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  • Question 1 - The patients listed below have had wounds or injuries and were treated as...

    Incorrect

    • The patients listed below have had wounds or injuries and were treated as described in a local walk-in clinic.

      Which of the following patients has had adequate tetanus protection?

      Your Answer:

      Correct Answer: 80-year-old diabetic, a rusty nail went through his shoe and into his foot when walking in the woods, uncertain of vaccination history - receives vaccination and immunoglobulin

      Explanation:

      25-year-old receives immunoglobulin and vaccination after cutting her hand on a drinking glass and not knowing her vaccination history.

      Because this is not a tetanus-prone wound, immunoglobulin is not recommended. Because you can’t be sure about her vaccination history, now is the best time to start a tetanus vaccination course to ensure coverage later in life. The first vaccination should be administered at the time of presentation; the patient’s own GP should then review the patient’s vaccination history and schedule the rest of the course as needed.

      8-year-old whose hand was cut with a kitchen knife, received her first round of vaccinations as a baby and a booster at the age of four – receives vaccination:
      The tetanus vaccinations for this child are up to date, and the next booster should not be given too soon. Immunoglobulin is not required because this is not a tetanus-prone wound.

      80-year-old diabetic, a rusty nail went through his shoe and into his foot while walking in the woods, and he was uncertain of his vaccination history – he received vaccination and immunoglobulin:
      A tetanus vaccination course may not have been completed by an 80-year-old UK resident (the vaccination was introduced in 1961). The vaccination should be given at a walk-in clinic, and the patient’s own GP should be contacted to confirm vaccination history and to schedule the rest of the course as needed. Because this is a tetanus-prone wound (puncture wound and potential soil contact), immunoglobulin would be recommended in a patient with incomplete tetanus vaccinations.

      A 28-year-old Polish man cuts his leg while working in the garden, the wound is heavily contaminated with soil, and his vaccination history is unknown – he receives vaccination:
      In a patient with an unknown vaccination history, this is a tetanus-prone wound. In this case, the best course of action would be to administer both the vaccination and immunoglobulin at the walk-in clinic, then contact the patient’s own GP to check his or her vaccination history and schedule the rest of the course as needed.

      30-year-old with a large amount of devitalized tissue in the torso from an electrical burn – has had all vaccinations, so no need for vaccination or immunoglobulin:
      Because this is a high-risk tetanus wound (with a lot of devitalized tissue), even if the patient has had a full course of vaccinations in the past, immunoglobulin is recommended. There is no need for any additional vaccinations.

    • This question is part of the following fields:

      • Immunological Products & Vaccines
      • Pharmacology
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  • Question 2 - A patient presents with severe vomiting. They take a maintenance dose of 12.5...

    Incorrect

    • A patient presents with severe vomiting. They take a maintenance dose of 12.5 mg of prednisolone daily for their COPD. They are unable to swallow or keep down tablets at present, and you plan on converting them to IV hydrocortisone.
      What dose of hydrocortisone is equivalent to this dose of prednisolone? Select ONE answer only.

      Your Answer:

      Correct Answer: 50 mg

      Explanation:

      Prednisolone is four times more potent than hydrocortisone, and therefore, a dose of 12.5 mg would be equivalent to 50 mg of hydrocortisone.
      The following table summarises the relative potency of the main corticosteroids compared with hydrocortisone:
      Corticosteroid
      Potency relative to hydrocortisone
      Prednisolone
      4 times more potent
      Triamcinolone
      5 times more potent
      Methylprednisolone
      5 times more potent
      Dexamethasone
      25 times more potent

    • This question is part of the following fields:

      • Endocrine Pharmacology
      • Pharmacology
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  • Question 3 - Which of the following is NOT a common side effect of antihistamines: ...

    Incorrect

    • Which of the following is NOT a common side effect of antihistamines:

      Your Answer:

      Correct Answer: Tremor

      Explanation:

      Common side effects of antihistamines may include:
      Anticholinergic effects (blurred vision, dry mouth, urinary retention)
      Headache
      Gastrointestinal disturbances
      Psychomotor impairment (sedation, dizziness and loss of appetite)
      These side effects are significantly reduced with second-generation agents.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
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  • Question 4 - A 36 year old man who is overweight with a history of gout,...

