17/11/21 Flashcards
Oral anitbiotic choices for treatment of acne.
- Doxycycline 50-100mg orally, once daily for 6 weeks, then review
ECG Changes in pericarditis (1 main point + 2 bonus)
- Widespread CONCAVE ST Elevation and PR depression throughout most of the limb-leads (I,II, aVL, aVF) and precordial leads (V2-6)
- Reciprocal ST depression and PR elevation in lead aVR
- Sinus tachycardia due to pain and/or pericardial effusion
Clinical Features associated with cardiac tamponade (3 main)
- Beck’s Triad → muffled heart sounds, elevated JVP, hypotension
Non-Pharmacological Options for management of insomnia.
- CBT including sleep hygeine/education
- Brief behavioural therapy
- Exercises
Specific Sleep Hygeine advice (5 points)
Sleep-Wake Activity Regulation
- Avoid lying in bed for extended periods of time worrying about sleeping → if cannot sleep for 20mins then get up, do something relaxing and return to bed when sleepy
- Avoid oversleeping + napping during the day
- Regularity of schedule → get up at the same time each day
Sleep Setting and Influences
- Regular Exercise but not vigourous within 3 hours of bedtime
- Do not have electronic devices in the bedroom + avoid exposure to bright light from late evening onwards
- Avoid stressful ruminations before or at bedtime → plan for this earlier in the day.
- Avoid caffeine after midday
- Reduce/Avoid Alcohol Intake + Tobacco Intake + Illicit Drugs
Sleep-promoting Adjuvants
- light snack or warm drink before bed
- warm bath or shower before bed
Difference between gestational hypertension and pre-eclampsia?
Both are diagnosed after 20/40.
Gestational hypertension does not ahve all the liver, renal, thrombocytopenia, urine acr, neuro and pulmonary changes or preeclampsia.
What is chronic (preexisting) hypertension in pregnancy?
- Hypertension diagnosed or present before pregnancy or before 20/40 gestation
1st line and 2nd line medications for treatment hypertension in pregnancy? (be specific)
- First Line → Methyldopa or Labetalol
- Methydopa 250-750mg TDS
- Labetalol 100-400mg TDS
- Second Line → Nifedipine, Hydralazine or Prasozin
- Nifedipine Sustained Release 20-40mg daily
- Hydralazine 25-50mg TDS
- Prazosin 0.5-5mg TDS
Which anti-hypertensive can you not use in pregnancy?
- ACE inhibitors are contraindicated in pregnancy → use as been associated with fetal death and neonatal renal failure
Diagnosis of chronic bacterial prostatitis
Diagnosis → comparing leucocyte count and the results of the pre- with post-prostatic massage urine samples - 2 glass test
Treatment of Chronic Bacterial Prostatitis?
- ciprofloxacin 500mg PO, BD for 4 weeks
2. OR Norfloxacin 400mg PO for 4 weeks
If no evidence of bacterial prostiatitis and still having prostatic symptoms, what is our diagnosis?
If no evidence of bacterial prostatitis → chronic (nonbacterial) prostatitis or chronic pelvic pain syndrome → no need for ABx and treatment is symptomatic
Diagnostic Criteria of Kawasaki Disease (5 points)
- Bilateral non-exudative conjunctivitis
- Polymorphous rash
- Cervical lymphadenopathy (at least 1 lymph node >1.5cm in diameter)
- Mucositis → cracked lips, injected pharynx, strawberry tongue
- Extremity Changes - erythema of palm/soles, oedema of hands/feet (acute phase), and periungal desquamation (convalescent phase)
Causes of Nappy Rash (5)
**Common** Irritant Dermatitis Candidiasis Seborrhoiec Dermatitis Psoriasis Milaria Atopic Dermatitis **Uncommon** Staphylococcal Infection Strep Vulvovaginitis Perineal Dermatitis Herpes Simplex Allergic Contact Dermatitis **Rare** Kawasaki Disease Tinea
Treatment of Kawasaki Disease
- Intravenous Immunoglobulin (IVIg) 2g/kg intravenously, as a single slow infusion over 10 to 12 hours
- methyprednisolone sodium succinate 30mg/kg up to 1000mg intravenously, over 1 hour, daily for up to 3 consecutive days
- aspirin 3 to 5mg/kg PO daily