Krok 1 – 2015 Base(Pharmacology)

A 30-year-old patient complains about having abdominal pain and diarrhea for five days; body temperature rise up to 37,5oC along with chills. The day before a patient had been in a forest and drunk from an open water reservoir. Laboratory analyses enabled to make the following diagnosis: amebic dysentery. What is the drug of choice for its treatment?

A woman works as railway traffic controller. She suffers from seasonal vasomotor rhinitis and gets treatment in the outpatient setting. She was prescribed an antihistamine that has no effect upon central nervous system. What drug is it?

During an operation a patient got injection of muscle relaxant dithylinum. Relaxation of skeletal muscles and inhibition of respiration lasted two hours. This condition was caused by absence of the following enzyme in blood serum:

A 60-year-old patient was admitted to the surgical department because of infection caused by blue pus bacillus (Pseudomonas aeruginosa) which is sensative to penicillin antibiotics. Indicate which of the given penicillins has marked activity to the Pseudomonas aeruginosa? 

A 45-year-old woman suffers from allergic seasonal coryza caused by the ambrosia blossoming. What medicine from the stabilizer of the adipose cells group can be used for prevention of this disease?

Systemic amebiasis with involvment of intestines, liver, lungs was diagnosed in a 52-year-old patient. What drug should be prescribed?

A 38-year-old man who poisoned himself with mercury dichloride was taken to the admission room in grave condition. What antidote should be immediately introduced?

A patient who suffers from insomnia caused by emotional disorder was prescribed a hypnotic drug with tranquillizing effect. What hypnotic was prescribed?

A patient had to go through an operation. Doctors introduced him dithylinum (listenone) and performed intubation. After the end of operation and cessation of anesthesia the independent respiration wasn’t restored. Which enzyme deficit prolongs the action of muscle relaxant?

The alternate usage of dichlotiazide, etacrin acid and lasex didn’t cause marked diuretic effect in patient with marked peripheral edema. Increased amount of aldosterone is in the blood. Indicate the medicine to be prescribed.

A 56-year-old patient with complains of thirst and frequent urination was diagnosed to have diabete mellitus and butamin was prescribed. What is the mechanism of action of this medicine?

A 37 year old patient suffering from obliterating vascular endarteritis of lower limbs takes daily 60 microgram/kilogram of phenylin. Because of presentations of convulsive disorder (craniocerebral trauma in anamnesis) he was prescribed phenobarbital. Withholding this drug caused nasal hemorhage. What is this complication connected with?

Patient with complaints of dryness in the mouth, photophobia and vision violation was admitted to the reception-room. Skin is hyperemic, dry, pupils are dilated, tachycardia. Poisoning with belladonna alkaloids was diagnosed on further examination. What medicine should be prescribed?

Patient was on glucocorticoids for a long time, discontinuation of usage caused exacerbation of the illness, decreased BP, weakness. How can you explain it?

Patient complaines of weakness, dyspnea, low extremities oedema. Diagnosis: chronic cardiac insufficiency. What medicine should be prescribed first of all?

Signs of gastropathy develop in the patient with rheumatoid arthritis who was treated with indometacin. With what activity of the drug can this complication be connected?

Testosterone and it’s analogs increase the mass of skeletal muscles that allows to use them for treatment of dystrophy. Due to interaction of the hormon with what cell substance is this action caused?

A patient ill with neurodermatitis has been taking prednisolone for a long time. Examination revealed high rate of sugar in his blood. This complication is caused by the drug influence upon the following link of carbohydrate metabolism:

Proserin increases skeletal muscle tone when given systematically. Halothane induces relaxation of skeletal muscles and reduces proserin effects. What is the nature of proserin and halothane interaction?

A 70-year-old man, who suffered from chronic bronchitis, was prescribed medicine for the cough – codeine. What is the mechanism of anticoughing effect?

A patient with frequent attacks of stenocardia was prescribed sustak-forte to be taken one tablet twice a day. At first the effect was positive but on the second day stenocardia attacks resumed. What can explain inefficiency of the prescribed drug?

A 37-year-old man was admitted to the surgical department with symptoms of acute pancreatitis: vomiting, diarrhea, bradycardia, hypotention, weakness, dehydration of the organism. What medicine should be used first of all?

The patient has taken the mixture prescribed by neuropathologist for neurasthenia for 2 weeks. Patient felt better but developed coryza, conjunctivitis, rash, inertia, decrease of memory. Bromizm was diagnosed. What should be prescribed to decrease symptoms?

Analeptical remedy of reflective type from the H-cholinomimetics group was given to the patient for restoration of breathing after poisoning with carbon monoxide. What medicine was prescribed to the patient?

An aged patient complains of headache, dizziness, quick tiredness, worsening of memory. Anamnesis: craniocerebral injury. Medicine of what group should be prescribed?

