Features of Amitryptiline overdose may include:
a) Hypertonus
b) Cardiac arrhythmias
c) Non respiratory acidosis
d) Respiratory depression
e) Hypothermia
Drugs exhibiting zero order metabolism at clinical dosage include:-
a) Phenytion
b) Morphine
c) d-tubocurarine
d) ethyl alcohol
e) lignocaine
Naloxone
a) Is metabolised by the liver
b) Crosses the placenta
c) Half life is less than 1 hour
d) Should be given by infusion for sustained effect
e) Has a half life shorter than Naltrexone
The following are metabolised greater than 10%
a) Nitrous oxide
b) Xenon
c) Isoflurane
d) Halothane
e) Enflurane
The following exert some of their actions by interference with calcium transport.
a) Dantrolene
b) Verapamil
c) Halothane
d) Adrenaline
e) Nifedipine
Flumazenil
a) Competes with GABA at post-synaptic sites
b) Has a half life of less than 1 hour
c) Has an active metabolite
d) Antagonises all benzodiazepines
e) Can cause convulsions
The flowing substances are freely transferred across the placenta
a) Insulin
b) Thyroxine
c) Ig G
d) Warfarin
e) Glucose
In patients receiving mono-amine oxidase inhibitors, adverse reactions may occur as a result of the ingestion or administration of
a) Amitriptyline
b) Allopurinol
c) Isoprenaline
d) Aspirin
e) Pethidine
The administration of propranolol may cause
a) A rise in cardiac output
b) A fall in blood pressure
c) Tachycardia
d) Coronary vasodilatation
e) Bronchodilatation
In a patient suffering from digoxin toxicity
a) The ECG characteristically shows widespread RST segment depression
b) Intravenous calcium gluconate may temporarily reverse the toxic effects on the myocardium
c) Propranolol may be helpful in the treatment of heart block if present
d) The plasma digoxin is a reliable guide to the severity.
e) Digitalis antibodies are specific antidote
The following cause raised intracranial pressure
a) Ketamine
b) Hypercapnia
c) Thiopentone
d) Halothane
e) Etomidate
The following cause an increase in intragastric pressure
a) Suxamethoium
b) Morphine
c) Neostigmine
d) Adrenaline
e) Cimetidine
Aminoglycosides may cause
a) Optic atrophy
b) Tinnitus
c) Renal failure
d) Neuromuscular blockade
e) Hepatic necrosis
Ephedrine
a) Causes increased noradrenaline release from nerve terminals
b) Has bronchoconstrictor activity
c) Increases systemic vascular resistance
d) Reduces uterine blood flow
e) Displays tachyphylaxis
Sulphonylureas
a) Increase peripheral utilization of glucose
b) Are effective in patients with no endogenous insulin
c) Are used in type 2 diabetes mellitus
d) Can cause lactic acidosis
e) Do not cause hypoglycaemia
Dextrans
a) Can interfere with blood clotting
b) Can cause renal failure
c) Can cause anaphylaxis
d) Decrease platelet aggregation
e) Increase blood viscosity
The following can have zero order metabolism at therapeutic doses.
