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Liver > Mock Exam Questions > Flashcards

Mock Exam Questions Flashcards

1
Q

Which of the following is contraindicated in convulsive disorders

A

NSAID
AMITRIPTYLINE
BUPRENORPHINE
NEFOPAM ⭐️

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2
Q

In regards to controlled drugs according to the misuse in drugs regulations 2001 Temazepam is classified as which kind of schedule

A

Schedule 3

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3
Q

Which of the following statements is incorrect in relation to prescribing

A

During the second trimester drugs can produce congenital malformations

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4
Q

True or false in regards to prescription writing it is a legal requirement to state the child’s age if they are under 12

A

True

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5
Q

True or false paramedics are allowed to prescribe controlled drugs

A

False

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6
Q

Which of the following drugs is not associated with the reaction of alopecia

A

Quinine

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7
Q

Within the realms of supplementary prescribing the independent prescriber must be a dentist or a dr

A

True

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8
Q

Bisoprolol should be avoided in patients with a history of asthma

A

True

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9
Q

What dose of aciclovir is indicated for the treatment of oral herpes simplex in a 52 year old man undergoing chemotherapy

A

400mgs 5 times a days for 5 days

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10
Q

When discontinuing a prescription of citalopram over what duration should dosing be tapered

A

The dose should be reduced gradually
Over about 4 weeks or longer if withdrawal symptoms emerge
6 months for patients who have been on longer term maintenance treatment

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11
Q

What is the definition of pharmacokinetics

A

The study of the movement of drugs through the body

ADME

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12
Q

What is the definition of a patient safety incident

A

Patient safety incidents are any unintended or unexpected incident which could have or did lead to harm of a patient receiving healthcare

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13
Q

Bioviability is the percentage or fraction of the administered dose that reached the systemic circulation of the patient. which of the following is not a factor that would effect bioavailability

A

Gender

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14
Q

When discussing potency in relation to pharmacology which of the following statements is true

A

Potency is related to the drugs affinity for the site of action

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15
Q

Which of the following is a potential cause of pre-renal failure

A

Gastro intestinal fluid loss secondary to laxative abuse

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16
Q

True or false half life is the amount of time taken for a drug to be eliminated from the plasma

A

False

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17
Q

The liver is a major site of bio transformation

A

True

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18
Q

Name two phase two metabolic pathways

A

Methylation

Acetylation

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19
Q

In relation to the pharmacokinetics Distribution of medicines list four ways children are different to adults

A

⭐️ Babies have a much higher water to total weight ratio.
⭐️As Children grow the percentage total body weight made up of water gradually decrease and their fat and muscle percentage increases
⭐️The amount of extra cellular fluid decrease and the intracellular fluid volume increases .
⭐️Due to the high percentage of water doses of water soluble Medicines need to be higher in infants.
⭐️Fat soluble medications need to be smaller in infants
⭐️Children have different levels of circulation proteins such as lower albumin levels so drug in free circulation will be higher

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20
Q

Bioavailability

A

Availability to the biological systems

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21
Q

ADMA

A

Absorption - transfer from site of administration
Distribution - transfer from the general circulation into the different organs of the body
Metabolism - brake down of the drug
Elimination - removal from the body, which may include metabolism and/or excretion

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22
Q

Absorption difference in adult to children

A

Slower gastric emptying and intestinal transit
Reduced absorption of certain drugs
The skin has very high hydration
Low skeletal muscle mass

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23
Q

Distribution difference in children and adults

A

Different fat/water content re adults
High plasma concentration of free fatty acids and bilirubin complete for plasma protein binding sites
Blood brain barrier

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24
Q

Metabolism

A

Immature liver enzymes in neonates

When enzymes system mature metabolism is more extensive because relative liver mass and hepatic blood flow are higher

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25
Q

Renal elimination

A

Less developed in neonates and infants

GRF in neonate about 40% of adult

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26
Q

Factors effecting pharmacology

A 
Age
Genetics 
Environmental factors 
Disease 
Drug interactions
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27
Q

Define the term Half life

A

Time taken for the concentration of a drug to fall to half its original value

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28
Q

Name two phase 1 pathways

A

Hydration

Oxidation

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29
Q

DDII

A

Decrease Dose OR Increase Interval

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30
Q

What group of enzymes most commonly involved in drug metabolism in the liver

A

Cytochrome p450

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31
Q

Where does first pass metabolism occur

A

Liver

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32
Q

Black triangle drug

A

A newly licensed drug or a drug that is currently been monitored by the MHRA

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33
Q

What are the principles of the Royal pharmaceutical society with regards to medicines optimisation

A

Principle 1 - patient experience
Principle 2 - evidence based
Principle 3 - safe
Principle 4 - make optimisation part of routine practice

34
Q

Medicines optimisation

Stop start

A

Look in BNF both there

35
Q

Crushing a tablet May alter the properties of the drug and may make it ineffective

A

True

36
Q

Bioviability is the percentage of changed reaching the systemic circulation following administration by any route

A

True

37
Q

Drug resistance is the term used to describe the loss of effectiveness that may occur with the use of some antibiotics

A

True

38
Q

Name one example of how liver disease may alter the response to drugs in patients with hepatic impairment

A

Impaired drug metabolism

39
Q

Acetylcholine is a sympathetic nervous system neurotransmitter

A

False

40
Q

Name one factor that affects the pharmacology of a drug

A

Age

41
Q

Name one factor you would consider when prescribing an antibacterial

A

ALlergies

42
Q

All suspected reactions to a black triangle drug must be reported through which system

A

Yellow card

43
Q

What does the abbreviation MAOI Mean

A

Monoamine oxidase inhibitor

44
Q

What are the four phases of PHARMACOKINETICS

A

ADME

45
Q

Define the term adverse drug reaction

A

Unwanted and harmful or noxious and unintended .

occurring after drug / combination administration.

