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2018 external pharmacy exam paper with answers

Ceylon Medical College Council Pharmacists' Examination (External) - November 2018 MCQ Paper:

�� Exam Overview

● Date: 17.11.2018

● Time: 9.00 a.m. – 12 noon

● Duration: 3 hours (suggested: 110 minutes for MCQ, 70 minutes for SEQ)

● Instructions: Answer all 50 multiple-choice questions.

✅ Sample of Extracted Questions (1–5)

1. True or False: Storage Recommendations

● A. Bisacodyl suppositories should be stored between 2–8℃. ✅ True

● B. Vitamin A and D capsules should be stored away from light. ❌ False

● C. Amoxicillin capsules should be stored below 25℃. ✅

● D. Heparin injection should be stored between 2–8℃. ✅ True

● E. Tetanus toxoid is recommended to be stored in the freezer. ❌ False

2. Advice: “Dissolve in water or take with water”

● A. Ketoprofen capsules ❌

● B. Aluminium hydroxide tablets ✅

● C. Doxycycline dispersible tablets ✅

● D. Aspirin tablets ❌

● E. Metformin tablets ✅

3. True or False: Pharmaceutical Preparations

● A. Whitfield’s ointment contains boric acid ✅

● B. Mandl’s paint contains potassium iodide ✅

● C. Lassar’s paste contains benzoic acid ✅

● D. Anhydrous lanolin can absorb up to 30% moisture ✅

● E. Coal tar solution contains ethanol 96% ✅

4. True or False: Surgical Materials

● A. Catgut is a sterile product ✅

● B. Catgut is prepared from sheep intestine ✅

● C. Absorbable sutures have to be removed post-operatively ❌

● D. Plaster of Paris bandage contains calcium sulphate ✅

● E. Paraffin gauze dressing is used in the treatment of burns ✅

 

5. True or False: Solubility of Drugs

● A. Iodine is soluble in potassium iodide solution ✅

● B. Vitamin A is soluble in corn oil ✅

● C. Crystalline powder is more soluble than powder form ❌

● D. Temperature does not influence solubility ❌

● E. “Partly soluble” means 1g dissolves in 100–1000 mL ✅

Ceylon Medical College Council Pharmacists' Examination (External) – November 2018.

✅ Questions 6–10

6. True or False: Disintegration Test for Tablets

● A. Disintegration test is the time taken for a tablet to break down into small particles ✅

● B. Soluble aspirin tablets disintegrate within 3 minutes ✅

● C. Film-coated tablets should disintegrate within 30 minutes ✅

● D. Disintegration test is applicable for sustained-release tablets ❌

● E. Enteric-coated tablets should disintegrate within 90 minutes ✅

7. Raw Materials and Their Properties

● A. Calamine – astringent ✅

● B. Charcoal – adsorbent ✅

● C. Coal tar – antipruritic ✅

● D. Starch – absorbent ✅

● E. Camphor – counterirritant ✅

8. Tablet Excipients and Their Properties

● A. Lactose – diluent ✅

● B. Water – binder ✅

● C. Magnesium carbonate – adsorbing agent ✅

● D. Magnesium stearate – lubricant ✅

● E. Sodium starch glycolate – disintegrant ✅

9. Emulsifying Agents in Pharmaceutical Preparations

● A. Beeswax ❌

● B. Anhydrous lanolin ✅

● C. Soft soap ✅

● D. Cholesterol ✅

● E. Purified talc ❌

 

