rps21 Flashcards
A 62-year-old man visits his GP for a routine blood test and is found to have a plasma
potassium of 5.9 mmol/L. He was recently admitted to hospital and treated for a non-ST-
elevation myocardial infarction (NSTEMI). He was treated with aspirin, clopidogrel,
atorvastatin, bisoprolol and ramipril. He has a past medical history of congestive heart
failure and is also taking furosemide.
Which one of the following medicines is most likely to have contributed to the
abnormal potassium reading?
Select one:
Aspirin
Bisoprolol
Clopidogrel
Furosemide
Ramipril
Ramipril
Risk of hyperkalaemia with ACE inhibitors
A 35-year-old female presents in your pharmacy complaining of a migraine which
started suddenly this morning. She has had a migraine once before but does not
remember what she took to ease the symptoms. She is not taking any regular
medication and has no other medical conditions or allergies. She took 1 g of
paracetamol two hours ago, after breakfast, which has not helped.
What is the most appropriate advice to provide to the patient?
Select one:
It is unlikely to be a migraine as she did not experience an aura beforehand
She can take one ibuprofen 400 mg tablet now to ease the pain
She can take one Imigran (sumatriptan) 50 mg tablet to relieve the migraine as
she has had a migraine before
She can take two yellow Migraleve tablets (paracetamol and codeine) now to
help relieve the pain
She should be referred to her GP for further investigation
Answer: She can take one ibuprofen 400 mg tablet now to ease the pain
Migraine can occur with or without ‘aura’. Patient has had paracetamol two hours ago
therefore cannot suggest Migraleve tablets.
Can’t suggest Imigran as she only has a history of one migraine prior to this.
A 60-year-old man is admitted to hospital with chest pain and is initiated on the Acute
Coronary Syndrome (ACS) protocol. He is prescribed aspirin 75 mg daily, clopidogrel 75
mg daily, bisoprolol 2.5 mg daily and ramipril 2.5 mg daily. He has no allergies and no
other past medical history.
On reviewing the drug chart, which one of the following medicines is most
appropriate to initiate?
Select one:
Atorvastatin 80 mg daily
Bendroflumethiazide 2.5 mg daily
Candesartan 4 mg daily
Simvastatin 20 mg once at night
Spironolactone 25 mg once in the morning
Answer: Atorvastatin 80 mg daily
Patients should be given DAPT, beta-blocker, ACE inhibitor, nitrate and statin.
Simvastatin 20 mg only recommended for primary hypercholesterolaemia.
Atorvastatin 40-80 mg for secondary prevention of cardiovascular events
You are concerned about side effects she may experience because of treatment with
intravenous hydrocortisone.
Which one of the following is most likely an expected glucocorticoid side-effect
associated with hydrocortisone?
Select one:
Hyperglycaemia
Hypertension
Hypokalaemia
Sodium retention
Water retention
Answer: Hyperglycaemia
Hyperglycaemia/diabetes is a glucocorticoid side effect.
The others are all mineralocorticoid side effects
You have been asked to conduct an audit about the administration of medicines on your
hospital ward so that you can identify areas for improvement.
Which of the follow processes is least appropriate to complete as part of an audit
cycle?
Select one:
Analysing the administration of medicines
Collecting data on the administration of medicines
Identifying standards for the administration of medicines
Investigating errors associated with the administration of medicines
Re-auditing the administration of medicines after a 12-month period
Answer: Investigating errors associated with the administration of medicines
Looking for errors is not part of audit/improvement process. This should be more around
identifying topic
A 20-year-old woman presents with a skin rash on the face. After questioning you
diagnose the rash as impetigo and tell her she needs to see the doctor for appropriate
treatment. You also advise hygiene measures to help control the spread of the rash.
Which of the following pieces of advice is most appropriate?
Select one:
She should stay away from work until the rash has gone whilst taking antibiotics
She should stay away from work until she has been taking antibiotics for 24 hours
She should stay away from work until she has been taking antibiotics for 48 hours
She should stay away from work until she has completed the course of antibiotics
She does not have to stay away from work whilst she has the rash
Impetigo is contagious and risk mitigation measures are needed. Current advice is 48
hours should elapse after initiation of an antibiotic before returning to work
A 68-year-old woman visits the pharmacy with a new prescription for theophylline. She
has been told that she will need to be monitored regularly by her doctor and is
concerned about potential side effects.
Which one of the following is most likely to be a sign of toxicity caused by
theophylline?
Select one:
Diarrhoea
Hyperthermia
Hypoglycaemia
Tachycardia
Wheezing
Tacycardia is the only clear red warning sign
An 82-year-old woman is admitted to hospital
with suspected ischaemic stroke. She has
a history of hypertension and
currently taking amlodipine 10mg daily. She has no known
drug allergies.
Which of the following is the most appropriate antiplatelet regime to initiate?
Select one:
Aspirin 75 mg once a day long-term and
clopidogrel 75 mg once a day for 12
months
Aspirin 300 mg immediately plus clopidogrel 300 mg immediately, then aspirin 75
mg once a day long-term and clopidogrel 75 mg once a day long-term
Aspirin 300 mg immediately plus clopidogrel 300 mg
immediately, then aspirin 75
mg once a day long-term and clopidogrel 75 mg once
a day for 12 months
Aspirin 300 mg once a day for 14 days, then
clopidogrel 300 mg once a day long-
term, thereafter
Aspirin 300 mg once a day for 14 days then
clopidogrel 75 mg once a day long-
term, thereafter
Initial treatment with aspirin 300 mg for 14
days. Secondary prevention with clopidogrel
75 mg daily thereafter.
According to the General Pharmaceutical Council
(GPhC), revalidation is a process
which helps to show that the trust members of
the public have in pharmacy
professionals, is well placed.
Which one of the following statements is the most accurate in relation to
revalidation?
Select one:
In the first year that you submit revalidation records, you will need to carry out,
record and submit one CPD record
For revalidation you need to carry out, record and submit two CPD records, a
peer discussion record, and a reflective account record
Revalidation submissions are only made when the GPhC call registrants to
submit
Revalidation applies only to pharmacists working in patient facing roles
Revalidation applies to both registered pharmacists and pharmacy technicians
Applies to both registered pharmacists and pharmacy technicians
A 28-year-old man presents in the pharmacy
asking for information about the smoking
cessation service.
Which one of the following is most suitable to advise regarding smoking
cessation?
Select one:
A quit date should agreed to keep the patient motivated
A single intervention is better than a combination
Bupropion is first line for smoking cessation
E-cigarettes are licensed for use in smoking cessation
The patient should purchase varenicline for smoking cessation
Quit date should be agreed to keep the patient motivated.
