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Random LPs From Qs > Mocks > Flashcards

Mocks Flashcards

1
Q

Vancomycin should be infused over

A

`100 minutes

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2
Q

Some drugs associated with phototoxicity

A

Isotretinoin
Doxycycline
Amiodarone
Tacrolimus

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3
Q

Prophylactic iron can be started how soon after birth and at what dose?

A

4-6 weeks

4.5 mg - 9 mg

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4
Q

Spironolactone carries a risk of

A

Gynaecomastia (enlargement of mans breasts)

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5
Q

How should perindopril be taken?

A

30-60 minutes before food

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6
Q

Which ONE of the following statements about Patient Group Directions (PGDs) is
true?
A a PGD applies to treatment by a registered nurse only.
B a PGD applies to treatment of a specific patient on an individual basis by a qualified
prescriber
C a PGD must be signed by the doctor, (or dentist) and pharmacist
D a PGD relates only to the supply of medicines
E prescription only medicines cannot be supplied under a PGD

A

C

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7
Q

Do anti Xa levels need to be monitored with DOACS or LMWH?

A

LMWH

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8
Q

Which antimalarial carries a risk of hallucinations, depression and psychosis?

A

Mefloquine

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9
Q

What is the reversal agent for benzodiazepines?

A

Flumazenil

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10
Q

Risk of causing epidural haematoma (collection of blood in between skill and dura mater) has been associated with which anticoagulants?

A

NOACS

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11
Q

What is first line in an acute attack of gout when NSAIDs are contraindicated?

A

Colchicine

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12
Q

True or false: antipyretics and analgesics should be given routinely before immunisation

A

False

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13
Q

When is the largest peak incidence of type 1 diabetes

A

Early adolescence

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14
Q

What are the symptoms of the following:

1- Bacterial vaginosis

2- Trichomoniasis vaginalis

3- candida albicanas (thrush)

A

1- Thin, white/clear, fishy smelling discharge (BV)

2- Itchy, lot of discharge that is forthy-smelling and is yellow-green in colour (TV)

3- White cottage-cheese like discharge (thrush)

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15
Q

A productive cough with pinky and forthy sputum is one of the characteristics of?

A

Heart failure

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16
Q

Antiemetic for premedication short term anxiety

A

Lorazepam

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17
Q

Failure to treat which condition could lead to heart failure and why?

A. Anaemia 
B. Asthma/COPD
C. Diabetes 
D. hepatic/renal disease
E. Hypercholestrolsemia
A

A

When anaemia becomes severe the heart has to pump harder and faster to compensate for decreased oxygen levels in body

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18
Q

Mrs E is collecting her regular repeat prescription for osteoporosis. You ask how she and the family are and she tells you that several members of the family have been suffering with diarrhoea on and off since their recent trip to Pakistan. What is the cause of diarrhoea?

A

Giardiasis
drinking water contaminated with the Giardia parasite, or through direct contact with an infected person – often contracted abroad, but many people don’t develop the symptoms until they return home.

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19
Q

Mrs F wants advice regarding her son aged 11 who is going on a school trip to London. He has had diarrhoea and she is worried that the other school children or his two young siblings may also get it. His diarrhoea started yesterday; he went to the toilet about six times and was sick once, but has not been sick since. He has cramping pains, but is generally well and anxious not to miss his trip. Yesterday he had pie and chips from the local takeaway during his lunch break at school. No one else in the family ate the same food

A

Salmonella

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20
Q

Co-fluampicil is not allowed on nhs prescription

A

.

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21
Q

External audit

A

involves an assessment which is carried out by a person who is not involved in the process being audited, and is not having their own standards of practice audited within the process

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22
Q

Self audit

A

involves an individual practitioner assessing his or her performance against published standards and personal objectives

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23
Q

Peer audit

A

involves a group of practitioners, of similar status, considering their own performance against standards decided by the group, usually based on national standards.

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24
Q

An increase of what hormone indicates pregnancy

A

hcG

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25
Q

Chloramphenicol is caused by which virus

A

Adenovirus

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26
Q

What can be characterised as a vesicular rash, presenting unilaterally over the scalp forehead which extends to eye.

A

Herpes Zoster

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27
Q

What can be characterised as isolated red erythrmatous scaly lesions with defined edges with some that are round and others oval in shape

A

Tinea corporis

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28
Q

What is the antipsychotic of choice to treat aggression in moderate to severe Alzheimer’s?

A

Risperidone

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29
Q

What electrolyte disturbances can occur during prolonged treatment with PPIs?

A

Hypomagnaesemia
Hyponatraemia

Especially if used with digoxin

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30
Q

Safety alert about naltrexone

A

Risk of disagrees and death from inappropriate doses of naloxone in patients on long term opioid treatment

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31
Q

What is an uncommon side effect of nicorandil?

A

Oral ulceration and intestinal ulceration (rare)

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32
Q

Which agent is used to correct blood ph?

A

Sodium bicarbonate

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33
Q

What is the only neuromuscular blockade reversal?

A

Suggamadex

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34
Q

After thyroxine initiation patients should be reviewed how often?

A

3-4 weeks, dose adjustments can be made.

Once TSH stabilised can be tested annually

8-12 weeks after changing dose

NB dose should be increased by 25/50 mcg in pregnancy

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35
Q

Side effects of thyroxine

A

Hyperthyroidism (over treatment)

Reduced bone mineral density

Worsening of angina

AF

Interacts with iron (give 2 hours apart)

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36
Q

When changing oral to sc route morphine, what should the dose be?

A

Oral morphine to sc morphine : ratio is 1 to 2 or 1 to 3. Normally divide by 2

Oral morphine to sc diamorphine divide by 3

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37
Q

In DKA which is the 1st line management?

A
  1. IV fluids
  2. IV insulin
  3. Correction or hypokalaemia
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38
Q

Antiemetic of choice for N&V due to mechanical bowel obstruction?

A

Cyclizine

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39
Q

Antiemetic of choice for metabolic causes of vomiting (eg hypercalcaemia, renal failure) and for opioid induced vomiting?

A

Haloperidol

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40
Q

Antiemetic of choice for N&V after operation or in patients receiving cytotoxics?

A

Ondansetron

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41
Q

Which antiemetic can’t be given via SC route as it can cause skin reactions at injection site?

A

Prochlorperazine

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42
Q

Antiemetic choice for migraine induced N&V

A

Domperidone or metoclopramide

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43
Q

Cluster headache

A

severe, unilateral pain within and above the eye in the temporal region which lasts for two hours and occurs three times a day. Refer.

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44
Q

Which disease presents with fever, loss of appetite, sore throat, raised spots on mouth, throat and skin and feeling unwell. After 12 to 36 hours, the red spots develop into yellowy-red ulcers in your mouth, on your tongue and inside your cheeks. After one to two days, sores may start on hands and feet?

A

Hand, foot and mouth disease.
seek medical advice if symptoms worsen or do not resolve in 7-10 days.
Drink plenty of fluids. Eat soft foods. Analgesics such as paracetamol or ibuprofen.

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45
Q

Angiodeama

A

Rash all over arms and legs, very itchy, breathlessnes, becoming progressively worse. Allergic reaction as fluid accumulates. (can happen as a result of ACEi)

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46
Q

Rotavirus vaccine

A

Protects against rotavirus infection, a common cause of childhood diarrhoea and sicknesss. It is given at 8 and 12 weeks of age. Rotavirus liquid vaccines are given by mouth (orally) to young infants.

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47
Q

Buccastem only indication

A

N&V in previously diagnosed migraine

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48
Q

Antipsychotics and methadone

A

Increased risk of QT prolongation and ventricular arrhythmias.

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49
Q

Antmuscuranics

Doses

A

Ipratropium: SAMA 3-4 times a day

Tioptropium: LAMA ONCE daily

Aclidinium: LAMA TWICE daily (Genuair Eklira green to red button when dose is inhaled)

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50
Q

How many mls should dioralyte be dissolved in?

A

200 ml

51
Q

In hypertension if patient is at risk of HF, oedema or intolerance what should be offered?

A

Thiazide like diuretics

52
Q

Inhalers with dose counter

A

Ellipta

Genuair eklira

Nexthaler

Respimat

53
Q

In piles what’s the difference between blood mixed in stools and bright blood on the stools?

A

Blood in stools can be a sign of a gastric ulcer or gastric carcinoma and requires referring whereas bright blood on the stool indicates fresh blood that is due to rectal bleeding which is a normal symptom of haemorrhoids

54
Q

How long should a thermometer be placed under tongue?

A

3-4 minutes

55
Q

What is microcytic anaemia?

A

Characterised by low MCV. Iron deficiency is most common cause. Associated with thalassaemia

56
Q

Which is a referral point in otitis externa?

Conductive hearing loss or symptoms present for 4 or more days?

A

4 or more days. (Refer if more than 2 days)

57
Q

Which one is not an excipient used in vaccine?

Formic avid
Gelatin
Penicillins 
Polymyxin
Thiomersal
A

Formic acid

58
Q

Research for evidence based clinical decisions?

A

Meta-analysis

59
Q

Viral infections can cause neutropenia

A

.

60
Q

Ispuagula husk and opioids?

A

Risk of faecal impaction. With isphagula husk you need to drink lots of water. Opioids have anticholinergic effects. Best laxative for opioid induced constipation is an osmotic such as lactulose.

61
Q

Waste should not be stored for longer than how many months?

A

3

And no more than 5 cubic meters of hazardous waste can be stored at any one time

62
Q

Re-audit performance is not part of one typical audit cycle

A

.

63
Q

Which of the following is there a legalisation that prohibits you from administering the medicine without instructions from practitioner?

Soluble insulin 
Diazepam rectal solution 
Salbutamol inhaler
Adrenaline 
Midazolam buccal solution
A

Soluble insulin

64
Q

True or false EHC can be used more than once per cycle

A

Not recommended but can do

65
Q

Which one will require everyone in household to be receive treatment?

Head lice
Scabies
Threadworm

A

Scabies and threadworm

66
Q

What must be reviewed and recorded before commencing olanzapine?

A

Fasting blood glucose

67
Q

Which test do you need before starting treatment with sodium valproate and/or simvastatin?

A

Serum ALT

68
Q

Which anti cancer drug?

Patient has to undergo echodrography assessment before starting, side effects include diarrhoea, dehydration, can colour urine red. High cumulative doses are associated with cardiomyopathy and therefore dose is capped at 450 mg/m2

A

Doxorubicin

69
Q

Which anti cancer drug is used for pulmonary fibrosis. Nasal lung crepitations or suspicious chest C-ray changes are indications to stop therapy.

A

Bleomycin

Also does not cause myelosupression

70
Q
  1. Cosmofer
  2. Hydroxocobalamin (vitamin b12)
  3. Filgrastim
  4. Sodium bicarbonate
  5. Calcium
  6. Pabrinex (thiamine vitamin b1)
  7. Sevelamer
  8. Menadiol sodium phosphate
  9. Cinacalet
A
  1. Iron deficiency anaemia
  2. Pernicious Anaemia
  3. Neutropenia
  4. Uraemic Acidosis
  5. Hyperkalaemia
  6. Wernicke’s encephalopathy
  7. High phosphate levels
  8. Vitamin k deficiency
  9. Hyperparathyrodism
71
Q

Is keeping a running balance a legal requirement in the CD register?

A

No, good practice

72
Q

Which antiepileptic can be given once daily due long half life?

A

Phenobarbital

73
Q

Treatment with this medicine is associated with impulse control disorders, including pathological gambling, binge eating and hypersexuality

A

Dopamine agonists (Pramipexol, Ropinirole, Rotigotine, apomorphine)

74
Q

Which class of anti-parkinsonian has been associated with fibrotic reactions and are therefore rarely used?

A

Ergot derived dopamine agonists (bromocriptine, carbegoline and pergolide)

75
Q

Carbamazepine + TCAs

A
  1. Carbamazepine will decrease TCAs

2. TCAs will antagonise anticonvulsant effect as they lower seziure threshold.

76
Q

Which antidiabetic should be avoided in elderly due to risk of hypoglycaemia and in parkinson’s patients due to confusion?

A

Sulphonylureas (especially long acting)

77
Q

Which drug is indicated in the treatment of tremors in Parkinson’s disease which are not controlled by antiparkinsonian agents?

A

Trihexyphenidyl

78
Q

Other than the obvious, what can happen in phenytoin toxicity?

A

Vitamin D metabolism abnormalities can occur

79
Q

How often should penciclovir 1% be applied?

A

8 times a day

80
Q

erythromycin + antacids

A

reduced absorption

81
Q
  1. NSAIDs with highest and lowest risk of thrombotic events?
  2. NSAIDs with highest, lowest and intermediate risk of GI events?
  3. NSAID with serious skin reactions?
A
  1. Highest: diclofenac then ibuprofen. Lowest: Naproxen
  2. Highest: Ketoprofen, ketorolac. Intermediate: Indometacin, diclofenac, naproxen. Lowest: Ibuprofen
  3. Piroxicam
82
Q

Hyponatraemia was reported with which TWO sulfonylureas?

A

Glimepiride

Glipizide

83
Q

True or False: Is allopurinol involved with a high risk of stevens-johnson syndrom?

A

True. Symptoms include: swollen face, ulcers inside cheek, itchy rash, dysphagia, blurry vision.

84
Q

True of False: is Hydroxycarbamide cytotoxic?

A

True

85
Q

Do enema preparations avoid first pass metabolism?

A

Yes. Access via haemorrhoidal vein

86
Q

SSRI – sedative effect with alcohol but not a black dot interaction

SSRI – Black dot with naproxen as increased risk of bleeding

Omeprazole and clarithromycin increase each others’ plasma concentration but not a black dot interaction

Increased risk of bleeding when NSAID given with corticosteroid but not a black dot interaction

NSAIDs cautioned in patients with asthma who have reacted to NSAIDs in the past

A

.

87
Q

Which antidiabetic needs to be stopped prior to using iodine-containing contrast media due to risk of renal failure

A

Metformin

88
Q

Erik is taking digoxin. Dose of 125mcg daily is for atrial fibrillation or heart failure. Citalopram can cause QT-interval prolongation – answer is not B

SSRIs should be cautioned with other drugs that increase the risk of bleeding. Erik is taking aspirin. Answer is not A, E or H and B again

Amitriptyline is a tricyclic antidepressant and can cause drowsiness – Erik is a driver so would not be suitable. Answer is not D

Monoamine-oxidase inhibitors are cautioned in cardiovascular disease so answer is not F or G

A

Mirtazapine most appropriate

89
Q

MOA of laxatives

A

Senna is a natural medicine derived from sennosides which act as a stimulant – stimulating contractions of the gut (gut peristalsis)

Docusate stimulates the gut and softens the stool

Lactulose draws fluid from the blood and the fluid it is drunk with

Arachis oil softens impacted stools

Glycerol causes peristalsis by irritating the area

Bulk forming laxatives cause stimulation by increasing faecal mass

90
Q

What risk is zafarilukast associated with?

A

Liver toxicity

91
Q

Nabilone

A

used for nausea and vomiting caused by chemotherapy; it is a cannabinoid

92
Q

True or false: can co-beneldopa colour the urine and other body fluids?

A

Yes. Red

93
Q

Stoma care: Iron supplements may cause loose stools and sore skin at the stoma site. Via what route should iron supplements be given if necessary?

A

Parenteral. Modified release should be avoided.

94
Q

What is gray syndrome? symptoms? What’s it caused by?

