Common Mx

Question 1

Cellulitis (w/ systemic features)

Answer 1

Flucloxacillin

Clarithromycin for pen-allergic

Question 2

Narrow complex regular tachycardia

Answer 2

1. Vagal manoeuvre

2. Adenosine

Question 3

Chronic COPD

Answer 3

1. SABA or SAMA
2. LABA + LAMA (If no asthmatic features), or
   LABA + ICS (if asthmatic features/features suggesting steroid responsiveness)
3. LABA + LAMA + ICS

Short acting beta agonist (SABA): Salbutamol
Short acting muscarinic antagonist (SAMA): Ipratroprium
Long acting beta agonist (LABA): Salmeterol
Long acting muscarinic antagonist (LAMA): Tiotropium
Inhaled corticosteroid (ICS): Fluticasone

Question 4

Chronic HF (with reduced ejection fraction)

Answer 4

ACEi and BB
(ARB if ACEi intolerant)

ACEis= ramipril, lisinopril
BB= bisoprolol, atenolol

Question 5

Renal/ureteric colic

Answer 5

NSAIDs

Question 6

Tonsillitis

Answer 6

Phenoxymethylpenicillin

Question 7

Dermatitis

Answer 7

Mild
1. Mild topical steroid (1% hydrocortisone cream) + emollients

Moderate
2. Moderate topical steroid (0.05% clobetasone butyrate or 0.025% betamethasone valerate) + emollient

Severe
3. Potent topical steroid (0.1% betamethasone valerate)

Question 8

Dog/cat/human bite

Answer 8

Co-amoxiclav

Question 9

Ocular herpes simplex virus

- dendritic ulcer

Answer 9

Aciclovir or ganciclovir

Question 10

Pneumocystis pneumonia

Answer 10

Co-trimoxazole

Question 11

Osteoarthritis

Answer 11

1. Paracetamol
2. Paracetamol + topical NSAID
3. Paracetamol + oral NSAIDs/ weak opioids

Question 12

Otitis media

Answer 12

(1. Regular paracetamol + ibuprofen)

2. Amoxicillin

Question 13

Pityriasis versicolour

dyspigmentation + hyperpigmentation

Answer 13

Ketoconazole

Question 14

Bell’s palsy

one sided facial drooping + recent viral illness

Answer 14

1. Oral steroids (if presenting within 72h syx onset)

2. ±Antivirals (alongside steroids)

Question 15

Hypercalcaemia

Answer 15

1. IV Fluids (4-6L over 24h)

2. Bisphosphonates (once pt adequately hydrated)

Question 16

Chronic asthma

Answer 16

1. SABA
2. SABA + ICS
3. SABA + ICS + LTRA
4. LABA + ICS ± LTRA
5. MART ± LTRA
6. MART (high dose ICS) ± LTRA

SABA= short acting beta2-agonist (Salbutamol)
ICS = Inhaled corticosteroid (fluticasone, beclomethasone)
LTRA= leukotrienece receptor antagonist (montelukast)
MART= LABA + ICS

Question 17

Broad complex regular tachycardia

Answer 17

If ventricular tachy (VT)
1. Amiodarone

If known SVT with BBB
- treat as narrow complex tachy (adenosine)

Question 18

Torsade de Pointes

QT prolongation

Answer 18

Magnesium sulphate

Question 19

Lyme disease / borrelia burgdorferi (erythema migrans)

Answer 19

Doxycycline

Question 20

Bacterial vaginosis

Answer 20

Topical or oral metronidazole

Question 21

Adrenal insufficiency

Hyponatraemia + hyperkalaemia

Answer 21

1. IV fluid resus

2. Corticosteroid (hydrocortisone - PO, unless adrenal crisis [quick deterioration <48h] IM or IV )

Question 22

Dementia

Answer 22

1. ACh-esterase inhibitor (donepezil, galantamine, rivastigmine)
2. Memantine
   (If Ach-est i intolerant, or severe AD)

Question 23

Mastitis/breast abscess

Answer 23

Fluclox

Question 24

Refeeding syndrome 
(Often parenteral nutr + derranged electrolytes)

Answer 24

1. Phosphate polyfusor

Important to deal w Phosphate first!!