Pass the PSA Flashcards
(88 cards)
1
Q
TSH 0.3, what should you do to levothyroxine dose?
A
Decrease it
2
Q
TSH 5.2, what should you do to levothyroxine dose?
A
Increase it
3
Q
Cause of secondary hypothyroidism
A
Pituitary damage
Reduced TSH causing reduced TH
4
Q
Secondary cause of hyperthyroidism
A
Pituitary tumour
5
Q
1st line treatment of diabetic neuropathy
A
Duloxetine (SNRI)
6
Q
Treatment of opioid overdose (low RR, drowsy)
A
Naloxone
7
Q
Which pain killer can lower seizure threshold?
A
Tramadol
8
Q
Which pain killer is good in renal failure because it isn’t really excreted?
A
Tramadol
9
Q
Which drug do you give for first-line T2DM in BMI 18, creatinine 172?
A
Sulphonyurea e.g. gliclazide
10
Q
First-line treatment of focal epilepsy
A
Lamotrigine
11
Q
1st prescription for hyperkalaemia
A
10U actrapid with 100ml of 20% dextrose over 30 minutes
12
Q
What interacts with warfarin to increase INR?
A
Erythromycin
13
Q
Drugs to stop before surgery
A
I LACK OP Insulin Lithium Aspirin COCP K+ sparing diuretics Oral hypoglycaemics Perinopril (ACEi)
14
Q
When should you ideally stop COCP before surgery?
A
4-6weeks!
15
Q
What should you stop in haemoptysis and any bleeding?
A
Anticoagulants e.g. aspirin and enoxaparin
16
Q
CYP450 inducers
A
PC BRAS Phenytoin Carbamazepine Barbiturates Rifampicin Alcohol (chronic excess) Sulphonyureas
17
Q
CYP450 inhibitors
A
AODEVICE Allopurinol Omeprazole Dislfiram Erythromycin Valproate Isoniazid Ciprofloxacin Ethanol (acute)
18
Q
When should you stop ACEi and K+ sparing diuretics before surgery?
A
The day of
19
Q
Causes of hyperkalaemia
A
DREAD Diuretics (K+ sparing) and ACEi and dalteparin (LMWH) Renal failure Endocrine (Addison's) Artefact DKA!
20
Q
Steroid side effects
A
Stomach ulcers Thin skin Edema Right heart failure Osteoporosis Infection Diabetes!!!!! Cushing's syndrome
21
Q
NSAID contraindications
A
Clotting issues Heart failure Asthma Indigestion Renal failure
CHAIR
22
Q
NSAID contraindications
A
Clotting issues Indigestion Renal failure Asthma! Heart failure
CHAIR
23
Q
How much paracetamol in 30/500 tablet of co-codamol?
A
500mg
24
Q
Typical maintenance fluid prescription in healthy individual
A
2 salty 1 sweet
1L bag of dextrose (8hr)
2L saline (8hr each)
25
Typical prophylactic LMWH for prophylaxis of blood clots in hospital
S/C 5000U dalteparin
26
Drug for nausea in heart failure
Metoclopramide
27
Drug for nausea in a normal patient
Cyclizine
28
Who shouldn't get metoclopramide?
Parkinson's patients
29
Drug causes of hypokalaemia
Loop diuretics
| Thiazide diuretics
30
Side effects of ACEi
Cough
Worsen renal failure
Can trigger renal failure in renal artery stenosis
Hyperkalaemia
31
Rheumatoid pt on methotrexate, got a UTI and given trimethoprim, what should you do?
Stop the methotrexate (current infection)
| Change trimethoprim because too much folate antagonism
32
Furosemide can lead to which electrolyte abnormalities?
Hyponatraemia
| Hypokalaemia
33
Drugs to stop in hyperkalaemia
ACEi
| Thiazide diuretics e.g. eplerone
34
Drug causes of neutropaenia
Clozapine
| Carbimazole
35
Causes of microcytic anaemia
Iron deficiency
Thalassaemia
Sideroblastic
36
Causes of normocytic anaemia
Anaemia of chronic disease
| Blood loss
37
Causes of macrocytic anaemia
Folate deficiency
Alcohol
B12 deficiency
38
Drug cause of HIGH neutrophils
STEROIDS
39
Causes of thrombocytopaenia
Heparin induced! Always do baseline and post treatment FBC
DIC
HUS
Hypersplenism
40
Causes of SIADH
```
Any serious illness
Head injury
Lung cancer
Anti-psychotics
Carbamazepine (used in schizophrenia)
```
41
Causes of raised urea
Renal failure
Gastric bleed
Chemotherapy
42
Causes of hyponatraemia, hypovolaemia
Dehydration
Addisons
Diuretics
43
Causes of hyponatraemia euvolaemia
SIADH
| Psychogenic polydipsia
44
Causes of hyponatraemia hypervolaemia
Renal failure
| Heart failure
45
Causes of intrinsic renal failure
Pre-renal
Nephrotoxic drugs
Rhabdomyolysis
Contrast
46
Causes of raised ALP
Fracture
Paget's disease
Post-hepatic jaundice
47
How do you calculate rate on ECG?
Divide 300 by squares between QRS complexes
48
Cause of sloping ST depression
Digoxin toxicity
49
Normal to find T wave inverstion in which leads?
V1 and aVR
50
T wave inversion can imply
Old infarct
| NSTEMI
51
INR target in recurrent thromboembolism
3-4
52
What to do if major bleed on warfarin
Stop warfarin
10mg Vit K IV
Prothrombin complex
53
Drug to reduce bleeding in surgery
Tranexamic acid!
54
How does N-acetylcysteine work?
It replenishes glutathione stores to remove toxic metabolites
55
Why should you stop ibuprofen in renal failure?
Reduces prostaglandin synthesis so reduces GFR
| Can contribute to renal failure
56
Drug causes of agranulocytosis
Carbamazepine
Clozapine
Lithium
57
What's in seratide?
LABA and ICS
58
Cut off for doing something about rate in AF
100bpm
59
Treatment of anaphylaxis
ABCDE
IM adrenaline
IV hydrocortisone
IV chlorphenamine
60
Treatment of asthma attack
5mg nebulised salbutamol
| Nebulised ipratropium bromide
61
Management of stable angina
```
GTN spray
Aspirin, statin
B blocker/CCB
?Long-acting nitrate
RF modification
```
62
Management of focal seizures
Lamotrigine
63
Management of seizures other than focal
Sodium valproate
64
Management of T2DM
1. Education and dietary/exercise advice
2. Cardiovascular RF Mx = consider 75mg aspirin & 20mg simvastatin
3. Annual review of complications = ophthalmology and albumin:creatinine ratio (indicator of diabetic nephropathy)
4. Blood glucose lowering therapy if HbA1c > 48mmol after these measures
65
Whats an early indication of diabetic neuropathy?
Albumin:creatinine ratio
66
Mx of mild, early parkinsons
Ropinerole
67
Mx of flare of rheumatoid?
Short course of glucocorticoid
68
How often can you use a salbutamol inhaler each week?
2x
69
What should you do if asthma pt using salbutamol inhaler 6x per week
Counsel about usage and add an ICS
70
Signs of congestive heart failure
RHF and LHF
RHF = raised JVP and peripheral oedema
LHF = pulmonary oedema
71
What is the treatment dose enoxaparin?
15000U
72
What does tamoxifen increase your risk of?
PE and DVT
| Endometrial cancer
73
HTN Mx drug in pregnancy
Labetalol
74
Side effect of gliclazide
Hypoglycaemia
75
Whats the risk of ramipril when you are unwell?
Increased risk of AKI
| Take precautions when vomiting/ill
76
Unwell on insulin? What should you do with the dose?
Increase it
77
What should you do with the rotation site with SC insulin?
Rotate it to avoid lipodystrophy
78
Recommendations for alendronic acid
Oesophagitis and indigestion
So, take it standing upright for 30 mins
Avoid food for 2 hours after
79
1g = how many mg?
1000
80
What ix should you do before commencing amiodarone?
Chest x-ray because pulmonary fibrosis
81
Lithium therapeutic range
0.4-0.8
82
What should you check before commencing statins?
ALT (liver function)
83
What should you check before commencing vancomycin?
Creatinine (renal function)
84
What should you check before starting anti-psychotics e.g. olanzapine?
Glucose levels (risk of diabetes)
85
What should you measure with carbimazole and general illness?
FBC (white cell count)
86
Treatment of infective endocarditis with streptococcus viridans
Penicillin and gentamicin
87
Treatment of infective endocarditis with s.aureus
Could be fluclox, most likely vancomycin
88
What should you check weekly for 18w for in clozapine treatment?
FBC
| Risk of agranulocytosis
