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McqMate
Chapters
1. |
Regarding paraquat poisoning |
A. | The interval between ingestion and death is usually hours because of immediate pulmonary toxicity |
B. | Mechanism of action involves single electron oxidation of the herbicide to free radical species |
C. | Probable human lethal dosage is 50-500mg/kg |
D. | Oxygen high flow stops the pulmonary lesions occurring |
E. | Paraquat doesn’t affect hepatic or renal functions |
Answer» C. Probable human lethal dosage is 50-500mg/kg |
2. |
Regarding NSAIDs |
A. | Piroxicam has a half life of >50 hours |
B. | Aspirin reversibly inhibits COX |
C. | Diclofenac is a selective COX1 inhibitor |
D. | Indomethacin is relatively free of adverse side effects |
E. | Ibuprofen is predominantly excreted unchanged in the urine |
Answer» A. Piroxicam has a half life of >50 hours |
3. |
Regarding paracetamol (acetaminophen) |
A. | Less than 5% is excreted unchanged |
B. | Acetaminophen has no anti-inflammatory properties |
C. | The half life of paracetamol is 2-3 hours |
D. | Haemolytic anaemia has rarely been noted with paracetamol |
E. | All of the above are true |
Answer» E. All of the above are true |
4. |
Regarding lead toxicity |
A. | Lead can induce an anaemia that is macrocytic |
B. | Young children absorb about 10% of ingested inorganic lead |
C. | Lead induced peripheral neuropathy often involves upper limb extensors resulting in wrist drop |
D. | High dose organic lead poisoning usually results in severe pneumonitis |
E. | All patients with elevated blood lead levels should have chelation treatment whether symptomatic or not |
Answer» C. Lead induced peripheral neuropathy often involves upper limb extensors resulting in wrist drop |
5. |
Regarding agents used to treat gout |
A. | As little as 8mg of colchicine taken over 24 hours may be fatal |
B. | Allopurinol is a xanthine oxidase stimulator |
C. | Probenecid is an organic alkaline substance |
D. | Colchicine may precipitate acute attacks of gout |
E. | Aspirin is effective against gout as it inhibits urate crystal phagocytosis |
Answer» A. As little as 8mg of colchicine taken over 24 hours may be fatal |
6. |
All of the following may be seen in organophosphate poisoning EXCEPT |
A. | Salivation |
B. | Tachycardia |
C. | Fibrillation of muscle fibres |
D. | Bronchospasm |
E. | Vomiting |
Answer» B. Tachycardia |
7. |
Regarding aspirin |
A. | The average anti-inflammatory dose of aspirin is 0.6g up to 4 hourly |
B. | Aspirin’s main side effect at usual doses is rash |
C. | Aspirin’s antiplatelet effect lasts 8 – 10 days |
D. | At low toxic doses – respiratory acidosis may occur |
E. | Aspirin has a pka of 4.5 |
Answer» C. Aspirin’s antiplatelet effect lasts 8 – 10 days |
8. |
The main mechanism of action of colchicine is |
A. | Inhibition of polymorphonuclear leucocytes |
B. | Inhibition of synoviocyte phagocytosis |
C. | Reduced formation of leukotriene D4 |
D. | Inhibition of mononuclear phagocytes |
E. | Decreasing the body pool of urate |
Answer» A. Inhibition of polymorphonuclear leucocytes |
9. |
Aspirin inhibits all of the following EXCEPT |
A. | Cyclo oxygenase |
B. | Recurrent miscarriages |
C. | Protacyclin synthesis |
D. | Kallikrein system |
E. | Lipo oxygenase |
Answer» E. Lipo oxygenase |
10. |
Acetaminophen (paracetamol) can undergo all of the following biotransformation reactions EXCEPT |
A. | Deamination |
B. | N-oxidation |
C. | Glucuronidation |
D. | Sulphation |
E. | Glutathione conjugation |
Answer» A. Deamination |
11. |
Aspirin |
A. | Is hydrolysed to acetone and salicylate |
B. | Exhibits first order kinetics with elimination in low doses |
C. | Is mostly conjugated by the liver and excreted in the bile |
D. | Reversibly blocks the cyclooxygenase enzyme |
E. | Causes an immediate doubling of bleeding time |
Answer» B. Exhibits first order kinetics with elimination in low doses |
12. |
Regarding NSAIDs |
A. | At high doses diclofenac demonstrates zero order kinetics |
B. | Aspirin is a reversible inhibitor of cyclooxygenase |
C. | Aspirin at doses of <2g/day reduces uric acid levels |
D. | All NSAIDs can be found in synovial fluid after repeated dosing |
E. | Use of ibuprofen and aspirin together increases the anti inflammatory effect |
Answer» D. All NSAIDs can be found in synovial fluid after repeated dosing |
13. |
The metabolic pathway of detoxification that becomes increasingly important in paracetamol toxicity is |
A. | Conjugation with glucuronide |
B. | Oxidation |
C. | Reduction |
D. | Cytochrome p-450 dependent glutathione conjugation |
E. | Methylation |
Answer» D. Cytochrome p-450 dependent glutathione conjugation |
14. |
Which of the following NSAIDs has a t1/2 of about 1 hour |
A. | Diclofenac |
B. | Naproxen |
C. | Piroxicam |
D. | Indomethacin |
E. | Ibuprofen |
Answer» A. Diclofenac |
15. |
Which of the following symptoms of aspirin toxicity occurs at plasma salicylate concentrations of 100mg/dl? |
A. | Tinnitus |
B. | Vasomotor collapse |
C. | Metabolic acidosis |
D. | Gastric intolerance |
E. | Renal failure |
Answer» C. Metabolic acidosis |
16. |
All of the following drugs can cause a wide anion gap metabolic acidosis EXCEPT |
A. | Lithium |
B. | Methanol |
C. | Cyanide |
D. | Salicylates |
E. | Isoniazid |
Answer» A. Lithium |
17. |
Which of the following drug overdoses may be amenable to the elimination technique of haemodialysis |
A. | Calcium channel blockers |
B. | Benzodiazepines |
C. | Valproate |
D. | Quinidine |
E. | Opioids |
Answer» C. Valproate |
18. |
Which of the following antidote – drug pairings is INCORRECT |
A. | Acetaminophen → n-acetyl cysteine |
B. | β blockers → glucagon |
C. | Opioids → naloxone |
D. | Benzodiazepines → Flumazenil |
E. | Tricyclic antidepressants → physostigmine |
Answer» E. Tricyclic antidepressants → physostigmine |
19. |
Regarding carbon monoxide poisoning |
A. | CO has an affinity for Hb that is about 2000 times that of oxygen |
B. | Hyperbaric oxygen is indicated as a treatment for all patients with CO Hb levels >20% |
C. | The average concentration of CO in the atmosphere is about 0.1ppm |
D. | With room air at 1atm the elimination half time of CO is about 80 minutes |
E. | The foetus is resistant to the effects of CO exposure |
Answer» C. The average concentration of CO in the atmosphere is about 0.1ppm |
20. |
“Erethism” is seen in which of the following intoxications |
A. | Lead |
B. | Mercury |
C. | Arsine gas |
D. | Penicillamine |
E. | Arsenic |
Answer» B. Mercury |
21. |
All of the following are NSAIDs EXCEPT |
A. | Sulindac |
B. | Piroxicam |
C. | Gemfibrozil |
D. | Ketorolac |
E. | Diflunisal |
Answer» C. Gemfibrozil |
22. |
Drugs which enhance other drug metabolism include all of the following EXCEPT |
A. | Rifampicin |
B. | Ketoconazole |
C. | Phenobarbital |
D. | Griseofulvin |
E. | Phenytoin |
Answer» B. Ketoconazole |
23. |
Which of the following has a high extraction ratio |
A. | Trimethoprim |
B. | Valproic acid |
C. | Lignocaine |
D. | Metronidazole |
E. | Diazepam |
Answer» C. Lignocaine |
24. |
Heparin and protamine used together is an example of |
A. | Physiologic antagonism |
B. | Chemical antagonism |
C. | Partial agonism |
D. | Irreversible antagonism |
E. | Agonal agonism |
Answer» B. Chemical antagonism |
25. |
The half life of a drug with a Vd of 200ml/70kg and clearance of 10ℓ/hr/70kg is |
A. | 10 hours |
B. | 14 hours |
C. | 20 hours |
D. | 40 hours |
E. | Indeterminate |
Answer» B. 14 hours |
26. |
All of the following are true regarding penicillins EXCEPT |
A. | Most penicillins only cross the blood brain barrier when the meninges are inflamed. |
B. | Penicillins don’t require dosage adjustment in renal failure |
C. | Penicillins inhibit cross linkage of peptidoglycans in the cell wall |
D. | Piperacillin is a penicillin active against pseudomonas |
E. | Only about 5 to 10% of people with a past history of penicillin allergy have a reaction on re exposure |
Answer» B. Penicillins don’t require dosage adjustment in renal failure |
27. |
Ciprofloxacin |
A. | Is a defluorinated analogue of nalidixic acid |
B. | Inhibits tropoisomerases 2 and 3 |
C. | Has no gram positive cover |
D. | Has a bioavailability of 30% |
E. | May cause an arthropathy |
Answer» E. May cause an arthropathy |
28. |
Resistance to B lactams |
A. | Can be due to an efflux pump |
B. | Is most commonly due to modification of the target PBPs |
C. | Does not involve penetration of drug to target PBPs |
D. | Infers resistance only to penicillinc |
E. | Can involve up to 5 different B lactamases |
Answer» A. Can be due to an efflux pump |
29. |
Macrolides |
A. | Have enhanced activity at acidic pH |
B. | Have little activity against legionella |
C. | Have half lives which increase in patients with anuria |
D. | Induce cytochrome p450 enzymes |
E. | Are contraindicated in neonates |
Answer» C. Have half lives which increase in patients with anuria |
30. |
Flucloxacillin |
A. | Is ineffective against streptococci |
B. | Is active against enterococci and anaerobes |
C. | Blocks transpeptidation and inhibits peptidoglycan synthesis |
D. | Is poorly absorbed orally |
E. | Has excellent penetration into CNS and prostate |
Answer» C. Blocks transpeptidation and inhibits peptidoglycan synthesis |
31. |
All of the following inhibit nucleic acid synthesis EXCEPT |
A. | Norfloxacillin |
B. | Chloramphenicol |
C. | Trimethoprim |
D. | Rifampicin |
E. | Sulfasalazine |
Answer» B. Chloramphenicol |
32. |
Which of the following is a second generation cephalosporin? |
A. | Cefaclor |
B. | Ceftazidime |
C. | Cephalexin |
D. | Cefotaxime |
E. | Cephalothin |
Answer» A. Cefaclor |
33. |
Regarding the pharmacokinetics of the tetracyclines |
A. | Tetracyclines are 40 to 80 % bound by serum proteins |
B. | Absorption is enhanced by coadministration of antacids |
C. | Tetracyclines cross the blood brain barrier easily |
D. | Doxycycline is excreted predominantly by the kidney |
E. | Demeclocyline is a short acting tetracycline drug |
Answer» A. Tetracyclines are 40 to 80 % bound by serum proteins |
34. |
All of the following are recognized adverse effects of isoniazid EXCEPT |
A. | Hepatitis |
B. | Peripheral neuropathy |
C. | Retrobulbar neuritis |
D. | Decreased phenytoin metabolism – increased phenytoin blood levels / toxicity |
E. | CNS toxicity |
Answer» C. Retrobulbar neuritis |
35. |
Vancomycin |
A. | 90% of vancomycin is excreted by glomerular filtration |
B. | Inhibits proteinsynthesis in bacteria |
C. | Is bactericidal against gram negative bacilli |
D. | Is well absorbed from the GIT |
E. | One adverse reaction to infusions of vancomycin is the “blue man” syndrome |
Answer» A. 90% of vancomycin is excreted by glomerular filtration |
36. |
Regarding mechanisms of antiviral drug action |
A. | blockage of viral uncoating is caused by rifampicin |
B. | Zidovudine is a protease inhibitor |
C. | Amantidine blocks viral DNA packaging and assembly |
D. | Indinavir is a reverse transcriptase inhibitor |
E. | Acyclovir inhibits viral DNA synthesis |
Answer» E. Acyclovir inhibits viral DNA synthesis |
37. |
Regarding toxicity of antibiotics |
A. | Enamel dysplasia is common with aminoglycosides |
B. | Gray baby syndrome occurs with rifampicin use |
C. | Haemolytic anaemias can occur with sulphonamide use |
D. | Nephritis is the most common adverse reaction with isoniazid |
E. | Disulfiram like reaction can occur with macrolides |
Answer» C. Haemolytic anaemias can occur with sulphonamide use |
38. |
Chloramphenicol |
A. | Does not penetrate the blood brain barrier |
B. | Must be administered parenterally |
C. | Can be safely used in premature infants |
D. | Can cause depression of bone marrow function |
E. | Can cause discoloration of developing teeth when given to children |
Answer» D. Can cause depression of bone marrow function |
39. |
Spironolactone |
A. | Has a steroid structure |
B. | Is a partial agonist |
C. | Promotes sodium retention |
D. | Increases potassium loss |
E. | Is a loop diuretic |
Answer» A. Has a steroid structure |
40. |
Which of the following drugs cause diuresis by the mechanisms indicated? |
A. | Ethanol – by preventing the reabsorption of sodium from renal tubular fluid |
B. | Digoxin – by inhibiting release of ADH |
C. | Dopamine – by inhibiting active transport of chloride over the entire length of the descending limb of the loop of Henle |
D. | Frusemide – by inhibiting carbonic anhydrase |
E. | Chlorothiazide – by inhibiting active sodium transport in the ascending limb of the loop of Henle |
Answer» E. Chlorothiazide – by inhibiting active sodium transport in the ascending limb of the loop of Henle |
41. |
All of the following antibiotics bind to the 50S subunit of the ribosome thereby inhibiting proteinsynthesis EXCEPT |
A. | Chloramphenicol |
B. | Erythromycin |
C. | Linezolid |
D. | Doxycycline |
E. | Clindamycin |
Answer» D. Doxycycline |
42. |
Pharmacokinetics of doxycycline |
A. | 20% bound by serum proteins |
B. | 60-70% absorption after oral administration |
C. | Absorption is impaired by divalent cations, Al3+, and antacids |
D. | Widely distributed especially into the CSF |
E. | Is eliminated via renal mechanisms |
Answer» C. Absorption is impaired by divalent cations, Al3+, and antacids |
43. |
Which of the following inhibits DNA gyrase? |
A. | Penicillin |
B. | Trimethoprim |
C. | Chloramphenicol |
D. | Ciprofloxacin |
E. | Gentamicin |
Answer» D. Ciprofloxacin |
44. |
Resistance to Penicillin and other β lactams is due to |
A. | Modification of target PBPs |
B. | Impaired penetration of drug to target PBPs |
C. | Presence of an efflux pump |
D. | Inactivation of antibiotics by β lactamase |
E. | All of the above |
Answer» E. All of the above |
45. |
All of the following are recognised adverse effects of isoniazid EXCEPT |
A. | Hepatitis |
B. | Peripheral neuropathy |
C. | Retrobulbar neuritis |
D. | ↓ Phenytoin metabolism → ↑ Phenytoin blood levels and toxicity |
E. | CNS toxicity |
Answer» C. Retrobulbar neuritis |
46. |
Regarding fluoroquinolones |
A. | Ciprofloxacin is ineffective in the treatment of gonococcus |
B. | Norfloxacin and Ciprofloxacin are predominantly faecally excreted |
C. | Norfloxacin and Ciprofloxacin have long half lives (12 hours) |
D. | They have poor oral bioavailability |
E. | May damage growing cartilage in children less than 18 years of age |
Answer» E. May damage growing cartilage in children less than 18 years of age |
47. |
Vancomycin |
A. | Is never orally administered as it is poorly absorbed from the GIT |
B. | Binds to the 30S unit on the ribosome and inhibits protein synthesis |
C. | 60% of vancomycin is excreted by glomerular filtration |
D. | Parenteral vancomycin is commonly used for treatment of infections caused by methicillin susceptible staphylococci |
E. | Adverse reactions to vancomycin are encountered in about 10% of patients |
Answer» E. Adverse reactions to vancomycin are encountered in about 10% of patients |
48. |
Regarding the “azole” group of antifungals |
A. | Fluconazole has low water solubility |
B. | Ketoconazole may be given IV/PO |
C. | Itraconazole undergoes renal elimination |
D. | Clotrimazole is the treatment of choice for systemic candidiasis – given orally |
E. | They work by reduction of ergosterol synthesis by inhibition of fungal cytochrome P450 enzymes |
Answer» E. They work by reduction of ergosterol synthesis by inhibition of fungal cytochrome P450 enzymes |
49. |
The fluoroquinolones |
A. | May be administered to patients with severe campylobacter infection |
