GPhC Exam Sample Paper

A 70-year-old lady is taking the following medicines:

• Atorvastatin 80mg tablet once daily
• Edoxaban 30mg tablet once daily
• Digoxin 62.5mcg tablet once daily
• Isosorbide mononitrate 20mg tablet once daily
• Ramipril 5mg capsule once daily

The community pharmacist is querying the unusual once daily dose of a medication with the local GP surgery. Which medication below is unlikely to be prescribed as once daily?

An elderly gentleman presents at the chemist with a prescription after his annual medication review. He was advised to take one particular medication with food.

The most important medication to take with food from his medication list is which one of the following?

A middle aged customer taking regular medication presents to the pharmacy for minor ailments advice. The pharmacist identifies an overgrowth of the gum tissue also known as gingival hyperplasia. A medication that is rarely known to contribute to gingival hyperplasia is?

Mrs Bradley, a 60 year old, visits her local pharmacist for advice. She reports side effects such as nightmares and sleep disturbances after commencing a new medication. What medication is the most likely cause of Mrs Bradley’s symptoms?

Mr Glinn, aged 66 years, has been discharged from the hospital after experiencing an ST elevated myocardial infarction (STEMI). The most appropriate statin dose for this patient to be prescribed is?

A 66 year old gentleman presents a new prescription for citalopram 40mg tablets. He also regularly takes omeprazole and paracetamol.  You decide that it is not appropriate to supply him with Citalopram 40mg tablets. Which of the below is the most appropriate reason you would not supply?

You receive a prescription for Priadel tablets for a 55 year old man. The patient hands you his lithium monitoring book so that you can check the results of his last blood test. What should the therapeutic range of serum lithium concentration be?

Mr Ahmed comes into collect his prescription for the below items which he started in recent weeks;

Co-careldopa 25/100mg tablets (Sinemet Plus)

Paracetamol 500mg tablets

Metformin 500mg tablets

Omeprazole 20mg capsules

He tells you he has noticed his urine appears darker than usual. Which of these medications could be causing his urine to appear dark?

Mr Thomas has been newly prescribed Durogesic Dtrans patches. You explain to him how to apply the patch and side effects to expect. Which of the below would not be appropriate advice to give?

The risk of hypoglycaemia associated with this sulfonylurea should be discussed with the patient, especially when concomitant glucose-lowering drugs are prescribed. Select the most appropriate anti-diabetic drug that best fits the statement. 

Manufacturer advises tablets should be chewed with the first mouthful of food or swallowed whole with a little liquid immediately before food. Select the most appropriate anti-diabetic drug that best fits the statement. 

This diabetic medication is given once a day by subcutaneous injection. Select the most appropriate anti-diabetic drug that best fits the statement below. 

A 55 year old male on your ward has developed diabetic foot ulcers on his right foot following poor diabetic control. PMH of hypertension, Diabetes Type 2.

He is allergic to penicillin and on the following medication: 

Canagliflozin 100mg OD

Metformin 1g BD

Aspirin 75mg OD

Ramipril 1.25mg OD

Upon reviewing his chart, what would you recommend first?

A 54 year old male with Type 2 Diabetes and Hypertension, currently taking;

Metformin 500mg OD

Ramipril 5mg OD

Otherwise fit and well, presents to his local GP practice for an annual Diabetic review.

At which of the following HbA1Cs would you consider an increase in therapy?

A 65 year old female with Hypertension, Hyperthyroidism and CKD stage 4 presents to A&E with Polyurea and Polydipsia. Basic blood results were done on admission and showed a HbA1C of 78mmol/ml and a eGFR of 15mL/min.

Following the information above, what medication would you suggest for the medical team to commence?

A 34 year old male presents to A&E pyrexic, confused and with a sore throat. A full blood count is performed and the neutrophil count is lowered.

Which of the following medications could be responsible for this and should be stopped?