a) Morphine
b) Alcohol
c) Phenytoin
d) Sulphonylureas
e) Tetracyclines
Droperidol
a) Reverses apomorphine induced vomiting
b) Causes alpha one blockade
c) Can cause parkinsonism
d) Can cause a catatonic state
e) Acts only on peripheral dopamine receptors
Cimetidine
a) Decreases lower oesophageal sphincter pressure
b) Causes microsomal enzyme inhibition
c) Is useful in treating acute anaphylaxis
d) Decreases hepatic blood flow
e) Decreases absorption of aspirin from the stomach
Midazolam
a) Is less potent than diazepam
b) Has a half life of 2 to 4 hours
c) Is 90% plasma protein bound
d) Is a useful drug in suspected intra-operative awareness
e) Produces anaesthesia in one arm brain circulation time
Bio-availability can be influenced by
a) First pass metabolism
b) Gastric acidity
c) Plasma protein binding
d) Gastrointestinal mucosa metabolism
e) Renal clearance
Thiazide diuretics may cause
a) Hypokalaemic alkalosis
b) Hyperuricaemia
c) Increased blood glucose
d) Hyperchloraemia
e) Hyponatraemia
Heparin
a) Should not be mixed with acidic solutions
b) Prolongs the clotting time but not the bleeding time
c) Inactivates thrombin
d) Can be reversed with vitamin K
e) Has a half life of 30 mins at therapeutic doses
Severe salicylate poisoning
a) Causes metabolic acidosis
b) Decreases platelet count
c) Decreases fibrinogen
d) Causes Tinnitus
e) Causes haemolysis
The following cross the blood brain barrier
a) Atenolol
b) Hyoscine
c) Propranolol
d) Tubocurare
e) Glycopyrrolate
Thiopentone
a) Has a pKa of 5.1
b) Has pentobarbitone as a metabolite
c) Elimination T1/2 is less then methohexitone
d) Volume of distribution is less than methohexitone
e) Is a better induction agent than Propofol in patients with poor cardiac reserve.
The following have a T1/2 more than 24 hours
a) Gelofusion
b) Amiodarone
c) Hetastarch
d) Thiopentone
e) diazepam
Alfentanil
a) Binds to alpha 1acid glycoptotein
b) Has a greater volume of distribution then fentanyl
c) Is metabolised by glucuronide conjugation
d) Causes a decrease in heart rate
e) Is antagonised by pentazocine
Omeprazole
a) Has an elimination T1/2 of 2 hours
b) Irreversibly binds to the proton pump
c) Has a bio-availability that increases with its use
d) Inhibits gastrin secretion
e) Is a H2 anatagonist
Dopamine:
a) Increases cardiac output
b) In high doses causes peripheral vasodilation
c) Increases renal blood flow
d) Causes increased ventricular excitability
e) Increases splanchnic blood flow
Cocaine:
a) Competes with noradrenaline at binding sites
b) May produce vomiting
c) Depresses respiration
d) Hypersensitivity is rare
e) Is largely excreted unchanged in urine
Pharmacokinetics
a) Vd= amount/ concentration
b) Half life=rate of elimination / clearance
c) CI=0.693*t1/2/vd
d) Alcohol is eliminated by a first order process
e) Theophylline exhibits zero order process elimination at low doses anD first order elimination at high does.
Prochlorperazine has the following properties.
a) Anti-cholinergic
b) Antibiotic
c) Membrane stabilising
d) Alpha blocking (Alpha 1)
e) Anti-dopaminergic
The following are hepatotoxic
a) Sodium valproate
b) Isoflurane
c) Amitriptyline
d) Halothane
e) Chlorpromazine
Alpha 1 acid glycoprotein is a major determinant of plasma protein binding for:-
a) Bupivacaine
b) Lignocaine
c) Methadone
d) Amitriptyline
e) Prednisolone
Anticholinergics
a) May be used in Parkinson’s disease
b) Ipratropium is better absorbed than atropine
c) Cause hyperthermia
d) Causes bradycardia before causing tachycardia
e) Causes retention of urine
Hypokalaemia
a) May be induced by liquorice
b) Is associated with renal tubular acidosis
c) Is a feature of Familial Periodic paralysis
d) May cause Hypotonia
e) The maximum potassium that can be safely administered in an hour is 40 m mol
The following are characteristic features of salicylate poisoning:
a) Loss of consciousness
b) Respiratory acidosis
c) Dry skin
d) Dilated pupils
e) Acute hepatic failure
Drugs used in terminating ventricular extrasystoles:-
a) Mexiletine
b) Disopyramide
c) Verapamil
d) Digoxin
e) Amiodarone
Effect lasting for > 24 hrs after stoppage:-
a) Amiodarone
b) Methyldopa
c) Clonidine
d) Temazepam
e) Alcohol
In patients on monoamine oxidase inhibitors, avoid:
a) Halothane
b) Pethidine
c) Amphetamine
d) Phenylephrine
e) adrenaline
Labetolol
a) Is a selective beta-1 antagonist
b) Has alpha-1 antagonist activity
c) Reduces bile excretion
d) Reduce rennin output.
