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  • Question 1 - A 39-year-old man with a long history of depression presents after intentionally overdoing...

    Incorrect

    • A 39-year-old man with a long history of depression presents after intentionally overdoing his heart medication. Verapamil immediate-release 240 mg is the tablet he takes for this condition, he says. He took the pills about 30 minutes ago, but his wife discovered him right away and rushed him to the emergency room.

      Which of the following is a verapamil toxicity?

      Your Answer:

      Correct Answer: Negative inotropy

      Explanation:

      Overdosing on calcium-channel blockers should always be taken seriously and regarded as potentially fatal. Verapamil and diltiazem are the two most lethal calcium-channel blockers in overdose. These work by binding the alpha-1 subunit of L-type calcium channels, preventing calcium from entering the cell. In cardiac myocytes, vascular smooth muscle cells, and islet beta-cells, these channels play an important role.

      The following summarises the toxicity of calcium-channel blockers:
      Cardiac effects
      Vascular smooth muscle tone affects
      Metabolic effects
      Excessive negative inotropy: myocardial depression
      Negative chronotropy: sinus bradycardia
      Negative dromotropy: atrioventricular node blockade
      Decreased afterload
      Systemic hypotension
      Coronary vasodilation
      Hypoinsulinaemia
      Calcium channel blocker-induced insulin resistance

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
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  • Question 2 - Which of the following is an action of glucagon: ...

    Incorrect

    • Which of the following is an action of glucagon:

      Your Answer:

      Correct Answer: Stimulates glycogenolysis

      Explanation:

      Glucagon is a peptide hormone that is produced and secreted by alpha cells of the islets of Langerhans, which are located in the endocrine portion of the pancreas. The main physiological role of glucagon is to stimulate hepatic glucose output, thereby leading to increases in glycaemia. It provides the major counter-regulatory mechanism to insulin in maintaining glucose homeostasis.
      Hypoglycaemia is the principal stimulus for the secretion of glucagon but may also be used as an antidote in beta-blocker overdose and in anaphylaxis in patients on beta-blockers that fail to respond to adrenaline.
      Glucagon then causes:
      Glycogenolysis
      Gluconeogenesis
      Lipolysis in adipose tissue
      The secretion of glucagon is also stimulated by:
      Adrenaline
      Cholecystokinin
      Arginine
      Alanine
      Acetylcholine
      The secretion of glucagon is inhibited by:
      Insulin
      Somatostatin
      Increased free fatty acids
      Increased urea production

      Glycolysis is the metabolic pathway that converts glucose into pyruvate. The free energy released by this process is used to form ATP and NADH. Glycolysis is inhibited by glucagon, and glycolysis and gluconeogenesis are reciprocally regulated so that when one cell pathway is activated, the other is inactive and vice versa.

      Glucagon has a minor effect of enhancing lipolysis in adipose tissue. Lipolysis is the breakdown of lipids and involves the hydrolysis of triglycerides into glycerol and free fatty acids. It makes fatty acids available for oxidation.

    • This question is part of the following fields:

      • Endocrine
      • Pharmacology
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  • Question 3 - You review a patient with a history of Addison’s disease. He takes 100...

    Incorrect

    • You review a patient with a history of Addison’s disease. He takes 100 mg of hydrocortisone per day to control this.
      What dose of prednisolone is equivalent to this dose of hydrocortisone? Select ONE answer only.

      Your Answer:

      Correct Answer: 25 mg

      Explanation:

      Prednisolone is four times more potent than hydrocortisone, and therefore, a dose of 25 mg would be equivalent to 100 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 4 - A 44-year-old man with an acute episode of gout presents to you and...

    Incorrect

    • A 44-year-old man with an acute episode of gout presents to you and you discuss treatment plan with him.

      Which one of these statements concerning the treatment of acute gout is true?

      Your Answer:

      Correct Answer: A common first-line treatment is Naproxen as a stat dose of 750 mg followed by 250 mg TDS

      Explanation:

      High-dose NSAIDs are the first-line treatment for acute gout. In the absence of any contraindications, Naproxen 750 mg as a stat dose followed by 250 mg TDS is commonly used.

      Aspirin is contraindicated in gout. It reduces the urinary clearance of urate and also interferes with the action of uricosuric agents.

      Colchicine is preferred in patients with heart failure or in those who are intolerant of NSAIDs. It is as effective as NSAIDs in relieving acute attacks.

