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  • Cppe mur section 1

    ​These are the questions for section one, they do change a bit so i recommend some reading around each one.
    I will be posting the other sections (when i get to them).
    All answers have been removed (that's your job).

    REMEMBER - SHARING IS CARING

    1/30 You are conducting an MUR for a patient who is asking your advice about the gastrointestinal side-effects of NSAIDs. Which of the following NSAIDs is the most likely to cause serious upper gastrointestinal side-effects? True
    a. Piroxicam
    b. Diclofenac
    c. Etoricoxib
    d. Ibuprofen
    2/30 Katherine, a 62 year old woman, complains of feeling drowsy during the day. She is currently prescribed amitryptyline 25 mg tablets, one tablet three times a day.Which one of the following actions would it be most appropriate for you to recommend to the GP to reduce Katherine's drowsiness? True
    a. Change amitryptyline to imipramine 10 mg tablets, one three times a day
    b. Change the amitryptyline dose to 75 mg at night
    c. Change amitryptyline to dosulepin 25 mg capsules, one three times a day
    d. Change the amitryptyline dose to 75 mg in the morning
    3/30 You are conducting an MUR with Brenda who has a history of alcohol abuse and has been taking zolpidem 5 mg at night for the last six months. She mentions that she has recently been waking at around 3.00am and finding it difficult to get back to sleep and sometimes takes another tablet to help. Otherwise she gets up to watch TV and opens another bottle of wine to pass the hours. What would be the most appropriate recommendation to the GP? True
    a. Ask the GP to consider increasing the dose to the maximum licensed dose of zolpidem 10 mg at night
    b. Inform the GP immediately of your concerns regarding Brenda’s alcohol consumption
    c. Ask the GP to review the use of the zolpidem and consider prescribing a longer acting benzodiazepine such as nitrazepam
    d. After discussing the issue with Brenda, inform the GP of the early morning waking and request review of the zolpidem, considering gradual withdrawal
    4/30 You are conducting an MUR for a patient who has been struggling to swallow and has been told that she will be having a nasogastric tube inserted in the next week. She is anxious about how she will manage to take her medicines via the tube. Her medication is lansoprazole 30 mg capsules, paracetamol 500 mg tablets, tramadol 50 mg capsules, and senna tablets. What would be the most appropriate form in which to supply the medicines? True
    a. Liquids and injections
    b. Liquids and soluble tablets
    c. Liquids and suppositories
    d. Liquids and capsules
    5/30 A patient has been prescribed Voltarol® dispersible tablets for the last four months. Which one of the following would be the most appropriate action for you to take? True
    a. Initiate a discussion with the patient's GP because of the length of treatment
    b. None, as no action is necessary
    c. Suggest to the GP that the patient's prescription is changed to Voltarol® 25 mg tablets
    d. Advise the patient to stop taking the Voltarol® dispersible tablets.

  • #2
    Re: Cppe mur section 1

    6/30 From your patient medication records (PMR) you note that George Granger has been receiving regular monthly prescriptions for paracetamol 500 mg tablets (224). During the MUR George tells you that they are prescribed for osteoarthritis and although he takes them regularly as prescribed they no longer seem to control his pain in his hip. He also takes aspirin dispersible 75 mg, simvastatin 40 mg and indapamide 2.5 mg. Which one of the following actions would be most appropriate for you to take? True
    a. Advise the GP of the poor pain control and request that the prescription is reviewed and co-codamol 8/500 tablets are considered in place of paracetamol
    b. Advise the GP of the poor pain control and request that the prescription is reviewed and an oral NSAID is considered in place of paracetamol
    c. Advise the GP of the poor pain control and request that the prescription is reviewed and a topical NSAID is considered in place of paracetamol
    d. Advise the GP of the poor pain control and request that the prescription is reviewed and co-codamol 30/500 tablets are considered in place of paracetamol
    7/30 A patient is prescribed calcium and ergocalciferol tablets, two daily. However, she tells you during her MUR that she has difficulty swallowing them. Which of the following options would it be most appropriate for you to recommend? True
    a. To take one twice daily
    b. To chew the tablets before swallowing them
    c. To try harder to swallow the tablets
    d. To dissolve the tablets in water before taking them
    8/30 During an MUR, Bridget says that she has been recommended by a friend to take chlorphenamine 4mg tablets, two tablets every four hours, to relieve her hay fever. Which one of the following statements is true about this medicines and its dosage? True
    a. It will not cause drowsiness
    b. Patients should be advised that they are fine to drink alcohol
    c. The dose is not correct
    d. Patients should be advised that they are OK to drive if they feel slightly drowsy
    9/30 A patient who has been prescribed verapamil for the last ten months has been advised by his GP to take Fybogel® granules to relieve constipation. Which one of the following pieces of advice should be given to the patient? True
    a. The granules should be taken immediately before going to bed
    b. The granules contains sugar and it is advisable to clean your teeth afterwards
    c. The granules must be swallowed with plenty of water
    d. It will take 12 hours for the full effects to develop
    10/30 At Grace's MUR she mentions that she is having recurrent bouts of diarrhoea. She has recently started taking the following medicines. Which one is the most likely to cause diarrhoea? True
    a. Verapamil
    b. Co-codamol 8/500
    c. Amitriptyline
    d. Ferrous sulphate

    Comment


    • #3
      Re: Cppe mur section 1

      11/30 Which of the following counselling points would be a consideration for a patient prescribed sulfasalazine? True
      a. It may cause excessive daytime sleepiness of sudden onset
      b. Report any unexplained bleeding, bruising, purpura, sore throat, fever or malaise
      c. Maintain an adequate fluid intake and avoid dietary changes which might increase or reduce sodium intake
      d. Report immediately any reddish discolouration to the urine
      12/30 You are conducting an MUR with Frank, an elderly gentleman who was recently diagnosed with atrial fibrillation. Which of the following is the target INR for this indication? True
      a. 2
      b. 2.5
      c. 3
      d. 3.5
      13/30 Lucile has recently been stabilised on co-beneldopa 25/100 three times daily, but is now experiencing nausea. You know this is a side-effect of the co-beneldopa and you can find no other reason for it. Which one of the following would it be most appropriate for you to recommend to Lucile's GP? True
      a. Reduce the dose of co-beneldopa until the nausea stops
      b. Prescribe metoclopramide for nausea
      c. Change to a co-beneldopa modified release formulation
      d. Prescribe domperidone for nausea
      14/30 Sarah has COPD. Her FEV1 is 55 percent and she has been using inhaled tiotropium once daily for the past six months but still suffers from breathlessness.What would be the most appropriate next step to consider from the following list? True
      a. Addition of a mucolytic
      b. Addition of a long-acting beta2 agonist plus inhaled corticosteroid in a combination inhaler
      c. Addition of oral prednisolone 40 mg daily for five days
      d. Addition of a long-acting beta2 agonist
      15/30 During his MUR a patient tells you that he has recently developed a tendency to become flushed. Which one of the following medicines that the patient is taking could be the cause of this? True
      a. Simvastatin
      b. Nifedipine
      c. Warfarin
      d. Clopidogrel

      Comment


      • #4
        Re: Cppe mur section 1

        16/30 When conducting an MUR with Fabio, you notice that he has had the dose of his antihypertensive treatment increased. On questioning, he tells you that he 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? True
        a. Ibuprofen 400 mg tablets
        b. Colofac® IBS
        c. Paracetamol 500mg tablets
        d. Pepcid two®
        17/30 When conducting an MUR a patient mentions that she has developed flushing and dizziness. For the last three months she has been taking a new medicine for hypertension. Which one of the following best describes how you should report suspected ADRs? True
        a. Report all adverse reactions if the drug has a black triangle in the BNF, but only serious reactions to established medicines
        b. Report the adverse reaction if the drug has a black triangle in the BNF, but only if the reaction is severe
        c. Do nothing if the drug does not have a black triangle in the BNF
        d. Do nothing if the reaction is severe but already listed in the BNF
        18/30 You are conducting an MUR with a patient who tells you they are about to be commenced on metformin. Which of the following statements relating to metformin therapy is correct? True
        a. The risk of gastrointestinal side effects may be minimised by starting at a low dose of 500 mg three times a day and titrating the dose upwards
        b. You should advise the patient to monitor their blood glucose levels closely at the start of treatment due to the risk of hypoglycaemia
        c. Hepatic function should be determined before treatment and at least six monthly to identify patients at risk of lactic acidosis
        d. You should advise the patient to take the metformin tablets during or just after meals to minimise gastrointestinal side effects
        19/30 Sybil is an elderly patient diagnosed with type 2 diabetes mellitus. She has been taking metformin and glipizide for the last two years. She tells you that recently she has been very tired and thirsty and her most recent blood glucose readings are 15.5 mmol/L and 19.2 mmol/L. Which one of the following is the correct explanation and course of action? True
        a. This is a common adverse effect of metformin which should be changed to pioglitazone
        b. This is a common adverse effect of glipizide which should be changed to nateglinide
        c. This has nothing to do with the patients' diabetes but the patient should make an appointment to see her GP
        d. The diabetes is poorly controlled and needs reviewing
        20/30 Jennifer has been prescribed Migraleve ® for no more than one attack of migraine per month. At her MUR she mentions that the medication no longer seems to be effective, even when she takes the maximum recommended dose.Which one of the following actions would you recommend to her GP? True
        a. Prescribe naratriptan instead of Migraleve®
        b. Prescribe co-codamol 8/500 instead of Migraleve®
        c. Prescribe propranolol and stop the Migraleve®
        d. Prescribe pizotifen and continue Migraleve®

        Comment


        • #5
          Re: Cppe mur section 1

          21/30 You are conducting an MUR for a patient taking an NSAID. Which of the following medicines would alert you to a potentially serious drug interaction? True
          a. Carbamazepine
          b. Valproic acid
          c. Lithium
          d. Zopiclone
          22/30 Ruby is currently stabilised on morphine sulphate m/r 30 mg twice daily. During her MUR she complains that she is having difficulty swallowing. Which one of the following would be the most suitable alternative for Ruby? True
          a. Fentanyl ‘25’ patch every three days
          b. Fentanyl ‘50’ patch every three days
          c. Fentanyl ‘75’ patch every three days
          d. Fentanyl ‘100’ patch every three days
          23/30 Bruce is regularly prescribed isosorbide mononitrate m/r tablets 60 mg twice daily. He tells you he does not think they are controlling his angina as well as they used to. You suspect nitrate tolerance.Which one of the following actions would be most appropriate for you to take? True
          a. Recommend his GP to increase the dose to 60 mg three times a day
          b. Recommend his GP to prescribe isosorbide mononitrate 10mg tablets twice daily in addition to his tablets
          c. Recommend his GP to reduce the dose to 60 mg daily
          d. Advise Bruce to take both his tablets as a single daily dose and arrange for the prescription to be changed accordingly
          24/30 You are conducting an MUR for a patient taking warfarin. Which of the following actions is the most likely to maintain a stable INR reading? True
          a. The patient is trying a vegetarian diet including more green vegetables such as spinach and broccoli
          b. The patient has started to take St Johns Wort as they have been feeling low
          c. The patient has been prescribed tramadol for chronic back pain
          d. The patient has started to take regular paracetamol to help with an ankle sprain
          25/30 Whilst completing an MUR the patient tells you that there is a family history of cardiac disease. He asks you how he can reduce the risk of developing it. From your knowledge of current guidelines which one of the following would be the most appropriate advice? True
          a. Stopping all alcohol consumption
          b. Increasing the proportion of saturated fat in his diet
          c. Eating at least five portions of fruit and vegetables each day
          d. Reducing the amount of carbohydrates in his diet

