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Miscellaneous > Lines + Conditions > Flashcards

Lines + Conditions Flashcards

1
Q

Acute porphyrias

A

Haem arginate

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2
Q

Adrenal insufficiency

A

Hydrocortisone (similar to cortisol)

Fludrocortisone (for aldosterone deficiency)

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3
Q

Adrenal insufficiency sick day rules

A

Double dose of hydrocortisone

In severe consider IM or IV hydrocortisone

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4
Q

Adrenal crisis

A

Hydrocortisone

Rehydration using sodium chloride 0.9%

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5
Q

Dry macular degeneration

A

Smoking cessation
Counselling and support
Visual aids

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6
Q

Wet macular degeneration 1st line

A

Anti VEGF (aflibercept, ranibizumab or bevacizumab)

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7
Q

Wet macular degeneration 2nd line

A

Add photodynamic therapy

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8
Q

Alcohol withdrawal symptoms

A

Chlordiazepoxide or diazepam

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9
Q

Delirium tremens 1st line

A

Oral lorazepam

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10
Q

Delirium tremens 2nd line

A

Parenteral lorazepam or haloperidol

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11
Q

Alcohol dependence 1st line/mild

A

CBT

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12
Q

Alcohol dependence 2nd line/want pharmacological treatment

A

Acamprosate calcium or oral naltrexone hydrochloride

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13
Q

Alcohol dependence 3rd line

A

Disulfiram

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14
Q

Wernickes encephalopathy

A

Thiamine

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15
Q

Preventer of sickle cell acute chest syndrome, reducer of painful crises and reducer transfusion requirements

A

Hydroxycarbamide

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16
Q

Acute anal fissure (<6 wks) 1st line

A

Bulk forming laxatives e.g. ispaghula husk

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17
Q

Acute anal fissure (<6 wks) 2nd line

A

Osmotic laxative e.g. lactulose

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18
Q

Acute anal fissure (<6 wks) prolonged burning pain following defecation

A

Topical local anaesthetic e.g. lidocaine

Simple analgesia

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19
Q

Chronic anal fissure (>6 wks) 1st line

A

Glyceryl trinitrate rectal ointment

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20
Q

Chronic anal fissure (>6 wks) 2nd line

A

Refer to specialist for local injection of botulinum toxin type A

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21
Q

Chronic anal fissure (>6 wks) 3rd line

A

Surgery

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22
Q

Anthrax treatment

A

Ciprofloxacin or doxycycline (>12 yrs) + 1 or 2 of

  • benzylpenicillin
  • clindamycin
  • rifampicin
  • vancomycin
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23
Q

Anthrax post exposure prophylaxis

A

Ciprofloxacin, doxycycline or amoxicillin

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24
Q

Acute AF + haemodynamic instability

A

Emergency electrical cardioversion

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25
Q

Acute AF + >48 hrs or onset uncertain

A

Rate control

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26
Q

Urgent rate control in AF

A

IV beta blocker

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27
Q

Rate control AF other

A

Calcium channel blockers e.g. verapamil (LVEF >40%, avoid of acute HF)
Digoxin

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28
Q

Pharmacological cardioversion in AF - no structural or IHD present

A

Flecainide

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29
Q

Pharmacological cardioversion in AF - structural or IHD present

A

Amiodarone

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30
Q

When can electrical cardioversion be done in AF

A

Delay until patient has been anticoagulated for >3 wks

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31
Q

Drugs to maintain sinus rhythm in AF 1st line

A

Beta blockers

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32
Q

Drugs to maintain sinus rhythm in AF 2nd line following cardioversion

A

Dronedarone

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33
Q

Drugs to maintain sinus rhythm in AF - coexisting HF

A

Amiodarone

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34
Q

Paroxysmal supra ventricular tachycardia 1st line

A

Vagal manoeuvres

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35
Q

Paroxysmal supra ventricular tachycardia 2nd line

A

IV adenosine

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36
Q

Paroxysmal supra ventricular tachycardia 3rd line

A

IV verapamil (CI if on beta blockers)

