Miscellaneous Flashcards
1
Q
What is the management plan for Fibroadenoma?
A
- Observation and reassurance - usually no treatment
- supported by no FHx of cancer and biopsy showing non-proliferative lesion
- If in doubt refer for USS +/- FNA
- If large or growing quick/ causing discomfort - surgical excisional biopsy
2
Q
What is the management plan for Mastitis/ breast abscess?
A
- Lactational Mastitis
- if not severe + not prolonged
- 1st Line = effective milk removal + simple analgesia
- if severe or prolonged
- 1st Line = 10-14 days oral flucloxacillin
- 2nd Line/MRSA confirmed = vancomycin
- if not severe + not prolonged
- Non-Lactational - same but go straight to ABx
- if Anaerobic consider cefalexin
- Breast abscess - surgical drainage + culture of fluid
- IV/Oral dicloxacillin or cefalexin
- Advice for relief - warm compress to aid milk flow and continue breast feeding to encourage milk removal
3
Q
What is the management plan for Bell’s Palsy?
A
- All patients
- 1st Line - oral prednisolone
- Eye protection - Tape + opthalmic lube
- Severe/complete facial paralysis
- Consider acycolivir
- If complete - surgical decompression can help
4
Q
What is the management plan for infectious mononucleosis?
A
- 1st Line - paracetomal/ibuprofen
- + rest, fluids and anti-pyretics
- If upper aiway obstruction or haemolytic anaemia in severe cases –> + corticosteroids e.g. prednisolone
- If thrombocytopenia consider IV immunoglobulins
- Avoid sport for 2 weeks to avoid risk of splenic rupture
Note - aciclovir and antivirals are not indicated in decreasing Sx and complications
DO NOT GIVE AMPICILLIN OR AMOXICILLIN -> 100% of cases get maculopapular rash
5
Q
What is the management for Testicular Torsion?
A
- Medical emergency
- 1st Line = Emergency scrotal exploration and repair within 6 hours
- Plus morphine and ondansetron
- 2nd Line = If unavailable in < 6hours - manual de torsion
- If testicle becomes necrotic - unilateral orchidectomy
