OXYTOCICS & UTERINE MUSCLE RELAXANTS 167

CHAPTER 11
CHEMOTHERAPY

1. Twenty months after finishing her chemo- 4. A 31-year-old man has gonorrhea. He has
therapy, the woman had a relapse of breast no drug allergies, but he recalls that a few
cancer. The cancer was now unresponsive years ago while in Africa he had acute
to standard doses of chemotherapy. The hemolysis following use of an antimalarial
decision was made to treat the patient with drug. The physician is concerned that the
high-dose chemotherapy followed by au- patient has an accompanying urethritis
tologous stem cell transplantation. Which due to C trachomatis, though no cultures
or enzyme tests have been performed.
of the following drugs is most likely to be
Which of the following drugs is most likely
used to mobilize the peripheral blood stem
to be effective against gonococci and to
cells for the patient’s autologous stem cell
eradicate C trachomatis in this patient?
transplantation?
(a) Cefixime (b) Ciprofloxacin
(a) Erythropoietin (b) G – CSF
(c) Ofloxacin (d) Spectinomycin
(c) Interleukin - 11 (d) Intrinsic factor
(e) Sulfamethoxazole
(e) Thrombopoietin
5. The mechanism by which sulfasalazine
2. The combination of trimethoprim and exerts its primary action in ulcerative
sulfamethoxazole is effective against colitis is inhibition of
which one of the following opportunistic
(a) Folic acid synthesis
infections in the AIDS patient?
(b) The formation of leukotrienes and prostaglandins
(a) Disseminated herpes simplex (c) Phospholipase C
(b) Cryptococcal meningitis (d) Proton pump activity
(c) Toxoplasmosis (e) The formation of interleukind
(d) Oral cnadidiasis
6. Which one of the following adverse effects
(e) Tuberculosis
is most likely to occur with sulfonamides?
3. The top four most commonly diagnosed (a) Neurologic effects, including headache,
cancers include all of the following except dizziness, and lethargy
(a) Lung (b) Prostate (b) Hematuria
(c) Colon and rectum (d) Thyroid (c) Fanconi’s aminoaciduria syndrome
(e) Breast (d) Kernicterus in the newborn
(e) Skin reaction
168 MCQs IN PHARMACOLOGY

7. This drug is the preferred agent for teat- 12. A patient with AIDS and a CD4 cell count
ment of nocardiosis and, in combination of 100/µµL has persistent fever and weight
with pyrimethamine, is prophylactic loss associated with invasive pulmonary
against preumocystis carinii infections in disease that is due to M avium complex.
AIDS patiens. Optimal management of this patient is
(a) Ampicillin (b) Clindamycin to
(c) Norfloxacin (d) Sulfadiazine (a) Treat with rifabutin, since it prevents the
(e) Trimethoprim development of MAC bacteremia
(b) Select an antibiotic regimen based on drug
8. Supplementary folinic acid may prevent susceptibility of the cultured organism
anemia in folate-deficient persons who
(c) Start treatment with INH and pyrazinamide
use this drug; it is a weak base, and
achieves tissue levels similar to those in (d) Treat the patient with clarithromycin,
plasma ethambutol, and rifabutin
(a) Ciprofloxacin (b) Norfloxacin (e) Treat with trimethoprim – sulfamethoxazole
(c) Sulfacetamide (d) Trimethoprim 13. This drug has been used prophylactically
(e) Trovafloxacin in contacts of children with infection due to
Haemophilus influenzae type B. It is also
9. It is now recommended that trovafloxacin prophylactic in meningococcal and
be reserved for treatment of life-threatening staphylococcal carrier states. While the
infections because drug eliminates a majority of meningococci
(a) Bacterial resistance to the drug is very common from carriers, highly resistant strains may
(b) Complete liver failure has occured be selected out during treatment
(c) It is very expensive (a) Ciprofloxacin (b) Clofazimine
(d) Its use is associated with torsade de pointes (c) Dapsone (d) Rifampin
(e) Nephrotoxicity is dose-limiting (e) Streptomycin
10. The primary reason for the use of drug 14. Once–weekly administration of this
combinations in the treatment of tuberculosis antibiotic has prophylactic activity against
is to bacteremia due to M avium complex in
(a) Ensure patient compliance with the drug AIDS patients.
regimen (a) Azithromycin (b) Clarithromycin
(b) Reduce the incidence of adverse effects (c) Isoniazid (d) Kanamycin
(c) Enhance activity against metabolically (e) Rifabutin
inactive mycobacteria
(d) Delay or prevent the emergence of resistance 15. Which one of the following drugs is most
likely to cause loss of equilibrium and
(e) Provide prophylaxis against other bacterial
auditory damage?
infections
(a) Amikacin
11. The mechanism of high – level INH
(b) Ethambutol
resistance of M tuberculosis is
(c) Isonazid
(a) Formation of drug-inactivating N-acetyltrans-
(d) Para-aminosalicylic acid
ferase
(e) Rifabutin
(b) Reduced expression of the katG gene
(c) Decreased intracellular accumulation of INH 16. Chemical interactions between this drug
(d) Mutation in the inhA gene and cell membrane components can
result in the formation of pores lined by
(e) Change in the pathway of mucolic acid
hydrophilic groups present in the drug
synthesis
molecule.
CHEMOTHERAPY 169

(a) Dactinomycin (b) Griseofluvin (d) Increased activity of host cell phosphodi-
(c) Fluconazole (d) Nystatin esterases that degrade tRNA is one of the
(e) Terbinafine antiviral actions of interferons
(e) Foscarnet has no requirement for activation
17. Which one of the following statements by phosphorylation
about fluconazole is most accurate?
22. Which of the following drugs is most like-
(a) It is highly effective in treatment of aspergillosis ly to cause additive anemia and neutro-
(b) It does not penetrate the blood – brain barrier penia if administered to an AIDS patient
(c) Its oral bioavailability is less than that of taking zidovudine?
ketoconazole (a) Acyclovir (b) Amantadine
(d) It inhibits demethylation of lanosterol (c) Ganciclovir (d) Pentamidine
(e) It is potent inhibitor of hepatic drug– (e) Stavudine
metabolizing enzymes
23. The antiviral actions of this drug include
18. Which one of the following drugs is least inhibition of both RNA and DNA synthe-
likely to be effective in the treatment of sis. The drug is used for the treatment of
esophageal candidiasis, it is used by the severe respiratory syncytial virus infec-
oral route? tions in neonates.
(a) Amphotericin B (b) Clotrimazole (a) Amantadine (b) Amprenavir
(c) Fluconazole (d) Griseofulvin (c) Foscarnet (d) Ribavirin
(e) Ketoconazole (e) Ritonavir
19. Which one of the following statements 24. Regarding interferon alpha, which one
about flucytosine is accurate? of the following statements is least
(a) It is bioactivated by fungal cytosine deaminase accurate?
(b) It does not cross the blood–brain barrier (a) At the start of treatment, most patients
(c) It inhibits cytochrome P450 experience flu-like symptoms
(d) It is useful in esophageal candidiasis (b) Indications include treatment of genital warts
(e) It has a wide spectrum of antifungal activity (c) It is used in the management of hepatitis C
(d) Lamivudine interferes with its activity against
20. Which one of the following drugs is most hepatitis B
appropriate for oral use in vaginal
(e) Toxicity includes bone marrow suppression
candidiasis?
(a) Clotrimazole (b) Griseofluvin 25. Over 90% of this drug is excreted in the
urine in intact form. Because its urinary
(c) Fluconazole (d) Flucytosine
solubility is low, patients should be well
(e) Nystatin hydrated to prevent nephrotoxicity
21. Which one of the following statements (a) Acyclovir (b) Amantadine
about the mechanisms of action of (c) Indinavir (d) Zanamivir
antiviral drugs is least accurate? (e) Zidovudine
(a) The initial step in activation of famciclovir in
26. Used in the prophylaxis and treatment of
HSV-infected cells is its phosphorylation by
infection due to influenza viruses, this drug
viral thymidine kinase
facilitates clumping of mature virions and
(b) The reverse transcriptase of HIV is 30–50 their adhesion to infected cells.
times more sensitive to inhibition by indinavir
than host cell DNA polymerases (a) Amantadine (b) Efavirenz
(c) Gancicolvir inhibits viral DNA polymerase (c) Oseltamivir (d) Rimantadine
but does not cause chain termination (e) Saquinavir
170 MCQs IN PHARMACOLOGY

