Deck 4

Question 1

Post-cardiac arrest - what clinical features is poor neurologic outcome?

Answer 1

Fever

Question 2

Side effect of liraglutide (GLP1 agonist)?

Answer 2

Tachycardia

Cholelithiasis

Question 3

What test differentiate VITT and HIT?

Answer 3

Platelet functional assay - it will be positive in HIT

Question 4

Leucoplakia is precursor to what cancer?

Answer 4

Tongue SCC

Question 5

What is causing aorta aneurysm and mycotic aneurysm these days?

Answer 5

Staphylococcus

Salmonella

Question 6

Side effects of
Imantinib?
Dasatinib?
Nilotinib?
Ponatinib?

Answer 6

Imantinib - Fluid retention/GI side effects

Dasatinib - pericardial, pleural effusion

Nilotinib - pulmonary hypertension

Ponatinib - Stroke/MI, vascular events

Question 7

Most cardioselective (B1) beta-blockers is ?

Answer 7

Nebivolol - has NO effect - vasodilatation

Question 8

Coccaine overdose - marker of severe toxicity? and treatment?

Answer 8

marker of toxicity - Hyperthermia!

Tx = Benzodiazepines

Question 9

Warfarin has 2 isomers
R - warfarin metabolised by CYP what?
S - warfarin metabolised by CYP what?

Which is more potent?

Answer 9

R -warfarin = CYP3A4

S- warfarin = CYP2C9

CYP2C9 is more potent to affect warfarin

Question 10

Risperidone (2nd generation anti-psychotics) inhibit what?

Answer 10

inhibit D2 and nearby 5HT2A serotonin receptors

Question 11

In obesity - can glomerular filtration be increased?

Answer 11

Yes hence renal clearance of drug is increased

Question 12

Which organ affected most by ageing?

Answer 12

Kidney

• more sensitive to CNS medications - need to reduce dose
• less sensitive to diuretics - need to increase dose

Question 13

Why Linezolid antibiotics cannot be use with SSRI?

Answer 13

Linezolid increases serotonin availability bcoz it inhibits MAO-A

Question 14

Why give Alcohol in ethylene glycol intoxication?

Keep serum alcohol concentration above?

Answer 14

Alcohol dehydrogenase will oxidise ethylene to oxalate acid and be excreted in the urine as oxalate crystals (toxic)

Give lots of alcohol to keep alcohol dehydrogenase preoccupied with metabolism alcohol and leaving ethylene glycol alone

Get rid of ethylene glycol via HD

Alcohol > 100 mg/dL

Question 15

In methylene/ethylene glycol intoxication - given alcohol but not working

Answer 15

Fomepizole - inhibit alcohol dehydrogenase enzyme so delay metabolism of ethylene glycol

Question 16

What formula use for renal dose adjustment? ( obtain CrcL)

Answer 16

ONLY Cockcroft-Fault formula!

Question 17

What is allosteric site?

Answer 17

Non-active site (on ENZYME) which if molecule binds to it causes conformational changes - so usual substrate can’t bind

Question 18

Name one special macrolides that is not CYP3A4 inhibitor?

Answer 18

Azithromycin - safe in pregnancy

Question 19

Benefit of metabolic acidosis?

Answer 19

Ionised calcium - increased contractility

Acidosis - Hb-O2 dissociation curve to right - facilitate O2 uptake by cells

Vasodilatation

Question 20

How gram negative build resistance against linezolid?

Answer 20

Efflux pump

Question 21

How is Daptomycin inhibited?

Answer 21

Surfactant - not good in pneumonia

Question 22

Pasireotide use in what form of cushing?

Answer 22

Cushing Disease ( Pituitary)
-Somatostatin analogue = inhibit PTH/ all hormones

Question 23

Metyrapone mechanism of action?

Answer 23

Inhibit 11b hydroxylase = so no cortisol production

Question 24

Mifepristone mechanism of action?

Answer 24

Glucocorticoid receptor antagonist

Question 25

Acute diarrhea by irinotecan - drug?

Answer 25

Atrophine

If later stages then usual loperamide