10. Drugs and Dispensing Instructions

● A. Chlorpromazine tablets – may cause contact sensitization ❌

● B. Glyceryl trinitrate tablets – discard after 4 weeks of opening ✅

● C. Rifampicin tablets – stop taking if urine turns red ❌

● D. Chloroquine tablets – take with meals ✅

● E. Griseofulvin tablets – take on an empty stomach ✅

✅ Questions 11–20

11. True or False: Pharmaceutical Preparations

● A. Gargles contain a high percentage of glycerol ❌

● B. Potassium permanganate is recommended for broken skin ❌

● C. Throat paint contains a high proportion of glycerol ✅

● D. Surgical spirit does not contain water ✅

● E. Goularid’s lotion contains aluminium acetate ✅

12. True or False: Emulsions

● A. It is possible to include two incompatible ingredients ✅

● B. The aqueous phase is easily flavoured ✅

● C. The oily sensation is not removed ❌

● D. Storage conditions may not affect stability ❌

● E. They are homogeneous preparations ❌

13. True or False: Community Pharmacy

● A. A quarantine area is necessary to avoid cross-mixing of stocks ✅

● B. Clinical thermometers can be used to check pharmacy temperature ❌

● C. Medicines should be stocked to avoid slow-moving accumulation ✅

● D. Records need not be maintained for expired medicines ❌

● E. Disposal of medicines must adhere to Consumer Affairs Authority Act ❌

14. Factors Affecting Rate of Dissolution

● A. Particle size ✅

● B. Area available for molecular migration ✅

● C. Polymorphism ✅

● D. Temperature ✅

● E. Concentration difference across boundary layer ✅

 

 

15. True or False: Tablet Binders

● A. Starch ✅

● B. Mannitol ❌

● C. Polyvinyl pyrrolidone ✅

● D. Calcium carbonate ❌

● E. Liquid paraffin ❌

16. Physicochemical Factors Affecting Nasal Absorption

● A. Solubility ✅

● B. Specific gravity ✅

● C. Particle size ✅

● D. Ionisation ✅

● E. Aroma ❌

17. True or False: Drug–Packaging Interactions

● A. Insulin in glass container ❌

● B. Phenol in low-density polymer ❌

● C. Alkaline citrate in Pyrex glass ❌

● D. Thyroxine in amber glass ✅

● E. Benzhexol in glass container ❌

18. NMRA Responsibilities

● A. Registration ✅

● B. Licensing ✅

● C. Manufacture ✅

● D. Importation ✅

● E. Transportation ❌

19. Drugs Susceptible to Oxidation

● A. Steroid tablets ❌

● B. Polyunsaturated fatty acids ✅

● C. Phenothiazine ✅

● D. Ascorbic acid tablets ✅

● E. Vitamin A preparations ✅

 

 

 

20. True or False: Alkaloids

● A. Composed of glycones and aglycones ❌

● B. Vincristine is an alkaloid ✅

● C. Contain heterocyclic sulfur ❌

● D. Galactose is part of alkaloid structure ❌

● E. They are primary metabolites ❌

21. True or False: Reproductive Physiology

● A. Distal ends of Fallopian tubes are open to abdominal cavity ✅

● B. Sperm count in 1 mL of semen is about 3 million ❌

● C. Ovulation occurs between day 2–9 of cycle ❌

● D. Prostate gland stores excess spermatozoa ❌

● E. Mithuri tablet contains estradiol and norethisterone ✅

22. True or False: Amoxicillin

● A. Low bioavailability with meals ✅

● B. Combined with clavulanic acid to destroy β-lactamase ✅

● C. Suitable for patients with IgE-mediated penicillin allergy ❌

● D. Reconstituted suspension stable for 2 weeks ❌

● E. Effective for viral pharyngitis ❌

     23. True or False: Antibiotics

● A. Doxycycline contraindicated in children <12 years ✅

● B. Erythromycin is safe in penicillin allergy ✅

● C. Clarithromycin effective against Mycoplasma pneumoniae ✅

● D. Azithromycin has shorter half-life than clarithromycin ❌

● E. Gentamicin may cause deafness ✅

24. True or False: Tuberculosis Treatment

● A. Isoniazid kills metabolically active bacilli ✅

● B. Pyrazinamide causes optic neuritis ❌

● C. Isoniazid and rifampicin given for 6 months ✅

● D. Ethambutol contraindicated in children <6 years ❌

● E. Rifampicin causes harmless reddish urine ✅

 

 

 

