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November resit > Mock Questions > Flashcards

Mock Questions Flashcards

1
Q

What is the dose of Naproxen for Rheumatoid Arthritis?

A

0.5 - 1g in divided doses

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2
Q

What countries can have their prescriptions dispensed in the UK?

A

Austria
Belgium; Bulgaria
Croatia; Cyprus; Czech Republic
Denmark
Estonia
Finland; France
Germany; Greece
Hungary
Iceland; Republic of Ireland; Italy
Latvia; Liechtenstein; Lithuania; Luxembourg
Malta
The Netherlands
Norway
Poland; Portugal
Romania
Slovakia; Slovenia; Spain; Sweden
Switzerland

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3
Q

A 10-year-old comes in with a sprained ankle. There is mild swelling and he does not seem to be in discomfort. What is the most appropriate option for him?

A

Using an ice pack

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4
Q

A 12-year-old comes in with a sprained ankle. There is moderate swelling and he does seem to be in discomfort. What is the most appropriate option for him?

A

Ibuprofen

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5
Q

A patient has started Simvastatin 40mg
His drug history: Bezefibrate, Amlodipine, Ramipril. What adjustment needs to be made?

A

Reduce dose of Simvastatin to 10mg due to bezafibrate.

If bezafibrate wasn’t there, reduce simvastatin to 20mg

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6
Q

What dose adjustment do you need to make to simvastatin due to interactions? 6

A

Bezfibrate or Ciprofibrate = 10mg daily

Amlodipine, Amiodarone, Ranolazine = 20mg daily

CYP inhbitors = reduce dose ->
Verapamil/Diltiazem (inhibitors) =20mg daily

Bempedoic acid (with ezetimbe) = 20mg daily

Severe hypercholesterolaemia and at high risk of cardiovascular complications = 40mg daily

lomitapide or ticagrelor = 40mg daily

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7
Q

When taking Carbimazole what causes sore throat and mouth ulcers

A

Agranulocytosis - lowered white blood cell count
and Neutropenia - low conc of neutrophils

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8
Q

What are contributing factors of hypoglycaemia

A

Taking too much insulin or diabetes medication.
Not eating enough.
Postponing or skipping a meal or snack.
Increasing exercise or physical activity without eating more or adjusting your medications.
Drinking alcohol

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9
Q

What is the age limit of OTC Naproxen for period pains

A

15-50

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10
Q

A patient has been taking pseudoephedrine for the past 3 days for a cold and flu. They present at the hospital with a fast heart rate, bp of 170/90 and headache.
Drug history:
Amlodipine - started last week
Phenelzine - taken off last week
Bempedoic acid - dose increase last week

Which could have caused the hospital admission?

A

There is a SEVERE interaction between
MAOIs e.g. Phenelzine, Isocarboxazid or Tranylcypromine and Pseudoephedrine

It’s predicted to cause hypertensive crisis during and up to 14 days after stopping MAOIs
symptoms = hypertension, palpitation, headache, dizziness, visual disturbances, SOB and malaise

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11
Q

List of notifiable disease in the UK that start with A, B, C, D

A

Acute encephalitis
Acute infectious hepatitis
Acute meningitis
Acute poliomyelitis
Anthrax
Botulism
Brucellosis
Cholera
COVID-19
Diphtheria

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12
Q

List of notifiable dieases that start with E, F, H, I

A

Enteric fever (typhoid or paratyphoid fever)
Food poisoning
Haemolytic uraemic syndrome (HUS)
Infectious bloody diarrhoea
Invasive group A streptococcal disease

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13
Q

List of notifiable diseases that start with L, M, P

A

Legionnaires’ disease
Leprosy
Malaria
Measles
Meningococcal septicaemia
Monkeypox
Mumps
Plague

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14
Q

List of notifiable diseases that start with R, S, T, C W, Y

A

Rabies
Rubella
Severe Acute Respiratory Syndrome (SARS)
Scarlet fever
Smallpox
Tetanus
Tuberculosis
Typhus
Viral haemorrhagic fever (VHF)
Whooping cough
Yellow fever

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15
Q

A pt chart shows hypokalemia which antihypertensice medication would you avoid?
a) Irbesartan
b) Lisinopril
c) Ramipril
d) Spironolactone
e) Furosemide

A

THE ANSWER IS E

A-D causes HYPERkalemia which is ‘fine’
However, diuretics (loop and thiazide) cause hypokalemia so you wouldn’t want to add Furosemide

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16
Q

What malarial prophylaxis is suitable in epilepsy

A

Atovaquone with proguanil
or
Doxycycline

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17
Q

What malarial prophylaxis is suitable in pregnancy

A

Chloroquine and Proguanil (+folic acid)

consider Mefloquine in 2nd-3rd trimester

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18
Q

Antimalarial in someone taking warfarin rule

A

start 2-3 weeks before depatrure
INR must be stable. Measure 7 days before starting prophylaxis and after completing the course

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19
Q

Nish is taking Aripiprazole 15mg OD. what is the least suitable antimalarial?
a) Chloroquine
b) Chloroquine with Proguanil
c) Mefloquine
d) Proguanil
e) Atovaquone with Proguanil

A

THE ANSWER IS C

Mefloquine is contra-indicated in individuals with a history of psychiatric disorders (including depression) or conclusions

Aripiprazole is used in Schizophrenia and Mania

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20
Q

What to do if taking warfarin and experience a major bleed

A

Stop warfarin
give Phytomenadione (Vit K1) by slow IV
give dried prothrombin complex (fresh frozen if unavailable)

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21
Q

What to do if taking warfarin. INR >8.0 and minor bleed

A

Stop warfarin
give Phytomenadione (Vit K1) by slow IV
repeat vit K1 if INR is still high after 24hrs
restart warfarin when INR <5.0

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22
Q

What to do if on warfarin. INR >8.0 and no bleed

A

Stop warfarin
give Phytomenadione (Vit K1) ORALLY using IV preparation
repeat vit K1 if INR is still high after 24hrs
restart warfarin when INR <5.0

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23
Q

What to do if INR 5-8 with minor bleeding

A

Stop warfarin
give Phytomenadione (Vit K1) by slow IV
resart warfarin when INR <5.0

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24
Q

What to do if INR is 5-8 with no bleeding

A

withhold 1 or 2 doses and reduce maintenance dose

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25
what to do if taking warfarin and there is unexpected bleeding at therapeutic levels
investigate the underlying cause
26
What level of renal function is an eGFR <15
Kidney failure
27
What level of renal function is an eGFR 15-29
Severe reduction
28
What level of renal function is an eGFR 30-44
Moderate - severe reduction
29
What level of renal function is an eGFR 45-49
Milde - moderate reduction
30
What level of renal function is an eGFR 60-89
Mild reduction... relative to normal range for a young adult
31
What level of renal function is an eGFR >90
Normal
32
A few months later, Mrs Aslam collects a prescription for Amiodarone, citalopram and atenolol tablets, and buys grapefruit juice. You contact her doctor to discuss possible interactions. Which of the following is false? a) Citalopram and amiodarone can both prolong the QT interval b) Amiodarone and atenolol can both cause bradycardia c) Grapefruit juice increases exposure to amiodarone d) Atenolol and amiodarone taken together increase the risk of cardiovascular side effects e) Amiodarone and citalopram can both cause hyponatraemia
The answer is E Citalopram causes Hyponatraemia Amiodarone affect Potassium
33
Mr Winks then tells you the medication he is currently taking. You suggest to Mr Winks that it may be one of his medicines causing his dry eyes and mouth. Which of the following medications is most likely to be causing his dry mouth? a) Amlodipine b) Olmesartan medoxomil c) Oxybutynin d) Piroxicam e) Salbutamol
The answer is C as its an antimuscarinic a) Amlodipine - CCB b) Olmesartan medoxomil - ARB c) Oxybutynin - ANTIMUSCARINIC d) Piroxicam -NSAID e) Salbutamol - B2 AGONIST
34
What reverses Digoxin toxicity
Digoxin-specific antibody fragments
35
A junior doctor wants to administer diazepam to one of his patients who is suffering from convulsive status epilepticus. However, there are not any intravenous injections available on the ward so she asks you for an alternative. Based on your knowledge of drug absorption and the available formulations, which one of the following would you recommend to the junior doctor? a) Diazepam buccal tablet b) Diazepam patches c) Diazepam intramuscular injection d) Diazepam oral solution e) Diazepam enema
The answer is E, enema
36
Cabergoline what is it? Other drugs in same class? and key side effects
is a stimulant of dopamine receptors (agonists) in the brain and inhibits the pituitary's release of prolactin. Other drugs in this call are Amantadine hydrochloride; Apomorphine hydrochloride; Bromocriptine; Pramipexole; Quinagolide; Ropinirole; Rotigotine Main side effects include - IMPULSE CONTROL DISORDERS e.g gambling, hypersexuality, binge eating - Monitored for dyspnoea, persistent cough, chest pain, cardiac failure, and abdominal pain or tenderness
37
What diuretic can cause gout
Furosemide
38
Key side effects of Phenytoin
Rash - discontinue Bradycardia/hypotension (IV) - reduce administration rate Plateletes decrease
39
Key points of Liothyronine
Liothyronine is more rapidly metabolised than levothyroxine So is suitable when a rapid response is needed Brands without a UK licence may not be bioequivalent and dose adjustment may be necessary.
40
What BMI range shows you're underweight
<18.5
41
What BMI range shows you're normal
18.5 - 24.9
42
What BMI range shows you're overweight
25 - 29.9
43
What BMI range shows your obese
>30
44
Dose for nystatin
100 000 units 4 times a day usually for 7 days, and continued for 48 hours after lesions have resolved.
45
Rabies dose regime
The patient should receive one dose of rabies vaccine today, one dose in 3 days’ time, one dose in 7 days’ time, one dose in 14 days’ time and one dose in 30 days’ time
46
Terbinafine (used in athlete foot) main side effect
Liver toxicity e.g. Jaundice Serious skin reaction e.g. rash like Stevens-Johnson syndrome and toxic epidermal necrolysis
47
Blood meningitis would be indicated by what blood parameter
C-reactive protein
48
What is the recommended dose of vitamin D
Recommend vitamin D 10 mcg tablets as this the advice given by Public Health England for all individuals in the UK during the winter months.
49
What advice would you give to someone with coeliac disease regarding vitamins
Go to the GP to review their vitamin levels via a blood test, as coeliac disease may mean that he needs additional supplementation
50
Key point about methotrexate and conception
Use effective contraceptives during and 6 months after stopping Methotrex = sex = six
51
Jeremy has been prescribed an antibiotic in hospital for surgical prophylaxis. However, his surgery has now been delayed as he has reacted to the antibiotic. He has a red rash and appears flushed around his torso, face, and arms. This reaction occurred within 10 minutes of being administered the antibiotic via IV infusion. Which one of the following antibiotics is most associated with this side effect? a) Vancomycin b) Neomycin c) Gentamicin d) Clindamycin e) Rifampicin
The answer is A
52
Tim has been taking Priadel® 400mg tablets at a dose of one tablet daily, for the last 2 months. He has recently started experiencing side effects of a skin rash, nausea and muscle weakness. He has come to the hospital for a blood test. Which of the following blood serum levels of lithium is Tim most likely to have? a) 0.4 to 0.8 mmol/L b) 0.5 to 1.0 mmol/L c) 0.8 to 1.0 mmol/L d) 0.8 to 1.2 mmol/L e) 1.2 to 1.6 mmol/L
The answer is E if he is experiencing toxicity it is likely to be over the target range 0.4-0.8/0.8-1.2
53
Key SSRI interactions
NSAIDs e.g. aspirin, naproxen Digoxin
54
Why would someone taking sotalol not be able to take domperidone
Domperidone is contra-indicated in conditions where cardiac conduction is, or could be, impaired and sotalol treats AF (rhythm)
55
Anti Nausea medicine to use in pregnancy (6)
Promethazine Ondansetron Prochlorperazine Chlorpromazine Cyclizine Metoclopramide
56
hyperemesis gravidarum
regular antiemetic therapy, intravenous fluid and electrolyte replacement, and sometimes nutritional support severe give antiemetic via parental or rectum consider Thiamie suplemant
57
management of nausea and vomiting in patients receiving cytotoxics
ondansetron granisetron, and palonosetron,
58
management of nausea in chemotherapy
Dexamethasone or Prochlorperazine can add on Nabilone
59
preventing chemo-induce nausea
aprepitant and fosaprepitant
60
Nausea in palliative care
Levomepromazine and Haloperidol
61
Prevention and treatment of opiod induced nausea
Cyclizine
62
Ménière's disease
accute attack: cinnarizine, cyclizine, promethazine teoclate, prochlorperazine severe acute attack: Buccal prochlorperazine or deep IM cyclizine or prochlorperazine reccurent attacks: Betahistine
63
Motion sickness
prevent with - Hyoscine Hydrobromide (Hy in the sky) - less sedating cinnarizine or cyclizine - more sedating promethazine
64
Methyldopa counselling
can cause drowsiness
65
Which CCB treat Raynauds syndrome
Nifedipine 5mg tds adjust acoording to response
66
This medication was prescribed to John to sedate him during a dental procedure.
Temazepam Conscious sedation for dental procedures by mouth 15-30mg 20-60mins before procedure
67
manual therapy to relieve pain is...
targeting the area e.g. deep tissue massage
68
Side effects for Chloramphenicol in chlidren
Circulatory collapse grey baby syndrome e.g. pallid cyanosis
69
TB ethambutol drug can cause...
Visual disturbance - discontinue and there should be recovery of eye sight
70
montelukast side effect
Hyperkinesia - excessive movement and impaired concentration Speech impairment OCD
71
16 year old taking ferrous fumarate oral solution. s experiencing loose stools and soreness what is the best thing to do
Change formulation and take with or after food
72
An epileptic patient who is vegan taking Phenytoin should consider taking what supplement
Vitamin D has an inadequate intake of calcium
73
elderly patient taking Isosorbide mononitrate immediate release keeps forgetting to take his medication what is an option that could help this situation
switching him to Modified Release
74
Nitrate Side effects
A Helicopter Falling Down Lost His Tail Arrhythmias Headache Flushing Drowsiness Lightheaded/dizzy Hypotension Tolerance
75
Clozapine Important Safety Information (5)
1) Risk of intestinal obstruction, faecal impaction, and paralytic ileus 2) Monitor blood conc 3) Risk of agranulocytosis and Neutropenia 4) Myocarditis and cardiomyopathy common in first 2 months 5) monitor prolactin (look out for breast enlargement /galactorrhoea)
76
Methylphenidate side effects
o M/r needs t be prescribed by brand o Weight loss o Growth retardation (in children) o Tourettes o Psychiatric o Hypertension
77
Cant swallow MR Methylphenidate. what can they do?
Advise patient to empty content onto a spoon of apple sauce or yoghurt and swallow content whole
78
Vancomycin IV most common side effect
Phlebitis - inflammation of a vein other: Thrombocytopenia Drug fever/shivering Tinnitus (discontinue) / Hearing loss Vomiting Agranulocytosis / Neutropenia (1 week after) Nephrotoxicity/renal failure Bradycardia rapid infusion = cardiac arrest/cardiogenic shock
79
Which OTC medication is MOST LIKLEY to have an MHRA warning associated with abuse due to increased risk of cardiovascular events a. Senna b. Loperamide c. Paracetamol d. Dioralyte e. Glycereine
the answer is B, loperaminde safety information: reports of serious cardiac adverse reactions with high doses of loperamide associated with abuse or misuse give naloxone
80
methotrexate missed dose
if you remember AFTER two days - miss the dose and continue as normal if you remember WITHIN two days - take the missed dose and continue as normal NEVER double dose
81
treatment for HYPERthyroidism in pregnancy treatment of HYPOthyroidism in pregnancy
Hyperthyroidism - Carbimazole (in 2nd trimester) Carbimazole is associated with an increased risk of congenital malformations when used during pregnancy, especially in the first trimester and at high doses (daily dose of 15 mg or more). Hypothyroidism - Levothyroxine (might need to increase dose)
82
Nicorandil ADR
Asthenia - weak/lack energy Mouth ulcer (discontinue) Dizziness/Headache Nausea and vomiting Haemorrhage Vasodilation
83
Treatment for animal or human bite
Oral: 1st - Co-amoxiclac pen allergy/alternative: Doxycycline and metronidazole
84
List of pregnant women the may require a higher dose of folic acid
previously had an infant with a neural tube defect taking carbamazepine/antiepileptic has type 1 diabetes has sickle cell anaemia 5mg daily before conception up to 12 weeks = 400mcg
85
tamsulosin OTC requirements
45 - 75 cant take drugs that cause hypotension cant take viagra tbc...
86
What reverses beta-blocker overdose
Activated charcoal within 1 hr of ingestion Atropine IV for symptomatic bradycardia Glucagon IV for severe hypotension
87
A vegan patient comes in for some blood tests what vitamin is she likely to have a deficient in?
Vitamin B12 because it commonly found in meat, fish, eggs, dairy products, yeast extract which a vegan wouldn't eat
88
What is used to treat Acute Severe Ulcerative Colitis
IV Corticosteriods alternative IV Ciclosporin or Ifliximab
89
Constipation in children treatment
1st = Macrogol 3350 still hard? Lactulose otr docusate faecal impaction = add stimulant to macrogol
90
Most appropriate NSAID to use in a patient with a history of GI bleed and ulceration
Celecoxib

November resit (10 decks)

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