Fast Track Questions (2026 Edition)||
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Instructions: Select the best answer. Correct answers are highlighted in bold.
Section 1: General Pharmacology & Pharmacokinetics (Qs 1–15)
1. A drug with a very high volume of distribution (Vd) primarily accumulates
in which compartment?
• A) Plasma
• B) Tissues
• C) Extracellular fluid only
• D) Red blood cells
*Rationale: High Vd (>42 L) indicates extensive tissue binding/uptake, low
plasma concentration.*
2. Which phase of drug metabolism most often decreases pharmacological
activity?
• A) Phase I (oxidation)
• B) Phase II (conjugation)
• C) Absorption
, • D) Distribution
Rationale: Phase II conjugation (glucuronidation, acetylation) typically
produces inactive, water-soluble metabolites.
3. A drug follows zero-order kinetics. If the initial dose is doubled, the half-life
will:
• A) Remain unchanged
• B) Increase proportionally
• C) Decrease by half
• D) Become first-order
Rationale: Zero-order (e.g., phenytoin, alcohol) – elimination rate constant,
half-life increases with dose.
4. Bioavailability of an intravenous drug is always:
• A) 100%
• B) 50%
• C) Variable
• D) <100%
Rationale: IV administration bypasses absorption, so 100% reaches
systemic circulation.
5. Which drug is a prodrug requiring hepatic activation?
• A) Morphine
• B) Lisdexamfetamine
• C) Atenolol
• D) Furosemide
Rationale: Lisdexamfetamine (vyvanse) is cleaved by RBCs to active
dextroamphetamine.
6. Therapeutic drug monitoring is essential for:
• A) Penicillin
• B) Vancomycin
, • C) Metformin
• D) Cetirizine
Rationale: Vancomycin has nephrotoxicity and narrow therapeutic index,
requiring trough levels.
7. Which CYP enzyme metabolizes ~50% of all drugs?
• A) CYP3A4
• B) CYP2D6
• C) CYP2C9
• D) CYP1A2
Rationale: CYP3A4 – most abundant, metabolizes statins, CCBs,
macrolides.
8. Grapefruit juice increases drug levels by inhibiting:
• A) CYP3A4
• B) CYP2E1
• C) P-glycoprotein
• D) MAO-B
Rationale: Grapefruit inhibits intestinal CYP3A4, ↑ bioavailability (e.g.,
simvastatin, amlodipine).
9. A drug with a narrow therapeutic index (e.g., warfarin) requires:
• A) Once-daily dosing only
• B) Frequent INR monitoring
• C) IV administration
• D) Enteric coating
Rationale: Narrow TI = small margin between efficacy and toxicity;
monitoring prevents bleeding/thrombosis.
10. First-pass effect is avoided by which route?
• A) Oral
• B) Sublingual