Anticoagulant MCQs 83

Anticoagulant Agents 

Unfractionated Heparin (60 to 100 kDa)

01. Which of the following statements about Unfractionated Heparin is wrong?

A. Mucopolysaccharides polymers 

B. Exctracted from bovine lung tissues 

C. Extract from Porcine intestinal mucosa 

D. High affinity for antithrombin III

E. Increase amount of fibrin formation 

Answer: E. Increase amount of fibrin formation 

UFHs catalyze inactivation of factor Xa and IIa by AT-III ultimately reducing the amount of fibrin formation. LMWHs also bind to AT-III but preferably inhibit factor Xa rather than IIa but ultimate result is reduced amount of fibrin formation.

02. Which of the following statements about low melecular weight heparin(LMWHs) is wrong?

A. Molecular weight 2 to 10 kDa

B. Produce by UFH fragmentation 

C. Prefer inhibition of Xa rather than IIa

D. Have less half-life than UFH

E. Treat pulmonary & venous thrombo emboli 

Answer: D. Have less half-life than UFH

LMWHs have more predictable pharmacokinetics profile with longer half-life.

LMWHs: Enoxaparin, Tinzaparin, Dalteparin 

03. A synthetic Pentasaccharide that inhibit factor X through the action of AT-III is following?

A. Enoxaparin

B. Tinzaparin

C. Dalteparin 

D. Fondaparinux

E. All of the above 

Answer: D. Fondaparinux

04. A drug that is mixture of heparin sulfate, dermatan sulfate and chondroitin sulfate extracted from porcine mucosa is following?

A. Enoxaparin

B. Tinzaparin

C. Dalteparin 

D. Fondaparinux

E. Danaparoid

Answer: E. Danaparoid

This drug have similar MOA as LMWHs.

Direct Thrombin Inhibitors 

05. Following is a 65 amino acid recombinant derivative of hirudin, the anticoagulant found in saliva of medicinal leech?

A. Lepirudin

B. Bivalirudin

C. Dabigatrin

D. Argatroban

E. Danaparoid 

Answer: A. Lepirudin

06. Following is a synthetic 20 amino acid derivative of hirudin?

A. Lepirudin

B. Bivalirudin

C. Dabigatrin

D. Argatroban

E. Danaparoid 

B. Bivalirudin

07. Following statements about hirudin derivatives(Lepirudin & Bivalirudin) is wrong?

A. Administered Parentrally

B. Inhibit thrombin activity without AT-III

C. Reduce formation of thrombi

D. Lepirudin has 20 amino acid 

E. Direct thrombin inhibitors 

Answer: D. Lepirudin has 20 Amino acids 

Lepirudin has 65 amino acid while Bivalirudin has 20 amino acids.

08. Which of the following is first orally active direct thrombin inhibitor?

A. Lepirudin 

B. Bivalirudin 

C. Dabigatran

D. Argatroban

E. All of the above 

Answer: C. Dabigatran

Used to prevent stroke in patients with atrial fibrillation.

09. A drug used to prevent stroke in patients with atrial fibrillation has a adverse effect of following?

A. Bleeding 

B. Abdominal pain 

C. Gastric bleeding 

D. Esophageal reflux

E. All of the above 

Answer: E. All of the above 

10. Which of the following direct thrombin inhibitor is also associated with GI disturbance?

A. Lepirudin 

B. Bivalirudin 

C. Dabigatran

D. Argatroban

E. All of the above 

Answer: C. Dabigatran

Anti platelets drugs 

11. Following statements about Aspirin is wrong?

A. Inhibit COX

B. Reduce Thromboxane A2 level

C. Treat Myocardial infarction 

D. Decrease thrombosis after coronary stenting

E. Anti platelets drugs 

F. None of these 

Answer F. None of these 

12. A that Drug elevate cGMP in platelets by inhibition of phosphodiesterase activity to decrease aggregation?

A. Dipyridamole 

B. Cilostazol

C. Aspirin 

D. A & B

E. All of the above 

Answer: D. A & B

13. A that Drug elevate cGMP in platelets by inhibition of phosphodiesterase activity to decrease aggregation?

A. Ticlopidine 

B. Cilostazol

C. Aspirin 

D. A & B

E. All of the above 

Answer: B. Cilostazol 

Along with Dipyridamole 

14. A Thienopyridine drug covalently bind to P2Y12 receptors on platelets to prevent ADP-mediated aggregation and adhesion to fibrin?

A. Ticlopidine

B. Cilostazol 

C. Dipyridamole 

D. Aspirin 

E. Lepirudin 

Answer: A. Ticlopidine (Clopidogrel, Prasugrel)

15. A Thienopyridine drug covalently bind to P2Y12 receptors on platelets to prevent ADP-mediated aggregation and adhesion to fibrin?

