Ultimate Treatments Flashcards
1
Q
Treatment for micro/macroprolactinomas
A
Cabergoline (dopamine agonist)
Transphenoidal resection
2
Q
Delirium
A
Acute:
- haloperidol
- benzodiazepines
Treat underlying cause (infection/ constipation)
3
Q
Hydronephrosis
A
Nephrostomy (at renal pelvis)
4
Q
Sinus bradycardia
A
Atropine
5
Q
Pulseless Electrical Activity
A
Adrenaline
6
Q
Asystole
A
Adrenaline
7
Q
Acute gout
A
NSAID (Naproxen)
8
Q
Superficial thrombophlebitis
A
NSAID (Naproxen)
Topical heparinoids
Compression stockings
LMWH
9
Q
Cholecystitis
A
Laparoscopic cholecystectomy
10
Q
Venous ulcers
A
Compression stockings
Compression bandages
Skin Grafting
11
Q
SVC obstruction
A
Dexamethasone
Balloon venoplasty/ stenting
Radiotherapy/ surgery
12
Q
Bronchiolitis
A
Supportive
13
Q
Asthma (5-16)
A
SABA (Salbutamol)
+ ICS (Beclomethasone)
+ LTRA (Montelukast)
+ LABA (Salmeterol), stop LTRA (Montelukast)
14
Q
Asthma (<5)
A
SABA (Salbutamol)
+ ICS (Beclomethasone)
+ LTRA (Montelukast)
+ Refer to paeds, stop LTRA (Montelukast)
15
Q
Pyloric stenosis
A
Ramstedt pyloromyotomy
16
Q
OCD
A
1st
- CBT
- Exposure & response prevention
2nd
- SSRI (Sertraline)
3rd
Tricyclic antidepressant
17
Q
Body dysmorphic disorder
A
Fluoxetine
18
Q
SAD
A
SSRIs
Vit D
19
Q
Depression
A
1st
CBT (cognitive behavioural therapy)
2nd
SSRI
3rd
SSRI + CBT
4th
ECT
20
Q
Mania in BPAD
A
- Stop antidepressant
- Olanzapine / Haloperidol
21
Q
Depression in BPAD
A
CBT + Fluoxetine
22
Q
GAD
A
- Self-help + mindfulness
- CBT
- Drugs: - SSRI (Sertraline)
- Alternative SSRI / SNRI
- Pregabalin - Specialist care
23
Q
Psychosis
A
Acute: Lorazepam (Benzodiazepines)
Long term: Antipsychotics
24
Q
PTSD
A
Watchful waiting CBT Eye-movement desensitisation + reprocessing (EMDR) Drugs: - Venlafaxine (SNRI) - Sertraline (SSRI) - Risperidone (Atypical antipsychotic)
25
Anorexia
Family behavioural therapy
CBT
Maudsley Anorexia Nervosa Treatment for Adults (MANTRA)
26
Bulimia
Family behavioural therapy
CBT
Monitor electrolytes
27
ADHD
1. Methylphenidate
2. Lisdexamfetamine
3. Dexamphetamine
28
Alcohol withdrawal
1. Long acting benzodiazepines
- Chlordiazepoxide
- Diazepam
- Lorazepam (if hepatic failure)
2. Carbamazepine
29
Alcohol abstinence
Disulfiram (Antabuse)
- flushing and sick
Acamprostate (Campral)
- reduced cravings
30
Opioid abstinence
Methadone (opioid mu receptor agonist)
| Buprenorphine (mixed opioid agonist/antagonist)
31
Paracetamol OD
N Acetylcysteine
Activated charcoal if < 1hr since ingestion
32
Lead poisoning
Dimercaptosucinic acid (DMSA)
Dimercaprol
Calcium edetate
33
Tricyclic AD OD
IV Sodium bicarbonate
34
Magnesium sulphate OD
Calcium gluconate
35
Benzo OD
Flumenazil
36
Opioid OD
Naloxone
37
Cocaine OD
Diazepam
38
Heparin OD
Protamine sulphate
39
Beta-blocker OD
Atropine + glucagon
40
Aspirin (salicylate) OD
Alkalisation (IV bicarbonate) = 7.5-8 pH
| Haemodialysis
41
Lithium toxicity
Haemodialysis
42
Methanol toxicity
Ethanol
43
Warfarin toxicity
Vit K
| Prothrombin complex concentrate
44
Cyanide OD
Hydroxycoalbumin
45
