A 57 year old homeless gentleman was admitted with haemoptysis and night sweats. His chest X ray shows caseating granulomae and he is subsequently diagnosed with Tuberculosis. One week after commencing treatment, he presents to his GP, complaining that his urine has turned ‘a tinge of orange’. Which of the following medications is most likely to have caused the above phenomenon?
A Ethambutol
B Isoniazid
C Prednisolone
D Pyrazinamide
E Rifampicin
A 71 year old gentleman is admitted with blackouts. He has a past medical history of asthma, atrial fibrillation, depression and epilepsy. An ECG identifies prolonged QT interval as being a likely cause of his blackouts. Which of the following medications, from his prescription sheet, is most likely to be contributing to this presentation?
A Amitriptyline 150mg Nocte
B Phenytoin 400mg OD
C Salbutamol 2 puffs PRN
D Sodium Valproate 500mg BD
E Warfarin 2mg Wednesday-Thursday, 3mg Friday-Tuesday
A 74 year old woman is admitted to hospital with a fractured neck of femur. She has a hemi-arthroplasy and begins rehabilitation. Three days post surgery, she is noted to be markedly less responsive, with pinpoint pupils and a respiratory rate of 9. What is the most appropriate drug to administer to treat these symptoms?
A Adrenaline IM 500micrograms stat
B Flumazenil 200 micrograms IV
C Morphine sulphate PO 5ml
D Naloxone 400 micrograms IV
E Sodium chloride IV 500ml over 10 minutes
A 54 year old gentleman is found to have elevated cholesterol and is subsequently commenced on atorvastatin. Which of the following blood tests would be most appropriate to commence monitoring after prescription of this medication?
A ESR
B FBC
C LFT
D TFT
E U&E
A 41 year old gentleman experiences worsening auditory hallucinations and is referred to a psychiatric consultant. The consultant recommends commencing IM clozapine therapy. Which of the following blood tests would be the most appropriate to commence monitoring?
A 45 year old lady is found to have atrial fibrillation and is commenced on anti-arrhythmic therapy: amioderone 200mg daily. Select the adverse effect of amioderone about which it is most important that this lady should be informed.
A Alopecia
B Chronic Liver Disease
C Leucopenia
D Pulmonary fibrosis
E Vasculitis
A 45 year old man presents to clinic with night sweats and shortness of breath. He is diagnosed with pulmonary tuberculosis and is commenced on multi-drug treatment. Unfortunately when he returns to clinic he states he has lost his job as an electrician. He tells you that he has had real difficulty in telling the difference between different colours of wires. Which of the following medications may have caused this effect?
An 81 year old woman is an inpatient on an elderly care ward and is suffering from AF, cellulitis and delirium. You are called to see her urgently after a medication round as she is ‘not herself’. On examination, she has a fixed forward gaze, which then progresses to maximum upward deviation of the eyes. She appears agitated and experiences spasming of the neck. Which of the following medications is most likely to have caused this presentation?
A Amiodarone
B Bisoprolol
C Cetirizine
D Flucloxacillin
E Haloperidol
A 54 year old woman is an inpatient on a psychiatric ward. She is currently undergoing treatment for schizophrenia and is subsequently on haloperidol. You are called to see the patient due to nursing concern and note she appears rigid and is more confused than normal. She has a temperature of 40 degrees Celcius and is tachycardic. She has had no cough, shortness of breath, abdominal pain, dysuria or rash. She has had one episode of incontinence, just now. Which of the following investigations would be the most appropriate in identifying the likely cause?
A Blood cultures
B Creatinine Kinase
C ECG
D U&E
E Urinary toxin screen
A 32 year old pregnant woman presents to GP concerned about a water infection. She asks for more information about the use of antibiotics in pregnancy. Which of the following antibiotics could be described as safe for use in pregnancy?
A Chloramphenicol
B Doxycycline
C Flucloxacillin
D Gentamicin
E Trimethoprim
Mrs Prudhoe is an 89 yr old lady, admitted following a fall. She is found to have a significant hyponatraemia. She appears clinically dehydrated. She has a low serum osmolality, with an elevated urinary sodium. What is the most likely cause of her hyponatraemia?
a) Citalopram
b) Furosemide
c) Inappropriate fluid resuscitation with 0.9% sodium chloride
d) Lisinopril
e) Senna