The patient was treated medically for psychosis for 2 weeks. Patient’s condition improved but rigidity, tremor, hypokinesia developed. Which of the drugs can cause such complications?

Gonorrhoea was revealed in the patient on bacterioscopy of the smear from urethra. Taking into account that medecines for gonorrhoea are fluorquinolones, patient should be prescribed:

Patient with bronchial asthma was taking tablets which caused insomnia, headache, increased blood pressure. What medecine can cause such complications?

Diuretic drug was prescribed to the patient with hypertension in the course of complex treatment. In a few days BP decreased but signs of hypokaliemia developed. What drug could cause such complications?

Patient was admitted to the infection unit with diagnosis of bacterial dysentery. On laboratory studies it was revealed that causative element is sensative to the many antimicrobial medicines, but patient has anemia. What medicine is contra-indicated to the patient?

Patient with pneumonia has intolerance to antibiotics. Which of the conbined sulfanilamide medicines should be prescribed to the patient?

A patient suffering from myasthenia has been administered proserin. After its administration the patient has got nausea, diarrhea, twitch of tongue and skeletal muscles. What drug would help to eliminate the intoxication?

A patient who had myocardial infarction was administered 75 mg of acetylsalicinic acid a day. What is the purpose of this administration?

Patient with mercury poisoning was admitted to the toxicological department from the chemical industry. What medicine should be used?

A 5-year-old child has been diagnosed with acute right distal pneumonia. Sputum inoculation revealed that the causative agent is resistant to penicillin, but it is senstive to macrolides. What drug should be prescribed?

A patient suffering from chronic hyperacidic gastritis takes an antacid drug for heartburn elimination. After its ingestion the patient feels better but at the same time he has a sensation of stomach swelling. Which of the following drugs might be the cause of such side effect?

A patient consulted a doctor about bowels disfunction. The doctor established symptoms of duodenitis and enteritis. Laboratory examination helped to make the following diagnosis: lambliosis. What medication should be administered?

Introduction of a pharmaceutical substance to an experimental animal resulted in reduction of salivation, pupil mydriasis. Next intravenous introduction of acetylcholine didn’t lead to any significant changes of heart rate. Name this substance:

Continious taking of a drug can result in osteoporosis, erosion of stomach mucous membrane, hypokaliemia, retention of sodium and water, reduced content of corticotropin in blood. Name this drug:

A 63 y.o. man with collapse symptoms was delivered to the emergency hospital. A doctor chose noradrenaline in order to prevent hypotension. What is the action mechanism of this medication?

Anapriline therapy caused positive effect in the dynamic of the disease of a 44-year-old woman suffering from stenocardia. What is the main mechanism of the effect of this medicine?

A patient suffering from syphilis has been treated with bismuth preparations. As a result of it some grey spots turned up on the mucous membrane of the oral cavity; nephropathy symptoms were also present. What drug should be used for treatment of bismuth intoxication?

A 4 year old child was admitted to the orthopaedic department with shin fracture together with displacement. Bone fragments reposition requires preliminary analgesia. What preparation should be chosen?

Patient with abscess of the cut wound applied to the traumatological department. Doctor for the cleaning of the wound from the pus washed it with 3% hydrogen peroxide. Foam was absence. What caused the absents on the drug activity?

A patient was diagnosed with active focal pulmonary tuberculosis. What drug should be prescribed in the first place?

A patient taking clonidine for essential hypertension treatment was using alcohol that caused intense inhibition of central nervous system. What may it be connected with?

Examination of a patient revealed extremely myotic pupils, sleepiness, infrequent Chain-Stoke’s respiration, urinary retention, slowing-down of heart rate, enhancement of spinal reflexes. What substance caused the poisoning?

A patient suffers from diabetes melitus. After the regular insulin injection his condition grew worse: there appeared anxiety, cold sweat, tremor of limbs, general weakness, dizziness. What preparation can eliminate these symptoms?

Continuous taking of some drugs foregoing the pregnancy increase the risk of giving birth to a child with genetic defects. What is this effect called?

A doctor administered a patient with allergic dermatitis a H1-histamine blocker as a part of complex treatment. Name this medication:

A 19 year old woman suffers from primary syphilis. Doctor administered her complex therapy that includes benzylpenicillin sodium salt. What is the mechanism of action of this drug?

A 65 year old female patient suffers from chronic renal insufficiency accompanied by evident edemata caused by chronic glomerulonephritis. What diuretic should be administered for forced diuresis?

A patient suffering from coronary artery disease had taken a certain drug many times a day in order to arrest stenocardia attacks. Overdose of this drug finally caused intoxication. Objectively: cyanotic skin and mucous membranes, dramatic fall in the arterial pressure, tachycardia, respiration inhibition. Blood has increased concentration of methemoglobin. The drug the patient had taken relates to the following group:

A patient with II stage hypertension has been taking one of hypotensive medications for the purpose of treatment. After a time arterial pressure decreased, but the patient started complaining of flaccidity, sleepiness, indifference. A bit later he felt stomach pain. He was diagnosed with ulcer. What hypotensive medication has the patient been taking?