A. Clopidogrel 

B. Cilostazol 

C. Dipyridamole 

D. Aspirin 

E. Lepirudin 

Answer: A. Clopidogrel  (Ticlopidine, Prasugrel)

16. A Thienopyridine drug covalently bind to P2Y12 receptors on platelets to prevent ADP-mediated aggregation and adhesion to fibrin?

A. Prasugrel 

B. Cilostazol 

C. Dipyridamole 

D. Aspirin 

E. Lepirudin 

Answer: A. Prasugrel  

17. Following drug have to be bioactivated by hepatic CYP enzymes before activation?

A. Prasugrel 

B. Cilostazol 

C. Dipyridamole 

D. Aspirin 

E. Lepirudin 

Answer: A. Prasugrel (Clopidogrel, Ticlopidine)

All theinopyridines.

18. A drug that reduces the interaction of platelets via the GPIIIa/IIb receptors to fibrogen thus decreasing platelets aggregation?

A. Abciximab 

B. Eptifibatide 

C. Tirofiban 

D. A & B

E. All of the above 

Answer: E. All of the above 

Abciximab causes hypotension and atrial fibrillation.

Tirofiban causes thrombocytopenia when combined with heparin.

19. A drug that is a cyclized heptapeptide with high affinity for fibrinogen receptor is following?

A. Abciximab 

B. Eptifibatide 

C. Tirofiban 

D. A & B

E. All of the above 

Answer: B. Eptifibatide 

Abciximab is a Fab fragment of a monoclonal antibody directed against GPIII/IIIa.

Thrombolytic Agents

19. Tissue plasminogen activators released by endothelial cells to activate fibrin bound plasminogen to plasmin. Plasmin then cleaves fibrin strands to cause the disintegration of clot. A drug used as Human tPA?

A. Alteplase

B. Reteplase

C. Tenecteplase

D. A & B

E. All of the above 

Answer: E. All of the above 

20. A drug is a 47 kDa protein produced by beta-haemolytic streptococcus that combines with plasminogen to produce plasmin is following?

A. Alteplase

B. Streptokinase 

C. Tirofiban 

D. Lepirudin 

E. Prasugrel 

Answer: B. Streptokinase 

This drug is less clot specific bcoz it doesn't require the presence of fibrin to activate plasminogen. High doses required to overcome antibody immunity in patients who has previous streptococcal infection.

21. A drug is a serine protease that cleaves plasminogen to plasmin that can then degrade formed clot?

A. Alteplase

B. Streptokinase 

C. Urokinase 

D. Lepirudin 

E. Prasugrel 

Answer: C. Urokinase

Lack of clot specificity predispose patients to a systemic lytic state.  Used to clear massive pulmonary emboli

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Antiviral Drugs MCQs. 82

01. 30-year-old male patient with human immuno- deficiency virus infection is being treated with a HAART (highly active antiretroviral therapy) regimen. Four weeks after initiating therapy, he presents to the emergency department complaining of fever, rash, and gastrointestinal upset. Which one of the following drugs is most likely the cause of his symptoms?

A. Zidovudine

B. Nelfinavir

C. Abacavir

D. Efavirenz

E. Darunavir

Answer: C. Abacavir

02. Which one of the following drugs has hypersensitivity reaction characterised by fever, rash, & GI upset?

A. Zidovudine

B. Nelfinavir

C. Abacavir

D. Efavirenz

E. Darunavir

Answer: C. Abacavir

03. Which of the following statements about NRTIs is wrong?

A. Treat HIV

B. Inhibit HIV reverse transcriptase 

C. Analog of native ribosides

D. Lack a 3-hydroxyl group 

E. None of these 

Answer: E. None of these 

Ribosides( nucleotides or nucleosides containing ribose)

04. Which of the following statements about NRTIs is wrong after entery into the cell?

A. Phosphorylated to triphosphate by cellular enzyme 

B. Triphosphate analog incorporated into viral DNA by RT

C. No bond between nucleoside triphosphate & growing DNA 

D. 3-5-phosphodiester bond not form due to lack of hydroxyl 

E. DNA chain elongation is increased 

Answer: E. DNA chain elongation is increased 

DNA chain elongation is terminated because there is not 3-hydroxyl group is present so no 3-5-phosphodiester bond is fromed between incoming nucleoside triphosphate and the growing DNA chain. 

05. Which of the following statements about Tenofovir is wrong?

A. Available as Tenofovir disoproxil fumerate (TDF)

B. Available as Tenofovir alafenamide (TAF)

C. Convert to Tenofovir diphosphate by lymphoid enzyme 

D. Tenofovir diphosphate is active from

E. TAF has less activity than TDF at lower doses 

Answer: E. TAF has less activity than TDF at lower doses 

TAF achieve improved anti HIV activity at lower doses than TDF that results in five to seven fold increase in intracellular diphosphate in the lymphoid cell and lower circulating plasma tenofovir levels. 

ADRs: Renal insufficiency and loss of bone mineral density 

06. Which of the following statements about NRTIs is wrong?

A. Dose adjustment in renal insufficiency 

B. Renally excreted 

C. Abacavir metabolised by alcohol dehydrogenase 

D. Abacavir metabolised by glucuronyl transferase

E. Zidovudine is only available as Skin formulation

Answer: E. Zidovudine is only available as Skin formulation

Zidovudine is available as oral and IV formulation while alla other NRTIS are available as oral. 

Dose adjustment for NRTIS is required in renal insufficiency except Abacavir which is metabolised by alcohol dehydrogenase and glucoronly transferase.

07.  A 75-year-old man with chronic obstructive pulmonary disease is diagnosed with suspected influenza based on his complaints of flu-like symptoms that began 24 hours ago. Which of the following agents is most appropriate to initiate for the treatment of influenza?

A. Ribavirin.

B. Oseltamivir. 

C. Zanamivir.

D. Rimantadine. 

E. Amantadine.

Answer: B. Oseltamivir

08. Which of the following drugs is prohibited in influenza if a person is diagnosed with chronic obstructive pulmonary disease?

A. Ribavirin.

B. Oseltamivir. 

C. Zanamivir.

D. Rimantadine. 

E. Amantadine.

Answer: C. Zanamavir 

Two drugs are frequently used for influenza Oseltamivir (oral) and Zanamavir, Zanamavir is administered via inhalation and is not recommended for patients with COPD.

09. A 24-year-old female is diagnosed with genital herpes simplex virus infection. Which of the following agents is indicated for use in this diagnosis?

A. Valacyclovir

B. Cidofovir

C. Ganciclovir

D. Zanamivir

E. Lamivudine

Answer: A. Valacyclovir 

Famcyclovir, Pencyclovir, Acyclovir all are indicated for HSV. Cidofovir and Gancyclovir are indicated for Cyclomegalo virus retinitis. Zanamavir is used to treat influenza.

10. One of the Following drugs is used to treat influenza  virus infection commonly?

A. Valacyclovir

B. Cidofovir

C. Ganciclovir

D. Zanamivir

E. Lamivudine

Answer: D. Zanamavir  

Famcyclovir, Pencyclovir, Acyclovir all are indicated for HSV. Cidofovir and Gancyclovir are indicated for Cyclomegalo virus retinitis. Zanamavir is used to treat influenza.

11. One of the Following drugs is used to treat Cyclomegalovirus retinitis?

A. Valacyclovir

B. Cidofovir

C. Ganciclovir

D. Zanamivir

E. A & B

F. B & C

Answer: F. B & C 

Famcyclovir, Pencyclovir, Acyclovir all are indicated for HSV. Cidofovir and Gancyclovir are indicated for Cyclomegalo virus retinitis. Zanamavir is used to treat influenza.

12. What is the mechanism of action of Acyclovir?

A. Premature DNA chain Termination 

B. Inhibit viral neuraminidase

C. Inferences with viral messenger RNA 

D. Inhibit reverse transcriptase 

E. Block M2 protein ion channel 

Answer: A. Premature DNA chain Termination 

13. Transient irritation of the eye and palpebral (eyelid) edema is the adverse effect of following?

A. Trifluridine

B. Penciclovir

C. Gancyclovir

D. Lamivudine

E. Zanamavir 

Answer: A. Trifluridine

It's an antiviral drug having short life necessitiates to apply frequently used in the treatment of HSV-1 and HSV-2 and vaccina virus. Restricted to topical ophthalmic preparation. Toxic for systemic use.

 

14. Following statements about Penciclovir and Famciclovir is wrong?

A. Famciclovir is prodrug of Penciclovir

B. Penciclovir has longer intracellular half-life than Acyclovir 

C. Penciclovir applied Topically 

D. Famciclovir not active orally 

E. None of these 

Answer: Famciclovir not active orally 

Famciclovir is effective orally while Penciclovir applied topically. 

15. A female patient who is being treated for chronic hepatitis B develops nephrotoxicity while on treatment. Which is the most likely medication she is taking for HBV treatment?

A. Entecavir

B. Telbivudine

C. Lamivudine

D. Adefovir

Answer: D. Adefovir 

16. Nephrotoxicity is the most common adverse effect of following drugs in the treatment of HBV?

A. Entecavir

B. Telbivudine

C. Lamivudine

D. Adefovir

Answer: D. Adefovir (Terminate chain elongation and prevents replication of HBV)

Uncommon in Lamivudine and Entecavir. Ribavirin is used for the treatment of hepatitis C infection.

17. Which class of direct acting antivirals for hepatitis C works by inhibiting formation of the membranous web that provides a platform for viral replication?

A. A. NS3/NS4A protease inhibitors 

B. NS5B polymerase inhibitor 

C. NS5A replication complex inhibitor 

D. Interferons

Answer: C. NS5A replication complex inhibitor 

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APHA FPGEE Practice MCQs. No. 81

01. Which of the following statements about GI tract problems in Cystic fibrosis is wrong?

A. Decrease viscosity of mucus secretion 

B. Deficiency of pancreatic digestive enzymes 

C. Decreased bicarbonate secretion 

D. Poor digestion of nutrients 

E. Lipase deficiency causes Fat soluble vit. Deficiency 

Answer: A. Decrease viscosity of mucus secretion 

Infact, in cystic fibrosis decreased function of exocrine glands disturb GI tract and pulmonary system.

GI problem include increased viscosity of mucus secretion. 

Poor digestion of protein and fats, Vitamin B12 and zinc deficiency. 

Insulin deficiency and glucose tolerance occurs in older children resulting in cystic fibrosis related diabetes mellitus.

02. Through what pathway is acetaminophen metabolised in neonates and infants?

A. Glucoronidation 

B. Sulfation 

C. Methylation 

D. Hydroxylation

Answer: B. Sulfation 

In neonates and infants, the Sulfation pathway is most active at birth, glucoronidation is least active pathway, acetaminophen is not metabolised via methylation or Hydroxylation.

03. At increased temperature, DNA is driven towards the single stranded state as the hydrogen bond between complimentary base pairs are broken, process called?

A. Denaturation 

B. Annealing 

C. Hybridisation 

D. Oligonucleotides

E. Polymorphism 

Answer: A. Denaturation (Denaturation of proteins is irreversible but nucleic acids is reversible)

At lower temperature and physiological ion levels, solution of nucleic acid form hydrogen bonded complimentary base pairs.

04. Any combination of DNA and RNA segments through base pairing will form DNA-DNA and DNA-RNA hybrids, this process is called?

A. Denaturation 

B. Annealing 

C. Polymorphism

D. Oligonucleotides

Answer: B. Annealing or hybridisation 

05. Technology is available to chemically synthesise short segments of DNA or RNA called?

A. Denaturation 

B. Annealing 

C. Polymorphism

D. Oligonucleotides

Answer: D. Oligonucleotides

Single stranded and approximately 20 nucleotide in length.

06. Two new nuclear membranes form and the cytoplasm is devided in half by following process?

A. Prophase 

B. Metaphase 

C. Anaphase 

D. Telophase 

E. Cytokineses 

Answer: E. Cytokinesis 

07. What of the following statements about ddNTPs in DNA sequencing is wrong?

A. Chain termination

B. Prevent continued strand synthesis 

C. Four bases are labelled with fluorescent marker

D. Synthesis of DNA that vary in length 

E. Base specific fluorescent tag at 3' terminus 

F. None of these 

Answer: F. None of these 

Analysis of fluorescence as a function of length allows determination of the DNA sequence of template.

08. Which of the following is the function of Vitamin B12?

A. RBCs development 

B. Folate metabolism 

C. Maintenance of myelin 

D. A & B

E. All of the above 

Answer: E. All of the above 

If the levels of serum methylmalonic acid and homocysteine are elevated then there is deficiency of B12.

09. Pernicious anemia originate because of the lack of following?

A. Serum methylmalonic acid

B. Homocysteine 

C. Intrinsic factor 

D. Alcoholism 

Answer: C. Intrinsic factor (needed to absorb the Vitamin B12 in the Gut)

10. Chronic High doses of following vitamin may lead to Diplopia?

A. Vit. A

B. Vit. B1

C. Vit. B2

D. Vit. C

E. Vit. B12

Answer: A. Vit. A

11. A vit. Needed to metabolise carbohydrates and important in neurological function, it's deficiency from alcoholism lead to Wernicke-korsakoff syndrome is following?

A. Vit. A

B. Vit. B1

C. Vit. B2

D. Vit. C

E. Vit. B12

Answer: B. Vit. B1 (thiamine deficiency causes beriberi)

12. A vitamin needed for production of precursors of collagen and also have antioxidant properties?

A. Vit. A

B. Vit. B1

C. Vit. B2

D. Vit. C

E. Vit. B12

Answer: D. Vitamins C 

13. Important cofactor in the production of clotting factors necessary for function of the coagulation cascade (factors VII, IX, X and III)?

