PSA 1

Question 1

Why do you avoid Tramadol with SSRI’s?

Answer 1

Serotonin Syndrome

Question 2

How do you measure the therapeutic effect of Aminophylline?

Answer 2

Measure O2 saturation

Question 3

What 2 medications do you usually continue during surgery?

Answer 3

Ca2+ channel blockers and beta-blockers

Question 4

What medications should you stop before surgery? (ILACKOP)

Answer 4

Insulin
Lithium
Anti-coagulation/anti-platelet
COCP/HRT
K-sparing diuretics
Oral hypoglycaemics 
Perindopril (other ACEi)

Question 5

When should you stop COCP/HRT before surgery?

Answer 5

4 weeks before

Question 6

When should you stop aspirin before surgery?

Answer 6

7 days before surgery

Question 7

What electrolyte imbalances do ACEi cause? (2)

Answer 7

Hyperkalaemia

Hyponatraemia

Question 8

How do you monitor the therapeutic effect of diuretics?

Answer 8

Monitor weight

Question 9

When should you use gliclazide instead of metformin? (2)

Answer 9

1. Renal impairment eGFR <30

2. If normal/underweight

Question 10

What are the common adverse effects of gliclazide? (2)

Answer 10

1. Weight gain

2. Hypoglycaemia

Question 11

How do you manage hypoglycaemia in an unconscious patient?

Answer 11

Glucagon IM

Question 12

How do manage hypoglycaemia in a conscious patient?

Answer 12

Oral glucose 10-20g

Question 13

When should you avoid compression stockings?

Answer 13

Peripheral arterial disease

Question 14

What is the contraindication for osmotic laxatives?

Answer 14

Bloating

Question 15

What is an example of a stool softner?

Answer 15

Docusate

Question 16

What can cause hypokalaemia? (DIRE)

Answer 16

Diuretics
Inadequate intake/intestinal loss
Renal tubular acidosis
Endocrine (cushing’s/conn’s)

Question 17

What commonly interacts with statins?

Answer 17

Macrolides e.g. erythromycin

Question 18

What is the management AF <48hr onset?

Answer 18

Amiodarone/Flecainide

Question 19

What dose IV chlorphenamine and hydrocortisone are given in anaphylaxis?

Answer 19

10mg chlorphenamine

200mg hydrocortisone

Question 20

What is given in a severe acute asthma attack? (5)

Answer 20

1. Oxygen
2. Hydrocortisone IV 100mg or prednisolone 40mg PO
3. Salbutamol 2.5-5mg
4. Ipratropium 500mcg
5. Senior input - theophylline/magnesium sulphate IV 2g

Question 21

What is given for the long-term management of focal seizures?

Answer 21

Carbamazepine/lamotrigine

Question 22

1% solution = ?g in ?mL

Answer 22

1% = 1g in 100mL

Question 23

1 in 1000 = ?g in ?mL

Answer 23

1 in 1000= 1g in 1000mL

Question 24

What do you give in the management of hepatic encephalopathy?

Answer 24

Lactulose

Question 25

How should oral bisphosphonates be taken?

Answer 25

Taken at least 30 minutes before breakfast with plenty of water + sit upright for 30 minutes following

Question 26

If INR >1.5 on the day before surgery, what is given?

Answer 26

Phytomenadione (vitamin K) 1-5mg PO

Question 27

How does topiramate affect the efficacy of a drug?

Answer 27

Enzyme inducer - efficacy of drug reduced

Question 28

What can occur during or shortly after treatment with co-amoxiclav?

Answer 28

Cholestatic jaundice

Question 29

What is a potentially serious adverse effect of carbimazole?

Answer 29

Neutropenia

Question 30

What are the two most adverse effects of ciclosporin?

Answer 30

Nephrotoxicity

Hypertension

Question 31

What drug is contraindicated in peripheral vascular disease?

Answer 31

Beta-adrenoceptor blockers

Question 32

What electrolyte imbalance is associated with SSRI’s?

Answer 32

Hyponatraemia

Question 33

What is a contraindication for stimulant laxatives? (e.g. Senna)

Answer 33

Cramping