1 Clinical Screening

Question 1

Mesalazine 2g indication?

Answer 1

mild to moderate ulcerative colitis

Question 2

What is pre-eclampsia? main symptoms

Answer 2

condition that affects some pregnant women, usually during second half of pregnancy (from 20 weeks) or soon after baby is delivered.

Early signs: HTN and proteinuria

Question 3

Metformin 500mg TDS indication in pregnant women?

Answer 3

Gestational diabetes
Check Blood glucose and monitor but would expect to settle after delivery

Question 4

how to do identify discrepancy OSCE?

Answer 4

STATE ACTION – PRECISE
A. Identify error/ discrepancy
B. Details of error/ discrepancy
C. Recommended action to resolve

Question 5

what is mastitis?

Answer 5

Mastitis is when your breast becomes swollen, hot and painful.

It is most common in breastfeeding women and does not usually need medical treatment.

Question 6

general flucloxacillin counselling in mastitis?
- what to check?
- how often to take?
- how long course?

Answer 6

• Check no penicllin allergy
• Take on empty stomach x4 daily
• 2 week course of antibiotics

Question 7

flucloxacillin good/ bad choice in mastitis and safe/not in breastfeeding?

Answer 7

• Good choice in mastitis
• Safe in breastfeeding

Continue to breastfeed. Else Sore and painful breast will keep getting bigger.
Due to infection, makes milk salty and baby doesn’t like that. px think Flucloxacillin is doing that and putting baby off so stop taking med.

Question 8

OTC purchase of analgesia - which 2 are safe in mastitis

Answer 8

Paracetamol/ ibuprofen

Question 9

why no codeine in mastitis?

Answer 9

No co-codamol, excreted in breast milk. Not predictable as morphine so worse. Not wanted in children
Don’t know if will be lots in breast milk or bit. Can’t quantify amount of codeine excreted.

Question 10

Furosemide and perindopril newly started likely indication? SOB symptoms

Answer 10

HF likely based on drug combo and SOB. Would confirm this in notes

Good combo to improve long term outcomes (perindopril) and fluid overload symptoms (furosemide)

Question 11

what 3 to monitor with new furosemide and perindopril (and alr on amlodipine)

Answer 11

BP. Already on amlodipine, 2 drugs added that will further lower BP. Check Obs for BP currently, may need to stop amlodipine to allow ACE.

K+. should balance as ACE cause hyperkalaemia but loop diuretics cause hypokalaemia. Check baseline and following initiation

Renal function. SEs more common in impairment. Check baseline and following initiation