A patient is to undergo a dental procedure and requires a local anesthetic. Which of the following is least appropriate?
Correct!
Wrong!
What is the maximum strength of pseudoephedrine and ephedrine that can be sold lawfully over the counter?
Correct!
Wrong!
A middle-aged man comes into the pharmacy requesting to buy three packs of pseudoephedrine. He seems nervous and impatient. On questioning, he is unable to describe his symptoms. Which of the following is not a sign of possible misuse?
Correct!
Wrong!
You are a locum pharmacist in a community pharmacy when Miss N, a 40-year-old lady, brings a prescription for phenobarbital 60mg CD3. Which of the following CD schedule 3 is subject to safe custody restrictions?
Correct!
Wrong!
Mr. P presents his prescription for mezolar 50mcg patches. Which of the following doses written by the prescriber is legally acceptable?
Correct!
Wrong!
Miss T is traveling and would like to purchase 224 paracetamol tablets over the counter. Which of the following statements is incorrect?
Correct!
Wrong!
You are working as a practice-based pharmacist in a GP surgery. You are asked to run a refresher course on prescribing in elderly patients. Which of the following is not a legal requirement for a standard NHS prescription?
Correct!
Wrong!
Mr. K, a 60-year-old man, is undergoing treatment with beta-blockers. He comes into the pharmacy to ask for a sleep disturbance remedy. Which of the following beta-blockers is least likely to cause sleep disturbances?
Correct!
Wrong!
Mr. G, a 45-year-old African man with insulin-dependent diabetes for 15 years, is admitted to the hospital due to an eye disease. On admission, he presents with a home blood pressure reading of 159/103. What is the first step of treatment to commence?
Correct!
Wrong!
Mr. G, a 45-year-old African man with insulin-dependent diabetes for 15 years, is admitted to the hospital due to an eye disease. On admission, he presents with a home blood pressure reading of 159/103. What stage of hypertension is Mr. G?
Correct!
Wrong!
Mr. G, a 45-year-old African man with insulin-dependent diabetes for 15 years, is admitted into the hospital due to an eye disease. On admission, he presents with a home blood pressure reading of 159/103. What target clinical blood pressure is most appropriate for Mr. G?
Correct!
Wrong!
Miss K is taking warfarin, an oral anticoagulant, for the treatment of dilated cardiomyopathy. What is the target INR Miss K needs to achieve?
Correct!
Wrong!
Miss K is taking warfarin, an oral anticoagulant, for the treatment of dilated cardiomyopathy. Miss K reports minor bleeding with an INR of 9. What is the most appropriate step for Miss K's treatment plan?
Correct!
Wrong!
Mrs. I, a 70-year-old lady, comes into the pharmacy seeking advice on vitamin products. She was told by her friend that it is good for general health. Mrs. I mentions she is taking digoxin. Which of the following vitamins is more likely to cause toxicity?
Correct!
Wrong!
Mr. A, a 55-year-old man, is starting treatment with amiodarone. Using the information in the SPC attached, counsel the patient on his new medicine. What is the average plasma half-life of amiodarone?
Correct!
Wrong!
Mr. A, a 55-year-old man, is starting treatment with amiodarone. Using the information in the SPC attached, counsel the patient on his new medicine. Which is the most appropriate cautionary label to provide for Mr. A?
Correct!
Wrong!
Which of the following is not a monitoring requirement before amiodarone treatment is initiated?
Correct!
Wrong!
NICE guidelines overview of management of atrial fibrillation recommends which of the following assessment tools to identify patients' risk of stroke?
Correct!
Wrong!
Ventricular rate can be controlled with a standard beta-blocker. Which of the following beta-blockers prolongs QT interval and, in return, causes ventricular arrhythmias?
Correct!
Wrong!
Mr. N, a 65-year-old man, presented with hemodynamic instability caused by atrial fibrillation in the last 72 hours. If hemodynamic instability is not life-threatening, what is the most appropriate therapy for Mr. N?
Correct!
Wrong!
Loop diuretics are powerful diuretics that inhibit reabsorption from the ascending limb of the loop of Henle in the renal tubule. Which of the following is not a type of diuretic?
Correct!
Wrong!
Loop diuretics are used in pulmonary oedema due to left ventricular failure and in patients with chronic heart failure. Which of the following cardiac medicines is least likely to interact with loop diuretics?
Correct!
Wrong!
You receive a prescription for hyoscine butylbromide tablets for Miss T. Her medical history shows she was previously on hyoscine butylbromide injections. What is the most likely reason for the change from injections to tablets?
Correct!
Wrong!
Mr. L, an 80-year-old man with existing renal impairment, is due to start a course of Cimetidine for reflux oesophagitis. His eGFR is reported to be 22ml/minute/1.73m². What is the most appropriate dose?
Correct!
Wrong!
A patient being treated with a proton pump inhibitor develops lesions on the hand and face accompanied with arthralgia. What is the most appropriate advice to give to the patient?
Correct!
Wrong!
Miss W, a hypertensive patient, has been diagnosed with obesity. At what body mass index value will it be appropriate to prescribe anti-obesity drugs?
Correct!
Wrong!
Mr. S, a 70-year-old man, has been admitted to the hospital after passing dark, sticky, tar-like stools. Which of his existing medicines could be the cause?
Correct!
Wrong!
Which of the following bacteria is most likely to cause peptic ulceration?
Correct!
Wrong!
Mr. S is to be administered antibiotics. Which of the following antibiotics will be least appropriate given his current medication?
Correct!
Wrong!
Mr. B, a 32-year-old man being treated for heartburn with antacids, comes into the pharmacy seeking advice for diarrhea. Which of the following antacid ingredients is most likely to cause diarrhea?
Correct!
Wrong!
Miss L presents an NHS prescription for some gluten-free products issued by her GP. Which of the following items would lead you to contact the prescriber for an alternative?
Correct!
Wrong!
A short-sighted 20-year-old lady has been experiencing rectal pain, bloody stools, diarrhea, and abdominal pain. Her GP diagnosed her with mild to moderate Ulcerative Colitis and prescribed Sulfasalazine 500mg. How often should blood counts and liver function tests be performed during the first three months of therapy?
Correct!
Wrong!
What is the maximum recommended dosage of sulfasalazine tablets that can be taken in 24 hours for a moderate attack?
Correct!
Wrong!
What is the most appropriate advice to give to this patient?
Correct!
Wrong!
Whilst working in a community pharmacy, Mr. S, who is 70-year-old, comes in to complain of headaches. He reports he was diagnosed with rectal cancer and underwent an ultra-low anterior resection and an end ileostomy. Which is the single most appropriate analgesic to treat Mr. S's headache?
Correct!
Wrong!
A 24-year-old pregnant lady suffering from severe constipation for 2 weeks has made dietary and lifestyle changes that have failed to control constipation. Which of the following is the most suitable laxative?
Correct!
Wrong!
Mrs. M is prescribed Coconut oil compound ointment to treat scalp eczema. The ingredients include Coal tar solution BP 12%, Salicylic acid Ph Eur 2%, and Sulphur for external use Ph Eur 4%. What is the correct weight of ingredients required to produce a 450g tub of ointment?
Correct!
Wrong!
Miss E, a 34-year-old lady, comes into the pharmacy seeking advice for the removal of ear wax. Miss E has a known allergy to peanuts. Which of the following remedies is the least appropriate for Miss E?
Correct!
Wrong!
Master K, a 6-year-old boy, lives in a local area where the water content is 500mcg per liter (0.5 parts per million). What Sodium Fluoride prophylaxis of dental caries, if any, would be appropriate for Master K?
Correct!
Wrong!
Mr. Y comes into the pharmacy seeking advice on dry mouth. Mr. Y complains of having dry mouth constantly. He had head cancer removed 3 years ago. He has otherwise been healthy since then. What is the most appropriate medicine for Mr. Y?
Correct!
Wrong!
A patient is brought into the A&E with suspected benzodiazepine toxicity. Which of the following is the most appropriate antidote to prescribe?
Correct!
Wrong!
A young mum brings in her 18-month-old baby to seek advice. She noticed white spots in the baby’s mouth for a couple of days. What is the most likely cause of the baby’s symptoms?
Correct!
Wrong!
A man comes into the pharmacy seeking advice about a rash on his arm. He has had it for a couple of days. He is not on any medication. What is the most likely diagnosis?
Correct!
Wrong!
A patient comes into the pharmacy seeking advice for a burn. Which of the following is not a danger symptom for urgent referral?
Correct!
Wrong!
A young mum brings in her 3-year-old boy to seek advice for nasal congestion. For the past couple of days, he has found it difficult to breathe due to mucus in the nasal passage and has complained of pain in his face. What is the least appropriate course of action?
Correct!
Wrong!
Mr. O, a 40-year-old man with chronic open-angle glaucoma, is admitted into the hospital with a suspected eye infection. He has no known allergies. What antibiotic is the most appropriate to treat Mr. O?
Correct!
Wrong!
Master O, a 5-year-old boy, is admitted into the hospital with shortness of breath and difficulty completing a sentence in one breath. On initial assessment, stats show: Heart rate 130/minute, Peak flow 30%, Respiratory rate 35/minute, SpO2 90%. What level of severity of acute asthma is Master O?
Correct!
Wrong!
Master O, a 5-year-old boy, is admitted into the hospital with shortness of breath and difficulty completing a sentence in one breath. What is the most ideal target oxygen saturation level?
Correct!
Wrong!
A 80-year-old with no long-term medical condition requires hydroxyzine hydrochloride for the treatment of pruritus. What is the most appropriate maximum dose to be administered in 24 hours?
Correct!
Wrong!
Mrs T, a 55-year-old lady with asthma, presented with dilated pupils, agitation, sinus tachycardia, and vomiting. Which of the following medications is most likely to cause Mrs T's symptoms?
Correct!
Wrong!
Mr F, a 40-year-old man with uncontrolled asthma, is being switched from a 250mcg Beclometasone dipropionate CFC-free inhaler to Fostair. What dose of Beclometasone dipropionate extrafine particles will be most appropriate?
Correct!
Wrong!
Mr F, a 40-year-old man with uncontrolled asthma, is being switched from a 250mcg Beclometasone dipropionate CFC-free inhaler to Fostair. What is the most appropriate reason for switching Mr F's inhaler?
Correct!
Wrong!
Miss U is being treated with salbutamol for exercise-induced bronchospasm. Which of the following is not a side effect of a beta2 agonist?
Correct!
Wrong!
A 12-year-old boy is prescribed a systemic antimuscarinic medicine: Oxybutynin 5mg modified-release tablet. Which of the following side effects is not commonly associated with the antimuscarinic class of medicine?
Correct!
Wrong!
Mr F, a 30-year-old man, is prescribed Finasteride 1mg daily for androgenetic alopecia. Two weeks later, he complains of feeling low and a loss of interest in his usual daily activities. Which of the following is the most appropriate advice to give to Mr F?
Correct!
Wrong!
Hormonal contraception is the most effective method of fertility control but can have minor and major side effects, especially for certain groups of women. Which of the following is not a reason to stop hormonal contraception immediately?
Correct!
Wrong!
Miss T, a 20-year-old lady, is to start a course of Rifampicin for 3 months. Rifampicin is an antibiotic with enzyme-inducing properties. Which of the following methods of contraception will be most suitable for Miss T?
Correct!
Wrong!
There is an increased risk of venous thromboembolic disease in users of combined hormonal contraceptives, particularly in the first year. Which of the following is not a risk factor for venous thromboembolism due to combined hormonal contraception?
Correct!
Wrong!
Miss H, a 35-year-old lady, is to start Qlaira for contraception after childbirth. Which of the following statements is incorrect?
Correct!
Wrong!
Miss K, a 23-year-old lady, is prescribed Cilest for contraceptive use. Which of the following medicines is least likely to interact with Cilest?
Correct!
Wrong!
Miss K, a 23-year-old lady, is on her third week of Cilest and forgot to take it for 3 consecutive days. What is the most appropriate advice to give her?
Correct!
Wrong!
Miss K, a 23-year-old lady, is prescribed Modafinil, an enzyme inducer that decreases contraceptive efficacy. How many days after discontinuing treatment with Modafinil should she continue with barrier contraceptive methods?
Correct!
Wrong!
Miss O is currently on an implant progesterone-only method of contraceptive. She is changing to combined hormonal patches. When should she apply the first patch?
Correct!
Wrong!
Which of the following side effects is least likely to be caused by progesterone-only contraceptives?
Correct!
Wrong!
Uterine perforation occurs in approximately 1 in every 1000 insertions. Which of the following is not a sign or symptom of uterine perforation?
Correct!
Wrong!
Mr. S, an 80-year-old man with dementia, is admitted to the hospital following a severe episode of behavioral disturbances. He is extremely agitated and aggressive. Which of the following medicines is least appropriate for intramuscular administration to control behavior?
Correct!
Wrong!