A. Vitamin K

B. Phytonadione

C. Cyanocobalamine

D. A & B

E. All of these 

Answer: D. A & B

Low Vit. K: potentiate the effect of warfarin leading to supra therapeutic anticoagulation

High vit. K: antagonise the effect of warfarin leading to sub therapeutics anticoagulation

14. A vitamin needed for proper bone formation and regulation of serum calcium levels also necessary for calcium absorption from GI tract?

A. Ergocalciferol

B. Cholecalciferol 

D. Vitamin D 

D. A & B

E. All of the above 

Answer: E. All of the above 

15. Following statements about use of Vitamin D is incorrect?

A. In bone formation 

B. Serum calcium regulation 

C. GI Calcium absorption 

D. Improve muscle strength and coordination 

E. High dose causes Hypocalcemia  

Answer: E. high doses cause Hypocalcemia 

Infact high dose causes hypercalcemia , anorexia, weight loss and kidney stone

16. A vitamin functions as an antioxidant and in steroid metabolism, deficiency causes edema and reproductive impairment?

A. Vit. A

B. Vit. B1

C. Vit. B2

D. Vit. E

E. Vit. B12

Answer: D. Vitamins E

High doses: reduce vitamin k levels, increasing warfarin prothrombin time prolongation 

17. A vitamin is a cofactor for many enzymes and is used in heme production, deficiency results from isoniazid and hydralazine?

A. Vit. A

B. Vit. B6

C. Vit. B2

D. Vit. E

E. Vit. B12

Answer: B. Vitamins B6 ( dermatitis, oral lesions, sideroblastic anemia and peripheral neuropathy)

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APHA FPGEE Practice MCQs. No. 80

01. ABO human blood groups is an example of post translational modification of proteins?

A. Phosphorylation 

B. Glycosylation

C. Methylation 

D. Hydroxylation

E. Formylation

Answer: B. Glycosylation( specific scheme of Glycosylation of cell surface proteins is essential to cell-cell recognition)

Amino acids: Ser, Thr, Phe, Pro

02. The nucleotide units of both DNA and RNA are composed of following basic components?

A. Purine & pyrimidine base molecules 

B. A sugar molecule 

C. A phosphoric acid molecule 

D. A & B

E. All of the above 

Answer: E. All of the above 

A sugar molecule contains D-ribose in RNA or D-2deoxyribose in DNA. 

03. Following has Single primary role of storing the information genetic code of cell?

A. RNA

B. mRNA

C. tRNA

D. rRNA

E. DNA

Answer: DNA (rDNA is a recombinant DNA molecule formed when DNA fragments from different sequences are joined using restriction endonucleases)

While all other are types of RNA that perform specific functions in transcription, translational and control of both transcription and translation. 

mRNA is a processed  transcription or a copy of the DNA 

tRNA is a highly ordered sequence of nucleotide folded into a cloverleaf like, inverted L structure with internal base paired secondary structure.

rRNA refers to two large RNA molecules that binds a multitude of protein to form the two subunit 30S and 50S or ribosome.

04. Following is a processed  transcription or a copy of the DNA?

A. RNA

B. mRNA

C. tRNA

D. rRNA

E. DNA

Answer: mRNA 

05. A polymeric macromolecules made of ribonucleotide subunits that is used for gene regulation?

A. RNA

B. mRNA

C. tRNA

D. rRNA

E. DNA

Answer: RNA (exist in cell as rRNA, tRNA, miRNA and mRNA. It also comprises genetic material of some viruses known as Retroviruses)

06. The following changes occurs in pregnancy affecting absorption?

A. Reduced gastrointestinal motility 

B. Increased gastric pH

C. Increased pulmonary alveolar drug uptake

D. A & B

E. All of these 

Answer: E. All of these 

A option is to allow better absorption of nutrients to the fetus. 

07. The following changes occurs in Geriatrics affecting absorption?

A. Reduced gastrointestinal motility 

B. Increased gastric PH

C. No change in passive diffusion 

D. Decrease active transport 

E. All of these 

Answer: E. All of these 

08. Geriatric patients may have following distribution effects?

A. Decreased total body water, resulting in decreased volume of distribution (Va) of water-soluble drugs (increased serum concentrations)

B. Decreased lean body mass and increased body fat, resulting in increased Vd of fat-soluble drugs 

C. Increased or decreased free fraction of highly protein-bound drugs

D. All of these 

Answer: D. All of these 

09. Decrease albumin in following results in reduction of binding sites for acidic drugs for example salicylic acid, sulfisoxazole, diazepam, Valproic acid, phenytoin?

A. Pediatric 

B. Geriatric 

C. Late Pregnancy 

D. B & C

E. A & B

Answer: C. Late pregnancy (maternal plasma increase by 50%)

Free drug serum conc. not effected 

10. Following drug properties enhance placental transfer from mother to fetus?

A. High Lipophilicity

B. Low ionisation 

C. Low maternal binding 

D. Low molecular weight 

E. All of the above 

Answer: E. All of the above 

Most teratogenic effects occur during 5th and 10th weeks of gestation (embryonic period).

