Pass the PSA textbook

Question 1

Side effects of steroids (therefore contraindications)

Answer 1

STEROIDS:
Stomach ulcers, Thin skin, oEdema, Right and left heart failure, Osteoporosis, Infection (including Candida), Diabetes (commonly causes hyperglycaemia and uncommonly progresses to diabetes), and Cushing’s Syndrome.

Question 2

Side effects of NSAIDs
(therefore contraindications)

Answer 2

NSAID:
No urine (i.e. renal failure), Systolic dysfunction (i.e. heart failure), Asthma, Indigestion (any cause), and Dyscrasia (clotting abnormality).

Question 3

What urine output indicates oliguria

Answer 3

<30 mL/h

Question 4

When is the maximum dose of paracetamol not 4g a day

Answer 4

In patients <50kg the MAXIMUM dose of Paracetamol is 500mg 6-hourly.

Question 5

Effect of thiazide like diuretics on potassium

Answer 5

Hypokalaemia

Question 6

What is indicated by raised bilirubin and ALP

Answer 6

Post-heaptic jaundice (e.g gallstones, drug causing cholestasis)

Question 7

Name 5 drugs which can cause post-hepatic jaundice

Answer 7

Flucloxacillin, Co-amoxiclav
Nitrofurantoin
Steroids
Sulphonylureas

Question 8

What is meant by 1% for calculations

Answer 8

1g in 100ml
or 10mg in 1ml

Question 9

Write a prescription for the FIRST DRUG to lower the patient’s potassium? K+ > 6.5

Answer 9

Short-acting insulin with glucose

10 units of actrapid in 100ml of 20% dextrose over 30 mins IV

Question 10

What parameter must be checked before starting an antipsychotic like onlanzapine

Answer 10

Blood Glucose

Risk of hypoglycaemia and diabetes

Question 11

Name 3 medications stopped before surgery

Answer 11

Antiplatelets & Anticoagulants
Steroids
Lithium