PRACTICE QUESTIONS

You are carrying out a health promotion campaign on rickets. A deficiency of which one of the following vitamins could cause rickets?

You have received prescriptions for the following medicines. Which of the following medication on the prescription is valid for 28 days?

Mr J, 92 years old man has been complaining he is suffering from constipation for the past few months and would like to know if any of his medications might be cause. Which of the following regular medications is least likely to be causing this?

The responsible pharmacist has left the pharmacy to deliver an urgent medication to a patient. Which one of the following tasks are you able to do whilst the responsible pharmacist is away (for less than 2 hours)?

Mr Smith, a 53 year old man weighing 79 kg. Who is admitted to the acute medical unit. Mr Smith has been admitted due to status epilepticus. The consultant has initiated intravenous phenytoin treatment. The nurse seeks advice on the administration of phenytoin injection.

Using the SPC provide the answer to the following question:
http://www.medicines.org.uk/emc/medicine/29601

Which is the following is correct in regarding the administration of Phenytoin intravenous injection?

Mr P is a 45 year old and has recently had a course of Co-Amoxiclav tablets. Since taking the course of Co-Amoxiclav he has been suffering from severe diarrhoea. Mr P was admitted to his local hospital and has been diagnosed with Clostridium Difficile.

Which of the following antibiotics is the most appropriate treatment for treating Mr P`s clostridium difficile infection?

Mr Johnson is a 54 year old man, who is a regular patient at your pharmacy. He suffers from Parkinson`s disease and he currently takes the following regular medications:

• Aspirin 75mg OD
• Ramipril 10mg OD
• Simvastatin 40mg ON
• Sinemet® Plus 25mg/100mg T TDS

He has recently been experiencing some nausea and vomiting and recently received a prescription from his GP. Which of following medication would be least appropriate to treat Mr Johnson`s nausea and vomiting.

Mr Markus a 56 year old man who has been admitted to the hospital due to a urinary tract infection. On investigation Mr Markus had a repeated clinic blood pressure of above 160mmHg/100mmHg. The ward doctor is asking you to recommend which pharmacological treatment Mr Markus could be stepped up to in order to manage his hypertension.

Mr Markus currently on the following medications:

• Trimethoprim 200mg BD initiated whilst in hospital
• Amlodipine 10mg OD
• Ramipril 10mg OD
• Atorvastatin 20mg ON

According to NICE Hypertension in adults: diagnosis and management guidance what would be the most appropriate additional anti-hypertensive to recommend?

Miss Joanna 62 year old women who has been admitted to the hospital due to an acute kidney injury. Miss Joanna has previously been diagnosed with non-valvular atrial fibrillation and currently taking prophylaxis stroke and systemic embolism treatment with Rivaroxaban 20mg OD.

Miss Joanna weighs 55kg
Plasma creatinine of 159 micromol/l
CHA2DS2-VASc of 2 points

Using the following Rivaroxaban SPC https://www.medicines.org.uk/emc/medicine/25586.

What changes to Miss Joanna Rivaroxaban would you advise?

Mr Patel is a 75-year old Asian man who was referred to an outpatient clinic by his general practitioner (GP). The GP’s letter stated that Mr Patel has had a 2-week history of epigastric pain with fatigue and intermittent nausea. It was also noted Mr Patel had an episode of melaena that morning and has been crouching when walking due to abdominal discomfort.

On examination Mr Patel was noted to be pale in colour and had a pulse rate of 127bpm and a blood pressure of 109/60 mmHg. His past medical history includes: hypertension and irritable bowel syndrome. He has no known allergies and was taking the following medications:

•  Aspirin 75mg daily
• Lisinopril 5mg daily
• Simvastatin 10mg nocte
• Imodium 4mg when required before each bowel movement

His haematology and biochemistry results on admission to the clinic were as follows:

• Haemoglobin 8.9 g/dL (11-13)
• Packed call volume (PVC) 0.127 (0.360-0.470)
•  Mean cell volume (MCV) 65 (80-100 fL)
•  Platelets 230 x109/L (150-400)
• C-reactive protein 24mg/L (0-4)
• Urea 25 mmol/L (1.7-8.3)

A query diagnosis of upper gastrointensional bleed was made on admission.

Which of the following factors would be most likely to have contributed to Mr Patel’s presenting symptoms?