A patient has presented to your community pharmacy with a new prescription for insulin. The patient has never used insulin before and is requesting that you advise how to administer it.

Which of the following is NOT appropriate advice for the administration of insulin;

Mr Thomas, a 33 year old, has been prescribed metronidazole 400mg tablets by the dentist. Which one of the above is the most appropriate advice to give him?

Mrs Giles takes antacids for indigestion. She has been prescribed doxycycline 100mg capsules. What interaction is possible?

Mrs Rooke, a 55 year old, takes methotrexate for rheumatoid arthritis. She has been prescribed trimethoprim tablets for a UTI.

Which one of the below would be a suitable oral antibiotic for a lady that is pregnant and in her first trimester?

Milly, a 6 year old, suffers from recurrent urinary tract infections. Her doctor decides to commence her on prophylactic antibiotics. He has prescribed trimethoprim and wants your advice on which dose would be suitable for her.

Which one of the following would be the most suitable dose?

The mechanism of action for penicillin is:

You receive a prescription from a dentist for Mr S, who has been diagnosed with periodontal abscess, which one of the following antibiotics would you expect to see alongside metronidazole if the patient has an allergy to penicillin?

A 19 year old gentleman presents with a small patch of ringworm on his arm. He is otherwise well and not on any medication. Which of the following medications is most suitable?

Mr Sumner, a 39 year old, has constipation. He wants you to recommend  a laxative that is quick acting. Which one of the above rectal preparations would take 15-30minutes to work?

Mrs Khan wants to purchase a stimulant laxative. This particular laxative can be purchased from the pharmacy for age 12 years and over.

Miss Laker, a 25 year old, has constipation due to IBS. She asks for some advice on laxatives. Which one of the above osmotic laxatives would you not recommend?

Mrs B is a 34 year old female patient with ulcerative colitis (UC). She was diagnosed 3 years ago however has presented to hospital with an acute severe exacerbation of her UC. She has been increasing bloody diarrhoea for 2 weeks, opening her bowels 8-10 times a day with 2-3 bowel motions during the night. She is in severe pain and has abdominal distension.

Which would you recommend as the initial treatment of Mrs B acute UC exacerbation given that she has no contradictions for treatment?

Miss F is a 28 year old female with irritable bowel syndrome. She takes Mebeverine 135mg TDS 20 minutes before meals.

How will Mebeverine help Miss F’s irritable bowel syndrome?

Mr PI has newly been initiated on lansoprazole 30mg OD for 4 weeks and then a maintenance dose of 15 mg OD indicated for his duodenal ulcer. Which of the following counselling points will you mention to Mr PI?

Miss A is suffering from short-duration constipation and asks what she can take to relieve her symptoms. She has tried dietary measures however this has not helped.

Which of the following would you recommend to Miss A?

Mrs D is a 48 year old lady who has been initiated on Octasa (Mesalazine) MR tablets 2.4g OD.

Which of the following counselling points applies to Octasa?

A FY2 doctor on your ward wants some help prescribing laxatives. He stated his consultant on the ward-round wants to initiate a patient on a prokinetic laxative.

Which of the following is an example of a prokinetic laxative?

Mr Thomas, a 22 year old, suffers from hay fever. He tells you he has had mild symptoms every year for the past 2 years and usually purchases an antihistamine from the pharmacy. He wants to purchase the same one again as it has been effective but he cannot remember the name. He remembers he has to take it 3 times a day. Which one of the above has he most likely purchased in the past?

Mr Harlow, a 65 year old, has COPD. His doctor has prescribed him a dry powder inhaler containing umeclidinium. Which one of the above types of inhalers would he have been prescribed?

Mrs Patel, a 26 year old, has been using a steroid inhaler for a few months. She has had a couple of episodes of oral thrush, most likely due to the inhaler she is using. Which one of the above devices could she use to reduce the incidence of oral thrush?

