Medical Questions and Answers PDF

**1. Which of the following best describes the mechanism of action of opioids at the pre-synaptic terminal?** A\) Increases neurotransmitter release B\) Decreases calcium ion influx, reducing neurotransmitter release C\) Blocks sodium channels to prevent neurotransmitter release D\) Inhibits pot...

**1. Which of the following best describes the mechanism of action of opioids at the pre-synaptic terminal?** A\) Increases neurotransmitter release B\) Decreases calcium ion influx, reducing neurotransmitter release C\) Blocks sodium channels to prevent neurotransmitter release D\) Inhibits potassium efflux to hyperpolarize the neuron **Answer:** B) Decreases calcium ion influx, reducing neurotransmitter release **2. A 68-year-old man with a history of chronic cancer pain has been prescribed fentanyl. Which of the following is true regarding fentanyl use?** A\) It is suitable for first-line use in mild to moderate pain B\) It is appropriate for treating mild headaches C\) It is more potent than morphine and used in severe cancer pain D\) It should be combined with naloxone for routine pain management **Answer:** C) It is more potent than morphine and used in severe cancer pain **3. A patient is being treated with a combination of oxycodone and naloxone. Why is naloxone included in this combination?** A\) To enhance the analgesic effects of oxycodone B\) To reduce the potential for opioid dependence C\) To prevent oxycodone-induced constipation D\) To reduce the sedative effects of oxycodone **Answer:** C) To prevent oxycodone-induced constipation **4. A 45-year-old female presents with chronic neuropathic pain that has persisted even after the initial peripheral injury has healed. What type of pain is she most likely experiencing?** A\) Nociceptive pain B\) Neuropathic pain C\) Neuroplastic pain D\) Acute pain **Answer:** B) Neuropathic pain **5. Which of the following adverse effects is most commonly associated with long-term opioid use?** A\) Tachycardia B\) Hypertension C\) Constipation D\) Hyperkalemia **Answer:** C) Constipation **6. A 36-year-old male has been prescribed buprenorphine patches for opioid dependence. What is the advantage of using buprenorphine compared to full opioid agonists like morphine?** A\) It does not induce any physical dependence B\) It has a ceiling effect on respiratory depression, making it safer at higher doses C\) It completely eliminates withdrawal symptoms D\) It has no potential for misuse **Answer:** B) It has a ceiling effect on respiratory depression, making it safer at higher doses **7. A 25-year-old woman with a history of depression is prescribed sertraline, a selective serotonin reuptake inhibitor (SSRI). Which of the following is a possible adverse effect in the early phase of SSRI treatment?** A\) Increased risk of suicide B\) Hyperthermia C\) Diarrhoea D\) Bradycardia **Answer:** A) Increased risk of suicide **8. A patient is undergoing a minor dental procedure. The dentist decides to use lidocaine as a local anaesthetic. Which of the following statements is true regarding the action of local anaesthetics like lidocaine?** A\) They inhibit the reuptake of serotonin B\) They block sodium channels, preventing action potential propagation C\) They block potassium channels, increasing action potential propagation D\) They decrease neurotransmitter release by blocking calcium channels **Answer:** B) They block sodium channels, preventing action potential propagation **9. A 55-year-old man presents with symptoms of opioid withdrawal after stopping his morphine medication abruptly. Which of the following is not a symptom of opioid withdrawal?** A\) Restlessness B\) Sweating C\) Constipation D\) Muscle aches **Answer:** C) Constipation **10. A 60-year-old woman is prescribed tramadol for chronic pain management. Tramadol has been described as a "dirty drug" due to its numerous interactions. What is a key pharmacological feature of tramadol?