Sample 1
Q1
Prochlorperazine is available over the counter as a Pharmacist Only Medicine. It is only approved to be supplied for which ONE of the
following symptoms?
A Nausea associated with gastro-enteritis
B Nausea associated with migraine
C Nausea associated with motion sickness
D Nausea associated with pregnancy
Q2
Certain pharmaceutical benefits are provided without charge to prescribers (in prescriber bag supplies), who in turn can supply them free
to patients for emergency use. Which ONE of the following medicines fits this category?
A Dopamine
B Ondansetron
C Dexamethasone
D Dicloxacillin
Q3
A customer comes into your pharmacy and asks you to identify a white tablet, which he shows you. Upon questioning him, he advises that
he found it at his personal assistant's workstation. Which ONE of the following actions is the MOST appropriate for you to take?
A Identify the tablet, if possible, and inform the customer about the medication
B Inform the customer that you are not able to provide any information and advise him to discuss the matter with his assistant
C Request further information regarding his assistant's medical history and general behaviour, before discussing the medication further
D Suggest that you are unable to properly identify the tablet, to remove yourself from the situation
Q4
Which ONE of the following reference text would be considered to have the MOST authority when deciding which medications require
labelling with a sedation warning?
A The Australian Medicines Handbook (AMH)
B The Australian Pharmaceutical Formulary (APF)
C The Schedule of Pharmaceutical Benefits (PBS)
D The Standard for the Uniform Scheduling of Medicines and Poisons (SUSMP)
Q5
Which ONE of the following statements is NOT a purpose where PBS authorities are required for medicines?
A PBS authorities are required where there is an increased quantity of medicine needed
B PBS authorities are required where there is an increased number of repeats needed
C PBS authorities are required where access to the medicine is restricted to certain approved doctors to prescribe
D PBS authorities are required where concerns exist about effects on patients of varying genetic heritage
Q6
Which ONE of the following statements best describes a Pharmaceutical Benefits (PBS) authority prescription medication?
A The medication has no PBS restriction on its therapeutic use
B The medication has a low therapeutic index, which requires close monitoring
C The medication has a high chance of adverse events, which requires the prescriber to consider carefully the risk benefit ratio for each
specific patient
D The medication has restrictions and requires approval from Department of Human Services or the Department of Veterans
Affairs for a specific condition
Q7
Which ONE of the following statements is CORRECT regarding the guidelines for pharmacists issuing medical certificates under the
Workplace Relations Act 1996?
A A medical certificate issued by a pharmacist must be accepted as evidence of illness or injury for the purpose of health and welfare
benefit entitlements
B It is recommended that records of the medical certificate be kept for at least 6 months
C A pharmacist may not issue a medical certificate in relation to an illness or injury outside of their scope of practice
D It is not necessary to conduct a consultation with the ill or injured person, if the medical certificate is being issued for a carer
Q8
A patient requests that you allow them to see what information is held about them on the dispensary computer.
Which ONE of the following statements is INCORRECT?
A A consumer is not allowed to see dispensary information as this may be misinterpreted by non-health professionals
B A consumer can demand that information held about them be modified if found to be inaccurate
C A pharmacist can deny access to information if he/she considers the information may be a threat to the life or health of an individual
D Access may be denied if information about another patient is contained within the same patient health record
Q9
Which ONE of the following beta-blockers would be LEAST likely to cause bronchospasm in an asthmatic patient at normal doses?
A Carvedilol
B Labetalol
C Bisoprolol
D Propranolol
Q10
What is aminophylline used clinically as?
A A bronchodilator
B An enzyme inducer
C A contractility inhibitor
D An enzyme inhibitor
Q11
A female customer has been taking isotretinoin for 6 weeks. She is about to go to Indonesia for
3 months and has a prescription for 100 mg doxycycline tablets i daily for malaria prophylaxis.
What should this customer be advised pertaining to her medications?
A Advise her to take the doses of isotretinoin and doxycycline at least 2 hours apart
B Advise her that the use of doxycycline for longer than two months continuously is not recommended and therefore alternative
prophylaxis is required
C Explain that the use of doxycycline with isotretinoin is not recommended and ask her to discuss alternative malaria
prophylaxis with her doctor
D Advise her to stop taking the isotretinoin during her trip, as isotretinoin will interfere with all drug alternatives for malaria prophylaxis
Q12
Which ONE of the following medications is LEAST likely to cause drug-induced oesophageal ulceration?
A Alendronate
B Doxycycline
C Metoclopramide
D Potassium chloride
Q13
A patient taking a nonselective monoamine oxidase inhibitor (MAOI) should avoid taking which ONE of the following medicines
concurrently?
A Pseudoephedrine
B Temazepam
C Aspirin
D Paracetamol
Q14
A person has a recent soft tissue injury and asks for your advice. Which of the following should you recommend?
A Rest, heat, compression and elevation
B Massage, heat, compression and elevation
C Massage, ice, compression and elevation
D Rest, ice, compression and elevation
Q15
The metalwork teacher from the local high school comes into your pharmacy with a student complaining of a red and painful eye. Upon
examination you can see a small piece of metal lodged in the surface of his eye. Which ONE of the following is the MOST appropriate
action to take?
A Irrigate the eye under a stream of cool tap water for at least 10 minutes
B Recommend the use of anti-inflammatory eye drops, with the instruction to visit the doctor if the inflammation persists after 24 hours
C Lie the student down and tell him to keep still, whilst you remove the metal with a clean pair of forceps
D Close the eye, cover it with a bandage or sterile pad, tell him to keep his head still and arrange for transport to the nearest
hospital
Q16
All of the following substances cause hypokalemia EXCEPT:
A Loop diuretic
B Salbutamol
C Beta-blockers
D Intravenous amphotericin
Q17
Which ONE of the following side effects might you expect in a patient on atorvastatin?
A Dizziness
B Hypotension
C Hair loss
D Tachycardia
Q18
Of the following, which ONE is the MOST appropriate dose for an initial six weeks' treatment of methotrexate, when used for the
management of rheumatoid arthritis in adults?
A 5 mg weekly
B 10 mg weekly
C 25 mg weekly
D 25 mg monthly
Q19
A customer who had a kidney transplant 6 months ago is taking ciclosporin regularly to suppress rejection. He has recently acquired a
fungal infection under his toenails. His doctor phones to ask your advice on treatment of onychomycosis. Which ONE of the following is
the MOST appropriate medication?
A Fluconazole capsules
B Terbinafine tablets
C Griseofulvin tablets
D Clotrimazole lotion
Q20
Which ONE of the following medications is MOST likely to result in a clinically significant interaction with erythromycin?
A Digoxin
B Warfarin
C Enalapril
D Amitriptyline
Q21
Which ONE of the following is LEAST likely to cause QT prolongation?
A Haloperidol
B Amiodarone
C Sotalol
D Azithromycin
Q22
A 36-year-old female patient telephones your pharmacy and complains of having a sore and swollen calf muscle, with no apparent reason
for the problem. She is on the following medication regimen:
Trimethoprim 300 mg
ONE at night
Ethinyloestradiol 30 /
levonorgestrel 150
ONE tablet daily
Omeprazole 20 mg
ONE daily
Citalopram 20 mg
ONE daily
Naproxen 250 mg
ONE every eight hours when required
Which medication is MOST likely associated with her symptoms?
A Trimethoprim
B Ethinyloestradiol / levonorgestrel
C Omeprazole
D Citalopram
Q23
Which ONE of the following counselling points is MOST appropriate for alendronate?
A Take in the morning 30 minutes before breakfast and remain upright until breakfast.
B Take in the morning with breakfast to avoid stomach upset
C Take at bedtime to avoid possible drowsiness
D Take one hour after a meal
Q24
A female customer has recently given birth and is breastfeeding her baby. Her doctor has prescribed the progesterone only pill and as she
has not used this type of pill before, she has a few questions.
Which ONE of the following counselling points would be MOST appropriate for her?
A The drug is not transferred in the milk to the baby
B When commencing the pill it is necessary to use an alternative method of contraception for seven days
C When breastfeeding ceases it will be necessary to change to the combined contraceptive pill
D It must be taken within 3 hours of the same time each day
Q25
A 45-year-old male patient, stabilised on warfarin at an International Normalised Ratio (INR) of 2.4, has decided to go on a vegetarian
diet. Which ONE of the following is the MOST appropriate advice to give him about his diet?
A You cannot go on a vegetarian diet whilst on warfarin
B Eat a consistent amount of leafy green vegetables day to day
C Take 1 iron tablet a day to maintain iron levels
D Increase mushroom intake for protein levels
Q26
A vial of insulin currently in use may be stored at up to 25°C without loss of potency for what length of time?
A 1 hour
B 1 day
C 2 weeks
D 4 weeks
Q27
Which ONE of the following statements is CORRECT with regards to using glyceryl trinitrate spray for the first time?
A Shake before use and discard 3 months after opening; a maximum of 2 sprays under the tongue should be used over 15 minutes
B Prime before use and spray under the tongue; a maximum of 5 sprays should be used over 15 minutes
C Prime before use and discard 3 months after opening; a maximum dose of 2 sprays under the tongue should be used over 15 minutes
D Prime before use and spray under the tongue; a maximum single dose of 2 sprays should be used and if necessary another
spray in 5 minutes up to a maximum of 3 sprays
Q28
A customer presents with a new script for felodipine 5 mg daily. Which ONE of the following points should you include in your counselling?
A A warning regarding consumption patterns of grapefruit juice
B The tablets may be crushed, if difficult to swallow
C A warning regarding constipation and the need for a high fibre diet
D A warning not to take potassium supplements while taking this medication
Q29
Which ONE of the following statements is CORRECT with regards to glyceryl trinitrate patches?
A Useful in the treatment of unstable angina
B Remove and replace every 24 hours
C Cut to provide lower doses if necessary
D Apply for up to 14 hours/day
Q30
Which ONE of the following medications may be taken at night to maximize its concentration in the blood and / or urine?
A Trimethoprim
B Atorvastatin
C Omeprazole
D Perindopril
Q31
Which ONE of the following medications is BEST taken half an hour before food?
A Metformin
B Flucloxacillin
C Amoxicillin
D Felodipine
Q32
Following a dose of salmeterol, when is the effect maximal?
A Instantaneously.
B After 10 minutes
C After 3 to 4 hours
D After 12 hours
Q33
A patient requires a 10-day course of a medicine. The dose of medicine is 250 mcg once daily on days 1 to 3 and then 125 mcg once
daily on days 4 to 10. The medicine is only available as a 150-mcg dispersible tablet, stable on production for 24 hours. What is the
minimum number of dispersible tablets required for the complete 10-day course?
A8
B 10
C 13
D 16
Q34
How many mL of 90% alcohol, when diluted to 135 mL, produces 60% alcohol?
A 60 mL
B 73 mL
C 81 mL
D 90 mL
Q35
A child requires a 3-day course of a 5 mg/mL prednisolone solution. The child weighs 23 kg and is to be dosed at 500 microgram/kg per
day. What volume of the prednisolone solution is required?
A 4.6 mL
B 6.9 mL
C 13.8 mL
D 19.2 mL
Q36
A 100 kg patient takes 5 mL of 30 mg/mL ferrous sulphate solution (equivalent to 6 mg/mL of elemental iron) twice a day. What is the total
daily dose of elemental iron administered?
A 0.6 mg/kg
B 3 mg/kg
C 6 mg/kg
D 30 mg/kg
Q37
Clonazepam drops are provided for use in the concentration of 2.5 mg/mL. The prescribed dose for a patient is 0.8 mg per day.
Calculate the dose in drops if one drop is 0.04 mL.
A 4 drops
B 8 drops
C 16 drops
D 40 drops
Q38
A medicine is provided as a 1 g powder which, when reconstituted with 9.6 mL of water for injection, provides a solution of 100 mg/mL.
The dose of the medicine for a child is 50 mg/kg/day in 2 divided doses. What volume of injection is required for each dose for a 35 kg
child?
A 1.25 mL
B 2.5 mL
C 8.75 mL
D 12.5 mL
Q39
An 80 kg man is being treated for ventricular fibrillation with lidocaine (lignocaine). The protocol for the lidocaine (lignocaine) infusion
(using a 5 mg/mL vial) is:
Bolus
1 mg/kg per minute for 2 minutes
Infusion
4 mg/min for 1 hour then 3 mg/min for 1 hour then 2mg/min for 10 hours
What volume of lidocaine (lignocaine) is required for the initial bolus and the first hour of the infusion?
A 44 mL
B 60 mL
C 64 mL
D 80 mL
Q40
Calculate the total dose of alteplase administered for a 50 kg female based on the following dose regimen:
Bolus
15 mg
Infusion
0.75 mg/kg over 30 minutes then 0.5 mg/kg over 60 minutes
A 16.25 mg
B 62.5 mg
C 52.5 mg
D 77.5 mg
Q41
Patients on a low-sodium diet often use a salt substitute.
What is the typical major ingredient in salt substitutes?
A Ammonium chloride
B Calcium chloride
C Potassium chloride
D Potassium iodide
Q42
A mother is concerned her child has nits. What should you advise her to look for to confirm this suspicion?
A Small winged insects in the child's hair
B White eggs and live lice in and on hair shafts close to the scalp
C White eggs stuck to the scalp and areas of redness on the scalp
D Small insects in the child's hairbrush and on clothing
Q43
Which of the following statements is INCORRECT with regard to omega-3 fatty acids?
A It is advisable for patients with high triglycerides to increase their intake of omega-3 fats
B Alpha-linolenic acid (ALA) is a plant-based omega-3 source from walnuts, flaxseed and soya beans
C Omega-3 fats are considered to be NSAID-sparing agents in the treatment of inflammatory disorders
D For patients with coronary heart disease, the recommended daily intake of omega-3 fats is the same as the daily dosage for
primary prevention
Q44
In the case of the management of vaginal candidiasis by a pharmacist, which ONE of the following does NOT warrant referral?
A Clear vaginal discharge
B Abdominal pain
C Fever
D Diabetes
Q45
Which ONE of the following medications requires the MOST caution when treating pregnant women?
A Vitamin A
B Vitamin B
C Vitamin K
D Vitamin E
Q46
Which ONE of the following statements about ginger is LEAST appropriate?
A Ginger has been used as an antiemetic adjunct to cancer therapy
B Ginger has traditionally been used for colic
C Ginger has no known drug interactions
D Ginger can cause side effects including heartburn, bloating and flatulence
Q47
St John's Wort would be MOST suitable for which ONE of the following patients?
A 40-year-old male anxious about a house renovation on warfarin for a previous deep vein thrombosis
B 20-year-old female anxious about exams and taking the combined oral contraceptive pill
C 26-year-old female anxious about starting a new job and taking a multivitamin
D 40-year-old female recently diagnosed with breast cancer on multiple medications
Q48
Which ONE of the following anthelmintics is LEAST appropriate for treating threadworm in a child under 5 years of age?
A Ivermectin
B Albendazole
C Mebendazole
D Pyrantel embonate
Q49
Which ONE of the following statements regarding the use of paracetamol for osteoarthritic pain is LEAST appropriate?
A Paracetamol is the treatment of choice for mild to moderate, persistent osteoarthritic pain
B Analgesic effects of paracetamol begin approximately 30 minutes after oral administration
C lack of pain control with paracetamol is frequently due to inadequate dosing of paracetamol
D Strong evidence suggests that the risk of hepatotoxicity from paracetamol is increased in patients with chronic liver failure
Q50
With regard to injector pens, when used for the basal-bolus regimen in the control of insulin dependent diabetes which of the following is
INCORRECT? Injector pens give
A added independence for the visually impaired
B the ability to mix different types of insulin together
C greater discretion when insulin needs to be used in a public place
D increased flexibility to people with irregular lifestyles such as shift workers
Q51
When counselling on the use of a topical azoles antifungal cream, you would advise all of the following EXCEPT:
A Fungal infections will be eradicated after 5-7 days
B It may not be necessary to use the entire tube
C Apply at regular intervals every day
D Keep area dry and open to the air
Q52
Which ONE of the following statements about a Permethrin 5% cream is MOST appropriate? Permethrin 5% cream when used for
scabies:
A should be applied daily for 1 week
B should be left on for 8 hours
C should be applied to warm, moist skin
D is not safe to use in pregnancy and breastfeeding
Q53
During a holiday excursion, a fellow passenger collapses and, when you check his vital signs, there is no breathing or pulse. Which ONE
of the following actions would be the MOST appropriate?
A Immediately commence expired air resuscitation and continue until the patient can get medical assistance
B Apply cardio-pulmonary resuscitation until medical help is available
C Insist that the patient is taken immediately to hospital, which is a 1-hour drive away
D Administer adrenaline (epinephrine) from the first aid kit because you suspect anaphylactic shock
Q54
An allergy to which ONE of the following requires that further considerations are met in excess of those normally in place for a person
wishing to have an influenza vaccination?
A Peanuts
B Sulfates
C Oysters
D Eggs
Q55
What is the recommended dose for the treatment of folate deficiency in an adult?
A 0.1 mg daily
B 0.5 mg daily
C 1 mg daily
D 5 mg daily
Q56
Which ONE of the following statements about whooping cough is INCORRECT?
A Whooping cough is caused by the organism Bordetella pertussis
B Amoxicillin is the standard first line treatment for whooping cough
C Adults may have mild illness experiencing only a persistent cough
D Whooping cough is a highly infectious bacterial infection of the upper respiratory tract
Q57
Agranulocytosis is MOST commonly associated with which ONE of the following antipsychotics?
A Olanzapine
B Risperidone
C Haloperidol
D Clozapine
Q58
Mrs Jones, a 35-year-old woman, is a regular patient at your pharmacy. She reports pain in her Achilles tendons that appeared 2 days
ago. She says that she had gastroenteritis on holiday in Thailand for which she was prescribed:
Metronidazole
400 mg tds
Ciprofloxacin
500 mg bd
Ranitidine
150 mg bd
Paracetamol/aspirin/caffeine
250 / 250 / 65 mg tds
Mebeverine
135 mg bd
Capsules containing lactobacillus
Which ONE of these medicines MOST likely caused the pain?
A Metronidazole
B Ciprofloxacin
C Ranitidine
D Mebeverine
Q59
Which ONE of the following is an expected adverse effect of long-term corticosteroid use?
A Hypotension
B Easy bruising
C Extreme tiredness
D Hypoglycaemia
Q60
When doxycycline is prescribed to travellers for malaria prophylaxis. Which ONE of the following statements regarding doxycycline is
LEAST appropriate?
A Offers broad protection against malaria
B Used in areas where there is mefloquine or chloroquine resistance
C Used in patients with low tolerance for mefloquine or chloroquine
D Used because dosing can be stopped on leaving an endemic area
Q61
Which ONE of the following beta-blockers has been proven to reduce both morbidity and mortality in patients with left ventricular systolic
heart failure?
A Atenolol
B Propranolol
C Carvedilol
D Sotalol
Q62
Which ONE of the following medications is MOST likely to cause a photosensitivity reaction?
A Chlorpromazine
B Haloperidol
C Clozapine
D Diazepam
Q63
Which ONE of the following statements regarding the use of zolpidem is CORRECT?
Zolpidem:
A Is a benzodiazepine
B Has a long duration of action
C Is recommended for use in children
D Should be used with caution in patients with hepatic impairment
Q64
A 25-year-old woman who is 11 weeks pregnant has a free T4 plasma level of 48 picomol/L (reference range: 10 - 25 picomol/L) and TSH
of < 0.4 m/U/mL (reference range: 0.4 - 5 m/U/mL). Which of the following statements in CORRECT regarding this scenario?
A This patient is likely to have symptoms of lethargy, bradycardia and cold intolerance
B Thyroxine is not contraindicated in pregnancy and thus can be used to treat this patient without concern
C Propylthiouracil is the preferred therapy for this patient
D Plasma levels of iodine decrease during pregnancy as a result of foetal use and increased renal clearance and thus require
supplementation
Q65
A regular female customer tells you that she feels a migraine is starting. She asks if her usual treatment is safe for her to use given that
she is 8 months pregnant. She has previously used soluble aspirin and metoclopramide which has proven to be effective. What is the
MOST appropriate safe advice to treat her migraine?
A Aspirin and metoclopramide are safe to use throughout pregnancy
B Aspirin should be ceased, as it is not recommended in late pregnancy - the metoclopramide alone should be effective
C Aspirin and metoclopramide should be substituted with ibuprofen 2 x 200 mg 3 times a day
D Aspirin can be substituted with 2 x 500 mg paracetamol, taken with the metoclopramide
Q66
Which ONE of the following therapies is NOT appropriate for an 80-year-old woman who presents with post herpetic neuralgia?
A Gabapentin 300 mg daily, titrated as tolerated
B Capsaicin topical application
C Transcutaneous electrical nerve stimulation (TENS)
D Citalopram 20 mg daily to a maximum of 40-60 mg
Q67
Which ONE of the following medicines MOST likely needs a dose adjustment in stage 3b renal dysfunction?
A Prednisolone
B Allopurinol
C Labetalol
D Fluoxetine
Q68
Which ONE of the following medications is LEAST likely to cause gastric upsets?
A Enalapril
B Sulindac
C Prednisolone
D Fluoxetine
Q69
Naphazoline can be used in eye drops to treat which ONE of the following?
A Red eyes/itchy eyes
B Dry eye syndrome
C Glaucoma
D Conjunctivitis
Q70
Which ONE of the following conditions is LEAST likely to be the primary cause of elevated serum creatinine?
A Diabetic nephropathy
B Rhabdomyolysis
C Renal failure
D Dehydration
Q71
Which ONE of the following is the MOST appropriate anti-platelet treatment following the insertion of a stent?
A Aspirin plus dabigatran
B Dabigatran
C Clopidogrel
D Clopidogrel plus aspirin
Q72
Which ONE of the following oral benzodiazepines has the shortest period of action?
A Lorazepam
B Diazepam
C Midazolam
D Alprazolam
Q73
Phytomenadione (vitamin K) is used for which ONE of the following reasons?
A To counteract excessive heparinisation
B To supplement potassium loss
C As a vitamin supplement in children
D To counteract excessive warfarinisation
Q74
Which ONE of the following is NOT a symptom of hyponatraemia?
A Thirst
B Headache
C Seizures
D Irritability
Q75
Which ONE of the following medications does NOT cause discolouration of the urine?
A Rifampicin
B Riboflavine
C Minocycline
D Mitozantrone
Q76
Which ONE of the following electrolytes can be affected by high dose inhaled salbutamol?
A Sodium
B Potassium
C Bicarbonate
D Magnesium
Q77
Which ONE of the following combinations of medications is LEAST likely to cause serotonin syndrome?
A Fluoxetine and dextromethorphan
B Fluoxetine and lithium
C Dextromethorphan and phenelzine
D Dextromethorphan and codeine
Q78
A female patient age 63, taking thyroxine 100 microgram tablets daily, has recently been diagnosed with an arrhythmia. She presents with
a prescription for amiodarone 200 mg daily. Which ONE of these clinical tests would be the MOST appropriate follow up?
A Creatinine clearance after 2 weeks
B Monitor thyroid function every 6 months
C Bone mineral density after 6 months
D Full blood examination after 1 week
Q79
Which ONE of the following Gram-negative bacteria is the primary cause of urinary tract infections?
A Escherichia coli
B Helicobacter pylori
C Shigella dysenteriae
D Pseudomonas aeruginosa
Q80
Which ONE of the following side effects is MOST likely to occur with high doses of hydrochlorothiazide?
A Photosensitivity
B Nightmares
C Urinary hesitancy
D Metabolic disturbances
Q81
Primary hyperaldosteronism results in which ONE of the following health outcomes?
A Elevated blood pressure and low plasma potassium
B Increased potassium resorption at the proximal tubule
C Hyperkalemia in most severe cases
D A rapid, often fatal, loss of blood pressure
Patient Profile __________________________________________________________________________________
Patient Name Amanda Brown
Address 115 Goublurn St, Hobart
Age 16
Height 170 cm
Sex Female
Weight 78 kg
Allergies Nil known
DIAGNOSIS
Presenting Complaint:
1. Dysmenorrhoea
Medical History:
1. Mid exercise-induced asthma
LAB / DIAGNOSTIC TESTS
Date
Test
Reference Range
MEDICATION RECORD
Date
Medication
Quantity
Sig
10/02
Terbutaline DPI 500 mcg/dose
1 OP
1-2 doses prn
PHARMACIT’S NOTES
Date
Comment
Nil
Nil
Q82
What is the MOST common adverse effect of alendronate
A Stomatitis
B Hypercalcaemia
C Osteonecrosis of the jaw
D esophagitis
Q83
What medicine therapy would be MOST appropriate for Amanda to relieve the pain of her menstrual cramping?
A Paracetamol
B Paracetamol/codeine
C Mefenamic acid
D Tramadol
Patient Profile __________________________________________________________________________________
Patient Name Audrey Jones
Address Wallaby Aged Care Facility
Age 80
Height 160 cm
Sex Female
Weight 64 kg
Allergies Dried fruit
DIAGNOSIS
Presenting Complaint:
1. Severe epigastric pain
2. Persistent and unresolved nausea
Medical History:
1. Severe dementia (worsening)
2. Transient ischaemic attacks
3. Depression
4. Falls / fractures
5. Osteoporosis
LAB / DIAGNOSTIC TESTS
Date
Test
Reference Range
MEDICATION RECORD
Date
Medication
Quantity
Sig
3/7
Aspirin 300 mg
100
0.5 mane
3/7
Calcitriol 0.25 microgram
100
1 bd
3/7
Calcium carbonate 600 mg
60
1 bd
3/7
Galantamine 16 mg
28
1 daily
3/7
Metoclopramide 10 mg
25
1 tds prn
3/7
Pantoprazole 40 mg
30
1 daily
3/7
Paracetamol 500 mg
200
2 mane
PHARMACIT’S NOTES
Date
Comment
3/7
Medications are current and ongoing.
37/
Recommended doctor review patient’s medicines in light of her exacerbation of epigastric pain and nausea.
3/7
Galantamine 8 mg ceased.
31
Q84
Which ONE of the following treatment options would be the MOST appropriate to relieve Audrey's nausea/vomiting?
A Change metoclopramide dosage to 1 tds regularly
B Add ondansetron 8 mg bd
C Trial discontinuation of galantamine
D Increase pantoprazole dosage to 40 mg bd
Q85
Which ONE of the following tests may be considered to investigate her continuing gastric discomfort?
A Colonoscopy
B B12/Folate
C Urea breath test
D Bronchoscopy
Q86
Which ONE of the following medications is LEAST suitable to manage Audrey's depression?
A Sertraline
B Mirtazapine
C Doxepin
D Moclobemide
Q87
Which ONE of the following medicines is LEAST likely to be contributing to Audrey's nausea/vomiting?
A Galantamine
B Calcitriol
C Aspirin
D Calcium carbonate
Patient Profile __________________________________________________________________________________
Patient Name Cassandra Green
Address 86 North Terrace, Croydon
Age 21
Height 170 cm
Sex Female
Weight 75 kg
Allergies Penicillin (anaphylaxis 10 years ago)
DIAGNOSIS
Presenting Complaint:
1. Pregnant with second child (38 weeks gestation)
Medical History:
1. Recurrent mastitis with previous child
2. Chronic depression
LAB / DIAGNOSTIC TESTS
Date
Test
Reference Range
MEDICATION RECORD
Date
Medication
Quantity
Sig
1/09
Paroxetine 20 mg
30
i daily
PHARMACIT’S NOTES
Date
Comment
Nil
Nil
Q88
What is the LEAST appropriate SSRI for the management of depression during pregnancy?
A Citalopram
B Paroxetine
C Sertraline
D Fluoxetine
Q89
Due to antidepressant use during pregnancy, there is potential for the onset of SSRI withdrawal effects in the newborn. Which ONE of the
following is LEAST likely to occur?
A Drowsiness
B Tremor
C Hyperreflexia
D Difficulty feeding
Q90
Due to complications of mastitis with her previous child, Cassandra decides not to breastfeed this new baby. Which ONE of the following
is the MOST appropriate for the suppression of lactation?
A Metoclopramide
B Domperidone
C Bromocriptine
D Cabergoline
Q91
If Cassandra did develop mastitis, which is the MOST appropriate antibiotic for treatment?
A Flucloxacillin
B Clindamycin
C Ciprofloxacin
D rythromycin
Q92
What is the MOST likely causative organism of mastitis?
A Pseudomonas aeruginosa
B Escherichia coli
C Streptococcus pyogenes
D Staphylococcus aureus
Patient Profile __________________________________________________________________________________
Patient Name Dane Christiansen
Address 85 Holloway Cres, South Port, QLD 4036
Age 63
Height 180 cm
Sex Male
Weight 70 kg
Allergies Nil known
DIAGNOSIS
Presenting Complaint:
1. Hyperglycaemia
Medical History:
LAB / DIAGNOSTIC TESTS
Date
Test
Reference Range
11/5
Blood glucose 9.0 mmol/L
(3-8 mmol/L)
11/5
Serum creatinine 0.17 mmol/L
(0.05-0.12 mmol/L)
11/5
Urate 0.58 mmol/L
(0.2-0.45 mmol/L)
MEDICATION RECORD
Date
Medication
Quantity
Sig
PHARMACIT’S NOTES
Date
Comment
Nil
Nil
Q93
Dane has never had an attack of gout, but his urate level is elevated.
Which ONE of the following is the MOST appropriate action to take?
A Allopurinol to be started at a dose of 100 mg daily
B Colchicine to be started at a dose of 0.5 mcg bd
C Probenecid be started at a dose of 500 mg bd
D No treatment needs to be initiated
Q94
If Dane was started on metformin, which ONE of the following statements is CORRECT in regard to this medication? Metformin:
A can be used in patients with severe renal impairment with careful monitoring.
B can be used in renal impairment but not below a CrCl of 60ml / minute.
C can be used and its dose is not dictated by the state of the renal function.
D can cause renal impairment and it should be ceased until renal impairment has resolved.
Q95
Dane has a number of risk factors for cardiovascular disease. Which ONE of the following would be an additional risk factor?
A Low homocysteine level
B An elevated serum albumin
C Hypertension
D Poor renal function
Q96
Which ONE of the following is the BEST indicator of Dane's ongoing blood glucose control?
A Random blood glucose levels
B 3 monthly HbA1C levels
C Weekly fasting blood glucose levels
D Regular serum creatinine measurements
Patient Profile __________________________________________________________________________________
Patient Name Jane Smyth
Address 32 Smith Street, Ginninderra
Age 18
Height 167 cm
Sex Female
Weight 60 kg
Allergies Nil known
DIAGNOSIS
Presenting Complaint:
1. Worsening acne
Medical History:
1. Cystic acne
2. Failed treatment with doxycycline
3. Failed treatment with cyproterone / ethinylestradiol
LAB / DIAGNOSTIC TESTS
Date
Test
Reference Range
MEDICATION RECORD
Date
Medication
Quantity
Sig
20/12
Isotretinoin 10 mg
60
i mane, ii nocte
20/12
Ethinylestradiol / levonorgesterol
112
i daily
20/12
Doxycycline 100 mg
21
i daily
20/12
Vitamin B complex tablets
90
i daily
PHARMACIT’S NOTES
Date
Comment
20/2
Jane is distressed because her is acne not improving. Jane wants to try benzoyl peroxide cream in addition to isotretinoin. Jane discloses
she regularly fails to the take the evening dose of isotretinoin.
Q97
What is the MOST appropriate advice to give Jane about benzoyl peroxide cream?
A It is not appropriate to use benzoyl peroxide cream when taking isotretinoin
B Exposure to more sunlight would be a better choice than benzoyl peroxide
C She would be better to add in an abrasive exfoliative treatment with the isotretinoin
D She would be better to use a product containing salicylic acid rather than benzoyl peroxide
Q98
Which ONE of the following statements is the MOST appropriate with regard to improving Jane's compliance with isotretinoin therapy?
A Don't worry about the missed doses because the medicine is so potent
B Recommend a once daily dosage regimen in the morning
C Recommend she takes 3 capsules the morning following the missed dose
D Recommend she take 2 capsules in the morning and 1 at night
Q99
Which ONE of the following adverse events is the MOST common during isotretinoin therapy?
A Gastrointestinal upset including diarrhoea
B Dry lips, skin, and mucous membranes
C Aggressive behaviour
D Convulsions
Patient Profile __________________________________________________________________________________
Patient Name Judith Bannis
Address Room number 15
Age 46
Height 170 cm
Sex Female
Weight 63 kg
Allergies Nil known
DIAGNOSIS
Presenting Complaint:
1. Advanced breast cancer
2. Bone metastases
Medical History:
LAB / DIAGNOSTIC TESTS
Date
Test
Reference Range
MEDICATION RECORD
Date
Medication
Quantity
Sig
30/9
Ondansetron 8 mg
iv
i q 8h for 3 days
17/9
Dexamethasone 20 mg
oral
stat
1/9
Doxorubicin 75 mg / m2
iv
every 3 weeks
PHARMACIT’S NOTES
Date
Comment
Nil
Nil
Q100
Judith presents with cardiac failure characterised by shortness of breath and peripheral oedema.
The doxorubicin dose of 75 mg/m2 should be:
A ceased.
B unchanged, as the cardiac failure is unrelated.
C changed to a 6-weekly cycle and reduced to 35 mg.
D changed to daunorubicin 75 mg/m2.
Q101
The MOST likely indication for dexamethasone in Judith's medication profile is as what type of agent?
A Analgesic
B Anti-emetic
C Anti-cancer
D Immunosuppressant
Q102
Which ONE of the following statements about ondansetron is INCORRECT?
A It acts by central and peripheral 5HT3 receptor blockade
B The dose needs to be reduced in severe renal impairment
C It is more effective for acute, rather than delayed, adverse effects of cancer therapy
D It decreases the analgesic effect of tramadol
Patient Profile __________________________________________________________________________________
Patient Name Phillip Derwent
Address 5 Marigold Road, Katoomba
Age 63
Height 180 cm
Sex Male
Weight 80 kg
Allergies Nil known
DIAGNOSIS
Presenting Complaint:
1. Nausea
Medical History:
1. Parkinson’s disease
2. Gastroesophageal reflux
3. Gout
4. Insomnia
LAB / DIAGNOSTIC TESTS
Date
Test
Reference Range
MEDICATION RECORD
Date
Medication
Quantity
Sig
5/11
Levodopa / Carbidopa 200 mg / 50 mg
100
i tds
5/11
Levodopa / Carbidopa 250 mg / 25 mg
100
i mane
5/11
Bromocriptine 5 mg
60
i tds
5/11
Omeprazole 20 mg
30
i mane
5/11
Allopurinol 300 mg
30
i mane
5/11
Diazepam 5 mg
50
i nocte
PHARMACIT’S NOTES
Date
Comment
Nil
Nil
Q103
Which ONE of the following is NOT a sign of worsening Parkinson's disease?
A Dysphagia
B Dyskinesia
C Myopia
D Dystonia
Q104
Phillip is complaining of vomiting and nausea. Which of the following is MOST likely to be prescribed?
A Domperidone
B Prochlorperazine
C Metoclopramide
D Ondansetron
Q105
When converting a patient from standard levodopa/carbidopa formulations to controlled release formulations, which of the following is
INCORRECT?
A Current therapy should be continued for the first two days
B Sustained release preparations have lower oral bioavailability
C The total daily dose of levodopa usually has to be increased
D The frequency of dosing with the controlled release formulations is every 8 to 12 hours
Patient Profile __________________________________________________________________________________
Patient Name Ralph Minter
Address 12 Nemesia Close, Tea Gardens
Age 64
Height 175 cm
Sex Male
Weight 72 kg
Allergies Nil known
DIAGNOSIS
Presenting Complaint:
1. Angina
Medical History:
1. Depression
2. Hypercholesterolaemia
LAB / DIAGNOSTIC TESTS
Date
Test
Reference Range
MEDICATION RECORD
Date
Medication
Quantity
Sig
14/11
Glyceryl trinitrate 600 mcg
100
prn
14/11
Amlodipine 5 mg
30
i mane
30/10
Simvastatin 20 mg
30
i mane
28/10
Fluoxetine 20 mg
28
i mane
3/10
Aspirin 100 mg
112
i mane
PHARMACIT’S NOTES
Date
Comment
3/10
Ralph has indicated he is experiencing nocturnal chest pain.
Q106
Ralph presents to you with a prescription for glyceryl trinitrate patches 10 mg/24hr. What is the MOST appropriate regimen for Ralph for
the use and application of glyceryl trinitrate patches?
A Mane and leave on 24 hours
B Mane and take off at 10pm
C Only when pain is experienced and leave on for 2 days
D In the late afternoon and remove in the morning
Q107
In an acute angina attack, which ONE of the following is the MOST appropriate way to use glyceryl trinitrate sublingual tablets?
A Dissolve 1 tablet under the tongue and wait 5 minutes. Call an ambulance if pain persists
B Dissolve 1/2 to 1 tablet under the tongue and repeat if pain persists. Call an ambulance if 2 repeats over 10 minutes do not
relieve pain
C Dissolve 1/2 to 1 tablet under the tongue. Call an ambulance if pain is not relieved after 15 minutes
D Dissolve 1 tablet under the tongue and repeat every 3 minutes if pain persists. Call an ambulance if 4 repeats over 15 minutes do not
relieve pain
Q108
Following the initiation of therapy with fluoxetine in this patient, the maximal anti-depressant effects is MOST likely achieved after:
A 1 week
B 10 days
C4 weeks
D 12 weeks
Q109
Along with swelling of the ankles, which ONE of the following side effects is MOST commonly observed with amlodipine?
A Cough
B Sedative medications
C Chest pain
D Dizziness
Patient Profile __________________________________________________________________________________
Patient Name Stephen White
Address 14 John Street, Howden
Age 70
Height 178 cm
Sex Male
Weight 93 kg
Allergies Nil known
DIAGNOSIS
Presenting Complaint:
1. Exacerbation of osteoarthritic pain
Medical History:
1. Chronic heart failure
2. Myocardial infarction
3. Depression
LAB / DIAGNOSTIC TESTS
Date
Test
Reference Range
12/11
Creatinine 0.160 mmol/L
(0.045-0.090 mmol/L)
MEDICATION RECORD
Date
Medication
Quantity
Sig
10/11
Aspirin EC 100 mg
112
i mane
10/11
Carvedilol 3.123 mg
30
i bd
10/11
Fluoxetine 20 mg
28
i mane
10/11
Frusemide 40 mg
100
ii mane
10/11
Paracetamol 500 mg
100
ii qid
10/11
Ramipril 2.5 mg
30
i mane
10/11
Simvastatin 80 mg
30
i nocte
PHARMACIT’S NOTES
Date
Comment
10/11
Stephen is experiencing an exacerbation of arthritic pain in both knees.
Q110
Which ONE of the following would be MOST appropriate to add to paracetamol for the treatment of osteoarthritis of the knee in Stephen?
A Tramadol SR 200 mg tablet twice daily
B Celecoxib tablet 200 mg once daily
C Fentanyl patch 12.5 microgram every 3 days
D Diclofenac gel four times a day
Q111
Which ONE of the following is NOT a potential adverse effect of Stephen's carvedilol treatment?
A Bronchospasm
B Insomnia
C Tachycardia
D Heart failure
Q112
Which ONE of the following would be a suitable alternative to carvedilol in Stephen?
A Atenolol
B Bisoprolol
C Propranolol
D Pindolol
Q113
Stephen presents a prescription for clarithromycin to treat a respiratory infection. Which ONE of the following recommendations should
you make to the treating doctor?
A Withhold fluoxetine for the duration of the antibiotic
B Increase dose of fluoxetine for the duration of the antibiotic
C Withhold simvastatin for the duration of the antibiotic
D Change simvastatin to atorvastatin for the duration of the antibiotic
Patient Profile __________________________________________________________________________________
Patient Name Thomas Bean
Address 32 Hickory Drive, Melamine
Age 3 years, 2 months
Height 120 cm
Sex Male
Weight 14 kg
Allergies Rash
DIAGNOSIS
Presenting Complaint:
1. Pain and fever
Medical History:
1. Otitis media
LAB / DIAGNOSTIC TESTS
Date
Test
Reference Range
17/3
Temperature 380C
36.80C plus / minus 0.4 degree
MEDICATION RECORD
Date
Medication
Quantity
Sig
PHARMACIT’S NOTES
Date
Comment
10/11
Thomas has been experiencing localised pain in the ear for 2 days, which has not resolved with regular paracetamol use.
Q114
If Thomas' mother is using paracetamol mixture 100 mg/mL, what directions are MOST appropriate for Thomas?
A 1.4 mL 4 hourly, maximum 5 doses in 24 hours
B 2.1 mL 4-6 hourly, maximum 4 doses in 24 hours
C 4.2 mL 4-6 hourly, maximum 4 doses in 24 hours
D 1.2 mL 4-6 hourly, maximum 4 doses in 24 hours
Q115
After 5 days of treatment, Thomas develops severe diarrhoea with the antibiotics that he is using. Which ONE of the following is the
MOST appropriate treatment?
A Cease the antibiotics and encourage fluids
B Cease antibiotic and use loperamide 2 mg stat and after each loose bowel motion
C Continue the antibiotics and encourage fluids
D Continue the antibiotics and use loperamide 2 mg stat and after each loose bowel motion
Q116
Which ONE of the following organisms is MOST likely to cause otitis media?
A Staphylococcus aureus
B Escherichia coli
C Streptococcus pneumonie
D Mycoplasma pneumoniae
Patient Profile __________________________________________________________________________________
Patient Name Thomas Jones
Address 3 Wirraway Lane, Aspley
Age 7 weeks
Height 16 cm
Sex Male
Weight 3 kg
Allergies Rash
DIAGNOSIS
Presenting Complaint:
1. Colic
Medical History:
1. Premature birth (34 weeks gestation)
2. Poor weight gain
3. Feeing problems
LAB / DIAGNOSTIC TESTS
Date
Test
Reference Range
MEDICATION RECORD
Date
Medication
Quantity
Sig
PHARMACIT’S NOTES
Date
Comment
10/11
Thomas’ mother requests ‘helpful’ advice on a range of issues, including colic, immunisation and cot death.
She thinks her son has colic as he has been unsettled over the last few days and asks for advice.
Q117
Which ONE of the following statements about colic is INCORRECT?
A It usually ends when the child is 3-4 months of age
B The child will be otherwise thriving
C It often starts within the first month of life
D Various successful treatments exist
Q118
In regards to colic, which ONE of the following practices is NOT recommended?
A Continuation of breast feeding
B Reduction of environmental stimulation
C Adherence to routines
D Change of usual feed times
Q119
Thomas is due to have his scheduled 2-month vaccination soon.
Which ONE of the following diseases/organisms is NOT immunised against with the Australian Standard Vaccination Schedule at two
months?
A Measles
B Tetanus
C Haemophilus influenzae B
D Streptococcus pneumoniae
Q120
Thomas' mother has also heard a lot about 'cot death' (Sudden Infant Death Syndrome; SIDS) and enquires about the current
recommendations to prevent 'cot death'.
Which ONE of the following statements of advice is INCORRECT, with regard to the baby?
A The baby should be placed on its side
B The baby should not be over wrapped
C The use of antihistamines should be avoided
D Exposure to cigarette smoke should be avoided
Patient Profile __________________________________________________________________________________
Patient Name Tim Bowes
Address 18 Poppy Parade, Waterford
Age 34
Height 182 cm
Sex Male
Weight 85 kg
Allergies Penicillin (rash)
DIAGNOSIS
Presenting Complaint:
1. Community-acquired pneumonia (mild persistent)
2. Pneumonia Severity Index (PSI) = Class 1
Medical History:
1. Asthma
LAB / DIAGNOSTIC TESTS
Date
Test
Reference Range
MEDICATION RECORD
Date
Medication
Quantity
Sig
15/11
Prednisolone 5 mg
60
vii mane
5/11
Budesonide 40 mcg / dose
DPI
ii puffs bd
5/10
Beclometasone 100 mcg / dose
MDI
ii puffs bd
5/10
Salbutamol 100 mcg / dose
MDI
ii puffs q4h prn
PHARMACIT’S NOTES
Date
Comment
5/10
Continuing therapy. Confirmed non-smoker.
Q121
What is the MOST common side effect of inhaled corticosteroids?
A Dysphonia (difficulty speaking)
B Cataracts
C Dysphagia (difficulty swallowing)
D Weight gain
Q122
Tim asks whether antihistamines would help his asthma.
Which ONE of the following is the MOST appropriate advice?
A Antihistamines are relatively contraindicated in asthmatics
B Antihistamines are helpful in symptom control in all asthmatics
C Sedating antihistamines are more appropriate than non-sedating antihistamines
D Antihistamines may help if the patient's asthma has an allergic component
Q123
What is the MOST appropriate treatment for Tim for community acquired pneumonia?
A Roxithromycin
B Doxycycline
C Gentamicin
D Trimethoprin with sulfamethoxazole
Q124
Following resolution of his pneumonia, Tim still does not have good control of his asthma.
What is the MOST appropriate treatment option to help him get control of his asthma?
A Add salmeterol 50 mcg ii puffs bd
B Change budesonide to fluticasone 500 mcg DPI ii puffs bd
C Add tiotropium 18 mcg daily
D Increase budesonide to iii puffs bd
Q125
Tim is commencing budesonide, what other change(s) should be made to his medication?
A Cease beclomethasone, as effects are additive
B Decrease beclomethasone dosage to 100 mcg/dose i puff bd
C Step down beclomethasone, as stopping abruptly may precipitate an attack
D Continue beclomethasone, as these two medications act on different receptors
End of the Examination
Sample 2
1
What volume of 2% potassium permanganate solution is required in order to provide 200ml of
75mg/5ml potassium permanganate solution?
A
15ml
B
30ml
C
150ml
D
1500ml
E
450ml
2
In which schedule of the Standard for the Uniform Scheduling of Medicines and Poisons would
you find codeine tablets 30mg?
A
Schedule 2
B
Schedule 3
C
Schedule 4
D
Schedule 8
E
Unscheduled
3
Substances, the safe use of which requires professional advice, but which should be available to the
public from a pharmacist without a prescription” is the general description statement for which ONE of
the following Poisons Schedules?
A
Schedule 2
B
Schedule 3
C
Schedule 4
D
Schedule 5
E
Schedule 6
4
What does Regulation 24 of the Pharmaceutical Benefits Scheme (PBS) refer to?
A
No requirement for a patient co-payment
B
Application to patients with specific medical conditions only
C
Supply of original and all of the repeats to be supplied at the one time
D
Application to patients from a remote area where access to PBS supplies is limited
E
Increasing the maximum quantity or number of repeats of a prescription
5
A prescription item designated as an unrestricted PBS benefit item is BEST described as a medication:
A
That has no PBS determinations on its therapeutic use
B
With a low therapeutic index, which requires close monitoring
C
That can only be prescribed on the PBS for specific therapeutic uses
D
That is restricted and requires prior approval from the Medicare Australia or the Department of
Veterans Affairs for a specific condition
E
With a high chance of adverse events, which requires the prescriber to consider
carefully the risk benefit ratio for each specific patient
6
According to the Standard for the Uniform Scheduling of Medicines and Poisons, what medicine is
classified in Schedule 4?
A
Prescription only medicine
B
Pharmacist only medicine
C
Controlled drug
D
Pharmacy medicine
E
Dangerous poison
7
What weight of potassium permanganate is required to produce 200 mL of solution such that 50 mL
of this solution diluted to 200 mL will produce a 1 in 400 solution?
A
0.2 g
B
0.4 g
C
1g
D
2g
E
4g
8
What is the ideal body weight for a 34 year old male who is 182 cm tall (of average frame)?
A
77 kg
B
82 kg
C
87 kg
D
92 kg
E
97 kg
9
An adult patient is stabilised on 0.2g twice a day of an oral medicine. What is the intravenous dose of
the same medicine where the IV equivalent dose is 30% of the total daily oral dose?
A
1300mcg/hour
B
5000mcg/hour
C
6600mcg/hour
D
2750mcg/hour
E
500mcg/hour
10
11
12
An 8 year old child (weight 25 kg) has been diagnosed with meningitis. She has been prescribed
dexamethasone at a dose of 0.6 mg/kg/day in four divided doses, for two days. What is the total DAILY
dose of dexamethasone prescribed?
A
6 mg
B
15 mg
C
25 mg
D
30 mg
E
90 mg
A baby (weighing 3.75kg) requires frusemide at 1.6mg/kg/day for 30 days. You have several 30mL
bottles of frusemide solution (10mg/mL) in stock. What is the required total daily dose of frusemide
solution?
A
0.6 mL
B
3.0 mL
C
4.8 mL
D
6.0 mL
E
18 mL
ZINC AND CASTOR OIL OINTMENT
Zinc oxide
7.5g
Castor oil
50.0g
Cetostearyl alcohol
2.0g
White beeswax
10.0g
Arachis oil
30.5g
The wt/mL of castor oil is 0.95 g.
The volume of castor oil required to make 500 g of this ointment is
A
210mL
B
225mL
C
237mL
D
250ml
E
263mL
13
14
15
A patient (height 1.7 m, weight 69 kg) is being treated for Hodgkin's disease with dacarbazine 210
mg/m2 on day 1 and day 15 of each 28 day cycle. What dose of dacarbazine is administered on
day 15 of the cycle?
A
208 mg
B
379 mg
C
675 mg
D
1219 mg
E
1350 mg
According to the Standard for the Uniform Scheduling of Medicines and Poisons, what classification does
cyproheptadine hydrochloride 4mg (50) tablets belong to?
A
Prescription only medicine
B
Pharmacist only medicine
C
Unscheduled
D
Pharmacy medicine
E
Controlled drug
Where can items to be recorded on Prescription Record Forms (PRFs) be recorded?
A
Community pharmacies and approved hospitals
B
Community pharmacies only
C
Medical clinics and community pharmacies
D
Approved hospitals and medical clinics
E
Community pharmacies and community health centres
16
17
18
Buprenorphine is classified in Schedule 8 in the Standard for the Uniform Scheduling of Medicines and
Poisons. What sort of medicine is Buprenorphine?
A
Prescription only medicine
B
Pharmacist only medicine
C
Controlled drug
D
Pharmacy medicine
E
Dangerous poison
What is the specific antidote for dabigatran?
A
Protamine sulfate
B
Vitamin K
C
Antifactor Xa
D
Vitamin E
E
There is no specific antidote
Patients with chronic pain are occasionally enrolled in double blind analgesic infusion studies at pain
clinics. The studies involve the infusion of a pseudorandom, equi- volumetric sequence of normal saline,
lignocaine, thiopentone and fentanyl. The effect on the pain score for each of these agents is reported by
the patient. The patient is unaware of the sequence.
Why is lignocaine included in these studies?
A
It causes a diffuse pain state
B
It acts as a ‘truth serum’
C
A response suggests neuropathic pain
D
It causes euphoria similar to opioids
E
A response suggests opioid-resistant pain
19
20
21
When administered intravenously, which of the following medications should only be given by infusion?
A
Ceftazidime
B
Hydrocortisone
C
Vancomycin
D
Metoclopramide
E
Adenosine
A patient is prescribed methotrexate for rheumatoid arthritis. Which of the following recommendations
should you give them?
A
Take 10mg of folic acid daily to prevent side effects
B
Start intramuscular or subcutaneous therapy
C
Continue the medication for at least 6 months to determine response
D
Have renal and liver function checked every 6 months during therapy
E
Avoid excessive or prolonged sun exposure
A patient with chronic back pain, related to a motor vehicle accident, is taking tramadol with good effect.
She is started on an antidepressant, sertraline, by her doctor.
In regards to these medications, the occurrence of which of the following side effects should MOST
concern you?
A
Visual disturbances, drowsiness
B
Constipation, sweating
C
Hyperreflexia, agitation
D
Hypertension, fatigue
E
Dizziness, insomnia
22
23
24
Children experience different Adverse Drug Reactions (ADRs) to adults. Which of the following
statements regarding ADRs in children is INCORRECT?
A
Severe skin reactions with lamotrigine are more frequently seen in children than in adults
B
There is a risk of tooth discolouration with tetracyclines used in children aged up to 8 years of
age
C
Aspirin should not be used routinely in children because of the risk of Kawasaki's
disease
D
Quinolones should be used with caution in children because of the risk of arthropathies
E
Valproate hepatotoxicity is seen most frequently in children less than 3 years of age
When used to treat congestive heart failure (CHF), frusemide
A
Must be used with digoxin for optimal effect
B
Should be combined with an angiotensin converting enzyme inhibitor or an angiotensin II
receptor antagonist
C
Can only be used if spironolactone is also prescribed
D
Is not as effective as a thiazide
E
Must be given with supplemental potassium
Which one of the following medications is the MOST appropriate for the treatment of trigeminal
neuralgia?
A
Tramadol
B
Carbamazepine
C
Morphine SR
D
Indomethacin
E
Paracetamol/codeine
25
26
27
A female customer has been taking digoxin for an extended period. She presents to your pharmacy
with a prescription for herself that is a 10 day course of roxithromycin tablets. What is the MOST
appropriate action to take?
A
Dispense the prescription and counsel her on the use of her antibiotics over the next 10
days
B
Consult her general practitioner to advise that roxithromycin may decrease digoxin levels
C
Advise her to contact her general practitioner immediately, should she experience
symptoms of digoxin toxicity
D
Consult her general practitioner to advise that the combination should be avoided due to
a significant drug interaction
E
Advise her to take the medications separately to reduce the likelihood of potential drug
interaction
Which of the following combinations of pharmacological effects would be produced by timolol?
A
Inotropic, positive chronotrope
B
Not cardiovascular selective, positive chronotrope
C
Cardiovascular selective, positive chronotrope
D
Not cardiovascular selective, negative chronotrope
E
Cardiovascular selective, negative chronotrope
A 25 year old female customer presents you with a prescription for levocabastine eye drops 0.05% 1
drop twice daily for seasonal allergic conjunctivitis. Which of the following advice is INCORRECT?
A
Use the drops regularly, as it may take several days for symptom relief
B
You may feel drowsy and the effects of alcohol may be increased
C
The drops are proven to be safe to use during pregnancy
D
Side effects may include stinging, mild eye irritation and headache
E
The frequency of use may be increased to three to four times daily if necessary
28
29
30
A male patient, aged 59 years, presents a prescription for sotalol 80 mg tablets, with a dose of 160 mg
daily. He has never taken sotalol before. How should you advise him to take this medication?
A
Once a day without regard to meals
B
Twice a day on an empty stomach
C
Once a day on an empty stomach
D
Twice a day with or immediately after food
E
Once a day at bedtime
With which of the following medications is it MOST important to maintain a high fluid intake?
A
Spironolactone
B
Indapamide
C
Norfloxacin
D
Cephalexin
E
Frusemide
The refrigerator in the pharmacy that is used for storage of pharmaceutical products should be kept at
a temperature of
A
0-3 oC
B
2-8 oC
C
5-10 oC
D
6-12 oC
E
Minus 3-8 oC
31
A frail female customer presents with a repeat prescription for verapamil sustained release 240 mg
tablets - half a tablet to be taken twice daily. She also presents a new prescription for erythromycin 250
mg qid (to treat a chest infection).
What is the MOST appropriate recommendation to make to the prescriber?
32
A
Change the antibiotic to ciprofloxacin, because it is the medication of choice for upper respiratory
tract infection
B
Change the antibiotic to doxycycline, because it is the medication of choice for communityacquired pneumonia
C
Increase the erythromycin to 500 mg qid, because verapamil increases the metabolism of
erythromycin
D
Change to another antibiotic because erythromycin could lead to increased plasma
concentration of verapamil in this patient
You make the following ointment for a female patient who has psoriasis
Coal Tar Solution
Dithranol
Yellow Soft Paraffin to 100 g
8%
0.25 %
The patient has not had this preparation before. Which of the following statements is
INCORRECT?
33
A
Erythema may occur
B
Ointment may stain the skin and hair
C
Ointment may stain bed linen and clothing
D
Avoid contact with the eyes and any broken skin
E
Improvement of condition can be expected within a few days, if used regularly
With which of the following medications is it recommended that alcohol consumption be avoided?
A
Digoxin
B
Ramipril
C
Sulphasalazine
D
Lorazepam
E
Aspirin
34
35
36
A patient comes into the pharmacy with a prescription for rifampicin 600mg. Looking through her profile you
see she is on an oral contraceptive. Which of the following is MOST appropriate advice for this patient?
A
Use a second method of oral contraception during treatment and for 4 weeks after the last
dose
B
Skip any inactive tablets in the present pack and then proceed to the active tablets in a new
pack
C
Use a second method of contraception and continue this until 7 days after completion of
the course of rifampicin
D
A typical course of rifampicin does not affect oral contraception
E
A second method of contraception will only be required if the rifampicin causes breakthrough
bleeding
A regular patient returns to the pharmacy complaining that her fluticasone inhaler dispensed last
week isn't providing improvement of her asthma symptoms. What would be the BEST course of
action?
A
Contact the doctor and suggest a change to fluticasone/salmeterol inhaler
B
Suggest she continues the medication, but refer her to her doctor
C
Suggest she takes an antihistamine in addition to fluticasone and see her doctor if she
has no relief in three to four days
D
Check her inhaler technique, advise her to continue treatment and see her doctor if there is
no improvement
E
Recommend she commences regular salbutamol with a spacer and see her doctor in two
days if no relief
A patient has heartburn. After questioning him, which one of the following factors would NOT
necessitate a referral to a doctor?
A
Sudden weight loss
B
Blood in stools
C
Difficulty swallowing
D
Bloating and reflux
E
History of taking NSAIDs
37
38
39
40
Which one of the following conditions has NOT been traditionally treated by Gingko?
A
Vertigo
B
Memory loss
C
Poor concentration
D
Bloating
E
Chilblains
A patient with diverticular disease is instructed to take a laxative. Which of the following should
you recommend?
A
Senna tablets
B
Sodium picosulfate drops
C
Glycerol suppositories
D
Ispaghula husk sachets
E
Bisacodyl tablets
Which of the following is NOT a sign/symptom of head lice?
A
Itch, especially toward back of neck
B
Blotchy flat, red rash behind ears and on face
C
Tiny dark lice on scalp
D
White specks stuck to base of hair shaft
E
White specks spread throughout hair
Which one of the following factors is LEAST likely to precipitate the onset of herpes labialis?
A
Common cold
B
Sun exposure
C
Trauma to the lips
D
Dental decay
E
Immunosuppression
41
Which one of the following conditions is LEAST likely to cause rectal bleeding?
A
Haemorrhoids
B
Crohn's disease
C
Colorectal cancer
D
Anal fissure
E
Irritable bowel syndrome
PATIENT PROFILE
Patient Name:
John Ascot
Address:
Room Number 48
Age:
68
Height:
168cm
Sex:
Allergies:
Male
Sticking plaster
Weight:
78kg
Diagnosis
Presenting Complaint:
Medical History:
1.
2.
1.
2.
3.
4.
5.
Shortness of breath
Fainting
Heart failure
Asthma
Hypertension
Gout
Depression
Laboratory / Diagnostic Tests
Date
Test
+
10/11
K =3.2 mmol/L
Reference Range
(3.5 - 5.0 mmol/L)
30/10
Cr=0.11 mmol/L
(0.05 - 0.12 mmol/L)
30/10
+
K =3.6 mmol/L
(3.5 - 5.0 mmol/L)
Medication Record
Date
Medication
2/11
Frusemide 40mg
Quantity
100
Sig
ii daily
30/10
30/10
Amlodipine 10mg
Beclomethasone 100mcg/dose
30
mdi
i mane
ii bd
30/10
Fluoxetine 20 mg
28
i daily
30/10
Frusemide 40mg
100
i mane
30/10
30/10
Perindopril 4mg
Potassium Slow Release 600 mg
30
100
i daily
ii daily
30/10
Salbutamol 5mg/2.5mL
60
i prn neb
30/10
Simvastatin 40 mg
30
i nocte
Pharmacist's Notes
DIETARY CONSIDERATIONS
30/10 Low fat/low salt diet
42
43
44
Which one of the following combinations of medications is treating the patient's heart failure?
A
Perindopril and amlodipine
B
Amlodipine, frusemide and perindopril
C
Perindopril and frusemide
D
Simvastatin and perindopril
E
Simvastatin, perindopril and amlodipine
If the patient had an acute attack of gout while in hospital, which one of the following would be the
MOST appropriate medication?
A
Allopurinol
B
Paracetamol
C
Colchicine
D
Aspirin
E
Indomethacin
While in hospital the patient acquires infective endocarditis, with positive blood cultures for
methicillin-resistant Staphylococcus aureus. Which of the following antibiotics would be the
MOST effective?
A
Cefoxitin
B
Ticarcillin/clavulanic acid
C
Vancomycin
D
Flucloxacillin
E
Cefotaxime
45
46
The patient's potassium levels are found to be low. Which one of the following combinations of
medication is MOST likely to be the cause?
A
Simvastatin and perindopril
B
Perindopril and frusemide
C
Salbutamol and amlodipine
D
Frusemide and salbutamol
E
Amlodipine and simvastatin
Which one of the following is NOT an adverse effect normally associated with fluoxetine?
A
Anxiety
B
Insomnia
C
Sexual dysfunction
D
Weight loss
E
Urinary retention
***
END OF PATIENT PROFILE
***
PATIENT PROFILE
Patient Name:
Veronica Shallay
Address:
66 Wilkes Street, Sherbrooke VIC 3804
Age:
17
Height:
160cm
Sex:
Female
Weight:
54kg
Allergies:
Nil Known
Diagnosis
Presenting Complaint:
Medical History:
1. Severe acne with scarring
Laboratory / Diagnostic Tests
Date
Test
Medication Record
Date
Medication
3/6
Isotretinoin 20 mg
Pharmacist's Notes
3/6 The patient has been to a dermatologist for review.
Reference Range
Quantity
60
Sig
ii daily
47
48
49
When counselling this patient, you should emphasise that pregnancy must be avoided whilst on isotretinoin
and for what period of time afterwards?
A
14 days
B
30 days
C
60 days
D
Three months
E
Six months
Side effects of oral isotretinoin include all of the following EXCEPT
A
Dry eyes
B
Photosensitivity
C
Mood changes
D
Dry skin
E
Skin atrophy
Which of the following regarding this patient's acne is NOT appropriate advice?
A
Avoid oil-based makeup
B
Avoid topical anti-acne preparations
C
The skin should be exfoliated twice daily
D
Acne may be due to changes in hormonal levels
E
Do not squeeze pustules as this can worsen scarring
***
END OF PATIENT PROFILE
***
PATIENT PROFILE
Patient Name:
Irene Trotter
Address:
45 Laurel Lane, Madison
Age:
55
Height:
170cm
Sex:
Allergies:
Female
Sulfonamides
Weight:
65kg
Diagnosis
Presenting Complaint:
Medical History:
1. Regular check-up with general practitioner
1. Glaucoma
2. Asthma
3. Heart failure
Laboratory / Diagnostic Tests
Date
Test
Medication Record
Date
Medication
18/8
Dorzolamide eye drops 2 %
Reference Range
Quantity
5 ml
Sig
i tds
20/7
Budesonide 400 mcg
1
ii bd
16/7
Timolol 0.25 % eye drops
5 mL
i bd
20/1
Beclomethasone MDI 100mcg/actuation
1
i bd
20/1
Enalapril 20 mg
30
i mane
20/1
Pilocarpine 2 % Eye Drops
5 mL
i qid
20/1
Salbutamol MDI 100mcg/actuation
2
i-ii prn
Pharmacist's Notes
20/7 Budesonide replaced beclomethasone inhaler due to worsening asthma. 18/7 Timolol eye
drops ceased.
16/7 Timolol commenced.
9/7 Pilocarpine ceased due to severe stinging.
50
51
52
Which one of the following is the LEAST appropriate for the treatment of Mrs Trotter's open angle
glaucoma?
A
Travoprost
B
Pilocarpine
C
Latanoprost
D
Brimonidine
E
Bimatoprost
Mrs Trotter was transferred from pilocarpine to timolol. Which of the following statements is
CORRECT? Timolol causes:
A
Miosis
B
Tachycardia
C
Less bronchospasm than betaxolol
D
Bradycardia
E
Mydriasis
Dorzolamide is contraindicated for glaucoma in patients with:
A
Reversible airways disease
B
A heart-rate less than 50 beats per minute
C
Severe iritis
D
Severe allergy to co-trimoxazole
E
Depression
PATIENT PROFILE
Patient Name:
Valma King
Address:
14 King Street, Sandy Bay
Age:
56
Height:
162cm
Sex:
Allergies:
Female
Nil known
Weight:
60kg
Diagnosis
Presenting Complaint:
Medical History:
1. Peripheral oedema.
2. Increasing frequency of seizure
1. Epilepsy
2. Hypertension
3. Osteoarthritis
4. Depression
Laboratory / Diagnostic Tests
Date
Test
Medication Record
Date
Medication
7/10
Amoxycillin 500 mg
Reference Range
Quantity
20
Sig
i tds
7/10
Fluoxetine 20mg
28
i nocte
10/7
Frusemide 40mg
100
i mane
10/5
Indomethacin 25 mg
100
i bd
10/5
Lercanidipine 20mg
30
i daily
10/5
Phenytoin 100 mg
200
i tds
Pharmacist's Notes
07/10 Respiratory infection
53
54
55
Which medication is MOST likely to worsen Mrs King's hypertension control?
A
Amoxycillin
B
Frusemide
C
Fluoxetine
D
Phenytoin
E
Indomethacin
Which ONE of the following medications is MOST likely causing Mrs King's legs to swell?
A
Phenytoin
B
Lercanidipine
C
Fluoxetine
D
Frusemide
E
Indomethacin
Following a change in the dose of phenytoin, how much time should be allowed to elapse before
measuring steady state phenytoin levels again?
A
Twenty-four hours
B
Two days
C
One week
D
Three weeks
E
One month
***
END OF PATIENT PROFILE
***
PATIENT PROFILE
Patient Name:
Mr Ahmed Hallad
Address:
142 Sydney Road, Brunswick
Age:
65
Height:
165cm
Sex:
Allergies:
Male
Penicillin (rash)
Weight:
60kg
Diagnosis
Presenting Complaint:
Medical History:
1. Shingles (herpes zoster)
1. Hypertension
2. High cholesterol
3. Transient ischaemic attacks
Laboratory / Diagnostic Tests
Date
Test
Medication Record
Date
Medication
18/2
Aspirin 100 mg
Reference Range
Quantity
100
Sig
i nocte
18/2
Pravastatin 40mg
30
i nocte
18/2
Ramipril 10mg
30
i nocte
Pharmacist's Notes
18/2
Has been taking aspirin, pravastatin and ramipril for more than 5 years.
Has had compliance problems – prefers to take the least number of tablets and all of his tablets
at once if possible.
56
57
58
Herpes zoster can respond to antiviral therapy if therapy is begun within which of the following time
frames (of onset of symptoms)?
A
12 hours
B
24 hours
C
48 hours
D
72 hours
E
One week
Which of the following medications would be the MOST suitable option to treat Mr Hallad's
shingles?
A
Famciclovir
B
Cephalexin
C
Aciclovir
D
Amoxycillin
E
Ritonavir
Which of the following is the MOST appropriate topical agent in this instance?
A
Capsaicin cream
B
A moisturiser
C
Aqueous cream
D
0.5% hydrocortisone cream
E
A hydrogel
59
60
Post-herpetic neuralgia is a painful condition that can occur after an attack of shingles. Which of the
following preparations is NOT used in the treatment of post-herpetic neuralgia?
A
Lignocaine 5% applied topically
B
Gabapentin
C
Carbamazepine
D
Phenelzine
E
Amitriptyline
Mr Hallad should be encouraged to be immunised against influenza and pneumococcal
disease. Which of the following statements is INCORRECT?
Mr Hallad
A
Should receive both the pneumococcal conjugate and the polyvalent vaccines
B
Can be immunised against influenza and pneumococcal by having the vaccines
administered on the same day
C
Should be re-vaccinated yearly for the influenza vaccine, to match the current circulating virus
D
May experience pain at the injection site and 'flu-like' symptoms
E
Should receive the pneumococcal polyvalent vaccine
***
END OF PATIENT PROFILE
***
PATIENT PROFILE
Patient Name:
Charles Xue
Address:
5 Agapanthus Lane, Wittaker
Age:
63
Height:
180cm
Sex:
Allergies:
Male
Nil known
Weight:
70kg
Diagnosis
Presenting Complaint:
Medical History:
1. Lung cancer
1. Chronic obstructive pulmonary disease (COPD)
Laboratory / Diagnostic Tests
Date
Test
Medication Record
Date
Medication
10/11
Morpine sulfate SR 30mg
Reference Range
Quantity
20
Sig
i bd
3/11
Morphine Mixture 5mg/mL
200mL
3ml qid
3/11
Prednisolone 5mg
30
i daily
3/11
Salbutamol 5mg/2.5mL
60
i qid
3/11
Tiotropium 18mcg
30
i daily
Pharmacist's Notes
10/11 Palliative care
10/11 Patient to incorporate sustained release morphine therapy and cease existing morphine sulfate
mixture.
61
62
63
Mr Xue presents with an initial prescription for sustained release morphine and asks your advice about
when to start it. You should advise him to commence the first dose
A
With the usual dose of morphine mixture tonight. Take the tablets 12 hourly ie 8am, 8pm
B
4 hours after the usual dose of morphine mixture tonight. Take the tablets 12 hourly ie 8am,
8pm
C
8 hours after the usual dose of morphine mixture tonight. Take the tablets twice a day when you
get up and when you go to bed
D
4 hours after the usual dose of morphine mixture tonight. Take subsequent doses when in pain
Given the current dose of slow release morphine, which of the following is the MOST
appropriate dose of morphine mixture for breakthrough pain?
A
0.4 to 0.8 mL
B
1 to 2 mL
C
3 to 4 mL
D
4 to 5 mL
E
6 to 8 mL
Mrs Xue states that her husband is constipated. He has been taking psyllium regularly but it doesn't
seem to help. Which of the following would be the laxative regimen of choice?
A
Liquid paraffin emulsion 45ml at night and increase the psyllium
B
Docusate and sennosides 1-2 tablets twice daily and maintain the psyllium
C
1 micro-enema and cease the psyllium
D
Bisacodyl suppositories (2 at night) and cease the psyllium
E
Glycerin adult suppositories
64
***
When prescribing morphine therapy for Mr Xue, all of the following are important considerations
EXCEPT
A
Attention to appropriate aperients (laxatives)
B
Attention to appropriate anti-emetics
C
Ensuring the dose is effective
D
Ensuring adequate supplies of medication
E
Ensuring dose does not exceed recommended maximum
END OF PATIENT PROFILE
***
PATIENT PROFILE
Patient Name:
Bob Roberts
Address:
Room Number 78 Fairview Nursing
Home
Age:
90
Height:
183cm
Sex:
Male
Weight:
55kg
Allergies:
Nil known
Diagnosis
Presenting Complaint:
Medical History:
1. Painful knee
2. Immobility
3. Falls
1. Constipation
2. Gastrointestinal reflux
3. Prostatic hypertrophy
4. Mild dementia
Laboratory / Diagnostic Tests
Date
Test
14/10
BP 130/90 sitting
14/10
Reference Range
100/90 standing
Serum creatinine 0.11mmol/L
Medication Record
Date
Medication
14/10
Fluoxetine 20mg
(0.05 - 0.12mmol/L)
Quantity
28
Sig
½ mane
14/10
Risperidone 1mg
60
i nocte
5/9
Allopurinol 300mg
60
i nocte
5/9
Tamsulosin 0.4mg
28
i daily
6/3
Lactulose 0.67g/mL
500mL
15mL nocte
6/3
Naproxen Oral liquid 25mg/mL
474mL
20mL bd
6/3
Ranitidine 150mg
30
bd
Pharmacist's Notes
20/10 Recommend naproxen be discontinued and replaced with paracetamol 500mg ii q 6 hours.
65
66
67
Which of Mr Roberts' medications has been associated with an increase in the incidence of
cerebral strokes?
A
Risperidone
B
Fluoxetine
C
Allopurinol
D
Ranitidine
E
Tamsulosin
Which of the following medications is MOST likely to have contributed to Mr Roberts' postural
hypotension?
A
Risperidone
B
Allopurinol
C
Naproxen
D
Lactulose
E
Ranitidine
Which of the following medications is MOST likely to cause skin rash in this patient?
A
Tamsulosin
B
Naproxen
C
Risperidone
D
Fluoxetine
E
Allopurinol
68
69
Which of the following daily doses of allopurinol should you recommend to Mr Roberts' doctor, as
appropriate to use in this patient?
A
100mg
B
300mg
C
400mg
D
500mg
Which of the following medications is MOST extensively cleared unchanged by the renal route?
A
Ranitidine
B
Risperidone
C
Naproxen
D
Allopurinol
E
Paracetamol
***
END OF PATIENT PROFILE
***
PATIENT PROFILE
Patient Name:
Mary Johnson
Address:
7 Primrose Street, Cornly VIC 3052
Age:
57
Height:
166cm
Sex:
Female
Weight:
78kg
Allergies:
Nil known
Diagnosis
Presenting Complaint:
Medical History:
1. Menopause
Laboratory / Diagnostic Tests
Date
Test
Medication Record
Date
Medication
3/10
Norethisterone 5 mg
3/10
Oestradiol 2 mg
Pharmacist's Notes
Nil
Reference Range
Quantity
30
Sig
½ daily
56
ii daily
70
71
***
Mrs Johnson complains of breakthrough bleeding. Which of the following should you recommend to
address this symptom?
A
Decrease norethisterone
B
Discontinue oestradiol valerate
C
Discontinue norethisterone
D
Increase oestradiol valerate
E
Increase norethisterone
Mrs Johnson has been prescribed norethisterone. The use of a progestogen is only indicated
A
If the patient has an intact uterus
B
If the patient has no uterus
C
If there is no relief with oestrogen alone
D
For women below 35 years of age
E
For women experiencing perimenopause
END OF PATIENT PROFILE
***
PATIENT PROFILE
Patient Name:
Jeff Cooper
Address:
15 Basil Street, Flagstaff
Age:
73
Sex:
Allergies:
Male
Weight:
Penicillin - rash and worsening
asthma symptoms
Diagnosis
Presenting Complaint:
Medical History:
Height:
178cm
77kg
1. Urinary tract infection
1. Congestive heart failure
2. Asthma
3. Osteoarthritis
Laboratory / Diagnostic Tests
Date
Test
Medication Record
Date
Medication
1/10
Diclofenac 50mg
Reference Range
Quantity
50
Sig
i tds
16/9
Simvastatin 20mg
30
i nocte
12/9
Aspirin 100mg
84
i daily
8/8
Metoprolol 100mg
60
i bd
30/6
Hydrochlorothiazide 25mg
50
i mane
5/5
Digoxin 250mcg
100
i daily
8/4
Paracetamol 500mg
100
ii prn
8/4
Beclomethasone MDI 100mcg/actuation
1
ii bd
23/3
Oxazepam 15mg
50
½ prn
12/1
Salbutamol MDI 100mcg/actuation
2
ii prn
Pharmacist's Notes
1/10
Mrs Cooper says that her husband complains of painful urination. Over the past weeks he
has also been experiencing nausea.
72
Mr Cooper presents a prescription for amoxycillin 500mg / clavulanic acid 125mg i bd, for his urinary
tract infection. You contact the prescriber regarding Mr Cooper's penicillin allergy and he asks for a
suggestion for an alternative antibiotic.
Which of the following is the MOST appropriate selection?
73
74
A
Sulfamethoxazole/trimethoprim
B
Nitrofurantoin
C
Cephalexin
D
Trimethoprim
E
Norfloxacin
What should you suggest to Mrs Cooper to address the burning symptoms of her husband's
urinary tract infection?
A
Reduce his fluid intake and take an urinary alkaliser
B
Drink copious fluids and take an urinary alkaliniser
C
Take an urinary alkaliniser and maintain usual fluid intake
D
Double the hydrochlorothiazide dose and drink plenty of fluids
E
Take paracetamol to relieve the pain
In monitoring the response to treatment for the urinary tract infection, which laboratory test would be
MOST appropriate for Mr Cooper?
A
Activated prothrombin time
B
Erythrocyte sedimentation rate
C
HbA1c
D
Full blood count
E
C-reactive protein
75
76
***
Which of the following would be the MOST likely cause of Mr Cooper's worsening asthma?
A
Diclofenac/paracetamol/metoprolol
B
Metoprolol/simvastatin/oxazepam
C
Metoprolol only
D
Diclofenac/aspirin
E
Aspirin/diclofenac/metoprolol
Which of the following medication therapies would be the MOST likely cause of Mr Cooper's
nausea?
A
Diclofenac and digoxin
B
Beclomethasone and digoxin
C
Diclofenac and beclomethasone
D
Metoprolol and hyrochlorothiazide
E
Simvastatin and diclofenac
END OF PATIENT PROFILE
***
77
78
Which one of the following is NOT a source of Vitamin B12?
A
Milk
B
Egg
C
Kidney
D
Liver
E
Pumpkin
A female customer with a history of epilepsy that is currently well controlled with phenytoin is
planning to become pregnant over the next few months. She is due to see her doctor, but asks your
advice as to what the requirements might be.
Which one of the following statements is the LEAST appropriate advice?
79
A
Withdrawal of antiepileptics should be considered if seizure free period has been at least
two years, or the dose lowered to as much as possible
B
Folic acid 5 mg daily should be taken for at least one month before pregnancy, with no change
in antiepileptic dose
C
Some antiepileptics require vitamin K 20 mg daily to be taken from 36 weeks gestation
onward
D
Stopping antiepileptic treatment after the diagnosis of pregnancy is reported to lower the risk of
congenital malformations
What would be the MOST appropriate treatment for constipation in a female patient during her 2 nd
trimester of pregnancy?
A
Docusate and sennosides
B
Bisacodyl
C
Polyethylene glycol
D
Sennoside granules
E
Psyllium husk
80
81
82
Which of the following medications is NOT commonly associated with dry mouth, as a condition in the
elderly?
A
Tricyclic antidepressants
B
Antihistamines
C
Antipsychotics
D
Diuretics
E
Antibiotics
Which of the following is the MOST appropriate treatment for ear wax impaction?
A
Acetic acid
B
Carbamide peroxide
C
Baby oil and cotton buds
D
Olive oil and cotton buds
E
Isopropyl alcohol
A female customer, who regularly worms the family pets, comes in to get a product to worm her children
(8, 6 and 3 years of age) 'just to be on the safe side'. You should advise her to
A
Use an ivermectin preparation
B
Use a mebendazole preparation
C
Avoid worming, unless the family shows signs of infestation
D
Avoid cross-infection by worming the family and the animals on the same day
83
84
85
With regard to the treatment of scabies with benzyl benzoate, which of the following statements is
INCORRECT?
A
Re-application is required if itch persists for longer than 2 weeks
B
Treatment should be applied to the affected person, all household/family members and
close contacts at the same time
C
It is used as an alternative when permethrin cream is unsuitable as it commonly
causes irritation when first applied
D
The lotion must be diluted for use on children to reduce irritation, but this reduces
efficacy
E
Common adverse effects include stinging and a burning sensation
With regard to maldison (malathion) head lice lotion, which of the following statements is CORRECT?
A
Hair must be wet before application
B
Allow hair to dry naturally after use
C
The lotion must be rinsed out after 10 minutes
D
The shampoo product is preferred to the lotion
E
It is recommended as safe to use during pregnancy
A female patient comes in with a prescription for erythromycin 250mg qid 7/7. She is also suffering from
hayfever. She would like a non-sedating antihistamine. Which of the following should you suggest?
A
Fexofenadine
B
Dexchlorpheniramine
C
Certirizine
D
Loratadine
86
87
88
Which of the following is INCORRECT, with regards to heartburn?
A
Heartburn is often aggravated by bending or lying down
B
Children with symptoms of heartburn should be referred to a doctor
C
Severe chest pain can occur and can be difficult to distinguish from a heart attack
D
Small meals, eaten frequently, are better than large meals in the prevention of heartburn
E
Difficulty in swallowing is a common symptom and does not require referral
Which of the following is NOT considered effective in the treatment of dandruff?
A
Coal tar
B
Terbinafine
C
Ketoconazole
D
Zinc pyrithione
E
Selenium sulfide
With regard to infantile diarrhoea which of the following is CORRECT advice?
A
Foods should not be given until diarrhoea has resolved
B
Fruit drinks or lemonade should be given for rehydration
C
Breast milk should be withheld until diarrhoea has resolved
D
Formula feeds should be diluted until diarrhoea has resolved
E
Antimotility medications are not suitable for children under 2 years of age
89
90
91
92
A male customer with high nicotine dependence wishes to give up smoking and asks your advice about
nicotine gum. You should counsel him to do all of the following EXCEPT...
A
Substitute cigarettes with nicotine gum
B
Chew slowly so as not to upset stomach
C
If soreness of the mouth occurs, a patch can used instead
D
Gradually increase the number of pieces of gum being used
E
The combined use of patches and gum can be used for severe dependence
A 70 year old female customer seeks information about self-management strategies for osteoporosis.
Which of the following recommendations is INAPPROPRIATE?
A
Calcium supplementation
B
Adequate intake of dairy products
C
Glucosamine supplementation
D
Vitamin D exposure/supplementation
E
Weight-bearing exercise
With regards to dry eye syndrome, which of the following statements is INCORRECT?
A
Patients may suffer with recurring eye infections
B
It may occur in conjunction with rheumatoid arthritis
C
May caused by sedating antihistamines
D
Excessive tear production is often a sympton
E
Artificial tear preparations have a similar viscosity to natural tears
All of the following are risk factors for developing osteoporosis EXCEPT
A
Lack of physical exercise
B
Amenorrhoea due to excessive physical training
C
Long term corticosteroid administration
D
Limited sun exposure
E
Use of the combined oral contraceptive
93
94
95
96
Which of the following combinations lists the MOST common risk factors for heart disease?
A
Cholesterol > 5.5, low fibre diet, smoking, obesity
B
Smoking, obesity, high blood pressure, cholesterol > 5.5
C
Low fish diet, infrequent exercise, smoking, high blood pressure
D
Low fibre diet, smoking, infrequent exercise
E
Obesity, renal impairment, hyperlipidemia
Which one of the following groups of symptoms BEST describes the common signs of dehydration?
A
Thirst, excitability, sunken eyes, decreased skin turgor
B
Decreased urine output, lethargy, sunken eyes, decreased skin turgor
C
Loss of consciousness, excessive urination, sunken eyes, loss of appetite
D
Lethargy, excess sweating, sunken eyes, blurred vision
Which of the following statements is CORRECT with respect to pain control in the terminally ill?
A
Morphine is the medication of choice for treating bone pain
B
Analgesics are more effective if given regularly rather than as required
C
There is no place for paracetamol in treating this group of patients
D
There is no need to adjust the dose of morphine when changing from oral to parenteral
therapy
E
Constipation does not usually occur with morphine administration
Which of the following is NOT a medication used (either alone or in combination with other therapy) to
treat the symptoms of Parkinson's disease?
A
Methyldopa
B
Pergolide
C
Apomorphine
D
Entacapone
E
Benztropine
97
98
99
100
Which of the following is the MOST prominent haematological adverse medication reaction
associated with heparin?
A
Aplastic anaemia
B
Haemolysis
C
Agranulocytosis
D
Thrombocytopenia
E
Lymphocytopenia
Which one of the following statements best describes open-angle glaucoma?
A
A sudden attack of increased pressure in the eye
B
Acute obstruction of the drainage of aqueous humour
C
Impairment of drainage in the trabecular network
D
Onset of severe pain and loss of vision
E
A sudden onset of tunnel vision
Which of the following antibiotics is the MOST appropriate for the treatment of mastitis in a breast feeding
mother with a known acute penicillin allergy?
A
Clindamycin
B
Flucloxacillin
C
Doxycycline
D
Roxithromycin
E
Cephalexin
Which of the following medications is MOST likely to cause postural hypotension?
A
Prazosin
B
Amlodipine
C
Candesartan
D
Atenolol
E
Enalapril
101
A female patient discovers that she has missed the fifth dose of her triphasic combined oral
contraceptive (21s), which was due more than 24 hours ago. She seeks your advice on how to
guarantee contraceptive cover.
What is the MOST appropriate advice?
102
103
A
She should take the missed dose as soon as possible, then continue taking the tablets as
normal and she will still be covered
B
She should not take missed dose; but continue with next day's dose at usual time and use
other contraceptive methods for at least 14 days
C
She should take the missed dose as soon as possible, then continue taking the tablets as
normal, and use other contraceptive methods for at least 7 days
D
She should take the missed dose as soon as possible, then continue taking the
tablets as normal and use other contraceptive methods for at least another 21 days
Long term use of continuous/combined hormone replacement therapy may be associated with
an increased risk of
A
Colorectal cancer
B
Platelet adhesion
C
Breast cancer
D
Endometriosis
E
Uterine cancer
All of the following medications routinely require therapeutic drug monitoring EXCEPT
A
Gentamicin
B
Cyclosporin
C
Lithium
D
Enoxaparin
E
Perhexeline
104
105
106
107
What baseline laboratory value/tests should be obtained prior to initiating therapy with amiodarone?
A
Liver function tests / international normalised ratio / serum creatinine
B
Liver function tests / thyroid function tests / respiratory function
C
Liver function / thyroid function tests / full blood count
D
International normalised ratio / thyroid function tests / serum creatinine
Which of the following measures should you recommend when a patient, who has been receiving
amiodarone for 1 year, is commenced on digoxin?
A
Start with a higher than normal dose of digoxin and monitor amiodarone levels
B
Start with a lower than normal dose of digoxin and monitor digoxin levels
C
Increase the normal amiodarone dose and monitor digoxin levels
D
Decrease the normal amiodarone dose and monitor digoxin levels
E
Add clopidogrel to minimise the chance of clotting
When treating rheumatoid arthritis with methotrexate, which of the following is
CORRECT?
A
Methotrexate should be taken every day at the same time
B
A missed dose should be taken together with the next dose
C
Trimethoprim is the antibiotic of choice to treat acquired infections
D
Adverse effects can occur acutely and in the long term
E
Coughing and wheezing are common side effects that subside with continued use
Which one of the following medicines should be avoided when using donepezil due to its antagonistic
side effects?
A
Galantamine
B
Prazosin
C
Amitriptyline
D
Sertraline
E
Moclobemide
108
109
110
A 75-year old patient with hypertension is diagnosed with rapid atrial fibrillation. Which of the following
medications is the MOST appropriate for stroke prevention in this patient?
A
Aspirin
B
Warfarin
C
Dipyridamole
D
Clopidogrel
E
Ticlopidine
Antibiotic-associated diarrhoea is MOST commonly associated with a new growth of which of the
following organisms?
