Qu's

Question 1

Mrs H has been diagnosed with coeliac disease and has just started a gluten free diet. She comes into your pjharmacy for some dietary advice. Which food should Mrs H avoid?
Rice
Ready made gravy
Pure oat
Corn flour
Nuts

Answer 1

Ready made gravy, tends to have wheat flour as a thickener

Question 2

Which would not form counselling for recently diagnosed coeliac disease patient?
You could self medicate with OTC vitamins and minerals
Your risk of osteoporosis is increased
Autoimmune condition where small intestines is inflamed causing malabsorption of nutrients
High fibre diet is recommended
Best effective treatment is a strict life long gluten diet

Answer 2

It is not recommended to self medicate with OTC vits and minerals, a discussion with healthcare team should be made to find the best supplementation formula for you.

Question 3

Which drugs are not used in chronic bowel disorders?
Sulfalasazine
Golimumab
Methotrexate
Olsalazide
Orlistat

Answer 3

Orlistat, its a lipid binder used in weight loss

Question 4

Which is a complication of Crohns?
Infertility
Myocardial infaction
HT
Hyperlipidemia
Delayed puberty in children

Answer 4

Delayed puberty

Question 5

Which is not used as monotherapy in Crohns?
Sulfalasazine
Infliximab
Methylprednisolone
Methotrexate
Prednisolone

Answer 5

Methotrexate

Question 6

Which is CI in acute UC due to risk of toxic megacolon?
Loperamide
Macrogol
Sodium bicarbonate
Mesalazine
Mebevarine

Answer 6

Loperamide

Question 7

Which is not a SE of mesalazine?
Vomitting
fever
Haemolytic anaemia
Constipation
Neutropenia

Answer 7

Constipation

Question 8

Which is not true about peppermint oil in IBS?
Can irritate the mouth and oesophagus hence shouldnt be chewed
Can cause bradycardiac effects
Taken 30-60 mins before food
Max dose is 2xQDS for up to 3 months
Can cause nausea and vomitting as SE

Answer 8

D, TDS not QDS

Question 9

Which is false about laxatives in constipation?
Adequate fluid is advised with ispaghula husks to avoid intestinal obstruction
Methylcellulose believed to act as a stimulant laxative and faecal softener
Lactulose works by increasing the amount of water in the large bowel
Bulk formers increase faecal mass stimulating peristalsis
Lactulose can be used in 1 month old babies

Answer 9

Methylcellulose is a bulk former not stimulant or faecal softener

Question 10

Which laxatives to be avoided in opioid induced constipation?
Lactulose
Ispaghula husk
Macrogol
Magnesium HCL
Arachis Oil

Answer 10

Ispaghula Husks- bulk formers

Question 11

What is licensed for symptomatic control of food allergy?
Ceproheptadine HCL
Clemastine
Chlorphenamine
Acrivastine

Answer 11

Chlorphenamine

Question 12

Which antimuscarinics are used for GI smooth muscle spasm? (More than one answer)
Ammonium compounds
Atropine
Dicycloverine
Propantheline bromide

Answer 12

All, tertiary amines such as those listed above used for GI SM spasm

Question 13

Food allergy is associated with which symptoms?
Anaphylaxis
GI reactions
Cutaneous reactions
Respiratory reactions

Answer 13

All

Question 14

Which can be used as an adjunct to dietary avoidance in patients with food allergies?
Hyoscine butylbromide
Mebeverine HCL
Sodium chromglomicate
Dicycloverine HCL

Answer 14

Sodium chromglomicate

Question 15

The MHRA advised hyopscine butylbromide should be avoided in which patients?
Renal disease
Paralytic ileus
Pregnant
Cardiac disease

Answer 15

Cardiac disease

Question 16

Cholestasis typically presents with...
fatigue
Pale stools
Jaundice
dark urine
All the above

Answer 16

All

Question 17

Can rifampicin, sertraline and naltrexone be used to treat cholestatis pruritis?

Answer 17

Yes

Question 18

Mebeverine MR caps are licensed from what age?

Answer 18

18+ yrs

Question 19

Mr J comes in to complain of a burning sensation in his chest that gets worst at night. He is 33yrs old and has had this for 5 days. He is a heavy smoker and BMI 25, what do you recommend?
Gaviscon
Esomeprazole
Lactculose
Loperamide
Ranitidine

Answer 19

Gaviscon

Question 20

Mr J has previously been taking gaviscon, it has calmed down the burning sensation but still feels worst after food. What do you do?
Sell another bottle
Sell esomeprazole and instruct to try it for a week
Sell another bottle and rennie
Sell him pepto-bismal

Answer 20

Sell esompeprazole, if this doesnt improve after a week instruct to go GP

Question 21

What BMI is classed as obese?

Answer 21

30kg/m2

Question 22

What is the medical treatment for obesity?

Answer 22

If weight management programme hasnt helped, use Orlistat

Question 23

how does orlistat work and how is it taken?

Answer 23

Lipase inhibitor, works by reducisng the absorption of dietary fat. taken TDS before during or after a meal

Question 24

Which centrally acting apetite suppressant can be used to control appetite?

Answer 24

None, Sertogenic drugs such as rimonabant and dexenfenfluramine are no longer used for obesity due to safety concerns

Question 25

Which vitamin does orlistat impair the absorption of?

Answer 25

Fat soluble vitamins (A,D,K,E)

Question 26

Why is long term topical steroids not recommended in piles?

Answer 26

if used longer than 7 days can increase risk of perianal skin thinning and ulceration

Question 27

Which treatment is most appropriate for piles in pregnancy?
Ispaghula husk
Anusol HC
Scheriproct
lactulose
Ibuprofen

Answer 27

Ispaghula husks- Bulk formers as they are not absorbed, Topical preparations are not licensed in pregnancy

Question 28

MRS J has completed h pylori eradication treatment but has come to the pharmacy with a rash, it has become worst since she went to the beach and she also experiences wrist pain, which of the following medication is most likely to be causing the presenting symptoms?
Lansoprazole
Metronidazole
Tripotassium
Amoxicillin
Clarithromycin

Answer 28

Lansoprazole- very low risk of subacute cutaneous lupus erythemateous