PSA

Question 1

Drugs causing hypokalaemia

Answer 1

Thiazide diuretics
Acetazolamide

Question 2

Drugs causing hyperkalaemia

Answer 2

ACEI, ARB
Spironolactone
Heparin
Trimethoprim

Question 3

Beta blocker SE

Answer 3

Bronchospasm
Cold peripheries
Reduce hypoglycaemia awareness
Fatigue
Sleep disturbances
Erectile dysfunction

Question 4

CCB SE

Answer 4

Amlodipine, nifedipine:
gingival hyperplasia, gum swelling
Reflex tachycardia
Ankle swelling
Postural hypotension
Headache
Flushing

Verapamil:
HF
Constipation
Hypotension
Bradycardia
most highly negative inotrope CCB
Don’t use in HF

Question 5

Statins SE

Answer 5

Myopathy, myalgia, Rhabdomyalysis
headahce,
Liver impairment, check LFTs at baseline, 3mths and 12mths

Question 6

Statins contraind

Answer 6

macrolides, erythro, clarithyro
Pregnancy

Question 7

Thiazide diuretics SE

Answer 7

Dehydration
Postural hypo
Hypokalaemia
Hyponatraemia
Hypercalcaemia, hypocalciuria
Gout
Impaired gluc tol
Erectile dysfunction
Digoxin toxicity

do not give to diabetics

Question 8

Amiodarone SE

Answer 8

hypo and hyperthyroid
Pulm fibrosis/ pneumonitis
Liver fibrosis/ hepatitis
Bradycardia
Lengths QT
Thrombophlebitis
Slate grey appearance, blue/grey
Peripheral neuropathy
Photosensitivity
Corneal opacities

Question 9

P450 enzyme inducers (inc other drugs metabolism,
reduce therapeutic conc)

Answer 9

P450 enzyme inducers (inc other drugs metabolism, reduce therapeutic conc)

Antiepileptics: phenytoin, carbamazepine
barbiturates: phenobarbitone
rifampicin
sulphonylureas
St John’s Wort
chronic alcohol intake
griseofulvin
smoking

Question 10

P450 enzyme inhibitors, inc therapeutic concentration

Answer 10

Ciprofloxacin, erythromycin
isoniazid
cimetidine, omeprazole
amiodarone
allopurinol
imidazoles: ketoconazole, fluconazole
SSRIs: fluoxetine, sertraline
ritonavir
sodium valproate
acute alcohol intake + grapefruit juice

Question 11

what is the breakthrough dose for morphine

Answer 11

1/6 of total dose

Question 12

what opioid is used in severe renal impairment

Answer 12

alfentanil,
buprenorphine,
fentanyl

Question 13

Drugs causing gynaecomastia

Answer 13

Spironolactone (most common drug cause)
cimetidine
digoxin
cannabis
finasteride
GnRH agonists e.g. goserelin, buserelin
oestrogens, anabolic steroids

Question 14

Thiazide diuretics side effects

Answer 14

hypokalaemia
hyponatraemia
hypercalcaemia

impaired glc tolerance
gout
sexual dysfunction
Dehydration
Postural hypo
digoxin toxicity

Question 15

Metformin side effects

Answer 15

GI upset
Reduced vit b12 asso
Lactic acidosis w severe liver disease or renal failure

Question 16

Sulphonyurea side effects (gliclazide)

Answer 16

weight gain
hypoglycaemia

(siadh)

Question 17

DDP-4 inhibitor side effects (sitagliptin)

Answer 17

weight neutral
pancreatitis
nausea
nasopharyngitis

Question 18

Thiazidolines side effects

Answer 18

weight gain
fluid retention - contraind HF
inc risk bladder cancer
inc risk fractures

Question 19

GLP-1 analogues side effects

Answer 19

weight loss
nausea pancreatitis

Question 20

SGLT2-inhib side effect

Answer 20

inc risk UTI
weight loss
Inc risk lower limb amputation
Contraind in active foot disease - skin ulcer
Necrotising fasciitis of genitalia

