PSA Flashcards
Neutropenia sepsis management
Tazocin! - however it contains penicillin
8 year old with appendicitis. Weighs 25kg. No signs of dehydration. What fluid replacement needed?
Go to BNF child -> type in fluids and electrolytes. Control F for maintenance. Answer = 1,600 using the table!!!
8 year old with appendicitis. Weighs 25kg. No signs of dehydration. What fluid replacement needed?
Go to BNF child -> type in fluids and electrolytes. Control F for maintenance. Answer = 1,600
IF A PATIENT has uncontrolled htn on maximum dose of CCB and ace inhibitor ->
must add on thiazide like diuretic eg ?
Indapamide
● Anxiety with adrenergic symptoms, like in the case of panic disorder is ONLY
treated with ?
Propanolol
emergency Hypercalcemia is managed with?
emergency hypocalcemia treatment (following blood transfusion, patient with tingling in legs, ecg shows prolonged QT, low calcium
emergency hypokalemia is managed with?
emergency hyperkaemia treatment?
emergency hypoglycemia
IV 0.9 % SALINE 1L over 4 hours
IV 10% calcium gluconate 10ml over 10 minutes
sodium chloride 0.9/potassium 0.3 (higher potassium) 1L over 4 hours . if it was a child with severe diarrhea and dehydrated, you would just give 0.9%saline over 10 min
IV 10% calcium gluconate 30ml given once only
glucose 20% 100ml over 10 min
● HHS in diabetic patients JBDS guidlines
1L OF NACL over 1 hour
Asthma uncontrolled on saba and ics -> NICE guidelines state to add on an LTRA FIRST
Prescribe monteleukast
Pneumonia oxygen prescription?
COPD?
oxygen 15 L/min non-rebreather mask, continuous (for frequency)
I critical, Ill with copd treat as above, if not = oxygen 28 % venturi mask continuous.
If someone with no lung disease is on 2L oxygen via nasal cannula and this is not enough increase to oxygen 5-6 L/min vía simple face mask. Only give flow rates <4 via nasal cannula
how to induce withdrawal bleed in PCOS?
medroxyprogesterone
Maintenance fluids in surgery? In this case it was a TURP:
The patient was already at top end of sodium cap in serum which was 146.mToo much sodium chloride can result in oedema, hyperchloraemic acidosis, increased kidney load, increased post-operative complications, and GI problems. If K+ is normal/low, you can give some, e.g. 20mmol in 12 hours. ( replace it more slowly)
5% Dextrose with 20
mmolPotassium Chloride V over 12 hours. Dextrose is preferred post operatively.
● Liver disease Maintenance fluids: Human albumin solution is a good alternative volume expander (e.g. 100ml 20% HAS).
continue at SAME dose until euthyroid. Once
euthyroid, gradually reduce dose to 5-15mg daily and this is required for 12-18
months.
Resus fluids in a child?
bolus of 10mL/Kg over 10 min.
Drugs causing hyponatremia,?
Omeprazole, Ramipril
GI side effect of nifedipine?
Constipation
Lying and standing blood pressure is most important!!! When titrating clozapine
-> risk of hypotension
●
For labetalol use in pregnancy, you monitor blood pressure twice a week in the
community until BP is 135/85 or less!! NOT everyday
For labetalol use in pregnancy, you monitor blood pressure twice a week in the
community until BP is 135/85 or less!! NOT everyday
For levothyroxine, in patients with cardiac disease or aged over 55, a lower
initial dose of 25 micrograms PO daily is required
Most important information to give someone on lithium is that they must
drink plenty of water and eat a balanced diet while taking lithium due to risk
of lithium toxicity!!!.
Iron reacts with doxycycline to reduce its effect
Iron reacts with doxycycline to reduce its effect
Malignant hyperthermia management?
Dantrolene
Diabetic undergoing surgery. Fluids to give?
Over 500ml over 6 hours specifically!! Or 1000 over 12 For the sodium 0.45
potassium 0.15 and glucose 5 infusion in diabetes surgery
You correctly chose alteplase 90 mg for stroke BUT the initial 10% shouldve
been administered by injection -> 9mg IV injection
You correctly chose alteplase 90 mg for stroke BUT the initial 10% shouldve
been administered by injection -> 9mg IV injection
Side effect of nitrofurantoin?
Pulmonary toxicity acute and chronic
Side effect of nitrofurantoin?
Pulmonary toxicity acute and chronic
Drugs causing hyperuricemia?
aspirin, bumetanide
and ticalegror
Ecg Side effect of quietapine? Name another drug that causes this
QT prolongation
Ondansetron !:
BNF treatment summary depression -> can change drugs after 4 weeks if no
efficacy. Step 1 switch to another SSRI, step 2 is switch to mirtazapine
Prescribing in palliative care treatment summary!!! Itll give you the conversion of
morphine from 48 mg goes to -> buprenorphine patch 20micrograms. But your
answer was 50mg which is close enough to 20 equivalent
Causes of hyperkalemia?
Tacrolimus
Ciclosporin
Trimethoprim
Starting pain medication is paracetamol. Avoid nsaid in IBD and elderly
●
Nitrofurantoin should be avoided if EGFR is less than 45!!!. Trimethoprim is
better
Nitrofurantoin should be avoided if EGFR is less than 45!!!. Trimethoprim is
better
Starting pain medication is paracetamol. Avoid nsaid in IBD and elderly
Starting pain medication is paracetamol. Avoid nsaid in IBD and elderly
Most important to monitor for adverse effects of ciclosporin after 2 weeks of treatment?
Serum creatinine.
Most important to monitor for adverse effects of ciclosporin after 2 weeks of treatment?
Serum creatinine.
Cholestatic jaundice is common with flucloxacillin!
Cholestatic jaundice is common with flucloxacillin!
● Naproxen causes ankle swelling
● Paracetamol dose in a 10 year old is different! This was the prescribing
error
If it is a child, and you need to find prescribing error, go on to bnfc to check doses
Important safety information section states ciprofloxacin may exacerbate
seizures in epilepsy. If you cant find things in the side effects section, it
may be here
Hyperuricemia for gout
GI disturbance for dyspepsia
Sleep disturbance for insomnia
Monitoring section of artovarstatin says that if serum transaminases are
raised but less than 3 times upper limit, continue artorvastatin at current
dose
dose
● Glargine is long acting insulin so you monitor it pre-breakfast capillary
glucose (fasting) and NOT 2 hour post-prandial
Diverticula disease is treated with co-amoxiclav
Diverticula disease is treated with co-amoxiclav
Make sure to add modified release to the name of the drug
levofloxacin should be avoided in a history of epilepsy
aminophylline worsens siezure control
Adenosine is contraindicated in asthma!!! As is beta blockers and NSAIDs
flecanaide is contraindicated in HF, also avoid oral Ibuprofen
For cellulitis, if there is the option of oral and Iv treatment. Go for oral first. As long as there are no signs of systemic upset
if a patient has PVD and needs a statin, you give them the statin at the higher dose! = 80mg not 20mg because they have established cardiovascular disease
Alendronate can be prescribed daily or weekly
Cardiovascular drugs are usually prescribed once daily so that’s one thing to double check
ECG is necessary in assessing digoxin toxicity
-> review the calculation questions in your Google drive from past papers, maybe do a few on pass med
The gentamicin dose peak and trough doses Cut off is lower in Infective endocarditis!!!
Start acetylcysteine if paracetamol dose is greater than 150 mg/kg
stable angina -> statin + beta blocker/cbb
liver disease can increase inr
search appendix 1 interactions. very important
always double check the unit they want your answer and double check calculations
if you search fluids and electrolytes, itll tell you how many moles of potassium for instance is in 0.3% solution -> 40mmol/litre
you need to know daily requirements =
23-30 ml/kg of water
1mmol/kg Na and K+
50-100g glucose
maintenance fluids you have to prescribe both o.9%saline and 0.15 potassium over 8 hours
bnf treatment summary -> orapharyngeal fungal infections -> nystatin is the drug of choice!!!
if youve given salbutamol inhaler and no relief. you still start in hospital by giving salbutamol NEBULISED
UFH better than enoxaparin in kidney failure. always check this
bleeding, lots
learn the treatment summaries
meningitis in community, give cefotaxime if allergic to penicillin
HRT prescribing. question here is a patient that wants a tablet. 48 yo. irregular periods how to find it?
search “conjugated oestrogens with medroxyprogesterone”
-> cyclical/sequential oestrogen if still having periods, continous if not
womb with LMP < 12 months = estradiol with norethisterone . can also be given as a patch
womb with LMP > 12 months = tibolone
vasomotor symptoms in someone that cant take HRT = clonidine or SSRI
post hysterectomy = estradiol
in BNF specifically, if you are looking for a drug that causes a particular side effect, search
psoriasis and (allopurinol or aspirin or bisoprolol or citalopram or carbamezapine). to get answer
if you dont find it the. usual way
can search by drug name under interactants in BNF specifically
search pioglitazone AND heart failure to quickly double check the side effect
for some drugs, under medicinal forms, when you expand it, you can often find instuctions on how to take it etc
furosemide increases risk of gout
double check insulin prescriptions to make sure its been prescribeed 1ce a day or 3 times as necesary
amoxicillin can cause oral thrush also immunosuppresants
Child with a seizure at the GP, how would you manage?
Rectal diazepam or buccal midazolam!!
The key here is that it is at the GP, so under medicine in the community treatment summary, IV lorazepam is not an option