Organophosphates (insecticide)
Atropine
46
Iron OD
Desferrioxamine
47
Ethylene glycol (anti-freeze) OD
Fomepizole
Ethanol
Haemodialysis
48
Carbon monoxide poisoning
02 100%
49
Digoxin toxicity
Digibind
50
LSD OD
Lorazepam
51
Local anaesthetic toxicity
IV 20% lipid emulsion
52
Sleep paralysis
Clonazepam
53
Narcolepsy
day: modafinil
night: sodium oxybute
54
Insomnia
```
Sleep hygiene education + identify causes
Short acting benzodiazepines
- zopiclone
- zolpidem
- zaleplon
```
55
Fistula in ano
Simple: Keep open (fistulotomy)
Complex: Seton band insertion
Ligation of intersphinteric tract (LIFT)
56
Fistulas
Self resolving
57
Varicose veins
Compression stockings
Weight loss
Leg elevation
Severe:
Endothelial ablation
Foam sclerotherapy
58
Anterior aortic dissection
Surgery + BP control
59
Posterior aortic dissection
IV Labetalol
60
AAA
Elective endovascular repair (EVAR)
| - via femoral artery
61
Peripheral arterial disease
Exercise
Statins
Clopidogrel
Surgery
- angioplasty
- stenting
- bypass
- amputation
62
Neuropathic ulcers
Cushioned shoes
| Amputation
63
Influenza
Vaccine prophylaxis (Autumn)
Oseltamivir
Zanamivir
64
Constipation
Laxatives
- Bulk forming
- Stimulant (Senna, bisocodyl)
- Osmotic (Lactulose, laid)
- Stool Softeners (sodium docusate)
65
Alzheimer's
1. Acetylcholinesterase inhibitors
- Donepezil
- Galantamine
- Rivastigmine
2. NMDA receptor antagonist
- Memantine
66
Vascular Dementia
- Reduce CVD risk factors
| - If mixed with alzheimer's then treat as such: Acetylcholinesterase inhibitors + NMDA antagonists
67
Lewy Body Dementia
1. Acetylcholinesterase inhibitors
- Donepezil
- Galantamine
- Rivastigmine
2. NMDA receptor antagonist
- Memantine
NOT HALOPERIDOL
68
Gardener's syndrome
Prophylactic colectomy to reduce risk
69
Neutropenic Sepsis
1. Tazocin
- Teicoplanin/ Aztreonam (if Penicillin allergic)
2. Vancomycin
70
Tumour lysis syndrome
```
Calcium gluconate (cardio protection from potassium)
Fluids
```
71
Bone mets
1. Analgesia
2. Biphosphonates
3. Radiotherapy
72
Neoplastic spinal cord compression
Oral dexamethasone (high dose)
- reduce oedema
Consider radiotherapy/surgery
73
Kaposi's sarcoma
Radiotherapy
| Surgical resection
74
Bladder cancer
CMV
Cisplatin
Methotrexate
Vinblastine
75
High-grade non-hodgkins lymphoma
R-CHOP
Cyclophosphamide
Hydroxydaunorubicin (doxorubicin)
Vincristine (Oncovin)
Prednisolone
76
Colorectal cancer
FOLFOX
5-FU
Leucovorin (colonic acid)
Oxaliplatin
77
Breast cancer
FEC
5-FU
Epirubicin
Cyclophosphamide
78
Hodgkin's lymphoma
ABVD
Adriamycin (doxorubicin)
Bleomycin
Vinblastine
Dacarbazine
79
Retinoblastoma
External beam radiation
Chemo
Photocoagulation
Enucleation
90% survive
80
Hypokalaemia
IV saline + Potassium (over 4 hours)
81
Hyperkalaemia
Stabilise cardiac membrane: Calcium gluconate
Short term (shift K from extracellular to intracellular):
Insulin + dextrose infusion
Nebulised salbutamol
Long term (remove K from body)
Calcium resonium
Loop diuretics
Dialysis
82
Hypocalcaemia
Calcium gluconate
| - 10ml of 10% solution over 10mins
83