27. Which statement regarding phase-specific 32. A patient with AIDS has an extremely
chemotherapic agents is correct ? They high viral RNA titer. While blood is being
(a) Are most effective in one phase of the cell drawn from this patient, the syringe is
cycle accidentally dropped, contaminating the
floor, which is made of porous material.
(b) Effective in all phases of the cell cycle
The best way to deal with this is to
(c) Are only effective in G0 phase
(a) Completely replace the contaminated part
(d) Include the alkylating agents
of the floor
(e) Include the antituber antibiotics
(b) Clean the floor with soap and water
28. Infections due to gram–negative bacilli (c) Seal the room and decontaminate with
have occurred when this agent has been ethylene oxide
used as a skin antiseptic (d) Clean the floor with a 10% solution of
(a) Acetic acid household bleach
(b) Benzalkonium chloride (e) Neutralize the spill with a solution of
(c) Hexachlorophene potassium permanganate
(d) Merbromin 33. Certain anaerobic protozoan parasites
(e) Thimerosal lack mitochondria and generate energy–
rich compounds, such as acetyl–CoA, by
29. Which one of the following compounds means of enzymes present in organelles
is used topically to treat scabies and called hydrogenosomes. An important
pediculosis? enzyme involved in this process is
(a) Lindane (a) Cytochrome P450
(b) Mupirocin (b) Glycerol – 3 – phosphate oxidase
(c) Nitrofurazone (c) Hypoxanthine – guanine phosphoribosyltran-
(d) Polymyxin B ferase
(e) Silver sulfadiazine (d) Pyruvate – ferredoxin oxidoreductase
30. Methenamine salts are used as urinary (e) Thymidylate synthase
antiseptics. The reason why they lack
34. Which of the following compounds is a
systemic antibacterial action is that they
good substrate for hypoxanthine–
are
guanine phosphoribosyltransferase in
(a) Not absorbed into the systemic circulation trypanosomes (but not mammals) and is
following oral ingestion eventually converted into metabolites that
(b) Rapidly metabolized by liver drug– metabolizing are incorporated into RNA?
enzymes (a) Allopurinol
(c) Converted to formaldehyde only at low urinary (b) Alpha - difluoromethylornithine
pH (c) Glycerol
(d) Substrates for active tubular secretion (d) Mebendazole
(e) Over 90% bound to plasma proteins (e) Salicylhydroxamic acid
31. Which one of the following antiseptics 35. One chemotherapeutic strategy used to
promotes wound healing? eradicate the blood-stream form of
(a) Cetylpyridium African trypanosomes is based on the
(b) Chlorhexidine absolute dependence of the organism on
(c) Hexachlorophene (a) Cytochrome – dependent electron transfer
(d) Iodine (b) Dihydropteroate synthesis
(e) None of the above (c) Glycolysis
CHEMOTHERAPY 171

(d) Lactate dehydrogenase glucose – 6 – phosphate dehydrogenase

(e) Mitochondrial respiration deficiency.
(a) Chloroquine (b) Clindamycin
36. Which of the following drugs enhances
GABA actions on the neuromuscular (c) Mefloquine (d) Primaquine
junctions of nematodes and arthropods? (e) Quining
(a) Glutamic acid (b) Ivermectin 42. This drug can clear trypanosomes from
(c) Picrotoxin (d) Pyrantel pamoate the blood and lymph nodes and is active
(e) Pyrimethamine in the late CNS stages of African sleeping
sickness.
37. Which of the following drugs is an anti-
(a) Emetine (b) Melarsoprol
metabolite that inhibits a trypanosomal
enzyme involved in putrescine synthesis? (c) NIfurtimox (d) Pentamidine
(a) Alpha - difluoromethylornithine 43. Which one of the following drugs is
(b) Alpha - fluorodeoxyuridine recommended as a single agent for oral
(c) Metronidazole treatment of uncomplicated malaria due
to chloroquine–resistant P falciparum
(d) Polymyxin
strains?
(e) Thiopurinol riboside
(a) Doxycycline (b) Iodoquinol
38. Which one of the following enzymes is (c) Primaquine (d) Proguanil
not unique to parasites?
(e) Quinine
(a) Dihydropteridine pyrophosphokinase
44. A missionary from Chicago is sent to work
(b) Hypoxanthine–guanine phosphoribosyltrans-
in a geographic region of a Cental Ameri-
ferase
can country wher onchocerca volvulus is
(c) Lanosterol demethylase endemic. Infections due to this tissue
(d) Purine nucleoside phosphotransferase nematode (onchocerciasis) are a major
(e) Trypanothione reductase cause of “river blindness”, since microfi-
lariae migrate through subcutaneous tis-
39. Which of the following antimalarial drugs sues and concentrate in the eyes. Which
causes a dose–dependent toxic state that
one of the following durgs can be used
includes flushed and sweaty skin,
prophylactically to prevent onchocercia-
dizziness, nausea, diarrhea, tinnitus,
sis?
blurred vision, and impaired hearing?
(a) Bithionol (b) Ivermectin
(a) Amodiaquine (b) Primaquine
(c) Niclosamide (d) Oxamniquine
(c) Pyrimethamine (d) Quinine
(e) Suramin
(e) Sulfadoxine
45. In a patient with diffuse lymphoma, the
40. Plasmodial resistance to chloroquine is oncologist suggests a treatment strategy
due to that involves the initial administration of
(a) Change in receptor structure doxorubicin to obtain a significant log–
(b) Decreased carrier–mediated drug transport kill, followed by the cell cycle–specific
(c) Increase in the activity of DNA repair drugs cytarabine and vincristine. This
mechanisms therapeutic strategy is called
(d) Induction of inactivating enzymes (a) Pulse therapy
(e) Inhibition of dihydrofolate reductase (b) Recruitment
(c) Rescue therapy
41. This drug is the antimalarial agent most
commonly associated with causing an (d) Sequential blockade
acute hemolytic reaction in patients with (e) Synchrony
172 MCQs IN PHARMACOLOGY

46. Which one of the following statements (a) B lymphocyte

about the mechanisms of action of drugs (b) Cytotoxic T lymphocyte
used in cancer chemotherapy is least (c) Dendritic cell
accurate?
(d) Macrophage
(a) Alkylatine agents commonly attack the
(e) TH lymphocyte
nucleophilic N-7 position in guanine
(b) Anthracyclines intercalate with base pairs to 51. Cyclosporine is effective in organ trans-
block nucleic acid synthesis plantation. The immunosuppressant
(c) In steady doses, leuprolide inhibits the release action of the drug appears to be due to
of pituitary gonadotropins (a) Activation of natural killer (NK) cells
(d) Mercaptopurine is an irreversible inhibitor (b) Blockade of tissue responses to inflammatory
of HGPRT ase mediators
(e) Paclitaxel acts mainly in the M phase of the (c) Increased catabolism of IgG antibodies
cell cycle (d) Inhibition of the gene transcription of
47. Which of the following agents used in interleukins
drug combination regimens to treat (e) Interference with antigen recognition
testicular carcinoma is mot likely to cause
52. Azathiprone
nephrotoxicity?
(a) Binds avidly to a cytoplasmic immunophillin
(a) Bleomycin (b) Cisplatin
(b) Blocks formation of tetrahydrofolic acid
(c) Etoposide (d) Leuprolide
(c) Is a precursor of cytarabine
(e) Vinblastine
(d) Is markedly hematotoxic and has caused
48. Which one of the following is least likely neoplasms
to be a mechanism of cancer cell resistance
(e) Is a metabolite of mercaptopurine
to antineoplastic drugs?
(a) Change in properties of a target enzyme 53. Body Surface Area (BSA) is used in
calculating chemotherapy doses because
(b) Decreased activity of activating enzymes
(c) Increase in drug–metabolizing cytochrome (a) BSA is an indicator of tumor cell mass
P450 (b) BSA correlates with cardiac output
(d) Increase in DNA repair (c) BSA correlates with gastrointestinal transit
(e) Increase in production of drug–trapping time
molecules (d) the National Cancer Institute requires that
BSA be used
49. All of the following agents have been
(e) the Food and Drug Administration requires
used in drug regimens for the treatment
that BSA be used
of breast carcinoma. Which one has
specific activity in a subset of female 54. Which one of the following agents acts
breast cancers? at the step of antigen recognition?
(a) Anastrozole (b) Doxorubicin (a) Cyclosporine
(c) Fluoxymesterone (d) Methotrexate (b) Cyclophosphamide
(e) Trastuzumab (c) Methotrexate
50. Which cell involved in immune function (d) Rho(D)immune globulin
recognizes foreign peptides bound of (e) Tacrolimus
MHC class II molecules on the surface of
APC cells, secretes interleukin-2, and 55. Tumor necrosis factor - α - appears to play
initiates the cell-mediated immunity an important role in autoimmunity and
reaction responsible for host-versus-graft inflammatory diseases. Which of the
reactions? following is a humanized monoclonal
CHEMOTHERAPY 173

antibody that binds to TNF - a and inhibits 60. Which of the following drugs or drug
its action? groups is not useful in the prevention of
nausea and vomiting included by cancer
(a) Etanercept
chemotherapy ?
(b) Infliximab
(a) Dexamethasone (b) Dronabinol
(c) Muromonab – CD3
(c) Ketaserin (d) Ondansetron
(d) Sirolimus
(e) Phenothiazines
(e) Thalidomide
61. Passive immunization involves
56. Which one of the following agents is able
(a) Live immunogens
to suppress both B and T lymphocytes via
its inhibition of de novo synthesis of (b) Polysaccharide vaccines
purines? (c) Stimulation of antibody formation
(a) Cyclophosphamide (d) Use of antigens
(e) Use of preformed antibodies
(b) Methotrexate
(c) Mycophenolate mofetil 62. A businessman intends to travel abroad
(d) Prednisone in a geographical region where several
diseases are endemic. He would not be
(e) Tacrolimus
able to be vaccinated against
57. Which one of the following agents increases (a) Cholera
phagocytosis by macrophages in patients (b) Malaria
with chronic granulomatous disease?
(c) Meningococcal infection
(a) Aldesleukin (d) Typhoid fever
(b) Interferon - γ (e) Yellow fever
(c) Lymphocyte immune globulin
63. Which of the following is used in active
(d) Prednisone immunization of children and combines
(e) Trastuzumab bacterial toxoids with a bacterial
antigen?
58. A young woman employed as a dental
laboratory technician complains of (a) BCG (b) BSA
conjunctivitis, skin irritation, and hair loss. (c) DTP (d) ISG
On examination, she has perforation of (e) Rho(D)
the nasal septum and a “milk and roses”
64. Which of the following is a polysaccharide
complexion. These signs and symptoms
used for active immunization in patients
are most likely to be due to
with chronic cardiorespiratory ailments?
(a) Acute mercury poisoning (a) Antilymphocyte immune serum
(b) Chronic inorganic arsenic poisoning (b) BCG vaccine
(c) Chronic mercury poisoning (c) Mumps virus vaccine
(d) Excessive use of supplementary iron tablets (d) Pertussis immune globulin
(e) Lead poisoning (e) Pneumococcal vaccine
59. In the treatment of acute inorganic ar- 65. A needlestick injury is sustained by a
senic poisoning, the most likely drug to health care worker, and the blood is
be used is known to contain HBV surface antigens.
(a) Deferoxamine (b) Dimercaprol The health care worker should be given
(c) EDTA (d) Penicillamine (a) Nothing
(e) Succimer (b) Immune globulin
(c) Hepatitis B immune globulin
174 MCQs IN PHARMACOLOGY

(d) Hepatitis B vaccine 71. This agent, which is used in the chemo-
(e) Hepatitis B vaccine and hepatitis B immune therapy of Hodgkin’s lymphoma, is po-
globulin tentially leukemogenic
66. Which one of the following compounds (a) Dacarbazine (b) Doxorubicin
enhances immune function in vitro and (c) Prednisone (d) Procarbazine
in clinical trials decreases the symptoms (e) Vinblastine
of the common cold?
(a) Echinacea 72. A 54-year-old farmer has a 5-year
history of frequent, recurrent, and very
(b) Feverfew
painful kidney stones. Appropriate
(c) Garlic
chronic therapy for this man is
(d) Melatonin
(a) Furosemide
(e) Milk Thistle
(b) Hydrochlorothiazide
67. An important therapeutic or toxic effect
(c) Morphine
of loop diuretics is
(d) Spironolactone
(a) Decreased blood volume
(e) Triamterene
(b) Decreased heart rate
(c) Increased serum sodium 73. A 55-year-old executive has cardiomy-
(d) Increased total body potassium opathy and congestive heart failure. He
(e) Metabolic acidosis is being treated with diuretics. The mech-
anism of action of furosemide is best de-
68. The most appropriate drug for reversing scribed as
myasthenic crisis in a patient who is
experiencing diplopia, dysarthria, and (a) Interference with H+/HCO3 exchange
difficulty swallowing is (b) Blockade of a Na+/K+/2Cl- transporter
(a) Neostigmine (b) Pilocarpine (c) Blockade of a Na+/Cl- cotransporter
(c) Pralidoxime (d) Succinylcholine (d) Blockade of carbonic anhydrase
(e) Tubocurarine (e) Inhibition of genetic expression of DNA in
the kidney
69. In the management of patients with AIDS,
the sulfonamides are often used in 74. Which one of the following peptides is
combination with inhibitors of folate not a vasodilator?
reductase. However, such combinations
(a) Atrial natriuretic factor (ANF)
have minimal activity against
(b) Calcitonin gene-related peptide
(a) Escherichia coli
(c) Endothelin
(b) Nocardia species
(d) Substance P
(c) Pneumocystis carinii
(e) Vasoactive intestinal peptide
(d) Toxoplasma gondi
(e) Treponema pallidum 75. A young female patient using an oral
contraceptive is to be treated for pulmo-
70. Chemoprophylaxis for travelers to
geographic regions where chloroquine– nary tuberculosis. She is advised to use
resistant P falciparum is endemic is best an additional method of contraception
provided by since the efficacy of the oral agents is
commonly decreased if her drug regimen
(a) Atovaquone
includes
(b) Mefloquine
(a) Amikacin (b) Ethambutol
(c) Primaquine
(d) Pyrimethamine plus sulfadoxine (c) Isoniazid (d) Pyrazinamide
(e) Quinine (e) Rifampin
CHEMOTHERAPY 175

76. Which one of the following drugs is most (c) Increased likelihood of causing exophthalmo
likely to be effective in the treatment of during the first week of treatment
gonorrhea in this patient and safe to use? (d) Increased risk of fetal toxicity
(a) Amoxicillin - clavulanate (e) More sustained antithyroid activity when used
(b) Ceftriaxone continuously for several months
(c) Clarithromycin 82. In antiviral immunity, what directly
(d) Ofloxacin recognized and kills viral-infected cells?
(e) Tetracycline (a) Cytotoxic T cells (CTLs)
77. The rationale for combination chemother- (b) Antiviral antibodies
apy includes all of the following except (c) Interferons
(a) Biochemical enhancement of effect 83. An organ donor who is human leukocyte
(b) rescue of normal cells antigen (HLA)- matched with the recipient
(c) overcoming or preventing resistance of a graft is sought. Which individual is
(d) biochemical nullification of effect at least somewhat likely to provide a total
HLA match?
(e) cytotoxic to both resting and dividing cells
(a) A sibling of the graft recipient
78. This compound reduces the need for
(b) A parent of the graft recipient
platelet transfusions in patients undergoing
cancer chemotherapy (c) A cadaver

(a) Cyanocobalamin 84. Graft–versus–host (GVH) disease is

(b) Erythropoietin associated primarily with which type of
transplantation?
(c) Interleukin - II
(d) Iron dextran (a) Kidney
(e) Tranexamic acid (b) Heart
(c) Bone marrow
79. Which one of the following anticancer
drugs acts in the M-phase of the cell cycle 85. Which is a valid comparison of live, at-
to prevent disassembly of the mitotic tenuated and killed, inactivated active
spindle? vaccines?
(a) Dactinomycin (b) Etoposide (a) Replication of the organisms in a live,
(c) Paclitaxel (d) Procarbazine attenuated vaccine increases the stimulation
of the immune system, and a lower dose is
(e) Vinblastine
often required
80. While colchicines has been used in acute (b) Attenuated vaccines often require multiple
gout, the drug often causes severe doses
gastrointestinal distress. Consequently, (c) A killed, inactivated vaccine probably
many authorities now consider that the produces life-long immunity in one or two
drug of choice for acute gout is doses
(a) Acetaminophen (b) Aspirin
86. Which type of cell does not contain double
(c) Indomethacin (d) methotrexate standard deoxyribonucleic acid (DNA)?
(e) Sulfinpyrazone
(a) Human cells
81. Relative to Lugol’s solution propylthou- (b) Bacteria cells
racil has (c) Human immunodeficiency virus (HIV)
(a) A faster onset of antithyroid action cells
(b) A greater inhibitory effect on the proteolytic 87. Which enzyme is used by the Human
release of hormones from the thyroid gland Immunodeficiency Virus (HIV) to form
176 MCQs IN PHARMACOLOGY

deoxyribonucleic acid (DNA) in the host (b) Adenine (c) Guanine

cell? (d) Thymine (e) All of the above
(a) Restrictive endonuclease
94. Which of the following statements
(b) DNA-directed polymerase regarding signal transduction is incorrect?
(c) Reverse transcriptase
(a) Thyroxine-bound receptors act on DNA and
(d) Both (a) and (b) regulate specific transcription of genes.
(e) None of the above (b) Cyclic adenosine monophosphate can act
88. Gamma immunoglobulin is considered as second messenger.
(c) The level of drug receptors at the cell surface
(a) Deoxyribonucleic acid (DNA)
increases with chronic stimulation by receptor
(b) Ribonucleic acid (RNA) agonists
(c) Protein (d) Binding of ligand to cell-surface receptors
(d) None of the above can lead to synthesis of proteins
89. Glycoprotein is considered a protein linked (e) Antacids act by interacting with small ions
to normally found in the gastrointestinal tract.
(a) A carbohydrate 95. All of the following chemotherapy agents
(b) A hormone can be administered intrathecally except
(c) A lipid (a) Methotrexate (b) Cytrabine
(d) A deoxyribonucleic acid (DNA) (c) Hydrocortisone (d) Thiotepa
(e) None of the above (e) Vincristine

90. An enzyme that cleaves deoxyribonucleic 96. The efficacy rates for nonprescription
acid (DNA) at a specific site is called antifungal agents for vaginal yeast
(a) Restrictive endonuclease infections is
(b) Restrictive ribonuclease (a) 50% (b) 60%
(c) Trypsin (c) 70% (d) 80%
(d) None of the above 97. The best product to treat vulvar pruritus
91. An example of a cytokine is in a woman with a vaginal yeast infection
is
(a) Interleukin
(a) External miconazole (Monistat)
(b) Insulin
(b) External miconazole and intravaginal
(c) Gonadotropin
miconazole (Monistat-7 combination pack)
(d) Thyroxine
(c) Intravaginal tioconazole (Vagistat 1)
(e) None of the above
(d) Intravaginal butoconazole (Femstat 3)
92. A common storage condition for most
98. Which of the following patients complain-
biotechnology products after reconstitution
ing of vaginal yeast infection symptoms
is
should be referred to a physician?
(a) Room temperature
(a) If there is a history of recurrent vaginal yeast
(b) Cool place infection
(c) Warm place (b) If she is pregnant
(d) No excessive heat (c) If she is less than age 12
(e) Freezer (d) All of the above
93. What base is found in deoxyribonucleic 99. Which of the following herbs is known
acid (DNA)? to cause cancer?
(a) Cytosine
CHEMOTHERAPY 177

(a) Chaparral (b) Comfrey 104. Cisapride should not be used in combination
(c) Ma huang (d) Licorice with either fluconazole or indinavir because
(e) St. John’s wort of increased potential for

100. Which of the following herbs should be (a) Atrial fibrillation

used with caution while driving or (b) Atrial flutter
performing other tasks that require (c) Ventricular fibrillation
alertness and coordination? (d) Torsades de pointes
(a) Valerian (b) Echinacea (e) Angina pectoris
(c) Dong quai (d) Feverfew
105. Which statement reageding phase-
(e) Saw palmetto
specific chemotherapeutic agents is
101. Tom would like to try Echinacea to correct? They
prevent colds and flus during the winter
(a) Are most effective in one phase of the cell
months. Which of the following
cycle
statements is true about Echinacea?
(b) Are effective in all phases of the cell cycle
(a) It is contraindicated in patients allergic to
(c) Are only effective in G0 phase
parsley
(b) It should only be taken continuously for three (d) Include the alkylating agents
months (e) Include the antitumor antibiotics
(c) It is contraindicated in patients with lupus 106. Body surface area (BSA) is used in calcu-
and leucosis
lating chemotherapy doses because
(d) Prolonged use of Echinacea will upregulate
the immune system (a) BSA is an indicator of tumor cell mass
(e) Side effects include headache, rash, and (b) BSA correlates with cardiac output
dizziness (c) BSA correlates with gastrointestinal transit
time
102. Hematological testing of a patient with
acquired immune deficiency syndrome (d) The National Cancer Institute requires that
(AIDS) is most likely to show which of the BSA be used
following abnormalities? (e) The Food and Drug Administration (FDA)
(a) Basophilia (b) Eosinophilia requires that BSA be used
(c) Lymphopenia (d) Reticulocytosis 107. The rationale for combination chemother-
(e) Agranulocytosis apy includes all of the following except
103. Hematological studies are most likely to (a) Biochemical enhancement of effect
show a low reticulocyte count in a patient (b) Rescue of normal cells
who has which one of the following (c) Overcoming or preventing resistance
abnormalities ?
(d) Biochemical nullification of effect
(a) Aplastic anemia secondary to cance (e) Cytotoxic to both resting and dividing cells
chemotherapy
(b) Acute hemolytic anemia secondary to 108. Which of the following chemotherapeutic
quinidine treatment agents is classified as an alkylating agent?
(c) Severe bleeding secondary to an automobile (a) Cyclophosphamide
accident (b) Etoposide
(d) Iron deficiency anemia 1 week after
(c) Mechlorethamine
treatment with ferrous sulfate
(d) Paclitaxel
(e) Megaloblastic anemia due to folate
deficiency 1 week after treatment with folic (e) Cyclophosphamide and mechlorethamine
acid
178 MCQs IN PHARMACOLOGY

109. Which of the following chemotherapy (a) Ovarian carcinoma

agents acts by intercalation? (b) Psoriasis
(a) Vincristine (c) Breast carcinoma
(b) Paclitaxel (d) Melanoma
(c) Doxorubicin (e) Hodgkin’s disease
(d) Vincristine and paclitaxel 115. The principal active alkaloid of ipecac is
(e) Topotecan
(a) Yohimbine (b) Caffeine
110. How do antimetabolites exert their (c) Apomorphine (d) Lobeline
cytotoxic effect? (e) Emetine
(a) Inhibiting DNA synthesis by sliding between 116. Emetine is used in the treatment of
DNA base pairs
(a) Malalria (b) Schistosomiasis
(b) Inhibiting RNA synthesis by sliding between
RNA base pairs (c) Tuberculosis (d) Amebiasis
(c) Acting as false metabolites in the (e) None of the above
microtubules 117. The therapeutic use of neostigmine
(d) Acting as false substitutions in the production bromide is as a
of nucleic acids (a) Miotic
(e) Promoting microtubule assembly and (b) CNS depressant
stabilization
(c) Treatment of curare poisoning
111. Which of the following chemotherapy (d) Neuromuscular blocker
agents are correctly paired according to (e) Muscle relaxant
their mechanism of action?
118. Ethylenediamine-tetracetic acid is an
(a) Vincristine and paclitaxel antidote for which of the following?
(b) Etoposide and paclitaxel
(a) Sodium secobarbital
(c) Docetaxel and paclitaxel
(b) Aspirin
(d) Docetaxel and etoposide
(c) Paris green
(e) Vincristine and etoposide
(d) Phosphorus
112. When does not neutrophil nadir associated (e) Lead
with chemotherapy agents generally
119. Which of the following chemotherapeutic
occur?
agents is classified as an alkylating
(a) During administration of the chemotherapy agent?
(b) 1–2 days after therapy (a) Cyclophosphamide
(c) 10–14 days after therapy (b) Etoposide
(d) 1 month after therapy (c) Mechlorethamine
(e) When the platelet count begins to rise (d) Paclitaxel
113. N-acetylcysteine is classified as a (an) (e) Cyclophosphamide and mechlorethamine
(a) Analgesic 120. Which of the following is a gametocidal
(b) Antitussive agent in malaria?
(c) Mucolytic agent (a) Atabrine (b) Quinine
(d) Antitubercular agent (c) Paludrine (d) Primaquine
(e) Protein hydrolysate (e) Aralen

114. Procarbazine (Matulane) is used primarily 121. Which of the following is contraindicated
to treat in the presence of active tuberculosis?
CHEMOTHERAPY 179

(a) Hydrocortisone (b) Streptomycin (a) Irritable bowel syndrome

(c) INH (d) PAS (b) Cholera
(e) PABA (c) Salmonella diarrhoeas
122. A drug that is very effective in the (d) Traveller’s diarrhoea
treatment of tinea versicolor is 129. The therapeutic effect of sulfasalazine in
(a) Undecylenic acid ulcerative colitis is exerted by
(b) Clotrimazole (Lotrimin) (a) Inhibitory action of the unabsorbed drug on
(c) Acrisorcin (Akrinol) the abnormal colonic flora
(d) Penicillin G (b) Breakdown of the drug in colon to release
(e) Prednisolone 5-aminosalicylic acid which suppresses
inflammation locally
123. Which of the following is a first-line drug
to treat tuberculosis? (c) Release of sulfapyridine having antibacterial
property
(a) PAS (b) Rifampin
(d) Systemic immunomodulatory action of the
(c) Ethionamide (d) Cycloserine drug
(e) Ethambutol
130. The preferred drug for controlling an
124. Yellow pigmentation of the skin is most acute exacerbation of ulcerative colitis is
common with
(a) Prednisolone (b) Sulfasalazine
(a) Chloraquine (b) Pamaquin
(c) Mesalazine (d) Vancomycin
(c) Quinacrine (d) Quinine
(e) Atabrine 131. To be effective in ulcerative colitis, 5-
aminosalicylic acid has to be given as
125. The most effective single chemotherapeutic
(a) Acrylic polymer coated tablet which releases
agent of those indicated, in the treatement
of tuberculosis is the drug only in the lower bowel
(b) A complex of two molecules joined together
(a) Neomycin (b) Sulfones
by azo bond
(c) Streptomycin (d) Penicillin
(c) A retention enema
(e) Terramycin
(d) All of the above
126. Which is an antidote for malathion
poisoning? 132. A small amount of atropine is added to
the diphenoxylate tablet/syrup to
(a) Vitamin K
(a) Suppress associated vomiting of gastroenteritis
(b) Protamine sulfate
(b) Augment the antimotility action of diphen-
(c) Nalorphine (Nalline)
oxylate
(d) Pralidoxine (Protopam)
(c) Block side effects of diphenoxylate
(e) Edrophonium (Tensilon)
(d) Discourage overdose and abuse of
127. Antimicrobial treatment does not alter the diphenoxylate
course of the following diarrhoeas except
133. Select the sulfonamide drug which is
(a) Mild enterotoxigenic E.coli diarrhoea active against pseudomonas and is used
(b) Campylobacter diarrhoea by topical application for prophylaxis of
(c) Coeliac disease diarrhoea infection in burn cases
(d) Food poisoning diarrhoea (a) Sulfadiazine
128. Which of the following diarrhoeas is (b) Silver sulfadiazine
consistently benefited by antimicrobial (c) Sulfadoxine
therapy (d) Sulfamethoxazole
180 MCQs IN PHARMACOLOGY

134. The drug of choice for prophylaxis of 140. Indicate the drug which attain therapeutic
meningococcal meningitis during an antibacterial concentration in the urinary
epidemic is tract but not in other tissues
(a) Phenoxymethyl penicillin (a) Sulfasomidine (b) Piperacillin
(b) Tetracycline (c) Nitrofurantoin (d) Both (b) and (c)
(c) Rifampin
141. Acidic urine augments the antibacterial
(d) Ciprofloxacin action of the following drug
135. Trimethoprim inhibits bacteria without (a) Sulfadiazine (b) Cotrimoxazole
affecting mammalian cells because (c) Gentamicin (d) Nitrofurantoin
(a) It does not penetrate mammalian cells
142. Which of the following is not a first line
(b) It has high affinity for bacterial but low affinity
antitubercular drug ?
for mammalian dihydrofolate reductase
enzyme (a) Ciprofloxacin (b) Streptomycin
(c) It inhibits bacterial folate synthetase as well (c) Pyrazinamide (d) Ethambutol
as dihydrofolate reductase enzymes
143. The intermittently multiplying (spurter)
(d) All of the above tubercle bacilli present within caseous
136. Trimethoprim is combined with sulf- material having low oxygen tension are
amethoxazole in a ration of 1:5 to yield most susceptible to
a steady state plasma concentration ratio (a) Ethambutol (b) Rifampin
of (c) Streptomycin (d) Pyrazinamide
(a) Trimethoprin 1:Sulfamethoxazole 5
144. Occurrence of the following adverse
(b) Trimethoprin 1:Sulfamethoxazole 10 reaction absolutely contraindicates
(c) Trimethoprin 1:Sulfamethoxazole 20 further use of rifampin in the treatment
(d) Trimethoprin 1:Sulfamethoxazole 1 of tuberculosis
137. Indicate the condition in which neither (a) Respiratory syndrome
trimethoprim nor sulfamethoxazole alone (b) Cutaneous syndrome
are effective, but their combination (c) Flu syndrome
cotrimoxazole is (d) Abdominal syndrome
(a) Prostatitis
145. Which of the following chemotherapy
(b) Lymphogranuloma venereum
agents acts by intercalation?
(c) Pneumocystis carinii pneumonia
(a) Vincristine
(d) Bacillary dysentery
(b) Paclitaxel
138. Select the antimicrobial drug which is (c) Doxorubicin
used orally only for urinary tract infection
(d) Vincristine and paclitaxel
for bacterial diarrhoeas
(e) Topotecan
(a) Pefloxacin
(b) Azithromycin 146. Ethambutol is not used in children below
6 years of age because
(c) Bacampicillin
(d) Nalidixic acid (a) Young children are intolerant to ethambutol
(b) Ethambutol causes growth retardation in
139. Nalidixic acid is primarily active against
young children
(a) Cocci (c) It is difficult to detect ethambutol induced
(b) Bacilli visual impairment in young children
(c) Gram-positive bacteria (d) In young children visual toxicity of ethambutol
(d) Gram-negative bacteria is irreversible
CHEMOTHERAPY 181

147. In a patient of pulmonary tuberculosis, (d) Isoniazid + Rifampin for 6 months with
pyrazinamide is most active on the additional Pyrazinamide during the initial 2
following subpopulation of tubercle bacilli months
(a) Rapidly multiplying bacilli located on cavity
152. Corticosteroids are absolutely contrain-
walls
dicated in which of the following types
(b) Slow growing bacilli within macrophages
of tuberculosis
and at sites showing inflammatory response
(c) Intermittently multiplying bacilli within (a) Miliary (b) Meningeal
caseous material (c) Intestinal (d) Renal
(d) Dormant bacilli
153. Multi Drug Resistant (MDR) tuberculosis
148. The most important reason for using a is defined as resistance to
combination of chemotherapeutic agents
(a) Any two or more antitubercular drugs
in the treatment of tuberculosis is
(b) Isoniazid + any other antitubercular drug
(a) To obtain bactericidl effect
(c) Isoniazid + Rifampin ± any one or more
(b) To prevent developmet of resistance to the
antitubercular drugs
drugs
(c) To broaden the spectrum of activity (d) All five first line antitubercular drugs
(d) To reduce adverse effects of the drugs 154. Mycobat tuberculosis infection in a HI V
infected patient is treated with
149. Addition of pyrazinamide and ethambutol
for the first two months to the isoniazid + (a) The same antitubercular regimen as HIV
rifampin therapy of tuberculosis serves the negative patient
following purpose(s) (b) Four first line antitubercular drugs for 2
(a) Reduces the total duration of therapy to 6 months followed by a longer continuation
months phase of 7 months with rifampin + isoniazid
(b) Produces more rapid sputum conversion (c) All five first line antitubercular drugs for nine
(c) Permits reduction of rifampin dose months
(d) Both (a) and (b) (d) Clarithromycin + Ciprofloxacin + Rifabutin
150. What is true of short course DOTS(WHO) for 12 months
stategy for treatment of tuberculosis ? 155. The most important dose dependent
(a) It consists of an initial intensive phase and a toxicity of dapsone is
later continuation phase
(a) Methemoglobinemia
(b) The dose of antitubercular drugs is reduced
(b) Haemolysis
after clinical response occurs
(c) The patient himself is made responsible for (c) Hepatitis
administering antitubercular drugs (d) Dermatitis
(d) All of the above 156. The tetracycline with highest antileprotic
151. According to the currect WHO guidelines activity is
new (untreated) sputum smear positive (a) Minocylcine (b) Docycycline
cases of pulmonary tuberculosis are to
be treated with the following regimen (c) Methacycline (d) Oxytetracycline

(a) Isoniazid + Rifampin + Pyrazinamide for 6 157. Multidrug therapy with dapsone,
months rifampin and clofazimine is the treatment
(b) Isoniazid + Thiacetazone + Rifampin for 2 of choice of
months followed by isoniazid + thiacetazone (a) Multibacillary leprosy
for 6 months
(b) Paucibacillary leprosy
(c) Isoniazid + Rifampin for 6 months with
additional Pyrazinamide + Ethambutol/ (c) Dapsone resistant leprosy
Streptomycin during the initial 2 months (d) All forms of leprosy
182 MCQs IN PHARMACOLOGY

158. The newer lipid formulations of amphot- (c) Varicella-zoster virus

ericin B differ from the conventional for- (d) Epstein–Barr virus
mulation in the following respects except
166. Which of the following is true of acyclovir
(a) They are more efficacious
treatment of genital herpes simplex ?
(b) They produce milder acute reaction
(a) Topical treatment affords symptomatic relief
(c) They are less nephrotoxic
in primary as well as recurrent disease
(d) They produce milder anaemia
(b) Oral therapy for 10 days affords symptomatic
159. The drug of choice for monilial diarrhoea relief as well as prevents recurrences
is (c) Oral therapy for 10 days affords symptomatic
(a) Flucytosine (b) Nystatin relief but does not prevent recurrences
(c) Natamycin (d) Ketoconazole (d) Continuous long-term topical therapy is
recommended to prevent recurrences
160. Griseofulvin is indicated in.
(a) All types of tinea infection 167. The virus directed reverse transcriptase
enzyme is inhibited by
(b) Onychomycosis
(c) Pityriasis versicolor (a) Amantadine (b) Zidovudine
(d) Both (b) and (c) (c) Vidarabine (d) Acyclovir

161. Choose the azole antifungal drug which 168. How do antimetabolites exert their cytotoxic
is used only topically effect?

(a) Ketoconazole (b) Fluconazole (a) Inhibiting DNA synthesis by sliding between
(c) Itraconazole (d) Econazole DNA base pairs
(b) Inhibiting RNA synthesis by sliding between
162. Fluconazole differs from ketoconazole in RNA base pairs
that
(c) Acting as false metabolites in the microtubules
(a) It is not active by the oral route (d) Acting as false substitutions in the production
(b) It is a more potent inhibitor of drug metabolizm of nucleic acids
(c) It is not effective in cryptococcal meningitis (e) Promoting microtubule assembly and
(d) It is unlikely to produce anti-androgenic side stabilization
effects
169. Antiretroviral therapy is not recommend-
163. The only antifungal drug which has some ed in asymptomatic HIV infected subjects
activity against moulds like Mucor and because of the following reason(s).
Aspergillus is
(a) All antiretroviral drugs lose efficacy after
(a) Itraconazole (b) Fluconazole some time
(c) Miconazole (d) Ketoconazole (b) Adverse effects of antiretroviral drugs
164. Iodoxuridine is indicated in compromise the quality of life of
asymptomatic subjects
(a) Herpes simplex keratitis
(c) The treated subjects may produce and
(b) Herpes zoster transmit drug resistant virus
(c) Chicken pox (d) All of the above
(d) All of the above
170. Choose the correct statement about aman-
165. Which of the following viruses is most tadine
susceptible to acyclovir ?
(a) It is an antimetabolite used for viral infections
(a) Herpes simplex type I virus
(b) It prevents penetration of the virus into the
(b) Herpes simplex type II virus host cell
CHEMOTHERAPY 183

(c) Concurrent administration of amantadine (b) Residents of endemic areas

prevents antibody response to influenzavaccine (c) Travellers from nonendemic to endemic areas
(d) It is used to protect high risk subjects during (d) Travellers from endemic to nonendemic areas
an influenza A2 epidemic
177. Radical cure of vivax malaria should be
171. The antiviral action of amantadine is attempted in
exerted through
(a) Areas where only sporadic cases occur
(a) Interaction with a virus directed thymidine (b) Endemic areas with effective vector control
kinase measures
(b) Interaction with a viral M2 protein (c) Endemic areas not covered by vector control
(c) Inhibition of a viral protease enzyme (d) Both (a) and (b)
(d) Inhibition of viral RNA mediated DNA
synthesis 178. Chloroquine acts as
(a) Preerythrocytic schizontocide for both P.
172. Erythrocytic schizontocide antimalarial
falciparum and P. vivax
drugs are used as
` (b) Erythrocytic schizontocide for both P.
(a) Suppressive prophylactic falciparum and P. vivax
(b) Clinical curative (c) Exoerythrocytic schizontocide for P. vivax
(c) Radical curative for P. Vivax (d) Gametocidal for P. falciparum
(d) Both (a) and (b)
179. Which of the following drugs is suitable
173. Which of the following drugs is a causal for treatment of malaria during pregnancy
prophylactic for falciparum malaria and
(a) Quinine
suppressive prophylactic for vivax malaria
(b) Chloroquine
(a) Chloroquine (b) Mepacrine
(c) Pyrimethamine
(c) Quinine (d) Chloroguanide
(d) Primaquine
174. Recrudescence of malaria refers to
180. Amodiaquine differs from chloroquine in
recurrence of malarial fever due to
the following respect(s)
(a) Reinfection of the patient by mosquito bite
(a) It is currently not recommended for treatment
(b) Reinfection of blood by exoerythrocytic of clinical attacks of malaria
hyponozoites
(b) Its used as a suppressive prophylactic is
(c) Incomplete clearance of schizonts from blood prohibited
(d) Reinfection of blood by sporozoites (c) It is less bitter and causes less itching
175. If a drug is active against the preeryth- (d) Both (b) and (c)
rocytic stage of the malarial parasite it
181. Choose the correct statement about me-
will be useful as a
floquine
(a) Suppressive prophylactic
(a) In a single dose it affords clinical cure in all
(b) Causal prophylactic types of malaria
(c) Clinical curative (b) It is selectively active against chloroquine
(d) Radical curative resistant P. falciparum but not the chloroquine
sensitive Strains
176. Chemoprophylaxis of malaria is recom-
mended for the following category of (c) It is recommended only in areas where
subjects chloroquine resistant P.falciparum is prevalent
(d) Both (a) and (c)
(a) Residents of nonedemic areas
184 MCQs IN PHARMACOLOGY

182. The drug of choice for cerebral malaria (a) Pyrimethamine (b) Artemisinin
due to P. falciparum is (c) Primaquine (d) Mefloquine
(a) Quinine
189. All of the following chemotherapy agents
(b) Mefloquine work through affecting microtubule
(c) Chloroguanide function except
(d) Pyrimethamine + Sulfadoxine (a) Docotaxel (b) Vinblastine
183. Intravenous injection of quinine produces (c) Mitoxantrone (d) Vincristine
(a) Rise in blood pressure (e) Vinorelbine
(b) Neuromuscular block 190. Choose the correct statement(s) about
(c) Hyperglycaemia metronidazole
(d) Hypoglycaemia (a) It is a drug of choice for amoebic dysentery
184. The following is true of quinine as well as amoebic liver abscess
(b) It affords the most rapid symptom relief in
(a) It has a longer elimination half-life than
amoebi dysentery
chloroquine
(c) It is the most effective drug in eradicating
(b) It is not to be used for prophylaxis of malaria
amoebic cysts from the colon
(c) It is not active against P. vivax
(d) All of the above
(d) It should not be used along with sulfapy-
rimethamine 191. Metronidazole is used for
185. The fastest acting schizontocidal drug (a) Round worm infestation
among the following is (b) Hook worm infestation
(a) Artemether (c) Kala-azar
(b) Melfoquine (d) Giardiasis
(c) Chloroquine 192. In addition to having antiamoebic activity,
(d) Pyrimethamine tinidazole inhibits
186. Pyrimethamine + sulfadoxine should be (a) Anaerobic bacillin
used as a (b) Aerobic bacilli
(a) Clinical curative in areas with chloroquine (c) Gram-positive cocci
resistance (d) Gram-negative cocci
(b) Clinical curative in areas without chloroquine
193. Tinidazole differs from metronidazole in
resistance
that
(c) Prophylactic in areas with or without
chloroquine resistance (a) It is not active against anaerobic bacteria
(d) All of the above (b) It has a broader spectrum of activity
(c) It has a longer elimination half life
187. Which of the following antimalarial drugs
(d) It has better oral absorption
is more active against pre-and exoeryth-
rocytic stages of the malarial parasite 194. Emetine is now used only as a reserve
than against the erythrocytic stage ? drug for amoebiasis because
(a) Chloroguanide (b) Primaquine (a) It is less effective than metronidazole
(c) Pyrimethamine (d) Quinine (b) It produces a slower response than
metronidazole
188. Use of the following antimalarial drug
carrys high risk of adverse effect in (c) It has cardiotoxic potential
subjects with G-6-PD deficiency. (d) It does not clear stools of amoebic cysts
CHEMOTHERAPY 185

195. Choose the most effective drug for mild 202. Albendazole is less effective than
intestinal amoebiasis and asymptomatic mebendazole in the following helminthic
cyst passers infestation
(a) Metronidazole (b) Emetine (a) Hydatid disease (b) Trichuriasis
(c) Quiniodochlor (d) Diloxanide furoate (c) Strongyloidosis (d) Ascariasis
196. The following antiamoebic drug should 203. The following helminthic disease can be
not be used in children because of risk of treated by albendazole but not by
causing blindness mebendazole
(a) Quinidochlor (b) Diloxanide furoate (a) Hook worm infestation
(c) Tinidazole (d) Secnidazole (b) Thread worm infestation
(c) Trichuriasis
197. After treating intestinal amoebiasis with
metronidazole, a course of diloxanide (d) Neurocysticercosis
furoate is often advised to 204. Piperazine antagonizes the anthelmintic
(a) Cure any subclinical hepatic involvement action of the following drug
(b) Suppress the symbiotic intestinal flora (a) Pyrantel pamoate (b) Mebendazole
(c) Eradicate luminal cyst forming trophozoites (c) Albendazole (d) Niclosamide
(d) Both (b) and (c)
205. The following anthelmintic has been
198. The following drug is used for oral treatment found to be safe during pregnancy
of trichomonas vaginitis (a) Thialbendazole (b) Piperazine
(a) Diiodohydroxyquin (c) Albendazole (d) Pyrantel pamoate
(b) Tinidazole
206. A child has been brought with intestinal
(c) Clotrimazole
obstruction due to clumping of round
(d) Natamycin worms. Which of the following anthelm-
199. The drug of choice for Kala Azar is intics administered by intragastic tube can
relax the ascarids and relieve the obstruc-
(a) Pentamidine tion
(b) Amphotericin B
(a) Levamisole (b) Mebendazole
(c) Sodium stibogluconate
(c) Pyrantel pamoate (d) Piperazine
(d) Ketoconazole
207. Thialbendazole is rarely used now be-
200. Pentamidine + contrimoxazole is the cause
treatment of choice for the following
disease (a) It is not active against round worm and hook
worm
(a) Toxoplasmosis
(b) It produces lower cure rates in intestinal
(b) Pneumocystis carnii pneumonia helminthiasis than mebendazole or
(c) Actinomycosis albendazole
(d) Schistosomiasis (c) It needs pretreatment fasting and post
treatment purgative
201. Leishmania donovani is susceptible to
certain antifungal drugs because both (d) It frequently produces incapacitating side
fungi and Leishmania effects