    Incorrect

    • A 36 year old man who is overweight with a history of gout, presents to emergency room with an acutely painful big toe which is red, hot and swollen. However, he is apyrexic and otherwise systemically well. He has been diagnosed with acute gout. The most appropriate first line treatment for him is which of the following?

      Your Answer:

      Correct Answer: NSAIDs

      Explanation:

      The first line treatment for acute gout includes NSAIDs like diclofenac, indomethacin or naproxen. In patients in whom NSAIDs are contraindicated, not tolerated or ineffective, colchicine is an alternative. In those who cannot tolerate or who are resistant to NSAIDs and colchicine, oral or parenteral corticosteroids are an effective alternative. In acute monoarticular gout, intra-articular injection of a corticosteroid can be used occasionally. In acute gout. allopurinol is not used in the actual treatment, but its use should be continued during an acute attack if the patient is already established on long term therapy.

    • This question is part of the following fields:

      • Musculoskeletal
      • Pharmacology
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  • Question 5 - Which of the following side effects is most likely caused by erythromycin: ...

    Incorrect

    • Which of the following side effects is most likely caused by erythromycin:

      Your Answer:

      Correct Answer: QT - prolongation

      Explanation:

      The side effects of erythromycin include abdominal pain, anaphylaxis,
      cholestatic hepatitis, confusion,
      diarrhoea, dyspepsia, fever, flatulence, hallucinations, hearing loss,
      headache, hypertrophic pyloric stenosis, hypotension, Interstitial
      nephritis, mild allergic reactions, nausea, nervous system effects,
      including seizures, pain, pruritus, pseudomembranous colitis,
      QT prolongation, rash, skin eruptions, tinnitus, urticaria,
      ventricular arrhythmias, ventricular tachycardia, vertigo, vomiting

    • This question is part of the following fields:

      • Infections
      • Pharmacology
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  • Question 6 - Which of the following statements about propofol is TRUE: ...

    Incorrect

    • Which of the following statements about propofol is TRUE:

      Your Answer:

      Correct Answer: Propofol has some antiemetic action.

      Explanation:

      Propofol has some antiemetic properties. It’s for this reason that it’s used to treat postoperative nausea and vomiting. Propofol is mostly processed in the liver, with the kidneys excreting just around 1% of it unaltered. Propofol, unlike thiopental, does not produce tissue necrosis when it is extravasated. Propofol lowers intracranial pressure via lowering brain metabolic rate and cerebral blood flow. Propofol is thought to be safe for people with bronchial asthma and chronic obstructive pulmonary disease.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
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  • Question 7 - A 27-year-old man was sent to the emergency department by ambulance with suspected...

    Incorrect

    • A 27-year-old man was sent to the emergency department by ambulance with suspected anaphylaxis. What is the best first-line treatment for this patient?

      Your Answer:

      Correct Answer: 500 micrograms of adrenaline intramuscularly

      Explanation:

      Anaphylaxis is the sudden onset of systemic hypersensitivity due to IgE-mediated chemical release from mast cells and basophils.

      If anaphylaxis is suspected, 500 micrograms of adrenaline should be administered promptly (0.5 ml of 1:1000 solution).

      In anaphylaxis, the intramuscular route is the most immediate approach; the optimal site is the anterolateral aspect of the middle part of the thigh.

      Intravenous adrenaline should only be given by people who are well-versed in the use and titration of vasopressors in their routine clinical practice.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
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  • Question 8 - A patient presents with acute severe asthma. Her initial salbutamol nebulization produced a...

    Incorrect

    • A patient presents with acute severe asthma. Her initial salbutamol nebulization produced a poor response and you administer another nebuliser with ipratropium bromide added on.

      Which statement about ipratropium bromide is true?

      Your Answer:

      Correct Answer: It can trigger acute closed-angle glaucoma

      Explanation:

      Ipratropium bromide is an antimuscarinic drug. It is used in the management of acute asthma and COPD.

      It provides short-term relief in chronic asthma. Short-acting β2agonists are preferred and act more quickly.

      The commonest side effect of ipratropium bromide is dry mouth. Tremor is commonly seen with β2agonists.

      It can trigger acute closed-angle glaucoma in patients that are susceptible.

      First-line treatment for moderate asthma attacks is short-acting β2agonists.

      The BTS guidelines recommend that nebulised ipratropium bromide (0.5 mg 4-6 hourly) be added to β2agonist treatment in patients with a poor initial response to β2agonist therapy or with acute severe or life-threatening asthma.

