Repeated USMLE Questions Step 1- Pharmacology- 275

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Q1– Patients with genetic polymorphism have a delay in the metabolism of drugs by acetylation. Which one of the following drugs is most likely affected by that?

A- Clonidine

B- Hydralazine

C- Nitroglycerin

D- Prazosin

B- Hydralazine- It is metabolized by N-acetyltransferase (Phase II metabolism reaction) and affected by genetic polymorphism. Patients of this condition are called slow acetylator and may develop SLE-like symptoms.

 

Q2– Which of the following is the reason that nitroglycerin is given sublingually?

A- It avoids first pass metabolism

B- It has less reflex tachycardia than other routes

C- It improves patient compliance

D- It diminishes the odds of developing methemoglobinemia

A- It avoids first pass metabolism- It increases its bioavailability and speeds its action in angina.

 

Q3– Which one of the following medications effectively lowers intraocular pressure?

A- Atropine

B- Ergonovine

C- Morphine

D- Latanoprost

D- Latanoprost- It is prostaglandin F analogue used in glaucoma to lowers intraocular pressure.



Q4– A 48-year-old man taking sildenafil presents to the emergency department with severe hypotension after using nitroglycerin. What is the mechanism behind this interaction?

A- Increased calcium influx into smooth muscle

B- Excessive nitric oxide–mediated vasodilation

C- Sympathetic nervous system inhibition

D- Blockade of aldosterone receptors

B- Excessive nitric oxide–mediated vasodilation- Sildenafil (PDE-5 inhibitor) and nitrates both increase nitric oxide signaling, causing profound vasodilation and hypotension.

 

Q5– A 48-year-old man taking sildenafil presents to the emergency department with severe hypotension after using nitroglycerin. What is the mechanism behind this interaction?

A-Increased calcium influx into smooth muscle

B-Excessive nitric oxide–mediated vasodilation

C-Sympathetic nervous system inhibition

D-Blockade of aldosterone receptors

B-Excessive nitric oxide–mediated vasodilation- Sildenafil (PDE-5 inhibitor) and nitrates both increase nitric oxide signaling, causing profound vasodilation and hypotension.

 

Q6– A patient taking isoniazid develops numbness and tingling in his feet. Supplementation with which vitamin prevents this effect?

A-Vitamin B1

B-Vitamin B6

C-Vitamin B12

D-Vitamin K

B-Vitamin B6- Isoniazid causes pyridoxine deficiency, leading to peripheral neuropathy.



Q7– Which drug is used to reverse opioid-induced respiratory depression?

A-Atropine

B-Flumazenil

C-Naloxone

D-Protamine

C-Naloxone- It is a competitive opioid receptor antagonist.

 

Q8– A patient taking an SSRI and linezolid develops agitation, hyperreflexia, and sweating. What is the diagnosis?

A-Anticholinergic toxicity

B-Malignant hypothermia

C-Neurologic malignant syndrome

D-Serotonin syndrome

D-Serotonin syndrome- Caused by excess serotonin from combining serotonergic drugs.

 

Q9– Which antihypertensive medication is preferred in pregnancy?

A-Lisinopril

B-Losartan

C-Methyldopa

D-Ramipril

C-Methyldopa- It is safe and widely used in pregnancy.

 

Q10– A patient develops a persistent cough while taking an ACE inhibitor. Which drug is the best alternative?

A-Amlodipine

B-Furosemide

C-Hydralazine

D-Valsartan

D-Valsartan- ARBs do not increase bradykinin, so no cough.



Q11– Which anticoagulant directly inhibits thrombin (factor IIa)

A-Dabigatran

B-Enoxaparin

C-Rivaroxaban

D-Warfarin

A-Dabigatran- It is an oral direct thrombin inhibitor.

 

Q12– Which diuretic can cause hypercalcemia?

A-Acetazolamide

B-Furosemide

C-Hydrochlorothiazide

D-Mannitol

C-Hydrochlorothiazide-Thiazides increase calcium reabsorption.

 

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Dr Ray Makar
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2 thoughts on “Repeated USMLE Questions Step 1- Pharmacology- 275”

  1. I will. Thank you for your comment.

  2. Thanks for letting me know about this keep on updating me

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