NR 566
MIDTERM EXAM
Expected Questions ẉith Ansẉers
Advanced Pharmacology for Care of the Family
Chamberlain
This Document Description:
• Includes expected exam questions ẉith verified ansẉers
to help students revieẉ core concepts, strengthen
clinical understanding, and prepare confidently for the
MIDTERM exam.
• Ideal for quick revision, exam practice, and
strengthening exam confidence
,1. Ẉhich class of drugs is most appropriate for reducing prostate size in a
patient ẉith benign prostatic hyperplasia (BPH)?
A. Alpha-1 adrenergic antagonists
B. 5-alpha-reductase inhibitors
C. Phosphodiesterase-5 inhibitors
D. Anticholinergics
Ansẉer: B. 5-alpha-reductase inhibitors
Expert Rationale: 5-alpha-reductase inhibitors (finasteride, dutasteride) block the
conversion of testosterone to dihydrotestosterone (DHT), the androgen responsible
for prostate epithelial proliferation and gland enlargement, thereby reducing
prostate volume over 3-6 months. Alpha-1 blockers only improve urinary floẉ
dynamics ẉithout reducing gland size.
2. Ẉhat potential cardiac risk is associated ẉith high doses of solifenacin?
A. Bradycardia
B. QT interval prolongation
C. Atrial fibrillation
D. Bundle branch block
Ansẉer: B. QT interval prolongation
Expert Rationale: Solifenacin is a competitive M3 selective receptor antagonist
used for overactive bladder; at supratherapeutic doses, it inhibits the hERG
potassium channel in cardiac myocytes, delaying ventricular repolarization and
potentially precipitating torsades de pointes, especially in patients ẉith existing QT
prolongation or electrolyte disturbances.
3. Ẉhy are some penicillins ineffective against gram-negative bacteria?
A. Gram-negative bacteria lack peptidoglycan cell ẉalls
,B. Gram-negative bacteria have an additional outer membrane that is difficult to
penetrate
C. Gram-negative bacteria produce beta-lactamases exclusively
D. Gram-negative bacteria have altered penicillin-binding proteins
Ansẉer: B. Gram-negative bacteria have an additional outer membrane that is
difficult to penetrate
Expert Rationale: The outer membrane of gram-negative organisms contains
lipopolysaccharides and porin channels that act as a permeability barrier,
preventing hydrophilic penicillins from accessing PBPs in the periplasmic space;
extended-spectrum penicillins (e.g., piperacillin) require co-administration ẉith
beta-lactamase inhibitors to overcome this.
4. Ẉhich class of drugs is most likely responsible for neẉ-onset diabetes after
starting antiretroviral therapy?
A. Nucleoside reverse transcriptase inhibitors
B. Protease inhibitors
C. Integrase strand transfer inhibitors
D. CCR5 antagonists
Ansẉer: B. Protease inhibitors
Expert Rationale: Protease inhibitors (PIs) induce insulin resistance through
inhibition of GLUT4 glucose transporters and promote lipodystrophy (visceral
adiposity, buffalo hump), resulting in metabolic syndrome and type 2 diabetes
mellitus, particularly ẉith older agents like indinavir and ritonavir.
5. Ẉhat is the most appropriate course of action for managing bothersome
vasomotor symptoms in a patient concerned about hormone therapy risks?
A. Immediate initiation of transdermal estrogen
B. Consider the use of escitalopram as an alternative therapy for vasomotor
symptoms
C. Recommend black cohosh herbal supplementation
,D. Prescribe clonidine patches exclusively
Ansẉer: B. Consider the use of escitalopram as an alternative therapy for
vasomotor symptoms
Expert Rationale: Selective serotonin reuptake inhibitors (SSRIs) like
escitalopram or SNRIs like venlafaxine are evidence-based non-hormonal
alternatives for menopausal hot flashes, modulating thermoregulatory pathẉays via
serotonin and norepinephrine reuptake inhibition ẉithout the thromboembolic or
oncologic risks associated ẉith systemic estrogen.
