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  • Question 1 - What is the main mechanism of action of dobutamine as an inotropic sympathomimetic:...

    Incorrect

    • What is the main mechanism of action of dobutamine as an inotropic sympathomimetic:

      Your Answer: Alpha1-receptor agonist

      Correct Answer: Beta1-receptor agonist

      Explanation:

      Dobutamine directly stimulates the beta1-adrenergic receptors in the heart and increases contractility and cardiac output with little effect on the rate. In addition action on beta2-receptors causes vasodilation.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      13.8
      Seconds

  • Question 2 - For which of the following infections is phenoxymethylpenicillin (penicillin V) primarily used? ...

    Incorrect

    • For which of the following infections is phenoxymethylpenicillin (penicillin V) primarily used?

      Your Answer: Infective endocarditis

      Correct Answer: Streptococcal tonsillitis

      Explanation:

      Phenoxymethylpenicillin (penicillin V) is less active than benzylpenicillin but both have similar antibacterial spectrum. Because penicillin V is gastric-acid stable, it is suitable for oral administration, but should not be used for serious infections as absorption can be unpredictable and plasma concentrations can be variable.
      Its uses are:
      1. mainly for respiratory tract infections in children
      2. for streptococcal tonsillitis
      3. for continuing treatment after one or more injections of benzylpenicillin when clinical response has begun.
      4. for prophylaxis against streptococcal infections following rheumatic fever and against pneumococcal infections following splenectomy or in sickle-cell disease.

      It should not be used for meningococcal or gonococcal infections.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      11.7
      Seconds

  • Question 3 - Which of the following best describes the therapeutic effect of calcium gluconate when used...

    Correct

    • Which of the following best describes the therapeutic effect of calcium gluconate when used in treatment for hyperkalaemia:

      Your Answer: Reduces cardiac cell membrane excitability

      Explanation:

      Calcium resonium is an ion-exchange resin that exchanges sodium for potassium as it passes through the intestine, leading to excretion of potassium from the body. Salbutamol and insulin act to increase intracellular uptake of K+ via Na-K ATP pump. Sodium bicarbonate acts to correct acidosis and thus promotes intracellular uptake of K+. Calcium gluconate acts to protect the cardiac membrane and has no effect on serum K+ levels.

    • This question is part of the following fields:

      • Fluids And Electrolytes
      • Pharmacology
      22
      Seconds

  • Question 4 - Regarding antacids, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding antacids, which of the following statements is CORRECT:

      Your Answer: Antacids are first line for treatment of peptic ulcer disease.

      Correct Answer: Antacids should not be taken at the same time as other drugs as they impair absorption.

      Explanation:

      Antacids should preferably not be taken at the same time as other drugs since they may impair absorption. Antacids act by neutralising stomach acid. They are used for symptomatic relief in dyspepsia, but are not first line for proven peptic ulcer disease where antisecretory drugs have a better healing effect. Magnesium-containing antacids tend to be laxative whereas aluminium-containing antacids tend to be constipating. Antacids are contraindicated in hypophosphataemia.

    • This question is part of the following fields:

      • Gastrointestinal
      • Pharmacology
      94.1
      Seconds

  • Question 5 - A 4-year-old girl is rushed to the Emergency Department by her grandparents after...

    Incorrect

    • A 4-year-old girl is rushed to the Emergency Department by her grandparents after swallowing some of her grandfather's Warfarin tablets. On further questioning, it turns out that she took 5 of his 3 mg tablets which he needs to take due to a history of atrial fibrillation. The child appears healthy well-oriented in time, place and person, and has normal vitals.

      What is the threshold dose of Warfarin that needs to be ingested for there to be a risk of anticoagulation?

      Your Answer: 0.05 mg/kg

      Correct Answer: 0.5 mg/kg

      Explanation:

      The clinical effects of Warfarin occur after a dose of greater than 0.5 mg/kg, and they will be observable 8-10 hours after consumption of the drug. The antidote used for Warfarin is Vitamin K.

      1. In low-risk cases with no apparent bleeding:
      an oral dose of 10 mg vitamin K

      2. If there is clinically significant bleeding
      an intravenous dose of 250-300 mcg/kg

      Activated charcoal:
      in cases of warfarin ingestion
      binds to it and reduces the absorption of warfarin
      the ingestion must have occurred within the last hour
      There is, however, rarely a need for the use of activated charcoal because vitamin K is such as safe and effective antidote.