Mr. A, a 70-year-old man with moderate dementia in Parkinson’s disease, is currently prescribed Rivastigmine tablets 6mg twice daily. His carer reports he is finding it difficult to swallow. Mr. A is now being prescribed Rivastigmine patches. Which of the following is the most appropriate dose of Rivastigmine patches for him?
Correct!
Wrong!
A patient with moderate hepatic impairment is due to start a course of Galantamine modified-release tablets. Which of the following is the most appropriate dosage regimen?
Correct!
Wrong!
A patient is prescribed 20mg oral solution of memantine daily. Memantine oral solution is available as 5mg/pump actuation in a 50ml bottle. Each pump actuation delivers 0.5ml of solution. What is the total daily dose in ml administered to the patient?
Correct!
Wrong!
Mr Q has been on carbamazepine (Tegretol) 400 mg modified-release tablets for the treatment of adjunct alcohol withdrawal for the last two years. The pharmacy is currently out of stock of Tegretol. Which of the following statements is the most correct?
Correct!
Wrong!
Mr T, a 70-year-old man, is being treated for tonic-clonic seizures with phenytoin. Which of the following is not a symptom of phenytoin toxicity?
Correct!
Wrong!
A 28-year-old lady is taking the following medication: Salbutamol, Salmeterol, Vitamin C, Sodium valproate. She discovered she is pregnant. Which of the following medicines, if any, is the most appropriate to review immediately?
Correct!
Wrong!
A patient is prescribed Lorazepam by his GP. He presents in the pharmacy with his prescription. Which of the following statements about Lorazepam, a benzodiazepine, is incorrect?
Correct!
Wrong!
Lithium salts are used in the prophylaxis and treatment of mania, hypomania, and depression in bipolar disorder. It has a narrow therapeutic/toxic ratio. Which of the following is not a sign or symptom of lithium toxicity?
Correct!
Wrong!
Piroxicam, an NSAID used in the treatment of rheumatoid arthritis, is associated with an increased risk of gastrointestinal side effects and serious skin reactions. Which of the following recommended restrictions by the Committee for Medicinal Products for Human Use (CHMP) is incorrect?
Correct!
Wrong!
Miss E is prescribed hydrocortisone for replacement in adrenocortical insufficiency. Which of the following is not a side effect due to hydrocortisone's mineralocorticoid activity?
Correct!
Wrong!
Miss W, an 18-year-old lady, is being treated for primary nocturnal enuresis with Desmopressin 200mcg once daily. She rings the pharmacy because she is having an episode of constant diarrhoea. Which of the following is the most appropriate advice for Miss W?
Correct!
Wrong!
Miss W, an 18-year-old lady, is being treated for primary nocturnal enuresis with Desmopressin 200mcg once daily. She rings the pharmacy because she is having an episode of constant diarrhoea. Which of the following is the most appropriate advice for Miss W?
Correct!
Wrong!
A lady comes into the pharmacy to make enquiries about diabetes and driving. The Driver and Vehicle Licensing Agency (DVLA) in 2016 updated the advice for a diabetic driver. Which of the following is least appropriate for her insulin-dependent diabetic lorry driver?
Correct!
Wrong!
While conducting a Medicine Use Review on Mr. Q, a 70-year-old diabetic patient, he expressed little knowledge of his type 2 medication. Which of the following best describes the action of sulfonylureas?
Correct!
Wrong!
Mr. D, an 18-year-old, experiences repeated and unpredictable hypoglycemia. He is currently trying to achieve optimal glycemic control with multiple-injection regimens. Which of the following is the most appropriate insulin to recommend?
Correct!
Wrong!
Mrs. T, a 70-year-old, is starting Alendronic acid 70mg once weekly for the treatment of postmenopausal osteoporosis. Which of the following is incorrect about Alendronic Acid?
Correct!
Wrong!
You receive a prescription for a patient to start carbimazole 15mg daily for hyperthyroidism. Carbimazole can induce bone marrow suppression and the patient needs to inform the doctor immediately. Which of the following is the least appropriate sign and/or symptom to report?
Correct!
Wrong!
Miss T, an 85-year-old woman currently taking levothyroxine 200mcg daily, calls the pharmacy to report she has taken twice her daily dose. Which of the following is not a side effect at excessive dosage?
Correct!
Wrong!
You are a pharmacist conducting a new medicine consultation. A patient is starting Dapagliflozin and you discuss signs and symptoms of Diabetic Ketoacidosis. Which of the following is not a sign and/or symptom of diabetic ketoacidosis?
Correct!
Wrong!
