Injuries

Which of the following is NOT a risk factor for mild to moderate analgesia?

• Chronic alcohol consumption

• Malnutrition

• Regular exercise

• Severe liver disease

Answer explanation

Regular exercise is generally associated with health benefits and does not contribute to risks for mild to moderate analgesia, unlike chronic alcohol consumption, malnutrition, and severe liver disease.

Fill in the blank: One of the risk factors for mild to moderate analgesia is ________.

• BMI/body weight < 50

• Age > 65 years

• History of hypertension

• Non-smoker status

Answer explanation

BMI/body weight < 50 is a recognized risk factor for mild to moderate analgesia, as lower body weight can affect drug metabolism and efficacy, making this choice the correct answer.

For children under 16 years, what is the first line of treatment for mild to moderate pain management?

• Paracetamol or ibuprofen only

• Aspirin only

• Morphine syrup

• Codeine tablets

Answer explanation

For children under 16 years, the first line of treatment for mild to moderate pain is paracetamol or ibuprofen. Aspirin is not recommended due to the risk of Reye's syndrome, and morphine and codeine are not first-line options.

Combination drugs should be avoided in the treatment plan for children under 16 years with mild to moderate pain.

• True

• False

Answer explanation

True. Combination drugs can increase the risk of side effects and complications in children under 16, making them unsuitable for treating mild to moderate pain.

For patients over 16 years, what is the second line of treatment if paracetamol is not sufficient?

• Add/switch to ibuprofen or codeine

• Increase paracetamol dose

• Use aspirin

• Use only ibuprofen

Answer explanation

If paracetamol is insufficient for pain relief in patients over 16, the second line of treatment is to add or switch to ibuprofen or codeine, as these options can provide better pain control.

Which medication is safe in pregnancy and breastfeeding?

• Paracetamol

• Ibuprofen

• Aspirin

• Warfarin

Answer explanation

Paracetamol is considered safe for use during pregnancy and breastfeeding, as it has a long history of safety. In contrast, ibuprofen, aspirin, and warfarin are not recommended due to potential risks to the mother and baby.

Which form of paracetamol should be avoided in patients with hypertension, heart failure, and renal failure?

• Effervescent form

• Tablet form

• Syrup form

• Suppository form

Answer explanation

The effervescent form of paracetamol contains sodium, which can exacerbate hypertension and fluid retention in heart failure and renal failure patients. Therefore, it should be avoided in these conditions.

Name one rare effect of paracetamol.

• Thrombocytopenia, allergic cystitis, or arrhythmias (any one is correct)

• Hypertension

• Hyperglycemia

• Increased appetite

Answer explanation

Thrombocytopenia, allergic cystitis, and arrhythmias are rare effects of paracetamol, making them correct choices. In contrast, hypertension, hyperglycemia, and increased appetite are not associated with paracetamol.

Paracetamol overdose manifestations in the first 24 hours include: nausea, vomiting, pallor, and ________.

• abdominal pain

• rash

• blurred vision

• joint swelling

Answer explanation

In the first 24 hours of paracetamol overdose, abdominal pain is a common manifestation alongside nausea, vomiting, and pallor. This symptom indicates liver distress, which is critical to recognize for timely intervention.

Paracetamol overdose manifestations in 24-48 hours include:

• hepatic dysfunction, hepatic pain

• renal failure, hematuria

• respiratory depression, cyanosis

• pancreatitis, hypoglycemia

Answer explanation

Paracetamol overdose typically leads to hepatic dysfunction and hepatic pain within 24-48 hours due to liver damage. Other options like renal failure or respiratory issues are not characteristic of this specific timeframe.