-
Question 1
Incorrect
-
A 65-year-old man is undergoing his yearly check-up for his type 2 diabetes. He is currently being evaluated for macroscopic haematuria.
Which medication for diabetes should be avoided in this case?Your Answer: Metformin
Correct Answer: Pioglitazone
Explanation:Safety Concerns Surrounding Glitazones
The glitazones, which include pioglitazone and rosiglitazone, have been associated with safety concerns. Rosiglitazone has been removed from use due to an increased risk of myocardial infarction in patients taking the drug. Pioglitazone is still in use, but there are concerns about an increased risk of cardiac failure, myocardial infarction, pneumonia, and fracture risk in patients taking the drug.
Additionally, the European Medicines Agency has advised that there is an increased risk of bladder cancer when taking pioglitazone. Although the risk is small, it should not be used in patients with a history of the disease, who have unexplained macroscopic haematuria, or are at a high risk of developing bladder cancer.
These safety concerns make glitazones less popular than some of the other new diabetes drugs. The European Medicines Agency advises that pioglitazone should only be used when other antidiabetes agents are not suitable. It is important for healthcare professionals to carefully consider the risks and benefits of glitazones before prescribing them to patients with diabetes.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 2
Correct
-
Which statement about receptor tyrosine kinases is accurate?
Your Answer: Dimerisation of receptors is usually involved in activation
Explanation:Receptor Binding and Activation
Substances such as insulin, epidermal growth factor (EGF), and platelet-derived growth factor (PDGF) can bind to receptors in the body. These receptors have four domains: ligand binding, transmembrane, catalytic, and autophosphorylation domains. When an agonist binds to the receptor, it causes a change in shape, which leads to phosphorylation. This process activates the receptor and triggers a response in the body.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 3
Incorrect
-
A 32-year-old female patient complains of a disrupted menstrual cycle, decreased libido, and lactation despite never being pregnant. Upon blood testing, she is found to have elevated serum prolactin levels. Which medication is associated with causing hyperprolactinemia?
Your Answer: Aspirin
Correct Answer: Cimetidine
Explanation:Hyperprolactinaemia in Women
Hyperprolactinaemia is a condition that affects women and is characterized by an excess of prolactin hormone in the body. This condition can present with various symptoms, including anovulatory infertility, reduced menstruation, production of breast milk, reduced libido, and vaginal dryness. The condition is caused by either disinhibition of the anterior pituitary or excess production due to a pituitary tumor. A serum prolactin concentration greater than 5000 mIU/L suggests a pituitary adenoma.
Moreover, hyperprolactinaemia can also be caused by certain prescription medications, including antihistamines, butyrophenones, cimetidine, methyldopa, metoclopramide, and phenothiazines. These medications are strongly associated with the condition and can lead to an increase in prolactin levels in the body.
It is important to understand the symptoms and causes of hyperprolactinaemia in women to seek appropriate medical attention and treatment. With proper diagnosis and management, women can effectively manage this condition and improve their quality of life.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 4
Incorrect
-
A young adult with a history of psychosis and mood disorder is experiencing frequent urination and is ultimately diagnosed with diabetes insipidus. Which medication is the probable culprit?
Your Answer:
Correct Answer: Lithium
Explanation:Common Side Effects of Lithium
Lithium is a medication that is commonly used to treat bipolar disorder. However, it can also cause a number of side effects. One of the most common side effects is gastrointestinal disturbance, which can include nausea, vomiting, and diarrhea. Another common side effect is fine tremor, which can affect the hands and fingers. Weight gain and oedema (swelling) are also possible side effects of lithium.
In addition, lithium can cause goitre, which is an enlargement of the thyroid gland. If taken in excess, it can also lead to blurred vision, ataxia (loss of coordination), drowsiness, and coarse tremor. One of the more unique side effects of lithium is that it causes antidiuretic hormone (ADH) resistance, which can lead to the production of large volumes of dilute urine. Overall, while lithium can be an effective treatment for bipolar disorder, it is important to be aware of these potential side effects.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 5
Incorrect
-
A previously healthy 95-year-old individual with a history of hypertension arrives at the Emergency department with dysphasia and right-sided hemiplegia. A CT scan is performed urgently 2 hours after the symptoms began, revealing a left hemisphere cerebral infarction. What is the time frame for administering alteplase in the treatment of this patient?
Your Answer:
Correct Answer: 4.5 hours
Explanation:Guidelines for Thrombolysis in Stroke Patients
According to the guidelines set by The Royal College of Physicians, thrombolysis with alteplase can be administered within three hours from the onset of stroke symptoms, regardless of the patient’s age, as long as a haemorrhagic stroke is ruled out and there are no contraindications to thrombolysis. However, in patients under the age of 80 years, alteplase can be given up to 4.5 hours from the onset of stroke, and in some cases, up to 6 hours. It is important to note that the benefits of thrombolysis decrease over time.
The guidelines emphasize the importance of timely administration of thrombolysis to maximize its benefits. However, the decision to administer thrombolysis should be made after careful consideration of the patient’s medical history, contraindications, and the potential risks and benefits of the treatment. It is also important to rule out haemorrhagic stroke before administering thrombolysis, as it can worsen the condition and lead to complications. Overall, the guidelines provide a framework for the safe and effective use of thrombolysis in stroke patients.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 6
Incorrect
-
A teenage girl is given a prescription for an antibiotic by her doctor, but she comes back after two days, reporting that she is developing a rash on her face and arms that gets worse when exposed to sunlight. What drug reaction is likely causing this photosensitive rash?
Your Answer:
Correct Answer: Doxycycline
Explanation:Common Side Effects of Tetracyclines
Tetracyclines are a class of antibiotics that are commonly used to treat bacterial infections. However, they are also known to cause several side effects. Nausea and vomiting are among the most common side effects of tetracyclines. Additionally, patients may develop a photosensitive rash, which can be triggered by exposure to sunlight. Dental hypoplasia is another potential side effect of tetracyclines, which is why they are not recommended for use in children, pregnant or breastfeeding women. Finally, tetracyclines have been associated with idiopathic intracranial hypertension, a condition that causes increased pressure inside the skull.
It is important to note that photosensitivity can also be caused by other antibiotics, such as quinolones and sulphonamides. Patients who experience any of these side effects should contact their healthcare provider immediately. In some cases, the dosage or type of antibiotic may need to be adjusted to minimize these side effects. Overall, while tetracyclines can be effective in treating bacterial infections, patients should be aware of the potential side effects and discuss any concerns with their healthcare provider.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 7
Incorrect
-
A 70-year-old female complains of abdominal pain and melaena. She has a medical history of hypertension, type 2 diabetes, and right knee osteoarthritis. Which medication could be causing her symptoms?
Your Answer:
Correct Answer: Diclofenac
Explanation:Causes of Peptic Ulceration and the Role of Medications
Peptic ulceration is a condition that can cause acute gastrointestinal (GI) blood loss. One of the common causes of peptic ulceration is the reduction in the production of protective mucous in the stomach, which exposes the stomach epithelium to acid. This can be a consequence of using non-steroidal anti-inflammatory drugs (NSAIDs) such as diclofenac, which is commonly used in the treatment of osteoarthritis. Steroids are also known to contribute to peptic ulceration.
On the other hand, tramadol, an opiate, does not increase the risk of GI ulceration. It is important to be aware of the potential side effects of medications and to discuss any concerns with a healthcare provider. By doing so, patients can receive appropriate treatment while minimizing the risk of adverse effects.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 8
Incorrect
-
As an investigator, you will be participating in a clinical trial of a new antihypertensive agent. The drug has already been tested on healthy volunteers, but this trial will be the first to involve patients. The aim of the trial is to determine the optimal dosage for therapy, which will be used in future studies. Are you ready to take part in this clinical trial?
Your Answer:
Correct Answer: Phase 2 study
Explanation:Phases of Clinical Trials
Clinical trials are conducted in several phases to determine the safety and efficacy of a new drug. The first phase, known as phase 1, involves testing the drug on healthy volunteers to determine its safety. In phase 2, the drug is tested on patients across a range of doses to establish the most effective dose with respect to clinical efficacy and adverse events. The third phase, known as phase 3, involves expanding the number of patients to confirm the drug’s efficacy and adverse event profile. This phase is conducted prior to registration. Finally, in phase 4, the drug is tested post-marketing to support clinical endpoints for reimbursement or to support marketing messages. These phases are crucial in determining the safety and efficacy of a new drug before it is made available to the public.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 9
Incorrect
-
Which statement about agonists and antagonists is accurate?
Your Answer:
Correct Answer: A partial agonist has affinity but reduced efficacy
Explanation:Affinity and Efficacy in Pharmacology
In pharmacology, the terms affinity and efficacy are used to describe the relationship between a drug and its target receptor. Affinity refers to the strength of the binding between the drug and the receptor, while efficacy refers to the ability of the drug to activate the receptor and produce a response.
An agonist is a drug that binds to a receptor and activates it, producing a response. An agonist has both high affinity and high efficacy, meaning it binds strongly to the receptor and produces a strong response.
An antagonist, on the other hand, binds to the receptor but does not activate it, blocking the action of other agonists. An antagonist has high affinity but no efficacy, meaning it binds strongly to the receptor but does not produce a response.
A partial agonist is a drug that binds to the receptor and produces a response, but the response is weaker than that produced by a full agonist. A partial agonist has high affinity but reduced efficacy, meaning it binds strongly to the receptor but produces a weaker response.
the concepts of affinity and efficacy is important in drug development and in the effects of drugs on the body. By manipulating these properties, researchers can develop drugs that selectively target specific receptors and produce desired effects with minimal side effects.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 10
Incorrect
-
Which statement about steroid receptors is accurate?
Your Answer:
Correct Answer: Receptors have a DNA binding domain
Explanation:Steroid Receptors
Steroid receptors are composed of three main domains: ligand binding, DNA binding, and transcription activation. These receptors are typically found in the cytoplasm and are only translocated to the nucleus after binding with a ligand. However, the oestrogen receptor is an exception to this rule, as it is constitutively found in the nucleus.
In summary, steroid receptors are essential for the regulation of gene expression. They are composed of three domains and are typically found in the cytoplasm. However, the oestrogen receptor is an exception to this rule, as it is always found in the nucleus. the function of steroid receptors is crucial for developing treatments for various diseases.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 11
Incorrect
-
Which patient with acute ischaemic stroke is a candidate for neurosurgical intervention?
Your Answer:
Correct Answer: A 50-year-old with infarction of 60% of the middle cerebral artery (MCA) territory
Explanation:Guidelines for Decompressive Hemicraniectomy in Large Cerebral Infarctions
Current clinical guidelines recommend that patients under 60 years of age with large cerebral infarctions in the middle cerebral artery (MCA) territory should be considered for decompressive hemicraniectomy. This procedure involves removing part of the skull to reduce intracranial pressure and should be done within 48 hours of the stroke. Eligibility for the surgery is based on clinical and radiological evidence of a stroke affecting the MCA territory, radiological evidence that more than 50% or 145 cm3 of the MCA territory is involved, and being classified as having a moderate to severe stroke according to the National Institute of Health stroke scale.
In addition to large cerebral infarctions in the MCA territory, other indications for neurosurgical intervention in acute ischemic stroke include a massive cerebellar infarction or evidence of hydrocephalus or brainstem compression. It is important for healthcare professionals to be aware of these guidelines and indications for neurosurgical intervention in order to provide the best possible care for stroke patients. Proper and timely intervention can greatly improve outcomes and quality of life for stroke survivors.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 12
Incorrect
-
A 20-year old woman arrives at the Emergency department after a night out with her friends. According to her friends, she has been talking to herself about nonsensical things and appears agitated and restless. During the examination, it is noted that her reflexes are heightened and an electrocardiogram (ECG) reveals ventricular ectopics. What type of substance abuse is suspected in this case?
Your Answer:
Correct Answer: Ecstasy
Explanation:Ecstasy Overdose
Ecstasy, also known as MDMA, is a drug that stimulates the central nervous system. It can cause increased alertness, euphoria, extroverted behavior, and rapid speech. People who take ecstasy may also experience a lack of desire to eat or sleep, tremors, dilated pupils, tachycardia, and hypertension. However, more severe intoxication can lead to excitability, agitation, paranoid delusions, hallucinations, hypertonia, and hyperreflexia. In some cases, convulsions, rhabdomyolysis, hyperthermia, and cardiac arrhythmias may also develop.
Severe cases of MDMA poisoning can result in hyperthermia, disseminated intravascular coagulation, rhabdomyolysis, acute renal failure, hyponatremia, and even hepatic damage. In rare cases, amphetamine poisoning may lead to intracerebral and subarachnoid hemorrhage and acute cardiomyopathy, which can be fatal. Chronic amphetamine users may also experience hyperthyroxinemia.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 13
Incorrect
-
A 55-year-old male patient complains of sudden chest pain and is being evaluated for acute coronary syndrome. Upon fasting, his serum cholesterol level was found to be 7.1 mmol/L (<5.2). What is the best initial course of action for managing this patient?
Your Answer:
Correct Answer: Statin therapy
Explanation:Statin Therapy for Hypercholesterolemia in Acute Coronary Syndrome
Hypercholesterolemia is a common condition in patients with acute coronary syndrome. The initial treatment approach for such patients is statin therapy, which includes drugs like simvastatin, atorvastatin, and rosuvastatin. Statins have been proven to reduce mortality in both primary and secondary prevention studies. The target cholesterol concentration for patients with hypercholesterolemia and acute coronary syndrome is less than 5 mmol/L.
According to NICE guidance, statins should be used more widely in conjunction with a QRISK2 score to stratify risk. This will help prevent cardiovascular disease and improve patient outcomes. The guidance recommends that statins be used in patients with a 10% or greater risk of developing cardiovascular disease within the next 10 years. By using statins in conjunction with risk stratification, healthcare professionals can provide more targeted and effective treatment for patients with hypercholesterolemia and acute coronary syndrome.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 14
Incorrect
-
You are creating a medication schedule for a patient with chronic renal failure who is elderly. Which medication may require a dosage modification due to the reduced renal clearance?
Your Answer:
Correct Answer: Morphine sulphate
Explanation:Opioid Use in Patients with Abnormal Renal Function
Patients with abnormal renal function should have their opioid doses reduced due to the prolonged duration of action. However, it is important to note that the initial loading dose may need to be greater in these patients to achieve the desired drug effect. This is because patients with chronic renal failure have an increased volume of distribution, which can affect drug concentration in the plasma. Despite the need for a higher initial dose, subsequent doses should be reduced to account for poor drug clearance. It is important to monitor patients closely and adjust doses as needed to avoid adverse effects. None of the other agents typically require caution in patients with abnormal renal function.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 15
Incorrect
-
What is the term used to describe a drug that binds to the same receptor as an agonist but is unable to produce a comparable effect even with increasing doses?
Your Answer:
Correct Answer: Partial agonist
Explanation:Agonists, Antagonists, and Partial Agonists
Agonists, antagonists, and partial agonists are terms used to describe drugs that interact with receptors in the body. Competitive antagonists work by binding to the same receptor site as the agonist, preventing it from binding and producing its effect. However, increasing the concentration of the agonist can overcome this effect.
Allosteric drugs, on the other hand, act at a site separate from the receptor site of the agonist. This can either enhance or inhibit the effect of the agonist. Partial agonists, like buprenorphine, produce a weaker effect than a full agonist. When combined with a full agonist, like morphine, the overall effect is decreased, leading to poor pain control.
the differences between agonists, antagonists, and partial agonists is important in the development and use of drugs for various medical conditions. By targeting specific receptors in the body, these drugs can produce a desired effect or block unwanted effects. Proper dosing and combination of these drugs can lead to effective treatment and management of various conditions.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 16
Incorrect
-
Which diabetes medication is the least likely to cause weight gain?
Your Answer:
Correct Answer: Exenatide
Explanation:Exenatide and its Benefits for Overweight Patients
Exenatide is a medication that mimics the effects of GLP-1, a hormone released by the gut in response to food intake. This hormone triggers insulin secretion in the pancreatic beta-cells, which makes GLP-1 mimetics like exenatide effective in stimulating insulin release. Additionally, exenatide is associated with weight loss, making it a good choice for patients who are significantly overweight.
According to NICE guidelines, exenatide should be used in patients with a BMI exceeding 35 kg/m2 or in those with significant weight-related comorbidity, even if their BMI is less than 35 kg/m2. After six months of therapy, exenatide should only be continued if the patient’s HbA1c has fallen by 11 mmol/mol and their weight has decreased by 3%.
However, exenatide does have some side effects, including nausea and vomiting. It should also be avoided in patients with renal failure, impaired liver function, and gastroparesis. On the other hand, other diabetes medications like gliptins, glitazones, and sulphonylureas are associated with significant weight gain, while repaglinide may result in minimal or no weight gain.
Overall, exenatide is a promising option for overweight patients with diabetes, as it not only stimulates insulin release but also promotes weight loss.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 17
Incorrect
-
A 45-year-old man with epilepsy has been prescribed carbamazepine. As time passes, the dosage of carbamazepine required by him has been gradually increasing. He only takes paracetamol occasionally and no other medications. What type of drug reaction is this indicative of?
Your Answer:
Correct Answer: Induction of metabolism
Explanation:Medications and their effects on metabolism
Some medications can affect the metabolism of other drugs. For instance, carbamazepine is a medication that induces liver enzymes, which can increase the metabolism of certain drugs that rely on those pathways. It is worth noting that carbamazepine is an auto-inducer, meaning that the amount of carbamazepine required can increase over time. This can lead to changes in the dosage required to achieve the desired therapeutic effect. Therefore, it is important to monitor patients who are taking carbamazepine or any other medication that can affect the metabolism of other drugs. By doing so, healthcare providers can ensure that patients receive the appropriate dosage of medication to achieve the desired therapeutic effect.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 18
Incorrect
-
A 57-year-old man arrives at the Emergency Department in a confused and unresponsive state. He had been given diazepam for his back spasms and had consumed half a bottle of wine during dinner. What type of drug reaction is this indicative of?
Your Answer:
Correct Answer: Synergistic
Explanation:Benzodiazepines and Ethanol Combination Leads to Excessive Sedation
The combination of benzodiazepines and ethanol can result in excessive sedation due to their shared action on GABA receptors, which leads to generalised neuroinhibitory effects. Both substances have a calming effect on the brain, and when taken together, they can intensify each other’s effects, leading to a dangerous level of sedation. This is likely the reason why the gentleman in question experienced excessive sedation. It is important to note that combining benzodiazepines and ethanol can be extremely dangerous and should be avoided.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 19
Incorrect
-
β-adrenergic receptor antagonists, like propranolol, are commonly prescribed in medical practice. In which of the following conditions are β-adrenergic receptor antagonists not recommended for use in elderly patients?
Your Answer:
Correct Answer: Asthma
Explanation:Beta Blockers and Asthma
Beta blockers are commonly used to treat various cardiovascular diseases due to their negative chronotropic and inotropic effects. However, they can be detrimental to individuals with asthma. This is because beta blockers antagonize beta-2 receptors, which can lead to bronchoconstriction and trigger asthma attacks. As a result, beta blockers are not recommended as a treatment for asthma. It is important for healthcare providers to be aware of this potential adverse effect and to consider alternative medications for patients with asthma who require cardiovascular treatment. Proper management of both conditions is crucial to ensure optimal health outcomes for patients.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 20
Incorrect
-
What is a true characteristic of G protein coupled receptors and their involvement in biological processes?