e) Is a class-II antiarrythmic agent
pH reversibly affect the structure of:-
a) Lignocaine
b) Tubocurare
c) Midazolam
d) Atracurium
e) Diazepam
Midazolam
a) More potent than diazepam
b) Elimination half-life 2-4 hours
c) Induces sleep in one arm brain circulatic
d) More then 90% protein bound
e) Causes retrograde amnesia
Tubocurare
a) Is a monoquaternary compound
b) Reduce BP by ganglion blockade
c) Releases histamine
d) Is excreted in bile
e) Blocks vagal tone
Sodium Nitroprusside toxicity;-
a) Not dose related
b) Due to reduced liver rhodanase
c) Due to cyanide
d) Due to thiocyanate
e) Antagonised by methylene blue
The following block calcium transport in muscle;
a) Nicardipine
b) Diltiazem
c) Hydrallazine
d) Dantrolene
e) Gentamicin
Parathormone
a) Is regulated by blood Calcium concentration
b) Increases urinary phosphate excretion
c) Increases bone resorbtion
d) Is a globulin
e) Can be produced by breast tumours
Frusemide
a) Causes hypoglycaemia
b) Increases uric acid excretion
c) Decreases the hypertonicity of the renal medulla
d) Cause hypokalaemia
e) Act on the collecting duct
Propranolol causes;-
a) Hypotension
b) Hypoglycaemia
c) Tachycardia
e) Decreased cardiac output.
Atropine:-
a) Is more sedative then hyoscine
b) Reverses some of the effects of morphine
c) Inhibits sweating
d) In overdose causes hyperpyrexia
e) Readily absorbed from stomach
Halothene:-
a) Has a boiling point of 52 ºC
b) Has a vapour pressure of 240 mm Hg at 20 ºC or 32 kPa
c) Has an oil / water solubility coefficient of about 220
d) Has a blood/gas solubility coefficient of 2.5
e) Has a MAC of about 0.7
Cerebral vascular resistance is decreased by:-
a) Thiopentone
b) Halothane
c) Enflurane
d) Trichlcroethylene
e) PEEP
The following penicillins are resistant to penicillinase
a) Methicillin
b) Cloxacillin
c) Amoxycillin
d) Phenoxymethylpenicillin
e) Carbenicillin
Pupillary dilatation is caused by:-
a) Cocaine
b) Ganglion blockers
c) Alpha-1 agonists
d) Anticholinesterases
e) Codeine
Trimetaphan
a) Potentates neuromuscular blockade
b) Causes hypotension
c) Is metabolised by esterases
d) Is a ganglionic blocker
e) Is useful in controlled hypotension
Metoclopramide
a) Causes on increase in oesophageal barrier pressure
b) Increases Prolactin
c) Causes hirsutism
d) Increases 5 Ht
e) Is more potent then Granisetron in preventing PONV
Thyroxine:-
a.) Is essential for skeletal development
b) Increases oxygen consumption
c) Stimulates T.S.H secretion
d) Depresses cholesterol synthesis
e) Is bound to plasma proteins in the blood
The following drugs relax uterus
a) Adrenaline
b) Isoprenaline
c) Ketamine
d) Halothane
e) Glyceryl trinitrate
Diazepaam:-
a) Is an anticonvulsant
b) Releases dopamine from the substantia gelatinosa
c) Has actions on the limbic system
d) Has tranquillising properties
e) Is metabolised to oxazepam in the lung
Increase of pH of the urine increases the excretion of :-
Pethidine
Amphetamines
Salicylates
Phenobarbitone
Hyoscine hydrobromide
Acute intermittent Porphyria may be precipitated by:-
Thiopentone
Morphine
Methohexitone
Propanidid
Pentobarbitone
The second member of each pair antagonises the first:-
Pentazocine ----- nalorphine
Warfarin --------- protamine
Pancuronium ----- Neostigmine
Carbachol --------- propranolol
Insulin ------------ glucagon
Panhypopituiterism in a 35 year old woman is suggested by:-
a) Galactorrhoea.
