PSA mock Flashcards
Likely contributors to renal failure
Ibuprofen (NSAID)
Ramipril
Drugs that can contribute to dehydration
Diuretics
Advice for taking alendronic acid
Should be taken on an empty stomach
Side effects of morphine
Confusion
Respiratory depression
Monitoring response to steroids in polymyalgia rheumatica, what should you ask after the first week?
Have the muscle pains subsided
Common side effect of adenosine
Chest tightness
Mx of supraventricular tachycardia after vasovagal manouvres
Adenosine
Why is it bad to give furosemide alongside lithium?
Furosemide decreases GFR
So less clearance of lithium
Symptoms of lithium toxicity
Confusion
GI disturbance
Drowsiness
Tremor
Why are NSAIDs bad for the kidneys?
They inhibit COX, reducing prostaglandin synthesis, reducing GFR
Why should alendronic acid be taken standing up, 30 mins before breakfast on an empty stomach?
Promote absorption
Reduce rates of oesphageal ulceration
Why does morphine cause constipatoon?
Acts on opiod receptors in the bowel, reducing peristalsis
What should you give alongside morphine?
Laxative
Raised CK and weakness in the muscles =>
Dermatomyositis (skin rash, heliotrope)
Polymyositis
Pain the muscles and stiffness =>
Polymyalgia rheumatica
Rash in dermatomyositis
Heliotrope (around the eyes)
Which condition is polymyalgia rheumatica linked with?
Temporal arteritis
How does aldosterone alter potassium levels?
Excretes them
Why do angiotensin blockers (ramipril) increase K+ levles
Reduced angiotensin 2 levels lead to decreased aldosterone levels, reducing potassium excretion
What should you prescribe alongside morphine?
Anti-emetic e.g. metoclopramide (don’t give this if bowel issues)
Typical adult morphine prescription
Morphine, 10mg, IV, once only over 10 minutes
Drug treatment for oral thrush
Nystatin
ECG changes in hyperkalaemia
Tented T waves
Bradycardia
Absent P waves
What type of drug is spironolactone?
An aldosterone angtagonist
What type of drug is furosemide
Loop diuretic
What can statins cause? Raising CK
Rhabdomyolysis
Important advice for patients beginning carbimazole therapy
Report any infections to the GP as there is a risk of agranulocytosis
What type of drug is prednisolone?
Glucocorticoid
Why do steroids induce hyperglycaemia?
It is a glucocorticoid, it stimulates gluconeogenesis
What blood measure can be used to determine treatment response to antibiotics in the first 72hr?
CRP
How long after pneumonia treatment should you do a repeat chest X-ray?
6 weeks later
Which common drugs cause hypertryglyceridaemia?
Thiazide diuretics (bendoflumethazide)
2 good drugs to start off asthma treatment
Salbutamol
Ipratropium
Treatment to terminate seizures
IV lorazepam
Bolus fluid prescription
Sodium chloride 0.9%, 500ml, IV, over 30 minutes
Anaphylaxis in adult, first drug to give (written as a prescription)
Adrenaline, 500, micrograms, IM, once only
Why does aspirin cause gastric ulcers?
Inhibits prostaglandin production, reducing gastric protection
Why should ACEi be stopped in pregnancy?
Alter foetal and maternal blood pressure control
Safest painkiller oin liver disease (albeit at a low dose)
Paracetamol
What type of drugs, used in heart failure can worsen psoriasis
Beta blockers
Metoprolol
Bisoprolol
Acceptable range of glucose before surgery
4-12
Why dont you give insulin on an empty stomach?
Risk of hypoglycaemia
In general, how much does 1U of insulin drop BM?
By 3
How many units of actrapid do you give in hyperkalaemia?
10U
Mx of hyperkalaemia
10ml 10% calcium gluconate
Bicarbonate
Insulin (10U actrapid)
Glucose
K
Drop (dialysis)
Complication of long term steroid use
Osteoporosis
Initial treatment of hypercalcaemia in dehydration
1L 0.9% saline IV infusion over 1 hour
Treatment of hypercalcaemia in malignany
Pamidronate (used to protect bone)
Initial treatment of hypoglycaemia in drowsy patient with no IV access
Glucagon 1mg IM STAT
Treatment for asymptomatic hypoglycaemia
Glucotabs
In an acute, life threatening asthma attack, what do you give after nebulisers?
Hydrocortisome IV
Drug to clear fluid in pulmonary oedema
Furosemide IV 40mg
(because resistant oedema)
1st line anti-emetic in hyperesmesis gravidarum?
Cyclizine
What type of drug is cyclizine
Antihistamine
What type of drup is promethazine?
Antihistamine
What are haptoglobin and platelet levels in HUS?
Low
What does haptoglobin do in the body?
Mops up lysed haemoglobin!
Diabetes drugs that can cause hypoglycaemia
Pioglitazone
Insulin
Acarbose (but only a little bit)
Which drugs can mask hypoglycaemic symptoms?
Beta blockers (bisoprolol)
Which drugs can interact with warfarin and cause increased INR?
Statins
They are also CYP450 medications
Can increase warfarins anticoagulant effet
What does ramipril reduce the breakdown of, resulting in a cough?
Bradykinin
Who shouldn’t get prescribed ACEi?
Asthmatics
Hyperkalaemia
Renal failure (acute)
What is the enzyme that metabolises alcohol to acetaldehyde?
Alcohol dehydrogenase
Good thing to monitor to see if good response to asthma treatment?
PEFR
Which statin do you give first line?
Atorvostatin
Can also use simvastatin
High risk of neural tube defect dose of folic acid
5mg PO once daily
Treatment of urticaria
Anti-histamines
What should you avoid when on anti-histamines?
Alcohol
You can get drowsy
Treatment of urticaria
Loratadine 10mg oral once a day
Sudden onset, widespread itchy skin rash =>
Urticaria
Treatment of chlamydia
Azithromycin
Treatment of scabies
Permethin 5% dermal cream
1 application (because cover whole body)
Mx of reflux in paediatrics (regurgitating infant)
Gaviscon sachet
Treatment of urinary urgency incontinence
Oxybutynin Hydrochloride IR
Why dont you prescribe morphine as required?
May overdose
Cut off for trying diet and exercise to lower glucose in pregnancy
<7mmol/L
How often should young people with T1DM check their glucose levels?
5 times a day or more
What must the patient do when on sulphonyureas?
Eat regular meals
Risk of hypoglycaemia
Rate of maintenance fluids/day in normal adult
25-30ml/kg/day
HTN drug that causes bilateral leg swelling
Amlodipine
