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PSA Flashcards

1
Q

treatment of wheeze in acute asthma

A

5mg salbutamol nebulised

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2
Q

DVT treatment

A

12500 units dalteparin (25000units/ml)

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3
Q

daily potassium requirement

A

1mmol/kg/dau

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4
Q

rate for 0.9% sodium chloride/0.15% potassium chloride

A

500 ml over 4 hours

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5
Q

hypercholesterolaemia

A

simvastatin

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6
Q

drugs causing impaired renal function

A

ibuprofen
ACEi
ARBs

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7
Q

drugs to stop in AKI

A 
DAMN
Diuretics 
ACEi/ARBs
Metformin 
NSAIDs
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8
Q

aspirin adverse effect FBC

A

iron deficiency anaemia

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9
Q

urinary retention drugs

A 
morphine
anti-cholinergics (anti-psychotics, antidepressants, detrusor relaxants)
alpha adrenoceptor agonists 
benzos 
NSAIDs
CCBs
Antihistamines 
Alcohol
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10
Q

drugs causing confusion

A

metaclopramide
morphine
corticosteroids

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11
Q

DKA management

A

insulin 50 units in 500ml 0.9% saline IV 0.1 units/kg/hour

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12
Q

dehydration early monitoring

A

blood pressure

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13
Q

HRT monitoring for adverse effects

A

blood pressure

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14
Q

lithium monitoring for toxicity

A

U&Es

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15
Q

simvastatin + slightly raised ALT

A

don’t stop simvastatin

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16
Q

potassium max rate

A

10mmol/hour

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17
Q

enzyme inducers

A 
PC BRAS
Phenytoin 
Carbamazepine 
Barbiturates 
Rifampacin 
Alcohol (chronic excess) 
sulphonylureas
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18
Q

other enzyme inducers

A

topiramate
St. John’s Wort
Smoking

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19
Q

Enzyme inhibitors

A 
AO DEVICES
Allopurinol 
Omeprazole 
Disulfiram 
Erythromycin 
Valproate 
Isoniazid 
Ciprofloxacin 
Ethanol (acute intoxication) 
Sulphonamides
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20
Q

other enzyme inhibitors

A

grapefruit juice
amiodarone
SSRIs

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21
Q

anaphylaxis treatment

A

1:1000 adrenaline 500 mcg IM (0.5ml)
chlorphenamine 10mg IM/slow IV
hydrocortisone 200mg IM/slow IV

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22
Q

ACEi side effects

A

cough

hyperkalaemia

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23
Q

amlodipine side effect

A

oedema

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24
Q

amiodarone side effects

A

pulmonary fibrosis

thyroid dysfunction

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25
Q

carbamazepine side effects

A

hyponotraemia

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26
Q

clozapine side effects

A

agranulocytosis

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27
Q

gliclazide side effects

A

agranulocytosis

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28
Q

metformin side effects

A

lactic acidosis

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29
Q

statin side effects

A

myalgia

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30
Q

major bleeding on warfarin

A

stop warfarin
give phytomenadione (Vit. K)
give prothrombin complex (or FFP)

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31
Q

INR > 8.0 + minor bleeding

A

stop warfarin
give phytomenadione (Vit. K) & repeat in 24 hours if INR still too high
restart warfarin when INR < 5.0

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32
Q

INR > 8.0 + no bleeding

A

stop warfarin
give phytomenadione (Vit. K)
restart warfarin when INR < 5.0

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33
Q

INR 5.0-8.0 + minor bleeding

A

stop warfarin
give phytomenadione (Vit. K)
restart warfarin when INR < 5.0

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34
Q

INR 5.0-8.0 + no bleeding

A

withhold 1 or 2 doses

reduce subsequent maintenance dose

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35
Q

stop warfarin when before elective surgery

A

5 days

if INR >/= 1.5 give phytomenadione (Vit. K) by mouth

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36
Q

emergency surgery, patient on warfarin can delay 6-12 hours

A

give phytomenadione (Vit. K)

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37
Q

emergency surgery, patient on warfarin, cannot delay

A

give phytomenadione (Vit. K) + prothrombin complex

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38
Q

co-amoxiclav adverse effect

A

cholestatic jaundice

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39
Q

creatinine rise when starting ACEi

A

< 20% ok

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40
Q

effective furosemide treatment measurement

A

weight

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41
Q

effective perindopril erbumine in heart failure treatment measurement

A

exercise tolerance

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42
Q

INR target 2.5 in

A 
DVT/PE treatment
AF 
cardioversion (3 weeks before)
dilated cardiomyopathy 
mitral stenosis/regurgitation 
MI
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43
Q

INR target 3.5 in

A

recurrent DVT/PE

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44
Q

warfarin treatment length for isolated calf DVT

A

6 weeks

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45
Q

warfarin treatment length for provoked VTE

A

3 months

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46
Q

warfarin treatment length for unprovoked VTE

A

at least 3 months

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47
Q

combined pill improves

A

acne

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48
Q

combined pill reduces risk of

A

ovarian, uterine and colon cancer

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49
Q

combine pill increases risk of

A

VTE, breast cancer and cervical cancer

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50
Q

contra-indications to combined pill

A 
pregnant 
smoking + >35years 
>35 years + stopped smoking < 1 year ago 
BMI . 35 
migraine with aura 
breastfeeding up to 6 weeks 
CVS/VTE risk factors 
family history of breast cancer
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51
Q

one missed combined pill

A

take missed pill straight away and continue with rest of pack
no extra contraception

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52
Q

two or more missed combined pills

A

take most recent pill straight away
condoms/avoid sex for 7 days
sec in previous 7 days -> emergency contraception

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53
Q

7+ combined pills in pack after two missed

A

finish pack and have 7 day break

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54
Q

<7 combined pills in pack after two missed

A

finish pack but no break

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55
Q

tacrolimus units

A

mg

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56
Q

hyperkalaemia causes

A 
dalteparin
ramipril 
tacrolimus
ciclosporin 
eplerenone
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57
Q

breakthrough for someone on >25mcg transdermal fentanyl patch

A

nasal fentanyl spray 50mcg into one nostril, repeat once if necessary

58
Q

acute alcohol withdrawal treatment

A

chlordiazepoxide 20mg PO 6 hourly

59
Q

advice for rivaroxaban

A

take with food

60
Q

beta blocker side effect

A

erectile dysfunction

61
Q

progesterone only pill increases risk of

A

ovarian cysts and breast cancer

62
Q

contraindications to progesterone only pill

A

pregnant
breast cancer
severe cirrhosis
liver tumours

63
Q

one missed progesterone only pill > 3 hours late

A

take missed pill
take next pill at usual time
condoms for next 2 days
recent sex may need emergency contraception

64
Q

one missed pill < 3 hours late (12 hours for desogesterel)

A

take pill as soon as remembered

take next pill at usual time

65
Q

rapid anticoagulation with warfarin

A

5mg or 10mg OD for 2 days

INR check on day 3

66
Q

lower rapid anticoagulation with warfarin dose if

A

elderly
low body weight
liver disease
heart failure

67
Q

slow initiation starting dose warfarin

A

1-2mg

68
Q

contraindications to warfarin

A 
haemorrhagic stroke 
clinically significant bleeding 
within 72 hours of major surgery 
within 48 hours postpartum 
pregnancy (teratogenicity)
bleeding disorder
69
Q

1 mcg =

A

0.001 mg

70
Q

1% =

A

1g in 100 ml

71
Q

0.1% =

A

0.1g (100mg) in 100ml

72
Q

1:1000 =

A

1mg per ml

73
Q

1:10000 =

A

1mg per 10 ml

74
Q

rivaroxaban contraindications

A 
eGFR < 15
active bleeding 
GI ulcer (current.recurrent)
oesophageal varices 
recent brain/spine injury 
recent brain/spine/eye surgery 
malignant neoplasm 
vascular aneurysm 
prosthetic heart valve
liver disease with coagulopathy
75
Q

resuscitation fluid

A

500ml bolus of 0.9% saline or Hartmann’s over less than 15 mins then reassess

76
Q

daily water requirement

A

25-20ml/kg/day

20-25 ml/kg/day in elderly, renal/heart failure, malnourished

77
Q

daily sodium requirement

A

1mmol/kg/day

78
Q

daily chloride requirement

A

1mmol/kg/day

79
Q

daily glucose requirement

A

50-100g/day

80
Q

0.9% saline tonicity

A

isotonic

resuscitation/maintenance

81
Q

0.9% saline constituents

A

154 mmol/L Na+

154 mmol/L Cl-

82
Q

Hartmann’s tonicity

A

isotonic

resuscitation/maintenance

83
Q

Hartmann’s constituents

A

131 mmol/L Na+
5 mmol/L K+
111 mmol/L Cl-
29 mmol/L HCO-3

84
Q

NaCl 0.18%/glucose 4% tonicity

A

hypotonic

maintenance

85
Q

NaCl 0.18%/glucose 4% constituents

A

30 mmol/L Na+
30 mmol/L Cl-
40g/L glucose

86
Q

5% dextrose tonicity

A

hypotonic

maintenance

87
Q

5% dextrose constituents

A

50g/L

88
Q

pulmonary oedema treatment

A

IV 20mg-50mg of Furosemide 10mg/ml

89
Q

DVT prophylaxis for total hip replacement/total knee replacement patients

A

rivaroxaban 10mg PO

90
Q

hypoglycaemia treatment

A

IV glucose 20% 75-100ml over 10 mins

91
Q

contraindications to HRT (current)

A 
undiagnosed PV bleeding 
Pregnancy/breastfeeding 
oestrogen dependant cancer 
acute liver disease 
uncontrolled hypertension
92
Q

contraindications to HRT (history)

A

history of breast cancer
history of VTE
recent stroke/MI/angina

93
Q

risks of HRT

A 
VTE (no risk with transdermal)
stroke
breast cancer (combined HRT)
ovarian cancer (if used >5 years)
endometrial cancer (if no progesterone)
94
Q

oestrogen HRT side effects

A

breast tenderness
leg cramps
nausea

95
Q

progesterone HRT side effects

A

pre-menstrual symptoms

96
Q

progesterone phase of cyclical HRT side effect

A

PV bleeding

97
Q

no uterus + need HRT

A

oestrogen only (oral or transdermal)

98
Q

users + peri-menopausal

A

cyclical HRT

99
Q

monthly cyclical HRT

A

oestrogen every day but + progesterone 12-14 days to cause bleed at end of every menstrual cycle

use if still having regular periods

100
Q

3 monthly cyclical HRT

A

oestrogen every day but + progesterone every 13 weeks

use if having irregular periods

101
Q

post-menopausal

A

no periods for >1 year or been on cyclical HRT >1 year

102
Q

post-menopausal + need HRT

A

continuous HRT

103
Q

continuous HRT

A

combined oestrogen + progesterone

no bleeds

104
Q

urogenital menopausal symptoms only

A

low dose vaginal oestrogen

105
Q

beta blockers contraindication

A

peripheral vascular disease

106
Q

drugs exacerbating heart failure

A

CCBs

steroids

107
Q

methotrexate teratogenicity

A

effects both men & women

avoid conception for 3 months after stopping too

108
Q

mirtazipine S/E

A

abnormal dreams

109
Q

simvastatin + gemifibrozil

A

severe myopathy and rhabdomyolysis

110
Q

before starting amiodarone check

A

potassium (causes hypokalaemia)

111
Q

sertraline monitoring

A

no routine blood monitoring

112
Q

symptoms + very raised CK (e.g. 5 x upper limit)

A

stop statin

if symptoms resolve, reduce dose and reintroduce

113
Q

nasal steroids + gets nosebleeds

A

stop taking

114
Q

carbamazepine s/e

A 
dizziness 
drowsiness 
dry mouth 
weight gain 
hyponotraemia 
leucopenia 
low platelets
115
Q

amitriptyline side effects

A 
dry eyes (+ blurry vision) 
dry mouth 
GI upset 
drowsiness 
QT prolongation
116
Q

post-op nausea & vomiting

A

ondansatron

117
Q

ondansetron contraindications

A

prolonged QT

118
Q

ondansetron alternative for PONV

A

cyclizine

119
Q

shingles in immunosuppressed

A

Aciclovir 800mg PO 5 x a day

120
Q

lansoprazole side effects

A

diarrhoea

121
Q

naproxen side effects

A

ankle oedema

122
Q

pregnant + thrush

A 
prolonged therapy (7 days)
e.g. clotrimoxazole pessary 100mg PV daily for 7 days
123
Q

first line acute pain in elderly

A

paracetamol

124
Q

ciclosporin monitoring

A

U&Es

125
Q

what to check before starting azathiprine

A

thiopurine methyltransferase (TPMT)

126
Q

how to check over coagulation for NOAC

A

patient reporting bruising

127
Q

morphine in renal impairment

A

swap to oxycodone

128
Q

Verapamil S/E

A 
heart failure 
constipation 
hypotension 
bradycardia 
flushing
129
Q

Diltiazem S/E

A

hypotension
heart failure
bradycardia
ankle swelling

130
Q

nifedipine, amlodipine, felodipine S/E

A

flushing
headache
ankle swelling

131
Q

drugs to improve long term prognosis of heart failure

A

ACEi

beta-blocker

132
Q

Diabetic drugs causing low sodium

A

sulfonylureas (cause SIADH)

133
Q

drugs which may worsen epilepsy control

A 
alcohol, cocaine, amphetamines
    ciprofloxacin, levofloxacin
    aminophylline, theophylline
    bupropion
    methylphenidate (used in ADHD)
    mefenamic acid
134
Q

barking cough

A

= croup

135
Q

croup

A

give sterids

136
Q

worsens psoriasis

A 
beta blockers
lithium
antimalarials (chloroquine and hydroxychloroquine)
NSAIDs
ACE inhibitors
infliximab
   withdrawal of systemic steroids
137
Q

beta blockers in diabetes

A

reduce hypoglycaemic awareness

138
Q

long term steroids + sick

A

double the steroids

139
Q

drugs to stop before surgery

A 
I LACK OP
Insulin 
Lithium 
Anticoagulants/Antiplatelets
COCP/HRT
K-sparing diuretics
Oral hypoglycaemics
Perindopril and other ACEi
140
Q

furosemide

A

gout

141
Q

spironolactone

A

gynaecomastia

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