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Question 1
Incorrect
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Which of the following is true regarding the dose of propofol?
Your Answer: 2-3 mg/kg
Correct Answer: 1-2mg/kg
Explanation:Propofol is a short-acting medication used for starting and maintenance of general anaesthesia, sedation for mechanically ventilated adults, and procedural sedation.
The dose of propofol is 1-2 mg/kg.Dose of some other important drugs are listed below:
Thiopental dose: 3-7 mg/kg
Ketamine dose: 1-2 mg/kg
Etomidate dose: 0.3 mg/kg
Methohexitone dose: 1.0-1.5 mg/kg -
This question is part of the following fields:
- Pharmacology
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Question 2
Incorrect
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Which of the following statement is not true regarding the effects of Dopamine in CNS?
Your Answer: Does not cross the blood brain barrier
Correct Answer: Most of the administered dose is converted to Noradrenaline in sympathetic nerve terminals
Explanation:Nausea and vomiting occur commonly due to Chemoreceptor Trigger Zone (CTZ) stimulation by dopamine (Domperidone but not metoclopramide can be used for the treatment of this vomiting)
Dopamine itself cannot cross the blood-brain barrier (BBB) but its precursor levodopa can cross BBB.
Dopamine can modulate extrapyramidal symptoms like acute dyskinesia, tardive dyskinesia, Parkinsonism, and Neuroleptic malignant syndrome.
Dopamine inhibits the secretion of prolactin from the pituitary gland.
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This question is part of the following fields:
- Pharmacology
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Question 3
Correct
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Drug toxicity when using bupivacaine is most likely to occur when this local anaesthetic technique is performed.
Your Answer: Intercostal nerve block
Explanation:An intercostal nerve block is used for therapeutic and diagnostic purposes. Intercostal nerve blocks manage acute and chronic pain in the chest area. Common indications are chest wall surgery and shingles or postherpetic neuralgia.
An intercostal nerve block is also an effective option for the management of pain associated with chest trauma and rib fractures. These blocks have been shown to improve oxygenation and respiratory mechanics, and offer pain relief that is comparable to that of epidural analgesia.
This technique, however, is limited by the relatively large doses of local anaesthetic required, and relatively high intravascular uptake from the intercostal space, increasing risk of local anaesthetic toxicity.
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This question is part of the following fields:
- Pharmacology
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Question 4
Incorrect
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While administering a general anaesthetic to a 65-year-old man booked for a hip hemiarthroplasty, with a weight 70 kg, and an ASA 1 score, you give 1 g of paracetamol IV but notice that he had received the same dose on the ward one hour prior.
What is the most appropriate subsequent management of this patient?Your Answer: Avoid paracetamol for the next 12 hours and monitor the patient clinically
Correct Answer: Do nothing and give the next doses of paracetamol at standard 6 hour intervals
Explanation:After ingestion of more than 150 mg/kg paracetamol within 24 hours, hepatotoxicity can occur but can also develop rarely after ingestion of doses as low as 75 mg/kg within 24 hours. Hepatocellular damage will not occur in this patient and therefore no need to engage management pathway for paracetamol overdose. If his weight was <33 kg or he already had a history of impaired liver function, then the management would bde different. Subsequent post-operative doses will be a standard dose of 1 g 6 hourly. This is a drug administration error and should be reported as an incident even though the patient will not be harmed.
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This question is part of the following fields:
- Pharmacology
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Question 5
Correct
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Question 6
Incorrect
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A 74-year-old man presents to a hospital for manipulation of Colles fracture. The patient is 50 kg and the anaesthetic plan is to perform an intravenous regional (Bier's) block.
Which of the following is the appropriate dose of local anaesthetic for the procedure?Your Answer: 2% lidocaine (10 ml)
Correct Answer: 0.5% prilocaine (40 ml)
Explanation:Prilocaine is the drug of choice for intravenous regional anaesthesia. 0.5% prilocaine (40 ml) is indicated for this condition.
Lidocaine is another alternative for this condition but volume and dose are likely to be inadequate for the procedure. -
This question is part of the following fields:
- Pharmacology
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Question 7
Incorrect
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Which of the following statements is not correct regarding Noradrenaline?
Your Answer: Decreases renal and hepatic blood flow
Correct Answer: Predominantly work through effects on ?-adrenergic receptors
Explanation:Noradrenaline also called norepinephrine belongs to the catecholamine family that functions in the brain and body as both a hormone and neurotransmitter.
They have sympathomimetic effects acting via adrenoceptors (?1, ?2,?1, ?2, ?3) or dopamine receptors (D1, D2).
May cause reflex bradycardia, reduce cardiac output and increase myocardial oxygen consumption
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This question is part of the following fields:
- Pharmacology
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Question 8
Incorrect
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All the following statements are false regarding gabapentin except:
Your Answer: Is indicated for use in absence attacks (petit mal)
Correct Answer: Requires dose adjustment in renal disease
Explanation:Therapy with gabapentin requires dose adjustment with renal diseases. However, plasma monitoring of the drug is not necessary.
Gabapentin is not a liver enzyme inducer unlike other anticonvulsants like phenytoin and phenobarbitone
Gabapentin has not been shown to be associated with visual disturbances.
Gabapentin is used for add-on therapy in partial or generalized seizures and used in the management of chronic pain conditions but is of no use in petit mal.
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This question is part of the following fields:
- Pharmacology
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Question 9
Incorrect
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Which of the following is the best marker of mast cell degranulation in a patient with suspected anaphylaxis who became hypotensive and developed widespread urticarial rash after administration of Augmentin?
Your Answer: Alpha-protryptase
Correct Answer: Tryptase
Explanation:Mast cell tryptase is a reliable marker of mast cell degranulation. Tryptase is a protease enzyme that acts via widespread protease-activated receptors (PARs).
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This question is part of the following fields:
- Pharmacology
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Question 10
Incorrect
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Which of the following factors significantly increases the risk of hepatotoxicity and fulminant hepatic failure in halothane administration?
Your Answer: Prior history of post-anaesthetic jaundice
Correct Answer: Multiple exposure
Explanation:Hepatotoxicity due to halothane administration is relatively common and is a major factor in its rapidly declining use. Type 1 hepatotoxicity has an incidence of 20% to 30%. A comprehensive report in 1969 demonstrated an incidence of type 2 hepatotoxicity (hepatitis) of 1 case per 6000 to 20000 cases, with fatal cases occurring approximately once in 35000 patients following a single exposure to the anaesthetic. This incidence of fatal cases increases to approximately 1 in 1000 patients following multiple exposures. Following this study was a large-scale review in the United Kingdom, which showed similar results. To put this into perspective, there is only a single case of hepatotoxicity confirmed after the administration of desflurane and 2 cases per 1 million after enflurane. By the 1970s, halothane was the most common cause of drug-induced liver failure.
Halothane-induced hepatotoxicity has a female to male ratio of two to one. Younger patients are less likely to be affected; 80% of the cases are typically in patients 40 years or older. Other risk factors include obesity and underlying liver dysfunction. Medications such as phenobarbital, alcohol, and isoniazid may play a role in affecting CYP2E1 metabolism, increasing one’s risk.
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This question is part of the following fields:
- Pharmacology
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SESSION STATS - PERFORMANCE PER SPECIALTY
