Repeated USMLE Questions Step 1 Review- 144- Pharmacology

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Q- A patient taking haloperidol develops muscle rigidity, high fever, and confusion. What is the best initial management step?

A- Administer dantrolene

B- Give epinephrine

C- Start propranolol

D- Stop the antipsychotic

D- Stop the antipsychotic- Neuroleptic malignant syndrome (NMS) is a medical emergency. The first step is to stop the offending drug, followed by supportive care and possibly dantrolene or bromocriptine
.

 

Q- A 25-year-old man presents with tremors, tachycardia, and anxiety after taking an excessive amount of caffeine. Which of the following drugs has a similar mechanism of action to caffeine?

A- Chlorpromazine

B- Diazepam

C- Metoprolol

D- Theophylline

D- Theophylline- Theophylline, like caffeine, inhibits phosphodiesterase → increases cAMP → bronchodilation. It also antagonizes adenosine receptors.

 

Q- A 26-year-old man presents with muscle pain and dark urine after starting simvastatin. Which enzyme system metabolizes this drug?

A- CYP1A2

B- CYP2C9

C- CYP2D6

D- CYP3A4

D- CYP3A4- Most statins (like simvastatin) are metabolized by CYP3A4; inhibitors (e.g., macrolides, azoles) increase toxicity risk, such as myopathy and rhabdomyolysis.

 

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