Planning management Flashcards
Where do you find the STEMI/NSTEMI clinical summary in the BNF?
Acute coronary syndrome
Where do you find the anaphylaxis clinical summary in the BNF?
Antihistamines
Where do you find the asthma clinical summary in the BNF?
Asthma
Where do you find the pneumonia clinical summary in the BNF?
Resp system infection -> pneumonia
Where do you find the PE clinical summary in the BNF?
VTE (in full)
Where do you find the meningitis clinical summary in the BNF?
Anti-infective -> CNS infections
Where do you find the DKA clinical summary in the BNF?
Diabetic hyperglycaemic emergencies -> DKA
When do you prescribe a MAO-In or dopamine agonists in PD over levodopa?
Patients with mild Parkinsons who (in the question) are concerned about the finite period of benefit from levodopa
What is the management of tonic-clonic seizures?
- Sodium valproate (men)
- Lamotrigine (women)
What is the management of myoclonic seizures?
- Sodium valproate (men)
- Levetiracetam (women)
What is the management of focal seizures?
- Carbamazepine or lamotrigine
What is the management of absence seizures?
- Ethosuximide or valproate
What is the management of Alzheimer’s disease? What about in moderate/severe?
- Acetylcholinesterase inhibitors
- Donepezil, rivastigmine, galantamine
- Moderate/severe = NMDA antagonist (memantine)
What should you do in response to an isolated rise in serum potassium without symptoms?
- Repeat biochemistry
- Potassium is the most likely electrolyte to be artefactually abnormal
When is metoclopramide contraindicated?
- 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)
When prescribing antiemetics to patients with bowel obstruction what is important?
- Given IV/SC
- In bowel obstruction oral administration is ineffective
What is given for pain relief in ACS?
- Morphine
- 5-10mg
- IV
with
- Cyclizine
- 50mg
- IV
What dose of adrenaline is given in anaphylaxis?
- Adrenaline
- 500mcg
- 1:1000
- IV
What oxygen is typically prescribed in COPD of the patient is stable?
- 28% oxygen
- ABG 30 mins later
What doses of salbutamol and ipratropium are given via nebulisers in acute asthma and COPD?
- Salbutamol - 5mg
- Ipratropium - 500mcg
What is pneumothorax management guided by?
Wether it is primary, secondary or tension
What is the management of primary pneumothorax?
- If <2cm and not SOB - discharge w OP FU in 4 weeks
- If >2cm/SOB - aspirate, if unsuccessful try again, if unsuccessful chest drain
What is the management secondary pneumothorax?
- Secondary always needs treatment
- If >2cm/SOB/>50 - chest drain
- If not - aspirate
What is the management of tension pneumothorax?
- Emergency aspiration
- Will need chest drain
What is the immediate management of suspected bacterial meningitis in community?
1.2 g Benzylpenicillin
(cefotaxime if penicillin allergy)
What is the treatment algorithm for bacterial meningitis?
- ABC
- High flow O2
- IV fluids
- IV dexamethasone (unless severly immunocompromised/septic shock/septicaemia)
- LP (+/- CT head)
- IV cefotaxime - add amoxicillin if immunocompromised or >60
- Consider ITU
What indicates a severe flare of UC?
> 6 bowel motions/day and systemically unwell
