Random Tidbits Flashcards

1
Q

Hepatic Encephalitis

A

Lactulose

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2
Q

Oral contraception for a smoker?

A

Desogestrel (POP = progesterone only pill)

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3
Q

Asthma management in children?

A
  1. SABA
  2. SABA + ICS (low dose)
  3. SABA + (low dose) ICS + LRTA
  4. SABA + (low dose) ICS + LABA
  5. Start the MARTs…

Low dose ICS = < 200 micrograms budesonide

LRTA = montelukast

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4
Q

Drug to give 9 hours after a stroke?

A

Aspirin 300mg

(Alteplase < 4.5 hours)

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5
Q

C Difficile management?

A

CKS - ‘Diarrhoea - antibiotic associated’

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6
Q

Paracetamol overdose?

A
  • Measure @ 8 hours
  • < 4 hours and > 150 mg = charcoal
  • Treat according to graph
  • 8-16 hours and > 75mg/kg start NAC while awaiting results
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7
Q

Statin interaction causing myopathy?

A

Clarithromycin

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8
Q

Drugs that cause diarrhoea?

A
  • Alendronic Acid
  • Lansoprazole
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9
Q

Maintenance fluids?

A
  • 8-hourly bags (3L) BUT elderly/underweight = 12-hourly bags (2L)
  • Add the potassium (divide by the 3 bags)
  • 25-30 ml/kg/day of water
  • 1 mmol/kg/day of potassium, sodium and chloride
  • 50-100 g/day of glucose to limit starvation ketosis
  • Adults generally require 3L IV maintenance fluids per day (8 hourly bags); 40-60 mmol KCL per day when NBM; 2 salt (saline) and 1 sweet (dextrose) every 24 hours
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10
Q

Hypoglycemic diabetic?

A

20% glucose 100 ml 20 minutes

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11
Q

Relieving oedema?

A

IV furosemide 40mg

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12
Q

Drug that causes flushing?

A

CCBs

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13
Q

What is normal urine output?

A

Average urine output should be approximately 0.5mL/kg/hour

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14
Q

Glycaemic control in stroke patients?

A

Tight glycaemic control has not been shown to improve outcome in stroke and current recommendations suggest maintaining plasma glucose in the range 5 to 15 mmol/L

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15
Q

Surgery and medication?

A

‘Surgery and long-term medication’ in treatment summary

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16
Q

Converting units?

A

Approximate Conversions and Units

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17
Q

Breakthrough pain?

A
  • Palliative = treatment summaries
  • Breakthrough pain = 1/6 of 24 hour dose given 4-hourly as required
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18
Q

Antidotes

A

‘Poisoning, emergency treatment’ on BNF

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19
Q

HRT

A

ESTRADIOL WITH NORETHISTERONE

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20
Q

COCP monitoring?

A

Blood Pressure

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21
Q

Transient rise in blood glucose caused by corticosteroids?

A

An increase in the usual insulin dose of 10% would be an appropriate way to manage a transient rise in blood glucose caused by corticosteroids

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22
Q

When is no change in Statin dose the appropriate management?

A

No change in dose is required, as after 3 months of treatment a > 40% reduction in non-HDL cholesterol has occurred

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23
Q
A
24
Q

When should ACEi be taken?

A

Can give postural hypotension = best given in the evening

25
Q

Hyperkalaemia management?

A
  • Found in ‘treatment summary’ for ‘fluids and electrolytes’
  • An intravenous injection of soluble insulin (5–10 units) with 50 mL glucose 50% given over 5-15 minutes
  • E.g. Actrapid or Novorapid
26
Q

Epilepsy treatment differences?

A
  • Lamotrigine = in pregnancy
  • Carbamazepine = causes SIADH
27
Q

Initial drug therapy in T2DM?

A
28
Q

Vomiting medications?

A

‘Nausea and labyrinth disorders’

29
Q

LMWH contra-indications?

A
  • Prophylactic heparin CIed in acute ischaemic stroke due to risk of bleeding into stroke (for at least 2 months)
  • @ Risk of bleeding/recent ischaemic stroke/if patient has PAD (absent foot pulses) = no compression stockings – can cause acute limb ischaemia
30
Q

Vancomycin side effects?

