GP – Case-based MCQs

A 63-year-old woman diagnosed with coronary artery disease was prescribed aspirin as part of disease management. She was brought to a local hospital emergency department by her family members in a disoriented state. History revealed consumption of a large number of aspirin tablets inadvertently. Which of the following best describes the rationale of using sodium bicarbonate in this setting?

To reduce tubular reabsorption of aspirin

To increase glomerular fltration of aspirin

To decrease ionization of aspirin

To decrease proximal tubular secretion of aspirin

None

A 41-year-old Caucasian woman recently diagnosed with pulmonary tuberculosis, had been receiving first-line anti-TB drugs for 2 months. In her general visit to physician, she complains of tingling sensation in the limbs. All the following statements are correct, EXCEPT

Isoniazid is responsible for patient complaints

Patient is having a genetic deficiency of N-acetyltransferase

Anti-TB drugs were ineffective in the patient

Reduction in the isoniazid dose must be considered

None

A 45-year-old man having a history of epilepsy and receiving oxcarbazepine daily was recently diagnosed with pulmonary tuberculosis. The patient was started on first-line anti-TB drugs. All the following can be expected in this patient, EXCEPT

Increase in the renal clearance of oxcarbazepine

Decrease in the volume of distribution of oxcarbazepine

Increase in the hepatic clearance of oxcarbazepine

Decrease in the half-life of oxcarbazepine

None

A 35-year-old man was admitted to the emergency department following a car accident, and a blood transfusion was started. A few minutes later, he complained symptoms suggestive of an acute anaphylactic reaction due to the release of histamine and other inflammatory mediators. An intramuscular injection of epinephrine was given, a drug that inhibits de-granulation of mast cells and opposes the effects of histamine. What type of antagonism exists between epinephrine and histamine?

Physiological

Non-Competitive

Chemical

Competitive

None

A 55-year-old man recently diagnosed with type 2 diabetes mellitus prescribed an oral hypoglycemic agent which is having ability to bind to plasma proteins. Which of the following statement is incorrect?

Drug binding to plasma proteins is always in dynamic equilibrium

Amount of drug binding to plasma proteins increases with increase in dose

Extent of plasma protein binding by the drug is highly variable

Acidic drugs bind to albumin and basic drugs to α-1 glycoprotein

None

A 53-year-old man having a history of coronary artery disease and receiving clopidogrel daily was recently diagnosed with peptic ulcer disease. The patient was started on omeprazole. Which of the following statements is correct?

Omeprazole increases the metabolism of clopidogrel

Omeprazole decreases the metabolism of clopidogrel

Clopidogrel decreases the metabolism of omeprazole

Clopidogrel increases the metabolism of omeprazole

None

A 45-year-old man diagnosed with brain tumor was prescribed carmustine by intravenous administration. Which of the following processes help the drug to transfer through the blood-brain barrier?

Lipid diffusion

Active transport

Endocytosis

Facilitated diffusion

None

A 57-year-old man diagnosed with osteoarthritis was prescribed ibuprofen for pain relief. Ibuprofen is a weak acid having a pKa of 4.8. Which of the following statements is incorrect?

Ibuprofen will be more nonionized in the stomach

Ibuprofen will be more ionized inside the mucosal cells

Ibuprofen gets trapped inside the mucosal cells

Ibuprofen will be more water soluble in the stomach

None