quesmed - mock 1

Question 1

donepezil hydrochloride - monitoring?

NB. not in BNF

Answer 1

ECG - risk of bradycardia, cardiac conduction disorders

Question 2

tamsulosin monitoring?

Answer 2

BP - due to risk of postural hypotension (esp. in elderly)

Question 3

test to monitor adverse effect of digoxin?

Answer 3

Serum potassium

Also increases calcium + magnesium so monitor U&Es throughout treatment

Question 4

patient on metformin, poorly controlled DB (HbA1c >60), PMHx of chronic pancreatitis.

Drug to add?
Drugs to avoid?

Answer 4

ADD gliclazide

AVOID (pancreatitis):

• DDP-4 inhibitors = SITAGLIPTIN
• GLP-1 = liraglutide

Question 5

prescribe an antidepressant to patient with mod-severe depression, recent MI?

Answer 5

sertraline

Question 6

prescribe for gastric/duodenal ulcer?

px has omeprazole allergy.

Answer 6

PPIs 1st line but do NOT give others as allergy to lansoprazole
H2-receptor antagonists: 
- ranitidine
- cimetidine 
- famotidine

Question 7

prescribe for angina (already given GTN)?

px is asthmatic

Answer 7

CCBs - amlodipine, diltiazem, felodipine, verapamil

avoid beta-blockers in asthmatics

Question 8

prescribe for UTI in non-pregnant woman?

px has allergy to co-trimoxazole

Answer 8

1st line = nitrofurantoin vs. trimethoprim

allergy to co-trimaxazole –> DONT give trimethoprim

Question 9

Antibiotic contra-indicated in children under 12 years?

Answer 9

Trimethoprim - teeth staining + dental hypoplasia

Question 10

diuretics causing hyponatraemia? examples?

Answer 10

• loop –> Bumetanide (in CI)

- thiazide –> Chlortalidone (in side effects)

Question 11

prescribe for shingles? (vesicular rash T10 dermatome)

Answer 11

Aciclovir 800mg PO 5 times a day

Question 12

prescribe 2 drugs for peripheral arterial disease symptoms?

Answer 12

1) clopidogrel –> 75mg PO OD (careful with dose, search peripheral in BNF)
2) atorvastatin –> 80mg PO OD

note - initial management is with clopidogrel

Question 13

prescribe for mastitis?

Answer 13

use BNF

Flucloxacillin 500mg PO QDS for 14 days

Question 14

should a px continue long-acting insulin during illness?

Answer 14

Yes - monitor every 2-4hrs and adjust accordingly