Expectorants: Potassium iodide MCQs With Answer

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Expectorants: Potassium iodide MCQs With Answer

This concise introduction is tailored for B. Pharm students studying expectorants, focusing on potassium iodide. It covers pharmacology, mechanism of action, clinical indications, dosing, formulations, adverse effects, contraindications, drug interactions, and monitoring. Emphasis is placed on expectorant versus mucolytic activity, iodine pharmacodynamics, thyroid considerations, pediatric and pregnancy use, and evidence-based therapeutic roles. These potassium iodide MCQs with answer aim to deepen your mechanistic understanding and clinical reasoning for pharmacy practice. Now let’s test your knowledge with 50 MCQs on this topic.

Q1. Which of the following best describes the primary expectorant action of potassium iodide?

  • Direct stimulation of alpha-adrenergic receptors in bronchial smooth muscle
  • Increasing hydration and secretion in bronchial mucous glands
  • Inhibition of mucin gene expression in goblet cells
  • Antagonism of histamine H1 receptors in the airway

Correct Answer: Increasing hydration and secretion in bronchial mucous glands

Q2. Potassium iodide is classified pharmacologically as which type of agent?

  • Beta-agonist bronchodilator
  • Mucolytic expectorant
  • Anticholinergic
  • Systemic decongestant

Correct Answer: Mucolytic expectorant

Q3. Which mechanism contributes to potassium iodide’s expectorant effect?

  • Destabilization of disulfide bonds in mucoproteins
  • Increased respiratory ciliary beat frequency
  • Reflex stimulation of gastric mucosa leading to vagal activation
  • Direct enzymatic cleavage of DNA in pus

Correct Answer: Reflex stimulation of gastric mucosa leading to vagal activation

Q4. The most important safety concern when using potassium iodide is monitoring which organ/system?

  • Renal cortex function
  • Thyroid gland function
  • Hepatic cytochrome enzymes
  • Cardiac conduction system

Correct Answer: Thyroid gland function

Q5. Which of the following is a common adverse effect of oral potassium iodide therapy?

  • Hyperglycemia
  • Gastrointestinal upset with metallic taste
  • Bradycardia
  • Insomnia

Correct Answer: Gastrointestinal upset with metallic taste

Q6. Potassium iodide is contraindicated in patients with which condition?

  • Hypothyroidism
  • Hyperthyroidism (thyrotoxicosis)
  • Diabetes mellitus type 2
  • Bronchial asthma

Correct Answer: Hyperthyroidism (thyrotoxicosis)

Q7. What is the typical adult oral dosing range for potassium iodide as an expectorant in acute use?

  • 0.1–0.5 mg daily
  • 10–15 g daily
  • 100–300 mg two to three times daily
  • 5–10 units intramuscularly

Correct Answer: 100–300 mg two to three times daily

Q8. In the context of mucolytic therapy, potassium iodide is most often used for which clinical situation?

  • Acute pulmonary embolism
  • Productive cough with thick mucus and bronchiectasis
  • Allergic rhinitis with sneezing
  • Nonproductive cough due to ACE inhibitors

Correct Answer: Productive cough with thick mucus and bronchiectasis

Q9. Which laboratory test should be checked prior to initiating prolonged potassium iodide therapy?

  • Serum amylase
  • Thyroid function tests (TSH, T4)
  • Arterial blood gases
  • Serum potassium

Correct Answer: Thyroid function tests (TSH, T4)

Q10. How does chronic high-dose iodine exposure from potassium iodide affect the thyroid in susceptible individuals?

  • Always causes hypothyroidism immediately
  • Can precipitate iodine-induced hyperthyroidism or hypothyroidism
  • No effect due to homeostatic regulation
  • Improves thyroid hormone synthesis permanently

Correct Answer: Can precipitate iodine-induced hyperthyroidism or hypothyroidism

Q11. Which formulation of potassium iodide is commonly used for expectorant therapy?

  • Suspension or solution for oral use
  • Inhaled aerosolized powder
  • Transdermal patch
  • Intravenous emulsion

Correct Answer: Suspension or solution for oral use

Q12. Potassium iodide can interact with which medication, requiring caution?

  • Metoprolol
  • Amiodarone
  • Vitamin C
  • Simvastatin

Correct Answer: Amiodarone

Q13. Which pediatric consideration is most important when prescribing potassium iodide?

  • Give double adult dose for efficacy
  • Avoid use in neonates due to risk of thyroid dysfunction
  • No monitoring is needed in children
  • Administer only by intramuscular route

Correct Answer: Avoid use in neonates due to risk of thyroid dysfunction

Q14. Which adverse dermatologic reaction is associated with iodide therapy?

  • Photosensitivity without rash
  • Acneiform eruptions or iododerma
  • Psoriasis improvement
  • Melanosis

Correct Answer: Acneiform eruptions or iododerma

Q15. The Wolff–Chaikoff effect describes which pharmacologic phenomenon related to iodide?

  • Long-term iodide increases thyroid hormone synthesis indefinitely
  • High iodide acutely inhibits organification of iodine in the thyroid reducing hormone synthesis
  • Iodide acts as a free radical scavenger in pulmonary tissue
  • Iodide induces rapid renal clearance of thyroid hormones

Correct Answer: High iodide acutely inhibits organification of iodine in the thyroid reducing hormone synthesis

Q16. Which symptom indicates severe iodide hypersensitivity requiring drug discontinuation?

  • Mild nausea that resolves
  • Diffuse urticaria and angioedema
  • Transient metallic taste
  • Dry mouth

Correct Answer: Diffuse urticaria and angioedema

Q17. In which infectious indication has potassium iodide historically been used off-label?

  • Bacterial endocarditis
  • Cutaneous sporotrichosis as adjunct therapy
  • Viral bronchitis prevention
  • Mycobacterial pulmonary disease first-line

Correct Answer: Cutaneous sporotrichosis as adjunct therapy

Q18. Which pharmacokinetic property characterizes iodide after oral administration?

  • Poor oral absorption with mainly fecal elimination
  • Rapid absorption and wide distribution including thyroid uptake
  • Extensive first-pass hepatic metabolism to organoiodine compounds
  • Binding to plasma proteins >99%

Correct Answer: Rapid absorption and wide distribution including thyroid uptake

Q19. Potassium iodide can be used as a protective agent in radiological exposure by which mechanism?

  • Increasing urinary excretion of radioactive cesium
  • Blocking radioactive iodine uptake by the thyroid through thyroidal saturation
  • Chelating radioactive plutonium systemically
  • Neutralizing alpha particles in the blood

Correct Answer: Blocking radioactive iodine uptake by the thyroid through thyroidal saturation

Q20. Which monitoring frequency is appropriate for a patient on long-term potassium iodide therapy?

  • No monitoring after baseline
  • Periodic thyroid function tests every 3–6 months
  • Daily serum iodide measurement
  • Monthly chest X-rays

Correct Answer: Periodic thyroid function tests every 3–6 months

Q21. Which adverse cardiovascular effect is most associated with iodide therapy in susceptible patients?

  • Severe bradyarrhythmias unrelated to thyroid status
  • Precipitation of atrial fibrillation secondary to thyrotoxicosis
  • Acute myocardial infarction due to vasospasm
  • Peripheral edema from sodium retention

Correct Answer: Precipitation of atrial fibrillation secondary to thyrotoxicosis

Q22. Which statement about potassium iodide’s effect on mucus is accurate?

  • It enzymatically degrades hyaluronic acid in mucus
  • It increases serous secretions and reduces mucus viscosity indirectly
  • It acts as a direct surfactant on mucus glycoproteins
  • It completely halts mucus production

Correct Answer: It increases serous secretions and reduces mucus viscosity indirectly

Q23. Which population requires dose adjustment or heightened caution with potassium iodide?

  • Young healthy adults with no comorbidities
  • Pregnant women and breastfeeding mothers
  • Patients with controlled hypertension only
  • Patients on topical antifungals

Correct Answer: Pregnant women and breastfeeding mothers

Q24. Which laboratory sign indicates iodide-induced hypothyroidism?

  • Low TSH and high T4
  • Elevated TSH with low free T4
  • Markedly elevated serum calcium
  • Low serum cortisol

Correct Answer: Elevated TSH with low free T4

Q25. What is the rationale for using potassium iodide in acute thyroid storm management?

  • To increase peripheral conversion of T4 to T3
  • To transiently inhibit thyroid hormone release via the Wolff–Chaikoff effect
  • To act as a long-term antithyroid maintenance drug
  • To chelate circulating thyroid hormones

Correct Answer: To transiently inhibit thyroid hormone release via the Wolff–Chaikoff effect

Q26. Which adverse effect is a sign of iodism from excess potassium iodide?

