Therapeutics/toxicology

Question 1

Malignant hyperthermia associated with

Answer 1

Anaesthetic agents

Question 2

Neuroleptic malignant syndrome associated with which drugs

Answer 2

Antipsychotics
Dopaminergics (Levodopa) if stopped suddenly

Question 3

Serotonin syndrome associated with which drugs

Answer 3

SSRIs (includes Tramadol)
MAO inhibitors
Amphetamine/MDMA

Question 4

Initial management of theophylline poisoning

Answer 4

Multiple dose activated charcoal

Question 5

2nd line management of theophylline poisoning

Answer 5

Haemodialysis/charcoal haemoperfusion

Question 6

Features of theophylline poisoning

Answer 6

Hypokalaemia, acidosis
Arrhythmia

Question 7

Which medication should be stopped on starting DAPT

Answer 7

Omeprazole - inhibits clopidogrel

Question 8

Nitrofurantoin - risks in long-term use

Answer 8

Folate deficiency
Pulmonary fibrosis
SLE-like syndrome

Question 9

Uses of doxazosin

Answer 9

Resistant HTN
BPH

Question 10

Uses of duloxetine

Answer 10

Depression/anxiety
Neuropathic pain
STRESS incontinence

Question 11

1st line management of urge incontinence

Answer 11

Bladder training 6 weeks

Question 12

2nd line management of urge incontinence

Answer 12

Anti-muscarinics (oxybutynin > tolteradine)

Question 13

2nd line management of urge incontinence if anti-muscarinics not appropriate

Answer 13

Mirabegron (beta-3 agonist)

Question 14

1st line management of stress incontinence

Answer 14

Pelvic floor training 3 months

Question 15

3rd line management of urge incontinence

Answer 15

Botox

Question 16

2nd line management of stress incontinence

Answer 16

Surgery: retropubic mid-urethral tape

Question 17

2nd line management of stress incontinence - if surgery not appropriate

Answer 17

Duloxetine

Question 18

Adverse effects of trimethoprim

Answer 18

Myelosuppression
Transient rise in creatinine

Question 19

Adverse effects of Efavirenz (NNRTI)

Answer 19

Nightmares
Confusion

Question 20

Adverse effect of Abacavir (NRTI)

Answer 20

Hypersensitivity reaction associated with HLA-B*5701

Question 21

Side effects of Tenofovir (NRTI)

Answer 21

Renal impairment
GI upset
Osteoporosis

Question 22

General adverse effects of NRTIs

Answer 22

Peripheral neuropathy
Lactic acidosis

Question 23

Trastuzumab (anti-HER2/neu) side effects

Answer 23

Cardiotoxicity, especially when anthracyclines (Doxorubicin) have been given

Question 24

Morbiliform rash + raised eosinophils after starting anti-epileptic/antibiotic/HAART

Answer 24

DRESS (drug reaction with eosinophilia and systemic symptoms)

Question 25

Management of Amiodarone-induced thyrotoxicosis type 2

(amiodarone-related destructive thyroiditis)

Answer 25

Corticosteroids

Question 26

Management of Amiodarone-induced thyrotoxicosis type 1

(excess iodine-induced thyroid hormone synthesis)

Answer 26

Carbimazole +/- potassium perchlorate

Question 27

Aspirin overdose - salicylate serum level requiring haemodialysis

Answer 27

> 700 mg/L

Question 28

Treatment of methanol poisoning

Answer 28

Fomepizole
Folinic acid to prevent opthalmological complications

Question 29

Features of Cinchonism (quinine toxicity)

Answer 29

Tinnitus
Blurred vision
Nausea
Arrhythma

Question 30

Poisoning showing high anion gap (>16) and high osmolar gap (10), think..

Answer 30

Ethylene glycol toxicity

Question 31

Side effects of Pyrazinamide

Answer 31

Arthralgia + myalgia
Gout
Hepatitis

Question 32

Indications for desferrioxamine in iron overdose

Answer 32

Serum iron >90 umol/L
Serum iron 60-90 and symptomatic, or iron visible on AXR despite irrigation
Shock, coma, metabolic acidosis

Question 33

Acute management of hereditary angioedema

Answer 33

IV C1 esterase inhibitor
FFP if not available