PRS Qs Flashcards
https://www.youtube.com/watch?v=9If3HS-hHR8
https://www.youtube.com/watch?v=9If3HS-hHR8
Mrs.A is a 60 yea old Black African female who has been diagnosed with both hypertension and diabetes. She is currently taking metformin 500mg twice daily for diabetes management. Her GP has decided to start her on a stepwise managment for both conditions. Which of the following medications is the most appropriate first step for hypertension?
A. Amlodiphine
B. Candesartan
C. Bendroflumethiazide
D. Lisinopril
E. Propranolol
B. Candesartan
An ACE inhibitor or ARB (consider an ARB in preference to an ACE inhibitor in people of black African or African Caribbean family origin
A 78 year old lady has recently come in to your GP practise as she wants to assess her risk of having a stroke. She is living with multiple co morbidities including hypercholerolaemia, type 2 diabetes molotus, hypertension, and peripheral arterial disease. She takes the following medication:
Metformin 500mg tablets - ONE tablet THREE times DAILY
Gilclazide 40mg tablets -ONE tablet TWICE DAILY
Atorvastatin 80 mg tablets - ONE tablet DAILY Paracetamol 500 mg tablets - TWO tablets FOUR times DAILY
Ramipril 2.5mg capsules - ONE capsule DAILY
What is her CHA2-DS2-VASC score?
A:8
B:5
C:3
D:6
D: 6
Question 3-4 relate to a 80 year old patient who weighs 60kg and requires prophylactic therapy for stroke since recently being diagnosed with Atrial fibrillation. You have been asked to provide advice on a appropriate dose of Aprixaban to administer to the patient.
Which of the following is the most appropriate dose to administer?
A: Apixaban 20mg once daily
B: Apixaban 10mg twice daily
C: Apixaban 5mg twice times daily
D: Apixaban 5mg once daily
E: Apixaban 2.5mg twice daily
E: Apixaban 2.5mg twice daily
Question 3-4 relate to an 80 year old lady who weighs 60kg and requires prophylactic therapy for stroke since recently being daignosed with Atrial fibrillation. On coming to collect her Apixaban prescription. the patient asks you for more information about her new medication.
Which of the following statements regarding the direct oral anticoagulants (DOACs) is the most appropriate?
A: Dabigatran and rivaroxban are direct inhibitors of Factor Xa
B: Rivaroxban should always be taken with food
C: Patients on DOACs should be advised to avoid excessive consumption of vitamin K
D: The antidote for rivaroxaban is idarucizumb
E: Monitoring of INR levels is not required
E: Monitoring of INR Levels is not required
A 65 year old patient with diabetes mellitus type 2 (T2DM) has recently been diagnosed with congestive heart failiure (CHF).
Considering the comorbidity.
What would be the most appropriates first line treatment for glycaemic control in this patient?
A) Metformin
B) Gliclazide
C) Sitaglipitin
D) Pioglitazone
E) Dapagliflozin
A) Metformin
If the patient has Chronic Heart Failure, then you offer them metformin and as soon as Metformin is tolerated then you offer them a SGGT2 inhibitor. For example, E it cannot be anything else because it is the only SGGT2 inhibitor. In this scenario your first line will have to be Metformin.
Mr and Mrs Khan walk into your pharmacy requesting treatment for conjunctivitis for their 20 month old son who has symptoms such as red and gritty eyes, yellow purulent eye discharge which they have noticed for 2 days. Mrs Khan also mentions that she has developed similar symptoms and that she is 3 months pregnant. Which of the following is the best action to take?
A. Advice them that every member of. the family must use chloramphenicol eye drops for 5 days.
B. Advice them that only Mrs Khan must use chloramphenicol eye drops for 5 days.
C. Advice them that Mrs Khan and their 20 month son must use chloramphenicol eye drops for 5 days.
D. Advice them that the symptoms are self limiting, so no need to worry.
E. Refer Mrs Khan and their son to the GP.
E. Refer Mrs Khan and their son to the GP
Explanation:
A,C.- The criteria for selling chloramphenicol is under two years
B. - Mrs Khan is pregnant so there is a risk of grey baby syndrome.
Ms G is a 65 year old female patient who takes a number of medicines such as Ramipril, Bisoprolol, Domperidone, Methotrexate. and clenil inhaler. Her doctor would like to prescribe a new drug- verapamil. If the doctor decides to prescribe verapamil, which one of her current medicines is likely to be stopped?
A. Ramipril
B. Bisoprolol
C. Domperidone
D. Methotrexate
E. Clenil Inhaler
B. Bisoprolol
Bisoprolol and Virapamil can cause Bradycardia - risk of heart block
You are working in a pharmacy, one Sunday afternoon when one of your patients walks into your pharmacy and presents his symptom (bloody nose). He mentions that he has noticed this over the entire weekend. What would be your next line of action given that he takes Mirtazapine 30mg ON, Hyoscine butyl bromide 10mg QDS, Apixaban 5 mg BD and Amlodipine 10 mg OM.
A. Give him lifestyle advice only
B. Tell him not to worry as the symptoms will subside after a short time as its probably due to stress.
C. Ask him to book an appointment with his GP.
D. Sell him alcohol wipes only
E. Refer to Accident & Emergency
E is the correct answer
B. Apixaban can cause bleeding
C. To book an appointment with a GP will take quite long.
A 6 year old was prescribed salbutamol evohaler and a spacer device. After dispensing, his mother asks you how to wash her sons spacer to ensure it is well maintained and hygienic. What would your response be?
A. Your spacer should be cleaned twice a week in warm water to prevent build up of medicine of residue on the inside. It should be dried with a cloth.
B. Your spacer should be cleaned once a month in a warm soapy water to prevent build up of medicine residue on the inside. It should be left to drip dry rather than dried with a cloth.
C. Your spacer should be cleaned once a year in warm soapy water to prevent build up of medicine residue on the inside. It should be left to drip dry rather that dried with a cloth.
D. No need to wash the spacer, just get a new one every month from the GP.
E. Your spacer should be cleaned once a month in warm soapy water to prevent build up of medicine residue on the inside. It should then be dried with a cloth.
B
Cleaning with a cloth will losses the static property of spacer and a spacer should be changed every 6 months
Mr B is an 86 year old patient whoo has C diff infection. He feels poorly and is also experiencing diarrhoea. What is the current first line antibiotic treatment for a patient like B?
A. Vancomycin
B. Clarithromycin
C. Co amoxiclav
D. Levofloxacin
E. Metronidazole
A
Mr A is taking co codamol, atenolol and hydroxychloroquine. Which antibiotic would interact with any of his current medication?
A. Penicillin G
Clarithromycin
Co amoxiclav
Levofloxacin
Metronidazole
B
Clarithromycin and Hydroxychlorquin Serious risk of Adverse CV reactions and alos QT prolangation
Mr K is a 63 year old patient who was admitted in hospital aftter suffering an ischemis stroke recently. His daughter phones 999 for an ambulance. Which of the following is he least likely symptom Mr K would present after a stroke?
A. Slurred speech
B. Restlessness
C. Facial Drooping
D. Numbness
E. Dysphagia
B
It isnt a fast symptom
Mr K is a 63 year old patient who was admitted in hospital after suffering an ischemic stroke recently without Atrial Fibrillation. The doctor is considering prescribing an antiplatelet drug for long term management/prevention of secondary cardiovascular events. Given that Mr K is allegic to clopidogrel, what is the next line antil platelet therapy according to NICE guidelines
A. Prasugrel
B. Aspirin
C. MR dipyridamole
D. Aspirin + MR dipyridamole
E. Apixaban + MR dipyridamole
D
No Calculator
Garry was prescribed 10ml Hypromellose 0.3% eye drops by his doctor.
Instill one drop in BE every 2 hours for 24 hours and then instill one drop every six hours for 4 days. Calculate volume that would remain in the container after treatment.
A.3.8ml
B.2.8ml
C.4.0ml
D.7.8ml
E.7.2ml
E
