USMLE QUESTIONS BANK 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moreGeneral Pediatric-related - MCQs 1-10Page 1 of 66 Loading...1. 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? Precocious puberty Androgen insensitivity syndrome Congenital adrenal hyperplasia Isolated premature thelarche Pituitary adenoma Loading...2. Which one of the following drugs is a selective beta-1 agonist? Dopamine Amrinone Dobutamine DigoxinRead moreThe following represents an essential element to an effective quality council? Loading...3. A drug that is more effective in combination with itraconazole to treat chromoblastomycosis? Flucytosine Nystatin Amphotericin B Griseofulvin Loading...4. What is the meaning of Dose Dumping phenomenon? Excess release of control released drugs Excess release of Insulin High dose of IV drugs Excess release of glucose Excess release of gastric acid Loading...5. Which of the following drugs is used to inhibit viral neuraminidase? Naftifine Ibandronate Acyclovir Oseltamivir Capecitabine Loading...6. Which one of the following anti-Parkinsonism medications should be avoided in patients with glaucoma? Trihexyphenidyl Selegiline Levodopa Bromocriptine Loading...7. Which statement about the use of pilocarpine is wrong? Lack of selectivity relaxation of Ciliary muscles Used for Xerostomia Used for Sjögren syndrome Produce rapid miosis Loading...8. Which of the following is the most serious contraindication of electroconvulsive therapy? History of seizures Meningioma Old age History of fracture Loading...9. 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? Vascular Trauma Pure psychogenic Endocrine Infection Loading...10. Anterior spinal artery arises from which of the following arteries? External carotid artery Internal carotid artery Vertebral artery Basilar artery Loading...11. EXPLANATION: It is positive in this patient. Tinel sign is reproduction of pain by tapping or percussion on the medial nerve. Cervical spine x-ray Erythrocyte sedimentation rate (SER) Anti-cyclic citrullinated peptide Rheumatoid factor Loading...12. 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 Ask the patient for the reason of refusal and don’t force her to take her medications 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. Loading...13. Which of the following drug belongs to H2 histamine receptor blocker? Niacin Nizatidine Glimepiride Oxacillin Cefoxitin Loading...14. Which of the following drug belongs to Sulfonylureas? Oxacillin Urae Glimepiride Niacin Cefoxitin Loading...15. Amantadine belongs to the class of following drugs? Antiprotozoal Antibiotics Antiviral Antipyretic Anti malaria Loading...16. 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. Hydralazine Verapamilich of the following drugs is most likely responsible for this condition? Propranolol Metoprolol Sotalol Loading...17. 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? Osteoporosis Osteomalacia Osteopetrosis Osteitis fibrosa cystica Loading...18. 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) Conduct disorder Bipolar disorder Loading...19. Gonadotropin-releasing hormones are synthesized by which of the following nuclei of the hypothalamus? Anterior nuclei Ventromedial nuclei Dorsomedial nuclei Arcuate nuclei Loading...20. 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 Metoprolol Refer to cardiologist Heparin Loading...21. Which one of the following glucocorticoids is a short acting? A & B Amiloride Betamethasone Hydrocortisone Prednisone Loading...22. Which of the following is a poor prognostic sign of acute pancreatitis a day after initiation of hydration and appropriate treatment? Blood urea nitrogen (BUN) rises 6 mg/dL Random serum glucose of 70 mg/dL Hematocrit drops by 4% Serum amylase of 900 IU/L Loading...23. 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 minimal biological effect 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 Loading...24. Which of the following medications acts to prevent cholesterol absorption at small intestine brush border? Colestipol Gemfibrozil Ezetimibe Cholestyramine Loading...25. Which one of the following joints is the only articulation between the upper limb and the trunk? Glenohumeral joint Sternoclavicular joint Acromioclavicular joint Coracoclavicular jointPage 2 of 66 Loading...26. Which of the following medications is the most effective immunosuppressant in cases of organ transplantation? Cyclophosphamide Azathioprine Vinblastine Cyclosporine Loading...27. 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? Amniotic fluid embolism Placenta previa Abruptio placenta Pre-eclampsia Loading...28. Cholestatic Jaundice is the adverse effect of the following drug? Clindamycin Chloramphenicol Cefepime Erythromycin Loading...29. A drug that belongs to Loop Diuretics is one of the following? Furosemide Doripenem Cefazolin A & B Sulbactam Loading...30. A female patient is found to have an absent right kidney. Which of the following may also be found in this patient? Absent right ovary Unicornuate uterus Imperforate hymen Pelvic testis Loading...31. Which one of the following drugs induce Dose Dumping syndrome? Digoxin Ethanol Amiodarone Erythromycin Rifampin Loading...32. Which of the following characteristics differentiates cephalohematoma from caput succedaneum in newborn? Cephalohematoma crosses suture lines Cephalohematoma disappears in the first few days Cephalohematoma does not cross suture lines Cephalohematoma will never calcify Loading...33. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Nizatidine Capreomycin Indanyl carbenicillin Ezetimibe Aluminium hydroxide Loading...34. Which one of the following nerves would be likely affected if a stab injury is established to the lower brachial plexus (C8-T1)? Ulnar nerve Radial nerve Axillary nerve Musculocutaneous nerve Loading...35. Which of the following characteristics is correct if the drug is highly tissue-bound? Low volume of distribution High metabolic rate Low plasma concentration Low drug dilution Loading...36. 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? Togavirus Toxoplasma gondii Treponema pallidum Trypanosoma cruzi Herpes simplex virus Loading...37. 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) Measurement of HbA1c Assessment of insulin-like growth factor 1 (IGF-1) Dexamethasone suppression test Fasting serum glucose test Loading...38. 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 antibody test HIV p24 antigen CD4 lymphocyte count HIV RT PCR Loading...39. Which of the following is the most likely cause of sudden death in a case of portal hypertension? Hepatic encephalopathy Congestive heart failure Rupture of esophageal varices Ventricular fibrillation Loading...40. 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? Miliary tuberculosis Acute glomerulonephritis Systemic lupus erythematosus Wegener granulomatosis Rheumatoid arthritis Loading...41. Amnestic syndrome due to thiamine deficiency is caused by lesions of which one of the following structures? Limbic system Cerebellum Temporal lobe Parietal lobe Loading...42. 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? Chronic hypertension Lyme disease Smoking High cholesterol Alcohol Loading...43. Indinavir belongs to the class of following drugs? Antiprotozoal Anti malaria Antibiotics Antiviral Antipyretic Loading...44. A drug that is a part of Aminoglycosides is following? Cefaclor Cefepime Cefdinir Tobramycin Loading...45. Which one of the following effects is correlated to direct beta1-adrenoreceptor stimulation? Tachycardia Vasoconstriction Bradycardia Bronchodilation Loading...46. 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 Hepatojugular reflux Raynaud’s phenomenon S3 gallop Loading...47. In an acute attack of gout, Indomethacin is preferred over Colchicine because of which characteristic? Less likely to cause acute renal failure Less likely to cause GI bleeding Less likely to cause diarrhea More likely to prevent further acute attacks More likely to reduce inflammation Loading...48. 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...49. Which of the following histamine H1 antagonists is identified for its serotonin-blocking effect? Loratadine Fexofenadine Cyproheptadine Desloratadine Loading...50. Terbinafine is a drug of choice for treating dermatophytoses, it's blood levels are Increased by following drug? Caspofungin Nystatin Cimetidine RifampinPage 3 of 66 Loading...51. Which of the following signs of infective endocarditis appears as small, tender nodules on the finger and toe pads? Roth’s spots Osler nodes Janeway lesions Splinter hemorrhages Loading...52. 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? Ifosfamide Procarbazine Chlorambucil Vincristine Cisplatin Loading...53. 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? History of diarrhea and weight loss Family history of inflammatory bowel syndrome Negative stool analysis Having first attack in his twenties Smoking cessation Loading...54. 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 End-organ hyposensitivity to parathyroid hormone End-organ hyposensitivity to calcitonin Increased secretion of calcitonin Decreased secretion of parathyroid hormone Loading...55. Which one of the following drugs is the most effective in improvement of ascites? Hydrochlorothiazide Lisinopril Spironolactone Digoxin Loading...56. The sympathomimetic which may promote diuresis by a direct effect on the kidney is: dobutamine norepinephrine Isoproterenol dopamine epinephrine Loading...57. 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 already has HPV infection but she should take the vaccine for other strains of HPV HPV vaccine is essential to treat the current infection She already has HPV infection so, no need for the vaccine She can only take the vaccine later after full recovery Loading...58. Select Dihydropyridines Calcium channel blocker drug? Verapamil Acetazolamide Nifedipine Amiloride Diltiazam Loading...59. Measurement of the content of which one of the following could help to compare the collagen content of several tissues? Proline Cysteine Hydroxyproline Glycine Loading...60. Which one of the following drugs is used to treat asthma? Ezetimibe Repaglinide Hydrochlorothiazide Theophylline Indanyl carbenicillin Loading...61. Which of the following layers of the heart forms the cardiac valves and continues with the intima of the aorta? Myocardium Epicardium Pericardium Endocardium Loading...62. Which one of the following is the most common cause of microcytic hypochromic anemia in a patient diagnosed with progressive renal failure? Iron deficiency anemia Erythropoietin deficiency Frequent hematuria Blood loss Loading...63. Which of the following drug belongs to Carbonic anhydrase inhibitors? A & B Acetazolamide Furosemide Mannitol Urea Loading...64. 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 Rh (D) immune globulin Wide spectrum antibiotics Folic acid derivatives Loading...65. 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? Amylase and lipase levels Laparoscopy Exploratory laparotomy Ultrasound Loading...66. Which one of the following drugs is a Meglitinide drug? Ezetimibe Nateglinide Indanyl carbenicillin Hydrochlorothiazide Fenofibrate Loading...67. 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? Sample distortion bias Hawthorne effect Information bias Confounding bias Loading...68. Peripheral resistance is linked with one of the following issue? Aids Fever Headache Blood pressure Loading...69. Chronic Daily ingestion of 5 g or more acetaminophen for longer than 1 month causes? Liver damage Bleeding compilations Hypersensitivity to NSAIDs Hypersensitivity to Salicylates GI disturbance Loading...70. Which one of the following drugs is a proton pump inhibitor drug? Sucralfate Rabeprazole Cimetidine Misoprostol Loading...71. Which of the following drugs is most likely protective against the toxicity of doxorubicin? Dexrazoxane Mensa Vitamin C Leucovorin Loading...72. Which of the following explains the reason for the formation of atheroma at the bifurcations of arteries such as aorta and carotid? Endothelial dysfunction Hypoxemia Regular blood flow Cholesterol breakdown Loading...73. 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? Stomach Esophagus Colon Small Intestine Loading...74. 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? Echocardiography Thallium stress test Coronary angiography Aspirin Loading...75. Antimuscarinic agent is following? Nicotine Physostigmine Acetylcholine Tacrine AtropinePage 4 of 66 Loading...76. 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 social worker Refer to the psychiatric clinic next day Prescribe antidepressant and follow up in a week Admit to the hospital Advise family that it is a normal reaction and keep an eye on her Loading...77. 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? Azithromycin Ampicillin No medication Amoxicillin Loading...78. 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? Xanthine oxidase Hypoxanthine guanine phosphoribosyltransferase Phosphoribosylpyrophosphate synthase Guanase Loading...79. Which one of the following effects is caused by administration of mecamylamine? Hypertension Tremors Tachycardia Pupillary constriction Loading...80. Injury of the C8 and T1 at the lower portion of the brachial plexus most likely affects which one of the following nerves? Ulnar nerve Median nerve Axillary nerve Radial nerve Loading...81. Which one of the following viruses most likely causes aplastic crisis in sickle cell disease? Hepatitis C virus Herpes simplex virus Parvovirus B19 Rotavirus Loading...82. Which of the following tests is most likely used to rule out congestive heart failure in a case of cardiomegaly during pregnancy? MRI of the chest Echocardiography Arterial blood gas Electrocardiogram (ECG) Loading...83. What is the antidote of Verapamil? Calcium Atropine Both C & D can be used Epinephrine Pyridostigmine Loading...84. Which one of these drugs is associated with aplastic anemia? Nitrofurantoin Penicillin Metronidazole Chloramphenicol Loading...85. Which of the following statements about the use of aminoglycoside is wrong? Accumulate in renal cortex Bind to 50S subunit cross the placental barrier Accumulate in endolymph and perilymph Causes ototoxicity Loading...86. Which of the following is the correct statement about the difference between a strain and a sprain? Strain affects ligaments while sprain affects muscles and tendons Strain affects muscles or ligaments while sprain affects tendons Strain affects muscles or tendons while sprain affects ligaments Strain affects tendons and ligaments while sprain affects muscles Loading...87. Which of the following is the most abused drug for all ages in the United States? Alcohol Cocaine Marijuana Methamphetamine Loading...88. Which of these medications is contraindicated in a case of cardiogenic shock? Metoprolol Norepinephrine Intravenous fluids Dopamine Loading...89. 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? 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 Glucose provides energy for NaCl to increase gastric emptiness Loading...90. 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? CREST syndrome Mallory-Weiss syndrome Bulimia nervosa NSAID-induced esophagitis Staphylococcal food poisoning Loading...91. 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? Celiac trunk Abdominal aorta Inferior mesenteric artery Superior mesenteric artery Loading...92. Which one of the following is the most common cause of vitiligo? Chemical Autoimmune Trauma Infection Loading...93. Which of the following substances is the risk factor in developing mesothelioma? Lead Asbestos Silica Copper Loading...94. 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? Defective closure of tunica vaginalis Undescended testis Defect in the inguinal canal Defect in the pelvic floor Patent processus vaginalis Loading...95. 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? Anterior cord syndrome Conus medullaris syndrome Brown-Sequard syndrome Transverse myopathy Central cord syndrome Loading...96. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Ezetimibe Capreomycin Indanyl carbenicillin Capecitabine Lamivudine Loading...97. Mafenamic acid belongs to following class? Oxicam Fenamates Propionic acid Acetic acid Salicylic acid Loading...98. 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? Fomepizole Physostigmine Flumazenil Nalaxone Neostigmine Loading...99. Which of the following drug belongs to H2 histamine receptor blocker? Niacin Famotidine Glimepiride Cefoxitin Oxacillin Loading...100. Which one of the following phases of the cell cycle is affected by binding p53 to DNA? M G0 G1 G2Page 5 of 66 Loading...101. Which one of the following statements about the functions of histamine is incorrect? Cause itching and pain Stimulate gastric acid secretion increase peripheral resistance Constriction of bronchioles Loading...102. 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? Septicemia Immobilization Surgical complication Effect of medications Loading...103. Which of the following medications prevents cholesterol absorption at small intestine brush border? Niacin Colestipol Fenofibrate Ezetimibe Loading...104. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Ibandronate Isoniazid Rabeprazole Furosemide A & B Loading...105. Conversion of ethanol to acetate will result in increase production of which of the following? Pyruvate NAD NADH Oxaloacetate Loading...106. Which of the following is the mechanism of action of cromolyn for asthmatic patients? Inhibits COX 2 Prevents degradation of mast cells Inhibits phosphodiesterase Blocks adenosine receptors in bronchial smooth muscle Loading...107. 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 Cardioversion Aspirin Loading...108. What is the mechanism of action of zileuton? Inhibition of muscarinic receptor action Inhibition of calcium (Ca2+) channel activity Inhibition of mediator release Inhibition of cytokine production Inhibition of leukotriene production Loading...109. 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 constitution of an organism 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 Loading...110. 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 Limits the production of histamine Stimulates the production of prostaglandin E2 Loading...111. Which one of the following drugs is 2nd generation flouroquinolone? Ciprofloxacin Levofloxacin Nalidixic acid Moxifloxacin Loading...112. Which of the following locations is the most common site of mural thrombus following myocardial infarction? Left ventricle Aorta Right atrium Right ventricle Loading...113. Incretin mimetic is one of the following? Pramlintide Bumetanide Exenatide Furosemide A & B Loading...114. Which of the following drugs is the initial therapy for Alzheimer disease? Pilocarpine Carbachol Methacholine Donepezil Loading...115. 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? Pacemaker implantation Refer to a cardiologist Repeat Holter monitor examination Reassurance and follow up visits Perform exercise stress test Loading...116. 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? Dilation of the pupils Tachycardia Delirium Excessive salivation Dry skin Loading...117. Administration of which one of the following substances most likely reverses the course of Wernicke-Korsakoff syndrome? Niacin Thiamine Vitamin K Riboflavin Loading...118. 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? Propranolol Verapamil Adenosine Lidocaine Amiodarone Loading...119. A drug has a large volume of distribution because it accumulates in muscles? Nitroglycerin Aspirin Digoxin Clopidogrel Acetaminophen Loading...120. Vertebral artery arises from which one of the following arteries? Common carotid artery External carotid artery Internal carotid artery Subclavian artery Loading...121. Which one of the following is a fatal complication of multiple long bone fractures in a young age? Pericardial effusion Fat embolism Deep venous thrombosis Thromboembolism Loading...122. Which one of the following blotting procedures is the best for studying mRNA levels? Western blot Northern blot Southwestern blot Southern blot Loading...123. 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? Metoprolol Procainamide Atropine Verapamil Digoxin Loading...124. A drug that act as laxative is one of the following? Furosemide Castor oil Sulbactam A & B Bumetanide Loading...125. Which of the following ligaments is most likely torn in a case of posterior dislocation of the hip? Iliofemoral ligament Sacrotuberous ligament Ischiofemoral ligamentPage 6 of 66 Loading...126. Which one of the following drugs has irritation of the respiratory tract and should avoid in severe reactive asthma? Oseltamivir Rimantadine Amantadine Zanamivir None of these Loading...127. Which of the following is the LEAST factor can lead to urinary tract infection? Urinary tract obstruction Diabetes mellitus Prolonged tetracycline therapy Pregnancy Loading...128. Which one of the following drugs decreases Glucose absorption? Miglitol Glipizide Metformin Rasagiline Loading...129. Which form of dosage has a high rate of bioavailability? Control released drugs Suspension Syrup Capsules Tablet Loading...130. 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? Coarctation of the aorta Tetralogy of Fallot Ventricular septal defect Atrial septal defect Transposition of great vessels Loading...131. Which one of the following conditions is associated with Acanthosis Nigricans? Diabetes mellitus Amyloidosis Hemochromatosis Diabetes insipidus Loading...132. Heteroaryl acetic acid drug is following? Piroxicam Tolmetin Nabumetone Ibuprofen Indomethacine Loading...133. 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? Lysergic acid diethylamide Cocaine Phencyclidine Alcohol Loading...134. Which of the following drugs is used after chemotherapy to increase the leukocyte count if it drops? Interleukin-2 Dexamethasone Filgrastim Prednisone Loading...135. 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...136. Which of the following drug is used as Mast Cell Stabilizers? Ipratropium Bromide Terbutaline Montelukast Salbutamol Sodium Cromoglycate Loading...137. 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? Thrombosis Embolism Arteriosclerosis Atherosclerosis Loading...138. Which type of bias is reflected when individuals with severe disease are uncovered because they die first? Late-look bias Selection bias Confounding bias Measurement bias Loading...139. 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? Assure the patient and schedule another CT scan after 6 months Order hormonal assay to evaluate if the mass is functional or not Perform a needle biopsy Refer to surgery for removal of the adrenal mass Order MRI of the mass Loading...140. What is the antidote of theophylline? Pralidoxime Activated charcoal Esmolol A & B All of the above Loading...141. 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? Begin anti-depressive medication Discontinue atenolol Further investigations including liver function test Arrange nursing and supportive assistance MRI of the brain Loading...142. 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? Promethazine Diphenhydramine Ranitidine Hydroxyzine Ondansetron Loading...143. Taste and visual disturbance is the adverse effect of the following drug? Nystatin Griseofulvin Terbinafine Miconazole Loading...144. Which one of the following medications inhibits protein synthesis by binding to 50S subunit and preventing the formation of the initiation complex? Minocycline Linezolid Clindamycin Azithromycin Loading...145. Which of the following drug contain sulfonamide structure in the structural formula? None of these Mefenamic acid Celecoxib Acetaminophen Meloxicam Loading...146. Which one of the following medications enters the cell and acts on a cytoplasmic receptor? Propranolol Adrenaline Insulin Dexamethasone Loading...147. Which one of the following drugs works through inhibition of acetyl-cholinesterase enzyme and used in myasthenia gravis? Noradrenaline Neostigmine Atropine Montelukast Loading...148. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ibandronate Voriconazole Naftifine Capecitabine Miconazole Loading...149. Which one of the following drugs is associated with optic neuritis? Isoniazid Ethambutol Capreomycin Rifampin Loading...150. Deficiency of which of the following enzymes is associated with von Gierke’s disease? α-1,4-phosphorylase Hexosaminidase A Glucose-6-phosphatase Phosphofructokinase-1Page 7 of 66 Loading...151. Which of the following medications may cause acquired angioedema within days to weeks after starting it? Clopidogrel Propranolol Aspirin Benazepril Loading...152. 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 Pilocarpine Acetazolamide Timolol Atropine Loading...153. Which one of these apoproteins is associated with chylomicrons? Apo A Apo E Apo D Apo C-II Apo B-48 Loading...154. Dull, Persistent, and tightening is the characteristics of the following type of headache? A & B Cluster Headache Migraine Headache Tension-Type Headache Loading...155. Which of the following is the main reaction of hepatic cytochrome P-450 in metabolism? Binding with glucuronic acid Binding with glutathione Methylation Hydroxylation Loading...156. Gingival hyperplasia, granulocytopenia and facial hirsutism are possible side effects of which one of the following medications? Phenobarbital Valproic acid Phenytoin Carbamazepine Loading...157. The following drug is a peripheral dopamine-1 receptor agonist? Hydralazine Fenoldopam Alpha-Methyldopa Minoxidil Loading...158. A 69-year-old male with angina develops severe constipation following treatment with: Propranolol Captopril Nitroglycerin Dobutamine Verapamil Loading...159. 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? Acute osteomyelitis Osteoporosis Osteomalacia Metastases Loading...160. 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? Echovirus Coxsackie virus Measles Adenovirus Rubella Loading...161. 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? Reaction formation Regression Splitting Repression Projection Loading...162. Which one of the following valve abnormalities is related to intravenous drug abuse? Aortic regurgitation Aortic stenosis Mitral stenosis Tricuspid regurgitation Loading...163. Which of the following type of virus causes chickenpox? Cytomegalovirus Herpesvirus A & B Orthomyxoviruses Varicella zoster Loading...164. 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 Buspirone Trazodone Lorazepam Promethazine Loading...165. 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? Palmer aponeurosis Skin Flexor retinaculum Superficial fascia Extensor retinaculum Loading...166. Which of the following correctly describes pleiotropy? Not all individuals with mutant genotype show the same mutant phenotype Phenotype is always the same among individuals having the same genotype Increased severity of a disease in succeeding generations One gene contributes to multiple phenotypic effects Loading...167. Which of the following is the mechanism of action of benzodiazepines in the treatment of insomnia? Dopamine receptor agonist Binds to serotonin receptors Binds to GABA receptors Alpha adrenergic antagonist Loading...168. Directly acting cholinergic agonist drug? Acetylcholine A & B Echothiophate Pilocarpine Tacrine Loading...169. Which one of the following may precipitate to an acute porphyria attack? Mediterranean diet Low carbohydrate diet Vegetarian diet High carbohydrate diet Loading...170. Which one of the following drugs is associated with peripheral neuropathy? Isoniazid Rifampin Ethambutol Capreomycin Loading...171. 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? Saquinavir Indinavir Efavirenz Zidovudine Etravirine Loading...172. 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? Atenolol Epinephrine Albuterol Cocaine Phenylephrine Loading...173. Beta-Blocker drug is following? Nicotine Pindolol Mecamylamine Atracurium Atropine Loading...174. 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? Clay colored stool Dark brown urine Increased plasma unconjugated bilirubin Increased bilirubin in urine Increased urobilinogen in urine Loading...175. 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? Metoprolol Hydrochlorothiazide Verapamil CaptoprilPage 8 of 66 Loading...176. 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? Cocaine Morphine Ethanol Heroin Loading...177. Which of the following medications is considered a selective beta-1 adrenergic agonist? Prazosin Dopamine Dobutamine Amrinone Loading...178. Chronic use of which of the following drugs may increase the toxicity of acetaminophen? Cimetidine Ketoconazole Ethanol Verapamil Loading...179. 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? Manual compression of the lesion Urgent surgical interference Broad spectrum antibiotics to avoid meningitis Immediate lumber puncture Loading...180. Select Phenyl Alkylamine Calcium channel blocker drug? Diltiazem Verapamil Nifedipine Triamterene Triamcinolone Loading...181. Which of the following conditions could be a serious side effect of sumatriptan? Dilated cardiomyopathy Cutaneous flushing Torsades de pointes Coronary vasospasm Loading...182. Albumin quantitatively a primary protein in serum is synthesized by? Lungs Brain Intestine Liver Kidney Loading...183. 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? Hypoglossus muscle Genioglossus muscle Palatoglossus muscle Styloglossus muscle Loading...184. 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? Adduction of the hip joint Extension of the knee joint Flexion of the knee joint Abduction of the hip joint Dorsiflexion of the ankle joint Loading...185. An old man presents with acute severe back pain, tachycardia, hypotension and syncope. Which of the following is the most likely diagnosis? Pulmonary embolism Rupture of abdominal aortic aneurysm Acute myocardial infarction Acute mesenteric ischemia Loading...186. 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 only available as an oral preparation digitoxin has a much higher incidence of toxicity in patients with renal disease digitoxin is excreted primarily unchanged in the kidney with a half-life of about 24 hours digitoxin is highly protein-bound in the serum Loading...187. Which of the following drugs acts directly on dopamine receptors to improve the effects of Parkinson’s disease? Carbidopa Selegiline Bromocriptine Amantadine Loading...188. 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 Necrotizing pancreatitis Pyelonephritis Appendicitis Loading...189. Which one of the following statements about the functions of ACE inhibitors is wrong? Increase vasodilation of vascular smooth muscle Increase retention of sodium and water Increase level of bradykinin Decrease output of the sympathetic nervous system Loading...190. 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? Verapamil Quinidine Propranolol Amiodarone Loading...191. Heteroaryl acetic acid drug is following? Ibuprofen Nabumetone Piroxicam Diclofenac Indomethacine Loading...192. Which one of the following is characteristic of Chlamydia? Facultative intracellular Anaerobic bacteria Gram-negative diplococci Obligate intracellular Loading...193. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ibandronate Ethambutol A & B Furosemide Anidulafungin Loading...194. A 35 woman undergoes a hysterectomy. A section of one of her fallopian tubes is shown on this picture. What is your diagnosis? Endometriosis Chronic salpingitis Papillary carcinoma Ectopic pregnancy Loading...195. Beta-Blocker drug is following? Tamsulosin Esmolol Acetylcholine Atropine Succinylcholine Loading...196. Which of the following esophageal disorders is the most likely a complication of HIV infection? Candida esophagitis Achalasia Adenocarcinoma Esophageal varices Loading...197. 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 Double-blind study Case-control study Cohort study Cross-sectional study Loading...198. 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? Cleaning, dressing and analgesics Admission to hospital Surgical debridement and grafting Broad spectrum antibiotics Loading...199. Following statements about the use of Metformin in wrong? Cause Vit. B12 depletion Discontinued in women with a SCr> 1.4 Cause renal impairment Don't use in alcoholic patients Loading...200. Fluconazole belongs to the class of following drugs? Antibiotics Antiprotozoal Antifungal Antiviral AntipyreticPage 9 of 66 Loading...201. Which of the following are the characteristics of Virchow’s triad? Hypotension, distant heart sounds and jugular vein distention (JVD) Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Stasis, hypercoagulability and endothelial damage Loading...202. The cough associated with Captopril is most likely associated with? Increase in bradykinin levels Stimulation of adenosine receptors in the lungs Direct airway irritation Decrease in the metabolism of acetylcholine Release of histamine Loading...203. Peripheral resistance is linked with one of the following issues? Blood pressure Aids Fever Headache Loading...204. Which of the following medications may cause acute cholestatic hepatitis? Erythromycin Acarbose Metformin Colchicine Loading...205. 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 fall of systolic blood pressure for more than 10 mmHg during inspiration A difference of 10/min between radial and femoral pulse Loading...206. Alendronate is effective in which one of the following conditions? Hyperthyroidism Hypoparathyroidism Osteoporosis Spinal cord lesions Loading...207. All of the following are currently used in hyperthyroidism EXCEPT? Methimazole Potassium perchlorate Propylthiouracil Diatrizoate sodium Loading...208. Which of the following drug is a derivative of Propionic acid? ketorolac Piroxicam Diflunisal Mefenamic Acid Etodolac Loading...209. 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 Osteosarcoma Pseudogout Osteoarthritis Gout Loading...210. N-acetylcysteine is an antidote, which restores the glutathione levels in the hepatocytes decreased by the toxicity of which of the following specific drug? Meloxicam Ketorolac Mefenamic acid Naproxen Acetaminophen Loading...211. Which one of the following urine electrolytes in the best to estimate extracellular fluid (ECF) volume in metabolic alkalosis? Urine sodium Urine urea Urine anion gap Urine chloride Loading...212. Which one of the following drugs is a loop Diuretics drug? Amiloride Bumetanide Chlorthalidone Acetazolamide Loading...213. 