxime Antivenin Nalmefene A & B Vitamin K Loading...998. A newly born infant is found to have a deformity on the iris. Eye exam reveals keyhole-shaped defect of the iris. Which of the following terms describes this defect? Coloboma Anisocoria Heterochromia iridis Aniridia Loading...999. Which one of the following drugs reverses the effects of heparin? Epinephrine Protamine Chloroquine Warfarin Loading...1000. Which of the following drug is belong to the dihydropyridines class of antihypertension? Amlodipine Diltiazem Amiloride Verapamil LosartanPage 41 of 66 Loading...1001. A 23-year-old woman was involved in a motor car accident three days ago. She was hypotensive and diagnosed with internal bleeding. She received several units of blood. Today her urine output is very low for the last six hours. Her urinalysis showed hematuria, proteinuria, muddy brown epithelial cells and granular casts. Her lab tests also show BUN: 26 mg/dL and serum creatinine: 2.6 mg/dL. What is the most likely diagnosis of her renal pathology? Acute tubular necrosis Acute glomerulonephritis Interstitial nephritis Traumatic avulsion of the ureter Loading...1002. Which of the following is the most dangerous adverse effect of chronic alcohol abuse? Cutaneous vasodilation Respiratory depression Impaired judgment Live cirrhosis Loading...1003. Which one of the following drugs belongs to drugs for hepatic viral infections? Interferon Indanyl carbenicillin Capreomycin Ezetimibe Aluminium hydroxide Loading...1004. Didanosine belongs to the class of the following drugs? Antiviral Antipyretic Antiprotozoal Antibiotics Anti-malaria Loading...1005. Which of the following virus infections mostly develops chronic hepatitis? Hepatitis B Hepatitis A Hepatitis C Loading...1006. Epinephrine acts on which one of the following receptors to constrict vascular smooth muscle? α2-Adrenoceptors β2-Adrenoceptors α1-Adrenoceptors β1-Adrenoceptors Loading...1007. Butoconazole belongs to the class of following drugs? Antifungal Antiviral Antibiotics Antiprotozoal Antipyretic Loading...1008. Chronic use of which of the following drugs may increase the toxicity of acetaminophen? Ketoconazole Cimetidine Verapamil Ethanol Loading...1009. Histamine Receptor found on the mucus layer causing the production of gastric acid secretion is the following? H⁵ Histamine receptor H³ histamine receptor H² histamine receptor H¹ histamine receptor H⁴ histamine receptor Loading...1010. Which of the following drug belongs to the Nonnucleoside reverse transcriptase inhibitor? Efavirenz Maraviroc Abacavir Atazanavir Indanyl carbenicillin Loading...1011. Which one of the following medications inhibits HMG-CoA reductase? Digoxin Aspirin Tacrolimus Simvastatin Loading...1012. A 65-year-old man is scheduled for a repair of an abdominal hernia. The patient has an abdominal hernia that can be reduced by pushing the contents of the abdomen back through the external ring. While performing the repair, the surgeon observes that the hernial sac is protruding from the superior abdominal wall to the inguinal ligament. It is also medial to the inferior epigastric vessels. After observing all these, what can be concluded about the type of a hernia the patient is suffering from? Femoral hernia Indirect inguinal hernia Hiatal hernia Direct inguinal hernia Loading...1013. Which of the following drug are Nonsteroidal antiestrogens? Estradiol acetate Estrogen Exemestane Estradiol Tamoxifen Loading...1014. Acyclovir belongs to one of the following classes of drugs? Antibiotics Antipyretic Antiviral Antiprotozoal Antifungal Loading...1015. Which of the following drug are indandione derivative oral anticoagulants? Dicumarol Menadione Phenindione Phytonadione Heparin Loading...1016. Which one of the following is the most appropriate next step in suspected scaphoid fracture (with normal radiology)? Thumb spica splint Admission and observation Assurance and follow up in 2 weeks Emergent orthopedic consultation Loading...1017. If a new effective treatment for COVID-19 is initiated, which of the following will be the appropriate effect on incidence and prevalence? No change in both No change in incident and decreased prevalence Both incident and prevalence decrease Incident decreases with no change in prevalence Loading...1018. A 24-year-old man presents to the clinic with a complaint of grey-colored penile discharge and burning micturition for 2 days. His medical, surgical and family histories are unremarkable. Examination reveals a purulent discharge that can be seen by squeezing his penis. Penile swab shows Gram-negative diplococci within neutrophils. What is the most appropriate treatment? IV ceftriaxone and oral doxycycline IV ceftriaxone Oral doxycycline IV penicillin IM ampicillin Loading...1019. Which one of the following drugs is a beta blocker (Class II)? Procainamide Amiodarone Verapamil Carvedilol Loading...1020. As physicians, we need to know some definitions in Genetics, which are related directly to our practice and guide us to diagnose and treat many genetic disorders. These items include genome, genotype, phenotype, genetic code, gene expression, etc. Which one of the following choices describes the definition of a phenotype? DNA structure that determines the expression of a trait An observable physical or biochemical trait on an organism Physical location of a trait on a DNA molecule Genetic constitution of an organism Loading...1021. A 3-month-old baby is recognized to have a horseshoe kidney. In this case, which of the following structure is known to prevent this abnormally shaped kidney from occupying the correct position? Inferior mesenteric artery Celiac trunk Abdominal aorta Superior mesenteric artery Loading...1022. Laboratory tests for a patient are as follows: Plasma creatinine concentration is 0.8 mg/dLine creatinine concentration is 80 mg/dL Urine volume is 1 ml/min 100 ml/min 200 ml/min 50 ml/minich of the following is the creatinine clearance? 300 ml/min Loading...1023. Which of the following correctly describes pleiotropy? Increased severity of a disease in succeeding generations One gene contributes to multiple phenotypic effects Phenotype is always the same among individuals having the same genotype Not all individuals with mutant genotype show the same mutant phenotype Loading...1024. Which of the following is the most common cause of congestive heart failure associated with systolic impairment in the United States? Diabetes Alcohol Rheumatic heart disease Atherosclerosis Loading...1025. What is the most common cause of chronic chest pain? Cardiac Malignant Gastrointestinal MusculoskeletalPage 42 of 66 Loading...1026. A drug that inhibits xanthine oxidase through the formation of a stable complex with xanthine oxidase is the following? Allopurinol Probenecid Colchicine Pegloticase Febuxostate Loading...1027. A 9-month-old boy is brought to the clinic by his mother who is concerned that the boy developed swelling in his right scrotum. On examination, there is a scrotal mass that disappears when pushing it back to the external inguinal ring. When the boy cries, the mass is felt again protruding out of the external inguinal ring. What is the most likely etiology of this condition? Patent processus vaginalis Defective closure of tunica vaginalis Defect in the pelvic floor Undescended testis Defect in the inguinal canal Loading...1028. Directly acting cholinergic agonist drug? Pilocarpine Tacrine Acetylcholine Echothiophate A & B Loading...1029. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Phenoxybenzamine Tacrine Mecamylamine Metoprolol Atracurium Loading...1030. Which one of the following naturally occurring penicillins has a higher minimum bactericidal concentration and can't be used for bacteremia? Penicillin G Penicillin V Methicillin Amoxicillin Loading...1031. Which statement about the use of pilocarpine is wrong? Produce rapid miosis Used for Xerostomia relaxation of Ciliary muscles Used for Sjögren syndrome Lack of selectivity Loading...1032. Which one of the following conditions most likely increases the risk for deep venous thrombosis (DVT)? Pulmonary tuberculosis Crohn’s disease Adenocarcinoma Coronary heart disease Loading...1033. Injury of the which of the following nerves results in loss of sensations of over the right scrotum and the medial side of the thigh? Genitofemoral nerve Ilioinguinal nerve Pudendal nerve Lateral cutaneous nerve Loading...1034. Which one of the following drugs is associated with optic neuritis? Capreomycin Isoniazid Rifampin Ethambutol Loading...1035. Paraneoplastic hypercalcemia is most likely caused by tumor cells secreting which one of the following substances? Parathyroid hormone-related peptide Parathyroid hormone Calcitonin-related peptide Calcitonin Loading...1036. ADP mediated platelets aggregation is inhibited by? Aspirin Dipyridamole Tirofiban Clopidogrel Eptifibatide Loading...1037. Which of the following types of necrosis occurs in abscesses and brain infarcts? Liquefaction necrosis Caseous necrosis Fibrinoid necrosis Coagulative necrosis Loading...1038. A 62-year-old man who has a history of various drug overdose incidents presents to the emergency room after administration of a high dose of aspirin. Which set of these findings characterizes this condition? Metabolic acidosis and respiratory acidosis Metabolic alkalosis and respiratory acidosis Metabolic alkalosis and respiratory alkalosis Metabolic acidosis and respiratory alkalosis Loading...1039. All of the following drugs have anti-inflammatory effects except? Naproxen Piroxicam Mefenamic acid ketorolac Acetaminophen Loading...1040. Which one of the following drugs is often added to nasal decongestants? Albuterol Norepinephrine Epinephrine Phenylephrine Loading...1041. Which one of the following drugs is used to treat constipation? Metamucil Alendronate A & B Sevelamer Sodium polystyrene sulfonate Loading...1042. Which of the following are the most likely effects of beta blockers on the end-diastolic volume (EDV) and the ejection time (ET)? Both of them decrease EDV decreases and ET increases Both of them increase EDV increases and ET decreases Loading...1043. Concurrent therapy of digitalis with the following drugs enhance the potential for cardiotoxicity? Amiodarone Quinidine Tetracycline Erythromycin All of the above Loading...1044. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Ibandronate Furosemide Rabeprazole A & B Rifamycins Loading...1045. Which one of the following neoplasms is the most likely related to HIV infection? Hodgkin’s lymphoma Kaposi sarcoma Myelocytic leukemia Burkitt’s lymphoma Loading...1046. Ganglion blocker drug is following? Atropine Atracurium Benztropine Mecamylamine Neostigmine Loading...1047. A 58-year-old woman comes to the emergency room complaining that her skin is turning yellow. The doctor performs a physical examination, which reveals that the woman is suffering from moderate jaundice. There is no abdominal pain and she also has a negative Murphy’s sign. The physician becomes concerned that he is able to feel the patient’s non-tender gallbladder. A CT scan is therefore ordered. What could be the most likely cause of the woman’s jaundice? Hemolytic anemia Pancreatic cancer Gall bladder stones Acute hepatitis Loading...1048. A 68-year-old man presents to the emergency room complaining of multiple episodes of fainting since he woke up today. His fainting mainly occurs when he stands up. He has a history of coronary artery disease, diabetes, high cholesterol and hypertension. He takes atenolol, metformin, lovastatin and lisinopril. On physical examination, his blood pressure is 120/75, pulse is 55/min. and irregular, heart sounds are normal and lungs are clear on auscultation. ECG shows dropped beat after progressive lengthening of the PR interval. What is the most likely initial diagnosis? Mobitz type I (Wenckebach) second degree AV block Atrial flutter Third degree atrioventricular block Mobitz type II second degree AV block Atrial fibrillation Loading...1049. Which of the following conditions is the most likely cause of development of velvety rash in the axilla? Testosterone hypersecretion Serotonin hypersecretion Thyroid hormone deficiency Insulin resistance Loading...1050. Which one of the following drugs belongs to drugs for hepatic viral infections? Indanyl carbenicillin Capreomycin Aluminium hydroxide Entecavir EzetimibePage 43 of 66 Loading...1051. Which one of the following drugs belongs to H2 histamine receptor blocker? Nizatidine Indanyl carbenicillin Atorvastatin Ezetimibe Torsemide Loading...1052. An 86-year-old female presented with a slate-gray pigmentation on the (butterfly) sun-exposed areas of the face with erythema and hyperpigmentation. There was no irritation, itching, ulceration, or discharge. Physical exam showed similar areas over both legs with atrophic skin, which the patient attributed to previous superficial wounds and bruises from falls. Examination showed no other pigmentation changes over the upper extremities, trunk, oral mucosa, sclera, or nail beds. Past medical history was significant for hypertension and atrial fibrillation. Which of the following drugs may be responsible? Bretylium Amiodarone Sotalol Digoxin Quinidine Loading...1053. A 15-year-old girl presents with potential growth delay. She had traumatic brain injury two years ago due to a car accident. Her secondary sex characteristics are absent. Endocrine profile shows low FSH, LH, estradiol, DTEAS and prolactin. What is the most likely diagnosis? Post-traumatic hypopituitarism Primary adrenal insufficiency Hashimoto’s disease Tanner syndrome Loading...1054. Mafenamic acid belongs to following class? Fenamates Oxicam Salicylic acid Propionic acid Acetic acid Loading...1055. Which of the following is a contraindication of use of benzodiazepines in anxiety disorder? Smoking Sleep apnea Seizures Diabetes mellitus Loading...1056. A 34-year old woman delivered a girl at her 37-week gestational age through a normal delivery two hours ago. Examination of the newborn girl reveals pink skin, red reflex in both eyes, high arched palate, webbed neck, swollen hands and feet and widely spaced nipples. Heart and lungs auscultation is unremarkable except for a systolic murmur below the left scapula. Which of the following congenital heart diseases is most likely found in this patient? Transposition of great vessels Atrial septal defect Coarctation of the aorta Ventricular septal defect Tetralogy of Fallot Loading...1057. Which of the following local anesthetics causes vasoconstriction and may lead to an increase of blood pressure? Tetracaine Lidocaine Cocaine Benzocaine Loading...1058. What is the proper treatment of ventricular fibrillation? Digoxin and verapamil Immediate cardioversion Morphine and nitroglycerin Metoprolol and heparin Loading...1059. A drug that act as laxative is one of the following? Sulbactam Sodium phosphate A & B Bumetanide Furosemide Loading...1060. A 30-year-old man visits the clinic complaining of recurrent bouts of diarrhea accompanied with bloating over the past few years. He also reports that he has itchy vesicles around the extensor surfaces of his upper and lower extremities. The rest of clinical examination is normal. What is the skin condition most likely present in this patient? Rosacea Dermatitis herpetiformis Shingles (herpes zoster) Seborrheic keratosis Psoriasis Loading...1061. While you were conducting the morning round in internal medicine department, one of the patients told you that the nurses are insensitive and irresponsible. You asked him for the reason. He said: “they are not good as doctors”. All doctors I’d seen here are sensitive and responsible. Which of these is the most likely defense mechanism involved in this case? Repression Splitting Regression Reaction formation Projection Loading...1062. Which one of the following conditions most likely occurs during normal delivery when the shoulders of the baby are impacted behind the maternal bony pelvis? Shoulder dystocia Tendinitis Rotator cuff tear Frozen shoulder Loading...1063. A 21-year-old Chinese student presents to the clinic for her pre-college physical examination. She tells her physician that she is worried about a solid mass in the roof of her mouth for about 3 years. The patient does not smoke or drink alcohol. She did not lose or gain weight in the last 3 years. On local examination, there is 1.5 inch non-tender mass on her hard palate with definite edges. There are no palpable lymph nodes. What is the most likely diagnosis of this mass? Torus palatinus Palatal abscess Lymphoproliferative disease Kaposi’s sarcoma of the palate Malignant melanoma of the palate Loading...1064. Phenylephrine has the least affinity for following adrenoceptors type? α1 Receptors α1 & B1 Receptors α2 Receptors All of these Both A & B Loading...1065. The structural formula of the following drugs contains the Biphenyl methyl group except? Candesartan Olmesartan Eprosartan Valsartan Losartan Loading...1066. Which one of the following statements about the use of Diclofenac is incorrect? Also used for ankylosis spondylitis Less potent than Naproxen Accumulate in synovial fluid Excrete out by the kidney Loading...1067. In an acute attack of gout, Indomethacin is preferred over Colchicine because of which characteristic? More likely to prevent further acute attacks Less likely to cause GI bleeding More likely to reduce inflammation Less likely to cause acute renal failure Less likely to cause diarrhea Loading...1068. Intermediate Acting Insulin is one of the following? Detemir NPH (neutral Protamine hagedorn) Glargine Lispro Loading...1069. Which of the following hormone belongs to the posterior pituitary? Desmopressin Somatrem Furosemide Urofollitropin A & B Loading...1070. A 58-year-old woman is brought to the emergency room complaining of lightheadedness for 4 hours. She has diarrhea with loose stool for 2 days. She explains her symptoms as flu and she drinks lots of water as her neighbor advised her to avoid dehydration. Her physician told her that she should take combined solution of sodium chloride (NaCl) and glucose to prevent dehydration. What is the mechanism of action of this mixture to improve dehydration? Glucose provides energy for NaCl to increase gastric emptiness The mixture helps to increase secretion of water and Na through the large intestine It reduces bowel contractions and consequently improves diarrhea Cotransport of glucose and NaCl across the intestinal membrane facilitates absorption of water Loading...1071. Ranitidine is used to treat one of the following diseases? Malaria Stomach Ulcer Blood pressure Diabetes Viral infection Loading...1072. Which of the following is the first line therapy for gastroparesis in patients with diabetes? Cimetidine Ondansetron Omeprazole Metoclopramide Loading...1073. A 58-year-old woman comes to the emergency room complaining that her skin is turning yellow. The doctor performs a physical examination, which reveals that the woman is suffering from moderate jaundice. There is no abdominal pain and she also has a negative Murphy’s sign. The physician becomes concerned that he is able to feel the patient’s non-tender gallbladder. A CT scan is therefore ordered. What could be the most likely cause of the woman’s jaundice? Acute hepatitis Gall bladder stones Hemolytic anemia Pancreatic cancer Loading...1074. Which one of the following cephalosporins belongs to the third generation? Cefixime Cefaclor Cefoxitin Ceftin Loading...1075. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Indanyl carbenicillin Aluminium hydroxide Ezetimibe Nizatidine EthionamidePage 44 of 66 Loading...1076. Which of the following is the mechanism of action of pioglitazone in diabetic patients? Increases glucose uptake in muscle cells Increases insulin release Increases glucose excretion Decreases insulin breakdown Loading...1077. Which of the following drugs is used to inhibit viral neuraminidase? Acyclovir Oseltamivir Ibandronate Capecitabine Naftifine Loading...1078. Which one of the following is characteristic of Chlamydia? Obligate intracellular Anaerobic bacteria Gram-negative diplococci Facultative intracellular Loading...1079. Which one of the following drugs is 4th generation cephalosporin drug? Cefuroxime Cefixime Cefepime Cefadroxil Loading...1080. Thyroid hormone can cause which one of the following effects? Lowers blood cholesterol Hypoglycemia Lowers oxygen consumption Lowers body temperature Loading...1081. Which one of the following drugs is used to prevent acute mountain sickness? Spironolactone Furosemide Mannitol Chlorthalidone Acetazolamide Loading...1082. Which of the following arteries is the most common site of coronary artery occlusion? Left circumflex artery Right coronary artery Left anterior descending artery Posterior descending artery Loading...1083. Gonadotropin-releasing hormones are synthesized by which of the following nuclei of the hypothalamus? Ventromedial nuclei Arcuate nuclei Dorsomedial nuclei Anterior nuclei Loading...1084. Which of the following is the mechanism of action of selegiline in treating Parkinson’s disease? Blocks catechol-O-methyltransferase (COMT) Agonist at dopamine receptors Precursor of dopamine Inhibition of MAO type B to reserve dopamine Loading...1085. During spermatogenesis, which type of cells enter meiosis 1 to from primary spermatocytes? Primordial germ cells Type B spermatocytes Type A spermatocytes Spermatids Loading...1086. Torsades de pointes may occur after the use of which one of the following medications? Propranolol Rifampin Sotalol Lidocaine Loading...1087. A drug that is a part of Macrolide is following? Cefepime Azithromycin Cefdinir Cefaclor Loading...1088. Histamine Receptor found on eosinophils and mast cells having a chemotactic function also found on neutrophils and CD⁴ T cells are following? H² histamine receptor H⁵ Histamine receptor H⁴ histamine receptor H³ histamine receptor H¹ histamine receptor Loading...1089. Which one of the following parts of the cell is the site of steroid synthesis? Peroxisome Golgi apparatus Rough endoplasmic reticulum Smooth endoplasmic reticulum Loading...1090. Which of the following substances is elevated due to vitamin B12 deficiency? Homocysteine Cyanocobalamin Folic acid Hemosiderin Loading...1091. Unilateral or bilateral sweating is the symptom of one of the following types of headache? Tension-Type Headache Migraine Headache Cluster Headache A & B Loading...1092. The drug which inhibits the action of histamine at parietal cells results in a reduction of hydrogen ions concentration and volume of gastric acid? Omeprazole Rabeprazole Sucralfate Cimetidine Loading...1093. Which of the following is a major complication of central retinal veins occlusion? Glaucoma Lens subluxation Cataract Retinal detachment Loading...1094. A group of people are assigned for a research study about the effect of a new hypoglycemia medication. Because they are aware of the study, they eat less carbohydrate. Which type of bias is involved in this study? Information bias Sample distortion bias Confounding bias Hawthorne effect Loading...1095. Which of the following drug belongs to potassium sparing Diuretics? Amiloride Urea Furosemide A & B Acetazolamide Loading...1096. A patient presents with recurrent urinary tract infections with episodes of compulsive diarrhea over the past year. Urine sample shows gas bubbles. Which of the following is the most likely initial diagnosis? Ulcerative colitis Crohn’s disease Irritable bowel syndrome Polycystic kidney disease Loading...1097. Which of the following is the main action of carbidopa when it is used in combination with levodopa in the management of Parkinsonism? It increases the permeability of blood-brain barrier to levodopa It inhibits the conversion of levodopa to dopamine peripherally It reduced levodopa side effects such as hypotension It increases the absorption of levodopa Loading...1098. Which of the following substances is used in mercury poisoning? Fomepizole Flumazenil Methylene blue Succimer Loading...1099. Which of the following is the mechanism of action of zileuton for asthma? Inhibition of 5-lipoxygenase Stimulation of beta-2 receptors Inhibition of phosphodiesterase Inhibition of Phospholipase A Loading...1100. Which of the following is an indandione analog Anticoagulant agent? Warfarin Clopidogrel Abciximab Anisindione HeparinPage 45 of 66 Loading...1101. The gland responsible for secretion of prolactin is derived from which of the following structures? Infundibulum Primordial follicle Rathke’s pouch Neurohypophysis Loading...1102. A 22-year-old female with a history of acquired immunodeficiency syndrome (AIDS) develops low grade fever, headache and blurred vision. Cerebrospinal fluid (CSF) testing for Cryptococcal antigen is positive. Which of these drugs can be given orally to treat Cryptococcal meningitis? Metronidazole Amphotericin B Fluconazole Caspofungin Loading...1103. Which of the following physiological changes is expected in a person comping on a mountain at an altitude of 4500 meters? Increased renal excretion of H ion Decreased 2,3-diphosphoglycerate Decreased arterial Pco2 Decreased erythropoietin production Loading...1104. Which of the following characterizes intravenous (IV) route of administration? Efficacy is affected by liver disorders Maximum bioavailability Undergo first pass metabolism Rabidly excreted Loading...1105. Which of the following medications increases cardiac output in pulmonary edema following myocardial infarction? Verapamil Dobutamine Lisinopril Metoprolol Loading...1106. Which one of the following drugs is a 4th generation Cephalosporin? Cefadroxil Cefdinir Cefaclor Cefepime Loading...1107. Which statement about the Actions of the incretin hormone Glucagon-like peptide-1 is wrong? Inhibit inappropriate Glucagon secretion Decrease Beta cells growth Suppress appetite Increase Glucose-dependent insulin secretion Loading...1108. A disease that is characterized by the movement of gastric contents from the stomach into the esophagus? Dyspepsia A & B Peptic Ulcer disease GERD Loading...1109. A patient comes to a rural hospital one hour after he experienced excruciating chest pain. After workup, you diagnose his case as myocardial infarction. The nearest hospital is 2-hour away. What is the best next step? Consult a cardiologist Administer thrombolytic now Transfer to the nearest hospital Loading...1110. Which one of the following statements about dobutamine is incorrect? Increase contractility Positive inotropic effect Treat acute heart failure Decrease myocardial cAMP Loading...1111. Nelfinavir belongs to the class of following drugs? Antipyretic Antiprotozoal Anti-malaria Antiviral Antibiotics Loading...1112. A 74-year-old woman visits her physician complaining of a new onset of fatigue and temporal headache. She lost about 5-7 pounds over the last year. She also has morning stiffness for one hour accompanied by aching in the shoulders and hips. She noticed that her vision was deteriorating during the last year. Physical examination is unremarkable. Laboratory tests indicate high erythrocyte sedimentation rate. What is the most appropriate next step? Carotid Doppler studies Start prednisone CT scan of the head Temporal artery biopsy Refer to a neurologist Loading...1113. Which one of the following antiretroviral drugs is a protease inhibitor? Lamivudine Tenofovir Ritonavir Etravirine Zidovudine Loading...1114. A patient presents to the ER with a history of taking a large amount of acetaminophen tablets. Which of the following is the most appropriate next step of action? Measure serum acetaminophen concentration Prepare for hemodialysis Blood transfusion Administer N-acetylcysteine Loading...1115. A drug causes accumulation of fat in the abdomen and the base of the neck on chronic administration? Lamivudine Zanamavir Vidarabine Amantadine Ritonavir Loading...1116. Red man syndrome is caused by vancomycin penicilin lincosamine cephalosporin Loading...1117. Which of the following is the mechanism of action of vinblastine? Interferes with DNA mobilization and replication Interferes with microtubule assembly Interferes with microtubule disassembly Interferes with purine synthesis Loading...1118. A drug used in severe DIGITALIS toxicity is the following drug? Fomepizole DIGIBIND Calcium Gluconate Amyl Nitrate Loading...1119. Which of the following organisms is associated with toxic shock syndrome due to exotoxin A? Staphylococcus aureus Vibrio cholera Clostridium perfringens Streptococcus pyogenes Loading...1120. Which one of the following agent is a insulin? Atorvastatin Detemir Torsemide Desmopressin Somatostatin Loading...1121. Which of the following is the mode of inheritance of cystic fibrosis? Autosomal recessive X-linked recessive X-linked dominant Autosomal dominant Loading...1122. A scientific researcher is classifying some drugs according to their actions on different receptors. One of these drugs binds to its receptor without producing any action. Partial agonistis drug should be classified as what? Agonist Antagonist Inverse agonist Loading...1123. A 29-year-old woman presents with bloody discharge from her right breast for 3 weeks. There is no pain, fever or swellings. There is no breast mass or lymphadenopathy. Which of the following is the most likely diagnosis? Pregnancy Metastatic carcinoma Prolactinoma Intraductal papilloma Loading...1124. Which of the following organisms is associated with pneumonia precipitated by aerosolized water (air conditions)? Pneumocystis jirovecii Chlamydophila pneumonia Legionella pneumophila Mycoplasma pneumonia Loading...1125. Which of the following drug is a part of drugs for osteoporosis? Acetazolamide Alendronate A & B Rabeprazole FurosemidePage 46 of 66 Loading...1126. Which one of the following statements about the use of the metformin is incorrect? Decrease intestinal absorption of glucose Inhibit hepatic glucose output Promote glucose uptake Promote insulin secretion Potential for lactic acidosis Loading...1127. A 1-year-old boy with a diagnosis of stable small ventricular septal defect is scheduled for a dental procedure. Which of the following medications should be administered prior to this procedure? Amoxicillin Azithromycin Ampicillin No medication Loading...1128. A 29-year-old man is brought to the ER by a policeman. He was driving his car under the influence of alcohol. The policeman asks the ER physician to get a sample of this patient’s gastric contents for analysis. The physician explains the procedure to him but the patient refuses to go through it. What is the best next action? Force the patient to do the procedure Inject the patient with anesthesia and do the procedure Respect the patient’s wishes and don’t do this procedure Convince the patient falsely that this procedure is part of treatment and do it Loading...1129. Which of the following in the mode of inheritance of glucose-6-phosphate dehydrogenase deficiency? Autosomal dominant Autosomal recessive X-linked recessive X-linked dominant Loading...1130. Which of the following is the mechanism of action of ursodiol to reduce the size of gallstones in the common bile duct? Dissolving calcium from the stone Reducing bile synthesis Relaxation of common bile duct Dissolving cholesterol form the stone Loading...1131. Which one of the following fungistatic drugs has a half-life of 30 hours? Voriconazole Posaconazole Fluconazole Ketoconazole Loading...1132. During normal inspiration, the diaphragm: Contracts Does not move Relaxes Loading...1133. Which one of the following is the most common cause of microcytic hypochromic anemia in a patient diagnosed with progressive renal failure? Frequent hematuria Blood loss Iron deficiency anemia Erythropoietin deficiency Loading...1134. A 24-year-old woman visits her physician for treatment of anxiety. She requests to change her current medication because it is sedative. Which one of these drugs has the minimum sedative effect? Midazolam Lorazepam Promethazine Trazodone Buspirone Loading...1135. Which one of the following is the effect of metoprolol on cardiac ejection time? Decreased No effect Increased Loading...1136. Risk of rupture of abdominal aortic aneurysm (AAA) is increased by all the following factors EXCEPT? Uncontrolled hypertension Male gender Increased aortic wall stress Smoking Loading...1137. Which one of the following liver disorders occurs due to hepatic vein thrombosis? Alcoholic hepatitis Budd-Chiari syndrome Pyogenic liver abscess Fatty liver Loading...1138. Which of the following is the reason that nitroglycerin is given sublingually? It improves patient compliance It diminishes the odds of developing methemoglobinemia It has less reflex tachycardia than other routes It avoids first pass metabolism Loading...1139. Amnestic syndrome due to thiamine deficiency is caused by lesions of which one of the following structures? Cerebellum Temporal lobe Limbic system Parietal lobe Loading...1140. 37-year-old previously healthy man is brought to the emergency room for dizziness, chest pain and A palpitations. Cardiac chemistry panel is normal. ECG shows a sloping upstroke of the QRS complex. What is the treatment of choice of this condition? Atropine Digoxin Metoprolol Verapamil Procainamide Loading...1141. Which one of the following drugs is a Substrate of the P-GP (glycoprotein) efflux pumps? A & B All of the above Digoxin Erythromycin Amiodarone Loading...1142. Verapamil, a calcium channel antagonist: Increases conduction velocity Decreases intracellular K Increases reactivation of sodium channels Decreases myocardial contractility Increases intracellular cAMP Loading...1143. What is the antidote of theophylline? Activated charcoal Pralidoxime All of the above Esmolol A & B Loading...1144. Beta-Blocker drug is following? Acetylcholine Tamsulosin Atropine Esmolol Succinylcholine Loading...1145. Which of the following medications is the most effective immunosuppressant in cases of organ transplantation? Azathioprine Vinblastine Cyclophosphamide Cyclosporine Loading...1146. A 70-year-old man is brought to the doctor having a sudden onset of severe lower back pain. Upon conducting a physical examination of the patient, severe kyphosis is revealed. An x-ray of the back shows a compression fracture in the lumbar area of a vertebral body. This is followed by marked thinning of the bones as well. Laboratory tests measuring serum calcium, alkaline phosphatase, phosphorus, and parathyroid hormone levels, all come back within the normal range. What is the most likely reason behind the bone changes in the patient? Osteitis fibrosa cystica Osteoporosis Osteomalacia Osteopetrosis Loading...1147. A 35 woman undergoes a hysterectomy. A section of one of her fallopian tubes is shown on this picture. What is your diagnosis? Ectopic pregnancy Papillary carcinoma Chronic salpingitis Endometriosis Loading...1148. Which one of the following proteins surrounds the nuclear envelope? Enkephalin Tropomyosin Vimentin Actin Loading...1149. A child is brought to the emergency room after ingestion of a full bottle of a medication two hours ago. The child is in coma with tachypnea, tachycardia and metabolic acidosis. Which of the following is the responsible medication? Acetaminophen Aspirin Hydrocodone Vitamin C Loading...1150. The pericardial cavity is a space lies between which of the following structures? Epicardium and myocardium Parietal serous pericardium and visceral serous pericardium Parietal fibrous pericardium and visceral fibrous pericardium Epicardium and pericardiumPage 47 of 66 Loading...1151. All of the following are currently used in hyperthyroidism EXCEPT? Potassium perchlorate Propylthiouracil Methimazole Diatrizoate sodium Loading...1152. Which of the following drug is commonly used for the Reactivation of inhibited Acetylcholine esterase? Carbachol Bethanechol Edrophonium Pralidoxime Echothiophate Loading...1153. A 35 year-old woman presents with troubled vision and severe pain in her left eye. She has been diagnosed with shingles on the left side of her face and the cornea of her left eye. Which of these nerves is the most likely affected in this patient? Optic nerve Oculomotor nerve Facial nerve Trigeminal nerve Loading...1154. A patient with hyperthyroidism develops a cardiac arrhythmia, the most suitable drug to treat his arrhythmia would include: Propranolol Bretylium Digoxin Amiodarone Loading...1155. Which of the following drugs are protein synthesis inhibitor? Tetracyclin Gentamicin Erythromycin All of the above Linezolid Loading...1156. A 65-year-old man is scheduled for a repair of an abdominal hernia. The patient has an abdominal hernia that can be reduced by pushing the contents of the abdomen back through the external ring. While performing the repair, the surgeon observes that the hernial sac is protruding from the superior abdominal wall to the inguinal ligament. It is also medial to the inferior epigastric vessels. After observing all these, what can be concluded about the type of a hernia the patient is suffering from? Femoral hernia Hiatal hernia Direct inguinal hernia Indirect inguinal hernia Loading...1157. A patient develops severe diarrhea after 2 weeks of treating pneumonia with broad spectrum antibiotics. Which of the following is the first line of treatment of this condition? Vancomycin Ampicillin Methicillin Ciprofloxacin Loading...1158. Which of the following differentiates physiologic jaundice from pathologic jaundice? Bilirubin in physiologic jaundice rises higher than 5 mg/dL/day Physiologic jaundice is present in the first 24 hours of life Bilirubin peaks at higher levels (> 15 mg/dL) in physiologic jaundice Direct bilirubin is lower than 10% of total bilirubin in physiologic jaundice Loading...1159. Erythromycin belongs to the class of following drugs? Antibiotics Antiprotozoal Antipyretic Anti-malaria Antiviral Loading...1160. Gonadotropin-releasing hormone is produced by which of the following nuclei of hypothalamus? Dorsomedial nucleus Ventromedial nucleus Anterior nucleus Arcuate nucleus Loading...1161. Which one of the following is the best treatment of trigeminal neuralgia? Fluoxetine Carbamazepine Methylphenidate Riboflavin Loading...1162. Which of the following is the percentage of thymine in a DsDNA if it contains 20% guanine? 40% 20% 50% 30% Loading...1163. A 24 year old medical student visits her physician for a refill of her treatment of depression. She is prescribed imipramine, a tricyclic antidepressant. During discussion of the treatment, her physician mentions that this drug undergoes first pass hepatic metabolism. The prescribed drug is most likely administered by which route? Sublingual Intravenous Oral Intramuscular Subcutaneous Loading...1164. A 40-year-old man with a long history of intravenous drug addiction presents to the emergency room complaining of fever, anorexia, malaise, shortness of breath, cough and chest pain for 2 days. On physical examination, temperature is 102.7 F, Pulse is 110/min. and blood pressure is 110/66. Irregular erythematous nodules are seen on his hands and feet. Which of the following is most likely valvular lesion associated with this infection? Mitral valve regurgitation Pulmonic valve stenosis Aortic valve stenosis Mitral valve stenosis Tricuspid valve regurgitation Loading...1165. A child presents with low body weight, edema of lower extremities, enlarged abdomen with ascites and desquamating skin and areas of depigmentation and hyperpigmentation. Which of the following is the most likely diagnosis? Marasmus Scurvy Pellagra Kwashiorkor Loading...1166. A 29-year-old woman with a history of rheumatic heart disease and prosthetic aortic valve presents to her physician for consultation. She is referred by her dentist for prophylaxis before she undergoes an oral surgery next month. She has no history of bacterial endocarditis. She is allergic to penicillin. Which of the following is the prophylactic drug of choice for this patient? Vancomycin Amoxicillin Azithromycin Gentamicin Ampicillin Loading...1167. Which one of the following statements about the platelets is wrong? Platelet have nuclei Can't synthesize the new enzyme PG2 decrease aggregation TXA2 enhance aggregation Life of platelet 3-7 days Loading...1168. Which of the following management plans is recommended for a case of myocardial infarction with 70% main left stenosis? Percutaneous coronary intervention (PCI) Pharmacotherapy and observation Percutaneous transluminal coronary angiography (PTCA) Coronary artery bypass graft (CABG) Loading...1169. Which one of the following drugs prevents the release of Renin and increase in heart rate from sympathetic stimulation? Dobutamine Metoprolol Digoxin Enalapril Loading...1170. The drug that produces dilation of the pupil (mydriasis) for 6 hours is one of the following drugs? Tropicamide Ipratropium Cyclopentolate Physostigmine Atropine Loading...1171. Administration of which one of the following can increase the excretion of a weak acid i.e. Aspirin toxicity? A weak acid A weak base A neutral salt A strong acid Loading...1172. A 45-year old man presents to the emergency room complaining of breathing difficulty, palpitations, dizziness and chest pain for 15 minutes. He is a new employee at the hospital. He was waiting for a meeting when he experienced these symptoms. He had 3 similar episodes during the past 3 months but they resolved spontaneously. His medical and surgical histories are unremarkable. He has no family history of cardiac disease or sudden death. On examination, he is anxious, vital signs are within normal limits and heart and chest examinations are normal. What is the next step of management for this patient? 