**E**

The BNF monograph for dantrolene specifies that the cumulative maximum is 10 mg/kg

**B**

See BNF, Chapter 7 (Obstetrics, gynaecology, and urinary-tract disorders), section 7.2.1. The drug monograph specifies this is a 0.01% cream, which is 0.01 g in 100 g; hence, 0.008 g ( = 8 mg) in a single 80-g tube

**E**

(6 × 5) + (4 × 3) + (2 × 3) + [(17 × 1)/2] = 30 + 12 + 6 + 8.5 = 56.5. As we cannot give half a tablet, the nearest practical amount is 57 tablets

**E**

*t*_{½} = 4 hours; *C*_{ss} = 19.6 hours. Therefore, 19.6/4 = 4.9, and hence, approximately 5 half-lives

**C**

100 × 0.84 = 84 mL of TPN per day; hence, 84/24 = 3.5 mL/hour

**A**

1 in 100 solution when diluted tenfold will provide a 1 in 1000 solution. This tells us we need to add 1 part of solution A to 9 parts of diluent

**C**

100 mL of omeprazole 10 mg/5 mL contains 200 mg of omeprazole

**D**

Aminophylline injection is an 80 : 20 mixture and so has a bioavailability of 0.8 (i.e. 80%)

**D**

Using the alligation method it can be found that there are 40 parts in total. Of these parts, 38 parts are for the 10% glucose, and 2 parts are for the 50% glucose. Hence, we will need 38/40 × 500 = 475 mL of glucose 10%, and 25 mL of glucose 50%

**E**

See conversion tables in the BNF.

Or see table in BNFC Appendix for Body surface area in children

**D**

The exact number is 24 but the product should be supplied as a special container of 30 capsules.

2 × 250 nanogram capsules, thrice weekly for four weeks = 24

**D**

6 tablets daily for 2 months i.e. 6 × 60 days = 360 tablets. See BNF, Chapter 5 (Infections), section 5.1.9

**A**

7.5 mg/kg for a 20-kg child is 150 mg/day, which would be 50 mg/dose. Therefore, 80 mg in 2 mL = 8 mg in 0.2 mL = 1 mg in 0.025 mL; hence, 0.025 mL ×50 = 1.25 mL

**A**

**D**

150 mg in 5 mL = 225 mg in 7.5 mL

7.5 × 4 = 30 mL (daily dose)

30 mL ×14 = 420 mL

**B**

20% w/v = 20 g in 100 mL

2 g in 10 mL

6 g in 30 mL (*x*)

0.6 g in 3 mL (*y*)

(*x*) + (*y*) = 6.6 g in 33 mL

**C**

1 drop into both eyes, five times daily = 10 drops per day

28 days = 280 drops

280 drops/15 = 18.67 mL

You would supply two full 10 mL bottles for Mrs D

**D**

Enteric-coated tablets are not available as 1-mg strength, so answers A and C are not possible. The tablets are not easily split (and the enteric coating would be pointless) so only using 5 mg tablets would not be appropriate.

**E**

To make Double-Strength Peppermint Water BP from Concentrated Peppermint Water BP, it is necessary to dilute 1 part concentrate with 19 parts water.

**B**

The maximum dose is 1.5 mg over 24 hours i.e. 6 × 250 mcg tablets; 10 × 250 mcg tablets would be 2.5 mg, which would be an overdose

**C**

*Atripla* contains efavirenz 600 mg + emtricitabine 200 mg + tenofovir disproxil 245 mg as a fixed dose combination. With the options given, the only way of achieving this combination at this dose is to choose 30 × *Truvada* tablets (emtricitabine 200 mg + tenofovir disproxil 245 mg) and 90 × *Sustiva* 200 mg capsules (taking three capsules daily would provide efavirenz 600 mg)

**A**

The recommended quantity for both arms is 30 g to 60 g for 2 weeks; for 1 month this would be about 60 g to 120 g for both arms. Mr E just needs sufficient for the left arm so an amount between 30 g and 60 g would be appropriate

**C**

See conversion tables in the BNF.

1 foot (ft) = 304.8 mm and 1 inch (in) = 25.4 mm, therefore 4 ft 11 in = 1.498 m

13 st = 82.55 kg and 1 lb = 0.45 kg, therefore 13 st 1 lb = 83 kg

Thus, BMI (kg/m^{2}) = (83/1.498)/1.498 = 36.988 kg/m^{2}

Or, with rounding = (83/1.50)/1.50 = 36.889 kg/m^{2}

Note: Calculating as 83/(1.50 × 1.50) will also give you 36.899 kg/m^{2}

**A**

Calculate target weight: (24 × 1.5) × 1.5 = 54 kg

Calculate weight to be lost: 83-54 = 29 kg

Use conversation tables in the BNF.