Your Answer:
Correct Answer: GPCRs interact with G proteins through their third intracellular loop
Explanation:G Protein Coupled Receptors and Their Role in Signal Transduction
G protein coupled receptors are present in various systems of the body, including opioid and adrenaline binding. These receptors consist of seven transmembrane domains and are encoded by approximately 7% of the human genome. When an agonist binds to a G protein coupled receptor, it causes a change in the conformation of the linked G protein through the third intracellular loop and C tail. This change leads to the transmission of messages using second messengers like cAMP, ADP, and phosphokinase.
In summary, G protein coupled receptors play a crucial role in signal transduction in the body. They are involved in the binding of various substances and cause a conformational change in the linked G protein, leading to the transmission of messages through second messengers. the function of these receptors is essential in developing drugs that target them and can be used to treat various diseases.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 21
Incorrect
-
A 40-year-old woman comes to the clinic with complaints of pain and swelling in her right calf. Upon further examination, it is confirmed that she has a deep vein thrombosis. Can any of the medications she is currently taking be a contributing factor to this condition?
Your Answer:
Correct Answer: Combined oral contraceptive pill
Explanation:Thromboembolic Risk and Oral Contraceptives
The use of combined oral contraceptives (OCP) is known to increase the risk of thromboembolism. This is due to the estrogen component of the pill, which promotes a pro-thrombotic environment. However, the risk of thromboembolism on the OCP is only about five times higher than normal, which is significantly lower than the risk during pregnancy, which is six to ten times higher. On the other hand, there is no clear evidence of an increased risk of thromboembolism associated with the use of progesterone-only contraceptive pills (mini pill). It is important for women to discuss their individual risk factors with their healthcare provider before starting any form of hormonal contraception.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 22
Incorrect
-
A patient is being treated for a pneumonia. She is given 200 mg of an antibiotic. The concentration of the drug in her bloodstream is measured at 5 mg/L.
What is the volume of distribution of this drug?Your Answer:
Correct Answer: 40 L
Explanation:Volume of Distribution
The volume of distribution is a measure of the volume required to achieve a specific concentration of a drug in the plasma. For instance, if 200 mg of a drug is administered and the concentration in the plasma is 5 mg/L, this is equivalent to dissolving the drug in 40 L of fluid. However, the volume of distribution varies depending on the drug’s properties, such as its affinity for proteins or fats. In general, a volume of distribution that is ten times greater than the average total plasma volume suggests that the drug is primarily bound to tissues or fat rather than being freely available in the plasma. This information is crucial when determining the appropriate loading doses for certain medications, particularly those used to treat epilepsy. To summarize, the volume of distribution is essential for optimizing drug dosing and ensuring effective treatment.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 23
Incorrect
-
A 65-year-old male patient is started on azathioprine treatment by a gastroenterologist for Crohn's disease. After six months of treatment, you receive a request from the gastroenterology department to assist with monitoring his treatment.
What is the current recommended protocol for monitoring patients on long-term azathioprine therapy?
Note:
FBC - Full blood count
LFT - Liver function tests
U&E - Urea and electrolytes.Your Answer:
Correct Answer: FBC, LFT and U&E every three months
Explanation:Azathioprine: A Cytotoxic Agent for Severe Refractory Eczema and Other Conditions
Azathioprine is a cytotoxic drug that is converted to mercaptopurine, which acts as a purine analogue that inhibits DNA synthesis. It is used off-label for severe refractory eczema, post-transplant, and in patients with rheumatoid arthritis and inflammatory bowel disease. However, bone marrow suppression and hepatotoxicity are serious and well-known complications of azathioprine therapy. Other side effects include nausea, vomiting, and skin eruptions. Patients with low levels of the enzyme thiopurine methyltransferase (TPMT), which metabolizes azathioprine, are at increased risk of toxicity, and their enzyme activity is often measured before starting treatment.