Mrs Wyatt, a 31 year old, has been prescribed a preventer inhaler for asthma. This particular inhaler should be prescribed by brand. Which one of the above inhalers should be prescribed by brand?

Mrs G has been admitted with active peptic ulceration. Which ONE of her following medications is contraindicated in those with active peptic ulceration?

You are reviewing blood results for Mrs J who was recently started on Theophylline for the management of her chronic asthma. What is the desired plasma theophylline concentration for Mrs J to achieve satisfactory bronchodilation?

Your pre-registration student is preparing for their mock exam. They are looking at steroid-containing inhalers of different potencies. Which ONE of the following inhalers has the highest total steroid dose?

Mr H is worried about developing a sore mouth in the future. Which of the following would you advise when using Symbicort?

You are a pharmacist prescriber working in a GP surgery specialising in COPD. Mr T has come in for his annual COPD review. His symptoms seem to be uncontrolled and you decide to titrate his inhaler therapy. Which ONE of the following is NOT a common symptom of COPD?

Methotrexate is an antimetabolite that stops cells making and repairing DNA. 

Which of the following counselling points about methotrexate is incorrect?

Mr OP has been prescribed aprepitant at a dose of 125 mg initially be taken 1 hour before chemotherapy, then 80 mg once daily for 2 days as part of his supportive chemotherapy treatment.

Which of the following indications best describes why Mr OP has been prescribed this treatment?

Mrs WR is a 57-year old patient being treated for breast cancer. She reports experiencing a fever and upon looking at her blood test results, the doctors conclude the patient requires immediate broad-spectrum antibacterial therapy.

Which of the following blood test parameters would indicate this?

Methotrexate has been used to produce regression in a wide range of conditions including acute leukaemias, non-Hodgkin’s lymphoma, soft-tissue and osteogenic sarcomas, and solid tumours.

Which one of the following medicines is used to reduce the frequency of side effects of methotrexate?

A junior doctor on the haematology and oncology ward asks advice on prescribing morphine sulfate oral solution for a 53 year old, who has recently been diagnosed with lung cancer. The patient currently takes:        

Morphine sulphate modified release tablets 30mg BD 


How much morphine sulfate oral solution (oramorph) would you advise the doctor to prescribe?

Vincristine is indicated for a variety of cancers including leukaemias, lymphomas, and some solid tumours (e.g. breast and lung cancer).

Which of the following is a contraindication of vincristine?

Mr TW is a 74-year old patient on chemotherapy treatment. During his post-treatment blood tests, the doctor prescribes recombinant human granulocyte-colony stimulating factor (rhG-CSF) Filgrastim.

Which of the following blood test parameters would rhG-CSF stimulate the production of?

Mr Khan, a 64 year old, has been having a subcutaneous injection every 28 days. This injection is indicated for advanced breast cancer and metastatic prostate cancer. Which one of the above has he most likely been prescribed?

Miss Finlay, a 41 year old, takes a daily tablet for breast cancer. You counsel her on the risk of developing endometrial cancer with this medication and to report any signs of this. Which one of the above is she most likely taking?

Mrs Perry, a 56 year old, is taking a liquid medication for prophylaxis of organ rejection in kidney allograft recipients. You advice her to mix the solution with at least 60 mL water or orange juice in a glass immediately before taking and refill glass with at least 120 mL of water or orange juice and drink immediately. Which one of the above is she most likely taking?

Mrs Jones, a 55 year old, has been prescribed an oral medication for severe rheumatoid arthritis. You remind her to avoid pomelo juice and purple grape juice. Which one of the above has she most likely been prescribed?

Mrs Giles takes Isoniazid as part of her treatment for tuberculosis. She has been advised to take a vitamin to prevent Isoniazid induced peripheral neuropathy. Please select one vitamin from the list that is related to this scenario.

Mrs Begum is 6 weeks pregnant. She has been advised to take a vitamin to prevent neural tube defects. Please select one vitamin from the list that is related to this scenario.

