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1
Q

what should you advise men taking finasteride

A

wear condoms

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2
Q

surgical thromboprophylaxis

A

LWMH (enoxaparin) for 10 days then low dose LMWH (dalteparin) or aspirin

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3
Q

%s of glucose

A

5% for maintanence
20% for hypos

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4
Q

drugs causing hyperkalaemia

A

heparin, ACEi, tacrolimus, spironolactone

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5
Q

when do you stop aspirin prior to surgery

A

7 days

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6
Q

drugs to stop in AKI

A

duiretics
ACE and ARBs
rifampicin
NSAIDS
Metformin
(cyclosporin, tacrolimus, -mycins, cisplatin)

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7
Q

can steroids cause confusion

A

yes

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8
Q

what drugs cause hypokalaemia

A

thiazides (indapamide), citalopram, steroids

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9
Q

should you use same or diff drug for breakthough pain

A

same

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10
Q

prefer or avoid nirtofurantoin in low eGFR

A

avoid

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11
Q

normal INR?

A

1
if INR more than 1.5 day before surgery give vit K

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12
Q

what drug stop 6 months before preggers

A

methotrexate

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13
Q

how many nanograms is a microgram

A

1000

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14
Q

what is expected and accepted when starting an ACEi

A

<20% rise in creatinine

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15
Q

what to not give in asthmatics

A

beta blockers or NSAIDs

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16
Q

what monitoring for heart failure

A

exercise tolerance

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17
Q

should you adjust or add new insulin first

A

adjust dumbo

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18
Q

when check gent

A

6-14 hrs after dose

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19
Q

what is bridging pre surgery anticoag

A

unfractionated heparin

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20
Q

what drugs do you stop prior to surgery

A

ACEi, ARBs, diuretics, lithium, NSAIDs, HRT and COPC (both 4 weeks), aspirin (7 days), warfarin (days 5), DOACs (2-3), heparin (day before), insulin (long acting continues), stop SUs and oral hypoglyacaemics

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21
Q

what drugs cause confusion

A

anticholinergics, antidepressants, sedatives, opioids, levodopa, oxybutin

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22
Q

what drugs cause hyponatraemia

A

NSAIDs, ACEi, loops, SSRIs,

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23
Q

what VTE prophylaxis or treatment in renal impairment

A

LMWH (dalteparin/ enoxaparin)

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24
Q

tx for unstable PE

A

unfractionated heparin + thrombolysis (alteplase and streptokinase)

25
tx for stable PE
DOAC and CTPA
26
how long anticoagulate after VTE
3 months provoked, 6 months unprovoked/ cancer
27
DVT anticoagulation
LMWH 5 days then DOAC
28
stroke 2nd prevention
aspirin 2 weeks then clopidogrel (dual if high risk), statin, HPTN control, DOAC
29
MI 2nd prevention
ACEi, dual antiplatelet, B blocker, statin
30
big drugs not safe in pregnancy
statin, methotrexate, carbimazole, ibruprofen
31
big drugs not safe when breast feeding
codeine, oestrogen contraception, DOACs (warfarin safe)
32
when can you take the emergency contraceptions up till
levonorgestrel 72 hours, ulipristal 5 days
33
advise for missed pills
take asap, even if two in same day if missed 2 use condoms until pills for 7 days if missed 2 in week 1 consider emergency contraception, if in week 3 continue pack without pill free week
33
advise for missed pills
take asap, even if two in same day if missed 2 use condoms until pills for 7 days if missed 2 in week 1 consider emergency contraception, if in week 3 continue pack without pill free week
34
what happens to thryoid drugs in pregnancy
increase levothyroxine, stop carbimazole
35
UTI in pregnancy
1 and 2nd trim nitro 3rd trimethoprim
36
how much morphine is 1 oxycodone
2
37
how much tramadol is 1 morphine
10
38
how much SC morphine is 1 oral
0.5
39
how to calculate breakthrough dose
1/6
40
pain ladder
paracetamol- co-codamol- codeine- tramadol- morphine- oxycodone
41
tx for acute dystonia
procyclidine 5-10 mg IV
42
resus fluids
500ml 0.9 NaCl in 15 mins (repeat to 2000mls)
43
maintenance fluids
(25mls water, 1 mmol K+, Na+, Cl-, 50g glucose) 1 x 1000 Na cl + 2 glucose 5% 1000 in 36 hours add replacement potassium if needed
44
what HRT do women with uterus' need
dual- oestrogen + progesterone
45
what HRT has no withdrawal bleed
continuous
46
big SE with ACEis
dry cough
47
what should you do if getting muscle symps from statin
stop then restart at lower dose if they resolve
48
curb score
confusion, urea >7, RR >30, BP <90 or 60 0-1 mild, 2 mod, 3 severe
49
anxiety meds
sertraline
50
SE for fluoxetine
suicidal ideation in young (only one liscenced for <18s) hyponatraemia
51
name 2 SSRIs
sertaline, citalopram
52
how many micrograms in a millygram
1000
53
what type of insulin for DKA
fixed rate, continue any long acting, stop short acting (replace potassium and glucose)
54
what pain relief for acute pain first
paracetamol
55
what for acute reversal of warfarin
prothrombin or FFP
56
what should you do if thyrotoxicosis due to amiodarone
withhold
57
tx for acute pulmonary oedema
furosemide, diamorph, GTN, O2 if needed

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