Archives: MRCGP AKT

AKT-0476

A 63-year-old Caucasian man with a history of hypertension and gout presented to the clinic seeking advice on controlling his blood pressure. He has been experiencing high blood pressure readings at home for the past week, with an average reading of 150/95 mmHg. He is currently asymptomatic and denies any chest discomfort. He is a non-smoker and non-drinker. His current medications include amlodipine and allopurinol, which he has been tolerating well. He has no known drug allergies. His recent blood test results are as follows:

– Sodium (Na+): 138 mmol/L (135 – 145)
– Potassium (K+): 4.0 mmol/L (3.5 – 5.0)
– Bicarbonate: 28 mmol/L (22 – 29)
– Urea: 6.7 mmol/L (2.0 – 7.0)
– Creatinine: 110 µmol/L (55 – 120)

What is the most appropriate next step in managing his hypertension?

AKT-0477

A 67-year old man with hypertension visited his general practitioner after an ambulatory blood pressure monitor showed a daytime average blood pressure of 155/98 mmHg. Despite taking optimal doses of ramipril and amlodipine with good adherence, which medication should be introduced to his treatment plan?

AKT-0478

A 54-year-old man has come in for his annual health check-up. He has a history of hypertension and is currently taking ramipril 10 mg once daily, felodipine 10 mg once daily, and bendroflumethiazide 2.5mg once daily. His blood pressure readings today are consistently high. Additionally, blood tests have been taken as part of the check-up. Based on this information, what would be the most suitable medication to initiate?

AKT-0479

A 67-year-old patient is being evaluated post-hospitalization for chest pain and has been prescribed standard release isosorbide mononitrate (ISMN) for ongoing angina. The medication instructions indicate taking it twice daily, but with an 8-hour interval between doses. What is the rationale behind this uneven dosing schedule?

AKT-0480

A 26-year-old woman has a 2-year history of right-sided throbbing headache that comes and goes, accompanied by nausea and sensitivity to light. She often experiences visual disturbances before the headache starts. Despite trying various over-the-counter pain relievers, she has found little relief. Her doctor has prescribed an oral medication to be taken at the onset of the headache, with the option of taking another tablet after 2 hours if needed. What is a typical adverse effect of this medication?

AKT-0481

What are the primary indications for administering alpha blockers?

AKT-0482

A 61-year-old man with ischaemic heart disease experiences chest pain while climbing stairs. He uses his sublingual glyceryl trinitrate (GTN) spray. What is the most likely side-effect profile of taking the GTN spray?

AKT-0483

A 65-year-old man comes to your clinic for a medication review. He has been prescribed clopidogrel after experiencing a transient ischaemic attack during an overnight hospital stay. Which medication from his repeat prescription is expected to decrease the efficacy of clopidogrel?

AKT-0484

Which of the following calcium channel blockers is most likely to cause pulmonary edema in a patient with a history of chronic heart failure?

AKT-0485

An 80-year-old man presents with a three-week history of increasing fatigue and palpitations on exertion. He has a medical history of myocardial infarction and biventricular heart failure and is currently taking ramipril 5mg, bisoprolol 5mg, aspirin 75 mg, and atorvastatin 80 mg. During examination, his heart rate is irregularly irregular at 98/min, and his blood pressure is 172/85 mmHg. An ECG confirms the diagnosis of new atrial fibrillation. What medication should be avoided in this patient?