PSA Advice thread
Here is some of the lessons i learned from my PSA exam and revision which i wish i had known beforehand. Feel free to add yours!
1. For the prescribing section, i'd say where i fell was in the following:
A- Know different forms of HRTs, but be able to search them on the PSA assessment website, find the right names, and memorise these beforehand. Otherwise, there's over 20 options and it can get so confusing with all of the brand names and combinations. Know which ones for pre, peri, post menopausal women. Contraceptions in these groups, in examples of emergency contraception. Know different modes of delivery, oral , patch etc. Be able to search them on Medicinescomplete, but also the interface on PSA assessment. So do a mock, but just use the search bar on the HRT style questions to search for all sorts.
B- Prescribing fluids. Know this in and out for all variety of cases. Know how to add different Mols potassium, know about different quantities and volumes, especially 500ml verses 1L, verses 2L and what sort of time frame you'd give this in. Oxfordmedical education has a great resource on prescribing fluids, and there are others.
C - Know the first, second and third line managements of key emergency conditions (often they ask for a second drug, when first line has been given and second can't be, so in effect a third line) - including common paediatric. Asthma, COPD, Gout, Croup, Anaphylaxis, etc. Now i'm unsure whether we're going to be asked emergencies where we as Juniors can't prescribe and would need a senior to do so? But it's worth knowing this anyway.
D- Go through BNF treatment summaries for everything on Medicinescomplete. Know how to locate as many conditions beforehand and know your way around it very well. So if you get a question about STIs, have no idea what the second line is, you'll know exactly what path to take to get on the STIs page, or even the viral page, know exactly where the link to the next page about drug treatments, and know exactly where the part detailing first, or second lines will be. CTRL + F is also very useful.
E - Be very wary! When you're on the drug page with indications and dosages, don't just go for the first one. Often the patient might have cancer, might be above or below an age or weight bracket. The questions will always be written in a way you can reliably just scroll down and find the category which matches them. So don't be tempted to just go on Adult for a pain killer, scroll down and find one for terminal illnesses if they have cancer. This was all on the available mocks.
F. Know the analgesic pathways and know how it diverges for cancer etc. Know this in detail.
Don't underestimate this section, spend a lot of time beforehand on this section, because if you score 55/80, you're probably well on the way to passing. I scored badly here, and it's worth 80/200 marks, so not far off half the exam.
______________
2. Prescription review
1. Memorise common rough dosages for common drugs. For example, Omeprazole, know the highest possible range. For antibiotics, know the highest dose. For pain killers. Use Anki cards, or even make your own, and just keep going through them. This will save time because you can identify ones clearly outside of any safe range. Now, some may be within the range you memorised but not suitable for the patient.
2. Know common unsuitable interactions between drugs.
3. Know clearly CIs i.e. kidney problems and NSAIDS.
4. If you know fluids well, you'll be able to ascertain common errors here.
_______________________
3. Adverse drug reactions
1. If you can do CTRL F, this is insanely useful. If the question says "Hyperkalaemia" you can literally type the drug on the search bar, get its main page, and then do CTRL + F, for each drug and flag up the ones where it's a big risk, or a rare risk, and choose the one with the big risk (unless only one of the drugs shows up Hyperkalaemia).
2. Method 1 can be used for any side effect they show you, just be quick at typing the drug, getting on the page, CTRL F for the thing you're trying to find.
However, you can't always do this for all of them, so memorise as many key ones you can score on, so the more obscure ones or ones you forget or are unsure you can search very quickly.
Be wary, some disable CTRL F because it makes it easier.
____________________
4. Calculations
PassthePSA book is the best for this section, despite being easier than the exam for some of the others. I'd also use fractions.
The most useful is:
Concentration = Mass/Volume
Practice using this and others now, and see if they help.
When the question stem looks too complicated, just look at the information. Use concentration = Mass/Volume to work out whatever you can imo if you get confused or lost, so you have some information at least down. Eliminate irrelevant bits of information. Often you only literally need two of the figures, just look at the fractions, use C = M/V, ratios.
Break it down, eliminate irrelevant parts which are there to distract you, work out what you can. Sometimes you need an extra step to get the answer, or two, but you don't need all of the information as it can confuse you. So practice identifying what's relevant.
Be comfortable converting between units and double checking the answer.
The questions are sometimes favourable in the sense that if you work out what you need, they fit in perfectly in terms of one being 1/4 of the other and needs timing by four etc. But this isn't always the case.
Practice covering 1% and 2% (they're in the PassthePSA), do the mocks on these too.
