FRCS Pharmacology in Surgery

Question 1

A patient on warfarin requires emergency surgery for a perforated duodenal ulcer. What is the most appropriate method to rapidly reverse the anticoagulation?

Accepted Answer

Prothrombin complex concentrate (PCC) and intravenous vitamin K

Answer

Fresh frozen plasma alone

Answer

Intravenous vitamin K alone

Answer

Oral vitamin K and wait 24 hours

Question 2

Which class of antibiotic acts by inhibiting bacterial cell wall synthesis through binding to penicillin-binding proteins?

Accepted Answer

Beta-lactams

Answer

Aminoglycosides

Answer

Fluoroquinolones

Answer

Macrolides

Question 3

A patient develops malignant hyperthermia during general anaesthesia. Which drug is the specific treatment?

Accepted Answer

Dantrolene

Answer

Suxamethonium

Answer

Neostigmine

Answer

Propofol

Question 4

Which of the following analgesic drugs inhibits both serotonin and noradrenaline reuptake in addition to being a weak opioid agonist?

Accepted Answer

Tramadol

Answer

Codeine

Answer

Morphine

Answer

Paracetamol

Question 5

A patient with renal impairment (eGFR 20 ml/min) requires thromboprophylaxis post-operatively. Which low molecular weight heparin dose adjustment is recommended?

Accepted Answer

Reduce dose or use unfractionated heparin instead

Answer

Use standard LMWH dose with no adjustment

Answer

Double the LMWH dose

Answer

Switch to warfarin immediately

Question 6

Which local anaesthetic has the longest duration of action and is most commonly used for post-operative regional nerve blocks?

Accepted Answer

Bupivacaine

Answer

Lidocaine

Answer

Prilocaine

Answer

Procaine