1.Easy
Which long-term side effect of phenytoin makes good oral hygiene especially important?
- ABlue-grey discoloration of the teeth and gums
- BExcess saliva production
- COvergrowth of the gums (gingival hyperplasia)
- DLoss of taste
2.Easy
Sumatriptan is used mainly to:
- ATreat an acute migraine attack
- BTreat high blood pressure
- CRelieve nerve pain from diabetes
- DPrevent epileptic seizures
3.Easy
Which vasopressor is usually first-line for septic shock that persists after fluids?
- AGlyceryl trinitrate
- BNoradrenaline (norepinephrine)
- CIsoprenaline (isoproterenol)
- DAdenosine
4.Medium
How do ACE inhibitors lower blood pressure?
- AThey increase sodium reabsorption in the kidney
- BThey block the conversion of angiotensin I to angiotensin II
- CThey block beta-1 receptors in the heart
- DThey block L-type calcium channels in vascular smooth muscle cells
5.Medium
Which advice helps reduce the most common side effect of varenicline?
- ATake it after food with a full glass of water
- BTake it with alcohol to reduce nausea
- CTake double doses in the first week
- DTake it on an empty stomach at bedtime with a little milk
6.Medium
Which receptor do beta blockers such as metoprolol mainly block?
- ABeta-3 receptors in fat tissue
- BBeta-1 adrenergic receptors in the heart
- CMuscarinic receptors in the heart
- DAlpha-1 receptors in blood vessels
7.Hard
A teenager took a large overdose of diphenhydramine. He is agitated, hot, flushed and confused, with dry skin, dilated pupils and a full bladder. What is this pattern?
- ASerotonin syndrome
- BCholinergic toxidrome
- COpioid toxidrome
- DAnticholinergic toxidrome
8.Hard
A woman using the combined oral contraceptive pill starts carbamazepine for epilepsy. What is the main concern?
- ASevere hypoglycaemia from the combination
- BNo concern, because the drugs do not interact
- CContraceptive failure because the hormones are metabolised faster
- DCarbamazepine toxicity because the pill strongly blocks its metabolism
Answer key
- 1. C · Overgrowth of the gums (gingival hyperplasia)
- 2. A · Treat an acute migraine attack
- 3. B · Noradrenaline (norepinephrine)
- 4. B · They block the conversion of angiotensin I to angiotensin II
- 5. A · Take it after food with a full glass of water
- 6. B · Beta-1 adrenergic receptors in the heart
- 7. D · Anticholinergic toxidrome
- 8. C · Contraceptive failure because the hormones are metabolised faster
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