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The One Deck To Rule Them All > Ultimate Treatments > Flashcards

Ultimate Treatments Flashcards

1
Q

Treatment for micro/macroprolactinomas

A

Cabergoline (dopamine agonist)

Transphenoidal resection

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2
Q

Delirium

A

Acute:

  • haloperidol
  • benzodiazepines

Treat underlying cause (infection/ constipation)

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3
Q

Hydronephrosis

A

Nephrostomy (at renal pelvis)

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4
Q

Sinus bradycardia

A

Atropine

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5
Q

Pulseless Electrical Activity

A

Adrenaline

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6
Q

Asystole

A

Adrenaline

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7
Q

Acute gout

A

NSAID (Naproxen)

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8
Q

Superficial thrombophlebitis

A

NSAID (Naproxen)
Topical heparinoids
Compression stockings
LMWH

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9
Q

Cholecystitis

A

Laparoscopic cholecystectomy

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10
Q

Venous ulcers

A

Compression stockings
Compression bandages
Skin Grafting

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11
Q

SVC obstruction

A

Dexamethasone
Balloon venoplasty/ stenting
Radiotherapy/ surgery

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12
Q

Bronchiolitis

A

Supportive

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13
Q

Asthma (5-16)

A

SABA (Salbutamol)
+ ICS (Beclomethasone)
+ LTRA (Montelukast)
+ LABA (Salmeterol), stop LTRA (Montelukast)

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14
Q

Asthma (<5)

A

SABA (Salbutamol)
+ ICS (Beclomethasone)
+ LTRA (Montelukast)
+ Refer to paeds, stop LTRA (Montelukast)

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15
Q

Pyloric stenosis

A

Ramstedt pyloromyotomy

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16
Q

OCD

A

1st

  • CBT
  • Exposure & response prevention

2nd
- SSRI (Sertraline)

3rd
Tricyclic antidepressant

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17
Q

Body dysmorphic disorder

A

Fluoxetine

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18
Q

SAD

A

SSRIs

Vit D

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19
Q

Depression

A

1st
CBT (cognitive behavioural therapy)

2nd
SSRI

3rd
SSRI + CBT

4th
ECT

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20
Q

Mania in BPAD

A
  • Stop antidepressant

- Olanzapine / Haloperidol

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21
Q

Depression in BPAD

A

CBT + Fluoxetine

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22
Q

GAD

A
  1. Self-help + mindfulness
  2. CBT
  3. Drugs: - SSRI (Sertraline)
    - Alternative SSRI / SNRI
    - Pregabalin
  4. Specialist care
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23
Q

Psychosis

A

Acute: Lorazepam (Benzodiazepines)

Long term: Antipsychotics

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24
Q

PTSD

A 
Watchful waiting
CBT 
Eye-movement desensitisation + reprocessing (EMDR) 
Drugs: - Venlafaxine (SNRI) 
- Sertraline (SSRI) 
- Risperidone (Atypical antipsychotic)
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25
Q

Anorexia

A

Family behavioural therapy
CBT
Maudsley Anorexia Nervosa Treatment for Adults (MANTRA)

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26
Q

Bulimia

A

Family behavioural therapy
CBT
Monitor electrolytes

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27
Q

ADHD

A
  1. Methylphenidate
  2. Lisdexamfetamine
  3. Dexamphetamine
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28
Q

Alcohol withdrawal

A
  1. Long acting benzodiazepines
    - Chlordiazepoxide
    - Diazepam
    - Lorazepam (if hepatic failure)
  2. Carbamazepine
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29
Q

Alcohol abstinence

A

Disulfiram (Antabuse)
- flushing and sick
Acamprostate (Campral)
- reduced cravings

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30
Q

Opioid abstinence

A

Methadone (opioid mu receptor agonist)

Buprenorphine (mixed opioid agonist/antagonist)

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31
Q

Paracetamol OD

A

N Acetylcysteine

Activated charcoal if < 1hr since ingestion

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32
Q

Lead poisoning

A

Dimercaptosucinic acid (DMSA)
Dimercaprol
Calcium edetate

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33
Q

Tricyclic AD OD

A

IV Sodium bicarbonate

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34
Q

Magnesium sulphate OD

A

Calcium gluconate

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35
Q

Benzo OD

A

Flumenazil

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36
Q

Opioid OD

A

Naloxone

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37
Q

Cocaine OD

A

Diazepam

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38
Q

Heparin OD

A

Protamine sulphate

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39
Q

Beta-blocker OD

A

Atropine + glucagon

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40
Q

Aspirin (salicylate) OD

A

Alkalisation (IV bicarbonate) = 7.5-8 pH

Haemodialysis

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41
Q

Lithium toxicity

A

Haemodialysis

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42
Q

Methanol toxicity

A

Ethanol

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43
Q

Warfarin toxicity

A

Vit K

Prothrombin complex concentrate

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44
Q

Cyanide OD

A

Hydroxycoalbumin

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45
Q

Organophosphates (insecticide)

A

Atropine

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46
Q

Iron OD

A

Desferrioxamine

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47
Q

Ethylene glycol (anti-freeze) OD

A

Fomepizole
Ethanol
Haemodialysis

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48
Q

Carbon monoxide poisoning

A

02 100%

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49
Q

Digoxin toxicity

A

Digibind

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50
Q

LSD OD

A

Lorazepam

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51
Q

Local anaesthetic toxicity

A

IV 20% lipid emulsion

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52
Q

Sleep paralysis

A

Clonazepam

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53
Q

Narcolepsy

A

day: modafinil
night: sodium oxybute

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54
Q

Insomnia

A 
Sleep hygiene education + identify causes
Short acting benzodiazepines 
- zopiclone 
- zolpidem 
- zaleplon
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55
Q

Fistula in ano

A

Simple: Keep open (fistulotomy)
Complex: Seton band insertion
Ligation of intersphinteric tract (LIFT)

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56
Q

Fistulas

A

Self resolving

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57
Q

Varicose veins

A

Compression stockings
Weight loss
Leg elevation

Severe:
Endothelial ablation
Foam sclerotherapy

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58
Q

Anterior aortic dissection

A

Surgery + BP control

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59
Q

Posterior aortic dissection

A

IV Labetalol

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60
Q

AAA

A

Elective endovascular repair (EVAR)

- via femoral artery

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61
Q

Peripheral arterial disease

A

Exercise
Statins
Clopidogrel

Surgery

  • angioplasty
  • stenting
  • bypass
  • amputation
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62
Q

Neuropathic ulcers

A

Cushioned shoes

Amputation

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63
Q

Influenza

A

Vaccine prophylaxis (Autumn)
Oseltamivir
Zanamivir

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64
Q

Constipation

A

Laxatives

  • Bulk forming
  • Stimulant (Senna, bisocodyl)
  • Osmotic (Lactulose, laid)
  • Stool Softeners (sodium docusate)
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65
Q

Alzheimer’s

A
  1. Acetylcholinesterase inhibitors
    - Donepezil
    - Galantamine
    - Rivastigmine
  2. NMDA receptor antagonist
    - Memantine
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66
Q

Vascular Dementia

A
  • Reduce CVD risk factors

- If mixed with alzheimer’s then treat as such: Acetylcholinesterase inhibitors + NMDA antagonists

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67
Q

Lewy Body Dementia

A
  1. Acetylcholinesterase inhibitors
    - Donepezil
    - Galantamine
    - Rivastigmine
  2. NMDA receptor antagonist
    - Memantine

NOT HALOPERIDOL

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68
Q

Gardener’s syndrome

A

Prophylactic colectomy to reduce risk

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69
Q

Neutropenic Sepsis

A
  1. Tazocin
    - Teicoplanin/ Aztreonam (if Penicillin allergic)
  2. Vancomycin
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70
Q

Tumour lysis syndrome

A 
Calcium gluconate (cardio protection from potassium)
Fluids
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71
Q

Bone mets

A
  1. Analgesia
  2. Biphosphonates
  3. Radiotherapy
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72
Q

Neoplastic spinal cord compression

A

Oral dexamethasone (high dose)
- reduce oedema
Consider radiotherapy/surgery

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73
Q

Kaposi’s sarcoma

A

Radiotherapy

Surgical resection

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74
Q

Bladder cancer

A

CMV

Cisplatin
Methotrexate
Vinblastine

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75
Q

High-grade non-hodgkins lymphoma

A

R-CHOP

Cyclophosphamide
Hydroxydaunorubicin (doxorubicin)
Vincristine (Oncovin)
Prednisolone

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76
Q

Colorectal cancer

A

FOLFOX

5-FU
Leucovorin (colonic acid)
Oxaliplatin

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77
Q

Breast cancer

A

FEC

5-FU
Epirubicin
Cyclophosphamide

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78
Q

Hodgkin’s lymphoma

A

ABVD

Adriamycin (doxorubicin)
Bleomycin
Vinblastine
Dacarbazine

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79
Q

Retinoblastoma

A

External beam radiation
Chemo
Photocoagulation
Enucleation

90% survive

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80
Q

Hypokalaemia

A

IV saline + Potassium (over 4 hours)

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81
Q

Hyperkalaemia

A

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

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82
Q

Hypocalcaemia

A

Calcium gluconate

- 10ml of 10% solution over 10mins

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83
Q

Hypercalaemia

A
  1. Rehydration (3L per day)
    IV 0.9% saline
  2. Biphosphonates
    • IV Pamidronate
    • Calcitonin salmon
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84
Q

Hypomagnesaemia

A

IV Magnesium over 24 hours

- can cause diarrhoea

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85
Q

Hypophosphataemia

A

Phosphate sandoz

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86
Q

Hyperphosphataemia

A 
Bi-phosphonates 
Calcium acetate (calcium-phosphate binder)
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87
Q

Hyponatraemia

A

Mild:
Fluid restriction <800ml/day + loop diuretics

Moderate:
Hypertonic saline (2.7%) slow infusion

Severe: Bolus hypertonic saline + Vasopressin (ADH receptor agonist)

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88
Q

Hypernatraemia

A

IV Fluids

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89
Q

SIADH

A

Fluid restriction
Demeclocycline
ADH Receptor blockers (Tolvaptan)

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90
Q

Malignant hyperthermia (from suxamethonium)

A

Dantrolene

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91
Q

Motion sickness

A

Hyoscine
Cyclizine
Promethazine

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92
Q

Neuropathic pain

A

Acute “rescue”: Tramadol

Chronic: 
Amitriptyline 
Duloxetine 
Gabapentin 
Pregabalin
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93
Q

Trigeminal neuralgia

A

Carbamazepine

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94
Q

Post-herpetic neuralgia

A

Topical capsaicin cream

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95
Q

Analgesia (renal impairment)

A
  1. Fentanyl
  2. Buprenorphine
  3. Alfentanil
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96
Q

Acute agitation

A
  1. Haloperidol
  2. Chlorpromazine
  3. Levomepromazine
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97
Q

End of life agitation

A

Midazolam

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98
Q

End of life hiccups

A
  1. Chlorpromazine

2. Haloperidol

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99
Q

End of life secretions

A

Hyoscine hydrobromide

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100
Q

End of life bowel colic

A

Hyoscine butylbromide (buscopan)

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101
Q

End of life oral/throat pain

A

Benzydamine hydrochloride

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102
Q

End of life nausea + vomiting

A

Levomepromazine

- long acting (8 - 12 hours)

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103
Q

Gastric nausea

A

Metoclopramide

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104
Q

Extra-pyramidal side effects

A

Domperidone

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105
Q

Chemotherapy related nausea

A

Ondansetron

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106
Q

Intra-cranial caused nausea

A
  1. Dexamethasone
    - reduces oedema around tumours
  2. Cyclizine (for vomiting)
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107
Q

Paroxysmal hemicrania headache

A

Idomethacin

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108
Q

Cluster headache

A

Acute:
Triptans
- Sumatriptan
High flow O2

Prophylaxis:
Verapamil
Lithium
Prednisolone

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109
Q

Migraine

A

Acute:
Triptans (Sumatriptan) + NSAIDs
Metoclopramide
Prochlorperazine

Prophylaxis:

  1. Topiramate
  2. Propranolol
  3. Riboflavin
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110
Q

Menstrual migraine

A

Fovatriptan

Zolmitriptan

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111
Q

Hydrocephalus

A

Acute:
External ventricular drain (EVD)
- drains to external bag

Long-term:
Ventriculoperitoneal shunt
- drains to peritoneum

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112
Q

Idiopathic intracranial HTN

A 
Weight loss
Acetazolamide 
Topiramate 
Repeat LP 
Surgery 
- optic nerve sheath decompression 
- lumboperitoneal shunt 
- ventriculoperitoneal shunt
113
Q

Low pressure headache

  • post LP
A

Caffeine + hydration

114
Q

Increased ICP

A

Controlled hyperventilation
Raise head to 30 degrees

Severe:
Prior to surgery
- IV Mannitol / furosemide
Surgery

115
Q

Tentorial herniation

A

Parietotemporal Craniotomy

116
Q

SAH

A
  1. Coiling of intracranial aneurysms
  2. Nimodipine (21 days)
    - CCB
    - Prophylaxis for vasospasm

Watch for - re-bleeding (10% first 12 hours)

  • hydrocephalus
  • hyponatraemia
117
Q

Vestibular schwannomas

A

Surgery
Radiotherapy
Observation

118
Q

Craniopharyngioma

A

Surgery

119
Q

Meningioma

A

Observe
Radiotherapy
Surgical resection

120
Q

Glioblastoma multiforme

A

Dexamamethasone

Post op chemo and radiotherapy

121
Q

Normal pressure hydrocephalus

A

ventriculoperitoneal shunting

122
Q

Wernicke’s encephalopathy

A 
Vitamin B1 (Thiamine)
IV Pabrinex (Vit B/C)
123
Q

Depressed skull fractures

A

Surgical reduction and debridement

124
Q

Progressive supranuclear palsy (PSP)

A

Levodopa

125
Q

Benign essential tremor

A

Propranolol

Primidone

126
Q

Infantile spasms (West syndrome)

A

Poor prognosis
Vigabatrin
ACTH

127
Q

Juvenile myoclonic epilepsy (Janz syndrome)

A

Juvenile myoclonic epilepsy (Janz syndrome)

128
Q

Lennox-Gastaut Syndrome

A

Ketogenic diet may help

129
Q

Febrile convulsions

A

> 5 mins or first seizure = call 999

If recurrent: Rectal diazepam
Buccal midazolam

130
Q

Status epilepticus

A 
Community: 
Buccal midazolam (mouth)
Rectal diazepam (derrière)
Hospital:
IV Lorazepam 
- repeat every 10 mins 
IV Phenytoin 
- start cardiac monitoring
131
Q

Absence seizures

A
  1. Sodium valproate
  2. Ethosuximide
    Self resolve in adulthood
132
Q

Myoclonic seizures

A
  1. Sodium valproate
  2. Clonazepam
    Lamotrigine
133
Q

Tonic-clonic seizures

A
  1. Sodium valproate
  2. Lamotrigine
    Carbamazepine
134
Q

Primary generalised seizures

A
  1. Sodium valproate

2. Lamotrigine

135
Q

Focal seizures

A
  1. Carbamazepine
    Lamotrigine
  2. Levetiracetam
    Oxcarbazepine
    Sodium valproate
136
Q

Bell’s Palsy

A
  1. Prednisolone
    Eye-lubricants, artificial tears
    Tape eye shut

Severe: Anti-virals

137
Q

Degenerative cervical myelopathy

A

Decompressive surgery

138
Q

Restless leg syndrome

A

Stretching
Dopamine agonists (Pramipexole, Ropinirole)
Benzodiazepines
Gabapentin

139
Q

Subacute degeneration of the cord

A

Vitamin B12 + then maybe folate

  • if you give folate first it may precipitate SADC
140
Q

Guillian-Barre syndrome

Paraesthesia + loss of sensation spreading up from feet

A

IV Immunoglobins

141
Q

Lambert-eaton myasthenia syndrome

Muscle weakness (improves on exercise)
- legs > arms
A

Amifampridine

142
Q

Cerebral Palsy

A

Diazepam
Baclofen
Botulin toxin type A (Botox)
Surgical dorsal rhizotomy

143
Q

Myasthenia gravis

Proximal muscle weakness (worse from exercise + at night)
- arms > legs
Extra-ocular muscle weakness (diplopia)

A
  1. Reversible acetylcholinesterase inhibitors (long-acting):
    - Pyridostigmine
    - Neostigmine

Immunosuppression:

  • Prednisolone
  • Azathioprine, cyclosporin, mycophenolate

Surgery (thymectomy)

Monoclonal antibody tx: Rituximab

144
Q

Myasthenia crisis

A

Plasmapheresis

IV immunoglobins

145
Q

MND

Gradual onset muscle weakness (hands + shoulders)
Eye muscles spared

A

Riluzole
- prevents stimulation of glutamate receptors (slows progression)

Non-invasive breathing support at night

146
Q

MS to reduce relapse rate

A

Beta-interferon therapy
Glaticamer acetate (immuno-modulating drug)
Natalizumab (monoclonal antibody)
Fingolimod (sphingosine 1-phosphate receptor modulator)

147
Q

MS Acute relapses

A

Methylprednisolone (5 days)

Monoclonal antibodies

148
Q

Spasticity in MS

A
  1. Baclofen + gabapentin
  2. Diazepam
    Dantrolene
    Tizanidine
149
Q

Oscillopsia in MS

A

Gabapentin

150
Q

Fatigue in MS

A

Amantadine

151
Q

Sleepiness in Parkinson’s

A

Modafinil

152
Q

Postural hypotension in Parkinson’s

A

Midodrine

153
Q

Drooling in Parkinson’s

A

Glycopyrronium Bromide

154
Q

Motor symptoms in parkinsons

A

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
Q

Tremor in Parkinson’s

A

Procyclidine

156
Q

Drug-induced Parkinsonism

A

Anti-muscarinics (block cholinergic receptors)
Procyclidine
Benzotropine
Trihexyphenidyl

157
Q

Carotid artery stenosis

A

if blockage > 50% = Carotid endarectomy

158
Q

TIA

A

Acute:
Aspirin 300mg + urgent specialist review

Secondary:
Clopidogrel
or
Aspirin + Dipyridamole

159
Q

Acute Ischaemic stroke

A
  1. Aspirin 300mg (haemorrhage excluded)

< 4.5 hours after onset: Thrombolysis (Alteplase)

< 6 hours after onset: Thrombectomy

160
Q

Long term Ischaemic stroke

A
  1. Aspirin (300mg) for 2 weeks
    Clopidogrel (75mg)
    Statin if cholesterol >3.5mmol/L
  2. Aspiring + dipyridamole
    (instead of clopidogrel)
161
Q

Otosclerosis

A

Hearing aid

Stapedectomy

162
Q

Sudden onset sensorineural hearing loss (SSNHL)

A

Urgent referral

Prednisolone

163
Q

Perforated tympanic membrane

A

Self resolves in 6-8 weeks
Keep dry + review in 4 weeks
Myringoplasty

164
Q

Meniere’s disease

A

Acute: Buccal/IM Prochlorperazine

Prophylactic:
Betahistamine
Vestibula rehab

165
Q

BPPV

A

Epley manœuvre
Brandt-Daroff exercises (vestibular rehab)

Recurrence is common 3-5 years later

Prevention: Betahistamine

166
Q

Vestibular neuronitis

A

Acute: Buccal/IM Prochlorperazine

Vestibular rehab exercises 
Antihistamines: 
- cinnarizine 
- cyclizine 
- promethazine
167
Q

Labyrinthitis

A

Self limiting
Prochlorperazine
Antihistamines

168
Q

Auricular haematoma

A

Same day assessment

Incision + drainage

169
Q

Mastoiditis

A

Admit

Amoxicillin

170
Q

Otitis media with effusion (glue ear)

A

Grommets

171
Q

Acute otitis media

A

Self-limiting
Analgesia

Severe: Amoxicillin (Erythromycin in PA)

Recurrent: Grommets

172
Q

Cholesteatoma

A

Surgical removal

173
Q

Otitis externa

A
  1. Topical Gentamicin + hydrocortisone (drops)
  2. Flucloxacillin (Erythromycin if PA)

Fungal: Cotrimazole drops
Diabetes: Ciprofloxacin (to cover pseudomonas)

174
Q

Malignant otitis externa

A

Ciprofloxacin

175
Q

“Sore throat”
Pharyngitis
Tonsillitis
Laryngitis

A

Phenoxymethylpenicillin (Penicillin V) 7-10 days

Erythromycin if PA

176
Q

Dental abscess

A

Amoxicillin

177
Q

Gingivitis

A

Metronidazole

Chlorhexidine mouth wash

178
Q

Quinsy (peritonsillar abscess)

A

IV ABx + needle drainage

179
Q

Laryngopharyngeal reflux

A

Lifestyle
PPI
Gaviscon

180
Q

Sialolithiasis

Salivary gland stones

A

Removed orally

Gland excision

181
Q

Pleomorphic adenoma

A

Parotidectomy

182
Q

Idiopathic rhinitis

A

Ipatropium

183
Q

Sinusitis

A

Analgesia
>10 days: Intranasal corticosteroids
Severe: Penicillin V

184
Q

Nasal haematoma

A

Drainage

185
Q

Allergic rhinitis

A

Mild: Antihistamines
Severe: Corticosteroids

Oxymetazoline (decongestant)
- can cause rebound congestion if chronic use

Montelukast

186
Q

Unilateral nasal symptoms

A

ENT Referral

187
Q

Nasopharyngeal carcinoma

A

Radiotherapy

188
Q

Nasal polyps

A

ENT referral

Topical corticosteroids

189
Q

Epistaxis

A
  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
Q

Cataracts

A

Decrease bright lights
Glasses
Surgical replacement with artificial lens
- risk of endophthalmitis

191
Q

Herpes zoster opthalmicus

A

Refer

Oral antiviral 7-10days

192
Q

Nasolacrimal duct obstruction

A

Massage lacrimal duct

self resolves by 1 year

193
Q

Wet ARMD

A

Intravitreal Anti-VEGF (monthly) = stops neovascularisation

  • Ranibizumab
  • Bevacizumab
  • Pegaptanib
194
Q

Dry ARMD

A

Anti oxidants + vitamin supplements

Not much else can be done

195
Q

Diabetic retinopathy

A

Laser photocoagulation
Intravitreal Anti-VEGF
Severe: Vitreoretinal surgery

196
Q

Stye

A

Hot compress
Analgesia
Abx if ?conjunctivitis

197
Q

Chalazion

meibomian cyst

A

Self resolves

Abx if severe

198
Q

Entropium

In-turning of the eyelid

A

Eye lubricants
Tape eyelid
Surgery

199
Q

Blepharitis

A

Hot compression (twice daily)
Lid hygiene
Artificial tears

200
Q

Retinal tear

A

Laster therapy

Cryotherapy

201
Q

Amaurosis fugax

A

Aspirin 300mg

202
Q

Retinal detachment

A

Virectomy + replacement
Scleral buckling
Pneumatic retinopexy

203
Q

Amblyopia “Lazy eye” prevention

A

Eye-patch on good eye

204
Q

Episcleritis

A

Lubricating eye drops

205
Q

Infective conjunctivitis

A

Self limiting (2 weeks)
Avoid sharing towels, don’t wear eye contacts
Chloramphenicol drops 2-3 hours
Pregnant: Fuscidic acid (BD)