      Its duration of action is 3-6 hours, maximum effect occurs 30-60 minutes after use, and bronchodilation can be maintained with three times per day dosing.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
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  • Question 9 - Which of the following is NOT a common side effect of amiodarone: ...

    Incorrect

    • Which of the following is NOT a common side effect of amiodarone:

      Your Answer:

      Correct Answer: Blue/green teeth discolouration

      Explanation:

      Common side effects of amiodarone include: Bradycardia, Nausea and vomiting, Thyroid disorders – hypothyroidism and hyperthyroidism, Persistent slate grey skin discoloration, Photosensitivity, Pulmonary toxicity (including pneumonitis and fibrosis), Hepatotoxicity, Corneal microdeposits (sometimes with night glare), Peripheral neuropathy and Sleep disorders.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
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  • Question 10 - After returning from Thailand two days ago, a 61-year-old man presents to the...

    Incorrect

    • After returning from Thailand two days ago, a 61-year-old man presents to the department with severe diarrhoea and vomiting. He has a history of hypertension and takes an ACE inhibitor to treat it.

      Which of the following statements about angiotensin-converting enzyme inhibitors is correct?

      Your Answer:

      Correct Answer: They have been shown to reduce mortality in heart failure

      Explanation:

      Angiotensin-converting enzyme (ACE) inhibitors prevent angiotensin I from being converted to angiotensin II. Angiotensin II has a variety of effects:
      Sympathetic activity has increased.
      Vasoconstriction in the arteries
      Secretion of Vasopressin
      Secretion of aldosterone

      The increase in systemic blood pressure is caused by arteriolar vasoconstriction. Vasopressin stimulates water reabsorption in the kidneys as well as the thirst sensation. In the distal convoluted tubules and collecting ducts, aldosterone causes the reabsorption of sodium and water from the urine in exchange for potassium secretion. As a result, ACE inhibitors lower systemic blood pressure while also causing hyperkalaemia.

      Angiotensin-converting enzyme inhibitors (ACE inhibitors) are used in a variety of clinical settings, including heart failure. According to a meta-analysis, ACE inhibitors reduce death, MI, and overall admission in patients with heart failure by 28%.
      ACE inhibitors are also used in the following clinical settings:
      Hypertension
      Chronic kidney disease
      Diabetic nephropathy 
      Following a myocardial infarction

      In the presence of renal artery stenosis, ACE inhibitors are contraindicated because they can cause or exacerbate renal failure.
      The most common side effect of ACE inhibitors is a dry cough caused by increased bradykinin production. There is, however, no known link to fibrosis of the lungs.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
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  • Question 11 - An ambulance transports a 37-year-old woman who is having a seizure. She is...

    Incorrect

    • An ambulance transports a 37-year-old woman who is having a seizure. She is moved to resuscitation and given a benzodiazepine dose, which quickly ends the seizure. You later learn that she has epilepsy and is usually treated with carbamazepine to control her seizures.

      What is carbamazepine's main mechanism of action?

      Your Answer:

      Correct Answer: Sodium channel blocker

      Explanation:

      Carbamazepine is primarily used to treat epilepsy, and it is effective for both focal and generalised seizures. It is not, however, effective in the treatment of absence or myoclonic seizures. It’s also commonly used to treat neuropathic pain, as well as a second-line treatment for bipolar disorder and as a supplement for acute alcohol withdrawal.

      Carbamazepine works as a sodium channel blocker that preferentially binds to voltage-gated sodium channels in their inactive state. This prevents an action potential from firing repeatedly and continuously.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
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  • Question 12 - You need to give your patient antibiotics, so you call microbiology for some advice.

    Of...

    Incorrect

    • You need to give your patient antibiotics, so you call microbiology for some advice.

      Of the following antibacterial drugs, which of them is a protein synthesis inhibitor?

      Your Answer:

      Correct Answer: Erythromycin

      Explanation:

      Bacteriostatic antibiotics include erythromycin and other macrolides. They work by attaching to the bacterial ribosome’s 50S subunit, preventing translocation and, as a result, inhibit protein synthesis. Macrolide antibiotics are actively concentrated inside leukocytes and delivered into the infection site as a result.

      Action Mechanisms- Examples:

      Cell wall production is inhibited
      Vancomycin
      Vancomycin
      Cephalosporins

      The function of the cell membrane is disrupted
      Nystatin
      Polymyxins
      Amphotericin B

      Inhibition of protein synthesis
      Chloramphenicol
      Macrolides
      Aminoglycosides
      Tetracyclines

      Nucleic acid synthesis inhibition
      Quinolones
      Trimethoprim
      Rifampicin
      5-nitroimidazoles
      Sulphonamides
      Anti-metabolic activity
      Isoniazid

    • This question is part of the following fields:

      • Infections
      • Pharmacology
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  • Question 13 - Which of the following is NOT an effect of benzodiazepines: ...

    Incorrect

    • Which of the following is NOT an effect of benzodiazepines:

      Your Answer:

      Correct Answer: Analgesic effect

      Explanation:

      Benzodiazepines are gamma-aminobutyric acid (GABA) receptor agonists which enhance inhibitory synaptic transmission throughout the central nervous system, with sedative, hypnotic, anxiolytic, anticonvulsant, amnesic and muscle relaxant properties.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
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  • Question 14 - A 56-year-old female presents at the hospital with a diabetic foot ulcer that...

    Incorrect

    • A 56-year-old female presents at the hospital with a diabetic foot ulcer that has become infected. She has a longstanding history of type 2 diabetes mellitus and diabetic polyneuropathy. She has trouble controlling her blood sugar levels, and recently, she was converted to a new insulin regimen that includes intermediate-acting insulin.

      Out of the following, which one is the intermediate-acting insulin?

      Your Answer:

      Correct Answer: Isophane insulin

      Explanation:

      Insulin is used mainly in type 1 diabetes, where the pancreas makes no insulin and can sometimes be prescribed in type 1 diabetes. There are different types of insulin categorized by their onset of action:

      1. Intermediate-acting insulins (isophane insulin NPH):
      – intermediate duration of action, designed to mimic the effect of endogenous basal insulin
      – starts their action in 1 to 4 hours
      – peaks in 4 to 8 hours
      – dosing is usually twice a day and helps maintain blood sugar throughout the day
      – Isophane insulin is a suspension of insulin with protamine

      2. Short-acting insulins (regular insulin)
      – starts the action in 30 to 40 minutes
      – peaks in 90 to 120 minutes
      – duration of action is 6 to 8 hours
      – taken before meals, and food is necessary within 30 minutes after its administration to avoid hypoglycaemia

      3. Long-acting insulins (glargine, detemir, degludec)
      – start action in 1 to 2 hours
      – plateau effect over 12 to 24 hours
      – Dosing is usually during the night-time after meals. Their long duration of action helps in reducing the frequency of dosing throughout the day.

      4. Rapid-acting insulins (lispro, aspart, glulisine)
      – start their action in 5 to 15 minutes
      – peak in 30 minutes
      – The duration of action is 3 to 5 hours
      – generally used before meals and always used along with short-acting or long-acting insulins to control sugar levels throughout the day.

    • This question is part of the following fields:

      • Endocrine Pharmacology
      • Pharmacology
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  • Question 15 - Regarding hypertensive crises, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding hypertensive crises, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: In a hypertensive emergency, blood pressure should be reduced by 20 - 25% within 2 hours.

      Explanation:

      A hypertensive emergency is defined as severe hypertension (blood pressure ≥ 180/110 mmHg) with acute damage to the target organs. Prompt treatment with intravenous antihypertensive therapy is generally required; over the first few minutes or within 2 hours, blood pressure should be reduced by 20 – 25%. Severe hypertension without acute target organ damage is defined as hypertensive urgency.; blood pressure should be reduced gradually over 24 – 48 hours with oral antihypertensive therapy. If blood pressure is reduced too quickly in the management of hypertensive crises, there is a risk of reduced organ perfusion leading to cerebral infarction, blindness, deterioration in renal function, and myocardial ischaemia.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
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  • Question 16 - A 78-year-old woman visits the emergency room with dizziness and nausea. She claims...

    Incorrect

    • A 78-year-old woman visits the emergency room with dizziness and nausea. She claims that her doctor gave her cinnarizine two days prior, but that it didn't seem to help.

      Cinnarizine's mechanism of action is which of the following?

      Your Answer:

      Correct Answer: Antihistamine action

      Explanation:

      Cinnarizine is a piperazine derivative with an antihistamine effect that makes it anti-emetic. Motion sickness and vestibular disorders, such as Méniéres disease, are the most common conditions for which it is prescribed.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
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  • Question 17 - A 40-year-old man complains of pain and redness in his lower thigh due...

    Incorrect

    • A 40-year-old man complains of pain and redness in his lower thigh due to an insect bite. He was diagnosed with cellulitis. Select the first-line antibiotic for cellulitis.

      Your Answer:

      Correct Answer: Flucloxacillin

      Explanation:

      Cellulitis is most commonly caused by bacteria from the group Aß-hemolytic streptococcus.

      Cellulitis can be caused by animal bites. For uncomplicated cellulitis, flucloxacillin is the first-line antibiotic. Because it is beta-lactamase stable, it is efficient against Staphylococcus aureus.

    • This question is part of the following fields:

      • Infections
      • Microbiology
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  • Question 18 - Regarding inflammatory bowel disease, acute mild to moderate disease of the rectum or...

    Incorrect

    • Regarding inflammatory bowel disease, acute mild to moderate disease of the rectum or rectosigmoid should be treated initially with:

      Your Answer:

      Correct Answer: Local aminosalicylate

      Explanation:

      Acute mild to moderate disease affecting the rectum (proctitis) or the rectosigmoid is treated initially with local application of an aminosalicylate; alternatively, a local corticosteroid can be used but it is less effective. A combination of a local aminosalicylate and a local corticosteroid can be used for proctitis that does not respond to a local aminosalicylate alone.

    • This question is part of the following fields:

      • Gastrointestinal
      • Pharmacology
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  • Question 19 - Regarding airway resistance, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding airway resistance, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: Airway resistance is predominantly determined by the radius of the airway as described by Poiseuille's law.

      Explanation:

      Flow through airways is described by Darcy’s law which states that flow is directly proportional to the mouth-alveolar pressure gradient and inversely proportional to airway resistance. Airway resistance is primarily determined by the airway radius according to Poiseuille’s law, and whether the flow is laminar or turbulent. Parasympathetic stimulation causes bronchoconstriction and sympathetic stimulation causes bronchodilation, but mediated by beta2-adrenoceptors. Muscarinic antagonists e.g. ipratropium bromide cause bronchodilation.

    • This question is part of the following fields:

      • Physiology
      • Respiratory
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  • Question 20 - A young male has presented to the Emergency Department with a sudden onset...

    Incorrect

    • A young male has presented to the Emergency Department with a sudden onset of severe palpitations, shortness of breath, and chest pain. A 12-lead ECG is recorded, and it shows a narrow complex tachycardia that points to a diagnosis of supraventricular tachycardia.

      Vagal manoeuvres are attempted but are unsuccessful in eliminating the arrhythmia. The next action plan is to use a drug to revert to sinus rhythm.

      Out of the following, which is the first-line treatment for supraventricular tachycardia?

      Your Answer:

      Correct Answer: Adenosine

      Explanation:

      Paroxysmal supraventricular tachycardia is an intermittent tachycardia (HR > 100 bpm) and has the following characteristics:
      1. Sudden onset/offset (Contrast with sinus tachycardia)
      2. Electrical activity originates above the ventricle (Contrast with ventricular tachycardia)
      3. Produces narrow QRS complex (<120ms) The most common cause of PSVT is Atrioventricular nodal re-entrant tachycardia (AVNRT), most common in young women with a mean age onset of 32 years old. There are recurrent episodes of palpitations, and most of the episodes spontaneously. Sometimes, some vagal manoeuvres are required:
      1. Valsalva manoeuvre
      2. immersing the face in ice-cold water
      3. carotid sinus massage.

      If PSVT keeps persisting or is causing severe symptoms, the treatment of choice is intravenous adenosine. The patient’s ECG should be continuously monitored throughout the treatment.

      The recommended doses in adults are as follows:
      – Initial dose of adenosine is 6 mg by rapid IV bolus
      – If unsuccessful, give another dose of adenosine 12 mg by rapid IV bolus
      – If unsuccessful, give a further dose of adenosine 12 mg by rapid IV bolus
      The latest ALS guidelines advocate 18 mg for the third dose, whereas the BNF/NICE guidelines advocate 12 mg.

      If adenosine fails or is contraindicated, intravenous verapamil can be used as an alternative, but it should be avoided in patients recently treated with beta-blockers.

      Synchronized electrical cardioversion will be necessary with signs of hemodynamic instability or if drug treatment has failed to restore sinus rhythm.
      Recurrent episodes of paroxysmal supraventricular tachycardia can be treated by catheter ablation or prevented with drugs such as flecainide, sotalol, diltiazem, or verapamil.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
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  • Question 21 - A known epileptic is transported in status epilepticus by ambulance. On the way...

    Incorrect

    • A known epileptic is transported in status epilepticus by ambulance. On the way to the hospital, she took some diazepam.

      Which of the following statements about diazepam is correct?

      Your Answer:

      Correct Answer: It crosses into breast milk

      Explanation:

      Diazepam boosts GABA’s effects, giving it sedative, hypnotic, anxiolytic, anticonvulsant, and muscle-relaxing properties. It can be administered orally, rectally, or intravenously.

      With a half-life of 20-100 hours, it is a long-acting benzodiazepine. Midazolam, oxazepam, and alprazolam are examples of short-acting benzodiazepines with a half-life of less than 12 hours (Xanax).

      If used in the presence of hepatic impairment, benzodiazepines can cause coma. If treatment is necessary, benzodiazepines with shorter half-lives should be used in lower doses. Diazepam is a sedative that crosses into breast milk and should be avoided by breastfeeding mothers.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
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  • Question 22 - Mannitol is primarily indicated for which of the following: ...

    Incorrect

    • Mannitol is primarily indicated for which of the following:

      Your Answer:

      Correct Answer: Cerebral oedema

      Explanation:

      Mannitol is an osmotic diuretic that can be used to treat cerebral oedema and raised intraocular pressure. Mannitol is a low molecular weight compound and is, therefore, freely filtered at the glomerulus and is not reabsorbed. It, therefore, increases the osmolality of the glomerular filtrate and tubular fluid, increasing urinary volume by an osmotic effect. It also does not cross the blood-brain-barrier (BBB).

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
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  • Question 23 - Regarding inhaled corticosteroids, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding inhaled corticosteroids, which of the following statements is INCORRECT:

      Your Answer:

      Correct Answer: Lower doses of inhaled corticosteroids may be required in smokers.

      Explanation:

      Current and previous smoking reduces the effectiveness of inhaled corticosteroids and higher doses may be necessary.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
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  • Question 24 - A 60-year-old female has a past medical history of diverticular disease. She now...

    Incorrect

    • A 60-year-old female has a past medical history of diverticular disease. She now presents in the clinic with crampy abdominal pain. The nurse at the triage suggests prescribing hyoscine butyl bromide to help relieve the abdominal pain. However, after administering this treatment, the patient develops a side-effect to the medication.

      What side-effect of using hyoscine butyl bromide is she MOST likely to develop out of the following?

      Your Answer:

      Correct Answer: Dry mouth

      Explanation:

      Hyoscine butylbromide is an antispasmodic drug that blocks muscarinic receptors and reduces intestinal motility. It is used for gastrointestinal and genitourinary smooth muscle spasms and symptomatic relief of IBS.

      It has the following side-effects:
      1. Constipation
      2. Dizziness
      3. Drowsiness
      4. Dry mouth
      5. Dyspepsia
      6. Flushing
      7. Headache
      8. Nausea and vomiting
      9. Palpitations
      10. Skin reactions
      11. Tachycardia
      12. Urinary disorders
      13. Disorders of vision

    • This question is part of the following fields:

      • Gastrointestinal Pharmacology
      • Pharmacology
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  • Question 25 - During her pregnancy, a 28-year-old lady was given an antibiotic. The neonate was...

    Incorrect

    • During her pregnancy, a 28-year-old lady was given an antibiotic. The neonate was prematurely born with cyanosis and ashen grey coloured skin as a result of this. Other symptoms were hypotonia, low blood pressure, and poor feeding.

      From the  following antibiotics, which one is most likely to cause this side effect?

      Your Answer:

      Correct Answer: Chloramphenicol

      Explanation:

      Grey baby syndrome is a rare but causes significant adverse effect caused by the build-up of chloramphenicol in neonates (particularly preterm babies).