Combination is better than single
A 40-year-old man presents in general practice
for his annual medication review. He is
taking finasteride for benign prostatic
hyperplasia
Which of the following pieces of advice is most appropriate to provide this
patient?
Select one:
Continuous lifelong use of finasteride is recommended
Finasteride is contraindicated in patients who smoke
Finasteride is excreted in semen therefore, if sexually active, use of a condom is
recommended
Finasteride is known to benefit patients with a history of depression
The patient requires annual urea and electrolytes monitoring, and blood pressure
checks
Finasteride is excreted in semen therefore, if
sexually active, use of a
condom is recommended
A 46-year-old
woman visits the pharmacy and hands you a bag of unused medicine.
She is very
distressed and tells you that there is some morphine in the bag that
belonged
to her late mother.
Which
of the following options with regards to patient returns of morphine is the
most appropriate action to take?
Select one:
A record should be made in the appropriate Controlled Drug register
The destruction of the morphine must be witnessed by another member of staff
The destruction of the morphine should preferably be witnessed by a registered
healthcare professional
The unused morphine can be disposed of in the drug disposal bin
The unused morphine will require destruction by the area Controlled Drugs officer
The
destruction of the morphine should preferably be witnessed by a
registered
healthcare professional
Medication
can be destroyed and denatured by the Responsible Pharmacist. A witness
is preferable not mandatory
and preferably it should be a registered healthcare
professional.
Reference: P104 MEP 2019
a 74-year-old man with a history of atrial
fibrillation (AF)
is taking warfarin for the prevention of stroke. His usual
dose is 2 mg daily on Monday to
Friday, and 3 mg daily on Saturday and Sunday.
He has no known drug allergies.
Which of the following is the most appropriate
target international normalised
ratio (INR) range for the patient?
Select one:
1.0 – 2.0
1.5 – 2.5
2.0 – 3.0
2.5 – 3.5
3.0 – 4.
AF target is 2.0-3.0
At his next clinic appointment, the patient’s
international normalised ratio (INR) is
unexpectedly outside of the normal
range. There have been no changes to his diet and
no concerns of adherence.
However, he has been initiated on a recent course of
antibiotics.
Which of the following effects is most likely to occur in relation to antibiotics and
warfarin?
Select one:
-Clarithromycin decreases the anticoagulant effect of warfarin
-Doxycycline decreases the anticoagulant effect of warfarin
-Erythromycin decreases the anticoagulant effect of warfarin
-Metronidazole increases the anticoagulant effect of warfarin
- Rifampicin increases the anticoagulant effect of warfarin
Answer: Metronidazole increases the anticoagulant effect of warfarin
Rifampicin decreases anticoagulant effect. Clarithromycin, doxycycline, erythromycin
and metronidazole increase anticoagulant effect.
A 69-year-old woman comes into your pharmacy to complain that she is suffering from
constipation. She has a range of chronic conditions and takes a number of prescribed
medicines and believes that one of them may have caused this adverse effect.
Which one of the following medicines has most likely caused this adverse effect?
Select one:
Amlodipine
Metformin
Oxybutynin
Paracetamol
Vitamin D
Oxybutynin
You have diagnosed headlice in a 6-year-old girl and are deciding upon the most
appropriate course of action. Her mother tells you that her daughter has epilepsy and
asthma.
Which of the following medicines would be most suitable for treating headlice?
Select one:
Dimeticone lotion
Dry combing
Electrical comb
Isopropyl myristate and isopropyl alcohol aerosol
Permethrin cream
Dimeticone lotion is the most effective
A 33-year-old man patient presents in your pharmacy asking to buy some medication to
treat heartburn. You confirm he has no red-flag symptoms, and you are satisfied it is
safe to recommend a medication for this patient to buy.
He has no known drug allergies, takes no other medication, and has tried a proton
pump inhibitor (PPI) previously which worked to treat symptoms.
Which one of the following medicines and dosage is most appropriate to supply
over the counter to the patient?
Select one:
Lansoprazole 15 mg capsules at a maximum dose of 15 mg once a day for four
weeks
Lansoprazole 15 mg capsules at a maximum dose of 30 mg once a day for four
weeks
Omeprazole 10 mg capsules at a maximum dose of 10 mg once a day for four
weeks
Omeprazole 10 mg capsules at a maximum dose of 20 mg once a day for four
weeks
Omeprazole 20 mg capsules at a maximum dose of 20 mg once a day for four
weeks
Omeprazole 10 mg capsules at a maximum dose of 20 mg once a day for
four weeks
Only preparation able to be sold OTC, so has to be C or D. Maximum dose is D.
You receive a private prescription for a controlled drug and note that the prescriber is
based outside the UK.
Which of the following controlled drugs can legally be supplied on this
prescription?
Select one:
Codeine
Ketamine
Morphine
Oxycodone
Pethidine
Codiene
B-E are Schedule 2. A is Schedule 5. The address of prescriber is required to be within
the UK for Schedule 2 drug but not for Schedule 5
A father of a 10-year-old girl with a diagnosis of epilepsy visits your pharmacy to collect
a prescription for buccal midazolam. He would like some advice on how to administer
the medicine.
Which one of the following is most likely to be included in your advice?
Select one:
Shake the syringe before administration
Starting a ketogenic diet may help prevent seizures
Store in the fridge to help keep the medication stable
The dose can be re-administered if the patient vomits
Wait five minutes before administering as the seizure may stop on its own
Wait five minutes before administering as the seizure may stop on its
own
A - Does not need to be shaken
B - May have some evidence supporting this but this is a very burdensome diet,
especially for a child
C - Does not need to be stored in the fridge
D - The medicine is administered buccally so this would mean that an extra dose has
been given. If the patient vomits while having a seizure you would recommend calling
an ambulance
E - Correct option
You have started work in the medicine information department at your local hospital. You
have received a query about biosimilar medicines.
Which of the following statements is the most accurate description of a biosimilar
medicine?
Select one:
A biosimilar is a medicine developed to treat a similar disease category as the
original product
A biologic medicine that is similar to an already licensed biologic medicine in
terms of quality, safety and efficacy
A biologic medicine that is similar to an unlicensed biologic medicine in terms of
quality
A biologic medicine that is similar to an unlicensed biologic medicine in terms of
safety
A biologic medicine that is similar to an unlicensed biologic medicine in terms of
safety and efficacy
A biologic medicine that is similar to an already licensed biologic
medicine in terms of quality, safety and efficacy
A 45-year-old man, weighing 65 kg, is started on gentamicin intravenously 325 mg daily.
His pre-dose plasma concentration is checked on day three and found to be 5 mg/L.
Which one of the following is most likely an adverse effect associated with
gentamicin toxicity?
