PSA Official Mocks Flashcards
Qs on drug choice
drug choice correct - half marks
dose and route correct - full marks
acute PO
obvs furosemide IV not PO silly billeh
tacrolimus can also cause this
hyperkalaemia
all heparins can trigger
hyperkalaemia
stop antiplatelets when pre surgery
1 week incl aspirin
kidney injury and allopurinol
with hold
SSRI can cause hyponat
via SIADH
drug checking
don’t just check dose, also check frequency
follow Prescriber model
breakthrough pain prescribing
try to use the same drug
sixth of daily dose, every 4 hrs
palliative page has all the conversions
even if folate deficient, can use
trimethoprim for short courses if no other good options e.g. pen allergic
warning with nitrofurantoin
low eGFR contraind
INR target day prior to surgery
INR <1.5
take rivaroxaban with
food
advice on how to take the drug i.e. with food
will be alongside indicaitons
COCP Qs
always screen enzyme inducers /inhib on contraception interactions page
co amox can trigger
cholestatic jaundice
interaction example SSRI, DOAC
citalopram increases bleeds with dabigitran
can continue ACEx with creat rise as long as
<20% inc from original
rv UEs in one week after
best diuretic monitoring
daily weights
fluid chart
monitoring HF drugs response chronic
exercise tolerance
ciclosporin at 2 weeks monitoring
BP and creatinine
small rise in blood glucose levels (e.g. on steroids/stress)
inc basal insulin by 10%
statin success metric
40%+ LDL reduction in 3 months
nomogram bloods
if taken too soon to read chart, redo just prior to second dose
dystonic crisis (painful eye, neck spasms, on antipschoticS)
give procyclidine 5mg IM/IV
exacerbation of COPD (not necessarily infective
give pred 30mg for 5 days
fluids prescribin
always check the fluids page + amount of potassium/sodium they’ve had
1-2 mmol Na / kg / day safe
0.5-1mmol K / kg / day safe
50-100g glucose needed if NBM
makes average 70-140mmol Sodium/day
35-70mmol Potassium/day
i.e. add 20mmol KCl to each of 3 daily bags
or if 2 daily do 20, 40
3L fluid normal pt per day
2L elderly per day
UO should be 0.5ml/kg/hr minimum
i.e. 35ml+ in most
5% dextrose equivalent in PSA
5% glucose with 0.3% KCl
HRT
if on intermittent may get breakthrough bleeds
if so switch to continuouscombined
can tell which type by number of patches
if 2 separate = sequential, if one only then combo
peripheral vasc disease / iscahemic ulcers
no beta blockers or ACEx
what are you going to remember to do for the first 2 sections?
they’re worth loads of marks, so we are going to look up everything by CONDITION rather than ‘being fairly sure’
for presc review, only don’t look up if utterly confident
and should still make time to double check
steroid worsens
ventricular failure/heart failure
inc chance of candida thrush
abx
pred
gluocse in urine
omeprazole max daily
20mg
fluids prescribing
always check the fluids page before confimring choice
afternoon glycaemic control poor
increase mornign dose by 10%
morning glyc control poor
inc evening dose 10%
meals gluocse control poor
add subcut insulin arounf meals
scarlet fever
10 day course phenoxypenicillin
INR range is always
0.5 each side of target number
one missed pill
protected but take double dose
two missed pills and on day 3
emergency contraception if had sex
7 days barrier contraception if not had any sex and restart pack
methotrexate feritlity caution
women AND men shouldnt conceive on it until 6 mo post dru
mirtazepine common SE
weird dreasm
avoid IM inj if
anticaog
can give 20% or 10% glucose in hypoglyc
use hypoglyc page
CK marked elevation
5x normal with statin
stop and see if stympto go
if do and no CK rise
restart lower dose
poor adherence to thyroxine and high TSH
maintain same dose obvs
another exam technique re reading Q
look up contraindications for each drug if specified what asking for
if doesn’t say that word look at cautions
always check doses of any not 100% sure of
stop amiodarone if
TFTs go off
renal impairment/ creatinine up with morphine post op and drowsy
switch to oxycodone as fully hepatic metabolism no renal metabolites
monitoring one month after COCP
blood pressure
not weight gain
ciclosporin monitoring
UEs
potassium can get high
starting azathioprine
check TPMT enzyme levels as some have low ones
severe bleed on warfarin INR8+
PT concentrate
if not an option giveFFP
prescription review
check all drugs before deciding on answer
more efficient to check both bits of the Q at once
write down your answers as going here?
liraglutide GLP agonist SE
vomiting common
antiemetic choice every time
cyclizine is the best
50mg TDS any way
metaclop not wit
QTc issues/cardiac/Parkin
must have what before picking a drug regime
precise indication seen on the BNF (must say exact name of the disease in question and the pt details too)
stat
over 15 mins
alendronate SE
irritates GIT - dyspepsia and diarrhoea
PPI side effec
diarrhoea
naproxen can cause
ankle oedema as well as other NSAID things
best analgesia elderly
always paracetamol pls
unless solid solid indication otherwise
c diff
metro then vanc second time
continuous HRT
estradiol with levonergestrel
continous, 1 patch a week
no withdrawal bleeds!
combined HRT
estradiol with norhisterone
2 patches a week
withdrawal bleeds
fentanyl patches, getting breakthrough pain
give nasal or buccal PRN (see fentanyl drug page lower down)
INR >1.5 day before surg
see vit K page
give PO 1-5mg vit K solution
scarlet fever/strep A inf
use prevention of invasive group A strep indication
Na, K daily
1 mmol / kg
80 kg man 80 mmol of both
account for that when prescribing next bag of fluids
if 2 saline already, likely excess sodium so give glucose 5% next with either 0.15% KCl or 0.3% depending on Potassium
- 15 = 20mmol
- 3 = 40mmol
over 8 or 12 hrs
tardive dyskinesia
change the antipsych or give tetrabenzine
grimacing, tongue protusion, lip smacking
antipsych extrapydramidal side effects
normal dose procyclidine if not acute
if acute dystonia, higher dose IV or IM
acute dystonia
painful eye movements, neck spasm, abrupt onset
on antipsych
give IM/IV procyclidine 5mg
SSRI can cause
hyponat
heparins
hyperkalaemia
stop allopurinol
renal dysfunction
shingles
has its own indication for dosing and also for if ISupp
calc Q
put to 1 decimal place, no rounding or algorithm won’t count it
acute bleed on warfarin
IV! vit K if v v bad >10, don’t get caught out by oral lol
then FFP or PT conc IV
NEVER give this to someone with possible cerebral oedema i.e. any head path
dextrose /glucose fluids!
too much water, not enough salt . hypo osmolar can worsen cerebral oedema and injury
fluids to give acute stroke pt
whatever the UEs, give 0.9% saline with 0.15/0.3 KCl
can’t have dextrose as will worsen injury to brain as hypo osmolar
must be at least 5 days post stroke
no metformin in
acute illness or sig renal imparimetn
if anaemic and asking which drugs to stop
always look for ulcer-causing agents, e.g. aspirin, NSAID, pred!
think of why IDA, chronic bleed
pioglitazone can cause
hypoglycaemia too, just like the others
have a sugary snak with you
> 55 or black
CCB first
lol how did you make a mess of that, hopefully fingers crossed you’ll check that sort of thing better in the exam but even so
never prescribe unless
YOU HAVE THE PRECISE SPECIFIC INDICATION IN FRONT OF YOU
no messin fam
folate preg
look at Neural Tube page, may need higher dose regime if RFs
dose changes gent
look at trough AND peak conc
if trough high, increase interval between dosing
if peak high, reduce dose itself
