Quinolones

Question 1

Which MHRA prescribing rule applies to quinolones? A. They are first-line antibiotics B. They are only prescribed when other antibiotics are inappropriate C. They are restricted to hospital use only D. They are used only for viral infections

Answer 1

Answer: B. Explanation: MHRA advises quinolones should only be prescribed when other commonly used antibiotics are inappropriate due to serious long-lasting adverse effects.

Question 2

Which symptom may indicate heart valve regurgitation in a patient taking quinolones? A. Rash B. Shortness of breath and ankle swelling C. Constipation D. Dry mouth

Answer 2

Answer: B. Explanation: Quinolones carry a small risk of heart valve regurgitation presenting with breathlessness

Question 3

Which cardiovascular risk is associated with quinolone use? A. Myocardial infarction B. Heart valve regurgitation C. Complete heart block D. Pulmonary embolism

Answer 3

Answer: B. Explanation: MHRA reports a small increased risk of heart valve regurgitation with quinolones.

Question 4

A patient taking a quinolone develops sudden severe chest

Answer 4

abdominal or back pain. What serious adverse effect should be suspected? A. Pancreatitis B. Renal colic C. Aortic aneurysm or dissection D. Peptic ulcer perforation

Question 5

In which patient group are quinolones contraindicated? A. Patients with asthma B. Pregnant patients C. Patients with hypertension D. Patients with penicillin allergy

Answer 5

Answer: B. Explanation: Quinolones are contraindicated in pregnancy due to risk of fetal arthropathy.

Question 6

Why should quinolones be avoided during breastfeeding? A. Risk of neonatal hypoglycaemia B. Risk of articular damage C. Risk of kernicterus D. Risk of respiratory depression

Answer 6

Answer: B. Explanation: Quinolones may cause damage to developing cartilage in infants.

Question 7

Which patient has the highest risk of quinolone-induced tendinitis or tendon rupture? A. Healthy adult B. Patient under 30 years C. Patient over 60 taking corticosteroids D. Patient with controlled hypertension

Answer 7

Answer: C. Explanation: Risk is increased in patients over 60

Question 8

When can tendon rupture occur after starting quinolone therapy? A. After one month B. After one week C. Within 48 hours D. Only after prolonged use

Answer 8

Answer: C. Explanation: Tendon damage and rupture can occur very early

Question 9

What is the correct action if tendon pain occurs during quinolone treatment? A. Continue treatment and monitor B. Reduce the dose C. Stop immediately and seek medical advice D. Switch to another quinolone

Answer 9

Answer: C. Explanation: Early discontinuation reduces the risk of tendon rupture.

Question 10

Which psychiatric adverse effect has been reported with quinolones? A. Insomnia only B. Anxiety only C. Suicidal thoughts and behaviour D. Memory impairment only

Answer 10

Answer: C. Explanation: MHRA reports risk of suicidal thoughts and behaviour

Question 11

Why should quinolones be used cautiously in patients with epilepsy? A. They increase sodium levels B. They prolong QT interval C. They lower the seizure threshold D. They reduce antiepileptic efficacy

Answer 11

Answer: C. Explanation: Quinolones lower the seizure threshold

Question 12

Which medicine further increases seizure risk when used with quinolones? A. Paracetamol B. Ibuprofen C. Metformin D. Omeprazole

Answer 12

Answer: B. Explanation: NSAIDs such as ibuprofen further lower the seizure threshold when combined with quinolones.

Question 13

Why is dose adjustment required for quinolones in renal impairment? A. Hepatic metabolism B. QT prolongation C. Reduced renal clearance D. Increased oral absorption

Answer 13

Answer: C. Explanation: Quinolones are mainly renally excreted and can accumulate in renal impairment.

Question 14

Why should quinolones be used cautiously in patients with diabetes? A. They permanently increase insulin resistance B. They increase HbA1c C. They affect blood glucose control D. They cause hypertension

Answer 14

Answer: C. Explanation: Quinolones can cause hypo- or hyperglycaemia

Question 15

Which drug increases QT prolongation risk when combined with quinolones? A. Iron B. Zinc C. Amiodarone D. Calcium carbonate

Answer 15

Answer: C. Explanation: Additive QT prolongation increases the risk of serious arrhythmias.

Question 16

How should ciprofloxacin be taken with iron or zinc supplements? A. At the same time B. With food C. Two hours before supplements D. Only at bedtime

Answer 16

Answer: C. Explanation: Metal ions chelate quinolones and significantly reduce absorption.

Question 17

Why should dairy products be avoided around quinolone dosing? A. Increased toxicity B. Reduced clearance C. Reduced absorption D. Increased QT risk

Answer 17

Answer: C. Explanation: Calcium binds quinolones and reduces their bioavailability.

Question 18

Which statement about long-term quinolone adverse effects is correct? A. Effects always resolve quickly B. Effects only involve muscles C. Effects may last months or years D. Effects occur only in elderly patients

Answer 18

Answer: C. Explanation: Rare but persistent musculoskeletal and neurological adverse effects have been reported.