GPHC questions I get Wrong Flashcards

Question

A patient is needing treatment for a severe deep seated bone infection. The patient has NKDA. What is the most appropriate treatment to give? A) Azithromycin B) Clarithromycin C) Co-amoxiclav D) Doxycycline E) Flucloxacillin F) Gentamicin G) Metronidazole H) Teicoplanin

Answer 1

**E) Flucloxacillin** This is first line for Bone related infections caused by staph. aureas. This should be used at high doses too

Answer 2

C. Influenza vaccine Influenza vaccine is a live vaccine which is contraindicated in active infections

Answer 3

D) Vulvovaginal candidiasis Typical signs of vulvovaginal candidiasis = thick white discharge that is odourless, accompanied by irritation. These symptoms are commonly triggered by antibiotic use, which disrupts normal vaginal flora, allowing overgrowth of Candida albicans. Bacterial vaginosis typically presents with thin, grey, fishy-smelling discharge, and STIs such as chlamydia or trichomoniasis usually involve a coloured discharge, odour, or systemic symptoms such as pain or fever;none of whichare present here.

Answer 4

B) Stop aspirin and take clopidogrel as monotherapy Aspirin should be discontinued when clopidogrel is initiated unless there is a specific secondary care indication for short-term dual antiplatelet therapy.If clopidogrel is not tolerated, an alternative regimen is aspirin 75mg daily plus modified-release dipyridamole 200mg twice daily. If both clopidogrel and aspirin are unsuitable, modified-release dipyridamole alone may be considered. If all other options are contraindicated, aspirin alone can be used.

Answer 5

C) Administer 10% glucose intravenously Patient is unable to swallow so cannot tolerate oral administration - rik of choking. In such cases, intravenous glucose (e.g. 10%) is the preferred route for rapid correction. IM glucagon is typically used when IV access is not available and the patient is unconscious. Insulin of any kind is inappropriate in hypoglycaemia.

Answer 6

E) Take the missed pill now, continue the pack as usual, and take the 7-day break as normal 14 hours late is not a missed pill as its < 24 hours. Therefore the dose can be taken immediately even if that means taking two pills in one day, and then continue thepack as normal, including the 7-day break if applicable. No additional contraception is required, and emergency contraception is not needed.

Answer 7

E) Dabigatran Dabigatran is contraindicated when eGFR is below 30 mL/min, due to its renal excretion and increased risk of accumulation and bleeding. This patient has an eGFR of 22 mL/min, which places him in stage 4 CKD, making dabigatran unsuitable. Other DOACs such as apixaban, rivaroxaban, and edoxaban may still be used with dose adjustments and caution, while warfarin remains a safe and effective option in severe renal impairment as it is not renally excreted.

Answer 8

A) 19 Y/O who has used the product for 6/12 without any significant improvement Amorolfine must be used until the entire nail has grown out which may take 3 months in fingers and 9-12 months in toes Patients with Diabetes, Breastfeeding, are under 18 or have an infection of the WHOLE toe are not able to be treated OTC

Answer 9

D) Recommend paracetamol 120mg/5mL, 2.5mL every 4–6 hours, maximum 3 doses in 24 hours For babies aged up to 3 months, paracetamol can be given for post-immunisation fever, specifically after the MenB vaccine, which is known to cause higher rates of fever in infants. The recommended dose is 2.5mL of 120mg/5mL oral suspension, given up to three times in 24 hours, with a minimum 4–6 hours between doses. This advice is supported by both the BNF for Children and NHS guidance on post-vaccine care.

Answer 10

C) Provide a delayed prescription with safety-netting advice This patient has symptoms of a self-limiting viral upper respiratory tract infection. Antimicrobial prescribing guidelines, immediate antibiotics are not usually indicated unless red flags are present (e.g. very unwell, immunocompromised, or signs of bacterial infection). A delayed prescription is appropriate when symptoms are not severe but the patient is concerned, as it allows for antibiotics to be started if symptoms worsen or do not improve within 3-5 days, while promoting antibiotic stewardship. Safety-netting advice is essential.