12-Lead ECG, random blood glucose and thyroid panel Assurance and send him home for the rest of the day Call cardiology department and prepare for PCI Psychotherapy and alprazolam Loading...1173. A 24-year-old man with a history of AIDS is currently managed by antiretroviral therapy (HAART) containing a protease-inhibitor, a nucleoside reverse transcriptase inhibitor and a non-nucleoside reverse transcriptase inhibitor. Which one of these drugs is a nucleoside reverse transcriptase inhibitor? Etravirine Zidovudine Efavirenz Saquinavir Indinavir Loading...1174. Gingival hyperplasia, granulocytopenia and facial hirsutism are possible side effects of which one of the following medications? Valproic acid Carbamazepine Phenobarbital Phenytoin Loading...1175. Emotions, judgments and motor aspects of speech are controlled by which one of the following lobes of the brain? Parietal Occipital Frontal TemporalPage 48 of 66 Loading...1176. Which of the following drug is a derivative of Enolic acid? Piroxicam Etodolac ketorolac Mefenamic Acid Diflunisal Loading...1177. A 62-year-old man presents to the clinic with rashes all over his body and painful joints. Last month, he was diagnosed with arrhythmia. He is taking one medication for it. Laboratory tests reveal anti-histone antibodies. Verapamilich of the following drugs is most likely responsible for this condition? Metoprolol Propranolol Hydralazine Sotalol Loading...1178. A 19-year-old man is referred to the clinic for a positive purified protein derivative (PPD) test for tuberculosis. He moved to the United States from Egypt 2 years ago and has been in a good health. He has no history of fever, cough, weight loss or night sweats. He has no family history or contacts with tuberculosis. His physical examination is normal. His chest x-ray shows no cavitation or hilar adenopathy. What is the appropriate next step in management for this patient? Start treatment with isoniazid for 9 months Isolation and full antituberculous therapy for 6 months Start treatment with multiple drug- antituberculosis therapy Repeat the PPD test and x-ray after 6 months Loading...1179. What is the most common injury resulting from wearing a heavy backpack for a long time? Rotator cuff injury Costoclavicular syndrome Frozen shoulder Shoulder dislocation Loading...1180. A direct-acting adrenergic agonist is following? Clonidine Amphetamine Acetylcholine Albuterol A & B Loading...1181. A 31-year-old pregnant woman presents to her physician on her second trimester for a prenatal checkup. She works at a big farm. She has no concerns except for some mild swellings on her neck. On physical examination, her vital signs are within normal limits. She has mild cervical lymphadenopathy. She is prescribed an oral antibiotic but she is noncompliant. Her child is delivered with hydrocephalus and intracranial calcifications. Which organism is the most likely responsible? Herpes simplex virus Togavirus Trypanosoma cruzi Toxoplasma gondii Treponema pallidum Loading...1182. A decrease of J chain due to a genetic defect will cause a decrease of the which of the following? Mature T lymphocytes Serum IgM Serum IgE Mature B lymphocytes Loading...1183. Which of the following drugs has the longest duration of bronchodilation? Salmeterol Metaproterenol Albuterol Epinephrine Isoproterenol Loading...1184. Which of the following is considered an indication of first-generation histamine H1-receptor blockers? Peptic ulcer Allergy Apoplexy Cough Loading...1185. A drug that is used to treat leprosy is one of the following? Magnesium hydroxide Etidronate Furosemide Clofazimine A & B Loading...1186. Which of the following is the enzyme responsible for conversion of testosterone into dihydrotestosterone (DHT)? 3-beta-hydroxylase 5-alpha-reductase 17 alpha-hydroxylase Aromatase Loading...1187. Which one of the following parts of lymph nodes has T lymphocyte as the predominate cell? Cortex Germinal center Paracortex Medulla Loading...1188. A 60-year-old man complains of shortness of breath. Examination reveals bilateral pleural effusions and pitting edema up to the thighs’ level. Which of the following is the most likely laboratory finding in this patient? Hypoalbuminemia Neutrophilia Hypoglycemia Anemia Loading...1189. The binding of a drug to plasma proteins will tend to: Increase its pharmacological activity Increase its concentration in the plasma. Decrease half-life. Increase its rate of biotransformation. Decrease its rate of glomerular filtration. Loading...1190. A patient is given epinephrine and an agonistic effect is produced on a certain organ. But when he is given Norepinephrine no such effect is produced. Which one of the following organs is it? It has no direct neural control. SA Node Cutaneous blood vessels Splanchnic blood vessels Radial muscle of the iris Respiratory smooth muscle Loading...1191. Which of the following tests is the most accurate one to confirm the diagnosis of achalasia? Barium esophagram Chest-x-ray Manometry Upper endoscopy Loading...1192. A 22-year- old man presents to the emergency room complaining of sudden onset of shortness of breath and palpitation for 2 hours. He had similar episodes in the past which resolved by breath holding. His past medical, surgical and family histories are unremarkable. He takes no medication. ECG reveals supraventricular tachycardia. Carotid massage on the right side fails to subside this attack. What is the most likely next step in management? IV succinylcholine Try carotid massage on the left side IV lidocaine IV adenosine IV procainamide Loading...1193. The only type of insulin that should be given intravenously is one of the following? Glargine Detemir Regular Lispro A & B Loading...1194. Which one of the following oral hypoglycemic drugs is the initial therapy for patients with type 2 diabetes? Metformin Repaglinide Glyburide Acarbose Loading...1195. A 72-year-old woman presents to her physician complaining of abdominal pain and frequent episodes of burning micturition. After physical examination and laboratory tests, she is diagnosed with urinary tract infection. She is prescribed gentamicin in addition to other medications. What is the most likely complication attributed to this antibiotic? Thrombocytopenia Agranulocytosis Hearing loss Hepatic toxicity Loading...1196. Imidazoline derivative drug with Alpha2 adrenoceptors effect? Albuterol Phentolamine Dipivefrin Clonidine Loading...1197. Consumption of which of the following products most likely reduces the risk for coronary heart disease in susceptible patients? Saturated fat Fish oils Beef products Sugar-free snacks Loading...1198. A drug that belongs to Loop Diuretics is one of the following? Cefazolin A & B Sulbactam Ethacrynic Acid Doripenem Loading...1199. The cough associated with Captopril is most likely associated with? Decrease in the metabolism of acetylcholine Release of histamine Direct airway irritation Stimulation of adenosine receptors in the lungs Increase in bradykinin levels Loading...1200. N-acetylcysteine is an antidote, which restores the glutathione levels in the hepatocytes decreased by the toxicity of which of the following specific drug? Naproxen Meloxicam Ketorolac Acetaminophen Mefenamic acidPage 49 of 66 Loading...1201. Which one of the following drugs belongs to drugs for hepatic viral infections? Lamivudine Ezetimibe Capreomycin Indanyl carbenicillin Aluminium hydroxide Loading...1202. The mechanism of action of etidronate disodium is most likely related to Excretion unchanged in the urine An unusual form of phosphorus (P) Inhibition of the formation of hydroxyapatite crystals Inhibition of both normal and abnormal bone resorptions Hyperphosphatemia Loading...1203. A 23-year-old nursing student presents with confusion, fatigue and sweating. Her blood sugar is 40 mg/dL. Lab tests show a high insulin level and a very low C peptide level. Which of the following is the most likely diagnosis? Pheochromocytoma Reactive hypoglycemia Insulinoma Factitious hypoglycemia Loading...1204. Elevation of which one of the following substances in blood occurs due to reduced renal blood flow? Calcium Cholesterol Ammonia Renin Loading...1205. Which of the following hormone belongs to the oral diabetic agent? Somatrem Glimepiride A & B Oxytocin Furosemide Loading...1206. Which of the following layers of the heart forms the cardiac valves and continues with the intima of the aorta? Endocardium Epicardium Pericardium Myocardium Loading...1207. Which of the following is the initial treatment of asymptomatic aortic stenosis? Valve replacement Furosemide Balloon valvuloplasty Hydrochlorothiazide Loading...1208. A 43 year-old woman visits her physician for a follow up after abdominal hysterectomy. During surgery, the obturator nerve was served. What is the most likely lost due to this injury? Dorsiflexion of the ankle joint Flexion of the knee joint Abduction of the hip joint Adduction of the hip joint Extension of the knee joint Loading...1209. Which of the following types of protein is encoded by the P53 gene? Caspase DNA repair enzyme Transcription factor Tyrosine kinase Loading...1210. A 24-year-old woman visits her physician for consultation about human papillomavirus (HPV) vaccine. She has been sexually active since she was a senior in high school with multiple partners. She had her last Pap smear last year and it was normal. On examination, there are multiple vaginal non-tender wart-like projections. What is the best advice concerning HPV vaccine to this patient? HPV vaccine is essential to treat the current infection She already has HPV infection but she should take the vaccine for other strains of HPV No need for the vaccine as long as Pap smear is normal She already has HPV infection so, no need for the vaccine She can only take the vaccine later after full recovery Loading...1211. A 72- year old man with a long history of hypertension and coronary artery disease presents for follow up examination. He takes metoprolol for many years. He started taking enalapril last week. His blood pressure is now under control. Physical and laboratory examinations are unremarkable except for slight increase in serum creatinine. What is the best explanation for this abnormality? Increased glomerular filtration rate (GFR) Drug-induced tubular obstruction Increase absorption of water in the proximal convoluted tubules Renal interstitial nephritis Blocking of efferent arteriole vasoconstriction Loading...1212. A drugs decrease the migration of granulocytes into the effected area Also Block cell division by binding to mitotic spindles? Allopurinol Sulindac Probenecid Colchicine Loading...1213. A 1-day old full term baby of a 23-year old mother who was delivered yesterday by normal vaginal delivery is coughing, choking and ejecting the formula from his nose and mouth. He also turns blue during feeding. What is the primary diagnosis of this boy? Tracheomalacia Imperforate anus Tetralogy of Fallot Tracheoesophageal fistula Pyloric stenosis Loading...1214. Griseofulvin belongs to the following drugs class? Antiprotozoal Antibiotics Antiviral Antipyretic Antifungal Loading...1215. Which one of the following local anesthesia is mainly used for regional nerve block? Tetracaine Bupivacaine Cocaine Dibucaine Loading...1216. Which one of the following dermatologic disorders presents with a herald batch and a Christmas tree pattern? Bullous pemphigoid Psoriasis Pityriasis rosea Pemphigus vulgaris Loading...1217. Meissner’s plexus of nerves is located within which layer of the gastrointestinal tract? Mucosa Submucosa Muscularis Externa External layer Loading...1218. Albumin quantitatively a primary protein in serum is synthesized by? Lungs Intestine Liver Kidney Brain Loading...1219. Which one of the following medications can be used safely in cases of lack of liver function? Lorazepam Midazolam Clonazepam Diazepam Loading...1220. Which one of the following causes induction of cellular enzymes that interfere with viral protein synthesis? Interferon-alpha Zanamavir Gancyclovir Amantadine Ribavirin Loading...1221. Atropine is an antimuscarinic agent block the binding of acetylcholine to muscarinic receptors. Which of the following Antagonist is required to counteract the poison of Atropine? Flumazenil Physostigmine Neostigmine Nalaxone Fomepizole Loading...1222. Which of the following is the most sensitive test for myocardial infarction? Lactose dehydrogenase (LDH) Troponin-C Troponin-1 Creatine kinase myocardial fraction (CK-MB) Loading...1223. A drug that belongs to Loop Diuretics is one of the following? A & B Sulbactam Bumetanide Doripenem Cefazolin Loading...1224. Which one of the following drugs is used to treat copper toxicity? Protamine Penicillamine Aminocaproic acid Atropine Loading...1225. Which of the following drug is used as a cervical ripening agent to induce labor? Nubemetone Celecoxib Etodolac Ketorolac DinoprostonePage 50 of 66 Loading...1226. Which of the following statements correctly describes the volume of distribution of a drug? It is the concentration of the drug in plasma at a certain time It is a kinetic parameter that correlates dose with plasma level of a drug at zero time It is the rate of diffusion of the drug through intracellular component It is the capacity of a drug to attach to plasma protein Loading...1227. The anterior pituitary is derived from which of the following structures? Rathke’s pouch Infundibulum Third pharyngeal arch Neurohypophysis Loading...1228. Which one of the following amines is permanently charged? Quaternary Primary Secondary Tertiary Loading...1229. Which one of the following drugs is the best treatment for seizures of eclampsia? Magnesium sulfate Carbamazepine Phenobarbital Haloperidol Loading...1230. Which one of the following anti-Parkinsonism medications should be avoided in patients with glaucoma? Trihexyphenidyl Levodopa Bromocriptine Selegiline Loading...1231. Which of the following is the role of infliximab in the management of rheumatoid arthritis? It is a TNF-alpha receptor agonist It neutralizes the activity of TNF-alpha by binding to soluble forms of it It is a TNF-alpha receptor antagonist Inhibition of dihydrofolate reductase Loading...1232. Which one of the following enzymes is extremely important in muscle energy metabolism through its role in purine nucleotide cycle? Hypoxanthine-guanine phosphoribosyltransferase (HGPRT) Myoadenylate deaminase Myo-inositol monophosphatase Adenosine deaminase Loading...1233. Which one of the following drugs is a H² receptor Antagonist? Cimetidine Omeprazole Rabeprazole Sucralfate Loading...1234. A 40-year-old man who works in a manufacture of explosives presents to the clinic for a routine physical examination. Medical history reveals that the patient experiences episodes of headache and palpitation every Monday. Physical examination, laboratory tests and ECG show normal results. The patient questions if the chemicals related to his job could be responsible for his symptoms. Which is the appropriate response for this question? Yes. They are related to withdrawal of chemical and may lead to massive heart attack No. They are not related to exposure because they are episodic No. They are not related to exposure because the symptoms occur on Monday after weekend Yes. They are related to exposure to a chemical and may lead to renal failure Loading...1235. Which one of the following drugs is a Thiazide Diuretic? Ezetimibe Fenofibrate Hydrochlorothiazide Indanyl carbenicillin Atorvastatin Loading...1236. The vitreous chamber of the eye is located between which of the following structures of the eye? The lens and the retina The cornea and the iris The cornea and the retina The iris and the lens Loading...1237. A drug that is a part of Macrolide is following? Cefaclor Cefepime Cefdinir Clarithromycin Loading...1238. A 16-month-old boy is brought to the clinic by his mother who is concerned that her boy turns blue and becomes short of breath several times during last three months. During these episodes, he becomes irritable and stays in squatting position until he relieves. Cardiac examination reveals systolic ejection murmur over the upper right sternal border. X-ray shows boot-shaped heart. What is the most likely diagnosis? Tricuspid atresia Transposition of the great arteries Tetralogy of Fallot Total anomalous pulmonary venous return Truncus arteriosus Loading...1239. A college student visits the clinic for pruritic maculopapular rash on abdomen, trunk, and palms of the hands and soles of the foot. Generalized lymphadenopathy and wart-like lesions are seen around anal area. Which of the following laboratory tests is the most useful for this patient? Venereal Disease Research Laboratory (VDRL) test Chlamydia titer Weil-Felix titer Blood culture of gonococci Loading...1240. A 54-year-old woman with a 6-year history of type 2 diabetes visits her physician for a regular examination. She was initially treated with oral hypoglycemic but her HbA1c had gotten worse so, her physician switched to insulin last year. Six-month ago, she had surgery in her wrist to release compression caused by carpal tunnel syndrome. Now, she complains of progressive increase in her feet size. Examination reveals coarse facial features with prominent supraorbital ridge. What is the most appropriate test to help reach the diagnosis of this case? Measurement of thyroid stimulating hormone (TSH) Assessment of insulin-like growth factor 1 (IGF-1) Fasting serum glucose test Measurement of HbA1c Dexamethasone suppression test Loading...1241. Following statements about the use of the Metformin is incorrect? A biguanide Hypoglycaemia risk is low Insulin sensitiser Requires insulin for action Promotes insulin secretion Loading...1242. A fireman presents to the ER with headache and dizziness after putting out a fire. Which of the following is the best first step of action? Obtain CT scan of the head Obtain EKG Obtain MRI of the brain Check carboxyhemoglobin level Loading...1243. Which of the following side effects occurs with both tricyclic antidepressants and phenothiazines? Orthostatic hypotension Excessive salivation Seizures Weight loss Loading...1244. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ibandronate Furosemide A & B Ethambutol Fluconazole Loading...1245. Which one of the following drugs is effective only for the influenza A virus? Oseltamivir None of these Zanamivir A & B Rimantadine Loading...1246. Which one of the following nerves would be likely affected if a stab injury is established to the lower brachial plexus (C8-T1)? Musculocutaneous nerve Axillary nerve Radial nerve Ulnar nerve Loading...1247. Cortisol is released from which part of the adrenal medulla? Zona glomerulosa All of these Zona fasciculate A & B Zona reticularis Loading...1248. Which of the following is the cellular mechanism of epinephrine? Activation of phospholipase Activation of acetylcholinesterase Activation of adenylyl cyclase Inhibition of adenylyl cyclase Loading...1249. A 42-year-old African-American woman presents to the clinic because of dyspnea that worsens over the last 6 months. She has no fever, chest pain or loss of weight. The patient works as a preschool teacher. Physical examination is unremarkable. Chest x-ray shows bilateral hilar lymphadenopathy. What is the most likely diagnosis? Asbestosis Tuberculosis Pneumonia Sarcoidosis Lung cancer Loading...1250. A 4-year-old boy is brought to his physician by his mother. She is worried and tells you that her son is weak and not growing properly. He chews his fingers and lips constantly and seems to enjoy it. On examination, there is marked loss of tissues on his fingers and lips. His serum and urine levels of uric acid are both high. What is the most likely diagnosis of this condition? Tay-sachs disease Hurler syndrome Lesch-Nyhan syndrome Gaucher disease GalactosemiaPage 51 of 66 Loading...1251. Which of the following drug is a derivative of Fenamic acid? Piroxicam Mefenamic Acid ketorolac Etodolac Diflunisal Loading...1252. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is no chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Aspirin Metoprolol Heparin Refer to cardiologist Cardioversion Loading...1253. Which of the following is the mechanism of action of digoxin to increase cardiac contractility? Inhibition of Na/K ATPase Inhibition of phosphodiesterase Inhibition of K/Ca ATPase Inhibition of Na/Ca ATPase Loading...1254. Bicornuate uterus results from failure of the fusion of which of the following structures? Paramesonephric ducts Urogenital sinus Nephrogenic ridges Mesonephric ducts Loading...1255. An 80-year-old man is diagnosed with severe atherosclerosis. He has been a heavy smoker for 62 years and also has a long history of hypercholesterolemia. Atherosclerotic occlusion of which of these arteries will cause insufficient perfusion of the urinary bladder? Lateral sacral External iliac Inferior epigastric Internal iliac Loading...1256. A 17-year-old boy who is being treated for leukemia develops a fever. He begins treatment with antibacterial, antiviral, and antifungal agents and 2 days later develops acute renal failure. Which of the following drugs is most likely responsible for this adverse effect? Amphotericin B Ampicillin Acyclovir Ceftazidime Vancomycin Loading...1257. Which of the following drug is Antiprogestrin? Sitagliptin Bicalutamide Metformin Acarboseich one of the following drugs Increases Glucose-dependent insulin release and decreases secretion of glucagon? Pioglitazone Loading...1258. Which one of the following antibiotics is the most appropriate treatment of chancroid, a bacterial infection caused by Haemophilus ducreyi? Ceftriaxone Ampicillin Ciprofloxacin Vancomycin Loading...1259. A 27-year-old pregnant woman in her sixth week presents for her first prenatal visit. Ultrasound confirms fetal cardiac activity and length consistent with 6 weeks of pregnancy. It also shows a simple cyst measures 4-cm on the left ovary. What is the best next step of management? Hormonal treatment Termination of pregnancy Surgical removal of the cyst Assurance and follow up on next visits Wide spectrum antibiotics to prevent infection Loading...1260. Which one of the following medications increases the threshold for angina? Metoprolol Furosemide Benazepril Digoxin Loading...1261. Which of the following is a characteristic finding in isopropanol poisoning? Elevated serum BUN and creatinine Ketosis without acidosis Blindness due to ocular accumulation Elevated anion gap Loading...1262. Which of the following ligaments is most likely torn in a case of posterior dislocation of the hip? Iliofemoral ligament Sacrotuberous ligament Ischiofemoral ligament Loading...1263. Which one of these drugs can lead to weight gain and constipation? Clozapine Ziprasidone Bromocriptine Pimozide Loading...1264. Aspirin has anti-platelet effect that lasts for the life of the platelet. What is the average life of a platelet? 