Which of the following statements is true concerning organophosphate poisoning?

Which of the following statements is true concerning organophosphate poisoning?
A. Their principal action is the stimulation of acetylcholinesterase activity
B. They are only absorbed through the respiratory tract
C. Miosis, sweating and hypersalivation are due to nicotinic-receptor effects
D. Atropine is useful in the management of organophosphate poisoning
E. Organophosphate neuropathy occurs within 24 hours

Answer:

Treatment Of High BP in Pregnancy

A 32-year-old woman who is 22 weeks’ pregnant is admitted to the maternity ward and found to be hypertensive with a BP of 180/100 mmHg. This is her first pregnancy and it is otherwise uncomplicated. She has no other relevant medical history and her urinalysis is normal, as is renal and liver function.

Question
Which of the following should not be used to control her BP?

A Hydralazine
B Methyldopa
C Labetalol
D Ramipril
E Amlodipine

Answer:

Regarding the use of antiviral agents...

Select an antiviral agent for each patient.
a. Ganciclovir
b. Acyclovir
c. Interferon α
d. Didanosine
e. Ribavirin
f. Amantadine
g. Vidarabine
h. Zalcitabine

A military recruit develops pneumonia secondary to influenza A. Symptoms began 24 h prior to physician visit.
Answer: f. Amantadine

An HIV-positive patient with a CD4 count of 50 complains of the onset of visual blurring; opacity is seen on funduscopic exam.
Answer:a. Ganciclovir

A sexually active young woman has anogenital warts and requests intralesional therapy.
Answer: c. Interferon α

An infant with respiratory syncytial virus infection requires mechanical ventilation.
Answer: e. Ribavirin

Discussion:

Regarding Adverse Effects of Interferon - alpha...

A 36-year-old former intravenous drug user is to commence treatment for hepatitis C with interferon-alpha and ribavirin. Which of the following adverse effects are most likely to occur when patients are treated with interferon-alpha?
A. Diarrhoea and transient rise in ALT
B. Cough and haemolytic anaemia
C. Flu-like symptoms and transient rise in ALT
D. Haemolytic anaemia and flu-like symptoms
E. Depression and flu-like symptoms

Answer:

Regarding Benzodiazepine Toxicity ..

A 24-year-old woman is brought to the emergency department with confusion, blurred vision, dizziness, and somnolence. Her friend states that the woman is generally healthy but is taking medication for occasional episodes of intense fear, sweating, nausea, and abdominal and chest pain. Physical examination reveals a respiratory rate of 8/min.

What is the most likely diagnosis?
Benzodiazepine toxicity, as characterized by respiratory depression, confusion, and other symptoms of central nervous system depression.

What class of drugs might be responsible for this patient’s symptoms?
Her friend’s description is consistent with a diagnosis of panic disorder. Benzodiazepines (such as
clonazepam, lorazepam, and alprazolam) are commonly used in the short-term treatment of panic disorder.

What treatment was likely administered to this patient in the emergency department?
Flumazenil, a competitive antagonist at the γ-aminobutyric acid (GABA) receptor, is effective in reversing symptoms of benzodiazepine overdose.

Regarding Theophylline Overdose

A 67-yr -old man with known long-standing asthma presents to the ER following an overdose of his regular theophylline. He took 20 tablets of theophylline 1 hour earlier because he is feeling rather depressed.

Which of the following is true concerning theophylline overdoses?
A. Symptoms of toxicity will always occur within 12 hours
B. Nausea and vomiting are uncommon features of toxicity
C. Bradycardia is the commonest cardiac arrhythmia
D. Large doses of IV potassium should be given as soon as possible
E. Multi-dose activated charcoal is useful in management

Answer:

Concerning Ecstasy (MDMA)...

A 19-yr -old woman is referred to the Medical Admissions Unit by her GP. A few hours before she had taken some ecstasy (MDMA) while out clubbing.

Which of the following is true concerning ecstasy (MDMA)?
A. It produces stimulation of the parasympathetic nervous system
B. Hyponatraemia can be due to SIADHS
C. Dantrolene is contraindicated in the management of hyperthermia
D. Most deaths are due to associated hyponatraemia
E. Effects only last for 2-3 hours

Answer:

A Patient Presents With Overdose of Ferrous sulfate..

A 32-yr -old man presents to A&E following a deliberate overdose of an unknown quantity of ferrous sulphate. Which of the following statements is true concerning the symptoms and management of this Patient?

A. Early GI features of toxicity are due to systemic iron concentrations
B. Dissolved tablets are radio-opaque before absorption
C. Initial hyperglycaemia indicates significant ingestion
D. Serum iron concentrations of 100 μmol/l are usually asymptomatic
E. Activated charcoal is useful in early presenting Pts

Answer:

A 67 year old woman with a history of breast cancer was diagnosed with Deep vein thrombosis...

A 67-year-old woman is reviewed a week after being diagnosed with having a deep vein thrombosis of her left leg. After receiving low-molecular weight heparin for 5 days she has now been started on warfarin. She has a history of depression, osteoporosis, breast cancer and type 2 diabetes. Which one of her current medications is most likely to have increased her risk of developing a deep vein thrombosis?

A. Trazadone
B. Tamoxifen
C. Sitagliptin
D. Denosumab
E. Rosuvastatin

Answer:

Long term management of stable but symptomatic atrial fibrillation?

Which of the following is a first-line drug for rate control in the longer term management of stable but symptomatic atrial fibrillation:

A. Verapamil
B. Quinidine
C. Digoxin
D. Procainamide
E. Amiodarone

 Answer :

Antiepileptic Drugs Associated With Weight Gain?

A 23-year-old man with difficult to control epilepsy is reviewed in surgery, four months after a change in his antiepileptic medication. He has remained seizure free but has gained 5 kg in weight since last reviewed. Which one of the following antiepileptic drugs is most associated with weight gain?

A. Ethosuximide
B. Sodium valproate
C. Levetiracetam
D. Carbamazepine
E. Lamotrigine

Answer:

A 54 Year Old Man With Epilepsy And Ischemic Heart Disease Presents With Complains Of Lethargy

A 54-year-old man with a history of epilepsy and ischaemic heart disease is seen in clinic with a 3 month history of lethargy.
Blood tests are as follows:
Hb 9.6 g/dl
MCV 123 fl
Plt 164 * 109/l
WCC 4.6 *109/l

Which one of his medications is most likely to be responsible?

A. Clopidogrel
B. Atorvastatin
C. Carbamazepine
D. Atenolol
E. Phenytoin

Answer:

Regarding Side Effects Of Aminosalicylate Drugs Like Mesalazine (Used In treatment of Ulcerative Colitis)

A 36-year-old man is reviewed in clinic. He has recently been started on mesalazine 400mg tds for ulcerative colitis. Which one of the following adverse effects is least likely to be attributable to mesalazine?
A. Interstitial nephritis
B. Headaches
C. Acute pancreatitis
D. Agranulocytosis
E. Infertility

Answer:

Treatment Of Bipolar Disorder

Which of the following medications is used in the classic treatment of bipolar disorder?
A) Lithium
B) Sertraline
C) Amitriptyline
D) Phenytoin
E) Alprazolam

Answer:

A Case Of Acetaminophen Overdose

A young female is brought to the emergency department after a suicidal attempt with acetaminophen overdose. Which of the following statements about acetaminophen overdose is correct?

A) Symptoms include extremity pain with physical findings of peripheral neuropathy.
B) Toxic effects rarely occur with ingestion of greater than 140 to 150 mg per kg of acetaminophen.
C) Elevations in liver tests peak 3 to 4 hours after ingestion.
D) Blood levels obtained 4 hours after ingestion determine treatment.
E) Treatment involves the use of deferoxamine.

Answer And Discussion:

A Case Of Serotonin Syndrome

A 35-year-old man with depression presents to the emergency department with flushing, diarrhea, sweating, and muscle rigidity. During the physical examination, he says that he began seeing a new psychiatrist because his sertraline was not working for him. His new doctor gave him a different medication, but he decided to use both medicines to “get rid of the depression.”
Which of the following medications did the new doctor most likely prescribe for this patient?

(A) Citalopram
(B) Lithium
(C) Nortriptyline
(D) Tranylcypromine
(E) Trazodone

Answer And Discussion: