MUR CPPE Section 1 -questions which are given

[fenantren]

I'm giving you questions which I had on CPPE assessment. I tried to pass 3 times and finally I failed. I'm not going to try more cause I'm taking Medaway, it's much much easier!
Questions on Section 1 are almost the same all 3times. Here are they:

1.A pacient is prescribed Calcichew tabl, one twice daily, because of swallowing difficultes.However,she tells you during her MUR that she dislikes the taste and finds difficult to chew. Which of the following would be the most suitable alternative for this patient?
a.Adcal tabl, one twice daily
b.Calcichew forte, one daily
c.Calcit tabl,one twice daily
d.Calcium 500, one twice daily

2.At MUR patients mentions that he is having recurrent bouts of diarrhoea.He is currenty taking the following medications.Which one is the most likely to cause diarrhoea?
A.Amlodipine
b.Co-codamol 8/500
c.Amitryptyline
d.Misoprostol

3.A patient has recently been commenced on penicillamine. I is recommended that they have regular blood checks.Which one of the following is the major problem that monitoring is intended to detect
a.reduction in platelets
b.impairment of renal function
C.impairment of hepatic function
d.elevated drug levels

4.At MUR Mary mentions she takes a St John's Wort product which she buys over the counter. She is taking phenytoin and you realise that tere is an interaction between the two substances that can result in which one of the following
a. increased plasma levels of phenytoin
b.decreased plasma levels of pheytoin
cincreased effect of St Johns Wort
d.decreased effect of St Johns Wort

more later

[johnep]

I confess that I could not do them. however, they are clinically biased and would be useful if undertaking a clinical revue. An MUR is a MEDICINES USE REVIEW, Not a clinical review.
johnep

[Nik]

So, what do you want - answers ?

[fenantren]

No, I don't need answers. I just want to give those questions to all who is going to take MuR assessment.

[fenantren]

more questions which are given:
(I have much more but later )


5.When conducting an MUR with Rabia, you notice that she has had the dose of her antyhipertensive treatment increased.On questioning,she tells you that she has recently bought an OTC product.Which one of the following medicines at the recommended dose is likely to cause a problem for this patient?
a.Paracetamol 500mg
b.Alverine caps 60mg
c.Loperamide 2mg
d.Pseudoephedrine 120mg tabl

6.When conducting an MUR a patient mentions that she has developed itching and rash.For the last three months she has been taking a new medication for type 2 diabetes.Which one of the following best describes how you should report suspected ADRs?
a.report all adverse reaction if the drug has a blach triangle in the BNF, but only serious reactions to established medicines
b.report the adverse reaction if the drug has a black triangle, but only if the reaction is severe
c.do nothing if the drug doesnt have a blach triangle in the BNF
d.do nothing if the reaction is severe but already listed in the BNF

7.Adam has a regular prescription for sumatriptn for treatment of migrene. At his MUR he mentions that he has been having at least three migraine attacks per month.Which one of the following actions would be most appropriate for you to recommend to his GP?
a.prescribe naratriptan instead of sumatriptan
b.prescribe Migraleve with the sumatriptan
c.prescribe propranolol and continue sumatriptan
d.prescribe propranolo and stop sumatriptan

8.Mary is regulary prescribed GTN 5mg/24hour patch bur she doesnt think the patch is controlling her angina as well as it used to.You suspect nitrate tolerance.Which of the following actions would be the most appropriate for you to take?
a.recommend to her GP that the dose is increased to 10mg/24hours
b.advaise the patient to remove her patch for a few hours each day
c.recommend to her GP to prescribe GTN spray in addition to her patch
d.recommend to her GP to prescribe GTN m/r tabl in addition to her current patch

9.Which one of the following is a reason for prescribing a m/r release once daily formulation of nifedipine for the treatment of hypertension
a.to reduce the likelihood of largo variations in blood pressure and reflex tachycardia
.to reduce the risk of renal imparment
c.to reduce the risk of hepatic imairment
d.to reduce prescribing costs

10.Anna is prescribed HRT to alleviate her menpausal symptoms.Her uterus is intact and her last period was six months ago.Which one of the following preparations is contra-indicated?
a.a patch containing oestrogen and low dose progestogen given continously
b.oral tablets containing stradiol plus cyclical progesterone
c.a patch containing oestrogen plus cyclical progesterone
d.oral tablets containing conjugated oestrogens plus cyclicl progesterone

11.Mr S is a patient known to you who is takeing lisinopril for hypertension.Which one of the following edications,whe added to his current prescription would cause you to contact the prescribing doctor
a.Amlodipine
b.Amiloride
c.Bisoprolol
d. Omeprazole

12.Alec has asthma and durin his Mur he reports that he uses his salbutamol inhaler at least twice daily.Which of the following would be an appropriate suggestion to the GP?
a.change prescription to regular dosage to reflect the patient's usage
b.change papient's inhaler device
c.change to a long action bronchodilator
d.add a steroid inhaler to the patient's prescription

13.Walter is an eldery patient diagnosed with type 2 diabetes mellitus.He has been taking metformin and gliclazide for the last two years.He tells you that recently he has been very tired and thirsty.The most recent reading on his blood glucose monitor is 17.2 mmol/l.Which one of the following is correct explanation and course of action?
a.this is common adverse effect of metformin and change to pioglitazone
b.this is a common adverse effect of gliclazide and change to glibenclamide
c.the diabetes is poorly controlled and needs reviewing
d.this has nothing to do with their diabetes but patient should make an appointment to see their GP

[fenantren]

I confess that I could not do them. however, they are clinically biased and would be useful if undertaking a clinical revue. An MUR is a MEDICINES USE REVIEW, Not a clinical review.
johnep

I totally agree with you johnep! I've just passed the Meadeway MUR and I recommend it for every one who needs MuR accreditation! CPPE assessment is horrible and such questions should be given in tests aimed to doctors not pharmacists!

[Nik]

such questions should be given in tests aimed to doctors not pharmacists!

Really ? Admittedly I haven't done this course as I don't work in community, but the above questions you've written don't seem that difficult. I do agree with John though, they are clinically focused.

[johnep]

Demonstrates the bias towards considering community as just an extension of hospital, it isn't and conditions are totally different in many respects.
johnep

[Nik]

Demonstrates the bias towards considering community as just an extension of hospital, it isn't and conditions are totally different in many respects.
johnep

Agree - but these are not questions which I think you have to have hospital experience to answer.

[joseph]

Section one of CPPE only requires a BNF in front you and perhaps also google seach to find interaction answers faster than when using a BNF. So regardless of community or hospital based pharamcist, anyone who can use a BNF should be able to pass. Obviously the more clinical knowlege you have the less time will be spent looking up answers hence you will not struggle with time.
My previous guide on section two should make that section relatively striaght forwards
section 3 requires clinical knowledge plus a few non clinical and annoying question. i.e. should you ask pt permission to send copy of mur to district nurse (I answered false rather i would telephone her to make sure she is a aware of what meds pt is taking).
Section 4 was striaght forwards, probably the easiest section