Wattle Pharmacy Prep

Renal and urology
Practice questions with explanations

Renal and urology belongs to Therapeutics and patient care, which makes up about 45% of the Overseas Pharmacist Readiness Assessment (OPRA®). Answer each question yourself before opening the explanation.

1. Which advice applies to a patient prescribed tamsulosin who is scheduled for cataract surgery?

  1. Stop it a week before surgery to eliminate the risk
  2. Only current use matters
  3. It has no effect on eye surgery
  4. Inform the ophthalmologist, since intraoperative floppy iris syndrome can occur even if the drug was taken years earlier
Show answer

D. Inform the ophthalmologist, since intraoperative floppy iris syndrome can occur even if the drug was taken years earlier

The effect on iris dilator muscle persists after cessation, so stopping the drug does not reliably prevent it and may worsen urinary symptoms. What matters is that the surgeon knows in advance and can modify their technique, which substantially reduces the risk of complications.

2. Which medicines should typically be withheld during an acute dehydrating illness in a patient with chronic kidney disease?

  1. ACE inhibitors or sartans, diuretics, NSAIDs, metformin and SGLT2 inhibitors, as sick day guidance
  2. Topical treatments
  3. Inhaled corticosteroids and bronchodilators
  4. All medicines without exception
Show answer

A. ACE inhibitors or sartans, diuretics, NSAIDs, metformin and SGLT2 inhibitors, as sick day guidance

Sick day guidance targets the drugs that either reduce renal perfusion, deplete volume, or accumulate dangerously if the kidney fails: renin-angiotensin blockers, diuretics, NSAIDs, metformin because of lactic acidosis risk, and SGLT2 inhibitors because of euglycaemic ketoacidosis. The patient needs written instructions on when to stop, when to restart and when to seek help.

3. Which is a recognised indication for referral rather than pharmacy treatment of urinary symptoms?

  1. Dysuria for one day in a non-pregnant woman with a previous similar episode
  2. Mild urinary frequency after excessive fluid intake
  3. Urgency relieved by reducing caffeine
  4. Visible haematuria, fever with loin pain, symptoms in a man, or symptoms in pregnancy
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D. Visible haematuria, fever with loin pain, symptoms in a man, or symptoms in pregnancy

Visible haematuria requires exclusion of malignancy regardless of infection, fever with loin pain suggests pyelonephritis, urinary infection in men is by definition complicated, and infection in pregnancy risks pyelonephritis and preterm birth. Simple cystitis in a non-pregnant woman may be managed with a pharmacist-led pathway where jurisdictions allow.

These are 3 of the 40 questions on renal and urology in the app.

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More topics in Therapeutics and patient care

Australian pharmacy practice and law · Cardiovascular therapeutics · CNS and psychiatry · Counselling, OTC and triage · Dermatology · Diabetes and endocrine therapeutics · Eye, ear, nose and throat · Gastrointestinal therapeutics · Infectious diseases · Musculoskeletal · Older people and polypharmacy · Oncology and supportive care · Paediatrics · Pain and palliative care · Pharmaceutical calculations · Respiratory therapeutics · Vaccines and immunisation · Women's health