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MRCP Part 1 > Clinical pharm = > Flashcards

Clinical pharm = Flashcards

1
Q

drug is most likely to cause impaired glucose tolerance in transplant patients

A

Tacrolimus

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2
Q

oculogyric crisis Management

A

Benztropine or procyclidine

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3
Q

Which common heart drug can cause sleep disturbances and nightmares

A

Beta blockers

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4
Q

mechanism underlying the drug-induced renal injury Of aminoglycosides

A

Acute tubular necrosis

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5
Q

Mechanism of action of aspirin

A

non reversible COX 1 and 2 inhibitor

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6
Q

Drug used for uti that can cause pulmonary fibrosis

A

Nitrofurantoin

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7
Q

Inducers of the P450 system

A

Inducers of the P450 system include
antiepileptics: phenytoin, carbamazepine
barbiturates: phenobarbitone
rifampicin
St John’s Wort
chronic alcohol intake
smoking

reduce the effects of drug

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8
Q

Inhibitors of the P450 system

A

Inhibitors of the P450 system include
antibiotics: ciprofloxacin, erythromycin
isoniazid
sodium valproate
cimetidine,omeprazole
amiodarone
allopurinol
imidazoles: ketoconazole, fluconazole
SSRIs: fluoxetine, sertraline
ritonavir
sodium valproate
acute alcohol intake
quinupristin

enhances drug effect/ prolongs drug effect

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9
Q

primary constituents of granulomatous structures

A

macrophages

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10
Q

what cytokine activates macrophages?

A

Interferon-γ released by Th1 cells activates macrophages

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11
Q

what cytokine is released by macrophages to cause FEVER and neutrophil chemotaxis?

A

TNF-a

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12
Q

what cytokine is released by macrophages to cause B cell differentation?

A

Interleukin-6

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13
Q

what cytokine is released by macrophages to cause neutrophil attraction (chemotaxis) to a site of inflammation/infection?

A

Interleukin-8

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14
Q

Diabetic nephropathy histological findings

A

Kimmelstiel-Wilson lesions (nodular glomerulosclerosis)

basement membrane thickening, capillary obliteration, mesangial widening.

hyaline arteriosclerosis

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15
Q

amyloidosis nephropathy histological findings

A

Apple-green birefringence under polarised light

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16
Q

diffuse proliferative glomerulonephritis (often due to SLE) nephropathy histological findings

A

Wire looping of capillaries in the glomeruli

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17
Q

which diabetic drug can cause B12 deficiency due to impact on gut mobility and absorption?

A

metformin

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18
Q

effect of cocaine during pregnancy?

A

induce preterm labour

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19
Q

Parametric tests

A

Parametric tests:
Student’s t-test - paired or unpaired

Pearson’s product-moment coefficient - correlation

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20
Q

Non-parametric tests

A

Mann-Whitney U test
compares ordinal, interval, or ratio scales of unpaired data

Wilcoxon signed-rank test
compares two sets of observations on a single sample, e.g. a ‘before’ and ‘after’ test on the same population following an intervention

chi-squared test
used to compare proportions or percentages e.g. compares the percentage of patients who improved following two different interventions

Spearman, Kendall rank - correlation

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21
Q

what are the cellular target options for drugs?

A

ion channels eg. lidocaine acts on these

G-coupled receptors. eg. adrenoreceptors
when drugs bind it triggers series of reactions –> produce cyclic AMP –> effects

Guanylate cyclase receptors
contain intrinsic enzyme activity
e.g. atrial natriuretic factor, brain natriuretic peptide

tyrosine kinase receptors eg. insulin acts on these
results in phosphorylation reactions which then cause cell growth/ differentiation

nuclear receptors eg. prednisolone, steroids and levothyroxine
they are lipid soluble so can penetrate the membrane to target these receptors and thereby increase/decrease gene expression

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22
Q

significance tests for correlation

A

parametric (normally distributed): Pearson’s coefficient

non-parametric: Spearman’s coefficient

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23
Q

treatment ethylyene glycol (antifreeze) or methanol poisoning

A

fomepizole,

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24
Q

Patients with which complement deficiency are most predisposed to disseminated meningococcal infection?

A

C5-9 deficiency

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25
Q

Patients with which complement deficiency are most predisposed to immune complex deficiencies like SLE, HSP?

A

C1q, C1rs, C2, C4 deficiency

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26
Q

Patients with which complement deficiency are most predisposed to recurrent bacterial infections?

A

C3

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27
Q

what cells produce IgE?

A

plasma cells produce IgE

IgE receptors are found on mast cells

28
Q

50% of the population are deficient in hepatic N-acetyltransferase

Drugs affected by acetylator status:

A

isoniazid
procainamide
hydralazine
dapsone
sulfasalazine

therefore increased risk of toxicity

29
Q

which hypersensitivity reaction is caused by immune complex deposition?

A

type 3

30
Q

which hypersensitivity reaction is caused by antibodies binding to an antigen?

A

type 2

31
Q

overdose associated with respiratory alkalosis?

