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Oh, now keep me to start it be Yeah, Let's go. That's a friend. All right, so I'll start with question one. So we have Mr Matthews, who is a 17 year old gentleman. Who? You see neurology. You practice. He's had, um, been a tree BP monitoring done at her, which shows that he's got a BP 190 over 85 on Despite trying some lifestyle changes you still manage to You still have been able to control his BP. So you're thinking you're going to start you on amlodipine 2.5 mg once a day on day. What? What side effects Would you cancel, Mr Matthews? That this arm? Lot of people, but we're starting to might cause So we've got a Is it gonna be called peripheries? See? Is it going to increase his risk of developing gout D? Is it gonna cause ankle swelling, or is it gonna cause hyperkalemic? Yeah, so go ahead with yeah, right on. If you don't know the answer, just still shit together ahead and just have a crack at it and we'll talk it through in just a sec. And one, we've system. We'll give you two minutes. So this Uh huh. All right, 30 seconds left, everyone. Yeah, Yeah. Okay. Sign or 10 seconds. Just give it a guess you have. Yeah, que brand. So these are the Lantus that we've got around 89%. You were correct. Answer is D ankle swelling. So if you go on to be a time, sure you have. You can see the amlodipine is a calcium channel for on back for this gentleman who's 73 years old. So over 55 we haven't said that he's got diabetes or that he's Africa ethnicity. This would be the first line treatment for stopped taking it on day. One of the main side effects to notice. Along with that, if you'd side effects, is that it can cause some peripheral edema. So particularly ankle swelling. It can also cause things such as abdominal pain, dizziness, drowsiness, flashing and headache and but the other sections on the pole. Wrong. So cough tends to be from an ace inhibitor on a risk of developing gout tends to, you know, and keeping the size. I called referees sorry as well. It actually tells the channel because he used to treat cold for a freeze and things like rain oats on. Hopefully, no, no, it's no, actually, it's not just saying that's very erratic. So expired on that. What he's thinking that good work on. The best question we'll have to do with that noise. Sorry. I can't agree that someone called in. Thank you. Okay, if everyone could just put themselves on mute. Yeah, yeah, yeah. If they haven't already. Thanks, guys. And then the next question So you were called to see Mr Jones. He's an 89 year old gentleman who's been admitted with the UTI on a background of dementia. He's fooling. Well, I think that means prevents on what? He's fallen on the ward. And he's unfortunately sustained a six centimeter laceration to the left forearm. Your US to stitch up the wounds using five mills of 2% lidocaine on as you're documenting in the notes. Yeah, we want to calculate how much anesthetic you actually used. So how many milligrams of lidocaine was injected if you gave him five mills of 2%? There's a first calculation question off. This will launch the pole. Yeah. Oh, no. Yeah. Okay. We got one more minute, and then we'll go through how to work out the answer here. Uh huh. Okay. 10 seconds. If you're not. Sure. Just guess one for now. And then we'll go through how to work out. Get in the pool. Less so about half of you. This question correct. Theanti is he 100 mg. I'm going through how to work this out. Calculation questions tend to be a bit more mighty. People either love them will hate them. So the fact that you need to know here which need to take with you into the exam is that 1% equals 1 g in 100 mils. So knowing that we know that that it's 2% lidocaine which has been used, which is to grounds in 100 mils on, we've used 5 mg of that. So the five millimeters of that so 200 mg is equal to 2000 micrograms and 100 mil on. We have used five mils, which is 1/20. So we have used 100 mg. Does that make sense to consider trying? I've got a shop. No, no one's gonna did anything. Yeah, so yeah, the fact you need to know here's 1% is 1 g and 100 mils, and that's something that's gonna be relevant to future calculation questions. And it's a fact they expect you to know in the exam. And then you just need to equate it down to what you've given. Uh, lovely. If there's any more questions on that when we have want to eat the next question. And I think some of the background noise might just because Easier even hasn't had time to leave work. So there was some little sorry, everyone, everyone. What makes Case? Three said Case three is Mr Jane's. He has a 25 year old male who has recently been described panel. There's recurrent mark grades, but he wasn't giving any GI information from his GP. He has no other regular medications and says he doesn't usually like taking tablets if he doesn't know how they work. So he asks for some advice about the common side effects of the panel. So which of these main, which of these is one of the main side effect is going to make you aware of so hypertension, palpitations, tremor, fatigue or heat intolerance? Okay, on, we'll stop all when you have two minutes. So you used to be enough. But if you don't know, just take a stab it. Yeah, yeah, I'm in terms of the previous questions on the chat. We will go through them at the end. So say about your question to the end as we both can't really keep up with the chance of very little. So 30 seconds left. Keep going to okay. Final stab, right. Nice. Like everyone. And I can't. Well, don't you be on those of you that part d the correct up to 30. So yes, that's one of the main side effects are common side effect off starting propranolol. And when in terms of hypertension, that's not usually a side effect and speedy upset, they can cause hypertension on palpitations as well. It doesn't tend to cause palpitation causes bradycardia on. It is often used to help treat palpitations and those for it's uncontrolled on again tremor. It's often used to help treat tremor on heat. Intolerance is not also not one of the most common side effects. Another common side effects worth noting. No nursing is abnormal. This country and also in males his age. We might want to come to a lot of rectal dysfunction something, but he would not be aware of it. So we'll defend basically that right onto the next. Great. So you want to question for this? One is about Mr Smith, who's a 56 year old man that presents to any with a two day history of nausea and vomiting. On examination, you find that he's drowsy and no orientated to time or place. He's got a background of high BP started on Perindopril 5 mg once a day last week. His blood counts show a normal white cell count, a normal hemoglobin, an elevated potassium at 5.7 and slightly elevated sodium, 148 on elevated urea 23 a craft in of 100 and 90 when his baseline is usually 65 on any Jaafar of 45 with his baseline being greater than 90 which other drug class could have caused this presentation? So we're assuming the perindopril has been the exacerbating factor for this change in his blood test. So his elevated captain So we, which other drug class could cause this calcium channel blockers, opiates and said's anti hypoglycemic So or macrolide antibiotics. Um, and we will watch the pole. Great. Guys. Could be Was in bit more confident with this answer. Got a minute left. But if you want answered before that, I'll stop the pole right? 15 seconds left. So for those who haven't answered, just pick one or go to have gotten picks. That answer, we'll go through it. Okay, Lovely. Say the majority of you got this answer, right? Um, it is unsaid. It's questions. See? So, um, answer. See? So So what this question was getting at is this gentleman has very recently been started on an ace inhibitor on, but as to have dramatically worsening renal function. So what we think about here is renal artery stenosis. So, in any patient, especially someone who's younger, who start on a sin, him bitter and the renal function deteriorates rapidly within the first couple of weeks of starting on it, you're thinking that it's renal lot. They might have another one of renal artery stenosis. Um, and that's because I ate inhibitors cause constriction of the effort arterials in the kidney. And so if they've already got, you know, artery stenosis going in, then they will have no hydrostatic pressure within the kidney on but just result in complete lack of America filtration and and said act in a similar way by inhibiting prostaglandins on day. What would have a similar effect on even if you didn't exactly pin this was renal artery stenosis probably would have realized inside. So basically something we stop in anyone with poor renal function on. But we'll just go back through the other answers and say why they're not the case, um, is accounting channel blockers they are kind of on associated with experiencing, you know, function. And don't have this link with the artery stenosis opiates you would. We would change your prescription of which type of opiate based on renal function. I think below immediate, far 30 or craft insurance of 30. You would use oxycodone rather than morphine, but it wouldn't cause this presentation on anti hypoglycemic, so it's very non specific. There's multiple different, multiple different drugs that cause, um, the for diabetics, and they don't all act on the kidney, so some of them would cause the worsening renal function is some wouldn't s Oh, that's too broad answer to be correct on macrolide antibiotics and wouldn't exacerbate renal artery stenosis. So you picked the That's clear white and says is the right answer, and we want to next. All right, So your question five Mr. W. Is an 89 year old gentleman who was seen in cardiology clinic for ongoing shortness of breath with the background of age defibrillation and congestive cardiac Sadia he started on spironolactone. What counsel should you give mister W prior to starting spironolactone? So this is targeting adverse drug reaction. This question. Are we advising him about tingling in the fingers or the hell need weekly blood tests from using things or that ckd two is the contraindications to this or that? Gynecomastia might be a side effect or if he should double his dose if he feels well, so have you get it that most people what? Even so I love people seem to want the whole toe only run for a minute because I yeah, they just wanna have bit more off time pressure, because I think yet you exile, you're at problem. So that's it seems to be a lot of people's wishes. If anyone doesn't want that, that just type in the chat off damn word watching how many people are ring and even at two minutes know everyone's answered. So we're happy to shorten the time. But actually, we watching how people answer the question. So if we cut it short, I think quite a lot of the questions. That would mean 100 people haven't answered. You know, there may be some really keen people who are being really quick, which is great, but I want to make sure that everyone gets ago not answering the questions. If people really keen, then say, But we're watching how many people answer in a short period of time? So we'll we'll finish it when the majority of aunts that if that's okay, everyone. So just over half a minute left, let's try to everyone has many swings possible. Yeah. No. Yeah. Yeah. Okay. Last time. Seconds. Yeah. Okay, great. We'll stop the fall. Okay, So that was the majority of you that got that right. So D gynecomastia is a side effect. So spironolactone is one of the few medications. He's a heart failure that can both be give a prognostic element. So actually, compositely prolong life expectancy in patients with heart failure. But Also, it's really good at controlling symptoms as well, so the shortness of breath will be helped by it. Spironolactone. So one of the side effects you do counsel your patient male patients office. Actually, gynecomastia, it's a side effect of this is because it acts on the middle. Of course. Well, so it's yet wanting to monitor on day one important thing and a question he has very question. Be saying that you would need weekly blood test easily, so the monitoring requirements it doesn't have to be weekly. We want to be monitoring the electrolytes because spironolactone is potassium sparing. We want to make sure that we're not causing hyper clean you in these patients on. If you do notice this, it's really to stop it so you'd start it. You wanted to the testing of the craft in in particularly one week after starting on after any dose increase on. You also don't want to do it monthly for the first three months and then every three months for a year, and then every six months, it out on the B enough as a monitoring requirement. Back on. Tingling in the fingers is not a side effect on this medication on. We've talked about how many How often evening with blood tests on CKD. So chronic kidney disease, too, is not necessarily contraindications. Obviously, if they haven't keep an acute kidney injury with Hyperkalemic, possibly that's one will be stopping it. But it's not an absolute contraindication. On day. When you're feeling unwell, use double your dose. That tends to be, um, in two feral to steroids, usually not disbarred. A laxative the world unto there majority of you got the answer. Correct for D that next one. I see your commencement chap, guys, if we'll put it down to a minute and a half just to try and make sure some people people who are answering quick, little bit more time, have bit more time pressure but don't want to stop people that just still getting into the swing of it from having ago the questions. Okay, six. Ms Agua, 74 year old lady, is an impatient being treated supportively for gastroenteritis. Her electrolytes have now normalized on her daily bloods on on the water, and she reports that nausea is improved, but she feels actually seizing up. She got past medical history of iron deficiency, anemia, Parkinson's and high BP. Which of the blame medications is responsible for what she is describing? Her first fumarate tablets. The metoclopramide paracetamol on dansetron or codeine and will be launched the pole. And if you have a minute and a half now, we'll give you a bit more time pressure. It's just about hopefully through in about half of the advance. It you 30 seconds left. Everyone okay? 10 seconds. If you're not. Sure. Just guess. Lovely. And what ended that in majority? If you got this one writes, um, Theanti is metoclopramide. Um and this is just to kind of emphasize which medications you should be careful with in Parkinson's disease. Eso Anything that accident dopamine antagonist is going to exacerbate someone's parkinsonian symptoms. So that would be your metoclopramide and your haloperidol. Don Paradorn is a dopamine agonist, but it doesn't antagonist but doesn't cross the blood brain barrier. So isn't contraindicated so looking at the other options that are on the list? First being raped the most likely side effects you'd have from this would be constipation or the eye symptoms paracetamol, unusually cold causes really any side effects to be honest on down. Citron also causes constipation. Doesn't have any action. It's, um, doesn't have any action on the dopamine pathways. So isn't contraindicated in Parkinson's on codeine? Um, the most common side, the base common thing and get on with codeine is that is, that is not effective in pain relief for patients. Um, so this question was getting at unexamined a shin of her parkinsonian symptoms on it's surprisingly common health. And this happens on the ward. You want to that question? Okay, so Ms is J is a night three year old lady who was admitted artery full with an unsafe swallow on a past medical history of hypertension. Skin it. Heart disease, F C E osteoarthritis on Parkinson's use passenger so nobody to check. And she also has type two diabetes on below. You can see quite extensive list off her inpatient medications, and this is something we'll see a lot of polypharmacy in the elderly care patients on. Do we want to look little bit inter what contributed her fall and maybe what medications we cut down the stock there are necessary, but which is the following drugs? Do we think could have contributed to her for so a ramipril be, um a lot of pain. CMA treachery. D doxaz is, um, or he ordered the above. And you got a minute a half of this? No. Okay, say 30 seconds left last 10 seconds. Okay. And I saw you guys say, well done to the door to me, that it got all of the above. That is the correct answer. So on the next. So we've just got a nest of the common medications that can cause falls. So ConEd magics, anti hypertensives, neuropathic pain killers, opioids on diuretics and all cause falls in one way or the other. So if we go back to the last slide will have a little less medication she's on. So she's on number off antihypertensive that can cause falls by lowering the BP. And after what you know, it's around. Really care patients. Is that often with the a number of hypertensive on track sent to their own, they can get something called a postural drop. So when they stand up, I get dizzy, and this contribute to the falls. She's also when I'm a trip to them, which is a tricyclic antidepressant to use for pain, particularly your perfect pain from this can cause. Drowsiness and sedation contribute as well on doxazosin as well. Contribute Teo uh, and hypertension because it could change your BP is well, it's also worth noting that she's on this ridiculous patch for her. A new body dementia, which can cause amongst a number of side effects. It can cause drowsiness on dizziness as well. It's also worth know, saying that some Parkinson's meditation medications can cause behavior changes as well. So that's worth looking out for. But when the risk with the elderly care patients is that there are a number of medications to help deal with a number of comorbidities. But because you have so many, you're going to get quite a few interactions with these s. So it's really worth kind of looking at a drug chart and just making sure does she need to be on all of these medications or less? Some things that we could possibly modify? Okay, well, don't today's to go that correct. Great. So I'm moving on to a question. Eight. Mister Christie is a 23 year old man who presents hospital with exacerbation of his asthma. His symptoms of now improved of back to backs, albuterol, nebulizers and steroids. The respiratory consultant commences Mister Christie on 200 mg of theophylline modified release twice a day. What are the monitoring requirements that Mister Christie needs? Does he need a level 4 to 6 hours after the first dose? A three days after the first dose. 2 to 4 hours after mission. Five days off the first dose, 4 to 6 hours after the administration. Or five days after first days. 4 to 6 hours after administration. Or does he not need anyone? Train it'll and say, this will be a question. You always definitely need to check in to be enough. Okay, 30 seconds left, everyone 10 seconds. Just give it a guess. If you're not sure, No. Okay, So d was the correct answer. This is unlikely to be something you have. No, no. Stop your head on. It's definitely not something on earth talking mind. So this, like, just showed where you find it in the online B N f. So it will be if you're looking on the drug side of the B n f. And looking up, the offline will be under the monitoring requirements section. on it, says he as a whole. I didn't read that. After five days of starting the old treatment, you'll need Teo. Check a level and you need to on the level we need to be taken 4 to 6 hours after the orders. And so, with the monitoring requirements question, It's good to just getting quicker, flicking to how you find that for each drug on specifically and and obviously the reason the other answers a wrong. This extent on what it says in the VNS is not really much to add There on Ready for next question. Evening. Yes, so we got ms. Is why there's a 67 year old lady admitted to any with some on that chest pain. Particularly worse, um, breathing in. She has a pass out of history of breast cancer or high production. You doing ABG on rematch? And these are your your findings that you see below. So pH is 7.46 p 29.1 PCO to be absolutely zero is four on by Communist 23 also of note that she has a recent you know, natural next one in which the GP put down to start in on multiple races. So based on these findings on what you think she may have rich of the other medications would you use to treat this? Is she And you said that's talked to Paul? Yeah. So a woman it left. Okay. Seconds. Okay. Want done for the day. So well done to the 45 70 that got that right. The questions is see a picks it up. So recent changes to the guidelines are showing that actually first line now for a venous window embolic event. So given the history that we've got here, it's very in keeping with a p e. So she's got risk factors of a history of breast cancer. Her, uh, a GI, that's where and clinical signs of a DVT. This, you know, actually, leg swelling that you had on If we were to look at the well school, she's probably got a score of a before. So this would say that P is likely her 80 do shows that she's in type one respiratory failure. So she has a low oxygen on also low, low, too likely due to the fact she's probably hypoventilating breathe off that they see it, too, that she's got here. So from the history that they got which routine pee on out of those choice there apixaban is the correct because it is a dock on the VNF will show that 10 mg twice day for seven days is the first the first line treatment for a peepee. You can also consider using at, uh, liver expert on or another doc on the juicing again. You can find them to be enough so you'd start fixed on 10 mg twice a day and then you to reduce it down off to seven days. I think it's too far. I've met grounds twice a day. You wouldn't give aspirin and Plavix because that would be the treatment for ski in prevent, such as heart attack or stroke. A Nox parent. The dose there. Obviously, it's weight bending, but that seems to be more in keeping with a prophylactic dose. Apixaban is the correct answer. Their old place would be used as normalizes, possibly if we're thinking this was a massive period, but it what it is. A very first treatment here on apixaban 2.5 mg is not the correct dose that would be probably a prophylactic dose. So well done, Teo. Those you've got that correct on. But it's also worth considering in patients that present with a p the length of treatment that she's going to need to be on this four. So given that she's got a history of breast cancer, we're considering this is most likely to be a provoked be so it would be likely that continuing this treatment fair three months. Sorry. At least three months, 36 months cause she's active cancer on if there was another provoked core. Such is inability, always surgery. It would be three months, but it's always left checking with your chemo. Tolentino your hospital on, possibly referring to Anticoagulations Clinic just to decide. Then, like the treatment, it wasn't the basic all that correct on. I haven't been able to see the chat nesters that will look into the questions that end. Okay, great. When next we'll move on. Teo Case 10. 12 questions, guys. Nearly there. Mr. Ahmed, He's a 66 year old gentleman with Intraabdominal Septus secondary to conservatively manage bowel perforation. He is on amoxicillin metronidazole on gentamicin, and he was given his first dose of gentamicin and any, but the dose has not been recorded. So you go and ask the nurse you gave the gentamicin and she tells you she gave 125 mills of gentamicin, which the concentration is 360 mg in 120 mils. So you're trying to record this on the drug chart to make you aware of what the dose was? How many milligrams of gentamicin was given give you a minute and a half. You're 30 seconds left. Yeah. Okay. Last five seconds. So just guess if you're not sure. Great. So a lot of you've got that quite quickly, which is good, because looking at these answers, there is only there was only one option which actually gave you more than 360 mg. And, you know, it was more than 120 mils. So it was quite you didn't even really need to. The calculation here. You could have ruled out rest of the answers, but we're going to have to work out. And so you know that there's a hunt 360 mills in 103 100 of my grounds in 100 20 mL. So if you just arrived. 361 120. You can work out the concentration, which is 3 mg in one mil on. Then you can times that by 125 because you get No. 125. Mills is given, and that works out. But 375 hatefully. That is clear. But like I said on this question, just given the other options that were here and the only answer which was greater than 360 Mills three hundred's my grands was your 375. So could have been a quick one just to stop up without property. Work out great. We want to continually nearly the guys say Question 11 Ms S is a 92 year old lady. It was a mission with a 44 to be secretary hydration. These that have blood on admission. So have a lesson that those and the range is that given on. But once we've seen those results were slightly worried by some of those. And we ask for the c g to be done. So I have another glass of those bloods that will show you the CD that came back. Yeah, All right. Okay. Easy. G is on the next Clyde. Oh, didn't take me very t e c j A little art. Have a little bit of time. Just did it come in type of this dcj on. So if there's any problem, okay? And we'll go on to the next side of the questions on. So I've kind I did this one because it was the fact that I was quite worried about on following those e c t changes. That's what I'm focusing in on on this question on what is the true Which one of you sorry is the treatment for the first line treatment to help reduce the potassium. But we can see here or right? Just a little bit of a tricky question, as it's asking for something specific. So a is It's a beautiful nebulizers. Be custom beautiful to see customers any, um d x ray pid or if you're a night, you have a minute. Just understand? No. Okay. Just have 30 seconds left. What? Oh, what? Okay. Yeah. Oh, okay. Well, let's stop it there. So it was a bit of a tricky question, and it was the way that I worked that the answers actually D on, but I specifically asked what the first line treatment would be to lower the chassis. Um, so actually, there's a really good something. A treatment summary on the Vienna, the management of high penia. And it comes under fluid and electrolytes. So it's not exactly very easy to far into that that is where you'd look. I think I touching had communion. It came up with that to see if we just go back to the previous answers, so we'll go through each one. So salbutamol nebulizers yes, that can help to reduce the potassium in the blood. However, it's not first line, and it's not actually in vice. It's to try to be enough to be used. Be causing gluconate is correct in the sense that it's cardio protective. So with those easy GI changes on with the potassium that high, it would be a severe hyper community. A on. We would also watch you getting calcium brutally, but it's not actually gonna help to reduce the potassium. It's going to protect the heart and prevent any further damage. Housing resilient is also an option that for later on, and it can help to reduce the Testim. It's not first line 5 to 10 units of acts rapid in 15 minutes later. Glucose is the correct answer. This on that is recommended in the month of May Be enough at first. Mine is actually yes, I guess hypokalemia is a side effect, but it is not used to treat type coming here. So tricky question, but well done, Teo, Give that. Yes, it is really important, obviously, to give casting blue plate at that time. Given those easy to changes that you see that all tend to be weight. However, it's not going to produce the calcium. Okay, great last question, guys. And then there's a lot of questions about how to navigate to be enough. So we'll get through that afterwards. Um, Mrs be a 60 year old lady who has a high quality vascular score in the next 10 years of the qs they do in GP. So her GP wants to start her on stem simvastatin 10 mg once a day before prescribing this medication. What blood tests? Should you check? We will launch the pole now. Yeah, Fab. The other half of you answered. So let's see if we can get all of the aunts 10 before a minute. Great, guys, 10 seconds. You will know the answer. This is in your head. It's just go to go. So what? You guys responded quickly that so I just can't tell your majority that would write. The answer is LFTs. And so this is the kind of classic monitoring situation off getting a baseline for your liver function test to check before starting, I thought had an extract that I don't to check before starting about the risk off. Oh, complete for the word. So the biggest risk of myalgias and developing kind of complications Secondary to that. Just go on the website for my head. Oh, just kept the edge. And shall we go through some VNF stuff and then I will make my answer bit more coherent because I've just complete loss of dreadful uh, let me stop showing my screen and I will share the B n f page. And if you want current, I can read out. The question is, if you get it takes on, if I don't if you could see the chat same time I read through the questions. Just got to be enough not sharing the screen again. You got to see the be enough for my face. Yeah. Okay, so there's a lot of questions that have to navigate the B N f. The one thing we could flags. Well, we can practice in this session kind of using it to answer questions. But I'd really recommend you spend some time looking at how to work the be enough yourself, cause we you kind of get to know where you find your common answers. And as we found with the question about the hyperkalemic, uh, is not always the most obvious thing. You search to find the treatment summaries. So we talked before about how it's been in three sections. You've got drugs specifically. So when were asking about drug monitoring? So say, for our theophylline question, you click on the drug monitoring your in tea and find your theophylline here, and then all of them have these same sections on any of the monitoring requirements questions. You just go straight to the monitoring requirements here, and it'll be the same for kind of side effects or for the kind of common dose in times. And what dose is you give for adults and Children, then going back to that same first page of hard to navigate interactions. To be honest, doesn't really come up that much in the exams. We won't go through those, but the treatment summaries Um, this is where it gets harder to navigate quickly. Obviously, a drug name when you search the drug name will be what comes up for this as we found like with the fluid and electrolytes with the electrolyte question, If you search hyperkalemic A, this won't necessarily come up, so you might just need to get familiar with things that seem to commonly come up, which are fluid and electrolytes. Things like eye on our monitoring come, come up, comes up a lot. So it's just worth spending a little bit of time familiarizing yourself with this page of treatment summaries and what you need to look at. So you're not going to search stemi. You're going to search acute coronary syndrome, for example, this is worth You're spending a little bit of time to memorize it yourself, with how to quickly find the one that you need on Dwell were on that page. Actually, someone's just put up a question saying, Really struggling to find the drugs, to prescribe contraception on HRT. And actually in that page, I think I need a contraception I just saw earlier. Except it's hormonal, as you can see there, that's again on the summary, and it will give you a little bit of an overview that so it's just less being a little bit more familiar with those which common. Yeah, definitely. We just have it. Have a little look through guys and just become more familiar cause we can practice you looking them up. But we can kind of give you the knowledge of hard to navigate it, so hopefully showing you the way it looks has been a bit more helpful. Um, and like I said, using the online version slightly more clunky than using the app So definitely worth practicing on the online, not the app, um, things like analgesia. Six. Um, that's quite good. There's a, um, there's a whole section, I think, for palliative medications on here and postop analgesia and things. So it's, um yeah, just the minerals yourself with that would be my advice for going forward. Is that any more questions popping up on the chart be enough in the jar? Yes, monitor your electrolytes when using base. There's one good question that's just popped up is what's the best way to use the Mirena online or coming Use the phone. I'd recommend getting similar with the online online version, because that's what technically you'll have access to through the platform. I don't think you're allowed to use your phone in there. Yeah, exactly. It's like driving test. If you're practicing for the exam, practices you this. If you want something real life I would usually on, even though, even though it might sound of, it's a little also practices in the calculator on there because, like I say is like different one. So just do it as if you're doing the actual exam and they're good remark exams as well on the pier. So family's from practice before hand, just to get from any witnesses, someone else that you want to train Asian hip hurts. So I think this is often GPS will do it within the first couple of weeks. I understand that I have not given a specific time frame, just a fly with these questions that come up in the PS a If if it's not clear in the be NF about the monitoring, they won't ask you about the monitoring, so don't ever think it. But for real life, you normally check it within the first two weeks to a month unless you're worried someone was high risk. But just in practice doesn't always a formal question on any benefit between using the B N F four meds and complete. This is a personal preference. I used to be an actress because it was what I was more used to. But if you're more useful medicines complete, go with what your most familiar with their have a play along with both. Another path. Um, I'm do what you find Easiest quickest recommend. Great. Anyone else going to burning questions? Or would you like to go and have dinner someone else About what? Using rough paper to work out? I don't know what you're not taking six out, and I can't see why that would be an issue. Um, just have some plain paper, uh, great. And thanks everyone. There's not any more questions. I don't think so. The past, the resource, it's a textbook. You just have to look up. I think there's some pdf copies which go around every year illegally. But it is something you take out the library. Okay. Tune into tomorrow. Stroke. Well, how do I stop? Great. Please fill out some feedback as well. Okay. Yeah, you go. I'm just done a paste. That one last time. Please, just spend two minutes on the the back wall. Right? Guys, I'm going to go see, actually, Sancti V. I will see, but try. You know I see. Tomorrow. Take that.