NBME CBSE: BASIC PHARMACOLOGY EXAM QUESTIONS

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NBME CBSE: BASIC PHARMACOLOGY EXAM QUESTIONS

Actual Qs and Ans Expert-Verified Explanation

This Exam contains:

-Guarantee passing score -24 Questions and Answers -format set of multiple-choice -Expert-Verified Explanation

Question 1: What three reactions occur during Phase II Metabolism?

Answer:

1) Glucuronidation

2) Acetylation

3) Sulfonation Question 2: What is a common drug that is restricted to the vascular compartment and has a low volume of distribution?

Answer:

Warfarin (large, chargerd molecule)

Question 3: T/F First Pass Metabolism can be reduced in liver disease patients.

Answer:

True (this can cause more drug to reach circulation then expected)

Question 4: Below there is data for 2 different enzymes in the body. Which enzyme has a higher binding affinity and which enzyme has a higher capacity?

Enzyme A: Km 0.002, Vmax 50

Enzyme B: Km 0.004, Vmax 80

Answer:

High Binding Affinity: Enzyme A

Higher Capacity: Enzyme B

Question 5: T/F

Cyclosporine, some macrolides, and azole antifungals can inhibit Phase I Metabolism through cytochrome P450.

Answer:

True

Question 6: What is a common protein that many drugs bind to in the plasma?

Answer:

Albumin

Question 7: T/F Phase II metabolism can slow in elderly patients.

Answer:

False:

Phase I metabolism can slow in elderly patients.

Question 8: If there is a slow acetylator what will be the effect of

hepatic N-acyltransferase on isoniazid metabolism?

Answer:

isoniazid metabolism will decrease because if depends on acetylation by hepatic N-acyltransferase Question 9: Are the following inhibitors or induces of P450: ? Isoniazid ? Erythromycin ? Cimetidine ? Azoles ? Grapefruit juice

? Ritonavir (HIV)

Answer:

Inhibitors

Question 10: What three reactions occur during Phase I Metabolism?

Answer:

1) Reduction

2) Oxidation

3) Hydrolysis Question 11: What are common causes of Hypoalbuminemia? (less plasma binding protein, increase volume of distribution in tissues)

Answer:

1) Liver Disease

2) Nephrotic Syndrome

Question 12: Both

Procainamide and Hydralazine are metabolized by acetylation. What issue can these two drugs cause?

Answer:

drug-induced lupus (more likely among slow acetylators

Question 13: What three class drugs follow capacity-dependent elimination?

Answer:

1) Ethanol

2) Phenytoin

3) Aspirin Question 14: Are the following inhibitors or induces of P450: ? Chronic EtOH ? Rifampin ? Phenobarbital ? Carbamazepine ? Griseofulvin ? Phenytoin

Answer:

Inducers Question 15: T/F In kidney/liver disease, maintenance dose may fall. This is because more drug is eliminated per unit time.

Answer:

False: In kidney/liver disease, maintenance dose may fall. This is because

LESS drug is eliminated per unit time.Question 16: What is a common drug that accumulates in tissue and has a high volume of distribution?

Answer:

Chloroquine (small, lipophilic molecule) Question 17: What are two clinical relevant possibilities of cytochrome P450 inhibition?

Answer:

1) Some Statins + Inhibitor (Gemfibizole) = Rhabdo (High CK)

2) Warfarin

Question 18: What is commonly used to alkalinize urine?

Answer:

Sodium Bicarbonate Question 19: Are Phenobarbital and Aspirin weak acids or bases and will the urine alkalinize or Acidify to excrete more drugs?

Answer:

Weak acids so the urine will alkalinize to excrete more drug