بنك أسئلة الصيدلة

اقرأ أسئلة عيّنة بنك أسئلة الصيدلة

1. 1.A 45 year old patient who is known to drink excessively presents in acute alcohol withdrawal. On examination he appears malnourished. He is commenced on diazepam. His BM is 4.2mmol/l. What is the next course of action?

   • أ.Commence IV Thiamineإجابة صحيحة
   • ب.IV magnesium
   • ج.IM glucagon
   • د.Liaison psychiatry

   لماذا: In a malnourished alcoholic, glucose loading can precipitate Wernicke's encephalopathy by exhausting already-depleted thiamine stores. IV thiamine should be given (before or with any glucose) to prevent this. The BM of 4.2 mmol/L is not hypoglycaemic, so glucose/glucagon is unnecessary.

2. 2.Which of the following micro-organisms is generally sensitive to Benzylpenicillin?

   • أ.Mycoplasma pneumoniae
   • ب.Streptococcus Pneumonaieإجابة صحيحة
   • ج.Bordetella pertussis
   • د.Legionella pneumophila

   لماذا: Streptococcus pneumoniae remains generally sensitive to benzylpenicillin, which targets cell-wall synthesis in this Gram-positive organism. The atypical pathogens Mycoplasma and Legionella lack a conventional cell wall or are intracellular and are unaffected, and Bordetella pertussis is treated with macrolides.

3. 3.For urethral underactivity, which drug class is clinically most useful?

   • أ.Topical (vaginal) estrogens
   • ب.E-?-Adrenergic receptor agonists
   • ج.Anticholinergics
   • د.Dual-reuptake inhibitorsإجابة صحيحة

   لماذا: Urethral underactivity (stress incontinence due to poor sphincter tone) is best addressed pharmacologically by agents that increase urethral closure pressure; duloxetine, a serotonin-noradrenaline dual-reuptake inhibitor, enhances pudendal nerve activity to the urethral sphincter and is the most clinically useful class. Anticholinergics target overactive (urge) incontinence, not underactivity.

4. 4.Which of the following is NOT a potential cause of hypothyroidism

   • أ.Pituitary failure
   • ب.Over-treatment with thionamides
   • ج.Hashimoto's thyroiditis
   • د.Beta-blocker therapyإجابة صحيحة

   لماذا: Beta-blocker therapy does not cause hypothyroidism (though propranolol can blunt peripheral T4-to-T3 conversion, it does not impair gland function). Pituitary failure (low TSH), excess thionamides, and Hashimoto's autoimmune thyroiditis are all genuine causes of hypothyroidism.

5. 5.Appropriate antibiotic treatment for the breast-feeding woman with mastitis is:

   • أ.Dicloxacillin 250 mg orally every 6 hours for 5 days
   • ب.Vancomycin 1 g orally every 12 hours for 7 days
   • ج.Cephalexin 500 mg orally every 6 hours for 14 daysإجابة صحيحة
   • د.Amoxicillin 500 mg orally 3 times a day for 10 days

   لماذا: Lactational mastitis is most often caused by Staphylococcus aureus; a beta-lactamase-stable agent is needed. Cephalexin is effective, safe in breastfeeding, and given for an adequate course. Plain amoxicillin is degraded by staphylococcal beta-lactamase, and oral vancomycin is not systemically absorbed.

6. 6.The least accurate method for measuring GFR is:

   • أ.Inulin clearance
   • ب.Iohexol clearance
   • ج.Creatinine clearanceإجابة صحيحة
   • د.Iothalamate clearance

   لماذا: Creatinine clearance overestimates true GFR because creatinine is both filtered and actively secreted by the tubules, making it the least accurate of the listed methods. Inulin clearance is the gold standard, and iohexol/iothalamate clearances are highly accurate filtration markers.

7. 7.Which of the following dopamine agonists would be an appropriate choice for a patient trying to conceive?

   • أ.Bromocriptineإجابة صحيحة
   • ب.Cabergoline
   • ج.Pramipexole
   • د.Pergolide

   لماذا: Bromocriptine has the most extensive safety data in pregnancy and is the preferred dopamine agonist for women trying to conceive (e.g., for prolactinoma-related infertility). Cabergoline is also used but has less reproductive safety data, while pramipexole and pergolide are not indicated in this setting.

8. 8.A patient is found to have a broad complex tachycardia. Which of the following is contraindicated?

   • أ.Lidnocaine
   • ب.Adenosine
   • ج.Verapamiإجابة صحيحة
   • د.Amiodarone

   لماذا: In broad-complex tachycardia that may be ventricular tachycardia, verapamil is contraindicated because its negative inotropic and vasodilator effects can precipitate haemodynamic collapse or accelerate the rhythm. Amiodarone and lidocaine are appropriate, and adenosine is generally safe diagnostically.

9. 9.The most effective treatment to alleviate postmenopausal vasomotor symptoms (hot flushes and night sweats) is:

   • أ.Testosterone therapyإجابة صحيحة
   • ب.Estrogen therapy
   • ج.Clonidine
   • د.Selective estrogen-receptor modulators (SERMs)

   لماذا: Systemic estrogen therapy is the single most effective treatment for postmenopausal vasomotor symptoms such as hot flushes and night sweats. Clonidine and SERMs are far less effective alternatives, and testosterone is not indicated for vasomotor symptoms. [REVIEW: keyed answer may be incorrect — the standard answer for most effective relief of hot flushes is estrogen (b), not testosterone (a).]

10. 10.What is the best treatment for severe agitation in an elderly patient overnight?

    • أ.Doxylamine
    • ب.Chlorpromazine
    • ج.Haloperidolإجابة صحيحة
    • د.Temazepam

    لماذا: Haloperidol, a high-potency antipsychotic, is the preferred agent for acute severe agitation/delirium in the elderly because it causes minimal sedation, hypotension, and anticholinergic burden compared with alternatives. Benzodiazepines and chlorpromazine increase confusion and fall risk in this population.