Finals Pharmacology

Question 0

Acute cellulitis of leg. What bacteria to treat

Answer 0

Hemolytic streptococcus

Question 1

Most serious toxicity work sodium valproate

Answer 1

Hepatic toxicity (necrotic Process)

Can cause thrombocytopenia

Question 2

Antibiotic responsible for warfarin interaction

Answer 2

Ciprofloxacin

Question 3

Anticonvulsant drug with least teratogenic risk

Answer 3

Lamotrigine
(Carbamazepine is in middle, valproate is the worse)

Absolute risk is only 4-5%

Question 4

Most likely adverse of verapamil at therapeutic dose

Answer 4

Constipation

Question 5

Which antipsychotic most likely to cause extraoyramidal effects

Answer 5

Flupentixol (first generation)

Atypical cause less

Question 6

Which is most likely adverse event of leukotriene antagonists

Answer 6

Effective in one third
Step 4
Once a day
One bad adverse event (church Strauss (eosinophilic vasculitis which can be fatal)

Right answer: used in exercise or cold induced asthma

Question 7

If patient presented with af within 6 hours

Answer 7

Then do DC cardioversion as best initial option

Question 8

Cancer patient prescribed morphine. What other treatment would you give

Answer 8

Antiemetic: hyoscine (not useful in this case,)
Laxative: co-danthramer

Question 9

Cancer chemo that causes severe hair loss and hemorrahgic cystitis

Answer 9

Cyclophosphamide

Question 10

Patient with hypertension and heart failure develop a increased breathlessness after adding one of these drugs

Answer 10

Verapamil (because inotrope negative (and kronotrope negative)

Question 11

Most likely adverse effect of ciclosporin

Answer 11

Hypertension

Question 12

75 year old recovers from cdiff. What to give her again?

Answer 12

Metronidazole 2 weeks

Question 13

80 y old patient drowsy with lOw potassium sodium and high urea. Most likely cause

Answer 13

Excessive treatment with loop diuretics

Question 14

Alcoholic:///confusion ataxia macrocytosis

Answer 14

Give thiamine

Question 15

Regarding copd

Answer 15

Long term oxygen therapy is indicated in presence of pulmonary hypertension

Recently: inhaled steroids no significant place in therapy

Question 16

Side effects of low Molecular weight heparin

Answer 16

Thrombocytopenia

Osteoporosis

Question 17

Most effective on Post prandial hyperglycemia

Answer 17

Acarbose

Question 18

Treatment of very high triglycerides (biggest risk can cause acute pancreatitis)

Answer 18

Fenofibrate

Question 19

In diabetic ketoacidosis

Answer 19

Blood glucose should be reduced to 10 mol/l within 24 hours
Iv bicarb avoided
Prophylactic antibiotics not given
Total boys potassium is depleted
Total fluid deficit is much higher than 3 litre

Question 20

Diarrhea as a side effect of

Answer 20

Misoprostol (synthetic prostaglandin analogue)

Question 21

Potentially dangerous combination with sildenafil causing hypotension

Answer 21

Isosorbide mononitrate

Question 22

Dangerous combination of fluoxetine with which of the drugs

Answer 22

Phenelzine (imao serotonin syndrome)

Question 23

Which antifungal drug inhibitor of cyp450

Answer 23

Ketoconazole

Question 24

Phase 2 Metabolic reaction

Answer 24

Glucuronidation Phase 2 are adding molecules too small molecules Phase 1: deanination, hydrolysis, reduxrion

Question 25

Hepatic drug metabolism in babies

Answer 25

Similar to adults

Question 26

In old

Answer 26

Glomerular filtration rate lower than at age of 20

Question 27

Initial treatment of generalised tonic clinic seizure it's

Answer 27

Diazepam

Question 28

Adverse effect of carvimazole

Answer 28

Neutropenia

Question 29

Know type I diabetes found unconscious | What to give without knowing anything Else

Answer 29

50 ml glucose 20% solution via rapid intravenous injection

Question 30

Most likely to cause ventricular dysrythmias in overdose

Answer 30

Imipramine (tricyclics)

Question 31

Most likely to cause significant hypoglycemia

Answer 31

Gliclazide

Question 32

First line treatment in immunocompromierd pneumocystis

Answer 32

Co-trimoxazole

Question 33

52 year old with t2m Normal renal function with proteinuria What antihypertensive to give

Answer 33

Acei | Arb

Question 34

How long to wait before starting enoxaparin after acute stroke

Answer 34

2 months

Question 35

Diclofenac and warfarin interaction

Answer 35

Increased activity of warfarin because diclofena displace warfarin from plasma protein. Other interaction is that Diclofenac has antiplatelet action that will increase of bleeding with warfarin

Question 36

Beta blocker and calcium channel blocker

Answer 36

To avoid because of risk of hypotension...bradycardia

Question 37

If vancomycin given too fast

Answer 37

Red man syndrome

Question 38

Iatrogenic causes of gout

Answer 38

Thiazide Cytotoxic drugs Pyrazinamide

Question 39

Hyoscine

Answer 39

Antiemetic Anticholinergic / antimuscarinic Causes constipation

Question 40

NSAIDs in head traum

Answer 40

Can cause cerebral edema

Question 41

Combination of acyclovir and lisinopril

Answer 41

Can cause aki

Question 42

If alki, what drugs to withheld

Answer 42

Some gliptins and metformin.

