Here are 18 questions from our epic question marathon just before the summer 2014 GPhC Exam. Took quite a while to compile into the different posts so for convenience, I've put it all into one for you guys.
GPhC Exam Marathon Question 1
A woman with schizophrenia is non-compliant with her oral antipsychotic medication. As a result you suggest that she is changed onto intramuscular depot injections. The patient asks how often she will be given the injections. What should be your answer?
A. Daily
B. Every 2 to 3 days
C. Every 1 to 4 weeks
D. Every 3 months
E. Yearly
GPhC Exam Marathon Answer 1
Antipsychotic depot injections are used for maintenance therapy especially when compliance with oral medication is unreliable. They are usually given at intervals of 1 to 4 weeks. The dosage & dosage intervals are titrated according to the patients response. See the BNF index under antipsychotic depots for more info.
GPhC Exam Marathon Question Closed Book 2
A 45-year-old man asks for your advice about the cause of a rash on his abdomen. The rash is circular in shape with well defined edges. It started as a small, red, 'spot', which spread. The centre has now healed. Which one of the following skin conditions is the most likely diagnosis:
A. Contact eczema
B. Ringworm
C. Atopic eczema
D. Impetigo
E. Ringworm
GPhC Exam Marathon Answer 2
The answer is E. This is an easy responding to symptoms to question it wont be contact/atopic eczema as this would not be defined with edges and is spreading. You may have thought in the question that this is possibly shingles however this is not an option and would occur in a line from the centre of the abdomen.
GPhC Exam Marathon Question Closed Book 3
Mrs J has recently been admitted to your hospital because of a gastro-intestinal (GI) bleed. Her medication on admission is:
Which of the following would be the possible culprit of the bleed?
A. Atenolol
B. Bendroflumethazide
C. Fluoxetine capsules
D. GTN spray
E. Piroxicam caps
GPhC Exam Marathon Answer 3
Looking at the options here you can immediately exclude atenolol, GTN and bendroflumethazide as you should know these have little no no GI effects. The only two left are and SSRI and an NSAID (you should be able to recognise these straight away as this is a closed book question). Whilst there are some GI effects in the upper GI tract for SSRI’s these are inconsequential in comparison to NSAIDs. If you did a cross sectional placement from community to hospital you should have seen one of the highest admission rates into hospital for medicine related ADRs are NSAIDs.
GPhC Exam Marathon Question 4
Mr Smith, a 50 year old man weighing 70 kg, requires an oral loading dose of digoxin. Which one of the following should be suggested to aim for a plasma concentration of 1.5 micrograms/litre?
You are given that the Volume of Distribution, Vd, per kg body weight is 6 litres; the Salt Factor S = 1; the Bioavailability F= 0.7; and the formula, where Cp is the Target Plasma Concentration:
Loading dose = (VdxCp)/(SxF)
A. A total dose of 1200 micrograms in four divided doses
B. A total dose of 500 micrograms as a stat dose
C. A total dose of 900 micrograms as a stat dose
D. A total dose of 500 micrograms in two divided doses
E. A total dose of 900 micrograms in three divided doses
GPhC Exam Marathon Answer 4
The answer here is E. Really this is a “plug and play answer”.
Firstly what is the VD? Well it is 70kg x 6 = 420
LD = (420x1.5mcg/l)/(1x0.7)
LD = 630/0.7 which is 900.
From the BNF you can ascertain that it needs to be divided into three parts therefore E would be the correct answer.
GPhC Exam Marathon Question 5
You receive the following prescription:
See Piccy
To be reimbursed by the PPA what amendment must be made by the doctor?
A. SLS
B. ACBS
C. LS
D. NCOS
E. DNG
GPhC Exam Marathon Answer 5
A is the correct answer. Although the Tariff is no longer a resource you are still expected to know your endorsements! To get proper reimbursement, SLS needs to be written next to Cialis as it is a selected list substance. However, this rarely occurs as it is usually automatically printed by the doctors computer but watch out for hand written prescriptions!
Many students ask us at PharmacyCPA why you need to know endorsements off by heart as the computer does this for them. Pharmacy is not always straight forward what would you do during a power cut? What is your plan for continuity?
