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PSA > General > Flashcards

General Flashcards

1
Q

How answer questions relating to paracetamol OD

A

Is chart on BNF for paracetamol levels

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2
Q

How access table to convert opioids

A

Type in prescribing in palliative care

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3
Q

How calculate PRN/breathrough analgesia

A

1/6th of 24 hour dose

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4
Q

How manage a rise in glucose if T1DM using insulin and have to go on course of corticosteroids

A

Increase units by 10%

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5
Q

Interpreting gentamicin nomogram

A
  • where plot is, that section determines the further dosing rate (below q24 hour line= redose in 24 hour intervals)
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6
Q

What do if on gentamicin nomogram, plot is on line between section

A

Use the longer interval above

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7
Q

What do if on gentamicin nomogram, plot is above the 48 hour section

A

Stop gentamicin and redraw levels in a few hours

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8
Q

What do if with gentamicin nomogram it is before 6 hours

A

Redraw later when can actually plot on graph

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9
Q

When have to taper steroid doses

A

Over 40mg prednisolone for 1 week
Received over 3 weeks treatment of any dose
Received lots of repeated courses recently

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10
Q

Oral to liquid morphine

A

Same

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11
Q

How to find out what concentration a drug is available at

A

Look at medicinal form

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12
Q

When it comes to gentamicin monitoring, what are peak and trough levels

A

Peak is taken within 1 hour of levels
Trough is taken just before next administration

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13
Q

What is normal peak and trough ranges for gentamicin monitoring

A

Peak- 5-7
Trough- under 1

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14
Q

What do if peak levels are too high for gentamicin monitoring

A

Reduce dose

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15
Q

What do if trough levels are too high in gentamicin monitoring

A

Increase interval between doses

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16
Q

What do if someone has a HbA1c of under 48 and on metformin

A

Do nothing

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17
Q

Anti-emetic if QT prolongation

A

Cyclizine 50mg

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18
Q

Person on morphine develops AKI what do

A

Switch to oxycodone

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19
Q

Develop thyrotoxicosis on amiodarone what is immediate management

A

Stop

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20
Q

When communicating information what need to consider if 2 answers are true

A

Medical history- is a side effect relevant to their condition

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21
Q

When searching for ferrous sulphate in interactions what search for

A

Iron

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22
Q

When doing data interpretation based off serum drug levels what need to consider

A

If on max dose?
What is their renal function and does BNF have dose adjustments for this?

23
Q

If theophylline/aminophylline monitoring question in community, what does it mean if they have been admitted with vomiting and confusion

A

Toxicity so withhold

24
Q

Side effect of pioglitazone relating to glucose

A

Is low

25
Q

When check ketones in T1DM when ill

A

If BM over 15

26
Q

Sick day rules for T1DM

A

If N&V means can not drink fluids then go to hospital straight away
Continue normal isulin
Take BM more often

27
Q

If have changed night-time insulin, what is best monitoring option

A

Pre breakfast glucose

28
Q

When may not stop aspirin during surgery

A

If patient has angina with recent stroke, MI or has coronary stent

29
Q

What may be done with DOAC perioperatively

A

Normally stopped 48 hours before but decision may be made to switch to UFH

30
Q

Which drugs need to be stopped pre surgery

A

DOAC- 48 hours before
Warfarin- 5 days before
Antiplatelets- 5 days before
Lithium- 24 hours before
COCP and HRT- 4 weeks before
MAOi- potentially depends on anaesthesia being use
Spironolactone- morning of op
ACEi/ARB- 24 hours before
NSAIDs- 1 week before

31
Q

If haemoptysis what drugs need to stop

A

Any antiplatelet or anticoagulant

32
Q

When are NSAIDs CI

A

Renal impairment
LVF
Clotting derangement
GORD etc
Asthma

33
Q

If ascites what fluid give

A

Human albumin solution

34
Q

Bolus give if HF

A

250ml NaCl

35
Q

Fluids to give if oligouric

A

NaCl 1L over 2-4 hours

36
Q

In adult weighing over 100kg, how long give maintenance fluids over

A

8 hours

37
Q

What do with methotrexate in active infection

A

Withold

38
Q

If acute stroke, what do with VTE prophylaxis

A

Do not give under any circumstances

39
Q

If oedema on CCB and been given furosemide what need to do

A

Stop furosemide

40
Q

Acute MI, what is best pain relief

A

GNT spray

41
Q

How monitor response to addisons tx

A

WEIGHT

42
Q

When looking at dose what 3 things need to tick off each time

A

Dose- think about weight
Frequency- is it divided?
Administration route

43
Q

What can do with insulin if not responding to DKA

A

Increase by 1 unit/ hour

44
Q

First line emollient for dermatitis like rash

A

Liquid paraffin ointment
Topical
As required

45
Q

Dermatitis rash on face, trialled emollient

A

Hydrocortisone 1%
Avoid potent ones on face

46
Q

Extensive dermatitis rash on chest what use

A

Potent topical corticosteroid- betamethasone valerate 0.025%

47
Q

What do for emergency contraception if taking P450 inducer

A

Double dose

48
Q

Monitoring LMWH vs UFH

A

UFH- aPTT
LMWH- factor Xa activity if renal impairment

49
Q

Post op how step down opioids

A

Works in reverse WHO pain ladder
If well controlled on regular opioids and not using PRN then can either switch to only PRN or weak opioid

50
Q

P450 inducers

A

antiepileptics: phenytoin, carbamazepine
barbiturates: phenobarbitone
rifampicin
St John’s Wort
chronic alcohol intake
griseofulvin
smoking

51
Q

P450 inhibitors

A

antibiotics: ciprofloxacin, erythromycin
isoniazid
cimetidine,omeprazole
amiodarone
allopurinol
imidazoles: ketoconazole, fluconazole
SSRIs: fluoxetine, sertraline
ritonavir
sodium valproate
acute alcohol intake

52
Q

DKA fluids in kids: shock vs not shocked

A

Shock- 10ml/kg over 10 minutes
Non- shock- 10ml/kg over 30 minutes

53
Q

How monitor response to antibiotics for pneumonia

A

RR

54
Q
A

PSA (8 decks)

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