      Clotting studies, including an INR, can be performed, but small children who have ingested warfarin do not require INRs or follow up if they have been treated with 10 mg vitamin K. This dose of vitamin will completely reverse the anticoagulative effects of warfarin.

      Perform INR if any of the following are present:
      1. Delayed presentation (>6 hours)
      2. Patients with symptoms or signs of anticoagulation
      3. Possible massive ingestion

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      94.7
      Seconds

  • Question 6 - ACE inhibitors are indicated for all of the following EXCEPT for: ...

    Incorrect

    • ACE inhibitors are indicated for all of the following EXCEPT for:

      Your Answer: Diabetic nephropathy

      Correct Answer: Angina

      Explanation:

      ACE inhibitors have many uses and are generally well tolerated. They are indicated for:

      • Heart failure
      • Hypertension
      • Diabetic nephropathy
      • Secondary prevention of cardiovascular events

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      17
      Seconds

  • Question 7 - Approximately how long is the duration of a lidocaine block (when given with...

    Correct

    • Approximately how long is the duration of a lidocaine block (when given with adrenaline):

      Your Answer: 90 minutes

      Explanation:

      Lidocaine is a tertiary amine that is primarily used as a local anaesthetic but can also be used intravenously in the treatment of ventricular dysrhythmias.
      Lidocaine works as a local anaesthetic by diffusing in its uncharged base form through neural sheaths and the axonal membrane to the internal surface of the cell membrane sodium channels. Here it alters signal conduction by blocking the fast voltage-gated sodium channels. With sufficient blockage, the membrane of the postsynaptic neuron will not depolarise and will be unable to transmit an action potential, thereby preventing the transmission of pain signals.
      Each 1 ml of plain 1% lidocaine solution contains 10 mg of lidocaine hydrochloride. The maximum safe dose of plain lidocaine is 3 mg/kg. When administered with adrenaline 1:200,000, the maximum safe dose is 7 mg/kg. Because of the risk of vasoconstriction and tissue necrosis, lidocaine should not be used in combination with adrenaline in extremities such as fingers, toes, and the nose.
      The half-life of lidocaine is 1.5-2 hours. Its onset of action is rapid within a few minutes, and it has a duration of action of 30-60 minutes when used alone. Its duration of action is prolonged by co-administration with adrenaline (about 90 minutes).
      Lidocaine tends to cause vasodilatation when used locally. This is believed to be due mainly to the inhibition of action potentials via sodium channel blocking in vasoconstrictor sympathetic nerves.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      8.8
      Seconds

  • Question 8 - Which of these drugs may reduce the efficacy of contraception? ...

    Correct

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

      Your 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
      8.2
      Seconds

  • Question 9 - Thiopental sodium is contraindicated in which of the following: ...

    Correct

    • Thiopental sodium is contraindicated in which of the following:

      Your Answer: Acute intermittent porphyrias

      Explanation:

      Barbiturates induce hepatic enzymes. The enzyme gamma aminolevulinic acid synthetase, which produces porphyrins, can be induced and in susceptible patients an attack of acute intermittent porphyria can occur. Thiopental is absolutely contraindicated in these patients.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      20.6
      Seconds

  • Question 10 - Which of the following is NOT a common effect of etomidate: ...

    Correct

    • Which of the following is NOT a common effect of etomidate:

      Your Answer: Significant hypotension

      Explanation:

      Etomidate causes less hypotension than thiopental sodium and propofol during induction. However, it 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. Pain on injection is common and there is a high rate of thrombophlebitis in the postoperative period. Postoperative nausea and vomiting commonly occur. Etomidate suppresses adrenocortical function, particularly during continuous administration, and it should not be used for maintenance of anaesthesia. It should be used with caution in patients with underlying adrenal insufficiency, for example, those with sepsis.

    • This question is part of the following fields:

      • Anaesthesia
      • Pharmacology
      21.2
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiovascular (0/2) 0%
Pharmacology (5/10) 50%
Infections (0/1) 0%
Fluids And Electrolytes (1/1) 100%
Gastrointestinal (0/1) 0%
Cardiovascular Pharmacology (0/1) 0%
Anaesthesia (3/3) 100%
Central Nervous System (1/1) 100%
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