MCQ From Ebm Flashcards
which of the following is not a barrier to effective prescribing?
A. Clinical complexity
B. Incomplete documentation
C. Limited consultation time
D. Patient resistance
E. Well trained clinicians
E. Well trained clinicians
What is a prescribing cascade?
A. When a patient experiences multiple adverse effects from one medication
B. When a patient is prescribed multiple medication to treat the same condition
C. When a patient is prescribed a medication to manage the adverse effects of another medication
D. When a patient stops taking a medication as a result of adverse effects
E. When clinicians follow guidelines to ensure appropriate medications are prescribed for
C. When a patient is prescribed a medication to manage the adverse effects of another medication
Choose the medicated related issue that the patient is most likely to be suffering from.
Mr A takes solifenacin, amitriptyline, linagliptin and senna for a history of urinary incontinence, type 2 diabetes and neuropathic pain.
A. Bleeding
B. Constipation
C. Hyponatraemia
D. Hyperkalaemia
E. Urinary incontinence
B. Constipation
Choose the medicated related issue that the patient is most likely to be suffering from.
Mrs C takes lisinopril, bisoprolol, eplerenone, dapagliflozin and atorvastatin for a history of heart failure and hypercholesterolaemia
A. Bleeding
B. Constipation
C. Hyponatraemia
D. Hyperkalaemia
E. Urinary incontinence
D. Hyperkalaemia
Choose the medicated related issue that the patient is most likely to be suffering from.
Ms B takes ramipril, bisoprolol, furosemide, omeprazole and citalopram for a history of heart failure, gastroesophageal reflux disease and depression
A. Bleeding
B. Constipation
C. Hyponatraemia
D. Hyperkalaemia
E. Urinary incontinence
C. Hyponatraemia
Choose the medicated related issue that the patient is most likely to be suffering from.
Mr D takes bisoprolol, edoxaban, citalopram, ibuprofen and atorvastatin for a history of AF, depression and hypercholesterolemia
A. Bleeding
B. Constipation
C. Hyponatraemia
D. Hyperkalaemia
E. Urinary incontinence
A. Bleeding
Which of the following medication is used in palliative care to treat respiratory secretions?
A. Domperidone
B. Glycopyrronium bromide
C. Levopromazine
D. Midazolam
E. Morphine sulphate
B. Glycopyrronium bromide
Which of the following treatments used to manage nausea and vomiting in palliative care patients should be avoided in those with a history of Parkinson’s disease?
A. Cyclizine
B. Hyoscine hydrobromide
C. Haloperidol
D. Ondansetron
E. Dexamethasone
C. Haloperidol
Antiemetic contraindicated in pregnant women
A. Levopromazine
B. Domperidone
C. Ondansetron
D. Prochlorperazine
E. Metoclopramide
C. Ondansetron
Medication used to treat nausea and vomitting caused by raised intracranial pressure
A. Ondansetron
B. Domperidone
C. Cyclizine
D. Haloperidol
E. Levopromazine
C. Cyclizine
Medication used to treat nausea and vomitting caused by hypercalcaemia, morphine use or renal failure
A. Ondansetron
B. Domperidone
C. Cyclizine
D. Haloperidol
E. Levopromazine
D. Haloperidol
Medication used to treat nausea and vomitting caused by gastritis or functional bowel obstruction
A. Ondansetron
B. Domperidone
C. Cyclizine
D. Haloperidol
E. Levopromazine
B. Domperidone due to its pro kinetic action promoting gastric motility
Medication used to treat nausea and vomitting caused by gastritis or functional bowel obstruction
A. Ondansetron
B. Metoclopramide
C. Cyclizine
D. Haloperidol
E. Levopromazine
B. Metoclopramide due to its pro kinetic action promoting gastric motility
Which of the following should not be stopped in a patient receiving palliative care?
A. Atorvastatin
B. Citalopram
C. Co-amoxiclax for chest infection
D. Levetiracetam
Levetiracetam
A 90-year-old woman is receiving palliative care for terminal cancer. Her pain is currently controlled by taking MST Continus (morphine sulfate m/r tablets) 70 mg every 12 hours and morphine sulfate oral solution 10 mg/5mL, 5 mL four times a day. The GP wishes to convert her opiates to a morphine sulfate subcutaneous infusion because she is now unable to take medicines by mouth.
USE EQUIVALENT OPIOID TABLE IN BNF
Which of the following is the most appropriate starting dose for this patient’s subcutaneous infusion of morphine sulfate?
A. 30mg in 24 hours
B. 60mg in 24 hours
C. 90mg in 24 hours
D. 120mg in 24 hours
E. 180mg in 24 hours
C. 90mg in 24 hours
A 76-year-old patient with atrial fibrillation is on anticoagulation therapy but has a high bleeding risk. PMH shows an episode of Gl bleed 5 years ago prior to starting anticoagulants. Which medication would you stop to reduce bleeding risk, and which would you start as an alternative anticoagulant
A) Stop Warfarin, Start Apixaban
B) Stop Apixaban, Start Warfarin
C) Stop Aspirin, Start Rivaroxaban
D) Stop Rivaroxaban, Start Aspirin
E) Stop Dabigatran, Start Warfarin
Stop Warfarin, Start Apixaban
DOACs have a lower bleeding risk than anti platelets
Not B because warfarin has a higher bleeding risk than apixaban
Not C because aspirin isn’t needed and it isn’t an anticoagulant, also Rivaroxaban has a higher bleeding risk than apixaban
Not D because aspirin isn’t an alternative to anticoagulation for AF
Not E because warfarin has a high bleeding risk
A 78 year old female patient has been diagnosed with AF. Which of the following should be started to reduce her risk of stroke?
A. Atorvastatin
B. Warfarin
C. Omeprazole
D. Lisinopril
E. Furosemide
Warfarin
A 75-year old patient with a history of CKD is prescribed a new med for hypertension. Which of the following should be avoided?
A. Amlodipine
B. Furosemide
C. Spironolactone
D. Atenolol
E. Hydralazine
Spironolactone
Which of the following should be stopped in a 70 year old diabetic patient with a history of hypoglyceamic episodes?
A. Metformin
B. Glibenclamide
C. Atenolol
D. Insulin
E. Amlodipine
Atenolol
Beta blockers mask symptoms of hypoglycaemia