      Colchicine acts on the neutrophils, binding to tubulin to prevent neutrophil migration into the joint. Where Allopurinol is not tolerated, it has a role in prophylactic treatment of gout.

      Allopurinol should not be started in the acute phase of gout as it increases the severity and duration of symptoms. It is used as a prophylaxis in preventing future attacks and acts by reducing serum uric acid levels.

    • This question is part of the following fields:

      • Musculoskeletal Pharmacology
      • Pharmacology
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  • Question 5 - Lidocaine's antiarrhythmic mode of action is as follows: ...

    Incorrect

    • Lidocaine's antiarrhythmic mode of action is as follows:

      Your Answer:

      Correct Answer: Blocks inactivated Na+ channels

      Explanation:

      Lidocaine is a class 1B antidysrhythmic; combines with fast Na channels and thereby inhibits recovery after repolarization, resulting in decreasing myocardial excitability and conduction velocity. However, in ischaemic areas, where anoxia causes depolarisation and arrhythmogenic activity, many Na+ channels are inactivated and therefore susceptible to lidocaine.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
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  • Question 6 - Which of the following side effects is more common of etomidate than other...

    Incorrect

    • Which of the following side effects is more common of etomidate than other intravenous induction agents:

      Your Answer:

      Correct Answer: Extraneous muscle movements

      Explanation:

      Etomidate is associated with a high incidence of extraneous muscle movements, which can be minimised by an opioid analgesic or a short-acting benzodiazepine given prior to induction. Etomidate causes less hypotension than thiopental sodium and propofol during induction. Etomidate is associated with rapid recovery without a hangover effect. The rate of respiratory depression and tachycardia is not higher in etomidate.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
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  • Question 7 - A 55-year-old female is urgently rushed into the Emergency Department as she complains...

    Incorrect

    • A 55-year-old female is urgently rushed into the Emergency Department as she complains of chest pain that is worse on breathing, shortness of breath, palpitations, and haemoptysis.

      She undergoes a CT pulmonary angiogram, which reveals a large pulmonary embolus. She is immediately started on heparin and shifted to the acute medical ward.

      Which of the following statements is true regarding heparin?

      Your Answer:

      Correct Answer: It activates antithrombin III

      Explanation:

      Heparin is a polymer of glycosaminoglycan. It occurs naturally and is found in mast cells. Clinically, it is used in two forms:
      1. Unfractionated: widely varying polymer chain lengths
      2. Low molecular weight: Smaller polymers only

      Heparin works by binding to and activating the enzyme inhibitor antithrombin III. Antithrombin III inactivates thrombin (factor IIa) by forming a 1:1 complex with thrombin. The heparin-antithrombin III complex also inhibits factor Xa and some other proteases involved with clotting. The heparin-ATIII complex can also inactivate IX, XI, XII, and plasmin.

      Heparin is not thrombolytic or fibrinolytic. It prevents the progression of existing clots by inhibiting further clotting. The lysis of existing clots relies on endogenous thrombolytics.

      Heparin is used for:
      1. Prevention and treatment of venous thromboembolism
      2. Treatment of disseminated intravascular coagulation
      3. Treatment of fat embolism
      4. Priming of haemodialysis and cardiopulmonary bypass machines

      There is no evidence that heparin is superior to low-molecular-weight heparins in preventing mortality from thrombosis.

      Vitamin K is used to reverse the effects of warfarin but not heparin. For heparin, protamine sulphate is used to counteract its effects.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
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  • Question 8 - A 50-year-old woman has an anaphylactic reaction following accidental ingestion peanuts at a...

    Incorrect

    • A 50-year-old woman has an anaphylactic reaction following accidental ingestion peanuts at a restaurant. She is a known hypertensive on atenolol 50 mg daily and BP is well controlled. She is also on amlodipine 5 mg daily. Two doses of IM adrenaline has been given without improvement.

      Which medication may prove helpful in this patient?

      Your Answer:

      Correct Answer: IM Glucagon

      Explanation:

      Resistant to the effects of adrenaline in anaphylaxis is seen in patients taking beta-blockers.

      Glucagon can be used to overcome the effects of the beta-blockade if initial doses of adrenaline are unsuccessful in patients taking beta-blockers.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory Pharmacology
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  • Question 9 - Due to severe palpitations, a 28-year-old woman is transported to the Emergency Department...

