PSA Flashcards
(141 cards)
1
Q
treatment of wheeze in acute asthma
A
5mg salbutamol nebulised
2
Q
DVT treatment
A
12500 units dalteparin (25000units/ml)
3
Q
daily potassium requirement
A
1mmol/kg/dau
4
Q
rate for 0.9% sodium chloride/0.15% potassium chloride
A
500 ml over 4 hours
5
Q
hypercholesterolaemia
A
simvastatin
6
Q
drugs causing impaired renal function
A
ibuprofen
ACEi
ARBs
7
Q
drugs to stop in AKI
A
DAMN Diuretics ACEi/ARBs Metformin NSAIDs
8
Q
aspirin adverse effect FBC
A
iron deficiency anaemia
9
Q
urinary retention drugs
A
morphine anti-cholinergics (anti-psychotics, antidepressants, detrusor relaxants) alpha adrenoceptor agonists benzos NSAIDs CCBs Antihistamines Alcohol
10
Q
drugs causing confusion
A
metaclopramide
morphine
corticosteroids
11
Q
DKA management
A
insulin 50 units in 500ml 0.9% saline IV 0.1 units/kg/hour
12
Q
dehydration early monitoring
A
blood pressure
13
Q
HRT monitoring for adverse effects
A
blood pressure
14
Q
lithium monitoring for toxicity
A
U&Es
15
Q
simvastatin + slightly raised ALT
A
don’t stop simvastatin
16
Q
potassium max rate
A
10mmol/hour
17
Q
enzyme inducers
A
PC BRAS Phenytoin Carbamazepine Barbiturates Rifampacin Alcohol (chronic excess) sulphonylureas
18
Q
other enzyme inducers
A
topiramate
St. John’s Wort
Smoking
19
Q
Enzyme inhibitors
A
AO DEVICES Allopurinol Omeprazole Disulfiram Erythromycin Valproate Isoniazid Ciprofloxacin Ethanol (acute intoxication) Sulphonamides
20
Q
other enzyme inhibitors
A
grapefruit juice
amiodarone
SSRIs
21
Q
anaphylaxis treatment
A
1:1000 adrenaline 500 mcg IM (0.5ml)
chlorphenamine 10mg IM/slow IV
hydrocortisone 200mg IM/slow IV
22
Q
ACEi side effects
A
cough
hyperkalaemia
23
Q
amlodipine side effect
A
oedema
24
Q
amiodarone side effects
A
pulmonary fibrosis
thyroid dysfunction
25
carbamazepine side effects
hyponotraemia
26
clozapine side effects
agranulocytosis
27
gliclazide side effects
agranulocytosis
28
metformin side effects
lactic acidosis
29
statin side effects
myalgia
30
major bleeding on warfarin
stop warfarin
give phytomenadione (Vit. K)
give prothrombin complex (or FFP)
31
INR > 8.0 + minor bleeding
stop warfarin
give phytomenadione (Vit. K) & repeat in 24 hours if INR still too high
restart warfarin when INR < 5.0
32
INR > 8.0 + no bleeding
stop warfarin
give phytomenadione (Vit. K)
restart warfarin when INR < 5.0
33
INR 5.0-8.0 + minor bleeding
stop warfarin
give phytomenadione (Vit. K)
restart warfarin when INR < 5.0
34
INR 5.0-8.0 + no bleeding
withhold 1 or 2 doses
| reduce subsequent maintenance dose
35
stop warfarin when before elective surgery
5 days
| if INR >/= 1.5 give phytomenadione (Vit. K) by mouth
36
emergency surgery, patient on warfarin can delay 6-12 hours
give phytomenadione (Vit. K)
37
emergency surgery, patient on warfarin, cannot delay
give phytomenadione (Vit. K) + prothrombin complex
38
co-amoxiclav adverse effect
cholestatic jaundice
39
creatinine rise when starting ACEi
< 20% ok
40
effective furosemide treatment measurement
weight
41
effective perindopril erbumine in heart failure treatment measurement
exercise tolerance
42
INR target 2.5 in
```
DVT/PE treatment
AF
cardioversion (3 weeks before)
dilated cardiomyopathy
mitral stenosis/regurgitation
MI
```
43
INR target 3.5 in
recurrent DVT/PE
44
warfarin treatment length for isolated calf DVT
6 weeks
45
warfarin treatment length for provoked VTE
3 months
46
warfarin treatment length for unprovoked VTE
at least 3 months
47
combined pill improves
acne
48
combined pill reduces risk of
ovarian, uterine and colon cancer
49
combine pill increases risk of
VTE, breast cancer and cervical cancer
50
contra-indications to combined pill
```
pregnant
smoking + >35years
>35 years + stopped smoking < 1 year ago
BMI . 35
migraine with aura
breastfeeding up to 6 weeks
CVS/VTE risk factors
family history of breast cancer
```
51
one missed combined pill
take missed pill straight away and continue with rest of pack
no extra contraception
52
two or more missed combined pills
take most recent pill straight away
condoms/avoid sex for 7 days
sec in previous 7 days -> emergency contraception
53
7+ combined pills in pack after two missed
finish pack and have 7 day break
54
<7 combined pills in pack after two missed
finish pack but no break
55
tacrolimus units
mg
56
hyperkalaemia causes
```
dalteparin
ramipril
tacrolimus
ciclosporin
eplerenone
```
57
breakthrough for someone on >25mcg transdermal fentanyl patch
nasal fentanyl spray 50mcg into one nostril, repeat once if necessary
58
acute alcohol withdrawal treatment
chlordiazepoxide 20mg PO 6 hourly
59
advice for rivaroxaban
take with food
60
beta blocker side effect
erectile dysfunction
61
progesterone only pill increases risk of
ovarian cysts and breast cancer
62
contraindications to progesterone only pill
pregnant
breast cancer
severe cirrhosis
liver tumours
63
one missed progesterone only pill > 3 hours late
take missed pill
take next pill at usual time
condoms for next 2 days
recent sex may need emergency contraception
64
one missed pill < 3 hours late (12 hours for desogesterel)
take pill as soon as remembered
| take next pill at usual time
65
rapid anticoagulation with warfarin
5mg or 10mg OD for 2 days
| INR check on day 3
66
lower rapid anticoagulation with warfarin dose if
elderly
low body weight
liver disease
heart failure
67
slow initiation starting dose warfarin
1-2mg
68
contraindications to warfarin
```
haemorrhagic stroke
clinically significant bleeding
within 72 hours of major surgery
within 48 hours postpartum
pregnancy (teratogenicity)
bleeding disorder
```
69
1 mcg =
0.001 mg
70
1% =
1g in 100 ml
71
0.1% =
0.1g (100mg) in 100ml
72
1:1000 =
1mg per ml
73
1:10000 =
1mg per 10 ml
74
rivaroxaban contraindications
```
eGFR < 15
active bleeding
GI ulcer (current.recurrent)
oesophageal varices
recent brain/spine injury
recent brain/spine/eye surgery
malignant neoplasm
vascular aneurysm
prosthetic heart valve
liver disease with coagulopathy
```
75
resuscitation fluid
500ml bolus of 0.9% saline or Hartmann's over less than 15 mins then reassess
76
daily water requirement
25-20ml/kg/day
| 20-25 ml/kg/day in elderly, renal/heart failure, malnourished
77
daily sodium requirement
1mmol/kg/day
78
daily chloride requirement
1mmol/kg/day
79
daily glucose requirement
50-100g/day
80
0.9% saline tonicity
isotonic
resuscitation/maintenance
81
0.9% saline constituents
154 mmol/L Na+
| 154 mmol/L Cl-
82
Hartmann's tonicity
isotonic
resuscitation/maintenance
83
Hartmann's constituents
131 mmol/L Na+
5 mmol/L K+
111 mmol/L Cl-
29 mmol/L HCO-3
84
NaCl 0.18%/glucose 4% tonicity
hypotonic
maintenance
85
NaCl 0.18%/glucose 4% constituents
30 mmol/L Na+
30 mmol/L Cl-
40g/L glucose
86
5% dextrose tonicity
hypotonic
maintenance
87
5% dextrose constituents
50g/L
88
pulmonary oedema treatment
IV 20mg-50mg of Furosemide 10mg/ml
89
DVT prophylaxis for total hip replacement/total knee replacement patients
rivaroxaban 10mg PO
90
hypoglycaemia treatment
IV glucose 20% 75-100ml over 10 mins
91
contraindications to HRT (current)
```
undiagnosed PV bleeding
Pregnancy/breastfeeding
oestrogen dependant cancer
acute liver disease
uncontrolled hypertension
```
92
contraindications to HRT (history)
history of breast cancer
history of VTE
recent stroke/MI/angina
93
risks of HRT
```
VTE (no risk with transdermal)
stroke
breast cancer (combined HRT)
ovarian cancer (if used >5 years)
endometrial cancer (if no progesterone)
```
94
oestrogen HRT side effects
breast tenderness
leg cramps
nausea
95
progesterone HRT side effects
pre-menstrual symptoms
96
progesterone phase of cyclical HRT side effect
PV bleeding
97
no uterus + need HRT
oestrogen only (oral or transdermal)
98
users + peri-menopausal
cyclical HRT
99
monthly cyclical HRT
oestrogen every day but + progesterone 12-14 days to cause bleed at end of every menstrual cycle
use if still having regular periods
100
3 monthly cyclical HRT
oestrogen every day but + progesterone every 13 weeks
use if having irregular periods
101
post-menopausal
no periods for >1 year or been on cyclical HRT >1 year
102
post-menopausal + need HRT
continuous HRT
103
continuous HRT
combined oestrogen + progesterone
no bleeds
104
urogenital menopausal symptoms only
low dose vaginal oestrogen
105
beta blockers contraindication
peripheral vascular disease
106
drugs exacerbating heart failure
CCBs
| steroids
107
methotrexate teratogenicity
effects both men & women
avoid conception for 3 months after stopping too
108
mirtazipine S/E
abnormal dreams
109
simvastatin + gemifibrozil
severe myopathy and rhabdomyolysis
110
before starting amiodarone check
potassium (causes hypokalaemia)
111
sertraline monitoring
no routine blood monitoring
112
symptoms + very raised CK (e.g. 5 x upper limit)
stop statin
| if symptoms resolve, reduce dose and reintroduce
113
nasal steroids + gets nosebleeds
stop taking
114
carbamazepine s/e
```
dizziness
drowsiness
dry mouth
weight gain
hyponotraemia
leucopenia
low platelets
```
115
amitriptyline side effects
```
dry eyes (+ blurry vision)
dry mouth
GI upset
drowsiness
QT prolongation
```
116
post-op nausea & vomiting
ondansatron
117
ondansetron contraindications
prolonged QT
118
ondansetron alternative for PONV
cyclizine
119
shingles in immunosuppressed
Aciclovir 800mg PO 5 x a day
120
lansoprazole side effects
diarrhoea
121
naproxen side effects
ankle oedema
122
pregnant + thrush
```
prolonged therapy (7 days)
e.g. clotrimoxazole pessary 100mg PV daily for 7 days
```
123
first line acute pain in elderly
paracetamol
124
ciclosporin monitoring
U&Es
125
what to check before starting azathiprine
thiopurine methyltransferase (TPMT)
126
how to check over coagulation for NOAC
patient reporting bruising
127
morphine in renal impairment
swap to oxycodone
128
Verapamil S/E
```
heart failure
constipation
hypotension
bradycardia
flushing
```
129
Diltiazem S/E
hypotension
heart failure
bradycardia
ankle swelling
130
nifedipine, amlodipine, felodipine S/E
flushing
headache
ankle swelling
131
drugs to improve long term prognosis of heart failure
ACEi
| beta-blocker
132
Diabetic drugs causing low sodium
sulfonylureas (cause SIADH)
133
drugs which may worsen epilepsy control
```
alcohol, cocaine, amphetamines
ciprofloxacin, levofloxacin
aminophylline, theophylline
bupropion
methylphenidate (used in ADHD)
mefenamic acid
```
134
barking cough
= croup
135
croup
give sterids
136
worsens psoriasis
```
beta blockers
lithium
antimalarials (chloroquine and hydroxychloroquine)
NSAIDs
ACE inhibitors
infliximab
withdrawal of systemic steroids
```
137
beta blockers in diabetes
reduce hypoglycaemic awareness
138
long term steroids + sick
double the steroids
139
drugs to stop before surgery
```
I LACK OP
Insulin
Lithium
Anticoagulants/Antiplatelets
COCP/HRT
K-sparing diuretics
Oral hypoglycaemics
Perindopril and other ACEi
```
140
furosemide
gout
141
spironolactone
gynaecomastia
