A 35-year-old woman with a history of polycystic ovary syndrome is trying to conceive. Despite losing two stone in weight, she is still only ovulating once every three to four months. She decides to try Clomiphene. What is the mechanism of action of Clomiphene?
A 65-year-old patient is suspected of having ingested a substance with anticholinesterase effects. What combination of signs, if present, would most likely confirm this effect?
A 54-year-old truck driver visits his cardiologist for a follow-up appointment before returning to work. He has been regularly monitored for atrial fibrillation, which was diagnosed four months ago, and mild heart failure with a left ventricular ejection fraction of 45% based on his recent echocardiogram. The patient is eager to resume his job as a night driver for a local haulage company. During the consultation, he inquires about the potential side effects of his current medications that could affect his job performance. Which medication is most likely to have adverse effects that could impact his ability to carry out his job?
A 85-year-old man with chronic myeloid leukaemia develops gout after treatment. His GP prescribed allopurinol to prevent the accumulation of uric acid. How does allopurinol achieve this?
What is the correct pairing of a disorder with its treatment?
A 57-year-old male presents to the emergency department with fever and diarrhoea. He has a medical history of systemic lupus erythematosus and received a renal transplant three years ago. He also has gout and dyspepsia and takes azathioprine, allopurinol, and omeprazole. He drinks 20 units of alcohol per week for the past ten years. His vital signs are as follows:
– Respiratory rate: 32/min
– Pulse: 133 bpm
– Temperature: 39.1ºC
– Blood pressure: 88/56 mmHg
– Oxygen saturation: 94% on room air
His blood test results show:
– Hb: 90 g/L (normal range for males: 135-180)
– Platelets: 85 * 109/L (normal range: 150 – 400)
– WBC: 1.3 * 109/L (normal range: 4.0 – 11.0)
– Neuts: 0.7 * 109/L (normal range: 2.0 – 7.0)
What drug interaction led to this patient’s presentation?
A 26-year-old swimwear model is hesitant to start a newly prescribed medication due to concerns about potential side-effects. Specifically, she is worried about staining of the teeth, which she read about in the patient information leaflet. As a model, she is worried that this side-effect could impact her work. Which antibiotic is known to cause staining of the teeth?
Which of the following is a competitive antagonist of aldosterone?
You review a 53-year-old man with multiple health problems, including arthritis and ischaemic heart disease. He was admitted 3 days earlier suffering from a respiratory tract infection. His general practitioner had prescribed an antibiotic, but he was not sure what the name of the tablet was. prehospital medications included diclofenac 50 mg orally (po) three times daily (tid), amlodipine 10 mg po daily, bendroflumethiazide 2.5 mg po daily, paracetamol 1 g as required (prn), and amoxicillin 500 mg po tid. Blood tests reveal:
Investigation Result Normal value
Bilirubin 256 μmol/l 2–17 µmol/l
Alanine aminotransferase (ALT) 98 IU/l 5–30 IU/l
Alkaline phosphatase (ALP) 56 IU/l 30–130 IU/l
Albumin 40 g/l 35–55 g/l
You review his medications.
Which of the following is most likely to be responsible for his liver blood picture?
A 72-year-old male patient arrives in hospital with a hip fracture. His wife mentions that he drinks around two bottles of wine per day. He is prescribed chlordiazepoxide, a benzodiazepine, for alcohol withdrawal.
What is the reason for using this medication in this situation?