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Year 6 > PSA > Flashcards

PSA Flashcards

1
Q

Dosage of LMWH for surgical

A

20mg SC- low risk- 2hrs pre
40mg SC high risk - 12 hrs pre

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2
Q

Reversal agent of LMWH

A

Protamine sulphate

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3
Q

Types of LMWH

A

Daltaparin/enoxiparin sodium
Fondaparinux

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4
Q

SE of LMWH

A

Heparin induced thrombo
Hyperkalaemia

Avoid in GFR <15

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5
Q

Tx of DVT/PE

A

Apixiban 10mg BD 7 days
Then 5mg BD 3 months

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6
Q

When to avoid DOACs

A

Pregnancy
GFR <15

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7
Q

Treatment of A fib

A

Beta blocker- atenolol 50-100mg OD
or RL CCB- verapamil or diltiazem

Apixiban 5mg BD if CHADVASC

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8
Q

When to use each antiemetic

A

Haloperidol- drug and chemical
Metoclopramide- GIT
Ondansetron- chemo and abdo surgery
Cyclizine- CNS and ear

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9
Q

Tx of DKA

A

1L saline- 1hr, then 2hr, then 4, 8

Insulin FRII
Start glucose when <14

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10
Q

Tx of HHS

A

1hr saline 2 hrs

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11
Q

When to stop insulin for surgery

A

Stop short acting
Give VRII
Reduce long by 20%

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12
Q

When to stop lithium for surgery

A

Day before

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13
Q

When to stop warfarin and DOACs for surgery

A

5 days for warfarin
2 days for DOACs

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14
Q

When to stop COCP for surgery and start again

A

4 weeks
restart 2 weeks after using POP in-between

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15
Q

When to stop sulphonylureas for surgery

A

day of surgery

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16
Q

When to stop ACEi, ARB and spironolactone for surgery

A

Day of surgery

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17
Q

What to do to steroid dose for surgery

A

Doubler it

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18
Q

When to start VRII for surgery

A

T1DM
>1 meal missed- stop metformin too
Poor BM >69
Post MI

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19
Q

Drugs that inhibit CYP450

A

Azoles/amiodarone/allopurinol
Macrolides
Valproate
Cipro
Statins

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20
Q

Steroids SE

A

Stomach ulcers
Thin skin
Oedema
Right/Left HF
OP
Infections
Diabetes
Syndrome- Cushing

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21
Q

NSAIDs SE

A

No urine- Renal
Systolic dysfunction_HF
Asthma
Indigestion
BlooD clotting abnormal

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22
Q

SE of ACEi

A

Dry cough
Prescribe ARB instead

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23
Q

SE of BB

A

Asthma
Worsen acute HF
ED

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24
Q

CCB SE

A

Peripheral oedema and flushing
Verpamil Constipation

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25
Q

Diuretics SE

A

Renal failure

loop- fureosomide- gout, hypokalaemia

Thiazide- hypokalaemia, gout

Spirono- hyperkalaemia, gynaecologist

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26
Q

Diuretics SE

A

Renal failure

loop- fureosomide- gout, hypokalaemia

Thiazide- hypokalaemia, gout

Spirono- hyperkalaemia, gynaec

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27
Q

Trimethoprim SE

A

Agranulocytosis
Neutropaenic sepsis
Folate

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28
Q

Drugs causing low neutrophils

A

Clozapine
Carbimazole

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29
Q

WCC in bacterial vs viral

A

Neutrophils high- Bacterial
Lymphs high- viral

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30
Q

Cause of low plts

A

Heparin
DIC
ITP- child post URTI
HUS- E coli- diarrhoea, haemolytic anaemia, low plt, renal failure
TTP- “, fever and neuro

