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Pre-reg (Rosie) > Questions > Flashcards

Questions Flashcards

1
Q

Rapid IV administration of loop diuretics can lead to what?

A

Tinnitus

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2
Q

IV loop diuretics should NEVER be given in combination with X?

A

Aminoglycosides as risk of ototoxicity

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3
Q

Spironolactone - with or without food?

A

With food

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4
Q

Hyperprolactinaemia is a side effect with most antipychotics, except?

A

Aripiprazole

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5
Q

Can an AChE inhibitor and memantine be given together?

A

NICE guidance states that the combination is NOT recommended.

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6
Q

Patients with epilepsy should not be given what anti malarials?

A

Chloroquine and mefloquine

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7
Q

metformin side effects

A

GI disturbance and metallic tast in mouth

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8
Q

Frothy pink sputum is indicative of what disease?

A

Heart failure

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9
Q

Outline gentamicin bacterial cover

A

Very active against gram neg.
Not active against anaerobes
Is active against pseudomonas

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10
Q

Treatment with gentamicin should ideally be limited to what duration?

A

7 days

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11
Q

When should treatment be offered to patients with stage 1 hypertension?

A

Treat stage 1 if patient is under 50 years and has one of the following: target organ damage, cardiovascular disease, diabetes or a CV risk >20%.

If the patient does not have any of these conditions, then offer lifestyle advice and review annually.

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12
Q

When should treatment be offered to patients with stage 2 hypertension

A

Treat all patients with stage 2 hypertension regardless of their age.

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13
Q

Step 1 hypertension treatment in patients <55 years

A

ACEi (or ARB if not tolerate)

OR a thiazide diuretic in patients with heart failure or at high risk

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14
Q

Step 2 hypertension treatment is patients <55 years

A

ACEi + CCB

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15
Q

Step 3 hypertension treatment in patients <55 years

A

ACEi + CCB+ thiazide diuretic

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16
Q

Step 1 hypertension treatment in patients >55 years or afro /carribbean

A

CCB or a thiazide diuretic if evidence of heart failure or at risk

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17
Q

Step 2 hypertension treatment in patients >55 years or afro/carribbean

A

CCB + ACEi/ARB (for black people of african or caribbean origin, consider an ARB in preference to an ACE inhibitor)

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18
Q

Step 3 hypertension treatment in patients >55 years or afrocarribbean

A

CCB+ ACEi + thiazide

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19
Q

When would a high dose thiazide diuretic be used over spironolate in step 4 hypertension?

A

If k+ is >4.5mmol/l then should not use spironolactone

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20
Q

How should isolated systolic hypertension be treated?

A

Should treat as normal

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21
Q

What is the BP target in diabetes?

A

140/80

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22
Q

What is the BP target in diabetes associated with target organ damage?

A

130/80

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23
Q

What is the target BP target in CKD?

A

130/80

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24
Q

What antihypertensive is used first line in pregnancy?

A

Labetolol usually (unless reason why they can’t have e.g. asthmatic)

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25
Q

Finasteride MHRA alert

A

MHRA alert r/e reports of depression

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26
Q

Finasteride counselling points

A

Risk of depression
S/E of breast enlargement, decreased libido, impotence
Requires contraception and should be avoided in women of child bearing age.
Report signs of male breast cancer.

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27
Q

Pre-disposing factors for tumour lysis syndrome?

A

Dehydration and renal impairment

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28
Q

how can cyclophosphamide induced cystitis be managed?

A

Mensa can be given

Increase the fluid intake 24-48 hours after IV administration can prevent cystitis

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29
Q

Anthracycline monitoring (doxorubicin, epirubicin)

A

Cardiomyopathy, can lead to HF

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30
Q

What formulations can be used to decrease cardiotoxicity associated with anthraycyclines?

A

Liposomal formulations - but these can cause foot and mouth syndrome.

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31
Q

How long should children with impetigo remain off school?

A

Should be kept off school until the lesions have crusted and healed or after 48 hours of starting treatment

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32
Q

Rust coloured sputum might indicate what?

A

Pneuomina

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33
Q

How often should curanail be applied?

A

Apply once a week

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34
Q

Ciclosporin monitoring

A

Hypertension is a common s/e need to monitor BP regularly.

Monitor FBC, LFTs, K and Mg

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35
Q

ACEi + ciclosporin interaction

A

Risk of hyperkalemia

36
Q

NSAIDs + ciclosporin interaction

A

Risk of nephrotoxicity

37
Q

Digoxin dose should be reduced by half if given with what 3 drugs?

A

Amiodarone, dronderone, quinine

38
Q

If lithium is to be discontinued, how should it be withdrawn?

A

Withdraw over at least 4 weeks (preferably 3 months)

39
Q

Theophylline and salbumatol nebulisers may lead to what electrolyte disturbance?

A

Hypokalemia

40
Q

When should theophylline serum monitoring be carried out?

A

Measure 5 days after starting oral treatment and at least 3 days after any dose adjustement

41
Q

How long does it take for NSAIDs to have their anti- inflammatory effect?

A

3 weeks

42
Q

Which NSAIDs have the highest GI risk?

A

Piroxicam, ketoprofen

43
Q

How should ringworm be treated? (drug, duration)

A

Topical clotrimazole

terbinafine is an alternative treatment - but is not licensed in <16 years and is more expensive.

Treatment should be continued 1-2 weeks after disappearance of infection

44
Q

Scabies treatment

A

Permethrin (or malathion) - all members of household should be treated. Apply all other body for 8 hours. Apply twice, one week apart.

45
Q

Headlice treatment

A

Dimeticone is product of choice

Benzylbenzoate is less effect and not recommended in children

Malathion - is not to be used in asthma

46
Q

Step 1 asthma treatment in adults and children over 5 years

A

PRN SABA

47
Q

Step 2 asthma treatment in adults and children over 5 years

A

Regular ICS

48
Q

Step 3 asthma treatment in adults and children over 5 years

A

Consider adding a LABA - if some benefit but control still not adequate then increase ICS

Discontinue if ineffective and increase ICS dose.

Consider adding a LTRA or M/R theophylline

49
Q

Step 4 asthma treatment in adults and children >5

A

Increase ICS dose - or add LTRA, m/r theophylline or an oral b agonist (but careful if already taking a LABA)

50
Q

Step 1 asthma treatment in children <5 years

A

SABA PRN

51
Q

Step 2 asthma treatment in children under 5

A

Add an ICS (if not appropriate then add LTRA)

52
Q

Step 3 asthma treatment in children under 5 years

A

Add a LTRA

Refer if <2 years to a specialist

53
Q

Management of an acute asthma attack in adults

A 
Oxygen (Target 94-98%)
High dose SABA nebulisers
Prednisolone 40-50mg for 7 days
Ipratropium nebulisers
Consider a single dose of IV Mg sulphate
Routine use of abx is NOT recommended
54
Q

Management of an acute asthma attack in children

A

Inhaled SABA using an MDI and spacer device
Prednisolone for 3 days (dose depends on age)
If SABA ineffective, consider adding ipratropium bromide
Consider Mg sulphate to nebs of salbutamol

55
Q

Which LABA is also licensed for short term symptom relief?

A

Formeterol - speed of onset is similar to salbutamol

56
Q

What inhaler treatment should be offered to a patient with COPD and FEV >50%

A

LABA or LAMA

57
Q

What inhaler treatment should be offered to a patient with COPD with FEV <50%

A

LABA/ICS or LAMA

58
Q

What time of the day should montelukast be taken?

A

In the evening

59
Q

What two cough agents might be offered to patients with a dry cough?

A

Dextrometorphan and pholcodiene

60
Q

How could a cough in palliative care be managed?

A

Morphine is preferred (diamorphine and methadone can also be used - avoid methadone as had a long half life and may accumulate)

61
Q

What is the first line treatment for mild-moderate UC?

A

Aminosalicylates

62
Q

Sulfasalazine monitoring

A

Renal function should be monitored at start, after 3 months and then annually.
FBC and LFTs

63
Q

Why are bismuth antacids (such as pepto bismul) not recommended?

A

Bismuth antacids are not recommended because absorbed bismuth can be neurotoxic causing encephalopthy

64
Q

Why are calcium containing antacids not recommended?

A

Can induce rebound acid secretion

65
Q

Alginates should be avoided in what patients?

A

In patients with fluid retention avoid as contain large amounts of sodium

66
Q

1st line treatment of GORD in pregnancy (after lifestyle)

A

Antacid or alginates

67
Q

What is the drug of choice for cholestatic pruritus?

A

Colestyramine

68
Q

What is the drug of choice for cholestatic pruritus in pregnancy?

A

Ursodeoxycholic acid

69
Q

How should gallstones be treated?

A

Analgesia with paracetamol or NSAID
Can give IM diclofenac
No evidence for use of ursodeoxycholic acid

70
Q

Treatment for oesophageal varices?

A

Terlipressin IV

71
Q

Orlistat can be given to patients with a BMI of what?

A

BMI >30

or a BMI >28 in the presence of other risk factors e.g. T2DM and HTN

72
Q

When should orlistat be discontinued as it is considered ineffective?

A

Discontinue if weight loss has not exceeded 5% after 12 weeks.

73
Q

1st line treatment for BPH?

A

Alpha blocker

74
Q

You receive a prescription for sirolumus 1mg OM 28/7. Can you supply 56 x 500mcg tablets?

A

No- 500mcg tablet is not bioequivalent to the 1 and 2mg tablets and should not be used as a substitute.

75
Q

What should be given to patients at high risk of chemo induced emesis ?

A

dexamethasone, 5HT3 antagonist and arepitant.

76
Q

What can be given for methotrexate over dose?

A

Folinic acid (given as calcium folinate)

77
Q

Cisplatin monitoring

A

Monitor FBC, audiology, electrolytes and renal function (risk of nephrotoxicity, cisplatin requires intensive hydration)

78
Q

Routine pre-med with what is recommended before docetaxel administration?

A

antihistamine - to prevent severe hypersensitivity reactions

79
Q

When is tamoxifen given in breast cancer?

A

Tamoxifen can be given to pre-menopausal women with oestrogen receptor positive breast cancer

80
Q

When is anastrozole given in breast cancer?

A

Anastrozole can be given to post-menopausal women with oestrogen positive breast cancer

81
Q

When should parkinsons treatment be initiated following diagnosis?

A

Treatment should not usually be started until symptoms cause significant disruption of daily activities

82
Q

What are the 1st line treatment options for parkinons disease?

A

Levodopa, non-ergot derived dopamine agonists or MAOi

83
Q

A patient on doxycyline has developed a headache and visual disturbances. What action do you take?

A) advise them this is a normal side effect and to finish the course
B) Advise them to make an appointment with their GP if it does go away in the next 24 hours
C) Tell them to stop taking immediately and seek medical attention
D) sell them paracetamol

A

C - headache and visual and disturbances when taking tetracyclines may be a sign of benign intracranial hypertension and treatment should be discontinued

84
Q

What is herpes zoster?

A

Shingles

85
Q

What is herpes simplex?

A 
HSV-1 = cold sores
HSV-2 = genital herpes
86
Q

What is varicella zoster?

A

Chicken pox

87
Q

Koplik spots are seen in what condition?

A

Measles (Fancy term for the spots inside the mouth)

Pre-reg (Rosie) (18 decks)

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