Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

To Revise > PSA > Flashcards

PSA Flashcards

1
Q

What anti emetic can worsen parkinson symptoms and why

A

Metoclopramide
crosses BBB and acts on central dopamine receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is Neo-naclex

A

bendroflumethiazide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Drugs causing hypokalaemia

A

Thiazides,any diuretic but spiro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Drugs causing hyperkalaemia

A

ACEi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What drugs are CI in asthmatics

A

beta blockers
NSAIDs
aspirin
ACEi can exacerbate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Causes of high neutrophils

A

infection
inflammation
steroids
Filgrastim- GCSF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Causes of low neutrophils

A

Chemo
Clozapine
Carbimazole
Viral infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Causes of thrombocytopenia

A

Reduced production - drugs eg penicilllamine, Myelofibrosis, myeloma, myelodysplasia
Increased destruction - heparin, DIC, ITP, TTP, HUS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Causes of hyponatraemia

A

hypovolameic - diuretics, d+v, addisons
euvolaemic - SIADH (inc carbamazepine causing SIADH)
hypervolaemic - heart failure, renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Causes of hypernatraemia - D’s

A

Dehydration, Drips (IV fluids), Diabetes insipidus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Causes of hyperkalaemia (DREAD)

A

Drugs eg ACEi and potassium sparing diuretics (spiro)
Renal failure
Endocrine eg Addisons
Artefact
DKA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

If a pt has a high urea but normal creatinine and isn’t dehydrated, what blood result should you look at and why?

A

Hb as an elevated urea in the absence of raised creatinine or dehydration can indicate an upper GI bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Prerenal causes of AKI

A

Dehydration.
Renal artery stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Renal causes of AKI

A

ATN
Nephrotoxic abs eg gent, vans and tetracyclines
ACEi and NSAIDs
Radiological contrast
Rhabdo
Gout
Glomeruloniphridities
Vasculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Post renal causes

A

Stones
fibrosis
tumours
BPH
Prostate cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Differeing between prerenal, renal and post renal causes based off U&E results

A

urea rise > creatinine - Pre renal. Eg (ur 19, Cr 342)
Urea rise <creatinine - Renal and Post (eg ur 7.5, CR 324). To differentiate bladder and hydronephrosis may be palpable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

LFTs in prehepatic jaundice

A

Increased bilirubin
Normal ALT/AST/ALP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

LFTs in hepatic jaundice

A

Increased bilirubin
Increased AST/ALT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

LFTs in post hepatic jaundice

A

Increased bilirubin
Increased ALP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What drugs can cause cholestasis (post hepatic)

A

Flucloxacillin
Co amoxiclav
Nitrofurantoin
Steroids
sulphonylureas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What change needs to occur to thyroxine in each result? Normal range 0.5-5

If TSH now <0.5 following levothyroxine
If TSH now 0.5-5
If TSH now >5

A

decrease dose
maintain same dose
increase dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Signs of pulmonary oedema on cxr

A

Batwing sign
Kerley B lines
Cardio thoracic ratio increased
Diversion of blood - larger vessels in upper
Pleural effusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Features of digoxin toxicity

A

confusion, nausea, arrythmias, visual halos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Features of lithium toxicity

A

Early - coarse tremor
Late - coma, seizures, confusion, arryhtmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Features of phenytoin toxicity

A

gum hypertrophy,
ataxia, nystagmus, peripheral neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Features of gentamicin and vancomycin toxicity

A

ototoxic and nephrotoxic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Target INR for its on warfarin. When is this this target different

A

2.5
3.5 if recurrent VTE whilst on warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

If there is a major bleed in a pt on warfarin what are 3 steps that should be done

A

stop warfarin
give IV vit K
Consider need for prothrombin complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

If there is no bleeding but INR is 5-8 what should be done

If there is no bleeding but INR is >8, what should be done

A

omit warfarin for 2 days then reduce dose

omit warfarin and give Vit K slow injection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

how do NSIADs like ibuprofen cause renal failure

A

reduce prostaglandins which usually dilate renal arteries. Reduces blood flow to kidneys and mimics prerenal failure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What electrolyte imbalance can carbamazepine cause

A

hyponatraemia due to it causing SIADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What drugs should be stopped perioperatively?
(and what to type in treatment summaries if cant rememeber)

A

combined contraceptives
anti platelets
anti coags
oral hypoglycaemics and insulin should be switched to a sliding scale

(surgery and long term meds
and oral anticoagulation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How much paracetamol in 30/500 co codamol

How much paracetamol in 8/500 co-codamol

A

500mg

every preparation has 500mg!!

