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PSA | Sarah Yasmine > Random Tidbits > Flashcards

Random Tidbits Flashcards

(57 cards)

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1
Q

Hepatic Encephalitis

A

Lactulose

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2
Q

Oral contraception for a smoker?

A

Desogestrel (POP = progesterone only pill)

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3
Q

Asthma management in children?

A
  1. SABA
  2. SABA + ICS (low dose)
  3. SABA + (low dose) ICS + LRTA
  4. SABA + (low dose) ICS + LABA
  5. Start the MARTs…

Low dose ICS = < 200 micrograms budesonide

LRTA = montelukast

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4
Q

Drug to give 9 hours after a stroke?

A

Aspirin 300mg

(Alteplase < 4.5 hours)

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5
Q

C Difficile management?

A

CKS - ‘Diarrhoea - antibiotic associated’

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6
Q

Paracetamol overdose?

A
  • Measure @ 8 hours
  • < 4 hours and > 150 mg = charcoal
  • Treat according to graph
  • 8-16 hours and > 75mg/kg start NAC while awaiting results
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7
Q

Statin interaction causing myopathy?

A

Clarithromycin

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8
Q

Drugs that cause diarrhoea?

A
  • Alendronic Acid
  • Lansoprazole
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9
Q

Maintenance fluids?

A
  • 8-hourly bags (3L) BUT elderly/underweight = 12-hourly bags (2L)
  • Add the potassium (divide by the 3 bags)
  • 25-30 ml/kg/day of water
  • 1 mmol/kg/day of potassium, sodium and chloride
  • 50-100 g/day of glucose to limit starvation ketosis
  • Adults generally require 3L IV maintenance fluids per day (8 hourly bags); 40-60 mmol KCL per day when NBM; 2 salt (saline) and 1 sweet (dextrose) every 24 hours
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10
Q

Hypoglycemic diabetic?

A

20% glucose 100 ml 20 minutes

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11
Q

Relieving oedema?

A

IV furosemide 40mg

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12
Q

Drug that causes flushing?

A

CCBs

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13
Q

What is normal urine output?

A

Average urine output should be approximately 0.5mL/kg/hour

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14
Q

Glycaemic control in stroke patients?

A

Tight glycaemic control has not been shown to improve outcome in stroke and current recommendations suggest maintaining plasma glucose in the range 5 to 15 mmol/L

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15
Q

Surgery and medication?

A

‘Surgery and long-term medication’ in treatment summary

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16
Q

Converting units?

A

Approximate Conversions and Units

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17
Q

Breakthrough pain?

A
  • Palliative = treatment summaries
  • Breakthrough pain = 1/6 of 24 hour dose given 4-hourly as required
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18
Q

Antidotes

A

‘Poisoning, emergency treatment’ on BNF

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19
Q

HRT

A

ESTRADIOL WITH NORETHISTERONE

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20
Q

COCP monitoring?

A

Blood Pressure

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21
Q

Transient rise in blood glucose caused by corticosteroids?

A

An increase in the usual insulin dose of 10% would be an appropriate way to manage a transient rise in blood glucose caused by corticosteroids

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22
Q

When is no change in Statin dose the appropriate management?

A

No change in dose is required, as after 3 months of treatment a > 40% reduction in non-HDL cholesterol has occurred

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24
Q

When should ACEi be taken?

