Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Alice's finals cards > Pass the PSA book notes > Flashcards

Pass the PSA book notes Flashcards

1
Q

Which common drugs are enzyme inducers?

A

PC BRAS:
Phenytoin
Carbamazepine
Barbituates
Rifampacin
Alcohol
Sulphonylureas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which common drugs are enzyme inhibitors?

A

AO DEVICES:
Allopurinol
Omeprazole
Disulfiram
Erythromycin
Valporate
Isoniazid
Ciprofloxacin
Ethanol
Sulphonamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which common drugs should be stopped before surgery?

A

I LACK OP

Insulin
Lithium
Anticoagulants
COCP/ HRT
K-sparing diuretics
Oral hypoglycaemics
Perindopril and other ACE-i

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the rules regarding long term steroid therapy and surgery?

A

Patients on long term steroid therapy often have adrenal atrophy so therefore are unable to mount the physiological stress response to surgery leading to hypotension

Steroid dose should be doubled (as with ‘sick day rules’). At induction, patients should be given IV steroids to prevent hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What happens if warfarin and erythromycin are taken together?

A

Erythromycin is an enzyme inhibitor -> increased levels of warfarin -> increased INR -> increased bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the common side effects of steroids?

A

STEROIDS

Stomach ulcers
Thick skin
Edema
Right and left heart heart failure
Osteoporosis
Infection
Diabetes
Syndrome (of Cushing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the common side effects of NSAIDs?

A

NSAID

No urine (renal failure)
Systolic dysfunction (heart failure)
Asthma exacerbation
Indigestion (stomach ulcers)
Dyscrasia (clotting abnormality)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the common side effects of ACE-i?

A

Dry cough
Hypotension
Hyperkalaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the common side effects of beta-blockers?

A

Wheeze in asthmatics
Bradycardia
Hypotension
Worsening of acute heart failure (but helps chronic HF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the common side effects of CCBs?

A

Hypotension
Bradycardia
Peripheral oedema
Flushing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When should a patient be prescribed an alternative to 0.9% saline? (3 reasons)

A
  1. If they are hypernatraemic or hypoglycaemic (when 5% dextrose should be given instead)
  2. If they have ascites. Human albumin solution (HAS) should be given instead
  3. If shocked from bleeding- a crystalloid such as blood should be given instead. If none available, do not delay and administer a bolus of saline anyway.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the maximum rate at which IV K+ should be given?

A

10mmol/ hour (can be given higher by the pros)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How much fluid should be prescribed in someone who is tachycardic or hypotensive?

A

500ml bolus immediately (250ml if HF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How much fluid should be prescribed in someone who is oligouric (not due to obstruction)?

A

1L over 2 hours and then assess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the general rules regarding maintenance fluids?

A

An adult needs 3L of fluid a day, the elderly require 2L

2 sweet, 1 salty

1mmol/kg/day of K+, Na+, Cl-
50-100g of glucose/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which antiemetic should be avoided in parkinsons disease?

A

Metoclopramide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the 3 first line treatments for neuropathic pain?

A

Amitriptyline
Pregablin
Duloxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

3 causes for hypernatraemia?

A

3 Ds
Dehydration
Diabetes insipidus
Drugs- effervescent tablet preparations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Causes of microcytic anaemia?

A

Iron deficiency
Thalassaemia
Sideroblastic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Causes of normocytic anaemia?

A

Anaemia of chronic disease
Acute blood loss
Haemolytic anaemia
Renal failure (chronic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Causes of macrocytic anaemia?

A

B12 folate deficiency
Excess alcohol
Liver disease
Hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What drugs can cause hypokalaemia

A
  • laxatives
  • glucocorticoids
  • insulin
  • loop diuretics
  • salbutamol
  • gentamicin
  • thiazide and loop diuretics
  • theophylline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Other non-drug Causes of hypokalaemia?

A

Inadequate intake/ intestinal loss (diarrhoea/ vomiting)
Renal tubular acidosis
Endocrine (cushings, conns)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Drug causes of hyperkalaemia