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/dLr physician discusses advantages and disadvantages of all treatment options with the patient. What is the most important disadvantage of radioactive iodine therapy? Acute renal failure Ablation of the gland and future hypothyroidism Repeated doses due to repeated failures Anemia and agranulocytosis Leukemia Loading...214. Thyroid hormone can cause which one of the following effects? Lowers body temperature Lowers blood cholesterol Hypoglycemia Lowers oxygen consumption Loading...215. Which of the following is most likely characteristic of oral route of administration? It is the most appropriate route to interact with most of the emergencies Most of oral medications reach the bloodstream through the liver It has the fastest onset of effect Absorption of the drug depends on the GIT function Loading...216. Nabumetone is a prodrug derived from which of the following class? Acetic acid derivative Enolic acid derivative Fenamic acid derivative Propionic acid derivative Salicylic Acid derivatives Loading...217. Which one of the following intravenous anesthesia has antiemetic action? Thiopental Ketamine Propofol Fentanyl Loading...218. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Indanyl carbenicillin Capreomycin Ezetimibe Lamivudine 6-thioguanine Loading...219. 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? Furosemide Chlorothiazide Acetazolamide Bumetanide Spironolactone Loading...220. 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? IV hydration and antibiotics Colonoscopy Refer to surgery for bowel resection MRI of the abdomen Contrast enema Loading...221. Which of the following substances increases absorption of iron in the intestine? Riboflavin Folic acid Cyanocobalamin Ascorbic acid Loading...222. What are the 5 Ps of ischemia due to peripheral vascular disease? Pain-Pallor-Paralysis-Polycythemia-Proteinuria Pain-Pallor-Proteinuria-Paresthesia-Paralysis Pain-Pallor-Paresthesia-Proteinuria-Poikilothermia Pain-Pallor-Paralysis-Paresthesia-Poikilothermia Loading...223. Which of the following differentiates HIV virus from RNA tumor viruses? HIV virus has a cytolytic activity HIV virus is a retrovirus HIV virus contains the pol gene HIV virus contains 2 copies of RNA Loading...224. Which of the following benefits is achieved as a result of adding progesterone to estrogen in HRT? Decrease the effect of estrogen on the breast Decrease bone resorption Increase the effect of estrogen on the heart Decrease the occurrence of endometrial cancer Loading...225. Which of the following drug is a Dihydropyridine antihypertensive drug? Amlodipine Carvedilol Ethacrynic Bumetanide DiltiazemPage 10 of 66 Loading...226. Duration of action of nitroprusside is following? 30 minutes 15 to 30 minutes 1 to 2 minutes 3 to 6 hours Loading...227. Which of the following causes pancreatitis? L-asparaginase Azathioprine Exenatide All of the above Didanosine Loading...228. Which of the following are the primary vessels responsible for the regulation of blood pressure? Venuses Capillaries Arteries Arterioles Veins Loading...229. Which of the following drugs are protein synthesis inhibitor? Tetracyclin Gentamicin Erythromycin Linezolid All of the above Loading...230. Which of the following is the role of infliximab in the management of rheumatoid arthritis? It neutralizes the activity of TNF-alpha by binding to soluble forms of it Inhibition of dihydrofolate reductase It is a TNF-alpha receptor agonist It is a TNF-alpha receptor antagonist Loading...231. Which one of the following drugs is a Thiazide Diuretic? Fenofibrate Atorvastatin Ezetimibe Metolazone Indanyl carbenicillin Loading...232. Deficiency of the enzyme argininosuccinate in urea cycle leads to the accumulation of which one of the following? Argininosuccinate Citrulline Arginine Ornithine Loading...233. Deferoxamine is an antidote used for toxicity of the following? Atropine Isoniazid Iron Calcium bicarbonate Loading...234. Which one of the following drugs is a Proteas inhibitor? Maraviroc Atazanavir Delavirdine Abacavir Indanyl carbenicillin Loading...235. 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? Preterm labor Spontaneous abortions in the first trimester Fetal malformations Having to undergo a cesarean section Loading...236. 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 Coarctation of the aorta Transposition of great vessels Ventricular septal defect Atrial septal defect Loading...237. 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? Stroke HIV/AIDS Lower respiratory tract infections Diarrheal diseases Ischemic heart disease Loading...238. Which one of the following drugs is associated with elevated liver function test results? Rifampin Ethambutol Isoniazid Capreomycin Loading...239. 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? Phenytoin Felbamate Topiramate Ethosuximide Loading...240. Which of the following is considered a limiting adverse effect of ACE inhibitors? Hypokalemia Hyponatremia Hyperkalemia Acidosis Loading...241. 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 low molecular weight heparin and warfarin Start heparin Start warfarin Start aspirin Loading...242. Which one of the following anti-depressants is most likely effective in bulimia nervosa? Fluoxetine Tranylcypromine Amitriptyline Imipramine Loading...243. Which of the following hormone belongs to the posterior pituitary? Oxytocin A & B Somatrem Urofollitropin Furosemide Loading...244. Indapamide belongs to the one of the following class of diuretics? Loop Diuretics Thiazide Diuretic Carbonic anhydrase inhibitors Potassium sparing diuretics Loading...245. Which one of the following hypertensive drug is poisonous when given orally? Sodium nitroprusside Minoxidil Hydralazine Fenoldopam Loading...246. Mechanism of action of Ticlopidine is following? Inhibit COX-1 Inhibit glycoprotein receptors Decrease Calcium levels Inhibit ADP mediation Inhibit COX-2 Loading...247. Which of the following characterized by painless blisters on the back of the hands with friable surrounding skin and hyperpigmentation of the face? Dermatitis herpetiformis Herpes Zoster Contact dermatitis Porphyria cutanea tarda Loading...248. 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? Attention-deficit-hyperactive disorder (ADHD) Antisocial personality Child abuse Mental retardation Oppositional defiant disorder (ODD) Loading...249. Which of the following is the most common etiology of type II diabetes? Low insulin production Increased hepatic glycogen breakdown Insulin receptor deficiency Altered hormone-receptor complex Loading...250. Immune related problem is one of the following? Fever Aids High Blood pressure HeadachePage 11 of 66 Loading...251. 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? Trigeminal nerve Facial nerve Oculomotor nerve Optic nerve Loading...252. 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? Tracheoesophageal fistula Pyloric stenosis Tracheomalacia Imperforate anus Tetralogy of Fallot Loading...253. Which one of the following lipid-lowering agents can cause skin flushing and pruritus? Atorvastatin Cholestyramine Niacin Gemfibrozil Loading...254. Which one of the following antihypertensive medications is NOT safe in pregnancy? Lisinopril Labetalol Methyldopa Nifedipine Loading...255. Which one of the following is NOT a factor in Apgar Scoring System? Reflex irritability Skull dimensions Heart rate Respiration Loading...256. Deficiency of which of the following enzymes results in elevated serum levels of alanine and lactate? Lactate dehydrogenase Pyruvate dehydrogenase Alanine aminotransferase Glucose-6-phosphatase Loading...257. 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? DiGeorge Syndrome Down syndrome Turner’s syndrome Stickler syndrome Loading...258. 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? Assurance and follow up in 2 weeks Urine culture MRI of the pelvis Refer to surgery for urgent reduction Abdominal CT scan Loading...259. In which one of the following locations a mural thrombus commonly occurs following myocardial infarction? Right atrium Thoracic aorta Right ventricle Left atrium Left ventricle Loading...260. Which of the following medications is the drug of choice for motion sickness? Tolterodine Scopolamine Dicyclomine Benztropine Loading...261. Ibuprofen belongs to one of the following class? Fenamates Propionic acid Oxicam derivative Acetic acid derivative Loading...262. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Furosemide Fluconazole A & B Ethambutol Ibandronate Loading...263. Type of hypoglycemia in which patient feels hypoglycemic symptoms but the blood glucose level is normal or slightly above normal? Gestational Diabetes mellitus Type 2. Diabetic mellitus Type 1 diabetes Mellitus Pseudo hypoglycemia Loading...264. 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 None of these Ketorolac Acetaminophen Loading...265. 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? Amiodarone Quinidine Bretylium Digoxin Sotalol Loading...266. Autonomic nervous system is the part of? Peripheral nervous system Central nervous system Somatic nervous system Brain Spinal cord Loading...267. 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 Staphylococcal food poisoning CREST syndrome Mallory-Weiss syndrome Bulimia nervosa Loading...268. Which of the following differentiates physiologic jaundice from pathologic jaundice? Physiologic jaundice is present in the first 24 hours of life Direct bilirubin is lower than 10% of total bilirubin in physiologic jaundice Bilirubin peaks at higher levels (> 15 mg/dL) in physiologic jaundice Bilirubin in physiologic jaundice rises higher than 5 mg/dL/day Loading...269. 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? Hospitalization and intravenous antibiotics Collect blood and urine samples for culture Schedule Intravenous pyelogram Schedule MRI of the abdomen and pelvis Outpatient wide spectrum antibiotics and schedule a visit after 3 days Loading...270. Which one of the following drugs is used to treat asthma? Indanyl carbenicillin Hydrochlorothiazide Montelukast Ezetimibe Repaglinide Loading...271. What is the most common injury resulting from wearing a heavy backpack for a long time? Shoulder dislocation Frozen shoulder Costoclavicular syndrome Rotator cuff injury Loading...272. Outpatient prophylaxis of superior ventricular tachycardia (SVT) is best accomplished by which of the following medications? Lidocaine Procainamide Adenosine Diltiazem Loading...273. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Furosemide Amphotericin B A & B Ibandronate Ethambutol Loading...274. 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? Metronidazole Tetracycline Nalidixic acid Trimethoprim Gentamycin Loading...275. 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? Azygos and hemiazygos veins Paraumbilical and epigastric veins Superior, middle and inferior rectal veins Esophageal venous plexus Splenic and external iliac veinsPage 12 of 66 Loading...276. A drug that belongs to DPP-IV inhibitors is one of the following? Sitagliptin Rosiglitazone Sulbactam A & B Ethacrynic Acid Loading...277. A thiophene-containing agent that blocks the synthesis of leukotrienes by inhibiting 5_ lipoxygenase is the following? Zileuton Acetaminophen Zafirlukast Montelukast Loading...278. Which of the following is the target LDL in a patient with diabetes? More than 130 100-130 Less than 70 70-100 Loading...279. Naloxone is the treatment of choice of which one of the following toxicities? Citalopram overdose Hydrocodone toxicity Amitriptyline toxicity Methylphenidate overdose Loading...280. 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 Famciclovir HBV vaccine Interferon alfa Acyclovir Loading...281. 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? Rickettsia Mycobacteria Mycoplasma Streptococci Fungi Loading...282. In a case of esophageal dysphagia, which one of the following is considered a mechanical obstruction versus motility disorder? Extrinsic compression Chagas disease Diffuse esophageal spasm Achalasia Loading...283. Which one of the following drugs is first generation flouroquinolone? Nalidixic acid Levofloxacin Moxifloxacin Ciprofloxacin Loading...284. Unilateral or bilateral sweating is the symptom of one of the following types of headache? Migraine Headache A & B Tension-Type Headache Cluster Headache Loading...285. 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...286. Drug distribution into tissues depends mostly on which of the following? Rate of absorption Interaction with other drugs Tissue receptors Binding to plasma protein Loading...287. 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? ECG stress test Prostate specific antigen (PSA) Colonoscopy Depression screening test Erythrocyte sedimentation rate Loading...288. Propranolol is used to treat one of the following diseases? Diabetes Stomach Ulcer Viral infection Malaria High Blood pressure Loading...289. Which one of the following proteins surrounds the nuclear envelope? Tropomyosin Actin Enkephalin Vimentin Loading...290. Which one of the following medications inhibits HMG-CoA reductase? Digoxin Aspirin Simvastatin Tacrolimus Loading...291. Which one of the following drugs is a Substrate of the P-GP (glycoprotein) efflux pumps? Amiodarone A & B All of the above Erythromycin Digoxin Loading...292. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Ethambutol Ibandronate Miconazole A & B Flucytosine Loading...293. A drug causes Blockage of the M2 protein ion channel and it's ability to modulate intracellular PH? Zanamavir Acyclovir Vidarabine Lamivudine Amantadine Loading...294. Which one of these drugs can lead to weight gain and constipation? Pimozide Ziprasidone Clozapine Bromocriptine Loading...295. 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? Ciprofloxacin Gentamicin Vancomycin Ampicillin Tobramycin Loading...296. A drug that belongs to proton pump inhibitor is one of the following? Esomeprazole Rosiglitazone Ethacrynic Acid Sulbactam A & B Loading...297. 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 Blood glucose test Liver function tests Loading...298. 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/dlat is the most likely diagnosis? Hemophilia a Hemophilia b Disseminated intravascular coagulation Thrombotic thrombocytopenic purpura Idiopathic thrombocytopenic purpuraukocyte count: 25,000 – 80% neutrophils Platelet count: 20,000 Loading...299. Which of the following organisms is responsible for the development of oral hairy leukoplakia in HIV patients? Candida albicans Bartonella henselae Epstein-Barr virus Human papilloma virus Loading...300. Which one of the following substances induces the closure of patent ductus arteriosus? Prostaglandin E Indomethacin Estradiol IbuprofenPage 13 of 66 Loading...301. 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...302. 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? 0.1 0.0001 0.0.1 0.001 Loading...303. Ranitidine is used to treat one of the following diseases? Malaria Viral infection Blood pressure Diabetes Stomach Ulcer Loading...304. Which of the following regions of the brain is most likely affected in patients with Huntington’s disease? Substantia nigra Anterior frontal lobe Temporal lobe Caudate nucleus Loading...305. Canal of Schlemm is located at which one of the following junctions? Cornea and ciliary body Ciliary body and iris Cornea and iris Cornea and sclera Loading...306. Which one of the following drugs is used to treat hyperphosphatemia? Alendronate A & B Sevelamer Sodium polystyrene sulfonate Metamucil Loading...307. 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? Discontinue metoprolol Discontinue hydrochlorothiazide Prescribe tolterodine therapy Refer to a urologist Try timed voiding Loading...308. Generally, Passive diffusion of Water-soluble drugs inside the cell membrane occurs by one of the following processes? Readily move due to lipid solubility Readily move across by active transport Penetrate through aqueous pores Readily move across by facilitated diffusion Loading...309. Which one of the following statements about dobutamine is incorrect? Decrease myocardial cAMP Positive inotropic effect Increase contractility Treat acute heart failure Loading...310. 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? Obsessive compulsive disorder Histrionic personality disorder Antisocial personality disorder Borderline personality disorder Conduct disorder Loading...311. Amphotericin B belongs to the class of following drugs? Antibiotics Antifungal Antiprotozoal Antipyretic Antiviral Loading...312. Bicornuate uterus results from failure of the fusion of which of the following structures? Urogenital sinus Mesonephric ducts Nephrogenic ridges Paramesonephric ducts Loading...313. Which of the following beta blockers has the longest duration of action? Nadolol Metoprolol Propranolol Sotalol Loading...314. 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? Coombs test Tinel test Phalen test ELISA test Loading...315. 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? Absence seizure Simple focal seizure Complex focal seizure Myoclonic seizure Tonic-clonic seizure Loading...316. A drug that effects the thyroid hormone is one of the following? Thyroxine A & B Sulbactam Furosemide Bumetanide Loading...317. 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 Kallmann’s syndrome Turner’s syndrome Loading...318. Bronchoconstriction results from stimulation of which one of the following receptor types? M3 cholinergic receptors M2 cholinergic receptors Beta-2- adrenergic receptors Alpha-1- adrenergic receptors Loading...319. 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. Respiratory smooth muscle Cutaneous blood vessels Splanchnic blood vessels SA Node Radial muscle of the iris Loading...320. Epinephrine acts on which one of the following receptors to constrict vascular smooth muscle? β1-Adrenoceptors α2-Adrenoceptors β2-Adrenoceptors α1-Adrenoceptors Loading...321. Following are the 17 alpha-Hydroxyprogesterone derivatives Having a pregnane nucleus in the structural formula? Fexofenadine Promethazine Cyproheptadine Cetirizine Hydroxyzine Loading...322. Which of the following is higher in athletics than in non-athletics in resting conditions? Cardiac output Heart rate Oxygen consumption Stroke volume Loading...323. 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? Gangliocytoma Germinoma Choriocarcinoma Teratoma Craniopharyngioma Loading...324. Which of the following drug is a PGF2-Alpha analog? Misoprostol Epoprostenol Treprostinil Dinoprostone Carboprost Loading...325. Which one of the following agents prolongs the duration of nerve block when combined with a local anesthetic? Isoproterenol Atropine Epinephrine DobutaminePage 14 of 66 Loading...326. Deficiency of which of the following enzymes most likely result in the development of Cori disease? Debranching enzyme (alpha-1,6-glucoside) Muscle glycogen phosphorylase Glucose-6-phosphatase Lysosomal alpha-1,4 glucosidase Loading...327. Which one of the following cells lines the alveoli and secretes the surfactant? Pneumocytes type II K cells Macrophages Pneumocytes type I Clara cells Loading...328. 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 B3 (niacin) Folic acid Vitamin D Vitamin A Vitamin C Loading...329. 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...330. 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 low molecular weight heparin and warfarin Start warfarin Start aspirin Start heparin Assurance and follow up in 3 months Loading...331. An anticancer agent 6-mercaptopurine metabolism disturbed by following drug due to which dose is reduced? Probenecid Allopurinol Sulfinpyrazone Colchicine Loading...332. Which one of the following cholinomimetic agents is used in the challenge test for diagnosis of asthma? Carbachol Methacholine Pilocarpine Bethanechol Loading...333. 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...334. One of the following statements is not right about the production of Acetylcholine? Uptake of choline is a rate-limiting step Acetylcholine is metabolized by COMT Acetylcholine rapidly hydrolyzed by Acetylcholinesterase Acetylcholine released by an increase in calcium level Neurotransmitter in vesicles are called varicosities Loading...335. 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 Asthma Viral croup Foreign body stuck in the main bronchus Loading...336. Amphotericin B exerts its anti-fungal effect by which of the following mechanisms? Alteration of cell membrane permeability Inhibition of fungal cell wall synthesis Inhibition of DNA synthesis Inhibition of fungal protein synthesis Inhibition of cell wall synthesis Loading...337. 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? Chloramphenicol Tetracycline Cephalexin Erythromycin Ampicillin Loading...338. 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...339. Administration of spironolactone and furosemide leads to which of the following? Reduce magnesium loss Reduce sodium loss Increase potassium loss Reduce potassium loss Loading...340. A drug that inhibits the M2 protein ion channel and its ability to modulate intracellular PH? Ribavirin Zanamivir Acyclovir Rimantadine Loading...341. Which one of the following parts of fallopian tube is the widest and the most common site for fertilization? Infundibulum Isthmus Ampulla Loading...342. A hypoglycemic drug that decreases insulin resistance by binding with peroxisome proliferator-activated receptor gamma (PPAR-gamma) in muscles, fat, and liver? Sitagliptin Pioglitazone Metformin Glyburide Loading...343. A drug that belongs to thiazolidinediones is one of the following? A & B Cefazolin Ethacrynic Acid Sulbactam Rosiglitazone Loading...344. 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? Staphylococcus aureus Meningococci Treponema pallidum Rickettsia prowazekii Borrelia burgdorferi Loading...345. 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? Aspirin Acetaminophen Vitamin C Hydrocodone Loading...346. 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? Alpha-ketoglutarate Acetyl CoA Fumarate Succinyl CoA Oxaloacetate Loading...347. 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? Major depressive disorder Bipolar disorder Brief psychotic disorder Schizophrenia Schizophreniform disorder Loading...348. Which of the following receptors are membrane receptors (not intracellular)? The nicotinic receptors for acetylcholine Receptors for vitamin D Receptors for steroids Receptors for thyroid hormones Loading...349. 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? IgM antibody to hepatitis A virus Antibody to hepatitis B surface antigen Serum anti-mitochondrial antibodies DNA for Epstein-Burr virus Antibody to hepatitis C virus Loading...350. One of the following statements about the sympathetic neurons is wrong? Preganglionic neurons originated from Lumber Preganglionic neurons originated from thoracic Postganglionic neurons innervate tissues Originated from Efferent autonomic system Preganglionic neurons are LongPage 15 of 66 Loading...351. 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 Hypothyroidism Immobilization Hypertension Daily aspirin Loading...352. Which of the following drug causes Calcium reabsorption that leads to hypercalcemia? Furosemide Triamterene Spironolactone Acetazolamide Hydrochlorothiazide Loading...353. 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? Metastatic adenocarcinoma Ewing sarcoma Osteosarcoma Osteoporosis Loading...354. Which of the following drug is a part of drugs for osteoporosis? Acetazolamide Rabeprazole Calcitonin Furosemide A & B Loading...355. Which of the following is characteristic of Hodgkin lymphoma and differentiates it from non-Hodgkin lymphoma? Reed-Sternberg cells Affects mostly old age Peripheral nodes are most likely involved Associated with HIV and autoimmune disease Loading...356. 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? Conversion disorder Transient ischemic attack Multiple sclerosis Meningioma Loading...357. 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? Cystic fibrosis Viral infection Trauma Gallstones Congenital annular pancreas Loading...358. Which of the following substances is used in mercury poisoning? Succimer Flumazenil Fomepizole Methylene blue Loading...359. Which one of the following studies measures heritability and influence of environmental factors? Cross-sectional study Case-control study Cohort study Adoption study Loading...360. Which of the following drugs appears unchanged in the urine? Zanamivir A & B Oseltamivir Amantadine All of the above Loading...361. 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. Hyperplastic arteriosclerosis Atherosclerosis Medical calcific sclerosis Deep venous thrombosisich of the following is the most likely vascular abnormality involved in this condition? Loading...362. 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? Detoxification of beta-naphthylamine by glucuronic acid conjugation. Metabolism of beta-naphthylamine by human cytochrome 450 system in the liver Human urinary glucuronidase splits beta-naphthylamine into glucuronic acid and a toxic metabolite. Beta-naphthylamine is directly carcinogenic to human bladder Loading...363. Which of the following is the mechanism of action of metoprolol in angina? Reduces production of epinephrine Reduces requirement of the heart for oxygen Increases peripheral resistance Increases central venous pressure Loading...364. Which one of the following drugs acts mainly by blocking the synthesis of leukotrienes? Montelukast Cromolyn Ipratropium Zileuton Loading...365. What is the best treatment of gastroparesis in a diabetic patient? Vagotomy Gastric resection Omeprazole Metoclopramide Loading...366. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Acetylcholine Tamsulosin Benztropine Atropine Succinylcholine Loading...367. Sensations to the external auditory meatus is innervated by which of the following nerves? Facial nerve Great auricular nerve Vagus nerve Auriculotemporal nerve Loading...368. 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 Ampicillin and gentamicin Ceftazidime Vancomycin Ceftazidime and gentamicin Loading...369. Which one of the following drugs belongs to H2 histamine receptor blocker? Ezetimibe Torsemide Indanyl carbenicillin Atorvastatin Nizatidine Loading...370. Oxytocin is an agent used to increase uterine contractions during labor and also control postpartum bleeding and hemorrhage has the following adverse effects except? Neonatal jaundice Phlebitis Bradycardia Uterine Hypertonicity Hyponatremia Loading...371. 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? Side effect of one of her medications Postural hypotension Alzheimer’s disease Old age Osteoarthritis Loading...372. 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? Electroencephalogram (EEG) Airway stabilization and 100% oxygen Intravenous injection of haloperidol Gastric lavage Intravenous fluids Loading...373. Which one of the following analgesics inhibits COX in CNS and can be used safely for pregnant women? Naproxen Ibuprofen Acetylsalicylic acid Acetaminophen Loading...374. 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 malariae Babesia microti Plasmodium falciparum Plasmodium vivax Loading...375. 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 Streptococcus pneumoniae Homophilus influenzae Pseudomonas aeruginosa Candida albicansPage 16 of 66 Loading...376. 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? Factitious hypoglycemia Pheochromocytoma Reactive hypoglycemia Insulinoma Loading...377. Which of the following drugs has the longest duration of bronchodilation? Isoproterenol Albuterol Epinephrine Metaproterenol Salmeterol Loading...378. 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? She does not need a consent Her regular physician The ER physician Her boyfriend Her father Loading...379. 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...380. Reflex tachycardia caused by systemic albuterol can be blocked by which of the following medications? Phenylephrine Metoprolol Prazosin Dobutamine Loading...381. 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? Case-control study Single blind clinical trial Randomized controlled trial Cross sectional study Double blind clinical trial Loading...382. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefaclor Cefotaxime Cefadroxil Cefepime Loading...383. Naphthalene ring containing Antihyperlipidemic drug in the structural formula is the following? Simvastatin Atorvastatin Colestipol Rosuvastatin Fluvastatin Loading...384. Which of the following is the indication for surgical repair of abdominal aortic aneurysm (AAA)? Larger than 5.5 cm Located under the origin of renal arteries Larger than 3.5 cm Right after been diagnosed Loading...385. Which one of the following drugs has a relatively lowest potential to induce drowsiness? Cetirizine Fexofenadine Loratadine Acrivastine Loading...386. Which of the following hormone belongs to the posterior pituitary? Somatrem Furosemide A & B Desmopressin Urofollitropin Loading...387. 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 VI II III Loading...388. Following drug causes Systemic acidosis by binding with cations in antacid? Metamucil A & B Sevelamer Alendronate Sodium polystyrene sulfonate Loading...389. 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? Pulmonic stenosis Aortic stenosis Aortic insufficiency Mitral regurgitation Mitral stenosis Loading...390. A patient with cystic fibrosis is treated by gene therapy. Which of the following types of cells should be targeted as host cells? T-cells Epithelial cells Hemopoietic stem cells Germ cells Loading...391. A) Atropine Penicillamine Flumazenil Dimercaprol Loading...392. Prolonged use of which one of the following diuretics can lead to hyperkalemia and gynecomastia? Hydrochlorothiazide Acetazolamide Furosemide Spironolactone Loading...393. Which of the following is the most sensitive test for myocardial infarction? Lactose dehydrogenase (LDH) Troponin-1 Troponin-C Creatine kinase myocardial fraction (CK-MB) Loading...394. A single injection of leuprolide was given to a man 2 weeks ago. Which of the following changes could be revealed today? Increased FSH receptors Increased testosterone production Increased LH receptors Decreased testosterone production Loading...395. The anterior pituitary is derived from which of the following structures? Neurohypophysis Infundibulum Rathke’s pouch Third pharyngeal arch Loading...396. Which of the following drug belongs to lincosamide antibiotics? Linezolid Sulbactam Oxytetracycline Clindamycin Ciprofloxacin Loading...397. 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? Ampicillin Acyclovir Amphotericin B Ceftazidime Vancomycin Loading...398. ADP mediated platelets aggregation is inhibited by? Dipyridamole Aspirin Tirofiban Clopidogrel Eptifibatide Loading...399. Which one of the following drugs is used to prevent acute mountain sickness? Furosemide Chlorthalidone Acetazolamide Spironolactone Mannitol Loading...400. Which of the following drugs is an ergosterol synthesis inhibitor? Ritonavir Ampicillin Acyclovir KetoconazolePage 17 of 66 Loading...401. Antipseudomonal penicillin is one of the following? Penicillin G Carbenicillin Amoxicillin Methicillin Loading...402. In a case of methemoglobinemia, which one of the following is the most likely cause of the brown color of the patient’s blood? Oxidized hemoglobin Decreased oxygen affinity Reduced hemoglobin Carbon monoxide Loading...403. Which of the following is a contraindication of use of benzodiazepines in anxiety disorder? Seizures Sleep apnea Diabetes mellitus Smoking Loading...404. 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? Inferior epigastric Internal iliac Lateral sacral External iliac Loading...405. During spermatogenesis, which type of cells enter meiosis 1 to from primary spermatocytes? Type A spermatocytes Primordial germ cells Type B spermatocytes Spermatids Loading...406. Which one of the following agent is a insulin? Detemir Desmopressin Torsemide Somatostatin Atorvastatin Loading...407. 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? Hydralazine 50 mg daily Metoprolol 25 mg daily Minoxidil 30 mg daily Continue lifestyle modification for 3 months Lisinopril 10 mg daily Loading...408. An 80-year-old woman develops chest pain on second day after hysterectomy. Which of the following is the most likely diagnosis? Right bundle branch block Pulmonary infarction Myocardial infarction Acute pericarditis Loading...409. The effect of two medications is greater than the sum of their individual effects explains which of the following drug interactions? Tachyphylaxis Permissive Synergistic Additive Loading...410. A drug is more effective when combined with Flucytosine to treat candidiasis or cryptococcosis? Itraconazole Caspofungin Amphotericin B Griseofulvin Loading...411. 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...412. Which one of the following statements about the use of Aspirin is wrong? Inhibit inflammation Causes Interstitial nephritis Increases alveolar ventilation Repress the sensation of pain Loading...413. Ganglion blocker drug is following? Mecamylamine B & C Atropine Nicotine Atracurium Loading...414. 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...415. Hydralazine is used to treat one of the following disease? Diabetes Stomach Ulcer High Blood pressure Malaria Viral infection Loading...416. 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? Old age dementia Creutzfeldt-Jakob disease Lewy body dementia Alzheimer’s disease Vascular dementia Loading...417. What is the most common cause of abdominal aortic aneurysm? Post-inflammatory Atherosclerosis Post-operative Complication of coronary artery disease Loading...418. Which of the following side effects occurs with both tricyclic antidepressants and phenothiazines? Weight loss Excessive salivation Orthostatic hypotension Seizures Loading...419. Which of the following is the most likely finding on a biopsy of a case of chronic bronchitis? Non-caseating granuloma Abundant mucus with plugging of the bronchioles Caseating granuloma Interstitial fibrosis Loading...420. 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...421. 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? Niemann-Pick disease Fabry’s disease Tay-Sachs disease Gaucher’s disease Loading...422. A 30-year-old man with hypertension is prescribed labetalol. It antagonizes which of the following receptors to be effective against hypertension? Beta-adrenoceptors Alpha-adrenoceptors Both alpha and beta adrenoceptors Nicotinic receptors Loading...423. Which of the following drug prevents bacterial protein synthesis by binding to the 30s ribosomal subunit penicillin lincosamine tetracyclin macrolides Loading...424. Which one of the following medications inhibits cell wall synthesis of bacteria?otein Synthesis Inhibitors: Aminoglycosides, Tetracyclines, Spectinomycin, Erythromycin, Lincomycin, Clindamycin and Chloramphenicol. Clindamycin Erythromycin Aminoglycoside. Carbapenem Loading...425. 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? Trichinosis Schistosomiasis Toxoplasmosis GiardiasisPage 18 of 66 Loading...426. Which one of the following anti-arrhythmic drugs may lead the development of torsade de pointes at therapeutic doses? Quinidine Adenosine Lidocaine Propranolol Loading...427. Which of the following side effects is the most common after prolonged use of SSRIs? Headache Insomnia Nausea Sexual dysfunction Loading...428. 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/L Solute diuresisat is the most likely diagnosis? Diabetes insipidus Psychogenic polydipsiaine Na: 18 mEq/L Urine osmolality: 260 mOsm/kg after 4h fluid deprivation. Urinary tract infection Diabetes mellitus Loading...429. Which of the following cells of the ovary secretes inhibin, follistatin and activin? Surface epithelial cells Theca externa cells Granulosa cells Theca interna cells Loading...430. 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? Streptococcus Pneumonia Streptococcus Bovis Staphylococcus Aureus Echovirus Neisseria Meningitidis Loading...431. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefepime Cefadroxil Ceftazidine Cefaclor Loading...432. Which one of the following statements about dobutamine is incorrect? Increase contractility Increase myocardial cAMP Avoid in acute heart failure Positive inotropic effect Loading...433. Which of the following statements is correct regarding the apex of the upright lung compared to its base? Blood perfusion is lower at the apex than at the base Alveoli are smaller at the apex than at the base Alveoli are more compliant at the apex than at the base Ventilation/perfusion ratio is lower at the apex than at the base Loading...434. Which of the following drug belongs to the Nonnucleoside reverse transcriptase inhibitor? Indanyl carbenicillin Maraviroc Atazanavir Abacavir Efavirenz Loading...435. Aspirin is contraindicated in following disease? A & B Peptic ulcer Reye's syndrome All of these Bleeding disorder Loading...436. 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? Radial nerve Ulnar nerve Suprascapular nerve Median nerve Axillary nerve Loading...437. Which one of the following is the most appropriate next step in suspected scaphoid fracture (with normal radiology)? Emergent orthopedic consultation Admission and observation Thumb spica splint Assurance and follow up in 2 weeks Loading...438. Action of incretin hormone GLP-1 is following except? slow gastric emptying Increase beta-cell growth Increase glucose-dependent insulin secretion Enhance appetite Inhibit inappropriate glucagon secretion Loading...439. Which one of the following agent is a insulin? Somatostatin Atorvastatin Aspart Torsemide Desmopressin Loading...440. Following drug consists of an aromatic derivative ring in the structural formula? Atorvastatin Lovastatin Colestipol Simvastatin Pravastatin Loading...441. Which statement is true regarding action of lung surfactant? It affects more large alveoli than sma alveoli It lowers surface tension and increases compliance It lowers surface tension and decreases compliance It elevates surface tension forces and decreases compliance Loading...442. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Prazosin Succinylcholine Benztropine Atropine Neostigmine Loading...443. Stimulation of muscarinic receptors by pilocarpine is competitively inhibited by which of the following medications? Atropine Pralidoxime Physostigmine Edrophonium Loading...444. 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. Barium swallow Esophageal manometry Upper endoscopy Trial of proton pump inhibitor CT body screening Loading...445. Which of the following joint conditions is characterized by narrowing of joint space and formation of osteophytes? Gouty arthritis Pseudo-gout Rheumatoid arthritis Osteoarthriti Loading...446. Which one of the following drugs causes a non-productive cough? Torsemide Somatostatin Atorvastatin Captopril Desmopressin Loading...447. At which of these vertebral levels does the trachea bifurcate? First thoracic Sixth thoracic Fourth thoracic Seventh cervical Loading...448. A disease that is characterized by the movement of gastric contents from the stomach into the esophagus? Peptic Ulcer disease GERD Dyspepsia A & B Loading...449. One of the following statements about the Parasympathetic neurons is wrong? Preganglionic neurons originated from the Sacral region Postganglionic fibers are long Preganglionic fibers are long Preganglionic fibers arise from cranial nerves Originated from Efferent autonomic system Loading...450. Which of the following drug is commonly used for the Reactivation of inhibited Acetylcholine esterase? Edrophonium Bethanechol Echothiophate Carbachol PralidoximePage 19 of 66 Loading...451. Cinchonism is a possible side effect of which one of the following drugs? Enflurane Quinidine Metoclopramide Isoniazid Loading...452. Which of the following drugs causes peripheral edema? Oxytocin Somatrem Amlodipine A & B Labetalol Loading...453. 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? Right ventricular hypertrophy Mitral stenosis Left ventricular hypertrophy Dilated cardiomyopathy Loading...454. 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 heparin IV dobutamine IV fluids stat Sublingual glyceryl nitrate (GTN) IV calcium gluconate Loading...455. Which of the following is the cellular mechanism of epinephrine? Activation of acetylcholinesterase Activation of adenylyl cyclase Activation of phospholipase Inhibition of adenylyl cyclase Loading...456. Which one of the following parts of the heart is the major consumer of oxygen and requires the best blood supply? Right atrium Left atrium Right ventricle Left ventricle Loading...457. Which one of the following conditions is characterized by painless blisters on the back of the hands and hyperpigmentation of the face? Contact dermatitis Dermatitis herpetiformis Herpes zoster Porphyria cutanea tarda Loading...458. 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 Immune complex deposition Anaphylaxis Cell mediated hypersensitivity Loading...459. Proliferation of endometrial glands results from stimulation by which one of the following hormones? Follicle stimulating hormone Progesterone Estrogen Androgen Loading...460. Which of the following drug is a Non-dihydropyridine antihypertensive drug? Nifedipine Carvedilol Bumetanide Amlodipine Diltiazem Loading...461. 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...462. Which of the following locations is the most common site of gastrinoma? Liver Pancreas Stomach Ileum Loading...463. 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? Secretory Psychogenic Inflammatory Osmotic Loading...464. 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? Hospitalization and induction of labor Diphenhydramine Ursodeoxycholic acid and vitamin K No treatment and repeat liver function tests in a week Loading...465. Which one of the following conditions most likely shows lower than normal erythrocyte sedimentation rate (ESR)? Polycythemia Giant cell arteritis Pregnancy Multiple myeloma Loading...466. A drug has black box warning due to severe hematologic ADRs? Aspirin Dipyridamole Clopidogrel Digoxin Ticlopidine Loading...467. Which of the following is the most frequent and irreversible side effect of typical anti-psychotics? Tardive dyskinesia Akathisia Anxiety Dystonia Loading...468. Which of these medications is the most appropriate treatment of malignant hyperthermia? Indomethacin Ibuprofen Dantrolene Acetaminophen Loading...469. Long Acting Insulin is one of the following? Aspart NPH Glargine Glulisine Loading...470. 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? Urinalysis Complete blood count Serum electrolytes Beta-HCG Loading...471. Nelfinavir belongs to the class of following drugs? Antibiotics Antipyretic Anti-malaria Antiprotozoal Antiviral Loading...472. Carbonic anhydrase enzyme is present in the epithelial cells of one of the following part functional zones of the nephron? The collecting tubule and duct The distal convoluted tubules The proximal convoluted tubules The ascending loop of Henle The descending loop of Henle Loading...473. At low doses, one of the following drugs irreversible inhibit thromboxane production in platelets leading to a decrease in platelets aggregation? A & B Clopidogrel Ticlopidine Aspirin Loading...474. 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 Cisplatin Cyclophosphamide Vincristine Daunorubicin Loading...475. 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? 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? Why don’t you like to take this medication? What side effects did you experience?Page 20 of 66 Loading...476. 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? Seventh cervical Fifth thoracic First lumbar Second cervical Third lumbar Loading...477. Which one of the following drugs is a neuromuscular blocker drug? Nicotine Atropine Benztropine Neostigmine Atracurium Loading...478. Which of the following is the mechanism of action of ciprofloxacin? Interferes with bacterial metabolic production Interferes with bacterial cell wall synthesis Inhibits DNA gyrase and relaxation of DNA Inhibits bacterial protein synthesis through binding with 30 S Loading...479. 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? Hypoglycemia Neutrophilia Hypoalbuminemia Anemia Loading...480. 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? Prolonged exposure to the sun Excessive sweating Strenuous exercise Prolonged standing Alcohol intake Loading...481. 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? Propranolol Quinidine Aspirin Amiodarone Verapamil Loading...482. A patient comes to the emergency ward with recent organophosphorus compound poisoning. He will have all of the following signs & symptoms except: Increased salivation Diarrhea Bronchodilatation Increased lacrimation Muscle Weakness Loading...483. Which one of the following drugs is a Thiazide Diuretic? Ezetimibe Indanyl carbenicillin Hydrochlorothiazide Fenofibrate Atorvastatin Loading...484. Amylin hormone is released from one of the following cells? Pancreatic Delta cells juxtaglomerular cells Pancreatic Alpha cells Pancreatic Beta cells Loading...485. Which one of the following drugs treatment usually causes a decrease in intestinal flora? All of the above Diuretics Calcium supplements Antibiotics A & B Loading...486. Which of the following drug is Leukotriene Antagonist? Terbutaline Sodium Cromoglycate Montelukast Salbutamol Ipratropium Bromide Loading...487. Which of the following medications should be given to a patient that exhibits severe adverse reactions after administration of IV midazolam? Protamine Glucagon Naloxone Flumazenil Loading...488. Ca+ channel blockers belongs to the one of the following CLASS of Antiarrhythmic drugs? CLASS I CLASS III CLASS II CLASS IV Loading...489. Autoantibodies to pancreatic islets Beta cells and insulin are found in the following types of Diabetes? All of the above Type 2 Diabetes mellitus Latent autoimmune diabetes of the adults Type 1 Diabetes mellitus A & C Loading...490. Polyuria is an adverse effect of which of the following drug? Desmopressin Vasopressin Conivaptan Oxytocin Loading...491. Which of the following is the most common complication of diverticulosis? Perforation Diverticulitis Bleeding Obstruction Loading...492. Which of the following is the initial treatment of asymptomatic aortic stenosis? Valve replacement Furosemide Hydrochlorothiazide Balloon valvuloplasty Loading...493. Bulging of anterior fontanelle is considered after examination of which one of the following anatomic landmarks? Pterion Sagittal suture Bregma Lambda Loading...494. 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 Cardioversion Aspirin Metoprolol Heparin Loading...495. Which of the following is an epithelial tumor with a “stuck-on” appearance? Seborrheic keratosis Basal cell carcinoma Squamous cell carcinoma Actinic keratosis Loading...496. A drug that blocks the glycoprotein GP IIb/IIIa receptors of platelets? Clopidogrel Tirofiban Dipyridamole Ticlopidine Aspirin Loading...497. Which of the following management plans is recommended for a case of myocardial infarction with 70% main left stenosis? Coronary artery bypass graft (CABG) Pharmacotherapy and observation Percutaneous transluminal coronary angiography (PTCA) Percutaneous coronary intervention (PCI) Loading...498. 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 Refer the patient for psychiatric evaluation Start treatment after obtaining a written consent from his wife Schedule another appointment for the patient only to be sure of his own decision Start treatment immediately Loading...499. Which of the following is not a feature of Tetralogy of Fallot? Pulmonary stenosis Right ventricular hypertrophy Atrial septal defect Overriding aorta Loading...500. A certain drug has a high serum protein binding. Which of the following is increased as a result of injecting this drug? Drug interaction Renal excretion Liver metabolism Distribution of the drugPage 21 of 66 Loading...501. 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? Left kidney Gall bladder Ileum Ascending colon Tonsils Loading...502. 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? Iodine Warfarin Propylthiouracil Dobutamine Levothyroxine Loading...503. Which one of the following medications can be used safely in cases of lack of liver function? Lorazepam Diazepam Midazolam Clonazepam Loading...504. 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? Septic shock Left bundle branch block Acute myocardial infarction Hypertrophic cardiomyopathy Pericardial effusion Loading...505. 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? Gall bladder stones Pancreatic cancer Hemolytic anemia Acute hepatitis Loading...506. 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? Testosterone deficiency Estrogen deficiency Progesterone deficiency Thyroid hormone deficiency Loading...507. Erythromycin belongs to the class of following drugs? Antipyretic Antiviral Antibiotics Antiprotozoal Anti-malaria Loading...508. Which of the following is the most dangerous adverse effect of chronic alcohol abuse? Impaired judgment Live cirrhosis Respiratory depression Cutaneous vasodilation Loading...509. Which one of the following can be found in sickle cell disease? Howell-Jolly bodies Schistocytes Spherocytes Bite cells Loading...510. Which of the following drug belongs to the Oxazolidinone class of Antibiotics? Sulbactam Linezolid Erythromycin Oxytetracycline Ciprofloxacin Loading...511. Which of the following is an indandione analog Anticoagulant agent? Heparin Clopidogrel Warfarin Anisindione Abciximab Loading...512. Which of the following tests is the most accurate for diagnosis of herpes encephalitis? Viral culture of CSF PCR of CSF Serological studies for herpes MRI of the brain Loading...513. 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? Positive predictive value Odds ratio Specificity Relative risk Loading...514. Which one of the following antihypertensive medications is appropriate to use for an asthmatic patient? Metoprolol Timolol Labetalol Propranolol Loading...515. Which one of the following medications can be reversed by administration of vitamin K? Warfarin Heparin Tirofiban Clopidogrel Loading...516. Which one of the following neoplasms is the most likely related to HIV infection? Hodgkin’s lymphoma Burkitt’s lymphoma Myelocytic leukemia Kaposi sarcoma Loading...517. 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? Intravenous levothyroxine and glucocorticoid Begin intravenous fluids Rapid rewarming Obtain T4 and TSH and wait for results Loading...518. An organophosphate drug that has a side effect of cataracts? Echothiophate Acetylcholine Neostigmine Donepezil Edrophonium Loading...519. Which one of the following substances is used to differentiate between central and nephrogenic diabetes insipidus? Desmopressin Cortisol Dexamethasone Cosyntropin Loading...520. 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...521. 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? Hypertrophic cardiomyopathy Mitral stenosis Aortic stenosis Myocardial infarction Loading...522. Which of the following is the most common complication of otitis media? Hearing loss Brain abscess Drum perforation Meningitis Loading...523. Which one of the following drugs is most likely to cause severe bone marrow depression? Prednisone Sirolimus Tacrolimus Cyclosporine Loading...524. Which of the following is the main role of colchicine in treating acute attack of gout? Decreased uric acid absorption Increased uric acid excretion Inhibition of xanthine oxidase Reduction of gout symptoms and pain Loading...525. 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 Urinary sodium Alanine aminotransferase (ALT) Blood glucosePage 22 of 66 Loading...526. Which of the following leukocytes have nuclei of 3-5 lobes and azurophilic light-pink small granules in their cytoplasm? Plasma cells Monocytes Neutrophils Basophils Loading...527. Amiodarone is considered one of which of the following classes of anti-arrhythmic drugs? Class IV Class III Class II Class I Loading...528. Bioavailability of a medication is maximal when it has which of the following factors? High water solubility High plasma binding High ionization High lipid solubility Loading...529. Which of the following group of medications prolongs GABA activity in the brain? Alcohols Methamphetamines Barbiturates Benzodiazepines Loading...530. Androgen is released from which part of the adrenal medulla? A & B Zona reticularis Zona fasciculate Zona glomerulosa All of these Loading...531. Which of the following is the appropriate treatment of a moderate case of acne vulgaris? Topical antibiotic Oral antibiotic and topical therapy Benzyl peroxide Oral isotretinoin Loading...532. Which of the following conditions is the most likely cause of development of velvety rash in the axilla? Testosterone hypersecretion Serotonin hypersecretion Insulin resistance Thyroid hormone deficiency Loading...533. 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? Verapamil Metoprolol Hydralazine Propranolol Sotalol Loading...534. Which of the following is the main action of carbidopa when it is used in combination with levodopa in the management of Parkinsonism? It reduced levodopa side effects such as hypotension It increases the permeability of blood-brain barrier to levodopa It increases the absorption of levodopa It inhibits the conversion of levodopa to dopamine peripherally Loading...535. Which of the following is most likely associated with normal vaginal pregnancy after a previous cesarean section (CS)? Previous CS is performed due to unknown cause Previous CS is performed due to breech presentation Previous CS is performed due to prolonged second stage Previous CS is performed due to arrest of cervical dilation Loading...536. 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? Niemann-Pick disease Von Gierke disease Pompe disease Gaucher disease Loading...537. Torsades de pointes may occur after the use of which one of the following medications? Lidocaine Sotalol Rifampin Propranolol Loading...538. Which one of the following agents is a muscarinic cholinomimetic? Atropine Tubocurarine Pilocarpine Hexamethonium Loading...539. Which of the following drug belongs to Osmotic Diuretic? Oxacillin Cefoxitin Ampicillin Urae Niacin Loading...540. Which of the following are the characteristics of Beck’s triad? Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Stasis, hypercoagulability and endothelial damage Hypotension, distant heart sounds and jugular vein distention (JVD) Loading...541. 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 Keratinized squamous epithelium Non-ciliated columnar epithelium Non-keratinized squamous epithelium Loading...542. 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? Schilling test Osmotic fragility test Metabisulfite test Coomb’s test Acid hemolysis test Loading...543. 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? Admit to the intensive care unit Throat swab and culture Prescribe broad spectrum antibiotic Ultrasonography of the neck Serology for infectious mononucleosis Loading...544. Which of the following is a characteristic finding in isopropanol poisoning? Elevated anion gap Ketosis without acidosis Blindness due to ocular accumulation Elevated serum BUN and creatinine Loading...545. 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 penicillin IV ceftriaxone IV ceftriaxone and oral doxycycline Oral doxycycline IM ampicillin Loading...546. 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? Hurler syndrome Tay-sachs disease Galactosemia Lesch-Nyhan syndrome Gaucher disease Loading...547. 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 Admit to the hospital Advise family that it is a normal reaction and keep an eye on her Refer to the social worker Loading...548. A drug that effects the thyroid hormone is one of the following ? A & B Sulbactam Bumetanide Levothyroxine Furosemide Loading...549. Which one of the following nicotinic antagonist drugs has the ability to lower blood pressure, a vasodilator? Succinylcholine Trimethaphan Ipratropium Tubocurarine Loading...550. Which of the following is the coagulation parameter affected by warfarin? Bleeding time Partial thromboplastin time (PTT) Prothrombin time (PT)Page 23 of 66 Loading...551. 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. Inverse agonist Antagonistis drug should be classified as what? Agonist Partial agonist Loading...552. Which of the following drug is a derivative of Acetic acid? ketorolac Mefenamic Acid Etodolac Diflunisal Piroxicam Loading...553. Which of the following hormone belongs to the posterior pituitary? A & B Urofollitropin Furosemide Somatrem Vasopressin Loading...554. Which of the following is the mechanism of action of zileuton for asthma? Inhibition of phosphodiesterase Inhibition of 5-lipoxygenase Inhibition of Phospholipase A Stimulation of beta-2 receptors Loading...555. A young man complains of little finger numbness and difficulty gripping things. Which of the following is the affected nerve root? Cervical 8 Cervical 7 Cervical 5 Cervical 6 Loading...556. Which one of the following conditions characterized by hemolytic episodes caused by increased erythrocyte sensitivity to complement lytic actions? Glucose-6-phosphate dehydrogenase deficiency anemia Sickle cell anemia Paroxysmal nocturnal hemoglobinuria Hereditary spherocytosis Loading...557. Which of the following is the mechanism of action of ursodiol to reduce the size of gallstones in the common bile duct? Dissolving cholesterol form the stone Relaxation of common bile duct Dissolving calcium from the stone Reducing bile synthesis Loading...558. Which of the following is the most common cause of adverse drug reactions? Allergic reaction Non-compliance Dosage discrepancy Idiosyncrasy Loading...559. What is the most common cause of hypertension in young women? Cardiomyopathy Rheumatic heart disease Oral contraceptive pills Atherosclerosis Loading...560. Alcohol is oxidized in the liver by which one of the following enzymes? Alcohol decarboxylase Alcohol dehydrogenase Alcohol reductase Alcohol oxidase Loading...561. Which one of the following medications is the best recommended for induction of medical abortion? Mifepristone Progesterone Ergotamine Estrogen Loading...562. 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? Tolazamide Glipizide Glyclopyramide Carbetamide Metformin Loading...563. Which of the following cell types is responsible for forming the blood brain barrier (BBB)? Astrocytes Microglia Schwann cells Oligodendrocytes Loading...564. Which one of the following drugs is a neuromuscular blocker drug? Mecamylamine Neostigmine Succinylcholine Atropine Benztropine Loading...565. Which one of the following differentiates exudate from transudate? High specific gravity Low protein content Few leukocytes High osmotic pressure Loading...566. Didanosine belongs to the class of the following drugs? Antibiotics Antiprotozoal Anti-malaria Antiviral Antipyretic Loading...567. Which of the following is most likely to occur with carbonic anhydrase inhibitors? Acidic urine Hyperkalemia Hyperuricemia Alkalosis Hyperchloremia Loading...568. Which one of the following types of cells is involved in foreign body reaction? Giant cell Plasma cell Neutrophil Eosinophil Loading...569. Which one of the following amines is permanently charged? Secondary Primary Quaternary Tertiary Loading...570. Which one of the following drugs is 4th generation cephalosporin drug? Cefixime Cefadroxil Cefuroxime Cefepime Loading...571. 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? Alcohol Fat Chocolate Protein Caffeine Loading...572. Which one of the following fungistatic drugs has a half-life of 30 hours? Voriconazole Posaconazole Fluconazole Ketoconazole Loading...573. Rocky mountain spotted fever is caused by following? Chlamydia trachomatis Rickettsia Rickettsii Clostridium tetani Spirochetes Loading...574. The drug which inhibits the action of histamine at parietal cells results in a reduction of hydrogen ions concentration and volume of gastric acid? Sucralfate Cimetidine Rabeprazole Omeprazole Loading...575. 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 toothachePage 24 of 66 Loading...576. When a blood clot adhere to vessel wall this is called as one of the following? Thrombus Coagulation Embolus All of the above Loading...577. Which of the following drug is a part of proton pump inhibitors? Mannitol A & B Furosemide Acetazolamide Pantoprazole Loading...578. Which of the following disorders is considered a nephrotic syndrome? IgA nephropathy (Berger disease) Alport syndrome Minimal change disease Goodpasture syndrome Loading...579. In which one of the following parts of the GIT most of the ingested iron is absorbed? Ascending colon Stomach Duodenum Descending colon Ileum Loading...580. The functions of insulin include the following except one? Cellular Uptake of plasma glucose inhibit the production of glucose from the liver increase breakdown of fat to Ketone bodies Uptake of Amino acids into a cell Loading...581. 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 Sweat chloride test TB skin test Loading...582. Which of the following statements correctly describe the lag time of a drug? Time from administration of the drug to reaching maximal effect concentration. Time from administration of the drug to appearance in blood Time in which plasma concentration remains the same Time from administration of the drug to reaching minimal effect concentration Loading...583. 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 attack Stroke Alcohol toxicityctose dehydrogenase 267 U/L What is the most likely diagnosis of this patient condition? Alcohol withdrawal Loading...584. 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 exposure to a chemical and may lead to renal failure No. They are not related to exposure because the symptoms occur on Monday after weekend No. They are not related to exposure because they are episodic Yes. They are related to withdrawal of chemical and may lead to massive heart attack Loading...585. Which one of the following medications causes black stools? Ampicillin Buspirone Iron Propranolol Loading...586. 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? Hemophilia A von Willebrand disease Disseminated intravascular coagulopathy Vitamin K deficiency Loading...587. A cytokine that induces proliferation of antigen-primed T cells along with enhancing the activity of NK cells? Interferon-gamma Interleukin-1 (IL-1) Interleukin-2 (IL-2) Tissue necrosis factor-alpha Loading...588. 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? Left oculomotor nerve Left optic nerve Right oculomotor nerve Right optic nerve Loading...589. A drug that act as laxative is one of the following? Lactulose Bumetanide Furosemide Sulbactam A & B Loading...590. Sjögren syndrome is characterized by a dry mouth and lack of tears. what is the recommended drug for this syndrome? Atropine Pilocarpine Bethanechol Cyclopentolate Tropicamide Loading...591. Which one of the following drugs is a Alpha Glucosidase inhibitors? Hydrochlorothiazide Repaglinide Ezetimibe Indanyl carbenicillin Acarbose Loading...592. Following drug is a phenylalanine derivative? Repaglinide Pioglitazone Metformin Nateglinide Loading...593. Indirect acting irreversible cholinergic agonist drug? Echothiophate Pilocarpine Neostigmine Tacrine Loading...594. Cortisol is released from which part of the adrenal medulla? Zona glomerulosa A & B All of these Zona fasciculate Zona reticularis Loading...595. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Ibandronate Furosemide Rifamycins A & B Rabeprazole Loading...596. Which one of the following enzymes catalyzes the transformation of testosterone into DHT? 17α-hydroxylase Aromatase Cholesterol side chain cleavage enzyme (CYP11A1) 5 α-reductase Loading...597. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Ezetimibe Indanyl carbenicillin Nizatidine Macrolides Aluminium hydroxide Loading...598. Blanching and sloughing of skin is the adverse effect of one of the following Direct acting adrenergic agonists? Dobutamine Epinephrine Isoproterenol Dopamine Norepinephrine Loading...599. Which of the following explains the benefit of lactulose in hepatic encephalopathy? 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 Lactulose antagonize the action of ammonia on hepatic cells Loading...600. Which one of the following glucocorticoids is long acting? Cortisone Amiloride Dexamethasone A & B PrednisolonePage 25 of 66 Loading...601. 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? Hydralazine Levothyroxine Amitriptyline Ibuprofen Loading...602. Which of the following local anesthetics causes vasoconstriction and may lead to an increase of blood pressure? Lidocaine Tetracaine Cocaine Benzocaine Loading...603. 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? Splenic artery Left gastric artery Celiac trunk Right gastric artery Superior mesenteric artery Loading...604. Which of the following prostaglandin type also called prostacyclin? PGE PGE1 PGA PGB PGI2 Loading...605. What is the mechanism of action of aminoglycosides? Inhibition of general metabolic pathways Blocking pathogens recognition of the host Disruption of cell wall hemostasis Disruption of ribosomal protein synthesis Loading...606. Regulation of which of the following regions is mostly dependent on extrinsic nerves? Large intestine Small intestine Upper esophagus Lower esophagus Loading...607. 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? Superior cerebellar artery Middle meningeal artery Inferior cerebral artery Cavernous sinus Loading...608. 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? Cicatricial pemphigoid Dermatitis herpetiformis Scabies Pemphigus vulgaris Bullous pemphigoid Loading...609. Which one of the following autoantibodies is associated with Goodpasture syndrome? Anti-Ach receptor Anti-basement membrane Anti-histone Anti-centromere Loading...610. Which of the following is the most likely rout of transmission of herpes simplex virus-1? Food contamination Respiratory secretions and saliva Congenital transfusion Sexual contact and perinatal Loading...611. Which one of these drugs reverses both muscarinic and nicotinic effects of organophosphorus compounds by restoring cholinesterase? Atracurium Pralidoxime Atropine Physostigmine Loading...612. 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...613. Receptors that produce the most rapid response: Tyrosine-Kinase Receptors Intracellular Receptors Cytokine receptors Ion channel linked receptors G-protein linked receptors Loading...614. Which one of the following agents is insulin? Atorvastatin Glargine Torsemide Desmopressin Somatostatin Loading...615. Which of the following conditions is characterized by the presence of smooth, painless, wart-like lesions on genital organs? Secondary syphilis Chlamydia infection Candida infection Gonococcal infection Loading...616. Megaloblastic anemia is caused by folic acid or Vitamin B12 deficiency. Which of these reactions is directly affected by vitamin B12 deficiency? Methylmalonyl CoA >> succinyl CoA Succinyl CoA >> fumarate Malonyl CoA >> palmitate Propionyl CoA >> methylmalonyl CoA Loading...617. Lidocaine is an effective antiarrhythmic because of which of the following mechanisms? It prolongs QT interval It suppresses excitability in ischemic areas of the heart It blocks alpha-receptors It block beta-receptors It prolongs PR interval Loading...618. A drug that act as laxative is one of the following? Sulbactam A & B Furosemide Bumetanide Sodium phosphate Loading...619. Clopidogrel belongs to which of the following class of antiplatelet agents? Dipyridamole Glycoproteins inhibitors Polyamines Fabric acid derivatives Theinopyridines Loading...620. 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? Fine needle aspiration Ultrasound of the thyroid Excisional biopsy T4 and TSH levels Loading...621. Which of the following features are most likely seen in a case of Takayasu arteritis? Febrile lymphadenopathy with rah Blanching and cyanosis of the fingers and toes Major organ failures Blindness and pulseless upper extremities Loading...622. 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? Endothelial cells of the cornea Epithelial cells of the retina Epithelia cells of the cornea Epithelial cells of the ciliary body Loading...623. A group of drugs bind to a receptor but do not produce any pharmacological effect is called: Agonist Antagonist Partial agonist Loading...624. Which one of the following drugs has a synergistic effect with Flucytosine? Griseofulvin Caspofungin Amphotericin B Nystatin Loading...625. Which of the following conditions is characterized by the presence of periventricular calcified densities on brain imaging? Down syndrome Huntington’s disease Cytomegalovirus infection ToxoplasmosisPage 26 of 66 Loading...626. Which one the following parts of the large intestine is extraperitoneal? Transverse colon Sigmoid colon Cecum Descending colon Loading...627. 