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FINALS > PSA > Flashcards

PSA Flashcards

1
Q

Prescriber mnemonic

A
  • Patient details
  • Reaction
  • Sign chart
  • Contraindications
  • Route
  • IV fluids
  • Blood clot prophylaxis
  • Anti Emetics
  • pain Relief
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2
Q

Contraindications for drugs that increase bleeding

A
  • bleeding
  • suspect of beeding
  • at risk of bleeding
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3
Q

SE for steroids

A
  • Stomach ulcers
  • Thin skin
  • Oedema
  • R and L HF
  • Osteoporosis
  • Infection
  • DM
  • Cushings
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4
Q

CI for NSAIDs

A
  • Renal failure
  • Systolic dysfunction = hf
  • Asthma
  • Indigestion
  • clotting abnormality
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5
Q

CI for anti hypertensives

A
  • hypotension
  • bradycardia
  • electrolyte disturbance
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6
Q

antiemetic choice if nauseated

A
  • cyclizine 50mg 8hrly
  • metoclpramide 10mg 8hrly if HF
  • ondansetrON 4MG Or 8mg 8hrly
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7
Q

anti emetic if not nauseated

A
  • cyclizine tomg up to 8hrly
  • met
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8
Q

when to avoid metoclopramide

A
  • parkinsons
  • young women
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9
Q

causes of hyponatraemia

A

Hypovolaemic
- Fluid loss
- Addissons
- Diuretics
Euvolaemic
- SIADH
- Polydipsia
- hypothyroid
Hypervolaemic
- HF
- Renal failure

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10
Q

Causes of hypokalaemia

A

DIRE
- Drugs = loop and thiazide
- Inadequate intake or intestinal loss
- Renal tubular acidosis
- Endocrine = cush and conn

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11
Q

causes of hyperkalaemia

A

DREAD
- Druhs = K sparing and ACEi
- Renal failure
- Endocrine = addison
- Artefact
- DKA

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12
Q

S+S digoxin toxicity

A
  • confusion
  • nausea
  • visual halos
  • arrhythmia
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13
Q

S+S lithium toxicity

A
  • early = tremor
  • intermediate = tired
  • late = arrythmia, seizure, coma, renal failure, DI
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14
Q

S+S phenytoin toxicity

A
  • gum hypertrophy
  • ataxia
  • nystagmus
  • peripheral neuropath
  • teratogenicity
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15
Q

S+S gent and vanc toxicity

A

-ototoxicity
- nephrotoxicity

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16
Q

usual dosing of gentamicin

A
  • high dose regimen of 5-7mg/kg once daily
  • RF or IE = 1mg/kg 12hrly
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17
Q

gent monitoring for divided daily dosing

A
  • peak = 1hr post dose = IE 3-5, else 5-10
  • trough = before enxt dose = IE <1 else <2
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18
Q

major bleed on warfarin

A
  • stop warfarin
  • 5-10mg IV vit K
  • give prothrombin complex
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19
Q

INR 5-8 and no bleeding

A

omit warfarin 2 days then reduce dose

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20
Q

INR 5-8 and minor bleeding

A
  • omit warwarin and gice 1-5mg IV vit K
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21
Q

INR >8 and no bleed

A

omit warfarin and give 1-5mg PO vit K

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22
Q

INR >8 and minor bleeding

A

Omit warfarin and give 1-5mg IV vit K

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23
Q

ramipril in pregnancy?

A

No - teratogenic
- switch to labetalol pre conception

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24
Q

Tamoxifen patient information

A
  • increases risk of endometrial cancer
  • increases efficacy of warfarin
  • increased VTE risk
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25
Q

sulphonylureas patient info

A
  • increased hypo risk
  • take in morning to avoid nocturnal hypo
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26
Q

monitoring for methotrexate

A

1-2 weekly bloof tests

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27
Q

what adjunct should be started with prednisolone

A

bisphosphonate if pred >3m

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28
Q

citalopram pateint info

A
  • more photosensitive
  • suicidal thoughts
  • dry mouth
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29
Q

HRT patient info

A
  • breask cancer risk higher for combined
  • excess risk persists >10yrs after stopping HRT
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30
Q

1% = …

A
  • 1g in 100 ml
  • 10mg in 1 ml
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31
Q

SE of gent and vanc

A

nephrotoxicity
ototoxicity

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32
Q

ACEi SE

A
  • hypotension
  • electrolyte abnormalities
  • AKI
  • dry cough
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33
Q

BB SE

A
  • hypotension
  • bradycardia
  • wheeze in asthma
  • worsens acute HF
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34
Q

