Nokea
A 57-year-old man was recently diagnosed with Type-2 diabetes mellitus and placed on a medication. He began having myalgias and feeling sick and later developed respiratory distress, so he went to the hospital. His pH was 7.2, and he had elevated blood lactate levels. Which drug is likely causing his problem?
- A. Acarbose
- B. Glyburide
- C. Metformin
- D. Pioglitazone
Correct Answer: C
Rationale: Metformin can cause lactic acidosis, a rare but serious side effect, presenting with low pH and elevated lactate levels.
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A 3 year old child has been admitted to hospital with suspicion of an atropine overdose. Which of the following symptoms could have led to the arrival of the diagnosis?
- A. Abdominal cramps
- B. Increased gastric secretion
- C. Increased cardiac rate
- D. Papillary constriction
Correct Answer: C
Rationale: Atropine overdose causes tachycardia due to muscarinic blockade.
Methanol causes blindness due to its
- A. Hypersensitivity reactions
- B. Conjugated products
- C. Idiosyncratic reaction
- D. Oxidative products
Correct Answer: D
Rationale: Methanol's metabolite, formic acid (oxidative product), damages the optic nerve, causing blindness.
In the presence of pentazocine, a higher concentration of morphine is required to elicit pain relief. Pentazocine by it self has a smaller analgesic effect than does morphine, even at the highest dose, Which of the following is correct regarding these medications?
- A. Pentazocine is a competitive antagonist
- B. Morphine is a full agonist, and pentazocine is a partial agonist
- C. Morphine is less efficacious than is pentazocine
- D. Morphine is less potent than is pentazocine
Correct Answer: B
Rationale: Pentazocine's submaximal effect and antagonism of morphine indicate it is a partial agonist, while morphine is a full agonist.
Serum digoxin levels are monitored for potential toxicity. Monitoring should occur:
- A. Within 6 hours of the last dose
- B. Because a reference point is needed in adjusting a dose
- C. After three half-lives from the starting of the drug
- D. When a patient has stable renal function
Correct Answer: C
Rationale: Monitoring after three half-lives (steady state) ensures accurate therapeutic levels.
Which of the following is natural mineralcorticoid:
- A. Methylprednisolone
- B. Betamethasone
- C. Triamcinolone
- D. Aldosterone
Correct Answer: D
Rationale: Aldosterone is the primary natural mineralocorticoid, regulating sodium and potassium balance.