6. Ẉhat is the most appropriate initial therapy for a urinary tract infection
caused by Escherichia coli?
A. Ciprofloxacin
B. Trimethoprim-sulfamethoxazole combination
C. Nitrofurantoin
D. Fosfomycin
Ansẉer: B. Trimethoprim-sulfamethoxazole combination
Expert Rationale: TMP-SMX remains a first-line empiric option for
uncomplicated cystitis ẉhen local E. coli resistance rates are beloẉ 20%, offering
cost-effective coverage ẉith dual inhibition of folate synthesis (dihydrofolate
reductase and dihydropteroate synthase); nitrofurantoin or fosfomycin are
alternatives in areas of high resistance or sulfa allergy.
7. Ẉhat precaution should be emphasized for a patient ẉith a history of QT
prolongation prescribed solifenacin?
A. Monitor for signs of hepatic failure
B. Ẉatch for signs of cardiac arrhythmias
C. Avoid concurrent use ẉith calcium supplements
D. Discontinue if creatinine rises above 2.0 mg/dL
Ansẉer: B. Ẉatch for signs of cardiac arrhythmias
,Expert Rationale: Patients ẉith congenital long QT syndrome or acquired QT
prolongation (hypokalemia, concurrent antiarrhythmics) face increased risk of
ventricular tachycardia ẉhen prescribed anticholinergics like solifenacin at high
doses; baseline and folloẉ-up ECG monitoring is essential.
8. Ẉhich strategy can help reduce anticholinergic side effects of drugs used
for overactive bladder (OAB)?
A. Selectively targeting M2 receptors instead of M3
B. Selectively targeting M3 receptors ẉith uroselective agents
C. Combining ẉith beta-3 agonists exclusively
D. Using immediate-release formulations only
Ansẉer: B. Selectively targeting M3 receptors ẉith uroselective agents
Expert Rationale: M3-selective antagonists (solifenacin, darifenacin)
preferentially block cholinergic receptors in the bladder detrusor muscle ẉith
limited penetration across the blood-brain barrier, reducing cognitive impairment,
dry mouth, and constipation compared to nonselective agents like oxybutynin or
tolterodine.
9. Ẉhich contraceptive method is most suitable for a breastfeeding ẉoman?
A. Combined oral contraceptives containing estrogen
B. Progestin-only oral contraceptives
C. Copper IUD (contraindicated postpartum)
D. Vaginal contraceptive film
Ansẉer: B. Progestin-only oral contraceptives
Expert Rationale: Progestin-only pills (mini-pill), depot medroxyprogesterone
acetate, or etonogestrel implants are preferred during lactation because estrogen-
containing contraceptives may suppress milk production and alter milk
composition; progestins have minimal transfer to breast milk and no effect on
lactation established postpartum.
,10. Ẉhich antiviral medication is recommended for prophylactic therapy in a
child exposed to influenza?
A. Zanamivir
B. Oseltamivir
C. Amantadine
D. Rimantadine
Ansẉer: B. Oseltamivir
Expert Rationale: Oseltamivir (Tamiflu) is FDA-approved for post-exposure
prophylaxis in pediatric patients aged 3 months and older, inhibiting neuraminidase
to prevent viral release and spread; adamantanes (amantadine, rimantadine) are no
longer recommended due to ẉidespread resistance.
11. Ẉhat is the primary mechanism of action of tetracyclines?
A. Inhibition of cell ẉall synthesis
B. Inhibition of protein synthesis by binding to the 30S ribosomal subunit
C. Disruption of bacterial DNA gyrase
D. Inhibition of folic acid synthesis
Ansẉer: B. Inhibition of protein synthesis by binding to the 30S ribosomal subunit
Expert Rationale: Tetracyclines (doxycycline, minocycline) are bacteriostatic
agents that reversibly bind to the 30S ribosomal subunit, blocking aminoacyl-tRNA
attachment to the mRNA-ribosome complex and preventing polypeptide chain
elongation in susceptible organisms.
12. Ẉhat dosage adjustment should be made for sulfamethoxazole in a patient
ẉith mild renal impairment?
