A 65-year-old female comes to see her GP for a check-up. She is currently taking multiple medications. Her recent blood test reveals that her INR has fallen below the necessary therapeutic level. Upon reviewing her medications, which one is most likely responsible for the decrease in her INR?
A 42-year-old woman comes back from her cardiology appointment where she was diagnosed with congenital long QT syndrome after an ECG was done for palpitations.
What medication should she avoid in the future?
A 75-year-old man is taking warfarin for paroxysmal atrial fibrillation. He has been referred to the Medical Admissions Unit from the Community Warfarin Clinic with an INR of 9.0. He has recently finished a course of antibiotics prescribed by his GP.
Which antibiotic is the most probable cause of the elevated INR?
A 25-year-old Afro-Caribbean man visits his GP complaining of dysuria and increased urinary frequency for the past four days. He denies any recent unprotected sexual intercourse or penile discharge. The patient has a medical history of gallstones and was hospitalised last year due to a severe blood reaction after consuming a meal rich in broad beans. On examination, he has suprapubic tenderness but no renal angle tenderness. All his observations are within normal limits. Which antibiotic should the doctor avoid prescribing to this patient?
A 24-year-old female patient complains of palpitations and admits to using cocaine for the first time. She denies any chest pain. Upon examination, her heart rate is regular at 165 beats per minute. An electrocardiogram shows sinus tachycardia with a QRS of 105ms and widespread ST segment depression. Her blood pressure is 112/82 mmHg. What is the most appropriate next step in managing this patient?
A 50-year-old Asian man with ischaemic heart disease is being treated for severe community-acquired pneumonia with amoxicillin and clarithromycin. What is the most important medication he should stop taking while on antibiotics?
An 81-year-old patient is admitted with dysuria and confusion. She is diagnosed with a urinary tract infection (UTI) and treated with ciprofloxacin. After 3 days, she develops a profuse offensive diarrhoea. Her pulse is 82 bpm, blood pressure 140/78 mmHg and temperature 37.4 °C. Her abdomen is mildly tender throughout, but no guarding. Bloods show a white cell count of 28.7 × 109/l (was 11.6).
What is the most likely cause of her symptoms?
A 50-year-old woman presents with fatigue, weight gain and constipation. On examination, she has cool and dry hands, bradycardia and slow-relaxing reflexes. When asked about medication, she reports taking a tablet for her mental health disorder for a prolonged period. Which medication is most likely responsible for her current symptoms?
A 55-year-old man complains of dysuria, urinary urgency, and rectal pain. During digital rectal examination, you note a tender prostate. You suspect acute prostatitis and plan to start empirical antibiotics while awaiting urine culture results. The patient informs you that he has G6PD deficiency, but he is not on any medication and has no drug allergies. Which medication should you avoid?
A 63-year-old man is admitted to hospital with two days of loin pain, fever, nausea and rigors. He reports having had a recent urinary tract infection, with associated dysuria and haematuria. He has a past medical history of hypertension and diabetes.
Upon examination, he has right-sided flank pain with some tenderness. Observations show mild hypotension and a raised temperature. Blood tests support an infective picture. The medical team decides to start the patient on an antibiotic.
The following day, the patient experiences a seizure, witnessed by the nursing staff. The doctors suspect that the antibiotic may have triggered the seizure.
Which antibiotic was prescribed to the patient?