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FCPS Part 1 Pharmacology MCQs
Pharmacology questions test mechanisms, pharmacokinetics, characteristic adverse effects and interactions: autonomic drugs, anaesthetic agents, antimicrobials, anticoagulants, antiepileptics and the drugs whose side effects are classic exam clues.
Below are 5 free single-best-answer questions drawn from the most frequently examined pharmacology concepts, each with the answer and a rationale for every option. The full bank has 469 pharmacology concepts, each asked several different ways.
Free pharmacology questions
Question 1
Gum hypertrophy in a patient on long-term antiepileptic therapy points to:
- A. Gabapentin
- B. Levetiracetam
- C. Sodium valproate
- D. Phenytoin
- E. Carbamazepine
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Answer: D. Phenytoin
Phenytoin blocks sodium channels, and its metabolism saturates within the therapeutic range, so small dose rises give large level rises. Chronic use causes gingival hyperplasia, hirsutism and folate deficiency.
Why not the others: Carbamazepine: hyponatraemia, Stevens-Johnson syndrome. Sodium valproate: tremor, alopecia, hepatotoxicity. Levetiracetam: mood and behaviour changes. Gabapentin: sedation, not enzyme inducing.
High-yield: Phenytoin: gums, hair, folate, bones, cerebellum, zero-order kinetics.
Question 2
How ipratropium dilates airways:
- A. Leukotriene receptor antagonist
- B. β2 agonist
- C. Muscarinic antagonist
- D. Corticosteroid
- E. Phosphodiesterase inhibitor
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Answer: C. Muscarinic antagonist
Ipratropium is a non-selective muscarinic antagonist; blocking airway smooth-muscle M3 receptors cuts vagal bronchoconstriction and mucus secretion. Being quaternary, it is poorly absorbed and does not cross the blood–brain barrier.
Why not the others: β2 agonism: salbutamol. PDE inhibition: theophylline. Leukotriene blockade: montelukast. Mast cell stabilisation: cromoglicate.
High-yield: Ipratropium short-acting, tiotropium long-acting; both antimuscarinic.
Question 3
First-line single-dose drug for intestinal Ascaris lumbricoides infection:
- A. Doxycycline
- B. Metronidazole
- C. Ivermectin
- D. Albendazole
- E. Praziquantel
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Answer: D. Albendazole
Albendazole is a benzimidazole that binds helminth tubulin and blocks microtubule polymerisation, immobilising and starving the worm. It is first-line for Ascaris.
Why not the others: Ivermectin: strongyloides, filariasis. Praziquantel: flukes and tapeworms. Metronidazole: protozoa, anaerobes. Doxycycline: bacteria. Niclosamide: tapeworms.
High-yield: Albendazole: roundworm, hookworm, whipworm; avoid in pregnancy.
Question 4
Fluoroquinolone avoided in growing children because of arthropathy and cartilage damage:
- A. Vancomycin
- B. Azithromycin
- C. Gentamicin
- D. Amoxicillin
- E. Ciprofloxacin
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Answer: E. Ciprofloxacin
Ciprofloxacin, a fluoroquinolone, inhibits DNA gyrase and topoisomerase IV. Quinolones damage immature cartilage and tendons, and ciprofloxacin covers Streptococcus pneumoniae poorly.
Why not the others: Azithromycin: macrolide that covers atypicals and pneumococcus. Gentamicin: ototoxic and nephrotoxic aminoglycoside. Vancomycin: red man syndrome. Amoxicillin: first-line oral pneumococcal cover.
High-yield: Ciprofloxacin: children, tendons, QT, C. difficile; not for pneumococcal pneumonia.
Question 5
First-line drug for Raynaud phenomenon, including in systemic sclerosis:
- A. Nifedipine
- B. Propranolol
- C. Losartan
- D. Enalapril
- E. Atenolol
Show answer
Answer: A. Nifedipine
Nifedipine blocks L-type Ca²⁺ channels in vascular and uterine smooth muscle, causing vasodilation and relaxation. It has little direct cardiac effect.
Why not the others: Enalapril: fetotoxic in pregnancy. Losartan: fetotoxic. Atenolol: fetal growth restriction. Propranolol: worsens Raynaud. Hydrochlorothiazide: not a tocolytic. Spironolactone: antiandrogenic.
High-yield: Nifedipine: Raynaud, tocolysis; headache, flushing, ankle oedema.
Keep going with pharmacology
Anaesgen brings every concept back on a spaced-repetition schedule timed to your exam date, as a different question each time, with full mock papers for Paper 1 and 2.
Get full access Try the 5 sample questionsHigh-yield pharmacology one-liners
The most-tested pharmacology concepts, as a clue and the answer it points to:
- Gingival hyperplasia, zero-order kinetics, fetal hydantoin syndrome → phenytoin.
- Ipratropium / tiotropium → muscarinic antagonist.
- Ascaris, hookworm, whipworm, benzimidazole tubulin inhibitor → albendazole.
- Cartilage in children, tendon rupture, poor pneumococcal cover → ciprofloxacin.
- Raynaud, tocolysis, pregnancy hypertension (second line) → nifedipine.
- Local ulcer barrier, acid-activated, minimal absorption → sucralfate.
- -floxacin → DNA gyrase (topo II) + topo IV.
- Allopurinol, febuxostat → xanthine oxidase.
- ABVD, BEP, pulmonary fibrosis, little marrow suppression, oxygen toxicity → bleomycin.
- Methotrexate, trimethoprim, folinic rescue → dihydrofolate reductase.
- Atropine, glycopyrronium, oxybutynin, antimuscarinic → dry mouth.
- Dry cough, diabetic proteinuria, prodrug ACE inhibitor → enalapril.
- Leptin, insulin, JAK-STAT, cytokine receptor → enzyme-linked receptor.
- Elderly, new antidepressant, hyponatraemia (SIADH), S-enantiomer of citalopram → escitalopram.
- Benzodiazepines, barbiturates, brain inhibition, striatopallidal → GABA.
- Ulcer-safe analgesia, glutathione depletion, no antiplatelet effect → paracetamol.
- Organophosphate, miosis, fasciculations, cholinesterase reactivation → pralidoxime.
- Gentamicin, amikacin, tetracycline → 30S ribosomal subunit.
- -osin, first-dose syncope, BPH + hypertension, postural hypotension → alpha-1 blocker.
- Meningitis, septic arthritis, once daily, calcium precipitate → ceftriaxone.
Other FCPS Part 1 subjects
AnatomyPathologyBiochemistry & GeneticsCardiovascularNeurophysiologyMicrobiologyHaematologyGeneral PhysiologyImmunologyEndocrineRespiratoryEmbryologyObstetrics & GynaeRenal & Acid-BaseHistologyGI & LiverPhysicsBiostatistics
New to the exam? Read the FCPS Part 1 exam guide: dates, format and a 12-week study plan.