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Final year Medicine > PSA > Flashcards

PSA Flashcards

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1
Q

Side effect of Thiazides

A

Dyslipidaemia

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2
Q

Sx of lithium toxicity

A 
D+V
drowsy
tremor
thirst
polyuria
muscle weakness
confusion
ataxia
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3
Q

Tx for oral candidiasis

A

Miconazole oral gel 2.5ml PO QDS
Nystatin 100000u topical QDS
for 7 days
or 48h after sx resolve

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4
Q

Caution with carbimazole

A

Report fevers or sore throat to dr immediatedly.

agranulocytosis

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5
Q

Side effect of gentamicin

A

Tinnitis, deafness, balance loss.

Monitor plasma concs.

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6
Q

Status epilepticus mx

A

IV Lorazepam 4mg once only

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7
Q

IV paracetamol dose

A

<50kg = 15mg/kg every 4-6h over 15mins
max 60mg/kg/day.

> 50kg 1g every 4-6h
over 15 mins max 4g/day.

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8
Q

Anaphylaxis med

A

Adrenaline 1 in 1000 0.5mg IM Once only

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9
Q

ACEi in pregnancy

A

avoid
affects neonatal BP control and renal function.
skull defects, oligohydramnios.

Alternative: Labetalol

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10
Q

Analgesia in alcoholic liver disease

A

Paracetamol 500mg PO QDS =Safe
Avoid NSAIDSs - risk of bleeding.
Avoid opiates - hepatic encephalopathy

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11
Q

drug induced psoriasis

A

beta blockers

RFs: Obesity, smoking, DM, HTN, Dyslipidaemia

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12
Q

glucose level to postpone surgery

A

Blood glucose >12
ketones >3
Urine ketones> +++

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13
Q

how to prescribe sliding scale insulin

A

continue long acting insulin at normal dose + time. (lantus, glargine, levemir, isophane, humulin 1)
50units actrapid to 49.5l of 0.9%sodium chloride -> 1unit/ml . syringe pump.
insulin requirements are 0.5-1unit per kg.
sign the scale required.
check glucose every hour if unstable. 2-4h if stable control.
fluids prescribe
dex-saline(0.18% NaCl + glucose 4%) + KCL (70mmoll/24h)

recheck U+Es
resign vrii chart daily

Stopping: confirm eating and drinking
ensure long acting on board 1h before stopping.

give mixed/rapid insulin at usual mealtime. and wait 30mins before stopping VRII.
monitor CBG QDS for 24h.

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14
Q

types of insulin

A

Rapid: At start off meal
Novorapid (aspart)
Humalog (lispro)
Adipra (glulisine)

Short (15-30min before meal)
Actrapid
Humulin S

Intermediate (OD/BD as mix)
Humulin I
Insulatard
Insuman basal

Long acting (OD)
Lantus (glargine)
Levemir (detemir)
tresiba (degludec)

pre Mixtures 
Intermed+short
30m before brek+dinner
Humulin M3 (30% short acting)
Insuman comb 15/25/50% short acting)

Intermed + rapid (start of brek+din)
Novomix 30
Humalog mix 25/50

basal bolus regimen
long (levemir/lantus) at night + rapid w every meal.

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15
Q

Adjusting insulin regimens

A

BASAL BOLUS

  • high/low before brek -> increase/decrease evening long acting insulin.
  • high.low before lunch/dinner/bed - increase/decrease rapid given with meal before.
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16
Q

Hypoglycaemia mx

A

Conscious/can swallow: 4-7 glucotabs if <4 BM
Reduced GCS: IM glucagon 1mg
20% dextrose 75ml IV over 15 mins

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17
Q

Asthma acute mx

A

Salbutamol nebs 5mg every once only. Back to back.
IV hydrocortisone 100mg QDS (severe)
mild (oral predinsolone 40 mg PO stat)
Ipratropium bromide 250 micrograms nebs every 4-6h

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18
Q

acute HF

A

IV furosemide 40mg once only.
diamorphhine 2.5mg over 5mins
metoclopramide 10mg

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19
Q

hyperemesis gravidarum mx

A

IV fluids
Cyclizine 50mg PO.IM
then metoclopramide

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20
Q

T2dM meds

A

Pioglitazone (thiazolidinedione) - can cause hypo
Metformin cant
acarbose -

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21
Q

statins

A

give atorvastatin 20mg

if qrisk2 score >10%

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22
Q

urticaria tx

A

Non sedating antihistamines.
Cetirizine 10mg PO OD
Fexofenadine 180mg PO OD
Loratidine 10mg OI OD

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23
Q

Chlamydia tx

A

Azithromycin 1g oral once only

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24
Q

Scabies tx

Study These Flashcards
A

permethrin 5% cream topical once a week 2 doses
Malathion
Hyperkeratotic - ivermedtin 200micrograms/mg

