Repeated questions Flashcards
What is the first line antihypertensive for 55+ or anyone who is of african/carribean origin?
CCB
2nd line ARB
What are the rules for emergency supplys?
CD 2 / 3 = Not allowed except for Phenobarbital where 5 days is permitted for epilepsy
CD 4 / 5 = 5 days only
30 days for everything else
What is the asthma step up plan for people aged 12 +
Purpose of a clinical audit for ?
Continuous cycle of quality improvement that seeks to improve patient care and outcomes
Symptoms of Scarlet fever?
First sign = flu like symptoms: high temp, sore throat and swollen glands
Rash= small, raised bumps and starts on chest and tummy then spreads. Rash makes your skin feel like sandpaper
Strawberry tongue
Symptoms of chickenpox?
Itchy, spotty rash
Before the rash= high temperature, aches and loss of appetite
Symptoms of molluscum contagiosum?
Only symptom is spots
2-5mm wide and appear together
Raised and dome-shaped with a shiny white dimpled
More common in children but can be seen in adults where the infection is spread through sexual contact
Symptoms of meningitis?
- High temp
- Cold hands and feet
- Vomiting
- Confusion
- Pale, mottled or blotchy skin
- Stiff neck
- Photophobia
Name 3 drugs that can cause hyponatraemia ?
What are the symptoms?
- Diuretic
- SSRI
- Carbamazepine
Symptoms = Fatigue, confusion, dizziness, cramps, difficulty concentrating
What is the meaning of different INR results?
INR is how long it takes the blood to clot
Normal INR is typically 1
INR too high = increased risk of bleeding
INR too low= increased risk of clots
Statins and Myalgia?
Need to confirm muscle damage
Check for raised creatinine kinase as an indicator
Generally for statins do LFTs before, 3 months and 12 months
Stop if ALT is over 3x
Apixaban doses
Apixaban
-2.5mg for VTE prophylaxis
- 10mg treatment of DVT / PE
- 5mg afterwards for 3 months (provoked) or 6 months provoked
When would you tend to see a reduced Apixaban doseas 2.5mg BD instead of 5mg ?
Reduced dose when a patient has 2(+) of:
- Aged 80+
- <60kg
- Serum creatinine 133
Insulin types
Rapid acting: Apidra, Fiasp, Humalog
Short acting: Actrapid, Humulin S
Intermediate acting: Humulin I, Insulatard
Biphasic: Humulog Mix, Humulin M3
What can you do if the Responsible Pharmacist in charge is absent?
Cannot sell GSL medicines
Cannot sell P medicines
Cannot hand out pre-bagged and checked medicines
RP can be absent for up to 2 hours
What is required for a signed order?
When a POM is supplied from a registered pharmacy to healthcare professionals, an entry needs to be made in the POM register
Signed order needs to be retained for 2 years
-Needs clear identification of the item being ordered
-Quantity
-Authorised signature
What route are Vinca Alkaloids given? name one
Only ever administered intravenously
Vinblastine, vincristine
Ibuprofen doses for children
3-5 MONTHS = 50mg max TDS
6-11 MONTHS= 50mg TDS - QDS
1-3 YEARS= 100mg TDS
4-6 YEARS= 150mg TDS
7-9 YEARS = 200mg TDS
10 - 11 YEARS = 300mg TDS
COPD guidelines
Vet prescribing cascade
Stages of change model
Pre-contemplation not even wanting to do it
Contemplation = need more info
Action = doing it/asking where to go to do
P value, when is it significant ?
P Value <0.05 = statistically significant
SADMAN drugs
SGLT2inhibitors
ACEinhibitors
Diuretics
Metformin
ARBs
NSAIDs
Prescription requirements for CD2
- Prescriber details
- Patient details
- Drug name, form and strength
- Dose must be CLEARLY stated
- Total quantity in words and figures
- No more than 30 days supply
- Signature and date, valid for dispensing within 28 days
Symptoms of hyperglycaemia vs hypoglycaemia
HYPERGLYCAEMIA =
- Extreme thirst
- Fatigue
- Blurred vision
- Frequent urination
HYPOGLYCAEMIA=
- Hunger
- Irritability
- Fast heatbeat
- Shaking
What is prescribed alongside Isoniazid and why
Pyridoxine (Vitamin b6)
Prevent Isoniazid induced neuropathy
Statin and macrolides
Interaction!
Macrolides increase blood levels of statins
Increased risk of myopathy and rhabdomyolysis
What to do for burns
- Immediately get away from heat source
- Remove any clothing or jewellery
- Cool the burn
- Keep the person warm
- After cooling the burn, cover the burn
- Paracetamol
Treatment for threadworm
Mebendazole
Everyone 2+ in the household need to be treated
Pregnant, breastfeeding and under 2 need to see GP
Signs of digoxin toxicity
- Confusion
- Irregular pulse
- Vision changes
- Skin rashes
- Diarrhoea
Treatment for type 2 diabetes
- Eating well and being more active
- Weight loss
- Metformin
- Insulin (sometimes)
Signs of subconjunctival haemorrhage
Red spot of blood on the white of your eye
Not painful, will not affect your eye sight
Sudden appearance
Should clear up by itself
Risk of long term PPI use?
- Increased risk of bone fractures
- Hypomagnesaemia
- Vit B12 deficiency
- Rebound acid hypersecretion syndrome
- C diff infection
Gilick competency and Fraser guidelines
Gilick competency is used to assess whether a child has the maturity to make their own decisions : needs to be considered under the age of 16
Fraser guidelines apply to contraception and sexual health
What is the treatment for C. Diff in adults?
1st line for first episode of mild, moderate or severe infection = Vancomycin 125mg orally QDS for 10 days
2nd line if Vancomycin is ineffective= Fidaxomicin 200mg orally BD for 10 days
If 1st and 2nd line are ineffective, seek specialist advice: Vancomycin 400mg QDS 10 days with(out) Metronidazole 500mg IV TDS 10days
This is the same as life threatening C diff
What is required for an isotretinoin prescription?
- Pregnancy prevention programme: during treatment and for 1 month after
- Monitoring: hepatic function and lipid before treatment, 1 month after starting then every 3 months
- For females of childbearing potential, each rx for oral tretinoin should be limited to a supply of up to 30 days’ treatment and dispensed within 7 days
Rivaroxaban doses
AF 20mg OD
If renally impaired then 15mg OD
DVT treatment = 15mg OD for 21 days then 20mg thereafter
Edoxaban doses
30mg OD for up to 61kg
60mg for 61kg+
