1 January Flashcards
What is the management of molluscum contagiosum?
Normally advice and reassurance
- normally resolves within 12-18 months
Can use Modullab- potassium hydroxide
- used BD until lesions become inflammed- normally 5 days
- if no inflammation by day 14 then stop treatment
Cryrotherapy for adults and older children
Curettage for uncertain large lesions
What are features of nasal polyps?
Nasal obstruction
Loss of sense of smell
Discoloured nasal discharge or post nasal drip
Facial congestion/pressure
What are features of sick euthyroid syndrome?
Low T4/T3 but normal TSH
Seriously ill patients
No signs of hypothyroidism
What are features of cluster headaches?
Intense unilateral, around 1 eye
Will have lacrimation from eye, nasal congestion, conjunctival injection, miosis, ptosis
Headache does not last long but are frequent
Acute
- oxygen
- sumatriptan
Prophylaxis
-prednisolone
- verapamil
What drugs cause Lichen planus?
ACEi
NSAIDS
Methyldopa
Chloroquine
Oral anti-diabetics
Thiazide
Gold
What are features of malignant breast lumps?
Hard
Painless
Irregular margins
Fixation to skin or chest wall
Skin dimpling
Discharge- unilateral, can be bloody
Nipple retraction
What are indications of DEXA bone scan?
Patient <75 with previous low trauma fracture
XR finding of vertebral collapse or osteopenia
Post menopausal women with FH of hip fracture
Low BMI <19
Long term steroid use
Oestrogen deficiency
What are features of chronic supparative otitis media?
Ear discharge >2 weeks with no pain or fever
Painless ear examination with evidence of tympanic membrane perforation
What is the correlation between GCS and AVPU?
Alert =15 GCS
Voice = 12 GCS
Pain = 8 GCS
Unresponsive = 3 GCS
What is the management of hyperemesis gravidarum?
Simple measures
- rest/ avoid triggers
- bland food in morning
1st Line meds
1) antihistamines e.g. cyclizine/ promethazine
2) Phenothiazines e.g. prochlorperazine
2nd line medications
1) Oral ondansetron
2) Short term oral metoclopramide
What is the triad for Hyperemesis gravidarum diagnosis?
5% pre pregnancy weight loss
Electrolyte derangement
Dehydration e.g. ketouria
What are features of marcus gunn pupil?
Affected pupil will not constrict to light
When light shone in unaffected pupil affect pupil will constrict
If affected pupil has light shown in eye immediately after both pupils will dilate
What is the management of pelvic inflammatory disease?
1) IM ceftriaxone stat + PO doxycycline and metronidazole for 14 days
2) PO oflaxacin and metronidazole
What markers would show acute Hep B infection?
HBsAg positive
Anti Hbc IgM positive
HBV DNA positive
What are features of chronic active Hep B infection?
HBsAg positive
HBeAg positive
Anti-HBc IgG positive
