McqMate
Chapters
| 1. |
Regarding antipsychotics as a group |
| A. | Metabolites are important to the action of these drugs |
| B. | Haloperidol has a higher systemic availability than thioridazine or chlorpromazine |
| C. | Elimination half lives of these drugs range between 3 – 6 hours |
| D. | This group of drugs generally has short clinical duration of action |
| E. | Clozipine is a member of the dihydroindolone group |
| Answer» B. Haloperidol has a higher systemic availability than thioridazine or chlorpromazine | |
| 2. |
Which of the following antipsychotics (in excess dose) is responsible for cardiac arrhythmias? |
| A. | Chlorpromazine |
| B. | Clozapine |
| C. | Thioridazine |
| D. | Haloperidol |
| E. | Thiothixene |
| Answer» C. Thioridazine | |
| 3. |
Plasma lithium levels (assuming no change in daily lithium dose) may become toxic in the presence of all of the following EXCEPT |
| A. | Pregnancy |
| B. | Use of thiazides |
| C. | Dehydration |
| D. | Use of some non-steroidal anti-inflammatory drugs |
| E. | Post partum state |
| Answer» A. Pregnancy | |
| 4. |
Regarding pharmacokinetics of antidepressants |
| A. | Most are highly protein bound |
| B. | Fluoxetine is poorly absorbed |
| C. | Tricyclics are predominantly excreted unchanged in the urine |
| D. | Plasma half lives of antidepressants are mostly less than 10 hours |
| E. | The half life of the older MAOIs is helpful in governing doses |
| Answer» A. Most are highly protein bound | |
| 5. |
Which of the following drugs is potentially dangerous in a single drug overdose |
| A. | Moclobemide |
| B. | Paroxetine |
| C. | Sertraline |
| D. | Trazodone |
| E. | Amoxapine |
| Answer» E. Amoxapine | |
| 6. |
Which of the following drugs is 99% protein bound in plasma |
| A. | Gentamicin |
| B. | Theophylline |
| C. | Carbamazepine |
| D. | Atenolol |
| E. | Diazepam |
| Answer» E. Diazepam | |
| 7. |
Which of the following drugs is contraindicated (absolutely) in a patient with porphyria |
| A. | Zolpidem |
| B. | Chloral hydrate |
| C. | Buspirone |
| D. | Phenobarbitone |
| E. | Diazepam |
| Answer» D. Phenobarbitone | |
| 8. |
Regarding local anaesthetic agents |
| A. | Lignocaine is also an antiarrhythmic of the Vaughan Williams classification group 1A |
| B. | At normal pH the larger fraction of local anaesthetic in the body fluids will be in the unchanged form |
| C. | Bupivacaine may cause an apparent cyanosis in some patients |
| D. | The duration of action of procaine will be increased in the presence of liver disease |
| E. | Local anaesthetic agents block conduction in small myelinated axons prior to blockade of other axons |
| Answer» E. Local anaesthetic agents block conduction in small myelinated axons prior to blockade of other axons | |
| 9. |
Regarding IV anaesthetic agents |
| A. | Ketamine is the induction agent of choice in a head injured patient |
| B. | Propofol has a slow offset of action |
| C. | Etomidate causes hypotension more commonly than thiopentone |
| D. | Ideal agents for neuroleptanalgesia are fentanyl and droperidol |
| E. | Thiopentone is metabolised at a rate of 40-50% per hour in humans following a single dose |
| Answer» D. Ideal agents for neuroleptanalgesia are fentanyl and droperidol | |
| 10. |
Suxamethonium |
| A. | Is a non-depolarising neuromuscular blocking agent |
| B. | Is contraindicated in all eye operations |
| C. | Stimulates cardiac muscarinic receptors and autonomic ganglia |
| D. | Its action is directly terminated by the action of plasma cholinesterase |
| E. | Should not be administered to patients with burns >24 hours old because of its hypercalcaemic effect |
| Answer» C. Stimulates cardiac muscarinic receptors and autonomic ganglia | |
| 11. |
Inhalational anaesthetics |
| A. | Enflurane is proconvulsant |
| B. | Isoflurane is the inhalational agent of choice in patients with active IHD |
| C. | Nitrous oxide is a useful adjunct to volatile anaesthetic use in women in the first trimester of pregnancy |
| D. | Halothane has a MAC value of 75% making it less potent than desflurane |
| E. | Desflurane is extensively metabolised via the liver |
| Answer» A. Enflurane is proconvulsant | |
| 12. |
Phenytoin |
| A. | Is 20-30% bound to albumin |
| B. | Is the drug treatment of choice in absence seizures |
| C. | Undergoes flow limited elimination |
| D. | Steady state mean plasma concentrations varies disproportionately with the dose |
| E. | Preferentially binds to activated state sodium channels |
| Answer» D. Steady state mean plasma concentrations varies disproportionately with the dose | |
| 13. |
Drugs of abuse can be extremely dangerous in the wrong hands! Which of the following is correct |
| A. | Ketamine is structurally related to psilocybin |
| B. | LSD acts on various 5 HT receptor subtypes to produce its mind altering effects |
| C. | Marijuana causes mydriasis and conjunctival infection |
| D. | Cocaine has a long plasma half life |
| E. | Amphetamine like drugs cause marked stimulation of appetite |
| Answer» B. LSD acts on various 5 HT receptor subtypes to produce its mind altering effects | |
| 14. |
Flumazenil |
| A. | Is cleared renally |
| B. | Predictably reverses benzodiazepine induced respiratory depression |
| C. | Antagonises CNS effects of opioids |
| D. | Can precipitate seizures in mixed overdose |
| E. | Has a half life of around 10 hours |
| Answer» D. Can precipitate seizures in mixed overdose | |
| 15. |
Regarding non-depolarising muscle relaxants |
| A. | Pancuronium is eliminated via the kidney |
| B. | Roacuronium is an isoquinolone derivative |
| C. | Roacuronium undergoes Hoffman elimination |
| D. | Vecuronium is eliminated predominantly via the kidney |
| E. | Atracurium is eliminated via plasma pseudocholinesterase |
| Answer» A. Pancuronium is eliminated via the kidney | |
| 16. |
Which of the following is a direct serotonin agonist |
| A. | Fluoxetine |
| B. | Amitriptylline |
| C. | Moclobemide |
| D. | Ondansetron |
| E. | Sumatriptan |
| Answer» E. Sumatriptan | |
| 17. |
The opiate associated with seizures when given in high doses to patients with renal failure is |
| A. | Morphine |
| B. | Pethidine |
| C. | Methadone |
| D. | Fentanyl |
| E. | Codeine |
| Answer» B. Pethidine | |
| 18. |
Ethanol |
| A. | Is lipid soluble |
| B. | Is metabolised by the MEOS system at blood concentrations below 100mg/dl |
| C. | Is a vasodilator |
| D. | The most frequent neurological abnormality in chronic alcoholism is asymmetrical peripheral nerve injury specific to hands and feet |
| E. | Alcohol is estimated to be responsible for approximately 10% of cases of hypertension |
| Answer» C. Is a vasodilator | |
| 19. |
Which of the following local anaesthetic agents is an ester |
| A. | Bupivacaine |
| B. | Ropivacaine |
| C. | Prilocaine |
| D. | Procaine |
| E. | Lignocaine |
| Answer» D. Procaine | |
| 20. |
Regarding temazepam – all of the following are true EXCEPT |
| A. | It produces inactive metabolites |
| B. | It induces enzymes only to a minimal extent |
| C. | It causes less hangover than nitrazepam |
| D. | It causes rebound insomnia |
| E. | It increases REM sleep |
| Answer» E. It increases REM sleep | |
| 21. |
Regarding the antiepileptic drugs |
| A. | Lorazepam has documented efficacy against absence seizures |
| B. | Phenytoin is able to stimulate its own metabolism by enzyme induction |
| C. | Valproate has a large Vd (>500l/70kg) |
| D. | The most common dose related adverse effects of Carbamazepine are ataxia and diplopia |
| E. | Vigabatrin works by sodium channel blockade |
| Answer» D. The most common dose related adverse effects of Carbamazepine are ataxia and diplopia | |
| 22. |
Benzodiazepines |
| A. | Increase the duration of GABA gated chloride channel openings |
| B. | Will depress (in high doses) the CNS to the point known as stage 3 of general anaesthesia |
| C. | Bind to GABAβ receptors |
| D. | Have extensive cardiodepressant effects in doses used to cause hypnosis |
| E. | Decrease the duration of stage 2 NREM sleep |
| Answer» B. Will depress (in high doses) the CNS to the point known as stage 3 of general anaesthesia | |
| 23. |
Regarding drugs used in Parkinson’s disease |
| A. | Bromocriptine is the first line drug to treat Parkinson’s disease in psychotic patients |
| B. | 80-90% of a single dose of Levodopa enters the brain unaltered |
| C. | Patients taking Selesiline to treat Parkinson’s disease are limited in what they can eat because of the tyranine reaction phenomenon |
| D. | Amantadine has anti Parkinsonian effects and is administered at a dose of 100mg bd |
| E. | Anti muscarinic drugs are of benefit in elimination of bradykinesia in Parkinson’s |
| Answer» D. Amantadine has anti Parkinsonian effects and is administered at a dose of 100mg bd | |
| 24. |
A patient complains of post op muscle pain. This is most likely to be due to |
| A. | Suxamethonium |
| B. | Propofol |
| C. | Isoflurane |
| D. | Atracurium |
| E. | Ketamine |
| Answer» A. Suxamethonium | |
| 25. |
Lithium |
| A. | Has rapid onset of action |
| B. | Is partially renally excreted |
| C. | Has no neurological side effects |
| D. | Has no contraindications to be given in conjunction with NSAIDS |
| E. | Is contraindicated in sick sinus syndrome |
| Answer» E. Is contraindicated in sick sinus syndrome | |
| 26. |
With respect to opioid receptors |
| A. | Fentanyl works predominantly at the kappa receptors |
| B. | Both U and delta receptors contribute to respiratory depression |
| C. | Methadone is used for heroin withdrawal because its actions are predominantly at the delta receptors |
| D. | Opioid receptors are coupled to a tyrosine kinase mechanism of action |
| E. | Physical dependence and tolerance is caused by the rapid disintegration of receptors |
| Answer» B. Both U and delta receptors contribute to respiratory depression | |
| 27. |
Lignocaine |
| A. | Penetrates the axon in its changed form |
| B. | Is more potent than bupivacaine |
| C. | Has higher affinity for activated than resting sodium channels |
| D. | Is a weak acid |
| E. | Blocks voltage gated sodium channels at their extracellular end |
| Answer» C. Has higher affinity for activated than resting sodium channels | |
| 28. |
Regarding adverse effects of propofol |
| A. | Post op vomiting is common |
| B. | Hypertension is a complication |
| C. | Severe acidosis can occur with its use in paediatric respiratory infections |
| D. | It is positively inotropic |
| E. | Tremor is a common side effect |
| Answer» C. Severe acidosis can occur with its use in paediatric respiratory infections | |
| 29. |
Regarding inhaled anaesthetics |
| A. | They reduce MAP in direct proportion to their alveolar concentration |
| B. | Nitrous oxide has a relatively low MAC |
| C. | Halogenated agents have a lower brain:blood partition coefficient |
| D. | Nitrous oxide causes a decrease in tidal volume and an increase in respiratory rate |
| E. | They decrease the metabolic rate in the brain by decreasing cerebral blood flow |
| Answer» A. They reduce MAP in direct proportion to their alveolar concentration | |
| 30. |
Local anaesthetic agents |
| A. | Are primarily K+ channel blockers |
| B. | Prevent repolarisation of the membrane |
| C. | Can be used with a vasodilator to prolong local action |
| D. | Activity is enhanced by high extracellular K+ concentration |
| E. | Activity is enhanced by high extracellular Ca2+ |
| Answer» D. Activity is enhanced by high extracellular K+ concentration | |
| 31. |
Which of the following side effects for given drugs is wrong |
| A. | Phenytoin – gum hypertrophy |
| B. | Ethosuximide – hirsuitism |
| C. | Phenobarbital – enzyme induction |
| D. | Carbamazepine – ataxia |
| E. | Valproate – idiosyncratic hepatic toxicity |
| Answer» B. Ethosuximide – hirsuitism | |
| 32. |
The main side effect of benztropine is |
| A. | Miosis |
| B. | Confusion |
| C. | Diarrhoea |
| D. | GIT haemorrhage |
| E. | Bronchorrhoea |
| Answer» B. Confusion | |
| 33. |
Thiopentone |
| A. | Is not lipid soluble |
| B. | Can be used IM or IV to induce anaesthesia |
| C. | Has good analgesic properties |
| D. | Can cause convulsive movements |
| E. | Anaesthetic action is terminated by redistribution from CNS to other highly vascularised tissues |
| Answer» E. Anaesthetic action is terminated by redistribution from CNS to other highly vascularised tissues | |
| 34. |
Nitrous oxide |
| A. | Can be used with O2 as a carrier gas for halothane |
| B. | Has poor analgesic properties |
| C. | Forms a vapour which is explosive |
| D. | Sensitises the heart to the action of catecholamines |
| E. | Is an effective agent for inducing anaesthesia |
| Answer» A. Can be used with O2 as a carrier gas for halothane | |
| 35. |
Codeine |
| A. | Is more potent than fentanyl |
| B. | Frequently causes diarrhoea |
| C. | Is used to treat nausea caused by morphine |
| D. | Occurs in foxglove plants |
| E. | Depresses the cough reflex |
| Answer» E. Depresses the cough reflex | |
| 36. |
Regarding GABA: all the following are true EXCEPT |
| A. | Receptor blockers have anticonvulsant activity |
| B. | Is found in high concentrations in the basal ganglia |
| C. | Concentrations in the basal ganglia are abnormally low in Huntington’s chorea |
| D. | Metabolism is inhibited by sodium valproate |
| E. | Receptors are sensitive to the activity of benzodiazepines |
| Answer» A. Receptor blockers have anticonvulsant activity | |
| 37. |
Regarding local anaesthetics (LA) |
| A. | Lignocaine is metabolised in the liver faster than any of the other amide LA |
| B. | Allergies to amide Las are more common than with the ester Las |
| C. | Prilocaine is the most cardiotoxic LA |
| D. | Cocaine is an amide LA which is often used as a drug of abuse |
| E. | The +1/2 of lignocaine may be increased 3-4 fold in a patient with severe liver disease |
| Answer» E. The +1/2 of lignocaine may be increased 3-4 fold in a patient with severe liver disease | |
| 38. |
Regarding nondepolarising muscle relaxants |
| A. | Jaw and eye muscles are paralysed before the limb and trunk muscles |
| B. | Rocuronium is the most potent nondepolarising skeletal muscle relaxant |
| C. | Atracurium is a steroid derivative |
| D. | Vecuronium blocks cardiac muscarinic receptors, thus inducing moderate increase in heart rate |
| E. | The nondepolarising agents produce a non-surmountable blockade |
| Answer» A. Jaw and eye muscles are paralysed before the limb and trunk muscles | |
| 39. |
The skeletal muscle relaxant with the longest duration of action is |
| A. | Suxamethonium |
| B. | Mivacurium |
| C. | Pancuronium |
| D. | Rocuronium |
| E. | Vecuronium |
| Answer» C. Pancuronium | |
| 40. |
Which of the following DOES NOT increase the susceptibility of a nerve fibre to conduction blockade by a local anaesthetic |
| A. | Small diameter |
| B. | Myelination |
| C. | Location in the periphery of a nerve |
| D. | High firing rate |
| E. | Short action potential duration |
| Answer» E. Short action potential duration | |
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