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Prescribing Safety Assessment > Pass the PSA > Flashcards

Pass the PSA Flashcards

1
Q

TSH 0.3, what should you do to levothyroxine dose?

A

Decrease it

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2
Q

TSH 5.2, what should you do to levothyroxine dose?

A

Increase it

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3
Q

Cause of secondary hypothyroidism

A

Pituitary damage
Reduced TSH causing reduced TH

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4
Q

Secondary cause of hyperthyroidism

A

Pituitary tumour

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5
Q

1st line treatment of diabetic neuropathy

A

Duloxetine (SNRI)

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6
Q

Treatment of opioid overdose (low RR, drowsy)

A

Naloxone

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7
Q

Which pain killer can lower seizure threshold?

A

Tramadol

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8
Q

Which pain killer is good in renal failure because it isn’t really excreted?

A

Tramadol

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9
Q

Which drug do you give for first-line T2DM in BMI 18, creatinine 172?

A

Sulphonyurea e.g. gliclazide

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10
Q

First-line treatment of focal epilepsy

A

Lamotrigine

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11
Q

1st prescription for hyperkalaemia

A

10U actrapid with 100ml of 20% dextrose over 30 minutes

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12
Q

What interacts with warfarin to increase INR?

A

Erythromycin

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13
Q

Drugs to stop before surgery

A

I LACK OP
Insulin
Lithium
Aspirin
COCP
K+ sparing diuretics
Oral hypoglycaemics
Perinopril (ACEi)

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14
Q

When should you ideally stop COCP before surgery?

A

4-6weeks!

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15
Q

What should you stop in haemoptysis and any bleeding?

A

Anticoagulants e.g. aspirin and enoxaparin

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16
Q

CYP450 inducers

A

PC BRAS
Phenytoin
Carbamazepine
Barbiturates
Rifampicin
Alcohol (chronic excess)
Sulphonyureas

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17
Q

CYP450 inhibitors

A

AODEVICE
Allopurinol
Omeprazole
Dislfiram
Erythromycin
Valproate
Isoniazid
Ciprofloxacin
Ethanol (acute)

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18
Q

When should you stop ACEi and K+ sparing diuretics before surgery?

A

The day of

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19
Q

Causes of hyperkalaemia

A

DREAD
Diuretics (K+ sparing) and ACEi and dalteparin (LMWH)
Renal failure
Endocrine (Addison’s)
Artefact
DKA!

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20
Q

Steroid side effects

A

Stomach ulcers
Thin skin
Edema
Right heart failure
Osteoporosis
Infection
Diabetes!!!!!
Cushing’s syndrome

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21
Q

NSAID contraindications

A

Clotting issues
Heart failure
Asthma
Indigestion
Renal failure

CHAIR

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22
Q

NSAID contraindications

A

Clotting issues
Indigestion
Renal failure
Asthma!
Heart failure

CHAIR

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23
Q

How much paracetamol in 30/500 tablet of co-codamol?

A

500mg

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24
Q

Typical maintenance fluid prescription in healthy individual

A

2 salty 1 sweet
1L bag of dextrose (8hr)
2L saline (8hr each)

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25
Q

Typical prophylactic LMWH for prophylaxis of blood clots in hospital

A

S/C 5000U dalteparin

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26
Q

Drug for nausea in heart failure

A

Metoclopramide

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27
Q

Drug for nausea in a normal patient

A

Cyclizine

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28
Q

Who shouldn’t get metoclopramide?

A

Parkinson’s patients

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29
Q

Drug causes of hypokalaemia

A

Loop diuretics
Thiazide diuretics

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30
Q

Side effects of ACEi

A

Cough
Worsen renal failure
Can trigger renal failure in renal artery stenosis
Hyperkalaemia

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31
Q

Rheumatoid pt on methotrexate, got a UTI and given trimethoprim, what should you do?

A

Stop the methotrexate (current infection)
Change trimethoprim because too much folate antagonism

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32
Q

Furosemide can lead to which electrolyte abnormalities?

A

Hyponatraemia
Hypokalaemia

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33
Q

Drugs to stop in hyperkalaemia

A

ACEi
Thiazide diuretics e.g. eplerone

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34
Q

Drug causes of neutropaenia

A

Clozapine
Carbimazole

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35
Q

Causes of microcytic anaemia

A

Iron deficiency
Thalassaemia
Sideroblastic

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36
Q

Causes of normocytic anaemia

A

Anaemia of chronic disease
Blood loss

37
Q

Causes of macrocytic anaemia

A

Folate deficiency
Alcohol
B12 deficiency

38
Q

Drug cause of HIGH neutrophils

39
Q

Causes of thrombocytopaenia

A

Heparin induced! Always do baseline and post treatment FBC
DIC
HUS
Hypersplenism

40
Q

Causes of SIADH

A

Any serious illness
Head injury
Lung cancer
Anti-psychotics
Carbamazepine (used in schizophrenia)

41
Q

Causes of raised urea

A

Renal failure
Gastric bleed
Chemotherapy

42
Q

Causes of hyponatraemia, hypovolaemia

A

Dehydration
Addisons
Diuretics

43
Q

Causes of hyponatraemia euvolaemia

A

SIADH
Psychogenic polydipsia

44
Q

Causes of hyponatraemia hypervolaemia

A

Renal failure
Heart failure

45
Q

Causes of intrinsic renal failure

A

Pre-renal
Nephrotoxic drugs
Rhabdomyolysis
Contrast

46
Q

Causes of raised ALP

A

Fracture
Paget’s disease
Post-hepatic jaundice

47
Q

How do you calculate rate on ECG?

A

Divide 300 by squares between QRS complexes

48
Q

Cause of sloping ST depression

A

Digoxin toxicity

49
Q

Normal to find T wave inverstion in which leads?

A

V1 and aVR

50
Q

T wave inversion can imply

A

Old infarct
NSTEMI

51
Q

INR target in recurrent thromboembolism

52
Q

What to do if major bleed on warfarin

A

Stop warfarin
10mg Vit K IV
Prothrombin complex

53
Q

Drug to reduce bleeding in surgery

A

Tranexamic acid!

54
Q

How does N-acetylcysteine work?

A

It replenishes glutathione stores to remove toxic metabolites

55
Q

Why should you stop ibuprofen in renal failure?

A

Reduces prostaglandin synthesis so reduces GFR
Can contribute to renal failure

56
Q

Drug causes of agranulocytosis

A

Carbamazepine
Clozapine
Lithium

57
Q

What’s in seratide?

A

LABA and ICS

58
Q

Cut off for doing something about rate in AF

59
Q

Treatment of anaphylaxis

A

ABCDE
IM adrenaline
IV hydrocortisone
IV chlorphenamine

60
Q

Treatment of asthma attack

A

5mg nebulised salbutamol
Nebulised ipratropium bromide

61
Q

Management of stable angina

A

GTN spray
Aspirin, statin
B blocker/CCB
?Long-acting nitrate
RF modification

62
Q

Management of focal seizures

A

Lamotrigine

63
Q

Management of seizures other than focal

A

Sodium valproate

64
Q

Management of T2DM

A
  1. Education and dietary/exercise advice
  2. Cardiovascular RF Mx = consider 75mg aspirin & 20mg simvastatin
  3. Annual review of complications = ophthalmology and albumin:creatinine ratio (indicator of diabetic nephropathy)
  4. Blood glucose lowering therapy if HbA1c > 48mmol after these measures
65
Q

Whats an early indication of diabetic neuropathy?

A

Albumin:creatinine ratio

66
Q

Mx of mild, early parkinsons

A

Ropinerole

67
Q

Mx of flare of rheumatoid?

A

Short course of glucocorticoid

68
Q

How often can you use a salbutamol inhaler each week?

69
Q

What should you do if asthma pt using salbutamol inhaler 6x per week

A

Counsel about usage and add an ICS

70
Q

Signs of congestive heart failure

A

RHF and LHF
RHF = raised JVP and peripheral oedema
LHF = pulmonary oedema

71
Q

What is the treatment dose enoxaparin?

72
Q

What does tamoxifen increase your risk of?

A

PE and DVT
Endometrial cancer

73
Q

HTN Mx drug in pregnancy

74
Q

Side effect of gliclazide

A

Hypoglycaemia

75
Q

Whats the risk of ramipril when you are unwell?

A

Increased risk of AKI
Take precautions when vomiting/ill

76
Q

Unwell on insulin? What should you do with the dose?

A

Increase it

77
Q

What should you do with the rotation site with SC insulin?

A

Rotate it to avoid lipodystrophy

78
Q

Recommendations for alendronic acid

A

Oesophagitis and indigestion
So, take it standing upright for 30 mins
Avoid food for 2 hours after

79
Q

1g = how many mg?

80
Q

What ix should you do before commencing amiodarone?

A

Chest x-ray because pulmonary fibrosis

81
Q

Lithium therapeutic range

82
Q

What should you check before commencing statins?

A

ALT (liver function)

83
Q

What should you check before commencing vancomycin?

A

Creatinine (renal function)

84
Q

What should you check before starting anti-psychotics e.g. olanzapine?

A

Glucose levels (risk of diabetes)

85
Q

What should you measure with carbimazole and general illness?

A

FBC (white cell count)

86
Q

Treatment of infective endocarditis with streptococcus viridans

A

Penicillin and gentamicin

87
Q

Treatment of infective endocarditis with s.aureus

A

Could be fluclox, most likely vancomycin

88
Q

What should you check weekly for 18w for in clozapine treatment?

A

FBC
Risk of agranulocytosis

Prescribing Safety Assessment (27 decks)

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