Three years later the patient presents to the community pharmacy to purchase loperamide 2mg capsules. They report a 48-hour history of persistent diarrhoea and vomiting following a meal at a restaurant.   Their repeat medications are recorded below: Apidra (Insulin glulisine) 100 units/mL pre-filled Solostar pens, 1 unit per 10 gram carbohydrate Tresiba (Insulin Degludec) 100 units/mL pre-filled pens, 12 units once a day Rigevidon (ethinylestradiol, levonorgestrel) take one tablet daily for 9 weeks followed by a 4-day pill free period. Sertraline 100mg tablets, take one daily

An S3 heart sound is heard:

What is the most appropriate action to take in relation to their insulin regimen?

Identify the skin lesions below.        

Possible causes of a pathologic SYSTOLIC murmur include:

END OF EXAM

Which factor does NOT influence the development of osteoporosis:

A positive Drawer Sign indicates

The patients partner requests advice about emergency contraception, after they had sexual intercourse last night and the condom split. She is 19 years old, has no relevant past medication history, is a healthy weight, takes no regular medications and has no allergies. Her last menstrual period started 6 days ago and she has a regular 30-day cycle.

Patients prescribed which of the following medications should be advised to report fatigue, a sore red tongue and cognitive changes.