SE CCB

A
  • hypotension
  • bradycardia
  • peripheral oedema
  • flushing
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35
Q

heparin SE

A
  • haemorrhage (esp RF or <50kg)
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36
Q

aspirin se

A
  • haemrrhage
  • peptic ulcers
  • gastritis
  • tinnitus (large doses)
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37
Q

digoxin SE

A
  • nausea and vomiting
  • diarrhoea
  • blurred vision
  • confusion and drowiness
  • xanthopsia = halo vision, yellow/green
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38
Q

amiodarone SE

A
  • ILD
  • thyroid disease
  • grey skin
  • corneal deposits
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39
Q

drugs with narrow therapeutic index

A

PC BRAS
- Phenytoin
- Carbamazepine
- Barbiturates
- Rifampicin
- Alcohol
- Sulphonylureas

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40
Q

Drugs needing careful dosage control

A

AODEVICES
- Allopurinol
- Omeprazole
- Disulfiram
- Erythromycin
- Valproate
- Isonizaid
- Ciprofloxacin
- Ethanol
- Sulphonamides

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41
Q

what fluid to give if hypernatramic of hypoglycaemic

A
  • 5% dextrose
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42
Q

what replacement fluid to give if ascites

A

human albumin solution

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43
Q

how much fluids to adults need

A
  • 3L IV fluid in 24 hrs (2l if elderly)
  • adequate electrolytes provided by 1l 0.9% saline and 2l 5% dextrose
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44
Q

how fast to give maintenance fluids

A
  • 3L a day = 8 hourly bags
  • 2L a day = 12 hourly bags
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45
Q

what does co-codomol 30/500 contain

A
  • 30mg codein and 500mg paracetamol
  • no more than 4g paracetamol a day
46
Q

why dont you prescribe CCB and BB together

A
  • serious cardiac side effects = 1st degree heart block and brady
47
Q

should CHC be stopped pre surgery

A

yes, 4 weeks prior to major elective surgery

48
Q

what medications reduce efficacy of hormonal contraception

A
  • enzyme inducing drugs = rifampicin, lamotrigine, carbamazepine
49
Q

drugs to stop before surgery

A

I LACK OP
- Insulin
- Lithium = day before
- Anticoagulants
- COCP/HRT = 4 w before
- K sparing diuretics = day of
- Oral hypoglycaemics
- Perindopril and ACEi

50
Q

causes of hypernatraemia

A
  • dehydration
  • drips
  • drugs
  • DI
51
Q

causes of hyponatraemia

A

hypovolaemic
- fluid loss, addisons, diuretics
euvolaemic
- SIADH, polydipsia, hypothyroid
hypervolaemic
- HF, RF, LF

52
Q

Pre renal AKI

A
  • Urea rise > creatinine
  • Dehydration
  • Renal artery stenosis
53
Q

intrinsic AKI

A
  • Urea rise < creatinine
  • Ischaemia
  • Nephrotoxic abx
  • ACEi, NSAIDs
  • Radio contrast
  • Injury
  • Gout
54
Q

postrenal AKI

A
  • Urea < creatinine
  • Stones
  • tumours
55
Q

TSH <0.5

A

decrease thyroxine dose

56
Q

TSH 0.5-5

A

same dose

57
Q

TSH >5

A

increase thyroxine dose

58
Q

what dose gent are most patients on

A

5-7mg/kg once daily

59
Q

dose morphine and BB in N/STEMI

A
  • 5-10mg IV with cyclizine 50mg IV
  • BB = 2.5mg oral
60
Q

adult acute asthma tx

A
  • 100% o2
  • Salbutamol 5mg neb
  • Hydrocortisone 100mg IV or pred 40-60mg oral
  • Ipratropium 500mcg neb
  • aminophylline
61
Q

PE tx

A
  • abc
  • high flow o2
  • morphine 5-10mg IV, cyclizine 50mg IV
  • LMWH e.g. tinz 175units/kg
62
Q

8 Cs of GI bleed

A
  • cannula x2
  • catheter
  • crystalloid bolus
  • cross match 6 units
  • correct clotting
  • camera
  • call surgeon
63
Q

bacterial meningitis

A
  • 4-10mg dex
  • lp
  • 2g cefotaxime IV
64
Q

Mx status

A
  • loraz 2-4mg IV or 10mg diaz IV or buccal midaz 10
  • after 5 repeat
  • still fitting = 15-20mg/kg ohenytoin
65
Q

chronic heart failure tx

A
  • ACEi e.g. lisinopril 2.5mg daily
  • BB = bisop 1.25mg daily
  • Sprionolactone 25mg daily
66
Q

HTN with T2DM

A

ACEi

67
Q

HTN, <55 and not black african

A
  • ACEi
68
Q

HTN and 55+

A

CCB

69
Q

HTN and black african

A

CCB

70
Q

CHA2D2S2VASc score

A
  • CHF
  • HTN
  • Age >75
  • Dm
  • Stroke/TIA
  • Vacular disase
  • Age 65-74
  • Sex
  • 1 = in men use apixaba,, riv or warfarin
  • 2 = same
71
Q