  • Rhinorrhea, salivation, and conjunctivitis
  • Hyperreflexia and muscle spasm
  • Petechial bleeding and thrombocytopenia
  • Elevated transaminases only

Correct Answer: Rhinorrhea, salivation, and conjunctivitis

Q27. In a patient with chronic bronchiectasis, potassium iodide is expected to provide what therapeutic benefit?

  • Reduce frequency of productive cough by thinning secretions
  • Eliminate bacterial colonization completely
  • Act as a primary bronchodilator
  • Suppress cough reflex centrally

Correct Answer: Reduce frequency of productive cough by thinning secretions

Q28. Which clinical sign in neonates would raise concern after maternal iodide exposure?

  • Hypothermia only
  • Neonatal hypothyroidism with prolonged jaundice and lethargy
  • Accelerated growth in first month
  • Increased neonatal reflexes

Correct Answer: Neonatal hypothyroidism with prolonged jaundice and lethargy

Q29. Which drug reduces the renal excretion of iodide, necessitating caution?

  • Loop diuretics like furosemide
  • Thiazide diuretics
  • Potassium-sparing diuretics
  • Nonsteroidal anti-inflammatory drugs

Correct Answer: Thiazide diuretics

Q30. Which is a correct counseling point when dispensing potassium iodide solution?

  • Shake well, and take with water after meals to reduce GI upset
  • Inject intramuscularly for best results
  • Use topical application for cough relief
  • Combine with thyroid hormone supplements routinely

Correct Answer: Shake well, and take with water after meals to reduce GI upset

Q31. Which imaging-related role can potassium iodide play in nuclear medicine emergencies?

  • Enhances uptake of radioactive iodine by tumor cells
  • Protects the thyroid from radioactive iodine uptake if given timely
  • Decontaminates external radiation burns
  • Neutralizes radiopharmaceuticals in the bloodstream

Correct Answer: Protects the thyroid from radioactive iodine uptake if given timely

Q32. Which is the correct mechanism by which potassium iodide aids expectoration compared to guaifenesin?

  • Potassium iodide acts via systemic vagal reflex while guaifenesin acts directly on bronchial secretions
  • Potassium iodide inhibits mucus synthesis; guaifenesin increases mucus production
  • Both act through the same receptor on goblet cells
  • Guaifenesin causes thyroid suppression

Correct Answer: Potassium iodide acts via systemic vagal reflex while guaifenesin acts directly on bronchial secretions

Q33. Which sign would suggest iodine-induced autoimmune thyroiditis?

  • Sudden hypoglycemia
  • New onset hypothyroidism with positive anti-thyroid antibodies
  • Resolution of goiter without treatment
  • Increased appetite and weight loss

Correct Answer: New onset hypothyroidism with positive anti-thyroid antibodies

Q34. During overdose of potassium iodide, what emergency management step is essential?

  • Immediate administration of intravenous calcium
  • Supportive care and monitoring of thyroid and renal function
  • Administer oral levothyroxine
  • Give activated charcoal for iodine binding

Correct Answer: Supportive care and monitoring of thyroid and renal function

Q35. Which statement about the taste and palatability of potassium iodide formulations is correct?

  • They are generally sweet and pleasant
  • They may have a metallic or salty taste causing poor compliance
  • They are completely tasteless
  • Taste can be ignored as it has no impact on therapy adherence

Correct Answer: They may have a metallic or salty taste causing poor compliance

Q36. Why is potassium iodide sometimes combined with potassium iodate in formulations?

  • To increase bronchodilatory action
  • To stabilize iodine content and improve shelf life
  • To reduce the risk of thyroid effects
  • To convert iodide into a mucolytic enzyme

Correct Answer: To stabilize iodine content and improve shelf life

Q37. Which statement about topical iodide use is true?

  • Topical iodide is routinely used for systemic expectorant effect
  • Topical iodide can be absorbed and cause systemic iodine effects if used extensively
  • Topical iodide has no chance of systemic absorption
  • Topical iodide increases mucus production locally in the skin

Correct Answer: Topical iodide can be absorbed and cause systemic iodine effects if used extensively

Q38. Which dietary consideration may affect iodide therapy?

  • High-salt diet has no effect on iodide kinetics
  • A diet rich in goitrogens like cassava may exacerbate thyroid dysfunction
  • Vitamin D supplements neutralize iodide
  • High-protein diets increase iodide excretion rapidly

Correct Answer: A diet rich in goitrogens like cassava may exacerbate thyroid dysfunction

Q39. Which is an appropriate counseling point regarding storage of potassium iodide solution?

