11 USMLE Pharmacology Quick Review Questions with Answers (Set 15)

These 11 quick USMLE review questions test high-yield facts that show up again and again on the exam: antihypertensives in pregnancy, ARBs, direct thrombin inhibitors, beta-blockers, lorazepam in liver failure, misoprostol, lidocaine, SVT prophylaxis, levodopa and amphotericin B. Each question includes the correct answer.

Written by Dr. Ray Makar, MD, author of the Repeated USMLE Questions eBook series.

Prefer video? Watch daily USMLE case questions on MedFocus by Dr. Ray on YouTube.

How to use this page: read the question, pick your answer, then tap Show Answer and Explanation.

Questions

Question 1. 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.
The correct answer is D

 

Question 2. Which anticoagulant directly inhibits thrombin (factor IIa)?

A- Dabigatran
B- Enoxaparin
C- Rivaroxaban
D- Warfarin

A-Dabigatran- It is an oral direct thrombin inhibitor.
The correct answer is A

 

Question 3. Which diuretic can cause hypercalcemia?

A- Acetazolamide
B- Furosemide
C- Hydrochlorothiazide
D- Mannitol

C-Hydrochlorothiazide-Thiazides increase calcium reabsorption.
The correct answer is C

 

Question 4. Reflex tachycardia caused by systemic albuterol can be blocked by which of the following medications?

A- Dobutamine
B- Metoprolol
C- Phenylephrine
D- Prazosin

B- Metoprolol- Beta blocker is the only choice that blocks beta agonists such as albuterol.
The correct answer is B

 

Question 5. Which one of the following medications can be used safely in cases of lack of liver function?

A- Clonazepam
B- Diazepam
C- Lorazepam
D- Midazolam

C- Lorazepam- It is the only one on the list that undergoes extrahepatic metabolism.
The correct answer is C

 

Question 6. Which of the following medications is selectively used in NSAID-induced gastric ulcer?

A- Bismuth
B- Cimetidine
C- Famotidine
D- Misoprostol

D- Misoprostol- NSAIDs inhibit the synthesis of prostaglandins which is GI protective.
The correct answer is D

 

Question 7. Lidocaine is an effective antiarrhythmic because of which of the following mechanisms?

A- It blocks alpha-receptors
B- It block beta-receptors
C- It prolongs QT interval
D- It prolongs PR interval
E- It suppresses excitability in ischemic areas of the heart

E- It suppresses excitability in hypoxic areas of the heart- Lidocaine is sodium channel blocker in fast response fibers. It has no significant effect on QT or BR interval.
The correct answer is E

 

Question 8. Outpatient prophylaxis of supraventricular tachycardia (SVT) is best accomplished by which of the following medications?

A- Adenosine
B- Diltiazem
C- Lidocaine
D- Procainamide

B- Diltiazem- It is the only drug of the list that acts on the AV node. Others are either used for treatment or have short actions.
The correct answer is B

 

Question 9. A combination of levodopa and carbidopa is recommended. Which of the following explains the significance of this combination?

A- Carbidopa enhances the absorption of levodopa
B- Carbidopa enhances the entry of levodopa into the brain
C- Carbidopa enhances the conversion of peripheral levodopa into dopamine
D- Unknown mechanism

B- Carbidopa enhances the entry of levodopa into brain- By Inhibition of peripheral dopa decarboxylase by carbidopa which gives levodopa a chance to enter the brain through blood brain barrier.
The correct answer is B

 

Question 10. A liposomal preparation of which one of the following medications may reduce the incidence of renal toxicity?

A- Acyclovir
B- Amphotericin B
C- Ketoconazole
D- Vancomycin

B- Amphotericin B- It decrease creatinine clearance leading to renal toxicity which can be reduced by using a liposomal preparation of amphotericin B.
The correct answer is B

 

Question 11. Which of the following medications is the most effective immunosuppressant in cases of organ transplantation?

A- Azathioprine
B- Cyclophosphamide
C- Cyclosporine
D- Vinblastine

C- Cyclosporine- It is specific T-cell inhibitor so, it is protective against organ rejection.
The correct answer is C

 

High-yield points from this set

  • Methyldopa, labetalol and nifedipine are safe in pregnancy; avoid ACE inhibitors and ARBs.
  • Switch to an ARB if an ACE inhibitor causes cough.
  • Dabigatran directly inhibits thrombin.
  • Lorazepam, oxazepam and temazepam are safest in liver disease.

Keep practicing

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