PSA practice paper content Flashcards
COPD acute exacerbation - bronchospasm
SABA - salbutamol 1 mg/mL nebuliser liquid
dose is 2.5-5mg via nebuliser
Found in asthma - airway obstructions
First line DVT
APIXABAN 10 mg PO twice daily for 7 days then 5 mg PO twice daily
When to offer statin as primary prevention
In pts. w/ 10 year-CV-risk of 10% or more
Drugs causing urinary retention
Anti-cholinergics
a-adrenoceptor agonists (metaraminol, phenylephrine)
Benzodiazepines
NSAIDs
CCBs
Anti-histamines
Alcohol
Drugs causing confusion
Anti-cholinergics
Anti-psychotics
Anti-depressants
Anti-convulsants
LESS COMMON: H2 receptor antagonists, Digoxin, Beta blockers, Corticosteroids, NSAIDS, antibiotics
DKA insulin administration
FIXED RATE short acting 0.1 Units/kg/hour
What should be monitored for effect in fluid replacement and why
Blood pressure -> dehydration usually associated with reduced urinary output but monitoring the production of urine is less reliable measure of success in the early stages of fluid replacement than blood pressure
HRT -> what to monitor and why
Blood pressure
HRT can cause sodium and fluid retention = rise in blood pressure. HRT should be stopped if BP rises above systolic 160 or diastolic 95
LIVER enzyme increase to warrant a reduction of dose or discontinuation of statin:
3 TIMES UPPER LIMIT OF RANGE VALUE
IF both peak and trough gentamicin levels are high, what should be done to gentamicin dose
DECREASE dose and INCREASE INTERVAL
First line IV tx. Hypoglycaemia
GLUCOSE 20% (50-100 ml) in up to 20 minutes
Electrolyte disturbance with Tacrolimus
May cause hyperkalaemia -> due to reduced potassium excretion
Which drug should be stopped at least 7 days prior to surgery
Aspirin
Which drug should be stopped at least 7 days prior to surgery
Aspirin
Electrolyte disturbance with SSRIs?
HYPONATRAEMIA
IF INR > 1.5 on the day of surgery, what should be given
Vit K
Antibiotics which can cause cholestatic jaundice
Flucloxacillin
What rise in creatinine is tolerated in pts. taking ACEis
<20%
Indication of effective treatment with furosemide
Reduction of weight
ACEi therapy in heart failure - how do you monitor for beneficial effect of treatment
Exercise tolerance
Palliative care prescribing: pain -> how much morphine
20-30 mg/day w/ 5 mg for breakthrough pain
Drugs causing:
a) ATAXIA
b) Parkinsonism
a) Phenytoin, carbamazepine, valproate
b) Antipsychotics, metoclopramide
Loop and thiazide diuretic effect on calcium
Loops: HYPOCALCAEMIA
Thiazides: HYPERCALCAMIA
Loop and thiazide diuretic effect on calcium
Loops: HYPOCALCAEMIA
Thiazides: HYPERCALCAMIA
Drugs causing impaired glucose tolerance
Thiazides
Loops diuretics
Corticosteroids
Ciclosporin
4 drugs causing constipation
Verapamil
Opioids
Antipsychotics
Tricyclic antidepressants
Monitoring parameters for LITHIUM
Drug level, TFT, UE
Common side effects of Levodopa
Dry mouth
Postural hypotension
Psychosis
Palpitations
Anorexia
Palpitations
anorexia
Maintenance fluids for children
100 ml/ kg/ day for first 10 KG
50 ml/ kg/ day for next 10 kg (to 20kg)
20ml/ kg/ day for the remaining weight over 20kg
4C antibiotics and what might they cause
C.difficile
Ciprofloxacin
Co-amoxiclav
Clindamycin
Cephalosporins
Medications to stop preoperatively
ACEi/ARBs
Diuretics
Anticoagulants
Antiplatelets
HRT and COCP (STOP 4 weeks before)
Lithium
NSAIDs
ILACKOP
Insulin (consider starting pt. on sliding scale
Lithium
Anticoagulants/antiplatelets
COCP
K sparing diuretic (spironolactone)
Oral hypoglycaemic
Phytonidione (Vit K) Perindopril (or any acei)
Diabetic drugs: which drug should be omitted on day of surgery
SGLT-2 inhibitors - Dapagliflozin
Diabetic drugs: which should be omitted the morning of surgery
Sulphonylureas
When should metformin be changed on the day of surgery
If taken TDS, omit LUNCHTIME dose
if OD or BD continue as normal
If pt. NBM - how must medication be given
Intravenously
Oral hypoglycaemics advice: Metformin
Look out for signs and symptoms of lactic acidosis such as dyspnoea, muscle cramps, abdominal pain, hypothermia or asthenia
Oral hypoglycaemics advice: Sulphonylureas
Look out for signs and symptoms of hypoglycaemia. Higher risk elderly patients or those with renal impairment
Oral hypoglycaemics advice: SGLT2 inhibitors
Look out for signs and symptoms of DKA even if BM is normal
(As glucose being removed through urine)
Diabetic management: T1DM how often should HbA1c be checked -
3 monthly
How often should diabetics visit the podiatrist
Once per year
Important information RE: all anti-psychotics
As photosensitisation may occur with higher doses, patients should avoid direct sun-light
Drowsiness may affect performance of skilled tasks, effects of alcohol are enhanced.
Which commonly prescribed anti-platelets should be avoided with lithium
NSAIDs -> can increase lithium levels in the blood resulting in an increased risk of lithium side effects
Who all should receive 5mg FOLIC ACID (increased dose) for the duration of pregnancy
Hx. of neural tube defects
Diabetes
Sickle cell disease
Anti-epileptics
Pain medications which can accumulate in renal failure
Morphine and Codeine
Oxycodone should be given instead
Which cardio drug should be stopped in SEVERE PVD
B-blockers - cause peripheral vasoconstriction and worsen ischaemia
(ACEis are also cautioned in severe PVD)
Which CCB may exacerbate heart failure
VERAPAMIL
DILTIAZEM
Is routine monitoring required with use of SSRIs
NO
Best marker of beneficial effects of antibiotic in UTI
Resolution of SYMPTOMS - over next 72 hours
What should be done when a statin is suspected to be th cause of myopathy and CK concentration is markedly elevated
Treatment should be discontinued, if symptoms resolve and CK levels return to normal, statin should be introduced at LOWER DOSE
