Planning Management

Question 1

Anaphylaxis management:

Answer 1

• 500 micrograms Adrenaline 1:1000 IM
• Chlorphenamine 10mg IV
• Hydrocortisone 200mg IV

Question 2

Acute exacerbation of asthma/ COPD:

Answer 2

• Salbutomol 5mg neb - back to back
• Ipratropium 0.5mg neb
• Hydrocortisone 100mg IV or Prednisolone 40-5-mg PO
• Theophylline

Question 3

Management of seizures…

Answer 3

>5mins:
- IV Lorazepam 2-4mg
- IV Diazepam 10mg 
- Buccal Midazolam 10mg 
Seizure still not controlled...
- Phenytoin infusion 
- Intubation then Propofol

Question 4

When is hypertension treatment started?

Answer 4

BP > 150/95 mmHg home reading

Question 5

When is warfarin/ DOAC used in AF?

Answer 5

CHADSVASC2 score > 1 in men, 2 in women

Question 6

Management of stable angina…

Answer 6

1. GTN spray PRN
2. Secondary prevention: Aspirin, Statin
3. One anti-anginal drug: BB or CCB
4. If sx persist - increase dose of anti-anginal drug
5. If sx persist - add other option (BB or CCB)
6. If sx persist on 2 anti-anginal drugs - assess for PCI/CABG

Question 7

Management of T2DM…

Answer 7

1. Diet and exercise
2. Metformin - 500mg PO OD with breakfast
   3.If HbA1c>58 - dual therapy (Metformin + DPP4i/ SU/ glitazone/ SGLT2i)
   4.If HbA1c>58 - triple therapy (Metformin + DPP4i + SU)
   Consider insulin therapy at this point

Question 8

First line treatment for PD

Answer 8

Co-Beneldopa or Co-Careldopa

combination of Levodopa and peripheral dopa decarboxylase

Question 9

Medical management of Dementia…

Answer 9

Mild/moderate dementia:
- Donepezil 
- Rivastigmine 
- Galantamine 
Moderate/ severe dementia: 
- Memantine

Question 10

Medical management of Crohns…

Answer 10

Inducing remission:

• Mild flare: Prednisolone 30mg PO OD
• Severe flare: Hydrocortisione 100mg IV 6hrly + supportive measures

Maintaining remission:
- Azathioprine - need to check TPMT levels first (TPMT = enzyme which breaks down AZA into inactive components)

Question 11

Medical management of RA…

Answer 11

1. DMARD monotherapy
2. Try different DMARD
3. Failure of 2 DMARDS = TNF-a inhibitors e.g. infliximab

Flares= short course of corticosteroids

Question 12

Management of constipation…

Answer 12

Laxatives:

• Stool softener in faecal impaction e.g. Docusate sodium
• Bulking agents - isphalga husk
• Stimulant laxatives - Senna
• Osmotic laxatives - Lactulose

Question 13

Management of diarrhoea…

Answer 13

Gastroenteritis - identify causative organism and treat with appropriate abx according to trust guidelines
Chronic - Loperamide 2mg orally OR Codeine 30mg orally

Question 14

Management of insomnia…

Answer 14

1st line = Zopiclone 7.5mg PO at night

* 3.75mg PO at night in elderly