prescribing

Question 1

General guidelines for post-operative nausea and vomiting. drugs that you can use

Answer 1

Question 2

route for vomiting

Answer 2

IV or IM

Question 2

Drug to be used for postoperative nausea and vomiting with QT prolongation and taking an antipsychotic

Answer 2

cyclizine 50mg/mL injection - IM or IV 3 times daily

Question 3

What disease does a demarcated vesicular painful rash on face in mandibular region in an immunocompromised patient indicate

Answer 3

shingles

Question 4

What does the BNF state about the treatment of shingles

Answer 4

Question 5

antivirals for shingles

Answer 5

aciclovir, valacliclovir, famaciclovir

Question 6

dose for aciclovir for shingles

Answer 6

800 mg PO 5 times daily

Question 7

Indication for emergency resuscitation fluid

Answer 7

hypotension, tachycardia, prolonged vomiting, AKI

Question 8

what in this case indicated emergency resus of fluids

Answer 8

Hypotension: Blood pressure is low at 100/50 mmHg, which can indicate hypovolemia or shock.

Tachycardia: The heart rate of 115/min suggests a compensatory response to hypovolemia or dehydration.

Elevated urea and creatinine: Urea (14 mmol/L) and creatinine (130 µmol/L) levels suggest pre-renal acute kidney injury, likely secondary to dehydration from vomiting.

History of vomiting for 3 days: Prolonged vomiting can lead to significant fluid and electrolyte losses, causing hypovolemia.

Question 9

IV fluid resuscitation choice

Answer 9

Question 10

IV fluid resuscitation optimal options

Answer 10

Question 11

first line drug for type 2 diabetes

Answer 11

Question 12

metformin dose

Answer 12

500mg tablets

Question 13

when to give metformin modified release

Answer 13

GI side effects with standard treatment

Question 14

What is the condition and Which drug to prescribe for this

Answer 14

pulmonary oedema

dose is between 20 - 50 mg. Route is IV once only

Question 15

what is the treatment for pulmonary oedema - where can you find this info

Answer 15

Diueretics treatment summary

https://bnf.nice.org.uk/treatment-summaries/diuretics/

Question 16

Answer 16

VTE prophylaxis for majoor orthopaedic surgery

• LMWH or Rivaroxaban

optimal is 40 mg. Route is SC

Question 17

Where can you find information for VTE prophylaxis

Answer 17

https://bnf.nice.org.uk/treatment-summaries/venous-thromboembolism/

venous thromboembolism treatment summary

Question 18

LMWH drugs

Answer 18

enoxaparin sodium, Tinzaparin sodium, dalteparin sodium,

Question 19

DOAC that can be used for VTE prophylaxis in elective hip patients

Answer 19

rivaroxaban 10mg tablets PO

Question 20

fluid for this?

Answer 20

emergency hypoglycaemia

• need rapid glucose restoration

Question 21

where to find treatment summary for hypoglycaemia

Answer 21

Hypoglycaemia
https://bnf.nice.org.uk/treatment-summaries/hypoglycaemia/

Question 22

For inpatients which plasma blood glucose concentration should be treated

Answer 22

< 4 mmol/litre

Question 23

fluid of choice for emergency hypoglycaemia

Answer 23

• infusion of glucose 10% (150-200ml) or 20% (75-100ml).
• Deliver between 15-20g glucose
• in 15 minutes or less (so can also be 2, 5 or 10 mins)

Question 24

What is the treatment for this

Answer 24

lymecycline or doxycycline to add to the benzoyl peroxide in this patient with moderate to severe BNFc - acne look up age for dosing

Question 25

which treatment summary for acne drug choice

Answer 25

acne https://bnf.nice.org.uk/treatment-summaries/acne/

Answer 26

Question 27

Answer 27

Question 28

Answer 28

Monotherapy, with either aspirin, ibuprofen, or a 5HT1-receptor agonist (‘triptan’) is recommended as first-line treatment and should be taken as soon as the patient knows that they are developing a migraine (start of headache phase). Could also give ibuprofen 200mg tablets and other doses/forms and naproxen 500mg tablets NOTE: Given the patients Current bP and hx of hypertension, triptans would be suboptimal

Question 29

When shouldn't you use triptans

Answer 29

>135/85 hypertension Contra-indications For sumatriptan Coronary vasospasm; ischaemic heart disease; **mild uncontrolled hypertension; moderate and severe hypertension**; peripheral vascular disease; previous cerebrovascular accident; previous myocardial infarction; previous transient ischaemic attack; Prinzmetal's angina

Question 30

what is the diagnosis

Answer 30

TIA - transient ishcaemic attack

Question 31

Answer 31

can also use dabigatran extelilate, edoxaban, rivaroxaban,

Question 32

what is the diagnosis

Answer 32

oropharyngeal candiasis

Question 33

which treatment summary for oral candiasis

Answer 33

oropharyngeal fungal infections

Question 34

Answer 34

remember dose can also be written in ml

Question 35

diagnosis

Answer 35

hypoglycaemia https://bnf.nice.org.uk/treatment-summaries/hypoglycaemia/

Question 36

fluid for emergency hypoglycaemia

Answer 36

glucose 20% 100ml 15mins or less

Question 37

diagnosis

Answer 37

severe dehydration - hypotension - needs emergency resus fluids

Question 38

Answer 38

other options include hartmanns solution, ringers solution and plasmalyte the child weights 25kg therefore 250ml given over less than 10 min is correct 10ml/kg

Question 39

Answer 39

NOTE: Not 15mg - 5 mg once daily for 4 months (until term in pregnant women), doses up to 15 mg per day may be required in malabsorption states. - start at 5mg first

Question 40

Answer 40

Question 41

Answer 41

make sure to do 10% of dose so 9mg

Question 42

Answer 42

NOT PREDNISOLONE

Question 43

tinea corpis

Answer 43

Imidazole antifungals The imidazole antifungals include clotrimazole, econazole nitrate, ketoconazole, and tioconazole. They are used for the local treatment of vaginal candidiasis and for dermatophyte infections. Miconazole can be used locally for oral infections; it is also effective in intestinal infections. Systemic absorption may follow use of miconazole oral gel and may result in significant drug interactions. ketoconazole 2% terbinfaine 1% econazole nitrate 1%