      The following are the main characteristics of ‘grey baby syndrome’:

      Skin that is ashy grey in colour.
      Feeding problems
      Vomiting
      Cyanosis
      Hypotension
      Hypothermia
      Hypotonia
      Collapse of the cardiovascular system
      Distension of the abdomen
      trouble breathing

    • This question is part of the following fields:

      • Infections
      • Pharmacology
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  • Question 26 - Which of the following best describes the mechanism of action of aspirin: ...

    Incorrect

    • Which of the following best describes the mechanism of action of aspirin:

      Your Answer:

      Correct Answer: Cyclo-oxygenase (COX) inhibitor

      Explanation:

      Aspirin is a non-steroidal anti-inflammatory drug (NSAID). Aspirin irreversibly inhibits cyclooxygenase (COX) enzymes and the resulting inhibition of prostaglandin synthesis results in analgesic, antipyretic and to a lesser extent anti-inflammatory actions.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
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  • Question 27 - Regarding calcium channel blockers, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding calcium channel blockers, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: Calcium channel blockers inhibit L-type voltage-sensitive calcium channels in arterial smooth muscle causing vasodilation.

      Explanation:

      Calcium channel blockers inhibit L-type voltage-sensitive calcium channels in arterial smooth muscle, causing relaxation and vasodilation (reduction in peripheral vascular resistance). They also block calcium channels within the myocardium and conducting tissues of the heart which produces a negative inotropic effect by reducing calcium influx during the plateau phase of the action potential.
      They have a variety of uses, including:
      Hypertension
      Angina
      Atrial fibrillation
      Migraine
      Calcium channel blockers have been found to be moderately useful in the prevention of migraines. The best evidence is for this is with verapamil. This may be due to the prevention of the arteriolar constriction that is associated with migraine. They are commonly used for this elsewhere in the world but are not currently licensed for this use in the UK.
      The following are common side effects of all calcium-channel blockers:
      Abdominal pain
      Dizziness
      Drowsiness
      Flushing
      Headache
      Nausea and vomiting
      Palpitations
      Peripheral oedema
      Skin reactions
      Tachycardia
      Verapamil is highly negatively inotropic and reduces cardiac output, slows the heart rate and may impair atrioventricular conduction. It may precipitate heart failure, exacerbate conduction disorders, and cause hypotension at high doses and should not be used with beta-blockers. Nifedipine has less myocardial effects than verapamil and has no antiarrhythmic properties but has more influence on the vessels. Nimodipine is used solely for the prevention and treatment of vascular spasm following aneurysmal subarachnoid haemorrhage.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
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  • Question 28 - Disease specific immunoglobulin is available for all of the following infectious diseases EXCEPT...

    Incorrect

    • Disease specific immunoglobulin is available for all of the following infectious diseases EXCEPT for:

      Your Answer:

      Correct Answer: Hepatitis A

      Explanation:

      Disease specific immunoglobulins are available for:
      hepatitis B
      rabies
      tetanus
      varicella-zoster
      Normal immunoglobulin can be used to confer protection against hepatitis A.

    • This question is part of the following fields:

      • Immunoglobulins And Vaccines
      • Pharmacology
      0
      Seconds

  • Question 29 - For which of the following class of drugs can neostigmine be used as...

    Incorrect

    • For which of the following class of drugs can neostigmine be used as a reversal agent?

      Your Answer:

      Correct Answer: Non-depolarising muscle relaxants

      Explanation:

      Neostigmine is used specifically for reversal of nondepolarizing (competitive) blockade and is anticholinesterase. It acts within one minute of intravenous injection, and the effects last for 20 to 30 minutes. After this time period, a second dose may then be necessary.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
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  • Question 30 - In relation to ketamine, which of the following statements is TRUE: ...

    Incorrect

    • In relation to ketamine, which of the following statements is TRUE:

      Your Answer:

      Correct Answer: It is usually associated with tachycardia, increased blood pressure and increased cardiac output.

      Explanation:

      Ketamine has hypnotic, analgesic and local anaesthetic properties. Major adverse effects include Hypertension, Increased cardiac output, Increased ICP, Tachycardia, Tonic-clonic movements, Visual hallucinations and Vivid dreams.
      Ketamine is mostly utilized in paediatric anaesthesia, especially when repeated dosing is necessary (such as for serial burns dressings). Ketamine has little effect on respiratory drive, and protective airway reflexes are unaffected. Ketamine is also a bronchial smooth muscle relaxant, hence it plays a unique function in the treatment of severe asthma.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      0
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