206
Q

Primary open angle glaucoma

A
  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
Q

Acute angle glaucoma

A

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
Q

Anterior uveitis

A

Cycloplegics:

  • atropine
  • cyclopentolate
  • steroids
209
Q

Keratitis

A

Viral: Topical aciclovir
Bacterial: Quionolones (ciprofloxacin)

Analgesia: cyclopentolate

210
Q

Congenital syphilis

A

Penicillin

211
Q

Congenital HSV

A

Aciclovir

212
Q

Congenital VZV

A

Aciclovir

Immunoglobin

213
Q

Transient synovitis

A

Self limiting

214
Q

Ples Planus

A

Self resolving

215
Q

Genu varum

A

Self resolving

216
Q

Genu algum “knock knees”

A

Self resolves

217
Q

Talipes equinovarus “Club foot”

A

Ponseti methods

- progressive braces

218
Q

DDH

A

Spontaneously stabilise by 3-6 weeks

Palik harness (dynamic flexion-abduction orthosis) 
- used <4-5 months

Surgery

219
Q

Perthes

A

< 6 years: observe
> 6 years: surgery

Keep femoral head in acetabulum (cast + braces)

220
Q

SUFE

A

Bed rest + non-weight bearing

Severe: Percutaneous pinning of the hip (internal fixation)

221
Q

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
A

Aspirin (high-dose)
IV Ig

Do Echo for Coronary artery aneurysm

222
Q

Measles

  • White grains of salt on buccal mucuosa (koplik spots)
  • Proximal period (irritable, fever, conjunctivitis)
  • Maculopapular rash behind ears > then whole body
A

Supportive

Notify public health

223
Q

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)
A

Penicillin V (oral, 10 days)
- Azithromycin (if PA)
Notify public health
Can return to school 24h after starting ABx

224
Q

Pertussis

Whooping cough

A

< 6 months old: Admit

Azithromycin/ Clarithromycin/ erythromycin
- if cough onset in 21 days

Can return to school 48hr from starting ABx

225
Q

Respiratory distress syndrome (RDS)
“Hyaline membrane disease”

  • premature babies
A
  • Give mother dexamethasone to induce foetal lung maturation
  • Surfactant (Curosurf) via ETT, given in first 6 hours since birth (pig lung extract)
  • CPAP
226
Q

Transient tachypnoea of the newborn (TTN)

  • C section babies
A

O2

Self resolves in a few days

227
Q

Croup

Age: 6 months - 3 years
Barking cough
Stridor
Common in Autumn

A

Dexamethasone (oral) + O2
- 0.15mg/kg

Severe: Nebulised adrenaline + O2

228
Q

Epiglottis

A

Senior help
O2
IV ABx

229
Q

Paediatric pneumonia

A
  1. Amoxicillin
  2. Macrolides (Erythromycin)

If associated with flu: Co-amoxiclav
If mycoplasma pneumoniae/ chlamydia: Macrolides

230
Q

Bronchiolitis

  • from RSV
A

Humidified O2
NG feeds
Suction for airway secretions

Reduce future episodes:
RSV Immunoglobin
Palivizumab

231
Q

Choanal atresia

Cyanosis when feeding
Posterior airway is occluded by soft tissue or bone

A

Fenestration procedure

232
Q

Constipation in kids

A
  1. Osmotic laxative
    - Movicol (polyethelyne glycol 3350 + electrolytes)
  2. Stimulant laxative
233
Q