** A\) It selectively inhibits serotonin reuptake only B\) It inhibits serotonin and noradrenaline reuptake and also acts on muscarinic receptors C\) It only acts on opioid receptors D\) It inhibits dopamine reuptake without affecting other neurotransmitters **Answer:** B) It inhibits serotonin and noradrenaline reuptake and also acts on muscarinic receptors **11. Which of the following is a clinical use for codeine?** A\) First-line for severe pain B\) Mild to moderate pain and cough suppression C\) Treatment for opioid dependence D\) Local anaesthesia **Answer:** B) Mild to moderate pain and cough suppression **12. A 34-year-old male is using fentanyl patches for severe cancer pain. What is a potential adverse effect he should be monitored for?** A\) Hypotension B\) Hyperkalemia C\) Tachycardia D\) Respiratory depression **Answer:** D) Respiratory depression **13. Which of the following statements regarding local anaesthetics is correct?** A\) They block potassium channels to prevent neurotransmitter release B\) They prevent sodium influx, blocking the generation of action potentials C\) They inhibit serotonin reuptake D\) They reduce calcium influx at presynaptic terminals **Answer:** B) They prevent sodium influx, blocking the generation of action potentials **14. A 60-year-old man presents with chronic pain and has been prescribed oxycodone. What is the main benefit of combining it with naloxone in certain formulations?** A\) To enhance the analgesic effect B\) To reduce respiratory depression C\) To prevent opioid-induced constipation D\) To decrease the risk of overdose **Answer:** C) To prevent opioid-induced constipation **15. A 72-year-old woman is prescribed paracetamol for mild osteoarthritis pain. How does paracetamol exert its analgesic effects?** A\) Inhibition of COX-3 B\) Inhibition of serotonin reuptake C\) Blockade of sodium channels D\) Inhibition of noradrenaline reuptake **Answer:** A) Inhibition of COX-3 **16. A patient presents with symptoms of opioid overdose, including respiratory depression. Which of the following is the most appropriate treatment?** A\) Tramadol B\) Naloxone C\) Morphine D\) Fentanyl **Answer:** B) Naloxone **17. A 50-year-old male is undergoing a minor surgical procedure and has been administered lidocaine with adrenaline. Why is adrenaline added to lidocaine?** A\) To decrease the duration of anaesthesia B\) To reduce the risk of systemic toxicity by slowing absorption C\) To increase the rate of sodium influx into the neuron D\) To prevent potassium efflux **Answer:** B) To reduce the risk of systemic toxicity by slowing absorption **18. Which opioid is most commonly used for opioid replacement therapy?** A\) Oxycodone B\) Methadone C\) Codeine D\) Fentanyl **Answer:** B) Methadone **19. A patient is diagnosed with major depressive disorder and prescribed escitalopram. Which of the following mechanisms best explains the action of escitalopram?** A\) Blocks dopamine reuptake B\) Inhibits serotonin reuptake C\) Blocks sodium channels D\) Enhances GABA release **Answer:** B) Inhibits serotonin reuptake **20. A 45-year-old man has been taking NSAIDs for chronic pain. What is the most concerning long-term adverse effect of NSAID use?** A\) Renal toxicity B\) Sedation C\) Hyperglycaemia D\) Bradycardia **Answer:** A) Renal toxicity **21. A patient presents with symptoms of serotonin syndrome. Which of the following drugs is most likely to cause serotonin syndrome when combined with an SSRI?** A\) Paracetamol B\) Tramadol C\) Lidocaine D\) Naloxone **Answer:** B) Tramadol **22. Which of the following is a contraindication for the use of opioids in pain management?** A\) Hypertension B\) Constipation C\) Respiratory depression D\) Hyperkalemia **Answer:** C) Respiratory depression **23. What is the mechanism of action of tramadol?** A\) Selective serotonin reuptake inhibition B\) Serotonin and noradrenaline reuptake inhibition with opioid receptor agonism C\) Dopamine receptor blockade D\) Inhibition of monoamine oxidase **Answer:** B) Serotonin and noradrenaline reuptake inhibition with opioid receptor agonism **24. A patient is prescribed naloxone in the event of opioid overdose. Which of the following best describes naloxone's action?** A\) Opioid receptor agonist B\) Opioid receptor antagonist C\) Sodium channel blocker D\) Serotonin receptor antagonist **Answer:** B) Opioid receptor antagonist **25. A 30-year-old female presents with mild to moderate pain. Which of the following would be the most appropriate initial analgesic therapy?** A\) Fentanyl B\) Paracetamol C\) Methadone D\) Oxycodone **Answer:** B) Paracetamol **26. What is a primary indication for the use of selective serotonin reuptake inhibitors (SSRIs)?** A\) Chronic pain B\) Depression and anxiety disorders C\) Local anaesthesia D\) Acute pain management **Answer:** B) Depression and anxiety disorders **27. Which of the following drugs is used to treat neuropathic pain?** A\) Paracetamol B\) Oxycodone C\) Duloxetine D\) Codeine **Answer:** C) Duloxetine **28. A patient presents with severe opioid withdrawal symptoms. Which drug is commonly used to manage opioid withdrawal symptoms?** A\) Naloxone B\) Methadone C\) Lidocaine D\) Paracetamol **Answer:** B) Methadone **29. A 40-year-old woman is prescribed a serotonin-noradrenaline reuptake inhibitor (SNRI) for chronic pain. Which of the following is a known adverse effect of SNRIs?** A\) Diarrhoea B\) Hypertension C\) Hypercalcaemia D\) Hypotension **Answer:** B) Hypertension **30. Which of the following statements is true about the use of opioids in the management of diarrhoea?** A\) Opioids decrease gastrointestinal motility by acting on mu receptors in the GI tract B\) Opioids increase gastrointestinal motility by stimulating serotonin release C\) Opioids block potassium channels in the intestines D\) Opioids increase water secretion in the intestines **Answer:** A) Opioids decrease gastrointestinal motility by acting on mu receptors in the GI tract **31. A patient is administered morphine following surgery. Which of the following is a common adverse effect of morphine?** A\) Hypertension B\) Respiratory depression C\) Diarrhoea D\) Tachycardia **Answer:** B) Respiratory depression **32. Which local anaesthetic is commonly used in dentistry?** A\) Lidocaine B\) Fentanyl C\) Naloxone D\) Oxycodone **Answer:** A) Lidocaine **33. What is the mechanism of action of amitriptyline in pain management?** A\) Sodium channel blocker B\) Serotonin and noradrenaline reuptake inhibitor C\) Calcium channel blocker D\) Dopamine receptor agonist **Answer:** B) Serotonin and noradrenaline reuptake inhibitor **34. A patient with chronic pain is prescribed methadone. What is the most concerning adverse effect of methadone?** A\) Bradycardia B\) QT prolongation C\) Hyperglycaemia D\) Renal toxicity **Answer:** B) QT prolongation **35. A 62-year-old man presents with chronic liver disease and requires analgesia. Which of the following should be avoided due to the risk of hepatotoxicity?** A\) Paracetamol B\) Tramadol C\) Lidocaine D\) Naloxone **Answer:** A) Paracetamol **36. Which of the following drugs is contraindicated in a patient taking monoamine oxidase inhibitors (MAOIs) due to the risk of hypertensive crisis?** A\) Paracetamol B\) Methadone C\) Codeine D\) Oxycodone **Answer:** C) Codeine **37. A patient is using buprenorphine as part of opioid replacement therapy. Which of the following best describes buprenorphine's action?** A\) Full agonist at mu receptors B\) Partial agonist at mu receptors C\) Antagonist at mu receptors D\) Full agonist at kappa receptors **Answer:** B) Partial agonist at mu receptors **38. Which of the following adverse effects is common with chronic opioid use?** A\) Diarrhoea B\) Constipation C\) Hypertension D\) Hyperglycaemia **Answer:** B) Constipation **39. What is the primary use of naloxone?** A\) Pain management B\) Treatment of opioid overdose C\) Local anaesthesia D\) Antidepressant therapy **Answer:** B) Treatment of opioid overdose **40. Which of the following is a key feature of tramadol's mechanism of action?** A\) Pure opioid receptor agonism B\) Serotonin and noradrenaline reuptake inhibition with weak opioid receptor activity C\) Dopamine receptor antagonist activity D\) Inhibition of GABA release **Answer:** B) Serotonin and noradrenaline reuptake inhibition with weak opioid receptor activity