exemplify review sessions 9+

Question 1

Features of adult patient presenting with severe acute asthma

Answer 1

unable to complete sentences
Pulse greater than 110bpm
Resp rate greater than 25/min
Peak flow 33-50% of best or predicted

Question 2

Is naloxone used to treat opioid addiction

Answer 2

no it is used for overdose- triggers severe withdrawal effects

Question 3

Loperamide does what

Answer 3

decreases peristalsis, increases segmental contractions (allows more transit time for fluid to be removed from faeces)

Question 4

describe the action of histamine antagonists

Answer 4

ranitidine - competitively inhibit H2 receptors in gastric parietal cells

Question 5

lactulose and macrogols

Answer 5

both osmotic laxatives

lactulose: draws fluid into bowels
Macrogols: limit loss of fluid from stool

Question 6

hyoscine hydrobromide acts

Answer 6

competitively

Question 7

How does methotrexate work

Answer 7

Dihydrofolate reductase inhibition

Question 8

3 facts about LMWH

Answer 8

Require less monitoring than UFH

Less likely to cause heparin induced thrombocytopenia

Risk of osteoporosis is smaller

Question 9

What is the antidote for unfractionated heparin

Answer 9

Protamine sulphate

Question 10

Which anticoag is most appropriate for an A Fib patient with renal failure to minimise risk of stroke

Answer 10

Warfarin

(Not Apixaban or Dabigatran as they are contraindicated in severe renal impairment)

Question 11

Which antihypertensive drug is least likely to exacerbate hyperkalaemia in a patient on heparin

Answer 11

Amlodipine (CCB)

Heparin inhibits aldosterone action so spironolactone and ramipril which inhibit aldosterone would increase risk of hyperkalaemia

Question 12

Patient specific pieces of information needed before starting chemotherapy

Answer 12

BMI
Liver function
Renal function
Performance status