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31
Q

Urea vs creatinine rise in AKI

A

Urea> creatine in pre renal
Creatinine> in intrinsic and post

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32
Q

Cholestatic drugs

A

Co amox
Fluclox
Steroids
Nitro
Sulphonyl

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33
Q

Target O2 for no resp failure vs T2 resp failure

A

> 94%
COPD- 88-92%

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34
Q

What oxygen delivery for acute COPD

A

High flow if bad but titrate to
Blue Venturi
24% can go up to 28%

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35
Q

Nasal Cannula flows

A

1L
2L
4L- may cause irritation

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36
Q

What O2 to give in emergency

A

Non rebreather Mask
15L

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37
Q

Gentamicin and vancomycin SE

A

Ototoxicity and nephrotoxicity

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38
Q

Lithium SE

A

Early- tremor
Intermediate- tiredness
Later- arrhythmia, seizure, DI

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39
Q

Paracetamol OD treatment

A

<1hr- activate charcoal
Measure 4hrs- graph- NAC

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40
Q

Tx of Warfarin OD

A

INR 5-8 no bleeding- miss 2 doses
5-8 minor bleed- stop and IV vit K restart when <5

> 8 no bleeding- stop, PO vit K, restart <5

Minor bleed >8- “ IV vit k

Major Bleed- Stop, IV vit K 5mg, IV PCC

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41
Q

AE-Asthma Tx

A

Salbutamol, Neb. 5mg
Ipratropium bromide, Neb. 0.5mg (500mcg)
Hydrocortisone, IV 100mg / PO 50mg

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42
Q

SE of sulphonylureas

A

Hypog
Weight gain

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43
Q

Info for patients taking steroids

A

Regular BM monitoring
PPI
>3m- bisphosphonates

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44
Q

SE of bisphosphonates

A

Osteonecrosis
Oesophageal reactions
Atypical femur fracture

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45
Q

Monitoring with statins

A

CK if lose in risk of myopathy

ALTs

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46
Q

When to stop statins

A

Taking macrolide

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47
Q

CI of ACEi

A

Aortic stenosis

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48
Q

Which drugs are contraindicated with lithium

A

ACEi, thiazides, loops
NSAIDs

Use CCBs

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49
Q

Rapid acting insulin

A

Nororapid
Humalog

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50
Q

Short acting insulin

A

Actrapid
Humulin S

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51
Q

Long acting

A

Lantus
Levemir

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52
Q

Intermediate insulin

A

Humulin I
Insulatard

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53
Q

Hypoglycaemia treatment

A

Conscious- BM<4- glucotabs

Unconscious- IM glucagon
or Glucose 20% 100ml if IV access

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54
Q

When to add to metformin for DM

A

When Hb1ac >58

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55
Q

Thiazaolidinedione CI

A

HF and bladder cancer

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56
Q

CI drugs in HF

A

TVNG

Thiazola
Verapamil
NSAIDs
Glucocorticoids

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57
Q

Steroid ladder

A

Hydrocortisone
Clobetasone
Betamethasone
Clobetasol

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58
Q

When does the LFTs make you stop taking statins

A

ALT/AST x3 ULN

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59
Q

Opioids used in renal failure

A

Fentanyl
Alfentanil
Buprenorphine

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60
Q

Dihydrocoedine to morphine oral

A

/10

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61
Q

Morphone oral to SC

A

/2

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62
Q

Morphine oral to oxycodone

A

/1.5

Used to be 2

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63
Q

Non palliative opioid dosing

A

Oromorph 2.5-5
4 hourly

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64
Q

Conversion of modified release

A

Half the immediate BD

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65
Q

Anti emetic in Parkinsons

A

Doperidone

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66
Q

When to take diuretics

A

Morning

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67
Q

Tx of hyperkalaemia

A

10ml 10% Ca gluconate
125ml of 20% dextrose
10U insulin

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68
Q

Drugs causing urinary retention

A

Opioids
Anticholinergics
GA
A adrenal agonists
Benzos
NSAIDs
CCBs
Antihistamine

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69
Q

Drugs causing confusion

A

Morphine
Metoclopramide
Anti-cholinergics, psychotics, depressants, convulsants

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70
Q

Folic acid dosage

A

400mcg

5mg- prev NTD, DM, epilepsy, obese, SCD, IBD, thala

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71
Q

Drugs causing hyponatraemia through SIADH

A

SSRI , TCA
PPI
Sulphonylurea
Carbamazepine

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72
Q

Monitoring with ACE/ARB

A

U&E before
Expect small rise <20% creatinine

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73
Q

What to monitor with cyclosporin

A

Nephrotox- U&E
HTN- BP

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74
Q

How long should antiplatelets be stopped before surgery

A

7 days
Including aspirin

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75
Q

When to stop allopurinol

A

In decreased renal function

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76
Q

Breakthrough pain for fentanyl patch

A

If on >25mcg fentanyl
Nasal fentanyl

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77
Q

When is nitrofurantoin CI

A

GFR< 45
At term

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78
Q

Tx of alcohol withdrawal

A

Chlordiazepoxide

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79
Q

If INR >1.5 on day of surgery who stopped taking warfarin what do you give

A

Phytomenadione
Vit K
2mg PO

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80
Q

Info for taking SSRI

A

Do not stop suddenly
Suicide ideation may increase for up to 4 weeks

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81
Q

How to take rivaroxiban

A

With food

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82
Q

Effects of toprimate with POP

A

Induces CYP450
Decrease POP
Need another contraception

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83
Q

Drugs inducing CYP450

A

Phenytoin
Carbamazepine
Barbituates
Rifampicin
Toprimate
Sulphonylurea

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84
Q

How to monitor furosemide

A

Weight

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85
Q

SE of trimethoprim

A

Tubular dysfunction
Hyperkalaemia

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86
Q

Tx of Migraine

A

Triptan and NSAID

Prophylaxis- toprimate or propanolol

Toprimate is teratogenic

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87
Q

SE of toprimate

A

Teratogenic- cleft lip
Reduced POP efficacy

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88
Q

Pregnancy thrush

A

Oral metronidazole BD 7d 400mg

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89
Q

Tx of UTI in pregnancy

A

Nitrofuratoin

No trimethoprim

90
Q

Drug causing facial swelling

A

ACEi- angioedema

91
Q

CI of triptan use

A

IHD, cerebrovascular disease

92
Q

SE of triptans

A

Tingling
Heat
Tightness

93
Q

SSRI and sodium

A

Causes SIADH and hyponatraemia

94
Q

If low sodium what should you check

A

Which drugs cause SIADH

95
Q

When should enoxiparin be stopped

A

If bleeding
Blood in sputum
If recent stroke

96
Q

Max dosage of paracetamol per day

97
Q

Max dosage of NSAIDs per day

98
Q

When should methotrexate be stopped

A

In active infection

99
Q

Tacrolismus SE

100
Q

Methotrexate SE

A

Myelosuppression
Mucositis
Liver fibrosis
Lung fibrosis

101
Q

Cyclophosphamide SE

A

Myelosuppression
TC carcinoma

102
Q

Cyclophosphamide SE

A

Myelosuppression
TC carcinoma

103
Q

Doxycyline SE

A

Oesophagitis, photosensitivity

104
Q

3 drugs CI in asthma

A

Adenosine
BB
NSAIDs

105
Q

ng to mcg to mg

A

1000ng= 1mcg =0.0001 g

106
Q

What sign means you have increased risk of problems in asthma

A

Nasal polyps

107
Q

What should be measured in digoxin toxicity

A

Digoxin level
U&E
ECG

108
Q

Tx of urge vs stress incontinence

A

Stress- duloxetine 40mg BD
Urge- oxybutinin 5mg BD

109
Q

Drugs CI in pregnancy

A

WASTE ASS

Warfarin
Amino
Sulphamides
Tetras

ACE
Statine
Sulphonylyurea

110
Q

When should you avoid giving glucose fluids

A

In stroke patients

111
Q

Common dosages in analgesia

A

Para- 1g QDS
Ibru- 200-400 TDS
Codeine- 30-60 qds
Co-codamol- 2 tabs qds- 8/500, 30/500

