OSCE Management Flashcards by Miranda King

O2 concentrations in COPD

24-28%

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Fluid challenge =

500ml IV saline

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Management of ICP in brain tumours

10m dexamethasone oral

0.25-0.5g/kg mannitol IV

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Management of Anaphylaxis

Adrenaline 0.5mg 1:1000 IM
Hydrocortisone 200mg IV
Chlorphenamine 10mg IV

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Management of Bradycardia

= atropine 500micrograms IV

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Management of Tachycardia - SVT

Try vagal manoeuvres
Medical = adenosine 6mg IV
Can give up to 3 times

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Management of Tachycardia - Broad

Amiodarone 300mg IV

If unstable use DC cardioversion

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Cardiac Arrest =

10ml (100mcg/ml) 1:10000 adrenaline

300mg amiodarone IV

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Opioid overdose =

400 micrograms of naloxone

Need to titrate if have taken a toxic dose

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Benzodiazepine overdose =

200 micrograms flumazenil

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Medication in delirium =

0.5-5mg haloperidol

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Management of ACS (6)

GTN - 2 puffs every 5 minutes
Aspirin 300mg oral 
Clopidogrel 300mg oral OR Prasugrel 60mg (depends on whether already on anti-coagulant)  
Morphine 5-10mg IV 
Metoclopramide 5-10mg IV 
High flow oxygen

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Prevention of ACS (4)

Aspirin 75mg oral
Clopidogrel 75mg oral
Atorvostatin 40mg oral
Anti-Hypertensives

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Starting Dose:

Amlodipine
Lisinopril
Ramipril

Amlodipine = 5mg 
Lisinopril = 10mg 
Ramipril = 2.5mg

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Management of Torsades de Pointes

IV Magnesium sulphate 2g

+ pacing

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Management of Chronic Heart Failure (3)

Furosemide 20-40mg oral OD
ACE-i e.g. lisinopril 10mg or ramipril 2.5mg (starting dose)
Bisoprolol 1.25mg oral

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Management of Acute Heart Failure (5)

Sit them up 
100% oxygen 
IV furosemide 40-80mg 
Consider: 
IV Morphine 5-10mg 
IV Nitrates

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Treatment of DVT (2 options)

Apixaban 10mg BD 7 days
(maintenance = 5mg BD)

Rivaroxaban 15mg BD 21 days
(maintenance = 20mg OD)

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1st Line in T2DM

= metformin 500mg OD

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Insulin in DKA

0.1 units/kg/hour of insulin

Given in an IV infusion

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Management of Thyroid Storm (3)

Propranolol 40mg PO
Hydrocortisone 100mg IV
Carbimazole 15-25mg PO

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Anti-Emetic in Vertigo

Cyclizine 50mg up to TDS

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Management of GORD (2 options)

Omeprazole 20mg OD

Lansoprazole 15mg OD

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Medication given in Varices

Terlipressin 2mg IV over 5 minutes

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Medication given in suspected Peptic Ulcer Disease

Omeprazole 80mg IV

Management of Hyperkalaemia (3)

10mls of 10% calcium gluconate IV 10 units of insulin in 50ml of 50% glucose 5mg salbutamol NEB

