General notes

Question 1

Explain risks of breast cancer in woman taking HRT

Answer 1

Low with oestrogen only

Question 2

Name risks associated with HRT

Answer 2

Breast cancer
Endometrial cancer
VTE
Stroke / CVD

Question 3

Who do the risks of HRT not apply to

Answer 3

Women < 50 years old

No increased CVD risk with oestrogen only HRT

Question 4

Who do you not give HRT to

Answer 4

Women > 60 years old

Risks outweigh benefits

Question 5

Name 5 CI to HRT

Answer 5

Undiagnosed endometral bleeding
Endometrial cancer
Breast cancer
Uncontrolled HTN
VTE
Active angina or MI
Pregnancy

Question 6

How long is the Mirena coil licensed for endometrial protection

Answer 6

4 years

Question 7

When is the risk of stroke / CAD increased

Answer 7

If taken > 10 years after menopause - combined

Question 8

How is the risk of breast cancer affected by stopping HRT

Answer 8

Declines once stopped and normal in 5 years

Question 9

Name 5 adverse effects of antimuscarinics

Answer 9

Confusion
Dry mouth
Tachycardia
Dilated pupil
Loss of accommodation

Question 10

What occurs if Methotrexate and Trimethoprim are co-prescribed

Answer 10

Pancytopenia
Neutropenic sepsis

Question 11

Name the presentation and ECG signs for Hypercalcameia

Answer 11

Renal stones
Bone pain
Abdominal groans
Psychiatric overtones

Short QT interval

Question 12

What medications should be cautioned in patients taking Methotrexate

Answer 12

PPI
NSAIDs
Ibuprofen - risk of nephrotoxicity

Question 13

Name the adverse effects of anticholinergics

Answer 13

cosntipation
dry mouth
blurred vision
urinary retention

Question 14

Name 3 anticholinergic drugs

Answer 14

Oxynutinin
Atropine
Tiotropium

Question 15

Name 3 drugs that effect lithium excretion

Answer 15

ACEi
Diuretics
NSAIDs

Question 16

Name 5 drugs causing agranulocytosis

Answer 16

Carbamazepine

Question 17

Name 5 drugs causing agranulocytosis

Answer 17

Carbamazepine
clozapine
colchicine
carbimazole

Question 18

Which opioids are safe in CKD

Answer 18

Oxycodone
alfentanil
fentanyl

Question 19

Name 5 drugs that cause C.diff infection

Answer 19

PPI
Clindamycin
Co-amox
CIprofloxacin
Cephalosporin

Question 20

Name drugs that prolong QTc

Answer 20

A - Antidepressants (SSRI / TCA)
A - Antipsychotics
A - Antibiotics
A - Anti arrhythmics
A - Antifungals
A - Antiemetics
D - Diuretics

Question 21

What is the minimum treatment length with steroids to require prophylactic bisphosphonates

Answer 21

3 months

Question 22

How do you assess the response to Abx in penumonia

Answer 22

1 - O2 stats / ABG

2 - Resp rate

Question 23

What are the contraindications to the COCP

Answer 23

Breastfeeding and <6 post partum
Migraine with aura
>35 and smoking >15/day
VTE
Active cancer

Question 24

What drugs do statins interact with

Answer 24

Macrolides
Grapefruit juice

Question 25

Which drugs cause urinary retention

Answer 25

Opiods NSAIDs Anticholinergics Antihistmaies TCA General anaesthetics Alpha adrenoreceptors agonists NSAIDs CCB Alcohol

