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PSA > Important Things to Remember > Flashcards

Important Things to Remember Flashcards

1
Q

How long before surgery should the COCP/HRT be stopped?

A

4 weeks

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2
Q

How long before surgery should Lithium be stopped?

A

Day before

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3
Q

How long before surgery should potassium-sparing diuretics be stopped?

A

Day of surgery

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4
Q

How long before surgery should ACE-inhibitors be stopped?

A

Day of surgery

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5
Q

How long before surgery should antiplatelets and anticoagulants be stopped?

A

Variable between hospitals (some continued throughout surgery)

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6
Q

How long before surgery should oral hypoglycaemics and insulin be stopped?

A

Variable
- Metformin stopped due to risk of lactic acidosis
- Insulin and other oral hypoglycaemics will cause hypoglycaemia unless stopped
- Start sliding scale with hourly blood glucose monitoring and adjust insulin accordingly

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7
Q

What are the three common side effects of antihypertensives?

A
  1. Hypotension (ALL - inc. postural hypotension)
  2. Bradycardia (β-blockers + some CCBs)
  3. Electrolyte disturbance (ACE-i + diuretics)
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8
Q

What is the most common side effect of ACE-i?

A

Dry cough

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9
Q

What are the two most common side effects of Β-blockers?

A
  • Wheeze in asthmatics
  • Worsening of acute heart failure (helps with chronic heart failure)
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10
Q

What are the two most common side effects of CCBs?

A
  • Peripheral oedema
  • Flushing
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11
Q

What are the common side effects of diuretics?

A
  • Renal failure (ALL)
  • Gout (thiazide-sparing diuretics)
  • Gynaecomastia (potassium-sparing diuretics)
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12
Q

What are the contraindications to giving saline as a fluid replacement and the alternative fluids given?

A
  • Hypernatraemia/hypoglycaemia (5% dextrose)
  • Ascitic (human-albumin solution (HAS))
  • Shock from bleeding (blood transfusion/crystalloid if blood unavailable)
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13
Q

What is the maximum rate of prescribing IV potassium?

A

10mmol/hour

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14
Q

What are the two contraindications for prescribing metoclopramide?

A
  • Parkinson’s disease (exacerbates symptoms)
  • Young women (dyskinesia - especially acute dystonia)
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15
Q

What is the maximum daily dose of paracetamol?

A

4g daily
- If pt <50kg = 500mg 6-hourly

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16
Q

What are some causes of hypernatraemia?

A

Dehydration
Drips
Drugs
Diabetes Insipidus

17
Q

What are some causes of a prehepatic (isolated rise in bilirubin) jaundice?

A

Haemolysis
Gilbert’s + Crigler-Najjar syndromes

18
Q

What are some causes of an intrahepatic (raised bilirubuin + raised ALT/AST) jaundice?

A

Fatty liver
Hepatitis
Cirrhosis
Malignancy
Metabolic (Wilson’s disease/haemachromatosis)
Heart failure (causing hepatic congestion)

19
Q

What are some causes of a posthepatic/obstructive (raised bilirubin + raised ALP) jaundice?

A

Stones (gallstones)
Drugs causing cholestasis (flucloxacillin, co-amoxiclav, nitrofurantoin, steroids, sulphonylureas)
Cholangiocarcinoma
Primary biliary cirrhosis
Sclerosing cholangitis
Pancreatic/gastric cancer
Lymph node

20
Q

What are the features of Digoxin toxicity?

A

Confusion
Nausea
Visual halos
Arrhythmias

21
Q

What are the features of lithium toxicity?

A

Early: Tremor
Intermediate: Tiredness
Late: Arrhythmias, seizures, coma, renal failure, diabetes insipidus

22
Q

What are the features of phenytoin toxicity?

A

Gum hypertrophy
Ataxia
Nystagmus
Peripheral neuropathy
Teratogenicity

23
Q

What are the features of gentamicin toxicity?

A

Ototoxicity
Nephrotoxicity

24
Q

What are the features of vancomycin toxicity?

A

Ototoxicity
Nephrotoxicity

25
Q

How many mmol of Na in a 0.9% bag of NaCl (1L)?

A

150mmol

26
Q

How many mmol of K in a 0.3% bag of KCl (1L)?

A

40mmol

27
Q

How many mmol of K in a 0.15% bag of KCl (1L)?

A

20mmol

28
Q

How many g of glucose in a bag of 5% glucose (1L)?

A

50g

29
Q

What are the daily water requirements of someone?

A

25-30ml/kg/24hr

30
Q

What are the daily Na + K + Cl requirements of someone?

A

1mmol/kg/24hr

31
Q

What are the daily glucose requirements of someone?

A

50-100g/24hr

PSA (2 decks)

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