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Pharm Y1 > The Public Semester 1 > Flashcards

The Public Semester 1 Flashcards

1
Q

What does vascular disease include?

A

Coronary heart disease
Stroke
Diabetes
Kidney disease

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2
Q

What is the target age group for the vascular risk assessment screening programme?

A

40-74

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3
Q

What 13 pieces of information should be obtained from someone undergoing a vascular risk assessment?

A 
Age
Gender
Smoking status
Family history of vascular disease
Existing treatment for hypertension
Postcode
BMI
Systolic blood pressure
Total and HDL cholesterol
Ethnicity
Rheumatoid arthritis 
Chronic kidney disease
Atrial fibrillation
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4
Q

At what percentage is vascular risk actionable with medication? What medication is given as standard?

A

At a risk of higher than 20%

Statins can be given

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5
Q

What is the name of the calculator developing for assessing vascular risk in the UK?

A

QRisk

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6
Q

What is the average total cholesterol value?

A

5.5mmol/L

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7
Q

What lifestyle factors contribute to vascular risk?

A

Physical inactivity, weight, smoking status, cholesterol levels, obesity, high blood pressure

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8
Q

What three types of medication are available for use in the UK as emergency hormonal contraception?

A 
Levonelle One Step (OTC)
Levonelle 1500 (POM)
Ella One (POM)
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9
Q

How much levonorgestrel do the Levonelle products contain?

A

1500mg

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10
Q

How does levonorgestrel work in EHC?

A

It appears to delay ovulation by up to a week and arrest the development of the ovarian follicle

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11
Q

When is levonorgestrel effective as an EHC?

A

Its effects are unknown if taken on or just after ovulation so the SPC states it is ineffective once the process of implantation has begun

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12
Q

What drug is present in Ella One and how much of it?

A

It contains 30mg of ulipristal

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13
Q

How does ulipristal work in EHC?

A

It interrupts the leutenising hormone surge just before ovulation, working later in the cycle than levonorgestrel

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14
Q

How long after UPSI is Ella One licensed for use?

A

Up to 120 hours

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15
Q

How long after UPSI is Levonelle licensed for use?

A

Up to 72 hours however there is evidence to show effectiveness up to 96 hours after UPSI

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16
Q

How long should a patient wait before breastfeeding after taking Ella One?

A

They should not breastfeed until 36 hours after ingestion

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17
Q

What type of drug can interact with Levonelle? And what is the result of this reaction?

A

Potent enzyme inducers (such as rifampicin) can increase metabolism of Levonelle and therefore reduce its efficacy

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18
Q

If an IUCD is inappropriate but a patient is taking potent enzyme inducers, what can be given as EHC?

A

Two Levonelle tablets can be given

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19
Q

What happens if an interaction between Levonelle and ciclosporin (potent enzyme inducers) occurs?

A

Toxicity increases so an IUCD may be more appropriate

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20
Q

Give examples of potent enzyme inducers.

A 
Rifampicin
Carbamazepine
St John's Wort
Phenylbutazone
Primidone
Ritonavir
Phenobarbital
Ciclosporin
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21
Q

How long after taking EHC should a patient return for another tablet if they vomit?

A

Levonelle- 2 hours

Ella One- 3 hours

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22
Q

On what grounds can EHC be given to an under 16?

A 
OTC Levonelle is unlicensed for this use
PGD can allow prescribing of EHC providing criteria is filled:
At risk of pregnancy
Deemed sufficiently mature to understand
Parental consent is discussed
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23
Q

Under what circumstances is it reasonable to believe COCP has failed?

A

EHC is indicated if two pills are missed in the first week and UPSI has occurred in the first or pill free week

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24
Q

Under what circumstances is it reasonable to believe POP has failed?

A

EHC is indicated if one pill is missed beyond the desired interval (12 hours for Cerazette, 3 hours for others)

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25
Q

With the POP how long after EHC until contraceptive effect is reestablished?

A

48 hours after Levonelle

9 days after Ella One

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26
Q

Under what circumstances is it reasonable to believe the contraceptive patch has failed?

A

If the patch remains fully or partially detached for 24 hours, apart from the patch free week, EHC is indicated

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27
Q

Under what circumstances is it reasonable to believe the vaginal ring has failed?

A

If expelled and remains outside the vagina for more than 3 hours or the ring free interval extends past 9 days, EHC is indicated

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28
Q

Under what circumstances is it reasonable to believe IUS/IUD has failed?

A

EHC is indicated if partial or full expulsion occurs, or it is removed mid cycle, and UPSI occurs 5 days before removal

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29
Q

Under what circumstances is it reasonable to believe Medroxyprogesterone Acetate has failed?

A

If more than 14 weeks since a DMPA injection has passed, contraceptive efficacy begins to wear off. Up to 120 hours after the 14 weeks EHC is indicated

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30
Q

What criteria must an EHC patient meet before using a PGD? And what does a PGD cover?

A

Age (potentially including under 16s)
Patients meeting requirements may receive EHC free of charge, referrals should occur quickly, signposting to clinics and long term contraception should occur, clients excluded from criteria may purchase the service

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31
Q

What is considered the main aim when commissioning a minor ailments scheme?

A

Reducing demand for GP appointments

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32
Q

What are the three typical methods of access to MAS?

A

Vouchers: referral via the GP where patient is given a token to demonstrate entitlement to treatment.
Passports: a form of registration issued by a pharmacist allowing access to target specific patient groups without the inconvenience of first going to the GP. Entitles use in the future but may limit number of visits over a certain time period.
Open: patient can present whenever treatment is required and eligibility criteria is minimal.

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33
Q

What 5 criteria will GP surgeries look for before supporting MAS?

A

Patients will receive fast and effective care, advice and treatment.
Patients will be referred back where needed.
Surgeries are kept informed about patient care.
The impact MAS has on the workload of the surgery.
The MAS reflects their practice in treatments.

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34
Q

What is the most common reason for a GP consultation?

A

Skin infections

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35
Q

What is impetigo?

A

A bacterial infection of the skin often caused by staphylococcus aureus

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36
Q

Who is most commonly affected by impetigo?

A

Young children and people with underlying conditions such as eczema, head lice and scabies.

37
Q

What is the most common form of impetigo?

A

Crusted impetigo- where lesions form around the nose and mouth which burst to form yellow-crusted, weeping plaques. It is very infectious.

38
Q

What are the most common local and systemic treatments for impetigo?

A

Fusidic acid can be used to treat small areas of localised infection.
Larger areas require systemic treatment for 7 days with Flucloxacillin or Clarythromycin.

39
Q

What bacteria causes folliculitis, boils, carbuncles, whitlows?

A

Staphylococcal

40
Q

What pre existing conditions increase risk of staphylococcal infections?

A

Dermatitis
Immunosuppression
Obesity
Malnutrition

41
Q

What is the treatment for folliculitis?

A

Daily use of antiseptic washes containing chlorhexidine or triclasan.
Antiseptic emollients such as dermal or oilatum.
Occasionally use of fusidic acid can be used on localised areas.

42
Q

What bacteria causes hot tub folliculitis?

A

Infection of hair follicles by pseudomonas aeruginosa.

43
Q

What symptom presents with hot tub folliculitis?

A

Rash consisting of 0.5-3cm red papule with central pustule that can erupt.

44
Q

What are the differences between boils and carbuncles?

A

Boils- appear as painful red lumps that fill with pus, most commonly on hair bearing sites on the body.
Carbuncles- appear as tender abscesses with discharge, most commonly on the back of the neck, shoulders, hips and thighs.

45
Q

What are the treatments for boils and carbuncles?

A

Moist heat should be applied if they contain pus.
Analgesics can reduce discomfort.
They can be drained by practitioners.
Antibiotics can be given for large lesions.

46
Q

What bacteria causes erysipelas and cellulitis?

A

Strep. pyogenes

47
Q

What is the difference between erysipelas and cellulitis?

A

Cellulitis involves subcutaneous tissue whereas erysipelas involves dermis and dermal lymphatics.

48
Q

How does cellulitis present?

A

Inflammation and redness of the skin which can lead to blistering.
Fever, nausea, malaise and shivering may be accompanying symptoms.

49
Q

What is the characteristic symptom of erysipelas?

A

Orange peel like rash on the face of extremities.

50
Q

What are the two main causes of fungal infection?

A

Dermatophytes that invade keratin.

Yeast which opportunistically invades warm, moist sites.

51
Q

________ dermatophytes cause mild inflammation and spread from person to person.

A

Anthropophillic

52
Q

_______ dermatophytes cause more severe inflammation.

A

Animal

53
Q

What is the most common type of fungal infection?

A

Athlete’s foot.

54
Q

What are the three mains aims when treating athlete’s foot?

A

Eradicating infection
Promoting healing
Preventing reinfection

55
Q

What are the two types of fungal topical treatments?

A

Imidazole derivatives e.g. miconazole (fungistatic)

Allylamines e.g terbinafine (fungicidal)

56
Q

What is onychomycosis?

