ADC Practice Question — Ibuprofen and COX-2 inhibitors

the extraction, you plan to prescribe analgesia. Given…

Pharmacology questions in the ADC written exam test applied prescribing decisions, not rote recall of drug names. This exam-level vignette tests your ability to work through clinical details and arrive at the correct management.

Mrs. Fatima Al-Rashid, a 75-year-old woman, presents for a routine dental check-up. She takes warfarin for atrial fibrillation. During examination, you discover a mobile, tender lower incisor (tooth 41) that she wishes to have removed. She also mentions she has been applying miconazole oral gel for oral thrush diagnosed by her GP last week. Her other medications include ramipril 5 mg and frusemide 20 mg daily. Her INR from 3 days ago was 2.6, but she does not have a more recent result. After the extraction, you plan to prescribe analgesia. Given this patient takes ramipril and frusemide, which additional risk must you consider if contemplating an NSAID?

A. NSAIDs may cause hyperkalemia when combined with ramipril
B. There is no additional renal risk since the patient's kidney function has presumably been monitored by her GP
C. NSAIDs reduce the antihypertensive effect of ramipril, potentially causing a hypertensive crisis
D. Frusemide is nephrotoxic and adding an NSAID would compound the renal damage
E. The combination of NSAID + ACEI (ramipril) + diuretic (frusemide) significantly increases the risk of acute kidney injury — the 'triple whammy'

ADC revision is a must, hence Reviz is a must

The only ADC prep platform where every answer is traced to the guideline source.

No invented explanations. No guesswork content. Every question mapped to Therapeutic Guidelines, Odell's, IADT, and more — so you study what the exam actually tests.

7,000+

Practice questions

All 4

ADC papers covered

Every

Answer cited

🤖

Remy — your AI tutor on WhatsAppRemy figures out what you're getting wrong and keeps hitting those topics until you stop getting them wrong. Like a tutor who remembers every mistake you've ever made.

🔄

You won't forget what you studiedGot a question wrong last week? Remy brings it back — right when you're about to forget it. The more you get right, the less it repeats. The stuff you struggle with keeps coming back until it sticks.

🎯

Know exactly where you're weakSee your score for every topic — Antimicrobials, Trauma, Anaesthesia, all of them. No more guessing what to study next. Remy builds your daily quiz from the gaps.

📱

Study on WhatsApp, review on the webYour daily quiz arrives right on WhatsApp — no app to download, no website to remember. Open WhatsApp, answer questions, done. Check detailed progress anytime on the web dashboard.

📖

Don't trust the answer? Look it up.Every explanation tells you the book, the edition, and the page number. If something doesn't feel right, you can verify it yourself in 30 seconds. No other platform does this.

⏰

Daily quizzes, your time, your timezoneRemy sends questions at the time you pick, in your timezone. You don't have to remember to study — Remy shows up every day. Consistency becomes automatic.

🔥 The Remy Challenge

Score high, pay less.

Think you already know your stuff? The Remy Challenge: 15 questions, one attempt — 13 timed and marked, plus 2 interactive finishers. Your score sets your discount — top scores take 50% off any plan, strong scores 30%, and every challenger leaves with at least 20%, locked for 72 hours.

Take the Remy Challenge

✅ No signup needed

Try Reviz on WhatsApp.

Message Remy and get one cited clinical question every morning — free until the day you sit. No card details, no forms, no app to download. Just open WhatsApp and start practising.

Message Remy on WhatsApp

Sources cited

Therapeutic Guidelines v4 Odell's 3rd & 4th Ed IADT 2020 Code of Conduct CMS (Evans) Infection Control + more

Show the answer and cited explanation

Correct answer: E

According to TG, the risk of acute kidney injury is significantly increased when an NSAID is co-administered with an ACEI (or ARB) plus a diuretic — the 'triple whammy'. This patient on ramipril + frusemide must NOT be prescribed an NSAID. Paracetamol is the appropriate analgesic. This patient therefore has two independent reasons to avoid NSAIDs.

Source: Ch 5: Triple whammy — NSAID + ACEI + diuretic = acute kidney injury risk

Remy's study tip — For pharmacology vignettes, read the patient’s medical history and allergies BEFORE looking at the drug options.

Exam preparation FAQ

Should I memorise guidelines word-for-word for Ibuprofen and COX-2 inhibitors?

Focus on decision points — when the guideline says X vs Y. The exam tests application, not recitation.

How are Ibuprofen and COX-2 inhibitors questions structured in the ADC written exam?

ADC Ibuprofen and COX-2 inhibitors questions present as clinical vignettes requiring management decisions. The correct answer is always traceable to a guideline source.

Every answer, traced to the source.

Remy — the AI tutor inside Reviz — drills you on 7,000+ ADC-style cited questions with spaced repetition, on WhatsApp and the web.

Start with 10 free questions

the extraction, you plan to prescribe analgesia. Given…

The only ADC prep platform where every answer is traced to the guideline source.

Score high, pay less.

Try Reviz on WhatsApp.

Exam preparation FAQ

More Ibuprofen and COX-2 inhibitors questions

Every answer, traced to the source.

You're on a roll.