PSA Medicine

Question 1

TSH results in hypothyroidism

Answer 1

• TSH high = because T4/3 are low thyroid being stimulated to produce
• T3/4 are low
• no negative feedback therefore increased TSH production

Question 2

what to do if TSH result is high in hypo

Answer 2

• If TSH too high this means the levothyroxine is too low
• T3/4 still too low so no negative feedback so still increased TSH production
• Increase the dose

Question 3

what to do if TSH result is low on levothyroxine

Answer 3

• levothyroxine is too high so need to reduce dose

Question 4

How to take thyroxine and monitoring

Answer 4

• empty stomach in morning
• check tsh 3m
• once stable check annually

Question 5

hyperthyroid blood results

Answer 5

• low TSH high T3/4

Question 6

Mx hyperthyroid

Answer 6

• carbimazole
• once level can either titrate or levothyroxine added

Question 7

what can carbimazole increase risk of

Answer 7

• pancreatitis
• agranulocytosis

Question 8

NSTEMI mx

Answer 8

Aspirin 300mg
Ticagrelor 180mg stat dose
Morphine
Antithrombin therapy with fondaparinux
Nitrates

Question 9

community mx paeds meningitis

Answer 9

IM benzylpenicillin
- 1m - 11m 300mg
- age 1-9y 600mg
- age 10-17y 1.2g
Cefotaxime if allergy

Question 10

mx meningitis hospital paeds

Answer 10

• 1 - 3m cefotaxime and amoxicillin
• 3m - 18y = cefotaxime
  dexamethasone

Question 11

what causes rheumatic fever

Answer 11

• group a strep

Question 12

s+s rheumatic fever

Answer 12

• fever
• joint pain
• rash
• sob
• chorea
• nodules

Question 13

abx for rheumatic fever

Answer 13

phenoxymethylpenicllin 10 days

Question 14

kawasaki S+S

Answer 14

• strawberry tongue
• cracked lips
• cervican ln
• bilateral conjunctivitis

Question 15

mx kawasaki

Answer 15

• high dose aspirin
• ivig

Question 16

s+s GAS scarlet fever

Answer 16

• sandpaper rash blanches
• strawberry tongue
• sore throat, fever, headache
  mx phenoxymethylpenicllin 10 days

Question 17

croup mx

Answer 17

• dexamethasone oral
• oxygen
• nebulised budenoside
• nebulised adrenaline

Question 18

mx epiglottitis

Answer 18

• IV abx ceftriaxime
• Steroids = dex

Question 19

mx whooping cough

Answer 19

macrolides
- azithromycin, erythromycin, clarithromycin

Question 20

acute asthma adults mx

Answer 20

• Oxygen
• Salbutamol = 5mg nebs
• Hydrocortisone 100mg 6hrly/pred (40mg for 5 days)
• Ipratropium
• T
• Magnesium sulfate

Question 21

asthma mx adult

Answer 21

• SABA = salbutamol, terbutaline
• ICS = beclametasone, budenoside, ciclesonide
• LTRA = montelukast
• LABA = salmeterol
• MART

Question 22

asthma mx 5-16yrs

Answer 22

• SABA
• ICS
• LTRA
• LABA
• MART

Question 23

PCI in STEMI

Answer 23

• if within 12 hours sx onset and 2 hours of hospital
• Prasugrel and aspirin

Question 24

NSTEMI Mx

Answer 24

BATMAN
- Base of GRACE score
- Aspirin 300mg
- Ticagrelor 180mg stat (clopi of bleed, pras if angiog)
- Morphine
- Antithrombin = fondaparinux
= Nitrates

Question 25

secondary prevention ACS

Answer 25

- ACEi - BB - Dual antiplatelet = 12m but aspirin indefinite - Statin

Question 26

uninvestigated dyspepsia mx

Answer 26

- PPI 4 weeks - H pylori testing

Question 27

Funcitonal dyspepsia

Answer 27

- PPI and H P tx

Question 28

COPD initial mx

Answer 28

- SABA - SAMA = ipratropium

Question 29

COPD mx no asthmatic/steroid response

Answer 29

- LABA - LAMA

Question 30

COPD mx there are asthatic/steroid response

Answer 30

- LABA - ICS

Question 31

Acute COPD mx

Answer 31

- Pred 30mg OD 5 days - Abx if infection

Question 32

T2DM mx

Answer 32

- Metformin - If Chronic HF or cvd= SGLT-2 inhibitor (empagliflozin) -

Question 33

1st line insulin in DM1

Answer 33

- basal bolus regimens - twice daily insulin detemir for long acting

Question 34

Hypocalcaemia

Answer 34

- Convulsions Arrythmias Tetany Numb - ECG = prolonged QT - Calcium gluconate 10% 10ml 10mins

Question 35

Hypercalcaemia

Answer 35

- Stones bones moans groans - ECG = shortened QT - 0.9% NaCl 1000ml 4hrs

Question 36

Hypokalaemia

Answer 36

- ECG = long PR and long QT - 0.3% KCL 1000ml 4hrs

Question 37

Hyperkalaemia

Answer 37

- Calcium gluconate 10% 30ml 10mins

Question 38

DVT Mx

Answer 38

- Initial = rivaroxaban (DOAC) - Long term = DOAC, warfarin, LMWH

Question 39

DVT prophylaxins and renal impairement

Answer 39

unfractioned heparin

Question 40

short duration constipation

Answer 40

- bulk forming 1st - osmotic laxative - stimulant laxative

Question 41

opioid induced constipation

Answer 41

- osmotic and stimulant 1st

Question 42

faecal impaction

Answer 42

- oral macrogol - stimulant