PSA

Question 1

Neutropenia sepsis management

Answer 1

Tazocin! - however it contains penicillin

Question 2

8 year old with appendicitis. Weighs 25kg. No signs of dehydration. What fluid replacement needed?

Answer 2

Go to BNF child -> type in fluids and electrolytes. Control F for maintenance. Answer = 1,600 using the table!!!

Question 3

8 year old with appendicitis. Weighs 25kg. No signs of dehydration. What fluid replacement needed?

Answer 3

Go to BNF child -> type in fluids and electrolytes. Control F for maintenance. Answer = 1,600

Question 4

IF A PATIENT has uncontrolled htn on maximum dose of CCB and ace inhibitor ->
must add on thiazide like diuretic eg ?

Answer 4

Indapamide

Question 5

● Anxiety with adrenergic symptoms, like in the case of panic disorder is ONLY
treated with ?

Answer 5

Propanolol

Question 6

emergency Hypercalcemia is managed with?

emergency hypocalcemia treatment (following blood transfusion, patient with tingling in legs, ecg shows prolonged QT, low calcium

emergency hypokalemia is managed with?

emergency hyperkaemia treatment?

emergency hypoglycemia

Answer 6

IV 0.9 % SALINE 1L over 4 hours

IV 10% calcium gluconate 10ml over 10 minutes

sodium chloride 0.9/potassium 0.3 (higher potassium) 1L over 4 hours . if it was a child with severe diarrhea and dehydrated, you would just give 0.9%saline over 10 min

IV 10% calcium gluconate 30ml given once only

glucose 20% 100ml over 10 min

Question 7

● HHS in diabetic patients JBDS guidlines

Answer 7

1L OF NACL over 1 hour

Question 8

Asthma uncontrolled on saba and ics -> NICE guidelines state to add on an LTRA FIRST

Answer 8

Prescribe monteleukast

Question 9

Pneumonia oxygen prescription?
COPD?

Answer 9

oxygen 15 L/min non-rebreather mask, continuous (for frequency)

I critical, Ill with copd treat as above, if not = oxygen 28 % venturi mask continuous.

Question 10

If someone with no lung disease is on 2L oxygen via nasal cannula and this is not enough increase to oxygen 5-6 L/min vía simple face mask. Only give flow rates <4 via nasal cannula

Question 11

how to induce withdrawal bleed in PCOS?

Answer 11

medroxyprogesterone

Question 12

Maintenance fluids in surgery? In this case it was a TURP:

Answer 12

The patient was already at top end of sodium cap in serum which was 146.mToo much sodium chloride can result in oedema, hyperchloraemic acidosis, increased kidney load, increased post-operative complications, and GI problems. If K+ is normal/low, you can give some, e.g. 20mmol in 12 hours. ( replace it more slowly)

5% Dextrose with 20
mmolPotassium Chloride V over 12 hours. Dextrose is preferred post operatively.

Question 13

● Liver disease Maintenance fluids: Human albumin solution is a good alternative volume expander (e.g. 100ml 20% HAS).
continue at SAME dose until euthyroid. Once
euthyroid, gradually reduce dose to 5-15mg daily and this is required for 12-18
months.

Question 14

Resus fluids in a child?

Answer 14

bolus of 10mL/Kg over 10 min.

Question 15

Drugs causing hyponatremia,?

Answer 15

Omeprazole, Ramipril

Question 16

GI side effect of nifedipine?

Answer 16

Constipation

Question 17

Lying and standing blood pressure is most important!!! When titrating clozapine
-> risk of hypotension

●

Question 18

For labetalol use in pregnancy, you monitor blood pressure twice a week in the
community until BP is 135/85 or less!! NOT everyday

Question 19

For labetalol use in pregnancy, you monitor blood pressure twice a week in the
community until BP is 135/85 or less!! NOT everyday

Question 20

For levothyroxine, in patients with cardiac disease or aged over 55, a lower
initial dose of 25 micrograms PO daily is required

Question 21

Most important information to give someone on lithium is that they must
drink plenty of water and eat a balanced diet while taking lithium due to risk
of lithium toxicity!!!.

Question 22

Iron reacts with doxycycline to reduce its effect

Question 23

Iron reacts with doxycycline to reduce its effect

Question 24

Malignant hyperthermia management?

Answer 24

Dantrolene

Question 25

Diabetic undergoing surgery. Fluids to give?

Answer 25

Over 500ml over 6 hours specifically!! Or 1000 over 12 For the sodium 0.45 potassium 0.15 and glucose 5 infusion in diabetes surgery

Question 26

You correctly chose alteplase 90 mg for stroke BUT the initial 10% shouldve been administered by injection -> 9mg IV injection

Question 27

You correctly chose alteplase 90 mg for stroke BUT the initial 10% shouldve been administered by injection -> 9mg IV injection

Question 28

Side effect of nitrofurantoin?

Answer 28

Pulmonary toxicity acute and chronic

Question 29

Side effect of nitrofurantoin?

Answer 29

Pulmonary toxicity acute and chronic

Question 30

Drugs causing hyperuricemia?

Answer 30

aspirin, bumetanide and ticalegror

Question 31

Ecg Side effect of quietapine? Name another drug that causes this

Answer 31

QT prolongation Ondansetron !:

Question 32

BNF treatment summary depression -> can change drugs after 4 weeks if no efficacy. Step 1 switch to another SSRI, step 2 is switch to mirtazapine

Question 33

Prescribing in palliative care treatment summary!!! Itll give you the conversion of morphine from 48 mg goes to -> buprenorphine patch 20micrograms. But your answer was 50mg which is close enough to 20 equivalent

Question 34

Causes of hyperkalemia?

Answer 34

Tacrolimus Ciclosporin Trimethoprim

Question 35

Starting pain medication is paracetamol. Avoid nsaid in IBD and elderly ●

Question 36

Nitrofurantoin should be avoided if EGFR is less than 45!!!. Trimethoprim is better

Question 37

Nitrofurantoin should be avoided if EGFR is less than 45!!!. Trimethoprim is better

Question 38

Starting pain medication is paracetamol. Avoid nsaid in IBD and elderly

Question 39

Starting pain medication is paracetamol. Avoid nsaid in IBD and elderly

Question 40

Most important to monitor for adverse effects of ciclosporin after 2 weeks of treatment?

Answer 40

Serum creatinine.

Question 41

Most important to monitor for adverse effects of ciclosporin after 2 weeks of treatment?

Answer 41

Serum creatinine.

Question 42

Cholestatic jaundice is common with flucloxacillin!

Question 43

Cholestatic jaundice is common with flucloxacillin!

Question 44

● Naproxen causes ankle swelling

Question 45

● Paracetamol dose in a 10 year old is different! This was the prescribing error If it is a child, and you need to find prescribing error, go on to bnfc to check doses

Question 46

Important safety information section states ciprofloxacin may exacerbate seizures in epilepsy. If you cant find things in the side effects section, it may be here

Question 47

Hyperuricemia for gout GI disturbance for dyspepsia Sleep disturbance for insomnia

Question 48

Monitoring section of artovarstatin says that if serum transaminases are raised but less than 3 times upper limit, continue artorvastatin at current dose

Question 49

dose ● Glargine is long acting insulin so you monitor it pre-breakfast capillary glucose (fasting) and NOT 2 hour post-prandial

Question 50

Diverticula disease is treated with co-amoxiclav

Question 51

Diverticula disease is treated with co-amoxiclav

Question 52

Make sure to add modified release to the name of the drug

Question 53

levofloxacin should be avoided in a history of epilepsy

Question 54

aminophylline worsens siezure control

Question 55

Adenosine is contraindicated in asthma!!! As is beta blockers and NSAIDs

Question 56

flecanaide is contraindicated in HF, also avoid oral Ibuprofen

Question 57

For cellulitis, if there is the option of oral and Iv treatment. Go for oral first. As long as there are no signs of systemic upset

Question 58

if a patient has PVD and needs a statin, you give them the statin at the higher dose! = 80mg not 20mg because they have established cardiovascular disease

Question 59

Alendronate can be prescribed daily or weekly

Question 60

Cardiovascular drugs are usually prescribed once daily so that’s one thing to double check ECG is necessary in assessing digoxin toxicity

Question 61

-> review the calculation questions in your Google drive from past papers, maybe do a few on pass med

Question 62

The gentamicin dose peak and trough doses Cut off is lower in Infective endocarditis!!!

Question 63

Start acetylcysteine if paracetamol dose is greater than 150 mg/kg

Question 64

stable angina -> statin + beta blocker/cbb

Question 65

liver disease can increase inr

Question 66

search appendix 1 interactions. very important

Question 67

always double check the unit they want your answer and double check calculations

Question 68

if you search fluids and electrolytes, itll tell you how many moles of potassium for instance is in 0.3% solution -> 40mmol/litre you need to know daily requirements = 23-30 ml/kg of water 1mmol/kg Na and K+ 50-100g glucose

Question 69

maintenance fluids you have to prescribe both o.9%saline and 0.15 potassium over 8 hours

Question 70

bnf treatment summary -> orapharyngeal fungal infections -> nystatin is the drug of choice!!!

Question 71

if youve given salbutamol inhaler and no relief. you still start in hospital by giving salbutamol NEBULISED

Question 72

UFH better than enoxaparin in kidney failure. always check this

Question 73

bleeding, lots

Question 74

learn the treatment summaries

Question 75

meningitis in community, give cefotaxime if allergic to penicillin

Question 76

HRT prescribing. question here is a patient that wants a tablet. 48 yo. irregular periods how to find it?

Answer 76

search "conjugated oestrogens with medroxyprogesterone" -> cyclical/sequential oestrogen if still having periods, continous if not womb with LMP < 12 months = estradiol with norethisterone . can also be given as a patch womb with LMP > 12 months = tibolone vasomotor symptoms in someone that cant take HRT = clonidine or SSRI post hysterectomy = estradiol

Question 77

in BNF specifically, if you are looking for a drug that causes a particular side effect, search psoriasis and (allopurinol or aspirin or bisoprolol or citalopram or carbamezapine). to get answer if you dont find it the. usual way

Question 78

can search by drug name under interactants in BNF specifically search pioglitazone AND heart failure to quickly double check the side effect

Question 79

for some drugs, under medicinal forms, when you expand it, you can often find instuctions on how to take it etc

Question 80

furosemide increases risk of gout

Question 81

double check insulin prescriptions to make sure its been prescribeed 1ce a day or 3 times as necesary

Question 82

amoxicillin can cause oral thrush also immunosuppresants

Question 83

Child with a seizure at the GP, how would you manage?

Answer 83

Rectal diazepam or buccal midazolam!! The key here is that it is at the GP, so under medicine in the community treatment summary, IV lorazepam is not an option