Ragni Hotels, a hospitality company, has developed a seconda…

Ragni Hotels, a hospitality company, has developed a secondary market for its services in a foreign country. This allows the company to minimize its losses when its primary market fails to generate enough revenue to benefit the company. In this scenario, which of the following is most likely to have influenced Ragni Hotels’ decision to set up a market in another country?

Patient KJ (male, 55 years old, weight 77 kg) is admitted to…

Patient KJ (male, 55 years old, weight 77 kg) is admitted to hospital following an episode of haematemesis. Past medical history: musculoskeletal back pain related to his occupation as a lorry driver Medication history: sometimes takes co-codamol for back pain which he buys from the pharmacy penicillin allergy Following endoscopy a diagnosis of major peptic ulcer bleeding is made. The ulcer is treated endoscopically and a test for H. pylori is POSITIVE. Which treatment plan is MOST APPROPRIATE?

Patient PU (female, 55 years old, weight 80 kg) has become s…

Patient PU (female, 55 years old, weight 80 kg) has become severely unwell with a skin problem, described in her notes as ‘detachment of around 5% of Body Surface Area with widespread erythematous macules’. This was preceded by an upper respiratory tract infection with a fever and headache, before the lesions suddenly developed. Which is the MOST LIKELY diagnosis?

Patient PO (male, 23 years old, weight 70 kg) is in hospital…

Patient PO (male, 23 years old, weight 70 kg) is in hospital being treated for poisoning. They are being correctly treated according to guidelines and administered activated charcoal to enhance the elimination of the overdosed substance. Which drug is MOST LIKELY to have been ingested?

Patient GS (male, 41 years old, 82 kg) is being assessed in…

Patient GS (male, 41 years old, 82 kg) is being assessed in primary care by the nurse practitioner. They have sinusitis which is causing pain, rated 7/10. Past medical history: Gastro-oesophageal reflux disease Medication history: Lansoprazole 30 mg daily Adverse drug reactions to tramadol and codeine. Caused extreme nausea and stomach cramps. Which medication would be MOST APPROPRIATE?

Patient UE (58 years old, weight 89 kg) presents to the walk…

Patient UE (58 years old, weight 89 kg) presents to the walk-in centre complaining of shortness of breath and a sharp pain when breathing in, plus feeling generally ‘awful’. On examination she is pale, her oxygen saturations are 88% on air, her heart rate is 112 beats per minute, blood pressure 109/78 mmHg, temperature 37°C. She denies any recent travel, she does not smoke nor drink alcohol. Her drug history is: Elleste-Solo tablets 1 mg daily which she takes for symptoms of the menopause. She has no other significant medical history. A two-level PE Wells score is calculated. From the information provided, what course of action would seem MOST APPROPRIATE?

Patient JS (71 years old, weight 93 kg) has presented with a…

Patient JS (71 years old, weight 93 kg) has presented with a painful, swollen joint affecting the big toe on his right foot. It is hot to the touch and red. Past medical history Hypertension Hypercholesterolaemia Heart failure Chronic Kidney Disease Stage 3a (eGFR 55 ml/min/1.73m2) Medication history Atorvastatin 20 mg once daily Lisinopril 20 mg once daily Furosemide 80 mg in the morning, 40 mg lunchtime (increased 2 weeks ago) Paracetamol 1 g four times daily Multivitamin ONE tablet once daily (buys over the counter) no known drug allergies A diagnosis of an acute flare of gout is made. What is the MOST LIKELY cause of this acute flare of gout in Patient JS?

Patient KW (female, 35 years old, 74 kg) is in hospital with…

Patient KW (female, 35 years old, 74 kg) is in hospital with an episode of diverticulitis. She rates her current pain as 4/10 and would like to take something to help. Past medical history: Diverticulosis Depression Medication history: Fluoxetine 20 mg once daily Allergy to ibuprofen, caused lip swelling and wheeze What would be MOST APPROPRIATE to offer in the FIRST instance?