b) Hyperoyrexial apisodes
c) Scanty pubic and Axillary hair
d) Impaired excretion of a water ---------
e) Hot flushes.
Severe salicylate intoxication may produce:-
a) Metabolic acidosis
b) Tinnitus
c) Hawmolysis
d) Hypoprothombinaemia
e) Thrombocytopaenia
The following drugs interfere with muscular contraction by interfering with calcium transport.
a) Diltiazem
b) Atracurium besylate
c) Dantrolene
d) Hydralazine
e) GTN
The Sulphonylureas
a) Decrease peripheral glucose utilisation
b) May cause hypoglycaemia in normal people
c) May cause lactic acidosis
d) Are effective in pancreatectomized patients
e) Have a half life fo more then 10 hours.
The following drugs show zero order kinetics at normal therapeutic concentrations.
a) Ethyl alcohol
b) Tubocurarine
c) Phenytoin
d) Acetylsalicylic acid
e) Methohexitone
The following drugs lower gastric barrier pressure
a) Suxamethonium
b) Adrenaline
c) Enflurane
d) Atropine
e) Secretin
The following drugs cross the placenta easily:-
a) Pethidine
b) Suxamethonium
c) Glycopyrrolate
d) Insulin
e) Warfarin
Pentazocine
a) Is a partial agonist
b) Is more potent than morphine
c) Is a respiratory depressant
d) Is antagonized completely by naloxone
e) Has been used in sequential analgesia.
Halothane
a) Has a molecular weight fo 197.2
b) Its molecule contains four fluorine atoms
c) Has a boiling point of 50 degrees centigrade
d) Has a MAC of 1.50
e) Has a SVP of 220 mmHg at 20 degrees centigrade
Theophylline may cause:-
a) An increase in cardiac output
b) An increase in GFR
c) An increase in alveolar dead space
d) Feelings of anxiety
e) Life-threatening ventricular arrythmias
Dextrans
a) May cause renal failure
b) May cause an increase in circulating volume greater than the volume infused
c) May cause rouleux formation and sludging
d) May cause anaphylaxis
e) May decrease blood viscosity
A substance with a volume of distribution the same as plasma and an elimination half life of 2 hours
a) Is highly protein bound
b) Is fat soluble
c) Is excreted by active renal tubular secretion
d) Is excreted unchanged by the kidney
e) May be a quaternary ammonium compound
Thiazide diuretics may cause:-
a) Hyponatraemia
b) Hypochloraemic alkalosis
c) Hyperuricaemia
d) Hyperglycaemia
e) Hyperkalaemia
Sodium Nitro Prusude toxicity:-
a) Is not dose related
b) May be due to a deficiency of live rhodanase
c) Is due to thiocyanate accumulation
d) Is due to cyanide ion accumulation
e) Is worse in patients with B12 deficiency.
Pethidine:-
a) Has a shorter half life than morphine
b) Has a shorter duration than morphine
c) Has active metabolites
d) Has metabolites with analeptic activity only
e) Has local anaesthetic action.
