Med Top Trumps Clinical Decisions

Question 1

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

Answer 1

a <140/90mmHg

t1dm

Question 2

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

Answer 2

d. cimetidine

Question 3

are the following enzyme inducers or inhibitors

carbamazepine
st johns wort
rifampicin

Answer 3

inducers

Question 4

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

Answer 4

increase

Question 5

inhibitor or inducer: cimetidine

Answer 5

inhibitor

Question 6

inhibitor or inducer: chloramphenicol

Answer 6

inhibitor

Question 7

inhibitor or inducer: phenobarbitone

Answer 7

inducer

Question 8

inhibitor or inducer: phenytoin

Answer 8

inducer

Question 9

inhibitor or inducer: fluoxetine

Answer 9

inhibitor

Question 10

are azoles like ketoconazole and fluconazole inhibitors or inducers

Answer 10

inhibitors

Question 11

is sodium valproate an inhibitor or an inducer

Answer 11

inhibitor

Question 12

omeprazole and erythromycin: inducer or inhibitor

Answer 12

inhibitor

Question 13

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

Answer 13

A.Flucloxacillin

Question 14

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

Answer 14

clarithromycin

Question 15

why is it best to take fluclox on an empty stomach

Answer 15

poor oral bioavailability

Question 16

adult dose range for fluclox

Answer 16

250mg to 2g qds

Question 17

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

Answer 17

true

Question 18

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®)

Answer 18

C.Insulin Degludec (Tresiba®)

Question 19

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

Answer 19

42

Question 20

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

Answer 20

36

Question 21

what are the 3 different long acting insulins

Answer 21

glargine
determir
degludec

Question 22

why are rapid acting analogue insulins less likely to cause hypoglycaemia

Answer 22

taken before, with or immediately after food

Question 23

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

Answer 23

1

Question 24

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

Answer 24

A – Night time waking with
breathlessness or wheeze

Question 25

onset of copd is usually over x years of age

Answer 25

35

Question 26

is a chronic productive cough common or uncommon in asthma patients

Answer 26

uncommon

Question 27

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

Answer 27

common

Question 28

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)

Answer 28

D - Ciprofloxacin

Question 29

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

Answer 29

infection injury changes in air pressure

Question 30

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

Answer 30

infection or injury

Question 31

what are the usual causative bacterial agents in otitis externa

Answer 31

staph and pseudemonas

Question 32

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

Answer 32

topical

Question 33

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

Answer 33

avoid ototoxic drugs where there is a perforation

Question 34

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

Answer 34

D.Nitrofurantoin

Question 35

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

Answer 35

+ nitrites and leukocytes

Question 36

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

Answer 36

3

Question 37

alternative first line abx to nitrofurantoin to treat uncomplicated uti cases

Answer 37

trimethoprim

Question 38

what 2 ecg changes can be seen in NSTEMI

Answer 38

st depression and t inversion

Question 39

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

Answer 39

A – Pioglitazone

Question 40

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

Answer 40

name of px GP

Question 41

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

Answer 41

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