Necrotising enterocolitis

A

Stop oral feeds (rest gut)
Vancomycin + cefotaxime
Laparotomy

234
Q

Intestinal malrotation

A

Laparotomy

Ladd’s procedure if with volvulus

235
Q

Pyloric stenosis

A

Ramstedt pyloromyotomy

236
Q

Congenital diphragmatic hernia

A

Intubate

237
Q

Umbilical hernia

A

Self resolves in 12 months

238
Q

Inguinal hernia

A

Urgent surgery

239
Q

Umbilical granuloma

A

Salt on wound

Silver nitrate

240
Q

Gastroschsis

A

Vaginal delivery + immediate repair

241
Q

Exomphalos

A

C-section at 37 weeks

Staged surgical repair 6-1 months

242
Q

Toddler’s diarrhoea

A

Introduce more fat

243
Q

GORD in kids

A
  1. Alginates/ thickened feeds

2. PPI

244
Q

Biliary atresia

A 
Kasai procedure (hepatoportoenterostomy)
Ursodeoxycholic acid (post-op)
245
Q

Intussuseption

A

Reduction by air insufflation

Surgical management

246
Q

Meckel’s Diverticulum

A

Blood transfusion

247
Q

Meconium ileus

A

PR contrast my dislodge stool
N-acetyl cystein
Surgery

248
Q

Hirschsprung disease

A

PR exam
Rectal washout
Anorectal pull through procedure

249
Q

Newborn jaundice

A

Blue light phototherapy

Exchange transfusion

250
Q

Caput succedaneum

A

resolves in days

251
Q

Cephalohaematoma

A

resolves in weeks

252
Q

Unilateral undescended testicle

A

Refer at 3 months
Review at 6 months
Orchidoplexy at 12 months

253
Q

Scabies

A
  1. Permethrin
  2. Malathion

Immunosuppressed: Irvermectin

254
Q

Head lice

A

Malathion
Dimethicone
Isopropyl myristate
Cyclomethicone

255
Q

Alopecia

A

Topical steroids

256
Q

Seborrheic keratosis

A

Small: cryotherapy
Large: shave off

257
Q

Basal cell carcinoma

A

Superficial:

  • cryotherapy
  • imiquimod (Aldara cream)
  • Photodynamic therapy
  • 5 Fluorouracil (Efudix cream)

Nose: Mohs surgery

Radiotherapy

258
Q

Squamous cell carcinoma

A

Singular: Cryotherapy

Multiple:

  • Imiquimod (Aldara cream)
  • 5 Fluorouracil (Efudix cream)
259
Q

Psoriasis

A 
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
Q

Acne

A
  1. Topical benzoyl peroxide + topical retinoid
    • topical clindamycin
  3. Topical benzoyl perioxide + topical retinoid + oral tetracycline (lymecycline, oxytetracycline, doxycycline) or COCP
    - Erythromycin if pregnant
  4. Isotretinoin
261
Q

Candidiasis

A

Fluconazole (oral)

262
Q

Folliculitis

A

Trimethoprim

263
Q

Impetigo

A

Topical hydrogen peroxide + flucloxacillin/ erythromycin

264
Q

Erysipelas

A

Flucloxacillin

- clarithromycin/ erythromycin/ doxycycline if PA

265
Q

Eczema

A

emollients
topical steroids (Hydrocortisone, Betamethasone)
UV radiation
immunosuppressants: e.g. ciclosporin, antihistamines and azathioprine

266
Q

Anaphylaxis

A

<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
Q

Lichen planus

A

Oral: Benzydamine mouthwash
Severe: Steroids/immunosuppression

268
Q

Lichen sclerosis

A

Topical clobetasol propionate (steroid cream)

269
Q

Pityriasis Rosea

A

Supportive

270
Q

Acne rosacea

A

Mild: Topical metronidazole
Severe: Oral tetracycline

Flushing: topical brimonidine

271
Q

Toxic Epidemal necrolysis

A

IV immunoglobulins
Immunosuppression:
- ciclosporin
- cyclophosphamide

272
Q

Erythasma

- rash in axillae + groin

A

Erythromycin

273
Q

Lipoma

A

surgical excision

274
Q

Tinea pedis

A

Topical miconazole

275
Q

Necrobiosis lipoidica diabeticorum

- yellow diabetic leg ulcer

A

Tacrolimus

Topical steroids

276
Q

Plantar wart

A

Topical salicylic acid

277
Q

Pyoderma gangrenosum

A

Oral prednisolone

278
Q

Eczema Herpeticum

A

Admit

IV Antivirals

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