MACE Medical Reactions or Conditions 4 — Questions and Answers
Question 1: Which medication reaction involves the immune system producing IgE antibodies upon first exposure and triggering symptoms upon re-exposure?
- Type I hypersensitivity (anaphylactic) reaction (Correct answer)
- Toxic reaction
- Idiosyncratic reaction
- Pharmacologic side effect
Correct answer: Type I hypersensitivity (anaphylactic) reaction
Type I hypersensitivity is IgE-mediated, with sensitization on first exposure and rapid symptom onset (urticaria, anaphylaxis) on re-exposure.
Question 2: A resident on lithium for bipolar disorder shows coarse hand tremors, confusion, and vomiting. The medication aide should suspect:
- Lithium toxicity (Correct answer)
- A psychiatric episode
- Low blood sugar
- Normal lithium side effects that do not require action
Correct answer: Lithium toxicity
Coarse tremor, confusion, and GI symptoms in a lithium-treated patient indicate toxicity, which is a medical emergency due to lithium's narrow therapeutic index.
Question 3: A resident taking a calcium channel blocker develops ankle swelling without signs of infection. This is MOST likely:
- Peripheral edema, a common side effect of calcium channel blockers (Correct answer)
- Deep vein thrombosis requiring immediate evaluation
- Heart failure worsening unrelated to the medication
- An allergic reaction to the drug
Correct answer: Peripheral edema, a common side effect of calcium channel blockers
Peripheral edema, particularly ankle swelling, is a well-known and common side effect of dihydropyridine calcium channel blockers due to vasodilation.
Question 4: Which sign best distinguishes hypoglycemia from hyperglycemia in a diabetic resident?
- Diaphoresis and shakiness suggest hypoglycemia; increased thirst suggests hyperglycemia (Correct answer)
- Flushed skin suggests hypoglycemia; pale skin suggests hyperglycemia
- Slow onset suggests hypoglycemia; rapid onset suggests hyperglycemia
- Confusion only occurs in hyperglycemia
Correct answer: Diaphoresis and shakiness suggest hypoglycemia; increased thirst suggests hyperglycemia
Diaphoresis (sweating) and shakiness are adrenergic signs of hypoglycemia; hyperglycemia produces polydipsia and polyuria with gradual onset.
Question 5: A resident who recently started an antipsychotic medication is holding his neck in an awkward twisted position and appears distressed. This most likely indicates:
- Acute dystonia, an extrapyramidal side effect (Correct answer)
- A seizure requiring CPR
- Voluntary muscle spasm from activity
- A sign of dehydration
Correct answer: Acute dystonia, an extrapyramidal side effect
Acute dystonia (involuntary muscle contractions causing abnormal posturing) is a well-known extrapyramidal side effect of antipsychotic medications.
Question 6: When a resident's skin turns yellow (jaundiced) while taking acetaminophen regularly, the medication aide should recognize this as a possible sign of:
- Hepatotoxicity (liver damage) (Correct answer)
- Renal failure
- An allergic rash
- Normal skin pigment change unrelated to medication
Correct answer: Hepatotoxicity (liver damage)
Jaundice indicates elevated bilirubin from liver damage (hepatotoxicity), a serious adverse effect of acetaminophen overdose or chronic overuse.
Question 7: A resident on a statin for high cholesterol reports severe muscle pain and dark brown urine. The medication aide should recognize this as a sign of:
- Rhabdomyolysis, a serious adverse effect requiring immediate reporting (Correct answer)
- Normal muscle soreness from exercise
- A urinary tract infection
- Dehydration only
Correct answer: Rhabdomyolysis, a serious adverse effect requiring immediate reporting
Severe myalgia with dark urine (myoglobinuria) in a statin user indicates rhabdomyolysis, a life-threatening muscle breakdown that can cause kidney failure.
MACE Medical Reactions or Conditions 4
Which medication reaction involves the immune system producing IgE antibodies upon first exposure and triggering symptoms upon re-exposure?