Managing Conditions

Question 1

What should a patient in mild pain receive?

Answer 1

Paracetamol 1g 6-hourly PO

Codeine 30mg up to 6 hourly PO

Question 2

What should a patient in severe pain receive?

Answer 2

Cocodamol 30/500, 2 tablets 6 hourly PO

Morphine sulphate 10mg up to 6-hourly PO as required

Question 3

What is the initial management of all cardiovascular emergencies?

Answer 3

ABC

15L oxygen via non-rebreathe mask

Question 4

How is a STEMI managed, as opposed to an NSTEMI?

Answer 4

300mg PO aspirin
5-10mg IV morphine
10mg IV metoclopramide
GTN spray/tablet
Primary PCI
5mg PO atenolol

NSTEMI given clopidogrel 300mg PO and enoxaparin 1mg/kg BD SC instead of primary PCI.

Question 5

Morphine, metoclopramide, GTN, and IV furosemide, form the management of which patient?

Answer 5

Acute heart failure

Question 6

In patients with acute heart failure, what other management can be tried?

Answer 6

Isosorbide dinitrate infusion

CPAP

Question 7

In which patients with VT should a synchronized DC shock be given, followed by 300mg IV amiodarone?

Answer 7

Signs of shock
Syncope
MI
HF

Question 8

What are the differentials for broad complex VT?

Answer 8

Irregular: AF w/ BBB
Regular: VT

Question 9

What are the differentials for narrow complex VT?

Answer 9

Irregular: AF
Regular: SVT

Question 10

What is the treatment of anaphylaxis?

Answer 10

ABC and 15L O2
IM adrenaline 500mcg of 1:1000
IV chlorphenamine
IV hydrocortisone
Asthma tx if wheeze

Question 11

What is the treatment of an acute exacerbation of asthma?

Answer 11

Oxygen
Salbutamol NEB
Hydrocortisone IV/Prednisolone PO
Ipratropium NEB
Theophylline

Question 12

What is the difference in management in acute exacerbation of COPD and asthma?

Answer 12

They are the same, except COPD patients receive antibiotics if an infective cause is suspected.

Also, oxygen is used with caution.

Question 13

What is the management of PE?

Answer 13

ABC and oxygen
IV morphine
IV metoclopramide
LMWH/thrombolysis

Question 14

What fluid is prescribed in patients with GI bleeding?

Answer 14

Crystalloid

Cross match 6 units

Question 15

If prothrombin time or APTT is >1.5x normal range, what is given?

Answer 15

FFP

Unless on warfarin - give prothrombin complex

Question 16

What threshold of platelets is used to guide platelet transfusions?

Answer 16

<50x10^9, unless critical bleeding

Question 17

What antibiotic is prescribed for bacterial meningitis?

Answer 17

IV cefotaxime 2g

Question 18

What is the management of status epilepticus?

Answer 18

IV lorazepam x3
Phenytoin infusion
RSI with sodium thiopentol

Question 19

What rate of insulin is given in DKA?

Answer 19

0.1IU/kg/hour

Question 20

What is the treatment threshold in hypertension?

Answer 20

135/85

Question 21

What medications are used in chronic HF?

Answer 21

ACEI and BB
ARB/hydralazine and isosorbide mononitrate
Furosemide

Question 22

What are the components of the CHAD2DS2-VASc score?

Answer 22

CCF
Hypertension
Age>75 (2)
DM
Stroke/TIA (2)
Vascular disease
Age 65-74
Female sex

Question 23

What is the treatment threshold of the CHAD2DS2-VASc score?

Answer 23

0 - no tx
1 - antiplatelet/anticoag
2- anticoag

Question 24

In which AF patients is rhythm control (cardioversion or amiodarone/flecainide) used?

Answer 24

Young
Symptomatic
First episode
Reversible cause

Question 25

Which AF patients undergo cardioversion?

Answer 25

Presented less than 48h | Haemodynamically unstable

Question 26

What is the rate control management of AF?

Answer 26

BB or diltiazem | Combine with digoxin

Question 27

What is the management of angina?

Answer 27

GTN spray Secondary prevention One anti-anginal drug such as BB or CCB (amlodipine or diltiazem)

Question 28

What is the treatment of absence seizures?

Answer 28

Sodium valproate or ethosuximide

Question 29

What is the treatment of GTC seizures?

Answer 29

Sodium valproate

Question 30

What is the treatment of partial seizures?

Answer 30

Carbamazepine or lamotrigine

Question 31

What should be checked before starting azathioprine?

Answer 31

TPMT levels

Question 32

What is the maximum amount of paracetamol that can be prescribed in 24h?

Answer 32

4g

Question 33

Name an osmotic laxative?

Answer 33

Lactulose

Question 34

Name a stool softener and what it is good for?

Answer 34

Docusate sodium | Good for faecal impaction

Question 35

How much fluid does a typical adult require per day?

Answer 35

3L IV maintenance fluids | 8-hourly bags

Question 36

How much fluid does an elderly patient require per day?

Answer 36

2L IV maintenance fluids | 12-hourly bags

Question 37

How much potassium is required per day when nil by mouth?

Answer 37

40-60mmol

Question 38

Why do colloids maintain blood pressure for longer?

Answer 38

They stay intravascularly

Question 39

What is a contraindication to lactulose?

Answer 39

Bloating

Question 40

What is a contraindication to senna/bisacodyl?

Answer 40

Cramps

Question 41

Name a stimulant laxative.

Answer 41

Senna

Question 42

Name an osmotic laxative.

Answer 42

Lactulose

Question 43

What is a disadvantage of isphagula husk?

Answer 43

May take days to have an effect

Question 44

Name a prokinetic anti-emetic.

Answer 44

Metoclopramide

Question 45

What drug class is cyclizine and ondansetron?

Answer 45

Cyclizine: anti-histamine Ondansetron: 5HT3 antagonist

Question 46

What anti-emetic is preferred in bowel obstruction?

Answer 46

Decompression with NG tube.

Question 47

Which drug is the best choice for acute severe pain, and an exception.

Answer 47

Morphine Unless regular pain is being controlled with a different drug

Question 48

How much potassium is required for a NBM patient per day?

Answer 48

1mmol/kg