Drugs Flashcards
Which of these antibiotics inhibits cell wall synthesis?
Ciprofloxacin
Rifampicin
Clindamycin
Doxycycline
Amoxicillin
Which of these antibiotics inhibits cell wall synthesis?
Ciprofloxacin
Rifampicin
Clindamycin
Doxycycline
Amoxicillin
Which of these antibiotics is a tetracycline?
Ciprofloxacin
Rifampicin
Clindamycin
Doxycycline
Amoxicillin
Which of these antibiotics is a tetracycline?
Ciprofloxacin
Rifampicin
Clindamycin
Doxycycline
Amoxicillin
Which of these antibiotic’s mechanism of action is to inhibit bacterial protein synthesis at the 30S subunit of the ribosome?
Ciprofloxacin
Rifampicin
Clindamycin
Doxycycline
Amoxicillin
Which of these antibiotic’s mechanism of action is to inhibit bacterial protein synthesis at the 30S subunit of the ribosome?
Ciprofloxacin
Rifampicin
Clindamycin
Doxycycline
Amoxicillin
Which of these antibiotic’s is a lincosamide?
Ciprofloxacin
Rifampicin
Clindamycin
Doxycycline
Amoxicillin
Which of these antibiotic’s is a lincosamide?
Ciprofloxacin
Rifampicin
Clindamycin
Doxycycline
Amoxicillin
Which of these antibiotic’s is a quinolone?
Ciprofloxacin
Rifampicin
Clindamycin
Doxycycline
Amoxicillin
Which of these antibiotic’s is a quinolone?
Ciprofloxacin
Rifampicin
Clindamycin
Doxycycline
Amoxicillin
Which of these antibiotic’s mechanism of action is inhibition of DNA gyrase to inhibit nucleic acid synthesis.
Ciprofloxacin
Rifampicin
Clindamycin
Doxycycline
Amoxicillin
Which of these antibiotic’s mechanism of action is inhibition of DNA gyrase to inhibit nucleic acid synthesis.
Ciprofloxacin
Rifampicin
Clindamycin
Doxycycline
Amoxicillin
Which of these antibiotic’s mechanism of action is inhibition of RNA polymerase to inhibit nucleic acid synthesis.
Ciprofloxacin
Rifampicin
Clindamycin
Doxycycline
Amoxicillin
Which of these antibiotic’s mechanism of action is inhibition of RNA polymerase to inhibit nucleic acid synthesis.
Ciprofloxacin
Rifampicin
Clindamycin
Doxycycline
Amoxicillin
Which of the following is the most appropriate antibiotic for this patient’s infected pressure ulcer?
Ceftriaxone
Ciprofloxacin
Clarithromycin
Flucloxacillin
Nitrofurantoin
Which of the following is the most appropriate antibiotic for this patient’s infected pressure ulcer?
Flucloxacillin
The patient has an infected sacral pressure sore. The infection is likely to be superficial with no extension to the underlying bone (which would be concerning for osteomyelitis). Along with cleaning and dressing the wound, culture swabs of the fluid should be taken so antibiotics can be tailored according to microbial sensitivities. Superficial infections are typically treated with oral antibiotics such as flucloxacillin as this is likely to provide coverage for gram-positive bacteria that reside on the skin surface, such as Staphylococcus aureus. As the patient is bed-bound, he should also be assessed for an air mattress.
A 59-year-old patient is referred to the Urology Clinic after an episode of visible haematuria. Two suspicious papillary lesions are subsequently excised from the bladder wall at cystoscopy, and histopathology confirms high-grade papillary transitional cell carcinoma (stage Ta) on both subsequent biopsies.
What is the most appropriate treatment?
Transurethral resection of bladder tumour followed by a single dose of intravesical chemotherapy
Transurethral resection of bladder tumour, followed by a six-week course of intravesical chemotherapy
Transurethral resection of bladder tumour, followed by a six-week course of intravesical bacille Calmette–Guerin (BCG)
Transurethral resection of bladder tumour combined with chemo-radiotherapy
Radical cystectomy and prostatectomy combined with chemo-radiotherapy
A 59-year-old patient is referred to the Urology Clinic after an episode of visible haematuria. Two suspicious papillary lesions are subsequently excised from the bladder wall at cystoscopy, and histopathology confirms high-grade papillary transitional cell carcinoma (stage Ta) on both subsequent biopsies.
What is the most appropriate treatment?
Transurethral resection of bladder tumour, followed by a six-week course of intravesical bacille Calmette–Guerin (BCG)
Treatment of high-grade tumours consists of TURBT combined with BCG. BCG is the main intravesical immunotherapy for treating early-stage bladder cancer.
An 85-year-old bedbound patient is seen regarding a wound under her left heel. She reports pain in the area and feels that things are gradually worsening. She is otherwise well in herself, with no fever. On examination, you note an area of erythema, measuring approximately 2 cm, under the left heel, with partial-thickness skin loss involving the epidermis. There is no necrotic tissue, discharge or offensive smell.
What is the most appropriate management?
Compression hosiery
Debridement
Oral flucloxacillin
Topical barrier cream and repositioning
Topical fusidic acid with hydrocortisone
An 85-year-old bedbound patient is seen regarding a wound under her left heel. She reports pain in the area and feels that things are gradually worsening. She is otherwise well in herself, with no fever. On examination, you note an area of erythema, measuring approximately 2 cm, under the left heel, with partial-thickness skin loss involving the epidermis. There is no necrotic tissue, discharge or offensive smell.
Topical barrier cream and repositioning
A 23-year-old female presents to her General Practitioner with a six-week history of sweating, tremors and palpitations. The patient is eight months pregnant. She has no significant past medical history. On clinical examination, she is noted to have prominent eyes, a heart rate of 110 bpm and a small, diffuse goitre. Her laboratory investigations are as follows:
Investigation Result Normal value
Free T4 44 pmol/l 11–22 pmol/l
Free T3 15 pmol/l 3.5–5 pmol/l
Thyroid stimulating hormone (TSH) < 0.01 µU/l 0.17–3.2 µU/l
TSH receptor antibody (TRAb) 20 U/l < 0.9 U/l
Which of the following treatments should be prescribed?
Carbimazole
Thyroxine
Ibuprofen
Tri-iodothyronine
Propylthiouracil as part of a blocking-replacement regime
A 23-year-old female presents to her General Practitioner with a six-week history of sweating, tremors and palpitations. The patient is eight months pregnant. She has no significant past medical history. On clinical examination, she is noted to have prominent eyes, a heart rate of 110 bpm and a small, diffuse goitre. Her laboratory investigations are as follows:
Investigation Result Normal value
Free T4 44 pmol/l 11–22 pmol/l
Free T3 15 pmol/l 3.5–5 pmol/l
Thyroid stimulating hormone (TSH) < 0.01 µU/l 0.17–3.2 µU/l
TSH receptor antibody (TRAb) 20 U/l < 0.9 U/l
Which of the following treatments should be prescribed?
Carbimazole
The primary concern with carbimazole use is the risk of agranulocytosis, necessitating immediate medical attention if infection symptoms emerge. In the third trimester of pregnancy, carbimazole can be safely administered.
Which of the following most accurately describes the mode of action of tamoxifen?
Progesterone receptor antagonist
Oestrogen receptor agonist
Selective oestrogen receptor modulator
Aromatase inhibitor
Progesterone receptor agonist
Which of the following most accurately describes the mode of action of tamoxifen?
Selective oestrogen receptor modulator
Tamoxifen is a selective oestrogen receptor modulator that exhibits dual effects on oestrogen receptors, acting as an anti-oestrogen in mammary epithelium. This makes it valuable for both the prevention and treatment of breast cancer. Specifically, it is indicated for treating oestrogen receptor-positive tumours in pre- and perimenopausal females. Additionally, as a prophylactic measure, it may be prescribed to women at moderate to high risk of developing breast cancer, particularly those with a notable family history of breast and ovarian cancer.
A 32-year-old man presented complaining of headaches and sweating, and was found to be hypertensive. Investigations confirmed the diagnosis of a phaeochromocytoma. He was treated with phenoxybenzamine before surgery.
What is the pharmacological property of phenoxybenzamine that makes it the most suitable treatment for a phaeochromocytoma?
