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Section 1 - Prescribing
Introduction
Section 1 of the PSA examination evaluates your ability to write safe and appropriate medication prescriptions, a fundamental skill for any FY1 doctor.
You will be presented with a clinical scenario and are expected to identify and prescribe the most appropriate treatment. This can include medications or fluids. Be aware, questions do not only focus on adults, and may also include paediatric patients.
Section 1 carries 40% of the total marks for the Prescribing Safety Assessment. It is a very heavily-weighted section, and thus the most important section. Maximising your score in section 1 will give you a strong footing for the rest of the exam.
| Question Style | Fill in the blanks (Drug name, dose, route, frequency) |
|---|---|
| Total Questions | 8 |
| Marks per Question | 10 (Total of 80 marks) |
| Advised Time per Question | 5 minutes |
Example Question
Case presentation
A 72-year-old man presents to the medical assessment unit with shortness of breath and oedema for 1 week. PMH: Ischaemic heart disease, type 2 diabetes, chronic kidney disease leg ulcers, gout. DH. BP 5 years ago: baseline 150/90 mmHg. He is on furosemide 40 mg PO daily, hydrochlorothiazide 500 micrograms PO daily, allopurinol 100 mg PO daily, amlodipine 5 mg PO daily, enalapril maleate 20 mg PO daily, losartan potassium 75 mg PO daily, and metformin 500 mg PO twice daily.
On examination
Temperature 37.2°C, HR 72 bpm and rhythm regular, BP 148/90 mmHg, JVP Raised, RR 22/min, O₂ sat 98% breathing 40% oxygen. Bilateral pitting leg oedema to thighs.
Investigations
Na⁺ 138 mmol/L (137-144), K⁺ 5.4 mmol/L (3.5-5.3), Urea 15.1 mmol/L (2.5-7.0), Cr 187 μmol/L (60-110)
CXR shows cardiomegaly and pulmonary oedema.
Prescribing request
Write a prescription for ONE drug that is most appropriate to alleviate his breathlessness and oedema.
(Use the "once-only medicines" prescription form provided.)
PRESCRIPTION FORM
Source: PSA
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Content Overview
The guide for this section is subdivided into: