OTC

Question 1

ACNE

Answer 1

Benzoyl Peroxide-2.5% gel

Refer- 
Over 25 first time
Treatment failure
Rosacea
Moderate/sever

Question 2

Allergic Rhinitis

Answer 2

Oral Loratadine/cetirizine
If fails-
Eyedrops- Antazoline
Nasal corticosteroid- Budesonide

Refer-
Failed treatment
Medicine induced
Nasal obstruction
Unilateral

Question 3

Cold Sores

Answer 3

Aciclovir 5% cream in tingly phase
hydrocolloid patch

Refer-
14+ days
In mouth
Rapid spread
Immunocomp
Severe widespread
Systemic symptoms

Question 4

Constipation

Answer 4

Softener-Docusate
Stimulant-Senna
Osmotic-Lactulose
Bulk- Psyllium

Refer-
Blood
14 days
Pain causing patient to suppress 
Over 40 with sudden changes
Depression
Hypothyroidism

Question 5

Cough/Cold

Answer 5

Expectorant- Guaifenesin
Mucolytic- Bromhexine
Suppressant- Pholcodine
Cold- Pseudo

Refer-
Chest pain
Regular
Flu symptoms
2+ weeks
Blood
Pain on breathing
Night cough in children
Wheeze/ SOB

Question 6

Diarrhoea

Answer 6

Hydration
Loperamide

Refer-
Change in habits over 50
Recent travel
longer than 2-3 days in risky group
Unable to drink fluid
Blood
Pain

Question 7

Dysmenorrhoea

Answer 7

Period pain
NSAIDS
Para
COC

Refer-
Heavy/unexplained bleeding
Pain before menses
Signs infection
New over 30

Question 8

Ear Problems

Answer 8

Sodium chloride drops

Refer-
Dizziness
Fever
Foreign body
Medicine failure
Ringing

Question 9

Eczema/dermatitis

Answer 9

Emollient
Hydrocortisone
Clobetasone

Refer-
Under 2
Face
Treatment failure
Widespread

Question 10

Emergency contraception

Answer 10

.

Question 11

Eye problems

Answer 11

Bacterial- Chloramphenicol
Viral- Lubricating eye drops

Referal-
Vomiting
Clouding of cornea
Vision problems
Photophobia
Foreign body
Eye pain

Question 12

Gingivitis

Answer 12

Gum inflammation
Chlorhexidine gluconate mouth wash

Refer-
Foul taste with bleed
Loose teeth
Systemic illness
Spontaneous bleeding

Question 13

Haemorrhoids

Answer 13

Reduce constipation
Anaesthetics- 
Steroid
Protectorant
Astringent

Xyloproct

Refer-
Abdominal pain
Blood in stool
Fever
Change in bowel habits
Unexpected bleeding

Question 14

Hair Loss

Answer 14

Minoxidil

Refer-
Fungal scalp infection
Under 18
Sudden onset

Question 15

Head Lice

Answer 15

Permethrin

Question 16

Headache

Answer 16

Paracetamol
NSAID
Metoclopramide+ Paracetamol

Refer-
Stiff neck under 12
Unresponsive to management
Recent head injury
More than 2 weeks
N+V
New over 50
Worsening over time
Sudden onset

Question 17

Heart Burn

Answer 17

Antacid
Ranitidine
PPI-Somac-pantoprazole

Refer-
Loss of weight
Progressive symptoms
Blood
Severe
Pain refered
Food sticking to throat
Exercise induced

Question 18

Infant colic

Answer 18

Infacol

Question 19

Insomnia

Answer 19

Doxylamine

Question 20

Mouth Ulcer

Answer 20

Triamcinolone at night
Local anaesthetics eg lignocaine
Antibacterial mouthwash

Refer-
Under 10yo
14+ Days
Painless
Fever
1cm+
5+ ulcer

Question 21

Nappy Rash

Answer 21

.

Question 22

Nausea/travel sickness

Answer 22

.

Question 23

PMS

Answer 23

Vit B6
Calcium

Refer-
Psychological symptoms
Severe
Worsen on period 
Under 30

Question 24

Scabies

Answer 24

Permethrin

Refer-
Severe

Question 25

Threadworm

Answer 25

mabendazole single dose- repeat after 2 weeks

Question 26

Thrush (Oral)

Answer 26

Nystatin Drops 1 drop 4 times daily under tongue for as long as possible ``` Refer- Diabetes 3 weeks Immuno Painless lesions ```

Question 27

Thrush (Vag)

Answer 27

Topical miconazole Oral Fluconazole Nystatin cream ``` Refer- Diabetes Strong odour Non prescription medication failure Pregnancy Recurrent under 16 or over 60 ```

Question 28

Tinea

Answer 28

Miconazole Refer- Failure Nail

Question 29

Warts

Answer 29

Salicylic acid products Cryotherapy ``` Refer- Anogenital Diabetes Face Widespread 50+First time Itch/bleed Grown/changed colour ```