PSA learning points

Question 1

What is the treatment for pulmonary oedema

Answer 1

Furosemide IV 20-50ml daily

Question 2

How is hypoglycaemia treated?

Answer 2

Oral intake: Sugar/buccal glucose
IV access: IV glucose 10-20g (1st line 20% 50-100ml OR alternative 10% 100-200ml)
No IV access: IM glucagon

Question 3

How does dalteparin impact K+ levels?

Answer 3

Can raise them through inhibition of aldosterone

Question 4

When do you stop antiplatelets before surgery?

Answer 4

7 days before

Question 5

How do steroids impact glucose levels?

Answer 5

Can increase blood glucose

Question 6

How does citalopram impact sodium levels?

Answer 6

Reduces sodium through SIADH

Question 7

How can you generally decide if nitrofurantoin or trimethoprim is contraindicated for UTI?

Answer 7

Nitro: eGFR <45
Trimethoprim: 1st trimester, methotrexate

Question 8

What is first line management for alcohol withdrawal?

Answer 8

Benzodiazepines

Question 9

What INR requires bridging therapy prior to surgery?

Answer 9

<1.5

Question 10

When should rivaroxaban be taken?

Answer 10

With food

Question 11

How much can creatinine rise when commencing an ACEI?

Answer 11

up to 20%
Above that is concerning

Question 12

How do you manage a steroid induced rise in glucose when on insulin therapy?

Answer 12

Increase insulin by 10%

Question 13

What drugs cause acute dystonic reactions?
What management treats it?

Answer 13

Psychiatric drugs (psychotics and depressants)
Procyclidine hydrochloride

Question 14

If someone hypos at night on biphasic insulin what should you do?

Answer 14

Increase their morning dose

Question 15

What do you advise regarding COCP pills if
No sex, 1 pill missed
No sex, 2 pills missed
Unprotected sex

Answer 15

1 pill: Take missed and that day’s pill
2 pills: Take today’s and barrier for 7 days
Week 4,1: Emergency
Week 2: 7 days contraception
Week 3: Continue taking pills through omission week

Question 16

What are the cutoff times for the following POP pills
Traditional
Levonogestrel

Answer 16

3 hours
12 hours

Question 17

Regarding cutoff times for POPs, what do you do if….
Under time
Over time

Answer 17

Under: Take as normal
Over time:
- Take missed pill ASAP
- Take next pill as usual
- Continue with rest of pack
- Use condoms for 48 hours

Question 18

For emergency contraception, when can you use…
Levonogesterel
Ullipristal acetate (EllaOne)
Intrauterine devices

Answer 18

3 days
5 days for the other two

Question 19

What cautions are require for EllaOne use?

Answer 19

Asthmatics
Breastfeeders

Question 20

What drug interacts with atorvostatin to cause myopathy

Answer 20

Fibrates
Clindamycin

Question 21

What should cross your mind if a patient on levothyroxine has a high TSH?

Answer 21

Check adherence

Question 22

What should you check for before commencing an antiemetic?

Answer 22

Parkinson’s history
QT interval

Question 23

How should insulin therapy be adapted if in DKA?

Answer 23

Swap fast actors for sliding scale
Continue long actors

Question 24

What drugs can cause serotonin syndrome?

Answer 24

SSRIs
Tramadol

Question 25

What drug is a go to for strong analgesia in renal impairment?

Answer 25

Oxycodone

Question 26

What eGFR cautions use of metformin?

Answer 26

under 30

Question 27

When would you taper rather than stop steroids?

Answer 27

>=40mg daily for 7 days >=3 weeks treatment Recent repeated courses

Question 28

What advice is given for bisphosphonates

Answer 28

Take weekly Take with food and stay upright for 30 mins after admin

Question 29

If an individual is sub transfusion level anaemic what do you do?

Answer 29

oral iron for normal Hb Continue 3 months post-normal

Question 30

What are the causes of HYPOkalaemia HYPERkalaemia

Answer 30

HYPO: DIRE (Drugs, Intestinal, RTA, Endocrine) HYPER: DREAD (Drugs, Renal failure, Endocrine, Artefact, DKA)

Question 31

What are the causes of SIADH?

Answer 31

SCLC Infections Abscesses Drugs Head injury

Question 32

What is the max rate of potassium/hr

Answer 32

<20mmol/hr

Question 33

What to do with anticoagulation if... Large bleed Small bleed No bleed, INR 5-8 No bleed, INR >=8

Answer 33

Large bleed: 5-10mg IV vitamin K Small bleed: 1-3mg IV vitamin K No bleed, INR 5-8: withold No bleed, INR >=8: Vit k 1-5mg Oral

Question 34

Which diabetic drugs cause... Hypos Weight gain Weight loss No change Fluids, Fractures, fibrosis and Fucked liver

Answer 34

Hypos: Sulfonylurea, GLP-1s Weight gain: Thiazolinediones Weight loss: GLP-1, SGLT-2 No change: Metformin, DPP4Is Fluids, Fractures, fibrosis and Fucked liver: Thiazolinediones