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PSA > Medicine > Flashcards

Medicine Flashcards

1
Q

What dies 8.4% sodium aqueous solution mean?

A

8.4g of sodium per 100ml

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2
Q

What does 0.9% saline mean

A

0.9g of sodium in 100ml

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3
Q
  1. Write 1 prescription to lower potassium in hyperkalaemia.

2. Write a prescription to protect the heart in hyperkalaemia

A

1 .date, time… 10UNITS OF ACTRAPID IN 50ml 50% DEXTROSE, IV, OVER 15mins, sign+bleep
2. date, time… 20ml 10% CALCIUM GLUCONATE, IV, OVER 5mins, sign+bleep

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4
Q

general principle of fluids

A

2 sweet, 1 salty.
1L of 0.9% NaCl with 20mmol KCl over 8hrs
1L of 0.9% NaCl with 20mmol KCl over 8hrs
1L of 5% dextrose with 20mmol KCl over 8hrs

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5
Q

When to avoid dextrose

A

head injury e.g. stroke!!!

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6
Q

name some low molecular weight heparins

A

Enoxaparin

Tinzaparin

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7
Q

what to monitor with LMWH

A

platelets

potassium

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8
Q

Max length of time before needing INR check?
what time of day is it usually taken?
what about change in dose?

A
  • 12 weeks.
  • In morning
  • After 2 days
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9
Q

What common drugs are used with caution with warfarin

A

NSAIDs (ibuprofen, aspirin a bit too)

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10
Q

How to monitor the response to treatment of diuretics

A

weight loss

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11
Q

How to monitor the response to treatment of ace inhibitors

A

Exercise tolerance

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12
Q

How to monitor the response to treatment of antibiotics

A

CRP

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13
Q

How to monitor the response to treatment of polymylagia rheumatica

A

ESR

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14
Q

How to monitor the response to treatment of HIV meds

A

HIV RNA levels

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15
Q

Digoxin monitoring

  • levels taken when
  • toxicity Ix
  • risks of toxicity
A

Take 6 hours after last dose.
Toxicity if over 2üg/L
Hypokalaemia increases toxicity risk
Monitor U+E and renal function

If ?toxicity = U+E, digoxin levels and ECGS

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16
Q

sick day insulin for T1 and T2 DM

A

T1DM = Increase quick acting by 10% if BM between 10-13mmol/L
Monitor ketones
T2DM = Increase insulin by 20% if BM between 10-15mmol/L

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17
Q

Prescription of morphine for pain

A

10mg every 4 hours.

18
Q

Rescue opioids for breakthrough pain

A

1/6 to 1/10 of background dose.

19
Q

how much to increase morphine by

A

1/2 to 1/3

20
Q

Meaning of co-codamol 8/500

A

500g paracetamol

8g codeine

21
Q

max paracetamol dose for a day

A

4g

22
Q

How to increase levothyroxine

A

By 25micrograms a change

23
Q

ADR of carbimazole and monitoring

A

FBC as can cause neutropenia and agranulocytosis

24
Q

When to take lithium levels

A

trough = 12 hours after last dose. Can delay morning dose to take sample

25
Q

gentamicin monitoring

A

Peak concentration = sample 1hr after last dose. If this is high (over 10mg’L) REDUCE dose.
Trough concentration = sample taken before administration of next dose. If high (over 2mg/L), INCREASE time between doses.

26
Q

Long term steroids and sick day rules

A

double dose of steroids when acutely unwell.

27
Q

Paracetamol OD.

  • dose which is toxic
  • use of NAC
A
  • > 150mg/kg within 1 hour.
  • Use empirically if presenting after 8hrs of ingestion.
  • Can only use NAC after paracetamol levels after 4hrs of ingestion are known and compared to nomogram.
  • Give if staggered OD (longer than 1hr).
    BNF = Poisoning, emergency treatment
28
Q

BIPHASIC INSULIN REGIME.

  1. HIGH BM before lunch/dinner?
  2. HIGH BM before bed/breakfast
  3. LOW BM before lunch/dinner?
  4. LOW BM before bed/breakfast
A
  1. Increase breakfast dose by 10%
  2. Increase evening meal dose by 10%
  3. Reduce breakfast dose by 10%
  4. Reduce evening meal dose by 10%
29
Q

What reduction in what parameter do you want to see with statin use and what to do if it is wrong?

A 
What to see a 40% REDUCTION in the NON-HDL cholesterol.
If not achieved:
1. check adherence.
2. increase atorvastatin dose
3. consider ezetimibe
30
Q

Monitoring of LFT and creatinine kinase with statins

A
  • LFTs - look at transaminases, if OVER 3X UPPER NORMAL LIMIT, stop!
  • CK - if OVER 5X UPPER NORMAL LIMIT, stop!
31
Q

Man got severe diarrhoea, what should he do with metformin meds?

A

If severe D+V, consider stopping metformin.

32
Q

Adrenaline:

  1. 1 : 10,000 meaning?
  2. 1 : 1000 meaning?
A
  1. 100micrograms/ml –> 1 mg in 10 mL

2. 500micrograms/0.5ml –> 1mg/ml

33
Q

BASAL BOLUS INSULIN:

  1. What time of day will tell you whether their pre-lunch bolus is right?
  2. What time of day will tell you whether their post-breakfast dose is right?
  3. What time of day will tell you whether their evening meal dose is right?
A
  1. Pre-evening meal BM
  2. Pre-lunch
  3. Bedtime
34
Q

Name 5 drugs which increase risk of hyperglycaemia

A

Steroids, anti-psychotics, tacrolismus, beta-blockers, thiazide diuetics.

35
Q

Name 6 drugs which increase risk of raised cholesterol

A 
Systemic steroids
Diuretics (thiazide and loop)
Most antipsychotics
Cyclosporine (and less frequently tacrolimus)
Most HIV medications
SGLT2 inhibitors (-flozins)
36
Q

Drugs to be used in caution in heart failiure

A

Pioglitazone
Verapamil
NSAIDs

37
Q

How many mmol of K in 0.15% and 0.3% KCl?

A
  1. 15% = 20mmol/L

0. 3% = 40mmol/L

38
Q

What to do with the patients insulin regime in DKA

A

Stop short acting
Continue long acting
Start a fixed rate IV insulin infusion.

39
Q

Mx for 1st case and 2nd case of c.diff

A 
1st = Metronidazole
2nd = Vancomycin
40
Q

Good drugs for post-op nausea

A 
Cyclizine (no QT effects)
Ondansetron
Promethazine
Prochlorperazine
BNF treatment summaries = DROPERIDOL but should only be prescribed by specialist for PONV

PSA (5 decks)

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