A

Fungal nail infection

57
Q

What is Candidiasis?

A

A yeast that causes infections of the skin folds, paronychia, genitals and mouth.

58
Q

What is molluscs contagiosum?

A

A highly contagious pox virus, spread by contact, that forms flesh coloured papules. If left untreated, it will clear on its own.

59
Q

What are viral warts caused by?

A

Infection of epidermal cells by the human papilloma virus.

60
Q

What are the 3 different possible appearances of warts?

A

Plantar- verrucas, occur on the soles of feet
Plane- smooth, flat topped and occur on the face or backs of hands
Mosaic- rough, marginated plaques made up of tightly packed plantar warts

61
Q

What are the 2 treatment options for warts?

A

Topical salicylic acid

Cryotherapy with liquid nitrogen

62
Q

What are the symptoms of herpes labialis?

A

Tingling around the mouth

Formation of painful vesicles that burst and crust over

63
Q

What is the treatment for eczema herpeticum?

A

Immediate systemic treatment with aciclovir

64
Q

What causes shingles?

A

Reactivation of the herpes virus which has remained dormant since an episode of chicken pox.

65
Q

What is the target age group for the Chlamydia screening services?

A

Under 25s

66
Q

Under what circumstances may under 16s use the chlamydia screening service?

A

They must be Fraser competent

67
Q

What do pharmacies offer as part of the chlamydia screening service?

A 
Testing kits
Advice on using the kit
Returns for testing
Contact chasing
Treatment in line with a PGD
68
Q

What symptoms can occur with chlamydia?

A 
Usually asymptomatic
Pain when urinating
Unusual discharge
Bleeding during/after sex
Burning/itching in the urethra
69
Q

What long term complications can occur with chlamydia?

A

Ectopic pregnancy
Pelvic inflammatory disease
Infertility
Inflammation of the testicles

70
Q

What is the standard treatment for chlamydia?

A

Azithromycin 500mg tablets

2-4 tablets given in one dose

71
Q

What is a PGD?

A

Documents permitting the supply of POMs to groups of patients without the need for an individual prescription

72
Q

What are the 7 types of nicotine replacement therapy?

A 
Gum
Patch
Lozenge
Sublingual tablet 
Inhalator
Nasal spray
Oral spray
73
Q

Name three diseases smokers have higher risk of?

A

COPD
Cancer (lung)
Cardiovascular disease

74
Q

What risks do smoking present in pregnancy?

A

Still birth
Premature delivery
Low birth weight
Oxygen deficiency

75
Q

Give examples of the immediate benefits of quitting smoking.

A 
Low blood pressure
Reduced carbon monoxide levels 
Lungs clear
Heart rate reduces
Smell and taste improves
76
Q

What is psychological dependence?

A

Feeling of satisfaction that requires periodic or continuous administration of the drug to feel pleasure or avoid discomfort

77
Q

What is physical dependence?

A

Intensive physical disturbances that occur when administration is suspended

78
Q

What are the 4 stages of drug use?

A
  1. Experimentation
  2. Recreational use
  3. Problematic use
  4. Addiction
79
Q

Give three examples of stimulants.

A

Amphetamine
Cocaine
Ecstasy

80
Q

Give three examples of depressants.

A

Opioids
Benzodiazepines
Cannabis

81
Q

Give two examples of hallucinogens.

A

LSD

Magic mushrooms

82
Q

What are the three measures of drug use?

A

Offences committed
Surveys
Treatment numbers

83
Q

What are the risks of heroin use

A

Physical dependence
Overdose
HIV, hepatitis or bacterial infections
Damaged veins

84
Q

What are the 6 steps for injection of heroin?

A

Mix freebase heroin, acid (citric) and water to form salt
Remove particles
Draw through filter into a syringe
Locate vein and tourniquet
Insert needle into vein and draw up some blood
Inject the drug and withdraw needle

85
Q

What four areas should be avoided as injection sites?

A

Femoral vein
Neck
Penis
Breast

86
Q

When should the tourniquet be removing during the heroin injection process?

A

Before injection of the drug

87
Q

Why should lemon juice and vinegar be avoided in the preparation of injectable heroin?

A

Lemon juice- risk of fungal infection

Vinegar- far too strong

88
Q

What are the two stages of methadone treatment?

A

1- maintenance, substitute heroin with methadone by increasing dose
2- withdrawal, aim to become completely drug free, reducing the dose

89
Q

What strength of buprenorphine tablets are available?

A

2mg and 8mg

Pharm Y1 (11 decks)

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