A child suffers from drug idiosyncrasy. What is the cause of such reaction? 

Examination of a 70 year old patient rrevealed insulin-dependent diabetes. What drug should be administered?

For the preparation of a patient’s burn skin surface a certain medication was used. Its antiseptic action is provided by free oxygen that segregates in presence of organic substances. Choose the right answer:

A patient suffering from chronic cardiac insufficiency was recommended to undergo a prophylactic course of treatment with a cardiological drug from the group of cardiac glycosides that is to be taken enterally. What drug was recommended?

A 50 y.o. patient with chronic cardiac insufficiency and tachyarrythmia was prescribed a cardiotonic drug. What drug was prescribed?

An ophthalmologist used a 1% mesaton solution for the diagnostic purpose (pupil dilation for eye-ground examination). What is the cause of mydriasis induced by the drug?

Mother of a 2 year old child consulted a stomatologist. In the period of pregnancy she was irregularly taking antibiotics for an infectious disease. Examination of the child revealed incisor destruction, yellow enamel, brown rim around the dental cervix. What drug has apparent teratogenic effect?

A 36 y.o. man has a craniocerebral trauma. Objectively: diminished breath sounds, thready pulse, no reflexes. What way of pyracetam introduction will be the most apropriate in this case?

A patient suffering from initial hypertension has been taking an antihypertensive preparation for a long time. Suddenly he stopped taking this preparation. After this his condition grew worse, this led to development of hypertensive crisis. This by-effect can be classified as:

A patient ill with bronchial asthma didn’t inform his doctor that he had attacks of stenocardia. Doctor administered him a medication, which taking resulted in less frequent attacks of bronchial asthma, but stenocardia attacks became more frequent. What medication was administered?

A patient who has been suffering from cardiac insufficiency for several months has been taking digoxin on an outpatient basis. At a certain stage of treatment there appeared symptoms of drug overdose. What phenomenon underlies the development of this complication?

A patient suffers from vision impairment – hemeralopy (night blindness). What vitamin preparation should be administered the patient in order to restore his vision?

A patient suffers from severe postoperative pseudomonadous infection. What of the following antibiotics should be administered in this case?

After a tooth extraction a patient felt persistent pain behind his breast bone. After sublingual intake of an antianginal drug the pain behind the breast bone disappeared, but the patient complained of headache and dizziness. What drug are these properties typical for?

A patient with fracture of his lower jaw was admitted to the maxillofacial department. It was decided to fix his bones surgically under anaesthetic. After intravenous introduction of muscle relaxant there arose short fibrillar contractions of the patient’s facial muscles. What muscle relaxant was applied?

Patient in the unconscious state was admitted to the emergency room. Skin is cold, pupils are delayed, breathing is heavy, with cycles of the Cheyne-Stokes type, blood pressure is decreased, urinary bladder is overloaded. Poisoning with what substance is the most likely? 

Examination of a 60 y.o. patient revealed hyperglycemia and glucosuria. A doctor administered him a medication for internal use. What medication is it?

An elderly female patient suffers from the type 2 diabetes mellitus accompanied by obesity, atherosclerosis, coronary artery disease. Basal hyperinsulinemia is also present. What treatment would be the most appropriate?

A patient suffers from stenocardia and takes isosorbide mononitrate. He was prescribed a complementary drug with disaggregating effect. What drug is it?

A patient in postoperative period was prescribed an anticholinesterase drug for stimulation of intestinal peristalsis and tonus of urinary bladder. What drug is it?

A liquidator of a breakdown at a nuclear power plant who was irradiated complained about vomiting that occurs all of a sudden. What medication should be prescribed?

A patient with chronic cardiac insufficiency has been treated with cardiotonic drugs and a thiazide diuretic, but in spite of it there are still edemata and risk of ascites. What medication should be prescribed to amplify diuretic effect of the applied drugs?

A patient ill with collagenesis has been taking prednisolone for a long time. Hypokaliemia development caused spastic pain of skeletal muscles. What medication should be used in order to correct potassium exchange?

A patient ill with essential hypertension was recommended a drug that prevents thrombosis. It is to be taken parenterally. What drug is it?

A patient presents with twilight vision impairment. Which of the following vitamins should be administered?

A female patient consulted a doctor about pain and limited movements in the knee joints. Which of the following nonsteroid anti-inflammatory drugs should be administered taking into consideration that the patient has a history of chronic gastroduodenitis?

A 66 year old female patient got intravenous injection of magnesium sulfate solution for the purpose of elimination of hypertensive crisis. But arterial pressure didn’t go down and after repeated introduction of the same preparation there appered sluggishness, slow response, inhibition of consciousness and respiration. What preparation is antagonist of magnesium sulfate and can eliminate symptoms of its overdose?

A 64 year old woman has impairment of twilight vision (hemeralopy). What vitamin should be recommended in the first place?

A patient underwent appendectomy. In the postoperative period he has been taking an antibiotic. The patient complains about hearing impairment and vestibular disorders. What group of antibiotics has such by-effects?

A student came to see a doctor and asked to administer him a drug for treatment of allergic rhinitis that occurs in the period of linden flowering. What drug may be used?

A 7 year old child is ill with bronchitis. It is necessary to administer him an antibacterial drug. What drug of fluoroquinolone group is CONTRA-INDICATED at this age?

A patient consulted a physician about muscle rigidity, constrained movements, permanent arm tremor. The patient was diagnosed with Parkinson’s disease. What preparation should be administered?

A patient takes digoxin for treatment of cardiac insufficiency. What diuretic may increase digoxin toxicity due to the intensified excretion of K+ ions?

A patient with coronary artery disease was admitted to the cardiological department. For stenocardia prevention a drug from the group of \beta-adrenoceptor blockers was administered. What drug is it?

A woman was delivered to a hospital for trachea intubation. What of the following drugs should be applied in this case?

A patient suffers from pulmonary tuberculosis. During treatment neuritis of visual nerve arose. What drug has caused this by-effect?

A patient ill with amebiasis was prescribed a certain drug. The use of alcohol together with this drug is contra-indicated because the drug inhibits metabolism of ethyl alcohol. What drug is it?

A patient suffers from chronic left-ventricular insufficiency. What medication should be administered?

A patient ill with chronic cardiac insufficiency was prescribed an average therapeutic dose of digoxin. Two weeks after begin of its taking there appeared symptoms of drug intoxication (bradycardia, extrasystole, nausea). Name the phenomenon that caused accumulation of the drug in the organism?

A patient with drug intoxication presented with the dryness of oral mucous membrane and mydriatic pupils. Such action of this drug is associated with the following effect:

A patient with a limb fracture must be administered a depolarizing drug from the myorelaxant group for the purpose of a short-time surgery. What drug is it?

A patient suffering from chronic bronchitis takes a synthetic mucolytic drug that facilitates the sputum thinning. What drug is it?

Burned skin surface was treated with a certain preparation. Its antiseptic properties are provided by atomic oxygen that is formed in presence of organic substances. What preparation was applied?

On the 2-3rd day after stomach resection intestinal peristalsis wasn’t restored. What is to be administered for stimulation of gastrointestinal tract?

A stomatologist injected a patient with a certain drug in order to reduce salivation during tooth filling. What drug is it?

A patient with chronic cardiac insufficiency has been taking foxglove (Digitalis) preparations for a long time. Due to the violation of intake schedule the woman got symptoms of intoxication. These symptoms result from:

Before tooth extraction a patient was advised to take a certain drug for haemorrhage prevention. What drug was advised?

A man who has been taking a drug for a long time cannot withhold it because this causes impairment of psychic, somatic and vegetative functions. Name the syndrome of different disturbances caused by drug discontinuation:

A patient consulted a stomatologist about purulent inflammation of his gums. What drug will be the most effective if it is suspected that a causative agent is an anaerobe?

A 45-year-old patient suffers from neurosis characterized by irritability, sleeplessness, motiveless anxiety. What drug would eliminate all the symptoms?

A 12 year old child has intolerance to some foodstuffs. Their consumption causes an allergic reaction in form of itching skin eruptions. What antihistaminic drug should be admistered so that the child could attend school?

A patient that entered the admission office had the following signs of acute cardiac insufficiency: paleness, acrocyanosis, frequent shallow respiration. What drug is indicated in this case?

A patient with myocardial infarction was admitted to the cardiological department. For pain relief it was decided to potentiate fentanyl action with a neuroleptic. Which of the following neuroleptics is the most suitable for neuroleptanalgesia?

A patient with bacterial pneumonia was prescribed benzylpenicillin. What is the mechanism of its antibacterial effect?

A patient has herpetic rash. What medication should be administered?

A patient who has been treated in a neural clinic and has been taking a sedative for a long time got the following complication: cough, rhinitis, epiphora. What drug caused these disturbances?

In order to accelerate healing of a radiation ulcer a vitamin drug was administered. What drug is it?

A patient with hip fracture was prescribed a narcotic analgetic. Its anesthetic action is determined by interaction with the following receptors:

A patient with hypertensic crisis was admitted to the cardiological department, he was injected intravenously with an antihypertensive drug – salt of an alkaline-earth metal. What drug was injected?

A patient with acute morphine poisoning was delivered to a hospital. What specific narcotic antagonist should be chosen in this case?