Hypercalaemia
1. Rehydration (3L per day)
IV 0.9% saline
2. Biphosphonates
1. - IV Pamidronate
2. - Calcitonin salmon
84
Hypomagnesaemia
IV Magnesium over 24 hours
| - can cause diarrhoea
85
Hypophosphataemia
Phosphate sandoz
86
Hyperphosphataemia
```
Bi-phosphonates
Calcium acetate (calcium-phosphate binder)
```
87
Hyponatraemia
Mild:
Fluid restriction <800ml/day + loop diuretics
```
Moderate:
Hypertonic saline (2.7%) slow infusion
```
Severe: Bolus hypertonic saline + Vasopressin (ADH receptor agonist)
88
Hypernatraemia
IV Fluids
89
SIADH
Fluid restriction
Demeclocycline
ADH Receptor blockers (Tolvaptan)
90
Malignant hyperthermia (from suxamethonium)
Dantrolene
91
Motion sickness
Hyoscine
Cyclizine
Promethazine
92
Neuropathic pain
Acute "rescue": Tramadol
```
Chronic:
Amitriptyline
Duloxetine
Gabapentin
Pregabalin
```
93
Trigeminal neuralgia
Carbamazepine
94
Post-herpetic neuralgia
Topical capsaicin cream
95
Analgesia (renal impairment)
1. Fentanyl
2. Buprenorphine
3. Alfentanil
96
Acute agitation
1. Haloperidol
2. Chlorpromazine
3. Levomepromazine
97
End of life agitation
Midazolam
98
End of life hiccups
1. Chlorpromazine
| 2. Haloperidol
99
End of life secretions
Hyoscine hydrobromide
100
End of life bowel colic
Hyoscine butylbromide (buscopan)
101
End of life oral/throat pain
Benzydamine hydrochloride
102
End of life nausea + vomiting
Levomepromazine
| - long acting (8 - 12 hours)
103
Gastric nausea
Metoclopramide
104
Extra-pyramidal side effects
Domperidone
105
Chemotherapy related nausea
Ondansetron
106
Intra-cranial caused nausea
1. Dexamethasone
- reduces oedema around tumours
2. Cyclizine (for vomiting)
107
Paroxysmal hemicrania headache
Idomethacin
108
Cluster headache
Acute:
Triptans
- Sumatriptan
High flow O2
Prophylaxis:
Verapamil
Lithium
Prednisolone
109
Migraine
Acute:
Triptans (Sumatriptan) + NSAIDs
Metoclopramide
Prochlorperazine
Prophylaxis:
1. Topiramate
2. Propranolol
3. Riboflavin
110
Menstrual migraine
Fovatriptan
| Zolmitriptan
111
Hydrocephalus
Acute:
External ventricular drain (EVD)
- drains to external bag
Long-term:
Ventriculoperitoneal shunt
- drains to peritoneum
112
Idiopathic intracranial HTN
```
Weight loss
Acetazolamide
Topiramate
Repeat LP
Surgery
- optic nerve sheath decompression
- lumboperitoneal shunt
- ventriculoperitoneal shunt
```
113
Low pressure headache
- post LP
Caffeine + hydration
114
Increased ICP
Controlled hyperventilation
Raise head to 30 degrees
Severe:
Prior to surgery
- IV Mannitol / furosemide
Surgery
115
Tentorial herniation
Parietotemporal Craniotomy
116
SAH
1. Coiling of intracranial aneurysms
2. Nimodipine (21 days)
- CCB
- Prophylaxis for vasospasm
Watch for - re-bleeding (10% first 12 hours)
- hydrocephalus
- hyponatraemia
117
Vestibular schwannomas
Surgery
Radiotherapy
Observation
118
Craniopharyngioma
Surgery
119
Meningioma
Observe
Radiotherapy
Surgical resection
120
Glioblastoma multiforme
Dexamamethasone
Post op chemo and radiotherapy
121
Normal pressure hydrocephalus
ventriculoperitoneal shunting
122
Wernicke's encephalopathy
