Greenlight wrong questions Flashcards
(23 cards)
Which of the following medicines is most likely to provoke symptoms of GORD?
A.Alendronic acid
B.Aripiprazole
C.Bempedoic acid
D.Famotidine
E.Omeprazole
A- Alendronic acid
Common side effect of bisphosphonates = upper GI issues
What are the signs of potential cardiotoxicity of doxorubicin?
Fatigue
Shortness of breath
Swollen ankles
What is an inappropriate dietary change for a patient on lithium therapy?
Low sodium diet should be avoided on lithium as this can increase blood concentration of lithium = can cause toxicity
You are carrying out a COPD review with a patient diagnosed two years ago. They are currently prescribed a salbutamol inhaler for symptom control, but aren’t prescribed any maintenance therapy.
The patient reports increased breathlessness and sputum production.
They have a normal eosinophil count and no asthmatic features. You decide to initiate a regular inhaled therapy.
Which of the following inhalers would be most appropriate for this patient?
A.Anoro (umeclidinium / vilanterol)
B.Clenil (beclometasone)
C.Seebri (glycopyrronium)
D.Seretide (fluticasone / salmeterol)
E.Trimbow (beclometasone / formoterol / glycopyrronium)
A- Anoro
LABA / LAMA
You are reviewing a patient with asthma who is currently prescribed a Relvar (fluticasone / vilanterol) inhaler.
The patient also has a diagnosis of COPD. In the last year, they have had two COPD exacerbations, and report a high CAT score today.
The patient has good inhaler technique and reports good compliance. You decide to change their inhaler therapy.
Which of the following options would be most appropriate COPD therapy for this patient in place of Relvar?
A.Clenil (beclometasone)
B.Incruse (umeclidinium)
C.Spiolto (tiotropium / olodaterol)
D.Spiriva (tiotropium)
E.Trelegy (fluticasone / umeclidinium / vilanterol
E- Trelegy
The father of an 8-week-old baby has come to the pharmacy to purchase paracetamol suspension. The child is due to have their 8-week immunisations.
Which of the following statements is the correct advice for giving a paracetamol 120 mg/5 mL oral suspension?
A.Give 2.5mL as a standalone dose at the time of vaccination. If necessary, given a second 2.5mL dose after 4-6 hours. Do not give more than two doses. If your child is still feverish after two doses, seek advice from a doctor or pharmacist.
B.Give 2.5mL up to four times daily starting at the time of vaccination. Seek advice from a doctor or pharmacist if your baby still needs this medicine two days after receiving the vaccination.
C.Give 5mL up to four times daily. Leave at least 4 hours between doses.
D.This medicine is not suitable for children aged under 3 months.
E.This medicine is not suitable for children aged under 6 years.
B.Give 2.5mL up to four times daily starting at the time of vaccination. Seek advice from a doctor or pharmacist if your baby still needs this medicine two days after receiving the vaccination.
Type 2 diabetes is a long-term condition. Optimum glycaemic control becomes more difficult over time as beta cell function deteriorates, and this can lead to insulin therapy becoming necessary.
Common insulin regimens involve once or twice-daily basal dosing of intermediate or long-acting insulin, or basal-bolus regimens where a rapid-acting or short-acting insulin is also used before meals.
Which of the following insulins would be most appropriate for bolus dosing in a basal-bolus regimen?
A.Humalog (insulin lispro)
B.Insulatard (isophane insulin)
C.Lantus (insulin glargine)
D.Levemir (insulin detemir)
E.Tresiba (insulin degludec)
A- Humalog (insulin lispro)
A 68-year-old woman is browsing the shelves of your pharmacy. She notices a vaginal moisturising cream containing estriol. She’s been experiencing vaginal dryness and discomfort for some time, and recalls a friend mentioning estriol. The packaging suggests it can relieve symptoms of vaginal atrophy.There is a different initial and maintenance dose.
What is the maintenance dose for estriol over the counter?
A.One application daily
B.One application on alternate days
C.One application twice daily
D.One application weekly
E.One application twice weekly
E) One application twice weekly
A 33-year-old woman at 13 weeks gestation, presents to her GP with symptoms of dysuria, urinary frequency, and lower abdominal discomfort. A urine dipstick test confirms a urinary tract infection (UTI). She has NKDA.
What is the correct first line option for her?
A.Amoxicillin 500mg capsules TDS for 7 days
B.Nitrofurantoin 50mg tablets QDS for 7 days
C.
Nitrofurantoin MR 100mg tablets BD for 3 days
D.Trimethoprim 100mg tablets TDS for 3 days
E.Trimethoprim 200mg tablets TDS for 7 day
B) Nitrofurantoin 50mg QDS for 7 days
Nitrofurantoin is first line in pregnancy in 7 day course
A 27-year-old breastfeeding mother has been managing her tonic-clonic seizures with antiepileptic medication for several years. Her neurologist recently adjusted her prescription, and she’s now concerned about the potential impact on her 3-month-old infant. She’s read online that some antiepileptic drugs are metabolized differently in infants.
Which of the following accumulates due to slower metabolism in infants?
A.Carbamazepine
B.Ethosuximide
C.Lamotrigine
D.Primidone
E.Zonisamide
C) Lamotrigine
A 51-year-old patient attends your pharmacy and requests some ibuprofen. It has been recommended by a friend for pain, and the patient would like to buy some. He has had some pain in his chest (especially on inspiration) for a couple of days. He thinks he may have pulled a muscle at the gym.
The patient has NKDA and takes Edoxaban 60 mg OD for a provoked DVT after a long-haul flight 1 month ago.
What is the most appropriate advice for this patient?
A.Recommend a different analgesic due to the interaction with edoxaban
B.Recommend a different analgesic due to the patient’s age
C.Refer the patient to Accident and Emergency as he may be unwell
D.Refer the patient to their GP for chest pain
E.Supply the ibuprofen with safety netting advice for the pain
C - Refer the patient to A&E
A 58-year-old male patient with type 2 diabetes and a history of hypertension is attending his routine follow-up. His recent blood tests show the following:
Urine albumin-to-creatinine ratio (UACR): 45 mg/g (reference range: 0-30 mg/g)
Serum creatinine: 110 µmol/L (reference range: 60-110 µmol/L)
Blood pressure: 128/85 mmHg (reference range: <140/90 mmHg)
Serum cholesterol: Total cholesterol 6.5 mmol/L (reference range: <5.0 mmol/L)
Echocardiogram: Left ventricular hypertrophy (LVH) present
The patient is experiencing no symptoms but is concerned about his kidney function and the potential risks to his heart.
What is the most appropriate treatment plan to address his microalbuminuria?
A.Initiate an ACE inhibitor
B.Prescribe a calcium channel blocker to control blood pressure
C.Recommend dietary modifications and increase exercise
D.Start a diuretic to reduce the urine albumin levels
E.Start a low-dose aspirin to reduce cardiovascular risk
A- Initiate an ACE inhibitor
ACEi are kidney protective medications that help reduce microalbuminuria and proteinuria
A 68-year-old male patient has been diagnosed with non-valvular atrial fibrillation (AF). He has no history of stroke or transient ischemic attacks (TIA), and he does not have significant renal or hepatic impairment. His CHA2DS2-VASc score is 3, and his HAS-BLED score is 2, indicating a moderate risk of stroke and a moderate risk of bleeding. The patient expresses a preference for a once-daily medication.
Which of the following medications is most appropriate for stroke prevention in this patient?
A.Aspirin
B.Apixaban
C.Dabigatran
D.Edoxaban
E.Warfarin
D- Edoxaban
DOAC is commonly used in AF for stroke prevention, but patient wants once-daily medication
A 3-year-old boy presents with a barking cough, mild stridor, and hoarseness. He is afebrile, does not appear distressed, and his oxygen saturation is 98% on room air. What is the most appropriate treatment?
A.Adrenaline
B.Amoxicillin
C.Azithromycin
D.High-flow oxygen and nasal suctioning
E.Intravenous ceftriaxone
F.Oral dexamethasone
G.Salbutamol via a spacer
H.Supportive care only
F) Oral dexamethasone
Reduces airway inflammation
Nebulised adrenaline is reserved for severe cases
A 2-month-old baby presents with severe coughing fits, post-tussive vomiting, and inspiratory whoop. His vaccinations are incomplete, and he has been coughing for the past two weeks. What is the most appropriate treatment?
A.Adrenaline
B.Amoxicillin
C.Azithromycin
D.High-flow oxygen and nasal suctioning
E.Intravenous ceftriaxone
F.Oral dexamethasone
G.Salbutamol via a spacer
H.Supportive care only
If admission is not necessary and the onset of the cough is within the last 14 days = antibiotic treatment
Vaccinations are incomplete
Macrolide first line
Children 1 month + = Azithromycin
For each of the statements below, select the single most appropriate medication from the list. Each option may be used once, more than once, or not at all.
