Questions I Got Wrong Flashcards
What class of drug is indapamide?
Thiazide-like diuretics
What classification is Isosorbide mononitrate?
P - so can be bought OTC
What is the strange side effect of spironolatone?
Gynacomastia
What is the treatment for trigeminal neuralgia?
Carbamazepine
What can cause insulin needs to drop?
Stress
Why is ramipril preferred over catopril?
Ramipril is OD
Catopril is TDS
What is the treatment for uncomplicated clamydia?
Azithromycin 1g stat for 1 day, then 500mg BD for 2 days
What is the treatment for uncomplicated gonorrhoea?
Azithromycin 2g stat
What is the treatment for Lyme disease?
Doxycycline 200mg daily in 1-2 divided doses for 21 days
What is the dosing for doxycycline used as malaria prophylaxis?
100mg OD
start 1-2 days before entering the endemic area and continue for 4 weeks after leaving
Same dose for both adults and children (over 12 years)
What is a side effect of rivaroxaban?
Anaemia
What is a side effect of theophylline? (4)
GORD
Tremor
Skin reactions
Hyperuricaemia
How should theophylline levels be monitored?
Take levels 5 days after starting and 3 days after any dose change
4-6 hours post oral dose
Target 10-20mg/L
When should warfarin be reviewed and potentially switched?
2 INRs less than 1.5
2 INRs greater than 5
1 INR greater than 8 in the past 6 months
A time in therapeutic range of less than 65%
How long before referral for sinusitis?
10 days
Is likely viral so reassure that is self limiting and provide pain relief
Scabies treatment
Permethrin - apply to whole body (apart from head) for 8-12 hours then wash off
Repeat this in a week
Paracetamol dosing in 3 month old child
60mg QDS
What are the treatments for gestational hypertension and preeclampsia?
1st line: labetalol
2nd line: nifedipine
3rd line: methyldopa
What is the treatment for mastitis during breast feeding? What if they are penicillin allergic?
1st line: fluclox
2nd line: erythromycin
Treat for 10-14 days
How should impetigo be treated? What about bullous or if they are systemically unwell?
Fusidic acid 2% TDS for 5 days
Mupirosin 2% TDS for 5 days if resistant to fusidic acid
Oral if systemic symptoms:
Flucloxacillin 500mg QDS for 5 days
If pen allergy:
Clarithromycin or erythromycin (pregnancy)
When should gradual withdrawal of corticosteroids be considered? (6)
More than 40mg prednisolone for more than 1 week
Repeated evening doses
More than 3 weeks of treatment
Recently received repeated courses
Taken a short course within 1 year of stopping long-term therapy
Other possible causes of adrenal suppression
Which cytotoxic drugs do NOT cause bone-marrow suppression?
Vincristine and bleomycin
Which cytotoxic drugs do not cause bone-marrow depression? (2)
Vincristine and bleomycin
When should gradual withdrawal of corticosteroids be considered? (6)
Taken more than 40 mg oral prednisolone daily or equivalent for more than 1 week.
Taken repeated evening doses of corticosteroids.
Received more than 3 weeks of corticosteroid treatment.
Recently received repeated courses of corticosteroids (especially if taken for longer than 3 weeks)
A history of previous long-term therapy (months or years).
Other possible causes of adrenal suppression, such as excessive alcohol consumption or stress.
How frequently should liver function tests be performed in patients taking amiodarone?
Before starting and every 6 months
What are the contraindications for sildenafil?
Recent stroke or MI
Systolic BP below 90 mmHg
Hereditary degenerative retinal disorders
Which DOACs are more appropriate for a patient with dyspepsia?
Apixaban or Edoxaban
Within how many days can a patient take a missed dose of methotrexate?
2 days
If 3 or more days late then the patient must contact a doctor or specialist for advice
How long should a patient wait to conceive after stopping methotrexate? (Both male and female)
6 months
Is a stye bacterial or viral? How is it treated?
