1.Easy
Which vasopressor is usually first-line for septic shock that persists after fluids?
- AGlyceryl trinitrate
- BNoradrenaline (norepinephrine)
- CAdenosine
- DIsoprenaline (isoproterenol)
2.Easy
How does activated charcoal work in poisoning?
- AIt neutralises acids in the blood
- BIt makes the patient vomit the poison before it is absorbed
- CIt speeds up liver metabolism of the poison
- DIt binds (adsorbs) the poison in the gut so less is absorbed
3.Easy
After chemotherapy, what is the "nadir"?
- AThe time when nausea is worst
- BThe day the drug is given
- CThe point when blood cell counts are at their lowest
- DThe point when the tumour is at its smallest after treatment
4.Medium
Which technique is correct when giving subcutaneous enoxaparin from a prefilled syringe?
- AInject into a vein on the back of the hand
- BExpel the air bubble from the syringe first, then inject into the deltoid muscle
- CInject into the abdomen away from the navel and do not rub the site afterwards
- DMassage the site well for one minute after the injection
5.Medium
Which type of diuretic acts on the thick ascending limb of the loop of Henle?
- ALoop diuretics such as furosemide
- BOsmotic diuretics
- CThiazide diuretics
- DPotassium-sparing diuretics
6.Medium
How should a hyoscine (scopolamine) patch for motion sickness be used?
- AApply it behind the ear several hours before travel
- BApply it to the chest only after the vomiting has started
- CSwallow it if no water is available
- DCut it in half for children without advice
7.Hard
A patient receiving a phenylephrine infusion has a rise in blood pressure and a fall in heart rate. What is the best explanation?
- APhenylephrine stimulates muscarinic receptors
- BAlpha-1 vasoconstriction raises blood pressure and causes reflex bradycardia
- CPhenylephrine directly blocks beta-1 receptors in the heart's conduction system
- DThe fall in heart rate shows phenylephrine toxicity of the AV node
8.Hard
A patient taking metoprolol is also started on verapamil. Which adverse effect is most likely?
- AHypoglycaemia and weight gain
- BRebound tachycardia and hypertension
- CHyperkalaemia and muscle weakness
- DSevere bradycardia and heart block
Answer key
- 1. B · Noradrenaline (norepinephrine)
- 2. D · It binds (adsorbs) the poison in the gut so less is absorbed
- 3. C · The point when blood cell counts are at their lowest
- 4. C · Inject into the abdomen away from the navel and do not rub the site afterwards
- 5. A · Loop diuretics such as furosemide
- 6. A · Apply it behind the ear several hours before travel
- 7. B · Alpha-1 vasoconstriction raises blood pressure and causes reflex bradycardia
- 8. D · Severe bradycardia and heart block
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