Prior Exam Flick Flashcards
Live vaccine administration?
Nasal
Inactive Vaccine administration form?
IM (intramuscular)
PMDI inhaler how to administer?
Slow & Deep
DPI (Dry powder) how to administer?
Quick forceful & Deep
Tetracyclines affect on INR?
Tetracycline Increases INR levels
5FU reaction Uv damage?
Expected so medical attention if hard to adhere
If constipated/ nausea when taking iron?
Give iron on alternate days
Which drug to give for oestrogen breast cancer to stop recurrence?
Tamoxifen
Hypertension step up treatment if you have to add a Thiazide?
Indapamide
If P Value is statistically significant?
0.5 or less
Measles mouth symptoms?
White spots in mouth
Scarlet fever mouth symptoms?
White coating on tongue peeling to a
Strawberry tongue
Also sandpaper skin
Clozapine monitor which blood component?
Monitor leukocytes & differential bloods
Monitor Before initiation as can lead to Agranulocytosis
Vaccine for whooping cough?
Boostrix IPV
Flu vaccine who else is eligible to take?
COPD pt can take
Pre contemplation example?
Pt not interested in quitting
ie not contemplated yet
If muscle cramps with metformin?
Urgent Referral
Hypoglycaemia what to take in the case of it occurring?
3-4 tablespoons of sugar
4-5 glucose tabs
150-200ml juice
DEXTROSE /Glucogel
IM Glucose -> if not responding -> IV
Heartburn step up from Gaviscon?
Esomeprazole/Omeprazole 20mg
Eczema Step up from Emollient?
Hydrocortisone 1%
SABA + Low dose ICS next Step up?
LTRA (NICE)
Or
LABA (BTS)
Moderate asthma attack?
Salbutamol 8-10 puffs
Severe Asthma Attack?
Salbutamol nebulised Oxygen +/- Ipatropium
Acute Asthma attack life threatening?
IV Aminophylline
Ulipristal and Breastfeeding, how long should you wait?
1 Week Delay
Ulipristal caution in which pt group?
Severe Asthmatics
Levonorgestrel how long to wait to Breastfeed?
No Delay!
Levonorgestrel caution in which patient group?
Malabsorption patients
Lidocaine and Pregnancy
Not to use lidocaine in pregnancy
Patches - which test to remove them in?
MRI
Which abx & Methotrexate increases toxicity?
Amoxicillin (Penicillin) - Bruising, mouth ulcer
Safest Anti-epileptic in pregnancy?
Levetiracetam / Lamotrogine
What is Med Reconciliation?
Pt lists meds usually themselves to check they know how to take them
Which opiod pt’s should avoid patches?
Opiod Naive patients - not daily basis
Lipodystrophy also confused with what?
Cutaneous Amyloid
Drug driving pharmokinetics usually in which stage? (Resource q so not always same)
Metabolism
Which anti emetic has a risk of oral cleft?
Ondansetron
Which med causes Tourette’s/Tic
Methylphenidate
Sorethroat otc med?
Flurbiprofen (Strefen)
Warfarin - Which OTC med interacts?
OTC Miconazole - increases INR
Warfarin and Tramadol?
INR increases
Daktarin oral gel minimum age?
4 months
Hydrocortisone maximum applications?
2 times out of- 8-12hrs apart
CD 2/3 which address types are not acceptable?
PO BOX address
Why should insulin needles not be used again?
Becomes blunt after single use
Clopidogrel should not be used in which condition long term?
Stroke prevention
HRT and Osteoporosis?
Osteoporosis is a benefit in HRT use
Nicorandil, Amlodopine and Isosorbide mononitrate all can have which side effect at treatment initiation?
Headache
Abiraterone common sign?
Heart Failure
Which abx can cause cholestatic jaundice?
Co-amoxiclav
Most time efficient and accurate study?
Systematic review
Bradycardia BPM?
Under 60bpm
Smells like fish?
Bacterial Vaginosis
Cottage cheese white and thick?
Thrush
Green, yellow or frothy?
Trichomoniasis
Vagina- Blister/Sores
Genital Herpes
Vagina - Pelvic pain/Bleeding?
Chlamydia or Gonorrhoea
Pioglitazone avoid in CVD?
Yes HF pts especially
Nebivolol and HF? Licensed or not? Age?
Yes licensed for 70years+
Constriction of Pupil?
Miosis
Dilation of Pupils?
Mydriosis
When to monitor Theophylline levels?
4-6hrs after dose
5 days after oral dose
3 days after dose adjustments
Do not Abrupt withdrawal corticosteroids in which conditions?
> 40mg Pred for more than 1 week
Repeat dose in evening
> 3wk treatment
Short course within 1 year of stopping
Pt repeated course (espec over 3wks)
Tramadol and epilepsy?
Tramadol lowers seizure thresholds
Levothyroxine monitor which attribute more?
TSH
Benign Prostate Hyperplasia treatment?
(CANNOT EMPTY BLADDER FULLY)
Alpha Blocker or Finasteride
Which tabs are moisture sensitive?
Nicorandil or Effervescent tabs or Sodium Valproate
Moisture sensitive for 30days out of package
Urinary frequency treatment?
Solifenacin, Tolteride, Oxybutynin
(Antimuscarinic)
Supervised consumption essential service or Advanced?
Essential service
Blood dyscrasia which drugs?
Carbomazole, Clozapine, Chloroquine, Chloropromazine
Warfarin for DVT Duration?
12 weeks
Chest compressions?
100-120 times
Which drug causes breast tenderness or libido change?
Spironlactone
Lowest Risk CVD of NSAIDs ?
Naproxen 1000mg Daily
Or
Ibuprofen 1.2g Daily
Lowest risk of Gi side effect NSAIDS?
Cox selective - Celoxib
Jerking muscles - Prokinetic treatment?
Metoclopramide
Carbamazepine and DOACS?
Carbamazepine decreases exposure of DOACS
If on CYP inducer for past 4 weeks 1st line contraceptive?
Copper IUD
Contraception if on CYP inducer for past 4 weeks - 2nd line and pt is 16+?
Double Levornorgesterol
Which emergency contraceptive should not be given in double dose when taking CYP inducer?
Ulipristal
An expiry of June 2025 means when?
End of June 2025 so 31/6/25
If pt had back pain and fewest opiod side effects?
Tramadol
Which DOAC does not require parental overlap?
ONLY Apixaban
How long parental overlap does Dabigatran/Edoxaban need?
5 days
Cyclophosphamide to avoid bladder toxicity, which drug is given as well?
Mesna
If a drug is toxic which levels should be checked?
Serum conc of Drug
Which drug causes Flushing body, Face, Neck?
Red man - Vancomycin
Tablet form of GLP-1?
Repaglinide
Retain signed order for how long?
2 years
CD Register retain for?
2 years
Pt using phenoxymethylpenicillin and Hydroxycarbamide classic case for treating what?
Sickle Cells
If Long time (eg >1yr) has flat patch, sideways, which condition most likely?
Melanoma
Which med should not be administered unless 4-6hrs after med or 1 hr before?
Colestyramine
Affects Absorption Meds
Which drug causes Oedema?
CCB
Breastfeeding analgesic?
Ibuprofen/Paracetamol
Which CD Require denature before disposal?
CD Sch 2,3,4
Decongestant for 6-12 years?
Sudafed liquid
Over 80 BP Target?
<150/90mmHg
NSAID contraindicated in which condition?
Heart failure
Levothyroxine efficacy reduced by what supplements?
Calcium and iron
Formeterol can cause what and as a result what happens to the dose?
Liver Cirrhois - Reduce dose
What Asthma drug causes shaky tremor?
Salmeterol - Beta 2 Agonist
What does Gabapentin with other opioids such as morphine cause?
Respiratory Depression
Which drug is Severely contraindicated in Sildenafil?
GTN - Causes Hypotension
Sulphasalazine causes which condition?
Hepatotoxicity
Lithium post dose duration?
12 hours
If Angina is not managed well with beta blocker what can be added?
CCB
Folic acid deficiency treatment?
5mg Folic acid
Vitamin B9?
Folate deficiency
Folic acid in pregnancy general with pt with no risks?
400mcg folic acid
Baby with yellow crusty patch skin condition?
Cradle cap
Digoxin toxicity can cause imbalance in what electrolyte
Hypercalcaemia ^
Hypokalaemia, Hypomagnesemia
What Nasal drops can a kid between 6-12 yrs use for congestion relief?
Xylometazone - 5 days use
What laxative can be given to clean bowels before colonoscopy?
Magnesium w/ Picosulphate
Co-codamol on a EU rx - can it be dispensed?
Yes dispense - CD Sch 5 is fine on eu rx
Why does Amiodarone cause thyroid disorders?
Due to its iodine content
DVT during HRT use?
STOP - Emergency referral
(Rare side effect)
If duration of menstrual period is mentioned and seems fairly recent what should be assumed? And as a result what should you think to give?
Intact uterus
Therefore: Progesterone & Oestrogen
If within 12months last period -> Cyclical HRT given
If pt is obese what HRT formulation is Preffered and why?
Patch preffered - due to risk of DVT
If pt had a Hysterectomy then what HRT and why? Give OTC example?
Oestrogen only due to risk of endometriosis
OTC example: GINA (estradiol)
Myoclonic treatment?
Levetiracetam
Cd expiry duration? And when would it expire if Rx dated 1st November
28 days!
