Past Paper Questions Flashcards
What is the first-line management of Bacterial vaginosis in pregnant patients?
First line both
1. Oral or vaginal metronidazole or
2. Oral or vaginal clindamycin
What is the management of normal-pressure hydrocephalus?
First line: ventriculoperitoneal shunting or endoscopic third ventriculostomy
If not suitable for surgery
* repeated large-volume cerebrospinal fluid (CSF) taps (30-60 ml via LP)
What is the most common organsims causing pneumonia in patients with HIV?
Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus
- similar to general population but more suseptible to Pneumococcal pneumonia
What is a typical presentation of Pneumocystis jirovecii pneumonia?
Usually in immunocompromised (If HIV CD4 < 200)
Often
- insidious, long-term presentation of fatigue, SOB, fever chills over weeks (associated with recurrent pneumonia, weight loss and oral candidiasis)
- Often normal chest exam (maybe mild crackels)
CXR
Reticular or granular opacities that are typically perihilar but may be diffuse
What is the first-line treatment for PCP pneumonia?
trimethoprim/sulfamethoxazole
+ ART if Low CD4
What is the first-line antibiotic choice for patients with prostatitis?
If no signs of sepsis: oral ciprofloxacin
if signs of sepsis piperacillin/tazobactam: 4.5 g intravenously every 8 hours/ or iv ciprofloxacin
What is the managment of botthersome LUTS in BPH?
Usually fist line alpha blocker - reduced bladder and urethral tension
Then add
5- alpha reducatase inhibitors (e.g. finasteride) - reduce prosate size but might cause reduced libido and gynaecomastia
What are the indicaitons for surgery in patients with BPH?
What approach is usually taken?
- Complications from BPH:
e.g. acute and/or chronic renal insufficiency, recurrent bladder stones, gross recurrent haematuria, recurent urinary tract infections, or refractory urinary retention
Then offer
TURP first line
What are the referral criteria for prostate cancer?
What are the recommended investigations?
Referral
- if prostate feels malignant on DRE
- consider if LUTS, erectily dysfuntion or visible haematuria AND PSA above reference range for Age (if >79 use clinical judgement)
Investigations
- MRI prostate
- (if likely (score >3) followed by MRI informed biopsy, biopsy usually not perfomed if MRI score 1 or 2 (but can be considered)
What is the acute mangement of acute angle-closure glaucoma?
- Carbonic anhydrase inhiibitors (e.g. acetazolamide)
- topical beta blockers (timolol)
- and/or topical alpha 2 agonsit (brimonidine
- ANd ophthalmic cholinergic agonists (pilocarpine)
Then if still not ocntrolled afer 30-60 minutes
* repea eye drops up to 3 times
* offer IV mannitol (hyperosmolar agent) in patients with nausea
What should be used in recussitation of Major haemorrhage in adults?
- Decrease source of bleeding (e.g. compression)
- Reversal of anticoagulation
- IV Tranexamic acid bolus
- Then transfusion (1:1 RBC with FFP, later add some platelets)
What organism causes Athelt’s foot?
What is the first-line treatment?
Caused by Tinea pedis (dermatophyte)
First line: topical terbinafine(1%) children ≥12 years of age and adults: apply to the affected area(s) twice daily for 1-3 weeks
Which nerve supplies the muscles for
- wrist and finger extension
- wrist and finger flexion
- inner muscles of the hand
- wrist and finger extension - radial nerve
- wrist and finger flexion - median nerve (except flesion 4th and 5th digit - ulnar)
- inner muscles of the hand - ulnar nerve
What is the antibiotic of choice for chlamydia (pregnant and non-pregnant)
Non-pregnant and men: doxy (100mg PO BD 7 days)
Pregntn: Azithromycin 1g orally single dose
What is the antibiotic choice for Gonorrhoea infectins?
Ceftriazone IM sigle dose (+/- azithromycin)
