PSA Tips Flashcards
What to type in Medicine Complete search bar depending on quest’n ✓
- for anti-emetic or opioid convers’n quest’n type ‘palliative care’ in search bar
- for steroid convers’n quest’n type ‘glucocorticoid therapy’ in search bar
- for q’s about communicating drug info to pt, type that drug in the search bar + then click on “important safety info”, “monitoring requirements”, “direc’ns for admin” + “pt + carer advice”
- for bleeding/ INR = click Tx summaries → then search ‘oral anticoagulants’ → then command F ‘INR’
- for any drug overdose type ‘poisoning’ in search bar
- for HRT q’s type ‘sex hormones’ in search bar + then command F ‘uterus’
- for q’s on hypoglycemia / meningitis /seizures / adrenaline type ‘medical emergencies’ in search bar + then command F
- For missed birth control q’s type the drug name in search bar + then command F ‘missed’
- For q’s on NMS type ‘psychosis’ in search bar + select ‘psychosis + related disorders’ + then command F ‘neurolep’
- For adrenal crisis type ‘adrenaline insufficiency’ in search bar
- For medica’n for neuropathic pain i.e diabetes neuropathy / trigeminal neuralgia type ‘neuropathic pain’ in search bar + then command F that disease
- for VTE q’s type ‘venous thromboembolism’ in search bar
→ choose ‘Tx’ if there’s a confirmed diagnosis i.e via U/S for ex
→ choose ‘Ppx’ if they’re asking about post op Ppx for ex
What 4 pages should u have open on PSA platform ✓
- Regular adult Medicine Complete
- Regular child Medicine Complete
- Regular interac’ns for adults
- Appendix 1 interac’ns for adults
Drug q’s ✓
- ALWAYS CHECK THE INDICA’N SO U CAN PICK THE RIGHT ROA + DOSE !
- click on ‘medicinal forms’ after typing drug name to find cau’nary labels
- read question carefully to know if it’s asking for COMMON or UNCOMMON side effects !
- for which meds to stop before Sx type “Sx + long term medica’n” in search bar
- for which Abx to give before Sx type ‘surgical ppx’ in search bar
- Always check if pt = NPO b/c in that case whatever ur looking for will have to be given IV !
Daily water + electrolyte reqs ✓
- Water = 30 ml/kg
- Glucose = 50-100g
- Na / K = 1 mmol/kg
⚠️ Never replace K faster than 10 mmol/hr !
3 Fluid quest’n answers to memorize ✓
- ressucita’n for hypotens’n (even if due to DKA) / shock
→ for adults = 0.9% NaCl 500ml over 10 mins
→ for kids = 0.9% NaCl 10ml/kg over 10 mins - HyperCa = 0.9% NaCl 1L over 4 hrs
- HypoK = 0.9% NaCl /KCl 0.3% 1L over 4 hrs
- Hypoglycemia = 10% glucose, 150mL over 15 mins
- maintenance i.e NPO for Sx = NaCl 0.9% / KCl 0.3% 1L over 8-12 hrs
- adding addi’nal maintenance bag i.e pt already got fluids
1. calculate daily reqs based on their weight
2. calculate how much they already got (1 bag of NS = 135 mmol of Na)
→ water = just the volume
How to go from nano to micro ? ✓
Move 3 to the left
How to go from micro to milli ? ✓
Move 3 to the left
Meds to stop prior to Sx ✓
- Stop all anti-platelets 1 wk prior to Sx
- Stop Warfarin 5 days prior to Sx + give Vitamin K1 if on day before Sx INR ≥ 1.5
Dilu’n Calcula’ns ✓
- How to find volume required for dilu’n . . .
1. Calculate final dose
2. Find the 2 volumes using old + new ratios
3. Subtract the 2 volumes
⚠️ x % = x g / 100 mL
When to avoid NSAID use ✓
- elderly pts
- IBD
- CKD
Is an ↑ in Cr after being started on an ACE-I normal ? ✓
Yes but has to be a < 20% ↑
How do we know whether or not pt’s statin dose is appropriate ? ✓
If we see a > 40% ↓ in non-HDL cholesterol after 3 months
What to pay atten’n to when quest’n asks to identify drug(s) w/ dosing error ✓
Actual dose, ROA + frequency
How to calculate how much to prescribe for breakthrough pain med i.e the PRN dose ✓
Divide ttl dose by 6
Drugs that should be stopped in pt presenting w/ head injury ✓
- blood thinners
- drugs that cause drowsiness i.e sleep drugs, amitriptyline, benzos, opioids
Important info to tell pregnant pts about their medica’n ✓
That it’s safe in pregnancy !
What does round to a certain number mean ? ✓
Answers must be a multiple of that number
DKA Full Tx ✓
IVF + fixed rate insulin infus’n + resume home insulin if it was stopped
How to calculate ml/hr of fluid to give ✓
- % dehyrated x pt’s weight x 10 mL
- convert their weight into fluid
→ 1st 10kg = 100 mL
→ next 10kg = 50 mL
→ any addi’nal kg = 20mL - Add sum of 1 + 2
- Divide that sum by 24hrs
In what increments is levothyroxine adjusted (if it needs to be adjusted ofc) ✓
25 mcg
In what increments is insulin ↑ed in hospital ✓
By 2 units
If morning insulin in hospital is high , during what time of day should insulin dose be ↑ed ✓
Evening b/c it’s the previous dose that determines the next BG
Acceptable max BG for pt in hospital ✓
180
Types of laxatives ✓
Stimulant laxatives
- senna
- bisacodyl
→ C/I = bowel obstruc’n
Osmotic laxatives (don’t give if pt feels bloated)
- lactulose
- macrogol
Bulk-forming laxative
- ispaghula husk
→ takes 72 hrs to act + is mainly for pts who don’t consume enough fiber
Softening laxative (don’t give if pt’s stools are already soft)
- docusate
Tx for opioid-induced constipa’n ✓
Osmotic + stimulant laxative
What to do when ur hesitating btw diff drugs ✓
Check C/Is + drug interac’ns w/ meds they’re taking to r/o some of the op’ns !
SSX of opioid toxicity ✓
- LOC
- pinpoint pupils
- resp. depress’n / bradypnea
When to transfuse ✓
Hgb < 7 or 70
WHO Ladder of pain (for post op pain as well) ✓
- Paracetamol
- Weak opiate i.e codeine / tramadol / hydrocodone
- Strong opiate i.e morphine / oxycodone / methadone / hydromorphone / fentanyl
→ morphine = renally cleared so don’t give this to pts w/ kidney dysfunc’n
→ oxycodone = hepatically metabolized so = fine to give to pts w/ renal dysfunc’n
What to do in order to decide whether or not to treat paracetamol overdose ✓
- Measure paracetamol [ ] if it’s been ≥ 4 hrs after ingest’n
- Use Tx graph
- If [ ] @ time after ingest’n lies on or above graph, then treat !
Tx for rhabdo ✓
Same as septic shock except over 15 mins
How to determine when to give next dose of gentamicin ? ✓
- Count how many hrs has elapsed btw current + previous dose
- Look @ graph
- Plot that point on the graph + where point falls will tell u when to give next dose
