11 USMLE Pharmacology Quick Review Questions with Answers (Set 26)

These 11 quick USMLE review questions test high-yield facts that show up again and again on the exam: heparin, spironolactone, ganglionic blockers, PPIs, lorazepam in liver failure, loop diuretics, hydralazine, misoprostol, succinylcholine and heart failure with preserved ejection fraction. 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 73-year-old patient with multiple myeloma has been treated with high doses of doxorubicin. Which of the following may develop during this treatment?

A- Bladder hemorrhage
B- Cardiomyopathy
C- Papilledema
D- Hemolytic anemia

B-Cardiomyopathy- High doses of doxorubicin in an old patient can lead to cardiomyopathy resulting in congestive heart failure and pulmonary edema.
The correct answer is B

 

Question 2. Heparin acts by binding to which of the following substances to achieve its anticoagulant activity?

A- Antithrombin III
B- Factor V
C- Factor VIII
D- Prothrombin

A-Antithrombin III- Heparin binds to this coagulation inhibitor to increase its activity. Other choices are clotting factors and do not interact with heparin.
The correct answer is A

 

Question 3. Prolonged use of which one of the following diuretics can lead to hyperkalemia and gynecomastia?

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

D-Spironolactone- It is a potassium-sparing diuretic acts by blocking aldosterone at its receptor resulting in high serum potassium and gynecomastia.
The correct answer is D

 

Question 4. A researcher is using a certain drug to produce controlled hypotension during surgical procedures. This drug is a ganglionic blocker, non-selective, non-competitive nicotinic antagonist. Which of the following drugs is the one used by this researcher?

A- Lisinopril
B- Mecamylamine
C- Methylphenidate
D- Verapamil

B-Mecamylamine-This is the only one on the list that is a ganglionic blocker. It was used on the past as anti-hypertensive drug but it is now used only on research due to its many side effects.
The correct answer is B

 

Question 5. Which of the following medications is helpful to relieve symptoms in a case of chronic heartburn?

A- Cimetidine
B- Milk of magnesium
C- Omeprazole
D- Promethazine

C-Omeprazole- This medication is an irreversible inhibitor of H/K/ATPase so, it reduces gastric acid secretion. It is used in the treatment of GERD, peptic ulcer and Zollinger-Ellison syndrome.
The correct answer is C

 

Question 6. In liver failure, which one of the following medications is used to avoid phase 1 metabolism?

A- Buprenorphine
B- Diazepam
C- Imipramine
D- Lorazepam

D-Lorazepam- This medication and oxazepam are the only benzodiazepines that undergo only phase II metabolism. Other listed drugs undergo first pass metabolism.
The correct answer is D

 

Question 7. Loop diuretics act by inhibition of the Na/K/Cl cotransporter on the luminal membrane of which one of the following locations?

A- Ascending loop of Henle
B- Collecting tubules
C- Descending loop of Henle
D- Proximal convoluted tubules

A- Ascending loop of Henle- Furosemide and other loop diuretics inhibit this cotransporter leading to diuresis and loss of Na, Cl and K in urine.
The correct answer is A

 

Question 8. Which one of the following anti-hypertensive medications acts mainly through lowering the peripheral resistance by direct arteriolar vasodilation?

A- Atenolol
B- Hydralazine
C- Lisinopril
D- Losartan

B- Hydralazine- It is one of the direct-acting vasodilators which also include nitroprusside, minoxidil and diazoxide.
The correct answer is B

 

Question 9. Which one of the following peptic ulcer treatments is a PGE1 analog and acts as a cytoprotective by increasing mucus and bicarbonate secretion and lowering acid secretion?

A- Cimetidine
B- Misoprostol
C- Omeprazole
D- Sucralfate

B- Misoprostol- It was used previously but now proton pump inhibitors are preferred for peptic ulcer treatment.
The correct answer is B

 

Question 10. Which one of the following muscle relaxants causes muscle fasciculations prior to muscle relaxation when administered?

A- Atracurium
B- Rocuronium
C- Succinylcholine
D- Vecuronium

C-Succinylcholine- It is a neuromuscular blocker. It initially stimulates nicotinic acetylcholine receptors causing fasciculations then depolarization block follows.
The correct answer is C

 

Question 11. Which one of the following medications is the best initial treatment for a case of heart failure with normal systolic function and preserved ejection fraction?

A- Digoxin
B- Furosemide
C- Metoprolol
D- Spironolactone

B-Furosemide- Diuretics is the best initial treatment for a case of non-systolic dysfunction heart failure with normal systolic function and preserved ejection fraction. Beta blockers and ACE inhibitors are helpful to maintain rate and blood pressure while digoxin and spironolactone are not beneficial in this case.
The correct answer is B

 

High-yield points from this set

  • Heparin works by activating antithrombin III.
  • Succinylcholine causes fasciculations before paralysis.
  • Hydralazine is a direct arteriolar vasodilator.
  • Diuretics relieve symptoms in heart failure with preserved ejection fraction.

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