PROMETRIC EXAM QUESTIONS WITH EXPLANATION
38)A 20 year-old man encounters a serious road accident. He is brought to the hospital with ‛deep wounds’. His vaccination history is unknown. Which of the following would be best to administer to this patient at this time?
A)Tetanus vaccine
B)Tetanus immune globulin
C)Tetanus vaccine and tetanus immune globulin
D)Tetanus vaccine and human papillomavirus vaccine
B)Tetanus immune globulin
C)Tetanus vaccine and tetanus immune globulin
D)Tetanus vaccine and human papillomavirus vaccine
Explanation:
The patient has a deep, tetanus-prone wound and an unknown vaccination history.
In such a scenario, the patient's vaccination status is assumed to be unimmunized, and a combination of both active and passive immunization is required.
The tetanus vaccine (active immunization) stimulates the patient's immune system to produce long-term antibodies, but this process takes days to weeks. Tdap is the preferred vaccine for adults under 65 who have not received it previously.
The tetanus immune globulin (TIG) provides immediate, short-term passive immunity through pre-made antibodies to neutralize any existing toxin, which is crucial for immediate protection in a deep wound setting.
The TIG and vaccine should be administered simultaneously at different anatomical sites using separate syringes. This combination is indicated for dirty or major wounds when vaccination status is unknown or incomplete.
The correct option is C. Tetanus vaccine and tetanus immune globulin.
Which of the following is a function of alcohol dehydrogenase enzyme ?
A)Accelerates the reduction of ethanol
B)Accelerate the addition of hydrogen to ethanol
C)Accelerates the addition of phosphate to ethanol
D)Accelerates the removal of hydrogen from ethanol
Explanation:
Alcohol dehydrogenase (ADH) is an enzyme that catalyzes the oxidation of ethanol to acetaldehyde in the body. Oxidation in this context involves the removal of a hydrogen atom. This process detoxifies the alcohol and converts it into a compound that can be further metabolized.
x A) Reduction is the opposite of what ADH does
x B) Adding hydrogen = reduction, not oxidation
x C) Phosphorylation is not involved in ethanol metabolism
The correct option is D. Accelerates the removal of hydrogen from ethanol.
The authors report two isolated gastro-intestinal tuberculosis in renal transplant recipients that illustrates the difficulty of making this diagnosis and a brief review of the literature on its clinical presentation, diagnosis and therapeutic approach.
What is the type of study in the above-mentioned abstract?
A)Case-series
B)Cohort studies
C)Case-control studies
D)Cross-sectional studies
Explanation:
The abstract describes two isolated cases of gastrointestinal tuberculosis in renal transplant recipients and includes a review of the literature. There is:
- No comparison group
- No follow-up of exposed vs non-exposed groups
- No assessment of risk factors or outcomes across populations
This fits the definition of a case series, which reports multiple cases of a condition without a control group. A case series is a type of observational study that involves a collection of case reports involving multiple patients who have a similar presentation or receive similar treatment. Reporting on a few specific cases (two in this instance) with detailed information falls under the definition of a case series.
x B) Cohort study → requires follow-up of exposed and unexposed groups
x C) Case-control study → requires cases compared with matched controls
x D) Cross-sectional study → assesses prevalence at a single point in time
📌 Key clue: “Two isolated cases” → Case series
The correct option is A. Case-series.
Which of the following is the process of breaking down of glycogen ?
A)Glycolysis
B)Glycogenesis
C)Glycogenolysis
D)Gluconeogenesis
Explanation:
Glycogenolysis is the catabolic process of breaking down glycogen, a stored form of glucose, into glucose-1-phosphate (which is then converted to glucose-6-phosphate) and ultimately to free glucose in the liver, for release into the bloodstream to maintain blood sugar levels. This process is crucial during fasting, exercise, or stress, to ensure the body has a readily available energy source.
x A) Glycolysis → breakdown of glucose, not glycogen
x B) Glycogenesis → formation of glycogen
x D) Gluconeogenesis → synthesis of glucose from non-carbohydrate sources
📌 Key memory tip: “-lysis” = breakdown → glycogenolysis = glycogen breakdown
The correct option is C) Glycogenolysis.
37-year-old mother breastfeeding her child has developed consistent high blood pressure. The physician consults the pharmacy to recommend an antihypertensive to control her blood pressure. Which of the following anti-hypertensive is most hazardous for the child?
A)Atenolol
B)Verapamil
C)Metoprolol
D)Propranolol
Explanation:
Atenolol is generally not a first-choice medication for breastfeeding mothers due to its pharmacokinetic properties which increase the risk of infant exposure and adverse effects.
- Has low protein binding
- Has a long half-life
- Is excreted in high concentrations in breast milk
- Can cause bradycardia, hypotension, and hypoglycemia in the infant
B) Verapamil → a calcium channel blocker with low levels found in breast milk and is generally considered safe, particularly for infants older than two months.
C) Metoprolol → low milk levels, preferred β-blocker in breastfeeding
D) Propranolol → high protein binding, low milk concentration
📌 Key point to remember:
Atenolol is avoided in breastfeeding due to significant infant exposure.
Which of the following is required to consider an adverse drug event report a valid report?
A)Drug dose
B)Patient's height
C)Event name
D)Reporter’s phone
Explanation:
For an adverse drug event (ADE) report to be considered valid, it must meet four minimum criteria as defined by international pharmacovigilance guidelines (ICH):
- An identifiable patient.
- An identifiable reporter.
- A suspect medicinal product (drug).
- A suspected adverse reaction or event name.
The "event name" (description of the reaction/symptoms) is one of these four mandatory data elements.
x A) Drug dose → helpful but not mandatory
x B) Patient’s height → not required
x D) Reporter’s phone number → contact info is useful but not essential; the reporter just needs to be identifiable
The correct option is C. Event name.
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