```
Vitamin B1 (Thiamine)
IV Pabrinex (Vit B/C)
```
123
Depressed skull fractures
Surgical reduction and debridement
124
Progressive supranuclear palsy (PSP)
Levodopa
125
Benign essential tremor
Propranolol
| Primidone
126
Infantile spasms (West syndrome)
Poor prognosis
Vigabatrin
ACTH
127
Juvenile myoclonic epilepsy (Janz syndrome)
Juvenile myoclonic epilepsy (Janz syndrome)
128
Lennox-Gastaut Syndrome
Ketogenic diet may help
129
Febrile convulsions
> 5 mins or first seizure = call 999
If recurrent: Rectal diazepam
Buccal midazolam
130
Status epilepticus
```
Community:
Buccal midazolam (mouth)
Rectal diazepam (derrière)
```
```
Hospital:
IV Lorazepam
- repeat every 10 mins
IV Phenytoin
- start cardiac monitoring
```
131
Absence seizures
1. Sodium valproate
2. Ethosuximide
Self resolve in adulthood
132
Myoclonic seizures
1. Sodium valproate
2. Clonazepam
Lamotrigine
133
Tonic-clonic seizures
1. Sodium valproate
2. Lamotrigine
Carbamazepine
134
Primary generalised seizures
1. Sodium valproate
| 2. Lamotrigine
135
Focal seizures
1. Carbamazepine
Lamotrigine
2. Levetiracetam
Oxcarbazepine
Sodium valproate
136
Bell's Palsy
1. Prednisolone
Eye-lubricants, artificial tears
Tape eye shut
Severe: Anti-virals
137
Degenerative cervical myelopathy
Decompressive surgery
138
Restless leg syndrome
Stretching
Dopamine agonists (Pramipexole, Ropinirole)
Benzodiazepines
Gabapentin
139
Subacute degeneration of the cord
Vitamin B12 + then maybe folate
- if you give folate first it may precipitate SADC
140
Guillian-Barre syndrome
Paraesthesia + loss of sensation spreading up from feet
IV Immunoglobins
141
Lambert-eaton myasthenia syndrome
```
Muscle weakness (improves on exercise)
- legs > arms
```
Amifampridine
142
Cerebral Palsy
Diazepam
Baclofen
Botulin toxin type A (Botox)
Surgical dorsal rhizotomy
143
Myasthenia gravis
Proximal muscle weakness (worse from exercise + at night)
- arms > legs
Extra-ocular muscle weakness (diplopia)
1. Reversible acetylcholinesterase inhibitors (long-acting):
- Pyridostigmine
- Neostigmine
Immunosuppression:
- Prednisolone
- Azathioprine, cyclosporin, mycophenolate
Surgery (thymectomy)
Monoclonal antibody tx: Rituximab
144
Myasthenia crisis
Plasmapheresis
| IV immunoglobins
145
MND
Gradual onset muscle weakness (hands + shoulders)
Eye muscles spared
Riluzole
- prevents stimulation of glutamate receptors (slows progression)
Non-invasive breathing support at night
146
MS to reduce relapse rate
Beta-interferon therapy
Glaticamer acetate (immuno-modulating drug)
Natalizumab (monoclonal antibody)
Fingolimod (sphingosine 1-phosphate receptor modulator)
147
MS Acute relapses
Methylprednisolone (5 days)
| Monoclonal antibodies
148
Spasticity in MS
1. Baclofen + gabapentin
2. Diazepam
Dantrolene
Tizanidine
149
Oscillopsia in MS
Gabapentin
150
Fatigue in MS
Amantadine
151
Sleepiness in Parkinson's
Modafinil
152
Postural hypotension in Parkinson's
Midodrine
153
Drooling in Parkinson's
Glycopyrronium Bromide
154
Motor symptoms in parkinsons
Motor symptoms affect QofL?