A 58-year-old man with heterozygous familial hypercholesterolaemia (FH) has been taking Atorvastatin 80 mg and Ezetimibe 10 mg for the past 6 months. His LDL remains above 3.5 mmol/L, despite good adherence to treatment. What is the most appropriate next step?
A.Atorvastatin 20 mg once daily
B.Atorvastatin 80 mg once daily
C.Bempedoic acid 180 mg once daily
D.Discontinue treatment
E.Ezetimibe 10 mg once daily
F.Inclisiran SC injection
G.PCSK9 inhibitor (e.g., Alirocumab)
H.Repeat lipid profile in 3 months
F- Inclisiran SC injection
Can be used for adults with high cholesterol as an add-on to diet ONLY if
They have a history of CVD problems such as Heart attack, unstable angina, CHD, Stroke due to reduced blood flow
AND
Their LDL cholesterol remains at 2.6mmol/L
When is bempedoic acid recommended?
For patients who cannot tolerate statins and have an inadequate response to ezetimibe alone
A 35-year-old male seeks advice for managing nasal congestion associated with a cold. Which age group is pseudoephedrine licensed for over-the-counter sale?
A.2 years and above
B.4 years and above
C.6 years and above
D.8 years and above
E.10 years and above
F.12 years and above
G.16 years and above
H.18 years and above
C- 6 years and above
A patient presents with symptoms consistent with a ST-elevation myocardial infarction (STEMI) and is within 10 hours of symptom onset. The local hospital does not have PCI capability, and the patient cannot be transferred to a PCI centre. What is the most appropriate management for reperfusion therapy?
A.Angiography
B.Aspirin with clopidogrel
C.Aspirin with prasugrel
D.Aspirin with ticagrelor
E.Clopidogrel
F.Fibrinolysis
G.Primary Percutaneous Coronary Intervention (PCI)
H.Ticagrelor
Fibrinolysis should be offered to patients with STEMI who present with 12 hours of symptom onset and are unable to access PCI within 120 mins
A 62-year-old patient with STEMI arrives at the emergency department, and the healthcare team is preparing for an imminent PCI. The patient is on edoxaban therapy due to a history of atrial fibrillation. Which of the following should be administered immediately to the patient as part of the early management?
A.Angiography
B.Aspirin with clopidogrel
C.Aspirin with prasugrel
D.Aspirin with ticagrelor
E.Clopidogrel
F.Fibrinolysis
G.Primary Percutaneous Coronary Intervention (PCI)
H.Ticagrelor
B- Aspirin with clopidogrel
NICE guidelines = STEMI who are already on oral anticoagulant, need DAPT using Aspirin and clopidogrel
Aspirin and Prasugrel = when not already using anticoagulant
75+ = assess risk of bleeding with prasugrel
A 49-year-old male patient presents to the emergency department with symptoms consistent with STEMI. After assessment, it is determined that the patient is not eligible for reperfusion therapy. The patient has low bleeding risk. The healthcare team is focusing on medical management to reduce the risk of complications. What is the most appropriate medical management for this patient?
A.Angiography
B.Aspirin with clopidogrel
C.Aspirin with prasugrel
D.Aspirin with ticagrelor
E.Clopidogrel
F.Fibrinolysis
G.Primary Percutaneous Coronary Intervention (PCI)
H.Ticagrelor
D- Aspirin and Ticagrelor
STEMI who are not eligible for reperfusion therapy = DAPT with aspirin and ticagrelor
A 52-year-old male patient is prescribed IV gentamicin for endocarditis. It will be administered in a multiple daily dose regimen . The healthcare team decides to monitor the patient’s gentamicin serum levels closely. What is the therapeutic range for gentamicin?
A.<1 mg/L
B.>1 mg/L
C.0.6-0.8 mmol/L
D.0.8-1 mmol/L
E.10-20 mg/L
F.20-30 mg/L
G.3-5 mg/L
H.5-15 mg/L
ENDOCARDITIS
G- 3-5mg/L
A 50-year-old male patient with type 2 diabetes mellitus has been started on a semaglutide weekly injections to help with weight loss. What is a likely adverse effect of this medication?
A.Binge eating
B.Burping
C.Hyperglycaemia
D.Mouth ulcers
E.Oily stools
F.Pain in both knees
G.Reduced dental mobility
H.Sweating
B- Burping
