USMLE-like pharmacology quiz. Part 1: general principles

The following are multiple choice questions in a style similar to those included in the USMLE step 1. The main topic here is basic principles of pharmacology. This quiz has been uploaded to Scribd by medical student James Lamberg. The answers can be found in link at the end of this post.

Note: the words underlined don’t mean right answer but link to another page.

1 – Introduction to Pharmacology: Basic Principles
1) Which of the following is NOT part of the etymology of the word pharmacology?
a) Medicine
b) Drug
c) Herb
d) Poison
e) Study

2.1) Which of the following describes an agonist?
a) Any substance that brings about a change in biologic function through its
chemical action
b) A specific regulatory molecule in the biologic system where a drug interacts
c) A drug that binds to a receptor and stimulates cellular activity
d) A drug that binds to a receptor and inhibits or opposes cellular activity
e) A drug directed at parasites infecting the patient
2.2) Xenobiotics are considered:
a) Endogenous
b) Exogenous
c) Inorganic poisons
d) Toxins
e) Ligands
2.3) Which of the following would be a toxin (poison of biological origin)?
a) Pb
b) As
c) Hg
d) Atropine
2.4) The vast majority of drugs have molecular weights (MW) between 100 and 1,000.
Large drugs, such as alteplase (t-PA), must be administered:
a) Into the compartment where they have their effect
b) Orally so they do not absorb too quickly
c) Rectally to prevent irritation to the stomach lining and vessels
d) Via the intraosseous (IO) route
e) Titrated with buffering agents to prevents cell lysis
2.5) Which of the following occurs with drugs that are extremely small, such as Lithium?
a) Receptor mediated endocytosis
b) Minor drug movement within the body
c) Vasodilation when injected intravenously (IV)
d) Specific receptor binding
e) Nonspecific binding
2.6) Drugs fit receptors using the lock and key model. Covalent bonds are the ____ and
the ____ specific.
a) Strongest; Most
b) Strongest; Least
c) Weakest; Most
d) Weakest; Least

2.7) Warfarin (Coumadin) is given as a racemic mixture with the S enantiomer being four
times more active than the R enantiomer. If the mixture of Warfarin given is 50% S and
50% R, what is the potency compared with a 100% R enantiomer solution?
a) 4 * R + 1 * S = 1
b) 4 * R + 1 * S = 1.5
c) 4 * R + 1 * S = 2
d) 4 * R + 1 * S = 2.5
e) 4 * R + 1 * S = 4
2.8) What determines the degree of movement of a drug between body compartments?
a) Partition constant
b) Degree of ionization
c) pH
d) Size
e) All of the above
3.1) Which of the following is NOT a protein target for drug binding?
a) Side of action (transport)
b) Enzymes
c) Carrier molecules
d) Receptors
e) Ion channels
3.2) Which of the following is an example of a drug acting directly through receptors?
a) Protamine binds stoichiometrically to heparin anticoagulants
b) Adrenergic beta blockers for thyroid hormone-induced tachycardia
c) Epinephrine for increasing heart rate and blood pressure
d) Cancer chemotherapeutic agents
e) Mannitol for subarachnoid hemmorhage
4.1) What is added with drug subclassification, such as an antitubercular drug versus an
antibacterial drug?
a) Cost
b) Size
c) Ionization
d) Precision
e) Speed
4.2) What type of drug is propranolol (Inderal)?
a) Anticonvulsive
b) Antihypertensive
c) Antinauseant
d) Antihistamine
e) Antipyretic
5.1) Which of the following is considered the brand name?
a) Propranolol
b) Inderal
c) Adrenergic ß-blocker
d) “off label” use
e) Blocks ß-receptors in heart myocardium
5.2) Which of the following is considered the class?

a) Propranolol
b) Inderal
c) Adrenergic ß-blocker
d) “off label” use
e) Blocks ß-receptors in heart myocardium
5.3) Which of the following cases would be contraindicated for propranolol (Inderal)?
a) Hypertension
b) Essential tremor
c) Angina
d) Tachycardia
e) Asthma
5.4) Which of the following adverse effects (side-effects) is NOT commonly seen with
cholinergic antagonists?
a) Blurred vision
b) Confusion
c) Miosis
d) Constipation
e) Urinary retention
6.1) The drug chloramphenicol (Chloromycetin) is risky for which of the following?
a) Neonates
b) Geriatric patients
c) Adult males
d) Obese patients
e) Congestive heart failure patients
6.2) How does the glomerular filtration rate (GFR) change after the age of 40?
a) Increase 1% each year
b) Increases 2% each year
c) Decreases 1% each year
d) Decreases 2% each year
e) Does not depend on age
6.3) A decrease in renal and liver function, as seen in the elderly, would prolong drug
half-life, ____ plasma protein binding, and ____ volume of distribution.
a) Increase; Increase
b) Decrease; Decrease
c) Increase; Decrease
d) Decrease; Increase
6.4) When prescribing isoniazid (Rimifon), pharmacogenetics must be considered as
>90% of Asians and certain other groups are ____ acetylators, and thus have a ____
blood concentration of a given dose and a decreased risk of toxicity.
a) Slow; Increased
b) Slow; Decreased
c) Fast; Increased
d) Fast; Decrease
6.5) Which of the following are the two modifying factors that contribute to why women
have higher blood peak concentrations of alcohol than men when consuming equivalent

a) Lower blood volume & increased hormones
b) Lower fat content & more gastric alcohol dehydrogenase (ADH)
c) Higher fat content & more gastric alcohol dehydrogenase (ADH)
d) Lower fat content & less gastric alcohol dehydrogenase (ADH)
e) Higher fat content & less gastric alcohol dehydrogenase (ADH)

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