  • Store in direct sunlight for potency
  • Keep in a tightly closed container protected from light
  • Freeze to extend shelf life
  • Store with strong oxidizers to maintain stability

Correct Answer: Keep in a tightly closed container protected from light

Q40. Which adverse hematologic effect is associated with iodide in rare cases?

  • Aplastic anemia
  • Transient leukocytosis only
  • Thrombocytopenia and neutropenia in hypersensitivity reactions
  • Polycythemia vera induction

Correct Answer: Thrombocytopenia and neutropenia in hypersensitivity reactions

Q41. In patients with renal impairment, potassium iodide dosing should be:

  • Unchanged because renal excretion is irrelevant
  • Used with caution and possibly reduced due to decreased iodide clearance
  • Increased to compensate for reduced lung distribution
  • Avoided completely in all stages of renal disease

Correct Answer: Used with caution and possibly reduced due to decreased iodide clearance

Q42. Which historical use of potassium iodide in pulmonary disease is well documented?

  • Primary therapy for tuberculosis
  • Adjunct for treating chronic bronchitis and abscesses to aid expectoration
  • Preventive therapy for lung cancer
  • Replacement therapy for surfactant deficiency

Correct Answer: Adjunct for treating chronic bronchitis and abscesses to aid expectoration

Q43. Which biochemical test could rise transiently after iodide administration without indicating intrinsic thyroid disease?

  • Serum creatinine kinase only
  • Serum thyroglobulin and temporary changes in thyroid hormones
  • Hemoglobin A1c
  • Serum troponin

Correct Answer: Serum thyroglobulin and temporary changes in thyroid hormones

Q44. Which is a recognized non-thyroidal therapeutic effect of iodide relevant to expectorant use?

  • Antiviral direct inactivation of respiratory viruses
  • Mild antisecretory action on mucous membranes increasing expectoration
  • Long-term suppression of cough center in the brain
  • Direct analgesic effect on chest pain

Correct Answer: Mild antisecretory action on mucous membranes increasing expectoration

Q45. Which finding on physical examination might indicate iodide-induced hypersensitivity?

  • Clear lungs with no wheeze
  • Fever with diffuse erythematous rash and swelling
  • Isolated hypertension without other signs
  • Improved sputum production

Correct Answer: Fever with diffuse erythematous rash and swelling

Q46. What is the major difference between potassium iodide and mucolytics like N-acetylcysteine?

  • Potassium iodide is a direct sulfhydryl donor, while N-acetylcysteine is not
  • Potassium iodide works primarily via systemic reflexes; N-acetylcysteine acts by breaking disulfide bonds in mucins
  • Both have identical mechanisms and side effect profiles
  • N-acetylcysteine increases thyroid uptake of iodine

Correct Answer: Potassium iodide works primarily via systemic reflexes; N-acetylcysteine acts by breaking disulfide bonds in mucins

Q47. Which pharmacovigilance report would be most relevant to monitor for potassium iodide safety?

  • Reports of hypoglycemia episodes
  • Reports of thyroid dysfunction, iodism, and severe hypersensitivity
  • Reports of hearing loss exclusively
  • Reports of improved athletic performance

Correct Answer: Reports of thyroid dysfunction, iodism, and severe hypersensitivity

Q48. In formulation development, taste-masking of potassium iodide is important because:

  • Its unpleasant taste may reduce adherence, especially in pediatric patients
  • Taste has no relationship to patient adherence
  • Masking taste increases thyroid uptake
  • Taste-masking prevents all adverse reactions

Correct Answer: Its unpleasant taste may reduce adherence, especially in pediatric patients

Q49. Which regulatory or public health use of potassium iodide is commonly recommended after certain nuclear incidents?

  • Population-wide administration to block radioactive iodine uptake by the thyroid
  • Monthly supplementation to prevent lung infections
  • Topical application to the skin of responders
  • Food additive to neutralize radioactivity in produce

Correct Answer: Population-wide administration to block radioactive iodine uptake by the thyroid

Q50. For exam preparation, which study tip is most useful when learning potassium iodide pharmacology for B. Pharm exams?

  • Memorize doses without understanding mechanism
  • Integrate mechanism, clinical uses, adverse effects, and monitoring into clinical scenarios and practice MCQs
  • Only study thyroid physiology and ignore pulmonary aspects
  • Rely solely on vague lecture notes without active recall

Correct Answer: Integrate mechanism, clinical uses, adverse effects, and monitoring into clinical scenarios and practice MCQs

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