Select one:
Agranulocytosis
Myopathy
Ototoxicity
Tachycardia
Visual disturbances
Ototoxicity
Your pharmacy dispensing technician is confused about record keeping requirements
for the supply of medicines and asks you about situations where records are legally
required and not required.
Which of the following scenarios does not require an entry to be made in the
prescription only medication (POM) register?
Select one:
You make an emergency supply of metformin tablets at the request of a doctor
You make an emergency supply of a salbutamol inhaler at the request of a
patient
You make a supply of amlodipine tablets prescribed on a veterinary prescription
You make a supply of morphine tablets prescribed on an NHS prescription
You make a supply of salbutamol inhalers requested
on a written order signed by
the principal or head teacher
You make a supply of morphine tablets prescribed on an NHS
prescription
A father brings his 8-month-old daughter into the pharmacy and would like some advice.
She has been experiencing a dry cough that tends to be worse at night. He says she
has a barking cough, takes a gasp for breath between coughs and seems to have noisy
breathing.
Which one of the following conditions is most likely to be associated with the
presenting symptoms?
Select one:
Asthma
Bacterial upper respiratory tract infection
Bronchitis
Croup
Pertussis
Croup
Upper Respiratory Tract Infection associated with cold-like symptoms and fever; Asthma
unlikely in an 8-month-old and pertussis associated with congestion and vomiting
A 52-year-old man has visited your pharmacy to obtain codeine liquid, as advised by his
GP, for a cough. He has been advised to take 15 mg three times a day for two weeks,
and then see his GP again for review.
Codeine linctus is available over the counter in the strength 15 mg/5 mL, in 200 mL
bottles.
How many millilitres of codeine linctus 15 mg/5 mL should you supply the patient
for a course of 14 days treatment?
Select one:
150 mL
200 mL
250 mL
300 mL
400 mL
5 mL x 3 x 14 = 210 mL.
200ml is closest bottle size
You can’t pack down OTC medicines and 400 mL is too much
A 32-year-old woman presents to your GP clinic to discuss her medication. She is a
primary school teacher and is keen to ensure her long-term condition is managed to
prevent sick leave.
Her current medication is:
Desogestrel tablets, one to be taken once a day
Beclometasone (Clenil) 200 micrograms inhaler one puff twice a day
Salbutamol 100 micrograms inhaler, one to two puffs up to four times a day
Which of the following scenarios regarding asthma is most appropriate to refer to
a GP?
Select one:
The patient feels breathless usually after strenuous exercise
The patient has noticed a cough at night causing waking
The patient informs you she has noticed white spots in her mouth since the
initiation of her beclometasone (Clenil) inhaler
The patient is using her short acting beta agonist (SABA) twice a week
The patient thinks she may not be using her preventative inhaler correctly
The patient has noticed a cough at night causing
waking
A regular patient comes in and asks for advice regarding their pet. They explain that
they have run out of repeat medication for their cat and would like some more. They
show you an empty bottle hypromellose eye drops that they administer to their cat.
Which of the following actions is most appropriate to take in response to the
request?
Select one:
Sell the hypromellose eye drops and advise the patient to continue the treatment
until the symptoms have eased in their cat
Sell the hypromellose eye drops and advise the patient to phone the vet to
confirm how long to use the medicine for
You refuse the supply and advise the patient to contact the vet for a further
supply of hypromellose eye drops
You supply hypromellose eye drops as an emergency supply and make a record
of this on your patient medication record (PMR)
You supply hypromellose eye drops as an eme
You refuse the supply and advise the patient to contact the vet for a
further supply of hypromellose eye drops
Can’t provide an emergency supply. Dose in adults is not equivalent to in humans.
Licensing of OTC products is for humans. There are specific labelling requirements for
veterinary products when the prepared medicine is for animal use, which has been
prescribed by a veterinary practitioner under the cascade
30-year-old woman sees her GP with symptoms of a
urinary tract infection (UTI) and has started on empirical therapy. She weighs 60 kg, has
an allergy to penicillin causing a rash, and is not taking any regular medication. A
midstream specimen of urine (MSU) sample has been sent to microbiology.
Which bacterial organism is the most likely cause of the urinary tract infection
(UTI)?
Select one:
Chlamydia trachomatis
Escherichia coli
Haemophilus influenza
Staphylococcus aureus
Streptococcus pneumonia
Escherichia coli
UTIs are predominantly caused by bacteria from the gastrointestinal tract entering the
urinary tract, with Escherichia coli being the most common cause
The GP would like to prescribe the patient with some antibiotics for initial empirical
treatment of the UTI.
Which following antibiotics is the most appropriate treatment choice for this
patient?
Select one:
Amoxicillin 500 mg three times a day for five days
Co-amoxiclav 625 mg three times a day for five days
Gentamicin 300 mg once a day for three days
Metronidazole 400 mg three times for three days
Nitrofurantoin 50 mg four times a day for three days
Nitrofurantoin 50 mg four times a day for three days
Nitrofurantoin (or trimethoprim) are oral first line options. Amoxicillin only to be used if
culture sensitivities (also not appropriate due to patient’s allergy status)
Responsible Pharmacist (RP) regulations mean that the owner of a retail pharmacy
business must appoint an RP to be in charge of the registered pharmacy. You are
discussing the regulations with your pre-registration trainee pharmacist to help them
with their revision.
Which one of the following statements is the most accurate in relation to the RP
regulations?
Select one:
RP can only be the RP for one pharmacy at any given time
The pharmacy record detailing the RP information must be kept for a period of
three years
The
RP may be absent for a maximum of four hours in the pharmacies business
hours
The RP only needs to display the RP notice when they are absent
The sale of GSL medicines does not require a RP to be in charge of the
pharmacy
RP can only be the RP for one pharmacy at any given time
Pharmacy record needs to be kept for 5 years
RPS absent for max 2 hours
Sale of GSL medicines do need an RP to be in charge
RP needs to display a notice whilst RP
A mother presents in the pharmacy with her
6-month-old son asking for advice on a
rash he has recently developed. She says
the rash is primarily on the buttocks but has
spread to the creases inside his
thighs. You diagnose nappy rash caused by a candida
infection.
Which medicine would be most appropriate to supply in this situation?
Select one:
Canesten bifonazole cream (bifonazole 1%)
Canesten cream (clotrimazole 1%)
Daktarin Activ cream (miconazole 2%)
Eurax cream (crotamiton 10%)
Lamisil cream (terbinafine 1%)
Only canister cream (clotrimazole 1%) is licensed for nappy rash
A 16-year-old patient visits your pharmacy asking for advice. She has been taking
chlorphenamine tablets for allergic rhinitis which she suffers from every year through the
summer, however, they make her extremely drowsy, so she has stopped taking them.