Question 21

Causes of G6PD exacerbation

Answer 21

anti malarials - primaquine
ciproflox
sulphonamides
sulfonureas
infection
fava beans

Question 22

drugs causing erythema multiforme

Answer 22

penicillin
sulphonamides, carbamazepine, allopurinol, NSAIDs, oral contraceptive pill, nevirapine

Question 23

Appendix 1 on BNF what SE can you find

Answer 23

hepatotoxicity
nephrotoxicity
anticoagulant effects
antiplatelet effects
bradycardia
hypotension
prolong QT interval
antimuscarinic effects
affect CNS
peripheral neuropathy
serotonin syndrome
anti-diabetic drug
myelosuppression
inc potassium
reduce potassium
hyponatraemia
ototoxicity
neuromuscular block

Question 24

Meds to stop before surgery

Answer 24

ACEI
ARB
COCP, HRT (4wks bfr)
Diuretics
Anticoags
Lithium
Nsaids

Question 25

What diabetic drugs to stop pre-op day of

Answer 25

Metformin lunch dose if TDS Sulphonylureas - gliclazide SGLT2

Question 26

treatment for scarlet fever

Answer 26

phenoxymethylpenicillin

Question 27

treatment of epiglottitis

Answer 27

cefotaxime

Question 28

treatment of impetigo

Answer 28

hydrogen peroxide if around eye then fusidic acid cream

Question 29

what drug is used instead of morphine in mild/mod renal impairment

Answer 29

oxycodone

Question 30

pain relief in severe renal egfr <30

Answer 30

severe renal egfr <30 - alfentanil, buprenorphine, fentanyl

Question 31

Stimulant type laxatives (iN BNF)

Answer 31

Senna Bisacodyl

Question 32

Osmotic type laxatives (in bnf)

Answer 32

Macrogol Lactulose

Question 33

What type of laxative is docusate (in bnf)

Answer 33

softener

Question 34

Bulking type laxative (in bnf)

Answer 34

isphagula husk

Question 35

Maintanence fluids ranges - water - electrolytes - glucose

Answer 35

water 25-30ml/kg/day electrolytes - 1mmol/kg/day glucose 50-100g a day

Question 36

what is 50g of glucose in fluid form

Answer 36

5% dextrose in 1000ml

Question 37

Over what time should resus fluids be given

Answer 37

less than 15mins

Question 38

infusion time for 500ml fluids

Answer 38

4-6hrs

Question 39

infusion time for 1000ml fluids

Answer 39

8-12hrs

Question 40

What level of K mmol can give you per hour

Answer 40

Up to 10mmol/hr

Question 41

what is 40mmol K in percentage form

Answer 41

0.3% K

Question 42

what is 20mmol K in percentage form

Answer 42

0.15%

Question 43

Ondansetron common side effect

Answer 43

constipation

Question 44

COCP names to search on bnf

Answer 44

microgynon ethinylestradiol with levonogesterol

Question 45

POP names to search on bnf

Answer 45

Cerazette - desogestrel Levonogesterol

Question 46

Implant name bnf

Answer 46

Nexplanon - etonogestrel

Question 47

depot injection bnf

Answer 47

medroxyprogest ( on bnf in contraceptives hormonal, injections)

Question 48

HRT type in patients with no uterus

Answer 48

oestrogen only (unless hysterectomy due to endometriosis)

Question 49

HRT type in patients with uterus

Answer 49

combined oestrogen and progesterone

Question 50

HRT in patients wtih LMP <1 years

Answer 50

cyclic

Question 51

HRT in patients wtih LMP >1 years

Answer 51

continuous HRT

Question 52

HRT combined cyclic types

Answer 52

estradiol 1mg + norethisterone sequential tablet Elleste-duet 1mg estradiol 2mg + norethisterone sequential tablet estradiol 50mcg + norethisterone 170mcg Sequi patch Evorel Sequi

Question 53

HRT combined continuous types

Answer 53

estradiol 2mg + norethisterone conti Elleste-duet conti tibolone estradiol 50mcg + norethisterone 170mcg CONTI patch Evorel conti

Question 54

HRT oestrogen only types

Answer 54

estradiol 1mg tablet estradiol patch

Question 55

Where can trigeminal neuralgia tx be found

Answer 55

Neuropathic pain TS

Question 56

Where can INR vit K tx info be found?

Answer 56

Oral antigcoagulants TS - haemorrhage

Question 57

Paediatric fluid maintenance calculation

Answer 57

100ml/kg for first 10kg 50ml/kg for next 10kg 20ml/kg for every kg after

Question 58

calculation for infusion rate

Answer 58

dose/time

Question 59

Serotonin syndrome causes

Answer 59

Tramadol St John's wort Triptans MAOIs

Question 60

Signs of DKA

Answer 60

ketones >3 or ketonuria 2+ pH <7.3

Question 61

DKA management

Answer 61

0.9% sodium chloride 500ml 10-15mins 0.1% fixed rate insulin stop short acting insulin continue long acting

Question 62

hypoglycaemia management where to find

Answer 62

TS medical emergencies in community - hypoglycaemia TS hypoglycaemia

Question 63

what is vitamin K drug name

Answer 63

phytomenadone

Question 64

Adrenal insufficiency treatment where to find?

Answer 64

TS adrenal insufficiency - hydrocortisone

Question 65

Asthma exacerbation tx find and pneumonic

Answer 65

TS asthma, acute O SHIT ME Oxygen Salbutamol nebulised Hydrocortisone/Predn Ipatropium bromide Theophylline/Amino Magnesium sulphate Escalate

Question 66

where to find antibiotic prophylaxis in surgery

Answer 66

TS antibacterials, use for prophylaxis

Question 67

what fluids are required pre-op NBM

Answer 67

maintenance fluids 2 sweet 1 salty

Question 68

Pulmonary oedema treatment where

Answer 68

TS chronic heart failure

Question 69

VTE tx in pregnancy

Answer 69

LMWH - dalteparin or enoxaparin

Question 70

digoxin toxicity ecg sign

Answer 70

reverse tick

Question 71

Venous thromboembolism prophylaxis in renal impairment?

Answer 71

unfractioned heparin

Question 72

drugs that prolong QT interval

Answer 72

amitriptyline amiodarone ciprofloxacin erythromycin ketoconazole

Question 73

child resus fluids dose

Answer 73

10ml/kg NaCL 0.9% 10mins

Question 74

hypercalcaemia fluid tx

Answer 74

0.9% NaCl 1000ml 4 hours

Question 75

hypokalaemia fluid tx

Answer 75

NaCl 0.9% + KCl 0.3% 1000ml 4 hours

Question 76

hypocalcaemia tx

Answer 76

calcium gluconate 10%, 10-20ml over 10mins

Question 77

hyperkalaemia tx

Answer 77

calcium gluconate 10%, 30ml over 10mins

Question 78

drugs prescribed in mcg

Answer 78

levothyroxine naloxone digoxin tamsulosin fludrocortisone GTN ipatropium

Question 79

Nephrotoxic drugs

Answer 79

DAMN diuretics ARB ACEI metformin NSAIDS gentamicin lithium opiates nitrofurantoin

Question 80

drugs causing drowsiness

Answer 80

Amitrityline fentanyl topiramate chloramphenamine benzos SSRIs

Question 81

drugs causing bradycardia

Answer 81

Beta blockers donepezil verapamil digoxin

Question 82

Wernickes encephalopathy sx and tx

Answer 82

nystagmus ataxia confusion opthalmoplegia tx - Pabrinex - vitamin b substances w ascorbic acid

Question 83

drugs taken in morning

Answer 83

Steroids Diuretics

Question 84

drugs taken at night

Answer 84

statins zopiclone

Question 85

rapid acting insulin

Answer 85

Novorapid

Question 86

long acting insulin

Answer 86

Levemir