Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

- Y6 PSA > Random 3 > Flashcards

Random 3 Flashcards

1
Q

Monitoring sodium valproate?

A

LFTs

NOT serum levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How to monitor DOACs?

A

Cr clearance/eGFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Ciclosporin monitoring?

A

Trough levels before dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Digoxin monitoring?

A

6hrs post dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

For gentamicin - when to increase time between, and when to change dose?

A

If the pre-dose (‘trough’) concentration is high, the interval between doses must be increased.

If the post-dose (‘peak’) concentration is high, the dose must be decreased.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Carbamazepine effect on Na?

A

Causes hyponatraemia

Other SE: rash, dysarthria, ataxia, nystagmus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What to prescribe alongside valproate?

A

Vitamin D

Monitor LFTs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Define status epilepticus.

A

Convulsive status epilepticus is a prolonged convulsive seizure for 5 minutes or longer, or recurrent seizures one after the other without recovery in between.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Lamotrogine SE?

A

Rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Valproate SE?

A

Tremor
Teratogenicity
Tubby (weight gain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Safest anti-epileptic in pregnancy?

A

Lamotrogine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

CCF treatment?

A

Upright
Oxygen
Nitrates
Furosemide
ACEi
Reduce and Na to reduce afterload.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Stable angina tx?

A

1st: BB - atenolol, bisoprolol. In decompensated HF: CCB like verapamil/diltiazem

2nd: combine BB + CCB (If inappropriate: long acting nitrate e.g. ivabradine, nicorandril)

Intolerant of both CCB/BB: long acting nitrate monotherapy

Response to treatment assessed 2-4 weeks

Prinzmetal’s angina - amlodipine may be effective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Chronic HF treatment?

A

AVOID any CCB (verapamil and nifedipine classes) in HFrEF

  1. Furosemide
  2. ACEi + BB(NB: not all licensed) - reduce morbidity and mortality
  3. K+ sparing - spironolactone, eplerenone

Other:
- amiodarone
- digoxin - no mortality effect
- sacubitril with valsartan (ARNI)
- ivabradine
- empagliflozin/ dapagliflozin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why is digoxin only generally used in older patients?

A

Affects exercise tolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

CCB rate control?

A

Vera and Dil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Rhythm control drugs AF?

A

Ami and Flec

CI in structural HD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

GTN prescription?

A

“GTN spray (glyceryl trinitrate)” (can write 400 micrograms/metered dose if you want next to this)
“2 sprays sublingual”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

BB in acute HF?

A

Worsen symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Antihyperglycaemic CI in HF?

A

Pioglitazone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Laxative types?

A

BOSS
Bulk forming e.g. methylcellulose

Osmotic e.g. macrogol, lactulose, phosphate enema

Stool softening e.g. docusate sodium, arachis oil

Stimulant e.g. senna, bisacodyl, glycerol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Disadvantages of bulk forming?

A

Slow to work
Must drink fluids
Unsuitable for atony/faecal impaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Disadvantages of osmotic laxatives?

A

Bloating
Unsuitable for obstruction with perforation risk

23
Q

Disadvantages of stimulant laxatives?

A

Cramping
Unsuitable for obstruction

24
Q

Advantages of stool softeners?

A

Can be used for faecal impaction but beware when giving to pt who already have soft stools

25
Q

UC management?

A

Mild <4, mod 4-6, severe >6 with systemic upset

Mild to moderate:
1. Topical 5-ASA
2. Oral 5-ASA - if remission not achieved within 4 weeks; all left sided UCs
3. Topical/oral corticosteroid

ADD Oral azathioprine or mercaptopurine - if 2 exacerbations in last year

Severe:
1. Hospital admission
2. IV hydrocortisone (+/- IV ciclosporin)

NB: methotrexate NOT used in UC tx

26
Q

Crohn’s management?

A

Steroids- topical, oral, IV

Enteral feeding + stop smoking

5-ASA - not as effective as in UC

Infliximab - refractory or fistulating Crohn’s

Add on aza/mercapto to induce remission.

NB: azathioprine/mercapto never used alone to induce remission in Crohn’s but used alone to maintain remission.

27
Q

Can you use PPI to Tx GI SE of alendronic acid?

