MFE

Question 1

Example of idiosyncratic effect

Answer 1

BZD causing memory loss

rare and unpredictable

Question 2

Prostate cancer + back pain - which type of scan

Answer 2

Techneitum bone scan

Question 3

Becks cognitive triad

Answer 3

Worthless self
World is unfair
Future is hopeless

Question 4

avoid with wafarin

Answer 4

leafy green veg
broccoli
cranberry
clarithromycin

Question 5

antiemetic for motility disorder

Answer 5

metoclopramide

domperidone in parkinsons (doesn’t cross BBB)

Question 6

antiemetic if multiple causes or inappropriate to Ix the cause

Answer 6

levopromazine

Question 7

antiemetic for metabolic cause/drug cause when you cant stop the drug

Answer 7

Da receptor antagonist - haloperidol

Question 8

antiemetic for raised ICP/motion disorders

Answer 8

anticholinergic - cyclizine

Question 9

which antiemetics are constipating

Answer 9

ondanseteron
cyclizine
buscopan
“Ouch Constipated Bum”

Question 10

Buscopan relieves ?

Answer 10

stomach cramps

Question 11

Management of incomplete bowel obstruction

Answer 11

prokinetic - metaclopromide
laxido for constipation
steroids to reduce peritumoral oedema

Question 12

management of complete bowel obstruction

Answer 12

stop prokinetic and antiemetic
stop steroid if not working
buscopan for stomach cramps
octreotide to dry up secretions

Question 13

gabapentin side effects

Answer 13

dizziness
confusion
visual disturbance
fatigue

Question 14

pain ladder

Answer 14

1. non opioid
2. • weak opioid e..g codeine/dihydrocodeine
3. strong opioid e.g. morphine
   adjuvants - antidepressants, antiepileptics, steroids

Question 15

when should fentanyl family be used first line

Answer 15

eGFR < 30

Question 16

breakthrough dose

Answer 16

1/6 total daily dose

Question 17

100mg codeine - how much morphine

Answer 17

10mg

Question 18

Anticipatory prescribing

Answer 18

Opiate - 1/6 of normal or 2mg if opiate naïve
(MST) (oxycodone or fentanyl if renal compromise)
Levomepromazine
Buscopan
Midazolam

Question 19

oral morphine to syringe driver

Answer 19

1/2 dose

Question 20

donezepil + atenolol ->

Answer 20

bradycardia

Question 21

what is first order elimination

Answer 21

rate of elimination is proportional to rate of admin&raquo_space; adapts to conc in body

Question 22

What are the 4 aspects of appropriate polypharmacy

Answer 22

all drugs have a therapeutic objective
therapeutic objectives are being achieved/likely will be
optimized to reduce risk of adverse reaction
patient is engaged and motivated to take it

Question 23

domperidone assoc with s/e in which body system

Answer 23

cardiac

Question 24

buccal antiemetic used in community

Answer 24

prochloperazine

Question 25

drugs most commonly implicated in delirium

Answer 25

psychotropics - sedatives, antipsychotics, antidepressants drugs with anticholinergic activity - digoxin, furosemide, oxybutynin, codeine

Question 26

how many hyperthyroidism present in elderly

Answer 26

``` apathy tiredness muscle weakness loss of appetite weight loss HF due to AF macrocytic anaemia ```

Question 27

Drugs that cause tremor

Answer 27

caffeine lithium cyclosporine neuroleptics

Question 28

antiemetic of choice parkinsons

Answer 28

domperidone

Question 29

when should a patient be dosed for IV paracetamol according to body weight

Answer 29

if < 50kg | - dose is 15mg/kg QDS (max 60mg/kg/day)

Question 30

How does coeliac disease often present in the elderly?

Answer 30

iron deficiency anaemia

Question 31

By which mechanism do amlodipine, perindopril and Tamsulosin cause hypotension?

Answer 31

vasodilatation

Question 32

how can digoxin cause hypotension

Answer 32

block AV conduction | bradycardia

Question 33

Drugs that can cause hyponatraemia

Answer 33

diuretics SSRIs NSAIDs ACEI

Question 34

antidepressant class assoc with increased bleeding risk

Answer 34

SSRI

Question 35

BB + ? > risk of heart block

Answer 35

verapamil

Question 36

Tripple whammy

Answer 36

ACEI NSAID Diuretic