psa mock 2 Flashcards
(34 cards)
drug of choice used in acute dystonic reactions
- Antimuscarinic drugs first line: procyclidine
4 main types of fluids to know for PSA
- Sodium chloride 0.9% 1000ml - 150mmol Na
- Potassium chloride 0.3% 1000ml - 40mmol K
- Potassium chloride 0.15% 1000ml - 20mmol K
- Glucose 5% 1000ml - 50g glucose
remember
Don’t replace K+ faster than 10mmol/ hour
Daily fluid requirements
25-30ml/kg/24hour water
1mmol/kg/24h Na & K
50-100g/24 hour glucose
Emergency resuscitation fluids
sodium chloride 0.9% 500ml 10 minutes
Emergency hypoglycaemia mx
glucose 20% 100ml over 15 min
Emergency hypokalaemia fluid tx
sodium chloride 0.9% / potassium chloride 0.3% 1000ms 4 hours
emergency hypercalcaemia fluid treatment
sodium chloride 0.9% 1000ml 4 hours
maintenance fluids without deficits or losses
25-30ml/kg/24hr water
1mmol/kg/24hr sodium and potassium
50-100g/24hr glucose
maintenance fluids with deficits or losses (Na or K, vomiting, diarrhoea)
minimum 30ml/kg/24hr water
(aim 1000ml 4-6hrs)
Paediatrics emergency resuscitation fluids
sodium chloride 0.9% 10ml/kg over 10 mins
Paediatrics maintenance fluids without deficiits or losses
100mls/kg/24h for first 10kgs
50mls/kg/24 hour for 10-20kgs
20mls/kg/24 hour for > 20kg
HRT: uterus intact and LMP<12
- oral sequential combined oestrogen + progesterone (Elleste-duet 1mg or 2mg) or patch sequential combined (evorel sequi_
Estradiol with norethisterone
HRT: Uterus intact + LMP >12 months
oral continuous combined oestrogen or progresterone (elleste-duet conti)
patch continous combined oestrogen and progesterone (evorel conti), tibolone
Continuous regime will avoid withdrawal bleeding:
- patch: levonorgestrel
HRT: post hysterectomy
oral or path oestrogen (elleste-solo) or tibolone
What may be given for post menopausal osteoporosis
alendronic acid or risedronate sodium
what may be given for vasomotor symptoms in someone who can’t take HRT
clonidine (or SSRI)
what may be given for menopausal atrophic vaginitis
topical vaginal oestrogen (pessary or ring)
drug that is contraindicated in peripheral vascular disease
beta blockers: cause peripheral vasoconstriction and worsen ischaemia in PVD
ACEi should also be cautioned if signs of severe critical ishcaemia
5 Male
pc: fever sore throat, runny nose, 38.5 temp. enlarged tonsils, strawberry tongue, no exudate, swollen neck lymph nodes.
likely diagnosis and mx
Scarlet fever
Abx: 10 day course phenoxymethylpenicillin 125mg PO 6 hourly
target INR
INR 2.5
-> DVT, PE, AF
–> cardioversion
–> mitral stenosis
–> biprosthetic heart valves
–> MI
INR 3.5
–> RECURRENT DVT
–> mechanical heart valves
Warfarin Haemorrhage guidelines
INR 5-8 no bleeding : withold 1 or 2 doses of warfarin, reduc subsequent maintenance dose
INR 5-8 MINOR BLEEDING: stop warfarin, give vitamin K (phytomenadione) by slow IV, restart when INR <5
INR >8 no bleeding: stop warfarin, iven vit K by mouth, repeat vit K if INR still high after 24 hours, restart when warfarin <5
INR >8 WITH MINOR BLEEDING: stop warfarin, give vit K IV, repeat if still high after 24 hours, restart when warfarin <5
INR >8 MAJOR BLEEDING: stop wafarin, give vit K by slow IV, dried prothrombin complex
common side effect of mirtazepine
abnormal dreams (sleep disturbances) very common
tx hypoglycaemia in an unconscious patient
glucose 20% 100ml IV
adult patient presents with painful rash to right side of face. likely diagnosis and management
SHINGLES:
aciclovir first line tx 400mg tablets
correct dose is 800mg PO 5 times a day for 7 days