120 days 2-4 days 24 hours 7-10 days Loading...1265. A 30-year-old man with hypertension is prescribed labetalol. It antagonizes which of the following receptors to be effective against hypertension? Both alpha and beta adrenoceptors Alpha-adrenoceptors Beta-adrenoceptors Nicotinic receptors Loading...1266. A 28-year-old man has a minor injury as a result of motor car accident. He complains of severe pain due to a scratch on his scalp across the front hairline. Which one of these nerves is related to this pain? Trigeminal nerve Oculomotor nerve Facial nerve Vagus nerve Orbital nerve Loading...1267. A 51-year-old man is brought to the emergency room because of severe abdominal pain which is radiating to his back. Today, the patient had many episodes of vomiting. He is an alcoholic, drinking daily but he does not smoke or take any recreational drugs. On physical examination, the patient is lying down in the fetal position and appearing to be ill and febrile. There is also an area of bluish periumbilical discoloration on the skin of his abdomen. However, there is no flank discoloration. There are also reduced bowel sounds and he is having severe mid epigastric tenderness upon palpitation. The rectal examination is normal. What is your primary diagnosis? Acute cholecystitis Pyelonephritis Necrotizing pancreatitis Appendicitis Loading...1268. Achilles tendon xanthoma is most likely characteristic of which one of the following conditions? Pseudogout Diabetes mellitus Systemic lupus erythematosus Familial hypercholesterolemia Loading...1269. Which of the following drugs is the initial therapy for Alzheimer disease? Pilocarpine Methacholine Carbachol Donepezil Loading...1270. A 56- year-old man visits his physician complaining of lower back pain for 1 week. He was moving to a new house and carrying a lot of furniture during the last 2 weeks. He does not remember any injury or trauma to his back. His pain is not radiating, improving by rest and ibuprofen and worsening by movement. Medical, surgical and family histories are unremarkable. On examination, vital signs are within normal limits. There is a diffuse tenderness over the lumbar area. Neurological examination is normal. Laboratory tests are normal. What is the most appropriate next step of management for this patient? X-ray of lumbar spine Refer to a rheumatologist HLA-B27 testing Complete bed rest with ibuprofen for 3 days Electromyography Loading...1271. Which of the following characteristics is correct if the drug is highly tissue-bound? High metabolic rate Low plasma concentration Low drug dilution Low volume of distribution Loading...1272. Oxytocin is an agent used to increase uterine contractions during labor and also control postpartum bleeding and hemorrhage has the following adverse effects except? Uterine Hypertonicity Bradycardia Hyponatremia Phlebitis Neonatal jaundice Loading...1273. Which one of the following drugs blocks dopamine uptake transporter? Marijuana Cocaine Alcohol Nicotine Loading...1274. Which of the following is the target LDL in a patient with diabetes? 70-100 100-130 Less than 70 More than 130 Loading...1275. Adrenal insufficiency is commonly combined with which one of the following findings? Hypercalcemia Hyperglycemia Hyperkalemia HypernatremiaPage 52 of 66 Loading...1276. A patient is brought to the emergency room in a deep coma following a motor car accident. Vital signs, general examination and local chest and abdominal examinations are normal. Head CT scan is normal. Which of the following is the most likely initial diagnosis? Epidural hematoma Diffuse axonal injury Cerebral contusion Subdural hematoma Loading...1277. Which of the following drug is Cholinergic agonist used for diagnosis of myasthenia gravis as well as an antidote for tubocurarine? Atropine Tyramine Atracurium Edrophonium Piruterol Loading...1278. A drug that act as laxative is one of the following? Sulbactam Bumetanide A & B Furosemide Magnesium hydroxide Loading...1279. Naloxone is the treatment of choice of which one of the following toxicities? Methylphenidate overdose Hydrocodone toxicity Citalopram overdose Amitriptyline toxicity Loading...1280. Which one of the following drugs may cause parkinsonism-like adverse effect? Haloperidol Quetiapine Olanzapine Clozapine Loading...1281. Mechanism of action of repaglinide? DPP-IV inhibitor A-glucosidase inhibitor Insulin sensitiser GLP-1 agonist Insulin secretagogue Loading...1282. Absorption of levodopa-carbidopa is reduced when taken with meals rich in which of the following nutrients? Fat Carbohydrate Protein Loading...1283. Zalcitabine belongs to the class of following drugs? Anti malaria Antiprotozoal Antifungal Antiviral Antipyretic Loading...1284. A 78- year-old-man who is recently diagnosed with a malignant brain tumor visits his physician with his wife to discuss his treatment options with radiotherapy and chemotherapy. When the physician explains the benefits and risks of each option, he notices that the patient does not understand everything he is saying. Meanwhile, his wife understands and asks questions. The physician knows them very well as they both share their own values and make their medical decisions together for a long time. They both agree to proceed with radiation and chemotherapy. What is the most appropriate next step in management? Seek guardianship through the court Schedule another appointment for the patient only to be sure of his own decision Start treatment after obtaining a written consent from his wife Start treatment immediately Refer the patient for psychiatric evaluation Loading...1285. Which of the following drug is a derivative of Propionic acid? Diflunisal Piroxicam ketorolac Mefenamic Acid Etodolac Loading...1286. Which one of the following drugs belongs to H2 histamine receptor blocker? Ezetimibe Indanyl carbenicillin Ranitidine Atorvastatin Torsemide Loading...1287. Which one of the following medications effectively lowers intraocular pressure? Morphine Ergonovine Latanoprost Atropine Loading...1288. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Succinylcholine Atropine Benztropine Acetylcholine Tamsulosin Loading...1289. Androgen is released from which part of the adrenal medulla? Zona glomerulosa Zona reticularis All of these Zona fasciculate A & B Loading...1290. Which one of the following gastrointestinal conditions is NOT associated with blood in stools? Cancer colon Irritable bowel syndrome Ulcerative colitis Diverticulosis Loading...1291. Which of the following receptors are membrane receptors (not intracellular)? Receptors for thyroid hormones Receptors for vitamin D Receptors for steroids The nicotinic receptors for acetylcholine Loading...1292. Prostaglandin is derived from prostanoic acid, prostanoic acid contains 20 carbon fatty acids, how many carbons rings in the structural formula of prostanoic acid? 4 carbon ring 3 carbon ring 6 carbon ring 2 carbon ring 5 carbon ring Loading...1293. Which of the following cellular pathological changes affects myocardial fibers in a case of irreversible myocardial infarction? Decreased intracellular pH Increased cytoplasmic sodium Depletion of myoglobin stores Karyorrhexis of the nuclei Loading...1294. Which of the following drug are coumarin derivative oral anticoagulants? Dicumarol Phenindione Heparin Menadione Phytonadione Loading...1295. Which of the following is not a feature of Tetralogy of Fallot? Right ventricular hypertrophy Overriding aorta Pulmonary stenosis Atrial septal defect Loading...1296. A drug that belongs to thiazolidinediones is one of the following? Ethacrynic Acid A & B Pioglitazone Sulbactam Cefazolin Loading...1297. Which one of the following medications has a significant alpha-adrenergic blocking activity? Clozapine Haloperidol Risperidone Chlorpromazine Loading...1298. Which of the following types of sensations is carried to the thalamus by the anterolateral tracts after crossing the spinal cord? Fine touch Crude touch Position Vibrations Loading...1299. Which one of the following is the most common cause of vitiligo? Chemical Trauma Infection Autoimmune Loading...1300. Atropine is often used prior to administration of inhalant anesthetics to reduce which of the following? Vomiting Muscle tone Secretions Heart ratePage 53 of 66 Loading...1301. Which one of the following statements about the digoxin is incorrect? 36 hours half-life None of these Indicated for diastolic HF Low therapeutic index Increase contractility Loading...1302. A 48-year-old man with a long history of type 1 diabetes and hypertension develops sudden chest pain and dizziness. On examination, pulse is 110, blood pressure is 80/50, no pulsus paradoxus, lungs are clear and jugular veins are dilated. ECG shows sinus tachycardia with ST elevation in leads II, III and AVF. What is the best next step of action? IV calcium gluconate IV dobutamine IV fluids stat Sublingual glyceryl nitrate (GTN) IV heparin Loading...1303. A 37-year-old woman presents to the emergency room complaining of general tingling sensation all over her body and spasm of her right hand for 1 hour. Her spasm is worsening and she feels as her body becomes more rigid. She had undergone subtotal thyroidectomy 2 weeks ago and the incision is healed and clean. Blood tests reveal very low serum calcium level. What should be the immediate therapy to reverse her symptoms? Levothyroxine Vitamin D Calcium gluconate Calcitonin Parathyroid hormone Loading...1304. Measurement of the content of which one of the following could help to compare the collagen content of several tissues? Cysteine Proline Hydroxyproline Glycine Loading...1305. A drug that causes REACTIVATION OF ACETYLCHOLINESTERASE? Echothiophate Pralidoxime Tacrine Neostigmine Loading...1306. Which one of the following glucocorticoids is long acting? A & B Prednisolone Amiloride Dexamethasone Cortisone Loading...1307. Which one of the following actions of epinephrine is blocked by prazosin? Pupil dilation Tachycardia High stroke volume Bronchial dilation Loading...1308. Which one of the following antihypertensive medications is appropriate to use for an asthmatic patient? Metoprolol Timolol Labetalol Propranolol Loading...1309. A 56 year old man is taken to the emergency room after having grand mal seizure during a staff meeting. He has no history of seizure but he complains lately of recurrent headaches on the morning and decrease in intensity later in the day. Laboratory investigations and imaging studies are performed. Which of these tests will confirm the diagnosis of glioblastoma multiform? MRI of the brain CSF analysis Head CT scan Brain biopsy Loading...1310. What is the mechanism of action of aminoglycosides? Inhibition of general metabolic pathways Disruption of ribosomal protein synthesis Disruption of cell wall hemostasis Blocking pathogens recognition of the host Loading...1311. What is the most appropriate treatment of organophosphate poisoning? Pralidoxime Morphine Hexamethonium Pyridostigmine Loading...1312. A patient is diagnosed with posterior dislocation of the hip. Which one of the following ligaments is most likely torn? Sacrotuberous ligament Iliofemoral ligament Ischiofemoral ligament Lacunar ligament Loading...1313. An alcoholic patient presents with progressive fatigue and lethargy. He has a history of liver cirrhosis. Hepatic encephalopathy is expected. Which of the following is the first line of treatment? Oral lactulose Oral lorazepam Broad spectrum antibiotics Intravenous thiamine Loading...1314. Which one of the following drugs is a Tetracycline? Cefepime Demeclocycline Cefdinir Cefadroxil Loading...1315. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefaclor Cefadroxil Cefepime Ceftibuten Loading...1316. Which one of the following medications enters the cell and acts on a cytoplasmic receptor? Propranolol Dexamethasone Insulin Adrenaline Loading...1317. A 30-year-old female after thyroidectomy needs replacement therapy. The preferred thyroid preparation for maintenance replacement therapy is which of the following drugs? Liotrix Desiccated thyroid Protirelin Liothyronine Levothyroxine Loading...1318. Erythema infectiosum (Fifth disease) is caused by which of the following organism? Parvovirus B19 Coxsackie A virus Paramyxovirus Rubella virus Loading...1319. Which one of the following cell markers is unique for NK cells? CD40 CD56 CD16 CD14 Loading...1320. Which of the following is the most likely cause of decreased visual acuity in pregnancy? Thickening of the cornea Macular degeneration Optic nerve degeneration Retinal detachment Loading...1321. Which of the following statements correctly describes the relative risk of a study? Odds that the group with a disease was exposed to a risk factor divided by odds that the group without the disease was exposed The proportion of risk reduction attributable to the intervention as compared to a control Risk of developing disease in the exposed group divided by risk in the unexposed group The difference in risk between exposed and unexposed groups Loading...1322. A 5-year-old boy is brought to the ER by his mother. He has fever, cough, lethargy, headache and neck pain. On examination, his temperature is 103.2 F, his neck is rigid and tender and Kernig sign is positive. CSF is clear and significant for glucose 60 mg/dL, protein 80 mg/dL, no bacteria or pus cells and lymphocytes count is 70%. What is the most likely causative organism? Staphylococcus Aureus Neisseria Meningitidis Streptococcus Pneumonia Streptococcus Bovis Echovirus Loading...1323. Which one of the following inhibit the excretion of Indomethacin, naproxen, and ketoprofen? Probenecid Allopurinol Sulfinpyrazone Colchicine Loading...1324. Which one of the following types of cell secretions involves exocytosis? Merocrine secretion Apocrine secretion Holocrine secretion Loading...1325. Purple toe syndrome is caused by using the therapy of which drug? Phenytoin Digoxin Amikacin Warfarin CyclosporinePage 54 of 66 Loading...1326. A 55-year-old man with a history of type 2 diabetes, hypertension and hypercholesterolemia presents for his routine examination. He is tall and obese. His vital signs are pulse 88/min, blood pressure 156/86 and oxygen saturation 98%. Which of the following is the most important action to reduce the risk of stroke in this patient? Blood glucose control Weight loss Blood pressure control Cholesterol reduction Loading...1327. Which of the following endocrine disorders is characterized by high blood pressure, sodium and water retention, low potassium level and decreased renin activity? Secondary hyperaldosteronism Pheochromocytoma Primary hyperaldosteronism Addison’s disease Loading...1328. Bulging of anterior fontanelle is considered after examination of which one of the following anatomic landmarks? Pterion Lambda Bregma Sagittal suture Loading...1329. A 26-year-old woman visits her physician with a complaint of discomfort in her left knee for 2 weeks. It is exaggerated when she is sitting for a long time and relieved with analgesics. She admits that she had this discomfort on and off since she was at high school. On examination, the left knee does not show any signs of inflammation. It shows induration and tenderness on the back of the knee. X-ray shows local opacity on the back of the left knee joint. Acute arthritis Hydrarthrosis Tear of posterior collateral ligament Baker cystat is the most likely diagnosis? Osteoarthritis Loading...1330. Dizziness, tinnitus, blurred vision, and headache are linked with the following drug? A & B Primaquine Quinine All of the above Quinidine Loading...1331. Which one of the following cells secretes glycosaminoglycan and is found in the terminal and respiratory bronchioles? Macrophages K cells Clara cells Pneumocytes type Loading...1332. Which of the following is the most common etiology of type II diabetes? Insulin receptor deficiency Low insulin production Increased hepatic glycogen breakdown Altered hormone-receptor complex Loading...1333. Which of the following characterizes syndrome of inappropriate antidiuretic hormone secretion? Hyperosmotic volume contraction Euvolemic hyponatremia with continued Na excretion Recommended treatment is desmopressin acetate and hydration Serum osmolality is greater than urine osmolality Loading...1334. Which one of the following drugs belongs to 1st generation Cephalosporins? A & B Cefadroxil Cefdinir Cefazolin All of the above Loading...1335. A 78-year-old woman presents to the office with her daughter. Last week, she fell twice while she was walking with her daughter. She was not shaking or lost her consciousness and she got up in a minute. Her medical history is significant for hypertension and osteoarthritis. She takes Lisinopril daily and ibuprofen as needed. She also takes diphenhydramine to help her sleeping during the night. Her vital signs are within normal limits on sitting and standing. All her laboratory tests are within normal ranges. Her mini-mental status test is normal. What is the best explanation for this patient’s fallings? Alzheimer’s disease Old age Side effect of one of her medications Osteoarthritis Postural hypotension Loading...1336. A 35-year-old woman begins treatment for an acute urinary tract infection. A few days later, she experiences hemolysis. Which of the following drugs is most likely to be da cause of the hemolysis? Trimethoprim Gentamycin Metronidazole Tetracycline Nalidixic acid Loading...1337. Which of the following locations is the most common site of mural thrombus following myocardial infarction? Right atrium Left ventricle Aorta Right ventricle Loading...1338. Terbinafine is a drug of choice for treating dermatophytoses, it's blood levels are Increased by following drug? Caspofungin Rifampin Cimetidine Nystatin Loading...1339. Which one of the following arteries is most likely affected in a case of expressive aphasia? Anterior cerebral Middle cerebral Posterior cerebral Vertebral Loading...1340. A 63-year-old woman visits her physician for a follow up after a week of antibiotic therapy for acute bronchitis. Her condition is deteriorated. Her physician suggested repeating the antibiotic. The patient disagreed saying that she does not like to take the antibiotic and she did not take it as prescribed. Which of the following is the appropriate response? Why don’t you like to take this medication? I am afraid, you have to take this antibiotic otherwise, you will have more complications of the condition. Do you understand the benefits of taking this medication on time? What side effects did you experience? Loading...1341. Infection in body causes one of the following issue? High Blood pressure Fever Aids Headache Loading...1342. A 32-year-old man visits his physician for a follow up after receiving a punch to the right side of his face. He complains of difficulty to chew food on the right side. Examination reveals possible injury to muscles of mastication. Muscles of mastication are derived form which of these structures? Branchial Arch 3 Branchial Arch 2 Branchial Arch 1 Branchial Arch 5 Branchial Arch 4 Loading...1343. Retention of sodium and water is decreased by using one of the following drugs? Enalapril Acetaminophen Methyldopa Diltiazem Loading...1344. Which one of the following features characterizes Crohn’s disease from ulcerative colitis? Bloody diarrhea Colectomy is curative Perineal fissures and fistulas Continuous disease beginning at rectum and extending without skipped areas Loading...1345. A drug that effects the thyroid hormone is one of the following ? Sulbactam Furosemide Bumetanide A & B Levothyroxine Loading...1346. Which one of the following statements about the use of Fenoldopam is wrong? Lowers blood pressure Dopamine-1 receptor agonist Increase renal perfusion Useful in Glaucoma Loading...1347. A 45-year-old man is admitted to the hospital for a scheduled surgery. Two days later, he develops fever, chills, cough and chest pain. This hospital has reported several cases of methicillin-resistant Staphylococcus aureus (MRSA) in the last 3 months. What should have been given to this patient to prevent his infection with MRSA? Ampicillin Tobramycin Vancomycin Ciprofloxacin Gentamicin Loading...1348. One of the following statements about the sympathetic neurons is wrong? Preganglionic neurons originated from thoracic