    Incorrect

    • Due to severe palpitations, a 28-year-old woman is transported to the Emergency Department by ambulance. Her heart rate is 180 beats per minute, and the rhythm strip shows supraventricular tachycardia. You intend to give adenosine.

      Which of the following is NOT a contraindication for adenosine use?

      Your Answer:

      Correct Answer: History of heart transplant

      Explanation:

      The purine nucleoside adenosine is used to diagnose and treat paroxysmal supraventricular tachycardia. Adenosine works by stimulating A1-adenosine receptors and opening potassium channels that are sensitive to acetylcholine. This causes the atrioventricular (AV) node’s cell membrane to become hyperpolarized, slowing conduction by inhibiting calcium channels.

      Patients who have had a heart transplant are extremely sensitive to the effects of adenosine and should start with a lower dose of 3 mg, then 6 mg, and finally 12 mg. Dipyridamole potentiates the effects of adenosine, so it should be used with caution in patients who are taking it.

      The use of adenosine is contraindicated in the following situations:
      Asthma
      COPD (chronic obstructive pulmonary disease)
      Decompensated heart failure 
      Long QT syndrome
      AV block in the second or third degree
      Sinusitis is a condition in which the sinuses become (unless pacemaker fitted)
      Hypotension that is severe

      It has a half-life of less than 10 seconds and acts quickly within that time frame. The actions last between 10 and 20 seconds.
      Because of the short half-life of the drug, any side effects are usually only temporary. These are some of them:
      a feeling of impending doom
      Flushing of the face
      Dyspnoea
      Uncomfortable chest
      Tastes metallic

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
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  • Question 10 - Lidocaine's mechanism of action as a local aesthetic is as follows: ...

    Incorrect

    • Lidocaine's mechanism of action as a local aesthetic is as follows:

      Your Answer:

      Correct Answer: Blocks influx of Na+ through voltage-gated Na+ channels

      Explanation:

      Local anaesthetics prevent generation/conduction of nerve impulses by reducing sodium permeability and increasing action potential threshold; inhibits depolarization, which results in blockade of conduction

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
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  • Question 11 - A 32-old woman comes for a follow-up visit after being discharged on medications...

    Incorrect

    • A 32-old woman comes for a follow-up visit after being discharged on medications for her newly diagnosed epilepsy. She now complains of a tremor in her arm when she holds a tray in her hand. You examine the patient and notice she has developed postural tremors.

      Which of the following medications for epilepsy is most likely responsible for this tremor?

      Your Answer:

      Correct Answer: Sodium valproate

      Explanation:

      A postural tumour is observed when a person maintains a position against gravity, such as holding the arms outstretched. (The patient holding her tray against gravity)

      Sodium valproate is the most commonly prescribed medication for epilepsy. It is commonly associated with tremors as valproate-induced tremors occur in around 6-45% of patients. The tremors are commonly postural, but a resting tremor may also occur.

      Approximately 25% of patients taking sodium valproate are found to develop a tremor within 3-12 months of initiating therapy.

    • This question is part of the following fields:

      • CNS Pharmacology
      • Pharmacology
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  • Question 12 - A 23-year-old female has been prescribed a medication in the first trimester of...

    Incorrect

    • A 23-year-old female has been prescribed a medication in the first trimester of pregnancy due to a life-threatening medical problem. After delivery, the foetus is found to have nasal hypoplasia, stippling of his bones and atrophy of bilateral optic discs along with growth retardation.

      Which ONE of the following drugs has this woman most likely received?

      Your Answer:

      Correct Answer: Warfarin

      Explanation:

      Warfarin is teratogenic and can cause a host of abnormalities in the growing foetus. These include hypoplasia of the nasal bridge, stippling of the epiphyses, multiple ophthalmic complications, growth retardation, pectus carinatum, atrial septal defect, ventriculomegaly and a patent ductus arteriosus.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
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  • Question 13 - On ambulatory blood pressure monitoring, a 48-year-old Caucasian man has an average BP...

    Incorrect

    • On ambulatory blood pressure monitoring, a 48-year-old Caucasian man has an average BP reading of 152/96 mmHg (ABPM).

      Which of the following would be the patient's first-line drug treatment?

