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Which of the following statements is/are TRUE about postnatal depression (PND)? [Select All That Apply]
 
a. About 10% of women experiencing a mental health problem during pregnancy or postpartum.
b. PND can begin at any time within one year after delivery.
c. Patients may experience a persistent low mood, lack of interest and enjoyment in usual activities, low self-esteem or lack of energy
d. PND can also occur following miscarriage, stillbirth or in parents who adopt a child.
e. Asian women and women from a non-English speaking background may be affected to a greater extent to PND.



Which of the following statements is/are TRUE about postnatal depression (PND)? [Select All That Apply]
 
a. About 10% of women experiencing a mental health problem during pregnancy or postpartum.
b. PND can begin at any time within one year after delivery.
c. Patients may experience a persistent low mood, lack of interest and enjoyment in usual activities, low self-esteem or lack of energy
d. PND can also occur following miscarriage, stillbirth or in parents who adopt a child.
e. Asian women and women from a non-English speaking background may be affected to a greater extent to PND.

Answer: (a,b,c,d,e).  All.
 
Pharmacists are likely to encounter patients affected by postnatal depression, therefore the ability to identify signs of this under-recognised disorder is essential for appropriate and prompt referral for help and support.
 
Maternal suicide remains the leading cause of death from a direct cause in the postnatal period, accounting for around 22% of maternal deaths reported in the UK between 2014 and 2016. With around 10% of women experiencing a mental health problem during pregnancy or postpartum, it is important for all healthcare professionals to understand and recognise the risk factors for perinatal mental health problems and know where to refer patients.
 
Postnatal depression (PND) can begin at any time within one year after delivery. It is a relatively common condition that occurs in around 10–15% of women following childbirth and around 10% of new fathers, although it is thought that the true prevalence is higher than this.
 
PND can also occur following miscarriage, stillbirth or in parents who adopt a child. In England, it is thought that particular ethnic groups (e.g. Asian women and women from a non-English speaking background) may be affected to a greater extent. This is possibly owing to cultural beliefs around depression, lack of integration and language barriers making it difficult to express difficulties in the postnatal period.
 
Many women will be emotional or experience mild mood changes in the first week after having a baby (referred to as the ‘baby blues’), but these feelings should be self-limiting.
 
In PND, these feelings last longer. Similar to depression, patients may experience a persistent low mood, lack of interest and enjoyment in usual activities, low self-esteem or lack of energy. In addition, they may feel as though they are a bad parent, are unable to cope with their baby or may feel indifferent to their baby.
 
Source: www.pharmacyexam.com
Citation: https://www.pharmaceutical-journal.com/cpd-and-learning/learning-article/postnatal-depression-recognition-and-diagnosis/20207360.article?firstPass=false


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Pharmacists should be able to recognise red flag signs of Postnatal depression (PND) and refer these patients immediately. Which of the following is/are Red flag signs or symptoms for postnatal depression?
 
I. Recent significant change in mental state or emergence of new psychiatric symptoms
II. New thoughts or acts of violent self-harm.
III. New and persistent expressions of incompetency as a mother, such as being over-critical for not recognising what the baby needs.
 
a. I only
b. I and II only
c. II and III only
d. All


Pharmacists should be able to recognise red flag signs of Postnatal depression (PND) and refer these patients immediately. Which of the following is/are Red flag signs or symptoms for postnatal depression?
 
I. Recent significant change in mental state or emergence of new psychiatric symptoms
II. New thoughts or acts of violent self-harm.
III. New and persistent expressions of incompetency as a mother, such as being over-critical for not recognising what the baby needs.
 
a. I only
b. I and II only
c. II and III only
d. All

Answer: (d).  All. Pharmacists should be able to recognise red flag signs and symptoms of PND and refer these patients immediately.
Red flag signs for postnatal depression:
 

  1. Recent significant change in mental state or emergence of new psychiatric symptoms;
  2. New thoughts or acts of violent self-harm;
  3. New and persistent expressions of incompetency as a mother, such as:
  • Estrangement from the infant;
  • Being over-critical for not recognising what the baby needs;
  • Saying that she/he is not doing things correctly;
  • Saying that she/he is not a good mother for her child;
  • Saying that the baby may be better cared for by someone else;
  • Saying that she/he is not providing good care for her baby or that other parents seem to be more able to look after their babies.
Patients with suicidal thoughts must be referred immediately to specialist perinatal mental health services.

