Block 18B past paper

Question 1

Match the drug to the side effect
Salbutamol
Beclomethasone
Ipratropium
Ketotifen
Theophylline

Answer 1

Salbutamol - palpitations
Beclomethasone - oral thrush
Ipratropium - constipation
Ketotifen - drowsiness
Theophylline - insomnia

Question 2

ACE-I does not have which side effect?

Answer 2

Hypokalemia

Question 3

2 drug combination that you would give to a patient with BP 180/120 type I diabetic

Answer 3

ACE I (enalapril) and diuretic (hydrochlorothiazide)

Question 4

Name the drug class of the following drugs
Nifedipine
Doxazosin
Alpha methyldopa
Propranolol
Guanethidine

Answer 4

Nifedipine - CCB
Doxazosin - alpha 1 blocker
Alpha methyldopa - alpha 2 agonist
Propranolol - beta blocker
Guanethidine - ganglion blocker

Question 5

What is not a defensive factor in the pathogenesis of PUD?

Answer 5

Does not increase in H+ ion production

Question 6

What is the MOA of tetracycline

Answer 6

Inhibits bacterial protein synthesis at 305 subunit

Question 7

What is the MOA of cotrimoxazole

Answer 7

Interferes with bacterial folate synthesis

Question 8

What is the MOA of erythromycin

Answer 8

Inhibits bacterial protein synthesis at 505 subunit

Question 9

What is the MOA of amoxicillin

Answer 9

Intereferes with cross-linking of peptidoglycans

Question 10

What is the MOA of ciprofloxacin

Answer 10

Inhibits DNA gyrase + topoisomerase

Question 11

Which drug class eradicates H pylori?

Answer 11

AB therapy

PPI

Question 12

Which drug class reduces secretion of gastric acid?

Answer 12

PPI

H2 receptor antagonists

Question 13

Which drug class provides agents that protect the gastric mucosa

Answer 13

Misoprostol

Sucralfate, alginates, bismuth

Question 14

Which drug class neutralizes gastric acid?

Answer 14

Non-absorbable antacids

Question 15

What are causative factors in the pathogenesis of PUD?

Answer 15

NSAIDS
Infection with Helicobacter pylori
Increased hydrochloric acid secretion
Inadequate mucosal defence against gastric acid

Question 16

What are the principles of management in PUD?

Answer 16

Symptomatic relief
Promoting of ulcer healing
Prevention of recurrence once healing has occurred
Prevention of complications

Question 17

Peptic ulcers can appear and disappear spontaneously

True or false?

Answer 17

True

Question 18

What are the long term effects of ACE-inhibitors?

Answer 18

Cough (15% of patients. Is reversible) -> suggests intolerance of whole group
Taste disturbance (reversible)
Angiodema
First-dose hypotension
Hyperkalaemia (esp. in patients with type II DM and renal dysfunction)

Question 19

Function and dosage off hydrochlorothiazide?

Answer 19

Can lower the dose and still have a effect (12.5mg - 25mg)
Vasodilator
Diuretic

Question 20

Side effects of hydrochlorothiazide?

Answer 20

Hypokalemia
Hyperuricemia
Hyperlipidaemia
Hyperglycemia

Question 21

Treatment of allergic rhinitis?

Answer 21

1st line = intranasal corticosteroids

Other: oral corticosteroids, antihistamines, decongestants e.g pseudoephidrine

Question 22

Why do intranasal corticosteroids have a delayed effect?

Answer 22

DNA changes

Question 23

What are mediators of rhinitis symptoms?

Answer 23

Histamine
Destabilised mast cells
TNF
Leukotrienes
Cytokines

Question 24

Side effects of new generation antihistamines?

Answer 24

Sedation
Raised IOP
Prostate hypertrophy

Question 25

Types of rhinitis?

Answer 25

Allergic Vasomotor Infective

Question 26

What is the allergic reaction incidence in penicillin?