GPhC Exam Marathon Calculation Question 6
A syringe driver is designed to contain 5 ml of injection and has the length of 6 cm. The strength of injection Z is 4mg/ml. A patient has to be administered with drug Z at a rate of 2mg/hr at what rate setting should the driver be set?
A. 6mm/hr
B. 3mm/hr
C. 9mm/hr
D. 12mm/hr
E. 15mm/hr
GPhC Exam Marathon Answer 6
The answer is A. The patient has to receive 2mg per hour which is equivalent to 0.5ml an hour. As a percentage of the total this is 0.5/5 which is 10%. 10% of the entire LENGTH is 0.1 x 6 cm is 0.6 cm which is 6mm per hour.
GPhC Exam Marathon Question 7
Which of the following is correct, regarding the supply of fentanyl patches (CD Schedule 2) against a private prescription?
A. An entry in the CD register is not legally required but it is a legal requirement to record the supply in the POM register.
B. The prescription is valid for 13 weeks from the date on the prescription.
C. All prescription details need to be handwritten.
D. It is illegal to dispense if not prescribed on a standardised form.
E. Only a prescriber's request for an emergency supply is permitted.
GPhC Exam Marathon Answer 7
The answer is D. All private prescriptions of schedule 2 and 3 CDs should be prescribed on the standardized form. All information on CDs can be found in the MEP.
GPhC Exam Marathon Question 8
You are asked by your technician who is taking an NVQ in pharmacy assistance about half-lives. The question involves a drug which has a half life of 2 hours. The question asks how much drug would be left in 6 hours.
A. 12.5%
B. 25%
C. 27.5%
D. 50%
E. 62.5%
GPhC Exam Marathon Answer 8
The answer is option A. 6 hours is 3 half lives as 6/2. One the first half life there will be 50% on the second there will be 25% and on the third there will be 12.5%.
GPhC Exam Marathon Closed Book Question 9
Which of the following statements is INCORRECT?
A. Vitamin K has a synergistic effect on warfarin.
B. Zinc can aid the absorption of vitamin C.
C. Vitamin D increases the uptake of calcium in the bones.
D. Vitamin B toxicity can cause to neurological symptoms.
E. During pregnancy retinol consumption should be avoided.
GPhC Exam Marathon Answer 9
The answer is option A. Vitamin K is an antagonist to warfarin.
GPhC Exam Marathon Closed Question 10
You check with the manufacturer and amoxicillin only lasts for 1 week after being made up. You decide to dispense one bottle and keep one owing which the patient can pick up the following week. What endorsement will enable you to be paid for this service you are providing?
A. SLS
B. LS
C. ACBS
D. NCOS
E. CD
GPhC Exam Marathon Answer 10
Option B is the best answer here. Please refer to the Drug Tariff about endorsements. The endorsement “LS” means limited stability and should be applied to any products which are dispensed in part due to their limited stability.
GPhC Exam Marathon Closed Book Question 11
Which one of the following is a typical symptom of GORD?
A. Epigastric pain described as a burning sensation behind the breastbone
B. Epigastric pain relieved by lying down
C. Epigastric pain which is more likely to occur when the stomach is empty
D. Epigastric pain relieved by belching
E. Epigastric pain described as colicky
GPhC Exam Marathon Answer 11
A is the correct answer here. The pain of GORD is caused by the acid contents of the stomach leaking ‘backwards’ into the oesophagus. The symptoms arising are typically described as heartburn, which is pain arising in the upper abdomen passing upwards behind the breastbone. See a responding to symptoms or medical text for more information.
GPhC Exam Marathon Closed Book Question 12
Regarding continuing professional development (CPD) which one of the following statements is false?
A. All pharmacists must complete 9 hours of CPD every year
B. CPD is a cyclical process involving reflection, planning, action and evaluation
C. CPD helps individuals to identify their learning needs
D. Work shadowing is a suitable activity to contribute towards CPD
E. CPD includes all activities that develop professional capabilities
GPhC Exam Marathon Answer 12
The best answer here is the option A. See the MEP – section 3.1 for more information, you need to know about the different stages of the CPD cycle.
GPhC Exam Marathon Closed Book Question 13
Which one of the following is the average time that it takes for a healthy adult to excrete one unit of alcohol?