Miss Holly, a 19 year old, has scurvy. She has been prescribed a vitamin to treat it. Please select one vitamin from the list that is related to this scenario.

A 67 year old female was diagnosed with folate deficient anaemia following a routine blood test. She has a previous history of Stroke, and Diabetes Type 2. What is the duration of treatment with folic acid?

While working on a haematology ward you come across a patient with G6PD- deficiency. Which of the following is not an at-risk category of developing G6PD?

A patient, a 69 year old male, presents to the GP with pain in the joints, thickening ankles and bowed legs. He has no other medical conditions, and does not take any regular or over the counter medication. Which of the following deficiencies could be causing these symptoms?

Mrs HS is a 78-year-old female patient who has a past medical history of heart failure. She has recently been experiencing chronic pain, inflammation, and swelling and her GP suspects rheumatoid arthritis. Mrs HS states that paracetamol has not helped her pain and would like a stronger pain-killer such as naproxen. Select the reason why the use of non-steroidal anti-inflammatory drugs (NSAIDs) in this elderly patient is potentially inappropriate if prescribed.

Mr GB is a patient who presents with acute kidney injury and presents with a rise in serum creatinine of 54 micromol/L within 48 hours compared to baseline and an eGFR of 28mL/min/1.73m2. Mr GB has been suffering with dental pain and therefore has been taking ibuprofen for the last 24 hours. Select the reason why the use of non-steroidal anti-inflammatory drugs (NSAIDs) in this elderly patient is potentially inappropriate if prescribed.

Mrs PL has prescribed celecoxib 200mg OD indicated for her pain and inflammation in osteoarthritis. She also has a background of diabetes and ischaemic heart disease. Select the reason why the use of non-steroidal anti-inflammatory drugs (NSAIDs) in this elderly patient is potentially inappropriate if prescribed.

Ms Lewis, a 50 year old, has been prescribed an anti-malarial for the treatment of active rheumatoid arthritis (RA) by a specialist.  Which one of the below antimalarials can be used for the treatment of active RA?

Mrs Johnson, a 47 year old, has been prescribed a biological disease modifying anti-rheumatic drug (DMARD) for rheumatoid arthritis. Which one of the below is a biological DMARD?

Miss Hale, a 70 year old, has been diagnosed with mild osteoarthritis (OA).  She has a body mass index (BMI) of 29 and tells you she leads a relatively sedentary lifestyle. Which of the below is incorrect advice to give her?

Miss K presents to your community pharmacy as she has been experiencing dry eyes. Which one of the following counselling points is least appropriate for Miss K?

Mr R has been prescribed latanoprost 50micrograms/ml eye drops to apply once daily.

Which one of the following counselling points is important for Mr R to know before initiating treatment?

Mrs P is a 47 year old female that presents with eye pain and impaired visual acuity and sees lights surrounded by halos. Her eyes are red and her pupil is fixed in a vertically oval shape.

Which one of the following is the most appropriate diagnosis for Mrs P?

Mr Robson, a 19 year old, has been prescribed isotretinoin capsules by a dermatologist. Which of the below is a side effect of isotretinoin?

Mr Lewis comes into the pharmacy looking for a shampoo for dandruff. He is particularly looking for one that contains an anti-fungal, ketoconazole. Which one of the below preparations contain ketoconazole?

You are working with a pre-registration trainee. You are having a discussion about treatment for psoriasis. Which one of the below would not be used to treat psoriasis?

You receive a NHS dental prescription for a topical local anaesthetic. Which one of the below topical anaesthetic preparations can be prescribed on a NHS dental prescription?

You attend a lunchtime seminar on premedication before anaesthesia. Which one of the below benzodiazepines is indicated to use as premedication before surgery?

Mr Lewis, a 26 year old, brings in a prescription for a local anaesthetic tetracaine 4% gel. Which one of the below preparations would you dispense?