T3 Flashcards
A 23-year-old woman comes into your pharmacy and complains that she is experiencing some unpleasant symptoms. Over the past couple of days she has found it painful to urinate. She describes it as being a burning, stinging type of pain. She feels like she needs to urinate frequently but is only passing small amounts of urine. She says that her urine is quite dark and smells strongly.
Which one of the following is this patient most likely to be suffering from?
Atrophic vaginitis Bacterial vaginosis Cystitis Trichmoniasis Vaginal thrush
The correct answer was Cystitis
Symptoms described are indicative of cystitis. Other conditions are associated with accompanying symptoms e.g. fever, discharge.
Which of the following should be avoided in a rental function of below 35ml/min
Alendronic acid
Bisoprolol
Clarithromycin
Denusomab
Paracetamol
Alendronic acid
A mother requests a product over the counter for her 3-year-old daughter who is suffering from a cold.
She wants to purchase a nasal decongestant containing xylometazoline. What is the maximum length of time the child should use it for?
Two days
Three days
Five days
Seven days
A child this age must not use it
Cannot be used in under 6
You are instructing a trainee pharmacist in the schedules contained in the Misuse of Drugs Regulations. The Misuse of Drugs Regulations 2001 (as amended) classify controlled drugs into 5 schedules according to the different levels of control attributed to each.
Which schedule includes clenbuterol?
Schedule 1
Schedule 2
Schedule 3
Schedule 4 Part 1
Schedule 4 Part 2
4.2
A 30-year-old female, who is 4 months pregnant, comes into your pharmacy complaining of persistent perianal pruritis that’s been keeping her up all night for the last couple of weeks. She is currently not taking any medicines or has any pre-existing medical conditions but does occasionally take lactulose for pregnancy-induced constipation. Also, one of her children was diagnosed with threadworm a month ago but this was treated successfully.
What is the most appropriate advice you should give this patient?
a. Advise Mrs G to maintain hygiene measures for a week (e.g. cut finger nails and launder bedding and towels on a daily basis)
b. Advise Mrs G to maintain hygiene measures for six weeks (e.g. cut finger nails and launder bedding and towels on a daily basis)
c. Advise Mrs G to wear loose clothes to avoid itching
d. Ask Mrs G if she has recently changed her laundry detergent, as her symptoms may be an allergic reaction
e. Tell Mrs G to take a single oral dose of mebendazole, which may need to be repeated in two weeks if re-infection occurs
6 weeks
You receive a prescription for phenytoin injection 250 mg/5 mL, 100 mg three times daily for one of your patients. The trainee dispensing technician comments that she has never seen phenytoin prescribed in injection form before and asks you why this is.
What is the best explanation to give her?
Injectable phenytoin decreases adherence
Injectable phenytoin increases the risk of adverse events
Injectable phenytoin is more error-prone with a risk of death
Injectable phenytoin provides a slower response
Injectable phenytoin reduces efficacy
The correct answer was Injectable phenytoin is more error-prone with a risk of death
Although the other points may be factually correct, in a practice the reason for phenytoin not being prescribed as an injection is primarily that it is more error-prone than in oral form and this can lead to an increased risk of patient deaths.
A 3-year-old boy comes into your pharmacy with his mother. She tells you that she is concerned about his hearing lately. He is otherwise well.
Which one of the following actions is the most suitable to take in this situation?
Advise his mother to take him to see his GP
Ask his mother to request ear syringing for her son at her GP practice
Reassure his mother that this is normal and that she should see her GP if it persists after 2 weeks
Reassure his mother that this is normal and that she should see her GP if it persists after 3 weeks
Supply olive oil ear drops
The boy may require referral for audiometry. It is difficult to ascertain hearing problems in young children. However, all parental concerns must be taken seriously.
A patient you estimate to be in her 30s visits you in your pharmacy. She is feeling very unwell. She says she feels dizzy, and you notice that she is pale, sweating and clammy, with rapid, shallow breathing. Her friend reports that “she’s just not been right for a while”.
What would the most appropriate next step be for the pharmacist?
a) Advise the patient to make an appointment with her GP
b) Allow her to rest in your consultation room
c) Call 999
d) Send the patient to A & E
e) Take her blood pressure
Showing signs of adrenal crisis which can be fatal if left untreated - phone 999
Mr PM is a regular customer to your pharmacy. He has come to collect his repeat prescription for a controlled drug.
Of the following controlled drugs, which is allowed to be issued via a repeat prescription? For example, the prescriber may write on the prescription ‘Repeat x 3’?
a) Buprenorphine
b) Diamorphine
c) Diazepam
d) Methadone
e) Oxycodone
Diazepam is schedule 4 so is allowed on repeats
A 23-year-old man has itchy patches on the inside of his elbows and he comes into your pharmacy regularly to collect his emollients. He has had this condition most of his life.
Which one of the following conditions is this man most likely to have?
Acne rosacea
Atopic eczema
Candidiasis
Impetigo
Psoriasis
Atopic eczema is classically itchy. It affects flexural sites such as folds of the elbows and backs of the knees
A patient comes in to your pharmacy. They appear confused and you a concerned that they may not be able to make a clear decision about their treatment. A pharmacy professional must base an assessment of capacity on the person’s ability to make a specific decision at the time it needs to be made.
