Em extending + rps23e

Question 1

A 34-year-old woman with bipolar disorder is prescribed tramadol for pain. Her current
medication includes lithium.

o Risk of bleeding
o Risk of QT prolongation
o Risk of serotonin syndrome
o Reduced seizure threshold
o Risk of nephrotoxicty
o Risk of myopathy
o Risk of hypotension
o Risk of hypertension

Answer 1

Tramadol interacts with lithium (increased risk of serotonin syndrome)

Question 2

A 56-year-old man is started on simvastatin 40mg ON. His current medication includes
amlodipine, aspirin and levothyroxine.
o Risk of bleeding
o Risk of QT prolongation
o Risk of serotonin syndrome
o Reduced seizure threshold
o Risk of nephrotoxicty
o Risk of myopathy
o Risk of hypotension
o Risk of hypertension

Answer 2

Amlodipine interacts with simvastatin (amlodipine causesanincrease in exposure of simvastatin, increasing the risk of myopathy). The maximum recommended dose of simvastatin is 20mg ON when used with amlodipine

Question 3

A 62-year-old woman has a flare up of osteoarthritis, and she is prescribed naproxen
with lansoprazole. She takes ramipril and indapamide for hypertension. Her recent clinic BP
reading was 125/79. She has no other medical conditions.

o Risk of bleeding
o Risk of QT prolongation
o Risk of serotonin syndrome
o Reduced seizure threshold
o Risk of nephrotoxicty
o Risk of myopathy
o Risk of hypotension
o Risk of hypertension

Answer 3

The patient is prescribed an NSAID, ACEinhibitor and diuretic; this combination of medications increases the risk of AKI, so we are most concerned about the risk of nephrotoxicity.Note that she has a PPI (lansoprazole) as gastroprotection on the NSAID (reducing the risk of GI bleed).Her blood pressure is within target

Question 4

94. A 70-year-old man is prescribed sertraline. His current medication includes apixaban and
    amlodipine.

o Risk of bleeding
o Risk of QT prolongation
o Risk of serotonin syndrome
o Reduced seizure threshold
o Risk of nephrotoxicty
o Risk of myopathy
o Risk of hypotension
o Risk of hypertension

Answer 4

Risk of bleeding. Both apixban and sertraline can cause bleeding (increased risk when used to together

Question 5

An elderly woman was recently started on citalopram by her GP. She presents to the
emergency department with confusion, nausea and vomiting

o Hyponatraemia
o Hypernatraemia
o Hypokalemia
o Hyperkalemia
o Hypocalcaemia
o Hypercalcaemia
o Hypomagnesemia
o Hypermagnesemia

Answer 5

Citalopram is an SSRI and can cause hyponatraemia(low sodium). Confusion, nausea and vomiting are potential symptoms of hyponatraemia

Question 6

A patient takes both ramipril and eplerenone and their blood test shows an electrolyte
disturbance.
o Hyponatraemia
o Hypernatraemia
o Hypokalemia
o Hyperkalemia
o Hypocalcaemia
o Hypercalcaemia
o Hypomagnesemia
o Hypermagnesemia

Answer 6

Both ramipril (an ACE inhibitor) and eplerenone (a mineralocorticoid receptor antagonist) can cause hyperkalemia (high potassium)

Question 7

A patient has been taking omeprazole on a long-term basis. She complains of symptoms
of nausea, weakness, twitching and cramps.
o Hyponatraemia
o Hypernatraemia
o Hypokalemia
o Hyperkalemia
o Hypocalcaemia
o Hypercalcaemia
o Hypomagnesemia
o Hypermagnesemia

Answer 7

Omeprazole is a proton pump inhibitor, whichcan cause hypomagnesemia(low magnesium),particularly with prolonged use. Nausea, weakness, twitchingand cramping are potential symptoms of magnesium deficiency

Question 8

A patient was started on furosemide for heart failure. They complain of fatigue and
palpitations.

o Hyponatraemia
o Hypernatraemia
o Hypokalemia
o Hyperkalemia
o Hypocalcaemia
o Hypercalcaemia
o Hypomagnesemia
o Hypermagnesemia

Answer 8

Furosemide is a loop diuretic, which can cause hypokalemia (low potassium). Fatigueand palpitations are potential symptoms of hypokalaemia

Question 9

This electrolyte disturbance must be corrected before a patient is started on alendronic
acid.
o Hyponatraemia
o Hypernatraemia
o Hypokalemia
o Hyperkalemia
o Hypocalcaemia
o Hypercalcaemia
o Hypomagnesemia
o Hypermagnesemia

Answer 9

Alendronic acid (bisphosphonate) is contraindicated in hypocalcaemia

Question 10

A patient has type 1 diabetes. He injects a long-acting basal insulin twice daily as part
of his insulin regime.
o Insulin lispro
o Insulin glargine
o Insulin aspart
o Insulin degludec
o Humulin I
o Humulin M3
o Insulin glulisine
o Insulin detemir

Answer 10

Insulin detemir is a long-actingbasal insulin which can beinjected twice a day. Insulin glargine and insulin degludec are also long acting, but these are injected once daily

Question 11

A patient injects a biphasic insulin.
o Insulin lispro
o Insulin glargine
o Insulin aspart
o Insulin degludec
o Humulin I
o Humulin M3
o Insulin glulisine
o Insulin detemir

Answer 11

Humulin M3 is a biphasic insulin.It contains both asuspensionof bothrapid-acting insulin and an intermediate-acting insulin

Question 12

A patient has recently started an intermediate acting insulin
o Insulin lispro
o Insulin glargine
o Insulin aspart
o Insulin degludec
o Humulin I
o Humulin M3
o Insulin glulisine
o Insulin detemir

Answer 12

Humbling I is an intermediate acting insulin

Question 13

After 5 years of taking this medication, a patient attends an annual eye check as part of
the monitoring for this medication.
o Digoxin
o Amiodarone
o Leflunomide
o Warfarin
o Sodium valproate
o Hydroxychloroquine
o Carbimazole
o Tacrolimus

Answer 13

Hydroxychloroquine carries a risk of retinopathy. Annual ophthalmological monitoring is recommended in patients who have taken hydroxychloroquine for over 5 years, althoughnote thatthis may be started earlier when there are risk factors for retinopathy

Question 14

This medication is a DMARD which is indicated for active rheumatoid arthritis, and a
patient attends for blood pressure monitoring as part of the monitoring for this medication.
o Digoxin
o Amiodarone
o Leflunomide
o Warfarin
o Sodium valproate
o Hydroxychloroquine
o Carbimazole
o Tacrolimus

Answer 14

Leflunomide is a DMARD which is indicated for active rheumatoid arthritis, and blood pressure should be monitored on leflunomide

Question 15

This medication must always be prescribed by brand if given orally
o Digoxin
o Amiodarone
o Leflunomide
o Warfarin
o Sodium valproate
o Hydroxychloroquine
o Carbimazole
o Tacrolimus

Answer 15

Tacrolimus as switching between brands has been linked to cases of toxicity and graft rejection

Question 16

A patient attends for a blood test for thyroid function tests, liver function tests, and
serum potassium before starting treatment with this medication.
o Digoxin
o Amiodarone
o Leflunomide
o Warfarin
o Sodium valproate
o Hydroxychloroquine
o Carbimazole
o Tacrolimus

Answer 16

Before treatment, amiodarone requires monitoring ofthyroid function tests,liver function tests, and serum potassium (and alsoa chest x-ray). Top Tip: Learn the reasons why certain monitoring requirements for medicationsare required. This will make the monitoring easier to remember as you understandthe reasons why it is needed. Forexample, amiodarone can cause pulmonary toxicity, which is why a chest x-ray is needed. Also note thatTFTs are needed as amiodarone can cause hypothyroidism and hyperthyroidism.LFTs are needed as amiodarone can cause hepatoxicity

Question 17

A gp asks for advice for a recommendation ov a very potent steroid cream
o Hydrocortisone 1% cream
o Timodine cream
o Permethrin cream
o Coal tar ointment
o Clobetasone cream
o Clobetasol cream
o E45 cream
o Dermol 500 lotion

Answer 17

Clobetasol (dermovate) is a steroid cream which is considered very potent

Question 18

A cream containing antimicrobials which can only be given on prescription
o Hydrocortisone 1% cream
o Timodine cream
o Permethrin cream
o Coal tar ointment
o Clobetasone cream
o Clobetasol cream
o E45 cream
o Dermol 500 lotion