          Comment


          • #6
            Re: Cppe mur section 1

            26/30 Camille is prescribed HRT to alleviate her menopausal symptoms. Her uterus is intact and her last period was 12 months ago. Which one of the following preparations is contra-indicated? True
            a. A patch containing oestrogen and low- dose progestogen given continuously
            b. A patch containing oestrogen plus oral progesterone
            c. A patch containing oestrogen only
            d. An oral preparation with oestrogenic activity and progestogenic activity
            27/30 Chris is a patient known to you who is taking theophylline. Which one of the following medicines, when added to his current prescription, would cause you to contact the prescriber? True
            a. Verapamil
            b. Bisoprolol
            c. Amiloride
            d. Omeprazole
            28/30 Gordon regularly uses Clenil Modulite® 250 microgram metered dose inhaler. During his MUR he explains that despite receiving appropriate treatment from his GP, he has recurring oral thrush. Which one of the following would you recommend to the GP? True
            a. To change to a breath actuated inhaler
            b. To reduce the strength of the inhaler
            c. The use of a spacer device
            d. A change to oral corticosteroids
            29/30 You are conducting an MUR on a patient who has been obtaining one glyceryl trinitrate sublingual spray every month. Which one of the following is the most appropriate course of action for you to take? True
            a. Nothing - there is not a problem
            b. Advise the GP that the quantity should be increased to two a month
            c. Ask the patient if she has used all the contents of the spray
            d. Suggest to the GP that the formulation is changed to tablets
            30/30 Spacer devices are often prescribed to patients who experience problems with inhaler technique or experience side effects from inhaled corticosteroid inhalers. Which of the following statements would provide inappropriate advice to a patient who uses a spacer device? True
            a. Inhale as soon as possible after actuation of the inhaler
            b. Tidal breathing is as effective as single breaths when inhaling via the spacer
            c. Clean the spacer once a week by washing in mild detergent and allow to air dry without rinsing
            d. Replace the spacer every 6-12 months

            Comment


            • #7
              Re: Cppe mur section 1

              Originally posted by Mince View Post
              ​These are the questions for section one, they do change a bit so i recommend some reading around each one.
              I will be posting the other sections (when i get to them).
              All answers have been removed (that's your job).

              REMEMBER - SHARING IS CARING

              1/30 You are conducting an MUR for a patient who is asking your advice about the gastrointestinal side-effects of NSAIDs. Which of the following NSAIDs is the most likely to cause serious upper gastrointestinal side-effects? True
              a. Piroxicam
              b. Diclofenac
              c. Etoricoxib
              d. Ibuprofen
              2/30 Katherine, a 62 year old woman, complains of feeling drowsy during the day. She is currently prescribed amitryptyline 25 mg tablets, one tablet three times a day.Which one of the following actions would it be most appropriate for you to recommend to the GP to reduce Katherine's drowsiness? True
              a. Change amitryptyline to imipramine 10 mg tablets, one three times a day
              b. Change the amitryptyline dose to 75 mg at night
              c. Change amitryptyline to dosulepin 25 mg capsules, one three times a day
              d. Change the amitryptyline dose to 75 mg in the morning
              3/30 You are conducting an MUR with Brenda who has a history of alcohol abuse and has been taking zolpidem 5 mg at night for the last six months. She mentions that she has recently been waking at around 3.00am and finding it difficult to get back to sleep and sometimes takes another tablet to help. Otherwise she gets up to watch TV and opens another bottle of wine to pass the hours. What would be the most appropriate recommendation to the GP? True
              a. Ask the GP to consider increasing the dose to the maximum licensed dose of zolpidem 10 mg at night
              b. Inform the GP immediately of your concerns regarding Brenda’s alcohol consumption
              c. Ask the GP to review the use of the zolpidem and consider prescribing a longer acting benzodiazepine such as nitrazepam
              d. After discussing the issue with Brenda, inform the GP of the early morning waking and request review of the zolpidem, considering gradual withdrawal
              4/30 You are conducting an MUR for a patient who has been struggling to swallow and has been told that she will be having a nasogastric tube inserted in the next week. She is anxious about how she will manage to take her medicines via the tube. Her medication is lansoprazole 30 mg capsules, paracetamol 500 mg tablets, tramadol 50 mg capsules, and senna tablets. What would be the most appropriate form in which to supply the medicines? True
              a. Liquids and injections
              b. Liquids and soluble tablets
              c. Liquids and suppositories
              d. Liquids and capsules
              5/30 A patient has been prescribed Voltarol® dispersible tablets for the last four months. Which one of the following would be the most appropriate action for you to take? True
              a. Initiate a discussion with the patient's GP because of the length of treatment
              b. None, as no action is necessary
              c. Suggest to the GP that the patient's prescription is changed to Voltarol® 25 mg tablets
              d. Advise the patient to stop taking the Voltarol® dispersible tablets.
              in other words you are trying to find out the answer for yourself.

              Comment


              • #8
                Re: Cppe mur section 1

                Originally posted by clinicist View Post
                in other words you are trying to find out the answer for yourself.
                No, I've already passed the section.
                These posts are to help others, not myself.
                I don't ask for answers nor do i think they should be posted, having the questions is more than advantage.

                Comment


                • #9
                  Re: Cppe mur section 1

                  My question 16 was almost the same as the one Mince had. However, 2 of my options were different. Would you believe that the correct answer is A (co-codamol) due to the high sodium content in effervescent tablets? Thanks in advance.

                  16/30 When conducting an MUR with Fabio, you notice that he has had the dose of his antihypertensive treatment increased. On questioning, he tells you that he 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. Co-codamol 8/500mg effervescent tablets
                  b. Colofac® IBS
                  c. Loperamide 2mg capsules
                  d. Pepcid two®

                  Comment


                  • #10
                    Re: Cppe mur section 1

                    Hi, I find the question below confusing.Can anybody explain to me in plain English how they would answer it please?
                    17/30 When conducting an MUR a patient mentions that she has developed flushing and dizziness. For the last three months she has been taking a new medicine for hypertension. Which one of the following best describes how you should report suspected ADRs? True
                    a. Report all adverse reactions if the drug has a black triangle in the BNF, but only serious reactions to established medicines
                    b. Report the adverse reaction if the drug has a black triangle in the BNF, but only if the reaction is severe
                    c. Do nothing if the drug does not have a black triangle in the BNF
                    d. Do nothing if the reaction is severe but already listed in the BNF

                    Comment


                    • #11
                      Re: Cppe mur section 1

                      Originally posted by jonnytablets View Post
                      Hi, I find the question below confusing.Can anybody explain to me in plain English how they would answer it please?
                      17/30 When conducting an MUR a patient mentions that she has developed flushing and dizziness. For the last three months she has been taking a new medicine for hypertension. Which one of the following best describes how you should report suspected ADRs? True
                      a. Report all adverse reactions if the drug has a black triangle in the BNF, but only serious reactions to established medicines
                      b. Report the adverse reaction if the drug has a black triangle in the BNF, but only if the reaction is severe
                      c. Do nothing if the drug does not have a black triangle in the BNF
                      d. Do nothing if the reaction is severe but already listed in the BNF
                      A.
                      so if the drug has a black triangle you report all side effects no matter how minor they might be, but if a drug is in use for long time like amlodipine (hence no black triangle) then you only report if adverse effect is severe like gone blind for example which is a very rare or unknown to amlodipine reaction.

                      It's explained simply under the answers options ..

                      Comment


                      • #12
                        Re: Cppe mur section 1

                        Thank You Janet, I thought it was A also, but I found the wording after the comma confusing. On re reading it and with your explanation it now makes perfect sense. Appreciate you taking the time to reply

                        Comment


                        • #13
                          Re: Cppe mur section 1

                          Originally posted by clinicist View Post
                          in other words you are trying to find out the answer for yourself.
                          Mince in question 4 i chose solutions ans sol tab. and 5 lenght of treatment ? was is the right choise because i keep failing and i m not sure where ?

                          Comment


                          • #14
                            I recently got my cppe mur accreditation and found all your posts helpful, the questions were similar if not the same!!! Posting them here allowed me to think about the scenarios and deduce which answer I thought was most logical in practice.

                            I would recommend everyone to 1) read psnc all sections regarding mur including faqs 2) go through all questions posted by all the users on this forum and think logically, trust me you won't fail if you do both prior to attempting the assessment.

                            As for section 1 clinical bit- USE BNF APP THIS IS FAST!

                            All the best

                            Comment


                            • #15
                              Please, does anybody has the right answer for these questions? I am really struggling to pass Thank you.

                              Comment

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