questions practice Flashcards
A patient is currently taking metoclopramide and develops dystonia, what would you recommend as treatment ?
Dystonia-uncontrolled muscle movements AKA. spasms
A. procyclidine
use: parkinsonism, extrapyramidal symptoms
Treatment for heroin overdose?
Naloxone
used opioid overdose
Anaphylaxis in adult patient, with swollen lips and difficulty breathing.
what is the recommended drug treatment?
A. Adrenaline 500mcg
learn the doses, child or adult,
different brands available.
Dose for Ibuprofen, 9 year old patient
200mg QDS
Motion sickness prevention 4 year old child for a 3 hour trip. A.. prochlorperazine B. cinnariizine C. cyclizine D. Hyoscine hydrobromide E. ?
A. hyoscie hydrobromide
(kwells)
learn different brands, age ranges for children to recommend!
A patient is a smoker and is suffering hyperchlosteraemia. When he climbs up stairs experiences cramping and numbness, exersize hasnt helped. what would you recommend?
A. NAFTIDROFURYL OXALATE
Perhipheral vascular disorder-is a blood ciruclation disorder causing narrowing arteries, especially pain in the legs and fatigue
A patient experiences pain when going up the stairs, and when he lifts heavy grocery bags. He is taking metoprolol and some other medications. what would you recommend…
A. angina GTN spray
q. needs to be more specific
43 year old patient has AF for which a BB has been prescribed. she also has hypercholesteraemia. what else would you recommend?
A. apixaban
- must learn CHADSVASC score men and women
75 y.o has hypertension and allergy to amlodipine. what would you give.
A. Indapamide or valsartan
look into the hypertension guidelines, updated and make a informed choice.
A patient has a uncomplicated UTi and was prescribed Trimethoprim 200mg BD for 7 days. what is wrong with this dose??
A. Duration is too long
Important to understand the durations for antibiotics and other complication with UTI s
A patient has developed sepsis in hospital and has had an anaphylactic reaction to penicillin in the past.which Abx would you not give
A. pip-taz
remember it contains penicillin
A patient culture for a respiratory infection shows haemophilus influenza. what antibiotic would you give>
A. amoxicillin
- not sure why, research more
Which bacteria is well covered by gentamicin>
A. Pseudomonas aeruginosa (other choices were all G+)
A patient has H.pylori, takes ciclosporin and clopidorel? what treatment would you recommened?
Amox + metron + lansop
NOTE:
clopidogrel + omeprazole Interaction- thats why it wasnt the right answer
A responsible pharmacist register, how long does it need to be kept??
A. 5 years
Private prescription for a POM *atenolol) how long do you need to keep?
A. 2 years
Which Rx cannot be given as a emergency supply
A. Tramadol CD 3
phenobarbital can be given in emergency for epilepsy
Vet prescribes ramipril under the cascade and there is no licensed rx for ramipril in that species. what to dispense?
A. same drug licensed in another species
- must go into detail for vetinary stuff
15 y.o comes into a pharmacy for EHC.She had a UPSI 4 days ago and doesnt want to go to another HCP?
A. ulipristal
- must know licensing and age requirement to give EC
A man takes methadone 30mg OD for opioid dependence and would like advice for driving?
A. not sure
as far as im aware cannot drive if taking methadone
however, possible with buprenorphine
A patient is taking tranylcypromine which food.drink should he avoid?
A. mature cheese
- MAOI inhibitor
A prescription for fentanyl what is the maximum duratio of supply to be given?
A. 30 days
remember expiration is 28 days, recommended supply is 30 days key word
picture of a label identify which legal requirement is missing?
A. Date of supply
Prescription for sativex shown- which do you decide not to dispense?
A. prescription expired
remember sativex cannabis product
A GP is seeing his patient who suddenly develops slurred speech. you ask him to raise his arm and hes not able to>
A. call 999 STAT
AAS 300mg also option but cannot incase haemorrhagic stroke
show image-
A. identify impetigo
show image
A. recognise stye. also treatment 1st line treatment is a warm compress
image of food onychomycosis on 3 toe nails. action to take?
A. refer- cannot treat OTC
Subconjunctival haemorrhage,no pain, no disturbed vision, no medicial condition and wants to buy opticrom for it. what would you recommend?