Yes:
1. Levodopa (effectiveness decreases over time)
+ Decarboxylase inhibitor
- Carbidopa
- Benserazide
Used to prevent peripheral metabolism of levodopa to dopamine
No:
1. Dopamine agonist (non-ergot derived)
- Ropinorole
- Apomorphine
2. Levodopa
3. MOAI (B)
- Selegiline
- Rasagiline
Second line add ons:
- Dopamine agonists
- MOAIs
- COMT Inhibitors
- Entacapone
- Tolcapone
155
Tremor in Parkinson's
Procyclidine
156
Drug-induced Parkinsonism
Anti-muscarinics (block cholinergic receptors)
Procyclidine
Benzotropine
Trihexyphenidyl
157
Carotid artery stenosis
if blockage > 50% = Carotid endarectomy
158
TIA
Acute:
Aspirin 300mg + urgent specialist review
Secondary:
Clopidogrel
or
Aspirin + Dipyridamole
159
Acute Ischaemic stroke
1. Aspirin 300mg (haemorrhage excluded)
< 4.5 hours after onset: Thrombolysis (Alteplase)
< 6 hours after onset: Thrombectomy
160
Long term Ischaemic stroke
1. Aspirin (300mg) for 2 weeks
Clopidogrel (75mg)
Statin if cholesterol >3.5mmol/L
2. Aspiring + dipyridamole
(instead of clopidogrel)
161
Otosclerosis
Hearing aid
| Stapedectomy
162
Sudden onset sensorineural hearing loss (SSNHL)
Urgent referral
| Prednisolone
163
Perforated tympanic membrane
Self resolves in 6-8 weeks
Keep dry + review in 4 weeks
Myringoplasty
164
Meniere's disease
Acute: Buccal/IM Prochlorperazine
Prophylactic:
Betahistamine
Vestibula rehab
165
BPPV
Epley manœuvre
Brandt-Daroff exercises (vestibular rehab)
Recurrence is common 3-5 years later
Prevention: Betahistamine
166
Vestibular neuronitis
Acute: Buccal/IM Prochlorperazine
```
Vestibular rehab exercises
Antihistamines:
- cinnarizine
- cyclizine
- promethazine
```
167
Labyrinthitis
Self limiting
Prochlorperazine
Antihistamines
168
Auricular haematoma
Same day assessment
| Incision + drainage
169
Mastoiditis
Admit
| Amoxicillin
170
Otitis media with effusion (glue ear)
Grommets
171
Acute otitis media
Self-limiting
Analgesia
Severe: Amoxicillin (Erythromycin in PA)
Recurrent: Grommets
172
Cholesteatoma
Surgical removal
173
Otitis externa
1. Topical Gentamicin + hydrocortisone (drops)
2. Flucloxacillin (Erythromycin if PA)
Fungal: Cotrimazole drops
Diabetes: Ciprofloxacin (to cover pseudomonas)
174
Malignant otitis externa
Ciprofloxacin
175
"Sore throat"
Pharyngitis
Tonsillitis
Laryngitis
Phenoxymethylpenicillin (Penicillin V) 7-10 days
| Erythromycin if PA
176
Dental abscess
Amoxicillin
177
Gingivitis
Metronidazole
| Chlorhexidine mouth wash
178
Quinsy (peritonsillar abscess)
IV ABx + needle drainage
179
Laryngopharyngeal reflux
Lifestyle
PPI
Gaviscon
180
Sialolithiasis
| Salivary gland stones
Removed orally
| Gland excision
181
Pleomorphic adenoma
Parotidectomy
182
Idiopathic rhinitis
Ipatropium
183
Sinusitis
Analgesia
>10 days: Intranasal corticosteroids
Severe: Penicillin V
184
Nasal haematoma
Drainage
185
Allergic rhinitis
Mild: Antihistamines
Severe: Corticosteroids
Oxymetazoline (decongestant)
- can cause rebound congestion if chronic use
Montelukast
186
Unilateral nasal symptoms
ENT Referral
187
Nasopharyngeal carcinoma
Radiotherapy
188
Nasal polyps
ENT referral
| Topical corticosteroids
