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MOCK TEST 1

1) What is the first line therapy for onychomycosis?


A. Itraconazole B. Terbinafine C. Fluconazole D.Cicloperox E.
Clotrimazole
Ans. B
1st line 2nd line 3rd line
Onychomycosis Terbinafine Itraconazole fluconazole
Athletes foot Clotrimazole Miconazole Tolnaftate
vaginalCandidiasis Clotrimazole Nystatin/miconazole
Oral thrush Nystatin
liquid
Dandruff Ketoconazole Selenium sulfide

Tips: Systemic antifungals are the most effective treatment, with


meta-analyses showing mycotic cure rates of 76% for terbinafine,
63% for itraconazole with pulse dosing, 59% for itraconazole with
continuous dosing, and 48% for fluconazole. Concomitant nail
debridement further increases cure rates. Topical therapy with
ciclopirox is less effective; it has a failure rate exceeding 60%. Several
nonprescription treatments have also been evaluated. Laser and
photodynamic therapies show promise based on in-vitro evaluation,
but more clinical studies are needed. Despite treatment, the
recurrence rate of onychomycosis is 10% to 50% as a result of
reinfection or lack of mycotic cure.

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2) Which of the following bacteria cause Lyme disease after I.
pacificus bites of ticks?
A) Corynebacerium diptheria B) Corynebacterium parvum. C)
Tropenema pallidum D) B. burgdoferi E) S. aureus
Ans. D
Infections Most common
CAP S. pneumonia
Otitis media S. pneumonia
Meningitis S. pneumonia
Sinusitis S. pneumonia
Lyme disease B. burgdoferi

3) Pramoxine 1% (Pramacaine) ointment is used in hemorrhoids as?


A) Anti inflammatory agent B) Astringent C) Local anesthetic
D) Wound healing agent
Ans. c

4) What is function of Corpus collasum in brain?


A. Part of brain control voluntary and non voluntary function
B. A nerve fiber connect right and left hemisphere of brain
C. A nerve fiber connect mid brain to corpus collasum
D. A nerve fiber connect front lobe to mid lobe
ans. B

5.RPK is 40 year old women newly diagnosed with type 2 diabetes. Doctor
prescribed metformin 1000 mg TID. Which of the following is the pharmacist
concern?
A. Metformin start with low dose and then use high dose to decrease GI side
effects

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B. Metformin start with low dose and then use high dose to decrease risk of
lactic acidosis
C. Metformin start with low dose and then use high dose to decrease risk of
diarrhea
D, Metformin start with low dose and then use high dose to decrease risk of
renal disease
E. Metformin start with low dose and then use high dose to decrease risk of
hepatic disease
Ans. A
Tips. Initiating high dose metformin is concern due to increase risk of
GI side effect.

6) Doctor prescribed 20 mEq of K for a patient. Hospital pharmacy


potassium salt preparation container labeled in mg. How many mg of
potassium should be taken? (M.W. K+ is 39)
A) 600 mg B) 358 mg C) 780 mg D) 480 mg
E) 320 mg
Ans. C
Tips
1 mEq= 39 mg K
20 mEq x 39 mg = 780 mg K

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7) You have 20 ml ampoule having a concentration of 0.75%
and you need to prepare 250 ml solution having a
concentration of 0.125%, so what the volume of liquid
needed to dilute the solution.
A) 41.67 B) 250 ml C) 75 ml D) 125 ml
Ans. A
Tips. C 1 V 1 = C 2 V2
0.75 x V = 0.125 x 250.
V = (0.125x250)/0.75
Therefore V = 41.67

8) A clinical trial report shows that a control drug gives side effects in
50 patients among 500 and test drug gives 25 among 500 patients.
Find the number needed to treat?
A) 20 B) 200 C) 2000 D) 100 E) 50
Ans. A
Tips:
(50/500) x 100 = 10%
(25/500) x 100 = 5%
ARR = 10-5 = 5%
NNT = 1/ARR = (1/5) x 100 = 20
Absolute risk reductions Relative risk
ARR = CER-EER RRR = (CER-EER)/CER
NNT = 1/ARR
NNH = 1/ARI

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9. An average Canadian pharmacy cost goods sold was
$1.500,000 and closing inventory was $400,000. What is the
opening inventory?
A. 1.500,000 B. $200,000 C. $800,000 D. $400,000 E.
350,000
Ans. D

10) You have 40 mg/mL of a stock solution of triamcinolone,


and are asked to prepare 200 mL of solution at a final
concentration of 3.75 mg/mL triamcinolone. How much
stock solution would you need?
a) 9.4 b) 14.1 c) 18.8 d) 28.1 e)
37.5
Ans. C
Working.
i. 200 mL of 3.75 mg/mL solution will contain
(200 x 3.75) = 750 mg of triamcinolone
ii. 750 mg triamcinolone is contained in 750/40 =
18.75 mL

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11.Which of the following is main barrier for drug
penetration through skin?
A. Stratum corneum B. Cornea C. Hair follicles D. Sweat
glands E. Sebaceous gland
Ans. A
Tips. Stratum corneum is present in epidermis layer is the
major barrier for topical absorption (rate determine factor).

12) HAMA stands for?


A) Human antigen Mouse antibody
B) Human anatomy and mouse anatomy
C) Human antibiotics developed from mouse
D) Human Assay for Mouse antigens
E) Human AntiMouse Antibody
Ans. E
Tips. HAMA is human antimouse antibody. Hypersensitivity and
infusion-related reactions, with or without the development of
human antimouse antibodies (HAMAs), are generally greatest with

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murine antibodies and least with humanized antibodies also known
chimeric antibodies. Example infliximab.

13) Type 4 hypersensitive reaction is triggered by T cells by


acting on?
A) Neutrophil
B) Ig E
C) Ig M
D) T cell receptors
E) Ig G
Ans. E
Tips. T cell binds with Ig G on T-cell surface, thus cause
hypersensitive reaction.

14) Demyelination nerve characterized as?


A) multiple sclerosis
B) autoimmune disease
C) Tuberculosis
D) Immunization
Ans. A

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Tips. The first attack of multiple sclerosis characterized by a
neurologic syndrome such as optic neuritis and generally seen with
silent or asymptomatic white matter lesions (seen on magnetic
resonance imaging) suggestive of demyelination (myelin sheet
damage). Individuals that experience a clinically isolated syndrome
are at high risk of developing definite multiple sclerosis.

15) In schizophrenic patient with Alzheimer and Parkinson


disease if haloperidol is used. Because haloperidol:
A) Is high potent neuroleptic with less extra pyramidal effect
B) Is high potent neuroleptic with less anticholinergic effect
C) Is high potent neuroleptic with less sedation
D) Is least potent neuroleptic with high extra pyramidal side
effects
E) Is least potent neuroleptic with high anticholinergic effect
Ans. C
Tips. Haloperidol is the high potency typical antipsychotics
however has less sedation (antihistamine) side effect.

16) Bisphosphonates act by?


A) Increases bone mineral density by inhibiting osteoblast
B) Increases bone mineral density by inhibiting osteoclast
C) Increases bone mineral density by formation of osteoblast
D) None of the above

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Ans. B
Tips. osteoclast cause bone resorption (bone death).
Osteoblast helps in bone formation.

17) A women comes to your pharmacy explains her


symptoms of vaginal irritation, yellow and fishy odor
discharge, which of the following can be cause of these
symptoms?
A) Candida infection B) Viral infection C) Fungal D)
Bacterial infections E) Allergic
Ans. D
Tips. Odor discharge and yellow color discharge are typical
symptoms of bacterial or Trichomonas symptoms. However
pruritus is the typical symptoms candida infections.

18) A woman phoned the pharmacist and told him that her husband
has swallowed 20 tabs of acetaminophen 325 mg. What is the proper
advice?
A) Ask her wait and watch, he will be ok
B) Induce emesis-using ipecac
C) Call the poison center to ask for advice
D) Take him to the emergency department
E) Call doctor to ask what to do
Ans. C

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Tips. The overdose of symptoms acetaminophen toxicity within 24 hours is
nausea and vomiting.
Symptoms:
Phase I (12-24 hrs) nausea, vomiting, anorexia, and sweating
Phase II (1-4 days) No symptoms (asymptomatic)
Phase III (2-3 days in untreated patient): nausea, abdominal pain, liver failure,
coma and death.
Treatment for more than 7 g in adults, 100 mg/kg in children
treatment is recommended. elderly and alcoholic patient higher
chance of toxicity. Within 2 hrs toxicity should be treated by ipecac
or gastric lavage. The N-acetyl cysteine is an antidote is used for
patients with toxic blood levels .

19) A doctor is considering anticoagulant therapy to treat deep vein


thrombosis. What is incorrect statement?
A) LMWH therapy are effective in preventing DVT
B) Heparin therapy require close monitoring than LMWH
C) Heparin is weight based intravenous therapy is used in acute DVT
D) Warfarin produce rapid anticoagulation than LMWH
E) Long term heparin therapy can cause osteoporosis side effect
Ans. D
Tips. LMWH have long half life therefore daily single dose SC
injections are use. Whereas heparin is q12h iv or sc injection are use.