11. Adequate, well controlled studies in pregnant women have not shown increased risk of fetal abnormalities?

A. Category A

B. Category B

C. Category C

D. Category D

E. Category X

Answer: A. Category A

12. No adequate well-controlled studies in pregnant women conducted and animal studies reveal no harm to the fetus?

A. Category A

B. Category B

C. Category C

D. Category D

E. Category X

Answer: B. Category B

13. No adequate well controlled studies in pregnant women conducted, but in animal studies have shown adverse effect?

A. Category A

B. Category B

C. Category C

D. Category D

E. Category X

Answer: C. Category C

Confusing category: it could be safe or probably safe, or it could be potentially harmful. Because it has insufficient date about its use in pregnancy.

14. Adequate well controlled studies or observational studies in animal or pregnant women have demonstrated a risk to the fetus?

A. Category A

B. Category B

C. Category C

D. Category D

E. Category X

Answer: D. Category D

Practitioner must weigh the benefits of therapy against the potential risk.

15. Adequate well controlled studies or observational studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities?

A. Category A

B. Category B

C. Category C

D. Category D

E. Category X

Answer: E. Category X

16. Causes stimulation of uterine contractions?

A. Castor oil 

B. Mineral oil 

C. Sodium bicarbonate 

D. Caffeine avoidance 

Answer: A. Castor oil

17. Shouldn't use in pregnancy because it reduce absorption of fat soluble vitamins e.g vit. K causing neonatal hemorrhage?

A. Castor oil 

B. Mineral oil 

C. Sodium bicarbonate 

D. Caffeine avoidance 

Answer: B. Mineral oil 

18. Avoid use of following drug because it causes electrolyte and fluid abnormalities?

A. Castor oil 

B. Mineral oil 

C. Sodium bicarbonate 

D. Caffeine avoidance 

Answer: C. Sodium bicarbonate 

19. Non pharmacological alternative to treat GERD in pregnancy?

A. Caffeine avoidance 

B. Elevation of head of bead

C. Small frequent meals 

D. A & B

E. All of the above 

Answer: E. All of the above 

20. First line treatment in hypotension because of its efficacy and safety in pregnant women?

A. Methyldopa

B. ACE inhibitors 

C. Diuretics 

D. Magnesium sulfate 

E. Avoid Drugs 

Answer: A. Methyldopa (other b-blocker, prazosin, nifedipine, hydralazine, Clonidine)

B option cause renal toxicity in the fetus so avoid and

C option decrease maternal plasma volume so avoid.

D. IV magnesium sulfate is used for seizure prevention 

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APHA FPGEE exam practice MCQs No. 79

01. Chromosomes become highly condensed in following phase?

A. Prophase 

B. Metaphase

C. Anaphase 

D. Telophase 

Answer: A. Prophase 

02. Chromosomes have achieved their highest state of condensation. They are attached to the spindle fiber and

aligned at the metaphase (equatorial) plate. During this phase, chromosomes are amenable to microscopic

analysis?

A. Prophase 

B. Metaphase

C. Anaphase 

D. Telophase 

Answer: B. metaphase

03. The centromere of each chromosome divides, and the two daughter chromosomes segregate along the spindle

fibers toward the centrioles, located at each pole?

A. Prophase 

B. Metaphase

C. Anaphase 

D. Telophase 

C. Anaphase 

04. Two new nuclear membranes form, and the cytoplasm is divided in half by cytokinesis. Two identical daughter

cells are the products of mitosis?

A. Prophase 

B. Metaphase

C. Anaphase 

D. Telophase 

Answer: D. TeloPhase

21. Preeclampsia (hypertension, proteinurea, edema) should be treated as follows?

A. IV hydralazine or labetalol

B. IV magnesium sulfate 

C. Ace inhibitors 

D. A & B

E. All of the above  

Answer: D. A & B

22. DOC in Venous thromboembolism in pregnant women?

A. Heparin 

B. Warfarin 

C. Lisinopril

D. Acetazolamide

Answer: A. Heparin (LMW heparin are alternate choice)

Warfarin should be avoided after 6 weeks of pregnancy bcoz it causes fetal bleeding, malformation or central nervous system anomalies.

23. When following drug used to treat headaches in pregnancy it causes bleeding and closure of ductus arteriosus?

A. Acetaminophen 

B. Aspirin 

C. Heparin 

D. Warfarin 

Answer: B. Aspirin 

Acetaminophen is DOC in headaches in pregnancy.

