Passmed

Question 1

2 medications given at night

Answer 1

statins

amitriptilline

Question 2

2 medications given once weekly

Answer 2

methotrexate

bisphosophonates

Question 3

Presentation of Acne Rosaecea

Answer 3

nose, cheeks and forehead
flushing 
telangiectasia are common
later develops into persistent erythema with papules and pustules
rhinophyma
ocular involvement: blepharitis
sunlight may exacerbate symptoms/

Question 4

Mx of Acne Rosaecea

Answer 4

Topical metronidazole for mild

Severe - oxytetracycline

Question 5

Presentation of Acne subtypes

Answer 5

Mild: open/closed comedones without inflammation lesions

Moderate: widespread non inflammation lesions with numerous papules/pustules

Severe: extensive inflammatory lesions including nodules, pitting, scarring

Question 6

Mx of Acne vulgaris

Answer 6

Topical: retinoids, benzoyl peroxide

Oral AB: tetracyclines (doxy) Unless pregnancy/breast feeding or under 12

COCP
Oral isotretinoin - only specialst.

Question 7

Examples of typical antipsychotics

Answer 7

Haloperidol

Chlorpromazine

Question 8

Examples of atypical

Answer 8

Olanzapine
Clozapine
Risperidone

Question 9

What are side effects of antipsychotics?

Answer 9

Anti-muscarininc like blurry vision, urinary retention, constipation
Weight gain
Prolactin
Glucose intolerance
neuroleptic malignant syndrome
Reduced seizure threshold (higher with atypical)
prolonged QT esp haloperidol

Question 10

General advise regarding antipsychotics

Answer 10

FBC, U&E, LFT at start and annually. Clozapine is exception 18w

Lipids, weight - start, 3 months and annual

FBG, PRL - start, 6 months, annual

BP - baseline and dose titration
ecg baseline
CVS risk assessment annually

Question 11

Children Asthma

Answer 11

SABA
SABA + ICS
SABA + ICS + LTRA
SABA + ICS + LABA
MART + SABA

Question 12

Reducing benzo

Answer 12

1/8 of daily dose, reduce every 2w.

Switch its to diazepam equivalent dose and reduce by 2 - 2.5mg every 2-3 weeks.

Question 13

Drugs to avoid in pregnancy

Answer 13

AB: tetracycline, ciproflaxin, chloramphenicol, sulphanimdes

Pysch - lithium, benzo
Aspirin
Carbimazole
Methtrexate
Sulphonylurea
Amiadroone

Question 14

C.I to the COCP

Answer 14

>35 yrs and smoking >15
aura
VTE
Stroke/IHD
Breast Ca
Immobilization post surgery
uncontrolled HTN
Breastfeeding <6w pp

Question 15

COCP risks

Answer 15

Increases clots, strokes, heart attack

Breast ca and Cervical ca

Question 16

Common drug doses of analgesia:
Ibuprofen
Codeine
Co-codamol

Answer 16

Ibuprofen - 200-500mg TDS
Codeine - 30-60mg QDS
Co-codamol 8/500 2 tablets QDS

Question 17

Doses of cardiovascular drugs:
Clopidogrel
Simvastatin
Atenolol
Ramipirl
Bendro
Furosemide
Amlodipine

Answer 17

Clopidogrel 75-300mg OD
Simvastatin - 10-80MG on
Atenolol 25-100MG od
Ramipirl 1.25 -10mg OD
Bendro 2.5mg OD
Furosemide - 20 mg OD 
Amlodipine 5-10mg od

Question 18

Emergency contraception

Answer 18

Levonorgestrestel - 72 hrs
Ulipristal 120
IUD 5 days

Question 19

Anxiety managmnet

Answer 19

Education
Psychotherapy
SSRI - sertraline 1st
2nd SNRI - duloxetine or venlafaxine

Question 20

Implantable contraceptive advice regarding onset

Answer 20

IUD - copper and works straight away.

IUS- Mirena - 7 days.

Question 21

Lithium monitoring

Answer 21

12hrs post dose.
Range 0.4-1

Weekly checks after starting until dose is established then checked blood levels 3monthly

Thyroid ans renal checks 6 monthly

Question 22

Adverse effects of lithium

Answer 22

N&V
Fine tremor
nephrotoxicity
D.I
Thyroid enlargement
ECG: T wave flattening
weight gain
IHTN
Thyroid and calcium

Question 23

Adverse effects of retinoids such as isotretinoin

Answer 23

Teratogenic
Dry skin/liips/mouth/eyes
Low mood
Triglycerides
Hair thinning
Nose bleeds
photosensitivity

Question 24

Interctions of citalopram

Answer 24

NSAIDS
Warfarin
SSRI
Aspirin
Triptans
MAOI

Question 25

TCA side effects

Answer 25

``` Drowsy Dry mouth Blurred vision Constipation Urinary retention WT prolongation ```

Question 26

Mx of stress incontinence

Answer 26

Pelvic floor | Duloxetine

Question 27

Mx of urge incontinence

Answer 27

Bladder retraining | Oxybutynin

Question 28

What can be used as VTE prophylaxis?

Answer 28

Fondaparinux SC LMWH like enoxaparin (dose reduced for renal) UFH - if CKD

Question 29

Therapeutic drug monitoring for: | Digoxin

Answer 29

6hrs post dose

Question 30

Therapeutic drug monitoring for: | Phenytoin

Answer 30

No routine monitoring | Trough level before dose checked if suspect toxicity, non-adherence, adjustment of dose.

Question 31

Monitoring for statins

Answer 31

LFT baseline, 3 + 12 months

Question 32

ACEI monitoring

Answer 32

U&E prior, annual and dose adjustment

Question 33

Amiodarone monitoring

Answer 33

TFT, LFT,U&E, CXR prior to treatment TFT, LFT, 6 monthly

Question 34

Methotrexate monitoring

Answer 34

FBC, LFT, U&E - start and weekly till stable then 2-3 monthly

Question 35

Glitazone monitoring

Answer 35

LFT before treatment, regularly during treatment

Question 36

Azathiorpine monitoring

Answer 36

FBC, LFT before treatment. FBC weekly for the first 4 weeks. | FBC, LFT 3 monthly

Question 37

Lithium Monitoring

Answer 37

TFT, U&E prior to lithium until stable then 3 monthly TFT, U&E 6 monthly

Question 38

Sodium Valproate Monitoring

Answer 38

LFT, FBC before | LFT 6 monthly

Question 39

Drugs impairing glucose tolerance

Answer 39

``` Thiazide, furosemide Steroids Tacrolimus, cyclosporin Interferon Nicotinic acid antipsychotics ```

