7/3

Question 1

What is important to note about UTI management of men?

Answer 1

They all must have MSSU (mid-stream sample urine)

Question 2

UTI management
- men
- women
- pregnant

Answer 2

Men
urine sample + 7 day ABx

Women
- nitriites present but mild symptoms -> self care + back-up prescription
- nitrites present but severe symptoms -> 3 days ABx

Pregnant
1st and 2nd trimester - nitrofuratonin
3rd trimester - trimethoprim

TRI = 3 = third trimester

Question 3

IQ cut off for mild intellectual disability?

Answer 3

70

Question 4

What is Russell’s sign?

Answer 4

Callous formation on people’s knuckles due to sticking fingers down throat - can be seen in bulimia

Question 5

What complementary medicine can predispose serotonin syndrome?

What is serotonin syndrome?

How does it compare to neuroleptic malignant syndrome?

How is it managed?

Answer 5

St John’s wort (can be used to treat mild to moderate depression)

Serotonin syndrome occurs by SSRIs, ecstasy

Neuroleptic malignant syndrome caused by antipsychotics

They both
- tachycardia, hypertension
- pyrexia, diaphoresis (sweating)
- rigidity
- confusion
- NEED IV fluids and benzos

Serotonin
- fast onset
- increased reflexes and clonus and dilated pupils (think someone of Eccies)

Neuolpetic malignant
- slower onset
- reduced reflexes, LEAD-PIPE rigidity

Question 6

What is the most definite management of aortic stenosis?

Answer 6

Valve replacement

OR balloon valvuloplasty if unfit for replacemetn

Question 7

What has to be done with ALL post-tonsillectomy haemorrhages (however small)?

Answer 7

Still in hospital within 48? hrs - back to surgery

In community - immediate referral to ENT