To minimize the risk of complications, current guidelines from the British Association of Dermatologists and the British National Formulary recommend monitoring full blood count (FBC), liver function tests (LFT), and urea and electrolytes (U&E) every three months once patients are established on azathioprine treatment. By following these guidelines, healthcare providers can ensure that patients receive the benefits of azathioprine while minimizing the risk of adverse effects.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 24
Incorrect
-
A 50-year-old male is referred by his GP for an endoscopy due to recurrent indigestion. During the procedure, a small duodenal ulcer is discovered and Helicobacter pylori is found to be present. What is the recommended treatment for this patient?
Your Answer:
Correct Answer: Omeprazole, metronidazole and clarithromycin
Explanation:Helicobacter pylori and Peptic Ulceration
The bacterium Helicobacter pylori, which is classified as a gram-negative curved rod, has been linked to the development of peptic ulceration by inhibiting the healing process. In fact, up to 90% of patients with duodenal ulceration and 70% of cases of peptic ulceration may be infected with Helicobacter. To treat this infection, therapy should focus on acid suppression and eradication of the bacterium. Triple therapy, which involves a proton pump inhibitor like omeprazole along with two antibiotics (amoxicillin/clarithromycin plus metronidazole), has been found to be the most effective treatment. This therapy should be administered for one week, with proton pump therapy continuing thereafter.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 25
Incorrect
-
A 68-year-old male with a three year history of type 2 diabetes complains of feeling dizzy, sweaty and confused. Upon checking his glucose levels, it is found that he is experiencing hypoglycaemia which is resolved with a glucose drink. Which medication is the most probable cause of this hypoglycaemic episode?
Your Answer:
Correct Answer: Glibenclamide
Explanation:Mechanisms of Hypoglycaemia in Sulphonylurea Therapies
Sulphonylurea therapies, including gliclazide, glimepiride, and glibenclamide, are known to cause hypoglycaemia. This is due to their ability to increase pancreatic insulin secretion, which can lead to a drop in blood glucose levels. On the other hand, metformin and pioglitazone work differently to control blood glucose levels. Metformin reduces the amount of glucose produced by the liver, while pioglitazone improves the body’s sensitivity to insulin. Neither of these medications typically causes hypoglycaemia.
Overall, it is important for healthcare providers to be aware of the potential for hypoglycaemia when prescribing sulphonylurea therapies and to monitor patients closely for any signs or symptoms of low blood glucose levels. Additionally, patients should be educated on the importance of monitoring their blood glucose levels regularly and seeking medical attention if they experience any symptoms of hypoglycaemia.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 26
Incorrect
-
A 50-year-old patient who had a kidney transplant two years ago is currently taking ciclosporin. However, due to a manufacturing issue, the patient cannot obtain their prescribed medication, Sandimmune, for the next five days. What should be done in this situation?
Your Answer:
Correct Answer: Switch him to another formulation and monitor his renal function, ciclosporin level and blood pressure whilst the changeover is being made
Explanation:Ciclosporin is an immunosuppressant used to prevent graft rejection and treat various conditions. Different formulations have varying pharmacokinetic properties, so it is important to prescribe by brand and monitor patients closely when switching formulations. Consultation with a renal unit is recommended before switching therapy.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 27
Incorrect
-
A disheveled woman is brought to the Emergency Department with constricted pupils, a respiratory rate of eight per minute and an oxygen saturation of 84% on room air. Her heart rate is 60 beats per minute and her blood pressure is 110/70. The medical team recognizes her as a frequent drug user in the area. She is placed in a supine position and given high-flow oxygen, but her respiratory rate remains at eight per minute and her oxygen saturation only improves to 86%.
What is the most appropriate medication to administer in this situation?Your Answer:
Correct Answer: Naloxone
Explanation:Treatment for Opiate-Induced Respiratory Depression
When a patient displays respiratory depression and mild bradycardia, it is likely due to opiate use. In such cases, the opiate antagonist naloxone is the most effective treatment. Naloxone has a rapid onset of action and can immediately reverse the effects of opiates. However, it is important to note that the half-life of naloxone is shorter than that of opiates, so patients must be monitored to prevent them from leaving prematurely.
Flumazenil is used to treat uncomplicated benzodiazepine overdose, while pralidoxime is used in organophosphate poisoning. However, in cases of opiate-induced respiratory depression, naloxone is the drug of choice. It is important to be aware that opiate abusers may become angry and aggressive when their high is suddenly reversed. Therefore, a slow infusion of naloxone may be necessary to ensure adequate oxygenation without completely reversing the effects of the opiates. Overall, naloxone is a highly effective treatment for opiate-induced respiratory depression.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 28
Incorrect
-
A 30-year-old expectant mother complains of feeling tired. During the examination, her nail beds and conjunctiva appear pale, and her haemoglobin level is below 98 g/L, indicating significant anaemia. What is the recommended amount of dietary iron that pregnant women should consume?
Your Answer:
Correct Answer: 15 mg
Explanation:Anaemia in Pregnancy
During pregnancy, anaemia is a common occurrence due to various factors such as reduced absorption, fetal demand, and expansion of plasma volume. As the pregnancy progresses, maternal iron stores tend to become depleted. Although cessation of menstruation prevents iron loss, it is not enough to compensate for the additional fetal requirements. To address this, it is recommended that pregnant women consume 15 mg of dietary iron per day.
It is important to routinely assess haemoglobin levels throughout each pregnancy. If haemoglobin levels are found to be less than 110 g/L, investigations and management should begin promptly. By monitoring haemoglobin levels and ensuring adequate iron intake, the risk of anaemia during pregnancy can be reduced, promoting better health outcomes for both the mother and the developing fetus.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 29
Incorrect
-
A 20-year-old woman arrives at the Emergency Department experiencing an asthma attack. Normally, her asthma is well managed with a salbutamol inhaler taken twice daily. Due to recent work-related stress, a friend offered her a propranolol pill to alleviate her symptoms. What type of drug interaction is this indicative of?
Your Answer:
Correct Answer: Antagonism
Explanation:Beta Blockers and Beta Agonists: Opposing Effects
Beta blockers like propranolol are commonly used to treat anxiety by slowing down the heart rate through beta-adrenoceptor blockade. However, this drug is not recommended for asthmatics as it can cause bronchoconstriction. On the other hand, salbutamol is a beta-adrenoceptor agonist that works by relaxing the airway muscles and is commonly used to treat asthma.
The effects of these two drugs are opposing, making them an example of an antagonistic reaction. While beta blockers slow down the heart rate and constrict the airways, beta agonists like salbutamol do the opposite by increasing heart rate and relaxing the airway muscles. It is important to note that these drugs should not be used together as they can cancel out each other’s effects and lead to potentially harmful outcomes.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 30
Incorrect
-
A 65-year-old male patient complains of a persistent cough that has been bothering him for the past three months. He has a medical history of hypertension and type 2 diabetes, which he manages with medication. Which of the following drugs is the most probable cause of his cough?
Your Answer:
Correct Answer: ACE inhibitors
Explanation:ACE Inhibitors and Coughing: the Mechanism
Angiotensin-converting enzyme (ACE) inhibitors are known to cause coughing in almost a third of the people who use them. However, angiotensin blockers, which have similar benefits to ACE inhibitors, do not cause coughing and are often prescribed to patients who cannot tolerate ACE inhibitors. The reason behind this difference lies in the mechanism of action of these drugs. ACE inhibitors lead to the accumulation of bradykinin in the bronchial tissue, which triggers coughing. On the other hand, angiotensin blockers do not affect bradykinin levels and hence do not cause coughing. this mechanism is crucial in selecting the right medication for patients who are intolerant to ACE inhibitors.
-
This question is part of the following fields:
- Pharmacology
-
00
Correct
00
Incorrect
00
:
00
:
00
Session Time
00
:
00
Average Question Time (
Mins)