Multiple choice questions Flashcards
(120 cards)
In a patient having a life-threatening asthma attack, why can inhaled salbutamol not be effective?
Due to the restrictions of the airways, the drug cannot reach the receptors.
You are called to Mike, a 26 year old male. On arrival he is very agitated, sweaty, tachycardic, tachypnoeic, non compliant and is very manic and not engaging.
His friends explain that he has been out with them all night and consumed lots of alcohol and 6 ‘lines’ of cocaine.
What best describes one of the main actions of cocaine on the central nervous system:
It increases dopamine concentrations in the synapses
After administering chlorphenamine, what should you advise your patient to do?
Avoid skilled tasks such as cycling, driving or operating machinery and avoid alcohol
You are called to Margaret, a 56 year old female who has been complaining of acid reflux. She has a history of post-menopausal osteoporosis and takes Alendronic Acid 10mg daily. After discussions with her GP, you both agree that Gaviscon (Sodium bicarbonate & Calcium carbonate) is the best course of treatment for Margaret. Which of the following pieces of advice must she be given prior to commencing this treatment?
Alendronic acid should be taken 30min before Calcium carbonate
Warfarin impacts the normal clotting cascade by which of the following?
Inhibits Vit K oxidase-reductase reaction
Effective digoxin therapy is associated with which of the following?
Increased Left Ventricular Ejection Fraction
Ted has been taking clopidogrel for some time and recently went to the pharmacist as he had some heart burn. He was given a pack of omeprazole which helped with his symptoms. Reading the patient information leaflet (although he is asymptomatic) he is now worried as it says he shouldn’t be taking omeprazole if he is already on clopidogrel. What is the most likely result of the interaction?
Omeprazole inhibits the cytochrome P450 enzymes that metabolise clopidogrel resulting in decreased plasma levels of the active metabolite of clopidogrel with the potential of clinical effects.
A histamine antagonist has which of the following properties?
Anti-emetic
You intend to give your patient a hydrocortisone injection for severe asthma. You check the medicine with someone and then pass the syringe to your ambulance technician colleague to administer. Is this legally allowed? Select the correct statement regarding the legality of the action.
Yes, it is listed under the Human Medicines Regulations 2012 schedule 19 and therefore they are allowed to administer it in an emergency
In palliative care why is the subcutaneous route often used to administer medicines?
It maintains a steady plasma concentration, avoiding the peaks and troughs of other routes
You are called to Angelica who is 6 and complaining of pain to her left ear for one day. The tympanic membrane is moderately inflamed, the ear canal appears normal and there are no signs of mastoiditis. Which of the following is recommended by NICE Clinical Knowledge Summaries (CKS) at this stage?
Regular paracetamol or ibuprofen.
You have administered haloperidol to a patient presenting with Acute Behavioural Disturbance. Considering the pharmacokinetics of haloperidol, which medicine is most likely to result in an adverse event when both medicines are in the systemic circulation at the same time?
Itraconazole - a CYP3A4 inhibitor
Paracetamol can be given by the IV route but must be given slowly. Which of the following statements is correct regarding this?
It is believed that the excipient, mannitol, causes hypotension.
Which of the following groups is at greatest risk of a type A reaction?
South East Asians
Which of the following is not a feature of an aspirin overdose?
Hypoventilation
Which of the following statements is true of Gram positive organisms?
Lower likelihood of developing antibiotic resistance
Vicarious liability is when
The employer accepts liability for the employees actions
In a patient with a mild asthma attack, why is it considered best practice to use a salbutamol inhaler rather than a nebuliser?
Sufficient drug will reach the target receptors without much systemic absorption.
Olivia has been given a prescription for clarithromycin. What is the advice regarding clarithromycin administration in a patient with hepatic impairment?
Avoid in severe hepatic impairment if renal impairment is also present.
You get called to Sara who is 22. 4 days ago she was supplied a course of amoxicillin for a productive cough with green sputum with fever. Sara now has signs of severe systemic illness. She says she took a few of the tablets but kept forgetting. What is the most likely reason for the progression of the illness?
The lack of adherence has led to an insufficient time above the minimum inhibitory concentration to have had an effect on the bacteria
When are benzodiazepines most effective in a tonic clonic seizure and why?
In the first 30 minutes as there is a significant decrease in the number of inhibitory GABAa receptor subunits after this time.
Jason is 19 yrs old, who has injected opioid and is unresponsive. On clinical assessment, he was also bradypnoeic. As a result of the presenting symptoms, he was given IM injection of naloxone which improved his respiratory function and consciousness levels but after a short time he becomes bradypnoeic and unresponsive again. What is the most likely reason for this?
Naloxone has a short half life relative to the opioid and the naloxone is therefore eliminated quicker.
Rivaroxaban impacts the normal clotting cascade by which of the following?
Inhibits factor Xa action.
Solomon has been given codeine by his doctor but explains that the pain is not improving and the medicine doesn’t seem to be working. He also takes Ramipril. What is the most likely reason that his pain is not improving?
Solomon has a deficiency in the CYP2D6 enzyme resulting in him not achieving therapeutic levels of the active metabolite.
