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PSA NOTES Flashcards

1
Q

Anti-emetic choice for migraines

A

Prochlorperazine or Metoclopramide

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2
Q

Drugs that can cause upper GI bleed

A
  • Prenisolone
  • Aspirin
  • Bisphosphonates
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3
Q

Drug for prevention of diabetic nephropathy

A

ACEi

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4
Q

Patient on amiodarone develops hypothyroidism. Next steps?

A

Continue amiodarone and start thyroid replacement tx

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5
Q

1st line mucolytic for CF

A

Dornase Alfa

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6
Q

What electrolyte abnormality can omeprazole cause?

A

Low magnesium

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7
Q

Monitoring requirements for furosemide

A

U&Es - check for hypokalaemia

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8
Q

Carbimazole monitoring requirements

A

Thyroid function tests should be performed every six weeks until the thyroid-stimulating hormone (TSH) is in the reference range according to NICE guidance.

Full blood count should be performed if there is clinical suspicion of infection due to the risk of agranulocytosis. Carbimazole should be stopped if there is any evidence of neutropenia and patients should report any clinical features of infection.

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9
Q

Carbimazole monitoring requirements

A

Thyroid function tests should be performed every six weeks until the thyroid-stimulating hormone (TSH) is in the reference range according to NICE guidance.

Full blood count should be performed if there is clinical suspicion of infection due to the risk of agranulocytosis. Carbimazole should be stopped if there is any evidence of neutropenia and patients should report any clinical features of infection.

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10
Q

1% solution

A

1 g in 100ml

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11
Q

Folic acid requirements in pregnancy for SCD patients

A

5mg folic acid until the end of pregnancy

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12
Q

Statin monitoring

A

Liver function tests should be repeated within 3 months of starting treatment and again at 12 months according to NICE guidelines.

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13
Q

Management of Raynaud’s phenomenon

A

Nifedipine

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14
Q

Management of dehydration with hypernatraemia

q

A

1000ml of 5% glucose over 8-12 hrs

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15
Q

Why do ibuprofen and prednisolone cause indigestion?

A

Ibuprofen inhibits prostaglandin synthesis needed for gastric mucosal protection from acid: there is therefore a risk of inflammation and ulceration.

Oral steroids inhibit gastric epithelial renewal, thus predisposing to ulceration.

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16
Q

When should bendroflumethiazode be taken?

A

Daytime (NOT evening)

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17
Q

Max paracetamol in one day

A

4g

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18
Q

How often should cyclizine and metoclopramide be given?

A

8 hrly

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19
Q

How often should methotrexate be given?

A

once a week

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20
Q

Aspirin dose for primary and secondary prevention

A

75mg

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21
Q

Max citalopram dose for patient aged over 65 yrs

A

20mg

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22
Q

How much are maintenance fluids (24 hrs)?

A

3 L (i.e. 8-hourly bags) for most adults, except the elderly or those with low body weight when 2 L per 24 h (i.e. 12-hourly bags) are needed.

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23
Q

Side effects of phenytoin

A

dysarthria and gum hyperplasia

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24
Q

Severe flare up of UC mx

A

IV hydrocortisone 100mg 6 hrly

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25
Q

What can excessive alcohol do to glucose levels?

A

Hypoglycaemia

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26
Q

What can excessive alcohol do to glucose levels?

A

Hypoglycaemia

27
Q

What condition should oxybutynin be avoided in?

A

MG - ACh receptors not functional

28
Q

How can we manage urge incontinence in MG?

A

Duloxetine

29
Q

Marker for pneumonia resolution

A

ABG ideally. RR is also good.

30
Q

What should you check for 2 weeks after starting fluoxetine?

A

Presence of rash - any rash should prompt consideration of discontinuing fluoxetine as it may be a sign of an impending serious systemic reaction.

31
Q

Patients under 50 kg - special considerations.

A

Enoxaparin is dose-adjusted in low eGFRs (<30 mL/min) but also in adults under 50 kg to prevent excessive anticoagulation.

Note that patients under 50 kg should also have lower dose paracetamol (as prescribed here) to prevent hepatotoxicity.

