PSA revision Flashcards
aName some enzyme inducers
PC BRAS:
Phenytoin
Carbamazepine
Barbiturates
Rifampicin
Alcohol
Sulphonylureas
Name some enzyme inhibitors
AO DEVICES
Allopurinol
Omeprazole
Disulfiram
Erythromycin
Valproate
Isoniazid
Ciprofloxacin
ethanol
Sulphonamides
What medications are most likely to cause delirium
BDZs
Zopiclone
Opioids
Anticholinergics
Pregabalin
]Antipsychotics
Metoclopramide
Thiazide diruetics
Diuretics
What defines insensible water loss
500-800ml
What is the daily water requirement in an adult
25-30ml/kg/day of water
How much sodium and potassium is required per kg/day
1mmol
What are crystalloid fluids
Soultion of mineral salts
How can we measure for hydration status
Weight
Name a hypertonic solution
Mannitol (draws fluid out of cells)
What is the first line IV fluid therapy for [atients who are dehydrated
0.9% Sodium Chloride 500ml over less than 15 minutes
What is the second line IV fluid therapy for patients who are dehydrated
Human Albumin Solutino (colloid solution)
What is the minimum urine output to aim for in fluid resuscitation
0/5 ml/kg/day
If a patient loses 1500 ml of blood, what is the equivalent volume replacement with a colloid
1500 ml
What are enteric coating drugs
Protects the drug from the stomach lining as it needs absorbing in the small intestines
When should your variable rate insulin be stopped
Around 30-60 minutes after a meal
At what eGFR is nitrofurantoin contraindicated
<45
What antibiottic can cause heaptic jaundice
Clarithromycin
By how much do we increase someone’s insulin dose
By 10-20%
1mg = how many mL?
10mL
How often do Digoxin levels need to be checked
Every 6 hours
What side effect should be looked out for in a patient just started on warfarin
Easy bruising
If the INR is greater than 8 with minor bleeding, how should warfarin doses be managed
Stop warfarin and give phytomenadione by slow IV injection
When should warfarin doses be witheld
When INR is 5-8 and there is no bleeding
If there is bleeding, you must give phytomenadione
Under what BNF guidelines can infor on heparin be found
Parenteral anticoagulants
Under what BNF guidelines can info on Paracetamol overdoses be found
Poisoning emergency treatment
Under what BNF guidelines can infor on steroid conversion be found
Glucocorticoid therapy
Where can the vaccine schedule be found
Immunisation shcedule
What is the limit at which Iv potassium can be given
10 mmol/hour (nothing more)
In what two people should metoclopramide not be given in
Parkinson’s
Young Women
What first line anti emetic is given for almost all cases
Cyclizine
How fast should fluids be given
if 2L a day: 24/2 = 12 hourly
if 3L a dau: 24/3 = 8 hourrly
If Genamicin concentration falls in the 36 hour area, what should be done
The dose should be given every 36 hours
If the gentamicin dose rests above the 48 hour area, what should be done
Repeat Gentamicin level and only re-dose once concentration is less than 1 mg/L
First line management of a supra ventricular tachycardia (narrow complex)
Vagal manoeuvres
If vagal manœuvrés fail to stop supraventricular tachycardies, what should be done next
IV Adenosine (6mg)
Third line: 12mg
Fourth Line: 18 mg
Last line: Cardioversion
First line management of broad complex tachycardia (>0.12 s)
Amiodarone
Management of AF In the presence of heart failure
Digoxin
Management of anaphylaxis
500mcg 1:1000 FIRST
Then give chlorphenamine and Hydrocortisone IV
what is the CURB-65 score and what do the scores indicate
Confusion
Urea > 7
RR > 30
BP <90mmHg systolic
65 +
1 = At home treatment
2 = oral or IV antibiotics in the hospital
3 = ITU
What should be given if PT/aPTT is over 1.5 times the normal range
Fresh Frozen Plasma
What CHADSVASC score indicates anti platelet use in men
1
What CHADSVASc score indicates a need for use in women
2
Management of AF <48 hours onset
Cardioversion with flecanide
AMiodarone if structural heart disease is present
Management of AF > 48 hours
Rate control mono therapy
At what Hba1c level should diabetic management be intensified
If levels remain over 58 mmol/mol
First line management of COPD
SABA or SAMA
Second line management of COPD
LABA + LAMA
Third line management of COPD
LABA + LAMA + ICS
Management of Crohn’s disease flare
Prednisolone
How do we retain remission in crohn’s
Azathioprine
What drug is contraindicated for use with the COCP
Carbamazepine (enzyme inducer)
If a diabetic patient’s glucose levels are raised in the evening, what insulin at what time of the day needs adjusting?
The morning dose
Why would we pick Glucose 5% solution over 0.9% NaCl?
If the patient has received his daily intake of sodium and chloride from NaCl, better to use 5% glucose with 0.3% KCL (if daily intake has not been reached yet)
