PSA Course Notes

Question 1

1. What quantity of sodium is in 1l of 0.9% NaCl?
2. If you forget answer to 1. where can answer be found on NICE?

Answer 1

150mmol

can be found on fluids and electrolytes in BNF

Question 2

What quantity of potassium is in 1l of 0.3% KCl

Answer 2

40mmol

(therefore 0.15% osly 20mmol)

Question 3

What quantity of glucose is in 1l of 5% dextrose

Answer 3

50g

Question 4

what are the daily requirements for

1. water
2. Na + K
3. glucose

Answer 4

25-30ml/kg/24h water
1mmol/kg/24h Na and K (and Cl)
50-100g/24h glucose

Question 5

What’s the fastest rate potassium can be replaced

Answer 5

10 mmol / hr

Question 6

What fluids should be given for
1. hypokalaemia
2. hypercalcaemia

Answer 6

1. NaCl 0.9% / KCl 0.3% 1 litre over 4 hours
2. NaCl 0.9% 1 litre over 4 hours

Question 7

What should be given for maintenance fluids if deficits or losses e.g. Na or K low or vomiting, diarrhoea

Answer 7

NaCl 0.9% / KCl 0.3% 1 litre over 4 hours

Question 8

What should be given for emergency resus in
1. adults
2. children

Answer 8

1. 500ml 0.9% NaCl over 15 mins
2. 10ml/kg 0.9% NaCl over 15 mins

Question 9

What maintenance fluids should be given for children

Answer 9

for first 10kg: 100ml/kg/24hr

for kilograms between 10-20kg: 50ml/kg/24hr

for all kilograms over 20kg: 20ml/kg/24hr

e.g. 28kg would require 1660mls / 24hr

Question 10

How should the following anticoagulants be monitored?

1. LMWH
2. unfractionated heparin
3. NOACs
4. warfarin

Answer 10

1. anti-factor Xa
2. APTT
3. clinically (patients watches for bruising)
4. INR

Question 11

What’s the management for trigeminal neuralgia?

Answer 11

carbamazepine

Question 12

what medications should be stopped if the patient is unwell?

Answer 12

metformin
statins
-flozins (SGLT2 inhibitors)

Question 13

What drugs can worsen heart failure?

Answer 13

• TZD (-tazone)
• CCBs
• NSAIDs

Question 14

What antiemetic drugs should not be given in Parkinsons?

Answer 14

• metoclopramide
• chlorpromazine
• prochlorperazine

Question 15

What advice should you give to someone who has diabetes when they’re sick (sick day rules)

Answer 15

• stay hydrated
• keep taking medications (except SGLT2i)
• check blood sugar every 4 hours
• test for ketones regardless (normally told only check when 15 or 13 when have pump)
• keep eating / drinking sugary drinks: if vomiting and can’t keep food down get medical help

Question 16

What should be taken with methotrexate?

Answer 16

folate

Methotrexate Mondays, Folate Fridays

Question 17

What should be avoided when taking warfarin / NOACs?

Answer 17

• binge drinking
• getting pregnant (teratogenic in first + third trimesters)

Question 18

What do you need to tell someone taking oral isotretinoin (roaccutane)?

Answer 18

• LFTs and lipids need monitored
• limit alcohol
• it is teratogenic (therefore contraception must be in place)
• there is a risk of neuropsychiatric reactions

Question 19

Where in the BNF do you find information on
a) COCP
b) POP

Answer 19

a) ethinylestradiol with Desogestrel

b) Desogestrel

Question 20

What drug is used to reverse benzodiazepines?

Answer 20

flumazenil

Question 21

What should be done for children on long term corticosteroids?

Answer 21

annual height and weight

Question 22

What is vitamin K known as in the BNF?

Answer 22

Phytomenadione