Chapter 2

Question 1

Prescriber pnemonic for essentials when prescribing

Answer 1

Patient details
Reaction
Sign
Contraindications
Route
IV fluids - if needed
Blood clot prophylaxis - if needed
antiEmetic - if needed
pain Relief - if needed

Question 2

Contraindications to steroids/side effects (8)

Answer 2

Stomach ulcers
Thin skin
oEdema
R+L heart failure
Osteoporosis
Infection - candida
Diabetes
Syndrome - cushing's

Question 3

Contraindications to NSAIDs/side effects (5)

Answer 3

No urine - renal failure
Systolic dysfunction - heart failure
Asthma
Indigestion
Dyscrasia - clotting abnormality

Question 4

Contraindications to antihypertensives/side effects (3) and caused by which ones

Answer 4

Hypotension
Bradycardia - CCBs and BBs
Electrolyte disturbance - ACEis and diuretics

Question 5

Side effect - ACE inhibs (1)

Answer 5

Cough

Question 6

Side effect - Calcium channel blockers (2)

Answer 6

Peripheral oedema

Flushing

Question 7

Side effect - Loop diuretics (1)

Answer 7

Gout

Question 8

Side effect - K+ sparing diuretics

Answer 8

Gynaecomastia

Question 9

Which replacement fluid do you give in ascites?

Answer 9

Human Albumin Solution (HAS)

Question 10

Which replacement fluid do you give in hypernatraemia?

Answer 10

5% dextrose

Question 11

Which replacement fluid do you give in hypoglycaemia?

Answer 11

5% dextrose

Question 12

Which replacement fluid do you give in shock not from bleeding, systolic <90mmHg?

Answer 12

Gelofusine (colloid)

Question 13

Which replacement fluid do you give in shock from bleeding?

Answer 13

Blood transfusion

colloid if no blood available

Question 14

How much replacement fluid and over how long do you give in tachycardic patients?

Answer 14

500ml STAT

Question 15

How much replacement fluid and over how long do you give in hypotensive patients?

Answer 15

500ml STAT

Question 16

How much replacement fluid and over how long do you give in only oliguric patients?

Answer 16

1L over 2-4 hours

Question 17

How much maintenance fluid does the typical adult require in 24 hours?

Answer 17

3L

Question 18

How much maintenance fluid do elderly patients require?

Answer 18

2L

Question 19

What is the standard maintenance fluid combination for adults?

Answer 19

1L 0.9% saline
2L 5% dextrose
40mmol KCl

Question 20

How fast should you give KCl?

Answer 20

Never faster than 10mmol/hour

Question 21

Antiemetic given in standard patients?

Answer 21

Cyclizine 50mg 8 hourly

Question 22

Antiemetic given in heart failure patients?

Answer 22

Metoclopramide 10mg 8 hourly

Question 23

Which is the standard concentration of oromorph?

Answer 23

10mg/5ml

Question 24

What is the first line medication for neuropathic pain?

Answer 24

Amitriptyline 10mg NIGHTLY

Question 25

What medicine would you give to people suffering with painful diabetic neuropathy?

Answer 25

Duloxetine

Question 26

Name groups of drugs that cause
Hyperkalaemia (2)
Hypokalaemia (2)

Answer 26

Hyper - ACEinhibs, K+ sparing diuretics

Hypo - Loop, thiazide diuretics

Question 27

Domperidone and Metoclopramide both are dopamine antagonists. Which one is safe to use in PD and why?

Answer 27

Domperidone - doesn’t cross BBB

Question 28

Which group of medications are both methotrexate and trimethoprim and therefore should never be prescribed together?

Answer 28

Folate antagonists

Question 29

Which drug is a direct contraindication to patients on methotrexate?

Answer 29

Trimethoprim

Question 30

Which drug should you not use with beta blockers and why?

Answer 30

Verapamil, bradycardia + hypotension

Question 31

Which patients require 5% dextrose as their replacement fluid?

Answer 31

Hypernatraemics

Hypoglycaemics

Question 32

In which patients would you give metoclopramide rather than cyclizine and why?

Answer 32

Heart failure patients

Can cause fluid retention