B. | Work by inhibiting dihydrofolate reductase |
C. | Have little effect against gram positive organisms |
D. | Are heavily metabolised in the liver |
E. | Are safe to give to breast feeding mothers |
Answer» A. May be administered to patients with severe campylobacter infection |
50. |
Clindamycin |
A. | Inhibits bacterial cell wall synthesis |
B. | Is often used for prophylaxis of endocarditis in patients with Valvular disease who are undergoing dental procedures |
C. | Penetrates through BBB into CSF well |
D. | Works well against enterococci and gram negative aerobic organisms |
E. | Is 10% protein bound |
Answer» B. Is often used for prophylaxis of endocarditis in patients with Valvular disease who are undergoing dental procedures |
51. |
Which of the following is a second generation cephalosporin? |
A. | Ceftazidime |
B. | Cephalothin |
C. | Cefotaxime |
D. | Cefaclor |
E. | Cephalexin |
Answer» D. Cefaclor |
52. |
The cephalosporin with the highest activity against gram positive cocci is |
A. | Cefaclor |
B. | Cephalothin |
C. | Cefuroxime |
D. | Cefepime |
E. | Cefotaxime |
Answer» B. Cephalothin |
53. |
Regarding the penicillins |
A. | Penicillin ix excreted into breast milk to levels 3-15% of those present in the serum |
B. | Absorption of amoxyl is impaired by food |
C. | Benzathine penicillin is given PO |
D. | Penicillins are 90% excreted by glomerular filtration |
E. | Dosage of nafcillin should be adjusted in the presence of renal failure |
Answer» A. Penicillin ix excreted into breast milk to levels 3-15% of those present in the serum |
54. |
Rifampicin |
A. | Inhibits hepatic microsomal enzymes |
B. | Inhibits DNA synthesis |
C. | Is bactericidal for mycobacteria |
D. | Is not appreciably protein bound |
E. | Is predominantly excreted unchanged in the urine |
Answer» C. Is bactericidal for mycobacteria |
55. |
Regarding resistance to antibiotics |
A. | Penicillinases cannot inactivate cephalosporins |
B. | Macrolides can be inactivated by transferases |
C. | Mutation of aminoglycoside binding site is its main mechanism of resistance |
D. | Tetracycline resistance is a marker for multidrug resistance |
E. | Resistance to antibiotics is rarely plasmid encoded |
Answer» C. Mutation of aminoglycoside binding site is its main mechanism of resistance |
56. |
Concerning toxicity of antibiotics |
A. | Enamel dysplasia is common with aminoglycosides |
B. | Grey Baby Syndrome occurs with rifampicin use |
C. | A disulfiram like reaction can occur with macrolides |
D. | Haemolytic anaemias can occur with sulphonamide use |
E. | Nephritis is the most common adverse reaction with isoniazid |
Answer» D. Haemolytic anaemias can occur with sulphonamide use |
57. |
Which of the following is considered to be bacteriostatic? |
A. | Penicillin |
B. | Chloramphenicol |
C. | Ciprofloxacin |
D. | Cefoxitin |
E. | Tobramycin |
Answer» B. Chloramphenicol |
58. |
Half life of amphotericin B is |
A. | 2 seconds |
B. | 20 minutes |
C. | 2 hours |
D. | 2 weeks |
E. | 2 months |
Answer» D. 2 weeks |
59. |
Regarding antiseptic agents – all of the following are true EXCEPT |
A. | Sodium hypochlorite is an effective antiseptic for intact skin |
B. | Potassium permanganase is an effective bactericidal agent |
C. | Formaldehyde may be used to disinfect instruments |
D. | Chlorhexidine is active against gram positive cocci |
E. | Ethanol is an effective skin antiseptic because it denatures microbial proteins |
Answer» A. Sodium hypochlorite is an effective antiseptic for intact skin |
60. |
Ciprofloxacin |
A. | Is a defluorinated analogue of nalidixic acid |
B. | Inhibits tropoisomerases 2 and 3 |
C. | Has no gram positive cover |
D. | Has bioavailability of 30% |
E. | May cause an arthropathy |
Answer» D. Has bioavailability of 30% |
61. |
Aminoglycosides |
A. | Have a β lactam ring |
