Safe Prescribing UK Medical PG Flashcards - Medical Study Cards
Master Safe Prescribing with OnCourse flashcards. These spaced repetition flashcards are designed for medical students preparing for NEET PG, USMLE Step 1, USMLE Step 2, MBBS exams, and other medical licensing examinations.
Safe Prescribing Flashcard Deck - 10 Cards
Flashcard 81: An ABG performed on a patient with salicylate poisoning will show mixed respiratory alkalosis & metabolic acidosis. What causes the respiratory alkalosis?
_____
Answer: Early stimulation of the respiratory centre
Flashcard 82: Why should opioid overdose patients be monitored closely after naloxone administration?\n_____
Answer: Naloxone has a shorter half-life than most opioids (risk of re-sedation)
Extra: The duration of action of Naloxone is approximately 30-90 minutes, whereas many opioids (like morphine or methadone) have a much longer half-life. Patients may appear to recover but then lapse back into respiratory depression as the naloxone wears off, requiring repeat doses or an infusion.
Flashcard 83: The most characteristic early clinical feature of salicylate poisoning is _____
Answer: tinnitus
Extra: Salicylate poisoning (aspirin) typically presents with:
1. CNS: Tinnitus, vertigo, respiratory center stimulation.
2. Acid-Base: Early respiratory alkalosis followed by an elevated anion gap metabolic acidosis (Mixed Disorder).
3. GI: Nausea, vomiting, and gastric irritation.
Treatment includes urine alkalinization with sodium bicarbonate.
Flashcard 84: A 21 year old has recently started their second year of university. They have had a headache since moving into a new student house but now presents with altered mental status and pink mucosae. What is the most likely treatment for this patient?
_____
Answer: 100% Oxygen via non-rebreathe mask (minimum 6 hours) - Carbon monoxide poisoning
Flashcard 85: Ethylene glycol poisoning is suspected based on clinical presentation and a _____ metabolic acidosis with an increased osmolal gap.
Answer: high anion-gap
Extra: Key findings include:
- CNS depression (initial phase)
- High anion gap metabolic acidosis (HAGMA)
- Increased osmolal gap
- Envelope/Needle-shaped calcium oxalate crystals in urine.
- Treatment: Fomepizole (DOC) or Ethanol; Dialysis for severe cases.
Flashcard 86: An ABG performed on a patient with salicylate poisoning will show mixed respiratory alkalosis & metabolic acidosis. What causes the metabolic acidosis?\n_____
Answer: Uncoupling of oxidative phosphorylation (leading to lactic acidosis) and accumulation of organic acids
Extra: Salicylate poisoning typically presents with a 'mixed' acid-base disturbance: a primary respiratory alkalosis and a primary elevated anion gap metabolic acidosis. If the pH is normal but CO2 and HCO3 are both low, suspect salicylate toxicity.
Flashcard 87: The initial management of suspected serotonin syndrome involves _____ and supportive care (IV fluids)
Answer: stopping serotonergic drugs
Flashcard 88: Digoxin level blood test should be performed _____ after administration
Answer: 6 hours
Flashcard 89: cyproheptadine is a _____
Answer: 5-HT2A receptor antagonist
Flashcard 90: The management of autonomic instability in serotonin syndrome involves treatment with _____ antihypertensives (e.g. esmolol or nitroprusside).
Answer: short-acting
Extra: Serotonin Syndrome management:
1. Discontinue offending agents.
2. Supportive care (IV fluids, oxygen).
3. Benzodiazepines for agitation and seizures.
4. Cyproheptadine (5-HT2A antagonist) as a specific antidote.
5. Hyperthermia: aggressive cooling (not antipyretics).
6. Autonomic instability: treat with short-acting antihypertensives; avoid monoamine oxidase inhibitors.
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