29th November
Isotretinoin expiry duration? And when would it expire if Rx dated 1st November
7 days
7th November
Which vaccines are due between 2 1/2yrs to 3yrs 4months?
Measles, Mumps, Rubella, (MMR)
Diphtheria, Tetanus, Pertussis (DTP)
+ Polio
Clozapine monitoring?
Weekly till wk18, fortnightly till 1 year then 4 weekly
Pt takes phenytoin, which uti to avoid and why?
Trimethoprim - Anti folate
H pylori which ppi interacts with Clopidogrel?
Omeprazole
Alendronic acid Jaw pain?
Risk of osteonecrosis refer to gp urgent
When can you restart regular hormonal contraception after levonorgestrel?
Straight away can resume
All CD’s have a validity of how many days?
28 days
Theophylline dose monitor after initiation? Post dose time and how many days after?
4-6 hours post dose
And 5 days after initiation
Theophylline dose monitor after change of dose? Post dose time and how many days after?
4-6 hours post dose
And 3 days after dose change
Amorolfine how many toes is ok to treat otc?
1 or 2 toes any more than 2 REFER
Scratch abx?
Fluclox
Carbimazole fever? Malaise? Sore throat?
Refer to Gp - Agranulocytosis/ neutropenia
Ischaemic stroke longterm treat?
Clopidogrel 75mg and Atorvastating high intensity (80mg)
What side effects can sildenafil cause other than dizziness/headache? Unusual
Congestion and HYPOtension
CANS?
Celiprolol
Atenolol
Nadalol
Sotalol
HRT before surgery?
Stop HRT 4-6wks before surgery
Permethrin advice?
Whole body cover and Repeat after 1wk!
Elderly pt on antidepressants, how long to wait to switch?
6 wks
Non elderly pt on antidepressants, how long to wait to switch?
4 wks
Pregnancy when to give metformin if gestational diabetes?
Has to be Over 7 mmol/l - anything less
Diet and lifestyle advice!
Shortest malaria treatment?
Malarone (Atovaq with prog)
1-2 days prior travel (same as dox)
1 week post unlike others are four wks
HF pts should avoid what drugs?
RL CCB eg Verapamil or Diltiazem
Carbamazepine and levonorgestrel interaction?
Carbamazepine Reduces efficacy of Levornorgesterol
Omeprazole otc referral age?
Over 55 years
Diazepam is what schedule? Can it be emergency supplied?
Sch 4 and therefore yes for 5 days
Cd 4/5 can be emergency supplied for 5days
CD Sch 3 drugs?
Tramadol
Gabapentin
Pregabalin
Temazepam
Midazolam
Buprenorphine
Are Diazepam and Temazepam
In the same CD class?
No Temazepam is schedule 3
Diazepam is schedule 4
Bullseye looking Rash?
Tick Bites (Lyme disease)
Hepatotoxic drugs?
Rifampacin
Co amoxiclav
Flucloxacillin
Tetracyclines
Pioglitazone
Paracetamol
Antifungals
Progesterone only Pill such as Norethisterone, what precautions need to be taken if started on 2nd day of cycle?
NONE - No additional precautions
As pt has started during first 5 days of cycle
Donepezil side effects?
Bradycardia, Nausea, urinary incontinence, Lacrimation, Salivation, Bronchospasms, Diarrhoea
How long can you not drive after changing / withdraw dose in anti epileptic drug?
6 months!
DKA side effect should you Report MHRA?
Yes report it’s serious
Mebendazole in pregnancy?
AVOID
Repeat vet rx valid for how long?
6 months
Which drugs increase Risk of bleeds?
SSRI
DOACS
NSAIDS
Carbocisteine!
Corticosteroids!
St John’s wort CYP?
CYP inducer - decreases efficacy of drugs
QT Prolongation increases in which drugs?
Domperidone
Macrolides
SSRI and TCA
Methadone
Antipsychotics - Haloperidol
Corticosteroids
Methadone
Methotrexate and diarrhoea?
YES METHOTREXATE CAN CAUSE DIARRHOEA + Stomatitis - GI TOXICITY
Phenothiazine antidote? (Give example of phenothiazine as well)
Procyclidine antidote
Example of Phenothiazine - Prochlorperazine
SERO-TONIN BUS?
SSRI, SNRI
TCA, Tramadol
Buspirone
Lithium exacerbation range?
0.8-1mmol
Not 0.4-1 which would be maintenance
The long acting Sulphonyureas that should be avoided in Elderly?
Gliblenclamide + Glimepiride
RISK OF FALLS
High CVD risk pt what anti diabetic is licensed?
Empagliflozin / Dapagliflozin
What circumstances should you refer to A&E
Acute and Time sensitive!
If longterm occurred then GP potential urgent appointment is enough