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? Negative stool analysis History of diarrhea and weight loss Having first attack in his twenties Smoking cessation Family history of inflammatory bowel syndrome Loading...628. Gynecomastia is the adverse effect of the following drug? Fluconazole Griseofulvin Ketoconazole Flucytosine Loading...629. 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? Heparin Sodium nitroprusside Labetalol Clopidogrel Calcium gluconate Loading...630. 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 carotid duplex ultrasonography Schedule MRI to the brain Obtain CT scan of the head Schedule another appointment whenever she has symptoms Loading...631. Which of the following amino acids is a non essential? Asparagine Glutamic acid Histidine Aspartic acid Alanine Loading...632. 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? Direct inguinal hernia Indirect inguinal hernia Femoral hernia Hiatal hernia Loading...633. Which one of the following anti-depressant drugs is contraindicated if the patient has a history of seizures? Bupropion Fluoxetine Imipramine Venlafaxine Loading...634. Which one of the following conditions is the most likely cause of acute lower gastrointestinal bleeding in patients older than 40? Ulcerative colitis Varicose veins Diverticulosis Colorectal cancer Loading...635. Which one of the following drugs belongs to Antidiarreals? Methyl cellulose Ezetimibe Indanyl carbenicillin Nizatidine Atorvastatin Loading...636. 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? Head CT scan Brain biopsy MRI of the brain CSF analysis Loading...637. Which of the following endocrine disorders is characterized by high blood pressure, sodium and water retention, low potassium level and decreased renin activity? Pheochromocytoma Primary hyperaldosteronism Secondary hyperaldosteronism Addison’s disease Loading...638. What is the best first step of action for a case of posterior myocardial infarction? Aspirin 325 mg administration Stress test Metoprolol 60 mg administration Tissue plasminogen activator Loading...639. A 70-year-old man develops chest pain 2 days after hip replacement. Which is the most likely diagnosis? Myocardial infarction Cor pulmonale Bundle branch block Pulmonary embolism Loading...640. Which one of the following diuretics may elevate blood glucose level in some patients? Triamterene Hydrochlorothiazide Acetazolamide Spironolactone Loading...641. 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 Superior mesenteric artery Right colic artery Ileocolic artery Loading...642. Terbinafine blood levels are decreased by the following the drug? Caspofungin Rifampin Griseofulvin Cimetidine Loading...643. 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 esophagus Injury to the lung tissue Injury to the myocardium Injury to the right bronchus Loading...644. Which of the following is/are the most likely biopsy features seen in Celiac disease? Crypt abscesses with excess neutrophils Lymphoid aggregates with granulomas Flattening of villi with excess lymphocytes Lack of ganglion cells Loading...645. 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 Vitamin B12 deficiency Folic acid deficiency Thiamine deficiency Riboflavin deficiency Loading...646. Which one of the following drugs is effective only for the influenza A virus? A & B None of these Zanamivir Rimantadine Oseltamivir Loading...647. The structural formula of the following drugs contains the Biphenyl methyl group except? Valsartan Candesartan Eprosartan Losartan Olmesartan Loading...648. 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? Germinoma Craniopharyngioma Gangliocytoma Choriocarcinoma Teratoma Loading...649. Which one of the following conditions most likely increases the risk for deep venous thrombosis (DVT)? Coronary heart disease Pulmonary tuberculosis Crohn’s disease Adenocarcinoma Loading...650. Which of the following findings distinguishes chronic renal failure from acute renal failure? History of elevated BUN High serum sodium High serum calcium History of elevated serum creatininePage 27 of 66 Loading...651. 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? 75 mg 0 mg 50 mg 25 mg Loading...652. 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? Papilledema Bladder hemorrhage Hemolytic anemia Cardiomyopathy Loading...653. A drug that inhibits the ergosterol synthesis causing disruption of membrane function and Increase permeability? Nystatin Ketoconazole Amphotericin B Flucytosine Loading...654. 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? Colonoscopy CT scan of the head Cosyntropin stimulation test Serum Thyroid Stimulation Hormone (TSH) level MRI of the brain Loading...655. Which of the following is the currently drug of choice for the treatment of cutaneous anthrax? Azithromycin Gentamicin Ciprofloxacin Penicillin Loading...656. Which one of the following drugs causes teratogenic effect? Zanamavir Ribavirin Oseltamivir Rimantadine Amantadine Loading...657. Which of the following is the best therapy for essential tremors? Propranolol Haloperidol Physiotherapy Metoclopramide Loading...658. Which type of hypersensitivity reaction develops from Mycobacterium tuberculosis? Type II Type IV Type I Type III Loading...659. Miconazole belongs to the following type of drugs class? Antifungal Antibiotics Antiviral Anti malaria Antipyretic Loading...660. 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? Staphylococcus aureus Streptococcus viridans Pneumonitis aeruginosa Bacillus anthracis Loading...661. A drug that is used for Hypotrichosis of the eyelashes? Treprostinil Bimatoprost Dinoprostone Carboprost Epoprostenol Loading...662. Intermediate Acting Insulin is one of the following? NPH (neutral Protamine hagedorn) Detemir Lispro Glargine Loading...663. 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 Copper Monosodium urate crystals Hemosiderin Loading...664. 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 Cholesterol reduction Blood pressure control Loading...665. Which of the following types of cells predominantly lines the conducting airways of the lung and is considered an important defense mechanism? Goblet cells Endocrine cells Basal cells Ciliated cells Loading...666. Which of the following anticoagulant medications works by binding to thrombin and inhibiting it? Hirudin Warfarin Ticlopidine Heparin Loading...667. Aminoglycosides inhibit protein synthesis through targeting which of the following? Peptidoglycan units 30S ribosomal subunits RNA polymerase mRNA Loading...668. Which of the following drugs is beneficial in treatment of glaucoma through increased outflow of aqueous fluid by causing contraction of ciliary muscle? Diuretics Alpha agonists Cholinomimetics Beta blockers Loading...669. Echothiophate, which is used mainly for ophthalmic actions inhibits: Catechol-O-methyltransferase (COMT) Acetylcholinesterase DOPA decarboxylase Monoamine Oxidase Tyrosine hydroxylase Loading...670. 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? Methoxamine Clonidine Metaproterenol Isoproterenol Epinephrine Loading...671. 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? Color of the lesion Depth of the lesion Age of the patient Diameter of the lesion Loading...672. In case of transposition of the great arteries, the pulmonary artery arises from which one of the following parts of the heart? Right atrium Left ventricle Right ventricle Left atrium Loading...673. 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 collecting tubule and duct The distal convoluted tubules The proximal convoluted tubules The ascending loop of Henle Loading...674. 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.at is the most likely diagnosis? Radioactive induced thyrotoxicosis Cancer thyroid Ectopic thyroid tissue Incomplete ablation of thyroid gland Hashimoto’s disease Loading...675. 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? Campylobacter Streptococcus viridans Escherichia coli Staphylococcus aureusPage 28 of 66 Loading...676. Which one of the following drugs belongs to 1st generation Cephalosporins? Cefadroxil Cefazolin Cefdinir All of the above A & B Loading...677. Which of the following organisms is associated with pneumonia precipitated by aerosolized water (air conditions)? Legionella pneumophila Chlamydophila pneumonia Pneumocystis jirovecii Mycoplasma pneumonia Loading...678. A drug that blocks the viral membrane matrix protein M2 and its ability to modulate intracellular PH? Zanamivir Oseltamivir Ribavirin Acyclovir Rimantadine Loading...679. Which one of the following medications has a significant alpha-adrenergic blocking activity? Clozapine Chlorpromazine Haloperidol Risperidone Loading...680. Which one of the following statements about the Digoxin is wrong? None of these Has a half-life of 36 hours Positive Inotropic drug A cardiac glycosides Inhibit Na+/K+ exchange Loading...681. Disease prevalence can be measured by which one of the following studies? Cohort study Adoption study Cross-sectional study Case-control study Loading...682. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Indanyl carbenicillin Nizatidine Ezetimibe Cycloserine Aluminium hydroxide Loading...683. Which of the following type of virus causes influenza? Herpesvirus A & B Varicella zoster Cytomegalovirus Orthomyxoviruses Loading...684. A drug that is used to treat HIV infections is one of the following? Cladribine Niclosamide Praziquantel Atazanavir Etidronate Loading...685. Which of the following drug is a part of drugs for osteoporosis? Alendronate A & B Acetazolamide Rabeprazole Furosemide Loading...686. During normal inspiration, the diaphragm: Relaxes Does not move Contracts Loading...687. 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? Phalen sign Tinel sign Chandler sign Wonder sign Loading...688. 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? Malignant melanoma Squamous cell carcinoma Basal cell carcinoma Langerhans cell histiocytosis Mycosis fungoides Loading...689. 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? Progestin therapy Radiotherapy Cytotoxic agents Lobectomy Loading...690. Which of the following drug is used as a cervical ripening agent to induce labor? Ketorolac Dinoprostone Nubemetone Etodolac Celecoxib Loading...691. Which one of the following structures is involved in a case of tarsal tunnel syndrome? Anterior tibial artery Tibial nerve Peroneal artery Deep peroneal nerve Loading...692. Which of the following is the main reason that acetylcholine not used in clinical practice? It is expensive It is hydrolyzed very quickly It is toxic It has a long half-life Loading...693. Which one of the following drugs is worst for causing gastric irritation? Sulindac Acetaminophen Diclofenac Misoprostol Aspirin Loading...694. Which of the following drug resembles sex steroids and act at other receptors causing gynecomastia and menstrual irregularities at high doses? Triamterene Spironolactone Bumetanide Acetazolamide Furosemide Loading...695. 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? Dorsal interossei Opponens pollicis Adductor pollicis Lumbricals Loading...696. Which of the following organisms is responsible for antibiotic-associated colitis? Clostridium botulinum Clostridium difficile Clostridium tetani Clostridium perfringens Loading...697. Which one of the following actions of epinephrine is blocked by prazosin? High stroke volume Tachycardia Pupil dilation Bronchial dilation Loading...698. Mechanism of action of Abciximab is following? Inhibit COX-2 Inhibit COX-1 Inhibit glycoprotein receptors Inhibit ADP mediation Decrease Calcium levels Loading...699. 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 Creutzfeldt-Jakob disease Vascular dementia Loading...700. Which of the following drugs is neuraminidase inhibitor drug? Zanamivir Ibandronate Capecitabine Naftifine MiconazolePage 29 of 66 Loading...701. 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 Atherosclerosis Hypotrichosis Reye syndrome Pulmonary embolism Loading...702. Which of the following drug is Cholinergic agonist used for diagnosis of myasthenia gravis as well as an antidote for tubocurarine? Edrophonium Tyramine Atropine Atracurium Piruterol Loading...703. Which one of the following conditions most likely shows lower than normal erythrocyte sedimentation rate (ESR)? Polycythemia Pregnancy Multiple myeloma Giant cell arteritis Loading...704. 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? Enlarged cardiac shadow in both directions Left ventricular hypertrophy Boot-shaped heart Right ventricular hypertrophy Loading...705. 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? CSF analysis Brain biopsy MRI of the brain Head CT scan Loading...706. Indomethacin belongs to one of the following class? Acetic acid derivative Oxicam derivative Propionic acid Fenamates Loading...707. Which of the following drug is the Antidote of Isoniazid? N-acetyl-cysteine Pyridoxine Amyl Nitrate Digibind Loading...708. 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? Anoscopy Fecal occult blood test Sigmoidoscopy Colonoscopy Barium enema Loading...709. Which one of the following drugs is a neuromuscular blocker drug? Mecamylamine Benztropine Neostigmine Atropine Pancuronium Loading...710. Which one of the following drugs belongs to an alkylating agent? Capreomycin Lamivudine Streptozocin Indanyl carbenicillin Gemcitabine Loading...711. Which of the following agents should a patient take for a stuffy, runny nose? Clonidine Oxymetazoline Terbutaline Metoprolol Albuterol Loading...712. Which of the following predicts better prognosis in cases of breast cancer? No metastases in the nearest lymph nodes Positive estrogen receptor Family history of breast cancer Tumor stage 2 Loading...713. Chemotherapeutic agents use may result in the loss of individual neoplastic cells through which of the following mechanisms? Apoptosis Phagocytosis Coagulative necrosis Acute inflammation Loading...714. 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? Mydriasis Bronchial smooth muscle dilation Constipation Decreased gastrointestinal motility Dilation of blood vessels Loading...715. Which of the following medications is a non-drowsy anti-allergic medication? Diphenhydramine Loratadine Chlorpheniramine Cetirizine Loading...716. A drug causes accumulation of fat in the abdomen and the base of the neck on chronic administration? Ritonavir Vidarabine Zanamavir Lamivudine Amantadine Loading...717. 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 and tetanus immunoglobulin Tetanus toxoid followed by tetanus immunoglobulin after 5 days Tetanus immunoglobulin Tetanus toxoid No further therapy Loading...718. Which of the following agents reduce the blood levels of certain drugs through its action on hepatic P450 system? Kava Grapefruit juice Guava juice St. John’s wart Loading...719. Which of the following is the substance released from the parietal cells of the stomach? Pepsinogen Mucus Hydrochloric acid Gastrin Loading...720. What is the antidote to organophosphates toxicity? B & C Dimercaprol Pralidoxime All of above Atropine Loading...721. 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? Temporal artery biopsy Start prednisone Carotid Doppler studies Refer to a neurologist CT scan of the head Loading...722. 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? Chicken pox Measles German measles Smallpox Mumps Loading...723. 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? Crohn’s disease Polycystic kidney disease Ulcerative colitis Irritable bowel syndrome Loading...724. Which one of the following gastrointestinal conditions is NOT associated with blood in stools? Ulcerative colitis Cancer colon Irritable bowel syndrome Diverticulosis Loading...725. Which one of the following glucocorticoids can cause sodium and water retention? Cortisol Dexamethasone Betamethasone TriamcinolonePage 30 of 66 Loading...726. Which one of the following glucocorticoids is long acting? Cortisone Amiloride Betamethasone Prednisone A & B Loading...727. Which of the following drug belongs to Sulfonylureas? Cefoxitin Tolbutamide Urae Niacin Oxacillin Loading...728. 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? Giardia lamblia Entamoeba histolytica cytomegalovirus Clostridium difficile Loading...729. Which of the following factors directly stimulates the release of antidiuretic hormone (ADH)? Decreased extracellular fluid osmolality Increased extracellular fluid osmolality Decreased temperature Increased blood volume Loading...730. Which of the following antibiotics is the most appropriate treatment of mycoplasma pneumonia? Ampicillin Doxycycline Azithromycin Gentamicin Loading...731. Which one of the following drugs is a Thiazide Diuretic? Ezetimibe Chlorthalidone Indanyl carbenicillin Fenofibrate Atorvastatin Loading...732. 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? Inject the patient with anesthesia and do the procedure Force the patient to 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...733. 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 can only take the vaccine later after full recovery No need for the vaccine as long as Pap smear is normal 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 She already has HPV infection so, no need for the vaccine Loading...734. 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? Refer to surgery for urgent reduction MRI of the pelvis Assurance and follow up in 2 weeks Abdominal CT scan Urine culture Loading...735. Antihistamine agent with nonsedative effect from the chemical class of piperazine is the following? Hydroxyzine Fexofenadine Cetirizine Promethazine Cyproheptadine Loading...736. Which of the following is Coumarin derivative Anticoagulant agent? Warfarin Heparin Abciximab Clopidogrel Ticlopidine Loading...737. An empty scrotal sac is found upon examination of a newborn male. Which of the following is the most likely abnormality? Agenesis Venous atresia Hypogonadism Undescended testis Loading...738. Which one of the following statements about the digoxin is incorrect? 36 hours half-life Low therapeutic index None of these Indicated for diastolic HF Increase contractility Loading...739. Paget disease of bone is characterized by which one of the following features? Increase osteoclastic activity only Increase both osteoblastic and osteoclastic activity Decrease osteoclastic activity Increase osteoblastic activity only Loading...740. 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 incident and decreased prevalence No change in both Both incident and prevalence decrease Incident decreases with no change in prevalence Loading...741. Which one of the following medications increases the threshold for angina? Benazepril Metoprolol Furosemide Digoxin Loading...742. Which one of the following drugs associated with nephrotoxicity? Ethambutol Rifampin Capreomycin Isoniazid Loading...743. Which of the following is the best initial management of esophageal candidiasis in an HIV patient? Upper endoscopy Oral fluconazole Oral nystatin Intravenous amphotericin Loading...744. 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 glomerulonephritis Acute tubular necrosis Traumatic avulsion of the ureter Interstitial nephritis Loading...745. Which one of the following drugs is a thiazide diuretic drug? Acetazolamide Amiloride Chlorthalidone Bumetanide Loading...746. Which of the following locations is the most common for Koplik’s spots of measles? Soft palate Tongue Buccal mucosa Hard palate Loading...747. Acetazolamide and other carbonic anhydrase inhibitors act at which part of the kidney? Collecting duct Descending loop of Henle Proximal tubule Distal tubule Loading...748. 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? Coagulation disorder Normochromic normocytic anemia Macrocytic anemia with neurological signs Microcytic anemia Macrocytic anemia Loading...749. Which one of the following indicates drug resistance? Induction of liver metabolism No or minimum effect on a microorganism due to genetic mutation Response to a drug decreases after repeated use Altered effect of the drug when used with another drug Loading...750. Prazosin blocks which of the following actions of epinephrine? Bronchodilation Tachycardia High stroke volume MydriasisPage 31 of 66 Loading...751. Which one of the following drugs inhibit the enzyme phosphodiesterase which inactivate the cAMP? Argatroban Warfarin Dipyridamole Aminocaproic acid Loading...752. 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? VDRL for syphilis Nucleic acid amplification test for chlamydia Biopsy of the anal lesions Stool and urine analysis Serology for Human papilloma virus Loading...753. 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 Tricuspid valve regurgitation Mitral valve stenosis Pulmonic valve stenosis Aortic valve stenosis Loading...754. Which of the following statements is true about warfarin? Warfarin is monitored by PTT Warfarin acts by activation of antithrombin Liver is the main site of action of warfarin Toxicity of warfarin is treated by protamine sulfate Loading...755. A drug induces rapid depolarization of the membrane inhibiting the intracellular synthesis of DNA, RNA, and protein? Vancomycin Imipenem Aztreonam Daptomycin Loading...756. Which of the following organisms is associated with toxic shock syndrome due to exotoxin A? Vibrio cholera Staphylococcus aureus Clostridium perfringens Streptococcus pyogenes Loading...757. 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/dlukocyte count: 25,000 – 80% neutrophils Platelet count: 20,000at is the most likely diagnosis? Idiopathic thrombocytopenic purpura Thrombotic thrombocytopenic purpura Hemophilia a Hemophilia b Disseminated intravascular coagulation Loading...758. Which of the following types of sensations is carried to the thalamus by the anterolateral tracts after crossing the spinal cord? Fine touch Vibrations Position Crude touch Loading...759. Mechanism of action of Aspirin is following? Inhibit ADP mediation Inhibit COX-1 Decrease Calcium levels Inhibit COX-2 Inhibit glycoprotein receptors Loading...760. In which of the following Diuretic, cyclic sulfonamide is replaced by an Amide? Hydrochlorothiazide Methylchlorothiazide Chlorothiazide Chlorthalidone Bendroflumethiazide Loading...761. Which of the following statements is true about live attenuated vaccine? Close contacts of influenza patients can be safely vaccinated with live attenuated vaccine It is mainly used for immunocompromised patients They only induce humoral immunity No booster is needed for live attenuated vaccines Loading...762. Red man syndrome is caused by penicilin lincosamine vancomycin cephalosporin Loading...763. 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. Thrombocytopenic thrombotic purpura Hemolytic uremic syndrome Renal stones Henoch-Schonlein purpura Idiopathic thrombocytopenic purpuraat is the most likely diagnosis? Loading...764. Which of the following conditions is considered a physiological change for normal pregnancy? Decreased blood volume Decreased respiratory tidal volume Decreased GI tone and motility Decreased body weight Loading...765. Which one of the following antipsychotics has higher affinity to both dopamine and serotonin receptors? Fluphenazine Clozapine Thioridazine Haloperidol Loading...766. 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? Intravenous thiamine Broad spectrum antibiotics Oral lorazepam Oral lactulose Loading...767. Which of the following cell types is responsible for forming the blood brain barrier (BBB)? Astrocytes Schwann cells Microglia Oligodendrocytes Loading...768. Which one of the following drugs blocks the urinary excretion of penicillin which leads to prolonged high serum concentration? Rifampicin Cimetidine Probenecid Chloramphenicol Loading...769. 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? Radial nerve Ulnar nerve Axillary nerve Median nerve Loading...770. 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? Admission to the intensive care unit (ICU) CT scan of abdomen and pelvis MRI of the kidney Administration of wide spectrum antibiotics Collection of urine and blood cultures Loading...771. 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 hot flashes and vaginal dryness HRT decrease the risk of coronary artery disease HRT decrease the risk of deep venous thrombosis HRT decrease the risk of stroke Loading...772. Which of the following characterizes intravenous (IV) route of administration? Maximum bioavailability Undergo first pass metabolism Rabidly excreted Efficacy is affected by liver disorders Loading...773. Beta-Blocker drug is following? Atropine Atracurium Tacrine Metoprolol Mecamylamine Loading...774. Which one of the following drugs blocks dopamine uptake transporter? Alcohol Marijuana Nicotine Cocaine Loading...775. 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? Weil-Felix titer Chlamydia titer Venereal Disease Research Laboratory (VDRL) test Blood culture of gonococciPage 32 of 66 Loading...776. Mitochondria are NOT found in which of the following organisms? Protozoa Yeasts Viruses Fungi Loading...777. 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? Cyproheptadine Carbinoxamine Loratadine Promethazine Triplodine Loading...778. Alkylating agents are associated with bone marrow depression and for this reason they are inappropriate for this patient. Deletion of a gene on the affected chromosome Duplication of a gene on the affected chromosome Missing of a chromosome Replication of a chromosome Presence of an extra chromosome Loading...779. Which of the following is responsible for the wrinkled appearance of the scrotum? Thickened keratinized epithelium Pampiniform plexus Tunica albuginea Dartos fascia Loading...780. 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 T-lymphocytes Donor B-lymphocytes Host B-lymphocytes Host T-lymphocytes Loading...781. Which one of the following maneuvers is recommended to deliver the baby arms in breech delivery? Lovest maneuver Mauriceau-Smellie-Veit maneuver Prague maneuver Pinard maneuver Loading...782. Acute decrease in response to a drug after initial or repeated intake is known as which of the following drug interactions? Tachyphylactic Synergetic Permissive Additive Loading...783. 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? Diazepam Citalopram Donepezil Fluoxetine Metoclopramide Loading...784. Which of the following drugs is used for respiratory virus infections? Miconazole Ibandronate Capecitabine Naftifine Oseltamivir Loading...785. Which one of the following drugs is used to treat helminthic infections for cestodes? Albendazole Ivermectin Praziquantel Mebendazole Thiabendazole Loading...786. A drug that Increases the cell permeability allowing more Flucytosine to penetrate the cell? Caspofungin Ketoconazole Nystatin Amphotericin B Loading...787. Which one of the following inhibit the excretion of Indomethacin, naproxen, and ketoprofen? Colchicine Sulfinpyrazone Allopurinol Probenecid Loading...788. Which of the following defense mechanisms is most likely associated with paranoia? Undoing Projection Superego lacunae Splitting Loading...789. Which one of the following substances is released by sympathetic postganglionic neurons which innervate renal vascular smooth muscle? Epinephrine Dopamine Acetyl choline Norepinephrine Loading...790. Which of the following is the major indication of ondansetron in patients receiving chemotherapy? Nausea and vomiting Headache GERD Hair loss Loading...791. Which one of the following conditions is characterized by high blood pressure, hypokalemia and elevated renal potassium? Fanconi syndrome Waardenburg syndrome Liddle syndrome Tay-sachs disease Loading...792. 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 B3 (Niacin) Vitamin B6 (Pyridoxine) Vitamin D (Cholecalciferol) Loading...793. Which of the following types of rashes characterizes Lyme disease? Erythematous maculopapular rash Erythema multiform Erythema marginatum Erythema migrans Loading...794. 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 lower motor neuron Activation of muscle spindles Lower blood supply to the muscle Activation of Golgi tendon organs Loading...795. Which one of the following drugs is a calcium channel blocker (Class IV)? Verapamil Procainamide Amiodarone Carvedilol Loading...796. Which one of the following statements about the use of Leflunomide is incorrect? Immunomodulatory agent Can't be used as monotherapy Reduce pain & inflammation Inhibit Dihydroorotate dehydrogenase Loading...797. Which of the following conditions is an indication for interferon gamma? Hepatitis A Chronic granulomatous disease Glomerulonephritis Chronic myeloblastic leukemia Loading...798. Which of the following is the enzyme responsible for conversion of testosterone into dihydrotestosterone (DHT)? 17 alpha-hydroxylase Aromatase 3-beta-hydroxylase 5-alpha-reductase Loading...799. Which of the following group is a compulsory part structural formula of Losartan? Carboxylate group Thiol group Sulfahydril group Phosphinic acid group Imidazole ring Loading...800. Which one of the following drugs is a selective Beta-2 adrenergic long-acting bronchodilator? Metaproterenol Albuterol Terbutaline Formoterol PirbuterolPage 33 of 66 Loading...801. Which one of the following conditions is characterized by joint space narrowing and osteophyte formation while bone density appears normal? Gout Pseudogout Rheumatoid arthritis Osteoarthritis Loading...802. Which one of the following drugs is the most fatal in suicidal overdose? Phenelzine Bupropion Citalopram Imipramine Loading...803. 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? Electromyography Refer to a rheumatologist HLA-B27 testing X-ray of lumbar spine Complete bed rest with ibuprofen for 3 days Loading...804. Which one of the following drugs is a Inducer of the P-GP (glycoprotein) efflux pumps? Rifampin All of the above Erythromycin Amiodarone Digoxin Loading...805. 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? Duodenal atresia Meckel’s diverticulum Pyloric stenosis Esophageal atresia Loading...806. Which one of the following treatment most likely prevents meningeal leukemia in a young boy diagnosed with acute lymphoblastic leukemia? Radiotherapy Intrathecal methotrexate Cyclophosphamide High dose of cortisone Loading...807. Which of the following factors most likely affects the result of a study due to awareness of study subjects that they are being studied? Hawthorne effect Pygmalion effect Berkson’s bias Recall bias Loading...808. Dizziness, tinnitus, blurred vision, and headache are linked with the following drug? Quinidine Quinine All of the above Primaquine A & B Loading...809. 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? Rifampin Chloramphenicol Ciprofloxacin C0-trimoxazole Loading...810. Which of the following is the appropriate next step of action to parents who refuse to vaccinate their child? Obtain a court order Proceed with immunizations Report to Department of Health Services (DHS) Explain the risks and benefits to them and document the conversation Loading...811. Which of the following medications is considered irreversible alpha receptor antagonist? Phenoxybenzamine Tolazoline Labetalol Prazosin Loading...812. An enolic acid derivative of Nonsteroidal anti-inflammatory drugs also called? N-arylanthranilic acids Oxicam derivative Salicylates Acetic acid Propionic acid Loading...813. 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? Facial nerve Oculomotor nerve Vagus nerve Trigeminal nerve Orbital nerve Loading...814. Which of the following is characteristic of Alzheimer’s disease? Lewy bodies Neurofibrillary tangles Nuclear atypia Negri bodies Loading...815. Which one of the following drugs is a Tetracycline? Cefadroxil Cefepime Doxycycline Cefdinir Loading...816. 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 Assurance and follow up in 3 months Start warfarin Start aspirin Start low molecular weight heparin and warfarin Loading...817. 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? Male pseudohermaphrodite Female pseudohermaphrodite True hermaphrodite Turner’s syndrome Loading...818. Which one of the following parts of the cell is the site of steroid synthesis? Peroxisome Smooth endoplasmic reticulum Golgi apparatus Rough endoplasmic reticulum Loading...819. Maraviroc belongs to the class of following drugs? Antipyretic Antifungal Anti malaria Antiviral Antiprotozoal Loading...820. Which one of the following statements correctly describes the inspiratory reserve volume? Volume of air that remains in the lung after a normal expiration Volume of air that can still be inhaled in after a normal inspiration Volume of air that present in the lung after maximal inspiration Volume of air that moves into the lung with each normal inspiration Loading...821. Counterregulatory hormone in diabetes that works against insulin include the following? All of the above Cortisol Catecholamines Glucagon Growth hormone Loading...822. 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? Human papillomavirus Cytomegalovirus Epstein-Barr virus Human immunodeficiency virus (HIV) Loading...823. Which of the following is the most common cause of sudden death in patients with diabetes mellitus? Hyperosmolar coma Gangrene Myocardial infarction Cerebral hemorrhage Loading...824. A drug that belongs to thiazolidinediones is one of the following? Ethacrynic Acid Pioglitazone Cefazolin Sulbactam A & B Loading...825. Which one of the following metals is the most likely cause of allergic contact dermatitis especially in females? Silver Copper Nickel GoldPage 34 of 66 Loading...826. 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 adenosine IV succinylcholine IV procainamide IV lidocaine Try carotid massage on the left side Loading...827. Which of the following is the percentage of thymine in a DsDNA if it contains 20% guanine? 30% 50% 40% 20% Loading...828. 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 Check carboxyhemoglobin level Obtain MRI of the brain Obtain EKG Loading...829. The binding of a drug to plasma proteins will tend to: Decrease half-life. Decrease its rate of glomerular filtration. Increase its concentration in the plasma. Increase its rate of biotransformation. Increase its pharmacological activity Loading...830. 