112
Q

Common AE dosages

A

Cyclizine 50mg tds
Meto 10mg tds

113
Q

Common AB doseages

A

Amox- 500mg tds
Clarithro- “

114
Q

PPI doseages

A

Lansoprazole 15-30 OD
Omeprazole 20-40 OD

115
Q

Common CVD doses

A

Aspirin 75-300 od
Clopi “

Artovostatin 10-80 ON

Atenolol 25-100 OD

Ramipril 1.25-10 ID

Bendro- 2.5 OD

Furos- 20mg OD -80 BD

Amlodipine 5-10 mg OD

116
Q

Common endocrine drugs doses

A

Levo 25-200mcg
Metformin 500mg OD 1g BD

117
Q

Which statin to use for secondary prevention

A

Atorvastatin 80mg On

118
Q

Lithium levels

119
Q

If troughs are high in Gentamicin what should you do

A

Change TDS to BD
Increase interval

120
Q

Croup Tx

A

Dexamethasone
150mcg/kg

121
Q

Drugs to avoid in BF

A

ABC SML
Aspirin, amiodarone
Benzo
Cipro, carbimazole
Sulph
Methotrexate
Lithium

122
Q

When should you gradually withdraw steroids

A

> 40mg pred >7d
3 weeks tx
Repeated courses

123
Q

When should you measure digoxin

A

8-12 hours after last

124
Q

Fluids and electrolytes needed per day

A

30ml/kg/day
1 K/Na/Cl
50-100g glucose /day

124
Q

Fluids and electrolytes needed per day

A

30ml/kg/day
1 K/Na/Cl
50-100g glucose /day

125
Q

Each 5% Dextrose day contains how much glucose

126
Q

Common SE of aspirin

127
Q

ECG changes with tricyclic OD

A

Sinus tachy
Wide QRS
Prolonged QT

128
Q

Digoxin OD sx

A

N+V
Blurred vision- yellow green, haloes
Palpitation
Confusion

129
Q

Tx of digoxin OD

A

Digibind, monitor K- treat accordingly

130
Q

What can interact with SSRI to cause serotonin syndrome

131
Q

Amox SE

A

Rash with IM

132
Q

Fluclox SE

A

Cholestasis

133
Q

Cirpo SE

A

Lower seizure threshold
Prolonged QT

134
Q

Metronidazole SE

A

Reaction with alcohol

135
Q

Trimethoprim SE

A

Rash, photo, pruritus, Haem suppression

136
Q

Which 2 diuretics cannot be prescribed together

A

Amiloride and spironolactone
Cause hyperkalaemia

137
Q

What should you co prescribe for TB

A

Pyridoxine

138
Q

How long should you stop metformin with a CT scan with contrast

A

For 48 hours after

139
Q

Indications of HRT

A

Flushing, insomnia, headaches

Premature menopasue- continue until 50

140
Q

When to give certain types of HRT

A

Monthly- oestrgoen 28d+ prog last 14d
Regular periods and menopause sx

3 monthly- oestogren for 3 months+ Prog 14d
Irregular

Oestrogen only if hysterectomy

Transdermal- if risk of VTE

141
Q

Cancer risks with HRT/COCP

A

Oestrogen- breast and endo

Combined- breast, cocp cervical

142
Q

Alternative meds for menopausal sx other than hormonal

A

SSRI- fluoxetine- vasomotor
Citalopram 2nd

Vaginal dryness- lubricants

OP- bisphosphonates

143
Q

COCP and POP names

A

Microgynon- cocp

Levongestrel, norethisterone, desogestrel- POP

144
Q

Absolute CI to COCP

A

BF <6w
BMI >40
>35 and smoke >15
HTN >160/95
VTW
Migraine and aura
Breast cancer

145
Q

If miss dose of COCP what happens

A

If miss 1- take 2
Miss 2-
First week- emergency contraception
Week 2- nothing
Week 3- omit pack free

