OSCE Management Flashcards

1
Q

O2 concentrations in COPD

A

24-28%

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2
Q

Fluid challenge =

A

500ml IV saline

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3
Q

Management of ICP in brain tumours

A

10m dexamethasone oral

0.25-0.5g/kg mannitol IV

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4
Q

Management of Anaphylaxis

A

Adrenaline 0.5mg 1:1000 IM
Hydrocortisone 200mg IV
Chlorphenamine 10mg IV

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5
Q

Management of Bradycardia

A

= atropine 500micrograms IV

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6
Q

Management of Tachycardia - SVT

A

Try vagal manoeuvres
Medical = adenosine 6mg IV
Can give up to 3 times

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7
Q

Management of Tachycardia - Broad

A

Amiodarone 300mg IV

If unstable use DC cardioversion

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8
Q

Cardiac Arrest =

A

10ml (100mcg/ml) 1:10000 adrenaline

300mg amiodarone IV

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9
Q

Opioid overdose =

A

400 micrograms of naloxone

Need to titrate if have taken a toxic dose

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10
Q

Benzodiazepine overdose =

A

200 micrograms flumazenil

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11
Q

Medication in delirium =

A

0.5-5mg haloperidol

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12
Q

Management of ACS (6)

A
GTN - 2 puffs every 5 minutes
Aspirin 300mg oral 
Clopidogrel 300mg oral OR Prasugrel 60mg (depends on whether already on anti-coagulant)  
Morphine 5-10mg IV 
Metoclopramide 5-10mg IV 
High flow oxygen
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13
Q

Prevention of ACS (4)

A

Aspirin 75mg oral
Clopidogrel 75mg oral
Atorvostatin 40mg oral
Anti-Hypertensives

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14
Q

Starting Dose:

  • Amlodipine
  • Lisinopril
  • Ramipril
A
Amlodipine = 5mg 
Lisinopril = 10mg 
Ramipril = 2.5mg
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15
Q

Management of Torsades de Pointes

A

IV Magnesium sulphate 2g

+ pacing

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16
Q

Management of Chronic Heart Failure (3)

A

Furosemide 20-40mg oral OD
ACE-i e.g. lisinopril 10mg or ramipril 2.5mg (starting dose)
Bisoprolol 1.25mg oral

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17
Q

Management of Acute Heart Failure (5)

A
Sit them up 
100% oxygen 
IV furosemide 40-80mg 
Consider: 
IV Morphine 5-10mg 
IV Nitrates
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18
Q

Treatment of DVT (2 options)

A

Apixaban 10mg BD 7 days
(maintenance = 5mg BD)

OR

Rivaroxaban 15mg BD 21 days
(maintenance = 20mg OD)

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19
Q

1st Line in T2DM

A

= metformin 500mg OD

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20
Q

Insulin in DKA

A

0.1 units/kg/hour of insulin

Given in an IV infusion

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21
Q

Management of Thyroid Storm (3)

A

Propranolol 40mg PO
Hydrocortisone 100mg IV
Carbimazole 15-25mg PO

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22
Q

Anti-Emetic in Vertigo

A

Cyclizine 50mg up to TDS

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23
Q

Management of GORD (2 options)

A

Omeprazole 20mg OD

Lansoprazole 15mg OD

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24
Q

Medication given in Varices

A

Terlipressin 2mg IV over 5 minutes

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25
Q

Medication given in suspected Peptic Ulcer Disease

A

Omeprazole 80mg IV

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26
Q

Management of Hyperkalaemia (3)

A

10mls of 10% calcium gluconate IV
10 units of insulin in 50ml of 50% glucose
5mg salbutamol NEB

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27
Q

Management of Hypokalaemia

A

40mmol IV potassium

- Rate shouldn’t exceed 10mmol/hour

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28
Q

Codeine Dosing

A

= 30-60mg 4 hourly

Maximum dose up to 240mg

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29
Q

Tramadol to Morphine Conversion

A

Divide by 10

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30
Q

Oral Morphine to S/C or IV

A

Divide by 2

31
Q

Neonatal Sepsis Abx

A

Benzylpenicillin + Gentamicin

32
Q

Prevention of Haemorrhagic Disease of the Newborn

A

= vitamin K injection at birth - can have later if they decline at birth

33
Q

Management of levodopa associated nausea

A

Domperidone

= dopamine antagonist

34
Q

Management of Status Epilepticus

A

IV Lorazepam 4mg

Can give up to 2 times

35
Q

Standard Management of Meningitis

A

Ceftriaxone IV 2g BD

Dexamethasone 10mg QDS

36
Q

Management of Encephalitis

A

IV Aciclovir 10mg/kg TDS

37
Q

1st Choice Management Migraine Prophylaxis

A

Propranolol 80mg
OR
Amitriptyline 10-25mg

38
Q

2nd Choice Management Migraine Prophylaxis

A

Topiramate

39
Q

Medical Management of Cluster Headache

A

Sumatriptan 6mg S/C

40
Q

Prophylaxis of Cluster Headache

A

Verapamil 240mg in 3-4 doses

41
Q

Management of TIA

A

300mg aspirin + PPI

42
Q

Management of Ischaemic Stroke <4.5 hours

A

Alteplase 15mg IV
Aspirin 300mg PO
PPI

43
Q

Post-Ischaemic Stroke or TIA Management

1st Choice

A

Clopidogrel 75mg daily

Atorvostatin 80mg daily

44
Q

Post-Ischaemic Stroke or TIA Management

2nd Choice

A

Dipyridamole 200mg BD

Atorvostatin 80mg daily

45
Q

Post-Embolic Stroke Management

A

Start warfarin

MUST BE >14 DAYS SINCE STROKE

46
Q

Management of Malignant Spinal Cord Compression

A

Dexamethasone 16mg IV

Then 8mg BD oral

47
Q

Management of Premature Rupture of the Membranes

A

Erythromycin 250mg QDS

Given as an infusion

48
Q

Management of PPH

1st Choice

A

5 units IV syntocinon

0.5 micrograms ergometrine IV

49
Q

Management of PPH

2nd Choice

A

Carboprost 0.25mg
Misoprostol 0.25mg IM
Tranexamic acid 1g IV

50
Q

Management of HTN in Pregnancy (2 options)

A

Labetalol 100mg BD

OR

Methyldopa 250mg BD

51
Q

PET Prophylaxis

A

Aspirin 75mg oral

From week 12 of pregnancy

52
Q

Management of Eclamptic Seizures

A

MgSO4 4g in 5 minutes IV = loading dose

1g over an hour

53
Q

2nd Line in Management of Eclamptic Seizures

A

10mg Diazepam

54
Q

Management of Septic Arthritis

A

Flucloxacillin 2g QDS IV

Get for two weeks

55
Q

Prophylaxis of Joint Infection

Surgery

A

Cefuroxime 1.5g IV

Once off dose

56
Q

Management of Osteomyelitis

  • Acute
  • Chronic
A
Acute = flucloxacillin IV 2g QDS 
Chronic = debridement and doxycycline PO
57
Q

Rapid Sedation

No previous use of anti-psychotics

A
  1. Oral lorazepam 1-2mg

2. IM Lorazepam 1-2mg up to 2 doses

58
Q

Rapid Sedation

Anti-psychotic use

A
  1. Oral lorazepam 1-2mg +/- 5mg haloperidol oral

2. IM Lorazepam 1-2mg up to 2 doses

59
Q

Management of Croup

  • All
  • Moderate to Severe Croup
A

All = dexamethasone 0.15mg/kg for 1 dose

Moderate/Severe = adrenaline nebuliser 5ml of 1:1000 and oxygen

60
Q

Management of epiglottitis

A

Ceftriaxone IV

61
Q

Management of CAP in Kids

Non Severe

A

<1 co-amoxiclav
>1 amoxicillin
= oral courses for 5 days

62
Q

Management of CAP in Kids

Severe

A

Co-amoxiclav
= IV then oral course for 7 days
Same as management of hospital acquired pneumonia

63
Q

Management of Acute Wheeze in Children (4)

A
Salbutamol 10 puffs 
Nebulisers - combination 
- Salbutamol 2.5-5mg 
- Ipratropium 0.25mg 
Prednisolone 
- 20mg in 2-4 years 
- 40mg in >5 years 
Magnesium sulphate 2.5mls
64
Q

Prednisolone Doses in Acute Wheeze in Children

A
2-4 = 20mg 
>5 = 40mg
65
Q

Steroid Strengths

A
Equivalent doses in order of increasing strength 
LEAST
20mg hydrocortisone 
4mg methylprednisolone 
5mg prednisolone 
0.75mg dexamethasone 
MOST
66
Q

Management of Acute Asthma Attack (6)

A
Oxygen 100% high flow 
Salbutamol 5mg NEB
Ipratropium 2.5mg NEB
Hydrocortisone 100mg IV 
Magnesium sulphate 1.2-2g over 20 minutes 
Call anaesthetist
67
Q

Alternative steroid in acute asthma attack if no IV access

A

Prednisolone 40mg PO

68
Q

Management of Acute Exacerbation of COPD (4)

A
O2 venturi
Salbutamol and Ipratropium (combination nebs) 0.5-2.5mg 
Steroid 
- Hydrocortisone 200mg IV 
OR 
- Prednisolone 30-40mg PO 
Amoxicillin 500mg TDS
69
Q

Chronic Management of Gout

A
1st = allopurinol 100mg OD PO 
2nd = febuxostat 80mg OD PO
70
Q

Management of Chlamydia

A

1g Azithromycin

71
Q

Management of Gonorrhoea

A

500mg IM Ceftriaxone

1g Azithromycin

72
Q

Management of Trichomonas

A

500mg metronidazole BD

73
Q

Management of Syphilis

A

2.4 MU benzathine penicillin IM