PFS Case assessments

Which of the following are correct?

A. Drug allergies typically occur around 2 weeks after the drug was started.
B. Taking a NSAID like ibuprofen with food dose not affect its effectiveness
C. The child dose of a drug should never exceed the adult dose of a drug irrespective of the weight of the child
D. Children should always be prescribed liquid medication as opposed to tablets up to the age of 8
E. An anxious patient wants to know why there is a “black triangle” for one of his medications. Does it mean that there are some known recognised safety issues with the drug?

Unfortunately a patient has filed a written complaint to your pharmacy about a consultation she had with you 2 months ago. She had come to see you as she had been experiencing reduced hearing in her left ear
You examined her and diagnosed impacted ear wax and recommended olive oil drops for a week
5 days later she presented to A&E with a fever and pus coming out of her ear canal. She was diagnosed with otitis media complicated by perforation of her ear drum.
Her complaints are that firstly you examined her inappropriately with close contact to her body and secondly you missed her ear infection

Which one of the following is correct in relation to this case?

A. You don’t need to offer a chaperone if you are a female pharmacist
B. A non-HCP employee of the pharmacy would be an acceptable chaperone
C. You don’t need to document if a chaperone was offered but declined
D. You can defer examination if you wish to have a chaperone but the patient does not
E. You can successfully claim that the patient was afebrile and had no signs of otitis media (bulging red tympanic membrane) even though you did not document it as you only documented the positive findings

A 6 year old boy with a sore throat is brought to see you by her mum. She insists that you prescribe antibiotics for tonsillitis and refer him for a tonsillectomy as this is the 3rd time he has had this problem in the past 18 months.

Which of the following are criteria that should influence positively whether you would prescribe antibiotics for his sore throat?

A. Cough
B. Tonsillar exudate / purulence (white spots)
C. Enlarged anterior cervical lymph nodes
D. Worse on lying flat
E. Coryza

A 6 year old boy with a sore throat is brought to see you by her mum. She insists that you prescribe antibiotics for tonsillitis and refer him for a tonsillectomy as this is the 3rd time he has had this problem in the past 18 months.

If antibiotics are indicated what is the recommended first line agent?

A. Doxycycline
B. Erythromycin
C. Amoxicillin
D. Phenoxymethylpenicillin
E. Clarithromycin

A 6 year old boy with a sore throat is brought to see you by her mum. She insists that you prescribe antibiotics for tonsillitis and refer him for a tonsillectomy as this is the 3rd time he has had this problem in the past 18 months.

Which patients should be referred for consideration of tonsillectomy?

A. 2 episodes of tonsillitis in 1 month
B. 5 episodes of tonsillitis per year for 2 consecutive years
C. 3 episodes of tonsillitis in 18 months
D. 3 episodes of tonsillitis per year for 3 years
E. 5 episodes of tonsillitis in one year

You are assessing a 6 year old child with a suspected ear infection

What one finding should alert you that this patient has an extensive middle ear infection that needs same day hospital assessment?

A. Redness and tenderness behind the ear
B. Temperature 38.60C
C. Purulent ear discharge
D. Associated sore throat
E. Perforated tympanic membrane

A 73 year old man comes to see you complaining of a painful, itchy rash on his chest. He says before the rash appeared a few days he noticed some tingling in that area.

What is the diagnosis?

A. Urticaria
B. Scabies
C. Impetigo
D. Shingles
E. Eczem

A 73 year old man comes to see you complaining of a painful, itchy rash on his chest. He says before the rash appeared a few days he noticed some tingling in that area.

Which factor(s) should positively influence whether you prescribe oral acyclovir?

A. Within 72 hours of rash onset
B. Immunocompromised patient
C. Mildly symptomatic rash
D. > 50 years old
E. < 30 years old

A 28 year old non pregnant woman has symptoms of a lower UTI (2 day history of dysuria, frequency and urgency). She appears well and afebrile. What one of the following is not a potential red flag feature for underlying pyelonephritis (kidney infection)

What is the most appropriate management?

A. Loin pain and tenderness
B. Rigors or chills
C. Nausea or vomiting
D. Myalgia or muscle pain
E. Erythematous rash

Case-Based Assessments

Quiz Summary

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1. Question

2. Question

Which one of the following is correct in relation to this case?

3. Question

Which of the following are criteria that should influence positively whether you would prescribe antibiotics for his sore throat?

4. Question

If antibiotics are indicated what is the recommended first line agent?

5. Question

Which patients should be referred for consideration of tonsillectomy?

6. Question

What one finding should alert you that this patient has an extensive middle ear infection that needs same day hospital assessment?

7. Question

What is the diagnosis?

8. Question

Which factor(s) should positively influence whether you prescribe oral acyclovir?

9. Question

What is the most appropriate management?