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Question 1
Incorrect
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A 42-year-old patient with worsening epigastric pain has been referred to you by a GP. The patient has been taking omeprazole for a month, but her symptoms are getting worse.Which of the following is NOT a well-known side effect of proton pump inhibitor treatment?
Your Answer: Hypomagnesaemia
Correct Answer: Pelvic fracture
Explanation:Proton pump inhibitors (PPIs) have a variety of side effects, including:Vomiting and nauseaPain in the abdomenFlatulenceDiarrhoeaConstipationHeadachePPIs have been linked to a significant increase in the risk of focal tachyarrhythmias (link is external).Low serum magnesium and sodium levels have been linked to long-term use of PPIs, according to the US Food and Drug Administration (link is external).Long-term PPI use has also been linked to an increased risk of fracture, according to epidemiological evidence (link is external). Observational studies have discovered a slight link between hip, wrist, and spine fractures. However, there is no link between the two and an increased risk of pelvic fracture. For this reason, the MHRA recommends that patients at risk of osteoporosis who take PPIs maintain an adequate calcium and vitamin D intake.
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This question is part of the following fields:
- Gastrointestinal Pharmacology
- Pharmacology
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Question 2
Incorrect
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Epigastric pain and haematemesis present in a 67-year-old man. In the emergency room, he is stabilised and referred to the on-call medical team. He has been scheduled for an endoscopy in the morning due to a suspected peptic ulcer. Before transferring him to the ward, you consider giving him a proton pump inhibitor (PPI).Which of the following doses and routes are the best?
Your Answer:
Correct Answer: A PPI should not be prescribed
Explanation:PPIs should not be used prior to endoscopic therapy when an early endoscopic examination is performed within 24 hours of admission, according to current recommendations.High-dose PPI therapy reduces the risk of rebleeding and surgery after endoscopic treatment of severe peptic ulcer bleeding. Both oral and intravenous PPIs produce similar results, and there is no discernible benefit to using the intravenous formulation in patients who can tolerate oral medication.
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This question is part of the following fields:
- Gastrointestinal Pharmacology
- Pharmacology
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Question 3
Incorrect
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A 55-year-old woman with mild dyspepsia seeks advice from her pharmacist on how to deal with her symptoms. In the first instance, the pharmacist advises her to take an over-the-counter antacid. She buys an antacid that contains aluminium hydroxide, which relieves her symptoms but has a negative side effect.She's most likely to have developed which of the following side effects?
Your Answer:
Correct Answer: Constipation
Explanation:Aluminium hydroxide is a common antacid that is used to treat ulcer dyspepsia and non-erosive gastro-oesophageal reflux disease.When antacids containing aluminium salts are given to patients with renal impairment, there is a risk of accumulation and aluminium toxicity. If renal function is normal, aluminium accumulation does not appear to be a risk.Because it reduces gastrointestinal phosphate absorption, aluminium hydroxide can also be used to treat hyperphosphatemia in patients with renal failure.Magnesium-based antacids are generally laxative, whereas aluminium-based antacids can be constipating. Renal impairment, angioedema, and anaphylaxis are not significantly increased.
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This question is part of the following fields:
- Gastrointestinal Pharmacology
- Pharmacology
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Question 4
Incorrect
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A 60-year-old female has a past medical history of diverticular disease. She now presents in the clinic with crampy abdominal pain. The nurse at the triage suggests prescribing hyoscine butyl bromide to help relieve the abdominal pain. However, after administering this treatment, the patient develops a side-effect to the medication. What side-effect of using hyoscine butyl bromide is she MOST likely to develop out of the following?
Your Answer:
Correct Answer: Dry mouth
Explanation:Hyoscine butylbromide is an antispasmodic drug that blocks muscarinic receptors and reduces intestinal motility. It is used for gastrointestinal and genitourinary smooth muscle spasms and symptomatic relief of IBS.It has the following side-effects:1. Constipation2. Dizziness3. Drowsiness4. Dry mouth5. Dyspepsia6. Flushing7. Headache8. Nausea and vomiting9. Palpitations10. Skin reactions11. Tachycardia12. Urinary disorders13. Disorders of vision
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This question is part of the following fields:
- Gastrointestinal Pharmacology
- Pharmacology
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Question 5
Incorrect
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A 72-year-old man has a past medical history of diverticular disease. He now presents in the clinic with crampy abdominal pain. The nurse at the triage suggests prescribing hyoscine butyl bromide to help relieve the abdominal pain. However, you do not agree with this medication, as you can see on his chart that the patient has several other comorbidities. Out of the following, what is NOT a contraindication to using hyoscine butyl bromide?
Your Answer:
Correct Answer: Prostatic hyperplasia
Explanation:Hyoscine butylbromide is an antispasmodic drug that blocks muscarinic receptors and reduces intestinal motility. It is used for gastrointestinal and genitourinary smooth muscle spasms and symptomatic relief of IBS.It has the following contraindications: 1. Closed-angle glaucoma2. Gastrointestinal obstruction3. Intestinal atony4. Paralytic ileus5. Toxic megacolon6. Severe ulcerative colitis7. Significant bladder outflow obstruction8. Urinary retention9. Myasthenia gravisUse cautiously in the following conditions: 1. Acute myocardial infarction (in adults)2. Arrhythmias (may be worsened)3. Autonomic neuropathy4. Hypertension5. Cardiac insufficiency (due to association with tachycardia)6. Congestive cardiac failure (maybe worsened)7. Cardiac surgery (due to association with tachycardia)8. Gastro-oesophageal reflux disease9. Ulcerative colitis10. Prostatic hyperplasia11. Use in children (increased risk of side effects)
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This question is part of the following fields:
- Gastrointestinal Pharmacology
- Pharmacology
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Question 6
Incorrect
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You're taking a history of a 59-year-old banker who has had heartburn in the past.Which of the following information about antacids is correct?
Your Answer:
Correct Answer: Magnesium carbonate can reduce the absorption of drugs taken at the same time
Explanation:Antacids such as aluminium hydroxide and magnesium carbonate are commonly used. They’re both water-insoluble and can reduce the absorption of drugs taken together. Allow at least 1-2 hours between taking these antacids and any other medications.Because it reduces gastrointestinal phosphate absorption, aluminium hydroxide can also be used to treat hyperphosphatemia in patients with renal failure.Magnesium carbonate has a laxative effect, whereas aluminium hydroxide has a constipating effect.
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This question is part of the following fields:
- Gastrointestinal Pharmacology
- Pharmacology
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Question 7
Incorrect
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A 52-year-old woman visits her local pharmacy to get medication to help with mild dyspepsia symptoms. The pharmacist on duty suggests she uses an over-the-counter antacid. She purchases an antacid that contains magnesium carbonate, which relieves her symptoms, but she unfortunately also develops a side effect.Out of the following, which side effect is she MOST likely to develop after using the antacid?
Your Answer:
Correct Answer: Diarrhoea
Explanation:Magnesium carbonate is an over the counter antacid commonly used to relieve symptoms in ulcer dyspepsia and non-erosive gastro-oesophageal reflux.Antacids containing magnesium also tend to work as a laxative, while the antacids with aluminium may cause constipation. There is no significant increased risk of anaphylaxis, hepatotoxicity or renal impairment.
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This question is part of the following fields:
- Gastrointestinal Pharmacology
- Pharmacology
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