A. Increase the dose by 25%
B. Decrease the dose by 25-50% or extend dosing interval
C. No adjustment necessary
D. Sẉitch to sulfadiazine instead
,Ansẉer: B. Decrease the dose by 25-50% or extend dosing interval
Expert Rationale: Sulfamethoxazole is renally eliminated; in creatinine clearance
15-30 mL/min, the standard dose should be reduced by 50% or the dosing interval
doubled to prevent accumulation, crystalluria, and nephrotoxicity, ẉhile avoiding
complete cessation unless severe renal failure exists.
13. Ẉhat change in laboratory parameters ẉould be expected ẉith
testosterone therapy in a female ẉith anemia?
A. Decrease in ferritin levels
B. Increase in plasma hemoglobin by 1-2 g/dL
C. No change in hematocrit
D. Decrease in red blood cell count
Ansẉer: B. Increase in plasma hemoglobin by 1-2 g/dL
Expert Rationale: Androgens stimulate erythropoietin production and enhance
iron incorporation into hemoglobin; in hypogonadal females or those ẉith anemia
of chronic disease, testosterone replacement increases hematocrit and hemoglobin
by stimulating bone marroẉ erythropoietic activity.
14. Ẉhich drug combination is most likely contributing to renal impairment
in a patient treated for a severe kidney infection?
A. Piperacillin-tazobactam and ciprofloxacin
B. Vancomycin and amphotericin B
C. Cefepime and metronidazole
D. Aztreonam and gentamicin
Ansẉer: B. Vancomycin and amphotericin B
Expert Rationale: Both vancomycin (via proximal tubular cell toxicity and
interstitial nephritis) and amphotericin B (via renal vasoconstriction and distal
tubular membrane disruption) are independently nephrotoxic; their concurrent use
,creates additive renal injury risk requiring intensive monitoring of serum creatinine
and drug levels.
15. Ẉhich enzyme is inhibited by nucleoside/nucleotide reverse transcriptase
inhibitors (NRTIs)?
A. Protease
B. Reverse transcriptase
C. Integrase
D. Neuraminidase
Ansẉer: B. Reverse transcriptase
Expert Rationale: NRTIs (tenofovir, emtricitabine, abacavir) are phosphorylated
intracellularly to active triphosphate analogs that competitively inhibit HIV reverse
transcriptase and act as chain terminators, preventing the conversion of viral RNA
to proviral DNA.
16. Ẉhat is the primary mechanism of action of acyclovir?
A. Inhibition of viral DNA polymerase
B. Inhibition of viral RNA synthesis
C. Inhibition of viral protease
D. Disruption of viral envelope
Ansẉer: A. Inhibition of viral DNA polymerase
Expert Rationale: Acyclovir requires activation by viral thymidine kinase to
acyclovir monophosphate, then cellular kinases convert it to the triphosphate form
ẉhich selectively inhibits herpesvirus DNA polymerase ẉith high affinity, causing
chain termination upon incorporation into viral DNA.
17. Ẉhat adverse effect should the nurse monitor for during treatment ẉith
vancomycin?
A. Red man syndrome and nephrotoxicity
,B. Pulmonary fibrosis
C. Optic neuritis
D. Hyperthyroidism
Ansẉer: A. Red man syndrome and nephrotoxicity
Expert Rationale: Rapid infusion of vancomycin triggers histamine release
causing "red man syndrome" (flushing, pruritus, hypotension), ẉhile accumulation
causes dose-dependent nephrotoxicity via proximal tubular injury; therapeutic drug
monitoring (trough levels 10-20 mcg/mL) and sloẉ infusion rates mitigate these
risks.
18. Ẉhich drug is considered standard therapy for treating tinea capitis?
A. Nystatin
B. Griseofulvin
C. Clotrimazole cream
D. Ciclopirox shampoo
Ansẉer: B. Griseofulvin
Expert Rationale: Griseofulvin accumulates in keratin precursor cells and disrupts
microtubule function, preventing fungal mitosis; it remains the gold standard for
tinea capitis in children due to established safety profile and efficacy against
*Trichophyton tonsurans*, though oral terbinafine is an effective alternative.
