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mrcp 1 > clinical pharma/toxicol > Flashcards

clinical pharma/toxicol Flashcards

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1
Q

Poor pupillary responses bilaterally, macular oedema, low GCS, raised anion gap metabolic acidosis?

A

Methanol poisoning

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2
Q

Causes of urticaria?

A

aspirin
penicillins
NSAIDs
opiates

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3
Q

Which receptor does Herceptin work on?

A

HER2

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4
Q

Letrozole and tamoxifen work on which hormone?

A

Oestrogen +ve

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5
Q

Partial agonist of the mu-opioid receptor and an antagonist of the kappa-opioid receptor?

A

Buprenorphine

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6
Q

History of suicide attempts presenting with metabolic acidosis characterised by an elevated anion gap and a high lactate level? Normal vitals and vision.

A

Ethylene glycol

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7
Q

PC BRAS

Enzyme induction?

Induction reduces INR

A

Phenytoin, carbamaz, barbs, rifampicin, alcohol XS, sulphonylureas (diabetic -zide drugs)

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8
Q

AODEVICES

Enzyme inhibition?

A

Allopurinol, omeprazole, disulfiram, erythromycin, valproate, isonazid, cipro, cimetidine, ethanol intox, sulphonamides

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9
Q

Anti TNF antibody?

A

Infliximab

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10
Q

Anti CD20 antibody?

A

Rituximab

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11
Q

EGFR antagonist?

A

Cetuximab

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12
Q

Widened QRS or arrhythmia in drug overdose - dx and rx?

A

IV bicarb for TCA overdose

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13
Q

Immunosuppresant inhibiting calcineurin thus decreasing IL-2?

A

Ciclosporin

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14
Q

Sodium channel blocker? Also known as pill in the pocket?

A

Flecanide

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15
Q

COCP - increases risk of which cancers and decreases risk of which cancers?

A

Increased - breast and cervical, Decreased - endometrial and ovarian

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16
Q

Urinalysis with ‘muddy brown casts’?

A

Acute tubular necrosis

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17
Q

TB drugs - side effects?

A

Rifampicin - orange urine
Isonazid - peripheral neuropathy
Pyrazinamide - hepatotoxicity and hyperuricemia
Ethambutol - optic neuritis

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18
Q

Visual field defects, hearing loss and paraesthesia? What type of poisoning?

A

Mercury

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19
Q

How long to wait before increasing metformin dose?

A

Leave at least 1 week before increasing dose

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20
Q

Drug used to induce remission in first presentation of Crohns?

A

Prednisolone

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21
Q

Cherry pink skin colour, drowsiness, hypervent, hypotension?

A

Carbon monoxide poisoning

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22
Q

Is nitro safe during pregnancy for UTI?

A

Yes

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23
Q

Palpitations on digoxin?

A

Premature ventricular beats - toxicity

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24
Q

Signs of ACS - anticholinergic syndrome?

A

Flushing, dry skin and mucus membranes

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25
After starting statin, should LFTs and lipid profiles be checked 1M later or 3M later?
3 months
26
Hyper or hypothyroidism due to amiodarone?
Hyperthyroidism
27
MDMA (Ecstasy) poisoning is associated with what abnormality?
Hyponatraemia
28
Mercury poisoning can cause which abnormalities?
Paraesthesia visual field defects hearing loss
29
Macular oedema, poor pupillary responses, and raised anion gap acidosis?
Methanol
30
Flecainide mechanism?
Blocks sodium channels -
31
Buprenorphine mechanism?
Partial agonist of the mu-opioid receptor and an antagonist of the kappa-opioid receptor
32
Levothyroxine works on which receptors?
Nuclear receptors
33
How does NAC help in overdose?
N-acetylcysteine is a precursor of glutathione - this joins with active metabolite to create non toxic substance
34
What happens in heparin-induced thrombocytopaenia?
Antibodies form against complexes of platelet factor 4 (PF4) and heparin
35
MI secondary to cocaine use?
Patients with MI secondary to cocaine use should be given IV benzodiazepines as part of acute (ACS) treatment
36
Medications for motion sickness (in order of efficacy)?
Hyoscine > cyclizine > promethazine
37
ER negative and HER-2 positive breast cancer?
Trastuzumab (Herceptin)
38
ER-positive early-stage breast cancer?
Aromatase inhibitor - decreases peripheral oestrogen synthesis
39
Most useful prognostic marker in paracet OD?
Elevated prothrombin time
40
Direct Xa inhibitors?
DOACs - except dabig
41
Direct thrombin inhibitor?
Dabig
42
Clotting factor inhibitor?
Warfarin
43
Inhibits the formation of thromboxane A2?
Aspirin
44
Inhibits factor Xa but does so via activation of antithrombin III?
LMWH
45
Kidney injury caused by gent?
ATN
46
What is the most important investigation to perform prior to initiating Herceptin?
ECHO - cardiac toxicity
47
Phenylephrine?
Alpha 1 agonist
48
Dobutamine?
Beta 1 agonist
49
Salbutamol?
Beta 2 agonist
50
Clonidine?
Alpha 2 agonist
51
Cyanide poisoning rx?
Hydroxocobalamin
52
Indication for haemodialysis in salicylate OD?
Serum concentration > 700mg/L
53
Which drug not cleared by dialysis?
Amitrip
54
Ciclosporin monitoring?
Level just before next dose
54
Acetazolamide?
Carbonic anhydrase inhibitor
55
Brimonidine?
Alpha 2 agonist
56
Latanoprost?
Prostaglandin analogue
57
Timolol?
Beta antagonist
58
Pilocarpine?
Musc agonist
59
Does adrenaline increase or decrease lactate production?
Increase
60
Mechanism of abciximab?
Glycoprotein IIb/IIIa receptor antagonist
61
Accumulation of acetylcholine sx?
Salivation, Lacrimation, Urination, Diarrhoea
62
Indication for haemodialysis in lithium toxicity?
Conc > 2
63
Severe serotonin syndrome treatment?
Cyproheptadine
64
Electrolyte imbalance in hypomag?
QT prolongation
65
Amiloride mechanism?
Blocks the epithelial sodium channel in the distal convoluted tubule
66
Tamsulosin mechanism?
Alpha 1a antagonist
67
Amiodarone-induced thyrotoxicosis (AIT) may be divided into two types - AIT 1 + AIT2?
AIT1 - no thyroiditis, goitre, carbimazole or potassium perchlorate AIT2 - thyroiditis, no goitre, steroids
68
Describe drug metabolism phases?
phase I: oxidation, reduction, hydrolysis phase II: conjugation
69
Mixed respiratory alkalosis and metabolic acidosis in a sweaty, confused patient?
Salicylate poisoning - aspirin
70
Beta-blocker overdose management?
Atropine + glucagon
71
Inhibition of 50S/30S subunit?
50S - macrolides i.e. clary 30S - tetracyclines i.e. doxy
72
Organophosphate insecticide antidote?
Atropine
73
Quinolones (e.g. ciprofloxacin) mechanism?
Inhibits DNA synthesis
74
Paracetamol overdose mechanism?
Occurs when glutathione stores run-out leading to an increase in NAPQI (N-acetyl-p-benzoquinone imine)
75
What normally happens to blood pressure during pregnancy?
Falls in first half of pregnancy before rising to pre-pregnancy levels before term.
76
Tests for Addisons and Cushings?
Addisons - ACTH stim Cushings - dexa suppression
77
Which abx can cause pancytopenia?
Trimethoprim
78

mrcp 1 (18 decks)

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