PLAB Pharmacology & Therapeutics — Questions and Answers
Question 1: Which class of medication is first-line for treating hypertension in patients under 55 years old according to current guidelines?
- ACE inhibitors or ARBs (Correct answer)
- Calcium channel blockers
- Beta-blockers
- Thiazide diuretics
Correct answer: ACE inhibitors or ARBs
ACE inhibitors (e.g., ramipril) or ARBs (e.g., losartan) are first-line antihypertensives for patients under 55, as they target the renin-angiotensin system that is typically more active in younger patients.
Question 2: What is the mechanism of action of metformin?
- Decreases hepatic glucose production and increases insulin sensitivity (Correct answer)
- Stimulates insulin release from pancreatic beta cells
- Blocks glucose absorption in the intestines completely
- Increases urine glucose excretion
Correct answer: Decreases hepatic glucose production and increases insulin sensitivity
Metformin works primarily by reducing hepatic glucose production and improving peripheral insulin sensitivity, making it the first-line treatment for type 2 diabetes.
Question 3: Which anticoagulant requires regular INR monitoring?
- Warfarin (Correct answer)
- Rivaroxaban
- Apixaban
- Dabigatran
Correct answer: Warfarin
Warfarin requires regular INR (International Normalized Ratio) monitoring because it has a narrow therapeutic index and its effect is influenced by diet, medications, and individual metabolism.
Question 4: A patient on a statin reports new-onset muscle pain. What blood test should be ordered?
- Creatine kinase (CK) levels (Correct answer)
- Serum calcium
- Thyroid function tests
- Blood glucose
Correct answer: Creatine kinase (CK) levels
Statin-related myopathy is assessed by measuring creatine kinase levels. Significantly elevated CK suggests muscle damage (rhabdomyolysis) requiring immediate statin discontinuation.
Question 5: What is the antidote for paracetamol (acetaminophen) overdose?
- N-acetylcysteine (NAC) (Correct answer)
- Flumazenil
- Naloxone
- Activated charcoal only
Correct answer: N-acetylcysteine (NAC)
N-acetylcysteine is the specific antidote for paracetamol overdose, replenishing glutathione stores and protecting the liver from the toxic metabolite NAPQI.
Question 6: Which antibiotic class should be avoided in children due to effects on developing cartilage?
- Fluoroquinolones (Correct answer)
- Penicillins
- Macrolides
- Cephalosporins
Correct answer: Fluoroquinolones
Fluoroquinolones (e.g., ciprofloxacin) are generally avoided in children because they can cause damage to developing cartilage and tendons, with exceptions only for serious infections.
PLAB Pharmacology & Therapeutics
Which class of medication is first-line for treating hypertension in patients under 55 years old according to current guidelines?