MSRA MSRA Pharmacology and Prescribing 2

Question 1

A patient prescribed gentamicin requires monitoring. Which parameters are most important to check?

Accepted Answer

Renal function and drug trough/peak levels

Answer

Gentamicin is an aminoglycoside antibiotic that is nephrotoxic and ototoxic; monitoring renal function and serum drug levels is essential to prevent toxicity.

Question 2

A patient on simvastatin is prescribed clarithromycin. What is the most significant clinical risk of this interaction?

Accepted Answer

Increased risk of myopathy and rhabdomyolysis

Answer

Clarithromycin inhibits CYP3A4, the enzyme responsible for simvastatin metabolism, causing statin levels to rise dramatically and increasing the risk of myopathy and rhabdomyolysis.

Question 3

A patient with a history of anaphylaxis to penicillin requires treatment for confirmed MSSA bacteraemia. Which antibiotic is most appropriate?

Accepted Answer

Vancomycin

Answer

Patients with penicillin anaphylaxis carry a small but clinically significant cross-reactivity risk with cephalosporins; vancomycin is the safest non-beta-lactam alternative for serious staphylococcal infections.

Question 4

Which of the following medications routinely requires therapeutic drug level monitoring in clinical practice?

Accepted Answer

Phenytoin

Answer

Phenytoin has a narrow therapeutic index and exhibits non-linear (zero-order) pharmacokinetics at higher doses, making plasma level monitoring essential to ensure efficacy and avoid toxicity.

Question 5

A patient on long-term prednisolone is scheduled for major surgery. What is the most critical perioperative consideration?

Accepted Answer

Administer hydrocortisone cover for adrenal insufficiency

Answer

Long-term corticosteroid use suppresses the hypothalamic-pituitary-adrenal axis; IV hydrocortisone cover is required perioperatively to prevent an Addisonian crisis during the physiological stress of surgery.

MSRA Exam (Multi-Specialty Recruitment Assessment) Practice Test

MSRA Exam (Multi-Specialty Recruitment Assessment) Practice Test

MSRA MSRA Pharmacology and Prescribing 2