Answer 18

Timodine

Question 19

This is a steroid cream which is available over the counter, licensed for short term
treatment of eczema for adults and children greater than 12 years of age
o Hydrocortisone 1% cream
o Timodine cream
o Permethrin cream
o Coal tar ointment
o Clobetasone cream
o Clobetasol cream
o E45 cream
o Dermol 500 lotion

Answer 19

Clobetasone cream (eumovate) is available OTC and is licensed for children over 12 years old. Note that hydrocortisone 1% cream is also available OTC but minimum licensing age is 10 years old

Question 20

You decline an OTC sale of sumatriptan because the patient is over this age.
o 2 years
o 6 years
o 10 years
o 12 years
o 16 years
o 18 years
o 60 years
o 65 years

Answer 20

65 years. The OTC licensing age of sumatriptan is 18-65 years old

Question 21

This is the minimum OTC licensing age for benzoyl peroxide gel for acne
o 2 years
o 6 years
o 10 years
o 12 years
o 16 years
o 18 years
o 60 years
o 65 years

Answer 21

12

Question 22

You decline the sale of OTC chloramphenicol eye drops as the patient is under this age
o 2 years
o 6 years
o 10 years
o 12 years
o 16 years
o 18 years
o 60 years
o 65 years

Answer 22

2 years

Question 23

A patient must be over this age to be treated with viagra connect

o 2 years
o 6 years
o 10 years
o 12 years
o 16 years
o 18 years
o 60 years
o 65 years

Answer 23

18 years

Question 24

For an acute exacerbation of COPD, this is the usual treatment duration of
prednisolone
o 1 day
o 2 days
o 3 days
o 5 days
o 7 days
o 14 days
o 28 days
o 30 days

Answer 24

Usual dose is 30mg OD for 5 days

Question 25

This is the maximum number of days’ supply which should be given on an oral isotretinoin prescription for a 23-year-old woman o 1 day o 2 days o 3 days o 5 days o 7 days o 14 days o 28 days o 30 days

Answer 25

In women of child-bearing potential, each isotretinoinprescription should be limited to up to a max supply of 30 days’ treatment(and must be dispensed within 7 days

Question 26

Duration of treatment with co-codamol should be limited to this amount of treatment when bought OTC o 1 day o 2 days o 3 days o 5 days o 7 days o 14 days o 28 days o 30 days

Answer 26

3 days - due to risk of addiction

Question 27

This is the usual course length for the first line triple-therapy regimen for eradication of H. Pylori. o 1 day o 2 days o 3 days o 5 days o 7 days o 14 days o 28 days o 30 days

Answer 27

Treatment for H pylori eradication usually consists of a PPI and two antibacterials (consult the BNF for details of regimens).The first line regimen has a 7-daycourse

Question 28

This is a dopamine receptor agonist used in Parkinson’s disease, available as a patch formulation. o Ropinirole o Rasagiline o Rotigotine o Entacapone o Amantadine o Co-beneldopa o Co-careldopa o Apomorphine

Answer 28

Rotigotine is a dopamine receptor agonist indicatedfor Parkinson’s disease. It is available as a transdermal patch formulation. Ropinirole, amantadine, and apomorphine are also dopamine receptor agonists but these are not available in a patch formulation

Question 29

This is a COMT inhibitor which may discolour urine reddish-brown. Ropinirole o Rasagiline o Rotigotine o Entacapone o Amantadine o Co-beneldopa o Co-careldopa o Apomorphine

Answer 29

Entacapone is a COMT inhibitor. Patients should be counselled that entacapone can cause urine to be coloured reddish-brown

Question 30

This can be given by subcutaneous injection or by continuous subcutaneous infusion o Ropinirole o Rasagiline o Rotigotine o Entacapone o Amantadine o Co-beneldopa o Co-careldopa o Apomorphine

Answer 30

Apomorphine is a dopamine receptor agonist which can be given as a subcutaneous injectionor by continuous subcutaneous infusion

Question 31

A 36-year-old man has a sore tongue. His tongue and cheeks are coated with white plaques. He is not experiencing any pain. Which of the following medicines is most likely to have caused the patient’s symptoms? A Amlodipine tablets B Beclometasone inhaler C Furosemide tablets D Lamotrigine tablets E Paracetamol tablets F Ramipril capsules G Salbutamol inhaler H Warfarin tablets

Answer 31

Steroid inhalers are highly likely to cause oral thrush (pseudomembranous oral candidiasis). Symptoms includepatches of curd-like, white or yellowish plaques that can occur anywhere in the mouth, especially the cheeks, gums,palate, and tongue. These are easily removed, revealing an underlying red base that is not usually painful.To avoid this adverse effect, it is recommended that patients rinse their mouth after using their inhaler

Question 32

A patient comes into the pharmacy. Their ankles and feet have been quite swollen recently and they think it is because of their new medicines. Which of the following medicines is responsible? A Amlodipine tablets B Beclometasone inhaler C Furosemide tablets D Lamotrigine tablets E Paracetamol tablets F Ramipril capsules G Salbutamol inhaler H Warfarin tablets

Answer 32

Oedema (swelling in the ankles, feet and legs caused by a build-up of fluid in these areas)is a common side effect of calcium-channel blockerssuch as amlodipine

Question 33

A 15-year-old boy has been started on a new anti-epileptic medication. You make sure that the boy and his parents understand the risks associated with over-heating and dehydration while he is on this medication. Which of the following medicines is this patient most likely to be taking A Diazepam B Ethosuximide C Gabapentin D Midazolam E Phenobarbitone F Sodium valproate G Topiramate H Zonisamide

Answer 33

Zonisamide - avoid overheating and ensure adequate hydration especially in children, during strenuous activity or if in warm environment (fatal cases of heat stroke reported in children)

Question 34

A patient is being discharged from hospital following on-going episodes of seizures lasting longer than ten minutes. The epilepsy nurse would like the patient to leave with a ‘rescue’ medication. The contents of the medication are to be inserted slowly into the space between the gum and cheek. Which of the following medicines is this patient most likely to be taking? A Diazepam B Ethosuximide C Gabapentin D Midazolam E Phenobarbitone F Sodium valproate G Topiramate H Zonisamide

Answer 34

Midazolam is often a part of patient’s anti-epileptic rescue medication plan. It is available for oromucosal use and adequate counselling on its use should be provided.

Question 35

An 83-year-old patient has increased seizure activity due to a potential infection. He is hard to cannulate, vomiting medications and would prefer a medication that can be administered rectally. Which of the following medicines is most suitable for this patient A Diazepam B Ethosuximide C Gabapentin D Midazolam E Phenobarbitone F Sodium valproate G Topiramate H Zonisamide

Answer 35

From the options available, diazepam is the only medication that is available as an enema allowing rectal administration. It is of great benefit in medical emergencies and where other routes of administration are not suitable. Diazepam can sometimes be seen as a part of patient’sepilepsy ‘rescue’ plan.

Question 35

A 38-year-old woman with a past medical history of asthma is exhibiting symptoms of severe vomiting, appears agitated and has a racing heartbeat. Which of the following medicines is most likely to have caused this patient’s symptoms? A Carbocisteine B Chlorphenamine C Fluticasone D Montelukast E Prednisolone F Pseudoephedrine G Salmeterol H Theophylline

Answer 35

Theophylline in overdose can cause vomiting (which may be severe and intractable), agitation, restlessness, dilated pupils, sinus tachycardia, and hyperglycaemia. More serious effects are haematemesis, convulsions, and supraventricular and ventricular arrhythmias. Severe hypokalaemia may develop rapidly

Question 36

A 42-year-old man with a past medical history of asthma has been admitted to hospital with difficulty speaking, body weakness, and tremor. They are also repetitively cleaning and washing their hands. Which of the following medicines is most likely to have caused this patient’s symptoms? A Carbocisteine B Chlorphenamine C Fluticasone D Montelukast E Prednisolone F Pseudoephedrine G Salmeterol H Theophylline

Answer 36

Uncommon and rare adverse effects of montelukast includeakathisia, asthenia, abnormal behaviour, and obsessive-compulsive symptoms.An adverse effect of steroids, such as fluticasone and prednisolone, is also abnormal behaviour. However, the other symptoms experienced by the patient are not reported adverse effects of fluticasone or prednisolone

Question 37

A 61-year-old man recently had a stroke. He is now having difficulty swallowing his medicines and asks for your advice on what to do. Which of the following healthcare professionals would be the most appropriate to refer this patient to? A Dispenser B Doctor C Nurse D Occupational therapist E Pharmacy technician F Physiotherapist G Social worker H Speech and language therapist

Answer 37

Speech and language therapists can aid patients who have swallowing difficulties ensuring they are suffering no form of aspiration. This can help pharmacists advise on the most appropriate forms of medication

Question 38

A 96-year-old woman is scheduled to be discharged from hospital. She lives alone after her husband passed away and her two children live abroad. You are slightly concerned that she may struggle to adjust to being on her own again after discharge. Which of the following healthcare professionals would be the most appropriate to refer this patient onto? A Dispenser B Doctor C Nurse D Occupational therapist E Pharmacy technician F Physiotherapist G Social worker H Speech and language therapist

Answer 38

Social workers help their patients to live their lives more successfully by finding solutions to their problems

Question 39

A 33-year-old man currently in the first month of tuberculosis treatment is reporting symptoms of muscle aches, weakness and pins and needles in his feet. He takes isoniazid, rifampicin, pyrazinamide and ethambutoL A Adcal D3 chewable tablet B Alfacalcidol tablets C Ascorbic acid tablets D Calcichew chewable tablet E Magnesium aspartate sachets F Phosphate Sandoz effervescent tablets G Pyridoxine tablets H Sevelamer tablets

Answer 39

These are typical symptoms of isoniazid included neuropathy. Pyridoxine is licensed to manage this

Question 40

A 42-year-old woman with a history of gastro-oesophageal reflux disease who has been taking omeprazole 40mg once daily for the past six months is reporting nausea and vomiting, pins and needles, fatigue and muscle twitches. Which of the following medicines is most suitable for managing these adverse effects? A Adcal D3 chewable tablet B Alfacalcidol tablets C Ascorbic acid tablets D Calcichew chewable tablet E Magnesium aspartate sachets F Phosphate Sandoz effervescent tablets G Pyridoxine tablets H Sevelamer tablets

Answer 40

A known side effect of omeprazole is hypomagnesaemia, which these are typical symptoms of.

Question 41

A 52-year-old woman was recently started on levothyroxine 25 micrograms once daily following a presentation to her GP with symptoms of unexplained weight gain, cold intolerance, and fatigue. Thyroid function tests indicated the development of hypothyroidism A Amiodarone B Ciclosporin C Digoxin D Gentamicin E Methotrexate F Phenytoin G Theophylline H Warfarin

Answer 41

Hypothyroidism is a known side-effect of amiodarone, with a requirement for thyroid function test monitoring before treatment and then every 6 months

Question 42

A 72-year-old man with a three day history of diarrhoea develops acute kidney injury and hypokalaemia. He subsequently demonstrates symptoms of nausea, vomiting, confusion and visual disturbances, including yellow vision. Which of the following medicines has most likely caused the symptoms A Amiodarone B Ciclosporin C Digoxin D Gentamicin E Methotrexate F Phenytoin G Theophylline H Warfarin

Answer 42

Typical early symptoms of digoxin toxicity are nausea and vomiting with confusion, which can be exacerbated by hypokalaemia that can result from diarrhoea. A characteristic symptom is visual disturbances with yellow vision.

Question 43

A patient has suspected unstable angina and a glyceryl trinitrate spray is ineffective. Which of the following medicines is most suitable to manage the emergency situation A Adrenaline injection B Aspirin 300mg dispersible tablets C Benzylpenicillin sodium injection D Cefotaxime injection E Flucloxacillin injection F Hydrocortisone intravenous injection G Prednisolone soluble tablets H Salbutamol inhaler

Answer 43

B-- Dispersible aspirin is used in addition to GTN spray for treatment of unstable angina

Question 44

A patient has presented at their GP surgery with photosensitivity, a non-blanching rash and a stiff neck. The patient has a documented skin rash allergy to amoxicillin. Which of the following medicines is most suitable to manage the emergency situation? A Adrenaline injection B Aspirin 300mg dispersible tablets C Benzylpenicillin sodium injection D Cefotaxime injection E Flucloxacillin injection F Hydrocortisone intravenous injection G Prednisolone soluble tablets H Salbutamol inhaler

Answer 44

Signs of meningitis. 1stline is benzylpenicillin but unsuitable due to penicillin allergy. Cefotaxime can be used as no history of immediate anaphylactic reaction to penicillins.

Question 45

A 45-year-old man has skin condition affecting his toes. The nail on two toes of his left feet are discoloured and look a bit flaky. The surrounding skin is a little red. There is no pain or itching. He is diabetic and takes metformin to manage his condition. Which of the following skin conditions is the patient most likely to have A Athlete’s foot B Corn C Dermatitis D Foot ulcer E Fungal nail infection F Psoriasis G Verruca H Wart

Answer 45

They symptoms suggest a fungal nail infection. The nail will often lookabnormal and is discoloured. A single nail, several, or rarely all nails may be affected. The first and fifth toenails are most commonly involved. Fingernails can also be affected

Question 46

An 18-year-old woman has a rash on her lower legs which has been for two days. The rash is red, sore, itchy, and there appears to be small, raised bumps. She mentions that she recently had hair removal treatment. A Athlete’s foot B Corn C Dermatitis D Foot ulcer E Fungal nail infection F Psoriasis G Verruca H Wart

Answer 46

The symptoms indicate dermatitis which is most likely to be associated with the hair removal treatment the patient has had. Acute contact dermatitis typically presents with erythema and vesiculation, dryness, scaling and bullae may also be present

Question 47

A 35-year-old man has a growth on his right index finger. It appeared two weeks ago. The growth is firm, raised and skin coloured. He is experiencing minor pain and itching where the growth is. A Athlete’s foot B Corn C Dermatitis D Foot ulcer E Fungal nail infection F Psoriasis G Verruca H Wart

Answer 47

The symptoms suggest a wart. They can appear on palms, knuckles, knees, and fingers, and occur in clusters.Wartsarefirmto touch, have raised papules with a rough surface that resembles a cauliflower, and are usually skin coloured butmay appear darker on dark skin; they sometimes itch andcause minor pain. They willoften resolveontheir own but may take months or even years

Question 48

An 89-year-old woman is under palliative care. She has been constipated for the past few days due to receiving large doses of opioids in a syringe driver. The laxative prescribed for the patient by the palliative care team is a stimulant laxative that is potentially carcinogenic according to animal studies. It can also change the colour of urine to red A Bisacodyl B Co-danthrusate C Docusate D Glycerol suppository E Ispaghula husk F Lactulose G Senna H Sodium picosulphate

Answer 48

Co-danthramer & co-danthrusateis indicated for constipation in palliative care. Rodent studies indicate potential carcinogenic risk. An adverse effect is that it can change the colour of urine to re

Question 49

A 19-year-old woman has been advised by her GP to purchase a stimulant laxative from a pharmacy. The GP mentioned the laxative has an onset of action of 8-12 hours and also warned that it can change the colour of urine to yellow/red-brown A Bisacodyl B Co-danthrusate C Docusate D Glycerol suppository E Ispaghula husk F Lactulose G Senna H Sodium picosulphate

Answer 49

Senna has an onset of action 8–12 hours and can discolour urine. Senna available for general sale has been limited to a pack size of two short treatment courses (up to 20 standard-strength tablets, 10 maximum-strength tablets or 100ml solution/syrup). Stimulant laxatives on general sale (in shops and supermarkets) will be recommended for use only in people 18 years or older. Children aged 12 to 17 years can be supplied under the supervision of a pharmacist. Note the MHRA/CHM advice about Stimulant laxatives (bisacodyl, senna and sennosides, sodium picosulfate) available over the counter: new measures to support safe use (August 2020).Bisacodyl tablets act in 10–12 hours, suppositories work in 20–60 minutes. Docusate oral preparations act within 1–2 days,suppositories work in 20 minutes. Bulk forming laxatives have an onset of action of 72 hours

Question 50

A 32-year-old woman who is 16 weeks pregnant and takes no regular medication has developed hypertension. Which of the following medicines is most suitable for this patient? A Amlodipine B Bendroflumethiazide C Bisoprolol D Doxazosin E Furosemide F Labetalol G Ramipril H Verapamil

Answer 50

Labetalol is the only medication listed that is recommended for hypertension in pregnancy

Question 51

A 63-year-old Caucasian man with no previous medical history, who is newly diagnosed with hypertension. Which of the following medicines is most suitable for this patient A Amlodipine B Bendroflumethiazide C Bisoprolol D Doxazosin E Furosemide F Labetalol G Ramipril H Verapamil

Answer 51

Calcium channel blockers recommended in age > 55 years

Question 52

A 64-year-old woman with diabetes needs blood pressure medication for the first time. Which of the following medicines is most suitable for this patient? A Amlodipine B Bendroflumethiazide C Bisoprolol D Doxazosin E Furosemide F Labetalol G Ramipril H Verapamil

Answer 52

Ramipril (ACEI) recommend in diabetes

Question 53

A 67-year-old man has been started on cisplatin for cancer. The SmPC for cisplatin 1 mg/ml concentrate for solution for infusion is provided below: https://www.medicines.org.uk/emc/product/6111/smpc#gref Which of the following is a rare side effect of treatment with cisplatin? A Allergic reaction B Alopecia C Anaemia D Anorexia E Convulsion F Deafness G Muscle spasms H Sepsis

Answer 53

Section 4.8 of the SmPC states that convulsions are a rare side effect. Other rare side effects include acute leukaemia, peripheral neuropathy, leukoencephalopathy, reversible posterior leukoencephalopathy syndrome, myocardial infarction, and stomatitis.

Question 54

A 71-year-old woman has been prescribed cisplatin for lung cancer. The SmPC for cisplatin 1 mg/ml concentrate for solution for infusion is provided below: https://www.medicines.org.uk/emc/product/6111/smpc#gref. Which of the following is a rare side effect of the treatment of cisplatin A Allergic reaction B Alopecia C Anaemia D Anorexia E Convulsion F Deafness G Muscle spasms H Sepsis

Answer 54

Section 4.3 of the SmPC states that cisplatin may give allergic reactions in some patients. Therefore, use is contraindicated in those patients with a history of allergic reaction to cisplatin or other platinum containing compounds, or any component of the formulation.

Question 55

A 34-year-old woman, with a BMI of 32, requests an over-the-counter medication. She also takes levothyroxine 100 micrograms and desogestrel 75 micrograms. You advise her that this medicine is not recommended because of potential interactions. Which of the following medicines is most likely to interact with the patient’s medicines? A Atovaquone 250 mg/proguanil 100 mg tablets B Chloramphenicol 0.5% eye drops C Hydrocortisone 1% cream D Nicotine 15 mg patch E Omeprazole 10 mg tablets F Orlistat 60 mg capsules G Prochlorperazine 3 mg tablets H Sildenafil 50 mg tablets

Answer 55

F- See Alli 60mg SmPC, section 4.5:-Hypothyroidism and/or reduced control of hypothyroidism may occur when orlistat and levothyroxine are co-administered. Patients taking levothyroxine should consult a doctor before starting treatment with Alli, as orlistat and levothyroxine may need to be taken at different times and the dose of levothyroxine may need to be adjusted.-Orlistat may indirectly reduce the availability of oral contraceptives and lead to unexpected pregnancies in some individual cases. The use of an additional contraceptive method is recommended to prevent possible failure of oral contraception that could occur in case of severe diarrhoea.

Question 56

A 65-year-old man requests an over the counter medicine. He also takes co-beneldopa dispersible tablets for Parkinson’s disease. You advise him that this medicine is not suitable for him because of his medical condition. Which of the following medicines is most likely to be contraindicated for this patient? A Atovaquone 250 mg/proguanil 100 mg tablets B Chloramphenicol 0.5% eye drops C Hydrocortisone 1% cream D Nicotine 15 mg patch E Omeprazole 10 mg tablets F Orlistat 60 mg capsules G Prochlorperazine 3 mg tablets H Sildenafil 50 mg tablets

Answer 56

Prochlorperazine 3 mg OTC is contraindicated in patients who have Parkinson’s Disease.Referencehttps://www.medicines.org.uk/emc/product/478