Question 43

Symptoms of lithium toxicity

Answer 43

``` Ataxia Dysarthria Tremor Muscle twitching ... ```

Question 44

Diclofenac and lithium?

Answer 44

Increased lithium toxicity because Diclofenac reduce renal clearance of lithium Frusemide Non steroids

Question 45

Gliclazide problem

Answer 45

Weight gain because increase insulin secretion Gliptins don't increase weight Pioglitazone

Question 46

What biochemical test to look for when assessing paracetamol toxicity

Answer 46

Clotting: pt, inr

Question 47

Digitoxin

Answer 47

Cardiac glycoside used in renal impairment (contrary to digoxin)

Question 48

Drug used to treat bradycardia caused by increased vagal tone

Answer 48

Atropine

Question 49

Drug used to terminate Svt and should be used with caution in asthma

Answer 49

Adenosine

Question 50

High dose loop diuretcs like frusemide

Answer 50

Hearing loss | Inner ear...

Question 51

ccb and beta blockers

Answer 51

To avoid because of risk of bradycardia (even syndrome) and hypotension

Question 52

Enoxaparin and warfarin

Answer 52

If INR > 2, then stop heparin

Question 53

If bradycardua (slow af) and digoxin

Answer 53

Stop digoxin

Question 54

Howe to calculate prn dose of morphine sulfate

Answer 54

Usually calculated as one sixth of the total daily dose

Question 55

In acute mi, regarding GTN

Answer 55

Try sublingual spray before infusion

Question 56

Alcohol and warfarin

Answer 56

Acute alcohol intoxication: enzyme inhibition | Chronic excess: enzyme induction

Question 57

1 % solution

Answer 57

= 1 g / 100 ml

Question 58

What time to give acei

Answer 58

Night because risk of orthostatic hypotension

Question 59

First treatment for New onset af (more than 48 hours)

Answer 59

Ccb or beta blockers before considering digoxin

Question 60

Treatment for diabetes type 2 in bmi 18 and creatinine more than 150

Answer 60

Don't give metformin | Gliclazide

Question 61

Vancomycin: ae and precautions

Answer 61

Ototox Nephrotox So check creatinine before starting to adjust dose

Question 62

What to do before starting statins

Answer 62

Check serum ALT

Question 63

Sodium and lithium

Answer 63

Sodium depletion can increase the risk of lithium toxicity and patients are advised to avoid making changes in their diet...

Question 64

Initiation of methotrexate treatment

Answer 64

No baseline chest xray | Don't start if liver enzymes abnormal

Question 65

Before starting olanxapine

Answer 65

Check hyperglycemia | Ecg only if patient with cardiovascular disease

Question 66

Edrophonium

Answer 66

Short acting cholinestetase inhibitor that is used in diagnosis of myasthenia gravis

Question 67

Gentamicin monitoring

Answer 67

One hour peak serum concentration should be 3-5 mg/l

Question 68

If inr > 8

Answer 68

Give iv vitamin k and stop warfarin and restart when less than 5

Question 69

Treatment for paroxysmal AT that may cause intermittent clauducation

Answer 69

Sotalol

Question 70

Treatment of hypercalcemia

Answer 70

Saline Biphosphonates Frusemide (increase calcium secretion), not thiazides (increase absorption): used in calcium stones

Question 71

Patient with gi hematemesis

Answer 71

Telepressin

Question 72

Dmard used to treat inflammatory arthritis. That can cause reversible azoospermia and bone marrow suppression

Answer 72

Sulfasalazine

Question 73

Ttt for mild systemic lupus erythematosus that requires regular ophthalmic review to check for the development of retinopathy

Answer 73

Hydroxychloroquine

Question 74

Bromocriptine

Answer 74

Barely used now in Parkinson as they can cause vascular fibrosis

Question 75

Drug that inhibits iconoclast mediated...

Answer 75

Rituximab

Question 76

Side effects of dmards

Answer 76

* Sulfasalazine- marrow suppression, oligospermia, hepatitis * Gold- nephrotic syndrome, marrow suppression * Penicillamine- disturbance of taste, nephrotic syndrome, myasthenia * Chloroquine- retinopathy, tinnitus * Steroids- diabetes, truncal obesity; azathioprine- marrow suppression * Cytotoxic drugs eg methotrexate- hepatic toxicity, marrow suppression * Newer immunosuppressants eg leflunomide- marrow suppression * Tumour necrosis factor antagonists eg infliximab- infusion reactions including anaphylaxis, infections including re-activation of TB