She would like to purchase an alternative medicine over the counter for her allergic
rhinitis to avoid the drowsiness she is currently experiencing.
What is the most appropriate product to provide the patient?
Select one:
Beclomethasone 50 mcg nasal spray
Cetirizine 10 mg tablets
Loratadine 10 mg tablets
Sodium cromoglycate eye drops
Sterimar nasal spray
Loratadine 10 mg tablets
C causes less drowsiness than Cetirizine and patient is an appropriate age to be >30
kg.
A. Beclometasone nasal spray is only available from 18 years and over.
D. Her symptoms do not include her eyes as a priority, so these drops are not needed.
E. Sterimar may help to give temporary relief to the sinuses but she is looking for an
alternative to her current antihistamine
A 24-year-old woman would like to discuss her prescription with you. She informs you
that she was recently diagnosed with a urinary tract infection by her GP and was
provided with a prescription that she collected three days ago from the pharmacy. She
has noticed her urine has changed to a brownish colour since taking the medication.
Which one of the following medicines is the most likely cause of urine
discolouration?
Select one:
Amoxicillin
Cefalexin
Nitrofurantoin
Pivmecillinam
Trimethoprim
Nitro can discolour the urine
You have received a prescription for a schedule 2 Controlled Drug (CD) and have
supplied it to a patient. You record the supply in the appropriate CD register.
Which of the following is a professional and legal requirement with regards to CD
register records?
Select one:
A running balance is mandatory to be recorded in the CD register
CD stock balance checks must be completed once a week on the same day each
week
Electronic CD registers may allow entries to be amended at a later date
Electronic CD registers should be kept for two years from the date of the last
entry
Written CD registers must be maintained alongside electronic registers at the
premises
Electronic CD registers should be kept for two years from the date of the
last entry
Don’t need to have both written and electronic. Registers shouldn’t be amendable at a
later date. For most organisations stock checks should be at least once a week but may
be more or less frequent based on risk. Registers should be kept 2 years from the date
of the last entry. Running balance is good practice not yet mandatory.
You are reviewing medication for a 74-year-old man with dementia. He is being treated
in hospital as he has recently deteriorated and is often confused. You are calculating the
Anticholinergic Cognitive Burden (ACB) score.
Which of the following medicines has the most significant contribution to the
patient’s anticholinergic burden?
Select one:
Aspirin
Donepezil
Oxybutynin
Ranitidine
Simvastatin
This can also be worked out through knowing the pharmacology of each of the above
Oxybutinin is an antimuscarinic drug and has the most significant contribution
A - No relevant mechanism
B - treats dementia – acetylcholine esterase inhibitor -> inhibits enzyme that breaks
down acetylcholine -> cholinergic stimulation
Although quetiapine and ranitidine also contribute - this is not as significant as
oxybutynin
54-year-old man visits his GP, complaining of
increasing frequency of urination at night and excessive thirst. His GP checks his blood
glucose levels and HbA1c (glycated haemoglobin).
Which of the following would most likely lead to suspected diagnosis of type 2
diabetes?
Select one:
HbA1c of 44 mmol/mol and fasting plasma glucose of 5.0 mmol/L
HbA1c of 44 mmol/mol and random plasma glucose of 7.0 mmol/L
HbA1c of 46 mmol/mol and random plasma glucose of 10.0 mmol/L
HbA1c of 48 mmol/mol and fasting plasma glucose of 5.0 mmol/L
HbA1c of 48 mmol/mol and random plasma glucose of 12.0 mmol/L
Based on HbA1c of 48 mmol/mol (6.5%) or more, fasting plasma glucose level of 7.0
mmol/L or more or random plasma glucose of 11.1 mmol/L or more in the presence of
symptoms or signs of diabetes
The patient is provided with dietary and lifestyle advice and initiated on a new medicine.
He brings in a prescription to the pharmacy for metformin 500 mg once a day.
Which of the following counselling points regarding metformin is most
appropriate to provide the patient?
Select one:
Gliclazide is associated with a lower risk of hypoglycaemia compared to
metformin
Hypoglycaemia commonly occurs with metformin use
Metformin can cause weight gain and is usually prescribed if symptoms persist
despite adequate attempts at dieting and weight loss
Metformin exerts its effect mainly by increasing gluconeogenesis in the liver
Metformin is only effective in the presence of insulin
Metformin exerts its effect mainly by decreasing gluconeogenesis and by increasing
peripheral utilisation of glucose; since it acts only in the presence of endogenous insulin
it is effective only if there are some residual functioning pancreatic islet cells
Which one of his medications is most likely to have contributed to the abnormal
result of low potassium?
Select one:
Amitriptyline
Amoxicillin
Bumetanide
Co-codamol
Paracetamol
bumentanide is a loop diuretic, therefore hypokalaemia can occur
A mother presents at the pharmacy to purchase some lactulose over the counter for her
3-year-old son, as recommended by her GP. The child takes lactulose regularly and is
taking 5 mL twice a day.
How many bottles of 200 mL lactulose is most appropriate to supply for 28 days
of treatment?
Select one:
0.5 bottle
1 bottle
2 bottles
3 bottles
4 bottles
5 mLs x 2 = 10 mL per day.
10 x 28 = 280 mL for 28 days.
Not appropriate to split bottles for OTC purchase, and long-term treatment so supply 2
bottles.
A 29-year-old man recently presented to his GP due to episodic bouts of diarrhoea. He
also experienced flatulence, abdominal cramps, and bloating. He was diagnosed with
irritable bowel syndrome (IBS). He was prescribed medicines to help relieve his long
term IBS symptoms.
Which one of the following medicines is most likely to have been prescribed for
the presenting symptoms?
Select one:
Fybogel sachets, one to be taken once daily
Laxido sachets, one to be taken once daily
Loperamide 2 mg capsules, one to two to be taken as required
Mebeverine 135 mg tablets, one to be taken three times a day
Mefenamic acid 500 mg tablets, once to be taken three times a day
Mebeverine 135 mg tablets, one to be taken three times a day.
For symptomatic relief of IBS symptoms- loperamide could be given however question
asks re long term symptomatic management
A patient comes into the pharmacy as they have run out of nifidipine 10 mg tablets. You
check their record and determine that it is appropriate for you to provide an emergency
supply of the medicine.
Which of the following is the most appropriate action to take with regards to the
supply?
Select one:
You can give a full two months supply of medication
You can lend the medicine to the patient and deduct the quantity from their next
prescription
You must give 28-day supply of medication
You must give five days supply of medication
You need to make a record of the form of the medication supplied
Answer: You need to make a record of the form of the medication supplied
Lending medication would be very difficult to justify if an emergency supply could have
been used. See P18 MEP
See requirements of recording and general requirements of Emergency supply at
request of patient, P58 or MEP
You cannot supply more than 30 days treatment.
