Pharmacology Practice Questions
Pharmacology tests drug mechanisms, selectivity, anticoagulant reversal, and DOAC selection, which is high-yield on the MCCQE, USMLE Step 2 CK, and PLAB. These four sample questions come from MediLingo's bank of 3,900+ questions across 23 specialties.
Sample questions
Question 1
What is the mechanism of action of ACE inhibitors in lowering blood pressure?
a) Blockade of L-type calcium channels in vascular smooth muscle to reduce arteriolar vasoconstriction
b) Blocks conversion of angiotensin I to angiotensin II and prevents bradykinin breakdown ✓ Correct
c) Competitive blockade of beta-1 adrenergic receptors in the heart to reduce cardiac output and renin release
d) Selective blockade of alpha-1 adrenergic receptors in peripheral vasculature to reduce vascular resistance
Key teaching point: ACEi: blocks ATI→ATII conversion + prevents bradykinin breakdown. Side effects: cough (bradykinin), angioedema, hyperkalemia.
Question 2
Which beta-blocker is non-selective (blocks both β1 and β2)?
a) Metoprolol
b) Propranolol ✓ Correct
c) Atenolol
d) Bisoprolol
Key teaching point: Non-selective (β1+β2): propranolol, nadolol, timolol — avoid in asthma. β1-selective: metoprolol, atenolol, bisoprolol, esmolol — safer in COPD/asthma.
Question 3
A 70-year-old man on warfarin presents with an intracranial hemorrhage. INR is 4.5. What is the recommended reversal strategy for this life-threatening bleed?
a) Vitamin K alone
b) FFP alone
c) Four-factor PCC plus IV vitamin K ✓ Correct
d) Observe and hold warfarin
Key teaching point: Life-threatening warfarin bleed: 4F-PCC plus IV vitamin K.
Question 4
What is the advantage of direct oral anticoagulants (DOACs) over warfarin in AFib?
a) DOACs are fully reversed with vitamin K, similar to warfarin
b) DOACs have no need for INR monitoring, fewer drug/food interactions, and lower intracranial hemorrhage risk ✓ Correct
c) DOACs are significantly cheaper than warfarin when accounting for total treatment costs
d) DOACs eliminate the risk of major bleeding compared to warfarin
Key teaching point: DOACs preferred over warfarin for non-valvular AFib: no INR monitoring, fewer interactions, less ICH. Use warfarin for mechanical valves/moderate-severe MS.
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