Pass the PSA - Section 2

Question 1

IV Fluids - the two types/causes

Answer 1

Maintenance
Replacement

Question 2

When would you not give 0.9percent sodium in replacement fluids?

Answer 2

If the patient i:
hypernatremia, hypoglycemic
has ascites
shocked from bleeding

Question 3

What replacement do you give if the patient is hypernatremic or hypoglycemic?

Answer 3

5 percent dextrose

Question 4

What replacement do you give if the patient has ascites?

Answer 4

Human albumin solution

Question 5

What do you give if someone is shocked from bleeding and there is no blood available?

Answer 5

Crystalloid solution (normal saline)

Question 6

In hospital, all patients need

Answer 6

Thromboprophylaxis in the form of LMWH
Dalteparin 5000 units daily, sub cut and compression stocks for VTE prophy

Question 7

When do you not prescribe anti coag

Answer 7

if bleeding risk including recent ischemic stroke

Question 8

When to not prescribe compression stockings

Answer 8

if peripheral arterial disease due to risk of acute limb ischemia

Question 9

Anti emetics - when to avoid metoclopramide

Answer 9

Young women - it can cause dyskinesia
Parkinson’s disease - it can worsen it

Question 10

Two drugs to give if a patient is nauseated or is not nauseated but needs anti emetics PRN

Answer 10

Cyclizine 50mg 8hours IM/IV/Orally
Metoclopramide 10mg 8hourly IM/IV/PO

Question 11

Which anti-emetic is for when someone is definitely nauseated?

Answer 11

ondansetron 4mg or 8mg 8hourly IV/oral

Question 12

When to avoid Cyclizine, what to use instead

Answer 12

any cardiac issue as can worsen fluid retention
give metoclopramide 10mg instead

Question 13

When to avoid antihypertensives

Answer 13

In hypotension

Question 14

Beta blocker SE

Answer 14

Bradycardia
Wheeze in asthma
Worsening of acute heart failure

Question 15

CCB SE

Answer 15

Bradycardia
Oedema
Flushing

Question 16

ACEi SE

Answer 16

Dry cough
Hyperkalemia

Question 17

Thiazide diuretics SE

Answer 17

Hypokalemia
Gout

Question 18

What is neo-naclex-K

Answer 18

Bendroflumethiazide and a potassium replacement drug

Question 18

Potassium sparing diuretics SE

Answer 18

Gynaeocomastia

Question 18

Steroids SE / CI

Answer 18

Stomach Ulcers
Thin skin
Edema
Osteoporosis
Infections
Diabetes
Cushings Syndrome

Question 18

NSAIDS se

Answer 18

No urine (renal failure)
Systolic dysfunction - Heart failure
Asthma
Indigestion
Dyscrasia (clotting abnormalities)

Question 18

Pain relief PRN if no pain currently

Answer 18

Paracetamol 1g 6 hourly

Question 18

Mild pain regular inpatient meds

Answer 18

Paracetamol 1g 6 hourly

Question 18

Mild pain PRN

Answer 18

Codeine 30mg 6hrly oral

Question 18

Severe pain regular inpatient meds

Answer 18

Co-codamol 30/500 2 tablets 6hrly oral

Question 18

Severe pain PRN

Answer 18

Morphine sulphate 10mg/5ml up to 6hrly PO

Question 19

Why do you avoid tramadol in the elderly?

Answer 19

Confusion

Question 20

Name another drug causing confusion in the elderly

Answer 20

Antimuscarinics e.g. oxybutynin

Question 21

Symptoms of antimuscarinic toxicity

Answer 21

Tachycardia after transient bradycardia Pupillary dilation with loss of accommodation Urinary retention Constipation