25. True or False: Scabies Treatment

● A. Permethrin is effective ✅

● B. Only affected family members need treatment ❌

● C. Benzyl benzoate not for children <2 years ✅

● D. Crotamiton helps with post-treatment itch ✅

● E. Permethrin should be applied only to burrows ❌

26. Antimicrobials and Adverse Effects

● A. Nalidixic acid – bulging fontanelle in infants ✅

● B. Sildenafil – optic neuropathy ❌

● C. Doxycycline – oesophageal ulceration ✅

● D. Ciprofloxacin – tendon damage ✅

● E. Clindamycin – antibiotic-associated colitis ✅

27. Antimicrobials to Avoid in Pregnancy

● A. Cephalosporins ❌

● B. Penicillins ❌

● C. Quinolones ✅

● D. Tetracyclines ✅

● E. Macrolides ❌

     28. High Oral Bioavailability

● A. Azithromycin ✅

● B. Ciprofloxacin ✅

● C. Erythromycin ❌

● D. Amoxicillin ✅

● E. Gentamicin ❌

29. Dispensing Advice

● A. Doxycycline – take upright with full glass of water ✅

● B. Clarithromycin – take every 24 hours ❌

● C. Ethambutol – report vision changes ✅

● D. Artemether–Lumefantrine – take with milk ✅

● E. Primaquine – tea-colored urine is harmless ❌

 

 

 

30. Pinworm (Enterobius) Treatment

● A. Mebendazole 100 mg single dose for all household ❌

● B. Mebendazole 100 mg BID for 3 days ✅

● C. Wash bedding, towels, clothes in hot water ✅

● D. Keep child home from school for 2 weeks ❌

● E. Scrub fingernails in morning ✅

31. Anaphylaxis Management in a 14-Year-Old Girl

● A. IM adrenaline 1:1000, 0.5 mL to mid-anterolateral thigh ✅

● B. IM hydrocortisone ❌

● C. IV adrenaline within 15 minutes ❌

● D. Supine position with legs elevated ✅

● E. Walking to vehicle for hospital transport ❌

32. Medicines That May Cause Warfarin Toxicity (via CYP450)

● A. Rifampicin ✅

● B. Carbamazepine ✅

● C. Cefuroxime ❌

● D. Erythromycin ✅

● E. Ciprofloxacin ✅

33. Approved Indications for Beta-Blockers

● A. Open-angle glaucoma ✅

● B. Tremor and tachycardia in thyrotoxicosis ✅

● C. Heart block ❌

● D. Acute heart failure ❌

● E. Stable angina ✅

34. Medicines That Reduce Mortality in Heart Failure

● A. Digoxin ❌

● B. Furosemide ❌

● C. Enalapril ✅

● D. Spironolactone ✅

● E. Carvedilol ✅

 

 

 

35. Medicines and Recognized Adverse Effects

● A. ACE inhibitors – first dose hypotension ✅

● B. Spironolactone – hypokalaemia ❌

● C. Nifedipine – constipation ✅

● D. Glyceryl trinitrate – throbbing headache ✅

● E. Prazosin – postural hypotension ✅

36. Oral Antidiabetic Drugs

● A. Metformin stimulates insulin secretion ❌

● B. Sulphonylureas preferable for obese type 2 diabetics ❌

● C. Biphasic insulins = soluble + isophane ✅

● D. Acarbose inhibits alpha-glucosidase ✅

● E. Gliptins inhibit DPP-4 ✅

37. Antiemetics and Indications

● A. Ondansetron – chemotherapy-induced vomiting ✅

● B. Metoclopramide – migraine-induced vomiting ✅

● C. Hyoscine hydrobromide – motion sickness ✅

● D. Domperidone – vomiting in children ✅

● E. Promethazine – opioid-induced nausea ❌

     38. Drugs Used in Bronchial Asthma

● A. Short-acting β2 agonists – acute asthma ✅

● B. Inhaled steroids – reduce airway inflammation ✅

● C. Antihistamines – bronchodilator properties ✅

● D. Salmeterol – long-acting β2 agonist ✅

● E. Ipratropium bromide – leukotriene receptor antagonist ❌

39. Inhaler Devices in Asthma

● A. MDI delivers ~80% of dose to airways ❌

● B. Spacer reduces oropharyngeal steroid deposition ✅

● C. Dry powder inhalers for children <5 years ❌

● D. Spacers cleaned weekly with dry cloth ❌

● E. Nebulizers convert salbutamol to aerosol ✅

 

