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PSA > Core Facts > Flashcards

Core Facts Flashcards

1
Q

When should prophylactic heparin not be administered?

A
  1. Bleeding
  2. Ischaemic stroke (risk of bleeding into stroke)
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2
Q

What is the maximum rate of infusion for potassium?

A

10mmol per hour

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3
Q

Which drug class may cause peripheral oedema?

A

CCBs

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4
Q

Which drugs may cause hyponatraemia?

A

All diuretics

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5
Q

Which drug class may cause hyperkalaemia?

A

ACEi

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6
Q

Which drug class may cause hypokalaemia?

A

Thiazide-like and loop diuretics

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7
Q

Which drugs may cause agranulocytosis and neutropenia?

A

Antipsychotics and carbimazole

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8
Q

Which drugs are used in acute and chronic HF?

A

Acute: furosemide
Chronic: ACEi

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9
Q

Give the management for hyperkalaemia

A
  1. Calcium gluconate (if ECG changes)
  2. Fast acting (soluble) insulin 100 units in 100ml 20% dextrose IV over 30 minutes
  3. Salbutamol nebuliser
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10
Q

Give the enzyme inducers

A

P - phenytoin
C - carbamazepine
B - barbiturates
R - rifampicin
A - alcohol (chronic excess)
S - sulfonylureas (e.g. glipizide)

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11
Q

Give the enzyme inhibitors

A

A - allopurinol
O - omeprazole
D - disulfiram
E - erythromycin
V - valproates
I - isoniazid
C - ciprofloxacin
E - ethanol (acute intoxication)
S - sulphonamidea

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12
Q

Which drugs should be stopped prior to surgery?

A

I LACK OP

I - insulin (switched to variable rate if needed)
L - lithium (day before)
A - anticoagulants/antiplatelets
C - COCP/HRT (4 weeks before surgery)
K - K+ sparing diuretics (day of)
O - oral hypoglycaemics
P - perindopril and other ACEi (day of)

Metformin must be stopped due to risk of lactic acidosis.

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13
Q

Which drugs must not be stopped prior to surgery?

A

Steroids

Patients on long term steroids may have adrenal atrophy and therefore be unable to mount an adequate stress response (resulting in profound hypotension)

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14
Q

What are the side effects of steroids?

A

Stomach ulcers
Thin skin
oEdema
Right and left heart failure
Osteoporosis
Infection (incl. candida)
Diabetes (hyperglycaemia)
cushing’s Syndrome

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15
Q

What are the side effects of NSAIDs?

A

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

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16
Q

Describe fluid replacement in adults

A

500ml bolus (250ml if retaining) in 10 mins

If oliguric (not due to obstruction) give 1L over 2-4 hours

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17
Q

How much maintenance fluid do adults need per day?

A

3L (2L in the elderly)

Usually NaCl and 5% dextrose combination

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18
Q

How much potassium do adults need per day?

A

40mmol

19
Q

Describe fluid maintenance in children

A

0-10kg: 100ml per kilo
10-20kg: 50ml per kilo
20+kg: 20ml per kilo

20
Q

Describe fluid replacement in children

A

Deficit (mL) = %dehydration x weight (kg) x 10

%dehydration = ((well weight-current weight)/well weight)x100

21
Q

Describe the management of hypoglycaemia

A

Conscious: oral glucose

Unconscious: 200ml IV glucose 20% over 15 minutes

22
Q

Which antiemetics should be used post-operatively?

A
  1. Cyclizine
  2. Ondansetron
23
Q

Which antiemetic should be given in gastroparesis?

A

Metoclopramide - prokinetic

24
Q

Which antiemetic should be given in vertigo?

A

Prochlorperazine

25
Q

Which antiemetic should be given in palliative care?

A

Haloperidol

26
Q

Which drug should be used to treat drug-induced extra-pyramidal side effects?

A

Procyclidine hydrochloride

27
Q

Which drugs must be stopped in AKI due to the risk of worsening?

A

NSAIDs
ACEi
Diuretics
Aminoglucosides (e.g. gentamicin)
ARBs

28
Q

Which drugs may need to be stopped in AKI due to increased risk of toxicity?

A

Digoxin
Lithium
Metformin

29
Q

Which drugs cause hypernatraemia?

A

Effervescent tablets

30
Q

What are the features of digoxin toxicity?

A

Confusion
Nausea
Visual halos
Arrhythmias

31
Q

What are the features of lithium toxicity?

A

Early: tremor

Intermediate: tiredness

Late: arrhythmias, seizure, coma, renal failure, dabetes insipidus

32
Q

What are the features of phenytoin toxicity?

A

Gum hypertrophy
Ataxia
Nystagmus
Peripheral neuropathy

33
Q

What are the features of gentamicin and vacomycin toxicity?

A

Nephrotoxicity
Ototoxicity

34
Q

Give the management of tachycardia

A

Beta blocker or diltiazem

Adenosine

(Use digoxin or amiodarone if in heart failure)

(Give DC shock and amiodarone if dverse effects such as shock)

35
Q

Give the management of anaphylaxis

A
  1. 15L O2 non-rebreathe
  2. Adrenaline (500mcg of 1:1000 IM)
  3. Chlorphenamine
  4. Hydropcortisone
36
Q

Give the management of acute asthma exacerbations

A
  1. 15L O2 non-rebreathe
  2. Salbutamol nebuliser
  3. Hydrocortisone (PO or IV)
  4. Ipratropium nebuliser
  5. Aminophylline (if life-threatening)
37
Q

Give the management of acute COPD exacerbations

A
  1. 15L O2 non-rebreathe
  2. Salbutamol nebuliser
  3. Hydrocortisone (PO or IV)
  4. Ipratropium nebuliser
  5. Aminophylline (if life-threatening)

+Abx if infective cause

38
Q

Give the management of chronic heart failure

A
  1. ACEi
  2. Beta blocker
39
Q

Give the management of COPD maintenance

A
  1. Smoking cessation
  2. SABA/SAMA (e.g. salbutamol/ipratropium)
    • LABA/LAMA (e.g. salmeterol/tiotropium)
    • ICS (e.g. beclometasone)
40
Q

Give the management of asthma maintenance

A
  1. SABA (e.g. salbutamol)
    • ICS (e.g. beclometasone)
    • LABA (e.g. salmeterol)
  4. +LTRA (e.g. montelukast)
41
Q

Give the management of AF

A
  1. Stroke prevention (e.g. DOAC)
  2. Rhythm control - cardioversion/amiodarone (must be within 48 hours of onset)
  3. Rate control - beta blocker/diltiazem (may use digoxin if other methods fail)
42
Q

Which laxatives should be used when?

A

Impaction - docusate sodium (softener)

Reduced motility - Senna (stimulant)

Other - lactulose (osmotic)

43
Q

When should metformin not be used?

A

Not overweight

Creatinine > 150

(use gliclazide instead)

PSA (2 decks)

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