A

Np - bisphosphonates are direct irritants so PPIs don’t improve symptoms

28
Q

Emergency contraceptive pills?

A

Lenonorgestrel (Levonelle) - <3days, double if BMI >26.

Ulipristal acetate - <5day

29
Q

Examples of continuous HRT (no bleed)?

A

levonorgestrel 7 mcg/estradiol 50 mcg/24hrs weekly patch

or estradiol 50/norethisterone acetate 170 /24 hours twice weekly patch

30
Q

Above which BP should COCP be stopped?

A

> 160/95 mmHg

31
Q

Main end of life medications?

A

1) Antisecretion
- HYOSCINE

2) Agitation
- MIDAZOLAM (10-20mg/24hrs)

3) Pain
- MORPHINE 10mg/24hr if new

4) Nausea
- CYCLIZINE 150mg/24hr

32
Q

Alternative to morphine if not tolerated?

A

Oxycodone

33
Q

Tx for bone pain?

A

Bisphosphonates

34
Q

Tx for bowel colic, bladder spasm?

A

Antispasmodic (e.g. hyoscine butylbromide)

35
Q

Opioid toxicity treatment?

A

IV 400 micrograms naloxone in 10mls 0.9% sodium chloride
IV 0.5ml (i.e. 20 micrograms naloxone) every 2mins until respiratory recovery

36
Q

Vomiting from gastric stasis?

A

Metoclopramide or domperidone

37
Q

Vomiting from raised ICP?

A

Cyclizine

38
Q

Can you use buprenorphine for breakthrough pain?

A

No because it has both agonist and antagonist properties and so may cause withdrawal or more pain in someone dependent on opioids

39
Q

Antihistamine in anaphylaxis?

A

Chlorphenamine

40
Q

Acute asthma management?

A

Oxygen
Salbutamol 5mg neb
Hydrocortisone IV* 100mg (or pred PO 40mg)
Ipratropium* 500mcg neb
(Theophylline)*
(Magnesium sulphate 2g IV)*
(Escalate, reassess every 15 min, repeat nebs)
() indicate senior input
* indicates if life threatening

41
Q

Acute COPD management?

A

Oxygen (28%, aim 88-92%, unless peri-arrest)
Salbutamol 5mg neb
Hmm…oral pred 30mg ( in 5 mg!! tablets
daily for 5 days) other oral steroids not appropriate
Ipratropium 500 mcg neb
Abx if evidence of infection (amox, clarithromycin, doxycycline)

O SHI- Ah

42
Q

Asthma ladder?

A

SABA
1. + ICS
2. + LABA
3. Increase ICS or add LTRA
4. Refer

43
Q

Paediatric asthma ladder?

A

SABA
1. + VL ICS
2. + LABA >=5, +LTRA <5
3. Increase ICS or add LTRA/LABA
4. Refer

SO same as adults except in young children you add LTRA as step 2

44
Q

Patient is in HF, do you give them either cyclizine or metoclopramide?

A

metoclopramide

NB: cyclizine S/E fluid retention, urinary retention, constipation, dry mouth

45
Q

ECG when citalopram given with clarithromycin?

A

Long QT

46
Q

Anticholinergic excess SE?

A

MAD - delirium (elderly), confusion
RED - flushing, tachycardia
DRY - dry mouth + eye, constipation, urinary retention
BLIND - blurred vision

Drugs such as amitriptylline, paroxetine, antipsychotics, cyclizine.

47
Q

How long does it take for enzyme induction?

A

Days to weeks

48
Q

How long does it take for enzyme inhibition?

A

Weeks to months

49
Q

β-blockers and verapamil together?

A

Profound hypotension and asystole

Verapamil is non-dihydropyridine

50
Q

Difference between classes of CCBs?

A

Dihydropyridine = peripheral

Non-dihydropyridine = more SA and AV node depression than peripheral action

51
Q

MAOi and alcohol?

A

Hypertension

52
Q

SE of BBs?

A

nightmares
bradycardia
hypotension
bronchospasm
cold extremities
fatigue

53
Q

What does 1: 1000 mean?

A

1g in 1000ml

54
Q

What does 1% mean?

A

1g in 100ml

- Y6 PSA (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions