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QUESTION 9

A mother enters your pharmacy with her 2-year-old daughter and explains to you that her daughter has been very agitated and crying a lot lately, she has a temperature and has been taking paracetamol for three days but just today she noticed a few white spots on the inside of her check surrounded by an inner red ring, with gritty eyes. Which of the following would be the best advice for the mother regarding her daughter’s symptoms?
A. Sell her chloramphenicol eye drops
B. Tell the mother not to worry as this is normal and it will go away in a couple of days
C Tell the mother to continue with paracetamol but sell her ibuprofen to help with the symptoms
D Tell the mother to take her daughter to the doctor because she might be suffering from mumps
E Tell the mother to take her daughter to the doctor because she might be suffering from measles

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QUESTION 10

Miss. AD. a 43-year-old walks into your pharmacy and shows you her symptom as shown in the picture. Her regular medication include salbutamol inhaler, warfarin, desogestrel and Qvar inhaler. She explains that she has noticed the symptoms for the past three days and it is not getting any better. She asks you for advice . What advice would you give miss. AD ? Select most appropriate option .
A. Sell Miss AD. Difflam oral spray
B. Sell miss. AD. miconazole oral gel
C. Sell miss. AD. chlorhexidine mouthwash
D. Refer miss AD. to her GP surgery.
E. Refer miss AD. to A & E urgently
London Pharmacist Network.

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QUESTION 11

A 60-year-old woman complains of fizzing shapes in her vision like zig-zag lines, followed by a headache and nausea. Her past medical history includes asthma, ischemic heart disease, osteoporosis, psoriasis, and type 2 diabetes. Her doctor diagnoses migraine with aura and considers prescribing sumatriptan. Which of the following conditions is sumatriptan contraindicated?

A. psoriasis
B. osteoporosis
C. type 2 diabetes
D. ischemic heart disease
E. Asthma

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QUESTION 12

A regular male patient presents with a box of ibuprofen gel. He tells you that he is not sure if it is still in date or expired. He shows you the box (shown in the picture). You are asked to say what the expiry date is.

Five available answer options. Select only one option

A. 01. JAN. 2024

B. 31. DEC. 2024

C. 31. JAN. 2024

D. 01. DEC. 2026

E. 31. DEC. 2026

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QUESTION 13

A mother calls your pharmacy via telephone and sounds very worried . She explains that her 5-year-old child is choking on a cookie. She is clutching at her chest and neck and not able to speak properly, She asks for your advice as her daughter is struggling desperately. Based on your judgment of the situation, what would your next line of advice be in this situation ?
A. Ask the mother to give her plenty of water.
B. Ask the mother to perform CPR on the child.
C. Ask the mother to give up to five back blows: hit her firmly on their back between the shoulder blades.
D. Ask the mother to give up to five abdominal thrusts: hold the child around the neck and pull inwards and upwards above their belly button.
E. Ask the mother to go to the GP surgery for help.

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QUESTION 14

A patient presents into your pharmacy with symptoms of vagina thrush. Which of the causative organisms below is the most likely cause of vagina thrush?
A.) Streptococcus pneumoniae
B.) Streptococcus aureus
C.) Candida albican
D.) Escherichia coli
E.) Klebsiella pneumoniae

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QUESTION 15

A 58-year-old woman enters your pharmacy for some advice. She has been feeling generally unwell for the past three days with a headache and painful area of skin on her back. Today she woke up with a red, blotchy rash on the left side of her back and abdomen. Which of the following is suitable treatment for the condition shown .
A. Clarithromycin 500mg BD for 5 days
B. Aciclovir 800mg five times a day for 7 days
C. Amoxicillin 500mg TDS for 7 days
D. Aciclovir 200mg BD for 3 days
E. Erythromycin 250mg QDS for 7 days

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QUESTION 16

A. transgender woman walks into your pharmacy. The patient would like the morning after pill. During the consultation, you establish that unprotected sex occurred 4 days ago and that the patient also takes amitriptyline and carbamazepine regularly for epilepsy. What would your next line of action be?
A. Supply levonelle-one-step
B. Supply Ella-one
C. Refer to another pharmacy
.D. Refer to a sexual health clinic
E. Ask the patient to book an appointment at the GP surgery

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QUESTION 17

One morning a mother calls your pharmacy via telephone about her 14-year-old son. The mother explains that her son is experiencing an anaphylactic reaction after eating chocolate containing nuts and his condition is rapidly deteriorating. She explains that she would like to administer an EpiPen but realised the EpiPen she has is now expired. She sounded very worried and asks for your advice.
Select the next best possible line of action.
A. Place an order for an EpiPen from the suppliers immediately.
B. Request a new script from the appropriate prescriber immediately.
C. Ask her to come to your pharmacy so you can Supply an EpiPen as emergency supply.
D. Place the child in a recovery position and phone the ambulance.
E. Advice the mother to administer the expired EpiPen to her son and call the ambulance.

London Pharmacist Network tutorials

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QUESTION 18

A 25-year-old patient presents her symptoms to your pharmacy and asks for your advice. What is the most appropriate advice you would give? See pic
A. Sell her Canesten cream
B. Refer her to A and E
C. Refer her to her GP
D. Sell her Amorolfine lacquer
E. Tell her that her symptoms are

self-limiting.

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QUESTION 19

One Saturday evening, a 51-year-old female walks into your pharmacy and asks to buy canesten oral capsule to treat thrush. She answers all the WWHAM questions and mentions that she had one episode of thrush within the last six months and takes Betahistine, Ventolin inhaler and levothyroxine tablets regularly. What is the most appropriate next line of action?

A. Refuse sale due to the patient’s age.
B. Sell the drug to the patient as you are totally satisfied with all information provided.
C. Refuse sale due to frequency of thrush.
D. Refuse sale and refer to her GP at earliest convenience.
E. Refuse sale and refer to Out of hours services as it is a Saturday evening.

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QUESTION 20

A 35-year-old man visits your pharmacy for some advice. He is complaining of a rash which consists of tiny red spots between the folds of his fingers, wrists and elbow and it is very itchy at night.
A. Diphenhydramine 2% w/w cream
B. Aciclovir 5% w/w cream
C. Hydrocortisone 1% w/w cream
D. Clotrimazole 1% w/w cream
E. Permethrin 5% w/w cream

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QUESTION 21

Mr. S. presents in your pharmacy and asks for advice. He suffers constipation due to intake of co-codamol tablets. He is otherwise fit and well. He has tried taking more fruits and vegetables but to no avail. He would like your advice. Select the most appropriate option below.

A. Give lifestyle advice only.

B. Sell lactulose solution.

C. Recommend senna tablets

D. Recommend both senna and lactulose solution.

E. Refer to GP for naloxegol

London Pharmacist Network

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ANSWERS TO WORKBOOK

CASES 1 TO 8 ARE YOUR DIRECTED STUDY write your L.R.Ds.

YOU HAVE TO THE RESEARCH ON YOUR OWN.

1 TO 8 ARE YOUR DIRECTED STUDY

9. E Tell the mother to take her daughter to the doctor because she might be suffering from measles. Koplik spots is a symptom of measles.

10. D. Refer miss AD. to her GP surgery. This is because she takes warfarin which can cause bleeding if you sell miconazole oral gel OTC.

11. D. ischemic heart disease. Contraindication of sumatriptan.

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ANSWERS TO WORKBOOK

12. E. 31st DECEMBER 2026

13. C. Ask the mother to give up to five back blows: hit her firmly on their back between the shoulder blades.

14. C.) CANDIDA ALBICANS.

15. B. Aciclovir 800mg five times a day for 7 days

16. D. Refer to a sexual health clinic. This patient takes an enzyme inducer – carbamazepine. So, refer to sexual health clinic for IUD.

17. E. Advice the mother to administer the expired EpiPen to her son and call the ambulance. In a situation of this nature, it is imperative to administer adrenaline even if it mean using an expired pen as the benefits of doing so outweigh the risk of not doing so at all.

18. C. Refer her to her GP as more than 2 toenails are infected.

19. B. Sell the drug to the patient as you are totally satisfied with all information provided. She meets all the requirements 16 years – 60 years.

20. E. Permethrin 5% w/w cream. Treatment for scabies. Treat the whole family and leave the cream on for 8 hours preferably overnight before washing off.

21. D- Both stimulant and osmotic agents should be given.