A
Clostridium perfringens
B
Salmonella typhimurium
C
Bacteroides fragilis
D
Clostridium difficile
E
Escherichia coli
The dosage of aciclovir should be adjusted on the basis of
A
Serum bilirubin
B
Hydration levels
C
Hepatic function
D
The patient's age
E
Renal function
111
112
Which ONE of the following medications will MOST likely contribute to urinary hesitancy?
A
Lamotrigine
B
Selegiline
C
Mirtazipine
D
Benztropine
E
Venlafaxine
A customer returns to your pharmacy for a repeat prescription, but complains that she has lost her
appetite since commencing on this new medication.
Which ONE of the following medications is the MOST likely to have caused this?
113
A
Atorvastatin
B
Sertraline
C
Naproxen
D
Amoxycillin
E
Glimepiride
What are the MOST common side effects of methotrexate?
A
Ulcerative stomatitis, fatigue, chills, fever
B
Photosensitivity, leucopenia, dizziness, nausea
C
Leucopenia, nausea, rashes, dizziness
D
Abdominal distress, blurred vision, alopecia, itch
E
Oral mucositis, urticaria, nausea and vomiting
114
The MOST likely outcome from the co-administration of an angiotension converting enzyme inhibitor
and non-steroidal anti-inflammatory medications is
A
Cough
B
Hypokalemia
C
Renal dysfunction
D
Hypotension
E
Neutropenia
PATIENT PROFILE
Patient Name:
Ivan Hardovic
Address:
15, Children’s Ward
Age:
13 months
Height:
75cm
Sex:
Allergies:
Male
Nil known
Weight:
11.5kg
Diagnosis
Presenting Complaint:
Medical History:
1. Worsening ascites, febrile, extremely grizzly, painful
teething
1. Severe liver failure
Laboratory / Diagnostic Tests
Date
Test
19/6
APTT 78 secs
Reference Range
(17-26 secs)
19/6
Bilirubin total 53µmoles/L
(<20 micromoles)
19/6
Creatinine 0.06mmol/L
(0.050-0.12mmol/L)
19/6
INR 1.6
(0.9-1.3)
19/6
Liver Function Test: GGT 163 units/L
(0-65 units/L)
19/6
Liver Function Test: ALP 249 units/L
(30-200 units/L)
19/6
Liver Function Test: AST 244 units/L
(6-40 units/L)
Medication Record
Date
Medication
24/6
Choline salicylate
Quantity
topical
Sig
prn
24/6
Lignocaine 2% gel
topical
prn
21/6
Paracetamol 150mg
po
4/24
16/6
Micellized vitamin A&E mixture
po
10ml daily
16/6
Omeprazole 10mg
po
10mg daily
16/6
16/6
Ranitidine
Spironolactone 25mg
iv
po
10mg, 6/24
12.5mg daily (1/2 tab)
16/6
Vitamin D
po
2,000 units daily
16/6
Vitamin K 10mg
po
5mg alt. Days (1/2 tab)
Pharmacist's Notes
26/6 Liquid - filled teething ring prn 19/6 Low
Protein diet
17/6 Severe liver failure - placed on transplant list
115
116
117
Which products are useful adjuncts in patients with liver failure and associated gall- bladder disease?
A
Omeprazole as these patients usually develop peptic ulcers
B
Antibiotics, to prevent infections as a result of gall-bladder blockage
C
Antihypertensives, as these patients will always have elevated blood pressure
D
Vitamin D and calcium products, as jaundice interferes with typical vitamin D absorption
E
Fat-soluble vitamins, as these may not be adequately absorbed
Why does Vitamin K need to be given to this patient?
A
It is always necessary when other fat-soluble vitamins are administered
B
It increases the elimination of bilirubin and decreases jaundice
C
It corrects the inadequate synthesis of clotting factors associated with liver failure
D
A significant amount of vitamin K is lost in patients with ascites
E
Low protein diets need to be supplemented with extra vitamin K
Which of the following statements about this patient's therapy is CORRECT?
A
Ranitidine should not be used as it is mostly metabolised by the liver
B
Paracetamol should be used with caution in a patient with liver disease
C
Choline salicylate applied topically is safe to use as very little salicylate is absorbed
D
Vitamin A is toxic to the liver and should not be used
E
Ibuprofen suspension is a more appropriate choice for teething pain in this patient
118
With regards to spironolactone in this patient, which of the following statements is
CORRECT?
A
Spironolactone is not required, as the patient is receiving vitamin K
B
Measurement of urea and electrolytes is essential to avoid excessive sodium and potassium
gain
C
Spironolactone can be ceased, as the patient's serum creatinine is normal
D
Paracentesis (drainage of fluid) can be avoided with the use of spironolactone
E
Hyperaldosterolaemia of ascites is best managed with spironolactone
***
END OF PATIENT PROFILE
***
PATIENT PROFILE
Patient Name:
Thomas Stevens
Address:
Room 9
Age:
6 months
Height:
75cm
Sex:
Allergies:
Male
Nil Known
Weight:
5.7kg
Diagnosis
Presenting Complaint:
Medical History:
1. Major Bowel Surgery with sepsis
1. Reflux
2. Vomiting
Laboratory / Diagnostic Tests
Date
Test
7/7
Creatinine 0.36 mmol/L
Reference Range
(0.05 – 0.120 mmol/L)
7/7
Urea 13.4 mmol/L
(3-8 mmol/L)
6/7
Vancomycin (trough) 9 mg/L
(5-10mg/L)
4/7
4/7
Gentamicin 0.7 mg/L (12 hours post dose)
Vancomycin (trough) 4 mg/L
(<2mg/L)
(5-10 mg/L)
23/6
Creatinine 0.03 mmol/L
(0.05 – 0.120 mmol/L)
23/6
Urea 2.5 mmol/L
(3-8 mmol/L)
Medication Record
Date
Medication
6/9
Erythromycin Ethyl Succinate - 400mg/5ml
Quantity
100mL
Sig
5mL tds
4/9
Erythromycin Inj 1 g
1
20mg 8/24 IV
26/8
Nystatin 100,000 units/ml
24 mL
1mL qid
26/8
26/8
Paracetamol 120mg/5mL
Ranitidine 150mg/10mL
100mL
300mL
6H prn (90mg)
15mg bd
5/7
Vancomycin 500mg/via
80mg 6H IV
3/7
Gentamicin 40mg/mL
40 mg daily IV
3/7
Gentamicin 500mg/vial
60 mg 6H IV
30/6
Paracetamol 120mg/5ml
100mL
Pharmacist's Notes
2/9
Provided information regarding erythromycin’s effect on gut motility. 29/8
Vomiting, reflux both continuing.
2/7
Febrile, grizzly, diarrhoea
4/24 prn (90mg)
119
120
121
Which of the following statements about vancomycin and gentamcin is INCORRECT?
A
Both are administered intravenously
B
Both can be administered concurrently
C
Both are contraindicated in very young children
D
Both may affect kidney function
E
Blood level measurements are useful for both antibiotics
Which of the following statements about Thomas' therapy is INCORRECT?
A
Paracetamol is effective when given either orally or rectally
B
Paracetamol should be given immediately before a feed to gain maximum benefits
C
Ranitidine may be continued through the peri-operative therapy
D
Erythromycin can be given orally after a short intravenous course
E
Ranitidine, paracetamol and nystatin combinations are relatively safe
Erythromycin was added as a pro-kinetic medication. An immediate change to the therapy is
ordered. The MOST likely reason for the change in therapy is?
A
The causative organism of infection was Staphylococcus aureus
B
Paracetamol may mask the effectiveness of erythromycin, especially if fever and infection
were present
C
Using an antibiotic and an anti-fungal combination is not advisable
D
A potentially dangerous erythromycin-ranitidine interaction may arise
E
The dose of erythromycin was too high
122
The MOST likely cause of changes in the results of Thomas' urea and creatinine is
A
Sepsis
B
Vomiting/diarrhoea
C
Gentamicin
D
Erythromycin
E
Paracetamol
***
END OF PATIENT PROFILE
***
PATIENT PROFILE
Patient Name:
Alan Jones
Address:
48 Tinderry Circuit, Harvey Bay
Age:
66
Height:
166cm
Sex:
Allergies:
Male
Nil known
Weight:
87kg
Diagnosis
Presenting Complaint:
Medical History:
1. Infective exacerbation of chronic obstructive
pulmonary disease (COPD)
1. COPD
2. Hypertension
3. Epilepsy
4. Alcohol abuse; smoker
Laboratory / Diagnostic Tests
Date
Test
11/7
Sputum culture
Reference Range
pending
Medication Record
Date
Medication
11/7
Candesartan 16mg
11/7
Fluticasone DPI 250mcg/actuation
Quantity
30
1
Sig
i mane
ii bd
11/7
Phenytoin 100 mg
100 iii nocte
11/7
Salbutamol MDI 100mcg/actuation
2
i-ii prn
11/7
Tiopropium 18mcg caps for inhalation
30
i daily
Pharmacist's Notes
11/7 Increased shortness of breath & cough.
Increased sputum volume.
Increased use of salbutamol puffer in preceding week. Heavy
smoker
Mr Jones has been taking all the medications listed for some time
123
124
125
Mr Jones is started on prednisolone 50mg daily (for five days) and ipratropium and salbutamol
nebulised every six hours. On review of his medications, what should you recommend as changes to
his medication plan?
A
Stop ipratropium, as this patient is already on tiotropium
B
Stop prednisolone, as this patient is already on fluticasone
C
Taper prednisolone
D
Withhold tiotropium, whilst patient is on ipratropium regularly, and restart tiotropium on
discharge
E
Withhold fluticasone puffer whilst on prednisolone and increase tiotropium to every six hours
Mr Jones presents a few days later complaining of tremors in his hands and heart palpitations. Which
of the following medications is MOST likely to have caused this reaction?
A
Prednisolone
B
Candesartan
C
Ipratropium
D
Tiotropium
E
Salbutamol
Which medication is LEAST appropriate to treat either alcohol or smoking addiction in this patient?
A
Bupropion
B
Nicotine inhaler
C
Varenicline
D
Naltrexone
E
Acamprosate
Sample 3
1
Which ONE of the following oral medicines is required to be ordered as an authority for
Pharmaceutical Benefit Scheme purposes?
2
3
A
Methylphenidate
B
Midazolam
C
Mercaptopurine
D
Methotrexate
Which ONE of the following does NOT entitle a patient to pay the concessional patient contribution for a
pharmaceutical benefit?
A
Pensioner Concession Card
B
Safety Net Concession Card
C
Australian Seniors Health Card
D
Repatriation Pharmaceutical Benefits Card
E
Reciprocal Health Care Agreements Medicare Card
Pharmaceutical Benefits Authority prescriptions are valid when:
A
Written by a doctor, nurse or dentist, and approved by the appropriate federal government
authority
B
Written by a doctor or dentist and approved by the appropriate federal or state government
authorities
C
Written by a doctor and approved by the appropriate federal government authority
D
Written by a doctor or nurse and approved by the appropriate federal government
authority
E
Written by a doctor or nurse and approved by the appropriate federal and state government
authorities
4
5
6
Which of the following professionals are able to write Pharmaceutical Benefits Scheme (PBS)
prescriptions?
A
Doctors only
B
Doctors, dentists and nurse practitioners only
C
Doctors and optometrists only
D
Doctors, optometrists, dentists and nurse practitioners
What is the maximum number of items (except for 'Authority required' items) that may be included on a
Pharmaceutical Benefits Scheme prescription?
A
One
B
Two
C
Three
D
Four
E
Unlimited
Which ONE of the following is INCORRECT in regard to 'Authority required' Pharmaceutical
Benefits Scheme (PBS) prescriptions?
A
The prescriber must include more than one item per PBS prescription
B
The prescriber must include their own information, including name, address, telephone
number and prescriber number
C
The prescriber may preclude brand substitution
D
The prescriber must include the entitlement status of the patient
7
8
9
Regulation 24 is a regulation for the provision of medications under the Pharmaceutical
Benefits Scheme. What is the equivalent regulation under the Repatriation Pharmaceutical
Benefits Scheme referred to as?
A
Emergency provisions
B
Prior approval provisions
C
Equity of access
D
Hardship conditions apply
E
Physical impairment provisions
In which schedule of the Standard for the Uniform Scheduling of Medicines and Poisons would
you find Salbutamol Metered Dose Inhaler 100 mcg/dose?
A
Schedule 2
B
Schedule 3
C
Schedule 4
D
Schedule 8
E
Unscheduled
The starting dose of vancomycin for infants less than one week old (average body weight of 2.5 kg)
is 15 mg/kg every 18 hours.
How many mL of an injection containing 500 mg/25 mL should be administered to obtain this dose?
A
1.875 mL
B
3.75 mL
C
3.33 mL
D
18.75 mL
E
37.75 mL
10
In an intensive care ward, a chart reads: "KCl 40 mmol in 1 litre of normal saline. Infuse at 20
mmol/h."
What is the flow rate in mL/min?
11
12
A
0.5 mL/min
B
0.83 mL/min
C
5 mL/min
D
8.3 mL/min
E
50 mL/min
What is the volume of cetrimide solution 40% required to prepare 2 litres of cetrimide 1:200?
A
2.5 mL
B
5 mL
C
12.5 mL
D
25 mL
E
50 mL
The molecular weight of potassium chloride (KCl) is 74.5.
What volume in mLs of potassium chloride injection (30% w/v) should be added to 1 litre of 0.9% sodium
chloride infusion to achieve a potassium concentration of 40 mmol/L?
A
2 mL
B
2.6 mL
C
10 mL
D
20 mL
E
26 mL
13
A prescription requires you to dilute a steroid cream, containing 0.5% of the active ingredient, to an
aqueous cream containing 0.1% of the active ingredient.
How many grams of aqueous cream base would you need to add to 100 g of the 0.5% strength?
14
A
50 g
B
100 g
C
200 g
D
250 g
E
400 g
You are required to prepare 500 g of zinc and salicylic acid paste using the following formulas.
To make zinc paste:
White soft paraffin
Zinc oxide
Starch
50 g
25 g
25 g
To make zinc and salicylic acid paste:
Salicylic acid
Liquid paraffin
Zinc paste
2g
2g
96 g
What quantity of zinc oxide and salicylic acid are required for this formulation?
A
Zinc oxide 250 g, salicylic acid 10 g
B
Zinc oxide 120 g, salicylic acid 10 g
C
Zinc oxide 75 g, salicylic acid 10 g
D
Zinc oxide 120 g, salicylic acid 5 g
E
Zinc oxide 75 g, salicylic acid 5 g
15
Pilocarpine HCl
Purified water q.s.
2%
30 mL
Sig: ii drops three times a day into left eye
What is the TOTAL daily dose of pilocarpine hydrochloride in the prescription given above? (Assume
that the dropper is calibrated to deliver 20 drops to the mL.)
16
A
6 mg
B
12 mg
C
24 mg
D
120 mg
E
240 mg
How many grams of potassium chloride should be used to compound this prescription?
Potassium chloride sufficient to give a total daily dose of 30 millimoles of potassium Raspberry syrup
120 mL
Water to
250 mL
Take 10 mL daily
[Atomic weight of potassium = 39] [Atomic weight of chlorine = 35.5]
A
1g
B
3g
C
5g
D
28 g
E
56 g
PATIENT PROFILE
Patient Name:
Katherine Trial
Address:
72 South Road
North Marden
Age:
65
Height:
162 cm
Sex:
Allergies:
Female
Nil known
Weight:
80 kg
Diagnosis
Presenting Complaint:
Medical History:
1. Type 2 diabetes
1. Ischaemic heart disease (IHD)
2. Hypercholesterolaemia
Laboratory / Diagnostic Tests
Date
Test
07/05
Creatinine 110 micromol/L
Reference Range
(60-120 micromol/L)
07/05
Fasting blood sugar level 9.6 mmol/L
(<7.8 mmol/L)
07/05
HbA1C 11.2%
(<7%)
Medication Record
Date
Medication
07/05
Aspirin 100 mg
Quantity
112
Sig
i mane
07/05
Atorvastatin 10 mg
30
i daily
07/05
Gliclazide 80 mg
100
ii bd
07/05
Irbesartan 150 mg
30
i mane
07/05
Temazepam 10 mg
25
i nocte
Pharmacist's Notes
07/05 Family history of IHD and diabetes. Patient has been experiencing muscle pain.
Smoker - heavy.
17
18
19
The doctor wishes to add another agent to Mrs Trial's diabetic medication, to help control her blood
glucose levels. Which ONE of the following is the MOST appropriate?
A
Metformin
B
Insulin
C
Pioglitazone
D
Sitagliptin
E
Glimepiride
When is the MOST appropriate time to take atorvastatin?
A
In the morning with food
B
At lunchtime
C
In the evening
D
Any time of the day irrespective of food
E
Any time of the day with food
Which ONE of the following is the MOST appropriate test(s) for monitoring the adverse effects
of atorvastatin in Mrs Trial?
A
Creatinine kinase
B
Creatine kinase and aminotransferase
C
Magnesium
D
Gamma glutamyl transferase
E
Bilirubin
***
END OF PATIENT PROFILE
***
20
21
22
Which ONE of the following medicines is LEAST appropriate for use by a breastfeeding
mother without appropriate monitoring?
A
Warfarin
B
Lithium carbonate
C
Loratadine
D
Paracetamol
E
Amoxycillin/Clavulanic acid
The dosage of doxycycline taken for malaria prophylaxis is:
A
100 mg daily, starting 2 days before entering area and continuing for 2 - 4 weeks after
leaving area
B
100 mg daily, starting 2 days before entering area and continuing for duration of trip
C
50 mg weekly, starting 2 days before and continuing for 2 - 4 weeks after leaving the
area
D
50 mg weekly, starting 2 weeks before entering malaria area and continuing after leaving
area, for a maximum period of 12 months.
E
50 mg daily, starting 2 days before entering area and continuing after leaving area for a
maximum period of 12 months
If a patient misses a dose of a progesterone-only oral contraceptive pill and the pill is more than three
hours overdue, for how many days (following the missed dose) does she have to take the pill before
she is fully covered?
A
Remainder of the month
B
Two days
C
Seven days
D
14 days
E
28 days
23
A regular female customer comes into the pharmacy and tells you she has recently been diagnosed
with lung cancer. She presents a prescription for controlled-release morphine tablets 10 mg, with
directions to take one tablet, twice daily.
Which ONE of the following counselling points is LEAST appropriate?
A
Take tablets every 12 hours
B
Inform the doctor of any breakthrough pain
C
Swallow the tablets whole
D
Drowsiness may be experienced
E
Take lactulose 15 mL twice daily
PATIENT PROFILE
Patient Name:
Sandra Whitely
Address:
Room number 24
Age:
8
Height:
130 cm
Sex:
Allergies:
Female
Cephalosporins - rash
Weight:
25 kg
Diagnosis
Presenting Complaint:
1. Infected eczema
2. Scabies
Medical History:
Laboratory / Diagnostic Tests
Date
Test
17/9
Blood culture
Medication Record
Date
Medication
17/9
50 % white soft paraffin / 50 % liquid
paraffin mixed with glycerin 10 % in
sorbolene cream
Reference Range
(Staph. aureus positive cultures)
Quantity
500 g
Sig
2-4h prn (to limbs & face)
17/9
Triclosan soap & bath oil
17/9
Betamethasone valerate 0.02 %
100 g
bd (5/7 days on - 2/7 off)
17/9
Cetirizine 1 mg/mL
75 mL
5 mL bd
17/9
Flucloxacillin 250 mg
24
qid
17/9
Hydrocortisone 1 % cream
50 g
bd (5/7 days on-2/7 off)
17/9
Paracetamol 500 mg
100
q4h prn
17/9
Permethrin 5 %
30 g
nocte
17/9
Wet dressing - aluminium acetate
500 g
q4h (to trunk)
2-4hrly (continuously to crusted areas)
Pharmacist's Notes
17/9 Mother also treated with permethrin.
daily (at bath time)
24
25
26
Which ONE of the following statements WOULD be included in advice on treati ng
Sandra's scabies with permethrin cream?
A
Apply to the whole body, including the face, scalp and ears
B
Ensure that the patient's skin is clean, dry and cool before application
C
Cream should be washed off after 4 hours
D
Ensure the whole tube is applied to the body
E
Reapplication after 24 hours improves treatment
Regarding Sandra's severe topical bacterial infections and eczema, which ONE of the following is the
BEST treatment option?
A
Topical antibiotics and corticosteroid creams, to decrease itchiness
B
A combination of topical and systemic antibiotics with corticosteroid creams
C
Symptomatic topical relief and an oral steroid to reduce inflammation
D
An oral antibiotic given with an antihistamine to reduce eczema related itch
E
A combination of corticosteroid creams, symptomatic relief and systemic antibiotics
What is the MOST likely reason for Sandra being prescribed flucloxacillin?
A
She had a proven Staphlyococcus aureus infection
B
Flucloxacillin has a synergistic effect with permethrin in treating scabies
C
Flucloxacillin is a safer medication, with fewer side effects, than cephalosporins
D
Patients with cephalosporins allergies are highly unlikely to also be allergic to flucloxacillin
E
Cephalosporins are not active against Staphlyococcus aureus
27
Sandra was ordered two steroid creams. What is the MOST likely reason for this?
A
A less potent steroid is more suitable for application to the face
B
It is safer to use a less potent steroid when the rash is less severe
C
Different steroid creams, when combined, potentiate the anti-inflammatory effects without
increasing harmful effects
D
Coexisting skin atrophy will increase systemic absorption and consequent side effects of more
potent corticosteroids
E
Moderately potent steroids can only be used for a few days in children
***
END OF PATIENT PROFILE
***
28
An elderly female customer with poor eyesight presents at your pharmacy with a new prescription for
verapamil slow release tablets 240 mg, half twice a day. You contact the prescriber to discuss the
prescription.
In this situation, which ONE of the following is the MOST appropriate change that should be made
to the patient's medication?
29
30
A
Verapamil slow release capsules 240 mg i daily
B
Verapamil tablets 80 mg i bd
C
Verapamil tablets 120 mg i bd
D
Verapamil tablets 40 mg i bd
Which ONE of the following statements is NOT appropriate when counselling a patient taking metformin?
A
Take with meals to reduce stomach upset
B
Adverse effects, such as nausea, vomiting and diarrhoea are common; refer to your doctor if the
adverse effects do not decrease in intensity after one week
C
Drinking alcohol decreases blood glucose, masking signs of hypoglycaemia and increases
the risk of serious side effects
D
Limit alcohol intake and eat something when drinking alcohol
An 18 year old female customer suffers from acne and is extremely self-conscious about her condition.
Her specialist prescribed isotretinoin capsules 10 mg and an oral contraceptive.
Which ONE of the following statements of advice is LEAST appropriate?
A
Improvement of acne may continue for several months after stopping isotretinoin
B
Adequate contraception should be used before, during and for one month after, treatment
C
Most patients remain acne free after a single course or have long remissions
D
Blood should not be donated during treatment and for eight weeks following treatment
E
Monitor kidney function tests and lipids at baseline and then as clinically required
31
In the case of paracetamol poisoning and treatment with acetylcysteine, which ONE of the following
statements is LEAST appropriate?
A
Beginning treatment within 4 hours of overdose is of no benefit and is likely to result in
overtreatment
B
Upon commencing treatment, rapid IV administration is necessary to decrease chance of
hepatotoxicity
C
If IV access is impossible, acetylcysteine may be given orally
D
If treatment is started within 8 hours of overdose there is complete protection from
hepatotoxicity
E
Common side effects with rapid IV treatment include flushing, urticaria, itch
PATIENT PROFILE
Patient Name:
James Wood
Address:
29 Gramps Cres
Adina
Age:
Sex:
Allergies:
72
Male
Ibuprofen (rash)
Diagnosis
Presenting Complaint:
Medical History:
Height:
Weight:
167 cm
60 kg
1. Skin discolouration, itchy rash
1. Ischaemic heart disease
2. Alcohol related liver cirrhosis
3. Thrombocytopaenia
4. Portal hypertension
5. Hypoalbuminaemia
6. Duodenal ulcer
Laboratory / Diagnostic Tests
Date
Test
Reference Range
10/5
Albumin 20 g/L
(32-45 g/L)
10/5
10/5
ALP 124 units/L
ALT 160 units/L
(25-100 U/L)
(<35 U/L)
10/5
AST 135 units/L
(<40 U/L)
10/5
GGT 225 units/L
(<50 U/L)
10/5
10/5
10/5
Haemoglobin 121 g/L
INR 1.6
Platelets 97 x 109 /L
(130-180 g/L)
(0.9-1.3)
(150-400 x 109 /L)
Medication Record
Date
Medication
Quantity
Sig
10/5
Aspirin 100 mg
28
i daily
10/5
10/5
Frusemide 40 mg
Glyceryl trinitrate 600 microgram
100
100
i bd
i s/l prn
10/5
Multivitamins
30
i daily
10/5
Omeprazole 20 mg
30
i daily
10/5
10/5
Paracetamol/codeine 500 g/30 mg
Propranolol 40 mg
50
100
ii bd prn
i bd
10/5
10/5
Spironolactone 100 mg
Thiamine 100 mg
100
100
i daily
i daily
Pharmacist's Notes
10/5
History of alcohol abuse.
32
33
34
Which ONE of the following is the MOST likely cause of Mr Wood’s raised INR?
A
Aspirin
B
Spironolactone
C
Low haemoglobin
D
Low platelets
E
Liver failure
What parameters should be monitored for patients on spironolactone?
A
Potassium and creatinine
B
AST and GGT
C
Albumin and potassium
D
Creatinine and INR
E
Platelets and red blood cells
Mr Wood is started on lactulose 20 mL every two hours until diarrhoea occurs. What is the MOST likely
indication?
A
Pseudomembranous colitis
B
Thrombocytopaenia
C
Hepatic encephalopathy
D
Constipation
E
Hypoalbuminaemia
35
With regard to his current symptoms, which other laboratory test is MOST appropriate to be ordered for
Mr Wood?
A
Creatine kinase
B
Bilirubin
C
Ferritin
D
Cholesterol
E
Vitamin B12
***
END OF PATIENT PROFILE
***
36
37
Which ONE of the following medications should be infused slowly to avoid a histamineinduced reaction?
A
Cyclosporin
B
Vancomycin
C
Erythromycin
D
Acyclovir
E
Amoxycillin
A female customer presents you with her first prescription for alendronate 70 mg once a week. In
counselling her.
Which ONE of the following statements is INCORRECT?
38
A
Alendronate should be taken in the morning with water, 30 minutes before breakfast
B
If a dose is forgotten, it should be taken as soon as it is remembered later that day, but after a
meal in order to avoid gastric distress
C
Do not lie down for at least 30 minutes after taking alendronate
D
Calcium supplements, antacids and other oral medications should not be taken at the same time
as alendronate
E
Side effects of alendronate include abdominal pain, headache, oesophageal ulcer and
musculoskeletal pain
A customer tells you she has just become pregnant. It is May and she mentions that she gets hay
fever and takes an antihistamine from about September to December each year.
Which ONE of the following antihistamines should you suggest if needed?
A
Loratadine
B
Cetirizine
C
Fexofenadine
D
Promethazine
E
Dexchlorpheniramine
39
Which ONE of the following conditions is LEAST likely to be caused by corticosteroids such as
prednisolone?
A
Diabetes
B
Osteoporosis
C
Mental disturbances
D
Cardiac arrhythmias
E
Muscle wasting
PATIENT PROFILE
Patient Name:
Greg Yurko
Address:
Age:
Canley Hospital, Emergency
Department, Room 4
25
Sex:
Allergies:
Male
Nil known
Diagnosis
Presenting Complaint:
Medical History:
Height:
178 cm
Weight:
73 kg
1. Amitriptyline overdose
1. Acute depression
Laboratory / Diagnostic Tests
Date
Test
Reference Range
Medication Record
Date
Medication
9/4
Amitriptyline 50 mg
Quantity
50
Pharmacist's Notes
9/6 Patient admitted for amitriptyline overdose.
Sig
iii daily
40
41
42
What is the main treatment for amitriptyline overdose?
A
Maintain airway and monitor cardiac function for 24 hours
B
Give activated charcoal within one hour of ingestion, monitor airways and cardiac function
C
Ipecac syrup, followed by monitoring of airways and cardiac function
D
Milk or water, followed by monitoring of airways and cardiac function
E
Flumazenil and naloxone, followed by monitoring of airways and cardiac function
Alternative antidepressants for a patient at risk of overdose would be all of the following
EXCEPT:
A
Moclobemide
B
Dothiepin
C
Citalopram
D
Sertraline
E
Venlafaxine
Mr Yurko has been taking St John’s Wort for depression in addition to the amitriptyline. Why
should concurrent administration of these two medications be discouraged?
A
Additive sedative effects
B
An increased risk of haemorrhage
C
Reduced elimination of the amitriptyline
D
Increased risk of profuse sweating and agitation
E
Increased anticholinergic side effects
43
Symptoms of abrupt withdrawal from amitriptyline include all of the following EXCEPT:
A
Runny nose
B
Sleep disturbance
C
Dry mouth
D
Abdominal cramping
E
Hypersalivation
***
END OF PATIENT PROFILE
***
44
45
46
When is calcium folinate (also known as folinic acid) primarily indicated?