A
  • ACEi
  • Digoxin overdose
  • ARBs
  • Heparin
  • NSAIDs
  • Penicillins
  • K-sparing diuretics
  • potassium supplementation
  • Trimethoprim
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Other non-drug Causes of hyperkalaemia?
Renal failure Endocrine Artefact (clotted) DKA
26
What are the causes for raised Alk phos?
ALK PPHOS Any fracture Liver damage Kancer Pagets disease of bone Pregnancy Hyperparathyroidism Osteomalacia Surgery
27
Which projection of X-ray means that you are unable to comment of the size of the heart?
AP
28
How do you assess the rotation of an Xray?
If the distances between the spinous processes and clavicles are equal on both sides then there is no rotation
29
How do you tell if there is adequate inspiration on a chest x-ray?
If the 7th anterior rib transects the diaphragm then there is adequate inspiration
30
Which sign is seen in left lower lobe collapse on CXR?
Triangle behind the heart (sail sign)
31
What can be seen on an ECG in pericarditis?
Widespread concave ST elevation and PR depression throughout most of the limb leads (I, II, III, aVL, aVF) and precordial leads (V2-6)
32
What actions would you take if a patient on warfarin has an INR of 5-8?
If no bleeding, omit warfarin for 2 days then reduce dose If bleeding then omit warfarin and give 1-5mg of vitamin K
33
What actions would you take if a patient on warfarin has an INR of >8?
Omit warfarin and give 1-5mg of vitamin K
34
What is the acute management of STEMI?
A-E 300mg aspirin Morphine 5-10mg with cyclizine 50mg IV GTN Primary PCI Beta blocker
35
What is the acute management on NSTEMI?
A-E 300mg aspirin Morphine 5-10mg with cyclizine 50mg IV GTN Clopidogrel 300mg and LMWH/ fondaparinux Beta blocker
36
What is the acute management of acute left ventricular failure?
A-E Sit patient up Morphine 5-10mg with cyclizine 50mg IV GTN Furosemide 40-80mg IV (repeat) Isosorbide dinitrate infusion +CPAP
37
What is the acute management and likely cause of narrow irregular QRS on ECG?
Probable AF Control rate with beta blocker or diltiazem Consider digoxin or amiodarone if evidence of heart failure
38
What is the acute management and likely cause of narrow regular QRS on ECG?
SVT Use vagal manoeuvres Adenosine 6mg rapid IV bolus, if unsucessful give further 12mg
39
What is the acute management and likely cause of broad regular QRS on ECG?
Ventricular tachycardia Amiodarone 300mg IV over 20-60 mins. Then 900mg over 24 hours
40
What is the acute management and likely cause of polymorphic VT on ECG?
Toursades de point magnesium 2g over 10 mins
41
What is the acute management of anaphylaxis?
ABC, 15L o2 Adrenaline 500mg 1:1000 IM once stabilised: Chlorphenamine 10mg IV Hydrocortisone 200mg IV
42
What is the acute management of an asthma attack?
100% O2 Salbutamol 5mg neb Hydrocortisone 100mg IV if severe, prednisolone 40-50mg oral if moderate Ipratropium 500mg neb Aminophylline if life threatening
43
What are the CURB65 criteria?
Confusion Urea >7.5mmol/L Resp rate >30/min BP systolic <90mmHg Age >65
44
What is the acute management of PE?
High flow o2 Morphine 5-10mg and cyclizine 50mg IV LMWH (tinzaparin) 175 units SC daily or DOAC treatment dose
45
What is the acute management of bacterial meningitis?
IV fluid 4-10mg of dexamethasone LP 2g cefotaxime IV (if immunocompromised or >55 yo add 2g ampicillin)
46
What is the management of status epilepticus?
Lorazepam 204mg IV or 10mg buccal midazolam Repeat after 5 mins if no improvement If still fitting after 5 more mins, Phenytoin 15-20mg/IV
47
What is the management of DKA?
IV fluid, 1L stat Fixed rate insulin (50 units actrapid) in 50ml saline at 0.1 units/ kg/ hour Monitor CBG and ketones hourly 10% dextrose to prevent hypoglycaemia if glucose <14mmol/L Monitor potassium
48
When should you treat with antihypertensives?
If BP >150/95 Or, if >135/85 and one of the below: Age 80 with clinic BP >150/90 Age <80 with end organ damage or CVD risk >10%
49
What is the target BP for people on antihypertensives?
140/90 in clinic, <135/85 ambulatory
50
What is the management of chronic heart failure?
ACE-i (lisinopril 2.5mg daily) Beta-blocker (bisoprolol 1.25mg daily) If inadequate add aldosterone receptor antagonist (spironolactone 25mg daily)
51
What do different chadsvasc scores suggest for treatment?
Score of 0= no anticoagulation Score of 1= consider DOAC in men using a vitamin K antagonist Score of 2+= consider anticoagulation in men and women
52
What is the management of hypertension?
If <55 and not of Afro-Caribbean origin: ACE-i or ARB, add CCB or thiazide diuretic if not enough or both if that is unsucessful If >55 or afro-caribbean origin: CCB, add ACE-i or ARB or thiazide like diuretic if not enough
53
What do the different HASBLED scores correlate to?
