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Learning from Mistakes > PSA Official Mocks > Flashcards

PSA Official Mocks Flashcards

1
Q

Qs on drug choice

A

drug choice correct - half marks

dose and route correct - full marks

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2
Q

acute PO

A

obvs furosemide IV not PO silly billeh

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3
Q

tacrolimus can also cause this

A

hyperkalaemia

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4
Q

all heparins can trigger

A

hyperkalaemia

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5
Q

stop antiplatelets when pre surgery

A

1 week incl aspirin

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6
Q

kidney injury and allopurinol

A

with hold

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7
Q

SSRI can cause hyponat

A

via SIADH

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8
Q

drug checking

A

don’t just check dose, also check frequency

follow Prescriber model

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9
Q

breakthrough pain prescribing

A

try to use the same drug
sixth of daily dose, every 4 hrs

palliative page has all the conversions

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10
Q

even if folate deficient, can use

A

trimethoprim for short courses if no other good options e.g. pen allergic

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11
Q

warning with nitrofurantoin

A

low eGFR contraind

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12
Q

INR target day prior to surgery

A

INR <1.5

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13
Q

take rivaroxaban with

A

food

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14
Q

advice on how to take the drug i.e. with food

A

will be alongside indicaitons

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15
Q

COCP Qs

A

always screen enzyme inducers /inhib on contraception interactions page

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16
Q

co amox can trigger

A

cholestatic jaundice

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17
Q

interaction example SSRI, DOAC

A

citalopram increases bleeds with dabigitran

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18
Q

can continue ACEx with creat rise as long as

A

<20% inc from original

rv UEs in one week after

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19
Q

best diuretic monitoring

A

daily weights

fluid chart

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20
Q

monitoring HF drugs response chronic

A

exercise tolerance

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21
Q

ciclosporin at 2 weeks monitoring

A

BP and creatinine

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22
Q

small rise in blood glucose levels (e.g. on steroids/stress)

A

inc basal insulin by 10%

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23
Q

statin success metric

A

40%+ LDL reduction in 3 months

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24
Q

nomogram bloods

A

if taken too soon to read chart, redo just prior to second dose

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25
Q

dystonic crisis (painful eye, neck spasms, on antipschoticS)

A

give procyclidine 5mg IM/IV

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26
Q

exacerbation of COPD (not necessarily infective

A

give pred 30mg for 5 days

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27
Q

fluids prescribin

A

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

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28
Q

5% dextrose equivalent in PSA

A

5% glucose with 0.3% KCl

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29
Q

HRT

A

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

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30
Q

peripheral vasc disease / iscahemic ulcers

A

no beta blockers or ACEx

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31
Q

what are you going to remember to do for the first 2 sections?

A

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

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32
Q

steroid worsens

A

ventricular failure/heart failure

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33
Q

inc chance of candida thrush

A

abx
pred
gluocse in urine

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34
Q

omeprazole max daily

A

20mg

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35
Q

fluids prescribing

A

always check the fluids page before confimring choice

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36
Q

afternoon glycaemic control poor

A

increase mornign dose by 10%

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37
Q

morning glyc control poor

A

inc evening dose 10%

38
Q

meals gluocse control poor

A

add subcut insulin arounf meals

39
Q

scarlet fever

A

10 day course phenoxypenicillin

40
Q

INR range is always

A

0.5 each side of target number

41
Q

one missed pill

A

protected but take double dose

42
Q

two missed pills and on day 3

A

emergency contraception if had sex

7 days barrier contraception if not had any sex and restart pack

43
Q

methotrexate feritlity caution

A

women AND men shouldnt conceive on it until 6 mo post dru

44
Q

mirtazepine common SE

A

weird dreasm

45
Q

avoid IM inj if

A

anticaog

46
Q

can give 20% or 10% glucose in hypoglyc

A

use hypoglyc page

47
Q

CK marked elevation

A

5x normal with statin

stop and see if stympto go

if do and no CK rise

restart lower dose

48
Q

poor adherence to thyroxine and high TSH

A

maintain same dose obvs

49
Q

another exam technique re reading Q

A

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

50
Q

stop amiodarone if

A

TFTs go off

51
Q

renal impairment/ creatinine up with morphine post op and drowsy

A

switch to oxycodone as fully hepatic metabolism no renal metabolites

52
Q

monitoring one month after COCP

A

blood pressure

not weight gain

53
Q

ciclosporin monitoring

A

UEs

potassium can get high

54
Q

starting azathioprine

A

check TPMT enzyme levels as some have low ones

55
Q

severe bleed on warfarin INR8+

A

PT concentrate

if not an option giveFFP

56
Q

prescription review

A

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?

57
Q

liraglutide GLP agonist SE

A

vomiting common

58
Q

antiemetic choice every time

A

cyclizine is the best

50mg TDS any way

59
Q

metaclop not wit

A

QTc issues/cardiac/Parkin

60
Q

must have what before picking a drug regime

A

precise indication seen on the BNF (must say exact name of the disease in question and the pt details too)

61
Q

stat

A

over 15 mins

62
Q

alendronate SE

A

irritates GIT - dyspepsia and diarrhoea

63
Q

PPI side effec

A

diarrhoea

64
Q

naproxen can cause

A

ankle oedema as well as other NSAID things

65
Q

best analgesia elderly

A

always paracetamol pls

unless solid solid indication otherwise

66
Q

c diff

A

metro then vanc second time

67
Q

continuous HRT

A

estradiol with levonergestrel

continous, 1 patch a week

no withdrawal bleeds!

68
Q

combined HRT

A

estradiol with norhisterone

2 patches a week

withdrawal bleeds

69
Q

fentanyl patches, getting breakthrough pain

A

give nasal or buccal PRN (see fentanyl drug page lower down)

70
Q

INR >1.5 day before surg

A

see vit K page

give PO 1-5mg vit K solution

71
Q

scarlet fever/strep A inf

A

use prevention of invasive group A strep indication

72
Q

Na, K daily

A

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

  1. 15 = 20mmol
  2. 3 = 40mmol

over 8 or 12 hrs

73
Q

tardive dyskinesia

A

change the antipsych or give tetrabenzine

grimacing, tongue protusion, lip smacking

74
Q

antipsych extrapydramidal side effects

A

normal dose procyclidine if not acute

if acute dystonia, higher dose IV or IM

75
Q

acute dystonia

A

painful eye movements, neck spasm, abrupt onset

on antipsych

give IM/IV procyclidine 5mg

76
Q

SSRI can cause

A

hyponat

77
Q

heparins

A

hyperkalaemia

78
Q

stop allopurinol

A

renal dysfunction

79
Q

shingles

A

has its own indication for dosing and also for if ISupp

80
Q

calc Q

A

put to 1 decimal place, no rounding or algorithm won’t count it

81
Q

acute bleed on warfarin

A

IV! vit K if v v bad >10, don’t get caught out by oral lol

then FFP or PT conc IV

82
Q

NEVER give this to someone with possible cerebral oedema i.e. any head path

A

dextrose /glucose fluids!

too much water, not enough salt . hypo osmolar can worsen cerebral oedema and injury

83
Q

fluids to give acute stroke pt

A

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

84
Q

no metformin in

A

acute illness or sig renal imparimetn

85
Q

if anaemic and asking which drugs to stop

A

always look for ulcer-causing agents, e.g. aspirin, NSAID, pred!

think of why IDA, chronic bleed

86
Q

pioglitazone can cause

A

hypoglycaemia too, just like the others

have a sugary snak with you

87
Q

> 55 or black

A

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

88
Q

never prescribe unless

A

YOU HAVE THE PRECISE SPECIFIC INDICATION IN FRONT OF YOU

no messin fam

89
Q

folate preg

A

look at Neural Tube page, may need higher dose regime if RFs

90
Q

dose changes gent

A

look at trough AND peak conc

if trough high, increase interval between dosing

if peak high, reduce dose itself

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