46
Q

Where a suspected adverse event in a child less than 18 years is associated with drug misuse or overdose it is not appropriate to report it through the yellow card scheme

A

False

47
Q

The time is takes to reduce a drug dose by 50% is know as the half life

A

True

48
Q

Sublingual preparation may be used to

A

Prevent first pass metabolism

49
Q

Name one approach that can be used to alter dosing regimes to avoid toxicity

A

Lower the dose

Extend the interval

50
Q

For drugs that require therapeutic drug monitoring name 3 factors that May effect drug levels

A

Dose
Patient adherence
Time and date blood taken
Other drugs

51
Q

If it takes 5 half-lives for a drug to reach a steady state and drug x has a half life of 30 hours how long will it take drug x to achieve a steady state give your answer in days

A

30x5 = 150 / 24hrs = 6 days

52
Q

Can citalopram be prescribed for a breast feeding mother

A

Yes

53
Q

An agonist mimics biological processes by binding to a receptor

A

True

54
Q

What is the description of a common side effect in the BNF

A

1 in 100 to 1 in 10

55
Q

Medicines reconciluation is the process of identifying the most accurate list of a patients current medicines - including the name, dosage, frequency and route and comparing them to the current list in use, recognising and discrepancies and documenting any changes thus resulting in a complete list of medications accurately communicated

A

True

56
Q

Choose the correct answer in relation to drug absorption

A

Is facilitated when a drug has a smaller molecular weight

57
Q

List two indications for increasing the frequency of INR monitoring

A

Change in clinical condition associated with liver disease

severe Renal impairment

58
Q

What drug is associated with the reaction of hepatitis

A

Isoniazid

59
Q

Choose correct answer in relation to drug absorption

A

Is facilitated when drugs have a small molecule weight

60
Q

Name one approach that can be used to alter dosing regimes to avoid toxicity in a patient with renal impairment

A

Extend the intervals between doses

Reduce the dose

61
Q

For drugs that require therapeutic drug monitoring name three factors that may effect drug levels

A

Other drugs
Patient adherence t
Time and date of last dose

62
Q

Name two Phase 2 enzyme reactions

A

Oxidation

Hydration

63
Q

Name two factors affecting pharmacology

A

Age
Adherence
Genetics

64
Q

Factors effect in children

Absorption

A
  • Slow gastric emptying
  • Reduced absorption of drugs
  • Thin skin
  • Low skeletal muscle mass
65
Q

Factors effecting children

Distribution

A
  • Different fat/water ratio to adults
  • High plasma concentration of free fatty acids and bilirubin compete for plasma protein binding sites
  • Blood brain barrier
66
Q

Factors effecting children

Metabolism

A
  • immature liver enzymes in neonate

* when enzyme system mature metabolism is more extensive because relative liver mass and hepatic flow higher

67
Q

Renal elimination

A
  • Less developed in children

* GFR in neonate 40% of an adult

68
Q

Q24

A
  • Reduced absorption
  • Altered protein binding
  • Accumulation of medicine due to reduced elimination
69
Q

What is the most common phase one pathway in metabolism

A

Oxidation ✅
Reduction
Hydrolysis
Hydration

70
Q

What percentage water are baby’s when born

A

85%

71
Q

How does infant renal elimination differ to adult renal elimination

A
  • higher perfusion press ❌
  • inadequate osmotic load to produce counter current effect✅
  • Immature glomerular development ✅
  • Lower perfusion pressure ✅
72
Q

How does an infant GI tract differ from an adult

A

Less acidic, shorter length & slower motility

73
Q

Children have a greater surface area to weight ratio than adults

A

True

74
Q

Kidneys

A

Regulate blood press
Control fluid balance
Electrolyte balance

75
Q

What are the 4 pillars of professional prescribing

A

Legal
Ethical
Professional
Employment

76
Q

What alters metabolism in the liver

A

Age

Genetics

77
Q

RPS Principals

A

Royal Pharmaceutical Society
Use the four RPS principles:

patient experience
evidence
safe and effective
routine practice.

78
Q

Factors affecting Hepatic

A

Gender

Genetics

79
Q

Factors that affect the rate of a drug metabolism

A

Age - can’t brake down as fast decrease the dose
Liver disease
Drug tolerance

80
Q

Stopp start

A

Screening Tool for Older persons prescribing

81
Q

Name two phase 1 pathways

A

Oxydation
Hydration

82
Q

Name one approach that can that can be used to alter dosing regimes to avoid toxicity in a patient with renal impairment

A

Extend the interval between doses
Reduce the dose given at usual interval

Liver (2 decks)

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