well 2018 Flashcards

1
Q

if a 11yr old is diagnosed with type 1 diabetes which following advice is appropriate
- cake and biscuits should be removed from diet
- he should cut down on fruit intake as fruit is high in sugar
- he should limit fruit juice to one small glass each day

A

he should limit fruit juice to one small glass each day

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2
Q

what is the reason for recommendations made in national guidance being different ot recommendations in local antibiotic guidance
- cost alone
- individual clinical experience
- lack of guidance review
- local resistance patterns
- prescriber perference

A

local resistance patterns

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3
Q

pt 65yr who is prescribed the following; bisoprolol, furosemide, methotrexate, paracetamol, ramipril is prescribed diclofenac why do you contact the prescriber

A

diclofenanc is CI in heart failure

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4
Q

which following of antimarials is CI in pt with past psychiatric disorders
- chloroquine
- doxycycline
- mefolquine
- progunanil

A

mefloquine

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5
Q

a 49yr pt presents with raised temperature and painful blistered rash on left side of neck only. what is the diagnosis
- chicken pox
- chronic plaque psoriasis
- shingles
- measles
- meningitis

A

shingles

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6
Q

if pt has low T4 and high TSH what is the tx

A

levothyroxine

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7
Q

if pt is started on warfarin should they cut out all leafy green veg prior to starting warfarin

A

no

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8
Q

PT has recently finished a course of antibiotics and has symptoms of vaginal thrush for which she was treated by the doctor 6 months ago, symp = itchy with a thick creamy coloured discharge. what do you do?

  • recommend the 150mg fluconazole capsule and a 2% clotrimazole cream
    to treat both the internal and external symptomS
  • recommend a 500mg clotrimazole pessary to be inserted at night before
    she retires to bed
  • refer her to the GP
  • refer her to the local GUM clinic as she may have an STI
  • sell her the 150mg fluconazole capsule
A

recommend 500mg clotrimazole pessary to be inserted at night before she sleeps

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9
Q

if prescriber requests emergency supply for diazepam on friday evening and says she will give prescription on monday morning what do you do?

A

say she needs to provide you with a reason to why she cannot provide you a script immediately

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10
Q

pt has high serum K+ and creatinine which meds are causing it?
- allopurinol
- bendrofluz
- lisinopril
- simvastatin

A

lisinopril

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11
Q

Ms J, a 50-year-old patient presents a prescription for fentanyl 25 mcg/h
transdermal patches
Which one of the following directions would be legally correct for this prescription?

  • apply every 72 hours
  • as per GP instructions
  • every 3 days
  • one as directed
  • use when required
A

one as directed

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12
Q

short duration constipation tx after dietary measures failed

A

isphagula husk?

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13
Q

A Police officer enters your pharmacy and asks to have a private word with you.
He has observed a suspect, a 15-year-old male entering the pharmacy on a daily
basis and has asked you to provide the details of his past medication history to
help him with his inquiries.
Which of the following statements is the most appropriate regarding patient
confidentiality in this case?

  • you cannot share medical details but you can provide the officer with a
    contact phone number for the patient so that he can speak directly with
    them
  • you should ask for the request in writing and determine whether there is a
    legitimate reason
  • you should by law provide the requested information immediately
  • you should contact the patients parents first to ask permission to share
    the information as he is under 16 years of age
  • you should refuse to provide the information as you are bound by patient
    confidently never to share it without patient consent
A
  • you should ask for the request in writing and determine whether there is a
    legit reason
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14
Q

if pt is on methotrexate + naproxen whay is the appropriate response as there is an interaction which can increase mtx levels in blood

A
  • advise pt of interaction and say it is safe to take as long as are taken regularly and blood tests are regular
  • inform pt of mx toxicity signs
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15
Q

Mr J, who weighs 75 kg has been prescribed azathioprine 25mg tablets following
a kidney transplant at a dose of 1mg/kg per day. He presents with a prescription
for 84 x 25mg tablets, 3 tablets daily.
Which one of the following counselling points would NOT be appropriate when
counselling Mr J about his medication?
- he may feel drowsy with this medication and if affected should avoid
driving or using machinery
- he should avoid coming into contact with chickenpox
- he should inform his doctor if he develops an unexplained rash
- he should inform his doctor if he develops an unexplained sore throat
- he will need regular blood tests while taking this medicatiom

A

he may feel drowsy with this medication and if affected should avoid

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16
Q

1st line tx of hypertension stage 2 in 63yr male

A
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17
Q

can microgynon-30 interact with ciclosporin and lower plasma levels of ciclosporins

A

no

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18
Q

Mr D was recently diagnosed with type 2 diabetes and has been initiated on metformin. He asks your advice on purchasing a meter to monitor his blood
glucose.
Which one of the following is the most appropriate advice regarding self-monitoring for
Mr D?
- it is only recommended for patients with type 1 diabetes
information on hypoglycaemia
- self- monitoring would be essential if he currently drives
- self-monitoring would be of little value and could cause him more anxiety and stress, HbA1c values will provide sufficient information on his blood glucose control

A

self-monitoring would be of little value and could cause him more anxiety and stress, HbA1c values will provide sufficient information on his blood glucose control

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19
Q

A patient presents with a thunderclap headache, stiff neck, blurred vision and
nausea. A CT scan confirms subarachnoid haemorrhage.
Which one of the following is the most appropriate first line pharmacological management for this patient?
- amlodipine
- felodipine
- isosorbide mononitrate
- nifedipine
- nimodipine

A

nimodipine

20
Q

Mrs J, a 47-year-old was diagnosed with asthma recently. They have come into
see you complaining of exacerbation of symptoms over the last few weeks.
They presently get salbutamol and low dose beclomethasone on prescription.
What would be the most appropriate alteration to the treatment according to BTS/SIGN
guidance?
- add in beta agonist tablet
- add in inhaled long acting beta agonist
- add in leukotriene receptor antagonist
- add in long acting muscarinic antagonist
- increase dose of inhaled corticosteroid