25.4 kg = 4 st, and 3.63 kg = 8 lbs, therefore 4 st 8 lbs = 29.03 kg

**C**

The Cockcroft and Gault formula is found in the prescribing in renal impairment guidance in the BNF.

Note: The constant will be 1.23 as this is a male patient.

CrCl = [(140-60) × 80 × 1.23]/200 = 39.36 mL/minute

It is possible to calculate this without rounding the constant to 1.25

**B**

First convert the height into cm: 180 cm.

Calculate values inside square brackets: [180 × 80] = 14 400.

Then, within the round brackets: (14 400/3600) = 4.

Power of a half (X^{0.5}) is the same as performing a square root.

Therefore, BSA: √ 4 = 2 m^{2}

**B**

For every 1 m^{2} of BSA the patient should receive 1.8 mg busulfan

Therefore: 1.8 × 2 = 3.6 mg

**E**

The patient is receiving 120 mg morphine each day. Therefore, the rescue dose is 120/6 = 20 mg

**C**

See BNF, Chapter 4 (Central nervous system), section 4.7.2. *Oramorph* oral solution is 10 mg/5 mL, and therefore 20 mg/10 mL

**D**

The total *Zomorph* dose is 140 mg, so the rescue dose is (140/7) 20 mg. Therefore, the patient receives 160 mg to 180 mg morphine daily.

Use the morphine-to-fentanyl conversion table in the prescribing in palliative care section of the BNF

**D**

Phenytoin capsules contain the sodium salt, while the suspension is the base.

Therefore, 100 mg of capsules is equal to 90 mg suspension, and thus, the daily dose is 180 mg.

See BNF, Chapter 4 (Central nervous system), section 4.8.1. The strength of suspension is 30 mg/5 mL

Therefore, 30 mL of suspension is needed (30 mg/5 mL × 6 = 180 mg /30 mL)

**D**

The equation of the line needs to be rearranged: *x* = (γ – 0.05)/0.01

Therefore: *x* = (0.55 − 0.05)/0.01 = 50 mg/mL

**D**

See BNF, Chapter 5 (Infections), section 5.4.1. *Malarone* should be started 1–2 days before entering an endemic area and continued for a week after leaving. The patient is not at risk while they are in Hanoi. Therefore, Miss L should receive 23 tablets (2 + 14 + 7)

**D**

See BNF, Chapter 2 (Cardiovascular system), section 2.8.1. See also conversion tables in the BNF.

Initial heparin loading dose for pulmonary embolism is 75 mg/kg.

The patient’s ideal body weight is 50 + (2.3 × 10) = 73 kg

Therefore, the dose is 75 × 73 = 5475 units

**A**

See BNF, Chapter 2 (Cardiovascular system), section 2.8.1. Continuous infusion for pulmonary embolism calculated at 18 units/kg/hour. Therefore, 18 × 73 = 1314 units/hour

**E**

200 microlitres of culture was grown so need to convert to 1 mL i.e. multiply each CFU count by 5.

Convert the grown samples to original culture, i.e. multiply each value by the respective dilution factor.

Add all the values together, then divide by six (the number of samples):

e.g. with plate 1: 12 × 5 = 60, then 60 × 10 000 = 600 000. This is the original culture CFU count, and therefore:

Average CFUs = (600 000 + 500 000 + 550 000 + 550 000 + 600 000 + 625 000)/6 = 570 830 CFUs

**B**

See BNF, Appendix 4. Use the list of intravenous additives to find the concentration.

Not fluid-restricted so should reconstitute to no stronger than 5 mg/mL.

Thus, 1000 mg (single dose)/5 mg/mL = 200 mL

**C**

See BNF, Appendix 4. For doses over 500 mg the rate should be no faster than 10 mg/minute.

Work out the number of minutes: 1000 mg (single dose)/10 = 100 minutes

Work out the rate: 200 mL /100 minutes = 2 mL/minute

**D**

See BNF, Chapter 2 (Cardiovascular system), section 2.8.2. Warfarin tablets are available in 500 mcg, 1 mg, 3 mg, and 5 mg strengths only.

Twenty-eight 3-mg tablets and 14 1-mg tablets will allow Mr B to achieve the desired 3-mg and 4-mg doses in the fewest number of tablets, and without breaking tablets.

Note: these tablets are not stated as being scored, so splitting should be avoided where possible