      Your Answer:

      Correct Answer: Ramipril

      Explanation:

      An ambulatory blood pressure reading of >150/95 is classified as stage 2 hypertension, according to the NICE care pathway for hypertension, and the patient should be treated with an antihypertensive drug.

      A calcium-channel blocker, such as amlodipine, would be the most appropriate medication for a 48-year-old Afro-Caribbean man.

      An ACE inhibitor, such as ramipril, or a low-cost angiotensin-II receptor blocker (ARB), such as losartan, would be the most appropriate medication for a 48-year-old Caucasian man.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
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  • Question 14 - Which of these drugs may reduce the efficacy of contraception? ...

    Incorrect

    • Which of these drugs may reduce the efficacy of contraception?

      Your Answer:

      Correct Answer: Carbamazepine

      Explanation:

      Antiepileptic medications such as carbamazepine (Tegretol), topiramate (Topamax), and phenytoin (Dilantin) are widely known for reducing the contraceptive effectiveness of OCPs.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
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  • Question 15 - A 10-year-old girl presents with polyuria, polydipsia, and stomach pain. She has a...

    Incorrect

    • A 10-year-old girl presents with polyuria, polydipsia, and stomach pain. She has a history of type I diabetes mellitus. On blood gas analysis, she has metabolic acidosis. Diabetic ketoacidosis (DKA) is diagnosed, and therapy is initiated. She becomes increasingly confused when intravenous fluids and insulin are administered.

      Which electrolyte imbalance is the MOST likely reason of the increased confusion

      Your Answer:

      Correct Answer: Hyponatraemia

      Explanation:

      Because of the shift of water from the intracellular to the extracellular compartment as a result of hyperglycaemia and increased plasma osmolality, dilutional hyponatraemia is common in diabetic ketoacidosis (DKA).

      If intravenous fluids are not delivered with caution, hyponatraemia might worsen, which can lead to increased degrees of disorientation. Hyponatraemia has also been linked to an increased risk of cerebral oedema, especially if blood glucose levels drop too quickly following treatment.

      Headache, recurrence of vomiting, irritability, Glasgow Coma Scale score, inappropriate heart rate slowing, and rising blood pressure are the most common causes of death in paediatric DKA, and children should be monitored for the symptoms mentioned above. To prevent this from developing,  s low osmolarity normalization, attention to glucose and salt levels, as well as hydration over 48 hours, is necessary. 

    • This question is part of the following fields:

      • Musculoskeletal Pharmacology
      • Pharmacology
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  • Question 16 - What is nimodipine used predominantly in the treatment of? ...

    Incorrect

    • What is nimodipine used predominantly in the treatment of?

      Your Answer:

      Correct Answer: Prevention and treatment of vascular spasm following subarachnoid haemorrhage

      Explanation:

      Nimodipine is a smooth muscle relaxant that is related to nifedipine, but the effects preferentially act on cerebral arteries. It is exclusively used for the prevention and treatment of vascular spasm after an aneurysmal subarachnoid haemorrhage.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
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  • Question 17 - 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 18 - In adult basic life support, chest compressions should be performed at which of...

    Incorrect

    • In adult basic life support, chest compressions should be performed at which of the following rates:

      Your Answer:

      Correct Answer: 100 - 120 per minute

      Explanation:

      Chest compressions should be performed at a rate of 100 – 120 per minute.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
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  • Question 19 - The primary mechanism of action of ketamine is: ...

    Incorrect

    • The primary mechanism of action of ketamine is:

      Your Answer:

      Correct Answer: N-methyl-D-aspartate (NMDA)-receptor antagonist

      Explanation:

      Ketamine is a non-competitive antagonist of the calcium-ion channel in the NMDA (N-methyl-D-aspartate) receptor. It further inhibits the NMDA-receptor by binding to its phencyclidine binding site. Ketamine also acts at other receptors as an opioid receptor agonist (analgesic effects), as an muscarinic anticholinergic receptor antagonist (antimuscarinic effects) and by blocking fast sodium channels (local anaesthetic effect).

      Overdose may lead to panic attacks and aggressive behaviour; rarely seizures, increased ICP, and cardiac arrest

      Very similar in chemical makeup to PCP (phencyclidine), but it is shorter acting and less toxic

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
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  • Question 20 - A 34-year-old male presents to the Emergency Department with the complaint of palpitations...

    Incorrect

    • A 34-year-old male presents to the Emergency Department with the complaint of palpitations and difficulty breathing, which started suddenly half an hour ago. His ECG shows findings of supraventricular tachycardia. You attempt vagal manoeuvres but cannot convert them back to sinus rhythm. Therefore, drug therapy is necessary to terminate the arrhythmia. Adenosine cannot be used in this patient because of a contra-indication listed in his medical record.

      Which one of the conditions listed below would be a contraindication in this case?

      Your Answer:

      Correct Answer: Asthma

      Explanation:

      Entonox is a mixture of 50% Oxygen and 50% nitrous oxide and is given in an inhaled form as a quick form of analgesia. Entonox causes non-competitive inhibition of NMDA (N-methyl-D-aspartate) receptors, which are a subtype of the glutamate receptor.

      It is stored in blue and white cylinders and administered via a pressure regulator and demand valve. The administration of this medicine reduces pain and anxiety in paediatric and dental procedures ands during labour.

      Effects are apparent after 20 seconds, and peak action occurs after 3 to 5 minutes as it is a drug with a rapid onset and the patient will also recover rapidly from its effects. Entonox is widely used as it does not accumulate in the body and does not cause many side effects. However, a notable side effect is the inhibition of Vitamin B12 synthesis.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
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  • Question 21 - Antispasmodic drugs are primarily indicated in which of the following conditions: ...

    Incorrect

    • Antispasmodic drugs are primarily indicated in which of the following conditions:

      Your Answer:

      Correct Answer: Irritable bowel syndrome

      Explanation:

      Antispasmodics, such as antimuscarinics, may be used in the management of irritable bowel syndrome. Other antispasmodics used include direct-acting smooth muscle relaxants such as mebeverine, alverine, and peppermint oil. Antispasmodics are contraindicated in bowel obstruction and severe inflammatory bowel disease. Antispasmodics are occasionally of value in treating abdominal cramp associated with diarrhoea but they should not be used for primary treatment. Antispasmodics should be avoided in young children with gastroenteritis because they are rarely effective and have troublesome side effects. Antimuscarinics are contraindicated in urinary retention.

    • This question is part of the following fields:

      • Gastrointestinal
      • Pharmacology
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  • Question 22 - Regarding co-amoxiclav, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding co-amoxiclav, which of the following statements is INCORRECT:

      Your Answer:

      Correct Answer: Clavulanic acid acts to inhibit cross-linking of bacterial peptidoglycan polymers.

      Explanation:

      Co-amoxiclav consists of amoxicillin with the beta-lactamase inhibitor clavulanic acid. Clavulanic acid itself has no significant antibacterial activity but, by inactivating beta-lactamases, it makes the combination active against beta-lactamase-producing bacteria that are resistant to amoxicillin.The most common adverse effects of co-amoxiclav include nausea, vomiting, skin rash and diarrhoea. Pseudomembranous colitis should be considered if a person develops severe diarrhoea during or after treatment with co-amoxiclav. Cholestatic jaundice can occur either during or shortly after the use of co-amoxiclav. An epidemiological study has shown that the risk of acute liver toxicity was about 6 times greater with co-amoxiclav than with amoxicillin. Cholestatic jaundice is more common in patients above the age of 65 years and in men; these reactions have only rarely been reported in children. Jaundice is usually self-limiting and very rarely fatal.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
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  • Question 23 - All of the following predisposes to lithium toxicity in patients taking long-term therapy...

    Incorrect

    • All of the following predisposes to lithium toxicity in patients taking long-term therapy EXCEPT:

      Your Answer:

      Correct Answer: Hypernatraemia

      Explanation:

      A common complication of long term lithium therapy results in most cases of lithium intoxication. It is caused by reduced excretion of the drug which can be due to several factors including deterioration of renal function, dehydration, hyponatraemia, infections, and co-administration of diuretics or NSAIDs or other drugs that may interact.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
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  • Question 24 - In which of the following cases is intravenous phenytoin contraindicated? ...

    Incorrect

    • In which of the following cases is intravenous phenytoin contraindicated?

      Your Answer:

      Correct Answer: Second degree heart block

      Explanation:

      Phenytoin Contraindications include:

      Hypersensitivity
      Sinus bradycardia
      Sinoatrial block
      Second and third degree A-V block
      Adams-Stokes syndrome
      Concurrent use with delavirdine
      History of prior acute hepatotoxicity attributable to phenytoin

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
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  • Question 25 - What is the appropriate dose of 1:1000 adrenaline solution for a 15-year-old patient...

    Incorrect

    • What is the appropriate dose of 1:1000 adrenaline solution for a 15-year-old patient with suspected anaphylactic shock?

      Your Answer:

      Correct Answer: 500 micrograms intramuscularly

      Explanation:

      1: 1000 Adrenaline solution dosage for children above the age of 12 and adults, including pregnant women (over 50 kg) is 0.50 mL, which is equivalent to 500 mcg of adrenaline.

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
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  • Question 26 - Co-amoxiclav is used first line for which of the following indications: ...

    Incorrect

    • Co-amoxiclav is used first line for which of the following indications:

      Your Answer:

      Correct Answer: Animal bite

      Explanation:

      Co-amoxiclav is used first line for infected and prophylaxis of infection in animal and human bites.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
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  • Question 27 - Which of the following statements is correct regarding the partial pressure of oxygen...

    Incorrect

    • Which of the following statements is correct regarding the partial pressure of oxygen during respiration?

      Your Answer:

      Correct Answer: Exhaled PO 2 > Alveolar PO 2

      Explanation:

      Because of humidification, inspired PO2 in the airways is less than inhaled PO2.
      Because of gas exchange, alveolar PO2 is less than inhaled or inspired PO2.
      Because of mixing with anatomical dead space (air that has not taken part in gas exchange, exhaled PO2 is greater than alveolar O2, and therefore that has relatively higher PO2 on the way out, but is less than inhaled or inspired PO2.
      Typical values for a resting young healthy male (in kPa) are shown below:
      -Inhaled air: PO221.2, PCO20.0
      -Inspired air in airways (after humidification): PO219.9, PCO20.0
      -Alveolar air (after equilibrium with pulmonary capillaries): PO213.3, PCO25.3
      -Exhaled air (after mixing with anatomical dead space air): PO215.5, PCO24.3

    • This question is part of the following fields:

      • Physiology
      • Respiratory
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  • Question 28 - Before a patient is discharged, you are asked to review them. He is...

    Incorrect

    • Before a patient is discharged, you are asked to review them. He is a 59-year-old man who was seen with epigastric pain that has since subsided, and he will be seen by his GP in the coming days. He's been hearing a lot about aspirin lately and wants to learn more about it.

      Which of the following statements about aspirin's mechanism of action is correct?

      Your Answer:

      Correct Answer: Inhibition of cyclo-oxygenase

      Explanation:

      Aspirin works by inhibiting cyclo-oxygenase in an irreversible manner, resulting in a decrease in prostaglandin and thromboxane production. As a result, platelet activation and aggregation are reduced.

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
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  • Question 29 - Which of the following is NOT a typical feature of lithium toxicity: ...

    Incorrect

    • Which of the following is NOT a typical feature of lithium toxicity:

      Your Answer:

      Correct Answer: Miosis

      Explanation:

      Features of toxicity include:
      Increasing gastrointestinal disturbances (vomiting, diarrhoea, anorexia)
      Visual disturbances
      Polyuria and incontinence
      Muscle weakness and tremor
      Tinnitus
      CNS disturbances (dizziness, confusion and drowsiness increasing to lack of coordination, restlessness, stupor)
      Abnormal reflexes and myoclonus
      Hypernatraemia
      With severe overdosage (serum-lithium concentration > 2 mmol/L) seizures, cardiac arrhythmias (including sinoatrial block, bradycardia and first-degree heart block), blood pressure changes, electrolyte imbalance, circulatory failure, renal failure, coma and sudden death may occur.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
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  • Question 30 - Which of the following best describes digoxin: ...

    Incorrect

    • Which of the following best describes digoxin:

      Your Answer:

      Correct Answer: A positive inotrope and negative chronotrope

      Explanation:

      Digoxin is a cardiac glycoside used in the treatment of atrial fibrillation and flutter, and congestive cardiac failure. It acts by inhibiting the membrane Na/K ATPase in cardiac myocytes. This raises intracellular sodium concentration and increases intracellular calcium availability indirectly via Na/Ca exchange. The increase in intracellular calcium levels causes an increases the force of myocardial contraction (positive inotrope), and slows the heart rate (negative chronotrope).

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds

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