25
reflux paeds
1-2week trial of Alginate theapy after every feed. 1. Gaviscon 2 infant sachets oral as required 2. PPI/h2 receptor antagonist 4 weeks. 3. bottle fed - thickened foods
26
Detrusor overactivity
oxybutynin IR 5mg oral TDS
27
Opioid od
naloxone 400micrograms IV once only
28
Gestational diabetes
Fasting plasma glucose level of 5.6 mmol/L or above; or Two-hour plasma glucose level of 7.8 mmol/L or above diet abd exercise 1-2w metformin 500mg insulin
29
gliclazide (sulphonylerua) se
weight gain diarrhoea hypo
30
gliflozin (SGLT2i) se
UTI
31
Can pregnant women have vaccines?
Yes- Whooping cough and Flu vaccine.
32
Treatment dose of LMWHs for VTE
• Tinzaparin = 175units/kg OD • Enoxaparin =1.5mg/kg OD Dalteparin = 200units/kg OD (max 18000)
33
Drugs to stop during surgery
``` insulin lithium COCP/HRT (stop 4weeks before) anticoagulants K Spironolactone oral hypoglycaemics ACEi (parindopril) ```
34
What is the best thing to monitor for dehydration post op?
Urine output
35
T2DM mx
``` 1. Lifestyle: Diabetes education nurse, Nutritionist. Weight loss. exercise. 3-4/w. Alcohol/smoking, HbA1c target BP mx Lipids Antiplatelets (if 50-75 w CVrisk) ``` 2. + Metformin 500mg IR OD 3. + SGLT2i /GLP1agonist/DPP4i/Sulfonylurea/basal insulin 4. acarbose/pioglitazone 5. basal bolus insulin 6. BAriatric surgery Pregnant (diet + basal bolus insulin)
36
Side effects of Diabetes drugs
metformin - GI side effects/Lactic acidosis Sulfonylureas: Hypoglycaemia, SIADH, cholestasis, wt gain, incerased appetite. Glitazones: (pioglitazone) wt gain, fluid retention, liver dysfunction, fractures hypoglycaemia DPP4i (gliptins) - pancreatitis SGLT2i (flozins) (UTIs) GLP1agnoists (exenatide) SC: nausea, vomiting ,diarrhoea, pancreatitis, wt loss
37
pt on 75ug levothyroxine TSH: 0.2 (0.3-4.2) T4:16.2 (9-25) mx?
Reduce dose by 25ug
38
PE management
Apixaban 10mg PO bd | /Rivaroxaban 15mg po bd
39
WHO pain ladder
1. Paracetamol 1g QDS Ibuprogen 400mg TDS Naproxen 500mg bd 2. Codeine 30mg QDS tramadol 50mg QDS Dihydrocodeine 30mg QDS 3. Morphine sulfate 10mg QDS oxycodone 20mg QDS age related dose.
40
Steroid Side effects
``` Oedema Stomach ulcers thin skin R+LHF Osteoporosis infections cushing diabetes ```
41
NSAIDS side effects
``` No urine (kidney failure) Systolic dysfunction (HF) Asthma indigestion Dyscrasia ```
42
Digoxin side effects
N+V+D, blurred vision confusion xanthopsia (hypokalaemia augments digoxin effect, high levels limit it)
43
lithium side effects
Early tremor intermediate tiredness late arrythmias, seizures, coma, renal failure.
44
ECG changes in hyperkalaemia
K>5.5 - peaked T waves >6.5 - wide p waves, PR long, absent P waves K>7 - long QRS, AV block, slow AF, bradycardia, sine wave.
45
Glucose range for surgery
6-12
46
Local anaesthetic toxicity tx
IV 20% Lipid emulsion
47
Malignant hyperthermia
Hyperpyrexia muscle rigidity Autosomal dominant Caused by Halothane, suxamethonium ix: CK raised contracture tests. Mx: Dantrolene
48
Anaesthetic asw Hepatotoxicity
halothane
49
Antiemetics
``` cyclizine 50mg TDS Antihistamine SEs: dry mouth, blurred vision, urinary retention. Fluid retention - caution if HF Beware drug seeking ``` ``` Ondansetron 4mg BD serotonin receptor blocker powerful expensive post chemo SEs:prolonged QTc, constipation ``` Metoclopramide -Dopamine antagonist -avoid in Parkinsons -young women- acute dystonia - IM 5-10mg Procyclidine. Prokinetic - not bowel obstruction domperidone - doesnt cross BBB -l ess central side effects.
50
End of life care
PRN - syringe driver/Sc Pain - morphine 2.5-10mg/h Nausea - haloperidol 1.5mg/4h agitation - midazolam 2.5-5mg/1h secretions- glycopyrronium 0.2mg /6h
51
Laxatives
Stool softener: docusate sodium. good for impaction. Bulking agents: Isaphagula husk. (for low fibre) C.I if faecal impaction. Stimulants: Senna. 15mg ON can cause cramps. Osmotic - lactulose.15mlsOD Phosphate enema. needs to be well hydrated. can-> bloating.
52
insomnia
zopiclone 7.5mg ON (3.75mg elderly)
53
digoxin side effects
N+V+D, blurred vision, confiusion/drowsy, xanthopsia (halos) Low K-> augments, high k -> inhibits
54
AF mx
B blocker, digoxin/amiodarone if HF
55
VT
Amiodarone 300mg IV 20-60m then 900mg over 24 h Polymorphic VT ->mg over 10mins
56
Stable Angina
GTN.. ASpirin and statin (secondary prevention) + 1 anti angina drug. eg. BB /CCB -> increase dose-> ISMN
57
Drug causes of hyperkalaemia
ACEi LMWH Tacrolimus
58
side effects SSRIs
hyponatremia

Final year Medicine (18 decks)

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