random questions

Question 1

what should be monitored when a patient is given magnesium sulphate?

Answer 1

Monitoring reflexes, particularly deep tendon reflexes (DTR), and respiratory rate are crucial during magnesium administration. Loss of DTRs may indicate magnesium toxicity, which can lead to muscle weakness, respiratory depression, and even respiratory arrest if not addressed promptly. Similarly, monitoring the patient’s respiratory rate is essential as a decreasing rate can be an early sign of magnesium toxicity.

Question 2

what causes cannon JVP waves?

Answer 2

Caused by the right atrium contracting against a closed tricuspid valve. May be subdivided into regular or intermittent

Regular cannon waves
ventricular tachycardia (with 1:1 ventricular-atrial conduction)
atrio-ventricular nodal re-entry tachycardia (AVNRT)

Irregular cannon waves
complete heart block

Question 3

How much should you increase opioids in palliative patients if pain not controlled?

Answer 3

30-50%

Question 4

What analgesia should you prescribe for palliative patients?

Answer 4

if no comorbidities use 20-30mg of MR a day with 5mg morphine for breakthrough pain. For example, 15mg modified-release morphine tablets twice a day with 5mg of oral morphine solution as required

Question 5

what is the breakthrough dose of morphine?

Answer 5

the breakthrough dose of morphine is one-sixth the daily dose of morphine

Question 6

what drugs can cause pulmonary fibrosis?

Answer 6

amiodarone
cytotoxic agents: busulphan, bleomycin
anti-rheumatoid drugs: methotrexate, sulfasalazine
nitrofurantoin
ergot-derived dopamine receptor agonists (bromocriptine, cabergoline, pergolide)