medicines 31 Flashcards
What medications cause hyperkalaemia?
- Trimethoprim / Ciclosporins
- Heparins
- ACEi and ARBs
- Mefenamic Acid
- NSAIDs
- Diuretics – e.g. Potassium sparing e.g.
Spironolactone
What cream is best for the itching of chicken pox otc?
Crotamiton cream would be most
suitable for itching (licensed for
children over 3 years)- but was not
an option in the question
* Calamine cream is licensed for children and is used to sooth the skin
(helping with itching)
Whats the difference between measles and mumps ?
Measles:
Cause: Caused by the measles virus.
Symptoms:
High fever
Cough, runny nose, and sore throat
Red, watery eyes
Koplik spots (small white spots inside the mouth)
Rash: Starts on the face and spreads to the rest of the body, usually 3–5 days after symptoms begin.
Mumps
Cause: Caused by the mumps virus.
Symptoms:
Swelling of the parotid glands (glands near the ears) – causes puffy cheeks and a jawline bulge
Fever, headache, and muscle aches
Fatigue
Loss of appetite
Key Differences:
Rash:
Measles causes a red rash.
Mumps causes swelling of the glands (especially near the ears).
Affected Areas:
Measles affects the eyes, throat, and skin.
Mumps primarily affects the salivary glands.
Transmission:
Both are highly contagious, but measles is more airborne, while mumps is spread through saliva.
What is pertussis?
The first signs of whooping cough are similar to a cold,
such as a runny nose and sore throat (a high
temperature is uncommon).
* will get coughing bouts that last for a few minutes
and are worse at night
* may make a “whoop” sound – a gasp for breath
* may have difficulty breathing after a coughing bout
and may turn blue or grey (young infants)
* may bring up a thick mucus, which can make you
may become very red in the face (more common in
adults)
* The cough may last for several weeks or months.
Red flags and referrals:
* Babies under 6 months old
* Been in contact with someone with whooping
cough and you are pregnant
* Those with a weakened immune system
* Signs of dehydration
* If they are having a seizure
* Difficulty breathing or the child is turning
blue or grey
vomit
What is wilsons disease and what is the treatment for it ?
What is Wilson’s disease?
* It is a genetic disorder that prevents the body
from removing copper from the body.
* The copper builds up in the eyes, brain, liver and
other organs
* If left untreated = the excess copper can cause
hepatitis, cirrhosis, necrosis and damage to the
spleen
Zinc can be used as a treatment.
Zinc acetate: Blocks the intestines from absorbing copper from food
What is the first line treatment for pyelonephritis ?
and what is used in pregnancy?
Oral first line:
Cefalexin. If sensitivity known: co-amoxiclav, or trimethoprim.
Pregnancy:Oral first line:
Cefalexin.
IV: (if severely unwell or unable to take oral treatment):
Cefuroxime.
What is Guillain-Barré syndrome?
Guillain-Barré syndrome is an acute ascending polyneuropathy which usually occurs
following an infection. It can eventually affect the respiratory muscles
What is Myasthenia gravis
Myasthenia gravis is a chronic autoimmune disorder that causes weakness in the voluntary muscles (muscles you can control).
✅ Muscle Weakness (Fluctuating and Fatigable):
Eye muscles:
Ptosis (drooping eyelids)
Diplopia (double vision)
Face and throat muscles:
Difficulty with speaking (dysarthria)
Trouble swallowing (dysphagia)
Problems with chewing
Limb and neck muscles:
Weakness in the arms, legs, and neck (especially after repeated use).
Respiratory muscles:
Severe cases can cause breathing difficulties (myasthenic crisis – a medical emergency).
What is haemochromatosis?
Haemochromatosis is a condition where the body absorbs too much iron from food.
The excess iron is stored in organs like the liver, heart, and pancreas, leading to organ damage if not treated.
It’s often called “iron overload disorder.”
Symptoms:
Tiredness and weakness
Joint pain (especially in the hands)
Abdominal pain
Liver problems (e.g., enlargement, cirrhosis)
Diabetes (due to damage to the pancreas)
Skin bronzing (a tanned appearance)
Heart problems (e.g., heart failure, arrhythmias)
Loss of sex drive and impotence
WHat is RSV ?
Respiratory Syncytial Virus (RSV) is a common virus that affects the lungs and breathing passages.
It causes mild, cold-like symptoms in most people but can lead to serious respiratory illness in:
Babies and young children (especially under 2 years)
Older adults
🤧 Common Symptoms:
Mild cases (like a cold):
Runny nose
Cough
Sneezing
Sore throat
Mild headache
Fever
Severe cases (especially in infants and elderly):
Wheezing
Rapid breathing or difficulty breathing
Bluish lips or face (a sign of low oxygen—medical emergency)
Apnoea (pauses in breathing, particularly in infants)
After starting treatment for impetigo how long do children have to be kept off school?
This child has impetigo. According to Public Health England guidance the child should
stay away from school until lesions are healed, dry and crusted over or 48 hours after
initiation of antibiotics.
What are the first line treatments for depression in post natal pregnancy?
Paroxetine and sertraline are generally the SSRIs of choice for treatment initiated in breastfeeding women
What is the treatment for cluster headaches?
High-flow Oxygen (100%)
12–15 L/min via non-rebreather mask for 15–20 minutes
Highly effective with minimal side effects.
Subcutaneous Sumatriptan (6 mg)
Provides rapid relief (within 10-15 minutes).
Intranasal Zolmitriptan (5 mg)
Alternative if injections are not tolerated.
🚫 What NOT to use for acute attacks:
Oral triptans (too slow in onset).
What are the blood pressure target in CKD?
ACR < 70 mg/mmol:
Systolic BP: <140 mmHg (target range 120–139 mmHg)
Diastolic BP: <90 mmHg
ACR ≥ 70 mg/mmol:
Systolic BP: <130 mmHg (target range 120–129 mmHg)
Diastolic BP: <80 mmHg
Aged ≥ 80 years (regardless of ACR):
Systolic BP: <150 mmHg
Diastolic BP: <90 mmHg
Which thiazide or thiazide like diuretics are best in renal impairment?
30ml per min and less
Indapamide (Thiazide-like)
Effective down to eGFR ~30 mL/min/1.73m²
Uniquely effective even in severe renal impairment (eGFR <30 mL/min/1.73m²).
What are the dosage adjustments required with rivaroxaban in renal impairment?
When used for Treatment of deep-vein thrombosis or pulmonary embolism:
Following the first 21 days of treatment for deep-vein thrombosis or pulmonary embolism, the usual dose of 20 mg once daily can be given, but consider reducing to 15 mg once daily if creatinine clearance 15–49 mL/minute and the risk of bleeding outweighs the risk of recurrent deep-vein thrombosis or pulmonary embolism.
When used for Prophylaxis of recurrent deep-vein thrombosis or pulmonary embolism:
When the recommended dose is 20 mg once daily, consider reducing to 15 mg once daily if creatinine clearance 15–49 mL/minute and the risk of bleeding outweighs the risk of recurrent deep-vein thrombosis or pulmonary embolism.
When used for Prophylaxis of stroke and systemic embolism in patients with non-valvular atrial fibrillation:
Reduce dose to 15 mg once daily if creatinine clearance 15–49 mL/minute.
What is Gillicks competence ?
Gillick competence is used to assess whether a child (under 16 years old) has the capacity to consent to their own medical treatment without the need for parental permission or knowledge.
What are some of the most important drug interactions with methotrexate to be aware of?
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs):
E.g., ibuprofen, naproxen.
Mechanism: Reduce renal blood flow → impaired MTX elimination.
Risk: Myelosuppression, mucositis, hepatotoxicity.
Note: Low-dose MTX (e.g., for RA) with NSAIDs is generally safe but requires caution and monitoring.
Trimethoprim (especially with sulfamethoxazole):
Mechanism: Additive folate antagonism + reduced MTX clearance.
Risk: Severe bone marrow suppression (pancytopenia) and nephrotoxicity.
⚠️ Contraindicated.
Penicillins (e.g., amoxicillin):
Mechanism: Compete for renal tubular secretion, increasing MTX levels.
Risk: Myelosuppression and mucositis.
Monitor closely if co-administration is necessary.
Proton Pump Inhibitors (PPIs) (e.g., omeprazole, esomeprazole):
Mechanism: Reduce MTX clearance by affecting renal transporters.
Risk: Elevated MTX levels → toxicity.
Consider alternatives like ranitidine if appropriate.
After initiating Clozapine, what is the most appropriate time frame to monitor blood
counts?
Weekly for the first 18 weeks
What colour sputum could indicate congestive heart failure?
Pink
What are the first line treatments for nocturnal enuresis in children?
- Desmopressin (Oral/Sublingual):
Indication:
Children >5 years when alarm therapy is unsuitable or rapid results are needed (e.g., trips).
Partial response after combined alarm + desmopressin therapy.
Duration:
Assess at 4 weeks; continue up to 3 months if responsive.
Repeat courses if relapse occurs, with gradual withdrawal (1 week off every 3 months) for reassessment. - Desmopressin + Antimuscarinic (Specialist Supervision):
For nocturnal enuresis with daytime symptoms (overactive bladder).
Antimuscarinics: Oxybutynin or Tolterodine (unlicensed).
Duration: 3 months; repeat if necessary.
Which antihypertensives can cause facial flushing?
All Calcium channel blockers! (common SE BNF)
Jow much more potent is QVAR than Clenil?
Qvar is twice as potent as Clenil
What is the first line treatment medication for trigeminal neuralgia ?
Carbamazepine