A. do not sell eye drops and reassure the patient as it will go away on its own
20 y.o patient has bad period cramps and pain, has currently taking lithium??
A. Dihydrocodeine with paracetamol
remember alot of questions on lithium must know it properly
which is a example of a clinical audit
learn what a clinical audit is to be able to answer this question
Mebendazole- what to advice to give to a 7 year old with threadworm
A. sleep with underwear so that he doesnt scratch his anus
- keeping away from school was part of the option
A mother comes into the pharmacy with her baby who has a fever and other sympto in the past 24 hrs. which symptom would be the most worrying?
A. no wet nappies
Dabigatran prescribed for a patient with AF. what advice would you give
A. take is same time each day
other options, dont eat green veg etc
List of medication and patient complains of breast discomfort. what medication is responsible.
spiralactone
A schizophrenia patient has been trialled on both haloperidol and olazapine however they did not work. what would be the best option to try now
Clozapine
a patient deelops a infection in hopsital and is started on co-amoxiclav + levofloxacin IV. the patient is also taking other mediciation during his hospitalizaation which are listed. which medication is likely to cause seizures?
A. levofloxacin
Quinolone- IV use likely to cause seizures.
A patient is taking warfarin and gets prescribed miconazole gel for oral thrush?
A. Interaction
A hospitalized patient develops a UTI and has a penicillin allergy. Crcl = 25ml/min. option: amox cephalosporin trimethoprim nitrofurontoin ciprofloxacin culture shows sensitivity to all except ciprofloxacin what would you recomend>
A. Trimethoprim
- nitrofurontoin not option if crcl less than 45
exclude penicillin and cephalosporin options
A women has been diagnosed with cellulitis on her leg, she saying she is allergic to pencilin due to vaginal thrush. what would you give>?
A. flucloxacillin-
clarithromycin was also included part of the option
patient has severe depressio and also diagnosed with bipolar. what would you give to treat>
A. Quetiapine
Which mediicne requires drug levels and close monitoring if a patient stops smoking?
A. clozapine
Theophylline was not a option
Which medicine require LFT to be measured, baseline, 3 month and 12 month.
A. atorvastatin
A patient initiated on atorvastatin experiences cramps in legs what needs to be measured>
Creatinine kinase
A patient started on amiodarone has gained weight and became more tired what needs to be measured?
A. TFTs
A patient is taking differnt asthma medication, starts to experience some symptoms?
A. hypokalaemia
identify symptoms
A patient recevied citalopram + valproic acid ?
A. hyponatraemia
A patient comes for sildenafil P medicine and takes other medication inlcuding tamsulosin. what would you do>
A. refer- cannot dispense as patient is taking a alpha blocker
mum brings 2 y.o non blanching rash and other symptoms? need to recognise meningitis. action to take
A. Ring 999. stat A/E
Which is a symptom of hypogylcaemia? all were symptom of hyperglycaemia.
A. Dizziness
A patient came for his methadone and calls later to get another dose as his previous bottle broke? what to do.
A. Contact the prescriber for a new rx
A patient has a sore throat and has taken paracetamol, pseudoephedrine and lozenges. he starts to experience palpitation and other symptoms insomnia. culprit
A. Pseudoephedrine
SE: headache
what is the maximum of non-effervescent aspirin that can be given OTC?
A.
How does a patient need to breathe when measuring peak expiratory flow>
A. Blow as hard as you can and fast into the small device
which type of food or drink do you need to avoid with ciclosporin.
A. Grapefruit juice
A patient takes ciclosporin for organ transplant. He got home and noticed the pharmacy dispensed another brand vs what he usually takes even though the Dr, prescribed his usual brand. what do you do>
A. give usual brand to the patient and take the wrong brand which needs to be disposed not back into stock,
A patient is suffering from diarrhoea for a few days. The Dr said to suspend one of her medicine to protect her kidney. which medicine was he reffering to?
ACEi -
remember the medicine must be stopped to prevent AKI. including metformin
Which opioid patc is given weekly
Buprenorphine (Butrans) - patch 7 days
other options fentanyl, another buprenorphine that was not butrans
A patient is receiving a vinka alkaloid, which is the correct route
A. Intravenous
AVOID INTRATHECAL!!
