OnTrack 2021 Flashcards by Nehmat Ahluwalia

A patient is admitted to the ward after suffering an acute bronchospasm. Which medication should be AVOIDED in this patient?

A- Aciclovir
B- Atenolol
C- Atorvastatin
D- Bendroflumethiazide
E- Levopromazine
F- Flucloxacillin

B- Atenolol

Beta blockers should be avoided in patients with a history of asthma or bronchospasms

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What drug may mask the signs of hypoglycaemia?

Beta blockers

As they mask symptoms such as rapid heartbeat and tremor

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A patient is admitted to the ward suffering with cholestatic jaundice. Which of the following drugs is most likely to be a causative factor in this admission?

A-Aciclovir
B- Atenolol
C- Atorvastatin
D- Flucloxacillin
E- Levomepromazine

D- Flucloxacillin

Rare side effect

This reaction is typically delayed and can occur weeks after the course of flucloxacillin has ended.

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During a ward round, a patient is found to be pregnant. Which drug should NOT be used in Pregnant women due to concerns over ‘grey baby syndrome’

Chloramphenicol

Risk associated with IV, Oral and topical use

Should also be avoided in breastfeeding.

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HbA1C percentage range?

Normal = below 5.7%
Prediabetes= 5.7 - 6.4
Diabetes= 6.5% or higher

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You are training to become an independent prescriber with the aim of specialising in diabetes.
A patient who has been taking metformin for 5 months with a HbA1C of 7.6% who is also obese. What is the next appropriate step?

A- Adress adherence
B- Basal insulin
C- DPP-4 inhibitor
D- GLP-1 agonist
E- SGLT2 inhibitor
F- Sulphonylurea

E- SGLT2 Inhibitor

Those not reaching their target and are obese, this is appropriate

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What does the endorsement PNC stand for?

Prescriber not contacted

When an Rx is presented with a missing strength / quantity and the prescriber cannot be contacted - if you have sufficient information to make a professional judgement you endorse PNC

Tends to be 5 days treatment or if combination pack / contraceptive = smallest pack size

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A terminally ill patient is very constipated and a doctor asks you to recommend a suitable laxative. Which laxative is licensed for this situation?

Co-danthramer and Co-danthrusate

Limited to constipation in terminally ill patients because of potential carcinogenicity

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Which of the following laxatives can colour your urine?

A-Isphaghula husk
B- Mehtylcellulos
C- Bisacodyl
D- Co-danthramer
E- Docusate sodium
F- Sodium picosuphate
G- Lactulose
H- Glycerol

D- Co-danthramer

May colour urine red

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Which laxative can be used to treat hepatic encephalopathy

Lactulose

Reduces the amount of ammonia in the blood which helps to improve neurological symptoms

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Which one of the following patients would have to pay the NHS prescription charge for a script written in england ?

A- Woman who has had a stillbirth within the last year

B- 63 year old woman on HRT

C- Patient with T2DM controlled by diet

D- Patient with epilepsy requiring continuous anticonvulsant therapy

E- Patient who currently receives income support

C- Patient with T2DM controlled by diet

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What is Supraventricular tachycardia?

SVT is a condition where your heart suddenly beats faster than normal

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Which one of the following drugs is NOT suitable for both supraventricular and ventricular arrhythmias?

A- Verapamil
B- Sotalol
C- Amiodarone
D- Flecainide
E- Propafenone

A- Verapamil

Indicated for supraventricular arrhythmias

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Intestinal absorption of which ONE of the following drugs may be impaired when taken with magnesium trisilicate?

A- Amoxicillin
B- Cefalexin
C- Co-amoxiclav
D- Tetracycline
E- Metronidazole

D- Tetracycline

CAL = Do not take milk, indigestion remedies or medicines containing iron or zinc 2 hours before or after this medicine

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Which of the following creams / ointments could stain clothing?