A

add in inhaled long acting beta agonist

21
Q

A patient comes in to return 56 MST 30mg tablets to your pharmacy because
they are no longer needed. Your counter assistant comes to ask you how she
should handle these.
What is the most appropriate information to provide to the staff member?
A denature the medication in the presence of an authorised person and
make a record in the controlled drugs register
- denature the medication in the presence of an authorised person and make
a record somewhere other than the controlled drugs register
- denature the medication in the presence of another member of staff and record in a register dedicated to controlled drugs returns
- dispose of the medication in the appropriate waste disposal bin and record somewhere other than the controlled drugs register
- dispose of the medication in the appropriate waste disposal bin, no record need be made

A
  • denature the medication in the presence of another member of staff and record in a register dedicated to controlled drugs returns
22
Q

4 Mr S returns some enalapril, simvastatin, morphine sulphate tablets and
morphine sulphate liquid (10mg/5ml) to your pharmacy.
Which of these statements relating to the disposal of these medicines is correct?
- any information identifying Mr S should be destroyed or totally obscured
- denaturing of the morphine sulphate tablets must be witnessed by an
authorised person
- enalapril and simvastatin tablets should be de-blistered before placing into
a pharmaceutical waste container

A
  • any information identifying Mr S should be destroyed or totally obscured
23
Q

is it illegal to prescribe unlicensed meds to children

A

no

24
Q

Mrs S, 35 asks for some advice regarding her eye. You can see her left eye looks
red and watery. She explains that it has been like this for the last 24 hours and
that this morning she was unable to open it as it was stuck together. You
diagnose bacterial conjunctivitis and recommend a course of OTC
Chloramphenicol 0.5% eye drops.
Which one of the following is the most appropriate advice to give Mrs S to manage her
condition?

  • bathing the eyelid with cold water to help remove discharge will help
  • it is not appropriate to use both eye drops and ointment, only one form should be used
  • the use of over the counter lubricant eye drops can help reduce discomfort in the eye
A
  • the use of over the counter lubricant eye drops can help reduce discomfort in the eye
25
Q

Mr T comes in to your community pharmacy. He reports to you that he has been experiencing pain and inflammation in both of his Achilles tendons. Upon further questioning, he states that he was prescribed a course of antibiotics on the previous day. Which one of the following antibiotics is most likely to cause these symptoms?
- cefalexin
- ciprofloxacin
- clarithromycin
- doxycycline
- flucloxacillin

A

ciprofloxacin

26
Q

how long is yellow fever certificate valid for?

A

duration of life person is vaccinated

27
Q

A 70-year-old female prescribed Priadel (lithium) MR tablets 400mg daily
complains of feeling drowsy and lethargic. Her latest lithium level is 1.6mmol/litre (range 0.4 to 1.0 mmol/litre). Which one of the following would be the LEAST appropriate analgesic to prescribe for
this patient?
- aspirin
- codeine
- ibuprofen
- tramadol

A

ibuprofen

28
Q

what is first line drug treatment for for heart failure with evidence of left
ventricular systolic dysfunction (LVSD)?
- ACEI only
- ACEI + aldosterone
antagonist
- ACEI + BBlocker
- ARB + digoxin
- ARB + a thiazide-like diuretic

A

ACEI + bblocker

29
Q

which following causes hyponatraemia
- atenolol
- carbimazole
- citalopram
- codein

A

citalopram

30
Q

tx of nausea after radiotherapy and no appetite

A

dexamethasone

30
Q

You receive a prescription for this dated 5 months ago but you are able to dispense
it.
- diazepam
- LSD
- phocodine
- tramadol

A

pholcodine

30
Q

what does diamorphine require for tx of addiction

A

a licence issued by the Home Secretary under the Misuse of Drugs (Supply to
Addicts) Regulations 1997 is required to prescribe

31
Q

tx of impetigo for 7yr

A

fluclox

32
Q

tx of bilateral otitis media for 18 month

A

amox

33
Q

type 1 diabetic badly bitten by cat tx

A

co-amox

34
Q

pain relief for a sprained ankle two weeks ago. has tried paracetamol but is still in pain. He is intolerant of NSAIDs.

A

codeine

35
Q

pain relief for 40yr woman = acute left sided shooting jaw pain, which she describes
as feeling like an electric shock. She explains that it is often worse when eating and
brushing her teeth.

A

carbmazepine

36
Q

a 70-year old male taking amlodipine for hypertension asks for your advice. He has
had a loss of feeling in his hand today whilst gardening. The symptoms lasted for 2
hours and then subsided
what is it?

A

transient ischaemic attack

37
Q

a 40-year old marathon runner taking part in the local marathon event has collapsed outside your community pharmacy with shortness of breath, rapid pulse and radiating chest pain. A concerned passer-by immediately asks for your help.
what is it?

A

myocardial infarction

38
Q

what is this?
a slightly breathless 75-year-old female presents at your pharmacy. She wants to
buy a bottle of magnesium trisilicate mixture which she says she takes regularly.
You notice she has swollen ankles.

A

heart failure

39
Q

interaction of amlodipine, aspirin + simvastatin

A

myopathy

40
Q

sertaline + ramipiril + apixaban

A

haemorhhage

41
Q

spirolactone + atorvastatin + aspirin + ramipril + bisoprolol

A

hyperkalaemia

42
Q

tx of candida infection for 3yr

A

canesten cream 1%

43
Q

blood test for atorvastatin

A

serum alanine transaminase

44
Q

what type of test for SORE THROAT when on carbimazole

A

FBC