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Pharmacology MCQ practice

Immunology Inflammation and MSK Pharmacology Quiz

Review NSAIDs, corticosteroids, allergy medicines, gout therapy, DMARDs, biologics, bone medicines, and immunosuppression.

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Sample Questions

Patient counselling

A patient starts inhaled budesonide. Which counselling point best reduces local adverse effects?

  • Stop when the voice improves
  • Rinse the mouth after each dose
  • Swallow residue after inhaling
  • Use only during acute attacks

Answer: Rinse the mouth after each dose

Mouth rinsing reduces local steroid effects such as candidiasis.

Swallowing residue, reliever-only use, or stopping early undermines safe inhaled steroid use.

Antihistamines

A 73-year-old patient with mild cognitive impairment presents with urticaria. Which drug would be most appropriate?

  • Cetirizine
  • Promethazine
  • Diphenhydramine
  • Desloratadine

Answer: Desloratadine

Desloratadine is a low-sedating second-generation antihistamine with little anticholinergic effect, useful when cognition is a concern.

Promethazine and diphenhydramine can worsen confusion; cetirizine is second generation but can still cause drowsiness in some older patients.

Antihistamines

Which option is an adverse effect rather than a clinical use of first-generation antihistamines?

  • Urticaria
  • Nausea and vomiting
  • Drowsiness
  • Allergic rhinitis

Answer: Drowsiness

Drowsiness is an adverse effect of first-generation antihistamines, not a symptom they are used to treat.

First-generation antihistamines may be used for allergic rhinitis, urticaria, and nausea or vomiting, especially motion sickness.

Antihistamines

Which condition is atypical for first-generation antihistamine toxicity?

  • Gingival hyperplasia
  • Ventricular arrhythmias
  • Postural hypotension
  • Xerostomia

Answer: Gingival hyperplasia

Gingival hyperplasia is not a typical adverse effect of first-generation antihistamines.

Xerostomia and postural hypotension reflect anticholinergic and α-blocking effects, while ventricular arrhythmias may occur rarely, especially in overdose.

Antihistamines

Which option is an adrenal hormone rather than a mast-cell mediator?

  • Heparin
  • Serotonin
  • Cortisol
  • Histamine

Answer: Cortisol

Cortisol is an adrenal corticosteroid hormone, not a mast-cell granule mediator.

Mast cells can release histamine, heparin, and serotonin, although mediator profiles vary by tissue and species.

DMARDs

A patient prescribed leflunomide wishes to become pregnant. To washout the leflunomide she can take?

  • Cholestyramine
  • Activated charcoal
  • Simvastatin
  • Cholesterol

Answer: Cholestyramine

Cholestyramine interrupts enterohepatic recycling of leflunomide's active metabolite, accelerating elimination before pregnancy.

Activated charcoal may be an alternative in some protocols, but simvastatin and cholesterol do not perform the standard leflunomide washout.

Learning Design

Drugzzle uses brief single-best-answer rounds, immediate feedback, confidence reflection, and missed-question review to support retrieval practice and safer prescribing reasoning.