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Pre-Reg November Exam '24 > Past Paper Learning Points > Flashcards

Past Paper Learning Points Flashcards

LEARN BITCH

1
Q

Treatment for bacterial meningitis in 2 month old boy

A

IV benzylpenicillin - 600mg

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2
Q

Treatment advice for pregnant woman using canestan pessaries

A

Insert without the applicator

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3
Q

Which vitamin can cause peripheral neuropathy when taken regularly, requiring hospital admission?

A

Vitamin B6

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4
Q

Which medications should be stopped as per ‘Sick Day Rules’

A
  • ACE inhibitors and ARBs (reduce risk of AKI)
  • Diuretics
  • NSAIDs
  • Metformin (risk of dehydration and lactic acidosis)
  • Sulfonylureas (hypoglycaemia risk)
  • SGLT-2 inhibitors
  • GLP-1 inhibitors
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5
Q

Risks associated with HRT

A
  • Endometrial cancer
  • Ovarian cancer
  • Breast cancer
  • Venous thromboembolism
  • Stroke
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6
Q

First line treatment for treatment of osteoporosis in mean at high risk of fractures?

A

Risedronate 35mg once weekly

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7
Q

Which beta blocker is least likely to give patients sleep disturbances?

A

Atenolol (water soluble)- least likely to enter the brain

However, more likely to cause renal damage

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8
Q

RTS- over 50 presenting with reflux or dyspepsia to pharmacy

A

Sell calcium carbonate (rennie) and refer to GP as soon as possible for investigation

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9
Q

Common tell-tale side effect of nitrofurantoin

A

Dark brown/yellow urine

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10
Q

Which thiazide-like diuretic is still safe in renal impairment

A

Metolazone

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11
Q

Does ramipril affect potassium levels?

A

Yes- elderly, diabetics and the renally impaired can become HYPERkalaemic

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12
Q

First line treatment for Parkinson’s disease dementia

A

Acetylcholinesterase inhibitor- Rivastigmine 1.5mg daily initially

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13
Q

Which statin (+ dose) should be offered to patients in secondary prevention of CVD

A

High dose atorvastatin (80mg nocte)

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14
Q

When should patients with thrush be referred to GP?

A
  • Over 60
  • Pregnant
  • First experience
  • Recurring experience within 6 months of last bout
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15
Q

What indication can carbimazole be taken for, aside from hyperthyroidism?

A

Grave’s disease

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16
Q

Monitoring requirements for carbimazole

A

Bloods every 6 weeks initially

Every 3 months when stable

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17
Q

Does grapefruit juice interact with warfarin?

A

No- cranberry juice can affect warfarin though

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18
Q

Contraception options for woman taking enzyme-inducing drugs e.g. carbamazepine

A

Always advised to switch to methods unaffected by enzyme- inducing drugs e.g. copper IUD, depo-provera injection

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19
Q

NSAID most likely to induce adverse gastro effects on patients who have never had GI upset in the past?

A

Piroxicam

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20
Q

What is prescribed for ‘off-episodes’ in Parkinson’s disease, when patient is controlled by co-careldopa therapy, or other dopaminergics?

A

Apomorphine

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21
Q

Which class of antihypertensive most likely to cause facial flushing?

A

Calcium channel blockers e.g. amlodipine

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22
Q

Can Canesten pessaries be used by women during pregnancy?

A

Yes- but only on advice from GP or midwife

Do NOT sell OTC

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23
Q

Oral anticoagulant of choice for patient with mechanical heart valve replacement (post surgery)

A

Warfarin

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24
Q

What is the duration of time a prescription for Isotretinoin should be dispensed after being written under the Pregnancy Prevention Programme

A

7 days

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25
Q

Maximum duration of treatment permitted for a controlled drug Schedule 4 under an emergency supply

A

5 days

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26
Q

First line treatment for glaucoma

A

360 degrees selective trabeculoplasty

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27
Q

What class of CD are cannabinoids

A

Schedule 5

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28
Q

What is dermatophytic onychomycosis?

A

Fungal infection of the nail

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29
Q

In what scenario should HRT be stopped immediately

A
  • Severe stomach pain
  • Sudden severe chest pain
  • Sudden breathlessness
  • Serious neurological effects
  • Liver symptoms
  • High BP
  • Prolonged immobility after surgery
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30
Q

Reason why pseudoephedrine is used in caution in diabetes

A

Stimulates release of epinephrine and norepinephrine, cuasing blood glucose to rise as muscles are energised

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31
Q

A patient with bipolar disorder, treated with lithium, requires analgesia.