A

salicylate and theophylline overdoses (these are respiratory stimulants)

theophylline –> seizures, hypoK

32
Q

why do NSAIDs cause UGI bleeds?

A

depletes mucosal prostaglandin levels –> mucosal injury

33
Q

How does NMDA cause its effects?

A

activates serotonin and sympathetic nervous system

SIADH –> hyponatraemia
–> seizures

34
Q

which HLA is most important in avoiding hyperacute organ transplant rejection?

A

HLA-C

35
Q

antibodies in myasthenia gravis vs lambert eaton syndrom

A

lamber eaten: voltage gated calcium

myasthenia gravis: anti acetylreceptor autoantibodies

36
Q

distinguishing feature between methanol vs ethylene glycol (antifreeze) overdose/poisoning?

A

methanol cause vision loss

37
Q

the most common lipid storage disorde

A

Gaucher disease
accumulation of glucocerebrosidase in the brain, liver and spleen. Key features include hepatosplenomegaly, aseptic necrosis of the femur

38
Q

cardiology drug that causes constipation

A

verapamil

39
Q

What is the target for rituximab?

A

Rituximab - CD20 on B cells

40
Q

what type of receptors are adrenoceptors?

A

G coupled

41
Q

lithium tremor trypes

A

fine = acute toxicity
coarse = chronic use

42
Q

Standard error of the mean equation

A

Standard error of the mean = standard deviation / square root (number of patients)

43
Q

where does cocaine act?

A

cocaine blocks the uptake of dopamine, noradrenaline and serotonin

mx. benzos

44
Q

power equation

A

Power = 1 - the probability of a type II error

45
Q

Quinine toxicity signs

A

Quinine toxicity - anti malarial + leg cramps meds

(cinchonism) presents with myriad ECG changes, hypotension, metabolic acidosis, hypoglycaemia and classically tinnitus, flushing and visual disturbances. Flash pulmonary oedema may occur

46
Q

what is used to demonstrate publication bias in meta-analysis?

A

funnel plot

symmetrical - unlikely bias
asymmetrical - bias

47
Q

vitamin B3 (niacin) deficiency

A

pellagra

dementia, diarrhoea and dermatitis

48
Q

inheritance of haemophilia

A

x linked recessive

49
Q

Causes of drug-induced photosensitivity

A

thiazides
tetracyclines, sulphonamides, ciprofloxacin
amiodarone
NSAIDs e.g. piroxicam
psoralens
sulphonylureasDepolarising neuromuscular blocker

50
Q

name a depolarising muscle relaxant?

A

suxamethonium

51
Q

statins and pregnancy/ conception

A

statins should be discontinued in women 3 months before conception due to the risk of congenital defects

52
Q

Drug-induced gingival hyperplasia causes

A

anticonvulsants, calcium channel blockers, and immunosuppressants.

53
Q

Quit smoking

A

NRT or Varenicline or Bupropion

prescription of NRT, varenicline or bupropion should be sufficient to last only until 2 weeks after the target stop date. Normally, this will be after 2 weeks of NRT therapy, and 3-4 weeks for varenicline and bupropion, to allow for the different methods of administration and mode of action.

Varenicline is more effective but caution in self harm/depression

Bupropion increases seizure risk so not for epileptic

Pregnancy - NRT

54
Q

Shigella mx

A

Cipro

55
Q

What drug is celecoxib?

A

NSAID

56
Q

Restless legs syndrome -what is the single most important blood test?

A

ferritin (common cause of RLS)

57
Q

Ciclosporin + tacrolimus: mechanism of action

A

Ciclosporin + tacrolimus: inhibit calcineurin thus decreasing IL-2

58
Q

drugs that cause Liver cirrhosis

A

methotrexate
methyldopa
amiodarone

59
Q

Ciclosporin side-effects

which is most common?

A

everything is increased - fluid, BP, K+, hair, gums, glucose

HTN is most common

60
Q

Molecular biology techniques

A

SNOW (South - NOrth - West)
DROP (DNA - RNA - Protein)
ElISA = detect antigens and antibodies

61
Q

which cardiac drug can cause corneal opacities?

A

amiodarone

62
Q

antiepileptic drug most commonly associated with weight gain?

A

sodium valproate

63
Q

Psoriasis triggers

A

The following factors may exacerbate psoriasis:
trauma
alcohol
drugs: beta blockers, lithium, antimalarials (chloroquine and hydroxychloroquine), NSAIDs and ACE inhibitors, infliximab
withdrawal of systemic steroids

64
Q

Drugs which exhibit zero-order kinetics include.
aka. saturation kinetics

A

phenytoin, alcohol and salicylates, heparin

65
Q

which diabetes drug causes syndrome of inappropriate ADH

A

Sulphonylureas

66
Q

Gingival hyperplasia drugs

A

phenytoin, ciclosporin, calcium channel blockers and AML

67
Q

Drugs known to induce Toxic Epidermal Necrolysis

A

phenytoin
sulphonamides
allopurinol
penicillins
carbamazepine
NSAIDs

MRCP Part 1 (21 decks)

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