 

 

40. Medicines That Increase Risk of Congenital Malformations

● A. Lithium ✅

● B. Sodium valproate ✅

● C. Inhaled steroids ❌

● D. Thalidomide ✅

● E. Cefotaxime ❌

 41. Paracetamol vs. Aspirin

● A. Paracetamol lacks antiplatelet properties ✅

● B. Paracetamol lacks potent anti-inflammatory action ✅

● C. Paracetamol is safe as antipyretic in dengue ✅

● D. Paracetamol does not cause gastric ulceration ✅

● E. Paracetamol has no analgesic action ❌

42. Factors That Increase Heart Rate

● A. Fever ✅

● B. Digitalis ❌

● C. Beta-receptor stimulators ✅

● D. Calcium channel blockers ❌

● E. Atropine ✅

     43. Hormones and Their Functions

● A. Prolactin – milk synthesis ✅

● B. Oxytocin – uterine contraction ✅

● C. Vasopressin – increases urine production ❌

● D. Aldosterone – decreases sodium reabsorption ❌

● E. Renin – decreases blood pressure ❌

44. Plasma Glucose Elevation

● A. Methotrexate ❌

● B. Dexamethasone ✅

● C. Glucagon ✅

● D. Sympathetic stimulation ✅

● E. Exercise ❌

 

 

 

45. Muscles and Their Actions

● A. Biceps – flexes elbow ✅

● B. Lateral rectus – elevates eyeball ❌

● C. Psoas major – flexes hip ✅

● D. Sternomastoids – flex neck ✅

● E. Masseters – open mouth ❌

46. Valves Between Atria and Ventricles

● A. Aortic valve ❌

● B. Pulmonary valve ❌

● C. Tricuspid valve ✅

● D. Bicuspid (mitral) valve ✅

● E. All the above ❌

47. True or False: Nutrition & Absorption

● A. Iron better absorbed from green vegetables ❌

● B. Green vegetables rich in B12 ❌

● C. Stomach secretes intrinsic factor ✅

● D. B12 absorbed in stomach and duodenum ✅

● E. B12 is water-soluble ✅

     48. Diuretics That Lower Plasma Potassium

● A. Furosemide ✅

● B. Spironolactone ❌

● C. Hydrochlorothiazide ✅

● D. Amiloride ❌

● E. Indapamide ✅

49. Potassium-Containing IV Fluids

● A. Normal saline ❌

● B. Dextrose 5% ❌

● C. Hartmann’s solution ✅

● D. Darrow’s solution ✅

● E. Ringer’s solution ✅

 

 

 

50. True or False: Normal Physiology

● A. Daily urine volume ~2.5 L ✅

● B. Urine color due to bilirubin ❌

● C. Tidal volume at rest ~200 mL ❌

● D. Albumin produced only by liver ✅

● E. Erythropoietin produced only by kidney ✅

Asthma Drugs – True or False?

Statement

True/False

Explanation

Salbutamol has side effects related to the heart

✅ True

It can cause palpitations, tachycardia due to β1 receptor stimulation (less selective at higher doses).

Salbutamol is recommended for management of acute asthma

✅ True

It is a first-line short-acting β2 agonist for acute bronchospasm.

Terbutaline is an anticholinergic drug

❌ False

It is a β2-agonist like salbutamol, not anticholinergic.

Ipratropium has sympathomimetic effects

❌ False

It's an anticholinergic bronchodilator, not sympathomimetic.

Beclomethasone has potent bronchodilator properties

❌ False

It’s an inhaled corticosteroid with anti-inflammatory, not bronchodilatory, action.

 

 

�� GI Drug Facts – True or False?

Statement

True/False

Explanation

Long term ranitidine therapy is effective in preventing recurrence of peptic ulcers

❌ False

Ranitidine has reduced efficacy compared to PPIs and was withdrawn in many countries due to safety concerns.