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A

Can give postural hypotension = best given in the evening

25
Hyperkalaemia management?
* Found in ‘treatment summary’ for ‘fluids and electrolytes’ * An intravenous injection of soluble insulin (5–10 units) with 50 mL glucose 50% given over 5-15 minutes * E.g. Actrapid or Novorapid
26
Epilepsy treatment differences?
* Lamotrigine = in pregnancy * Carbamazepine = causes SIADH
27
Initial drug therapy in T2DM?
28
Vomiting medications?
'Nausea and labyrinth disorders'
29
LMWH contra-indications?
* Prophylactic heparin CIed in acute ischaemic stroke due to risk of bleeding into stroke (for at least 2 months) * @ Risk of bleeding/recent ischaemic stroke/if patient has PAD (absent foot pulses) = no compression stockings – can cause acute limb ischaemia
30
Vancomycin side effects?
Ototoxicity + Nephrotoxicity
31
Statins management?
* **LFTs** checked **before** treatment, **3 months** & **12 months** * CI if 3 x normal ALT/AST * CI if 5 x normal CK * CK monitoring only if risk factors
32
Adverse Drug Reactions: Low GCS or Acidotic?
Look for Metformin!
33
Which 2 drugs should NEVER be co-prescribed?
ACEi and NSAIDs
34
Neuropathic pain in an elderly person?
Paracetamol \> Amitryptiline initially for neuropathic pain
35
Conversions?
* 1000 micrograms = 1 mg * 1 microgram = 1000 nanograms * 0.1% = 0.1 g per 100 mL = 100 mg per 100 mL = 1 mg in 1 ml * 1% = 1g in 100ml (100g) = 10 mg in 1 ml * 1 in 1000 = 1g in 1000ml
36
Severe lithium toxicity?
* Stop Lithium (severe toxicity = arrhythmia, seizure, renal failure) * Stop Thiazide diuretics and ACEi and NSAIDs (= can cause decreased excretion via kidneys)
37
KCL maximum?
20mmol/hour
38
Levothyroxin dose changes?
Change levothyroxine doses in 25-50 microgram increments
39
Anaphylaxis treatment?
0.5mg of 1:1000; high flow oxygen FIRST (ABC); Chlorphenamine = 10mg IV
40
Which drug is CI in indigestion?
NSAIDs
41
COPD exacerbation managment?
1) Salbutamol nebs 2) Ipratropium bromide nebs 500mg 3) Prednisolone 30mg. 4) Non-threatening OBS + ABG = 24% Oxygen BiPAP = Type 2 Respiratory Failure CPAP = Type 1 Respiratory Failure 5) Aminophylline only if all other treatments failed = senior colleague observation required
42
Human Albumin Solution
Liver Failure (low-sodium content required)
43
Cough w ACEi. Management?
Change to a trial of an ARB
44
Monitoring of ACEi?
* After initiating ACEi: renal function and potassium should be checked 1-2 weeks later * Creatinine baseline * N.B. renal impairment can present as general malaise and fatigue
45
Abrupt cessation of steroids?
* Addisonian Crisis * Prescribe a calcium tablet, and sometimes a bisphosphonate, as osteoporosis prophylaxis with steroids
46
Methotrexate monitoring?
Every 3-4 weeks (FBC, LFT, U&E) → neutropenia
47
Considerations w Statins?
* Avoid **grapefruit juice** when taking a statin * Take statin at **night** * Do not use statins in active **liver disease** * Stop statins when a **macrolide** is prescribed.
48
Steroids prescription when ill?
STEROID PRESCRIPTIONS ARE DOUBLED during sepsis/illness → ‘sick day rules’
49
When should methotrexate be stopped?
Methotrexate should be stopped during **active infection**
50
Initial relief of indigestion?
**Antacid** (e.g. **Magnesium Carbonate**) for INITIAL RELIEF
51
Weak Opioids?
Codeine and Tramadol
52
What should you monitor w Aminophylline?
Monitor **OXYGEN** → improvement in **saturations** (**asthma**)
53
How to know if antibiotics are working in pneumonia?
Response to antibiotics = **oxygen saturations**, **ABG**, **respiratory rate** * consolidation can take 6 weeks to clear * crepitations take days to resolve
54
Tacrolium monitoring?
**Trough**
55
Fluoxetine monitoring?
* Hyponatremia * First **2 weeks** = check for **suicidal** ideation * Assess for **efficacy** = **4 weeks**
56
DKA monitoring?
**serum ketones** \> serum glucose
57
Oxygenation in COPD?
* 88-92% * Monitor w pulse oximetry

PSA | Sarah Yasmine (1 decks)

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