Mrs. R, a 65-year-old lady, is on ciclosporin for short-term treatment of very severe atopic dermatitis. Her carer is finding it difficult to administer the medicine. Which of the following is incorrect with regard to the directions of administration of ciclosporin?
Correct!
Wrong!
Miss E, a 35-year-old, is a kidney allograft recipient currently on sirolimus for prophylaxis of organ rejection. Her current dose is 2mg once daily. The pharmacy has available sirolimus in 500mcg tablets. Which of the following statements is correct?
Correct!
Wrong!
Mr. A, a 60-year-old man weighing 75kg, is admitted to the hospital. He is being treated with gentamicin intravenous infusion for endocarditis. Gentamicin 4 mg/kg daily every 8 hours. Mr. A's one-hour peak serum concentration was reported as 6 mg/liter. Which of the following statements is correct?
Correct!
Wrong!
Mr A, a 60-year-old man weighing 75kg, is admitted to the hospital. He is being treated with gentamicin intravenous infusion for endocarditis. Gentamicin 4 mg/kg daily every 8 hours. Mr A's trough concentration was reported as 1.5 mg/liter. Which of the following is the most appropriate course of action?
Correct!
Wrong!
Miss T is a 30-year-old pregnant lady. She is experiencing a burning sensation during urination. The doctor would like to prescribe an antibiotic for a urinary tract infection. Which of the following antibiotics is the least appropriate for use in pregnancy?
Correct!
Wrong!
You are the hospital pharmacist on the hepatology ward. A patient is to begin treatment with systemic Ribavirin for chronic hepatitis C. Which of the following is incorrect about Ribavirin?
Correct!
Wrong!
Master N, a 6-year-old, was prescribed Flucloxacillin for the treatment of impetigo. After ingestion of the first dose, he experienced a severe case of hives and itching. His mother called the pharmacy to seek advice. Which of the following is the most appropriate advice for Master N?
Correct!
Wrong!
Master N, a 6-year-old, was prescribed Flucloxacillin for the treatment of impetigo. After ingestion of the first dose, he experienced a severe case of hives and itching. It has been established Master N is penicillin allergic. Which of the following antibiotics is less likely to cause a penicillin-related allergy?
Correct!
Wrong!
Mrs T is a 75-year-old lady. She is treated for a respiratory infection with Erythromycin 500 mg twice daily. Her current medication includes Aspirin 75mg once daily, Omeprazole 20mg once daily, Levothyroxine 75mcg daily, Simvastatin 40mg at night, and Paracetamol 500mg four times daily. Which of the following medicines is likely to cause an interaction with erythromycin?
Correct!
Wrong!
A patient walks into the pharmacy seeking advice. He is due to travel to a rural area in Bolivia and would like to know if he requires anti-malaria medication. Which of the following is the most appropriate anti-malaria treatment to recommend?
Correct!
Wrong!
Miss T walks into the pharmacy with a dental prescription for Metronidazole 400mg three times daily. What is the most appropriate cautionary advice for metronidazole?
Correct!
Wrong!
Miss D, a 28-year-old pregnant lady, comes into the pharmacy presenting with symptoms of seasonal hay fever. She presents with watery eyes and an itchy throat. She has tried allergen avoidance, but symptoms are persisting. Which of the following medicines is the most appropriate treatment?
Correct!
Wrong!
Miss D, a 28-year-old, is worried her 1-year-old baby has early onset of meningitis. Which of the following is not a symptom of meningitis in children under 2 years old?
Correct!
Wrong!
You are to take on the role of the responsible pharmacist in the pharmacy you are working. What is the correct operating temperature range of the refrigerator?
Correct!
Wrong!
Miss T, a 34-year-old lady with glucose-6-phosphate dehydrogenase deficiency, has a suspected urinary infection. She is to be prescribed antibiotics. Which of the following antibiotics will cause a definite risk of haemolysis in Miss T?
Correct!
Wrong!
A patient's most recent biochemistry results are shown below: Serum sodium 120 mmol/L (Reference Range: 137 - 145), Serum potassium 4.1 mmol/L (Reference Range: 3.5 - 5.1), Serum urea 3.5 mmol/L (Reference Range: 2.5 - 7.5), Serum creatinine 65 micromol/L (Reference Range: 46 - 92), Estimated GFR 60 mL/min/1.73 m² (Reference Range: >60). Which of the following concurrent use of medication is most likely to cause low sodium concentration?
Correct!
Wrong!
