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Calculation questions

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SIMPLE COMPLETION QUESTIONS


Amar Iqbal, Alistair Murray and Ryan Hamilton



  1. A patient in theatre is suffering from malignant hyperthermia following anaesthesia. The anaesthetist wishes to prescribe dantrolene sodium by rapid intravenous injection. The patient weighs 70 kg. What is the collective maximum dose this patient can have?

    1.  A  70 mg
    2.  B  140 mg
    3.  C  280 mg
    4.  D  360 mg
    5.  E  700 mg

  2. A GP wants to prescribe Gynest cream for one of her patients. How many milligrams of estriol are there in one tube of this cream?

    1.  A  1 mg
    2.  B  8 mg
    3.  C  10 mg
    4.  D  80 mg
    5.  E  100 mg

  3. You receive a prescription for a reducing dose of prednisolone in Child H who has brittle asthma. The dose is to be reduced until Child H is back on his normal alternating daily dose. The prescribing doctor has written: ‘30 mg o.d. for 5 days, then 20 mg o.d. for 3 days, then 10 mg o.d. for 3 days, then 5 mg alternate days’. The prescription asks for a 28-day supply.

    How many 5-mg tablets should you supply?



    1.  A  48
    2.  B  49
    3.  C  52
    4.  D  56
    5.  E  57

  4. The half-life of a new drug compound is said to be approximately 4 hours. It takes 19.6 hours to reach steady state. Approximately how many half-lives does it take the new drug compound to reach steady state?

    1.  A  1
    2.  B  2
    3.  C  3
    4.  D  4
    5.  E  5

  5. Baby K who weighs 0.84 kg requires some total parenteral nutrition (TPN). His total daily fluid intake is 100 mL/kg/day and is to consist solely of his TPN bag. The neonatal sister asks for you to check her calculated rate for the TPN that she is to set up via an infusion pump. Which of the following is the correct rate assuming you have a 250 mL stock bag of TPN available?

    1.  A  0.84 mL/hour
    2.  B  1.75 mL/hour
    3.  C  3.5 mL/hour
    4.  D  4.2 mL/hour
    5.  E  10.4 mL/hour

  6. You are asked for instructions on how to dilute solution A (1 in 100) in order to produce a 1 in 1000 solution. Which of the following is the correct dilution?

    1.  A  1 part of solution A added to 9 parts diluent
    2.  B  1 part of solution A added to 10 parts diluent
    3.  C  1 part of solution A added to 11 parts diluent
    4.  D  1 part of solution A added to 99 parts diluent
    5.  E  1 part of solution A added to 100 parts diluent

  7. You receive a request for omeprazole 10 mg/5mL suspension. Given that omeprazole has a molecular weight of approximately 345, how many millimoles of omeprazole are there (to one decimal place) in a 100 mL bottle of this product?

    1.  A  0.06 mmol
    2.  B  0.1 mmol
    3.  C  0.6 mmol
    4.  D  1 mmol
    5.  E  6 mmol

  8. Mr KF is admitted to hospital while on Uniphyllin Continus M/R tablets at a dose of 200 mg twice daily. Mr KF has dysphagia and so is finding it difficult to tolerate the tablets. As theophylline syrup is unlicensed and not readily available in your hospital, it is decided to switch Mr KF to aminophylline injection. What is the most suitable dose of aminophylline for Mr KF?

    1.  A  80 mg
    2.  B  160 mg
    3.  C  240 mg
    4.  D  320 mg
    5.  E  400 mg

  9. You are called by a neonatal nurse. She needs to make up a 500 mL bag of glucose 12% solution. She has in stock 500 mL bags of glucose 50% and glucose 10%. What approximate volume of each will she need to make up the required bag?

    1.  A  315 mL of glucose 10% and 185 mL of glucose 50%
    2.  B  380 mL of glucose 10% and 120 mL of glucose 50%
    3.  C  440 mL of glucose 10% and 60 mL of glucose 50%
    4.  D  475 mL of glucose 10% and 25 mL of glucose 50%
    5.  E  490 mL of glucose 10% and 10 mL of glucose 50%

  10. What is the body surface area (BSA) of Child S, a 5-year-old who weighs 18 kg and is 3 ft 8 in tall?
    equation


    1.  A  0.62 m2
    2.  B  0.65 m2
    3.  C  0.68 m2
    4.  D  0.71 m2
    5.  E  0.74 m2

  11. A patient is prescribed alfacalcidol at a dose of 500 nanograms three times per week. The dispensary has capsules that are half the strength of the prescribed dose. How many capsules would you supply to cover 28 days?

    1.  A  12
    2.  B  18
    3.  C  24
    4.  D  30
    5.  E  36

  12. How many Rifater tablets should a man weighing 70 kg be prescribed to cover the initial phase of his unsupervised treatment for tuberculosis?

    1.  A  180
    2.  B  240
    3.  C  300
    4.  D  360
    5.  E  420

  13. A child weighing 20 kg requires gentamicin 7.5 mg/kg/day. What volume of gentamicin 80 mg in 2mL should be given every 8 hours?