Which is the LEAST appropriate analgesic for this patient?

A

NSAIDs- serious interaction, leading to reduced excretion of lithium and subsequent toxicity

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32
Q

Can prescribers outside of the UK prescribe Sch 2 and 3 CDs?

A

No- patients hsould be advised to get a Rx from a local prescriber

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33
Q

Mrs A presents to the pharmacy complaining of dysuria, fever and flank pain.

Which condition is this symptom cluster most indicative of?

A

Pyelonephritis

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34
Q

Malaria prophylaxis options during pregnancy

A

Proguanil

Dose to be started 1 week before enterin endemic area and continued for 4 weeks

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35
Q

Classic symptoms of impetigo

A

Weeping golden pustules on the peri-oral and nasal region

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36
Q

Why should atenolol be avoided in asthmatic patients

A

It is a beta blocker and BBs can precipitate bronchospasm

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37
Q

What does MDRD mean in medical notes?

A

Modification of diet in renal disease

Used to calculate the eGFR of a patient

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38
Q

Can co-codamol eff tabs be sold to the public

A

yes- but only in a pack size of 32

Pack size of 100 is a POM

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39
Q

How often should SOPs be reviewed by the RP?

A

At least every 2 years

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40
Q

How long should the RP record be kept after the last entry?

A

5 years

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41
Q

Second line treatment for patient taking metformin with a high HbA1c

A

A sulphonylurea e.g. gliclazide

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42
Q

Which painkiller can antagonise the analgesic effect of opioid painkillers

A

Buprenorphine- is a partial agonist/partial antagonist and will block the effect of other opioids

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43
Q

What is the BCG vaccine indicated against?

A

Tuberculosis

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44
Q

What vaccines would be indicated for a patient travelling to an area of poor sanitation and poor food hygiene?

A
  • Typhoid
  • Cholera
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45
Q

Which laxative can be used for hepatic encephalopathy?

A

Lactulose- by its MoA, it prevents the reabsorption of ammonia and other toxins from faecal matter which cn cause hepatic encephalopathy

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46
Q

What is the chief underlying mechanism of encephalopathy?

A

Build up of ammonia in the blood

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47
Q

Which painkiller has a risk of overdose in infants if used in BF due to maternal variation in capacity to metabolise?

A

Codeine- metabolised in the liver to morphine, by enzyme CYP2D6. There are many genetic variations of this enzyme in the population, meaning overdose can be unexpected but common

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48
Q

Safe laxative for use in pregnancy?

A

Lactulose

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49
Q

When must the first dispensing of a script occur on an Rx stating “repeat x-times”

A

Within 6 months- after which there is no legal final dispensing date. This is left to clinical judgement

50
Q

Are repeats permitted on a private/standard script for Sch 4/5 drugs?

A

Yes- as long as first dispensing was within 28 days of signing

51
Q

How long after ceasing methotrexate therapy must women continue to use contraception and avoid pregnancy?

A

6 months

52
Q

How long after ceasing methotrexate therapy must men continue to use contraception and avoid pregnancy?

A

3 months- it is not known if methotrexate is present in sperm, and there is limited data. This is a precautionary measure

Men should also not donate sperm during therapy or within 3 months of discontinuation

53
Q

How to treat blepharitis on the community (OTC)

A
  • Warm compress to closed eyelids for 5-10 mins to help melt oils that may have built up. Carry out BD but the OD once symptoms calmed
  • If general hygiene doesn’t resolve issue- use propamidine isetionate (brolene 0.1% drops) BD
54
Q

How many times can a private Rx be repeated if the number of repeats aren’t stated?

A

Can be repeated ONCE- so dispensed twice including the first initial dispensing

55
Q

How many times can a private Rx for combined oral contraceptives be dispensed with “repeat” stated on them?

A

6 times

56
Q

Incubation period for chickenpox

A

11-20 days

57
Q

Incubation period for slapped cheek disease

A

13-18 days

58
Q

Incubation period for whooping cough

A

7-10 days

59
Q

Incubation period for mumps

A

15-24 days

60
Q

What is the limit on number of months supply on CD scripts?

A

There is no legal limit on CD script duration, however it should be limited to 30 days

Any longer, and the patient’s prescriber should be contacted to enquire why more than a month has been prescribed

61
Q

First line treatment for gout prophylaxis

A

Allopurinol or febuxostat

Both are first line but patient preference should be considered and co-morbidities. Allopurinol is recommended in those with major cardiovascular disease

62
Q

Methadone patient drops their dose outside the pharmacy and requests another to replace it. Best course of action?

A

Advise patient that they must obtain another Rx from their prescriber (it is a Sch 2 drug)

63
Q

Which hot drinks should a patient taking warfarin avoid?

A

Green tea- anything containing vitamin K

64
Q

Most common organism causing vaginal thrush

A

Candida albicans

65
Q

Which antipsychotic at high doses requires protection of the skin from UV light?

A

Promazine

66
Q

Does ear discharge require referral to GP

A

Yes, potential infectioin requiring antibiotic ear drops

67
Q

Recommended cream to prevent itching for 6 year old patient with scabies

A

Crotamiton cream 10% (Eurax)

68
Q

Which direct-acting oral anticoagulant should be taken with food?

A

Rivaroxaban

Due to lack of efficacy on an empty stomach

69
Q

Signs of digoxin toxicity

A
  • Nausea
  • Anorexia
  • Diarrhoea
  • Visual disturbances- yellow haze or blurred vision
  • Arrhythmias
  • General malaise
70
Q

What age is hydrocortisone 1% licensed from?

A

10 years

71
Q

What does the Latin p.c. mean on a script?

A

To be taken after food

72
Q

Which Parkinson’s medication is associated with impulse control side effects e.g. gambling, binge eating, obsessive shopping etc)

A

Dopamine-receptor agonists e.g. ropinirole

73
Q

Signs of theophylline toxicity

A
  • Vomiting
  • Agitation
  • Restlessness
  • Dilated pupils
  • Sinus tachycardia
  • Hyperglycaemia
74
Q

Treatment for girl presenting with several red lumps and patches (1-5cm) on lower legs

A

The lumps are characteristic of erythema nodosum

Treatment: rest and ibuprofen

75
Q

Treatment for scalp fungal infection (tinea capitis)

A

Griseofulvin

76
Q

Treatment for uncomplicated hyperpigmented patches on trunk and back

A

Ketoconazole shampoo

77
Q

Can digocin therapy cause hypokalaemia or hyperkalaemia?

A

HYPOkalaemia

78
Q

Common treatment of hypertension during pregnancy

A

Methyldopa

79
Q

MoA of metformin

A

Decreases gluconeogenesis by increasing peripheral utilisation of glucose

80
Q

MoA of acarbose?

A

Delays the digestion and absorption of starch and sucrose

81
Q

Drug class of saxagliptin

A

DDP-4 inhibitor

82
Q

What Sch. controlled drug is temazepam?

A

Sch 3

83
Q

Common neuro SE of baclofen

A

Hallucinations

84
Q

What sch. controlled drug is buprenorphine

A

Sch 3

85
Q

Which prescriber can not request emergency supply of a POM medicine?

A

Veterinarians

85
Q

Mechanism of action of dabigatran etexilate

A

Dabigatran etexilate is direct thrombin inhibitor with a rapid onset of action

85
Q

Treatment options of transient ischaemic attack when aspirin and dipyridamole are not tolerated

A

Clopidogrel

85
Q

Counselling point for patient starting lamotrigine therapy

A

If patient develops severe skin reaction in the first 8 weeks, stop treatment immediately

86
Q

Which drug is commonly prescribed at a dose of 1 gram STAT for uncomplicated genital chlamydial infections

A

Azithromycin

87
Q

Medicine-induced colitis is a risk factor with use of this medication

A

Clindamycin

88
Q

What is the MoA of cholestyramine

A

A bile acid sequestrant

Binds to bile acids, preventing their reabsorption. This promotes cholesterol conversion into bile acids, therefore increasing LDL-receptor activity in liver cells, lowering plasma LDL

89
Q

Does grapefruit juice interact with warfarin?

A

No

90
Q

On which diabetes medication class do you need to be vigilant re diabetic ketoacidosis when withdrawing insulin?

A

GLP-1 agonists e.g. dulaglitide, semaglutide

91
Q

A mother comes into your pharmacy to ask for advice. Her 3-year-old daughter has been waking at night and has recently started wetting the bed.

Which parasitic infection is most likely to be causing these symptoms?

A

Threadworm

92
Q

Is the warning: ‘Keep out of sight and reach of children’ a legal requirement on dispensing labels?

A

No, only advised by the RPS

93
Q

An 18-year-old girl enters your pharmacy and asks for your advice regarding a sore throat, tiredness and swollen glands in her neck.

What do you suspect may be her condition and most likely cause?

A

Glandular fever caused by Epstein-Barr virus

94
Q

A 12-year-old girl is taken to see her GP by her mother to discuss prevention of cervical cancer.

Which vaccine is indicated for this patient?

A

HPV- Human papiloma virus vaccine

95
Q

Which laxative is indicated for constipation in terminally ill patients?

A

Co-danthramer

96
Q

What monitoring is required for enoxaparin?

A

Plasma-potassium concentration for hyperkalaemia

97
Q

Is the midwife’s name and address needed on a midwife supply order?

A

No

98
Q

What is the interaction between MOAI and other antidepressants?

A

Increased risk of serotonin syndrome

Other antidepressants should not be started for 2 weeks after treatment with an MOAI

99
Q

Common causes of migraine with aura

A
  • Hormonal changes
  • Emotional triggers
  • Fatigue
  • Dietary triggers e.g. cheese, chocolate or alcohol
  • Certain medications
100
Q

Which cream would be suitable for treatment of a child over the age of 8 with infected eczema because it contains an antibacterial with the steroid?

A

Fucidin H

101
Q

Mr King, a 44 year old, presents with symptoms of nasal congestion, slight sore throat, headache and general loss of smell. He has had these symptoms for 10 days and feels unwell. The patient has been tested to confirm they do not have coronavirus.

The pharmacist decides to make a referral to the doctor because the differential diagnosis suggests?

A

Sinusitis

102
Q

Which tuberculosis treatment drugs can cause flatulence?

A

Ethambutol

102
Q

In which conditions is pseudoephedrine cautioned

A

HTN and diabetes

103
Q

How should private Rx for a sch 3 drug be processed?

A

Sent to the relevant NHS agency

104
Q

How should a veterinary Rx/ requisition for Sch 3 CDs be processed

A

Retained for 5 years- no need to send to an NHS agency

105
Q

How long should an invoice for Sch 3 CD be retained for, taking into account tax requirements

A

Retained for 6 years

Although the law relating to CDs requires 2 years, the law relating to tax requires they be retained for 6 years

106
Q

Which illness is characterised by white spots surrounded by a red ring on the inner cheek and gums?

A

Measles (morbilli)

107
Q

Pregnant women have to be extra cautious to ensure that they will not come into contact with this disease as there is an increased risk of congenital abnormalities

A

German measles (rubella)

Only a serious concern if caught during first 20 weeks of pregnancy. The virus can disrupt the development of the baby and cause a wide range of health problems

108
Q

Considerations for use of bendro in patients with lowered eGFR

A

Not effective in patients with eGFR lower than 30ml/min/1.73m2

109
Q

Which high risk drug for arrhythmias is contraindicated in patients with thyroid dysfunction due to its ability to accentuate thyroid problems

A

Amiodarone

110
Q

Mrs R is a patient who has AIDS. She has been diagnosed with mild pneumocystis pneumonia. She is unable to tolerate trimethoprim.

Which single medication is the most likely treatment option for her pneumonia?

A

Atovaquone

111
Q

What is the initial recommended daily dose for patients taking metformin for polycystic ovary syndrome?

Can this then be increased?

A

500mg OD for 1 week, then 500mg BD for 1 week

This can then be increased between 1.5g-1.7g daily in 2-3 divided doses

112
Q

What is the maximum daily dose of etodolac?

A

600mg

113
Q

Which OTC topical prep is to be used wit caution in patients taking phenytoin?

A

Daktarin oral gel

Miconazole enhances the anticonvulsant effect of phenytoin (plasma conc. enhanced

Although with topical use, the risk is lower

114
Q

What is the maximum duration of treatment which can be given via over the counter chloramphenicol?

A

5 days

115
Q

Which side effect of clozapine should patients report due to the risk of fatality?

A

Constipation- clozapine has been associated with varying degrees of intestinal peristalsis

116
Q

What is the target INR for patients taking warfarin with a mechanical prosthetic heart valve?

A

This depends on the type and location of the valve etc

117
Q
A

Pre-Reg November Exam '24 (10 decks)

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