Passmed Questions 3.0 Flashcards
simple measures for acne rosacea
daily suncream
camouflage cream
first line treatment for acne rosacea with predominant flushing and minimal telangiectasia
topical brimonidine (alpha agonist)
treatment for mild/moderate/severe acne rosacea with papules/pustules
mild - topical ivermectin
moderate/2nd line - topical metronidazole or topical azelaic acid
severe - topical ivermectin + oral doxycycline
what drugs can trigger psoriasis
lithium
betablockers
antimalarials
NSAIDS
ACE inhibitors
inflixamab
treatment for diabetic otitis externa
ciprofloxacin
patient has angina, is on gtn spray but still experiences symptoms. What medication would you add next?
betablocker or CCB
what type of CCB should be used if used as monotherapy for angina
monotherapy = rate limiting i.e. verapamil or diltiazem
if in conjunction with betablocker as 2nd line then use dihydropyradine i.e. nifedpine or amlodipine
treatment for MSRA
nasal mupirocin + topical chlorhexidine
what age would a child require the ability to crawl
9 months
what age would a child respond to their name
what age would a child sit unsupported
7-8 months
diagnosis ? –> chronic unilateral conjunctivitis resistant to treatment
orbital lymphoma
breastfeeding at how many weeks post partum s a UKMEC 4 for contraindication for OCP
< 6 weeks post partum and breast feeding
treatment for bacterial vaginosus if metronidazole allergy
topical clindamycin
treatment bacterial vaginosus if pregnancy
oral metronidazole
treatment for fibroid in a patient who is wanting to concieve
refer for myomectomy
side effects of herceptin (tratzumab) for HER2 positive breast cancer
flu like symptoms
cardiac toxicity
partial seizures at night in children
benign rolandic epilepsy
EEG = centrotemporal spikes
imipramine drug class and side effects
TCA
anti cholinergic side effects
treatment for galactorhoea
bromocriptine (dopamine agonist)
1st line treatment for osteoporosis post hip fracture
IV zolendronate
treatment for osteoporosis if renal failure
desonumab (bisphosphonates are contraindicated)
at what dose of daily prednisolone would a patient also require bone protection
if they are on 7.5mg or more daily for the next 3 months would require bone protection
main indication for cryoprecipitate
low fibrinogen
what is the constitutes ofcryoprecipitate
contains factor VIII:C, VonWillebrand factor, fibrinogen, factor XIII, and fibrinonectin
section 2 of MHA
admission for assessment for up to 28 days (not renewable)
section 3 of MHA
admission for treatment for up to 6 months
section 4 of MHA
72 hour assessment order
first line treatment for all patients with peripheral vascular disease
atorvastatin + clopidogrel
Causes of massive splenomegaly
Can My Massive SPLEEN be Very Great
chronic myeloid leukaemia
myelofibrosis
malaria
visceral leishamniasis
gauchers
section 135 of MHA
a court order can be obtained to allow the police to break into a property to remove a person to a Place of Safety
section 136 of MHA
someone found in a public space who appears to have a mentlal health disorder and take them to a place of safety
section 5(2) of MHA
someone who is voluntarily in hospital can be detained for 72 hours
section 5(4) of MHA
allows a nurse to detain a voluntary patient in the hospital
can pregnant women have the pertusis vaccine
yes between 16-32 weeks
what is the feverPAIN score
fever
purulent tonsils
attend rapidly
inflammed tonsils
no cough or coryza
0-1 safety net
2-4 = delayed abx
score of 4-5 = immediate abx
what investigation is useful for IgE mediated allergy i.e. bee venom, food allergy, inhaled allergen (pollen)
RAST
what investigation is useful for contact dermatitis
skin patch
what investigation is useful for food allergy (non-anaphylactic reaction)
skin prick test
what is fouchers sign
describes Bakers cyst which becomes tense on extension of the leg
2nd line investigation for NAFLD if enhanced liver fibrosis blood test (ELF) not available
FIB4 score or NAFLD fibrosis score
scores may be used in combination with fibroscan (liver stiffness measurement assessed with transient elastography)
presentation of vitreous haemorrhage
large haemorrhage - sudden loss of vision (painless)
moderate - large black spots
small - floaters
features of central retinal artery occlusion vs vein occlusion on fundoscopy
renal artery - afferent pupillary defect, cherry red spot
retinal vein - multiple severe haemorrhages
first line investigation for suspected lyme disease if erythema migrans not present
ELISA
features of disseminated lyme disease
cardiac - heart block, myo/pericarditis
neuro - facial nerve palsy, meningitis, radicular pain
patient develops fever, rash, tachycardia after starting abx for lyme disease or syphilis
Jarisch Herxheimer reaction
cardiac complications associated with polycystic kidney disease
long QT
mitral regurgitation
main mechanism of nexplanon
inhibits ovulation
when can you drive after first unproved seizure
6 months
can you drive with epilepsy diagnosis
can qualify for drivers liscence if seizure free for 12 months
when can you drive after TIA/stroke
1 month
when can you drive after multiple TIA’s over short period of time
3 months
treatment for scarlet fever if penicillin allergic
azithromycin
when can a child with scarlet fever return to school
24 hours after starting antibiotics
causative organism of scarlet fever
group A strep (usually strep pyogenes)
complications associated with scarlet fever
otitis media (most common)
acute glomerulonephritis
rheumatic fever
other i.e. meningitis, nec fasc, sepsis
janeway lesions and osler nodes, - what are they are which are painful/painless
janeway lesions are painless caused by septic emboli
osler nodes are painful - caused by immune complex deposition
are antiepileptics safe in breastfeeding
yes except from barbiturates
increased risks in elderly taking antipsychotic medication
stroke + VTE
genital wart treatment
single - cryotherapy
multiple - topical podophyllum
incubation period of campylobacter, salmonella, e.coli and shigella
shigella, salmonella and e.coli - 12-72 hours
campylobacter - 2-5 days
what anti rheumatic drug can cause exacerbation of myaesthenia gravis
penicillamine
acute tretament for cluster headache
100% 02
subcutaneous triptan
risk factors for cluster headaches
smoking
male
alcohol may trigger
treatment for malignant otitis externa
severe otitis externa found in immunocmpromised individuals
usually pseudomonas
worsening and not responding to tretament should be referred urgently to ENT
IV ciprofloxacin
missed pill rule for ‘traiditional’ POP and desogestrel
all POP have a 3 hour window so if missed > 3 hours then take pill + protection for 48 hours
desogestrel is the only POP that has 12 hour window.
monitoring required for amiodarone
TFT and LFT every 6 months
monitoring required for ACE inhibitors
u&e prior to treatment, after dose change and at least annually
monitoring required for methotrexate
FBC, U&E, LFT every 2 weeks until treatment established then every 2-3 months
monitoring required for lithium
lithium level every 3 months
U&E + TFT every 6 months
tear drop poikoilocytes on blood film
myelofibrosis