189
Epistaxis
1. Sit forward, mouth open + pinch cartilage for 20 mins
- ice on mouth or back of neck
2. If bleeding site seen = silver nitrate cautery
3. If bleeding not seen = co-phenylcaine + packing (rapid rhino pack)
4. Ligation of sphenopalatine artery
5. Ligation of external carotid
Can also give topical antiseptic (chlorhexidine + neomycin) to decrease risk of vestibulitis + crusting
- contraindicated in nut allergy, use Mupirocin instead
190
Cataracts
Decrease bright lights
Glasses
Surgical replacement with artificial lens
- risk of endophthalmitis
191
Herpes zoster opthalmicus
Refer
| Oral antiviral 7-10days
192
Nasolacrimal duct obstruction
Massage lacrimal duct
| self resolves by 1 year
193
Wet ARMD
Intravitreal Anti-VEGF (monthly) = stops neovascularisation
- Ranibizumab
- Bevacizumab
- Pegaptanib
194
Dry ARMD
Anti oxidants + vitamin supplements
| Not much else can be done
195
Diabetic retinopathy
Laser photocoagulation
Intravitreal Anti-VEGF
Severe: Vitreoretinal surgery
196
Stye
Hot compress
Analgesia
Abx if ?conjunctivitis
197
Chalazion
| meibomian cyst
Self resolves
| Abx if severe
198
Entropium
In-turning of the eyelid
Eye lubricants
Tape eyelid
Surgery
199
Blepharitis
Hot compression (twice daily)
Lid hygiene
Artificial tears
200
Retinal tear
Laster therapy
| Cryotherapy
201
Amaurosis fugax
Aspirin 300mg
202
Retinal detachment
Virectomy + replacement
Scleral buckling
Pneumatic retinopexy
203
Amblyopia "Lazy eye" prevention
Eye-patch on good eye
204
Episcleritis
Lubricating eye drops
205
Infective conjunctivitis
Self limiting (2 weeks)
Avoid sharing towels, don't wear eye contacts
Chloramphenicol drops 2-3 hours
Pregnant: Fuscidic acid (BD)
206
Primary open angle glaucoma
1. Prostaglandin analogue drops (latanoprost) -Increases outflow
Second line:
1. Beta-blockers (Timolol): decreases secretions
2. Carbonic anhydrase inhibitor (Dorzolamide): decreases secretions
3. Sympanomimetic drops: mixed action
4. Alpha-2-agonist (apraclonidine): mixed action
5. Pilocarbine: increases outflow
Severe: Trabeculectomy
207
Acute angle glaucoma
Phone 999
Place in supine position (without pillow)
1. Pilocarbine eye drops (constrict pupi, increases outflow)
+ Acetazolamide: decreases secretions
+ Latanoprost (prostaglandin): increases outflow
2. Timolol: decreases outflow
3. Alpha-2-agonist (apraclonidine): mixed
Definitive: Laser iridotomy (creates hole in iris allowing outflow)
208
Anterior uveitis
Cycloplegics:
- atropine
- cyclopentolate
- steroids
209
Keratitis
Viral: Topical aciclovir
Bacterial: Quionolones (ciprofloxacin)
Analgesia: cyclopentolate
210
Congenital syphilis
Penicillin
211
Congenital HSV
Aciclovir
212
Congenital VZV
Aciclovir
| Immunoglobin
213
Transient synovitis
Self limiting
214
Ples Planus
Self resolving
215
Genu varum
Self resolving
216
Genu algum "knock knees"
Self resolves
217
Talipes equinovarus "Club foot"
Ponseti methods
| - progressive braces
218
DDH
Spontaneously stabilise by 3-6 weeks
```
Palik harness (dynamic flexion-abduction orthosis)
- used <4-5 months
```
Surgery
219
Perthes
< 6 years: observe
> 6 years: surgery
Keep femoral head in acetabulum (cast + braces)
220
SUFE
Bed rest + non-weight bearing
| Severe: Percutaneous pinning of the hip (internal fixation)
221
Kawasaki disease
- High-grade fever (>5 days), resistant to antipyretics
- Strawberry tongue + white coating (mucous membranes)
- Red + swollen palms/soles/lips (peeling)
- Bilateral conjunctival injections (no discharge)
- Polymorphic blanching rash on abdo
- Cervical lymphadenopathy
Aspirin (high-dose)
IV Ig
Do Echo for Coronary artery aneurysm
222
Measles
- White grains of salt on buccal mucuosa (koplik spots)
- Proximal period (irritable, fever, conjunctivitis)
- Maculopapular rash behind ears > then whole body
Supportive
| Notify public health
223
Scarlet fever
```
2-6 years old
Nausea
Fever (2 days)
Headache
Sore throat
Strawberry tongue
"Pinhead" rash (punctate erythema) on torso with sand paper texture (palm/sole sparing)
```
Penicillin V (oral, 10 days)
- Azithromycin (if PA)
Notify public health
Can return to school 24h after starting ABx
224
Pertussis
Whooping cough
< 6 months old: Admit
Azithromycin/ Clarithromycin/ erythromycin
- if cough onset in 21 days
Can return to school 48hr from starting ABx
225
Respiratory distress syndrome (RDS)
"Hyaline membrane disease"
- premature babies
- Give mother dexamethasone to induce foetal lung maturation
- Surfactant (Curosurf) via ETT, given in first 6 hours since birth (pig lung extract)
- CPAP
226
Transient tachypnoea of the newborn (TTN)
- C section babies
O2
| Self resolves in a few days
227
Croup
Age: 6 months - 3 years
Barking cough
Stridor
Common in Autumn
Dexamethasone (oral) + O2
- 0.15mg/kg
Severe: Nebulised adrenaline + O2
228
Epiglottis
Senior help
O2
IV ABx
229
Paediatric pneumonia
1. Amoxicillin
2. Macrolides (Erythromycin)
If associated with flu: Co-amoxiclav
If mycoplasma pneumoniae/ chlamydia: Macrolides
230
Bronchiolitis
- from RSV
Humidified O2
NG feeds
Suction for airway secretions
Reduce future episodes:
RSV Immunoglobin
Palivizumab
231
Choanal atresia
Cyanosis when feeding
Posterior airway is occluded by soft tissue or bone
Fenestration procedure
232
Constipation in kids
1. Osmotic laxative
- Movicol (polyethelyne glycol 3350 + electrolytes)
2. Stimulant laxative
233
Necrotising enterocolitis
Stop oral feeds (rest gut)
Vancomycin + cefotaxime
Laparotomy
234
Intestinal malrotation
Laparotomy
| Ladd's procedure if with volvulus
235
Pyloric stenosis
Ramstedt pyloromyotomy
236
Congenital diphragmatic hernia
Intubate
237
Umbilical hernia
Self resolves in 12 months
238
Inguinal hernia
Urgent surgery
239
Umbilical granuloma
Salt on wound
| Silver nitrate
240
Gastroschsis
Vaginal delivery + immediate repair
241
Exomphalos
C-section at 37 weeks
| Staged surgical repair 6-1 months
242
Toddler's diarrhoea
Introduce more fat
243
GORD in kids
1. Alginates/ thickened feeds
| 2. PPI
244
Biliary atresia
```
Kasai procedure (hepatoportoenterostomy)
Ursodeoxycholic acid (post-op)
```
245
Intussuseption
Reduction by air insufflation
| Surgical management
246
Meckel's Diverticulum
Blood transfusion
247
Meconium ileus
