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PRE-REG-Thuri > LOW WEIGHTED- EYE, SKIN, EAR/NOSE/THROAT, VACCINES, ANASTHESIA > Flashcards

LOW WEIGHTED- EYE, SKIN, EAR/NOSE/THROAT, VACCINES, ANASTHESIA Flashcards

1
Q

What to do if using 2 different eye drops?

A

Space out with 5 min interval + longer if gel.

Apply ointments last

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2
Q

When to apply ointments?

A

Always last

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3
Q

What are expiry dates for eye preparation use at home?

A

28 DAYS

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4
Q

What are expiry dates for eye preparation use at HOPSITAL?

A

1 week

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5
Q

What are expiry dates for eye preparation use at surgery?

A

single use

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6
Q

What is a common preservative in eye preps?

A

Benzalkonium chloride

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7
Q

What type of lens can you use eye drops with them still in?

A

Hard lenses

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8
Q

How to put eye drops on soft lens?

A

Remove lens or use preservative free drops

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9
Q

Can I wear lenses with ointment eye drops?

A

No

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10
Q

What 2 drugs stain contacts orange?

A

Rifampicin

sulfasalazine

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11
Q

What is used for allergic conjunctivitis as a mast cell stabiliser?

A

Sodium cromogilate

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12
Q

What is used for allergic conjunctivitis as an antihistamine?

A

Antazoline

azelastine

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13
Q

What dry eye prep is applied QDS?

A

Carmellose

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14
Q

What dry eye prep is applied hourly?

A

Hypromellose

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15
Q

What drops are given for bacterial conjunctivities?

A

Chloramphenicol eye drops

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16
Q

What drug given for viral (HSV) conjunctivitis?

A

Aciclovir 5 times day until 3 days after healing

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17
Q

What drug is used for blepharitis?

A

Fusidic acid - staph infection

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18
Q

What drug is can cause steroid glaucoma + cataracts?

A

Topical corticosteroids

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19
Q

What abx is used for corneal ulcers?

A

Ciprofloxacin

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20
Q

What class of drugs used to dilate pupils in eye exams?

A

Mydriatics/cycloplegics

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21
Q

2 Examples of drug used to dilate eye during eye examinations?

A

Antimuscarinic e.g. atropine

phenylephrine - MAOI interaction/ risk of hypertensive crisis.

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22
Q

Can you drive with antimuscarinic eye drops?

A

No - wait till vision clear as it paralyses ciliary muscle

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23
Q

What is 1st line for glaucoma?

A

1- Prostaglandin eye drops

  1. BB eye drops - betaxolol
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24
Q

List 3 examples of Prostaglandin eye drops?

A

Latanoprost, travoprost, bimatoprost

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25
Q

What is 5 key SE for Prostaglandin eye drops?

A

dry eyes + ocular discomfort

Long eyelashes

Darker iris colour + hyperpigmentation of skin

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26
Q

What is BB eye drops contra-indicated in?

A

Asthma

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27
Q

What is 3rd line for glaucoma is BB drops don’t work?

A

Carbinic anhydrase inhibitor drops

e.g. brinzolomide

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28
Q

What carbonic anhydrase inhibitor is taken orally?

A

Acetazolamide

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29
Q

What is most common form of glaucoma and why does it occur?

A

Open angle - limited drainage of aqueous humour through trabecular meshwork causing occular HTN

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30
Q

What type of glaucoma is an emergency?

A

Closed-angle glaucoma

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31
Q

What are 6 symptoms of Closed-angle glaucoma?

A

Cloudy eye, N + V, headache, pain, blurred hazy vision, rainbow coloured ring around eyes

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32
Q

What are 3 ear conditions?

A

Otitis media

otitis externa

ear wax removal

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33
Q

What is 1st line tx for otitis media?

A

Amoxicillin (5 days)

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34
Q

What is 2nd line tx for otitis media if worsening after 2-3 days tx?

A

Co-amoxicillin

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35
Q

What is 1st line tx for otitis externa?

A

acetic acid 2%

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36
Q

What is 2nd line tx for otitis externa?

A

Neomycin with corticosteroid

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37
Q

What is tx for otitis externa if systemic tx needed??

A

Flucloxicilin

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38
Q

What tx is given for nasal rhinitis?

A

Sodium chloride, Antihistamines, steroids

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39
Q

How long to use nasal steroids?

A

Max 7 days - due to rebound congestion risk

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40
Q

What is tx for nasal polyps?

A

Nasal steroids - review by specialist initially

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41
Q

What is 1st line for Nasal staphylococci
?

A

Naseptin e.g. chlorhexidine with neomycin cream (Naseptin®)

OR

Mupirocin

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42
Q

What are scabies symptoms?

A

red spots with silver lines - webbing of fingers and toes.

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43
Q

What is 1st line for scabies?

A

Permethrin or Malathion- twice- 1 week apart

Treat all members of family

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44
Q

How to apply Malathion or permethrin for scabies?

A

Scalp , neck , face, ears

Leave for 8 hrs

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45
Q

What is mechanical method of removing headlice?

A

Wet combing - 30 mins every 4 days until no lice found for 3 consecutive sessions.

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46
Q

What is minimum time to do wet combing?

A

2 weeks

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47
Q

What is 1st line headlice tx?

A

Dimeticone - apply for 8 hrs to dry + repeat after 7 days.

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48
Q

What is 2ND line headlice tx?

A

Malathion - apply to dry for 12 hrs + repeat after 7 days

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49
Q

When to avoid malathion?

A

Severe eczema due to alcohol amount.

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50
Q

why is benzoate + permethrin not used for headlice anymore?

A

less effective + not for children (benzoate) + formulations hard to use.

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51
Q

What is eczema smyptoms?

A

Small red spots with dry flaky skin

52
Q

What is used as treatment for eczema?

A

Emollients

Topical steroids -POM

antihistamines - not in atopic

53
Q

What type of eczema does antihistamines DO NOT work on?

A

Atopic dermatitis

54
Q

What is used in severe eczema?

A

Systemic meds -e.g. ciclosporin, MABs, Azathioprine

55
Q

Why are aqueous creams not recommended?

A

Higher risk of skin reactions

56
Q

What drug is given for mild-moderate atopic eczema?

A

Topical pimecrolimus

57
Q

What drug is given for severe atopic eczema?

A

tacrolimus

58
Q

Describe psoriasis?

A

skin thickening with silvery scales and plaques.

Systemic + immune mediated

59
Q

What are 4 1st line therapy for psoriasis?

A

Topical emollients, topical corticosteroids, coal tar preparations, + topical vitamin D/analogues

60
Q

What to give when 1st line topical therapy has failed in psoriasis?

A

UV phototherapy - UVA/UVB

Systemic therapy- mtx, ciclosporin or acitretin

61
Q

What is a mild topical corticosteroid?

A

HC

62
Q

What is a moderate topical corticosteroid?

A

Clobetasone

63
Q

What is a potent topical corticosteroid?

A

Beclomethasone

64
Q

What is a VERY potent topical corticosteroid?

A

Clobetasol

65
Q

How to apply steroids?

A

Apply to not broken skin + thinly to avoid skin thinning.

66
Q

What is used in severe acne?

A

Isotretinoin

67
Q

What are 3 MHRA warnings linked to Isotretinoin?

A

2 prescribers needed to prescribe it for under 18

Rare Erectile dysfunction + reduced libido.

PPP

68
Q

How many days supply is isotretinoin limited to?

A

30 days

69
Q

What should women be on when taking isotretinoin?

A

Contraception 1 month before and till 1 month after stopping.

70
Q

What are some reaction that can occur with isotretinoin?

A

neuropsychic reactions

71
Q

What to avoid doing when on isotretinoin + 6 months after?

A

UV light, epilation, laser skin treatment

72
Q

What are some less severe and 1st line treatments for acne?

A

Benzoyl peroxide, adapalene , clindamycin, erythromycin

73
Q

What is 1st line dandruff treatment?

A

antimicrobial agents

e.g.pyrithione zinc + selenium, tar extracts

74
Q

What drug is used for psoriasis of scalp?

A

Coal tar + salicylic acid

74
Q

What is used for more severe dandruff?

A

Ketaconazole (also in cushing syndrome)

75
Q

What is used for alopecia?

A

Finasteride

minoxidil

76
Q

How to treat hirutism?

A

Weight loss

laser therapy, co-cyprindil.

77
Q

Can live vaccines be given in pregnancy?

A

No

78
Q

What is 1st line for facial erythema in rosacea?

A

Brimonidine

79
Q

Consecutive use of potent topical corticosteroids should not be used for more — weeks at any 1 site?

A

8 weeks

80
Q

How long can very potent topical steroids be used at any 1 site?

A

Max 4 weeks

81
Q

What is 2 MHRA warnings for brimonidine?

A

Risk of CVD effects - bradycardia, hypotension, dizziness

Risk of exacerbation of condition

82
Q

What 3 drugs can be used topically for pustules and papules in rosacea?

A

topical azelaic acid, ivermectin OR metronidazole

83
Q

What 3 drugs can be used orally for pustules and papules in rosacea? (TOE)

A

Oxytetracycline, tetracylcine + erythromycin

84
Q

How long is treatment for rosacea?

A

6-12 week course + repeated intermittently.

85
Q

Are repeats allowed for isotretinoin?

A

No

86
Q

When is emergency supply of isotretinoin allowed?

A

Specialist request with negative pregnancy test

87
Q

What are some side effects of isotretinoin?

A

skin peeling, dryness, hepatotoxic, pancreatitis

88
Q

What are 2 Contra-indications of isotretinoin?

A

Hyperlipidaemia

hypervitaminosis A

89
Q

What are 3 live attenuated vaccines?

A

MMR

90
Q

What is an inactivated vaccine?

A

Meningococcal

91
Q

What are 2 inactivated toxin vaccines?

A

Diptheria + tetanus

92
Q

What is a viral vector vaccine?

A

Covid 19 (Astrazeneca)

93
Q

What is a nucleic acid based vaccine?

A

Covid 19 - moderna + pfizer

94
Q

How long to leave between giving different inactivated vaccines?

A

No interval needed

95
Q

How long to leave between giving SAME inactivated vaccines?

A

wait 4 weeks

96
Q

How long to wait between giving varicella zoster + MMR?

A

4 weeks -can be given on same day

97
Q

How long to wait between giving yellow fever + MMR?

A

minimum 4 weeks -cannot be given on same day

98
Q

What 2 vaccines cannot be given on same day?

A

yellow fever + MMR

99
Q

What 6 in 1 vaccines are given at 8 weeks? (8 in total)

A

Diptheria

tetanus

pertusis

Hep B

Polio

Haem influenza B

Meningococcal B + Rotavirus

100
Q

What 6 in 1 vaccines are given at 12 weeks? (8)

A

Diptheria

tetanus

pertusis

Hep B

Polio

Haem influenza B

pneumococcal + rotavirus

101
Q

What 6 in 1 vaccines are given at 16 weeks? (7)

A

Diptheria

tetanus

pertusis

Hep B

Polio

Haem influenza B

Meningococcal B

102
Q

What 5 vaccines are given at 1 years old?

A

MMR

Haem influenza B

Meningococcal C

Meningococcal B

pneumococcal

103
Q

What 5 vaccines are given at 3 years 4 months?

A

MMR

Diptheria

tetanus

pertusis

poliomyelitis

104
Q

What vaccine given at 11-14 years?

A

HPV

2nd dose given 6-24 months after

105
Q

When is second dose of HPV given?

A

6-24 months after 1st dose

106
Q

What vaccine should be given at age 13-15?

A

Meningococcal A +C

107
Q

What 3 vaccines are given between 13-18 years?

A

Diptheria, tetanus, poliomyelitis

108
Q

What 5 vaccines are given during pregnancy?

A

Diphteria, tetanus, pertussis, poliomyelitis, influenza

109
Q

When are vaccines given in pregnancy?

A

1 dose from 16th week

110
Q

What is 5 eligible criteria for influenza vaccine?

A

65+ and over
Pregnant women
carers
household contact with immunocompromised
living in long stay residential care

111
Q

What 6 conditions make it good for patients to get influenza shot?

A

DM
Resp disease
CHD
CKD
adrenal insufficiency
asplenia

112
Q

What 2 agents are used for local anasthesia?

A

Lidocaine

bupivicaine (longer)

113
Q

Which IV anasthesia has low hangover effect+ rapid recovery?

A

Propofol

114
Q

Which IV anasthesia is fat soluble + has a longer hangover effect due to it?

A

Thiopental (rapid onset)

115
Q

Which IV anasthesia has NO hangover effect?

A

etomidate

116
Q

Which IV anasthesia has less hypotension, slow recovery + high psychoactive SE?

A

Ketamine

117
Q

What is used in treatment of malignant hyperthermia?

A

Dantrolene sodium

118
Q

What can anaesthesia and corticosteroids do?

A

Dangerous fall in BP

119
Q

When to stop COC pil before surgery?

A

4 weeks before major surgery which involves prolonged immobilisation.

120
Q

When to stop HRT before surgery?

A

4-6 weeks before surgery

start after mobile

121
Q

When to stop MAOI before surgery?

A

gradually stop 2 weeks before surgery

122
Q

When to stop lithium before surgery?

A

24 hrs before major surgery - need fluids + electrolyte balance.

123
Q

What to do if patient has DM and is due for surgery?

A

Switch to insulin.
Infusion of glucose with K + Insulin on sliding scale.

After patient eats - start SC insulin before breakfast + stop IV 30 mins after.

124
Q

What kind of drugs can be continued maybe during surgery?

A

Anti-epileptics/PD drugs, bronchodilators, CVD drugs except K+, POC, Thyroid drugs

125
Q

What CVD drug is stopped during surgery?

A

K + sparing diuretics

126
Q

When should each prescription of isotretinoin be dispensed within?

A

Each prescription for oral isotretinoin should be limited to a supply of up to 30 days’ treatment and dispensed within 7 days.

Pregnancy testing should ideally be carried out on the same day as prescription issuing and dispensing.

PRE-REG-Thuri (44 decks)

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