24. A drug causes increased risk of kernicterus to the neonates when used in third trimester of pregnancy?

A. Ampicillin 

B. Amoxicillin 

C. Sulfa drugs

D. Nitrofurantoin

E. Cephalexin

Answer: C. Sulfa drugs 

25. A drug should be avoided in pregnancy causing folate reduction?

A. Ampicillin 

B. Amoxicillin 

C. Sulfa drugs

D. Nitrofurantoin

E. Trimethoprim 

Answer: E. Trimethoprim (folate antagonist)

26. Following drugs are safe to use in pregnancy except?

 A. Ampicillin 

B. Amoxicillin 

C. Cephalexin

D. Nitrofurantoin

E. Trimethoprim 

Answer: E. Trimethoprim 

Ampicillin and Amoxicillin are safe in pregnancy for escherichia coli but now they show increasing resistance against E. coli. 

Fluoroquinolones and tetracycline are contraindicated in pregnancy.

Syphilis transmitted trans placentally and must be treated early in sexually transmitted diseases (STD)

27. Safe drugs used for allergic rhinitis and asthma during pregnancy?

A. Chlorpheniramine

B. Beclomethasone

C. Beta2 agonist 

D. Theophylline 

E. All of these 

Answer: E. All of these 

Chlorpheniramine as oral antihistamine and orally inhaled corticosteroids are recommended.

Beta2 agonist for bronchodilation and theophylline is second option.

A nasal decongestant pseudoephedrine and Prednisone as a burst in acute exacerbation.

Dermatology: Avoid retinoid compounds 

28. Following is the recommended drug in HIV after the 14th week of gestation for the duration of pregnancy?

A. Ampicillin 

B. Amoxicillin 

C. Cephalexin

D. Zidovudine

E. Trimethoprim 

Answer: D. Zidovudine 

29. One of the Following drugs preferred in pregnancy used to treat hyperthyroidism?

A. Levothyroxine

B. Propylthiouracil

C. Methimazole

D. Carbamazepine 

E. Valproate 

Answer: B. Propylthiouracil

Levothyroxine is used to treat hypothyroidism not hyperthyroidism.

Propylthiouracil is preferred than methimazole because it cross placenta less readily than methimazole.

Carbamazepine and Valproate are used in pregnancy but causes congenital malformation.

30. An autosomal recessive disease involves a defect in chloride transport channel resulting in decreased function of exocrine glands leading to GI and pulmonary disturbance?

A. Hyperthyroidism 

B. Cystic fibrosis 

C. Ciliac disease 

D. Maple syrup urine disease 

E. Sickle cell anemia 

Answer: B. Cystic fibrosis 

GI problem increased viscosity  of  mucus secretion, deficiency of pancreatic digestive enzymes and decreased bicarbonate secretion.

Enzymes deficiency causes poor digestion, fat soluble vitamin deficiency 

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Apha FPGEE practice Amino Acid MCQs. 78

01. Following is the basic structure of following component?

 

A. Amino Acid

B. Protein 

C. Lipids 

D. Carbohydrates 

E. Glucose 

Answer: A. Amino Acid basic structure

02. Following formula structure belongs to following non essential Amino acid?

A. Arginine 

B. Asparagine 

C. Aspartic Acid

D. Alanine 

E. Cysteine

Answer: A. Arginine (Arg/R)

03. Following formula structure belongs to following Amino acid?

A. Arginine 

B. Asparagine 

C. Aspartic Acid

D. Alanine 

E. Cysteine

Answer: B. Asparagine (Asn/N)

04. Following formula structure belongs to following Amino acid?

A. Arginine 

B. Asparagine 

C. Aspartic Acid (Aspartate)

D. Alanine 

E. Cysteine

Answer: C. Aspartic Acid (Aspartate) (Asp/D)  

05. Following formula structure belongs to following Amino acid?

A. Arginine 

B. Asparagine 

C. Aspartic Acid (Aspartate)

D. Alanine 

E. Cysteine

Answer: E. Cysteine (Cys/C)

06. Following formula structure belongs to following Amino acid?

A. Arginine 

B. Asparagine 

C. Aspartic Acid (Aspartate)

D. Alanine 

E. Cysteine

Answer: D. Alanine (Ala/A)

07. Following is the structure formula of one of the amino acids?

A. Glutamic Acid

B. Glutamine 

C. Glycine 

D. Histidine 

E. Isoleucine 

Answer: A. Glutamic Acid (Glutamate) (Glu/E)

Carefully differentiate between Glutamic Acid structure and Aspartic Acid structure.

