Random Flashcards
Acne Management
mild acne - topical benzoyl peroxide - tretinoin or adapalene gel - OCP - washes containing salicylic acid - light/laser therapy moderate acne - add tetracycline or doxycycline for 6 months - consider anti androgen therapy in women un responsive to the pill e.g. cyproteterone acetate or spironolactone - isotretinoin severe acne - refer to dermatologist
Acute Otitis Media Management
If > 12 months no abx for first 24-48 hours then review
If < 12 months amoxicillin TDS for 5 days
What are the criteria for abx treatment for sinusitis?
need 3 of the following:
- persistent purulent discharge > 7 days
- facial pain
- poor response to decongestants
- tenderness over the sinuses
What are the symptoms for alcohol withdrawal?
anxiety insomnia craving hallucinations irritability vivd dreams confusion seizures
What are the examination finding for alcohol withdrawal?
diaphoresis mydriasis tachycardia hypertension low grade fever
What are the red flag features of back pain?
young patient elderly patient not resolving for greater than 3 months neurology febrile severe night pain unexplained weight loss significant trauma IV drug use use of anticoagulants use of corticosteroids cauda equina features saddle anaesthesia bowel/bladder symptoms bilateral neurological deficit
What are the indications for imaging in back pain?
red flags (XR)
doesn’t resolve with conservative management (XR)
possible cauda equina (MRI)
possible spinal canal stenosis (MRI)
What family history of bowel cancer is required for colonoscopy rather than FOBT?
one first degree relative diagnosed before 55
two first degree relatives at any age
risk of FAP or Lynch syndrome
What is the pharmacological treatment for BPH?
duodart - an alpha antagonist and a 5 alpha reductase inhibitor
What is the most common pathogen for bronchiolitis?
RSV
What are the indications for admission for bronchiolitis?
requires respiratory support - significant increase in work of breathing
requires oxygen - if saturation is <90% with associated increased WOB
requires fluid resuscitation - if intake is less than 50% of normal
if patient is very young
if it is day 1 of the illness
if parent is not comfortable at home caring for child
How often should patients have their CV risk calculated?
Every 2 years after 45 or 35 if ATSI
What factors are used to calculate CV risk?
Age Sex Smoking status Total and HDL cholesterol Systolic BP Diabetes LVH (on ECG)
What are the indications for colposcopy?
2 x LSIL HSIL smear reported as invasive carcinoma, glandular neoplasia, adenocarcinoma suspicious symptoms cervix suspicious of invasive disease
Which patients should be screened for CKD?
Smoking more than 40 years Hypertension Obesity FHx Diabetes ATSI over 30
What are the goals of management for CKD?
BP less than 130/85 if proteinuria <1g BP less than 125/75 if proteinuria >1g cholesterol total <4 LDL <2.5 fasting blood sugar <6.7 HbA1c < 7% Hb 110-120 potassium <6 bicarb > 22 phosphate < 1.75 no smoking alcohol < 2 standard drinks per day
When should you refer to a nephrologist for CKD?
haematuria eGFR < 30 rapidly declining kidney function significant proteinuria >1g poorly controlled hypertension diabetes with kidney impairment and an eGFR < 60
What are the contraindications for the COCP?
undiagnosed vaginal bleeding CV disease, stroke, TIA previous VTE focal migraines with aura active liver disease hormone dependent cancer drug interaction - e.g. carbamazepine if breastfeeding is not well established can make it drop off
What are the common side effects of the COCP?
breast tenderness nausea breakthrough bleeding headaches mood changes
What are the benefits of the COCP?
contraception less acne less hirsuitism regular periods lighter periods less painful periods timed periods no periods if you wish reduced endometrial cancer, polyps, fibromyomas reduces endometriosis prevents ectopic pregnancy (unlike IUD) reduces ovarian cysts reduces ovarian cancer no change in breast cancer - does not increase the risk with the dose of oestrogen reduces benign breast disease reduces pre menstrual syndrome (progestogen withrdrawl)
What are the key steps in COPD management?
confirm diagnosis optimise function prevent deterioration develop a self management plan treat exacerbation
