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Oral iron counselling — GPhC CRA MCQ

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HardGastro-intestinal TherapeuticsOral iron counsellingGPhC CRA

A patient with type 2 diabetes and albuminuric chronic kidney disease has eGFR 42 mL/min/1.73 m² and serum potassium 5.2 mmol/L. How should eligibility for newly prescribed finerenone 10 mg daily be appraised?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Finerenone initiation is ineligible while potassium exceeds 5.0 mmol/L

Explanation lettering: C = shown as A · D = shown as B · A = shown as C · B = shown as D

A misses the explicit initiation threshold and delays monitoring. B is correct: serum potassium above 5.0 mmol/L makes the patient ineligible to start finerenone; contributing factors should be addressed and treatment reconsidered after reassessment. C invents an unsupported schedule. D would worsen hyperkalaemia. E uses the wrong renal threshold: eGFR 42 affects the starting dose but is not itself a prohibition; potassium and eGFR are rechecked 4 weeks after a valid initiation or dose change.

Reference: Kerendia finerenone SmPC. https://www.medicines.org.uk/emc/product/13438/smpc