cardiology

Question 1

Mr 66 year old lady takes the below medication:

Simvastatin 40mg tablets

She has been newly prescribed amlodipine 10mg tablets. You contact her doctor due to an interaction. What is the likely consequence of this drug interaction?

Answer 1

Risk of muscle related side effects
maximum dose of simvastatin is 20mg when used with Amlodipine
Amlodipine slightly increases the exposure of simvastatin and therefore can increase the risk of myopathy and rhabdomyolysis

Question 2

A 54 year old man take the following medication:

Citalopram 20mg tablets

He has been prescribed rivaroxaban 15mg tablets. What is the likely consequence of drug interaction?

Answer 2

risk of bleeding
increased risk due to both of the medications effects on platelets

Question 3

Mrs Riley, a 65 year old, takes amiodarone tablets. She has been newly prescribed simvastatin 40mg tablets. You contact her doctor because of a drug interaction. What is the likely consequence of this drug interaction?

Answer 3

Risk of muscle related side effects
Maximum dose of simvastatin is 20mg when used with amiodarone. The risk of rhabdomyolysis is increased by concomitnt use of amiodarone

Question 4

A 35 year old pregnant lady has gestational hypertension. Her blood pressure is 148/96mmHg. She is not on any other medication and has no other medical conditions. Which one of the above antihypertensive drugs would be appropriate to prescribe?

Answer 4

Labetalol tablets

Question 5

Which one of the above antihypertensives would you recommend for a 53 year old Afro-Caribbean man who has been diagnosed with hypertension. He is not on any other medication and has no other medical conditions.

Answer 5

amlodipine tabs
CCB first line for non diabetic patients 55+, all ages of black african

Question 6

Mrs Lister, a 45 year old Caucasian lady, has been newly diagnosed with hypertension. She is not on any other medication and has no other medical conditions. Which one of the above would be the most appropriate to prescribe?

Answer 6

Ramipril

Question 7

Mrs Patel, a 45 year old, has hypertension which she takes medication for. She has a dry cough and her doctor suspects it is due to her antihypertensive medication. Which one of the above is most likely to cause a dry cough?

Answer 7

Ramipril tablets

Question 8

Mr Thomas, a 47 year old, has been newly prescribed simvastatin 20mg tablets . You counsel him on how and when to take the medication. In addition you advise him to avoid which one of the above?

Answer 8

Grapefruit juice

Question 9

A 62 year old takes warfarin tablets. You remind him to avoid which one of the above with his medication?

Answer 9

Cranberrry Juice

Question 10

Ms Lewis, a 56 year old, has been newly prescribed amlodipine 5mg tablets for hypertension. You counsel her on the medication and advise her to avoid which one of the above?

Answer 10

Grapefruit Juice

Question 11

A 66 year old has been prescribed rivaroxaban 15mg tablets for DVT prophylaxis. He has difficulty swallowing tablets and you recommend they can be crushed and mixed with which one of the above?

Answer 11

apple puree

Question 12

Mr Lam, a 60 year old, has been prescribed ticagrelor 90mg tablets. He takes simvastatin tablets regularly. What dose of simvastatin should he not exceed?

Answer 12

Simvastatin 40mg

Question 13

Mrs Law, a 57 year old, takes amlodipine 5mg tablets. She has been newly prescribed simvastatin tablets. What is the maximum dose of simvastatin that can be prescribed for her?

Answer 13

Simvastatin 20mg

Question 14

Mr Thomas, a 42 year old, has been newly prescribed perindopril for hypertension? Select one cautionary/advisory label from the above list that would appear on the dispensing label for this drug.

Answer 14

Take 30 to 60 minutes before food

Question 15

Mrs Popat has been prescribed rivaroxaban 20mg tablets for deep vein thrombosis (DVT). Select one cautionary/advisory label from the above list that would appear on the dispensing label for each of the below drugs

Answer 15

Take with or just after food, or a meal

Question 16

Mrs Adams, a 66 year old, takes amiodarone 100mg tablets for arrhythmia. Select one cautionary/advisory label from the list that would appear on the dispensing label for each of the below drugs.

Answer 16

Protect your skin from sunlight—even on a bright but cloudy day. Do not use sunbeds

Question 17

A 48 year old man has been prescribed a lipid lowering drug that works by binding to bile acids. Which one of the above has he most likely been prescribed?

Answer 17

cholestyramine

Question 18

Mr Khan, a 55 year old, has been prescribed a lipid lowering drug that works by inhibiting the intestinal absorption of cholesterol. Which one of the above has he most likely been prescribed?

Answer 18

Ezetimibe

Question 19

Mr Thomas, a 48 year old, has been started on a lipid lowering drug. Which one of the above belongs to a class of drugs that are used as first line treatment for hypercholesterolaemia?

Answer 19

Simvastatin

Question 20

Mrs Patel a 56 year old has hypercholesterolaemia but has failed to respond to statins and other oral lipid regulating drugs. Her doctor has suggested she tries a lipid modifying drug that is only available as a subcutaneous injection. Which one of the above has she most likely been prescribed?

Answer 20

Evolocumab

Question 21

Mr Thomas, a 66 year old doctor, has recently stopped her oral antiarrhythmic drug. You advise her that she should continue to protect her skin from sunlight even on a cloudy day for several months after stopping this drug. Which antiarrhythmic drug was she most likely taking?

Answer 21

Amiodarone

Question 22

Mrs Rowe, a 58 year old, has very occasional ectopic beats which she has seen the doctor about. Her doctor told her she doesn’t need any medication but if they become troublesome that he may consider treatment. Which one of the above can be used for ectopic beats?

Answer 22

Propranolol
ectopic beats do not usually require treatment unless severe or troublesome. beta blockers can be used

Question 23

Mrs Azad, a 29 year old, has gestational hypertension. She has been prescribed labetalol and should achieve a BP of less than which one of the above readings?

Answer 23

135/85mmHg

Question 24

Mrs Greer, a 45 year old, has had her BP checked at the pharmacy. She is not on any medication and has no medical conditions. Her reading would diagnose her with severe hypertension. Which one of the above readings would be considered severe?

Answer 24

180/120mmHg

Question 25

An 82 year old man comes to the pharmacy for a BP check. He has hypertension but no other medical conditions. His target clinical BP should be below which one of the above readings?

Answer 25

150/90mmHg

Question 26

Miss Lane, a 60 year old lady, comes to the pharmacy for a BP check. She has hypertension but no other medical conditions. Her target clinical BP should be below which one of the above readings?

Answer 26

140/90mmHg

Question 27

Mr Lucas, a 53 year old, comes to the pharmacy for a BP check. He has chronic kidney disease and diabetes. His blood pressure should be below which of the above readings?

Answer 27

130/80mmHg

in patients with ckd target clinic bp should be below 140/90 mmHg
with ckd AND diabetes its below 130/80