Med Top Trumps Clinical Decisions Flashcards

1
Q

Q1 CV
Mr Ball is a 55-year-old man with a PMH of hypertension, type 1
diabetes (ACR = 65mg/mmol) and glaucoma.
Which of the below is representative of the correct target clinic BP
target?
A.<140/90mmHg
B.<120/80mmHg
C.<150/90mmHg
D.<130/80mmHg

A

a <140/90mmHg

t1dm

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2
Q

Which of the below medications is
the MOST potent INHIBITOR of the
cytochrome P450 enzyme system?
A.Carbamazepine
B.Rifampicin
C.St Johns Wort
D.Cimetidine

A

d. cimetidine

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3
Q

are the following enzyme inducers or inhibitors

carbamazepine
st johns wort
rifampicin

A

inducers

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4
Q

enzyme inhibitors increase the effectiveness of other drugs metabolised by that enzyme thus increase or decrease the likelihood of toxicity

A

increase

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5
Q

inhibitor or inducer: cimetidine

A

inhibitor

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6
Q

inhibitor or inducer: chloramphenicol

A

inhibitor

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7
Q

inhibitor or inducer: phenobarbitone

A

inducer

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8
Q

inhibitor or inducer: phenytoin

A

inducer

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9
Q

inhibitor or inducer: fluoxetine

A

inhibitor

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10
Q

are azoles like ketoconazole and fluconazole inhibitors or inducers

A

inhibitors

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11
Q

is sodium valproate an inhibitor or an inducer

A

inhibitor

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12
Q

omeprazole and erythromycin: inducer or inhibitor

A

inhibitor

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13
Q

what would be the first line antibiotic to treat infections that care caused by staphylococcus
A.Flucloxacillin
B.Amoxicillin
C.Co-amoxiclav
D.Clindamycin

A

A.Flucloxacillin

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14
Q

give an appropriate abx that targets staphylococcus if fluclox is contraindicated due to pencillin allergy

A

clarithromycin

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15
Q

why is it best to take fluclox on an empty stomach

A

poor oral bioavailability

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16
Q

adult dose range for fluclox

A

250mg to 2g qds

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17
Q

true or false, fluclox can be given both iv or im

A

true

18
Q

Which ONE of the below insulins has the LONGEST duration of
activity?
A.Biphasic insulin isophane (Humulin M3®)
B.Insulin Aspart (Novorapid®)
C.Insulin Degludec (Tresiba®)
D.Insulin Lispro (Humalog®)

A

C.Insulin Degludec (Tresiba®)

19
Q

insulin degludec is ultra long acting and can last up to x hrs

A

42

20
Q

long acting insulins provide a continuous level of insulin activity which is usually 24-x hrs

A

36

21
Q

what are the 3 different long acting insulins

A

glargine
determir
degludec

22
Q

why are rapid acting analogue insulins less likely to cause hypoglycaemia

A

taken before, with or immediately after food

23
Q

doses of rapid acting analogue insulins may need reducing Xhrs before planned exercise and subsequent doses within a 24 hr period

A

1

24
Q

Which of the below is NOT a common feature or symptom of
COPD?
A.Night time waking with breathlessness or wheeze
B.Persistent and progressive breathlessness
C.Chronic and productive cough
D.Onset > 35 years

A

A – Night time waking with
breathlessness or wheeze

25
Q

onset of copd is usually over x years of age

A

35

26
Q

is a chronic productive cough common or uncommon in asthma patients

A

uncommon

27
Q

is significant diurnal or day to day variability of symptoms common or uncommon in asthma

A

common

28
Q

Which ONE of the following ear drop or spray preparations may be
used to treat otitis externa in patients with a perforated tympanic
membrane in the absence of a specialist referral?
A.Gentisone HC ® (gentamicin with hydrocortisone)
B.Sofradex ®(framycetin with dexamethasone and gramicidin)
C.Otomize spray ® (neomycin with dexamethasone and glacial acetic
acid)
D.Ciloxan ® (ciprofloxacin)

A

D - Ciprofloxacin

29
Q

list some common causes for perforated tympanic membrane/ perforated ear drum

A

infection
injury
changes in air pressure

30
Q

otitis externa can heal on its own but can result in hearing loss and makes the middle ear vulnerable to what 2 things

A

infection or injury

31
Q

what are the usual causative bacterial agents in otitis externa

A

staph and pseudemonas

32
Q

is topical or systemic treatment better for penetration with a steroid in otitis externa treatment

A

topical

33
Q

why is ciprofloxacin better to treat otitis externa where there is a perforated tympanic membrane instead of aminoglycosides

A

avoid ototoxic drugs where there is a perforation

34
Q

For an uncomplicated UTI in a 23 year old female (who is not
pregnant). What is the BEST antibiotic to recommend?

A.Metronidazole
B.Cefalexin
C.Flucloxacillin
D.Nitrofurantoin

A

D.Nitrofurantoin

35
Q

what would you expect to see on a urine dipstick for an uncomplicated uti

A

+ nitrites and leukocytes

36
Q

a short course of x days is usually appropriate for uncomplicated uti cases in women

A

3

37
Q

alternative first line abx to nitrofurantoin to treat uncomplicated uti cases

A

trimethoprim

38
Q

what 2 ecg changes can be seen in NSTEMI

A

st depression and t inversion

39
Q

Which ONE of the below drugs would be unsuitable to initiate in a patient with
heart failure to improve their diabetic control?
DH:
Metformin po 1g BD
Gliclazide po160mg BD
A.Pioglitazone
B.Dapagliflozin
C.Linagliptin
D.Exenatide

A

A – Pioglitazone

40
Q

which of the following is not a requirement for the emergency supply dispensed label when requested by a member of the public

pharmacy address
name of px GP
words ‘emergency supply’
total quantity of tabs

A

name of px GP

41
Q

what 6 things are required on the label of a container or package for emergency supply

A

supply date
drug name, quantity form and strength
pt name
pharmacy name and address
words emergency supply
keep out of reach of children

42
Q
A