A
During pregnancy to prevent neural tube defects
B
For infants fed solely on goat's milk
C
As rescue treatment after methotrexate chemotherapy
D
As a diet supplement for mineral deficiency
E
To reduce the renal side effects of methotrexate
Which ONE of the following factors is LEAST likely to contribute to a patient's "dry eye"?
A
Severe photophobia
B
Medication for glaucoma
C
Rheumatoid arthritis
D
Systemic dehydration
Which ONE of the following statements of advice is MOST appropriate regarding the use of nicotine
chewing gum?
A
The gum cannot be used by persons with dentures
B
Each piece has a duration of action of approximately one hour
C
Indigestion can result from excessive chewing
D
The gum should be disposed of when a tingling or bitter taste occurs
E
Palpitations are a common side-effect
47
A moderately overweight male patient has a history of taking antacid tablets containing
aluminium hydroxide/magnesium hydroxide/simethicone for upper abdominal pain he usually
has after a meal.
Which ONE of the following symptoms would require immediate referral to a doctor?
48
49
A
A burning sensation in the oesophagus
B
Discomfort from constipation
C
Wind and colic pain
D
Bad breath and no other symptoms
E
Difficulty swallowing food
Itraconazole oral liquid interacts with all of the following EXCEPT:
A
Fluoxetine
B
Warfarin
C
Cyclosporin
D
Simvastatin
E
Digoxin
Benzoyl peroxide used to treat acne acts as a/an:
A
Antifungal
B
Emollient
C
Keratolytic
D
Antiviral
E
Retinoid
PATIENT PROFILE
Patient Name:
Matt East
Address:
46 Mary Wesley Crescent
Uringa
Age:
Sex:
Allergies:
5 months
Male
Penicillin - rash
Diagnosis
Presenting Complaint:
Medical History:
60 cm
5 kg
1. Bilateral acute otitis media with fever
1. Atopic dermatitis
Laboratory / Diagnostic Tests
Date
Test
Medication Record
Date
Medication
23/7
Betamethasone 0.02 %
Pharmacist's Notes
None.
Height:
Weight:
Reference Range
Quantity
100 g
Sig
Apply to arms bd
50
51
52
What is the MOST likely bacterial organism responsible for Matt's ear infection?
A
Haemophilus influenzae
B
Staphylococcus aureus
C
Pseudomonas aeruginosa
D
Mycoplasma pneumoniae
E
Campylobacter jejuni
Which ONE of the following is the MOST appropriate antibiotic treatment for Matt?
A
Cefuroxime
B
Amoxycillin
C
Ciprofloxacin ear drops
D
Cephalexin
Five days later, Mrs East brings Matt into the pharmacy with red, irritated nappy rash that has spread
into his skin folds.
Which ONE of the following statements of advice is LEAST appropriate to give Mrs East?
A
Apply miconazole/zinc oxide ointment for seven days
B
Use barrier cream at each nappy change
C
Use unscented nappy wipes
D
Apply his eczema cream to the nappy rash until cleared
E
Leave nappies off for as long as possible
53
Mrs East also tells you that Matt has had loose bowel motions for the past four days. What is the
MOST appropriate advice to give Mrs East?
A
Stop breastfeeding, give water and see a doctor
B
Give electrolyte replacement fluids to supplement breastfeeding
C
Continue breastfeeding and see a doctor as soon as possible
D
Stop breastfeeding and give electrolyte replacement
E
Express breast milk and dilute with boiled water
***
END OF PATIENT PROFILE
***
54
55
56
Which ONE of the following supportive statements concerning breastfeeding is
INCORRECT?
A
Breastfeeding provides an optimal nutritional diet
B
Breastfeeding provides protection against infections
C
Breastfeeding provides protection against allergies
D
Breastfeeding provides an inexpensive and convenient nutrition source
E
Breastfeeding provides a complete diet up to 12 months of age
Which ONE of the following medications is the MOST appropriate first line treatment for depression in
an elderly patient who has recently been bereaved?
A
Nortriptyline
B
Tranylcypromine
C
Citalopram
D
Moclobemide
E
Oxazepam
Which ONE of the following statements is CORRECT?
Alendronate:
A
Has a long biological half life
B
Has a short biological half life
C
Can be taken at bedtime to avoid possible drowsiness
D
Should be taken one hour after a meal
E
Can be taken in the morning with breakfast to avoid stomach upset
57
58
59
When used as a nasal decongestant, pseudoephedrine acts by which ONE of the following
mechanisms?
A
Indirect stimulation of the muscarinic receptors in the nasal mucosa
B
Direct stimulation of the adrenoreceptors in the nasal mucosa
C
Direct and indirect stimulation of adrenoreceptors in the nasal mucosa
D
Direct and indirect stimulation of the muscarinic receptors in the nasal mucosa
E
Direct stimulation of the muscarinic receptors in the nasal mucosa
What is the recommended immunisation schedule for Diptheria, Tetanus and acellular Pertussis?
A
2, 4, 6 months and 4 years
B
6 weeks, 2 months, 6 months
C
12 months only
D
6, 12 and 18 months
A customer comes into the pharmacy with her 12 month old daughter. She explains that her daughter
has had the recommended immunisation to date. However, she is now in two minds about MMR
(measles, mumps, rubella) vaccine due to recent adverse reports about immunisation.
Which ONE of the following statements is INCORRECT?
A
A child who may have had measles can be vaccinated with MMR since the risk of adverse
effects is not increased
B
A child may develop a fine rash a few days after immunisation with MMR (subclinical
measles is not infectious)
C
Immunisation against measles before 12 months of age may not be effective due to residual
maternal antibodies
D
Paracetamol is not routinely used at the time of immunisation, but may be recommended
for fever or pain
E
There are no possible long term health consequences following an episode of measles
PATIENT PROFILE
Patient Name:
James Joyce
Address:
Room 4A, Chandler Ward
Age:
7 1/2
Height:
125 cm
Sex:
Allergies:
Male
Penicillin (anaphylaxis)
Weight:
20 kg
Diagnosis
Presenting Complaint:
Medical History:
1. Left lower quadrant abdominal pain (possible
appendicitis)
1. Asthma
Laboratory / Diagnostic Tests
Date
Test
Reference Range
Medication Record
Date
Medication
5/7
Diclofenac suppositories 25 mg
Quantity
10
Sig
i PR tds prn for pain
5/7
Morphine infusion
20
30 microgram/kg/hr
5/7
Paracetamol suppositories 250 mg
24
i PR q4-6h prn (max 4 in 24hr)
5/6
Montelukast 5 mg
30
i daily
5/6
Salbutamol MDI
2
ii puffs qid prn
Pharmacist's Notes
5/7 Admitted 5/7 - Ultrasound confirmed appendicitis.
Patient to theatre for the removal of appendix - found to be perforated.
Postoperatively admitted to the surgical ward.
Patient has a pain score 4 out of 10.
60
61
62
Which ONE of the following is NOT a common adverse effect of morphine?
A
Nausea
B
Itch
C
Respiratory depression
D
Constipation
E
Seizures
James complains of shortness of breath. Which ONE of the following medicines is
MOST likely responsible?
A
Morphine
B
Paracetamol
C
Diclofenac
D
Montelukast
Two days post operatively, James is starting to tolerate an oral diet and he is changed from rectal
diclofenac to oral ibuprofen tds for pain. He is also changed from intravenous morphine to oral codeine
20 mg 4-6 hourly when required.
Which ONE of the following statements about codeine is INCORRECT?
A
Its metabolism displays significant polymorphism
B
It is an opioid considered equipotent with morphine
C
Constipation is a frequently seen adverse effect of codeine
D
There is a ceiling dose beyond which no extra effect is seen
E
Its effect is largely dependent on its metabolism to morphine
63
Which ONE of the following statements regarding the use of NSAIDs is INCORRECT?
A
NSAIDs should be used with caution in patients who are dehydrated
B
NSAIDs should be used with caution in patients with renal impairment
C
NSAIDs should be used with caution in patients with a history of asthma
D
NSAIDs should be used with caution in patients who are already taking codeine
E
NSAIDs should be used with caution in patients with a history of
gastrointestinal bleeding
***
END OF PATIENT PROFILE
***
64
65
66
Which ONE of the following medications is LEAST effective if administered rectally?
A
Hydrocortisone
B
Diazepam
C
Paracetamol
D
Phenytoin
Which medication displays a significant pharmacokinetic interaction with amiodarone?
A
Verapamil
B
Warfarin
C
Sotalol
D
Atorvastatin
E
Thyroxine
A diabetic patient has just been diagnosed with hyperlipidemia. Dietary measures have failed.
Monotherapy is preferred to encourage compliance.
Lipid levels:
Cholesterol
6.5 mmol/L (NR < 5.5)
Triglycerides 3.2 mmol/L (NR < 2.2)
Which ONE of the following medications is the BEST option?
A
Gemfibrozil
B
Cholestyramine
C
Atorvastatin
D
Probucol
E
Ezetimibe
67
68
Which ONE of the following is MOST likely to increase the INR of patients on warfarin?
A
Rifampicin
B
Griseofulvin
C
Carbamazepine
D
Sulfamethoxazole/trimethoprim
E
Cefaclor
Which ONE of the following statements is CORRECT with regard to vaginal thrush?
A
Vaginal antifungals should not be used during pregnancy
B
The most common causative organism is Candida glabrata
C
Single doses of azole antifungals are effective for frequent episodes
D
When treating with an azole, treatment should cease when symptoms abate
E
Excessive use of vaginal antifungals may cause allergic vaginal and vulval reactions
PATIENT PROFILE
Patient Name:
John Porter
Address:
Room A, Emergency Ward
Age:
4
Height:
120 cm
Sex:
Allergies:
Male
Amoxycillin (rash)
Weight:
18 kg
Diagnosis
Presenting Complaint:
Medical History:
1. Lethargy
2. Stiff neck
3. High fever
4. Photophobia
5. Sore throat
1. Non-specific cough
2. Fever
3. Ear pain
Laboratory / Diagnostic Tests
Date
Test
Medication Record
Date
Medication
14/7
Erythromycin 40 mg/mL
Reference Range
Quantity
100 mL
Sig
5 mL q6h
Pharmacist's Notes
14/7 Patient consulted GP and was treated for a throat infection.
16/7 Patient rapidly deteriorated and developed lethargy, stiff neck, high fever, photophobia and inconsolable crying.
Patient presented to hospital emergency ward. Patient was pyrexial with temperature of 39.2 degrees and nonblanching purpuric rash. Chest was clear but he still has a red sore throat.
Provisional diagnosis: Meningococcal septicaemia.
Immunisation status: up-to-date.
69
70
71
Which ONE of John's signs and symptoms is NOT an expected sign of meningitis?
A
Stiff neck
B
Sore throat
C
Lethargy
D
High fever
Which ONE of the following organisms would be the MOST likely cause of John's symptoms?
A
Escherichia coli
B
Haemophilus influenzae type B
C
Staphylococcus aureus
D
Streptococcus pneumoniae
E
Neisseria meningitidis
John's signs and symptoms are consistent with septicaemia and he is admitted to the Intensive Care
Unit for treatment, with high dose intravenous antibiotics.
Which ONE of the following antibiotics would be the MOST appropriate choice?
A
Cefotaxime
B
Ceftazidime
C
Cefazolin
D
Gentamicin
E
Vancomycin
72
Later that day, John's mother presents to the pharmacy with a prescription for rifampicin 600 mg bd for
two days, for meningococcal prophylaxis for herself and her husband.
Which ONE of the following statements is LEAST appropriate? Rifampicin:
A
Is an enzyme inhibitor and interacts with a number of drugs
B
Should be avoided in late pregnancy because of potential risk of neonatal bleeding
C
Can cause permanent staining of soft contact lenses
D
Is best taken 30 minutes before food to enhance absorption
E
Requires additional contraceptive measures, if using hormonal contraception
***
END OF PATIENT PROFILE
***
73
74
With regard to the following combinations of medications and potential side effect, which
combination is LEAST likely to match?
A
Phenytoin + gingival hyperplasia
B
Carbamazepine + agranulocytosis
C
Lamotrigine + Stevens-Johnson syndrome
D
Sodium valproate + renal failure
E
Vigabatrin + visual field defects
For an acute angina attack and treatment with sublingual medication, which ONE of the following is
INCORRECT?
A
Sit or lie down before using sublingual tablets or spray, as they may cause dizziness
B
Call an ambulance if symptoms are severe, get worse, or last for 10 minutes
C
The recommended dose of sublingual spray is 400-800 micrograms (1-2 sprays), repeated once
after 5 minutes if necessary
D
The recommended dose of sublingual tablets is 600 micrograms (1 tablet) repeated every 3-4
minutes until pain is resolved, to a maximum of 2 or 3 tablets
E
For prevention of acute angina before activity, swallow ½ to 1 sublingual tablet 5 to 10 minutes
prior to activity
PATIENT PROFILE
Patient Name:
Fredrick Moore
Address:
113 Oak Tree Road
Pine Gap
Age:
Sex:
Allergies:
67
Male
Nil known
Diagnosis
Presenting Complaint:
Medical History:
Height:
Weight:
180 cm
85 kg
1. Exacerbation of asthma
1. Rheumatoid arthritis
2. Hypertension
3. Type 2 diabetes
Laboratory / Diagnostic Tests
Date
Test
Medication Record
Date
Medication
18/12
Prednisolone 25 mg
Reference Range
30
Quantity
30
Sig
ii daily for 5 days
17/10
Salmeterol 25 microgram/dose MDI
1
i bd
29/9
Fluticasone 250 microgram/dose MDI
1
i-ii bd
20/9
Meloxicam 7.5 mg
30
i daily
20/9
Methotrexate 10 mg
50
i weekly
20/9
Salbutamol 100 microgram/dose MDI
2
ii q4h prn
16/4
Amlodipine 10 mg
30
i daily
Pharmacist's Notes
18/12 Poor compliance with inhalers due to arthritis; dietary controlled diabetes.
75
76
77
What is the MOST likely effect of long-term high-dose prednisolone for Mr Moore?
A
Hyperkalaemia
B
Decreased glucose tolerance
C
Diabetes insipidus
D
Increased plasma cortisol levels
E
Increased urine output
What is the MOST appropriate advice to be given to a patient taking salmeterol?
A
Use an extra dose in the event of an asthma attack
B
Rinse mouth out after use
C
Use 5 minutes before mild to moderate exercise
D
Use regularly twice daily
E
Never use in conjunction with salbutamol
Which ONE of the following is the MOST appropriate description of asthma?
A
Wheezing with a cough
B
Tightness of the airways
C
Shortness of breath after exercise
D
Tightness and congestion of chest
E
Inflammation of airways
78
79
Given Mr Moore's poor compliance with inhalers, what would be the best advice to make his
treatment more effective?
A
Add montelukast 10 mg daily
B
Add fluticasone 500 / salmeterol 50 two puffs bd
C
Add budesonide 400 / eformoterol 12 one puff bd
D
Cease salmeterol and add fluticasone 500 / salmeterol 50 Accuhaler one puff bd
Mr Moore returns to his doctor two days later, as he is concerned about his elevated Blood Glucose
Level (BGL) [random BGL above 12mmol/L].
What is the MOST probable cause of his elevated BGL?
80
A
Methotrexate (increases gluconeogenesis)
B
Short course high dose prednisolone
C
Long term inhaled corticosteroid therapy
D
Methotrexate induced insulin resistance
E
Increased appetite following high dose oral corticosteroids
Which ONE of the following adverse side effects is MOST likely to occur when meloxicam is
combined with methotrexate being used as an antineoplastic agent?
A
Acute renal failure
B
Myelosuppression
C
Gastrointestinal bleeding
D
Hyperglycaemia
E
Stevens Johnson Syndrome
***
END OF PATIENT PROFILE
***
81
82
83
The first dose of angiotensin converting enzyme (ACE) inhibitors can cause marked hypotension. This
is MOST likely to occur in patients already taking:
A
Prazosin
B
Metoprolol
C
Frusemide
D
Candesartan
E
Potassium chloride
All of the following are advantages of moist wound healing EXCEPT for:
A
Scab formation
B
Promotion of granulation
C
The dressing can be left on for up to five days
D
The temperature of the healing environment is kept constant
Which ONE of the following statements regarding the use of griseofulvin is
INCORRECT?
A
Patients should be advised to avoid alcohol
B
It is best taken with a meal high in carbohydrate
C
Exposure to intense artificial or natural sunlight should be avoided
D
Men should be advised not to father a child during therapy or for six months after treatment
E
It should be avoided during pregnancy and while breastfeeding
84
85
Which ONE of the following clinical conditions is simvastatin used for?
A
Hypertriglyceridaemia with reduced HDL
B
Hypercholesterolaemia with elevated LDL
C
Mixed lipidaemia with elevated triglyceride
D
Hypocholesterolaemia with normal to elevated HDL
E
Acute cholesterol reduction following TIA
When assessing a risk/benefit ratio for recommending the use of warfarin in a patient with atrial
fibrillation.
Which ONE of the following is LEAST important?
86
A
Falls risk
B
Smoking status
C
Alcohol consumption
D
Dementia
E
Peptic ulcer
A 2 year old child has a honey-coloured crusted lesion beside her mouth that has been present for
three days. The child also has a small blister on her hand that looks like a burn. The child has no other
symptoms.
What is the MOST likely cause of the lesions?
A
Herpes zoster
B
Mollacum contagiosum
C
Vitiligo
D
Tinea corporus
E
Impetigo
PATIENT PROFILE
Patient Name:
Richard Bore
Address:
2/14 Jasmine Drive
Flowervale
Age:
Sex:
Allergies:
56
Male
Nil known
Diagnosis
Presenting Complaint:
Medical History:
Height:
Weight:
180 cm
91 kg
1. Mycobacterium infection
1. Hypercholesterolaemia
2. Diabetes
3. Ischaemic heart disease
4. Rheumatoid arthritis
5. Atrial fibrillation
Laboratory / Diagnostic Tests
Date
Test
Reference Range
Medication Record
Date
Medication
7/10
Methotrexate tablets 10 mg
Quantity
50
Sig
ii weekly
24/9
Simvastatin tablets 20 mg
30
i nocte
3/9
Glipizide tablets 5 mg
100
i bd
3/9
Metformin tablets 500 mg
100
i bd
25/8
Glyceryl trinitrate patches 25 mg
30
i daily
25/8
Metoprolol tablets 50 mg
100
i bd
1/7
Beclomethasone nasal spray
1
i bd each nostril
1/7
Warfarin 5 mg
30
i daily
Pharmacist's Notes
Nil
87
88
Mr Bore is diagnosed with a mycobacterium infection. He presents with a prescription for rifampicin 600
mg bd. This antibiotic might lead to:
A
Decreased control of his hypercholesterolaemia because rifampicin can induce the metabolism
of simvastatin
B
Decreased glycaemic control due to induction of metabolism of metformin
C
Increased risk of lactic acidosis due to inhibition of metabolism of metformin
D
Increased toxicity of methotrexate due to inhibition of metabolism
E
Migraine headaches due to inhibition of metabolism of glyceryl trinitrate
Although Mr Bore tolerates his medication well, his glycaemic control worsens (HbA1c increases to 9%).
Which ONE of the following is the MOST appropriate therapeutic option?
89
A
Introduce insulin therapy
B
Increase dose of metformin to 2 g daily
C
Increase dose of glipizide to 20 mg daily
D
Introduce pioglitazone
E
Introduce acarbose
What additional counselling should you give Mr Bore about his diabetes?
A
Conduct daily urine testing
B
Completely avoid eating all sugars
C
Have regular liver function tests and eye tests
D
Have regular kidney function tests and eye tests
E
Have monthly glycosylated haemoglobin (HbA1c) tests
90
91
What laboratory tests should be used to monitor Mr Bore while on treatment with methotrexate?
A
Full blood count, liver function, plasma electrolytes
B
Full blood count, renal function, liver function
C
Thyroid function, full blood count, renal function
D
Full blood count, cardiac function, plasma electrolytes
E
Cardiac function, renal function, plasma electrolytes
Due to unacceptable side-effects with methotrexate, Mr Bore's consultant rheumatologist changes his
treatment to leflunomide 100 mg daily for 3 days, reducing to 20 mg daily.
You contact the prescriber because:
A
Leflunomide increases the metabolism of metoprolol, the dose of which may need to be
altered
B
Leflunomide, via its active metabolite, inhibits the enzyme that metabolises warfarin, which
may lead to bleeding
C
Leflunomide inhibits the enzyme that metabolises simvastatin, the dose of which may
need to be reduced
D
Leflunomide, via its active metabolite, induces the metabolism of metformin with the
possible outcome being lactic acidosis
E
Glipizide increases the metabolism of leflunomide, the dose of which may need to be increased
***
END OF PATIENT PROFILE
***
92
A female customer has diabetes. She has developed a post-viral cough and runny nose.
Which ONE of the following would be the MOST suitable to address this patient's symptoms?
93
A
A product containing glycerol to soothe the throat
B
A sugar-free elixir containing pholcodine and pseudoephedrine
C
A decongestant nasal spray and a sugar-free elixir containing pholcodine. A sugar-free elixir
containing pholcodine and a decongestant nasal spray
D
A referral to the doctor as an antibiotic will be required
E
Senega and ammonia mixture and beclomethasone nasal spray
An 8 year old girl has been hit in the face with a tennis ball and a nose bleed has resulted. Which
ONE of the following actions should you recommend?
Tilting her head:
94
A
Back and pinching the top of her nose
B
Forward and pinching the top of her nose
C
Forward and pinching the lower soft part of the nose
D
Back and applying a cold compress to the nose area
E
Forward and inserting gauze plugs into each nostril
Doxycycline is contraindicated in young children due to:
A
A high incidence of photosensitivity
B
A physical incompatibility with milk
C
Hepatotoxicity in the immature liver
D
Unavailability of a liquid product
E
A risk of causing bone deformity
95
96
Which ONE of the following statements is CORRECT with regard to vitamin B6?
A
Exceeding the upper point of the recommended range for the intake of vitamin B6 does not lead
to toxicity
B
Peripheral neuropathy has been reported to be an adverse reaction of excessive
intake of vitamin B6
C
The official upper point of the recommended range for intake of vitamin B6 is 100 mg per day
D
Concomitant use of multivitamins and single-vitamin products does not increase the
risk overdosing
Which ONE of the following statements is LEAST accurate regarding emergency contraception?
A
A single dose of 1.5 mg of levonorgestrel is effective if taken within 72 hours of unprotected
intercourse
B
Copper IUDs continue to provide contraceptive effect for the rest of the cycle
C
750 microgram of levonorgestrel is effective if taken within 72 hours of unprotected
intercourse and then repeated 12 hours later
D
Oral levonorgestrel, single dose regimen, is the method of choice for emergency
hormonal contraception
E
Emergency contraception should be used with caution in women who are breastfeeding
PATIENT PROFILE
Patient Name:
Diane Morgan
Address:
14 Briarwood Road
Maxwell
Age:
Sex:
Allergies:
25
Female
Nil known
Diagnosis
Presenting Complaint:
Medical History:
Laboratory / Diagnostic Tests
Date
Test
Medication Record
Date
Medication
Pharmacist's Notes
30 weeks pregnant
Height:
Weight:
158 cm
68 kg
1. Vaginal discharge
1. 1st pregnancy
2. Urinary tract infection (UTI)
Reference Range
Quantity
Sig
97
Mrs Morgan presents at the pharmacy asking to speak to the pharmacist. She complains of 'thrush' and
further describes it as a white, clumpy vaginal discharge and pain on urination. Although she has had
'thrush' before, it has been over one year since her last bout.
Which ONE of the following over-the-counter medications would be MOST appropriate to treat thrush in
Mrs Morgan?
98
99
A
Clotrimazole solution
B
Clotrimazole pessaries
C
Oral fluconazole
D
Clotrimazole topical cream
E
Oral itraconazole
Mrs Morgan later presents with a prescription for the treatment of her UTI. Of the following
medications, which ONE is the MOST appropriate choice for Mrs Morgan?
A
Norfloxacin
B
Sodium citro-tartrate granules
C
Erythromycin
D
Cephalexin
Mrs Morgan asks what she can use for a runny nose which the doctor has told her was caused by a
virus.
Which ONE of the following is the MOST appropriate option with regard to efficacy and safety?
A
Pseudoephedrine tablets
B
Beclomethasone nasal spray
C
Oxymetazoline nasal spray
D
Expectorant cough syrup
E
Fexofenadine tablets
100
101
Which ONE of the following over-the-counter oral medications is MOST likely to cause problems for Mrs
Morgan and her unborn foetus?
A
Dextromethorphan
B
Aspirin
C
Guaiphenesin
D
Dexchlorpheniramine
After the birth of the baby, Mrs Morgan (who is breastfeeding) presents to the pharmacy with a
prescription for an oral contraceptive. Which ONE of the following is the MOST appropriate
recommendation?
A
Levonorgestrel 50 mcg; ethinyloestradiol 30 mcg
B
Levonorgestrel 30 mcg
C
Norethisterone 30 mcg
D
Ethinyloestradiol 35 mcg; norethisterone 100 mcg
E
Mestranol 50 mcg; norethisterone 1000 mcg
***
END OF PATIENT PROFILE
***
102
A doctor contacts you about a 40 year old woman who has chronic adrenocortical insufficiency. Her
treatment is hydrocortisone 20 mg daily. She has just got the flu.
The doctor asks you what would be the MOST appropriate treatment.
103
104
A
Doubling or trebling of hydrocortisone dosage
B
Add 0.1 mg fludrocortisone to her regimen
C
Halve the hydrocortisone dosage
D
Change to 25 mg daily of cortisone
E
Give tetracosactrin 0.25 mg as a single dose
What is the recommended dose and duration of amoxycillin therapy for the treatment of acute otitis
media in a five year old child?
A
62.5 mg tds for 5 days
B
62.5 mg tds for 14 days
C
62.5 mg tds for 10 days
D
250 mg tds for 5 days
E
250 mg tds for 14 days
Gemfibrozil is contraindicated in:
A
The elderly
B
Hyponatremia
C
Acidosis
D
Pregnancy
E
Heart failure
105
A male customer wants to purchase a salbutamol metered aerosol for his asthma. You know he is a
regular customer and has a long history of asthma. However, this is his second request for salbutamol in
the past week.
What is the main complication arising from his increased use of the medication?
106
107
A
It has a relatively high risk of causing cardiac arrest
B
It can mask the deterioration of his asthma
C
There is a high risk of him becoming habituated to the salbutamol
D
It can cause dangerous hypotension
E
It can cause bradycardia
Which ONE of the following is an important adverse effect of beta-blockers?
A
Urinary retention
B
Bronchospasm
C
Hyperglycaemia
D
Nasal congestion
E
Muscle cramp
Which ONE of the following medications has a serious interaction with azathioprine?
A
Probenecid
B
Indomethacin
C
Allopurinol
D
Colchicine
E
Methotrexate
PATIENT PROFILE
Patient Name:
Ron Clooney
Address:
39 Wallis Street
Nanna Hill
Age:
Sex:
Allergies:
38
Male
Penicillin
Diagnosis
Presenting Complaint:
Medical History:
Height:
Weight:
180 cm
80 kg
1. Constipation
1. Prostate cancer
2. Nausea
Laboratory / Diagnostic Tests
Date
Test
Reference Range
Medication Record
Date
Medication
25/7
Paracetamol 500 mg
Quantity
100
Sig
ii qid prn
25/7
Paracetamol 500 mg/codeine phosphate 15 mg
20
ii qid prn
25/7
Paracetamol 500 mg/codeine phosphate 30 mg
20
ii qid prn
25/7
Morphine sulfate SR 30 mg cap
20
i bd
Pharmacist's Notes
Nil
108
109
110
Which ONE of the following is the MOST significant potential toxicity problem for Mr Clooney?
A
An overdose of paracetamol
B
An overdose of codeine
C
An overdose of opiates
D
An overdose of morphine
E
An overdose of oxycodone
In counselling Mr Clooney, you should advise him to take the morphine tablets:
A
As required AND any combination of paracetamol, with or without codeine up to a maximum of
4 g total paracetamol per day, regularly
B
Regularly, AND in combination with paracetamol, up to a maximum of 4 g total paracetamol per
day, as required
C
As required, OR any combination of paracetamol, with or without codeine up to a maximum of 4
g total paracetamol per day, as required
D
Regularly, OR any combination of paracetamol, with or without codeine up to a maximum of 4 g
total paracetamol per day, regularly
Which ONE of the following measures is the MOST appropriate to control Mr Clooney's
nausea?
A
Esomeprazole
B
Dimenhydrinate
C
Metoclopramide
D
Reduce morphine dose
E
Change morphine to oxycodone
111
Which ONE of the following is the MOST appropriate advice to give Mr Clooney about managing his
constipation?
A
Take lactulose when necessary
B
Take bisacodyl tablets at night
C
Take a docusate enema twice daily
D
Take docusate and senna tablets regularly
E
Take sterculia and frangula granules regularly
***
END OF PATIENT PROFILE
***
112
113
114
A suitable maintenance dose of methotrexate, in a patient with rheumatoid arthritis and a creatinine
clearance less than 40 mL/min, is:
A
5 - 15 mg each day
B
25 - 50 mg each day
C
30 - 50 mg weekly
D
2 - 15 mg weekly
E
5 - 25 mg 3 x weekly
Which ONE of the following pairs of medications is MOST likely to be prescribed together?
A
Colchicine and allopurinol
B
Cabergoline and ergometrine
C
Amiodorone and sotalol
D
Lithium and NSAIDs
E
St John’s Wort and digoxin
Therapeutic drug monitoring of medications is LEAST appropriate for medications with which ONE of the
following?
A
A narrow therapeutic range
B
A target concentration range
C
Little pharmacokinetic variability
D
An available cost effective medicine assay
E
A strong relationship between plasma concentrations and clinical effects
115
116
117
In an elderly person, which ONE of the following antidepressants is MOST likely to exacerbate
postural hypotension?
A
Nortriptyline
B
Moclobemide
C
Fluoxetine
D
Paroxetine
E
Amitriptyline
Which ONE of these medications should be administered MORE frequently than once daily?
A
Amlodipine
B
Piroxicam
C
Warfarin
D
Sotalol
E
Glimepiride
Laboratory test results indicate a patient's potassium level to be 5.5 mmol/L. The patient's ECG
shows no change.
Which ONE of the following statements is CORRECT?
A
This patient's potassium level is high and requires immediate administration of IV calcium
gluconate
B
This patient's potassium level is within normal limits, but requires ongoing monitoring
C
This patient's potassium level is low and oral supplementation should be prescribed
D
This patient's potassium level is low and requires immediate IV
supplementation
E
This patient's potassium level is high and requires investigation
PATIENT PROFILE
Patient Name:
Margaret Chamberlain
Address:
Room number 3
Age:
53
Height:
151 cm
Sex:
Allergies:
Female
Penicillin (rash)
Co-trimoxazole (rash)
Weight:
61 kg
Diagnosis
Presenting Complaint:
Medical History:
1. Recurrent urinary tract infections
2. Gastro-oesophageal reflux
1. Schizophrenia
2. Depression
3. Hyperlipidaemia
Laboratory / Diagnostic Tests
Date
Test
1/4
ALP 204 U/L
Reference Range
<35 U/L
1/4
ALT 90 U/L
<35 U/L
1/4
AST 90 U/L
<40 U/L
1/4
Cholesterol 8.4 mmol/L
(<5.5mmol/L)
1/4
ESR 30 mm/hr
<20 mm/hr
1/4
HDL 0.9 mmol/L
1.0-2.2 mmol/L
1/4
Lithium 0.3 mmol/L
0.4-1.0 mmol/L
1/4
Total cholesterol/HDL ratio 9.3
<3.5
1/4
Triglycerides 4.7 mmol/L
1.7 mmol/L
Medication Record
Date
Medication
1/4
Lithium carbonate 250 mg
Quantity
100
Sig
i bd
1/4
Ranitidine 150 mg
60
i bd
20/3
Pravastatin 10 mg
30
i nocte
15/3
Amitriptyline 25 mg
50
v nocte
15/3
Benztropine 2 mg
60
half bd
7/2
Clozapine 100 mg
100
ii nocte
Pharmacist's Notes
1/4 Uses Ural® sachets (sodium citro-tartrate granules) two or three times a day, when urinary tract infections occur.
Norfloxacin 400mg i bd (several courses over last 12 months) Taking St
John’s Wort.
118
119
120
Mrs Chamberlain suffers from hay fever. She asks you for a suitable product to relieve her symptoms.
Which ONE of the following would be MOST appropriate?
A
Pseudoephedrine 60 mg tds
B
Promethazine 50 mg daily
C
Loratadine 10 mg daily
D
Oxymetazoline 0.5% nasal spray prn
E
Pheniramine 45.3 mg bd
Which ONE of the following combinations of medications is MOST likely to cause serotonin
syndrome?
A
Benztropine and lithium
B
Lithium and pravastatin
C
Benztropine and St John's Wort
D
Lithium and St John's Wort
E
Lithium and clozapine
Due to Mrs Chamberlain's recurrent urinary tract infections, hexamine hippurate 1 g bd has been ordered.
Which ONE of the following would need to be ceased to optimise use of this agent?
A
Benztropine 1 mg bd
B
Sodium citro-tartrate granules
C
Norfloxacin 400 mg bd
D
Lithium carbonate 250 mg bd
E
St John's Wort
121
Mrs Chamberlain has recently complained of a sore throat and painful gums. A blood test shows
evidence of leukopenia.
Which ONE of the following is MOST likely to be responsible for this effect?
A
Lithium carbonate
B
Clozapine
C
Benztropine
D
Ranitidine
E
Pravastatin
***
END OF PATIENT PROFILE
***
122
123
124
What is the MOST common adverse effect of IV zoledronic acid?
A
Stomatitis
B
Hypercalcaemia
C
Osteonecrosis
D
Hypokalaemia
E
Flu-like symptoms
What is the initial management for an obese patient, diagnosed with Type 2 diabetes?
A
Insulin
B
Gliclazide
C
Metformin
D
Gliclazide with metformin
E
Diet modifications and exercise
Which ONE of the following adverse drug reactions is NOT a recognised side-effect of tramadol?
A
Seizures
B
Renal impairment
C
Serotonin syndrome
D
Nausea
E
Constipation
125
Which ONE of the following groups does NOT contain a significant drug interaction?
A
Cyclosporin, ramipril, phenytoin
B
Digoxin, amiodarone, frusemide
C
Amitriptyline, lithium, fosinopril
D
Allopurinol, colchicine, naproxen
E
Digoxin, erythromycin, diltiazem
***
END OF EXAM
***
2013
Q1
Howmuchelementalcalcium(MW=40g/mol)doesapatientreceiveperdayif taking calcium carbonate
(MW = 100 g/mol) 600 mg twice daily?
A
480 mg B
2400 mg
C
1200 mg
D
600 mg
E
240 mg
Q2
A patient requires a 5-day course of a medicine, the dose of which is 500 mg once dailyonday1and250mgonce
dailyonday2today5.Themedicineisonlyavailable as a 150mg dispersible tablet and is stable after dispersion
for 6 hours. What is the minimum number of dispersible tablets required for the 5-day course?
A
10
B
20
C
16
D 12 E
8
Q3
Phenytoin is available as 5 mL vials at a concentration of 50 mg/mL. The dose required is 15mg/kg and the
patient weighs75kg. If the required rate of infusion of phenytoin is 40 mg/minute, how long will it take to
complete the infusion?
A 2.8 minutes B 28
minutes
C
56
minutes
D
18 minutes
E
1.8 minutes
© Australian Pharmacy Council Ltd, 2013
2
Q4
A patient who uses tramadol 200 mg SR orally mane and 50 mg orally twice daily regularly to control
breakthrough pain, is declared nil by mouth in hospital. What rate of IV morphine infusion would provide
equivalent opioid analgesia if the equieffective analgesia ratio of tramadol oral to tramadol IV is 1.5:1 and the
ratio of tramadol IV to morphine IV is 10:1?
A
16.6 mg/hour
B
694 micrograms/hour
C
187 mg/hour
D
833 micrograms/hour E
69 mg/hour
Q5
What weight of an ingredient is required to produce 1000 mL of a solution such that
2.5 mL diluted to 50 mL gives a 0.25% (w/v) solution?
A
5g
B
50 mg C
50 g
D
25 mg
E
25 g
© Australian Pharmacy Council Ltd, 2013
3
Q6
A female patient, who is 68 years old and weighs 68kg, presents with a serum creatinine of 0.178mmol/L. What is
her approximate serum creatinine clearance rate?
A
10mL/min
B
30mL/min
C
45mL/min
D
60mL/min
E
80mL/min
Q7
A 30 year old female with a starting weight of 65 kg and a height of 160 cm has lost 10 kg. What is the change in
her Body Mass Index (BMI)?
A
1.6
B
2.6 C
3.9
D
1.9
E
4.5
© Australian Pharmacy Council Ltd, 2013
4
Q8
A patient is prescribed a reducing prednisolone regimen of:
20 mg daily for 5 days, then reduce the daily dose by 5 mg every 3 days, then cease.
How many 5 mg tablets ofprednisolone will the patient requirefor this regimen? A
B
24
C
28
D
30
E
38
20
Q9
Which of the following is CORRECT, regarding the supply of Pharmaceutical Benefits Scheme (PBS) prescriptions?
A
B
C
D
E
the same PBS prescription identifying number must apply to each item on the prescription
a repeat authorisation does not require endorsement by the pharmacist with his/her approved
supplier number
a pharmacist cannot supply an alternative brand of medicine without reference to the
prescriber
a pharmaceutical benefit cannotbe supplied more times than specified in the
PBS prescription
the original PBS prescription identifying number is not duplicated on a repeat authorisation for an item
© Australian Pharmacy Council Ltd, 2013
5
Q10
Methylphenidate is included in which of the following schedules?
A
Schedule 2
B
Schedule 3
C
Schedule 4
D
Schedule 7 E
Schedule 8
Q11
For which Poisons Schedule is the following statement a general description?
“Substances with a low potential for causing harm, the extent of which can be reduced through the
use of appropriate packaging with simple warnings and safety directions on the label.”
A
Schedule 2
B
Schedule 3
C
Schedule 4 D
Schedule
5
E
Schedule 6
© Australian Pharmacy Council Ltd, 2013
6
Q12
A prescription item designated as a restricted PBS benefit is BEST described as
medication…
A
B
C
D
E
that has no PBS restriction on its therapeutic use
with a low therapeutic index, which requires close monitoring
that can only be prescribed on the PBS for specific therapeutic uses
thatisrestrictedand requirespriorapprovalfromtheMedicareAustraliaor the Department of
Veterans Affairs for a specific condition
with a high chance of adverse events, which requires the prescriber to consider carefully the
risk benefit ratio for each specific patient
Q13
The original supply and repeats of a pharmaceutical benefit may be supplied on the same day if the
A doctor has endorsed the prescription “Reg 19” B doctor has
endorsed the prescription “Reg 24” C item is listed as an
“unrestricted benefit”
D patient is the holder of a health care card E patient has a
safety net entitlement
© Australian Pharmacy Council Ltd, 2013
7
Q14
For which Poisons Schedule is the following statement a general description?
“Substances, the use or supply of which should be by or on the order of persons permitted by State or
Territory legislation to prescribe and should be available from a pharmacist on prescription.”
A
Schedule 2
B
Schedule 3
C
Schedule 4
D
Schedule 5
E
Schedule 6
Q15
A patient enters the pharmacy wishing to fill a prescription for morphine sulphate SR 30 mg (60), having had a
supplyfourdayspreviously. WhatistheMOSTappropriate action?
A
B
dispense prescription aswritten
C
D
decline to dispense the prescription, as the patient could be misusing the medication
E
supply the patient with a restricted amount only
ascertain why the patient needs the medication and contact the prescriber to authorise supply if
necessary
supply the patient with an over-the-counter (OTC) paracetamol/codeine medication in the
interim
© Australian Pharmacy Council Ltd, 2013
8
Q16
For which Poisons Schedule is the following statement a general description?
“Substances which should be available for use but require restriction of manufacture, supply,
distribution, possession and use to reduce abuse, misuse and physical or psychological dependence.”
A
Schedule 2
B
Schedule 3
C
Schedule 4
D
Schedule 5
E
Schedule 8
Q17
Chicken pox vaccine should be completed at
A
3 months
B
6 months
C
18 months
D
5 years
Q18
Whichofthefollowingconditionswouldpreventtheuseofanangiotensin- converting enzyme
inhibitor?
A
bilateral renal artery stenosis
B
non-insulin dependent diabetes mellitus C
Ménière’s disease
D
hyperlipidaemia
E
lupus erythematous
© Australian Pharmacy Council Ltd, 2013
9
Q19
Which of the following statements is CORRECT regarding paracetamol? Paracetamol
A
has significant anti-inflammatory activity B
induces inhibits cyclo-oxygenase
C
is excreted largely unchanged by the kidneys Dcan be given
by intravenous infusion
E
is contraindicated in pregnancy
Q20
Which of the following statements about doxycycline is INCORRECT? Doxycycline
A
can be used in the treatment of rosacea
B
may decrease blood methotrexate concentration C
may be
taken by children over 8 years of age
D
should be taken in the morning rather than at night
E
should not be taken after the first 18 weeks of pregnancy
Q21
Which of the following statements about doxycycline is CORRECT?
A
B
C
D
it increases the metabolism of phenytoin and should be used with caution in epilepsy
it is effective as monotherapy in treating infection with Plasmodium falciparum
it may reduce bone growth in young children
it should not be used in the second trimester of pregnancy, due to risk of teratogenicity
E
it is used at a dose of 100mg bd to treat acne
© Australian Pharmacy Council Ltd, 2013
10
Q22
A female customer misses a dose of a progesterone only pill. Within how many hours does she have to
take the pill, before contraceptive cover is reduced?
A
one B
three
C
four
D
six
E
twelve
Q23
Apatient has been taken off fluoxetineandprescribed venlafaxineand told by the doctor to ask the pharmacist
how long to waitbefore starting the new medication. The BEST advice would be to wait for
A
one day
B
two days
C
ten to fourteen days D
four to six weeks
E
one to two months
Q24
Itching is NOT a symptom of
A
allergic dermatitis B
scabies
C
fungal infection
D
acne vulgaris
E
lichen planus
© Australian Pharmacy Council Ltd, 2013
11
Q25
A worried father brings his 3 yearold daughter into your pharmacy. She has had a bad cough and mild fever
spasmodically during the winter which has kept the whole family awake at night. She has already used a whole
bottle of expectorant, which had no effect.
He asks you for a good cough mixture and describes his daughter’s cough as a barking cough, which is worse at
night. There is no phlegm and she gasps for air after coughing.
Fromthescenarioabove,youadvisethefathertotakehisdaughtertothedoctor,as you suspect her cough may
be caused by
A
pneumonia
B
bronchitis C
croup
D
post nasal drip
Q26
A female customer asks you about using St Johns Wort, saying she feels a bit ‘down’. You ask what medications
she is taking, as you are concerned about interactions. Which of the following medications should MOST
concern you regarding its combination with St Johns Wort?
A
ibuprofen B
tramadol
C
codeine
D
paracetamol
E
dextropropoxyphene
© Australian Pharmacy Council Ltd, 2013
12
Patient Profile
Patient Name Dick Cross
WA
Address 49 Caffers Place, SUBIACO
6051
Age 62
Height 170cm
Sex Male
Weight 85kg
Allergies Nil known
DIAGNOSIS
Presenting complaint 1. Elevated blood glucose
Medical history
1. Diabetes Type II
2. Hyperlipidaemia
3. Insomnia
4. Constipation
LAB/DIAGNOSTIC TESTS
Date
20/7
20/7
1/3
1/3
Test
Urate 0.58 mmol/L
Fasting Blood Glucose 9.0 mmol/L
Creatinine 0.16 mmol/L
Cholesterol 6.5 mmol/L
Reference Range
(0.18 – 0.47 mmol/L)
(< 5.5 mmol/L)
(0.05 – 0.12 mmol/L)
(<5 mmol/L)
MEDICATION RECORD
Date
1/3
16/1
16/1
Medication & Strength
Atorvastatin 20 mg
Docusate 50 mg with Senna 8 mg
Aspirin 100 mg
Qty
30
90
28
Sig
i daily
prn
i daily
PHARMACIST’S NOTES
Date
20/7
20/7
Comment
Patient has been placed on dietary restriction for his elevated blood glucose in the past 2 years.
His most recent blood glucose indicates that dietary control alone has not been adequate.
Asymptomatic elevated urate
© Australian Pharmacy Council Ltd, 2013
13
Q27
The MOST appropriate option for the management of the patient’s hyperuricaemia
is
A
allopurinolstarted at adose of 100 mgdaily B allopurinol
started ata dose of 300 mg daily
C
probenecidstarted atadoseof500 mgtwice aday D
no
treatment be initiated
E
colchicine 0.5 mg twice daily
Q28
Which of the following would be an additional risk factor for cardiovascular disease in this patient?
A
low homocysteine level
B
an elevated serum albumin C
hypertension
D
postural hypotension
E
waist measurement 75 – 85 cm
Q29
Which of the following medications would be the MOST appropriate to manage Mr
Cross’ diabetes?
A
metformin B
acarbose
C
insulin
D
glibenclamide
E
rosiglitazone
© Australian Pharmacy Council Ltd, 2013
14
Q30
Which of the following tests is the BEST indicator of ongoing blood glucose control?
A
random blood glucose levels B
three monthly HbA1c levels
C
weekly fasting blood glucose levels
D
regular serum creatine measurements E
weekly urine testing
Q31
Which of the following primary health initiatives should you strongly recommend to Mr Cross?
A
annual ocular examinations
B
annual bone densitymeasurement
C
faecal occult blood test every 3 months
D
prostate specific antigen test every 5 years E creatine
kinase levels every 3 months
END OF PATIENT PROFILE
© Australian Pharmacy Council Ltd, 2013
15
Patient Profile
Patient Name : Jack Smithers
Address : Room 22, Garren Aged Care Facility
Age : 95 years
Sex : Male
Allergies pencillin allergy (rash)
Height : 180 cm
Weight : 73 kg
DIAGNOSIS
Presenting complaint 1. Swallowing difficulties and agitation
Medical history
1. Benign prostatic hyperplasia
2. Pacemaker
3. Depression
4. Prostate Cancer
LAB/DIAGNOSTIC TESTS
Date
3/2
Date
Test
Blood pressure 140/80
Medication & Strength
MEDICATION
RECORD
3/2
Buprenorphine
10 mcg/hour patch
3/2
Paracetamol 500 mg
3/2
Docusate/senna 50 mg/8 mg
3/2
Tamsulosin SR 400 mcg
3/2
Rabeprazole 20 mg
3/2
Citalopram 20 mg
3/2
Goserelin acetate 10.8 mg SC
3/2
Aspirin 100 mg
24/1
Metoclopramide 10 mg
22/1
Cephalexin 500 mg
10/1
Roxithromycin 300 mg
10/1
Oxycodone 5 mg tablets
12/12
Meloxicam 15 mg
Reference Range
Qty
Sig
2
100
90
30
30
30
1
112
25
20
5
20
30
Apply once weekly
2 qid
2 nocte
1 daily
1 mane
1 mane
Implant every 12 weeks
1 mane
1 tds prn
1 tds course completed
1 daily course completed
1 qid prn
1 daily - ceased
PHARMACIST’S NOTES
Date
3/2
24/1
Comment
Visual and hearing impairment. Recent falls and wheelchair bound.
Nursing staff have advised of decreased cognition in patient.
GP noted no prior problems with cephalexin - cause of nausea unknown.
© Australian Pharmacy Council Ltd, 2013
16
Q32
Mr Smithers is becoming increasingly agitated each time tablets are given to him, due to difficulty swallowing.
Which of the following medications the patient is currently taking should NOT be crushed?
A
paracetamol
B
citalopram
C
aspirin
D
oxycodone E
rabeprazole
Q33
Due to the patient’s swallowing difficulties, changes to his medications are necessary to alleviate this
problem. Which of the following recommendations is NOT appropriate?
A
B
C
oxycodone immediate release tablets, liquid, suppositories or injections can be used
D
E
tamsulosin tablets may be crushed, or the tablets opened and dispersed in water
roxithromycin tablets should not be crushed, but the dispersible tablets can be used
docusate and senna tablets may be crushed, or other options include suppositories or
lactulose
dispersible proton-pump inhibitors should be used and include omeprazole, pantoprazole or
lansoprazole
© Australian Pharmacy Council Ltd, 2013
17
Q34
Mr Smithers’ pain is currently well managed with regular therapeutic doses of paracetamol and a weekly
buprenorphine patch. If furthertreatment forchronic pain is required, which of the following is NOT appropriate
in light of the patient’s current medication regimen?
A
increased oxycodone dose B
supplementary paracetamol
C
higher strength buprenorphinepatch
D
replace paracetamol with combination paracetamol/codeine E
replace
oxycodone tablets with suppositories
Q35
MrSmithersrequiredmetoclopramideforthetreatmentofnausea.Whichofthe following statements
regarding metoclopramide is INCORRECT?
A
tablets may becrushed
B
drowsiness is a common side effect
C
oral adult dose for nausea is 0.5 mg/kg every 4-6 hours
D
reduce dose in the elderly to reduce risk of extrapyramidal effects
E
avoid long term use in depressed patients, as mental state may worsen
END OF PATIENT PROFILE
© Australian Pharmacy Council Ltd, 2013
18
Patient Profile
Patient Name Beryl Groper
Address 64
Highfield Drive, Thornlie
Age 49
Height 148cm
Sex Female
Weight 55kg
Allergies Nil
known
DIAGNOSIS
Presenting complaint
1. Obstructive airways disease with shortness of breath
Medical history
1. Congestive cardiac disease
2. Glaucoma
Date
Test
LAB/DIAGNOSTIC
TESTS
16/10
Temp
37.8°C; Pulse 65bpm;
BP 120/65mm Hg
Date
Medication & strength
2/10
MEDICATIONFluticasone
RECORD 250mcg and Salmeterol 25mcg
30/9
Salbutamol nebules 5mg/2.5mL
30/9
Tiotropium 18mg capsules
30/9
Prednisolone 5mg
15/9
Betaxolol eye drops 0.25%
8/8
Enalapril 10mg
6/7
Frusemide 40mg
6/7
Docusate sodium (50mg)and senna (8mg)
Reference Range
Qty
120
60
30
60
5ml
30
100
90
Sig
ii puffs bd
5mg 4-hourly
inhale i daily
40mg mane
ii drops bd
i daily
i mane
ii nocte
PHARMACIST’S NOTES
Nil
© Australian Pharmacy Council Ltd, 2013
19
Q36
Beryl recently consulted you at the pharmacy with apparent flu symptoms, which cleared within a few days.
However, three or four weeks later she is still suffering with apersistent, dry night timecoughthatisdisturbing
hersleep pattern. She asks you for a cough suppressant. Whichofthe following is the MOST appropriate action
for you to take?
A
B
advise her to use the tiotropium capsule at night before bed
advise her to use the fluticasone/ salmeterol inhaler immediately before using the salbutamol
nebules, to increase activity of the salbutamol
C
supply her with a pholcodine elixir, to be taken before bed D
contacther
doctortodiscussthepatient’suseofenalapril
E
supplypromethazinetablets,tobetakenthreetimes adaywiththelastdose before bed
Q37
Beryl arrives to collect her regular supply of medication and is complaining of swollen ankles, so severe that she
can’t fit into her shoes. The MOST appropriate action would be for you to
A
advise her doctor and suggest Beryl’s frusemide and prednisolone be
reassessed
B
adviseherto increaseherfrusemidedosetotwotabletsinthemorningand to take a potassium
supplement
C
D
recommend she wear graduated support stockings and elevate her legs more often
E
advise her to reduce her dose of prednisolone to 5mg
advisehertousehersalbutamolmoreregularlytoallowhertoundertake gentle walking to
improve her venous return
20
Q38
Beryl later suffers muscle cramps. The MOST likely cause is
A
hypocalcaemia due to the prednisolone
B
hypokalaemia due to the frusemide and prednisolone C
hyperphosphataemia due to heart failure
D
excessive fluid retention of feet and ankles
E
drug interaction between enalapril and frusemide
Q39
To improve Beryl’s asthma the doctor could
A
change the eye drops B
change theenalapril
C
increase the frusemide
D
change the tiotropium to an inhaler E
reduce and cease the prednisolone
Q40
You should ensure that Beryl’s prednisolone dose is reduced slowly because
A
stopping quickly may induce an asthma attack B
inhaledsteroidsneedtobeincreasedslowly C
the
adrenal glands may be suppressed
D
electrolytes need to return to normalslowly E the
possibility of rebound wheezing
END OF PATIENT PROFILE
21
Patient Profile
Patient Name David Frost
Address 27 Christmas Parade, Wagga Wagga, NSW 2073
Age 70
Height 168cm
Sex Male
Weight 75kg
Allergies Nil known
DIAGNOSIS
Presenting complaint
1. Diarrhoea
Medical History
1. Osteoarthritis
2. Hypertension
3. Cardiac Failure
LAB/DIAGNOSTIC TESTS
Date
7/4
7/4
7/4
Test
Potassium 6.0 mmol/L
Creatinine 0.23 mmol/L
Urea 36 mmol/L
Reference Range
(3.5 – 5.0 mmol/L)
(0.05 – 0.12 mmol/L)
(3 – 8 mmol/L)
MEDICATION RECORD
Date
31/3
31/3
31/3
6/1
6/1
6/1
6/1
Medication & Strength
Paracetamol 1 gram
Celecoxib 200 mg
Frusemide 80 mg
Lisinopril 10 mg
Spironolactone 25 mg
Frusemide 40 mg
Glucosamine 1500 mg
Qty
100
30
100
30
100
30
60
Sig
tds
i daily
i daily
i daily
i daily
i daily
i daily
PHARMACIST’S NOTES
Date
7/4
Comment
The patient was admitted to hospital following two days of severe diarrhoea, - one week after the
patient was started on celecoxib and the dose of frusemide was increased.
© Australian Pharmacy Council Ltd, 2013
22
Q41
TheMOST likelycauseofthe resultsofthe laboratoryteststhathavebeenprovided for this patient is
A
liver failure
B
acute renal failure C
respiratory distress D
hyperkalaemia
E
worsening cardiac failure
Q42
Which of the following medications is MOST likely to cause gynecomastia in Mr Frost?
A
lisinopril
B
celecoxib
C
frusemide
D
glucosamine
E
spironolactone
Q43
Mr Frost is on spironolactone for his cardiac failure. What is the usual recommended dose of this medication in
patients with cardiac failure?
A
400 mg daily
B
100 mg daily
C
25 mg twice a day D
25mgonceaweek E
25 mg once a day
© Australian Pharmacy Council Ltd, 2013
23
Q44
Which of the following combinations of medications is MOST LIKELY to cause acute renal failure in this patient?
A
spironolactone, frusemide, paracetamol B
frusemide, lisinopril,celecoxib
C
paracetamol, frusemide, lisinopril D
celecoxib, lisinopril, glucosamine
E
lisinopril, spironolactone, glucosamine
Q45
The patient is currently taking celecoxib, which is a selective inhibitor of cyclo- oxygenase type 2 (COX-2). What is
the mode of action of this type of medication?
A
stimulates the production of prostacyclin (PGI2) B
inhibits
the production of prostacyclin (PGI2)
C
stimulates the production of thromboxane (A2) D
inhibits the production of thromboxane (A2)
E
inhibits both prostacyclin (PGI2) and thromboxane (A2)
END OF PATIENT PROFILE
© Australian Pharmacy Council Ltd, 2013
24
Patient Profile
Patient Name Ms Cecily Weary
Address 17 Filamore Street, Portland, SA
Age 19
Sex Female
Allergies Nil known
Height 160cm
Weight 58kg
DIAGNOSIS
Presenting complaint
1. Emergency contraceptive advice
MEDICATION RECORD
Date
Medication & Strength
Qty
Sig
PHARMACIST’S NOTES
Date
Current
Comment
Patient has had unprotected sex in the last 24 hours and has consulted her doctor
for advice, as she feels at risk of falling pregnant.
© Australian Pharmacy Council Ltd, 2013
25
Q46
Ms Weary’s doctor has recommended oral levonorgestrel. Which of the following statements is CORRECT regarding
this method of emergency contraception?
A
B
C
D
E
oral levonorgestrel mustbe taken within the first72 hours afterunprotected intercourse to have a
contraceptive effect
levonorgestrel has more severe side effects when taken as emergency contraception
compared to its use as regular contraception
levonorgestrel with ethinyloestradiol (2 doses of four tablets, 12 hours apart) is considered to be as
effective as the oral levonorgestrel regimen
oral levonorgestrel emergency contraception has been shown to increase the risk of ectopic
pregnancy
oral levonorgestrel does not induce a withdrawal bleed, although irregular
bleeding may occuroccasionally
Q47
MsWearyisbreast-feedinghersevenmontholdmontholdson.Whichofthe following is the MOST
appropriate advice to give the patient?
A
milk supply will significantly decrease
B
the child should not be breast-fed for at least 24 hours
C
emergency contraception is safe to take during breast-feeding D emergency
contraception should not be taken if breast-feeding
E
emergency contraception doseshould be split overtwelve hours to minimise
excretion into breast milk
© Australian Pharmacy Council Ltd, 2013
26
Q48
Which of the following should you recommend to Ms Weary, regarding the MOST
effective time to take hormonal emergency contraception?
