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Final year Medicine > PSA > Flashcards

PSA Flashcards

1
Q

Side effect of Thiazides

A

Dyslipidaemia

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2
Q

Sx of lithium toxicity

A 
D+V
drowsy
tremor
thirst
polyuria
muscle weakness
confusion
ataxia
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3
Q

Tx for oral candidiasis

A

Miconazole oral gel 2.5ml PO QDS
Nystatin 100000u topical QDS
for 7 days
or 48h after sx resolve

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4
Q

Caution with carbimazole

A

Report fevers or sore throat to dr immediatedly.

agranulocytosis

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5
Q

Side effect of gentamicin

A

Tinnitis, deafness, balance loss.

Monitor plasma concs.

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6
Q

Status epilepticus mx

A

IV Lorazepam 4mg once only

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7
Q

IV paracetamol dose

A

<50kg = 15mg/kg every 4-6h over 15mins
max 60mg/kg/day.

> 50kg 1g every 4-6h
over 15 mins max 4g/day.

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8
Q

Anaphylaxis med

A

Adrenaline 1 in 1000 0.5mg IM Once only

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9
Q

ACEi in pregnancy

A

avoid
affects neonatal BP control and renal function.
skull defects, oligohydramnios.

Alternative: Labetalol

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10
Q

Analgesia in alcoholic liver disease

A

Paracetamol 500mg PO QDS =Safe
Avoid NSAIDSs - risk of bleeding.
Avoid opiates - hepatic encephalopathy

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11
Q

drug induced psoriasis

A

beta blockers

RFs: Obesity, smoking, DM, HTN, Dyslipidaemia

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12
Q

glucose level to postpone surgery

A

Blood glucose >12
ketones >3
Urine ketones> +++

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13
Q

how to prescribe sliding scale insulin

A

continue long acting insulin at normal dose + time. (lantus, glargine, levemir, isophane, humulin 1)
50units actrapid to 49.5l of 0.9%sodium chloride -> 1unit/ml . syringe pump.
insulin requirements are 0.5-1unit per kg.
sign the scale required.
check glucose every hour if unstable. 2-4h if stable control.
fluids prescribe
dex-saline(0.18% NaCl + glucose 4%) + KCL (70mmoll/24h)

recheck U+Es
resign vrii chart daily

Stopping: confirm eating and drinking
ensure long acting on board 1h before stopping.

give mixed/rapid insulin at usual mealtime. and wait 30mins before stopping VRII.
monitor CBG QDS for 24h.

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14
Q

types of insulin

A

Rapid: At start off meal
Novorapid (aspart)
Humalog (lispro)
Adipra (glulisine)

Short (15-30min before meal)
Actrapid
Humulin S

Intermediate (OD/BD as mix)
Humulin I
Insulatard
Insuman basal

Long acting (OD)
Lantus (glargine)
Levemir (detemir)
tresiba (degludec)

pre Mixtures 
Intermed+short
30m before brek+dinner
Humulin M3 (30% short acting)
Insuman comb 15/25/50% short acting)

Intermed + rapid (start of brek+din)
Novomix 30
Humalog mix 25/50

basal bolus regimen
long (levemir/lantus) at night + rapid w every meal.

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15
Q

Adjusting insulin regimens

A

BASAL BOLUS

  • high/low before brek -> increase/decrease evening long acting insulin.
  • high.low before lunch/dinner/bed - increase/decrease rapid given with meal before.
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16
Q

Hypoglycaemia mx

A

Conscious/can swallow: 4-7 glucotabs if <4 BM
Reduced GCS: IM glucagon 1mg
20% dextrose 75ml IV over 15 mins

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17
Q

Asthma acute mx

A

Salbutamol nebs 5mg every once only. Back to back.
IV hydrocortisone 100mg QDS (severe)
mild (oral predinsolone 40 mg PO stat)
Ipratropium bromide 250 micrograms nebs every 4-6h

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18
Q

acute HF

A

IV furosemide 40mg once only.
diamorphhine 2.5mg over 5mins
metoclopramide 10mg

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19
Q

hyperemesis gravidarum mx

A

IV fluids
Cyclizine 50mg PO.IM
then metoclopramide

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20
Q

T2dM meds

A

Pioglitazone (thiazolidinedione) - can cause hypo
Metformin cant
acarbose -

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21
Q

statins

A

give atorvastatin 20mg

if qrisk2 score >10%

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22
Q

urticaria tx

A

Non sedating antihistamines.
Cetirizine 10mg PO OD
Fexofenadine 180mg PO OD
Loratidine 10mg OI OD

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23
Q

Chlamydia tx

A

Azithromycin 1g oral once only

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24
Q

Scabies tx

A

permethrin 5% cream topical once a week 2 doses
Malathion
Hyperkeratotic - ivermedtin 200micrograms/mg

25
Q

reflux paeds

A

1-2week trial of Alginate theapy after every feed.

  1. Gaviscon 2 infant sachets oral as required
  2. PPI/h2 receptor antagonist 4 weeks.
  3. bottle fed - thickened foods
26
Q

Detrusor overactivity

A

oxybutynin IR 5mg oral TDS

27
Q

Opioid od

A

naloxone 400micrograms IV once only

28
Q

Gestational diabetes

A

Fasting plasma glucose level of 5.6 mmol/L or above; or
Two-hour plasma glucose level of 7.8 mmol/L or above

diet abd exercise 1-2w
metformin 500mg
insulin

29
Q

gliclazide (sulphonylerua) se

A

weight gain
diarrhoea
hypo

30
Q

gliflozin (SGLT2i) se

31
Q

Can pregnant women have vaccines?

A

Yes- Whooping cough and Flu vaccine.

32
Q

Treatment dose of LMWHs for VTE

A

• Tinzaparin = 175units/kg OD
• Enoxaparin =1.5mg/kg OD
Dalteparin = 200units/kg OD (max 18000)

33
Q

Drugs to stop during surgery

A 
insulin
lithium
COCP/HRT (stop 4weeks before)
anticoagulants
K Spironolactone
oral hypoglycaemics
ACEi (parindopril)
34
Q

What is the best thing to monitor for dehydration post op?

A

Urine output

35
Q

T2DM mx

A 
1. Lifestyle: Diabetes education nurse, Nutritionist. Weight loss. exercise. 3-4/w. 
Alcohol/smoking, 
HbA1c target
BP mx
Lipids
Antiplatelets (if 50-75 w CVrisk)
    • Metformin 500mg IR OD
    • SGLT2i /GLP1agonist/DPP4i/Sulfonylurea/basal insulin
  3. acarbose/pioglitazone
  4. basal bolus insulin
  5. BAriatric surgery

Pregnant (diet + basal bolus insulin)

36
Q

Side effects of Diabetes drugs

A

metformin - GI side effects/Lactic acidosis

Sulfonylureas: Hypoglycaemia, SIADH, cholestasis, wt gain, incerased appetite.

Glitazones: (pioglitazone) wt gain, fluid retention, liver dysfunction, fractures
hypoglycaemia

DPP4i (gliptins) - pancreatitis

SGLT2i (flozins) (UTIs)

GLP1agnoists (exenatide) SC: nausea, vomiting ,diarrhoea, pancreatitis, wt loss

37
Q

pt on 75ug levothyroxine
TSH: 0.2 (0.3-4.2)
T4:16.2 (9-25)

mx?

A

Reduce dose by 25ug

38
Q

PE management

A

Apixaban 10mg PO bd

/Rivaroxaban 15mg po bd

39
Q

WHO pain ladder

A
  1. Paracetamol 1g QDS
    Ibuprogen 400mg TDS
    Naproxen 500mg bd
  2. Codeine 30mg QDS
    tramadol 50mg QDS
    Dihydrocodeine 30mg QDS
  3. Morphine sulfate 10mg QDS
    oxycodone 20mg QDS age related dose.
40
Q

Steroid Side effects

A 
Oedema
Stomach ulcers
thin skin
R+LHF
Osteoporosis
infections
cushing
diabetes
41
Q

NSAIDS side effects

A 
No urine (kidney failure)
Systolic dysfunction (HF)
Asthma
indigestion
Dyscrasia
42
Q

Digoxin side effects

A

N+V+D, blurred vision
confusion
xanthopsia
(hypokalaemia augments digoxin effect, high levels limit it)

43
Q

lithium side effects

A

Early tremor
intermediate tiredness
late arrythmias, seizures, coma, renal failure.

44
Q

ECG changes in hyperkalaemia

A

K>5.5 - peaked T waves
>6.5 - wide p waves, PR long, absent P waves
K>7 - long QRS, AV block, slow AF, bradycardia, sine wave.

45
Q

Glucose range for surgery

46
Q

Local anaesthetic toxicity tx

A

IV 20% Lipid emulsion

47
Q

Malignant hyperthermia

A

Hyperpyrexia
muscle rigidity
Autosomal dominant
Caused by Halothane, suxamethonium

ix: CK raised
contracture tests.

Mx: Dantrolene

48
Q

Anaesthetic asw Hepatotoxicity

49
Q

Antiemetics

A 
cyclizine 50mg TDS
Antihistamine
SEs: dry mouth, blurred vision, urinary retention. 
Fluid retention - caution if HF
Beware drug seeking
Ondansetron 4mg BD
serotonin receptor blocker
powerful expensive
post chemo
SEs:prolonged QTc, constipation

Metoclopramide
-Dopamine antagonist
-avoid in Parkinsons
-young women- acute dystonia - IM 5-10mg Procyclidine.
Prokinetic - not bowel obstruction
domperidone - doesnt cross BBB -l ess central side effects.

50
Q

End of life care

A

PRN - syringe driver/Sc

Pain - morphine 2.5-10mg/h

Nausea - haloperidol 1.5mg/4h

agitation - midazolam 2.5-5mg/1h

secretions- glycopyrronium 0.2mg /6h

51
Q

Laxatives

A

Stool softener: docusate sodium. good for impaction.

Bulking agents: Isaphagula husk. (for low fibre)
C.I if faecal impaction.

Stimulants: Senna. 15mg ON can cause cramps.

Osmotic - lactulose.15mlsOD Phosphate enema. needs to be well hydrated. can-> bloating.

52
Q

insomnia

A

zopiclone 7.5mg ON (3.75mg elderly)

53
Q

digoxin side effects

A

N+V+D, blurred vision, confiusion/drowsy, xanthopsia (halos)
Low K-> augments,
high k -> inhibits

54
Q

AF mx

A

B blocker, digoxin/amiodarone if HF

55
Q

VT

A

Amiodarone 300mg IV 20-60m
then 900mg over 24 h
Polymorphic VT ->mg over 10mins

56
Q

Stable Angina

A

GTN..
ASpirin and statin (secondary prevention) + 1 anti angina drug. eg. BB /CCB -> increase dose->
ISMN

57
Q

Drug causes of hyperkalaemia

A

ACEi
LMWH
Tacrolimus

58
Q

side effects SSRIs

A

hyponatremia

Final year Medicine (18 decks)

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