08. Following is the structure formula of one of the amino acids?

A. Glutamic Acid

B. Glutamine 

C. Glycine 

D. Histidine 

E. Isoleucine 

Answer: B. Glutamine (Gln/Q)

09. Following is the structure formula of one of the amino acids?

________H

A. Glutamic Acid

B. Glutamine 

C. Glycine 

D. Histidine 

E. Isoleucine 

Answer: C. Glycine (Gly/G)

10. Following is the structure formula of one of the amino acids?

A. Glutamic Acid

B. Glutamine 

C. Glycine 

D. Histidine 

E. Isoleucine 

Answer: D. Histidine (His/H)

11. Following is the structure formula of one of the amino acids?

A. Glutamic Acid

B. Glutamine 

C. Glycine 

D. Histidine 

E. Isoleucine 

Answer: E. Isoleucine (Ile/I)

12. Following is the structure formula of one of the amino acids?

A. Leucine 

B. Lysine  

C. Methionine  

D. Phenylalanine  

E. Proline  

Answer: A. Leucine (Leu/L)

Carefully differentiate between Leucine and Isoleucine's structure.

13. Following is the structure formula of one of the amino acids?

A. Leucine 

B. Lysine  

C. Methionine  

D. Phenylalanine  

E. Proline  

Answer: B. Lysine ( Lys/K)

14. Following is the structure formula of one of the amino acids?

A. Leucine 

B. Lysine  

C. Methionine  

D. Phenylalanine  

E. Proline  

Answer: C. Methionine (Met/M)

15. Following is the structure formula of one of the amino acids?

A. Leucine 

B. Lysine  

C. Methionine  

D. Phenylalanine  

E. Proline  

Answer: D. Phenylalanine (Phe/F)

16. Following is the structure formula of one of the amino acids?

A. Leucine 

B. Lysine  

C. Methionine  

D. Phenylalanine  

E. Proline  

Answer: E. Proline (Pro/P)

17. Following is the structure formula of one of the amino acids?

A. Serine 

B. Threonine   

C. Tryptophan   

D. Tyrosine   

E. Valine

Answer: A. Serine (Ser/S)

18. Following is the structure formula of one of the amino acids?

A. Serine 

B. Threonine   

C. Tryptophan   

D. Tyrosine   

E. Valine

Answer: B. Threonine (Thr/T)

19. Following is the structure formula of one of the amino acids?

A. Serine 

B. Threonine   

C. Tryptophan   

D. Tyrosine   

E. Valine

Answer: C. Tryptophan (Trp/W)

20. Following is the structure formula of one of the amino acids?

A. Serine 

B. Threonine   

C. Tryptophan   

D. Tyrosine   

E. Valine

Answer: D. Tyrosine (Tyr/Y)

21. Following is the structure formula of one of the amino acids?

A. Serine 

B. Threonine   

C. Tryptophan   

D. Tyrosine   

E. Valine

Answer: E. Valine ( Val/V)

22. A linear sequence of Amino acids is following type of protein?

A. Primary structure 

B. Secondary structure 

C. Tertiary structure 

D. Quaternary structure 

Answer: A. Primary structure 

Protein and enzymes structure has four main elements.

23. Two main structure of folded proteins of local amino acids that is Alpha helices and beta pleated sheets are type of protein?

A. Primary structure 

B. Secondary structure 

C. Tertiary structure 

D. Quaternary structure 

Answer: B. Secondary structure (occurs when the sequence of AA are linked by hydrogen bonds)

Two main structure: Alpha helices and formed from predominantly hydrophilic AA.

Beta-Pleated sheets: largely formed from hydrophobic AA. Both chains form large through hydrogen bonding.

24. A more complex folding and arrangements of these helices and sheets into a globular structure held togas through hydrogen bonds, ionic interaction and disulfide bonds?

A. Primary structure 

B. Secondary structure 

C. Tertiary structure 

D. Quaternary structure 

Answer: C. Tertiary structure 

Tertiary amine also incorporate non amino acid component e. G metal ions structure elements. 

25. A combination of two or more individual protein chains to form a multisubunit protein complex maintained by hydrogen bond, ionic and hydrophobic interactions?

A. Primary structure 

B. Secondary structure 

C. Tertiary structure 

D. Quaternary structure 

Answer: Quaternary structure (allows greater regulation of transport function such as hemoglobin and oxygen delivery and enzyme activity such as cooperatively and on off control.

26. An example of mutational change in DNA that can lead to abnormal protein such as a single nucleotide polymorphism (SNP) in the sequence of the coding DNA lead to alternate amino acid sequence?

A. Sickle cell anemia 

B. Tuberculosis 

C. Immunodeficiency 

D. Autoimmune disease 

Answer: A. Sickle cell anemia 

Normal adults: hemoglobin has glutamic acid at the sixth position in the beta globin protein chain.

Because of a Single mutation A-T, sickle cell patient have a Valine at 6th position. This change in beta globin structure leads to change in overall hemoglobin structure. 

Common Post translational modification of specific amino acids 

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