A- Daktacort ointment
B- Fucibet cream
C- Betamethasone valerate / clioquinol cream
D- Synalar cream
E- Locoid ointment

C- Betamethasone valerate / clioquinol cream

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A patient is initiated on a medication for which they will need to take extra precautions to protect their skin from sunlight whilst taking it.
Which of the following drugs when given at higher doses does this apply to?

A- Indapamide
B- Lithium carbonate
C- Pizotifen
D- Promazine
E- Ramipril

D- Promazine

Promazine makes the skin more susceptible to the uV rays from the sun

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Most instances of nausea and vomiting are acute and short lived. Which scenario would alert you to potentially refer the patient?

A- Symptoms of less than 24 hours in an adult
B- Symptoms of 24hours - 36 hours in an adult
C- Symptoms of up to 48 hours in an adult
D- Symptoms of more than 24 hours in a 5 year old
E- Symptoms of more than 24 hours in a 9 month old

E- Symptoms of more than 24 hours in a 9 month old

At greater risk of complications such as dehydration

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A 17 year old boy has been very run down and has a headache, sore throat and swollen/tender lymph glands. He has been spending a lot of time with his new girlfriend. What could this be?

Glandular fever
‘Kissing disease’
Common in teenagers

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5 year old with a rash that started around her ears and moved down to her trunk and limbs. In addition to this she has had a fever, head cold and cough. On her inner cheeks and gums she has small white spots.

What could this be?

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Measles

White koplik spots inside mouth are indicative of measles

A 17 year old female who experiences lower abdominal pain 8 weeks after having unprotected sex?

What is the most appropriate answer?

A) Rheumatoid arthritis
B) Gout
C) Osteoporosis
D) Anaphylaxis
E) IBS
F) Hernia
G) Ectopic pregnancy

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G) Ectopic pregnancy

A 45 year old is admitted on a hospital ward, suggering from dizziness, blurred vision, nausea and vomiting and ataxia

Which drug combinations may be related?

A) Warfarin and Fluconazole
B) Amiodarone and Simvastatin
C) Aspirin and Salbutamol
D) Carbamazepine and Erythromycin
E) Simvastatin and St Johns wort

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D) Carbamazepine and Erythromycin

Plasma conc of carbamazepine is increased by erythromycin

37 year old patient on a hospital ward suffers from hyperglycaemia, dilated pupils and haematemesis

Which drug combinations may be related?

A) Warfarin and fluconazole
B) Amiodarone and Simvastatin
C) Aspirin and Salbutamol
D) Theophylline and Disulfiram

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D) Theophylline and Disulfiram

Metabolism of theophylline is inhibited by disulfiram and therefore = increased risk of theophylline toxicity

Severe optic neuropathy may occur with the use of this antibiotic and as such visual function should be monitored regularly if treatment is required for longer than 28 days

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Linezolid

Which antibiotic can cause yellowing of the eyes, dark urine and pale stools?

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Flucloxacillin
These symptoms are of cholestatic jaundice and flucloxacillin has been reported to cause this even 2 months post treatment

This antibiotic is commonly used in infections where anaerobic bacteria are the suspected cause and its commonly used in acute pericoronitis

Metronidazole

You are the pharmacist on an orthopaedic ward. Mr G is a 71 year old man who has admitted with an atypical femoral fracture. You review his medical record and he tells you that he has been taking the same medications for over 8 years now. Which one of the following medications are the most likely to be the cause of his fracture? A) Alendronic acid B) Aspirin C) Atenolol D) Metformin E) Amlodipine

A) Alendronic acid Atypical femoral fractures may occur with patients receiving long-term bisphosphonate therapy

Whilst working on a hospital acute medicines ward you determine that a patient had a low level of leukocytes in their blood Which of the following medications may be causing this? A) Amiloride B) Clozapine C) Naloxone D) Paracetamol E) Sodium docusate

B) Clozapine Leucopenia is a common / very common side effect of clozapine treatment

What are the categories of antiepileptics ?

CATEGORY 1= Patients need to be maintained on a specific manufacturers product Carbemazepine, Phenobarbitol, Primidone and Phenytoin CATEGORY 2= Continuation of brand is based on clinical judgement Lamotrigine, Topiramate, Clonazepam, Clobazam, Zonisamide CATEGORY 3= Not usually necessary to ensure brand continuation

How do NHS prescription charges work in England

9.90 per item Exemptions=Under 16, 16-18/full time education and 60+ Certain conditions are also exempt

Which of the following increases the risk of developing gout? A) Being female B) Renal impairment C) Low triglycerides

B) Renal impairment

You receive a requisition for a controlled drug. Which one of the following is NOT a legal requirement for the requisition ? A) Address of recipient B) Date of requisition C) Occupation D) Purpose of the requisition E) SIgnature of the recipient

B) Date of requisition

Which schedule includes growth hormones?

Schedule 4 Part 2

An auditor arrives at your pharmacy to review the electronic pharmacy record. Which of the following is INCORRECT A) Ensure that any alterations made to the record identify when and by whom the alterations were made B) Ensure that the record is available at the registered pharmacy staff and the inspector C) Ensure that the record is backed up and there is an audit trail so that in the event of any incident or error it shows who is accountable D)Ensure that the record is kept for 3 years from the day it was created

D) Ensure that the record is kept for 3 years from the day it was created This is incorrect because the electronic pharmacy record must be kept for at least 5 years

This drug is commonly prescribed at a dose of 1gram STAT for uncomplicated genital chlamydial infections ?

Azithromycin

Side effects of Isotretinoin ?

Used for severe acne Common side effects= dryness of the skin, eyes and mouth. Skin rashes and itching. Causes skin thinning and patients should be counselled to take precautions in the sun as their skin is more susceptible to the harmful UV rays.

Medicine-induced colitis is a risk factor with use of this medication ? A) Allopurinol B) Azathioprine C) Cholestyramine D) Clindamycin E) Ethosuximide

D) Clindamycin Antibiotic induced colitis is a risk for patients when they are prescribed courses of clindamycin.

With what drug are patients of Chinese ancestry more likely to be associated with deveoping Stevens-Johnson syndrome A) Amiodarone B) Clozapine C) Digoxin D) Phenytoin E) Theophylline

D) Phenytoin

On which drugs should patients be carefully evaluated clinically and be considered for a chest X-ray before starting therapy A) Amiodarone B) Digoxin C) Gentamicin D) Theophylline

A) Amiodarone Amiodarone can be associated with serious and sometimes fatal lung toxicity, X-ray before starting establishes a baseline

What are the monitoring requirements for Clozapine

White blood cell monitoring weekly for 18 weeks Then every 2 weeks for 1 year Then monthly

What is the suitable number of units of heparin to administer for a 70kg man for PE treatment?

5000u

Which of the following can be a side effect of lisinopril? A) Hyperglycaemia B) Hypernatraemia C) Hyperkalaemia D) Hypomagnesaemia E) Hypophophataemia

C) Hyperkalaemia

What is the most likely option for this presentation 23 year old female has suffered from rapid onset headaches around her right eye every night for the [ast week. She describes it as excruciating and tells you that she suffers from photophobia in that eye A) Rebound headache B) Tension headache C) Cluster headache D) Migraine E) Sinus headache

C) Cluster headache

What is a suitable drug for: 32 year old man has premature ejaculation, has had poor control over this for several months. The patient is distressed and it is affecting his relationship

Dapoxetine

What drug requires hydroxylation by the kidneys to its active form, therefore in patients with a severe reduction in renal function, alfacalcidol should be prescribed instead

Vitamin D Colecalciferol is the non-activated form of vitamin D

What is the combination of drugs used for the initial phase of TB treatment

Ethambutol, Isoniazide , Pyrazinamide and rifampicin

OnTrack 2021 Flashcards

(46 cards)