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Learning from Mistakes > Pass the PSA Mocks > Flashcards

Pass the PSA Mocks Flashcards

1
Q

anticoag and metform pre surgery

A

Stop all anticoagulants pre surgery, stop metformin day of surgery

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2
Q

max daily alendronate

A

10mg

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3
Q

paracetamol and cocodamol combo OD - how to change?

A

stop paracetamol if combo OD and leave co-codamol as stronger.

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4
Q

crucial step in checking for prescribing errors

A

Be alarmed if you see any ‘grams’ in units – uncommon and usually massive OD. Check all dose units.

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5
Q

another ACEx side effect

A

can be dizziness

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6
Q

watch aspirin dosing

A

Watch for aspirin dosing – only 300mg for short periods in stroke / MI, then should be moved down to 75mg.

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7
Q

co codamol dosign

A

Max co codamol paracetamol dose is 2 tabs QDS (as 500mg in each co-codamol tab)

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8
Q

aspirin doesn’t cause this unlike other NSAIDs

A

Aspirin doesn’t cause renal failure

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9
Q

drowsy pt stop some drugs

A

obviously stop any benzos but also If drowsy, stop any opioids including codeine!

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10
Q

warfarin induced OD

A

Don’t stop warfarin on induced OD, stop the interactant (commonly erythromicin)

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11
Q

pre op alteratioins on bb, ccb, aspirin

A

Avoid altering beta blockers or calcium blockers pre-op. stop antiplatelets like aspirin.

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12
Q

common trick in Qs about prescribing erros

A

Watch out for mg/g units being wrong either way! Common trick!

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13
Q

lithium toxicity possible trigger

A

Lithium excretion much reduced by ACEx, thiazides, and NSAIDs i.e. kidney toxics – can lead to toxic!

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14
Q

changing thyroxine doses

A

Only change levothyroxine in 25mcg increments eitherway

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15
Q

if unfamiliar with normal dosing for a drug, check what?

A

Check MAX doses if unfamiliar with it

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16
Q

fluid balance Qs

A

With FLUID balance questions, match input to output! Look at U/O and oral intake and match.

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17
Q

increasing dosing how

A

Always increase dosing by smallest possible increment, esp with narrow range e.g. phenytoin

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18
Q

sodium already low, what drugs to avoid?

A

Do not start SIADH risky drugs i.e. carbamazepine in patients with already low sodium

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19
Q

normal pt no electro probs what bag of fluid when NBM

A

If given a ‘normal’ patient NBM and no electrolyte info, give standard 8hr 1 L normal saline +20KCl

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20
Q

pen allergic - carbapanems?

A

There is 10% cross reactivity with carbapanems with penicillin allergic patients.

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21
Q

first step acute Qs

A

When asked what to do first acutely, always follow ABCDE order as usual

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22
Q

kidney disease T2DM and tried lifestyle

A

. SU drugs 1st line if kidney disease and type 2 diabetes + tried lifestyle change.

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23
Q

COPD stable obs

A

Start on 24% venturi COPD if stable obs

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24
Q

fluid deplete

A

Fluid – check over what time, picture real life – STAT needed in acutely deplete pts

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25
Q

ACEx angio oedema

A

Angio-oedema withACEx occurs slowly, months later

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26
Q

ACEx test renal function

A

Test renal 2 wks post starting ACEx.

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27
Q

statins info warnings

A

Statins are taken at night. stop statins alongside clarythromicin. Don’t drink grapefruit juice ‘dietary restriction’.

28
Q

antipsychotics starting thing

A

Antipsychotics – need starting ECG and baseline bloods+lipids. Recheck lipids 3monthly, gluc 6mo.

29
Q

unwell but on ISupp

A

Immunosuppresants are stopped during illness e.g. UTI and methotrexate

30
Q

steroid sick day rules

A

Sick day rules steroids – double the normal daily dose for duration of illness!

if long term steroids

31
Q

1% solution is what you foolish papaladoop?

A

A 1% solution contains 1 g in 100 mL.

Thus there are 10 mg in 1 mL. !!! YOU KEEP FORGETTING THIS. JUST USE YOUR MATHS BRAIN FFS LOL.

