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PSA > Passmed and past paper bits > Flashcards

Passmed and past paper bits Flashcards

1
Q

What maintenance fluids should you be prescribing in adults?

A

Volume - 25-30ml/kg/day

Na+/K+/Cl- = 1mmol/kg/day

50-100g of glucose

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2
Q

What do you have to be wary of when prescribing 0.9% saline?

A

Large volume increase risk of hyperchloraemic metabolic acidosis

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3
Q

What do you have to be wary of when prescribing Hartmann’s?

A

Large volume - risk of hyperkalaemia

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4
Q

Which drugs in heart failure improve long term prognosis?

A

ACEi

Beta Blockers

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5
Q

What drugs can cause SIADH?

A 
Sulfonylureas
SSRI's
Tricyclic's
Carbamazepine
Vincristine
Cyclophosphamide
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6
Q

Which drugs are taken at night?

A

Statins

Amitriptyline

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7
Q

Which drugs are contraindicated in Asthma?

A

NSAID’s
Beta blockers
Adenosine

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8
Q

What should be monitored at the start of treatment with quetiapine?

A

Prolactin

All antipsychotics:

  • FBC, U&E, LFT
  • Lipids and weight
  • Fasting BM
  • BP, ECG
  • Cardiovascular risk assessment
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9
Q

Why should dextrose be avoided in stroke patients?

A

Risk of cerebral oedema

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10
Q

What drug should be given in acute heart failure for breathlessness and oedema?

A

IV furosemide 20-50 mg

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11
Q

What VTE prophylaxis should be offered in orthopaedic patients?

A

Enoxaparin 100mg/ml
40mg
SC
OD

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12
Q

What reasons are there to hold in renal injury?

A

Nephrotoxic drugs - ACEi, ARB etc.

Drugs that will accumulate

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13
Q

Which drugs are nephrotoxic?

A 
NSAIDs
Tetracyclines
Nitrofurantoin
Metformin
ACEi/ARB
Lithium
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14
Q

Which drugs accumulate in renal failure?

A

Most antibiotics - penicillins, cephalosporins, vancomycin, gentamicin, streptomycin

Digoxin
Atenolol
Allopurinol
Methotrexate
Sulphonylureas
Furosemide
Opioids

May need dose adjustment

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15
Q

When prescribing for breakthrough pain, what should you use?

A

Ideally the same drug

Make sure you check the dose will be effective (if time)

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16
Q

When is nitrofurantoin contraindicated?

A

GFR <45

Even if taking folic acid supplements, choose trimethoprim

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17
Q

What is first line in acute alcohol withdrawal?

A

Chlordiazepoxide

Give Pabrinex in alcohol dependence

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18
Q

What should you do with regards to warfarin and surgery?

A

Stop 7 days before
Aim for INR <1.5
If >1.5 - give vit k

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19
Q

What key information should be given when prescribing SSRI’s?

A

Suicidal ideations may worsen for 4 weeks
Shouldn’t stop abruptly
Dose can be increased

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20
Q

Which drug is associated with cholestatic jaundice?

A

co-amoxiclav

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21
Q

What is normal to happen with creatinine on starting ACEi therapy?

A

Small rise <20%

Doesn’t req. investigation or change of drug

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22
Q

What is used to measure efficacy of furosemide?

A

Weight

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23
Q

What is used to assess for beneficial effects of ACEi?

A

Exercise tolerance

24
Q

How much should you increase insulin dose by if it appears to be ineffective?

A

Around 10%

25
Q

What do you aim for when starting statin treatment?

A

> 40% reduction in non-HDL cholesterol

26
Q

How would you monitor the beneficial effects of allopurinol?

A

Serum urate

27
Q

How would you monitor for beneficial effects of fluids?

A

Blood pressure

28
Q

How do you calculate the breakthrough pain dose for morphine?

A

Total daily dose/6

29
Q

How do you calculate new doses for morphine if the current dose isn’t controlling pain sufficiently?

A

Calculate total daily dose (slow release + all break through) and divide this by number of doses (typically 2) for new SR

Total dose/6 = new breakthrough

30
Q

What is the typical basic dose for morphine?

A

15mg BD slow release

5mg oral morphine breakthrough

31
Q

How do you convert between codeine to morphine?

A

divide by 10

32
Q

How do you convert from oral morphine to IV morphine?

A

divide by 2

33
Q

What is used to treat acute dystonia?

A

Procyclidine

34
Q

What is the ideal infusion rate for 1L maintenance fluids?

A

8-12 hours

35
Q

How can you ensure a patient doesn’t have withdrawal bleeding when on ERT?

A

Give oestrogen and progesterone

Make sure the drug is given constantly as opposed to sequential regimes

36
Q

Which drugs are contraindicated in peripheral vascular disease?

A

Beta blockers

ACEi are cautioned

37
Q

Which drugs commonly exacerbate heart failure?

A

Calcium channel blockers

Steroids

38
Q

What is the typical dosing for omeprazole?

A

10-20mg daily

39
Q

What should you do if a urine dip is + for leucocytes and nitrites?

A

Immediately start treatment even if not v positive.

92% positive predicted value

40
Q

How is scarlet fever managed?

A

10 days phenoxymethylpenicillin

41
Q

When should IM glucagon not be given?

A

IV glucose feasible to give quickly

Patient anti-coagulated

42
Q

How should beta blocker therapy in AF be monitored for positive effect?

A

Heart Rate

43
Q

How is antibiotic effectiveness in sepsis monitored?

A

Symptom resolution

44
Q

What should you do if statins cause a markedly raised CK?

A

Discontinue statin and see if symptoms/CK resolve

Restart on lower dose

45
Q

What may cause a painful unilateral rash?

A

Herpes - Shingles

46
Q

Which anti-emetic should be used in patients at risk of extra pyramidal side effects or QT prolongation?

A

Cyclizine

47
Q

Which drugs commonly cause ankle oedema?

A

Amlodipine

NSAIDs - naproxen

48
Q

When should loperamide be taken?

A

After each loose stool

49
Q

What can cause serotonin syndrome?

A

Taking SSRI’s can predispose to serotonin syndrome

Taking a serotonin inducing drug such as tramadol can induce it

Other drugs include:

  • ecstacy
  • amphetamines
  • TCA’s
  • SSRI’s etc.
50
Q

How is anti-psychotic induced Parkinsonism managed?

A

Anticholinergics

51
Q

What should be done to pain management in case of AKI in acute pain?

A

Change to oxycodone

Fentanyl better in renal impairment but not for acute pain

52
Q

What should be done with amiodarone in case of thyrotoxicosis?

A

Withhold amiodarone

53
Q

What is used for drug induced N&V?

A

Haloperidol

Ondansetron if chemo

54
Q

What is used for GI stasis/peristaltic failure induced N&V?

A

Metoclopramide or Domperidone

55
Q

What is used for anxiety related N&V?

A

Lorazepam

56
Q

What is used for N&V due to intracranial disease, vestibular disturbance, pharyngeal irritation or liver stretch?

A

Cyclizine

+ tex if raised ICP

57
Q

When is hyoscine used as an antiemetic?

A

Prophylaxis

Motion sickness

PSA (7 decks)

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