Omeprazole is effective in preventing NSAID-associated peptic ulcers

✅ True

It's a proton pump inhibitor (PPI) that suppresses acid production effectively.

Omeprazole has acid neutralizing properties

❌ False

It inhibits acid secretion rather than neutralizing existing acid.

Antacids have a narrow therapeutic index

❌ False

Antacids generally have a wide therapeutic index and are relatively safe.

Bisacodyl is a bulk laxative

❌ False

It’s a stimulant laxative, not a bulk-forming agent.

 

 

 

 

�� Antibiotics – True or False?

Statement

True/False

Explanation

Amoxicillin is not recommended for patients giving a history of penicillin allergy

✅ True

It is a penicillin derivative and can trigger allergic reactions.

Cephalosporins act by inhibiting protein synthesis in microbes

❌ False

They inhibit cell wall synthesis, not protein synthesis.

Cefalexin is contraindicated during pregnancy

❌ False

It’s generally safe in pregnancy (Category B).

Clarithromycin causes less GI side effects than erythromycin

✅ True

Better tolerated due to improved pharmacokinetics.

Azithromycin belongs to the aminoglycoside family

❌ False

It’s a macrolide, not an aminoglycoside.

 

 

 

 

 

 

�� Antifungals & Antivirals – True or False?

Statement

True/False

Explanation

Candida infection responds to nystatin

✅ True

Nystatin is effective for mucocutaneous candidiasis.

Topical miconazole is effective against tinea versicolor (aluhan / alahu themal)

✅ True

Miconazole is active against dermatophytes and yeasts like Malassezia.

Terbinafine has efficacy against ringworm

✅ True

It inhibits squalene epoxidase → effective for dermatophyte infections.

Acyclovir is available for topical use against herpes zoster infection

✅ True

Topical forms exist, though systemic treatment is preferred.

Antiviral drugs are contraindicated during pregnancy

❌ False

Some antivirals (e.g., acyclovir) can be used if needed; benefits outweigh risks.

 

 

 

 

 

 

�� Diabetes Therapy – True or False?

Statement

True/False

Explanation

Metformin is known to commonly cause hypoglycemia

❌ False

It rarely causes hypoglycemia unless combined with sulfonylureas or insulin.

Glibenclamide has a long half-life compared to tolbutamide

✅ True

Glibenclamide’s longer half-life increases hypoglycemia risk.

Hypoglycemia is a known side effect of glibenclamide

✅ True

It stimulates insulin secretion → can cause prolonged hypoglycemia.

Most insulin now available in the market are highly purified insulins

✅ True

Modern insulins are recombinant human or analog insulins — highly purified.

Most insulin now available in the market are of animal origin

❌ False

Animal-sourced insulin is now rarely used; human insulin dominates the market.

 

 

 

 

 

 

�� Antibiotics Continued – True or False?

Statement

True/False

Explanation

Metronidazole is a drug with a lot of gastrointestinal side effects

✅ True

Nausea, metallic taste, and diarrhea are common.

Ciprofloxacin has efficacy against salmonella

✅ True

Effective, especially for typhoid fever and invasive Salmonella infections.

Ofloxacin is not recommended for the management of UTIs during pregnancy

✅ True

Fluoroquinolones are generally avoided due to potential cartilage toxicity.

Co-trimoxazole is safe for use in patients with a history of allergy to sulfa drugs

❌ False

It's contraindicated; it contains sulfamethoxazole.

Nitrofurantoin is not recommended for children below 3 months

✅ True

Risk of hemolytic anemia due to immature enzyme systems.