(a) Utilize purine salvage pathway 208. Select the drug used in the treatment of
(b) Utilize similar glycolytic mechanisms filariasis
(c) Have similar topoisomerase II enzyme (a) Diethyl carbamazine citrate
(d) Have ergosterol in their cell membranes (b) Thialbendazole
186 MCQs IN PHARMACOLOGY

(c) Levamisole (a) Vincristine

(d) Piperazine citrate (b) Chlorambucil
(c) 6-Mercaptopurine
209. Diethyl carbamazine citrate has the
following action in filariasis (d) Cisplatin
(a) Rapidly kills adult filarial worms and stops 215. The most important target of action of
production of microfilariae chlorambucil is
(b) Kills circulating microfilariae (a) Myeloid tissue (b) Lymphoid tissue
(c) Kills microfilariae present in nodules and (c) Neural tissue (d) Skin
serous fluids
216. Which of the following antineoplastic
(d) Promotes phagocytosis of circulating
drugs is a mitotic inhibitor and causes
microfilariae
metaphase arrest ?
210. Hormonal agents that are useful in the (a) Busulfan (b) Vincristine
treatment of cancer include
(c) Cytarabine (d) Procarbazine
(a) Tamoxifen
217. Vinca alkaloids exert antitumor activity
(b) Prednisone
by
(c) Flutamide
(a) Activating topoisomerase II to cause breaks
(d) Tamoxifen and flutamide
in DNA strands
(e) Tamoxifen, prednisone and flutamide
(b) Crosslinking DNA strands
211. Praziquantel is preferred over niclosamide (c) Inhibiting DNA mediated RNA synthesis
for Taenia solium infestation because (d) Inhibiting polymerization of tubulin to form
(a) It achieves higher cure rates intracellular microtubules
(b) It produces fewer side effects
218. Vincristine differs from vinblastine in the
(c) It does not lead to digestion of worm and following respect(s)
kills encysted larvae, so that chances of
(a) Its prominent adverse effect is neuropathy
cysticercosis are minimized
(b) It frequently produces alopecia
(d) Both (a) and (b)
(c) It does not significantly depress bone marrow
212. For the treatment of Hymenolepis nana (d) All of the above
infestation, praziquantel has the following
advantage(s) over niclosamide 219. Patients treated with the following
anticancer drug are likely to develop a
(a) It is better tolerated
disulfiram like reaction on taking alcohol.
(b) It requires single dose treatment against 5
days treatment with niclosamide (a) Dacarbazine (b) Procarbazine
(c) A purgative is required after niclosamide but (c) Melphalan (d) Hydroxyurea
not after praziquantel 220. Select the cell cycle nonspecific antineo-
(d) All of the above plastic drug.
213. Praziquantel is effective against the (a) Vincristine (b) Bleomycin
following helminth(s) (c) Methotrexate (d) 5-Fluorouracil
(a) Taenia saginata 221. Biological response modifiers like GM-CSF
(b) Diphyllobothrium latum are used in conjunction with anticancer
(c) Schistosomes drugs for the following purpose(s).
(d) All of the above (a) To enhance antitumour activity of the drug
214. The following anticancer drug has high (b) To prevent hypersensitivity reactions to the
emetogenic potential drug
CHEMOTHERAPY 187

(c) To hasten recovery from druginduced 229. Isoniazid is ineffective in

myelosuppression (a) Treatment of M. avium complex
(d) Both (a) and (c) (b) Chemoprophylaxis of tuberculosis in HIV-
infected persons
222. Select the drug which is used exclusively
(c) Chemoprophylaxis of tuberculosis in children
in organ transplantation and autoim-
mune diseases, but not in cancers (d) Multi-drug resistant tuberculosis

(a) Cyclophosphamide 230. The agent useful in prevention of MAC

infection in HIV infected individuals is
(b) Cyclosporine
(c) Methotrexate (a) Isoniazid (b) Pyrazinamide
(c) Rifabutin (d) Streptomycin
(d) 6-Mercaptopurine
231. Dose of rifampicin recommended in
223. The following drug(s) is/are effective in
multibacillary leprosy is 600 mg
reducing the occurrence of embolic stroke
in auricular fibrillation patients (a) Once daily
(b) Once in a week
(a) Aspirin (b) Warfarin
(c) Twice weekly
(c) Digoxin (d) Both (a) and (c)
(d) Once in a month
224. Sulfonamide used in treatment of
232. The antimalarial agent that can be used
ulcerative colitis is during pregnancy is
(a) Sulfasalazine (a) Halofantrine (b) Chloroguanide
(b) Sulfacetamide (c) Mefloquine (d) Primaquine
(c) Silver sulfadiazine
233. The anti-fungal agent amphotericin B is
(d) Mafenide also active aganist
225. The cephalosporin that is active against (a) Anaerobic bacteria
pseudomonas aeruginosa is (b) Giardia lambila
(a) Cephalexin (b) Cephalothin (c) Leishmania
(c) Cefuroxime (d) Ceftazidime (d) Rickettsiae
234. The anti amoebic agent implicated in
226. To increase its blood concentration,
causing subacute myelo-optic neuropathy
imipenem is combined with
(SMON) is
(a) Clavulanic acid (b) Sulbactam (a) Diloxanide furoate
(c) Probenecid (d) Cilastatin (b) Iodochlorohydroxyquin
227. Characteristic toxicity of ethambutol is (c) Emetine
(d) Metronidazole
(a) Hepatitis
(b) Renal damage 235. The drug of choice for tropical eosinophilia
(c) Vestibular damage is
(d) Visual defects (a) Niridazole
(b) Niclosamide
228. Pyridoxine given to a patient of tubercu- (c) Diethyl carbamazine citrate
losis prevents
(d) Tetramisole
(a) INH induced peripheral neuritis
236. The agent used to treat tapeworm infes-
(b) Rifampicin induced hepatotoxicity tations is
(c) Ethambutol induced visual defects
(a) Praziquantel (b) Diloxanide furoate
(d) Streptomycin induced nephrotoxicity
(c) Pentamidine (d) Thialbendazole
188 MCQs IN PHARMACOLOGY

237. Methotrexate (c) To broaden the spectrum of antimicrobial

activity
(a) Is useful in choriocarcinoma
(d) All of the above
(b) Is safe in patients with renal dysfunction
(c) Induced neurotoxicity is reversed by leucovorin 244. The bactericidal drugs act most effectively
(d) Is not used in children on
(a) The toxin liberated by organisms
238. Prolactin
(b) Preventing liberation of toxins from organisms
(a) Has somatotropic activity
(c) Slowly dividing organisms
(b) If low can cause infertility in women
(d) Rapidly dividing organisms
(c) Can suppress menstrual cycle in lacting
women 245. Most of the laboratory sensitivity tests for
antimicrobials are conducted at pH
(d) Levels are increase by dopamine
(a) 4.6–4.8 (b) 8.4–8.6
239. Thioamide drugs
(c) 3.2–3.6 (d) 7.2–7.4
(a) Aggravate endocrine exophthalmos
246. Sulphonamides prevent the synthesis of
(b) Are safe in children
folic acid in bacterial cells because
(c) Produce irreversible hypothyroidism
(a) They compete with PABA which is a precursor
(d) Do not produce relapse of folic acid
240. Liothyronine is the drug of choice in (b) They potentiate action of PABA which is
treatment of natural antagonist of folic acid
(a) Myxoedema coma (c) They bind to PABA and form a complex
(b) Cretinism (d) None of the above
(c) Iodine deficiency goiter 247. Sulphonamide-trimethoprim combination
(d) Non-resectable cases of papillary thyroid becomes bactericidal because
carcinoma (a) Sulphonamide inhibits conversion of folic
acid to folinic acid, and trimethoprim from
241. When does the neutrophil nadir
PABA to folic acid
associated with chemotherapy agents
generally occur? (b) Sulphonamide inhibits conversion of PABA
to folic acid and trimethoprim from folic acid
(a) During administration of the chemotherapy to folinic acid
(b) 1–2 days after therapy (c) Trimethoprim increases the free drug
(c) 10–14 days after therapy concentration of sulphonamide
(d) 1 month after therapy (d) Sulphonamide increases the free drug
(e) When the platelet count begins to rise concentration of trimethoprim

