MRCOG Part 1 PHARMACOLOGY MCQ's + ANSWERS
1) The action of the coumarin anticoagulants may be potentiated by
Effect enhanced by Cimetidine & Sulphonamides(Enzyme inhibition)
T a) Sulphonamides & Broad spectrum A/B(reduce Vitamin k absorption).
F b) Phenylbutasone Warfarin inhibits synthesis of Vit K dependant clotting factors
c) - ie 2, 7, 9 & 10.
d) - Effect reduced by: Enzyme inducers eg anticonvulsants, Rifampicin,
e) - Griseofulvin also Vit K, O/C.
2) Impaired elimination of the following drugs occurs in renal failure
T a) Chlorpropamide A Sulphonyl-urea (long acting)
F b) Warfarin
T c) Streptomycin An Aminoglycoside like Gentamycin
T d) Morphine All opiates excreted in urine as Glucuronide
T e) Benzyl-Penicillin Virtually all antibiotics are excreted renally
3) The following may potentiate the action of Sulphonyl ureas
T a) Chloramphenicol FX potentiated by Chloramphenicol, Co-trimoxazole, Phe- butazone,
F b) Phenobarbitone Miconazole, Clofibrate, Sulphinpyrazone.
T c) Sulphadimidine
T d) Phenylbutazone
F e) Heparin
4) The following drugs have oxytocic like activity
T a) Vasopressin Does give some uterine stim because of structural similarity to oxytocin
T b) Ergometrine Amine alkaloid
T c) PGE2
F d) Trichloroethylene
F e) Halothane
5) Complications of Methotrexate Rx include
T a) Stomatitis
T b) Diarrhoea
T c) Anaemia
F d) Tinnitis
T e) Allopecia
6) Halothane produces
Non-irritant, non-flammable. Liquid @ room temp
F a) Bronchial irritation 80% excreted unchanged in expired air (therefore must use
F b) Explosive with air closed anaesthetic circuit) 20% metabolised in liver.
T c) Uterine relaxation Hepatic damage(rare) may manifest 10ds after exposure.
T d) Hepatotoxicity with prolonged use Multiple exposures over a short period of time increase
T e) Hypotension this risk. Depresses Resp & myocardium & causes
T f) Hyperglycaemia vasodil & hypotension.
7) Neostigmine
An anti Choline Esterase drug(cf Distigmine, Edrophonium)
T a) Inhibits hydrolysis of ACh which increases ACh & so potentiates neuromuscular
F b) Causes paralytic ileus transmission. Used in myasthenia gravis & urinary
F c) Lasts for several days retension. Side FX due to excessive PS stimulation causing
T d) Is beneficial in Myasthenia Gravis diarrhoea, salivation, colic etc. Can be given with
F e) Is used to reverse the action of anticholinergic (eg Atropine) to minimise side FX.
Carbachol Carbachol has a similar action & is used un retension too.
8) Lignocaine
F a) Action more prolonged than bupivicaine
b)
F c) Used with Adrenaline in ring blocks
T d) Weak base
e)
9) Morphine
T a) Causes constipation
F b) Contraindicated with metoclopramide
c)
d)
e)
10) Action of drugs
T a) Ergometrine - stimulates alpha Also acts on 5HT receptors
receptors in uterus
F b) Indomethacin - effective by PG Inhibits PG synthesis by blocking Cyclo-oxygenase
receptor blockade
c)
d)
e)
11) Drugs exciting the uterus
T a) PGE2
F b) Nifedipine
F c) Hydrallazine
F d) Mefanemic acid
T e) Vasopressin
12) Akylating agents
T a) Cyclophosphamide
F b) Flurouracil An antimetabolite(blocks Thymidylate synthetase)
F c) Methotrexate An aantimetabolite (blocks Dihydrofolate Reductase)
T d) Chlorambucil
F e) Mercaptopurine An antimetabolite(along with AZT)
13) Naloxone antagonises respiratory depression caused by
F a) Thiopentone
T b) Pethidine
c) Pentazocine
F d) Glutethimde
T e) Diamorphine
14) The following are mainly progestogens
F a) Buserelin
T b) Dydrogesterone
T c) Norethisterone
T d) 17-a-hydroxyprogesterone
F e) Androstenedione
15) Suxamethonium is
F a) A non-depolarising agent V short action (5mins). Broken down by
F b) Given with Thiopentone as a plasma Choline Esterase. Side FX include
combined injection at induction bradycardia, muscle pain, raised IOP.
F c) Reversed by Neostigmine Some people have enzyme defect which
T d) Duration is longer than Tubocurarine prolongs duration of action.
16) The following reduce uterine activity
F a) MgSO4
T b) Ritodrine
T c) Isoprenaline A beta agonist like Ritodrine so should relax uterus
d)
e)
17) Nalorphine reverses the respiratory effects of
T a) Diamorphine
F b) Alcohol
T c) Pethidine
F d) Thiopentone
F e) Diazepam
18) Which of the first drugs are potentiated by the second
F a) Phenytoin - Ethinyl oestradiol Phenytoin will decrease efficacy of COC
F b) Warfarin - Phenobarbitone Inhibits due to liver enzyme induction
T c) Lithium - Thiazide diuretics Potentiated due to reduced Lithium clearance
T d) Penecillin - Probenecid Blocks tubuler excretion
F e) Bromocriptine - Metpoclopramide Antagonism of hypoprolactinaemic effect
19) Gentamicin
F a) Is inactivated in the stomach
T b) Causes 8th nerve palsy
T c) Toxicity is accentuated by Frusemide
T d) Excreted mainly by the kidney
e)
20) The following are effective when taken orally
F a) Streptomicin
T b) Tetracycline
T c) Nifedipine
F d) Chloramphenicol
F e) Gentamicin
21) Isoprenaline
F a) Affects mainly alpha receptors
F b) Causes bradycardia
T c) can cause bronchodilation
F d) Potentiated by Propranolol A Beta blocker
F e) Can be given sublingually
22) Carbimazole
F a) Causes neonatal hyperthyroidism
T b) Is secreted in the breast milk
T c) Causes agranulocytosis
d) Is a thiourea
e)
23) Effect of oral contraceptive is decreased by
F a) Bromocriptine
F b) Digoxin
T c) Rifampicin
T d) Ampicillin
T e) Phenytoin
24) Gentamicin
Aminoglycoside. Ototoxic & nephrotoxic.
T a) Ineffective orally Good against Gm-ve aerobes (Proteus/Pseudomonas)
F b) Bacteriostatic Synergistic with penicillin vs Strep
T c) Excreted in urine Bactericidal.
T d) Is toxic to 8th cranial nerve
T e) Frusemide enhances toxicity
25) Isoprenalin
A beta agonist. Main action on B2 in lung giving
F a) Can be given sublingually bronchodilation. Also stims B2 in heart causing
F b) Acts minimally on alpha receptors tachycardia.
F c) Causes bradycardia
F d) Increases respiratory rate
T e) Causes bronchodilation
26) Tetracyclines
Bacteriostatic. Excreted unchanged in bile.
F a) Are bacteriocidal Bind with 30S ribosomal unit & upset protein synthesis
F b) Excreted in the urine Hepatotoxic in pregnancy.
T c) Cause liver damage in pregnancy Causes discolouration of growing bones therefore not
T d) Are concentrated in bile used in children/pregnancies.
T e) Depress protein anabolism Impair protein synthesis & contrindicated in renal Dx.
27) Which are MAOI's
F a) Hydrallazine
T b) Phenelzine
T c) Iproniazid
T d) Tranylcypromine
F e) Chlorpromazine
28) Bromocritptine
T a) Is a dopamine receptor agonist Promotes GH release in normal subjects but decreases it
T b) Inhibits prolactin release in acromegally. Excreted in bile.
T c) Promotes GH release Side FX=postural hypotension, nausea, psychiatric FX
T d) Is an ergot derivative
F e) Is oxytocic
29) Which give uterine relaxation
F a) Atropine
T b) Halothane
F c) Morphine sulphate
T d) Amyl nittrite
T e) Alcohol
30) PGF2alpha
Modified FA.
F a) Is a naturally occuring polypeptide
T b) Causes uterine contraction
F c) Lowers diastolic BP
T d) Synthesis inhibited by aspirin
F e) Causes water retention
31) Which of the following are true of anti-hypertensives
T a) Guanethidine blocks post ganglionic transmissionBlocks release of NA & depletes nerve
T b) Ganglion blockers have max effect on BP in endings of NA. No effect on supine
BP.
erect posture
F c) Reserpine causes SLE-like state Hydralazine causes this
T d) Guanethidine causes failure to ejaculate
F e) Me DOPA acts as ganglion blocker
32) Which of the following drugs are ineffective when taken by mouth
F a) Probenecid
T b) Heparin
F c) Cyclophosphamide
T d) Suxamethonium
F e) Methicillin
33) Atropine causes
T a) Increased heart rate
F b) Vasodilation of the skin
T c) Reduced saliva
F d) Overactivity of the small intestine
F e) Reduced gastric secretion
34) Vasopressin
F a) Causes diuresis
F b) Raises BP in therapeutic doses
T c) Secretion is stimulated by nicotine
F d) In therapeutic doses causes intestinal colic
T e) Secretion stimulated by increased osmotic
pressure of blood supplying the hypothallamus
35) Morphine
T a) Causes vasodilation
F b) Lowers BP
F c) Reduces intestinal tone
T d) Causes respiratory acidosis
F e) Has anticonvulsant properties
36) Chloramphenicol
T a) Has a nitrobenzine group V broad spectrum. Use limited by bone marrow suppression
F b) Has a narrow range of activity Contraindicated in neonates because of CV collapse
T c) Effective against Gm -ve
T d) Metabolised in the liver
T e) Can cause leucopaenia
37) Streptomicin
F a) Is excreted actively in renal tubules
F b) Bacteriostatic
T c) May cause 'Drug Fever'
F d) Is destroyed in stomach
F e) Broken down in liver
38) Morphine
T a) Is metabolised in the liver
F b) Impairs conduction in sensory nerves
F c) Depresses vomiting centre
T d) Constricts pupils
T e) Stimulates vasopressin release
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