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Pharmacology Quiz | Pharmacology Multiple Choice Questions and Answers

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Questions
1 A 58-year-old man has a history of obesity, gastro-oesophageal reflux disease, low back pain and IHD. He presents with large, itchy wheals over the trunk and limbs and a sensation of tightness in the throat. Which one of the following drugs is the most likely to have triggered this skin eruption?
A aspirin
B GTN (nitrate) spray
C omeprazole
D paracetamol

Answer: aspirin
2 A 30-year-old man presents with a history of transient loss of consciousness and palpitations. His ECG shows ventricular tachycardia. Which of the following treatments should be avoided?
A adenosine
B amiodarone
C DC cardioversion
D verapamil

Answer: verapamil
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3 A 67 year old man presents with sudden onset atrial fibrillation (ventricular rate of 150/minute). His serum creatinine concentration was 250 umol/L (70-110). What is the main factor that determines the choice of loading dose of digoxin in this patient?
A Absorption
B Apparent volume of distribution
C Lipid solubility
D Renal clearance

Answer: Renal clearance
4 An 18-year-old woman is admitted after taking drugs at a night-club. Which of the following features suggest she had taken Ecstasy (MDMA)?
A A pyrexia of 40oC
B hypernatraemia
C hypokalaemia
D metabolic acidosis

Answer: A pyrexia of 40oC
5 A youth worker, aged 40, presents to Accident and Emergency with vomiting. On detailed questioning, he admits to having taken 36 paracetamol tablets 2 hours previously. He is vomiting profusely with a BP of 90/60. Which of the following measures would be most appropriate?
A Paracetamol levels
B oral methionone
C IV N-acetyl cysteine
D IV fluids

Answer: IV fluids
6 A 24 year old man presented twelve hours after an overdose of dihydrocodeine 1.2 g and paracetamol 30 g. He had pinpoint pupils, a Glasgow Coma Scale score of 14 and a blood pressure of 100/60 mmHg. Which one of the following is the most appropriate management?
A 500ml of 10% glucose intravenously over four hours.
B Intravenous Flumazenil.
C Intravenous Naloxone.
D Intravenous N-acetylcysteine.

Answer: Intravenous N-acetylcysteine.
7 An 85 year old woman presented with bilateral osteoarthritis of the knees. She had no history of previous gastrointestinal disease. Which of the following is the most appropriate initial treatment for her?
A Celecoxib
B Naproxen
C Dihydrocodeine
D Paracetamol

Answer: Paracetamol
8 Which of the following reactions is involved in the metabolism of paracetamol under normal conditions?
A cytochrome p450 dependent oxidation
B hydrolysis
C conjugation to glucuronic acid
D conjugation to glutathione

Answer: conjugation to glucuronic acid
9 Which of the following drugs is most likely to cause systemic lupuslike syndrome?
A baclofen
B isoniazid
C methotrexate
D procainamide

Answer: procainamide
10 Which of the following may be responsible for an acute relapse of Systemic Lupus rythematosus in a 38 year old female?
A hydralazine therapy
B Pregnancy
C Progesterone only contraceptive pill
D Salmeterol therapy

Answer: Pregnancy
11 A 51-year-old female is referred by her GP over concerns about osteoporosis. She had a hysterectomy and oophorectomy because of uterine fibroids one year ago, after which she developed hot flushes that now have stopped. Her elderly mother recently fractured the neck of her femur and the patient is worried about the possibility that she too will fracture her hip later in life. She is otherwise well, is a non-smoker drinks about 5 units of alcohol weekly and has a healthy diet. Examination reveals a fit thin female with a BMI of 18, her blood pressure is 122/88mmHg and breast examination is normal. Which of the following would you recommend for her?
A Bisphosphonates
B Calcitonin
C Combined Oestrogen and progesterone therapy
D Unopposed Oestrogen therapy

