MSRA MSRA Pharmacology and Prescribing

Question 1

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

Accepted Answer

Increase in INR

Answer

Decrease in INR

Answer

No change in INR

Answer

Variable effect depending on dose

Question 2

Which of the following is a contraindication to metformin use?

Accepted Answer

eGFR < 30 mL/min/1.73m²

Answer

Type 2 diabetes with HbA1c > 7%

Answer

BMI > 35 kg/m²

Answer

Age > 70 years

Question 3

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

Accepted Answer

Initiating allopurinol

Answer

Colchicine

Answer

Naproxen

Answer

Prednisolone

Question 4

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

Accepted Answer

Switch to an angiotensin receptor blocker (ARB)

Answer

Add an antihistamine

Answer

Reduce the ACE inhibitor dose

Answer

Add a short-acting beta-agonist inhaler

Question 5

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

Accepted Answer

Lithium toxicity

Answer

Lithium withdrawal syndrome

Answer

Neuroleptic malignant syndrome

Answer

Serotonin syndrome

Question 6

Which best describes the mechanism of action of furosemide?

Accepted Answer

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

Answer

Blocks Na-Cl cotransporter in the distal convoluted tubule

Answer

Inhibits carbonic anhydrase in the proximal tubule

Answer

Antagonises aldosterone receptors in the collecting duct

Question 7

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

Accepted Answer

Calcium channel blocker

Answer

ACE inhibitor

Answer

Beta-blocker

Answer

Thiazide-like diuretic