Med Top Trumps Clinical Decisions Flashcards
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 <140/90mmHg
t1dm
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
d. cimetidine
are the following enzyme inducers or inhibitors
carbamazepine
st johns wort
rifampicin
inducers
enzyme inhibitors increase the effectiveness of other drugs metabolised by that enzyme thus increase or decrease the likelihood of toxicity
increase
inhibitor or inducer: cimetidine
inhibitor
inhibitor or inducer: chloramphenicol
inhibitor
inhibitor or inducer: phenobarbitone
inducer
inhibitor or inducer: phenytoin
inducer
inhibitor or inducer: fluoxetine
inhibitor
are azoles like ketoconazole and fluconazole inhibitors or inducers
inhibitors
is sodium valproate an inhibitor or an inducer
inhibitor
omeprazole and erythromycin: inducer or inhibitor
inhibitor
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.Flucloxacillin
give an appropriate abx that targets staphylococcus if fluclox is contraindicated due to pencillin allergy
clarithromycin
why is it best to take fluclox on an empty stomach
poor oral bioavailability
adult dose range for fluclox
250mg to 2g qds
true or false, fluclox can be given both iv or im
true
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®)
C.Insulin Degludec (Tresiba®)
insulin degludec is ultra long acting and can last up to x hrs
42
long acting insulins provide a continuous level of insulin activity which is usually 24-x hrs
36
what are the 3 different long acting insulins
glargine
determir
degludec
why are rapid acting analogue insulins less likely to cause hypoglycaemia
taken before, with or immediately after food
doses of rapid acting analogue insulins may need reducing Xhrs before planned exercise and subsequent doses within a 24 hr period
1
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 – Night time waking with
breathlessness or wheeze
onset of copd is usually over x years of age
35
is a chronic productive cough common or uncommon in asthma patients
uncommon
is significant diurnal or day to day variability of symptoms common or uncommon in asthma
common
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)
D - Ciprofloxacin
list some common causes for perforated tympanic membrane/ perforated ear drum
infection
injury
changes in air pressure
otitis externa can heal on its own but can result in hearing loss and makes the middle ear vulnerable to what 2 things
infection or injury
what are the usual causative bacterial agents in otitis externa
staph and pseudemonas
is topical or systemic treatment better for penetration with a steroid in otitis externa treatment
topical
why is ciprofloxacin better to treat otitis externa where there is a perforated tympanic membrane instead of aminoglycosides
avoid ototoxic drugs where there is a perforation
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
D.Nitrofurantoin
what would you expect to see on a urine dipstick for an uncomplicated uti
+ nitrites and leukocytes
a short course of x days is usually appropriate for uncomplicated uti cases in women
3
alternative first line abx to nitrofurantoin to treat uncomplicated uti cases
trimethoprim
what 2 ecg changes can be seen in NSTEMI
st depression and t inversion
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 – Pioglitazone
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
name of px GP
what 6 things are required on the label of a container or package for emergency supply
supply date
drug name, quantity form and strength
pt name
pharmacy name and address
words emergency supply
keep out of reach of children