Use condoms for 7 days

146
Q

Miss dose of POP what happens

A

Traditional
If miss 1<3 hours - take 2
>3 hours- emergency contraception

Desogestrel
<12hrs- normal
>12 hours- take, 48 hours condoms

147
Q

SE of Herceptin/trastuzumab

A

Cardiac toxicity - echo before and after tx
Flu like symtptoms

148
Q

Most important prognostic factor of paracetamol OD

149
Q

What must be done 6 monthly in amiodarone

A

TFT and LFT

150
Q

Adrenaline amount for ALS

A

If PEA/Asystole- 10ml 1:10000

151
Q

Common SE of sildenafil

A

Headaches, flushing, dyspepsia, green tinge of vision

152
Q

TCA SE

A

Arrhythmias, seizures
Metabolic acidosis

Sinus achy, wide QRS, QT

Early AC- dry mouth, dilated pupils, blurred vision

153
Q

Drugs to avoid in G6PD

A

Nitro, sulphonylurea, cipro , antimalarials

NASC

154
Q

What is protective in paracetamol OD

A

Anything that inhibits Py450- Acute alcohol

Anything inducing e.g carbamazepine increases risk

155
Q

Risk of NSAID and SSRI

A

GI bleed- require PPI

156
Q

When is diclofrenac CI

A

IHD, PAD, CVD, CHF

157
Q

What to do if heparin induced thrombocytopaenia

A

Stop heparin and start argatroben- direct thrombin inhibitor

158
Q

What can precipitate lithium toxicity

A

NSAIDS
Renal failure
Dehydration
Diuretics, ACE, metronidazoel

159
Q

Effects of amiodarone on thyroid

A

Hypothyroid
Thyrotoxicosis

160
Q

Antidote for methanol poisoning

161
Q

Antidote for BDZ OD

A

Flumezanil

162
Q

Beta blocker toxicity tx

A

Atropine if Brady
Resistant- glucagon

163
Q

Mx of organophosphate OD

164
Q

Tamoxifen adverse affects

A

Vaginal bleeding, amenorrhoea
Hot flushes
VTE
Endometrial cancer

165
Q

What is high on VBG for smokers

A

COHb up to 10%

166
Q

What electrolyte abnormality does PPI cause

A

Hypomagnesia

167
Q

NAC reaction tx

A

Stop the IV infusion
Give nebuliser salbutamol
Re start at slower

168
Q

Anti freeze tx

A

Fomepizole

169
Q

Features of oculogyric crisis

A

Restlessness
Upward gaze of eyes

170
Q

Causes of oculogyric crisis

A

AP, metoclopramide

171
Q

Tests vital before RIPE tx

A

LFTs
Visual and renal for ethambutol

172
Q

Organophosphate sx

A

Pinpoint pupils
Excessive urination
Bradycardia

173
Q

SE of cipro on MSK

A

Achilels tendon rupture due to tendinopathy

174
Q

Statin, ACE and amiodarone monitoring

A

Statin- LFT- baseline, 3m, 12m

ACE- U+E- prior, increasing, annually

Amiodarone- TFT, LFT- Every 6m
U+E and CXR prior

175
Q

Azathiprine and methotrexate monitoring

A

Meth- FBC, LFT, U+E
Repeated until stabilised, every 2-3m

Aza- FBC, LFT- 3 months
FBC weekly first 4w

176
Q

Lithium and SV monitoring

A

Lithium level, TFT, U+E- LLweekly until stable, TFT U+E 6m

SV- LFT- periodically first 6m

177
Q

Thiazolidinedione monitoring

178
Q

Digoxin monitoring

A

No monitoring levels needed unless toxicity - 8-12 hrs after
Should monitor renal levels tho as is excreted really