B. | Can produce neuromuscular blockade |
C. | Are DNA gyrase inhibitors |
D. | Normally reach high CSF concentrations |
E. | Have good oral absorption but high first pass metabolism |
Answer» B. Can produce neuromuscular blockade |
62. |
Ribosomal resistance occurs with |
A. | Sulphonamides |
B. | Penicillin |
C. | Fluoroquinolones |
D. | Macrolides |
E. | Trimethoprim |
Answer» D. Macrolides |
63. |
Regarding antivirals |
A. | Delvindine is a nucleoside reverse transcriptase inhibitor (NRTI) |
B. | Zidovudine (AZT) is a non nucleoside reverse transcriptase inhibitor (NNRTI) |
C. | NRTIs activate HIV-1 reverse transcriptase |
D. | Abacavir is a protease inhibitor |
E. | NRTIs require intracytoplasmic activation to the triphosphate form |
Answer» E. NRTIs require intracytoplasmic activation to the triphosphate form |
64. |
All of the following are true regarding metronidazole EXCEPT |
A. | It is used to treat giardia |
B. | It causes a metallic taste in the mouth |
C. | It inhibits alcohol dehydrogenase |
D. | It is used to treat gardnerella |
E. | It is useful against trichomonoas vaginalis |
Answer» C. It inhibits alcohol dehydrogenase |
65. |
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 |
66. |
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 |
67. |
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 |
68. |
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 |
69. |
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 |
70. |
Which of the following drugs is 99% protein bound in plasma |
A. | Gentamicin |
B. | Theophylline |
C. | Carbamazepine |
D. | Atenolol |
E. | Diazepam |
Answer» E. Diazepam |
71. |
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 |
72. |
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 |
73. |
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 |
74. |
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 |
75. |
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 |
76. |
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 |
77. |
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 |
78. |
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 |
79. |
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 |
80. |
Which of the following is a direct serotonin agonist |
A. | Fluoxetine |
B. | Amitriptylline |
C. | Moclobemide |
D. | Ondansetron |
E. | Sumatriptan |
Answer» E. Sumatriptan |
81. |
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 |
82. |
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 |
83. |
Which of the following local anaesthetic agents is an ester |
A. | Bupivacaine |
B. | Ropivacaine |
C. | Prilocaine |
D. | Procaine |
E. | Lignocaine |
Answer» D. Procaine |
84. |
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 |
85. |
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 |
86. |
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 |
87. |
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 |
88. |
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 |
89. |
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 |
90. |
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 |
91. |
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 |
92. |
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 |
93. |
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 |
94. |
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 |
95. |
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 |
96. |
The main side effect of benztropine is |
A. | Miosis |
B. | Confusion |
C. | Diarrhoea |
D. | GIT haemorrhage |
E. | Bronchorrhoea |
Answer» B. Confusion |
97. |
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 |
98. |
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 |
99. |
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 |
100. |
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 |
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