ENDGAME Q Flashcards
(3 cards)
Mr D, aged 60, presents at the pharmacy requesting an indigestion remedy. Upon
questioning, Mr D reports suffering from heartburn for nearly four weeks. He has tried
Gaviscon liquid (sodium alginate 250 mg, 133.5 mg sodium bicarbonate and 80 mg
calcium carbonate per 5 mL) which has not helped. Mr D also reports unexplained
weight loss and difficulty swallowing.
A. Coeliac disease
B. Crohn’s disease
C. Dyspepsia
D. Irritable bowel syndrome
E. Haemorrhoids
F. H. Pylori infection
G. Oesophageal cancer
H. Ulcerative colitis
Dysphagia, and/or people aged over 55 with upper abdominal pain, reflux or dyspepsia are all symptoms that
require urgent referral for GI endoscopy to assess for oesophageal cancer. Therefore G is the correct answer
A 35-year-old man presents to the pharmacy to collect his regular repeat
medication, for which he is taking for maintenance of remission of Crohn’s
disease. Upon talking to the patient, he explains he has been experiencing
breathlessness recently, along with a cough and a raised temperature. He has
been having these symptoms for the past week and has put it down to a
common cold. You are concerned that these symptoms could be caused by the
medication that he is on, so you advise him to stop taking the medication and
speak to the GP as soon as possible.
Which if the following is the most likely drug contributing to the patient’s
symptoms?
A. Azathioprine
B. Budesonide
C. Methotrexate
D. Prednisolone
E. Sulfasalazine
MTX
. Azathioprine Can cause immunosuppression and infection risk, but not classically linked to direct lung toxicity
B. Budesonide A corticosteroid with local gut activity; low systemic effect, unlikely to cause these symptoms
D. Prednisolone A systemic steroid; would typically suppress inflammation and fever, not cause it
E. Sulfasalazine Can cause hypersensitivity reactions, but lung involvement is rare compared to methotrexate
A pharmacist is running late for a shift at a community pharmacy. They contact the dispensary team and inform them that they will be about
one hour late. The pharmacist reminds the dispensary team that there are several activities that cannot legally take place until they arrive at
the pharmacy as the Responsible Pharmacist.
Which of the activities below can legally take place during the time there is no Responsible Pharmacist?
A. Assembling a prescription for amoxicillin 250mg capsules
B. Generating a dispensing label for metformin 850mg tablets
C. Handing out a previously dispensed box of ramipril 20mg capsules to a patient
D. Receiving 50 boxes of levothyroxine 100 microgram from pharmaceutical wholesalers into the pharmacy
E. Sale of a pack of 32 paracetamol 500mg tablets
⚖️ Activities that can legally take place without an RP:
Receiving stock (e.g. from wholesalers)
Cleaning or date checking stock
Clerical tasks like producing labels (as long as not attached to products)
Assembly of prescriptions may begin but not completed or supplied, depending on local SOPs and under pharmacist direction
