All most important things from notes and mocks that you need to remember Harry Flashcards
common cause or urticara
aspirin
when can you not give sumatriptan
hx of hypertension and high BP
if you cant give sumatriptan what do you give instead for migraine
aspirin or ibuprofen
resus fluids in a child
sodium chloride 10ml/kg
two drugs contributing to postural hypotension
flozins and BB
what medications should you suspend in a suspected head injury
anything causing bleeding - antiplatelet , anticoag
drowsines and confusion drugs - amitritpylline sand zopilcone - would be problematic in context of acute head injruy
dexamethasone prescirbed at night why might this be a problem
can cause insomnia if night that is why normally prescribed in the morning
gestational diabetes what tx summary can you find it in
diabetes pregnancy and breast feeding
in what drug next - what should you check
check they are on optimal doses of that drug thus meaning they are on the maximum or if you can give them another
hypercalcaemia what do you treat with
sodium chloride IV 1ltr over 4hrs
post emergency contraception what should happen
preg test
wiht iron supplementation what is the most important info
dont take calcium and iron together
considered does mean defo measure
what feature suggest heaptic necrosis in paraceamol overdose
RUQ tenderness
during mineralcortiocid therap what needs to be measured
UandE - k and na , bp fluid balance
what things are useful to monitor benefits of treatemnet and assess effectiveness
self reporting of symtpoms severity and freqeyncy
best way to measure a ong acting insulin to tittrate up
monitor pre breakfast fasting capillary blood glucose
somone not maintainign sats on 24% venturi mask what do you do
chnage to 28% venturi
given that oxygen saturation is below the limit - fio2 should be increased under controlled conditions
normal strength of novarapid
100 units/ml
A 44-year-old man is admitted to the acute medical unit diagnosed with acute coronary syndrome. He usually takes 140inits of insulin degludec (Tresiba 200inits/ml) twice daily and Novorapid with meals. The insulin is unavailable overnight and he has forgotten his pen device. What is the most appropriate course of action?
Administer 140 units of insulin Tresiba (100units/ml)
never chnage the dose just the concentraiotn as it just a differenence in volume
You are the FY1 on call overnight. You are asked by nursing staff to review a patient with type 1 diabetes mellitus who has suffered from hypoglycaemia at 0700. He takes Lantus 20 units at night and a variable dose of Humalog with meals. He has had a carbohydrate snack and his CBG is now 4.5mmol/l. What is the correct course of action?
Give usual dose of Humalog with breakfast
stiill give usual insulin dont change the regime
A 78 year-old lady who lives with her daughter is admitted with general decline. Her daughter administers the patients twice daily insulin dose at 0800 and 2000. The dose is 40 units twice daily. She reports that her mother has had repeated overnight hypoglycaemia. What should you prescribe on the insulin chart?
Reduce evening insulin dose by 20%
rule of thumb adjust by 20% fro hypos
hypers can be 10%
A 64 year old man is admitted electively the evening before a right hemi-colectomy. He is taking once daily insulin lantus (glargine) at 2200 at a dose of 50 units. What is the correct course of action?
Prescribe 40 units lantus at 2200
surgery rule of thumb drop by 20%
Following left mastectomy a 55 year-old woman with type 1 diabetes is feeling ready to eat lunch. She is on VRII (Variable rate insulin infusion). The capillary blood glucose is 6.8mmol/l. She has had an appropriate dose of long acting insulin the previous evening. She usually takes Apidra (insulin glulisine) with meals. What is the correct course of action?
Give Apidra with lunch and stop VRII 30 minutes later
long acting is always continued alongside VRII - short actings have a 15-30min onset of action which is also why we ask to inject before meals - there needs to be an overlap period
A75-year old man is admitted to hospital. He takes Insuman basal 40 units twice daily for type 2 diabetes mellitus. His insulin pen device is broken and the same insulin is unavailable that evening. What is the most appropriate course of action?
Administer 40 units of an alternative intermediate-acting insulin such as Insulatard.
do bisphosphonates cause reducting in kindey function
yes
2 meds that contribute to anoxeria
metoformin
rivastigmine
more likely to cause dka SGLT-2 or insulin
SGLT-2
montior adverse affects of ceft
FBC
how quickly does fertility return with the implant
straight away
sumatriptain muscle se
muscle ache
on inuslin infusion waiting for surgery what do you give with
%5 dextrose with potasium over 8-12hr