PR contrast my dislodge stool
N-acetyl cystein
Surgery
248
Hirschsprung disease
PR exam
Rectal washout
Anorectal pull through procedure
249
Newborn jaundice
Blue light phototherapy
| Exchange transfusion
250
Caput succedaneum
resolves in days
251
Cephalohaematoma
resolves in weeks
252
Unilateral undescended testicle
Refer at 3 months
Review at 6 months
Orchidoplexy at 12 months
253
Scabies
1. Permethrin
2. Malathion
Immunosuppressed: Irvermectin
254
Head lice
Malathion
Dimethicone
Isopropyl myristate
Cyclomethicone
255
Alopecia
Topical steroids
256
Seborrheic keratosis
Small: cryotherapy
Large: shave off
257
Basal cell carcinoma
Superficial:
- cryotherapy
- imiquimod (Aldara cream)
- Photodynamic therapy
- 5 Fluorouracil (Efudix cream)
Nose: Mohs surgery
Radiotherapy
258
Squamous cell carcinoma
Singular: Cryotherapy
Multiple:
- Imiquimod (Aldara cream)
- 5 Fluorouracil (Efudix cream)
259
Psoriasis
```
Primary care:
1. Topical steroid + Vit D analogue (calcipotriol, calcitriol, tacalcitol), once daily, applied different times
2. Vit D analogue (twice daily)
3. Topical steroid (twice daily)
or coal tar (twice daily)
+ dithranol can help
```
Secondary care:
- Phototherapy
Systemic:
- Oral methotrexate
- Ciclosporin
- Retinoids
- Infliximab, etancercept etc
260
Acne
1. Topical benzoyl peroxide + topical retinoid
2. + topical clindamycin
3. Topical benzoyl perioxide + topical retinoid + oral tetracycline (lymecycline, oxytetracycline, doxycycline) or COCP
- Erythromycin if pregnant
4. Isotretinoin
261
Candidiasis
Fluconazole (oral)
262
Folliculitis
Trimethoprim
263
Impetigo
Topical hydrogen peroxide + flucloxacillin/ erythromycin
264
Erysipelas
Flucloxacillin
| - clarithromycin/ erythromycin/ doxycycline if PA
265
Eczema
emollients
topical steroids (Hydrocortisone, Betamethasone)
UV radiation
immunosuppressants: e.g. ciclosporin, antihistamines and azathioprine
266
Anaphylaxis
<6 months:
- IM adrenaline (150 micrograms)
- Hydrocortisone (25mg)
- Chlorphenamine (250micrograms/kg)
6 months - 6 years:
- IM adrenaline (150 micrograms)
- Hydrocortisone (50mg)
- Chlorphenamine (2.5mg)
6 - 12 years:
- IM adrenaline (300 micrograms)
- Hydrocortisone (100mg)
- Chlorphenamine (5mg)
> 12 years:
- IM adrenaline (500 micrograms)
- Hydrocortisone (200mg)
- Chlorphenamine (10mg)
IM into anterolateral high every 5 mins
Salbutamol neb for breathing
267
Lichen planus
Oral: Benzydamine mouthwash
Severe: Steroids/immunosuppression
268
Lichen sclerosis
Topical clobetasol propionate (steroid cream)
269
Pityriasis Rosea
Supportive
270
Acne rosacea
Mild: Topical metronidazole
Severe: Oral tetracycline
Flushing: topical brimonidine
271
Toxic Epidemal necrolysis
IV immunoglobulins
Immunosuppression:
- ciclosporin
- cyclophosphamide
272
Erythasma
| - rash in axillae + groin
Erythromycin
273
Lipoma
surgical excision
274
Tinea pedis
Topical miconazole
275
Necrobiosis lipoidica diabeticorum
| - yellow diabetic leg ulcer
Tacrolimus
| Topical steroids
276
Plantar wart
Topical salicylic acid
277
Pyoderma gangrenosum
Oral prednisolone
278
Eczema Herpeticum
Admit
| IV Antivirals
