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1.سهلة
How does tramadol relieve pain?
AWeak opioid agonism plus inhibiting the reuptake of serotonin and noradrenaline
BAntagonising NMDA receptors in the spinal cord and blocking sodium channels
CBlocking COX enzymes in the periphery
DBlocking sodium channels in peripheral nerves
2.سهلة
Disulfiram is used in alcohol use disorder because it:
ACauses an unpleasant reaction if alcohol is drunk
BReplaces alcohol at its receptors in the brain
CRemoves alcohol from the blood faster
DCures liver damage caused by alcohol
3.سهلة
Which drug can be used in beta blocker overdose because it raises heart rate through a non-adrenergic pathway?
AGlucagon
BFlumazenil
CNaloxone
DInsulin
4.متوسطة
A patient with Addison's disease on hydrocortisone develops a fever with flu. What is the usual advice?
AIncrease the dose as instructed (sick-day rules) and seek help if vomiting
BMake no change, as illness does not affect cortisol needs
CStop the hydrocortisone until the fever settles, to let the body recover
DHalve the hydrocortisone to reduce side effects
5.متوسطة
Why are patients taking simvastatin often advised to avoid large amounts of grapefruit juice?
AGrapefruit inhibits CYP3A4 in the gut, raising simvastatin levels and myopathy risk
BGrapefruit blocks cholesterol absorption and causes low cholesterol
CGrapefruit makes the tablet dissolve in the mouth
DGrapefruit speeds up simvastatin breakdown in the liver, so the drug stops working
6.متوسطة
After instilling eye drops, why should the patient press gently on the inner corner of the eye for a minute or two?
ATo reduce drainage into the nose and absorption into blood
BTo spread the drop evenly over the eyelid
CTo stop the eye from producing tears for about an hour
DTo make the pupil dilate faster
7.صعبة
A patient taking azathioprine is prescribed allopurinol for gout. What is the main danger?
AGout becomes worse because allopurinol is inactivated by azathioprine
BLiver enzyme induction, making azathioprine ineffective
CSevere hypertension from the combination
DSevere bone marrow suppression, because azathioprine breakdown is reduced
8.صعبة
A nurse calculates a child's dose and finds it is ten times higher than the usual range in the drug reference. What should the nurse do?
AGive one tenth of the dose without telling anyone
BGive half the dose as a compromise
CWithhold it, recheck the calculation and clarify with the prescriber
DGive the dose, because the prescriber is responsible for the order
مفتاح الإجابات
1. A · Weak opioid agonism plus inhibiting the reuptake of serotonin and noradrenaline
2. A · Causes an unpleasant reaction if alcohol is drunk
3. A · Glucagon
4. A · Increase the dose as instructed (sick-day rules) and seek help if vomiting
5. A · Grapefruit inhibits CYP3A4 in the gut, raising simvastatin levels and myopathy risk
6. A · To reduce drainage into the nose and absorption into blood
7. D · Severe bone marrow suppression, because azathioprine breakdown is reduced
8. C · Withhold it, recheck the calculation and clarify with the prescriber
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