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20. What laboratory values should be periodically monitored on a
patient that has just been prescribed valproic acid to generalized
seizure?
A. Complete blood counts
B. Liver function test
C. Renal function
D. Blood pressure
E. Triglycerides
Ans. B
Tips. valproic acid is hepatotoxicity require liver function test
monitoring.

21. JP is 35 year old man. He has been diagnosed hypertension, high


triglycerides and high blood sugar levels. He became health
conscious and he recently quit smoking. Which of the following is
NOT a withdrawal symptoms?
A. weight gain B. constipation C. blurred vision D. Craving E.
Headache
Ans. C
Tips. Smoking cessation symptoms includes. Severe craving, anxiety
or irritability, restlessness, nervousness, difficulty with
concentration. Sleep disturbance, headaches, increase appetite
(weight gain) or eating habit and constipation.

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22) How many mEq of Mg2+ are present in 50 ml of 20%
MgSO 4 solution? (MW of MgSO4 246 g)
A. 31.56
B. 81.30
C. 101.52
D. 41.25
E. 2.60%
Ans. B
50ml of 20% MgSO4 = 10 g
Equivalent weight = 246/2 = 123 g
Total mEq of Mg2+ = (10/123)x1000 = 81.30 mEq

23. Addition of permeability enhancer to increase of permeation of


drug from transdermal drug delivery system (TDDS) by which
mechanism?
A. Change lipid content in the skin by solubilising lipid content within
stratum corneum
B. Change of skin absorption system by decreasing diffusion of drug
in to system
C. Interact with skin to decrease the flux
D. Decrease diffusion coefficient
E. Increasing the water content of stratum corneum
Ans.A
Tips. stratum corneum contain 50-80% water. The permeability
enhancer (surfactants) increase lipid content of stratum corneum
thus enhance absorption of topical drugs.

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24. What is correct about vaccination?
A. Dukoral vaccine is given 3 months before travel
B. Pneumococcal vaccine is given annually
C. Flu vaccine is not given for children age 6 months to 5 years
D. Tetanus toxoid is given every 10 years up to adolescent
E. Hepatitis vaccine is NOT recommended to travelers
Ans. D.
Tips.
Dukoral. 2 dosage 1 week apart, first dose 2 wks before travel.
Pneumococcal vaccine q5 to 10 yrs.
Vaccine
Flu vaccine annually
pneumococcal 5-10 y
Dukoral Effective up to 3 yrs
Hepatitis A and B
Gardasil 12-26 yo
Zostavax >55 yo

25) In insurance plan drug price is $29.00 and $6.00


prescription fee. Every time this patient pays $2.00 for each
prescription what is it called?
a. Coinsurance

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b. Co-payment
c. Prescription fee
d. Gross margin
Ans. B
Tips. Each time patient pays specific amount is co-payment.

Deductible Co-payment Co-insurance


Pay onetime in the Pay each time for Each time you share
beginning of every every prescription the expenses
year.

26) A 60 year old patient is suffering from CHF. He is taking Captopril


25 mg tid and Carvedilol 25mg bid. His LVEF 35%, BP 115/82,
Creatinine clearance 65 ml/min, Serum potassium 6.15 mmol/L,
Serum sodium= 140 mEq/L. If doctor considering to treat edema.
Which of the followings should Not be added to this patient?
A) Digoxin
B) Furosemide
C) Spironolactone
D) Hydrochlorothiazide
E) All of the above
Ans. C

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Tips: Lab results of potassium (normal K levels to 3.5 to 5 mmol/L)
shows 6.15 mmol/L thus adding potassium sparing agent like
spironolactone may increase potassium. Therefore avoid
spironolactone.

27) A man comes to your pharmacy for his wife because she is ill, not
eating food and not talking for the past two day. She is pregnant and
have severe nausea vomiting. She has vomited several time in last
two days. What to do?
A) give dimenhydrinate
B) refer doctor get Diclectin prescription
C) refer to emergency
d) recommend self care
E) give oral rehydration solution
Ans. C

28) A 52 yo women using Synthroid 75 mcg daily dose. Recently her


blood test done it showed her TSH are less than 0.4 mU/L. What is
the appropriate action to do?
A) increase dose of Synthroid to 100 mcg

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B) Double the dose Synthroid
C) do not change the dose of Synthroid
D) decrease dose of Synthroid
E) Recommend to take empty stomach
Ans. D
Tips. TSH are less than 0.4 mU/L is indicator of overdose of
Synthroid, thus decrease dose.

29) A researcher develops a new drug to prevent the common cold in


children over the of two. 1000 children received placebo and 1000
received the drug. During the one-year follow up the research
diagnosed colds in 2.5% of the kids on placebo and in 2% of the
active treatment. What is the absolute risk reduction?
A) 0.5% B) 20% C) 10% D) 40% E) 5%
Ans. A
Tips. Absolute risk reduction (ARR) = EER – CER : 2.5%-2% = 0.5%

30) What is Not true about the excipients?


A)They help in efficient manufacturing of tablets
B)They can change the bioavailability of the tablets
C) They include diluents, binders, lubricants, disintegrant,
etc.

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D) Different excipients are used to serve different purposes
while formulating tablets.
E) They affect the pharmacokinetic and pharmacodynamic
properties of the drug
Ans. E

31) Adduction is?


A) Movement toward the midline of the body
B) Movement away from the midline of the body
C) Lengthening or straightening of a flexed limb
D) Bending a part of the body
E) Back ward (upward) bending of the foot
Ans. A

32) What equation describes the velocity of enzyme reaction?


A-Law of mass action
B-Michaelis-Menten equation
C- Fick’s law
D- Stokes’ law
E- Noyes-Whitney equation

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Ans. B

33) Which of the followings is used as an emulsifying agent?


A. Petrolatum
B. Triethanolamine oleate
C. Aluminum acetate
D. Witepsol
E. Sodium alginate
Ans. B

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34) All the following is/are true with respect to the storage of
medications except:
A) Cold not to exceed 10 oC
B) Freezer (-10 to -20 oC)
C) Cool (8-15oC)
D) Warm (30-40 oC)

Ans. A
Tips. Cold is fridge 2-8 oC

34) If Drug A 500 mg sustain release product is given every 12 hours


and Drug B 250 mg of immediate release product is given every 12
hours, assuming the bioavailability of product is the same.
A. Drug A and drug B, AUC will be equivalent at steady state
B. Drug A and drug B Cmax will be equivalent at steady state
C. Drug A and drug B Tmax will be equivalent at steady state
D. Drug A and drug B AUC, Cmax, Tmax will be equivalent at steady
state
Ans. A

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35) What are the most common cause of bacterial meningitis
infections?
A. S. pneumonia B. H. influenza C. Nisseria meningitis D. E.coli E. S.
aureus
Ans. A

36) A patient calls to ask if her digoxin has changed color and
shape. What would be the most appropriate response?
a) Tell the patient that an error has been made and refer her
to the physician.
b) Determine if the color and shape for the tablets dispensed
have been changed by the manufacturer and convey this
information to the patient
c) Obtain the patient’s name, prescription number and the
color of the tablet and verify the patient prescription.
d) Explain that this is a serious matter and the medication
should be brought back to the pharmacy to be checked by
the pharmacist
Ans. C

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37) A 75-year-old patients suffering from pneumonia. Her daughter
is looking after her. She has 2 children at home. Doctor hesitates to
give flu shot to the patient. What will doctor do?
A) Immunize other family member
B) Send him to nursing home
C) Do not gives flu shot to others
D) Flu vaccine is irrelevant
E) Refer to emergency
Ans: A

38) Cholesterol is synthesized in?


A) Blood circulation
B) Liver
C) Bacterial cell wall
D) lymphatic system
E) Adipose tissue
Ans. B
Tips: endoplasmic reticulum of cell. More commonly in liver cells.
Most bacterial do NOT synthesize cholesterol.

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39) If a pediatric patient is to receive ampicillin oral suspension,
which of the following is NOT important?
A) Affix label of expiration date
B) Affix an auxiliary "shake well before use" label
C) Ensure the patient is NOT allergic to penicillin's
D) Use aseptic techniques to reconstitute the medication
E) Label store in refrigerator
Ans. D
Tips. All extemporaneous preps should contain expiration date. All
oral preps need NOT to prepare in sterile conditions. Only
parenteral, chemo and ophthalmic products require sterile
conditions.

40) What is incorrect about benzodiazepines?


A) Agents lacking 3-hydroxyl group undergo phase I metabolism
B) Most long-acting agents form intermediate metabolite
C) Agents with 3-hydroxyl group are easily metabolized by phase II
metabolism
D. Benzodiazepine have diazepine ring
E. Benzodiazepine are analogs of benzazepine
Ans. E
Tips. benzazepines are 2nd gen antipsychotics such as clozapine,
quetiapine.

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41) A pharmacist adds 400 ml of alcohol (95%) v/v to a 1 litre
of a mouthwash formula. What is the new percentage of
alcohol present if the ordinary mouthwash was labelled as
12% v/v of ethanol?
A) 36% B) 40% C) 45% D) 50%
Ans. A
(400 ml) (95 %) + 1000 ml (12%) = (1400 ml) (X%)
380 + 120 = (1400 ml) (X%)
X% or (X/100) = (500/1400)
X = 35.7

42) Find the absolute bioavailability of comp B tab

Company Dose form Dose Cumulative urinary amount


admin.
A Parenteral 10 mg i.v. 9.4
A Tab 20 mg po 12.0
B Tab 20 mg po 8.2
B Cap 15 mg 6.8
A) 0.94 B) 9.4 C) 0.44 D) 8.2
Ans. C
Absolute Bioavailability = (AUC oral/dose)/AUC iv/dose
=( 8.2/20)/ (9.4/10)
= 0.42/0.94 = 0.44

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43. Canadian Health Care System is?
A. Centralized health care system
B. Pharmaceutical care
C. Compassionate care
D. Medicare system
E. social care
Ans.D
Tips. Canadian health care system is medicare system.

44) A patient weighs 70 kg with normal renal function is injected


with an IV drug for 10 hours. The desired plasma concentration is 15
mg/dL. T ½ of drugs is 1 hr and an apparent volume of distribution is
9 Litres. What is the rate of infusion for this patient?
a) 936 mg/hr
b) 1350 mg/hr
c) 468 mg/hr
d) 93.6 mg/hr
e) 135 mg/hr
Ans. A
Tips: V d = 9 L → 90 dL k = 0.693/t1/2
T ½ = 1 hr = 0.693/1
Css = 15 mg/dL = 0.693
R = Css x V d x K el
= 15mg/dl x 90 dl x kel
= 935.55 mg/hr

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45) How many milliosmoles of calcium chloride are represented in
147 ml of a 10% w/v calcium chloride solution? (MW of CaCl2. 2H2 O
= 147)
A) 300 mOsmol B) 3 mOsmol C) 30 mOsmol D) 200 mOsmol
E-100 mOsmol
Ans. A
(147 x 10)/100 = 14.7 ml
[(14.7 ml x 3)/147] x 1000 = 300 mOsmol

46) A cancer patient is suffering from Anemia due to his


chemotherapy. Which drug is recommended for his
condition?
A) Filgrastim
B) Rituximab
C) Epoetin alfa
D) Interleukin-11
E) Iron + Folic Acid
Ans. C

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47) A patient is admitted in hospital emergency with vomiting,
lethargy, tinnitus and metabolic acidosis. Which drug poisoning can
be explained with the above-mentioned symptoms?
A)Theophylline
B)Methadone
C) Acetyl Salicylic Acid
D) Lead
E) Ethylene glycol
Ans. C
Tips: symptoms of overdose of acetyl salicylic acid.
Metabolic acidosis Respiratory alkalosis
↑CO2 ↓HCO3 Hyperventilation

48) Which of the following is the drug of choice to treat secondary


prevention of cardiogenic stroke?
A) ASA B) Warfarin C) statins D) Beta blockers E) ACEi
Ans. B

49) The sedimentation of particles in a suspension can be


minimized by:
I. Adding sorbitan mono oleate
II. Reducing the particle size of the active ingredient
III. Increasing the viscosity of the suspension
A.I only

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B. III only
C.I and II only
D. II and III only
E. I,II,III
Ans. D

50.Which of the following blood pressure a medication therapy


should be initiated to treat uncomplicated blood pressure?
A. 120/80
B. 130/85
C.140/90
D.160/90
E. 180/100
Ans. C
Tips.
Blood pressure.
120/80 Normal
140/90 Treatment
130/80 Treatment in DM, renal disease

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51. Which of the following common metabolizing enzyme for
clopidogrel?
A. CYP3A4
B. CYP 1A2
C. CYP 2C19
D. CYP 2D6
E. CYP 2C9
Ans. C
Tips. Clopidogrel is substrate of CYP2C19. PPI are inhibitor of
CYP2C19.

52) Gluathione (GSH) is a tripeptide that contain unusual


tripeptide linkage between aminoacids of?
HS
O
H
HOOC N COOH
N
H
NH2 O
Glutatione

A) L-Glutamic acid, L-Cysteine and glycine


B) L-Glutamic acid, L-Cysteine and valine
C) L-Glutamic acid, L-Cysteine and isoleucine
D) L-Glutamic acid, L-Cysteine and tryptophan
E) L-Glutamic acid, L-Cysteine and phenyl alanine
Ans. A

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53) Which gland does aldosterone secrete from?
A) Anterior pituitary gland
B) Adrenal Cortex
C) Pancreas
D) Hypothalamus
E) None of the above
Ans. B

54) Inadequate blood circulation (perfusion) to the kidneys,


which leaves them unable to clean the blood properly, is
characterized as?
A-Intrinsic acute renal failure B) Post renal acute renal
failure
C) Prerenal acute renal failure D) Chronic renal failure
E-Chronic liver failure
Ans. C

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Tips. Prerenal ARF is characterized by inadequate blood
circulation (perfusion) to the kidneys, which leaves them
unable to clean the blood properly. Many patients with
prerenal ARF are critically ill and experience shock (very low
blood pressure). There often is poor perfusion within many
organs, which may lead to multiple organ failure.

55) You have a perpetual inventory record in the hospital for


narcotics and controlled drugs. The following is/are true:
A) It is a continuous record.
B) Purchases added and products delivered are subtracted.
C) Products when returned from the ward are added to the
perpetual.
D) All of the above.
E) None of the above.
Ans. D

56) When filling a prescription for Tylenol with codeine 30


mg, a pharmacist should do all the following, except?
A) Fill the prescription as a verbal narcotic preparation
B) Affix a auxiliary label cautioning against performing tasks
requiring alertness or driving

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C) Verify that patient is NOT allergic to acetaminophen or
codeine
D) Inform the patient refills are only provided as doctor
prescribed.
E) Ask patient to monitor constipation and recommend
senna or docusate
Ans. D
Tips. Tylenol # 3 are narcotic preps or verbal narcotics and
straight narcotics have no repeats.

57) In a DNA, if a base sequence is AGT, what is the


complimentary paired base sequence?
A) ACG B) GUC C) AAC d)TCU e) TCA
Ans. E

Tips. A--T, G -- C, T --A are complimentary pairs.

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58) Quinidine is class 1a antiarrhythmic drug, which act as
sodium ion channel blocker, it exhibit action, by acting on?
A) Slows phase 0 depolarization
B- Shortens phase 3 repolarization
C- Lengthens phase 0 depolarization
D- Decreases phase 4 depolarization
E- Prolongs phase 3 repolarization
Ans. A

59) Formulary drugs in the hospital share all the following


characteristics, EXCEPT:
A) All hospitals have the same formulary.
B) Each hospital has a distinct formulary.
C) The formulary in the hospital is chosen by Pharmacy
and Therapeutics committee.
D) For all medications, the patient that is admitted to the
ward will not pay for them.
E) None of the above.
Ans. A
Tips: Each individual hospital publishes its unique formulary
drug listing.

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60) Psychotic patients non compliant and unreliable in taking
medication. Which of the following strategy enhance
compliance?
A) recommend long acting or depot dosage forms
B)Education geared towards patient becoming more
informed about their illness.
C) recommend rapid dissolving dosage form
D) recommend non pharmacotherapy like cognitive
behavioral therapy
E) hospitalization
Ans. A

61. What is correct about special populations like infants?


I. Infant has higher proportion of water in body than fat
compared to adult.
II. Increase volume of distribution of water soluble drug.
III. Increase volume of distribution of lipid soluble drug.
A.I only
B. III only
C.I and II only
D. II and III only
E. I,II,III

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Ans. C

62) Protein C and its cofactors S?


A) anticoagulants
B) Thrombolytic
C) localize clot
D) Dissolve the clot
E) increase vitamin K clot factors effect
Ans. C

63) Two generic brands of drugs with equal strength are


given orally. Tablet A results in AUC 250 (mg/L)x hour and
Tablet B results in an AUC 500 (mg/L) x hour. Which product
has better bioavailability?
A. Tablet A has higher bioavailability
B. Tablet B has higher bioavailability
C. Tablet A and Tablet B has equal bioavailability
D. Tablet A has high bioavailability then Tablet B
Ans. B

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64) What is true about the following?
A) Community workers like police officers need not take flu
shot
B) Pneumococcal vaccine is to be taken once in every 2 years.
C) Pregnant women can take both live and killed vaccines
D) Passive vaccines are IV/IM injection of antibody
preparations
E) None of the above is correct
Ans. D

65. What is incorrect about the relation of confidence interval and


sample size
A. There is a relationship between sample size and the width of the
confidence interval.
B. The general rule is that the width of the confidence interval will be
proportional to 1/√n, so to halve the interval you need 4 times the
sample size.
C. Larger samples give more precise estimates with lower standard
error and tighter confidence intervals.
D. As the sample size increases, the interval and its width decrease,
thus providing a more precise estimate of the population value.
E. The larger the sample size the larger the confidence interval
Ans. E
Tips. The larger the sample size the smaller confidence interval.

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66) Muromonab (OKT3) is monoclonal antibody indicated?
A) Renal, cardiac and hepatic graft rejection
B) Neutropenia associated with cancer chemotherapy
C) Thrombocytopenia associated with cancer chemotherapy
D) Anemia associated with chronic renal diseases
E) None of the above
Ans. A

67. A patient has been prescribed combination of clopidogrel 75 mg


and Aspirin 325 mg, this is indicated in patients who have had?
A. ST-segment elevation myocardial infarction.
B. Congestive heart failure
C. Acute stroke
D. Transient Ischemic stroke
E. Stable angina
Ans. A

68) How many grams of 60% w/w HCl acid should be added
to 100 g of 40% w/w HCl acid to prepare 400 g of 55% w/w
HCl acid?
a) 300 g b) 250 g c) 150 g d) 100 g e) 50 g

36
Ans. A

60 15 (60%)
55
40 5 (40%)
-----------
20
400 : 20 = X : 15 ; 400/20 = X/15; 400 x15/20 = X
X= 300 g

69) You are giving ZnCl2 0.7%, phenylephrine 0.1% and boric
acid 1.1% with E values 0.16, 0.32 and 0.5 respectively. This
solution will be:
a) Isotonic b) Hypertonic c) Hypotonic d) Iso-osmotic
e) Isotonicity cannot be finding.
Ans. C
Tips. (0.7 x 0.16) + (0.1 x 0.32)+ (1.1 x 0.5) = 0.0694
= 0.0112 + 0.0032 + 0.055
NaCl = 0.9/100 = 0.009>0.00694 = Hypotonic

70) Which part of brain that controls important cognitive


skills in humans, such as emotional expression, problem
solving, memory, language?
A. Frontal lobe

37
B. Occipital lobe
C. Temporal lobe
D. Parietal lobe
E. Brainstem
Ans.A

71) What is the sensitivity of a balance that can weight 120


mg of a substance and has a permissible error of 5%?
a) 6 mg b) 16 mg c) 66 mg d) 26 mg e) 1.6 mg
Ans. A SR = Weight x Error → 15 = weight x 5/100 = 6
mg

72) If the rate of infusion of the drug is 750 mg q6hours and


clearance is 8.3 L/hr. Find steady state concentration.
a) 15.06 g/L b) 15 mg/L c) 150 mg/L d) 90 mg/L

e) 24.7 mg/L

Ans: B Css = Rate of infusion = 750/6 = 15 mg/L


Clearance 8.3

38
73. A patient clinical presentation include coarse features,
dry skin, hair, bradycardia and hypertension may be?
A. hypothyroid
B. hyperthyroid
C. hypoglycemia
D. hyperglycemia
E. hypo corticosteroid
Ans. A

74) Which one of the followings is a β-lactamase inhibitor?


A) Cloxacillin
B) Linezolid
C) Clindamycin
D) Clavulanic acid
E) Pentamidine
Ans. D

39
75.Which of the following infection prevents middle ear
infection in children?
A. Flu vaccine B. Polio vaccine C. Measles vaccine D.
pneumococcal vaccine
Ans. D

76) Which of the following drugs give side effects like


depression, bradycardia and bronchospasm?
A) Salbutamol
B) Pindolol
C) Prazosin
D) Digoxin
E)Amiodarone
Ans. B
Tips. BB that penetrate in brain cause CNS side effects.

77. Which of the following bacteria is the most common cause of


middle ear infection in children?
A. H. influenza B. S. pneumonia C. M. catarrhalis D. E. coli
Ans. B

40
78) Which of the followings is Not a phase II metabolism reaction?
A) Methylation
B) S-dealkylation
C) Acetylation
D) Glutathione conjugation
E) Sulfate conjugation
Ans. B

79) To avoid dispensing error, pharmacist can check and verify all of
the followings before dispensing a prescription, Except:
A) Patient’s name, address and date of birth
B) Name of the drug prescribed
C) Drug strength
D) Directions for use
E) Manufacturer’s name
Ans. E

80) A patient call the pharmacy asking why his heart medication is
yellow instead of the usual white color. Upon investigation, it is
discovered that the prescription was filled with digoxin 0.125 mg

41
instead 0.25 mg strength. Which of the following is the most
appropriate action to take?
A) Tell patient to take two tablets daily
B) Tell patient cut the tablets in half and take one half tablet daily
C) Ask the patient to call doctor immediately to inform inappropriate
intake of digoxin and document
D) Explain the situation to patient and ask the patient to bring the
medication to replace with correct and document the error.
E) Prepare a new prescription with 0.25 mg strength and inform the
patient that pharmacy manager is solely responsible for accuracy of
prescription
Ans. D

81) A prescription direction says ‘tabs ii stat pc; tab i pc od’.


In this prescription, the term ‘od’ can be differently meant as
A-Right ear
B-Left ear
C-Both the eyes
D-Left eye
E-Right eye
Ans. E
Tips. o.d or OD

42
82) What dosage form of drug is preferred post cataract
management?
A. oral B. Injection C. Topical D. Sublingual
E. OTIC
Ans. C

83) A patient is on warfarin for DVT and on ramipril for hypertension.


Two weeks ago, he has started a new medication. Now a days, he is
feeling severe pain in his legs again. Which drug is responsible for
worsening his DVT?
A. Sulfamethoxazole
B. Ciprofloxacin
C. Carbamazepine
D) Cephalexin
E) None of the above
Ans: C
Tips. Carbamazepine is CYP2C9 enzyme inducer and warfarin is
substrate of CYP2C9. Thus increase clearance of warfarin and may
reduce the anticoagulant effect.

84) A diabetic patient suffering from hypertension is having


enalapril, however he is complaining from severe dry cough that we
can associated as a side effect of the enalapril. Which would be the
best choice for changing this medication?
a) Ramipril

43
b) Losartan
c) Amlodipine
d) Indapamide
e) Captopril
Ans. B

85) Rasagiline is IRREVERSIBLE selective MAOi type B


inhibition, it irreversible action is due essential moiety
present as?
A) propargylamine B) alkylamine C) catecholamine D)
dihydroxyl group
Ans. A
Tips: propargylamine group is essential for irreversible action
of Rasagiline and selegiline.

86) Late cycle breakthrough bleeding is side effect


contraceptives due to?
A) deficiency of estrogen
B) deficiency of progesterone
C) deficiency of androgens
D) ethinyl group present on C-17 position
E) benzene ring present in estrogen
Ans. B

44
Tips. Late cycle breakthrough bleeding is due to deficiency of
progesterone. Mid-cycle breakthrough bleeding is due to deficiency
of estrogen. Androgenic progesterone like norgesterol are associated
with acne and increase appetite effects.

87) A patient is taking salbutamol and fluticasone. He brings a new


prescription of propranolol. What type of interaction is expected?
A) Drug and Disease interaction B) Drug and food interaction
C) Drug and Drug interaction D) Both A & B E) Both A & C
Ans. E
Tips. Salbutamol is beta 2 agonist and propranolol is beta 2 blockers.
cause drug-drug interactions. Propranolol can worsen asthma thus
drug and disease interactions.

88) Which of the following is an essential building block of


folate antagonist and antimetabolites anticancer drug
methotrexate?
A. Purine analog guanine and adenine
B. Pyrimidine analog cytosine, thymine, and uracil
C. Para aminobenzoic acid

45
d. nucleotide analog
Ans. C

89) The most important enzyme in a polymer chain reaction


(PCR) reaction is called?
A. Reverse transcriptase
B. DNA restrictive polymerase
C. Taq polymerase
D. Lyase
E. Ligase
Ans. C
Tips. Taq polymerase enzyme is produced from Thermos
aquaticus bacteria and is used in PCR.

90) Which drug should be taken 30 min before meal?


A) Captopril B) Lovastatin C) Methotrexate D) Ramipril
E) Metformin
Ans. A
Tips. Captopril is taken empty stomach. (30 min before
meals). Antidiabetic drugs taken just before meals like
meglitinides and Acarbose.

46
91) Correct statements regarding trituration include:
a) Process of mixing powders in a large container rotated by
a motorized process
b) Process when potent substance must be mixed with a
large amount of diluents.
c) Process of reducing the substance to small particles by
rubbing it in a mortar with a pestle.
d) Process of reducing the substance by addition of a solvent
that is easily removed after pulverization.
e) Process of mixing powders by passing them through sifters
Ans. C

92. Which of the following the most common type of drug


absorption form cell membrane?
A. Drug diffusion
B. Active transport
C. drug diffusion and active transport
D. Protein linked transport
E. None of the above
Ans. A

47
93) According to institute of safe medication practice (ISMP)
guidelines, which of the following is the least confusing
abbreviation?
A) q4h B) per os c) q.d d) µg e) mg
Ans. A
Tips. q6h or qid

94)A pharmacist would like to make a compound


prescription where he needs to mix 1% of camphor into
white petroleum. Which would be the appropriate technique
to be used by the pharmacist
a) Trituration
b) Levigation
c) Pulverization by intervention
d) Geometric dilution
e) Attrition
Ans. B

48
Tips. Camphor (pulverize with ethanol) gives eutectic
mixture. Ointment slab take white petrolatum and pulverize
camphor geometric dilution

95) ELISA is a common serological test for the presence of


particular antigens or antibody. What does ELISA stand for?
A-Enzyme Linked Immunosorbent Assay
B. Enzyme Linked Immune system Assay
C. Enzyme Linked Immune Serum Assay
D) none of the above
Ans. A

96) Which one is incorrect among the following drug-side


effect relations?
A) Amphetamine-Weight gain
B) Verapamil- Constipation
C) Prazosin-Postural hypotension
D) Atorvastatin-Myalgia
E) Zopiclone-Metallic taste
Ans. A

49
97) You have 20 ml ampoule having a concentration of 0.75%
and you need to prepare 250 ml solution having
concentration of 0.125%, so what the volume of liquid
needed to dilute the solution?
A) 75 ml B) 42 ml C) 250 ml D) 125 ml E) 20 ml
Ans. B
How to solve:
C 1 x V1 = C 2 x V2
0.75 x V = 0.125 x 250
Therefore V = 41.67 ml

98) All are tertiary literatures, Except:


A. Compendium of Therapeutic choice
B. Remington
C. Medline
D. Martindale
E. Compendium of Therapeutic Minor Ailment
Ans. C
Tips. Text books are tertiary literature and Medline is an
index therefore it is secondary literature.

50
99) What correct instructions should be labelled in the
following preparation?
Salicylic acid 2%
Lactic acid 6 ml
Flexible collodion ad 30 ml
A- Flexible collodion is extremely flammable.
B- Tightly close the container to prevent ether and alcohol.
C- Keep away from fire
D- All of the above
E- None of the above
Ans. D

100. Mercaptopurine are chemical analog of?


a. Purine antagonist
B. Pyrimidine antagonist
C. Folic acid antagonist
D. Nucleotide analog
Ans. A
Tips. Mercaptopurine are purine (adenine and guanine)
analogs, 5-FU is analog of pyrimidine bases (cytocil, uracil,
thiamine) and methotrexate is an example folate antagonist.

51
101) Mass spectroscopy is used to:
a) Detect traces of unknown chemical structure
b) Structure elucidation of unknown chemical
c) Traces in environmental samples
d) Drug traces in blood samples
e) All of the above
Ans. E
Tips: Mass spectrometer detects molecular structures based
molecular weight ions. Thus this can be used for unknown
chemical structures.

102) A patient is taking a prescription drug. The renal


excretion of this drug is markedly reduced by ingesting
antacid (Al-Mg). The prescription drug is:
A) A weak acid B) A weak base C) A strong acid
D) A strong base E) None of the above

52
Ans. B
Tips
Base + base = no ionization thus less renal excretion
base + acid = ionization and increase renal excretion

103) The ethical standard veracity in pharmacy counseling


means:
A-Pharmacist act with justice
B-Pharmacist act with fairness
C-Pharmacist act with honesty and without deception
D-Pharmacist does well to patient
E) Pharmacist do prevent harm
Ans. C

53
104) Mr. Mason’s mother is a patient of your pharmacy. Now
Mr. Mason wants to admit her into a rehabilitation centre.
He thinks that it will help her to improve her health
condition. He requests you to talk to his mother. Both of you
have tried to convince her to go there. Although she thinks
that it will not make any difference and she does not want to
go there. Which ethics have you applied (uphold) as a
pharmacist?
a) Paternalism
b) Beneficence
c) Autonomy
d) Veracity
e) Justice
Ans: b

105) All of the following are the principles of Canadian Health


Act, EXCEPT:
A. Universality
B) Private administration
C-Accessibility
D. Portability
E) Comprehensiveness
Ans. B
Tips. Canadian health care system is public administration.

54
106) A new patient came to your pharmacy with a
prescription of a narcotic from a walk-in clinic and it is,
written in to be used, AS DIRECTED. What would you do?
A. Dispense the prescription
B. Call the clinic to know direction of use
C. Call the clinic to verify the prescription
D. Send the patient to another pharmacy
E. Call the clinic to know the exact amount
Ans. C
Tips. Narcotic prescription should specify exact "mitte" or
direction should be clearly state frequency and days.

107) What is correct about schedule III drugs?


I) Prescription is not required
II) Need direct pharmacist intervention
III) Stored behind the counter
a) I only b) III only c) I and II d) II and III only e) I,II,III
Ans. C
Tips. Schedule III are OTC and pharmacist presence is
essential. Schedule are placed in self selection area.

55
108) A diabetic patient came to you complaining about his
hyperglycemia; you noticed that he is buying a rich
chocolate, sugar candies and food containing high
carbohydrates. What should you do?
A) Advice him and explain the risks and ask her see her
physician/Display high sugar/caffeine content product
B) Let him decide what he wants
C) Try to forbid him from buying those items
D) Refer her to doctor
E) Refer her to emergency
Ans. A
Tips. First ask patient is it for you?

109) You noticed the technician come down to help a patient


choosing a cough product contains codeine. You may do all of
the following actions, except:
A. Go down to interrupt the discussion and make the sale

56
B. Ask the technician if the patient has allergy to codeine
after the sale
C. Review with her the Law of dispensing over the counter
drugs
D. Don't humiliate the technician in front of the customer
E. Send her to additional training courses
Ans. B

110) A senior pharmacy technician has a worked in a


community pharmacy for 10 years. He is well trained and
welcomes new learning opportunities. His manager now
wants to delegate a new technical project to him, should:
I. Discuss suggested steps to accomplish the project
II. Negotiate a time schedule for completion of the project
III. Provide support and follow up as required
a) I only
b) III only
c) I and II only
d) II and III only
e) All are correct
Ans. E
Tips: Delegation of a job should include the suggested steps
to accomplish the project; a negotiation of time schedule for
completion of the project and the person doing the
delegation should provide support and follow up as required.

57
111.Which of the following is the incorrect statement?
A. Aqueous humour is formed from ciliary body
B. Tears are produced by lacrimal gland
C. Ear wax is produced by ceremonial gland
D. Cold sore are related to HSV 1
E. Mouth ulcers are related HSV2
Ans. E
Tips. vestibular glad, moist in ear. Sebaceous gland produce
sebum and cause acne. Salivary gland. Debecutus gland in
rectum cause pressure atrophy.
Secreting glands
ciliary body
lacrimal gland
ceremonial gland
Sebaceous gland
Salivary gland.

112) Cochrane collaboration databases are?


A. Evidenced based medicine database
B. A Canadian pharmacy journal
C. Collaboration of medical professionals
D. A natural products database
E-The group of people with same characteristics
Ans. A

58
113) All can be done after an IV injection, except:
I) Assess for blood clotting
II- Check for any swelling or redness
III- Apply ice to reduce pain
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans. B
Tips: do not apply to reduce pain.

114) Anabolic steroid used for to enhance athletes


performance, is derived from:
A) Testosterone B) Androstenedione C) Progesterone
D) Estrogen
E) All of the above combinations
Ans. A

59
115) What are the advantages of transdermal patches?
I) Show better bioavailability
II- Avoid first pass metabolism
III- Provide longer duration of action
A-I only
B-III only
C-I and II only
D-II and III only
E-All of the above
Ans. E

116) When only the patient does not know whether he is


taking the drug or placebo, the trial is called:
A) Single blind B. Un blinded C. double blind D-triple
blind
E-Randomization
Ans. A

60
117) How many 500 mg tablets of Ciprofloxacin HCl is
required to prepare 240 ml of 2% Ciprofloxacin HCl solution?
A. 5 Tablets B. 10 Tablets C.20 Tablets D. 25 Tablets
E)30 Tablets
Ans. B

118) Find out the ratio of ionized to unionized species of


drug at pH 7 (pKa = 5)
A) 100 B) 150 C) 1 D) 10 E) 1000
Ans. A
Tips.
pH = pKa + Log (salt/acid)
7 = 5 + Log salt/acid
Log salt/acid = 2
salt/acid = 102 = 100

119) All are correct about Irritable Bowel Syndrome, Except?


A) It is associated with a greater risk of stomach cancer.
B-Stress may aggravate IBS

61
C-Avoiding candies, gums and caffeine help to improve the
condition
D-It may be constipation or diarrhea predominant
E-Abdominal pain or discomfort is the most common
characteristic
Ans.A

120) A 33 years old patient with diabetes type I. He is taking basal


insulin NPH 30/70 40U in the morning and 50U at night, and using
Insulin IR 200U BID (morning and bedtime). His blood glucose level
is as such:
Morning Noon Supper Bedtime
3-5 7 5 8
(A) Reduce IR dose in the morning and increase IR dose in the
evening
(B) Change Insulin NPH to insulin glargine (Lantus)
(C) Avoid giving insulin IR and keeps him on basal insulin NPH
(D) Reduce insulin NPH dose at night, and increase insulin NPH in the
morning
(E) None of the above
Ans. D
TIPS. The regular (IR) insulin has no effect on the morning and night
level. It may have in the afternoon or early morning. However the
basal insulin should be adjusted, taking into consideration no change
in the diet or physical exercise.