Score of 0= low risk of bleeding, anticoagulation should be strongly considered Score of 1-2= low to moderate risk of bleeding, anticogulation should be considered Score>/=3= high risk of major bleeding, alternatives to anticoag should be considered
54
What is the management of new onset AF <48hrs?
Rhythm control by cardioversion. Can be electrical or pharmacological (flecanide if no structural heart disease, amiodarone if structural heart disease)
55
What is the management of AF which started >48hrs ago?
Rate control. Use either a beta blocker (bisoprolol 2.5mg OD) or a rate limiting CCB (diltiazem 120mg daily). If this is not effective then commence dual therapy with a beta blocker or CCB and digoxin
56
What are the contraindications for beta-blockers?
hypotension, asthma, acute heart failure
57
What are the contraindications for calcium channel blockers?
Hypotension, bradycardia and peripheral oedema
58
What is the management of stable angina?
1. GTN spray 2. Secondary prevention- aspirin, statin and CVD risk factor modification 3. Beta-blocker or CCB
59
What is the management of chronic asthma?
1. SABA and low dose ICS 2. add inhaled LABA (this can be part of a MART) 3. Increase dose of ICS or add LTRA. If there is no response to LABA at this point then stop 4. Refer on
60
Which blood glucose therapy can be started when metformin is contraindicated or not-tolerated?
DPP4-i Pioglitaone SU
61
What is the most commonly used regimen in parkinsons disease?
co-beneldopa or co-careldopa
62
What is the first line drug (for males and for females) in myoclonic seizures?
Males= valporate Females= levetiracetam
63
What is the first line drug (for males and for females) in tonic seizures?
Males= valporate Females= lamotrigine
64
What is the first line drug (for males and for females) in focal seizures?
Males= carbamazipine Females= lamotrigine
65
What are the 3 AChE inhibitors which can be used in alzheimers disease?
Donepezil, rivastigmine and galantamine
66
What is the management of an acute flare of crohn's disease?
prednisolone 20-40mg orally. If severe, IV hydrocortisone
67
Which drugs can be used to induce remission in crohn's disease?
Azathioprine. It is metabolised by the enzyme thiopurine S-methyl transferase (TPMT) which 10% of the population have a congenitally low activity with. It is important to check TPMT levels before starting, if levels are low then start methotrexate
68
What are the notable side effects of lamotrigine?
Rash, rarely steven-johnson syndrome
69
What are the notable side effects of carbamazipine?
Rash, dysarthria, ataxia, nystagmus and hyponatraemia
70
Name 2 examples of a stool softener
Docusate sodium Arachis oil
71
What is a contraindication to arachis oil?
Nut allergy
72
Name a bulking agent
Isphagula husk
73
Name 2 stimulant laxatives
Senna Bisacodyl
74
Name 2 osmotic laxatives
Lactulose Phosphate enema
75
What is a contraindication to isphagula husk?
Faecal impaction Colonic atony- reduced gut motility
76
What is a contraindication to bisacodyl
Acute abdomen
77
What is a contraindication to a phophate enema?
Acute abdomen, IBD
78
What are the notable side effects of phenytoin?
Ataxia, peripheral neuropathy, gum hyperplasia, hepatotoxicity
79
What are the notable side effects of sodium valporate?
Tremor, teratogenicity, weight gain
80
What are the notable side effects of levetiracetam?
Fatigue, mood disorders and agitation
81
What is the management on non-infective diarrhoea?
Loperamide 2mg oral up to 3hrly Codeine 30mg oral up to 6hrly
82
What should be given for CVD risk factor management in diabetes (1 and 2)?
Aspirin 75mg daily if any significant CV risk factors (or >50 DMT2) Atorvastatin 20mg daily if significant CV risk factors (or >40 DMT2)
83
What is the reversal agent for benzodiazepine overdose?
Flumazenil
84
What is the management of hyperkalaemia?
10mls of 10% calcium gluconate to stabilise the myocardium Actrapid insulin (10 units) and 50mls of 50% dextrose
85
Which condition can a combination of CCB and steroids worsen?
Biventricular heart failure
86
When should metformin use be avoided?
In those with a creatinine >150 because it causes lactic acidosis. Should also be avoided/stopped in those with a eGFR <30
87
Which antiemetic should be used in the event of ileus and gastric stasis?
Metoclopramide / domperidone
88
Which antiemetic should be used in the event of nausea induced by chemotherapy?
Ondansetron
89
Which antiemetic should be used in the events of obstruction, vestibular causes, peritoneal irritation and raised intracranial pressure?
Cyclizine
90
How long does an oral/SC/IV opioid need to be continued for when transferring over to a fentanyl patch?
Should be continued for 12 hours after application of the patch to allow the plasma level to reach a therapeutic level

Alice's finals cards (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions