Pass the PSA E-Book

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Here you will be given a clinical scenario and asked to decide which treatment would be most appropriate from several plausible answers. Know which drugs are prescribed in MICROgrams (e.g. levothyroxine, digoxin) – these are often prescribed in MILLIgrams to catch you out.

Data interpretation made memorable and simple including ECG, ABGs, chest X-rays and basic bloods. Common traps highlighted throughout. Sometimes it is inappropriate to treat/change management and it important to bear in mind non-drug therapies (e.g. physiotherapy, TENS machines for pain relief) have a role. Enzyme inhibitors: AO DEVICES – allopurinol, omeprazole, disulfiram, erythromycin, valproate, isoniazid, ciprofloxacin, ethanol (acute intoxication), sulphonamides. Others: grapefruit juice, amiodarone, and SSRIs (fluoxetine, sertraline). The beginning of Appendix 1 in the paper BNF contains several tables of ‘drugs that cause…’. This saves you from looking up each drug individually when being asked which drug is most likely to cause ‘x’. Don’t lose easy marks! As prescribing counts for a whopping great 40% of the marks don’t lose out on the ample marks available for your signature and the date!

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The PSA is undertaken by medical students in the early spring of their final year. It is an online exam that lasts for two hours and comprises 60 questions across eight-question formats. The total number of marks available is 200. Each medical school is allowed to choose whether or not they interpret the PSA as a summative assessment towards their medical degree. Ctrl F’ is your friend. The BNF is huge so ‘Ctrl F’ is ideal for finding drug interactions and side effects easily.

PSA questions are predominantly based on information that can be found within the BNF. This includes: drug dose, drug route, drug frequency, side effects, adjustments in renal impairment, monitoring requirements and so on. It has a wealth of information beyond simply drug dosing, including interactions and treatment summaries. Sp aced repetition is a technique for improving the retention of information . It works by spacing out the intervals between review sessions . This spacing allows you to consolidate the information making it more likely you will recall it during the prescribing safety assessment. Get familiar with the BNF (both online and paper versions) and know where to find things as it isn’t always obvious or easy. For example, converting opioid doses is in the palliative care summary, HRT is in the sex hormones summary, and high INR management is in the oral anticoagulants summary.

There are often several correct drug/ dose/ route combinations which will receive full marks. Lower marks are given for suboptimal options. This section will task you with selecting the most suitable plan of monitoring for either beneficial or harmful effects of a newly started medication. If unsure of how to manage ADR, the answers can often be found in the respective treatment summaries of the BNF. For examples – medication overdoses (poisoning, emergency treatment), hypoglycaemia (hypoglycaemia), reversal of a high INR (oral anticoagulants).