A & D

Question 1

Nina, a 5-year old girl presented to the GP with 1- month history of intermittent cough. She was previously well. 1 month ago, Nina and her family moved to a house with carpet-covered floors. She then started to have nightly cough. She had difficulty of breathing with wheezing when she went to the GP. She was then diagnosed with asthma and prescribed salbutamol 6 puffs every 3 hours and corticosteroid, with a weaning plan and advised to come back for follow-up. At the end of the lecture, answer these questions: 1. Which of the following drugs is used as a bronchodilator or as a reliever for Nina during an acute attack of asthma? (A) disodium cromoglycate (B) salbutamol (C) hydrocortisone (D) budesonide (E) beclomethasone

Answer 1

(B) salbutamol

Question 2

Nina, a 5-year old girl presented to the GP with 1- month history of intermittent cough. She was previously well. 1 month ago, Nina and her family moved to a house with carpet-covered floors. She then started to have nightly cough. She had difficulty of breathing with wheezing when she went to the GP. She was then diagnosed with asthma and prescribed salbutamol 6 puffs every 3 hours and corticosteroid, with a weaning plan and advised to come back for follow-up. 1. Which of the following drugs is used as an anti-inflammatory drug that is used during an acute attack of asthma? (A) corticosteroid (B) salbutamol (C) salmeterol (D) theophylline (E) ipratropium bromide

Answer 2

(A) corticosteroid

Question 3

1. Which of the following side effects is associated with long term usage of corticosteroids? (A) hyperkalaemia (B) hypokalemia (C) hypoglycaemia (D) adrenal stimulation (E) hypotension

Answer 3

(B) hypokalemia

Question 4

2. Which of the following side effects is associated with beta2 agonists ? (A) hyperkalaemia (B) tachycardia (C) hypoglycaemia (D) adrenal stimulation (E) hypotension

Answer 4

(B) tachycardia

Question 5

2. Where is the most desirable site for insulin injection and why? Should be subcutaneous: 30 min before meal

Answer 5

• abdominal wall: generally fastest and the most uniform rate of absorption. • legs: slowest absorption (unless exercising), acceptable site. • buttocks

Question 6

3. What are the treatment options for gestational diabetes?

Answer 6

• nutrition therapy: avoid excess weight gain • insulin • hypoglycaemic drugs not advised

Question 7

4. Why can free fatty acid cause insulin resistance (in muscle)?)

Answer 7

Excessive triglyceride storage blocks insulin signalling pathway resulting in insulin resistance in liver, muscle and fat. (Free fatty acid is converted into diacyglycerol which blocks the insulin signalling through IRS-1. This can subsequently cause the internalising of GLUT4 which hinder the uptake of glucose. )

Question 8

5. What is the most common complication in insulin therapy? A. Lipodystrophies B. Hypotension C. Gallstones D. Hypoglycemia E. Retinopathy

Answer 8

Hypoglycemia

Question 9

Answer 9