PSA mock

Question 1

Likely contributors to renal failure

Answer 1

Ibuprofen (NSAID)
Ramipril

Question 2

Drugs that can contribute to dehydration

Answer 2

Diuretics

Question 3

Advice for taking alendronic acid

Answer 3

Should be taken on an empty stomach

Question 4

Side effects of morphine

Answer 4

Confusion
Respiratory depression

Question 5

Monitoring response to steroids in polymyalgia rheumatica, what should you ask after the first week?

Answer 5

Have the muscle pains subsided

Question 6

Common side effect of adenosine

Answer 6

Chest tightness

Question 7

Mx of supraventricular tachycardia after vasovagal manouvres

Answer 7

Adenosine

Question 8

Why is it bad to give furosemide alongside lithium?

Answer 8

Furosemide decreases GFR
So less clearance of lithium

Question 9

Symptoms of lithium toxicity

Answer 9

Confusion
GI disturbance
Drowsiness
Tremor

Question 10

Why are NSAIDs bad for the kidneys?

Answer 10

They inhibit COX, reducing prostaglandin synthesis, reducing GFR

Question 11

Why should alendronic acid be taken standing up, 30 mins before breakfast on an empty stomach?

Answer 11

Promote absorption
Reduce rates of oesphageal ulceration

Question 12

Why does morphine cause constipatoon?

Answer 12

Acts on opiod receptors in the bowel, reducing peristalsis

Question 13

What should you give alongside morphine?

Answer 13

Laxative

Question 14

Raised CK and weakness in the muscles =>

Answer 14

Dermatomyositis (skin rash, heliotrope)
Polymyositis

Question 15

Pain the muscles and stiffness =>

Answer 15

Polymyalgia rheumatica

Question 16

Rash in dermatomyositis

Answer 16

Heliotrope (around the eyes)

Question 17

Which condition is polymyalgia rheumatica linked with?

Answer 17

Temporal arteritis

Question 18

How does aldosterone alter potassium levels?

Answer 18

Excretes them

Question 19

Why do angiotensin blockers (ramipril) increase K+ levles

Answer 19

Reduced angiotensin 2 levels lead to decreased aldosterone levels, reducing potassium excretion

Question 20

What should you prescribe alongside morphine?

Answer 20

Anti-emetic e.g. metoclopramide (don’t give this if bowel issues)

Question 21

Typical adult morphine prescription

Answer 21

Morphine, 10mg, IV, once only over 10 minutes

Question 22

Drug treatment for oral thrush

Answer 22

Nystatin

Question 23

ECG changes in hyperkalaemia

Answer 23

Tented T waves
Bradycardia
Absent P waves

Question 24

What type of drug is spironolactone?

Answer 24

An aldosterone angtagonist

Question 25

What type of drug is furosemide

Answer 25

Loop diuretic

Question 26

What can statins cause? Raising CK

Answer 26

Rhabdomyolysis

Question 27

Important advice for patients beginning carbimazole therapy

Answer 27

Report any infections to the GP as there is a risk of agranulocytosis

Question 28

What type of drug is prednisolone?

Answer 28

Glucocorticoid

Question 29

Why do steroids induce hyperglycaemia?

Answer 29

It is a glucocorticoid, it stimulates gluconeogenesis

Question 30

What blood measure can be used to determine treatment response to antibiotics in the first 72hr?

Answer 30

CRP

Question 31

How long after pneumonia treatment should you do a repeat chest X-ray?

Answer 31

6 weeks later

Question 32

Which common drugs cause hypertryglyceridaemia?

Answer 32

Thiazide diuretics (bendoflumethazide)

Question 33

2 good drugs to start off asthma treatment

Answer 33

Salbutamol Ipratropium

Question 34

Treatment to terminate seizures

Answer 34

IV lorazepam

Question 35

Bolus fluid prescription

Answer 35

Sodium chloride 0.9%, 500ml, IV, over 30 minutes

Question 36

Anaphylaxis in adult, first drug to give (written as a prescription)

Answer 36

Adrenaline, 500, micrograms, IM, once only

Question 37

Why does aspirin cause gastric ulcers?

Answer 37

Inhibits prostaglandin production, reducing gastric protection

Question 38

Why should ACEi be stopped in pregnancy?

Answer 38

Alter foetal and maternal blood pressure control

Question 39

Safest painkiller oin liver disease (albeit at a low dose)

Answer 39

Paracetamol

Question 40

What type of drugs, used in heart failure can worsen psoriasis

Answer 40

Beta blockers Metoprolol Bisoprolol

Question 41

Acceptable range of glucose before surgery

Answer 41

4-12

Question 42

Why dont you give insulin on an empty stomach?

Answer 42

Risk of hypoglycaemia

Question 43

In general, how much does 1U of insulin drop BM?

Answer 43

By 3

Question 44

How many units of actrapid do you give in hyperkalaemia?

Answer 44

10U

Question 45

Mx of hyperkalaemia

Answer 45

10ml 10% calcium gluconate Bicarbonate Insulin (10U actrapid) Glucose K Drop (dialysis)

Question 46

Complication of long term steroid use

Answer 46

Osteoporosis

Question 47

Initial treatment of hypercalcaemia in dehydration

Answer 47

1L 0.9% saline IV infusion over 1 hour

Question 48

Treatment of hypercalcaemia in malignany

Answer 48

Pamidronate (used to protect bone)

Question 49

Initial treatment of hypoglycaemia in drowsy patient with no IV access

Answer 49

Glucagon 1mg IM STAT

Question 50

Treatment for asymptomatic hypoglycaemia

Answer 50

Glucotabs

Question 51

In an acute, life threatening asthma attack, what do you give after nebulisers?

Answer 51

Hydrocortisome IV

Question 52

Drug to clear fluid in pulmonary oedema

Answer 52

Furosemide IV 40mg (because resistant oedema)

Question 53

1st line anti-emetic in hyperesmesis gravidarum?

Answer 53

Cyclizine

Question 54

What type of drug is cyclizine

Answer 54

Antihistamine

Question 55

What type of drup is promethazine?

Answer 55

Antihistamine

Question 56

What are haptoglobin and platelet levels in HUS?

Answer 56

Low

Question 57

What does haptoglobin do in the body?

Answer 57

Mops up lysed haemoglobin!

Question 58

Diabetes drugs that can cause hypoglycaemia

Answer 58

Pioglitazone Insulin Acarbose (but only a little bit)

Question 59

Which drugs can mask hypoglycaemic symptoms?

Answer 59

Beta blockers (bisoprolol)

Question 60

Which drugs can interact with warfarin and cause increased INR?

Answer 60

Statins They are also CYP450 medications Can increase warfarins anticoagulant effet

Question 61

What does ramipril reduce the breakdown of, resulting in a cough?

Answer 61

Bradykinin

Question 62

Who shouldn't get prescribed ACEi?

Answer 62

Asthmatics Hyperkalaemia Renal failure (acute)

Question 63

What is the enzyme that metabolises alcohol to acetaldehyde?

Answer 63

Alcohol dehydrogenase

Question 64

Good thing to monitor to see if good response to asthma treatment?

Answer 64

PEFR

Question 65

Which statin do you give first line?

Answer 65

Atorvostatin Can also use simvastatin

Question 66

High risk of neural tube defect dose of folic acid

Answer 66

5mg PO once daily

Question 67

Treatment of urticaria

Answer 67

Anti-histamines

Question 68

What should you avoid when on anti-histamines?

Answer 68

Alcohol You can get drowsy

Question 69

Treatment of urticaria

Answer 69

Loratadine 10mg oral once a day

Question 70

Sudden onset, widespread itchy skin rash =>

Answer 70

Urticaria

Question 71

Treatment of chlamydia

Answer 71

Azithromycin

Question 72

Treatment of scabies

Answer 72

Permethin 5% dermal cream 1 application (because cover whole body)

Question 73

Mx of reflux in paediatrics (regurgitating infant)

Answer 73

Gaviscon sachet

Question 74

Treatment of urinary urgency incontinence

Answer 74

Oxybutynin Hydrochloride IR

Question 75

Why dont you prescribe morphine as required?

Answer 75

May overdose

Question 76

Cut off for trying diet and exercise to lower glucose in pregnancy

Answer 76

<7mmol/L

Question 77

How often should young people with T1DM check their glucose levels?

Answer 77

5 times a day or more

Question 78

What must the patient do when on sulphonyureas?

Answer 78

Eat regular meals Risk of hypoglycaemia

Question 79

Rate of maintenance fluids/day in normal adult

Answer 79

25-30ml/kg/day

Question 80

HTN drug that causes bilateral leg swelling

Answer 80

Amlodipine