Treatments

Question 1

Treatment of parasitic infection Strongyloides stercoralis

Answer 1

Ivermecin (or albendazole)

Question 2

Treatment of schistomiasis

Answer 2

Praziquantel

Question 3

Prophylaxis of malaria

Answer 3

Doxycycline

Question 4

Management of thrombolysis patients post-STEMI

Answer 4

ECG at 90 min
If <50% reduction in ST elevation –> rescue PCI

Question 5

Acute management of SVT

Answer 5

Vagal manoeuvres
IV adenosine (CI in asthmatics) - 6mg –> 12mg –> 18mg
Electrical cardioversion

Question 6

Treatment of autosomal dominant polycystic kidney disease

Answer 6

Tolvaptan
Vasopressin receptor 2 antagonist

Question 7

Treatment of organophosphate poisoning

Answer 7

IV atropine (anti-muscarinic) - successfully mitigates the excess cholinergic transmission AChE inhibition.

Question 8

Treatment of alcohol hepatitis

Answer 8

Prednisolone

Question 9

Prevention of alcoholic encephalopathy

Answer 9

Lactulose and Rifaxamin

Question 10

main indications for placing a chest tube in pleural infection

Answer 10

• frankly purulent or turbid/cloudy pleural fluid
• presence of organisms identified by Gram stain and/or culture
• pleural fluid pH < 7.2

Question 11

How does NAC work in paracetamol overdose

Answer 11

1. liver conjugates paracetamol with glucuronic acid/sulphate.
2. During an overdose the conjugation system becomes saturated
3. Results in the production of a toxic metabolite (N-acetyl-B-benzoquinone imine)
4. glutathione acts as a defence mechanism by conjugating with the toxin forming the non-toxic mercapturic acid.
5. If glutathione stores run-out, the toxin forms covalent bonds with cell proteins, denaturing them –> cell death
6. N-acetyl cysteine is a precursor of glutathione and hence can increase hepatic glutathione production.

Question 12

Tx of thyrotoxic storm

Answer 12

Beta-blockers
Propylthiouracil
Hydrocortisone