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? Obstructive jaundice Hepatocellular disease Hemolysis Gallstones Pancreatic cancer Loading...831. Which of the following is the most effective treatment of a case of an old man with benign prostatic hypertrophy (BPH)? Doxazosin Doxazosin and finasteride Propranolol Finasteride Loading...832. Which one of the following is the class of aliskiren? Angiotensin receptor blocker Interior pituitary hormone Direct renin inhibitor ACE inhibitor Corticotropin Loading...833. Which one of the following statements about the platelets is wrong? PG2 decrease aggregation Life of platelet 3-7 days Platelet have nuclei Can't synthesize the new enzyme TXA2 enhance aggregation Loading...834. Which of the following drug is Phenoxy acetic acid derivative diuretic? Ethacrynic acid Torasemide Benzthiazide Chlorthalidone Furosemide Loading...835. 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 Skeletal muscles Liver Small intestine Loading...836. 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. Serum thyroid stimulating hormone Blood urea nitrogen and serum creatinineat is the most appropriate lab test you should order on this visit? Blood glucose and serum lipids Serum cortisol Loading...837. Which one of the following cell markers is unique for NK cells? CD40 CD14 CD56 CD16 Loading...838. Which of the following is the most common primary disturbance of acid-base balance in pregnant women? Respiratory acidosis Metabolic acidosis Metabolic alkalosis Respiratory alkalosis Loading...839. Phentolamine and Tolazoline have similar structures to imidazoline Alpha Agonists due to lack of? Lipophilic substitutions on the aromatic ring Hydrophilic substitutions on the Cyclic ring Hydrophilic substitutions on the aromatic ring None of these Lipophilic substitutions on the Cyclic ring Loading...840. Which one of the following drugs is a Thiazide Diuretic? Indanyl carbenicillin Atorvastatin Ezetimibe Fenofibrate Torsemide Loading...841. Which one of the following drugs may cause parkinsonism-like adverse effect? Olanzapine Quetiapine Clozapine Haloperidol Loading...842. To diagnose myasthenia gravis we use? Pralidoxim Malathion Ambenonium Edrophonium Physostigmine Loading...843. 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? Inflammation Embolism Atherosclerosis Thrombosis Loading...844. A 15-year-old boy is diagnosed with “Walking pneumonia”. Which of the following is the most effective treatment of this condition? Vancomycin Ampicillin Azithromycin Tetracycline Loading...845. 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? Termination of pregnancy Hormonal treatment Surgical removal of the cyst Assurance and follow up on next visits Wide spectrum antibiotics to prevent infection Loading...846. 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 4 Branchial Arch 2 Branchial Arch 1 Branchial Arch 5 Branchial Arch 3 Loading...847. Which one of the following is the effect of metoprolol on cardiac ejection time? Increased No effect Decreased Loading...848. 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 Scaphoid fracture Colles fracture Loading...849. Consumption of which of the following products most likely reduces the risk for coronary heart disease in susceptible patients? Fish oils Saturated fat Beef products Sugar-free snacks Loading...850. Which of the following is the main step in treating alcoholic liver disease? Baclofen Disulfiram Abstinence NaltrexonePage 35 of 66 Loading...851. Which of the following is the epithelial covering of vocal cords? Simple cuboidal Simple columnar Simple squamous Stratified squamous Loading...852. Lactic acidosis is the adverse effect of one of the following drugs? Glyburide All of the above Metformin Aspirin Loading...853. Which one of the following drugs is associated the most to tardive dyskinesia after use for years? Aripiprazole Olanzapine Risperidone Chlorpromazine Loading...854. Which one of these conditions is most likely associated with peripheral lymphocytosis? Myocardial infarction Viral hepatitis Inflammatory bowel syndrome Pyogenic bacterial infections Loading...855. A drug that inhibits xanthine oxidase through the formation of a stable complex with xanthine oxidase is the following? Probenecid Allopurinol Febuxostate Colchicine Pegloticase Loading...856. Which one of the following parts of the cell is the site of steroid synthesis? Rough endoplasmic reticulum Smooth endoplasmic reticulum Peroxisome Golgi apparatus Loading...857. 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...858. 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? Call the cardiology attendant Electric cardioversion Intravenous injection of broad spectrum antibiotics Intravenous injection of heparin Subcutaneous injection of epinephrine Loading...859. Which of the following types of protein is encoded by the P53 gene? Tyrosine kinase Caspase DNA repair enzyme Transcription factor Loading...860. 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. Antagonistis drug should be classified as what? Inverse agonist Agonist Partial agonist Loading...861. Niemann-Pick disease is characterized by deficiency of which one of the following enzymes? Alpha-glucosidase Beta-glucosidase Arylsulfatase Sphingomyelinase Loading...862. What is the proper treatment of adrenal insufficiency? Adrenaline Prednisone Fludrocortisone Prednisone and fludrocortisone Loading...863. Which one of the following drugs is Nonsteroidal antiestrogens? Exemestane Estrogen Tamoxifen Estradiol Estradiol acetate Loading...864. 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? Ovarian cyst Acute appendicitis Pelvic abscess Ectopic pregnancy Endometriosis Loading...865. 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? C8 and T1 C6 and C7 C7 and C8 C5 and C6 Loading...866. 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? Osteoarthritis Postural hypotension Old age Side effect of one of her medications Alzheimer’s disease Loading...867. 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 B lymphocyte CD4 lymphocyte CD8 lymphocyte Loading...868. Which of the following is the earliest EKG sign of myocardial infarction? Pathological Q –wave S-T elevation Inverted T-wave Large peaked T-wave Loading...869. Bleeding and thrombocytopenia is an adverse effects of one of the following drugs? Heparin Protamine sulphate Vitamin K Aprotinin Loading...870. Which one of the following drugs is a H² receptor Antagonist? Omeprazole Rabeprazole Sucralfate Cimetidine Loading...871. A drugs inhibit the urate-anion exchanger in the proximal tubules that mediates urate reabsorption? Allopurinol Colchicine Sulindac Probenecid Loading...872. Which of the following groups are found in the structural formula of Angiotensin-converting enzyme inhibitors Except? Thiol group Carboxylate group Sulfahydril group Imidazole ring Phosphinic acid group Loading...873. 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 Acid perfusion test Endoscopy Loading...874. Which of the following indicates the probability that a person who has a positive test result actually has the disease? Attributable risk Sensitivity Positive predictive value Specificity Loading...875. 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 Chemical Physiological CompetitivePage 36 of 66 Loading...876. 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? Antibiotic ear drops and follow up in three days Empiric oral antibiotic therapy and follow up in one week Initiation of left myringotomy and induction of topical treatment Hospitalization for intravenous antibiotics and control of diabetes Loading...877. Which one of the following drugs is a Meglitinide drug? Fenofibrate Hydrochlorothiazide Indanyl carbenicillin Repaglinide Ezetimibe Loading...878. N-Substitutions of the catecholamine pharmacophore with isopropyl groups or aryl-alkyl groups improve the selectivity of which receptor? Neuromuscular Activity Beta Receptor Dopaminergic receptor Alpha Receptor Muscarinic Receptor Loading...879. Emotions, judgments and motor aspects of speech are controlled by which one of the following lobes of the brain? Frontal Parietal Occipital Temporal Loading...880. Acyclovir belongs to one of the following classes of drugs? Antibiotics Antipyretic Antiviral Antifungal Antiprotozoal Loading...881. 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? Furosemide Albuterol Atenolol Epinephrine Digoxin Loading...882. Which one of the following drugs belongs to 3st generation Cephalosporins? Cefepime Cefdinir Cefaclor Cefadroxil Loading...883. 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? No further therapy Tetanus toxoid Tetanus toxoid and tetanus immunoglobulin Tetanus toxoid followed by tetanus immunoglobulin after 5 days Tetanus immunoglobulin Loading...884. 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. Hospitalization and treatment with antihypertensive and epileptic drugs and wait until delivery at term Outpatient treatment and recommend regular visits to the clinic Hospitalization and induction of labor Hospitalization and observation until delivery at termat is the next step of management of this patient? Loading...885. Which one of the following cephalosporins belongs to the third generation? Cefixime Cefoxitin Ceftin Cefaclor Loading...886. Which of the following drug is Non-NucleoSide Reverse Transcriptase inhibitors(NNRTIs)? Zidovudine Amprenavir Nevirapine Saquinavir Acyclovir Loading...887. 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 Smallpox Chicken pox Measles Loading...888. Which of the following is the best next step for a suspicious malignant melanoma? Excisional biopsy Observation Shave biopsy Excision with a safety margin Loading...889. Which of the following medications is most likely prescribed in cases of asthma associated with chronic environmental allergies? Fluticasone nasal spray Oral fexofenadine Oral montelukast Albuterol inhaler Loading...890. 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 and replace it with formula for 3 months Advise her to use the pump to collect her breast milk every 24 hours right before she takes daily metronidazole Stop metronidazole and choose another less effective drug as you weigh the benefits and the risks Stop breast feeding indefinitely Advise her to keep breastfeeding her child as there is no risk of the drug on breast feeding Loading...891. Which of the following virus infections mostly develops chronic hepatitis? Hepatitis C Hepatitis B Hepatitis A Loading...892. Histamine Receptor found on the mucus layer causing the production of gastric acid secretion is the following? H² histamine receptor H⁵ Histamine receptor H¹ histamine receptor H⁴ histamine receptor H³ histamine receptor Loading...893. Which one of the following complications is the common cause of death in acromegaly? Renal failure Heart failure Hepatic failure Splenic infarction Loading...894. 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 dissection Aortic regurgitation Aortic stenosis Hypertrophic cardiomyopathy Loading...895. Which of the following is the mechanism of action of vinblastine? Interferes with purine synthesis Interferes with microtubule assembly Interferes with DNA mobilization and replication Interferes with microtubule disassembly Loading...896. Which one of the following is the adverse effect of Heparin? Osteoporosis All of the above Thrombocytopenia Bleeding Hypersensitivity Loading...897. 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? Transabdominal ultrasonography Vaginal examination Immediate delivery Hospitalization and observation until labor Loading...898. 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? Tendinitis Frozen shoulder Shoulder dystocia Rotator cuff tear Loading...899. Which of the following is the most likely developmental defect associated with tetralogy of Fallot? Anterosuperior displacement of the infundibular septum Transportation of the great vessels Bicuspid pulmonary artery Patent ductus arteriosus Loading...900. Which of the following autoantibodies is associated with diffuse scleroderma? Anti-SSB Anti-DNA topoisomerase 1 Anti-histone Anti-SSAPage 37 of 66 Loading...901. Which one of the following statements about the use of Labetalol is incorrect? Doesn't cause reflex tachycardia 3-6 hours duration of action Used as I.V infusion in emergency Selective Beta-1 blocker Loading...902. Which one of the following statements about the use of Celecoxib is wrong? Inhibition is irreversible Half-life of 11 hours Causes kidney toxicity Selective inhibitor of COX-2 Loading...903. Which of the following arteries is the most common site of coronary artery occlusion? Right coronary artery Left anterior descending artery Left circumflex artery Posterior descending artery Loading...904. 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? T-helper cells B Lymphocytes Fibrocytes Cytotoxic T cells Plasma cells Loading...905. Which of the following substances is used in mercury poisoning? Methylene blue Succimer Flumazenil Fomepizole Loading...906. The pericardial cavity is a space lies between which of the following structures? Epicardium and myocardium Parietal serous pericardium and visceral serous pericardium Epicardium and pericardium Parietal fibrous pericardium and visceral fibrous pericardium Loading...907. 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 Parkinson’s disease Tourette’s syndrome Huntington’s disease Creutzfeldt-Jakob disease Loading...908. 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 B-lymphocytes Activation of the donor T -lymphocytes Development of liver failure Activation of the host T-lymphocytes Loading...909. 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? Lung cancer Sarcoidosis Tuberculosis Asbestosis Pneumonia Loading...910. Which of the following options is the adverse effect of Vancomycin? All of the above Fever Chill's Phlebitis Redman syndrome Loading...911. Which one of the following types of cell secretions involves exocytosis? Apocrine secretion Merocrine secretion Holocrine secretion Loading...912. Tazobactam belongs to the one of the following class? Cephalosporin Beta lactamase inhibitor Carbapenems Monobactams Penicillins Loading...913. Which of the following is the most common etiology of type II diabetes? Low insulin production Altered hormone-receptor complex Insulin receptor deficiency Increased hepatic glycogen breakdown Loading...914. High levels of which one of the following substances signals the initiation of gluconeogenesis? Citrate Adenosine triphosphate (ATP) Acetyl CoA Oxalate Loading...915. Which one of the following actions is produced by muscarinic cholinergic agonists? Inhibition of phospholipase C Decreased release of intracellular calcium Activation of inhibitory G protein Decreased IP3 production Loading...916. Which of the following drug is a derivative of Fenamic acid? Diflunisal ketorolac Etodolac Mefenamic Acid Piroxicam Loading...917. Canrenone is an active metabolite of one of the following Diuretic drug? Bumetanide Triamterene Acetazolamide Furosemide Spironolactone Loading...918. Which of the following is the classic electrocardiogram (ECG) finding in inferior myocardial infarction (MI)? Sawtooth P waves Diffuse S-T segment elevation S-T segment elevation in anterior leads (V1-V4) S-T segment elevation in leads II. III and aVF Loading...919. Which one of the following drugs belongs to drugs for hepatic viral infections? Indanyl carbenicillin Ezetimibe Interferon Capreomycin Aluminium hydroxide Loading...920. 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? Elevated parathyroid hormone Parasympathetic stimulation Decreased peripheral resistance Decreased sodium and water retention Sympathetic stimulation Loading...921. Which one of the following drugs binds with dietary phosphate & prevents its absorption? Calcitonin Furosemide Rabeprazole Sevelamer Acetazolamide Loading...922. What is the congenital heart disease most likely associated with Turner’s syndrome? Ventricular septal defect Transposition of the great vessels Atrial Septal defect Coarctation of the aorta Loading...923. 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? Pseudomembranous colitis Renal stones Ulcerative colitis Enterovesical fistula Loading...924. Which one of the following drugs increase survival in patients with MI? Verapamil Digoxin Atenolol Furosemide Loading...925. A direct-acting adrenergic agonist is following? Clonidine Amphetamine A & B Acetylcholine AlbuterolPage 38 of 66 Loading...926. 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 unionized The pH at which 100% drug becomes completely ionized Loading...927. What is the most common cause of epididymitis in males older than 35 years of age? Streptococci Gonococci Chlamydia E Coli Loading...928. Which of the following is a frequent side effect of amphetamine? Depression Diarrhea Constipation Hair loss Loading...929. Which of the following medications is a non-drowsy anti-allergic medication? Diphenhydramine Chlorpheniramine Loratadine Cetirizine Loading...930. A drug that inhibits the fungal squalene epoxidase thus decreasing the synthesis of ergosterol? Nystatin Itraconazole Terbinafine Griseofulvin Loading...931. Which one of the following enzymes catalyzes the rate limiting step in glycolysis? 6-Phosphofructo-1 kinase Phosphofructokinase-2 Pyruvate kinase Glyceraldehyde-3-phosphate dehydrogenase Loading...932. Which of these medications is the drug of choice in treatment of severe digitalis intoxication? Propranolol Immune Fab Calcitonin Bupropion Loading...933. 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? Ventricular septal defect Tetralogy of Fallot Patent ductus arteriosus Transposition of the great arteries Atrial septal defect Loading...934. 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 Hepatocellular carcinoma Small cell carcinoma of the lung Loading...935. Which one of the following drugs belongs to ANTIMETABOLITES drugs for Cancer? Capreomycin Ezetimibe Lamivudine Gemcitabine Indanyl carbenicillin Loading...936. 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? Homonymous hemianopsia Superior hemianopsia Binasal hemianopsia Bitemporal hemianopsia Loading...937. Immune-related problem is one of the following? Aids High Blood pressure Fever Headache Loading...938. Cefaclor belongs to one of the following generations of the cephalosporin? 4th generation 3rd generation 2nd generation 1st generation Loading...939. 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 difficile Clostridium Septicum Clostridium histolyticum Clostridium butyricum Clostridium botulinum Loading...940. 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? Serum test for IgG antibodies against H. Pylori Examination and culture of gastric contents Stool analysis and culture Rapid urease test Urea breath test Loading...941. Periumbilical discoloration is found in a patient diagnosed with acute pancreatitis. Which of the following signs is considered positive in this patient? Cullen’s sign Nikolsky’s sign Murphy’s sign Grey Tunner sign Loading...942. The effect of medications on parasympathetic function declines slowly in which one of the following organs? Heart Glands Eye Smooth muscles Loading...943. Uric acid excretion is Increased by using one of the following options? Sulfinpyrazone A & B Probenecid Allopurinol All of the above Loading...944. What is the correct match regarding the genetic transmission of the following diseases? Huntington’s disease- Autosomal recessive Hypophosphatemic rickets- X-link recessive Duchenne muscular dystrophy- X-link dominant Leber hereditary optic neuropathy- Mitochondrial inheritance Loading...945. 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? Mutation in the NF1 gene on chromosome 17 Deletion of VHL gene on chromosome 3 Mutation in APC gene on chromosome 5 Defective DNA repair mechanisms Mutation in PKD1 on chromosome 16 Loading...946. Which of the following in the most likely cause of spontaneous abortion in the first trimester? Toxemia of pregnancy Maternal drug use Congenital infection Chromosomal abnormalities Loading...947. 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 cannot release you before you become sober We will call the police if you don’t take treatment You have to sign consent to leave You can leave anytime if you want Loading...948. 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 Obstruction of cerebral aqueduct Impaired CSF resorption Excessive CSF production Loading...949. 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? Meckel’s diverticulum Appendicitis Volvulus Diverticulitis Intussusception Loading...950. During development, hypothalamus arises from which one of the following structures? Diencephalon Metencephalon Telencephalon MesencephalonPage 39 of 66 Loading...951. Which of the following is the most prominent side effect of scopolamine? Mydriasis Miosis Profuse sweating Bradycardia Loading...952. Which one of the following drugs inhibits ribonucleotide reductase? 5-Fluorouracil Mycophenolate Ribavirin Hydroxyurea Loading...953. 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? Direct smooth muscle vasodilator ACE inhibitor Beta adrenergic antagonist Alpha adrenergic antagonist Ganglion blocker Loading...954. Which of the following placental sites of insertion most likely predispose to an inverted uterus? Lower Posterior Anterior Fundal Loading...955. A liposomal preparation of which one of the following medications may reduce the incidence of renal toxicity? Acyclovir Ketoconazole Amphotericin B Vancomycin Loading...956. Which one of the following medications act as bacteriostatic by inhibiting bacterial dihydrofolate reductase? Sulfamethoxazole Dapsone Trimethoprim Ciprofloxacin Loading...957. Which of the following correctly describes permissive drug interaction? Effect of drug A and drug B is equal to the sum of their individual effects Presence of drug A is required for full effect of drug Bich of the following drugs is the effective treatment of benzodiazepines toxicity? Effect of drug A and drug B is greater than the sum of their individual effects Decrease in response of a drug after repeated administration Loading...958. 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? Tracheoesophageal fistula Tracheomalacia Tetralogy of Fallot Imperforate anus Pyloric stenosis Loading...959. Which one of the following conditions is the most common cause of aortic stenosis in the the elderly patients? Bicuspid aorta Calcification of the aortic valve Rheumatic fever Subacute bacterial endocarditis Loading...960. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? Rabeprazole A & B Pyrazinamide Furosemide Ibandronate Loading...961. Which of the following is the most significant action of monoamine oxidase A? Metabolism of serotonin and epinephrine Metabolism of norepinephrine, serotonin and tyramine Metabolism of dopamine Metabolism of serotonin and dopamine Loading...962. Which of the following groups of drugs are useful for night terrors and sleepwalking? Benzodiazepines Alcohols Barbiturates Tricyclic anti-depressants Loading...963. 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 Shingles (herpes zoster) Dermatitis herpetiformis Psoriasis Seborrheic keratosis Loading...964. Which one of the following drugs is the best treatment for seizures of eclampsia? Carbamazepine Magnesium sulfate Haloperidol Phenobarbital Loading...965. Which one of the following is the most common cause of ruptured aortic aneurysm? Atherosclerosis Cardiomyopathy History of intravenous drug use Hypertension Loading...966. Which of the following conditions could be a serious side effect of sumatriptan? Coronary vasospasm Cutaneous flushing Torsades de pointes Dilated cardiomyopathy Loading...967. Reflex bradycardia caused by alpha-1-agonists is blocked by which of the following medications? Atropine Phenylephrine Adrenaline Metoprolol Loading...968. The antimuscarinic drug used for motion sickness as well as for blockage of short-term memory? Phenylephrine Scopolamine Physostigmine Pirenzepine Atropine Loading...969. A drug that belongs to proton pump inhibitor is one of the following? Ethacrynic Acid A & B Omeprazole Sulbactam Rosiglitazone Loading...970. A drug inhibit the human gonadal and adrenal steroids synthesis along with fungistatic property? Flucytosine Nystatin Caspofungin Ketoconazole Loading...971. A patient with acute appendicitis complains of abdominal pain. Which of the following chemical mediators are responsible for this pain? Histamine and serotonin Leukotriene and interlukin-1 Tumor necrosis factor and IgG Prostaglandin and bradykinin Loading...972. A patient with hyperthyroidism develops a cardiac arrhythmia, the most suitable drug to treat his arrhythmia would include: Amiodarone Propranolol Digoxin Bretylium Loading...973. 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? Cryptococcus neoformans Aspergillus fumigatus Streptococcus pneumonia Toxoplasma gondii Loading...974. A fenamic acid derivative of Nonsteroidal anti-inflammatory drugs also called? Oxicam Propionic acid N-arylanthranilic acids Salicylates Acetic acid Loading...975. Which one of the following drugs is a Thiazide Diuretic? Ezetimibe Atorvastatin Fenofibrate Indapamide Indanyl carbenicillinPage 40 of 66 Loading...976. Administration of which one of the following can increase the excretion of a weak acid i.e. Aspirin toxicity? A weak base A weak acid A strong acid A neutral salt Loading...977. Na+ channel blockers belongs to the one of the following CLASS of Antiarrhythmic drugs? CLASS II CLASS III CLASS IV CLASS I Loading...978. Which one of the following contraceptive methods is contraindicated in women with a history of deep venous thrombosis (DVT)? Norplant Intrauterine contraceptive device (IUD) Depo-Provera injections Combined oral contraceptive Loading...979. 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? Sulfur dioxide Carbon monoxide (CO) Ozone Nitrogen Loading...980. Which one of the following medications stimulates muscarinic receptors in airways when inhaled? Methacholine Bethanechol Carbachol Pilocarpine Loading...981. Which of the following substances is responsible for growth of the prostate at puberty? Estrogen Dihydrotestosterone Progesterone Testosterone Loading...982. Which one of the following features characterizes Crohn’s disease from ulcerative colitis? Continuous disease beginning at rectum and extending without skipped areas Perineal fissures and fistulas Colectomy is curative Bloody diarrhea Loading...983. Which one of the following drugs belongs to Antidiarreals? Ezetimibe Atorvastatin Indanyl carbenicillin Nizatidine Aluminium hydroxide Loading...984. Blockage of ɑ1 and ɑ2 adrenergic receptors on the arteriolar beds lead to following? None Increase renin secretion Increase renin secretion Reduce peripheral resistance Increase peripheral resistance Loading...985. Which one of the following drugs is a inhibitors of the P-GP (glycoprotein) efflux pumps? All of the above Digoxin Linezolid Amiodarone A & B Loading...986. A disease characterized as recurrent and persistent abdominal discomfort and abdominal pain? Dyspepsia GERD Peptic Ulcer disease A & B Loading...987. 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 Metoprolol Verapamil Captopril Diltiazem Loading...988. Which of the following is the effect of digoxin on a case of heart failure? Increased stroke volume and cardiac output Rapid conduction through AV node Decreased stroke volume and vagal activity Increased sympathetic tone and decreased vagal activity Loading...989. Which of the following drug belongs to the Nonnucleoside reverse transcriptase inhibitor? Maraviroc Atazanavir Indanyl carbenicillin Delavirdine Abacavir Loading...990. What is the genetic abnormality related to Cri-du-chat-syndrome? Deletion of short arm of chromosome 5 Deletion of phenylalanine in position 508 Mutations of the fibrillin gene on chromosome 15 Trisomy 18 Loading...991. Which of the following is the most common cause of acute mesenteric ischemia? Mesenteric vein thrombosis Abdominal aortic aneurysm Embolism Vascular autoimmune disease Loading...992. Which one of the following macrolide drugs has a half-life of >40 hours? Erythromycin Azithromycin Clarithromycin Telithromycin Loading...993. Which of the following drug are coumarin derivative oral anticoagulants? Heparin Phytonadione Menadione Phenindione Dicumarol Loading...994. 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 Rickettsia Mycobacteria Streptococci Loading...995. 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? Competitive inhibition of iodide transport mechanism Inhibition of the release of thyroid hormone from the thyroid gland Blocking of peripheral deiodination of T3 and T4 Blocking of peroxidase catalyzed reactions Blocking of coupling of iodotyrosines Loading...996. Which one of the following factors is the most accurate measure for the severity of diabetic ketoacidosis? Serum bicarbonate level Serum glucose level Blood ketones Urine ketones Loading...997. Rapid Acting Insulin is one of the following? Glulisine Glargine Regular NPH Loading...998. Which of the following is the earliest abnormal test after infection with hepatitis B? Surface antigen Anti-hepatitis B antibodies Serum bilirubin ALT Loading...999. Which of the following are the characteristics of Dressler’s syndrome? Hypotension, distant heart sounds and jugular vein distention (JVD) Fever, pericarditis and elevated erythrocyte sedimentation rate (ESR) Stasis, hypercoagulability and endothelial damage Loading...1000. Which of the following correctly describes unstable angina? Angina following strenuous exercise Angina occurs at rest Angina relieved by restPage 41 of 66 Loading...1001. 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? Peptic esophageal stricture Lower esophageal ring Diffuse esophageal spasm Cancer esophagus Achalasia Loading...1002. 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 Inactivation of bacterial toxins Inhibition of bacterial wall synthesis Inhibition of mycolic acid synthesis Inhibition of bacterial protein synthesis Loading...1003. Which one of the following is the most common etiology of abdominal aortic aneurysm in the United States? Rheumatic heart disease Turner syndrome Cystic medial necrosis Atherosclerosis Loading...1004. Which of the following proteins in the serum transport drugs? Albumin Organic anion polypeptides Alpha-1 acid glycoprotein A & B All of the above Loading...1005. Which one of the following drugs is a Tetracycline? Cefepime Demeclocycline Cefdinir Cefadroxil Loading...1006. Ketorolac is derived from which of the following class? Salicylic Acid derivatives Enolic acid derivative Fenamic acid derivative Propionic acid derivative Acetic acid derivative Loading...1007. 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.at is the most likely diagnosis? Acute arthritis Baker cyst Osteoarthritis Tear of posterior collateral ligament Hydrarthrosis Loading...1008. Which one of the following conditions is NOT a common cause of vitamin B12 deficiency? Malabsorption syndrome Diet deficiency of vitamin B12 Intrinsic factor deficiency Gastric bypass Loading...1009. Which of the following is the main site of action of HMG-CoA reductase inhibitors? GI tract Liver Kidney Blood Loading...1010. 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? Obsessive compulsive disorder Antisocial personality disorder Conduct disorder Borderline personality disorder Histrionic personality disorder Loading...1011. Which one of the following is a anterior pituitary hormone? Desmopressin Urofollitropin Fenofibrate Atorvastatin Torsemide Loading...1012. 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? Diffuse axonal injury Subdural hematoma Epidural hematoma Cerebral contusion Loading...1013. Pancreatic exocrine secretions empty into the duodenum through which one of the following? Duct of Wirsung Accessory pancreatic duct Common bile duct Duct of Santorini Loading...1014. Foci of hemorrhage and necrosis in which of the following parts of the brain is characteristic of Wernicke’s encephalopathy? Mamillary bodies Anterior pituitary Basal ganglia Posterior pituitary Loading...1015. Which of the following drug is belong to the dihydropyridines class of antihypertension? Amlodipine Verapamil Amiloride Diltiazem Losartan Loading...1016. 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? Lamotrigine Chlorpromazine Benztropine Sertraline Loading...1017. Which of the following substances is elevated due to vitamin B12 deficiency? Hemosiderin Homocysteine Cyanocobalamin Folic acid Loading...1018. 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...1019. Paraneoplastic hypercalcemia is most likely caused by tumor cells secreting which one of the following substances? Calcitonin Parathyroid hormone Calcitonin-related peptide Parathyroid hormone-related peptide Loading...1020. Atropine is often used prior to administration of inhalant anesthetics to reduce which of the following? Muscle tone Vomiting Heart rate Secretions Loading...1021. CLASS II drugs of the Antiarrhythmic drugs interfere with one of the following options? Beta adrenoceptors Blockers Ca+ channel blockers Na+ channel blockers K+ channel blockers Loading...1022. 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? β-thalassemia Sickle cell anemia Lead poisoning Iron deficiency Loading...1023. Which one of the following types of cells myelinates axons of neurons of CNS? Oligodendroglia Microglia Astrocytes Schwann cells Loading...1024. Purple toe syndrome is caused by using the therapy of which drug? Warfarin Amikacin Digoxin Cyclosporine Phenytoin Loading...1025. 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? Hepatic toxicity Agranulocytosis Hearing loss ThrombocytopeniaPage 42 of 66 Loading...1026. Which one of the following cells secretes glycosaminoglycan and is found in the terminal and respiratory bronchioles? Clara cells Macrophages K cells Pneumocytes type Loading...1027. Which of the following is the mechanism of action of the main drug used for the treatment of high LDL cholesterol? Inhibition of HMG-CoA reductase Inhibition of cholesterol uptake by the liver Decreased synthesis of LDL receptors Breakdown of adipose tissues Loading...1028. 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? Tetanus antitoxin Both tetanus toxoid and antitoxin Tetanus toxoid Neither tetanus toxoid or antitoxin Loading...1029. 