32
Q

Hypoglycaemia IV management

A

20% Glucose (50-100ml)
10% Glucose (100-200ml)

within 20 min

33
Q

Drugs to stop prior to surgery

A

I LACK OP

  • Insulin - variable
  • Lithium - stop day before
  • Antiplatelets/Anticoagulants - variable
  • COCP/HRT - stop 4 weeks before
  • K-sparing drugs - stop on day
  • Oral hypoglycaemics - variable
  • Perindopril + other drugs - stop on day
34
Q

UTI management in patient with eGFR< 45 ml/min/1.73 m2

A

Trimethoprim preferred over nitrofurantoin

35
Q

Patient stopped warfarin sodium 5 days before surgery. INR is 1.6 (Target 2.5). What should he be given?

A

Vitamin K

BNF recommends that if INR > 1.5 on the day before surgery, Vit K 1-5 mg PO using the IV prep is indicated

36
Q

Information to give about Rivaroxaban tx

A

Take with food

37
Q

How to look for pain relief conversions on BNF

A

Prescribing in palliative care

38
Q

Who should not be given 0.9% saline

A
  • Hypernatraemia or hypoglycaemia (5% glucose)
  • ascites (human albumin solution)
  • shocked from bleeding (blood transfusion)
39
Q

Fluids for: High HR or low BP

A

0.9% NaCl stat
If hx of HF given 250ml

40
Q

Fluids for: Olyguric

A

1L 0.9% NaCl over 2-4 hrs

41
Q

Max rate potassium can be given at

A

10 mmol/hr

42
Q

Maintenance fluid and electrolytes (24hrs)

A

3 L (i.e. 8-hourly bags) for most adults, except the elderly or those with low body weight when 2 L per 24 h (i.e. 12-hourly bags) are needed.

1 L of NaCl 0.9%
2 L of dextose 5%
Potassium 1mmol per Kg

43
Q

Drugs that can exacerbate HF

A

CCB and corticosteroids

44
Q

Mirtazapine SE not really stated on BNF

A

Abnormal dreams

45
Q

Elevated CK levels (>5x upper limit) in a pt on a statin, next steps?

A

Stop atorvastatin and restart at lower dose if symptoms resolve

46
Q

Mastitis management

A

Flucloxacillin 500mg for 10-14 days

If allergy: Erythromycin 250mg-500mg QDS for 10-14 days

47
Q

What causes tendon rupture

A

Ciprofloxacin (fluoroquinolone). Most commonly within 48hrs of commencing tx or if combined with a corticosteroid.

48
Q

What should be done if a patient on statin has3x upper limit of normal serum transaminases?

A

Discontinue statin and consider ezetimibe

49
Q

Not on BNF: Olanzapine monitoring

A

Can cause prolonged QTc particularly if CV RFs therefore need ECGs (baseline, one week after start)

50
Q

BNF navigating. oral pred to IM

A

Glucocoritcoid therapy treatment summaries. Hydrocortisone or methylpred can be given IM

51
Q

1st line for reducing constipation

A

Isphagula hulk

52
Q

GCA with visual loss

A

Methylprednisolone 1g IV daily for 3 days

53
Q

Patient started on VRII, NBM, what fluids should be prescribed?

A

Sodium chloride 0.45%/Glucose 5%/Potassium chloride 0.15% solution 500ml over 4-6hrs

54
Q

Bolus in children in dehydration

A

20x weight over less than 10 min.

55
Q

Medications that can cause tremor

A
  • Salbutamol
  • Haloperidol
  • Theophylline
56
Q

Medications that can cause gout/hyperuricaemia

A

-Aspirin
- Bumetanide (diuretics)
- Ticagrelor

57
Q

Medications that increase CK levels

A
  • Statin
  • Haloperidol
58
Q

What should patients on gentamicin be told?

A

To report any hearing loss

59
Q

What are the first signs of lidocaine toxicity?

A

Circumoral tingling

60
Q

Monitoring efficacy of thyroxine replacement therapt

A

TSH

61
Q

Most appropriate option to monitor for benefical effects of dalteparin sodium prescription after 72 hrs of tx

A

Peak anti-Xa conc.

62
Q

How to monitor for beneficial effects of donepezil?

A

Validated cognitive assessment score

63
Q

How to monitor beneficial effects of cortisol in adrenal insufficiency

A

Weight

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