planning management

Question 1

Thrush drug contraindication in pregnancy

Answer 1

fluconazole - oral azole drugs

Question 2

treatment of choice for thrush in pregnancy

Answer 2

clotrimazole pessary 100mg PV daily for 7 days

Question 3

treatment summary page name for thrush

Answer 3

vaginal and vulvovaginal conditions

Question 4

First line treatment for C-difficile

Answer 4

vancomycin 125mg PO 6 hourly

Question 5

second line treatment for c diff

Answer 5

Fidaxomycin 200 mg PO 12 hourly

Question 6

can antidiarrhoeals be used in c.diff

Answer 6

no - loperamide for example?

Question 7

which drug may be used under specialise advice as an adjuvant in c diff

Answer 7

metronidazole

Question 8

treatment summary for c.diff

Answer 8

Gastro-intestinal system infections, antibacterial therapy

Question 9

diagnosis in this case

Answer 9

DKA

Question 10

BNF advice in regards to insulin regimen for DKA

Answer 10

Question 11

is insulin glargine short or long acting

Answer 11

long acting

Question 12

is soluble insulin (humulin) with meals short or long acting

Answer 12

short acting

Question 13

fluid recitation in DKA

Answer 13

sodium chloride 1L over 30mins

Question 14

Treatment summary for DKA

Answer 14

Diabetic hyperglycaemic emergencies

Question 15

diagnosis in this case

Answer 15

scarlet fever

Question 16

scarlet fever drug and dose

Answer 16

Question 17

summarise the WHO pain ladder

Answer 17

Question 18

how to treat mild pain

Answer 18

Question 19

wheb is amitrypatline inidacted for pain and what are the adverse effects of drugs from this class

Answer 19

Question 20

what condition is this and whats the management?

Answer 20

This case describes Herpes Zoster (Shingles).

Key Features:
Prodromal Symptoms:

Shivering and myalgia (viral prodrome)
Mild burning pain and numbness (neuropathic pain)

Dermatomal Rash:

Unilateral, erythematous vesicular rash
Localized to the T7 dermatome on the left
Follows a classic dermatomal distribution, which is characteristic of herpes zoster.
Risk Factors:

Age: Older adults are at higher risk.
Immunosuppression: The patient is taking azathioprine, which increases susceptibility to viral reactivation.
Diagnosis:
Clinical diagnosis based on unilateral vesicular rash in a dermatomal distribution.
PCR or Tzanck smear can confirm varicella-zoster virus (VZV) if needed.
Management:
Antiviral therapy (ideally within 72 hours of rash onset):
Aciclovir 800 mg 5 times daily for 7 days (or)
Valaciclovir 1g 3 times daily for 7 days.
Pain management:
Paracetamol/NSAIDs for mild pain.
Gabapentin/pregabalin for severe neuropathic pain.
Monitor for complications:
Postherpetic neuralgia (persistent pain >3 months).

Question 21

adverse effects of NSAIDs

Answer 21

gastrotoxicity
renal impairment

Question 22

adverse effects of opioid analgesics

Answer 22

• constipation
• nausea
• drowsiness

Question 23

Answer 23

The combination of infection (UTI), fever, and confusion strongly suggests urosepsis

not nitrofurantoin because “In adults: Avoid if eGFR less than 45 mL/ minute/1.73 m2; may be used with caution if eGFR 30–44 mL/ minute/1.73 m2 as a short-course only (3 to 7 days), to treat uncomplicated lower urinary-tract infection caused by suspected or proven multidrug resistant bacteria and only if potential benefit outweighs risk.”

trimethoprim - Adult
200 mg twice daily for 3 days (7 days in males).

Question 24

Answer 24

alcohol withdrawal - treatment

alcohol dependence treatment summary

NOT thiamine - vitamin supplementation is not given first line for acute treatment of alcohol withdrawal. Use prophylactic thiamine in the dependant drinker

Question 25

Answer 25

phytomenadione - vitamin K

Question 26

where can you find information about preparing for theatre on anticoagulants

Answer 26

oral anticoagulation treatment summary https://bnf.nice.org.uk/treatment-summaries/oral-anticoagulants/

Question 27

Answer 27

Initially 5 mg once daily, usual maintenance 10 mg once daily; increased if necessary up to 20 mg once daily.

Question 28

diagnosis?

Answer 28

osteoarthritis For Ibugel® Forte Pain relief in musculoskeletal conditions, Treatment in knee or hand osteoarthritis (adjunct) for Ibugel® Forte To the skin Adult Apply up to 3 times a day.