PSA Official Mocks Flashcards
(90 cards)
1
Q
Qs on drug choice
A
drug choice correct - half marks
dose and route correct - full marks
2
Q
acute PO
A
obvs furosemide IV not PO silly billeh
3
Q
tacrolimus can also cause this
A
hyperkalaemia
4
Q
all heparins can trigger
A
hyperkalaemia
5
Q
stop antiplatelets when pre surgery
A
1 week incl aspirin
6
Q
kidney injury and allopurinol
A
with hold
7
Q
SSRI can cause hyponat
A
via SIADH
8
Q
drug checking
A
don’t just check dose, also check frequency
follow Prescriber model
9
Q
breakthrough pain prescribing
A
try to use the same drug
sixth of daily dose, every 4 hrs
palliative page has all the conversions
10
Q
even if folate deficient, can use
A
trimethoprim for short courses if no other good options e.g. pen allergic
11
Q
warning with nitrofurantoin
A
low eGFR contraind
12
Q
INR target day prior to surgery
A
INR <1.5
13
Q
take rivaroxaban with
A
food
14
Q
advice on how to take the drug i.e. with food
A
will be alongside indicaitons
15
Q
COCP Qs
A
always screen enzyme inducers /inhib on contraception interactions page
16
Q
co amox can trigger
A
cholestatic jaundice
17
Q
interaction example SSRI, DOAC
A
citalopram increases bleeds with dabigitran
18
Q
can continue ACEx with creat rise as long as
A
<20% inc from original
rv UEs in one week after
19
Q
best diuretic monitoring
A
daily weights
fluid chart
20
Q
monitoring HF drugs response chronic
A
exercise tolerance
21
Q
ciclosporin at 2 weeks monitoring
A
BP and creatinine
22
Q
small rise in blood glucose levels (e.g. on steroids/stress)
A
inc basal insulin by 10%
23
Q
statin success metric
A
40%+ LDL reduction in 3 months
24
Q
nomogram bloods
A
if taken too soon to read chart, redo just prior to second dose
25
dystonic crisis (painful eye, neck spasms, on antipschoticS)
give procyclidine 5mg IM/IV
26
exacerbation of COPD (not necessarily infective
give pred 30mg for 5 days
27
fluids prescribin
always check the fluids page + amount of potassium/sodium they've had
1-2 mmol Na / kg / day safe
0.5-1mmol K / kg / day safe
50-100g glucose needed if NBM
makes average 70-140mmol Sodium/day
35-70mmol Potassium/day
i.e. add 20mmol KCl to each of 3 daily bags
or if 2 daily do 20, 40
3L fluid normal pt per day
2L elderly per day
UO should be 0.5ml/kg/hr minimum
i.e. 35ml+ in most
28
5% dextrose equivalent in PSA
5% glucose with 0.3% KCl
29
HRT
if on intermittent may get breakthrough bleeds
if so switch to continuouscombined
can tell which type by number of patches
if 2 separate = sequential, if one only then combo
30
peripheral vasc disease / iscahemic ulcers
no beta blockers or ACEx
31
what are you going to remember to do for the first 2 sections?
they're worth loads of marks, so we are going to look up everything by CONDITION rather than 'being fairly sure'
for presc review, only don't look up if utterly confident
and should still make time to double check
32
steroid worsens
ventricular failure/heart failure
33
inc chance of candida thrush
abx
pred
gluocse in urine
34
omeprazole max daily
20mg
35
fluids prescribing
always check the fluids page before confimring choice
36
afternoon glycaemic control poor
increase mornign dose by 10%
37
morning glyc control poor
inc evening dose 10%
38
meals gluocse control poor
add subcut insulin arounf meals
39
scarlet fever
10 day course phenoxypenicillin
40
INR range is always
0.5 each side of target number
41
one missed pill
protected but take double dose
42
two missed pills and on day 3
emergency contraception if had sex
7 days barrier contraception if not had any sex and restart pack
43
methotrexate feritlity caution
women AND men shouldnt conceive on it until 6 mo post dru
44
mirtazepine common SE
weird dreasm
45
avoid IM inj if
anticaog
46
can give 20% or 10% glucose in hypoglyc
use hypoglyc page
47
CK marked elevation
5x normal with statin
stop and see if stympto go
if do and no CK rise
restart lower dose
48
poor adherence to thyroxine and high TSH
maintain same dose obvs
49
another exam technique re reading Q
look up contraindications for each drug if specified what asking for
if doesn't say that word look at cautions
always check doses of any not 100% sure of
50
stop amiodarone if
TFTs go off
51
renal impairment/ creatinine up with morphine post op and drowsy
switch to oxycodone as fully hepatic metabolism no renal metabolites
52
monitoring one month after COCP
blood pressure
not weight gain
53
ciclosporin monitoring
UEs
potassium can get high
54
starting azathioprine
check TPMT enzyme levels as some have low ones
55
severe bleed on warfarin INR8+
PT concentrate
if not an option giveFFP
56
prescription review
check all drugs before deciding on answer
more efficient to check both bits of the Q at once
write down your answers as going here?