    1.  A  1.25 mL
    2.  B  2.5 mL
    3.  C  3.75 mL
    4.  D  7.5 mL
    5.  E  12.5 mL

  14. What weight of clobetasol propionate is present in 30 g of Dermovate cream?

    1.  A  15 mg
    2.  B  5 mg
    3.  C  1.5 mg
    4.  D  0.05 mg
    5.  E  0.015 mg

  15. Drug M is available as an elixir containing 150 mg/5 mL. You receive a prescription for 225 mg q.d.s. for two weeks. What is the volume that should be supplied?

    1.  A  140 mL
    2.  B  210 mL
    3.  C  280 mL
    4.  D  420 mL
    5.  E  490 mL

  16. What volume of a 20% w/v solution contains 6.6 g of ingredient?

    1.  A  66 mL
    2.  B  33 mL
    3.  C  30 mL
    4.  D  6.6 mL
    5.  E  3.3 mL

  17. Mrs D uses hypromellose 0.3% w/v eye drops to treat dry eyes. Her daily dose is one drop into both eyes five times daily. Assume that there are 15 drops/mL. How many 10 mL bottles would she be supplied with for 28 days’ treatment?

    1.  A  1.4
    2.  B  1.87
    3.  C  2
    4.  D  14
    5.  E  18.67

  18. Mrs V is prescribed a course of prednisolone enteric-coated tablets with a reducing dose. Her instructions on the prescription are as follows:

    1. Week 1: 20 mg daily
    2. Week 2: 17.5 mg daily
    3. Week 3: 15 mg daily
    4. Week 4: 12.5 mg daily
    5. Week 5: 10 mg daily
    6. Week 6: 7.5 mg daily
    7. Weeks 7 and 8: 5 mg daily
    8. Weeks 9 and 10: 2.5 mg daily
    How many tablets should you supply for this prescription?

    1.  A  112 × 5 mg tablets and 70 × 1 mg tablets
    2.  B  112 × 5 mg tablets and 28 × 2.5 mg tablets
    3.  C  119 × 5 mg tablets and 88 × 1 mg tablets
    4.  D  119 × 5 mg tablets and 35 × 2.5 mg tablets
    5.  E  137 × 5 mg tablets

  19. How much water should you use when diluting Concentrated Peppermint Water BP to produce 500 mL of Double-Strength Peppermint Water BP?

    1.  A  19 mL
    2.  B  25 mL
    3.  C  95 mL
    4.  D  250 mL
    5.  E  475 mL

  20. Mr F has been prescribed an oral loading dose of digoxin for rapid digitalisation. Which of the following prescriptions would give the highest appropriate dose over 24 hours to achieve this?

    1.  A  10 × 250 mcg tablets
    2.  B  6 × 250 mcg tablets
    3.  C  10 × 125 mcg tablets
    4.  D  6 × 125 mcg tablets
    5.  E  20 × 62.5 mcg tablets

  21. There is currently a supply problem with Atripla tablets and you need to continue Mr J’s antiretroviral treatment with alternative products to achieve the same doses. Which of the following would be the same for 30 days’ supply?

    1.  A  30 × Sustiva 600 mg tablets and 30 × Viread 245 mg tablets
    2.  B  30 × Eviplera tablets and 90 × Sustiva 200 mg capsules
    3.  C  30 × Truvada tablets and 90 × Sustiva 200 mg capsules
    4.  D  60 × Sustiva 200 mg capsules and 30 × Eviplera tablets
    5.  E  30 × Truvada tablets and 30 × Viread 245 mg tablets

  22. Mr E has a prescription for Eumovate cream from the dermatology outpatient department. The prescription indicates that Mr E will be applying the cream to the left arm for one month. Which of the following would be a suitable amount to dispense?

    1.  A  60 g
    2.  B  90 g
    3.  C  100 g
    4.  D  15 g
    5.  E  200 g

    Questions 23 and 24 concern the following scenario:


    Mrs G comes to see you about losing weight and would like to try orlistat. During the consultation you take some weights and measurements and find that Mrs G is 4 ft 11 in tall and weighs 13 st and 1 lb.


  23. What is Mrs G’s body mass index (BMI) expressed as a whole number?

    1.  A  B9 kg/m2
    2.  B  D3 kg/m2
    3.  C  37 kg/m2
    4.  D  42 kg/m2
    5.  E  56 kg/m2

  24. How much weight does Mrs G need to lose in order to reach a healthy BMI of 24 kg/m2?

    1.  A  4 st 8 lbs
    2.  B  4 st 11 lbs
    3.  C  5 st 1 lb
    4.  D  5 st 6 lbs
    5.  E  5 st 8 lbs

    Question 25 concerns the following scenario:


    Mr E is on your acute renal unit and the nephrology team would like to prescribe some medicines. You take a look at Mr E’s admission notes and discern the following information:



    1. Age: 60 years
    2. Height: 1.8 m
    3. Ideal body weight: 80 kg
    4. Blood pressure: 150/95 mmHg
    5. Serum potassium: 5.0 mmol/L
    6. Serum creatinine: 200 micromol/L
    7. Urea: 7.2 mmol/L

  25. You decide to use the Cockcroft and Gault formula to calculate his renal function. What is Mr E’s estimated creatinine clearance rate?

    1.  A  B0.7 mL/minute
    2.  B  32.0 mL/minute
    3.  C  39.4 mL/minute
    4.  D  40.0 mL/minute
    5.  E  41.7 mL/minute

    Questions 26 and 27 concern the following scenario:


    Mr V is due to commence a course of chemotherapy and the consultants would like to dose him by body surface area (BSA).


    equation

  26. You look at Mr V’s notes and find that he is 1.8 m tall and weighs 80 kg. What is his body surface area?

    1.  A  0.02 m2
    2.  B  2 m2
    3.  C  4 m2
    4.  D  8 m2
    5.  E  20 m2

  27. The consultant decides to initiate busulfan at a dose of 1.8 mg/m2. What should the dose be?

    1.  A  0.04 mg
    2.  B  3.6 mg
    3.  C  7.2 mg
    4.  D  14.4 mg
    5.  E  360 mg

    Questions 28–30 concern the following scenario:


    You are visiting a nursing home to undertake medicines reviews for the patients when you are approached by one of the medics. His patient Mrs R is currently taking Zomorph capsules 60 mg twice daily. However, she is starting to experience regular breakthrough pain and rescue doses of Oramorph at one-tenth of her total daily Zomorph dose are not controlling the pain sufficiently.


  28. You mutually agree to increase the rescue dose of Oramorph to one-sixth of her total daily Zomorph dose. What would the dose be?

    1.  A  2 mg
    2.  B  4 mg
    3.  C  5 mg
    4.  D  10 mg
    5.  E  20 mg

  29. When prescribing liquids it is necessary to state the number of millilitres to give. How many millilitres of Oramorph would be appropriate for Mrs R to receive for each rescue dose?

    1.  A  1 mL
    2.  B  2.5 mL
    3.  C  10 mL
    4.  D  20 mL
    5.  E  25 mL

  30. You return to the nursing home the following week and the medical team wish to transfer Mrs R on to fentanyl patches. When you review her notes you see she is now receiving Zomorph 70 mg twice daily and receives one or two rescue doses of Oramorph at one-seventh of the daily dose each day. Which fentanyl patch would be the most appropriate to prescribe for Mrs R?

    1.  A  fentanyl 12 mcg/hour patch
    2.  B  fentanyl 25 mcg/hour patch
    3.  C  fentanyl 50 mcg/hour patch
    4.  D  fentanyl 75 mcg/hour patch
    5.  E  fentanyl 100 mcg/hour patch

    Question 31 concerns the following scenario:


    Mr Q has been admitted to your ward and has had a nasogastric tube fitted. Upon taking his medication history you note he was taking phenytoin capsules 100 mg twice daily to control his epilepsy. The medical team have prescribed phenytoin liquid, which you know is not bioequivalent.


  31. You find that 100 mg of phenytoin sodium is equivalent to 90 mg of the phenytoin base. How many mL of phenytoin suspension should Mr Q receive each day?

    1.  A  6.0 mL
    2.  B  16.6 mL
    3.  C  18.5 mL
    4.  D  30.0 mL
    5.  E  33.3 mL

    Question 32 concerns the following scenario:


    You are a quality control pharmacist working in the QC labs for your hospital’s manufacturing unit. You are testing the concentration of drug Z in a batch of solution utilising UV-visible spectrophotometry at 270 nm. Your QC department has produced the following calibration curve for drug Z.

    image

  32. The UV-visible absorbance reading at 270 nm for this batch is 0.550. What is the concentration of drug Z in the solution?

    1.  A  0.5 mg/mL
    2.  B  5 mg/mL
    3.  C  49.5 mg/mL
    4.  D  50 mg/mL
    5.  E  60 mg/mL

    Question 33 concerns the following scenario:


    Miss L is going travelling and her GP calls you to discuss malaria prophylaxis as she will be visiting Vietnam. Miss L will arrive in Hanoi where she will stay for a week, before heading to visit family in a rural town in South Vietnam for two weeks, then returning to the UK. You confirm that it will be unlikely for Miss L to avoid exposure to the sun so you suggest that the GP prescribes Malarone tablets once daily.


  33. How many tablets of Malarone should be prescribed for Miss L?

    1.  A  14
    2.  B  16
    3.  C  21
    4.  D  23
    5.  E  28

    Questions 34 and 35 concern the following scenario:


    Mr A has been admitted to your ward with a pulmonary embolism. His renal impairment prevents him from receiving enoxaparin so the medical team decides to initiate heparin, dosed by body weight. Mr A is obese so it is necessary to determine his ideal body weight (IBW).


    equation

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May 19, 2017 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on questions

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