Scrubs Repro pharma

Question 1

Gonorrhoea Tx

Answer 1

Ceftriazone (IM) and azithromycin (PO)

Question 2

Chlamydia Tx

Answer 2

Doxacyclin (teratogen). or azithromycin

Question 3

Syphilis Tx

Answer 3

PenicillinG/doxycyclin (teratogen)/amoxicillin

Question 4

Chancroid Tx

Answer 4

Azithromycin/erythromycin

Question 5

Genital warts Tx

Answer 5

Nitrate removal

Topical imiquimod, sinecatechine/trichloroacetic acid

Question 6

Public lice/scabies Tx

Answer 6

Malathion+permethrin

Question 7

Trichomoniasis Tx

Answer 7

Metronidazole

Question 8

Oestrogens used for:

Answer 8

PRimary hypogonadism, primary amenorrhoea, concenception (with progesterone) and HRT

Question 9

OEstrogen ADE

Answer 9

N&V, breast tenderness, headache, salt/water retention, increased VTE

Question 10

Progesterone uses

Answer 10

Conception, endometrial protection, Tx of endometriosis and endometrial carcinoma

Question 11

Progesterone ADE

Answer 11

Acne, lfuid retention, wt change, depression, altered libido, breast discomfort, spotting, increased VTE risk

Question 12

Coc and Pop

Answer 12

Coc is more reliable, inhibits ovulation and thickens mucus. Increased CVD and VTE risk, increased cervical and breast cancer risk.
Pop more suitable for smokers, women over 45, obese women, but not as reliable. Can have spotting

Question 13

Emergency contraception

Answer 13

Copper coil (up to 5 days), ulipristal (progesterone modulator) - 120h, levonorgestrel (progesterone) 96hours

Question 14

HRT

Answer 14

Oestrogen + progesterone. 
Risks - endometrial cancer (if not countered with progesterone), breast cancer, VTE, CVD, small ovarian cancer risk
If local symptoms then topical. 
If systemic then systemic treatment.
Peri menopausal - > cyclical Tx
Postmenopausal - > continuous

Question 15

Aromatase inhibitor

Answer 15

Breast cancer (oestrogen dependent).
ADE: osteoporosis, vulvovaginal dryness, PV bleed, carpal tunnel,

Question 16

SERM

Answer 16

Tamoxifen is breast cancer Tx, but agonist at endometrium.
Raloxifene is bone agonist, breast and endometrium antagonist.

Clomiphene is partial ovarian agonist, antagonist at hypothalamus. PCOS (WHO II)

Tibolone is prodrug for osteoporosis and for menopausal symptoms

Question 17

SPRM

Answer 17

Progesterone receptor mods.
Mifepristone - abortant in 1st trimester - combine with misoprostol (PG)

Asoprisnil - Tx for endometriosis/fibroids (endometrial growth inhibition)

Question 18

Continuous GnRH agonist in women

Answer 18

Goserelin.
Used for endometriosis, fibroids, precocious puberty, amenorrhoea/infertility in PCOS, controlled ovarian hyperstimulation.
ADEs: menopausal symptoms, osteoporosis, androgen depletion

Question 19

GnRH agonist, pulsatile in women

Answer 19

WHO I ovulatory dysfunction

Question 20

GnRH antagonist (women)

Answer 20

Controlled ovarian hyperstimulation

Question 21

Testosterone - male

Answer 21

Primary male hypogonadism.
In prepubertal boys, can stunt growth. In adults, anabolic, water/salt ret., acne, thick/dark skin, spermatogenesis inhibition

Question 22

5alpha reductase inhibitorinhibitor

Answer 22

Reduce DHT. Used for BPH (androgenic alopecial)

Question 23

Flutamide

Answer 23

Androgen receptor antagonist - Prostate cancer Tx

Question 24

Cyproterone acetate

Answer 24

Androgen receptor antagonist - Prostate cancer/hypersexuality

Question 25

GnRH agonist men

Answer 25

Contuous goserelin.
Precicious puberty and prostate cancer Tx.
ADEs: androgen depletion and initial tumour flare (inc. bone met pain)

Question 26

Degarelix

Answer 26

Sequential GnRH antagonist, used in advanced prostate cancer