A. 30 minutes
B. 1 hour
C. 2 hours
D. 3 hours
E. 4 hours
GPhC Exam Marathon Answer 13
B. This is a bit of a tricky lifestyle question along with this you need to know about how many units a healthy adult can consume and what their salt intake should be for a healthy lifestyle. The body's ability to process alcohol depends on various factors, e.g. age, weight and sex. Although there is variation, the body breaks down alcohol at an average rate of one unit per hour.
GPhC Exam Marathon Closed Book Question 14
Mr C is an opioid misuser currently on a methadone programme. On Monday morning he collects his weekly instalment of methadone, but soon returns to say that on his way home he accidentally dropped the bottle, which broke. He asks if you can replace it. Which one of the following is the most appropriate response?
A. Dispense the following week’s supply of methadone, and ask Mr C to obtain his next prescription 1 week earlier than usual
B. Agree to provide a substitute bottle, and record the details in the Controlled Drug register
C. Indicate that you are able to provide a substitute bottle, but that you first need to notify the local police
D. Advise Mr C that he will have to go to the nearest Accident and Emergency Department for a duplicate supply
E. Advise Mr C that he will have to go back to the doctor who normally prescribes the methadone for him to request a further prescription
GPhC Exam Marathon Answer 14
That was a bit of a meaty question wasn’t it! The correct answer was E (Advise Mr C that he will have to go back to the doctor who normally prescribes the methadone for him to request a further prescription). Methadone is a Schedule 2 Controlled Drug and a pharmacist may only supply it to a patient on the authority of a prescription in the required form issued by an appropriate practitioner. In the case of instalment prescriptions, the first instalment must be dispensed within 28 days of the appropriate date, with the remainder of instalments dispensed in accordance with the instructions.
GPhC Exam Marathon Closed Book Question 15
Which one of the following side-effects of hydrocortisone is caused by its mineralocorticoid activity?
A. Osteoporosis
B. Diabetes
C. Muscle wasting
D. Hypertension
E. Depression
GPhC Exam Marathon Answer 15
The answer is D. Remember that the mineralocorticoid activity of hydrocortisone causes sodium and water retention which can result in hypertension.
GPhC Exam Marathon Calculation (Open Book) Question 16
A patient with cardiovascular disease is prescribed Gaviscon, 10ml qds and 20ml at bedtime. The prescriber asks the pharmacist how mmol of sodium ions the patient is taking from this in 24 hours. Which of the following is correct?
A. 180
B. 27.6
C. 36
D. 18
E. 24
GPhC Exam Marathon Answer 16
C is the best option here…
BNF : 3 mmol Na+ / 5ml dose
Total daily dose = 60ml
60/5 = 12 “doses”
12 x 3mmol = 36mmol in 24 hours
GPhC Exam Marathon Question 17
An adult patient has been prescribed Benorilate suspension 5ml tds, for rheumatic pain. If needed, how many paracetamol tablets BP may be taken in addition each day without exceeding the normal daily recommended dose of paracetamol?
A. 8
B. 6
C. 4
D. 2
E. 0
GPhC Exam Marathon Answer 17
This is a bit tricky for the first one of the day! The answer is 2 extra tablets i.e. D.
BNF : Benorilate = aspirin-paracetamol ester
2g benorilate ≈ 1.15g aspirin + 970mg paracetamol (≈ 2 paracetamol tabs)
Benorilate suspension = 2g/5ml
Total daily dose of suspension = 15ml
15/5 = 3 “doses” ≈ 6 tablets
Maximum daily dose of paracetamol (adult) = 8 x 500mg
Therefore, can have an extra 2 tablets per day
GPhC Exam Marathon Question 18
What weight of hydrocortisone acetate is contained in 1 tube of Anusol-HC ointment?
A. 2.5mg
B. 25mg
C. 75mg
D. 50mg
E. 250mg
GPhC Exam Marathon Answer 18
This one is a bit easier.
BNF : hydrocortisone acetate = 0.25% = 0.25g in 100g = 250mg in 100g
= 25mg in 10g
1 tube of Anusol HC = 30g
25 x 3 = 75mg
GPhC Exam Marathon Question 1
A woman with schizophrenia is non-compliant with her oral antipsychotic medication. As a result you suggest that she is changed onto intramuscular depot injections. The patient asks how often she will be given the injections. What should be your answer?