Answer: Unopposed Oestrogen therapy
12 There is presently no known effective treatment for a chronic disease. A new treatment is known to be effective in animal models and shows promise in short-term studies in patients. There is some theoretical concerns regarding possible hepato- and bone marrow toxicity although thus far, no toxicity have been observed in studies. What is the most appropriate next step in the drug's development?
A A case control study
B No further studies should be done and drug development should be stopped
C An open study
D A randomised double blind placebo controlled study

Answer: A case control study
13 A 70 year old male was receiving amiodarone 200 mg daily for intermittent atrial fibrillation. However, he was aware of tiredness and lethargy. He appeared clinically euthyroid with no palpable goitre. Investigations revealed:

Serum free T4 23pmol/L (9-26)

Serum total T3 0.8 nmol/L (0.9-2.8)

Serum TSH 8.2 mU/L (<5)

Which of the following statements would explain these results?
A Abnormal thyroxine binding globulin
B Amiodarone-induced hypothyroidism
C Spontaneous hypothyroidism
D TSH secreting pituitary adenoma

Answer: Amiodarone-induced hypothyroidism
14 Which of the following is NOT associated with hyponatraemia and hyperkalaemia?
A Acute hypoadrenalism
B Carbenoxolone therapy
C Co-Amilofruse therapy
D Congestive cardiac failure.

Answer: Carbenoxolone therapy
15 Which one of the following drugs works by inhibiting the tumour necrosis factor?
A cyclosporin
B infliximab
C methotrexate
D montelukast

Answer: infliximab
16 A 70-year-old male is referred by his GP for management of recently diagnosed congestive heart failure. The patient has a history of poorly controlled hypertension. Over the last three months he has been aware of deteriorating shortness of breath, fatigue, and orthopnea. Over the last month he had been commenced on Digoxin (62.5 micrograms daily), Frusemide (80 mg daily), and amiloride 10 mg. On examination he has a pulse of 96 bpm regular, a blood pressure of 132/88 mmHg. His JVP was not raised, he had some scattered bibasal crackles on auscultation with a displaced apex beat in the anterior axillary line, 6th intercostal space. Auscultation of the heart revealed no murmurs and he had peripheral oedema to the mid tibia. Investigations showed: electrolytes normal serum urea concentration 17 mmol/l (NR 2-8 mmol/l) creatinine 175 micromol/l (NR 55-110) Serum digoxin 0.7 ng/mL {therapeutic: 1.0-2.0} One month previously his urea had been 11 mmol/l and creatinine 110 micromol/l. An ECG reveals left ventricular hypertrophy and Chest X-ray shows cardiomegaly and calcified aorta. What is the most appropriate next step in management?
A Add an ACE inhibitor to the current regimen
B Add atenolol at a dose of 25mg daily
C Increase digoxin to 0.25 mg daily
D Increase frusemide to 80 mg twice daily

Answer: Add an ACE inhibitor to the current regimen
17 In which of the following circumstances would the treatment of anaemia with erythropeitin still be expected to be effective?
A Aluminium toxicity
B Folate deficiency
C Hyperkalaemia
D Infection

Answer: Hyperkalaemia
18 Which ONE of the following oncerning Insulin is correct?
A acts via a similar mechanism as steroid receptors
B causes an increased glucose-protein transport on the endoplasmic reticulum
C can be detected in the lymph
D interacts with the nuclear membrane

Answer: can be detected in the lymph
19 A 30 year old male presented with a paranoid psychosis accompanied by visual hallucinations which resolved over the next three days. Which one of the following is the most likely diagnosis?
A Alcohol withdrawal.
B Diazepam dependence.
C Fluoxetine overdose.
D Heroin withdrawal.

Answer: Alcohol withdrawal.
20 Which of the following statements concering the treatment of acute myocardial infarction is correct?
A A pansystolic murmur developing within the first 24 hours does not require further investigation.
B Dipyridamole therapy reduces reinfarction within the first year.
C Heparin is beneficial if given with streptokinase.
D Treatment with a dihydropyridine calcium antagonist is associated with increased cardiovascular mortality.

Answer: Treatment with a dihydropyridine calcium antagonist is associated with increased cardiovascular mortality.