Question 26

What are the risks assosciated with PPIs

Answer 26

Low sodium Low magnesium Osteoperosis fracture Micoscopic colitis C.difficile

Question 27

What drugs should you stop during sick day rules

Answer 27

ACE ARB Diuretics NSAIDs SGLT-2i Metformin

Question 28

What do you monitor for the adverse effects of ACEi

Answer 28

Serum Cr

Question 29

Which group of drugs should be avoided in severe PVD - critical ischaemia

Answer 29

ACEi

Question 30

Name 5 adverse effects of statins

Answer 30

Myalgia Myositis Rhabdomyolysis Headache Sleep disturbance GI disturbance

Question 31

Name 5 drugs causing haematemesis

Answer 31

NSAIDs - Ibuprofen Aspirin Bisphosphonates

Question 32

Name 2 adverse effects of aspirin use

Answer 32

Dyspepsia IDA

Question 33

Drugs causing confusion

Answer 33

Anticholinergics - TCA Opiates BDZ Antipsychotics Antidepressants Anti-epileptics Antihistmaies Digoxin Beta blockers Steroids NSAIDs

Question 34

Drugs increasing falls risk in elderly

Answer 34

Antidepressants - TCA / SNRI / MAOi Opiods Anti-epileptics Antipsychotics Sleeping pills Diuretics alpha blockers ACEi SU / Gliclazide - Check BM

Question 35

When should SSRIs be cautioned

Answer 35

Poorly controlled epilepsy PUD

Question 36

What do you avoid prescribing in IHD

Answer 36

NSAIDs

Question 37

What do you avoid prescribing in IHD

Answer 37

NSAIDs Oestrogens

Question 38

What increases the risk of Methotrexate toxicity

Answer 38

PPI

Question 39

When should you degrease the dose of SGLT-2 inhibitors

Answer 39

When eGFR decreases

Question 40

Name 4 causes of constipation

Answer 40

Antidepressants Anticholinergics Opioids Antiemetics - Ondansetron

Question 41

When should a diabetic patient be prescribed antihypertensives

Answer 41

Albumin:Cr > 3 --> ACEi or ARB

Question 42

When should ACEi be avoided

Answer 42

Renal artery stenosis PVD - Critical eGFR < 30

Question 43

Long term treatment post ACS

Answer 43

CRABS C - Clopidogrel R - Ramipril A - Aspirin B - Beta blocker S - Statin

Question 44

Name 5 drugs that worsen seizure control

Answer 44

Alcohol Tramadol Lithium Clozapine Ciprofloxacin Aminophylline Mefanamic acid

Question 45

Name 4 drugs to avoid in Heart failure

Answer 45

Pioglitazone Verapamil NSAIDs Steroids Flecanide

Question 46

Name 4 drugs to avoid prescribing in renal failure

Answer 46

NSAIDs ACEi Metformin Lithium Digoxin

Question 47

Name 6 drugs to avoid prescribing in pregnancy

Answer 47

Tetracycline Amingoglycosides Sulphonamides / Trimethorpim Quinolones Warfarin Sulphonyurea Statins Cytotoxics

Question 48

Name 6 drugs to avoid in breastfeeding patients

Answer 48

Ciprofloxacin Sulpjonamides Lithium BDZ Aspirin Carbimazole MXT SU Amiodarone

Question 49

What effect do quinolones have on the heart

Answer 49

Lengthen QT interval

Question 50

What condition are aminoglycosides CI in

Answer 50

Myasthenia gravis

Question 51

What is the management of PVD

Answer 51

Antiplatelet + Statin (high dose)

Question 52

What is the baseline monitoring and treatment moniotring required for aminophylline

Answer 52

Baseline - LFT Treatment - U+E

Question 53

In what patients should you prescribe with caution / are CI to NSAIDs

Answer 53

Asthma AKI / CKD Elderly Gastric ulcers CCF

Question 54

When should you take: - ACEi - Loop diuretics

Answer 54

Morning - avoid postural hypotension Evening

Question 55

What is a side effect of a PPI

Answer 55

Gynaecomastia

Question 56

When is cyclizine CI

Answer 56

HF

Question 57

When is metocloprmaide CI

Answer 57

PD Post gastrectomy Bowel obstruction

Question 58

Management of acute asthma in the community

Answer 58

For an adult, give 4 puffs initially, followed by 2 puffs every 2 minutes according to response, up to 10 puffs. Repeat every 10-20 minutes if clinically necessary. For a child, give a puff every 30–60 seconds, up to 10 puffs.