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37
Q

Paroxysmal supra ventricular tachycardia + haemodynamically unstable

A

Direct current cardioversion

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38
Q

Bradycardia 1st line

A

IV atropine

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39
Q

Bradycardia 2nd line

A

Adrenaline/epinephrine

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40
Q

Pulseless ventricular tachycardia or ventricular fibrillation

A

Resuscitation

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41
Q

Sustained VT + harmodynamically unstable

A

Direct current cardioversion

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42
Q

Sustained VT

A

Amiodarone

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43
Q

Non sustained VT

A

Beta blocker

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44
Q

Torsade de pointes

A

IV magnesium sulfate

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45
Q

ADHD

A

Methylphenidate

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46
Q

Septicaemia (community) 1st line

A

Piperacillin w/ taxobactam or cefuroxime

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47
Q

Septicaemia (community) + MRSA

A

Add vancomycin or teicoplanin

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48
Q

Septicaemia (community) + anaerobic infection

A

Add metronidazole to broad spectrum cephalosporin

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49
Q

Septicaemia (community) + other resistant organism

A

Meropenem

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50
Q

Septicaemia (hospital) 1st line

A

Piperacillin w/ tazobactam, ceftazidime or meropenem

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51
Q

Septicaemia (hospital) + MRSA

A

Add vancomycin or teicoplanin

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52
Q

Septicaemia (hospital) + anaerobic

A

Add metronidazole to broad spectrum cephalosporin

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53
Q

Meningococcal septicaemia 1st line

A

Benzylpenicillin or cefotaxime or ceftriaxone

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54
Q

Meningococcal septicaemia + can’t have other drugs

A

Chloramphenicol

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55
Q

HER2 +ve breast cancer

A

Trastuzumab (herceptin) and pertuzumab

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56
Q

Oestrogen receptor +ve breast cancer

A

Tamoxifen

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57
Q

Post menopausal women ER +ve breast cancer

A

Anastrozole

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58
Q

Severe acute hypocalcaemia or hypocalcaemic tetany

A

Slow IV calcium gluconate 10%

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59
Q

Severe hypercalcaemia 1st line

A

IV sodium chloride 0.9%

Stop thiazides + vit D compounds

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60
Q

Severe hypercalcaemia 2nd line

A

Pamidronate disodium (bisphosphonate)

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61
Q

Hypercalcaemia from malignancy

A

Calcitonin

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62
Q

Hypercalciuria

A

Increase fluid intake

Bendroflumethiazide

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63
Q

SAH

A

Nimodipine

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64
Q

Native valve endocarditis - blind

A

Amoxicillin +/- gentamicin

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65
Q

Native valve endocarditis, penicillin allergic or MRSA or severe sepsis - blind

A

Vancomycin + gentamicin

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66
Q

Native valve endocarditis, severe sepsis w/ gram -ve - blind

A

Vancomycin + meropenem

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67
Q

Prosthetic valve endocarditis - blind

A

Vancomycin + rifampicin + gentamicin

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68
Q

Native valve endocarditis staphylococci

A

Flucloxacillin >4 wks

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69
Q

Native valve endocarditis staphylococci - penicillin allergic or MRSA

A

Vancomycin + rifampicin >4 wks

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70
Q

Prosthetic valve endocarditis staphylococci

A

Flucloxacillin + rifampicin + gentamicin 6 wks

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71
Q

Prosthetic valve endocarditis staphylococci - penicillin allergic or MRSA

A

Vancomycin + rifampicin + gentamicin 6 wks

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72
Q

Meningitis empirical - community

A

Benzylpenicillin

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73
Q

Meningitis empirical - hospital, 3months - 50 yrs

A

Cefotaxime or ceftriaxone 10 days

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74
Q

Meningitis empirical - hospital, >50 yrs

A

Cefotaxime or ceftriaxone + amoxicillin 10 days

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75
Q

Meningitis caused by meningococcal

A

Benzylpenicillin or cefotaxime 7 days

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76
Q

Meningitis caused by pneumococci or haemophilus influenzae

A 
Cefotaxime + dexamethasone 
14 days (pneumococci) 10 days ( h. Influenzae)
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77
Q

Meningitis caused by listeria

A

Amoxicillin + gentamicin 21 days

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78
Q

Meningitis caused by listeria - penicillin allergic

A

Co trimoxazole 21 days

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79
Q

Cholestatic pruritis

A

Colestyramine

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80
Q

Intrahepatic cholestasis in pregnancy

A

Ursodeoxycholic acid

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81
Q

Cluster headache - acute

A

Sumatriptan

100% 15L O2

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82
Q

Cluster headache prophylaxis

A

Verapamil

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83
Q

Croup 1st line

A

Dexamethasone single dose

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84
Q

Croup 2nd line

A

Nebulised adrenaline/epinephrine solution 1 in 1000

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85
Q

Cushing’s syndrome

A

Metyrapone

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86
Q

Endogenous cushing’s syndrome

A

Ketoconazole

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87
Q

CF - 1st line mucolytic

A

Dornase Alfa

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88
Q

CF - 2nd line mucolytic

A

Add hypertonic sodium chloride

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89
Q

Hyperuricaemia (tumour lysis syndrome)

A

Allopurinol

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90
Q

Hyperuricaemia in haematological malignancy

A

Rasburicase

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91
Q

Mild-moderate Alzheimer’s

A

Donepezil, galantamine or rivastigmine

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92
Q

Moderate Alzheimer’s + CI acetylcholinesterase inhibitor or severe Alzheimer’s

A

Memantine

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93
Q

Mild-moderate Lewy body dementia

A

Donepezil or rivastigmine

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94
Q

Pre existing T2 DM in pregnancy

A

5 mg folic acid

All anti diabetic drugs except metformin stopped

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95
Q

Gestational DM - 1st line, fasting glucose <7

A

Diet and exercise

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96
Q

Gestational DM - 2nd line, fasting glucose <7

A

Metformin

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97
Q

Gestational DM - 3rd line, fasting glucose <7

A

Insulin

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98
Q

Gestational DM - 1st line, fasting glucose >7

A

Insulin +/- metformin

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99
Q

DKA step 1

A

IV fluid

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100
Q

DKA step 2

A

IV insulin

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101
Q

DKA step 3

A

Potassium + glucose administration

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102
Q

Oedema and ascites caused by cirrhosis of liver

A

Spironolactone

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103
Q

Galactorrhoea

A

Bromocriptine

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104
Q

Prolactinomas

A

Bromocriptine

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105
Q

Suppression of lactation

A

Cabergoline

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106
Q

Mild otitis externa

A

Acetic acid 2%

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107
Q

Otitis externa - pseudomonas

A

Ciprofloxacin

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108
Q

Otitis externa - no penicillin allergy

A

Flucloxacillin

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109
Q

Otitis externa - penicillin allergy

A

Clarithromycin or azithromycin or erythromycin

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110
Q

Otitis externa 1st line

A

Topical antibiotic or topical antibiotic + steroid

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111
Q

Otitis externa 2nd line

A

Oral antibiotics

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112
Q

Otitis media 1st line - no penicillin allergy

A

Amoxicillin

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113
Q

Otitis media 2nd line - no penicillin allergy

A

Co amoxiclav

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114
Q

Otitis media 1st line - penicillin allergy

A

Clarithromycin or erythromycin

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115
Q

When to consider Abx in otitis media

A 
Symptoms >4 days or not improving
Systemically unwell
Immunocompromised 
<2 yrs w/ bilateral 
If they have perforation +/or discharge in canal
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116
Q

Eczema 1st line

A

Emollients

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117
Q

Eczema 2nd line

A

Topical steroids

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118
Q

Emergency contraception - time allowed for an IUD

A

Up to 120 hrs (5 days)

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119
Q

Emergency contraception - time allowed for levonorgestrel

A

72 hrs (3 days) (efficacy decreases over time)

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120
Q

Emergency contraception - time allowed for ullipristal acetate

A 
120 hrs (5 days) 
More effective than levonorgestrel
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121
Q

Emergency contraception - BMI >26 or >70kg, hormonal option

A

Ullipristal acetate OR

Double dose levonorgestrel

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122
Q

Emergency contraception - when is levonorgestrel 1st line

A

Females on regular combined hormonal contraception who have missed contraception within the 1st week of restarting their contraceptive

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123
Q

Emergency contraception - when to restart contraception following levonorgestrel

A

Immediately

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124
Q

Emergency contraception - when to start contraception following ulipristal acetate

A

5 days after + use barrier/abstain during this period

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125
Q

Endometriosis - 1st line

A

Paracetamol +/- NSAID

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126
Q

Endometriosis - 2nd line

A

COCP or POP

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127
Q

Endometriosis - 3rd line (after referring)

A

Gonadotropin releasing hormones for 3 months

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128
Q

Endometriosis - 4th line

A

Laparoscopic excision or ablation

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129
Q

Endometriosis - 5th line

A

Hysterectomy

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130
Q

Erectile dysfunction

A

Avanafil, sildenafil or vardenafil

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131
Q

Huntington’s chorea

A

Tetrabenazine

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132
Q

Tardive dyskinesia

A

Tetrabenazine

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133
Q

Essential tremor

A

Propranolol

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134
Q

MND ALS

A

Riluzole

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135
Q

Exocrine pancreatic insufficiency

A

Pancreatin

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136
Q

Purulent conjunctivitis

A

Chloramphenicol eye drops

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137
Q

Trachoma (eye thing) from chronic infection w/ chlamydia

A

Oral azithromycin

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138
Q

Hyperkalaemia - stabilisation of cardiac membrane (1st step)

A

IV calcium chloride 10% or calcium gluconate 10%

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139
Q

Hyperkalaemia - short term shift in K+ from ECF to ICF (2nd step)

A

Combined insulin/dextrose infusion

Nebulised salbutamol

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140
Q

Hyperkalaemia - removal of K+ from body (3rd step)

A

Calcium resonium
Loop diuretics
Dialysis

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141
Q

Gallstones - mild-moderate pain

A

Paracetamol or NSAID

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142
Q

Gallstones - severe pain 1st line

A

IM diclofenac

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143
Q

Gallstones - severe pain 2nd line

A

IM morphine or IM penthidine

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144
Q

Gallstones - definitive management

A

Laparoscopic cholecystectomy

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145
Q

Campylobacter enteritis

A

Clarithromycin or azithromycin or erythromycin

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146
Q

Suspected or confirmed uncomplicated acute diverticulitis

A

Oral co amoxiclav

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147
Q

Suspected or confirmed complicated acute diverticulitis

A

IV co amoxiclav OR IV cefuroxime w/ metronidazole OR IV amoxicillin w/ gentamicin and metronidazole

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148
Q

Salmonella

A

Ciprofloxacin or cefotaxime

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149
Q

Shigellosis

A

Ciprofloxacin or azithromycin

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150
Q

Typhoid fever

A

Cefotaxime or ceftriaxone

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151
Q

1st episode c diff - 1st line

A

Oral vancomycin

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152
Q

1st episode c diff - 2nd line

A

Fidaxomicin

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153
Q

Further episode of c diff (infection within 12 wks) - 1st line

A

Fidaxomicin

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154
Q

Life threatening c diff

A

Oral vancomycin + IV metronidazole

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155
Q

Biliary tract infection

A

Ciprofloxacin or gentamicin or a cephalosporin

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156
Q

Peritonitis

A

A cephalosporin + metronidazole OR gentamicin or metronidazole + clindamycin OR piperacillin w/ tazobactam

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157
Q

Peritonitis - peritoneal dialysis associated

A

Vancomycin + ceftazidime added to dialysis fluid OR vancom added to dialysis fluid + ciprofloxacin by mouth

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158
Q

GORD - 1st line

A

PPI for 4 or 8 wks

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159
Q

GORD - 2nd line

A

Histamine 2 receptor antagonist

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160
Q

Bacterial vaginosis

A

Oral metronidazole 5-7 days or single high dose metronidazole
Alternative: topical metronidazole for 5 days or topical clindamycin for 7 days

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161
Q

Chlamydia

A

Azithromycin or doxycycline

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162
Q

Gonorrhoea - 1st line

A

IM ceftriaxone

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163
Q

Gonorrhoea - needle phobia

A

Oral cefixime + oral azithromycin

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164
Q

PID

A

Doxycycline + metronidazole + single dose IM ceftriaxone

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165
Q

Early syphilis (<2 yrs)

A

Single dose benzylpenicillin

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166
Q

Early syphilis (<2 yrs) - penicillin allergic

A

Doxycycline or erythromycin for 14 days

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167
Q

Late latent syphilis (asymptomatic >2 yrs)

A

Benzylpenicillin once weekly for 2 wks

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168
Q

Asymptomatic contacts of patients w/ infectious syphilis

A

Doxycycline for 14 days

169
Q

Chronic open angle glaucoma - 1st line

A

360° selective trabeculoplasty

170
Q

Chronic open angle glaucoma - first line if 360° SLT not used/while waiting

A

Topical prostaglandin analogues e.g. latanoprost

171
Q

Chronic open angle glaucoma - 2nd line

A

Topical beta blocker e.g. timolol OR topical carbonic anhydrase inhibitor e.g. brinzolamide OR topical sympathomimetic e.g. brimonidine OR a combination of these

172
Q

Chronic open angle glaucoma - 3rd line

A

Surgery

173
Q

Acute gout attack

A

Colchicine or high dose NSAID

174
Q

Long term control of gout - 1st line

A

Allopurinol + colchicine (for 6 months after acute attack)

175
Q

Long term control of gout - 2nd line

A

Febuxostat

176
Q

H pylori, no penicillin allergy - 1st line

A

PPI + amoxicillin + clarithromycin or metronidazole

7 days

177
Q

H pylori, no penicillin allergy - 2nd line

A

PPI + amoxicillin + clarithromycin or metronidazole (whichever wasn’t used 1st line)
7 days

178
Q

H pylori, penicillin allergy - 1st line

A

PPI + clarithromycin + metronidazole

179
Q

Heavy menstrual bleeding - 1st line

A

IUS

180
Q

Heavy menstrual bleeding - IUS unsuitable

A

Tranexamic acid
NSAID
COCP

181
Q

Fibroids that cause enlarged or distorted uterus

A

Gonadotropin releasing analogue then myomectomy or hysterectomy

182
Q

Chronic hepatitis B

A

Entecavir, peginterferon alfa, tenofovir alafenamide or tenofovir disoproxil

183
Q

Chronic hepatitis C

A

Sofosbuvir w/ ribavirin

184
Q

Systemic treatment of VZV

A

Aciclovir

185
Q

Systemic and topical treatment of HSV of skin and mucus membranes

A

Aciclovir

186
Q

HIV initial treatment

A

2 NRTIs as backbone regimen + 1 of…

  • INI
  • NNRTI
  • PI
187
Q

Hyperhydrosis

A

Topical 20% aluminium chloride

188
Q

Primary hyperparathyroidism - 1st line

A

Parathyroidectomy

189
Q

Primary hyperparathyroidism - surgery unsuccessful or not suitable

A

Cinacalet

190
Q

Graves’ disease - 1st line

A

Radioactive iodine

191
Q

Graves’ disease - 1st line if radioactive iodine unsuitable

A

Carbimazole

192
Q

Graves’ disease - 2nd line or pregnant/trying to conceive

A

Propylthiouracil

193
Q

Thyrotoxicosis without hyperthyroidism

A

Beta blockers

194
Q

Hypoglycaemia, BG >4

A

Small carb snack

195
Q

Hypoglycaemia, BG <4 - conscious and able to swallow

A

Glucose tablet, gel, pure fruit juice

196
Q

Hypoglycaemia, BG <4 - oral stuff doesn’t work

A

IM glucagon or glucose 10% IV

197
Q

Hypoglycaemia + unconsciousness - 1st line

A

Glucagon

198
Q

Hypoglycaemia + unconsciousness - 2nd line (no response after 10 mins)