Reference: P18 and P58 MEP
A
43-year-old woman presents to your pharmacy complaining of pins and needles in
her
feet. She tells you that she has recently been very fatigued and has not
had the energy
to complete daily tasks. Alongside this, she has had a low mood for
the past few weeks.
She tells you that she has a good vegetarian diet, although
her recent mouth ulcers
have made eating a little more difficult.
Which one of the following tests are you most likely to advise?
Select one:
C reactive protein
Ferritin
Mean cell volume
Platelets
Vitamin B12
Vitamin B12
Symptoms highlighted indicate b12 deficiency- also indicated by vegetarian diet
You suspect a man in your pharmacy is experiencing a hypoglycaemic episode. He is
sweaty, feeling dizzy but is conscious and responsive. He is 45 years old.
Which of the following would be the most appropriate management of his
hypoglycaemia?
Select one:
1 mg glucagon injection
2 glucose tablets
20 g of sugar dissolved in water
100 mL of pure fruit juice
200 mL of diet coke
20 g of sugar dissolved in water
15–20 g (3–4 heaped teaspoonfuls of sugar dissolved in water,
or 150–200 mL pure fruit juice,
or 4–7 glucose tablets)
repeated after 10–15 minutes if necessary
Glucagon only used if patient unresponsive/no oral rout
You are the responsible pharmacist at a community pharmacy. A 24-year-old patient
visits your pharmacy and complains that they have been given the wrong medication.
Upon further investigation you find the prescription and notice that the incorrect
medicine was supplied the previous day when another pharmacist was on duty as the
responsible pharmacist.
Which of the following is the most appropriate initial actions to take?
Select one:
Apologise for the error made and make a correct supply of the medicine
Ask the patient to come back when the regular pharmacist is in as they need to
know about the error
Explain that the error is not very serious, so the patient does not complain further
Find out who made the error and escalate the issue to senior colleagues
Never apologise, as this is an admission of guilt
Apologise for the error made and make a correct supply of the medicine
A 24-year-old man asks to buy the new POM to P antihistamine, fexofenadine (Allevia)
to treat his hay fever. You find out he is taking an antibiotic for sinusitis, but he cannot
remember the name of the antibiotic.
Which antibiotic should most likely be avoided when taking fexofenadine?
Select one:
Amoxicillin
Cefalexin
Doxycycline
Erythromycin
Flucloxacillin
Erythromycin - co-administation has been found to result in 2-3 times increase in the level of fexofenadine
You are delivering training to the healthcare assistants that work with you in your
community pharmacy. The training is regarding medication for constipation, and you
discuss the use of senna tablets.
Which one of the following statements regarding senna is most appropriate to
advise the healthcare assistants?
Select one:
Senna can be used in patients with intestinal obstruction
Senna is safe in pregnancy however needs to be prescribed
Senna is the first line treatment for constipation when treating over the counter
Senna tablets are licensed for use in adults and children over 2 years old
Senna tablets can be sold for anyone over 12 years old over the counter
E is only true option. C/I in obstruction, 3rd line for medication treatment, is safe in
pregnancy, and licensed as POM > 6 years old.
The focus of this question is about a supply over the counter as you are training a
healthcare assistant, therefore clinical cautions and legal restrictions need to be
considered. Also healthcare assistants need to know that it is safe in pregnancy but the
patient would need a prescription. It would be part of their role to refuse a supply and
direct the patient to a GP.
A 32-year-old woman is currently eight weeks pregnant. She has been advised by her
midwife to take the higher dose of folic acid, 5 mg tablets once a day, for the first 12
weeks of her pregnancy. She has no known allergies.
Which of the following is the most likely reason for the higher dose folic acid?
Select one:
Patient’s first pregnancy
Patient had a low body mass index prior to pregnancy
Patient has iron deficiency anaemia
Patient is a diabetic
Patient takes low dose antibiotics for urinary tract infection prevention
Patient is a diabetic
Higher dose recommended for those with history of neural tube defects, diabetic,
overweight, antiepileptic medication / antiviral for HIV prescribed
A 37-year-old woman is booked in for a routine medication review. Upon reviewing her
notes, you notice she was prescribed subcutaneous methotrexate 20 mg once weekly
by the outpatient hospital team.
Which one of the following is the most appropriate advice to provide the patient
about folic acid?
Select one:
Folic acid 400 microgram tablets is usually prescribed for those patients using
subcutaneous methotrexate
Folic acid 5 mg tablets are not required as the patient is prescribed subcutaneous
methotrexate rather than oral methotrexate
Folic acid 5 mg tablets should be taken once a day every day
Folic acid 5 mg tablets should be taken on the same day as taking methotrexate
Folic acid 5 mg tablets to be taken daily except on the day of taking methotrexate
Folic acid 5mg tablets to be taken daily except on the day of taking
methotrexate
Same clinical rationale if patient were to be prescribed oral methotrexate – to continue
with folic acid apart from on the day of taking methotrexate
You are reviewing an NHS prescription for a new patient who has not visited your
pharmacy before. You notice the prescription does not legally meet prescription
requirements.
The item is for aciclovir 200 mg. The prescription is dated 2 April 2021.
Which of the following details makes the prescription legally invalid?
Select one:
The prescription does not specify the formulation of the medicine
The prescription does not specify the particulars of the prescriber
The prescription does not specify the patient’s date of birth
The prescription does not specify the patient’s middle name
The prescription does not specify the quantity of the medicine to supply
No particulars
A 19-year-old woman presents to your pharmacy with a prescription for ferrous sulfate
tablets 200 mg to be taken three times a day. She is worried about the potential side
effects that she may experience and would like some advice on the medicine.
Which of the following is the most appropriate counselling point for the use of
ferrous sulfate?
Select one:
Crush the tablets and mix in yoghurt to aid palatability
Go to accident and emergency if stools are discoloured
Magnesium hydroxide is a useful laxative to alleviate constipation
Stop taking the medicine if constipation occurs
Take the medicine after food to help reduce gastrointestinal side effects
A - ascorbic acid improves absorption
B - Normal side effect- expected and not always harmful
C - Magnesium hydroxide may impair absorption of ferrous sulfate - avoid due to
interaction
D - normal side effect – can take laxatives or increase fiber instead
E - Correct - taking after food may help to reduce GIT side effects
A 38-year-old man is started on treatment for tuberculosis. He has been prescribed
rifampicin, ethambutol, pyrazinamide, isoniazid, and pyridoxine.
What is the most likely reason to prescribe pyridoxine as part of this regimen?