A
immediately
B
immediately after the nextbreastfeed C
within 12 hours of unprotected sex
D
E
72 hours after unprotected sex
with the evening meal to increase absorption
END OF PATIENT PROFILE
© Australian Pharmacy Council Ltd, 2013
27
Patient Profile
Patient Name Kay Sutton
Address 66 Argyle St Hackett
Age 23
Height 171 cm
Sex Female
Weight 58 kg
Allergies Metoclopramide
DIAGNOSIS
Presenting complaint 1. Urinary tract infection
Medical history
1. Asthma
2. Type 1 diabetes
3. Bipolar Disorder
LAB/DIAGNOSTIC TESTS
Date
12/1
Test
Lithium
0.8 micromol/L
Reference Range
0.5 – 1.2 micromol/L
MEDICATION RECORD
Date
12/1
12/1
12/1
12/1
12/1
Medication & Strength
Insulin glargine 20iu
Insulin lispro 10 iu
Lithium 250mg tab
Ethinyloestradiol/levonorgestrol
Salbutamol 100mcg
Qty
100
4x28
MDI
Sig
bd
tds
2 tds
1 daily
1-2 inh prn
PHARMACIST’S NOTES
Nil
© Australian Pharmacy Council Ltd, 2013
28
Q49
MsSuttonpresentstoyourpharmacywithascriptforcephalexin.Whichofthe following is the MOST
appropriate advice?
A
cease taking the oral contraceptive pill when taking this antibiotic B
avoid
alcohol while taking this antibiotic
C
start taking acidophilus to prevent vaginal thrush
D
start taking cranberry juice to treat the urinary tract infection E
use barrier
contraceptive measures while taking this antibiotic
Q50
Ms Sutton requests a product containing sodium citrotartrate to relieve the burning associated with her urinary tract
infection. Which of the following statements is CORRECT?
A
the increase in urinary pH will decrease the renal clearance of lithium B
clearance of lithium will increase with the use of sodium
citrotartrate
C
D
E
the renal
theantibacterialactivityofcephalexinwillbeincreased withtheuseof sodium citrotartrate
the tubular reabsorption of lithium will increase with the use of sodium citrotartrate
lithium and sodium citrotartrate granules can be safely used in combination
© Australian Pharmacy Council Ltd, 2013
29
Q51
Regarding the Ms Sutton’s insulin, which of the following statements is INCORRECT?
A
insulin lispro should be administered 30 minutes after each meal B
the vial in
use can be stored at room temperature for 28 days
C
insulin lispro is injected subcutaneously
D
insulin glargine is referred to as a basal release insulin
E
insulin glargine should not be mixed with insulin lispro before each injection
Q52
Ten days laterMs Suttonhasbeen referred toyourpharmacybythe doctor fora treatment for vaginal
thrush. Which of the following statements regarding oral fluconazole is CORRECT?
A
it must be accompanied by topical antifungal therapy B it must be
taken on three consecutive days
C
it is contraindicated in diabetes
D
itisnotrecommendedforusebypregnantwoman E
the course
should be repeated in seven days
© Australian Pharmacy Council Ltd, 2013
30
Q53
Ms Sutton’s doctor contacts you for advice regarding her bipolar disorder therapy. He says that while her
condition is well controlled, she is complaining of nausea and fine tremor. Which of the following
recommendations is the MOST appropriate?
The lithium
A
should be taken one hour before food
B
could be changed to a sustained release preparation C dose should
be increased by 50%
D
dose should be decreased by 50% E should be
replaced with olanzapine
END OF PATIENT PROFILE
© Australian Pharmacy Council Ltd, 2013
31
Patient Profile
Patient Name Peter Barnard
Address Room 19, Garran Ward
Age 9
Height 120 cm
Sex Male
Weight 25 kg
Allergies Nil Known
DIAGNOSIS
Presenting complaint 1. Urinary tract infection
Medical history
1. Chronic renal failure
2. Streptococcal glomerulonephritis
LAB/DIAGNOSTIC TESTS
Date
16/11
16/11
16/11
16/11
16/11
Test
Creatinine 0.42 mmol/l
Calcium 2.3 mmol/l
Phosphate 2.4 mmol/l
Potassium 5.8 mmol/l
Urinalysis: Pseudomonas aeruginosa detected
Reference Range
0.02-0.06 mmol/l
2.1-2.6 mmol/l
1.1-1.8 mmol/l
3.5-5.0 mmol/l
MEDICATION RECORD
Date
16/11
16/11
16/11
16/11
16/11
16/11
16/11
16/11
16/11
Medication & Strength
Calcium Carbonate 1.5g
Calcitriol 0.25 mcg
Darbopoietin 30 mcg
Enalapril 5mg
Sodium bicarbonate 840mg
Ferrous sulphate 325mg
Folic acid 0.5mg
Nifedipine SR 30mg
Hydralazine 25mg
Qty
100
100
5
30
100
30
100
30
100
Sig
i bd cc
i daily
i weekly subcut
i bd
i tds
i daily
i daily
i bd
i tds
PHARMACIST’S NOTES
Date Comment
17/11
Admitted to hospital with a urinary tract infection. Patient is pyrexial with a temperature of
39oC and looks unwell”. BP is 130/90. Recently stable on peritoneal dialysis.
Patient is on transplant waiting list awaiting renal transplant.
Patient has gum hypertrophy.
© Australian Pharmacy Council Ltd, 2013
32
Q54
The patient has chronic kidney disease. Which of the following statements regarding this condition is INCORRECT?
A
protein starts to pass into the urine
B
anaemia is a complication that must be treated or prevented C
hypercalcaemia occurs due to deficient vitamin D production
D
toxins such as urea and creatinine build up and cause problems
E
risk factors include diabetes mellitus, hypertension and increasing age
Q55
Which of the following medications is MOST likely to be the cause of the patient’s
gum hypertrophy?
A
calcitriol
B
enalapril
C
ferrous sulphate D
nifedipine
E
hydralazine
Q56
The patient is experiencing hyperkalaemia. Which of the following statements is
CORRECT regarding the patient’scondition?
A
the patient’s potassium levels indicate severe hyperkalaemia
B
the patient’s current medications are not likely to be a contributing factor C oral frusemide can
be given to promote potassium excretion
D
muscle weakness, cardiac arrhythmia and myalgia are common symptoms E the use of NSAIDs
should be avoided in this patient
© Australian Pharmacy Council Ltd, 2013
33
Q57
Which of the following IV antibiotics is the MOST suitable treatment against
Pseudomonas aeruginosa for this patient?
A
amoxycillin
B
vancomycin
C
ceftriaxone D
ciprofloxacin E
gentamicin
Q58
The patient has hyperphosphataemia. Which medication dosage could be increased to reduce his phosphate
level?
A
calcium carbonate B
calcitriol
C
sodium bicarbonate D
darbepoetin
E
enalapril
END OF PATIENT PROFILE
© Australian Pharmacy Council Ltd, 2013
34
Patient Profile
Patient Name Janine Smitters
Address 2B Nursing Home
Age72
Height 152 cm
Sex Female
Weight 50 kg
Allergies Nil Known
DIAGNOSIS
Presenting complaint 1. Fractured neck of femur
Medical history
1. Rheumatoid arthritis
2. Hypertension
LAB/DIAGNOSTIC TESTS
Date
Test
Reference Range
MEDICATION RECORD
Date
3/11
3/11
22/10
22/10
7/10
5/9
5/9
Medication & Strength
Enoxaparin 40mg/0.4mL
Paracetamol 500mg/codeine 8mg
Oxazepam 30mg
Diclofenac 25mg
Prazosin 5mg
Atenolol 50mg
Perindopril 4 mg
Qty
10
50
25
50
100
30
30
Sig
i daily subcut
ii qid
i bd
i tds
½ tds
i mane
i daily
PHARMACIST’S NOTES
Date
2/11
Comment
Patient admitted to acute care hospital after a fall.
Patient has been taking diclofenac for 2 years.
© Australian Pharmacy Council Ltd, 2013
35
Q59
The doctor has decided to cease the oxazepam and asks for your advice. Mrs Smitters has been on this
medication for 3 years. The MOST appropriate advice to give the doctor is to
A
B
C
D
E
stop the oxazepam immediately
change to temazepam and reduce the dose over a few weeks
reduce the oxazepam dose by 15mg a day for 4 days before ceasing
change to an equivalent dose of diazepam and gradually reduce the dose over 3 weeks
reducethedoseoftheoxazepamtoonetabletonalternativenights,overa 4-6 week period
Q60
Following Mrs Smitters’ fall, osteoporosis is suspected. Before initiating alendronate, all of the following
investigations should be undertaken EXCEPT
A
bone mineral density
B
vitamin D and calcium levels C
hepatic function
D
renal function
E
full dental assessment
Q61
Which of the following medications is LEAST likely to have contributed to Mrs
Smitters’ fall and subsequent fractured femur?
A
prazosin
B
atenolol
C
diclofenac
D
perindopril
E
paracetamol/codeine
© Australian Pharmacy Council Ltd, 2013
36
Q62
At a follow-up appointment, Mrs Smitters’ hypertension is found to have worsened.
The MOST appropriate management would be to
A
increase the prazosindose
B
increase prazosin and atenolol dose
C
initiate frusemide and potassium supplementation D
cease
prazosin and initiate verapamil
E
cease perindopril and initiate irbesarten
END OF PATIENT PROFILE
© Australian Pharmacy Council Ltd, 2013
37
Patient Profile
Patient Name John Coles
Address 16 Adam Street, Hillcrest
Age 69
Sex Male
Allergies Penicillin
DIAGNOSIS
Presenting complaint
Medical History
Height 173cm
Weight 63kg
1. Ischaemic heart disease
2. Gout
1. Mild left sided heart failure
2. Hypothyroidism
3. Transient Ischaemic attacks (TIA)
LAB/DIAGNOSTIC TESTS
Date
Test
Reference Range
MEDICATION
Date
20/6
20/6
20/6
15/5
20/4
20/4
20/4
RECORD
Medication & strength
Naproxen 500mg
Diltiazem 180mg
Aspirin 100mg
Thyroxine 200mcg
Temazepam 10mg
Frusemide 40mg
Colchicine 0.5mg
Qty
50
30
90
200
25
100
100
Sig
bd prn
1 mane
1 mane
1 mane
1 nocte
1 mane
1–
16/2
Thyroxine 100mcg
200
1 mane
2hrly until pain
ceases
PHARMACIST’S NOTES
Date
Comment
20/6
Naproxen to be used until acute attack of gout settles.
© Australian Pharmacy Council Ltd, 2013
38
Q63
Which ofMrColes’medicationsisMOST likelytocausedeteriorationofhis heart failure?
A
diltiazem B
thyroxine
C
frusemide
D
aspirin
E
colchicine
Q64
The use of low dose aspirin by Mr Coles
A
will reduce the effectiveness of the frusemide
B
has the same gastrointestinal bleeding risk as placebo C may mask the
symptoms of hypothyroidism
D
is indicated for TIA despite a possible adverse effect on his gout E will be sufficient
to reverse an acute attack of gout
Q65
Mr Coles has been prescribed naproxen to be used when needed for acute gout. Which of the following
statements is CORRECT?
A
B
C
E
asingledailydoseofnaproxenwouldbemoreeffective,sotaketwotablets at night when necessary
naproxencannotbetakenatthesametimeasaspirininthemorning,sotake two tablets at night when
necessary
naproxen should only be taken when necessary for gout pain. Continue the
aspirin regularly D
cease naproxen
aspirin should not be taken, whilst taking naproxen for gout
© Australian Pharmacy Council Ltd, 2013
39
Q66
Since 15 May, Mr Coles has noticed an increased incidence of chest pain. Which of the following is the MOST
likely cause?
A
the introduction of diltiazem
B
interaction between frusemide and diltiazem C
excessive use of naproxen for gout
D
interaction between frusemide and naproxen E
increased dose of thyroxine
Q67
Mr Coles is prescribed cefaclor for a respiratory tract infection. The incidence of cross sensitivity to
cephalosporin in patients with penicillin allergy is
A
1%
B
3%
C
10%
D
15%
E
20%
© Australian Pharmacy Council Ltd, 2013
40
Q68
Mr Coles has previously been prescribed colchicine for acute gout. The MOST likely reason
for ceasing colchicine and commencing naproxen would be
A
B
C
D
E
colchicine increased the elimination of thyroxine by causing diarrhoea
an interaction between colchicine and frusemide, causing the precipitation of
urate crystals in the kidneys
colchicine is contraindicated in patients with heart failure due to increased
fluid retention
for a patient with heart failure, it is more appropriate to use colchicine at
lower doses for prophylaxis
that nausea, vomiting and diarrhoea occurred before appropriate symptom
relief was achieved
END OF PATIENT PROFILE
© Australian Pharmacy Council Ltd, 2013
41
Medical Profile
Patient Name Marilyn Jones
Address 5 Backus Avenue, WESTBOURNE, TAS 7001
Age 56
Height 168cm
Sex Female
Weight 62kg
Allergies Nil known
DIAGNOSIS
Presenting complaint
1. Tremor, nausea, vomiting and blurred vision
Medical history
1. Bipolar depression
2. Heart failure
3. Atrial fibrillation
MEDICATION RECORD
Date
7/10
Medication & Strength
Lithium Carbonate 250mg
Digoxin 62.5mcg
Perindopril 4mg
Spironolactone 25mg
Frusemide 20mg
Qty
200
100
30
100
100
Sig
i bd
ii daily
i daily
i daily
i daily
PHARMACIST’S NOTES
Date
7/10
Comment
Patient reports recent bout of dehydration and diarrhoea (suffered during her holiday last week).
© Australian Pharmacy Council Ltd, 2013
42
Q69
Which of the following is the MOST likely cause of Mrs Jones’ presenting symptoms?
A
hypertension
B
gastroenteritis
C
urinary tract infection
D
decreased lithium and digoxin clearance
E
increased lithium clearance and digoxin clearance
Q70
This patient has bipolar disorder. Which of the following may be a suitable medication toallow fora
decreasein lithium dose, while maintainingcontrol of her psychiatric illness?
A
diazepam
B
oxazepam
C
carbamazepine D
phenelzine
E
chlorpromazine
Q71
Which of the following is CORRECT, with regards to using digoxin in atrial fibrillation (AF)?
A
it has a high therapeutic index
B
it should not be used as monotherapy
C
it is no longer indicated for the treatment of AF
D
the onset of effect occurs 2 – 3 hours after initial dose
E
is useful in achieving satisfactory resting ventricular rate control in patients
with chronic AF
© Australian Pharmacy Council Ltd, 2013
43
Q72
Mrs Jones is commenced on venlafaxine. Her other medications remain unchanged. She suffers confusion,
hypermania and sweating. Which of the following may explain Mrs Jones sudden deterioration?
A
'significant decrease in synaptic lithium concentration B significant
decrease in hepatic function
C
decrease in synaptic adrenaline concentration D
increase in potassium concentrations
E
'precipitation of serotonin syndrome
Q73
Mrs Jones also complains of an irritating cough. Which of the following options is MOST likelytoaddressthisissue
withoutcompromising themanagement ofher medication?
A
decrease perindopril to 2mg per day
B
replace perindopril with lisinopril 5mg per day
C
replace perindopril with candesartan 8mg per day D
increase
frusemide to 80mg per day
E
add irbesartan at 300mg per day
END OF PATIENT PROFILE
© Australian Pharmacy Council Ltd, 2013
44
Patient Profile
Patient Name Mr Brian Furter
Address 43 Albion Way BRIGHTON
Age 35
Height 174cm
Sex Male
Weight 78kg
Allergies Nil known
DIAGNOSIS
Presenting complaint 1. Red, inflamed, itchy rash on lower trunk of body
2. Slightly elevated temperature
LAB/DIAGNOSTIC TESTS
MEDICATION RECORD
Date
Medication & Strength
Qty
Sig
PHARMACIST’S NOTES
Date
Comment
Patient indicated he first noticed the rash 24 hours ago and has just seen the doctor and received
a script for Valaciclovir for shingles.
© Australian Pharmacy Council Ltd, 2013
45
Q74
The recommended dose of valaciclovir for the treatment of herpes zoster is
A
500mg twice daily for 5 days
B
500mgthreetimesa dayfor7days C
1g daily for 7 days
D
1g three times a day for5 days E
1g
three times a day for 7 days
Q75
Which of the following statements is CORRECT regarding the effectiveness of the
patient’s treatment? Treatment
must
A
not be commenced until rash clears
B
be commenced within 12 hours of noticing the rash C
commenced within 24 hours of noticing the rash D
be
be commenced within
72 hours of noticing the rash E be commenced within 120 hours of noticing
the rash
© Australian Pharmacy Council Ltd, 2013
46
Q76
Which of the following statements is CORRECT regarding herpes zoster?
A
early treatment reduces the incidence of post-herpetic neuralgia
B
dosage adjustment of guanine analogues is required in hepatic impairment C
is not
contagious after three days from the appearance of a rash
D
herpes zoster is activated from a latent state
E
topical aciclovir must be used as an adjunct to systemic antivirals, for the treatment of herpes
zoster ophthalmicus
Q77
The MOST effective topical treatment for the patient’s post herpetic pain is
A
aqueous cream with menthol 3% B
diclofenac gel 1%
C
paraffin based ointment with menthol 3% D
betamethasone gel 0.02%
E
capsaicin ointment 0.05%
Q78
Which group of people in the community is MOST likely to contract herpes zoster with greater severity?
A
pregnant women
B
adults > 65 years of age
C
immuno-suppressed patients D
children up to the age of 14 E
diabetics
END OF PATIENT PROFILE
© Australian Pharmacy Council Ltd, 2013
47
Patient Profile
Patient Name Thomas Lipton
Address Room 9, Paediatric Ward
Age 7 years
Height 125cm
Sex Male
Weight 30kg
Allergies Carbamazepine (Agranulocytosis)
DIAGNOSIS
Presenting complaint 1. Fever (temperature 39.2oC)
2. Increased seizure activity
3. Vomiting
Medical history
1. Cerebral Palsy
2. Epilepsy (poorly controlled seizures)
LAB/DIAGNOSTIC TESTS
Date
Test
Reference Range
MEDICATION RECORD
Date
17/3
17/3
17/3
17/3
17/3
17/3
Medication & Strength
Diazepam 5mg
Sodium Valproate 200mg
Lamotrigine 50mg
Vigabatrin 500mg
Phenytoin 30mg
Phenytoin 50mg
Qty
50
100
100
100
100
100
Sig
i tds
i bd
i bd
i daily
i bd
I bd
PHARMACIST’S NOTES
Nil
© Australian Pharmacy Council Ltd, 2013
48
Q79
Which of the following statements regarding epilepsy in childhood is INCORRECT?
A
B
epilepsy is one of the most common chronic neurological conditions of childhood
the majority of children with a firstunprovoked seizure will have a
recurrence
C
antiepileptic medication treatment should not be commenced routinely after the first unprovoked
seizure
potential adverse effects of antiepileptic medications are a major determinant in the
choice of medication
if seizure free for two or more years, withdrawal of antiepileptic treatment should be considered
D
E
Q80
Which of the following would NOT be an appropriate treatment for someone with acute status epilepticus?
A
intranasal midazolam B
rectal diazepam
C
rectal paraldehyde
D
oral sodiumvalproate E
buccal midazolam
© Australian Pharmacy Council Ltd, 2013
49
Q81
The doctors are concerned about whether the doses of anticonvulsants are appropriateandenquireas to
whethermeasuringblood levelsofthepatient’s anticonvulsants would be useful. For which of the following
anticonvulsants are plasma levels of MOST value in clinical practice?
A
diazepam
B
lamotrigine
C
sodium valproate D
phenytoin
E
vigabatrin
Q82
Which of the following anticonvulsants is MOST likely to be associated with visual field effects?
A
diazepam
B
lamotrigine
C
sodium valproate D
phenytoin
E
vigabatrin
© Australian Pharmacy Council Ltd, 2013
50
Q83
In conversation with the medical staff, Thomas’ mother mentions that he has gained a lot of weight recently.
Weight gain is a well recognised side effect of which of the following anticonvulsants?
A
sodium valproate B
lamotrigine
C
phenytoin
D
tiagabine
E
phenobarbitone
END OF PATIENT PROFILE
© Australian Pharmacy Council Ltd, 2013
51
Q84
A patient with epilepsy comes into your pharmacy and tells you she is pregnant. She is concerned about the
effect of her medication on the baby. Which of the following statements is the MOST appropriate advice?
A
epilepsy medications should be ceased during pregnancy B
epilepsy
medications are safe to use during pregnancy
C
the dosage of current medications should be reduced to minimum levels D the risk to the baby is
greater from uncontrolled epilepsy than from the
medication
Q85
What is the recommended period (for females) for folate supplementation before conception and during
pregnancy?
A
one week before conception and the 1stmonth ofpregnancy B
one month
before conception and the 1st month of pregnancy
C
three months before conception and the 1st three months of pregnancy D
one month before
conception and the 1st three months of pregnancy
E
one month before conception and the entire duration of pregnancy
Q86
Which of the following is NOT a risk factor for cardiovascular disease?
A
thyroid dysfunction B
increased HDL
C
increased LDL
D
hypertension
E
diabetes
© Australian Pharmacy Council Ltd, 2013
52
Q87
One of your regular patients presents a prescription for prednisolone 25 mg orally daily for the treatment of asthma.
What is the optimal time to take this medication?
A
at lunchtime
B
at bedtime
C
on anemptystomach inthemorning D
with or afterbreakfast
E
anytime of the day without respect to food
Q88
Which of the following would be INAPPROPRIATE advice on caring for a pruritic rash?
A
keep the area cool
B
wash area with soapy water, prior to applying cream C only use
cotton clothing to cover the area
D
avoid shampoos on the area E
avoid hot water
Q89
Alendronate can be taken
A
daily or once weekly
B
with milk to enhance absorption
C
at bedtime to avoid possible drowsiness
D
half an hour before food or one hour after a meal
E
in the morning with breakfast to avoid stomach upset
© Australian Pharmacy Council Ltd, 2013
53
Q90
With which of the following medications is it MOST important to maintain a high fluid intake?
A
spironolactone B
ciprofloxacin
C
indapamide
D
cephalexin
E
frusemide
Q91
Which of the following medications is MOST appropriate for the prevention of
nausea and vomiting in Parkinson’s disease?
A
ondansetron B
domperidone
C
metoclopramide D
prochlorperazine
E
hyoscine
© Australian Pharmacy Council Ltd, 2013
54
Q92
A male customer presents the following prescription for his recurrent urinary tract infection
Rx Norfloxacintablets 400 mgmitte 14 +1 Rpt Sig i bd
Which of the following should NOT be included in your counsellingof the patient? A
maintain a good fluid
intake whilst being treated with norfloxacin
B
take on an empty stomach one hour before or two hours after food C
avoid taking
urinary alkalinisers during treatment with norfloxacin
D
see your doctor as soon as possible in the event of muscle or tendon soreness or
inflammation
E
take medication for three days and stop; recommence if symptoms recur
within 48 hours
Q93
What advice should you give when a woman on a combined oral contraceptive presents with a prescription for
doxycycline for bronchitis? She should be advised that
A
B
C
D
there will be a decreased risk of breakthrough bleeding
doxycycline will increase the incidence of thromboembolic disorders and she should take aspirin
100mg daily
doxycycline may affect the efficacy of the ‘pill’ and she should take additional
contraceptive precautions this month
the contraceptive pill may affect the efficacy of doxycycline and she should cease the pill and use
barrier contraceptive methods
© Australian Pharmacy Council Ltd, 2013
55
Q94
Which of the following vitamins has antioxidant properties?
A
ascorbic acid B
ergocalciferol
C
pantothenic acid D
folic acid
E
cyanocobalamine
Q95
Acustomercomesintoyourpharmacycomplainingofaheadache. Youelicitother symptoms–nausea,stiff
neck,sensitivitytolightandfever.Whichofthefollowingis MOST consistent with this patient’s symptoms?
A
tension headache B
cluster
headache
C
meningitis
D
migraine
E
sinusitis
© Australian Pharmacy Council Ltd, 2013
56
Q96
Aperson presents witha twisted ankle which occurred an hourpriorto visiting the pharmacy. What advice
should you give as first-aid treatment?
A
suggest aspirin or another non-steroidal anti-inflammatory medication and apply a heat pack with
the foot elevated
B
apply a cold pack for 15 minutes at a time, elevate the ankle and apply a
compression bandage
C
trysomegentleexercisetoprevent the jointstiffening upandgiveibuprofen D
massage
frequently with methyl salicylate cream, apply heat and take
paracetamol/codeine/doxylamine tablets, elevate the ankle
E
rest withtheankle elevatedand applya coldpack for5minutes every 30 minutes, for two hours
following the injury
Q97
A customer, who is 8 weeks pregnant, comes into the pharmacy for a worm treatmentforherfamily.
Her children areshowingsignsofinfestation.Herson is 6 years of age and her daughters are 18 months and 4
years of age. Which of the following treatments should you recommend?
A
pyrantelembonategiventothewholefamily B
pyrantel embonate given to the son only
C
mebendazole given to the whole family D
mebendazole given to the son only
© Australian Pharmacy Council Ltd, 2013
57
Q98
Which of the following statements regarding oral electrolyte replacement fluids is
CORRECT?
A
the fluids relieve gas-related abdominal discomfort
B
the fluids are first line for the treatment of diarrhoea in children
C
the fluidsbond toxinsandbacteria and form a protectiveintestinal lining D rice-based
preparations reduce stool output in patients with non-cholera
diarrhea, as opposed to glucose-based preparations
E
higher osmolality preparations are more effective than reduced sodium hypo- osmola
preparations
Q99
Inwhatsituationwouldtheuseofglucosaminepluschondroitinforosteoarthritisbe considered
INAPPROPRIATE?
A
sulfonamide allergy B
penicillin allergy
C
asthma
D
seafood allergy E
peanutallergy
Q100
All of the following could be used to treat motion sickness EXCEPT
A
promethazine theoclate B
domperidone
C
dimenhydrinate
D
hyoscinehydrobromide E
pheniramine
© Australian Pharmacy Council Ltd, 2013
58
Q101
Acustomer, whoissixmonthspregnant,isconcernedthatshehas beensuffering mildconstipationoverthelast
week. Shesaysthatshehasnotexperiencedthisfor a long time and feels sure that it must be connected to her
pregnancy. Which of the following treatments would be INAPPROPRIATE for her constipation?
A
bulk laxatives
B
moderate exercise C
stimulant laxative D
high fibre diet
E
increased fluid intake
Q102
With regard to maldison(malathion) head lice lotion, which ofthe following statements is CORRECT?
A
hairmustbewetbefore application B
allow hair to dry naturally after use
C
the lotion must be rinsed out after 10 minutes D
the
shampoo product is preferred to the lotion
E
it is recommended as safe to use during pregnancy
© Australian Pharmacy Council Ltd, 2013
59
Q103
In treating methotrexate overdose, what is the agent of choice?
A
sodium bicarbonate B
acetylcysteine
C
filgrastim D
folinic acid E
folic acid
Q104
A customer asks for your advice when purchasing a laxative for her husband who is taking morphine for cancer
pain. Which of the following would be the LEAST appropriate?
A
docusate sodium 50 mg, total sennosides 8 mg B
bisacodyl
C
docusate sodium 50 mg
D
ispaghula husk in an effervescent base E
glycerin suppositories
Q105
What advice should you give to a customer requesting a decongestant nasal spray for a stuffy nose, due to a
head cold?
A
usetwiceadayuntilnoseisclear B use
once daily for 5 days
C
do not use continuously for more than five days
D
use three times a day for a minimum of one week until clear E
use on
alternate days only until nose is clear
© Australian Pharmacy Council Ltd, 2013
60
Q106
Which of the following statements is INCORRECT regarding scabies?
A
symptoms include pimple-like irritations in skin folds
B
treatment with permethrin requires 2 applications 1 week apart
C
the itch generally lasts 2–3 weeks and is not a sign of ongoing infection
D
a person remains infectious until 24 hours after treatment is commenced E infestation occurs
after brief contact with household items or pets
Q107
WhichofthefollowingisNOTariskfactorforChronicObstructivePulmonary Disease?
A
genetics
B
smoking
C
occupational pollutants (smoke, fumes) D
obesity
E
alpha-1 antitrypsin (enzyme)deficiency
Q108
Thelocaldoctorphonesyourpharmacyforadviceontreatmentforhispatient,who works as a fireman and is
suffering from his annual bout of seasonal allergic rhinitis. The patient is 6 weeks into a 3 month course of
ketoconazole. Which of the followingtreatmentsshouldyourecommendastheMOST appropriate,to
manage his acute symptoms?
A
pseudoephedrine 60mg three times daily B
promethazine 25 mg twice daily
C
fexofenadine 60 mg twice daily
D
prednisolone 5mg daily for 10 days
© Australian Pharmacy Council Ltd, 2013
61
Q109
All of the following medications have been used for the treatment of attention deficit hyperactivity
disorder (ADHD) EXCEPT
A
methylphenidate B
clonidine
C
imipramine D
sertraline
E
dexamphetamine
Q110
Which of the following statements regarding psoriasis is INCORRECT?
