11 USMLE Pharmacology Quick Review Questions with Answers (Set 24)

These 11 quick USMLE review questions test high-yield facts that show up again and again on the exam: epinephrine with local anesthetics, phenytoin, acetaminophen overdose, post-herpetic neuralgia, antiarrhythmics, bulimia, probenecid, metformin, lactulose and levodopa. 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. Gingival hyperplasia, granulocytopenia and facial hirsutism are possible side effects of which one of the following medications?

A- Carbamazepine
B- Phenobarbital
C- Phenytoin
D- Valproic acid

C- Phenytoin- It may cause gastrointestinal irritation as well.
The correct answer is C

 

Question 2. A patient presents to the ER with a history of taking a large amount of acetaminophen tablets. Which of the following is the most appropriate next step of action?

A- Administer N-acetylcysteine
B- Blood transfusion
C- Measure serum acetaminophen concentration
D- Prepare for hemodialysis

C- Measure serum acetaminophen concentration- If the time of ingestion is known and under 8 hours, measure the acetaminophen level at 4 hours (or later) after ingestion and plot it on the Rumack-Matthew nomogram to decide on N-acetylcysteine. If more than 8 hours have passed, the time is unknown or liver tests are abnormal, start N-acetylcysteine right away without waiting for the level.
The correct answer is C

 

Question 3. An old patient complains of severe pain in his right shoulder. He mentions that he had shingles on the same area of skin last week. Which of the following is the most appropriate treatment at this time?

A- Carbamazepine
B- Ibuprofen
C- Morphine
D- Nortriptyline

D- Nortriptyline- This is a case of post-herpetic neuralgia (PHN) which affects nerves. Tricyclic antidepressants such as Nortriptyline are very effective in this case. Carbamazepine is more effective in trigeminal neuralgia.
The correct answer is D

 

Question 4. Which one of the following anti-arrhythmic drugs may lead to the development of torsade de pointes at therapeutic doses?

A- Adenosine
B- Lidocaine
C- Propranolol
D- Quinidine

D- Quinidine- Its use is very strict due to this fatal side effect.
The correct answer is D

 

Question 5. Which one of the following drugs is a calcium channel blocker (Class IV)?

A- Amiodarone
B- Carvedilol
C- Procainamide
D- Verapamil

D- Verapamil
The correct answer is D

 

Question 6. Which one of the following anti-depressants is most likely effective in bulimia nervosa?

A- Amitriptyline
B- Fluoxetine
C- Imipramine
D- Tranylcypromine

B- Fluoxetine
The correct answer is B

 

Question 7. Amiodarone is considered one of which of the following classes of anti-arrhythmic drugs?

A- Class I (sodium channel blockers)
B- Class II (beta blockers)
C- Class III (potassium channel blockers)
D- Class IV (calcium channel blockers)

C- Class III- Amiodarone is one of the potassium-channel blockers. Class I are sodium-channel blockers, Class II are beta blockers while Class IV are calcium-channel blockers.
The correct answer is C

 

Question 8. Which one of the following drugs blocks the urinary excretion of penicillin which leads to prolonged high serum concentration?

A- Chloramphenicol
B- Cimetidine
C- Probenecid
D- Rifampicin

C- Probenecid- It delays the tubular secretion of penicillin resulting in high serum concentration for a long period of time.
The correct answer is C

 

Question 9. Which of the following groups of drugs are useful for a patient suffers from night terrors and sleepwalking?

A- Alcohols
B- Barbiturates
C- Benzodiazepines
D- Tricyclic anti-depressants

C- Benzodiazepines- This group of drugs are associated with reduced REM and delta sleep.
The correct answer is C

 

Question 10. Which one of the following oral hypoglycemic drugs is the initial therapy for patients with type 2 diabetes?

A- Acarbose
B- Glyburide
C- Metformin
D- Repaglinide

C- Metformin- It is the first line of treatment for patients with pre-diabetes or recently diagnosed type 2 diabetes, if is not contraindicated.
The correct answer is C

 

Question 11. An alcoholic patient presents with progressive fatigue and lethargy. He has a history of liver cirrhosis. Hepatic encephalopathy is expected. Which of the following is the first line of treatment?

A- Broad-spectrum antibiotics
B- Intravenous thiamine
C- Oral lactulose
D- Oral lorazepam

C- Oral lactulose- It helps to trap the ammonia in the colon by binding to it and prevent absorption of ammonia which is the main cause of hepatic encephalopathy.
The correct answer is C

 

High-yield points from this set

  • Epinephrine prolongs local anesthetic nerve block by vasoconstriction.
  • Acetaminophen overdose: check a 4-hour level and give N-acetylcysteine.
  • Probenecid blocks renal secretion of penicillin.
  • Protein-rich meals reduce levodopa absorption.

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