Drug Toxicity and Adverse Drug Reactions Quiz

Question 1

A 74-year-old man is on once-daily intravenous antibiotics for a prosthetic-joint infection. On day 5, he develops dizziness, tinnitus, and his serum creatinine has doubled from baseline. Which drug is most likely responsible for his symptoms?

Accepted Answer

Gentamicin

Answer

Vancomycin

Answer

Ceftriaxone

Answer

Piperacillin/tazobactam

Question 2

Twenty minutes into an intravenous infusion, a patient becomes flushed and itchy over the face, neck, and upper chest, but is haemodynamically stable. Which drug is most likely causing this reaction?

Accepted Answer

Vancomycin

Answer

Linezolid

Answer

Teicoplanin

Answer

Daptomycin

Question 3

A 45-year-old with bipolar disorder is brought to A&E after vomiting and confusion. He has a coarse tremor and a persistent headache. Which drug is causing his symptoms?

Accepted Answer

Lithium

Answer

Carbamazepine

Answer

Sodium valproate

Answer

Haloperidol

Question 4

A patient treated for atrial fibrillation reports visual disturbances, describing yellow-green halos around lights. Which medication is the most likely cause?

Accepted Answer

Digoxin

Answer

Amiodarone

Answer

Bisoprolol

Answer

Sotalol

Question 5

Three days after starting chemotherapy, a patient develops painful haematuria. Urinalysis shows blood but no infection. Which drug is the most likely cause of this reaction?

Accepted Answer

Cyclophosphamide

Answer

Methotrexate

Answer

Cisplatin

Answer

Ifosfamide

Question 6

A patient on once-weekly treatment for rheumatoid arthritis presents with mouth ulcers, sore throat, and pancytopenia. Which drug is most likely responsible for this presentation?

Accepted Answer

Methotrexate

Answer

Leflunomide

Answer

Azathioprine

Answer

Mycophenolate

Question 7

Six months after starting an anti-arrhythmic, a patient develops a dry cough and exertional breathlessness. Chest X-ray reveals interstitial shadowing. Which medication is most likely responsible?

Accepted Answer

Amiodarone

Answer

Flecainide

Answer

Dronedarone

Answer

Propafenone

Question 8

Three months post-renal transplant, a patient develops worsening hypertension, elevated serum creatinine, and gingival overgrowth. Which drug is the most likely cause?

Accepted Answer

Ciclosporin

Answer

Tacrolimus

Answer

Azathioprine

Answer

Mycophenolate

Question 9

A man recently had his medication dose increased. He now presents with slurred speech, gait instability, and horizontal nystagmus. Which drug is most likely causing his symptoms?

Accepted Answer

Phenytoin

Answer

Valproate

Answer

Carbamazepine

Answer

Levetiracetam

Question 10

Six weeks after starting an antiepileptic, a patient develops fever, mouth ulcers, and bruising. FBC shows agranulocytosis. Which drug is most likely responsible?

Accepted Answer

Carbamazepine

Answer

Lamotrigine

Answer

Topiramate

Answer

Gabapentin

Question 11

A type 1 diabetic takes insulin glargine at 22:00. After skipping breakfast, he’s found confused and sweating at 09:00. Capillary glucose is 2.2 mmol/L. What is the most likely cause of his symptoms?

Accepted Answer

Insulin

Answer

Metformin

Answer

Sitagliptin

Answer

Dapagliflozin

Question 12

An 80-year-old woman with type 2 diabetes is found drowsy at home. BM is 1.7 mmol/L and she takes a long-acting oral hypoglycaemic. Which drug class is most likely responsible?

Accepted Answer

Sulfonylurea

Answer

SGLT-2 inhibitor

Answer

DPP-4 inhibitor

Answer

Thiazolidinedione

Question 13

A COPD patient recently quit smoking. One week later, he develops nausea, tremor, and palpitations while taking a sustained-release medication. Which drug is most likely responsible for his symptoms?

Accepted Answer

Theophylline

Answer

Salbutamol

Answer

Prednisolone

Answer

Ipratropium

Question 14

A patient on a medication for atrial fibrillation collapses. ECG shows torsades de pointes and a QTc of 580 ms. Which drug is most likely responsible?

Accepted Answer

Sotalol

Answer

Amiodarone

Answer

Flecainide

Answer

Disopyramide

Question 15

A patient develops a new DVT seven days after starting unfractionated heparin. Platelet count has fallen from 320 to 85 × 10⁹/L. What is the most likely diagnosis?

Accepted Answer

Heparin-induced thrombocytopenia

Answer

Warfarin skin necrosis

Answer

Ticagrelor-induced thrombocytopenia

Answer

DIC from sepsis

Question 16

A 72-year-old man is prescribed rivaroxaban 20 mg once daily for stroke prevention in atrial fibrillation. He mentions he prefers to take all his morning tablets on an empty stomach. What is the most appropriate advice regarding rivaroxaban administration?

Accepted Answer

Take it with food to ensure proper absorption

Answer

It can be taken with or without food

Answer

Take it at bedtime to reduce bleeding risk

Answer

Take it on an empty stomach to improve absorption

Question 17

A 55-year-old man has been taking a medication for chronic joint pain. He now presents with black, tarry stools and epigastric discomfort. Which drug is most likely responsible for this presentation?

Accepted Answer

Piroxicam

Answer

Paracetamol

Answer

Codeine

Answer

Sumatriptan

Question 18

A patient is found unconscious with shallow breathing (respiratory rate = 6) and pinpoint pupils. Which drug is most likely responsible for this presentation?

Accepted Answer

Morphine

Answer

Diazepam

Answer

Pregabalin

Answer

Amitriptyline

Question 19

A patient receiving rapid IV electrolyte replacement develops limb weakness. ECG shows tall, peaked T waves. Which preparation is most likely responsible?

Accepted Answer

Potassium chloride

Answer

Calcium gluconate

Answer

Magnesium sulfate

Answer

Hypertonic saline

Question 20

A 30-year-old woman is about to start treatment with a known teratogenic medicine. She is not currently using any contraception. According to the Pregnancy Prevention Programme, which of the following is an appropriate contraceptive strategy for this patient?

Accepted Answer

Intrauterine device (IUD) alone

Answer

Use of condoms alone

Answer

Combined oral contraceptive pill only

Answer

Emergency contraception on standby