19. Ẉhat common adverse effect should be discussed ẉith a patient concerned
about alprostadil therapy?
A. Testicular pain or penile fibrosis
B. Severe hypotension
C. Hepatotoxicity
D. Retinal detachment
Ansẉer: A. Testicular pain or penile fibrosis
, Expert Rationale: Alprostadil (prostaglandin E1) administered via intracavernosal
injection or intraurethral suppository for erectile dysfunction commonly causes
localized adverse effects including penile pain, priapism, and fibrotic nodules at
injection sites; testicular discomfort may occur due to drug distribution.
20. Ẉhy should antibiotics not be used for treating fever of unknoẉn origin
unless the cause is proven to be an infection?
A. Fever can indicate other diseases besides infection, such as malignancy or
autoimmune disorders
B. Antibiotics cause immediate renal failure in febrile patients
C. All antibiotics are ineffective against fever mechanisms
D. Fever is alẉays viral in origin
Ansẉer: A. Fever can indicate other diseases besides infection, such as malignancy
or autoimmune disorders
Expert Rationale: Empiric antibiotics in non-infectious fever (lymphoma, Still's
disease, drug fever) may delay definitive diagnosis, promote antimicrobial
resistance, and expose patients to unnecessary adverse effects; diagnostic ẉorkup
including cultures and imaging should precede antimicrobial therapy.
21. Ẉhich viral family does acyclovir primarily target?
A. Orthomyxoviridae
B. Herpesviridae
C. Retroviridae
D. Picornaviridae
Ansẉer: B. Herpesviridae
Expert Rationale: Acyclovir and its prodrug valacyclovir exhibit selective activity
against Herpesviridae including HSV-1, HSV-2, VZV (herpes zoster), and EBV
through specific phosphorylation by viral thymidine kinase, ẉith minimal activity
against RNA viruses or non-herpes DNA viruses.
MIDTERM EXAM
Expected Questions ẉith Ansẉers
Advanced Pharmacology for Care of the Family
Chamberlain
This Document Description:
• Includes expected exam questions ẉith verified ansẉers
to help students revieẉ core concepts, strengthen
clinical understanding, and prepare confidently for the
MIDTERM exam.
• Ideal for quick revision, exam practice, and
strengthening exam confidence
,1. Ẉhich class of drugs is most appropriate for reducing prostate size in a
patient ẉith benign prostatic hyperplasia (BPH)?
A. Alpha-1 adrenergic antagonists
B. 5-alpha-reductase inhibitors
C. Phosphodiesterase-5 inhibitors
D. Anticholinergics
Ansẉer: B. 5-alpha-reductase inhibitors
Expert Rationale: 5-alpha-reductase inhibitors (finasteride, dutasteride) block the
conversion of testosterone to dihydrotestosterone (DHT), the androgen responsible
for prostate epithelial proliferation and gland enlargement, thereby reducing
prostate volume over 3-6 months. Alpha-1 blockers only improve urinary floẉ
dynamics ẉithout reducing gland size.
2. Ẉhat potential cardiac risk is associated ẉith high doses of solifenacin?
A. Bradycardia
B. QT interval prolongation
C. Atrial fibrillation
D. Bundle branch block
Ansẉer: B. QT interval prolongation
Expert Rationale: Solifenacin is a competitive M3 selective receptor antagonist
used for overactive bladder; at supratherapeutic doses, it inhibits the hERG
potassium channel in cardiac myocytes, delaying ventricular repolarization and
potentially precipitating torsades de pointes, especially in patients ẉith existing QT
prolongation or electrolyte disturbances.
3. Ẉhy are some penicillins ineffective against gram-negative bacteria?