Question 40

Drug induced urinary retention

Answer 40

``` tricyclic antidepressants e.g. amitriptyline anticholinergics opioids NSAIDs disopyramide ```

Question 41

Drugs causing lung fibrosis

Answer 41

amiodarone cytotoxic agents: busulphan, bleomycin anti-rheumatoid drugs: methotrexate, sulfasalazine nitrofurantoin ergot-derived dopamine receptor agonists (bromocriptine, cabergoline, pergolide)

Question 42

TB side effects medications

Answer 42

R - hep, secretions I - neuropathy and hep P - hep, arthralgia, myalgia E - optic neuritis (VA)

Question 43

When should aspirin not be used?

Answer 43

<16 - risk of Reyes, unless Kawasaki

Question 44

S.E of tamoxifen

Answer 44

menstrual disturbance hot flushes VTE Endometrial cancer

Question 45

What drugs may worsen heart failure?

Answer 45

NSAID Thiazolid - pioglitazone verapamil Flecainide

Question 46

Drugs to avoid in asthma/COPD

Answer 46

NSAIDS BB Adenosine

Question 47

Mx of opiate OD

Answer 47

Naloxone

Question 48

Mx of paracetamol OD

Answer 48

<1hr activated charcoal | NAC

Question 49

Mx of benzo overdose

Answer 49

Flumazenil

Question 50

TCA overdose

Answer 50

IV BICARBONATE

Question 51

Metformin adverse effects

Answer 51

GI | Lactic aciddosis

Question 52

Metformin c.i

Answer 52

CKD Egfr<30

Question 53

Gentamicin C.I + adverse effects

Answer 53

CI = MG | Adverse: ototoxicity, nephrotoxicity

Question 54

SVT mx

Answer 54

Vagal manœuvres - valsalva, carotid sinus massage Adenosine. - 6, 12, 12 (verapamil if asthma) Unless asthma

Question 55

ABx for CAP

Answer 55

Amoxicillin unless allergic | Doxy

Question 56

Abs for pneumonia with an atypical pathogen

Answer 56

Clarithromycin

Question 57

Abx for HAP

Answer 57

CO-amoxiclav

Question 58

Mx of impetigo

Answer 58

Topical hydrogen peroxide | Oral fluclo or erythromycin if widespread

Question 59

Mx of cellulitis

Answer 59

flucloxacillin

Question 60

Azathioprine S.E

Answer 60

BM depression N&V Pancreatitis safe in pregnancy

Question 61

C.diff infection mx

Answer 61

Metronidazole

Question 62

Drugs increasing potassium

Answer 62

ACEI ARB Spiro K sparing

Question 63

Drug decreasing potassium

Answer 63

Thiazide | Loop

Question 64

Drugs causing peripheral neuropathy

Answer 64

Amiodarone Isoniazid Nitro Metronidazole

Question 65

When should hartmaans not be used?

Answer 65

Hyperkalaemia

Question 66

Types of insulin

Answer 66

novorapid - insulin aspart Humalog - insulin lisper Short acting - actarapid Long acting - Lantus (Glargine) and determiner )Levemir)

Question 67

Types of laxatives

Answer 67

Osmotic - lactulose Stimulant - SENNA, DOCUSATE, BISACODYL Bulk forming - methylcellulose Faecal softener

Question 68

Metoclopromide adverse effects

Answer 68

Extrapyramidla Hyperprolactinaemia Tardive dyskinesia Parkinsnism Avoid in bowel obstruction, good in paralytic ileum

Question 69

Migraine Mx and prophylaxis

Answer 69

Mx - triptan | Prophylaxis - propranolol or topiramate

Question 70

Opioid conversion: | Oral morphine to SC morphine

Answer 70

Divide by 2

Question 71

Side effects of methotrexate

Answer 71

Myelosuppression Lover cirrhosis Pneumonitis

Question 72

Side effects of sulfasalzine

Answer 72

Rash oligospermia Interstitial lung disease

Question 73

Adverse effects of spironolactone

Answer 73

Hyperkalaemia | Gynaecomastia

Question 74

Mx of trigeminal neuralgia

Answer 74

Carbamazepine

Question 75

What may reduce hypoglycaemic awareness?

Answer 75

BB

Question 76

Can warfarin be given in pregnancy?

Answer 76

No

Question 77

Drugs to take at night

Answer 77

Statin | Amitriptilline

Question 78

What is carbimazole?

Answer 78

anti-thyroid

Question 79

What is carbmazepine?

Answer 79

anti-epileptic

Question 80

What is chlorphenamine

Answer 80

anti histamine

Question 81

What is chlorpromazine?

Answer 81

anti psychotic

Question 82

Types of extrapyramidal side effects

Answer 82

Acute dystonia Akithesis Parkinsonism Tardive dyskinesia

Question 83

What type of drug is amitriptilline?

Answer 83

TCA

Question 84

SE of TCA

Answer 84

``` Common side-effects drowsiness dry mouth blurred vision constipation urinary retention lengthening of QT interval ```