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Mock Errors Flashcards

1
Q

What is the hierarchy for evidence?

A

1) Meta-Analysis & Systematic Reviews
2) Randomised controlled trials
3) Cohort Studies
4) Case-Control Studies
5) Expert Opinion

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2
Q

What is the maximum recommended amount of alcohol for:
Men?
Women?

A

For both men and women, the maximum recommended amount of alcohol per week is 14 units

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3
Q

If a patient receives an Rx for methotrexate and an NSAID, what should be done?

A

If a patient receives a script for both methotrexate and an NSAID, they should be informed of the interaction but ensure that regular blood tests need to be conducted.

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4
Q

If a patient suffers from liver disease and is suffering from pain, which analgesic would be the most appropriate for them?

A

Paracetamol

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5
Q

What causes vaginal thrush?

A

Candida albicans

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6
Q

What are the signs and symptoms of vaginal thrush?

A

Some of the signs and symptoms of vaginal thrush include: white-curd/cottage cheese like discharge, pain when passing urine or sex and association with itching, burning and irritation

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7
Q

What is NOT a sign of vaginal thrush?

A

Strong smelling discharge (if with white/clear fluid, likely to be BV, if green/yellow, it could be trichiomoniasis)

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8
Q

Is trimethoprim recommended during pregnancy?

A

No, trimethoprim is not recommended in pregnancy and it should be changed to an alternative

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9
Q

When would it be important to have a type 2 diabetic monitoring their blood glucose?

A

If they were on insulin

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10
Q

Which drug is suitable for the treatment of subarachnoid haemorrhage?

A

Nimodipine

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11
Q

Can a medication prescribed outside of the Marketing Authorisation be used legally?

A

Yes

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12
Q

What can be used to help with discomfort in the eye in the case of bacterial conjunctivitis?

A

Lubricant eye drops

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13
Q

Which groups of drugs are the elderly be more sensitive to?

A

Anti-Parkinson drugs
Antipsychotics
Benzodiazepines
Opioid analgesics

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14
Q

What are the legal requirements for child prescribing?

A

The age if <12

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15
Q

If a patient’s eGFR decreases upon starting an ACEi, what should be done?

A

Stop and consider an alternative

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16
Q

What condition is associated with a shooting pain in the jaw, that can be described as an electric shock? What can be used to treat it?

A

Trigeminal neuralgia - treatment is only carbamazepine

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17
Q

What are the symptoms of a TIA? How long do the symptoms last?

A

The symptoms of a TIA include;
Weakness in an arm or leg, partial blindness, slurred speech and potential dizziness. These symptoms can last for 1-2 hours

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18
Q

What can be used in the treatment of vaginal thrush?

A

Canesten 2%

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19
Q

What are the side-effects of corticosteroids?

A 
A - Adrenal Suppressison
C - Cushing's
H - Hyperglycaemia
I - Immunosuppression
N - Neurological Reactions
G - Glaucoma/ GI peptic ulcers
B - Blood Pressure
O - Osteoporosis
S - Skin Thinning
O - Obesity
M - Muscle wasting
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20
Q

Which steroid(s) have the greatest mineralocorticoid effect?

A

Fludrocortisone

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21
Q

Which steroid(s) have the greatest glucocorticoid effect?

A

Beclomethasone/Dexamethasone

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22
Q

How to manage the side-effects of steroids?

A

Lowest effective dose locally during the day

Alternative days with intermittent short courses

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23
Q

Where should the abrupt withdrawal of steroids be avoided?

A

Other causes of adrenal suppression
Taking more than 40mg prednisolone daily or equivalent
Treatment exceeding 3 weeks
Repeat doses within the evening
Recent repeated courses
Starting a short course within a year of stopping long-term steroids

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24
Q

What risk factors increase the likelihood of a patient developing VTE?

A

BMI>30
Smoking
Age>35
Family history of VTE

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25
Q

Which factors are contraindicated for COC?

A 
Liver impairment
BP> 160/95
Migraine with aura
Smoking >40
BMI>35
Age>50
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26
Q

Under how long should another COC or POP be taken if the patient vomits it out?

A

< 2 hours

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27
Q

How long do patients have to take the COC? What happens if missed?

A

24 hours- if missed one pill take ASAP and next dose

>48 hours - 7 day pill free

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28
Q

How long do patients have to take the POP? What happens if missed?

A

3 hours, 12 hours if desogestrel. If gone over the window, then use a barrier method for 2 days

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29
Q

Under how long should another ulipristal or levonorgestrel be taken if the patient vomits it out?

A

< 3 hours

30
Q

Where would levonorgestrel be cautioned?

A

Ciclosporin treatment (toxicity)
Malabsorption (Crohn’s)
Past ectopic pregnancy

31
Q

Where would ulipristal be cautioned?

A

Asthma treatment with steroids

Severe renal impairment

32
Q

What is the first line treatment for gestational diabetes?

A

Diet and Exercise

33
Q

What is the second line treatment for gestational diabetes?

A

Metformin (Insulin can be added if metformin alone is not effective)

34
Q

What is first line treatment for gestational diabetes with a blood glucose reading >7mmol/L?

A

Insulin (Metformin can be added)

35
Q

What option is available for women not wanting to take either metformin or insulin for gestational diabetes?

A

Glibenclamide after 11 weeks (when organogenesis occurs)

36
Q

What is the difference between primary, secondary and tertiary disease prevention?

A

Primary- Aim to prevent the disease (stop smoking)
Secondary- Preventative measures which lead to early disease detection and prevent more serious problems from developing (mammograms)
Tertiary Prevention - Rehabilitation following serious illness

37
Q

Which antibiotics can cause C.difficile?