If also prescribed with paracetmol make sure they aren’t over their daily allowance (4g for >50kg, 2g for <50kg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what meds can cause lithium levels to increase and why

A

ACEi
diuretics
NSAIDs

Because they reduce renal excretion of lithium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

whihc insulins are rapid acting

A

lispro
aspart
humulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

by how many microgram increments in levothyroxine titrated up or down

A

25-50 micrograms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Why can carbamazepine decrease sodium levels

A

bc can cause SIADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

maintenance fluids rule

A

2 salty, 1 sweet + potassium
2x 1L Normal saline
1x 1L glucose
40-60mmol K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

if metformin contraindicated, what is first line

A

either pioglitazone or sulfonylureals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Which hypoglycaemic cause hypoglycaemia and weight gain

A

sulfonylureas and thiaziodiones (glitazones)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Information for its on statins

A

take at night
not used in active liver disease
seek medical assistance if muscle cramps
avoid grapefruit
stop statins if on clarithro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

which diabetic drug is contraindicated in heart failure

A

pioglitazone - thiazolidiones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Drugs that can cause cholestasis

A

Cocp
Co amox
Erythro
Fluclox
Prochlorperazone
Sulphonylureas
Fibrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Drugs that cause hepatic injury

A

Paracetamol
Valproate
Phenytoin
Isoniazid, rifampicin, pyrazinamide
Statins
Alcohol
Amiodarone
Nitrofurantoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What crises can bisoprolol (and other beta blockers) precipitate?

A

Myasthenia gravis crisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What are the aminoglycosides examples

A

Gentamicin
Neomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What are the aminoglycosides. Examples

A

Gentamycin
Neomycin

48
Q

When should creatinine clearance be used instead if eGFR

A

Older adults
When prescribing and monitoring pts on toxic meds eg Vanc, Gent
Extremes of muscle mass
When prescribing and monitoring pts on DOACs

49
Q

Two ways in which doses can be adjusted in renal impairment

A

Reducing the dose
Increasing the interval between doses

50
Q

Which fluid is best for aki

A

Saline
Avoid hartmanns due to potassium content

51
Q

What diuretics should be used in CKD and in what circumstance?
Which ones should be avoided and why?

A

Loop (furosemide) can be used for fluid overload and hyperkalaemia in CKD

Thiazides tend to be ineffective in ckd
Potassium sparing should be avoided bc of hyperkalaemia risk

52
Q

When should ACEi be avoided in ckd

A

If b/l renal artery stenosis

53
Q

How do ACEi work

A

Block ACE, inhibit production of angiotensin II. Prevents vasoconstriction of the efferent arteriole so reduces bp

54
Q

What electrolyte must you check before ACEi started and when should this be re checked

A

Potassium. Recheck 7 days after starting or increasing dose

55
Q

Drug for fast AF if HF with reduces EF

A

Digoxin

56
Q

What can a CCB and beta blocker cause when co prescribed

A

HB

57
Q

Recommended requirements for maintenance fluids and electrolytes

A

1mmol/kg per day K, Na, Cl
50-100g per day glucose
25-30ml/kg/day of water (20-25 if frail or HF)

58
Q

How much potassium per hr max

A

10mmol per hr

59
Q

Good fluid regime for NBM pt with normal electrolytes

A

NaCl 0.18%/glucose 4% with 40mmol/l of Potassium

60
Q

Benzo antidote

A

Flumazenil

61
Q

Toxidrome for amitriptyline

A

Coma,
hypertonia
+ anticholinergic sx:
- Dilated pupils
- Urinary retention
- Tachycardia

62
Q

Toxidrome for heroin

A

(Opioid triad)
Coma
Constricted pupils
Reduced RR

63
Q

Toxidrome for ecstasy

A

Delirium,
Tachycardia
Agitation
Dilated pupils
Hyperthermia

(Sympathetic overdrive)

64
Q

Toxidrome for barbiturates

A

Hypotonia
Coma
Hypotension
Hyporeflexia

(Think that some are used as anaesthetic agents)

65
Q

How does activated charcoal work

A

Reduces absorption by binding to poisons in gut

66
Q

Antidote for cholinergic poisoning

A

Atropine

67
Q

Antidote for iron poisoning

A

Desferrioxamine

68
Q

Antidote for digoxin

A

DifiFAB

69
Q

Antidote for methanol poisoning

A

Fomepizole

70
Q

Antidote for beta blocker toxicity

A

Glucagon

71
Q

Antidote for warfarin posioning

A

Phytomenadione (vit k)

72
Q

Which drug overdoses is dialysis good for

A

Ethanol
Ethylene glycol
Lithium salts
Methanol
Salicylates eg aspirin (can also use urine alkalisation for these)

73
Q

What do up to 10% of pts receiving NAC develop wothin the first hr
If this occurs, what should you do

A

Rash and bronchospasm
Stop infusion, give antihistamine (Iv chlorphenamine) and bronchodilator (salbutamol).
Once sx subsided restart the infusion at a slower rate

74
Q

Rx of a staggered paracetamol overdose

A

Give NAC irregardless of plasma paracetamol concentration

75
Q

What imaging could be done in iron overdose and why

A

Axr
Iron tablets are radio opaque so in large doses they may be visible

76
Q

Side effect of desferroxamine

A

Orange red urine

77
Q

Half life of naloxone
Significance of this

A

20-40mins
Repeat dosing often required

78
Q

Acid/base balance in salicylate (aspirin) toxicity

A

Metabolic acidosis

79
Q

Symptoms of salicylate poisoning

A

N+v
Diarrhoea
Metabolic acidosis - increased RR
Tachycardia
Sweating

80
Q

Rx of salicylate (aspirin) poisoning

A

Activated charcoal if within 1 hr
IV fluids
Urine alkalinisation with Sodium bicarb
Haemodialysis

81
Q

How often should you repeat salicylate concentration

A

Every 2hrs

82
Q

Side effect of using flumazenil in a pt who has benzo dependence

A

May precipitate withdrawal symptoms

83
Q

what abx should never be co prescribed with methotrexate and why

A

trimethoprim (co-trimoxazole)
Can cause severe myelosupression

84
Q

what drug should be co prescribed with methotrexate
how often is it taken and when is it taken in relation to methotrexate

A

folic acid once weekly
24hrs after methotrexate

85
Q

how long after stoppingg methotrexate should women not get pregnant and men wear contraception for

A

6 months

86
Q

what ix should be done before starting a pt on amiodarone and why
what should be checked every 6 months

A

TFT - can cause both hypo and hyper
CXR - risk of pulmonary fibrosis
U+E - for potassium
LFTs - hepatotoxic

LFTs and TFTs every 6 mo

87
Q

Rx of hypoglycaemia

A

See uhl guidelines and cards in ‘endo’ pack

88
Q

How many mg/ml of glucose in 10% glucose?
How many in 20%?

A

100 mg
200mg

89
Q

How much glucose are you aiming to give in mild/mod hypoglycaemia

A

15-20g

90
Q

When should the dvla be informed in diabetes
Normal and occupational

A

If on insulin (or any meds if occupational)
If suffered hypo whilst driving
If had more than 1 ep of severe hypo in last 12 months (or any if occupational)

91
Q

First step of rx for dka
(And how much)

A

Fluid replacement
If BP<90 then 500ml 0.9%NaCl over 15mins
If BP>90 then 1l 0.9%NaCl over 1hr

92
Q

What should you do with a patients normal insulin regime when in DKA
what about if on pump

A

Continue longacting as normal
stop short acting

If pump gives long acting give pump. Stop function of short acting

93
Q

T2DM may get DKA if they are taking what type of hypoglycaemic medication

A

SGLT2 inhibitors

94
Q

Which abx can interact with warfarin to increase the anti coag effect

A

Erythromycin

95
Q

What should pts on warfarin be issues with

A

A yelllw anticoagulant book to record INT

96
Q

Once a stable INR is achieved, how often does it need monitoring

A

Every 12 weeks

97
Q

Where on the bnf to find info about high INR or bleeding on warfarin

A

Treatment summaries
Oral anticoagulation
Haemorrhage

98
Q

What is digoxin, its moa and its indication

A

Cardiac glycoside
Increased force of myocardial contraction
HF and svt

99
Q

What electrolyte imbalance increases the risk of digoxin toxicity

A

Hypokalaemia as myocardium more sensitive

100
Q

Presentation of digoxin toxicity

A

Pretty vague
N+v
Diarrhoea
Malaise
Weakness
Palpitations
Confusion
Hallucinations
Arrhythmias

101
Q

Is the dose of lithium tablets the same as lithium liquids

A

No!

102
Q

Which drugs should you prescribe as brand specific

A

Insulin
Lithium

103
Q

Monitoring requirements for lithium plus timings

A

ECG every 6-12 mo
TFTs every 6mo
U+Es every 6mo
Ca every 6mo
BMI every 6mo

104
Q

How many hrs after a lithium dose should lithium lebels be checked

A

12hrs

105
Q

What electrolyte imbalance can precipitate lithium toxicity

A

Hyponatraemia - beware diuretic use

106
Q

When should metformin be avoided in T2DM?

A
  • patient is not overweight
  • creatinine is over 150 due to risk of lactic acidosis
107
Q

What drug should be used fist line in T2DM when metformin is contraindicated?

A

Sulphonylurea- eg gliclazide

108
Q

How long before surgery should HRT and COCP be stopped?

A

4 weeks

109
Q

How long before surgery should lithium be stopped?

A

day before

110
Q

How long before surgery should ACEi be stopped?

A

day of surgery

111
Q
A
112
Q

Which tb drug causes peripheral neuropathy?
What do you co prescribe

A

Isoniazid
Pyridoxine

113
Q

common side effect of beta blockers

A

diarrhoea

114
Q

first line long term drug rx for chronic hf

A

beta blocker and ACEi first line

115
Q

amiodarone monitoring

A

LFTS and TFTs every 6 months
CXR at start of treatment

116
Q
A

To Revise (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions