QuestionMultiA
QuestionChoice
50059
a
Amlodipine;10mg;PO;OD 
QuestionChoice
50061
c
Metformin;500mg;PO;BD
QuestionChoice
50065
g
Paracetamol;1g;PO;QDS
QuestionChoice
50066
h
Allopurinol;100mg;PO;OD
QuestionChoice
50063
e
Salbutamol;200 micrograms;INH;QDS
QuestionChoice
50060
b
Colchicine;500 micrograms;PO;BD
QuestionChoice
50062
d
Atorvastatin;20mg;PO;ON
QuestionChoice
50067
i
Metronidazole;500mg;IV;TDS
QuestionChoice
50064
f
Cefuroxime;2.5g;IV;TDS
QuestionComment
apparently atorvastatin and allopurinol shouldn't be co prescribed too according to the BNF?
40038
User
subscriber
obturator foramen
Concept
Chapter
Osteoporosis, otherwise known as thin bones, is a condition associated with high risk of low trauma fractures due to reduced bone mineral density. Osteoclast activity exceeds osteoblast activity, meaning that bone resorption is occurring at a greater rate than bone formation.

**Symptoms and Signs**

- Generally asymptomatic until a fragility fracture occurs
- Back pain
- Kyphosis (stooped posture)
- Fragility fractures

**Risk factors**

- Female sex
- Increasing age
- Smoking
- Corticosteroid use
- Low BMI (< 20-25kg/m<sup>2</sup>)
- Low body weight (<58kg)
- Vitamin D deficiency

**Protective factors**

- Higher BMI
- Exercise - mechanical loading stimulates bone formation

**Diagnosis**
Osteoporosis can be detected on dual-energy x-ray absorptiometry (DEXA) scan.
A T score of < -2.5 indicates osteoporosis

**Management**

- Fall prevention
- Vitamin D and calcium supplementation
- Hormone replacement therapy (postmenopausal women)
- Oral bisphosphonates
2657
3594
An increased risk of rhabdomyolysis when prescribing colchicine and atorvastatin together and a dosing error when prescribing lisinopril
Topic
13
Neurosurgery
1. Colchicine should not be prescribed in patients with gout flare-ups who are taking statins. This is due to the reported increase in rhabdomyolysis when these medications are given together.

2. Cefuroxime dosing is between 750mg to 1.5g IV TDS. This patient would be receiving 3g of cefuroxime over the maximum daily dose each day.
10062
b d
f
Case presentation: A 68-year-old gentleman is admitted to the general surgical ward following an episode of diverticulitis. He is prescribed IV antibiotics to treat his diverticulitis.


**PH** Diverticular disease, hypertension, hypercholesterolaemia, COPD, type 2 diabetes mellitus, gout

**DH** His current medications are listed (below). Weight 88kg.

**On Examination**
HR 65/min, BP 135/95mmHg, RR 16, O2 sats 96% RA, temperature 37.7. Abdomen soft, tender in LIF region.

**Investigation**

CT abdomen and pelvis - uncomplicated sigmoid diverticulitis with no localised perforations.

Question 1: Select the TWO prescriptions that should not be co-prescribed. (mark them with a tick in column A)

Question 2: Select the ONE prescription that contains a serious dosing error (mark it with a tick in column B).