Bacterial
Soak a clean flannel in warm water and hold against the eye for 5-10 minutes
Repeat this 3 or 4 times a day
What needs to be monitored when taking methylphenidate?
Pulse
BP
Appetite
Weight and height
Psychiatric symptoms
Measure theses at initiation, following any dose adjustments and every 6 months thereafter
Which TB drug can cause ocular toxicity?
Ethambutol
What are the symptoms of phenytoin overdose?
Nystagmus
Slurred speech
Diplopia (double vision)
Ataxia
Confusion
Hyperglycaemia
What is the drug therapy for stable angina?
1st:
Beta blocker or CCB
Then, use both together (dihydropyridine CCB e.g amlodipine)
2nd:
Long acting nitrate OR ivabradine OR nicorandil OR ranolazine
At what percentile is a child a) over weight and b) very overweight
a) 91st and above
b) 98th and above
When are lithium levels taken?
12 hours post dose or just before next dose (trough)
What HRT should be provided for a patient whose last period was less than 12 months ago and has no risk factors for VTE?
Cyclical combined HRT tablets
Can hypothyroidism cause constipation?
Yes
What are the brand names for the very potent topical corticosteroids? (2) What are the active ingredients?
Dermovate (clobetasol)
Nerisone forte (diflutocotolone)
What is the active ingredient of Elocon and what is the potency?
Mometasone 0.1%
Potent
What potency is betamethasone valarate 0.1%?
Potent
What is the potency if cuticate? What is the active ingredient?
Potent
Fluticasone
Which topical corticosteroids are classed as mild?
Hydrocortisone 0.1-2.5%
Synalar 1 in 10 dilution
What is in Eumovate and what is the potency?
Clobetasone butyrate 0.05%
Moderate
What is in diprosone cream and what is the potency?
Betametasone dipropionate 0.05%
Potent
What potency is betnovate-RD?
Moderate
What is the difference between fusidin and fucibet?
Fusidin has hydrocortisone therefore mild
Fusibet has betamethasone 0.1% in therefore potent
What complementary therapies can be considered for vasomotor symptoms of the menopause?
Black cohosh
Isoflavones
What are the risks of tamoxifen?
Endometrial cancer
Thromboembolism
What is the main caution for letrozole?
Osteoporosis
What is the treatment for breast cancer for both pre/post-menopausal women and men?
For pre-menopause and men: tamoxifen
For post-menopause: aromatase inhibitor e.g letrozole (2nd line tamoxifen)
If a patient with breast cancer has been previously treated with tamoxifen, what should be offered?
Aromatase inhibitor (letrozole)
What is 1st line for urinary incontinence?
Anticholinergics immediate release:
Oxybutynin
Tolteridone
Darifenacin
When should you review anticholinergic treatment for urinary incontinence?
4 weeks after starting
If effective, review again @ 12 weeks then every 12 months (6 months of over 75 years)
Which drugs cause blue/green urine?
Amitriptyline
Cimetidine
Promethazine
Indometacin
Sulfasalazine turns urine what colour?
Yellow/orange
Phenytoin turns urine what colour?
Pink/brown
Levodopa turns urine what colour?
Reddish / darker in colour
The ‘rubacins turn urine what colour?
Pink/red (1-2 days post treatment)
Senna turns urine what colour?
Yellow/red
What are the P450 inducers?
Carbamazepine
Rifampicin
Alcohol
Phenytoin
Griseofulvin
Phenobarbitone
Sulfonureas / St John’s wort / smoking
What are the P450 inhibitors?
Sodium valproate
Isoniazid
Cimetidine
Ketoconazole
Fluconazole
Alcohol and grapefruit juice
Chloramphenicol
Erythromycin
Sulfonamides
Ciprofloxacin
Omeprazole
Metronidazole
Patients which a sensitivity to which drug class should avoid tacrolimus?
Macrolides (cross-sensitivity)