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? Neurohyperphysis Uterohypophysis Adenohyperphysis Neurohypophysis Adenohypophysis Loading...1030. 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 She already has HPV infection so, no need for the vaccine No need for the vaccine as long as Pap smear is normal She can only take the vaccine later after full recovery Loading...1031. 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? Chronic lymphocytic leukemia Prostatic cancer Renal cell carcinoma Hodgkin’s lymphoma Thyroid follicular carcinoma Loading...1032. Which one of the following is the main mechanism of absorption of most drugs in the gastrointestinal tract (GIT)? Passive diffusion Facilitated transport Endocytosis and exocytosis Pinocytosis Loading...1033. Which test of the following is used to evaluate acute exacerbation of asthma? Complete blood count Chest x-ray Pulse oximetry Pulmonary function tests Loading...1034. 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 Pubococcygeus Loading...1035. 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? Blood samples and intravenous antibiotics Oral ampicillin and gentamicin MRI of the pelvis CT scans of the abdomen and pelvis Observation and waiting for the results of blood culture Loading...1036. Which of the following medications is used in opioid overdose? Phencyclidine Norepinephrine Flumazenil Naloxone Loading...1037. A 9-month-child who was delivered after premature labor and is feeding on cow milk and orange juice. What is the predicted deficiency? Calcium IronVitamin D Vitamin C Loading...1038. A patient presents with vomiting, diarrhea and abdominal cramps a few hours after a picnic. Which is the causative organism? Staphylococcus aureus Streptococcus pyogenes E-coli Clostridium difficile Loading...1039. Which one of the following drugs belongs to alkylating agent? Dacarbazine Lamivudine Gemcitabine Capreomycin Indanyl carbenicillin Loading...1040. Which of the following drugs has the least CNS side effects? Rimantadine Amantadine Zidovudine Acyclovir Ganciclovir Loading...1041. Which one of the following types of necrosis is most likely associated with myocardial infarction? Coagulative Liquefactive Fibrinoid Caseous Loading...1042. Which one of the following disorders is accompanied by blue sclera? Systemic lupus erythematosus Duchenne muscular dystrophy Osteogenesis imperfecta Neurofibromatosis type 2 Loading...1043. What is the most common cause of chronic chest pain? Musculoskeletal Malignant Gastrointestinal Cardiac Loading...1044. 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 Ampicillin Amphotericin B Acyclovir Ciprofloxacin Loading...1045. 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? Digoxin Lisinopril Furosemide Atenolol Loading...1046. 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 malariae Plasmodium vivax Babesia microti Plasmodium falciparum Loading...1047. Absorption of levodopa-carbidopa is reduced when taken with meals rich in which of the following nutrients? Carbohydrate Fat Protein Loading...1048. Which one of the following macrolide drugs has a short half-life of 2 hours? Azithromycin Erythromycin Telithromycin Clarithromycin Loading...1049. Phenylephrine has the least affinity for following adrenoceptors type? α1 Receptors α1 & B1 Receptors Both A & B All of these α2 Receptors Loading...1050. Which of the following anti-retroviral treatments is a non-competitive reverse transcriptase inhibitor? Didanosine Zidovudine Saquinavir NevirapinePage 43 of 66 Loading...1051. 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? Gout Rheumatoid arthritis Osteoarthritis Osteomyelitis Loading...1052. Which of the following is the most likely mechanism of action of hydralazine in treating cardiovascular disorders? Parasympathetic stimulation Decreased cardiac preload Relaxation of arterial smooth muscle Sympathetic antagonism Loading...1053. 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 Risk of developing disease in the exposed group divided by risk in the unexposed group The difference in risk between exposed and unexposed groups The proportion of risk reduction attributable to the intervention as compared to a control Loading...1054. Which of the following medications increases cardiac output in pulmonary edema following myocardial infarction? Metoprolol Lisinopril Verapamil Dobutamine Loading...1055. Pharmacokinetics of a drug is defined as which one of the following? Reaction of the body to a drug Effect of a drug on certain body systems Amount of drug needed to produce an effect The movement of a drug within the body Loading...1056. A neonate presents by renal failure and pulmonary hypoplasia. What is your diagnosis? Pompe disease Phenylketonuria Niemann-Pick disease Recessive polycystic kidney disease Loading...1057. Which one of the following drugs reduce the absorption of phosphate when taken with diet? Hydrochlorothiazide Ezetimibe Indanyl carbenicillin Montelukast Sevelamer Loading...1058. ADP-mediated platelets aggregation is inhibited by? Abciximab Ticlopidine Aspirin Tirofiban Dipyridamole Loading...1059. A young man complains of daytime sleeping, cataplexy and sleep paralysis. Which of the following is the best treatment? Hydroxyzine Modafinil Zolpidem Diazepam Loading...1060. 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 Obstructive jaundice Gallstones Hemolysis Pancreatic cancer Loading...1061. Hypertriglyceridemia and hypercholesterolemia are the adverse effects of following drugs? Integrase inhibitors Entry inhibitors Protease inhibitors Nucleoside analogs Loading...1062. Which of the following methods is the most likely to demonstrate spores? India ink stain Acid-fast stain Gram stain Malachite green stain Loading...1063. 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 Cotransport of glucose and NaCl across the intestinal membrane facilitates absorption of water and Na. It reduces bowel contractions and consequently improves diarrhea The mixture helps to increase secretion of water and Na through the large intestine Loading...1064. Which of the following is the central action of cocaine? Inhibition of reuptake of serotonin Inhibition of reuptake of dopamine and epinephrine Inhibition of phosphodiesterase Stimulation of dopamine release Loading...1065. Interferon alpha is indicated for the treatment of which one of the following conditions? Kidney transplantation Rheumatoid arthritis Bullous pemphigoid Hepatitis C virus infection Loading...1066. Which one of the following defines the drug efficacy? 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 The minimal amount of drug administered that leads to toxicity Loading...1067. Amylin consecrated with insulin has the following actions except? Increase beta-cell growth Delayed gastric emptying time Decrease postprandial glucagon secretion Suppress appetite Loading...1068. Which one of the following is an anterior pituitary hormone? Somatostatin Fenofibrate Atorvastatin Corticotropin Torsemide Loading...1069. Mechanism of action of repaglinide? Insulin secretagogue GLP-1 agonist DPP-IV inhibitor A-glucosidase inhibitor Insulin sensitiser Loading...1070. A drug increase cAMP results in activation of protein kinase? Aspirin Ticlopidine Clopidogrel Tirofiban Dobutamine Loading...1071. 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 Ibuprofen Morphine Nortriptyline Loading...1072. Which of the following drugs has/have beneficial role in Torsades de pointes ? Magnesium Sulfate Amiodarone b & c Propranolol Eplerinone Loading...1073. Gonadotropin-releasing hormones are synthesized by which of the following nuclei of the hypothalamus? Dorsomedial nuclei Ventromedial nuclei Arcuate nuclei Anterior nuclei Loading...1074. M1 Receptors are primarily located in: Myocardium, smooth muscles Postganglionic neurons Skeletal muscle neuromuscular endplates Cerebral cortex, Sympathetic ganglia, myenteric ganglia Exocrine glands, vessels (smooth muscles & endothelium) Loading...1075. Which one of the following is the wrong statement about the use of Acetylcholine as a neurotransmitter? In preganglionic fibers terminated at the adrenal medulla Neurotransmitter of parasympathetic nerves Acetylcholine has a positive chronotropic effect Neurotransmitter of somatic nerves Rapidly inactivated by cholinesterasePage 44 of 66 Loading...1076. Which one of the following drugs is a 2nd generation Cephalosporin? Cefoxitin Cefdinir Cefepime Cefadroxil Loading...1077. Which one of the following agent is a insulin? Glulisine Somatostatin Atorvastatin Torsemide Desmopressin Loading...1078. Which of the following hormone belongs to the oral diabetic agent? Somatrem A & B Oxytocin Acarbose Furosemide Loading...1079. Which of the following screening tests should be recommended for a patient taking olanzapine for schizophrenia? Diabetes Hemochromatosis Cancer Hemolysis Loading...1080. Which of the following should be added to premature infants of breast-feeding mothers after 2 month of age? Copper Iron Zink Vitamin C Loading...1081. Which of the following cellular pathological changes affects myocardial fibers in a case of irreversible myocardial infarction? Decreased intracellular pH Karyorrhexis of the nuclei Depletion of myoglobin stores Increased cytoplasmic sodium Loading...1082. Which of the following is Sulphamoyl Derivative diuretic drug? Ethacrynic Acid Chlorthalidone Metolazone Bumetanide Hydrochlorothiazide Loading...1083. The binding of a drug to plasma proteins will tend to: Increase its concentration in the plasma. Decrease half-life. Increase its rate of biotransformation. Increase its pharmacological activity Decrease its rate of glomerular filtration. Loading...1084. Which of the following effects is caused by alcohol intake? Increased body temperature Increased body heat loss No effect on body temperature or body heat loss Decreased body heat loss Loading...1085. Which of the following drug is a derivative of N- arylanthranilic acid? Piroxicam ketorolac Etodolac Mefenamic Acid Diflunisal Loading...1086. 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 both beta and alpha-blocker while labetalol is a beta-blocker only Atenolol is a beta 2 blocker while labetalol is a beta1 blocker Atenolol is a beta1 blocker while labetalol is both alpha and beta-blocker Atenolol is a non-selective beta-blocker while labetalol is a beta1 blocker Atenolol is a beta1 blocker while labetalol is a beta 2 blocker Loading...1087. Which of the following conditions most likely be presented with primary amenorrhea? Pregnancy Turner syndrome Pituitary adenoma Loading...1088. Which of the following enzymes is markedly elevated in primary biliary cirrhosis? Acid phosphatase Aspartate aminotransferase (AST) Alanine aminotransferase (ALT) Alkaline phosphatase Loading...1089. Penicillin type antibiotics half-life is increased due to inhibition of tubular secretion by which of the following drug? Pegloticase Probenecid Aspirin Celecoxib Colchicine Loading...1090. Para-aminophenol derivative drug is the following? Mefenamic acid Celecoxib None of these Meloxicam Acetaminophen Loading...1091. 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? Candida albicans Streptococcus pneumoniae Haemophilus influenzae Pseudomonas aeruginosa Moraxella catarrhalis Loading...1092. Drug-to-drug interaction based on absorption, transformation, distribution and excretion is considered which one of the following types of interaction? Chemical interaction Pharmacokinetic interaction Pharmaceutical interaction Pharmacodynamic interaction Loading...1093. Low doses of one of the following drugs produce sedation, but at high doses it produces excitement? Scopolamine Phenylephrine Pirenzepine Physostigmine Atropine Loading...1094. Which drug belongs to the Quinoline methanol antimalarial class? Quinidine Pyrimethamine Mefloquine Quinine Chloroquine Loading...1095. 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? Conn syndrome C-11 hydroxylase deficiency C-17 hydroxylase deficiency C-21 hydroxylase deficiency Loading...1096. Serotonin Receptor which acts presynaptically at Serotonergic and adrenergic neurons to reduce neurotransmitter release is following? 5HT² 5HT5 5HT4 5HT³ 5HT¹ Loading...1097. Which one of the following antibiotics is the most appropriate treatment of chancroid, a bacterial infection caused by Haemophilus ducreyi? Ceftriaxone Vancomycin Ampicillin Ciprofloxacin Loading...1098. Ingestion of which of the following products may cause hypertensive crisis in patients taking MAO inhibitors? Tyramine-rich food Vitamin D and calcium Gluten-rich food Carbohydrates such as starch Loading...1099. Which of the following is the most accurate test for multiple myeloma? Bone marrow biopsy 24-hour urine calculation Brain MRI Urine electrophoresis Loading...1100. Which of the following is the classic electrocardiogram (ECG) finding in atrial flutter? Diffuse S-T segment elevation S-T segment elevation in anterior leads (V1-V4) S-T segment elevation in leads II. III and aVF Sawtooth P wavesPage 45 of 66 Loading...1101. Which of the following pathological signs is the first visible one in atheroma formation? Thrombus Hemorrhage Fatty streak Calcification Loading...1102. A drug that effects the thyroid hormone is one of the following ? Sulbactam Bumetanide Furosemide A & B Triiodothyronine Loading...1103. 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? Acute lymphatic leukemia Chronic lymphocytic leukemia Chronic myeloid leukemia Sezary syndrome Hairy cell leukemia Loading...1104. Following statements about the use of the Metformin is incorrect? A biguanide Insulin sensitiser Requires insulin for action Promotes insulin secretion Hypoglycaemia risk is low Loading...1105. Combination of levodopa and carbidopa is recommended. Which of the following explains the significance of this combination? Unknown mechanism Carbidopa enhances the entry of levodopa into brain Carbidopa enhances the conversion of peripheral levodopa into dopamine Carbidopa enhances the absorption of levodopa Loading...1106. 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? Fasciotomy and tissue perfusion Intravenous broad-spectrum antibiotics Referral to orthopedics Send home and observation Loading...1107. Which one of these medication groups is contraindicated in a patient with narrow-angle glaucoma? Beta blockers Muscarinic-receptor antagonists Cholinomimetics Diuretics Loading...1108. Gonadotropin-releasing hormone is produced by which of the following nuclei of hypothalamus? Ventromedial nucleus Dorsomedial nucleus Anterior nucleus Arcuate nucleus Loading...1109. Which of the following agents most likely causes vasoconstriction? Bradykinin Nitric oxide Norepinephrine Histamine Loading...1110. Which of the following drugs improves skeletal muscle spasm by acting inside the muscle cell? Tubocurarine Dantrolene Diazepam Botulinum toxin Loading...1111. Adrenal insufficiency is commonly combined with which one of the following findings? Hyperglycemia Hypernatremia Hyperkalemia Hypercalcemia Loading...1112. 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? Ampicillin Piperacillin Gentamicin Vancomycin Loading...1113. Which of the following is the best immediate treatment for unresponsive patient with diabetic ketoacidosis? Metformin Observation and hospitalization Bicarbonate Insulin and glucose Loading...1114. Which one of the following enzyme deficiencies is related to Tay-Sachs disease? Arylsulfatase A deficiency Sphingomyelinase deficiency Glucocerebrosidase deficiency Hexosaminidase A deficiency Loading...1115. Which one of the following drugs is often added to nasal decongestants? Norepinephrine Albuterol Phenylephrine Epinephrine Loading...1116. 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 rejection Chronic rejection Normal reaction Acute pyelonephritis Hyperacute rejection Loading...1117. Following drug has a low therapeutic index? Digoxin Ticlopidine Clopidogrel Abciximab Aspirin Loading...1118. In cases of atrial septal defect (ASD), foramen ovale is formed by incomplete development of which one of the following structures? Septum primum Ostium primum Septum secundum Ostium secundum Loading...1119. Gray baby syndrome is the adverse effect of the following drug? Quinupristin Clindamycin Linezolid Chloramphenicol Loading...1120. Autoantibodies to pancreatic islets Beta cells and insulin are found in one of the following types of Diabetes? Pseudo hypoglycemia Gestational Diabetes mellitus Type 2 Diabetes mellitus Type 1 Diabetes mellitus Loading...1121. Which one of the following medications inhibits protein synthesis by binding to 50S subunit and preventing the formation of the initiation complex? Minocycline Clindamycin Linezolid Azithromycin Loading...1122. Meissner’s plexus of nerves is located within which layer of the gastrointestinal tract? Submucosa External layer Mucosa Muscularis Externa Loading...1123. 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? Cardiac catheterization Coronary angioplasty Enoxaparin Ibuprofen Tissue plasminogen activator (tPA) Loading...1124. 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? Increased pulmonary venous pressure Decreased pulmonary artery pressure Normal arterial CO2 partial pressure Normal respiratory function tests Normal arterial O2 partial pressure Loading...1125. Which one of the following antibacterial drugs is a protein synthesis inhibitor drug? Chloramphenicol Vancomycin Cefuroxime AztreonamPage 46 of 66 Loading...1126. 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? Liver cirrhosis Cervical cancer Endometrial cancer Ovarian cancer Lung cancer Loading...1127. 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 Lisinopril Interaction of ciprofloxacin to oxygen Interaction of ciprofloxacin to ipratropium bromide Loading...1128. 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? Atropine Activated charcoal Flumazenil Ethyl alcohol Sodium nitrite Loading...1129. Which one of the following drugs is Quaternary compound antispasmodic? Oxybutynin Cyclopentolate Dicyclomine Biperiden Propantheline Loading...1130. Zalcitabine belongs to the class of following drugs? Antiprotozoal Antifungal Antipyretic Antiviral Anti malaria Loading...1131. Which of the following explains the higher incidence of sickle cell disease in African Americans more than other races? Increased mutation rate Natural selection Increased gene flow Genetic drift Loading...1132. Which one of these drugs is more beneficial to treat hypertension in diabetic patients? Verapamil Amlodipine Enalapril Furosemide Loading...1133. Which of the following findings is consistent with a case of right lung atelectasis? Trachea is deviated to the left Trachea is not deviated (normal location) Trachea is deviated to the right Loading...1134. Heparin acts by binding to which of the following substances to achieve its anticoagulant activity? Factor VIII Antithrombin III Prothrombin Factor V Loading...1135. Which of the following activity of Acetaminophen is weak? Anti inflammatory A & C Antipyretic Analgesic A & B Loading...1136. Infection in body causes one of the following issue? Fever Aids High Blood pressure Headache Loading...1137. Which of the following drug is Pyrazolone Derivative NSAID? Ketorolac Diclofenac Phenylbutazone Indomethacin Nimesulide Loading...1138. Which one of the following drugs is a natural penicillin with a property of high acid stability than other naturally occurring penicillin? Amoxicillin Methicillin Penicillin G Penicillin V Loading...1139. Which of the following drug is Antiprogestrin? Pioglitazone Sitagliptin Metformin Bicalutamideich one of the following drugs Increases Glucose-dependent insulin release and decreases secretion of glucagon? Acarbose Loading...1140. Which of the following drugs is used to treat pulmonary embolism? Dalteparin Niacin Oxacillin Tolbutamide Cefoxitin Loading...1141. Which of the following drugs are carboxylate derivatives of ACEIs except? Lisinopril Fosinopril Ramipril Enalapril Quinapril Loading...1142. Which of the following substances lines the vesicles that involved in LDL uptake by hepatocytes? Clathrin Laminin Transferrin Chylomicrons Loading...1143. Which one of the following arteries is most likely affected in a case of expressive aphasia? Vertebral Middle cerebral Posterior cerebral Anterior cerebral Loading...1144. Which of the following is the diagnostic test used when ultrasound is equivocal for cholecystitis? Liver function tests CT scan Abdominal x-ray HIDA scan Loading...1145. 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? Azithromycin Ampicillin No medication Amoxicillin Loading...1146. 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? Meningioma Multiple sclerosis Conversion disorder Transient ischemic attack Loading...1147. A decrease of J chain due to a genetic defect will cause a decrease of the which of the following? Mature T lymphocytes Mature B lymphocytes Serum IgE Serum IgM Loading...1148. 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) Dexamethasone suppression test Assessment of insulin-like growth factor 1 (IGF-1) Measurement of HbA1c Fasting serum glucose test Loading...1149. 5-FdUMP a false nucleotide inhibits thymidylate synthetase decreasing thymidylic acid(an essential DNA component) is MOA of following drug? Amphotericin B Flucytosine Nystatin Ketoconazole Loading...1150. Which one of the following antibiotics has NO effect on anaerobes? Ampicillin Tobramycin Metronidazole ClindamycinPage 47 of 66 Loading...1151. 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...1152. Which one of the following drugs belongs to drugs for hepatic viral infections? Aluminium hydroxide Capreomycin Indanyl carbenicillin Adefovir Ezetimibe Loading...1153. Atropine causes:? Bradycardia followed by tachycardia Tachycardia followed by bradycardia No effect on Heart Only bradycardia Only tachycardia Loading...1154. Administration of which one of the following medications can lead to the development of hemolytic anemia? Quinidine Propranolol Hydralazine Verapamil Loading...1155. 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 Denial Anger Acceptance Depression Loading...1156. Which of the following laboratory tests is diagnostic for adrenal insufficiency? Serum ACTH CT scan of adrenal gland ACTH stimulation test Serum cortisol Loading...1157. 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? Ductus arteriosus Atherosclerosis Reye syndrome Hypotrichosis Steven-johnson syndrome Loading...1158. The tracheal tube is originated from which of the following structures? Ductus arteriosus Foregut Third pharyngeal arch Fourth pharyngeal arch Loading...1159. 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? Kwashiorkor Pellagra Marasmus Scurvy Loading...1160. Food allergies are typically causing which one of the following immunologic abnormalities? Cell-mediated hypersensitivity Localized anaphylaxis Complement activation Immune-complex deposition Loading...1161. 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? Encysted larvae Ovum Rhabditiform larvae Cyst Loading...1162. Which one of the following cells is derived from monocytes and lying within the alveoli? Pneumocytes type I Pneumocytes type II K cells Macrophages Clara cells Loading...1163. 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? Blood pressure Exercise Family history of breast cancer Weight Age Loading...1164. Which of the following drugs should NOT be initiated in case of acute decompensated heart failure? Potassium supplements Digoxin Metoprolol Lisinopril Loading...1165. Which of the following drug can disrupt the enteric coating by increasing the Gastric PH? Cefoxitin Omeprazole Glimepiride Oxacillin Sitagliptin Loading...1166. 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? Normal pressure hydrocephalus Alzheimer’s disease Middle cerebral artery stroke Anterior pituitary adenoma Trauma to the head due to elderly abuse Loading...1167. Which one of the following drugs is used for subcutaneous and systemic mycoses? Itraconazole Butoconazole Griseofulvin Econazole Loading...1168. 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? Diazepam Fluoxetine Donepezil Metoclopramide Citalopram Loading...1169. Which of the following drug contain the Sulfahydril group in the structural formula? Enalapril Lisinopril Ramipril Quinapril Captopril Loading...1170. 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? Contrast enema MRI of the abdomen Refer to surgery for bowel resection IV hydration and antibiotics Colonoscopy Loading...1171. Secretion of which one of the following hormones is decreased due to renal failure? Erythropoietin Insulin Thyroxin Glucagon Loading...1172. 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? Osteomalacia Osteitis fibrosa cystica Osteoporosis Osteopetrosis Loading...1173. Receptors have a high sensitivity for which of the following drug? A & B All of these Isoproterenol Norepinephrine Epinephrine Loading...1174. Which one of the following local anesthesia is mainly used for regional nerve block? Tetracaine Dibucaine Cocaine Bupivacaine Loading...1175. 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 retina The cornea and the iris The iris and the lensPage 48 of 66 Loading...1176. 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? Left coronary artery Posterior interventricular artery Anterior interventricular artery Right coronary artery Circumflex artery Loading...1177. Which one of the following drugs is an adrenergic antagonist Alpha Blocker drug? Tacrine Phenoxybenzamine Mecamylamine Atracurium Metoprolol Loading...1178. Which one of the following statements of tetracycline is wrong? Deposition in bones and teeth Causes GIT disturbance Bind with 50S ribosomal subunit Avoid in Pregnancy Loading...1179. A drug that is used to treat leprosy is one of the following? Etidronate Clofazimine Magnesium hydroxide Furosemide A & B Loading...1180. 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 Schedule MRI to the brain Obtain CT scan of the head Loading...1181. Misoprostol is an analog of the following type of prostaglandin? PGA PGB PGI2 PGE PGE1 Loading...1182. Which one of the following oral hypoglycemic drugs is the initial therapy for patients with type 2 diabetes? Glyburide Metformin Acarbose Repaglinide Loading...1183. A drug that belongs to Loop Diuretics is one of the following? A & B Furosemide Cefazolin Bumetanide Sulbactam Loading...1184. Which one of the following correctly describes nicotinic Ach receptors? G-protein–coupled receptors Ligand-gated Na+/K+ channels Enzyme-linked receptors Loading...1185. A drug that is a part of Macrolide is following? Azithromycin Cefaclor Cefdinir Cefepime Loading...1186. Which of the following receptors is the most likely affected in patients with diabetes mellitus? Meissner’s corpuscle End-bulbs of Krause Ruffini’s end organ Pacinian corpuscle Loading...1187. Aldosterone is released from which part of the adrenal medulla? A & B Zona glomerulosa Zona reticularis All of these Zona fasciculate Loading...1188. Which of the following types of necrosis occurs in abscesses and brain infarcts? Caseous necrosis Coagulative necrosis Fibrinoid necrosis Liquefaction necrosis Loading...1189. Which one of the following drugs causes inhibition of viral neuraminidase? Amantadine Zanamivir Ribavirin A & C Oseltamivir A & B Loading...1190. Which one of the following drugs is a beta blocker (Class II)? Amiodarone Procainamide Verapamil Carvedilol Loading...1191. Which one of the following is a anterior pituitary hormone? Torsemide Somatostatin Atorvastatin Desmopressin Fenofibrate Loading...1192. A drug that is used to treat HIV infections is one of the following? Niclosamide Cladribine Tenofovir Etidronate Praziquantel Loading...1193. Which one of the following drugs is a calcium channel blocker (Class IV)? Carvedilol Procainamide Amiodarone Verapamil Loading...1194. A patient is suffering from gouty arthritis along with hyperuricemia, which of the following drugs is indicated to give relief to this patient? Allopurinol Pegloticase Febuxostate Probenecid Colchicine Loading...1195. Which of the following esophageal disorders is the most likely a complication of HIV infection? Esophageal varices Achalasia Candida esophagitis Adenocarcinoma Loading...1196. Which one of the following reactions occurs between five days and three months after transplant? Chronic rejection Acute rejection Hyperacute rejection Delayed rejection Loading...1197. A drug that inhibit the guanosine triphosphate formation thus preventing viral mRNA capping and RNA dependent RNA polymerase blockage? Ribavirin Amantadine Oseltamivir Both A & B All of the above Loading...1198. 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 MRI of the abdomen and pelvis Hospitalization and intravenous antibiotics Schedule Intravenous pyelogram Outpatient wide spectrum antibiotics and schedule a visit after 3 days Collect blood and urine samples for culture Loading...1199. Which one of the following conditions is most likely affects the lungs of a patient with Parkinsonism? Thrombosis Arteriosclerosis Atherosclerosis Embolism Loading...1200. 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? Pergolide Flutamide Finasteride Tadalafil AbirateronePage 49 of 66 Loading...1201. Which one of the following drugs is the most effective for nausea and vomiting of pregnancy? Meclizine Ondansetron Cimetidine Loratadine Loading...1202. Which one of the following stain is most likely relevant to diagnose Cryptococcus neoformans? Ziehl-Neelsen stain Silver stain Giemsa stain India ink stain Loading...1203. 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? Intramuscular Sublingual Subcutaneous Intravenous Oral Loading...1204. Which of the following statements is true about innate immunity? Resistance persists through generations Its main secreted proteins are immunoglobulins Its main components are T cells, B cells and circulating antibodies Highly specific and refined over time Loading...1205. 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 Caspofungin Amphotericin B Fluconazole Loading...1206. Erythema infectiosum (Fifth disease) is caused by which of the following organism? Rubella virus Parvovirus B19 Paramyxovirus Coxsackie A virus Loading...1207. About Nateglinide; All are true, except? decrease postprandial hypoglycemia release insulin Hypoglycemia less common than with Sulfonylureas Decrease insulin resistance Loading...1208. 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? Thinning of hair Gonadal toxicity Gastrointestinal toxicity Myelosuppression Nausea Loading...1209. Which one of the following medications is a non-selective beta receptor agonist? Epinephrine Isoproterenol Phenylephrine Ephedrine Loading...1210. A drug that is a part of Macrolide is following? Cefdinir Cefaclor Cefepime Clarithromycin Loading...1211. Which of the following substances is responsible for growth of the prostate at puberty? Estrogen Testosterone Dihydrotestosterone Progesterone Loading...1212. Which one of the following drugs belongs to drugs for hepatic viral infections? Capreomycin Lamivudine Aluminium hydroxide Indanyl carbenicillin Ezetimibe Loading...1213. 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 Pancreatic cancer Gall bladder stones Hemolytic anemia Loading...1214. 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...1215. Increased level of bradykinin causes? Fatigue Fever Dry cough Headache Vertigo Loading...1216. Which of the following chemotherapeutic agents is specific for the M phase of the cell cycle? Hydroxyurea Daunorubicin Cytarabine Mechlorethamine Vincristine Loading...1217. Which of the following organs is the most commonly affected one by a blunt trauma to the abdomen? Small intestine Liver Spleen Large intestine Loading...1218. Which of the following is the main mechanism of action of methylergonovine in treating postpartum hemorrhage? Blocking sympathetic stimulation Instant blood coagulation Forceful contraction of myometrium Strong vasoconstriction Loading...1219. What is the proper treatment of ventricular fibrillation? Morphine and nitroglycerin Immediate cardioversion Metoprolol and heparin Digoxin and verapamil Loading...1220. Abacavir belongs to the class of following drugs? Anti malaria Antiviral Antipyretic Antiprotozoal Antibiotics Loading...1221. 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? Kaposi’s sarcoma of the palate Lymphoproliferative disease Malignant melanoma of the palate Palatal abscess Torus palatinus Loading...1222. Aspirin has anti-platelet effect that lasts for the life of the platelet. What is the average life of a platelet? 2-4 days 7-10 days 120 days 24 hours Loading...1223. A patient presents with painless scrotal mass and increased thyroid panel. Which of the following markers would be elevated in this patient? Alpha-fetoprotein Lactate dehydrogenase Follicle stimulating hormone Human chorionic gonadotropin Loading...1224. Which one of the following drugs belongs to Second-line drugs used to treat tuberculosis? Ezetimibe Aluminium hydroxide Nizatidine Indanyl carbenicillin Ethionamide Loading...1225. 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? Order cardiac enzymes Refer to a cardiologist Start heparin Perform electric cardioversion Start metoprololPage 50 of 66 Loading...1226. Concurrent therapy of digitalis with the following drugs enhance the potential for cardiotoxicity? Quinidine All of the above Amiodarone Erythromycin Tetracycline Loading...1227. Which of the following tests is diagnostic in case of a 2-week old boy with persistent vomiting of non-bilious material after feeding? Barium studies Esophagostomy Abdominal ultrasound Chest x-ray Loading...1228. 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 Acute myocardial infarction Hypertrophic cardiomyopathy Left bundle branch block (LBBB) Loading...1229. Which one of the following viruses is responsible for the development of viral myocarditis? Mumps virus Coxsackie B virus Adenovirus Rhinovirus Loading...1230. 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 EDV increases and ET decreases Both of them increase Loading...1231. Which of the following drug is prototypical phenylalkylamine? Diltiazem Verapamil Losartan Amlodipine Amiloride Loading...1232. 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? Primary osteosarcoma Paraneoplastic disease Muscular spasm of paravertebral muscles Metastases to the vertebral column Loading...1233. 