62
121) A pharmacy dispensing error dispensed Pradaxa (Dabigatran)
instead of Plavix (clopidogrel). If patient used. Which of the following
problem expected?
A) Increase risk myocardial infarction
B) Increase risk of platelet aggregation
C) Increase risk of bleeding
D) Increase risk of blood clot formation
Ans. C
Tips. Pradaxa is a new anticoagulant dabigatran act as factor Xa
inhibitor. However Plavix is clopidogrel an antiplatelets drugs. So
increase risk of bleeding

122) The most common agents involve in dental infection or dental


caries?
A. E. coli
B. S. aureus
C. S. viridens
D. Solmonella
Ans. C
Tips. Pathogens identified in dental caries are members of the
viridens (alpha-hemolytic) streptococci family
including Streptococcus mutans, Streptococcus sobrinis
and Streptococcus milleri. Once bacteria invade the dental pulp an
inflammatory reaction results in necrosis and a lower tissue
oxidation-reduction potential.

63
123) A pharmacist can effectively prevent dispensing error by
checking the following?
A) Patient date of birth
B) Drug identification number (DIN)
C) Color of pills
D) Shape of pills
E) Physician name
Ans. B

124) What is incorrect about, iron supplements?


A) The highest elemental iron supplement is = ferrous
fumarate
B) The highest iron supplement that have GI absorption =
ferrous gluconate
C)The iron supplement common side effect = constipation
D)The iron supplements preferable taken = empty stomach
E) The iron supplements + vitamin C = decrease iron
absorption
Ans. E
Tips. Vitamin C or ascorbic acid increase iron absorption.
Fe.fumerate 33%
Fe. sulphate 20%

64
Fe.gluconate 12%

125). Beta carotene undergoes oxidative cleavage to partially


produce vitamin A in gastrointestinal tract by which of the
enzyme?

A. CYP450
B. Alcohol dehydrogenase
C. Dioxygenase
D. CYP3A4
E. Oxidative deamination
Ans. C

126) What is incorrect about sitagliptin (Januvia)?


A- Inhibitor of dipeptidyl peptidase enzyme (DPP-4) that
enhances the incretin hormone
B- Can cause hypoglycemia with sulfonylureas
C- Not used in type I diabetes, there is no clinical studies

65
D- Can be taken with or without food
E- Drug of choice for the type I diabetes mellitus
Ans. E

127.All of the following drug formulation are contain osmotic


pump design technology? except
A. Enteric coated ASA
B. verapamil (Covera HS)
C. methylphenidate (Concerta)
D. Glipizide (Glucotrol)
E. Oxybutynin (Lyrenel XL)
Ans. A

128) An angry father comes to your pharmacy. He has found oral


contraceptives in his 14 years old daughter’s drawer. He accuses you
of loosing social values and supporting his daughter to get derailed.
He wants to see her profile right now. What would you do?
A) Tell him, that you cannot breach confidentiality
B) Just ignore him and call your junior pharmacist to manage the
situation
C) Show him the daughter’s profile, as he seems to be a very
responsible father
D) Tell him to talk to his daughter and to ask her why she is taking
the medication.

66
E) Tell him to bring his daughter with him, then he can see the profile
Ans. D

129) MK is 50 year old occasional customer of your pharmacy


approaches for refill of rosuvastatin 20 mg tab daily for 3 months.
While discussion MK, his wife is nurse and checked his blood
pressure at home and it was 150/90. Pharmacist advised him to
check his blood pressure in pharmacy monitor. Pharmacy blood
pressure monitor shows 155/90. What is appropriate action?
A) Ask how did his wife checked his blood pressure
B) Refer to doctor for further assessment
C) Should be referred emergence for urgent treatment
D) recommend low dose hydrochlorothiazide 25 mg until see his
doctor
E) recommend self care measure like reduce salt intake and physical
activity
Ans. B

130) If patient used Lasix (furosemide) instead of Losec


(omeprazole). What problem is expected?
A) hyperglycemia
B) hyperthyroidism
C)hypotension
D)Hypercalcemia
E)None
Ans. C

67
Tips. Lasix is furosemide can cause hypotension. Losec is
omeprazole.

131) What is NOT a clinical presentation of insecticide poisoning?


A) diarrhea
B) diaphoresis
C) urination
D) Miosis
E) constipation
Ans: E
Tips: Anticholinesterase toxic symptoms are lacrimation, salivation,
sweating, diarrhea, miosis, urination, vomiting, and shortness of
breath (DUMBLESS)

132) Which of the following ophthalmic conditions required referral


to doctor?
A) Red eye B) Pain in eye C) Blurred vision D) Dry eyeE) B and C
Ans. E

133. The following structure non super imposable on its mirror


images, shows R and S configuration. This optical isomerism is
defined as?

A. diasteromers B. optical isomers C. enantiomers D. Geometrical


isomers

68
Ans. C

134) The role of a Registered (regulated) pharmacy


technician with additional training could include:
I) Filling the Rx
II) Maintaining and updating patient profile
III) Preparation of chemotherapeutic preps
A.I only B-III only C.I and II only D. II and III only E. I,II,III
Ans. E
Tips. Technician cannot a new prescription from a doctor,
nurse and doctor assistance.

135) A patient is 5 years old child was kept on a regimen of


and fluticasone 1 puffx2. Patient is suffering with daytime
coughing twice weekly, and wakes up once weekly. The
patient’s asthma was still not under control. What is
appropriate dosage form is recommended to children <8 year
age?
A-Turbuhaler
B. Nasal spray
C. Meter dose inhaler and aerochamber

69
D) Handihaler
E) Diskus
Ans. C

136) Low molecular weight compounds that act as


immunogens after chemically complexing to a larger
molecule or cell surface is called:
A. Hapten B. Haploid C. Diploid D. Immunogens
E. Antigen
Ans-A

137) Special access program (SAP) is used to?


A) To obtain drugs that are not approved to sale in Canada
B) To obtain compassionate drugs from manufacturer
C) To obtain illegal drugs or street drug from health Canada
D) To obtain drug that do not have safety information
E) To obtain narcotics and control drugs form health Canada
Ans. A
Tips. Health Canada special access program (SAP), provides
drugs that are NOT approved in Canada or investigational
drugs by special request from prescribers.

70
138) What is the pharmacist concern in patient using fixed
ratio insulin?
A) Exercise before insulin dose
B) Snacks between meals
C) Patient compliance
D) Patient age
E) Types of insulin
Ans. B

139) The Pharmaceutical and Therapeutics (PT) committee is


responsible for all, EXCEPT
A) The evaluation and selection of all drugs currently in use in
the hospital
B) Setting of use for all medications in the hospital
C) Setting standards with that third party
D) Evaluating drugs based on drug studies, available literature
and financial considerations.
E) Education program for staffs
Ans. C

71
140. The following chemical structure is the type of essential fatty
acids?
15 12 9 1
COOH

A. Linolenic acid B) Lenoleic acid C) Omega 6 D) DHA E) EPA


Ans. A

141. An optometrist prescribed ciprofloxacin drops 2 gtt OD for 10


days. What is correct?
A. Instill 2 drops in both eye for 10 days
B. Instill 2 drops in affected eye for 10 days
C. Take ciprofloxacin 500 mg daily for 10 days
D. Instill 2 drops in right eye for 10 days
Ans. d

72
142) A patient 16 year old with Community Acquired Pneumonia. He
has allergy to penicillin. The following medication may be given to
him to treat his pneumonia:
A) Imipenem-Cilastatin B) Ciprofloxacin C) Cefixime D)
Cloxacillin E. Doxycycline
Ans. E
Tips. The drug of choice in CAP is amoxicillin, doxycycline,
azithromycin, clarithromycin. If allergic to penicillin can use
doxycycline, azithromycin and clarithromycin. Respiratory tract
quinolone levo and moxifloxacin are used for pneumonia.

143) If physician name is not readable in prescription, what is


the appropriate action?
A. Call physician
B. Ask patient first
C. Ignore and process prescription
D-Look in computer
E. Write doctor name
Ans. B

73
144. What clinical study is useful to collect data about a
pandemic disease occurred 10 years ago?
A. Systemic reviews
B. Cross over study
C-Cohort study
D-Case control study
E-Parallel study
Ans-D

145) The following is/are true with respect to influenza


vaccine, EXCEPT
a) Contraindicated before 2 years of age
b)One dose is sufficient each year for adult
c)Those who have allergy to egg protein, should not take
influenza vaccine.
d) Should be kept in fridge.
Ans. A

74
146) A union negotiating the wages, working hours, and
conditions on behalf of pharmacist with company?
A) Arbitration
B) Mediation
C) Collective Bargaining
D) Arguing
E) Consulting
Ans. C

147) Which of the following vitamin is the key in production


of collagen?
A. Vitamin K B. Vitamin D C. Vitamin A D. Vitamin C
E. Vitamin B 12
Ans. D

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148. A patient brings you a prescription for 16 mEq KCl. Your
pharmacy has 600 mg KCl (MW 74.5) controlled release
tablets. How many tablets are needed for this patient?
a) 0.5 tablets
b) 1 tablets
c) 2 tablets
d) 4 tablets
e) 5 tablets
Ans: C
Working. use the formula MEq = (mg x valence)/(molecular
weight)
)Each tablets contains: (600 x1)/(74.5) = 8.05 mEq
Patient needs 16 mEq = 2 tablets

149) Total parenteral solutions number components, the


long duration of contact time and exposure to ambient
temperature and light increase potential for incompatibility.
The interaction of Calcium and Phosphate (PO4 ) to form
CaPO 4, can results into fine white particles that create milky
solution. This incompatibility can described as?
A) Therapeutic incompatibility
B) Physical incompatibility
C) Chemical incompatibility

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D) All of the above
Ans. B

150) A patient currently using dexamethasone eye drops daily for


3 to 4 wks after eye surgery. Another eye doctor prescribed
tobramycin/dexamethasone 2 gtts for 10 days. What is pharmacist
concern?
A. Tobramycin
B. dexamethasone
C. duration of therapy
D. prescription from other doctor
Ans. B

151. What is the most reliable study in the following:


A. Randomized clinical trials
b. Randomized double blind clinical trials
C. Stratified clinical trials
D. Observational studies
E. Cohort studies
Ans. A

152. What is correct about phase 2 clinical trials?


A. Healthy population is tested for pharmacokinetics
B. Disease population is tested for effectiveness
C. Large group is tested to eliminate type 2 error
D. Drug is approved for market
E. Post marketing surveillance and pharmacovigilance
Ans. B

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153. What is correct about pharmacovigilance?
A. Health Canada MedEffect program release advisories to
healthcare professional about a new side effects of drugs in post
marketing surveillance
B. Health Canada MedEffect program send recall notice about drugs
with defect in manufacturing and packaging.
C. Health Canada gathers information about drugs unknown adverse
drug reactions
D. Health Canada MedEffect program inform about drugs withdrawn
from market
E. All of the above
Ans. C

154. MP is a pharmacy manager. He was told about a mistake made


by a technician. What will be the proper action as pharmacy
manager?
a) Complain to college of pharmacy about mistake
b) Do a private meeting with the concerned person.
c. Do a meeting for all staff and discuss the incidence
D. Report mistake to institute of safe medication practices Canada
E. Report mistake to the Health Canada MedEffect
Ans. B

155. All of the following is indicator of non adherence of medications


by the patient?except
A. Patient filling prescription higher interval than it should be
B. Patient filling prescription less frequently than it should be
C. Patient filling only filling partial medication from the all the list of
chronic therapy
D. Patient not filling on time as prescribed
E. Patient fills medications as prescribed by the doctor
Ans. E

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156. A economic analysis that compares the relative costs and
outcomes in effect unitof two or more drugs is described as?
A. Cost minimization analysis
B. Cost effective analysis
C. Cost utility analysis
D. All of the above
Ans. B

157. What is correct treatment choice for head lice?


A. permethrin 5% cream rinse shampoo
B. permethrin 1% cream rinse shampoo
C. permethrin 3% cream rinse shampoo
D. permethrin 4% cream rinse shampoo
D. permethrin 10% cream rinse shampoo
Ans. B

158. What is NOT a symptoms of acne vulgaris?


A) microcomedone
B) close comedone
C) papule
D) Erythema
E) Nodule or cyst
Ans. D
Tips. Erythema occurs in rosacea acne. Eyes may also turn to red. If
microcomedone need antibiotic therapy.

159. A mother of 1 year old child approaches to pharmacist. Asking


what is appropriate recommendation for confluent tomato red
plaques (beefy red with lacy or scaly border or, white scaly border at
diaper area?
A) Apply zinc oxide cream or petrolatum

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B) Anti yeast agents miconozole, clotrimazole, or nystatin.
C) Dry diaper area with alcohol wipes
D) Change diapers frequently
E) Use 1% hydrocortisone cream
Ans. B
Tips. Complicated diaper rash likely colonized by Candida require
antifungal therapy. Topical antifungals are the drug of choice, they
are 70-90% effective candida.

160. Which of the following have NO antiperspirant (deodarant)


action?
A) aluminum chloride
B) aluminum acetate
C) zinc oxide corn start
D) Talcum powder
E) Aluminum chloralhydrate
Ans. D
Tips. Talcum powder can retain moisture thus avoid use as
antiperspirant.

161. Contact lens solutions that contain papain are?


A) Surfactants
B) Protein or enzyme cleaners
C) Wetting agents or artificial tears
D) Soft lens
E) Rigid gas permeable lens
Ans. B
Tips: Papain and pancreatin enzymes are present in enzyme or
protein cleaners are used in contact lens solutions.
Surfactants. Disinfect and remove contaminants.

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Protein cleaners or enzyme cleaners contain papain, pancreatin, or
subtilism. Remove protein deposits by catalysing the natural
breakdown of debris into simple compounds.
Wetting and rewetting solutions. Produce cushioning and lubricant
effect between lens and eyelid, between eye and cornea (removes
dryness).

162. A 30 yr old woman walks into pharmacy. She want to buy over
the counter pain reliever to treat migraine. All of the following are
migraine symptoms, except?
A) Hemicranial throbbing pain
B) Pain is so bad so that one cannot do usual activity and effect on
quality of life.
C) Nausea and Vomiting
D) Photophobia and get worse around light
E) Facial and shoulder pain
Ans: E
Tips. Facial pain are trigeminal neuralgia. It is not symptom of
migraine. Nauseas vomiting, hemi cranial throbbing pain are classical
symptoms. Shoulder and upper back pain can be present in
fibromyalgia.

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163. All of the following antibiotics are effective in treatment of
bacterial meningitis? except
A. Ceftriaxone
B. Cefotaxime
C. Vancomycin
D. Rifampin
E. Gentamycin
Ans. E
Tips. Third gen cephalosporin's are the drug of choice to treat
bacterial meningitis. Rifampin is used as prophylaxis for close
contacts.

164. Bacteriophage is?


A. Virus that infects and replicates within bacteria
B. Bacteria that infects and replicates within virus
C. Bacteria that infects in brain
D. Viruses capable of reverse transcription
E. Virus that capable of translation
Ans. A

165. Which of the following high levels usually indicates iron


deficiency?
A. Mean cell volume (MCV)
B) Hematocrit (Hct)
C) Hemoglobin

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D) Serum ferritin
E) Total iron binding capacity (TIBC)
Ans. E

166. Transferrin is?


A. A glycoprotein that bind and transports iron into blood
B. A glycoprotein that bind to vitamin B 12
C. A glycoprotein that bind to bacteria
D. A glycoprotein that store iron and iron is converted to ferric ion
E. A glycoprotein
Ans. A
Transferrin. A glycoprotein that bind and transports iron into blood
Ferritin. A glycoprotein that store iron and iron is converted to ferric
ion.

167. Which of the following contain heavy and light chain connected
by disulfide bond.
A. chemeric antibodies
B. Immunoglobulins
C. Deoxyribose nucleic acid
D. Ribose nucleic acid
E. Gene
Ans. B

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168. Sponge-like regions of erectile tissue, most of the blood in the
penis during an erection is termed as?
A. Corpus cavernosum
B. Bladder
C. Seminal vesicles
D. Urethra
E. Sperms
Ans. A

169. A schizophrenic patient may present with all of the following,


symptoms? except
A. Patient believes that he has some great but unrecognized talent or
insight, a special identity, knowledge, power, self-worth, or special
relationship with someone famous or with God.
B. Hearing voices when no one spoken
C. Seeing loved one who recently died
D. Feel like they are telling you to do harm to others
E. Seizure with conscious like simple partial
Ans. E

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170. All are correct about sunscreen is essentials, except?
A. Sunscreen that protect against UVA and B, and one that has sun
protection factor of 50 is essential to protect sunburn.
B. Sunburn is more common on peak hours 10 am to 4 PM
C. Sunscreen prevent the penetration of UV light and protect the skin
D. Sunscreen are most effective when applied at least 30 min before
exposure to sun.
E. Sunscreen should be re applied every 2-3 hour after swimming or
sweating or otherwise the duration of protection is reduced
Ans. A
Sunscreen that protect against UVA and B, and one that has SPF
minimum of 15 is essential to protect sunburn.

171. What is INCORRECT about sunscreen?


A. Sunscreen products containing PABA need to avoided by the
individuals, who are allergic to benzocaine, sulfonamides, or
thiazides.
B. Sunscreen can cause contact dermatitis and photosensitive
reactions
C. The UV light is the least between the hours of 10:00 am to 4:00 pm
D. Organic sunscreen absorb UV light
E. Inorganic physical sunscreen reflect and scatter UV light

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Ans. C

172. Tetrahydrocannabinol (THC) is principle active constituent of?


A. Opium
B. Tobacco
C. Marijuana
D. Benzodiazepine
E. Phenobarbital
ans. C

173. Which of the following a prototypical agonist of peroxisome


proliferator-activated receptor alpha (PPAR a) ?
A. Fenofibrate B. Losartan C. Rosiglitazone D. Metfromin E.
Sitagliptine
Ans. A
Tips. Fenofibrate is one of the fibrate drugs which are agonists of
peroxisome proliferator-activated receptor (PPAR), a transcription
factor that regulates lipid, glucose, and amino acid homeostasis via a
number of routes.
Rosiglitazone PPAR  agonist.

174. What is cheilitis?


A. Inflammation of lips
B. Dry mouth
C. Dry skin
D. Dry eye
E. taste changes
Ans. A

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175. What is appropriate socks for athletes foot and diabetic foot
problems?
A. 100% cotton socks
B. Nylon socks
C. Synthetic fiber
D. Synthetic socks
E. Cotton (60% less) blend with synthetic fiber, nylon, acrylic or
rayon
Ans. E

176. A 58 yo man brings prescription of timolol 1gtt bid OD,


prednisolone 1 gtt bid OD, and voltaren (diclofenac) 1 gtt bid OD
after cataract surgery. What drug gives burning and stinging
sensation?
A) Timolol
B) Prednisolone
C) Voltaren (diclofenac)
D) levocabastine
Ans. C

177. All of the following are used for the treatment of mouth ulcers,
except?
A. Benzocaine or lidocaine
B. Topical steroids for pain
C. Benzydamine 0.15% topical solution
D. Tetracycline mouth rinse
E. Amoxicillin suspension

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ans. E

178. A 26 yo women visited to your pharmacy, with complain ear


wax and clear discharge from her middle ear. What is appropriate
action?
A. Recommend her non prescription antibiotic eye drops and try for
2 days if no improvement happens she should visit her physician.
B. Send her immediately to physician
C. Ask her to clean discharge with tissue and use warm compress
D. Send her to emergence for diagnosis
E None of the above
Ans.B

179. What is incorrect about tiotropium?


A) A muscarinic blocker
B) Longer duration action than ipratropium
C) Used single daily dose for the maitenence asthma and COPD
D) It can cause diarrhea adverse reaction
E) It is administered used in handihaler
Ans. D
Tips. Muscarinic blockers cause xerostomia (dry mouth), xerosis (dry
skin), xero-ophthalmia (dry eyes).

180. An example antimetabolites include, all except?

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A) 5-fluorouracil
B) Cytarabine
C) Mercaptopurine
D) Thioguanine
E) Cyclophosphamide
Ans: E

181. Which of the following drugs least likely associated with


tolerance?
a. Clobazam B. diazepam C. Phenobarbital D. Gabapentin E.
Clonazepam
Ans. D
Tips. Benzodiazepine (clobazam, clonazepam, diazepam),
phenobarbital are associated with tolerance.

182. A 70-year-old female COPD patient should receive the following


vaccination?
A. Tetanus vaccine and Influenza vaccine
B. Influenza vaccine and Pneumococcal vaccine
C. Influenza vaccine only
D. Pneumococcal vaccine only
E. Tetanus vaccine only
Ans.B

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183. Metronidazole is used in all except
A) H. pylori
B) Bacterial vaginosis
C) Anaerobic infections
D) Head lice
E) Ameba
Ans. D

184. Penicillin G, all of the following true except?


a. Only available as IV and IM, and no PO dosage is available
B. The drug of choice to treat Syphilis
C. Often need 1 injection for Syphilis treatment
D. available PO, but poorly absorbed so used only for minor
infections
Ans. D
Tips: penicillin G is not available as oral . Pen V is available oral but
has poorly absorbed.

185. Thermometers site that give accurate temperature (exact


reading) in infants from birth to 2years age.
A. Mouth
B. Rectum
C. Armpit
D. Ear
E. All of the above
Ans. B

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186. What is incorrect about cephalosporin auxiliary labels?
A. Do not take alcohol
B. Take plenty of water
C. cephalosporins increase INR if given with warfarin
D. Taken with or without food
E. all cephalosporins are taken an empty stomach
Ans. E

187. Flu mist nasal spray vaccine is recommended in?


A. can be used in children over 6 mo
B. pregnant women
C. Persons over 65 years age.
d. Any resident of nursing home or other care facilities regardless of
age.
e. Adult with chronic condition
Ans. A

188. A 71 year-old person has Parkinson’s disease, what is the drug


of choice?
A) Levodopa/carbidopa
B) Selegiline
C) Benztropine
D) Amantadine
E) dopamine agonist
Ans. A

189. Nociceptive pain are caused by?


A. Psychological factors
B. Injury to body tissue
C. Damage to nerve

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D. Diabetes
E. Post herpetic infection
Ans. B
Tips. Nociceptives are due injury to body tissue, throbbing pain
(migraine).

190. A patient with renal disease and has low back pain. What is the
treatment option?
A. Acetaminophen
B. Capsaicin
C. Oral NSAIDs
D. Methadone
E. Codeine
Ans. A

191. Which one of the following is not associated with


osteoarthritis?
A. Joint pain in weight bearing joints
B. Joint pain in hip joint
C. Joint pain in knee joint
D. Soft tissue pain
E. Cartilage erosion.
Ans. D

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192. Gabapentin is used for? except
A. Gabapentin is used for the treatment of diabetic neuropathy
B. Gabapentin is used for the treatment of Trigeminal neuralgia
C. Gabapentin is used for the treatment of bipolar disorder
D. Gabapentin is used as adjunctive for the treatment of seizure
E. Gabapentin decrease efficacy of oral contraceptive pills
Ans. E
Tips. Gabapentin has no drug interaction with oral contraceptive
pills.

193. Example of peptidomimetic and neuropeptide analog is?


A. Omalizumab
B. Infliximab
C. montelukast
D. Chimeric antibody
E. Liraglutide

Ans. C

194. What is the drug of choice to treat Gonorrhea?


A. Ceftriaxone b. Azithromycin C. amoxicillin D. Penicillin V E.
Penicillin G
Ans. A

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Tips: Cefixime 400 mg orally as single dose, ceftriaxone 125 mg IM as
single dose and ciprofloxacin 500 mg orally as single dose are the
recommended regimens for the treatment of uncomplicated
gonorrhea.

195. All of the following can be done by pharmacist to help patient


stay healthy (wellness programs) or lifestyle management and
disease prevention, except?
A. screening services
B. smoking cessation
C. Nutrition and lifestyle recommendations
D. develop a meal plan
E. sun exposure and vitamin D supplement recommendation
Ans. D

196.All of the following are the health risk of obesity? except


A. hypertension
B. high cholesterol
C. Pulmonary embolism
D. Gout arthritis
E. Osteoporosis
Ans. E
Tips. The potential risk factors that associated with obesity are
cardiovascular disease, insulin resistance (type 2 DM), cancer, sleep
apnea, vericous circulatory disease, gout, osteoarthritis, PE,
osteoarthritis, gall bladder disease, skin (stretch marks), endocrine,
gestational diabetes and mortality.

197.What is the drug of choice to treat Chlamydia infections?


A. Cefixime
B. Ceftriaxone

94
C. Ciprofloxacin
D. Azithromycin
Ans. D
Tips. Azithromycin is the drug of choice to treat chlamydia infection.

198. All of the following are the pyrophosphates, except?


A. Ibandronate
B. Residronate
C. Etidronate
D. Zolindranoic acid
E. Teriperatide
Ans. E
Tips. Teriperatide is parathyroid hormone analogue.

199. A patient is allergic to amoxicillin. What is the first line


treatment for cystitis?
a) Sulphamethoxazole + trimethoprim (cotrimoxazole)
b) Amoxicillin clavulanate
c) Penicillin procaine
d) Erythromycin
e) Ciprofloxacin
Ans. A
Tips. Cystitis is bladder infection and first line treatment of UTI
associated with E. coli infected agent is mainly treated by
sulphamethoxazole and trimethoprim .

200. Which of the following agents would be used in the treatment


of infections caused by Helicobacter pylori as combination therapy?
a) Penicillin, amoxicillin, ampicillin and metronidazole

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b) Clarithromycin, omeprazole and amoxicillin or metronidazole
c) Clarithromycin, azithromycin and lansoprazole
d) Ceftriaxone and metronidazole only
e) Combinations of antibiotic should not be used due to resistance.
Ans. B
Tips: Helicobacter pylori is a GI infection associated with peptic ulcer
and gastric cancer that may be treated by the “triple therapy” that
involves amoxicillin, clarithromycin and omeprazole with or without
metronidazole.

Over 160 Excellent


Over 130 good
<110 Must improve

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