RPS overall Flashcards
(5 cards)
A 66-year-old woman is scheduled for surgery under general anaesthetic. During her pre-operation
consultation she was informed of the rare risk of malignant hyperthermia as a result of general anaesthesia,
which is characterised by high temperature and tachycardia.
Which of the following is the most appropriate treatment for malignant hyperthermia?
a. acetylcysteine
b. activated charcoal
c. dantrolene sodium
d. high flow oxygen
e. naloxone
Daltrolene sodium
Acetylcysteine - paracetamol OD
Activated charcoal for Aspirin poisiing
High flow oxygen for CO poisioning
Naloxone for opioid OD
A 72-year-old woman has been prescribed alendronic acid 70 mg tablets to reduce the risk of hip fractures.
Which of the following is the most appropriate advice?
a. take at least 30 minutes before first food, beverage, or other medicinal product of the day
b. take at the same time as a calcium supplement
c. take one tablet daily before bedtime
d. take upon arising for the day with at least 300 mL of water
e. you may lie down as soon as you have taken alendronic acid
A is correct
B – should not be taken at the same time as a calcium supplement.
C – this is incorrect because alendronic acid is taken as a weekly dose rather than a daily dose.
D & E – the patient must take with at least 200 mL of water and must sit up for at least 30 minutes after the
dose to reduce oesophageal irritation.
A 62-year-old man has been suffering from abdominal cramps and loose stools for nearly 4 weeks. Upon
further questioning he tells you that there is no blood in his stools but there is some mucus. He does not
recall a change in his diet but has been feeling stressed recently.
Which of the following is the most appropriate advice to give to the patient?
a. make an appointment with your GP for further investigation
b. monitor your symptoms for a further two weeks
c. reduce the amount of fibre in your diet
d. take loperamide capsules at the recommended dose
e. take rehydration salts to replenish any salts lost
Refer to GP
Although there is no blood in his stool, there has been a change in bowel habits and, especially at his age,
this warrants further investigation to rule out anything more serious. His symptoms describe irritable bowel
syndrome e.g. abdominal cramps, loose stools, no blood but mucus with stress being the trigger, however
this cannot be confirmed until further tests have been done.
A 42-year-old patient was diagnosed with diabetes six months ago. They have tried to control their
condition by changing their diet and increasing exercise, however, this has not been successful. They have a
past medical history of hernia and epilepsy which is well controlled by medication.
Which one of the following options should the patient avoid?
a. acarbose
b. alogliptin
c. dapagliflozin
d. gliclazide
e. glimepiride
Acarbose is contra-indicated in those who have hernia as it can worsen the condition. Due to its mechanism
of action, its use is also contra-indicated in those with disorders of digestion or absorption.
A 32-year-old man is on his third cycle of chemotherapy and is due to receive doxorubicin by intravenous
infusion. You note that he has anaemia, constipation, and nausea. He has previously received doxorubicin
with no dose reductions or adverse effects.
Which one of the following is most likely to require a doxorubicin dose reduction?
a. alopecia
b. constipation
c. elevated bilirubin
d. if the patient is also to receive intravenous tacrolimus
e. respiratory depression
Elevated bilirubin
A is incorrect as alopecia is a dose dependent side effect and often reversible, thus this would not require a
dose reduction.
B is more of a potential side effect (under the umbrella term of gastro-intestinal disturbances); thus, this is
also incorrect.
D is a distractor; the product specification suggests a dose reduction for those also receiving ciclosporin.
E is incorrect as not specified in the product specification; bronchospasms are noted as a side effect