Source: www.pharmacyexam.com
Citation: https://www.pharmaceutical-journal.com/cpd-and-learning/learning-article/postnatal-depression-recognition-and-diagnosis/20207360.article?firstPass=false


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_______________ glaucoma happens when the eye makes extra blood vessels that cover the part of your eye where fluid would normally drain.
 
a. Neovascular
b. Pigmentary
c. Exfoliation
d. Uveitic


_______________ glaucoma happens when the eye makes extra blood vessels that cover the part of your eye where fluid would normally drain.
 
a. Neovascular
b. Pigmentary
c. Exfoliation
d. Uveitic

Answer: (a).  Glaucoma is a group of eye diseases that are usually characterized by damage to the optic nerve and gradual vision loss that starts with losing peripheral (side) vision. People who have high eye pressure are at higher risk for glaucoma.
 
Primary glaucomas:

When experts don’t know what causes a type of glaucoma, that type is called a primary glaucoma.
 
Secondary glaucomas:

Sometimes glaucoma is caused by another medical condition — this is called secondary glaucoma.
 
1. Neovascular glaucoma

Treatments: Medicines, laser treatment, surgery
 
Neovascular glaucoma happens when the eye makes extra blood vessels that cover the part of your eye where fluid would normally drain. It’s usually caused by another medical condition, like diabetes or high blood pressure. 
 
If you have neovascular glaucoma, you may notice:
 

  • Pain or redness in your eye
  • Vision loss
 
This type of glaucoma can be hard to treat. Doctors need to treat the underlying cause (like diabetes or high blood pressure) and use glaucoma treatments to lower the eye pressure that results from it.
 
2. Pigmentary glaucoma
 
Treatments: Medicines, laser treatment, surgery
 
Pigment dispersion syndrome happens when the pigment (color) from your iris (the colored part of your eye) flakes off. The loose pigment may block fluid from draining out of your eye, which can increase your eye pressure and cause pigmentary glaucoma.
 
Young, white men who are near-sighted are more likely to have pigment dispersion syndrome than others. If you have this condition, you may have blurry vision or see rainbow-colored rings around lights, especially when you exercise. 
 
Doctors can treat pigmentary glaucoma by lowering eye pressure, but there currently isn’t a way to prevent pigment from detaching from the iris.
 
3. Exfoliation glaucoma

Treatments: Medicines, laser treatment, surgery
 
Exfoliation glaucoma (sometimes called pseudoexfoliation) is a type of open-angle glaucoma that happens in some people with exfoliation syndrome, a condition that causes extra material to detach from parts of the eye and block fluid from draining. 
 
Recent research shows that genetics may play a role in exfoliation glaucoma. You are at higher risk if someone else in your family has exfoliation glaucoma.
 
This type of glaucoma can progress faster than primary open-angle glaucoma, and often causes higher eye pressure. This means that it’s especially important for people who are at risk to get eye exams regularly. 
 
4. Uveitic glaucoma

Treatments: Medicines, surgery
 
Uveitic glaucoma can happen in people who have uveitis, a condition that causes inflammation (irritation and swelling) in the eye. About 2 in 10 people with uveitis will develop uveitic glaucoma.
 
Experts aren’t sure how uveitis causes uveitic glaucoma, but they think that it may happen because uveitis can cause inflammation and scar tissue in the middle of the eye. This may damage or block the part of the eye where fluid drains out, causing high eye pressure and leading to uveitic glaucoma. 
 
In some cases, the medicines that treat uveitis may also cause uveitic glaucoma or make it worse. This is because corticosteroid medicines may cause increased eye pressure as a side effect.


Source: www.pharmacyexam.com
Citation: https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/glaucoma/types-glaucoma


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Which of the following types of glaucoma is NOT CONSIDERED a primary glaucoma?
 
a. Open-angle
b. Congenital
c. Pigmentary
d. Angle-closure


Which of the following types of glaucoma is NOT CONSIDERED a primary glaucoma?
 
a. Open-angle
b. Congenital
c. Pigmentary
d. Angle-closure

Answer: (c).  Glaucoma is a group of eye diseases that are usually characterized by damage to the optic nerve and gradual vision loss that starts with losing peripheral (side) vision. People who have high eye pressure are at higher risk for glaucoma.
 
Primary glaucomas:
When experts don’t know what causes a type of glaucoma, that type is called a primary glaucoma.
 
Pigmentary glaucoma is considered secondary glaucoma.
 
1. Open-angle glaucoma

Treatments: Medicines, laser treatment, surgery 
 
Open-angle glaucoma is the most common type in the United States, where 9 in 10 people with glaucoma have the open-angle type. Many people don’t have any symptoms until they start to lose their vision, and people may not notice vision loss right away.
 
Experts aren’t sure what causes open-angle glaucoma, but it may be caused by pressure building up in your eye. If the fluid in your eye can’t drain fast enough, it creates pressure that pushes on a nerve in the back of your eye (the optic nerve). 
 
Over time, the pressure damages the optic nerve, which affects your vision. This can eventually lead to blindness — in fact, open-angle glaucoma causes almost 2 in 10 cases of blindness in African Americans. People with high blood pressure are also at higher risk for this type.
 
2. Normal-tension glaucoma

Treatments: Medicines, laser treatment, surgery
 
Normal-tension glaucoma is a type of open-angle glaucoma that happens in people with normal eye pressure. About 1 in 3 people with open-angle glaucoma have the normal-tension type. 
 
You may be at higher risk for normal-tension glaucoma if you:
 

  • Are of Japanese ancestry
  • Have a family history of normal-tension glaucoma
  • Have had certain heart problems, like an irregular heartbeat
  • Have low blood pressure
 
Experts don’t know what causes normal-tension glaucoma, but research shows that treatments that lower eye pressure can help slow the disease and stop vision loss.
 
3. Angle-closure glaucoma

Treatments: Medicines, laser treatment
 
Angle-closure glaucoma, also called narrow-angle or acute glaucoma, is a medical emergency. Go to the doctor or emergency room immediately if you suddenly have:
 
  • Intense pain in your eye
  • Nausea
  • Red eyes
  • Blurred vision
 
In this type of glaucoma, the outer edge of the iris (the colored part of your eye) blocks fluid from draining out of the front of the eye. The fluid builds up quickly, causing a sudden increase in eye pressure. If it’s not treated, angle-closure glaucoma can cause blindness in just a few days.
 
A doctor can use laser treatment and give you medicine to help the fluid drain. This can lower eye pressure and protect your vision. Your doctor might treat both eyes to prevent future problems, even if you only have angle-closure glaucoma in one eye.
 
Another type of angle-closure glaucoma, sometimes called slow or chronic angle-closure glaucoma, happens more slowly and might not have any symptoms. Your doctor can treat this type with medicines, laser treatments, or surgery.
 
4. Congenital glaucoma

Treatments: Medicines, surgery
 
Some babies are born with glaucoma — this is called congenital glaucoma. About 1 out of 10,000 babies born in the United States have a defect (problem) in the eye that keeps fluid from draining normally.
 
In these cases, you can usually notice the symptoms right away. Children with congenital glaucoma:
 
  • Have cloudy eyes
  • Are sensitive to light
  • Make extra tears
  • May have eyes that are larger than normal
 
Surgery works very well to treat congenital glaucoma. If a doctor does surgery early enough, children with congenital glaucoma usually won’t have any permanent vision loss.
 
Several other types of glaucoma can also develop in children. Any glaucoma that affects babies or children is called pediatric glaucoma.
 