179
Q

Tx of LSD OD

180
Q

SE of Mg

181
Q

Electrolyte abnormality in chronic alcoholics

182
Q

Cyclizine affect cholinergic system

A

Anti cholinergic

183
Q

If taking enzyme inducing drugs what contraceptive should you be on

184
Q

Tx of gestational HTN

A

Labetalol 1st
Nifedipine
Methyldopa

185
Q

Tx of eclampsia

A

Magnisum Sulphate

186
Q

Pre-eclamspia

A

HTN >20w and proteinuria/organ dysfunction

187
Q

Blood pressure control before conception

A

Stop ACEi before conception
Start labetolol

188
Q

When should you be cautious when taking ACEi

A

If develop N+V- can cause AKI

189
Q

What HRT has the highest risk for breast cancer

190
Q

When should you not give metformin and choose alternate AD

A

GFR <30 , creatine >150
Gliclazide

191
Q

What should be checked as baseline with AP

192
Q

Monitoring in sodium valproate

A

Hepatotoxicity so LFT measured

193
Q

Dark stool meaning

A

Bleed- likely steroid or NSAID use

194
Q

Gabapentin SE

A

Neutropenia

195
Q

Amiloride SE

A

Hyperkalaemia

196
Q

Stroke patients fluid requirement

A

Day 1- 1L Nacl, 1L Nacl
Day 2- 1 glucose, 1 NaCl

197
Q

Types of movement disorders and sx

A

Acute dystonia- upward eyes, stiff neck, abnormal posture
Tardive dyskinesia- sudden irregualr
Parkinsons
Akathasia- restless

198
Q

Tx of movement disordes

A

Procyclidine- all
Tardive- tetrabenazine

199
Q

What to give in addition to nebulisers in exacerbation of COPD

A

Prednisilone

200
Q

Combined HRT

A

Estradiol and northisterone

201
Q

CI in PAD

A

BB
ACEi in severe

202
Q

If fungal infection what presipitates

A

Antibiotics and steroids

203
Q

If warfarin INR in range and on macrolide what do you do

A

Measure INR again in 48 hours if in range

204
Q

When does it count as 2 pills missed in COCP

A

When missed 1st and 24 hours after meant to take 2nd

205
Q

K sparing diuretics monitoring

A

Potassium after 1 week

206
Q

Contraception and methotrexate

A

6 months after stopping

207
Q

Monitoring effectiveness of BB in AF

A

Heart rate

208
Q

Monitoring in amiodarone

A

Potassium as hypokalaemia dangerous

209
Q

If on statin in muscle ache and high CK what do you do

A

Stop statin restart when resolved

210
Q

Morphine to fentanyl patch

211
Q

Common SE of metoclopromide

212
Q

PPI electrolyte abnormality

A

Hyponatraemia
Low Mg

213
Q

If Creatine over 150 and Hba1c >48 what do you give

A

Gliclazide

214
Q

What causes ATN quickly vs slowly

A

Contrast- hours
Drugs- week

215
Q

What to change to if omeprazole causes hyponatraemia

A

Ranitidine

216
Q

Drugs that interact with amiodarone

A

PaWSD

Phenytoin
Warfarin
Statin
Digoxin

217
Q

Immediate vs long term relief of dyspepsia

A

Magnesium carbonate short
Omeprazole long

218
Q

Laxative to give if bloated

A

NOT osmotic
Give Senna

219
Q

Tx of CAP vs HAP

A

CAP- mild- amox
Severe- co amox +clarith

HAP- mild co amox
Severe- tazosin

220
Q

Post op N+V with long QT which AE do you use

A

Cyzlizine as ondansetron CI

Year 6 (28 decks)

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