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  • Question 1 - Which statement about agonists and antagonists is accurate? ...

    Incorrect

    • Which statement about agonists and antagonists is accurate?

      Your Answer: An agonist demonstrates affinity but no efficacy

      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
      43.7
      Seconds
  • Question 2 - Which statement about receptor tyrosine kinases is accurate? ...

    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
      26.4
      Seconds
  • Question 3 - A 20-year old woman arrives at the Emergency department after a night out...

    Correct

    • 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: 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
      22.8
      Seconds
  • Question 4 - A previously healthy 95-year-old individual with a history of hypertension arrives at the...

    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: 6 hours

      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
      30.3
      Seconds
  • Question 5 - A teenage girl is given a prescription for an antibiotic by her doctor,...

    Correct

    • 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: 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
      24.9
      Seconds
  • Question 6 - A 70-year-old female complains of abdominal pain and melaena. She has a medical...

    Correct

    • 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: 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
      23.1
      Seconds
  • Question 7 - You are managing a pediatric patient with a multidrug resistant chest infection in...

    Incorrect

    • You are managing a pediatric patient with a multidrug resistant chest infection in the pediatric intensive care unit and are consulting with the pediatric infectious disease specialist regarding the antibiotics that have been administered. All of the following antibiotics inhibit protein synthesis in the bacterial ribosome except for which one?

      Your Answer: Chloramphenicol

      Correct Answer: Cefuroxime

      Explanation:

      Mechanisms of Action of Antibiotics

      Antibiotics are drugs that are used to treat bacterial infections. They work by targeting specific components of the bacterial cell, which can either kill the bacteria or stop them from multiplying. Cefuroxime is a second generation cephalosporin that inhibits cell wall synthesis, making it bactericidal. Chloramphenicol and clindamycin, on the other hand, bind to the 50S subunit of the bacterial ribosome, which prevents protein synthesis and is bacteriostatic. Aminoglycosides like gentamicin and tetracyclines such as doxycycline act on the 30S subunit, which disrupts protein synthesis and is bactericidal. the mechanisms of action of antibiotics is important in selecting the appropriate drug for a specific bacterial infection.

    • This question is part of the following fields:

      • Pharmacology
      30.4
      Seconds
  • Question 8 - What is a true statement about the way local anaesthetics work during minor...

    Incorrect

    • What is a true statement about the way local anaesthetics work during minor surgical procedures?

      Your Answer: The sodium ligand gated ion channel is the target of local anaesthetics

      Correct Answer: Adrenaline is sometimes co-administered to prolong the local action of local anaesthetics

      Explanation:

      Lidocaine and Procaine Target VGIC in Sensory Neurons

      Lidocaine and procaine are two drugs that target voltage-gated ion channels (VGIC) in sensory neurons. These drugs are particularly effective against sensory neurons with small diameters, low myelination, and low conduction velocity, such as C and Ad fibers. In contrast, large motor neurons with Aß fibers are less affected by these drugs.

      VGIC have three states: closed, transiently open, and inactivated. Lidocaine binds preferentially to the inactivated state of VGIC and stabilizes it. This mechanism of action is known as use dependence, which means that the drug is more effective when the neuron is firing rapidly.

      Overall, lidocaine and procaine are useful drugs for treating pain and other sensory disorders by targeting VGIC in sensory neurons. Their selective action on inactivated VGIC and use dependence make them effective and safe for clinical use.

    • This question is part of the following fields:

      • Pharmacology
      30
      Seconds
  • Question 9 - What is the term used to describe a drug that binds to the...

    Correct

    • 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: 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
      26.2
      Seconds
  • Question 10 - What is the rate of elimination of phenytoin based on its zero-order kinetics?...

    Incorrect

    • What is the rate of elimination of phenytoin based on its zero-order kinetics?

      Your Answer: Proportional to the plasma concentration

      Correct Answer: Constant regardless of the plasma concentration

      Explanation:

      Zero-Order Kinetics in Drugs

      Zero-order kinetics is a term used to describe the rate of elimination of certain drugs, such as ethanol, phenytoin, and aspirin. In these drugs, the rate of elimination remains constant and is not dependent on the concentration of the drug in the plasma. This means that even if the concentration of the drug in the plasma increases, the rate of elimination remains the same.

      However, this also means that if the metabolism capacity of the body is overwhelmed, the plasma levels of these drugs can rapidly increase, leading to an overdose. This is particularly dangerous in drugs with zero-order kinetics, as the rate of elimination cannot be increased to compensate for the overdose. Therefore, it is important to understand the pharmacokinetics of drugs and their elimination rates to prevent such incidents.

      In summary, zero-order kinetics in drugs means that the rate of elimination is constant and not dependent on plasma concentration. This can lead to dangerous situations if the metabolism capacity is overwhelmed, as the rate of elimination cannot be increased to compensate for an overdose. the pharmacokinetics of drugs is crucial in preventing such incidents.

    • This question is part of the following fields:

      • Pharmacology
      23.6
      Seconds
  • Question 11 - Following the administration of lorazepam to a severely agitated senior patient, the nursing...

    Incorrect

    • Following the administration of lorazepam to a severely agitated senior patient, the nursing staff contacts you to report a decrease in respiratory rate and the patient's unresponsiveness. What medication would be suitable for reversing the adverse effects of this drug?

      Your Answer: Naloxone

      Correct Answer: Flumazenil

      Explanation:

      Reversing the Effects of Benzodiazepines

      Benzodiazepines work by binding to GABA receptors in the central nervous system, which enhances the calming and sleep-inducing effects of this neurotransmitter. However, these effects can be reversed by administering flumazenil. On the other hand, naloxone is used to counteract the effects of opiate overdose, while protamine is used to reverse the effects of excessive heparinization.

      In the case of benzodiazepine overdose, it is important to ensure that the patient is receiving adequate ventilation. Additionally, administering flumazenil through a bag valve mask can help to reverse the effects of the drug. By doing so, the patient’s breathing and consciousness can be restored to normal levels. Proper management of benzodiazepine overdose is crucial in preventing serious complications and ensuring the patient’s safety.

    • This question is part of the following fields:

      • Pharmacology
      19.2
      Seconds
  • Question 12 - Which diabetes medication is the least likely to cause weight gain? ...

    Incorrect

    • Which diabetes medication is the least likely to cause weight gain?

      Your Answer: Gliclazide

      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
      12.5
      Seconds
  • Question 13 - As an investigator, you will be participating in a clinical trial of a...

    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: Pre-clinical study

      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
      67.7
      Seconds
  • Question 14 - A young adult with a history of psychosis and mood disorder is experiencing...

    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: Clozapine

      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
      16.1
      Seconds
  • Question 15 - Which of the following drug/receptor interactions accurately describes steroid hormones? ...

    Incorrect

    • Which of the following drug/receptor interactions accurately describes steroid hormones?

      Your Answer: Mifepristone – Progesterone agonist

      Correct Answer: Tamoxifen – Oestrogen antagonist

      Explanation:

      Examples of Agonist and Antagonist Hormones

      Agonist and antagonist hormones are two types of hormones that have opposite effects on the body. Agonist hormones bind to specific receptors in the body and activate them, while antagonist hormones bind to the same receptors but block their activation. This can have a variety of effects on the body, depending on the specific hormone and receptor involved.

      Examples of agonist hormones include glucocorticoids like prednisolone, dexamethasone, and hydrocortisone, which are used to treat inflammation and autoimmune disorders. These hormones bind to glucocorticoid receptors and activate them, reducing inflammation and suppressing the immune system.

      On the other hand, mifepristone is an antagonist hormone that blocks the effects of glucocorticoids. It is used to terminate pregnancies and to treat conditions like Cushing’s syndrome, which is caused by an excess of glucocorticoids in the body.

      Another example of an agonist hormone is fludrocortisone, a mineralocorticoid that is used to treat conditions like Addison’s disease, which is caused by a deficiency of mineralocorticoids. Fludrocortisone binds to mineralocorticoid receptors and activates them, helping to regulate salt and water balance in the body.

      In contrast, spironolactone is an antagonist hormone that blocks the effects of mineralocorticoids. It is used to treat conditions like high blood pressure and heart failure, which can be caused by excess mineralocorticoid activity.