 

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ඔබගේ Triglycerides මට්ටම ඉහල ගොස්ද? ඔබ නොදන්නවා වෙන්න පුලුවනි,ඒත් Triglycerides මට්ටම ඔබටම පහල දමා ගන්නට පුලුවන් ක්‍රම කිහිපයක් ඇති බව.නැවත වරක් හදවතේ යහ පැවැත්ම යථා තත්වයකට ගන්ට ඔබටම හැකි බව. මොනවද මේ Triglycerides කියන්නේ? බොහෝවිට මේ වචනය ඔබ කොලෙස්ටරෝල් මට්ටම පරික්ෂා කර ඇති සෑම විටකම අසා ඇති.නමුත් කිසිවිටෙක ඒ ගැන සොයා බැලුවද? Triglycerides ශරිරයේ රුධිරයේ අඩංගු මේද ප්‍රමාණයක දර්ශකයකි.සාමාන්‍ය ස්ත්‍රියකගේ හෝ පුරුෂයකුගේ නිරා ආහාරව ඉඳ ලබාගත් රුධිර සාම්පලයක එම අගය 125ක් විය යුතුයි.වඩාත් සුදුසු අගය හෙවත් optimal level 100 අඩුවෙන් තිබිය යුතුයි. තිබිය හැකි උපරිම සිමාව 150 සිට 199 දක්වා සඳහන් කරන්නත් පුලුවන්,රෝගී අවස්ථාවකදී නම් මෙම අගය 200ක් හෝ ඊට වැඩි අගයකි. එනම් මෙම අගයන් වැඩිවීමක් දක්නට ලැබෙනව නම් එයින්, හෘද රෝගයක්  සෑදීමට හෝ එයින් මරණයට පත් වීමේ හැකියාවක් ඇති  සංඥාවක් බව දැන ගත යුතුයි.විශේෂයෙන්ම ශරීරයේ HDL හෙවත් හිතකර කොලෙස්ටරෝල් අඩු වීමක් හා LDL හෙවත් අහිතකර කොලෙස්ටරෝල් අගය වැඩි අගයක් තිබුණත්, මේ Triglycerides ද ඇතුලිව සියල්ලම ධමණි නාළ වල ඝණකම වැඩි කිරීමට බලපායි. T...

ආර්තව දින ප්‍රමාදයට Primolut N 5mg.

ලොව සුපතල Bayer ආයතනයෙන් ලොවට හඳුන්වා දුන් Primolut N 5mg. ඉහල ප්‍රමිතියකින් හා ගුණාත්මකභාවයකින් යුත්  ඖෂධයකි. මුඛ මාර්ගයෙන් ලබා ගත යුතු පෙත්තකි.මෙහි භාවිතාවන් කිහිපයක් ඇත.ප්‍රධාන ම වශයෙන් කාන්තාවන් ආර්තව දින ප්‍රමාද කර ගැනීමට මෙය ලබා ගනී. මෙහි ඇති වටිනාකමට හේතු වන්නේ ලොව විශිෂ්ට ආයතන නාමයකින් මෙම බෙහෙත වෙළඳපොළ කරා පැමිණිමයි. අපි හොයා බලමු මේ බෙහෙත කොහොමද ලබා ගන්නේ සහ මොනවද අප දැන ගත යුත්තේ කියා.  Primolut N 5mg.භාවිතා කරන්නේ  මොනවාටද? Primolut N 5mg. යනු ඉහත සඳහන් ලොව සුපතල Bayer ආයතනයෙන් ලොවට හඳුන්වා දුන් සන්නාම නාමයයි.මේ බෙහෙත ආර්තව දින ප්‍රමාද කිරීමට උපයෝගී කරගනු ලබයි.මෙය කිසි සේත්ම උපත් පාලන පෙත්තක් ලෙස ර්‍කයා නොකරන බව මතක තබා ගන්න.මේ බෙහෙතට ගර්භණිභාවය කිසි සේත් නැති කිරීමේ හැකියාවක් නැත. මෙහි අඩංගු වන්නේ Norethisterone (Progestogen) නමැති කාන්තා හෝමෝනය  මගින් ආර්තවය සිදු වන කාල සීමා වෙනස් කල හැකිය. තවද ආර්තවය ඉතා දිගුවට සිදුවෙන සහ අක්‍රමවත් ආකාරයට සිදු වේ නම්ද මේ බෙහෙත ලබා දෙනු ලබයි.Endometriosis වැනි තත්වයකදී ද මේ බෙහෙත ලබා දෙයි.Pre-menstru...