PSA Flashcards

1
Q

drugs causing SIADH

A

sulfonyureas
SSRIs,
cyclophosphamide
carbamazepine
tricyclics
vincristine

SSCCTV

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2
Q

drugs usually prescribed weekly

A

bisphosphonates
methotrexate

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3
Q

aminophylline SE

A

lowering the seizure threshold

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4
Q

6 monthyl bloods for someone on lithium

A

u+es and fbc

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5
Q

what is a contraindicated to diltalezem

A

heart failure

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6
Q

Levofloxacin contraindicated

A

epilepsy as reduces the seizure threshold –> is a fluroquinone Abx

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7
Q

Flecanide contraindication

A

structural heart disease –> increased risk of arrhyhthmia

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8
Q

SE of steroids

A

S-stomach ulcers
T- thin skin
E-oEdema
R- right and left heart failure
O-osteoporsis
I-infection
D-diabetes
S- cushigns Syndrome

also sleep disturbance + psychosis

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9
Q

NSAIDs considerations w mnemonic

A

N- no urine (RENAL)
S- systolic dysfunction (heart failure)
A- Asthma
I - Indigestion
D-dyscrasia –> clotting abnormalities

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10
Q

avoid metoclopramide in

A
  1. parkinsons disease (its a dopamine antagonist and mya worsen Sx)
  2. Young women due to risk of dyskinesia
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11
Q

cyclizine is pretty much 1st choice antiemetic EXCEPT in

A

CARDIAC CASES –> can cause fluid retention

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12
Q

0.005% solution means what

A

5mg/ 1000ml

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13
Q

what does a 1% solution mean

A

1g / 100ml

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14
Q

scabies Tx

A

permethrin cream 5%

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15
Q

sulfonurea counselling

A
  • low blood augars
  • weight gain
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16
Q

names of rapid acting insulins

A

insulin aspart: NovoRapid
insulin lispro: Humalog

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17
Q

medications taken at night

A

statins and amytryptilline

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18
Q

why should aspirin not be taken by a breastfeeding mother

A

increases risk of Reyes syndrome in the child

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19
Q

Reyes syndrome

A

neurological disease that happens in children after a flu or virus (chicken pox most commonly) linked w increased incidence posure to aspriin

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20
Q

which class of medications can mask Sx of hypoglycaemia - causing reduced hypoglycaemic awareness

A

beta blockers e.g. atenolol

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21
Q

derm SE of lithium

A

worsens psoriasis

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22
Q

which class of Abx should you use with caution if penicillin allergy

A

cephalosporins ( about 0.5-6% of people w allergy to penicillin will also be allergic to these)

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23
Q

Chlorphenamine and Chlorpromazine differnece

A

chlorphenamine: antihistamine
chlorpromazine: antipsychotic

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24
Q

Carbimazole and Carbmazepine difference

A

carbimazole: antithyroid
carbmazepine: antiepileptic

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25
Q

PEAK AND THROUGH GENTAMIACIN

A
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26
Q

why should 5% glucose as maintenance fluids be avoided in someone who has had a stroke

A

increased risk of cerebral oedema

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27
Q

antipsychotic monitoring - Ix at beginning of Tx

A

FBC, U+Es, LFTs, lipids, weight, fasting glucose, prolactin,
blood pressure + ECG

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28
Q

why do you need U+Es when question digoxin level in digoxin toxcitiy

A

if pt hypokalaemic digoxin toxicity can occur AT A LOWER PLASMA DIGOXIN level

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29
Q

when do you need a steroid withdrawal plan

A

received more than 40mg prednisolone daily for more than one week
received more than 3 weeks treatment
recently received repeated courses

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30
Q

emergency surgery - drugs to stop w/o alternative

A
  • antiplatelets
  • anticoagulants
  • contraceptive pills
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31
Q

emergency surgery - drugs to consider alternative for

A
  • oral hypoglycaemics ( metformin needs to be stopped due to risk of lactic acidosis but do DM need insulin sliding scale?)
  • insulins
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32
Q

drugs that shouldn’t be stopped before surgery

A

b blockers
CCBs

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33
Q

obvious things to check in preription r/vs

A

dose of paracetamol
dose of statins
daily vs weekly for osteoporosis and methotrexate
dose of aspirin - Tx vs prophylactic
dose of anticoag like enoxaparin - treatment for WHAT

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34
Q

in a drowsy pt

A

stop opiods

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35
Q

lithium rulse w surgery

A

should be stopped a day before

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36
Q

lithium excretion is dramatically reduced with (3) classes of drugs

A

ACE inhibitors
diuretics
NSAIDs

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37
Q

mild mod and sever lithium toxicity

A

mild = tremor
Mod = lethargy
severe = arrhythmias , seizures, coma, renal failure (=dialysis)

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38
Q

if you need to amend dose

A

by SMALLEST increment as a rule

often in BNF if unsure

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39
Q

fluid after aggressive fluid therapy for AKI when kidneys are working again

A

input needs to match output
so if peeing alot and not intaking much still will need alot of fluid to balance

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40
Q

if sodium is upper end of normal for fluid therapy hwhat should u. use

A

5% dextrose with or w/o K deepening on levels

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41
Q

diabetes with low GFR first line

A

gliclazide

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42
Q

BiPAP vs CPAP

A

BiPAP = type 2 resp failure
CPAP = type 1 resp failure

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43
Q

if 2 answers seem right following guidelines MEANS

A

1 will have wrong dose!!!!

44
Q

when do u check lipids with someone on 2nd gen antipsychotic

A

baseline
every 3 months for first year
then annually

45
Q

if you need to convert between steroid therapies

A

type in “glucocorticoid therapy”

46
Q

to find all pain drug conversions

A

palliative care

47
Q

to find Tx in GP for emergencies

A

medical emergencis in the community

48
Q

to find all tips on bleeding / haemorrhage

A

oral anticoagulant

49
Q

to find all ovedose management

A

poisoning

50
Q

to find HRT info

A

sex hormones

51
Q

aminophylline toxicity

A

cause tachycardia –> tachyarrhythmia which can be fatal

52
Q

how long aftr does of aminophyline should level be taken

A

18 hrs unless toxicity concerns

53
Q

how long does consolidation take to clear up on cxr

A

up to 6 wks

54
Q

gum hyperplasia is se of

A

ciclosporin ( immunosurpressant used in organ donation / severe AI diseases)

55
Q

tacrolimus monitoring

A

trough level before dose

56
Q

monitoring of progress of DKA

A

serum ketones

glucose is less useful cos will normalise rapidly agter starting insulin

57
Q

antimuscarinic se

A

urinary retention, constipation blurred vision , dry mouth, GI distrubance

58
Q

why is cyclizine contraindicated in heart failure

A

can worsen fluid retention –> metoclopramide is better choice

59
Q

how long before surgery should antiplatelets be stopped

A

1 week

60
Q

allopurinol and AKI

A

should be stopped as can accumulate without proper renal clearance

61
Q

aspirin and AKI

A

although NSAID not acc nephrotoxic so fine to keep using usually

62
Q

breakthrough pain relief option

A

generally there maintenance and breakthrough should be same drug (e.g. fentanyl patches can be supplemented with fentanyl nasal spray for quick relief)

63
Q

if INR is >1.5 on day of surgery

A

give vit k

64
Q

science name for vit K

A

phytomenadione

65
Q

rivoxaban instructions for taking

A

WITH FOOD - increases absorption

66
Q

most serious SE of ciclosporin

A

nephrotoxicity + HTN

so renal function needs to be monitored closely - esp in first 2 wks of use!!

67
Q

whats the cut off to show working statin

A

more than 40% reduction in non-HDL cholesterol in 3 months

68
Q

diclofenac contraindicated

A

IHD

69
Q

what to monitor if on a heparin like enoxaparin for longer than 4 days

A

platelets due to risk of heparin induced thrombocytopenia

70
Q

threshold for blood transfusion

A

70g for normal
80 is having ACS/ bleed

71
Q

folic acid in pregnant women WITH sickle cell

A

5mg folic acid TILL BIRTH

72
Q

EGFR limit that would suggest stopping / reducing dose of acei

A

if eGFR declines by 25% or more after commencing or increasing the dose of ACE inhibitor

73
Q

whats wrong with paracetamol PRN up to 4 hourly

A

4 HOURLY EXCEESDS MAX DOSE –> NEEDS 6 HRS

74
Q

when should diuretics be given

A

not at NIGHT –> will be up to piss 20 times

75
Q

how often are antiemetics given

A

typically 8 hrly

76
Q

citalopram in elderly

A

over 65s max dose is 20mg

77
Q

what is the highest percentage dextrose you can give as maintenance fluids

A

5%

10/20% is reserved for treating hypoglycaemia

78
Q

ABx review time if not given

A

IV = 3 days
oral = 5 days

79
Q

sodium valproate toxicity and therefore monitoring

A

hepatotoxicity so lfts

80
Q

max rate of KCl

A

10mmol / hour
max 20 if in central line and cardiac monitoring

81
Q

iron and levothyroxine

A

give 4 hours apart cos iron reduces absorption

82
Q

increase in insulin…

A

roughly 2 units (10%)

83
Q

Tx for oral candidiasis

A

nystatin

84
Q

anaphylazis dose

A

500mcg of 1:1000 IM , can be repeated after 5 mins

85
Q

SE of furosemide face

A

sensioneural hesaring loss

86
Q

weird SE of ramipril

A

ANGIOEDEMA
due to inhibition of bradykinin breakdown

87
Q

how to monitor and titrate heparin

A

APTT

88
Q

SE of amiodarone

A

thyroid and fibrosis

89
Q

what precipitates lithium toxicity

A

anything that causes AKI

90
Q

what category of Abx is gentamiacin

A

aminoglycose

91
Q

Weird SE of DMARDs that cant monitor on bloods

A

HIGH BP

92
Q

what type of diuretic is spirinolactone

A

aldosterone antagonist

93
Q

bisphosphonate on for 3-5 years

A

take a bisphosphonate holiday

94
Q

mnemonic for bisphosphonate SE

A

HOld the JAFA cake
H-hyperCa
O-oeseophagitis/heartburn
ld the
J-jaw necrosis
A- atypical #
F- femoral shaft #
A - acute phase reaction (like inflame response)

95
Q

Ranitidine use

A

linked to gastric cancer
NO NEW PTS

96
Q

Secondary prevention drugs

A

aspirin
acei
bblocker
statin

97
Q

aspriin in kid

A

contrindicated cos of risk of reyes syndrome

98
Q

mnemonic for cpy450 inducers

A

CRAPGPS drive me to Madness
C-carbemazepine
R-rifampicin
A-alcohol (chronic)
P- phenytoin
G- griseofluvin
P-phenobarbitone
S-sulfonyureas

99
Q

mnemonic for CYP450 inhibitors

A

SICKFACES.COM

S-sodium valproate
I-Isonazid
C-cimetidine
K- ketoconazole
F- Fluconazole
A - alcohol (acute) + grapefruit
C - chlormapenicol
E- erythromycin
S-sulfonamide
.
C-ciprofloxacin
O-omeprazole
M - metronidazole

100
Q

wake up stroke treatment

A

thrombectomy!!!!

101
Q

the 4 life threatening Fx of arrhythmias

A
  • acute HF
  • shock
  • ischaemia (chest pain)
  • collapse (syncope)
102
Q

what class of Abx is clarithyromycin

A

macrolide

103
Q

which antiemetic is safe in parkinsons disease

A

ONLY DOMPERIDONE

104
Q

sgnif se of macrolides

A

prolonged QTc

105
Q

prescribing code for sublingual

A

SL

106
Q

what class of drug is mefanamic acid

A

NSAID

107
Q
A