A

Ototoxicity + Nephrotoxicity

31
Q

Statins management?

A
  • LFTs checked before treatment, 3 months & 12 months
  • CI if 3 x normal ALT/AST
  • CI if 5 x normal CK
  • CK monitoring only if risk factors
32
Q

Adverse Drug Reactions: Low GCS or Acidotic?

A

Look for Metformin!

33
Q

Which 2 drugs should NEVER be co-prescribed?

A

ACEi and NSAIDs

34
Q

Neuropathic pain in an elderly person?

A

Paracetamol > Amitryptiline initially for neuropathic pain

35
Q

Conversions?

A
  • 1000 micrograms = 1 mg
  • 1 microgram = 1000 nanograms
  • 0.1% = 0.1 g per 100 mL = 100 mg per 100 mL = 1 mg in 1 ml
  • 1% = 1g in 100ml (100g) = 10 mg in 1 ml
  • 1 in 1000 = 1g in 1000ml
36
Q

Severe lithium toxicity?

A
  • Stop Lithium (severe toxicity = arrhythmia, seizure, renal failure)
  • Stop Thiazide diuretics and ACEi and NSAIDs (= can cause decreased excretion via kidneys)
37
Q

KCL maximum?

A

20mmol/hour

38
Q

Levothyroxin dose changes?

A

Change levothyroxine doses in 25-50 microgram increments

39
Q

Anaphylaxis treatment?

A

0.5mg of 1:1000; high flow oxygen FIRST (ABC); Chlorphenamine = 10mg IV

40
Q

Which drug is CI in indigestion?

A

NSAIDs

41
Q

COPD exacerbation managment?

A

1) Salbutamol nebs
2) Ipratropium bromide nebs 500mg
3) Prednisolone 30mg.
4) Non-threatening OBS + ABG = 24% Oxygen

BiPAP = Type 2 Respiratory Failure

CPAP = Type 1 Respiratory Failure

5) Aminophylline only if all other treatments failed = senior colleague observation required

42
Q

Human Albumin Solution

A

Liver Failure (low-sodium content required)

43
Q

Cough w ACEi. Management?

A

Change to a trial of an ARB

44
Q

Monitoring of ACEi?

A
  • After initiating ACEi: renal function and potassium should be checked 1-2 weeks later
  • Creatinine baseline
  • N.B. renal impairment can present as general malaise and fatigue
45
Q

Abrupt cessation of steroids?

A
  • Addisonian Crisis
  • Prescribe a calcium tablet, and sometimes a bisphosphonate, as osteoporosis prophylaxis with steroids
46
Q

Methotrexate monitoring?

A

Every 3-4 weeks (FBC, LFT, U&E) → neutropenia

47
Q

Considerations w Statins?

A
  • Avoid grapefruit juice when taking a statin
  • Take statin at night
  • Do not use statins in active liver disease
  • Stop statins when a macrolide is prescribed.
48
Q

Steroids prescription when ill?

A

STEROID PRESCRIPTIONS ARE DOUBLED during sepsis/illness → ‘sick day rules’

49
Q

When should methotrexate be stopped?

A

Methotrexate should be stopped during active infection

50
Q

Initial relief of indigestion?

A

Antacid (e.g. Magnesium Carbonate) for INITIAL RELIEF

51
Q

Weak Opioids?

A

Codeine and Tramadol

52
Q

What should you monitor w Aminophylline?

A

Monitor OXYGEN → improvement in saturations (asthma)

53
Q

How to know if antibiotics are working in pneumonia?

A

Response to antibiotics = oxygen saturations, ABG, respiratory rate

  • consolidation can take 6 weeks to clear
  • crepitations take days to resolve
54
Q

Tacrolium monitoring?

A

Trough

55
Q

Fluoxetine monitoring?

A
  • Hyponatremia
  • First 2 weeks = check for suicidal ideation
  • Assess for efficacy = 4 weeks
56
Q

DKA monitoring?

A

serum ketones > serum glucose

57
Q

Oxygenation in COPD?

A
  • 88-92%
  • Monitor w pulse oximetry