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Pharmacology and vaccines: RCSI aptitude test practice questions

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Pharmacology and vaccines on the RCSI theory paper

Paracetamol limits, NSAIDs, aspirin, warfarin and INR, clopidogrel, beta blockers, ACE inhibitors, diuretics, PPIs, levothyroxine, steroids, lithium, inhalers, and the Irish childhood and school vaccine schedules.

28 multiple-choice questions, each with an explanation and the document it was checked against. Three questions are free; the pass opens the other 25 and every other topic. Wrong answers come back first the next time you practise, and a question counts as mastered after two correct answers in a row.

Sample questions from this topic

  1. Question 1

    How do beta blockers work, and what sign suggests the heart rate has dropped too far?

    1. AThey widen the arteries to drop the pressure; a pounding headache suggests overdose
    2. BThey thin the blood to prevent clots; easy bruising and nosebleeds suggest overdose
    3. CThey block adrenaline to slow the heart; dizziness and breathlessness suggest bradycardia
    4. DThey pull fluid out through the kidneys; thirst and cramps suggest overdose
    Show answer

    Answer: C. HSE, Beta blockers: they slow the heart by blocking hormones such as adrenaline. A very slow heart rate is a serious side effect; dizziness and breathing difficulty can be its signs. Because they cause dizziness, the first dose is often taken at bedtime. They must not be stopped suddenly, and asthma or lung disease is a reason for caution.

    Source: HSE medicines: Beta blockers

  2. Question 2

    A patient with asthma is using the blue salbutamol inhaler more than 4 times in 24 hours. What does the HSE advise?

    1. ASwitch to using the blue inhaler only at night when the wheeze is worst
    2. BStop the brown preventer inhaler to reduce the total number of puffs a day
    3. CDouble the number of puffs taken each time so that each dose lasts longer
    4. DSee a GP or asthma nurse: asthma is not controlled and can worsen quickly
    Show answer

    Answer: D. HSE, Salbutamol inhaler: the blue reliever opens the airways within minutes, but needing it more than 4 times in 24 hours means the asthma is poorly controlled and needs review; attacks can get worse very quickly. Do not exceed 8 puffs in 24 hours outside an emergency plan. Shakiness, dizziness and a faster heartbeat are the expected side effects.

    Source: HSE medicines: Salbutamol inhaler

  3. Question 3

    Which everyday situations can push a lithium level into the toxic range?

    1. ATaking paracetamol for a headache or a cold
    2. BEating more fruit and vegetables and cutting down on red meat
    3. CDehydration, a sudden cut in salt intake, or starting an NSAID
    4. DDrinking extra water on a hot day or after heavy exercise
    Show answer

    Answer: C. HSE, Lithium: too much causes lithium toxicity, an emergency. Levels rise with dehydration (sweating, illness, diarrhoea), so patients drink plenty of fluids; they should not cut salt suddenly; and NSAIDs such as ibuprofen, aspirin and diclofenac interact. Blood levels are checked weekly at the start, then every 2 to 3 months. Blurred vision, tremor and diarrhoea are warning signs.

    Source: HSE medicines: Lithium

The practice above shuffles the options each time and keeps your score. 30 more free questions across the paper, with a PDF.

Documents behind these questions

Every fact was checked against the public document named on the answer. This topic draws on:

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