MSRA mock 3 Flashcards
side effects of melatonin
Headache, back pain and arthralgia
What meds used for migraine and which meds to avoid
1st line - simple anaglesia - NSAID, aspirin, paracetamol
Cmbo with oral triptan and analgesia
anti-emetic - prochloperazine, domperidone, metoclopramide)
which blood test used for Primary Biliary Cholangitis?
AMA - in 90-95% of patients
Carbimazole - considerations
adequate contraception
stop if pancreatitis
FBC in unwell patients - especially sore thorat
will be present in breast milk
Should conjunctivitis stop kids and teachers going to school m
NO
what are options of hirsutism in PCOS
conservative mx - weight loss, hair removal, waxing, laser hair removal
Topical EFLORNITHINE (stop after 4 months if no improvement)
Dianette can be given
Referral to secondary care
how to take bisphosphonates
empty stomach
upright with 200ml water
not to be chewed
remain uprgith for 30mins
dental check before hand
how to manage oral candidiasis in children
immunocompetent
1st line: miconazole gel 7 days
2nd line: Nystatin 7 days
no oral antifungals and refer to paediatric team if no response after 2 weeks of treatment
what Rx options for acne vulgaris
top retinoid or benzoyl peroide should always be co-prescribed with oral abx to reduce risk of abx resistance
if menorraghia /needing contraception - COCP and top benzoyl peroxide
if no reposnd to two courses of abx or if starting to scar - refer to dermatologist for isotretinoin
NO POP - MAY MAKE ACNE WORSE
Which circumstances should abx be given for acute otitis media
normally not - analgesia only
if sx going for more than 3 days , systemic upset, those with high risk of complications
immediate amdission if severe infection, mastoiditis, children less than 3 months old with temp 38.
what is the stepwise approach to GAD
step 1: education and monitoring
step 2- low intesnisty psycholigival intevention - self help, groups
step 3 - CBT or drugs
-SSRI 1st line (sertraline, paroxetine
- SNRI venlafaxine or duloxetine alternative
step 4 - specialist referral
how to manage greater trochanteric pain
chronic intermittent pain felt round the greater trochanter
reassure that condition self limiting and avoid exersiz and lose weight
steroid injection and physio next
lyme disease mx
diagnosis can be made clinically and give oral doxy
if no rash and still suspicious - can send ELISA test
How to manage TIA in community
if symptoms within 7 days then urgent assessment with stroke specialist and commence aspirin 300mg
what percentage reduction should occur in cholesterol when statring statin
> 40% reduction in the non HDL cholesterol after 3 months.
How to manage chlamydia
if contact - self swab and abx
doxy or azithromycin
how to manage asthma in less than 5 y.o
ICS and SABA for 8 weeks
refer specialist if still sx following adherance and inhaler technique checl
if sx do resolve with trail - stop ICS and SABA for 3 month and if still fail then restart ics and SABA for 12 motnhs
if sx recur again, consider LTRA + ICS + SABA
meds in depression
SSRI
SSRI not to be given with triptans
sertraline preferred in those with multple co-morbidities
Whooping cough
Bordetella pertussis
notifiable
macrolide if onset within 21 days
Asthma management >12
1)low dose MART PRN
2) low dose regular MART
3) Moderate-dose regular MART
4) add trial of LTRA or LAMA
5) refer specialist