Morphine:-
a) Causes a rise in intraocular pressure
b) May be antagonised by nalbuphine
c) Relaxes the jejunum
d) Is less emitogenic than Fentanyl
e) has a longer half life than naloxone
Isoprenaline
a) Causes a fall in total peripheral resistance
b) Increase cardiac output
c) Is useful in raising cardiac output in arrhythmias
d) Relaxes uterine smooth muscle
e) Is a bronchodilator
Glyceryl trinitrate
a) Raises central venous pressure
b) Raises blood pressure
c) Is metabolised to nitric oxide
d) Has high first pass metabolism
e) Causes meningeal vasodilation
The ideal intravenous anaesthetic agent
a) Is stable in aqueous solution
b) Crosses the blood brain barrier
c) Is completely metabolised in 1 hour
d) Has a pKa around 7.4
e) Is excreted unchanged
Propofol
a) Is formulated in propylene glycol
b) Reduces total peripheral resistance
c) Is metabolised to glucuronide and sulphonides
d) Undergoes rapid hepatic metabolism
e) Is 2, 4 Di-iso Propyl Phenol
The following are enzyme inhibitors
a) Aminophylline
b) Enoximone
c) Vecuronium
d) Edrophonium
e) Atropine
The following are used to treat raised intracranial pressure
a) Dexamethasone
b) Mannitol
c) Bumetanide
d) Isoflurane
e) Ketaamine
The following increase intra-ocular pressure
a) Suxamethonium
b) Ketamine
c) Hypoventilation
d) Hypoxia
e) Halothane
The following cannot be used with MAOIs
a) Morphine
b) Pethidine
c) Amphetamine
d) Phenylephrine
e) Lithium
The following are safe to use in Porphyria
a) Ketamine
b) Atomidate
c) Diazepam
d) Etomidate
e) Di-Iso Propyl Phenol
Carbamazepine
a) Is an anticonvulsant
b) Induces liver enzymes
c) Is a benzodiazepine
d) Is used to treat trigeminal neuralgia
e) used to treat reflex sympathetic dystrophy
Insulin
a) Has the same action as growth hormone on blood glucose concentration
b) Increases protein catabolism
c) Increase fat anabolism
d) Prevents potassium uptake into cells
e) Antagonised by Glucagon
Atropine
a) Increases physiological dead space
b) Decreases lower oesophageal sphincter tone
c) Decreases H+ secretion in the stomach
d) Decreases exocrine secretions in he body
e) Causes mydriasis
The duration of action of an intravenous anaesthetic agent will be affected by:-
a) PH of the anaesthetic solution
b) Lean body mass
c) Renal blood flow
d) Total blood volume
e) Administration of a pre-med
Physostigmine
a) Crosses the blood brain barrier
b) Reverses the CNS effects of tricyclic overdose
c) Is contraindicated in atropine poisoning
d) Can be used to reverse a depolarising neuromuscular blockade
e) Is the structural isomer of Neostigmine
The bio-availability of the following orally administered drugs is over 50%
a) Morphine
b) Propranolol
c) Methadone
d) Atenolol
e) Lignocaine
The output of acid urine
a) Is controlled by aldosterone
b) Varies with the ammonium output
c) Varies with plasma inorganic phosphate
d) Is reduced by inhibitors of carbonic anhydrase
e) Is reduced in chloride depletion
The binding of a drug to plasma albumin
a) Is usually covalent in nature
b) Is markedly different in arterial and venous blood
c) Occurs only after i.v. administration
d) Prevents rapid renal glomerular filtration of the drug
e) Reduces renal tubular secretion of the drug
The blood-brain barrier
a) Is anatomically situated at the arachnoid villi
b) Is less permeable in the newborn
c) Only permits free passage of lipid-soluble solutes
d) Does not permit free passage of organic anions
e) Has similar functional characteristics to a cell membrane
Gastric absorption of weak acids
a) Proceeds at a rate directly proportional to pH of gastric juice
b) Is faster than that of weak bases
c) Involves diffusion of he un-ionised acid across the gastric mucosa
d) Is reduced in achlorhydria
e) Occurs during gastrin- but not histamine- induced gastric acid secretion
Thiopentone is a “short-lasting” barbiturate because
a)