T15 Flashcards
A 69-year-old man, who takes warfarin and has chronic obstructive pulmonary disease (COPD), has been admitted into hospital following reports of increased sputum production and a change in sputum colour (clear to green). He was started on 28% oxygen, antibiotics, steroids and regular nebulisers. After 4 days, his INR was reported to be 5.4.
Which single drug is most likely to have contributed to his increased INR?
Atenolol
Clarithromycin
Ipratropium
Loperamide
Salbutamol
Warfarin is metabolised via CYP450. Therefore inhibitors of this such as clarithromycin will increase the INR
A mother of a 5-year-old daughter has come to your community pharmacy and wants some advice. Her daughter has recently developed a red rash on her face after being unwell with cold symptoms.
Based solely on this information, which is the most likely condition causing the rash?
Atopic dermatitis
Erythema infectiosum
Pertussis
Pityriasis rosea
Psoriasis
The correct answer was Erythema infectiosum
Pertussis does not have facial rash; psoriasis can have scalp involvement but lesions away from the hairline are rare; pityriasis rosea is associated with a rash on the body. This leaves atopic dermatitis and erythema infectiosum - both could show facial lesions. Based on other ‘cold-like’ symptoms erythema infectiosum is more likely. Its alternative name is ‘slapped cheek disease’.
A 27-year-old woman tells you she’s getting married next month. She worries that the ‘bumps’ on her hands are something contagious. On closer inspection, you see rough, raised papules with a cauliflower-like appearance and black dots on their surface.
What is the cause of this condition?
Coxsackie virus
Herpes simplex virus type 1
Herpes simplex virus type 2
Human papillomavirus
Varicella zosta virus
Warts are caused by the human papillomavirus
You are the pharmacist on duty in a community pharmacy that offers emergency contraception. A woman presents to your pharmacy for emergency contraception. She is 18 years old and would like advice on the most effective form of contraception going forward.
What is the most appropriate answer?
Combined hormonal oral contraceptive
Diaphragm
IUD
Male condom
Natural family planning
An Intrauterine device is more than 99% effective. With typical use the combined oral contraceptive is around 91% effective. With typical use male condoms are around 82% effective. With typical use diaphragms are around 71-88% effective, the natural family planning method is around 76% effective.
You are training a foundation student in the situations when they should refer a patient to their GP. Ensuring appropriate GP referral will help safeguard patients.
Which of the following should result in referral to the patient’s GP?
A 15-year-old patient who is complaining of constipation
A 46-year-lady complaining of cystitis like symptoms
A patient aged 68 complaining of a migraine like symptoms for the first time
A 7-year-old child who is congested
A 12-year-old boy who has pyrexia
Any patient over the age of 60 experiencing a first time migraine should be referred to the GP
