ADC Practice Question — Ibuprofen and COX-2 inhibitors

this patient required an NSAID for dental pain, which…

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. Jean Campbell, a 79-year-old woman, presents for a routine dental review. Her medication list includes warfarin for atrial fibrillation, amlodipine 10 mg for hypertension, metformin 500 mg twice daily for Type 2 diabetes, omeprazole 20 mg daily, and fluoxetine 20 mg daily for depression. She complains of a persistent dry mouth, bleeding gums, and a sore area under her upper denture. On examination, she has generalised gingival enlargement, erythema under the denture consistent with denture-associated candidiasis, and reduced salivary flow. If this patient required an NSAID for dental pain, which specific combination risk makes this particularly dangerous?

A. NSAID + warfarin increases bleeding risk, NSAID + fluoxetine (SSRI) further impairs platelet function — the combination creates very high bleeding risk from multiple mechanisms
B. NSAID + metformin causes lactic acidosis
C. NSAID + fluoxetine causes serotonin toxicity
D. NSAID + omeprazole is a dangerous combination that should be avoided
E. NSAIDs are safe in this patient because omeprazole protects the stomach

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: A

This patient has three medications affecting haemostasis: warfarin (anticoagulant), fluoxetine (SSRI — impairs platelet function per TG ), and adding an NSAID would create a third mechanism of bleeding risk. TG states NSAIDs increase bleeding in patients on antithrombotics. TG lists concurrent SSRIs as a risk factor for increased GI toxicity with NSAIDs. Paracetamol is the only safe analgesic option.

Source: Ch 23: Warfarin + SSRI + NSAID = very high bleeding risk from multiple mechanisms

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

Exam preparation FAQ

How should I prepare for Pharmacology & Therapeutics in the ADC exam?

Build competence across all topics. The exam tests application of guidelines to clinical scenarios, not memorisation.

How do I approach an unfamiliar Ibuprofen and COX-2 inhibitors vignette?

Extract key clinical data from the stem before reading options. There are usually 3–4 critical variables that determine the correct answer.

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

this patient required an NSAID for dental pain, which…

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.