Answer 26

High

Question 27

Pharmacological treatment of anaphylaxis and mechanism of action

Answer 27

Adrenaline Adrenocorticosteroids Antihistamine Aminophylline Decrease bronchoconstriction Increase BP Stop angioedema Reverse bradycardia

Question 28

What do you use when penicillin or cephalosporins cannot be used?

Answer 28

Macrolides e.g clarithromycin

Question 29

Most common UTI pathogen?

Answer 29

E.coli

Question 30

Treatment of e.coli infection?

Answer 30

1st line: co-trimoxazole Ciprofloxacin Ceftriaxone

Question 31

Which drug inhibits the liver metabolism of warfarin?

Answer 31

Ciprofloxacin

Question 32

Side effect of tetracyline use in children?

Answer 32

Teeth discolouration

Question 33

H. pylori is responsible for what percentage of ulcers?

Answer 33

70% gastric | 90% duodenal

Question 34

Aliminium salt antacids have what side effect?

Answer 34

Constipation

Question 35

Mechanism of action of penicillin?

Answer 35

Attacks cell wall

Question 36

Mechanism of action of macrolides?

Answer 36

Ribosomal inhibitors

Question 37

Atypical pathogens in community acquire pneumonia

Answer 37

Chlamydia pneumonia Mycoplasma pneumoniae Legionella spp

Question 38

Treatment of CAP?

Answer 38

Macrolides

Question 39

Which drug do you not use in asthma?

Answer 39

Atenolol (beta 1 blocker) | Will cause bronchospasm

Question 40

What is the mainstay of asthma treatment?

Answer 40

Corticosteroids

Question 41

Common side effects of inhaled corticosteroids?

Answer 41

Oral thrush | Dysphonia (hoarseness)

Question 42

Side effect of theophylline?

Answer 42

Insomnia

Question 43

Side effect of bismuth?

Answer 43

Black mouth

Question 44

Side effect of magnesium hydroxide?

Answer 44

Diarrhoea

Question 45

What is the mechanism of action of nitrofurantoin?

Answer 45

Inhibits ribosomal proteins and other macromolecules to interfere with metabolism and cell wall synthesis

Question 46

Sucralfate only reacts in a basic environment | True or false?

Answer 46

False

Question 47

Alginates are safe in pregnancy | True or false?

Answer 47

True

Question 48

Prostaglandins (e.g. misoprostol) cannot be given to pregnant people True or false?

Answer 48

True

Question 49

Which drug class can cause nasal congestion?

Answer 49

Alpha blockers

Question 50

Histamine is the only mediator of inflammation | True or false?

Answer 50

False

Question 51

H. pylori is a spirochete | True or false

Answer 51

False

Question 52

Characteristics of PUD

Answer 52

Occurs after eating or at night, Worsens when a person lies down or bends over. Is common in pregnant women May be triggered by consuming food in large quantities, or specific foods containing certain spices, high fat content, or high acid content

Question 53

Danger signs in PUD?

Answer 53

Dysphagia Weight loss Haematemesis

Question 54

In PUD, dyspepsia combined with what is a danger sign?

Answer 54

Family history | Palpable virchow's nodes

Question 55

Gastric acid secretion by parietal cells is stimulated by?

Answer 55

Acetylcholine Histamine Gastrin

Question 56

The presence of bile in vomit does not indicate heartburn | True or false

Answer 56

True

Question 57

Omeprazole inhibits which enzyme?

Answer 57

CYP450

Question 58

Side effect of prolonged omeprazole use?

Answer 58

Low vitamin B12

Question 59

Side effects of PPIs

Answer 59

Hypomagnesemia Facture risk Diarrhoea (c. difficile)

Question 60

Cimetidine affects which enzyme?

Answer 60

CYP450

Question 61

What are H2 histamine receptor blockers best for?

Answer 61

Good for nocturnal acid secretion

Question 62

PPI vs H2 histamine receptor blockers?

Answer 62

PPI - irreversible | H2 - reversible

Question 63

When does bismuth subcitrate precipitate?

Answer 63

Acidic pH

Question 64

Side effect of calcium antacids?

Answer 64

Rebound acid hypersecretion