Pre-reg Sample Open Book Exam
Pre-reg sample open book paper 2010
- 1.
What is the usual dose of bendroflumethiazide in hypertension
- A.
1.25mg
- B.
2.5mg
- C.
5mg
- D.
10mg
- E.
25mg
Correct Answer
B. 2.5mgExplanation
see bnfRate this question:
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- 2.
Which of these situations would not necessarily require immediate withdrawal of the drug?
- A.
A 59 year old man taking amiodarone who develops hypothyroidism
- B.
A 72 year old woman who gets a headache after recently being initiated on dipyridamole
- C.
A 23 year old woman taking phenytoin who develops a widespread rash
- D.
A 55 year old man with a recent pulmonary embolism who has a nose bleed while taking warfarin
- E.
A 77 year old woman who develops hypokalaemia whilst taking bumetanide
Correct Answer
B. A 72 year old woman who gets a headache after recently being initiated on dipyridamoleExplanation
Headaches can be a common side effect of some medications, including dipyridamole. In many cases, a headache can be managed with over-the-counter pain relief or by adjusting the dosage. It does not typically warrant immediate withdrawal of the drug unless it is severe or accompanied by other concerning symptoms.Rate this question:
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- 3.
Which of these would be the most suitable antibiotic to give to a patient who has a history of anaphylaxis with penicillins
- A.
Meropenem
- B.
Tazocin
- C.
Cefuroxime
- D.
Gentamycin
- E.
Co-amoxiclav
Correct Answer
D. GentamycinExplanation
Gentamycin would be the most suitable antibiotic to give to a patient with a history of anaphylaxis to penicillins because it belongs to a different class of antibiotics called aminoglycosides, which have a different chemical structure and mode of action compared to penicillins. Therefore, the likelihood of cross-reactivity and causing an allergic reaction is lower with gentamycin.Rate this question:
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- 4.
Which of the following drugs is not an enzyme inducer?
- A.
Phenytoin
- B.
Carbemazepine
- C.
Rifampicin
- D.
Griseofulvin
- E.
Fluconazole
Correct Answer
E. FluconazoleExplanation
Fluconazole is not an enzyme inducer. Enzyme inducers are drugs that increase the activity of certain enzymes in the body, which can affect the metabolism and clearance of other drugs. Phenytoin, carbamazepine, rifampicin, and griseofulvin are all known to be enzyme inducers, while fluconazole is not. Fluconazole is an antifungal medication that works by inhibiting the activity of certain enzymes involved in the synthesis of fungal cell membranes.Rate this question:
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- 5.
Which of the following vitamins increases absorption of iron from plant sources?
- A.
A
- B.
B12
- C.
C
- D.
D
- E.
E
Correct Answer
C. CExplanation
Vitamin C increases the absorption of iron from plant sources. Iron from plant sources, also known as non-heme iron, is not as easily absorbed by the body as heme iron from animal sources. However, consuming vitamin C along with non-heme iron can enhance its absorption. Vitamin C helps to convert non-heme iron into a more easily absorbable form, increasing its bioavailability. Therefore, including foods high in vitamin C, such as citrus fruits, bell peppers, and strawberries, can help improve the absorption of iron from plant sources.Rate this question:
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- 6.
A 48-year-old woman asks you to recommend a treatment for itching. The itchiness is widespread over her body and started about 2 days ago. She has a yellow-brown tanned appearance, and has returned from a holiday in Turkey 2 weeks ago. On questioning she reveals that she feels generally unwell and has difficulty sleeping. She does NOT take any medication and since returning from holiday she has not changed her diet, or used any new cosmetics or detergents. Which one of the following courses of action is the most appropriate for you to take?
- A.
Advise her to take chlorphenamine tablets
- B.
Advise her to use calamine lotion
- C.
Advise her to apply hydrocortisone cream 1% twice a day to the affected areas (except her face)
- D.
Advise her to use a soap substitute such as emulsifying ointment
- E.
Advise her to see her GP
Correct Answer
E. Advise her to see her GPExplanation
The symptoms described are of jaundice. Jaundice is caused by liver failure, by bilirubin leaking out and depositing in the skin leaving a yellow colour and causing itching. The symptoms of jaundice should especially be reported to GP if they have just returned from a foreign country. The other options of OTC treatment may help reduce itching, but referral to a GP is the best course of actionRate this question:
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- 7.
For which of these indications can OTC hdrocortisone cream be sold?
- A.
Nappy rash for 18 month old todder
- B.
Shaving rash on a 33 year old man
- C.
53 year old women with a nickel allergy rash on her wrist
- D.
Vulval allergy and rask on a 42 year old woman
- E.
Insect bite on a 9 year old boy
Correct Answer
C. 53 year old women with a nickel allergy rash on her wristExplanation
Topical hydrocortisone is only licensed for OTC sale for over 10 years old. Therefore any age group below this should be referred.
- Topical hydrocortisone is not for OTC sale for the face, broken skin, mucus membranes, and sensitive areas of the skin such as the vulva.Rate this question:
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- 8.
Which of these drugs have a narrow therapeutic range?
- A.
Gentamycin
- B.
Methotrexate
- C.
Lithium
- D.
Phenobarbital
- E.
Itraconazole
Correct Answer
C. LithiumExplanation
Lithium is known for having a narrow therapeutic range. This means that the difference between a therapeutically effective dose and a toxic dose is small, requiring careful monitoring of blood levels to ensure safety and effectiveness.Rate this question:
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- 9.
Which of the following drugs is least likely to cause blood disorders?
- A.
Carbimazole
- B.
Amiodarone
- C.
Phenytoin
- D.
Mesalazine
- E.
Methotrexate
Correct Answer
B. AmiodaroneExplanation
Amiodarone is least likely to cause blood disorders compared to the other drugs listed. Amiodarone is an antiarrhythmic medication used to treat irregular heartbeats. While it can have side effects, such as lung or liver problems, it is not commonly associated with blood disorders. On the other hand, drugs like carbimazole, phenytoin, methotrexate, and mesalazine have been known to cause blood disorders such as agranulocytosis, aplastic anemia, or thrombocytopenia. Therefore, amiodarone is the least likely drug to cause blood disorders among the options provided.Rate this question:
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- 10.
Which one of the following side effects of hydrocortisone is caused by its mineralocorticoid activity?
- A.
Osteoporosis
- B.
Diabetes
- C.
Muscle wasting
- D.
Hypertension
- E.
Skin thinning
Correct Answer
D. HypertensionExplanation
all others are glucocorticoidRate this question:
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- 11.
Directions: For the question below, ONE or MORE of the responses is (are) correct. Decide which of the responses is (are) correct. Then choose: A if 1,2 and 3 are correct B if 1 and 2 only are correct C if 2 and 3 only are correct D if 1 only is correct E if 3 only is correct Directions Summarised A 1,2,3 B 1,2 C 2,3 D 1 only E 3 only The Responsible Pharmacist Regulations 2008, which come into force on 1 October this year, will replace the following provisions in the Medicines Act 1968. 1. Personal control 2. Supervision 3. Superintendent pharmacist
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
D. DExplanation
Rationale/Explanation
The Health Act 2006 replaced the term “personal control” in the Medicines Act 1968 with the concept of a “responsible pharmacist”; the Responsible Pharmacist Regulations 2008 will bring that into effect. There are currently no proposals to amend the superintendent pharmacist provisions.
Notes
1. RPSGB registration exam syllabus, sections 1a: Sale and supply of medicines; 1b: Conditions for operating a registered pharmacy.
2. Closed book: Questions that pre-registration trainees are expected to answer without recourse to a reference.
One of the requirements for trainees is that they keep up to date with important developments in pharmacy. Information on this topic has appeared in the pharmacy press and a consultation on the proposals has been issued by the RPSGB.Rate this question:
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- 12.
The supply of which one of the following would be unlawful? Select the best answer.
- A.
A prescription for six weeks supply of a Schedule 2 Controlled Drug issued three weeks previously (and not forward dated).
- B.
A prescription for 28 days supply of a Schedule 3 Controlled Drug issued six weeks previously (and not forward dated).
- C.
A prescription for 28 days supply of a Schedule 2 Controlled Drug issued three weeks previously (and not forward dated), with the total quantity written only in figures.
- D.
A repeat supply, made six weeks after the original dispensing, of a Schedule 4 Controlled Drug for which repeats are allowed, on a private prescription requesting one repeat but with no specification, either of the date or length of time after the initial supply, as to when the repeat is to be made.
- E.
A repeat supply, made one year after the original dispensing, of a Schedule 5 Controlled Drug on a private prescription requesting one repeat, but with no specification, either of the date or length of time after the initial supply, as to when the repeat is to be made.
Correct Answer
B. A prescription for 28 days supply of a Schedule 3 Controlled Drug issued six weeks previously (and not forward dated).Explanation
Only B is prohibited by the Misuse of Drugs Regulations: prescribers have been advised by the Department of Health and the Scottish Executive not to prescribe more than 30 days supply of a Controlled Drug in Schedule 2, 3 or 4, but it is not unlawful to do so or for pharmacists to supply more than 30 days if prescribed.
Pharmacists can correct minor technical errors or omissions on CD scripts, and this applies to C. So long as the initial supply of a Schedule 4 CD is made within 28 days of being prescribed, and for a Schedule 5 CD within six months, there is no restriction on when repeats can be supplied. The question is closed book because pharmacists are expected to be conversant with the rules for supply of CDs and not have to look them up.Rate this question:
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- 13.
In order to make 200ml of Gentian Mixture Alkaline BP, which contains 50 per cent double strength chloroform water, you would need to use: 1. 0.25ml of chloroform 2. 2.5ml of concentrated chloroform water, which contains 10 per cent chloroform 3. 10ml of chloroform spirit, which contains chloroform 1 part in 20 One or more of the responses below is (are) correct. Decide which of the responses is (are) correct. Then choose: A if 1, 2 and 3 are correct B if 1 and 2 only are correct C if 2 and 3 only are correct D if 1 only is correct E if 3 only is correct Directions Summarised A 1,2,3 B 1,2 C 2,3 D 1 only E 3 only
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
E. EExplanation
The correct answer is E because option 3 is the only correct response. Option 1 states that 0.25ml of chloroform is needed, which is not mentioned in the question. Option 2 states that 2.5ml of concentrated chloroform water is needed, but the question specifies that the chloroform water should be double strength, not concentrated. Option 3 states that 10ml of chloroform spirit is needed, which contains chloroform 1 part in 20, and this aligns with the requirement of 50% double strength chloroform water mentioned in the question. Therefore, only option 3 is correct.Rate this question:
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- 14.
Directions: For the question below, ONE or MORE of the responses is (are) correct. Decide which of the responses is (are) correct. Then choose: For the question below, ONE or MORE of the responses is (are) correct. Decide which of the responses is (are) correct. Then choose: A if 1,2 and 3 are correct B if 1 and 2 only are correct C if 2 and 3 only are correct D if 1 only is correct E if 3 only is correct Directions Summarised A 1,2,3 B 1,2 C 2,3 D 1 only E 3 only Which of the following symptoms might indicate that a patient who is taking levothyroxine is on too high a dose? 1. Diarrhoea 2. Sweating 3. Weight gain
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
B. BExplanation
The correct answer is B because both sweating and weight gain can indicate that a patient who is taking levothyroxine is on too high a dose. Diarrhea, on the other hand, is not a symptom typically associated with an overdose of levothyroxine.Rate this question:
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- 15.
A pregnant woman taking medication for which one of the following conditions is at increased risk of giving birth to a baby with spina bifida?
- A.
Asthma
- B.
Chrohn's disease
- C.
Epilepsy
- D.
Diabetes
- E.
Hypertension
Correct Answer
C. EpilepsyExplanation
A pregnant woman taking medication for epilepsy is at an increased risk of giving birth to a baby with spina bifida. This is because certain anti-seizure medications used to treat epilepsy can interfere with the body's ability to absorb folic acid, which is important for the development of the baby's spine. Insufficient folic acid can lead to neural tube defects, including spina bifida, in the baby. Therefore, pregnant women with epilepsy need to closely monitor their folic acid levels and may require higher doses of folic acid supplements to reduce the risk of spina bifida.Rate this question:
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- 16.
Directions: For the question below, ONE or MORE of the responses is (are) correct. Decide which of the responses is (are) correct. Then choose: A if 1,2 and 3 are correct B if 1 and 2 only are correct C if 2 and 3 only are correct D if 1 only is correct E if 3 only is correct Directions Summarised A 1,2,3 B 1,2 C 2,3 D 1 only E 3 only For which of the following could you lawfully make an emergency supply of a prescription only medicine at the request of a patient? 1. A person who has previously been prescribed the medicine by a doctor in France 2. A person who has previously been prescribed the medicine by a dentist in Germany 3. A person who has previously been prescribed the medicine by a dentist in the United Kingdom
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
A. AExplanation
Since November 2008, as result of an EU directive, pharmacists can make emergency supplies of prescription only medicines that have been previously prescribed by a practising doctor or dentist in Switzerland and the European Economic Area, which includes all EU states plus Norway, Iceland and Liechtenstein.
In May 2009, the Medicines Act 1968 regulations were amended to allow emergency supplies of POMs previously prescribed by a UK dentist.Rate this question:
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- 17.
Your pharmacy participates in a ‘Heart Health’ scheme run by your local PCT, in which you measure patients’ height, weight, blood pressure and, depending on results, offer lifestyle advice or refer them to their GP. A 40 year old male patient weighs 70 kg and is 1.8 metres in height. His blood pressure is 160/110mmHg. Assertion/Reason Directions. The following question consists of a statement in the left hand column followed by a second statement in the right hand column. Decide whether the first statement is true or false. Decide whether the second statement is true or false. Then choose: A. If both statements are true and the second statement is a correct explanation of the first statement. B. If both statements are true but the second statement is not a correct explanation of the first statement. C. If the first statement is true but the second statement is false. D. If the first statement is false but the second statement is true. E. If both statements are false. First statement Second statement He should be referred to his GP. He is overweight. Directions Summarised First statement Second statement A True True 2nd statement is a correct explanation of the first B True True 2nd statement is not a correct explanation of the first C True False D False True E False False
- A.
A
- B.
B
- C.
C
- D.
D
- E.
E
Correct Answer
C. CExplanation
Rationale/calculation
Calculate his body mass index (BMI) using the formula: BMI = Weight (in kilograms) divided by height (in metres)2
Calculation: 70 / 1.8x1.8 = 70 / 3.24 = 21.6
A BMI between 18.5 and 24.9 is considered normal, so the patient is not overweight. However, he should be referred to his GP because his blood pressure is above the generally accepted target level of 140/90mmHg.Rate this question:
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- 18.
Which one of the of the following side-effects of antipsychotic drugs relates exclusively to males?
- A.
Akathisia
- B.
Dystonia
- C.
Galactorrhoea
- D.
Gynaecomastia
- E.
Tardive Dyskinesia
Correct Answer
D. GynaecomastiaExplanation
Rationale: Akathisia (uncontrollable motor restlessness), dystonia (involuntary jerking movements of the trunk and limbs) and tardive dyskinesia (twitching, mainly of the face and tongue) can be experienced by both men and women. Galactorrhoea (spontaneous flow of breast milk) is exclusive to women. Gynaecomastia is excessive breast development in males.Rate this question:
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- 19.
A patient with non-insulin dependent diabetes has been admitted to the ward for which you are the clinical pharmacist, to investigate the cause of his poor blood glucose control. He takes gliclazide tablets to control his blood glucose levels. Which one of the other medicines he takes, listed below, is the most likely to have adversely affected his blood glucose levels?
- A.
Aspirin 75mg OM
- B.
Bendroflumethiazide 2.5mg OM
- C.
Prazosin 1mg TDS
- D.
Simvastatin 40mg ON
- E.
Tramadol 100mg QDS
Correct Answer
B. Bendroflumethiazide 2.5mg OMExplanation
Hypoglycaemic effect of antidiabetics is antagonised by thiazidesRate this question:
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- 20.
The following is an extract from a prescription: Norethisterone 5 mg tablets, one tds from day 5 to 24 of menstrual cycle, supply 4 cycles. How many tablets should you supply?
- A.
168
- B.
252
- C.
320
- D.
228
- E.
240
Correct Answer
E. 240Explanation
Day 5 to 24 = 20 days@3/day = 60 x 4 (cycles) = 240Rate this question:
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