UCL Flashcards
Ms. C is considering taking an oral combined contraceptive pill as her main form of
contraception. She is worried about the risk factors that she has been reading about on the
internet.
Which of the following is least likely to be a risk factor for venous thromboembolism in
patients taking the combined oral contraceptive?
Select one:
1. age over 35 years
2. obesity
3. family history
4. smoking
5. hypertension
Hypertension
Mrs G’s doctor diagnoses her with type 2 diabetes which is initially managed with lifestyle
and diet changes. After 3 months it is decided that a blood test should be taken to see what
her HbA1c levels are.
Which of the following HbA1c values is the most appropriate target for Mrs G?
Select one:
1. 53 mmol/mol
2. 51 mmol/mol
3. 50 mmol/mol
4. 49 mmol/mol
5. 48 mmol/mol
48 mmol/L
What are blood glucose targets for diabetes?
A target HbA1c level of 48 mmol/mol (6.5%) is generally recommended when type 2 diabetes is managed by diet and lifestyle alone, or when combined with a single antidiabetic drug not associated with hypoglycaemia (such as metformin hydrochloride). Patients prescribed a single drug associated with hypoglycaemia (such as a sulfonylurea) should usually aim for an HbA1c level of 53 mmol/mol (7.0%).
Mr A has been prescribed theophylline, as this drug has a narrow therapeutic window, he
should be counselled to recognise the signs of toxicity.
Which of the following is a toxic effect of theophylline?
Select one:
1. bruising
2. drowsiness
3. convulsions
4. goitre
5. watering eyes
Convulsions
What are the toxicity signs of theophylline?
N&V/gastric irritation
Tachycardia
Convulsions
CNS stimulations (dizziness/agitation/dilated pupils)
Arrhythmias
Hypokalaemia
Blood in vomit
Severely uncontrolled asthma
You are running a training day with your medicine counter assistants for over-the-counter
(OTC) referrals.
Which of the following symptoms of piles is the least likely to warrant a referral to a doctor?
Select one:
1. a constant throbbing pain, made worse by sitting down
2. blood mixed in the stools, giving them a tarry red or black appearance
3. bright blood on the stools
4. symptoms have not improved after 1 week of treatment with over the counter products
5. haemorrhoid symptoms with nausea and vomiting
Bright blood on the stools
Mr H brings in a new prescription for sildenafil 100mg tablets. You are looking at his patient
medication record (PMR) and notice that this prescription is not safe due to a
contraindication from his regular medicines.
Which of the following medicines is contra-indicated with sildenafil?
Select one:
1. isosorbide 20 mg mononitrate
2. simvastatin 40 mg tablets
3. amlodipine 5 mg tablets
4. warfarin 5 mg tablets
5. aspirin 75 mg tablets
Isosorbide mononitrate
What is the interaction between sildenafil and isosorbide mononitrate?
Isosorbide dinitrate potentially increases the risk of hypotension when given with Sildenafil. Manufacturer advises avoid.
Question 20-22 concerns Mr R, he has presented to Accident and Emergency with central
crushing chest pain, which radiates down his arm. He is short of breath and feels nauseous.
The doctors have ordered an electrocardiogram (ECG) and troponin I levels to be taken immediately and after 12 hours.
Which of the following statements is false?
Select one:
1. an ECG will differentiate whether the patient has had a STEMI or NSTEMI
2. troponin I is a specific indicator of damage to the heart muscle
3. troponin I levels are taken immediately after chest pain is experienced and then after 12 hours to identify if the patients troponin levels have decreased
4. The patients symptoms are characteristic of a myocardial infarction
5. aspirin 300mg should be administered
troponin I levels are taken immediately after chest pain is experienced and then after 12 hours to identify if the patients troponin levels have decreased
When should troponin I levels be taken in an MI?
10–12 hours after the onset of symptoms
Ms. W is taking regular oral hydrocortisone for the foreseeable future.
Which of the following is not a recognised side effect of corticosteroid therapy?
Select one:
1. Addison’s disease
2. diabetes
3. hypertension
4. osteoporosis
5. water retention
Addison’s disease
What is Addison’s disease?
Addison’s disease (primary adrenal insufficiency) is caused by destruction of the adrenal cortex. This results in reduced production of glucocorticoids (such as cortisol), mineralocorticoids (such as aldosterone), and adrenal androgens (such as dehydroepiandrosterone).
How is Addison’s disease treated?
Mineralocorticoid replacement e.g., hydrocortisone
A lady comes into your community pharmacy. She would like some advice about her
daughter who has been suffering from a fever. You suspect they have an infection.
Which of the following may not need to be reported as a notifiable disease?
Select one:
1. food poisoning
2. toxic shock syndrome
3. meningitis
4. measles
5. whooping cough
Toxic Shock Syndrome
Mr T appears at the pharmacy asking for your advice. He has developed hypopigmented
macules and patches on his left arm and upper back. The patches started off as small but
have coalesced together and now cover the entire back of his arm and upper back.
He is self-conscious about the discolouration and has been wearing long sleeves to hide the
patches. You examine the skin and notice the patches to be slightly pink in colour and
covered in a fine powdery scale. Upon further questioning you discover that the patches are
not painful and he does not have these patches anywhere else
View resources
Which of the following conditions is Mr T most likely to be suffering from?
Select one:
1. eczema
2. psoriasis
3. pityriasis versicolor
4. rosacea
5. vitiligo
Pityriasis versicolour
What does eczema look like?
Inflamed skin can look red on white skin, and darker brown, purple or grey on brown or black skin. This can also be more difficult to see on brown and black skin.
Scratching can affect your sleep, make your skin bleed, and cause secondary infections.
What does psoriasis look like?
Psoriasis typically causes patches of skin that are dry and covered in scales.
On brown, black and white skin the patches can look pink or red, and the scales white or silvery. On brown and black skin the patches can also look purple or dark brown, and the scales may look grey.
What does pityriasis versicolor look like?
Pityriasis versicolor is a common fungal skin infection. It’s sometimes also called tinea versicolor. A GP can prescribe treatment for it, but it can keep coming back.
Pityriasis versicolor causes patches of skin to change colour.
The patches are flat and round and can join up to form large areas. They may look scaly and can sometimes be itchy.
A locum GP at one of your nearby surgeries rings you and would like to prescribe a medicine
as a private repeat. He is unsure about repeatable prescribing and how to supply lawfully.
Which of the following statements is least appropriate when advising the GP about repeatable prescribing?
Select one:
1. prescriptions for Schedule 2 and 3 Controlled Drugs are not repeatable
2. NHS prescriptions are not repeatable
3. when a prescriber has endorsed ‘REPEAT x 3’ the prescription can be dispensed a maximum
of three times
4. when a prescriber writes ‘REPEAT’ for an oral contraceptive pill the prescription may be
dispensed a maximum of six times
5. if the prescription states “REPEAT” but the number of repeats is not stated then it can only
be repeated once (dispensed twice in total) unless it is for an OCP
when a prescriber has endorsed ‘REPEAT x 3’ the prescription can be dispensed a maximum
of three times
[can be dispensed four times]
Mrs J has a history of acid reflux. She is very worried that her medicines may aggravate her
symptoms.
Which of the following medicines is most likely to aggravate her symptoms and should
therefore be taken after food?
Select one:
1. amoxicillin
2. digoxin
3. mefenamic acid
4. lisinopril
5. temazepam
Mefenamic acid
