Random bits

Question 1

When is the Shingles vaccine offered?

Answer 1

given as one-off dose at age of 70.

- shingle more common and more serious in the over 70s, with mortality of 1/1000.

Question 2

Features of Shingles vaccine

Answer 2

• vaccine against herpes zoster,
• introduced in 2013
• offered to pts aged 70-79yrs
• is live-attenuated and given sub-cutaneously.

Main contraindication:
- in immunosuppressed.

Side effects:

• injection site reaction
• less than 1 in 10,000 will develop chickenpox.

Question 3

Which deaths would need to be reported to the coroner?

Answer 3

1. unexpected or sudden death
2. when doctor attending death, hasn’t seen them 14 days before death.
3. if death occurs within 24 hrs of hospital admission.
4. accidents and injuries
5. suicide
6. industrial injury or disease e.g. asbestos
7. death due to ill treatment, starvation or neglect.
8. death during operation or before recovery from effect of an anaesthetic.
9. poisoning, including taking illicit drugs.
10. stillbirths - if there’s doubt as to whether child was born alive.
11. prisoner or people in police custody.
12. service disability pensioners.

Question 4

how is necrotising ulcerative gingivitis diagnosed and what treatment is recommended?

Answer 4

• it is distinguised from simple gingivitis (painless, red swollen gum maragins with bleed on contact) by presence of followign features: painful, bleeding gums, with halithosis and punched-out ulcers on gums).

Treatment:
- refer to dentist, meanwhile start: oral metronidazole for 3 days + chlorhexidine mouth wash or hydrogen peroxide 6% mouth wash with simple analgesia.

Question 5

Which vaccines are indicated for those with CKD inclluding those on haemodialysis?

Answer 5

• Pneumococcal, influenza and hepatitis B.

Question 6

When is return to work after inguinal hernia repair?

Answer 6

• 2-3 weeks after open repair

- 1-2 weeks after laparoscopic repair.

Question 7

Common drugs that are unsafe in G6PD

Answer 7

Drugs causing haemolysis:

• anti-malarials: primaquine
• ciprofloxacin
• sulph- group drugs - sulphonamides, sulphasalazine, sulfonylureas.

Some drugs thought to be safe:

• penicillins
• cephalosporins
• macrolides
• tetracyclines
• trimethoprim.