      Other examples of agonist and antagonist hormones include oestrogen and tamoxifen, which are used to treat breast cancer, and progesterone and danazol, which are used to treat menstrual disorders and endometriosis. the effects of these hormones and their receptors is important for developing effective treatments for a variety of conditions.

    • This question is part of the following fields:

      • Pharmacology
      21.5
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  • Question 16 - A 45-year-old male is undergoing treatment for ischaemic heart disease. He has recently...

    Incorrect

    • A 45-year-old male is undergoing treatment for ischaemic heart disease. He has recently reported experiencing cold peripheries. What medication could be causing this symptom?

      Your Answer: Angiotensin blocker

      Correct Answer: Beta-blocker

      Explanation:

      Causes of Cold Peripheries

      Beta-blockers are known to cause cold peripheries due to their ability to constrict the superficial vessels. This constriction leads to a decrease in blood flow to the extremities, resulting in a feeling of coldness. In addition to beta-blockers, other factors can also contribute to cold peripheries. Bronchospasm, which is a narrowing of the airways in the lungs, can also cause coldness in the extremities. This is because the body redirects blood flow away from the extremities and towards the lungs to help with breathing. Finally, fatigue can also cause cold peripheries as the body’s energy levels decrease, leading to a decrease in blood flow to the extremities. Overall, there are several factors that can contribute to cold peripheries, and it is important to identify the underlying cause in order to provide appropriate treatment.

    • This question is part of the following fields:

      • Pharmacology
      32
      Seconds
  • Question 17 - Which statement about voltage gated ion channels (VGIC) is accurate? ...

    Incorrect

    • Which statement about voltage gated ion channels (VGIC) is accurate?

      Your Answer: The potassium VGIC is evolutionarily more recent than the sodium VGIC

      Correct Answer: Each subunit has six transmembrane spanning domains (S1-S6)

      Explanation:

      Voltage Gated Ion Channels

      Voltage gated ion channels (VGICs) are composed of four subunits, each containing six transmembrane domains (S1-S6). The S4 domain is believed to be the voltage sensor, as every other residue is charged. The channel of calcium and sodium VGICs is formed by a single peptide, while the potassium receptor channel is made up of four separate peptides, indicating that it is evolutionarily more primitive. The sodium VGIC is targeted by local anesthetics. In summary, VGICs are essential for the proper functioning of cells and play a crucial role in the transmission of electrical signals in the nervous system.

    • This question is part of the following fields:

      • Pharmacology
      10.4
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  • Question 18 - A 50-year-old patient who had a kidney transplant two years ago is currently...

    Correct

    • 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: 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
      69.9
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  • Question 19 - A 65-year-old male patient is started on azathioprine treatment by a gastroenterologist for...

    Correct

    • 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: 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
      57.9
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  • Question 20 - A young adult female arrives at the Emergency Department after ingesting 18 paracetamol...

    Correct

    • A young adult female arrives at the Emergency Department after ingesting 18 paracetamol tablets in a moment of impulsivity during a disagreement with her partner. It has been six hours since she took the tablets and her paracetamol levels are measured, indicating the need for treatment. The patient is initiated on N-acetylcysteine. What is the mechanism of action of this medication?

      Your Answer: Replaces compounds used in paracetamol metabolism

      Explanation:

      Paracetamol Metabolism and Toxicity

      Paracetamol is metabolised in two ways. The first mechanism involves conjugation with glucuronic acid, resulting in a safe metabolite that can be excreted. However, there is a limit to how much paracetamol can be metabolised this way. The second mechanism is used when a large amount of paracetamol is taken. In this case, paracetamol is oxidised to a toxic metabolite called N-acetyl-p-benzoquinone. This metabolite can cause liver and kidney necrosis if glutathione supplies are exhausted.

      Glutathione is responsible for making the toxic metabolite safe. However, when glutathione supplies are depleted, the toxic metabolite can cause damage to the liver and kidneys. N-acetylcysteine is a protective agent that increases the rate of glutathione synthesis. Therefore, it can help prevent liver and kidney damage caused by the toxic metabolite of paracetamol.

    • This question is part of the following fields:

      • Pharmacology
      15.2
      Seconds
  • Question 21 - An 80-year-old man is brought to the Emergency Department by his physician due...

    Incorrect

    • An 80-year-old man is brought to the Emergency Department by his physician due to sudden confusion. The patient had been treated for a chest infection with clarithromycin recently. He has a history of atrial fibrillation and is taking warfarin as an anticoagulant. Due to his confusion, it is challenging to obtain a detailed medical history from him. However, his blood tests reveal a significantly low haemoglobin level of 56 g/L (115-160). What type of drug reaction is this indicative of?

      Your Answer: Antagonism

      Correct Answer: Inhibition of metabolism

      Explanation:

      Drug Interaction Causing Bleeding and Confusion

      This patient’s symptoms are a classic example of a drug interaction between clarithromycin and warfarin. While there are many medications that can interact with warfarin, antibiotics are particularly known for affecting its effectiveness. In this case, clarithromycin has inhibited the metabolism of warfarin, causing it to become more potent. As a result, the patient has experienced bleeding, most likely in the gastrointestinal tract, which has led to confusion.

      Further investigation is necessary to ensure that there is not an underlying issue, such as colon cancer, that has been unmasked by this drug interaction. It is important for healthcare providers to be aware of potential drug interactions and to monitor patients closely for any adverse effects. By doing so, they can help prevent complications and ensure that patients receive the best possible care.

    • This question is part of the following fields:

      • Pharmacology
      48
      Seconds
  • Question 22 - A 20-year-old woman arrives at the Emergency Department experiencing an asthma attack. Normally,...

    Correct

    • 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: 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
      13.5
      Seconds
  • Question 23 - These thyroid function tests were obtained on a 55-year-old female who has recently...

    Incorrect

    • These thyroid function tests were obtained on a 55-year-old female who has recently been treated for hypertension:
      Free T4 28.5 pmol/L (9.8-23.1)
      TSH <0.02 mU/L (0.35-5.5)
      Free T3 10.8 pmol/L (3.5-6.5)
      She now presents with typical symptoms of hyperthyroidism.
      Which medication is likely to have caused this?

      Your Answer: Warfarin

      Correct Answer: Amiodarone

      Explanation:

      Amiodarone and its Effects on Thyroid Function

      Amiodarone is a medication that can have an impact on thyroid function, resulting in both hypo- and hyperthyroidism. This is due to the high iodine content in the drug, which contributes to its antiarrhythmic effects. Atenolol, on the other hand, is a beta blocker that is commonly used to treat thyrotoxicosis. Warfarin is another medication that is used to treat atrial fibrillation.

      There are two types of thyrotoxicosis that can be caused by amiodarone. Type 1 results in excess thyroxine synthesis, while type 2 leads to the release of excess thyroxine but normal levels of synthesis. It is important for healthcare professionals to monitor thyroid function in patients taking amiodarone and adjust treatment as necessary to prevent complications.

    • This question is part of the following fields:

      • Pharmacology
      33.3
      Seconds
  • Question 24 - β-adrenergic receptor antagonists, like propranolol, are commonly prescribed in medical practice. In which...

    Correct

    • 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: 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
      40.7
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  • Question 25 - As a third year medical student in an outpatient department with a dermatology...

    Correct

    • As a third year medical student in an outpatient department with a dermatology consultant, you are evaluating a 27-year-old patient who is unresponsive to current hyperhidrosis treatment. The consultant suggests starting botox injections to prevent sweating. Can you explain the mechanism of action of botulinum toxin at the neuromuscular junction?

      Your Answer: Inhibits vesicles containing acetylcholine binding to presynaptic membrane

      Explanation:

      Botulinum Toxin and its Mechanism of Action

      Botulinum toxin is becoming increasingly popular in the medical field for treating various conditions such as cervical dystonia and achalasia. The toxin works by binding to the presynaptic cleft on the neurotransmitter and forming a complex with the attached receptor. This complex then invaginates the plasma membrane of the presynaptic cleft around the attached toxin. Once inside the cell, the toxin cleaves an important cytoplasmic protein that is required for efficient binding of the vesicles containing acetylcholine to the presynaptic membrane. This prevents the release of acetylcholine across the neurotransmitter.

      It is important to note that the blockage of Ca2+ channels on the presynaptic membrane occurs in Lambert-Eaton syndrome, which is associated with small cell carcinoma of the lung and is a paraneoplastic syndrome. However, this is not related to the mechanism of action of botulinum toxin.

      The effects of botox typically last for two to six months. Once complete denervation has occurred, the synapse produces new axonal terminals which bind to the motor end plate in a process called neurofibrillary sprouting. This allows for interrupted release of acetylcholine. Overall, botulinum toxin is a powerful tool in the medical field for treating various conditions by preventing the release of acetylcholine across the neurotransmitter.

    • This question is part of the following fields:

      • Pharmacology
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  • Question 26 - A 70-year-old female complains of abdominal pain and melaena. She has a medical...

    Correct

    • 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: 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
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  • Question 27 - Which statement regarding ligand gated ion channels (LGIC) is accurate? ...

    Incorrect

    • Which statement regarding ligand gated ion channels (LGIC) is accurate?

      Your Answer: Each monomer of the channel has six transmembrane spanning domains

      Correct Answer: Agonist recognition and ion channel are intrinsic to a single protein complex

      Explanation:

      Ligand Gated Ion Channels: A Brief Overview

      Ligand gated ion channels (LGICs) are protein complexes that have both agonist recognition and ion channel functions. These functions are intrinsic to a single protein complex, which is usually pentameric in nature. For example, the nicotinic acetylcholine receptor (nAChR) is composed of a2ßδγ subunits. Each monomer of the LGIC has four transmembrane domains (TMSD) labeled M1-M4. The M2 domain forms a putative alpha-helix within the membrane.

      LGICs typically have a charged entrance that plays a role in ion selectivity. For instance, the nAChR has a negatively charged entrance that attracts Na and K ions. This selectivity is crucial for the proper functioning of the LGIC. the structure and function of LGICs is important for developing drugs that target these channels. By targeting LGICs, researchers can develop drugs that modulate the activity of these channels, which can have therapeutic benefits for a variety of diseases.

    • This question is part of the following fields:

      • Pharmacology
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  • Question 28 - You are creating a medication schedule for a patient with chronic renal failure...

    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: Warfarin

      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
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  • Question 29 - A 24-year-old man with asthma is brought to the emergency department due to...

    Incorrect

    • A 24-year-old man with asthma is brought to the emergency department due to shortness of breath. He has been experiencing a worsening cough with thick yellow phlegm for the past three days. He regularly uses a beclomethasone inhaler and salbutamol inhaler as needed.

      Upon assessment, the patient's heart rate is 166 bpm, blood pressure is 113/65 mmHg, oxygen saturation is 91%, and respiratory rate is 29. He is only able to speak in broken sentences.

      Which of the following therapies is most likely to exacerbate his asthma?

      Your Answer: Salbutamol

      Correct Answer: Bisoprolol

      Explanation:

      Treatment for Acute Asthma Attack

      When a person experiences an acute asthma attack, the first and most important treatment is to administer oxygen. This is followed by nebulised salbutamol to dilate the airways, oral steroids, and appropriate antibiotics if the productive cough is due to a chest infection. However, the use of the beta blocker bisoprolol to reduce the heart rate would be inappropriate.

      Salbutamol works by targeting beta-2 adrenoceptors, which causes the bronchi to dilate. However, cardiac muscle also has beta adrenoceptors, which can cause an increased heart rate. In this case, the patient is likely tachycardic due to increased work of breathing and salbutamol administered on the way to the hospital. Bisoprolol, on the other hand, is a beta antagonist that counteracts these effects by causing a reduction in heart rate and smooth muscle constriction, which would constrict the bronchi. This is the opposite of the desired effect and can worsen the patient’s condition. Therefore, it is important to avoid using bisoprolol in the treatment of acute asthma attacks.

    • This question is part of the following fields:

      • Pharmacology
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  • Question 30 - A 30-year-old expectant mother complains of feeling tired. During the examination, her nail...

    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: 2 mg

      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
      25.7
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Pharmacology (12/30) 40%
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