Rop exam questions - all qs put into one document PDF

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2016/17 SECTION B Answer ALL FIVE questions from this section

A B C D E F G H 1.

Chickenpox Fifth Disease Impetigo Measles Meningitis Mumps Nappy rash Scarlet fever

For the patients described in the statements below, select the single most suitable diagnosis from the list above. Each option may be used once, more than once, or not at all. (1 mark each)

i.

Reena is 5 years old and has been feeling under the weather. She has had a slight temperature for a few days then this morning has come out in a rash (small red lumps, some of which have turned into blister-like spots). They are mostly on her abdomen and back and are very itchy. – chicken pox

ii.

Baby Jimmy is 9 months old with a temperature and a rash. He has high pitched moaning, a whimpering cry and blank, staring expression. He also has a bulging fontanelle. – meningitis

iii.

Miriam is 2 years old and has had cold-like symptoms including a fever and runny nose for the last few days. Today she has a rash behind her ears and small white spots on the inner cheeks. – measles

iv.

Roberto is 6 months old and has pink blotchy spots on his bottom. He has been drooling and crying when he urinates. – nappy rash

v.

Lila is 4 years old and has red blotches on her chest and stomach area. She also had a high temperature, sore throat and headache over the last few days. Her tongue had a white coating, which when scraped off, is red and swollen underneath (strawberry tongue). -scarlet fever

vi.

Derek is 3 years old and has a slightly high temperature and bright red rash on both cheeks. – fifths disease (Total 6 marks)

Continued… 2. Answer BOTH parts of this question.

a. Obesity is currently a health problem in the UK; List FOUR health conditions that could be a consequence of obesity? - Cancer - Atherosclerosis - Heart attacks - Stroke (2 marks)

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b. which patients are at risk of high cholesterol? What is the optimal target of total and LDL cholesterol for these patients, and their preferred value of HDL cholesterol? LDL – under or equal to 3 HDL – men – over 1, women - over 1.2 Total – under or equal to 5 (4 marks) (Total 6 marks)

3. Consider the following scenario. A second-year pharmacy student is asked to leave the university’s LRC at 9.00 pm as they do not have their student ID with them. The student makes no effort to leave and are asked politely once again by the university’s security officer to leave. The student starts to scream and shout at the officer and abusively swears at them, telling the officer as a student they have a right to be in the LRC. The officer politely points out that students need their student ID to remain after 9.00 pm. The student continues their abusive language to the officer, which becomes racist in nature. The security officer tells the student that they will call the police if the student does not leave. The student packs their bag and leaves hurling insults at the officer as they leave. The officer makes a complaint to the School the next day. With reference to the Pharmacy student Code of Conduct briefly discuss how this student has broken the Code. (6 marks) 4. State the functions of Local NHS Education and Training Boards (LETBs)

Four regions. 1. 2.

3. 4.

Statutory committees of Health Education England Responsible for NHS education and training across all professions and support staff at a local level. Workforce planning This includes pre-registration pharmacist training

(6 marks) 5. A patient is taking 60mg oral prednisolone and his consultant wants to switch him to oral methylprednisolone.

a. What dose of methylprednisolone would you advise? 48mg (2 marks) This table takes no account of mineralocorticoid effects, nor does it take account of variations in duration of action Prednisolone 5 mg ≡

Betamethasone 750 micrograms

≡

Deflazacort 6 mg

≡

Dexamethasone 750 micrograms

≡

Hydrocortisone 20 mg

≡

Methylprednisolone 4 mg

≡

Prednisone 5 mg

≡

Triamcinolone 4 mg

b. A 5-day old baby weighing 2.6kg has sinusitis that is susceptible to amoxicillin. What total daily dose of amoxicillin should be administered to this baby by mouth? -

2.6 x 30 = 78 mg and three times daily = 78 x 3 = 234mg in total in a day (2 marks)

c. A patient is prescribed 60mmol potassium, which is to be given using 240mL of fluid at a rate of 20mmol/hr. If a normal giving set delivers approximately 20 drops per millilitre, calculate the drop rate required to administer the potassium (in drops per minute) (Give answer to closest whole number). -

240mL and 20 drops per mL  240 X 20 = 4800 DROPS IN TOTAL

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60mmol and 20mmol/ hr therefore if 20mmol = 1 hr, then 60mmol = 3hrs 3 hrs = 180 minutes  4800/180 = 26.6666 = 27drops per minute (2 marks) (Total 6 marks) (Total 30 marks for section) Continued... SECTION C Answer TWO questions only

6. Answer ALL THREE parts of this question

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i. What are the nine standards of pharmacy Person centred care Partnership working Effective communication Professional knowledge + skills Professional judgement Professional behaviour Confidentiality + privacy Speaking up about concerns Leadership (9 marks)

ii.

Outline how a pharmacist’s actions could breach or break six of these standards (12 marks)

iii.

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The standards apply to pharmacists at all times not just when working with patients. Give an example of where a pharmacist could break one of these standards outside of their work as a pharmacist. Trying to give false scientific advice to someone outside working hours Social media (1 mark) (Total 22 marks)

7. Answer ALL THREE parts of this question Mr Summers, a 42-year-old male, calls in to your pharmacy and requests some advice for his athlete’s foot. There is flaky skin between his two smallest toes and the skin is itchy but not broken. He has not tried anything yet, is not taking any other medication and has no other medical conditions.

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a. List the active ingredients of the most common treatment creams available for you to recommend Mr Summers to purchase over the counter from your pharmacy for his athlete’s foot. Terbinafine Clotrimazole Salicylic acid? (4 marks)

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b. List the practical measures Mr Summers should take to ensure the athlete’s foot treatment is effective. Cotton socks change daily Wash feet daily Dry feet properly Leather or breathable shoes Changes shoes every 3 days to let air out Powder in shoes to absorb moisture Don’t wear barefoot in public Leave shoes off as much as possible inside Don’t scratch or itch harshly Avoid swimming areas (8 marks)

c. Which ONE of the 8 essential services of the Community Pharmacy Contract does respond to Mr Summer’s symptoms and providing an over-the-counter product fall under and what do the service specifications entail? (8 marks) -

self care 1. 2. 3. 4.

providing advice for athletes foot giving management options to them minor ailment based on advice, give OTC product

(Total 20 marks) Continued.... 8. Answer ALL SIX parts of this question Mrs. Gerald would like some advice from you regarding her 4 year old daughter Janet. Janet has been scratching her bottom which has become quite red and sore today and Mrs. Jackson has noticed some white thread-like deposits in her faeces. Mrs. Gerald is very embarrassed by it, as it is the first time Janet has had it. She is also very concerned that her younger son Michael who is 18 month old may also catch it.

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a. What would you consider to be the most likely diagnosis? Threadworms

(1 mark)

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b. Mrs Gerald asks how might Janet have caught this, construct an appropriate response Oral faecal route – when the child scratched their bottom/ washed, and then ate food with hand or bit nails – transfers to mouth Under rare or certain circumstances, it can be through indirect contact e.g., bedding (4 marks)

(c) What OTC treatment will you recommend -

Ovex – mebendazole

(3 marks)

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d. What specific measures should Mrs. Jackson take to prevent re-infection? Tight fitting underwear Wash bedding and clothing at 50 degrees Put unwashable items in a container for 2 weeks Avoid scratching Use gloves/ cover hands at night as its itchy Wash hands after going to the toilet and before eating food Wash under nails with soap Wash toothbrush Shower daily in the morning Avoid sharing clothes Whole family has treatment at same time (10 marks) (e) Which of the available OTC treatments for this condition should be avoided in Epilepsy? - mebendazole (give piperazine) (1 mark) (f) Mrs Jackson asks if the children should be kept off school, how would you respond to this request? - nah go school (1 mark) (Total 20 marks)

2017/18 END OF EXAMINATION PAPER SECTION B

Answer ALL FIVE questions from this section

A B C D E F G H

Ashton & Parsons Powder Bonjela gel (choline salicylate) Call 999 Call General Practitioner (GP) Chlorpheniramine 5mg/5ml oral solution Dentinox gel (lidocaine) Dexpanthenol 5% ointment Infacol drops

31. For the patients described in the statements below, select the single most suitable treatment option or advice from the list above. Each option may be used once, more than once, or not at all. A. Lisa is 3 years old and has not been feeling well. She has had a slight temperature (around 38 C) for 2 days then this morning has come out in a rash (small red lumps, some of which have turned into blister-like spots). They are mostly on her abdomen and back and are very itchy. o

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B. Baby Kyle is 10 months old with a fever (38.5 C) and a rash which does not fade when pressed. He has refused some of his feeds and does not want to be held. Call 999

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C. Maaya is 11 months old and has had symptoms such as fever, runny nose and sore eyes for the last few days. Today she has a rash behind her ears and small white spots on the inner cheeks. Call GP

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D. Jeremy is 8 months old and has red patches on his bottom. He has been drooling and crying when he urinates. Ashtons and parsons

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E. Layla is 4 months old and has been drooling more often than usual for the last 2 days. She also has a flushed cheek on one side and her gums are swollen. She has not been sleeping well the last 2 days. Bonjela gel (choline salicylate)

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F. James is 3 months old and has a high temperature (around 38.5 C) and bright red rash on his bottom. There is some yellow discharge exuding from the spots on the bottom. Dexpanthenol 5% ointment

o

o

(6 marks) 32. High cholesterol level can increase the risk of coronary heart disease (CHD) and strokes in patients, you have just measured the total cholesterol levels for one of your patients and it was 4.7mmol/L. It is in the upper range of normal. You advise the patient to get it checked in few

months’ time but in the meanwhile to follow the cardioprotective diet. Outline the main recommendations of this diet. - eat healthy lol - eat 5 portions of fruits and vegs daily - avoid salty food - lol (6 marks) Continued…

33. Please answer ALL PARTS of this question.

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A. The antibiotic amoxicillin must be reconstituted before it is dispensed. The label indicates that 82mL of water must be added to the powder to result in 100mL of a 250mg/5mL suspension. What is the displacement volume of 250mg of the amoxicillin? 100 – 82 = 18 (2 marks)

B. A patient is to be given 500mL of normal saline solution over a 6-hour period. If 20 drops = 1mL, how many drops per minute should be administered? Give your answer to the nearest WHOLE drop. 500ml = 20 per 1ml If 1 ml = 20 drops, 500 = 10,000 6 hrs = 360 minutes 10000/ 360 = 27.777 28 drops (2 marks)

C. Review this table from the BNF and answer the following question:

Continued….

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Mrs Smith has been taking oral morphine 120mg daily to control her pain. She is finding it difficult to swallow the tablets so her doctor has asked you to recommend an equivalent dose of intramuscular diamorphine for her. What is the equivalent TOTAL DAILY DOSE of intramuscular diamorphine that Mrs Smith would require to match her current oral morphine dose? 10mg = 3mg Therefore, 1= 3/10 120 = 3/10 x 120 = 36 (2 marks) (Total 6 marks) Continued…

34. The British National Formulary lists various organisations and information sources that are utilised in the production of the BNF, in their abbreviated forms. What do the following abbreviations stand for? (6 marks)

a. b. c. d. e.

MHRA – medicines and healthcare product regulatory agency CHM – commission on human medicine ACBS – association for contextual behavioural science NICE – national institute of health and care excellence SPC – summary products characteristics

f. PIL – patient information leaflet

35. Hepler and Strand defined pharmaceutical care as ‘The responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient’s quality of life.’ They also defined what these outcomes are. What are these four outcomes and give an example of each of them. -

Skippy skippy (6 marks)

Continued… SECTION C Answer only TWO questions only from this section

36. Answer ALL parts of this question. Standard Operating Procedures (SOPs) specify what should be done, by whom and when in the processes in pharmacy.

a. Briefly outline the benefits of utilising SOPs in the dispensing process in pharmacy.        

Assure quality + consistency of service Ensure good practice is always achieved Provides opportunity to fully utilise the expertise of all the members of the pharmacy team Enables pharmacist to delegate and free up time for other activities Avoids confusion over who does what Provides advice and guidance to locums and part time staff Useful tool for training and new members of staff Provides a contribution to the audit process

(4 marks)

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b. List the mandatory SOPs in community pharmacy. Responsible pharmacist Controlled drugs Clinical guidance Service specific contractual SOP

(4 marks)

c. What are the SIX headings in the outline of a Standard Operating Procedure (SOP) according to the Royal Pharmaceutical Society (RPS) of Great Britain? Briefly describe what considerations should be made to the information each of the headings should contain. OSS ROR O- Objective S – Scope S – stages R – responsibilities O – other information R – review (12 marks) (Total 20 marks)

Continued…

37. Answer BOTH parts of the following question.

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a. Discuss the aetiology and course of symptoms for chickenpox. Virus Varicella zoster virus Direct contact

Symptoms - Spots – red, raised - Blister - Burst and blister over after a few days - Itchy - Yellowish spots too - Starts in abdomen or back (10 marks)

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b. Discuss the various treatment options which are available for chickenpox, including non-drug advice in your answer. Rest Calamine lotion

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Stay hydrated Paracetamol if pain (not ibuprofen unless advised otherwise) Virasoothe Antihistamines Avoid picking/ itching spots Take a cool bath with oatmeal Stay off school/ work till spot crusts over Cut nails Do not rub skin, pat dry Dress in loose clothing (10 marks) Total 20 marks)

38. Answer ALL THREE parts of this question

        

a. The General Pharmaceutical Council (GPhC) has recently replaced its code of conduct, ethics and performance with a set of 9 standards that every pharmacy professional is accountable for meeting. What are these 9 standards? Person centred care Partnership working Effective communication Professional knowledge + skills Professional judgement Professional behaviour Confidentiality + privacy Speaking up about concerns Leadership (9 marks)

b. The GPhC state in the standards that they are relevant to pharmacy students. Outline for each of the standards how you as a pharmacy student could show you were meeting the standards. (9 marks)

c. Outline briefly why it is important that the standards apply to pharmacy students. (2 marks) (Total 20 marks)

END OF EXAMINATION PAPER

2018/19 SECTION B Answer ALL FIVE questions in one answer booklet

1.

The acronym ASMETHOD is used as a questioning technique when dealing with over the counter requests and responding to symptoms. Discuss what the A and S in this acronym represent and why it is important to ask these questions. (6 marks)

2. A 24 year old female approaches the pharmacy counter and asks for some advice regarding her feet. She has something on her right foot and is not sure if is a corn or callus. Describe the clinical features of hard corns, soft corns and calluses and their most common cause. (6 marks)

3. List SIX practical measures to advise patients to implement when responding to symptoms of athlete’s foot in the pharmacy. (6 marks)

4. Answer BOTH parts of this question. You offer an NHS health service at your pharmacy to a male patient aged 65. He smokes about 10 cigarettes a day and drinks a glass of wine with his evening meals in the weekend. His weight is 88kg and height is 175 cm. Two measurements of blood pressure (BP) were taken and they were 160/85mmHg. His cholesterol was 5.2mmol/l and random blood glucose (BG) 13.5mmol/l.

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a. Comment on the BP, cholesterol, BG and weight and height measurements undertaken. Discuss their significance. Everything is high He has obesity lol (4 marks)

b. List FOUR life style advice that you would give to this patient. Exercise Balanced diet Reduce fats, oils Avoid stressful situations

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Stop or reduce alcohol and smoking use Try smoking cessation haha (2 marks) (Total 6 marks)

Continued…

5. Answer BOTH parts of this question. A patient has been asked to take Peptac® liquid at a dose of 10mL four times a day. Each 10mL contains 160mg of calcium carbonate.

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a. How many millimoles of Ca2+ will the patient consume in one day if they take the indicated dose of Peptac®? 6.4 (3 marks)

An adult patient has been prescribed Meropenem, as an intravenous infusion, for the treatment of hospital-acquired septicaemia at a dose of 1 gram every 8 hours. Consider the following information: Vial size = Meropenem 1-gram vial Displacement value for 1-gram vial = 0.9 mL Administration: Reconstitute with water for injection (using appropriate displacement values) to give 20mg in 1ml: IV injection, give over at least 5 minutes, dilute if required with glucose 5% or sodium chloride 0.9% and give immediately. IV infusion, dilute as above and give over 15-30 minutes.

b. What volume (in millilitres) of water for injection do you need to add in order to reconstitute a single meropenem 1-gram vial? (3 marks) (total 6 marks)

(Total 30 marks) Continued… SECTION C

Answer TWO questions only Answer each question in a separate answer booklet

6. Answer ALL THREE parts of this question. Mrs Javid is a 30-year-old customer at your pharmacy who wants advice about her young daughter, Ayesha. She is 7 ...