Select one:
To correct B12 deficiency
To improve absorption of isoniazid
To improve efficacy of rifampicin
To prevent drug induced peripheral neuropathy
To reduce side effects of pyrazinamide
Pyridoxine should be given alongside isoniazid to prevent neuropathy
Some Controlled Drug (CD) medicines legally need to be stored under safe custody.
You are training a pre-registration pharmacist who wants to know more about CDs and
safe custody requirements.
Which one of the following medicines does not need to be kept under safe
custody?
Select one:
Buccolam (midazolam)10 mg/2 mL oromucosal solution
MST Continus (morphine sulfate) 10 mg tablets
Oramorph (morphine sulfate) 20 mg/mL concentrated oral solution
Oxycontin (oxycodone hydrochloride) 10 mg prolonged release tablets
Temazepam 10 mg tablets
Temazepam schedule 3 – not exempt from safe custody
B,C,D - Schedule 2 therefore require safe custody
A (midazolam) Schedule 3 - exempt from safe custody
A father brings his 3-year-old child into the pharmacy. The child’s symptom of perianal
night-time itching leads you to conclude that he has threadworm.
Which one of the following is the most appropriate course of action?
Select one:
Do not supply mebendazole as he is too young and provide hygiene advice
instead
Supply mebendazole as a single dose to the child only
Supply mebendazole as two doses, at a 14-day interval to the child only
Supply mebendazole to all family members as a one-off dose
Supply mebendazole to the whole family, followed by a repeat dose after 14 day
Supply mebendazole to the whole family, followed by a repeat dose after
14 days
Mebendazole is drug of choice to people over the aged of two. It is recommended that
all family members should be treated and a repeated dose should be given
A 15-year-old girl has been given a prescription by her GP for H. pylori eradication
therapy. She has no known drug allergies and takes no other medication.
Which one of the following options is most appropriate as first line treatment?
Select one:
Amoxicillin 1 g three times a day, clarithromycin 500 mg twice a day, and a PPI
for 7 days
Amoxicillin 1 g twice a day, clarithromycin 500 mg twice a day, and a PPI for 7
days
Amoxicillin 1 g twice a day, clarithromycin 500 mg twice a day, and a PPI for 14
days
Clarithromycin 500 mg twice a day, metronidazole 400 mg twice a day, and a PPI
for 7 days
Clarithromycin 500mg twice a day, metronidazole 400 mg twice a day, and a PPI
for 14 days
Amoxicillin 1 g twice a day, clarithromycin 500 mg twice a day, and a PPI
for 7 days
A, C, E – wrong doses/durations of medication
D – for penicillin allergic patients. She is not penicillin allergic
A 25-year-old woman is taking the combined oral contraceptive pill and enquires about
how frequently she should go undergo routine cervical screening. She has no known
medical conditions and is not taking any other medicines.
Which of the following is the most appropriate f frequency at which routine
cervical screening should be undertaken?
Select one:
Every 1 year
Every 2 years
Every 3 years
Every 4 years
Every 5 years
Every 3 years
Women aged 24.5 years should receive their first invitation to ensure they can be
screened before they are aged 25 years. Those who are 25–49 years should be offered
screening every 3 years. Women who are 50–64 years should be offered screening
every 5 years.
A 46-year-old patient with a history of epilepsy is admitted with sepsis of unknown
origin. The consultant wishes to initiate broad-spectrum antibiotics.
Which of the following medicines is most likely to be contraindicated?
Select one:
Amoxicillin
Ceftriaxone
Ciprofloxacin
Clindamycin
Piperacillin -Tazobactam
Answer: Ceftriaxone
Ciprofloxacin lowers seizure threshold
An 8-year-old boy requires treatment with antibiotics for a chest infection. He has a
history of asthma and an allergy to penicillin. His drug history includes salbutamol 100
mcg inhaler two puffs as required, and beclometasone (Qvar) 50 mcg one puff twice
daily.
Which one of the following antibiotics would be most appropriate to treat the
patient’s chest infection?
Select one:
Amoxicillin
Azithromycin
Ciprofloxacin
Co-amoxiclav
Doxycycline
Azithromycin
Amoxicillin and co-amoxiclav is not appropriate due to allergy
Doxycycline – deposits in bones/teeth so not ideal for children
A 17-year-old girl comes into the pharmacy presenting with small red pustules on the
face which are tender to touch. You believe she has mild acne.
Which one of the following is most appropriate to be recommended over the
counter as treatment for her symptoms?
Select one:
Azelaic acid 20% cream
Benzoyl peroxide 5% gel
Benzoyl peroxide 10%, potassium hydroxyquinoline 5% cream
Hydrocortisone 1% ointment
Nicotinamide 4% gel
B
A patient has attended your pharmacy to purchase treatment over the counter for mouth
ulcers. He has no known drug allergies and takes methotrexate and folic acid for
rheumatoid arthritis. There is no recent trauma to the mouth, and the patient has been
well with no other concerns.
Which one of the following is the most appropriate advice to provide with regards
to his mouth ulcers?
Select one:
Mouth ulcers can be a side effect of folic acid and are not cause for concern
Mouth ulcers can be a side effect of folic acid and are treatable over the counter
Mouth ulcers can be a side effect of methotrexate and are not cause for concern
Mouth ulcers can be a side effect of methotrexate and are treatable over the
counter
Mouth ulcers can be a sign of methotrexate toxicity and this patient needs to be
referred to their doctor immediatel
Mouth ulcers can be a sign of methotrexate toxicity and this patient
needs to be referred to their doctor immediately
A 2-year-old boy has been suffering with hay fever symptoms. His mother would like to
purchase some medicine from the pharmacy to control his symptoms.
Which one of the following medicines and doses would be most appropriate for
the patient?
Select one:
Beclometasone nasal spray 50 mcg (50 mcg) two puffs twice a day
Cetirizine oral solution 2.5 mL (2.5 mg) twice a day
Chlorphenamine oral solution 5 mL (2 mg) four times a day
Loratadine oral solution 10 mL (10 mg) daily
Pseudoephedrine 5 mL (30 mg) three times a day
Cetirizine oral solution 2.5 mL (2.5 mg) daily
A, C to E are appropriate doses but for children older than 2 years of age
You are working alongside a commissioning pharmacist to improve patient health
outcomes in your local area. You have been asked to present to the local healthcare
professionals in your area about the importance of primary prevention in cardiovascular
disease (CVD).
Which one of the following statements regarding primary prevention is most
accurate?
Select one:
Aspirin is recommended in the primary prevention of CVD
Consider a risk assessment in patients with a CVD 10-year risk of 10 % or more
QRISK2 is the only CVD risk calculator currently available
The risk of CVD is lower in certain ethnic backgrounds such as South Asian
Total cholesterol, HDL-cholesterol, and non-HDL-cholesterol concentrations
should be checked six months after starting treatment with a high-intensity statin
Consider a risk assessment in patients with a CVD 10-year risk of 10 %
or more
A patient was admitted into hospital for a coronary bypass surgery. A parenteral nutrition
bag was mistaken for a cardioplegic solution for the coronary bypass surgery resulting
in a significant medication error. Following this medication error, the hospital pharmacy
conducted a root cause analysis.
Which of the following is the most appropriate action regarding a root cause
analysis in this case?
Select one:
A root cause analysis is inappropriate to be used in this case
A root cause analysis should be used to confirm that a medication error has
taken place
A root cause analysis should be used to identify all factors that could have
contributed to this error for analysis
A root cause analysis should be used to identify the pharmacist who made the
error
A root cause analysis should be used for indemnity insurance purposes
A root cause analysis is used to identify all factors that could have
contributed to this error for analysis
A root cause analysis is not intended to focus on blame but on all factors that could
have been related to this error and therefore prevented by better systems. Factors might
include training of pharmacist and technicians, the label etc.
Reference: NHS Improvement https://www.england.nhs.uk/w
A midwife
calls the pharmacy about a 32-year-old woman, who is five months pregnant
and
has a BMI of 40. She requires further information about pain relief during
labour.
Which of the following is most likely to be used for acute labour pain?
Select one:
Codeine
Fentanyl
Levobupivacaine
Morphine
Tramadol
Levobuprivacine is indicated for acute labour pain. The other options are not
A 65-year-old, black-African man, with persistent stage 2 hypertension, needs to be
initiated on hypertension treatment. He has no known drug allergies and currently takes
metformin 500 mg three times a day.
Which of the following antihypertensive medicines would be most appropriate to
initiate?
Select one:
Amlodipine
Candesartan
Indapamide
Nifedipine
Ramipril
As the patient is diabetic (on metformin) ACEIs and ARBs are first line - irrespective of
age (see the NICE guidelines and flow chart).
B or E are also suitable options, however ARBs are preferred over ACEIs due to the
patient’s ethnicity, therefore B is the single best answer.
A 46-year-old man presents with a rash around his wrists that is raised and shows fine
white streaks on their surface. You suspect lichen planus.
He is taking medicines for hypertension.
Which of the following medicines is most likely to cause symptoms similar to
lichen planus?
Select one:
Atenolol
Atorvastatin
Bendroflumethiazide
Losartan
Nifedipine
Bendroflumethiazide
Rash is possible with all but a lichenoid drug eruption has been reported with thiazide
diuretics
A 37-year-old woman presents at your pharmacy to purchase pseudoephedrine to
control symptoms of nasal congestion. She has a medical history of hypertension and
heart disease, and get dialysis three times a week for end stage renal disease.
Which of the following statements regarding pseudoephedrine is most
appropriate to provide to the patient?
Select one:
A maximum of 720 mg of pseudoephedrine can be
sold at any one time, but is
not suitable for this patient
A product containing pseudoephedrine and a product containing ephedrine can
be purchased over the counter at the same time
Pseudoephedrine can be used in patients with heart disease without concern
Pseudoephedrine can be used in patients with severe renal impairment without
concern
Women who are pregnant or breastfeeding can buy and take pseudoephedrine
over the counter
A maximum of 720 mg of pseudoephedrine can be sold at any one time,
but is not suitable for this patient
An 81-year-old woman brings in a prescription
for her 82-year-old husband who has
dementia. He has been prescribed donepezil
5 mg tablets, to be taken once a day.
Which one of the following statements regarding donepezil is most accurate?
Select one:
Aggression is a common side effect of donepezil
Caution when prescribing in the elderly is not required for donepezil
Donepezil is not indicated for dementia in Alzheimer’s disease
Donepezil should be used with caution in renal impairment
The dose of donepezil usually starts at 10 mg to be taken once a day
Aggression is a common side effect of donepezil
Dose usually starts at 5 mg, prescribe cautiously in elderly, no renal restrictions (as per
BNF and manufacturer)
You are reviewing an NHS prescription for methadone. It is coming up to a Bank Holiday
and the pharmacy will be closed. You need to ensure that the prescription contains
appropriate approved wording for you to make a supply to cover the closed days.
Which of the following is the most appropriate wording for supplying methadone
on closed days?
Select one:
Please dispense instalments due on Bank Holiday on the day prior to this
Please
dispense instalments due on closed days on the day prior to this
Please dispense
instalments due on pharmacy closed days on the next suitable
day
Please dispense instalments due on pharmacy closed days on a prior suitable
day
Please dispense instalments in advance for closed days and the Bank Holiday
lease dispense instalments due on pharmacy closed days on a prior
suitable day
A 74-year-old man is taking methotrexate 20 mg once a week for his psoriasis. He has
recently been experiencing abdominal pain and his urine is a dark colour.
Which of the following investigations is the most appropriate for this patient?
Select one:
Chest x-ray
Inflammatory markers
Liver function tests
Neurological examination
Urea and electrolytes
Dark urine is attributed to liver disease - LFTs
A 65-year-old Caucasian man experiences swelling and pain in his right foot. His GP
assesses the patient and diagnoses him with an acute flare of gout and initiates the
patient on colchicine. He has a past medical history of hypertension, gout, and benign
prostatic hyperplasia. His repeat medicines include amlodipine, ramipril, allopurinol,
indapamide, and tamsulosin.
Which one of his medicines most likely contributed to the exacerbation of gout?
Select one:
Allopurinol
Amlodipine
Indapamide
Ramipril
Tamsulosin
Indapamide
Thiazides and related diuretics can exacerbate diabetes, and gout
You have received a delivery of temazepam from your pharmacy wholesaler in your
hospital pharmacy.
Which of the following record keeping requirements is most appropriate for
temazepam?
Select one:
A running balance of temazepam must be recorded in the Controlled Drugs
register
Invoices for temazepam do not need to be retained
Invoices for temazepam need to be retained for five years
Invoices for temazepam need to be retained for two years
The receipt of temazepam must be recorded in the Controlled Drugs register
Invoices for temazepam need to be retained for two years
Temazepam is a Schedule 3 drug therefore is exempt from certain record keeping
requirements required for other schedules of controlled drugs.
Some hospitals will record temazepam in their CD register, but this is not a legal
requirement.
An 84-year-old man is initiated on co-careldopa after being referred to a specialist
hospital outpatient clinic, presenting with hypokinesia and rigidity.
Which of the following drugs is most appropriate to be prescribed for the
management of nausea or vomiting, associated with co-careldopa use?
Select one:
Domperidone
Haloperidol
Levomepromazine
Metoclopramide
Prochlorperazine
Domperidone
All others are CI or cautioned in Parkinson as they can exacerbate symptoms
A 3-year-old girl is prescribed aspirin as an antiplatelet following cardiac surgery to
prevent thrombus formation. You check the BNF, and confirm the dose is correct and it
is listed as appropriate to prescribe.
Which of the following is statements regarding aspirin in paediatric patients is
most accurate?
Select one:
Aspirin is licensed for use in under 16-year olds
Aspirin is safe to prescribe in previous history of hypersensitivity to NSAID
Aspirin is safe to use in asthmatic patients
Manufacturer states avoid aspirin in under 16-year olds due to risk of Kawasaki
disease
Manufacturer states avoid aspirin in under 16-year olds due to risk of Reyes
syndrome
Manufacturer states avoid aspirin in under 16-year olds due to risk of
Reyes syndrome
A 34-year-old man visits the pharmacy for advice on his symptoms. He has just eaten at
a new restaurant and now feels wheezy, lightheaded with clammy skin and a fast
heartbeat. Upon questioning him about his medical conditions, you find out he has a nut
allergy.
Which of the following actions is the most appropriate to take?
Select one:
Administer adrenaline to the patient immediately
Advise the patient that you need a prescription to supply adrenaline
Advise the patient to attend accident and emergency immediately
Call 999 for an ambulance immediately
Call NHS 111 for advice on what action to take
Administer adrenaline to the patient immediately
P125 MEP- Regulation 238 of the Human Medicines Regulations 2012 allows
adrenaline to be administered by anyone for the purpose of saving life in an emergency.
Therefore pharmacists using their professional and clinical judgement can administer
adrenaline in an emergency to persons presenting with symptoms of anaphylaxis.
If a pharmacist administers adrenaline they must also ensure that an ambulance is
called by dialling 999 and reporting that there is a case of suspected anaphylaxis
An 18-year-old man is started on phenytoin 300 mg capsules daily, for tonic-clonic
seizures.
Which one of the following is the most appropriate plasma phenytoin
concentration for an optimum response?
Select one:
1 – 2 mg/L
10 – 20 mg/L
40 – 80 mg/L
100 – 200 mg/L
400 – 800 mg/L
10-20
A 6-year-old boy presents to the GP clinic with worsening asthma symptoms. He uses
beclometasone 100 micrograms inhaler and salbutamol 100 micrograms inhaler.
He presents with the following observations:
Breathless when talking
SpO2 < 92%
Peak flow 45% best
Heart rate 130 bpm
Respiratory rate 28 breaths /min
Which one of the following is the most appropriate course of action?
Select one:
Ask the patient to wait in the patient waiting area for 30 minutes and then recheck
his observations
Ask the patient to wait in patient waiting area for one hour whilst administering
salbutamol nebules and then recheck his observations
Recommend a prescription for salbutamol 100 micrograms inhaler, 10 puffs to be
used every two hours
Refer the patient to accident and emergency
Step up the beclometasone treatment as his peak flow is 45 % be
Refer to A + E. Potentially severe acute asthma
A new patient brings in a private prescription for codeine 30 mg tablets. It appears that
all legal requirements have been met.
You have been made aware that two local pharmacies have recently received forged
prescriptions. The patient appears to be agitated and nervous which also makes you
suspect that the prescription may not be genuine.
Which of the following is most likely to suggest that the prescription is
fraudulent?
Select one:
The prescription is for 90 tablets
The prescription is handwritten
The prescription is not on letter headed paper
The prescription is signed by a local GP
The prescription specifies Dr before the signature
The insertion of title ‘Dr’ before the signature could suggest a fraudulent prescription.
Prescribers would not usually use their title next to their signature
You are a checking the accuracy of some dispensed medication within your pharmacy to
ensure it contains all the necessary legal requirements.
Which of the following is most likely to be a legal requirement required on
dispensed medication labels?
Select one:
The brand and generic name of the product
The date the item was dispensed
The expiry date of the product
The formulation of the product
The warning ‘Keep out of the reach and sight of children’
The date the item was dispense
It should be noted that the RPS recommends the following also appears on the
dispensing label, ‘Keep out of the reach and sight of children’, however this is not a legal
requirement.
An additional note is that keep out of reach part is a legal requirement but not and sight
A 38-year-old woman presents to an endocrinology ward where she is being treated for
primary hyperparathyroidism. Blood tests have been ordered.
Which of the following is most likely to be monitored regularly and potentially
supplemented?
Select one:
Vitamin A
Vitamin B12
Vitamin C
Vitamin D
Vitamin E
For people with a probable diagnosis of primary hyperparathyroidism, measure vitamin
D and offer vitamin D supplements if needed.- as stated in NICE guidance.
A 62-year-old man informs you he has been prescribed a new medicine for his
overactive bladder that requires close blood pressure monitoring.
Which of the following medicines has most likely been prescribed for the patient?
Select one:
Finasteride
Mirabegron
Oxybutynin
Propiverine
Solifenacin
Blood pressure should be monitored before starting treatment and regularly during
treatment, especially in patients with pre-existing hypertension with mirabegron
All licensed for overactive bladder apart from A but no specific requirement regarding
BP
A 65-year-old woman is admitted to hospital with an exacerbation of chronic obstructive
pulmonary disease (COPD). She has had five exacerbations in the last 12 months.
Her current inhaler therapy is Trimbow (beclometasone dipropionate, formoterol
fumarate dihydrate, glycopyrronium) and salbutamol. The respiratory specialist decides
to initiate azithromycin as a prophylactic antibiotic.
Which of the following monitoring requirements is most appropriate for this
patient?
Select one:
Baseline ECG and LFT’s
Baseline ECG and U and E’s
Baseline chest x-ray and LFT’s
Baseline chest x-ray and U and E’s
U and E’s and LFT’s
Baseline ECG and LFT’s
ECG needed to rule out prolonged QT and LFT’s also required (CT scan and sputum
cultures also actioned)
A 32-year-old woman with has a known history of childhood asthma presents for a
medication review with you in general practice. You decide to change her treatment from
her Clenil inhaler (beclometasone dipropionate) to Fostair inhaler (beclometasone
dipropionate and formoterol fumarate dihydrate).
Which one of the following statements regarding Fostair inhaler is correct?
Select one:
Fostair can be used as maintenance and reliever therapy in response to COPD
symptoms
Fostair has extra fine particle size distribution which can produce a more potent
effect
Fostair is a dry powder inhaler
Fostair is unlicensed for use in asthma
Fostair is unlicensed for use in COPD
Fostair has extra fine particle size distribution which can produce a more
potent effect
Not A as this is for asthma
Not C as the Fostair NEXThaler device is a dry powder inhaler
Not D or E as licensed in both
B – comparing to other beclomethasone inhalers with particles not as fine
