well 2018 Flashcards
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
he should limit fruit juice to one small glass each day
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
local resistance patterns
pt 65yr who is prescribed the following; bisoprolol, furosemide, methotrexate, paracetamol, ramipril is prescribed diclofenac why do you contact the prescriber
diclofenanc is CI in heart failure
which following of antimarials is CI in pt with past psychiatric disorders
- chloroquine
- doxycycline
- mefolquine
- progunanil
mefloquine
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
shingles
if pt has low T4 and high TSH what is the tx
levothyroxine
if pt is started on warfarin should they cut out all leafy green veg prior to starting warfarin
no
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
recommend 500mg clotrimazole pessary to be inserted at night before she sleeps
if prescriber requests emergency supply for diazepam on friday evening and says she will give prescription on monday morning what do you do?
say she needs to provide you with a reason to why she cannot provide you a script immediately
pt has high serum K+ and creatinine which meds are causing it?
- allopurinol
- bendrofluz
- lisinopril
- simvastatin
lisinopril
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
one as directed
short duration constipation tx after dietary measures failed
isphagula husk?
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
- you should ask for the request in writing and determine whether there is a
legit reason
if pt is on methotrexate + naproxen whay is the appropriate response as there is an interaction which can increase mtx levels in blood
- 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
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
he may feel drowsy with this medication and if affected should avoid
1st line tx of hypertension stage 2 in 63yr male
can microgynon-30 interact with ciclosporin and lower plasma levels of ciclosporins
no
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
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 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
nimodipine
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
add in inhaled long acting beta agonist
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
- denature the medication in the presence of another member of staff and record in a register dedicated to controlled drugs returns
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
- any information identifying Mr S should be destroyed or totally obscured
is it illegal to prescribe unlicensed meds to children
no
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
- the use of over the counter lubricant eye drops can help reduce discomfort in the eye