Answer 11

D) Advise nasal saline drops and reassure the mother Most cough and cold remedies are not licensed for use in children under 6 years, and especially not in infants under 3 months. Products such as simple linctus or lemon and honey syrup are not licensed for this age group. Menthol-based vapour rubs can cause respiratory distress in very young infants and are generallylicensed in those aged 2 years and over. Ibuprofen is not licensed under 3 months of age, and in the absence of fever or pain, there is no clinical indication. Nasal saline drops, which are licensed from birth, are the safest and most appropriate choice, alongside reassurance, as symptoms are likely to be viral and self-limiting.

Answer 12

E) Signs of high blood sugar such as excessive thirst and urination Olanzapine is associated with a high risk of metabolic side effects, including hyperglycaemia, weight gain, and diabetes mellitus. Patients should be counselled to monitor for signs such as increased thirst, frequent urination, fatigue, or unexplained weight loss, and to seek prompt medical advice if these occur. While other side effects such as sedation or restlessness (e.g. akathisia) may occur, metabolic complications are often silent until severe, making early counselling critical.

Answer 13

C) Take the tablets on an empty stomach, ideally with orange juice Iron absorption is maximised when taken on an empty stomach and enhanced by vitamin C, which is found in orange juice. Tea and milk can reduce absorption due to their calcium and tannin content. Although gastrointestinal discomfort is common, the best approach is not to reduce the dose unless necessary, but rather to manage timing and co-administration. It can betaken after food to reduce gastro-intestinal side-effects if necessary.

Answer 14

**A) Report all adverse reactions, regardless of severity, for newly licensed medicines**

Answer 15

**C) Lactulose oral solution** In pregnancy, bulk-forming laxatives are considered first-line, but if ineffective, osmotic laxatives such as lactulose are considered safe and effective. Stimulant laxatives like senna or bisacodyl are generally reserved for short-term use and may cause uterine contractions in high doses. Docusate can be considered, but lactulose has a longer track record of safe use in pregnancy.

Answer 16

**D) Flunitrazepam 1mg tablets** Schedule 2 controlled drugs, except for quinalbarbitone (secobarbital) and certain Schedule 3 controlled drugs must be stored in a locked CD cabinets. Although Schedule 3 drugs are generally exempt from safe custody requirements, there are exceptions. The following CD3s do require safe custody: - Buprenorphine - Diethylpropion - Flunitrazepam - Temazepam (Ben Doesn't Feel Tired)

Answer 17

**E) Benzydamine hydrochloride oral rinse** Benzydamine is a locally acting analgesic and anti-inflammatory that provides symptomatic relief for painful mouth ulcers. Corticosteroid lozenges are already being used, and systemic corticosteroids like prednisolone are not typically first-line unless ulcers are severe and persistent. Antibacterial (amoxicillin) and antifungal (fluconazole, nystatin) treatments are not appropriate unless there is clear evidence of secondary infection. Benzydamine rinse can be used as an adjunct for pain relief during ulcer flare-ups.

Answer 18

**E) Isophane insulin** NICE guidance recommends that insulin therapy should be initiated immediately in women diagnosed with gestational diabetes who have a fasting plasma glucose level above 7.0 mmol/L at the time of diagnosis. Insulin can be started with or without metformin, but it remains the primary treatment of choice in this context due to the increased risk of complications with higher fasting glucose levels. Metformin may be used if fasting plasma glucose is below 7.0 mmol/L and dietary measures fail. Gliclazide, pioglitazone, and exenatide are not recommended during pregnancy due to safety concerns.

Answer 19

**A) When two different eye preparations must be used at the same time, leave an interval of at least 5 minutes between each eye drop** When administering multiple topical ophthalmic preparations, patients should be advised to leave at least a 5-minute gap between each different eye drop to prevent one from diluting or washing out the other. This helps ensure optimal absorption and therapeutic effect.

Answer 20

**A) Anusol Plus HC ointment** Anusol Plus HC contains hydrocortisone and lidocaine and is available as a pharmacy (P) medicine without the need for a prescription. This makes it the most suitable OTC option for a patient seeking similar symptomatic relief to Anugesic-HC, which also contains a corticosteroid and local anaesthetic The other listed products (Xyloproct, Ultraproct, Uniroid-HC, and Scheriproct) are all prescription-only medicines (POMs) and cannot legally be supplied without a prescription.

Answer 21

**D) Advise Mr L that he is experiencing a side effect of isosorbide mononitrate; it is safe to continue taking it, but he may wish to see his GP if the headaches persist** Throbbing headache is a common and well-recognised adverse effect of nitrate therapy, including isosorbide mononitrate. It usually occurs early in treatment and often subsides with continued use as tolerance develops. Patients should be reassured that it is a known effect, and advised not to stop the medication abruptly without medical review, especially since it is being used for angina prophylaxis. If the headaches remain troublesome, the GP may consider a dose adjustment or switch to a different anti-anginal agent.

Answer 22

C) Simeticone This is an anti-foaming agent that helps reduce gas and bloating in the gastrointestinal tract. It is the most commonly used active ingredient in licensed colic treatments such as Infacol®, which is indicated for relief of infantile colic and is safe from birth. Simeticone is considered safe and effective for symptomatic relief, although non-drug advice such as winding, feeding techniques, and soothing methods remain first-line.

Answer 23

D) £1000 According to the DVLA guidelines, people with medical conditions such as epilepsy must notify the DVLA if the condition may affect their ability to drive safely. Failing to do so is a criminal offence and can lead to a fine of up to £1000. Additionally, if an individual withholds this information and is subsequently involved in an accident, prosecution may follow. This regulation exists to ensure public and personal safety on the road.

Answer 24

C) 12 months According to DVLA medical standards, a person with epilepsy may apply for a Group 1 driving licence (cars and motorcycles) only if they have been seizure-free for at least 12 months, regardless of whether they are on antiepileptic medication. This rule helps ensure public safety and allows the DVLA to assess the likelihood of seizure recurrence. If Miss R has been seizure-free for less than 12 months, her application would be declined, and she must wait until she meets the minimum threshold before reapplying.

Answer 25

E) Reduced risk of dementia Combined hormonal contraceptives (CHCs) have multiple recognised non-contraceptive benefits, including: * Reduced risk of endometrial and ovarian cancer * Improved control of menstrual-related symptoms such as dysmenorrhoea and menorrhagia * Improvement in acne in some women due to suppression of androgens * Cycle regulation and reduction of premenstrual syndrome symptoms However, reduced risk of dementia is not an evidence-based benefit of CHC use. In fact, some studies have raised concerns over the long-term cognitive effects of hormonal therapies, though data remains inconclusive.

Answer 26

**D) Fluticasone nasal spray** For patients presenting with nasal congestion alongside sneezing and watery eyes, intranasal corticosteroids such as fluticasone are considered the most effective treatment option. They address both inflammatory symptoms and congestion, which antihistamines alone may not fully relieve Avoid sedating antihistamines like Chlorphenamine and Promethazine. Cetirizine and Loratidine are not sedating but they are unlikely to help with the nasal congestion

Answer 27

A) Bonjela Cool Mint® Bonjela Cool Mint® contains salicylate, a derivative of aspirin, which is not suitable for children under 16 years due to the risk of Reye’s syndrome, a rare but serious condition. It is specifically contraindicated in infants and young children, making itthe least appropriate option in this scenario For infants under 6 months, it is crucial to only recommend products that are specifically licensed for use in that age group, and Bonjela Cool Mint® does not meet that criterion.

Answer 28

D) 72 hours Under the Human Medicines Regulations 2012, when a pharmacist makes an emergency supply at the request of a prescriber, the prescriber must provide a written prescription within 72 hours of the supply. This applies even if the prescriber is not the patient’s usual doctor, as long as they are able to provide the appropriate prescription within the required legal timeframe. In this case, a salbutamol inhaler is not a Controlled Drug and can be supplied in an emergency without a prescription, provided all conditions are met —including the prescriber undertaking to provide a prescription within 72 hours. The pharmacist must record the supply in the Prescription-Only Medicine (POM) register at the time of supply.

Answer 29

C) Cyclophosphamide Cyclophosphamide is a well-known cause of haemorrhagic cystitis due to its metabolite acrolein, which is excreted in urine and irritates the bladder mucosa. Methotrexate and doxorubicin are associated with other toxicities but not specifically haemorrhagic cystitis. Cisplatin is nephrotoxic but not associated with this particular condition.

Answer 30

C) Acrolein Acrolein is the toxic metabolite of cyclophosphamide and ifosfamide that causes direct irritation and inflammation of the bladder lining, leading to haemorrhagic cystitis. Preventive strategies are essential in patients receiving high-dose cyclophosphamide.

Answer 31

A) Mesna Mesna (mercaptoethane sulfonate) is routinely co-administered with cyclophosphamide or ifosfamide to neutralise acrolein in the bladder and prevent urotoxicity. It binds to acrolein, rendering it inactive, and thereby protects the urothelium.

Answer 32

D 12 weeks According to the NHS childhood immunisation schedule, the 6-in-1 vaccine is administered at 8, 12, and 16 weeks of age. The second dose is due 4 weeks after the first, making 12 weeks the correct interval for the next administration. Giving the vaccine tooearly may reduce the effectiveness and not align with the established immunisation schedule.

Answer 33

A) Kawasaki disease Kawasaki disease is a vasculitic condition that most commonly affects children under the age of 5. It typically presents with a persistent fever (lasting 5 or more days), bilateral conjunctivitis, cervical lymphadenopathy, rash, mucosal inflammation, and extremity changes. Blood test findings may include markedly raised inflammatory markers (e.g. CRP), leukocytosis, and thrombocytosis, all of which are seen here. CSF findings are usually normal, helping to distinguish this from meningitis. Early diagnosis is essential to prevent coronary artery complications.

Answer 34

B) Lay him on his back and raise his legs This patient is breathing and has a pulse, which means CPR is not appropriate. The best first aid response for a person who has fainted but is breathing is to lay them on their back and elevate the legs. This position helps restore blood flow to the brain and can aid in recovery from fainting (syncope). Administering sugar-based products (such as honey) is only appropriate for conscious hypoglycaemic patients. Massaging or rubbing parts of the body is not a recommended or evidence-based emergency intervention for fainting.

Answer 35

E) Levomepromazine Levomepromazine is commonly used in palliative care as a broad-spectrum anti-emetic and is effective in patients where other agents, such as haloperidol, have failed. It is particularly beneficial when nausea and vomiting are multifactorial or when centrally acting causes are suspected. It also has sedative properties, which can be helpful in the palliative context.

Answer 36

D) Ondansetron Ondansetron is a 5HT3 receptor antagonist with minimal renal clearance, making it appropriate for patients with significant renal impairment. It is effective for controlling nausea and vomiting and does not pose the same risks of extrapyramidal side effects or QT prolongation at standard doses when compared to some other agents.

Answer 37

B) Domperidone Domperidone is considered safer in Parkinson’s disease as it does not cross the blood-brain barrier, reducing the risk of worsening extrapyramidal symptoms. Alternatives like metoclopramide or haloperidol are dopamine antagonists that may worsen motor symptoms and should be avoided.

Answer 38

E) Erectile dysfunction Thiazide diuretics like bendroflumethiazide are known to cause erectile dysfunction as a side effect due to decreased vascular perfusion and potential psychological impacts.

Answer 39

A) Sumatriptan Sumatriptan, a serotonin (5HT1) receptor agonist used for acute migraine, may cause drowsiness. Patients should be cautioned that if affected, they should avoid driving or operating machinery.

Answer 40

F) Carvidolol Carvedilol is one of the three beta-blockers (alongside bisoprolol and nebivolol) licensed for the treatment of chronic heart failure. It is often initiated at 3.125mg twice daily and titrated upwards depending on clinical response and tolerability.

Answer 41

G) Hydralazine + nitrates This combination is recommended for patients with heart failure who cannot tolerate ACE inhibitors or ARBs, due to side effects such as a persistent dry cough. It is especially beneficial in patients with hypertension and systolic dysfunction.

Answer 42

o 180mg every 4-6 hours (max QDS)

Answer 43

o There is a drug interaction There is a drug interaction between the patient’s newly prescribed losartan and Priadel (lithium). Losartan (an ARB), can increase lithium concentration, increasing the risk of toxicity–this is the most concerning issue that should be acted upon first

Answer 44

o Sell glycerol and sucrose syrup There are no red flags listed in the presentation so a referral to the GP is not necessary at this stage. OTC dextromethorphan and guaifenesin is not suitable for this patient due to his age. Guaifenesinis also indicated for productive coughs rather than dry coughs, as it is an expectorant. Ibuprofen may help with fever and pain but is unlikely to help with the cough which is the patient’s main symptom.Glyceryl and sucrose syrup is the most appropriate option for this patient.

Answer 45

o Acupuncture should not be recommended for symptom relief inosteoarthritis Simple analgesia for osteoarthritis should only be used infrequently and short term. Exercise is recommended in osteoarthritis. Strong opioids should not be prescribed for pain management in osteoarthritis.Glucosamine and acupuncture should not be recommended for symptom reliefin osteoarthritis (this is due to the lack of evidence base – see the NICE CKS topic on osteoarthritis).

Answer 46

**o Refer patient to GP** This patient should be referred to the GP to investigate due to the red flag of weight loss and the fact that the PPI hasn’t helped their symptoms. The GP is the most appropriate route of referral, and they should be seen promptly by the GP.

Answer 47

o Propranolol Propranolol is a non-selective betablocker.The other betablockers listed above are relatively cardio-selective. Remember "Be A MAN" for cardioselective Beta-blockers B - Bisoprolol A - Atenolol M - Metoprolol A - Acebutolol N - Nebivolol

Answer 48

**o Sodium valproate** According to the recent MHRA alert (October 2023), medicines containing valproate must always be dispensed in the manufacturer’s original full pack, unless there are exceptional circumstances. This is to ensure that patients are provided with all the relevant material regarding the risks of valproate.

Answer 49

o Indapamide Indapamide is a thiazide-like diuretic, which can exacerbate gout.

Answer 50

o 300 microgram Consult the BNFc – a 300 microgram adrenaline autoinjectoris appropriate for a child aged 6-11 years old.

Answer 51

**o Nitrofurantoin** Nitrofurantoin carries a risk of pulmonary adverse effects and patients should be counselled to report any new or worsening pulmonary symptoms. This is based off a 2023 MHRA alert.

Answer 52

B - Bisoprolol A - Atenolol M - Metoprolol A - Acebutolol N - Nebivolol

Answer 53

o Vitamin A Vitamin A should be avoided during pregnancy due to its potential teratogenic affect.

Answer 54

o < 130/80 According to NICE guidance, because they have CKD andan ACR of 70 mg/mmol or more, their BP target is less than 130/80 mmHg.

Answer 55

o HPV vaccine The HPV vaccine is offered at age 11-14 years old

Answer 56

o 300mg TDS

Answer 57

o Bunov patch Bunovpatch is not appropriate for acute painor where pain relief requirements are rapidly changing.

Answer 58

o Flucloxacillin Flucloxacillin is the first line antibiotic choice in bullous impetigo.

Answer 59

o Metformin B12 deficiency is a common side effect of metformin. This based off a June 2022 MHRA alert. Periodic monitoring should be considered in patients who have risk factors for B12 deficiency.

Answer 60

o 4 CPD records

Answer 61

o Contact the ADHD specialist and ask them to review the patient’s treatment You should contact the ADHD specialist and ask them to review the patient’s treatmentas treatment should be initiated by the specialist and only transferred over to the GP oncethe patient is stable.The other options are not appropriate

Answer 62

o Decline the sale as you cannot sell this quantity of pseudoephedrine The patient is trying to buy two boxes; each capsule contains 60mg pseudoephedrine and there are 12 capsules per box, so 2 boxes would be 24 capsules. Total quantity of pseudoephedrine = 24x 60mg = 1440mg. The sale should be declined because it is against the law tosupply any product that containsover 720 mg pseudoephedrine or over 180 mg ephedrine without a prescription

Answer 63

The last day of the month before If the use by date is June 2025, this medication should not be used after the 31st may 2025

Answer 64

o Risk of serotonin syndrome

Answer 65

- Insulin Detemir The other 2 are once daily

Answer 66

**Hydroxychloroquine** Hydroxychloroquine carries a risk of retinopathy. Annual ophthalmological monitoring is recommended in patients who have taken hydroxychloroquine for over 5 years, although note that this may be started earlier when there are risk factors for retinopathy

Answer 67

**Leflunomide** This drug should have regualr blood pressure monitoring as hypertension is a common side effect of the medication. Other things to monitor: FBCs and liver function (hepatotoxicity)

Answer 68

Tacrolimus Oral tacrolimus must be prescribed and dispensed by brandname, as switching between brands has been linked to cases of toxicity and graft rejection.This is based off a 2017 MHRA alert.

Answer 69

Amiodarone Before treatment, amiodarone requires monitoring ofthyroid function tests,liver function tests, and serum potassium (and alsoa chest x-ray).

Answer 70

Timodine Cream Thsi is a combination product that contains Hydrocortisone, benzalkonium chloride, dimeticone and nystatin. It is a POM Permetrhin is a P medicine

Answer 71

Clobetasone cream (Eumovate) Clobetasone cream (Eumovate) is available OTC and is licensed for children over 12 years old. Note that hydrocortisone 1% cream is also available OTC but the minimum licensing age is 10 years old

Answer 72

18 to 65 years old

Answer 73

12 years and above

Answer 74

18 years old and above

Answer 75

3 days This is due to the risk of addiction.

Answer 76

o Entacapone Entacapone is a COMT inhibitor. Patients should be counselled that entacapone can cause urine to be coloured reddish-brown. Roinerole, Rasagiline, Rotigotine, Amantadine, and Apomorphine are dopamine agonists Co-benldopa and Co-careldopa are forms of Levodopa

Answer 77

o Apomorphine Apomorphine is a dopamine receptor agonist which can be given as a subcutaneous injectionor by continuous subcutaneous infusion.

Answer 78

C. Haemoglobin S Disease Only Haemoglobin S disease (Sickl Cell) requires folic acid to be taken for the whole duration of pregnancy. Pregnant women that are obese, epileptic, have ceoliac disease are recommeded to take folic acid 5mg up to 12 weeks getsatiopn. Although Pre-eclampsia does not increase the risk of neural tube defects itslelf, it is still recommened to take 400mchg of folic acid up to 12 weeks gestation.

Answer 79

C. Chloramphenicol IV For the treatment of meningococcal diseases benzylpenicillin is recommended, however due to cross-sensitivity between Benzylpenicillins and Cephalosporins this would not be an appropriate treatment option. If there is a history of hypersensitivity reactions (excludingrash) to penicillin’s and cephalosporins, then chloramphenicol is recommended

Answer 80

B 150 micrograms, then repeated after 5–15 minutes as required - For Child up to 6 months = 100–150 micrograms - For Child 6 month – 5 years (<15kg) = 150 micrograms - ForChild - 6–11 years (>30kg) = 300 micrograms - For Child 12 years old and over = 500 micrograms (300 micrograms to be administered if child is small or pre-pubertal)

Answer 81

E. Sitagliptin A common side effect of Sitagliptin, Saxagliptin and Alogliptin is upper respiratory tract infection and nasopharyngitis. The other options listed do not have this increased risk.

Answer 82

Screening tool used to help diagnose or rule out Cushing's syndrome 1 mg oral dexamethasone is given between 11 pm and midnight, and a blood sample for cortisol level is taken between 8 am and 9 am the next morning. Dexamethasone inhibits the prodction of cortisol If cortisol levels remain high, it may indicate Cushing's syndrome.

Answer 83

Congestive heart failure, chronic alcoholism, hepatic dysfunction, or viral infections

Answer 84

B. Lithium Lithium should be stopped 24 hours before major surgery, however in a minor surgery the usual dose can be continued with careful monitoring. Other drugs that should be stopped before surgery include: - Hormone contraceptives - MAOIs - ACE-I/ARBs (stop 24 hours before surgery).

Answer 85

C. Latanoprost Prostaglandin analogues can cause brown pigmentation of the iris and can cause hair growth.

Answer 86

Highest risk = piroxicam, ketoprofen, and ketorolac Medium risk = indometacin, diclofenac, and naproxen Low risk = iburprofen and COX-2 inhibitors (lowest)

Answer 87

Highest risk = COX-2 inhibitors, Ibuprofen (2.4g daily) and diclofenac (150 mg daily)

Answer 88

D. Stop taking isotretinoin and inform to your GP and your dermatology team Patients who present with mood or behaviour changes and showing any signs of a mental illness should stop their medication immediately and inform your GP and dermatology team This is a as per British Association of Dermatologists (BAD) patient guide

Answer 89

A. Name of the medication Legal requirements of the CD requisition: 1. Name of the recipient 2. Address of the recipient 3. Profession or occupation 4. Total quantity of drug 5. Purpose of the requisition 6. Signature of the recipient.

Answer 90

- Tachycardia - Dilated pupils - Nausea and Vomiting - Agitation - Seizures

Answer 91

- Gabapentin - Phenobarbitol - Pregabalin - Midazolam - Tramadol Great people make perfect tea

Answer 92

- Antibiotics: Tteracyclines, Quinolones, Co-trimoxazole (sulphonamide component) - Voriconazole (antifungal) - Hydroxychloroquine and Chloroquine (Antimalarials)

Answer 93

- Amiodarone - Isotretanoin - Tacrolimus - Phenothiazine antipsychotics (levomepromazine, chlorpromazine, prochlorperazine, promazine) - Benzyol peroxide

Answer 94

- Antibiotics = macrolides, quinolones, aminoglycosides - Antifungals = itrakonazole, ketoconazole - Antimalarials = Chloroquine and Hydroxychloroquine

Answer 95

- Lithium - Sumatriptan - Anti-emetics = Metoclopramide / Ondansetron / Domperidone - SSRIs = Citalopram / Escitalopram - TCAs - Venlafaxine - Antipsychotics

Answer 96

- Amiodarone - Sotalol

Answer 97

- Quinolones - SSRIs - Antipsychotics - Tramadol - Theophylline - Lithium

Answer 98

- Sumatriptan - Ondansetron - SSRIs - TCAs - MAOIs - St. Johns Wart

Answer 99

- Aminoglycosides (Gentamycin / Amicacin) - Vancomycin - Cisplatin - Vinka alkaloids - Loop diuretics

Answer 100

CCD - Cyclophosphamide (high dose) - Cisplatin - Darcarbazine

Answer 101

Dont Touch Children's Midday Meals - Doxorubicin - Taxanes (Paclitaxel) - Cyclophosphamide (low/medium dose) - Methotrexate (high dose) - Mitoxantrone

Answer 102

- Vincristine - Bleomycin

Answer 103

FL A ME - Flurouracil - Anthracyclines (Doxorubicin) - Methotrexate

Answer 104

Cyclophosphamide and Ifosphamide They both produce the toxic metabolite acrolein which causes

Answer 105

- 4-6 hours after dose - 3 days after dose change - 5 days after initiation

Answer 106

- Azathiprine and Mercaptopurine Metabolises thiopurine drugs —> increased SE’s if enzyme is low

Answer 107

Azathioprine

Answer 108

Mycophenolate

Answer 109

6 weeks of contraception

Answer 110

5-15 mcg/L

Answer 111

100 - 300 μg/L

Answer 112

- Methotrexate - Cyclophosphamide - Bleomycin

Answer 113

Should be given through a syringe

Answer 114

Through a 50 mL minibag

Answer 115

- Co-danthromer - Doxorubicin

Answer 116

Parenteral anticoagulation (Heparin)

Answer 117

Membrane stabilising drugs - Na+ channel blockers Examples = lidocaine & flecainide

Answer 118

Beta blockers

Answer 119

Potassium channel blockers - Amiodaraone and Sotalol (also class 2)

Answer 120

Calcium channel blockers (not dihydropyridines) - Diltiazem and Verapamil

Answer 121

- New onset AF - Atrial flutter suitable for an ablation strategy [use of heat or cold energy to block electrical signals and restore a normal heart rate] - AF with a reversible cause [MI, hyperthyroidism, PE, excess caffeine & alcohol] - Heart failure primarily caused by AF - Or if rhythm control is more suitable

Answer 122

Amiodarone and Flecainide

Answer 123

Pharmacological cardioversion - less invasive

Answer 124

3 weeks of anticoagulation Risk of the clot moving and potentiall causing a stroke

Answer 125

Heparin IMMEDIATELY before cardioversion

Answer 126

- Congestive Heart Failure = 1 - Hypertension = 1 - Age > 75 = 2 - Diabetes = 1 - Stroke/TIA = 2 - Vascular heart disease = 1 - Age 65-74 = 1 - Sex (female) = 1

Answer 127

2 or above Remember anticoagulants = AN2COAGULANTS

Answer 128

- Older than 75 = 1 - Reduced Hb = 2 - Bleeding history = 2 - Impaired renal function (<60) = 1 - Treatments with antiplatelets = 1

Answer 129

3 - Remeber THREE makes you BLEED Anything less than 3 is considered low risk

Answer 130

● Thyroid function tests ● Liver function tests ● Serum potassium concentration - causes hypokalaemia ● Chest X-ray ● Annual eye tests ● ECG (with intravenous use) ● Blood pressure (BP)

Answer 131

Increased risk of arrhythmias and QT prolongations

Answer 132

Increase plasma concentration (bleed risk)

Answer 133

Increase plasma concentration

Answer 134

Increase plasma concentration

Answer 135

Increase plasma concentration

Answer 136

Increased risk of myopathy

Answer 137

1 - 2 mcg/L

Answer 138

- High Calcium - Low potassium - Low Magnesium

Answer 139

Hypoxia can cause toxicty of digoxin

Answer 140

- Give Sando K (K supplements) - Give a potassium sparing diuretic (spironolactone)

Answer 141

DANG SAT D – Diarrhea A – Abdominal pain N – Nausea/ Vomiting G – Green/yellow vision S – Skin reactions A – Arrhythmias (bradycardia, AV block) T – Tremors

Answer 142

● Plasma-digoxin concentration ● Serum electrolytes ● Renal function

Answer 143

6 hours post administration

GPHC questions I get Wrong Flashcards

(174 cards)