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? Prepare for hemodialysis Blood transfusion Measure serum acetaminophen concentration Administer N-acetylcysteine Loading...1234. Which of the following is the leading cause of blindness in the USA? Glaucoma Cataract Diabetic retinopathy Macular degeneration Loading...1235. 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 Perianal abscess Pilonidal abscess Suppurative hidradenitis Loading...1236. A drugs interfere with metabolism of azathioprine requiring a reduction in dosage? Colchicine Probenecid Allopurinol Sulfinpyrazone Loading...1237. 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? Renal interstitial nephritis Increased glomerular filtration rate (GFR) Blocking of efferent arteriole vasoconstriction Drug-induced tubular obstruction Increase absorption of water in the proximal convoluted tubules Loading...1238. 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? Full recovery with radiation and chemotherapy Symptomatic improvement with supportive therapy Full recovery with specific medical therapy Full recovery with multiple surgeries Slow progression to permanent disability Loading...1239. Which of the following drug contain the Carboxylic group, replaced with tetrazole ring in the structural formula? Valsratan Irbesartan Losartan Candesartan Telmisartan Loading...1240. Which one of the following drugs decreases endogenous hepatic production of glucose? Acarbose Metformin Pioglitazone Sitagliptin Loading...1241. 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 nerve conduction studies Perform electromyogram (EMG) Start hydrocodone Start prednisone Start duloxetine Loading...1242. Which one of the following drugs form insoluble chelates that are not absorbed? Levofloxacin & magnesium Rabeprazole & Sitaglipton All of the above A & B Pioglitazone & Calcium Loading...1243. 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? Phencyclidine (PCP) Cocaine Amphetamines Barbiturates Loading...1244. Which of the following drug belongs to Osmotic Diuretic? A & B Furosemide Ampicillin Mannitol Urea Loading...1245. Which of the following is the main complication of sickle cell disease? Cerebral hemorrhage Renal failure Autosplenectomy Hepatic failure Loading...1246. Following drugs should be avoided in patients with heart failure? CCBs ACE inhibitors Diuretic Inotropic drugs B-blocker Loading...1247. Which one of the following naturally occurring penicillins has a higher minimum bactericidal concentration and can't be used for bacteremia? Amoxicillin Penicillin G Methicillin Penicillin V Loading...1248. Cimetidine is used to treat one of the following diseases? Malaria Stomach Ulcer Viral infection Diabetes Blood pressure Loading...1249. Ganglion blocker drug is following? Atropine Benztropine Neostigmine Mecamylamine Atracurium Loading...1250. Which of the following hormone belongs to the oral diabetic agent? Somatrem Oxytocin Pioglitazone Furosemide A & BPage 51 of 66 Loading...1251. Which one of the following glucocorticoids is short acting? Amiloride Prednisone A & B Cortisone Betamethasone Loading...1252. 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? 6 hours 14 hours 1/2 an hour 18 hours 12 hours Loading...1253. Which one of the following medications inhibits fibrinolysis? Heparin Rifampin Aminocaproic acid Lepirudin Loading...1254. 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 succinyl-CoA to fumarate Conversion of methylmalonyl-CoA to succinyl-CoA Conversion of propionyl –CoA to methylmalonyl –CoA Conversion of malonyl-CoA to palmitate Loading...1255. Amoxicillin inhibits which one of the following enzymes? Transpeptidase Squalene epoxidase Transglycosylase Beta lactamase Loading...1256. Which of the following Diuretic drugs contain cyclic sulfonamide Except? Bendroflumethiazide Hydrochlorothiazide Indapamide Chlorothiazide Methylchlorothiazide Loading...1257. Which of the following is the appropriate treatment of amoebic liver abscess? Vancomycin Amoxicillin Metronidazole Surgical drainage Amikacin Loading...1258. Which of the following is the next step to investigate oliguria in a catheterized patient? Measure serum creatinine Irrigate the catheter Measure urine specific gravity Start intravenous fluids Loading...1259. Which of the following is the mechanism of action of metoclopramide? Serotonin reuptake reuptake inhibitor (SSRI) Nicotinic receptor antagonist Dopamine D2-receptor antagonist α-Adrenoceptor antagonist Loading...1260. Reversible neutropenia and thrombocytopenia is the adverse effect of following drug? Amphotericin B Flucytosine Ketoconazole Nystatin Loading...1261. Which of the following medications is useful to distinguish nephrogenic from neurogenic diabetes insipidus? Acetazolamide Desmopressin Demeclocycline Hydrochlorothiazide Loading...1262. 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...1263. One of the following statements is false about the functions of epinephrine? Increase in systolic blood pressure Strengthen the contractility of the myocardium Hyperglycemic effect Increased blood supply to the kidney Bronchodilation Loading...1264. 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 Cancer esophagus Peptic esophageal stricture Diffuse esophageal spasm Achalasia Loading...1265. Which of the following is the most common cause of congestive heart failure associated with systolic impairment in the United States? Diabetes Atherosclerosis Rheumatic heart disease Alcohol Loading...1266. Amylin analog is one of the following? Levothyroxine Furosemide Bumetanide A & B Pramlintide Loading...1267. 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? Transposition of the great arteries Total anomalous pulmonary venous return Tricuspid atresia Tetralogy of Fallot Truncus arteriosus Loading...1268. Prolonged vomiting results in which one of the following findings? Metabolic alkalosis with hypokalemia Metabolic alkalosis with hyperkalemia Metabolic acidosis with hypernatremia Metabolic acidosis with hyperkalemia Loading...1269. Which of the following is the first line therapy for gastroparesis in patients with diabetes? Omeprazole Ondansetron Metoclopramide Cimetidine Loading...1270. Imidazoline derivative drug with Alpha2 adrenoceptors effect? Clonidine Dipivefrin Albuterol Phentolamine Loading...1271. Which of the following drugs causes Rhabdomyolysis as an adverse effect? Digoxin Warfarin Dronedarone Amikacin Simvastatin Loading...1272. 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? Shingles (herpes zoster) Seborrheic keratosis Dermatitis herpetiformis Psoriasis Rosacea Loading...1273. 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 Churg Strauss syndrome Hypotrichosis Reye syndrome Ductus arteriosus Loading...1274. Which one of the following conditions is a long term complication of cystic fibrosis? Emphysema Adenocarcinoma of the lung Bronchiectasis Pneumothorax Loading...1275. 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? Repeat the PPD test and x-ray after 6 months Isolation and full antituberculous therapy for 6 months Start treatment with multiple drug- antituberculosis therapy Start treatment with isoniazid for 9 monthsPage 52 of 66 Loading...1276. Prophylaxis in HIV patients with TMP-SMX should be initiated at which of the following CD4 counts? Under 200 Under 100 Under 300 Under 50 Loading...1277. Which of the following is NOT considered an indication for HIV testing? Homosexuality Patients with symptoms of AIDS Recent positive test of a partner Semen donor Loading...1278. 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? Whole body CT scan MRI of the chest Ultrasound guided biopsy X-Ray of the chest Mammography Loading...1279. 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 Hypopituitarism Undescended testis Hypospadias Loading...1280. 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 Liothyronine Protirelin Levothyroxine Loading...1281. What is the antidote to snake bites? Nalmefene A & B Pralidoxime Vitamin K Antivenin Loading...1282. 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? Life-long levothyroxine Begin radioactive iodine Supportive treatment until it resolves Surgery and life-long levothyroxine Begin methimazole therapy Loading...1283. Which of the following insects is the victor responsible for transmission of Rocky Mountain spotted fever? Mite Flea Tick Louse Loading...1284. Which of the following medications inhibits folic acid synthesis through its effect on dihydropteroate synthetase enzyme?ich of the following is the mechanism of action of misoprostol for the treatment of peptic ulcer? Suppression of secretory responses to food stimulation Direct inhibition of the proton pump Formation of a protective coating of the ulcer beds Increased mucus and bicarbonates secretion and decreased HCL secretion Loading...1285. Which one of the following is most likely normal in duodenal ulcer? Pepsin secretion Response of gastrin to food Fasting serum gastrin Parietal cell mass Loading...1286. Which of the following is NOT an adverse effect of aspirin? Bleeding Tolerance Renal problems Gastritis Loading...1287. Dose related bone marrow depression is the adverse effect of following drug? Probenecid Ketoconazole Caspofungin Flucytosine Loading...1288. 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 100% chance to clinically have the disease The baby has no chance to be a carrier The baby has 50% chance to clinically have the disease The baby has 50% chance to be a carrier Loading...1289. Serotonin Receptor linked with nausea and emesis? 5HT4 5HT³ 5HT² 5HT5 5HT¹ Loading...1290. 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 Freckles Vitiligo Benign lentigo Loading...1291. Which of the following medications inhibits folic acid synthesis through its effect on dihydropteroate synthetase enzyme? Pyrimethamine Methotrexate Sulfonamides Trimethoprim Loading...1292. A drug that belongs to Loop Diuretics is one of the following? Doripenem Cefazolin A & B Ethacrynic Acid Sulbactam Loading...1293. 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? Oral acetaminophen Topical betamethasone Topical mupirocin Oral amoxicillin Loading...1294. Insulin dependent Diabetes mellitus? A & D Type 2. Diabetic mellitus Pseudo hypoglycemia Gestational Diabetes mellitus Type 1 diabetes Mellitus Loading...1295. Which one of the following neurologic drugs can cause diplopia, thickened gums and hirsutism? Valproic acid Carbamazepine Phenytoin Phenobarbital Loading...1296. Which one of the following drugs can be used as a patch to avoid sea sickness? Nicotine Digoxin Adrenaline Scopolamine Loading...1297. 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 oseltamivir for 2 weeks to all residents Administer flu vaccine plus oseltamivir for 2 weeks to all residents Treat only patients with oseltamivir until their symptoms subside Administer flu vaccine to all residents Loading...1298. Laboratory tests for a patient are as follows: Plasma creatinine concentration is 0.8 mg/dL 200 ml/minine creatinine concentration is 80 mg/dL Urine volume is 1 ml/minich of the following is the creatinine clearance? 100 ml/min 300 ml/min 50 ml/min Loading...1299. 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? Inhibition of H+/K+ ATPase pump Blocking of H2 receptor Forming a layer to protect gastric mucosa Neutralization of gastric acid Anti-cholinergic effect Loading...1300. Which of the following errors is considered if the researcher states that there is no difference when one exists? Type II error Type 1 errorPage 53 of 66 Loading...1301. 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? Lipoma Ectopic thyroid gland Branchial cleft cyst Dermoid cyst Thyroglossal duct cyst Loading...1302. Which of the following is the most likely cause of decreased visual acuity in pregnancy? Macular degeneration Retinal detachment Optic nerve degeneration Thickening of the cornea Loading...1303. Which of the following is considered an indication of first-generation histamine H1-receptor blockers? Cough Peptic ulcer Allergy Apoplexy Loading...1304. Which one of the following drugs belongs to inhibitors of viral coating? Zidovudine Nevirapine Oseltamivir Amantadine Acyclovir Loading...1305. Which of the following is the most important risk factor for coronary artery disease? High total cholesterol High LDL cholesterol Low HDL cholesterol Obesity Loading...1306. Which of the following drugs should NOT be initiated in case of acute decompensated heart failure? Lisinopril Digoxin Metoprolol Potassium supplements Loading...1307. The only type of insulin that should be given intravenously is one of the following? A & B Glargine Regular Lispro Detemir Loading...1308. 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 haloperidol administration Diphenhydramine to enhance sleeping Sleep enhancement protocol and family support as well as haloperidol administration Refer to psychiatry department Restrain in bed and lorazepam administration Loading...1309. Which one of the following drugs belongs to an alkylating agent? Cladribine Gemcitabine Lamivudine Fludarabine Melphalan Loading...1310. 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? Amitriptyline Deferoxamine AVitamin K Penicillamine Leucovorin Loading...1311. Which one of the following tests is performed to determine if a fetus develops hemolytic disease of the newborn? Hemoglobin electrophoresis Radioimmunoassay Osmotic fragility test Direct Coombs test Loading...1312. 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? 10 mg 20 mg 30 mg None Loading...1313. 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? Cyclophosphamide Bleomycin Paclitaxel Cisplatin Etoposide Loading...1314. A patient becomes tetanic because of a recent thyroidectomy. Rapid Reversal of this problem can be done by giving the patient? Calcium gluconate (CaG) PTH Vitamin D Plicamycin (mithramycin) Calcitonin Loading...1315. Which of the following is the mechanism of action of flumazenil in the treatment of lorazepam toxicity? Noncompetitive inhibition of benzodiazepine receptors Stimulation of dopamine receptors Competitive inhibition at benzodiazepine receptors Inhibition of alpha adrenoceptors Loading...1316. 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 Chloramphenicol Erythromycin Loading...1317. Pemphigus is an autoimmune skin disease associated with which of the following structures? , Gap junctions Cell matrix junctions Desmosomes Tight junctions Loading...1318. 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? Pancreatitis Diverticulitis Intestinal obstruction Gastroenteritis Loading...1319. Which of the following laboratory tests could be slightly increased in Gilbert’s syndrome? Bilirubin, direct Bilirubin, indirect Triglyceride Haptoglobin Loading...1320. Which of the following is the mode of inheritance of cystic fibrosis? X-linked recessive Autosomal dominant X-linked dominant Autosomal recessive Loading...1321. 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...1322. Which one of the following procoagulant factors is produced by the epithelial cells? Fibrinogen Thromboxane A2 Prostacyclin von Willebrand’s factor (vWF) Loading...1323. Thrombocytopenic purpura (TTP) is the adverse effect of the following drug? Ticlopidine All of the above Both A & B Clopidogrel Abciximab Loading...1324. Which one of the following statements about the use of the metformin is incorrect? Decrease intestinal absorption of glucose Promote insulin secretion Potential for lactic acidosis Inhibit hepatic glucose output Promote glucose uptake Loading...1325. Which one of the following is a fat-soluble vitamin? Thiamine Retinoid Ascorbic acid RiboflavinPage 54 of 66 Loading...1326. Which of the following drug are indandione derivative oral anticoagulants? Dicumarol Phenindione Heparin Phytonadione Menadione Loading...1327. A patient is diagnosed with posterior dislocation of the hip. Which one of the following ligaments is most likely torn? Iliofemoral ligament Sacrotuberous ligament Ischiofemoral ligament Lacunar ligament Loading...1328. 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? Aortic valve stenosis Mitral valve regurgitation Pulmonic valve stenosis Tricuspid valve regurgitation Mitral valve stenosis Loading...1329. Elevation of which one of the following substances in blood occurs due to reduced renal blood flow? Calcium Ammonia Renin Cholesterol Loading...1330. Which of the following differentiates Dubin-Johnson syndrome from Rotor syndrome? Mode of inheritance Black pigmentation of the liver Level of liver enzymes Conjugated hyperbilirubinemia Loading...1331. 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? Acarbose Rosiglitazone Glyburide Glucagon Metformin Loading...1332. Which of the following is the most common cancer of the lower third of esophagus in non-alcoholic, non-smoker patients? Squamous cell carcinoma Melanoma Sarcoma Adenocarcinoma Loading...1333. Which of the following is a major complication of central retinal veins occlusion? Cataract Glaucoma Retinal detachment Lens subluxation Loading...1334. 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) Argatroban Ticlopidine Aspirin Loading...1335. Which one of the following structures provides the majority of noradrenergic innervation to the cerebral cortex? Raphe nucleus Caudate nucleus Locus coeruleus Substantia nigra Loading...1336. 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? Digoxin Mexalitine Amiodarone Acetaminophen Loading...1337. Which of the following hormone belongs to the oral diabetic agent? Oxytocin Somatrem Glimepiride Furosemide A & B Loading...1338. Retention of sodium and water is decreased by using one of the following drugs? Acetaminophen Diltiazem Methyldopa Enalapril Loading...1339. The therapeutic indication of Clomiphene drug specifically is to treat the following disease? Treat osteoporosis Induce ovulation Thromboembolic disease Fluid retention Estrogen-dependent Breast Cancer Loading...1340. The mechanism of action of etidronate disodium is most likely related to Inhibition of both normal and abnormal bone resorptions Hyperphosphatemia Inhibition of the formation of hydroxyapatite crystals An unusual form of phosphorus (P) Excretion unchanged in the urine Loading...1341. Which one of the following anti-hypertensive medications is contraindicated in pregnancy? Ramipril Labetalol Nifedipine Methyldopa Loading...1342. Which one of the following drugs is used to treat copper toxicity? Penicillamine Aminocaproic acid Protamine Atropine Loading...1343. Which of the following group of medications prolongs GABA activity in the brain? Methamphetamines Alcohols Benzodiazepines Barbiturates Loading...1344. Which of the following conditions is most likely caused by over-secretion of growth hormone in adults (acromegaly)? Hypothyroidism Carpal tunnel syndrome Malignant melanoma Gastric adenocarcinoma Loading...1345. 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 history of an organism Loading...1346. A cytokine that enhances the activity of NK cells and attracts neutrophils and macrophages? Interferon gamma Interleukin-1 Tissue necrosis factor-alpha Interleukin-2 Loading...1347. 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? Methicillin Ciprofloxacin Ampicillin Vancomycin Loading...1348. Which of the following is a characteristic finding in isopropanol poisoning? Elevated anion gap Elevated serum BUN and creatinine Blindness due to ocular accumulation Ketosis without acidosis Loading...1349. 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? Aortic stenosis Mitral valve prolapse Tricuspid regurgitation Mitral stenosis Dilated cardiomyopathy Loading...1350. Ethacrynic acid belongs to one of the following classes of diuretics? Thiazide Diuretic Loop Diuretics Potassium-sparing diuretics Carbonic anhydrase inhibitorsPage 55 of 66 Loading...1351. Which one of the following medications effectively lowers intraocular pressure? Atropine Morphine Latanoprost Ergonovine Loading...1352. 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? Ductus venosus Azygous vein Umbilical artery Ductus arteriosus Loading...1353. Which one of the following drugs is a prostaglandin that suppresses gastric acid secretion? Sucralfate Cimetidine Rabeprazole Misoprostol Loading...1354. Which of the following conditions may occur as a result of a long umbilical cord? Amnion nodosum Nuchal cord Placenta previa Abruptio placenta Loading...1355. Which of the following is considered a dynamic stabilizer of the glenohumeral joint? Inferior glenohumeral ligament Subscapularis muscle Glenoid fossa Coracohumeral ligament Loading...1356. Which of the following side effects is most likely associated to spironolactone? Hyperkalemia Metabolic alkalosis Hyperglycemia Hypercalcemia Loading...1357. Which of the following is calculated by dividing the incidence rate of a disease in exposed by the incident rate of unexposed? Relative risk Positive predictive value Attributable risk Odds ratio Loading...1358. Which one of the following medications is used for cases of Parkinson’s disease and influenza type A? Benztropine Bromocriptine Amantadine Ribavirin Loading...1359. What is the mechanism of action of finasteride? Inhibition of 5-alpha-reductase Stimulation of the posterior lobe of pituitary gland Inhibition of testosterone negative feedback Gonadotropin-releasing hormone analog Loading...1360. Which one of the following drugs results in disulfiram- like action when it is accompanied with alcohol? Dipyridamole Cimetidine Cefotetan Ampicillin Loading...1361. Aldosterone production is reduced by using one of the following drugs? Aspirin Diltiazem Lisinopril Erythromycin Loading...1362. Which of the following is the most common inherited cause of hypercoagulability? Congenital antithrombin III deficiency Factor V Leiden mutation Prothrombin gene mutation Protein C deficiency Loading...1363. A drug used in severe DIGITALIS toxicity is the following drug? Calcium Gluconate Amyl Nitrate Fomepizole DIGIBIND Loading...1364. 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 Obtain a court order Explain to her with documentation the benefits and risks of immunization Loading...1365. 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%? Supplemental oxygen at night Daily oral prednisone Albuterol inhaler as needed Continuous supplemental oxygen Loading...1366. 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 Glycine Tryptophan Phenylalanine Methionine Loading...1367. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefadroxil Ceftizoxime Cefepime Cefaclor Loading...1368. Which one of the following contraceptive methods is contraindicated in women with a history of deep venous thrombosis (DVT)? Combined oral contraceptive Depo-Provera injections Norplant Intrauterine contraceptive device (IUD) Loading...1369. Which of the following is the best screening test for colon cancer? Blood in stool (FOBT) Barium enema Sigmoidoscopy Colonoscopy Loading...1370. Verapamil, a calcium channel antagonist: Decreases intracellular K Decreases myocardial contractility Increases reactivation of sodium channels Increases conduction velocity Increases intracellular cAMP Loading...1371. Which one of the following drugs is effective against prolactin-secreting tumors? Chlorpromazine Prazosin Adrenaline Bromocriptine Loading...1372. Anemia occurs in cases of multiple myeloma most likely results from which one of the following factors? Loss of blood due to gastrointestinal bleeding Low production of hemopoietin Infiltration of bone marrow with massive numbers of plasma cells Defective absorption of urine Loading...1373. Which of the following is the most common cause of death in an old patient with uncontrolled diabetes? Myocardial infarction Hyperosmolar coma Pulmonary embolism Cerebral hemorrhage Loading...1374. Which of the following drug is Propionic acid derivative NSAID? Aspirin Diclofenac Piroxicam Naproxen Mefenamic Acid Loading...1375. Which one of the following enzymes is associated with Lyesh-Nyhan syndrome? Ribonucleotide reductase Hypoxanthine-guanine phosphoribosyl transferase Xanthine oxidase Adenosine deaminasePage 56 of 66 Loading...1376. Which of the following controls the secretion of thyrotropin? Concentration of thyrotropin in the pituitary gland Concentration of iodine in the thyroid gland Concentration of thyroid hormones in the blood Concentration of thyroid hormones in the thyroid gland Loading...1377. 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? Stiff neck Neuropsychiatric disturbances Hypotension Polyphagia Loading...1378. Hemorrhagic cystitis may develop after the use of cyclophosphamide. Which one of the following drugs can reduce this risk? Infliximab Mensa Ampicillin Vitamin K Loading...1379. A patient with HIV history develops fecal urgency and bloody diarrhea. Which of the following is the most likely causative organism? Cytomegalovirus Clostridium difficile Entamoeba histolytica Giardia lamblia Loading...1380. When a intravascular clot started floating in the blood termed as one of the following option? Thrombus All of above Embolus Coagulation Loading...1381. 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 Lateral cutaneous nerve Pudendal nerve Loading...1382. Which one of the following drugs is a more effective drug and drug of choice for fungal infection with a shorter duration of therapy? Itraconazole Griseofulvin Terbinafine Delavirdine Loading...1383. 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? Multifactorial Mitochondrial Autosomal recessive Autosomal dominant X-linked recessive Loading...1384. 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? Projection Transference Acting out Displacement Countertransference Loading...1385. What is the antidote to Atenolol? Flumazenil atropine Glucagon Pyridoxine Loading...1386. 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? Scopolamine Atropine Cromolyn sodium Epinephrine Loading...1387. 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...1388. A young woman presents with chronic diarrhea found to have rectovaginal fistula. Which of the following is most likely her diagnosis? Crohn’s disease Ischemic colitis Celiac disease Ulcerative colitis Loading...1389. Which one of the following drugs belongs to H2 histamine receptor blocker? Ezetimibe Ranitidine Indanyl carbenicillin Torsemide Atorvastatin Loading...1390. Estrogen is the female hormone due to which female sex organs and secondary sexual characteristics developed. Estrogen has the following adverse effects except? Endometrial cancer Paresthesia Hepatic Adenoma Thromboembolic disease Fluid retention Loading...1391. 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? Aplastic anemia Iron deficiency anemia Vitamin B12 deficiency Folic acid deficiency anemia Loading...1392. Primitive spermatogenic germ cells are located in which one of the following sites? Seminiferous tubules Vas deferens Interstitium of the testes Seminal vesicles Loading...1393. The therapeutic indication of Tamoxifen Drug specifically is to treat one of the following diseases? Treat osteoporosis Thromboembolic disease Induce ovulation Estrogen-dependent Breast Cancer Fluid retention Loading...1394. 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 erythropoietin production Decreased 2,3-diphosphoglycerate Decreased arterial Pco2 Loading...1395. Which one of the following drugs is commonly contributing to hypokalemia? Verapamil Furosemide Spironolactone Lisinopril Loading...1396. Which of the following drug belongs to potassium sparing Diuretics? Furosemide Urea Acetazolamide A & B Amiloride Loading...1397. Which of the following drug belongs to Osmotic Diuretic? Cefoxitin Niacin Oxacillin Ampicillin Mannitol Loading...1398. 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? Peripheral neuropathy Myasthenia gravis Spinal cord compression Meningitis Loading...1399. 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? 15 hours 7.5 hours 10 hours 5 hours Loading...1400. Which one of the following local anesthetics that causes local vasoconstriction and may leads to hypertension? Tetracaine Lidocaine Etidocaine CocainePage 57 of 66 Loading...1401. Which one of the following enzymes is extremely important in muscle energy metabolism through its role in purine nucleotide cycle? Myo-inositol monophosphatase Hypoxanthine-guanine phosphoribosyltransferase (HGPRT) Myoadenylate deaminase Adenosine deaminase Loading...1402. Which of the following adverse effects of L-dopa is the most likely the reason to limit the use of it? Dyskinesia Orthostatic hypotension Depression Nausea and occasional vomiting Loading...1403. Liposomal preparation of one of the following drugs decreases the risk of nephrotoxicity? Ethambutol Isoniazid Nystatin Amphotericin B Loading...1404. Which one of the following is an antimuscarinic agent? Neostigmine Scopolamine Tacrine Pralidoxime Echothiophate Loading...1405. 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 Atovaquone Chloroquine Doxycycline Loading...1406. Varicella zoster vaccine is not recommended if an elderly patient already developed shingles. False True Loading...1407. Risk of rupture of abdominal aortic aneurysm (AAA) is increased by all the following factors EXCEPT? Smoking Uncontrolled hypertension Male gender Increased aortic wall stress Loading...1408. The gland responsible for secretion of prolactin is derived from which of the following structures? Infundibulum Primordial follicle Neurohypophysis Rathke’s pouch Loading...1409. 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 heparin Perform electric cardioversion Order cardiac enzymes Start metoprolol Loading...1410. Which of the following is absolute contraindication of fibrinolytic therapy in MI? History of hypertension History of hemorrhagic stroke 9 years ago History of ischemic stroke 4 years ago History of diabetes Loading...1411. The drug that produces dilation of the pupil (mydriasis) for 6 hours is one of the following drugs? Cyclopentolate Atropine Tropicamide Physostigmine Ipratropium Loading...1412. Which of the following is the nonessential amino acid? Leucine Methionine Alanine Lycine Histidine Loading...1413. Which one of the following symptoms is most likely found in Parkinson’s disease? Visual hallucinations Intention tremors Cogwheel rigidity Chorea Loading...1414. Which of the following medications is selectively used in NSAID-induced gastric ulcer? Famotidine Misoprostol Bismuth Cimetidine Loading...1415. Following is the Structural analog of the aldosterone antagonist spironolactone with androgenic activity but to a little extent? Fluoxymesterone Drospirenone Bicalutamide Mifepristone Megestrol Acetate Loading...1416. Which of the following drug has Ocular effects like mydriasis and fixed far vision? Phenylephrine Mecamylamine Neostigmine Timolol Phentolamine Loading...1417. Which of the following characterizes syndrome of inappropriate antidiuretic hormone secretion? Serum osmolality is greater than urine osmolality Hyperosmotic volume contraction Euvolemic hyponatremia with continued Na excretion Recommended treatment is desmopressin acetate and hydration Loading...1418. Which of the following statements about ACh release and deactivation is true? ACh release is blocked by the toxin associated with clostridium tetani 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 MAO inhibitors are important in the treatment of depression because they inhibit the breakdown of ACh into its constituents acetic acid and choline Uptake of ACh into the presynaptic receptor is the most important mechanism in terminating the ACh signal The influx of Na+ into the depolarized axon terminal is a prerequisite for the release of stored ACh Loading...1419. In high doses, Aspirin lacks anti-platelet activity by which of the following phenomena Inhibits leukotrienes Stimulates prostacyclins Stimulates thromboxanes Inhibits prostacyclins Stimulates leukotrienes Loading...1420. Which of the following disorders is most likely related to body dysmorphic disorder? Malingering Obsessive compulsive disorder Post-traumatic stress disorder Generalized anxiety disorder Loading...1421. Which one of the following types of drug interactions occurs when aspirin is given with acetaminophen? Tachyphylactic Additive Permissive Synergistic Loading...1422. 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? Azithromycin Ampicillin Vancomycin Amoxicillin Gentamicin Loading...1423. Histamine Receptor found on eosinophils and mast cells having a chemotactic function also found on neutrophils and CD⁴ T cells are following? H⁴ histamine receptor H³ histamine receptor H¹ histamine receptor H² histamine receptor H⁵ Histamine receptor Loading...1424. Which one of the following drugs is used to treat asthma? Repaglinide Ezetimibe Indanyl carbenicillin Ipratropium Hydrochlorothiazide Loading...1425. Which of the following markers identifies B lymphocytes in a blood sample treated with different fluorescent-labeled antibodies? CD19 CD4 CD3 CD8Page 58 of 66 Loading...1426. 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? Metastatic carcinoma Pregnancy Intraductal papilloma Prolactinoma Loading...1427. Which one of the following anti-acne drugs act by induction of apoptosis in sebaceous glands? Benzoyl peroxide Tetracycline Azelaic acid Isotretinoin Loading...1428. Bones of calvarium and facial bones are formed by which one of the following types of ossification? Membranous ossification Endochondral ossification Loading...1429. Release of which of the following chemical mediators results in pain in cases of acute inflammation? Prostaglandin Complement C3b Histamine Serotonin Loading...1430. 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? 90% 92% 84% 88% 86% Loading...1431. Which of the following conditions is caused by a frameshift mutation? Becker muscular dystrophy Sickle cell disease Duchenne muscular dystrophy Hereditary nonpolyposis colorectal cancer Loading...1432. A toddler swallowed a coin. Which of the following is the most common site of impaction of this coin? Ileocecal junction Esophagus Stomach Transverse colon Loading...1433. A drug that belongs to Loop Diuretics is one of the following? A & B All of the following Furosemide Bumetanide Bumetanide Loading...1434. Which of the following drug are Nonsteroidal antiestrogens? Tamoxifen Exemestane Estradiol acetate Estradiol Estrogen Loading...1435. Which of the following is the drug of choice of anaphylactic shock? Adrenaline Dopamine Diphenhydramine Phenylephrine Loading...1436. Which of the following medications reduces the effectiveness of oral contraceptives? Omeprazole Carbamazepine Ritonavir Ketoconazoleich of the following medications is the best treatment of absence seizures? Loading...1437. 