2015 Paper

Question 1

medication contraindicated in renal artery stenosis

Answer 1

ACEi

they affect dilation of arteries…

Question 2

How might macrolides interact with some antipyschoyics?

Answer 2

Macrolides inhibit CYP

Clarithromycin not recommended with quetiapine

Question 3

For significant results

p=

Answer 3

less than or equal to

0.05

Question 4

If diuretics are given twice a day what times are appropriate?

Answer 4

No later than 4pm

so 8am and 2pm is suitable for BD

Question 5

Pt counselling for mirtazepine

Answer 5

report signs of infection (fever, stomatitis, sore throat)

- risk of blood dyscrasia

Question 6

Indication for mesna

Answer 6

Reduce haemorragic cycstitis (s/e of anticancer agents)

Question 7

Medication causing haemorragic cycstitis?

Answer 7

Cyclophosphamaide

Question 8

Which Vitamin aids the absorption of calcium

Answer 8

D

Question 9

Can you crush finasteride?

Answer 9

Women of child baring potential should not handle crushed or broken tablets

Question 10

Anti obesity drugs are indicated when….

Answer 10

BMI over 30
In whom at least 3 months of of managed care involving supervised diet, exercise and behaviour modification fails to achieve realistic reduction in weight
OR
BMI over 28 and other risk factors (T2DM, hypertension, hypercholesterolaemia)

Question 11

Maximum treatment duration for orlistat

Answer 11

12 months

Question 12

Risk of beta blockers in diabetes ?

Answer 12

Loss of warning of hypoglycaemia

Question 13

Being dazzled by headlights is a side-effect of

Answer 13

Amiodarone

Question 14

GI bleed causes stools to look….

Answer 14

Tarry in consistency

Question 15

Causes of nausea due to medication etc that should be corrected and not treated with antiemetics

Answer 15

DKA

Digioxin and antiepileptic overdose

Question 16

Main adverse effects of antihistamines

Answer 16

Antimuscurinic side effects and drowsiness

Question 17

Mode of action of phenothiazine antiemetics (eg. …………)

Answer 17

Dopaminergic antagonists at chemoreceptors trigger zone

E.g. Prochloperazine and chlorpromazine

Question 18

Problematic sideeffect of phenothiazines

Answer 18

Systemic reactions especially in children

Question 19

Mode of action of metoclopramide

Answer 19

DA anatag acting on the GI

Question 20

What antiemetic can be used in Parkinsons diease?

What is contraindicated ?

Answer 20

Dimperidone – it doesn’t cross the BBB

NOT metoclopramide

Question 21

Mode of action of domperidone

Answer 21

Da anatag - at the chemo trigger zone. Less

Question 22

Metoclopramide use is cautioned due to …. Up to what age?

Answer 22

EPS

-19

Question 23

Granisetron and ondansetron act on what? When are they used (2)

Answer 23

5HT Antagonist

Post op and cytotoxic

Question 24

Dexamethasone is used to treat nausea due to

Answer 24

Chemotherapy

Question 25

Aprepitant action .... | is used to treat....

Answer 25

Neurokinin receptor antagonist | Nausea due to cisplatins

Question 26

What antiemetic can be used in pregnancy ?

Answer 26

None - but sometimes short term Promethazineo | Also supplementation with thiamine thiamine to prevent wernickes

Question 27

Risk factors for post op nausea and vom

Answer 27

Female Non smoker History of post op or motion sickness Opioids

Question 28

Three drug classes in BNF recommended for post op nausea and vom

Answer 28

5HT antagonists (ondansetron) Phenothiazines Antihistamines

Question 29

Most effective drug at preventing motion sickness

Answer 29

Hyoscine hydrobromide Promethazine is useful for sedative effect (Metoclopramide, domperidone, 5HT anatag and phenothiazines - except promethazine - are ineffective)

Question 30

Uses of beta histine

Answer 30

Vertigo, tinnitus, hearing loss associated with Ménière's disease

Question 31

Treatment for cradle cap

Answer 31

Olive or coconut oil or simple emollient

Question 32

counselling for bisphosphonates 3

Answer 32

Report thigh, hip or groin pain. Regular dental check ups. Swallow whole with a full glass of water 30 mins before breakfast and other oral meds. Remain upright for 30mins.

Question 33

How long until full effect of NSAIDs is achieved for Pain Inflammation

Answer 33

1 week for pain | 3 weeks for inflammation

Question 34

Less GI side effects when NSAIDs are selective for .....

Answer 34

Cox 2

Question 35

Anti-inflammatory effects of ibuprofen are weaker therefore it is not suitable for...

Answer 35

Conditions where inflammation is prominent such as gout

Question 36

First line NSAID is

Answer 36

Naproxen - lower incidence of side effects ( but more than ibuprofen)

Question 37

Can methotrexate be given with ibuprofen ?

Answer 37

No- interaction with NSAIDS. Reduced excretion of methotrexate.

Question 38

Can NSAIDs be given with Li

Answer 38

No. Interaction. Lithium excretion reduced by NSAIDs

Question 39

Can NSAIDs be given with SSRIs?

Answer 39

No - increased bleeding risk

Question 40

What anti diabetic drugs can't be used with NSAIDs

Answer 40

Sulfonyureas

Question 41

Medications that interact with trimethoprim 3

Answer 41

Phenytoin Methotrexate Some antimalarials

Question 42

Drug licensed for premature ejaculation and its mode of action

Answer 42

Dapoxetine - short acting SSRI.

Question 43

Two drugs that are excreted unchanged into the bile and therefore can accumulate in hepatic impairment

Answer 43

Rifampicin | Fusidic acid

Question 44

Hypo proteineamia in hepatic disease is associated with reduced protein binding which can cause toxicity with highly protein bound drugs such as (2)

Answer 44

Prednisolone and phenytoin

Question 45

Medication that percipitate hepatic encephalopathy

Answer 45

Sedative drugs Opioid analgesics Diuretics that cause hyperkalaemia Drugs that cause constipation X

Question 46

Oedema and ascities in hepatic disease can be exacerbated by drugs that cause fluid retention such as 2

Answer 46

NSAIDs and corticosteroids

Question 47

drug for urinary incontinance that is not antimuscurinic

Answer 47

merabegron

Question 48

drugs that are contraindicated with imidazoles (miconazole) include

Answer 48

statins | Imidazoles inhibit CYP

Question 49

can clobetasone butyrate or clobetasone propionate be bought over the counter?

Answer 49

clobetasone butyrate 0.05% (eumovate)

Question 50

maximum OTC dose of hydrocortisone cream

Answer 50

1%

Question 51

Guidance for OTC hydrocortisone preparations for haemorrhoids

Answer 51

Only for over 18s Can be used in pregnancy and breastfeeding No more than 7 days Not for new suffers who should be referred

Question 52

what is premarin for? how long should premarin be left on for? coucelling for this?

Answer 52

scabies | 8-12 hours. If hands are washed in this time it should be reapplied

Question 53

what is a once only application for athletes foot? | direction

Answer 53

``` Lamisil once (terbinifine 1%) Wash off 24 hours after application ```

Question 54

The initial and maximum dose of what statin depends on ethnicity

Answer 54

Rosuvastatin (start 5-10mg max 40mg) | Patients of asian origin (start at 5, max 20mg)