Practice Test Geeks(MSRA) Multi-Specialty Recruitment Assessment Practice Test
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MSRA Pharmacology and Prescribing Flashcards

7 cards from real MSRA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 MSRA Pharmacology and Prescribing flashcards as text

  1. A patient on warfarin is started on amoxicillin for a chest infection. What is the most likely effect on their INR?

    Answer: Increase in INR

    Antibiotics reduce gut flora that produce Vitamin K, decreasing its availability and potentiating warfarin's anticoagulant effect, thereby raising the INR.

  2. Which of the following is a contraindication to metformin use?

    Answer: eGFR < 30 mL/min/1.73m²

    Metformin is contraindicated in severe renal impairment (eGFR < 30) because impaired excretion leads to accumulation and risk of potentially fatal lactic acidosis.

  3. A patient presents with an acute gout attack. Which intervention should be avoided during the acute phase?

    Answer: Initiating allopurinol

    Starting allopurinol during an acute gout attack can mobilise urate crystals and prolong or worsen the attack; it should be initiated 2–4 weeks after resolution.

  4. A patient taking an ACE inhibitor develops a persistent dry cough. What is the most appropriate management?

    Answer: Switch to an angiotensin receptor blocker (ARB)

    ACE inhibitor cough is caused by bradykinin accumulation; switching to an ARB avoids this mechanism while maintaining renin-angiotensin system blockade.

  5. A patient on lithium develops coarse tremor, ataxia, and confusion. What is the most likely diagnosis?

    Answer: Lithium toxicity

    Lithium toxicity classically presents with coarse tremor (distinct from the fine tremor at therapeutic levels), ataxia, and confusion, progressing to seizures and coma in severe cases.

  6. Which best describes the mechanism of action of furosemide?

    Answer: Inhibits Na-K-2Cl cotransporter in the loop of Henle

    Furosemide inhibits the NKCC2 (Na-K-2Cl) cotransporter in the thick ascending limb of the loop of Henle, producing powerful diuresis.

  7. According to NICE guidelines, which antihypertensive is recommended as first-line for a patient aged 55 or older with uncomplicated hypertension?

    Answer: Calcium channel blocker

    NICE recommends a calcium channel blocker as Step 1 treatment for patients aged 55 or over, as renin-angiotensin system blockers are less effective in this age group due to lower plasma renin activity.

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Sources & references

Exam facts on this page (fees, format, dates, passing scores) are checked against these official sources; the date is our last check. Editorial policy

  1. medical.hee.nhs.uk — Registration deadline, score release, test dates, eligibility, passing score, retake policy, exam format, time limit, test delivery · verified Oct 2026