Source: www.pharmacyexam.com
Citation: https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/glaucoma/types-glaucoma


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Which of the following is/are Type(s) of Refractive Errors? [Select All That Apply]
 
a. myopia
b. hyperopia
c. Astigmatism
d. Presbyopia
 
a. a only
b. a and b only
c. a, b and c only
d. a, b, c and d


Which of the following is/are Type(s) of Refractive Errors? [Select All That Apply]
 
a. myopia
b. hyperopia
c. Astigmatism
d. Presbyopia
 
a. a only
b. a and b only
c. a, b and c only
d. a, b, c and d
 
Answer: (d)  All. Refractive errors happen when the shape of your eye keeps light from focusing correctly on your retina (a light-sensitive layer of tissue at the back of your eye).
Each type of refractive error is different, but they all make it hard to see clearly.

Nearsightedness (myopia):

Nearsightedness makes far-away objects look blurry. It happens when the eyeball grows too long from front to back, or when there are problems with the shape of the cornea (clear front layer of the eye) or the lens (an inner part of the eye that helps the eye focus). These problems make light focus in front of the retina, instead of on it.
Nearsightedness usually starts between ages 6 and 14. Children who spend more time outdoors during these years are less likely to develop nearsightedness, but experts aren’t sure why.

Severe nearsightedness (also called high myopia) can increase the risk of other eye conditions, like retinal detachment (when the retina is pulled away from its normal position).

Farsightedness (hyperopia):

Farsightedness makes nearby objects look blurry. It happens when the eyeball grows too short from front to back, or when there are problems with the shape of the cornea or lens. These problems make light focus behind the retina, instead of on it.

People with farsightedness are usually born with it.

Astigmatism:

Astigmatism can make far-away and nearby objects look blurry or distorted. It happens when the cornea or lens has a different shape than normal, which makes light bend differently as it enters the eye.

Some people with astigmatism are born with it, but many people develop it as children or young adults. People with astigmatism often have another refractive error, like nearsightedness or farsightedness.

Presbyopia:

Presbyopia makes it hard for middle-aged and older adults to see things up close. As you age, the lens in your eye gets harder and less flexible and stops focusing light correctly on the retina.

Everyone gets presbyopia as they get older, usually after age 45. Many people have another refractive error in addition to presbyopia.
 
Source: www.pharmacyexam.com
Citation: https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/refractive-errors/types-refractive-errors


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The following warning is currently published on the DEA website:
 
The Drug Enforcement Administration is warning the public including the DEA registrant community to include practitioners and pharmacies about criminals posing as DEA Special Agents, DEA Investigators or other law enforcement personnel as part of an international extortion scheme.


The following warning is currently published on the DEA website:
 
The Drug Enforcement Administration is warning the public including the DEA registrant community to include practitioners and pharmacies about criminals posing as DEA Special Agents, DEA Investigators or other law enforcement personnel as part of an international extortion scheme.
The criminals call the victims (who in most cases previously purchased drugs over the internet or by telephone) and identify themselves as DEA agents or law enforcement officials from other agencies. The impersonators inform their victims that purchasing drugs over the internet or by telephone is illegal, and that enforcement action will be taken against them unless they pay a fine. In most cases, the impersonators instruct their victims to pay the "fine" via wire transfer to a designated location, usually overseas. If victims refuse to send money, the impersonators often threaten to arrest them or search their property. Some victims who purchased their drugs using a credit card also reported fraudulent use of their credit cards. Another scheme involves criminals contacting doctors and pharmacists and stating that they are the subject of an investigation and demanding money to clear up the matter.

Anyone receiving a telephone call from a person purporting to be a DEA special agent, DEA Investigator, or other law enforcement official seeking money should refuse the demand and report the threat using the online form below.

https://www.deadiversion.usdoj.gov/pubs/pressreleases/extortion_scam.htm


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Life-threatening breathing difficulties can occur in patients who use gabapentin or pregabalin with opioids or other drugs that depress the central nervous system, as well as those with underlying respiratory impairment and the elderly, the US Food and Drug Administration (FDA) warned in a drug safety communication issued today.
 
To read more, please click here: https://www.rxlist.com/script/main/art.asp?articlekey=226865
 
Source: www.pharmacyexam.com


Life-threatening breathing difficulties can occur in patients who use gabapentin or pregabalin with opioids or other drugs that depress the central nervous system, as well as those with underlying respiratory impairment and the elderly, the US Food and Drug Administration (FDA) warned in a drug safety communication issued today.
 
To read more, please click here: https://www.rxlist.com/script/main/art.asp?articlekey=226865
 
Source: www.pharmacyexam.com


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Negative childhood events and family history could increase risk.
 
Most of us experience anxiety at some point in our lives. You might feel anxious when taking a test, crossing a busy street, or making an important life decision.
 
But for people with an anxiety disorder, these feelings usually last longer and are more intense. They often worsen over time and interfere with everyday life.
 
Anxiety disorders are the most common form of mental illness and affect more than 25 million Americans. There are a variety of anxiety disorders, though many share similar symptoms and methods of treatment.
 
To read more, please click here: https://magazine.medlineplus.gov/article/anxiety-what-you-need-to-know
 
Source: www.pharmacyexam.com


Negative childhood events and family history could increase risk.
 
Most of us experience anxiety at some point in our lives. You might feel anxious when taking a test, crossing a busy street, or making an important life decision.
 
But for people with an anxiety disorder, these feelings usually last longer and are more intense. They often worsen over time and interfere with everyday life.
 
Anxiety disorders are the most common form of mental illness and affect more than 25 million Americans. There are a variety of anxiety disorders, though many share similar symptoms and methods of treatment.
 
To read more, please click here: https://magazine.medlineplus.gov/article/anxiety-what-you-need-to-know
 
Source: www.pharmacyexam.com


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Hypochromic microcytic anemia with iron overload is a condition that impairs the normal transport of iron in cells. Iron is an essential component of hemoglobin, which is the substance that red blood cells use to carry oxygen to cells and tissues throughout the body. 


Hypochromic microcytic anemia with iron overload is a condition that impairs the normal transport of iron in cells. Iron is an essential component of hemoglobin, which is the substance that red blood cells use to carry oxygen to cells and tissues throughout the body. In this condition, red blood cells cannot access iron in the blood, so there is a decrease of red blood cell production (anemia) that is apparent at birth. The red blood cells that are produced are abnormally small (microcytic) and pale (hypochromic). Hypochromic microcytic anemia with iron overload can lead to pale skin (pallor), tiredness (fatigue), and slow growth.
 
In hypochromic microcytic anemia with iron overload, the iron that is not used by red blood cells accumulates in the liver, which can impair its function over time. The liver problems typically become apparent in adolescence or early adulthood.
 
For more information, click here: https://ghr.nlm.nih.gov/condition/hypochromic-microcytic-anemia-with-iron-overload


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Prescription drug samples may only be distributed to licensed practitioners or to the retail pharmacies, the pharmacies of hospitals or other health care entities upon the written request of a licensed practitioner.
 
a. True
b. False


Prescription drug samples may only be distributed to licensed practitioners or to the retail pharmacies, the pharmacies of hospitals or other health care entities upon the written request of a licensed practitioner.
 
a. True
b. False

Answer: (b) False, [21 CFR 203.3 and Section 503(d) of the Act].
 
Under section 503(d) of the FFDCA, prescription drug samples may only be distributed to licensed practitioners or to the pharmacies of hospitals or other health care entities upon the written request of a licensed practitioner.
 
A “health care entity” means any person that provides diagnostic, medical, surgical, or dental treatment, or chronic or rehabilitative care, but does not include any retail pharmacy (21 CFR 203.3(q)).
 
A health care entity cannot simultaneously also be a retail pharmacy.
 
If a pharmacy of a health care entity operates as part of the health care entity, it is eligible to receive prescription drug samples from a manufacturer or authorized distributor of record, if the drug samples are obtained pursuant to a written, signed request of a licensed practitioner affiliated with the health care entity.
 
“Affiliation” is interpreted to mean that the requesting practitioner sees patients at the health care entity. A retail pharmacy that has no relationship to a health care entity is not permitted to receive prescription drug samples (21 CFR 203.3 and Section 503(d) of the Act).




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