S9 Flashcards
(22 cards)
For each of the following patients, select the vitamin deficiency that is the most likely cause of the signs and symptoms described in the scenario. Each option may be used once, more than once, or not at all.
Mrs A comes into your pharmacy. She tells you that her 5-year-old daughter tires easily, is reluctant to walk and it looks like her legs are bowed.
Vitamin A
Vitamin B1
Vitamin B3
Vitamin B12
Vitamin C
Vitamin D
Vitamin E
Vitamin K
Mr D comes into your pharmacy. He tells you that he has recently been to visit his 93 year old father. He expresses his concern regarding his father’s health over the past 3 months. He says that he has swollen and bleeding gums and that he has developed red spots on his shins. He has also noticed a few bruises on his body.
Vitamin A
Vitamin B1
Vitamin B3
Vitamin B12
Vitamin C
Vitamin D
Vitamin E
Vitamin K
His father’s symptoms are indicative of scurvy (vitamin C deficiency). Although rare, it could occur in very elderly patients who may find it harder to cook or maintain a healthy diet.
A 56 year-old male patient presents with newly diagnosed generalised tonic-clonic seizures and a doctor requests information on the first line treatment of this condition. Which drug would you recommend?
The following link is to the BNF https://bnf.nice.org.uk/treatment-summaries/epilepsy/#focal-seizures-with-or-without-secondary-generalisation
Carbamazepine
Eslicarbazepine
Lamotrigine
Levetiracetam
Oxcarbazepine
Phenobarbital
Sodium valproate
Topiramate
SV
Is usually seen in elderly women.
Cluster headache
Medication-overuse headache
Meningitis
Migraine
Sinusitis
Sub-arachnoid haemorrhage
Temporal arteritis
Tension-type headache
Tempotal arteritis is the only condition listed which is strongly associated with advancing age and is more common in women
Is most commonly associated with young children.
Cluster headache
Medication-overuse headache
Meningitis
Migraine
Sinusitis
Sub-arachnoid haemorrhage
Temporal arteritis
Tension-type headache
Meningitis
Is associated with a blocked or runny nostril and excruciating attacks of pain one side of the head.
Cluster headache
Medication-overuse headache
Meningitis
Migraine
Sinusitis
Sub-arachnoid haemorrhage
Temporal arteritis
Tension-type headache
Cluster headache
Accompanying symptoms with headache are useful in helping with a differential diagnosis. Nasal congestion associated with headache is not common and the only conditions listed where this would be seen is in sinusitis and cluster headache. As the pain is described as severe, then this points to cluster headache being the most likely diagnosis.
Patients may experience a dull, overall headache for over a week but can also be characterised by a sudden severe headache
Cluster headache
Medication-overuse headache
Meningitis
Migraine
Sinusitis
Sub-arachnoid haemorrhage
Temporal arteritis
Tension-type headache
The correct answer was Sub-arachnoid haemorrhage
Sinusitis, cluster headache, migraine and temporal arteritis are associated with frontal headache; meningitis, tension-type headache and medication overuse headache are more generalised in nature.
A 35-year-old female suffered from a history of pernicious anaemia (in which a lack of gastric intrinsic factor results from an autoimmune gastritis). This caused the malabsorption of a vitamin and subsequently megaloblastic anaemia.
Calcium
Phosphate
Vitamin A
Vitamin B1
Vitamin B6
Vitamin B12
Vitamin E
Vitamin K
b12
1 mg of this vitamin could be given as a single intramuscular injection at birth to prevent serious bleeding, including intracranial bleeding.
Calcium
Phosphate
Vitamin A
Vitamin B1
Vitamin B6
Vitamin B12
Vitamin E
Vitamin K
k
A patient suffering from moderate to severe hypophosphatemia would require an infusion of this.
Calcium
Phosphate
Vitamin A
Vitamin B1
Vitamin B6
Vitamin B12
Vitamin E
Vitamin K
Phosphate
Wernicke’s encephalopathy secondary to chronic alcoholism is treated in the long term with the oral administration of this.
Calcium
Phosphate
Vitamin A
Vitamin B1
Vitamin B6
Vitamin B12
Vitamin E
Vitamin K
Vitamin B1
Miss O is a 24-year-old patient who tells you that she has weight loss accompanied by insomnia and palpitations.
