Planning management

Question 1

Where do you find the STEMI/NSTEMI clinical summary in the BNF?

Answer 1

Acute coronary syndrome

Question 2

Where do you find the anaphylaxis clinical summary in the BNF?

Answer 2

Antihistamines

Question 3

Where do you find the asthma clinical summary in the BNF?

Answer 3

Asthma

Question 4

Where do you find the pneumonia clinical summary in the BNF?

Answer 4

Resp system infection -> pneumonia

Question 5

Where do you find the PE clinical summary in the BNF?

Answer 5

VTE (in full)

Question 6

Where do you find the meningitis clinical summary in the BNF?

Answer 6

Anti-infective -> CNS infections

Question 7

Where do you find the DKA clinical summary in the BNF?

Answer 7

Diabetic hyperglycaemic emergencies -> DKA

Question 8

When do you prescribe a MAO-In or dopamine agonists in PD over levodopa?

Answer 8

Patients with mild Parkinsons who (in the question) are concerned about the finite period of benefit from levodopa

Question 9

What is the management of tonic-clonic seizures?

Answer 9

• Sodium valproate (men)
• Lamotrigine (women)

Question 10

What is the management of myoclonic seizures?

Answer 10

• Sodium valproate (men)
• Levetiracetam (women)

Question 11

What is the management of focal seizures?

Answer 11

• Carbamazepine or lamotrigine

Question 12

What is the management of absence seizures?

Answer 12

• Ethosuximide or valproate

Question 13

What is the management of Alzheimer’s disease? What about in moderate/severe?

Answer 13

• Acetylcholinesterase inhibitors
• Donepezil, rivastigmine, galantamine
• Moderate/severe = NMDA antagonist (memantine)

Question 14

What should you do in response to an isolated rise in serum potassium without symptoms?

Answer 14

• Repeat biochemistry
• Potassium is the most likely electrolyte to be artefactually abnormal

Question 15

When is metoclopramide contraindicated?

Answer 15

• 3-4 days post abdo surgery
• In patients with bowel obstruction

Metoclopramide is pro-kinetics. Also remember to avoid in patients with PD (can exacerbate symptoms)

Question 16

When prescribing antiemetics to patients with bowel obstruction what is important?

Answer 16

• Given IV/SC
• In bowel obstruction oral administration is ineffective

Question 17

What is given for pain relief in ACS?

Answer 17

• Morphine
• 5-10mg
• IV

with

• Cyclizine
• 50mg
• IV

Question 18

What dose of adrenaline is given in anaphylaxis?

Answer 18

• Adrenaline
• 500mcg
• 1:1000
• IV

Question 19

What oxygen is typically prescribed in COPD of the patient is stable?

Answer 19

• 28% oxygen
• ABG 30 mins later

Question 20

What doses of salbutamol and ipratropium are given via nebulisers in acute asthma and COPD?

Answer 20

• Salbutamol - 5mg
• Ipratropium - 500mcg

Question 21

What is pneumothorax management guided by?

Answer 21

Wether it is primary, secondary or tension

Question 22

What is the management of primary pneumothorax?

Answer 22

• If <2cm and not SOB - discharge w OP FU in 4 weeks
• If >2cm/SOB - aspirate, if unsuccessful try again, if unsuccessful chest drain

Question 23

What is the management secondary pneumothorax?

Answer 23

• Secondary always needs treatment
• If >2cm/SOB/>50 - chest drain
• If not - aspirate

Question 24

What is the management of tension pneumothorax?

Answer 24

• Emergency aspiration
• Will need chest drain

Question 25

What is the immediate management of suspected bacterial meningitis in community?

Answer 25

1.2 g Benzylpenicillin

(cefotaxime if penicillin allergy)

Question 26

What is the treatment algorithm for bacterial meningitis?

Answer 26

1. ABC
2. High flow O2
3. IV fluids
4. IV dexamethasone (unless severly immunocompromised/septic shock/septicaemia)
5. LP (+/- CT head)
6. IV cefotaxime - add amoxicillin if immunocompromised or >60
7. Consider ITU

Question 27

What indicates a severe flare of UC?

Answer 27

> 6 bowel motions/day and systemically unwell