A 
Ampicillin
Amoxicillin
Co-Amoxiclav
2nd and 3rd generation cephalosporins
Clindamycin
Quinolones
38
Q

What ages is tranexamic acid licensed for OTC?

A

18-45 years old

39
Q

After how many cycles should patients see their GPs if there is no reduction in menstrual bleeding?

A

After 3 cycles

40
Q

What is croup and what are the symptoms of croup?

A

Croup is a condition common in young children. It is caused by a virus. Mild cases of croup are usually self-limiting, however, more severe cases can be treated by using dexamethasone oral solution.

41
Q

Which electrolyte in excess can cause fatal arrhythmias?

A

Potassium (hyperkalaemia)

42
Q

Which enzyme is associated with blocked bile ducts?

A

Alkaline Phosphatase

43
Q

Which enzymes are associated with statins? At what level should statins be stopped?

A

Transaminases (if 3x norm) - stop the statin

44
Q

How long can it take for SSRIs to work?

A

Up to 4 weeks (6 weeks for the elderly)

45
Q

How long should the SSRIs be taken for?

A

At least 6 months (A year for the elderly)

46
Q

What is the second-line treatment for depression?

A

Different SSRI, different dose or mirtazepine

47
Q

Why are SSRIs first line?

A

They are better tolerated and safer in the case of overdose

48
Q

What are the SEs of SSRIs?

A 
B- Bleeding
S- Serotonin Syndrome
A- Appetite
G- GI SEs
H- Hyponatraemia
Q- QT interval prolongation
S- Seizure threshold lowered
49
Q

What are the SEs of TCAs?

A 
Q- QT interval prolongation
T- more toxic in overdose
C- more cardiac ses
A- more antimuscarinic ses
S- more sedative
H - Hyponatraemia
S- Seizures
50
Q

What are the SEs of MAOIs?

A

Hepatotoxicity

Hypertensive crisis

51
Q

Which class of antipsychotics are associated with the greatest amount of sedation?

A

Promazines

52
Q

Which class of antipsychotics are associated with the least amount of EPSES?

A

Cyazines

53
Q

Which class of antipsychotics are associated with the greatest amount of EPSES?

A

Perazines

54
Q

Which side-effects are associated with second-generation antipsychotics?

A 
M - Metabolic SEs
S - Sexual Dysfunction
N - Narcoleptic Malignant Syndrome 
B - Blood Dyscrasias
H - Hypertension and temperature irregulation
H - Hyperprolactinaemia
E - EPSEs
55
Q

Which anti-psychotics are associated with antipsychotic side-effects?

A

M - Metabolic SEs (CiROQ- Diabetes), COw(weight gain)
S - Sexual Dysfunction (Risperidone and Haloperidol)
N - Narcoleptic Malignant Syndrome
B - Blood Dyscrasias
H - Hypotension and temperature irregulation (QT interval prolongation) - QT interval prolongation with haloperidol
H - Hyperprolactinaemia (Risperidone and Amisulpride, least with Aripiprazole)
E - EPSEs

56
Q

What are the side effects of benzodiazepines?

A

Paradoxical aggression, Overdose (respiratory depression, coma, ataxia and drowsiness) and Sedation

57
Q

What antiepileptic drug is associated with SJS and toxic epidermal necrolysis?

A

Lamotrigine

58
Q

What are the side effects associated with atomoxetine?

A

QT prolongation
Suicidal ideation
Hepatotoxicity

59
Q

What can interact with carbazepine to cause hypnatraemia?

A

NSAIDS

60
Q

What can be used to treat mania and hypomania?

A

Risperidone
Olanzapine
Quetiapine
Asenapine(Moderate-Severe)

61
Q

When should the plasma concentration be monitored if a patient is taking lithium?

A

Lithium samples should be taken after 12 hours

Monitoring should be done every 3 months

62
Q

What are the side effects associated with lithium?

A 
Intercranial hypertension
QT interval prolongation
Renal impairment
Hypo/Hyperthyroidism
Seizure threshold lowered
63
Q

What are the signs and symptomsbof liyhium toxicity?

A

R- Renal disturbances (polyuria)
E- EPSES
V- Visual disturbances
N- Nervous System Side effects (drowsiness, confusion and stupor)
G- GI side effects (vomiting and diarrhoea)

64
Q

Is lithium safte in pregnancy and breast feeding?

A

No lithium is not safe in pregnancy as it is teratogenic. Toxicity may also arise in breast fed infants. Consequently, these patients need to use effective contraception if they are taking lithium and of a child bearing age

65
Q

What is the blood pressure targets in:
Pregnancy
After birth

A

Prengancy - 150/100<

After birth - 140/90

66
Q

When is clozapine considered an option for schizophrenia?

A

When 2 or more drugs have been initiated for atleast 6-8 weeks each and they have been ineffective

67
Q

How long should clozapine be trialed for before being deemed ineffective?

A

Clozapine can be trialed for 8-10 weeks before being deemed ineffective

68
Q

What happens if a patient on clozapine missed 2 or more doses?

A

It has to be reinitiated by the specialist

69
Q

What side effects exist with clozapine?

A

Myocarditis+ Cardiomyopathy, Agranulocytosis (measured once a week for 18 weeks, every 2 weeks to a year and then once a month, GI disturbances (Constipation and faecal impaction is fatal), diabetes and weight gain Blood dyscrasias

70
Q

What interactions exist regarding clozapine?

A

Aminosalicylates, Methotrexate and Cytotoxic drugs

71
Q

What can be used to treat hypersalivation with clozapine?

A

Hyoscine

Errors (6 decks)

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