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Question 1
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Which of the following medications, when given before & during pregnancy may help to protect neural tube defects?
Your Answer: Folic acid
Explanation:Maternal exposure to dietary factors during pregnancy can influence embryonic development and may modulate the phenotype of offspring through epigenetic programming. Folate is critical for nucleotide synthesis, and preconceptional intake of dietary folic acid (FA) is credited with reduced incidences of neural tube defects in infants.
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This question is part of the following fields:
- Pharmacology
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Question 2
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Tamoxifen is associated with an increased risk of which of the following?
Your Answer: Endometrial cancer
Explanation:Tamoxifen is an oestrogen antagonist in breast tissue but it acts as a partial oestrogen agonist on the endometrium increasing the risk of hyperplasia and has been linked to endometrial cancer. Tamoxifen improves bone density in post-menopausal women. It is an off license treatment for gynaecomastia. Reduced lactation is a potential side effect of Tamoxifen.
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This question is part of the following fields:
- Pharmacology
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Question 3
Correct
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Tamoxifen is associated with an increased risk of which of the following?
Your 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.
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This question is part of the following fields:
- Pharmacology
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Question 4
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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: 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.
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This question is part of the following fields:
- Pharmacology
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Question 5
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What is the target INR in a patient who has just been started on warfarin therapy due to a pulmonary embolism?
Your 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.
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This question is part of the following fields:
- Pharmacology
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Question 6
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You are called to review a baby with cyanosis when feeding immediately after birth. Subsequent investigation and imaging reveals choanal atresia. Upon questioning the mother reveals she had been getting repeat prescriptions from her GP in Poland without her UK GPs' or your knowledge. Which of the following medication was most likely to cause this?
Your Answer: Carbimazole
Explanation:This is one of the defects attributable to Carbimazole use.
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This question is part of the following fields:
- Pharmacology
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Question 7
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Question 8
Correct
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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.
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This question is part of the following fields:
- Pharmacology
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Question 9
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The following drugs cross the placenta to the foetus, EXCEPT:
Your 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.
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This question is part of the following fields:
- Pharmacology
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Question 10
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An 26 year old patient currently 9 weeks pregnant. This is her 1st pregnancy. She has been suffering with nausea and vomiting that has failed to respond to conservative measures including ginger, dietary changes and acupuncture. She wants to start medical therapy. Which of the following is 1st line drug treatment according to NICE guidance?
Your Answer: Promethazine
Explanation:Promethazine or Cyclizine are 1st choice options for management of nausea and vomiting in pregnancy according to NICE. Prochlorperazine is also appropriate 1st line.
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This question is part of the following fields:
- Pharmacology
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