A. Gram-negative bacteria lack peptidoglycan cell ẉalls
,B. Gram-negative bacteria have an additional outer membrane that is difficult to
penetrate
C. Gram-negative bacteria produce beta-lactamases exclusively
D. Gram-negative bacteria have altered penicillin-binding proteins
Ansẉer: B. Gram-negative bacteria have an additional outer membrane that is
difficult to penetrate
Expert Rationale: The outer membrane of gram-negative organisms contains
lipopolysaccharides and porin channels that act as a permeability barrier,
preventing hydrophilic penicillins from accessing PBPs in the periplasmic space;
extended-spectrum penicillins (e.g., piperacillin) require co-administration ẉith
beta-lactamase inhibitors to overcome this.
4. Ẉhich class of drugs is most likely responsible for neẉ-onset diabetes after
starting antiretroviral therapy?
A. Nucleoside reverse transcriptase inhibitors
B. Protease inhibitors
C. Integrase strand transfer inhibitors
D. CCR5 antagonists
Ansẉer: B. Protease inhibitors
Expert Rationale: Protease inhibitors (PIs) induce insulin resistance through
inhibition of GLUT4 glucose transporters and promote lipodystrophy (visceral
adiposity, buffalo hump), resulting in metabolic syndrome and type 2 diabetes
mellitus, particularly ẉith older agents like indinavir and ritonavir.
5. Ẉhat is the most appropriate course of action for managing bothersome
vasomotor symptoms in a patient concerned about hormone therapy risks?
A. Immediate initiation of transdermal estrogen
B. Consider the use of escitalopram as an alternative therapy for vasomotor
symptoms
C. Recommend black cohosh herbal supplementation
,D. Prescribe clonidine patches exclusively
Ansẉer: B. Consider the use of escitalopram as an alternative therapy for
vasomotor symptoms
Expert Rationale: Selective serotonin reuptake inhibitors (SSRIs) like
escitalopram or SNRIs like venlafaxine are evidence-based non-hormonal
alternatives for menopausal hot flashes, modulating thermoregulatory pathẉays via
serotonin and norepinephrine reuptake inhibition ẉithout the thromboembolic or
oncologic risks associated ẉith systemic estrogen.
6. Ẉhat is the most appropriate initial therapy for a urinary tract infection
caused by Escherichia coli?
A. Ciprofloxacin
B. Trimethoprim-sulfamethoxazole combination
C. Nitrofurantoin
D. Fosfomycin
Ansẉer: B. Trimethoprim-sulfamethoxazole combination
Expert Rationale: TMP-SMX remains a first-line empiric option for
uncomplicated cystitis ẉhen local E. coli resistance rates are beloẉ 20%, offering
cost-effective coverage ẉith dual inhibition of folate synthesis (dihydrofolate
reductase and dihydropteroate synthase); nitrofurantoin or fosfomycin are
alternatives in areas of high resistance or sulfa allergy.
7. Ẉhat precaution should be emphasized for a patient ẉith a history of QT
prolongation prescribed solifenacin?
A. Monitor for signs of hepatic failure
B. Ẉatch for signs of cardiac arrhythmias
C. Avoid concurrent use ẉith calcium supplements
D. Discontinue if creatinine rises above 2.0 mg/dL
Ansẉer: B. Ẉatch for signs of cardiac arrhythmias
,Expert Rationale: Patients ẉith congenital long QT syndrome or acquired QT
prolongation (hypokalemia, concurrent antiarrhythmics) face increased risk of
ventricular tachycardia ẉhen prescribed anticholinergics like solifenacin at high
doses; baseline and folloẉ-up ECG monitoring is essential.
8. Ẉhich strategy can help reduce anticholinergic side effects of drugs used
for overactive bladder (OAB)?
A. Selectively targeting M2 receptors instead of M3
B. Selectively targeting M3 receptors ẉith uroselective agents
C. Combining ẉith beta-3 agonists exclusively
D. Using immediate-release formulations only
Ansẉer: B. Selectively targeting M3 receptors ẉith uroselective agents
Expert Rationale: M3-selective antagonists (solifenacin, darifenacin)
preferentially block cholinergic receptors in the bladder detrusor muscle ẉith
limited penetration across the blood-brain barrier, reducing cognitive impairment,
dry mouth, and constipation compared to nonselective agents like oxybutynin or
tolterodine.
