Repeated USMLE Questions Step 1 Review-157- Pharmacology

Q- A patient treated with cisplatin develops hearing loss. What is the mechanism of this adverse effect?

A- Accumulation in cochlear hair cells

B- Autoimmune inner ear inflammation

C- Decreased cerebral perfusion

D- Inhibition of prostaglandin synthesis

A- Accumulation in cochlear hair cells- Cisplatin accumulates in inner ear hair cells, leading to dose-dependent ototoxicity and irreversible hearing loss.

 

Q- A patient taking phenelzine develops severe hypertension after eating aged cheese. What is the underlying cause of this reaction?

A- Excess dopamine release

B- Increased norepinephrine levels

C- Inhibition of acetylcholinesterase

D- Reduced serotonin reuptake

B- Increased norepinephrine levels- Tyramine in aged foods increases norepinephrine release, which cannot be broken down in patients taking MAO inhibitors, causing hypertensive crisis.

 

Q- Which medication is most likely to cause photosensitivity as a side effect?

A- Amoxicillin

B- Doxycycline

C- Erythromycin

D- Vancomycin

B- Doxycycline- Tetracyclines commonly cause photosensitivity reactions, leading to exaggerated sunburn.

 

Q- A patient with heart failure is started on an ACE inhibitor. Which physiologic change contributes to its beneficial effect?

A- Decreased aldosterone secretion

B- Decreased heart rate

C- Increased preload

D- Increased sympathetic tone

A- Decreased aldosterone secretion- ACE inhibitors reduce angiotensin II and aldosterone, leading to decreased sodium and water retention and improved cardiac remodeling.

 

Q- A patient with type 2 diabetes is started on acarbose. What is the mechanism of action of this drug?

A- Decreases hepatic gluconeogenesis

B- Delays intestinal carbohydrate absorption

C- Increases insulin secretion

D- Improves insulin sensitivity

B- Delays intestinal carbohydrate absorption- Acarbose inhibits intestinal α-glucosidases, slowing carbohydrate digestion and reducing postprandial glucose spikes.

 

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