32
Q

deciding on codeine vs tramadol

A

Tramadol can cause agitation / hallucination in the elderly, codeine produces constipation – weigh these risks up based on pt profile i.e. bowels.

33
Q

pen allergic and on methotrexate

A

Nitrofurantoin for UTI in pen allergic patients on methotrexate.

34
Q

pneumonia HAP

A

Pneumnia guidelinles – HAP – tazocin first.

35
Q

laxative broad contraindications

A

No lactulose if bloated! No stimulants if cramping or colitis.

36
Q

codeine starting dose

A

Codeine start at 30mg 6 hourly. (don’t leap straight to morphine!!!)

37
Q

indigestion

A

Indigetion – magnesium carbonate 10ml.

38
Q

kidney impaired ACEx may show as what?

A

kidney impairment and ACEx may present as malaise!

39
Q

facial flushing anti HTN

A

Amlodipine can cause facial flushing

40
Q

enox needs these pre starting

A

Enoxaparin need minimum eGFR of 30 and minimum weight 50kg

41
Q

rv paracetamol dose with

A

adult <50kg

42
Q

AKI approach

A

With deviated electrolytes and acute kidney injury, focus on removing the nephrotoxics rather than on the electrolytes too much (unless massive deviation)

43
Q

if unsure what’s gone wrong

A

If unsure, always double check dosese – esp old people, e.g. citalopram dose is lower in over 65s

44
Q

Hb levels for transfusion

A

Low Hb -> only transfuse if severely sympto and Hb <70. If IHD be more careful even if Hb higher. Better option is ferrous sulphate which increases by 10 a week the Hb

45
Q

ferrous sulphate

A

Better option is ferrous sulphate which increases by 10 a week the Hb

46
Q

acute anxiolytic

A

If asked for acute anxiolytic, given diazepam or beta blocker.

47
Q

sodium valproate starting

A

Sodium valproate – need LFTs to start, don’t routinely check vit D baseline.

48
Q

on steroids, wcc high

A

Remember steroids can cause leucocytosis (high WCC – check other markers to exclude infection)

49
Q

adjusting dosing with patient in mind

A

Always adjust dosing vs your own patient not the normal range – i.e. with phenytoin if getting gum changes and dysrarthira then reduce dose if in range and no seizures. #

50
Q

hypotensive bleeding patient

A

In a bleeding Q asking about ‘first step’ and pt is hypotensive – stat saline first, then transfuse! Remember ABCDE approach

51
Q

FFP given when

A

FFP given only if PT 1.5 x normal limits

52
Q

v low glucose and cannula in

A

100ml 20% glucose IV if severe hypoglyc and IV access

53
Q

severe UC flare

A

Severe UC flar >6 motions a day and systemic upset – thus IV hydrocort/fluids

54
Q

milder UC flare

A

If milder flare, give 30mg pred OD PO.

55
Q

approach with cal gluconate and hyperkal

A

Repeat calcium gluconate 10% every 15 mins up to 50ml total until ECG stable in hyperkal.

56
Q

AF there longer than 48 hrs, check the Q details!!

A

If AF there for 48 hrs+, then resort to other drugs not cardioverting agents.

57
Q

asthmatic with AF

A

Use digoxin in ashmatics with AF

58
Q

warfarin bleeding first step always

A

If haemo stable, reversing warfarin most important step in bleeding pt, not transfusing.

59
Q

rotate insulin injection site

A

Rotate insulin site or get lipodystrophy and variable insulin absorption.

60
Q

excess alcohol young type 1 DM

A

Excess alcohol is high risk for HYPOlycaemia in young diabetic adults.

61
Q

monitor this when giving phenytoin

A

IV phenytoin needs ECG monitor as assoc with arrythmias.

62
Q

monitoring aminophylline

A

Even for aminophylline, you take a theophylline level to monitor.

63
Q

best markerk for abx clearing chest inf

A

Best marker abx for CAP working – oxygen sats/ABG then resp rate

64
Q

on fluoxetine and new rash

A

If new rash with fluoxetine, discontinue as may be first sign of systemic reaction

65
Q

adverse effects of COCP

A

Adverse COCP affects- weight gain, irritability, new headaches +/- HTN

66
Q

m gravis with incontinence CAUTION

A

M gravis can’t have anticholinergics – esp relevant in bladder incontinence – give duloxetine.

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