A patient got prescribed isoniazid as part of TB regimen. which vitamin needs to be prescribed to prevent neuropathic complications>
A. pyridoxine
On a product you read expiry: 10/2021 when will the product expire.
A. 31st october 2021
A baby is teething, what would you give after using gum toys
A. paracetamol
- CKS mentions painkiller before lidocaine, tricky Q
Zoplicone and tramadol
interaction
Which insulin is basasl.
bnf
Predisolone for a patient suffering a acute asthma attack
bnd
Metformin contra-indicated and on sulphonylurea- what do you add next
A. sitagliptin
- need to know both treatment options
Lady has a Hb1AC of 46 what treatment if any would you recommned?
dietarry - need to know about diagnosis
patiet has chicken pox what would you do?
A. give paracetamol
patient with mouth ulcers it has been 5 weeks what would you do?
A. would you treat or refer
Theophylline
A. report nausea and vomiting
How many units recommended for a man per week>
14 units maximum
Enoxaparin + DOAC given
INTERACTION
How to give lansoprazole
30-60 minutes before food
what is the expiry on GTN spray?
8 weeks after opening
Enoxaparin + DOAC (rivoroxvan) given
INTERACTION
Nappy rash what would you recommend?
A. clotrimazole
Heirachy study - options was a case, cohort, RCT, specialist advie and other option
A. RCT highest option
[learn table of evidence]
pt on 70mg morphine BD, what is their maximum breakthrough
A. 1/6th . 20
need to learn how to do division for clinical
Patient suffereing from mesalazine SE might have been thrombocytopenia
report to MHRA it was serious
14 year old gets a vaccine what is it likely for
A> HPV cervical cancer
Hypertension- 45 year old lady what to give
1st line ACE inhibitor
CPR compression to 2 rescure breath answer
bnf back
calculate curb-65 score but you were given , the patient had a newly disoriented feeling
learn it
calculate dose 800u vitamine D takes for 5 days a week the 12 week total
calculation question to know
Fludrocortisone how to sotre it
unsure
which drug most likely causes weight gain?
Olanzapine
What are the most likely SE of taking prednisolone from a 5 day course
A. mood changes
A dentist forgot to put toothpaste on a rx so you have agreed to give a E/S , how long does the dentist have to provide a prescription
A. 72 hours
which drugs are likely to cause falls in the elderly?
patient on mirtazipine + zoplicone
check all drugs
why is there a gap between chemotherapy doses?
- maybe to do with myrelosuppression
methotrexate + folic acid - why is it given on another day
A. they are both antifolate drugs so cannot be given on the same day
also- to reduce SE
tricky q
A patient from london has travelled to glasgow, forgot his insulin, you do not have the same brand but same active ingredient what do you do
signpost the patient, you do not need a prescription genuine case
also insulin needs to be brand specific
what is the best prescribing for insulin-
a. brand name + units,
not IU
patient allergic to penicillin, gets prescribed pivmacillinam
A. contra-indicated
Diabetic patient has collapsed, someone thinks he is drunk but you notice his diabetic bracelet,
A. drink high in sugar
other: glucagon
need to know diabetic emergencies
Metallic taste from list of medicine
A. clarithromycin
or metformin
patient acute dystolic reaction
give prochlorperazine
Diabetic patient has collapsed, someone thinks he is drunk but you notice his diabetic bracelet, still concious
A. drink high in sugar
other: glucagon
need to know diabetic emergencies
Trough and peak graph for gentamicin
look into more detail
COPD - antimucolytic
BNF
inhaler conversion?
recognising generic and brand names
learn both
Tamsulosin with amlodipine
check interaction
what to give second stage of TB
bnf
SPC - gap between iron and HIV mediciation
spc
SPC pregablin capsule for 21 days
look at spcs practice
ciclosporin with clarithromycin
look interaction
which food contains tyramine
mature cheese
a patient is taking valproate lady- what is the best form of contraception
check BNF
long term use with gentamicin what is the risk
ototoxicity
Dabigatran counselling
BNF and anticoagulant booklet
rivoroxaban dose for AF prophylaxis
learn the dosing
which antihypertensive to stop for 55 year old, amlodipine, lisinopril, max dose, TLD,
A. thiazide like diuretic
reasoning- they are not as effective unsure why now