Anorexia nervosa
Bulimia nervosa
Cancer
Coeliac disease
Crohn’s disease
Diabetes mellitus
Thyrotoxicosis
Tuberculosis
Thyrotoxicosis
Her symptoms are those of thyrotoxicosis. This includes: weight loss, palpitations (associated with atrial fibrillation) and insomnia.
Mrs X is a 40-year-old patient who presents with abdominal pain, foul smelling steatorrhoea, weight loss and dermatitis herpetiformis on her elbows and buttocks.
Anorexia nervosa
Bulimia nervosa
Cancer
Coeliac disease
Crohn’s disease
Diabetes mellitus
Thyrotoxicosis
Tuberculosis
Coeliac disease
Her symptoms are indicative of coeliac disease (autoimmune response to gluten, a dietary protein found in various foods such as cereal, bread and pasta). Her symptoms are abdominal pain, foul smelling steatorrhoea (fatty stools due to malabsorption), weight loss and dermatitis herpetiformis (a type of skin rash that is itchy and has blisters that burst when scratched).
From the below list, what is the closest incubation period for these infectious illnesses in children? Each option may be used once, more than once, or not at all.
Chickenpox.
No incubation period
1-20 days
7-10 days
11-20 days
13-18 days
15-24 days
4-6 weeks
2 months
11-20 days
Slapped cheek disease.
No incubation period
1-20 days
7-10 days
11-20 days
13-18 days
15-24 days
4-6 weeks
2 months
13-18 days
Whooping cough.
No incubation period
1-20 days
7-10 days
11-20 days
13-18 days
15-24 days
4-6 weeks
2 months
7-10 days
Mumps.
No incubation period
1-20 days
7-10 days
11-20 days
13-18 days
15-24 days
4-6 weeks
2 months
15-24 days
A patient contacts you at the local community pharmacy to discuss symptoms of flushing, headache and vomiting. The patient is unsure if an antibiotic is the causative factor. Upon further questioning, she informs you that she has had two days treatment of the antibiotic and on the second day of treatment drank three large glasses of wine. What is the likely antibiotic the patient is taking?
Aztreonam
Benzylpenicllin sodium
Flucloxacillin
Linezolid
Metronidazole
Nalidixic acid
Phenoxymethylpenicillin
Tinidazole
Metronidazole
Metronidazole must not be taken with alcohol due to the disulfiram-like reaction with alcoho
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.
Aztreonam
Benzylpenicllin sodium
Flucloxacillin
Linezolid
Metronidazole
Nalidixic acid
Phenoxymethylpenicillin
Tinidazole
Linezolid
Linezolid is known to cause severe optic neuropathy so patients should be advised to report any changes in eyesight to a medical practitioner. All patients should be advised to report symptoms of visual impairment, such as changes in visual acuity, changes in colour vision, blurred vision or any visual field defect. In such cases, prompt evaluation is recommended with referral to an ophthalmologist as necessary. If any patients are taking linezolid for longer than the recommended 28 days, their visual function should be regularly monitored.
On the hospital ward you are carrying out a medicines reconciliation for a patient who has been admitted with yellowing of the eyes, dark urine and pale stools. The patient informs you that five weeks ago they completed a 2 week course of an antibiotic which they had never taken before. Which antibiotic is most likely to cause these symptoms?
Aztreonam
Benzylpenicllin sodium
Flucloxacillin
Linezolid
Metronidazole
Nalidixic acid
Phenoxymethylpenicillin
Tinidazole
Flucloxacillin
The symptoms suggest cholestatic jaundice. Flucloxacillin has been reported by the MHRA to cause cholestatic jaundice and this may be delayed by up to two months post treatment.
This antibiotic is commonly used in infections where anaerobic bacteria are the suspected cause and it is commonly used in acute pericoronitis.
Aztreonam
Benzylpenicllin sodium
Flucloxacillin
Linezolid
Metronidazole
Nalidixic acid
Phenoxymethylpenicillin
Tinidazole
Metronidazole
Metronidazole is commonly used in dental conditions such as acute oral infections due to the spectrum of bacteria it covers which includes anaerobes.
Paracetamol 500 mg and pseudoephedrine 30 mg.
Asthma
Diabetes and hypertension
Epilepsy
Hay fever
Hypertension and asthma
Migraine
Ulcer
Ulcer and asthma
Diabetes and hypertension
