2nd 20

Question 1

Which medication should be stopped because of metabolic acidosis?

Answer 1

Metformin because it can cause a lactic acidosis all by itself

Question 2

Suspected Meningitis treatment in the community

Answer 2

IM benzylpenicillin
600mg if 1yr - 11 years old
Check BNFC for dosing based on age

Question 3

Treatment of croup

Answer 3

Oral dexamethasone (150mcg/kg)
Nebuliser budenoside

Question 4

Drug that can cause hyponatraemia

Answer 4

Indapamide (thiazide diuretic)

All diuretic drugs!

Question 5

Drugs to avoid in pregnancy

Answer 5

Lithium
Sertraline
Sodium valproate
Trimethoprim

Question 6

When should metformin be stopped?

Answer 6

Any sign of renal disease
Any signs of lactic acidosis = dyspnoea, abdominal pain, muscle cramps
Can also cause change in taste but this is benign

Question 7

Lithium treatment, target treatment range

Answer 7

0.4-1.0

Question 8

Signs of lithium toxicity

Answer 8

Tremor 
GI effects 
Seizures and coma 
Disorientation 
Feeling shit

Question 9

Drug that interacts with lithium to cause serotonin syndrome

Answer 9

Sertraline

Question 10

What to do if lithium is slightly raised (1.2) >1

Answer 10

Withhold lithium and consider reducing dose

Question 11

Anaphylaxis treatment for child

Answer 11

300mg IM adrenaline

Question 12

Side effect of amiodarone

Answer 12

Thyrotoxicosis

Question 13

Max INR for warfarin therapy

Answer 13

5

Question 14

INR of 8 on warfarin, what to do?

Answer 14

Stop warfarin and give oral vit K

Question 15

When should you stop statins?

Answer 15

Myopathy and CK 5x upper limit of normal

Monitor if their symptoms improve

Question 16

Alternative strong pain killer in renal impairment to morphine

Answer 16

Oxycodone

Question 17

60mg morphine is equivalent to how many mg of oxycodone?

Answer 17

30mg

Question 18

Drug to treat AF

Answer 18

Amiodarone

Question 19

Theophylline is used to treat which condition?

Answer 19

COPD