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? HBV vaccine Acyclovir Famciclovir Interferon alfa Supportive treatment Loading...1438. Which one of the following causes induction of cellular enzymes that interfere with viral protein synthesis? Gancyclovir Ribavirin Interferon-alpha Amantadine Zanamavir Loading...1439. Ceftriaxone belongs to the one of the following generation of the cephalosporin? 4th generation 1st generation 2nd generation 3rd generation Loading...1440. 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? Coxsackie A virus Blastomyces dermatitidis Hemophilic influenzae Histoplasma capsulatum Loading...1441. 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. Streptomycinich of these drugs acts by inhibition of formation of mycolic acid? Ethambutol Rifampin Isoniazid Pyrazinamide Loading...1442. Antihyperlipidemic drugs which consist of open hydroxy acid lactone ring in the structural formula except? Pravastatin Simvastatin Fluvastatin Atorvastatin Rosuvastatin Loading...1443. Which of the following drug is a part of proton pump inhibitors? Mannitol Rabeprazole Acetazolamide Furosemide A & B Loading...1444. Which of these substances should be taken before consumption of milk in a patient who complains of abdominal pain and cramping after drinking milk? Niacin Lactase Acetaminophen Aspirin Loading...1445. An old patient presents with multiple tumors on the liver. Which of the following is the most common site of the primary tumor? Breast Kidney Lung Colon Loading...1446. Which one of the following is the best treatment of trigeminal neuralgia? Riboflavin Carbamazepine Methylphenidate Fluoxetine Loading...1447. 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? Hypertrophic cardiomyopathy Myocardial infarction Aortic dissection Pericarditis Loading...1448. Which of the following is the common cause of secondary dyslipidemia? Diabetes mellitus Familial combined hyperlipidemia Familial hypercholesterolemia Apo C-II deficiency Loading...1449. Which one of the following liver disorders occurs due to hepatic vein thrombosis? Budd-Chiari syndrome Alcoholic hepatitis Fatty liver Pyogenic liver abscess Loading...1450. A drug that act as laxative is one of the following? Bumetanide Furosemide A & B Sulbactam Magnesium hydroxidePage 59 of 66 Loading...1451. 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 3.2 230 2.3 Loading...1452. A drug is used in severe alcohol poisoning is the following drug? Amyl Nitrate DIGIBIND Fomepizole Calcium Gluconate Loading...1453. Which of the following types of sensations is carried to the thalamus by the anterolateral tracts after crossing the spinal cord? Vibrations Position Fine touch Crude touch Loading...1454. Which of the following locations is the site of action of furosemide to inhibit sodium reabsorption? Collecting tubules Distal convoluted tubules Descending limb of loop of Henle Ascending limb of loop of Henle Loading...1455. Which of the following drug is a derivative of salicylic acid? Diflunisal Mefenamic Acid ketorolac Etodolac Piroxicam Loading...1456. Which one of the following drugs is tertiary amine antispasmodic? Cyclopentolate Dicyclomine Propantheline Biperiden Oxybutynin Loading...1457. Which of the following drug is a derivative of Enolic acid? Etodolac Piroxicam Mefenamic Acid ketorolac Diflunisal Loading...1458. Which of the following parts of the stomach has a dome-shaped appearance and lies superior to the lower end of esophagus? Fundus Antrum Body Pylorus Loading...1459. Which of the following conditions is associated with the presence of non-inflammatory follicular papules (comedones)? Acne vulgaris Pemphigus vulgaris Bullous pemphigoid Atopic dermatitis Loading...1460. 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 Vitamin C supplement Iron supplement Loading...1461. Which of the following is the mechanism of action of digoxin to increase cardiac contractility? Inhibition of phosphodiesterase Inhibition of Na/Ca ATPase Inhibition of K/Ca ATPase Inhibition of Na/K ATPase Loading...1462. Patients with genetic polymorphism have delay in metabolism of drugs by acetylation. Which one of the following drugs is most likely affected by that? Nitroglycerin Clonidine Hydralazine Prazosin Loading...1463. Which of the following leads to toxic reactions when a drug is taken repeatedly? Tachyphylaxis Absorption disorder Tolerance Cumulative action Loading...1464. During normal inspiration, the diaphragm: Contracts Relaxes Does not move Loading...1465. 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? Carbachol Scopolamine Methacholine Cevimeline Bethanechol Loading...1466. 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? Atrial thrombus Atrial myxoma Vegetative valvular lesions Left ventricular wall aneurysm Loading...1467. A drug that inhibits replication of the influenza A virus by interfering with viral attachment and uncoating? Acyclovir Rimantadine Nevirapine Zidovudine Oseltamivir Loading...1468. 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 breast abscess Milk engorgement Inflammatory carcinoma A clogged milk duct Mastitis Loading...1469. 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 7.47, bicarbonate 15, Pco2 30 and Po2 90 pH 7.05, bicarbonate 15, Pco2 30 and Po2 90 pH 7.00, bicarbonate 15, Pco2 60 and Po2 90 pH 7.60, bicarbonate 24, Pco2 60 and Po2 90 pH 7.50, bicarbonate 24, Pco2 40 and Po2 90 Loading...1470. Which one of the following drugs reverses the effects of heparin? Chloroquine Warfarin Protamine Epinephrine Loading...1471. What is the most appropriate treatment of organophosphate poisoning? Hexamethonium Pyridostigmine Pralidoxime Morphine Loading...1472. A) Bupropion Haloperidol Ethosuximide Methylphenidate Loading...1473. 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? Call cardiology department and prepare for PCI Assurance and send him home for the rest of the day 12-Lead ECG, random blood glucose and thyroid panel Psychotherapy and alprazolam Loading...1474. Which of the following receptors is inhibited by ondansetron to treat nausea following chemotherapy? Dopamine receptors Muscarinic receptors Serotonin 5-HT receptors Nicotinic receptors Loading...1475. Which of the following is the reason that nitroglycerin is given sublingually? It improves patient compliance It has less reflex tachycardia than other routes It diminishes the odds of developing methemoglobinemia It avoids first pass metabolismPage 60 of 66 Loading...1476. Stimulation of hepatic microsomal cytochrome p450 enzymes can cause which one of the following? Decreased metabolism of certain drugs Enhancement of excretion of some drugs Increased intestinal absorption of certain drugs Increased metabolism of certain drugs Loading...1477. Sulindac belongs to one of the following class? Oxicam derivative Fenamates Acetic acid derivative Propionic acid Loading...1478. Which of the following is a major complication of central retinal veins occlusion? Lens subluxation Glaucoma Cataract Retinal detachment Loading...1479. Which of the following muscles are the primary abductors of the arm at the shoulder? Deltoid and infraspinatus Deltoid and supraspinatus Deltoid and biceps Deltoid and coracobrachialis Loading...1480. 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? Parietal lobe Ankle and elbow joints Cerebellum Frontal lobe Loading...1481. NucleoSide Reverse Transcriptase inhibitors(NRTIs) drug in Antiviral class? Acyclovir Nevirapine Amprenavir Saquinavir Zidovudine Loading...1482. Which one of the following drugs is a sodium channel blocker (Class I)? Amiodarone Verapamil Procainamide Carvedilol Loading...1483. One of the following statements about the use of succinylcholine is wrong? causes Hyperkalemia Resistance to plasma cholinesterase Act like Acetylcholine to depolarize junction Malignant hyperthermia with halothane prolonged apnea in patients deficient in cholinesterase Loading...1484. Which of the following is the most common cause of nasal obstruction and bleeding in adolescents? Nasal cancer Angiofibroma Papilloma Nasal polyps Loading...1485. Which one of the following drugs is a Tetracycline? Minocycline Cefadroxil Cefepime Cefdinir Loading...1486. Which of the following types of receptors are associated with the slowest response time? Ion channel receptors Transmembrane enzyme receptors Steroid receptors G-protein coupled receptors Loading...1487. 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 Inhibition of MAO type B to reserve dopamine Precursor of dopamine Loading...1488. 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 Lateral spinothalamic tract Spinal nucleus of fifth cranial nerve Inferior cerebellar peduncle Loading...1489. Which of the following drug is a part of drugs as first-line drugs used to treat tuberculosis? A & B Ibandronate Ethambutol Furosemide Rabeprazole Loading...1490. 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. Cystic fibrosis Congenital annular pancreas Gallstones Trauma Viral infectionat is the most likely etiology of this boy’s condition? Loading...1491. - - - disease is inherited disorder of copper metabolism characterized by reduced serum copper & increased cincentration of copper in brain & viscera Gout restless legs syndrome wilsons disorder parkinsons disorder Loading...1492. Decreased production of which type of collagen may result in osteogenesis imperfecta? Type II Type IV Type III Type I Loading...1493. Dry or “sandy eyes” is seen after administration of large doses of which one of the following medications? Carbacho Timolol Pilocarpine Atropine Loading...1494. 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? Calcium gluconate Levothyroxine Vitamin D Calcitonin Parathyroid hormone Loading...1495. Which of the following is the most likely cause of death in cases of overdose of hypnotics? Cerebral edema Hypothermia Status epilepticus Depression of the medullary respiratory center Loading...1496. 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? Dipyridamole Warfarin Aspirin Heparin Streptokinase Loading...1497. Which one of the following cells is neuroendocrine and found within the epithelium of the bronchi? Macrophages K cells Pneumocytes type I Clara cells Pneumocytes type II Loading...1498. Which one of the following parts of lymph nodes has T lymphocyte as the predominate cell? Medulla Germinal center Paracortex Cortex Loading...1499. A drug that belongs to proton pump inhibitor is one of the following? A & B Sulbactam Ethacrynic Acid Rosiglitazone Lansoprazole Loading...1500. All of the following drugs have anti-inflammatory effects except? Acetaminophen ketorolac Piroxicam Naproxen Mefenamic acidPage 61 of 66 Loading...1501. 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? Lipofuscin Bilirubin Hemosiderin Melanin Loading...1502. A drug that causes REACTIVATION OF ACETYLCHOLINESTERASE? Neostigmine Tacrine Pralidoxime Echothiophate Loading...1503. 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...1504. An indirect-acting adrenergic agonist is following? Acetylcholine Clonidine A & B Albuterol Amphetamine Loading...1505. The structural formula of epinephrine and Norepinephrine called? Pyrocatechol Catechol All of these 1,2-dihydroxybenzene Loading...1506. A drug that belongs to Loop Diuretics is one of the following? Bumetanide Sulbactam Cefazolin A & B Doripenem Loading...1507. 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? Ultrasound examination of the pelvis Admit the patient Stabilize the patient Digital pelvic examination Loading...1508. Administration of clopidogrel with aspirin is an example of which of the following drug interactions? Synergistic Permissive Tachyphylactic Additive Loading...1509. 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? Try your best to explain the treatment plan to them Find any Spanish-speaking person in the clinic to interpret the instructions Speak to the boy to find out if he speaks English, and if he does, explain the instructions to him. Use electronic interpreting device to translate the instructions Loading...1510. Which one of the following local anesthetics can NOT be given parenterally due to its physicochemical properties? Etidocaine Procaine Mepivacaine Benzocaine Loading...1511. Which of the following conditions should be screened at the age of 50? Adrenal insufficiency Colon cancer Prostate cancer Lung cancer Loading...1512. Which of the following drug belongs to Sulfonylureas? Niacin Urae Oxacillin Cefoxitin Glyburide Loading...1513. An agent that contains sulfonamide structure in structural formula and blocks cysLT¹ receptor thus blocking the effect of leukotrienes? Zafirlukast Ergotamine Zileuton Acetaminophen Loading...1514. Which one of the following antiretroviral drugs is a protease inhibitor? Tenofovir Lamivudine Zidovudine Etravirine Ritonavir Loading...1515. 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 Thromboplastin Melanin Loading...1516. 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? Barium swallow Esophageal manometry Upper endoscopy 24-hour pH monitoring Trial of a proton-pump inhibitor Loading...1517. 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? Alcoholic hepatitis Fatty liver Acetaminophen toxicity Budd-Chiari syndrome Loading...1518. Which of the following tests is the most accurate one to confirm the diagnosis of achalasia? Manometry Chest-x-ray Upper endoscopy Barium esophagram Loading...1519. 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? Hypertension Daily aspirin Alcohol abuse Immobilization Hypothyroidism Loading...1520. Which of the following drugs has the shortest half-life and used in acute anxiety? Clonazepam Flurazepam Alprazolam Chlordiazepoxide Loading...1521. Which one of the following statements about the use of Diclofenac is incorrect? Accumulate in synovial fluid Also used for ankylosis spondylitis Less potent than Naproxen Excrete out by the kidney Loading...1522. Which of the following in the mode of inheritance of glucose-6-phosphate dehydrogenase deficiency? X-linked dominant Autosomal recessive X-linked recessive Autosomal dominant Loading...1523. Which of the following is the classic electrocardiogram (ECG) finding in pericarditis? Diffuse S-T segment elevation S-T segment elevation in anterior leads (V1-V4) S-T segment elevation in leads II. III and aVF Sawtooth P waves Loading...1524. Which one of the following cells secretes glycosaminoglycans and found in the in the terminal and respiratory bronchioles? Pneumocytes type I K cells Macrophages Clara cells Pneumocytes type II Loading...1525. Which one of the following gout treatments lowers serum uric acid? Colchicine Allopurinol Indomethacin ProbenecidPage 62 of 66 Loading...1526. Aztreonam belongs to the one of the following class? Cephalosporin Monobactams Penicillins Carbapenems Loading...1527. Which one of the following drugs mediates histamine release from mast cells causing flushing? Nystatin Terbinafine Griseofulvin Caspofungin Loading...1528. Cephalexin belongs to the class of following drugs? Antiprotozoal Antipyretic Antiviral Anti malaria Antibiotics Loading...1529. 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? Lovastatin Niacin Orlistat Atenolol Fenofibrate Loading...1530. 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? Zinc Lead Iron Arsenic Copper Loading...1531. Which one of the following medications binds tumor necrosis factor (TNF-α) and used in the treatment of rheumatoid arthritis? Methotrexate Trastuzumab Paclitaxel Infliximab Loading...1532. 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 Viral croup Asthma Foreign body stuck in the main bronchus Loading...1533. 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:ich of these findings shows that the body is compensating to this condition?2: 100 mmHg PCO2: 30 mmHg Elevated hydrogen ion excretion Elevated arterial PO2 Elevated hydrogen ion concentration Elevated bicarbonate excretion Elevated respiratory rate Loading...1534. Which statement about the Actions of the incretin hormone Glucagon-like peptide-1 is wrong? Increase Glucose-dependent insulin secretion Decrease Beta cells growth Suppress appetite Inhibit inappropriate Glucagon secretion Loading...1535. Which of the following drug is a part of drugs for subcutaneous and systemic mycoses? Caspofungin Ethambutol Ibandronate A & B Furosemide Loading...1536. 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? Axillary nerve Median nerve Suprascapular nerve Ulnar nerve Radial nerve Loading...1537. Which one of the following drugs is a microtubule inhibitor chemotherapeutic drug? Methotrexate Vincristine Busulfan Dactinomycin Loading...1538. 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? Direct inguinal hernia Indirect inguinal hernia Hiatal hernia Femoral hernia Loading...1539. Which one of the following drugs is a potassium channel blocker (Class III)? Procainamide Verapamil Carvedilol Amiodarone Loading...1540. Which of the following is the best treatment of genuine stress incontinence? Urethropexy Surgical repair Anticholinergic Intermittent self-catheterization Loading...1541. Which one of the following agents is used to eradicate the organism's (Phthisis pubis) extraerythrocytic phase? Pyrimethamine Chloroguanide Primaquine Quinacrine Chloroquine Loading...1542. Which one of the following drugs belongs to 3rd generation Cephalosporins? Cefaclor Cefepime Cefadroxil Ceftibuten Loading...1543. 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? Nonsense mutation Point mutation Thymidine dimers Missense mutation Loading...1544. Which of the following drugs is used for respiratory virus infections? Naftifine Zanamivir Capecitabine Miconazole Ibandronate Loading...1545. Indirectly acting reversible cholinergic agonist drug? Echothiophate Acetylcholine Pilocarpine Tacrine Loading...1546. Which one of the following dermatologic disorders presents with a herald batch and a Christmas tree pattern? Pityriasis rosea Bullous pemphigoid Pemphigus vulgaris Psoriasis Loading...1547. Which of the following pathological terms describes the disordered, non-neoplastic cell growth? Dysplasia Neoplasia Anaplasia Metaplasia Loading...1548. Organophosphorus poisoning can be treated with which of the following agents? Atropine Physostigmine Atenolol Ipratropium bromide Loading...1549. Which one of the following drugs is the most effective in midazolam paradoxical reaction? Adrenaline Protamine Albuterol Flumazenil Loading...1550. Which of the following are side effects of Aspirin? Bronchoconstriction Urticaria Metabolic acidosis All of the above Peptic ulcer diseasedPage 63 of 66 Loading...1551. 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? Inhibits H+,K+-ATPase Adds a protective membrane to gastric mucosa Stimulates H2 receptors Blocks H2 receptors Loading...1552. 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? Parkinsonism Epilepsy Tourette syndrome Huntington disease Loading...1553. Which one of the following drugs is a 2nd generation Cephalosporin? A & B Cefdinir All of the above Cefaclor Cefprozil Loading...1554. Which one of the following adverse effects of calcium channel blockers is wrong? Diarrhea Fatigue Hypotension Vertigo Loading...1555. Which one of the following statements about the use of Fenoldopam is wrong? Useful in Glaucoma Lowers blood pressure Dopamine-1 receptor agonist Increase renal perfusion Loading...1556. 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? Varicella DTaP MMR Oral polio vaccine Loading...1557. Which of the following drugs are highly bound to albumin? A & B Warfarin Ibuprofen Digoxin All of the above Loading...1558. Which of the following tests would most likely indicates the etiology of vitamin B12 deficiency anemia? Osmotic fragility test Complete blood count (CBC) Schilling test Coomb’s test Loading...1559. Which one of the following drugs is a Proteas inhibitor? Delavirdine Darunavir Maraviroc Indanyl carbenicillin Abacavir Loading...1560. Which one of the following fractures is incomplete and involving the cortex of only one side of the bone? Torus fracture Greenstick fracture Nursemaid’s elbow Osgood-Schlatter disease Loading...1561. 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 ultrasonography Abdominal MRI Abdominal X-ray Abdominal CT scan Loading...1562. 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 Normal reaction Acute rejection Chronic rejection Hyperacute rejection Loading...1563. A patient presents to the ER with acute myocardial infarction. After administration of aspirin and oxygen what is the nest step of action? Administer metoprolol Check cardiac biomarkers Send for echocardiography Initiate perfusion therapy Loading...1564. Which of the following is the checkpoint in cell development that is affected by ionizing radiation? G0/G1 G2/M S/G2 G1/S Loading...1565. Griseofulvin belongs to the following drugs class? Antifungal Antibiotics Antipyretic Antiprotozoal Antiviral Loading...1566. 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? Streptococcus pyogenes Staphylococcus aureus Ascaris lumbricoides Trichophyton rubrum Trypanosoma cruzi Loading...1567. 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? Ampicillin Rifampin Amoxicillin Cloxacillin Methicillin Loading...1568. Which of the following is the mechanism of action of pioglitazone in diabetic patients? Decreases insulin breakdown Increases glucose uptake in muscle cells Increases glucose excretion Increases insulin release Loading...1569. Which of the following is the main role of hydroxyurea in treatment of sickle cell anemia? Increase levels of HbF in red blood cells Decrease levels of HbF in red blood cells Increase ability of HbS to bind 2.3-bisphosphoglycerate Decrease oxygen affinity to HbS Loading...1570. Which one of the following drugs belongs to drugs for hepatic viral infections? Capreomycin Entecavir Ezetimibe Aluminium hydroxide Indanyl carbenicillin Loading...1571. Which one of the following drugs is a 4th generation Cephalosporin? Cefadroxil Cefdinir Cefepime Cefaclor Loading...1572. Gastric inhibitory peptide (GIP) and Glucagon-like peptide-1 (GLP-1) are secreted by? Kidney Intestine's Liver Adrenal glands Loading...1573. Which one of the following factors stimulates the renal secretion of renin? Decreased serum sodium ion concentration Decreased pressure in the afferent glomerular arterioles Increased chloride ion concentration in the renal distal tubules Increased pressure in the afferent glomerular arterioles Loading...1574. Which one of the following anticonvulsant drugs in used only in the treatment of absence seizures? Lorazepam Carbamazepine Ethosuximide Levetiracetam Loading...1575. 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? Left middle lobar bronchus Left superior lobar bronchus Right superior lobar bronchus Right middle lobar bronchusPage 64 of 66 Loading...1576. Which of the following is the mechanism of action of misoprostol for the treatment of peptic ulcer? Suppression of secretory responses to food stimulation Formation of a protective coating of the ulcer beds Direct inhibition of the proton pump Increased mucus and bicarbonates secretion and decreased HCL secretion Loading...1577. Which one of the following cardiac conditions occurs in about 25% of patients with systemic lupus erythematosus (SLE)? Pericarditis Atrial hypertrophy Aortic stenosis Ventricular myxoma Loading...1578. Achilles tendon xanthoma is most likely characteristic of which one of the following conditions? Diabetes mellitus Familial hypercholesterolemia Systemic lupus erythematosus Pseudogout Loading...1579. 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? 92% 88% 84% 86% 90% Loading...1580. Which of the following is the active form of vitamin D? 25-hydroxycholecalciferol 1,25-dihydroxycholecalciferol 1-dihydroxycholecalciferol Cholecalciferol Loading...1581. Which of these drugs inhibits epoxide reductase? Warfarin Streptokinase Aspirin Heparin Loading...1582. An antihyperlipidemic drug that consists of a closed six-membered lactone ring in the structural formula? Pravastatin Rosuvastatin Simvastatin Atorvastatin Fluvastatin Loading...1583. Which one of the following antihypertensive medications is directly acting vasodilator? Clonidine Enalapril Labetalol Nifedipine Loading...1584. 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...1585. Extrapyramidal side effects develop after the use of haloperidol due to its effect on which of the following receptors? Dopamine receptors Muscarinic receptors Alpha-adrenergic receptors Nicotinic receptors Loading...1586. Which of the following antibiotics is the most appropriate one to treat a case of Legionella pneumonia? Clindamycin Erythromycin Metronidazole Vancomycin Loading...1587. Following is the 2nd generation cephalosporin drug? Cephalexin Cefadroxil Cefaclor Cefdinir Cefepime Loading...1588. Which one of the following is the most common cause of non-adherence to administration of prescribed drugs? Forgetfulness Food restrictions Fear of addiction Frequent dosing Loading...1589. 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 II second degree AV block Atrial fibrillation Atrial flutter Third degree atrioventricular block Mobitz type I (Wenckebach) second degree AV block Loading...1590. 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 Tanner syndrome Hashimoto’s disease Loading...1591. Which one of the following antibiotics is the empiric treatment of cellulitis in a diabetic patient? Amoxicillin Vancomycin Imipenem Neomycin Loading...1592. 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 Deep venous thrombosis Atherosclerosis Hyperplastic arteriosclerosis Loading...1593. What is the most appropriate next step in management of a patient complaining of symptoms of GERD? Endoscopy Barium swallow Omeprazole Ranitidine Loading...1594. A drug that elevate bronchial smooth muscle cAMP leading to decreased intracellular calcium and prompt bronchodilation. Dipivefrin Albuterol Clonidine Epinephrine Phenylephrine Loading...1595. 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? Sublingualugs administered by intramuscular, intravenous, subcutaneous and sublingual routes reach the blood stream first before they are metabolized by liver enzymes. Intravenous Oral Intramuscular Loading...1596. Which of the following is a serious complication of ergotamine? Headache Depression Hypotension Prolonged vasospasm Loading...1597. Which of the following differentiate neostigmine from pilocarpine? Prolonged skeletal muscle contraction Stimulation of salivary glands Stimulation of bowel motility Acceleration of heart rate Loading...1598. Pins and needles and numbness is the adverse effect of the following drug? Ethambutol Isoniazid Nystatin Streptomycin Loading...1599. 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? Hyperglycemia Constipation Sexual dysfunction Diarrhea Loading...1600. 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 Calcium pyrophosphate dehydrate crystals Cholesterol crystals Negatively birefringent urate crystals Calcium oxalate crystalsPage 65 of 66 Loading...1601. Coagulation factor VIII is produced by which of the following cells? Splenic macrophages Juxtaglomerular cells Hepatic cells Endothelial cells Loading...1602. One of the OATPs (Organic anion transporting polypeptides) drugs transporters OATP4C1 has a mainly limited distribution to the following? Skin Liver Heart Kidney Stomach Loading...1603. 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 Aspirin Heparin Metoprolol Cardioversion Loading...1604. Which one of the following disease is caused by bite of infected ticks? Cholera Mycoplasma Pneumonia Lyme disease Rocky mountain spotted fever Loading...1605. Which one of the following medications should be taken on an empty stomach and at least one hour before meals? Aspirin Prednisone Levothyroxine Propranolol Loading...1606. Control of diabetes is most likely determined by which one of the following laboratory tests? Hemoglobin A1C Random blood glucose Fasting blood glucose Urinary glucose content Loading...1607. Which one of the following cranial openings is located at the greater wing of sphenoid and contains the middle meningeal artery? Foramen rotundum Foramen lacerum Foramen ovale Foramen spinosum Loading...1608. Imidazoline derivative drug with Alpha1 adrenoceptors effect? Oxymetazoline Brimonidine Clonidine Phenylephrine Apraclonidine Loading...1609. Which one of the following statements about the use of Alpha-methyldopa is incorrect? Cardiac output is decreased Causes Sedation and drowsiness Alpha² agonist activity Reduce peripheral resistance Loading...1610. Failure of degeneration of the urachus may lead to which of the following defects? Renal agenesis Bladder adenocarcinoma Bladder exstrophy Polycystic kidney disease Loading...1611. Which of the following drugs is used to inhibit viral neuraminidase? Ibandronate Acyclovir Zanamivir Naftifine Capecitabine Loading...1612. Which of the following are the major sites for heme synthesis? Bone marrow and spleen Kidney and liver Bone marrow and kidney Bone marrow and liver Kidney and spleen Loading...1613. 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 Gentamicin Vancomycin Ampicillin Loading...1614. Which one of the following substances is used to acidify the urine? Ammonium chloride Sodium bicarbonate Acetazolamide Loading...1615. Onychomycoses is the fungal infection of one of the following? Nails Hair Skin Teeth Loading...1616. Which one of the following is the adverse effect of ACE inhibitors? hypokalaemia Dry cough All of the above Skin rashes A & B Loading...1617. Which one of the following tests can be used to distinguish between Folic acid and vitamin B12 deficiencies? Serum methylmalonate level Serum methionine level Serum cystathionine level Serum homocysteine level Loading...1618. 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 1 year in 3 years in 6 months in 2 years During this visit Loading...1619. Which substance is degraded by COMT (Catechol-O-Methyl transferase)? Epinephrine Catechol estrogens Norepinephrine Dopamine All of these Loading...1620. Drugs that show capacity-limited elimination have which of the following property? The elimination half-life(t½) remains constant First-order elimination kinetics is followed by low and high doses both As the administered dose increases the elimination half-life (t½) increases A constant ratio of drug metabolites are formed as the administered dose increases Loading...1621. Which one of the following oral anti-diabetic drugs is associated with lactic acidosis? Nateglinide Metformin Glipizide Pioglitazone Loading...1622. Which one of the following medical conditions is associated with an arthritis that resembles ankylosing spondylitis? Celiac disease Crohn’s disease Whipple disease Peptic ulcer Loading...1623. Loss of individual cells by fragmentation of nuclei and cytoplasm caused by a chemotherapeutic agent is produced through which one of the following mechanisms? Mitochondrial poisoning Acute inflammation Apoptosis Phagocytosis Loading...1624. 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 osteoblast activity Decrease parathormone activity Decrease osteoclast activity Increase vitamin D absorption Increase urinary calcium reabsorption Loading...1625. Which of the following drug belongs to H2 histamine receptor blocker? Niacin Cefoxitin Oxacillin Glimepiride CimetidinePage 66 of 66 Loading...1626. Intramuscular vitamin B12 should be prescribed after gastrectomy. Which of the following gastric cells is responsible for this replacement treatment? Chief cells Goblet cells Parietal cells G cells Loading...1627. Which one of the following drugs prevents the release of Renin and increase in heart rate from sympathetic stimulation? Metoprolol Enalapril Digoxin Dobutamine Loading...1628. 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 Simvastatin Zidovudine Cocaine addiction HIV infection Alcohol abuse Loading...1629. Which one of the following drugs is contraindicated in a case of osteoporosis? Simvastatin Albuterol Prednisone Calcium oxalate Loading...1630. One of the following statements about the use of scopolamine is wrong? Short term memory blocker Shorter duration of action as compared to atropine in CNS Used for Motion sickness Belladonna Alkaloid produce excitement at high doses Loading...1631. Which one of the following results of Tensilon test confirms the diagnosis myasthenia gravis Slow and gradual amelioration of symptoms Rapid amelioration of symptoms Exaggeration of weakness No effect Loading...1632. 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...1633. Which of the following treatments should be used in cases of methanol or ethylene glycol poisoning? Glucagon Pyridoxine Sodium bicarbonate Ethanol Loading...1634. Which one of the following drugs is the first line medication in transplant immunopharmacology? Thalidomide Methotrexate Cyclosporine Sulfasalazine Loading...1635. What is the most likely explanation of this finding? Metabolism of beta-naphthylamine by human cytochrome 450 system in the liver Beta-naphthylamine is directly carcinogenic to human bladder Detoxification of beta-naphthylamine by glucuronic acid conjugation. Human urinary glucuronidase splits beta-naphthylamine into glucuronic acid and a toxic metabolite. Loading...1636. Which one of the following medications acts at the proximal tubule of the kidney? Spironolactone Acetazolamide Furosemide Hydrochlorothiazide Loading...1637. Butoconazole belongs to the class of following drugs? Antiviral Antipyretic Antibiotics Antiprotozoal Antifungal Loading...1638. Prostaglandin is derived from prostanoic acid, prostanoic acid contains 20 carbon fatty acids, how many carbons rings in the structural formula of prostanoic acid? 3 carbon ring 4 carbon ring 2 carbon ring 6 carbon ring 5 carbon ring Loading...1639. Which one of the following drugs is used to treat constipation? Alendronate Metamucil A & B Sevelamer Sodium polystyrene sulfonate Loading...1640. 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? Decreased production of cAMP Deficiency in the brush border enzymes Increased motility of the small intestine Increased production of cAMP Destruction of the absorptive epithelium Loading...1641. Which one of the following drugs causes cyanide toxicity? Nicardipine Minoxidil Clonidine Sodium nitroprusside Loading...1642. 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? Ethosuximide Acetazolamide Gabapentin Carbamazepine Clonazepam 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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