-
Question 1
Correct
-
A foetus is noted to be small for gestational age (SGA) on the 20 week scan. One of the mothers medications is stopped at this time. Follow up scans reveal renal dysgenesis. Which of the below medications was stopped?
Your Answer: Ramipril
Explanation:Use of angiotensin II receptors blocks and ACE inhibitors are known to result in renal dysgenesis. Due to renal dysgenesis oligohydramnios occurs that leads to IUGR.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 2
Incorrect
-
Tamoxifen is associated with an increased risk of which of the following?
Your Answer: Induced lactation
Correct Answer: Endometrial cancer
Explanation:Tamoxifen is a SERM that is effective in treating hormone-responsive breast cancer, it acts as an antagonist to prevent receptor activation by endogenous oestrogen. As agonist of the endometrial receptors it promotes endometrial hyperplasia and hence increases the risk of endometrial cancer.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 3
Incorrect
-
In which part of the body does clomiphene trigger ovulation by antagonising oestrogen receptors?
Your Answer: Ovaries
Correct Answer: Hypothalamus
Explanation:Clomiphene citrate is widely used in the induction of ovulation, especially in the treatment of anovulatory infertility and in conditions such as PCOS. The drug functions as a selective oestrogen receptor modulator, which acts in the hypothalamus to indicate low serum oestrogen levels. Reduced levels of negative feedback stimulate the secretion of GnRH from the hypothalamus, which in turn stimulate the production of gonadotropins (FSH and LH) from the anterior pituitary. These work to increase ovarian follicular activity.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 4
Incorrect
-
Question 5
Correct
-
Warfarin embryopathy is typically the result of the mother taking warfarin during which stage of pregnancy?
Your Answer: 6-12 weeks
Explanation:Warfarin is teratogenic if it is used in the first trimester. It causes bone defects and haemorrhages in the developing foetus.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 6
Incorrect
-
A 27 year old patient is maintained on warfarin during pregnancy due to a mechanical mitral valve. She has read about warfarin embryopathy. Which of the following is a typical feature?
Your Answer: Omphalocele
Correct Answer: Stippled epiphyses
Explanation:Warfarin is teratogenic if it is used in the first trimester. It causes bone defects and haemorrhages in the developing foetus. It causes the formation of multiple ossification centres in the long bones. Resulting in stippled epiphyses and hence deform long bones.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 7
Incorrect
-
The following drugs cross the placenta to the foetus, EXCEPT:
Your Answer: Tetracycline
Correct Answer: Heparin
Explanation:Standard heparin, an effective treatment for antepartum thromboembolic disease, is thought to be safe for the foetus since it does not cross the placenta.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 8
Incorrect
-
You see a patient who gave birth earlier in the day. She was taken off warfarin during pregnancy and is currently on LMWH. She intends to breastfeed for the first 6-8 weeks and wants advice regarding restarting warfarin. Which of the following is appropriate?
Your Answer: Recommence warfarin immediately
Correct Answer: Recommence warfarin in 5-7 days
Explanation:The use of anticoagulants during pregnancy is a complicated issue because warfarin is teratogenic if used in the first trimester, and is linked with fetal intracranial haemorrhage in the third trimester (mainly at doses 5 mg daily). Low molecular weight heparin may be insufficient at preventing thrombosis in women with mechanical prosthetic heart valves, where the risk of valve thrombus is 10 per cent. Anticoagulation is essential in patients with congenital heart disease who have pulmonary hypertension, or artificial valve replacements, and in those in or at risk of atrial fibrillation. The options are either to continue warfarin for the pregnancy, or replace it with heparin between 6 and 12 weeks gestation to avoid the teratogenic risk. Warfarin should be started a week after delivery.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 9
Incorrect
-
Lidocaine works by blocking which of the following ion channels?
Your Answer: slow voltage gated potassium channels
Correct Answer: fast voltage gated sodium channels
Explanation:It blocks the voltage gated sodium channels and reduce the influx of sodium ions preventing depolarization of the membrane and blocking the conduction of the action potential. The affinity of the receptor site in the sodium channels depends on whether it is resting, open or inactive.
-
This question is part of the following fields:
- Pharmacology
-
-
Question 10
Incorrect
-
What is the target INR in a patient who has just been started on warfarin therapy due to a pulmonary embolism?
Your Answer:
Correct Answer: 2.0-3.0
Explanation:Warfarin can be useful for management of thromboembolism. The target INR range for this medication is between 2.0-3.0 in patients with venous thromboembolism, pulmonary embolism etc. The INR range may increase to 3.0-4.0 in patients with mechanical valves. However, warfarin is not recommended in pregnancy, and Low Molecular Weight Heparin should be used for thromboprophylaxis instead.
-
This question is part of the following fields:
- Pharmacology
-
SESSION STATS - PERFORMANCE PER SPECIALTY
