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Pharmacology Flashcards

7 cards from real NBME practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A patient on warfarin presents with INR of 8 and active bleeding. Which agent provides the most rapid reversal of warfarin anticoagulation?

    Answer: Fresh frozen plasma

    Fresh frozen plasma provides immediate replenishment of all clotting factors and is the fastest reversal for life-threatening warfarin-related bleeding.

  2. Which mechanism best explains why ACE inhibitors cause a dry cough in approximately 10-15% of patients?

    Answer: Increased bradykinin accumulation in the lungs

    ACE inhibitors block the breakdown of bradykinin, causing its accumulation in pulmonary tissue and stimulating cough receptors.

  3. A 72-year-old patient develops confusion, bradycardia, and yellow-green visual disturbances while on a drug for atrial fibrillation. Toxicity from which drug best explains these findings?

    Answer: Digoxin

    Digoxin toxicity classically presents with visual changes (xanthopsia), GI upset, and arrhythmias including bradycardia, particularly in elderly patients.

  4. Aminoglycosides such as gentamicin are associated with nephrotoxicity. Which nephron segment is primarily damaged?

    Answer: Proximal tubule

    Aminoglycosides accumulate in proximal tubular cells via endocytosis and cause direct tubular cell necrosis.

  5. A patient is receiving heparin for a DVT. Her platelet count drops from 250,000 to 60,000 after 8 days of therapy. Which drug should be used to continue anticoagulation?

    Answer: Argatroban

    Heparin-induced thrombocytopenia (HIT) requires immediate discontinuation of all heparin products and substitution with a direct thrombin inhibitor such as argatroban.

  6. Which beta-blocker property makes carvedilol preferable over metoprolol in patients with heart failure and peripheral vascular disease?

    Answer: Alpha-1 blocking activity causing vasodilation

    Carvedilol blocks alpha-1 receptors in addition to beta receptors, causing peripheral vasodilation that benefits patients with peripheral vascular disease.

  7. A child is brought to the ER after ingesting penicillin tablets. Allergic reaction to penicillin is most commonly mediated by which mechanism?

    Answer: Type I (IgE-mediated) hypersensitivity

    The most common and clinically significant penicillin reactions are IgE-mediated (Type I), which can cause anaphylaxis within minutes of exposure.