___________________________
5. Data monitoring, Data interpretation etc
1. Don't be scared by Insulin and drug questions and funny units. Sometimes, it's just common sense. If your levels of X are too high in time Y, you might want to increase the drug A during the time preceding (give it enough time) where it would change it. The same would apply if it was too low.
2. Know how to interpret graphs pertaining to drug dosages, paracetamol graphs. Easy marks - use PassthePSA to help with this.
I have missed out other sections and have not gone in detail with others because i too want to learn how to get better at them.
1. For the prescribing section, i'd say where i fell was in the following:
A- Know different forms of HRTs, but be able to search them on the PSA assessment website, find the right names, and memorise these beforehand. Otherwise, there's over 20 options and it can get so confusing with all of the brand names and combinations. Know which ones for pre, peri, post menopausal women. Contraceptions in these groups, in examples of emergency contraception. Know different modes of delivery, oral , patch etc. Be able to search them on Medicinescomplete, but also the interface on PSA assessment. So do a mock, but just use the search bar on the HRT style questions to search for all sorts.
B- Prescribing fluids. Know this in and out for all variety of cases. Know how to add different Mols potassium, know about different quantities and volumes, especially 500ml verses 1L, verses 2L and what sort of time frame you'd give this in. Oxfordmedical education has a great resource on prescribing fluids, and there are others.
C - Know the first, second and third line managements of key emergency conditions (often they ask for a second drug, when first line has been given and second can't be, so in effect a third line) - including common paediatric. Asthma, COPD, Gout, Croup, Anaphylaxis, etc. Now i'm unsure whether we're going to be asked emergencies where we as Juniors can't prescribe and would need a senior to do so? But it's worth knowing this anyway.
D- Go through BNF treatment summaries for everything on Medicinescomplete. Know how to locate as many conditions beforehand and know your way around it very well. So if you get a question about STIs, have no idea what the second line is, you'll know exactly what path to take to get on the STIs page, or even the viral page, know exactly where the link to the next page about drug treatments, and know exactly where the part detailing first, or second lines will be. CTRL + F is also very useful.
E - Be very wary! When you're on the drug page with indications and dosages, don't just go for the first one. Often the patient might have cancer, might be above or below an age or weight bracket. The questions will always be written in a way you can reliably just scroll down and find the category which matches them. So don't be tempted to just go on Adult for a pain killer, scroll down and find one for terminal illnesses if they have cancer. This was all on the available mocks.
F. Know the analgesic pathways and know how it diverges for cancer etc. Know this in detail.
Don't underestimate this section, spend a lot of time beforehand on this section, because if you score 55/80, you're probably well on the way to passing. I scored badly here, and it's worth 80/200 marks, so not far off half the exam.
______________
2. Prescription review
1. Memorise common rough dosages for common drugs. For example, Omeprazole, know the highest possible range. For antibiotics, know the highest dose. For pain killers. Use Anki cards, or even make your own, and just keep going through them. This will save time because you can identify ones clearly outside of any safe range. Now, some may be within the range you memorised but not suitable for the patient.
2. Know common unsuitable interactions between drugs.
3. Know clearly CIs i.e. kidney problems and NSAIDS.
4. If you know fluids well, you'll be able to ascertain common errors here.
_______________________
3. Adverse drug reactions
1. If you can do CTRL F, this is insanely useful. If the question says "Hyperkalaemia" you can literally type the drug on the search bar, get its main page, and then do CTRL + F, for each drug and flag up the ones where it's a big risk, or a rare risk, and choose the one with the big risk (unless only one of the drugs shows up Hyperkalaemia).
2. Method 1 can be used for any side effect they show you, just be quick at typing the drug, getting on the page, CTRL F for the thing you're trying to find.
However, you can't always do this for all of them, so memorise as many key ones you can score on, so the more obscure ones or ones you forget or are unsure you can search very quickly.
Be wary, some disable CTRL F because it makes it easier.
____________________
4. Calculations
PassthePSA book is the best for this section, despite being easier than the exam for some of the others. I'd also use fractions.
The most useful is:
Concentration = Mass/Volume
Practice using this and others now, and see if they help.
When the question stem looks too complicated, just look at the information. Use concentration = Mass/Volume to work out whatever you can imo if you get confused or lost, so you have some information at least down. Eliminate irrelevant bits of information. Often you only literally need two of the figures, just look at the fractions, use C = M/V, ratios.