HASBLED score

A
  • HTN
  • Abnormal renal function
  • Stroke
  • Bleeding
  • Labile INR
  • Elderly >65
  • Drugs
72
Q

asthma mx adults

A
  • SABA
  • ICS
  • LABA
  • LTRTA
73
Q

1g = how many mg

A

1g = 1000mg

73
Q

1 mcg = ?ng

A

1mcg = 1000ng

74
Q

1 milligram = how many mcg

A

1mg = 1000mcg

75
Q

1st line choice for T1DM

A
  • multiple daily injection basal bolus insulin
  • twice daily insulin detemir as ling acting basal insulin #
76
Q

T2DM drugs

A
  • metformin (not if obese)
  • SGLT2 inhibitor as well if HF
77
Q

resuscitation fluids

A
  • crystalloids with Na 130-154
  • 500ml bolus
  • <15 minutes
78
Q

speed to replace K

A
  • no faster than 10mmol/h
79
Q

emergency resus fluids

A

NaCl 0.9% 500ml 15mins

80
Q

emergency hypoglycaemia fluids

A

glucose 10% 150ml 15 min

81
Q

emergency hypokalaemia fluids

A

NaCl 0.9%/KCl 0.3% 1000ml 4hr

82
Q

emergency hypercalcaemia fluids

A

NaCl 0.9% 1000ml 4hrs

83
Q

maintenance fluids with deficits or losses

A

minimum 30ml/kg/24hr water and ensure electrolytes replaced, aim 4-6hr

84
Q

how many mmol Na in 0.9%

A

150 mmol

85
Q

how many mmol K in 0.3 and 0.15%

A

0.3% = 40mmol
0.15% = 20mmol

86
Q

emergency resus fluids for children

A

NaCl 0.9% 10ml/kg 15 minutes

87
Q

maintenance fluids for children

A

10ml/kg/24 hr if <10kg
50ml/kg/24hr 10-20kg
20ml/kg/24h for >20kg

88
Q

anticoagulation treatment dvt

A

apixaban or rivaroxaban

89
Q

anticoagulation prophylactic dvt

A
  • LMWH = dalteparin, enoxaparin, tinzaparin
  • renal failure = unfractioned heparin
90
Q

uterus intact and LMP <12 m ago hrt

A
  • oral sequential combined oestrogen and progestogen = elleste-duet 1mg or 2mg
  • patch sequential combined oestrogen and progestogen = evorel sequi
91
Q

uterus intact and LMP >12m ago

A
  • oral continuous combined oestrogen and progestogen = elleste-duet conti
  • patch continuous combined oestrogen and progestogen = evorel conti, tibolone
92
Q

hrt post hysterectomy

A
  • oral or patch oestrogen = elleste solo or tibolone
  • estradiol
93
Q

Missing 1 pill when the pill is >24hrs late

A

<72hrs since last pill was taken
- Take missed pill ASAP even if 2 in 1 day
- No extra protection needed

94
Q

Missing >1 pill (>72hrs since last pill)

A
  • take most recent pill ASAP
  • Additional contraception for 7 days
  • if days 1-7 emergency contraception
  • 8-14 no emergency contraception
  • 15-21 no emergency contraception and back to back
95
Q

Who are sequential HRT preparations for

A
  • intact uterus
  • Perimenopausal <12m
96
Q

Tablet sequential HRT regimes

A
  • Estradiol 1mg + norethisterone sequential
  • Estradiol 2mg + norethisterone sequential
97
Q

transdermal sequential HRT

A
  • estradiol 50mcg + levonorgestrel 10mcg SEQUI patch
98
Q

who is continuous combined hrt for

A
  • > 12m last period
  • > 54
  • > 3yrs on sequential
99
Q

Continous tablet hrt

A
  • Estradiol 2mg + norethisterone 1mg CONTI
  • Estradiol 0.5mg + norethisterone 1mg CONTI
100
Q

Transdermal continuous hrt

A
  • Estradiol 50mcg + norethisterone 7mcg CONTI patch
101
Q

DDP4i meds are…

A
  • linagliptin
  • improve insulin sensitivity
  • SE = pancreatitis
  • Increase weight
102
Q

Sulfonylurea

A
  • gliclazide
  • Enhance insulin secretion
  • Can cause hypo
103
Q

SGLT2i

A
  • empagliflozin
  • Reduce renal glucose reabsoprtion
  • SE = ketoacidosis, genital infection
104
Q

|GLP1 analogue

A
  • semaglutide
  • Increatin effect
105
Q

name 3 rapid acting insulins

A
  • novorapid
  • apidra
  • humalog
106
Q

name 3 short acting insulins

A
  • actrapid
  • humulin r
  • humulin s
107
Q

name 2 intermediate insulins

A
  • humulin I
  • insulatard
108
Q

name 3 long acting

A
  • tresiba
  • lantus
  • semglee
109
Q

name 3 pre mixed insulins

A
  • humulin M3 = short and inter
  • novomix 30 = novorapid annd another
  • humalog mix 25 and 50
110
Q

paeds resus fluids

A

10ml/kg NaCl 0.9% <10 mins

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