Qs wrong from mocks

Question 1

a breastfed baby has a cows milk allergy what is the best course of action

Answer 1

Continue breastfeeding but advise the mother to exclude all cow’s milk protein from
her diet, and to take calcium and vitamin D supplements.

Question 2

what electrolyte can be affected by antidepressants?

Answer 2

Sodium - Hyponatraemia (usually in the elderly and possibly due to inappropriate secretion of antidiuretic hormone) has been associated with all types of antidepressants; however, it has been reported more frequently with SSRIs than with other antidepressants.

hyponatraemia can then trigger seizures

Question 3

Treating heart failure with reduced ejection fraction

Answer 3

Offer an angiotensin-converting enzyme (ACE) inhibitor and a beta‑blocker licensed for heart failure.
Offer an mineralocorticoid receptor antagonists (MRA), in addition to an ACE inhibitor (or ARB) and beta-blocker if they continue to have symptoms of heart failure.

Question 4

what are resitrictions around controlled drugs and emergency supply ?

Answer 4

that no greater quantity shall be supplied than will provide** 5 days’ treatment** of phenobarbital, phenobarbital sodium, or Controlled Drugs in Schedules 4 or 5 (doctors, dentists, or nurse prescribers from the European Economic Area and Switzerland, or their patients, cannot request an emergency supply of Controlled Drugs in Schedules 1, 2, or 3, or drugs that do not have a UK marketing authorisation)

Question 5

which NSAIDs have lower risk of serious GI side effects

Answer 5

The selective inhibitors of COX-2, etoricoxib and celecoxib,

Question 6

which NSAIDs have the highest risk of GI toxicity?

Answer 6

Piroxicam

Question 7

what can contribute to lithium toxicity?

Answer 7

excessive sweating, renal impairment, vomitting, diarrhoea, furosemide

Question 8

carbamazepine interaction and red flag symptoms

Answer 8

sore throat, mouth ulcers and fever - can interact with cimetidine, anticoags, MOAIs, antibiotics or antifungals,immunosupressants, antivirals and antidepressants

Question 9

what is most appropriate lifestyle advice to reduce CVS risk

Answer 9

Aiming for less than 6 g of salt in your diet per day can reduce the risk of
cardiovascular disease.

Question 10

which thiazide like diuretic is most appropriate for renal function below 30 egfr

Answer 10

For metolazone

See Prescribing in renal impairment.

Manufacturer advises metolazone remains effective if eGFR is less than 30 mL/minute/1.73 m2 but is associated with a risk of excessive diuresis

Question 12

what blood results would indicate hyperthyroidism

Answer 12

high T4 and low TSH

Question 13

blood results for hypothyroidism

Answer 13

low T4 high TSH

Question 15

tetracyclines administration advice

Answer 15

Manufacturer advises tablets or capsules should be swallowed whole with plenty of fluid while sitting or standing

Question 16

what are common symptoms of sepsis?

Answer 16

Confusion, fever, high heart rate, SOB

Question 17

Cycle of change model

Answer 17

The five stages are:
Precontemplation: Individuals are not yet thinking about changing their behavior.
Contemplation: Individuals are aware of the problem and considering change, but haven’t made a commitment.
Preparation: Individuals are preparing to take action and have a plan in place.
Action: Individuals are actively changing their behavior.
**Maintenance: **Individuals are working to sustain the change and prevent relapse.

Question 18

severe interaction with mtx

Answer 18

omeprazole- decreases the clearance of Methotrexate (high-dose). Manufacturer advises use with caution or avoid.

Question 19

clozapine requirements

Answer 19

At least 2 different antipsychotic drugs (one of which should be a second-generation
antipsychotic drug), each for an adequate duration

Question 20

how often to monitor blood counts in clozapine treatment

Answer 20

Weekly for the first 18 weeks

Question 21

What colour sputum could indicate congestive heart failure?

Answer 21

pink

Question 22

what food and lifestyles can impact warfarin INR

Answer 22

The effects of coumarins can be reduced or abolished by vitamin K, including that found in health foods, food supplements, enteral feeds, or large amounts of some green vegetables or green tea. Major changes in diet (especially involving salads and vegetables) and in alcohol consumption can affect anticoagulant control. Pomegranate juice increases the INR in response to warfari

Question 23

Antidepressant interaction with sumatriptan

Answer 23

SSRI, SNRIs and mirtazapine can cause serotonin syndrome with sumatriptan,
lofepramine has best safety profile of the tricyclics