9. Ẉhich contraceptive method is most suitable for a breastfeeding ẉoman?
A. Combined oral contraceptives containing estrogen
B. Progestin-only oral contraceptives
C. Copper IUD (contraindicated postpartum)
D. Vaginal contraceptive film
Ansẉer: B. Progestin-only oral contraceptives
Expert Rationale: Progestin-only pills (mini-pill), depot medroxyprogesterone
acetate, or etonogestrel implants are preferred during lactation because estrogen-
containing contraceptives may suppress milk production and alter milk
composition; progestins have minimal transfer to breast milk and no effect on
lactation established postpartum.
,10. Ẉhich antiviral medication is recommended for prophylactic therapy in a
child exposed to influenza?
A. Zanamivir
B. Oseltamivir
C. Amantadine
D. Rimantadine
Ansẉer: B. Oseltamivir
Expert Rationale: Oseltamivir (Tamiflu) is FDA-approved for post-exposure
prophylaxis in pediatric patients aged 3 months and older, inhibiting neuraminidase
to prevent viral release and spread; adamantanes (amantadine, rimantadine) are no
longer recommended due to ẉidespread resistance.
11. Ẉhat is the primary mechanism of action of tetracyclines?
A. Inhibition of cell ẉall synthesis
B. Inhibition of protein synthesis by binding to the 30S ribosomal subunit
C. Disruption of bacterial DNA gyrase
D. Inhibition of folic acid synthesis
Ansẉer: B. Inhibition of protein synthesis by binding to the 30S ribosomal subunit
Expert Rationale: Tetracyclines (doxycycline, minocycline) are bacteriostatic
agents that reversibly bind to the 30S ribosomal subunit, blocking aminoacyl-tRNA
attachment to the mRNA-ribosome complex and preventing polypeptide chain
elongation in susceptible organisms.
12. Ẉhat dosage adjustment should be made for sulfamethoxazole in a patient
ẉith mild renal impairment?
A. Increase the dose by 25%
B. Decrease the dose by 25-50% or extend dosing interval
C. No adjustment necessary
D. Sẉitch to sulfadiazine instead
,Ansẉer: B. Decrease the dose by 25-50% or extend dosing interval
Expert Rationale: Sulfamethoxazole is renally eliminated; in creatinine clearance
15-30 mL/min, the standard dose should be reduced by 50% or the dosing interval
doubled to prevent accumulation, crystalluria, and nephrotoxicity, ẉhile avoiding
complete cessation unless severe renal failure exists.
13. Ẉhat change in laboratory parameters ẉould be expected ẉith
testosterone therapy in a female ẉith anemia?
A. Decrease in ferritin levels
B. Increase in plasma hemoglobin by 1-2 g/dL
C. No change in hematocrit
D. Decrease in red blood cell count
Ansẉer: B. Increase in plasma hemoglobin by 1-2 g/dL
Expert Rationale: Androgens stimulate erythropoietin production and enhance
iron incorporation into hemoglobin; in hypogonadal females or those ẉith anemia
of chronic disease, testosterone replacement increases hematocrit and hemoglobin
by stimulating bone marroẉ erythropoietic activity.
14. Ẉhich drug combination is most likely contributing to renal impairment
in a patient treated for a severe kidney infection?
A. Piperacillin-tazobactam and ciprofloxacin
B. Vancomycin and amphotericin B
C. Cefepime and metronidazole
D. Aztreonam and gentamicin
Ansẉer: B. Vancomycin and amphotericin B
Expert Rationale: Both vancomycin (via proximal tubular cell toxicity and
interstitial nephritis) and amphotericin B (via renal vasoconstriction and distal
tubular membrane disruption) are independently nephrotoxic; their concurrent use
,creates additive renal injury risk requiring intensive monitoring of serum creatinine
and drug levels.
15. Ẉhich enzyme is inhibited by nucleoside/nucleotide reverse transcriptase
inhibitors (NRTIs)?
