A 69 year old woman is admitted to hospital after having had a fall. Whilst recovering, it is noticed that she has a shuffling gait, bradykinesia and a pill-rolling tremor. She is diagnosed with Parkinson’s disease and commenced on levodopa. Select the most appropriate option which should be communicated to the patient regarding levodopa.
A Levodopa may be taken at different times each day.
B Patients often experience end-dose deterioration after 5 years and must change therapy
C Levodopa has a slow acting effect
D Levodopa is associated with weight gain
E Levodopa therapy is not associated with reduced morbidity
A 71 year old man is seen by his GP with increasing shortness of breath and worsening pedal oedema. He has a past medical history of hypertension, gout and COPD. He is commenced on furosemide 40mg daily. Select the most appropriate option which should be communicated to the patient regarding furosemide.
A Furosemide is associated with hyperkalaemia: too much potassium in the blood
B Furosemide is not associated with kidney failure
C Furosemide is also commonly used to treat high blood pressure
D There is a chance that furosemide could lead to flares of his gout
E Furosemide has been demonstrated to reduce mortality in heart failure
A 17 year old lady sees her GP with low mood and anhedonia. She is keen to start antidepressant therapy. After discussing treatment options, the patient asks about sertraline. Select the most appropriate option which should be communicated to the patient regarding sertraline.
A Sertaline is not associated with withdrawal symptoms
B If the initial dose is ineffective then it would be appropriate to commence higher dose therapy
C Sertraline may cause an increased risk of suicidal thoughts in under 18s.
D It would take between one to two weeks for positive effects of sertraline to be noticed
E She may become dependent on SSRI therapy
A 24 year old woman presents to her GP clinic stating that she would like to try contraception. She has never used any contraception other than condoms before. You decide to counsel her on the different types of long term contraception. Select the most appropriate option which should be communicated to the patient regarding contraception.
A The progesterone only pill is the most full-proof contraceptive
B The progesterone implant lasts for five years
C The intra-uterine device (IUD) is associated with lighter periods
D The progesterone injection is associated with osteoporosis
E The combined oral contraceptive can be taken if the patient has migraine with aura.
A 49 year old lady was seen by her GP, and found to have an elevated cholesterol level, contributing to a raised cardiovascular risk score. They came to a decision together to commence statin therapy. Please select the most appropriate option which should be communicated to the patient regarding the statin.
A She will need a blood test after three months and one year following commencing the statin
B She should continue using the statin if she becomes pregnant
C Statins are usually commenced at 40mg at night and then gradually reduced
D Most patients taking statins experience muscle pain, stiffness, weakness and cramps
E She will definitely be on statins for the rest of her life
A 34 year old gentleman presents to his GP with a sore throat. On examination, he is apyrexial, has a cough and no lymphadenopathy. There is no tonsillar enlargement or exudate. He is systemically well. The gentleman is very keen to commence antibiotics to treat this sore throat, as he will be attending a very important business meeting in two days. Please select the most appropriate option which should be communicated to the patient regarding antibiotics in this case.
A He may commence oral amoxicillin immediately
B You may prescribe a delayed dose, which can be taken after two days if symptoms do not improve
C The evidence suggests that antibiotics would not be beneficial for this patient given his symptoms
D He may commence pheynoxymethylpenicillin 500mg two to four times daily for 10 days
E Antibiotics shorten the duration of symptoms by a mean of around one week, if taken halfway through the illness
A 23 year old woman presents to dermatology clinic suffering from severe acne. This has been resistant to multiple treatments, and therefore it is decided that she will commence isotretinoin therapy. Which of the following investigations is the most important to be undertaken prior to beginning treatment?
A Blood glucose
B Clotting screen
C Lying and standing blood pressures
D Patch testing
E Urine pregnancy test
A 30 year old woman presents to her GP. She states she has had a positive pregnancy test and is concerned as she has been on anti-epileptic medication for many years. Which of the following drugs is most suitable for use in pregnancy?
A Carbamazepine
B Lamotrigine
C Phenobarbital
D Phenytoin
E Sodium valproate