Break it down, eliminate irrelevant parts which are there to distract you, work out what you can. Sometimes you need an extra step to get the answer, or two, but you don't need all of the information as it can confuse you. So practice identifying what's relevant.
Be comfortable converting between units and double checking the answer.
The questions are sometimes favourable in the sense that if you work out what you need, they fit in perfectly in terms of one being 1/4 of the other and needs timing by four etc. But this isn't always the case.
Practice covering 1% and 2% (they're in the PassthePSA), do the mocks on these too.
___________________________
5. Data monitoring, Data interpretation etc
1. Don't be scared by Insulin and drug questions and funny units. Sometimes, it's just common sense. If your levels of X are too high in time Y, you might want to increase the drug A during the time preceding (give it enough time) where it would change it. The same would apply if it was too low.
2. Know how to interpret graphs pertaining to drug dosages, paracetamol graphs. Easy marks - use PassthePSA to help with this.
I have missed out other sections and have not gone in detail with others because i too want to learn how to get better at them.
Scroll to see replies
I'd also like to add:
1. Know analgesic ladder well, so you know when you can escalate , change.
2. Know common presentations, such as renal, and when you'd need to change drugs. Constipation and pain killers , etc
3. Medicinescomplete will have sections about levels of certain drugs which often require monitoring. Don't be alarmed, just type the drug in, do a CTRL F or find the section - it will be there. It may give you levels above which it's not safe to carry on, or when it is safe. Things like this are important for statins, and other drugs.
1. Know analgesic ladder well, so you know when you can escalate , change.
2. Know common presentations, such as renal, and when you'd need to change drugs. Constipation and pain killers , etc
3. Medicinescomplete will have sections about levels of certain drugs which often require monitoring. Don't be alarmed, just type the drug in, do a CTRL F or find the section - it will be there. It may give you levels above which it's not safe to carry on, or when it is safe. Things like this are important for statins, and other drugs.
Thanks for starting this! Super helpful!!
Original post by Anonymous
Thanks for starting this! Super helpful!!
I forgot the most useful bit of advice
On Medicinescomplete, there's a drug interaction checker
You type in drug A followed by a comma, then Drug B, Drug C etc, and hit enter.
It will tell you the interactions.
Often, PSA questions ask about which one would be most likely to cause an adverse effect etc, and often one causes a caution, the other an absolute contraindication. This bit of the Medicinescomplete tells you this information - super helpful.
Original post by Anonymous
On Medicinescomplete, there's a drug interaction checker
You type in drug A followed by a comma, then Drug B, Drug C etc, and hit enter.
It will tell you the interactions.
Often, PSA questions ask about which one would be most likely to cause an adverse effect etc, and often one causes a caution, the other an absolute contraindication. This bit of the Medicinescomplete tells you this information - super helpful.
On Medicinescomplete, there's a drug interaction checker
You type in drug A followed by a comma, then Drug B, Drug C etc, and hit enter.
It will tell you the interactions.
Often, PSA questions ask about which one would be most likely to cause an adverse effect etc, and often one causes a caution, the other an absolute contraindication. This bit of the Medicinescomplete tells you this information - super helpful.
any idea where I canfind the interaction checker on medicinescomplete?
can't seem to find it
Guys I’ve got a urgent q - you know when choosing the drug on the mocks - how do you know which dose to choose e.g in treatment of DVT how do you know to choose dalteparin 25000units/ml or dalteparin 12500units/ml - and why does one score only half marks
Even though the dose is 12500 units it says 25000units/mil is the correct option
Even though the dose is 12500 units it says 25000units/mil is the correct option
Original post by Rain water
Guys I’ve got a urgent q - you know when choosing the drug on the mocks - how do you know which dose to choose e.g in treatment of DVT how do you know to choose dalteparin 25000units/ml or dalteparin 12500units/ml - and why does one score only half marks
Even though the dose is 12500 units it says 25000units/mil is the correct option
Even though the dose is 12500 units it says 25000units/mil is the correct option
You need to differentiate between prophylaxis and treatment. I think you're looking at the wrong area! Treatment dose > prophylaxis dose. Also doses can differ for surgical and medical patients depending on your LMWH of choice.
When is next psa and how is it being sat in lockdown situation? Monitoring etc too
Taking the PSA in june as F1, glad i've found this thread.
Original post by Anonymous
When is next psa and how is it being sat in lockdown situation? Monitoring etc too
My uni wont let us gradute till we have the PSA. The next sitting is 11thy May, which will be done remotely from home.
My uni too - Taking may 11 and remotely from home seems quite daunting. As far as monitoring they said they will monitor keystrokes and if they find out you have been communicating with anyone at all but is vague "monitoring" statement. The time pressure is terrifying in the exam - and with such a short time left I am still feeling like I know absolutely nothing. Someone say it's totally possible to crush it with a week of solid attack starting from not great : ) (please)
"monitor keystrokes" wtf does that mean lmao
Original post by Anonymous
"monitor keystrokes" wtf does that mean lmao
I think to see if we are trying to open other windows or if we are typing when we should be calculating? idk to be honest...does anybody else?
Original post by Anonymous
I think to see if we are trying to open other windows or if we are typing when we should be calculating? idk to be honest...does anybody else
It's possible to install a keylogger. Now, if they did install a remote keylogger 1) it's unethical to do so without explicit consent, 2) your computer would be at risk if you were to ever type in your card details to buy anything or ever write any messages/emails 3) most anti-virus softwares will not permit this and will probably cause the system to restart/slow down the computer and you're going to have major techniclal issues. Sounds fun. Keep us updated i've got an interest in ICT so i've love to see how this supposedly pan's out! Surely they should have told you by now if you're exam is in a few days
Original post by Anonymous
It's possible to install a keylogger. Now, if they did install a remote keylogger 1) it's unethical to do so without explicit consent, 2) your computer would be at risk if you were to ever type in your card details to buy anything or ever write any messages/emails 3) most anti-virus softwares will not permit this and will probably cause the system to restart/slow down the computer and you're going to have major techniclal issues. Sounds fun. Keep us updated i've got an interest in ICT so i've love to see how this supposedly pan's out! Surely they should have told you by now if you're exam is in a few days
In the email it just said "we will be monitoring your keystrokes and your timing" - I certainly haven't had anything installed so perhaps through their end? I am zero aware of IT possibilities though - probably they just want to give an appearance of monitoring cheating. Between now and the exam we just get a pin number to put in on the day, after logging into the site. It doesn't sound possible to me but who knows
Original post by Anonymous
I forgot the most useful bit of advice
On Medicinescomplete, there's a drug interaction checker
You type in drug A followed by a comma, then Drug B, Drug C etc, and hit enter.
It will tell you the interactions.
Often, PSA questions ask about which one would be most likely to cause an adverse effect etc, and often one causes a caution, the other an absolute contraindication. This bit of the Medicinescomplete tells you this information - super helpful.
On Medicinescomplete, there's a drug interaction checker
You type in drug A followed by a comma, then Drug B, Drug C etc, and hit enter.
It will tell you the interactions.
Often, PSA questions ask about which one would be most likely to cause an adverse effect etc, and often one causes a caution, the other an absolute contraindication. This bit of the Medicinescomplete tells you this information - super helpful.
Hi, I can't find this on medicines complete? Please can you say which section it is under?
Thanks so much
Original post by Anonymous
My uni too - Taking may 11 and remotely from home seems quite daunting. As far as monitoring they said they will monitor keystrokes and if they find out you have been communicating with anyone at all but is vague "monitoring" statement. The time pressure is terrifying in the exam - and with such a short time left I am still feeling like I know absolutely nothing. Someone say it's totally possible to crush it with a week of solid attack starting from not great : ) (please)
Definitely possible.
If you had two computers, i hardly see how they'd know you're on the second typing with your right or left hand? To pass, you need to try to get as many of those prescribing ten markers...and if you can literally google the more vague ones if you don't remember the management and can't find it on Medicinescomplete, that's a huge bonus.
I don't advocate cheating, i am just saying it's going to be very possible to do so. I hardly see how their measures contain that.
Original post by Anonymous
Hi, I can't find this on medicines complete? Please can you say which section it is under?
Thanks so much
Thanks so much
Left hand side, 'Interactions' after typing the drug onto the search bar
Original post by Anonymous
Hi, I can't find this on medicines complete? Please can you say which section it is under?
Thanks so much
Thanks so much
I posted an image but it needs to be approved, it's on the left hand side when you type in the drug and enter onto the search bar. You'll see 'drug' treatment summary' 'interactions'. Click on 'interactions' and type in the drugs you want, follow each one by a comma so it becomes its own separate box on the search bar.
Original post by Anonymous
Hi, I can't find this on medicines complete? Please can you say which section it is under?
Thanks so much
Thanks so much
When you click on interactions you go onto a new page with a new search bar at the centre. Type in the drugs you want to check, make sure each is separated by a comma so the system recognises it and it becomes surrounded by its own 'box' on the search bar.
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