A

occurs due to excessive doses in neonates with immature hepatic metabolism. Symptoms include abdominal distension, cyanosis, circulatory collapse.

Cholramphenicol

95
Q

Toxic epidermal necrolysis

A

potentially life-threatening dermatologic disorder characterised by widespread erythema, necrosis, and bullous detachment of the epidermis and mucous membranes, resulting in exfoliation and possible sepsis and/or death. Rare side effect of terbinafine

96
Q

True or false: Suspected shingles is an emergency referral

A

True

97
Q

Which organisms are most likely cause of an acute exacerbation of COPD? Treatment?

A

Moraxella catarrhalis, haemophilus influenza and strep pneum.
Treat with tetracyclines or amoxicillin or macrolides. (broad spectrum)

98
Q

True or false: beta blockers are contraindicated in sever peripheral vasuclar disease

A

True. If already on it, reduce dose gradually until stopped.

99
Q

Which is toxoid vaccine: diphtheria, hep B, Hib, HPV?

A

Diphtheria

100
Q

In african descent patients or over 55 with hypertension and diabetes, do you start antihypertensive treatment as normal?

A

No, if diabetic add ramipril at step 1. So CCB + ACEi. aka start at step 2.

101
Q

Avoid foods high in fibre in stoma care

A

E.g broccoli, grains etc

102
Q

If a drug is licenced for use in animal does it have to say under cascade on prescription?

A

No

103
Q

Quinolones + corticosteroids

A

Increase risk of tendon damage

104
Q

If a patient had a course of antibotic recently and did not work. Should they change the AB or increase dose/duration?

A

Change antibiotic as there might risk of resistance.

105
Q

Bath additives should not be applied directly to dry skin

A

Poses an ignition risk becuase of becuase of liquid paraffin and white soft paraffin.

106
Q

Why is methotrexate contraindicated in sever infections such as pneumonia, sepsis etc?

A

Immunosupressant

107
Q

In DKA what should happen to basal insulin?

A

Continue on same dose along side fluids and soluble insulin

108
Q

Diuretics and NSAIDs can precipitate lithium toxicity. Which is more severe?

A

NSAIDs

109
Q

Warfarin vs miconazole

A

Miconazole increases effect of warfarin. Potentially serious

110
Q 
Which is associated with highest risk of fatality in overdose?
Amitriptyline
lofepramine
mirtazapine
paroxetine
trazodone
A

Amitriptyline

Trazodone is related but has less effects. Lofepramine is least associated in comparison to others

111
Q

Pioglitazone is contraindicated in

A

HF or past medical history of HF

112
Q

NICE guidance following an MI states to use a high propensity statin (such as atorvastatin) initially with a view to switching over to a more cost-effective alternative such as simvastatin after a set period of time.

A

.

113
Q

What measure is used for monitoring compliance in smoking cessation?

A

Carbon monoxide

114
Q

A fair and just error reporting, analysis, and feedback system is an appropriate overarching safeguard to protect patient safety in relation to a medication error.

A

.

115
Q

Nitrates need to be taken so as to leave an 8-hour nitrate free period to avoid tolerance. This is possible if the dose is taken regularly at 6 hourly intervals.

A

.

116
Q 
Which of the following drugs would NOT present a clinically significant interation with grapefruit juice?
Amiodarone
Codeine
Colchicine
Fexofenadine
Pravastatin
A

Pravatsatin. Only statin to avoid with grapefriuit juice is simvastatin.

117
Q

A low neutrophil count requires withholding of methotrexate

A

.

118
Q

Sildenafil is SLS for erectile dysfunction secondary to diabetes

A

.

119
Q

Isotretinoin should be used for acne when

A

other topical antibiotics have failed

120
Q

MHRA warning with metoclopramide

A

Risk of neurological (especially young women0 max use 5 days

121
Q

Otomize ear spray

A

1 spray tds

122
Q

Flixonase nasules

A

6 drops in each nostril daily

123
Q

penicillin vs cephalosporin for UTI in pregnancy

A

Both safe but cephalosporins are more effective

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