Management of Hypokalaemia

40mmol IV potassium | - Rate shouldn't exceed 10mmol/hour

Codeine Dosing

= 30-60mg 4 hourly | Maximum dose up to 240mg

Tramadol to Morphine Conversion

Divide by 10

Oral Morphine to S/C or IV

Divide by 2

Neonatal Sepsis Abx

Benzylpenicillin + Gentamicin

Prevention of Haemorrhagic Disease of the Newborn

= vitamin K injection at birth - can have later if they decline at birth

Management of levodopa associated nausea

Domperidone | = dopamine antagonist

Management of Status Epilepticus

IV Lorazepam 4mg | Can give up to 2 times

Standard Management of Meningitis

Ceftriaxone IV 2g BD | Dexamethasone 10mg QDS

Management of Encephalitis

IV Aciclovir 10mg/kg TDS

1st Choice Management Migraine Prophylaxis

Propranolol 80mg OR Amitriptyline 10-25mg

2nd Choice Management Migraine Prophylaxis

Topiramate

Medical Management of Cluster Headache

Sumatriptan 6mg S/C

Prophylaxis of Cluster Headache

Verapamil 240mg in 3-4 doses

Management of TIA

300mg aspirin + PPI

Management of Ischaemic Stroke <4.5 hours

Alteplase 15mg IV Aspirin 300mg PO PPI

Post-Ischaemic Stroke or TIA Management | 1st Choice

Clopidogrel 75mg daily | Atorvostatin 80mg daily

Post-Ischaemic Stroke or TIA Management | 2nd Choice

Dipyridamole 200mg BD | Atorvostatin 80mg daily

Post-Embolic Stroke Management

Start warfarin | MUST BE >14 DAYS SINCE STROKE

Management of Malignant Spinal Cord Compression

Dexamethasone 16mg IV | Then 8mg BD oral

Management of Premature Rupture of the Membranes

Erythromycin 250mg QDS | Given as an infusion

Management of PPH | 1st Choice

5 units IV syntocinon | 0.5 micrograms ergometrine IV

Management of PPH | 2nd Choice

Carboprost 0.25mg Misoprostol 0.25mg IM Tranexamic acid 1g IV

Management of HTN in Pregnancy (2 options)

Labetalol 100mg BD OR Methyldopa 250mg BD

PET Prophylaxis

Aspirin 75mg oral | From week 12 of pregnancy

Management of Eclamptic Seizures

MgSO4 4g in 5 minutes IV = loading dose | 1g over an hour

2nd Line in Management of Eclamptic Seizures

10mg Diazepam

Management of Septic Arthritis

Flucloxacillin 2g QDS IV | Get for two weeks

Prophylaxis of Joint Infection | Surgery

Cefuroxime 1.5g IV | Once off dose

Management of Osteomyelitis - Acute - Chronic

``` Acute = flucloxacillin IV 2g QDS Chronic = debridement and doxycycline PO ```

Rapid Sedation | No previous use of anti-psychotics

1. Oral lorazepam 1-2mg | 2. IM Lorazepam 1-2mg up to 2 doses

Rapid Sedation | Anti-psychotic use

1. Oral lorazepam 1-2mg +/- 5mg haloperidol oral | 2. IM Lorazepam 1-2mg up to 2 doses

Management of Croup - All - Moderate to Severe Croup

All = dexamethasone 0.15mg/kg for 1 dose Moderate/Severe = adrenaline nebuliser 5ml of 1:1000 and oxygen

Management of epiglottitis

Ceftriaxone IV

Management of CAP in Kids | Non Severe

<1 co-amoxiclav >1 amoxicillin = oral courses for 5 days

Management of CAP in Kids | Severe

Co-amoxiclav = IV then oral course for 7 days Same as management of hospital acquired pneumonia

Management of Acute Wheeze in Children (4)

``` Salbutamol 10 puffs Nebulisers - combination - Salbutamol 2.5-5mg - Ipratropium 0.25mg Prednisolone - 20mg in 2-4 years - 40mg in >5 years Magnesium sulphate 2.5mls ```

Prednisolone Doses in Acute Wheeze in Children

``` 2-4 = 20mg >5 = 40mg ```

Steroid Strengths

``` Equivalent doses in order of increasing strength LEAST 20mg hydrocortisone 4mg methylprednisolone 5mg prednisolone 0.75mg dexamethasone MOST ```

Management of Acute Asthma Attack (6)

``` Oxygen 100% high flow Salbutamol 5mg NEB Ipratropium 2.5mg NEB Hydrocortisone 100mg IV Magnesium sulphate 1.2-2g over 20 minutes Call anaesthetist ```

Alternative steroid in acute asthma attack if no IV access

Prednisolone 40mg PO

Management of Acute Exacerbation of COPD (4)

``` O2 venturi Salbutamol and Ipratropium (combination nebs) 0.5-2.5mg Steroid - Hydrocortisone 200mg IV OR - Prednisolone 30-40mg PO Amoxicillin 500mg TDS ```

Chronic Management of Gout

``` 1st = allopurinol 100mg OD PO 2nd = febuxostat 80mg OD PO ```

Management of Chlamydia

1g Azithromycin

Management of Gonorrhoea

500mg IM Ceftriaxone | 1g Azithromycin

Management of Trichomonas

500mg metronidazole BD

Management of Syphilis

2.4 MU benzathine penicillin IM

OSCE Management Flashcards

(73 cards)