Postganglionic neurons innervate tissues Preganglionic neurons originated from Lumber Preganglionic neurons are Long Originated from Efferent autonomic system Loading...1349. Which one of the following analgesics inhibits COX in CNS and can be used safely for pregnant women? Acetaminophen Naproxen Ibuprofen Acetylsalicylic acid Loading...1350. Antimuscarinic agent is following? Nicotine Physostigmine Acetylcholine Atropine TacrinePage 55 of 66 Loading...1351. A 62-year-old farmer visits his physician at his wife’s request who noticed that he had an irregular dark pigmented lesion on his back. According to his wife, he has had this lesion since their wedding 35 years ago but lately it became darker and irregular. What is the most important prognostic factor in this case? Diameter of the lesion Color of the lesion Depth of the lesion Age of the patient Loading...1352. Receptors that produce the most rapid response: Intracellular Receptors Ion channel linked receptors Tyrosine-Kinase Receptors G-protein linked receptors Cytokine receptors Loading...1353. An elderly woman complains of sharp pain in her right hip region after she falls out of bed. Radiological studies show fracture of the right femoral head and compressed fracture of T10. Which of the following is the most likely predisposing to these fractures? Osteoporosis Metastases Osteomalacia Acute osteomyelitis Loading...1354. Which of the following are the characteristics of Beck’s triad? Stasis, hypercoagulability and endothelial damage Hypotension, distant heart sounds and jugular vein distention (JVD) Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Loading...1355. A patient is suffering from xerostomia due to the Sjogren’s syndrome he has been afflicted with for the last few months. Which one of the following is the best for treating xerostomia? Scopolamine Methacholine Carbachol Cevimeline Bethanechol Loading...1356. Which one of the following drugs is a Proteas inhibitor? Maraviroc Indanyl carbenicillin Delavirdine Darunavir Abacavir Loading...1357. A 36-year-old man visits his physician complaining of chronic gastric pain for several years. Physical examination is unremarkable. Serology studies are positive for Helicobacter Pylori. Endoscopy reveals gastritis with no ulcers or tumors. Treatment starts with omeprazole, clarithromycin and metronidazole. What is the most appropriate noninvasive test to check for H. pylori eradication? Examination and culture of gastric contents Rapid urease test Urea breath test Stool analysis and culture Serum test for IgG antibodies against H. Pylori Loading...1358. Which one of the following drugs is a microtubule inhibitor chemotherapeutic drug? Busulfan Vincristine Methotrexate Dactinomycin Loading...1359. A patient comes to the emergency ward with recent organophosphorus compound poisoning. He will have all of the following signs & symptoms except: Muscle Weakness Increased salivation Diarrhea Bronchodilatation Increased lacrimation Loading...1360. Workers in the aniline dye industry are more susceptible to bladder cancer than general population. Meanwhile, studies show that animals, when exposed to beta-naphthylamine develop liver cancer but not bladder cancer. What is the most likely explanation of this finding? Human urinary glucuronidase splits beta-naphthylamine into glucuronic acid and a toxic metabolite. Detoxification of beta-naphthylamine by glucuronic acid conjugation. Beta-naphthylamine is directly carcinogenic to human bladder Metabolism of beta-naphthylamine by human cytochrome 450 system in the liver Loading...1361. A 56-year-old man presents to the emergency room complaining of severe chest pain, nausea and excessive sweating for 30 minutes. ECG and laboratory tests confirm the diagnosis of acute myocardial infarction. What is the most likely reason of diaphoresis in this patient? Parasympathetic stimulation Decreased peripheral resistance Sympathetic stimulation Decreased sodium and water retention Elevated parathyroid hormone Loading...1362. Which of these medications is the drug of choice in treatment of severe digitalis intoxication? Immune Fab Calcitonin Propranolol Bupropion Loading...1363. A 17 year old girl is brought to the emergency room by her boyfriend complaining of severe and progressive abdominal pain. Physical examination and laboratory tests confirm a diagnosis of appendicitis. An emergent appendectomy is recommended. Who should sign the consent of surgery? Her boyfriend Her father The ER physician She does not need a consent Her regular physician Loading...1364. Which one of the following medications inhibits protein synthesis by binding to 50S subunit and preventing the formation of the initiation complex? Minocycline Clindamycin Azithromycin Linezolid Loading...1365. A 30-year-old man visits the clinic complaining of recurrent bouts of diarrhea accompanied with bloating over the past few years. He also reports that he has itchy vesicles around the extensor surfaces of his upper and lower extremities. The rest of clinical examination is normal. What is the skin condition most likely present in this patient? Rosacea Seborrheic keratosis Psoriasis Dermatitis herpetiformis Shingles (herpes zoster) Loading...1366. Which one of the following autoantibodies is associated with Goodpasture syndrome? Anti-centromere Anti-Ach receptor Anti-basement membrane Anti-histone Loading...1367. Ozone toxicity leads to chest pain, cough, shortness of breath and sore throat. Sulfur dioxide toxicity is causing cough, runny nose and difficulty breathing due to swollen lungs. Nitrogen toxicity is very rare and is known as inert gas asphyxiation which is used as a suicide method. Trial of proton pump inhibitor Barium swallow Upper endoscopy CT body screening Esophageal manometry Loading...1368. Which of the following conditions could be a serious side effect of sumatriptan? Torsades de pointes Cutaneous flushing Dilated cardiomyopathy Coronary vasospasm Loading...1369. Which of these substances should be taken before consumption of milk in a patient who complains of abdominal pain and cramping after drinking milk? Lactase Acetaminophen Niacin Aspirin Loading...1370. Which one of the following contraceptive methods is contraindicated in women with a history of deep venous thrombosis (DVT)? Intrauterine contraceptive device (IUD) Combined oral contraceptive Depo-Provera injections Norplant Loading...1371. A 72-year-old man complains of itchy skin lesions in the axilla, groin and medial aspect of the thigh. Examination reveals pruritic lesions and bullae in the areas mentioned above and also on forearms and lower legs. There are also painful oral lesions. There is no eye involvement and Nikolsky sign is negative. What is the most likely diagnosis? Dermatitis herpetiformis Scabies Cicatricial pemphigoid Pemphigus vulgaris Bullous pemphigoid Loading...1372. Which of the following anti-retroviral treatments is a non-competitive reverse transcriptase inhibitor? Zidovudine Didanosine Saquinavir Nevirapine Loading...1373. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Indanyl carbenicillin Nizatidine Macrolides Ezetimibe Aluminium hydroxide Loading...1374. A 26-year-old man presents to the clinic with a complaint of recurrent episodes of bloating, flatulence and diarrhea following eating dairy products. He mentions that he does not experience these symptoms if he does not drink milk or if he is fasting. What is the most likely cause of diarrhea in this patient? Osmotic Psychogenic Inflammatory Secretory Loading...1375. Disease prevalence can be measured by which one of the following studies? Cross-sectional study Adoption study Cohort study Case-control studyPage 56 of 66 Loading...1376. Which one of the following intravenous anesthesia has antiemetic action? Ketamine Thiopental Propofol Fentanyl Loading...1377. Periumbilical discoloration is found in a patient diagnosed with acute pancreatitis. Which of the following signs is considered positive in this patient? Nikolsky’s sign Grey Tunner sign Cullen’s sign Murphy’s sign Loading...1378. Which one of the following drugs belongs to Antidiarreals? Aluminium hydroxide Nizatidine Atorvastatin Indanyl carbenicillin Ezetimibe Loading...1379. ADP-mediated platelets aggregation is inhibited by? Abciximab Aspirin Tirofiban Dipyridamole Ticlopidine Loading...1380. A young adult complains of fever, sore throat and lymphadenopathy for 5 days. Examination reveals bilateral enlarged tender cervical lymph nodes and enlarged spleen. Which of the following organisms is most likely responsible for this patient’s condition? Epstein-Barr virus Human papillomavirus Human immunodeficiency virus (HIV) Cytomegalovirus Loading...1381. An 88-year-old woman complains of fatigue and loss of weight over the past 6 months. She lives alone and she has no children. She has a long history of controlled hypertension with atenolol. Vital signs are within normal limits. Her weight is 5Ib less than it was in her last medical visit . Physical examination is unremarkable. Laboratory tests including CBC, thyroid panel and creatinine are normal. Her health screening tests are up-to-date and are unremarkable. What is the appropriate next step? Arrange nursing and supportive assistance Discontinue atenolol MRI of the brain Further investigations including liver function test Begin anti-depressive medication Loading...1382. Which of the following drugs should NOT be initiated in case of acute decompensated heart failure? Metoprolol Lisinopril Potassium supplements Digoxin Loading...1383. Which one of the following cells secretes glycosaminoglycans and found in the in the terminal and respiratory bronchioles? Pneumocytes type I Clara cells K cells Pneumocytes type II Macrophages Loading...1384. Which one of these medication groups is contraindicated in a patient with narrow-angle glaucoma? Cholinomimetics Muscarinic-receptor antagonists Diuretics Beta blockers Loading...1385. Which of the following is the mechanism of action of metoprolol in angina? Reduces requirement of the heart for oxygen Reduces production of epinephrine Increases peripheral resistance Increases central venous pressure Loading...1386. Which of the following conditions is caused by a frameshift mutation? Hereditary nonpolyposis colorectal cancer Becker muscular dystrophy Duchenne muscular dystrophy Sickle cell disease Loading...1387. Rocky mountain spotted fever is caused by following? Chlamydia trachomatis Clostridium tetani Spirochetes Rickettsia Rickettsii Loading...1388. A 22-year-old man with testicular cancer begins chemotherapy. One week later he develops edema of the legs and eyelids and is also found to have a substantial decrease in bilateral auditory acuity. Which of the following agents is most likely responsible for these adverse effects? Methotrexate Cyclophosphamide Cisplatin Vincristine Daunorubicin Loading...1389. Which of the following is the appropriate treatment of amoebic liver abscess? Surgical drainage Amikacin Vancomycin Metronidazole Amoxicillin Loading...1390. Which of the following is the mechanism of action of ciprofloxacin? Inhibits bacterial protein synthesis through binding with 30 S Interferes with bacterial metabolic production Interferes with bacterial cell wall synthesis Inhibits DNA gyrase and relaxation of DNA Loading...1391. A patient presents with itching on his arms and legs for 2 weeks. Erythematous plaques covered with silvery scale are seen on his legs and back of his arms. Which of the following treatment most likely improves this condition? Topical betamethasone Topical mupirocin Oral amoxicillin Oral acetaminophen Loading...1392. What is the most common cause of hypertension in young women? Rheumatic heart disease Oral contraceptive pills Cardiomyopathy Atherosclerosis Loading...1393. Autonomic nervous system is the part of? Spinal cord Brain Peripheral nervous system Somatic nervous system Central nervous system Loading...1394. A 17-year-old male student presents to the clinic with episodes of starring with lip smacking. He reports that he became unresponsive when he has these episodes. These episodes last for 1-2 minutes and he feels confused when he retains his consciousness. General, neurological examinations and EEG are normal. What is the most likely diagnosis? Complex focal seizure Myoclonic seizure Absence seizure Simple focal seizure Tonic-clonic seizure Loading...1395. A patient presents with painless scrotal mass and increased thyroid panel. Which of the following markers would be elevated in this patient? Human chorionic gonadotropin Lactate dehydrogenase Alpha-fetoprotein Follicle stimulating hormone Loading...1396. Which one of the following complications is the common cause of death in acromegaly? Renal failure Hepatic failure Heart failure Splenic infarction Loading...1397. Canal of Schlemm is located at which one of the following junctions? Cornea and sclera Cornea and iris Ciliary body and iris Cornea and ciliary body Loading...1398. Which of the following is the classic electrocardiogram (ECG) finding in pericarditis? S-T segment elevation in anterior leads (V1-V4) Diffuse S-T segment elevation Sawtooth P waves S-T segment elevation in leads II. III and aVF Loading...1399. A 2-year old girl is presented with rectal bleeding. Her mom noticed blood in her BM yesterday and was worried about it and she decided to go to your clinic to examine her daughter. There is mild pain, not related to meals. No nausea or vomiting. The girl is healthy and her routine physical examination 2 months ago was normal. You perform a biopsy and the histopathology of the affected part shows mixed gastric and intestinal tissues. Which of the following is the most likely diagnosis? Volvulus Meckel’s diverticulum Appendicitis Diverticulitis Intussusception Loading...1400. Which of the following medications is considered irreversible alpha receptor antagonist? Labetalol Prazosin Tolazoline PhenoxybenzaminePage 57 of 66 Loading...1401. A 36-year-old man comes to the office for evaluation of involuntary movements of his hands and feet. These movements developed gradually over the past 3 years. He is otherwise in a good health and takes no medication. He does not smoke or drink alcohol. He does not drink any caffeinated beverages or use any recreational drugs. His family noticed recent personality changes over the same period. On examination, there are abnormal involuntary movements of his hands with no certain pattern. He walks in dancing like-movements that make him almost losing his balance. Mental status examination shows abnormal low score. What is the most likely diagnosis of this patient? Drug-induced tremors Tourette’s syndrome Creutzfeldt-Jakob disease Parkinson’s disease Huntington’s disease Loading...1402. Which one of the following medications can be reversed by administration of vitamin K? Clopidogrel Tirofiban Warfarin Heparin Loading...1403. Failure of degeneration of the urachus may lead to which of the following defects? Bladder exstrophy Polycystic kidney disease Bladder adenocarcinoma Renal agenesis Loading...1404. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Ibandronate Furosemide Ethambutol Rabeprazole A & B Loading...1405. Indirect acting irreversible cholinergic agonist drug? Echothiophate Tacrine Pilocarpine Neostigmine Loading...1406. A 19-year-old man with a history of immunodeficiency disease develops fever. Prophylactic measures including some medications are initiated. A few days later, the patient develops acute renal failure. Which of these drugs is most likely responsible? Nystatin Ciprofloxacin Acyclovir Ampicillin Amphotericin B Loading...1407. Which one of the following statements about the use of Leflunomide is incorrect? Reduce pain & inflammation Immunomodulatory agent Can't be used as monotherapy Inhibit Dihydroorotate dehydrogenase Loading...1408. Which of the following is the best initial management of esophageal candidiasis in an HIV patient? Intravenous amphotericin Oral fluconazole Oral nystatin Upper endoscopy Loading...1409. Duration of action of nitroprusside is following? 3 to 6 hours 15 to 30 minutes 1 to 2 minutes 30 minutes Loading...1410. A 70-year-old man with a history of paraplegia develops sudden pleuritic chest pain. A chest CT scan shows a hemorrhagic wedge-shaped pleural based area localized in the right lower lobe. Which of the following is the most likely cause of this lesion? Embolism Atherosclerosis Thrombosis Inflammation Loading...1411. A group of researchers investigate the effect of daily intake of baby aspirin on the development of coronary artery diseases. They are observing two groups of people divided according to intake of aspirin or not and how many develop CHD on each group. The results are listed on a chart. Which of the following is the correct measure to make an assumption? Specificity Positive predictive value Relative risk Odds ratio Loading...1412. Which of the following drug is a part of drugs for osteoporosis? Acetazolamide Rabeprazole Furosemide A & B Calcitonin Loading...1413. Which one of the following drugs binds with dietary phosphate & prevents its absorption? Furosemide Calcitonin Rabeprazole Acetazolamide Sevelamer Loading...1414. Which of the following explains the higher incidence of sickle cell disease in African Americans more than other races? Increased gene flow Natural selection Genetic drift Increased mutation rate Loading...1415. Which one of the following medications stimulates muscarinic receptors in airways when inhaled? Bethanechol Methacholine Pilocarpine Carbachol Loading...1416. Drug distribution into tissues depends mostly on which of the following? Binding to plasma protein Tissue receptors Rate of absorption Interaction with other drugs Loading...1417. Abacavir belongs to the class of following drugs? Anti malaria Antiprotozoal Antibiotics Antipyretic Antiviral Loading...1418. Which one of the following correctly describes nicotinic Ach receptors? Ligand-gated Na+/K+ channels Enzyme-linked receptors G-protein–coupled receptors Loading...1419. Which one of the following cells is derived from monocytes and lying within the alveoli? Clara cells Pneumocytes type I Pneumocytes type II Macrophages K cells Loading...1420. Which one of the following is a anterior pituitary hormone? Torsemide Somatostatin Fenofibrate Atorvastatin Desmopressin Loading...1421. A 64 year-old woman complains of continuous chest pain for 20 minutes. It started suddenly during a stressful meeting. Her pain is dull, aching in nature and 9/10 in severity. She had several episodes of chest pain in the past that starting after exertion and resolving by rest. She was diagnosed with type 2 diabetes and hypertension 8 years ago. Her pulse is 98/min., regular and blood pressure is 160/100. ECG shows T inversion in leads II, III and AVF. Cardiac enzymes are negative. Echocardiography shows no wall motion abnormalities and ejection fraction of 65%. What is the most appropriate immediate treatment of this patient? Enoxaparin Coronary angioplasty Tissue plasminogen activator (tPA) Cardiac catheterization Ibuprofen Loading...1422. Combination of levodopa and carbidopa is recommended. Which of the following explains the significance of this combination? Carbidopa enhances the conversion of peripheral levodopa into dopamine Unknown mechanism Carbidopa enhances the absorption of levodopa Carbidopa enhances the entry of levodopa into brain Loading...1423. Which one of the following can be found in sickle cell disease? Schistocytes Spherocytes Bite cells Howell-Jolly bodies Loading...1424. Alendronate is effective in which one of the following conditions? Osteoporosis Spinal cord lesions Hyperthyroidism Hypoparathyroidism Loading...1425. A drug causes Blockage of the M2 protein ion channel and it's ability to modulate intracellular PH? Amantadine Acyclovir Zanamavir Lamivudine VidarabinePage 58 of 66 Loading...1426. A 45-year-old woman working as a secretary visits her physician complaining of tingling and numbness in her hands. Upon conducting a physical examination, the doctor finds that the patient also has decreased sensation in all her fingers, except for the fifth digit. Keeping these in mind, which of the following muscles is usually weakened in patients suffering from this condition? Opponens pollicis Adductor pollicis Dorsal interossei Lumbricals Loading...1427. Which of the following drug causes Calcium reabsorption that leads to hypercalcemia? Triamterene Hydrochlorothiazide Furosemide Spironolactone Acetazolamide Loading...1428. Megaloblastic anemia is caused by folic acid or Vitamin B12 deficiency. Which of these reactions is directly affected by vitamin B12 deficiency? Propionyl CoA >> methylmalonyl CoA Methylmalonyl CoA >> succinyl CoA Malonyl CoA >> palmitate Succinyl CoA >> fumarate Loading...1429. Which of the following screening tests should be recommended for a patient taking olanzapine for schizophrenia? Hemochromatosis Diabetes Cancer Hemolysis Loading...1430. Which one of the following drugs acts mainly by blocking the synthesis of leukotrienes? Cromolyn Ipratropium Montelukast Zileuton Loading...1431. Mullerian-inhibitory factor plays a major rule in development of the male reproductive system. Which type of cells secrets it? Sertoli cells Leydig cells Loading...1432. Which of the following controls the secretion of thyrotropin? Concentration of iodine in the thyroid gland Concentration of thyroid hormones in the thyroid gland Concentration of thyroid hormones in the blood Concentration of thyrotropin in the pituitary gland Loading...1433. Which of the following conditions should be screened at the age of 50? Prostate cancer Colon cancer Adrenal insufficiency Lung cancer Loading...1434. Which of the following drug is Propionic acid derivative NSAID? Piroxicam Naproxen Mefenamic Acid Aspirin Diclofenac Loading...1435. A 46-year-old woman with a history of fibromyalgia presents to the clinic with a complaint of anxiety, frequent diarrhea and occasional palpitations. She also noticed an unexplained loss of weight and irregular menstrual periods over the last 3 months. What is the most likely laboratory investigation that could lead to a diagnosis in this case? MRI of the brain Cosyntropin stimulation test CT scan of the head Colonoscopy Serum Thyroid Stimulation Hormone (TSH) level Loading...1436. Immune related problem is one of the following? Headache Aids Fever High Blood pressure Loading...1437. A hypoglycemic drug that decreases insulin resistance by binding with peroxisome proliferator-activated receptor gamma (PPAR-gamma) in muscles, fat, and liver? Metformin Sitagliptin Pioglitazone Glyburide Loading...1438. A cytokine that enhances the activity of NK cells and attracts neutrophils and macrophages? Interleukin-1 Tissue necrosis factor-alpha Interleukin-2 Interferon gamma Loading...1439. Epinephrine acts to dilate bronchial smooth muscle through which one of the following receptors? Alpha-2-adrenoreceptors Beta-2-adrenoreceptors Beta-1-adrenoreceptors Alpha-1-adrenoreceptors Loading...1440. A 54-year-old woman with a history of hypothyroidism, hypertension, depression and joint pains develops fatigue, facial rash, headaches, dizziness, confusion, diarrhea and personality changes. She takes levothyroxine, hydralazine, amitriptyline and ibuprofen. Which of these drugs is most likely responsible for this patient new symptom? Amitriptyline Levothyroxine Ibuprofen Hydralazine Loading...1441. N-Substitutions of the catecholamine pharmacophore with isopropyl groups or aryl-alkyl groups improve the selectivity of which receptor? Neuromuscular Activity Alpha Receptor Beta Receptor Muscarinic Receptor Dopaminergic receptor Loading...1442. Which one of the following medications inhibits fibrinolysis? Rifampin Lepirudin Aminocaproic acid Heparin Loading...1443. Which of the following drug is prototypical phenylalkylamine? Diltiazem Losartan Amiloride Verapamil Amlodipine Loading...1444. In case of transposition of the great arteries, the pulmonary artery arises from which one of the following parts of the heart? Right ventricle Left ventricle Right atrium Left atrium Loading...1445. Which of the following organisms is responsible for the development of oral hairy leukoplakia in HIV patients? Human papilloma virus Candida albicans Epstein-Barr virus Bartonella henselae Loading...1446. Patients with genetic polymorphism have delay in metabolism of drugs by acetylation. Which one of the following drugs is most likely affected by that? Hydralazine Clonidine Nitroglycerin Prazosin Loading...1447. A 24-year old woman is diagnosed with vaginal trichomoniasis. She is prescribed metronidazole. She is breastfeeding her 3 month old boy. What is the appropriate advice for this patient concerning the use of metronidazole during breastfeeding? Stop breast feeding indefinitely Advise her to use the pump to collect her breast milk every 24 hours right before she takes daily metronidazole Advise her to keep breastfeeding her child as there is no risk of the drug on breast feeding Stop breast feeding and replace it with formula for 3 months Stop metronidazole and choose another less effective drug as you weigh the benefits and the risks Loading...1448. A 23-year-old man who takes anti-mycobacterial therapy for pulmonary tuberculosis presents to the clinic because of recent visual disturbance and pain with movement of his left eye. On examination, there is tenderness to the pressure of the left eye and a blind spot at the center of vision. Fundus examination reveals pale optic disc. What is the most likely etiology of this patient’s visual symptoms? A side effect of rifampinAs a complication of tuberculosis A side effect of ethambutol A side effect of pyrazinamide A side effect of isoniazid Loading...1449. Which one of the following metals is the most likely cause of allergic contact dermatitis especially in females? Nickel Gold Copper Silver Loading...1450. Which one of the following drugs causes teratogenic effect? Oseltamivir Rimantadine Ribavirin Zanamavir AmantadinePage 59 of 66 Loading...1451. A 23-year-old man with a history of Marfan syndrome presents to the ER complaining of sharp pain on the upper back. He is admitted to intensive care unit (ICU) for the risk of aortic dissection. Which of the following proteins are responsible for the probable development of abdominal aortic aneurysm (AAA) in this patient? Myosin and fibrin Fibrin and actin Myosin and actin Fibrillin and elastin Loading...1452. Which one of the following drugs is a Thiazide Diuretic? Chlorthalidone Indanyl carbenicillin Ezetimibe Fenofibrate Atorvastatin Loading...1453. A 67-year old man is brought to the emergency room by his colleagues for a possible heart attack. One hour ago, he felt excruciating chest pain, shortness of breath and nausea. ECG shows elevation of ST segment in leads 11, 111 and aVF. Therapy is initiated and the patient starts feeling better. ER physician explains to the patient mechanism of action of different drugs used in the treatment. Which of these drugs is responsible for rapid reperfusion in this patient? Tissue plasminogen activator (tPA) Aspirin Argatroban Ticlopidine Loading...1454. Niemann-Pick disease is characterized by deficiency of which one of the following enzymes? Sphingomyelinase Alpha-glucosidase Arylsulfatase Beta-glucosidase Loading...1455. Heparin acts by binding to which of the following substances to achieve its anticoagulant activity? Antithrombin III Factor V Factor VIII Prothrombin Loading...1456. A drug that act as laxative is one of the following? A & B Bumetanide Castor oil Sulbactam Furosemide Loading...1457. An 18-year-old male complains of nausea and slight icterus for 2 weeks. Medical, surgical and family histories are unremarkable. Physical examination reveals slight jaundice and tenderness on the right upper side of the abdomen. Laboratory findings include positive IgM anti-HAV and marked elevation of ALT and AST levels. What is the appropriate management of this patient at this time? Interferon alfa Acyclovir Supportive treatment Famciclovir HBV vaccine Loading...1458. Onychomycoses is the fungal infection of one of the following? Teeth Nails Hair Skin Loading...1459. A 37-year-old woman complains of watery diarrhea, abdominal cramps and periodic facial flushing for the last six months. Examination reveals bilateral wheezing and slightly enlarged liver. Urine analysis shows high levels of 5-hydroxyindoleacetic acid (5-HIAA). Multiple tumors are detected by a CT scan. What is the most likely primary site of these tumors? Small Intestine Colon Stomach Esophagus Loading...1460. Which of the following medications is a non-drowsy anti-allergic medication? Diphenhydramine Chlorpheniramine Loratadine Cetirizine Loading...1461. A 28-year-old man is brought by his father to the emergency room with flaccid coma for 15 minutes. His father mentions that his son had seizures on a regular basis. This time, he lost his consciousness, fell to the ground and his body started jerking for about 3 minutes. While talking to his father, the patient becomes conscious, confused and complains of headache. Which of the following medications is the initial treatment for this condition? Ethosuximide Felbamate Topiramate Phenytoin Loading...1462. A 60-year-old man visits the clinic due to profuse watery diarrhea and left lower abdominal colicky pain for the last 6 hours. Upon taking history, the patient claims that he is taking broad spectrum antibiotics for acute bronchitis. Which is the most likely causative organism for the patient’s new symptoms? Clostridium histolyticum Clostridium Septicum Clostridium difficile Clostridium butyricum Clostridium botulinum Loading...1463. A severe reaction to medicine which causes skin blisters and peels off outside of the body but also could make blisters inside the human body and make it hard to eat anything, this disease is known as? Atherosclerosis Ductus arteriosus Steven-johnson syndrome Hypotrichosis Reye syndrome Loading...1464. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ethambutol Anidulafungin A & B Ibandronate Furosemide Loading...1465. Injury of which of the following nerves caused loss of sensation of the palmar surface of the lateral three and half digits and the lateral part of the palm? Median nerve Ulnar nerve Radial nerve Axillary nerve Loading...1466. Which of the following is calculated by dividing the incidence rate of a disease in exposed by the incident rate of unexposed? Attributable risk Positive predictive value Odds ratio Relative risk Loading...1467. A 35-year-old man comes to the clinic complaining of myalgias and fever. Two weeks ago, he had experienced a brief, self-limited spell of diarrhea after going to a barbecue party. After that, there were no more symptoms and the patient remained asymptomatic. Yesterday evening, he developed fever of 103 F (39.4oC), severe muscle pain, and conjunctivitis. There is also generalized muscular soreness along with a diffuse maculopapular rash. Several minute hemorrhages can be seen under his fingernails. Complete blood count (CBC) performed at the time of admission shows white blood cell count of 15,000/mm3 with 30% eosinophils. Which one of these developmental forms is responsible for his infection? Ovum Rhabditiform larvae Encysted larvae Cyst Loading...1468. A 16 year old woman is brought to the emergency room by her mother following a seizure. She is 30 week pregnant with twins. Her mother told you that her daughter was eating lunch and when she stood up she fell on the floor and started shaking. She never had any seizures before. During last week, she complained of headache and swelling of her face. She missed her last two obstetrician’s appointments. On Examination, she is unresponsive and difficult to arouse. Her blood pressure is 210/120. There is edema of her face and both hands. Fetal heart rate is 140/min.at is the next step of management of this patient? Hospitalization and induction of labor Outpatient treatment and recommend regular visits to the clinic Hospitalization and treatment with antihypertensive and epileptic drugs and wait until delivery at term Hospitalization and observation until delivery at term Loading...1469. A 1-year-old boy with a diagnosis of stable small ventricular septal defect is scheduled for a dental procedure. Which of the following medications should be administered prior to this procedure? Amoxicillin No medication Ampicillin Azithromycin Loading...1470. Which of the following characterized by painless blisters on the back of the hands with friable surrounding skin and hyperpigmentation of the face? Herpes Zoster Contact dermatitis Dermatitis herpetiformis Porphyria cutanea tarda Loading...1471. Which of the following regions of the brain is most likely affected in patients with Huntington’s disease? Temporal lobe Substantia nigra Caudate nucleus Anterior frontal lobe Loading...1472. Para-aminophenol derivative drug is the following? None of these Acetaminophen Mefenamic acid Celecoxib Meloxicam Loading...1473. Alkylating agents are associated with bone marrow depression and for this reason they are inappropriate for this patient. Replication of a chromosome Missing of a chromosome Presence of an extra chromosome Duplication of a gene on the affected chromosome Deletion of a gene on the affected chromosome Loading...1474. Which of the following drug is Non-NucleoSide Reverse Transcriptase inhibitors(NNRTIs)? Nevirapine Zidovudine Saquinavir Amprenavir Acyclovir Loading...1475. Which of the following is Sulphamoyl Derivative diuretic drug? Hydrochlorothiazide Ethacrynic Acid Metolazone Bumetanide ChlorthalidonePage 60 of 66 Loading...1476. Increased level of bradykinin causes? Fatigue Headache Vertigo Fever Dry cough Loading...1477. A patient becomes tetanic because of a recent thyroidectomy. Rapid Reversal of this problem can be done by giving the patient? PTH Vitamin D Calcitonin Calcium gluconate (CaG) Plicamycin (mithramycin) Loading...1478. Following drug causes Systemic acidosis by binding with cations in antacid? Alendronate Metamucil A & B Sevelamer Sodium polystyrene sulfonate Loading...1479. Which of the following is most likely to occur with carbonic anhydrase inhibitors? Hyperchloremia Hyperuricemia Acidic urine Alkalosis Hyperkalemia Loading...1480. Which one of the following drugs causes cyanide toxicity? Sodium nitroprusside Nicardipine Clonidine Minoxidil Loading...1481. Which one of the following diuretics may elevate blood glucose level in some patients? Hydrochlorothiazide Spironolactone Acetazolamide Triamterene Loading...1482. A drug that blocks the viral membrane matrix protein M2 and its ability to modulate intracellular PH? Oseltamivir Ribavirin Acyclovir Rimantadine Zanamivir Loading...1483. A 35 year old man is brought to the ER by his coworker complaining of shortness of breath and dizziness. He was acting hysterical most of the day before he felt dizzy and needed help. They work at a plastic manufacture plant for seven years. What is the treatment needed to be given instantly? Activated charcoal Ethyl alcohol Atropine Sodium nitrite Flumazenil Loading...1484. A 76 year old woman comes to your office for a consultation. Yesterday, she had left hemiparesis for 30 minutes. She thought it was a stroke but now she is completely asymptomatic. She has a history of atrial fibrillation, angina and hypertension. She takes aspirin 81 mg and propranolol 80 mg. What is your appropriate initial management for this patient? Schedule transesophageal echocardiography Schedule another appointment whenever she has symptoms Schedule carotid duplex ultrasonography Obtain CT scan of the head Schedule MRI to the brain Loading...1485. Which of the following is the common cause of secondary dyslipidemia? Familial hypercholesterolemia Diabetes mellitus Familial combined hyperlipidemia Apo C-II deficiency Loading...1486. A 52-year-old man who is recently diagnosed with gout is presented to his physician to discuss his treatment plan. One of the treatments that will be taken is allopurinol. Which of these enzymes is targeted by this medication? Hypoxanthine guanine phosphoribosyltransferase Xanthine oxidase Phosphoribosylpyrophosphate synthase Guanase Loading...1487. Which of the following factors most likely affects the result of a study due to awareness of study subjects that they are being studied? Pygmalion effect Recall bias Hawthorne effect Berkson’s bias Loading...1488. Which one of the following medications act as bacteriostatic by inhibiting bacterial dihydrofolate reductase? Ciprofloxacin Trimethoprim Sulfamethoxazole Dapsone Loading...1489. Which of the following effects is caused by alcohol intake? No effect on body temperature or body heat loss Increased body temperature Increased body heat loss Decreased body heat loss Loading...1490. Which of the following needs to be added to a breast-fed 9-week-old premature infant to improve pallor? Vitamin C Milk formula Orange juice Iron supplements Loading...1491. Which of the following is the most likely cause of death in cases of overdose of hypnotics? Cerebral edema Status epilepticus Hypothermia Depression of the medullary respiratory center Loading...1492. A 72-year-old man presents to the office for evaluation of new symptoms. He has a history of cancer and takes chemotherapeutic treatment. Now he complains of dyspnea and mild fatigue since last week. Examination reveals temperature of 98.3 F, pulse of 80/min, blood pressure of 140/86 and respiratory rate of 22/min. On chest auscultation, there are crackles on both lung bases with no wheezes. A chest x-ray shows bilateral diffuse interstitial markings. Which of the following agents is responsible for this patient’s new features? Cisplatin Etoposide Cyclophosphamide Paclitaxel Bleomycin Loading...1493. A 42 year-old woman presents to the clinic with progressive fatigue and weakness for 6 months. She also complains of tingling and numbness of her arms and legs. Physical examination reveals decreased both superficial and deep sensations in her arms and legs. Blood count reveals decreased numbers of erythrocytes, leucocytes and platelets along with increased mean red blood cell volume. Peripheral blood smear shows enlarged erythrocytes and hypersegmented neutrophils. Which one of these biochemical reactions is involved in this case? Conversion of propionyl –CoA to methylmalonyl –CoA Conversion of succinyl-CoA to fumarate Conversion of methylmalonyl-CoA to succinyl-CoA Conversion of malonyl-CoA to palmitate Loading...1494. A 58-year-old woman is brought to the emergency room complaining of lightheadedness for 4 hours. She has diarrhea with loose stool for 2 days. She explains her symptoms as flu and she drinks lots of water as her neighbor advised her to avoid dehydration. Her physician told her that she should take combined solution of sodium chloride (NaCl) and glucose to prevent dehydration. What is the mechanism of action of this mixture to improve dehydration? It reduces bowel contractions and consequently improves diarrhea Glucose provides energy for NaCl to increase gastric emptiness Cotransport of glucose and NaCl across the intestinal membrane facilitates absorption of water and Na. The mixture helps to increase secretion of water and Na through the large intestine Loading...1495. A 62-year-old man presents to the clinic with rashes all over his body and painful joints. Last month, he was diagnosed with arrhythmia. He is taking one medication for it. Laboratory tests reveal anti-histone antibodies. Which of the following drugs is most likely responsible for this condition? Propranolol Hydralazine Metoprolol Sotalol Verapamil Loading...1496. Sulindac belongs to one of the following class? Oxicam derivative Acetic acid derivative Fenamates Propionic acid Loading...1497. In a case of Barrett esophagus, the normal tissue of the distal part of the esophagus is transferred into which of the following type of tissues? Ciliated columnar epithelium Non-ciliated columnar epithelium Keratinized squamous epithelium Non-keratinized squamous epithelium Loading...1498. An old patient presents with multiple tumors on the liver. Which of the following is the most common site of the primary tumor? Breast Lung Colon Kidney Loading...1499. A 1-year-old boy is brought to the clinic by his mother due to recurrent upper respiratory tract infections and oral fungal infections. Physical examination reveals low set ears and fish-like mouth. Laboratory tests reveal hypocalcemia and chest x-ray shows no thymus shadow. What is the most likely etiology of hypocalcemia in this case? Increased secretion of parathyroid hormone Decreased secretion of parathyroid hormone Increased secretion of calcitonin End-organ hyposensitivity to parathyroid hormone End-organ hyposensitivity to calcitonin Loading...1500. Which one of the following drugs induce Dose Dumping syndrome? Erythromycin Ethanol Digoxin Amiodarone RifampinPage 61 of 66 Loading...1501. Which one of the following drugs is a selective Beta-2 adrenergic long-acting bronchodilator? Formoterol Pirbuterol Albuterol Terbutaline Metaproterenol Loading...1502. High levels of which one of the following substances signals the initiation of gluconeogenesis? Citrate Acetyl CoA Oxalate Adenosine triphosphate (ATP) Loading...1503. Which of the following in the most likely cause of spontaneous abortion in the first trimester? Congenital infection Chromosomal abnormalities Toxemia of pregnancy Maternal drug use Loading...1504. A medical condition in which a portion of blood from the left heart started flowing back to the lungs flowing through the aorta to the pulmonary artery is called? Ductus arteriosus Hypotrichosis Reye syndrome Pulmonary embolism Atherosclerosis Loading...1505. A 32-year-old woman who is recently divorced visits her physician for visual disturbances. The patient complains of trouble vision for 3 days. On examination, tunnel vision is detected along with marked weakness of planter flexion although the patient can walk on her tiptoes without any complaint. All laboratory tests and imaging studies are normal. What is the most likely diagnosis of this patient? Multiple sclerosis Conversion disorder Transient ischemic attack Meningioma Loading...1506. Which of the following is the best screening test for colon cancer? Sigmoidoscopy Barium enema Blood in stool (FOBT) Colonoscopy Loading...1507. Which of the following tests is the most accurate for diagnosis of herpes encephalitis? Viral culture of CSF MRI of the brain PCR of CSF Serological studies for herpes Loading...1508. Following is the 2nd generation cephalosporin drug? Cefdinir Cefadroxil Cephalexin Cefepime Cefaclor Loading...1509. Antihyperlipidemic drugs which consist of open hydroxy acid lactone ring in the structural formula except? Simvastatin Rosuvastatin Pravastatin Atorvastatin Fluvastatin Loading...1510. Researchers perform a study on foot ulcers caused by diabetes. They collect patients of foot ulcers and divided them into a group of patients with diabetes and another group of non-diabetic patients. The researchers compute the rate of foot ulcers in diabetic patients versus non-diabetic patients. This study is considered: Longitudinal study Cohort study Double-blind study Cross-sectional study Case-control study Loading...1511. A 62-year-old man complains of fatigue, progressive weakness and numbness of his arms and legs. Complete blood count shows decreased numbers of erythrocytes and increase in the mean cell volume. Removal of which of these structures requires lifelong administration of the vitamin involved in this case? Ascending colon Left kidney Tonsils Gall bladder Ileum Loading...1512. A 74-year-old man with a long history of emphysema presents to the office for a routine examination. He is complaining of fatigue and shortness of breath for 2 weeks. Physical examination is remarkable for scattered wheezes on both lung bases. Arterial blood gas is ordered for the patient. Which one of these results reflects the shift of oxygen dissociation curve to the right? pH 7.05, bicarbonate 15, Pco2 30 and Po2 90 pH 7.60, bicarbonate 24, Pco2 60 and Po2 90 pH 7.00, bicarbonate 15, Pco2 60 and Po2 90 pH 7.50, bicarbonate 24, Pco2 40 and Po2 90 pH 7.47, bicarbonate 15, Pco2 30 and Po2 90 Loading...1513. Interferon alpha is indicated for the treatment of which one of the following conditions? Rheumatoid arthritis Hepatitis C virus infection Bullous pemphigoid Kidney transplantation Loading...1514. An old patient with a history of a 2-week blunt trauma to his thigh develops an area of yellow-brown color at the site of injury. Which one of the following substances is responsible for this color? Hemosiderin Melanin Bilirubin Lipofuscin Loading...1515. Which of the following types of rashes characterizes Lyme disease? Erythematous maculopapular rash Erythema multiform Erythema migrans Erythema marginatum Loading...1516. A 2-year-old boy is brought to the emergency room by his mother. She tells you that her boy has been crying since she picked him up yesterday form the daycare. She thinks that he has abdominal pain. He vomited twice and he didn’t want to eat breakfast. There is no history of fever, rashes or any prior illnesses. On examination, there is a diffuse abdominal tenderness. Laboratory tests are significant for amylase of 1500 and lipase of 2500. Trauma Congenital annular pancreas Cystic fibrosisat is the most likely etiology of this boy’s condition? Gallstones Viral infection Loading...1517. A 45-year-old woman visits her physician with a complaint of pain and fatigue in her wrist and hand for 6 weeks. MRI confirms the diagnosis of carpal tunnel syndrome. What is the structure that forms the anterior wall of the carpal tunnel? Skin Superficial fascia Palmer aponeurosis Flexor retinaculum Extensor retinaculum Loading...1518. An autopsy of an adult shows enormous cardiomyopathy, high level of cardiac deposition of glycosphingolipids and restricted cardiocytes. Which of the following lipid storage disease is most likely the correct diagnosis? Fabry’s disease Tay-Sachs disease Niemann-Pick disease Gaucher’s disease Loading...1519. Which of the following is the leading cause of blindness in the USA? Cataract Diabetic retinopathy Glaucoma Macular degeneration Loading...1520. An obese 46-year-old man presents to the clinic with complaints of weakness, fatigue and tingling and numbness of his hands and feet. He rarely exercises and he eats almost daily in fast food restaurants. Laboratory tests show fasting blood glucose of 156 mg/dL. He is advised to improve his lifestyle and follow up in 2 weeks. On the next visit, the level of blood glucose is 164 mg/dL. Which of these drugs improves his condition without affecting insulin secretion? Glipizide Carbetamide Tolazamide Glyclopyramide Metformin Loading...1521. Which one of the following statements about the use of Alpha-methyldopa is incorrect? Cardiac output is decreased Causes Sedation and drowsiness Reduce peripheral resistance Alpha² agonist activity Loading...1522. Which of the following is the most common cause of death in an old patient with uncontrolled diabetes? Myocardial infarction Hyperosmolar coma Cerebral hemorrhage Pulmonary embolism Loading...1523. Your 8-year-old daughter wakes you up in the middle of the night complaining of severe coughing. You bring the child to the doctor the next day and upon examination, the following is revealed: noisy breathing on inspiration, flaring of the nostrils, marked retractions of the chest wall, and a severe barking cough. She has also developed an upper respiratory tract infection. What would be the best diagnosis for the patient? Bronchiolitis Foreign body stuck in the main bronchus Asthma Viral croup Loading...1524. Select Dihydropyridines Calcium channel blocker drug? Acetazolamide Diltiazam Verapamil Amiloride Nifedipine Loading...1525. One of the OATPs (Organic anion transporting polypeptides) drugs transporters OATP4C1 has a mainly limited distribution to the following? Liver Skin Heart Kidney StomachPage 62 of 66 Loading...1526. Which of the following differentiates Dubin-Johnson syndrome from Rotor syndrome? Conjugated hyperbilirubinemia Level of liver enzymes Mode of inheritance Black pigmentation of the liver Loading...1527. Which of the following is the nonessential amino acid? Methionine Lycine Alanine Histidine Leucine Loading...1528. Following drug is a phenylalanine derivative? Pioglitazone Metformin Nateglinide Repaglinide Loading...1529. What is the correct match regarding the genetic transmission of the following diseases? Huntington’s disease- Autosomal recessive Leber hereditary optic neuropathy- Mitochondrial inheritance Hypophosphatemic rickets- X-link recessive Duchenne muscular dystrophy- X-link dominant Loading...1530. A 73-year old man is brought to the emergency room for dizziness and nystagmus. Examination reveals loss of sensation on the left side of his face and the right side of his body. He has hoarseness of voice and drooping of his right eyelid. The right side of the face is drier than the left side. He is referred for CT scan on his head. What is the site of lesion responsible for hoarseness of this patient? Nucleus Ambiguus Inferior cerebellar peduncle Spinal nucleus of fifth cranial nerve Lateral spinothalamic tract Loading...1531. A 57-year-old man with a history of bleeding per rectum visits his physician to discuss the results of his recent CT colpography test. The test was positive for the presence of a colorectal polyp. The sensitivity and specificity of this test to detect a colorectal polyp is 75% and 90% respectively. What is the probability that this patient indeed has a colorectal polyp? 88% 84% 86% 90% 92% Loading...1532. A 5-year-old boy is brought to the emergency room for cough and trouble breathing. His parents mention that he was playing with some coins a short time ago. The coin is most likely lodged in which of the following lobar bronchi? Right superior lobar bronchus Right middle lobar bronchus Left superior lobar bronchus Left middle lobar bronchus Loading...1533. A 27-year-old man complains of 2-week history of watery diarrhea and 5 lb. weight loss. He had no similar episodes in the past, did not travel recently, did not eat out or take antibiotics. He quit smoking last month after 1 PPD for 5 years. His family history is significant of some relatives who are diagnosed with inflammatory bowel syndrome. His examination reveals diffuse mild abdominal tenderness and hyperactive bowel sounds. Stool analysis is negative for blood and ova. What is in the history and/or examination could support the diagnosis of ulcerative colitis rather than Crohn’s disease in this patient? Smoking cessation Having first attack in his twenties History of diarrhea and weight loss Negative stool analysis Family history of inflammatory bowel syndrome Loading...1534. Extrapyramidal side effects develop after the use of haloperidol due to its effect on which of the following receptors? Alpha-adrenergic receptors Nicotinic receptors Muscarinic receptors Dopamine receptors Loading...1535. Which one of the following medications inhibits cell wall synthesis of bacteria? Erythromycin Aminoglycoside. Carbapenemotein Synthesis Inhibitors: Aminoglycosides, Tetracyclines, Spectinomycin, Erythromycin, Lincomycin, Clindamycin and Chloramphenicol. Clindamycin Loading...1536. A drug that belongs to proton pump inhibitor is one of the following? Rosiglitazone Ethacrynic Acid A & B Esomeprazole Sulbactam Loading...1537. Which of the following is the mechanism of action of benzodiazepines in the treatment of insomnia? Alpha adrenergic antagonist Binds to serotonin receptors Dopamine receptor agonist Binds to GABA receptors Loading...1538. A 61-year-old male represents to the ER with severe substernal chest pain. He’s given sublingual nitroglycerin and oxygen. His vital signs are within normal limits and ECG is normal. Which of the following is the best next step? Coronary angiography Echocardiography Thallium stress test Aspirin Loading...1539. Following are the 17 alpha-Hydroxyprogesterone derivatives Having a pregnane nucleus in the structural formula? Promethazine Fexofenadine Cyproheptadine Hydroxyzine Cetirizine Loading...1540. Drug-to-drug interaction based on absorption, transformation, distribution and excretion is considered which one of the following types of interaction? Pharmaceutical interaction Pharmacokinetic interaction Pharmacodynamic interaction Chemical interaction Loading...1541. A patient presents with wrist pain at night. It affects his palm, thumb, index and radial half of his ring finger. Flexion of the wrist reproduces the pain. Which of the following is the name of this sign? Wonder sign Tinel sign Phalen sign Chandler sign Loading...1542. A 55 year-old man underwent internal fixation of fractured femur after a motorcar accident and massive bleeding 24 hours ago. He was stable after the surgery and his urine output was normal after he received intravenous fluids. Now he complains of substernal chest pain and shortness of breath. On examination, His temperature is 98.8 F, Pulse is 110/min, blood pressure is 160/100 mmHg and his respiratory rate is 24/min. There is no jugular vein distention. His extremities have established pulses bilaterally and good perfusion. Auscultation reveals harsh systolic murmur across the precordium and crackles on both lung bases. ECG shows sinus tachycardia with delayed precordial transition and no other changes. Laboratory tests including cardiac enzymes are all normal. What is the most likely diagnosis? Pericardial effusion Hypertrophic cardiomyopathy Acute myocardial infarction Left bundle branch block (LBBB) Septic shock Loading...1543. A 3-year- old boy is brought to the emergency room by his mother for vomiting and bloody diarrhea for 4 days. She also noticed low urinary output in the past 2 days. He had no similar attacks in the past and his medical and family histories are unremarkable. On examination, his vital signs are within normal limits, no signs of dehydration, no abdominal tenderness or organomegaly and no rashes or any skin manifestations of hemorrhage or internal disease. Laboratory tests reveal mild anemia, thrombocytopenia and abundant reticulocytes and schistocytes. Urinalysis reveals red blood cells with no casts. Kidney function tests reveal marked increase in serum urea and creatinine. Coagulation profile is normal. Stool Shiga toxin test is positive for Shiga toxin 2. Idiopathic thrombocytopenic purpura Hemolytic uremic syndrome Renal stones Henoch-Schonlein purpura Thrombocytopenic thrombotic purpuraat is the most likely diagnosis? Loading...1544. A 64 year old woman complains of low back pain for 1 week. Her pain and tenderness is localized over the lumbar spine and exaggerated by movement. Her physician prescribes her a phosphonate drug. What is the mechanism of action of this drug for this patient? Increase urinary calcium reabsorption Increase osteoblast activity Increase vitamin D absorption Decrease osteoclast activity Decrease parathormone activity Loading...1545. A patient presents with persistent dry cough and high potassium. Which of the following medications is associated with these side effects? Digoxin Albuterol Furosemide Captopril Loading...1546. Drugs that show capacity-limited elimination have which of the following property? A constant ratio of drug metabolites are formed as the administered dose increases The elimination half-life(t½) remains constant As the administered dose increases the elimination half-life (t½) increases First-order elimination kinetics is followed by low and high doses both Loading...1547. Which one of the following macrolide drugs has a half-life of >40 hours? Azithromycin Telithromycin Clarithromycin Erythromycin Loading...1548. Which of the following is the best immediate treatment for unresponsive patient with diabetic ketoacidosis? Observation and hospitalization Bicarbonate Insulin and glucose Metformin Loading...1549. A 9-month-old boy is brought to the pediatrician for persistent cough, poor weight gain, and several bouts of pneumonitis. Upon taking history from his mother, she mentions that her boy had been also having foul-smelling and very large stools for a few months. Which of the following diagnostic techniques will help to provide the correct diagnosis of this condition? CT of the chest Serum immunoglobulins TB skin test Sweat chloride test Loading...1550. Deficiency of the enzyme argininosuccinate in urea cycle leads to the accumulation of which one of the following? Arginine Citrulline Ornithine ArgininosuccinatePage 63 of 66 Loading...1551. A young woman presents with chronic diarrhea found to have rectovaginal fistula. Which of the following is most likely her diagnosis? Celiac disease Ischemic colitis Crohn’s disease Ulcerative colitis Loading...1552. Which of the following is the earliest EKG sign of myocardial infarction? Large peaked T-wave S-T elevation Inverted T-wave Pathological Q –wave Loading...1553. A patient presents with multiple ecchymosis of the skin, high prothrombin and partial thromboplastin times, Low serum He, low platelet count and positive D-Dimer test. Which of the following is the most likely diagnosis? Vitamin K deficiency Hemophilia A Disseminated intravascular coagulopathy von Willebrand disease Loading...1554. Which one of the following enzymes catalyzes the rate limiting step in glycolysis? Pyruvate kinase 6-Phosphofructo-1 kinase Glyceraldehyde-3-phosphate dehydrogenase Phosphofructokinase-2 Loading...1555. Release of which of the following chemical mediators results in pain in cases of acute inflammation? Histamine Serotonin Prostaglandin Complement C3b Loading...1556. A 30-year-old man with a history of recurrent generalized tonic-clonic seizures visits his psychiatrist to refill his prescriptions. He complains of recent diplopia and ataxia. His doctor thinks that these new symptoms are related to one of his medications. Which of these drugs is most likely responsible for these new symptoms? Carbamazepine Gabapentin Ethosuximide Acetazolamide Clonazepam Loading...1557. Which one of the following gout treatments lowers serum uric acid? Probenecid Indomethacin Allopurinol Colchicine Loading...1558. A 25-year-old man presents to his physician for his first annual physical examination. He moved to the city for a new job and he got health insurance so, he decided to do regular annual checks. His past medical, surgical and family histories are unremarkable. He does not smoke or drink alcohol. He does not take any recreational drugs. His physical examination and laboratory tests are normal. What is the recommended screening test for all patients at his age? Colonoscopy Prostate specific antigen (PSA) Depression screening test Erythrocyte sedimentation rate ECG stress test Loading...1559. A 45-year-old man who was diagnosed with malaria and received anti-malarial medication presents to the office with progressive fatigue and loss of appetite. He also mentions that he noticed that his urine has become dark lately. Urinalysis is positive for both bilirubin and urobilinogen. Blood studies show serum total bilirubin of 4.3 mg/dL, hemoglobin concentration of 8.5 g/dL and hematocrit of 30%. Which medication is used to treat this patient? Primaquine Doxycycline Atovaquone Chloroquine Loading...1560. Which of the following is the most likely cause of sudden death in a case of portal hypertension? Congestive heart failure Ventricular fibrillation Rupture of esophageal varices Hepatic encephalopathy Loading...1561. Which of the following conditions is considered a physiological change for normal pregnancy? Decreased body weight Decreased GI tone and motility Decreased blood volume Decreased respiratory tidal volume Loading...1562. Which one of the following parts of the heart is the major consumer of oxygen and requires the best blood supply? Right ventricle Right atrium Left atrium Left ventricle Loading...1563. Which of the following activity of Acetaminophen is weak? Anti inflammatory Analgesic Antipyretic A & C A & B Loading...1564. Which of the following anticoagulant medications works by binding to thrombin and inhibiting it? Ticlopidine Hirudin Warfarin Heparin Loading...1565. The structural formula of epinephrine and Norepinephrine called? 1,2-dihydroxybenzene Pyrocatechol Catechol All of these Loading...1566. A 28-year-old woman visits her physician complaining of fatigue, palpitations, loss of weight, diarrhea and irritability for 4 months. She is also intolerant to hot weather. She does not smoke or drink coffee or alcohol. Her vital signs are within normal limits except for rapid regular pulse. She has fine tremors and her skin is warm and moist. Her thyroid gland is asymmetrically enlarged and lobulated. Laboratory tests show: Thyroid stimulating hormone (TSH) 0.02 mu/ml and T4 28 mu/dL Repeated doses due to repeated failures Ablation of the gland and future hypothyroidismr physician discusses advantages and disadvantages of all treatment options with the patient. What is the most important disadvantage of radioactive iodine therapy? Anemia and agranulocytosis Acute renal failure Leukemia Loading...1567. A 22-year-old man visits the clinic for evaluation of fever, headache and dry cough for 7 days. His medical history is unremarkable and he takes no medications. He had no previous similar episodes. On examination, temperature is 101.3 F, pulse is 88/min. and blood pressure is 100/60 mmHg. On auscultation, his lungs are clear bilaterally. X-ray shows diffuse infiltration in the lower lobes of both lungs. What is the most likely causative organism? Mycobacteria Mycoplasma Rickettsia Fungi Streptococci Loading...1568. Which one of the following drugs is a neuromuscular blocker drug? Atropine Nicotine Neostigmine Atracurium Benztropine Loading...1569. Which of the following esophageal disorders is the most likely a complication of HIV infection? Adenocarcinoma Candida esophagitis Achalasia Esophageal varices Loading...1570. A 55-year-old woman presents to the emergency room for a cut wound on her hand. While she was cutting a piece of meat, she lost control of the knife resulting in a longitudinal wound in her hand. Bleeding stopped after a few minutes. Now she is concerned about tetanus vaccination. Records show that she received all the doses of tetanus-diphtheria (Td) and the last one was 4 years ago. What is the appropriate therapy for prophylaxis of tetanus in this patient? Tetanus toxoid Tetanus immunoglobulin Tetanus toxoid and tetanus immunoglobulin Tetanus toxoid followed by tetanus immunoglobulin after 5 days No further therapy Loading...1571. Which of the following group is a compulsory part structural formula of Losartan? Carboxylate group Phosphinic acid group Sulfahydril group Thiol group Imidazole ring Loading...1572. A 57 year-old man presents to the ER complaining of sudden dizziness and heart racing for 2 hours. He is a CEO of a big corporation and those symptoms started during a stressful meeting. At first, he felt irregular heartbeats and ignored it but he felt dizzy soon after and his staff drove him to the ER. There is NO chest pain, shortness of breath or loss of consciousness. His vital signs are temp 97.8 F, Pulse 138/min and irregular, blood pressure 107/60 and oxygen saturation is 96% on room air. His ECG shows irregular irregularity with absence of P waves. What is the appropriate treatment to improve his symptoms in this current situation? Refer to cardiologist Heparin Metoprolol Aspirin Cardioversion Loading...1573. A 23-year-old woman presents to the clinic with a complaint of pain in her left breast since last night. She is breastfeeding her 1-week-old girl. On examination, her temperature is 99.8 F, her pulse is 88/min. and her blood pressure is 120/80. Local examination of the left breast reveals a localized soft tender 1-inch area. Her past medical, surgical and family histories are unremarkable. What is the most likely diagnosis? A clogged milk duct Inflammatory carcinoma Milk engorgement Mastitis A breast abscess Loading...1574. A 32 year-old woman visits her physician because she hasn’t been able to protrude and depress her tongue. Which of the following is the most likely affected muscle? Genioglossus muscle Hypoglossus muscle Palatoglossus muscle Styloglossus muscle Loading...1575. Which one of the following medications inhibits protein synthesis by binding to 50S subunit and preventing the formation of the initiation complex? Azithromycin Minocycline Clindamycin LinezolidPage 64 of 66 Loading...1576. Which one of the following antihypertensive medications is directly acting vasodilator? Nifedipine Labetalol Clonidine Enalapril Loading...1577. Three boys are brought to the urgent care clinic complaining of fever, sore throat and itchy eyes. On examination, their temperature range from 101.2 F to 102.7 F. Their conjunctivas are red and inflamed. They are a part of a group of five kids from alimentary school camp out on the lake. Which of these is the most likely causative organism of this illness? Measles Rubella Coxsackie virus Adenovirus Echovirus Loading...1578. A 61-year-old man with a history of recurrent angina and hypertension presents to the clinic for routine examination. His vital signs are within normal limits and his cardiac examination is satisfactory. Reviewing his medication, his physician noticed that he had been prescribed labetalol for 2 years. He discussed with his patient replacing it with atenolol. What is the difference between the mechanism of action of atenolol and labetalol? Atenolol is a beta1 blocker while labetalol is a beta 2 blocker Atenolol is a non-selective beta-blocker while labetalol is a beta1 blocker Atenolol is a beta 2 blocker while labetalol is a beta1 blocker Atenolol is both beta and alpha-blocker while labetalol is a beta-blocker only Atenolol is a beta1 blocker while labetalol is both alpha and beta-blocker Loading...1579. Terbinafine blood levels are decreased by the following the drug? Griseofulvin Cimetidine Caspofungin Rifampin Loading...1580. Which one of the following joints is the only articulation between the upper limb and the trunk? Glenohumeral joint Coracoclavicular joint Acromioclavicular joint Sternoclavicular joint Loading...1581. A 20-year-old male athlete complains of pain and weakness of his right arm. He had a successful surgery on his knee last week. He has been walking with the aid of crutches since then. On examination, he is unable to extend his right arm at the elbow or the hand at the wrist. There is also a sensory deficit over the dorsolateral area of the right hand. Neurological examination is otherwise normal. Which nerve is most likely related to his symptoms? Ulnar nerve Median nerve Radial nerve Suprascapular nerve Axillary nerve Loading...1582. Which one of the following drugs increase survival in patients with MI? Digoxin Furosemide Verapamil Atenolol Loading...1583. Which of the following is Coumarin derivative Anticoagulant agent? Ticlopidine Abciximab Warfarin Heparin Clopidogrel Loading...1584. Which of the following statements about ACh release and deactivation is true? Acetylcholinesterase (AChE) inhibitors, such as pyridostigmine, are not effective in the treatment of myasthenia gravis, because patients with myasthenia gravis have no cholinergic nerve terminals to release ACh The influx of Na+ into the depolarized axon terminal is a prerequisite for the release of stored ACh MAO inhibitors are important in the treatment of depression because they inhibit the breakdown of ACh into its constituents acetic acid and choline ACh release is blocked by the toxin associated with clostridium tetani Uptake of ACh into the presynaptic receptor is the most important mechanism in terminating the ACh signal Loading...1585. A 68-year-old woman presents to her physician with a complaint of urinary incontinence. She is a nursing home resident and her staff tells you that the patient feels desire to void but she cannot hold it to the restroom. She has no pain, dysuria or hematuria. She has a long history of hypertension and she takes metoprolol and hydrochlorothiazide. Which of the following is the most appropriate first step of management? Refer to a urologist Prescribe tolterodine therapy Try timed voiding Discontinue metoprolol Discontinue hydrochlorothiazide Loading...1586. A 57-year-old woman presents to the clinic with a complaint of abnormal uterine bleeding. A biopsy is taken for evaluation of endometrial cancer. At which stage endometrial cancer is often diagnosed? I II VI III Loading...1587. A 72-year-old man presents to his physician for a follow up after a stroke. The physician pays more attention for the care of this patient, as he reminds the physician of his father who passed away 3 years ago after having a stroke. This is an example of which one of these mechanisms? Displacement Transference Acting out Projection Countertransference Loading...1588. Following statements about the use of Metformin in wrong? Cause renal impairment Discontinued in women with a SCr> 1.4 Cause Vit. B12 depletion Don't use in alcoholic patients Loading...1589. Which of the following drug is used as Mast Cell Stabilizers? Montelukast Ipratropium Bromide Salbutamol Terbutaline Sodium Cromoglycate Loading...1590. As physicians, we need to know some definitions in Genetics, which are related directly to our practice and guide us to diagnose and treat many genetic disorders. These items include genome, genotype, phenotype, genetic code, gene expression, etc. Which one of the following choices describes the definition of a phenotype? Physical location of a trait on a DNA molecule An observable physical or biochemical trait on an organism Genetic history of an organism DNA structure that determines the expression of a trait Loading...1591. Which of the following receptors is the most likely affected in patients with diabetes mellitus? Pacinian corpuscle Meissner’s corpuscle Ruffini’s end organ End-bulbs of Krause Loading...1592. A 15-year-old boy is diagnosed with “Walking pneumonia”. Which of the following is the most effective treatment of this condition? Tetracycline Ampicillin Vancomycin Azithromycin Loading...1593. A 32-year-old woman who is recently divorced visits her physician for visual disturbances. The patient complains of trouble vision for 3 days. On examination, tunnel vision is detected along with marked weakness of planter flexion although the patient can walk on her tiptoes without any complaint. All laboratory tests and imaging studies are normal. What is the most likely diagnosis of this patient? Multiple sclerosis Conversion disorder Transient ischemic attack Meningioma Loading...1594. A 62-year-old woman with a history of type 2 diabetes complains of nausea and bloating for the last three months. Gastric emptying studies confirm the diagnosis of diabetic gastroparesis. What is the first line therapy for this patient? Clindamycin Sodium bicarbonate Omeprazole Metoclopramide Ondansetron Loading...1595. A drugs interfere with metabolism of azathioprine requiring a reduction in dosage? Probenecid Allopurinol Colchicine Sulfinpyrazone Loading...1596. Which one of the following actions is produced by muscarinic cholinergic agonists? Activation of inhibitory G protein Inhibition of phospholipase C Decreased release of intracellular calcium Decreased IP3 production Loading...1597. A 65-year-old farmer presents to the clinic for evaluation of a long time lesion on his forehead. During an examination for life insurance, the nurse noticed it and advised him to go to the clinic for evaluation. The lesion is 1.5 in diameter, tan and nodular with an adherent greasy scale. Microscopically, it shows atypical keratinocytes invading the dermis and presence of intercellular bridges between the tumor cells. What is the most likely diagnosis? Mycosis fungoides Langerhans cell histiocytosis Malignant melanoma Squamous cell carcinoma Basal cell carcinoma Loading...1598. During development, hypothalamus arises from which one of the following structures? Metencephalon Telencephalon Diencephalon Mesencephalon Loading...1599. Which of the following characteristics differentiates cephalohematoma from caput succedaneum in newborn? Cephalohematoma crosses suture lines Cephalohematoma will never calcify Cephalohematoma does not cross suture lines Cephalohematoma disappears in the first few days Loading...1600. Which of the following drug contain the Carboxylic group, replaced with tetrazole ring in the structural formula? Valsratan Candesartan Losartan Irbesartan TelmisartanPage 65 of 66 Loading...1601. Which of the following groups are found in the structural formula of Angiotensin-converting enzyme inhibitors Except? Carboxylate group Phosphinic acid group Thiol group Sulfahydril group Imidazole ring Loading...1602. A 64-year-old man arrives to the emergency room after recurrent vomiting of blood for the last 2 hours. He recently underwent right hip replacement and had taken heparin to prevent thromboembolic complications. Internal bleeding is suspected and treatment with protamine has begun. What kind of antagonism is related to this treatment? Irreversible Physiological Competitive Chemical Loading...1603. A drug that Increases the cell permeability allowing more Flucytosine to penetrate the cell? Amphotericin B Nystatin Caspofungin Ketoconazole Loading...1604. Which of the following drugs improves skeletal muscle spasm by acting inside the muscle cell? Dantrolene Diazepam Botulinum toxin Tubocurarine Loading...1605. A 22-year-old G2P1 at 28 weeks gestation presents to the emergency room with heavy vaginal bleeding. Which of the following is NOT recommended as the next step of action? Admit the patient Digital pelvic examination Ultrasound examination of the pelvis Stabilize the patient Loading...1606. Which one of the following medications causes black stools? Propranolol Buspirone Iron Ampicillin Loading...1607. A 6-year-old boy presents with fever, malaise, cough, running nose and conjunctivitis. His past medical history indicates that he did not receive any immunizations due to his parents’ religious belief. On examination, his temperature is 102.7 F and there are white spots on a red base close to his second molar teeth. He also has non-pruritic, maculopapular rash on his face, behind his ears and spreading to his chest. What is the most likely diagnosis? Mumps German measles Measles Chicken pox Smallpox Loading...1608. What are the 5 Ps of ischemia due to peripheral vascular disease? Pain-Pallor-Proteinuria-Paresthesia-Paralysis Pain-Pallor-Paralysis-Paresthesia-Poikilothermia Pain-Pallor-Paralysis-Polycythemia-Proteinuria Pain-Pallor-Paresthesia-Proteinuria-Poikilothermia Loading...1609. A 75-year-old man presents to his physician for a routine examination. He has a history of hypertension, hypercholesterolemia and osteoarthritis. He takes atenolol, simvastatin and ibuprofen as needed. His pulse is 76/min and irregular. Blood pressure is 130/74. Physical examination and imaging studies are normal except for asymptomatic atrial fibrillation. What is the most appropriate next step in management of this patient? Assurance and follow up in 3 months Start aspirin Start low molecular weight heparin and warfarin Start warfarin Start heparin Loading...1610. A 56-year-old man with a history of type 2 diabetes presents to his physician for a follow up. He complains of recurrent hypoglycemic reactions to his medications. Which of these medications is most likely responsible for this patient’s hypoglycemic reactions? Glyburide Glucagon Acarbose Metformin Rosiglitazone Loading...1611. A 37-week-pregnant woman is brought to the ER for fainting, severe abdominal pain and massive vaginal bleeding. She is pale, diaphoretic, her pulse is 130 and her blood pressure is 90/60. Which of the following is the most likely diagnosis? Pre-eclampsia Placenta previa Abruptio placenta Amniotic fluid embolism Loading...1612. A 17-year-old girl visits the clinic with her mother who is concerned that her daughter had not menstruated yet and her breast had not been significantly developed. She also notes that her daughter is color blind. The girl denies any sexual relationship or using any recreational drugs. Examination reveals normally appearing girl with small non-developed breasts. There is lack of pubic hair and her vagina and cervix are not fully developed. She is 5f5in tall and weighs 130 Ib. Cardiac, chest and abdominal examinations are unremarkable. What is the most likely initial diagnosis? Androgen insensitivity disorder Early pregnancy Kartagener’s syndrome Turner’s syndrome Kallmann’s syndrome Loading...1613. Cefaclor belongs to one of the following generations of the cephalosporin? 4th generation 1st generation 2nd generation 3rd generation Loading...1614. Dull, Persistent, and tightening is the characteristics of the following type of headache? Tension-Type Headache A & B Cluster Headache Migraine Headache Loading...1615. A young man presents to the ER with a head injury. He lost his consciousness after the accident but he is alert now. A CT scan shows convex-shaped area of hemorrhage over the left parietal region. Which of the following structures is the most likely injured due to this accident? Inferior cerebral artery Middle meningeal artery Cavernous sinus Superior cerebellar artery Loading...1616. Conversion of ethanol to acetate will result in increase production of which of the following? Pyruvate NAD NADH Oxaloacetate Loading...1617. A drug inhibit the human gonadal and adrenal steroids synthesis along with fungistatic property? Ketoconazole Caspofungin Nystatin Flucytosine Loading...1618. One of the following statements about the Parasympathetic neurons is wrong? Preganglionic neurons originated from the Sacral region Preganglionic fibers are long Postganglionic fibers are long Originated from Efferent autonomic system Preganglionic fibers arise from cranial nerves Loading...1619. Penicillin type antibiotics half-life is increased due to inhibition of tubular secretion by which of the following drug? Pegloticase Aspirin Celecoxib Probenecid Colchicine Loading...1620. Misoprostol is an analog of the following type of prostaglandin? PGI2 PGE PGE1 PGA PGB Loading...1621. A 21 year-old college student complains of the appearance of yellowish coloration on her sclera. She mentions that she had been dizzy and weak for the last 3 days but did not feel any pain or fever and no change in stool color. Abdominal examination reveals normal bowel sounds and no tenderness or organomegaly. Laboratory tests show normal levels of liver enzymes and serum bilirubin. Which is the most likely initial diagnosis? Hepatocellular disease Gallstones Pancreatic cancer Hemolysis Obstructive jaundice Loading...1622. Which of the following hormone belongs to the oral diabetic agent? A & B Somatrem Pioglitazone Oxytocin Furosemide Loading...1623. At which of these vertebral levels does the trachea bifurcate? Seventh cervical Sixth thoracic First thoracic Fourth thoracic Loading...1624. Pellagra is a disease that causes inflammation of the skin, diarrhea, dementia, and sore in the mouth. It's also characterized by 4D's diarrhea, dermatitis, dementia, and death. Which vitamin deficiency cause pellagra? Vitamin C (Ascorbic Acid) Vitamin A (Retinol) Vitamin D (Cholecalciferol) Vitamin B3 (Niacin) Vitamin B6 (Pyridoxine) Loading...1625. Which of the following is the main reason that acetylcholine not used in clinical practice? It is hydrolyzed very quickly It is toxic It has a long half-life It is expensivePage 66 of 66 Loading...1626. Which one of the following anti-depressants is most likely effective in bulimia nervosa? Amitriptyline Fluoxetine Tranylcypromine Imipramine Loading...1627. Gonadotropin-releasing hormones are synthesized by which of the following nuclei of the hypothalamus? Anterior nuclei Arcuate nuclei Ventromedial nuclei Dorsomedial nuclei Loading...1628. A 16-year-old high school student presents to the office with her mother for consultation. Her mother admits that her daughter is sad because she broke up with her friend recently. Yesterday, she tried to cut her wrist but her brother screamed and they stopped her. The girl does not make eye contact and her head is bent down through the interview. She tells the doctor that she does not want to live anymore. She refuses to answer any question and declined physical examination. What is the most appropriate next step of management for this patient? Prescribe antidepressant and follow up in a week Refer to the psychiatric clinic next day Refer to the social worker Advise family that it is a normal reaction and keep an eye on her Admit to the hospital Loading...1629. Which of the following is/are the most likely biopsy features seen in Celiac disease? Flattening of villi with excess lymphocytes Lymphoid aggregates with granulomas Crypt abscesses with excess neutrophils Lack of ganglion cells Loading...1630. A patient is suffering from gouty arthritis along with hyperuricemia, which of the following drugs is indicated to give relief to this patient? Colchicine Probenecid Allopurinol Pegloticase Febuxostate Loading...1631. Drugs that are taken orally must first cross several biological membranes (diffusion barriers) before they reach their target receptors inside the body. Which of the following drug characteristics would best facilitate this process? protein-bound quaternary charge glucuronidated form unionized form ionized form Loading...1632. A college student is brought to the ER for fever and agitation. Examination reveals high temperature, tachycardia, constricted pupils and horizontal nystagmus. Which of the following is the responsible substance? Phencyclidine Lysergic acid diethylamide Alcohol Cocaine Loading...1633. Which one of the following is an anterior pituitary hormone? Fenofibrate Somatostatin Torsemide Corticotropin Atorvastatin Loading...1634. Indomethacin belongs to one of the following class? Propionic acid Acetic acid derivative Fenamates Oxicam derivative Loading...1635. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefadroxil Cefepime Cefaclor Cefotaxime Loading...1636. Peripheral resistance is linked with one of the following issues? Headache Blood pressure Fever Aids Loading...1637. During normal inspiration, the diaphragm: Relaxes Does not move Contracts Loading...1638. A 34 year-old man with one week history of sore throat presents today for fever, hoarseness, difficulty breathing and drooling. On physical examination, his temperature is 102.3f and has inspiratory stridor. What is the most preferred next action for this patient? Throat swab and culture Ultrasonography of the neck Admit to the intensive care unit Prescribe broad spectrum antibiotic Serology for infectious mononucleosis Loading...1639. Which of the following medications may cause acute cholestatic hepatitis? Colchicine Metformin Acarbose Erythromycin Loading...1640. A 43 year-old man presents to the ER with an excruciating chest pain radiates to his jaw and left shoulder. The patient is in moderate distress. Examination reveals a small nodule in his right Achilles tendon. Family history indicates that his father died of a heart attack in the age of 45. His laboratory tests reveal elevated levels of CK-MB, troponin T and very high level of cholesterol (670 mg/dL). A diagnosis of myocardial infarction and familial hypercholesterolemia is made in this patient. The patient is admitted to the intensive care unit (ICU) for urgent treatment. The patient has improved in the following week and is discharged. A list of medications has been prescribed for this patient. Which one of these medications acts through inhibition of the enzyme HMG-CoA reductase? Atenolol Lovastatin Fenofibrate Orlistat Niacin Loading...1641. Which of the following medications is a non-drowsy anti-allergic medication? Chlorpheniramine Diphenhydramine Loratadine Cetirizine Loading...1642. Anemia occurs in cases of multiple myeloma most likely results from which one of the following factors? Infiltration of bone marrow with massive numbers of plasma cells Defective absorption of urine Loss of blood due to gastrointestinal bleeding Low production of hemopoietin Loading... By Medical Tactics|2022-03-01T16:03:08+00:00March 1, 2022|Question Banks|0 CommentsShare This Story, Choose Your Platform!FacebookXRedditLinkedInWhatsAppTelegramTumblrPinterestVkXingEmail About the Author: Medical Tactics Related PostsPharmacology Questions Bank 1.0 Pharmacology Questions Bank 1.0 Easy Biology MCQs Gallery Easy Biology MCQs Easy Medical MCQs Gallery Easy Medical MCQs Medical Questions & Answers Gallery Medical Questions & Answers Leave A Comment Cancel replyComment Save my name, email, and website in this browser for the next time I comment. Hover or click the text box below or Type/Enter: med2020
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