242. Which of the following are the principal 248. Sulphonamide given in late pregnancy or
organisms in superinfection? to new born can result in kernicterous
because
(a) Salmonella, shigella
(a) It stimulates synthesis of bilirubin
(b) Candida, albicans, proteus and staphylococci
(b) It displaces bilirubin from plasma protein and
(c) E. Coli, Mycobacterium tuberculosis
and results in high free bilirubin concentration
(d) None of the above
(c) It prevents the metabolism of bilirubin
243. In tuberculosis combination of antimicro- (d) It is metabolized in bilirubin
bials is used
249. Concentration of sulphonamides in C.S.F.
(a) To delay the development of drug resistance is about 40 to 80% of that in blood
(b) To reduce severity of adverse reactions because
CHEMOTHERAPY 189

(a) In C.S.F. there is no protein to bind the drug (c) Interfering with plasmodium mitochondria
(b) C.S.F. has higher protein content than the (d) By all of the above mechanisms
blood
257. Drug resistance develops
(c) C.S.F has low protein content than the blood
(a) More readily to pyrimethamine than chloroquin
(d) In C.S.F sulphonamides are quickely
destroyed (b) More readily to chloroquin than pyrimethamine
(c) In both cases resistance does not develop
250. Sulphonamides are primarily metabolized
(d) In both cases resistance develops readily
by
(a) Acetylation 258. For suppressive prophylaxis of malaria
the drug used is
(b) Glucuronidation
(c) Etheral sulphate formation (a) Pyrimethamine 25 mg. once a week
(d) None of the above (b) Pyrimethamine 250 mg. once a week
(c) Primaquine 15 mg daily for 2 days
251. In an alkaline urine sulphonamides are
(d) All of the above drug can be used
(a) Less soluble
259. For radical cure of malaria the drug of
(b) More soluble
choice is
(c) Not at all soluble
(a) Primaquine 25 mg bd. × 7 days
(d) No effect of pH on stability of sulphonamides
(b) Primaquine 15 mg once daily × 14 days
252. The risk of crystallurea by suylphonamides (c) Chloroquine 400 mg. once is a month
can be reduced by
(d) None of the above
(a) Giving more soluble sulphonamides
260. Which of the following statements
(b) Making urine alkaline
describe hemorrhagic cystitis? It
(c) Ensuring urinary volume at least 2 liters a
day (a) Is caused by excretion of tumor cell
(d) All of the above breakdown products
(b) Is associated with iforfamide or cyclophos-
253. Sulphamethizole is principally used for phamide administration
(a) Topical application (c) Is caused by the administration of mesna
(b) Systemic infection (d) Can be prevented or treated with acrolein
(c) Occular infection (e) Can be treated with G-CSF
(d) Urinary infection
261. The less common causative organism in
254. Stomatitis is characterized by all of the urinary tract infection is
following signs and symptoms except (a) E. Coli (b) Pseudomonas
(a) headache (b) erythema (c) Tubercular bacilli (d) Proteus
(c) bleeding (d) ulcerations
262. In an acute U.T.I. with alkaline urine and
(e) dryness of mouth unidentified organism, the treatment
255 In co-trimoxazole, sulphamethoxazole should begin with
and trimethoprim are in ratio of (a) Co-trimoxazole (b) Sulphonamide
(a) 2 : 1 (b) 1 : 5 (c) Nitrofurantoin (d) Mendallic acid
(c) 1 : 1 (d) 5 : 1 263. Nitrofurantion is useful only in urinary
256. Pyrimethamine and progunil act by tract infection because

(a) Interfering with parasite’s ability to digest Hb (a) It is rapidly excreted and concentrated in
urine
(b) Inhibiting dihydrofolate reductase which
converts folic acid to folinic acid (b) It is rapidly metabolized in liver which
prevents effective plasma concentration
190 MCQs IN PHARMACOLOGY

(c) It’s concentration in renal tissue is high (c) It potentiates the antitubercular effect of other
because of renal tubular reabsorption drugs
(d) It is effective against common organisms of (d) It has reduced the duration of antitubercular
U.T.I e.g. proteins, and E. Coli therapy
(e) All above reasons
270. In cell targeted suicide mode of gene
264. Hexamine mandelate is only effective in therapy for cancer the prodrug used is
U.T.I. and not in systemic infection (a) Gancyclovir (b) Acyclovir
because (c) Ara c/m (d) All of the above
(a) It is only concentrated in urine
271. Drug of choice for guinea worm infestation
(b) In urine at pH less than 5.5, it liberates active
is
antibacterials
(a) Digoxin (b) Furosemide
(c) For systemic infection dose required is too
high which is toxic (c) Enalapril (d) Amrinone
(d) Organisms in systemic infection are not 272. Which of the following can not be treated
sensitive to it with danzol ?
265. All of the following chemotherapy agents (a) Endometriosis
are vesicants except (b) Menorrhagia
(a) Doxorubicin (b) Mechlorethamine (c) Fibrocystic disease
(c) Vincristine (d) Methotrexate (d) Hirsutism
(e) Idarubicin 273. Melphalan is the drug of choice in
266. Which of the following is most effective (a) Leukemia
antitubercular drug? (b) Multiple myeloma
(a) INH (b) Thioactazone (c) Hodgkin’s disease
(c) PAS (d) Pyrazinamide (d) Osteosarcoma
267. Which of the following drugs is effective 274. Prolonged chlorpromazine therapy
against intracellular organism of tuber- results in
culosis?
(a) Osteomalacta
(a) INH (b) Streptomycin (b) Photosensitivity
(c) PAS (d) Ethambutol (c) Yellowish discolouration
268. Isoniazid may cause peripheral (d) Altered renal function
neuropathy and anaemia as its side
275. Drug of choice for actionomycosis is
effects because
(a) Penicillin (b) Tetracycline
(a) It is toxic to nerves and to R.B.C
(c) Sulfonamide (d) Dapsone
(b) It interferes with pyridoxin metabolism and
induces its defeciency 276. Match each of the following toxicities to
(c) It prevents absorption of iron and ascorbic acid the agent most likely to cause the toxicity
(d) It is a type of hypersensitivity reaction (a) Cardiotixicity (1) Vincristine
269. Rifampicin has gained significance in (b) Hypersensitivity (2) Irinotecan
antitubercular therapy because (c) Diarrhea (3) Doxorubicin
(a) It is the cheapest and effective drug (d) Pulmonary toxicity (4) Paclitaxel
(b) It is least toxic, so suitable for chronic use (e) Constipation (5) Bleomycin
CHEMOTHERAPY 191

ANSWERS
1. d 2. c 3. b 4. c 5. b 6. e
7. d 8. d 9. b 10. d 11. b 12. d
13. d 14. a 15. a 16. d 17. d 18. d
19. a 20. c 21. b 22. c 23. d 24. d
25. a 26. c 27. a 28. b 29. a 30. c
31. e 32. d 33. d 34. a 35. c 36. b
37. a 38. b 39. d 40. b 41. d 42. b
43. e 44. b 45. b 46. d 47. b 48. c
49. e 50. e 51. d 52. d 53. b 54. d
55. b 56. c 57. b 58. b 59. b 60. c
61. e 62. b 63. c 64. e 65. e 66. a
67. a 68. a 69. e 70. b 71. d 72. b
73. b 74. c 75. e 76. d 77. d 78. c
79. c 80. c 81. e 82. a 83. a 84. c
85. a 86. c 87. c 88. c 89. a 90. a
91. a 92. b 93. e 94. c 95. e 96. d
97. b 98. d 99. b 100. a 101. b 102. c
103. a 104. d 105. a 106. b 107. d 108. e
109. c 110. d 111. c 112. c 113. c 114. e
115. e 116. d 117. c 118. e 119. e 120. d
121. a 122. c 123. b 124. e 125. c 126. d
127. b 128. c 129. b 130. a 131. d 132. d
133. b 134. c 135. b 136. c 137. c 138. d
139. d 140. c 141. d 142. a 143. b 144. a
145. c 146. c 147. b 148. b 149. d 150. a
151. c 152. c 153. c 154. b 155. b 156. a
157. d 158. a 159. b 160. b 161. d 162. d
163. a 164. a 165. a 166. c 167. b 168. d
169. d 170. d 171. b 172. d 173. d 174. c
175. b 176. c 177. d 178. b 179. b 180. d
181. d 182. a 183. d 184. b 185. a 186. a
187. b 188. c 189. c 190. a 191. d 192. a
193. c 194. c 195. b 196. a 197. c 198. b
199. c 200. b 201. d 202. b 203. d 204. a
205. b 206. d 207. d 208. a 209. d 210. e
211. c 212. b 213. d 214. d 215. b 216. b
217. d 218. d 219. b 220. d 221. c 222. b
223. d 224. a 225. d 226. d 227. d 228. a
229. a 230. c 231. d 232. b 233. c 234. b
235. c 236. a 237. a 238. c 239. b 240. a
241. c 242. b 243. a 244. d 245. d 246. a