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On Track Flashcards

1
Q

A patient comes into your pharmacy and is concerned about a change in the colour of their urine.

Which is the LEAST likely to have caused this?

  • Co-beneldopa
  • Co-careldopa
  • Co-danthramer
  • Co-danthrusate
  • Co-fluampicil
A

Co-fluampicil

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2
Q

Which of the following medicines may cause hyperuricaemia?

  • Allopurinol
  • Febuxostat
  • Cochicine
  • Indapamide
  • Sulfinpyrazone
A

Indapamide

Thiazide diuretic

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3
Q

Which of the following is not likely to cause bradycardia?

Bisoprolol
Adizem® SR	 	
Ivabradine
Amiodarone
Ramipril
A

Ramipril

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4
Q

Which one of the following is most likely to cause ketoacidosis?

Intravenous salbutamol
Salmeterol
Ipratropium
Tiotropium
Inhaled salbutamol
A

IV salbutamol

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5
Q

Which of the following terms describes ‘asbestos-like’ scales on the scalp?

  • Pityriasis alba
  • Pityriasis amiantacea
  • Pityriasis rosea
  • Pityriasis versicolor
  • Psoriasis
A

Pityriasis amiantacea

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6
Q

Which ONE of the following drugs is NOT suitable for both supraventricular and ventricular arrhythmias?

  • Verapamil
  • Sotalol
  • Amiodarone
  • Flecainide
  • Propafenone
A

Verapamil

usually effective for supraventricular tachycardias only

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7
Q

Which of the following is NOT a recognised side effect of long term corticosteroid usage?

  • Weight gain
  • Glaucoma
  • Osteoporosis
  • Nystagmus
  • Diabetes
A

Nystagmus

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8
Q

Is a faxed CD drug requisition acceptable?

A

No

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9
Q

Which of the following risks are NOT associated with the use of anti-psychotics in elderly patients?

  • Hypothermia
  • Hyperthermia
  • Hypogylcaemia
  • Postural hypotension
  • Stroke
A

Hypoglycaemia

Can cause hyperglycaemia

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10
Q

Which of the following is NOT a cause of bleeding gums?

  • Asthma
  • Diabetes
  • Poor oral hygiene
  • Pregnancy
  • Smoking
A

Asthma

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11
Q

With respect to the ingredients used in the preparation of an unlicensed medicine, which of the following is NOT a requirement for the record keeping process?

  • Batch number
  • Certificate of analysis
  • Certificate of conformity
  • Ingredient manufacture date
  • Manufacturer, brand and wholesaler/distributor
A

Ingredient manufacture date

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12
Q

Miss K is a 21 year old female who presents with a round bloated, moon-like face, facial acne and stretch marks on her abdomen.

These signs are associated with high doses of which one of the following drugs?

Clindamycin
Folic acid
Aspirin
Methylprednisolone
Magnesium trisilicate
A

Methylpred

Cushings syndrome risk

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13
Q

How many NHS prescription charges do compression hosiery 2 pairs levy (assuming the patient is not exempt from NHS charges) for an NHS prescription written in England?

0
1
2
3
4
A

4

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14
Q

Which one of the following medicines does NOT affect the monoamine oxidase enzyme family?

Selegiline
Linezolid
Moclobemide
Phenelzine
Clonidine
A

Clonidine

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15
Q

Mrs Smith has been taking 800 units of ergocalciferol for 2 weeks now because she has a lack of vitamin D.

She develops nausea and has now vomited. What is the likely reason for this?

  • The vitamin D may have led to an increase in serum calcium causing the symptoms
  • The vitamin D therapy may have decreased serum calcium causing the symptoms
  • The preparations of ergocalciferol are generally not well tolerated
  • If ergocalciferol is given without calcium, it may cause this symptom
  • These symptoms are unrelated to Mrs Smith’s therapy
A

The vitamin D may have led to an increase in serum calcium causing the symptoms

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16
Q

Which of the following is NOT a requirement for pregabalin?

  • Dose on prescription
  • Drug formulation on prescription
  • Drug strength on prescription
  • Safe custody
  • Total quantity in words and figures on prescription
A

Safe custody

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17
Q

Which of the following will facilitate the absorption of calcium?

  • Ascorbic acid
  • Colecalciferol
  • Hydroxycobalamin
  • Pyridoxine
  • Phytomenadione
A

Colecalciferol

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18
Q

Which of the following requires a dose reduction with concomitant use of verapamil?

Warfarin
Rivaroxaban
Dabigatran
Apixaban
Phenindione
A

Dabigatran

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19
Q

Which of the following non-prescription topical preparations is to be used with caution in patients taking phenytoin?

HC45® hydrocortisone 1% cream
Clotrimazole 2% cream
Daktarin® oral gel
Zovirax® 5% cream
Benzoyl peroxide 4% cream
A

Daktarin gel

Miconazole enhances anticonvulsant effect of phenytoin (plasma concentration enhanced) although with topical use, the risk is lower.

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20
Q

Which of the following medications are listed in the BNF as suitable for treatment of pruritus?

Carbamazepine
Cinnarizine
Hydroxyzine hydrochloride Ketotifen
Loratadine

A

Hydroxyzine hydrochloride

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21
Q

Which one of the following medicines does NOT stimulate the pancreas to release insulin?

Gliclazide
Exenatide
Canagliflozin
Vildagliptin
Repaglinide
A

Canagliflozin - reversibly inhibits SGLT2 in the kidney to reduce glucose reabsorption and increase urinary glucose excretion.

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22
Q

Which one of the following risk factors is NOT a trigger factor for GORD?

Smoking
Verapamil
Stress
Travelling abroad
Obesity
A

Travelling abroad

Trigger factors for GORD include: drugs which cause lower oesophageal sphincter relaxation (e.g. calcium channel blockers), smoking, alcohol, obesity and stress.

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23
Q

Miss M is a 29 year old pregnant women with suprapubic pain over the past 4 days and a “burning” sensation on urination.

Given that Miss M is in her first trimester of pregnancy and is not on any other medication, which one of the following antibiotics is the most appropriate for her condition?

Ciprofloxacin 250 mg twice daily
Doxycycline 200 mg once daily Nitrofurantoin 50 mg four times a day
Ofloxacin 200 mg daily Trimethoprim 200 mg twice daily

A

Nitrofurantoin 50 mg four times a day

Trimethoprim should not be given in the first trimester

Quinolone antibiotics should be avoided

Doxycycline affects the skeletal development so should be avoided

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24
Q

Which ONE of the following can cause urine to be coloured pink or orange?

Warfarin	 	
Rivaroxaban
Dabigatran
Apixaban
Phenindione
A

Phenindione

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25
Q

A mother requests a product over the counter for her 7 year old son who is suffering from a cold.
She wants to purchase a nasal decongestant containing xylometazoline. What is the maximum length of time the child should use it for?

Two days
Three days
Five days
Seven days
A child this age must not use it
A

5 days

Otrivine child nasal drops can be used for 6-12 years

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26
Q

Your dispenser is measuring out the daily methadone liquid prescriptions. As she returns the bottle to the cupboard she drops it and it smashes on the floor.
What is the most appropriate way to clear up the spillage?

  • Clear up with tissue and denature
  • Clear up with tissue and store in a bag in the CD cupboard
  • Clear up with tissue and throw in the bin
  • Mop up the floor and pour waste water down the drain
  • Mop up the floor and pour waste water into denaturing kit
A

Clear up with tissue and store in a bag in the CD cupboard

Destruction of stock of a CD should be witnessed by an authorised person. This includes spillages. Therefore, the spillage should be cleaned up and kept in the CD cupboard until destruction can be witnessed.

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27
Q

Mrs R is a patient who has AIDS. She has been diagnosed with mild pneumocystis pneumonia. She is unable to tolerate trimethoprim.

Which single medication is the most likely treatment option for her pneumonia?

  • Atovaquone
  • Co-trimoxazole
  • Pentamidine
  • Hydrocortisone
  • Prednisolone
A

Atovaquone

Co-trimoxazole is made up of sulfamethoxazole and trimethoprim - Note that Mrs R can not tolerate trimethoprim

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28
Q

Which of the following Benzodiazepine drugs belongs to Schedule 3 of the Controlled Drugs list?

Alprazolam
Diazepam
Nitrazepam 	
Oxazepam
Temazepam
A

Temazepam

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29
Q

Treatment pack of chloramphenicol must not exceed what volume pack size?

A

10mL

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30
Q

Dermatophytic onychomycosis is a fungal infection of:

Nails
Scalp
Oral cavity
Genitals
Soles of the feet
A

Nails

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31
Q

Mrs G is a 27 year old student who presents with red scaly patches on her cheeks, eyebrows and hairline. She has had these patches for 2 years now.
Which one of the following conditions is Mrs G most ikely to have?

Atopic eczema Candidiasis
Psoriasis
Seborrhoeic dermatitis
Tinea faciei

A

Seborrhoeic dermatitis

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32
Q

Which of the following laxative agents can cause interference of fat soluble vitamins?

Lactulose	 	
Liquid paraffin
Co-danthramer
Sodium docusate
Movicol®
A

Liquid paraffin

33
Q

Coughs that last longer than how many weeks prompt a referral?

A

Longer than 3 weeks

34
Q

Which ONE of the following is NOT a reason to STOP the combined oral contraceptive pill?

Sudden breathlessness
Severe stomach pains Hypertension - 150/90 mmHg Jaundice
Unexplained swelling of the calf of one leg

A

Hypertension - 150/90 mmHg

Only blood pressure above systolic 160mmHg or diastolic 95mm Hg is a reason to stop the combined oral contraceptive pill.

35
Q

Mr N is worried about the abdominal pain, nausea and vomiting he has recently been suffering from. You know he is usually prescribed sodium valproate for the management of his epilepsy.

What advice should you give?

  • There is no connection between his medication and the symptoms he’s describing, you could suggest over the counter symptomatic relief
  • These are normal side effects of the medication, nothing to worry about
  • Seek immediate medical attention
  • Advise Mr N to go to his GP, as the dose of sodium valproate might need to be increased
  • Advice Mr N to go to his GP, as the dose of sodium valproate might need to be decreased
A

Mr N should seek immediate medical attention, as the symptoms he describes may be indicative of sodium valproate-induced pancreatitis.

36
Q

A patient presents in your pharmacy and asks you for advice.
When he was cleaning his teeth this morning, he noticed bleeding from his gums. He is taking no medicines and is otherwise healthy. What is the best course of action?

  • Advise the patient to stop brushing his teeth for 48 hours
  • Recommend the patient brush his teeth four times daily
  • Recommend the patient floss between his teeth
  • Tell the patient he needs to see a dentist urgently
  • Tell the patient he needs to see his GP
A

Flossing between teeth to clean this area is advised to help with bleeding gums.

37
Q

What does the latin abbreviation p.c. mean on prescriptions?

A

After food

38
Q

For which of the following antiepileptic drugs should you ensure the same brand is dispensed each time?

Carbamazepine
Ethosuximide
Gabapentin
Levetiracetam
Pregabalin
A

Carbamazepine

Category 1: Carbamazepine, Phenobarbital, Phenytoin, Primidone

Need to prescribe these by brand

39
Q

Which option, when stopped suddenly, is the most likely to cause withdrawal symptoms?

  • 40 mg prednisolone for 5 days
  • 25 mg prednisolone for 14 days
  • 10 mg prednisolone for 21 days
  • 20 mg prednisolone for 10 days
  • 40 mg prednisolone for 10 days
A

40 mg prednisolone for 10 days

Gradual withdrawal should be considered for patients receiving more than 40 mg prednisolone (or equivalent) daily for more than 1 week.

40
Q

Mrs T comes into the hospital with a potassium level of 7 mmol/L (range 3.5-5.3) so she is diagnosed with hyperkalaemia.

Which drug is most likely to have caused the hyperkalaemia?

  • Citalopram
  • Enoxaparin
  • Furosemide
  • Naproxen
  • Salbutamol
A

Enoxaparin

41
Q

Which one of the following is NOT a legal requirement for a CD requisition?

  • Address if recipient
  • Date of requisition
  • Occupation of recipient
  • Purpose of requisition
  • Signature of recipient
A

Date of requisition

The legal requirements for a controlled requisition are: signature of the recipient, name of recipient, address of recipient, profession/occupation, total quantity of drug and purpose of requisition.

42
Q

Mrs X, is a 55 year old patient. She has recently been suffering from acute migraine attacks which have not responded to paracetamol. She has a history of ischaemic heart disease.
Which of the following medications is the most suitable to treat her migraine?

  • Metoclopramide and aspirin
  • Almotriptan
  • Naratriptan
  • Rizatriptan
  • Sumatriptan
A

Metoclopramide and aspirin

Triptans are contraindicated in those with ischaemic heart disease

43
Q

A doctor calls you to ask what dose of atorvastatin her patient should be transferred to. The patient was previously on simvastatin 40 mg daily. What is a suitable dose?

  • 10mg
  • 20mg
  • 30mg
  • 40mg
  • 80mg
A

10mg

44
Q

Which of the following antisecretory and mucosal protectant drugs may cause severe diarrhoea which may require withdrawal of this drug?

Cimetidine
Misoprostol	
Paracetamol
Ranitidine
Tripotassium dicitratobismuthate
A

Misoprostol

45
Q

Mrs H comes to collect her prescription for candesartan regularly from your pharmacy. She has recently been prescribed lithium for the treatment of depression. She comes into your pharmacy disorientated and complains of diarrhoea and vomiting.
What do you suspect may be the most likely cause of Mrs H’s presentation?

  • Gastro-intestinal disturbances are a side effect of candesartan
  • Candesartan could cause hypernatraemia which is causing lithium toxicity
  • Lithium toxicity secondary to Mrs H taking extra doses of lithium
  • Taking candesartan could lead to lithium toxicity
  • She has an infection
A

Taking candesartan could lead to lithium toxicity

46
Q

A pregnant woman comes in to your pharmacy. She tells you that her friend has told her that ‘she should check if she has had a rubella vaccination and if she is immune to Rubella’.
What can a rubella infection cause in pregnant patients who DON’T have immunity to rubella?

  • Develop flu-like symptoms, such as sore throat and swollen glands
  • Future infertility in the woman
  • Lead to premature labour
  • Nothing
  • Organ damage to the foetus during the early stages of the pregnancy
A

Organ damage to the foetus during the early stages of the pregnancy

47
Q

You are dispensing a prescription for sodium valproate for Mrs DS who is 26 years old.
When dispensing the prescription, you ask if she has signed a risk acknowledgement form, but she says that she hasn’t. What should you do?

  • Dispense the prescription, but advise the patient to see her GP as soon as possible
  • Dispense the prescription without taking any further steps
  • Do not dispense the prescription and advise the patient to see her GP as soon as possible
  • Do not dispense the prescription and alert the GP that you have not dispensed it
  • Do not dispense the prescription as this form should be signed before the prescription can be dispensed
A

Dispense the prescription, but advise the patient to see her GP as soon as possible

As per government advice:

Check whether women are enrolled in the Pregnancy Prevention Programme and have signed a Risk Acknowledgement Form (updated March 2019) – if not, dispense the prescription and advise the patient to speak to her GP as soon as possible (including by contacting the GP directly if necessary) for a specialist referral

48
Q

Which of the following is NOT true regarding entries into the controlled drug register?

  • A separate register is used for each class of drugs
  • Entries must be in chronological order
  • Entries must be in indelible ink
  • Entries must be made on day of the transaction or within the following five days
  • The register must not be removed from the premises at any time during use
A

Entries must be made on day of the transaction or within the following five days

Entries into the CD register must be made either on the day of transaction or the FOLLOWING day.

49
Q

Mrs N explains that her 5 year-old niece has sores around her mouth and nose that quickly burst to leave a yellow-brown crust.
Which bacterium do you suspect could have caused this infection?

Helicobacter pylori Streptococcus pyogenes Escherichia coli
Sarcoptes scabiei
Streptococcus pneumoniae

A

The description the patient has given is that of impetigo secondary to infection with bacteria, usually Staphylococcus aureus or Streptococcus pyogenes.

50
Q

Mrs L brings her 6 year old child into your pharmacy. The child has scabies. The mother would like to purchase a cream, which might stop the child from itching and causing a secondary infection.
Which of the following creams could you recommend for non-prescription supply?

  • Crotamiton cream 10% (Eurax®)
  • Titanium dioxide cream (Metanium®)
  • Cod liver oil and zinc oxide cream (Morhulin®)
  • Hydrocortisone cream 1%
  • Clotrimazole 1% cream
A

Crotamiton cream is recommended for itching post scabies infection, other creams are not.

51
Q

For CPR, what is the ratio of chest compressions to breaths needed?

A

30 chest compressions

2 breaths

52
Q

If unopened, the shelf life of GTN tablets is what?

A

24 months

53
Q

Which of the following prescribers CANNOT request an emergency supply of a prescription-only medicine?

Supplementary nurse prescriber
Swiss doctor
Vet
Dentist
Community nurse prescriber
A

Vet

54
Q

How much longer after MMF treatment can a male and a female conceive?

A

For a woman- 6 weeks after stopping (until then, need adequate contraception)

For a man - 90 days after (Females who’s male partner has been taking mycophenolate should use contraception for 90 days after their partner discontinues using the medicine.)

55
Q

True or false:

Oxytocin is used for the induction of labour

A

True

56
Q

A Doctor requests an emergency supply of a drug for a patient, when must the doctor present the prescription to the pharmacy?

Within 24 hours
Within 48 hours
Within 72 hours
Within 84 hours
Within 96 hours
A

Within 72 hours

57
Q

A woman is breastfeeding her four week old baby and the baby has oral thrush. Her and her baby are being treated for the condition. She asks you about expressing milk. What is the best advice to give the lady?

  • Advise her that expressing milk is not advised when treating oral thrush
  • Advise her to freeze the expressed milk before using it
  • Advise her to refrigerate the expressed milk before using it
  • Advise her to use the expressed milk only while she and the baby are undergoing treatment
  • Refer her to her health visitor
A

Advise her to use the expressed milk only while she and the baby are undergoing treatment

58
Q

Which of the following drugs may antagonise analgesic effects of other opioids?

Buprenorphine	 	
Codeine
Ibuprofen
Morphine
Paracetamol
A

Buprenorphine is a partial agonist/partial antagonist and will block, or antagonise, the effects of other opioids.

59
Q

A patient newly started on tuberculosis treatment comes into your pharmacy with a bowel complaint.
What is the most likely cause of flatulence?

  • Ethambutol
  • Rifampicin
  • Isoniazid
  • Streptomycin
  • Pyrazinamide
A

Ethambutol

60
Q

Which of the following medications can cause QT prolongation?

  • Bendroflumethiazide
  • Chlorphenamine
  • Ciprofloxacin
  • Paracetamol
  • Sodium valproate
A

Ciprofloxacin

61
Q

What is the maximum duration of treatment which can be given via over the counter chloramphenicol?

  • 2 days
  • 3 days
  • 5 days
  • 7 days
  • 10 days
A

5 days

62
Q

The responsible pharmacist is allowed to be away from the Pharmacy for up to 2 hours, and that they are the only pharmacist working at the pharmacy, which one of the following activities could you do in their absence?

  • Hand over medications to a patient, which had been dispensed and checked earlier in the day
  • Provide insulin, as an emergency supply, to a diabetic patient
  • Supply Beconase® 0.05% Hayfever Nasal Spray 100 dose pack to a patient with hayfever
  • Supply chloramphenicol eye drops to a patient with conjunctivitis
  • Supply 2 packs of 32 tablets of paracetamol to a patient with osteoarthritis
A

Supply Beconase as it is a GSL medicine

63
Q

Which of the following laxative agents is first line for faecal impaction in a patient with hard stools?

  • Lactulose
  • Liquid paraffin
  • Co-danthramer
  • Sodium docusate
  • Macrogols
A

Macrogols

64
Q

What does a.u mean on a prescription?

A

Both ears

65
Q

Which of the following beta blockers is not a once daily regimen for angina?

  • Atenolol
  • Bisoprolol
  • Nadolol
  • Celiprolol
  • Propranolol
A

Propranolol

66
Q

A patient is breastfeeding her four week old baby and the baby has oral thrush. She has been prescribed miconzaole cream for herself but she is unsure what to do with it. What is the best advice to give to the lady?

  • Advise her that this is not the correct treatment for her
  • Advise her to apply it to her nipples after feeding the baby
  • Advise her to apply it to her nipples before feeding the baby
  • Advise her to stop breastfeeding while undergoing treatment
  • Refer her to her health visitor
A

Advise her to apply it to her nipples after feeding the baby

67
Q

Which of the following creams/ointments could stain clothing?

  • Betamethasone valerate/clioquinol cream
  • Daktacort® ointment
  • Fucibet® cream
  • Locoid® ointment
  • Synalar N® cream
A

Betamethasone valerate/clioquinol cream

68
Q

Co-careldopa can turn urine what colour?

A

Dark red

69
Q

What does the latin abbreviation a.c. mean on prescriptions?

A

Before food

70
Q

How long should the pharmacy record be kept for?

A

5 years

71
Q

For which of the following antiepileptic drugs should you consult the prescriber to establish if the same brand is to be dispensed each time?

  • Carbamazepine
  • Gabapentin
  • Lamotrigine
  • Levetiracetam
  • Vigabatrin
A

Lamotrigine

In Category 2

72
Q

Of the following controlled drugs, which is allowed to be issued via a repeat prescription? For example the prescriber may write on the prescription ‘Repeat x 3’?

  • Lorazepam
  • Pethidine
  • Methadone
  • Morphine
  • Temazepam
A

Lorazepam

CD4 drugs are allowed on repeats

73
Q

Omeprazole is said to ‘reduce the antiplatelet activity’ of this drug if given concurrently.
What drug interacts with omeprazole in this way?

  • Apixaban
  • Aspirin
  • Dalteparin
  • Clopidogrel
  • Dipryidamole
A

Clopidrogrel

74
Q

Folic acid is what vitamin?

A

B9

75
Q

Which of the following can lower seizure threshold?

  • Aspirin
  • Bisoprolol
  • Sertraline
  • Ramipril
  • Isosorbide mononitrate MR
A

Sertraline

76
Q

Which one of the following is the most suitable counselling advice you should offer with bromocriptine?

  • Report a skin rash on your chest immediately to your doctor
  • Report any signs of tremor immediately to your doctor
  • Take this at least 2 hours after other medications
  • Take this medication in the morning
  • You may experience low blood pressure initially with this medication so take extra care to avoid falls
A

You may experience low blood pressure initially with this medication so take extra care to avoid falls

Hypotensive reactions can occur in some patients taking dopamine-receptor agonists; these can be particularly problematic during the first few days of treatment and care should be exercised when driving or operating machinery.

Excessive daytime sleepiness and sudden onset of sleep can occur with dopamine-receptor agonists.

Take at night

77
Q

What is the hierarchy of evidence?

A
  1. Systematic reviews/meta-analysis
  2. RCTs
  3. Non RCTs
  4. Observational studies
  5. Case reports
78
Q

Are systematic reviews or randomised controlled trials a more robust form of evidence?

A

Systematic review (same as meta-analysis)

BNF (21 decks)

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