IPE

Question 1

What are alpha blockers used in?

Answer 1

BPH and HTN

Question 2

What are some examples of alpha blockers?

Answer 2

doxazosin and tamsulosin

Question 3

What are some side effects of alpha blockers?

Answer 3

Postural hypotension
drowsiness
dyspnoea
cough

Question 4

What are the side effects of calcuim channel blockers?

Answer 4

headache
flushing 
ankle oedema
hypotension
constipation

Question 5

What are the side effects of bendroflumethiazide?

Answer 5

Gout
Hypokalaemia
Hyponatraemia
Impaired glucose tolerance

Question 6

Name some inducers of the P450 system?

Answer 6

Phenytoin
Carbemazepine 
Barbiturates
Rifampicin
Alcohol acute
sulphonylurea and St johns wort

Question 7

What are some inhibitors of the P450 system

Answer 7

Omeprazole
Disulfiram
Ethanol
Valproate
Isonazid
Cimetidine 
Erythromycin 
Sulfonamides

Question 8

What are some side effects for ciclosporin?

Answer 8

Everything increased

• fluid retention
• hypertrophy of the gums
• tremor
• increased BP
• increased hair
• high K
• hepatotoxic

Question 9

Name three drugs that can cause lung fibrosis

Answer 9

Amiodarone
Methotrexate
Cytotoxic drugs - bleomycin
Dopamine receptor antagonists- bromocriptime
Nitrofuratoin

Question 10

What are the side effects of B blockers?

Answer 10

Bronchospasm
fatigue
cold peripheries
sleep disturbances

Question 11

What are the side effects of nicorandil?

Answer 11

headache
flushing
anal ulceration

Question 12

What are the side effects of nitrates?

Answer 12

Headache
postural hypotension
tachycardia

Question 13

What are the features of lithium toxicity?

Answer 13

coarse tremor (a fine tremor is seen in therapeutic levels)
hyperreflexia
acute confusion
seizure
coma

Question 14

What may precipitate lithium toxicity?

Answer 14

dehydration
renal failure
duiretics
ACEi
Metrondiazole
NSAIDs

Question 15

What monitoring is required with a patient on lithium?

Answer 15

TFT, U&E prior to treatment
Lithium levels weekly until stabilised then every 3 months
TFT, U&E every 6 months

Question 16

What monitoring is required for amiodarone?

Answer 16

TFT, LFT, U&E, CXR prior to treatment

TFT, LFT every 6 months

Question 17

What is given along side isonazid and why?

Answer 17

Pyrodixine

Reduce the risk of peripheral neuropathy

Question 18

When is lithium monitoring done?

Answer 18

12 hours post dose

Question 19

When is ciclosporin monitoring done?

Answer 19

Immediately before dose

Question 20

When are digoxin levels done?

Answer 20

6 hours post dose

Question 21

What Abx should be avoided when a patient is on statins and why?

Answer 21

Macrolides eg erythromycin due to the increased risk of myopathy and rhabdomyolysis due to inhibition of the P450 system

Question 22

What are the adverse effects of gentamicin?

Answer 22

Ototoxicity - irreversible due to auditory or vestibular nerve damage
Nephrotoxicity - accumulates in renal failure

Question 23

What antibiotic should be prescribed in caution in those with epilepsy and why?

Answer 23

Quinolones such as ciprofloxacin

lower seizure threshold

Question 24

Why should we be careful with quinolones in athletes?

Answer 24

Tendon damage and rupture

Question 25

What is the treatment for legionella pnuemonia?

Answer 25

Erythromycin

Question 26

What is the bacteria in bacterial vaginosis?

Answer 26

Gardnerella vaginalis

Question 27

What are some differentials for lymphadenopathy?

Answer 27

``` EBV virus HIV rubella Toxoplamosis, CMV , TB Leukaemia and lymphoma SLE and RA Sarcoidosis ```

Question 28

What is the most common organism found in central line infections?

Answer 28

Staph epidermidis

Question 29

What electrolyte imbalances can precipitate digoxin toxicity?

Answer 29

Hypokalaemia | hypomagnesaemia, hypercalcaemia, hypernatraemia, acidosis

Question 30

When is diclofenac contraindicated?

Answer 30

ischaemic heart disease peripheral arterial disease cerebrovascular disease congestive heart failure (New York Heart Association classification II-IV)

Question 31

What may indicate a paracetamol over dose on liver function tests?

Answer 31

Transaminitis (elevated ALT and AST) in the 10,000s

Question 32

What is the problem with rapid correction of chronic hypernatraemia? How should this be avoided?

Answer 32

predisposes to cerebral oedema | Replace fluids slowly and U&Es should be monitored- aim for a reduction <12mmol/day

Question 33

What is sick euthyroid disease?

Answer 33

Caused by systemic illness low total and free T4/T3 Normal or low TSH

Question 34

Methotrexate and which other drug is a never prescribe together?

Answer 34

Trimethoprim

Question 35

What are the SEs of ivabravine?

Answer 35

visual effects, particular luminous phenomena, are common. Headache. Bradycardia, due to the mechanism of action, may also be seen