MAU

Question 0

Before administering ACEi what blood test(s) should be performed and what else should be monitored

Answer 0

U&Es should be measured then monitored alongside blood pressure.

Question 1

Name 5 renal toxic drugs

Answer 1

ACEi, NSAIDs, lithium, gentamicin and IV contrast

Question 2

Name 3 common anti-emetics and their doses

Answer 2

Cyclizine 50mgTDS
Metaclopramide 10mg TDS
Ondansetron 4-8mg TDS

Question 3

Name 6 strong opioids

Answer 3

Morphine, diamorphine, methadone, pethadine, fentanyl and alphentanyl

Question 4

What’s a typical morphine dose and what should be prescribed alongside if it will be used for sustained periods

Answer 4

PO 5-20mg 4 hourly titrated to control pain
PO slow release 10-30mg 12 hourly
IV 2.5-10mg 4 hourly

Prescribe with a laxative if to use for >24hr

Question 5

Name 3 weak opioids

Answer 5

Codeine
Dihydrocodeine
Tramadol

Question 6

What level of urine output is worrying

Answer 6

0.5mL/kg/hr

Question 7

What is a typical maintenance fluid regimes for a healthy adult?

Answer 7

1x 1L 0.9% saline
2x 1L 5% dextrose with 20mmol KCl

Over 24 hours

Question 8

How is a child’s maintenance fluid regime calculated?

Answer 8

100mL/kg for 10kg
50mL/kg for 10kg
20mL/kg from that point onwards.

For example a 38kg child needs:
10x100 + 10x50 + 18x20
=1000 + 500 + 360
= 1860mL every 24hr

Question 9

What dose of morphine should be prescribed for breakthrough pain compared to maintenance

Answer 9

1/6

Question 10

If I patient is not controlled on regular co-codamol 30/500 at max dose what shuld be used next in pain management

Answer 10

A strong opioid e.g. Morphine with paracetamol

*consider an anti-emetic and laxative

Question 11

What medications are commonly prescribed alongside morphine to control it’s side effects

Answer 11

An anti-emetic e.g. Cyclizine and a laxative e.g. Senna or docusate

Question 12

What would be a typical starting daily dose of morphine for opioid naive patients

Answer 12

20-30mg

Question 13

What would be a typical starting dailiy dose of morphine for patients switching from a weak opioid

Answer 13

40-60mg

Question 14

In morphine titration how much can the dose be increased by

Answer 14

50% of the previous daily dose

Question 15

What is the management of the dopanergic side effect of metaclopramide

Answer 15

Acute dystonic reactions subside within 24 hours of stopping the drug and can be aborted using procyclidine

Question 16

What direct factor X inhibitor can be prescribed in AF. What dose is used and what are a few common side effects

Answer 16

Rivaroxaban 20mg OD with food

Common side effects include nausea and vomiting and haemorrhage

Question 17

What is the management of hyperkalaemia

Answer 17

Stop any sources of Potassium
Put on high flow O2

Get an ECG!
- any changes give 10mL of 10% calcium gluconate
10 units of insulin in 50mL of 50% dextrose
5mg neb salbutamol
Consider calcium resonium

Question 18

What are the criteria for diagnosing SIADH

Answer 18

Concentrated urine >500mosm/kg
Dilute blood 20mmol/L
No recent diuretics
Euvolaemic
Normal thyroid and adrenal gland
 - TSH and short synactin test

Question 19

What dose of morphine is equivalent to 8mg codeine

Answer 19

1mg

Question 20

What is senakot and what is a typical dose

Answer 20

Senna - stimulating laxative

Normal dose 10-20mg ON