1. All of the following are true concerning heparins EXCEPT [1]:

A. The risk of bleeding complications is reduced with low molecular weight heparin compared with standard heparin
B. Heparins bind to antithrombin (AT III) and increase their actions on thrombin
C. Heparins specifically block the function of clot-bound thrombins
D. Heparins also bind to and inhibit Clotting Factor X
E. Low molecular weight heparins do not require monitoring by activated partial thrombo-plastin time (APTT)

2. Interferon alpha has been shown to be an effective treatment for all of the followingEXCEPT [2]:

   A. Chronic Hepatitis B Virus (HBV)
   B. Chronic Myelogenous Leukemia (CML)
   C. Chronic Hepatitis C Virus (HCV)
   D. Churg-Strauss Syndrome
   E. Hepatitis A Virus (HAV)

3. Compared with second generation macrolides such as clarithromycin or azithromycin, erythromycin is effective against all of the following EXCEPT [3]:

   A. Legionella
   B. Heamophilus influenza
   C. Mycoplasma pneumoniae
   D. Chlamydia pneumoniae
   E. Streptococci

4. All of the following are true EXCEPT [4]:

A. Sulfa drug antibiotics inhibit bacterial but not mammalian tetrahydrofolate synthesis
B. Sulfa drugs are usually bacterostatic
C. Metronidazole kills most gut-associated anaerobes, giardia, amoeba, and trichomonas
D. Vancomycin trough levels must be monitored in all patients
E. Fosfomycin single 3gm oral dose is effective against nearly all organisms causinguncomplicated urinary tract infections

5. All of the following may be recommended for chronic lower back pain EXCEPT [5]:

   A. Tramadol
   B. Gabapentin
   C. Codeine or Oxycodone
   D. Carbamazepine
   E. Tricyclic antidepressants

6. All of the following are true concerning penicillins EXCEPT [6]:

   A. Penicillin has excellent coverage against methicillin sensitive staphylococci
   B. Piperacillin-clavulonate (Zosyn®) has good anti-pseudomonal activities
   C. Meropenam and imipenam-cilastatin have excellent aerobic and anaerobic coverage
   D. Dicloxacillin is a good oral agent for treatment of methicillin staphylococci
   E. Ticarcillin and piperacillin have improved gram-negative coverage compared to ampicillin

7. All of the following are true concerning prostaglandins EXCEPT [7]:

   A. Prostacyclin (PGI2) is vasodilatory and anti-thrombotic
   B. Prostaglandin E2 analogs have gastric protective activities
   C. Prostaglandins are necessary for normal cellular functions produced
   D. Inflammatory prostaglandins are synthesized through the cyclooxygenase 2 (Cox-2)pathway
   E. Inhibition of cyclooxygenase 1 has no effect on renal function

8. Fluoroquinolones are indicated for all of the following EXCEPT [8]:

   A. A 60 year old diabetic patient with a urinary tract infection
   B. A 10 year old boy with penicillin allergies and chronic sinusitis
   C. A 25 year old woman with Chlamydia psiticossis
   D. A 65 year man with Legionnaire's Disease
   E. A 45 year old smoker with community acquired pneumonia

9. All of the following have significant alpha-adrenergic agonist activity EXCEPT [9]:

   A. Epinephrine
   B. Norepinephrine
   C. Dopamine (high dose)
   D. Dobutamine
   E. Phenylephrine

10. All of the following are true concerning vitamins EXCEPT [10]:

    A. Overdoses of vitamin A can cause night blindness
    B. Deficiency of folic acid can lead to elevated levels of homocysteine
    C. Vitamin E has been shown to slow the progression of Parkinson's Disease
    D. Hypervitaminosis D can cause hypercalcemia
    E. Increased ingestion of vitamin K can partially reverse the coagulopathy of liver disease

Answers

1. C (Only direct antithrombins can block clot-bound thrombin action.)
2. E
3. B (Erythromycin does not cover gram-negative bacteria.)
4. D (Trough levels may be helpful for monitoring toxicity in patients with renal dysfunction.)
5. C
6. A
7. E (Prostaglandins play a role in arteriolar vasodilation in the kidney.)
8. B (Quinolones are not indicated for use in children.)
9. D (Dobutamine is a pure ß-agonist)
10. C