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Wrong Exam Questions > Boots Part 1 > Flashcards

Boots Part 1 Flashcards

1
Q

A 34-year-old male has recently been prescribed citalopram for depression. He also has epilepsy but had been seizure free for several years until last week.

Which of the following is most likely to have caused the seizure?
a) Hypercalcaemia
b) Hyperkalaemia
c) Hypoglycaemia
d) Hypomagnesaemia
e) Hyponatraemia

A

e) Hyponatraemia

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2
Q

Which electrolyte imbalance do antidepressants, specifically SSRs cause?

A

Hyponatraemia

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3
Q

A 70-year-old patient is being treated for moderate heart failure associated with a reduced left ventricular ejection fraction.
Their current medication is:
* Ramipril 5mg once daily
* Bisoprolol fumarate 10mg once daily

The patient has tolerated the medication but continues to remain symptomatic and the consultant wishes to prescribe an additional drug to relieve symptoms.
Which of the following is the most appropriate medication to be added to the patient’s treatment?

a) amiloride hydrochloride 10mg daily
b) bendroflumethiazide 2.5mg daily
c) candesartan cilexetil 4mg once daily
d) furosemide 40 mg daily
e) spironolactone 25mg once daily

A

e) spironolactone 25mg once daily

(potassium sparing is add on therapy for heart failure)

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4
Q

Which NSAIDs have HIGH risks of GASTROINTESTINAL side effects

A
  • Piroxicam
  • Ketoprofen
  • Ketorolac
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5
Q

Which NSAIDs have LOW risks of GASTROINTESTINAL side effects

A
  • Ibuprofen
  • COX2 Inhibitors (Celecoxib, Etoricoxib)
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6
Q

Which NSAIDs have HIGH risks of CARDIOVASCULAR side effects

A
  • COX2 Inhibitors (Celecoxib, Etoricoxib)
  • High dose ibuprofen (2.4g)
  • Diclofenac
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7
Q

Which NSAIDs have LOW risks of CARDIOVASCULAR side effects

A
  • Naproxen
  • Low dose Ibuprofen (1.2)
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8
Q

3 Big NSAID interactions

A
  • Methotrexate
  • Lithium
  • Ciprofloxacin (quinolones)
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9
Q

A 54-year-old male has been taking the following medication for the past four years:

  • Amlodipine 10 mg tablets – Take one daily
  • Cetirizine 10 mg tablets – Take one daily when required
  • Indapamide 2.5 mg tablets – Take one daily
  • Ramipril 10 mg capsules – Take one daily
  • Paracetamol 500 mg tablets – Take two tablets four times a day when required

The patient rings the pharmacy and tells you that they have been suffering with diarrhoea and vomiting that started this morning.
Which one of these medicines would you recommend that they stop for 1 - 2 days until they recover?

a) Amlodipine
b) Cetirizine
c) Indapamide
d) Ramipril
e) Paracetamol

A

Ramipril (ACE inhibitor)

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10
Q

At which serum levels does lithium toxicity occur?

A

1.5mol/L

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11
Q

What are the signs of Lithium toxicity?

A
  • Diarrhoea
  • Anorexia
  • Muscle weakness
  • blurred vision
  • tinnitus
  • N+V
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12
Q

Which Diuretics interact with Lithium to increase its concentration

A
  • Thiazide
  • Loop
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13
Q

Within what time frame must treatment with alteplase following an acute ischaemic stroke be given?

a) 6 hours
b) 12 hours
c) 3.5 hours
d) 4.5 hours
e) 6-12 hours

A

4.5 hours

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14
Q

A 66-year-old man has been discharged with a diuretic for oedema in renal disease.
Which of the following thiazide or thiazide related diuretics are appropriate for a patient with an eGFR 27 mL/minute/1.73m2?

a) Bendroflumethiazide
b) Chlortalidone
c) Indapamide
d) Metolazone
e) Xipamide

A

Metolazone (most thiazide and thiazide like diuretics are not recommended in eGFR under 30)

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15
Q

What thyroid hormone imbalances occur in HYPERTHYROIDISM

A

TSH: Low
T4: High
T3: High
FT4: High

  • excess production of thyroid hormones (T4 and T3)
  • suppression of TSH by the pituitary gland due to negative feedback.
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16
Q

What thyroid hormone imbalances occur in HYPOTHYROIDISM

A

TSH: High
T4: Low
T3: Low or normal (in some cases, T3 is preserved longer)
FT4: Low

  • thyroid gland produces insufficient thyroid hormones (T4 and T3).
  • the pituitary gland increases TSH production to stimulate the thyroid.
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17
Q

Stye symptoms

A

Localised red swelling on upper right eyelid

18
Q

Stye treatment (OTC)

A
  • warm compress up to 4 times a day
  • Chloramphenicol eye gel (max for 5 days)
19
Q

A patient brings in a prescription for some antibiotics. Upon handout, she explains that she enjoys drinking a glass of wine with her evening meal and asks whether this would be okay.
Which one of the following antibiotics is least suitable to take when drinking alcohol?

a) Amoxicillin
b) Clarithromycin
c) Co-amoxiclav
d) Metronidazole
e) Nitrofurantoin

A

d) Metronidazole

20
Q

A 24-year-old woman comes into your pharmacy asking for advice about her sore throat. Upon questioning you find out that she is taking fluoxetine and methotrexate. She tells you that it started yesterday. She has taken paracetamol, but it hasn’t helped.
What is the most appropriate advice you would you give her?

a) Recommend benzocaine lozenges
b) Recommend benzydamine spray
c) Recommend ibuprofen
d) Refer to GP as a non-urgent appointment
e) Refer to GP for same day appointment

A

Refer to GP for same day appointment

(because methotrexate can cause immunosuppression, therefore sore throat can develop into something worse)

21
Q

A 45-year-old woman has been prescribed an antidepressant. She is concerned about weight gain.
Which of the following is most likely to cause weight gain?

a) Amitriptyline
b) Escitalopram
c) Lofepramine
d) Mirtazapine
e) Venlafaxine

A

Mirtazapine (highest chance of weight gain)

22
Q

Common signs of sepsis

A
  • Confusion
  • Fever
  • High heart rate
  • Shortness of breath
23
Q

A 21-year-old woman with type 1 diabetes visits your pharmacy for some advice. She is driving to see some relatives tomorrow but is worried about her glucose levels on the long 6-hour drive.
Which is the most appropriate advice for this patient?

a) Adjust her insulin dose before setting off on the journey
b) Ensure her blood glucose concentration is below 8 mmol/L before driving
c) Ensure she has a supply of long-acting carbohydrate in the vehicle
d) Ensure she maintains her glucose levels at 5 mmol or more during the journey
e) Ensure she tests her glucose less than 3 hours before driving

A

d) Ensure she maintains her glucose levels at 5 mmol or more during the journey

24
Q

What are common side effects of Montelukast for children (and what to do if they occur)

A
  • sleep disturbances
  • mood changes

(speak to GP as soon as possible)

25
Q

What colour can nitrofurantoin turn urine and what to do?

A

Yellow/Brown
No need to do anything, it is harmless

26
Q

Symptoms of Anaphylaxis that you should call 999

A
  • your lips, mouth, throat or tongue swollen
  • fast breathing
  • struggling to breathe
  • throat feels tight
  • your skin, tongue or lips turn blue, grey or pale
  • confused, drowsy or dizzy
  • fainting and cannot be woken up
  • limp
27
Q

Which EHC is contraindicated in severe asthma controlled by glucorticosteroids?

A

Ulipristal Acetate (EllaONE)
(5 days protection)

28
Q

What are both EMC and when are they effective

A
  • Uliprital Acetate (EllaONE)
    (5 days)
  • Levonorgestrel
    (3 days)
29
Q

One of your regular patients has been diagnosed with gastro oesophageal reflux disorder (GORD). She has been prescribed Omeprazole 20mg capsules and would like to know if it is safe to take this with her other medication.

Which of her current medication has a significant interaction with omeprazole?
a) Atenolol
b) Metformin
c) Methotrexate
d) Ramipril
e) Simvastatin

A

Methotrexate

30
Q

What is the interaction between methotrexate and PPIs

A

increases methotrexate serum concentration by reducing its elimination via kidney

31
Q

Which of the following is an example of a long-acting insulin?
a) Insulin aspart
b) Insulin glargine
c) Insulin glulisine
d) Insulin isophane
e) Insulin lispro

A

Insulin Glargine

32
Q

Digoxin toxicity signs

A
  • Dizziness
  • Tachycardia
  • Vomiting
  • Yellow vision/ blurred vision
33
Q

After initiating Clozapine, what is the most appropriate time frame to monitor blood counts and what to monitor?

a) Every 3 months
b) Every 6 weeks
c) Fortnightly for the first year
d) Monthly for the first year
e) Weekly for the first 18 weeks

A

e) Weekly for the first 18 weeks
(neutrophil an leucocyte)

34
Q

What two common drug classes cause build up of fluid

A
  • ACE Inhibitors
    (angioedema= build up of fluid in skin tissue)
  • CCBs
    (peripheral oedema= build up of fluid in ankles and legs)
35
Q

What electrolyte imbalance is Ramipril know for?

A

Hyperkalaemia

36
Q

A 67-year-old man has been recently diagnosed with mild Parkinson’s disease dementia.
Which of the following is most likely to be prescribed?
a) Co-beneldopa
b) Co–careldopa
c) Pergolide
d) Rivastigmine
e) Ropinirole

A

d) Rivastigmine

37
Q

What colour sputum could indicate congestive heart failure?
a) Clear
b) Green
c) Pink
d) Red
e) Yellow

A

c) Pink

38
Q

Which one of the following antipsychotics is licenced to manage non-cognitive symptoms of dementia?
a) Aripiprazole
b) Clozapine
c) Haloperidol
d) Olanzapine
e) Quetiapine

A

c) Haloperidol

39
Q

A 37-year-old woman with gestational diabetes who is currently on metformin is not meeting her blood glucose target.
What is the most appropriate next step in her treatment?
a) Add gliclazide
b) Add insulin lispro (Humalog Mix)
c) Add isophane insulin
d) Add soluble human insulin
e) Replace with Liraglutide

A

Insulin Lispro

40
Q

Secondary prevention (after cardiac incident) for lowering cholesterol

A

Atorvastatin 80mg (max strength statin)

Wrong Exam Questions (25 decks)

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