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
2
Q
When to apply ointments?
A
Always last
3
Q
What are expiry dates for eye preparation use at home?
A
28 DAYS
4
Q
What are expiry dates for eye preparation use at HOPSITAL?
A
1 week
5
Q
What are expiry dates for eye preparation use at surgery?
A
single use
6
Q
What is a common preservative in eye preps?
A
Benzalkonium chloride
7
Q
What type of lens can you use eye drops with them still in?
A
Hard lenses
8
Q
How to put eye drops on soft lens?
A
Remove lens or use preservative free drops
9
Q
Can I wear lenses with ointment eye drops?
A
No
10
Q
What 2 drugs stain contacts orange?
A
Rifampicin
sulfasalazine
11
Q
What is used for allergic conjunctivitis as a mast cell stabiliser?
A
Sodium cromogilate
12
Q
What is used for allergic conjunctivitis as an antihistamine?
A
Antazoline
azelastine
13
Q
What dry eye prep is applied QDS?
A
Carmellose
14
Q
What dry eye prep is applied hourly?
A
Hypromellose
15
Q
What drops are given for bacterial conjunctivities?
A
Chloramphenicol eye drops
16
Q
What drug given for viral (HSV) conjunctivitis?
A
Aciclovir 5 times day until 3 days after healing
17
Q
What drug is used for blepharitis?
A
Fusidic acid - staph infection
18
Q
What drug is can cause steroid glaucoma + cataracts?
A
Topical corticosteroids
19
Q
What abx is used for corneal ulcers?
A
Ciprofloxacin
20
Q
What class of drugs used to dilate pupils in eye exams?
A
Mydriatics/cycloplegics
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.
22
Q
Can you drive with antimuscarinic eye drops?
A
No - wait till vision clear as it paralyses ciliary muscle
23
Q
What is 1st line for glaucoma?
A
1- Prostaglandin eye drops
- BB eye drops - betaxolol
24
Q
List 3 examples of Prostaglandin eye drops?
A
Latanoprost, travoprost, bimatoprost
25
What is 5 key SE for Prostaglandin eye drops?
dry eyes + ocular discomfort
Long eyelashes
Darker iris colour + hyperpigmentation of skin
26
What is BB eye drops contra-indicated in?
Asthma
27
What is 3rd line for glaucoma is BB drops don't work?
Carbinic anhydrase inhibitor drops
e.g. brinzolomide
28
What carbonic anhydrase inhibitor is taken orally?
Acetazolamide
29
What is most common form of glaucoma and why does it occur?
Open angle - limited drainage of aqueous humour through trabecular meshwork causing occular HTN
30
What type of glaucoma is an emergency?
Closed-angle glaucoma
31
What are 6 symptoms of Closed-angle glaucoma?
Cloudy eye, N + V, headache, pain, blurred hazy vision, rainbow coloured ring around eyes
32
What are 3 ear conditions?
Otitis media
otitis externa
ear wax removal
33
What is 1st line tx for otitis media?
Amoxicillin (5 days)
34
What is 2nd line tx for otitis media if worsening after 2-3 days tx?
Co-amoxicillin
35
What is 1st line tx for otitis externa?
acetic acid 2%
36
What is 2nd line tx for otitis externa?
Neomycin with corticosteroid
37
What is tx for otitis externa if systemic tx needed??
Flucloxicilin
38
What tx is given for nasal rhinitis?
Sodium chloride, Antihistamines, steroids
39
How long to use nasal steroids?
Max 7 days - due to rebound congestion risk
40
What is tx for nasal polyps?
Nasal steroids - review by specialist initially
41
What is 1st line for Nasal staphylococci
?
Naseptin e.g. chlorhexidine with neomycin cream (Naseptin®)
OR
Mupirocin
42
What are scabies symptoms?
red spots with silver lines - webbing of fingers and toes.
43
What is 1st line for scabies?
Permethrin or Malathion- twice- 1 week apart
Treat all members of family
44
How to apply Malathion or permethrin for scabies?
Scalp , neck , face, ears
Leave for 8 hrs
45
What is mechanical method of removing headlice?
Wet combing - 30 mins every 4 days until no lice found for 3 consecutive sessions.
46
What is minimum time to do wet combing?
2 weeks
47
What is 1st line headlice tx?
Dimeticone - apply for 8 hrs to dry + repeat after 7 days.
48
What is 2ND line headlice tx?
Malathion - apply to dry for 12 hrs + repeat after 7 days
49
When to avoid malathion?
Severe eczema due to alcohol amount.
50
why is benzoate + permethrin not used for headlice anymore?
less effective + not for children (benzoate) + formulations hard to use.
51
What is eczema smyptoms?
Small red spots with dry flaky skin
52
What is used as treatment for eczema?
Emollients
Topical steroids -POM
antihistamines - not in atopic
53
What type of eczema does antihistamines DO NOT work on?
Atopic dermatitis
54
What is used in severe eczema?
Systemic meds -e.g. ciclosporin, MABs, Azathioprine
55
Why are aqueous creams not recommended?
Higher risk of skin reactions
56
What drug is given for mild-moderate atopic eczema?
Topical pimecrolimus
57
What drug is given for severe atopic eczema?
tacrolimus
58
Describe psoriasis?
skin thickening with silvery scales and plaques.
Systemic + immune mediated
59
What are 4 1st line therapy for psoriasis?
Topical emollients, topical corticosteroids, coal tar preparations, + topical vitamin D/analogues
60
What to give when 1st line topical therapy has failed in psoriasis?
UV phototherapy - UVA/UVB
Systemic therapy- mtx, ciclosporin or acitretin
61
What is a mild topical corticosteroid?
HC
62
What is a moderate topical corticosteroid?
Clobetasone
63
What is a potent topical corticosteroid?
Beclomethasone
64
What is a VERY potent topical corticosteroid?
Clobetasol
65
How to apply steroids?
Apply to not broken skin + thinly to avoid skin thinning.
66
What is used in severe acne?
Isotretinoin
67
What are 3 MHRA warnings linked to Isotretinoin?
2 prescribers needed to prescribe it for under 18
Rare Erectile dysfunction + reduced libido.
PPP
68
How many days supply is isotretinoin limited to?
30 days
69
What should women be on when taking isotretinoin?
Contraception 1 month before and till 1 month after stopping.
70
What are some reaction that can occur with isotretinoin?
neuropsychic reactions
71
What to avoid doing when on isotretinoin + 6 months after?
UV light, epilation, laser skin treatment
72
What are some less severe and 1st line treatments for acne?
Benzoyl peroxide, adapalene , clindamycin, erythromycin
73
What is 1st line dandruff treatment?
antimicrobial agents
e.g.pyrithione zinc + selenium, tar extracts
74
What drug is used for psoriasis of scalp?
Coal tar + salicylic acid
74
What is used for more severe dandruff?
Ketaconazole (also in cushing syndrome)
75
What is used for alopecia?
Finasteride
minoxidil
76
How to treat hirutism?
Weight loss
laser therapy, co-cyprindil.
77
Can live vaccines be given in pregnancy?
No
78
What is 1st line for facial erythema in rosacea?
Brimonidine
79
Consecutive use of potent topical corticosteroids should not be used for more --- weeks at any 1 site?
8 weeks
80
How long can very potent topical steroids be used at any 1 site?
Max 4 weeks
81
What is 2 MHRA warnings for brimonidine?
Risk of CVD effects - bradycardia, hypotension, dizziness
Risk of exacerbation of condition
82
What 3 drugs can be used topically for pustules and papules in rosacea?
topical azelaic acid, ivermectin OR metronidazole
83
What 3 drugs can be used orally for pustules and papules in rosacea? (TOE)
Oxytetracycline, tetracylcine + erythromycin
84
How long is treatment for rosacea?
6-12 week course + repeated intermittently.
85
Are repeats allowed for isotretinoin?
No
86
When is emergency supply of isotretinoin allowed?
Specialist request with negative pregnancy test
87
What are some side effects of isotretinoin?
skin peeling, dryness, hepatotoxic, pancreatitis
88
What are 2 Contra-indications of isotretinoin?
Hyperlipidaemia
hypervitaminosis A
89
What are 3 live attenuated vaccines?
MMR
90
What is an inactivated vaccine?
Meningococcal
91
What are 2 inactivated toxin vaccines?
Diptheria + tetanus
92
What is a viral vector vaccine?
Covid 19 (Astrazeneca)
93
What is a nucleic acid based vaccine?
Covid 19 - moderna + pfizer
94
How long to leave between giving different inactivated vaccines?
No interval needed
95
How long to leave between giving SAME inactivated vaccines?
wait 4 weeks
96
How long to wait between giving varicella zoster + MMR?
4 weeks -can be given on same day
97
How long to wait between giving yellow fever + MMR?
minimum 4 weeks -cannot be given on same day
98
What 2 vaccines cannot be given on same day?
yellow fever + MMR
99
What 6 in 1 vaccines are given at 8 weeks? (8 in total)
Diptheria
tetanus
pertusis
Hep B
Polio
Haem influenza B
Meningococcal B + Rotavirus
100
What 6 in 1 vaccines are given at 12 weeks? (8)
Diptheria
tetanus
pertusis
Hep B
Polio
Haem influenza B
pneumococcal + rotavirus
101
What 6 in 1 vaccines are given at 16 weeks? (7)
Diptheria
tetanus
pertusis
Hep B
Polio
Haem influenza B
Meningococcal B
102
What 5 vaccines are given at 1 years old?
MMR
Haem influenza B
Meningococcal C
Meningococcal B
pneumococcal
103
What 5 vaccines are given at 3 years 4 months?
MMR
Diptheria
tetanus
pertusis
poliomyelitis
104
What vaccine given at 11-14 years?
HPV
2nd dose given 6-24 months after
105
When is second dose of HPV given?
6-24 months after 1st dose
106
What vaccine should be given at age 13-15?
Meningococcal A +C
107
What 3 vaccines are given between 13-18 years?
Diptheria, tetanus, poliomyelitis
108
What 5 vaccines are given during pregnancy?
Diphteria, tetanus, pertussis, poliomyelitis, influenza
109
When are vaccines given in pregnancy?
1 dose from 16th week
110
What is 5 eligible criteria for influenza vaccine?
65+ and over
Pregnant women
carers
household contact with immunocompromised
living in long stay residential care
111
What 6 conditions make it good for patients to get influenza shot?
DM
Resp disease
CHD
CKD
adrenal insufficiency
asplenia
112
What 2 agents are used for local anasthesia?
Lidocaine
bupivicaine (longer)
113
Which IV anasthesia has low hangover effect+ rapid recovery?
Propofol
114
Which IV anasthesia is fat soluble + has a longer hangover effect due to it?
Thiopental (rapid onset)
115
Which IV anasthesia has NO hangover effect?
etomidate
116
Which IV anasthesia has less hypotension, slow recovery + high psychoactive SE?
Ketamine
117
What is used in treatment of malignant hyperthermia?
Dantrolene sodium
118
What can anaesthesia and corticosteroids do?
Dangerous fall in BP
119
When to stop COC pil before surgery?
4 weeks before major surgery which involves prolonged immobilisation.
120
When to stop HRT before surgery?
4-6 weeks before surgery
start after mobile
121
When to stop MAOI before surgery?
gradually stop 2 weeks before surgery
122
When to stop lithium before surgery?
24 hrs before major surgery - need fluids + electrolyte balance.
123
What to do if patient has DM and is due for surgery?
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
What kind of drugs can be continued maybe during surgery?
Anti-epileptics/PD drugs, bronchodilators, CVD drugs except K+, POC, Thyroid drugs
125
What CVD drug is stopped during surgery?
K + sparing diuretics
126
When should each prescription of isotretinoin be dispensed within?
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.