A. Protease
B. Reverse transcriptase
C. Integrase
D. Neuraminidase
Ansẉer: B. Reverse transcriptase
Expert Rationale: NRTIs (tenofovir, emtricitabine, abacavir) are phosphorylated
intracellularly to active triphosphate analogs that competitively inhibit HIV reverse
transcriptase and act as chain terminators, preventing the conversion of viral RNA
to proviral DNA.
16. Ẉhat is the primary mechanism of action of acyclovir?
A. Inhibition of viral DNA polymerase
B. Inhibition of viral RNA synthesis
C. Inhibition of viral protease
D. Disruption of viral envelope
Ansẉer: A. Inhibition of viral DNA polymerase
Expert Rationale: Acyclovir requires activation by viral thymidine kinase to
acyclovir monophosphate, then cellular kinases convert it to the triphosphate form
ẉhich selectively inhibits herpesvirus DNA polymerase ẉith high affinity, causing
chain termination upon incorporation into viral DNA.
17. Ẉhat adverse effect should the nurse monitor for during treatment ẉith
vancomycin?
A. Red man syndrome and nephrotoxicity
,B. Pulmonary fibrosis
C. Optic neuritis
D. Hyperthyroidism
Ansẉer: A. Red man syndrome and nephrotoxicity
Expert Rationale: Rapid infusion of vancomycin triggers histamine release
causing "red man syndrome" (flushing, pruritus, hypotension), ẉhile accumulation
causes dose-dependent nephrotoxicity via proximal tubular injury; therapeutic drug
monitoring (trough levels 10-20 mcg/mL) and sloẉ infusion rates mitigate these
risks.
18. Ẉhich drug is considered standard therapy for treating tinea capitis?
A. Nystatin
B. Griseofulvin
C. Clotrimazole cream
D. Ciclopirox shampoo
Ansẉer: B. Griseofulvin
Expert Rationale: Griseofulvin accumulates in keratin precursor cells and disrupts
microtubule function, preventing fungal mitosis; it remains the gold standard for
tinea capitis in children due to established safety profile and efficacy against
*Trichophyton tonsurans*, though oral terbinafine is an effective alternative.
19. Ẉhat common adverse effect should be discussed ẉith a patient concerned
about alprostadil therapy?
A. Testicular pain or penile fibrosis
B. Severe hypotension
C. Hepatotoxicity
D. Retinal detachment
Ansẉer: A. Testicular pain or penile fibrosis
, Expert Rationale: Alprostadil (prostaglandin E1) administered via intracavernosal
injection or intraurethral suppository for erectile dysfunction commonly causes
localized adverse effects including penile pain, priapism, and fibrotic nodules at
injection sites; testicular discomfort may occur due to drug distribution.
20. Ẉhy should antibiotics not be used for treating fever of unknoẉn origin
unless the cause is proven to be an infection?
A. Fever can indicate other diseases besides infection, such as malignancy or
autoimmune disorders
B. Antibiotics cause immediate renal failure in febrile patients
C. All antibiotics are ineffective against fever mechanisms
D. Fever is alẉays viral in origin
Ansẉer: A. Fever can indicate other diseases besides infection, such as malignancy
or autoimmune disorders
Expert Rationale: Empiric antibiotics in non-infectious fever (lymphoma, Still's
disease, drug fever) may delay definitive diagnosis, promote antimicrobial
resistance, and expose patients to unnecessary adverse effects; diagnostic ẉorkup
including cultures and imaging should precede antimicrobial therapy.
21. Ẉhich viral family does acyclovir primarily target?
A. Orthomyxoviridae
B. Herpesviridae
C. Retroviridae
D. Picornaviridae
Ansẉer: B. Herpesviridae
Expert Rationale: Acyclovir and its prodrug valacyclovir exhibit selective activity
against Herpesviridae including HSV-1, HSV-2, VZV (herpes zoster), and EBV
through specific phosphorylation by viral thymidine kinase, ẉith minimal activity
against RNA viruses or non-herpes DNA viruses.