Irreversible α-adrenoceptor antagonist
Irreversible α- and β-adrenoceptor antagonist
Reversible α-adrenoceptor agonist
Reversible α-adrenoceptor antagonist
Reversible β-adrenoceptor antagonist
A 32-year-old man presented complaining of headaches and sweating, and was found to be hypertensive. Investigations confirmed the diagnosis of a phaeochromocytoma. He was treated with phenoxybenzamine before surgery.
What is the pharmacological property of phenoxybenzamine that makes it the most suitable treatment for a phaeochromocytoma?
Irreversible α-adrenoceptor antagonist
Irreversible α- and β-adrenoceptor antagonist
Reversible α-adrenoceptor agonist
Reversible α-adrenoceptor antagonist
Reversible β-adrenoceptor antagonist
A 40-year-old male with a history of intravenous drug abuse 21 years ago is referred by his doctor with abnormal liver function tests. He has significantly raised alanine aminotransferase (ALT). He tests positive for hepatitis C RNA and genotyping reveals genotype 1 hepatitis C. Liver biopsy reveals lymphocytic infiltration with some evidence of early hepatic fibrosis with associated necrosis.
Which of the following is the most appropriate treatment?
Direct acting antivirals (DAAs)
Interferon gamma
Ribavirin
Pegylated (PEG)-interferon α and ribavirin
PEG-interferon α with ribavirin and a protease inhibitor
A 40-year-old male with a history of intravenous drug abuse 21 years ago is referred by his doctor with abnormal liver function tests. He has significantly raised alanine aminotransferase (ALT). He tests positive for hepatitis C RNA and genotyping reveals genotype 1 hepatitis C. Liver biopsy reveals lymphocytic infiltration with some evidence of early hepatic fibrosis with associated necrosis.
Which of the following is the most appropriate treatment?
Direct acting antivirals (DAAs)
Interferon-based treatment regimens are no longer recommended for HCV infection, as DAAs are now considered first-line treatment. DAAs target different stages in the HCV lifecycle and are successful for over 90% of people with HCV infection. The treatment is usually a once-daily oral tablet regimen for either 8 or 12 weeks and is most effective when given before the onset of cirrhosis.
A 22-year-old female student who is studying hard for exams develops intermittent periods of abdominal pain and bloating. She also notices a change in her bowel habits and finds that going to the ‘loo’ helps to relieve her abdominal pain.
Which of the following drug treatments is most likely to help treat her colic and bloating symptoms?
Loperamide
Fybogel
Mebeverine
Cimetidine
Metoclopramide
A 22-year-old female student who is studying hard for exams develops intermittent periods of abdominal pain and bloating. She also notices a change in her bowel habits and finds that going to the ‘loo’ helps to relieve her abdominal pain.
Which of the following drug treatments is most likely to help treat her colic and bloating symptoms?
Loperamide
Fybogel
Mebeverine
Cimetidine
Metoclopramide
Mebeverine is an antispasmodic which can help relieve colicky abdominal pain in these patients.
Describe the difference in symptoms that you would consider when prescribing Loperamide, Mebeverine & Fybogel for IBS? [3]
Mebeverine: is an antispasmodic which can help relieve colicky abdominal pain in these patients.
Loperamide: useful adjunct for patients with diarrhoea-predominant IBS (IBS-D).
Fybogel: For patients with constipation-predominant IBS (IBS-C),
Which one of the following types of oral steroid has the least amount of mineralocorticoid activity?
Fludrocortisone
Hydrocortisone
Dexamethasone
Prednisolone
Cortisone
Which one of the following types of oral steroid has the least amount of mineralocorticoid activity?
Fludrocortisone
Hydrocortisone
Dexamethasone
Prednisolone
Cortisone
A 53-year-old man visits his local GP surgery for a diabetes review. He has T2DM for which he takes metformin. His recent HbA1c was 56 mmol/mol. Ramadan is approaching and he wants to know whether he’ll be able to stop taking his metformin while he fasts.
What is the most appropriate management of this patient?
Advise him he can halve his metformin dose but he must monitor his blood glucose regularly
Advise him to take one-third of his normal metformin dose before sunrise and two-thirds after sunset
Advise him to take two-thirds of his normal metformin dose before sunrise and one-third after sunset
Advise him you do not recommend that he fasts due to his current HbA1c level
Arrange an appointment with your Muslim colleague who can advise him on managing his diabetes during Ramadan
A 53-year-old man visits his local GP surgery for a diabetes review. He has T2DM for which he takes metformin. His recent HbA1c was 56 mmol/mol. Ramadan is approaching and he wants to know whether he’ll be able to stop taking his metformin while he fasts.
What is the most appropriate management of this patient?
Advise him he can halve his metformin dose but he must monitor his blood glucose regularly
Advise him to take one-third of his normal metformin dose before sunrise and two-thirds after sunset
Advise him to take two-thirds of his normal metformin dose before sunrise and one-third after sunset
Advise him you do not recommend that he fasts due to his current HbA1c level
Arrange an appointment with your Muslim colleague who can advise him on managing his diabetes during Ramadan
A 58-year-old woman presents to her general practitioner complaining of reflux-like symptoms over the past month after eating despite making dietary changes. She reports no symptoms such as fever, unexpected weight loss or night sweats. She has been taking omeprazole over the counter for the past two weeks. The patient also has a past medical history of a DVT for which she is taking apixaban. The GP wants to refer her for an upper GI endoscopy.
What additional piece of advice should she be given before the procedure?
Stop taking the apixaban for four weeks before the procedure
Stop taking the apixaban for two weeks before the procedure
Stop taking the omeprazole for four weeks before the procedure
Stop taking the omeprazole for six weeks before the procedure
Stop taking the omeprazole for two weeks before the procedure
Stop taking the omeprazole for two weeks before the procedure
You are an FY2 working on the wards and have just reviewed a 67-year-old man with moderately severe community-acquired pneumonia. He has a background of type 2 diabetes, COPD, and hypertension, and his current medications include metformin, a combination long-acting muscarinic antagonist + long-acting beta-2 agonist inhaler, amlodipine, and salbutamol inhaler as required. On examination, he has no wheeze or dyspnoea currently. His observations are stable with a heart rate of 88bpm, respiratory rate of 19 breaths per minute, and temperature of 37.3ºC. His capillary blood glucose (CBG) is 9 mmol/L.
Intravenous antibiotics have already been prescribed, what other medication should you add in addition to this patient’s regular medications?
Gliclazide
Salmeterol inhaler
Leukotriene receptor antagonist
Paracetamol
Prednisolone
Prednisolone
Patients diagnosed with pneumonia who have COPD should be given corticosteroids even if no evidence of the COPD being exacerbated
With respect to the NICE Chronic Obstructive Pulmonary Disease guidelines (COPD), what criteria should be used to determine whether patients who are having an excerbation of COPD require antibiotics?
Those with moderate or severe COPD
Those who are > 65 years of age or patients with significant comorbidities
Those with purulent sputum or clinical signs of pneumonia
All patients
Those who have had a positive sputum culture
With respect to the NICE Chronic Obstructive Pulmonary Disease guidelines (COPD), what criteria should be used to determine whether patients who are having an excerbation of COPD require antibiotics?
Those with moderate or severe COPD
Those who are > 65 years of age or patients with significant comorbidities
Those with purulent sputum or clinical signs of pneumonia
All patients
Those who have had a positive sputum culture
An 18-year-old man is admitted to the emergency department with an episode of acute asthma. He is unable to complete sentences, tachycardic (118 beats per minute) and tachypnoeic (respiratory rate 30). He has received salbutamol, ipratropium bromide nebulisers and intravenous hydrocortisone through a large bore cannula in the right antecubital fossa. Despite another salbutamol nebuliser, there is no improvement in his condition. What medication would be most appropriate to add?
Beclamethasone
Magnesium sulphate
Amoxicillin
Nifedipine
Adrenaline
Magnesium sulphate
The SIGN guidelines give clear instructions on how to escalate care.
1. Oxygen
2. Salbutamol nebulisers
3. Ipratropium bromide nebulisers
4. Hydrocortisone IV OR Oral Prednisolone
5. Magnesium Sulfate IV
6. Aminophylline/ IV salbutamol
Whats a pneumonic for remembering asthma exacerbations? [4]
Oh
Shit,
I
Hate
My
Asthma
1) Oxygen
2) Salbutamol nebulisers
3) Ipratropium bromide nebulisers
4) Hydrocortisone IV or Oral Prednisolone
5) Magnesium Sulfate IV
6) Aminophylline / IV salbutamol
