Chemotherapy: fingolimod first-dose observation: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Chemotherapy: fingolimod first-dose observation

Sample item

A patient starting fingolimod for multiple sclerosis is monitored for six hours after the first dose. What is being watched for?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Bradycardia and AV block

Fingolimod is a sphingosine-1-phosphate receptor modulator that traps lymphocytes in lymph nodes. Its action on S1P receptors in atrial myocytes causes a transient fall in heart rate and sometimes AV block after the first dose. Macular oedema and infections are other cautions.

Option by option

  • A. Anaphylaxis

    Anaphylaxis is not the characteristic first-dose problem with fingolimod.

  • B. Hepatic failure

    Liver enzyme rise is monitored over months and is not a first-dose concern.

  • C. Hypertensive crisis

    Fingolimod can slightly raise blood pressure over time, but not as a first-dose crisis.

  • D. Bradycardia and AV block (correct)

    Correct. First-dose bradycardia and AV block are the reason for observation.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is D, Bradycardia and AV block. Fingolimod is a sphingosine-1-phosphate receptor modulator that traps lymphocytes in lymph nodes.

Why is "Anaphylaxis" not the answer?

Anaphylaxis is not the characteristic first-dose problem with fingolimod.

Why is "Hepatic failure" not the answer?

Liver enzyme rise is monitored over months and is not a first-dose concern.

Why is "Hypertensive crisis" not the answer?

Fingolimod can slightly raise blood pressure over time, but not as a first-dose crisis.

What concept does this question test?

It tests Chemotherapy: fingolimod first-dose observation in Pharmacology. Its action on S1P receptors in atrial myocytes causes a transient fall in heart rate and sometimes AV block after the first dose. Macular oedema and infections are other cautions.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Chemotherapy: fingolimod first-dose observation?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.