Mock Exam Questions

Question 1

Which of the following is contraindicated in convulsive disorders

Answer 1

NSAID
AMITRIPTYLINE
BUPRENORPHINE
NEFOPAM ⭐️

Question 2

In regards to controlled drugs according to the misuse in drugs regulations 2001 Temazepam is classified as which kind of schedule

Answer 2

Schedule 3

Question 3

Which of the following statements is incorrect in relation to prescribing

Answer 3

During the second trimester drugs can produce congenital malformations

Question 4

True or false in regards to prescription writing it is a legal requirement to state the child’s age if they are under 12

Answer 4

True

Question 5

True or false paramedics are allowed to prescribe controlled drugs

Answer 5

False

Question 6

Which of the following drugs is not associated with the reaction of alopecia

Answer 6

Quinine

Question 7

Within the realms of supplementary prescribing the independent prescriber must be a dentist or a dr

Answer 7

True

Question 8

Bisoprolol should be avoided in patients with a history of asthma

Answer 8

True

Question 9

What dose of aciclovir is indicated for the treatment of oral herpes simplex in a 52 year old man undergoing chemotherapy

Answer 9

400mgs 5 times a days for 5 days

Question 10

When discontinuing a prescription of citalopram over what duration should dosing be tapered

Answer 10

The dose should be reduced gradually
Over about 4 weeks or longer if withdrawal symptoms emerge
6 months for patients who have been on longer term maintenance treatment

Question 11

What is the definition of pharmacokinetics

Answer 11

The study of the movement of drugs through the body

ADME

Question 12

What is the definition of a patient safety incident

Answer 12

Patient safety incidents are any unintended or unexpected incident which could have or did lead to harm of a patient receiving healthcare

Question 13

Bioviability is the percentage or fraction of the administered dose that reached the systemic circulation of the patient. which of the following is not a factor that would effect bioavailability

Answer 13

Gender

Question 14

When discussing potency in relation to pharmacology which of the following statements is true

Answer 14

Potency is related to the drugs affinity for the site of action

Question 15

Which of the following is a potential cause of pre-renal failure

Answer 15

Gastro intestinal fluid loss secondary to laxative abuse

Question 16

True or false half life is the amount of time taken for a drug to be eliminated from the plasma

Answer 16

False

Question 17

The liver is a major site of bio transformation

Answer 17

True

Question 18

Name two phase two metabolic pathways

Answer 18

Methylation

Acetylation

Question 19

In relation to the pharmacokinetics Distribution of medicines list four ways children are different to adults

Answer 19

⭐️ Babies have a much higher water to total weight ratio.
⭐️As Children grow the percentage total body weight made up of water gradually decrease and their fat and muscle percentage increases
⭐️The amount of extra cellular fluid decrease and the intracellular fluid volume increases .
⭐️Due to the high percentage of water doses of water soluble Medicines need to be higher in infants.
⭐️Fat soluble medications need to be smaller in infants
⭐️Children have different levels of circulation proteins such as lower albumin levels so drug in free circulation will be higher

Question 20

Bioavailability

Answer 20

Availability to the biological systems

Question 21

ADMA

Answer 21

Absorption - transfer from site of administration
Distribution - transfer from the general circulation into the different organs of the body
Metabolism - brake down of the drug
Elimination - removal from the body, which may include metabolism and/or excretion

Question 22

Absorption difference in adult to children

Answer 22

Slower gastric emptying and intestinal transit
Reduced absorption of certain drugs
The skin has very high hydration
Low skeletal muscle mass

Question 23

Distribution difference in children and adults

Answer 23

Different fat/water content re adults
High plasma concentration of free fatty acids and bilirubin complete for plasma protein binding sites
Blood brain barrier

Question 24

Metabolism

Answer 24

Immature liver enzymes in neonates

When enzymes system mature metabolism is more extensive because relative liver mass and hepatic blood flow are higher

Question 25

Renal elimination

Answer 25

Less developed in neonates and infants | GRF in neonate about 40% of adult

Question 26

Factors effecting pharmacology

Answer 26

``` Age Genetics Environmental factors Disease Drug interactions ```

Question 27

Define the term Half life

Answer 27

Time taken for the concentration of a drug to fall to half its original value

Question 28

Name two phase 1 pathways

Answer 28

Hydration | Oxidation

Question 29

DDII

Answer 29

Decrease Dose OR Increase Interval

Question 30

What group of enzymes most commonly involved in drug metabolism in the liver

Answer 30

Cytochrome p450

Question 31

Where does first pass metabolism occur

Answer 31

Liver

Question 32

Black triangle drug

Answer 32

A newly licensed drug or a drug that is currently been monitored by the MHRA

Question 33

What are the principles of the Royal pharmaceutical society with regards to medicines optimisation

Answer 33

Principle 1 - patient experience Principle 2 - evidence based Principle 3 - safe Principle 4 - make optimisation part of routine practice

Question 34

Medicines optimisation | Stop start

Answer 34

Look in BNF both there

Question 35

Crushing a tablet May alter the properties of the drug and may make it ineffective

Answer 35

True

Question 36

Bioviability is the percentage of changed reaching the systemic circulation following administration by any route

Answer 36

True

Question 37

Drug resistance is the term used to describe the loss of effectiveness that may occur with the use of some antibiotics

Answer 37

True

Question 38

Name one example of how liver disease may alter the response to drugs in patients with hepatic impairment

Answer 38

Impaired drug metabolism

Question 39

Acetylcholine is a sympathetic nervous system neurotransmitter

Answer 39

False

Question 40

Name one factor that affects the pharmacology of a drug

Answer 40

Age

Question 41

Name one factor you would consider when prescribing an antibacterial

Answer 41

ALlergies

Question 42

All suspected reactions to a black triangle drug must be reported through which system

Answer 42

Yellow card

Question 43

What does the abbreviation MAOI Mean

Answer 43

Monoamine oxidase inhibitor

Question 44

What are the four phases of PHARMACOKINETICS

Answer 44

ADME

Question 45

Define the term adverse drug reaction

Answer 45

Unwanted and harmful or noxious and unintended . | occurring after drug / combination administration.

Question 46

Where a suspected adverse event in a child less than 18 years is associated with drug misuse or overdose it is not appropriate to report it through the yellow card scheme

Answer 46

False

Question 47

The time is takes to reduce a drug dose by 50% is know as the half life

Answer 47

True

Question 48

Sublingual preparation may be used to

Answer 48

Prevent first pass metabolism

Question 49

Name one approach that can be used to alter dosing regimes to avoid toxicity

Answer 49

Lower the dose | Extend the interval

Question 50

For drugs that require therapeutic drug monitoring name 3 factors that May effect drug levels

Answer 50

Dose Patient adherence Time and date blood taken Other drugs

Question 51

If it takes 5 half-lives for a drug to reach a steady state and drug x has a half life of 30 hours how long will it take drug x to achieve a steady state give your answer in days

Answer 51

30x5 = 150 / 24hrs = 6 days

Question 52

Can citalopram be prescribed for a breast feeding mother

Answer 52

Yes

Question 53

An agonist mimics biological processes by binding to a receptor

Answer 53

True

Question 54

What is the description of a common side effect in the BNF

Answer 54

1 in 100 to 1 in 10

Question 55

Medicines reconciluation is the process of identifying the most accurate list of a patients current medicines - including the name, dosage, frequency and route and comparing them to the current list in use, recognising and discrepancies and documenting any changes thus resulting in a complete list of medications accurately communicated

Answer 55

True

Question 56

Choose the correct answer in relation to drug absorption

Answer 56

Is facilitated when a drug has a smaller molecular weight

Question 57

List two indications for increasing the frequency of INR monitoring

Answer 57

Change in clinical condition associated with liver disease | severe Renal impairment

Question 58

What drug is associated with the reaction of hepatitis

Answer 58

Isoniazid

Question 59

Choose correct answer in relation to drug absorption

Answer 59

Is facilitated when drugs have a small molecule weight

Question 60

Name one approach that can be used to alter dosing regimes to avoid toxicity in a patient with renal impairment

Answer 60

Extend the intervals between doses | Reduce the dose

Question 61

For drugs that require therapeutic drug monitoring name three factors that may effect drug levels

Answer 61

Other drugs Patient adherence t Time and date of last dose

Question 62

Name two Phase 2 enzyme reactions

Answer 62

Oxidation | Hydration

Question 63

Name two factors affecting pharmacology

Answer 63

Age Adherence Genetics

Question 64

Factors effect in children | Absorption

Answer 64

* Slow gastric emptying * Reduced absorption of drugs * Thin skin * Low skeletal muscle mass

Question 65

Factors effecting children | Distribution

Answer 65

* Different fat/water ratio to adults * High plasma concentration of free fatty acids and bilirubin compete for plasma protein binding sites * Blood brain barrier

Question 66

Factors effecting children | Metabolism

Answer 66

* immature liver enzymes in neonate | * when enzyme system mature metabolism is more extensive because relative liver mass and hepatic flow higher

Question 67

Renal elimination

Answer 67

* Less developed in children | * GFR in neonate 40% of an adult

Question 68

Q24

Answer 68

* Reduced absorption * Altered protein binding * Accumulation of medicine due to reduced elimination

Question 69

What is the most common phase one pathway in metabolism

Answer 69

Oxidation ✅ Reduction Hydrolysis Hydration

Question 70

What percentage water are baby’s when born

Answer 70

85%

Question 71

How does infant renal elimination differ to adult renal elimination

Answer 71

* higher perfusion press ❌ * inadequate osmotic load to produce counter current effect✅ * Immature glomerular development ✅ * Lower perfusion pressure ✅

Question 72

How does an infant GI tract differ from an adult

Answer 72

Less acidic, shorter length & slower motility

Question 73

Children have a greater surface area to weight ratio than adults

Answer 73

True

Question 74

Kidneys

Answer 74

Regulate blood press Control fluid balance Electrolyte balance

Question 75

What are the 4 pillars of professional prescribing

Answer 75

Legal Ethical Professional Employment

Question 76

What alters metabolism in the liver

Answer 76

Age | Genetics

Question 77

RPS Principals

Answer 77

Royal Pharmaceutical Society Use the four RPS principles: patient experience evidence safe and effective routine practice.

Question 78

Factors affecting Hepatic

Answer 78

Gender | Genetics

Question 79

Factors that affect the rate of a drug metabolism

Answer 79

Age - can’t brake down as fast decrease the dose Liver disease Drug tolerance

Question 80

Stopp start

Answer 80

Screening Tool for Older persons prescribing

Question 81

Name two phase 1 pathways

Answer 81

Oxydation Hydration

Question 82

Name one approach that can that can be used to alter dosing regimes to avoid toxicity in a patient with renal impairment

Answer 82

Extend the interval between doses Reduce the dose given at usual interval