PSA Flashcards
A 22-year-old man presents to his GP
complaining of increased shortness of breath and
wheezing. PMH. He has suffered from asthma
since early childhood. DH. He normally takes
salbutamol, salmeterol and fluticasone.
His GP prescribes a short course of oral
prednisolone and amoxicillin for an infective
exacerbation of asthma.
Select the adverse effect that is most likely to be
caused by the prednisolone.
Candidiasis
A 17-year-old man presents to his GP
complaining of an itchy rash. He attended A&E
3 days ago complaining of a painful infected
finger following an injury. DH. Flucloxacillin
500 mg orally 6-hrly for 7 days and
paracetamol 1g orally 6-hrly as required.
The rash is thought to be drug-induced and he
is advised to stop taking flucloxacillin.
What is the most appropriate management for
his rash
Chlorphenamine 4mg orally four times a day
A 72-year-old woman has her regular INR check. PMH. She has suffered from a pulmonary embolism 2 months ago. DH. She normally takes warfarin 3mg daily. Her INR is found to be 3.5. What is the most appropriate decision option with regard to the next dose of warfarin based on these data.
Reduce dose to 2mg and recheck INR
A 64-year-old man is seen for his regular diabetes
review appointment. PMH. He has suffered from
type 2 diabetes mellitus for 10 years and has
diabetic nephropathy. He has atrial fibrillation.
DH. He normally takes metformin, atorvastatin,
ramipril, amlodipine and warfarin.
His most recent bloods show: HbA1c 70, Na+ 141
mmol/L (137–144), K+ 4.4 mmol/L (3.5–4.9), U
13.7 mmol/L (2.5–7.0), Cr 210 µmol/L (60–110),
eGFR 29.
What prescription is contraindicated.
Metformin
A 28-year-old woman presents to the outpatient
thyroid clinic complaining of weight loss, racing
heart, nervousness and diarrhoea.
O/E HR 104/min and rhythm irregular. Proptosis, lid
lag and a smooth goitre.
Investigatipons plasma thyroid-stimulating hormone <0.3 mU/L (0.4–5.0), free T4 53.5 pmol/L (10.0–22.0).
What is the most appropriate management
option
Carbimazole 20mg orally daily
A 75-year-old woman presents to the Acute
medical admissions ward complaining of
palpitations and shortness of breath. PMH. She
has suffered from angina in the past. DH. She
normally takes clopidogrel and isosorbide
mononitrate. A diagnosis of atrial fibrillation is
made and she is started on metoprolol.
What is the most appropriate monitoring options
to assess the beneficial effects of this treatment
Symptoms
A 34-year-old woman presents to the medical
assessment unit with a painful, swollen right
leg. A DVT is diagnosed. Dalteparin sodium
6000 units twice daily is recommended for the
remainder of the pregnancy. She is worried
about the safety of this treatment.
What is the most important item of information she
should be given
Low molecular weight heparin does not cross the
placenta
An 81 year old woman presents feeling generally
unwell, lethargic and nauseated.
Past medical history includes hypertension, atrial
fibrillation and TIA.
Her blood results were: Na+ 121 mmol/L (137–
144), K+ 3.4 mmol/L (3.5–4.9), U 17.7 mmol/L
(2.5–7.0), Cr 203 µmol/L (60–110), eGFR 27.
What are the two medications which are the most
likely cause of the hyponatraemia
Indapamide 2.5 mg orally daily
Citalopram 10 mg orally daily
A 32-year-old woman presents to the Accident and
Emergency department complaining of acute onset
breathlessness and pleuritic right sided chest pain.
PMH. She has no past medical history. DH. She
normally takes Microgynon 30. SH. She is a smoker.
On examination: O2 sat 93% on air, BP 121/76 mmHg,
HR 110/min and regular, HS normal, RR 26/min, chest
sounds clear. She weighs 96 kg.
Investigations: ECG shows sinus tachycardia. CXR
shows normal lung fields.
A diagnosis of pulmonary embolism is suspected.
What drug will help to treat a pulmonary embolism, dose and route?
Dalteparin 18000units S/C
A 54-year-old woman presents to the Accident and
Emergency department complaining of severe acute
abdominal pain. On examination: O2 sat 97% on air, BP 154/88 mmHg,
HR 90/min and regular, HS normal, RR 22/min, chest
sounds normal, abdomen generally tender with
guarding.Investigations: Hb 145 g/l, WCC 13.1 x 109/l. ECG
shows sinus tachycardia. CXR shows air under the
diaphragm but no focal abnormality.
Write a prescription for ONE drug that will help to alleviate her pain. (name, dose, route)
Morphine, 5mg, IV
How many mg of Lidocaine is in 5ml of a
Lidocaine 2% solution?
2% solution means there is 2g of Lidocaine in 100ml
Therefore, 1ml = 2g/100 = 0.02g
So, 5ml = 0.1g
A 500ml bag of Sodium Chloride Solution (0.9%)
is given to a patient. How much sodium will be
given?
0.9% sodium chloride means that there is 0.9g in
100ml (or 9g in 1000ml).
Therefore, 500ml contains 4.5g sodium.
A patient with a non-ST elevation MI is going for
coronary angiography. The cardiologist has asked for
an infusion of Abciximab (ReoPro). The bolus dose has
been given. Calculate the dose needed (125
nanograms/kg/minute). The patient weighs 78kg.
Dose = 78 x 125 nanograms = 9750 nanograms = 9.75mcg
per minute or 585mcg per hour
