Treatment

Question 1

What is the first-line management of type 2 diabetes?

Answer 1

3m trial of diet and lifestyle

then metformin 500mg

Question 2

When should metformin not be used first line in T2DM? What can be used instead?

Answer 2

osmotic symptoms

sulfonylurea eg gliclazide

Question 3

Why should sulfonylureas be used if T2DM and osmotic symptoms?

Answer 3

rapid glucose lowering effect

Question 4

How should migraine be managed acutely?

Answer 4

simple: aspirin 900mg, ibruprofen 400mg, or paracetamol 1g

oral sumatriptan ( oral or SC)

antiemetic eg metoclopramide

Question 5

Should triptans be started when aura starts or headache starts?

Answer 5

headache

Question 6

What pharmacological treatment can be used for migraine prophylaxis?

Answer 6

propanolol
topimarate - CI in pregnancy
amitryptiline

Question 7

What questions should screen for severity of asthma?

Answer 7

How many times have they had steroids in the last year ?

Have they ever been admitted with their asthma?

Question 8

What is the first line treatment of an uncomplicated UTI?

Answer 8

nitrofurantoin 100mg MR bd or 50mg qds

Question 9

When should someone with sickness in early pregnancy be admitted?

Answer 9

unable to keep fluids/oral antiemetics down
ketonuria or weight loss
confirmed comorbidity