57
liraglutide GLP agonist SE
vomiting common
58
antiemetic choice every time
cyclizine is the best
50mg TDS any way
59
metaclop not wit
QTc issues/cardiac/Parkin
60
must have what before picking a drug regime
precise indication seen on the BNF (must say exact name of the disease in question and the pt details too)
61
stat
over 15 mins
62
alendronate SE
irritates GIT - dyspepsia and diarrhoea
63
PPI side effec
diarrhoea
64
naproxen can cause
ankle oedema as well as other NSAID things
65
best analgesia elderly
always paracetamol pls
unless solid solid indication otherwise
66
c diff
metro then vanc second time
67
continuous HRT
estradiol with levonergestrel
continous, 1 patch a week
no withdrawal bleeds!
68
combined HRT
estradiol with norhisterone
2 patches a week
withdrawal bleeds
69
fentanyl patches, getting breakthrough pain
give nasal or buccal PRN (see fentanyl drug page lower down)
70
INR >1.5 day before surg
see vit K page
give PO 1-5mg vit K solution
71
scarlet fever/strep A inf
use prevention of invasive group A strep indication
72
Na, K daily
1 mmol / kg
80 kg man 80 mmol of both
account for that when prescribing next bag of fluids
if 2 saline already, likely excess sodium so give glucose 5% next with either 0.15% KCl or 0.3% depending on Potassium
0. 15 = 20mmol
0. 3 = 40mmol
over 8 or 12 hrs
73
tardive dyskinesia
change the antipsych or give tetrabenzine
grimacing, tongue protusion, lip smacking
74
antipsych extrapydramidal side effects
normal dose procyclidine if not acute
if acute dystonia, higher dose IV or IM
75
acute dystonia
painful eye movements, neck spasm, abrupt onset
on antipsych
give IM/IV procyclidine 5mg
76
SSRI can cause
hyponat
77
heparins
hyperkalaemia
78
stop allopurinol
renal dysfunction
79
shingles
has its own indication for dosing and also for if ISupp
80
calc Q
put to 1 decimal place, no rounding or algorithm won't count it
81
acute bleed on warfarin
IV! vit K if v v bad >10, don't get caught out by oral lol
then FFP or PT conc IV
82
NEVER give this to someone with possible cerebral oedema i.e. any head path
dextrose /glucose fluids!
too much water, not enough salt . hypo osmolar can worsen cerebral oedema and injury
83
fluids to give acute stroke pt
whatever the UEs, give 0.9% saline with 0.15/0.3 KCl
can't have dextrose as will worsen injury to brain as hypo osmolar
must be at least 5 days post stroke
84
no metformin in
acute illness or sig renal imparimetn
85
if anaemic and asking which drugs to stop
always look for ulcer-causing agents, e.g. aspirin, NSAID, pred!
think of why IDA, chronic bleed
86
pioglitazone can cause
hypoglycaemia too, just like the others
have a sugary snak with you
87
>55 or black
CCB first
lol how did you make a mess of that, hopefully fingers crossed you'll check that sort of thing better in the exam but even so
88
never prescribe unless
YOU HAVE THE PRECISE SPECIFIC INDICATION IN FRONT OF YOU
no messin fam
89
folate preg
look at Neural Tube page, may need higher dose regime if RFs
90
dose changes gent
look at trough AND peak conc
if trough high, increase interval between dosing
if peak high, reduce dose itself