In order for a patient to demonstrate capacity, they do NOT need to be able to:
Communicate their decision to you (by any means)
Prove they are aged 18 and over
Remember the information provided
Understand the information provided
Use and weigh up the information provided
Prove they are 18 years and over
A 63-year-old woman recently had a myocardial infarction and has been feeling depressed since. Her doctor has prescribed her a selective serotonin re-uptake inhibitor (SSRI).
Which of the following SSRIs is the most safe for someone who has had a recent myocardial infarction?
Citalopram
Escitalopram
Fluoxetine
Paroxetine
Sertraline
According to the BNF, SSRIs are considered first line in the treatment of depression, given their safety profile. Sertraline in particular has been shown to be safe for those patients with unstable angina or who have had a recent myocardial infarction
A doctor asks for advice regarding dyspepsia. A patient is complaining of worsening dyspepsia.
Which of the following is NOT associated with exacerbation of symptoms of dyspepsia?
Bisphosphonates
Calcium supplements
Doxycycline
Excess alcohol
Prednisolone
Calcium supplements are not known to exacerbate symptoms of dyspepsia. The rest of these will and should be avoided where possible to reduce worsening dyspepsia.
Miss RG asks your advice on taking her combined oral contraceptive as she is 5 hours late in taking her next tablet. She is at the middle of her cycle.
Which of the following would be the correct advice?
a) Take two tablets now and no further action is required
b) Take the missed tablet straight away and no further action is required
c) Take the missed tablet straight away and use another form of contraception for 7 days
d) Take the missed tablet straight away and use another form of contraception for 14 days
e) Stop the present cycle of the pill and start a new cycle in 7 days’ time
1 pill missed in week 2 or week 3 after hormone free interval (or subsequent consecutive weeks of continuous pill-taking) EC not required if consistent, correct use in the previous 7 days. Take the missed pill as soon as possible, continue the remaining pills at the usual time, no additional contraceptive precaution required
You are asked to give a presentation to the physiotherapists on medicines that contribute to falls in the elderly.
Which one of the following groups would you NOT include because it is least likely to cause falls?
a) Benzodiazepines
b) Diuretics
c) NSAIDs
d) Opioids
e) Phenothiazines
NSAIDS do not cause falls
You are writing a standard operating procedure for making CD records in the pharmacy.
Which of the following is NOT a legal requirement to be recorded in the CD register when making a supply of a CD to a patient with a valid prescription?
a) Date of supply
b) Name of dispensing pharmacist
c) Name of patient
d) Name of prescriber
e) Quantity supplied
The name of the dispensing pharmacist is not a legal requirement
A terminally ill patient is very constipated and a doctor asks you to recommend a suitable laxative.
Which one of the following is licensed only for use in terminally ill patients?
a) Bisacodyl
b) Co-danthramer
c) Docusate sodium
d) Lactulose
e) Senna
All of these laxatives may be suitable for use in a patient who is palliative. However, only Co-danthramer is specifically indicated for use in patients who are in palliative care or terminally ill.
You are the on-duty pharmacist in a community pharmacy. A 40-year-old man comes into your pharmacy complaining of having a sore throat and a cough. His glands are not swollen, and although it is a little uncomfortable to swallow, there is no pain upon swallowing. He takes no other medicines.
What is the most suitable course of action?
a) Refer him to his dentist
b) Refer him to his GP for further investigation and/or treatment
c) Refer him to his GP urgently
d) Sell him a throat lozenge
e) Send him to the Accident and Emergency department
These symptoms do not currently indicate an infection and he is on no other medicines which a sore throat could be a side effect of. Something to sooth the pain may be helpful in this instance and the patient should be advised to seek further advice if his symptoms persist for longer than a week, get worse or if he gets swelling.
You are working a Sunday morning shift in a high street pharmacy in England.
A mother approaches you and asks for a spacer for her five-year-old son because his has broken. What would be the most appropriate course of action?
a) Advise the mother to ask her GP for a prescription on the Monday
b) Demonstrate how to use an inhaler without a spacer
c) Make an emergency supply
d) Sell the mother a spacer
e) Send the mother to an out of hours service for a prescription
A spacer is a medical device not a medicine. Therefore there are no restrictions on the sale of the spacer. As the medical device can be sold to the patient, there is no need for the pharmacy to complete emergency supply record keeping and apply any applicable administrative charges.
A patient attends anticoagulation clinic for a routine INR check. The target INR for this patient is 2.5-3.5, however in clinic the INR reading is 5.2 with no associated bleeding.
Stop warfarin and administer intravenous phytomenadione
Stop warfarin and administer oral phytomenadione
Stop warfarin and review in 5 days
Withold 1 or 2 doses of warfarin and reduce subsequent maintenance dose
Withold 1 or 2 doses of warfarin
Withhold 1 or 2 doses of warfarin and reduce subsequent maintenance dose as per BNF guidance.
You have a patient who has been diagnosed with COPD and is about to start treatment. Several drugs are used in the management of COPD. These drugs are prescribed at various stages of this chronic condition.
Which of the following drugs belong to the class of drugs known as xanthines?
a) Clindamycin
b) Indacaterol
c) Indomethacin
d) Olodaterol
e) Theophylline
Theophylline
Which of the following is NOT a recognised side effect of long-term corticosteroid usage?
a) Diabetes
b) Glaucoma
c) Nystagmus
d) Osteoporosis
e) Weight gain
Nystagmus -a rhythmical, repetitive and involuntary movement of the eyes is not a recognised long term corticosteroid issue