A. Daily
B. Every 2 to 3 days
C. Every 1 to 4 weeks
D. Every 3 months
E. Yearly
GPhC Exam Marathon Answer 1
Antipsychotic depot injections are used for maintenance therapy especially when compliance with oral medication is unreliable. They are usually given at intervals of 1 to 4 weeks. The dosage & dosage intervals are titrated according to the patients response. See the BNF index under antipsychotic depots for more info.
GPhC Exam Marathon Question Closed Book 2
A 45-year-old man asks for your advice about the cause of a rash on his abdomen. The rash is circular in shape with well defined edges. It started as a small, red, 'spot', which spread. The centre has now healed. Which one of the following skin conditions is the most likely diagnosis:
A. Contact eczema
B. Ringworm
C. Atopic eczema
D. Impetigo
E. Ringworm
GPhC Exam Marathon Answer 2
The answer is E. This is an easy responding to symptoms to question it wont be contact/atopic eczema as this would not be defined with edges and is spreading. You may have thought in the question that this is possibly shingles however this is not an option and would occur in a line from the centre of the abdomen.
GPhC Exam Marathon Question Closed Book 3
Mrs J has recently been admitted to your hospital because of a gastro-intestinal (GI) bleed. Her medication on admission is:
- Atenolol 25mg ON
- Bendroflumethazide 5mg OM
- Fluoxetine capsules 20mg ON
- GTN spray Prn
- Piroxicam caps 20mg ON
Which of the following would be the possible culprit of the bleed?
A. Atenolol
B. Bendroflumethazide
C. Fluoxetine capsules
D. GTN spray
E. Piroxicam caps
GPhC Exam Marathon Answer 3
Looking at the options here you can immediately exclude atenolol, GTN and bendroflumethazide as you should know these have little no no GI effects. The only two left are and SSRI and an NSAID (you should be able to recognise these straight away as this is a closed book question). Whilst there are some GI effects in the upper GI tract for SSRI’s these are inconsequential in comparison to NSAIDs. If you did a cross sectional placement from community to hospital you should have seen one of the highest admission rates into hospital for medicine related ADRs are NSAIDs.
GPhC Exam Marathon Question 4
Mr Smith, a 50 year old man weighing 70 kg, requires an oral loading dose of digoxin. Which one of the following should be suggested to aim for a plasma concentration of 1.5 micrograms/litre?
You are given that the Volume of Distribution, Vd, per kg body weight is 6 litres; the Salt Factor S = 1; the Bioavailability F= 0.7; and the formula, where Cp is the Target Plasma Concentration:
Loading dose = (VdxCp)/(SxF)
A. A total dose of 1200 micrograms in four divided doses
B. A total dose of 500 micrograms as a stat dose
C. A total dose of 900 micrograms as a stat dose
D. A total dose of 500 micrograms in two divided doses
E. A total dose of 900 micrograms in three divided doses
GPhC Exam Marathon Answer 4
The answer here is E. Really this is a “plug and play answer”.
Firstly what is the VD? Well it is 70kg x 6 = 420
LD = (420x1.5mcg/l)/(1x0.7)
LD = 630/0.7 which is 900.
From the BNF you can ascertain that it needs to be divided into three parts therefore E would be the correct answer.
GPhC Exam Marathon Question 5
You receive the following prescription:
See Piccy
To be reimbursed by the PPA what amendment must be made by the doctor?
A. SLS
B. ACBS
C. LS
D. NCOS
E. DNG
GPhC Exam Marathon Answer 5
A is the correct answer. Although the Tariff is no longer a resource you are still expected to know your endorsements! To get proper reimbursement, SLS needs to be written next to Cialis as it is a selected list substance. However, this rarely occurs as it is usually automatically printed by the doctors computer but watch out for hand written prescriptions!
Many students ask us at PharmacyCPA why you need to know endorsements off by heart as the computer does this for them. Pharmacy is not always straight forward what would you do during a power cut? What is your plan for continuity?
GPhC Exam Marathon Calculation Question 6
A syringe driver is designed to contain 5 ml of injection and has the length of 6 cm. The strength of injection Z is 4mg/ml. A patient has to be administered with drug Z at a rate of 2mg/hr at what rate setting should the driver be set?
A. 6mm/hr
B. 3mm/hr
C. 9mm/hr
D. 12mm/hr
E. 15mm/hr
GPhC Exam Marathon Answer 6
The answer is A. The patient has to receive 2mg per hour which is equivalent to 0.5ml an hour. As a percentage of the total this is 0.5/5 which is 10%. 10% of the entire LENGTH is 0.1 x 6 cm is 0.6 cm which is 6mm per hour.
GPhC Exam Marathon Question 7
Which of the following is correct, regarding the supply of fentanyl patches (CD Schedule 2) against a private prescription?
A. An entry in the CD register is not legally required but it is a legal requirement to record the supply in the POM register.
B. The prescription is valid for 13 weeks from the date on the prescription.
C. All prescription details need to be handwritten.
D. It is illegal to dispense if not prescribed on a standardised form.
E. Only a prescriber's request for an emergency supply is permitted.
GPhC Exam Marathon Answer 7
The answer is D. All private prescriptions of schedule 2 and 3 CDs should be prescribed on the standardized form. All information on CDs can be found in the MEP.
GPhC Exam Marathon Question 8
You are asked by your technician who is taking an NVQ in pharmacy assistance about half-lives. The question involves a drug which has a half life of 2 hours. The question asks how much drug would be left in 6 hours.
A. 12.5%
B. 25%
C. 27.5%
D. 50%
E. 62.5%
GPhC Exam Marathon Answer 8
The answer is option A. 6 hours is 3 half lives as 6/2. One the first half life there will be 50% on the second there will be 25% and on the third there will be 12.5%.
GPhC Exam Marathon Closed Book Question 9
Which of the following statements is INCORRECT?
A. Vitamin K has a synergistic effect on warfarin.
B. Zinc can aid the absorption of vitamin C.
C. Vitamin D increases the uptake of calcium in the bones.
D. Vitamin B toxicity can cause to neurological symptoms.
E. During pregnancy retinol consumption should be avoided.
GPhC Exam Marathon Answer 9
The answer is option A. Vitamin K is an antagonist to warfarin.
GPhC Exam Marathon Closed Question 10
You check with the manufacturer and amoxicillin only lasts for 1 week after being made up. You decide to dispense one bottle and keep one owing which the patient can pick up the following week. What endorsement will enable you to be paid for this service you are providing?
A. SLS
B. LS
C. ACBS
D. NCOS
E. CD
GPhC Exam Marathon Answer 10
Option B is the best answer here. Please refer to the Drug Tariff about endorsements. The endorsement “LS” means limited stability and should be applied to any products which are dispensed in part due to their limited stability.
GPhC Exam Marathon Closed Book Question 11
Which one of the following is a typical symptom of GORD?
A. Epigastric pain described as a burning sensation behind the breastbone
B. Epigastric pain relieved by lying down
C. Epigastric pain which is more likely to occur when the stomach is empty
D. Epigastric pain relieved by belching
E. Epigastric pain described as colicky
GPhC Exam Marathon Answer 11
A is the correct answer here. The pain of GORD is caused by the acid contents of the stomach leaking ‘backwards’ into the oesophagus. The symptoms arising are typically described as heartburn, which is pain arising in the upper abdomen passing upwards behind the breastbone. See a responding to symptoms or medical text for more information.
GPhC Exam Marathon Closed Book Question 12
Regarding continuing professional development (CPD) which one of the following statements is false?
A. All pharmacists must complete 9 hours of CPD every year
B. CPD is a cyclical process involving reflection, planning, action and evaluation
C. CPD helps individuals to identify their learning needs
D. Work shadowing is a suitable activity to contribute towards CPD
E. CPD includes all activities that develop professional capabilities
GPhC Exam Marathon Answer 12
The best answer here is the option A. See the MEP – section 3.1 for more information, you need to know about the different stages of the CPD cycle.
GPhC Exam Marathon Closed Book Question 13
Which one of the following is the average time that it takes for a healthy adult to excrete one unit of alcohol?
A. 30 minutes
B. 1 hour
C. 2 hours
D. 3 hours
E. 4 hours
GPhC Exam Marathon Answer 13
B. This is a bit of a tricky lifestyle question along with this you need to know about how many units a healthy adult can consume and what their salt intake should be for a healthy lifestyle. The body's ability to process alcohol depends on various factors, e.g. age, weight and sex. Although there is variation, the body breaks down alcohol at an average rate of one unit per hour.
GPhC Exam Marathon Closed Book Question 14
Mr C is an opioid misuser currently on a methadone programme. On Monday morning he collects his weekly instalment of methadone, but soon returns to say that on his way home he accidentally dropped the bottle, which broke. He asks if you can replace it. Which one of the following is the most appropriate response?
A. Dispense the following week’s supply of methadone, and ask Mr C to obtain his next prescription 1 week earlier than usual
B. Agree to provide a substitute bottle, and record the details in the Controlled Drug register
C. Indicate that you are able to provide a substitute bottle, but that you first need to notify the local police
D. Advise Mr C that he will have to go to the nearest Accident and Emergency Department for a duplicate supply
E. Advise Mr C that he will have to go back to the doctor who normally prescribes the methadone for him to request a further prescription
GPhC Exam Marathon Answer 14
That was a bit of a meaty question wasn’t it! The correct answer was E (Advise Mr C that he will have to go back to the doctor who normally prescribes the methadone for him to request a further prescription). Methadone is a Schedule 2 Controlled Drug and a pharmacist may only supply it to a patient on the authority of a prescription in the required form issued by an appropriate practitioner. In the case of instalment prescriptions, the first instalment must be dispensed within 28 days of the appropriate date, with the remainder of instalments dispensed in accordance with the instructions.
GPhC Exam Marathon Closed Book Question 15
Which one of the following side-effects of hydrocortisone is caused by its mineralocorticoid activity?
A. Osteoporosis
B. Diabetes
C. Muscle wasting
D. Hypertension
E. Depression
GPhC Exam Marathon Answer 15
The answer is D. Remember that the mineralocorticoid activity of hydrocortisone causes sodium and water retention which can result in hypertension.
GPhC Exam Marathon Calculation (Open Book) Question 16
A patient with cardiovascular disease is prescribed Gaviscon, 10ml qds and 20ml at bedtime. The prescriber asks the pharmacist how mmol of sodium ions the patient is taking from this in 24 hours. Which of the following is correct?
A. 180
B. 27.6
C. 36
D. 18
E. 24
GPhC Exam Marathon Answer 16
C is the best option here…
BNF : 3 mmol Na+ / 5ml dose
Total daily dose = 60ml
60/5 = 12 “doses”
12 x 3mmol = 36mmol in 24 hours
GPhC Exam Marathon Question 17
An adult patient has been prescribed Benorilate suspension 5ml tds, for rheumatic pain. If needed, how many paracetamol tablets BP may be taken in addition each day without exceeding the normal daily recommended dose of paracetamol?
A. 8
B. 6
C. 4
D. 2
E. 0
GPhC Exam Marathon Answer 17
This is a bit tricky for the first one of the day! The answer is 2 extra tablets i.e. D.
BNF : Benorilate = aspirin-paracetamol ester
2g benorilate ≈ 1.15g aspirin + 970mg paracetamol (≈ 2 paracetamol tabs)
Benorilate suspension = 2g/5ml
Total daily dose of suspension = 15ml
15/5 = 3 “doses” ≈ 6 tablets
Maximum daily dose of paracetamol (adult) = 8 x 500mg
Therefore, can have an extra 2 tablets per day
GPhC Exam Marathon Question 18
What weight of hydrocortisone acetate is contained in 1 tube of Anusol-HC ointment?
A. 2.5mg
B. 25mg
C. 75mg
D. 50mg
E. 250mg
GPhC Exam Marathon Answer 18
This one is a bit easier.
BNF : hydrocortisone acetate = 0.25% = 0.25g in 100g = 250mg in 100g
= 25mg in 10g
1 tube of Anusol HC = 30g
25 x 3 = 75mg
This is e-TDS returns very low.
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