1.Easy
How do local anaesthetics such as lidocaine block pain?
- AThey activate opioid receptors in the spinal cord
- BThey block prostaglandin synthesis at the injury site
- CThey block voltage-gated sodium channels in nerve membranes
- DThey enhance the action of GABA in the brain and spinal cord
2.Easy
What does "bacteriostatic" mean?
- AThe drug prevents the patient's immune response
- BThe drug stops bacteria multiplying without killing them directly
- CThe drug kills viruses as well as bacteria
- DThe drug kills bacteria directly by breaking down their cell wall
3.Easy
In hepatic encephalopathy, lactulose is given mainly to:
- AStop bleeding from varices
- BReduce fluid in the abdomen
- CRaise the blood glucose level
- DLower the blood ammonia level
4.Medium
An adult patient is due to receive digoxin. The apical pulse, counted for a full minute, is 52 beats per minute. What should the nurse do?
- AGive half the dose and document the pulse
- BWithhold the dose and notify the prescriber
- CGive the dose with food to slow absorption
- DGive the dose and recheck the pulse in one hour
5.Medium
A patient receives lactulose for hepatic encephalopathy. Which finding shows that it is working?
- ABetter alertness and orientation, with two to three soft stools a day
- BHigher blood ammonia with improved appetite
- CTen watery stools a day and a low serum potassium
- DNo bowel movement for three days, with less confusion than before
6.Medium
How does clopidogrel reduce platelet aggregation?
- AIt blocks the platelet P2Y12 receptor for ADP
- BIt inhibits platelet COX-1
- CIt blocks the glycoprotein IIb/IIIa receptor directly
- DIt activates antithrombin
7.Hard
A patient recently started on haloperidol develops high fever, "lead-pipe" muscle rigidity, confusion and a very high creatine kinase. What is the most likely diagnosis?
- AMalignant hyperthermia from anaesthesia
- BAcute dystonia
- CSerotonin syndrome
- DNeuroleptic malignant syndrome
8.Hard
Why can an ACE inhibitor cause acute kidney injury in a patient with bilateral renal artery stenosis?
- AGFR depends on angiotensin II constricting the efferent arteriole
- BACE inhibitors are directly toxic to the proximal tubule cells in the kidney
- CACE inhibitors constrict the afferent arteriole
- DThe drug crystallises in the renal tubules
Answer key
- 1. C · They block voltage-gated sodium channels in nerve membranes
- 2. B · The drug stops bacteria multiplying without killing them directly
- 3. D · Lower the blood ammonia level
- 4. B · Withhold the dose and notify the prescriber
- 5. A · Better alertness and orientation, with two to three soft stools a day
- 6. A · It blocks the platelet P2Y12 receptor for ADP
- 7. D · Neuroleptic malignant syndrome
- 8. A · GFR depends on angiotensin II constricting the efferent arteriole
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