things to remember

Question 1

Emergency resuscitation fluids

Answer 1

Sodium chloride 0.9% 500ml over 10 minutes (consider 250ml if elderly/co-morbidities)

Question 2

Emergency hypoglycaemia fluids

Answer 2

Glucose 20% 100ml 15 minutes

Question 3

Emergency hypokalaemia fluids

Answer 3

Sodium chloride 0.9%/ Potassium chloride 0.3% 1000ml 4h

Question 4

Emergency hypercalcaemia fluids

Answer 4

Sodium chloride 0.9% 1000ml 4h

Question 5

Maintenance fluids without deficits or losses

Answer 5

25-30ml/kg/24h water
1mmol/kg/24h Na and K
50-100g/24h glucose
(aim 1000ml 8-12 hours)

Question 6

Maintenance fluids with deficits or losses e.g. Na or K low, vomiting, diarrhoea

Answer 6

minimum 30ml/kg/24h water
ensure electrolytes are replaced
aim for 1000ml 4-6h

Question 7

Paediatrics emergency resuscitation fluids

Answer 7

sodium chloride 0.9% 10ml/kg 10m

Question 8

paediatrics maintenance fluids without deficits or losses

Answer 8

100ml/kg/24h for <10kg
50ml/kg/24h for 10-20kg
20ml/kg/24h for >20kg

Question 9

HRT prescribing for intact uterus + LMP <12m

Answer 9

estradiol with norethisterone sequential

Question 10

HRT prescribing for intact uterus + LMP >12m

Answer 10

estradiol with norethisterone continuous

Question 11

HRT post-hysterectomy

Answer 11

estradiol

Question 12

vasomotor symptoms in someone that can’t take HRT

Answer 12

Clonidine

Question 13

Menopausal atrophic vaginitis

Answer 13

topical vaginal oestrogen

Question 14

Rapid acting insulin

Answer 14

Insulin aspart (Novorapid)

Question 15

1% equals

Answer 15

1g in 100ml

Question 16

Enzyme inducers PC BRAS

Answer 16

phenytoin
carbamazepine
barbiturates
rifampicin
alcohol (chronic excess)
sulphonylureas
Others: topiramate, St John’s Wort, and smoking.

Question 17

what is the effect of enzyme inducers

Answer 17

increased metabolism of drugsand subsequentlyreducing the therapeutic concentration

Question 18

Enzyme inhibitors (AO DEVICES)

Answer 18

allopurinol
omeprazole
disulfiram
erythromycin
valproate
isoniazid
ciprofloxacin
ethanol (acute intoxication)
sulphonamides
Others: grapefruit juice, amiodarone, and SSRIs (fluoxetine, sertraline)

Question 19

Effect of enzyme inhibitors

Answer 19

decreases drug metabolismin the body andincreases the potential for toxicity

Question 20

Drugs prescribed in micrograms

Answer 20

levothyroxine, digoxin, naloxone, fludrocortisone, inhalers, GTN, ipratropium nebs

Question 21

Weekly drugs

Answer 21

methotrexate and some doses of bisphosphonates

Question 22

When do you need to adjust the dose of Aciclovir

Answer 22

Renal failure

Question 23

Gentamycin dose is based off what in obese patients

Answer 23

ideal body weight

Question 24

Escitalopram has a maximum dose in what group of people

Answer 24

elderly

Question 25

When should Nitrofurantoin be avoided

Answer 25

eGFR <45
third trimester of pregnancy

Question 26

How do you manage usual insulin in a patient with DKA

Answer 26

continue long acting insulin, stop short acting and start a fixed rate insulin infusion

Question 27

Drugs taken in the morning

Answer 27

diuretics, steroids

Question 28

Drugs taken at night

Answer 28

statins, night sedation

Question 29

common classes of drugs causing urinary retention

Answer 29

opioids
anticholinergics

Question 30

drugs that may worsen myasthenia gravis

Answer 30

antibiotics
beta blockers
local anaesthetic
sedating drugs

Question 31

drugs that may worsen psoriasis

Answer 31

beta blockers
lithium
some antibiotics

Question 32

vitamin K name in BNF

Answer 32

phytomenadione

Question 33

what fluid cannot be given 24 hours post ischaemic stroke

Answer 33

glucose

Question 34

PPI’s increase risk of what

Answer 34

fractures

Question 35

what drugs should you stop in an AKI

Answer 35

Diuretics
ACE/ARBs
Metformin
NSAIDs

Question 36

1st line drug for postural hypotension

Answer 36

Fludrocortisone