A

Glucose 20% IV infusion

199
Q

Infertility in PCOS

A

Clomifene

200
Q

Hypothyroidism

A

Levothyroxine

201
Q

What is given to reduce the possibility of methotrexate toxicity

A

Folic acid

202
Q

Acute immune thrombocytopenic purpura

A

Prednisolone

203
Q

Persistent or chronic immune thrombocytopenic purpura

A

Thrombopoietin receptor agonists OR fostamatinib

204
Q

immune thrombocytopenic purpura - drug therapy has failed

A

Splenectomy

205
Q

Influenza

A

Oseltamivir or zanamivir

206
Q

Iron overload associated with haemochromatosis - 1st line

A

Repeated venesection

207
Q

Iron overload associated with haemochromatosis - 1st line CI

A

Desferrioxamine

208
Q

Leprosy

A

Dapsone + rifampicin + clofazimine

209
Q

Acute low back pain

A

NSAIDs

210
Q

Acute low back pain - NSAID not tolerated

A

Weak opioid +/- paracetamol

211
Q

Severe sciatica

A

Epidural injections of local anaesthetic +/or corticosteroid

212
Q

Lyme disease

A

Doxycycline

213
Q

Lyme disease - doxycycline CI

A

Amoxicillin

214
Q

Hypomagnesaemia - symptomatic

A

IV or IM magnesium sulfate

215
Q

Hypomagnesaemia - asymptomatic

A

Oral magnesium glycerophosphate

216
Q

Malaria prophylaxis - 1 wk before travel

A

Chloroquine + proguanil hydrochloride

217
Q

Malaria prophylaxis - 2-3 wk before travel

A

Mefloquine

218
Q

Malaria prophylaxis - 1-2 days before travel

A

Atovaquone w/ proguanil hydrochloride or doxycycline

219
Q

How long should malaria prophylaxis be continued for after leaving the area

A

4 wks

Except Atovaquone w/ proguanil hydrochloride, which should be stopped 1 wk after leaving

220
Q

Uncomplicated p. falciparum malaria

A

Artemether w/ lumefantrine

221
Q

Severe or complicated p. falciparum malaria

A

IV artesunate

222
Q

Uncomplicated non falciparum malaria

A

Artemether w/ lumefantrine or artenimol w/ piperaquine phosphate or chloroquine

223
Q

Uncomplicated non falciparum malaria - prevention of relapses

A

Primaquine

224
Q

Complicated non falciparum malaria

A

IV artesunate

225
Q

Acute mania or hypo mania - 1st line

A

Haloperidol, olanzapine, quetiapine or risperidone

226
Q

Acute mania or hypo mania - 2nd line

A

Add Lithium or valproate

227
Q

Long term management of bipolar disorder - 1st line

A

Lithium

228
Q

Long term management of bipolar disorder - 2nd line or if lithium CI

A

Add valproate/valproate alone

229
Q

Depression + bipolar

A

Fluoxetine

230
Q

Acute migraine - 1st line

A

Aspirin or ibuprofen or sumitriptan

231
Q

Acute migraine - 2nd line

A

Sumatriptan + naproxen

232
Q

Migraine antiemetic - 1st line

A

Metoclopramide or prochlorperazine

233
Q

Migraine antiemetic - 2nd line

A

Domperidone

234
Q

Migraine prophylaxis- 1st line

A

Propranolol

235
Q

Migraine prophylaxis - 2nd line (non child bearing)

A

Topiramate

236
Q

Migraine prophylaxis - other

A

Amitriptyline, sodium valproate

237
Q

MND muscle cramps - 1st line

A

Quinine

238
Q

MND muscle cramps - 2nd line

A

Baclofen

239
Q

MND muscle spasticity, stiffness or increased tone

A

Baclofen, dantrolene, tizanidine or gabapentin

240
Q

Active relapsing remitting MS

A

DMARDs

241
Q

Reducing relapse risk in MS - 1st line

A

Natalizumab

242
Q

Reducing relapse risk in MS - other

A

Fingolimod
Beta interferon
Glatiramer acetate

243
Q

MS acute relapse

A

High dose oral or IV methylprednisolone for 5 days

244
Q

Spasticity in MS

A

Baclofen or gabapentin

245
Q

Osteomyelitis

A

Flucloxacillin 6 wks

246
Q

Osteomyelitis - penicillin allergic

A

Clindamycin 6 wks

247
Q

Osteomyelitis - MRSA suspected

A

Vancomycin or teicoplanin 6 wks

248
Q

Septic arthritis

A

Flucloxacillin 4-6 wks

249
Q

Septic arthritis - penicillin allergic

A

Clindamycin 4-6 wks

250
Q

Septic arthritis - MRSA suspected

A

Vancomycin or teicoplanin

251
Q

Septic arthritis - gonococcal arthritis or gram -ve

A

Cefotaxime or ceftriaxone 4-6 wks

252
Q

Menieres - acute

A

Antihistamines e.g, cyclizine or prochloperazine

253
Q

Menieres - reducer if severity and frequency

A

Betahistine dihydrochloride

254
Q

myasthenia gravis - 2nd line

A

Prednisolone + azathioprine

255
Q

myasthenia gravis - 3rd line

A

Ciclosporin, methotrexate or mycophenolate mofetil

256
Q

Myasthenia gravis - 1st line

A

Pyridostigmine

257
Q

Myasthenic crisis

A

Plasmapheresis + IV immunoglobulins

258
Q

Lambert Eaton syndrome

A

Prednisolone +/- azathioprine

259
Q

Trigeminal neuralgia

A

Carbamazepine

260
Q

Nocturnal enuresis - 1st line

A

Behaviour type advice

261
Q

Nocturnal enuresis - 2nd line

A

Enuresis alarm

262
Q

Nocturnal enuresis - 3rd line

A

Desmopressin

263
Q

Sinusitis - 1st line

A

Phenoxymethylpenicillin

264
Q

Sinusitis - 2nd line

A

Co amoxiclav

265
Q

Sinusitis - 1st line, penicillin allergic

A

Doxycycline or clarithromycin (erythromycin in pregnancy)

266
Q

Obesity - BMI >30

A

Orlistat

267
Q

Obesity - BMI >40 or 35-40 w/ T2 DM or high BP

A

Bariatric surgery

268
Q

Abortion

A

Mifepristone + misoprostol

269
Q

Induction of labour - 1st line

A

Membrane sweep

270
Q

Induction of labour - 2nd line

A

Vaginal prostaglandin E2

271
Q

Induction of labour - 3rd line

A

Oxytocin infusion

272
Q

Induction of labour - 4th line

A

Amniotomy

273
Q

Induction of labour - 5th line

A

Cervical ripening balloon

274
Q

Uterine hyperstimulation

A

Stop oxytocin

Terbutaline

275
Q

Ectopic pregnancy

A

Methotrexate

276
Q

Thrush from inhaler use - 1st line

A

Rinse mouth with water or clean teeth after use

277
Q

Thrush from inhaler use - 2nd line

A

Nystatin or miconazole

278
Q

Gingivitis

A

Metronidazole or amoxicillin

279
Q

Mouth abscess - 1st line

A

Phenoxymethylpenicillin or amoxicillin

280
Q

Mouth abscess - penicillin allergy

A

Clarithromycin

281
Q

Mouth abscess + signs of spreading infection

A

Add metronidazole

282
Q

Acute sore throat

A

Phenoxymethylpenicillin 5-10 days

283
Q

Acute sore throat - penicillin allergic

A

Clarithromycin or erythromycin 5 days

284
Q

Osteoarthritis - 1st line

A

Paracetamol +/- topical NSAID

285
Q

Osteoarthritis - 2nd line

A

Oral NSAID or codeine

286
Q

Osteoarthritis - moderate to severe

A

Intra articular corticosteroid injection

287
Q

Osteoporosis - 1st line

A

Smoking cessation

Calcium + vitamins D

288
Q

Osteoporosis - 2nd line

A

Oral bisphosphonate - alendronic acid or risedronate sodium

289
Q

Osteoporosis - 3rd line

A

Denosumab

290
Q

Osteoporosis - severe, very high risk, vertebral fractures

A

Teriparatide or romosozumab

291
Q

When should bisphosphonate therapy be reviewed

A

After 5 years

292
Q

Parkinson’s w/ motor symptoms that decrease their quality of life - 1st line

A

Levodopa + co careldopa or co beneldopa

293
Q

Parkinson’s w/ motor symptoms that do not decrease their quality of life - 1st line

A

Levodopa OR non ergotic dopamine receptor agonist (pramipexole, ropinirole or rotigotine) OR monoamine oxidase B inhibitors (rasagiline or selegiline)

294
Q

Parkinson’s w/ dyskinesia or motor symptoms despite optimal levodopa therapy should be offered…

A

Adjunct - non ergotic dopamine receptor agonist (pramipexole, ropinirole or rotigotine) OR monoamine oxidase B inhibitors (rasagiline or selegiline) OR COMT inhibitors (entacapone or tolcapone)

295
Q

Parkinson’s - What to offer if symptoms not controlled w/ levodopa + non ergotic dopamine agonists

A

Ergot derived dopamine agonist e.g. bromocriptine, cabergoline or pergolide

296
Q

Parkinson’s + excessive daytime sleepiness

A

Modafinil

297
Q

Parkinson’s psychotic symptoms - 1st line

A

Quetiapine

298
Q

Parkinson’s psychotic symptoms - 2nd line

A

Clozapine

299
Q

Parkinson’s drooling

A

Glycopyrronium bromide

300
Q

Hyperphosphateaemia + stage 4/5 CKD - 1st line

A

Dietary management + dialysis optimised

301
Q

Hyperphosphateaemia + stage 4/5 CKD - 2nd line

A

Calcium acetate (phosphate binder)

302
Q

Hyperphosphateaemia + stage 4/5 CKD - 3rd line

A

Selelamer (non calcium based phosphate binder)

303
Q

Superficial basal cell carcinoma

A

Imiquimod + topical fluorouracil

304
Q

actinic keratosis

A

Fluorouracil +/- salicylic acid

305
Q

Pneumocystis jirovecii - 1st line

A

Co trimoxazole

306
Q

Pneumocystis jirovecii - 2nd line

A

Atovaquone

If severe - pentamidine IV

307
Q

PCOS symptoms

A

COCP

308
Q

Primary biliary cholangitis

A

Ursodeoxycholic acid

309
Q

Schizophrenia - illness not responded to 2 different antipsychotic drugs

A

Clozapine

310
Q

Severe bronchiolitis caused by RSV

A

Ribavirin

311
Q

Prophylaxis against RSV

A

Palivizumab

312
Q

Epiglottitis (h. Influenzae)

A

Cefotaxime or ceftriaxone

313
Q

Bronchiectasis acute exacerbation - 1st line

A

Amoxicillin, clarithromycin or doxycycline

314
Q

Bronchiectasis acute exacerbation - 2nd line

A

Co amoxiclav or levofloxacin

315
Q

COPD acute exacerbation - 1st line

A

Amoxicillin, clarithromycin or doxycycline 5 days

316
Q

COPD acute exacerbation - 2nd line

A

Try one of the other 1st line drugs

Co amoxiclav, levofloxacin or co trimoxazole 5 days

317
Q

Pneumonia, community acquired - low severity, 1st line

A

Amoxicillin

318
Q

Pneumonia, community acquired - low severity, 1st line, penicillin allergy

A

Clarithromycin, doxycycline or erythromycin (pregnancy)

319
Q

Pneumonia, community acquired - moderate severity, 1st line

A

Amoxicillin

320
Q

Pneumonia, community acquired - moderate severity, 1st line, atypical suspected

A

Amoxicillin + clarithromycin or erythromycin (pregnancy)

321
Q

Pneumonia, community acquired - moderate severity, 1st line, penicillin allergic

A

Clarithromycin or doxycycline

322
Q

Pneumonia, community acquired - high severity, 1st line

A

Co amoxiclav + clarithromycin or erythromycin

323
Q

Pneumonia, community acquired - high severity, 1st line, penicillin allergic

A

Levofloxacin

324
Q

Pneumonia, hospital acquired - low severity, 1st line

A

Co amoxiclav

325
Q

Pneumonia, hospital acquired - low severity, 1st line, penicillin allergic

A

Doxycycline, cefalexin, co trimoxazole or levofloxacin

326
Q

Pneumonia, hospital acquired - high severity, 1st line

A

IV piperacillin w/ tazobactam, ceftazidime, ceftriaxone, cefuroxime, levofloxacin or meropenem

327
Q

Pneumonia, hospital acquired - high severity, MRSA suspected

A

Add vancomycin or teicoplanin or linezolid

328
Q

Rheumatoid arthritis - 1st line

A

DMARD - methotrexate, leflunomide or sulfasalazine

329
Q

Rheumatoid arthritis - 2nd line

A

DMARD combination therapy - methotrexate, leflunomide, sulfasalazine or hydroxychloroquine

330
Q

Rheumatoid arthritis - 3rd line

A

TNF alpha inhibitor - adalimumab, etanercept, golimumab or infliximab
OR biological DMARD - abatacept, sarilumab or tocilizumab
OR targeted synthetic DMARD - baricitinib, filgotinib, tofacitinib

331
Q

Rheumatoid arthritis - 4th line

A

Rituximab + methotrexate

332
Q

Rosacea - mild

A

Topical metronidazole

333
Q

Rosacea - predominant flushing but limited telangiectasia

A

Topical brimonidine gel

334
Q

Rosacea - severe

A

Oral antibiotics e.g. oxytetracycline

335
Q

Rosacea - prominent telangiectasia

A

Laser therapy

336
Q

Severe dandruff/seborrhoeic dermatitis

A

Ketoconazole shampoo

337
Q

Hirsutism - mild-moderate

A

Eflornithine

338
Q

Hirsutism - moderate-severe

A

Co-cyprindiol

339
Q

Pityriasis versi color

A

Ketoconazole shampoo

340
Q

Scabies - 1st line

A

Permethrin

341
Q

Scabies - 2nd line

A

Malathion

342
Q

Scabies - 3rd line

A

Ivermectin

343
Q

Head lice - 1st line

A

Dimeticone

344
Q

Head lice - 2nd line

A

Malathion

345
Q

Crab lice - 1st line

A

Permethrin or malathion

346
Q

Impetigo, localised non bullous, systemically well - 1st line

A

Hydrogen peroxide 1% cream

347
Q

Impetigo, localised non bullous, systemically well - 2nd line

A

Fusidic acid

348
Q

Impetigo, widespread non bullous impetigo, systemically well

A

Topical or oral antibiotic

349
Q

Impetigo, non bullous + systemically unwell or bullous - 1st line

A

Flucloxacillin

350
Q

Impetigo, non bullous + systemically unwell or bullous - 1st line, penicillin allergy

A

Clarithromycin or erythromycin (pregnancy)

351
Q

Cellulitis/erysipelas - 1st line

A

Flucloxacillin

352
Q

Cellulitis/erysipelas - 1st line, penicillin allergic

A

Clarithromycin, erythromycin (pregnancy) or doxycycline

353
Q

Cellulitis/erysipelas near eyes or nose - 1st line

A

Co amoxiclav

354
Q

Cellulitis/erysipelas near eyes or nose - 1st line, penicillin allergic

A

Clarithromycin + metronidazole

355
Q

Cellulitis/erysipelas, severe - 1st line

A

IV co amoxiclav, clindamycin, cefuroxime or ceftriaxone

356
Q

Cellulitis/erysipelas, severe - 1st line, MRSA suspected

A

Add IV vancomycin or teicoplanin or linezolid

357
Q

Human/animal bite - 1st line

A

Co amoxiclav

358
Q

Human/animal bite - 1st line, penicillin allergic

A

Doxycycline + metronidazole

359
Q

Mastitis during breast feeding

A

Flucloxacillin 10-14 days

360
Q

Mastitis during breast feeding , penicillin allergic

A

Erythromycin

361
Q

Ankylosing spondylitis - 1st line

A

NSAIDs + physiotherapy

362
Q

Ankylosing spondylitis - 2nd line

A

TNF alpha inhibitor

363
Q

Ankylosing spondylitis - 3rd line

A

Try another TNF alpha inhibitor

364
Q

Ankylosing spondylitis - 4th line

A

Ixekizumab or secukinumab

365
Q

Psoriatic arthritis - non progressive mono arthritis

A

Local corticosteroid injections

366
Q

Psoriatic arthritis - peripheral polyarthritis, oligoarthritis or persistent mono arthritis

A

DMARDs - methotrexate, leflunomide or sulfasalazine

367
Q

Angina - acute attack

A

Sublingual glyceryl trinitrate

368
Q

Angina - prophylaxis, 1st line

A

Beta blocker - atenolol, bisoprolol, metoprolol or propranolol

369
Q

Angina - prophylaxis, 1st line if beta blockers CI

A

Rate limiting calcium channel blocker - verapamil or diltiazem

370
Q

Angina - prophylaxis, 2nd line

A

Beta blocker + calcium channel blocker

371
Q

Angina - prophylaxis, 3rd line

A

Long acting nitrate, ivabradine, nicorandil or ranolazine mono therapy

372
Q

TIA

A

Aspirin

373
Q

Ischaemic stroke <4.5 hrs onset

A

Alteplase

374
Q

Stroke long term management - 1st line

A

Clopidogrel

Statin

375
Q

Stroke long term management - 1st line not tolerated

A

Aspirin + dipyridamole

Statin

376
Q

Opioid dependence

A

Methadone or buprenorphine

377
Q

TB - initial phase

A

Rifampicin + ethambutol + pyrazinamide + isoniazid for 2 months

378
Q

TB - continuation phase

A

Rifampicin + isoniazid for 4 months

379
Q

Latent TB, <65 yrs + treatment indicated e.g. HIV

A

Isoniazid + rifampicin for 3 months

Isoniazid for 6 months

380
Q

T1 DM - 1st line

A

Basal-bolus

381
Q

Acute mild-moderate UC - 1st line

A

Topical aminosalicylate

382
Q

Acute mild-moderate UC - 2nd line

A

Oral aminosalicylate

383
Q

Acute severe UC - 1st line

A

IV corticosteroids - hydrocortisone or methylprednisolone

384
Q

Acute severe UC - 2nd line

A

IV ciclosporin

385
Q

Acute severe UC - 3rd line

A

Infliximab

386
Q

Maintaining remission in UC - 1st line

A

Rectal aminosalicylate +/- oral aminosalicylate

387
Q

Maintaining remission in UC - 2nd line (2+ exacerbations in 12 months that required systemic corticosteroids, or remission not maintained with first line)

A

Oral azathioprine or mercaptopurine

388
Q

Urgency incontinence - 1st line

A

Bladder training

389
Q

Urgency incontinence - 2nd line

A

Oxybutinin

390
Q

Stress incontinence - 1st line

A

Pelvic floor muscle training

391
Q

Stress incontinence - 2nd line

A

Duloxetine

392
Q

Benign prostatic hyperplasia - 1st line

A

Alpha-1 antagonists e.g. tamulosin

393
Q

Benign prostatic hyperplasia - 1st line, raised PSA, high risk of progression

A

5 alpha reductase inhibitor e.g. finasteride

394
Q

Benign prostatic hyperplasia - 2nd line

A

Alpha-1 selective adrenoceptor blocker + 5 alpha reducesse inhibitor

395
Q

Benign prostatic hyperplasia - 3rd line

A

TURP

396
Q

Lower UTI, not pregnant - 1st line

A

Trimethoprim or nitrofurantoin

397
Q

Lower UTI, not pregnant - 2nd line

A

Nitrofurantoin (if not used 1st line), fosfomycin, pivmecillinam

398
Q

Lower UTI, pregnant, 1st trimester - 1st line

A

Nitrofurantoin

399
Q

Lower UTI, pregnant, 3rd trimester - 1st line

A

Amoxicillin or cefalexin

400
Q

Lower UTI, pregnant, 1st trimester - 2nd line

A

Amoxicillin or cefalexin

401
Q

Acute prostatitis - 1st line

A

Ciprofloxacin or ofloxacin

Alternative: trimethoprim

402
Q

Acute prostatitis - 2nd line

A

Levofloxacin or co trimoxazole

403
Q

Pyelonephritis - oral first line

A

Cefalexin or ciprofloxacin

404
Q

Pyelonephritis - IV first line (severely unwell)

A

Gentamicin, ceftriaxone, cefuroxime, ciprofloxacin

405
Q

Catheter associated UTI, no upper UTI symptoms - 1st line

A

Amoxicillin, nitrofurantoin or trimethoprim

406
Q

Catheter associated UTI, no upper UTI symptoms - 2nd line

A

Pivmecilinam

407
Q

Catheter associated UTI, upper UTI symptoms - oral 1st line

A

Cefalexin, ciprofloxacin, co amoxiclav or trimethoprim

408
Q

Catheter associated UTI, upper UTI symptoms - IV 1st line

A

Gentamicin, ceftriaxone, cefuroxime, ciprofloxacin or co amoxiclav

409
Q

Vulvovaginal candidiasis

A

Oral fluconazole or itraconzaole OR pessary/cream clotrimazole, miconazole

410
Q

Vulvovaginal candidiasis in pregnancy

A

Intravaginal clotrimazole

411
Q

VTE prophylaxis - mechanical

A

Anti embolism stockings

412
Q

Proximal DVT or PE - 1st line

A

Apixaban or rivaroxaban

413
Q

Proximal DVT or PE - 2nd line

A

LMWH for 5 days then dabigatran or edoxaban

414
Q

How long anticoagulation after provoked DVT/PE

A

3 months

415
Q

How long anticoagulation after unprovoked DVT/PE

A

6 months

416
Q

Anogenital warts - multiple non keratinised, 1st line

A

Topical podophyllotoxin

417
Q

Anogenital warts - solitary keratinised, 1st line

A

Cryotherapy

418
Q

Anogenital warts - 2nd line

A

Imiquimod

419
Q

Acute dystonia 2⁰ to antipsychotics

A

Procyclidine

Miscellaneous (16 decks)

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