A
B
C
treatment with dithranol is more feasible when plaques are large
D
E
salicylic acid assists in the removal accumulated scale to allow topical agents to penetrate lesions
coal tar is photosensitising and may be irritating to the face, genitals and skin folds
calcipotriol is useful in the treatment of resistant plaque psoriasis, as tolerance does not
occur
topical corticosteroids have a slower onset of action than other topical treatments, but
prolong the period between relapses
Q111
Which of the following applies to oral typhoid vaccine? The vaccine
A
can be given concurrently with antibiotics
B
can be given any time before commencing antibiotics
C
can be given immediately after finishing a course of antibiotics D should not be
given within one week of taking antibiotics
© Australian Pharmacy Council Ltd, 2013
62
Q112
Which of the following combinations of medications is MOST likely to cause hypokalaemia?
A
indomethacin/salbutamol B
insulin/salbutamol
C
insulin/amlodipine
D
amlodipine/indomethacin E
insulin/propranolol
Q113
A number of medications interact with warfarin to cause life-threatening situations. Which of the following
medications is MOST likely to alter the INR?
A
enalapril
B
hydrochlorothiazide
C
sulfamethoxazole-trimethoprim D
cephalexin
E
propranolol
Q114
WhichofthefollowingstatementsisCORRECT withregardtoanalgesic nephropathy?
Analgesic nephropathy is
A
characterised by chronic liver failure
B
a chronic kidney disease that can lead to end stage renal failure C an acute kidney
disease caused by a high doses of analgesics
D
characteristic of heavy aspirin dosage and not seen in association with other analgesics
E
an easily reversible condition with little associated pathology
© Australian Pharmacy Council Ltd, 2013
63
Q115
A regular patient in your pharmacy is stabilised on life-long warfarin therapy having had amitral valve
replacement 6months ago. He has justbeen foundtohave high serum triglyceride and cholesterol levels and
has a prescription for nicotinic acid 250mg tds. Which of the following statements is CORRECT?
A
B
the recommended dosage of nicotinic acid is 750mg once daily
nicotinic acid is contraindicated in patients with mitral valve replacements C fenofibrate is first line
treatment for this patient
D
nicotinic acid can increase the anticoagulant response to warfarin in some patients, so close
monitoring is required
E
nicotinic acid does not interact with warfarin and is not contraindicated in
this patient
Q116
The dosage of aciclovir should be adjusted on the basis of
A
pre-existing hepaticimpairment B pre-
existing renal impairment
C
time since onset of symptoms D
occurrence of side effects
Q117
A74yearold malepatienthas been ondigoxinforheartfailure forseveral years. His recentlymeasureddigoxin
plasmalevelwas within thenormalrange. Hepresents you with a prescription for phenytoin 200 mg bd,
which is a new addition to his regular therapy. Which of the following is CORRECT?
A
B
phenytoin may induce the hepatic metabolism of digoxin
phenytoin may decrease the hepatic metabolism of digoxin C
digoxin may
decrease the hepatic metabolism of phenytoin
D
digoxin may increase the unbound concentration of phenytoin in the blood E
unlikely to interact with digoxin, since digoxin is cleared largely
phenytoin is
by renal excretion
© Australian Pharmacy Council Ltd, 2013
64
Q118
Which ofthefollowingis NOT an adverse effectassociated with longterm corticosteroid use?
A
weight gain
B
increased susceptibility to infection C
rounding of the face
D
osteoporosis
E
hyperkalaemia
Q119
Which ofthefollowingtestsshouldbe carried outregularly forpatientstaking amiodarone?
A
serum cholesterol and triglycerides
B
ocular examination and thyroid function test C
thyroid function test and blood glucose
D
thyroid function test and blood urea nitrogen
Q120
Which of the following BEST monitors the anticoagulant effect of heparin?
A
the level of AST in serum
B
international normalised ratio (INR) C
a complete blood examination
D
the level of albumin in serum
E
activated partial thromboplastin time (APTT)
© Australian Pharmacy Council Ltd, 2013
65
Q121
Which of the following combinations may cause a clinically significant medication interaction?
A
phenytoin, atenolol, hydrochlorothiazide, ranitidine B
lithium,
fosinopril, frusemide, thyroxine
C
amiodarone, ranitidine, pravastatin, metformin D
metoprolol, ramipril, frusemide, clopidogrel
Q122
Which of the following biochemical abnormalities can predispose patients to lithium toxicity?
A
hypernatraemia B
hyponatraemia C
hypokalaemia
D
hypermagnesaemia E
hypoalbuminaemia
Q123
Which of the following medications would NOT be used in the management ofatrial fibrillation?
A
warfarin
B
verapamil
C
digoxin
D
amiodarone
E
perhexiline (use ivabradine for CAOP)
© Australian Pharmacy Council Ltd, 2013
66
Q124
Q121
Which ONE of the medication combinations could NOT account for symptoms of muscle pain, weakness and/or dark coloured
urine?
A
gemfibrozil / glibenclamide B
pravastatin / metoprolol
C
gemfibrozil / pravastatin
D
glibenclamide / metoprolol E
glibenclamide /pravastatin
Q125
A female patient, 48, has just been prescribed oestradiol patches 37.5 mcg/24hour. In your counselling to her, you should
advise her to place a new patch
A
on her chest every Monday morning and Thursday evening B
in a different place
every day
C
on her upper buttocks every three to four days D
in the same
place twice a week
LAW AND ETHICS
•
•
•
•
Which of the following medications may require a medical officer to get approval from Department of health
and aging?
Thalidomide
Danazol
Testosterone
Danaparoid
Pharmacist regularly making dispensing error. What would you do?
• Mandatory notification
• Voluntary notification
• Not doing anything
A locum pharmacist looks intoxicated after having lunch. What would you do
• Mandatory notification
• Voluntary notification
• Not doing anything
A methadone patient lost his takeway on a Saturday and GP won’t be available until Monday.
• Do not give him anything- refuse supply unless you get into contact w the doctor
• Give him the dose for today
• Give him takeaways doses and contact doctor on Monday
What is correct for a non-streamlined authority Rx
• A dentist can©write
authority prescription within the scope of dental practice
Australian Pharmacy Council Ltd, 2013
• Non-streamlined authority prescription is not valid until approval from Department of health 66
• Medical practitioner are allowed to write more than one authority item on a non-streamlined Rx
•
•
•
•
Doctor called for patient info treated by another doctor
Do not give anything regardless of consent
Q121
Give health information if you deem is important to the patient health
Provide information after having a written consent
Provide information first and get the consent after
Privacy and confidentiality Commonwealth, State and Territory privacy laws set out the privacy principles
applicable to health providers. Pharmacists should ensure that all pharmacy services are provided in a manner
that respects the patient’s privacy requirements, and is in accordance with relevant professional and quality
assurance standards. Guidelines Information about a person that a pharmacist obtains in the course of
professional practice is confidential and may be disclosed only: 1. with that person’s permission or 2. to other
persons authorised to the extent of the latter person’s lawful jurisdiction or 3. on a court order or 4. if, in the
pharmacist’s opinion, it is in the patient’s best interest to divulge pertinent information to another health
practitioner who is treating the patient. Authorised persons include: • a Pharmacy Board of Australia officer or an
Australian Health Practitioner Regulation Agency (AHPRA)- appointed investigations officer • an officer of the
State or Territory pharmacy authority • a person authorised under the State or Territory poisons law (including a
member of the police force to the extent authorised) • a member of an enforcement agency in accordance with
the Privacy Act 1988 (Cwth), or State or Territory privacy laws • an authorised officer of Medicare Australia for
the purposes of examining prescriptions supplied as pharmaceutical benefits under the National Health Act 1953
(Cwth) • an authorised officer of State or Territory statutory authorities that administer laws of work or road
trafficrelated insurance. Particular care should be exercised if other official bodies seek information. State or
Territory privacy authorities should be contacted in cases of uncertainty. The name or details of a therapeutic
product (medicines and devices) should not be identified in information given to other than the person for whom
it was intended, unless the person waives that right. Examples of persons to whom information may be
inadvertently disclosed could include a person paying a family account or to third party organisations (including
service companies) that process accounts, and organisations collecting statistical data. The inadvertent
disclosure of the identities of patients’ medicines (and therefore the patients’ medical conditions) to third parties
is to be avoided.
•
•
•
•
How long is a S4 prescription valid for?
6 months
12 months
18 months
24 months
Which of the following medications can a medical practitioner order free of charge from PBS so that he/she
can supply to patient when emergency?
• Oxycodone
• Haloperidol
• Insulin
• Isosorbide mononitrate
Which schedule; does, “Substances with a low potential for causing harm, the extent of which can be
reduced through the use of appropriate packaging with simple warnings and safety directions on the
label”, apply to?
Schedule 5.
Caution – Substances with a low potential for causing harm, the extent of which
can be reduced through the use of appropriate packaging with simple warnings
and safety directions on the label.
Prochlorperazine approved S3 indication: (susmp)
© Australian Pharmacy
2013containing not more than 10 dosage units for the treatment of
• in divided preparations
for oralCouncil
use inLtd,
packs
66
nausea associated with migraine
Which of the following CAN NOT prescribe oral Codeine 30mg?
• Optometrist cannot prescribe oral formulations of medications- only eye drops
Q121
Which locations can use a PRF (prescription record file) for safety net?
• Community pharmacies and approved hospitals
What is the maximum number of PBS items ; authorised on a single prescription (excluding authority
prescriptions)?
Community
Hospital scripts
• Three items on one script
• Max 10 items on one script
• Authority items only ONE PER SCRIPT • Authorities can be mixed and written on
the same script
• Cant have a mix of PBS and non PBS
items
• Pharmacist can defer auth items
• Cant defer auth items
• Non pbs items can count towards the
hospital formulary
• Non PBS items don’t contribute to the
SN threshold
The functions of the Pharmacy Board of Australia include:
• registering pharmacists and students
• developing standards, codes and guidelines for the pharmacy profession
• handling notifications, complaints, investigations and disciplinary hearings
• assessing overseas trained practitioners who wish to practise in Australia
• approving accreditation standards and accredited courses of study.
Which of the following is requires a mandatory report to AHPRA?
• PIC has a sexual relationship with a patient
• PIC has a mental condition which is adequately controlled by medications
• PIC has a medical condition which is adequately controlled by medications
• PIC is intoxicated
Mandatory notification
Notifiable conduct by registered health practitioners is defined as:
•
•
•
•
practising while intoxicated by alcohol or drugs
sexual misconduct in the practice of the profession
placing the public at risk of substantial harm because of an impairment (health issue), or
placing©the
public Pharmacy
at risk because
a 2013
significant departure from accepted professional standards.
Australian
Councilof
Ltd,
66
Which of the following medication is it most appropriate to put label 1
•
•
•
•
•
Mirtazapine
Duloxetine
Venlafaxine
Q121
Ondansetron
Allopurinol
Pharmacy going give reward/incentive for the pharmacist who sells the most vitamins, what does this
compromise?
• Patient confidentiality
• Pharmacist autonomy
A pharmacist respects the autonomy and dignity of each patient. A pharmacistpromotes the right of self-determination and recognizes individual selfworth by encouraging patients to participate in decisions about their health. A pharmacistcommunicates with patients in terms that are understandable.
•
Business privacy
Which of these is an inappropriate way of discarding private sensitive patient information
• All the options had shredding and discarding in some form EXCEPT one which said place in a sealed
container in the bin-correct answer because you can still access the info
Most controlled schedule to least controlled schedule?
• 9>10>8>4>7>3>2>6>5
How long is a methylphenidate script valid for?
• Methylphenidate is a S8 according to SUSMP therefore is valid for 6 months
Who cannot write repeats for a PBS script ?
• Medical practitioner
• Dentist – cannot write repeats
• Midwife
• Nurse Practitioner
How long is a safety net card valid for ?
• 12 months after the date the card was issued
• Remainder of the calendar year the card was issued
• 6 months after the date the card was issued
Highest authority for sedation label?
•
•
•
SUSMP
APF
AMH
A dr calls you and gives you verbal details to provide a patient of his with an s8 medication, you are
able verify doctor. How many /much quantity would you provide the patient.
• 2 days
• 3 days
• 7 days
• Full supply
o however the prescriber is required to write down the script within 24 hours post verbal and should be sent to
o
the pharmacy as soon as possible (ideally within 7days)
Max 2 days supply only apply when a prescriber cannot be contacted and you can’t establish Rx legitimacy
for S8
Dispensing from a verbal instruction
Regulation 33
A prescriber may,
where there
is a good
reason,
give a prescription by telephone, facsimile, or other electronic means.
© Australian
Pharmacy
Council
Ltd, 2013
66
The same information as required for a written prescription must be provided. Unless the prescription was faxed and
endorsed with the name of the single pharmacy to dispense the prescription, the prescriber must forward a written
prescription as confirmation as soon as practical or if a drug of dependence, within 24 hours.
When would an emergency supply NOT be appropriate?
• The medication
is for the medical treatment for the patient
Q121
• The patient requires the medication for the continuity of their health
• The patient is going to see their doctor to get their script soon – already getting a script therefore
why do they need emergency supply?
• The patient would go through hardship getting their script in time
Which of the medications prescribed only by dermatologist?
• Acterin- only dermatologist can prescribe appendix D pg 280 of SUSMP
Dr call for patient’s info treated by another doctor
• give after patient consent
• give all info to doctor
Pharmacist does a lot of dispensary mistakes
• mandatory notification to AHPRA (As the pharmacist has fell below the professional standard and is putting
the patients at harm) Mandatory notifications involve HCP’s)
•
•
voluntary notification to AHPRA
no action
Non streamlined authority script
• needs approval by DVS prior dispensing Non streamlined authority scripts required approval by DVS,
cannot be approved in retrospect
• can dispense due to authority number
Which of the following is NOT required for a PBS script?
• Dr’s place of practice
• Dr’s name
• Provider number – only req for hospital scripts
• Pt’s name
Privacy question regarding someone comes in to ask you about a tablet they found on their assistance
desk?
• tell them about it
• tell them to ask there assistant
Mother comes in asking for tax report for her husband and two kids aged 4 and 6years. What can you
provide her with?
• The tax report for herself and two children only.
After how long from the date a controlled drug script is written will it expiry?
• 1 year
• 6 months
Who can write pbs scripts?
For doctors:
•
Personalised forms — are printed with the doctor's name, qualifications, practice address/es, telephone
number and prescriber number (which relates to pharmaceutical benefits). They are only provided to
doctors who have a Medicare provider number.
•
Non-personalised (blank) forms — are distributed as an emergency supply (usually when a doctor has
temporarily run out of personalised forms).
•
Locum forms — have the doctor's name, prescriber number and telephone number (if available) and a
Australian
space to©record
thePharmacy
practice Council
where Ltd,
the 2013
doctor is working.
•
PBS/RPBS Authority Prescription Forms — can be in personalised, non-personalised or locum format.
66
•
Computer PBS prescription forms — are either continuous or single sheet. On the reverse side they list the
name, address and telephone number of the practice, and in the case of a sole doctor practice, the doctor's
name. Q121
For dentists:
•
Personalised forms — have the dentist's name, qualifications, practice address/es, telephone number and
prescriber number.
•
Non-personalised (blank) forms — are distributed for emergency supply only.
For optometrists:
•
Personalised forms — have the optometrist's name, qualifications, practice address/es, telephone number
and prescriber number. These forms can be also be used to prescribe authority-required PBS/RPBS items.
For midwives:
•
Personalised forms — have the midwife's name, qualifications, practice address/es, telephone number and
prescriber number.
•
Non-personalised (blank) forms — are distributed for emergency supply only.
For nurse practitioners:
•
Personalised forms — have the nurse practitioner's name, qualifications, practice address/es, telephone
number and prescriber number.
•
Non-personalised (blank) forms — are distributed for emergency supply only.
Not podiatrists and VETS
Provider number only required for:
• hospital pbs scripts
• community authority scripts
• PBs scripts
Which medication requires further training for medical practitioner in terms of stricter control and close
therapeutic monitoring?
• Morphine
• Tramadol
• Venlafaxine
• Clozapine susmp
Doctor calls you to ask about information about his patient from another doctor. What do you do?
• Only give information once the patient has given consent
• Only give information once the other doctor gives consent
• Only share information, which you as a pharmacist, believes is required for the health of the
patient
• Do not share information at all
Which of the following medications can a doctor obtain for his Prescriber Bag?
• Dexamethasone
• Ketamine
• Ondansetron
PBS: Which of
these medication
required
an PBS authority?
© Australian
Pharmacy Council
Ltd, 2013
• Dabigatran
A fellow pharmacist asks for answers for CPD modules. What is in stake?
66
•
•
•
Professional autonomy
privacy and confidentiality
patient care
Q121
Which one of the following is INCORRECT?
• Brand premium fee does not count towards Safety net
• Therapeutic group premium count towards safety net
• Reg 24 supply all count towards safety net
A lawyer called in and ask for information of his client’s dispensing history. What would you do?
• Print it out and fax it to him
• Refuse supply to protect patient’s privacy
• Supply to him after receiving the patient’s written consent
• Ask him to let the patient call us to confirm first, then supply it to him.
Which of the following drug needs “special authority” in order to supply?
• Danazol (Azol)
Under which circumstances can you not disclose patient’s information?
• Police request for crime investigation (You are only obliged to give police info after 1. Patient consent 2.
Police has a court order/warrant)
•
•
•
•
Doctor requesting to treat a patient
Life-threatening circumstances that would cause the patient immediate harm
Court orders
Patient requesting for their own history
Following a phone order, by what time should the script be sent to the pharmacist?
• 7 days – PBS
• 1 month
• 24 hour
• 48 hours
• 2 weeks
By law, the manufacturer is required to include which warning on haloperidol?
•
•
•
•
•
Pharmacy Medicine
Prescription Medicine
Sedation Warning –Appendix k
Controlled Medication
Pharmacy only medicine
Which is wrong about the need of a PBS Authority prescription?
• Exceeds PBS number of repeats
• Exceeds PBS quantity of medication
• Prescribed by a specialist only
• According to patient’s genetic polymorphism/heritage
What kind of doctor (endocrinologist, dermatologist etc.) can prescribe thalidomide?
• Specialist Physician or dermatologist form SUSMP p.279
Emergency supply of S4 medication:
• maximum 2-3 days of treatment
• one week
• full supply
© Australian Pharmacy Council Ltd, 2013
Parents find daughter's medication and calls you up to ask what it is for → your concern is66the
daughter's privacy
• needs patient consent
What schedule is aspirin 324mg in effervescent form?
• Unscheduled
• Schedule 2
Q121
• Schedule 3Something about when disclosure should not be overridden
• When information can help another patient
• When information is needed for court
• When information is needed for a crime
• Where somebody’s life/the public is threatened
Another question similar to the one above about a mother finding a pill in her child's room/drawer and wanting to know
what it was, what would you ask the mother?
•
•
•
•
•
child's gender
child's age
child's weight
General health of the child
Height of the child
What authority do you need for dabigatran?
• Streamline authority
• For people who can’t take warfarin
• No authority required
• Only specialists can prescribe this
Something about discretion. When is it least appropriate to hand out
• When it’s going to cause harm to society
• When its going to cause harm to the patient themselves
• When it’s needed for court matter
• When police need it for criminal matter WITHOUT COURT ORDER
• When another pharmacist asks for it to treat the patient
There was a sentence about the pharmacy profession. Which statement defines it least
• Pharmacists work within their scope or something
• Pharmacists acknowledging that the health of the patient is a priority
• Counselling must be done in confidentiality
• The health of a colleague must be kept confidential
Which medication requires label 1
• Lamotrigine
• Duloxetine
Which one is free when requested as a doctor’s bag medication?
• Haloperidol
• GTN
• oxycodone
Which emergency medication from the doctor’s bag doctor can be used in case of Acute dystonic
reaction?
• Benztropine
Parents called your pharmacy saying that they found a pill intheir15years old daughter draw and they are afraid
and worried of what it is. what is your main concern as a professional pharmacist?
© Australian
Pharmacy Council Ltd, 2013
• Daughters
privacy
66
• Harm of the patient
Which drug needs monitoring by pharmacists and prescribers from doctors and pharmacists?
• Clozapine
• Quetiapine
Q121
• Risperidone
• Olanzepine
In which schedule would you find esomeprazole 20mg (QTY: 14)
• Unscheduled
• S2
• S3
• S4
• S8
Medical practitioner (unless authorised) cannot prescribe or supply which of thefollowing medication:
• Clozapine
• Amoxicillin
• Diclofenac
Condition of requesting dr bags:
• Weekly with appropriate weekly form
• Monthly with appropriate monthly form
• When required for an emergency
Which of the following medicine needs an authority to be entitled for PBS:
• Azithromycin
• Isoniazid
• Isotretinoin
Which drug can only be prescribed by a hematologist or oncologist?
• Doxorubicin
• Cisplatin
• cyclophosphamide
Which drug need authority to be prescribed on PBS
• Answer: Methylphenidate
Advertisement of a medication; can you advertise orlistat?
• Answer: No
Which locations can use a PRF?
• Community pharmacies ONLY
• Community pharmacies and approved hospitals
• Medical Clinics
• Community pharmacies, approved hospitals AND medical clinics
Prochlorperazine is available over the counter as a Pharmacist Only Medicine. It is only approved to be
supplied for which ONE of the following symptoms?
• A Nausea associated with gastro-enteritis
• B Nausea associated with migraine
• C Nausea associated with motion sickness
• D Nausea associated with pregnancy
Certain pharmaceutical benefits are provided without charge to prescribers (in prescriber bag supplies),
who in turn can supply them free to patients for emergency use.
Pharmacy
Council Ltd,
2013
Which ONE of© Australian
the following
medicines
fits
this category?
66
• A Dopamine
• B Ondansetron
•
•
C Dexamethasone
D Dicloxacillin
Q121
A customer comes into your pharmacy and asks you to identify a white tablet, which he shows you.
Upon questioning him, he advises that he found it at his personal assistant's workstation.
Which ONE of the following actions is the MOST appropriate for you to take?
• A Identify the tablet, if possible, and inform the customer about the medication
• B Inform the customer that you are not able to provide any information and advise him to discuss
the matter with his assistant
• C Request further information regarding his assistant's medical history and general behaviour, before
discussing the medication further
• D Suggest that you are unable to properly identify the tablet, to remove yourself from the situation
Which ONE of the following reference text would be considered to have the MOST authority when
deciding which medications require labelling with a sedation warning?
• A The Australian Medicines Handbook (AMH)
• B The Australian Pharmaceutical Formulary (APF)
• C The Schedule of Pharmaceutical Benefits (PBS)
• D The Standard for the Uniform Scheduling of Medicines and Poisons (SUSMP)
Which ONE of the following statements is NOT a purpose where PBS authorities are required for
Medicines?
• A PBS authorities are required where there is an increased quantity of medicine needed
• B PBS authorities are required where there is an increased number of repeats needed
• C PBS authorities are required where access to the medicine is restricted to certain approved doctors to
prescribe
• D PBS authorities are required where concerns exist about effects on patients of varying genetic
heritage
Which ONE of the following statements best describes a Pharmaceutical Benefits (PBS) authority
prescription medication?
• A The medication has no PBS restriction on its therapeutic use
• B The medication has a low therapeutic index, which requires close monitoring
• C The medication has a high chance of adverse events, which requires the prescriber to consider
carefully the risk benefit ratio for each specific patient
• D The medication has restrictions and requires approval from Department of Human Services or
the Department of Veterans Affairs for a specific condition
Which ONE of the following statements is CORRECT regarding the guidelines for pharmacists issuing
medical certificates under the Workplace Relations Act 1996?
• A A medical certificate issued by a pharmacist must be accepted as evidence of illness or injury for the
purpose of health and welfare benefit entitlements
• B It is recommended that records of the medical certificate be kept for at least 6 months
• C A pharmacist may not issue a medical certificate in relation to an illness or injury outside of
their scope of practice
• D It is not necessary to conduct a consultation with the ill or injured person, if the medical certificate is
being issued for a carer
A patient requests that you allow them to see what information is held about them on the dispensary
computer.
Which ONE of the following statements is INCORRECT?
• A A consumer is not allowed to see dispensary information as this may be misinterpreted by nonhealth professionals
© Australian Pharmacy Council Ltd, 2013
• B A consumer can demand that information held about them be modified if found to be inaccurate
66
• C A pharmacist can deny access to information if he/she considers the information may be a threat to the
life or health of an individual
•
D Access may be denied if information about another patient is contained within the same patient health
record
In which schedule
Q121 of the Standard for the Uniform Scheduling of Medicines and Poisons would you find
codeine tablets 30mg?
• A Schedule 2
• B Schedule 3
• C Schedule 4
• D Schedule 8
• E Unscheduled
3 Substances, the safe use of which requires professional advice, but which should be available to the
public from a pharmacist without a prescription” is the general description statement for which ONE of
the following Poisons Schedules?
• A Schedule 2
• B Schedule 3
• C Schedule 4
• D Schedule 5
• E Schedule 6
What does Regulation 24 of the Pharmaceutical Benefits Scheme (PBS) refer to?
• A No requirement for a patient co-payment
• B Application to patients with specific medical conditions only
• C Supply of original and all of the repeats to be supplied at the one time
• D Application to patients from a remote area where access to PBS supplies is limited
• E Increasing the maximum quantity or number of repeats of a prescription
A prescription item designated as an unrestricted PBS benefit item is BEST described as a medication:
• A That has no PBS determinations on its therapeutic use
• B With a low therapeutic index, which requires close monitoring
• C That can only be prescribed on the PBS for specific therapeutic uses
• D That is restricted and requires prior approval from the Medicare Australia or the Department of
Veterans Affairs for a specific condition
• E With a high chance of adverse events, which requires the prescriber to consider carefully the risk
benefit ratio for each specific patient
6 According to the Standard for the Uniform Scheduling of Medicines and Poisons, what medicine is
classified in Schedule 4?
• A Prescription only medicine
• B Pharmacist only medicine
• C Controlled drug
• D Pharmacy medicine
• E Dangerous poison
According to the Standard for the Uniform Scheduling of Medicines and Poisons, what classification
does cyproheptadine hydrochloride 4mg (50) tablets belong to?
• A Prescription only medicine
• B Pharmacist only medicine
• C Unscheduled
• D Pharmacy medicine
• E Controlled drug
15 Where can items to be recorded on Prescription Record Forms (PRFs) be recorded?
• A Community pharmacies and approved hospitals
• B Community pharmacies only
© Australian
Council Ltd,
2013
• C Medical
clinics Pharmacy
and community
pharmacies
• D Approved hospitals and medical clinics
• E Community pharmacies and community health centres
66
16 Buprenorphine is classified in Schedule 8 in the Standard for the Uniform Scheduling of Medicines
and Poisons. What sort of medicine is Buprenorphine?
• A Prescription only medicine
Q121 only medicine
• B Pharmacist
• C Controlled drug
• D Pharmacy medicine
• E Dangerous poison
Which ONE of the following oral medicines is required to be ordered as an authority for Pharmaceutical
Benefit Scheme purposes?
• A Methylphenidate
• B Midazolam
• C Mercaptopurine
• D Methotrexate
Which ONE of the following does NOT entitle a patient to pay the concessional patient contribution for a
pharmaceutical benefit?
• A Pensioner Concession Card
• B Safety Net Concession Card
• C Australian Seniors Health Card
• D Repatriation Pharmaceutical Benefits Card
• E Reciprocal Health Care Agreements Medicare Card
Pharmaceutical Benefits Authority prescriptions are valid when:
• A Written by a doctor, nurse or dentist, and approved by the appropriate federal government authority
• B Written by a doctor or dentist and approved by the appropriate federal or state government authorities
• C Written by a doctor and approved by the appropriate federal government authority
• D Written by a doctor or nurse and approved by the appropriate federal government authority
• E Written by a doctor or nurse and approved by the appropriate federal and state government authorities
Which of the following professionals are able to write Pharmaceutical Benefits Scheme (PBS)
prescriptions?
• A Doctors only
• B Doctors, dentists and nurse practitioners only
• C Doctors and optometrists only
• D Doctors, optometrists, dentists and nurse practitioners
What is the maximum number of items (except for 'Authority required' items) that may be included on a
Pharmaceutical Benefits Scheme prescription?
• A One
• B Two
• C Three
• D Four
• E Unlimited
Which ONE of the following is INCORRECT in regard to 'Authority required' Pharmaceutical Benefits
Scheme (PBS) prescriptions?
• A The prescriber must include more than one item per PBS prescription
• B The prescriber must include their own information, including name, address,
• telephone number and prescriber number
• C The prescriber may preclude brand substitution
• D The prescriber must include the entitlement status of the patient
Australian
Pharmacy
Ltd, 2013 of medications under the Pharmaceutical Benefits
Regulation 24© is
a regulation
forCouncil
the provision
Scheme. What is the equivalent regulation under the Repatriation Pharmaceutical Benefits66
Scheme
referred to as?
•
•
•
•
•
A Emergency provisions
B Prior approval provisions
C Equity of access
Q121
D Hardship conditions apply
E Physical impairment provisions
In which schedule of the Standard for the Uniform Scheduling of Medicines and Poisons would you find
Salbutamol Metered Dose Inhaler 100 mcg/dose?
• A Schedule 2
• B Schedule 3
• C Schedule 4
• D Schedule 8
• E Unscheduled
© Australian Pharmacy Council Ltd, 2013
66